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HomeMy WebLinkAboutNORTON PARK #2 BLK 4 LT 1Norton Park #i Block 4 Lot 1 #016-211-63 02/20/2015 22:05 907--345-3262 ALPINE DRILLING (Municipality of Anchorage Community Development Departnr Or�Prograli 4700 Elmore St. • P,p. Bax 196650 nclhorage, te AIC 9and 519-665oerhttc:pww Well Decommissioning PAGE 01,101 .tnuni.orgfo!tsie • (507} 343-7904 Subdi+iision&lahi"�' Block T _ _ R _Section_.,__ Wt- -On -ode Woter 8. Wastewater Program oeitaed Contractor performing the veil &commissioning: Na � 0 . •S 6 _ 1f,0lYb^ company. —"4—" �18.4.�r►wS Wl�j�9�f ••old,$ (�f,((� WON deconuhissionlr+g date •�—/I f., Signature; w 61('0aIi �3 Mef!wd of dacommissioning:AMC 1J.5S,osQi.i i3. b, 0 c,N Locatlon: Use the spat* nelmvto provlda Nonh aaow a draw!ng of the p.•ooerty showing she firllowing items, • • Decammiasionad,veil• • Oftr oratorx lls nn the proparly, • Two separaie swing tla distances (or each Well sho .. on the drawing, Note; Tha swing.tle distances snail ne mesaured from either permanent structures or tna pmpany oornam. F.9• P D !r. Time e Date ---��lL Date Date In pector — - 3) - oZ AA ' Inspector Inspect Comments ---- Conditional Approval Date Sewer Installed Permit No. Septic Tank Size Holding 'rank Size Soils Rating—����` Weil To Absorption Area Well Log Receive Well to Tank APPLICANT FILLS OUT LOWER HALF ONLY �-- Property Mailing Address 3�31 uric(� ([`ir(�Z� X37 Etu—ye r Address Lending Institutlon__NDT EPhone Address � � / tn� ! ,yt / � %_ Realty Co. &Agent Address Legal Description __ t Street Location��� T Residence -( �- �ngle Family ❑ Multiple Family El Other No. of Bedrooms _ Wats upply �iIndividual F1 ATTACH WELL LOG. A well log is required for all wells drilled since June Community 1975. For wells drilled prior to that date, p g f7 Public Utiles - available.) Segive well depth attach to if wage Disposal �--`—'-"-"�� Individual ublic Utility Year Individual Installed: 11 Fielding rankC�. Utdtiili.t When NOTl�'TI3E INSPECTION FEE MUST A( t,OMPANY EACH REQUEST BEFORE PROCESSING CAN 13E INITIATE11[[U`:� DIRECTIONS TO PRO _.ATY TO BE INSPECTL. Sewer and Water Program Note: be sure to put colour of house or other landmarks that will make it easy for the inspector to find. Accurate directions will save time and not cause delays in scheduling. SWP/025 IT' r I- c� i'j- ri iloof! f-, Lo I)o I.vlav yl (I The 1 -v"it 1. nood- to bo I li-- f'. i I CCCC 'Ji- co Vrcwl F.h n ("`-l(;va 1,n.1), 3 i f3f 7-(,�ot[ 'loj--- om' 'Coy kiliell -11 'scr", I it ric iavc, cio rZ (:'L -r.7. I Ira t F. nerclal if;t 73TI Vox--ridrw Oij'cic�, 4 llo)-to)i Park Vtdvi 'L2 I nf, lintU the "'ol-Inwirici lino ; I)ov(, lvoyl col--Irdot-,Clcl 0 Tlw Lcj) 0, (-�,nc) 1 --lin t -�IU ,,.77�tur IT' r I- c� i'j- ri iloof! f-, Lo I)o I.vlav yl (I The 1 -v"it 1. nood- to bo I li-- f'. i I CCCC 'Ji- co Vrcwl F.h n ("`-l(;va 1,n.1), 3 i f3f 7-(,�ot[ 'loj--- om' 'Coy kiliell -11 'scr", I it ric iavc, cio rZ (:'L -r.7. I Ira t F. nerclal if;t l.