HomeMy WebLinkAboutSPENARD COURTS LT 3
MUNICIPALITY OF ANCHORAGE DElft, OF IlEAl.TH &
· DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIOI~jVIRONMENT/\L PROTECTION
825 L Street - Anchorage, Alaska 99501
JUL, 6 !979
~ ENVIRONMENTAL ENGINEERING DIVISION
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all parts on page 1, Incomplete requests will net be processed. Please allow ten (~) days for processing.
~ PROPERTY OWNER PHONE
MAILING ADDRESS
PROPERTY RESIDENT. (tf different from ~bove) PHONE
2, BUYE~ PHONE
MAILING ADDRESS
_,. l
3. LENDING I~S~ITUTION , PHONE
§, LEGAL DESCRIPTION
STREET LOCATION'
TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] One [] Foul'
~L/~ SINGLE FAMILY [] 'fwo ~ Five
[] MULTIPLE FAMILY ~ Three E~_ Six
[] Other
7. WATER SUPPLY
/~ INDIVIDUAL~
COMMUNITY
[] PUBLIC UTILITY
~', SEWAGE DISPOSAL SYSTEM
[] INDIVIDUAL/ON-SITE**
I~ PUBLIC UTILITY
ATTACH WELL LOG. A well log is required for alt wells drilled
since June 1975. For wells drilled prior to that date, give well
depth (attach log if available.) ~ ~-~.~ ~
*'If individual/on-site, give installation aa[e ..
If system ~s over two (2) years old an adequacy [es[ is 'eauired
by this Department.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED,
72-010(3/78)
THIS SIDE FOR OFFICIAL USE ONLY
DATE RECEIVED
INSPECTION APPOINTMENTS
TIME T~ME TIME
DATE DATE DATE
I NSPECTO'R INSPECTOR INSPECTOR
DIRECTIONS:
1, TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE, FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2, WATER SUPPLY
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY --
DATE DRILLED
[] PUBLIC UTILITY
Connection Verified LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[]INDIVIDuAL/oN -SITE DATE INSTALLED i'
[]PUBLIC UTILITY·
Connection Verified INSTALLER ,./
[]Septic Tank or []Holding Tank ,.
Size: If Tank is homemade SOILS RATING
give dimensions:
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL '
4. DISTANCES Septic/Holding Tank Absorption Area S~v~ r Line Nearest Lot Line
WELL TO:
Absorption Area to nearest Lot Line
~ '~' BEDROOMS
'~'~APPROV ED FOR
[] CONDITIONAL APPROVAL Ilette[~ust.~compa~¥ certificate)
DATE ('~ ~') ~ (~1 BY(Title) ¥' ""7/
72-010 (Rev. 3/78)
July 9, 1979
Terry Davis
1305 West 39th
Anchorage, Alaska
99503
~ ', Span,etd Courts
SUBJECt.: Lot 3,
Dear Sir~
Your request for approval ~n your individual water supply cm~ not be approved
uutil the following 'have been completed, and provided the water sample drown
is sati6factoryo
(1) Raise the well easing above ground level.
(2) Pour cement around the well caning ~o that is is fl~sh with
the ~asemm~t floor.
Notify this department for a reinspeetion when d~cr~panciem have been correct,do
If there are any further qu~stions~ please contact this office at 264"-4720.
Sincmrely,
Robert C. Pratt:, R.S.
Associate Specialist
RCP/ea