HomeMy WebLinkAboutSeptic New 40 Ordway Drive FEE
TO THE BUILDING DEPARTMENT Application No. -1-14zy/
TOWN OF SOUTH WINDSOR Date o -/7 w
I hereby apply for permit to build a sewage disposal system for a
(Residence , boarding house, hotel , etc.) T
Owned by Si9�-� �� /. �� C of
And located at A11�0 a-119 J a
To be built by -J,q 127 f'S /J of d.1'0 /t
in accordance with detailed information stated below.
SignedQ -���
(Applicant)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
GENERAL INFORMATION
1 . Estimated population of premises (present) L,C (future)
2. Description of premises (including number of bedrooms) / 1'
No. Fixtures
(Above basement): Water Closets Urinals Lavatories
Bath tubs r Showers / Kitchen Sinks Laundry Tubs 7t��
Garbage Grinder List basement fixtures �Aj-A s c ,�
3. Water Supply 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 Sa-' CO
(sand, loam, clay , hardpan, 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
Inlet and outlet arrangements
Facilities for cleaning�4,,,k Distance from dwellings on same
property //e7 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 hft.
Width of trenches—'-)- ft. , depth of broken stone or screened gravel ft.
Stone or gravel will be covered by �('� �4 rL Distance between
(tar paper, salt hay)
trenches C ft. Distance from. water supply on same property 12 a
'W 6 4R I a Fl- on adjoining property
Secondary Treatment, if other than soil absorption.
Describe in detail and locate on map_ n L o� G
System was designed byF 2 p
Above information furnished bye'—
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.
NAJ
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SOUTH WINDSOR HEALTH DEPARTMENT A??Ur.A=0*N 30.
="M=GATTCR 1PCR SM(;X DISKSAL SYS3'S'�!
Naar LOC.1TI01�
?l000=09 TF�'1�5: (Record all. testa) SOIL MO
TEST READINGS
SOLB #1 1DLR #2 acLE
Ties Reading Time Reading , Time Reading Time Resdin�
� Ur p
' TABtTLATIO?f OF Tc'T °MTLTS
Depths_ � ?�iaimtsm .Pescolstioa Rats
Role (•n_-_)
1 _
2
3
CBSERVATION PITS: (Record all pits) Ott Ground •dater Table.: a ov Max.,
Son RIg"TC40
F= A PIT B ' C PIT D
1A8tJiA".'IOR GrF OS`II�IA'!'I AR P'i'"S
Ground Soil
LoeatScsz nth Leda* At water At
pit
A
B
C
D
Cv�
FCR4 #2 SOUTH WINDSOR HEALTH •.2• Iavestijo;Lt ou.for .-ALSO Dispoaal.`Sysz-
DEPARTMENT
SMUL CONDITIONS .
system design larger than 2,000 g.p.d. Water supply 'watershed
sigh ground water (less than 44 ft. ) possible seasonal high
ground water
Wgterccurse, marsh or pond possible seasonal floodias
Limited suitable area Slope over 15x'-
Marst=l soil(30 - 60 mina./inch) Shallov ledge (less than. 7 ft.)
Underlying tight soil (less than '+ ft)_ Other.
COMMMON
Suitable for savage disposal
utsuitable for savage disposal
Additional investigation. required
?tetast during Bret season
Ingjneer'.s plan, required .
D=GN RMOItMMATIONS
1 YK• uirlk
4 IT
Investigated b;► Title
Confirmed/Witnessed by Title
. �ommeats; .
Benchmark location Elevation
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Apr 13 2008/ 7: 49AM vcn VALLEY AH 8605282061 p. 2
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ias SKIPS SEPTIC TANK SERVICE, INC-
27 Muddy Brook Road Ellington,Connecticut,06029
lodlo (860)875-2332 www.skipsseptic.com
THIS IS NOT A REAL ESTATE INSPECTION Date_
� — —
House(Lot)# Owner
Street - A ---
Telephone
Town-
— ;
Building Serviced: Residential ❑Apartment ❑Commercial Garbage Disposal N
Size of Tank: P Gal. Depth Below Grade: 3 Separate Graywater System Y
Water treatment discharge to septic Y
Rise r(s): f -----_---j I
—� �1 Distance from tank to truck when pumpina _ft
Solids: �� c ' '
Tank: ❑Good ')'Acceptable ❑Poor !�utletlternO^ L Approximate vertical(uphill)pull-if any: ft
-_--_- __ Type of Tank:❑Steel )P Concrete
Inlet pipe:_ _.._— 'n-A- — — ❑Multi Compartment El Other:
Baffles: Type Condition
.
Fields appear to be: a
Tank at. or--Tteve 1 Slightly above
WK
Considerably above Water running back ;
Last pumped: — s c2 — Next pump: rs --- `i
Need to call office re: ' — 1( 9 *"f -
Location of tank: Diagram w/dimensions and locations of covers. . .. .
Not responsible for change or damage due to seasonal water table variations
or change in household use. if you have any further questions,please call our
office or your local or state health department. '
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