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US SURVEY 3042 LT 2C T10N R2E SEC 19
US Survey 3042 Lot 2C #075-132-97 V1/ell Log water Wci Dritl nil andTur: Seri:c 'AnAl.ragc.'AraskaC,10 )?45-o5�_ I)riflingStaned:9112007fnmplLKcd:O9: 11.:2007 Citvtl3omngn: Subdivision: BLOProperly 0%%wr Name &Addti<t: Dana L. Durham P.O. Box 1016 Site: Crow Creek Road chorage US Survey 3042 2C Girdwood AK 99587 i \lcridian Tmmship Range Section _ _ ... • .__..—. Ya of _ _. �i of _ V4 of BOREHOLE DATA(from top of casingpepth Drilling ntcthud: (X) Air rotary. ( ) Cable tool, Other Material:1)•pe, Color & wetness rmm To Wcll usc: ( ) Public suppIv. 17(1 Domestic. Other _ 0 2 Depth or hole: i 0� - ft, Casing stickup: 2 fi stickup Casing typc:steel_ _ Thickness: _250 inches Casing diameter. `6 inches C•asine depth: 100 ft overburden 2 3 Liner type: - Diameter: =inches Depth: - A 3 Static water (from top of casing): 66_ ft on 09' 11 -M7 silt &gravel Pumping level & yield: _ fi et after ., hours at _ gPtn Recovery rate: 17 gpm. Method of tt% ing: airlift moist silt & gravel 68 80 Dev,clopmcnt method: airlift Duration: 1 hour 80 94 Well intake opening type: ( X) Open end. t ) Open hole, Other wet gravel Screened: Start: ti. Stopped Screen type:- _ Slot mesh size: - - gravel W1 H2O 94 100 - Perforated: Stan: If. Stopped: It Stan: - 11. Stopped: fi Note: ...................... ............................................................................. Grout type: _NSerl_tonfte Volume - Depth; from ground surface . to 20 fi Pump intake depth: It Pump site: _ hp. Brand name: Was well disinfected upon completion? 1 X) Ycs. 1 ) No Method of disinrcction:Caleium.H hlo&e..(.Chlorine.)... Millereontmcnis� disclairacm:...............................................:............ ......................... _.................................................................... _....... ................................................................---......-............................... ............................................................................................................. Welldrillcrnarne: Johnny Key Company nzmc:...Hefty.Drillin9t.Inc.......................................... Mailing addnss:...3r.`>4...�.Akula Dr. ,,,,,,,,,,,,,,,,,,,,,,,, _g _ _ .AK Zip 99516 C•;,�: Anchorage State: Phone number : ( 907 ) 345 - 0593 fax:345-4700 Drillers signature: Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Section 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Alin Tat/Ot,-slc a well log to the DSD within 60 days of well completion. Permit Number. SW070219 Date of Issue: Parcel Identification . umber. n75 -1 - q7 Is well located at approved permit location' ( X1 Yss or ( ) No Pump Installation LogG,,,N�,, cLCCATIOWYGV4,cyA ,4c(- NALtE Dan6'._ 17"r6m ADM CROUNO DATE: CASNG W w a� � Pitless Adapter Manufacturer's Name: CO j:he (j•; J� Pitless Adapter Installer. PS LY )I'n5 w PUMP TTPE_ /�J to 10 r " .1 / D 1 MA< (') rtc ncl :r o S .9 YOOEL /b C Q !�y7 -tiU SMAL x Pump q 6 ! frh 1+34 u Yoler oxGP TYPE: Tp. 1 I i S" PO%U CABLL Tp. SYo• Y f?) N C s:. 