HomeMy WebLinkAboutSeptic New 485 Foster 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. � —"? 19.�, L
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted: /J�
1. Owner of Property j, Address of Owner d f. /I At
2. Location of Property Lot. No.
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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 2— Urinals Lavatories Bathtubs_
Showers_ Kitchen Sinks,_ Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tan G� Material of Septic Tank //��_C A2J,,C-!1 C (�
7. Soil Conditions: Type of Soil P • Maximum ground water table
(Sand,Gravel,Clay,etc.)
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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_a-r
10. Percolation Tests: Time for 1" drop in soil test afn=4 Classification of soil
11. Minimum square feet of effective seepage area required Zy o
12. Leaching System: Number of trenches_^ Length Width g,�<l Total C
Other
Signature
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(Sketch showing all minimum distances and other details requir bel /w)
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Permit Issued 19 By
Installation Completed, Inspected and Approved f 19 414 By
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