HomeMy WebLinkAboutSchool New 420 John Fitch Boulevard TOWN OF SOUTH WI N DSOR � /
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
App;disposal
t' No.
TO THE BUILDING DEPARTMENT: Date 19 ��
A permit is requested for repair or construction of an individual sewag system concerning which the
following information is submitted: /�-
1. Owner of Property s-,S m �'.ft'�C Address of Owner p
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2. Location of Property ot. No.
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3. Type of Structure No. of Bedrooms
(Dwelling,Comm rcial Ba��guilding,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
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 l'b-7-t
(Sand,Gravel,CRY,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
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12. Leaching System: Number of trenches -2 Length 7S Widt Total 7
Other
Signature
Z�-
(Licensed Installer)
(Sketch showing all minimum distances and other details required below)
TA
12'
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8 "-$
900 G4b,Ti7�l�
Permit Issued 19 68 By ✓ T.V K 167i .�i�"/C
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Installation Completed, Inspected and Approved /3 19_� By /: e&C=Z"
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