HomeMy WebLinkAboutSeptic New 94 Highland Drive TOWN OF SOUTH WIN DSOR Sqr
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Appliccat�io�n No. q
TO THE BUILDING DEPARTMENT: Date 1 cZL. Y 191E
A permit is requested for repair or onstruction of an individual sewage disposal system concerning which the
following information is submitted: � 0
1. Owner of Property W GN C / � Z / Address of Owner—?—� L�'/�D �.
2. Location of Property -Lot. No. 99
3. Type of Structure
No. of Bedrooms_
(Dwelling,Commercia ulld�/ing,Store,etc.)
4. Number of Families or Persons to Occup Premises_ /4 �
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs! �-/
Showers _ Kitchen Sinks aundry Tubs -� Garbage Grinder 9---
Other
6. Liquid Capacity of Septic Tank L• Material of Septic Tank
7. Soil Conditions: Type of Soil Maxim ground water table
(Sand,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well l-� L C from adjacent^wells
9. Distance to nearest water course, drainage ditch, st r ain or embankment T i
' 10. Percolation Tests: Time for V drop in soil test ® Classification of soil ,&
'
11. Minimum square feet of effective seepage area required ram
12. Leachin System: Number of trenches_ Length WidthJ-�L Total
Other
4
Signature a`
censed netalle
(Sketch showing all minimum distances and other details required below)
b dim'If 7
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Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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