HomeMy WebLinkAbout1966-7-17 - 18 Edgewood Drive - Septic ApplicationTOWN OF SOUTH WI N DSOR ;'
BUILDING DEPARTMENT cgi/-3
South Windsor, Connecticut Ey 2 D
Application for Permit to Install or epai Individual Sewage Disposal Sysee
Application No. _
TO THE BUILDING DEPARTMENT: Date 19
A permit is requested fo repa r construction of an individual sewage disposal system concerning which the
following information is submitted:
1. Owner of Property }�0 n] �7 / E(_ Address of Owner Id- Z, 'Y &P
2. Location of Property �/� �� Lot. No.-S�
3. Type of Structure _ No. of Bedrooms —
(Dwelling, Commercial Building, Store, etc.)
4. Number of Families or Persons to Occupy Premises_
5. Plumbing Fixtures: Water Closets Urinals Lavatories Bathtubs
Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other
6. Liquid Capacity of Septic Tan ., (fo Material of Septic Tank
7. Soil Conditions: Type of Soil Maximum ground water table
(Sand, Gravel, 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" i d Width 1� i'7 Total 64 f d
Other
Signature
(License nstaller)
(Sketch showing all minimum distances and other details required below)
Permit Issued__ —.19 By
Tu
Installation Completed, Inspected and Approved I "_.-b' 113y
CHECKED
I
SCALE
CEJRTIFiEo SLk;S'rA?4'r
iff SIGNE�.