HomeMy WebLinkAboutSeptic New 00 Foster Street (3) TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
17 Application No.
TO THE BUILDING DEPARTMENT: Date — �! 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 Proper ty---1 Address of Owner-Cad �.1� ,p
2. Location of Propertyw Lot. No. �EJ
3. Type of Structure _ No. of Bedrooms_
(Dwelling,C mercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets Urinals Lavato les y Bathtubs /
Showers Kitchen Sinks Laundry Tubs Garbage Grinder_ Other
6. Liquid Capacity of Septic Tank Material of Septic Tank
7. Soil Conditions: Type of Soil Maximum ground water table —�
( and,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 d t.�.�-C���Classii�ficcation of soi#01l
11. Minimum square feet of effective seepage area required 5�no r>`. /Yeede,21--
12. Leaching System: Number of trenches_ Length f Width 2..� Totalol`�
Other
Signature ►`
(Licensb Ins ler)
(Sketch showing all minimum distances and other details r uired below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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