HomeMy WebLinkAboutSeptic Repair 17 Wild Rose Drive 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: Da' J 19
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 Address of Owner
2. Location of Property �� 13
I to.
.ot. /L5
3. Type of Structure r No. of Bedrooms -e-
(Dwe g,commercial Budding,Store,etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets lia Urinals Lavatories---c2- Bathtubs _
Showers__ Kitchen Sinks / Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank Material of Septic Tank---� Ql
7. Soil Conditions: Type of Soil Maximum ground water table
(sand,uravel,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 Length Width (mac _ Total
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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!'r0)'EPTY OF
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NO . 'WILD ROSE DRIVE SOUTH W I 'd)SOR, CONN.
Reinq Lot No. 15 on a►,v, entith-d "FINE HILL_ EtiT,,\TES Addition
No. I South Windsor, Conn. :cafe 1 " 40' March 10, 1 6.
Griswold Engine.ering Inc. "
Sea f P I = 40' SEAT- �„ _. ► Q .__,._:
GR I SWO LD ENO I INE I " �� I PdC