HomeMy WebLinkAboutSEAVIEW HEIGHTS BLK 2 LT 7Boview
H
ight
Block 2
Lot 7B
#011-261-21
Expired Permit
From:Brons Olanna
To:Townsend, Curtis L.
Subject:Fwd: Well dimension - Seaview Heights Blk 2, L7B
Date:Tuesday, May 19, 2026 1:28:22 PM
Attachments:image001.png
Seaview Heights Blk 2 Lt 7B As-Built_signed.pdf
[EXTERNAL EMAIL]
Message from bell below
Brons Olanna
CharBro Construction LLC
C: 907-304-1977
brons@charbroconstruction.com
Begin forwarded message:
From: Werner Macedo <wmacedo@bellalaska.com>
Date: May 19, 2026 at 1:22:47 PM AKDT
To: brons@charbroconstruction.com
Cc: Bradford Rinckey <brinckey@bellalaska.com>
Subject: FW: Well dimension - Seaview Heights Blk 2, L7B
Hi Brons,
Below is a screenshot showing an approximate dimension (tenths of a foot) from
where the measurement was made to the utility easement line.
Please note that the measurement was made to the approximate center of the well and
could have approximately +/- 0.2 tenths of a foot margin of error (appropriate for the as-
built survey).
It is possible that a portion of the well is within the easement. We would need to get an
accurate measurement on the center of the well and measure the diameter to provide
more accurate dimensions.
Please let me know if you have any questions.
Thank you,
Werner Macedo, PLS, CFedS
Survey Project Manager
BELL & Associates
801 W Fireweed LN, Ste 201 | Anchorage, AK 99503
Desk 907.743.3416 | Office 907.274.5257 | Cell 907.903.2712
Department of Health and Humar: Services
Rich Mvsfrom. 825 " L" Street
Mavo; P O Box 196650 Anchorage., Alaska 99519-6650
Permit Number SW01 001 0 Date Of Issue 1 -12 -r�l Parcel Identification Number 011 - 261 -21 _
Date Started 1' -1 6 - 01 Date Completed 1 �''
211 Is well located at approved permit location? ! a
Yes No
Legal Description
Seaview Heights
Subdivision
Borehole Data:
Soil Type & Thickness & Water Strata
Sandy Fill
Dry Brown Sand
Block I Lot 11 Property Owner Name & Address:
L
L7b
Depth
From To
0T
15
Small) 180'
Gray Silty Sand,GravelL 30'
Brown Silty Sand 180' 1140'
Gray Silty Sand 1140' 1180'
Hard Packed Gray Clay
M�r.�
Delldo Isabelle
P.O. Box 220021
Anchorage, AK 99522-0021
Method Of Drilling: air rotary U. cable tool
Casing Type: ee Wall Thickness ' inches
Diameter. _-inches, depth 2-jr, feet
Liner Type: Diameter inches, depth feet
Casing Stickup Above Ground: 2 feet
Static Water Level (from ground level): 1 75 feet
Pumping Level: feet after hrs. pumping gpm
Recovery Hate:^1_5_gpm
Method Of Testing: Air
Well Intake Opening Type: Q Open End ❑ Open Hore
D Screened; Start feet Stopped feet
0 Perforations Startfeet Stopped feet.
Wet (;ray Silty Sa21
0'm
:�hiG Volume gar ,
feet,
to, 20 feet
Dry EH"
220'
ke Depth: feet
hp Brand NameWet
225 ,
fected Upon Completion? Q Yes No
r
Disinfection:
Water with good w35
: I
'
Well Driller Name Joe Wininaer
Company rlAnal i rlri 1 1 i nnY,TnC
Mailing Address 8240 Petersbura Street
City Anchorage
r
State AK zip 99507
Attention: The well driller shall provide a well log to the property owner within 30 days of completion
and the property owner or the well driller shall provide a well log to the Dept. of Health & Human
Services within 60 days of completion.
