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HomeMy WebLinkAboutMOUNTAIN PARK ESTATES #2 BLK 3 LT 12iV UNICTIR ALITY OF ANCHORAGE On -Site VVater & VYastewater Program PO Box 1 5D 4700 Elmore Road AroouxaW, Alaska 99519 850 Phare: (W7) 3A3-7904 Fax: {907) 343-7997 MPMMW rr-U+'e, ?60! IC On -Site Wastewater Disposal System Permit Perm?t Number; OSP211127 Work Type: SepbcTiank Uporade Eft-.tl ve Date: Expir-atlorr Da to, Tax Dcde Number_ 1)1T02224a0O Site Legal Addrirss: MOUNTAIN PARK E87ATES #k2 BLIP 3 LT 12 G;2839 Site Mai ling Address; 13140 SAUNDERS RID, Anohomge Owner, VAN DYKE KI RT E & MELISSA L Design Engineer: 1•IR 7 DATER CON S ULTIN-G Th Is permit is for the construetlon of_ ❑ Disposal Field [a Septic Tank 11 Holding Tank ❑ Primo &5f2021 ,9J512022 Lot Size in Sq Ft: 201 �0 Total Eedrooms: 4 ❑ Private Wal I ❑ VV@tar Sterege All construcii on shall bo in accordance with: 1. The attached approved design. 2. Al I requirements specified in Anchorage N un icipal wde Chapcem 15,55 and 15.65 a nd the State of Alaska Wastewater Disposal Regulations (i 8AAC72) and Del eking Water Regulations (1 A 80) 8. Thu wautuwa(er vud6 ray ui reg it i Y{pt ;lkw � duri rig ilm invulialiun. The vinglrieur !hall natl Fy the Development Services Department per AMC 15.05. Provide notification by calling (907) 343-7904 (24f7). 4. From October 15 to April 15, a subsurrace soil absorption system undeT construction Burin@ freezing weather shall be either; 9. Opened end Closed on Fhe safne day, or h. Qovered, sealed, an -d heated to prevent freezing Received By,. Issued B}: ct,174& Date: Gate: 51612021 MUNICIPALITY OF ANCHORAGE Development Services Department �`�' Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I. D. 017-022-24 Property owner(s) KIRT & MELISSA VAN DYKE Day phone _ Mailing address 13140 SAUNDERS ROAD, ANCHORAGE, AK 99516 Site address 13140 SAUNDERS ROAD, ANCHORAGE, AK 99516 Legal description (Sub'd., Block & Lot) MOUNTAIN PARK EST. #2 133 L12 Legal description (Township, Range & Section) Lot Size 20,130 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) El (w/wo ADU) Septic Tank 0 Upgrade 0 Duplex (D) El Holding Tank ElRenewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. nature of property owner or authorized agent) Permit/Rush Fees: 2 Z Waiver Fees: Date of Payment: -5 .20-� 1 Date of Payment: Receipt Number: F0 G os O Receipt Number: Permit No. 0-!f, PZ I I 107 Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com May 4, 2021 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: EMERGENCY SEPTIC TANK UPGRADE PERMIT LEGAL: MOUNTAIN PARK ESTATES #2 BLOCK 3, LOT 12 The owner has requested that we obtain a septic permit to upgrade the existing COLLAPSED aged steel septic tank on the above referenced lot. Due to the collapsed tank, we request an expedited permit review. We propose to install a 1250-gallon HDPE tank per the attached design to serve the existing 4-bedroom residence. The lot and area are served by private wells. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211127, Rebecca Carroll, 05/05/21 FIRST WATER CONSULTING NO WELLS WITHIN 100' OF PROPOSED SEPTIC TANK MOUNTAIN PARK ESTATES #2 B3, L12 DESIGN DETAILS: STAKE WELL RADIUS PRIOR TO CONSTRUCTION. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211127, Rebecca Carroll, 05/05/21 GRb^,t:R ANCHORAGE AREA BOrc~,JGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 ,~ INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM fS~ ,3'7 7 l?