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Home My WebLink AboutUS SURVEY 3042 LT 104 T10N R2E SEC 18US Survey 3042 Lot 104 #075-093-01 ALPINE DRILLING & ENTERPRISES Permit Number: PSW050096 Date of Issue: 4-25-05 Parcel Identification Number: 075-093-01 Date Started: 10-17-05 Date Completed: 10-18-05 Is well located at approved permit location? ® Yes ❑ No Legal Description: US Survey 3042 Lot 104 TION R2E Sec 18 Property Owner Name & Address: Geralsd & Carol Fox PO Box 1151 Girdwood, Alaska 99587-1151 Borehole Data: Soil Type, Thickness & Water Strata stick-up Depth (ft) From To 0 2 Method of Drilling ® air rotary ❑ cable tool Casing type: steel Wall'Ibickness: ,250 inches silty gravel 2 71 Diameter: 6 inches Depth: 163 feet silt 71 85 Liner Type: gravellysilt silt gravelly silt wet water sand & gravel 85 91 .135 152 91 135 152 163 Diameter: inches Depth: feet Casing stickup above ground: 2 feet Static water level (from ground level): 67 feet Pumping level: 160 feet after 2 hours pumping 50+ gpm Recovery Rate: 50+ gpm Method of Testing: airlift Well Intake Opening Type: ® Open End ❑ Open hole ❑ Screened Start feet Stopped feet ❑ Perforations Startfeet Stopped feet Grout Type. bentonite rranuler Volume: 1 Depth: Start 0 feet Stopped ? feet Pump: Intake Depth feet Ptunp size hp Brand Name Well Disinfected Upon Completion? ® Ycs ❑ No Method of Disinfection: chlorine tablets Comments: Well Driller. Alpine Drilling & Enterprise PO Box 110496 Anchorage, AK 99511 Attention: The well driller shall provide a well log to the property owner within 30 days of completion and the property 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 Date Issued: Apr 25, 2005 Expiration Date: Apr 25, 2006 Permit Number: SWO50096 Parcel ID: 075-093-01 Legal Description: US SURVEY 3042 LT 104 TI ON R2E SEC 18 Design Engineer: 0000 None Required Site Address: Owner Name: GERALD & CAROL FOX Owner Address: PO BOX 1151 GIRDWOOD , AK 99587-1151 Lot Size: 55539 SO. FT. Total Bedrooms: 3 Permit Bedrooms: 3 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 dosed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. -THE INSTALLATION OF A WATER WELL SHALL MEET ALL THE ANCHORAGE MUNICIPAL CODE 15.55. PLEASE SEETHE ATTACHED SHEET "PERMIT REQUIREMENTS FOR A DOMESTIC WATER SYSTEM". ITIS THE BURDEN OF THE PROPERTY OWNER TO DETERMINE ANY EXISTING WASTEWATER PERMITS EFFECT THE LOCATION OF THE WELL. -WHEN THE WELL HAS BEEN COMPLETED AND SATISFACTORY WATER PRODUCTION HAS BEEN DETERMINED, THE WELL DRILLER SHALL PLACE AN APPROVED SANITARY SEAL ON THE WELL HEAD AND NO PITLESS ADAPTER OR PUMP SHALL BE INSTALLED UNTIL AN APPROVED WASTEWATER DISPOSAL SYSTEM HAS BEEN CONSTRUCTED. -IF THERE ARE ANY QUESTIONS PLEASE CALL THE MUNICIPAL ON SITE WATER AND