HomeMy WebLinkAboutSTEWART BLK 2 LT 9LoT
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
PERMIT NO.
INSTALLATION Of: SEPTIC TANK seePAge Pit , DRA~N FIELD
TYPE AND SIZE OF FAC'L'TY TO BE SERVED ~ ~ [~
FINANCED THROUGH
TO BE INSTALLED BY
SOIL TEST RESULTS
NOTE: THIS PERMIT I$ 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.
...,,,~T~.~s,z~.~O-~ ~/~[ TYPE 5'~-~- f
DRAIN FIELD
, DRAIN FIELD
SEEPAGE PiT
ALSO CONSIDER AREA WELLS.
SEEPAGE PIT
., DRAIN FIELD
CAST IRON INTO AND OUT OP 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
FITTED WITH AIRTIGHT REMOVABLE CAPS.
/
TYPE
DIAGRAM OF SYSTEM
I CERTIFY THAT IAM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DATE APPLICANT'S SIGNATURE
~ MUNICIPALITY OF ANCHORA%F~ ~
':~"~,~?¢~!~e~-~ D EPARTM~ ~F OF HEALTH AND E NVIRONMEi IL PROTECTION
~'~/~, 279-25~1, ext. 224 or 225
Date Received: August ~29, 1977
#1: Ti.me 10:30 a.m.
Date 9-1-77 Thursday
In sp ___K_enned_~y___
#2: Time _~ '~_~~__ #3:
Date .... ~
In sp ~'~
Time.
Date
o
REQUEST FOR APPROVAL OF
Lending Institution Request:
Mailing Address:
INDIVIDUAI~ER AND WATER FACILITIES
Property Owner:
Mailing Address:
Harold S. Dickman Phone:
7931 Spruce Road 99507
Legal Description: Lot 9 Block 2 Stewart Subdivision
344-8429
4: Single Family Residence: (x)
Multiple Family Residence: (
5. Well System: Individual Well
Permit #
Construction
Number of Bedrooms: Three
Number of Bedrooms:
( ) Co~mnunity/Public System (x)
Depth of Well Well Log on File
Bacterial Analysis
( )
need documentation for our files and in order to get a
permit
Sewage Disposal System: On-site System (x) Public utility ( )
Permit #
installed
Ins taller
Septic Tank Size
Absorption Area
Manufacturer
Soils Rate Material
'7.
Distances: Well to Septic
to Sewer Line
to Nearest Lot Line
Tank
Nearest Lot line
tO Absorption Area
Absorption Area
o MUNICIPALITY OF ANCHORAGF ' ~ ....
l(~(~_%'~!\' 825 L Street, Anchorage, Alaska 99501
-'~ 279-2511, ext. 224, 225
':~ ~quest for Approval of Individual Sewer and Water Fa'c~ll~l~s ~ .
I
o
Name of Buyer: /;~/~6:
Mailing Address:
Phone:
Lending Institution: ~/~
Mailing Address:
Phone:
4. Realtor/Agent:
Mailing Address: Phone:
5. Legal Descripti'on:
Street Location:
Single Family Residence: (P')Number of Bedrooms:
Multiple Family Residence: ( ) Number of Bedrooms:
Water Supply: *Individual Well
If Individual Well, well depth
) Public/Community System
*NOTE:
If Community System, name of system
Sewage Disposal System: On-site System
If On-site System, date of installation:
/
(~Public System ( )
A well log is required on ALL wells drilled since 6/75.
3/77
~.ge'~ T%~o·
D~partment of Health and Environmental Protection
Request for Approval of Individual Sewer and Water Facilities
Legal Description: Lot 9 Block 2 Stewart Subdivision
Conunent s:
Affadavit Attached: i(i ) Letter Attached: ( )
Approved: Date:
Disapproved: Date:
Department Worksheet:
September 9, 1977
~arold S. Dickman
7931 Spruce
A~chorage, Alaska
99507
~bject: Lot 9 Block 2 Stewart Subdivision
The percolation test performed on your sewer facilities
faile~ to pass the adequacy test.
Therefore, ~efore we can send any approval on apgrade of
your eewer system will be needed.
A permit must be obtained from this office prigr to
any construction. A soil test must be obtained before
the permit can be issued.
If there are any further questions, please contact this
office at 2~4-4720.
~incerely,
Robert C. Pratt,
Sanitarian
RCP/lJh