HomeMy WebLinkAboutSeptic New 89 Glenwood Road (2) r
TOWN OF SOUTH WI N DSOR 's D
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date //y 19
A permit is requested for repair o construction of an individual sewage disposal system concerning which the
following information is sub ' ted: ��tP
1. Owner of PropertyI I CCC?077t77 Address of Owner
2. Location of Property Lot. No.� -
3. Type of Structure No. of Bedrooms
(Dwelling,Com r
cial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets ;,2- Urinals 19 Lavatories o2 Bathtubs _
Showers_ Kitchen Sinks _ Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tan 6-0-0 Material of Septic Tank 43�� (�,)
7. Soil Conditions: Type of Soil ct-" cc, 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 embankment
10. Percolation Tests: Time for 1" drop in soil test Classification of soil
11. Minimum square feet of effective seepage area required
it
12. Leaching System: Number of trenches Length Width 30 Total S4zJ
Other
Signature%-,�-zc_.
(Licensed Inst811e)r)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By