HomeMy WebLinkAboutNEVILLA PARK LT 36O ff
GAAB-HD-2
GREATE?
327 Eagle St.
ANCHORAGE AREA
HEALTH DEPARTMENT
Anchorage, Alaska 99501
'-'gROUGH
279-2511
Case No.
SEWAGE DISPOSAL SYSTFM - APPLICATION & PERMIT
NAME OF APPLICANT. ('Z~';~ LC/ ~ MAILING ADDRESS PHONE
RESIDENCEAOORESS~O;~L/ ~ 2,~g~ LOCATION OF INSTALLATION
LEGAL DESCRIPTION. ~-~d .
APPLICATION TO INSTALL: SEPTICTANK ~ ~//~C'~r~'~
,SEEPAGE PIT .~ /' ,DR~ FIELD/ ~ ,OTHER
FINANCED THROUBH_ ~/; ~TD BEn, STALLED B~ )~¢¢-"~'~Lq
PERCOLATION TEST RESULTS &'~'2~ '~//[- ~ "/ //
ANTICIPATED DATE OF COMPLETION
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
-,-.is .s-rD SERVE AS '"~' ~/y~-:;:/ .PERM,T TO .NSTALLA ~'-~ ~:~Yc~d
I '
AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED
· SEPTIC TANK SIZE '"~-' TYPE --~ SEEPAGE AREA. .- TYPE
DIAGRAM OF SYSTEM
DISTANCES:
LICENSED DESIGNER ·
t certify that ~ am [amJlJa~ with [he requb'ements of G~eater Anchorage A~ea Borough Ordinance No. 28-68 a~d that the
above described system Js in ~ccordance with said code.
DATE < P ' ~ /'
~L~/~ [~] APPLICANTSSIGNATURE~k' ~14.~. ~-,.~Q c~..-%~.p... ~
// //
P,(). ~oX 4110
FltA Case No. 10505
tctnl>oro, r), cesspool installed with a pemit froa
t:his i)c]'mrt~:~eflt. Thc ct~;:q~(~ol :ira to be um)d until
i~hil.(;y i.~ supplied vi~t (',~l~tral Alaska Utilities
t.,h:i, oi i~-:. an apl,rovcu .~;ource ,,'ith this [k,.partl..~nto
CLIFFOR~ P, JUDKIN5, R,5o
^&i~ni. styativc Dirocto~'
Sa:nit ariin i
Cim¥1es LaGr~mt