HomeMy WebLinkAboutAURORA BLK 10 LT 23Onsite File
Aurora
Block 10
Lot 23
#013-012-12
Currently on public water & sewer
(9/13/2021)
Municipality of Anchorage
Community Development Department
On -Site Water & Wastewater Program
4700 Elmore St. ■ P.O. Box 196650 ■ Anchorage, AK 99507-6650 ■ www.muni.org/onsite ■ (907) 343-7904
ILegal Address:
Subdivision
Well Decommissioning Log
LT �)</ Block il 0 Lot ; 3
T R I Section Lot
On-site Water & Wastewater Program certified contractor performing the well decommissioning:
Name:= 1 �� Signature ACLPI 11A
Company: �� ` t� VAA IA -
Well decommissioning date: 4XG ')_ Method of decommissioning: AMC 15:55.060L1 a. ❑ b. ❑ c. �—
Location: Use the space below to provide a drawing of the property showing the following items;
• North Arrow
• Decommissioned well,
• Other water wells on the property,
• Two separate swing -tie distances for each well shown in the drawing,
Note: The swing -tie distances shall be measured from either permanent structures of propel