The URL can be used to link to this page

Home My WebLink AboutSCHROEDER LT 23>�.�,roed� S�� oo v - :3 MUNICIPALITY OF ANCHORAGE _—_`_ "® DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION �I ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 2644720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL. INSPECTION REPORT NAME PHONE EW ---bC�� / yC ❑ UPGRADE MAILING ADDRESS ._� 9 LEGAL DESCRIPTION LOCATION NO. OF BEDROOMS � DISTANCE TO: Well C '� Absorption areas �'� Dwelling _ l �� - PERMIT NO. 7 G !^moi Y h Z °ui I_— _ Manufacturer Mat riaL, �- No. of compartments Liq. Cap city i alions fij� IF HOMEMADE: Inside len th N1 dth Liquid depth OODISTANCE 0Z TO: Well Dwelling PERMIT NO. z Q T F- Manufacturer Material Liquid capacity in gallons wx ® DISTANCE TO:J�,l[' Well _ Foundation Nearest lot lige PERMIT N�'p/ LL Z .22 No. of lines n lc''/ Length of ea line Total lenwth of lines r Trench width s(e inches Distance between li es /� CZ -- ---- Q H /aches 8 Top of tile to finish grade .^- — ) Material beneath tile/J Total effective absorption area `A Length �t Width Depth -- PERMIT NO. C9 AF- Lu A Type of crib Crib diameter Crib depth Total effective absorption area Lu w DISTANCE TO: Well Building foundation Nearest lot line Clans o ' _ Depth Driller Distance to lot line _ PERMIT NO. 1° DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) T OTHER LEGALYLI PIPE MATERIALS v3 YL- S IL TESTRFlTING cam- INSTALLER GL Ix k C" Lc'- t — REMARKS Im, I l�l APPROVED DATE l_ (7 J: [f:: l 11__ : II.-. , P, V17 oil 141 Q 0 -11 P DEPRRTMENT O� HEHLTH RND ENVIRUNMENTHL Px�TECTION ' 825 'L' STREET/ HNCHORAGE/ HK. 264 4720 PERMIT NO0660 ) :PPLICHNT 61YNE COUSINEHU PO BOX 76] ER .00HTlON MHRCUS RD .EGHL L2] SCHROEDER S/D LOT SIZE [YPE OF SOIL HBSORBTION SYSTEM IS: TRENCH 12000 SQU8RE T &( Lot to. / AM 1HXlMUM NUMBER OF BEDROOMS = ] SOIL. FORT ING (SQ FT/BR)� 100 `----- [HE REQUIRED SIZE OF THE SOIL RBSORPTIUN SYSTEM IS� F::� 11 :1_ ��11 11-0 � F?. H ...... V-_": Fi�::" - 11" F-F= � THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DR8INFIELK THE DEPTH OF R TRENCH OR PIT DISTHNCE BETWEEN THE SURFHCE OF THE GROUND HND THE BOTTOM OF THE EXCHVRTICIN (IN FEET) THERE IS NO SET WIDTH FOR TRENCHES THE GRHVEL DEPTH IS THE MINIMUM DEPTH OF GR8VEL BETWEEN THE OUTFHLL PIPE FINE:' THE BOTTOM OF THE EXCHVHTION (IN FEET) �:11". �V *f: If IF_:: A: F`�_'�_ U~U: �:_11 Ii". .11� "EMIT HPPLICHNT HHS THE RESPONSIBILITY TO INFORM THIS DEPHRTMENT DURING THE [NSTHLLHT10N INSPT-CTIONS OF HNY WEI T TO THIS PROPERTY RND THE UMBER OF RESIDENCES THRT THE WELL WILL SERVE. �1,� �� P_:-11 �HCKFILLING OF 171 Y SYSTEM WITHOUT FINHL INSPECTION RND RPPROVHL BY THIS )EPHRTMENT WILL BE SUBJECT TO PROSECUTION 1I14IMUM I)ISTHNCE BETWEEN 8 WELL HND HNY ON-SITE SEWHGE DISPOSRL SYSTEM IS L00 FEET FOR H PRIVHITE WELL/ OR i50 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL ]TMER REQUIREMENTS MAY HPPLK SPECIFICAT IONS 0ND CONSTRUCTION DIHGRHMS RRE lVRILHBLE TO INSURE PROPER INSTOLLHTION. im EvE w IF -P x ir FIE X 111" 1: IT: ER ��11"I F-_�: �_14_.... [ CERTIFY THHT LI HM FHMILIHR WITH THE REQUIREMENTS FOR ON-SITE