HomeMy WebLinkAboutSeptic New 55 Miller Road TOWN OF SOUTH WI N DSOR -
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No. Q
TO THE BUILDING DEPARTMENT: Date._/ / 19
A permit is requested for repair Kr construction of an individual sewage disposal system concerning which the
following information is sub fitted:S�1? °
1. Owner of Property � �7/�?f,,i/ Address of Owne_&/ � , ��
2. Location of Prope ty + 5— Lot. No.
a53. Type of Structur welling,Commercial Building,Store,etc.) No. of Bedrooms
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets_62. _ Urinals Lavatories_ Bathtub
s s_
Showers Kitchen Sink / Laundry Tubs Garbage Grinder /� Other
6. Liquid Capacity of Septic Tank���`3M Material of Septic Tank < .� !re
7. Soil Conditions: Type of Soi1Gj� /Jlir Maximum ground water table
(Band,gravel,Clgry,etc.)
8. If not served by public water supply: Distance from Owner's well/C-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 3�1/
12. Leaching System: Number of trenches Length 35'25 zoaA,4 Width 2 ' Total
Other
Signatur4;;��;
(Licensed Installe
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
s OUT r�jv� D S OR,C ONN
.
Scale 1' 40 _ An. 1 7,1 9A,6
1 Note ;
Building b-lilt as shown.
Thera are no violatior's of
m. ; • the toning, ordinances.
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11rgf? $94
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