HomeMy WebLinkAboutSeptic New 00 Ellington Road (25) TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: 19
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 Address of Owner J
2. Location of Property C ✓ - - Lot. No. .Z -a
3. Type of Structured No. of Bedrooms 2
(Dwelling,Co ercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ �l-s�•-c�ii
5. Plumbing Fixtures: Water Closets y Urinals Lavatories Bathtubs
Showers_ Kitchen Sinks Laundry Tubs Garbage Grinder Other��--
6. Liquid Capacity of Septic Tank /06'a Material of Septic Tankkr,�cA
7. Soil Conditions: Type of Soil Maximum ground water table
(SarK 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 E CE-,Oy z Classification of soil
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches - Length /,2 Width 2 Total d
Other
Signature
(Licensed nstaller)
(Sketch showing all minimum distances and other details required bet w)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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