HomeMy WebLinkAboutT14N R2W SEC 11 LT 54 N 150'' MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ‘1/4-4, ENVIRONMENTAL ENGINEERING DIVISION \825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 KV ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME y/�� / PHONE. j✓/ t% /A%s i Ba. wm2/ NEW k'LPGRADE MAILING ADDRESS 6• £o -13t, Ak, I` .7"7j C -1144 G.71 LEGAL DESCRIPTION (.nT sq Se c. I I Tip/,'! PraUJ LOCATION Mile_ /9 rQ,t1 �uay i e iakeas/ NO. OF pEpROOMS ,T /3 eery) SEPTIC TANK DISTANCE TO: Well ! k1077Ls e' ! Absorption area /.5- / welling / 10 PERMIT NO. ,C lq�✓LiaG Manufacturer Mate ' I �,uerat, No. of compartments ottiI Liq. capacity in gallons IF HOM MADE: Inside length Width Liquid depth a J(7Z o z < 2 I- DISTANCE TO: Well Dwelling PERMIT NO. Manufacturer Material Liquid capacity in gallons TILE DRAINFIELD TRENCH DISTANCE TO: Well/t� / Foundation ao_30 Nearest lot lint' PERMIT NO.ne 306 No. of lines Length of chi Ione Total IP ' f lines �iJJCC ! Trericf i-,djh t d inches Distance betvvivb�a� /tA Top of tile to finish grade t 3 Material beneath tile �y (!? lP inches Total effect, bsorption area /C/Q 1 SEEPAGE I PIT Length Width Depth PERMIT NO. Type of crib Crib diameter Crib depth Total effective absorption area DISTANCE TO: Well Building foundation Nearest lot line J J w Class Depth Driller Distance to lot line PERMIT NO. DISTANCE TO: Building foundation Sewer line Septic tank Absorption creels) OTHER .It CC - PIP MATERIAL / MSrm 3°3�l /2Yc - �-s' Y SOIL TEST RATING iqo I INSTALLERn111 �A l 7— �s LJ�(}Et' .j ,0 REMARKS a I% i�� i (Ng (DeLL n ` ee POT z idd. et ii ''°i_ ._ q 77 ne c9,r ra_}.4 G . liiiiIn: a _04-r stispai-a, 01-)1 A`mCI to W vt ( 1-4 APPROVE DATE LEGAL % k teJ1 &/2 PM 72-dt (Rev. 3/78) k MVr4 I C`- I IPFIL. I TY OF= FINC.=HoFcnec DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 'L' STREET: ANCHORAGE: AK. 99501 / c' 264-4720 or -4-s I TE sE WEEP_ tiP.ICxf$AC>E F"EF Pi I T PERMIT NO. •.( 790306 ) ��J din �/ QC$H ISYI S 1JY1 / lY l.l_( fl )L n V. APPLICANT BILL YATES P.0 BOX 243 CHUGIAK RK. 99567 688 9663" LOCATION MILE 14 GLEN HWYIE.R. BAKERY LEGAL L 54 SEC 11 T 14 1 R ltd 5. M. LOT SIZE 33750 SQUARE FEET gitt 9/ a6 79 chic/ TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS - 2 SOIL RATING (SQ FT/BR}= 146 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM I5: CaEP'TH = E3 L.EF'-U3TH= 'flt2 OF fl VEL. DEPTH= f5 THE LENGTH DIMENSION IS THE LENGTH CIN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION CIN FEET). THERE IS HO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH I5 THE MINIPiJM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION CIN FEET). PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS NUMBER. OF RESIDENCES THAT THE WELL WILL SERVE. TLIO <2> I r-1SP'EC: T i oNs flF E f=zEQILI I E EC> BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. DEPARTMENT DURING THE PROPERTY AND THE MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL; OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. P•Etv'm I T E {F" i FBEPI Er. EF? :1 . I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE , RESIDENCE co -e. RE�IO¢ELED TO IPcC UD ec; THANs-C) BEDRQOPIS. -�Q,� . ttWU�R ,t � co "� � � ri `i -•',u °t�.:^- e� J 'tom be (,� • �a SIGNED:_ APPLICANT BILL YATES ISSUED BY (;: 11/4142-.:1)"'“1 CXY\ ' vvv0-6QA3-1" Od" GCC `' c> DATE_'{ 1JA___ V3• SuN%•c- vim:% '. "' ` , �vfl� I ck0 a‘tis- -L\ 2Jjc4L a • &2, »os' Staven A. Johnson 13.0. Box 76 Chugiak, AK 99567 Phone: 907-688-3085 SOILS LOG — PERCOLATION TEST PERFORMED FOR: I )e. ena f.,, s ( f re -Vs � ` 9cL LEGAL DESCRIPTION: / ^v © n Lt®'#. C y SLOPE by,wy s 4i or- col) L(stw.,> s;11-, 1066c l V .,LS+ `.2,00‘11"/111(.1 atwit rtiti-rk st.flt caft.L-eI COP), lodSC ('fl ivte` JVh Ae,..vvvCid4 ,0041. ) ifhn �C-A 4, VUL•>V� Sh Vl``:1 grc.L,e-1 C&? P) M e tl i d t-.4 e^As f. / tine. 4. . J / ()ILL, 1 �,.� icr- o i WAS GROUND WATER ENCOUNTERED? � 0 P E COMMENTS N SOILS LOG o PERCOLATION TEST DATE PERFORMED: (14(y/ ) of f C N r IF YES, AT WHAT DEPTH? I (/ f Si LI ITE PLA 12 io son H O sc,✓►LL= ftt FA Illi` e Rea •' • • Date Gross Time Net Time Depth to Water Net • e • cis I- rear v IL c u:<.