HomeMy WebLinkAboutSeptic Repair 10 Edgewood Drive TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System j
Applic ion No.
TO THE BUILDING DEPARTMENT: Date 4 19
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted:
1. Owner of Property A, Address of Owner
2. Location of Property---- Lot. No. Z 63
3. Type of Structure No. of Bedrooms
(Dw J ,Commercial Building,Store,etc.)
4. Number of Families or Pew to Occupy Premises_ 1L
5. Plumbing Fixtures: Water Closets 1 Urinals Lavatories 1 Bathtubs
Showers_ Kitchen Sinks f Laundry ubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank S7l Material of Septic Tank
7. Soil Conditions: Type of Soil i I Maximum ground water table
and,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 L g4h �Q _ Width Total 3V 1:��/
Other --7
Signature l ,�
Licensed Installer)
(Sketch showing all minimum distances and other details required below) w�
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EXl'8T'UJG ------
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Permit Issued 19 By °
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Installation Completed, Inspected and Approved oft 43P gA,e�/ 1968 By
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