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Home My WebLink AboutSMITH TERRACE TR IGREATER ANCHORAGE AREA HORUGH Department of Environmental Quality 9 u 3330 C Street 6/ Anchorage, Alaska 99503 SPE.CTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME(N/vILING ADDRESS A I� �i ��J�6n PHONE LOCATION �7 % t� > LEGAL DESCRIPTION SEPTIC TANK: DISTANCENUMBER OF FROM WELL 1`�MANUFACTURER MATERIAL COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY GALLONS. SEEPAGE Pte: NUMBER OF PITS LINING MATERIAL BUILDING FOUNDATION ADDITIONAL ABSORPTION j r /> '_f DIAMETER OR WIDTH, LENGTH , DEPTH CRIB SIZE: DIAMETER —DEPTH _0—'/DISTANCE FROM: WELL TOTAL EFFECTIVE NEAREST LOT LINE ABSORPTION AREA (WALL AREA) SQ. FT. WELL: TYPE CONST RUC BUILDING NEAREST FOUNDATION LOT LINE— CESSPOOL APPROVED DISTANCES: INSTALLED BY: PIPE MATERIAL: LOT SLOPE: REMARKS: Form No. EQ -031 _ 7 r. _'j -- '4, X)2h�' TION DEPTH DISTANCE FROM: , OTHER SOURCES NEAREST SEPTIC SEEPAGE SEWER LINE TANK SYSTEM DISAPPROVED_ REMARKS DIAGRAM OF SYSTEM tI d- DATE _ /I I�Z APPROVED � iY 6" -la r4I?je-U- G A.A.B. / P DATE _ /I I�Z APPROVED � iY 6" -la r4I?je-U- G A.A.B. 3lD at'n -- cel% GREATER ANCHORAGE AREA BOROUGH 74��i DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 294-4561 ,o nw'hVU�/ SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT NAME OF APPLICANT INSTALLATION LOCATION LEGAL DESCRIPTION INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH SOIL TEST RESULTS COMPLETION DATE ANTICIPATED MAILING ADDRESS PIT , DRAAN FIELD TO BE INSTALLED BY PHONE OTHER X , 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 BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE TYPE MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT SEPTIC TANK TO SEEPAGE PIT WALL DRAIN FIELD SEEPAGE AREA SIZE SEPTIC TANK SEEPAGE PIT , DRAIN FIELD TO NEAREST LOT LINE. WELL TO SEPTIC TANK SEEPAGE PIT , ✓� DRAIN FIELD c1 C7 ALSO CONSIDER AREA WELLS.♦ WATER MAIN TO SEPTIC TANK SEEPAGE PIT DRAIN FIELD 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 FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. 4?Q G.A.A.S. OR LICENSED DESIGNER TYPE DIAGRAM OF SYSTEM 1 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. 5 DATE '7-1-76; 6; APPLICANT'S SIGNATUR FORM NO. EQ -016 ✓ 9 1 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. 