„ oyI (ft /n tit C, J 't n rrt' -:atm c r. T11. J� r P P lc Ii H O sc,✓►LL= ftt FA Illi` e Rea •' • • Date Gross Time Net Time Depth to Water Net • e • PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND FT it ME12f�O hA&OQPrrn l kR& I IE -Qu RI) E-A wi `OGS = 1,3c4i1/in r c PERFORMED BY: c4 coo, v,Sen" CERTIFIED BY: %�,� A /^U,...,—... DATE: (e I /61 ) 1 q in 1) MUNICIPALITY OF ANCHORAGE PROTECTION - " `-' ' 3 FACILITIES' 1 DEPARTMENT OF HEALTH & ENVIRONMENTAL • 825 L Street - Anchorage, Alaska 99501 I. (1ENVIRONMENTAL ENGINEERING DIVISION Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days fo processing. 1. PROPERTY OWNER -7—/' /� / r70MR S 1J 24 PnJ O MULTIPLE FAMILY • Three I• Six PHONE 699 -am r MAILING ADDRESS R 6 SD //25— `�l- ,3 . re"— '4( `/`9-57 PROPERTY RESIDENT (If different from above) //McA4/ i3eatt L1/7p Li ,u INDIVIDUAL/ON-SITE** If system is over two (2) years old an adequacy test is required PHONE X70 26o/ 2. ---Bt €W .4g -Ar -e --f - 414S%4 /?4f -e J/4' <.NC. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. PHONE MAIL GDDRESS .-- AN© %3'�/ 21; 9, Z e ,f� t P3 /, , 22572 3. LENDING INSTITUTION (/ PHONE MAILING ADDRESS Qn va�1!y K 1 ce 4. REALTOR/AGENTPHONE 1 1 riNfT w a r J CAS MAILING ADDRESS - Zli o 13A ke 5. LEGAL DESCRIPTION t ' 1/1 &10) o/ COi'/0/y',jy fec/7O•s €ei✓ 6// 77/9c) !e -s7 A / STREET LOCATION fil / t /3 Xz c2<] C/e,w /? 6. TYPE OF RESIDENCE NUMBE F BEDROOMS Co Fi,c't.e`te e4 C- • One ■ Four OtheL y4..Q . ■ SINGLE FAMILY /31_ , t;u3- O Two MI Five O MULTIPLE FAMILY • Three I• Six 7. WATER SUPPLY IS. INDIVIDUAL*' *ATTACH WELL LOG. A well log is required for all wells drilled O COMMUNITY since June 1975. For wells drilled prior to that date, give well • PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM **If individual/on-site, give installation date INDIVIDUAL/ON-SITE** If system is over two (2) years old an adequacy test is required • PUBLIC UTILITY by Department. this NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) A/��D5 drp5et•5,A VQy LSTA ) z/c /���L HIS SIDE FOR OFFICIAL USE ONL INSPECTION APPOINTMENTS DATE RECEIVED TIME 9 . , torn TIME I:e3n PM TIME I:SO Pin DATE -9 L. DATE 6 -II -7R (i h.. . - DATE .6-I-78 a../.. INSPECTOR �� y INSPECTO PPC(4 INSPECTOR car&b„' DIRECTIONS: 1. TYPE OF RESIDENCE O SINGLE FAMILY E MULTIPLE FAMILY NUMBER OF BEDROOMS O ONE IN THREE IN FIVE ■ OTHER O FOUR • TWO ■ SIX 2. WATER SUPPLY El INDIVIDUAL PERMIT NUMBER DEPTH OF WELL • COMMUNITY DATE DRILLED • PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM • INDIVIDUAL/ON -SITE PERMIT NUMBER DATE INSTALLED ❑PUBLIC UTILITY Connection Verified INSTALLER • Septic Tank or • Holding Tank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS I �T / , I -SI 'i?a 0 z "Y, /02_ ^ L /%c) z. C 7( S • APPROVE�FOR ,' �p BEDROOMS A • CONDITIONAL APPROVAL(lettermust accompany certificate) O DISAPPROVED DATE BY (Title) a 246 LEGAL DESCRIPTION 72-010 (Rev. 3/78) ? rMUNICIPALI`l`Y OF ANCHORAc. DEPARTM_ OF HEALTH AND ENVIRONMEI ), PROTECTION 825 L Street,'Anchoraae. Alaska 99501 264-4720 #1: Time 7/ f,(0, Date 2,/2,Q/7$- Insp ?e»T% Date Received: 2/x//281 #2: Time #3: Time Date Date Insp Insp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES �,?f//� 4/ -lan G,cS/-;Zz1`f 1. r a 'nerlia- r itu_tion. Request:. / v0 C5A/ Jl /HGF. i Max-Ying Address: 1* j4o-n-s-- Ao. 333- o SK -s-6 Phone: 2. Property Owner: Mailing Address: 3. Legal Description: A/a ,&0.cdD OG S YS/t"dl 4: Si.,le Family Residence: ( ) Number of Bedrooms: Multiple Fam'tily`•esidence: ( ) Number oms• Post/ale 4-1-'i 6 cG4 or,es ,� t 'A5# ��tt 5. Well System: Individual well ( ) Counity/Public System ( ) Permit # Construction Depth of Well Well Log on File ( ) Bacterial Analysis 6. Sewage Disposal System: On-site System ( ) Public Utility Permit # Installed Installer Septic Tank Size Manufacturer Absorption Area Soils Rate Material 7. Distances: Well to Septic Tank to Absorption Area to Sewer Line to Nearest Lot Line Nearest Lot line Absorption Area ca.$ 7484.f/ /roar 0,c f�� P p;7vrets l9cce#7:464;