HomeMy WebLinkAboutSeptic New 41 Sunnyside Drive TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Appli ion No.
TO THE BUILDING DEPARTMENT: Date
A permit is requested for repair or construction of an individual se disp 19
al system concerning which the
following information is submitted:
1. Owner of Property Address of ��Owner
2. Location of Property ola4dN SIbE 'l¢t✓L Lot. No. Ca
3. Type of Structure
D elling,Commercial Building,Store,etc.) No. of Bedrooms
4. Number of Families or Persons to Occ py Premises_.
5. Plumbing Fixtures: Water Closets :�!_____ Urinals Lavatorie
Bathtubs, _
Showers Kitchen Sinks ___ Laundry Tubs Garbage Grinder Other I
6. Liquid Capacity of Septic Tank /,2 �Zj Material of Septic Tank J
7. Soil Conditions: Type of So' 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 embank
10. Percolation Tests: Time for 1" drop in soil test Claftification of soil
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches_ Length 3 Width �� Total
Other
Signature:: -�—
(License I 11
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By