HomeMy WebLinkAboutSeptic New 896 Pleasant Valley Road FEE
TO THE BUILDING DEPARTMENT S_=WQ;4- 10e�,tmrr Application No. �y
TOWN OF SOUTH WINDSOR Date
I hereby apply for permit to build a sewage disposal system for a
xve r
-- Jc-,m 644-z�L (Residence , boarding house , hote etc.)
Owned by of 6
And located at
To be built by of
in accordance with detailed information stated below.
Signed
(Applicant)
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
GENERAL INFORMATION r
1 . Estimated population of premises (present) (future)
2. Description of premises (including number of bedrooms) V-a + S
f
�
No. Fixtures
(Above basement): Water Closets Urinals Lavatories l
Bath tubs Showers Kitchen Sinks Laundry Tubs
Garbage Grinder List i
t b '_,
basement fixtures l III
3. Water Supply l-:� b 1 1 G 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 a roposed location of leaching system, including depths of
various strata
(sand, loa T,
clay , hardpan, rock, e c. --Use test pi s.)
5. Elevation of highest ground water
(with reference to both present & future grade)
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
Dimensions lZrVeA&4t Capacity below flow line
Inlet and outlet arrangements
Facilities for cleaning Distance from dwellings on same
property 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 �Lb�'7'� ft.
Width of trenches a2� ft. , depth of broken stone or screened gravel eft.
Stone or gravel will be covered by Distance between
(tar paper, salt hay)
trenches 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 1eelA y4
System was designed by
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.`
f
d'"
• ti
PRIMUS & WELTI ENGINEERS
Glastonbury, Conn.
1 t
i
f `
FOUNDATION CHECKED
DATE !GALE - ir" C> CERTIFIED 9UOSTANTIALLY CORRECT
SIGNED DATE C_�
s .,� . .
_ , �,
�� � � �
•