HomeMy WebLinkAboutALDERWOOD ADDITION #1 BLK 3 LT 7
1 APPLI(-,NT FILLS OUT UPPER HA, ONLY
Property Owner --~--~ "~:/, ~ ,~, ,,, ..... / Phone
Buyer
Address Zip Code
Lending Institution ~ ~ ~ /
/: ,' ' -' ~ " , ' ..' Phone
Address ' ~; ~' / /' / ~ Zip Code
Realty Co. & Agent ,/~,.,. , / ( ~', ."'~
/. ~ -. -': ', l' '~ Phone
Address Zip Code
Legal Description ,Z:,'/ // Z~/.'
Street Location / ~,, /
Type of Residence
[] Single Family
Multiple Family No. of Bedrooms
[] Other
Water Supply
[] Individual AI-FACH WELL LOG. A well Icg is required for all wells drilled since June 1975.
~] Community For wells drilled prior to that date, give well depth (attach Icg if available).
[] Public Utility
Sewer Disposal
[] Individual Year Individual Installed:
1~] Public Utility When Connected to Public Utility:
[] Holding Tank - - '
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
Time Time Time Time
Date Date Date Date
Inspector Inspector Inspector Inspector ~,5 C~ ~., ~'
Field Notes: ' '
MUNICIPALITY OF ANCHORAGE
DF~T ~,-~ :,-,,-r:, ,e.
ENVIR J: ~,', :r...~ .... ,.;' :urlON
C,]T 2 6 1982
RECEIVED
( ~ APPROVED BEDROOMS *CONDITIONS OF APPROVAL
( ) DISAPPROVED
( ) CONDITIONAL APPROVAL* _
Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received
Well to Tank Septic Tank Size
72-023 (3/82)