HomeMy WebLinkAboutRAVEN WOODS #1 BLK 4 LT 6Raven Woods #1
Block 4
Lot 6
015-232-27
Not eligible for Certificate of On -
Site Systems Approval because
final Inspection Paperwork is
needed!
DZunieipalit3 of.
r
P.O. Dox VX;G50 • .1,lchomgc, Alaska !.1519 -CM) • Tcicphonc (!N)7) 343-NUH • Fax (!N)7) 333-82(N)
A 7(N) nragaw• S(rccl • Anchomgc, :llaskn 9R5(17
Alayor Alark Begich w, ,c.imml.nrg
Building S dety Division
22 Jun 05
Audrey Aanes
11840 Moose Road
Anchorage, AK 99516-2470
Subject: Expired On -Site Water and/or Wastewater Permit
Permit Number: SW030151
Legal Description: Raven Woods #1 Block 4 Lot 6
Dear Ms. Aanes:
This letter is to inform you that your permit S W030151 expired on 22 May 04.
a
o• d„
wS•, rrr/
Our records indicate that a house was built on this property. To date we have not received a final
Inspection Report for the installation of the on-site wastewater disposal and/or the water supply
system.
Please be aware that you will not be able to receive a Certificate of On -Site Systems Approval at the
time of any transfer of title.
If you have any questions, please call this office at 343-7904.
Sincerely,
Kathleen Maricle
Permit Clerk
On -Site Water and Wastewater Program
Enc: Copy of permit
Community, Security, Prosperity
April 23, 2004
Alunicipali' T7lI
of Anchorage
3fa� kich, Mayor
MARL1g ifety Division
P.O. Boz 1��°) • 4700 Rragaw Street.
Anchorage, Maska 99519.6650 • (90 i) 343.8301 • Paz (907) 343.8`00
1ittp://A�.mttni.org
Audrey Aanes
11840 Moose Road
Anchorage, AK 99516-2470
Subject: On -Site Nater and/or Wastewater Permit.
Permit Number: SW030151
Legal Description:'Raven Woods #I Block 4 Lot 6'
Dear Ms. Aanes:
An On -Site Water/Wastewater Permit, number S W030151, issued by this office for a single-family
system, will expire on May 22, 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 Eneineer 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 for a second year may
be issued for a fee of $115.00 if the renewal application is received on or before the expiration date of
the original permit.
When applying for anew 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 3.33-7904.
lin/rely,
�/ fo�
s Cross, P.E.
ger
On -Site Nater and Wastewater Program
Enc: Copy of permit
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 WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: May 23, 2003
Expiration Date: May 22, 2004
Permit Number: SW030151 Parcel ID: 015-232-27
Legal Description: RAVEN WOODS #1 BLK 4 LT 6
Design Engineer. 0088 Anderson Construction & Eng'g Site Address: 011840 MOOSE RD
Owner Name: AUDREY AANES Lot Size: 61420 SQ. FT.
Owner Address: 11840 MOOSE ROAD Total Bedrooms: 3 Permit Bedrooms: 3
ANCHORAGE. AK 99516-2470
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 closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By:
Issued By:
000ft///*1//'2//'Z� Date:
Date: 23 LO
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 SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D.QIS 232-27 Permit Number SWV 30/ F/
Property owner(s)e4y dfila( Aa n
e 5
phone 3'q S- O jZ 1
Mailing address (1) /1.Y'-/0 Woo--
(2
/ ,//Day
41, .�AI-A LL 4195110
Mailing address (2)
Zip Code
Legal description (Lot, Block & Sub'd.) 0VfiV
LV60DS */ BLack 4 LDT
4
Legal description (Section, Township & Range)
Lot Size 2. Q 'f' creg.Ft
Number of Bedrooms 3
61, 20
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
❑
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: y(i O, fr Waiver Fees: _
Date of Payment: .711201Date of Payment:
S % 3 Receipt Number:
Receipt Number: 3
(Rev. 12/00)
Michael N. Anderson, P.E.