�y 10, 1979 (.74 -Ary 1i%rollquo.ijt l:ar Route- A llo:x .1.61 nchora Jr , Alaska 99502 ,ttrlajec t: lot l Bloch '! Nortaolz 'Pa.rk. Subdiv:isio n Rile Well :aeVVi"U the suDjec:t refiiClen(.e war3 saripled Jointly by nl,raoka D,c'Tartlmont c):% Lnvir4nrlfxntal Consorvatinn and tiro i:�r-!part�te�nt of xtealt.h and i-Invironrnental Protection on 'lay 1, 19700 Tho res4alt s arc-, indic at;.incr arsenic in oxcrefls of allowable l iialt ,3 for driir.1G?:ng water. Nei4hboring wolo:l:a wore also sampled and found to have traces of arsenic`" far I z,lo"s'J it11i1�r:1L:r71`.3. bly inquiry to this r'lopartmont' s medical. officorp Dr. A. Burst, M.D. r-gardinc7' your pater contaarni.nat;ion raHulteci in a r acormt end ation that you awl fartlly sook {:ledic;al counsel. 4yiYrGu your prob:lc at is lrlol ai:cd to a privato wato wc.:ll uneler your control, corrective action is recommonded as goon as L.)oasi.lA.c`. If t:horo are. any furUie�r questions, plcrnso contact this office at 264 -4720. Sbic(1wa ly, I:te:o W. isustrhol.z, t;.n. e-nior 1;;nviroll amts itJ(JC'ira7 3 U LNI.'3//1Jw Nlunll A01 1 fY May 1, 1979 Poucf 1 6 650 AINICHORAGE, ALASKA 99502 (907) 279 2511 rsur_ rvah, VAtiOR T`,' Sandy Kronquest Star Route A Boli 161 Anchorage, Alaska 99502 Subject: Pater Sample from Norton Park Residential Lot 1 Block 4 From analysis information submitted, your well exceeds drinking water standards for arsenic and is excessively high in iron. The matter of providing an approved water supply to your new residence remains between you and your builder. This department will provide or refer you to expertise as requested, however, the civil matter between you and your builder remains to be resolved. Incidential.ly, the well was drilled prior to the Municipal well ordinance. This department was lead to believe that a second sample to confirm the excessive contamination limits would be taken. As of this date, arrangements have been made,by this department, to sample the neighboring area. The department can document problems for individuals or community groups and offer expertise in finding alternatives, however., construction and cost o` alternatives remains with each residence. Additionally, the use of treating for arsenic on a residential household basis is not recommended by this department or the Alaska Department of Environmental. Conservation. Costs of maintenance cont -ince to increase and the homeowner can not be guaranteed of continual satisfactory operti.on to insure no health problems occur at