5 DATE '7-1-76; 6; APPLICANT'S SIGNATUR FORM NO. EQ -016 UwH GRE,' -"4 ANCHORAGE AREA BOF 7H Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME 1 rLN l—Vf'-ci,_ (_�IAoc l MAILING ADDRESS IOL CHO] , (1"k;': , '( 1 ,PHONE �%�-2'�'- LOCATION GrL'✓ S LEGAL DESCRIPTIONLei5 iy ni l V Ludy -G SEPTIC TANK: DISTANCE`` �/� 6, NUMBER OF FROM WELL MANUFACTURER'I'-'"ti I I' l 5 MATERIAL Y'�v't7`a!i{ SS COMPARTMENTS j INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY /"Hc' GALLONS. SEEPAGE PIT: NUMBER OF PITS DIAMETER &L' OR WIDTH %� , LENGTH IL, DEPTH c 1 . LINING MATERIAL �r avC=L CRIB SIZE: DIAMETER(? DEPTHJ' DISTANCE FROM: WELL TOTAL EFFECTIVE BUILDING FOUNDATION NEAREST LOT LINE ABSORPTION AREA (WALL AREA) S7 SQ. FT. ADDITIONAL ABSORPTION /Y'e6 t'l (011(/'S -C /616'(e WELL: TYPE �lIIGLC-%> CONSTRUCTION -L- C%r% DEPTH DISTANCE FROM: BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION LOT LINE -,SEWER LINE -,TANK SYSTEM CESSPOOL OTHER SOURCES APPROVED DISAPPROVED REMA DISTANCES: INSTALLED BY: PIPE MATERIAL: ('I5'r 11 -?w LOT SLOPE: REMARKS: DIAGRAM OF SYSTEM DATE IUP-� Z4", SCI �S C� J C. T_ 111 �^ Gi(LLU4 flL4 v` - APPROVE / /G.A.A.B. Form No. EQ -031 (--dil lfll lfIMI��itp �� v¢eo u+`A GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM — APPLICATION AND PERMIT NAME OF APPLICANT "Z..`� v c c:: 1c INSTALLATION LOCATION >z kv'-ty LEGAL DESCRIPTION Lk, INSTALLATION OF: SEPTIC TANK MAILING ADDRESS i �1 SEEPAGE PIT/ PHONE "- L�ZLI - DRAIN FIELD OTHER TYPE AND SIZE OF FACILITY TO BE SERVED c,.,..,. -c.. ruen„r_. ( e -I \ rn or ,n,cre, i cn ov �(i t1 V --`t SOIL TEST RESULTS(�k-Ll(.�t,L'r NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST / COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE 15 L} TYPE Slee �_ CL�xCvY "c SEEPAGE AREA SIZE �'I�Cti.�lL1S� MINIMUM DISTANCES, REQUIREMENTS WATER MAIN TO SEPTIC TANK SEEPAGE PIT , DRAIN FIELD loot r ( l 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 FITTED WITH AIRTIGHT REMOVABLE CAPS GRAVEL BACKFILL CONFORM TO BOROUGF I / ULATIONS REGARDING INSTALLATION. G.A.A.B. OR LICENSED DESIGNER II a -z C�t TYPE DIAGRAM OF SYSTEM FOUNDATION TO SEPTIC TANK �I �L' FOUNDATION TO SEEPAGE PIT DRAIN FIELD I SEPTIC TANK 70 SEEPAGE PIT WALL ( SEPTIC TANK , SEEPAGE PIT '" DRAIN FIELD TO NEAREST LOT LINE. WELL TO SEPTIC TANK SEEPAGE PIT DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK SEEPAGE PIT , DRAIN FIELD loot r ( l 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 FITTED WITH AIRTIGHT REMOVABLE CAPS GRAVEL BACKFILL CONFORM TO BOROUGF I / ULATIONS REGARDING INSTALLATION. G.A.A.B. OR LICENSED DESIGNER II a -z C�t TYPE DIAGRAM OF SYSTEM 1 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE- •� APPLICANT'S SIGNATURE FORM NO. EA -016 77(( T 1 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE- •� APPLICANT'S SIGNATURE FORM NO. EA -016 i 0 Et E GEOTECHNICAL & DEVELOPMENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster Earl Ellis 694-2774 688-2280 Soils Et Foundations Land Development SOIL LOG Performed for: Name: Tel . No. lot l 2 'c Mailing Address: 7KU Legal Description: Vc�- -7�+75 g Depth (feet) 0 Soil Characteristics 1 (� �$N- Z� c Z�,X_- y Q%') Cay vSj-- 2 3 4 5 7 N 9 10 11 \I- 51�zl 12 Ground Water Encountered: Yes No ?