HomeMy WebLinkAboutSeptic New 200 Hillside Drive TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No. !�
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TO THE BUILDING DEPARTMENT: Date 19 4�0
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 Address of Owner/ C2g 2- �`l'.f°. ��/U if
2. Location of Propertye—t� Lot. No. j!f—a
3. Type of Structure No. of Bedrooms_
welling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ O H e 4&ih 1
5. Plumbing Fixtures: Water Closets 2- Urinals Lavatories 1 2_ Bathtubs_
Showers Kitchen Sinks_._ Laundry Tubs Garbage Grinder_ Other
6. Liquid Capacity of Septic Tank ZZ," .00 Material of Septic Tank___
7. Soil Conditions: Type of Soil '�5d ii W Maximum ground water table_
(band,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 ` t ea D VZ
c�Yt ,
10. Percolation Tests: Time for 1" drop in soil test :I® 5f C Classification of soil
11. Minimum square feet of effective seepage area requiredd�
12. Leaching System: Number of trenches Lengt �a ,f _ Width 9d Total 3 -Z
Other
Signature — C
� _�';• (Licensed Installer)
(Sketch showing all minimum distances an"her details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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MEGSON & HYYPPA
CIVIL ENGINEERS
GLASTONBURY, CONN.
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CERTIFIED SUBSTANTIALLY CORRECTi
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