10' UTILITY EASEMENT
ROCK RETAINING WALL
3.8'x3.9' SHED
44.0' SOUTHWEST ANCHORAGE
Sg SCHOOL SITE
4 S TRACT 2
SEE DETAIL A
`366 33
Rj
I. •
35.2'
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TRACT 8
50'R TEMPORARY
TURNAROUND
• ••
19 2.4'
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4-WHEEL
DIRT TRAIL GRAVEL
I.
DRIVEWAY
LOT 7B
136,902 S.F.
3.143 AC. (R)
BOULDERS
RETAINING WALL
— 116'�
WEST 332.18' (R)
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GRAPHIC SCALE
1" = 100'
DETAIL A
SCALE: 1 " = 20'
I HEREBY CERTIFY THAT AN ACCURATE
SURVEY OF THE FOLLOWING DESCRIBED
PROPERTY;
SEAVIEW HEIGHTS BLOCK 2 LOT 7B
WAS MADE ON OCTOBER 3, 2025
AND THAT THIS PLAT REPRESENTS A
SURVEY MADE BY ME OR UNDER MY DIRECT
SUPERVISION, AND THAT ALL DIMENSIONAL
AND OTHER DETAILS ARE TRUE AND
CORRECT TO THE BEST OF MY KNOWLEDGE.
OF
1
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t �F9 • , Oct. 14, 2025. • • • �JQi
1,\��`ESS IONK%. o
\tt
LEGEND
(R)
RECORD PER PLAT 74-258
®
FOUND 2" BRASS CAP
FOUND 1-1/2" ALUMINUM CAP
00
FOUND 5/8" REBAR
•
10-INCH DIAMETER CONCRETE PILE
GAS METER
WATER WELL
WOOD FENCE
NOTES
1. EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN
ON THE RECORDED PLAT, ARE NOT SHOWN HEREON.
THIS DRAWING REPRESENTS A MORTGAGE LOCATION SURVEY PREPARED IN ACCORDANCE WITH
THE ASPLS MORTGAGE LOCATION SURVEY STANDARDS.
THIS MORTGAGE LOCATION (AS -BUILT) SURVEY IS A REPRESENTATION OF THE CONDITIONS THAT
WERE FOUND AT THE TIME THE LOCATION SURVEY WAS PERFORMED AND DOES NOT CONSTITUTE
A BOUNDARY SURVEY AND IS SUBJECT TO ANY INACCURACIES THAT A SUBSEQUENT BOUNDARY
SURVEY MAY DISCLOSE.
INFORMATION CONTAINED HEREON SHALL NOT BE USED TO ESTABLISH ANY FENCE, STRUCTURE,
OR OTHER IMPROVEMENTS.
UNLESS GROSS NEGLIGENCE IS DISCOVERED, THE LIABILITY EXTENT OF THE PREPARER SHALL BE
LIMITED TO THE AMOUNT OF FEES COLLECTED FOR SERVICES IN PREPARATION OF THIS PRODUCT,
engineers SEAVIEW HEIGHTS BLOCK 2 LOT 7B
surveyors11 AS -BUILT SURVEY
PREPARED FOR:
DRAWN BY: VFS
CHECKED BY: BJR
801 W. FIREWEED LN. #201
ANCHORAGE, AK 99503
JOB NO.: 2025-309�
(907)274-5257
CoA No. AECC582
SCALE: AS SHOWN
BRONS OLANNA
FIELD BOOK: FRBA 2025
MOA GRID: SW2322
DATE: 10/14/2025
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No 151-71a
George
Anchorage
Municipality of Anchorage
Ali.America City
2002
2/3/2003
Delido Isabelle
PO Box 220021
Anchorage AK 99522-0021
Subject:
Expired On-Site Water and/or Wastewater Permit.
Permit Number: SW020012
~ripti6n Se~yj~w H~eight Blo .......
