Loading...
HomeMy WebLinkAboutTHOMAS L BOYLE BLK 1 LT 16BThomas L. Boyle Block Lot 16B #015-283-02 W. 15th A U©° °Cab 4PM�°3�idQaDo Po o ANCHORAGE,VALASKAIT995203 01 CONSULTING ENGINEER TELEPHONE: (9071 279-3916 MUNICIPALITY OF ANCHORAGE C@T. OF Hr,!UH , August 11, 1982 ENW;4I,'-WA_[>o'[_n_;� hUu 1 ;, 19C2 Department of Health RECEIVEp & Environmental Protection 825 L Street Anchorage, AK 99501 Subject: Sewer System Installed on Lot 16-13, Block 1, Boyle Gentlemen: Per your requirement, an additional 500 gallon septic tank was installed on this lot on August 10, 1982. By this, the system is brought up to Municipal Code. Yours truly, Tobbe Spurkland, P.E. TS/cl MUNICIPALITY OF ANCHORAGE i DEPARTMENT OF HEALTH 81 ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION ' 825 L Street. Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME ALASKA ALASKA STATE M1,11c PHONE �% =%4.; XO RADE MAILING ADDRESS LEGAL DESCRIPTION �Z0 Lo LE LOCATION _ ,J, _ NO. OF BEDROOMSk O C DISTANCE TO: Well Absorption area Dwelling PERMIT NO. D _Y F-Z Q Manulxturer Material No, of compartments is N~ capacity in gallons IF HOMEMADE: Inside length Width epthdLiq. Liquid depth- 6z Z DISTANCE TO: Well Dwelling PERMIT NO. Szf Manufacturer Material Li uid capacity qin gallons Lu DISTANCE TO: Well �� '+ Foundation % Nearest lot hne 35 PEHMI Q / Me u. Z No. of lines Length of each line Total length of lines Trench width Distance between lines i- a ¢ Z OQ O inches Top of rile to finish grade / _ Material beneath rile Q H Total effective absorption area f9 inches Soo US Length Width Depth PERMIT NO. 0 n H wd Type of crib Crib diameter Crib depth Total effective absorption area so DISTANCE TO: Well Building foundation Nearest lot line Class Depth Driller Distance to lot line PERMIT NO. W 3 DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS SOIL TEST RATING /2S INSTALLER OL 11-1 DE k 1 REMARKS A M A {� 46 'rO V irl A'_Je Y Lk m s r ^ f ea r /n L.LrctA If #I d rtd� t e uA V,t r t*. OF At i Pit i q A26Anil y~P.•••......,4�1f j •91 J r*` 49111-l�V a �..:,1........ 0 ..: r ................... / �'• 25 97E •yam _ r 122 JUNE &;"l `6 r, ........ • APPROVED DATE LEGAL zutatnev.JIrill v Piur-i I C I F-nL_ I -ro-e QP- Fit -.1 CHOF;>n:,-E / DEPARTMENTX.HEALTH AND ENVIPONMENTAL"`OTECTION 825 UP.EET, ANCHORAGE, Al:. 44 264-4720 CAt-F—' — I TE EWEF UF='IM C- E_= F=`EF?M I T PERMIT NO. ( 511206 ) (. APPLICANT ALASKA STATE BANK 310 E. N LTS. ANCH ci of vs 274-7637 LOCATION HUFFMAN AREA LEGAL LT.16-8 SLK 1 BOYLE S?D LOT SIZE 48000 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS yy SOIL PATIF)G (SC? T/BR.)= 125 THE REQUIRED SIZE OF THE SOIL ABSOR TION SYSTEM IS: oN j E>EF0l-V4= nLED LEV4C31- A= = f1hu icgpalit ® Anchorage � 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 264-4111 GEORGE AL SULLIVAN, MAYOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION December 31, 1980 Alaska Statebank 310 East Northern Lights Boulevard Anchorage, Alaska 99503 Russell/Mc Clellan Property Permit # 800642 Subject: Lot 16B Block. 