HomeMy WebLinkAboutSeptic New 90 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 itted:
1. Owner of Property A dress of Owner��`"�
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2. Location of Propert Lot. No-0 c.')—/
3. Type of Structure 9, No. of Bedrooms
(Dweling,Commercial Build Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closet sl -- Urinals d Lavatories _ Bathtubs
Showers_ Kitchen SinksL Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tan o— Material of Septic Tank 2�/�_n_ ('a4zozo
7. Soil Conditions: Type of Soil Ci—n CX— 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 4" Length /SSF 7 Width 2.S XT Tota1387� FT
Other �-
Signature / oA
'(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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HAMPDeN-_ COUNTY BOOK OF PLANS:
PAGE IVO: LOT NO: (p2I PLAN N_.
SMITH ,�'.� WALL ice,
DEEP BOOK: MASS. _1._1C. NO E.NGINEE.RINS COMPANY i NC.
PAGE "Nd: 5304 602 WHITE.- $T. $PRtN girt ELD, 'MAS