HomeMy WebLinkAboutSeptic New 245 Scott Drive TOWN OF SOUTH WI N DSOR
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BUILD,ING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No,
TO THE BUILDING DEPARTMENT: Date_„-2 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 UI _ _ Address of Owner Q��
2. Location of Property I (,J Lot. No.—/
3. Type of Structure No. of Bedrooms
(Dw 1 ing,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 Tank /.V 6-0 Material of Septic Tank
7. Soil Conditions: Type of Soil Maximum ground water table
(sand,-GrSkei IF
lay,e 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 6j/1z2.//11.q Classification of soil
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches Length) Width r LZ� Total
Other
Signatur
(License 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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