HomeMy WebLinkAboutSeptic New 00 Pleasant Valley Road 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, boarding house , hotel , etc.)
Owned by 1 ��cl-el of
And located at � ��,,T' r/� �c C�--•—c��c�
To be built by �7 7-�� of S)
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) C� n�
c?
No. Fixtures
(Above basement): Water Closets ( Urinals Lavatories
Bath tubs- _Showers _J _Kitchen Sinks -Laundry Tubs
Garbage Grinder 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
(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
(with reference to both present & future grade)
PPP
i
PP
X-/Z'
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 1 ` BIZ6S `
Dimensions Capacity below flow line /a0 6 /
Inlet and outlet arrangements
Ao"
�f�z os
Facilities for cleanin �/ E� Distance
from
g
g >7 jy Distance from dwelling
s on same
property C7 �� 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 1dZ,-P ft.
Width of trenches I..:), ft. , depth of broken stone or screened gravel [ ft.
Stone or ravel will be covered b "�t "rsv
g Y_ �l�i4�7�ies Distance between
(tar paper, salt hay)
trenches i� ft. Distance from water supply on same property ��lj,w
on adjoining property
Secondary Treatment, if other than soil absorption.
Describe in detail and locate on map �o /�`► "�
System was designed by �;� �,z I� T. �;,J
Above information furnished
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.