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Home My WebLink AboutQUIET WOODS LT 6C40 Quiet Woods Lot 6C #050-281-49 -- _--•...,. •..-. •-...... �.::..........—:��.�...►..�-a,.su..elam.rwr:anaa.s y.,.a.2'.+.1v: MGL:: WELL CONSIRU.7104 L01 - Dr.lting Co.��flilrZlit��o USGS no. Dri (ler �.ctaf--�7�TG {G li---Type of Fig. Slllg—oats •ell eo•°feted 4%e T.t y-/)Ij-i will ownu — �_-Nearest crmmunilY�Jt��<�P� K'nC well location; (edduss L Legalndacn;t ion) _/,r� '��/ef/� C•ad.L ltd y. LaCeliOn eaefch of remark: Depth of ■eil_1�j--_.It. Casing, ir. Stake rater reel — _ It, aLo.e, beton) land surface, Date_/1%r' Tri. Finish of well: (ole- -arta, screen, terierate9, open -hole, other)-- Describe intercell a^d site:�.LefSf_,✓�/ y ��lwrwL Milt Yield tested by (pumping, bailing, air) 11 .i or, �i Lgal/tin. III —hours ■It>_—r�� ft. of drordorn from stetlb lees,. Depth below land surlece In feet —�—'----Ion p—'a-6O _Lo__to pG —F,.—t o—q£B �•i —to_L[ 1�—to G� t°wiz. --to ---to DRILLER'S MATERIAL LOG Rive description of stlate penetrated (alae of material, color, hardness of drilling, and later cement) '_�S.e fw.✓� �_1�wrr L • tour -1 I C I F-_ F, I T•r CiF Fit iCHIDF;�Fir E DEPARTMENT OP HEALTH AND ENVIRONMENTAL PF�OTECTION 825 'I")STP.EET, ANCHORAGE, AK. 95 1 264-4720 IJELL PEF�t•7 I PERMIT NO. C 811053 T APPLICANT HARRY A./MADELINE MACKN SR 2 BOX 6465 99567 688-2813 LOCATION LEE STREET LEGAL L 6C B 8 QUIET WOODS S/D LOT SIZE 13000 SQUARE FEET MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER, LINE IS 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER. INSTALLATION. PERMIT EXP I FR 1-= EMEF- EF< �' 1 51 I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. j 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. SIGNED APPLICANT HARRY A./MADELINE MACKEY ISSUED BY ------------------ 7 ----------- DATE_=1:�0-,QJ----- V4.0 Applicant: Location: MUNICIPALITY OF ANCHORAGE n Department Health and Environmental rotection 825 L Street, Anchorage, AK. 99501 264-4720 * * HANDWRITTEN PERMIT /� 1, WELL PERMIT �7 / T7Al2✓Z T %%A-ChIje � Mailing Address: ,Lee /alb. Phone Number- ;4S umber; S Legal Description: 1-0-r l005Lk S Qu12T c>7 Lot Size: 3 k Type of Soil Absorption System Is: Trench: Drainfield: Seepage Bed: Holding Tank: Maximum Number of Bedrooms: Soil Rating(sq.ft/br) _ The Required Size of the Soil Absorption System Is: DEPTH LENGTH GRAVEL DEPTH WIDTH The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE = GALLONS Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. * *,* TWO(Z) INSPECTIONS ARE REQUIRED Backfilling of any system without final inspection and approval by this departmen will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 fee for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 3 1 I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if the residence is remodeled to include more that3 bedrooms Signed: Issued by: Z Applicant Date: 5-450-231 SWP/024(1/81) MUNICIPALITY OF ANCHORAGE t DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Dato i LE ° IzG 41r_s 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, r nge) � - e ten, sem, Location (address or directions — �� Vi (b) Applicant Name t*"4efziq21'.pTTelephone:'Flome yens_ Business �e6 Applicant Address /✓ �� ' � i+� v .- �9r-7 (c) Applicant is (check one): Lending Institution ❑ ; Owner/bu4der'M ; Buyer ❑ ; Other ❑ (explain); i - .01 _ _ s-. .'_ A1"'/.__ _ __ (d) Lending Insti Address (e) Real Estate C Address _ Telephone _ (f) v Telephone and Agent 2. TYPE OF RESIDENCE Single -Family Multi -Family ❑ Other Number of Bedrooms 3 3. WATER SUPPLY Individual Well Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite ❑ Publich Community ❑ Holding Tank ❑ Note: It community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 71-0()[5111 841 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION 14 As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system Is In compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address Date _ Telephone It DHEP Approveded for forE/F/Lays_ _-- bedrooms by Date Approved Disapproved Conditiona Terms of Conditional Approval CAUTION WS aeb.A A. Shafer , No. 1457E •• avi e ��OFE35�Ov+ The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 '_"'c7Pqury Of F I�kl. OF he trH DRAG: L PkoreZroN El.VED Legal Description: LS7- A. WELL DATA Well Classification S I F• If A, B, C, D.E.C. Approved (Y/N) 1A Well Log Present &N) Date Completed ( 0 - 7-4 -'1D t Yield . S G, eA.t -t- Total Total Depth (01-r Cased to ¢rO + Depth of Grouting +hn- Static Water Level g r Pump Set At N Casing Height Above Ground 3D Sanitary Seal on Casing49/N) Electrical Wiring in Conduit tVN) Separation Distances from Well Depression Around Wellhead (Y/gp To Septic/Holding Tank on Lot aLP ; On Adjoining Lots a /?t To Nearest Edge of Absorption Field on Lot N d ; On Adjoining Lots N �n (+ To Nearest Public Sewer Line 7 s To Nearest Public Sewer Cleanout/Manhole (� 1+ To Nearest Sewer Service Line on Lot I t 4 Water Sample Collected by S-4 S <::b,� rr-aLE�l-�Y. ; Date to -" "E S Water Sample Test Results Comments 'Cts Prt-�oJc.f. IN .4576"P k• B. SEPTIC/HOLDING TANK DATA Date Installed Size No. of Compartments Standpipes (Y/N) Air -tight Caps (Y/N) Foundation Cleanout (Y/N) Depression over Tank (Y/N) Date Last Pumped Pumping/Maintenance Contract on File (Y/f f) + —;for Holding Tank High -Water Alarm (Y/N) ^I Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water -Supply Well To Building Foundation To Property Line To Water Main/Service Line Course To Disposal Field To Stream, Pond, Lake, or Major Drainage Comments C OAJAJIIC!T� To PLUBe./e SE-w-CErL /AJ /9971 VAfLMssrik, (0-27 -97r Page 1 of 2 72-026(11,84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water -Supply Well - To Building Foundation Lot To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course Type of System Design Length of Field Depth of Field Gravel Bed Thickness Standpipes Present(Y/N) L�Date of Last Adequacy Test . To Property Line To Existing or Abandoned System on On Adjoining Lots To Cutbank (if present) To Driveway, Parking Area, or Vehicle Storage Area Comments 07a P Jt3% rc fro l9B1. t/�tQrl�r�_s�7n.J MA-nC_ G-Zry—'5-S D. LIFT STATION Date Installed Size in Gallons Dimensions Manhole/Access (Y/N) "Pump On" Level at "Pump Off' Level at High Water Alarm Level at04 1Vent (Y/N) Tested for _ Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments •' Check Permitted Bedroom Rating Against HAA Request •• I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Date a Coma SRB Ig6X y� MOA No. 694.2873 �( •••A:•,, Receipt No.�{lAs�,� •.% 1� Date of Payment l'�'�J ,W : j� �.•}#,�� Of DU • ' Seal Amount: S 4S .. yb.n �.•se.f.� : e Page 2 of 2 72026 (1 U84) + . D. 1 RECE ED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECT6R MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & \ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIDWIRONMENTAL Fi0T CTION On L Stmt • Anelw age, Ahaboa 59501 • 17 it ENVIRONMENTAL SANITATION DIVISION �NNOV V19981� Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWEFLFACI�ITIES DIRECTIONS: Complete all parts on page 1. Inoomplete reqs ft will not be Processed. Please allow ten (10) days for processing. 1. PROPERTYOWNER PHONE Harry A. and Madeline M. Mackey 688-2813 MAILING ADDRESS St. Rt. # 2 Box # 6365 Pioneer St., Chuaiak, Alaska 9567 PROPERTY RESIDENT fit different from above) PHONE 2. BUYER PHONE Morrison MAILING ADDRESS . LENDING INSTITUTION PHONE I WILL PICK UP AND TAKE TO BANK MAILING ADDRESS 4. REALTOWAGENT PHONE Target Realtors Dick Brown Agent 1277-0551 MAILING ADDRESS 5. LEGAL DESCRIPTION Elk 8_ Quiet Wo oda STREET LOCATION Lee Street, Eagle River S. TYPE OF RESIDENCE NUMBER OF BEDROOMS 7 ❑ One ❑ Four ❑ Other SINGLE FAMILY ❑ Two ❑ Five ❑ MULTIPLE FAMILY [M Three ❑ Six 7. WATER SUPPLY t7 INDIVIDUAL' *ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) S. SEWAGE DISPOSAL SYSTEM . ❑ INDIVIDUAL/ONSITE" YEAR ONSITE SYSTEM WAS INSTALLED. X3 PUBLICUTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED, 72.010 (Rev. 6179) ing 72010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY ` 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ . SIX 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 ❑SepticTankor ❑Holding Tank Size: If Tank is homemade give dimensions: SOILS RATING - TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL T0: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE BY 72010 (Rev. 6/79)