HomeMy WebLinkAboutSeptic New 38 Tudor Hill Road TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System QdQ
Application No.
TO THE BUILDING DEPARTMENT: Date._ F-- l(� 19
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submi ed:
1. Owner of Property Address 9f Owner
2. Location of Property 3 8 Lot. No.
3. Type of Structure No. of Bedrooms_
(Dwelling, ommercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ ((
5. Plumbing Fixtures: Water Closets 2, Urinals Lavatories 2_ Bathtubs J
Showers Kitchen Sinks_ Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank D d C7 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 ;;I-,J am- Classification of soil
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches -3' Length Width Total �J
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
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