HomeMy WebLinkAboutSeptic New 309 Ellington Road j- TOWN OF SOUTH WI N DSOR
`s✓ BUILDING DEPARTMENT
South Windsor, Connecticut
`/ Application for Permit to Install or Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date_ ��_?19
A permit is requested for re air or construction of an individual sewage disposal system concerning which the
following information is su itted:
1. Owner of Property Address of Owner �•`'�-
2. Location of Prop r Lot. No.
3. Type of Structure No. of Bedrooms
/ (Dwelling,Commercial Wiling,Store etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets l Urinals Lavatories Bathtubs
Showers_ Kitchen Sinks_,_ Laundry Tubs Garbage Grinder Other _!
6. Liquid Capacity of Septic Tank Material of Septic Tank
7. Soil Conditions: Type of Soil �!/� Maximum ground water table /!mod
(Sand,Gravel,Clay,etc.)
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8. If not served by public water supply: Distance from Owner's well from adjacent wells- C t
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 Z� � Total 3gz a i
Other T e'
Signature
Licensed Installer)
(Sketdh showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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FOR BUILDI c
PURPOSES
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