Civil/Structural Engineering
4640 Shoshoni Avenue
Anchorage, Alaska 99516
Phone 345-3377
Fax 345-1391
343-5-229
May 20, 2003 7 2 7—$�66 4
Municipality of Anchorage
Department of Health and Human Services
P.O. Box 196650 1
Anchorage, Alaska 99519-6650
Re: Lot 6 Block 2 Raven Wood Subd.
To Whom it may concern:
This is a request for a permit to replace the existing septic system for the above residence. The current
leach system has failed, the tank is collapsing, and the system is inside the 100 foot well radius. One
new test hole was excavated to 17 feet, the soils were silty gravels for the top 6 feet, then 3 feet of tight
silts then sandy gravel below that to the bottom of the hole. The perc rate was 3.3 minutes per inch
however the system was designed using a slower rate for life of the system. A new 5 wide with 4 feet
of rock has been used to keep the system away from the slower silts. No water was observed during
the excavation or over the 7 day monitoring period. The slope of the lot is from the ridge see the plan
which bisects the lot, with 2 to 3 percent towards the house and the northwest lot comer.
This new system will not impact the neighboring properties due to the large lot sizes and layout of the
existing systems.
If you have any question please call me at 345-3377
Sin�cer�elyy
Mich' hael N. fdrerson
DESIGN CRITERIA:
3 SDRM X 150 = 450 GPD
SOILS = 450/0.9 = 500 SQ FT REQ'D
500/8= 63' TRENCH
(1) TRENCH
6' DEEP
4' EFFECTIVE
2.0' WIDE
63' LONG
EXISTING 100' WELL RADIUS
0
IZZL
li
MOUND OVER
b GRADE
1OR b (FILTER FABRIC do
—16'
b
GM
u
Ave
I
Septic Design Prepared For
AUDREY P. ANNES
LOT 6 BLK 2 RAVEN WOOD S/D
Anchorage, Alaska
Prepared By
MICHAEL N. ANDERSON, P.E.
4640 SHOSHONI DRIVE
(907) 345-3377 / FAX (907) 345-1391
SCALE: 1"=200' MAY 14, 2003
z.W 1 --DRAIN ROCK
\ t
of at4 �
MICHAEL N. ANDERSON
•, C�E 9469
I
I
1
1
1
1
L-- TEST
1 �
I
I 1
1 1
MT
GALLON T
DOUBLE
------------
EXISTING HOUSE
WELL`
DRIVEIVAy
�{ T.C.O.
Septic Design Prepared For
AUDREY P. ANNES
LOT 6 DLK 2 RAVEN WOOD S/D
Anchorage, Alaska
Prepared By
MICHAEL N. ANDERSON, P.E.
4640 SHOSHONI DRIVE
(907) 345-3377 / FAX (907) 345-1391
SCALE: 1"=50' MAY 14, 2003
L` EXISTING TANK AND '^
CRUSH IN PLACE w
1
I
1 a
1 0
I a
I
1 =
1
1 0
D
vDi
EXISTING WELL
100' RADIUS
Sp�E•OF qtQ %l
*0
.490 • ,I
PvMICHAEL
N. ANDERSONX, CE79449
J
Municipality of Anehoraga
DEPARTMENT OF HEALTH 3 HUMAN SERVICES
825 "L" Street. Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: I //'F /IAS I -ph A9 DATEPER
LEGAL DESCRIPTION: v Y 17 Z 1� �W �n N!n✓� ToWnship. Range. Section:
DEPTH SLOPE SITE PL
►ESTI oiq ant r .�, � F—F—F7-
1-
2-
3-
4-
5-
6-
7-
fl.
-
3-
4-
5-
6-7•9.
9•
10.
11
12
13
14
15
16.
