HomeMy WebLinkAboutSeptic New 255 Graham Road 1
FEE
TO THE BUILDING DEPARTMENT �, Application No.
TOWN OF SOUTH WINDSOR Date `43.7--
I hereby apply for permit to build a sewage disposal system for a
(Residence, boarding 4@k*qe , L_ _, _*"4
Owned by
And located at
To be built by e_ of �� `
in accordance with detailed information stated below.
Signed�l��,&-,,7
11 (Ap icant
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
GENERAL INFORMATION
1 . Estimated population of premises (present) (future)
2. Description of premises (including number of bedrooms) C�
No. Fixtures
(Above basement): Water Closets Urinals Lavatories_.
Bath tubs Showers_ 0 Kitchen Sinks_Z Laundry Tubs
Garbage Grinder F .List basement fixtures
3. Water Supply 'well,
D.IX 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 locati of leaching system, including depths of
various strata
(sand, loam, clay, hardpan, rock, etc. --Use test pits.)
5. Elevation of highest ground water
r , 01 (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 �RRoct,
Dimensions Capacity below flow line 16
Inlet and outlet arrangements
Facilities for cleaning_ ,-Distan e from dwellings on same
property S on adjoining property20
Automatic Dosing Apparatus , if any (describe)
Soil Absorption System
If cesspools , No. diameter ft.; depth (?*L inlet ft.
If tile field or leaching trenches , total length is t.
a ,#/ i 1
Width of trenches 02 , depth of broken stone or screened gravel-r^
Stone or gravel will be covered by Distance between
(tarp per It hay)
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�yf� PjgAI
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.
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