HomeMy WebLinkAboutSeptic Repair 44 Imperial Drive TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South,Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT:
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
2. Location of Property-4 . t l' .� Lot. No.
3. Type of Structure
(Dwe ling,Commercial ullding,Store,etc.) NO. of Bedrooms
4. Number of Families or Persons to Occupy Premises_ O-yr e
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs
Showers 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
(sand,Gravel, lay, c.)
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 Length a d e Width Vl� s. 0 Total`J
Other
Signatur
(L sed Installer)
, 1
(Sketch showing all minimum distances and other details required below)
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Permit Issued 19 By
Installation Completed, Inspected and Approved lg By