HomeMy WebLinkAboutSeptic New 154 Gray Road ws
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. /_= 9 19 4�F
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted: Je Al—'-* CA N //
1. Owner of Propert Address of Owner.i
2. Location of Propert S4 /2.4 i �og Lot. No.
3. Type of Structure No. of Bedrooms
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets 7--- Urinals Lavatories Bathtubs
Showers__ Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank Material of Septic Tank.6ze �
7. Soil Conditions: Type of Soil A Agp__ ' Maximum ground water table
(Sand, ravel,Cla3f,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 O 4
12. Leaching System: Number of trenches Length idth_�`„ Total f
Other
Signatur
(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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