1 Boyle Subdivision A permit issued by this department for well and/or sewer system has expired as of this date. Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal Ordinance. If you have drilled the well, a well log should be sent to this department to document the installation date. If an engineer inspected the installation of the on-site sewer system, please have them send us the as-builts for our files. If there are any further questions, please call this office at 264-4720. Sincerely, C4Q In, &--f' Les N. Buchholz, R.S. Senior Environmental cialist LNB/ljw enc: Copy of Permit SWP/057 MUr-F I C I F='FiL_ I TY OF= F=l r.FCHC]FZnC3E DEPARTMENT ('-,,HEALTH AND ENVIRONMENTAL - ,OTECTION ►� 825 STREET, ANCHORAGE, AK. 9_ 264-4720 �) u OrF=S I TE SEWEFZ uF='GFRnr>a Fn- EmM I T PEP,M I T NO' C 800642 ) PO PPL APPLICANT ALASKA STATEBANK 310 EAST N.L.BLVD 99503 279-7637 LOCATION WAGNER ROAD LEGAL CLOT 168 BLOCK 1'BOYLE StDl LOT SIZE 48000 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING CSO FT/BP,)= 125 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: E7EF�'TH= :I- ID L_a"0-r"H 32 0FZf=l VE:L_ [?EFaTH= vS THE LE14GTH DIMENSION IS THE LENGTH CIN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETPIEE14 THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION CIN FEET). THERE IS NO SET 14IDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION CIN FEET>. F$EGtiLJ I FZEE> S~EF}T I C TFiFMFC 'SIZE= SQQ GnL_L_QrJS} 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. --- T140 C2> nFZE REQU I FZEE? BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY OFJ-SITE SE14AGE 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. OTHER. REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER. INSTALLATION. F3EFRM I T EXF} I FRES [7ECEMBEFZ 31� 1 Si;z-oG:+ 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 14ILL INSTALL THE SYSTEM IN ACCORDANCE 14ITH THE CODES. 3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. SIGNED APPLICANT ALASKA STATEBANK ISSUED BY ------------------------------ DATE_ICL=LL-_�---- Q Y4.0 �iL Sl %:::"uW-�'u �"t MUNI C I F"RIL I TY OF R"CHORR(3E � • DEPARTMENT n HEALTH AND ENVIRONMENTAL"�OTECTION 825 STREET, ANCHORAGE, AK. 9S _ J1 264-4720 J �) Or�F—SITE SEWER UP'13RRI7E P EFSM I T PERMIT NO. C 800641 ) n e APPLICANT ALASKA STATEBANK 310 EAST W.L.BLVD 99503 279-7637 LOCATION WAGNER ROAD LEGAL iLOT 16B BLOCK 1 BOYLE SID LOT SIZE 48000 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS MAXIMUM NUMBER. OF BEDROOMS = 3 TRENCH SOIL RATING (50 FT/DR)= 125 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: L7EFaTH= :1 -ID LEr4GTH= 3:2 iGRRVEL D>EF}TH= iS THE LENGTH DIMENSION IS THE LENGTH CIN 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 CIN 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 CIN FEET). REQU I REO SEF}T I C TRtVFG SIZE= 11010(D GRLL_OrJS 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. --- TIJC <--:>> I R7SPECT I OifJS RRE REQU I RED> --- BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. 