']2~'~'~l'D ; ......... s ck 2 Lot 7B
Dear Delido Isabelle:
An On-Site Water/Wastewater Permit, number SW020012, issued by this office for a single-family
system, expired on January 24, 2003. This permit was valid for 365 calendar days.
If this was a well permit and the well has been drilled, a well log must be sent to this office for
documentation of the installation and to close the permit.
If this permit was for a wastewater disposal system, an original as-built inspection report must be
sent to this office for review, approval and documentation. This as-built inspection report must be
signed by the licensed Professional Engineer who inspected the installation of the system. As-built
inspection reports are required to be submitted within 30 days of the completion of the system.
If no system was installed under this permit, and you are still planning to install a well or wastewater
disposal system, a new permit must be obtained from this office. When applying for a new permit,
the fees are: $320.00 for a wastewater permit and $120.00 for a well permit.
If you have any questions, please call this office at 343-7904.
On-Site Water and Wastewater Program
Enc: Copy of permit
P.O. Box 196650 · Anchorage, Alaska 99519-6650 * Tcleplion¢: (907) $~g-8501 · Fmx: (907) 8&3-8~00
~700 Soufl~ Bragaw Strect' Anchorage, Alaslm 99507
h ttI)://~x~xnv.ci.anchoragc.ak.us
MUNICIPALITY OF ANCHORAGE
Development Sen/ices Department
On-Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Renewal
Date Issued: Jan 24, 2002
Expiration Date: Jan 24, 2003
Parcel ID: 011-261-21
Permit Number: SW020012
Legal DeScriptiO~ SEAVIEW ~EI~,G~,TS~B~ 2 [:~,~ ~B
Design Engineer: 00(~':~0~o~n S;U~l(i~rt~i~ ~ '~' ' ~ii~ ~§~:' (3~ 6i~6~b BLVb W
Owner Name: Delido Isabeile Lot Size: 136909 SQ. FT.
Owner Address: PO Box 220021 Total Bedrooms: 6 Permit Bedrooms: 6
Anchorage, AK 99522-0021
This permit is for the construction of:
~ Disposal Field [] SepticTank [] Holding Tank ~ Privy
Private Well
[] Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and WasteWater Program
4700 South Bragaw St,
P.O. Box 196650 Anchorage, AK 99519-6650
www,ci.anchorage.ak.us
(907) 343-7904
ON-SITE SEWER/VMELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Permit Number SWOZ OOi~,
Property owner(s)
Mailing address (1)
Mailing address (2)
Legal description (Lot, Block & Sub'd.) ~.o ~L
Legal description (Section, Township & Range)
Lot Size J~(~ ~.,~ ~ Acres/Sq. Ft.
Day phone
Zip Code
Number of Bedrooms
THIS APPLICATION IS FOR:
Sewer Only
Sewer and Well
Sewer Upgrade
Well Only []
Water Storage []
THIS PROPERTY CONTAINS:
Hot Tub [] Jacuzzi []
Swimming Pool [] Water Softening Unit []
Therapy Pool []
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is ?n accordance with applicable Municipal Codes.
(Signature of property~ized agent) ~.,,
Permit Fees:
Waiver Fees:
Date of Payment:
Receipt Number:
(Rev. 12100)
Date of Payment:
Receipt Number:
December 11, 2001
Municipality of Anchorage
George P. Wuerch, Mayor
Building Safety DivisiOn
P.O. Box 196650 · 4700 S. Bragaw Street
Anchorage, Alaska 99519-6650 · (907) 343-8301
http://x~a'w.ci.anchorage.ak.us
~epartment o~
Public Works
Delido Isabelle
PO Box 220021
Anchorage AK 99522-0021
Subject:
On-Site Water and/or Wastewater Permit.
Permit Nmb_er: SW0!0011
'Legal D~sfifip~i0n seaview Heights Block 2 L°t 7B
Dear Delido Isabelle:
An On-Site Water/Wastewater Permit, number SW010011, issued by this office for a single-family
system, will expire on January 25, 2002. This permit was valid for 365 calendar days.
