HomeMy WebLinkAboutCOLEMAN Block 2 Lot 8LO'
REATER gNOtOP~GE ARE^ BOROUGH
"3~00 Tu&~r i~c~d .-- Pouch 6-~50
Anchorage, Alask¢ 99502
!~ALTH DEPART~IENT
327 EAGLE STREET
ANCHORAGE, ALASKA 99501
279-2511
INSPECT:
TIHE:
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWAGE AND WATER FACILITIES
FOR
1. Approval Requested By..~f ~.~F~ / __~.~ f
Address ~~ ~, ~-~'
Phone, ,,
2. Property Owner 0--0~)~ //~C/~/q~?~ Phone~?~fc~~~-2~/
3. Legal Descriptio~
4. Type o~, Facility to be Inspected
Sumber of Bedroom~
5. ~ell Data: f~
A. Type x~
B, Depth ~
C. Size
D. Construction
Bacterial Analysis
6. Sewage Disposal System:
Septic Tank (If homemade, show diagram on back)
4. Installer
Approval Request for Se~ .e ~ Water Facilities
Page Two
B. Seepage Pit
2. Lining.
..C .... Disposal Field ' N~
1. Number of Lines, h
2. Total Length
7. Required Measurements
A. Well to Septic Tank
B. Well to Seepage Pit
C. Well to Sewer Line
D. Well to Property Line
E. Well to Other Possible Contamination
F. Foundation to Septic Tank
G. Foundation to Seepage Pit
H. Seepage Pit to Property Line
8. COMMENTS:
DISAPPROVED:
DATE:
APPROVAL VALID FOR ONE YEAR FR0rl DATE SIGNED.
GREATER ANCHORAGE AREA BOROUGH HEALTH DEPARTMENT
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