HomeMy WebLinkAboutSeptic New 160 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. (U
TO THE BUILDING DEPARTMENT: Date -— 19
A permit is requested for repair or construction of an individual sewage osa" 1 system concerning which
following information is submitted:
1. Owner of Property_ III Address of Owner
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2. Location of Proper t ty 1� i GYP.e rk \i.e Lot. No.
3. Type of Structure 17
No. of Bedrooms _
(Dw ling,Commercial Building,Store,etc.)
4. Number of Families or 1krLon Occupy Premises_ d %A. P
5. Plumbing Fixtures: Water Closets_ Urinals Lavatories_ Bathtubs_
Showers Kitchen Sinks_ Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank_ 9' JQ , Material of Septic Tank (�1�l AP C_ye_`e
7. Soil Conditions: Type of Soil ' _U ' Maximum ground water table e� fl k�
(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
12. Leaching System: Number of trenches 3 _ 'r '��
Length �� � Width �' Total �3c
Other
Signatur �icensedlnstaller)
Truer
(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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