HomeMy WebLinkAboutSeptic New 00 Strong Road (5) V
TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal SysteW1'd'Vq
Application No.
TO THE BUILDING DEPARTMENT: Date '&,d 1 ems" 19 e2�
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 Proper 42 U Lot. No.
3. Type of Structure No. of Bedrooms_
(Dwelling, ommercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ dZN:ems
5. Plumbing Fixtures: Water Closets .7 Urinals Lavatories -1 Bathtubs
Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank ` Material of Septic Tank
7. Soil Conditions: Type of Soil Maximum ground water table .�..
and,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 ✓J-
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: Number of trenches _ Length Width Total
Other
Signature
(Licensed Installer)
(Sketch showing all minimum distances and they details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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