HomeMy WebLinkAboutSeptic New 43 Manor Lane TOWN OF SOUTH WINDSOR a �
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 iAsuitted:
1. Owner of Propert Address of Owner .
2. Location of Prope
Lot. No.
3. Type of Structure No. of Bedrooms_ellin g,Com mercial Bi ulding,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets Urinals ±atorie$- Bathtubs__
Showers__ Kitchen Sinks___L Laundry Tubs l Garbage Grinder 6. Liquid Capacity of Septic Tank, �X%S7;',v� Material of Septic Tank Ot her Other
r
7. Soil Conditions: Type of Soil_ 4.�ical i9iy Maximum ground water table
(Sand,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well v61i'<' 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 Classification of soil
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches I i Length Widt i s Tota �"" ,r r
Other
g ,� �
\ Si nature c'
(Licensed Installer)
13 (Sketch showinp all minimum distances and other details required below)
�31a r.
Permit Issued 19 By
Installation Completed, Inspected and Approved /-g Qc,—�/�E/. 19 6S� By