HomeMy WebLinkAbout1963-12-26 - 1510 John Fitch Boulevard - Septic ApplicationBUILDING DEPARTMENT
South Windsor,Connecticut
Application for Permit to Install or Repair Individual Sewage Disposal System
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TO THE BUILDING DEPARTMENT:
following information is submitted:
1.Owner of Property %/’9 ‘
Location of Property (;?%;«a2.
Address of Owner
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Application No.
19 ée”
ge disposal system concerning which the
7.Soil Conditions:Type of Soil KS‘A fwd/ct!
8.If not served by public water supply:Distance from Owner’s well 7 g
(Sand,Gravel,Clay,etc.)Maximum ground water table
¢
from adjacent wells 79"‘i’
9.Distance to nearest water course,drainage ditch,storm drain or embankment ‘5 C
10.Percolation Tests:Time for 1"drop in soil test
11.Minimum square feet of effective seepage area required 3‘0 6‘
Length />3
Other
12.Leaching System:Number of trenches an .y‘”Width v7 72/
(Licensed Installer)
(Sketch showing all minimum distances and other details required halo/w
Permit Issued,1 9
Installation Completed,Inspected and Approved
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By
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Date
A permit is requested for repair or construction of an individual sewa
TOWN OF SOUTH WINDSOR
01:3”,£7,"’
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Signature if /Xvi/bx
52 «24 ~~
I~p,Classification of soil f3 Qt;
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Type of Structure La/rvx/‘.?£/¢/§3 1/.No.of(Dwelling,Commercial Building,Store,etc.)of Bedrooms
4.Number of Families or Persons to Occupy Premises w
5.Plumbing Fixtures:Water Closets j Urinals Lavatories x Bathtubs
Showers Kitchen Sinks Laundry Tubs Garbage Grinder Other
6.Liquid Capacity of Septic Tank hie 'Z)
Material of Septic Tank f”c?Mfr’
FEE £i
/2/”6fTOTHEBUILDINGDEPARTMENTAppllcat1o
TOWN OF SOUTH WINDSOR Date g/g/
I hereby apply for permit to build a sewage disposal system for a
éjar'€[K’s us Q «is»
(Residence ,boarding house ,hotel ,etc.)
Owned by t/3c)/G\6 Poo?of \yo /L)/I)”;KT 0 i"
And located at /\(/a [yA i/1%e zé!ed‘agwérct/J éu-‘bt,,
Tobebuiltby I )'of $a (A2 IWJI’OI"
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)
No.Fixtures
(Above basement):Water Closets 5 Urinals Lavatories 3
Method of obtaining or storing supply D U m )0 q 7Lm Mk
(P’umps,tank etc )'
4.Character of soil at proposed location of leaching system,including depths of
various strata xS‘A AK
(sand ,loam ,clay ,hardpan ,rock ,etc.--Use test pits .)
i5.Elevation of highest ground water
(with reference to both present &future grade)
Bath tubs 6 Showers l Kitchen Sinks 0 Laundry Tubs a
Garbage Grinder O List basement fixtures 0
3 .Water Supply Kind of Well /9 r 7Z&‘f/#M(Public,well ,spring ,cistern)
Location of well and underground water piping H I”,t‘7
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 y xi £2V 5’Capacity below flow line /a J C)
Inlet and outlet arrangements pa F/(LQ ({l'
Facilities for cleaning ‘>Distance from dwellings on same
property a o i e /’,on adjoining property '71 M1 /‘?
Automatic Dosing Apparatus ,if any (describe)AC)
S,oil Abs orption System
If cesspools ,No.’-;diameter z-ft.;depth below inlet ft.
If tile field or leaching trenches ,total length is_/\5"C}ft.
rWidth of trenches r i£ft.»r,sdepth ofbroken stone or screened gravel g (é ft.
Stone or gravel will be covered by 0 C1 h é l/.Distance between
(tar paper],salt hay)trenches g/ft.Distance from water supply on same property c9 d I
f;on adjoining property 3 O C3
Secondary Treatment,if other than soil absorption.
Describe in detail and locate on map e c
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System was designed by /77Q/rg ’A,fi/hs 1y if wy/r/
Above information furnished by
No discharge of sewage or sewage effluent into any watercourse should be permittedwithoutapprovaloftheStateDepartmentofHealthandStateWaterCommission.
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