~ PHONE NAME . , '~- . '~ MAILING ADDRESS ~.' iT- (~(_ LOCATION SEPTIC TANK: DISTANCE FROM WELL ~ MANUFACTURER INSIDE LENGTH /~P INSIDE WIDTH ,,~}---¢~6¢' ~/~ MATERIAL LIQUID DEPTH .... NUMBER OF COMPARTMENTS ¢~---~ ,LIQUID CAPACITY ,/~-~3 GALLONS. NUMBER OF PITS ~ DIAMETER LINING MATERIAL BUILDING FOUNDATION ADDITIONAL ABSORPTION OR WIDTH ~ CRIB SIZE: DIAMETER__ NEAREST LOT LINE__ / LENGTH-Ct~ DEPTH .DEPTH ~¢ODISTANCE FROM: WELL TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) SQ. FT. WELL: TYPE CONSTRUCTION BUILDING NEAREST NEAREST FOUNDATION_ LOT LINE SEWER LINE CESSPOOL OTHER SOURCES APPROVED DISAPPROVED DEPTH DISTANCE FROM: SEPTIC SEEPAGE TANK __ SYSTEM REMARKS DISTANCES: INSTALLED BY: PIPE MATERIAL:__ LOT SLOPE: REMARKS: __ DIAGRAM OF SYSTEM ~.A.B. -DEF'F~RTMENT OF HEFIL.'i"H Ri'.,!D ENVIRONMENTFIL.. PROTEC'TION ;~.~;iID E. 'TUDOR R[:,. F'EF:i'd 1' T I'.,IO. ,:'. ?"e.';C:iG;::i~: ::~ L. 0C:FIT :[ ON E:,FJFIRHC~UN 8: LEGFII._ L:L.2: B[J: I"IT F"K E:S'[' LOT T'~"PE OF ./~. ,5. 2:: ,:S, $ d; .1..5 ::~:,'~ ,'.-t. (~ '1~. I..10P' GI~:FI',/EL E:ETt4EE:N THE OIJ"i"FRLL . IFE F~ND THE: E:~.::C:FI',,,'FfT'ION BOTTOH I ~;; 6;. 5 "['H[i:F:E' '.iS; NO '.'SET 14IE:,TH F'OF.' T,[~'.ENCHES. FO~t rJ:,FeRINFIF. Z'L. DFS., THE I.,.!IDTH THE DEF'TH OF 'f'REiNCH OF..' F'IT I:~; THE DZ:.STF~NCE BETHEEN THE; GROUND SUF.!FRC:E RN[:, THE E:O'!"TOH 01::' 'THE EXC:FCv'F'~TION. THF. Z:' L..ENG'I"H E:,If,IE:N~;ZON I% 'f'H[:: LENGTH OF' EFICH ~;I[:,f£ EOf;.: I'a 2;EEPFIGE F'iT OF:.~. ']'PIE LENGTH OF' THE.' TF.:ENCH., OF.: [:,f:4!RINF'IELD. THE I.;.:E6:!U:[RE.L'[.':, '.'5. EF'"i"IC TFINK 5;IZ.E: IS J..2~50 GI:~.LLONS BF~CKF]iLL:[NCi OF' FIN]',*-' S'.¢E;"f'EP1 HZTHOIJT F]lh!F~L. I.N[SF'ECTZON EP'r' THIfS E:,EPF~'.THENT HILL DF£ SL![3.J'ECT TO S2T'%'f'E:H ]:E; :]J;::~C'i F:T FOR R F'F.:]:'v'F:ITbEP.IEL. L lq. ND L:-ZO:E'~ F'T F"OF-:: FI PUBLIC 14EL.L. HEL.L LOCJ:'S ML.EST E:E F.:ETLIF::NED TO THE D[SF'Flfk'!"F1ENY I,.i ]: TH ]Z N Z-":C¢ E:,R'¢S OF' THE HELL .C:Ot'4PLE T I ON. I N:S'f'RL LI::IT Z ON. I C:E[~:'T I F:'"r' THF~T ]: Ffft P'FtH [ L I FIF.: I.,.t :[ TH THE F::E6!U I F.:L::HEh!"FE; F'OP:: ON'-2; Z'f'E '.SEHEF-'tL=, RNE:' HEI_L--'S, Ft:5 '.SE:TFFIRTH D"r' THE: HUh! ]: C ]: F'F~L I 'f"~" CIF' FINC:H. ORRGE RND [,.1 ! EL.. I NSTt~LL I N RC:CCIF.:E:'taNC:E l.,,iI TH THE 'f:OE:'E. SAUNDERS T.H.1 T.H.1 SANDY SILT W/TRACE ORGANICS (}~) SkNDY SILT W/TRACE GRAVEL-Layers of Silty Sand (SM-ML] (260) SAND W/TRACE SILTY SAND W/ SOMEa~ SANDY GRAVEL GRAVEL W/SOME SAND & SILT (GM) .0.0' 0.5' 2.0' ~' ~ ;;~:,.%~,7~.~, I ;. ' ':r '~ :'"C~'~1~ii'~;. I ~, · 7~.,5: 9.0" 10.0' 16.0' 19.0' T.D. Log Represents No Water Table Location of Test Hole LOt 12 Block 3 Mountain Park Estates No. · I Joyce Const~ction Co. ~ ~g of Test Hole ~nsultants Inc .... ~~o~o~o~o~o~o~ ooooo~~~oo oo oooooooooooo~ ~CH WATER wELL DRILLED AND CASED OUT TO THE DEPTH OF 25¢ .feet _ED AT THE RATE OF. ~12~00 .... PER FOOT. _ LOG: ~90' Looae gravel° 1-155' H~l:~ mnti oobhl.~o -~0 ~a.vel ~ oobblo~ ~th 20% o1~ b~o -~' ~ grave!~ S~e ~ of wa~ Silty mat~ial, -251" ~to~ bo~ ~t~i~ ~av~l~ Pr~mo~g o~ht G~ ~uao F~ty foot he~ of ~ or ~]1~ $4250000 INCLUDES ALL LABOR AND ~4ATERIAL FOR COMPLETION OF SAID DRILLING. .E CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF ~270o0~) THANK YOU VERY MUCH, Oot. l~t. 76 BERNIE CLAU.:c' OF RAMPART DRILLING WORKS DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # 1, GENERAL INFORMATION Complete legal description CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING location (site address or directions) I ~/.4-0 Property owner Mailing address Day phone 2~c~'- ~-~/ Lending agency .Mailing address Day phone / Agent ~DKz.