HomeMy WebLinkAboutSeptic New 102 Hillside Drive 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
(Residence ,�iaec-rd-t-ff.g=-�ause ,
Owned by ��t�c of
And located at/a2
To be built by ��t-tlf3 r_ _ ofLPC `LGt z
in accordance with de a ed information stated below,
Signed ..�
(Applic )�
. . . . . . . . . .. . . .
GENERAL INFORMATION""
1 . Estimated population of premises (present) (p (future)
2. Description of premises (including number of bedrooms)
No. Fixtures
(Above basement): Water Closets_1 Urinals Lavatories_L
Bath tubs- Showers Kitchen Sinks _Laundry Tubs
Garbage Grinder List basemen _ ixtures
3. Water Supply I� � `� e x'` Kinfj of Well
(Public, well, spring, cistern) /
Location of well and underground water piping PLC a k < F
Method of obtaining or storing supply
(Pumps , tank, etc.)
4, Character of soil at proposed location of leaching system, including depths of
various strata
(sand, loam, clay , hardpans, 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
Dimensions Capacity below flow line of d o
Inlet and outlet arrangements_
Facilities for cleaning G �, ��,� Distance from dwellings on same
property Ja on adjoining property
Automatic Dosing Apparatus , if any (describe)_ ��,g-�., C✓
Soil Absorption System
If cesspools , No. diameter ft.; depth below inlet ft.
1-1
If tile field or leaching trenches , total length is L/5 ft.
Width of trenches-U ft. , depth of broken stone or screened gravel ft.
Stone or gravel will be covered by 0-1 . Distance between
*w paper, alt hay)
trenches ft. Distance from water supply on same property
117
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
--A7, )/)��44
No discharge of sewage or sewage effluent into an /g g g y�atercourse should be permitted
without approval of the State Department of Health and State Water Commission.
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