HomeMy WebLinkAboutSeptic New 67 High Ridge Road TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal Systen241// -1:1$
Application No.
TO THE BUILDING DEPARTMENT: Date `" r 19
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 as.�tiJ 217 r f v Address of Owner_4& e-,-c 4i � 4.Y-
2. Location of Propert J . ` Lot. No.�_
3. Type of Structure 1 vu " / /L H t 444 ipc oA No. of Bedrooms
(Dwel ng,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets 2—. Urinals Lavatories_" Bathtubs
Showers_ Kitchen Sinks_/ Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank I.-a 6f Material of Septic Tank a, r 1rj
7. Soil Conditions: Type of Soil Maximum ground water table
(Sand,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well from adjacent wells
9. Distance to nearest water course, drainage ditch, storm drain or embankment
10. Percolation Tests: Time for 1" drop in soil test z] — Classification of soil
11. Minimum square feet of effective seepage area required_ 16106 -'V
12. Leaching System: Number of trenches Length-4 sJ Width 3G Total �/O Ir-r
Other
Signature
—c—;�:::
(Licensed staller
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
FOR BUILDING PURPOSES V /°"
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