1 a �r. Gnct C dticn � rrG 1tiiJ IEIECTWCAL• Vdtb Affw •AM TANK: Tprr !'I/f 11 X41 o i sue- 14 Ga HELL CA9NG T . /S'f:.f j LE• CASM NOFran O J To WTANE STNUCTUAE: Tp. _ /') �F V^ r ;: ? From To OPEN HOLE From To COLOAMM. well was disinfected upon completion. method: calcium hypochlorite. VC ZOLkll ...vim i ... � _ i. 1-['�v • 5W 1914o-lq MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water 6 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: Aug 28, 2007 Expiration Date: Aug 27, 2008 Permit Number: SW070219 Parcel ID: 075-132-97 Legal Description: US SURVEY 3042 LOT 2C Design Engineer: 0000 ZZ - NONE NEEDED Site Address: NHN CROW CREEK ROAD Owner Name: DANA L. DURHAM Lot Size: 15444 SO. FT. Owner Address: PO BOX 1016 Total Bedrooms: 1 Permit Bedrooms: 1 GIRDWOOD , AK 99587 - 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 specked 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 catling (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: Date: Date: rq' 29-0 Municipality of Anchorage �-1 Development Services Department Building Safety Division _ On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 www.muni.org/onsite (907)343-7904 ON-SITE SEWERIWELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. t 5- 1:59"'gq Propert Mailing 317-3gll (el � phone 7 93-1187 3M :ode e?(?!93 !93 Site address �1 ice] 6kao K TET) Zip Code Legal description (Sub'd., Block & Lot) US • S t rV f Ll --)'0 0P, [ 5 { -�C Legal description (Township, Range & Section) Lot Size 15.4 U-4 Sq. Ft. 1 Number of Bedrooms ` THIS APPLICATION IS FOR (® all that apply): THIS APPLIFATION IS AN: Absorption Field ❑ Initial 19' Septic Tank ❑ Upgrade ❑ Holding Tank ❑ Renewal ❑ Privy ❑ Private Well [ Water Storage ❑ certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling anis in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: /7S Waiver Fees: Date of Payment: — /�v/ UP" Date of Payment: Receipt Number. '�79t7 Receipt Number: (Rev. 11/05) 10/011n10Yn1 'H Oi.'10 11I1Y]0111Y 101 H I•V '/tOK'0l 91 M1001Y I J07 re 08/16/2007 11:46 5625427 AWWU PAGE 01 MUNICIPALITY OF ANCHORAGE WASTEWATER :. CONNECT:PERMIT, `07:=5607: .. : WATER'S WASTEWATER UTILITY. DATE OF y\PPLICATION:j.', r�:> 08L14/2007 3000 ARCTIC BLVD: '• '. . SCHEDULED. COMPLETION PHONE: (907)564-2762 , ra SLOCKlLOTITRACT LT 2C. : X� SINGLE FAMILY. ' :SUBMISION USSURVEY:3042, ..-, :...' Q MULTI-DWELI:ING No.APTS_ ' r,LtOMMERCIAL''r`• ' :7AX.GOdF 7513297 SE5012:•� STREET ADDRESS OWNER.SS l A r n PHONE„ JNAlLADDRESS 66N0TRRAeC•p.TaOir Rtx'isUuNnKNOWNc yS . T,. 9 Sem e : ' ;r .. . ;• © Ma„in,,UneA EifrScriEsiSonS X ;OriPropertyOnly,•. .. f, }� Cftyjap 0 Have Been Levied ?:Hydrant Only :': ` '.- : ;<;'.Q 50' or Longer To:Be,levied �' - MainTa 7oP.ro`e Unebnl 'Q rty :i:; _ ;+.•; �,• P P Y .Comments: alnTAP & On Property Connect R6,WN'o:' `Disconnect R&R-MalnTip Only er tall?:<, CONNECT SIZE 4.' ISSUED .INSPECTION FEE S 64.00 PO' CASH `c&-AI PERMIT FEE-S :'.' 48.00 .. CHECKSfX :5:" 000OTHER..>.:'. ... i •1)EPOSrr. : 0.00 •INSPECTED BY - REIMBURSABLE TOTAL$ 102.00 .: •. DATE .. ! / NUMBER,' REMARKS' PERMITTEE (Please Print) PHONE �1'/-3l/ ' MAIL ADDRESS -Ca- L� q GICHATURE POST IN A CONSPICUOUS PLACE AT THE JOB SITE CUSTOMER COPY Original a CL A'. M O J F1 I \ CL MS ••�j���:•:.. �, �� bib 16 .c s M o •.-. : �'.a� this \1 .0j Ci / \ ��0. 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