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Home My WebLink AboutNEW MCRAE Block 2 Lot 2 FI~A Form '~573 Rev. July 1958 L ,.J/ ~ Form Approved FEDERAL HOUSING ADMINISTRATION U,~- Budget Bureau No. 63-R296.~ HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM PART I.--TO BE COMPLETED BY FHA INSURING OFFICE MORTGAGEE SERIAL NO. Anchorag% Alaska First I~ational B~nk of Anchorage 60-00'/094 MORTGAGOR OR SPONSOR PROPERTY ADDRESS BetT~en 33rd & 34th St~'eets (~enard) H. M. Newell Amchorage~ Alaska SUBDIVISION NAME . BLOCK. NO. LOT NO. · ~ew Ncl~ae Sufodivision ' 2 2 LIVING UNITS BEDROOMS TOTAL NUMBER: ~' 'k" BA?H~ WATER SUPPLY BY: D Public system SEWAGE DISPOSAL BY: '--]'Public system · ', Can attic or other area be made into BASEMENT J-~ New installation ,: .~ ad~iti°na~l ~ed~,~om~? ~ .. z.~. . '~ 'i ;.~ · "i, 'i: '. (if Yes7 h~W many.a [---] Yes ~ No ' ~ r ~YeS ~~r~N~:~ ~''~ : J ~;Y~STEM DESIGNED !FOR ~ CommuniW system ~ IndividuM~?e~6)oF ~o.~i. GARBAGE DISPOSAL ~ ~mmunity system ~ Individdal'. J "5'~3 ~ Yes ~ No PART II.--TO BE COMPLETED BY HEALTH DEPARTMENT HEALTH' DEPARTMENT INSPECTOR'S SKETCH It is the opinion of the [~] State [] County [~ Local Department of Health that this individual water-supply system ~ is [] is not satisfactory as a domest!c...water supply for the subject property. It is the opinion of the f--Ii'State tem with proper maintenance: ~..'-Z [~ Can be expected to fdn6tion satisfactorily,, and is not likely to create an insanitary'cbndition [] County [] Local Department of Health that this individual sewagle-disposal sys- [--'] Cannot be expecte& to function.;, satisfactorily NOTE: The health authority should complete the appropriate opinion statement above and affix date, ~ignature and title in the spaces provided. Use of the above grid for Health Department inspector's sketch as well as use of the back of this form is at the option of the health authority. ": PART rills--FOR USE OF FHA OFFICE TO THE CHIEF UNDERWRITER: I have reviewed the foregoing arid the pertinent FHA Compliance Inspection Report, and recommend that'the Individual water-supply system be considered ['-] Acceptable [-'] Not Acceptable Sewage disposal be considered [~] Acceptable [] Not Acceptable. DATE SIGNATURE HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM ] CHIEF ARCHITECT ---] DEPUTY FOR CHIEF ARCHITECT FHA Form 2573 K~¥. JuLy 1958 6I" uoD~odsu! jo Xq pa~adsuI 'Xu~ j~ 's~q~qxa paaosdd~ q~ Xld~o0 ~ou saop ~ saop ~ uopqlmSUI · uondmnsuo> uemnq aoj X~oD~jsN~s lou s~ ~ s~ ~ Ja~g~ jo ' 61 ' ~ff/_ a~p aa}~ ,,'saa,, si sa~su~JI 'ON ~ 'saX ~ ~aprm uaaq ~a~g~jo u D t,~mgx [ ! 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'pooqJoq~g~au u~ ~*mmsno ~ou oJe ~ aJg ~ Slla~ lunp~{~puI uaaj- a~aJ ~ 'apjs ~ huoJj ~ 1~ auH ~oI lsa~eau llaaj--'uo{l.pulloj ~u~pHnq haaj 'lla~ :~oaj le~aagm gu~u[~ uaaj qadaG uaaj "V "~alame}p ap~smO ~ il[d jo Jaq~nN :Slid ofludees · saqou~ ~ ~ 'alp ~aao l~a]~ ~a~I~ Jo q~da~ 'saq>u~ ~/ %lP ~auaq l~[~a~ ~a~l~ ~o qlda~ aamcO 'qums ua~o~ ~ 'pm~D ~:l~a~.m ~a~l~ jo adaL 'sa~u~ ~ ~ ~. 'aping qs~u~ ~ alp jo dm 'q~da~ '~aaj ~ 'audi qa~a jo '~aaj aa~nbs ~O ~' ~saqoua~l jo ~olloq u~ ~a~ uoudaosq~ aa~loa~a 1~o~ 'saqou[ ~ '~p~/~ qoua~ uaaJ ~ O~ 'saU~l uaa~aq a~umq~ ' ~ 'sau~l jo ~aqmnN '~aa) ~ ~/ 'sauH aD ~o q~uaI lmO& '~<.~ 'l~J ~ 'JeaJ ~ 'apv ~'luo~j ~ le auH ~o1 lsa~eau '.laaj ~ 'uogepunoJ :laaj' ~ 11a& :moJj :plelt IDsodslQ ell/ : Jag;O 's:!d a~udaas ~ 'Pla9' l~S°&'P.~, al,~ ~jo sis~sUOa~'mawzw~lisuvanOaas lg!Zol~ gu~u]q 'SUOlle8 '&t~ud~0 p~nb[q 'laaj '~ldaG uaaj '. 'smammp apTsui'.~ '~a*j 'JeaJ ~ 'ap]s ~ huoJj ~ ~ auH ~o1 ~sa~au :~aaj 'uopupunoj :~a~j 'lla~ :moxj :lOOd~Jo~ uaaj ~ 'q~dap p~nb~l uaaj ~ 'q~p:~ ap:suI uaaj- ~ 'tpguaI ap}mI · suoi[~g O~ O/ '~uamn~dmo> ~alU~ X~ped~D 'SUOlleg .~. O~ %p~d~0 p}nbH ImO~ sluamlJedmo~ jo JaqmnN ~ 'lu[jolu~ uoaj~'llO~ mosj / :~u~l andes Wa&SAS lVSOdSIQ-:IOyI~AaS lVFtQIAlaNImNOIJ.:)ldSNI tO .LBOdttl u~ u! ~[nso.~ X~u tp.tq:a puno~ o.~ suo!'