HomeMy WebLinkAboutSeptic New 80 Mountain 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. l0
TO THE BUILDING DEPARTMENT: Date. F- -?--
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted: fd w i 14 Lt 6ci f?r
1. Owner of Property. Address of Owner
2. Location of Property CjrI ou t Lot. NO. <T
4 3. Type of Structure w f M No. of Bedrooms
(De W ing,commercial Building,Store,etc.)
j 4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs _
Showers_, Kitchen Sinks l Laundry Tubs Garbage Grinder /' Other
6. Liquid Capacity of Septic Tank / 2 / Material of Septic Tank ( . �' c r-c 4, _�7�/0
7. Soil Conditions: Type of Soil >r2 I Maximum ground water table /
(Sand,Gravel,clay,etc.) I_
8. If not served by public water supply: Distance from Owner's well !I�a 7 I[ 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 -_e 4
12. Leaching System: Number of trenches Length Z>4d Width 5 Total -tea d fW
Other Z�2 ��7 4/
Signature
(Licensed Installer)
(Sketch showing all minimum distances and other details requir, elow)
Permit Issued 19 By
Installation Completed, Inspected and Approved ig By