HomeMy WebLinkAboutSeptic New 32 Highland Drive TOWN OF SOUTH WINDSOR
�2 � BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date—&" � 19!r
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted:p�af 00,ne [I
1. Owner of Property Y dress of Owner 3 ,4 6'A/M10
2. Location of Property' ' Lot. No.—
3. Type of Structure Lu PL[,I A' 6S No. of Bedrooms
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises�7�L 5t&,1 T f
5. Plumbing Fixtures: Water Closets Urinals "" "" Lavatories_ Bathtubs /
Showers Kitchen Sinks _ Lau ry Tubs Garbage Grinder OtherklS#/,(.S( �/��iGe-
6. Liquid Capacity of Septic Tank o • Material of Septic Tank
7. Soil Conditions: Type of Soil /�-� Maximum ground water table f
(Sand,Gravel,Clay,etc.) /�
8, If not served by public water supply: Distance from Owner's well Pt( /C from adjacent wells
9. Distance to nearest water course, drainage ditch, storm drain or embankmentGi
10. Percolation Tests: Time for 1" drop in soil test "`"' Classification of soil
11. Minimum square feet of effective seepage area requiredL�
12. Leaching System: Number of trenchesLength (7-�/Widt ,
Total
Other C' C LG/C 6 PGC1L �=T
Signature C
4 ( ensed Installer)
(Sketch showing all minimum distances and other details required below)
!7( 6,?-A°d W,
a�
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By