HomeMy WebLinkAboutSeptic Repair 5 Steep Road TOWN OF SOUTH WI N DSORzo.
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System���„f/
Applica ' No
TO THE BUILDING DEPARTMENT: Date. 02, 19 C7
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitte
1. Owner of Property Address of Owner ����/ - S•K/
2. Location of Property--- a Lot. No.
3. Type of Structure c% No. of Bedrooms S
(DwellisM ommercial Building,Store,etc.)
4. Number of Families or lZasons to Occupy Premises_
5. Plumbing Fixtures: Water Closets f Urinals _ Lavatories % Bathtubs
Showers I Kitchen Sinks_/ Laundry ubs / Garbage Grinder Other
6. Liquid Capacity of Septic Tank /ban Material of Septic Tank
7. Soil Conditions: Type of Soil (Sand,Gravel,Clay,etc. Maximum ground water table
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
12. Leaching System: Num er of trench e 3r' Length ` 7 Widt � Total `/0
Other
Signature
(Licensed Installer)
(Sketch showing all minitnum distances and other details required below)
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Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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