HomeMy WebLinkAboutSeptic New 89 Glendale Road TOWN OF SOUTH WI N DSOR- Pr,9W i 7'
BUILDING DEPARTMENT
South Windsor, Connecticut
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Application for Permit to Install or Repair Individual Sewage Disposal System
Application No�gZs�d
TO THE BUILDING DEPARTMENT: Date. ! R A- 19
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted:LA > p (�
1. Owner of Property ! A'S f� t C® -/
E- -17-A"42 . AAdress of Owner_`Z�T. / " � d O• W.l.-VY a.2
2. Location of Property (A."i.-L-1) . Lot. No.
3. Type of Structure (its x_6 1h'"at
No. of Bedrooms
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ /f—C)N C'
5. Plumbing Fixtures: Water Closets I Urinals 0 Lavatories— Bathtubs Ca
Showers Kitchen Sinks G Laundry Tubs G Garbage Grinder__O_ Other 0
6. Liquid Capacity of Septic Tank L�0-" �d L Material of Septic Tank
7. Soil Conditions: Type of Soil Maximum ground water table_ &�
(Sand,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 embankmentt�o
10. Percolation Tests: Time for 1" drop in soil test Classification of soil
11. Minimum square feet of effective seepage area required 'r 7
12. Leaching System: Number of trenches Length Width %;-' Total tl-
Other
Signature 's94)
(L
icensed Installer)
(Sketch showing all minimum distances and a required below)
Permit Issued 19)�j_ By
Installation Completed, Inspected and Approved 27 19� By
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