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Home My WebLink AboutTHOMAS L BOYLE BLK 1 LT 6BThomas L. Boyle Block 1 Lot 6B #015-282-04 1 MUNICIPALITY OF ANCHORAGE r - DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION $25 L Street - Anchorage, Alaska 99501 Telephone 2644720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NA PH /VE MAIyy��ING ASS gRE giUPGR ADE /) 6K A LEGAL DESCRIPTION I /hOmAS p — LOCATION ('-A� Oh��,►1 O. OF BEDROOMS NlJ DISTANCE TO: Wall Absorption area Dwelfln9 Uy PERMIT NO. F2 Manufacturer w � Material No. of compartments Lin, capacity in gallons Inside length IF HOMEMADE: g Width Liquid depth dpZ DISTANCE TO: Well Dwelling 11 P PERMIT NO. _?� Manufacturer Xj Material Liquid capacity in gallons sp w = Well �/W L� Found tion PJ Nearest lot line DISTANCE TO: C PERMIT NO LL 2 2 W ~ M No. of lines Length o ell/ line Total le t o�lines Trench width '{ti inches Dlslanq tween lines o h Top of I. e,to finish grade Material beneath tile Cl Total frctiva inches ab /orption area W Length Width Depth C. PEH IT NO. l7 WType of crib Crib diameter Crib depth Total effective absorption area w DISTANCE TO: Well Building foundation Nearest lot line ,u JVA Class Depth Driller Distance to lot line PERMIT NO. W DISTANCE TO: Building foundati n Sewer line Septic tank Absorption area (s) OTHER PIPE MATERIALS A-4 Z2oJ SC ILTIE/S RATING N � INSTAL ER SE' REMARKS 5 P i. C APP V D DATE LEGAL Tmfis 72-013 (R /7B) fc�FF_ DEFrIRTMENT Cr / �iEALTH AND ENVIRONMENTAL I-TECTICiN 825 'L` STREET, ANCHORAGE, AK. ?_?5uA' 264-4120 �_� t -a —'=ITE •= E L F="9:3 F_nL�E- F'C=F?r•1 I T 9 jo PERMIT NO. 780262) APPLICANT RON MOCK r SPAEG;?.1?45-M }.} _2T2� LOCATION CANGE OFF O'MALLEY �- ty LEGAL LEE: 81 THOMAS BOYLE S/D LOT SIDE 46200 SGUNF'E e� TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH MA7iIMUM NUMBER OF BEDROOMS = 3 SOIL EATING (=Q kFTAR)== Ci THE REQUIRED SIZE OF THE SOIL AB=ORPTION SYSTEM IS: C•EF -r 1-i LEt>fGTH a!�f: C3AF11%!E=L E>KF !Ful .�. THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION SIN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE FOTTOM OF THE EXCAVATION CIN FEET). PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION IN_PECTIONS OF ANY'WELL`• ADJACENT TO THIS P'ROP'ERTY AND THE NUMBER OF RESIDENCES THAT THE WEA WILL SERVE. c ] I ta= F F=I Clr-J: nF= E FRET -!1J I rz: EHCKFILLING OF ANY SYSTEM WITHOUT FINAL IFJ_PECTION AND APPF:rn,AL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTIO INSPECTION N. MINIMUM DI_TANCE BETWEEN A WELL AND ANY ON-SITE:SRiWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL; OR.. 150 TO 200 FEET FROM A PUBLIC WELL DEPENDINQ VRON THE TYPE OF PUBLIC WELL. OTHER REQUIREMENT_ MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAM= ARE AVAILABLE TO INSURE PR..OFER'IN_TALLATION. PE F: r•1 I T F' I F= E:E�:C•ECEr•1E:EF: = 2� :I_� I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWER FORTH BY THE MUNICIPALITY OF ANCHORAGE. I WILL INSTALL THE _':STEM Ifi ACCORDANCE WITH THE CODES. ?' I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE RESIDENCE IS REMODELED TO INCLUDE MORE THAN = BEDROOMS. -------SSSS-- AF r I -:ANT RON MOCK, . ' \ ISSUED BY L� ._(_ A --- wS1 AND WELLS AS SET ENLARGEMENT IF THE V3. �-. „ V c GR TER ANCHORAGE AREA BOROLI ^4 0lrARTMENT OF ENVIRONMENTAL QUALII' 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279.8686 L INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME &- `f� MAILING .�4^ ADDRESS-/PD.I' �f/�i fClA PHONE-=iC.