HomeMy WebLinkAboutSeptic New 00 Ellington Road (12) w
FEE r
TO THE BUILDING DEPARTMENT Application No.
TOWN OF SOUTH WINDSOR Date �� 2- _/XO/-2
I hereby apply for permit to build a sewage disposal system for a
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(Residence, boarding house, hotel, etc.)
Owned byZz"'I'l� of 7 Y� �� �
And locate at
To be built by of w
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in accordance ith detailed information stated below.
Signe -
(Applicant)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
GENERAL INFORMATION
I . Estimated population of premises (present) (future)
2. Description of premises (including number of bedrooms)
/ Z ��u�
No. Fixtures
(Above basement): Water Closets 2_ Urinals &,o Lavatories !�
Bath tubs- Showers_ / Kitchen Sinks� aundry Tubs
Garbage Grinder List basement fixtures
3. Water Supply Kind of Well_�l�J
(Public, well , spring, cistern)
Location of well an4underground 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
( nd, loa , clay , hardpan, rock, etc. --Use test pits.)
5. Elevation of highest ground water /S'.�
(with reference to both present & future grade)
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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 L11 ,t f Y � Capacity below flow line CJv
Inlet and outlet arrangements
Facilities for cleaning_ M—k Distance from dwellings on same
property on adjoining property
Automatic Dosing Apparatus , if any (describe) 0 �V
Soil Absorption System
if ,—No. ,• diameter ft.; depth below inlet ft. .
If tile field or leaching trenches , total length is lAff, ft.
Width of trenches �L , depth of broken stone or screened gravel ( t/� ft.
Stone or gravel will be covered by 1A /Z" 'IQ Distance between
!r (tar paper, salt hay) `
trenches ft. Distance from water supply on same property
s
on adjoining property
Secondary Treatment, if other than soil absorption.
Describe in detail and locate on map
System was designed by ` ,
Above information furnished bye ,-
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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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