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HomeMy WebLinkAboutGALATEA ESTATES BLK 8 LT 10Gakitea Estates Block 8 Lot 10 #014-054-13 Alpine Drilling & Enterprises Well Log Permit Number: #SW 141339 Date of Issue: 8-29-14 Parcel Identification Number: 01405413000 Date Started: 10-10-14 Date Completed: 10-10-14 Is well located at approved permit location? x Yes ❑ No Legal Description: Galatea Estates Block 8 Lot 10 Property Owner Name & Address: Hagmeier John C & Judith A DBA John Hagmeier Company 2204 Cleveland Ave # 201 Anchorage< Alaska 9917 Borehole Data: Depth (ft) Method of Drilling x air rotary ❑ cable tool Soil Type, Thickness & Water Strata From To Casing type: steel Stick-up - 0 2 Wall Thickness:.250 inches Diameter: 6 inches Depth: 110 feet silt) gravel fill 2 6 = — , gravelly silt silt -Tdve Iv salt silt) gravel gravelly silt silt gravelly silt water sand & gravel 6 12 12 28 2W- ____.. _ 41 41 63 63 89 89 94 108 77=7777777IT7n WATER OLLALITY TESTING s Nitrates Diameter: inches Depth: feet Casing stickup above ground: 2 feet Static water, level (from ground level): 0 feet Pumping level: 105 feet after 2 hours pumping 20+ gpm Recovery Rate: 20+ gpm 94 108 Well Intake Opening Type: 110 x Open End ❑ Open Hole ❑ Screened Start feet Stopped feet Grout Type: bentonite granules Volume: 2 b.zs Pump: Intake Depth feet Frump size lip Brand Name Well Disinfected Upon Completion? x Yes ❑ No Method of Disinfection: chlorine tablets k-omments: Well Driller: Alpine Drilling ce Enterprises PO Box 110496 Anchorage AK 99511 • Development Services Department Building Safety Division • a� On -Site Water &Wastewater Program 4700 Elmore Road V P.O. Box 196650 Mark9eglch - - _ Anchorage, AK 99507 s A STY Mayor www.rnuni.ora/onsite (907)343-7904 - Pump -Installation Log Well Drilling Permit Number: SW 141339 Date of Issue, 8•29.14 Parcel Identification Number: 01405413000 Legal Description Property Owner Name & Address: John Hagmeler company Galatea Estates Block 8 Lot 10 - 2204 Cleveland Ave k 201 11 11 Anchorage, Alaska 98517 Pump Installation Date! j/2312015 Pump Intake Depth Below Top of Well Casing: 72 feet Pamp Manufacturer's Name: Goulds Pump Model: 1os806 Pump Size 112 hp Pitless Adapter Burial Depth: t2 feet Pitless Adapter Manufacturer's Name: Martensan Pitless Adapter Installer: Aarow l=ump a Well service, LLC Well Disinfected Upon Completion? Q Yes ❑ No Method of Disinfection: Comments: Pump Installer Name: Aerow pump a well Service, LLC P.O. Box 110496 Anchorage, AK 99511.0490 Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. rll�'�'�l[}1 C !> X F r 1 .s 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 Permit Number: OSP141339 Tax Code Number: 01405413000 Work Type: Well Initial Permit Effective Dates: August 29, 2014 to August 29, 2015 Design Engineer: Subdivision: GALATEA ESTATES Site Legal Address: GALATEA ESTATES BLK 8 LT 10 G:2033 Owner/Address: HAGMEIER JOHN C & JUDITH A DBA JOHN HAGMEIER COMPANY 2204 CLEVELAND AVENUE #201 ANCHORAGE AK 995173011 Lot Size in Sq Ft: 7200 Site Mailing Address: Total Bedrooms: 6 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. MUNICIPALITY OF ANCHORAGE Community Development DePartment Development Services Division On-Site Water & Wastewater Program Phone: 907-343-7904 Fax: 907-343-7997 ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. ~j _~/-.