HomeMy WebLinkAboutSKYWAY PARK ESTATES #1 BLK 8 LT 9Skyway Park
Estates #1
Block 8
Lot 9
#019-201-02
Gk'' ;TER ANCHORAGE AREA Br'�IOUGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
11'4arcV-!IUry KtrUKI UN -SITE SEWAGE DISPOSAL SYSTEM
NAME1JQLe{f/Old✓ Flu//Q1,C1" MAILING ADDRESS_�G.�6��G�/I/r/0%f PHONE
Jt� .' Z99Saa
LOCATION- IF, %,,CD!/d LEGAL DESCRIPTION —Cf 9 L' d -r, i.l
SEPM TANK:
DISTANCE
FROM WELL -f^/ MANUFACTURER G.E�sf� NUMBER
MATERIAL.fTff,L/ COMPARTMENTS—/
INSIDE LENGTH — INSIDE WIDTH - LIQUID DEPTH - I IQUID CAPACITY 426"x7' GALLONS.
SEEPAGE PIT:
NUMBER OF PITS DIAMETER OR WIDTH
LINING MATERIAL CRIBSIZE
BUILOIN UNDATION__, NEAREST LOT
ADDITIONAL ABSORPTION
WELL:
DEPTH
DIAMETER—DEPTH— DISTANCE M:
TOTAL EFFECTIVE
LINE ABSORPTION AREA (WALL AREA)
WELL
FT.
TYPE A9,fl"15CONSTRUCTION
to "�!/e/.«Cb
�l� l
DEPTH a DISTANCE FROM:
BUILDING
FOUNDATION I�,
//- NEAREST AWrV
LOT LINE ell'
NEAREST ������hh``
SEWER LINEA,
19E C1p7/ SEEPAGE
TANK! . SYSTEM ,
CESSPOOL OTHER SOURCES A/f/Fi eO,4-AaW. SfE/,e<f /v,- ,o�,S//
APPROVED DISAPPROVED 'Z REMARKS__ e6f4f' TD xj5r/6C /Jd/GO
DISTANCES: I -10A tl
INSTALLED BY:
PIPE MATERIAL: ersi . �N
LOT SLOPE:'<jG/J£/- I f0A11-
REMARKS: /wAS ..:v✓ie��
.f lam/ s�a/ Jf// It Lu DATE
Form No. EQ -031 A: oa
DIAGRAM OF SYSTEM
PA'd y
J
�tPPR01FED
or�,cy .e�io.�svco
GREATER ANCHORAGE AREA BOROUGH 1
i• p
DEPARTMENT OF ENVIRONMENTAL QUALITY
PERM]Y
3330 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274.4561
SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT
NAME OF APPLICANT
INSTALLATION LOCATION / R O
LEGAL DESCRIPTION / ^ " r'
14,44m-
INSTALLATION
4,4 /-
INSTALLATION OF: aEPTTOTANK
TYPE AND S1ZE OF FACILITY TO BE SERVED
FINANCED THROUGH
MAILING ADDRESS F'���' r �� ��/`/ArT•NONE
SEEPAGE PIT
TO BE INSTALLED BY
DRAIN FIELD OTHER
SOIL TEST RESULTS /r / NOTE, THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
COMPLETION DATE ANTICIPATED �C, 7
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
'vim TANK S12E� Cc . TYTYPE 'x I SEEPAGE-AaEA SIZE TY
MINIMUM DISTANCES. REQUIREMENTS
FOUNDATION TO KRZIC TANK
S
FOUNDATION TO SEEPAGE PIT - DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT WALL
BEPFIC TANK `V SEEPAGE PIT DRAIN FIELD
TO NEAREST LOT LIN
WELL TO SEPFIC TA SEEPAGE PIT
DRAIN FIELD ALSO CONSIDER AREA WELLS.
,
WATER MAIN TO SEPTIC TANK SEEPAGE PIT
DRAIN FIELD
S?PSIG TANK. .Od SEEPAGE PIT �� DRAIN FIELD
TO RIVER, LAKE. STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION B FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
TMJ
OR
LICENSED DESIGNE
1 CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. 4,
% /7 3.1�
DATE APPLICANT'6 SIGNATURE
FORM NO. EO -01•
SYSTEM
)UGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
Parcel I.D.
1.
