HomeMy WebLinkAboutBURLWOOD TERRACE BLK 2 LT 6
/]~,~, MUNICIPAl !TY OF ANCHORAGE
"~~:~>. ' DEPA~r~TMENT F HEALTH ,~NJ E~,,V~JN,dEN~,~, )ROTECTiON
...... . 27.-~: :,~-1, e:<t. 224 or 225
...... ~-I0~ ~g~)C~ Date R. ece~ red ~ August k 1977
REQUEST FOR APPROVAL OF ~N., IVIDiJi%L SEWER AND WA'i'ER FACILi']'IES
Lending Institution Request: Spokane Mortgage Company
Ma i ]. :in cZ Add r e s s: _.3_~_0~i____C_ __S_.~?_e._.e_~_._~.~t__e_~_5_0~ ............. Ph @ n e:
277-0543
Pro per t y Own er
Mailing Address: 3924 Boniface Parkway 99504
hOD e:
333-8231
Legal Descci. ption: Lot 6 Block 2 Burlwood Terrace Subdivision
4: ,:,.,.r, jle Pami].y Res'ide:nce: 'iX]i
~umb:c,r of '~.'a~"'"ms Three
b~ul. tip!e, Faro] iy ResJ.c..,i',~ ...... : ~
Number of Bedrooms:
We.L[ System:
Permit #
Construction
Individual "~
!~e~_.'l (xR Cormnunitv/'Pubt. i.c ,S,,~t~ ........ '-.m ~
Depth oil Well 110'-115' Well Log on File ( )
Bacterial Analysis
~,,.e System ( )
Sewage Disposal. System: On-s'~'-
Public Utility
Permit #
Instal 1 ed
In s t a 11 er
Septic Tank Size Manufacturer
Absorption Area Soils
Material
Distances:
Well[. to Septic Tank
to Sewer Line
Nearest Lct line
to Absorption Area
Absorption Area
Nearest I.ot Line
-- MUNICIPALITY OF ANCHORAGE -
DEPARTMENT OF ENVIRONMENTAL QUALITY- Sewer aad Water Section
825 L Street, Fourth Floor, Anchorage, .Ak.~99503 2~9~-25'lt'~!Ext. 229
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES
1. Type of Inspection: CMRO
2. Property Owner: Vera M. Lon~bottom
Mailing Address: 3924 Boniface Parkway
3. Name of Buyer: Annabelle F. Moore
Day Phone, 333-8231
Mailing Address:
4. Name of Lending Institution:
Mailing Address: 3201
5. Name of Realtor or Agent:
Mailing Address:
1419 Wintergreen St.
Spokane Mortgage Co.
"C" Street~ Suite 250
none - direct sale
Day Phone 272-0426 .
Phone 277-6543
Phone
Legal Description: Lot 6, Block 2, Burlwood Terrace
Location: 3924 Boniface Parkway
7. Type of Facility to be inspected:
8. Water Supply'
Type of Supply:
single family
No. Bdrms. 3
Public Utility
Individual XXXX
If Individual, number of dwellings presently served
If Individual, depth of well 110 or 115 feet
Sewage Disposal System
Type of System:
If Individual, date of installation
one
pUmp at 90 or 95 feet
Public Utility
Individual (on-site)
(seller estimates
EQ.037 (1/74)
Page .T~o. - "
" Department of Health and Environmental ~?rotection
Request for Approval of Individual Sewer and ~t...r ~'acilit~_cs
Legal Description:
Lot 6 Block 2 Burlwood Terrace Subdivision
Cowmen'ts:
Affadav[t Attached: ( ) Letter Attached
Approved:
Disapproved:
Date:
Department Worksheet:
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