~(-./_~ - Property owner(s_) _"-~oo.~,.~ ~ E"~,/~ ~~g~y phone Mailing address ~ ~~/~~' ~ Site address ~, /~ ~/~ ~ ~' Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) Lot Size ~ ~ o o Sq. Ft. Number of Bedrooms APPLICATION IS FOR: APPLICATION IS AN: (~;~ all that apply) Absorption Field [] Initial ~ Septic Tank [] Upgrade [] Holding Tank [] Renewal [] Privy [] Private Well [] Water Storage TYPE OF DWELLING: Single Family (SF) (w/wo ADU) Duplex (D). Multiple Dwellings (SF and/or D) THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further cell~lt l~Ltbj,%~l~l~(~lld~nce with applicable Municipal Codes. UI MI I (,S'~-.~,~'re"' of property dwrr~3"OT~uthorized agent) Permit/Rush Fees: ~_~.~ Date of Payment: Receipt Number: Permit No. Waiver Fees: Date' of Payment: Receipt Number: Waiver No. Permit App_9-1-12.doc Regulatory Division · POA-2013-421 DEPARTMENT OF THE ARMY U.S: ARMY ENGINEER DISTRICT, ALASKA ANCHORAGE FIELD OFFICE CEPOA-RD-SA t600 A STREET SUITE 110 ANCHORAGE, ALASKA 9950'1-5t46 AUG 16 20]3 Mr. John Hagmeier John Hagmeier Homes, LLC 2204 Cleveland Avenue, Suite 201 Anchorage, Alaska 99517 Dear Mr. Hagmeier: This letter responds to your July 11, 2013, request for a Department of the Army (DA) jurisdictional determination for Lots 8-12, Block 8 in the Galatea Estates. It has been assigned number POA~2013-421, N; F. Little Campbell Creek, which should be referred to in all correspondence with us: The project site is located within Section 5, T. 12 N., R. 3 W., Seward Meridian; USGS Quad Map Anchorage A-8; Latitude 61.1603° N., Longitude 149.8368° W.; in Anchorage, Alaska. Based on our review of the information you provided, we have determined the subject property does not contain waters of the United States (U.S.) under Corps jurisdiction. Therefore, a DA permit is not required. A.copy of the Approved Jurisdictional Determination form is available at: www.poa.usace.army.mil/Missions/Regulatory/JurisdictionalDeterminations under the above file number. Please contact us if you decide to alter the method, scope, or location of your proposed activity. This approved jurisdictional determination is valid for a period of five (5) years from the date of this lei/er unless new information supporting a revision is 3rovided to Us before the expiration date. EnclOsed is a NotificetiOn of Administrative Appeal Options and Process and Request for Appeal form regarding this approved jurisdictional determination (see section.labeled "Approved Jurisdictional Determination"). · Section 404 of the Clean Water Act requires that a DA permit be obtained foi' the placement or discharge of dredged and/or fill material into waters of the U.S.; including jurisdictional wetlands (33 U.S.C. 1344). The Corps defines wetlands as those areas that are inundated or saturated by surface or groundwater at a.frequency and duration sufficient to support, and under normal circumstances do. support,, a prevalence of vegetation typicelly adapted for life in saturated soil conditions. www. poa.usaCe, army. mil/Missions/Regu/atory -2- Section 10 of the Rivers and Harbors Act of 1899 requires that a DA permit be obtained for structures or work in or affecting navigable waters of the U.S, (33 U.S.C. 403). Section 10 waters are those waters subject