HomeMy WebLinkAboutSeptic New 144 Orchard Hill Drive TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal S stem
Application No. �...�
TO THE BUILDING DEPARTMENT: ,lJ — sa 19
Date
i 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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I. Owner of Property ddress of Owner---
2. Location of Property i Q
fir/
Lot. No.
3. Type of Structure c.V f �/
(Dwelling,Con ercial Building,Store,etc.) No. of Bedrooms
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 h C"C l
r ry wJ
7. Soil Conditions: Type of Soil_ V aV e Maximum ground water table
(Sane,-travel,Ciay,etc.)
8. If not served by public water supply: Distance from Owner's well �` ���
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 �v� , .�
Classification of soil
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches _ Length
Len
g - � Widths O Total �G d
Other
Signature
(Licensed Install
(Sketch showing all minimum distances and other details req d below)
Permit Issued 19 By
Installation Completed, Inspected and Approved
19 By
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FOR BUILDING PURPOSES Oil,
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