HomeMy WebLinkAboutSeptic New 20 Fox Meadow Lane TOWN OF SOUTH WINDSOR 01:�rizmv .
,By edEm&A IEov BUILDING DEPARTMENT /ern. ?tl-ys
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No.- 043070-1
TO THE BUILDING DEPARTMENT: Date. 3o TWrdr 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 Property �Address of Owner
2. Location of Property Lot. No. K V
3. Type of Structure k—e_
wel ng,CommercialBuildingptore ,etc.) NO. of Bedrooms
4. Number. of Families or Persons to OccupA rremises_
5. Plumbing Fixtures: Water Closets '� Urinals Lavatories .� Bathtubs—
Showers Kitchen Sinks Laundry Tubs Garbage Grinder /�f Other
6. Liquid Capacity of Septic Tan O �� Material of Septic Tank / _a 42 '� y P �
7. Soil Conditions: Type of Soil Maximum ground water table— ZIjj
d
( d,Gravel,Clay,WE)
8. If not served by public water supply: Distance from Owner's well_lp / from adjacent wells Cl
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 Z•S FT Total
Other
Signature
A-(LWe-rfflffTn'9ta-ne*WT
(Sketch showing all minimum distances and other details required below)
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Permit Issued $D L 197 By Mac EO&OAA DS ZJL,
Installation Completed, Inspected and Approved_ o2 &4X 19 M BY)V40L
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