HomeMy WebLinkAboutALYESKA #1 Block 15 Lot 4t
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15
' SEWAGE DISPOSAL SYSTEM - APPLICATION C PERMIT
Name of Applicant Mailing �� i'; / / Mailing Address Ph.
Residence Address ?•�/,E %cr�,:n A). Location of Installation
Legal Description /17-4- Al. / /Sr r%%/) /%/Y/ S%lit o,11
Application to Install: Septic tank, Seepage pity, Drain field__, Other
To Serve the Following Facility 4./'- 1117^x= ��U^•�G
Financed Through To be Installed by
Percolation Test Results Anticipated Date of Completion
BELOW TO BE FILLED OLTP BY HEALTH DEPARTMENT
This is to serve as %l)h�W—
permit to install a
as described below. Size of unit to be served
clic tank size72U Type e' -47c, -e- Area .VXA- (,_Type
DISTANCES: DIAGRAM OF SYSTEM
IN- Fy,— LFr1� a'
M^/tn� [FSS T7rFhv
r
141 r 17 Lir USC
health Authority
L 1bC`' i,f• ,.r
(cc'
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.