HomeMy WebLinkAboutSeptic Repair 158 Scantic Meadow Road TOWN OF SOUTH WINDSOR ��og
33 Yelzo BUILDING DEPARTMENT �Fgs ,*A✓ Sb `J
Plu.n hr.79- i#29 &-7 South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date
41 19
A permit is requested for repair or construction of an individual sewage di posal system concerning which the
following information is submitted:
1. Owner of Property---,,-
roperty Address of Owner.
2. Location of Property
/ Lot. No.
3. Type of Structure ! No. of Bedrooms
( welling,Commercial Building,Store,etc.)
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 Material of Septic Tank
7. Soil Conditions: Type of Soil
Maximum ground water table
(Sand, a 1,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 V drop in soil test Classification of soil
11. Minimum square feet of effective seepage area required
12. Leaching System Number of trenches
/ Length 7S^ Width__ Total o
Other-
add
gnature
( �Instaiier)'
/ (Sketch showing all minimum distances and other details required below)
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Permit Issued
Installation Completed, Inspected and Approved_ /7 fct.J£ 19�_ By_/�Gu� �t ��