` If yes, what depth Proposed Installation: Seepage Pit Drain Field Comments: L\ yz tC> IN '\'i' 12c:s v M to t'! 1 rc 1 (� \ J S w� �\�L`Zi'i � �\— �\ i�(l�� d \ •-C \ £tiC,�`z�? 3•�ii� �i-�J \ Ci � rte' iCl��,-� Performed by: r\N—' r �� ,sDate: GREATER ANCHORAPE AREA MROUGH -" HEALTH DEPARTMENT CASE, # 327 EAGLE STREET ANCHORAGE, ALASKA 99501 Performed For. Frank Maus Date Performed June 3, 1970 Legal Description: Lot Block Sub ivision Smith Terrace This Form Reports a: Soi�ilslLop >< percolation est Depth Feet Soil Characteristics 6 p ,3 B. ..me $ t5k)6tHTLY f[L-T i' y S/�ry C /Q Location Sketch ..rM..r... •� -- y Was Ground Water Encountered? AID j0 If Yes$ At.What Depth lrvw5ea 1nszaiiat1on: Seepage Pit ' Depth'of Inlet Dr :n >epth To Bottom Of Pit ' r COMMENTS:T)ue to the variation in tie types of soils, we estini;i, the nuni'bui uf- r- --mage naariad in tho aapn,%" pit Vil�l ba—nwroximately 150 Sn77ara facer 11"1- o Test Performed By: ,k >> Col i onsultaants Data Certified By. G�c - e'I,v��{�i Date no 4, GAAB-HD-2 GREATEr ANCHORAGE ACA '- TROUGH Case No. � - HEALTH DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 279.2511 1- ✓Y! SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT NAME OF APPLICANT�4 "I 'I MAILING ADDRESS 7`�G <+- 1 341V~ /� 1A��i(i�%PHONE N0. RESIDENCE ADDRESS _ z 7%� LOCATION OF INSTALLATION_ /&7�'S" LEGAL DESCRIPTION APPLICATION TO INSTALL SEPTIC TANK SEEPAGE PIT DRAIN FIELD , OTHER TO SERVE THE FOLLOWING FACILITY er 9,e,� FINANCED THROUGH TO BE INSTALLED BY J` TEST RESULTS ANTICIPATED DATE OF COMPLETION/" BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT THIS IS TO SERVE As �� /� PERMIT TO INSTALL A�✓'��l7/ AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED SEPTIC TANK SIZE X�_TYPE /f SEEPAGE AREA yp DIAGRAM OF S TEM DISTANCES: L 'tO 7-6 ZIAG, , 2� W_ HEALTH AUTHORITY OR LICENSED DESIGNER U I certify that I am familiar with the requirements of Greater Anch- age Area Borough Ordina 6e No. 2 [8 and that th above described Sys em is in accordance with said code. DATE 2, APPLICANTS SIGNATOR GARB"D GRF4TER ANCHORAGE AREA BOROII^H HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON SITE SEWAGE DISPOSAL SYSTEM NAME- f ✓�'i,� /G L�ZZy MAILING�(ejcl ADDRESS 7Nys Q'c& Ff2crr� PHONE LOCATION / LEGAL DESCRIPTIO) SEPTIC TANK: DISTANCE FROM WELL CT L. MATERIAL Xt&_&_Z, NUMBER OF COMPARTMENTS_ f LIQUID CAPACITY /COO GALLONS. INSIDE LENGTH _5'�L ��' /�70 LIQUID INSIDE WIDTH DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS- OUTSIDE DIAMETER / OR WIDTH LENGTH l5 , DEPTH__ .LINING MATERIAL ` C 129 .DISTANCE FROM WELL •E,. 