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QUICK BLK 3 LT 2
Quick Block 3 Lot 2 #016-203-49 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Water System Permit Permit Number: OSP231384 Work Type: Well Initial Tax Code Number: 01620349000 Site Legal Address: QUICK BLK 3 LT 2 G:2731 Site Mailing Address: 12266 DIVISION ST, Anchorage Owner: BRADLEY ROBERT Design Engineer: This permit is for the construction of: Effective Date: Expiration Date: �. f Department Lot Size in Sq Ft: Total Bedrooms: 11 /17/2023 11 /16/2024 13054 ❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy Q Private Well ❑ Water Storage All construction shall 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 wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: (s SV (J.) lT j ��>r�'� (��21J L-F y Issued By: Date: Date: ( i Z 17 Z q, --_� 4 ON -SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 016-203-49 Property owner(s) Robert Bradley Mailing address PO Box 110226 Anchorage AK 99511 Site address 12266 Division St Anchorage AK 99515 Day phone (907)229-8153 Legal description (Sub'd., Block & Lot) Quick Blk 3 Lt 2 Legal description (Township, Range & Section) Lot Size 13,054 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (N all that apply) Absorption Field ❑ Initial Single Family (SF) 0 Septic Tank ❑ Upgrade ❑ (w/wo ADU) Holding Tank ❑ Renewal ❑ Duplex (D) El Privy ❑ Multiple Dwellings ❑ (SF and/or D) Private Well 0 Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. 6/'_ (Signature of property owner or authorized agent) Permit/Rush Fees: Z Waiver Fees: Date of Payment: i 2-02 3 Date of Payment: Receipt Number: Receipt Number: Permit No. 05,9 Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc M-W Drilling, Inc. ♦P.O. Box 110389♦Anchorage, AK 99511♦ ♦907-345-4000♦ Job No. 24-109 Permit No. OSP231384 GROUNDWATER WELL LOG Well Owner: The Bradley Company Use of Well: Domestic Site Description: Legal Description: Well Coordinates: 12266 Division Road, Anchorage, Alaska Lot 2, Block 3, Quick Subdivision Lat: 61.109648 Long: -149.871640 CONSTRUCTION Drill Method: Air rotary Hole Size: 6” Well Depth: 122.87’ Casing Material: A53B steel Casing Size: 6” Wall: .250 Cased to: 117.67’ Well Completion: Open end: Screen: X Liner: Perforated: Method: Screen/Perforation Description: 5” k-packer & riser pipe: 115.67’ to 117.67’, 5” x 0.010 slot ss well screen: 117.67’ to 122.87’ Grout Notes: 2 sacks (50#ea) of bentonite Well Development: Air surge Well Disinfected: yes Method: Chlorine bleach Yield Test at 20+ GPM for 3 hour(s) with 100% of drawdown (DD) from static level (SWL). Method: Air lift Static Water Level (SWL): 27.7’ Start Date: 2/20/24 Completion Date: 3/1/24 Test Pump Date: 2/29/24 Final Pump Install Date: WELL LOG Depth in feet from top of casing. Details of formations penetrated, size of material, color and miscellaneous details. 