HomeMy WebLinkAboutSeptic New 90 Scott Drive TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System-21/1-/&-s�
Application No. M
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 Address of Owner
2. Location of Propert 9� �eoTT�,e�J Lot. No. y//.3
7 3. Type of Structure No. of Bedrooms_
(Dwelling,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 Tan 2daterial of Septic Tank__1f��
7. Soil Conditions: Type of So is(Sa Maximum ground water table
,Gravel,Clag,a c.)
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 3, a Classification of soil
11. Minimum square feet of effective seepage area required is
12. Leaching System: Number of trenches Lengthy ' Width Total
Other
Signature
censed Installer)
(Sketch showing all minimum distances and other details requite below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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24' GAQ22
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55'r
90.00
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SC—OTT DP—IVE
PEt�MIr P>•.AiV
LOT # 113, BIRCH HILL ESTATES, SECTION 6,
TOWN OF S. WINDSOR, CONN. Scale: 1"$ .50 '
—�r�.- .p; �,t , . _,,�r+�• ,, L.S . 4395
MAY 3( , Rockville, Conn„