5_1 ,��B//UILDING SQ. FT. FOUNDATION�i NEAREST LOT LINE TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)_ �Yy TILE DRAIN FIELD: DISTANCE FROM NUMBER OF LINES ABSORPTION AREA FOUNDA SQ. FT. LEN INES NEAREST LOT LI WIDTH TOTAL LENGTH —, OF LINES IN. TOTAL DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE_ WELL: TYPE flp /DISTANCE FROM IN. ABOVE TILE DEPTH (�� , BUILDING FOUNDATION._ WATER SAMPLE �- NEAREST NEAREST LOT LINE , SEWER LINE , TANK C SYSTEM SEEPAGE 122 'OTHER CESSPOOL SOURCES= DISTANCES: A~ � 9z' -t) = 7' DIAGRAM OF SYSTEM y - IATER :SELL IIRILLE'RS LOG JMLINO CO. G _�c C ,RTTLI` 00. DRILLER ME H. COHR DO NOT FILL IN USGS NO. +ELI. O'F 1ER PETERS CREEK-CHAPEL—..:7ILLIA:Y D.. S''YDE'R.. -. tJSTa OF LLL OC:;„ STIC . Xocation (address oft Toomshipp Hang% & section' if knaw�; or distance from main, _ road LOT #5, SMITH T. ^- SUP, _ _.. . RR:1 _, A 3CE LRhG RECO-cD '•;G DIST. PLAT 63-69, T15N5 RAv., sm. Alae 1YZE OF CASZ^'G 6_11. 19# n -TH OF HOLE ^ 180 FECT CASED TO 180 T --Y.._.. M1TIC "td,TER LEVEL 153 FET (F{�ME) (srLQ r). LAtn SURFACE. FINISH OF'°T"U (CHECK --e.:...... ONE) 0"EN ENI! (:{:{} 3 "ua^R' EId ( } ; PERFORATEP �+ } DEta SCREEN OR PERFORATIONS. 'EIL FU':PDtG TEST AT 6� 0� GA110111 PER Wirii) (_. :o FOR 2 HOU;35 ..UTFI 7 FETT"OF DRK7 D0_N FROM STATIC LEVEL: ' MARKS round surface- - ------ and hardness. - •"•"""j"i8 penevsawa. •size ofias _eriaj e5o or 0- to 17 GRAY TILL, 17• to 30 CLAY at GrRAV7L 30 to 45 CLOY kt ROOKS 45 to 80 CLAY (GRAY).,,` 80 to 88 ROC'S (IARD) 88 12 IT, V........> '25 . to--.•�• 153 CRAY t �553a-*�tOAJ7 7D ° �-Itl _L RA EAjtT= C -167:. t� 175 �•i`iJ 175 to l .� J-._:� _. J_? (. _.. _; :dr. GAAB-HD-1 GRFATER ANCHORAGE AREA BOROUGH e+ HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING ADDRESS LOCATION / LEGAL DESCRIPTION 7_ i ZZ -2V CFPTI(' TAMC. PH0NE�- DISTANCE FROM WELL % MATERIAL �'�`��-L.� NUMBER OFCOMPARTMENTS LIQUID CAPACITY �G7 GALLONS. INSIDE LENGTH s INSIDE WIDTH DEEPTHD S y SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS / OUTSIDE DIAMETER-� OR WIDTH � s� / �/ LENGTH, DEPTH LINING MATERIAL e_ -j-. DISTANCE FROM WELL �a BUILDING FOUNDATION —:7> . NEAREST LOT LINE .�nU:a6TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) -5 --%-2- SQ. FT. TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER ABSORPTION AREA NDA ISTANCE BETWEEN LINES SQ. FT. , NEAREST LOT LINE - TRENCH WID E TOTAL LENGTH OF LINES , IN. TOTAL EFFECTIVE DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE - IN. ABOVE TILE WELL: DISTANCE FROM / WATER TYPES//�f ,_DEPTH�BUILDING FOUNDATION. 