HomeMy WebLinkAboutSEACLIFF BLK 1 LT 4h LVJ -- �( '�2[
5. LEGAL DESCRIPTION
MUNIC i
MUNICIPALITY OF ANCHORAGE
D[PT. G ',.
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTEcT%NRON;,/,FVTI-.'_ •,'•.-- -CTION
825 L Street - Anchorage, Alaska 99501
nn
ENVIRONMENTAL ENGINEERING DIVISION
6. TYPE OF RESIDENCE
Telephone 264-4720
RECEIVED ECjVED
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. PROPERTYOWNER
-
PHONE
John & L. Jolene Hoelter
243-3277
MAILING ADDRESS
❑ COMMUNITY
9231 Shorecrest Dr. 99502
IM PUBLIC UTI LITY
PROPERTY RESIDENT (If different from above)
8. SEWAGE DISPOSAL SYSTEM
PHONE
INDIVIDUAL/ON-SITE**
give installation date
2. BUYER
❑ PUBLIC UTILITY
PHONE
Robbie W. & Lillian E. Mattson
349-4806
MAILING ADDRESS
7003 Stanley Dr. 99502
3. LENDING INSTITUTION
PHONE
Alaska Mutual Savings Bank
274-5722
MAILING ADDRESS
P.O. B Anchorage. Ak. 99508
ATTN: Carmen Garri
4. REALTOR/AGENT
PHONE
Dahe Xaviere Cook Inlet
276-1222
MAILING ADDRESS
619 E. 5th Ave. Anchorage, Alaska
5. LEGAL DESCRIPTION
L 4, Blk. 1 Seacliff Sub.
STREET LOCATION
9231 Shorecrest Dr.
6. TYPE OF RESIDENCE
NUMBER OF BEDROOMS
L] SINGLE FAMILY
❑ One L] 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
IM PUBLIC UTI LITY
depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM
**If individual/on-site,
INDIVIDUAL/ON-SITE**
give installation date
If system is over two (2) years old an adequacy test is required
❑ PUBLIC UTILITY
by this Department.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010(3/78)
February 26, 1979
THIS SIDE FOR OFFICIAL USE ONLY
DATE RECEIVED
INSPECTION APPOINTMENTS
TIME
TIME
TIME
DATE
DATE
DATE
INSPECTOR
INSPECTOR
INSPECTOR
DIRECTIONS:
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
❑ SINGLE FAMILY ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER
a
❑ MULTIPLE FAMILY ❑ TWO ❑ FOUR ❑ SIX
e
PERMIT NUMBER -
2. WATER SUPPLY
❑ INDIVIDUAL
DEPTH OF WELL
❑ COMMUNITY
DATE DRILLED
❑ PUBLIC UTILITY
Connection Verified
LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM
I PERMIT NUMBER
❑INDIVIDUAL/ON -SITE
I 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
Nearest Lot Line
WELL TO:
Absorption Area to nearest Lot Line
5. COMMENTS
;. I
O 4.1
(f i.c.
�rq' �t�g�f-t�B:��ti (�}lk- 7.
tt.(�� ..1, ".\ 1•h t.. § <..�C. g��C- ♦ 1`�"tr��� �.h 4_r A 1A_1'-.
APPROVED FOR BEDROOMS
I ]","CONDITIONAL APPROVAL (letter must accompany certificate)
❑ DISAPPROVED
f�
DATE
BY (Title)
�
r
LEGAL DESCRIPTION
72-010 (Rev. 3/78)
April 8, 1969
Mr. T. C. Burrell
2436 Lee Road
Anchorage, Alaska 99504
SUBJECT: Sewer and Water
Facilities - Lot 4, Block 1,
Seacliff Subdivision
Dear Mr. Burrell:
The subject facilities were inspected on April 8, 1969
and are hereby approved. The sewer system consists of
an adequate size septic tank and seepage pit and the
water is supplied via a public system approved by
this office.
Sincerely,
DAVID R. L. DUNCAN$ M. D.
Medical Director
BY:
Rolf R. Strickland, R. S.
Sanitarian
RRSlsrr