.,. '. Municipality o~fAnchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Box.196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
CERTIFICATE OF
" FOR A SINGLE FAMILY
GENERAL INFORMATION
Complete legal description
Location (site address or dire;cti(~r~)
HEALTH AUTHORITY APPROVAL
DWELLING
r qbt)O
Expiration Date: ~ '-
SKYWAY P~,~K EST~,TES SUBDiVi§ISN; LOT 9, BLOCK 8
~ 1420 sH~j~E.DRiVE
13-oq---'
Current Property owner(s)
Mailing address
ANN O'BAR Day phone 344-7209
1420 SHORE DRIVE * ANCHOP~(}E, AK 99515
Lending agency
Day phone
Mailing address
Real Estate Agent
Mailing address
MARY DEE FOX WITH REMj~ PROPERTIES. Day phbne
2600 CORDOVA * ANCH(~RA~E, AK 99503
257-0168
Unlessotherw~e mqueste~ HAAwillbe.held.byDSD ~rpick~.''
2. NUMBER OFBEDROOMS: 4
e
TYPE OF WATER SUPPLY:
Individual Well ·
Individual Water Storage D
community class Well D
Public W~ter'System D
T~i~ OF W'A~TEWATER DISI~OSAL:
Individual On-site [-']
Individual Holding tank ['-]
CommUnity On-site
Public Sewer
The Municipality of Anchorage Development Services Department (DSD) Issues Cedificates of Health Authority
Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer
of title (except between spouses) for propedies served by a single-family on-site wastewater disposal and/or
water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority
Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may
be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid
water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water
system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's
work.
Municipality of Anchorage
.Development Services Department
r '' "L
' ~ . :'~_'uilding Safety Oivisi0~n
.', :!: 'Or{-site Water & ;wastewate~ Program '
:'i - Ii':. ~4700SouthBragawSt~.' i' :.i !..ii.!,
". ! P.O. Box 196650Anchorage, AK99519-6650 i' i":: ir.`.
· ' . i; I .i I~ . .' ~i . . . ~{/¢w.ci,ar~chorage,ak~Us
· . ~ : i: ' : :;:' ~ I, (907) 343-7904 . ..'.
' ' ~i ' i ~ , . ~, ' -ri, ' ' 'r' · ",
~ :' : ,:: i' .HEAETHAUTHORITY APPROVAL UHEC,K. UIST:~ , .
· ' , ;i ' ' : ' . , ;" ' ; : .... . · . ' ': I i '. : . ;'
· ' ':' I'; ,.~ ....... :i' '.", '",' ' : ":';'~' '. .':'. "' ~ ,")i'~ln0=2.
",:." " Le'dlal De§~rintion' SKYWAY ,PARKI. EST. ?, SUBDIVlSION; LOT,..9;. BLOCK 8 :Parcel ID: 019~ _
. , ; ' · ! ' ' '. " ;' I:F : : ' ; :. :.. ' . . : !.. ;...i ' . .
A WEIJL DATA .: .... ' , . , , . . .......
';; ' ': L!= ~ i ~ ;,~ ' ' :;, ':~ ' ;" : ; ' ! ' "' ' ' '" '= ! ' : ;, ', t i i' ,, , ,
'' :.' . .WIll typ~PR~'^'rE ""'i.;'lfA, B!:orC'~Jr0videPWSID# N/A'.~, :.,.. ;W.elll..og~(y/N
'i ' :- D;4{~'bom~leted PRE:.lO/1,/1973sai-iit'a~ §~al fYl,, YES..:i.!!.!' ,'Wires propefy:proteoted (Y/N) ' YES _
· . II~, ~ i .... ,. ,. . , I , ,
' .. : ; Total depthUNKNOWNft .... i ~', '.. Cased to. 40'+ ft, . : ::, Casing he~gh! (a~0ve ground) .12+ ~n,
' ' '. : '! ! .... ' ; . ; '., [i" ; ' ; , ' ;,. ,
;"; ~ .... '" :':: : :FROM WELL LOG . ::. ' ;!
':. :'i : , ! : , ,. ' :' ::. !.. .:., .' .,~., '" ~ ,!i ',: ' '.il,? ,;;i~i · , .
, ' ,!,' , '; ; , L "~'' ,~, "!'' I .; ,;,', .!~ :' '
', n,,,~,,-,¢,~,~t ' ' ' :; ..... ' .... ,, ::~,';'<'. i' :. :;,,.,, 12/31/2005 .... :.
