HomeMy WebLinkAboutSCHROEDER LT 52Schroder 51 0
050
052
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL. PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
C�825
LStreet - Anchorage, Alaska 99501 Telephone 264-4720ON-SITE
SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
PHONE N1.W
NAME/
U PGRADE
py�7�
' l//�'
MAI LING ADDRESS, �ZL
LEGAL DESCRIPTION
/
li Q(75� -
LOCATION
N0. OF BEDROOMS
nn i
Well
�
AbsorptioJ�ar.a
'F
Dwelling QQ
PERM NO. /
U
DISTANCE TO:
�%
•(0
— --
Y
L- Z
—
Manufacturer
C1�1�.��L-
Mater
No. of co mments
a a
UJ
N
(n
Liq. capacJ t in allons
/����
IF HOMEMADE:
Inside length
Width
Liquid depth
DISTANCE TO:
Well
Dwelling
PERMIT NO.
O Z_ Q
Manufacturer
Material
Liquid capacity in gallons
2 F-
_
p
J-
wx
DISTANCE TO:
Well el
�QQ
/ /
CP�
Neares of me
PERMIT NOl� +�
D }-•�)o�ro
� u
F Z Lu
CCt�o
No. of lin s Length Qf e�ch,ine
__ _ r�-r7L
Total lenc}tJ� f Iynes Trench v t
p( ( r inches
Distance bVenes
frption
finishgrade /
Material beneath tile �%
Total e area
inchesj
Length
Width
Depth
PERMIT NO.
LU
H F-
Type of crib
Crib diameter
Crib depth
Total effective absorption area
wa
Well
Building foundation
Nearest lot line
W
y
DISTANCE TO:
Class
Depth
Driller
Distance to lot linew
EE
Building foundation
Sewer line
Septic tank
tion area(s)
DISTANCE TO:
�®
OTHER
PIPE MATERIALS
SOIL TEST RATING
INSTA ER
REMARKS
_
0
%
l`
1
r
APPROVE DATE LEGAL �(
HPPLICHNT
LOCHTIOhl
LEGHL
L52 SCHROEDER
PO BOX 594 ER
0, cc)
01�D�~�2�
694~2]G9 �J`u..
LOT SIZE 40000 SQUHRE FEET
TYPE OF SOIL H8SORPTIOH SYSTEM IS: TREKCH
MHXIMUM MUMBER OF 8EDROOMS � I SOIL RHTING (SQ FT/BR)� 8�
THE REQUIRED SIZE OF THE SOIL HBSORPTION SYS!EM IS�
�NEE ���� 1- cis 1.~PIT b q QN 0- q.] V=. Q tit WIN M J01 "0" E�T L. EJ M too V 1-1�' �
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHIPFIELD,
THE DEPTH OF H TRENCH OR PIT IS THE DISTHNCE 8ETWEEN THE SURFHCE OF THE
GROUND HND THE BOTTOM OF THIE EXCHVHTIOM (IN FEET)
THERE IS NO SET HIDTH FOR TREMCHES
THE GRHVEL DEPTH IS THE MINIMUM DEPTH OF GRHVEL BETWEEN THE OUTFHLL PIPE
HND THE BOTTOM OF THE EXCIA VHTION (IH FEET).
Fit NEE All U 1: T"? vKT Q SRI TRE EON - 9 K ITT J- TOP 141 v< 745 T: 27 PIE 0. CEO PHI ��E�f ......����
PERMIT HPPLICHNT HHS THE RESPONSIBILITY TO INFORM THIS DEPHRTMENT DURING THE
INSTHLLHTION INSPECTIONS OF HNY WELLS HDJHCENT TO THIS PROPERTY HNC, THE
NUMBER OF RESIDENCES THHT THE NELL WILL SERVE
�1 _ go Ann N::: �if;., 1 Gy 170 M 117 1- 1: 1:1 vyi Y0 OR Q ORK �i_3 :1 !F:�O: �-i
BFIC KFILLING OF HNY SYSTEM NITHOUT F[NRL INSPECTION HND HPPROVHL BY THIS
DEPRRTMENT NILL BE SUBJECT TO PROSECUTIOM
MlNIMUM DISTHHCE BETNEEN H WELL HND HNY OH.SITE SEWHGE DISPOSHL SYSTEM IS
100 FEET FOR H PRlYHTE WELL OR 150 TO 200 FEET FRDM H PUSLIC HELL DEPENDING
UPON THE TYPE OF PUBLIC WELL
MINIMUM DISTHNCE FROM H PRIVHTE WELL TO H PRIYRTE SEWER LINE IS 25 FEET 900
TO H COMMUNlTY SEWER LINE IS 75 FEET,
OTHER REQUIREMENTS MHY APPLY SPECIFICHTIOHS 190" CONSTRUCTlON DIHGRHMS HRE
HVHILHBLE TO INSURE PROPER INSTHLLHTIO11.
!IN M NYC owl :1 0- EX 0=" 31 17? EE 51 TV. E17 Q M 1. 1���
I CERTIFY THHT
1� I HM FHMILIHR WITH THE REQUIREMENTS FOR ON-SITE SEWERS HN� NELLS HS SET
FORTH BY THE MUNICIPHLITY OF HNCHORHGE
2 I WILL INSTHLL THE SYSTEM IN HCCORDHNCE NITH THE CODES
]� I UNDERSTHND THHT THE ON S STEM
MM' REQUIRE ENLRRGEMENT IF 1110 -
FRES DESiC k
HERESIDENCE HN I BEDROOMS
...
