HomeMy WebLinkAboutCREEKSIDE PARK #1 LT 58r
REQUEST FOR APPROVAL OF
INDIVIDUAL SEI'F,~R A~ID IJATER FACILITIES
FOR
9
5. · ~'IEIA. JATA:
B, DEPTH,
£. s~zE
D. CO~.:STRUCrIm
E, BACTERIAL A/7~I.YSIS.
G, SB'IAOE DISPOSAL SYST~I:
A, SEPTIC TAr]K
0 7'-
q.
Sl'IO'! DIAGRAI~I ~! BACK)
!
77
,,:: ~,~.:,~, FOP. S~ "ATER FACILITIE~
PAG2 T~ D
3, SEEPAGE PIT
C. 3~SPOSAL FIELD
~|~l '~"~ r-r) .
9
7, ~Rm ~UR~,~S
~, ~2~ TO SEPTIC T~ ;{.
B,' ~E~ 10 SE2DAGE PIT
C, ~?E~ TO ~E2 LI~
D, ~'~ TO PROP~
E, '~E~ TO OTIER POqgI~;kE COr~TNII JATIOD[
F. FO~'~ATIO[') TO SE~IC T~JK
F~ATIOH TO SEEPAGE PIT
SEEP~E PIT TO ~PE~ LINE
(31~T~E,q AiI:I0t'd~ZE AREA '~DROUC~t DEPAR'I?'IEi~ OF E~IROr~IENTAL .L3JALITY
KASSLER/WEST MORTGAGE CORPORATION
604 EAST SI XTH AVENUE .ANCHORAGE, ALASKA 99501 · 212-9501
DATE: 7/27/71
GREATER ANCItORAGE AREA BOROUGH
Dept. of Environmental ttealth
Pouch 6-650
Anchorage, Alaska 99502
RE: Laura L. Puhr
Legal: Lot 58 Creekg Side Park S/D
(VA') Case # 184 377
Gentlemen:
Per the attached form, we hereby request inspection for Health
Authority Approval.
Please send your findings to either the FHA offices or the VA Office
as noted above for the "Case Number': Also, please send an exact
copy of the report to our office.
Your swiftness in expediting this request woula be most appreciated.
Sincerely,
KASSLER /WEST MORTGAGE CORP.
P.S. If you wish to make an appointment before inspects, on, please call
Jim McCourt at Yukon Realty 272 0558
INDIVIDUAL SEWAGE AND WATER FACILITIES
(Fill out in Triplicate) ~.
t, ~ of person requestzng, approva~l._ .........
NumL~'r'~, bedrooms in house c~ .
Water. Analysis:
a. Bact~_~ial_ .
b. Detergent "' ·
6, Well data:
a. Type
b. Depth
c. Casing Size
Distance from well to closest existing or proposed:
1. Sewer line
2. Septic tank
3. Seepage Area
Cesspool'
5. Property Line
6. Other sources of possible contamination, i.e., creeks, lakes,
houses, barn, drainage ditch, etc. .
Sewage disposal system.
a. Age of system ~
b. Septic tank capacity in gallons - i
c. Name of septic tank manufacturer
1. If "home made" show diagram on reverse side of this form·
d.' Disposal field or seepage pit size and type
1. Distance to propertyline.. ~
to house foundation ~Y ·
-e. Percolation Test '~esults
f. Pemcolation Test performed by
following information: p~operty lines; .w~tl location, house location,
~tic tank location, disposal area location, location of percolation test,
an~ direction of ground slope.
The information on this form is true and correct to the best of my knowledge·
$zgnature of AppliCan~
T__O BE FILLED OUT BY HEALTH DEPARTr.~ENT PERSONNEL
~Fhe shove described sanitary facilities are hereby approved, subject to the
~61,~owing cond~{ons: ..........
Conditions:
The above described sanitary facilities are disapproved for the following
reasons:
' Szgnature '--'"
Approval is valid for one year following the date of approval.
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