HomeMy WebLinkAboutSCHROEDER LTS 62 & 63LOOM40� 6 lock
GREA. �eR ANCHORAGE /AREA BOROUGH
DEPARTMENTOF ENVIRONMENTAL QUALITY
3330 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-4561
SEWAGE DISPOSAL, SYSTEM . APPLICATION AND PERMIT
NAME OF APPLICANT `-�U- MAILING ADDRESS
INSTALLATION LOCATION
LEGAL DESCRIPTION
Y
�0
PERMIT NO. -
PHONE
`>?`/
INSTALLATION OF SEPTIC TANK _ SEEPAGE PIT ---. DRAIN FIELD OTHER -.
-
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH
SOIL TEST RESULTS
COMPLETION DATE ANTICIPATED
TO BE INSTALLED BY
NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL 13E SU13JCCT TO PROSECUTION.
SEPTIC TANK SIZE�.-'--
MINIMUM DISTANCES, REQUIREMENT'S
FOUNDATION TO SEPTIC TANK -
FOUNDATION TO SEEPAGE PIT -. DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT WALL
SEPTIC TANK -. SEEPAGE PIT
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK
DRAIN FIELD __-
WATER
_
WATER MAIN TO SEPTIC TANK
DRAIN FIELD --
DRAIN FIELD
SEEPAGE AREA SIZE
SEEPAGE PIT
ALSO CONSIDER AREA WELLS.
SEEPAGE PIT
SEPTIC TANK. _- SEEPAGE PIT -. DRAIN FIELD
TO RIVER, LAKE. STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL..
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
Fll'TED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL AACKFILI_
CONFORM TO BOROUGH REGULATIONS RE Aft ING INSTALLATION.
G.A. .B.
OR
LICENSED DESIGNER
TYPE
DIAGRAM OF SYSTEM
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE
DESCRIBED YSTEM 15 IN ACCORDANCE WITH SAID CODE.
DATE--- APP'LICANT'S SIGNATURE "� `���
Fn.ni F(n-71;) 1
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GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
Date Received
PERC TEST Time of Inspection 0;LL) 'Pal
Date of Inspection
__LQ - ')[l
REQUEST FOR APPROVAL OF rLOQ'
'K INDIVIDUAL SEWER & WATER FACILITIES
(39 Ile (" FOR
Approval requested by:l rrnn,.°,�+ �i1 A.'tL�C _U -1-1
Mailing Address: Q_L_.z�"j Phone:
694-9349
Property Owner: w illiam Cole Phone: ---
Mailing Address: Davis Street — -- -
Legal Description: Lot 62 and 63 Schroeder Subdivision
Location: Davis Street —
4
Type of facility to be inspected Single Family No. of bedrooms _
Well Data:
A. Type
C. Construction
7. Sewage Disposal System: on-site system,
A. Installed
C. Septic Tank: 1. Size
B. Depth
D. Bacterial Analysis
B. Installer
2. Manufacturer
D. Seepage Pit: 1. Absorption Area 2. Material
E. Disposal Field: Total length of lines �-
8. Distances:
A. Well to: Septic tank Absorption area—�Sewer Lines ,
Nearest lot line _ Other contamination
B. Foundation to septic tank , Absorption area
C. Absorption area to nearest lot line - —
EQ -034 (1/74) Page 1 of two pages
GlUTGx AU INGE NU DOROUGI I
'JEPARTMENT OF ENVIROUve fAL lUALITY
3500 TUDOR ROAD
A CHORAGE, ,"ILASKA 9.9507
DATE :iECEIVID:_�
INSPECT:,__
TIME Jp" �)
Plry.UEST FOR APPROVAL OF
INDIVIDUAL SE411E1 AND 4IATE:R FACILITIES
FOR
1 APPROVAL REOUEST[�
ADDRESS :1-1
_QX.._._SU.:__
44./ PROPERTY O!�J!CR:"SL.y7:-----_�..:�;._.�..J'FIOi':E;•��'�' `i,�
1 LEGAL DESCR I PTIOi; :flw____�
4. TYPE FACILITY TO ;MEIPdSPECTE]�:,� �v l'' STRI"ET:.(ta�
HUMUER of ui�R00h1S:_. __..0 _ _ ��- r (_c r-,v� n �,c�� p
I TELL ,BATA:
1 1 /
Tyr-
I3 DEPTH„—�i' n O (
C, SIZE-__ <<?�,�� _ J
D.
E. DACTER IAL Ai LILYS IS----,-
6, S01AGE DISPOSAL SYSTEM:
A, SEPTIC TAi'1K SIF IfOMEfIADE, !
SI la DIAGRAM ON BACK)
2.
3/ f WUFACTURER-
41 I1!STALLER C)1c Y G.4,
APPROVAL NY U'S T FOR Sr!17R n: ' AT -UP FAC I LITI4
1'AG" T, !o
B
v"GPAG' nIT
C.
DISPOSAL FIELD
Ul Ei „ OF
Z. TOTAL LENC,TH__—
�, itnUIRED 'EASUREMENTS
A.
HELL TO S�.-:PTIC TA:;,,
�
/
�.'
IT/,
''ELL TO SEEPAGE: PIT-2/,;L/
C.
',''ELL TO Sr, "ERD.
WELL TO PROPERTY
C.
!I'LL TO OXER PO.S I',L..
W M II IATI01`±_
F.
FOUIZATIOP! TO SEPTIC TAI\!i:
�.
FOUNDATION TO SEEPAGE
PIT_
I1.
SEEPAGE PIT TO PROPERTY LINE
3. M, iE TS
AP 1 i\l/VD);e 1.- / t1,
_� !/
f
SWAM ANCIORACE AREA BOROUGH DEPARTME!T OF CIVIRMflEI'TTAL nUAI_ITY
GD�%�
FHA for n 2573
Rev. July 1958 U. S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT Form Apprevod
FEDERAL HOUSING ADMINISTRATION Budget Bureau No. 63-R296.8
HEALTH AUTHORITY APPROVAL
INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM
PART I. -TO BE COMPLETED BY FHA
INSURING OFFICE MORTGAGEE
—_� SERIAL NO.
MORTGAGOR OR SPONSOR
SUBDIVISION NAME
PROPERTY ADDRESS
BLOCK NO. I LOT NO,
TOTAL NUMBER:
-- BASEMENT New installation Can attic or other area be made Into
LIVING UNITS BEDROOMS BATHS addlNonal bedrooms?
Yes (if Yes, how M"yi)
NO Yes No
WATER SUPPLY BY:
Public System SYSTEM DESIGNED FOR
® Community system Individual
SEWAGE DISPOSAL BY: r NO. OF BDRMS. GARBAGE DISPOSAL
Public system L.__I Community system Individual � � No
Yes
PART I1.—TO BE COMPLETED BY HEALTH DEPARTMENT
HEALTH DEPARTMENT INSPECTOR'S SKETCH
REPORT OF INSPECTION—INDIVIDUAL SEWAGE -DISPOSAL SYSTEM
PRIMARY TREATMENT consists of ❑ Septic tank. ❑ Cesspool.
Septic Tank:
Distance from well, Feet. Material,
Number of compartments
'total liquid capacity,_ gallons. Capacity inlet compartment,_
Inside length,_ ,_ Inside width—gallons.
lees Liquid Jepth, __feet.
Cesspool:
Distance from: Well, feet; foundation, _feet; nearest lot line at front,
Inside diameter, ❑ ❑side, ❑rear, feet.
___- (tet. Depth, feet. Liquid capacity, - gallons. Linine material