HomeMy WebLinkAboutSeptic New 361 Clark Street TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No._ ��
TO THE BUILDING DEPARTMENT: Date /0- Z 19 �3
A permit is requested for rep * or construction of an individual sewage disposal system concerning which the
following information is p it ed: ;' Cyr �u.,"e(0 12.
1. Owner of Property - -Address of OwnerYl
2. Location of Property�O� ' ! AL4 rLce-ln Lot. No.
3. Type of Structure � - No. of Bedrooms &
(Dwelling, mmercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs
Showers Kitchen Sinks Laundry
/ Tubs Garbage Grinder A&rz.-_ Other
P�
6. Liquid Capacity of Septic Tank / � 41 Material of Septic Tank
7. Soil Conditions: Type of Soil 45�> - Maximum ground water table ��0
(Band, ravel, ,etc.)
8. If not served by public water supply: Distance from Owner's well rf from adjacent wells �� ¢
9. Distance to nearest water course, drainage ditch, storm drain or embankment
10. Percolation Tests: Time for 1" drop in soil test Classification of soil
11. Minimum square feet of effective seepage area required �g -
12. Leaching System: Number of tr n es Length Width Total
Other '7 `(z
Signature
kLiCerfieffid Tins ler)
(Sketch showing all minimum distances and other details require d''bepw)
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Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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