HomeMy WebLinkAboutSeptic New 1803 Main Street TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
r- e
South Windsor, Connecticut
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Application for Permit to Install or Repair Individual Sewage Disposal System ,/���
Application]No.
TO THE BUILDING DEPARTMENT: Dat�-f �(p 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 PropertyAddress of OwnerlL3d3
2. Location of Property r>7 ar c e� Lot. No.
3. Type of Structure i�c h Qr 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 UO O Material of Septic Tank Q., .
7. Soil Conditions: Type of Soil4� �-,, I Maximum ground water table }
(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 q q I Classification of soil
11. Minimum square feet of effective seepage area required , o ..,
12. Leaching System: Number of trenches_ Length Width =�d Total/ C----
Other
Signatu das��
(Licensed Installer)
(Sketch showing all minimum distances and other details required below)
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I; 1
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Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By