If this was a well permit and the well has been drilled, a well log must be sent to this office for
documentation of the installation and to close the permit.
If this permit was for a wastewater disposal system, an original as-built inspection report must be sent to
this office for review, approval and documentation. This as-built inspection report must be signed by
the licensed Professional Engineer Who inspected the installation of the system. As-built inspection
reports are required to be submitted within 30 days of the completion of the system.
If no system was installed under this permit, and you are still planning to install a well or wastewater
disposal system, a new permit must be obtained from this office. A new permit for a second year may
be issued free of charge through December 31, 2001or for a fee of $100.00 after January 1, 2002. The
application for the renewal must be received on or before the expiration date of the original permit.
When applying for a new permit, the fees are: $400.00 for a wastewater permit and $150.00 for a well
permit.
If you have any questions, plea§e call this office at 343-7904.
Manager
On-Site Water and Wastewater Program
Eno: Copy of permit
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On-Site Services Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Initial
Date Issued: Jan 24, 2001
Expiration Date: Jan 24, 2002
Permit Number: SW010011 Parcel ID: 011-261-21
Leg~i b~ScHl~i6~': Lot' 7b' B!0ck 2 seaview H. eigEts S~d!y!~!?
Design Engineer: 0007 Tobben Spurkland, PE Site Address: Lori Drive
Owner Name: Delido Isabelle Lot Size: 136909 SQ. FT.
Owner Address: PO Box 220021 Total Bedrooms: 6 Permit Bedrooms: 6
Anchorage, AK 99522-0021
This permit is for the construction of:
~ Disposal Field [] SepticTank [] Holding Tank ~ Privy
[] Private Well
Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By: ~' - ~
Date:
Department of Health & Human serVices
On-Site Sewer/Well permit APplication
SINGLE FAMILY DWELLING
NOTE: Application must be filled out completely
Prope OwnerName _
Mailing Address_
Legal Description _
MUNICIPALITY OF ANCHORAGE
o//- Z_~! - 2/
Parcel identification Number
. Day Phone.
Brock
Lot
Range
Township
Section
Lot Size .~.Acres/Sq. Ft. Number of Bedrooms ~'
Inspections will be conducted by: ~Approved Engineering Firm [] Municipality (permit fee included)
contain any of the following: []l~ot Tub [] Swimming Pool [] Therapy Pool [] Jacuzzi [] Water Softener Unit
Does your house .~J ....... ~Awer U,-,,~rade [] Well Only [] Water Storage
This application is for: [] Sewer Only [~/Sewer and we, LJ o~ ~-u
I certify that the above informat on is correct. I further certify that
~pplication s beingmadeforaSingleFamilyDwellingand '~, ,~¢L.,CY~~
~ce with applicable Municipal Codes. "---~.__~rty Ow.er/We[[ Dril~e, ~ ~
Receiet # _
Waiver Fees:__
72-012 (Rev. 4/98)*
Permit
Waiver
203 W 15th. Avenue, Suite 203
ANCHORAGE, ALASKA 99501
(907) 279-3916
Fax (907)-276-6013
SEPTIC SYSTEM DESIGN
LOT 7A BLOCK 2 SEAVIEW HEIGHTS
DEL ISABELLE
Municipality of Anchorage
Department of Health and Social Services
820 1 Street
Anchorage, Alaska 99501
Jan. 4, 2001
We are submitting an application for the installation of a well and septic system for this lot. The
submittal consists of three (3) drawings showing the present improvements on the lot and the
adjoining properties, (sheet 1/3), the proposed improvements of the lot, of which only the well and
septic system is subject to this permit application, (sheet 2/3), and a schematic of the septic system,
(sheet 3/3). Soil logs and percolation tests of applicable testholes are also enclosed. The septic
system design is based on the following:
No Ground Water or Impervious Layer to 18 ft.
