HomeMy WebLinkAboutSeptic Repair 00 Windsorville Road (7) 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 of an individual sewage disposal system concerning which the
following information is sub 'tted:
1. Owner of Property Address of Owne 2
2. Location of Prope .3
ot. No..
3. Type of Structure No. of Bedrooms_
( e 1 g, mercial Building,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets 2 Urinals Lavator es 21 Bathtubs _
Showers Kitchen Sinks______ Laundry Tubs Garbage Grinder ther _
6. Liquid Capacity of Septic Tan 0 aterial of Septic Tank
7. Soil Conditions: Type of Soil Maximum ground water table -V-_
(Sa}�,(,•avel,C a ,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 s� Classification of soil
11. Minimum square feet of effective seepage area required_
12. Leaching System: Number of trenches_ N-7 Length Total If
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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FOR BUILDING PURPOSES ONLY
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