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Home My WebLink AboutSHADY LANE BLK 5 LT 6r Lor 31oc-I� lip 5 (`'}UNICIPALITY OF ANCHORAGE - *\,)) DEPARTMENJFHEALTH AND ENVIRONMENTAL .'ROTECTION 825 L Street, AnchoraaR. Alaska 99501 \�� 264-4720 Date Received: October 12, 1977 #1: Time0 #2: Time 11,LjLj #3 Time -��',L Lj _ Date - C cnS Date 11-�-1i�iE Date c Insp Insp &A_"L�Lo Insp �uyLP REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES 1. Lending Institution Request: Spokane Mortgage Company Mailing Address: 3201 C Street, Suite 250 9950ghone: 277-0543 2. Property Owner: Ruby L Jordan Phone: Mailing Address: 6807 East 15th Avenue 99504 3. Legal Description: Lot 6 Block 5 Shams Lane Subdivision _ 4: Single Family Residence: (X) Multiple Family Residence: ( ) Number of Bedrooms: Three Number of Bedrooms: 5. Well System: Individual Well ( ) Community/Public System (X) Permit # Construction 6. Sewage Disposal System Permit # Septic Tank Size Absorption Area Depth of Well Well Log on File ( ) Bacterial Analysis On-site System (xA Installed Public Utility ( ) Installer Manufacturer Soils Rate 7. Distances' Well to Septic Tank to Sewer Line Nearest Lot line to Nearest Lot Line Material to Absorption Area Absorption Area n Page Two Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 6 Block 5 Shady Lane Subdivision Comments: Affadavit Attached: Letter Attached: ( ) Approved: Date: I Disapproved: Date: Department Worksheet: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF ENVIRONMENTAL QUALITY MUNI IPALITY OF ANCHORAGE Sewer and Water Section, Fourth Floor, 825 L Street, E1ncffffi�jiEagska 99501 Attention: Laura Harrison ENVIRONMENTAL PROTECTION REQUEST FOR APPROVAL OF OCT 12 1977 INDIVIDUAL SEWER and WATER FACILITIES RECEIVED 1. Type of Inspection: CMRO VA xx FHA CONV 2. Property Owner: Ruby L. Jordan Mailing Address: 6807 E. 15th Avenue Day Phone 3. Name of Buyer: MICHAEL D. & CAROLYN. K. KNIGHT Mailing Address: Day Phone 4. A Name of Lending Institution: sru&aNh MUMUaen cv. Mailing Address: 3201 "C" Street, Suite 250, Anch., Ak.Phone Name of Realtor or Agent: Marston Realty - Barbara Lion 277-0543 Mailing Address: Phone 277-3511 6. Legal Description: Lot 6 Block 5 Shady Lane Subdivision Location: on 15th just offMarten Street Anchorage, Alaska 7. Type of Facility to be inspected: Single Family No. Bdrms. 3 8. Water Supply Type of Supply: Public Utility XX Individual If Individual, number of dwellings presently served If Individual, depth of well 9. Sewage Disposal System Type of System: Public Utility Individual (on-site) xR If Individual, date of installation Unknown EQ -037 (1174) REAM A U1011ME 11,10 BOROUGH DEPARDIEU OF ENVIROWIENTAL CUALITY 3500 TuDoR ROAD A,!CwRAGE ALASKA 99507 279-30K DATE ICEIVED: INSPECT: TIME: REMEST FOR APPROVAL OF INDIVIDUAL SUIER AIM NATER FACILITIES FOR APPROVAL REPUESTO) A DMC PROPERTY Q;rJERt LEGAL DESCRIPT16j;11-4 4, TYPE FACILITYTo, DFINSPECTED: -LZSTREET: WIDER OF immmis ULU, jATA: 19-71 KASSLER/WEST MORTGAGE CORPORATION 604 EAST SIXTH AVENUE -ANCHORAGE, ALASKA 99501.212-9501 DATE : July 27, 1971 GREATER ANCIIORAGL• AREA 'BOROUGH Dept, of Environmental Health Pouch 6-650 Anchorage, Alaska 99502 RE: Jack Buchannan Legal: Lot 6, Blk 5,Shady Lane S/D (VA) Case # 184 354 Gentlemen per the attached form, we hereby request inspection for health Authority Approval. Please send your findings xxxxx1)c2yTx tAxaxn_MaNft6zkera€1s; ax the VA Office as noted above for the ''Case Number': Also, please send an exact copy of the report to our office. Your swiftness in expediting this request would be most appreciated. Sincerely, KASSLER /R'ES'1' MORTGAGE CORP. Loan 'rocesst.ng Department P.S. If you wish to make an appointment before inspection, please call Gail McCormick at Profession`a1 Realty Inc. 279 8551 g Is F.fm ,HA Form 13, n �Rer. loly 1956 , .