HomeMy WebLinkAboutSeptic New 618 Deming Street k t 1a
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. 19
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted: AP(er14r
1. Owner of Property Address of Owner �,:�,, 4,_1L`
2. Location of Property�m Lot. No.
3. Type of Structure_ No. of Bedrooms_
(Dwelling,C mercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Prem. es_
5. Plumbing Fixtures: Water Closets Z Urinals vatories Z Bathtubs
Showers_/ Kitchen Sinks_,_ Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank X,2,SU Material of Septic Tank
7. Soil Conditions: Type of Soil O Maximum ground water table =�
J,ffand,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well 7S from adjacent wells �S G
9. Distance to nearest water cogrse, drainage ditch, storm drain or embankment
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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 Installer)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
i Installation Completed, Inspected and Approved 19 By
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