HomeMy WebLinkAboutCREEKSIDE PARK #1 LT 27L. 7'
1972
::~ o x 2 4 0
Attention:
Larry An2erson
~e ~, 1 ~st~te
S u Lj ect:
Lot 27, Creeksi(~.e ParL Subdivision ~'l, 7~ tC..'
~'.arTlc~n'.~ Drive.
['revioasly tiqc subj(ct qrGfierty was ~iis,:~pr'r,;,v¢:,', be, causo iL was
not connacted Lc ~he availabi~:u public sewer. As
24, lgTZ, I have cunfirr~ed the connection of s~b]ec~tprooerty
to !)ublic sewer an~J tn~ wat~Jr facilities are via C(~ntrcl Alaska
Utilities, Therefore, ~lC sewer and water Facilities
s.b~ec~ ioc are
Sincerely,
Susan E. bickcrson
Sani tarian
GREATER ANCHOP~GE AREA BOROUGH
Department of 5nvirenmental Quality
9500 Tudor Road, Anchorage, Alaska 99507 279-8686
Time of Inspection
Date of Inspection
e
REQIJ~$T FOR APCROVAL OF
INDIVIDUAL gE~ER & WATER FACILITIES
FOR
Phone:
Address
Number of Bedrooms: Z
Well Data:
A. Tvr>. e ~~_
C. Construction
7. Sewage Disoosal System:
Deoth
Bacteria] Analysis
Distances:
A. Well To:
Installed
Septic Tank:
Seepage Pit: ]..
Disposal Fie]d:
1. Size
Size
2. Installer
2. Manufacturer
2. Material
Total Length of Lines
Septic Tank
, Absorption Area
, Nearest Lot line
B. Foundation to Seotic Tank
C. Absorption Area to Nearest Lot Line
, Sewer Lines
, Other Contamination ·
AbSorption Area ·
R..equest for Approval of 1 lvidual Sewer & Water Facilittc
Page Two
9. Comments:
ADoroved Disapproved Date
/
Approval Valid for One Ye.~'r From Date Signed
Greater Anchorage Area Borough, Dep~.a~tment of ~_nvironmental Quality
/
O IAS P~ANt,~F SYSTE~
I certify that the information contained in this request for approval to be a true
and accurate representation of the subiect sewer and water facilities located at:
Signed Date
GREATER ANCHORAGE AREA BOROU~,
HEALTH DEPARTMENT
327 EAGLE STREET
AN~{ORAGE, ALASKA 99S01
279-2Sll
INSPECT:
TIME:
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWAGE AND }VATER FACILITIES
FOR
Approval Requested By
Address V ~7~
Phone
2. Property Owner
5. Legal Description~dC, 7
4. Type of Facility to be Inspected
Number of Bedrooms
S. Well Data:
A. Type
Phone
B. Depth
Size
Construction
Bacterial Analysis
Sewage Disposal System:
A. Septic Tank (If homemade, show diagram on back)
1. Size /Od)O -'
.2 JZ;,-/
2.
5. Manufacturer
4. Installer
A~proval Request for S
Page Two
oe ~ Water Facilities
B. Seepage Pit
1. Size
2. Lining
C. Disposal Field
1. Number of Lines
2. Total Length
Required Measurements
A.
B.
C
D
E
F
G
H
Well to Septic Tank ,
Well to Seepage Pit
Well to Sewer Line
Well to Property Line
lqell to Other Possible Contamination
Foundation to Septic Tank .f
Foundation to Seepage Pit ,~?~
Seepage Pit to Property Line
8. CO~ENTS:
APPROVE~'.'.~Cc,t
DATE:~
/
DISAPPROVED:
DATE:
APPROVAL VALID FOR ONE YEAR FROrI DATE SIGNED.
GREATER ANCHORAGE AREA BOROUGH HEALTH DEPARTMENT
UDllTO