�J SEPTIC TANK: DISTANCE FROM WELL,.51) MATERIAL .fT��Z NUMBER OF COMPARTMENTS LIQUID CAPACITY �n GALLONS. INSIDE LENGTH INSIDE WIDTH s��DEPTLIQUI '— SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS Z OUTSIDE DIAMETER �� OR WIDTH '1�-, ,LENGTH ��--, DEPTH �� LINING MATERIALS U C `->�--/i' , DISTANCE FROM WELL , BUILDING FOUNDATIONl'� , NEAREST LOT LINETOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) SO. FT. TILE DRAIN FIELD: DISTANCE FROM WELL_ NUMBER OF LINES—_ DEPTH: TOP OF TILE TO FWI WEII: TYPE LOT LINE Ll�— DISTANCES: �Seo�or�v /.CJ/'O.lfh TOTAL LENGTH FOUNDATION , NEARNT LOT LINE , OF LINES , BETWEEN LINES TRENCH WIDTH SO. FT. LENGTH OF EACH LINE IN. TOTAL EFFECTIVE OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE DISTANCE FROM c— WATER DEPTH , BUILDING FOUNDATION. SAMPLE SEPTIC L, SEEPAGE .TANK-. SYSTEM Li - CFSSPnr DIAGRAM OF SYSTEM c� NEAREST OTHER SOURCES= .. ('l._y I ,I �c Z 1 Cptf T�Dn 1 DATE r GREATER ANCHORAGE AREA SORUUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 4 7500 TUDOR ROAD POUCH 6.670 ANCHORAGE, ALASKA 99702 T[LEPHONE 279-8688 SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT PERMIT NO. NAME OF APPLICANT —�y��'�J ///OG = / MAILING ADDRESS -,_,L.rPHONE INSTALLATION LOCATION - LEGAL DESCRIPTION - �0 //-�- INSTALLATION OF: SEPTIC TANK " SEEPAGE PIT DRAIN FIELD OTHER —r TYPE AND SIZE OF FACILITY TO BE SERVED �Ld 0 �j- hJ FINANCED THROUGH �— TO BE INSTALLED BY SOIL TEST RESULTS /'�//1<G /°L'�L�?/��` 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 HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION. 9 Z SEPTIC TANK SIZE 0 �10 TypESEEPAGE AREA SIZE ��/N� !U/L TYPE L�/'�f I`�<<G_ [�f� %HJT MINIMUM DISTANCES. REQUIREMENTS FOUNDATION TO SEPTIC TANK -57- FOUNDATION FOUNDATION TO SEEPAGE PIT DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL - �J SEPTIC TANK - SEEPAGE PIT �lJ DRAIN FIELD TO NEAREST LOT LINE. WELL TO SEPTIC TANK --�SO SEEPAGE PIT 1-14e::I49 DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK_. n ' SEEPAGE PIT DRAIN FIELD SEPTIC TANK. '� Y SEEPAGE PIT Z_CDRAIN FIELD TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION B 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. HEALTH AUTHORITY OR LICENSED DESIGNER 1 CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE — APPLICANT'S SIGNATURE DIAGRAM OF SYSTEM ORDINANCE NO. 28.68 AND THAT THE ABOVE e. INSPECTION APPOINTMENTS DATE RECEIVED �— �+ s.� TIME TIME TIME DATE DATE DATE NUMBER OF,BEDROOMS INSPECTOR INSPECTOR INSPECTOR S� MUNICIPALITY OF ANCHORAGE 7. WATER SUPPLY `,Yr,,s DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION e INDIVIDUAL C/ 825 L Street • Anchorage, Alaska 88601 • 1 ❑ COMMUNITY ENVIRONMENTAL SANITATION DIVISION ❑ PUBLIC UTILITY A09" Telephone 264.4720 B. SEWAGE DISPOSAL SYSTEM 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 19%1 NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. MAILING DRESS 8 PROPERTY RESIDENT fit �different from above) _�49.H StFftt-, PHONE LXA/rSIF 3//s—SGr/U 2. BUYER T PHONE MAILING ADD ESS 3. LENDING INSTITUTION PHONE 5 c Govf4�'Q 4 i iJ L72— MAILING ADDRESS 35Do elix- 4. REALTOR/AGENT PHONE MAILING ADDRESS 5. LEGAL DESCRIPTION �— �+ s.� 6 c ocK STREE LOCATION 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS P7 SINGLE FAMILY ❑ One ❑ Four ❑ Other 1:1 MULTIPLE MULTIPLE FAMILY �� 1:1 Five ❑ Three ❑ Six 7. WATER SUPPLY `,Yr,,s �{ e INDIVIDUAL C/ 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 ❑ PUBLIC UTILITY A09" depth (attach log if available.) B. SEWAGE DISPOSAL SYSTEM � � / - Yw INDIVIDUAL/ON-SITE" Y h ON-SITE YSTE/M/ AS INSTALLED. ❑ PUBLIC UTILITY 19%1 NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72010 (Rev. 6/79) ` THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON-SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATEINSTALLED INSTALLER ❑SepticTankor [:]HoldingTank Size: If Tank is homemade give dimensions: SOILS RATING TYPE OFTANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES W ELL TO: Sept.clHoltling Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line - 5. COMMENTS Er APPROVED FOR _ BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE N 72010 (Rev. 6/79) ToWn Spurkland P.E. 8155 Cranberry St. Anchorage, Alaska 99502 Phone (907) 243-5302 Bill Lyman ERB 7255 Palmer, Ak. SEWER A D E g U A C Y TEST Legal Lot 6B, Block 1, Thomas Boyle SID Location On Cange Road Owner Bill Iyman Residence Three Bedroom A -Fume Water On Site Well MUNICIPALITY OF ANCHORAO: DEPT. OF W -AL I A. EM✓IRONNENTAL V..OTYTION SEP 1 6 1981 RECEIVED Sept.16,1981 Sewer From flunicipal Records: Tank 1000 gal. Steel, one Compartment Absorption System Trench Absorption Area 290 sq.ft. Installation Date June 19739 Upgrade in Sept. 1978 Date of Test Sept. 11 and 12, 1981 Test Procedure System was inspected on Sept. 10, 1981. Tank was found 9 feet deep with a liquid depth of 4514 inches. Sump is 7'-4" deep with a liquid depth of 2%1 inches. Tank was pumped on Sept. 109 and on Sept. 11 water was added to the trench in increments of 300 gal. and the following readings of the water depth was taken: Water Depth - 9.5 300 21.5 300 33.5 300 42 - Dry Sept. 12 C 4pm. Test Result This system absorbed more than 900 gal in a 24 hour period. The Municipal code requires an absorption rate of 450 gal for a three bedroom house. This system meets that requirement. municipality of AnchorMe n Lc)C/ C? -ate' -11 825 "L" STREET ANCHORAGE, ALASKA 99501 (901) 264-4111 "< CCCIP;= M.SULLIVAN, KA%Olt DEPARTMENT OF HEALTH AND ENVIRONNII"NTAL PHnTECTION September 10, 1981 William D. Eyman Star Route Box 7255 Palmer, Alaska 99645 Subject: Lot 6B Block 1 Thomas B�eLSubdivision Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: (1) _The water analysis report needs to be submitted to phis office from the Chem Lab, 5633 B Street, for our review. (2) The seal on the well head needs to be tightened so Q that it is water tight. &(3). Exposed electrical wires to the well head are in violation of the Municipality of Anchorage codes and must be incased in conduit. (4) The septic tank pumped with a receipt submitted to V kthis office. (5) An adequacy test needs to be performed on the existing leaching area. This test will determine if the system is adequate.according to National Standards. A listing of private firms performing the test is enclosed. This report needs to be submitted to this office for our Wt review. Please notify this office for a re -inspection when the noted descrepancies have been corrected. If there are any further questions, please call this office at 264-4720. Sincerely, James S. Roberts Associate Environmental Specialist JSR/ljw \ 1_ 0. LEGAL DESCRIPTION ~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION • 05 L Street • ArdwWW, Alaska 99501 ENVIRONMENTAL ENGINEERING DIVISION Telephone 2644720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Compleb all parts on page 1. 1 plate retpna4 will not be processed. Please allow ten 110) days for processing. 1. PROPERTY R ❑ One ❑ Four ❑ Other ❑ MULTIPLE FAMILY PHONE MAILING ADDRESS PROPERTY RE 1 NT 11 different from apo PHONE 4' 2. BUYER INDIVIDUAL' 1 MAILING ADDRESS i 10-V 7 S '7 LENDING I O PHONE S. SEWAGE DISPOSAL SYSTEM MAILING ADDRESS 4. REAL TORIAGENT "if individual/on-site, give installation date MAILING ADDRESS If system is over two (2) years old an adequacy test is required \ 1_ 0. LEGAL DESCRIPTION v STREET LOCATION y /V S. TYPE OF RESIDENCE_ NU MBER OF BEDROOMS �( SINGLEFAMILY� ❑ One ❑ Four ❑ Other ❑ MULTIPLE FAMILY ❑ Two ❑ Five ❑ 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 ❑ PUBLIC UTILITY depth (attach log if available.) S. SEWAGE DISPOSAL SYSTEM 1 INDIVIDUAL/ON-SITE" "if individual/on-site, give installation date ❑ PUBLIC UTILITY If system is over two (2) years old an adequacy test is required