HomeMy WebLinkAboutSeptic New 67 Gordon Drive 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. � 19_46
A permit is requested f r repair r construction of an individual sewage disposal system concerning whi the
following information is submitte ,
1. Owner of Property 'Address of Owner
T �y
2. Location of Property4l� oc cii✓ o�t r[ Lot. No. f
3. Type of Structure No. of Bedrooms
(Dwelling, ercial Building, tore,etc.)
4. Number of Families or Persons to Occupy Pre s_
5. Plumbing Fixtures: Water Closets Urinal a-t��avatories�_ Bathtubs
Showers Kitchen Sinks_, Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank ZZ Q �. Material of Septic Tank ��- .
7. Soil Conditions: Type of Soil Maximum ground water table_sip
(San ravel,C a ,
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 o embankment
10. Percolation Tests: Time for 1" drop in soil test Classification of soil
11. Minimum square feet of effective seepage area required oz:J-14/
12. Leaching System: Number of trenches_ Length Q Width 2,;� Total
Other
Signature / w U--It��.
censed Installer)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
POR BUILDING PURPOSES ONLY
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