HomeMy WebLinkAboutSeptic New 106 Mountain Drive ti
TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date v 19 1�
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted:
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1. Owner of Property d s of�Owner
2. Location of Property Ob u i�/��WY C� Lot. No.
3. Type of Structure No. of Bedrooms
( ellng,Co mercial Building,Store,etc.)
4. Number of Families or Persons to Occup Premises_
5. Plumbing Fixtures: Water Closets Urinals Lavatories_ Bathtubs_
Showers _ Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank. 2 � Material of Septic Tank Pi h C / e
7. Soil Conditions: Type of Soil ►'a Maximum ground water table
( and,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 drain or embankment
10. Percolation Tests: Time for 1" drop in soil test 5�/-? Classification of soil
11. Minimum square feet of effective seepage area required n�
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12. Leaching System: Number of trenches Length �_ Width—s Total C>O
Other ZD ;j/O
Signature
(Licensed Installer)
(Sketch showing all minimum distances and other details required ow)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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