HomeMy WebLinkAboutSeptic New 88 Ash Road FEE
TO THE BUILDING DEPARTMENT Application No.
TOWN OF SOUTH WINDSOR Date A/"
I hereby apply for permit to build a sewage disposal system for a
(Residence , boarding house, hotel , etc.)
Owned by ���2%2�� of ` L �
And located at #
To be ldlt by� of -
in accordance with detailed information stated below.
Signed JL�2i_ ' "&�
-
(Applicant)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
GENERAL INFORMATION
1. Estimated population of premises (present) & (future)
2. Description of premises (including number of bedrooms) ru/
No. Fixtures
(Above basement): Water Closets y Urinals Lavatories
Bath tubs ` Showers Kitchen Sinks Laundry Tubs
Garbage Grinder List basement fixtures
3. Water Supply �J �'- Kind of Well
(Public, well , spring , cistern)
Location of well and underground water piping
Method of obtaining or storing supply
(Pump , tank , etc.)
4. Character of soil at proposed location of leaching system, including depths of
various strata
(saw, loam, clay , hardpa , rock, etc. --U test pits.)
5. Elevation of highest ground water
(with reference to both present & future grade)
Description of proposed system (Furnish drawings of same , with plot plan showing
system including location, size , grade and material of house sewer and locations
of ground or surface water drains , wells and bodies of surface water.)
Septic Tank
i
Dimensions Capacity below flow line
Inlet and outlet arrangements
Facilities for cleaning Distance from dwellings on
property , on adjoining property
Automatic Dosing Apparatus , if any (describe)
Soil Absorption System
If cesspools , No. diameter ft.; depth below inlet ft.
If tile field or leaching trenches total length is ft.
Width of trenches-3 ft. , depth of roke stone or screened gravel ( w ft.
Stone or gravel will be covered by Distance between
(tar paper, sa hay)
trenches / ✓ ft. Distance from water supply on same property ✓
on adjoining property
Secondary Treatment, if other than soil absorption.
Describe in detail and locate on map
v�
System was designed by
Above information furnished by V
No discharge of sewage or sewage effluent into any watercourse should be permitted
without approval of the State Department of Health and State Water Commission.
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