HomeMy WebLinkAboutSeptic New 144 Edgewood Drive TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut 'q
000,
Application for Permit to Install or Repair Individual Sewage Disposal System 149
Application No.
TO THE BUILDING DEPARTMENT: Date. '*7 191
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 1 7 ( ` Address of Owner-2 �� � 0 44 -Z A,", 4lel-
2. Location of Prop Lot. No. z '7
3. Type of Structure No. of Bedrooms
(Dwelling,connnercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closetsk. Urinals D Lavatoriesk. ZE Bathtubs_
Showers_ Kitchen Sinks_ Laundry Tubs 1_ Garbage Grinder Other _
6. Liquid Capacity of Septic Tan 2- , _d 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 4;'- Width � Z Total
Other
Signature - e
( icensed Installer)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
X,
s 100.96 s�
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