HomeMy WebLinkAboutSeptic Repair 70 Scantic Meadow Road TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date � 19-y�_
A permit is requested for repair or construction of an individual sewage disposal stem concerning which the
following information is submitted:
1. Owner of Property +t�A� �vl-1' - Address of Owner
�4�2. Location of Property 70 J c
;C' l t cx apt' Lot. No.
3. Type of Structure 7
(Dwelling,Com cial Building,Store,etc.) No. of Bedrooms
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets__ Urinals Lavatories_ Bathtubs_
Showers_ Kitchen Sinks __ Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank 7 .s C� Material of Septic Tank C--,0 fL -CA
7. Soil Conditions: Type of Soil a( ,c 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: Number of trenches Length Width Total
Other
Signature ��t�t_
'(Licensed Installer)
(Sketch showing all minimum distanc and other details required below)
�i
t
Permit Issued 19 By ,
Installation Completed,Inspected and Approved 19 By