HomeMy WebLinkAboutSeptic New 11 Glenwood Road � 1 �
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: Date. / -
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is s mitted: nodQsf�=ddress
1. Owner of Property of Owne
2. Location of Property -- �.s+-�r-C Lot. No. 9
3. Type of Structure No. of Bedrooms .3
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets Z`' Urinals Lavatories_ Bathtubs /
Showers_ Kitchen Sinks Laundry Tubs Garbage Grinder Other
r
6. Liquid Capacity of Septic Tank /.2,54�2 —Material of Septic Tank
7. Soil Conditions: Type of Soil Maximum ground water table
(Sand,T
avel,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 Classification of soil
11. Minimum square feet of effective seepage area required V f !�zq
s
12. Leaching System: Number of trenches LengthG� Width o2 X2<r Total
Other
Signa e
(Licensed Installer)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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