HomeMy WebLinkAboutSeptic New 23 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_ 41 — - C. 19 1p
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 Address of Owner
2. Location of PropertyZS Lot. No. _
3. Type of Structure No. of Bedrooms
(Dwelling ommercial Bu
ilding,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets 2, Urinals Lavatories 2 Bathtubs _
Showers 4_ Kitchen Sinks r 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 -,7.—, -
(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 -3, 10 Classification of soil
11. Minimum square feet of effective seepage area required �Z,
12. Leaching System: Number of trenches Length Width Total d
Other
Signature
icensed 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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