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HomeMy WebLinkAboutFYFE BLK 1 LTS 5 & 6�i . POST IN A CONS ------- P'CUOUS SPLACE -:�"'TR CONNECTION APPLI CATION & P FAIT GREATER ANCHORAGE AREA BOROUGH 7686 500 TUDOR ROAD ANCHORAGE LOT sue--- ALASKA,99s07 L S. 97A CONN' GRID ON STRE ET ADDRC LOT -SS f-ke —Z -sd, BLOCK • PROPERTY U WNE RENAME - - ".... PROPERTY OV RES. APT. NO. UNITS CONNECT TO TRUNK SIZE YES Cl No CONrjECT Oj OCATION C-4a"Ic. ER"C' STATUS K SE7"��%; LA _?� CON� rt lM_ A 'GEN43-Y PAYER NAME PAYER ADDRa_9S c -ry----- ........ ...... -AS SMT- <zlt CONNECT^vnitlR F. 1,TeTAT. YES No 0 CO AMOUNT PATD' rd I <".cp t ACCT. NO. BILLING -ATE- rim W�= L � _s' - hey:_(_ )ATE,_- r- 4. 73 31T DATE [)EpOS,_j MO- DAY YR. 14011,1 174 /J A L )BEFIrr OF MiNIVEMONIHNINTAL CONSERVATION, - April 27, 1972 WILLIAM A. EGAN, GOVERNOR � ROOM 222 - I -AC .KAY BLDG. 338'DENALI STREET ROOM 99501 Mr. Henry Howe, Civil Engineer Greater Anchorage Aiea Borough `Public Works Department 3500 Tudor Road Anchorage, Alaska 99507 Subject: FYFE SUBDIVISION - LID N0. 39 Dear Mr. Howe: The plans and specifications for the subject project are approved for those features with which this Department is concerned. Yours truly, Kyle J. Cherry Regional Environmental Engineer KJC/mw cc: GAAB-DEQ '- RECEIVED' GREATER ANCHORAGE AREA BOROUGH FEPT. OF ENVIRONMENTAL QUALITY MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON -SITE SEWER AND WATER FACILITY 264-4720 Application Date 5 A (� /8G 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) r- � C c S 3 I, -2-1 ► 3? Location (address or directions) ,'5-8 ,9 �0 Gc 1 (b) Applicant Name k Sa G. < s Telephone: Home 5 5 C `Et3 Business Applicant Address (c) Applicant is (check ewe , Lending Institution *9; Owner/builder; Buyer ❑ ; Other ❑ (explain); (d) Lending Institution - /Y T3 i le u -U L E O0..r Telephone 26 51 2 88 3 Address So x -2c12- S A, I-, D 9.5 I C (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: L c�- U r c'_ — �% e a� s e C_ ) I P<�',, )_ 4 -3 2. TYPE OF RESIDENCE Single -Family o Multi -Family ❑ Other Number of Bedrooms 3. WATER SUPPLY Individual WellET--Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Onsite ❑ Public C Community ❑ Holding Tank ❑ Note: If community/well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11/84) 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that rry investigation of this Health Authority Approval shows that the on -site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on -site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm M%fa i. -), , eti'vi e. — L- - ✓­ Telephone 734--4- *-7 1 / Address z C S h�i�-' y�c 9 SI R Date WATER WELL NOTE: This Health Authority Approval inspection merely certifies that the subject water well produced 150 gallons per bedroom per day and that certified laboratory tests showed no presence of coliform bacteria in a sample of that water. No warantee or certification is expressed or implied concerning the long term adequacy or safety of the water supply. -SITE SEWAGE DISPOSAL SYSTEM NOTE: This Health Authority Ap e inspec erely certifies that the subject on -site se disposal system accepted ast 150 gallons of water bedroom per day as determined by methods ed by unicipality of Anchorage Department of Health and an vices. No warantee or certification is ex ed or implied conce the long term adequacy of on -site sewage disposal system. Cons • n data repo on buried system components is from MOA files and w not verified during this inspection. • A +(a ° .a A w•ci`Soo +�c eoccc.e naoe..S ..... y NC'RINE'I'L HAVYTHO a f-. ' a LE - 4369 Y: A "^r "� 6. DHEP APPROVA �� Approved for _ bedrooms by✓1 �� �- �,c, .r a{e `� c'X Approved Disapprove d�� Conditional Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 r. 7 C MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE (MOA) DEPT. OF HEALTH & HEALTH AUTHORITY APPROVAL (HAA) ENVIRGNMENTAL PROTECTION, CHECKLIST - FEBRUARY 1984 264-4720 LG1 Le _S T� '3 K RLegalDescription: DFv �f- ne .3 1 1 lU F3 i.J A. WELL DATA Well Classification icz 5 If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) N Date Completed UI I- naCAJ)l Yield Total Depth 51' 4- Cased to Depth of Grouting Static Water Level ry 48� Pump Set At SG� Casing Height Above Ground rc r f4 - Sanitary Seal on Casing (Y/N) y Electrical Wiring in Conduit (Y/N) % Depression Around Wellhead (Y/N) Separation Distances from Well: q To Septic/Holding Tank on Lot On Adjoining Lots AJ1A To Nearest Edge of Absorption Field on Lot - ; On Adjoining Lots Al � To Nearest Public Sewer Line 5'0To Nearest Public Sewer Cleanout/Manhole roo To Nearest Sewer Service Line on Lot 'PC) rf Water Sample Collected by ; Date .5- Water Sample Test Results 5 Comments Abut2% LL 1 4afc B. SEPTIC/HOLDING TANK DATA ate Installed Size 4�1 I l Ede i 1, ; s �`�, s tee- a v, Standpipes (Y/N) Air -tight Caps (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High -Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water -Supply Well To Property Line To Water Main/Service Line Course No. of Compartments Foundation Cleanout (Y/N) Date Last Pumped ;for Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Comments MUN►OPAL ry nF ANF� DEPT. OF HEALTH & MAY !G19-N. Page 1 of 2 U RECEIVED 67/_ 72-026(11/84) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" Street, Anchorage, Alaska 99503 — zT-`61 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: ZPIX�QY VA FHA CONV 2. Property Owner: Tl'S 11Z--2.,��=-le Mailing Address: _ �� Sf y ��/,cJ �Gf��E Day Phone 4 3. Name of Buyer: nLosfc 10,E Mailing Address: 5364 410 Day Phone <33 % -r SS �-3 4. Name of Lending Institution: 2'&ael1"/e—? Mailing Address: /D!/ ,f�Di¢6 Phone 5. Name of Realtor or Agent: _ LI) P t ST�TEz�'WWAJ i Mailing Address: d ,We,(2 Phone _2 1-26, a 6. Legal Description: 4A'/ a�= vG_%A;Fb Locat io n : P- 6 601 / /AV d � �� C ! Gt> A/ OR 5 t=1.ti /9 H/ GJ A y 7 7 7. Type of Facility to be inspected: No. Bdrms. 8. Water Supply Type of Supply: Public Utility Individual If Individual, number of dwellings presently seined / If Individual, depth of well 9. Sewage Disposal System Type of System: Public Utility Individual (on -site) If Individual, date of installation E Q-037 (1 /74) Page" Two Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description• Lot 5 and 6 Block 1 Fyfee Subdivision Comments: Affadavit Attached: ( ) Letter Attached: ( ) Approved: Date: Disapproved: Date: Department Worksheet: Complainant REPORT OF ACTION TAKEN Investigator: /V Date Investigated: A c t i o n T a k e n -/o f)?,t . /2Ci.P �1 �,�x .y�'., ;, `�,c�" you ew Vm,,0 4 1{ /.,a �)t-aC (�1' �%/ ('l� lJ/�1 i1 cu�2 i JJGI //iLC �� //.A' !�Z Lf�C�CJ • /^K GL�Ci/✓ e /iDAn �f h� t-o � Gll"k>�,� v-e .�/Y� �Gc�toc .��c �r�c�% � I�LI�J • l LL �� �s�l2dYtz �/Lt�-e:c/,. % % /V Y'�J .� I�'if-!'D/lir/ i !itn /'U%t � )/, i .nri , .,/ �_ .. �n s J..� � _ _ _ n vii�f - �L' o //Jil-„l•i? �ii�,. %%,-,13 /) ea-L&d _ S 9 G iO ©LLPOi G�LL'i 1?) -K 71,60-'K 1117a,4 �..� f d �� .fie •-%�� �7 � >'�%. / /��_ i'�.f'1' t.C.f/Yt 1013l l/ a42 Ad- Scud r-1 e W h 6t.