HomeMy WebLinkAboutSeptic New 00 Foster Road (5) TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date -y` 19
A permit is'requested for repair or construction of an individual sewage disposal syste concerning which the
following information is submitted:
1. Owner of Property c (fAP&Sh • �Zdd of Owner
2. Location of Property ,O !1� S Tom, odrress Lot. No.
3. Type of Structure No, of Bedrooms_
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets Urinals_ Lavatories_ Bathtubs_
Showers Kitchen Sinks,` Laundry Tubs.L#A&4rGarbage Grinder 4N Other
6. Liquid Capacity of Septic Tan / Material of Septic Tank
7. Soil Conditions: Type of Soil 605: 4f L Maximum ground water table
(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
12. Leaching System: Number of trenches Length Width Total
Other
Signature
(Licensed Installer)
(Sketch showing all minimum distances and other details required below)
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Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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