HomeMy WebLinkAboutSeptic New 66 Farnham Road 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: Date. (7—
A permit is requested for repair or construction of an individual sewage disposal system concerning which th
following information is submitted:
1. Owner of Property Address of wner < U�71
2. Location of Property ` Lot. No.
3. Type of Structure No. of Bedrooms 3
(Dwelnng,Commercial Building,Stor�eetc.) ,
4. Number of Families or Persons to Occupy Premises—
5. Plumbing Fixtures: Water Closets 1.:2— Urinals /Lavatories- Bathtubs _
Showers_y Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank Material of Septic Tank
7. Soil Conditions: Type of Soil 14,AV' Maximum ground water table
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(Sand,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well from from adjacent wells
9. Distance to nearest water course, drainage ditch, storm drain or embankment_ z.5
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 J? Total
Other
Signatures'
(Licensed Installer)
(Sketch showing all minimum distances and other details required below)
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Q
7
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Permit Issued 19 By
Installation Completed, Inspected and Approved —19— By