HomeMy WebLinkAboutSeptic New 81 Scott Drive A
TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal Systern�/, &
Application No.
TO THE BUILDING DEPARTMENT: Date%�� 19
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 � C �- �fj�q Address of Owner —
2. Location of Proper I/?//G/7 • ,fy� �� �� ac�0 ot. No.
3. Type of Structure
(Dwelling,Commercial Building,Store,etc.) NO. Of Bedroom
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets Urinals ,/ Lavatories _ Bathtubs
Showers_ Kitchen Sinks___ / �_L�aundry Tubs Garbage Grinder Other Y---
6. Liquid Capacity of Septic Tan Material/6r V Material of Septic Tankj-�Z_
s
7. Soil Conditions: Type of Soil � Maximum ground water table
a ,Grav ,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� rt Classification of soil
11. Minimum square feet of effective seepage area required__
12. Leaching System: Number of trenches Length—e?�� Widt � / Total
Other ,. �� �/Z/
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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7 LOT #117, "BIRCH HILL ESTATES"
SECTION #6
TOWN OF SOUT11 WINDSOR, CONNECTICUT
SCALE: 1" _ 40' d/
39
9-5=67 Rockville, Conn .