HomeMy WebLinkAboutBELLA VISTA #1 LT 10B
APPLF NT FILLS OUT UPPER HAl ONLY
Pro.~' ;'ty Owner :_,/.~/T~.,~/~ Phone
Lending Institution ~ r? ~" ~': ~ g '? ~ ~~'~' Phone
Address Zip Code
Realty Co. & A~nt Phone
Street Locati~ '~ ~ ~ ' ~ .~ /'~ ~ .... ~r~ <~ . q, (. ~ , ,, , ~( ,
Type of Resi~nce -..~
~ Single Family
~ Multiple Family No. of Bedroo~
~ Other
Water Supply
~ Individual A~ACH WELL LOG. A w~l log is required for all wells drilled since June 1975.
~ Community For wells drilled prior to that date, give well depth (attach log if available).
~ Public Utility
Sewer Disposal
: Individual Year Indiv~ual Installed:
~ Public ~ility When Connected to Public Utility:
: Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSlNG CAN BE INITIATED.
Time Time Time Time
Date Date Date Date
Inspector Inspector Inspector Inspector
ND T ROVAL'
Soils Rating Date Sewer installed Well To Absorption Area Well Log Received
Well to Tank Septic Tank Size
72-023 (3182)
/ Department of Environmental Quality ' IP~ ~/~(_J
~~/ ~3330 "C" Street, .Anchor~_~AlaSklati95Rile]v2ei4-456Mlay ~3~,/~~976~-.- -,
Time of Inspection
~/~/~/ / ~0 .~' Date of Inspection ~,J~/r~ (~,~,.~.
~(.L~'-Y--J.../- INDIVIDUAL SEWER & WATER FACILITIES~ ?x~l~/ z~/1~K~ .'"'""
State - V.A. I~, pOP' ~~
Approval requested by: d J ~ ~' '
~p ,one~'~
Mailing Address:
2. Property Owner: Ruth Cramer
Phone:
Mailing Address: 725 East 78th Avenue
:'3, Legal Description: Lot 10 Bella Vista Subdivision
Location:
Type of facility to be inspected
Well Data: Individual
A. Type
Single Family No. of bedrooms
B. Depth 203'
C. Construction
D. Bacterial Analysis
Sewage Disposal System:
A. Installed
Public Utility.
B. Installer
C. Septic Tank: 1. Size
2. Manufacturer
D. Seepage Pit: 1. Absorption Area
2. Material
E. Disposal Field: Total length of lines
8. Distances:
A. Well to: Septic tank
, Absorption area
, Sewer Lines
Nearest lot line
, Other contamination
B. Foundation to septic tank
, Absorption area
C. Absorption area to nearest lot line
EQ-034 (1/74) Page 1 of two pages
Page 2 of two pages - Req~ ~t for Approval of Individual S~ .r & Water Facilities
Legal Description Lot 10 Bella Vista
Comments
Approved
Approval Valid for one
year from date si
Greater Anchorage Area Borough, Department of Environmental Qual
ity / ~
DIAGRAM OF SYSTEM
certify that the information contained in this request for approval to be a true and
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED
Date
EQ-034 (1/74)
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" Street, Anchorage, Alaska 99503 - ~4~1
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES
Type of Inspection: ~ .'~~VA ~' . FHA
Property Owner: ~"~x.¢-~ ~,~_.-2g,.~/t.,~ -
Mailing Address:
Name of Buyer: ~ O~ ~z- U~d/~-~
Mailing Address:
Day Phone
4. Name o'f Lending Institution:
MUNICIPALITY OF ANCHORAGE
DEPT. OF H£ALTH &
ENVIRONMENTAL PROTECTION
o
MAY
RECEIVED
CONY
Mailing Address: · Phone
Name of Realtor or Agent:
Mailing Address: ~'/.~ /_/L/). ~;/~¢~~z~_ /~,~. Phone
Location: ~7-/-2/ ~¢¢C ~6~,' ~. ,4~..'~,.,,,~ 7/¢_ ' .~./~
Type of Facility to be inspected:
NO. Bdrms. _ ~ ,
Water Supply
Type of Supply: Public Utility
If IndividuaJ, number of dwellings presently served
If Individual, depth of well
Sewage Disposal System
Type of System:
Public Utility
Individual (on-site)
If Individual, date of installation
EQ-037 (1/74)
Municipali
of
Anchorage
POUC,~ 6-650
ANCHORAGE, ALASKA 99502
(907) 278-4531
MUNICIPALITY OF ANCHORAGE
G£ORGEM. SULLIVAN, DEPT. OF HEALTH &
MA YOR ENVIRONMENTAL PROTECTION
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
Environmental Sanitation Division
(2510 East Tudor Road)
June 17,1976
JUN 2 5 1976
RECEIVED
4.1
State of Alaska
Veteran' s Administration
507 West Northern Lights Blvd.
Anchorage, Alaska 99503
Subject: Lot 10 Bella Vista Subdivision #1
The well serving the subject residence must be upgraded
to meet health code requirements.
The well casing must be extended twelve (12) inches
above ground surface and the pit filled in with
impervious soil.
If you have any further questions, please contact
us at 276-2221, extension 285.
Sincerely,
Les N. Buchholz
Sanitarian
LNB/ljh
CC:
Homestate Realty
517 West Northern Lights
Ruth Cramer
725 East 78th Avenue