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GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
Date Received /
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
1. Approval'requested by:
Mailing Address:
2. Property Owner:
Mailing Address:
3. Legal Description:
Location:
e
Time of Inspection
Date of Inspection
No. of bedrooms'
D. Bacterial Analysis
Type of facility to be inspected ~..~
Well Data: ~!>--· ~ ---
C. Construction
7. Sewage Disposal System:
A. Installed
B. Installer
C. Septic Tank: 1.
-D. Seepage Pit: l.
Size //~ ~ ~x..,,./_ 2. Manufacturer -----'
Absorption Area 2. Material
E. Disposal Field:
8. Distances:
Total length of lines
A. Well to: Septic tank -------- , Absorption area
Nearest lot'line .~0-i~ , Other contamination
B. Foundation to septic tank ~.~ , Absorption area
C. Absorption area to nearest lot line ,~9 ~.~ --7c
Sewer Lines
· ?~ge 2,of two pages - Request for Approval of Individual Sewer & Water Facilities
Legal Description
Approved Disapproved Date
'Approval Valid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
I 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
PLEASE SEND REPO-:fS TO KASSLER & CO.~ 319 West F
ARF~k BOROUGH.
h Avenue, Anchorage, AK 99501
~GREATER ANCHORAGE ARL,", BOROUGH
Department of Environmental Quality
3330 "C" St., Anchorage, Alaska 99503 - 274-456]
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
Type of Inspection: CMRO VA xx
Property Owner: OIANDER, Charles
Mailing Address: 7623 Old Harbor Road
Name of Buyer: Billy M. Lindsey
Mailing Address: 1615 Northwestern
Name of Lending Institution: KASSLER & ¢0.
Mailing Address: 319 West Fifth Avenue
Name of Realtor or Agent:
Mailing Address:
FHA CONV
Day Phone 333 5463
Da~/ Phone 274 2525 x 365
Phone 272-9501
Dow Real Ea~ate - Beth Mack
503 E. Northern Lights Blvd. Phone 277-3581
Legal Descri pti on: CREEDSIDE PARK ~)2, Parcel ~f6
Location: 7623 Old Harbor Road~ Anchorage, Alaska
99504
No. Bdrms. 4
Type of Facility to be inspected:
Water Supply
Type of Supply: Public Utility
septic tank
XXX 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 installatiomnknown
Individual (on-site) xx