HomeMy WebLinkAboutFYFE BLK G LT 1•r�
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tkGREATER ANCHIRAGE AREA BOROUGH
Department of Environmental Quality
5�,3500 Tudor Road, Anchorage, Alaska 99507 279-8686
Date Received
Time of Inspection 9•'D e) 14
Date of Inspection I �% S %-7
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOOR
V. 14
Approval Requested By: //_1 Xx -1-Y-
6X1. >(,A
Address: Phone: n2 7,_ I/- Z 3
2. Prooerty Owner:
3. Legal Description:
4. Location:
5. Type of Facility to be Inspected:
Number of Bedrooms:
6. Well Data:
A. Type, B. Depth
C. Construction /) D. Bacterial Analysis
7. Sewage Disposal System: j�ei��`�
A. Installed B. Installer
C. .Septic Tank: 1. Size 2. Manufacturer-
D. Seepage Pit: 1. Size 2. Material
E. Disposal Field: Total.Length of Lines
8. Distances:
Phone: 333- Gf�,-,e
A. Well To: Septic Tank Absorption Area Sewer Lines
Nearest Lot Line r Other Contamination
B. Foundation to Septic Tank Absorption Area
C. Absorption Area to Nearest Lot Line
Re-q-,eEt for Approval of Inaividual Sewer & Water Facilities
Page Two
9. comments:
.Annrove , ��* pproved Dat
MWI, "-i ::�
r — Approval Valid for One Year From Date Signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM,
6-17 T4
2
I certify that the information contained in this request for approval to be true
and accurate representation of the subJect sewer and water facilities located at:
I
Signe�4Z--�,Date----.
Buyer: LARSH, Monte M.
Nove40 er 27, 1973
The,,' `st Natl Bank of Anchorage
GREATER APiCHORAGE ARL,`, BOROUGH
Department of Environmental Quality
3330 "C" St., Anchorage, Alaska 99503 - 274-4561
REQUEST FOR APPROVAL OF
RECEIVED
INDIVIDUAL SEWER & WATER FACILITIES
NOV e, u 1913 A
1.
Type of Inspection: CMR0 VA X
FHA
GREATER ANCHRAGE AREA BOROUC
IV�NVRONMENTALQUADT)
2.
Property Owner: Roger Hamacher DBA Itasca Co.
Mail i n g Address : 2937 Ambergate Drive
Day phone
r
333-6884
3.
Name of Buyer: Monte M. & Marilyn M. Larsh
Mai i i ng Address : 1864 E. 57th Avenue
Day Phone
265-4677 (his)
4.
Name of Lending Institution: The First National Bank of Anchorage
Mailing Address: P.O. Box 720, Anchorage,
Phone
279-4481, Ext. 237
5.
Name of R e •a 1 t o r or Agent: ---------------------
Mailing Address:
Phone
6. Legal Descri pti on Lot 1, Block G, Fyfe S/D
Location:
7. Type of Facility to be inspected: No. Bdrms. 3
8. Water Supply
Type of Supply: Public Utility Individual X
If Individual, number of dwellings presently served /
If Individual, dep;;h o-C well
9. Sewage Di sposa i• Syst :m
Tyne .o-7 System: Public Utility X Individual (on -site)
If Individual, date of installation