HomeMy WebLinkAboutSeptic New 74 Greenfield Drive t
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 submitted: b o W i M S X y� I.,w AA 0.7
1. Owner of Property Address of Owne-4;; r
2. Location of Property Lot. No.
3. Type of Structure ,tom;/ No. of Bedrooms
(Dwelling,Co ercial Building,Sto;e.etc.)
4. Number of Families or Persons to Occupy Premises_ �----
5. Plumbing Fixtures: Water Closets Urinals U Lavatories Bathtubs_
Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other JJ
6. Liquid Capacity of Septic Tank O X-16' 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 !�/ Classification of soil
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches T Length /52.FT' Width Z, $$f T Total
Other
Signature < f
Licensed Installer)
(Sketch showing all minimum distances and other details required below)
J�7S
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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