HomeMy WebLinkAboutSeptic New 1281 Main 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 / 19
A permit is requested for repair or construction of an individual sewage disposal system c cerning which the
following information i ubmltted:
1. Owner of Property a Address of Owner
2. Location of Property Lot. No.
3. Type of Structure s No. of Bedrooms
(Dwel7misesk_
ommercial Building, tore,etc.)
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4. Number of Families or Persons to Occupy P !J'
5. Plumbing Fixtures: Water Closets Urinals avatories 15�— Bathtubs
Showers__ Kitchen Sinks Laundry Tubs_ Garbage Grinder Other
6. Liquid Capacity of Septic Tank 1114F-06 Material of Septic Tank f—'—
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, 'f
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 Le gth' id f Total
Other
Signature �
(Licens nstaller)
(Sketch showing all minimum distances and other details required o )
Permit Issued 19 By
Installation Completed, Inspected and Approved 19/-y By
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