WASTEWATER Received By: CCX4 jn0.P_L36Z Date: Issued By:Date: -\ Municipality of Anchorage Development Services Department Building Safety Division'` ° a 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 SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcell.D. 07S-0Cf3-DI-Crr>0 Permit Number SW Property owner(s) r pro IR IV -f-Cl, rnt R . ro,e—Day phone %i33-9407-9 Mailing address (1) P.r) . Qir!,Y 1 1 I Mailing address (2) -t; ✓ k_ P\ Zip Code 4?Q_SP�7 Legal description (Lot, Block & Sub'd.) Lot lir LC 5, S„ ✓vc�j _'any 7 Legal description (Section, Township & Range) �r _ I T In D'I fz 2, C_ Lot Size J 4S3 c/ Acre lSq.Ft. THIS APPLICATION IS FOR: Number of Bedrooms Sewer Only ❑ Well Only 0 Sewer and Well ❑ Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit 19 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: # Waiver Fees: Date of Payment: of Payment: Receipt Number: & _ Receipt Number: (Rev. 12/00) PLT C-1/0.2/2005 05:18 t IHS ram +eA'mI zw�_ Galnu )16= 9072767804 • „` b 1•11H, F Io OS P09ERT E J0 41S JP, PAGE 01 5) 0 )se °O CABIN --�\Roo. ex/MELH r T].- 115 7 SOw.1 N. u 4u.3' S2 r ?• ]2V I '�+• ��• h 1` n Y txA It eCL Loeeet'.ol.. \ �A try Q�/ MN.11 / 1 V,/; Lt- jrxG+ ltntai .. 2J TcGt,0 NLl nAYRc to Qri iro--CC. 5c4A se ice Line i -to puhIzc. S'GVJ Cr- '�yE,Jt,hl �00 �'� r+M1atxScL SCRVEY CERTFICATION.., i / Prepared by PILOT PL:N ��P-�E„OF IF��o .Robert E. Johns, Jr. & Assoc. Professional Land Surveyors c... ..aur r r w. r1 ..,�. ; • r •. - -•e+2 E 12 AVE. W M M b •r M r b .. t. �� ANC110RACL. AL ASKA 99501 / SOON(HY.. Lel S.F.PIC• FIC No. r�vnoanan.s-rullT w ••W% ' .. .1": a� 6A.'. � ,5'"S�.'jJ 9 U.`.S w Uate S rH" e: .n w, r.,.-...� .....,n •. r ♦ E Sr!T' I.Z 2 / O 7 Ureby,t]y J leetea e R jERTA�.C� r..v...... rAar.. .. rai s.. n•...v. w..r "'• ••� f : , J l Dote Onm: : UnA'N.O. >'j �:. 41'21 S .d SE4912 2.. 911' F!NAL STRJ4:U4E 45-OWLT +7A +e ♦ ...�. c rw. •. A•YT aaN ..+ I ' '•^ "'•«.......+r�`'JA'�' :e9d CJexTlytlw: R.rw a.�.M:' �+.�rrs � �aleselendl'0n.1�' LOT' 104, USS 3042 GIRD'r700D P.LASKA LOT TJl.TT SURVEY •TYPE - . } rW1N TON AS -e JLT ME30LS v rl..L 1mmJ4•ncA A mlr • SET REBAR CRAJNACE ASPHALT p •LOT 0.4! ... AS LT ... LOT 9L ... 'IOFOC"A �O FOUND FWBAfi q��p tYOOO FEN :'L fd ' C7.CRCTE .s -n: LT .rn- !A COD;) ASSUMED ELEV, *X --.P: ()T P1 AMS Je I nT CI IPvcvC„��, N[TAL FEN!:'E ( _ W^<M DFP•! IF Iz r,c Ml�rVNWCIU IT OF THE BUILDER OR OWNER, PRIOR 7TJ 'ONLY CCVSlTHOSE IMPAOVgMENTS ABOVE GROUND AND Vl_^iiBLC u1 LL BC O FINiShE)I,40 N, TO VERIFY PROPOSED BUILDING GRADE RF—ATIVE SHOWN, FCNOLS, WIELS, S rc CLUNOUTS, SIOEWALKS. ORw.,-9. ' GRADE AND UTILITY CUHNECTONS AND TO DLTERUM LTC., ARE b OWIQ IN TNOR AOPROXIM ATC LOCATION. ONLY. SNOW' .FE C S�^NCE Ce ANY F+ ME14T5 COVENANTS OR RESTRICTIONS