HomeMy WebLinkAboutSeptic New 9 Gray Road TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date C s2 19
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is subm1171ted:J,nr�N
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1. Owner of Property A- Address of Owner, ,�/
2. Location of Property AC®RCN 2Z) 1Y9/G-//TS Lot. No. 3
l 1
3. Type of Structure ""'�'' No. of Bedrooms_
(DWelling,CommerI Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets ; Urinals Lavatories Bathtubs
Showers__ Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tan 4'J 4,i ``n Material of Septic Tank " F° �"
7. Soil Conditions: Type of Soil �-i�, V `' 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 .10 M 12l-, Classification of soil
11. Minimum square feet of effective seepage area required1/70 S4 �AbAmm — C70 Sta gt+.-,-40.1
12. Leaching System: Number of trenches S/ 6 Length ou Width--!?, Total (od4
Other
Signature ,- !
(Li used 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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