HomeMy WebLinkAboutLot 05LC
GRE/-ER ANCttORAGE AREA BOP'UGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
LOCAT, N
SEPTIC TANK:
DISTANCE
FROM WELl_
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTE/~
NUMBER OF
~'o~'('z~' ('- MATERIAL COMPARTMENTS
INSIDE LENGTH
_ INSIDE WIDTH
LIQUID DEPTH
LIQUID CAPACITY. ~ ~O~) GALLONS.
SEEPAGE PIT:
NUMBER OF PITS I DIAMETER __OR WIDTH__
LINING MATERIAL~/~.~ CRIB SIZE: DIAMETER
BU LD NG FOUNDATION [~ i NEAREST LOT LINE'~'O
ADDITIONAL ABSORPTION
LENGTH DEPTH ~r,
___.DEPTH DISTANCE FROM: WELL C,~ .¢k~, ¥c) ~o_,
TOTAL EFFECTIVE
ABSORPTION ARFA (WALL AREA) Z-//-~-(¢ SQ. FT.
WELL:
TYPE ~-~ ,.~k- k.,.~., CONSTRUCTION
BUILDING NEAREST
FOUNDATION LOT LINE
C[--SSPOO L OTHER SOURCES
APPROVED ~ DISAPPROVED
NEAREST
SEWER LINE
REMARKS
DEPTH DISTANCE FROM:
SEPTIC , SEEPAGE--
TANK "/c~o O SYSTEM -~/~)~"~ O
DISTANCES:
INSTALLED BY:
PIPE MATERIAL:
LOT SLOPE:
REMARKS:
Form No, EQ. 031
DATE
DIAGRAM OF SYSTEM
APPROVED
G.A.A.B.
GREATER ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-4561
PERMIT NO,
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
......... ~L, ' - ' ' -
INSTALLATION LOCATION C~~~y ~' ~' -- /~/¢~
INSTALLATION OF: SEPTIC TANK --__~/' SEEPAGE PiT ~ DRAIN FIELD ...... OTHER
___ NOTE: THIS PERMIT 15 NOT VAtJD wrrHOUT SOIL TE~T
FINAl. INSPECTION: 24 HOUR NOTICE ~EQUIRED. BACKFILLING OF ANY SYSTEM WITI-tOL.VF FINAL, INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION,
MINIMUM DIS'rANCE~, r~EOUIREMENT~
FOUNDATION TO SEPTIC 'rANK
, , DRAIN FIELD
TO NEAREST LOT LINE.
WATE. MAIN TO SEPTIC %ANK
SEPTIC TANK,~5~ SEEPAGE PIT
SEEPAGE AREA SIZE /L~/~L/~ TYPE
SEEPAGE PIT
ALSO CONSIDER AREA WELLS,
.... SEEPAGE PIT /¢
CAS~ IRON INTO AND OUT OF SEPTIC 'rANI( AND INTO CRIb3 CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
I CERTIFY 'FHAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA ~OROUGH ORDINANCE NO. ;28.68 AND THAT 'THE ABOVE
DESCRIBED SYSTEM~. /'~IS IN ACCORDANCE WITH SAID CODE. ,' ~.~.:~. //? , ~ .~
"O.e test is worth a thousand opinion, s"
Top BleV
2
¢ [ASS IP ICAT ION
, 1¢ (/,,t ,.:)
4
10
12
15
16,
17
19,
20,
23
Sheet of
woo, ~--/)Te~ato~ ,-.',-,'.,,/i/~,- f~:
Date, ~ ~Z- /~?
SAMPLE
DATA
LEGEND
Gravel
Sand
Silt
Clay
3rganic
Content
Peat
rroa~
Water
Table
,Eguco,'-¥~"~,.,, A ~Pki')VAI. . OF
IHD!~ ~ ~
F'OR
, .., .... .,. ~ ~~/;~_~ ~.
Hailing
Address
Property Owne~:
~. Type .~¢ ' ~' ' ~ ....... 8. Oept:h ................................
--, ~_, .-~
GREATER ANCHORAGE ARE/, BOROUGH
Department of EnvironmeF, tal Quality
3330 "C" St., Anchorage, Alaska 99503 - 274-4561
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
1. Type of Inspection:
2. Property Owner:
Mailing Address:
3. Name of Buyer:
CMRO VA
John C. Dickens
FHA
CONV ×
6509 Chevigny, A.n. chorage~ Ak,. Day Phone
John C. Dickens
279-8657x131
Mailing Address: Same Da~ Phone
4. Name of Lending Institution: The First National Bank of Anchorage
Mailing Address: F, O. Box 720, Anchoragei AkPhone 279-4481
5. Name of Realtor or Agent,.' none
Mailing Address: Phone
Legal Description:
Locati on: Sand Lake
Lot 5, Blk. 1~ Highland Park S/D
7. Type of Facility to be inspected:
8. Water Supp'ly
Type of Supply: Public Utility × Individual
If Individual, number of dwellings presently served
If Individual, depth of well
9, Sewage Disposal. System
Type ,of S~stem: Public Utility
If Individual, date of installation
Single family No. Bdrms, 3
Individual (on-site
X