HomeMy WebLinkAboutSeptic New 33 Lake Street TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System ?fool
Application No.
TO THE BUILDING DEPARTMENT: Date_ ZJ — �7— z'( 9
' A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted: IAZ;-.ss a 1?e7'-l44-ST 2 C
i 1. Owner of Property Address of Owner .AO'
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2. Location of Propert Lot. No. y
3. Type of Structure Welling,Commercial Building,Store,etc.) No. of Bedrooms
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets Urinals Lavatories` Bathtubs
Showers Kitchen Sinks Laundry bs 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,CXy,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 soi
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches Length o�.3 id ®� Total
Other
Signature
ce sed Installer)
(Sketch showing all minimum distances and of r details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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