HomeMy WebLinkAboutSeptic New 111 Orchard Hill Drive TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No. / 7 TO THE BUILDING DEPARTMENT: Date _-�� ' I qZa�
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted:
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1. Owner of Property Adrs of wner.__�
2. Location of Property i Lot. No.�
3. Type of Structure E' 1 lC No. of Bedrooms
Dwells 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
Other
6. Liquid Capacity of Septic Tan ® Material of Septic Tank ( �1 M C it�Q�iC4,�Irs
7. Soil Conditions: Type of Soil a V$ Maximum ground water table
(Sa Gravel,Clay,etc.) I 1
8. If not served by public water supply: Distance from Owner's well �lt b 1 LAC 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 �b''/ ,i �� Classificati n of soil
11. Minimum square feet of effective seepage area required I® ® 7
12. Leaching System: Number of trenches Length d 61 Widt / i
Total— 0 _
Other lB ° Z 'I...
Signatur
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(Licensed Installer)
(Sketch showing all minimum distances and other details required ow)
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Permit Issued 19 By
Installation Completed,Inspected and Approved 19 By
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LOT' 47
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LOT 53 L bT 52 LOT 51
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