HomeMy WebLinkAboutSeptic New 189 Laurel Street 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--a�
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 Lot. No. S 3
3. Type of Structure No. of Bedrooms 3
Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Per sons to Occupy Premises_
5. Plumbing Fixtures: Water Closets f Urinals Lavatories Bathtubs 1
Showers ( Kitchen Sinks Laundry Tubs— Garbage Grinder ��Other.
6. Liquid Capacity of Septic Tan 7 �,� Material of Septic Tank e�� tc
7. Soil Conditions: Type of Soil Maximum ground water table
(Sand,Gravel,Clay,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
°
12. Leaching System: Number of trenches Length Cl? Width Total
Other
Signatur P� -�'^i
(Licensed Installer)
(Sketch showing all minimum distances and other details required below)
f c�
i�
1
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
.�
:�
��,
To EX/ST/NC F>�D
i
�+ I
�SD
,Z
.� ,
_ _ � �
� �w
7a'
r � ,�-
,C,Ru2r-L �r,