HomeMy WebLinkAboutSeptic New 31 Ordway Drive FEE
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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 , boarding house , hotel , etc.)
Owned by of
And located at
To be built by , /,,�-�.(%' `���- < of
in accordance with detailed information stated below.
Signed, _,r� l,
(Applicant)
. . . . . . . . . . . . . . . . . . .
- GENERAL i1NFORMATIONr-.1
1 . Estimated population of premises (present) _ (future)
2. Description of premises (including number of bedrooms)_
No. Fixtures
(Above basement): Water Closets 71 Urinals Lavatories /
Bath tubs- // Showers _Kitchen Sinks-Laundry Tubs
Garbage Grinder All,. List basement fixtures
3. Water Supply Kind of Well
(Public, well , spring , cistern)
Location of well and underground water piping
Method of obtaining or storing supply LC.
(Pumps , tank , etc.)
4. Character of soil at proposed location of leaching system, including depths of
Svarious strata &-v /r5-5- - /
(sand, loam, clay , hardpan, rock, etc. --Use test pits.)
5. Elevation of highest ground water
(with reference to both present & future grade)
r, •s ;
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 o
Dimensions Capacity below flow line
Inlet and outlet arrangements
Facilities for cleaning dd /cc Distance from dwellings on same
property on on adjoining property U F
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 �� S� ft.
Width of trenches ft. , depth of broken stone or screened gravel_�ft.
Stone or gravel will be covered by V])- ff a . Distance between
(tar paper, salt hay)
trenches ��w ft. Distance from water supply on same property
Ct'47 S on adjoining property
Secondary Treatment, if other than soil absorption.
Describe in detail and locate on map �e�
System was designed by L/ /
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.
,MIS MAP FOR MORTGAGE PliMM3 ONLY ,
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