HomeMy WebLinkAboutMAJESTIC VIEW BLK 1 LT 25
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
Date Received
Time of Inspection
Date of Inspection
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
Mailing Address:
3. Legal Description:
4. Location:
Type of facility to be inspected
Well Data: ~p-?'2~"~?q
A. Type
C. Construction
Sewage Disposal System:
A. Installed
C. Septic Tank:
D. Seepage Pit:
E. Disposal Field:
Distances:
A. Well to: Septic tank
Nearest lot line
B. Foundation to septic tank
Depth
No. of bedrooms
D. Bacterial Analysis
B. Installer
1. Size 2. Manufacturer
1. Absorption Area 2. Material
Total length of lines
, Absorption area
, Other contamination
, Absorption area
, Sewer Lines
C. Absorption area to nearest lot line
EQ-034 (1/74) Page 1 of two pages
'l, Type of ~ ~'~'"
rio pcC .
2, ?roperty Owner:
Hailing Address:
a~ ) F H A Cfi ~, V X
C, ,,0 ~iA ~ ,,
Michael, Patricia, & Lottie VonWalter
9251 Kavik Day Phor~e 344-5509
Porter L. & Virginia Pierce
3. Hame oF ~ .....
~.> LI ,y ,,~ i' :
1916 Thunderbird Pl. 274-3561
,,iail lng Address: P..'-LY Phone
Alaska Mutual Savings Bank
'~. Hame of Lending Institut. ion:
601 W. 5~h 274-3561
Mailing Address: Pi~0ne
Barbara Repasky or Peggy O'Bryan
5. Name of Realtor or Agent.:
3300 C S~ee~ 2?8-2525
Mail ing Address: Phone
Lega'l Description: Majestic View Sub. Lot 25 Block 1
9251 Kavik
Location:
Res 5
Type of Facility to be i~spected: No. Bdrms.
Water Supply
Type of Supply:
Public Utility
Community Well
! ]~ i vi dual
X
..T'f' Indiv'idu~.xi :, numo,.r oF dwellings I) ..... ,..s~."_,,uly served
i -F i n ,,:! i v 'i i u a 'l. d e o 'b h c, f ,..,~ e '1 '1
9, Sewage Disposal' System
Pub'i~' Uti'iity X
)Cn ,:1 i v '; d k~ a '1 ( 0 ?, ,- s i ~: ? )
IF .[ndiv'idual; da'i;e of insi:a'l'iation
Page 2 of two pages - R
Legal Description ~ ,~-
st for Approval of Individual . ~.r & Water Facilities
Comments
Approved {~, .~2 Disapproved Date
Approval,Valid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
I 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)