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HomeMy WebLinkAboutSCHROEDER LT 26Schroecaer SIO (Woo)SSI Z Lo � 6►oc.K APPLIC NT FILLS OUT UPPER HAI ONLY Properly Owner ) U o i 1 f-( /`( --f? I C- /- r Address ./-A[Plone', IMailing Zip Code2U Buyer Time Address /''0 !�-( l__ Zip Code Lending Institution —� --., ,,,-� one Address--'�,''.>; Zip Code Date Realty Co. & Agent Date Phone Address ��--� C? k._J k_. Zip Code Legal Description S Street Location - - �- - ------ -'_�- 1 Type of Residence { Single Family J� Inspector ❑ Multiple Family No. of Bedrooms Inspector ❑ Other Water Supply 11 Individual ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. ❑ Community 7/ n For wells drilled prior to that date, give well depth (attach log if available). ❑ Public Utility Field Notes: - --1,-.=t -' =e� l Sewer Disposal Individual Year Individual Installed: Public Utility When Connected to Public Utility: ❑ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Dale Date Date Date Inspector Inspector Inspector Inspector f .-.� 7/ n Field Notes: - --1,-.=t -' =e� l ( APPROVED BEDROOMS`{ 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' DATE 12 W "'- BY: Soils Rating Date Sewer Installed Well To Absorption Area /C1 Well Log Received Well to Tank �".- �� Septic Tank Size do t -c -I/e_ (-tn OL-ISSL 01 — January 6, 1.1.11LS3 J m , R j. ( , 1-1 99 5 0 7 c I I c (--rvot 0 Y., o v a o 1. tho indivichlill sowey - ml(l wator c'. 11 1 itolo"", I- hav" jn(m to(l Thotol) of u1c, uel. C. I o u h e t; c that. '1'(: i. fiL e7ater Liql1j:.. ".ho water ronorl: llopd�! A he -110 f0l: MIC I-Ovinw� o t: J. c c 0) 1' 5 6 3 3 P) 10 s Q tank pum])(th it 11-70 CO j, J)i- 'Al rMli '1,-. i..C% (I l(;() '-JI j An �-.ites)t oll to Nat 1 o MCI I j,(3 .-t�por� wx,dn to he -m j. t t. ) I I `;omn: systc,11 17L Ll Cil )=isLaIld,pil)o to t thm.-I. ; De i � L 11 tle P 1 1 � c noti I.v c) r � i r o r i c, o n I I iloted fizlvf-± hoop c c) r 1, , oc L.od thm", al" all,/ furthcr-4720. P Il 0 i" r, (? C; I J. I t I I j. Il�; Of ti 2u 1 l -. 'k r 7f q b 111jim f) 1110hot Asmociate X11vi rorluwnicaj. j I,' I, ( ) /T.)/j'1j f 1,11C la V-1 tr DATE RECEIVED INSPECTION APPOINTMENTS TIME ME � � 1 � P,{)� TIME _Tfi1:. DATE DATE c DATE INSPECT _��� INSPEC R INSPECTOTT i1�11�itrip6I ITT DEPT. oF MUNICIPALITY OF ANCHORAGE FNVIRONMEM;,L [;,,' DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION L&TION 825 L Street - Anchorage, Alaska 99501 NAR 3 j980ENVIRONMENTAL 0* SANITATION DIVISION Telephone 264.4720 R E C E REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER - PHONE JUD'17-14 Pic MAILINn ADDRESS S 3 6 o (,visit dz A PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE MAI LING ADDRESS 14�� 3. LENDING INSTITUTION PHONE A4Ash'A_ ING ADDRESS _FTEALTOR/AGENT &MALINGADDRESS �7 F, � — ��,e>rr�=��=-N r�� 7� �'z� ,� _� ,f✓_i��. I ' �, tet,, � �q �z ;/�j' 5. EGAL DESCRIPTION o :9 6 1® STREET LOCATION p X `:P b M A �Q C cJ.s `3 F, 6. " YPE OF RESIDENCE NUMBER OF,BEDROOMS >41 SINGLE FAMILY ❑ One ❑ Four ❑ Other ❑ Two ❑ Five ❑ MULTIPLE: FAMILY ,[ Three ❑ Six 7. WATER SUPPLY INDIVIDUAL* *ATTACH WELL LOG. Awell log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITYdepth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM X INDIVIDUAL/ON-SITE** 1-9N.F_YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 1 72-010 (Rev. 6 79) �C -L6 c.t 9l Aft? 001 s THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS ❑ SINGLE FAMILY ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ MULTIPLE FAMILY ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY PERMIT NUMBER ❑ INDIVIDUAL DEPTH OF WELL ❑ COMMUNITY DATE DRILLED ❑ PUBLIC UTILITY Connection Verified_ LOG RECEIVED - 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER ❑INDIVIDUAL/ON -SITE DATE INSTALLED ❑PUBLIC UTILITY Connection Verified _ INSTALLER ❑Septic Tank or ❑ Holding Tank Size:, If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank Absorption Area Sewer Line rest Lot Line Nearest WELL TO: Absorption Area to nearest Lot Line 5. COMMENTS 5 t I O`' -APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) el 6 --DISAPPROVED DATE: BY 77-nin (Rev. 6/79) MUNICIPALITY 01 INCHORAGE •mm POACH 666 ANCHORAGE, ALASKA 99502 1 1 -lQ-- v REFERENCEO ! _ 4� �G���(7�. /a�-- --'-- ---= - To REPLY DATE FROM rwONSTIkJCTION 1! T T LAD MATERIALS TESTING • QUALITY CONTROL SOILS ENGINEERING 2204 Cleveland Ave. P.O. Box 10- 1 12 6 Anchorage, AK. 99511 277-0231 LEGAL DESCRIPTION PERFORMED FOR: JUDY RICH 710 Third Ave. P.O. Box 2540 Fairbanks, AK. 99707 452 -12 67 • 456-5155 LOT 26 , BLOCK , OR 8300 Wisteria Anchorage Al aa' ^ aaROt1 PHONE NO. 24'�OT 7h SF-r'TIC SYSTEM ADEQUACY REPORT JOB No. ACTL 80-1317 �l DATE OF REPORT DATE OF TEST SCHROEDER 12 May 1980 9 April 1980 SUBDIVISION SECTION —, T_N, R_—W, S. M. , ALASKA REQUESTED BY: PHONE NO. — TYPE OF SYSTEM X[N SEPTIC TANK - SIZE 1500 GALLONS CRIB OR SEEPAGE PIT (LOG) ❑ LEACH FIELD NUMBER OF BEDROOMS _-3-- SEPTIC TANK WAS PUMPED X� YES ❑ NO 000+ ABSORPTION RATE: AVERAGE 24 HOURS 1,GALLONS. SURGE RATE: 750 GALLONS IN 20 MINUTES. NOTES a OBSERVATIONS: MUNICIPALITY OF ANCHORAGE DEPT. OF 1-ALTH & ENVIRCNMENTAL i i OiECTION ,; U iq 6 1980 R.ECEI BP BN APPROVED BY:JAMES E. RINGSTA, TEST PERFORMED BY: REPORT PREPARED BY: — P.