HomeMy WebLinkAboutEKLUND Block 3 Lot 2
DEPFiF~:TMENT Of HERL, TH f"~N[." EN',/IF;?,ONMENTFI1,_ PI~..Eq"ECTtON
825 "' L '" STREET., I::INCHORRGE., I::IK. 9S~.501
264-4';::'20
7'80'75'? )
LOCFIT I ON E[:,L1,JND
±00 FEET FOR FI PRI',,,'FtTE I.qELL.; OR
::l. SE~i TO 2~i0 FEET FROi','I F:t PUBLIC WELL [)EPENDING UF::'ON THE T'.r'PE OF PUBLIC t.,.IEL.[ ....
HELL. LOGS RRE REQUIRE[:, FIND MUST BE RETURNED TO THE [:,EPRF;?.TMENT FIITHIN
OF THE HELL COMPLETION.
OTHER REQU I REI"IENTS MFIY FIPF:'L'*'. SPEC ~.F I CRT I OI",IS FIND CON~;'I"RUCT I ON [)I RGRRMS RRE
FIVFIIL. FtE:LE TO INSURE PROPER ):NSTRL.LFtT ION.
[ _.1::1': [ IF* ~' THFtT
:1.: I Flt"l FFIM I L I F:IR I.,.I I I"H THE REg!IJ I REI"tENT:~:!; F:*OR 01',1-S 11"E SE}.IEFr:L"kl I::IN[) J.,.lELg.:!ii; I::~E!; SET
FOR]"H E"~' THE MIJN
2-':'.: I WIL. 1,. IN~.:.r,"I"RLL~ THE ::]'r'k']"l"EM ;[N I':ICCORE:,Ir:tNCE I.,.IITH THE. CO[:,E:E;.
': I ]NF'[':, '~~!i:~iT ORR[:,NER
' Municipalityof
Anchorage
POUCL ..,-k350
ANCHORAGE, ALASKA 99502
(907) 279-2511
GEORGE M. SULLIVAN,
MA YOR
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
(825 "L" Street)
December 29, 1978
~780757
Robert Gardner
Star Route Box 230F
Eagle River, Alaska 99577
Subject: Lot 2 Block 3.E ...... division
A permit issued by this department for well and/or
sewer system has expired.
Permits are issued on a calendar year basis, as stated
on the permit, by authority of Municipal ordinance.
If you have drilled the well, a well log should be
sent to this department to document the installation
date.
If there are any further questions, please contact
this office at 264-4720.
Sinc~erely,
Les N. , ....~'
Senior Environmental Spe~falist
LNB/ljw
enc: copy. of permit
APPLIC~NT FILLS OUT UPPER HAl: %DNLY
'~-~ b '~ Phone
Property Owner )~) c~O~{ l~'J - ~'!~)' -~? ~)'~-3r~ ~
Phone
Lending Institution
Address Zip Code
Phone
Realty Go. & Agent
Address Zip Code
Type of Residence
~ Single Family ~
Multiple Family No. of Bedrooms
~ Other
~lndividual A~ACH WELL LOG. A w~l log is required for all wells drilled since June 1975.
~ Community For wells drilled prior to that date, give well depth (attach log if available).
~ Public Utility
Sewer Disposal ~ ,~
~ Individualf' . ~ ~ ,~ ) Year Individual Installed:
~L.-:~. ~ ~ ~ '~ ' When Connected to Public Utility:
Public
Utility
~ Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED.
Time I /
Time Time Time O~_.~C~ N~~::)'qN' ~.)
~ Date ~ -- ~ ~ ~ ~
Date Date Date ~ ~ ~ ~ ~_ OO ~ ~
Insp~tor Inspirer Insp~tor Inspirer
Field Notes: ~ /~ ~j1 ~ ~[1~ '~ MUNICIPALITY OY ANCHOEAGE
~ ~'~'~ ~ ~ ~b ~ ~D ~ t~ 1 ENVIRONMENTAL PROTECTION
~ .... h~- ~ ~,~ ~,m D~Ot~ ~ ~ov
¢ RECEIVED
( ) APPROVED BEDROOMS *CONDITIONS OF APPROVAL
( ) DISAPPROVED
( ) CONDITIONAL APPROVAL*
DATE
BY:
Soils Rating Date ~wer Installed Well To Absorption Area Well Log Received
Well to Tank Septic T~k Size
72.023 (3182)