HomeMy WebLinkAboutSeptic New 70 Elizabeth Street .Zr�
FEE
TO THE BUILDING DEPARTMENT Application No. ��
TOWN OF SOUTH WINDSOR Date to 117�W�
I hereby apply for permit to build a sewage disposal system for a
(Residence , boarding house , hotel, etc.)
g-/ AV I)A ' G4EF-,0G,6R RP
Owned by�LEf�3A�t/1 1/�Gl.�y ESTATEf of 1-1,VS77C C0A/1-"
And located at I.CT ��` E-4-1 APE Tfy ST
To be built by,S"D, jAllVZIra�r edA&7jece22gLVof y GN� ;V eh- '
in accordance with detailed information stated below
Signed a
(Applicant)
GENERAL INFORMATION
1 . Estimated population of premises (present) (future)
2. Description of premises (including number of bedrooms)
No. Fixtures
(Above basement): Water Closets 2 Urinals Lavatories_
Bath tubs�_Showers Kitchen Sinks Laundry Tubs
Garbage Grinder List basement fixtures
3. Water Supply � 13 L l C Kind of Well
(Public, well , spring, cistern)
Location of well and underground water piping
Method of obtaining or storing supply
(pumps , tank, etc.)
4. Character of soil at proposed location of leaching system, including depths of
various strata
sand, loam, clay, hardpan,- rock, etc --Use test pits.)
5. Elevation of highest ground water
(with reference to both present & future grade)
QF�j6h�0tl'A .
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 `6� / ,#/8� Capacity below flow line ^S�
.-
Inlet and outlet arrangements 409155244-: All-ET 7" 007- L 7"
�+ 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.; dep below inlet ft.
If tile field or leaching trenches , total length is ft.
Width of trenches c d ft. , depth of broken stone or screened gravel ft.
Stone or gravel will be covered by o , . Distance between
(tar paper Ksalt ay)
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
System was designed by
Above information furnished by
No discharge of sewage wage effluent into any watercourse should be permitted
without ,approval of the State Department of Health and State Water Commission.
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�O'JNJATIOH CHECKED
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CERTIFIED SUBSTANTIALLY CORRECT
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SIGHED C� iJe P .DATE A Ijcrlw s10Nla 5.... �„�; r 4.,f� F'.4-
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