HomeMy WebLinkAbout1968-2-8 - 10 Edgewood Drive - Septic ApplicationTOWN OF SOUTH WI N DSOR
BUILDING DEPARTMENT
South Windsor, Connecticut f�
Application for Permit to Install or Repair Individual Sewage Disposal System
Applic 'on No.
TO THE BUILDING DEPARTMENT: Date 19 C�
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 //1%rY _Address of Owner � �:•`�"�
S�
2. Location of Property — Lot. No. S 3
3. Type of Structure ��'"� No. of Bedrooms
4. Number of Families or Pe;, -Am to Occupy Premises
5. Plumbing Fixtures: Water Closets 1 Urinals Lavatories / Bathtubs
Showers�Kitchen Sinks Laundry ubs Garbage Grinder Other
6. Liquid Capacity of Septic Tank Sb Material of Septic Wank
7. Soil Conditions: Type of Soil Maximum ground water table
( and. Grave], Cl.'. 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
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12. Leaching System: Number of trenches 3 L �h Widt 2 a Total
C3tlier 71 _
Signa
(Sketch showing all minimum distances and other details required below)
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4'
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Permit Issued 19 By
Installation Completed, Inspected and Approved ne 43PIOA-19108
By