HomeMy WebLinkAboutUS SURVEY 3045 LT 52 T10N R2E SEC 8US Survey
3045
Lot 52
#075-031-04
r
Municipality ofAsichorage ,
;W),3-RR)i-
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Hayor Marl, Ilergicle mi�c.munl.org
Building Safety Dhvision
June 21, 2004
Justin Shoffner
P.O. Box 1013
Girdwood, AK 99587
Subject: On -Site Water and/or Wastewater Permit.
Permit Number: SW030255
Legal Description:rIJS Survey 3045 Lot 52 TI ON R2E Sec 8
Dear Mr. Sheffner:
An On -Site 1Vater/Wastewater Permit, number S W030255, issued by this office for a single-family
system, will expire on July 15, 2004 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
obta
ned
frothis oce. A
be disposalpermit for a second year may
sued for fee of $115.00tif the renewalmust bel appli ati n is received neor before the expiration date of
the original permit.
When applying for a new permit, the fees are: $460.00 for a wastewater permit and $175.00 for a well
permit.
If you have any questions, please call this office at 343-7904.
Sincerely,
06zo 1-��
Daniel Roth
Program Manager
On -Site Water and Wastewater Program
Enc: Copy of permit
CO11U111111ity, Security, Prosperity
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water 8 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: SW030255
Legal DescriptiomgUS SURVEY.3045 LT-52TION R2E SEC 8
Design Engineer: 0071 LANTECH
Owner Name: Justin Sheffner
Owner Address: PO BOX 639
MEAD. WA 99021-0639
Date Issued: Jul 16, 2003
Expiration Date: Jul 15, 2004
Parcel ID: 075-031-04
Site Address:
Lot Size: 23087 SQ. FT.
Total Bedrooms: 2 Permit Bedrooms: 2
This permit is for the construction of.
❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ PrivyPrivate Well
❑ El 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 catling
(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:
Date:
Municipality of Anchorage
• Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
ON-SITE SEWERMELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
41:50
Parcel I.D. (y)`--b-Z-) l D 'I Permit Number SW 0302 SS
Property owner(s) t )kta
5 Day phone �F5�- g7oD
Mailing address (1) P 01 RTX Lo
�g
o-r�t.t'1a7 A J Ak
Mailing address (2)
Zip Code 9 q S &j
Legal description (Lot, Block & Sub'd.) IHSS
3D4S" (C4 5Z.
Legal description (SectionY Township & Range)
C -1
Z3
Lot Size f Acres/Sq.Ft.
Number of Bedrooms
THIS APPLICATION IS FOR:
Sewer Only
❑
Well Only
Sewer and Well
❑
Water Storage ❑
Sewer Upgrade
❑
THIS PROPERTY CONTAINS:
Hot Tub
❑
Jacuzzi ❑
Swimming Pool
❑
Water Softening Unit ❑
Therapy Pool
❑
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.
of
or authorized agent)
Permit Fees: `7 O Waiver Fees:
Date of Payment: 7- 171 - D 3 Date of Payment:
Receipt Number: 3 3 3 Receipt Number:
(Rev. 12100)
OT
LOT 51
PROPOSED
16' X 24'
WOOD STRUCTURE
LAY -OUT
CTI0 wctl ILA" 6ce•, &6&v, v4 )
LARRY WILLIAMS
440
2002—L-1
[XCW ftt; to. ons rego..A•II
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103
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UCI
OF. t[ar��iO3
(907) 562-5291
LOT
552
L!Amw'�'1
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�4715
SJ3,66
U.S.
SURVEY
NO. 3045
dor Sus4�n � tCn�lna>rw,0. ��,�!
HEFTY DRILLING
3540 AKULA DRIVE
ANCHORAGE, ALASKA 99516
(907) 345-0593.
city/Borough: !SS9
ion/USS: Block Lot
saLWa ett)<fs �o
S'I•ATC O ALASKA
DI1'PAIZT,%IJ,'N'1 OF NATURAL RESOURCES
ALINING, LAND, WATER IIYDROLOGIC SURVEY,
\Vn'1'F:It WrIJ, LOG
Drilling Staricd: G�j/— Comp lctcd.b
Property Owner Namc & Address:' / p
\X,�. 1��_ t,SU�eelna
11"1.1,ol --. Township
Range Scction
�cN_.1J.UN Long -IV
BOREHOLE DATA: ll't•,nn (rnand vnriacc) Depth
Material: Type, Color & wetness
_ � From I To
S�
IA—j
J -f S IO
r4.v-.ISIIS
1s
$talc 143 d')"-
1.08-020.46.1
'
1.08. 20.46.1 fad<a.a_M1�St<IM+n�. .. ,38.05 35
1.0a.020, 46.13.020 And AK regulaiip^r I I AAC 97.0;4,}20, 39.05.033,
DEPARTME.YT OF NATURAL RESOURCES
Mining, Land & Water Ilydrologic Survey
550 W 7th Ave., Suite 900A
Anchorage. AK 99501-3577
Telephone ( 07) 269-9639 and FAX (907) 562.1384
T'd
W
of V. of .. ._t/4 of .—.---V,
Drilling nxthod:Air rotary, O Cable tool, Other
Well use: O Public supply, Domestic, ❑ Other _ _
Depth oChol 540 n, Casing stickup:
Casin o1 -- n
g ;YPc:�Td /4 i1 Sl-';dF sickness . �� !- inches
Casing diameter. N Z.—
inches Casing depth ✓)LU it
Liner type: Dianicier: inches Depth:
Stalic water ....,. n on
ip,�
Pumping level & eld: • a7 J
YIL•rt after hours at _ _•_ gpm
Recovery rate: tA D spm, Method of testing:.
Development method: Duration:
Well intake opening type: KOpcn end, O Open hole —
D Screened; Stan: ft, Stopped
Screen type: ..ft
Slot/mesh size _ _
D Pcrforatcd;Stan: fl, Storped n
Start: n, Stopped
n
Grout t : a
�e Volume
Depth; from n, to
Pump intake depth: ft
n
Pump size hp. Brand name:
Was well disinfected upon �}in Iction? ayes, O No
Method of disinfcction.'� 2 ' _
Driller comments.' disclainwrs
Well Driller Name:
a1
Company Name:HEFTY
DRILL
Mailing Address:
3540 AKULA DRIVE
Clty ANC—GF
Slate: ALASKA Zip:. 99516
Phone Number:
1-q07-3< .0593
Orillers Sionalura- /
. - . t1 t:. , / _ L• s _
Within the City of Anchorage, it is required that a copy of the well log bt
sent to the appropriate city orrice within 60 days and that another copy of
the w011 log be sent to the Well/properowner within 30 days.
Permit Number: y�Q�d S^s-
DateOrISStIC; ��_,
Parcel Identification Nmul>Lr:
Is well located 21 approved permit location? D Yes or No
eTSrLO 10 bZ unr