HomeMy WebLinkAboutSeptic New 34 Governor's Highway 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 requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted:
1. Owner of Property _.p "��°' `'LAPAddress, of Owner
2. Location of Property4 (; �"� �iJ Lot. No.
3. Type of Structure 1Y��•� t '�" No. of Bedrooms
(Dwelling,Con1mercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ �i
5. Plumbing Fixtures: Water Closets L Urinals Lavatories_ Bathtubs_
Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank c Material of Septic Tank �f
7. Soil Conditions: Type of Soil »-a(' 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 2 2 I
12. Leaching System: Number of trenches Length_/ / Width � Total
Other .,3 ISC • `���2• 39Q,,,
Signatures � � 6
(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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