HomeMy WebLinkAboutSeptic New 24 Highland Drive TOWN OF SOUTH WI N DSOR .��--�
BUILDING DEPARTMENT Zd,0
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 disp sal system concerning which the
following information is submitted: (Z�clla,�l �ss�na.r
1. Owner of Property _ Address of Owner
2. Location of Property 2� ��s / _ � �
Lot. No.
3. Type of Structure_ No. of Bedrooms-__�__
jr (Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises__
var�a
5. Plumbing Fixtures: Water Closets_. 2i Urinals Lavatories
Bathtubs /
Showers__ Kitchen Sinks f Laundry Tubs Garbage Grinder_ Other
6. Liquid Capacity of Septic Tank 0CaO G a 1 Material of Septic Tank_
7. Soil Conditions: Type of Soil Cj it Maximum ground water table(Sand,Gravel,C y,etc.) t
CC"
8. If not served by public water supply: Distance from Owner's well V"O°., ,r l�y t ,
from adjl;cent wells
9. Distance to nearest water course, drainage ditch, storm drain or embankment_ ac) J#
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 Length Width
Total
Other
Signature
(Licensed stauer)
(Sketch showing all minimum distances and other details required below)
Cot Co
�P
Permit Issued 19 By
Installation Completed, Inspected and Approved o6 �'ToaF2 19�5— By