HomeMy WebLinkAboutSeptic New 00 Graham Road (6) 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 5'-/.Z- 4-J-1, 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 s Address of Owner J 5i
2. Location of Property Lot. No. l
3. Type of Structure No. of Bedrooms I
(Dwell' .Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
ell
5. Plumbing Fixtures: Water Closets 17-- Urinals ' L vatories Z Bathtubs_
Showers Kitchen Sinks Laundry Tubs Garbage Grinder - Other
6. Liquid Capacity of Septic Tank Material of Septic Tank..
7. Soil Conditions: Type of Soil Maxi?bankment
ound water table
(Sa ravel,Clay, tc.)
O
8. If not served by public water supply: istance from Owner's wel om adjacent wells
9. Distance to nearest water course, drainage ditch, storm drain or a
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 /J2-� Widt Total
Other
Signature
(Licenie4 Installer)
(Sketch showing all minimum distances and other details requir bel w)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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