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HomeMy WebLinkAboutT15N R1W SEC 30 Lot 52 MUI-~ I C- I PFIL I TY CmF FtNFjHCm~zFtF_~P' DEPRRTMENT,/-'% HEALTH RND ENVIRONHENTRL/~0TEOTIOM ~C, ~ ~ 8~5 ~ STREET, 8NCHOR~G[., ~K. 9S ~ blELL PERil I T P.O. BOX 197 E.R 9~577 6~4-2588 LOT SIZE ~0000 SQUARE FEET ~INIMLIM DISTANCE BETWEEN A HELL AND ANY ON-SITE z, EWM~E DISPOSAL S'¢STEM IS I00 FEET FOR A PRIVRTE WELLs OR i50 TO ~700 FEET FROM A PUBLIC HELL DEPENDING UPON THE TYPE OF PUBLIC HELL HELL LOGS ARE REQUIRED 8ND MUST BE RETURNED TO THE DEPARTMENT WITHIN _~0 DRYS OF THE HELL COMPLETION. - OTHER REQUIREMENTS MAY RPPLY. SPECIFICRTIONS AND CONSTRUCTION DIRGRRHS RRE RVAILABLE TO INSURE PROPER INSTALLRTION. PERt-11 T EXP I RES DE£:E["IBER 3:1-.. 1.978 I CERTIFY THAT l: I AM FAMILIRR WITH THE REOUIREMENTS FOR ON-SITE SEWERS 8ND HELLS RS SET FORTH BY THE MLINICIPRLITY OF ANCHORRGE. 2: I WILL INSTRLL THE SYSTEH IN 8CCORDRNCE WITH THE CODES. [...~~~,) ..~,~;, . - ~. S I~]NED:-¢."~-L0¢/2--i~'- -~--- ' ........ ~PPL ICANT R. KEKONI , , .. . / by A & L DRILLING COMPANY BOX 97, EAGLE RIVER, ALASKA 99577 · TELEPHONE 694-2589 OWNER OF LAND ADDRESS LEGAL DESCRIPTION d ,~-~ ,~L<'C ~ 'l--),~-l'rd /~/~ 5'~7 ~ DRAW DOWN ~. PE~IT NUMBER ¢[~ O~6 7 KIND OF CASING STATIC LEVEL OF WATER FT. /O G or"_2 KIND OF FORMATION: From O Ft. to I Ft. From I Ft. to / I Ft From ] ] Ft. to &e~ Ft. From Ft. to Ft From Ft. to.__ Ft From ~Ft. to Ft From .Ft. to Ft From__.Ft. to Ft, From Ft. to__Ft. From .Ft. to Ft, From Ft. to Ft. From Ft. to Ft. From__.Ft. to Ft, From__.Ft. to__Ft. From .Ft. to Ft. From .Ft. to Ft. From Ft. to Ft, From Ft. to.__Ft._ From Ft. to Ft From_ Ft. to Ft. From .Ft. to.__Ft, From__Ft. to Ft From__.Ft. to Ft. From__.Ft to.__Ft, From Ft. to Ft, Frmn Ft. to Ft. From__.Ft. to Ft. From__Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to. Ft. From Ft to. Ft. From Ft. to Ft, MISCL. INFORMATION: / 2 7-o DRILLER'S NAME ,~.]./-'~f]]~''~' ...... ¥>