0 TO 3 Casing Stick up 3 TO 57 Gravel: silty, some clay 57 TO 62 Water gravel: medium to coarse, silty, 2-3 gpm 62 TO 118 Gravel: silty, some clay 118 TO 128 Water sand: fine to medium, some gravel, 20+ gpm 128 TO 140 Silt: sandy, very fine, heaving, wet Kris G. Westberg Vice President, M-W Drilling, Inc. Alaska Gen Contr Lic #1000 MUNICIPALITY OF ANCHORAGE Development Services Department Ins Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Pump Installation Log Well Drilling Permit Number: o S f 39 H Date of Issue: Parcel Identification Number: Legal Description Block Lot Property Owner Name & Address: Ou, I UK 6"ccLie7 Q -z Pump Installation Date: -�- Pump Intake Depth Below Top of Well Casing: �t 0 feet V Pump Manufacturer's Name: (,L flkz� Pump Model: /D 5 g C b 7- 2 act Pump Size: 1 hp Pitless Adapter Burial Depth: l0 feet Pitless Adapter Manufacturer's Name: C A vb4! j Pitless Adapter Installer: AC''C b 'P! ,✓1��✓►C Well Disinfected Upon Completion? k Yes ❑ No Method of Disinfection: (A I,)/ 1,A -f_ Comments: Pump Installer Name: D4,1.yl Company: �-�{� , P✓ i I I 1 'lG ,J'! C Mailing Address: P0 )1 Z) 3 0 City: AWL ` State: &� Zip: Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation. Received Date/Time 03/04/2024 12:30 03/04/2024 12:00Collected Date/Time 1240836001 Matrix SGS Ref.# Client Sample ID 12266 Division St. Client Name Project Name/# Printed Date/Time 03/08/2024 13:17Hefty Drilling Technical Director Stephen C. Ede 12266 Division St. Lt2 Blk3 Drinking Water Sample Remarks: Parameter Results LOQ Units Method Allowable Limits Prep Date Analysis Date InitContainer ID Metals by ICP/MS HGS03/07/24EP200.8ug/LArsenic 03/06/2444.0 5.00 (<10)*B Waters Department EBH03/07/24SM21 4500NO3-Fmg/LTotal Nitrate/Nitrite-N ND 0.200 (<10)C Microbiology Laboratory PHK03/04/24SM21 9223B100mLE. Coli Negative 1 A PHK03/04/24SM21 9223B100mLTotal Coliform Negative 1 A 2 of 5 MUNXCIPALiTY OF ANCHORAGE &F WASTEWATER CONNECT,PERMIT y ` WATER & WASTEWATER UTILITY 3000 ARCTIC BLVD. DATE OF APPLICATION: 8/16/2023 1PHONE:(907)564-2762 SCHEDULED COMPLETION DATE: 12/31/2023 BLOCK/LOTITRACT: BLK 3/ LT 11 SING Q LE FAMILY ❑ DUPLEX ❑ COMMERCIAL ❑ MULTI -DWELLING No. APTS 0 PHONE: L� ❑ RCPC71� GRIbUIIy nervjce On Property Only ❑ City Tap u viain une extension. Have Been Levied ❑ Hydrant Only ❑ To Be Levied Q Main Tap - To Property Line Only ❑ Cured in Place Pipe Comments: ❑ Main Tap & On Property Connect ❑ Disconnect Row No-19 ❑ R & R - Main Tap Only, Owner Staff CONNECT SIZE 4 in ISSUED WWVAH INSPECTION FEE $112.00 PAID ❑ CASH PERMIT FEE$77.00 ❑ CHECK Nn Rcc .. .. ,$1.30, 1 OTHE REIMBURSABLE DEPOSIT $0.00 INSPECTED BY , . ' NUMBER TOTAL' $190.30 _ DATE REMARKS' PHONE (907)345-8153 PERMITTEE (Please Print) The Bradley Company wfN Aoc DATE 12/31/2023 TIME 12:00 AM INSPECTOR SCHEDULED SUBDIVISION QUICK BLOCK/LOT/TRACT'BLK 3/ LT 1/ INDICATE NORTH f ffn :SkAt W�Nbl tt 4� v i it S Y i SIZE MAIN: TYPE MAIN; DEPTH AT MAIN: "" AT kOP. LINE:#"a CONNECT LOCATION: COMMENTS: CoLA Kmakiv # �, ULJ z v INSPECTED BY: � ` 6 DATE;' ] INSPECT ON PROPERTY SEWER TIE-IN DATE 12/31/2023 TIME 12:00' AM INSPECTOR 12/31/2023 TIME 12:00' AM INSPECTOR SCHEDULED SUBDIVISION QUICK BLOCK/LOT/TRACT BLK 3/ LT 2/ INDICATE NORTH PLC j �"` � �'S5Ti V1G Jr'_V"fll Cam? S 1 SIZE MAIN: TYPE MAIN: - DEPTH AT MAIN: AT PROP. LINE: CONNECT LOCATION: COMMENTS: INSPECTED BY: y! �, DATE:�� ctp d 3 J VZ ii / t )mil e 5' bv.0 tom- 7� -e ;/ l/ i & . I✓ e tl A IP- 4, � 4o G��lll�J t fA;'r J �1i U�1� S `7` ? •e G� n—i c+ 41 i� t,t. t �ScC�r1 e S S 9 tit, e S N'V\ ct �Ls Jed by P exYl � av1� 1lav\ P f � C_ m c c C/)-� �fn I W mm0 �cnFn ow m I Dom <c Om x G) w o H ZW n�m �! tii ,,�•�.,,,.wa:.. 