HomeMy WebLinkAboutSeptic New 48 Greenfield Drive TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
Z3'('552- South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date Z O 19
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is bmitted:
1. Owner of Property Address of Owner / /
2. Location of Property Lot. No.
3. Type of Structure No. of Bedrooms
( welling,Commerci r
uilding,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 Tank G-" 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
s,. 9. Distance to nearest water course, drainage ditch, storm drain or embankment
10. Percolation Tests: Time for V drop in soil test Classification of soil
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches Length /S!o FT Width 7—i.4'fT Total-39a :59 CT
OtherSignature.
TLicensed Installer)
(Sketch showing all minimum distances and other details required below)
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Permit Issued 19 By
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Installation Completed, Inspected and Approved 19 By
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SEWER .
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OWNER. jA r.n Eg M LK�( 8y iL yFA� PLAN OF LAND AT,
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ADDRESS:
tea. Wie•aDSbG� coN�`!,_ DATE.: G 12p, � CAL.E: t' =46 C,
Cou NYY BOOK OF PL.A N S: �w r� T .r
PAGE N O: - Lo-r—NO:fv 1'1 --- , ivl l 1 H r� � + PLAN ':
dEED BOOK'^ -- _ Mr s. L- C. No ENGINEERING COlV PA"y ' NO-
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