a later date. Sandy Kronquest May 1, 1979 Page Two If you feel, as evidenced through your certain contracL-ual descrepanc.i.es exist satisfactorially resolve the matter, I Consumer Protection for advice on legal Sincerely, Les N. Buchholz,I-:'S. -� Senior Environmental Specialist I,NB/I j phone conversation, that and you can not suggest you contact rights. cc: Thimsen Construction Jerry D. Thimsen Pioneer Realty, Inc. 206 Northern Lights Boulevard 99503 Kyle Cherry Department of Environmental Conservation State of Alaska 338 Denali Street - :Mackay Building 99501 Drinking Water Analysis Report for Inorganic, Organic, and Radiochemical Contaminants _ p _ PUBLIC WATER SYSTEM: FTT I.D. NO. L i'R x r t Publ c Water System Name ddress TO BE COMPLETED BY PUBLIC WATER SUPPLIER State Ip o e Note: Check box to left of contaminants listed below for the analyses desired. JUN 6 SAMPLE DESCRIPTION: tet- r• Collected By J1 �n^ 4 -Ai -r `� r OA-rc1c Sample Location Source Type ❑ Surface Water FL -Ground Water Sample Date 1:015 Mo. ❑ Routine Sample [ 4 -Special Purpose Sample TO BE COMPLETED BY CERTIFIED LABORATORY Laboratory Name ` 11 F 0 -fiV fllal COpSOrV2110f1 C'c 1!;-s L ioralcry Failily Address D6eglas, Alaska 99224 City State Zip Code INORGANICS Mg/I (� 7 f7 -F-,)] Day Year K Untreated Water ❑ Treated Water 010 2kD 5 7 `I _ Limit G'a Arsenic (0.05) ❑ Barium (1.) A Cadmium (0.010) ❑ Chromium (0.05) ❑ Fluoride (2.4) ,io4 Iron (0.3) ❑ Lead (0.05) k�- Manganese (0.05) ❑ Mercury (0.002) -- 4 -Nit -rate (10.) 1�+Selenium (0.01) ❑ Silver (0.05) ❑ Sodium (250) ❑ ❑_ Mg/I (� 7 f7 -F-,)] Day Year K Untreated Water ❑ Treated Water 010 2kD 5 7 `I _ (0.0002) Sample No. Station No. (0.004) —q 0L — ;Laborato Analysis No., (0.1) eived by Date ORGANICS Limit ❑ Endrin (0.0002) ❑ Lindane (0.004) ❑ Methoxychlor (0.1) ❑ Toxaphene (0.005) ❑ 2, 4-D (0.1) ❑ 2,4,5 - TP Silvex (0.01) 171 SA Mtout$ El att? L, TA Kl=ai ft -S RADIOACTIVITY ND Indicates Not Detected Limit ❑ Gross Alpha (15) ❑ Radium 226 & 228 (5) ❑ Gross Beta (50) ❑ Strontium - 90 (8) ❑ Tritium (20,000) 171 SA Mtout$ k(- E att? L, TA Kl=ai ft -S El )u ND Indicates Not Detected _ /�� Date Analysis Completed Form No. 18-316(Rev. 9/78) No.? e" Signature of Laboratory Supervisor P LIFA 5 C- P._-ui iA — 74�5t= SA Mtout$ k(- E att? L, TA Kl=ai ft -S CHicw vN tl(r)q M"tGA;r(4L=vr=ts, )u 7At-e yknxA GRudt'D)VV r'rEYI.. Mg/I pCi/I 7r Date repor ed/ /1c- USTOMER Gary 1:. Kronquest ATE COLLECTED 4-11-79 AMPLED BY Gar Ell AR KS ANALYTICAL REPORT _ SAh1PL[ LOCATIOI•!: Norton Park, Lot 1 , Block 4 FOR LAB USE OilLY TIME COLLECTED: _V- IRECVD.3Y -SJK LAB #i 0 SOURCE Mater We,II ]Ag,Silver ]Al ,Al U,l1i11um ]As,Arsenic ]Au,Gold ]B, Boron DATE RECEIVED 4-11 DATE COMPLETED 4 -13 - DATE REPORTED 