HomeMy WebLinkAboutWell New 411Slater Street Slater Street FEE g
TO THE BUILDING DEPARTMENT Application No. �/
TOWN OF SOUTH WINDSOR Date F—/� `62,-
I hereby apply for permit to build a sewage disposal system for a
P h—,I, ;2L
(Residence , boarding house, hotel , etc.)
Owned by 71117 '
And located azxar
To be built by fj of X e i
in accordance with detailed information stated below.
Signed
(Applicant)
. . . . . . . . . . .
GENERAL INFORMATION
1 . Estimated population of premises (present)-..�Ja ,`'?� (future)
2. Descript' n f premises (including number of bedrooms)__ � �
No. Fixtures
(Above basement): Water Closets Urinals Lavatories rya
Bath tubs Showers Kitchen Sinks-1 Laundry Tubs
Garbage Grinder 1"1 U List basement fixtures
3. Water Supplya Kind of Well
(Public, well , spring, cistern)
Location of well and underground water piping
Method of obtaining or storing supply
(Pump , tank, etc.)
4. Character of soil at proposed location of leaching system, including depths of
various strataY -
(sand, loam, clay , hardpan, rock, etc. --U e test pits.)
5. Elevation of highest ground water CC_
(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 Distance from dwellings on same
•
property on adjoining property
Automatic Dosing Apparatus , if any (describe)
Soil Absorption System
N-o diameter ft.; depth below inlet ft.
If tale field or leaching trenches , total length is " ft.
VlTdth of trenches ft. ,`depth of broken stone or screened graveh
Stone or gravel will be covered by ? Distance between
(tar paper, salt ay)
trenches ' ft. Distance from water supply on same property
a
on adjoining property
Secondary Treatment, if other than soil absorption.
Describe in detail and locate on map
System was designed by OP
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.
THIS MAP FOR MORTGAGE PURPaSES D
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1 hereby CO" tltiS M80 to be
=b$Wft ty eo"d and 9* no
Zoning regulations are violated.