HomeMy WebLinkAboutSeptic New 105 Greenfield Drive h � �
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 s ml ted:
1. Owner of PropertyA Address of Owner 4
2. Location of Property Lot. No. (1:v
3. Type of Structure No. of Bedrooms_
(Dwelling,CommerclamBuilding,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets/ Urinals Lavatories c Bathtubs
Showers Kitchen Sinks / Laundry Tubs Garbage Grinder Other f
6. Liquid Capacity of Septic Tan Material of Septic Tank
r
7. Soil Conditions: Type of Soil Maximum ground water table
(Band,Grave ay,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 3 Len th � ? FT Width s T Tota .?
Other
1-14
-7�—
Signature _ / i
(Licensed Installer)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
GAS-.
CoNorrioN SF-WER:
REMARKS PAVEfl $m
,V�F SHEPARD
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OWNER: PLAN OF LAND AT:
AcoaEse:
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COUNTY BOOK OF PLAN$:
_PAGE No: LoT -NO: _ _ �'� � .4�.��..�► �.�� z.
DEEo Soot: MiA83. Lic . ENGit4EE.fat!N4 COMPANY INC.
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