4-13- SIGi'!ED(, c_r / �_ []P,Phosphorous 0.3 []Cyanide 0:05------- []Pb,Lead------ -- ` OIAL 1 ����irINI'V.r?r �r, G� ALAry //�� oo,QQyyO TELEPHONE 05-_----- []Pt,Platinunr---0^05— ]Ca,Calcium------ (007) 278-4014 - []Sr,Strontiu:a__-- _=505 -_ []Sb,Antimcny_ =-0.05 []Total Dissolved___ P.O. BOX 4.1276 ___ CaCO3 []Alkalinity as [] Solids ANCHORAGE, ALASKA�0 - - []Se,Seleniu,n---- 0.05 []dotal Volatile_____ 5633 "B" STREET USTOMER Gary 1:. Kronquest ATE COLLECTED 4-11-79 AMPLED BY Gar Ell AR KS ANALYTICAL REPORT _ SAh1PL[ LOCATIOI•!: Norton Park, Lot 1 , Block 4 FOR LAB USE OilLY TIME COLLECTED: _V- IRECVD.3Y -SJK LAB #i 0 SOURCE Mater We,II ]Ag,Silver ]Al ,Al U,l1i11um ]As,Arsenic ]Au,Gold ]B, Boron DATE RECEIVED 4-11 DATE COMPLETED 4 -13 - DATE REPORTED 4-13- SIGi'!ED(, c_r / �_ ]Da,Bari unl---- []P,Phosphorous 0.3 []Cyanide 0:05------- []Pb,Lead------ -- - =055 — - []Sulfate ------ 05-_----- []Pt,Platinunr---0^05— ]Ca,Calcium------ -- []Phenol—T--- - []Sr,Strontiu:a__-- _=505 -_ []Sb,Antimcny_ =-0.05 []Total Dissolved___ - []Ti,TitatliLIM r]'I,-i'urgsten ___ CaCO3 []Alkalinity as [] Solids _-.0_05 - - - []Se,Seleniu,n---- 0.05 []dotal Volatile_____ --_0.1 _ _ Solids ]Da,Bari unl---- ---- 0.07 -- []Si ,Sil icon --------12 --- []Suspended 1B1,B1SrnUi:11 — -----C0-1--- -- []Sn,Tlr-- ----- 0_1----- Sol ids []Volatile. Sus------ ]Ca,Calcium------ _ 51 --- - []Sr,Strontiu:a__-- pencled Solids []Hardness as 223 ]Cd,Cadmiunl ]Co,Cobaii; -' 0.05 < 0.05 - []Ti,TitatliLIM r]'I,-i'urgsten _0.3 _=-0.05 0. CaCO3 []Alkalinity as [] [IV Vanadium 0.05 ICu,Copper ]Fe,Ircn--- - -- I Ig ,NercurY ]K,Potasslum 0.1 []Zn,inc_0.05 [] 22 (-]Lr',Zirconivar ------- -..0.05 ia----------- []mrnhos Conductivity IJ trocen-ll 1 []Kjedahl11 units___ --- -------- []P 1,litrogen-!' ...... - --- []Turbidity NTU _]Mn 11anganese 0_9 []nitrite -P! []Color Units _]Mo,Molybdenum p[]P I ospilorus_ [] f.Col iform/1Dom 1 Na,SOdium -- --- 6 `-- []Chloride [] []Ni Nickol 0.05 rluoride M 054 JAYS. HAMMOND, GOVERNOR OF SAI BR9)N 11NTAL C9)N SERVATI0N 338DENALI SREET MACKAY BUILDING, ROOM 1206 SOU771CMTRAL REGIONAL OFFICE ANCHORAGE, ALASKA 99501 April 25, 1979 Ms. Sandi L. Kronquest SRA Box 161 Anchorage, Alaska 99502 Dear Ms. Kronquest: I am writing in response to your letter of April 19, 1979, regarding a chemical analysis of well water from Lot 1, Block 4, Norton Park Subdivision. This analysis was assigned lab # 0054. The level of arsenic is indicated to be 0.1 mg/1. This is twice the level for this toxic chemical as allowed by Chapter 80, Title 18, Alaska Administrative Code (18 AAC 080). The level of iron is indicated to be 22 mg/l. The amount allowed by 1.8 AAC 080 is 0.3 mg/l. Manganese is indicated to be 0.9 mg/l. The amount allowed by 18 AAC 080 is 0.05 mg/1. The