HomeMy WebLinkAboutSeptic New 00 Main Street TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System p�
Application No. Q
TO THE BUILDING DEPARTMENT: Date. 'Z .2- 2 19
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted kl�
1. Owner of Property Z Address of Owner
2. Location of Property Lot. No.
3. Type of Structure No. of Bedrooms_
(Dwe ng,Commercial Building,Store,etc.)
.t/�
4. Number of Families or Persons to Occupy Premises_ /
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs
Showers_ Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank Material of Septic Tank C -
7. Soil Conditions: Type of Soil y? Maximum ground water table C
(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
�- e i
11. Minimum square feet of effective seepage area required , y
12. Leaching System: Number of trenches Length 2 C) Width� Total 1 0e
Other
Signature �,./fs -r z� / -• �..
(FAcensed Installer)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
q ,
1 0�
•o I Ica
w I� I qAl f V
� I �
h
• � E 4
i
v k
/t7 �
I �
i
{ 1.-c: _. :.J Y �' �=�i3 ... .:�� irc:7.,G-y�:�% -"�-�-"'/�7'/C-µme• %�1 