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Home My WebLink AboutT15N R2E SEC 6 S2SW4SE4NW4T15N R2E SEC 91 52 SW4 SE4 NW4 #057-131-02 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On -Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519.6650 (907) 343-4744 ONSITE WATER SUPPLY PERMIT Initial Permit Number: SW000173 Legal Description: Ti 5N R2E SEC 6 S2SW4SE4NW4 Design Engineer. 0000 None Required O.rncr Name: Chris 8 Alza Paulsen Owner Address: PO Box 243224 Anchorage , AK 99524. Date Issued: Jun 15, 2000 Expiration Date: Jun 15, 2001 Parcel ID: 057-131-02 Site Address: -- Lot Size:_ 217800 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of Disposal Field ❑ Septic Tank ❑ Holding TankPrivy ❑ ❑✓ 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 DHHS at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-4744 (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. .5: The following special provisions. AFTER THE WELL HAS BEEN CONSTRUCTED AND PRIOR TO THE WELL DRILLER LEAVING THE PROPERTY, A SANITARY SEAL SHALL BE INSTALLED ON TOP OF THE CASING. NO PUMP OR PITLESS ADAPTOR SHALL BE INSTALLED IN THE WATER WELL` UNTIL A PERMIT HAS BEEN ISSUED BY THIS OFFICE TO CONSTRUCT AN ON-SITE WASTEWATER SYSTEM. Received By: Issued By: Date:-) Date: ��,0 Municipality of Anchorage, George P. 11'uerch, Mayor Bttildirlg Stlfely Dittisiotl P.O. Dox 196650 • 4700 S. Bragaa- Strect Anchorage, Alaska 99519-G650 a (907) 343-5301 h It p://��•,d. and �orugc.nk.us 6/7/2001 Chris & AizaPaulson PO Box 243224 Anchorage AK 99524 Subject: On -Site Water and/or Wastewater Permit. Permit Number: SW000173 Parcel ID: #057-131-02 Dear Chris & Aiza: --�� uepa� omens ut Publi— c Works An On -Site Water/Wastewater Permit, number S W000173, issued by this office for a single-family system, will expire on June 15, 2001. This permit was valid for 365 calendar days. If this was a well permit and the well has been drilled, a well log must be sent to this office for documentation of the installation and to close the permit. If this permit was for a wastewater disposal system, an original as -built inspection report must be sent to this office for review, approval and documentation. This as -built inspection report must be signed by the licensed Professional Engineer who inspected the installation of the system. As -built inspection reports are required to be submitted within 30 days of the completion of the system. If no system was installed under this permit, and you are still planning to install a well or wastewater disposal system, a new permit must be obtained from this office. A new permit may be issued free of charge for a second year if the application for the renewal is received on or before the date of expiration of the original permit. When applying for a new permit, the fees are: $320.00 for a wastewater permit and $120.00 for a well permit. If you have any questions, please call this office at 343-7904. Janles Cross, PE Manager On -Site Water and Wastewater Program enc: Copy of permit MUNICIPALITY OFANCHORAGE Department of Heafth and Human Services On -Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ONSITE WATER SUPPLY PERMIT Initial Permit Number: SW000173 Legal Description: T1 5N R2E SEC 6 S2SW4SE4NW4 Design Engineer: 0000 None Required Owner Name: Chris & Aiza Paulson Owner Address: PO Box 243224 Anchorage . AK 99524. Date Issued: Jun 15, 2000 Expiration Date: Jun 15, 2001 Parcel ID: 057-131-02 Site Address: Lot Size: 217800 So. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of. Disposal Field E] Septic Tank Ej Holding Tank Ej 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 DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 (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. t5: The following special provisions. 1, AFTER THE WELL HAS BEEN CONSTRUCTED AND PRIOR TO THE WELL DRILLER LEAVING THE PROPERTY, A SANITARY SEAL SHALL BE INSTALLED ON TOP OF THE CASING. NO PUMP OR PITLESS 4, ADAPTOR SHALL BE INSTALLED IN THE WATER WELL UNTIL A PERMIT HAS BEEN ISSUED BY THIS OFFICE' TO CONSTRUCT AN ON-SITE WASTEWATER SYSTEM. Received By: Issued By: Date: 6-6-6v Date: —cv p �niT sU�OOW73 by DOC Co. fte SULLIVAN WATER WELLS P.O. BOX 870272, CHUOIAK, ALASKA 99587 • TELEPHONE 888-2759 OWNER OF LAND _C/, ea ' - A z.4 y04q L . j ADDRESS /10X J43 Qay 14^J1: H 99rM LEGAL DESCRIPTION T /S A) R 62 E irG I _t.2 SL: A) PERMIT NUMBER_tMb/7;l Date of Issue TAX INDENTIFICATION NUMBER n2i"4 -r3-31 "- WL - Is well located at approved permit location? Dres'❑ No Method of Drilling: it rotary ❑ cable tool Depth of well: AFD Casing Type CIL611. Wall Thickness nches Diameter. /inches, depth feet Liner Type: A) &,J E Casing Stickup Above Ground: feet Static Water Level (from ground level): % feet Pumping level:—feet after hrs. pumping _gpm Recover Rate: __!L_gpm Method of Testing: .412 �� Well Intake Opening Type: ❑ Open End Pen Hole ❑ Screened; Start feet Stopped feet ❑ Perforations Start Meet' Stopped feet Grout Type: A'F. , a i' itolume d oz, <!Lr Depth: from [7 feet, to �- feet Pump Intake Depth: feet Pump Size hp Brand Name Well Disinfected Upon Completion? &W9 ❑ No Method of Disinfection: C 1![ 44i.J E SA 11" Comments: 4 6 loZ y l.2oDo BORE HOLE DATA j C.4StAr.yrictd-P _o U 1=d- Duo( De.J Sjfnli0 (�RAJ�c <u4Y 'e4 !T �S/e�� S�f•.l� < lQi4Jc(. /?c rO,tJcC ERA �l /07-!' d�CaGK 6R if Y ! ?JhATZ Sc4M3 -(JATE Drillees Name .2'U 1'3-– ' ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. MatSu Borough: Department of Environmental Conservation. r 3 CZ. W 2 O J Y t J a i V l p ! n � O r N r 4 p t �4 O r M , N ►n o M J N } 1. r N O;N JO M 0000 a11 h Z i r� LJ 330'