HomeMy WebLinkAboutFYFE BLK I LT 2n'�
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yII I A At Ct IOP.AGGMUNICIPALITY OF ANCHORAGE / j lDEPARTMENT
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OF HEALTH & ENVIRONMENTAL PROTEIOI�L•, 1V1�
825 L Street - Anchorage, Alaska 99501
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ENVIRONMENTAL ENGINEERING DIVISION
Telephone 264-4720
TL'ITEES +
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER'
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
1. PROPERTY OWNER
PHONE
MAILING ADDRESS
k z7 /=—
PROPERTY(RREESIDENT (If/different from above)
PHONE
2. BUYER
PHONE
6=
MAILING ADDRESS
3. LENDING INSTITUTION
PHONE
MAILING ADDRESS
4. REALTOR/AGENT
PHONE
MAILING ADDRESS
5. LEGAL DESCRIPTION
STREET LOCATION
J / r
/
6. TYPE OF RESIDENCE
NUMBER OF BEDROOMS
❑ SINGLE FAMILY
❑ One ❑ Four ❑ Other
Two ❑ Five
MULTIPLE FAMILY
❑ Three ❑ Six
7. WATER SUPPLY
�— INDIVIDUAL*
* ATTACH WELL LOG. A well log is required for all wells drilled
❑ COMMUNITY
since June 1975. For wells drilled prior to that date, give well
❑ PUBLIC UTILITY
depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM
❑ INDIVIDUAL/ON-SITE**
**If individual/on-site, give installation date
PUBLIC
If system is over two (2) years old an adequacy test is required
—UTILITY
by this Department.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010(3/78)
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'Municipality
of
Anchorage
(
3000 ARCTIC BOULEVARD
ANCHORAGE, ALASKA 99503
(907) 277-7622
GEORGEM. SULLIVAN,
MAYOR
DEPARTMENT OF ENTERPRISE ACTIVITIES
Sewer & Water Utility
Mav 9, 1979
To Whom It May Concern;
The property located at Fyfe Subdivision, Block I, Lot 2, is
connected to our sanitary sewer system. A dye test was conducted
on the premises on 14ay 8, 1979, the results of which were shown to
be positive.
P1-
ckie M Mace
Customer Service Supervisor
Anchorage Water and Sewer Utilities