HomeMy WebLinkAboutSeptic New 19 Fox Meadow Lane 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:
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 O 2�,s,%,,
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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_
a.
5. Plumbing Fixtures: Water Closets , Urinals _ Lavatories�� Bathtubs___
Showers_ Kitchen Sinks Laundry Tubs_ Garbage Grinder Other
6. Liquid Capacity of Septic Tank Material of Septic Tank
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7. Soil Conditions: Type of Soil 14011-t Maximum ground water table--a
(Sand,Gravel,Clay c.)
8. If not served by public water supply: Distance from Owner's well from adjacent wells /jg22 "
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: Numb r of trenches_ ength `Q Width / Total :
Other
Signature C -•.•
(LAcensed 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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