HomeMy WebLinkAboutJOHN WELLS Block 4 Lot 14 Non Existent Re-SubdividedLo'l'
GREATER ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3500 TUDOR ROAD
ANCHORAGE, ALASKA 99507
279-8686
DATE RECEIVED:
INSPECT:
TIME:
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER AND WATER FACILITIES
FOR
APPROVAL REQUESTED BY:
ADDRESS:
PHONE:
o
o
PROPERTY OWNER:
PHONE:
LEGAL ~DESCRIPTION:__
TYPE FACILITY TO BE INSPECTED:~
STREET:
NUMBER OF BEDROOMS:
WELL DATA:
A. TYPE
B. DEPTH
C.
SIZE
D. CONSTRUCTION ' ~ .... ' · --
E BACTERIAL ANALYSIS_"~:~i ' '~ : '/'~'/'~ '
·
SEWAGE DISPOSAL SYSTEM:
Ao SEPTIC TANK (IF HOMEMADE, SHOW DIAGRAM ON BACK)
l, SIZE~'~:?Z-/~
2. AGE ' ' '
3. MANUFACTURER
4. INSTALLER __
?
APPROVAL REQUEST FOR SEWER & WATER FACILITIES
PAGE TWO
B. SEEPAGE PIT
lo SIZE
2. LINING /~m~
DISPOSAL FIELD
1. NUMBER OF LINES
2o TOTAL LENGTH
7. REQUIRED MEASUREMENTS
A. WELL TO SEPTIC TANK
B. WELL TO SEEPAGE PIT
C. WELL TO SEWER LINE
D,
E.
Fo
G.
H.
WELL TO PROPERTY LINE ~/ /
WELL TO OTHER POSSIBLE CONTAMINATION
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT
SEEPAGE PIT TO PROPERTY LINE
APPROVED: ~/' I SAPPROVED:
APPROVAL VALID FOR ONE YEAR FROM DATE SIGNED.
GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALIT
January ll, 1972
Greater Anchorage Area Borough
Department of Environmental Quality
3500 Tudor Road
Anchorage, Alaska 99507
Dear Sir:
This letter is to confirm the agreement that Is Gordon
Buffington will upgrade the existing semi-public well lo-
cated on Lot 14~ Block 49 John Wells Subdivision~ within
the regulations of applicable State and Borough codes~ to
obtain the proper well construction for the four-plex serving
the above mentioned lot~ no later than August 1~ 1972.
DATE: January ll, 1972
Sincerely,
~4ro Gordon
This is to certify that on the llth day of Januarys 1972,
before me~ the undersigned Notary Public in and for the State
of Alaska~ duly commissioned and sworn~ personally appeared
Mr. Gordon Buffington~ known to me and to me known to be the
individual named in and who executed the foregoing instrument~
and acknowledged to me that he signed and sealed the same as
his voluntary act and deed for the uses and purposes therein
set forth.
IN WITNESS NHEREOF, I have hereto set my hand and official
seal the day and year first above written.
My Commission Expires:__~