HomeMy WebLinkAboutSeptic New 00 Ellington Road (14) TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No. -;e76l
TO THE BUILDING DEPARTMENT: Datee e, it)6
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 ✓►l 2 d Address of Owner.1.1 /.I>-
2. Location of Property Lot. No.
r �
3. Type of Structure No. of Bedrooms_`
(Dw ing,Commercial Building,Store,etc.)
4. Number' of Families or Persons to Occupy Premises_ 4 Z7 -e_
5. Plumbing Fixtures: Water Closets Urinals Lavatories_ Bathtubs_
Showers Kitchen Sinks Laundry Tubs 11 Garbage Grinder Other
�}6. Liquid Capacity of Septic Tank -8 `S�ug'Material of Septic Tank e5� !o e- -
7. Soil Conditions: Type of Soil r A,& !____Maximum ground water table e(�$6i/Z �
(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
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12. Leaching System: Number of trenches � Length ,F P �Width � Total
Other
Signature -
c4
ensed Installer
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By