HomeMy WebLinkAboutSeptic New 115 Diane Drive TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No. 7�v�
TO THE BUILDING DEPARTMENT: Date 4102.1V 2,3 196
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is supmitteii
1. Owner of Property - Address of Owner �C�/3o JC =31, & t21 ky
2. Location of Proper D / v P Lot. No.
3. Type of Structure No. of Bedrooms_,
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets Urinals Lavatories /LLlt,0-_ Bathtubs z7lr
Showers Kitchen Sinks-2jdP Laundry Tubs Garbage Grinder Other zi�l�c���f�eY
6. Liquid Capacity of Septic Tank Boo G
/ Material of Septic Tank e "c -
7. Soil Conditions: Type of Soil � r'o�t/C / Maximum ground water table Xc-
(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 Z,S^S"JD
12. Leaching System: Number of trenches Length Width Total —',0 o/
Other
Signature r G''��%�
Licensed 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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