HomeMy WebLinkAboutNORTH WOODS BLK 4 LT 12 MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & 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 PHONE I []NEW
MAILING ADDRESS
'LEGAL DESCRIPTION
LOCATION ~-~' d~ "O. OF BEDRO0~
DISTANCE TO:]We,Absorption area ~, Dwelling ~/ PERMIT NO.~o
~ ~ ~ ~ Manufacturer ~ ~ Matefia] ~,~L N°' of compartments
~ ~ L~q. capacity in 9allons Inside length Width Liquid depth
/~ IF HOMEMADE:
~ ~ DISTANC~ TO: Well Dwellin~ PERMIT NO.
O Z ~ Manufacturer ~ v/~ Material Liquid capacity in gallons
~ Well Foundation Nearest lot line PERMIT NO.
,STA C. TO:
~ ~ Z No. of lines Length of each line Total length of lines Trench width Distance between lines
~ ~ ~ inches
~ Top of tile to finish grade ~j~ Material beneath tile
Total
effective
absorption
area
~~ inches
Length ~.~ ' Width Depth /
~J~ ~ Type of crib ..... Crib diameter Crib depth Total effective absorption area /~ /
~ DISTANCE TO: Well ~/~ Building foundation~ ~ Nearest lot line ~O j ~
Class Depth Driller Distance to lot line PERMIT NO.
~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s)
OTHER
PIPE MATERIALS
SOIL TEST RATING
,: &D ~ F'r/~
REMARKS T r
~ OF ~ ~_ ~-,+ .
I
~[~ -J Robert A. ~.ater ~' ,~ ~
~,~'.., No. ~-~ ..~'~ -
APPR DATE LEGAL ,i;~ ~ 'L- ,.-..~ q" .
72-O1~ (Rev. 3~78)
F'EF'H-:.' T NO.
DEPF:ff;~:'THENT ,""*'i .NEFIL'T'H FI!'.,ID EN',,,'i RONMENTF!L"'""T.-:CFF[:iCT I ON
825 ' ,.., STREET, ~NCHOF.'.FtC. iE., RK.
254.--472~Z~
':.' S2(~d..SL-':: )
FIPF:'L I CRNT
L 0 C: Fl T I 0 N
LEGRL
'~"::'-~' MULDC~ON
LOT SIZE
F~F~:. C!F 5;OIL FfI~SORF'"FICIN ':.;"r?'"EM IS: [:'RFtINFIELD
MUM N
SOIL PFtTZ N 2
'THE REQUIRED SIZE OF' THE SOIL HBS.;ORPTION SYSTEM IS:
THE LENGTH DIMENSION !5 THE LENGTH (tN FEET) OF' THE TRENCH OR DRFIINF'iELD.
"FHE: [:'EF'TH OF' R TRENCH OR F'!T IS THE [:'iSTFINCE 8ETNEEN THE SL.tF~:F!:~CE OF THE
GROUND RN[::, THE BO"FTOM OF' THE EXCRVF~TION (IN FEET).
'T ~ EE 'T ~;;~: EC ~-,~ C::: ~'~ ~.."-~ Z [~" 'T' ~"~ Z S; ~1- ~ - ~ ~'-E~t ~Z~ F::r ~ ~ T'.
THE GRR',,,'EL DEPTH iS; THE HZNZMt...IH [:,EPTH OF GRFI'¢EL BETWEEN THE OL.rTFI:~LL PIPE
RND THE BOTTOM OF TP!E E',:.~CFIVFITZON (IN FEET>.
PERMIT F!PPL. ZC:FtNT HFt:S TH.E: P.E"ZF'Fi'.,!'::;',"Rt'L IT'?' ............. TO :[NFOt;.:H THIS [.',EF. ........... .- F..] ir t l:. i' ,t ". l DIJF..'. I NG THE
;[ f.,!S:TF!LLFtT I ON I I'-,ISPECT I CLt'.,tS OF FIN'.? I.,.!ELL:F.'; FiE:,,:rRc:Et'.,FF.. 'TO TH I S Fr.'"'9 '"'-"""t;;'""',r-~Z... ~'r' FIND
N,,HEER EF RESIDENCES; THFtT THE HELL t4iL.L .SER',,,'E.
h'IINIMUH D!S'TRNC:E E:E:THEEN R WELL RND FiNY ON-SITE SEI.,.IF!GE [>!SPOSFIL SYSTEM iS
J,.C~C~ FEET FOR R PRIYRTE P.IEL. L. OR 15C~ TO 2C¢EI FEET FROM R PUBLIC HELL DEPENDING
UPON THE 'TYPE OF' PUBLIC I.,.tELL.
t"I!NIMt. JH [:,ISTRNCE FROM f~ F'RIVR]"E HELL TO t::i F:'RIVRTE ~SE!.4ER LINE IS 25 FEET FIND
TO !:a COHHUNIT'¢ SEHER L. ZNE IS; 7'5 FEET.
