HomeMy WebLinkAboutDALE BRIGGS BLK 1 LT 15bcde Briggs
Block 1
Lot 15
#050 - 181 - 18
r i E_E r 1
III- I f='r=r F_ I T' -r' Cir-
DEPARTMENT
Cof=DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTEOTION
2516E. TUDOR RD. , ANCHORAGE, AK. 9950-
276-222].
FJ E r_ f_ F- E F='t•1 I T
PERMIT NO. i 75584 )
APPLICANT MARY K _ TAYLfh P. 0. BOX 935 E. R:.
LOCATION MUN 1 E KUHLf —
LCUAL L16 E1 PALE BRIGGS HOMESTEAD S LOT SIZE
,�+77 �,D.
694 2554
5400 SQUARE FEET
MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IE
100 FEET FOR: A PRIVATE WELL OR 200 FEET FOR A PUBLIC WELL.
KnLL LOG= ARE REQUIRED ANE.:' MUST BE RETURNED TO THE DEPARTMENT WITHIN 10 DAY=
OF THE WELL COMPLETION.
SFEi_IFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER
I"Sl6LLATION.
E _' L F t 1 17- ri L I C• F= I_I F=] f _l r-4 E F F=: I_l r•7 I =• -• E_1 E
I CERTIFY THAT
L. I HM FAMILIAR: WITH THE REQUIREMENTS FOR: ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
I GNED : ---,- -J_5!L '_v._y
APPL CANT PY K. TRYU
I S•_=SUED E:'r' - - _LC--C?ATE-d__= ni =- Alzy
,wrtifirb Britting Kwg
by
A & L DRILLING COMPANA'
BOX 97, EAGLE RIVER, ALASKA 99577 • TELEPHONE 6942588
OWNER OF LAND E• ra Y t `;` l l "'
DEPTH OF WELL j
ADDRESS
I STATIC LEVEL OF NATER FT. '
LEGAL DESCRIITIO'tL,.} t t` DRAWDOWNr
Q X
DATE - Started '/ Ended
74 F,0a�J- GALS. PER IIR %
PERMIT NUMBER
KIND OF CASING
KIND OF FORMATION:
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NUSCL. INFORMATION:
MILLER'S NAME