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. OTHER, REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F=*ERM I T EXP' I RES F>ECEM0aFR 1 55l+ 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 THE CODES. 3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. SIGNED:---------------------------------------- FJhL/w�' APPLICANT ALASKA STATEBANK gg//�� nn''11 ISSUED BY ------------------------------ DATE_Jn=_%sLL_DLL__ V4.0 fin, bLowJ C; H� vfn r� �a D „►s 4ck"l - a rte. I• • ALASKA STATE MANIC Lo -r 11,-8, BLOCK 1, BoYLE 5/a DCL Z2 -►4,31 CONT2ACTOe- : sV4A;ZZ r-KCAVATIN6 'DES16N '70IMEN SPUe, t-t-tNl> RE No o� �B�droow+e W�ao�t Fln�/i so - Bast eL�.est � Hlo a N or ; VS a Iwo 4.6w tel, e _i N 17 d c L Qf--�, /a.7 = 30yd3 _ Of Soil- Ho Woo 13 F -Contra Engineers & Associates so1Ls Loc ' .212 East International Airport Rd. Suite 204 ANCHORAGE, ALASKA 99502 ❑ PERCOLATION (907) 278.3773' .. ,'.• TEST SOILS LOG — PERCOLATION TEST PERFORMED FOR: ST,•%� /�'//;//=�li^i/j �� �,�DATE PERFORMED: /y — L LEGAL DESCRIPTION: L v T 0 DEPT H O /L V SLOPE SITE PLAN 1 • 2 / 3 ,B/L S1 w/r/J /yL S'A 6 Enr 5Cr 'E OF AZ j \ • ..... .I 1 i.......«..;........ flph B Jokelo • ; 4: NO. 1995-E ' S� r N WAS GROUND WATER S ENCOUNTERED? ti O L O P IF YES, AT WHAT E DEPTH? d Reading 5- Gross Time Net Time 6- 67 Net Drop 7 :• A s � i i 11 ,: e• 13- 14 15 . is 17 18 19 ,B/L S1 w/r/J /yL S'A 6 Enr 5Cr 'E OF AZ j \ • ..... .I 1 i.......«..;........ flph B Jokelo • ; 4: NO. 1995-E ' S� r N WAS GROUND WATER S ENCOUNTERED? ti O L O P IF YES, AT WHAT E DEPTH? d Reading Date Gross Time Net Time Depth to Water Net Drop A � i i 20 - PERCOLATION RATE (minutes/inehl TEST RUN BETWEEN FT AND FT COMMENTS SLS SA FTf/,'CO /1oJ/•l '^ERFORMEDBY: Gfl/t% S /`7 it LOrr CERTIFIED BY;�/-�'•"�iT��--�T)ATE: �� •C �/� -"�'GH GREr'R ANCHORAGE AREA BOF Department of Environmental Quality - ���� 3500 Tudor Road Anchorage, Alaska 99507 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME /1/ LJ11 It" l:U SG lL MAILING ADDRESS �� f''�x ISIT6 6 PHONE _1? 44 ",9(.-13 1 LOCATION Llla�f ST LEGAL DESCRIPTION IrT Ib /1�'�/�r h� `(•,'�f• SEPTIC TANK: DISTANCENUMBER OF FROM WELL L 8 MANUFACTURER 'STn X' •242- I- CO. MATERIAL S)`c'I u'I rJ�� �'� � COMPARTMENTS 2 - INSIDE LENGTH - INSIDE WIDTH-" LIQUID DEPTH - I-IQUID CAPACITY 1?5O GALLONS. SEEPAGE PIT: NUMBER OF PITS DIAMETER __OR WIDTH -<r , LENGTH �� , DEPTH LINING MATERIAL lL9_ PT SIA CRIB SIZE: DIAMETER�'�8'DEPTH 9/ DISTANCE FROM: WELL /^,� , , TOTAL EFFECTIVE BUILDING FOUNDATION&C-, NEAREST LOT LINE ?0 1 . ABSORPTION AREA (WALL AREA) 666 SQ. FT. ADDITIONAL ABSORPTION LT11:4R1' TYPE `SNin,•/v,hll^ CONSTRUCTION �('OSINF.-(?4rrrDOnIPo'r,lDEPTH X47 DISTANCE FROM: BUILDING NEAREST , NEAREST r SEPTIC �-, SttPAUL , FOUNDATION, LOT LINE-L.L.' ± SEWER LINE 1C V TANKLL—, SYSTEM 115 CESSPOOL OTHER SOURCES AJCAZ KtinNAJ APPROVED DISAPPROVED REMARKS 1.0- "')L C' DISTANCES: INSTALLED BY: `Iff PIPE MATERIAL: _Prll S I Fr- Fns' V Vvl �ri:r,rro: usrA u'/i 11N Iu.ln,o-rrl LxY' LOT SLOPE: REMARKS: `C"'nT._, r' TC A74 -FAr rfAi(.