7. SAMPLE �� NEAREST NEARELOT LINE ,/ d �'� SEWERSINE �TANKC / / O SEEPAGE / OTHER �� ,SYSTEM CESSPOOL-, SOURCES 4' DISTANCES: DIAGRAM OF SYSTEM l z` / a/ /j�o DATE APPROVED HEALTH AUTHORITY GAAB-HD=2 GREATEf ANCHORAGE AREA '_ OROUGH Case No. HEALTH DEPARTMENT l 327 Eagle St. Anchorage, Alaska 99501 279-2511 NAME OF APPLICANT RESIDENCE ADDRESS SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT LEGAL DESCRIPTIO APPLICATION TO INSTALL: SEPTIC TANK TO SERVE THE FOLLOWING FACILITY_ a!e3/l MAILING ADDRESS �� HONE NO. � 2q'` LOCATLON OF INSTALLATION//I�,�� 221 ' T SEEPAGE PIT Y DRAIN FIELD , OTHER FINANCED THROUGH TO BE INSTALLED BY PERCOLATION TEST RESULTS ANTICIPATED DATE OF COMPLETION MM�0 5 �S/YJe°Z M TO BE FILLED OUT BY HEALTH DEPARTMENT THIS IS TO SERVE AS X/4 `' PERMIT TO INSTALL A AS DESCRIBED BELOW. SIZE OF UNIT 0 BE SERVED SZci'L� SEPTIC TANK SIZE �' TYPE �ak�SEEPAGE AREA TYPE y DIAGRAM OF SYSTEM (� t /16-Pbf_444"tc. DISTANCES: ,gyp' uoe ` /' a�.06 r !r, llrplofl zlzeip( 1 HEALTH AUTHORITY OR LICENSED DESIGNER I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the above described system is in accordance with said code. DATE /LLL APPLICANTS SIGNATURE NOON■ ■��IIL��■■■■■■..�� NOON■■■Y■■■1_�O�■�..�' �� ■/NUJ■ NOON■■■c■■��► ��■■■■■■■■■ ■ ■■EEMENIINE■ ME■■■N ■■ONE ■■■■■■0■0011011ENEE■■■ NOON■■■■EOM IMIIIi■■■NOME■ ■■■ NOON■INNNI Sam- M JIBHNIN NOON■■■EN■EEMNE■EE mom N■=■�■■■O■EE■ir■■NE■EE■ ■■ ■ ■■■■■■■■■■■■■■NEIN EEE ■■■ ■■■EE■E■■E■■■■ NOON■■ ■E■■E■■E■■■■ONN ■■■■■■■■ ■E■N■■■NENN■N ■■■■EE■■■ ■■■■■■■■■■■■ .... ■■■■■■ mom .■■■■■■■ ■■■■_■■■■■■■■.■.■.■■ ■■ ■■■■■■■■■■■■■■■■■ a APPLICi-AT FILLS OUT UPPER HAL ONLY Time n Property Ow„er 1, -:-(C��i/.'"�� / ( i �f r (r`�, t ' 4✓ Phone M,Ziling Address ,� -� '�- 7 t` .•;� LA '= i / . )--1' /' - V Zip Code Buyer Date Address Zip Code - Lending Institution Phone Address Zip Code Inspector Realty Co. & Agent Ins for Phone Address (je v r 4 e T Zip Code - Legal Description - tl ✓VC t ✓(-,n(T(� Street Location Type of Residence ❑ Single Family - ❑ Multiple Family No. of Bedrooms EK Other Water Supply - ' f3,IndiviSlUal _ ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. Oommunity^'''` 'T-r—Pub(OG—ti l For wells drilled prior to that date, give well depth (attach log. if available). Sewer Disposal V( Individual -,- Year Individual Installed - - El Public 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 Date Date Date Date Inspector Inspector - Inspector Ins for Field Notes, nr "'1'�i�Q'C;✓/i'® GL(�y AUG 10 1983 �.�Fy�-L � !W F - ".__' '^ „ t q t,s.. 11tV t`f ( ) APPROVED BEDROOMS - a 'CONDOITI.ON•iS G,t OF uAPPROVA;)! L, jVPruISAPPROVED amkI , (✓�) # � ( ) CONDITIONAL APPROVAL' DATEBY: ��'-') (t o %}-0,k- Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received Septic Tank Size Well to Tank 72-023 (3182)