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Home My WebLink AboutSHEETS LT 1 PETERS CRK TERR TWNHMS PH 261) 72010 ( Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLEFAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ TWO ❑ FOUR ❑ SIX ❑ OTHER 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑ INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER ❑Septic Tank or ❑ Holding Tank Size: If Tank is homemade give dimensions: SOILS RATING 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. C&MMENTS ` J LJ APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE 101!?� BY 61) 72010 ( Rev. 6/79) Ay MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEE13ING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 2.64-4720 -- ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL. INSPECTION REPORT NAME / W / L E % �� 1\1-.5O N -------- PHONE 6 C3 C'i 223 (SCJ NEW ❑UPGRADE _---- MAILING ADDRESS 0 hcls, _R LEGAL DESCRIPTION LOT /, �lCFLcE%S '`L� LOCATION NO. OF BEDROOMS ^^ u x DISTANCE TO: Well Absorption area Dwelling PERMIT NO. NZ Manufacturer Material No. of compartments LU N Liq. capacity m gallonsIF HOMEMADE: Inside length Width Liquid depth O D Z DISTANCE TO: Well Dwelling PERMITNO. O Z Q 2 F Manufacturer Material Liquid capacity in gallons O -2 x w DISTANCE TO: _ Well _ /V /� Foundation .f- // � Nearest lot line / ___— z -- PERMIT NO. 9c�a 2 i J 7 w No. of lines Length of each line Total length of lines Trench width Distance between lines F' -o[ -F LS _� /C�O----- r� inches 5C7 --- Top finish ---�7 Material beneath _ _ - Total F of til, to grade tile effective absorption area p �? / - 4 r �7 ;-, inches / .2-00 Sat • t T• Length Width Depth PERMIT NO. w O Q F Type of crib Crib diameter Crib depth Tbtal effective absorption area Lul w DISTANCE TO: Well Building foundation Nearest lot line Class Depth Driller Distance to lot line PERMIT NO. J w � Septic tank DISTANCE TO: ndation Building totSewer line Absorption ami(s) OTHER C i -I( ( PIPE MATERIALS -- Py(- _ SOI L TEST RATING INSTALLER 5r'2 i�i� c2 --- — —� -- -- --- REMARKS - -T- IN 6"s 0 T r1Z,14A4l=11 C' IZ-Ay - - - -- -- - -- - - -- r so -:0449TH ✓•.lea 0J1...0 e.n�•d.o u.�if(tn o.• / h _J0( Earl P. Ellis Q .pe O. 1745- pDP -- APPROVE - DATE LEGAL '2-013 ((.Rev. 3/78) Ilv R 9_3 VA A-' , 0 F'"" 1c:A If .... . T -1 "-11 , �pr- 9 ll-_': :::, DEPHRTMENT O( |EDLTH HND EHVIR0NMENTHL F TECTION 825 /L' STREET/ HNCHORHGE/ HI j0z 264�4720 (-:11 5�.A Ar. T- d FE" rf`i�". F::', F-�!! 11-.1 �1.: V, FIE F.", T NO. ( 7900�C.; ) HPPLIAMT WlLEY DENSON BOX 966 688 22]9 LOCHTI()N CHUGIHK DR OFF T|�UNDERBIRD ST LEGHL L.J. SHEETS S/D LOT SIZE 22000 SQUHRE FEET TYPE OF SOIL 8BSORBTION SY5TEM ISTRENCH FV4 xc MAXIMUM NUMBER OF BEDROOMS= 6 I R�TING (S( FT/�R)� 1�5 THE REQUIRED SIZE OF THE SoIL H�SORPTION S9�TEM I5� ��Ro" -11- 111 ��i"'R ��A 11' I -M Poo "no FEE P.. Q IF. Fol"K�� te�o 41-2 THE LENGTH DIMENSION IS THE OF THE TRENCH OR DRHINFIELD. THE DEPTH OF H TRENCH OF! PIT IS THE DISTRNCE 8ETWEEN THE SURFHCE OF THE G�OUND RND THE BOTTOM OF THE EXCRVRTION (IN FEET)� THERE IS NO SET WIDTH FCiR T�ENCHES THE GRHVEL DEPTH IS THE MINIMUM DEPTH OF GRHYEL 8ETWEEN THE OUTFHLL P1PE HND THE BOTTOM OF THE FEET). ��T IFE: V.