-i- /r� ki'i /Y l -ns -r lAl�'rl Tn F,(Kt/n% Crew. Preva,',S_S./t„m rrrre,vcL E. -IS -71, t>>c, h,n wa�rcDs Form PW -028 - 4;,� DIAGRAM OF SYSTEM I�� ex' incl S,,erxv, • P. /01. DATE I 21 1972 APPROVED tutL New Taa K G.A.A.B. l9 T N y`C NAM[ OF APPLICANT GF�TER ANCHORAGE AREA 6 JUGH DEPARTMENT OF ENVIRONMENTAL QUALITY • 3700 TUDOR ROAD POUCH 8.660 ANCHORAOC. ALASKA 99302 T[LEFHOK[ 379.8686 ' SEWAGE DISPOSAL SYSTEM — APPLICATION AND PERMIT INSTALLATION LOCATION LT LEGAL OESCRIPTION I INSTALLATION Or, SEPTIC TANK TYPE AND SIZE OF FACILITY TO SE SIRV[D FINANCED THROUGH TO 99 INSTALLED SY kr - n l& -t / S'q8 PERMIT NO. ---- DRAIN FIELD OTHER &OIL TEST.R[SULTS NOT[1 THIS r[RMIT Is NOT VALID WITHOUT &OIL, TEST COMPLETION DATE ANTICIPATED —_ FINAL INSP[CTIONs ie HOUR NOTICK RKQUIR[D. &ACKPILLINO Or ANY SYMM WRHOUT FINAL INSF[CTION &Y THK HEALTH D[PARTM[NT AUTHORITY WILL &K SU&J[CT TO PROSECUTION. SEPTIC TANK SIZE —+ OD<) TqE &[[PAGE ARCA flit MINIMUM DISTANCES, R[OUIR[M[NTS C FOUNDATION TO SEPTIC TANK ✓ / _ FOUNDATION TO S[[►AO[ PIT � _ DRAIN FIELD SEPTIC TANK TO SECPAO[ PIT WALL / SEPTIC TANK �, SC[PAO[ PIT DRAIN FIELD TO NEAREST LOT LIN[. •/ WELL TO SCPTIC TANK SCE►AGI PIT DRAIN FIELD ALSO CONSIDER AREA WILLS. WATER MAIN TO SEPTIC TANK SICPAGI PIT DRAIN FIELD SEPTIC TANK, SECPAG[ PIT GRAIN FIELD TO RIVER. LAK[. STRUM. CAST-IRON INTO AND EXCAVATION S FECT 1p TANK AND INTO CRIB CROSSING GAP OF I SOIL. A INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SECPAG[ PIT ` FITTED WITH AlRT M MOVASL[ CAPS. ORAVEL &ACKFI CONFORM TO BOROUGH [OULATIONS RIOAROINO INSTALLATION. HEALTH AUTHORITY OR LICCNSEO DESIGNER TYPE DIAGRAM OF SYSTEM 1 CERTIFY THAT 1 AM FAMILIAR WITH THC REOUIRCMCNTS OF GREATLR ANCHORAGE AREA BOROUGH ORDINANCE NO. 36.68 AND THAT THC ABOVE DESCRIS I) SYSTEM IIS` IN ACCCOMDANCE WITH SAID COOL. I`/��� DAT[ 72 APPLICANT'S NONATURL r ezSo 16667 C�na�ti�•��cLc� � � � _. 4�.Cit bc-u [we . 1�U �A-1 To p vC 12 I G�"`ER ANCHORAGE AREA BORO^Y DtrARTMENT OF ENVIRONMENTAL OUALI I It <� 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279.8686 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING f-e'Aa9 ✓l�rfl�<.Z' L.�. -� I. f��lN� tr•� � /�iir . SEPTIC DISTANCE FROM WELL �7" ' MATERIAL STS" FA6� </L�//�ttarirb %97/ LIQUID INSIDE LENGTH NSIDE WIDTH '' DEPTH CAPACITY /Dno GALLONS. SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS OUTSIDE DIAMETER OR WIDTH LENGTHDEPTH y �J / LINING MATERIAL LOG G'tdZe -_plro iY , DISTANCE FROM WELL BUILDING FOUNDATION_?`' NEAREST LOT LINE .in ' e . TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) SO. FT. TILE DRAIN FIELD: 111y TOTAL LENGTH DISTANCE FROM WELL , FOUNDATION , NEAREST LOT LINE , OF LINES , NUMBER OF LINES .I A CE BETWEEN LINE IQFK,rm winTm IN. TOTAL EFFECTIVE ARSnRPTI AREA SQ. F . NGTH OF EACH LINE DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE WELL'eel �`'�' I� '' / DISTANCE FROM i WATER TYPEg DEPTH /,BUILDING FOUNDATION. f/ SAMPLE &'2 NEAREST NEARETSEEAGE OTHER LOT LINE �� �� EWER