HomeMy WebLinkAboutSeptic New 30 Oakland Road n
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_ /4/ 19
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is s bmitted:
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1. Owner of Property l-Y Address of Owner
' 2. Location of Property Lot. No.
3. Type of Structure r No. of Bedrooms
r (Dwe nVises
mmercial Building,Stop etc.)
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4. Number of Families or Persons to Occupy Pre _
5. Plumbing Fixtures: Water Closets Urinals Lavo ries Bathtubs_
Showers Kitchen Sinks_ Laundry Tubs_ Garbage Grinder Other
6. Liquid Capacity of Septic Tank Material of Septic Tank, �o �r
?. Soil Conditions: Type of Soil Maximum ground water table
(sand,Gravel,clay,etc.)
8. If not served by public water supply: Distance from Owner's well �b'S�� from adjacent wells 7-!57'iG
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
12. Leaching System: Number of trenches th Width Total
Other
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Signatureo
(Licensed Installer) -
(Sketch showing all minimum distances and other details required below)
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Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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