HomeMy WebLinkAboutNORTON PARK #3 BLK 2 LT 4q
77
1. Approval requested by:
Mailing Address:
2. Property Owner:
Mailing Address:
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
Date Received October 5~ 1976
Time of Inspection
Date of Inspection .~_
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
Well Inspection
Bruce M. Jones
3701 Eureka ~33C
Phone:
Phone:
276-2732 x 203
Legal Description: Lot 4 Block 2 Norton Park Addition Unit ~3
Location:
Mary Avenue & 123rd Street
5. Type of facility to be inspected
6. Well Data: Individual
A. Type
C. Construction
Sewage Disposal System:
A. Installed
C. Septic Tank:
D. Seepage Pit:
E. Disposal Field:
Distances:
A. Well to:
1. Size
1. Absorption Area
Total length of lines
Single Family
No. of bedrooms
B. Depth
D. Bacterial Analysis
Septic tank
Nearest lot line
B. Foundation to septic tank
B. Installer
2. Manufacturer
2. Material
, Absorption area
, Other contamination
, Absorption area
, Sewer Lines
C. Absorption area to nearest lot line
EQ-034 (1/74) Page 1 of two pages
page 2 of two pages - Re ;t for Approval of Individual [ ~r & Water Facilities
Legal Description Lot 4 Block 2 Norton Park Subdivision Addition Unit ~3
Comments
Approved
Approval ~Valid for one year from date signed
Greater Anchorage Area 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)
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMI-'NTAL PROTECTION
2510 East Tudor Road, Anchorage, Alaska 99504 276-2221
REQUEST FOR APPROVAL OF
INDIVIDUA · ~1.-~!~ WATER FACILITIES
1. Type of Inspection: CMRO. .VA FHA
2. Property Owner:_ .~'_~? ~t. (2 ¢~ . /Z d_.¢' d/~ /?c:c
Mailing Address: ~//~/ ~Z'd~q ~
CONV.
3. Name of Buyer:
Mailing Address: Day Phone;_
4. Name of Lending Institution:
Mailing Address: Phone:
5. Name of Realtor or Agent:
Mailing Address: Phone:
Location:
7. Type of Facility to be Inspected:
8. Water Supply
Type of Supply:
Public Utility
No. Bdrms.
Individual ////'
If Individual, number of dwellings presently served
If Individual, depth of well
Sewage Disposal System
Type of System:
Public Utility
.Individual (on-site)
If Individual, date of installation
72-003(3/76)
FROM: DEPARTMENT:
INITIATED BY:
TO: DEPARTMENT:
RECEIVER:
FOR INFORMATION ONLY
FOR IMMEDIATE ACTION
FOR YOUR CONSIDERATION
OTHER
GREATER ANCHORAGE AREA BOROUGH
DATE ANSWER
REQUESTED:
REQUESTED ACTION SCHEDULE
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