HomeMy WebLinkAboutSeptic New 190 Northview Drive ,FEE
TO THE BUILDING DEPARTMENTL�v `'`, Application No. ��
TOWN OF SOUTH WINDSOR Date 7
I hereby apply for permit to build a sewage disposal system for a
eh ee
U a«-`,I (Residence , boarding house , hotel , etc.)
Owned by .25- 41e_ s - of
And located at 9J /go /74 �r/
To be built by I-&c c_100C/ Ae P-eS of �Xl
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) aiseZ k/
3 e-d"a on s
No. Fixtures
(Above basement): Water Closets Urinals Lavatories
Bath tubs / Showers Kitchen Sinks / Laundry Tubs
Garbage Grinder List basement fixtures / Alc
3. Water Supply ct f� �j (. 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 location of leaching system, including depths of
various strata
(sand, loam, cla hardpan, rock, etc. --Use test pits.)
5. Elevation of highest ground water
(with reference to both present & future grade)
1
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
Inlet and outlet arrangements
Facilities for cleaning Distance from dwellings on same
property le on adjoining property
Automatic Dosing Apparatus , if any (describe)
Soil Absorption System
If cesspools , No. diameter ft.; depth below inlet ft.
If tile field or leaching trenches , total length is 340e" 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 mapgal
q/ �yJ
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.
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 , oarding house , hotel, etc.)
Owned y f
And located at ,
To be built by of
in accordance with detailed information stated below.
Sign
�Opplicantf
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
GENERAL INFORMATION
1 . Estimated population of premises (present) (future)
2. Description of pre ises (including number of bedrooms)
No. Fixtures
(Above basement): Water Closets Urinals Lavatories
Bath tubs- Showers Kitchen Sinks Laundry Tubs
Garbage Grinder List basement fixtures---VxA 6642 o,124 '
3. Water Supply Kind of Well
(P lic, 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
(sand, loam, clay , hardpan, rock, etc. --Use test pits.)
5. Elevation of highest ground water r
(withrefep6nce to both present & future grade)
v. M
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
,� 3.�
Inlet and outlet arrangements 3 .— f
Facilities for cleaning IMI Distance from dwellings on same
property on adjoining property �
Automatic Dosing Apparatus , if any (describe)
Soil Absorption System
If cesspools , No. diameter ft.; depth below inlet ft.
/d"
If tile field or leaching trenches , total length is �� ft.
r/
Width of trenches ✓?� :W. , depth of broken stone or screened gravel
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
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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PRIMUS 3 WELTI ENGINEERS
Glastonbury, Conn.
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FOUNDATION CHECKED
nArg4 !GALS C[RTIFM0SUSITANTIALLY CORRECT
SIGNED DATE 5- 1-6