~)~--~t~ ~![~'i'~/~,a,~...~ /-l~l--z,.~.c'_.~.r,_Day phone Ad dress ~ e Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: ~-~ TYPE OF WATER SUPPLY: Individual well ' ~( Community.well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system.~ TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA#21 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date ol t~/~inspection. Name of Firm r Wastewat Phone ~e~efHts. Address A n~ra~e,/A~ska Engineer's signatUre ~ ~[]~~~--] __ Date 6. DHHS SIGNATURE ~ Approved for ~ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments Date The Municipality of Anchorage Department of'Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025(Rev. 1/91) Back MOA~I RECEIVED Municipality of Anchorage MAY 2 6 1998 DEPARTMENT OF HEALTH & HUMAN SERVI~B~IP^uTy O~^NC~O~A Environmental Services Division ENVIRONIvIENTAL.SERViCES DIVI~ 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Legal Description: A. WELL DATA Health Authority Approval Checklist ~ ~J_) ~'10UN"'h~'~/ Parcel I.D.: Well type ~ Log present (Y/N) Total depth ~ ~5' I Sanitary seal (Y/N) Date of test If A, B, or C, attach ADEC letter. ADEC water system number Date completed ~,} I'z~ Cased to z~''O~'' Casing height (above ground) Static water level Well production AT INSPECTION 'WATER SAMPLE RESULTS: Coliform (~ Nitrate Date of sample: ~ , TA.K DATA /0 g.p.m. Collected by: o~- Other bacteria Date installed Foundation cleanout (Y/N) Date of Pumping /O/~/'~, C. ABSORPTION FIELD DATA Date installed ~/'7 Length 3 '7 / Width Effective absorption area ~' Date of adequacy test Depression (Y/N) Pumper ¢~o ~ Soil rating (g.p.d./fF or ft2/bdrm) o System type ~ Gravel thickness below pipe ~'.~ /Total depth // Monitoring Tube present (Y/N). ~ Depression over field (Y/N) Results (Pass/Fail) ~ For ,~o Fluid depth in absorption field before test (in.); ~P--Y Immediately after ~' gal. water added (in.): '~' Fluid depth ~J~(~ (ins) Minutes later: ~ Peroxide treatment (past 12 months) (Y/N) Absorption rate =: :Z'lt"~O'~ g.p.d. If yes, give date ~//~ Tank size /Z-~'O Number of Compartments :~ Cleanouts (Y/N) High water alarm (Y/N) bedrooms 72-026 (Rev. 3/96)* FROM WELL LOG Wires properly' protected (Y/N) YE; ~ Date installed ~ Size in Manhole/Acoess (Y/N) ~at* "Pump off" level at* _ *Datum E. SEPARATION DISTANCES Absorption field on lot Public sewer main f'J Sewer/septic service line SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot JO I'Zo ± On adjacent lots On adjacent lots / Public sewer manhole/cleanout Lift station F. SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation ~ '7 ~ ~ Property line t~=~ / 'P Absorption field Water main/service line ~' ID i Surface water/drainage -~co/ , Property line Surface water Curtain drain SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Building foundation '~ ~ ~ ! ~' Ioo Wells on adjacent lots Water main/service line Driveway, parking/vehicle storage area j Wells on adjacent lots >. ~o ENGINEER'S CERTIFICATION I certify that l h~v~t¢¢,ined r 'inspections and review in conforma~/~ with~ in effect on this date. Signatur~ (,,_~,/,/j//~~/n s~ EngineersNam/~...~/~~ ~Z~, ~,~=.~_..~ Date .~-¢-~/?