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Home My WebLink AboutZODIAK MANOR ALASKA BLK 4 LT 6'bloc Hea HUNICIPALITY OF ANCHORAGE and Environmental Prote~ Fourth Floor West 825 L Street Anchorage, Alaska 99501 264-4720 .... J~q~i~CTION R~PORT ON-SlTF. SEWAGE DISPOSAL SYSTEM ],og Crib Rings Crib Size: °ll',;1El[ R _iL)' __ OISTANCE FROM: WELl_ ~11 lass: Depth: _~11 Disbanc:e To: Lot I,ine Ldg: Sewer Line: o[ Bedrooms: 'i i :li::'i :'1.. i [:I:;:IN'I I.,.l"[ L:iI::IL, IIi'l" :!~:]]Z!.i:[ ;~::ll~t;!)l.:) :(:;i]:!l..ll":tl:,?.E; I::lil;ii£'l I"r'l:::'lE ,]:IF: :ii;Clll I":IL:Ri~;I]t:{:IiFI ICIN E;'r'f~;ll:]"l iE~;: iFi:IEI",II]:II I"II:::I;~.:;]ii"IL.iI"I NI]l"il:iiHEl:;[: ElF: I~:[iZI]:,J;i:[u]f'l:!il, ::; .... .l :!~;(] :[ I.. I:;i:F:itl" It IqG ( :iii];! [:'f,."l.'-]l;~: ) = :t.E;U 'l'Hli: I;ifliEli;!LI :t] F?.IED liii; It ;?:t~: OF' I'1'11!!; ::;(] I I.. 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I..I]l]i:!~-, I::I[,?.E I:Riitl:4iJJ:l:;dii]]) [::ll",ll::, HI...l':];l"' iEII~: Fi:[~;II]I,i:I'.,IIEI]:, ]'CI I'HIE I)E]:::'F:IF~'.['I"iEI"4T I.,.ITTH]:I'-4 ]i:E~ Ii::' '[l"lliE I.,J[i:L.l_ [:[]l"lf:'L..i:i]"]:[IN. ] I J IEI;~'. t:;;:JiE(:.!l.I ]: t:;:[ii:f'l[:ilF,t J ':~; FIFI'./ I::IF'F'i ."r'. '~:;I::'IE[: I l:: i [:1::1-[ i ill.,t!!; [:]f',ll[::~ [:[llq~:~i;'l I-,:~1]1]'1" It CIi",I D I I:::l[iil;~'.l::ll'"l:~:; l":ll~'.l}!: ::F,,,q::litl,l":lEH_.i:it ICI ii",l%itJl:;::t~: F:'I';?.[)I":'I~:F?. II"~%'l (:IL,I,.I::Ii' Itl]l",j. I:l~'F'l,. I It::f:li",l T [:' :i: CK 1.4Et%l Gl'Il ' J]l":l 'J Iii] .................. 1.,.,I] .I.. F"/ S - -- r DAT{~ RECEIVED ~ ~ '~r~'-~-'- i PECTION APPOINTMENTS (~ ~-~ ~(~.-O~E _ g~- ~-. J TIME / TIME TIME -~ATE/ DATE D~TE MUNICIPALITY OF ANCHORAGE MUNIC~PALI~ OF ANCHORAGE DEPARTMENTOF HEALTH & ENVIRONMENTAL PROTECTIONDEpT, OF HEALTH & 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL PkOFECT[ON E.W.O.UE.TALSA.[TA'nO.D WS O. JUL 6 1981 Telephone 264-4720 DIRECTIONS: Complete all parts on page 1, Incomplete requests will not ha processed, Please allow ton (10) days for processing. 1, PROPERTY OWNER PHONE MAILING A~R ESS PROPERTY RESI DENT (If different from above) PHONE ~' ~0v~'. ~uo~ MAILING ADDRES~ ~AILING ADDRESS ~ REALTOR/AGENT , PHONE MAILINGADDRESS,~O C gl'F~' ~ 5, LEGAL DESCRIPTION STREET LOCATION S, TYPE OF RESIDENCE NUMBER OF~BEDROOMS [] One [~] Four [~, SINGLE FAMILY D Two I~] Five [] MULTIPLE FAMILY ~] Three I~ Six Other 7, WA'rER SUPPLY INDIVIDUAL* [] COMMUNITY [] PUBLIC UTI LITY SEWAGE OISPOSAL SYSTEM INDIVIDUAL/ON-SITE PUBLIC UTi LITY ATTACH WELL- LOG. A well Icg is required for all wells drilled since June 1975. For wells drilled prior to that date, give wel del~th (attach Icg if available.) YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCF. SSING CAN BE INITIATE[). 72-O10 (Rev, 6/79) THIS SIDE FOR OFFICIAL USE ONLY - 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS ~ SINGLE FAMILY [] ONE--[~'~'HREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY ~' INDIVIDUAL DEPTH OFWELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY ""~ Connection Verified LOG RECEIVED 3, SEWAGE DISPOSAL SYSTEM PERMIT NUMRER []INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified iNSTALLER []Septic Ta~l~ or [] Holding Tank Size: / ~' ~ ~') If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURE TOTAL ABSORPTION AREA MATERIAL 4. DISTANCESwELLTO: Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line Absorption Area to nearest Lot Line ,. COMMENTS ~/~1.