H
ISSUED
U v
Box 90, Davis St., Eagle River, Alaska 99577
694-2774 or 688-2280
t usooll Oyster End ;w
694-2774 SOH LOG
it
4/ e57
Performed for: Name:--_�""��---------
��'f i _
Mailing Address: �.. 'z— ��T=` ti<<�,=—
Legal Description: —Z--�Z f�_t!--.-----
Depth (feet) Soil Characteristics
U
:i
J _ /
PLOT PLAN
10
11
A
PERC. TFS`i°
13 .
14
,erg d�,s• aoe ooe<.2�4J�f i}i
epth
Ground Water Encountered: Yes-- No f If yes, what depth--
_Proposed
ProposedInstallation: Seepage Pit Drain Field_
Comments:
Performed by: < <�'� � E�`�-'�—_
Date: � / --
2
Tio,
1415 2a.1»
eagle meow. Alan»« OW177
T, " ")2 "e-hroo(lor
.
near no, x:
I z (A of o I A I - files 0 7s m
tin ooll or !--m.otic! t�iv
ir"!3uoa -ror tbr! obove Tomil.
r()ianneetiorm ez anb,iTtm ofa,septie styFir- on FiJo
wi.0-1 t1in 1"IlDioincl Ii lw.
oil ii. c! f
Est/2/2I
Trr,,ifirb Brittibuig wog
by
DOC Co. dba
SULLIVAN WATER WELLS
P.O. 80X 272, CHUG IAK, ALASKA 99567 • TELEPHONE 688-2759
OWNER OF LAND
ADDRESS
LEGAL DESCRIPTION
DATE - Started Ended
PERMIT NUMBER
KIND OF FORMATION:
. o
From Ft. to
Ft.
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.
Ft. to—Ft.—
oFt.From
From
From Ft. to
Ft. 7
FromFt. to
Ft.
F Ft t
Ft
rom
. o
.
From
Ft. to
Ft.
From—
Ft. to
From
Ft. to
Ft.
From
Ft. to—Ft.—
o
Ft.FromFt.
Ft.
From—Ft.
to
Ft.
From
From
Ft. to—Ft.—
oFt.From
From
Ft. to_
From—Ft.
Ft. to
Ft.
MISCL. INFORMATION:
DEPTH OF WELL
STATIC LEVEL OF WATER FT.
DRAW DOWN FT. —
GALS. PER HR
KIND OF CASING _
From
From
From
From__
Ft. to
Ft. to__
Ft. to_
-Ft. to_
—Ft.
Ft.
uNl
_F �pgt/Tv 6� _
NVic � qN�H
U c
From—
Ft. to
Ft `•.- ` C
N 1961)1
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.
Froin—Ft.
to_
Ft.
From
Ft. to
Ft. _
From
Ft. to_
Ft.
Frmn
Ft. to_
Ft_
DRILLER'S NAME
�I Ad 11., 0�����
�EP�RTMENT HEHLTH HHD EAYIRONMENTHL AOTECTION
STREETHHCHORRGE, HK. J.
264~4720
PERMIT NO ( S20197 )
HPPLICHNT D SMITH & EYH BOX SR 1H 5 CHRL9 EHGLE RIVER 9957 59^~]6]8
LOCHTION
LEGHL L52 SHROEDER S/D EHGLE RIVER LOT SIZE 12167 SQUHRE FEET
�FEE lot �X -A- THE 1-0 to, 1: W PRE S; Cy 17T 11; FYZ M PTO s1z lot :20 & , :1. SO YlE7, 0::
two 0
Time
APPLIC
'IT PILLS OUT UPPER MAL ONLY
Properly Owner
.� !( ,) ,
�� (� �� /(�..] !,} }(
Phone
Mailing Address � � �� '' /.;;
� - _ //A Code
lj. __
Buyer
y
Inspector
Address
Inspector
/ Pie, E--. Zip Code
Lending Institution
S `�
Ir
Ir
/
? /-f, C-/(,
Phone
Address
Zip Code
Realty Co. & Agent
)
Phone
Address /
r o A / -
Zip Code
Legal Description
h� S`�T
/a /4 �� E- e N
v�.
Street Locations
( ) DISAPPROVED
( ) CONDITION L APPROVAL'
Type of Residence
Single Family
7
Multiple Family
No. of Bedrooms
Well To Absorption
❑ Other
Well Log Received .1
Septic Tank Size ' d
Water Supply
Individual
Well to Tank
ATTACH WELL LOG. A well log is required for all wells drilled since June 1975.
Community
For wells drilled prior to that d ive well depth (attach log if available).
O Public Utility
Sewer Disposal
Individual
�!
Year Individual Installed:
Public Utility
When Connected to Public Utility:
❑ Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
Time
Time
Time
Time
)
Date
Date
Date
Inspector
Inspector
Inspector
Inspector
Q-
Field Notes:
�� �0V4 Cnc
'W
( !,'P—APPROVED BEDROOMS
'CONDITIONS OF APPROVAL
( ) DISAPPROVED
( ) CONDITION L APPROVAL'
DATE +-...
BY:
Soils Rating
Date Sewer Installed
Well To Absorption
Area a<
Well Log Received .1
Septic Tank Size ' d
Well to Tank
t ,
iN--
72023 (3182)