HomeMy WebLinkAboutSeptic New 107 Mark Drive 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 ll—s—WI-7 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
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2. Location of Property Lot. No._�
3. Type of Structure No. of Bedrooms
(Dw ing,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises-- ( Y/,7?
5. Plumbing Fixtures: Water Closets Urinals U Lavatories Bathtubs I
Showers Kitchen Sinks Laundry Tubs — Garbage Grinder Other
6. Liquid Capacity of Septic Tank Material of Septic Tank
7. Soil Conditions: Type of Soil i/ 1 Maximum ground water table
( d,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 �� .—Classification of soil z4
11. Minimum square feet of effective seepage area required c 7�
12. Leaching System: Number of trenches 13 Length /6 Width �5 � Total
Other
Signatures �t� / i /� o—r2 `
IAcensedInstaller)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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VRCPERTY LF MUR:>Y ^iCMES , IPdC -�;GUTH 'ltINDSOP , (%ONN .
HAYES & NE VEPS RCAL . Jul `!r ';'+' INDS :P . CUNN
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ERT IcE �; I HEREBY CERTIFY
THIS PLAN TO BE ENGINEERING AND LAND SURVEYING
SUBSTANTIALLY
NO. 3732
CORRECT; 740 NO. MAIN STREET. CROSSROADS PLAZA
WEST HARTFORD 7. CONNECTICUT
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0SURV �' E DATE REVISED D
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