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HomeMy WebLinkAboutLARSON LT 9AOnsite File Formerly US Survey 3042 Lot 9 (West sideE HEM DRILLING 3540 FlKU A: DRIVE AW,CFiORAGE, AK 9951,G (907) 145-0553 WATER WELL RECORD STATE OF ALASKA DEPARTMENT OF NATURAL�RESOURES Division of Geological a Geophysical Surveys Drilllna Parm fT No. LOCATION OF WELL {Phos• cample Ta ellhor 10. Ib or Il:,) A.D. 1,. Na. ---- —• 1D. BaraupR Suadivleion Let $Ivsk Ib. 1/dglrt.T llon No. Tofw}nohia N� Range E� Meridian C J f li gm� yr� It..A NCTAND DIRECTION FROM ROAD INTERSECTIONS 3. OWNER of WE1,1, �, y � ., 1 ►-` •� U 5 Lir 4y 3 �-] .r�LL ZZ..4 �1 ,`]�•� �� aadr�] -Sly llscc' c7r1 u� Street Addrese 'and} Area o Well Loc filen -4(J'S0,� _ 1 2. WELL LOU real Below d Surfve■ Materlof Typo 7op pollam FELL DEPTH+ I Flag" S. OATS QF CdfitLCCi14N ' S _t - --f!' : S'- 1b _ Q, ❑ Coble tool ARolary riven Auger ❑ 401 led'* ❑ bored ❑ Dv9 ❑ olher : '.i Ltttt����AAAA C7 7. USE:'7s1 Domesllc: ❑ public •Supply Cl Induslry ❑ lrrigalion ❑ ReChorge ❑ Commrrieol Y -- Teat WeiI other: S. CASING+ ❑ Throodod xWeided diam.ln, Ta it. Depth Weighs —lbs,/ it. Blom, ln, to !1. fleplh $lickup (1, �J 9. FIN13H OF WELL: Typo: 6?4t=Q__ Dlomefer' _ $lolfhlseh Slse: Lenplh: i Sol bilmoon ft, end Backfilling Orevel pact 10, STATIC WATER LEVEL ! 0 ❑ Above or 0 $slaw loud-sarfaes baii Egulpmenl used: I I , PUMPINO LEVEL below land ourfdto and YIELD F1. afl■r hrs, pumping q,p,m, fl. oiler bra. pumping J.P.M. 12,GROUTiNO Well Grouled: ,Yee Cl No Male rlaI C] Neal Climanl 0 Other: i 13. PUMP: (If availoblei HP Lsnglh of Drop Pips Fl, aopaefly a,p,m. 0 Subm. ❑ Jet ❑ Caniriffeal ❑ Giller la P=UAQNQI 18. WATER WELL CONTRACTORS CERTIFICATION: 15. Water Temporolureo e ❑ F C Tnis well wee deltisIl �rndrr my lurladrerlon 0nd Ihit rap,ri l: limy knowledge end bells!, HD Islefed out no t Nemo Cvnlrati License Number .« Dulet ~Au1ll erl tl He fll ee nlYIIVD� •__•-�T � »• COPY E)"Ifiablion: WHITE - S11,r9 ❑CCS, PJNI("flfiHkr1 ' —............_.._.._.,_,..,.,..W�_�.._,.-.�.,.,.��.,."...�,4. , CANARY�Cuet*mer s. T-cl Qo*-Di so 81 quo Permit Number: SW020192 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ONSITE WATER SUPPLY PERMIT Initial Date Issued: Jun 25, 2002 Expiration Date: Jun 25, 2003 Parcel ID: 075-092-38 Legal Description: US SURVEY 3042 LT 9 T1 ON R2E SEC 19 Design Engineer: 0000 None Required Site Address: Owner Name: Brett & Patty Wilbanks Lot Size: 65340 SQ. FT. Owner Address: 8030 Ressurection Dr. Total Bedrooms: 3 Permit Bedrooms: 3 Anchorage , AK 99504-4731 This permit is for the construction of: ❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑✓ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: Ig r" Z'1- 0 -z— Date: Date: G 2 5-- OZ Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program ; r 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us RV!914 (907) 343-7904 4 ON-SITE SEWER/� WELL PERMIT APPLICATION 6/ FORA SINGLE FAMILY DWELLING 4"?" C O Parcel I.D. 015- ©oLZ 3 `b' Permit Number SW 2S� Property owner(s) '1 �>&—(T'c tJ rLY54 -Q1 P -S Day phone 7, 37^ 433 Mailing address (1 Mailing address Legal description (Lot, Block & Legal description (Section, Township & Range) Lot Size 051 tkeres/Sq.Ft. THIS APPLICATION IS FO' Sewer Only �o �2 4,0 Z Sewer and Well Sewer Upgrade C* (, L EQ THIS PROPERTY CONTA // Hot Tub AC!4 L L Swimming Pool Therapy Pool Zip Code q 95 O q'" 8731 U S Nm , r, o 14 Z Number of Bedrooms f3RE1T ►vIL L s'JaA.,�s ! 14 SX,EO A4 /_-_ OhtC'ie APP A4.OR £ /ai'a, I certify that the above it�qv� 73-2 P70 or a Sing Family Dwelling; CSL 227- 7$ /2 (Signature of property owner or uthonze age �6D,60 +/b-0•" Permit Pees: es: Date of Payment: & 1;2glO OR Date of Payment: Receipt Number: Z% % oZ J�� 021 5 -ceipt Number (Rev. 12/00) 5-24-02; 1:45PM;CISCO SYSTEMS ALASKA 70' m 5 SPROAT ROAD p Ci ■■ O C CD En ;11 6 ;907 556599 T ALYESKA HIGHWAY v d7a7yy� CONTRACTOR REDMOMD ASSESSMENTS.. Repair Existing Service 0 Main Line Extension XCI On Properly Only MIMATt t -ms+r�' 1 µ City Tap Q Have Been Levied Hydrant Only lS 50' or Longer To Be Levied ❑ Main Tap -To Property Line Only . Comments: [] Main Tap & On Property Connect Row No. Disconnect E] R & R - Main Tap Only ner tall CONNECTSIZE4" ISSUED acpmg INSPECTION FEE $ 64.00 PAID CASH PERMIT FEE $ 38.00 r CHECK# I©5�r�1 $ 0.00 OTHER DEPOSIT $ 0.00 INSPECTED BY REIMBURSABLE TOTAL $ 102.00 NUMBER I I DATE REMARKS PERMITTEE (Please Print) PHONE MAIL ADDRESS . SIGNATURE POST IN A CONSPICUOUS PLACE AT THE JOB SITE CUSTOMER COPY Original