HomeMy WebLinkAboutT12N R3W SEC 6 E330' of S325 Lot No Longer Exists
GREATE], ANCHORAGE AREA _OROUGH Ca,eNo. &4
HEALTH DEPARTMENT
327 Eagle St. 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
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
k0CATION OF INSTALLATION
,SEEPAGE PIT. ~ ,DRAIN FIELD ~ ,OTHER
TO BE INSTALLED BY
AS DESCRIBE. D BELOW· SiZE OF UNIT~TOJ]ESERVED
· SEPTIC TANK SIZE /z~"~z¢-~ ,'~l~-~J l SEEPAGE AREA~ ~-~'~-~__TYPE
DISTANCES:
DIAGRAIVI OF SYSTEM
1 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 ~-~-/~/~ ~) APPLICANTS SIGNATURE& ~t'~'~/.~~C--
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