HomeMy WebLinkAboutSeptic Repair 184 Woodland Drive TOWN OF SOUTH WINDSOR �'i
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BUILDING DEPARTMENT /i
South Wind Connecticut ' 3l��ZG,
Application for Permit to Install or;T epair� Individual Sewage Disposal System
t
l`��•-' Application No.
TO THE BUILDING DEPARTMENT:
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 Lot. No. g
3. Type of Structure R
ing,Commercial Building,Store,etc.) No. of Bedrooms
4. Number of Families or $sons to Occupy Premises__ 14
5. Plumbing Fixtures: Water Closets / Urinals Lavatories_ Bathtubs
Showers I Kitchen Sinks Laundry Tubs Garbage Grinder O er
6. Liquid Capacity of Septic Tank 00 Material of Septic Tank
7. Soil Conditions: Type of Soil Maximum ground water table
(Sand,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 V drop in soil test Classification of soil
11. Minimum square feet of effective seepage area required
12. Leaching System: Number of trenches_ L ngth Jr-® Widt Total /D
Other
Signature J X1X
(Licensed Installer)
(Sketch showing all minimum distances and other details required below)
Permit Issued 19 By
Installation Completed,Inspected and Approved_ 0l 6e-9,FL 19� By ev
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