HomeMy WebLinkAboutSeptic New 20 Elizabeth Street FEE
TO THE BUILDING DEPARTMENT Application No. d
TOWN, OF SOUTH WINDSOR Date 4::;� 11 wl 2--
I hereby apply for permit to build a sewage disposal system for a
(Residence , boarding house, hotel, etc.)
�,/ -
Owned of
And located at T ' y �'L/Z/��?�C��f 37—
To be built by,5-6.&/t&AW e'4K1JWC'7,Wo' of oV kST,-C Go i✓�
in accordance with detailed information stated below/
Sign
` (Applicant)
. . . . . . . . . . . . . . . . . . . . I./ . .. . . . . . . . . . . . . . . . . . . . . . . .
GENERAL INFORMATION
1 . Estimated population of premises (present)ZR9i&1;Zk (future)
2. Description of premises (including number of bedrooms)
No. Fixtures
(Above basement): Water Closets Urinals Lavatories
Bath tubs / Showers Kitchen Sinks Laundry Tubs
Garbage Grinder List basement fixtures_L,,9cfA-o Po S' Gait/it/�=C'r`idNf
3. Water Supply Py�L./�� 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 �A
sand, loam, clay , hardpan, rock, etc. --Use 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
tt �oDimensions Y f ri Capacity below flow line
Inlet and outlet arrangements
Facilities for .cleaning&/9/' Z,6� 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 ft.
Width of trenches Cy ! ft. , depth of broken stone or screened gravel�'�ft.
tJ�REA'TED���
Stone or gravel will be covered by_T/ 4-6j01 ja4e-P Distance between
(tar paper, salt hay)
trenches /22 ft. Distance from water supply on same property a
on adjoining property
Secondary Treatment, if other than soil absorption.
Describe in detail and locate on map
System was designed by ��l///J CQ�S/���'7/U/� GC)
Above information furnished by
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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