HomeMy WebLinkAboutMEADOW BROOK Block 6 Lot 31
HUHICIPALITY OF ANCIIORA6E
OF HFALTH AND ENVIP, ONHEN
]_, Sbreet_, Anchorac~r~, Alaska
2 :~ ,'! -- 4 7 2 0
EAGLE RIVER AREA
PROTECT1 ON
) ~:~,J .
3
DaLe
RNQUES'I: J?()R AI~PROVAL OF' ZIN).'V.II)[JAL SI"]NEI: AND ~'~A'I']:R FAC It ['PlFS
Own,ar: Eric S. Johnson Phon. e 694-9734
3. Lega.1. DescrJ.l_l'.ion: Lot 31 Block 6 Meadow Brook Subdivision
Numbex' of Bc'drooms: Four
Number Of
5. Well System: :.ndzv:[ciu,ttl W('.i]. ( ) C'onm'tunity/Public System
Permit ii Del)th of Wel£L Well f.,og on Pile ( )
Cons'hruc'hJ.on Bacterial Ana].ysis
Sewage Disposal SysLem: On,--sJke System ( ) Pub].ic Uhiiity
Permit ~ .Installed Installer
Septic Tank Size Manufac-huuer
Absorp'tion Area Soils Rate Materia
'7 Distances: WOl] to 8opti(; Lank
ho Sewer I,ine Nes. res[t Lot line
to Jca] _~. 11,o1::
to Absor'pkion Al:ea
Absorpt:i.on Area
'l.'!a g e
l)epa~,:hmant; o:I] ttealhh and i!h~vi]:onmenha]_
Rc.~t.e.~t for Approval off' lhx'tJ.vidua]. {3ewe]: and Waher_ fac]]' ' ' .ti:to' ",s
Comlnon'L S:
~flfadaviL Ak'Lathed: (~ .Ne~he:[: AtLached: ( )
D:Lsa pproved: Dalce:
Departmenh Worksheol::
r}
iUi',~iCI~ALITY OF ANCtlORAG~.
{? L;opartnlonD of lleaJ Lh and i:h~vJ.]:onmenbal. ProLocLio~UNICIPALITY OF
: k~(~f,((j,~ .~ ,' ..... ENVIRONMENIAL P~QIL [iOiq
...... X]~ecjnesL lh3t:' ,~,,,t.o~,a]' .... of Individual_ S(x,zor and ~',a,_
2, Name of Bnver: ~__] .................................
},ia:ii h~g Addres,~;: Phone:
Rea ].kor/Agent::
Mai].ing Address: Phone:
6 o
Sinqle Family ] .c,'r ~ - ,
Hultiple Pamity 12. esidlen¢::e:
{ ~ Number o/ Bedrooms:
( ) Number of Bedrooms:
Water Supply: *Individual Nell ( ) Public/Community Syshem
If Individual We~ .) , weJ.] depLh
Sewage PJsoosa!; Svstom:~ *~'On--.sJt:e SysLem ( ) ~ub].ic ~y.o '~Lo_.~ (~.
I~ On-s:ite System, dale oE JnsLa.]]ation:
* NOTE:
A well ]_og Js requ:ircd on Ai',L wells drilled since 6/75.
** If on-site sewer system :is over hwo(2) years old, an ade(luacy
hest is requJ.~ed bv l:)~is deparhment.
A fee oil $25.00 mus~ accompany each ~equesh be/'o~-e p~:o(:essi, ng
can be ini. t.:iakod~
3/7 7
MUNIr LITY OF ANCHORAGE
POUCH 6-650.ANCHORAGE, Al( 99502 ~PHONE 279-8586
FINANCE DEPARTMENT
CASN .ECE,PT No. 3 3 i) 9 4
ZiP
Org/CC Acct/Obj Task Option Cost Center, WA/WO 6 Amount
Collecting Orgn. No. , / .~ ('" ',~.~/,.~-~ ¢* -~., ..~ ('(~ .~_: ,,,,: ?v _~._~-'
40 007 (Rev. 1/77) DISTRIBUTION: White Treasury; Yellow Customer; Pink -- Book: Goldenrod r~n*~t~,~
UNITED STATES POSTAL SERVICE
OFFICIAL r~USiNESS
Print your name address, and ZIP Code in the s
RETURN
TO
PENALTY FOR PRIVATE
USE TO AVOID PAYMENT
OF POSTAGE, $300
(Street
((~lty, State, and ZIP C!otle)
UNITED STATES POSTAL SERVICE
OFFICIAL BUSINESS
SENDER INSTRUCTIONS
Print your name, address, and ZIP Code in the space halew, * Complete items 1, 2, and 3 on the reverse,
· Moisten gummed ends end attach to '~ront of article
f sp&ce p~'m s Othenvise sffix to back of article.
· Endorse article "Retur~ Race Ot Re(~uosted" adja-
cent to humber,
RETURN
TO
[;~,?> .W: 1~. ,.,..~
PENALTY FOR PRIVATE
USE TO AVOID PAYMENT
OF POSTAGE, $300
(Street or P.O. Box)
(City, State. nnd ZIP Collel
return receipt r( sted
· SENDER.: Compiete item; l, 2. =n~t %
Add your addr~s in thc "RE~ TO" space on
I. The follow/ng service is requested (check one).
[] Show to whom and date delivered ............ 15¢
[] Show to whom, date, & address of delivery_. 35¢
[] RESTRICTED 13ELIVERY.
Show to whom and date dellvered ............. 65¢
[] RESTRICTED DELIVERY.
Show to whom, dante, and address of deliver~ 85¢
LJB/ljh Sewer and Water
2. ARTICLE ADDRESSED TO:
Glen Briggs
Box 517
:_Eaqle Riverr Alaska 99577
3. ARTICLE DESCRIPTION:
I REGISTERED NO' I CERTIFIED NO-I INSURED NO.
102272
have received the article described above.
;IGNA_~T,.~RjE/'.' [] Addre.~] .~. thorized agent
5. ADDRESS (Complete only if requested) ~ ' .~-',
.:-~
6. UNABLE TO DELIVER BECAUSE:.
