HomeMy WebLinkAboutSeptic New 64 Dower Road TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT i C �
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No. l
TO THE BUILDING DEPARTMENT: Date l 19
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted: ff � / �
1. Owner of Property��C L-L^�'/►fl ws O�ddress of Owner ( Do &J��- ro '
2. Location of Property)tt.�fiC1,46 Lot. No.
3. Type of Structure_ U/1F4-L l A/ No. of Bedrooms_
(Dwelling,Commercial)Building,Store,etc.)
4. Number of Families or Persons to Occu y Premises i7/f'e- E&Aft l L
5. Plumbing Fixtures: Water Closets Urinals Lavatories_ Bathtub/Ls� _
Showers_ Kitchen Sinks ndr, y Tubs Garbage Grinder — -fr Other_ ,3�GT/ Je
6. Liquid Capacity of Septic Tank G�L M •Material of Septic Tank_f
7. Soil Conditions: Type of Soil + CL Maximum ground water table T/
(Band,Gra el,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well �f.��from adjacent wells
9. Distance to nearest water course, drainage ditch, storm drain or embankment 7/ ,
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 enches_ length Width Total '
ther
3 Signature
1,K WcensFed Ins ller)
cI (Sketch showing all minimum distances and other details required below)
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Permit Issued 19 By
Installation Completed, Inspected and Approved 19 6! By