HomeMy WebLinkAboutSeptic New 1486Main Street Main Street TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No. ��Z/
TO THE BUILDING DEPARTMENT: Date_ /9�y 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 Propert �yv Lot. No.
3. Type of Structure No. of Bedrooms
(Dwel:Yiscs.
mmercial Building, tore,etc.)
4. Number of Families or Persons to Occupy P
77
5. Plumbing Fixtures: Water Closets Urinals Lavatories 6,2— Bathtubs /
Showers_L_ Kitchen Sinks_ ` Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank - k4. Material of Septic Tank �2ta
61-
7. Soil Conditions: Type of Soil tis ,-A Maximum ground water table
(Band,Gravel,Clay,e .F
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 Jd
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 Ler z Width Total
Other
Signature
(Licensed Installer)Cbelo)/)
(Sketch showing all minimum distances and other details required
Permit Issued 19 By
Installation Completed,Inspected and Approved 19 By
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