-Lie,, —in DATE COMPLAINANT WAS CALLED REGARDING DISPOSITION OF COMPLAINT: GREATER ANCHORAGE AREA 'BOROUGH Department of Environmental Quality 3500 Tudor Road, .Anchorage, Alaska 99507 279-8696 Date Received Time of Inspection Date of Insnection 7 REQUEST FOR APGROVAL OF 1INDIVIDUAL SELNER & INATER FACILITIES �i.Ct f .•� il'`-ISIZiC ��-tll���Gi j FOR 1. Aoproval Requested 9: Address: ,%"� % ( Phone: 2 nrooerty Owner: , `�=—t'4J'�C.�7 Phone = _ _ 3. Legal Description: 4. Location: 5� Tvpe of Facility to be Inspected: - ---_— -- ` Number of - Bedrooms: = 5. Well Data: A. Type ��c� c �f .;�t -mac B. Depth_ C. Construction F;;L,«�c«_."sic Bacterial Analysis��z�;�� 7. Sewage Disposal Svstemc ,, . .'c i c ; ! - A. Installed B, installer C. Septic Tank: D. Seap-ade- Pit: 1.. Size A 2. Manufacturer 1. Size 2. Material E. Disposal Field: Total Length of Lines 9. Distances: A. Well To: Septic Tank, Absorption Area Sewer Lines Nearest: Lot Line Other Contamination B. Foundation to Septic Tank '; Absorption Area C. Absorption Area to Nearest Lot Line Requc=' t fcr Annroval of .>...tivi(1_el Sewer & 'water Faciliti Paya Two 9. Comments: Annroved Disannrovedc .,_.�1L.,/_ c_L-�'��te %— 3 - J% APnrova] Valid for One Year From Date Sioned Greater Anchorage Area Borough, Department of Environmental Quality DTAGRAM OF SYSTEM. 1 certiry tnat the intormation contained in this request for approval to be a true and accurate representat;on of the subject sewer and water facilities located at: Signed Date r;i ,1,TE i u Ci'9 �Iff ,'1 ) ,0UGI j, JEPARITiENT OF L`!VIROFif�lEi-)TAL U UALITY 30 TUDOR KOAD AXHORAGE, ALAsm 9.9507 271,d3rorr JATE ECEIVED: If!SPECT: TIME: RErUEST FOR APPROVAL OF INDIVIDUAL SEl'!ER APM I!ATER FACILITIES FOR APPROVAL REQUESTED LY -- _Kass���ju ADDRESS:--6QAZja.s_.t�t11_.r�nu� An hor-taPAla�l�a Q�snl PROPERTY 0! r, !CR : PF(Oi•dE 1--344- 91 ?9 j, LEGAL DESCRIPTIOii: T.nts__S_and_h Rlnr-k T Pv-F,� 4. TYPE FACILITY TO DE IilSPECTED:, �rrnnm-1 f i-iTSTREET: i1U UER OF MR0Of1S:_.3Badmoms- 5- iiLLL :DATA: TYPE B, DEPTT i C. SIZE_ _ D. Cffl'STRUCTIOf! E. DACTERIAL AiXYSI G, SMAGE DISPOSAL SYSTEM: A. SEPTIC TA',K (IF HOf IlcfirDl E. Sf-10" DIAGRf;(,i OIN LACK} 1, "I'- Z, AGE = _ — 3, flV,;,IUFACTURER 4, I++STALLER Ar . ROVAL R,7"J`77 rC?n S~'�R "�1�'`R F"CILITI ^ T r TT 2. C. ,DISPOSAL FIELD l o .:U( L'�-;: OF U .L- 2. TOTAL LENGTH 7, ;CzQUIRED .EASUREMENTS ."LL TO &'=,urIC TA;.'I B,' "wLL TO SEEPAGE PIT C. !'ELL TO S,'7 !EP LI 'E WELL TO PROPERTY E. '-'rLL TO OT.':ER ^O,S^I";L" CO':TPJJI''ATIO!", F. FOUMATIO c TO SEPTIC TAi•ffC FOUP-DATION' TO SEEPAGE PIT Ie SEEPAGE PIT TO PROPERTY LINE rr APPRON11); J, I. ."l, vl--I-,- r4l, Df rl GREATER MWORAC E AREA BOROUGH DEPARTMENT OF Ei NIROt-VEP4TAL QUALITY m- 77! C. f ST KASSLER/WEST MORTGAGE CORPORATION 604 EAST SIXTH AVENUE oANCHORAGE, ALASKA 995010212-9501 GREATER ANCHORAGE AREA BOROUGH Dept. of Environmental Health Pouch 6-650 Anchorage, Alaska 99502 DA,ri : November 8, 1971 RE: JOLLEY, Lester T. Legal-: Lots 5 $ 6, Block I F fe Subdivision T)=-) VA) Case Gentlemen: Per the attached :Form, we hereby request 'inspection for Health Authority Approval. Please send your findings to either the F1IA offices or the VA Office as noted above for the "Case Number" Also, please send an exact copy of the report to our office. Your swiftness in expediting this request would be most appreciated. Sincerely, KASSLER /WEST MORTGAGE CG)W. 110011. 1'1"0cess1ng, ue11 T—ment P.S. I f you wish to lna.l:c Ln ahl,n. ntnlcii t- he l oi-c inspec L.i.on, pleease call I ,ECEIVE7 1 Nov 9 GD PT.OF ENVIRONMENTAL QU 61TYH