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GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
"C" Street, Anchorage, Alaska 99503 274-4561
Date _Received may 17, 1976
Time of Inspection 10:30 a.m.
Date of Inspection 5-19-76 Les
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
F.H.A.
1. Approval requested by:
Mailing Address: Phone:
2. Property Owner: Herbert D. Foster Phone: 333-7190
Mailing Address: 1319 Turpin Road,
3. Legal Description: Lot 1 Block 5 Shady Lane Subdivision
4. Location: 1319 Turpin Road ?
5. Type of facility to be inspected Duplex No. of beidrooms 2 each
6. Well' Data: 1
A. Type rUui B. ueptn I
C. Construction- D. Bacterial Anaplysi's
7. Sewage Disposal System: on-sie system��� ` (I
A. Installed 1962�� Install
C. Septic Tank: 1. Size 2. Manufacturer C�ONGPsE'��.
D. Seepage Pit: 1. Absorption Area °5 =c :MAeriai `' 0C. CF1,
T
E. Disposal Field: Total length of'ljbes
8. Distances: rA,y
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
- _l
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
2510 East Tudor Road, Anchorage, Alaska 99504 276.2221
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES
1. Type of Inspection: CMRO VA FHA
AiiUNOCIPP.LIIY OF ANCHUf'/',f>!;
20
CONY
2. Property Owner: �D��
Mailing Address:/,I !/A P I i✓ 40 4,W Day Phone: l � 3 21 ire
3. Name of Buyer:
J
Mailing Address: Day Phone:
4. Name of Lending Institution: N '5_U 4':�
Mailing Address:
5. Name of Realtor or Agent:
Mailing Address:
Phone:
6. Legal Description: //,7.7 ✓ Zg -,C L d, .F} ryr-
Location: % I i 2 / 3 )�/ 112 12i'r')/try(''#/ I}IC
7. Type of Facility to be Inspected -1_2zz' >`9 -2, No. Bdrms.-2 2 �-
8. Water Supply
Type of Supply: Public Utility ✓ Individual
If Individual, number of dwellings presently served
If Individual, depth of well
9. Sewage Disposal System
Type of System: Public Utility
If Individual, date of installation
72-003(3/76)
Individual (on-site)
Page'2 of two pages - Req^;t for Approval of Individual Sir & Water Facilities
A
Legal Description Lot 1 Block 5 Shady Lane Subdivision
Comments
Approved Disapproved Date �- 7 w
Approv Valid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental Quality
4IAGRAM OF SYSTEM
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I certify that the information contained in this request for approval to be a true and
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED N- Date
EQ -034 (1/74)
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