HomeMy WebLinkAboutSeptic New 84 Hillside Drive 4 Flo(
FEE
TO THE BUILDING DEPARTMENT Application No. 1�10
TOWN OF SOUTH WINDSOR Date
I hereby apply for permit to build a sewage disposal system for a
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(Residence , , etc.)
Owned by _ n- of o
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And located at — /'l s '9194 P r ve-
To be built bywom + of
in accordance with detailed information stated below.
Signed / ,
(APpl t)
. . . . . . . . . .
GENERAL INFORMATION
1 . Estimated population of premises (present) (future)
2. Description of premises (including number of bedrooms)
No. Fixtures
(Above basement): Water Closets Urinals Lavatories_r _
Bath tubs- Showers j_Kitchen Sinks_ _Laundry Tubs
Garbage Grinder List basement fixtures_ d we
3. Water Supply A) �a I/+C.- Kind of Well
(Public, wed, sag , cictem)
Location of well and underground water piping
Method of obtaining or storing supply h �
( , tYA atc.)
4. Character of soil at proposed location of leaching system, including depths of
various strata SA lVa {
(sand, loam, clay, hardpan, rock, etc. --Use test pits.)
5. Elevation of highest ground water �d
(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
Dimensions � Capacity below flow line 4) A 1
Inlet and outlet arrangements
Facilities for cleaning COV81AS Distance from dwellings on same
property_ �� , on adjoining property A 6'
Automatic Dosing Apparatus , if any (describe) Ivy! Nam.
Soil Absorption System
If cesspools , No. diameter ft.; depth below 'inlet ft.
If tile field or leaching trenches , total length is 3-0 ft.
Width of trenches—c-� t. , depth of broken stone or screened gravel�_ft.
Stone or gravel will be covered by 4CLO . Distance between
1 (a , s 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
System was designed by
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Above information furnished by t�`t L-
No discharge of sewage.4'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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