HomeMy WebLinkAboutELMRICH VILLAS #3 Block 3 Lot 6A Public Information
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
Date Received
Time of Inspection
Date of Inspection
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
1. Approval requested
Mailing Address:
2. Property Owner:
Mailing Address:
4.
5.
6.
Phone: ~??-
Phone: ~ ~_;~'~ ~¢~?o ~j
Legal Description:
Location:
./
Type of facility to be inspected ~'.~.~../ No. of bedrooms
Well Data: ~' ~, ~), - i///:o/?~ ~}~t~_ ~ ~
A. Type B. Depth
C. Construction
D. Bacterial Analysis
7. Sewage Disposal System:
A. Installed /,~..z_. B. Installer ~ ~ /~oP-/-O,'v"~o
C. Septic Tank: 1. Size/j) ~'~ 2. Manufacturer
D. Seepage Pit: 1. Absorption Area 2. Material
E. Disposal Field:
Distances:
Total length of lines
A. Well to: Septic tank
Nearest lot line 7-/7~
B. Foundation to septic tank
C. Absorption area to nearest lot line
, Absorption area
, Other contamination
~-,/0~ Absorption area
, Sewer Lines
t~ag~ 2 of two pages - Request for Approval of Individual Sewer & Water Facilities
Legal Description
Approved
d~ ~ Disapproved Date
1 V
pprova al id for one year from date signed
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 ~//?~,~-Z~/dd~' ~-¢~'L~ Date ~,_~.'--
GREATER ANCHORAGE ARE/, BOROUGH
Department of Environmental Quality
3330 "C" St., Anchorage, Alaska 99503 - 274-4561
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
Type of Inspection:
Property Owner:
Mailing Address:
Name of Buyer:
Mailing Address:
Name of Lending Institution:
CMRO VA ~ FHA CONV
,:~ ,~d~ /:c:x~4 ; DaS Phone
i~" Mailing Address: ~('~.i~.
.": 5. Name
of Realtor or Agent:
:~:y,,' r ma~ling Address:
Legal Description:
Location: ,.~6~-
~:('>,~A>~i ,~' /'-
7. .Type of Facility to be inspected:
8. Water Supply
Type of S~pply: Public Utility
Individual
If Individual, number of dwellings presently served
/.~.::-: .... . If Individual, depth of well _
~.~9>:e~:~ Disposal' System
~of S~stem: Public Utility
If Individual, date of installation
Individual (on-site)
./~: y~.~