HomeMy WebLinkAboutSeptic New 15 Palmer Drive •'
FEE
TO THE BUILDING DEPARTMENT Application No. �1�
TOWN OF SOUTH WINDSOR Date a
I hereby apply for permit to build a sewage disposal system for a
(Residence, boarding house, hotel , etc.)
Owned by U Me 0 C6"Vo of j,� -rt 11,o5�41-
And located at & o T /�
To be built by (.) f--/f of /9A"
in accordance with detailed information stated below.
Signed
(Applicant)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
GENERAL INFORMATION
1. Estimated population of premises (present) (future) V
2. Description of premises (including number of bedrooms) 1
No. Fixtures
(Above basement): Water Closets / Urinals Lavatories
Bath tubs / Showers / Kitchen Sinks Laundry Tubs l
Garbage Grinder List basement fixtures
3. Water Supply J� b/ i'c _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 J,g,�,�/
(sand, loa , clay, hardpan, rock, etc. --Use test pits.)
5. Elevation of highest ground water N� tiF
(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 11 a Y �- -2- Capacity below flow line 9 a-O
Inlet and outlet arrangements 6S/-/?,I �G�r
0
Facilities for cleaning_/17NAI'Ov /'F Distance from dwellings on same
property l 0 , 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 % 'FJ - ft.
Width of trenches 1 ft. , depth of broken stone or screened gravel � ft.
Stone or gravel will be covered by LNTeol- Distance between
(tar paper, salt hay)
trenches P1 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 4ke'-, fIr
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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