HomeMy WebLinkAboutSeptic New 94 Orchard Hill Drive TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal 5ystemi,
Application No. /
TO THE BUILDING DEPARTMENT: Date o 19 b —
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted:
1. Owner of Property A ess of Owner
94' II �j n
2. Location of Property c�'`? v4 r d r C " Cl Lot. No.�_
3. Type of Structure � �'f_/.y 9 No. of Bedrooms
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(Dwelling,Cgrinmercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs
Showers / Kitchen Sinks r Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank I S—o U Material of Septic Tank_ 00 cr e 4-e j�y Y o w
7. Soil Conditions: T ( � --*Type of Soil J Q r a"-e I Maximum ground water table
(Sand,Gravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well 1 I C 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 her ® .. Classification of soil
11. Minimum square feet of effective seepage area required � 0S a'
12. Leaching System: Number of trenches Length �a Width _ Total
Other 4 �Z JtQ J*
Signature
(Licensed Inatalle ;Oz�Y��
(Sketch showing all minimum distances and other details requir below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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OR BUILDING PURPOSES ONLY _ t L L t 12