to the ebb and flow of the tide shoreward to the mean high water mark, and/or other waters identified by the Alaska District. Nothing in this letter excuses you from compliance with other Federal, 'State, or local statutes, ordinances, or regulations. Please contact me via email at shane.m.mccoy@usace.army.mil, by mail at the address above, by phone at (907) 753-2715, or toll free from within Alaska at (800) 478- 2712, if you have questions. Sincerely, Enclosures MUNICIPALITY OF ANCHORAGE Development Services Department Phone: (907)343-7904 On -Site Water & Wastewater Section Fax: (907)343-7997 Parcel ID 014-054-13 Certificate of On -Site Systems Approval OSC241482 Expiration Date: Legal description GALATEA ESTATES BLK 8 LT 10 Site address 6672 O'BRIEN ST, DUPL Current property owner(s) HARBISON SHAUN R & X The On -site system(s) is/are approved for 7 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or conditions: By: This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Service Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's submittal. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other MUNICIPALITY OF ANCHORAGE '4 Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 014-054-13 Complete legal description GALATEA ESTATES BLOCK 8 LOT 10 Location (site address) 6670 O'BRIEN STREET, ANCHORAGE, ALASKA 99507 Current property owner(s) HARBISON SHAUN R & ZHAQ HUI — Day phone 2. ON -SITE SYSTEMS SIZED FOR 7 BEDROOMS 3. TYPE OF WATER SUPPLY: [Z Private Well Fj Private Well serving 2 dwelling units El Private Well serving 3+ dwelling units F1 Community Well or Public Fj Water Storage 4. TYPE OF WASTEWATER DISPOSAL: R Private Septic 0 Private Septic serving 2 dwelling units F-1 Holding Tank Z Community Septic or Public Sewer 5. SEPTIC TANK: F-1 Steel F-1 Plastic E] Concrete F-1 Fiberglass Age - See advisory if steel older than 20 years 6. ABSORPTION FIELD: F-1 AWWTS 0 Bed F] Deep Trench R Wide Trench R Seepage Pit Waiver request for: Expedited review requested: F Distance: By applying for this entitlement, this property is subject to inspection by municipal On -site staff to verify the accuracy of the information provided. COSA Fee $ 0 50 Date of Payment I COSA # 05 (,-291 q 02- Waiver Fee $ Date of Payment Waiver # COSA Appliration.doc COSA Checklist WELL ONLY.docx COSA Checklist Legal Description: GALATEA ESTATES BLOCK 8 LOT 10 Parcel ID: 014-054-13 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA Well log is filed with Onsite (or attached) Date drilled 10/10/14 Total depth 110 ft Cased to 110 ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 18 in. Date of flow test for COSA 11/18/24 Static water level at beginning of test 0 ft. Well production at time of test 4.5 gpm Water storage tank volume None gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate 1.08 mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date 11/18/2024 Comments Sullivan installed an artesian plug, extended casing with a new sanitary seal & conduit. B. TANK DATA – PUBLIC SEWER Measured operating fluid level in septic tank Date of pumping Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA - PUBLIC SEWER Which system tested (date installed) ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes go to bottom of effective. If not, state depth into