HomeMy WebLinkAboutSeptic New 8 Scott Drive TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System Q
Application No/ /�l
J 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 %�i�� Address of Owner_ � ��'�✓�/ �f�',��
2. Location of Pro pert /
P Y�� i �''c `� � r ' L"J � �@c77�1 d I. Lot. No.
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3. Type of Structure No. of Bedrooms
(Dwelling,Co ercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs '.
1
Showers_ Kitchen Sinks ; Laundry Tubs_ __ Garbage Grinder Other
6. Liquid Capacity of Septic Tank % S` J Material of Septic Tank
7. Soil Conditions: Type of Soil S.�, 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 v. :• Classification of soil
11. Minimum square feet of effective seepage area required
12. Leaching 5yst : Number of tr c s� Len I Widt - / Total 3
Other ' �.� _ _ , ii�.• 4 '��
Signature
(Licensed Installer -
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By '
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