SEWERS 8ND WELLS AS SET � ORTH BY THE MUNICIPHLITY OF ANCHORRGE 2 I WILL INSTHLL THE SYSTEM IN RCCORDHNC� WITH THE CO0ES 7� I UNDERST8N1.) THVIT MAY REQUI;�!E ENLHRGEMENT IF THE ��SIDENCE IS REMOD�L�D TO I�CLUDE MOR� T��N ] BEDROOMS - �IGNEY HPPLICHNT WH;NE COUSINEHU a 0 Ef E (CEO ECHNI CAL Et- ®EVEL,- PMENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster Earl Ellis 694-2774 SOIL LOG 6BB-2200 Soils Et Foundations Land Development Performed for: Name: AIE-- Oe _ Tel. No. Mailing Address: Legal Description:_<- Depth feet So Characteristics 0 2 3 5� 7 8s/- Ground Water Encountered: Yes— No /.- If yes, what depth_._ Proposed Installation: Seepage Pit__Drain Field. Comments:.--. Performed by:— Date: QnHfb�b jrog by BOX 97, EAGLE RIVER, ALASKA 99577 o TELEPHONE 694-2588 OWNER OF LAND YDEPTH OF WELL ADDRESS LEGAL DESCRIPTION / v ! a 3 SC Hk'06,0&X DATE - Started h"Vi F" Ended -7s-1 PERMIT NUMBERS `� 9 KIND OF FORMATION: STATIC LEVEL OF WATER FT. DRAW DOWN FT. GALS. PER HR KIND OF CASING From Ft. to -- Ft. Q06.49✓JROE�'d From Ft. to Ft. From Ft. to � { Ft. From Ft. to Ft. From Ft. to ' .5 Ft. ..5.9 1Z) From Ft. to Ft. From Ft. to i __: Ft. From Ft. to Ft. From Ft. to Ft. S "" J (S 5-71�9-= ` From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. MISCL. INFORMATION: DRILLER'S NAME M U IVA I ]-. 11 *-:R 11 1 -T- Ivy jiv lli:�:I 11'.4 11 o.rf::::-Ij IC:�:q� DEPHRTMENT O/ HEHLTH HND ENVIRONMENTHL / JTECTION 825 'L' STREET/ HNCHORHGun, HO 99501 264�4720 PERMIT NO ( 780099 ) )PPLICRNT L OCHTION ,EGHL LT2] SCHROEDER S/D POBX197 ER ��MIII LOT SIZE 12000 SQURRE FEET 1INIMUM DISTHNCE BETWEEN H WELL HND HNY ON~SITE SEWRGE DISPOSHL SYSTEM IS .00 FEET FOR H PRIVHTE WELL/ OR .50 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL 1ELL LOGS HRE REQUIRED HND MUST BE RETURNED TO THE DEPHRTMENT WITHIN ]0 DHYS )F THE WELL COMPLETION. )TIER PPIFICHTIONS HND CONSTRUCTION DIHGRRMS HRE �VHILHBLE TO INSURE PROPER INSTHLLHTION too ITE lot owl I W ��1: oE�...:� Q KI: EH: Wo IS FE F,-, :11 �.EB: [ CERTIFY THHT LI HM FOMILIHR WITH THE REQUIREMENTS FOR ON�SITE SEWERS HND WELLS HS SET �ORTH BY THE MUNICIPHLITY OF HNCHORHGE. �� I WILL INSTHLL THE SYSTEM IN HCCORDHNCE WITH THE CODES �IGNE ��~—~------------~~... ..... --- HPPLICHNT LEE SULLIVHN F1 I IS�r��P IL¢iS MUNICIPALITY OF ANCHORAGE DEPARTMENTOF HEALTH & ENVIRONMENTAL PROTECTIQIV 825 L Street • Anchorage, Alaska 99501 STREET LOCATION See attached ntap. Outside ENVIRONMENTAL ENGINEERING DIVISION 0* 5. TYPE OF RESIDENCE. Telephone 264.4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requestswillnot be processed. Please allow ten (10) daysfor processing. 1. PROPERTYOWNER KY. Three ❑ Six PHONE Wayne Cousineau _694-2140 *ATTACH WELL LOG. A well log is required for all wells drilled MAILING ADDRESS since June 1975. For wells drilled prior to that date, give well PROPERTY RESIDENT (If different from above) depth (attach log if available.) — PHONE 2. BUYER - - �. - - PHONE David/Linda Peck If system is over two (2) years old an adequacy test is required ❑ PUBLIC UTILITY MAILING ADDRESS NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 3. LENDING INSTITUTION PHONE Peoples Bank and Trust - � 279-7511 MAILING ADDRESS Pouch 7-007 99510 4. REALTOR/AGENT � PHONE Susan Gallion 695-955.5 MAI LING ADDRESS Post Office Box 249 99577 5. LEGAL DESCRIPTION sem^ Lot 23 Schroeder Subdivision STREET LOCATION See attached ntap. Outside tap 5. TYPE OF RESIDENCE. NUMBER OF BEDROOMS ❑ One ❑ Four ❑ Other ®x SINGLE FAMILY ❑ Two ❑ Five ❑ MULTIPLE FAMILY KY. Three ❑ Six 7. WATER SUPPLY �s ARx INDIVIDUAL.