HomeMy WebLinkAboutSeptic Repair 845 Main Street k Y w
TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date 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'� { .<f.� s: �Mnt
.fwrAddress of Owner.
2. Location of Property . r" ,A 1 '�7 Lot. No.
3. Type of Structure �� A M C No. of Bedrooms
(Dwelling,commercial Building,Store,etc.)
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 Tan Material of Septic Tank
7. Soil Conditions: Type of Soils- 'P. Maximum ground water table
(Sand,Gra el,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 V drop in soil test Classification of soil
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches .. Length*„�_ Width I Total
Other
Signature -a9....,.�
(Li used Installer)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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