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HomeMy WebLinkAboutSeptic New 181 Kent Lane TOWN OF SOUTH WI N DSOR - � BUILDING DEPARTMENT South Windsor, Connecticut ©/ Application for Permit to Install or Repair Individual Sewage Disposal Systeli7/ Application No. TO THE BUILDING DEPARTMENT: Date /2 "' 1 19 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 Z Address f Owner_ 2. Location of Property Zot. No. 3. Type of Structure No. of Bedrooms o� (Dw ing,Commercial Budding,Store,etc.) 4. Number of Families or Persons to Occupy Premises_ 5. Plumbing Fixtures: Water Closets 3 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 9•-, Maximum ground water table (Sand,Gravel,Clay,etc.) 8. If not served by public water supply: Distance from Owner's well/r/�/,Iov from adjacent well j0rA1'/100 9. Distance to nearest water course, drainage ditch, storm drain or embankment 10. Percolation Tests: Time for 1" drop in soil test --Agk-o Classification of soil 11. Minimum square feet of effective seepage area required 12. Leaching System: Number of trenches Length �� Width OX Total Other OQ Signature (Licensed nstaHer) (Sketch showing all minimum distances an other details required below) j� J� � , (eV Permit Issued 19 By A Installation Completed,Inspected and Approved 19 By