17
18
19
20
:OMMENTS
Sr 14,h �-ve&,.r l
t' h �- SI I I'.,
WAS GROUND WATER n,( „
ENCOUNTERED? ��
So I J— IF YES. AT WHAT
/ DEPTH?
kr av-a�
Ni�w? WSW
PERCOLATION RATE ¢
� r / lmmutevun1 PERC HOLE DIAMETER 4
TEST RUN BETWEEN FT AI ND FT
PERFORMED BY: Ni t f 6, C /K Am J e( 4+4 I CERTIFY THAT T� �� 3 WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
ffAM����WAMMNFAQMMK
MM
PERCOLATION RATE ¢
� r / lmmutevun1 PERC HOLE DIAMETER 4
TEST RUN BETWEEN FT AI ND FT
PERFORMED BY: Ni t f 6, C /K Am J e( 4+4 I CERTIFY THAT T� �� 3 WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
72-013 ev. 3/78)
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH &RAGE
PROTECTION
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIONNVIRONMENTAL
ENVIRONMENTAL ENGINEERING DIVISION
�C T �[�@
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
p, „z QV'
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION
NAME
A
APMEs
AP
p
EW
Ude
5•IS I;<UPGRADE
MAILING ADDRESS
O,
LEGAL DESCRIPTION
6 ,jetlWoo Su T
W SEC 23
LOCATION
NO. OF BEDROOMS
'�1G0
Well
Absorption area
Dwelling
RMIT
PENO
U
DISTANCE TO:
-71I
+
{.
g 4,C)�J �G
_Y
nZ
Manufacturer
Mate
. No. of compartments
yf
e
S
Liq. capacity in gallonsIF
HOMEMADE:
length
Width
Liquid depth
Y
DISTANCE
DISTANCE TO:
Well
�-
Dwelling
PERMIT NO.
J�2
_ H
Manufacturer
�.
Material
Liquid capacity in gallons
O
m=
DISTANCE TO:
Well
0
Foundation
(oS
Nearest lot line -
S
PERMIT NO.
BfsO C7 G
j IL Z
No, of lines
Length of each line
Total length of lines
Trench width
Distance between lines
f z.�
70
410
O inches
f
Top of rile to finish
grade
Materizl beneath tile
Total effective absorption area
o,5
(CC) inches
DO .8F
Length
Width
Depth
PERMIT NO.
Qa L
w °
Type of crib
Crib diameter
Crib depth
Total effective absorption area
y
DISTANCE TO:
Well e'
Building foundation
Nearest lot line
J
ClaspDepth._
'-
Drillef
Distance to lot�line
PERMIT NO.
J
rIU k4a
,1 I
Akzo
DISTANCE TO:
Building fqutidation
Sewer line
Septic tank
Absorption area(s)
416
T.I
}
OTHERt
o. O A sn/ 4
,,+
PIPE MATERIALS
:a .,,
oq
SOIL TEST RATING/ +:
S917
I
INSTALLER ••••• •• • •�•�•••
;0
WUER/
....
ell r
o
REMARKS•
ony D. BeYTer •�
1,
r
: ... CE—bIf30 �.�%
A o
W amp
i�' '•. a Ib� r
1
t u
�
1�
S'tcwle s r
r 4
Sine e. t
^Lonek tsb
eo es r
re ore
q
APPROVED
DATE LEGAL
72-013 ev. 3/78)
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENV! NTAL PROTECTION .
B25 L STREET, ANCHORA6 K 99501
264-4720
ON—SITE SEWER PERMIT
PERMIT NO: 860306 UPGRADE
DATE ISSUED: 08/22/86
APPLICANT: AUDREY ARMES
ADDRESS: 11840 MOUSE DR.
ANCHORAGE, AK 99516
CONTACT PHONE: 345-0715
LEGAL DESCRIN SUBDIVISION: RAVE064D LOT: 6R BLOCK: 4
SECTION: 23 TOWNSHIP: 12N RANGE: 3W
LOT SIZE: 1.5A {SO.FT, OR ACRES)
I certify that:
1. I am familiar with the requirements for on-site sewers and wells as set
forth by the Municipality of Anchorage {MOA) and the State of Alaska.
