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HomeMy WebLinkAboutSeptic Repair 1021Main Street Main Stree . j TOWN OF SOUTH WI N DSOR BUILDING DEPARTMENT rSouth Windsor, Connecticut © Application for Permit to Install or Repair Individual Sewage Disposal System Application No. TO THE BUILDING DEPARTMENT: Date I 19 A permit is requested for repair or construction of an individual sewage disposal stem concerning which the following information is submi d: 1. Owner of Property Address of Owner 2. Location of Property �' Lot. No.. 3. Type of Structure No. of Bedrooms (Dw.elPfig,Commercial Building,Store,etc.) 4. Number of Families or Persons to Occupy Premises_ 5. Plumbing Fixtures: Water Closets AY f U pals avatories j Bathtubs _ Showers Kitchen Sinks ` Laundry Tubs 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,Clay,etc.) 8. If not served by public water supply: Distance from Owner's well S from adj�ace t wellsa 9. Distance to nearest water course, drainage ditch, storm drain or embankment-2 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 Width Total Other Signature sed Ins 1 ) (Sketch showing all minimum distances and other details required below) V Permit Issued 19 By Installation Completed, Inspected and Approved 19 By