HomeMy WebLinkAboutSchool New 175 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.
—7—lp
TO THE BUILDING DEPARTMENT: Date 1.2` <y 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 ��..¢....
2. Location of Property i: : /� r Lot No. JOV-
3. Type of Structure No. of Bedrooms
(Dwellin3fConunercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ lfz e-
5. Plumbing Fixtures: Water Closets Urinals Lavatories ly Bathtubs
Showers Kitchen Sinks _ Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank /Z S`O Material of Septic Tank
7. Soil Conditions: Type of Soil Maximum ground water table
(Sarff,Gravel,Clay,etc.)
i f
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
11. Minimum square feet of effective seepage area required
I
12. Leaching System: Number of trenches Length/49j?" — Width _ Total
Other
Signature / 44Vb
(Lice d Installer)
(Sketch showing all minimum distances and other details required �bejjw)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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