HomeMy WebLinkAboutSeptic New 131 Hilton Drive (2) TOWN OF SOUTH WI N DSOR to (Yy 3 4 01-
BUILDING DEPARTMENT
South Windsor, Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
Application No.TO THE BUILDING DEPARTMENT: Date z LGL 9 �J
0
A permit is requested for repair or construction of an individual sewage disposal system concerning which the
following information is su mitted:
1. Owner of Property_la VA) ?&P=4 W&:�f Address of Owner
2. Location of Property Lot. No.
3. Type of _SL Structure (DweIling,Commercial BUildi g,Store,etc.) No. of Bedrooms
4. Number of Families or Persons to Occupy Premises—(
5. Plumbing Fixtures: Water Closets Urinals ""—'" Lavatories _ Bathtubs,__/ __
Showers Kitchen Sinks_ LLa indry Tubs Garbage Grinder Other ���✓/ ✓�
6. Liquid Capacity of Septic Tan Material of Septic Tank / ICE/
7. Soil Conditions: Tround water tabIAti
Type of Soil L— MaxMaximup}
(Sand,Gra el,Clay,etc.)
8. If not served by public water supply: Distance from Owner's well f3L(C from ad'�jcent wells
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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 r �'
12. Leaching System: Number of trenches '� Length Width j Total 04✓ ,44
Other .�-
1 �+
Signature G
fl( icensed Installer)
(Sketch showing all min' istance an other . elil ,r�.quired below)
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Permit Issued 19 By
Installation Completed, Inspected and Approved 19 By
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