HomeMy WebLinkAboutSeptic New 80 Palmer Drive FEE
TO THE BUILDING DEPARTMENT Application No.
TOWN OF SOUTH WINDSOR Date !�"1A
I hereby apply for permit to build a sewage disposal system for a
(Residence , boarding house, hotel , etc.)
Owned by u ¢ !? Ha el-/r.- of C6ye r Te,r L°!
And located at go JD/? 1A
To be built by U 7t. 1_a.t/t- of /V//�
in accordance with detailed information stated below.
Signedz�,
(Applicant)
. . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
GENERAL INFORMATION
1 . Estimated population of premises (present)_/ (future)
2. Description of premises (including number of bedrooms)
No. Fixtures
(Above basement): Water Closets a Urinals Lavatories Z
Bath tubs / Showers _Kitchen Sinks�[_Laundry Tubs —
Garbage Grinder List basement fixtures
3. Water Supply i� bl,L 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 � as9-ri C/,Vy / .airdp/t y
(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
DimensionsT Capacity below flow line
Inlet and outlet arrangements_
Facilities for cleaning Distance from dwellings on same
property on adjoining property / I
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 ft.
Width of trenches_ _ft. , depth of broken stone or screened gravel
Stone or gravel will be covered Pg6V Distance between
(tar paper, salt hay)
trenches 1% 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 bye = ,� �. y
tip
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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