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Home My WebLink AboutBROOKWOOD BLK 2 LT 7016- I FHA Form 2573 Form Approved Rev. July 1958 FEDERAL HOUSING ADMINISTRATION Budget Bureau No. 63-R296.8 HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM PART I.--TO BE COMPLETED BY FHA INSURING OFFICE MORTGAGEE SERIAL NO. Anohor~e. A~sk~ First National ~ of Anohora~e 60-008327 MORTGAGO~ OR SPONSOR PROPERTY ADDRESS Ro~ld E. Van Sie~e 1926 Dol~ Va~en SUBDIVISION NAME BLOCK NO. LOT NO. ~oo~ood 2 Can a~lc or other area be made into TOTAL NUMBER: BASEMENT New installation additional bedrooms? LIVING UNITS BEDROOMS BATHS 1 ~ Yes ~ No ~ Yes ~ No WATER SUPPLY BY: SYSTEM DESIGNED FOR ~ Public system ~ Communi. system ~ Individual ,o. o* ,o,~s o,.ao~ SEWAGE DISPOSAL BY: ~'~blic system ~ Community system ~ Individual 5 ~ Yes ~ No PART 'I.--TO BE COMPLETED BY HEALTH DEPARTMENT HEALTH DEPARTMENT INSPECTOR'S SKETCH ............. ~ ~ .... ~ ........ ~-~ It is the opinion of me ~ State_ .~ Coun~ __~ Local Department of Health that this individual Water-supply system ~ is ~ is not satisfactory as a domestic water supply for the subject properS. It is the opinion of the ~ State ~ County ~ Local Department of Health that this individual sewage-disposal sys- tem with proper maintenance: Use of the above grid for Health Department Inspector's sketch as well as use of the back of this form is at the option of the ....... PART ilI.'F6R USE OF FHA OFFICE TO THE CHIEF UNDERWRI~R: I have reviewed the foregoing and the pe~inent FHA Compli~ce Ins~ion Repo~, and recommend that 'the Individual water-supply system be considered ~ Acceptable ~ Not Acceptable ~wage dis~sfl be considered ~ Acceptable ~ Not Acceptable. j ~ OE~UTY ~o~ c~F ~UCHIT~CT HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FHA Form 2573 Rev. July 1958 6I · asnu:tu Jad suoIl~:ff' · aanu:tu :ad SUOll~t '~?u:sra, jo q3da(I uo:a~adsu} jo a~(I ssuaualn;duao~ jo :aqtunN W;ILSAS 'I¥SOdSI(I':IOyMBS 'I¥flCIIAIGNI--NOIX:):IdSNI t0 ,LilOd{il 1. Approval requested by: Mailing Address: 2. Property Owner: Mailing Address: .~~'~REATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received March l?, 1976 Time of Inspection Date of Inspection FOR APPROVAL OF REQUEST INDIVIDUAL SEWER & WATER FACILITIES FOR C~nv. 4. 5. 6. Spokane Mortgage Company 3201 C Street, Suite 250 Ronald E. & Linda Romph Phone: Phone: Star Route Box 1507E, Anchorage 99507 277-0543 344-5908 'Legal Description: Lot 7 Block 2 Brookwood Subdivision Location: 1926 Dolly Varden Avenue, Type of facility to be inspected Single Family No. of bedrooms Well Data: A. Type C. Construction 7. Sewage Disposal System: A. Installed 1960 C. Septic Tank: D. Seepage Pit: E. Disposal Field: 8. Distances: Semi-Public On-site system. 1. Size 1. Absorption Area Total length of lines B. Depth D. Bacterial Analysis A. Well to: Septic tank Nearest lot line B. Foundation to septic tank B. Installer 2. Manufacturer 2. Material , Absorption area , Other contamination C. Absorption area to nearest lot line , Absorption area , Sewer Lines EQ-034 (1/74) Page 1 of two pages ~iJNIcI!:'/:LI'FY 'Gi,',IEATER /",NCHORAGE ARi::!, BOROUC':H cu-,;~, c,,": Department of Environmental Quality ~Nw.~o,,~,,,.~%,,i.~,~ ,~. ....... -~- cL ION 3330 "C" Si:., Anchorage, Alaska 99503 -274-4561 Type of Inspection: CMRO VA FHA Property Owner: ~nald E. & Linda Romph Mailing Address: SPA Box 1507E, Anch. Ak. Name of Buyer: Daniel & Victoria Stewart Hail lng Address: 1200 W. Dimond, Sp. #1493 ..... [)~. Phone 349'1897 Name of LendJng InstJl:ution' Spokane Mortgage Co. MaJ]Jng Address: 3201 "C" St., Suite 250 Phone 277-0543 Name o'f Reattor or Agem¢: None MaJling Address: Phone cor4v _. ~a.y Phone 344-5908 o Legal Descri pti on: ~_ot_~?~_.Bl_oc__k .2_,_ BroOkwood Subdivision L o c a t i o n: _192~__6__.D_o.l_!zZ Varden Ave. Type of Facility to be inspected: Wa%er Supply l'ype of S~.