~'/~ ~ HAA Fee $ ~ C'70' ~'~ Receipt Number~ ~? :7'~ ~/~) 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number Manhole~Access ~/N)~~,,Pump off"level at* "' ' ' ' - ' SEPARATION DISTANCES .. SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding .tank on lot Absorption field on lot I~-o 4- On adjacent lots On adjacent lots Waier main/serVi'~e li~e > i~/ 'Surface water/drainage SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: · Property line ~/+ B.ui!ding foundation ~ ~'/-+ ! Public sewer main NJ ~V Public sewer manhole/cleanout '' Lift station hJ Sewer/septic service line .Cj'i ~ SEPARATION. -DISTANCES"'i FR0.M. SEPTIC/HOLDING.. TANK/ ON' LOTTO:. ' .t,~ Foundation ' I'7 ~- . . Property line I~ .t- Absorption field / Wells on adjacent Jots Surface water ~' Ioo Curtain drain Water main/service line Driveway, parkingJYel]icle storage area Wells on adjacent lots >. we .... : ..- F. ENGINEER'S CERTIFICATION .A .- , ced,~ ,at ~h~t~ine~r~ ~,J inspections and'review of Municipal record~at ,lin~s in effect on ,is date. · in conforma~ Signature ~ ~[~ ~ Date''~ r/~/* * . · . HAA Fee $ Date of Payment ~'-/~/~ Receipt Number~~--~ .Waiver Fee $ Date of Payment .Receipt Number 72-026 (Rev. 3/96)* ' . .... · · Alaska Wa er & Wastewater October 9, 1996 Carolyn Humphrey 13140 Saunders Road Anchorage, Alaska 99516 8471 Brookridge Drive ~ Anchorage - Alaska 99504 Phone (907) 337-6179 - Fax (907) 338-3246 Consulting Engineers Subject: Well & Septic System Evaluation. Lot 12, Bk 3, Mountain Park S/D #2. Dear Ms. Humphrey: Per your request I performed an inspection of the subject well & septic system. My findings are summarized as follows: A. WELL: I was unable to find a well log on file at the municipality, however, according to M.O.A. records (4/22/81), it is 251 feet deep. On the day of my inspection the static level was 188.5 feet below the top of the casing. Water was pumped from the well at a rate of 5.31 gpm for 90 minutes (478 gallons). The water level dropped a total of 26.5 feet to approximately 215 feet. At the end of the pumping period the recovery of the well was monitored for 30 minutes. During that period the level in the well recovered completely (to 188.5 feet). Based upon this data it was determined that the capacity of the well exceeds 5.3 gpm, which meets the Municipal requirements for a 3 bedroom house (450 gallons per day). As mentioned previously, there is no well log on file, consequently, it is not possibl9 to determine the total depth of the casing. Based upon my knowledge of .other wells in the area, it is reasonable to assume that it is cased to at least 40 feet, as required by the Municipality; however, the only way to be certain would be to have it verified by a well driller. As required by code, the casing extends greater than 12 inches above the ground, and has a sanitary seal. B: SEPTIC TANK: The existing septic tank was installed in September of 1976. According to the M.O.A records, it is 1250 gallons, has two compartments and is made of steel. Given the tanks age (20 years old), it is reasonable to assume that it is approaching the end of its useful life. The next homeowner should anticipate replacing it within the next several years. The tank was pumped on 10/8/96 by Old McDonalds Pumping Service. C: DRAINFIELD: The drainfield is a trench type system, which has an effective depth of 78 inches. Based upon my observations, it appears that the sump is non-perforated "orangeburg" pipe, and