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HomeMy WebLinkAboutEAGLE RIVER MID HEIGHTS BLK 4A LT 1A Eagle River Area GREATER ANCNORAGE AREA BOROUGH Department of Environmental Quality 3330 "¢" Street, Anchorage, Alaska 99503 274-4561 Date Received March 10, 1977 Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR 1. Approval requested by: Mailing Address: 2. Property Owner: Mailing Address: 3. Legal Description: 4. 5. 6. Alaska Mutual Savings Bank Post Office Box 1086 99577 Phone: Charles S. Barr Phone:694-9010 Post Office Box 541 Eagle River ~ Lot 1 Block 4A Eagle River Mid-Heights Location: Type of facility to be inspected Well Data: A. Type Individual C. Construction Sewage Disposal System: A. Installed C. Septic Tank: D. Seepage Pit: E. Disposal Field: Distances: Single Family Eagle River & Baffin Street - ~(lu~. No. of bedrooms B. Depth 160' D. Bacterial Analysis Public 1. Size 1. Absorption Area Total length of lines B. Installer ~ 2. Manufacturer A. Well to: Septic tank Nearest lot line B. Foundation to septic tank , Absorption area Other contamination C. Absorption area to nearest lot line 2. Material , Sewer Lines , Absorption area EQ-034 (1/74) Page 1 of two pages MUNICIPALITY OF ANCHORAGE MUHICIPALIT( OF ANCHOP, AGE PT. OF DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTEL~,~J~NME~rAL 825 L Street, Anchorage, Alaska 99501 279-2511, ext. 224, 225 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES RECEIVED Type of Inspection: VA FHA CONY Property Owner:_//'//~ ¢~ ~- ~' ',~ '-~" Mailing Address:(~0' O, b1~ X 5'~// ~,b~ Day Phone: Nameof Buyer: ~ ~ (ff. / /~/~ MaiiingAddress:/D,C' (~A' ~2,~ ~Re//_'~ /~'/u,~,<~DayPhone:~/¢/-/~-- Name of Lending Institution: ~J/~ ~/(~ ~/x 7-Jc~/. ~5/~k/~ Ma ngAddress: ~/4 G ~/~ _~','~,3~ / ~ /( Phone: /¢¢ 5. Name of Realtor or Agent: z~,f///~ Mailing Address: /~///~ Phone:_A~//~ 6. Legal Description: / ~ __/ ~/~ ~ ~ ~AC'/¢ ~l'Jzi~ - ~/'~- Location: F~C-tE ~,'~lS~___~ ~ ~/'~ ~ 7. Type of Facility to be Inspected: 8. Water Supply Type of Supply: /'/0 ~ ~ No. Bdrms. ~,~ Public Utility Individual ,)( 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 X Individual (on-site). 72-003(3/76) P~ge 2 of two pages - Rec ;t for Approval of Individual S )r & Water Facilities Legal Description Lot 1 Block 4A Eagle River Mid-Heights Comments Approv~d~.~d pproved or one year from date signed Date ~ ~/J->7 Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM certify that the information 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 Date EQ-034 (1/74) ZIP CODE ~mple. [] Beffle ~oken in lraMJt, please ~ new sample. ~I~PLE ~COLLECTED 00th~ Tap [~ Bathroom Tap [] ~asemen~p n Bored Open Top ~] Caflcrm~ I'1 Under H~e'~ Fe~t. Pr~ ~. ._--~.~ . ~,&NIT~ I~RKS I~..D INSTRUCTIONS B~FORE c t .iNG Sr.. m, PLE