MAY PREVENT SOME MRROVRMENTS FROM BEING SC -'4 ANO LOCIITEO. -A'�I CI+ CO NOT A,)eggR Ont THF REOOPDEO SUPDINS'ON PLAT ALL DI^TANCrs ARE Pt—OF,, tjr a 1•,tu OT�n UNOER NO OROJUSTASOCS SHOULD AN AS-9ULLT BE USA FOR CONSTRUCT” OR FOR ESTABJSH!YO BOUNDARY OR FENCE LINES. .HE SURVEYOR TAKES RESPONSIBILITY FOR THE INITIAL TRANSACTION ONLY'AND'ASSUMES FINANCIAL UAEWTY ONLY FOR Tf1E C= OF THE SURVEY. USYM DISTANCES PREVAIL OVER SCALING REPRCOUCOON MAY CAUSE ERRORS N SCALE, .� ..�.«.� IPO. 9072767804 • „` b 1•11H, F Io OS P09ERT E J0 41S JP, PAGE 01 5) 0 )se °O CABIN --�\Roo. ex/MELH r T].- 115 7 SOw.1 N. u 4u.3' S2 r ?• ]2V I '�+• ��• h 1` n Y txA It eCL Loeeet'.ol.. \ �A try Q�/ MN.11 / 1 V,/; Lt- jrxG+ ltntai .. 2J TcGt,0 NLl nAYRc to Qri iro--CC. 5c4A se ice Line i -to puhIzc. S'GVJ Cr- '�yE,Jt,hl �00 �'� r+M1atxScL SCRVEY CERTFICATION.., i / Prepared by PILOT PL:N ��P-�E„OF IF��o .Robert E. Johns, Jr. & Assoc. Professional Land Surveyors c... ..aur r r w. r1 ..,�. ; • r •. - -•e+2 E 12 AVE. W M M b •r M r b .. t. �� ANC110RACL. AL ASKA 99501 / SOON(HY.. Lel S.F.PIC• FIC No. r�vnoanan.s-rullT w ••W% ' .. .1": a� 6A.'. � ,5'"S�.'jJ 9 U.`.S w Uate S rH" e: .n w, r.,.-...� .....,n •. r ♦ E Sr!T' I.Z 2 / O 7 Ureby,t]y J leetea e R jERTA�.C� r..v...... rAar.. .. rai s.. n•...v. w..r "'• ••� f : , J l Dote Onm: : UnA'N.O. >'j �:. 41'21 S .d SE4912 2.. 911' F!NAL STRJ4:U4E 45-OWLT +7A +e ♦ ...�. c rw. •. A•YT aaN ..+ I ' '•^ "'•«.......+r�`'JA'�' :e9d CJexTlytlw: R.rw a.�.M:' �+.�rrs � �aleselendl'0n.1�' LOT' 104, USS 3042 GIRD'r700D P.LASKA LOT TJl.TT SURVEY •TYPE - . } rW1N TON AS -e JLT ME30LS v rl..L 1mmJ4•ncA A mlr • SET REBAR CRAJNACE ASPHALT p •LOT 0.4! ... AS LT ... LOT 9L ... 'IOFOC"A �O FOUND FWBAfi q��p tYOOO FEN :'L fd ' C7.CRCTE .s -n: LT .rn- !A COD;) ASSUMED ELEV, *X --.P: ()T P1 AMS Je I nT CI IPvcvC„��, N[TAL FEN!:'E ( _ W^<M DFP•! IF Iz r,c Ml�rVNWCIU IT OF THE BUILDER OR OWNER, PRIOR 7TJ 'ONLY CCVSlTHOSE IMPAOVgMENTS ABOVE GROUND AND Vl_^iiBLC u1 LL BC O FINiShE)I,40 N, TO VERIFY PROPOSED BUILDING GRADE RF—ATIVE SHOWN, FCNOLS, WIELS, S rc CLUNOUTS, SIOEWALKS. ORw.,-9. ' GRADE AND UTILITY CUHNECTONS AND TO DLTERUM LTC., ARE b OWIQ IN TNOR AOPROXIM ATC LOCATION. ONLY. SNOW' .FE C S�^NCE Ce ANY F+ ME14T5 COVENANTS OR RESTRICTIONS MAY PREVENT SOME MRROVRMENTS FROM BEING SC -'4 ANO LOCIITEO. -A'�I CI+ CO NOT A,)eggR Ont THF REOOPDEO SUPDINS'ON PLAT ALL DI^TANCrs ARE Pt—OF,, tjr a 1•,tu OT�n UNOER NO OROJUSTASOCS SHOULD AN AS-9ULLT BE USA FOR CONSTRUCT” OR FOR ESTABJSH!YO BOUNDARY OR FENCE LINES. .HE SURVEYOR TAKES RESPONSIBILITY FOR THE INITIAL TRANSACTION ONLY'AND'ASSUMES FINANCIAL UAEWTY ONLY FOR Tf1E C= OF THE SURVEY. USYM DISTANCES PREVAIL OVER SCALING REPRCOUCOON MAY CAUSE ERRORS N SCALE, 0 NfunicipaUty of Anchorage �0 Development Services Dep===t t4v I "z-Oding Sz..y Dit si= :.