level of cadmium is indicated to be less than 0.05 mg/1, while. the amount allowed by 18 AAC 080 is .010 mg/l. Selenium is indicated to be less than 0.1 mg/1, while the amount allowed by 18 AAC 080 is 0.01 mg/1. The water is also excessively hard, as indicated by the value of 223 mg/1 reported. While 18 AAC 080 is used to regulate public water supplies, the .limits placed on chemical parameters are directly applicable to the quality of private water supplies. Using these parameters, it is my belie` that this water is totally unacceptable for potable water use. The excess- ive level of arsenic should be of great concern to any- one who would consider consuming this water, due to its toxic effects. If you have any further questions, please contact me at. 274-552.7. S/ incer.ely, KylV J.ierry Regional Environmental Supervisor KJC/mm .IRACLE WATER REFINING CO. 3003 E. MCCAIN ST. ANCHORAGE, ALASKA 99503 PHONE: (907) 279.1125 9z lt� �/' ,��a-_ t�l'�..�"� �i4t� /YYI�" Gc� G�GL� G �%7 SGC •� J " -C �' > �/ � `/, (/" �� �c����C�• u�✓U<� ��N� �c.�d-.�=•:� �-t.— C.'- Ilif �t-C �.-C�• c�G�r+'�--�6' 13 PPA 1 �, %�c�-,/ti oo /(�.�,.2�•l �aG�- /iyyu�LaL�"iJ-2�'i'�-d�-c���. ,-G6ZL= �- �f LL,'I G%.�I"-�'""t-!i''c/Gj-- .-f>J GLv--L�'c�>'• �It-�, c2-✓�C/'Ei/n'�--G�'�L % � r �(6 �%-c.���rn /1-�1 ��'", c�;/ �,GLGL,� � �f�'JZfn�--�, y //•' f�/�"-��' ✓ ��LL,'' J �-C� /�i �/ �i.c-c=v � c_-v�-- ��-r�L.-..>-Yt� i✓7'!�' V�' � ..C- C pCe� U't-L�� j L MIRACLE WATER REFINING CO. / 03 E. McCAIN ST. /! ANCHORAGE, ALASKA 99503 PHONE: (907) 279-1125 Get � 17 � • G� �-,� � ^ �� i ,� � ,., ✓may �l%�-,ad u ,.�'�L-�G.L'-fL�'/! fi /„� /� � � �� �•�r �L.�,,z-{:F�.G�-1_ .-y7t.�,2_�C ZCC-L'1t.x� J / -u y GALL l All C2�' ` _ y� Q�!"!�'""_"`�✓ �I/ C1 vi%t'`'t.��, .�Gti-�-K 1..-.�1� �/�J<-i•L iG� C��/ ��� , ����iJ'-'Cl=_��K2" /'!/ C! ' 12���.Gj� / �.'L%U�✓ V�� i L � vL A1_ _� vA�C �iz6'7��'`� /��irELGPH0IJE leol► 270-4014 P.O. BOX 4-1276 464 9 EUSItJf SS PARS BLVD. �tFlALY]ANCHORP'GF, ALASKA -ICA[_ REPORT - JSTC!�L.R lhi;. 5en Construction SAIiPLE LOCATION: Oceanview, Alaska FOR LAB USF ONLY - TF COFLLCI ED 11 1-78 LIME COLLECTED. - - RFCVD.BY GY -IA8 11 9088 SPLFD 8Y--- SOURCE Old ',;ell ''lot used 4 yrs.) DATE RECEIVED 11-7-78 !',ARKS Hardnk,ss ctwivalent to 13.8 grains per -gallon. DATE COMPLETED 11-1-78 _ Vgr__high-ir_on content DATE REPORTED 11-8-78 - IS IG 1ED gig/l nu)/1 --mg�l------ -- ]Ag,Silver - - - - []P,Plosphorous - []Cyanide ]A1 ,Aluminum []Ph,Lead - - - []Sulfate <_1 ]AS,,,rsonic []Pt,Platinum []Phenol ]Au,Gold - []Sb,Antimony []Total Dissolved 202 Sol ids - ---- JB, Boron -- []Se,Selenium []Total Volatile Sol ids ;3a,f3arium --- -- -- []Si,Silicon []Suspended - Sol ids Bi,!siss;uth []Sn,Tin []Volatile Sus - Ca ,Calr_ium 5/ ---- []Sr,Strontium []Hardness as 2.42 Cd,Ccdmium []Ti Titanium CaCO33 []Alkalinit as- 210 ]Co,Cobalt - - []bl,TungsLen HCaCO3 ;G ,Chromium - []V,Vanadium [] 1Cu,Cupper - - - []Zn,Z_inc JFe, Iron - - -25 ---- []Zr,Zirconium [] ,1Hg,iercury - -- []Ammonia []mnihos Conductivity 350 --- -- ------------ -------------------- ----- Nitrogen -N ]Y.,Potassium el [IKjedahI []pH Units 6.8 Nitrogen -N JMg,Magncsium 8.0 []Nitrate -N []Turbidity NTU ]Mn,Flanganese -- []Nitrite -N []Color Units ]Moj1olybdenum_ - - []Phosphorus []T.Col iform/100m1 ( Ortho ) -P (Na,Sod iLill] - 4•5 []Chloride 6 r1 ]Ni,Nickel - - []Fluoride i _ � .1 `.I � �,l'i`.I1 ori l_� •'t)i �i'J t i i �.�,.. i � 'i ( :: •i n-'+� �i... i v zv ISI S„II:1.0I (i I �.I:`.1. U 0” ! •SN C 101y1 Fv11POIN,f •;( ; I I I F',f,ill_Y C •,E l'I iiFF FIVF r 1 01 HER roux six ! I Gl,PPLY :di)IVIDO AL DEP YH Of V._I - o,alr.AI .Ef) _f(, U1li_!ll'' i &D- vo"FNI,__ 03,1. l S IT GSI. L,'.;.IT SAM f I I _1 '' i I` dfl',< i.5 If 0! "1711CICSOHA RAI w, lw.uf 'C i' A.i_i: i i TY i i i .. i it l,Ilo i f f I f i I /I NP.?OVFn FOR __-- r l f)ROC)n.iS I :CIi=C)ITIONAL iAPP;'1(',-Al_ i I It L the reonotrowner RD A,\/F—.builder, hri, cnstuctioverity roposed building ggiirade relative to fin - to determineatheuexiiity eton a ofcalnygouoand 4"k covenants, or restrictions which not appear on the recorded 3ubdivi- 6on plat. 2- IO/Zo/78 _ OF 41,1 49M ' 1•fq/.0 .. ...... ..� ALLAN W.LAHNUM ! No. 1108•S ;- \�?�fSSIOHAI``I��- hiUFFMAN RfDAp LO -7- I i3LCCK 4 -- 319 �X15TI1.ICa ; ,i HOUSE N N1 I WELL 3' ion uT1�iN EASEME K T S I MAMMUZ-011 I 0 I0M I� J I LOT SURVEY CERTIFICATION --LEGEND: _ ®�' • Brass Cap Monument Lot Block 2�— Area Sq. Ft. i Iron P pe StePin 7. o Survey Hub a Tack Plat File No. Zoning District [— Anchorage Recording District, Alaska VIS Kli i�L111n" WtiL ' WHL� H' Lr�,l Residence of:=�— _n �( J 4040 B STREET RaOCNGIN-CiCANCHORAGE. ALASKA A7B'= 11572 i Y:/ro - 4 5 POUCH 6650 °1zE�R'LJOF;-��{ iiJ ANCHORAGE, ALASKA 99502 (907) 279 2511 q �f y, ,a�', ` :� �L �_ �� GEAR 6!-,h 1. SUIL/VAN, rf � wa': SV' 'tf � i} i� .� �� AIA VOR UE=P 1R T^�1-NTO( ViFt'li_tHi,ND E�1V If-IONA9FNTAL PR D1 1875 "t."' Sireeti November 2.1, 1978 Thimson Construction 206 West Northern Lights Boulevard Anchorage, Alaska 99503 Subject: Lot 1 Block 4 Norton Park Subdivision ##2 Approval for your individual sewer and water facilities will. not be granted until the following items have been completed: A well. log is submitted to this department. if there are any further questions, please contact this office at 264--4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw CC: Security Pacific Mortgage 1101 East Tudor Road, Suite 190 99507 Pioneer Realty 206 West Northern Lights Boulevard 99503 APPRAISALS REAL ESTATE SALES INVESTMENTS 9 07-277 -454 1 piamm 206 NORTHERN LIGHTS BOULEVARD ANCHORAGE, ALASKA 99503 �haarb • g�II�b, jprEB. D.E.Q. A 90 foot well with 6" casing was drilled to service Lot 1 Block 4 Norton Park N0. 