effective Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) If yes, enter date Adequacy test date Results Pass Fluid depth prior to test in Water added gal New fluid depth in Elapsed time min Final fluid depth in Absorption rate gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) in Effective depth used in Effective depth remaining in Comments/Deficiencies: COSA Checklist WELL ONLY.docx E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100’ Yes if No NA ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No NA ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS See AWWU sewer connect card & sewer mainline data. G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Engineer’s Printed Name CURTIS HUFFMAN, PE Date 11/26/2024 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & 11/26/24 RUSS • -� Municipality of Anchorage °a On -Site Water and Wastewater Program (907)343-7904 Certificate of On -Site Systems Approval Parcel I.D. 014-054-13 Expiration Date: 1. GENERAL INFORMATION Complete legal description Galatea, Block 8, Lot 10 Location (site address) 6670/6672 O'Brien St. Anchorage, AK Current Property owner(s) John Hagmeier Homes LLC Day phone Mailing address 2204 Cleveland Ave. #201 Anchorage, AK 99517 Real Estate Agent Day phone 2. TYPE OF DWELLING: ❑ Single Family (w/wo ADU) ❑ Duplex { �+u/ F-1MultipleDwellings (Single Family and/or Duplex) ' f USH! 3. NUMBER OF BEDROOMS: 8 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well F Individual ❑ Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer i] WaiverNariance request for: Received by: ( te /k )-k Date: `'I I I to I S COSA to be released to ith f engineer, unless otherwise requested by the engineer. COSA Fee $ 11 1&13 Date of Payment it 115 Receipt Number 073? COSA# Q SCtstI19 Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. In conducting an adequacy test, 1 attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may Fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone 6. DSD SIGNATURE In System #1 Approved for __.? bedrooms System #2 Approved for bedrooms Disapproved Date 3/26/2015 Conditional approval for bedrooms, with the following stipulations: 4U,6�L Original Certificate Date: / / ° The M1lpi6ipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Nitrate Advisory - Septic System Advisory Arsenic Advisory - Well Flow Advisory Other COSAbluesheer ° ., c If more than 1 septic system is on the tot: COSA Checklist # 1 of Structure served by this system i Certificate of On -Site Systems Approval Checklist Legal Description: Galatea, Block 8, Lot 10 A. WELL DATA Well type Private If A, B, or C provide PWSID # Date completed 10/10/2014 Sanitary seal (YIN) Y Total depth 11 Q ft. Cased to 110 ft FROM WELL LOG Date of test 10/10/2014 Static water level 0 ft. Well production 20+ g.p.m. Parcel 10: 014-054-13. Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) 18+ in. AT INSPECTION New New ft New WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate %00 umg/L Arsenic 5.00 u ug/L Date of sample: 3 d3 �-O 1S Collected by: / B. SEPTICIHOLDING TANK DATA Tank Type/Material Tank size gal. Number of Compartments Foundation cleanout (Y/N) _ Depression over tank (Y/N) Date of pumping C. ABSORPTION FIELD DATA Pumper Date installed Cleanouts (YIN) g.p.m. High water alarm (Y/N) Date installed Soil rating (g.p.d./f:2 or e/bdrm) System type Length ft. Width ft. Gravel below pipe ft. Total depth ft. Eff. absorption area if Monttoring tube _ Depression over field Date of adequacy test Results (Pass/Fail) For bedrooms Fluid depth in absorption field before test in. Water added gal. New depth in. Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed Size in gallons _ "Pump on" level at in. "Pump off" level at Datum Cycles tested _ Manhole/Access (Y/N) in. High water alarm level at Meets alarm & circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot N/A On adjacent lots 100+ Absorption field on lot N/A On adjacent lots 100+ Public sewer main 75+ Public sewer manhole/cleanout 100+ Sewer /septic service line 25+ Holding tank 100+ Animal containment areas 50+ Manure/animal excrete storage areas 100+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation Property line Absorption field Water main Water service line Surface water Wells on adjacent lots ABSORPTION FIELD ON LOT TO: Property line Building foundation Water main Water Service line Surface water Driveway, parking/vehicle storage _ Curtain drain Wells on adjacent lots F. COMMENTS G. ENGINEER'S CERTIFICATION - i certify that f have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Steven R. Pannone Date 3/26/2015 COSA canary sheet 2.6-15.doc in. O clW m 3`\11. 00 V) 0. 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D o ,* N O _I pada, d in _ Z � N3SO LLIrDZ W L W c� mO �I w$a '�0N L: MUNICIPALITY OFANCHORAGE SEWER io CONNECT PERMIT 81-2/434 DATE OF APPLICATION _/DZj3ld/ WATER B SEWER UTILITIES SCHEDULED COMPLETION DATE / R9/ 300D ARCTIC BOULEVARD ❑ SINGLE FAMILY PHONE - 277-762 2 ❑ MULTI -DWELLING No. APTS_ �y OCOMMERCIAL LOT/T4AGFFJ0 //++ BLOCK a ❑ INDUSTRIAL SUBDIVISION (7A!/47r19 ETrA7r5 2,0.33 TAX CODEQ%�4"'13 GRID 2133 DRAWING No. BUILDING ADDRESS QI &IeW �7 OWNER PHONE CONTRACTOR: //Yoe ASSESSMENTS (License B bond reW iced ❑ Poid previously O,SON PROPERTY ONLY ❑ Main extension agreement .uvMAINTAP-TOPROPERTY LINE ONLY ❑ Subdlvlsion agreement ❑ Extended connect agreement ❑MAINTAP 90N PROPERTY CONNECT Pending -AMOUNTS LIU /)7 CONNECTION SIZE �-vl CHARGE AI INSPECTION FEE # ❑CASH PERMIT FEE # �FAID ❑CK# REIMBURSIBLE INSPECTED BY NUMBER DEPOSIT TOTAL # DATE; PERMITTEE ^ MAIL ^^�-- (PLEASE PRINT) 4[41"w ADDR. 7000 v'&"X SIL PHONE: I HAVE READ THE CONDITIONS AND REGULTIONS ON THE REVERSE SIDE OF THIS PERMITAND AGREE TO COMPLY WITH THEM PERMITTEE SIGNATURE POST IN A CONSPICUOUS PLACE ATTHE JOBSITE e0—MI (4/80) TAX CODE No. O/s/ GRID No. z PROPERTY; Name Plat No. Residential ❑ MUNICIPALITY OF ANCHORAGE — SEWER UTILITY Address OB/I�E�Aoct.No Subd. Lot Block Commerial ❑ Industrial ❑ No. of units CONNECT: Main Tap 13 Drawing No. Insulation ❑ Connect Agenty Comments�� On Property ❑ Permit No. Size �Type Size Maim Type G"Depth at Connect 9 Cleanouts Type -/ '.Inspector Date 6 ��• ��� Connect Location ASSESSMENTS: L.I.D. No.Private Dev. No. Sewer Agreement ❑ No.—RTE. Subd. Agreement ❑ No. ❑ Roll No. DYE TEST Positive ❑ Page No. Tested By Negative ❑ M.H. No. N.S.A. ❑ Date Billing Cycle Comments A311V s{uawwo0 V rf �j'�ri i� Cam/ 10� 32i1S 0104UDVJ 101000 0U01100o-1 M04S / p 'S"W 4004S RB uoM003 aul I SOIAJOS „.ki83d O8d NO,, MUNICIPALITY OF ANCHORAGE �A WASTEWATER S141019 CONNECT PERMIT s WATER & WASTEWATER UTILITY DATE OF APPLICATION: 01103/2014 3000 ARCTIC BLVD.