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HomeMy WebLinkAboutLot 0701 ,- FHA Form 2573 Form Approved ~ev. July 1958 FEDERAL HOUSING ADMINISTRATION Budget Bureau No. 63-R296.8 HEALTH AUTHORITY APPROVAL IHDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM PART I.--TO BE COMPLETED BY FHA INSURING OFFICE MORTGAGEE SERIAL NO. Anchorage, Alaska l~r~t ~a~tl ~ of ~hor~ lll~hOlO-~3 MORTGAGOR OR SPONSOR PROPERTY ADDRESS SUBDIVISION NAME BLOCK NO. LOT NO. TOTAL NUMBER: Can a~ie or o~er area be made Jnt~ BASEMENT ~ N~w J~s~all3[Jo~ additional bedrooms? uw~o u~s s~aoo~s ~.s (If Yes, how many~) WATER SUPPLY BY: SYSTEM DESIGNED FOR ~ Public system ~ Communi~ system ~ Individual NO. O~ BDRMS. GARBAGE DISPOSAl. ~ Public system ~ Community system g Individual ~ g Yes ~ No PART ".--TO BE COMPLETED BY HEALTH DEPARTMENT HEALTH DEPARTMENT INSPECTOR'S SKETCH , ~-~ ~ ~ ~ ..... --' ,_ , ' It is the opinion of the~ ~ State ~ Court, ~ Local Department of Health that this individual water-supply system ~ is ~ is not satishctory as a domestic water supply Gr 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:  Can be expected to function satishctorily, and ~ Cannot be expected to hnction satishctorily ~s not likely to create an insanita~ condition DATE SIGNATURE TITLE NOTE: The health authority should complete the approgrlate opinion statement Gbove and a~x' date, signature and title in the space~ provided. Useof 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 fore~o[n~ ~nd ~he pe~[nenc FHA CompH~ce Inspe~{on ~epo~, ~nd ~ecommend ~h~t 'che Individual w~ce~-supplF s~scem b~ considered ~ Acceptable ~ Noc ~wage dis~sal 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. 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XJ~mmsn> lou aae [] as, [] siia,~ lenp!a!pui · saqau! 'm~m jo az!s uaaj- -- u}~tu ~a~ >!lqnd 3SOJI~U O~. WtlSAS AlddflS'llllV/~A IYI'IQIAIQNI~NOII:):IdSNI :!O ltlOdltl 'saq2u! uaaj aJenbs · [oodssaD [] '~uul 2!ld~.s~ jo sls!suo> .LNIWJ.¥IiI.L iilVWlild WIISAS IY'SOdSI(3-IOY/9~tS lVflalAlaNI--NOIJ.3:ldSNI 40 1UOd]iJ - ":? APP. TOIN~. FROST 6RAVEL _. SILT CL AY ANIC TENT PEAT WATER TABLE TABL. E PbZZ Y t0' U~'ILI T Y ~..qM TX) I0' lO' IJ T/I./ f Y / 0,5" Jo; / "= FHA Form 2573 Form Approved Rev. July '19.58 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. MORTGAGOR OR SPONSOR PROPERTY ADDRESS TOTAL NUMBER: ~ Can afflc or other area be made into tlV,.O U.ITS aEoeoo~s ~Ams ~Aj installation bedrooms? (If Yes, how manyg) WATER SUPPLY BY:~ SYSTEM DESIGNED FOR ~ Public system ~ Communiw system ~ Individual No. OF BDRMS. GARBAGE DISPOSAL SEWAGE DISPOSAL BY: ~ Public system ~ ~mmunity system ~ Individual ~ ~ Yes ~ No PART II.--lO BE COMPLETED BY HEALTH DEPARTMENT HEALTH DEPARTMENT INSPECTORIS SKETCH (~ Atta~ 2 ~_~ ' ~ ...... , ~--~ ....... ~___ M ' ~_~ It is the opinion of the ~ State ~ County ~ 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: ~ Can be expected to function satisfactorily, and ~ Cannot be expected to function satisfactorily is not likely to create an insanita~ condition NOTE: The health authority should complete the appropriate opinion statement above and affix date, signature and title in the spaces provided. Use of the above grid for Health Department Inspe.:tor's sketch as well as use of the back of this form is at the option of the health authority. PART Ill.--FOR USE OF FHA OFFICE TO THE CHIEF UNDERWRITER: I have reviewed the foregoing and the pertinent FHA Compliance 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 ~ C~IEF ARCHITECT  DEPUTY FOR CHIEF HEALTH AUTHORITY APPROVAL FHA Form 2573 INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM Rev. July 19SB