HomeMy WebLinkAboutSeptic New 8 Highland Drive TOWN OF SOUTH WINDSOR
y/ 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 isposal system concerning which the
following information is submitted:
I. Owner of Property_�s;/r. C aY��g tt� so Address of Own 1 2' r
2. Location of Property
3. Type of Structure IQ C-_1-�r �, � Lot. No. �
(Dwelling,Commercial Building,Store,etc.) No. of Bedrooms _
- 4. Number of Families or Persons to Occupy Premises_ '�
5. Plumbing Fixtures: Water Closets 5 UrinalsL Lavatories
Bathtubs
Showers Kitchen Sinks______ Laundry Tubs Garbage Grinder ll
^' Other
6. Liquid Capacity of Septic TankT&off Material of Septic Tank
7. Soil Conditions: Type of Soil Maximum
clay,etc.> ground water table_
8. If not served by public water supply: Distance from Owner's well 1, from adjacent wells
9. Distance to nearest water course, drainage ditch, storm drain or embankment_ 7 IT 11
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_ LengthT_
�_ Width �. Total 7� El�
Other
Signature
(Licensed Installer)
(Sketch showing all minimum distances and other details required below)`�+�
6
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Permit Issued 19 By
Installation Completed, Inspected and Approved 1.t �u c�� 19�_ By 19j�7-
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