Use Standard Trench
Soil Rating. From Testhole 01/03/01
5 rain/in = 1.2 gal per sq.ft/day
No. of Bedrooms 6
Required Area per Bedroom: 150/1.2 = 125 sq.ft.
Total area required: 125 x 6 = 750 sqft
Testhole depth 18 feet
Bottom Rock At 12feet
Top Rock At 2 feet
Rock Depth 10 feet
Total Trench Length 750 / 20 - 37.5 ft.
SYSTEM CONFIGURATION
STANDARD TRENCH
TOTAL LENGTH 50 FT
TOTAL WIDTH 2 FT
TOTAL DEPTH 12 FT
ROCK DEPTH 10 FT
COVER 3 FT
SEPTIC TANK 2000 GAL
The installation of this well and septic system will not prevent development on the adjacent lots.
There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots.
The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface
nmoff will not result from this installation.
16
~00
£$0
300
I
TRACT 8
~rell
II
13
TOBBEN SPURKLANO P E.
~EAVIEW HEIGHTS, BLOCK
205 · 15TN AVENUE
LUI~I
SEPTIC SYSTEkl DESIGN
DATE: JAN. $, 2001
SHEET: 1/$ GRID: 2522
PERMIT # OIOOXXX PID # YY SVHO2OT1.D~/G
......... ~ ~ I00 1£5
· ' ' i 50
...
8000 6AL sEPTIC TAN~ ~..
I .'. '" .........
· ...:':'5~...'
i ....:.>~.'.::.' '
i 2 ~7"C.' ~..C.'' ~ wo~I Ii
I .~<.:.>::
~ ::i:::!:?' ,
COVER 3 FF
I
I
ANCH. ~K. 99501 D¢[~SABELLE SHEED 1/5 qRIO: 2J22
I'OBBEN iS£URKLAND P.E.
~ OIOOXXX
PID # YY
Foundation Oean out
Standard
3 IF~de
50' Long
12' Deep
10' Sewer rock
3' Cover
S/it Borrier~
I0.0 £t o£ Septic Rock
Effective
Monitor
~ Cleonou~s
NO SCALE
0o
gal. septic tank
TDBBEN SPURKLAND P.E,
;:>03 W15th Ave
Anchorage Ak 99501
P79-3916
IISEA VIEW HEIGHTS BLOCK 2 LOT 7A
DEL ISABELLE
PERI, IT ~ $WOIOXXX
PARCEL ID # YY
SEPTIC SYSTEM SCHEMATIC
DATE: JAN. ~ 2001
SHEET: $/~ ~D: 232£
Municil:,ality of Anchorage
DEPARTMENT OF -~EALTH & HUMAN SERVICES
825 "L" Street, A[mhorage, Alaska 99502-0650
SOILS LOG - PERCOLATION TEST
DATE PERFORMED;
LEGAL DESCR'PT'ON: La 7 'TA f5 I/- ¢--
Township, Range, Section:
1
2
3
4
5
6
7
8
9
10
11
16
17
18
2O
SLOPE
WAS GROUND WATER
ENCOUNTERED? SI
L
IFYES, ATWHAT 0
DEPTH? ~/ P
E
SITE PLAN
0
Gross Net Depth to Net
Feading Date Time Time Water Crop
~l '%¢ ~7 (~ 1oo
DISCLAINIFR: GrnundwatRr
Past and future presence
trom these obser~,~nons. ~/~,_~
PERFORMED BY: i
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUI[E. UNESIN EFFECT ON THIS DATE. DATE:
72-008 (Rev, 4/85)
PERCOLATION RATE ~ (minutes/inch) PERC HOLE D~AMETER ~
TESTRUNBETWEEN ,~ FTAND ~ , FT
cnnditions indicated arR for the dates shown only.
and/0¢ d6Pth 6~ gr6b~dwater can not be predicted
CERTIFY THAT THIS TEST WAS PERFORMED IN
Municipality of Anchorage
George P. Wucrch, Mayor
Building Sa.fcty Dirision
P.O. Box 1966.50 · 4700 S. Bragaw Strcct
Anchorage, Alaska 99519-66.50 · (907) 848-8801
http://www, cl.anchoragc.ak.us
December 11,2001
Department of
Public Works
Delido Isabelle
PO Box 220021
Anchorage AK 99522-0021
Subject:
On-Site Water and/or Wastewater Permit.
