HomeMy WebLinkAboutBURLWOOD TERRACE BLK 23 LT 3
PERMIT NO.
[:,EF'FIF.'.TMENT HEFILTH FINE:, El'.,l'v' I F.:KiI'.,IHEI'.,ITFIL .)TECT I ON
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ISSUE[:, E:"r'.
T I r, IE:ER E F'LUME: I'.,IG ,
[: RTE
GREATEr ANChORaGe AREa BOROUgh
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHON~ ~-/~4-456 I
-:~-~-'-'-- ..... -- ..... :-=T-~', APPLICATION AND PERMIT
PERM,T NO. 7'2_
PHONE --'~"'~')--10i?";)7'-
INSTALLATION OF: SEPTIC TANK SEEPAGE PIT DRAIN FIELD
. OTHER
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH
TO BE INBTALLED BY
SOIL TEST RESULTS
NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
COMPLETION DATE ANTICIPATED
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE TYPE
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
$EEPAGE AREA SIZE
TYPE
DIAGRAM OF SYSTEM
FOUNDATION TO SEEPAGE PIT
DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT WALL
SEPTIC TANK , SEEPAGE PIT , DRAIN FIELD
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK / G (~' seepAGe PiT /
DRAIN FIELD ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK
DRAIN FIELD
SEEPAGE PiT
SEPTIC TANK, . SEEPAGE PIT
TO RIVER, LAKE, STREAM.
, DRAIN FIELD
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
G .A .A .B.
OR
LICENSED DESIGNER
AREA BOR G~ ANCE NO. 28-68 A AT
FORM NO. EGI-016
THE ABOVE
.. APPLI(. NT FILLS OUT UPPER HA[ ONLY
Prbperty Owner_ ,~./~.~,/~..~ ~ ~ ~ ~ ~ Phone
Mailing Addre~ ~ ~ ~__~~ ~ ~ ~ ~ Zip Code ~'~
Buyer
Address Zip Code
Lending Institution Phone
Address Zip Code
Realty Co. & A~nt ~ / /. ~ ~ - Phone
LegalDescript~n~ ~ ~ Z ~ ~<~'T
Type of Resi~nce
~ Single Family
~ultiple Family No. of Bedroo~
~ Other
Water Supply
~ividual A~ACH WELL LOG. A w~l log is required for all wells drilled since June 1975.
~ Community For wells drilled prior to that date, give well depth (attach log if available).
~ Public Utility
Sewer Disposal --'~ ~ ~
~ ~ividual Yoar Indiv~u~l Installod:
~¢uBlic ~ility ~hon Gonnoctod to ~u~lie ~fility:
~ ~oldino Tank
Time Time Time Time .
Date Date Date Date
Inspector Inspector Inspector Inspector
Field Notes:
MUNICiPALiTY OF ANCHORAGE
~'~ DEPT. Of HE/'.LTH
ENVIRO~M,T. NTAL p P, OT F..CT IO~
RECEIVED
I ~ ) APPROVED BEDROOMS 'CONDiTiONS OF APPROVAL
( ) DISAPPROVED
( ) CONDITIONAL APPROVAL*
DATE/,~ [(
Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received
0
Well to Tank Septic Tank Size
72-023 i3182)
October 24, 1977
#76872
Timberline Plumbing
2910 Boniface
Anchorage, Alaska 99504
SubJect~ Permit Expiration
Dear Sir=
A permit issued by this department for well and/or on-site
sewer installation on Lo~ 3 Block 23 Burlwood Subdivision
has expired since the issue date exceeds one (1) year.
In the event you still plan to install the well and/or on-site
sewer system, a new permit is required. The original soil
test may be used to obtafn a current permit.
If the well has been drilled, a well log should be sent to
this department to document the installation date.
If you have any questions regarding the above matter, please
do not hesitate to contact this office immediately at 264-
4720.
Sincerely,
Les N. Buct~olzw R.S.
Sanitarian
I2qB/lJ h