HomeMy WebLinkAboutBELLA VISTA #1 LT 13C
GAAB-HD-2 Case No. ~
GREATEk ANCHORAGE AREA ~ ~)ROUGH
HEALTH DEPARTMENT
327 Eagle S~. -.~' Anchorage, Alaska 99501 279-2511
SEWAGE. DISPOSAL SYSTEM - APPLICATION & PERMIT
RESIDENCE ADDRESS
LEGAL DESCRIPTION
APPLICATION TO INSTALL: SEPTIC TANK
TO SERVE THE FOLLOWING FACILITY
FINANCED THROUGH
PERCOLATION TEST RESULTS
THIS IS TO SERVE AS
DISTANCES:
LOCATION OF INSTAL.'LATION
SEEPAGE PIT / .~DRAIN FIELD
'?lea ~ ~ P' ~'/~
,OTHER
TO BE INSTALLED By' ~ ~
'/~NTICIPATED DATE OF COMPLETION
BELOW :TO B~ILL'ED OUT BY HEALTH ~EPARTMENT
4_~) - ,P~RMIT TO INSTALL A
AS OESCRIBEB BELOW. SIzEOF'uNIT TO BE SERVEB
'"-'"'- TYPE, SEEPAGE AREA "~00
" DIAGRAM OF SYSTEM
· SEPTIC TANK SIZE
lealth Authority
I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the
above described system is in accordance with said code.
DATE
527 EAGLE STREET
ANCHORAGE, ALASKA 99501
279-2511
RECEIVED / .- / ~/ - p.~A2-
INSPECT: / - / ~ - VT
TINE: / ,'~' ~
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWAGE AND WATER FACILITIES
FOR
Address__ /~gO
Phone o277-73/,/,,,, 2-
2. Property O~r ~r~a
3. Legal Description
T~e of Facility/to be Inspected ~t ,~O~
Number of Bedrooms ~-l~
Well Data:
A.
B.
C.
D.
E.
Phone 5%iq -; ~?Oq .......
Depth /~/~ /
Bacterial Analysis
Sewage Disposal
~. Septic Tank (If ho~emade~ sho~ dSagram on back)
1. Size
2. Age
3. Manufacturer
4. Installer
Approval Request for Sew
Page Two
~ ~ater Facilities
B. Seepage Pit
1. Size
2. Lining
C .... Disposal Field
1. Number of Lines
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. ~ell to Other Possible Contamination
F. Foundation to Septic Tank
G. Foundation to Seepage Pit
H. Seepage Pit to Property Line
,A..PPROVAL VALID FOR ONE YEAR FROId DATE SIGNED
GREATER ANCHORAGE AREA BOROUGH HEALTH DEPARTMENT
EDll70
~a~u~y 2~, 1972
~.!r, Palter
lg£7 E. ~imond Boulever~l
Anciiorm.~r.. Alaska
This f~ei:artr,~nt was unable t(; ir,~sF~ct ti~". w(:I1 or'~ th{'.
Sul>'~Ct lot. lye can therefore neither ar~rov;~ nor
disa~,rov~'~ t~c ~.~(.er S.yste~.
If you ~av.~:~ any ,~u(~stlons
~:!o not ~csitat~ t~:; contact this of~ic~.~,
St ncer~ly,
Lynn S,
E~vi ronmen &~l Speci~lts~;
cc.' Civ~llan ~tltt~r¥ l~eferr~ Office
r,J~)ruary 7, lg72
~,'~r. ~alte. r Stephen
~,~7 £ ~;i,,'~nd ~oulevard
J~,nc~orage, Alaska 995(12
Subject: Lot l~, Bella Vista Subd(vtston,~l.
~'>ea.r !r. Stephen:
An ii~s~,ection of the ~ell at the subject property revealed that the ~.~ell
anc'~ nressure tank vmr¢ l~ated in a pit, Before this De~)art~nt's
ca~ he c~tven for tJ~c .~,ater syst~J, the pressure, tan~ and oth~'r relational
equtp,~)ent ~ill need to b(~ relocated a~-ove ground or in the apartr~eF~t
inC. .Also, ti~e ~<(:ll casing v,tll need to ,he extendr, d above ground, the well
eauipped ~-,iti:.. a pttless a~apt~r and the v'ell pit fill~d in ~'tth dirt.
Sinco'. the ~,ell is :)reseP, tly a~ artesian ~'¢ll, you n~a.v r,,eed to nrovide a
sr~all ~,-ull house a~und ti~e casinQ.
If you i~ave any questions regarding the above, please do not hesitate tm
contmct this office-.
Sincerely
L.¥nr~ S. Coad
E)~vt to,mental Special tst
st
cc: Civilian i.;ilttary Referral Office
'~ game .of person requesting approval
2. ~,~an~q of prope~tyjowner , , . ~, ,.,, _ ~
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWAGE AND WATER FACILITIES
(Fill out in~ Tmiplicate)
Numbe~,.:.of J)e~rooms in house , ,~_,; ~,. ,~
Water,.Anals~is: ~ ~
a. Bacterial .
b. DetePgen~ " .
We 11 dar a:
a. Type .
/ ·
c. Casing Size /~; ~
d. Distance from well to closest existing or proposed:
i. S,we~ line, f~.~ Z~_. ·
3. Seepaf. e Area ~t,~. t~/'/~~
~4, Cesspool.~~~._.,
p !
5. roperty Line ~ .
Other sources of Possible contamination, i.e., creeks, lakes,
houses, barn, drainaEe ditch, etc. --~.
Sewage disposal system. '~~
b. Septic tank capacity in gallons
c. Name of septic tank manufactum~.P .
1. If "home made" show dia~Pam on reverse side of this fo~m.
d.' Disposal field ore__seepage pit size and type ./~/,~ /~ /~~
1. Distance to~prope~y line ~ ~ /
- , , to house foundation, ~ ~ /
Percolatio~Te'st'results
f. Percolation Test performed by,, , ................. _ .... .
Use the reverse ,side of this form to show diafram. Diagram should include
~..%he foil,owing information: p.~operty lines; .well location, house location,
P~pt~C tank location~ disposal area location, location of percolation test~
and~ direction of ground slope.
The l~,fox~t,ion on ~his form is true and correct to the best of my knowledge,
S!gnature of Applicant ba~e Si~n'~d
TO BE FILLED OUT BY HEALTH DEPART~.~ENT PERSONNEL
above described sanitary facilities are hereby approved~ subject to the
Conditions: y~~-sub ject to
__ ]Q7D when ~y~ilable.
connection to ~anitary ~wer$ ,spring ,,
The above described sanitary facilities are disapproved for the following
reasons t
· , Approval is valid for one year following the date of approval.
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