HomeMy WebLinkAboutWALTER G PIPPEL Block 10 Lot 8q
6loclc
'Time ~ Time ...~!~ e
Date~/~ ·
Inspector Inspector Inspector
Comments'~[~ CondiHonal Approval
Date Sewer Installed Permit No. Septic Tank Size
Holding Tank Size
Soils Rating Well To Absorption Area Well Log Received
Well to Tank
APPLICANT FILLS OUT LOWER HALF ONLY
Property Owner /~0~ ~. ~o E~rt~ ~ Phone
Buyer
Address
Lending Institution ~ ~ ~hono
Address
Realty Co. & Agent ~/~ ~hono
Address
Type,~ Residence '
~ Single Family
~ Multiple Family N0. of Bedrooms "
~ Other
Water~upply
~ individual A~ACH WELL LOG. A well Icg is required for all wells drilled since June
Q Community 1975. For. wells drilled prior to that date, give wail depth (attach Icg if
~ Public Utilit~ available.)
Sewage Disposal
~ individual Year rndividual Installed: ......
~Public Utility When Connected to Public Utility~ / 7
Q Holdin~ Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
#1: Time
Date
Insp
~ 1UNICIPALITY OF ANCHORAGE,
DEPARTMENI--aF HEALTH AND ENVIRONMENTAL~.~ROTECTION
825 L Street, Anchoraa~. Alaska 99501
9:30 a.m. #2:
10-10-77 Monday
Pratt
264-4720
Date Received: October 6, 1977
Time ~3: Time
Date Date
Insp Insp
REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES
Lending Institution Request: State of Alaska Veteran's Administration
Mailing Address: 907 West Norther lights Blvd. Phone:
Property Owner:
Mailing Address:
Legal Description:
Single Family Residence: (x)
Multiple Family Residence: ( )
Don Hanks Phone: 694-2229
% Rick May, Gold Rush Realty, 694-2287
Lot 8 Block 10 Walter G. Pipple Subdivision 91
Number of Bedrooms: Three
Number of Bedrooms:
Well System: Individual Well
Permit 9
Construction
(x) Community/Public System ( )
Depth of Well 193' Well Log on File
Bacterial Analysis
Sewage Disposal System:
Permit #
Septic Tank Size
Absorption Area
On-site System ( ) Public Utility
Installed Installer
Manufacturer
Soils Rate Material
(x)
Distances: Well to Septic Tank to Absorption Area
to Sewer Line Nearest Lot line Absorption Area
to Nearest Lot Line
~a, ge~Two k~
Department of Health and Environmental Protection
Request for Approval of Individual Sewer and Water Facilities
Legal De.scription: Lot 8 Block 10 Walter G. Pipple Subdivision #1
Comments:
Affadavit Attached:
Approved:
Disapproved
Letter Attached: (
Date:
Department Worksheet:
'~ Department of Health and Environmental/. PrQ~,~O~.
· 825 L Street, Anchorage, Alaska 9~;~Ol.~;:i]/.['/~
~~quest for Approval of Individual Sewer and Wa~c~ties
1. Property 0wn r: I i%/11
Mailing Address: Phone:
Name of Buyer:
Mailing Address:
Phone:
3. Lending Institution:
Railing Address:
Mailing Address:
Phone:
Legal Description:
Street Location:
Single Family Residence: (~ Number of Bedrooms:
Multiple Family Residence: ( ) Number of Bedrooms:
7. Water Supply: *Individual Well (~ Public/Community System (
If Individual Well, well depth l ~ ~ !
If Community System, name of system
8. Sewage Disposal System: On-site System ( ) Public System
If On-site System, date of installation:
*NOTE: A well log is required on ALL wells drilled since 6/75.
3/77