by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REOUEST BEFORE PROCESSING CAN BE INITIATEQ 72-010(3/78) THIS SIDE FOR OFFICIAL USE ONk. 1" -DATE • INSPECTION APPOINTMENTS RECEIVED •- TIME TIME TIME , DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER ❑Septic Tank or ❑ Holding Tank Size: If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCEStic/ WELL TO: olding Tank Absorption Area Sewer Line wren Lot Line Absorption Arm to nearest Lot Line 5. COMMENTS ❑ APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE BY ITitlel LEGAL DESCRIPTION 72010 (Rev. 3/78) r F R M SUBIECT,T 8�/GJ DATE MESSAGE "r Slc. GU . REPLY SIGNED _ DATE�_�/�� ®4$ 471 - RRdifprm - - SMD PARTS 1 AND WITH GRRON INTACT . PART 0 WILL RE RETURNED WITH REPLY. DETACH AND FILE FOR FOLLOW-UP July Cr 1978 Ron flock Star Route A Bos 1745-A Anchorago, Alaska 99507 Subjects Thomas Boyle Subdivision Lot G 8 Blalock 1 The percolation test perfomred on your sewer system failed to pass the adequacy test. Therefore before we will send the approval to the lending agency an upgrade will be necessary. The upgrade would include a twenty-fivo(25) foot trench with six(G) foot of gravel below the drainpipe. The width of the teench would be the size of the backhoe bucket. A permit must be obtained from this office before any construction. If there are any further questions, pleaeo contact this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Sanitarian RCP/ljh If , ccs Alaska \Toster's Federal\Credit Union 1200 Airpo3t Tieights-P.oad, Suitp 430 99504 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION • 825 L Steal • Andwrop, Aleks 99501 ENVIRONMENTAL ENGINEERING DIVISION Telephone 2844720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all pan, on pap 1. Ineomplab requaau will not be Proeamd, Pl a allow ten (10) days for procuring, 1. PRO OWNER PHONE f4 -32 72 MAI IN A RESS 745-4 ,S— PROPERTY RESIDENT (it diFleranin t from above) PHONE ER, 2, BUYPHONE I—i?J✓ �u �� c i CSl—.iSlS3 h,AILiNG ADDRESS 7. WATER SUPPLY 3. NDINO INSTITUTION �' PHONE MAILING ADDRESS. tC C L- l� �O ✓ ..JC'Y 4. REALTO ADEN - depth (attach log if available.) t" s MAILINGAODRESS _. 6. LEGAL DESCRIPTION C STRE TION / r L�%A'IIk7 6. TYPE RESIDENCE NUMBER G;V' SINGLE FAMILY ❑ One ❑ Four ❑ Other [a -,Two ❑ Five ❑ MULTIPLE FAMILY ❑ Three ❑ Six 7. WATER SUPPLY 19' 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 ❑ PUBLIC UTILITY depth (attach log if available.) t" s 6. SEWAGE DISPOSAL SYSTEM i;P "If 12' INDIVIDUAL/ON-SITE" individua on-site, give installation date ❑ PUBLIC UTILITY If system is over two (2) years old an adequacy test is required by this Department NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. ,or.n,ene� '700 � a I /t , , N1h 3' i P, y-&.6 . THIS SIDE FOR OFFICIAL USE ONLY - DATE RECEIVED INSPECTION APPOINTMENTS IME TIME TIME _ Irn DATE / DATE ( n DATE INSPETOR Y INSPECTOR INSPECTOR , 'r DIRECT NS: 7. TYPE OF RESIDENCE NUMBER OF BEDROOMS ❑SINGLE FAMILY ❑ ONE THREE ❑ FIVE ❑ OTHER ❑ MULTIPLE FAMILY ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY PERMIT NUMBER ®/INDIVIDUAL DEPTH OF WELL ❑ COMMUNITY DATE DRILLED ❑ PUBLICUTILITY LOG RECEIVED Connection Verified 3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER C0+10DIVIDUAL/ON -SITE ❑ PUBLIC UTILITY DATE INSTALLED ^� / Connection Verified INSTALLER (13teptic Tank or ❑Holding Tank Size: 16" If Tank is homemade SOILS RATING give dimensions: TYPE QfI.jAN MANUFACTURER TOTAL A13S PrTJON AREA MATERIAL r j�QQ _ p t% 4. DISTANCES Septic/Holding Tank Absorption Area r Lim nett Lot Lim WELL T0: Absorption Area to nearest Lot Line 5. COMMENTS No %1G — � fB/APPROVED FOR _ BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED ' DATE BY (Title) ^/ L LEGAL DESCRIPTION 72-010 (Rev. 3/78)