LINE .,•�O /�', TANKC %G , SYSTEM_/CESSPOOL_, OURCEbtltN/ti DLSTANCE N n DATE ze<l ��%� DIAGRAM OF SYSTEM SIQ _. DATE ze<l ��%� GREP, a ER ANCHORAGE AREA BOtxoUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 9800 TUDOR ROAD POUCH 6.650 • ANCHORAGE. ALASKA 99802 TELEPHONE 279.8886 NAME OF APPLICANT INSTALLATION LOCATION LEGAL DESCRIPTION INSTALLATION OF: SEWAGE DISPOSAL SYSTEM — APPLICATION AND PERMIT t U isMAILING ADDRESS C' y SEPTIC TANK SEEPAGE PIT / TYPE AND SIZE OF FACILITY TO BE FINANCED THROUGH SOIL TEST RESULTS DRAIN FIELD PERMIT NO. /1539 PHONE / OTHER COMPLETION DATE ANTICIPATED , / , ' v 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 MINIMUM DISTANCES. REOUIREME�TS FOUNDATION TO SEPTIC TANK 4 FOUNDATION TO SEEPAGE PIT DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL •�/ SEPTIC TANK rI / SEEPAGE PIT •` o I DRAIN FIELD TO NEAREST LOT LINE. / / WELL TO SEPTIC TANK SEEPAGE PIT DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK /c/ SEEPAGE PIT DRAIN FIELD ZLy/ 1 SEPTIC TANK. Z � SEEPAGE PIT �Cj DRAIN FIELD �D !2/ TO RIVER. LAKE. STREAM. 9 �I q 11 E AREA SIZE // /� /f O/'! 1 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. G/ HEALTH AUTHORITY OR LICENSED DESIGNER DIAGRAM OF SYSTEM 1 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE EEJWWIITH SAID CODE. OAT ti ARPLICANT'8 SIGNATURE y/EZ �!��t 7-�' C.• //-��-`_(I-"`.�� f REATER ANCHORAGE AREA BOROUGH f+ y HEALTH DEPAPTMENT I CASE f n ` 377 EAGLE STREET ANCHO GE ALASKA 995 1 4ewd For Roy Andefson� Data Performed_ 11/6/70 ,6al Descriptions of Block vision - Boyle --� this Form Reports a: Sots Log xx erco a on est Depth7`�� _Feet Soil I aracteristics Location sr...w tan silty fine sand (SM) l f� gray fine to medium sand .• (SP) Z I 1 : �!1� t Was Ground :tater rrcountered? ' A n c F lig tea: Seepage Pit Dep.!, -If Inlet COMMENTS: rain rield t Or Trench tTesL Performed 8y: R. E. t pu Carli9le !hese recommendations are•comted from visual observations and basad Data Certified By:tlationalTPart on the unified classification system. Date: nc. kj MUNICIPALITY OF ANCHORAGE 1� a�•� OSFAIITNENT OF HEALTH & ENVIRONMENTAL PROTECTION Sffi L Snort AMarage. Alaska 98801 p�QY-J • ENVIRONMENTAL ENGINEERING DIVISION Telephone 284.4720 NUMBER OF BEDROOMS REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Inca tplaes requests will not be praaasasd. Please allow ten (10) days for protesting. 1. PROPERTY OWNER ❑ Two ❑ Five PHONE THOMAS KANE 7. WATER SUPPLY 694-9819 MAILING ADDRESS *ATTACH WELL LOG. A well log is required for all wells drilled tffgC P.O.Box 8277, Anchorage, AK 99508 PROPERTY RESIDENT (It different from above) depth (attach log if available.) PHONE 2. BUYER Ll INDIVIDUAL/ON-SITE" PHONE N/A If system is over two (2) years old an adequacy test is required ❑ PUBLIC UTILITY MAILING ADDRESS NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATEQ LENDING INSTITUTION PHONE Alaska Statebank - 265-2326 MAILING ADDRESS 310 E. Northern Lights Blvd., Anchorage, AK 99503 4. REALTOR/AGENT MAILING ADDRESS