HomeMy WebLinkAboutSeptic New 41 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 .-rJWK /V 19 6 S'
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 F+ ,didX of z6d Address of Owner. 42 GAW
2. Location of Property+I T4�� L gr{ Lot. No.
3. Type of Structure �t/G=- No. of Bedrooms_
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ O 4-19
5. Plumbing Fixtures: Water Closets 2 Urinals Lavatories Bathtubs_
Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tan Gl G'v Material of Septic Tank r,7 2 vC!- r✓
7. Soil Conditions: Type of Soil el /f Maximum ground water table
Sand,Gravel,Clay,etc.
8. If not served by public water supply: Distance from Owner's well r _'�from adjacent wells �r
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_��
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11. Minimum square feet of effective seepage area required / J,
411-
12. Leaching System: Number of trenches Length Width G Total
Other
Signature t
(Licensed Installer)
(Sketch showing all minimum distances an$ 16other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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