2. I will install the system in accordance with all MOA codes and regulations,
and in compliance with the design criteria of this permit,
3. I will adhere to all MOA and State of Alaska requirements for the set back
distances from any existing well, wastewater disposal system or public
sewerage system on this or.any adjacent or nearby lot.
IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES,
THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED, i2) AS-BUILTS
WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT! AND 13) THE
ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN,
1
SIGNED DATE:
APPLICANT: AUDREY AANES
ISSUED BY I DATE:
NICIPALITY OF ANCHORAGE
Department oliealth and Environmental 4tection
Pouch 6-650, Anchorage, AK 9950
264-4720
On-site Sewer/Water Permit
HANDWRITTEN
Permit No:
Date Issued:
Applicant:
Address:
Legal Des
Section: Z,1 Township: /Z -LL_ Range: .?—Z/,—)-
Lot Size: _(Sq. Ft
Lot Location:
Max Bedrooms: 2
or Acres)
Listed below are the options available to you in designing your septic
system. Choose the option that best fits your site.
----------------------------------------------------------------------------
TREN�C-Hr ABED W. DRAIN
Depth to pipe bottom(ft.)
Gravel depth (ft.) 'vriO
Total depth (ft.)
Gravel width (ft.)
Gravel length (ft.) (1CJ�D
Tank size (gal.)!STi�t
Soil rating (sq. ft./br) 39 7
** Gravel length 75 feet requires multiple runs (not exceeding 75 feet each)
** Tank must have at least two compartments
----------------------------------------------------------------------------
I certify that:
1. I am familiar with the requirements for on-site sewers and wells as set
forth by the Municipality of Anchorage(MOA) and the State of Alaska.
2. I will install the system in accordance with all MOA codes and
regulations, and in compliance with the design criteria of this permit.
3. I will adhere to all MOA and State of Alaska requirements for the set
back distances from any existing well, wastewater disposal system or
public sewerage system on this or any adjacent or nearby lot.
4. I understand that this permit is valid for the maximum number of bedrooms
stated above, and any enlargement or modification will require an
additional permit.
IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN
(1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS WILL
NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE
ELECTRIAL WORK MUST BE DONE B'(Y� A LICENSED ELECTRICIAN.
SIGNED �QPJ�G`_Y 1V�ves DATE:
Applicant
ISSUED BY:
DATE: 4ZZ:�
• . SOILS LOG
MUNICIPALITY OF ANCHORAGE
+.e DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION
TEST
825 L. Street, Anchorage, Alaska 99501 264-4720
n/. SOILS LOG - PERCOLATION TEST
PERFORMED FOR: adLE {{3811a DATE PERFORMED:
LEGAL DESCRIPTION: L - hp 6169k 4A1,12d WOOD %/ZAI )eSW 46-C..2.3
I IIIATIHI SLOPE SITE PLAN
1 1111
2
3
4-
5-
6
5 6
7 :Q
10
15
16
17
18
19
06- 6PN
S;l�}y Grwuel
pS� OF A(,4S�1
*0:49111*T*1
D. Barter
C _jj0000
•F d'o
`!'7•ry0
GROUND WATER S
OUNTERED? O I-
P I T
YES, AT WHAT E
!PTH?
