HomeMy WebLinkAboutSeptic New 87 Clinton Drive r
TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System 9/
Application No.
TO THE BUILDING DEPARTMENT: Date. S ` I/ ,�' 19;
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted: Po r'Au1 J l
1. Owner of Property Addre s of Owner /
2. Location of Property '� / C' C i` C11,I ' Y-'R 7 ! Lot. No. /
3. Type of Structure —No. of Bedrooms_
„k (Dwelling,Comm rcial 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 Other
6. Liquid Capacity of Septic Tank Material of Septic Tank �: r r, j
7. Soil Conditions: Type of Soil� iv ( r I "Maximum ground water table
(Sand,Grave,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
L
10. Percolation Tests: Time for 1" drop in soil tes Classification of soil
11. Minimum square feet of effective seepage area required S §
12. Leaching System: Number of trenches Length �z Width Total
Other
Signature
(Licensed Installs
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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