-' FEDERAL I10USlKG ADMINISTRATION Bvdg ovdyvi nu. HEALTH AUTHORITY APPIROV AL PAU I.—To BE COMPLETED BY FHA No. 63-8296.8 SERIAL NO INSURING OFFICE 11AOPTGAGEE ttiAi,4 rr I a lit rod.€ -J 11. Holmi e- f r!,n !,t.<i t;.30., -j � T[r3Oi? `j7t'sP P'n 4 e � {Top /l7 `I js€.S ��rd-�lr�'ty �J:j� MORTGAGOR OR SPONSOR PROPERTY ADDRESS n y 'IS `k St''"JR 7 oIodwr1 4 T Of7p, ire, .-r -- LOT NO SUftDivi )6N_YNAM �.._ YOYat hdUFAiIEA: _-_�� I uvwc onus ueonoorns �__. ex.u- BASEMENT M New installation BLOCK NO. U Can nNk or other arae bo made into addltlonal bodrooms7 (If Yes, how r„oY?) PART ii.__'f0 Rid COMPLETED BY HEALTH DEPARTAIv"aEN tEALTH DE'PART'MENT INSPECTOR'S SKETCH jEl Yes No Elv Yes No 3 _; SYSTEM DESIGNED FOR 5 R°� D WATER SUPPLY DV: i� CnbllC S'Stf.m } y� Commune_ System _.-. -- --❑ led - - ...Ino. _ - -.- GA]81Gf DIS>OSAI or evu s �- -- - -. F SsWAGE DISPOSAL BY: Elpublic syst :m -- Fj Community system Individual . j �� Yes R No PART ii.__'f0 Rid COMPLETED BY HEALTH DEPARTAIv"aEN tEALTH DE'PART'MENT INSPECTOR'S SKETCH 2t is the opinion of the L-1 state County [artment of Heat that this individual water -supply sysle n Local Dep is is not satisfactory as a domestic water supply for the subject property. It is the opinion of the [�] State Ej County Local Department of Health that this individual sewage -disposal sys- tern with proper maintenance Cannot be expected to function satisfactorily Can be expected m function sahstactorily, and — is not likely to create an insanitary condition--- --iGNATUNF TITLE DATE �,7G� r _ , /t NOTE: The health authanty shook! complete the aPpro Proate on:mon sta oment above and aff�, slguaiere aad flne !n 4h i spaces provided. r'S sketch as well as use of the ba¢4 of 4hi, form is at the option o the Use of the abgVa geld for Noolth nepartmant Iasr,- Pt ha,hh authority. PAPY III.—FOR U5F OF € HA OFFICE To THE CHIEF UNLBE€dV11 1YM: I have reviewed the foregoing and the pertinent FILA Compliance Inspection Report, and. recommend that tile Individual water -supply system be considered El Acceptable IJ Not Acceptable Sewage disposal kx considered E] Acceptable El Not Acceptable. ■ C ■ p ■ . SIGNATURE CHIEF ARCHITECT DEPUTY FOR CHIEF ARCHITECT FHA Form 2572 Rae luly 1958 was C ; ■�! 2t is the opinion of the L-1 state County [artment of Heat that this individual water -supply sysle n Local Dep is is not satisfactory as a domestic water supply for the subject property. It is the opinion of the [�] State Ej County Local Department of Health that this individual sewage -disposal sys- tern with proper maintenance Cannot be expected to function satisfactorily Can be expected m function sahstactorily, and — is not likely to create an insanitary condition--- --iGNATUNF TITLE DATE �,7G� r _ , /t NOTE: The health authanty shook! complete the aPpro Proate on:mon sta oment above and aff�, slguaiere aad flne !n 4h i spaces provided. r'S sketch as well as use of the ba¢4 of 4hi, form is at the option o the Use of the abgVa geld for Noolth nepartmant Iasr,- Pt ha,hh authority. PAPY III.