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Home My WebLink AboutPAPAGO PARK BLK 1 LT 1B MUNICIPALITY OF ANCHORAGE A4UNICIPALITY OF ANCHC)RA~F DEPT. OF t!SALTH ENVIRONMENTAL PF, OTECTION DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street- Anchorage, Alaska 99501 MAR 1_ 3 1979 R E C E 1 ENVIRONIV] ENTAL ENGINEERING DIVISION Telephone 264-4720 V [ D REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all oarts on page 1, Incomplete requests will not be processed, Please allow ten (10) days for processing. 1. PROPERTY OWNER /% J J PHON/I~ Ernest P./Ardeania Sue Brouillet _ ~ l/.~ J~72~561 7508 Arctic Boulevard 99502 I '~ ' ~ J~%434~9917 PROPERTY RESIDENT IIf diff~rent from above) J~/J[/ ~--~'~'~ ~ t ~0~ ~ PHONE 2, BUYER ~ ~ ~ / ~ I ....... ~irst ~ational Bank of ~chora~o ~ Gudy 265-3683 MAILING ADDRESS Post Office Box 720 99510 4. REALTOR/AGENT JPHONE MAILING ADDRESS $, LEGAL DESCRIPTION Lot 1-B Block 1 Papago Park Subdivision STREET LOCATION 7508 Arctic Boulevard 99502 6, TYPE OF RESIDENCE ~ SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF BEDROOMS [] One [] Four [] Two ~ Five ~ Three [] Six [] Other 7. WATER SUPPLY INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY * ATTACH WELL LOG. A well log is req aired for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON-SITE** PUBLIC UTI LITY **If individual/on-site, give installation date If system is over two (2) years old an adequacy test is required by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) THIS SIDE FOR OFFICIAL USE ONLY rr DATE RECEIVED INSPECTION APPOINTMENTS TIME ~'TIME r TIME DATE DATE DATE INSPECTOR ' " INSPECTOR INSPECTOR DIRECTIONS: 1. TYPEoF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] ' MULTIPLE FAMILY FI TWO [] FOUR [] SIX 2. WATER SUPPLY PERMIT NUMBER [] ,INDIVIDUAL - DEPTH OF WELL [] COMMUNITY '"[~,T E DRILLED I--~ PUBLIC UTILITY Connectiori Verified 'LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM 'PERMIT NUMBER [] INDIVI DUAL/ON -SITE DATE INSTALLED I-'-IPUBLiC UTILITY ' Connection Verified __ INSTALLER · []SepticTank or [] Holding Tank Size: , If Tank is homemade SOILS RATING ' give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL Absorption Area to nearest Lot Line 5. COMMENTS [] APPROVED FOR BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY (Title) LEGAL DESCRIPTION 72-010 (Rev, 3/78) MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPT. OF '::ALTH & DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ENVIRONMENTAL -~'~" ~EcTtON 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 MAR 1 3 t979 BEQUEST FOR APPROVAL OF INDIVIDUAL S EWER and WATER FACILITIES RECEIVED 1. Type of Inspection: 2. Property Owner: Ma iling Address: 3. Name of Buyer: CMRO VA FHA Ernest P. & Ardeania Sue Brou~]]et CONV x Ak. 9~502 · 272-4561 ?508 Arctic Blvd.~ Anchorage, .Day Phone: 344-9917 Same as owner Mailing Address: Same as above Day Phone: Name of Lendinglnstitution: The First NationaZ Bank of Anchorage 99510 Mailing Address: P.O. Box 720, Anchorage, Alaska Phone: 265-368~ Attn: Judy Payne 5. Name of Realtor or Agent: Mailing Address: Phone: 6. Legal Description: Lot l-B, Block 1 Papago Park S/D Location: 7508 Arctic Blvd., Anchorage 7. Type of Facility to be Inspected: 8. Water Supply Type of Supply: o Well No. Bdrms. Public Utility Sewer Individual Well If Individual, number of dwellings presently served If Individual, depth of well Sewage Disposal System Type of System: Public Utility x One Individual (on-site) If Individual, date of installation 72-003{ 3/76) P.O. BOX 4-1276 ANCHORAGE, ALASKA 99509 5633 "B" SIREET TELEPHONE (S07) 27°,9-4014 Drinking Water Analysis Report for Total CoIfform Bacle',ia TO BE CO[~PLETED BY WATER SUPPLIER City t State Code Mo. Day SA~2PLE TYPE: '%~' Routine Check Sample (for routine sample with lab ref. no [] .Special Purpose [] Treated Water [] Untreated Water SAMPLE NO. 3 I 4 I LOCATION Time Collected Collected By TO BE CO,~iPLETED BY LABORATORY LABORATORY: CHEM & GEO LABS OF AK., ][NC.j_ NAME 5633 "B" STREET ADDRESS ANCHORAGE, ALASKA 99502 CiTY Time Received Analytical Method: [] Fermentation Tube /~Membrane Filter Lab Ref. No. Result' I-F1 IT1 Analyst READ INSTRUCTIONS BEFORE COLLECTING SAMPLE Form No. 18.3t0 (3-78) 06-1220 (b} BACTERIOLOGICAL WATER ANALYSIS RECORD Rev. 1978 EMB Broth 24 I~our$: Multiple Tube Report: .... Sand Lake Area Reference Map-PlO 126 113 ~ 126A 133 (~) 1974