HomeMy WebLinkAboutSeptic New 00 Wendy Drive (7) TOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No. 74�z1
TO THE BUILDING DEPARTMENT: Date. 19 L)
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is submitted:
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1. Owner of Property "�yJ�d Address of Owner__
2. Location of PropertyV Lot.. No. �.
3. Type of Structure No. of Bedrooms
(Dwelling,Commercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_ T
—4
5. Plumbing Fixtures: Water Closets — Urinals LL Lavatories__y Bathtubs_
Showers_ Kitchen Sinks Laundry Tubs Garbage Grinder Other_
6. Liquid Capacity of Septic Tank 0 d L _Material of Septic Tank e,,1, ,j�
7. Soil Conditions: Type of Soil 0441, Maximum ground water table /l 1
(Sand,Gravel, ay,etc.)
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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
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11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches_ Length lJ ; Width / Total
Other Yd/ O
Signature_��4( icense�— `�+�a
Installer)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
MM PURPOSES ONLY
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