~!puoo ~I .uo.t~uuo~u.t ~uoU.t]~oc[ I~;[uouto[ddn~ Xu~ (Revisedbemlg4s) FEDERAL HOUSING ADMINISTRATION rorm~p,,oved. [~ New installation. REPORT OF INSPECTION ...... ~g~ ................ ~Existing installation. INDIVIDUAL WATER-SUPPLY SYSTEM To Be Headed in by FHA O~ice ~ATZ0~ ~ 0F (Insuring offi~) (Mortgage) (Mortgagor or s~nsof) ..................................... ~C~0~AGE (gity) .................................................................................................................................... (County) (~t~te) Total number: Living uni~ _..~ ....... Bedroo~ ......~ ..... Baths ___~. ...... Basement: ~ Yes Sewage disposal by: ~ Pabiie Sewer. ~ Community ~ys~m. ~ Individual system on site. Part I-a.--FOR USE OF INSPECTING OFFICIAL (Fill in below information applicable to subject installation) ~NSTRUCTIONS: If ~SW installation, inspect for compliance with approved exhibits' and record any observed information not shown on, or which varies from, the approved exhibits. If existing installation, furnish as much of the information as may be available. Distance to .u~arest public water main ............. feet. Size of main ............. inches. Individual wells [] are [] are hot customary in neighborhood. Give most recent record of failure of wells in immediate vicinity to furnish adequate supply of water .......................................... Properties in neighborhood [] are [] are not being developed with both individual water-supply and sewage-disposal systems. Lot size: .................. feet wide ................... feet deep. Dwelling set back from front property llne ................... feet. Individual water supply from: [] Drilled well. [] Driven well. [] Dug well. [] Bored well. Distance of well from: Building foundation, .............................. feet;' nearest lot line at [] front, [] side, [] rear, .................................... feet, cast iron sewer, ................. feet; tile sewer .................. feet; septic tank, ................. feet; disposal field, ................. feet; seepage pit ................... feet; cesspool, .................. feet; other sources of- possible pollution, .................. feet. Well construction: Diameter ............. inches. Total depth ............. feet. Type of casing ............................ Depth of casing, ............ feet. Approximate depth to pumping level of water in well ............. feet. Approximate yield, ............ gallons per minuS. Sealed watertight to depth of ............ feet. · Exterior space ~round casing sealed with: [] Cement grout. [] Puddled clay. [] Ordinary backfill. Well cover: [] Concrete. [] Wood. [] Metal. Openings in well cover watertight,~ [] Yes. [] No. Pump: ~] Shallow well. [] Deep well. Length of drop pipe, ............. feet. Pump capacity ............. gallons per minute. Located in: [] Basement. [] Pump room off basement. [] Pump house above ground. [] Pump pit. Pump room properly 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 ........................... ,19 ...... 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. rq Local Health Authority. (Signed) ................................................................................ Date of inspection ..................................... 19 ...... (Title) Part I-b.--See reverse side Part IL--FOR USE OF THE HEALTH DEPARTMENT OFFICIAL REVIEWING REPORT Based on the information reported hereon and other available information, it is the opinion of the [] State [] County [] Local Department of H~alth that this system [] is gis not Satisfactory as a domestic water supply-for the subject property. Remarks: (Signed) ............................................................................... Date ..... (Title) TO THI~ CHIEF UNDERWRITER: Part IIL--FOR USE OF F. H~ A. OFFICE I have reviewed the foregoing and the pertinent FHA Compliance Inspection Report, and recommend that the individual water- ~upply system be considered [] acceptable [] not acceptable. Remarks: Date ..................................... 19 ...... 2217--Individual Water-Supply System (Signed) .: ............ Report of Inspection