HomeMy WebLinkAboutSeptic Repair 00 Windsorville Road (6) TOWN OF SOUTH WINDSOR
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No.
TO THE BUILDING DEPARTMENT: Date _ 19�
A permit is requested for repair or construction f an individual sewage disposal system concerning which the
following information is sub itted:
1. Owner of Property Address of wner
2. Location of Prop Lot. No. ��-
3. Type of Structure No. of Bedrooms_(Dwelling,Co ercial Building,Stor etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets Urinals Lavat les---2 Bathtubs_
Showers Kitchen Sinks_ Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank Material of Septic Tank
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7. Soil Conditions: Type of Soil Maximum ground water table
S nd,Grav ,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 Classification of soil
11. Minimum square feet of effective seepage area required / ~
12. Leaching System: Number of trenches 117 Length !o Width o�.--4
Total ® �
Other
01 _
Signatur
Licensed Inst�Ilr)
(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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