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HomeMy WebLinkAboutFREEMAN LT 11II . I0  GREATER AN~iHORAGE AREA BOROUGH .'' Department of Environmental Quality 3500 Tudor Road, Anchorage, Alaska 99507 279-8686 Time of ,nspection ~,.~ 1. Aoproval Requested By: -1 2. Prooertv ~ner. 3. Legal Description. . 5. Type of Facility to be ,nspect~d: ~./ .. Number of Bedrooms: --~ ~ 6. Well Data: t ' '~ A. T~e~ B. Dep . ~7 o. Const ctio . D. ' acteriel Analysis' 7.' Sewage DisPosal System:~. . ~/ . D. Seepage Ptt~ 1. Stze~2. ~.~ Disposal Field: To,al. Lenpth of Lines Distances: A. Well To~ .Septic Tank/~/~ · Nearest Lot Line ~O /7 , Other Con'tamtnation B. Foundation to Septic Tank ~ /~ "~ Absorption Area /~0f ~ C. Absorption Area to Nearest Lot Line ~/J) ~ ~ · Absorption Area/~)c9/~ , Sewer Lines 'GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" St., Anchorage, Alaska 99503 - 274-4561 I~ECEIVED REQUEST FOR APPROVAL OF DE[: 1973 INDIVIDUAL SEWER & WATER FACILITIES * 1. Type of Inspection: 2. Property Owner: Hailing Address: 3. :;~ uf Buyer: Hailing Address: 4e CMRO __ VA xlocx FHA Jay D, CONV (NHN} Hawkins Avenue Da), Phone ........... P.O. Box 10099 ~TT STATIo~ay Phone~7' 3581 ~ 344 1200 Na~e of Lending Institution: ~S~ER & CO, gail~n~ gddre~: 319 ~e~t Flfth Avenue Phons 272-9501 ~ame of Realtor or g~eng: ~O~ PL~Sg G~ORGE ~OR~LI~S O 277 ~581 ~atl~n~ gddre~s: cio 503 E~ ~orthern L~ght~ ~o~e 6. Legal Description: Lot 11, FREEMAN SUBDIVISION Location: (NIIN) Ha,.'kins Avenue 7. Type of Facility 8. Water Supply Type of Supply: ge to be inspected: ~-'ep~ t~ Bdrms.3 Public Utility Individual xx If Individual, number of dwellings presently served If Individual, depth of well Sewage Disposal'System Type.of S~stem: Public Utility Individual If Individual, date of installation 1 (on-site) RRqyezt for Approval of 2nu,vidua! Sewer & Water Facilities Pa.~e Two .Anr, ro ~ ~l-, Apurova! talid for One Year Fro~ Date Signed Gre~te? Anchorage Area Borough, DeF~rtment of Enviro~.ental Quality D2AOP~U OF SYSTF~: ! ¢~r~if~, thet the in~ormation contained in this ~equest for approval to be m t~ue and accura~ representation o~ the subject sewer and water ~acilitie$ located