HomeMy WebLinkAboutSeptic New 647 Ellington Road r
TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMEN;T
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date _196. _
A permit is requested for repair or construction of an individual sewage disposa system concerning which the
following information is submitted:
1. Owner of PropertyAddress of Owner
2. Location of Property ot. No.
3. Type of Structure f No. of Bedrooms
welling,Commercial B 'ilding,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets 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 "�ClMaximum ground water table_/
(9A rav ,etc.)
8. If not served by public water supply: Distance from Owner's well �f.1� from adjacent wells /da
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 Total
Other
'����� � s Signature
( tensed Installer)
(Sketch showing all minimum distances and other details required below)
0
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By