S. LEGAL DESCRIPTION Lot 16B, Block 1, Boyle Subdivisibn STREET LOCATION NHN Wagner Street S. TYPE OF RESIDENCE NUMBER OF BEDROOMS 91 SINGLE FAMILY ❑ One M Four ❑ Other ❑ Two ❑ Five ❑ MULTIPLE FAMILY ❑ Three ❑ Six 7. WATER SUPPLY ® 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 Ll INDIVIDUAL/ON-SITE" "If individual/on-site, give installation date If system is over two (2) years old an adequacy test is required ❑ PUBLIC UTILITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATEQ /dV4utj/15j �L r' THIS SIDE FOR OFFICIAL USE ONLY _ ' DATE RECEIVED '•t +~ INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE ❑ SINGLEFAMILY ❑ 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 DATEINSTALLED INSTALLER ❑Septic Tank or ❑ Holding Tank Size: If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic Holding Tank Abwrption At" SLine ewer serest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS `� •.I�4�0� or► 4 Soo i� w [UNAPPROVED FOR BEDROOMS Qgo�CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED r-�e� _�_ V K— DATE BY Titlel LEGAL DESCRIPTION 72.010 (Rev. 3nS) • v. �. DATE RECEIVED INSPECTION APPOINTMENTS i T, t TIME TIME DATE DATE DATE 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS • - Q INSPECTOR INSPECTORINSPE R , ❑ MULTIPLE FAMILY Three ❑ Six f MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPT. OF I -ALT; & -\ DEPARTMENT OF HEALTH$ ENVIRONMENTAL PROTECTIQ� ttd�1RON1J.1 a.:L •.. TCCTION 1 825 L Street - Anchorage, Alaska 99501 • ENVIRONMENTAL SANITATION DIVISION APR 141980 Telephone 2644720 [[�� F� CC V REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER PACI��IET,D' DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed- Please allow ten I 10 days for processing. 1. PROPER YOWNER PHONE ❑ PUBLICUTILITY MAILING ADDRESS PROPERTY RESIDENT (It different from above) PHONE 2. BUYER H MAILING ADDRESS 3. LEN017 INSTITU TON PHONE N� -2 7I 76, d 7 MAILING ADDRESS 4. REALTO NT / PHONE _-.2 7�7 -as -7 MAILING ADDRES .2 jZ /�` '` 9 S7�j 5. LEGAL OESCRIPTIOIL STREET LOCATION 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS SINGLE FAMILY ❑ One ❑ Four ❑ Other ❑ Two 1:1 Five ❑ MULTIPLE FAMILY Three ❑ Six 7. WATERS PPLY 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/ON-SITE" YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLICUTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72010 (Rev. 6/79) 72 010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE, ❑ SINGLEFAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ TWO ❑ FOUR ❑ SIX ❑ OTHER 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLICUTILITY 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 ❑Septic Tank or ❑ Holding Tank Size: 1.15'c) If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER 4&+— TOTAL ABSORPTION AREA MATERIAL t ^ 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Lme Absorption Area to nearest Lot Line - 5. COMMENTS P ❑ APPROVED FOR BEDROOMS �❑, /CONDITIONAL APPROVAL (letter must accom any certificate) LL✓ DISAPPROVED DATE FQ 72 010 (Rev. 6/79)