HomeMy WebLinkAboutSeptic New 43 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.
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 _ /r
2. Location of Propert Lot. No.
3. Type of Structure No. of.Bedrooms
(Dw Bing,Comm vial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets L.T Urinals Lavato 'es --7 Bathtubs
Showers_ Kitchen Sinks_4_ Laundry Tubs Garbage Grinder Other,
6. Liquid Capacity of Septic Tank d z1 Material of Septic Tank
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 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
r 11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches Length Width Total ter°
9 Other
Signature
(Licensed Install
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed,Inspected and Approved 19 By
7�
hl
s
d.:
ftZ' Z lit/f.
W SG�c1� All VlO.50R,
ti
weq
c�, o
ro 3� v.
rry op
u,
O
c
/� ice"s,vnia y T.�.oc�s cGvy
9CP�
�C7'• �; -'�..Q\� Goo uMo v�/.�7jER- NONE
Q A eo
or 0
:QQ t V
� V
- � .C.. �� �� /•O Zor:i/7j �C P9��R�iof�j.Si/.to/R7�'�-
-
t