HomeMy WebLinkAboutSeptic New 81 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
A permit is re ted for epair or.construction of an individual sewage disposal system concerning which the
following information is ub itted:
1. Owner of Property Address of Owner
2. Location of Pro Lot. No. --4��a
3. Type of Struc a No. of Bedrooms
lung,Commercial Building, re,etc.)
4. Number of Families or Persons to Oc y Premises_
5. Plumbing Fixtures: Water Closets Urinal avatories 4X— Bathtubs___ __
Showers__ Kitchen Sinks , Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank 400 Material of Septic Tank
7. Soil Conditions: T 1 ype of Soil Maximum ground water table -gff, txCe
(Sand,Gravel,Clay,etc—.
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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 op/'embankment
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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 OX Total 3;;i
Other
1
Signature i >
(Licensed Installer)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
1
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