HomeMy WebLinkAboutSeptic New 493 Griffin Road TOWN OF SOUTH WI N DSOR
�e BUILDING DEPARTMENT
South Windsor, Connecticut &^��� �'
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No. -38
TO THE BUILDING DEPARTMENT: Date r9d- a C— 19 ' 3
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted: ����
1. Owner of Property Awl= _,g ,/L. Address of Owner N �'! 3 V V/
2. Location of Property Lot. No.
3. Type of Structure •r No. of Bedrooms_
(Dwell r,
)
4. Number of Families or Persons to OccTy Premises_
5. Plumbing Fixtures: Water Closets T/ Urinals Lavatories j Bathtubs 1
Showers_ Kitchen Sinks I Laundry T(nubs_I Garbage Grinder Other
6. Liquid Capacity of Septic Tank 7 S() -1-J Material of Septic Tank C
7. Soil Conditions: Type of Soil Maximum ground water table ��
8. If not served by public water supply: Distance from Owner's well 3 from adjacent wells
9. Distance to nearest water course, drainage ditch, storm drain or(embankmentl 3 d ..!_o`-
10. Percolation Tests: Time for 1" drop in soil test Classification of soil cl-A-1,
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches.— Length /I D Width a Total
Other OTC 11_�
Signature
(Licensed Installer)
(Sketch showing all minimum distances and other details required below)
N N
l�ocJS4 �o `� $
7 y8
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Permit Issued °�C�/ -Z ' 19� By
Installation Completed, Inspected and Approved 19 By