2 June 14 1974. No well drillers log is available. Thimsen Co truction. HOME PHONE 907 277-7656 AV C ) � GREATER ANC ORALE AREA BOROUGH Department of Environmental Quality d 30 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received March 22, 1976 Time of Inspection 3:30 p.m. Date of Inspection 3-22-76 Les REQUEST FOR APPROVAL OF Monday INDIVIDUAL SEWER & WATER FACILITIES FOR Conv. 1. Approval requested by: Alaska Bank of Commerce Mailing Address: Fudor Branch 2. Property Owner: Jeffery Thimsen Mailing Address: 206 Northern Lights Boulevard 3. Legal Description: Lot 1 Block 4 Norton Park #2 Phone: Phone: 2746073 4. Location: Ellen Drive 5. Type of facility to be inspected ow 0f.1 ms 6. Well Data: Well -• Individual A. Type B. Depth 90, C. Construction D. Bacterial Analysis .. 2 (,e 7. Sewage Disposal System: A. Installed C. Septic Tank: 1. Size D. Seepage Pit: E. Disposal Field: 8. Distances: B. Installer 2. Manufacturer 1. Absorption Area 2. Material Total length of lines A. Well to: Septic tank Absorption area Nearest lot line Other contamination B. Foundation to septic tank e , Absorption area C. Absorption area to nearest lot line , Sewer Lines , EQ -034 (1/74) Page 1 of two pages Page 2 of two pages - Re( t for Approval of Individual ` r & Water Facilities Legal Description Lot 1. Block 4 Norton Park #2. Comments Approved ` Disapproved _ Date App 1,Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM certiry tnat the intormation 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 EQ -034 (1/74) Date 6. Legal Description: MUNIC'IPAlAY OF ANCH()kAGt; /_ 17� /. C/ MUNICIPALITY OF ANCHORAGE JLP7. Of flLrit.ihl 8. FNVIfi��;�nlNfAt pfCTi;ftlpl,I DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" Street, Anchorage, Alaska 99503 — 274-4561 f NAR rj Cj IfJ�iJ REQUEST FOR APPROVAL OF , INDIVIDUAL SEWER and WATER FACILITIES 1. Type Inspection: i of CMRO v VA FHA CONV 2. Property Owner: Mailing Address: ��c h i j��� �- ��� Day Phone 3. Name of Buyer: Mailing Address: Day Phone 4. Name of Lending Institution: j 5 �i` �: G� �' � , Iy_ a I'GGl- Mailing Address: ���f _ �i� n` -z- Phone 5. Name of Realtor or Agent: 'Ie> Mailing Address: 4 7 Phone 6. Legal Description: z 2- /_ 17� /. C/ Location: 7 9 Type of Facility to be inspected: Water Supply Type of Supply: Public Utility If Individual, number of dwellings presently served If Individual, depth of well Sewage Disposal System Type of System: Public Utility If Individual, date of installation EQ -037 (1/74) No. Bdrms. Individual ttic- // f�) �--) -1/ Individual (on-site)