Permit Number: SW010010
Legal Description: Seaview Heights Block 2 Lot 7B
Dear Delido Isabelle:
An On-Site Water/Wastewater Permit, number SW010010, issued by this office for a single-family
system, will expire on January 12, 2002. This permit was valid for 365 calendar days.
If this was a well permit and the well has been drilled, a well log must be sent to this office for
documentation of the installation and to close the permit.
If this permit was for a wastewater disposal system, an original as-built inspection report must be sent to
this office for review, approval and documentation. This as-built inspection report must be signed by
the licensed Professional Engineer who inspected the installation of the system. As-built inspection
reports are required to be submitted within 30 days of the completion of the system.
If no system was installed under this permit, and you are still planning to install a well or wastewater
disposal system, a new permit must be obtained from this office. A new permit for a second year may
be issued free of charge through December 31, 2001or for a fee orS100.00 after January 1, 2002. The
application for the renewal must be received on or before the expiration date of the original permit.
When applying for a new permit, the fees are: $400.00 for a wastewater permit and $150.00 for a well
penMt.
If you have any questions, please call this office at 343-7904.
Sinc,~,ef,
On-Site Water and Wastewater Program
Enc: Copy of permit
MUNICIPALITY OF ANCHORA GE
Department of Hea/th and Human Services
On-Site Services Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-4744
ON-SITE WATER SUPPLY PERMIT
Initial
Date Issued: Jan 12, 2001
Expiration Date: Jan 12, 2002
Permit Number: SWOJ0010
Legal Description: Lot 7b Block 2 Seaview Heights Subdivision
Design Engineer: 0000 None Required
Owner Name: Delido Isabella
Owner Address: PO Box 220021
Anchorage, AK 99522-0021
Parcel ID: 011-261-21
Site Address: Lori Drive
Lot Size: 136909 SQ. FT,
Total Bedrooms: 6 Permit Bedrooms: 6
This permit is for the construction of:
[] Disposal Field [] Septic Tank [--] Holding Tank [] Privy
[] Private Well r~ Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
: 5: The following speCial provisions.
AFTER THE WATER WELL CONSTRUCTION IS COMPLETED, A PUMP OR PITLESS ADAPTER WILL NOT BE
INSTALLED UNTIL A WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PERMIT HAS BEEN ISSUED.
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage. AK 99519-6650
www.cLanchorage.ak.us
(907) 343-7904
ON-SITE SEWER/VVELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. O//- 2~'! -.~!
Permit Number SWO/oolo
Property owner(s)
Mailing address (1)
Mailing address (2)
Legal description (Lot, Block & Sub'd.) /cT 7b
Legal description (Section, Township & Range)
LotSize /3~,, ~ Acres/~.
THIS
THIS
Day phone
Zip Code
Number of Bedrooms
APPLICATION IS FOR:
Sewer Only [] Well Only []
Sewer and Well [] Water Storage []
Sewer Upgrade []
PROPERTY CONTAINS:
Hot Tub [] Jacuzzi []
Swimming Pool [] Water Softening Unit []
Therapy Pool []
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
Permit Fees: 440 ~
Date of Payment: / - 5-- 0/
Receipt Number: ~;/.~
(Rev, 12/00)
Waiver Fees:
Date of Payment:
Receipt Number:
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203 IV ISTN. AVENUE
ANCtt. ,~. $9501
PERt~[I"I # OIOOXXX
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TOTAL £EPIH 18 rr ·
EFFECNVE ROCK £EPTtt I~ FT
COVER 3
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Piti # Y¥
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LOT 7A