HomeMy WebLinkAboutSeptic New 5 Hilton Drive TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to 14100M Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date 19 6 4,
A permit is requested for repair or construction of an individual sewage disp al system concerning which the
following information is submitted:
1. Owner of Property � Address of Owner�,� ��2�
2. Location of Propert 4 Lot. No.
3. Type of Structure _ No. of Bedrooms_
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises / ;n Cf-
5. Plumbing Fixtures: Water Closets / Urinals 1_ Lavatories Bathtubs_
Showers_1_ Kitchen Sinks_ Laundry Tubs_ Garbage Grinder_( Other
6. Liquid Capacity of Septic Tank. l`S U n Material of Septic Tank
7. Soil Conditions: Type of Soil.-.-.4"-- Maximum ground water table_ —
Sand,Gra el,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well from adjacent wells 7L /sy
9. Distance to nearest water course, drainage ditch, storm drain or embankment_1 7 s
10. Percolation Tests: Time for 1" drop in soil test J /1J'1_Classification of soil A-
11. Minimum square feet of effective seepage area required 7�
12. Leaching System: Number of trenches` Length / _ Width 3 Total
Other r
Signature AOC or." . W iq,H,t,�l
(Licensed Installer)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved Yv AuecLsT- 19-k�_ By
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