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HomeMy WebLinkAboutSeptic New 220 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. �3�� TO THE BUILDING DEPARTMENT: Date S— 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 Address of Owner. � 2. Location of Property -- Lot. No. Z 3. Type of Structure No. of Bedrooms (D;"Ihg,Commercial Building,Store,etc.) 4. Number of Families or Persons to Occupy Premises_ 41- 5. Plumbing Fixtures: Water Closets Urinals Lavatories C Bathtubs �— Showers G Kitchen Sinks /�— Laundry Tubs G Garbage Grinder Othe 6. Liquid Capacity of Septic Tank . e Mater 1 of Septic Tank 7. Soil Conditions: Type of Soil —�4;; 7� Maximum ground water table 7 (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 C 2 � 12. Leaching System: Number of trenches 3 ��o Length Width Total Other Z o ? Signature (Licensed Installer) (Sketch showing all minimum distances and other details required below) i � J F 1 I I I I 1 � I I � i 9) 1 I I I � } � I I I ! 1 I I W i I I 2 Permit Issued 19 By Installation Completed, Inspected and Approved ©s 19 By