that the drainpipe holes are facing up. In short, there is no perforated sump or monitoring tube. Prior to starting the adequacy test it was noted that the sump was complete!y dry. Water was added into trench c/o at a rate of 5.31 gpm for a total of 90 minutes (481 gallons). In addition, while I was filling the trench, the homeowner washed two loads of laundry, and flu~hed the toilet, which added an estimated 40 gallons to the trench. In short, the total amount of water added to the trench was approximately 520 gallons. At the end of the pumping period, the sump was filled to the top of the horizontal drainpipe. The sump was inspected 24 hours later and was found to be dry, indicating that all of the water had been. absorbed. Based upon this data it was concluded that the absorption rate of the trench exceeds 450 gallons per day, as required for a 3 bedroom house. D: SEPARATION DISTANCES: As required by M.O.A regulations, there are no septic systems ~ithin 100 feet of the wett. tn .addition, the septic system is greater than t00 feet from the private wells on the adjacent lots. In short, the subject separation distances appear to be in c0mpli~nce with the regulations in effect at the time of construction. If you have any questions, please contact me at (907) 337-6179, or on my digital pager at 1-800,481-1162. Thank you for your business. Jeffre //q/Game M.S. OwneY/Cbnsultant Carolyn Humphrey Report. wps HAY-22-'1998 08:40 CT&E ESI ANCHORAGE 9075~ 1530 i P, 05/09 CT&~ R~,# ¢ll~t Name Project Name/# Client Sample ID Matrix Orde~d By le Remarks: A.K W~ter & Wastowate~ Se~vice~ 140 S~der$ Rd. Dri~ Water 0 Ciletxt Primed Date/Time 0.5/21/98 14:09 Collected Date/Time 0~/18/98 15:20 RecCve~l Date/Time 05/19/98 09:25 Technical Director: Stephen C. Efle R cleasefl BY'//~~'%A~ ~ PQL Units Methcd Lin(ts Date Date 0 ;~[/lOOt~ sNt8 9~29 05/19798 T~ 0.1~0 m~/t ~P~ ~00.0 10 max 0~/1~/9B 05/19/g8 RMV DA:rE RECEIVED ~ ~ '<' INSPECTION APPOINTMENTS TIME TIME ~ TIME DATE DATE DATE ' NSPECTOR , NSPECTOR INSPECTOR ~/~LIN lC I F(A~IC~AC}~ N C H O RAG E DEPT. OF H~ALTH & ~UNIglPALITY OF ANCHORAGE ENVIRONMENTAL PROTECTION ) D~PABT~ENT OF HEALTH · ENVIrONmeNTAL P~OTEOTION ENVIRONMENTAL SANITATION DIVISION RECEIVED REOUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all psrts on page ~. I~omplete reques~ will n~t be pro~essed. Please allow ten (10) days for processing. MAILING ADDRESS~ ' PR~R~Y RESIDENT (If different from above) PHONE 2. BUCk' -- ~ PHONE MAILI~RESS O MAILING ADDRESS 5, LEGAL DESCRIPTION STREET LOCATIOn% ~. C-~ (k ~' ~/~,_C%-%~_-~v 6. TYPE OP RESIDENCE ~ SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF~BEDROOMS [] One [] Four [] Two [] Five ~;~hree [] Six [] Other 7. WATER SUPPLY ~ INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY * ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach Icg if available.) 8. SEWAGE DISPOSAL SYSTEM ~ INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. I'HIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FiVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2, WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER I-q INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER [~]Septic Tank or [] Holding Tank Size: /~;)~O If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4, DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS [~]~AFP R OV ED FO R ~"'~ BEDROOMS [] CONDITIONAL APPROVAL (letter r~st accompany certificate) [] DISAPPROVED