HomeMy WebLinkAboutSeptic New 106 Edgewood Drive (2) a
TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date S— -;?- 3 19 C
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 f Address of Owner_ �is �
c
2. Location of Property Lot. No. 3 7
3. Type of Structure No. of Bedrooms_
(Dwellin ,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets Z Urinals o Lavatories 2— Bathtubs r
Showers_ Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank�f U O Material of Septic Tank
7. Soil Conditions: Type of Soil_ Maximum ground water table
(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_ Length Width '� Totals
Other
Signature
(Licensed Installer)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
'r
ter_'
CIO
W-3-w,
IV.41,
SES
- E
C'E I 1 C; I_O i !.0 . J 7 wi m a: C'.C1 t i t l e d u ll d i v i i o CAI .-)Cc 1 1 C. I I 01
r y l_L'._i L. { ! �_ G'J Ci+ f (?c.fJ01" , 011tl
July 23 , l ••i3 ;,., �'r is;iJs
y,