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HomeMy WebLinkAboutT13N R3W SEC 26 Parcel 20 (~({~l~i I)~) GREATER ANCHORAGE AREA BOROUGH ~'~k}/r~ Department of Environmental Q~ality ~'~y~]O ~ ~ 3330~ge, Alaska 99503 274-4561 ~ ~ , ~ ~ /~,' / Date Received ~a~ 1~, . ~'~-q , ~ ~ ~ ,~ ~'l~ Time of Inspection /~ ~A ~;~--~ '~'~' Date of Inspection ~-~ ~~ REQUEST FOR APPROVAL OF 2~X ~ ~ ~ INDIVIDUAL SEWER & WATER FACILITIES ~ ' FOR ~.~. I. Approval 'requested by: Coast ~o~tgage Comgan~ Mailing Address: 9o~t o~ce ~o~ Z200, 995Z0 Phone: 279-0665 2. Property Owner: ~onald D. ~ba~p Phone: 337-2836 Mailing Address: 3516 9atte~so~ Street 3. Legal Description: ~i~ ~3~ ~ectlon 26 ~a~cel ~0 ~1t51~ ~ 4. Location: 3516 9ette~on Street 5. Type of facility to be inspected ~i~gle ~amiZ~ No. of bedrooms 6. Well Data: A. Type Individual C. Construction 7. Sewage Disposal System: B. Depth 175' D. Bacterial Analysis A. Installed 1974 C. Septic Tank: 1. Size D. Seepage Pit: 1. Absorption Area On-site system B. Installer 2. Manufacturer E. Disposal Field: Total length of lines Distances: A. Well to: Septic tank Nearest lot line B. Foundation to septic tank C. Absorption area to nearest lot line , Absorption area , Other contamination 2. Material , Sewer Lines , , Absorption area EQ-034 (1/74) Page 1 of two pages MUNICIPALITY OF ANCHORAGE DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" Street, Anchorage, Alaska 99503 -- 274-4561 REQUEST FOR APPROVAL OF INDIV, IDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO VA X FHA 2. Property Owner: R~.Trl D. Mailing Address: 357g 3. Name of Buyer: ¢,e~.41 Mailing Address: ~2]1 "~" 4. Name of Lending Institution: Mailing Address: P_O. 1~o~' "~pon A~h~-.~ Name of Realtor or Agent: ~f~m~.~+.n.~.~ ~nn.l~% Mailing Address: 517 W; Nn~h~ T.~ MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION MAY ;2 RECEIVED CONV __ Day Phone 337~839 Day Phone 863-!!93 Phone ~79-n~5 Phone o7~-35!3 6. Legal Description: Pa:coel 20 ~itbi~ ~-~. S 26~ ~ 1~ ~¢ R ~¢ BM Location: 3~16 P~tter~on S~reet Anohora~n AI~.~. 99504 Type of Facility to be inspected: Water Supply Type of Supply: Public Utility If Individual, number of dwellings presently served If Individual, depth of well Sewage Disposal System Tvpe of System: If Individual, date of installation 175 ~EET Public Utility 1974 No. Bdrms. 3 Individual X On-site OI~IE Individual (on-site) X LQ-037 (1/74) Page 2 of two pages - R(~st for Approval of Individual~--~er & Water Facilities Legal Description T13N R3W Section 26 Parcel 20 within NE½ Comments Approve~ Disapproved Date Appr~l~Valid for one year from date signed Greater Anchorage Ar6a Borough, Department of Environmental Quality DIAGRAM OF SYSTEM 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 EQ-034 (1/74) GREATER ANCHORAGE_ AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 DATE RECEIVED: INSPECT: ~'- /.~" TIME: ,~: REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES FOR APPROVAL REQUESTED ADDRESS: PHONE: LEGAL NUMBER OF BEDROOMS: WELL DATA: A. TYPE B. DEPTH C. SIZE D. I~5 ~' &'~ C~ ;~ . :v?,¥,~.~/~,,~-~o,-s BACTERIAL ANALYSIS 6. SEWAGE DISPOSAL SYSTEM: Ao (IF SEPTIC TANK 1. SIZE 2. AGE 3. MANUFACTURE~ 4. INSTALLER HOMEMADE, SHOW DIAGRAM ON BACK) ! 7~ APPROVAL REQUEST FOR SEWER & WATER FACILITIES PAGE TWO SEEPAGE PIT 1.NNNSiZE ~ 1. NUMBER OF LINES 2. TOTAL LENGTH MEASUREMENTS TO SEPTIC TANK TO SEEPAGE PIT WELL TO SEWER LINE REQUIRED A. WELL B. WELL C. D. WELL TO PROPERTY LINE E. WELL TO OTHER POSSIBLE CONTAMINATION F. FOUNDATION TO SEPTIC TANK G. FOUNDATION TO SEEPAGE PIT H. SEEPAGE PIT TO PROPERTY LINE COMMENTS: APPROVAL ~ALID FOR ONE YEAR FROM DATE SIGNED. GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY