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HomeMy WebLinkAboutSeptic New 585 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 Application No. TO THE BUILDING DEPARTMENT: Date_ /Q 7 19 A permit is requested for repair or construction of an individual sewage disposal system concerning which the following information is submitted: /� yy� 1. Owner of Property X. y4P�C�'��, Address of Owner.-/�z/"F/,� �y�s r 2. Location of Property "' dl9iY �� < fv4'� Lot. No. 3. Type of Structure 2cNA No. of Bedrooms C> pwelling, mmerciBuilding,Store,etc.) 4. Number of Families or Persons to Occupy Premises_ 5. Plumbing Fixtures: Water Closets 1 Urinals_ Lavatories_ Bathtubs Showers ( Kitchen Sinks_ Laundry Tubs b Garbage Grinder_ Other 0 6. Liquid Capacity of Septic Tank �7,�6,d ace, Material of Septic Tank ��a-- 7. Soil Conditions: Type of Soil S/9 Maximum ground water table fo i f (Sand,Gravel,Clay,etc.) 8. If not served by public water supply: Distance from Owner's wellA6//G from adjacent wells 9. Distance to nearest water course, drainage ditch, storm drain or embankment 0-S1 10. Percolation Tests: Time for 1" drop in soil test . 25� -Classification of soil_ 11. Minimum square feet of effective seepage area required a of S , �' a 12. Leaching System: Number of trenches Ad Length Width Z,z Total Other Signature (Licensed Installer (Sketch showing all minimum distances and other details required below) t©•-�,�S #of Post-its Fax Note 7671 Date! pages To From Vy��i� (N c Co./Dept.•. Co. Phone#• Phone# Fax# Fax# Permit Issued 19 B `/D- A14 Installation Completed, Inspected and Approved 19 By