HomeMy WebLinkAboutSeptic New 47 Scantic Meadow Road f� TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT 3 44�
C+► 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:
1. Owner of Property _LLZejWA1ddress of Owner
2. Location of Property Lot. No.
3. Type of Structure No. of Bedrooms_
(Dwelling,Commer/ci�al Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_CO 1,1,6:7—
5. Plumbing F'xtures: Water Closets i� Urinals Lavatories Bathtubs
Showers Kitchen Sinks_ _ Laundry Tubs""' Garbage Grinder Other Djj
6. Liquid Capacity of Septic Tan `O - . Material of Septic Tank�Jl
7. Soil Conditions: Type of Soil.(/Q Maximum ground water table
( and ravel,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well •om adjacent wells
9. Distance to nearest water course, drainage ditch, st m r in
embankment 0 Z/
10. Percolation Tests: Time for 1" dropm soil test Y O�
� - Classifi ation of soil
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches 4ZA Length Width Tota16 0
Other Cf/ Cu
L�
Signature - G
censed Installer
(Sketch showing all minimum di tances and her details require "Now)
F '~L
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740,
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Permit Issued 19 By TT
Installation Completed, Inspected and Approved Lt duOA 19 40 9 By
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