HomeMy WebLinkAboutUS SURVEY 3043 LT 1 OF 22U
3043
Lot I
of 22
075-092
-42
Well Log
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Legal Dvscripfirm, US & miley 3043 1 c.,.22
Pro Rerty C.Kvnc�r N'.1ine & Add ress-,
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Gird,,-voad, Afaska 9,Q56-7
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WATER QUALITY TESTING
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Demlepw t 5ervIc s Department
Sup poing fety bivis i o n --
-Site l oter & w stewater Program
4700 Elmore, Ram �
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M&* t r Arichorage. AK 995,07
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Pump Installation Log
Well Drilling Pe,znit Nu m bvr; SVS mPli 11 In 11gkte of ISSue: V4 1 1
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RAU;41 Description
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Pomp l aiuskke depth lore Top of Well Cising; 98
Pump Mau u f.uto rer's Maric: c-�xiids
PM mp Modo�; x Gpitt
131u mp SiZe V2 hip
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Pit6ess Ad:Ppter Ma nufactu ter's Name: W"'" n
Pill; Adapttr In ata Ilcr- Baau Mawrn
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Prop" fi,,vmer Name & AMrvzs.:
Kb=hd:u D-Ak!;!kr
F'.0.4L.A-84ly— l6 ?wr °!
0OwA M, AK 99597
A wnktiom The - pump 33Ss1al Ler Slf all provide a pump 11 isLalla[ Ion lag to the D within 30 clays of Txump imlal lation.
Permit Number:
Tax Code Number:
Work Type:
Permit Effective Dates:
Design Engineer:
Subdivision:
Site Legal Address:
Owner/Address:
Site Mailing Address:
On-Site Water System Permit
MUNICIPALITY OF ANCHORAGE
Development Services Department
On-Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
OSPl11188
07509242000
Well Initial
August04,2011 to August03,2012
US SURVEY 3043
US SURVEY 3043 LT 1 OF 22 G:4913
D'ALESSIO NICHOLAS J
PO BOX 506 GIRDWOOD AK 995870506
161 JUNIPER DR, Girdwood
Lot Size in Sq Ft: 16700
Total Bedrooms: 3
This permit is for the construction of:
N Disposal Field N Septic Tank
N Holding Tank N Privy Y Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing.
Special Provisions: Please include the water quality test results with either the Well Log or Pump
Installation Log submittal. AMC 15.55.060F2
Received By:_ ~~ /j~ /"/~
Date: ~/L////
MUNICIPALITY OF ANCHORAGE
Community Development Department
Development Services Division
On-Site Water & Wastewater Program
Mayor Dan Sullivan
Phone: 907-343-7904
Fax: 907-343-7997
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D.'-~' ~' ~'c-',~'~, f-~-'-7 ':~¢' '~'~'~.~-~- ~
Properly owner(s)~/I~ ~/~ ~ ~/'¢*¢~/~ Dayphone.. S~
Mailing address '~'2¢ '~ ~ ~, ~ f:~~ ~~
Site address i(~ [ ~~, p~ ~¢ ~¢
Legal description (Sub'd., Block & Lot)
Legal description (Township, Range & Section) ¢5 ~¢~ ~
Lot Size ~¢ Sq. Ft. Number of Bedrooms ~
THIS APPLICATION IS FOR:
([] all that apply)
Absorption Field
Septic Tank
Holding Tank
Privy
Private Well
Water Storage
THIS APPLICATION IS AN:
Initial ~
Upgrade []
Renewal []
THIS APPLICATION_INCLUDES A VARIANCE / WAIVER REQUEST FOR:
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/Rush Fees:
Date of Payment:_ ~,- /._L/i _//
Receipt Number: /
Permit No.
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
G:\Building\On Site\Forms\Client Forrns\Perrnit App_010411.doc (Rev. 1/11)
Tract
18A
Fnd Brass Cap
Monument on
2" Iron Pipe
PFC 86.5']
0.0 b
Proposed
House
FF=87.0'
38.0
,eline
Lot 1
16,812 Sq. Ft.
Lot 2
I..ot 21
(R)
(~)
IPFG ~6.~'1
- RECORD PER PLAT 69-25
- MEASURED THIS SURVEY
- ELEV. (NO DATUM)
- PROPOSED FINISH GRADE
-- DRAINAGE
Le~llol Oelcdptlorl:
PLOT PLAN
Lot 1,
Ordered By:. Nick D'Alessio