HomeMy WebLinkAboutSeptic New 11 Greenfield Drive r
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_,-;"—il- 19-CY
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 Address of Owner
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2. Location of Property Lot. No. ('7 C-)
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3. Type of Structure --t No. of Bedrooms
(Dwelling,commerciar Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ OY�
5. Plumbing Fixtures: Water Closets 2 Urinals — Lavatories -,2— Bathtubs f
Showers_ Kitchen Sinks,_ Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank Material of Septic Tank
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 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 to I MlO4 Classification of soil
h 11. Minimum square feet of effective seepage area required---Iy1 Q16r<drCb'W^
12. Leaching System: Number of trenches Length /48 4C7 Width Z.S FT TotaiftoS4 /`T
Other
Signature, -i`zc,,
(Licensed Installer)
(Sketch showing all minimum distances and other details required below)
Permit Issued Sig A 14ar- 19ro9 a POW—f
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Installation Completed, Inspected and Approved .2-Qe 4-q k1 o r- 19 B
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��3N 3't�ti Cfi-ION: 4` WI►'`T�"Fi _
N hGHT: GAS:
CONDITION : -� SEWER :
RE M A R K S /fix p t/ �roQM PAV F.o S-r:
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PLAN OF LAND XT,
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