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C O tO tj E d E t +r iO L '+o cSf ow A � CL O a) 0 () LL > w I rte: Quick Block 3 Lot 2 N/A N/A N/A > Property is served by public sewer. Benjamin Schiller, P.E. N/A N/A N/A N/A Property is served by public sewer. (907) 522-7773 LLJ V) X Q) CJ 4-J co :� 4- 0 0 Ul) CL 0 > CY) L -r)4 0 V) 0 > 0 L- < Ln E vii+J V) (1) 4-J 0 0 4-J �t 4-J &- C) u 0 ro 0 0 (.nC: .5 3 cn z -0 c) J_- .,A < LLJ >- U < 0 4� w 0 " CL -Fu 4-1 E C: 0 > 4--J (A >, Ln I- Q) 4--J M to , u o 4- 0 -J U 15; — — W 4� C: +j U Q) V) -0 L- c: -J LO < a - LU C� ro 0 4� 4-j u -0 =-0 V) +, 0 V) CL s > 0 _0 (L) C w N L- Q) -C U c m C: 0 4-J E 0 4--J Z7i0u 0 7, 0 L- M m .N EC: 0 C: . 0 E L- 0 4- s . Ul) W > E 0 M mQ) lzT ro 4-J 0 L 0 E > V) E 0 4-1 -j 4Ln 4--J 4-- u u Q) 4� V) 0 u u 4-J m (1) -0 4-J Ln 0 > .0 CL(1) 41 WrU V) LIJ ce- V) UJ a V) 0 by ui 0 LU >ui 0 0 V) X Q) CJ 4-J co :� 4- 0 Q) Ul) CL 0 > CY) L -r)4 0 V) 0 > 0 L- < Ln E vii+J V) (1) 4-J 0 0 4-J �t 4-J &- C) u 0 ro 0 0 (.nC: .5 3 cn Q) 0- Ln E o O L- E 0 cu L -o 4-J (v u C: u u Ln mu c -0 w -Fa w > w E M V) ca 4-jcB+, -0 c) J_- .,A < LLJ >- U < 0 4� w 0 " CL -Fu 4-1 E C: 0 > 4--J (A >, Ln I- Q) 4--J M to , u o 4- 0 -J U 15; — — W 4� C: +j U Q) V) -0 L- c: -J LO < a - LU C� ro 0 4� 4-j u -0 =-0 V) +, 0 V) CL s > 0 _0 (L) C w N L- Q) -C U c m C: 0 4-J E 0 4--J Z7i0u 0 7, 0 L- M m .N EC: 0 C: . 0 E L- 0 4- s . Ul) W > E 0 M mQ) lzT ro 4-J 0 L 0 E > V) E 0 4-1 -j 4Ln 4--J 4-- u u Q) 4� V) 0 u u 4-J m (1) -0 4-J Ln 0 > LOT 6A N 00020'12" W 68.00' 5' UTILITY EASEMENT UTILITY POLE 10' WATER, TELE. & ELEC EASEMENT - — — — — — —7----- ,V, UTILITY PEDESTAL LOT 2 13,054 sq. ft. m � x Z GO (0 WELL l W LOT 3 -P, Ul N DECK m 19.8' 36.0' 77 2 -STORY 00 FRAME Do HOUSE 8.0' 77_78 28.0' 12.1' p ASPHALT `D DRIVEWAY S 00022'15" E 68.00' 0 Co 0 Co 00 co w U1 N m 01 REBAR LOT 1 — — — — DIVISION STREET — — — — — — �� OF �q �)i /i * 49TH * i ............... ............., NOTE 03/11/24 DRIVEWAY LOCATION IS B u Saliz 0 - APPROXIMATE DUE TO // �s LS -14837 SNOW AND ICE COVER. 5J�_ rrrf'�p%0��� �Io� A�0`` 0 15' 30' EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED SUBDIVISION PLAT (2018-81) ARE NOT SHOWN HEREON. THIS DOCUMENT DOES NOT CONSTITUTE A BOUNDARY SURVEY AND IS SUBJECT TO ANY INACCURACIES THATA SUBSEQUENT BOUNDARY SURVEY MAY DISCLOSE. UNDER NO CIRCUMSTANCES SHOULD ANY OF THE DATA HEREON BE USED FOR CONSTRUCTION OF FENCES, IMPROVEMENTS, OR FOR AS -BUILT I HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY: LOT 2, BLOCK 3, QUICK SUBDIVISION ANCHORAGE RECORDING DISTRICT, ALASKAAND THAT THE IMPROVEMENTSAS DEPICTED HEREON EXISTAS SHOWN IN RELATION TO THE PROPERTY LINES. DATED THIS 7th DAY OF MARCH, 2024, ATANCHORAGE, ALASKA. ESTABLISHING PROPERTY BOUNDARIES. FIXED HEIGHT LLC HEIGHT, C.O. A. 122554 Land Surveying Services 907.290.8949 JOB # 23028 1 NO CORNERS SET THIS DATE I SCALE 1" = 30' 225 W 23rd Ave., Anchorage, AK 99503 WWW. FIXEDHEIGHTCOM