HomeMy WebLinkAboutSeptic New 00 Graham Road (7) TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System p
Application
No.
TO THE BUILDING DEPARTMENT: Date ZA�'5— 19
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted-
I
1. Owner of Property Address of Owner
2. Location of Property - Lot. No. a
3. Type of Structure
No. of Bedrooms
(Dwelling,c ercial Building,S re,etc.)
4. Number of Families or Persons to Occupy Prem ses_ D �
5. Plumbing Fixtures: Water Closets y Urinals vatories_-4A-- Bathtubs l
Showers l Kitchen Sinks / Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank Material of Septic Tank_'L--2O'VC, Z&"'-d -
7. Soil Conditions: Type of Soil Maximum ground water table
(Sand,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well 7Jf" from adjacent wells 71-3�74
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 Widt Z Tota1G 3
.D
Other
Signature
(Licensed Installeo °
(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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