HomeMy WebLinkAboutSeptic New 200 Scott Drive r
TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date. 7 — / Z.- 19
A permit is requested for repair or construction of an individual sewage disposal system concerning whic
following information is submitted h the
I. Owner of Property Address of Owner
2. Location of Property &1 �� r Zap �a� 4L G'
F
Lot. No.
3. Type of Structure �v No. of Bedrooms_
(Dwelling,Com ercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets-1-3Urinals Lavatories Bathtubs_
Showers Kitchen Sinks_ Laundry Tubs Garbage Grinder ' Other
_
6. Liquid Capacity of Septic Tank z�.� a Material of Septic Tank (r u C r C
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 to ZrO
12. Leaching System: Number of trenches Length—,a��— Width eG
Total
Other
Signa
(Licensed Install
(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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50'
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55,+
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