HomeMy WebLinkAboutSeptic New 2071 Ellington Road FEE
TO THE BUILDING DEPARTMENT Application No. ��
TOWN OF SOUTH WINDSOR Date
I hereby apply for permit to build a sewage disposal system for a
0.(Residence , boarding house, hotel , etc.)
Owned by of
And located at �7/
To be built by of �.
in accordance with detailed information stated below.
Signed
(Applicant)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
GENERAL INFORMATION
1 . Estimated population of premises (present) :3 (future) 3
2. Description of premises (including number of bedrooms)__ 3
No. Fixtures
(Above basement): Water Closets Urinals Lavatories
Bath tubs Showers—_ _Kitchen Sinks 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 a& �� f
(P t�i mps , tank, etc.)
4. Character of soil at proposed location of leaching system, including depths of
\various strata 'Con_,.ti
(sand, loam, clay, hardpan, rock, etc. --Use test pits.)
of highest ground water 'j /
(with reference to both present & future grade)
1
lop
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 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
'J
If cesspools , No. diameter ft.; depth below inlet ft.
If tile field or leaching trenches , total length is .4 1-1D ft,
Width of trenches _ft. , depth of broken stone or screened gravel ft.
Stone or gravel will be covered by 1411 4A4OE:n , . Distance between
r (tar paper, salt hay)
trenches ft. Distance from water supply on same property y
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 or sewage effluent into any watercourse should be permitted
without approval of the State Department of Health and State Water Commission.