HomeMy WebLinkAboutSeptic New 00 John Fitch Boulevard (5) `' d° �
FEE
TO THE BUILDING DEPARTMENT Application No. O
TOWN OF SOUTH WINDSOR Date
I hereby apply for permit to build a sewage disposal system or a
• r
(Residence , boardin4house, hotel, etc.)
Owned by C -�?� of 12, & f TTL-
Dy►.f rr0_r+tipe.
And located at %/r— �"�" el
�►1-c� �+
To be built by�iE,r� ��r/V! of 4rtmwt�� X
in accordance with detailed information stated below.
Signed
( pplicant)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
GENERAL INFORMATION
1 . Estimated population of premises (present) fb (future) /d
2. Description of premises (including number of bedrooms)
No. Fixtures �
(Above basement): Water Closets 4/-& Urinals �! Lavatoriesrt
`♦Bathtubs kyl - Showers� -- Kitchen Sinks #dwx —Laundry Tubs a �
Garbage Grinder List basement fixtures
3. Water Supply �I Kind of Well
(Public, well , spring , cister
Location of well and underground water piping .
Method of obtaining or storing supply
umps , tank, etc.)
4. Character of soil at proposed location of leaching system, including depths of
various strata S4 Al D
(sand, loam, clay , hardpan, rock, etc. --Use test pits.)
5. Elevation of highest ground water
(with reference to both present & future grade)
3
y 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 /0 6 O `
Capacity below flow line__
Inlet and outlet arrangements `7 �r�•a�` y- C �� Q-�-7.�1
Facilities for cleanin� Distance from dwellings on same
property 0 , on adjoining property
Automatic Dosing Apparatus , if any (describe)
Soil Absorption System
If cesspools , No. diameter ft.; depth below inlet ft.
,3
If tile field or leaching trenches , total length is ft.
Width of trenches ,2— ft. , depth of broken stone or screened gravel ft.
Stone or gravel will be covered by"�Ti�" Distance between
(tar paper, �It ay)
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
Above information furnished by E',-� �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.
,l