* *ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) — _ 8. SEWAGE DISPOSAL SYSTEM s— L?;X INDIVIDUAL./ON-SITE*' **If individual/on-site, give installation date_ 1978 If system is over two (2) years old an adequacy test is required ❑ PUBLIC UTILITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) <y THIS SIDE FOR OFFICIAL USE ONLY �— -- DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE INSPECTOR - INSPECTOR INSPE:CTOR - DIRECTIONS ❑Septic Tank or ❑ Holding Tank Size: If Tank is homernade SOILS RATING give dimensions: _ TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES - Septic/Holding Tank Absorption Area - - Sewer Lone Nearest LotLine WELL TO: �� --- Absorption Area to nearest Lot Line - 5. COMMENTS NUMBER of BEDROOMS__ DATE 1. TYPE OF RESIDENCE: LEGAL DESCRIPTION - - - ❑ SINGLE FAMILY ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ MULTIPLE FAMILY ❑ TWO ❑ FOUR ❑ SIX e m — e PERMIT NUMBER 2. WATER SUPPLY _ DEPTH OF WELL ❑ INDIVIDUAL ❑ COMMUNITY - DATE DRILLED ❑ PUBLIC UTILITY RECEIVED Connection Verified__LOG 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER ❑INDIVIDUAL/ON-SITE DATE -INSTALLED r-1PIIRI IC HTILITY ❑Septic Tank or ❑ Holding Tank Size: If Tank is homernade SOILS RATING give dimensions: _ TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES - Septic/Holding Tank Absorption Area - - Sewer Lone Nearest LotLine WELL TO: �� --- Absorption Area to nearest Lot Line - 5. COMMENTS 72-010 (Rev. 0/76) APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE LEGAL DESCRIPTION - - - 72-010 (Rev. 0/76) REALTORS' REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES I. Type of Inspection: CMRO VA FHA CONV X 2. Property Owner: Wayne Cousineau Mailing Address: Day Phone 694-2140 3. Name of Buyer: David & Linda Peck Mailing Address: Day Phone 4. Name of Lending Institution: Peoples Bank & Trust Mailing Address: Pouch 7007, Anchorage, AK Phone 2797511 5. Name of Realtor or Agent: Susan Gallion AK Mailing Address: P. O. Box 249, Eagle River,Phone 694-9555 6. Legal Description: Lot 23, Schroeder Subdivision Location: See map on revers 7. N a Type of Facility to be inspected: Private Residence No. Bdrms_. 3 Water Supply Type of Supply: Public Utility Individual X If Individual, number of dwellings presently served If Individual, depth of well 61 1/2.' Sewage Disposal System Type of System: Public Utility Individual (on-site) If Individual, date of installation: _ 8 - 78 03 AREA, INC. REALTORS [] Anchorage "C" St. Office REALTOR 3300 C Street (907) 278-2525 X East Anchorage Eagle River Eastgate Office Parkgate Office 5437 E. Northern Lights P.O. Box 249 (907) 278-2525 (907) 694-9555