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
O
�: oa
$9116
/Jl6
ao6c
i
S:3o
(,�*6 r5
N
6:01
6:
.30
S
� /b
9
20 I JJJ
L___I PERCOLATION RATE !,J� -(minutes/inch) Ju SJ=/ej(ep11
.�TEST RUN BETWEEN �L. FT AND � FT
PERFORMEDBY: CERTIFIEDBY: DATE:
72-008 (6/79)
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264.4720
SOILS LOG — PERCOLATION TEST
SOILS LOG
� -oV-e� C/ -
PERCOLATION
TEST
I)P&R. }-L7 E
z 8edrer-
PERFORMED FOR: Adee,1 It!/ kYleA . / (� %0G7DA1TE PERFORMED: �ia 49
LEGAL DESCRIPTION: F -R/ f -9K �L �f- Q�1 1L®6d�lE �"1
SLOPE SITE PLAN
PE/(R��FrORMED,�JBY::
W " d"
72-008 (6/79)
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Alp
F
E
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
1�
�e0
(lib
90
10
12,0
51l 1,16
�o
Ib
PERCOLATION RATE�T 14F�hLB (minutes/inch)
TCCT QI IPI RFTIMPPKI I FT AND If FT
G
WIM
,' AA9-HD.i t G R ANCHORAGE AREA BORO10
O RTMENT OF ENVIRONMENTAL QUAILIT
3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279.8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
AL
SEPTIC TANK:
i
DISTANCE FROM WELL 71 MA
MAILING
C«= �66
OF i
MFNTi
LIQUID
LIQUID CAPACITY 1� —GALLONS. INSIDE LENGTH INSIDE WIDTH DEPTH_
SEEPAGE SYSTEM: SEEPAGE PIT:
7g—
NUMBER OF PITS OUTSIDE DIAMETER OR WIDTH , LENGTH le , DEPTH 41 ,
LINING MATERIAL ,LO Gam' .DISTANCE FROM WELL �d i ` , BUILDING FOUNDATION Z ,
NEAREST LOT LINE �/ TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) SQ. FT.
DISTANCE FROM WELL
NUMBER OF LINES DISTANCE BETWEEN LINES
ABSORPTION AREA SQ. FT. LENGTH OF EACH LINE
TOTAL LENGTH
NEAREST LOT LINE . OF LINES_
TOTAL EFFECTIVE
DATE F " 7" 7e -
TOTAL
e
i
i GROER ANCHORAGE AREA BOUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO.
3500 TUDOR ROAD POUCH 6-650
ANCHORAGE, ALASKA 99502
TELEPHONE 279.6686
SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT
NAME OF APPLICANT _v'Ste'AJ �OP-T/4MAILING ADDRESS �y /" ���/'w PHONE a�q --12 77
INSTALLATION LOCATION +1 -t C IV C I
LEGAL DESCRIPTION P�Uz��'
INSTALLATION OF: SEPTIC TANKySEEPAGE PIT j� DRAIN FIELD . OTHER
TYPE AND SIZE OF FACILITY TO BE SERVED p B F
FINANCED THROUGH T TO BE INSTALLED BY /-Y
SOIL TEST RESULTS - P�-wl�/JY� NOTE, THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
COMPLETION DATE ANTICIPATED - - 70
FINAL INSPECTION. 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
HEALTH DEPARTMENT' AUTHORITY WILL BE SUBJECT TO PROSECUTION. ..J [- /
SEPTIC TANK SIZE • �6 TYPES EEG ®R'` f6� ,0 EPAGE AREA SIZE &'r/L� �J/` ZES/ TYPE Z ee/&/ s
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK /
q /
FOUNDATION TO SEEPAGE PIT 6 0 DRAIN FIELD �6 /
SEPTIC TANK TO SEEPAGE PIT WALL
r / /
SEPTIC TANK 5 SEEPAGE PIT _2 DRAIN FIELD 1/10
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK -
5Q / SEEPAGE PIT
DRAIN FIELD �� / ALSO CONSIDER AREA WELLS.
f ( /
WATER MAIN TO SEPTIC TANK
'lei
PIT �Q ,
DRAIN FIELD
SEPTIC TANK, SEEPAGE PIT ,LfB�, GRAIN FIELD ,
TO RIVER, LAKE. STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 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.