:': , , Stat c water level ;. ''., .'. . .::. 75 :.. .
.:'. ..' .... ,' ·:'... .... , I: 'm,..,', ......... gpm
:: ;... . Wel product on...,: ....... g.P. . .., , ~ ~.. .....
,'., : . ·.. ' .~ r 't' r i :: ,, ,
. ... , ; . . WATER SAMPLE.RESULTS.,. ,. ....... ..................
.... ' ' . : .~-' . [ '~"..''. : , ' i ,: .... .I , . .
. ! .' ..'. Chi f~rm i !"(~ 'cb'lb-n'ieS)lO0 n~l... NitJ-ate i.i',~:~ mg./L.,.i
I. f , ' ~ . , , :~, ~; , , ., , , ~ , , : I . , ; : : .i i ' . , '. ,
;; ' ' . ~ . , " : '. "~, :i' i .' ,: "i , ' ..... ~'~, '
{'i!': .; ..- A~en c: tlN/A' mg.'/L';, , ~. !, ;',, I:,,,. ,: ." ,; I 'l' ~, D~*,!elolf sample:l 2/311~2003.,,, ' Collec~te ~d
... , , ,,,,.,,,.. ....... , ................
, -' ." Tank:sze~' '.' gal.,, ...! i Numberof,Compartments.
'' ::'.:
':: ~ C ABSORPTION FIELD DATA, . :' ~, I.~.. ,' : ": i'~ ~ ..... ~: · . '_
i ..... ' · ' Date nstalled .... ',. ,, , Sol rat ng (g.p~ d./ft or fllbdrm)
, - Length,,,: ..... .....
ff.
: :* ~ ** ~'f~f'~n.~v*t~t; *~ ' ~ ~,: * ~' R~ ', ~'~' ."For, bedrooms
.' : . : Fluid Oepith n absorptonfed ~~~ New depth ..n..
':~, :' ',";: E ?ed, ime~' '~: :i;;~ :'[:' ;:' >
g.p.d.
;'~; ..:, E . ' ~ ;: .... .:" i.'iI I' .~ '; "E ~' fi': '.'' ': . :;'';
LOT lO
nV~LL
/
RET.
'%
'LOT
AS-BUILT SURVi'Y
NO CORNERS SET THIS DATE
II HEREDY CERTIFY THAT I HAVE P£RFDRME9 A
MORTGAGEE'S INSPECTION OF THE FOLLOWING
DESCRIBED PROPERTY.
LOT 9, BLOCK 8, SKYWAY PARK ESTATES ~U~.NO.
ANCHORAGE RECORD[NG DISTRICT. ALASKA AND TH
I THE flH~RDVEMENTS SITUATED THEREON ARE
THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPEClF'lCALLY TO SHOW ANY CONFLICTSII~T.~'~k~ITy LINES AN]) NO VISII~LE ENCRDACHHENT-~
EXISTING ~TRUCTURES AND PLATTED LOT UHES OR r.A~EIdENTS AND IS NOT TO Eli USED [rOE POSITIONING ADJ ~l~]~r.~ THAN NOTED.
STRUCTURES OR £ENCEUNES.
EAS",.'E'""' 0" RECOR". OT,~ TH'., T, OSE S,OW" 0, TH~ ,ECO"OEO ,'LAT. AR" ,OT ,,-,OW, ,E,EO".'''''1~¢¢T'"~""~'~-"'-~"~"~~:::~_T_:::L"~'-~::::--
_1 HDLT. L.A~;
L D SURV£YING 9Z36, FSI09 46
NOTE: ANY FENCEUN£S SHOWN ARE LOCATED APPROXI,ATELY AND ARE NOT TO BE USED TO DETERUIHE
OR LOCATE ~'TRUCTURES.
/
1-- B--04; 6:49PM; ;907 5615301 ~ 2/ 3
GS Ref.#
lient Name
'roject Name/~
lient Sample ID
tatrix
1038151001
AK Watcr & Wastcwatcr Consultants Inc.