DATE BY 72-010 (Rev. 6/79) M-W DRILLING INC. INVOICE N~ 1 5 7 8 UNiT ANCHORAGE, ALASKA 99511 QTY. MATERIALS PRICE AMOUNT PHONE 344'0526 ! LEGAL DESCRIPTION DESCRIPTION OF WORK DATES Ali charges sham be paid in fu// within ten days unless other arrangements are made prior to driMing. The customer shall pay in- terest at the rate of 1 ~ % per month on any amount not paid within ten days, Failure to pay may result in a Men against the property. OTHER CHARGES CUSTOMER SIGNATURE PAY THIS AMOUNT "- '~~:~ v--?' · ' ,D_, AR[i'%.N, ~,F:"HE.AETR ~AND" ENV:IRONMEN~L . ,f ~ ",",, ",.. ' . '- - fl ¢~' i" : 825 - L. stre~¢t, Anchorage, Alaska ' -~ 279-2511, ext. 224, 225 ~~~ ~O Date Received: ls% Inspection: Time 9:00 a.m. 2nd. Inspection: Date 3-23-77 Wednesday March 22, 1977 Time Date Inspector Kennedy In spector REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES 1. Lending Institution Request: Mailing Address: Phone: 2. Property Owner: Mailing Address~ James/Karyn Joyce Star Route A Box 337B 99507 Phone: 344-8883 3. Legal Description: Lot 12 Block 3 Mountain Park Estates #2 4. Single Family Residence: (x~ Multiple Family Residence: ( ) Number of Bedrooms: Number of Bedrooms: 5. Well Data: Type Construction Individual Depth 251 feet Well Log Filed (x~ Bacterial Analysis 6. Sewage Disposal System: On-site system ~ Public Utility ( ) Permit % 76063 Installed 1976 Septic Tank Size Installer Manufacturer ~, Absorption Area Soils Rate Material 7. Distances: Well to Septic Tank / to Absorption Area /~ %< to Sewer Lines Nearest Lot Line Absorption Area to Nearest Lot Line c? ~' C~Dep'ar%~nent~~ Of Health and Environmental Protection .Request: for. ApproVal of Individual Sewer~ and wafer'Facilities Legal Description: Lot 12 Block 3 Mountain park Estates #2 Comments: Affadavit Attached: (i) Letter Attached: ( ) Date: Department Worksheet: 2. Name of Buyer: Mailing Address Phone: Lending Institution: Mailing Address: Phone.: 4 Realtor/Agent: Mailing Address: Legal Description: Street Location: ~~.~ Phone: Single Family Residence: ('~ Number of Bedrooms: Multiple Family Residence: ( Number of Bedrooms: Water Supply: *Individual Well (~ If Individual Well, well depth 2~1 If Community System, name of system Public/Community System Sewage Disposal System: On-site System (~ Public System ( ) If On-site System, date of installation: (~/-7-7(,~ *NOTE: A well log is required on ALL wells drilled since 6/75. 3/77 $_ 87,750.00 ~,-Account #59982 k. LoanNo. FOR VALUE RECEIVED, the undersigned, jointly and severally, promise to pay, in lawful money of the United States of America, to the ALASKA USA FEDERAL CREDIT UNION OF ANCHORAGE, Alaska, at its home office in this city, the principal sum ofEIGHTY SEVENTItOUSAND SEVEN HUNDRED FIFTY ($87 TS0.00). . ~ together with interest from the date hereof on all unpaid principal, at the rate of nine per cent ( 9 %) per annum to be paid in successive monthly installments of ONE THOUSAND ONE HUNDRED ELEVEN 60/100 ($1~111.60) t:~,~'~o.2.