- - PHONE:(907)564-2762 SCHEDULED COMPLETION DATE: 12/31/2014 BLOCK/LOTf FRA;I�TISLK &1 LT 101 ❑ SINGLE FAMILY SUBDIVISION: GALATEA ESTATES ❑ DUPLEX ❑ COMMERCIAL ❑X MULTI -DWELLING No. APTS 2 TAXCODE: 01405413000 GRID: SW2033 STREET ADDRESS: .AK OWNER: HAGMEIER JOHN C & JUDITH A DBA JOHN HAGMEIER COMPA PHONE: MAIL ADDRESS: 2204 CLEVELAND AVENUE #201 ANCHORAGE, AK 995173011 BC ❑ Repair Existing Service X❑ On Property Only ❑ Hydrant Only ❑ Maig Tap - To Property Line Only ❑ Main Tap& On Property Connect ❑ Disconnect ❑ R & R - Main Tap Only CONNECT SIZE 4 in ASSESSMENTS ❑ Main Line Extension ❑ City Tap © Have Been Levied ❑ To Be Levied Comments: Row No. INSPECTION FEE $ 103.00 � PAID ❑ CASH • PERMIT FEE$ 72.00 ❑ CHECK# $ 0.00 OTHER DEPOSIT$ 0.00 REIMBURSABLE INSPECTED BY NUMBER TOTAL $ 175.00 G� DATE $_5_ty REMARKS PERMITEE (Please Print) HAGMEIER JOHN C & JUDITH A DBA JOHN HAGMEHENDMPANY MAIL ADDRESS 2204 CLEVELAND AVENUE #201 ANCHORAGE, AK 995173011 SIGNATURE POST IN A CONSPICUOUS PLACE AT THE JOB SITE INSPECTOR COPY DATESCHEDULED 12/31/2014 TIME 12:OOam INSPECTOR cl.'l W�� SUBDIVISION GALATEA ESTATES BLOCK/LOT/TRACT BLK 8 / LT 10 / INDICATE NORTH 1 d 1'N I a�i I zo 1— 6` X: C !F �i 'o SIZE MAIN: TYPE MAIN: DEPTH AT MAIN: AT PROP. LINE: $V CONNECT LOCATION: l$yl` $ of V) v COMMENTS: � � �� �b" 0 0+,6 c. W-,444 40 c1- `s l (e t trF 4" fN[. �- t* A Illy' uV4'y 'F� Nw •'(ZO. L-� p CLd @-wd• INSEPECTED BY: DATE: g ` L 5frv�us� �tat.l Cyc}a 4'0 prygoucA MUNICIPALITY OF ANCHORAGE S WATER & WASTEWATER UTILITY 3000 ARCTIC BLVD. PHONE:(907)564-2762 BLOCK/LOT/TRACT: BLK 8 / LT 10 / SUBDIVISION: GALATEA ESTATES TAX CODE: 01405413000 GRID: SW2033 STREET ADDRESS: 006670 O'BRIEN ST AK OWNER: HAGMEIER JOHN HOMES LLC WASTEWATER S�51UTi CONNECT PERMIT DATE OF APPLICATION: 04/03/2016 SCHEDULED COMPLETION DATE: 12/31/2015 ❑ SINGLE FAMILY ❑X DUPLEX ❑ COMMERCIAL ❑ MULTI -DWELLING No. APTS PHONE: MAIL ADDRESS: 2204 CLEVELAND AVENUE #201 ANCHORAGE, AK 995173011 ❑ Repair Existing Service X❑ On Property Only ❑ Hydrant Only ❑ Main Tap -To Property Line Only ❑ Main Tap & On Property Connect ❑ Disconnect ❑ R & R - Main Tap Only CONNECT SIZE 4in REIMBURSABLE NUMBER REMARKS C/O Install ❑ City Tap Row No. INSPECTION FEE $ 0.00 PERMIT FEE $ 0.00 $ 0.00 DEPOSIT $ 0.00 TOTAL$ 0.00 ASSESSMENTS ❑ Main Line Extension X❑ Have Been Levied ❑ To Be Levied Comments: ISSUED WWKMM ❑ PAID ❑ CASH ❑ CHECK# ❑ OTHER INSPECTED BY SU•y>— DATE PERMITEE (Please Print) HAGMEIER JOHN HOMES LLC PHONE MAIL ADDRESS 2204 CLEVELAND AVENUE #201 ANCHORAGE. AK 995173011 SIGNATURE POST IN A CONSPICUOUS PLACE AT THE JOB SITE INSPECTOR COPY DATE SCHEDULED 12/31/2015 TIME 12:00 am INSPECTOR J L SUBDIVISION GALATEA ESTATES BLOCK/LOT/TRACT BLK 8 / LT 10 / INDICATE NORTH y <a� T L SIZE MAIN: TYPE MAIN: DEPTH AT MAIN: AT PROP. LINE: CONNECT LOCATION: COMMENTS: 30 l (f \ VL INSEPECTED B)-� DATE: YZ55 a ZZ9T ��11 "If IN NV���� 1p / + - z" - OE n C w t8Fs _ C9,90.5 Iv 34.ul 103NN00 dOHC I 2 I z� i ry rmmK-/i�+'• I �_ _ e z umJ m J F y w 0 Z J 0 zw w= m O v M " „P p U a 6 II II I " In p II '3AV H10G 1SV3" m I n �o I 1 I ry I o I ZO+Z/ I t �s $g @f' " llYy •4% stje " " a' oF1vu� LS*0/ O O O W 0 0 O m 0+w `* s o IM fir " m o w lap=? 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