HomeMy WebLinkAboutSeptic New 123 Orchard Hill Drive TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal 'Ste
Application No.
TO THE BUILDING DEPARTMENT: Date 149 S1f- Ige
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted: J* IneS gk4,--,gA z r
1. Owner of Property re of Owne P
2. Location of Property
Lot. No.�_
3. Type of Structure w 0 r4' No. of Bedrooms
(Dwelling,C mercial uilding,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 Tank- Material of Septic Tank vti
7. 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 k Ji C
from adjacent wellsL.
9. Distance to nearest water course, drainage ditch, storm drain or embankment
10. Percolation Tests: Time for 111 drop in soil test / - Classification of soil
11. Minimum square feet of effective seepage area required S o d
12. Leaching System: Number of trenches y Length, Q 0 Width 6 �� Total -31"'0 r
Other
Signature
(Licensed Installer)
(Sketch showing all minimum distances and other details requir below)
Permit Issued lg By
Installation Completed, Inspected and Approved 19�_ By
90 0 /5�9.oa qe
LOT 52 LOFT 57 LIST 5Q
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�58.00
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FOR BUILDING PURPOSES ONLY q
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