HomeMy WebLinkAboutSeptic New 661 Foster Street TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
App
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licatio No. 1
TO THE BUILDING DEPARTMENT: Dae 19(aJ
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 7 �(/ V�` - Address of Owner X� I/ -
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2. Location of Property Lot. No.
3. Type of Structure GG' L LC_/ f^ No. of Bedrooms_
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occup Premises (2/V,g- �/�Wt-
5. Plumbing Fixtures: Water Closets Urinals ' Lavatories Bathtubs_
Showers Kitchen Sinks La dry Tubs Garbage Grinder Other_ n
6. Liquid Capacity of Septic Tank Material of Septic TankJL
7. Soil Conditions: Type of Soil CL��/�-E Maximum ground water table y 1
(Band,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well 173 from
/ adjacent wells
!1✓9. Distance to nearest water course, drainage ditch, storm dr in or embankment 0 y g!
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 /G( Width _p'R Total
Other L R
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Signatur G
-(Licensed-(Licens6d Installer
(Sketch showing all minimum distances and other details requi below
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Permit Issued 1 19 By
Installation Completed, Inspected and Approved zPo va.Q 196� By ,'
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