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HomeMy WebLinkAboutSeptic Repair 165 Scantic Meadow Road TOWN OF SOUTH WI N DSOR BUILDING DEPARTMENT South Windsor, Connecticut a s Application for Permit to Install or Repair Individual Sewage Disposal Sy ten Application No. TO THE BUILDING DEPARTMENT: Date,_,/, L/ 19 <S� 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 Address o& Owner 2. Location of Property C S Lot. No. 3. Type of Structure (Dweliin ud No. of Bedrooms mmercialBu 3 ling,Store,etc.) 4. Number of Families or Persons to Occupy Premises_. -5-- 5. Plumbing Fixtures: Water Closets / Urinals / Lavatories_ / Bathtubs / Showers ( Kitchen Sinks Laundry Tubs Garbage Grinder Other 6. Liquid Capacity of Septic Tan 5�©. terial 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 Classification of soil 11. Minimum square feet of effective seepage area required 12. Leaching System: Number of trenches Len th Width`2 Total Other j Signature L$;- -- ----—---ss (Licensed Installer) (Sketch showing all minimum distances and other details required below) V, I �Xi1�i�/►/g S� Yy Permit Issued 19 By Installation Completed, Inspected and Approved 19 By