HomeMy WebLinkAboutSeptic New 127 Palmer Drive TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal Systtee
Application No. '`✓lE�
TO THE BUILDING DEPARTMENT: Date 19 J
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 �� 7"/� �!L�' ' Address of Owner /'' "yam'�Xu'�� -2.
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2. Location of Property l� -2y u 2 l Z�L `��%v� �f �^�. '._ Lot. No.
3. Type of Structure No. of Bedrooms
(Dwellit1g,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ JL�l�4-�-
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs
Showers Kitchen Sinks Laundry Tubs Garbage Grinder,�'�zj_,' _Other
6. Li quid Ca of Se Tank ( .Z .� Q '
q Capacity Septic Material of Septic Tank Cry yZ acit -
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 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 Classification of so'
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches Length Width I-e Total
Other {�
Signature
(Likened Installer) Q
(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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