HomeMy WebLinkAboutSeptic New 66 Orchard Hill Drive ► _s - r
TOWN OF SOUTH WINDSOR
v BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal S st
Application No. //
TO THE BUILDING DEPARTMENT: Date._ CT 19b�
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted: An hon of
y non 2_1. Owner of Property Addvess of Owner I•V1 cA e-3 4 e
2. Location of Proper KC ?� c
Lot. No.
3. Type of Structure ci.l e
No. of Bedrooms
( welli g,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets Urinals Lavatories__ Bathtubs
Showers/ Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tan O Material of Septic Tank c H c+t rYe 1
7. Soil Conditions: Type of Soil .t Maximum ground water table__
(Sand,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well_- t c from adjacent wells
9. Distance to nearest water course, drainage ditch, storm drain or embankment
10. Percolation Tests: Time for V drop in soil test Classification of soil
11. Minimum square feet of effective seepage area required G G
12. Leaching System: Number of trenches Lengt li: ( Widt Total —
Other
Signature
(Licensed Installer)_
(Sketch showing all minimum distances and other details requir,4a below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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