HomeMy WebLinkAboutSeptic New 00 Graham Road (4) TOWN OF SOUTH W1 N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No. v V I TO THE BUILDING DEPARTMENT: Date 224c, G 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 (_..2% Address of Owner
2. Location of Property Lot. No.-
3. Type of Structure No. of Bedrooms 113
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs
Showers Kitchen Sinks Laundry T s Garbage Grinder Other
6. Liquid Capacity of Septic Tank Material of Septic Tank AM!
7. Soil Conditions: Type of Soil Maximum ground water table--
(Band,Gravel,Clay,et .)
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 Total
Other
Signa/her
4
ensed Insta er)
(Sketch showing all minimum distances anails required below
Permit Issued 19 By
Installation Completed, Inspected and Approved —19— By
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