Loading...
HomeMy WebLinkAboutSeptic New 73 Greenfield Drive 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 19 A permit is requested for repair or construction of an individual sewage disposal system concerning which the. following information is su fitted: 1. Owner of Property ddress of Owner, 2. Location of Property r Lot. No. 3. Type of Structure __---No. of Bedrooms welling,Commercial Building,Store,etc.) 4. Number of Families or Persons to Occupy Premises_ 5. Plumbing Fixtures: Water Closets c--2, Urinals © Lavatories_ '2 Bathtubs_ Showers_ Kitchen Sinks_ Laundry Tubs Garbage Grinder Other 6. Liquid Capacity of Septic Tanks Material of Septic Tank - 7. Soil Conditions: Type of Soil 4�,Wg:�C Maximum groundwater 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 Classification of soil 11. Minimum square feet of effective seepage area required 12. Leaching System: Number of trenches 4' Length /43 FT Width2..T 1CT Tota13S2. g,CT Other �' Signature / -P (Licensed Installer) (Sketch showing all minimum distances and other details required below) Permit Issued 19 By Installation Completed, Inspected and Approved 19 By F�EtGHT:: GAS: � u CON Oi-rION * S EWER: REMARKS : PAv E D--ST: s,yEt�4R0 y Zo, o0o S.F ►r �. f3 (71, i 87 r • q r. 4.9p I i 9¢5S �.... } k '.k i .i dN c=r1.f','_»..�./4 M fi M �.1��f g U L O Q PLAN OF on.Gt Era t-L DAT E: M A mac. �✓.� _ .__ .. _r`C:At \ 4rc�-c v'rY 600K OF PLANS: Pa��S. /��I C �'`.Ic, Qv r 'J 2t i ys' ly IL s� 4S NOTES SOUTH WINDSOR HEALTH DEPARTMENT LOCATION OWNER TYPE OF WORK DATE t - - PERMIT PIPE INSTALLER WilM cL,, k't INSPECTOR DRAWN BY�f