*'j, F." -1 - �-V Fop 14A K .1, F-_ ��. O:::�)�� ,~~ (a) PERMIT HPFLIC-iNT HAS TME RESPCNSI8ILITY TO INFORVI 111I13 DEPART�Et-,IT I`)I I TI r INSTHLLHTION INSPECTIONS OF HNY WELLS HDJHCENT TO THE NUMBER OF RESfDENCES THAT THE WELL WILL SERVE. �__ 'IF 1.4 CIO < W: 1-H X p"ll 7,_'3 1=1 PEE 110 W 1: IC-fi VA 1=1 Q IEVE F&T FEE Go U :1 Fit RHE V> BHCKFILLING OF HNY SYSTEM WITHOUT FINAL INSPECTION HND HPPROVHL BY THIS DEPRRTMENT WILL BE SUBJECT TO PROSECUTION MINIMUM O WELL HND Fit -11T, ON-SIT� SEWAG� DISPOSRL SY�T�M IS 1�0 A IdE�L/ OR 150 TO 200 FEET FROM H PUBLIC WELL UPOAI THE TYPE OF PU8LIC WELL OT��R �E��TS MHY APPL\! �P�C�FICHTIU�S FN) CON5TRUCTIO111 DIFAARHMS FIRE HVAILH�LE TO �NSURE PROPER INSTHLLHTION ��"T ��po" T �C:"- FEE 14 V FEE Fit I CEF:!TIFY THMT J. I HM WITH THE WERS HND WELLS HS SET FORTH BY THE MUNICIPHLITY OF iMUORRGE. 2 I WILL L THE SYST�M IN R�CORDHNCE WIT� THE C�DES ]� I THAT THE IF THIE R�SIDEN�E � AN 6 G��ROOM� SIGNED��~awl. HPP�I�HNT W / (V![yJLK 8H[11(}1"8(1 il!!iA |;08/}U « ))cydrt|ncUL of |ovir*mxx/|ol ()uo|iiy � 3330 "C" v Anchorage, /\lasi0 �()|LS|'M /`|3l0|A1l0Xll"1 Pcrfun/eU [or_ Lc3a| kcscriyLiuo�--- ��r_�__--_��E�� 0�&/-----_----.--_'-_'_'--_� This form reports: Soils lng__�¢______~_______^__ Percn\atino Lest___^__^_____~___~______ Uepth Feet ^l 0-7 Top�� 2�—^ � / / 2' ��4 G\A1 8 5 Was ground water cuCOuntCrcd? ��°�_ l[ yus, at mwi J,/U/! ` }\�-~-:-^ C Proposed ixSL�-~ Pit IJIrdiU FiCi d UeyU| of Ix|xC C0HhLUT3� ' /-----)� '- UeVt|\ to L ' b V[ i y/ ' or L[toC// --- � �^m�(�'--'c/u��7�/rcL.'��-�U�Le'��'-��1��s---�__� � � ^ - __---'-_'-'--' '-'--��-' '/^--_-_- Porf0n/�c� Sv� -T� \��^ C�r�ifi�J ' �' �_-' �/��\- b5[`()'010 (0/74) ' GREATER ANCIIORAGE_ JLA L'OROU(,.. Uepartment of EnvironmenIaI Quality 3330 "C" Street Anchorage, Alaska 9903 SOILS LOG - PI;ROLATION ']•1'ST Performed for --SPR.INF eREEK��I} y.p�'GLAJ�___----------._)ate Perforn,t,a Legal Description: -------ACT—a----------g.kt`i'____>D�uLioN._---------------__---_.__.._.__- This form reports: Soils log Percolation test Depth Feet 1 _ 3 - 2 —br 85 5- 6 - 7 - 4{�--IH� GM -GW: 155 B - 9- Was ground water encountered? �N If yes, at what depth? Reading Date Gross Time Net Ti — —A - -- - - - -- - --- — - -- --- — — colme Depth to Water Net drop Peration rate minute. Proposed instil la! r.: Seepage Pit Drain Field Depth of Inlet Depth toho�J-tom of pit or trend COMMENTS:.�a��S _ _eXasp�e __f2�_.�iS_�a�Y_ 15-b5EQ-040 (6/74) hdcaAA,?� 5. LEGAL DESCRIPTION DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME One Four I/X Other El Two E] Five / L2� MULTIPLE FAMILY DATE DATE DATE INSPECT R INSPECTOR INSPECTOR ❑ since June 1975. For wells drilled prior to that date, give well MUNI ICI y Ki 10FAGF. L G;'7. MUNICIPALITY OF ANCHORAGE ciloN DEPARTMENT OF HEALTH 81 ENVIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 I ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 ` 4:E CEL REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomple equests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER . PHONE MAILING ADDRESS PROPERTY RESIDENT (If diffe ent from above) ; PHONE 2, BUYER PHONE MAILING ADDRESS 3. LENDING INSTITUTION PHONE MAILING ADDRESS - 4. REALTOR/AGENT PHONE MAILING ADDRESS 5. LEGAL DESCRIPTION - STREET LOCATION 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS ❑ ❑ ❑ SINGLE FAMILY One Four I/X Other El Two E] Five / L2� MULTIPLE FAMILY ❑ Three ❑ Six 7. WATER SUPPLY ❑ INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ❑ since June 1975. For wells drilled prior to that date, give well /COMMUNITY ()�PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM Com'_INDIVIDUAL/ON-SITE** �U YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79)