HomeMy WebLinkAboutSeptic New 36 Cliffwood Drive 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. Z� lf' 19 d7
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted:
1. Owner of Property Address of Owner
2. Location of Property 3 Lot. No.
3. Type of Structure No. of Bedrooms -
(Dwelling,Co mercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets Urinals t, vatories Bathtubs
Showers Kitchen Sinks / Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank % Goo Material of Septic Tank e?0�,e2t
7. Soil Conditions: Type of Soil —Maximum ground water table
(Sand,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well ;2s o from adjacent wells .Z o o
9. Distance to nearest water course, drainage ditch, storm drain or embankment %o'>
10. Percolation Tests: Time for 1" drop in soil test /j. 1:�,,464AcF/Classification of soil
T-
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches Length Width Total
Other
Signature
(Licensed Instaer)
(Sketch showing all minimum distances and er details re ired below) _
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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