HomeMy WebLinkAboutSeptic New 108 Mark Drive TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
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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 is submitted:
1. Owner of Property d ncJ Address of Owner
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2. Location of Property Lot. No.
3. Type of Structure No. of Bedrooms_
welling,commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets Urinals Lavatories D Bathtubs_A�C.—
Showers / Kitchen Sinks Laundry Tubs Garbage Grinder — Other
6 Liquid Capacity of Septic Tank Material of Septic Tank'
7. Soil Conditions: Type of Soil 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 drainor embankment
10. Percolation Tests: Time for 1" drop in soil test_ /�ll7u�'U. Classification of soil
11. Minimum square feet of effective seepage area required I.J�0215—1
12. Leaching System: Number of trenches Length 1?19 Width JeJ" Total�'�,�'
Other
frAcensed Installer)
(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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I HEREBY CERTIFY
THIS PLAN TO BE
SUBSTANTIALLY ENGINEERING AND LAND SURVEYING
NO. 3782 CORRECT; 740 NO. MAIN STREET, CROSSROADS PLAZA
WEST HARTFORD 7, CONNECTICUT
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O ,SuR E� �+ � DATE REVISED DR
40 101716 3 E;35
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