HomeMy WebLinkAboutSeptic New 210 Scott Drive 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.�r 1 Z
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 Property rC ii: O �00 b2 i Lot. No.�
1 /
3. Type of Structure
No. of Bedrooms
(Dwel i g,Com ercial 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 Tank`°� O Material of Septic Tank��!c#I If -�
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, stormdrain or embankment/
10. Percolation Tests: Time for 1" drop in soil test l k-^ , A Classification of soil
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches Length S I o _ WidthTotal
Other
Signatu
(Licensed In.tall
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
LAND OF CHR(STENSEN
/45. 25'
59 ro o �14 e3
66
- -- - o
40" 22 40 >--
i
149.12' ;
ty
SCOTT DRIVE
FERMIT FLAN
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