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HomeMy WebLinkAboutPALOS VERDES BLK 5 LT 14 APPLIC[ FILLS OUT UPPER HALt )NLY Pr°pe/O~--~vner -~¥ z~'"']D PJ~,'~,~ ~]~'~v~S Phone ~" ~, ~' ~ 130 Me~dow Creek ]~ive, F~gle ~ver, Alaska 99577 none l,-Maillng Addre~ Zip Code Buyer ~C]~d Address Zi~ Code Lending Institution ~N~ [,{0~ Phone ~. O. ~ox ~0-~00 Address ~ ~ ~3~ ~q3~ Zip Code Realty Co. & A~nt ~O~S ~ ~STA~ - t~ ~oeh~e~ Phone ~. O. ~O~ 279, ~ A~Mm 99567 Address Zip Code Legal Description Street Locati~ Type of Resi~nce ~Single Family ~ Multiple Family No. of Bedroo~ 4 ~ Other Water Supply ~lndividual~ A~ACH WELL LOG. A w~l 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: ~ Public Utility ~ ~ ~ When Connected to Public Utility: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSlNG CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspector Inspector Inspector MUNICIPALITY OF ANCHORAG,E Field Notes: DEPT, OF HF~,~,LTH ENVIRONM2NTAL PROTECTION NOV 2 RECEIVED ) APPROVED BEDROOMS *CONDITIONS OF APPROVAL ( ')-"" ')~DISDISA P PR OV E D ( ( ) CONDITIONAL APPROVAL* DATE t ~- --~ CD Soils Rating Date Sewer installed Well To Absorption Area Well Log Received Well to Tank Septic Tank Size 72-023 (3182) ~3ary and pamela i-ieri~es 130 i'.ieado~,~ Creek Ea~31e it(vet, AK 99577 SuD3ect: Lot ].4~ ~3tock b, Palos Verdes ~;~bdivlsion Approval ~or tile i[l(iividual sewer and water ~aciliLiei5 ca~'inot be ~3ranted until tile followin{~ (texas ilave been completed: The State o~! Alaska's l)epart~nt o~ Environ:~ental Conserva~.ion cannot al}prove the cormnunity %;eli until the sa~l[)ling schedule is current. Please contact, their office at 274~2533 ~ior their instructions. Please notify this ~3e~}artment ~or a reinspection when noted discre[~ancies ~ave been corrected. If there are any ~urttler ~tuestioas, please call this o~fice at 264-4720. Sincereiy ~ Cory %~,~illis, K.~3~ Actin~D ~ewer & %~ater Pro.~ram ~a~%a~,~e r