HomeMy WebLinkAboutT12N R3W SEC 21 Christ Church
~ ~'/ ::INSPECTION APPOINTMENTS
TIME TIME k.~ TIME
DATE DATE DATE
I NSPEOTO R INSPECTOR I NSPEOTOR
MUNICIPALITY OF ANCHORAGE MUNlapALllY OF ANCHORAGE
) DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIO~~T' OF ~L¢ &
825 L Street - Anchorage, Alaska 99501
ENVIRONMENTAL SANITATION DIVISION
Telephone 264-4720
pi R ECTIONS: Complete all parts on page 1. Incomplete requests will not be proce~ed. Please allow ten (10) days for processing.
PROPERTY WNER I PHONE
MAILING ADDRESS
PROPERTY RESIDENT (If different from above) PHONE
2. BUYER PHONE
3. LENDING INSTITUTION
MAILING ADDRESS
4. REALTOR/AGENT
MAILING ADDRESS
5. LEGAL DESCRIPTION
Ph~CeL
STREET LOCATION
6. TYPE OF RESIDENCE ~ SINGLE FAMILY
[~ MULTIPLE FAMILY
7. WATER SUPPLY
INDIVIDUAL~
[] COMMUNITY
[] PUBLIC UTI LITY
8. SEWAGE DISPOSAL SYSTEM
.~ INDIVIDUAL/ON-SITE~
NUMBER OF~BEDROOMS
[] One [] Four [] Other__
[] Two [] Five
'~ Three~_~, [] Six
ATTACH WELL LOG. A well log is required for all wells drilled
since June 1975. For wells drilled 'prior to that date, give well
depth (attach log if available.)
A oo r'
! ~ 7~) YEAR ON-SITE SYSTEM WAS INSTALLED.
[] PUBLiCUTiLiTY ~~ ~¢~J~ C~ ~.~x~,
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
THIS SIDE FOR OFFICIAL USE ONLY
1, TYPE OF RESIDENCE NUMBER OF BEDROOMS
[~'~"SINGLE FAMILY [] ONE ~;}-" THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2. WATER. SUPPLY
[~'~"~ INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTI LITY
Connect[on Verified LOG RECEIVED ~.~,,]
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[].H~DIVIDUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY
Connection Verified INSTALLER
[]Septic Tank or []Holding Tank
Size: If Tank is homemade SOILS RATING
give dimensions:
['YPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCESwELL TO: Septic/HoldingTank Absorptio]] Area Sewer Line Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
[~PPROVED FOR ~ BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
E~] DISAPPROVED ~'~
DATE BY:~
72-010 (Rev. 6/79)
· ~ MUNI,~.?ALITY OF ANCHORAGE
POUCH 6-650 · ANCHORAGE, AK 99502 · PHONE 264-6400
' FINANCE DEPARTMENT
CASH RECEIPT
No. 16'!381
FROM
REMARKS
.I
DES RIPTI N
Or~/CC
Col,ecting Orgn. No. [~,1 '- l I, ,,I,~ I B~:
DIRECTIONS TO PROPERTY TO BE INSPECT~0~
Sewer and Water Program
Note:
be sure to put colour of house or other
landmarks that will make it easy for the
inspector to find. Accurate directions
will save time and not cause delays in
scheduling.
SWP/0 2 5
A, ,':0 J/' CY RLEPOR1-
81-1598
7-s, I0-1 12G P.O. gox 2540 DAlE OF RI. PORT
RECEWED
45Z-IZG7-45G-5i55 D&I'[: Of TEST July 16~ .198~
[ LF.;C. RMED FOR:
J~m ~abskZ
SRA Box.15-25
Anchorage, AK _99507
Century 21Metropolitsn .
Gail Opalinski .......
SEPq'IC
CRIB OR SEEPAGE PI'T
t EACH FIELD
1 ...... ¢ Of B~DROOMS 4 __
SEPI~C TANK WAS puMPED ](~YES ED NO
ABSORPTION RATE: AVERAGE 24 HOURS __600 _GAl_ION'S.
TANK - S'IZE .. _ 1'250 __ GALLONS
· ~%% Kinney R. Baxter ~. ~
~ ~ ~ PROFESSkO~
SLiFGE RAIE: 480__GALLONS IN_ 4B M!~WUIES.
Day 1 ....... P~Y ~- ~ ...... Day 3 _
'rank Crib Taak _ ___Crib Zan .... crib ......
I: n ~ t _i_a_ 1~ .... ~6~j ..... 94]'~
+80 .......... 9~". - - 90" ....
!20 ~rg~ ....... ~ ....... : 92~'
lEST pERFORMED BY] T.B. REPORT i:REPARED BY~ K..Braun _ APPROVED
81-1598
July 16, 1981
0 F
Parcel l~si c ilo~; 21 ,
Jim Babski
SRA Box 15-25
Anchorage~ AK. .99507 .
345-0580
Century 21 Metropolitan
Gall Opalinski
SEPTIC TANK - S'IZE
OR SEEPAGE PI'T
FIELD
1250
13 NO
480 G~,J i O~WS IN 48 M!NUlt S.
NO1 ES & OBSER\'AiIONS[ z ........ -
Day 1 p~y ~ . . Day 3 _
Tank Crib Tang Crib ..... Tank C~ib
~nitia_l._ ~§" ..... 94" - _ gg!! . 93H .... ~6!t -92 3/4U - -
92" 90 ~"
480 91" _ 90"
92" _ 90.5" -
120 Sqrge . .m
· ~r-,' ApERDVF D BY7K'R'B'
I~S~ pERFOF.~ED BY: T.B. _ REPOR~ F~_~=E~ BY; K. Braun __
October 9, 1981
~d~ (1)
(2)
James F./Anne M. Babski
Star Route A Box 1525
Anchorage, Alaska 99507
Subject: T12N R3W Section 21 Parcel 11
Approval for the individual sewer and water facilities
cannot be granted until the following items have been
completed:
The water analysis report needs to be submitted to
this office from the Chem Lab, 5633 B Street, for
our review.
The standpipes to the sewer system need to have
covers placed on them. This will need to be reinspected
after completion.
(3) The well appears to be in a pit, this will need to be
open for our inspection.
If there are any further questions, please call this office
at 264-4720.
Sincerely,
James S. Roberts
Associate Environmental Specialist
JSR/ljw
CC:
Jorgen Lilliebjerg
% Jorgen Realty
406 G Street 99501