HomeMy WebLinkAboutSeptic New 00 Wendy Drive (2) 4
TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No. //Ot/
TO THE BUILDING DEPARTMENT: Date 194
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted:
I. Owner of Property Address of Owner
2. Location of Proper,
Lot. No.
3. Type of Structure No. of Bedrooms
(Dwelling, mercial Buildingj,Store,etc.)
4. Number of Families or Persons to Occupy Pre
5. Plumbing Fixtures: Water Closets Urina ! Lavatories 01-1— Bathtubs ✓
Showers / Kitchen Sinks r Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank 1WM4V Material of Septic Tank_..wa.� .
7. Soil Conditions: Type of Soil "' Maximum ground water table
(San ,Gravel,Clay,etc.)
t
8. If not served by public water supply: Distance from Owner's well adjacent wells
9. Distance to nearest water course, drainage ditch, storm drain or embankment
10. Percolation Tests: Time for V drop in soil test Classification of soil
11. Minimum square feet of effective seepage area required '3,2'S
12. Leaching System: Number of trenches y Length �J�C� Width � Total
Other 7-- --�
Signature- j ��,;�
(Licensed Installer)
(Sketch showing all minimum distances and other details required below)
Permit Issued 1 g By
Installation Completed, Inspected and Approved 19 By
BUILDING P RPOSES ONLY s 1 � r
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