HomeMy WebLinkAboutSeptic New 44 Manor Lane TOWN OF SOUTH w 1NDSOR
�,G%�• � �..5°�s BUILDING DEpq,
RTMENT
sfiio South Windsor, Connecticut
/ Application for Permit to Install or Repair Individual Sewage Disposal System
TO THE BUILDING DEPARTMENT: ApplicationDate -tells, 19
vidual sewage di �T.
A permit is requested for repair or construction of an indisposal system concerning which the
following information is submitted:
I. Owner of Property s Address of Owner_ 44 {1,w
u
2. Location of Property
Lot. No.
3. Type of Structure No. of Bedrooms_
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises-
5. Plumbing Fixtures: Water Closets 1 Urinals Lavatories
Bathtubs_
Showers- Kitchen Sinks-___L — Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank_ Zn Material of Septic Tank C U uC R O7i
7. Soil Conditions: Type of Soil_ AR0-NAti Maximum ground water table
(sand,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well O OZ L 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 !�6 3,S 5 ►_
12. Leaching System: Number of trenches ,,3 Length ,3�1)r)� Width 3.� Total
Other
0
t Signature 3
(Licensed Installer)
(S+6 showing all minimum distances and a er deLtails required below)
I � I
I
t t
I I
t � I
i
Permit Issued 19 By
Installation Completed, Inspected and Approved_ pm /-Fqeu�a� 19 By