HomeMy WebLinkAboutSeptic New 80 Edgewood Drive TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System 9�d
Application No.
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TO THE BUILDING DEPARTMENT: Date — 5 — 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 --�,--_ Address of Owner '-7 K � 4,� �
2. Location of Property Lot. No.TT -73
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 21— Urinals O Lavatories — Bathtubs J
Showers_ Kitchen Sinks _ Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank d 0 v Material of Septic Tank �¢-
7. Soil Conditions: Type of Soil Makimum ground water table_ ,J�-1114 /
(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
d
12. Leaching System: Number of trenches **3 Length 6f Widt s & Total %3,7701.
Other
Signature �� J1 a
(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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o FOR BUILDING PURPOSES ON[.T
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Fe i nq Lot No . 3-3 on map ent i t I od " :uhd i v I I cn o f sect i c�n V I I off
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