HomeMy WebLinkAboutTHIRD ADDITION BLK 20A LT 1MUNICIPALITY OF ANCHORAGE
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DEVELOPMENT SERVICES DEPARTMENT 907-343-79134
On -Site Water and Wastewater Section 'Il Fax: 343-7997
www.muni.org/onsite
Well Decommissioning Lo
Legal Address:
Subdivision 3rd Additional Block 20A Lot 1
T R9* Section Lot
On-site Water & Wastewater Section certified contractor performing the well decommissioning_
Name:
David Harper Signature
Company:
Arrow Pump & Well
Well decommissioning date 9/1!2020 Method of decommissioning: AMC 15.55.0601-1 a. ❑ b. ❑ c. Q
Location: Use the space below to provide a drawing of the property showing the following items:
• North arrow
• Decommissioned well location
• Location of other water wells an the property,
• Two separate swing -tie distances for each well shown on the drawing
Note: The swing -tie distances shall be measured from either permanent structures or the property corners.
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