HomeMy WebLinkAboutWONDER PARK #4 BLK 7 LT 7-7
7
N MUNICIPALITY OF ANCHORAGF
~~-'~ · DEPARTMENT ,~F NEALTH AND ENVIRONMENTAL 2ROTECTION
!~i~ 825 L Street, Anchorage, A1 aska 9950].
~i~[~.~ ! 279-2511, ex%. 224, 225
1St Inspe~ Time ~/'~D~ 2nd Inspection: Time
REQUEST FOR APPROVAL OF INDIVIDUAL~SEWER AND WATER FACILITIES
1. Lending Institution Request: First Natig~al Bank of A~nchorage _
Mailing Address: Post OffJ. ce Box 4-2090 99509 Phone: 274-1521
Property Owner: John/Barbara Wendel
Mailing Add=ess,: ~'0
3. Legal Description: Lot 7 Block 7 Wonder Park
Phone: 276-79'38
Subdivision
4. Single Fa]nJ. ly ResLdence: (x$ Number of Bedrooms: 3
Multiple Family Residence: ( ) Number of Bedrooms:
Well Data: Type Individual pth ~.-'/ Well Log F'iled ~/~
Construction ~~~ Bacterial Analysis ' ~..~ ~Z 'f '
6. Sewage Disposal System: On-site/system
Septic Tank Size __ _~': Manufacturer
Absorption Area _ J Soils Rate
7. Distances: W o Septic Tank
to Sewer Lines ~'~Nearest
Absorption Area to Nearest Lot Line
( ) Public Utility
Installer
Material
_~' to l~sorption Area
Lot Line ~!
(x)
Page o.~wo
Departmenb of Health and Environmental Protection
Request for Approval of Individual Sewer and Watez Faoilities
Legal Description: Lot 7 Block 7 Wonder Park Subdivision
Comments:
Affadavit Attached
Approved: __
Disapproved:
Letter Attached: (
Date:
Department Worksheet:
- : , . I , MUNICIPALITY OF ANCHORAGE .
/,/~'~-~[E~] 825 L Streeh~ Anchorage, Alaska ,9,,~z~Z '' ' '
ese for Approval of Individual Sewer and
RECEIVED
1. Property Owner: ~,~. ,__~g~_, ~/~
Mailing Address: Phone:
o
Name of Buyer:
Mailing Address:
Phone:
Mailing Address: ~/~ ~_~z/ Z~/J~d~'_/ Phone:
o
Realtor/Agent:
Mailing Address: ~ / _ ~
Legal Description: _J~'-~
Street Location: ~O~
6. 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
If Community System, name of system
8. Sewage Disposal System: On-site System ( ) Public System
If On-site System, date of installation:
*NOTE:
3/77
A well log is required on ALL wells drilled since 6/75.
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3500 Tudor Road, Anchorage, Alaska 99507 279-8686
~'~ Date Received ~]-~ ~
Time of Inspection
Date of Inspection
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
Approval Requested By:
Address:
2. Prooertv Owner:
3. Legel Description:
a. Location:. ~(~-
5.
Type of Facility to be Inspected: ..... J~4~.
Number of Bedrooms:
.....
Sewage Dts~o~al ovstem. ~_ ~ ~ _
A. ~nsgalled ' / B. Installer .....
C. Septic Tank: 1. Size 2. Manufacturer
D. Seepage Pit: 1. Size 2. Materiel
Disposal ?ield: Total Length of Lines
8. Distances:
A. Well To: Septic Tank ........... , Absorption Area
, Sewer Lines
, Nearest Lot Line
, Other Con'taminatton
B. Foundation to Septic Tank
Absorption Area
C. Absorption Area to Nearest Lot ~.ine
Request for Approval of I .vtdual Sewer & Water Facflitie.
Page Two
Disapproved
Approval Valid for One Year From Date Signed
Greater Anchorage Area Borough, Department of Environs. entel Quality
DIA'.GRAM OF SYSTSNI
I certify that the information contained in this request for approval to be a true
and accurate representation of the sub.Jeer sewer and water facilities located at:
Signed Date
GREAT,iR ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3500 Tudor Road, Anchorage, Alaska 99507 279-8686
REqUeST FOR APPROVAL OF
IND!VIDUAt, ~E,~;~R & ?h~T~R FACiLITIeS
FOR
Approval Requested By:~ ~-~
2. Property Owner,_ Phone:
5.' Type of Facility to be Ioapected: .~ ~ . ).,~
Number of Bedrooms: ~
6, Well Date:
~. Installer
A. Installed
C, Septic Tank: 1,
D. Seepage Pit: 1.
E. Disposal Field:
Size 2. Manufacturer
Size 2. Material
Total Length of Lines
8. Dist~nces~
A, Well To: Septic Tank .......... --..' Absorption. Area ..__' Sewer Lines
__, Nearest Lot l,ine
Foundation to SPptic 'rank
· Other Contamination
Absorption Area
C. Absorption Aree to ,Nearest I..ot Line
Request for Approval of Individua! $'ewer & Water Facilities
9, Comments:
Aporoved Disapproved Date
Approval Valid for One Year From Date Signed
Greater Anchorage Area ~orough, Department of Environmental Quality
I certffv that the information contained in this request for approval to be a true
and accurate representation of the ~:.~ieet sewer and water facilities located at:
.Date
31 ~(~ 33
¥
Mou,tain View Area Reference Map-P3
(~) 1974 JH