HomeMy WebLinkAboutSeptic New 80 Orchard Hill Drive TOWN OF SOUTH WI N DSU
BUILDING DEPARTMENT . . '
South Windsor, Connecticut
Application for Permit to Install or. Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date 7
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted: - at ,s
1. Owner of Property Address of O ner -
2. Location of Property,\J r Q if T21 4 Lot. No. 6
3. Type of Structure �" a V'J f No. of Bedrooms
(Dwelling, ommercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets 2 Urinals Lavatories_ Bathtubs
Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank �,l d U Material of Septic Tank C v e Fe f..J
7. Soil Conditions: Type of Soil �v 2 J e- t Maximum ground water table
JeSand,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well t I,k 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 —3 Classification of soil
11. Minimum square feet of effective seepage area required X—17
eF
12. Leaching System: Number of trenches Length /J i� Width N C Total
Other 6
Signature
(Licensed Installe
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed,Inspected and Approved 19 By
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