HomeMy WebLinkAboutSeptic New 00 Clark Street (3) FEE
TO THE BUILDING DEPARTMENT Application No. �
TOWN OF SOUTH WINDSOR Date -i�; 2--
I hereby apply for permit to build a sewage disposal system for a
(Residence , boarding house , hotel , etc.)
Owned by Lv L_/-1AP1 Ala �' ��V S of /-,41Z k -S
And located at C L-.Aj) t� S T ' C, U �/; �/C/_S ��/� ��� /�/411
� /
To be built by , S JYI 1��� of Sri U� L' � 6R2 (I
in accordance with detailed information stated below.
Signed �, i-
(Appli ant)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
GENERAL INFORMATION
1 . Estimated population of premises (present) , (future)
2. Description of premises (includingnumber of bedrooms -3
)
No. Fixtures
(Above basement): Water Closets_1 Urinals Lavatories
Bath tubs —Showers Kitchen Sinks_ Laundry Tubs
Garbage Grinder — List basement fixtures
3. Water Supply Kind of Well—
(Public, well , spring , cistern)
Location of well and underground water piping
Method of obtaining or storing supply ��� /L� /
(Pumps , tank, etc.)
4. Character of soil at proposed location of leaching system, including depths of
various strata ,a-, /!l�
sand, loam, clay , hardpan, rock, etc. --Use test pits.)
5. Elevation of highest ground water,
(with reference to both present & future grade)
1
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
Dimensions /mod Capacity below flow line
Inlet and outlet arrangements —
Facilities for cleaning Distance from dwellings on same
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 /9-/' ft.
Width of trenches ,,2f ft. , depth of broken stone or screened gravel /6 ft.
Stone or gravel will be covered by .04. - Distance between
(tar paper, salt hay)
trenches 6���u.� ft. Distance from water supply on same property �✓�f
on adjoining property
Secondary Treatment, if other than soil absorption.
Describe in detail and locate on map ?101A1n,d-
System was designed by
Above information furnished by -ice ?
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.