HomeMy WebLinkAboutSeptic New 00 Popular Drive ,t
TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: ,4 19 �T
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted:
t 1. Owner of Property. /i0i( � Address of Owner �y
2. Location of Property Lot. NoO
# 3. Type of Structure /LfJL'��i/t/ No. of Bedrooms
(Dwelling,Co ercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ d r>«
5. Plumbing Fixtures: Water Closets .Z Urinals Lavatories_ - Bathtubs
Showers _ Kitchen Sinks / Laundry Tubs_ Garbage Grinder Other
6. Liquid Capacity of Septic Tank /,:04 Material of Septic Tank Oo /(r,
7. Soil Conditions: Type of Soil Maximum ground water table
(Sand, ravel,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 soila -
11. Minimum square feet of effective seepage area required -:-, -J�
12. Leaching System: Number of trenches—S12 Length - /a Width %?�V
Other
Signature
(Licensed installer)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
CCT '# 39
POP!-AR ROAD
SOUTH W INDSOR , CONN
112
87 7
i 1 _
L--------- -� ---
PCPLAR ROAD
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