HomeMy WebLinkAboutSeptic Repair 25 Imperial Drive FEE
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TO THE BUILDING DEPARTMENT Application No. e481-2'
TOWN OF SOUTH WINDSOR Date .y/ f G/ L�3
I hereby apply for permit tea sewage disposal system for a
P
(Residence , boarding house , hotel , etc.)
Owned by /` (a 4ZA of .26 j /3,F/P
And located at J 9 /-7 6 J i�b a vf=
To be built by of
in accordance with detailed information stated below.
Signed
(Applicant)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
GENERAL INFORMATION
1 . Estimated population of premises (present) _�/ (future) /
2. Description of premises (including number of bedrooms) J
No. Fixtures
(Above basement): Water Closets Urinals Lavatories
Bath tubs Showers Kitchen Sinks Laundry Tubs
Garbage Grinder List basement fixtures
3. Water Supply IA/or-l/ Kind of Well iPi,
(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 location of leaching system, including depths of
various strata !I Y V�;-"L z
(sand, loafn, clay , hardpan, rock, etc. --Use test pits.)
5. Elevation of highest ground water �U r
(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 �Vg papacity 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
If cesspools , No. diameter diameter qVF ft.; depth below inlet k4`.? 1W
If tile field or leaching trenches , total length is ft.
Width' of trenches ft. , depth of broken stone or screened gravel ft.
Stone or gravel will be covered by . Distance between
(tar paper, salt 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 9x A9
System was designed by .%� 1 ,
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.
PHILADELPHIA, PA, ■ LOCUST 3-6644
NEW YORK ■ MURRAY HILL 3-8756
COLUMBIA, S. C. 0 ALPINE 3-1606 -
�� RALEIGH, N. C. ■ VANCE 8-3231
ATLANTA, GA. ■ 522-1666 M
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