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MUNICIPALITY OF ANCHORAGE__
DEFAfjME' OF HEALTH AND ENVIRONMEN7�
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v'0, 825 j, Street, Anchorage, Alas—,
279-2511, ext. 224 or 225
Date Received:
l : Time # 2 : Time
Date � /A 77 Date
1.
2.
Insp
Insp
PROTECTION
99501
May 4, 1977
#; 3 : Time
Date
Insp
REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES
Lending Institution Request: Alaska Statebank
Mailing Address: 310 East Northern Lights Blvd.
Property Owner: David P. Saunders
Mailing Address: 1853 East 57th Avenue
3. Legal Description: Lot 2 Block H _Fyfe Subdivision
Phone: 279-7637
Phone: 344-6508
4: Single Family Residence: (x) Number of Bedrooms: 3
Multiple Family Residence: ( ) Number of Bedrooms:
5. Well System:
Permit #r`
Construction
Individual Well (x) Community/Public System ( )
Depth of Well
Well Log on File ( )
Bacterial Analysis
6. Sewage Disposal System: On -site System ( ) Public Utility (x)
Permit #r l ) (,CS —Installed 6 ` (c/-7 staller
Septic Tank Size _ Manufacturer
Absorption Area
Soils Rate
Material
7. Distances: Well to Septic Tank to Absorption Area
to Sewer Line Nearest Lot line Absorption Area
to Nearest Lot Line
MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCH
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DEPARTMENT OF HEALTH AND ENVIRONMENTAL. PROTECTION DEPT. OF HEALTH e,
825 L Street, Anchorage, Alaska 99501 ENVIRJ�.+rTrL FROT£CT1C,v
279-2511, ext. 224, 225
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES
fJ I k_d
A
1. Type of Inspection: VA FHA CONV
2. Property Owner: David Fo Saunders
Mailing Address:_1853 EA 57th Ave. Day Phone: 344-6508
3. Name of Buyer: George H. Stewart
Mailing Address: 2507 W. 43rd. Day Phone: 272-479h
4. Name of Lending Institution:ka Stat4hank
Mailing Address: - PO Box 2.40 Anah, Ak _ Phone:279-7637
5. Name of Realtor or Agent: AAO. Syren ( Spernarci Reality)
Mailing Address: 7530 Margaret Ciro ke Phone:'49m4261
6. Legal Description: _ Lot 2 Block H Fyf e s /d
Location: 1853 E. 57th, Ave, Anch, Ak,
7. Type of Facility to be Inspected: Single Family Home No. Bdrms.
8. Water Supply
Type of Supply
Public Utility
Individual
If Individual, number of dwellings presently served /
If Individual, depth of well L
9. Sewage Disposal System
Type of System: Public Utility tZ Individual (on -site)
If Individual, date of installation
72-003(3/76)