HomeMy WebLinkAboutNORTON PARK LT 6A6a?
~ ~.~,'~,~ % X D E PA R TM E
#1: Time
FIUINIClVA[.IIY Of- ANCHORAGE
OF HEA~YH AND ENVIRONMEN"
Street, Anchorage, Ala.%,.~
279-2511, ext. 224 or 225
Date Received:
PROYECTION
99501
May 12, 1977
#2: Time #3:
Date
Insp
Time
Date
Insp
REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES
Lending Institution Reguesh: Alaska Statebank
Mailing Address: Post Office Box 240 99510 Phone: 277-1553
Property Owner: Carol A/James R. Jork Phone: 277-1553/realtor
MailJ.fig Address: % Jack White Company, C. Dale MurphY
3. Legal Description: Lot 6A6 Norton Park Subdivision
4:
Single Family Residence: (x)
Multiple Family Residence: ( )
Number of Bedrooms:
Number of Bedrooms:
Well System:
Permit ~
Construction
Individual Well '( ) Conm]unity./Pub].ic System (x)
Depth of Well Well Log on File ( )
Bacterial Analysis
Sewage Disposal System:
Permit #
Septic Tank Size
Absorption Area
Om-site System ( ) Public Utility
InstalLled Installer
Manufacturer
Soils Rate Material
Distances: Well to Septic Tank
to Sewer Line Nearest Lot.line
to Nearest Lot Line
to Absorption Area
Absorption Area
P&ge' Two
Department of Health and Environmental Protection
Request for Approval of Individual Sewer and Water Facilities
Legal Description: Lot 6A6 Norton Park Subdivision
Com/nents:
Affadavit Attached: ' (~) Letter Attached
Approved: _ _ _ Date: ~---/~ ~7
Disapproved:
Date:
Department Worksheet:
MUNICIPALITY OF ANCHORAGF.
DEPARYMENTOF ItEALTI-I AND ENVIRONMENTAL PROTECTION
825 ;[, Street, Anch. o]-age, Alaska 995011_
2'19-25].1, ext. 22d, 22[;
REO. UEST EOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES
1. Type of Inspection: VA_..__X ...... FHA ..... CQNV
2. Property Owner:____C__aPo_l~_A_.,_. e_n_._d___J_a_r~es R., ¥o_Pk_
Mailing Address:.._~5~_oA~'e~_s ~v_enue. Day Phone:2~Z.~_~J
3. Name of Buyer: Riohard [(., and Na~.gey_ K_~.__Wri_.g~_t_
Mailing Address:2~l-__3_6_8' A~ Ci_t.Pus_~__t;_~_._F, lm,_AJB'~y' '
4. Name of Lending Institution:.____Ala~sk~':'3~
Mailing Address: ~Q__!l.c~.~_2flO Arvc~b, ~ ......... Phone:. °~7.9=263_7_
5. Name of Realtor or Agent: .__ C~__~alE_ ~p_}A¥_ _(,~'ac~_~"lj,_l;z3_) ...........................
Ma i lin g Address: ,~_~__0_.1_._ _C',~_ S t; 12__~e'h _,A_~OJ5 ...... Phone: --.,P~_7--_-_]5.~ ~z
6. Legal Description: .... %ol; 6A6 No~I;o~
I_ocation: Nol*'borl Pa~k
7. Type of Facility to be Inspected:_~J,~ff__~,~_
8. Wai'er Supply
Type of Supply: Public Utility
II: Individual, number of dwellings presently served
If Individual, depth ot: well
9, Sewage Disposal System
Type of System: Public Utility *
If Individual, date of installation
No. Bdrms.__.~
Individual
Individual (on-site)
72 003(3/76)