HomeMy WebLinkAboutSeptic New 89 Glenwood Road (3) o M
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 `/J-- 19
A permit is requested for repair o construction of an individual sewage disposal system concerning which the
following information is sub ' ted: ��tP f(errl �trl
1. Owner of Property Address of Owner
2. Location of Property ✓ Lot. No.
__.. ._ .
3. Type of Structure No. of Bedrooms
(Dwelling,Com cial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets c--Z Urinals_ Lavatories o2 Bathtubs
Showers_ Kitchen Sinks_ _ Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tan 6'0 a Material of Septic Tank CAZZ� < )
7. Soil Conditions: Type of Soil Qii-z Cc,-Maximum ground water table— I/, _�
(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
12. Leaching System: Number of trenches Length Width &D Total .544r/
Other
Signatur
(Licensed installer)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By