HomeMy WebLinkAboutSeptic Repair 45 Valley View Drive 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 of
Go e ¢
And located at rJ
To be built by of
in accordance ith detailed information stated below.
Signed ,�
(A licant)
. . . . . . . . . . . . . .
GENERAL INFORMATION
I . Estimated population of premises (present) future)
n
2. Description of premises (including number of bedrooms)
No. Fixtures
(Above basement): Water Closets Urinals Lavatories o2
Bath tubs Showers r_Kitchen Sinks _Laundry Tubs
Garbage Grinder List basement fixtures
3. Water Supply � tu�w ��n�, �-- 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, lo4C clay, Ardpan, 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
Dimensions r OAS C _ Capacity below flow line
Inlet and outlet arrangements
Facilities for cleaning C-tm4�►^- 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- / ft.
Width of trenchesft. , depth of broken stone or screened gravel ft.
Stone or gravel will be covered by 2 Distance between
i (tar p per, t hay)
trenches �� ft. Distance fr m 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 aw, �� ST
Above information furnished by _
No discharge of sewage or sew a effluent into any watercourse should be permitted
without approval of the State Department of Health and State Water Commission.
—7
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VOL PZ UT PZ14N FOR
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J HEREBY CERTIFY THAT THIS MAP AND SURVEY WERE PREPARED IN ACCORDANCE
W/TH THE STANDARDS OF A CLASS SURVEY AS DEFINED IN THE CODE OF
�, PRACTICE FOR STANDARDS OF ACCURACY OF SURVEYS AND MAPS ADOPTED
/NV A.t 4 P. V.C. " DECEMIER lO, 1975 AS AMENDED BY THE CONNECTICUT ASSOCIATION OF LAND
�. //yy, B: SEPTIC ` ► P SURVEYORS, INC.
/IVY.
� t SURVEfVff rriLd
ATXW?b
4'f/EAYY OCJTy PV.c. Fi4EE DRAINING
rPT/C SYSTEM D�'T�9/C (",OCR OR/VE'W.4Y W/7h' MATE'�4'/�9L /N ME '
N.TS. ONE- FDOT %z "S701W ACC_ORLL9NCE WITH
ABOVE r- BELOW CONK. //E.4e_ DEFT. ENGINEERING 1750 ELLINGTON ROAD
S'f C_//—/if X 710 A1,S c INC, SOUTH WINDSOR Cl 06074
FiD 203 644-4691