~pply:SemiPublic Utility Single Family No, Bdrms. 3 XX I'ndividual If Individual~ number of dwellings presently served If Individual, depth of well Sewage Disposal' System Type ,of SYstem: Public Utility If Individual., date of installation Individual (on-site) ::~ I960 P~ge 2 of two pages - Re~' st for Approval of Individual ~ ~r & Water Facilities Legal Description Lot 7 Block 2 Brookwood Subdivision Comments Approved ~K) ~/~~ Disapproved Date 3-~ ~--7~ val 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) e GREATER ANCHORAGE AREA BOROUGH Department of Environmental Qualtty 3500 Tudor Road, Anchorage, Alaska 99507 279-8686 Time of Inspection ~ 0'-'~ 0 I.. REQUEST FOR APPROVAL OF I~VIDUAL SE~ER & WA~R FACILITIES FOR Number of Bedrooms= '~ e A. Type . . B. Depth ~ .. Sewage Disposal System'- ~ ~-~ ~-~'~} ~ 'o A. InstalIed 8. Installer C. Septic Tank: 1. Size 2. Manufacturer D. Seepage Pit: 1. Size 2. Material E. Disposal Field= Total Length of Lines 8. Distances: A. Well To~ Septic Tank , Absorption Area , Sewer Lines , Nearest Lot Line , Other Contamination B. Foundation to Septic Tank Absorption Area C. Absorption Area to Nearest Lot Line . Request for Approval o ~.ndtvidua] Sewer & Water Facili' ~.s Page Two 9. ,Comments.' Apcroved Disapproved Date Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM pl'p~- I' certtfv that the information contmined in this request for appreval to be a true and accurate representation of the subiect sewer and water facilities located at.' FHa, FORM NO. 2573 U.S. DEPARTMENT Of HOUSING AND URBAN DEVELOPMENT Form Approved Rev. 11/71 FEDERAL HOUSING ADMINISTRATION Budget Bureau No. 63-R0296 HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM PART I'.--:TO BE COMPLETED BY HUD/FHA Insuring Office FHA Case No, Anchorage Mortgagee -'Name, Address and Zip Code Mortgagor or Sponsor-' --I Ronald i and Linda N. Ramph ~-First National Bank of Anchorage ' Property Address: 1926 Dolly Varden, Anchorage, Alaska Subdivision: Lot No, L_ _] Brookwood Subdivision, Block 2, 7 TOTAL NUMBI',R [] Can Attic or other Area be made into additional r.rvrl~cl tiNl"rR BEDROOMS BATI-I~ BASEMENT New Installation bedrooms? (If yes~ how many?,) · ] 3 ] r]Yes ~No ~Yes [] No WATER SUPPLY BY~ SYSTEM DESIGNED FOR [~ Public System [] Community :SyStem [] Individual No. of '' · ' Bedrooms Garbage Disposal SEWAGE DISPOSAL BY: [] Public System V-~ Community System ~Individual [] Yes [] No. PART II.~TO BE CoMpLETED BY HEALTH DEPARTMENT HEALTH DEPARTMENT INSPECTOR'S SKETCH -r- ........... ~-~ ....... r- It is the , opinion of the [] State [] County ~-~ Local Department of Hca thatthis individual water-supply system ~_] is [] is not satisfactory as a domestic water supply for the subject property. It is the opinion of thei ~ State ~-~ County [] Local Department of Health that this individual sewage-disposal system with proper maintenance: ~ Can be expected to function satisfactorily, and ~-~ Cannot be expected to function satisfactorily is not likely to create an insanitary condition DATE SIGNATURE TITLE NOTE: Theheolthauthorlty should complete the appropriate'o~nio~'statement obove and affix dote. signature and ,~~ spaces provided. Use of the above grid for Health Department Inspector% sketch as well as use of the back of this form is at the opinion of the health authority. 'PART III.---' FOR USE OF FIELD OFFICE TO THE CHIEF UNDERWRITER, OR ASSISTANT DIRECTOR SINGLE FAMILY MORTGAGE INSURANCE BRANCH: I have reviewed the foregoing and the pertinent Compliance Inspection Report, and recommend that the Individual water-supply system be considered [] Acceptable ~-] Not Acceptable Sewage disposal be considered [] Acceptable [] Not Acceptable. DATE SIGNATURE [] CHIEF ARCHITECTURAL SECTION ]DEPUTY FOR CHIEF ARCHITECT HEALTH AUTHORITY APPROVAL FHA FORM NO. 2573. INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM R. ev. 11/71