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Home My WebLink AboutNEVILLA PARK LT 21 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM Mama . 0 ailin tess ,8~x; -- Ph, SEPTIC TANK: Distance from well____Mate~ialf~_~C~eTr~_ Number of compartments__~___ S~EEPAG__E~SYSTEM: Seepage Pit: Number of pits.~:~_Outside diametem._..____., or width_i~ length.._ ~ , depth .... k_, lining material /--0~.~ , Distance from well , building foundation ' ~-7 ~ line..~O/ Total ~_, .~ ~. nearest lot effective absorption amea (wall area) ~..~;'~f)'~[... sq. ft. TILE DRAIN FIELD: Distance from ~ell .... , foundation .... ~ nearest .lot line Total length of lin~s__ Number of lines Distance between lines Trench width__,___in, Total effective absorption area~____sq, ft. Length of each line__ Depth: Top of tile ~o finish grade .... Depth of filter material beneath tile in. Above 'tile lot line~~., nearest sewe~ line~, septic tank__._~ seepage cesspool._. _~_~ other sources DIAGRAM OF SYSTEM DISTANCES A DEPARTME_ 825 MUNICIPALITY OF ANCHORAGE OF HEALTH AND ENVIRONMEN', L Street, Anchoraa~. Alaska 264-4720 Time //·l~ A~ _ 02: Time Date .f~ -~C/~)-U<~ /'~'~l~ Date Insp _ ~. _ Insp Date Received: PROTECTION 99501 March 15, 1978 MB: Time Date Insp REQUEST }?OR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES Lending Institut. ion Request: The First National Bank of Anchorage Mailing Address: Post Office Box 720 99510 Phone: 276-6300/683 Property Owner: Vernon E. Nielsen Mailing Address: 8101 East 2nd Avenue 99504 Phone: 265'6148/w~ 333-9940/h Legal Description: Lot 21 Ne~illa Park Subdivision 4: Single Family Residence: ( ) Multiple Family Residence: (x) Number of Bedrooms: Number of Bedrooms: Four Well System: Permit ~ Construction Individual well ( ) Depth of Well Sewage Disposal System: Permit ~ Septic Tank Size Absorption Area On-site System (x) Installed ? I~S~O Manufacturer Soils Rate Material Community/Public System (x) Well Log on File ( Bacterial Analysis Public Utility ) Installer 7. Distances: Well to Septic Tank to Absorption Area to Sewer Line Nearest Lot line Absorption Area to Nearest Lot Line i~age Two Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 21 Nevilla Park Subdivision Comments: fadauit Attac. hed: ~ Disapproved: Letter Attached: Date: Department Worksheet: O SENDER: Corapleteitems t, 2, and L Add yaur address in Ihe "RETURN TO" space on l. The following sv-vice is requested (check one). [] Show to whom add date delivered ........... ¢ [] Show to whom, u~.te, and address of delivery.. [] RESTRICTED DELIVERY Show to whom and date delivered .......... ¢ [] RESTRICTED DELIVERY. Show to whom, date, and address of deliver/. $ - Lot( ¢~).~/S ti~x~ ~3~tiI~ S ~r vl~ R St~ ~c~. ivi s ~. ARTICLE ADDRESSED TO: Letter - 1st National Bank of Anchorage Post office Box 720 Anchorage, Alaska 99510 3. ARTICLE DESCRIPTION: REGISTERED NO' I CERTII"IED NO'[ 741843 INSURED NO. (Always obtain signature ef eddreslee or agent) I have received the article desc[ib,,qd above. SIGNATURE [~] Addressee ~ Au~thorized~agent., "/DATE OF DELiCER~~ 5. ADDRESS (Compta[~ onty if requested) , ~'%,~t ~ ~ ~ ., . - ' }. :/ · , . - .../ ~6. UNABLE TO DELIVE'R BECAUSE: "' .' ' 'INITIALS ....... , ...... us postage) SENTEO STREET AND © P.O. STATE ^~D ZIP CODE OPTIONAl. SERVICES FOR ADDITIONAL FEES fl~YUltq ~ 1. ShoWs t9 wliorn m~d date delivered ........... ]~J. R~CEli T 2. Shows to wlmonL date aad where delivered _ 35~ DELIVER TO ADDRESSEE 0liLY ................................................. 50d POSTMARK OR DATE PS For,,, 3800 NO INSURANCE COVERAGE PROVIDED-- (See o~her side) NOT FOR INTE,qNATIONAL MAIL Apr, I97] ~ GPO: 1972 O? 460-743 MUNICIPALITY OF ANCHORAGE Department of Health and Environmental Protection 825 L Street, Anchorage, Alaska 99501 264-4720 equest for Approval of Individual Sewer and Water Facilities Property Owner: Mailing Address: Name of Buyer: Mailing Address: Vernon E. Nielsen 8101 E. 2nd Ave.~ Anch.~ Ak. 99504 Refinance Phone: 265-6148 Work 333-9940 Home Phone: Lending Institution: Mailing Address: The First National Bank of Anchorage 99510 P.O. BOX 720, ANCHORAGE, AK. Phone: 276-6300 Ext. 683 Realtor/Agent: Mailing Address: Legal Description: Street Location: None Phone: Lot 21 New[lla Park S/D 8101 E. 2nd Ave., Anchorage Single Family Residence: ( ) Number of Bedrooms: Multiple Family Residence: (x) Number of Bedrooms: four Water Supply: *Individual Well ( ) If Individual Well, well depth If Community System, name of system Public/Community System (x) *NOTE: Sewage Disposal System: *~n-site System (ix) Public System ( ) If On-site System, date of installation: ? MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & I~N%'IRON~4E,N_,T~L PROTECTION A well log is required on ALL wells drilled since / / . ** If on-site sewer system is over two(2) years o].d,I,~/a~.~cy test is required by this department. A fee of $25.00 must accompany each request bef~~9~ng can be initiated. 3/77 March 21, 1978 Vernon l,;i~l son 8108 East 2nd Avenue Anchorage, Alaska 99504 Subject: Lot 21 Nevilla Park Sbbdivision r~qu~st for approval of sewer and water faoiliti~s not be approved at this time. Befor~ approval may be granted, you must connect to th(~, i~ubit~ ,~e~er line that is available to th~ property. Temporary approval may be ~ranted if monies are esorow~d Co complete the conneoCion on. or before July 1~ 1978. If th~,r~ are any further questions, please ~onta~t this offica at 264~4720. Sincerely, Robert C. Pratt~ R.S. Sanitarian Pirst National i~ank of i~chora~ Post Office Box 720 99510 % Judy Tax Code,, I Date.. Owner., Mailing Address: User / Tenant: Property Address: ~ Positive ~ Negative ADDITIONAI_ INFORMATION: Of lice: Field: Administered By..