HomeMy WebLinkAboutSeptic New 344 Hilton Drive J
TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut C'x
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No.
4diposal
TO THE BUILDING DEPARTMENT: Date 19 lC-A permit is requested for repair or construction of an individual sewag system concerning which the
following information is submitted:
1. Owner of Property Address of Owner 9 4W494 4-,- v !�
2. Location of Property Lot. No.
3. Type of Structure No. of Bedrooms 3
Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ G
5. Plumbing Fixtures: Water Closets I Urinals 1 Lavatories I Bathtubs /
Showers 1 Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank _Material of Septic Tank
7. Soil- Conditions: type of Soil Maximum ground water table 7
(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 Classification of soil
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches Letigtha Width Total 3 d0
Other
�i Signature
�(LicenAedin.talier)
(etch showing all minihium distances and other details required below)
I�i c:74K/��Ri G
Permit Issued 19 By ;
Installation Completed, Inspected and Approved LJI-ci lg L4 By