•_,� On-site Water za3 Wnte-wzter Progr2—n 4700 south B:agzw St P.O. Box 196550 Ancbozge, AK 99519-6550 F-sw.ci.z.-r_horzg e.zlc.us (90 7) 343-7909 PERU T REQUIREMENTS FOR A DOIdES T IC WATER SYSTEM Permit. An application to drill a new or replacement well shall be submitted to this department by the property owner or their agent prior to commencement of drilling operations for a single family water well. A permit for domestic water source shall not be issued if there is no existing or pe, ni Led on-site wastewater disposal system or connection to public sewer service for the property available, scheduled and approved. A permit for a domestic water system shall be valid for one year from the date of issue. Application. The application shall be on a form provided by the department. It shall be signed by the property ov✓ner or authorized agent a"esting that the well will be sited, drilled and completed in accordance with standards and provisions in AMC Chapters 15.55 and 15.65. The applicant shall submit an accurate site plan signed by the property owner or property owners agent drawn on an 8- 112 by 11 inch sheet (or larger if necessary) to a scale not smaller than 1 inch to 50 feet. The site plan shall show: 1. Legal description of the lot or parcel. 2. Location of the proposed well. 3. Lot lines, roads, rights-of-way and easements on or adjacent to the lot. 4. Location of all proposed or existing structures on the lot. 5. Measured distance to all existing water supply wells within 50 feet of the proposed well site. 6. 100 foot protective well radius. 7. The location must be shown of all components of wastewater disposal systems.' This shall include sewer trunk and service lines; sewer clean -outs and manholes; fuel tanks; curtain drains and out -falls; and any known areas containing hazardous waste or other potential pollutants. Also included are existing (or proposed) paddocks, kennels, animal enclosures or containment areas vrithin 200 feet of the proposed well. The minimum separation requirements between wells and specified facilities or areas shall be: SEP?.RATION BEN✓EEN F?Old WELL TO: Sewage holding tank Septic tank Septic absorption field Private sever service line Public sever trunk line Public sewer manhole or clean-out LON. SEPARATION DISTANCE IN FEET Hydrocarbon storage tank Curtain drain Animal feed lots, shelters, containment areas Any source of potential contariination 75 100 100 25 75 100 25 25 100 75 Attention: The well driller shall provide a well log to the property owner within 30 days of completion and the property owner or the well driller shall provide a well log to the Dapt. of Health, & Human Services within 60 days of comol 'Lion.