HomeMy WebLinkAboutSeptic New 54 Dower Road TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to hex Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Dateec / , 19
A permit is requested for repair or construction of an individual sewage disposal system concerning whiZ the
following information is submitted: J
1. Owner of Property a C ! _ Address of Owner_ e
2. Location of Property s w C r Lot. No.
3. Type of Structure C. z k g> No. of Bedrooms—:3—
(pWeuing,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ Ae
5. Plumbing Fixtures: Water Closets I. Urinals_ ) avatories 3— Bathtubs
Showers Kitchen Sinks_ Laundry Tubs_ Garbage Grinder_ Other G
6. Liquid Capacity of Septic Tank. 7 S D f Material of Septic
7. Soil Conditions: Type of Soil_S','V iY /t Maximum ground water table
(Sand,-Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well.P Ile adjacent wells jQv C
9. Distance to nearest water course, drainage ditch, storm drain or embankment
10. Percolation Tests: Time for 1" drop in soil test 0 41/ Ak�Y Classification of soil
11. Minimum square feet of effective seepage area required � 7-S r _4 /-
12. Leaching System: Number of trenches Length `S` y Width .Z?d Total 1S6 .1 34
C
Other
Signature
(Licen a nstaller)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved / E�F M/s FQ 19_2 By
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