XYUIL 0 , 49
HEALTH AUTHORITY
OR
LICENSED DESIGNER
1 CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE.
DATE ---L J - ZZ APPLICANT'S SIGNATURE
DIAGRAM OF SYSTEM
AREA BOROUGH ORDINANCE NO. 2 -60 AND THAT THE ABOVE
' GREPER ANCHORAGE AREA BOUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. ------
_ 3500 TUDOR ROAD POUCH 6.650
ANCHORAGE, ALASKA 99502
TELEPHONE 279.8686 -
SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT
NAME OF APPLICANT ��rf%C-i✓ IVO,��
��✓'c�� MAILING ADDRESS �j � �✓�G`,fT
P ON I,
INSTALLATION LOCATION T''t./3/?iC.7
%G <&we
LEGAL DESCRIPTION
� ��� �,t j
INSTALLATION OF: SEPTIC TANK
J
SEgPAGE PIT /� DRAIN FIELD
OTHER
TYPE AND SIZE OF FACILITY TO BE SERVED..%lff0
Q�ZflO/Yi
.f%�✓�I:G %/�/Gf ®�(�/ 7//���
//��E'Zt✓
FINANCED THROUGH //
TO BE INSTALLED BY I-71-1 -
SOIL TEST RESULTS - .� L%��!>/l'='
NOTEt THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
COMPLETION DATE ANTICIPATED. z'
y% -e
FINAL INSPECTION, 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE TYPE
SEEPAGE AREA SIZE-��*✓� ��G TYPE -14fJ
MINIMUM DISTANCES, REQUIREMENTS DIAGRAM OF SYSTEM
FOUNDATION TO SEPTIC TANK ✓�� /
FOUNDATION 70 SEEPAGE PIT,DRAIN FIELD___„_,
SEPTIC TANK TO SEEPAGE PIT WALL
— _9
SEPTIC TANK 'sy SEEPAGE PIT -'ate DRAIN FIELD
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK SEEPAGE PIT j
DRAIN FIELD ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK zzl . SEEPAGE PIT '/o/
DRAIN FIELD
SEPTIC TANK, o:Z5 SEEPAGE PIT f, DRAIN FIELD
TO RIVER, LAKE, STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION S FEET INTO UNDISTURBED SOIL,
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKPILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
HEALTH AUTHOR TY
OR
LICENSED DESIGNER
I CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF
DESCRIBED SYSTEM IS I�TNACCORDANCE WITH SAID CODE.
DATE - / APPLICANT'S SIGNATURE
I
ORDINANCE NO. 28.68 AND THAT THE ABOVE
i
DEPARTMENT OF ENV! ROI'VENi`:L QUAL11= CASE #
3500 TUDOR ROAD
ANCHORAGE, ALASKA 99502
Performed For ccx. 1 i 6ee ' Date Performed qu�_tiSg)�
Leaal Descrintion: Lot L_Block. Suhdivision-V-12�Ufv\ALk)O, l —
This Form Renorts Soils Log _ Percolation Test_
Oenth
Feet Soil Characteristics
1 —
2 —
3— C e 1-y, s'
A— C3so�
5 — _ -- -- _- -_
6 —
10
Was Ground Water Encountered? nc
If Yes, At what Depth?
Percolation Rate "Iinute
Proposed Installation: Seenane Pit m a i n d
Depth of Inlet_ Deeth To Fiottom Of Pit Or Trench.
COMMENTS — --- i�Q �I�owe�. iia
Test Performed By_%per_--=--L - i- Data Certified F,v:
Date:
Reading Date Gross Time
I Net Time
Depth to H2O Net Dron;
I
(
i
!
j
I
I
i
i
Percolation Rate "Iinute
Proposed Installation: Seenane Pit m a i n d
Depth of Inlet_ Deeth To Fiottom Of Pit Or Trench.
COMMENTS — --- i�Q �I�owe�. iia
Test Performed By_%per_--=--L - i- Data Certified F,v:
Date:
Reading Date Gross Time
I Net Time
Depth to H2O Net Dron;
Percolation Rate "Iinute
Proposed Installation: Seenane Pit m a i n d
Depth of Inlet_ Deeth To Fiottom Of Pit Or Trench.
COMMENTS — --- i�Q �I�owe�. iia
Test Performed By_%per_--=--L - i- Data Certified F,v:
Date:
i
i
A-e,u� da-�
W 46--�4 /��a�ec�r6nd
C au y d. \J L-1) A -,e cL(,)j ac