—FOR U5F OF € HA OFFICE To THE CHIEF UNLBE€dV11 1YM: I have reviewed the foregoing and the pertinent FILA Compliance Inspection Report, and. recommend that tile Individual water -supply system be considered El Acceptable IJ Not Acceptable Sewage disposal kx considered E] Acceptable El Not Acceptable. ■ C ■ p ■ . SIGNATURE CHIEF ARCHITECT DEPUTY FOR CHIEF ARCHITECT FHA Form 2572 Rae luly 1958 tI1°E ORT OF INSPECa1ON-1€ DIVI DUAL SEWAGE -DISPOSAL SYoTEi'v'i PRIMARY "EATIAMY consists of 9 Septic tank. ❑ Cesspool Septic Tank: Distance from well,_ _feet. Number of compartnn,rus -- Total liquid capacity,--_—_ _'t'-eM0_ gailons. Capacity inlet compartment,------ Inside ompartment,_ _ Inside len_ach,— —feet. Inside width, feet. Liquid depth, _feet. cosapool: Distance from: Well, ..._.--.feet; foundation, --__—feet, nearest lot line at ❑ front, ❑ side, ❑ rear. Inside diameter, ----feet. Depth, feet. Liquid capacity, __gallons Lining material — SECONDARY Titt[ATIAEPLT consists of ❑ Tile disposal field. PSeepage pits. Other_ ----- Tito Disposal Field: - Distance from: Well,_ feel, foundation,_ —feeq nearest lot line at ❑ front, ❑ side, ❑ rear,__— feet. Total length of the lines,- .___feet. Number of lines,_ __--- Distance between lines,_.__ ___— —.feet. Trench width, _ .__.inches. Total effective absorption area in bottom of trendies.__— —square feet. Length of each line,_ _fee[. Depth, top of rile to finish grade,--— inches. Type of filter material: ❑ Gravel. ❑ Broken stone. Other_—__ --------------'— Depth of filter material beneath tile,,, inches. Depth of filter material over tile, _inches. sot;pago pits: [ 1 / Loi Number of pits_1—_. Outside diawt2'r,"g .feet. Depth, `S feet- Lining material s- -- Distance from: Well,— __feet, building foundation,_feet; nearest lot line at ❑ Front, 9 side, ❑ rear,�feet. Inspaealon mado byt ❑ State. ❑ County. gLocal Health Authority. > Inspected by-=---!'` b4.; Date of inspection—r�-# nree) 9. W/ J i. ✓iJd7 ' i/; REPORT OF INSPECTION—INDIVIDUAL MM-SUPPLY SY lkivi Distance to nearest public water man), ----feet Size of main, _inches. Individual wells ❑ are ❑ are riot custornaty in neighborhood. Give most recent record of failure of wells in immediate vicinity to famish adequate supply of water Properties in neighborhood ❑ are ❑ are not being developed with both individual water -supply and sewage disposal systems. Loc size:—__ ----_Fee[ wide ,—._.__--feet deep. Dwelling set back from front property line, .—feet. Individual water supply frmn: ❑ Drilled well. ❑ Driven well. ❑ Dug well. ❑ Bored well. Distance of wall from: Building foundation,________ _feet, nearest lot line at ❑ front, ❑ side, ❑ rear.___ feet, cast iron sewer__feet•, tile sewer,__ feet; septic tank, _feer; disposal field.. ---feet, seepage pit, _.... _.--.--feet; cesspool-- feet; other sources of possible pollurion,_. feet. Well cons;rucNan: Diameter, inches. Total depth, feet. Type of casing, _ Depth of casing, feet. Approximate depth to pumping level of water in well- -feet. Approximate yield,— S•rllons per minute. Seated watertight to depth of—_— fecr. Exterior space around casing scaled with: ❑ Cement grout. ❑ Puddled clay. ❑ ordinary backfill. Well cover: ❑ Concrete. ❑ Wood. ❑ Nietal. Openings in well cover watertight: ❑ Yes. ❑ No. pomp: ❑ Shallow well. ❑ Deep well. Length of drop pipe,-----.- feet. Rump capacity, gallons per minute. Located in: ❑ Basement. ❑ Pumpmom off basement ❑ Pumphouse above ground ❑ Pump pit. Pumproom property drained: ❑Yes. ❑ No. pump mounting watertight: ❑ Yes. ❑ No. Type of storage: ❑ Pressure. ❑ Gravity. Capacity, gallons. Has bacteriological examination of water been made? ❑ Yes. ❑ No. if answer is '•yes," give date ---- Quality of water ❑ is ❑ is not satisfactory for human consumption. Installation ❑ does ❑ does not comply with approved exhibits, if any. Inspection made by: �] State. ❑ County. ❑ Local Health Authority. Inspected t>y--_—____ ._—._--- Date of inspection 19 p u. s. eovcnnu u�r rainuxs onia � �zsv or—u>o>e 19_—