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Home My WebLink AboutSeptic New 20 Tudor Hill Road 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 7-,/ 19 Zr A permit is requested for repair or construction of an individual sewage disposal system concerning which the following information is subm' ted: 1. Owner of Property Addr ss of Owner 2. Location of PropertyZv Lot. No. S 3. Type of Structure No. of Bedrooms (Dwelling,Compiercial /Building,Store,etc.) 4. Number of Families or Persons to Occupy Premises_ ( 5. Plumbing Fixtures: Water Closets Z Urinals Lavatories Z Bathtubs _ Showers Kitchen Sinks_L_ Laundry Tubs Garbage Grinder Other 6. Liquid Capacity of Septic Tank 0 a _Material of Septic Tank L 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, 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 ✓2 '/ 12. Leaching System: Number of trenches --3 Length r Width Total -3 S Other Signature (Licensed Installer) (Sketch showing all minimum distances and other details required below) Permit Issued 19 By Installation Completed, Inspected and Approved 19 By ! (A tt 5 l s a G✓U I � � �j V � � < 7 r 7 Ile f P { r "t Ms ti �L } 61 - 16J'go 1 I { �� © �� (✓ �� tom'�w�a\ F t I s c l I 1 Scnt � t 3CJ �. �ff