HomeMy WebLinkAboutSeptic New 54 Northview Drive ` � �)A �
r� TOWN OF SOUTH WI N DSOR
BU I LDI.NG DEPARTMENT
South Windsor, Connecticut
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Application for Permit to Install or Repair Individual Sewage isposal ystem
Application No.
TO THE BUILDING DEPARTMENT: Date 19
A permit is requested for repair or construction of an individual sewage di posal system concerning which the
following information is submitted:
1. Owner of Property- Address of Owner �y �2 z"'2 JO wl
2. Location of Property — Lot. No.
3. Type of Structure No. of Bedrooms 3
(Dwellin ommercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ -P//-,I vy�
5. Plumbing Fixtures: Water Closets L Urinals Lavatories Bathtubs
Showers L Kitchen Sinks Laundry Tubs G Garbage Grinder Other,
6. Liquid Capacity of Septic Tank 9D0 &,A 4 a^Js" Material of Septic Tank 4,
7. Soil Conditions: Type of Soil Maximum ground water table /-r�-
(Sand,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well from adjacent ells
9. Distance to nearest water course, drainage ditch, storm drain or embankment / SJ
10. Percolation Tests: Time for 1" drop in soil test lti►2 Classification of soil
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches Length -4-0 Widt Total 2 dd
Other
Signature
(I.icensedInstal er)
(Sketch showing all minimum distances and other details required below)
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Permit Issued 19 By
Installation Completed, Inspected and Approved 10 .°4ik 19_! 4 By