Sk~va¥ Park S/D, Lg, B8
Skyway Park S/D, Lg, B8
Drinking Water
ample Remarks:
All Dates/Times are Alaskn Standard Time
Printed DateTTime 01/05/2004 14:55
Collected Date/Time 12/31/2003 14:07
Received DateYTime 12/31/2003 14:30
Technical D~ <~St/en C. Ede
Resul~ PQL
Unit~. Method
Allowable Prep
Conlainer ID Limit~ Date
Analysis ,
Dae Init
aters Department
Nit~at~-N
v
icrobiology Laborator~
T0~
1.36
0
0.100
mg/L' EPA 300.0
col/lOOmL SMI8 9222B
B (<=1o)
A (<=1)
12/31103 J.IB
12/31/03 DKC
1-- 6--04; 6:49PM;
sGs/C:I'E .E.N~iRONMEN. TAL SER,.V..ICES
;907 5615301 # 3/
· '200 W. PO'I-rEP, DP,IVE
ANCHORAGE. ALASKA 99518
Tel: 907-562-2343
Fax: 907-561-5301 "
Lab Ref No.
Drinking Water Analysis Report for Total Coliform B~cteria
READ INSTRUCTIONS ON REVERSE SIDE BEFORE COLLEC13NG SAMPLE
-MUST BE COMPLETED BY WATER SUPPLIER
[] PUBEC WATER SYSTEM ID~ ..
A PRIVATE WATER SYSTEM [] Send Results
r-i send Invoice
ICl~act Name
.rex Nu~be~.
SAMPLE COLLECTION: ·
Tmnspo~
~ Same as Colle~or Other:
to
Lab
SAMPLE TYPEi
" ~ Routine
[] Treated Water
-Zip Co~e
[] Repeat Sample
(refer to lab no.
[] Special Purpose
I-I Untreated Water
3
ro BE COMPLETED BY LABORATORY
Date:
[] Sample over 30 hours old;
Results may be unreliable
'rime:
Temp:_ ~..~'~"~'~"-' [] 4e HourWatver
Delivery Method:
Received By:
Comments: "
Phone #:
[] RUSH SAMPLE
· m mmommm JoJmmm mJmoemJoma om e! mm mmmmmm oommom emm memmo mae emu · m memmommomommmmmom emm mm eeJoJJ mmmm me · ommmmmemmt
,... ...... . -. · . ...... : - ... -.... . :.....-.--;. .-..- : .........- ....:::..
Bacteriolo.qlcal Water Analysis Record: ~Sent to ADEC: [
· MMO-MUG (P/A) RESULTS: I ANC FBK JUN
I
Analyst: ~ E. Coli:
Analytical Method:
[~ Mem..brane Filter
[] MMO-MUG (P/A)
Signatu~'e ~
MEMBRANE FILTER RESULTS:
Direct Count: ~'~
Verification:
Te~a~ Celltom~
BGB:
EC:
Oate~ime:
ColonleS/lOOml
ISent to Client:
Phoned ~
Date/Time:
S poke v,,tth:,
~ Saiisfactisry
[] Unsatisfactory
Faxed r--I
~'NTC · Too Numerous to Count
Form # FVV- 0053 10/24103
~\petra\publ[c\DOCUM EN~FORMSWlicro\Coli Form.xls
r1 MUNICIPALITY OF ANCHORAGF-,
DEPARTME.. OF HEALTH AND ENVIRONMEN. _ PROTECTION/�
825 L Street, Anchorage, Alaska 99501 I l�
279-2511, ext. 224 or 225 �', Z
#1: Time I'`Sp9M #2: Time
Date Received: September 1. 1977
#3: Time
Date
4LQA
Date
Date
Insp( ,( , 1�kjk—
Insp
Insp
REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES
1. Lending Institution Request: Spokane Mortgage Company
Mailing Address: 3201 C Street, Suite 250 Phone: 277-0543
2. Property Owner: Jack O'Bar Phone: 344-7209
Mailing Address: Star Route 191A 272-5522/w
3. Legal Description: Lot 9 Block 8 Skyway Park Estates #1
4: Single Family Residence: ( $ Number of Bedrooms: Four
Multiple Family Residence: ( ) Number of Bedrooms:
5. Well System: Individual Well (xi Community/Public System ( )
Permit In dj- Depth)0'
Well Well Log on File ( 011V
1't
Construction O tBacterial Analysis
6. Sewage Disposal System: On-site System ( Public Utility--(-4
Permit # Installed Installer
Septic Tank Size Manufacturer
Absorption Area Soils Rate Material
7. Distances: Well to Septic Tank to Absorption Area
to Sewer Line Nearest Lot line Absorption Area
to Nearest Lot Line
PageTwo
Department of Health and Environmental Protection
Request for Approval of Individual Sewer and Water Facilities
Legal Description: Lot 9 Block 8 Skyway Park Estates #1
Comments:
Affadavit Attached: ( )
Letter Attached: ( )
Approved:
Date:
Disapproved:
Date:
Department Worksheet •
n 0 nl-t-
U v`
V
N
MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAG2
DEPARTMENT OF ENVIRONMENTAL QUALITY DEPT. OF HEALTH &
Sewer and Water Section, Fourth Floor, 825 L Street, "age°; WFAWPiI9501
Attention: Laura Harrison
AUG 3 11977
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES RECEIVED
1. Type of Inspection: CMRO VA R% FHA CONV
2. Property Owner: JACK 0`BAR
Home 344-7209
Mailing Address: Htar Route 191A. Anch. , Ak. Day Phone work Mr: 272-5522
3. Name of Buyer: same
Mailing Address: same Day Phone
4. Name of Lending Institution: SPOKANE MORTGAGE CO.
Mailing Address: 3201 "C" Street, Suite 250, Anch. , Ak. Phone 277-0543
5. Name of Realtor or Agent: n/a
Mailing Address: Phone
6. Legal Description:
Lot
9, Block 8,
Skyway Park Estates Subd., Addn. No. 1
Location:
NHN
Shore Drive,
Anchorage, Alaska
7. Type of Facility to be inspected: single Family No. Bdrms. 4
8. Water Supply
Type of Supply: Public Utility
Individual X%
If Individual, number of dwellings presently served One (1)
If Individual, depth of well unknown
9. Sewage Disposal System
Type of System: Public Utility XX
If Individual, date of installation
Eo.037 final
Individual (on-site)
j.
JV
F �,CcioLcr 2�> 1573'
Jo; StcfftLlj
0
P :cfftclJ
c/ S i l
P. tlox builders
1J�11.11att Station r'
Ancaurag� ! t `•
,Sulj ect - , �, ! ', n t + •a
Pr(vatc hall Proposed fo
Gtacn
Sky>rai:Subdivi°9tc Faintly 11;i
iJL
sia
ar r S;tcfficlJ: c , . i
Triis
lett-,-r. is to confi r
lotata' t'1L ��, rm our CD)Verodtl0q
ova st.ujcct lot Octo)a a
r T)tc wall is clisa�r 1�'"1 Ja, rcgrtr, j ufa well
))
T. 11 IS'locatcu r;�-feet :fron to holt+iu Iroved {r,r tt, folfo�rinl reasons `
t
uct s;y„a� Su Jivisi
q.fan.;-
la,,:a al• (T lis is violati` 1 L�liat :'r
1n na
,ater f�eyuiatioas ir; o lc. t;�. .
1 „ell to a .)ul lic(1 Mluita G11 0f . �.,S .
di taxi: ) s a ttini: u �af� of t
{
iVi iu,, "ea�te pit locatcd'u,i Lo {' y
t't
t.
is ,loca0.� approxiaatel t "1J> Lloc;
i„ violatiu:r cf Y, 51.'fac t-f�mt �•.S;;y,
;1•�iaan ti':Crcatcr.I,ricitoratae f:�)T t
"regUfr 9c. f,h�a:ftoroar
pit.) i s a' rijnii lu:,l 1J 9 t..
of yls+t
J fcLt'fru✓)
1J1 C,.I rrJ, S ,li a
nlasl.� tarp Ll�li)Cer
u,:e,,ra t,,at Lenart wnt 0f Lnvir'ou►ntal'C�nserv.na r �{
rot �r ^ttli.ed .•utless the xell JistiacQ _
SI;y./Qy Urlt)1."SUC,i tir., a tili: re'ltlirejwnCS'arm rGCt* Cate Ofd
Si,'A:C Ju riV' iajlic", SLrlr�eu. by )Ubl icdseuc r,�9s lOC1 tL�1 ,Un .LUta Jj ung' 7l nU lc�t r r
c r.Lly "o _ Pitasc aJyise Sri It't`luiu el,iloCK ��
9 -awell
rtr:.. ,tut t
Sani taria.l
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