~O gj..,, on the clay of each calendar month, commencing 3t~.N~R ~'~'~"-~ ~[~x°xfx gaa-~ugt , 1977 ; said installments shall be inclusive of interest This note is secured bya Deed of Trust recorded Or to be recorded at Page , Volume , of the records of the District Recorder for the Anchorage Recording District, State of Alaska. If default be made in the payment of any installment due under this note, or of any installment clue under any other note secured by said deed of trust, then the entire principal sum and accrued interest due under fids note, and also the entire principal sums and accrued interest due under all other notes secured by said Deed of Trust, shall become at once due and payable ,~t the option of the holder, of this note. Failure to exercise this option shall not constitute a waiver of the right to exercise the same in the event of any subsequent default. The holder of this note may cause additional parties to be added hereto or release any part,/hereto, either with or without notice to any of us, either as co-makers, endorsers or guarantors, or may extend the time for making any installment provided for herein, or may accept said installment in advance, all without affecting the liability of any of us hereon. Should suit be commenced to collect this note or any part hereof, the undersigned jointly and severally agree to pay, in addition to the costs and disbursements provided for by statute, a reasonable sum as attorney's fees in such kuit, plus any actual expenditures incurred to secure the payment of or collect this note. The undersigned, whether, principal, surety, guarantor, endorser, or other party hereto, agrees to be jointly and severally bound hereby, severally hereby waive any homestead or exemption right against said debt, waive demand, protest and notice of demand, protest and nonpayment, and expressly agree that this note or any payment thereunder may be extended from time to time and consent to the acceptance of further security, including other types of security, all without in any way affecting the liability of such parties. The undersigned does hereby agree that the credit union hereunder shall have a lien, as provided for by law, upon all paid shares, payments on shares and dividends, which I/We now have or hereafter may have in this credit union, for the payments of this note and interest, fines, costs or expenses that may accrue thereon and I/We hereby authorize said credit union to apply all such shares and dividends to the payment of said loan and interest, fineg, costs or expenses. The undersigned hereby authorizes the ALASKA TITLE GUARANTY CO. OF ANCHORAGE, Alaska, to date this note as of the day when the loan evidenced hereby is made, and to complete this note in any other particulars according to the terms of the said loan. ? Address: Signatures: 49o°1 E.Sth St. AnchoraR~, Alaska ?9504 Wend~L ~n G.~i at t . Helen A. Glatt Borrower(s) Form No. ATG-E-? / May 1, 1981 WendJ in./Helen Ao Glatt Star Route Box 377-G z~ncho] age, Alaska 99507 Subject: Lot 1.2 Bloc]< 3 Mountain Park Estates Subdivision /~p'}~*oval. t-- .- for the individual sewer and water facilities cannot be granted until the following items have been completed: (3) The water analysis report needs to be delivered to this effice from the Chem Lab, 5633 B Street, for our review. The septic tank pumped with a receipt submitted to this office. An adequacy test needs to be performed on the existing leaching area. This test will determine if the system is adequate according to National Standards. A listing of private firms performing the test is enclosed. This report needs to be submitted to this office for our review. Robert C. Pt ztt, R.S. RCP/ljw If there are any further questions, please call this off:Lce at 264-4720. cc: National Ban]< of Alaska Kathleen Claiborne Pouch 7-025 9910 Jeannine Erhart 4794 Associate Specialist