HomeMy WebLinkAboutSeptic Repair 20 Plum Lane TOWN OF SOUTH Wl D N SOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Applicati t No,
TO THE BUILDING DEPARTMENT: Date ' -2 19�
A permit is requested for repair or construction of an individual sewage disposal syste concerning which the
following information is sub itted
1. Owner of Property - ✓ Address of Owner
2. Location of Property Lot. No.
3. Type of Structure No. of Bedrooms_
(Dwelling mercial Building,store,etc.)
4. Number of Families or P-e=ns to Occupy Premises_ 14-
5. Plumbing Fixtures: Water Closets Urinals Lavatories - Bathtubs
Showers Kitchen Sinks Laundry ubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank ?'3 i2- Material of Septic Tank � ti
7. Soil Conditions: Type of Soil 1� 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 soil
11. Minimum square feet of effective seepage area required
12. Leaching System:�Numbr of trenches,,, Width ,3' Total ?o C,
Other v
i
Signature
(Licensed Installer)
(Sketch showing allminimn distances and other details required below) "
' I
�i ' ace
Permit Issued 19 By
l Installation Completed, Inspected and Approved 19 By
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