O'T'HER REQUIREMENTS P'IFI'.? I:~F'F'L"r'. SPECtFIC:FtTIOF,!S F:tND CONS;TRUCTiON [:'I~GRRMS; F:!RE:
RVF~ZLRBLE TO INSURE F'ROF'ER ZNS'TF1LLRT!ON.
t CERTIFY THRT
:!: I RH F'FIHIL. IF!R !.,.!ITH THE". REQU!REMENT,'S FOR ON-SITE SEP,IER:i:T, FIN[." HELLS f:tS S";ET
FORTH E;"? ]'HE F!LiI'.,! I C: I PF:tL t'T"r' OF' t~NC:HOF:FtGE.
2: I 14tL. L IN'L:;TF!LL. THE S'¢:::'i;TEM iN FICC:ORDFffqC:E NI".rH ]"HE CODES.
7:.::: I L.INE:,EF:tSTF-'!ND 'r'Hm' "['HE ON-SITE %E!.,.IEF:: S'-r'STEM MFi'¢ REQUIRE ENLFtRGEMEN]" IF THE
RESIDENCE i::S F.:EMODEL. ED TO INCLUDE MORE THRN :~: E.-'Ei}ROOHS.
FIF PL I C:I::iNT ~2.1d-.H]'.D"F BROS, C.:ON2.ST ' ....
:[:E:SI...!E.() E,"T'. ............ W,~,.....,~:...,....u. .......... .C:,F.~TE_ ?--""'"'
-/ ..... [ ......................................... ...................
4
Russell Oyster
694-2774
Performed for:
Legal Description:
Depth (feet)
0
O & E EN(:..,INEERING & DEVELO,~MENT CO.
Box 90, Davis St., Eagle River, Alaska 99577
694-2774 or 688-2280
SOIL LOG
Name: ~.~j/
Mailing Address: ,( ~,~,
Soil Characteristics
10__
11
12__
Earl Ellis
688-2280
N°,~-~~'5/
13__
PLOT PLAN
14__
Ground Water Encountered: Yes ~'"~No If yes, what depth
Proposed Installation: Seepage Pit Drain Field
Comments:
Performed by: ~'~ tj"'~ 4/,~T-~-.~_, ,
PERC. TEST
C~-~.~d~.,~ -- 'z
?
'D APPLI( '" IT FILLS OUT UPPE hAI "ONLY
~opertyOwner ~' "/~/~(~' t'~. Phone
Mailing Address ,~,~ /~ ~.~ ~'~ 7~,~ ~,,? Z/' :~?~ ZiP C°de 9/~ ~- ~7 1.~99 ~ ~'~
Lending 'nstituti°n j~ I~ Z~ ~'~ ~(~{ ~ //~/l Zip Code Phone
i~h~ne ...... j
~,.~ ~ -, .,~/ / - . .,,,, .... _ ........ . _, .
Realty Co. t /II / ~
Address Zip Code
Legal Descriptio~ Ldj+ / .~. /~/
StreetL0cation ~ Ci~/~/~'i!5'
Type of Residence
~ Single Family
[] Multiple Family No. of Bedrooms
[] Other
Water Supply
[] Individual ATTACH WELL LOG, A wail log is required for all wells drilled since June 1975,
.~Community For wells drilled prior to that date, give well deptL(attach log if available): .
[] Public Utility
Sewer Disposal
~lndivtdual ? Year lndividual Installed:
-II 'Public Utility When Connected to Public Utility:
[] Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
Time Time Time Time
~..~ 7.~.~/ Date Date Date
Inspector Inspector Inspector Inspector
Field Notes:
(._~ ) APPROVED BEDROOMS *CONDITIONS OF APPROVAL
( ) DISAPPROVED
( ) CONDITIONAL APPROVAL*
"1 t.-
BY: y2 t.
Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received
L/ ~ ~-~ WeiltoTank SepticTa~kSizo / ~_~
72-023 (3182)