~,~._~;~. (... ~,:i · '~ '¢ "~' ~APPROVED FOR . BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate} [] DISAPPROVED DATE BY~ ._ 7 ~/5'.~ ~'t " ......... 72-010 (Rev. 6/79) ANCHO ?,AC~ E. {907) 264 4 July 10, 198] Geroge Anderso.n, Robin Uubach 8441C~ome. t, Court Anchor:age, Alaaka 99507 Subject: LoL 6 B].ock 4 Zodiak Manor Subdivision Approval for the comp] eted; ~( 1 ) S~ ncere].~, individual sewer and water' facilities until the followJllg items have been The water analysis needs to be submitted to this office f~-om the Chain Lab~ 5633 B Sevee'L, for The septfc tank pumped with a receipt submit, ted t:o this any questions, please cal.[ Lb:is office JSR/].jw A] a " " , 442 ~" ".- 995 J~doi' 5iih Avenue . .. O1 I.)t:ob / SedwJck % [520 East 4th Avenue 9 950.[ MUNICIPALITY OF ANCHORAGE DEPARTMENT DF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street - A~ehoraoa, Ala,.ka 99S01 ENVIRONMENTAL ENGINEERING DIVISION Tetephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIDNS~ Complete all parts on page I, Incem~lete requests will not he processea. Please allow tan (10) davs for processing, PFIONE I, pRDPERTY OWNER ,. ~ ~ MAi-LING A'DDR ESS ~) ~ERTY RESILIENT (if d fferent from abovel (,}:K ? PHONE MAILI N~i ADDRESS PHONE ~". ?~E N D I NO I NSTI TUT~,ON ,~ PHONE MAILING ADDRESS ~REALTOR/AGEN'r ' ¢ ' ' ~ / PHONE MAI LIN G ADDR EgS ~'. I~E~AL DESCRIPTION STREET LOCATION ~ TYPEO¢'I~ES(DENCE ~ SINGLE FAMILY ~ MUL-IPLE FAMILY ~ WATER SUPPLY INDIVIDtJAL' ~OMMUNIT~ ~ PUBLIC [lTl LI'TY SEWA6 E DISPOSAL SYSTEM ~DIVI DUAL/ON'SITE'~ PUBLIC tJTI LITY NUMBER OF BEDROOMS ~ One E] Four [~ O~ne~. _ ~ Two E] Five ~ Three ES Six * ATTACH WELL LOG. A well mg IS required for all wells drilled s~nce June 1975, For wells drilled odor to that oa~e, give wetl death (attach log if available.) *' f individual/on-site, give installation date ~E~, ] 2 ~ .. If system is over two (2) years old an adeouacy test is reauired DY this Department, NOTI-': THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED, '~2-O10(3/78) " THIS SIDE FOR OFFICIAL USE ONLY '.. , ' DATE RECEIV,EI;) . INSPECTION APPOINTMENTS TIME ----' TIME TIM~ DATE DATE DATE INSPECTOR -- INSPECTOR INSPECTOR DIRECTIONS: -- 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX 2, WATER SUPPLY PERMIT NUMBER [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTI LITY Connection Verified LOG RECEIVED 3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER []INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified -- INSTALLER []Septic Tank or []Holding Tank Size;_ ~ If Tank is homemade SOILS RATING give di~ensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AR EA MATERIAL 4, DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5, COMMENTS ~.N APPROVED FOR "~ BEDROOMS [] CONDITIONAL APPROVAL (Fetter must accompany certificate) [] DISAPPROVED DATE BY (Title)