HomeMy WebLinkAboutSeptic New 59Cliffwood Drive Cliffwood D TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
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Application No,_
TO THE BUILDING DEPARTMENT: Date_ alp ljlie 19
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 OAddress of Owner 401,
2. Location of Property S 2Q9 /q Lot. No.
3. Type of Structure No. of Bedrooms c..�
(Dwelling, lsw--
mercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premi
5. Plumbing Fixtures: Water Closets 21 Urinals Lavat ies Bathtubs_
Showers_ Kitchen Sinks _ Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank to y y 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
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches Length Width Total
Other
Signature
(Licensed Insta )
(Sketch showing all minimum distances and/ther details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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