HomeMy WebLinkAboutSeptic New 100 Diane 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. y�/
TO THE BUILDING DEPARTMENT: Date �. , Z 2,� 19� +'
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted: Q,-u b2
1. Owner of Property "',_,=— r Address of Owner. �? '
2. Location of Property��>.��� 1 v�. Lot. No..
3. Type of Structure CU e &Lgq No. of Bedrooms_
(Dyv lling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ Lr-
5. Plumbing Fixtures: Water Closets zlde, Urinals Lavatories 00e Bathtubs a J
Showers Kitchen Sinksaundry Tubs Garbage Grinder Other_ �� ✓, N�'?�
6. Liquid Capacity of Septic Tank gc�zn Material of Septic Tank C4 �;gC,
7. Soil Conditions: Type of Soil l�P�Maximum ground water table_ /JF' L,
(Sand, ravel,C ay,e'tc.
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 11y Length� _ Width c,;� Total
Other T
Signature ! ,
( censed Installer)
(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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