HomeMy WebLinkAboutLYON LT B1sm
#012-291-34
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On-Site Water & Wastewater Section Fax: 907-343-7997
Pump Installation Log
Well Drilling Permit Number: _______________ Date of Issue: ____-____-____
Parcel Identification Number: ____-____-____
Legal Description Block Lot Property Owner Name & Address:
Pump Installation Date: _____-_____-_____
Pump Intake Depth Below Top of Well Casing: __________ feet
Pump Manufacturer’s Name: ___________________________ Pump
Model: _____________________________________
Pump Size: ____________hp
Pitless Adapter Burial Depth: _________ feet
Pitless Adapter Manufacturer’s Name: _________________________
Pitless Adapter Installer: ____________________________
Well Disinfected Upon Completion? XX Yes No
Method of Disinfection: _____________________________
Comments:
Pump Installer Name: __________________________________
Company: ___________________________________________
Mailing Address: ______________________________________
City: ___________________ State: __________Zip: _________
Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation.
Municipality of Anchorage
Department of Health and Human Services
an •h_• street
RkkMysf m P.O. Boz 196650 Anchorage, Alaska 99519.6650
Mayor hap:rnwaw.a.andlaage tele us
Permit Number: #SW Date of Lune: 10-01-03 pared Identification Number. g1c't291-34
Date Started: ¢ Date Completed: 8-24-04 is well located at approved permit location? ® Yea No
Ugal Description: LM Trod 6
Property Owner Name k Addrm: Albert & Valatte Young
8701 Runamuck Place
Borehole Data:
Sora Trpe. ThkAuss & Water Strata
Stick -W
organics & Sr5
gravelly aft
ON
gravelly Sgt
afflygravel
slfty watersand•& gravel
Depth (R)
From To
0 2
2
3
23
45
121
135
3
23
45
121
Method of Drilling ® air rotary 0 cable tool
*sing "C-. f!
WWI Thickness: 2M inches
Diameter: Q inches Depth: IV f=t
Uner Type:
Diameter: inches Depth feet
Casing stickup above ground:,? fed
135 Static water levet (fiuru gtuuml level). Q fct
Pumping levd:J�eetafter
141 ,j hours pumping $ Spin
Recovery Rate: # Spm
Method of Testing: ¢
Weil Intake Opening Type:
❑ Open End ❑ Open Hole
® Surnamed Start 136 feet Stopped141 fed
0 Perforations Start fed Stopped feet
Great Type: bentonite # A Volume: j
Depth: Start Q fed Stopped 2 fed
Pump: Intake Depth feet
Well Disinfected Upon Completion? ® Yea ❑ No
Method of Disinfection: chlorkm tahw-q
Comments:
Well Driller. VPkm Or8/ing & Et#erpriw.1
PO BOX 110496
Anchorage Alaska 29511
Attention: The well driller shall provide a well log to the property owner within 30 days of completion and the property
......... ...1 11 1.•11 ..t .tl .......: 1. ....111.. �. .1.. r�. .. .111...., • 11.. ...
>:d wdSE:90 MW 9z *Grpd MW sys 4M : •ori XUA ONr-nlaa 3NIdltl : WOU
N
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519.6650
(907) 343-7904
ON-SITE WATER SUPPLY PERMIT
Initial
Permit Number: SW030408
Legal Description: �t'iYjR ,+
Design Engineer: 0000 None Required
Owner Name: Albert & Valerie Young
Owner Address: 8701 RUNAMUCK PLACE
ANCHORAGE, AK 99511 -
Date Issued: Oct 01, 2003
Expiration Date: Sep 30, 2004
Parcel ID: 012-291-34
Site Address: 8701 Runamuck Place
Lot Size: 42402 SQ. FT.
Total Bedrooms: 5 Permit Bedrooms: 5
This permit Is for the construction of:
❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑✓ Private Well ❑ Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3, The engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling
(907) 343-7904 ( 24 hours). ( Not required for a Water Supply Permit only).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By:
Issued By:
Date: /d/6/�
Date: 0
Municipality of Anchorage
• Development Services Department
Building Safety Division
On -Site Water and Wastewater Program '
s• cr•
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.ancharage.ak.us
(907)343-7904
fJN-SITE`SEWER/WELL PERMITAPPL-(CATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 0 Z - ZI I - 3,/ Permit Number SW 030408
Property owner(s)��� Y13 Ice, 6 _�lixz? Day phone �y5�19Z5
—. M��. i
Mailing address (1
Mailing address (2) Zip Code 29511-,nb 7/
Legal description (Lot, Block & Sub'd.) 70I gj zroc alxya, LL4hyN Tr
Legal description (Section, Township & Range)
Lot Size 194 oz, Acres/Sq.Ft.
THIS APPLICATION IS FOR:
Number of Bedrooms :
Sewer Only ❑ Well Only N
Sewer and Well ❑ Water Storage ❑
Sewer Upgrade ❑
THIS PROPERTY CONTAINS:
Hot Tub ❑ Jacuzzi ❑
Swimming Pool ❑ Water Softening Unit ❑
Therapy Pool ❑
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit Fees: �5 O . ° Waiver Fees:
Date of Payment: r/126 /a? Date of Payment:
Receipt Number. �ZZ JZ Receipt Number:
(Rev. 12100)
S9yp16 10' UTILITY EASEMENT
o: CST R IN T A e' D cLso ---'— — — — — — — — — —
—a,ay
RUNAMUCKPIA- — - _ 30' ACCESS EASEMENT
P 00 OA ce i c.
$it mdl-1 I
9
g3 c 0
m
AA A
Z
C
Z zi
OD0
o?a
LO w
.N
O
n
..
/ F
p
O
O
ha
n
aowrn
Na -n
—
_--- —
_
—
.'f
{�yaNA
!SNA
-
Oct
_ oNo
TI _
N
UPUTY
EASE4
m
�.
D
- - -
o
n
N
m
I
--
m
ogrm
•
� 2
vm
N
;o
ate'
m m
C
O
�.
-n
a
m
�
Z ..g
Z
6.22
?
i
.S x
mz
C>
W
g
�= N�
2
zo
�m
Z
G1
y
o x'
N
W
0
II.
A
m $
^O
r
�/
mF �w!lt
Z.:. _.
m
m.
y
o
y
O
-IL
-
W
iw
N'
W v
A
o 6
— /
c m
W
m�
m
�.
y
zo
Oil
ZIP
X
A
m
OD0
o?a
LO w
.N
O
..
/ F
p
O
O
ha
n
in ..
—
_--- —
_
—
.'f
_
-
z
O
10
UPUTY
EASE4
�.
- - -
m
--
m
ogrm
;o
m m
C
O
�.
-n
a
m
�
Z ..g
Z
Z
m
o
W
g
m
Z
G1
y
o x'
N
W
0
II.
A
O
Z.:. _.
m
m.
y
o
'
O
-IL
-
W
c m
m
m
D
m
�.
y
n
D
X
A
D
'0
;
O