HomeMy WebLinkAboutSeptic New 37 Mountain Drive TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application Noo../7 K% �
TO THE BUILDING DEPARTMENT: Date — 49^ 19
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted: b.4,- k a n^
1. Owner of Property Address of Owner Wiz^ t Y
2. Location of Property C Lot. No.�
3. Type of Structure esU tk-/ 4 No. of Bedrooms_
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ 1
5. Plumbing Fixtures: Water Closets A Urinals Lavatories Bathtubs !
Showers_ Kitchen Sinks ` Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank// e G Material of Septic Tank r c, e1??1V1r&fJJ)
7. Soil Conditions: Type of Soil' r?G Maximum ground water table
and,Gravel, lay,etc.)
8. If not served by public water supply: Distance from Owner's well 't 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 2 7 S e
12. Leaching System: Number of trenches Length Width Total
Other 13,
Signature
(Licensed Instal r
(Sketch showing all minimum distances and other details req below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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