HomeMy WebLinkAboutSeptic New 699 Deming Street TOWN OF SOUTH WI N DSOR , ,V
BUILDING DEPARTMENT
South Windsor, Connecticut ��
Application for Permit to Install or Repair Individual Sewage Disposal ystem
Elk WIA1 Iti, Application No.
TO THE BUILDING DEPARTMENT: Date 2- J 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 Address of Owner G J
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2. Location of Property 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 Lavatories 2— Bathtubs
Showers 1 Kitchen Sinks ! Laundry Tubs Garbage, Grinder Other
6. Liquid Capacity of Septic Tank q4• Material of Septic Tank �� ,
7. Soil Conditions: Type of Soil / Maximum ground water tall
— San ,Gravel,Cray,etc.)
8. If not served by public water supply: Distance from Owners well ,f from adjacent wells Lis l
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 Installer)
(Sketch showing all minimum distances and other details required b w)
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Permit Issued 19 By
Installation Completed, Inspected and Approved a 19 By