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Mm-licipwW of
Department of Health and Human Services
825 "L" Street
Rick Mystrom, P.O. Box 196650 Anchorage, Alaska 99519-6650
Mayor
343-4744
October 23, 1996
Dennis Murphy
PO Box 214
Girdwood, Alaska 99587 0214
Subject: U.S. Survery #3042 Lot 75A
Permit #SW950349, PID #075-132=76
The subject permit, issued October 18, 1995 by this office for a
single family well and/or on -site wastewater system, has
expired as of October 18, 1996.
A new permit must be obtained from this office for a well
and/or on -site wastewater system NOT installed by the
expiration date.
If you have drilled the well, a well log must be sent to
this office for documentation of the installation and to
close the permit.
If a licensed Professional Engineer has inspected the
installation of the on -site wastewater system, the original
as -built inspection report must be sent to this office for
review, approval and documentation. All inspection reports
must be submitted within 30 days of construction completion.
When applying for a new permit, the fees are: $320.00 for an
on -site wastewater permit; $120.00 for a well permit and
$440.00 for a combined on -site wastewater and well permit.
If you have any questions, please call this office at 343-4744.
Siric rely,
i r
Ja esI Cross, P.
P gram Manager
On -site Services
enc: Copy of Permit
AA C°Py
PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON -SITE WELL SYSTEM PERMIT
PERMIT NUMBER:SW950349 DATE ISSUED:10/18/95
DESIGN ENGINEER: EXPIRATION DATE:10/18/96
OWNER NAME:MURPHY DENNIS H
OWNER ADDRESS:P.O. BOX 214
GIRDWOOD, AK. 99587
PARCEL ID:07513276
LEGAL DESCRIPTION:
US SURVEY 3042 LT 75A
LOT SIZE: 14702 (SQ. FT.)
NUMBER OF BEDROOMS: 2 THIS PERMIT: 2
THIS PERMIT IS FOR THE CONSTRUCTION OF:
WELL' SYSTEM
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 DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT)
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
RECEIVED B
ISSUED BY:
DATE:
DATE: 8
0)
^Q
i `
LOCATION OF WELL (preaaa cvmplala alther 10, Ib
Iq. Borough Subdiriaion Lot Block Ql r
Ib. /'t a.
- I
It. DISTANCE AND DIRECTION FP()M RQAD INTERSECTIONS
$treat Addracc and Argo Of Wall Loeatian
2 w-
WATER WELL RECQRD
$TATE OF ALASkA
DEPARTMENT OF NATUPAL RESOURES
DIVlcipn Of 15ci logirul a GC(3phYSiCGl .rurvoya
0rlllinq Permit No,
A. 0, L. No,
Section No, ;3hipNO Ronge' EO Marldlan
s❑ wd
OF WELL:
Addrara; /F �1t t r' J
1 G� >�( c
cLL LOG �1 � ) k \ � L I Feel 8olDv
l__;_a cJL_J surface 4 WELL DCRTH: (final) $. DATE OF COMPLETION
M gfarial Type _
Top PDfftm ft' _
FlCable tool R to Y ,_
10
-�— ------.-...—Municipal ity of Anohora
—_ —Dept Health & Human Ser-t
IG WATE
0 ry ❑ Onvan Q bug
❑ Auger ❑ Jpffed gored ❑ Other:
7. USE: O Damoelle ❑ public Supply Jrtduefry
d� t 0, Irrigation (D Rechar v
g ❑ Commerical
❑ Tott Well ❑ Olher:
A. CASING: 0 Throaded ❑ Welded
fo if. OePlh Wal ht
g — lhc,� tf.
_:r. fo
_— ----- ----- ff. D*Pth
-- � -- Slitkup if.
FINISH 0P WELL:
- Typv. Dlgmafert�T
Slot,fdech Slzo: _ I angih ;
— —_. +et bofrvotn (t. qnd if
—_ Bachfilling �_ Gravgl p0tk
10. STATIC WATER LEVEL: � _ (1, /
Abeva or D 8elaw land nurfoce Dole
Equipmvnf utod:
11 . PUMPING LEVEL balow IgnC :urfgco and YIELD
l ft. gflar _ firs. pumping" g. p. M.
ft. offor nhro. pumping g,p.m.
t2.GROUYING Walt Growled: Yea a 4Jo
Mato rlif Q Neat Courant bthor:
13. PUMP: (if avallablo) HP
Longth of Drop Pip*
O.P.M.
D r
Subm. Jot � Cgnlriligql � Other
14.?EMARKS:
v
R WELL CONTR4CTC:RCS CENTIFICATION! II r
15. Water Temparalura
7h11 wkli ':rna tlri flya undgr m r
Y 1'Jr i;df<.lion Ond this rtporl i.. true th ih,c bp3t of my knowledge On=` balinf,
e $0?�
Rogfef qtt Bu:inarcJ Names
Contract LiCun.a 44um11e1
1. At, {h Drf� A r,J .t h!nli�n Date: C, ( 4
1
❑ F ❑ C