HomeMy WebLinkAboutSeptic New 136 Rye Street 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: Date_ =,��
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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1. Owner of Property Address of Owner
2. Location of Property i. Lot. No.
3. Type of Structure No. of Bedrooms
g Dwelling,CommercialP14pwngl
Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets Urinals Lavatories Zr Bathtubs
Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank, ?a Material of Septic Tank
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 Z Classification of soil
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches � Length Widtk--c->/2 Total ��
Other
Signature
( c d I taller)
(Sketch showing all minfirnum distances and other data s ired below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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PT T PLAN FOR
KEITH HIi.jZ
SOUTH WINDSOR, CONN.
Note ;
There is no building built
Th�r. efors there Fire no violatirzag
of the zoning oral inarces .
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NO. 1594
!HEOEBY CERTIFY.THAT THIS
,U85TAMALLY CORRECT ;