HomeMy WebLinkAboutBROOKWOOD BLK 2 LT 14 (3)
FHA Form 2573 Form Appr~ed
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.
Anehora~e, Alaska F-trst llat~onal Bank of Anehorage 60-008j~89
MORTGAGOR OR SPONSOR ........... 'j PROPERTY ADDRESS
RaF~ond L. and llinor O. Lynch 11901 l~a~nbov - lnohora~e
SUBDIVISION NAME BLOCK NO. LOT NoIJl
]h, ook'~ood ~abdtvision 2 1~ & 1~
__ ~ Can attic or other area be made into
TOTAL NUMBER: BASEMENTI--I New installation additional bedrooms?
uw~G UN~TS BEDBOOMS BATHS
................................ (If Yes, how rnany~.)
WATER SUPPLY BY: SYSTEM DESIGNED FOR
E~] Public system~L~J Community system~L_] Individual No. oF BO.MS. GARBAGE DISPOSAL
SEWAGE DISPOSAL BY:
I--1 Public system D Community system [[] Individual [5] Yes 71
PART II.--TO BE COMPLETED BY HEALTH DEPARTMENT
HEALTH DEPARTMENT INSPECTOR'S SKETCH
L ~-4 ...... ~---
~, ,
i
It is the opinion of the E~ State [~ County ['-'] Local Department of Heahh that this individual
water-supply
system
[--'] is [--] is not satisfactory as a domestic water supply for the subiect property.
It is the opinion of the ~ State [---] County E~] Local Department of Health that this individual sewage-disposal sys-
tem with proper maintenance:
Can be function satisfactorily, and r-'] Cannot be function
expected
expected
to
to
satisfactorily
is not likely to create an ins~ary condition
NOTE: The health authority should complete the appropri~,e opinion statement ab~v~and alTix date' signature and title in the
spaces provided,
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
health authority,
PART III,--FOR USE OF FHA OFFICE
TO THE CHIEF UNDERWRITER:
I have reviewed the foregoing and the pertinent FHA Comp'.iance Inspe~ion Report, and recommend that'the
Individual water-supply system be considered [--] Acceptable [--] Not Acceptable
Sewage disposal be considered [~] Acceptable [--] Not Acceptable.
DATE SIGNATURE
CHIEF ARCHITECT
[ DEPUTY FOR CHIEF ARCHITECT
HEALTH AUTHORITY APPROVAL
INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM
FHA Form 2573
Rev. July 1958
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