HomeMy WebLinkAboutNORTH WOODS BLK 4 LT 14MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 hftp://www.muni.org/onsite Can -Site Wastewater Disposal System Permit Permit Number: OSP241083 Work Type: SepticTank Upgrade Tax Code Number: 05173119000 Site Legal Address: NORTH WOODS BLK 4 LT 14 G:1459 Site Mailing Address: 22635 MC MANUS DR, Chugiak Owner: STONE STEVEN D & KATHLEEN B Design Engineer: PANNONE ENGINEERING SERVICES This permit is for the construction of: Effective Date Expiration Date: Lot Size in Sq Ft: Total Bedrooms: S' r. f� DeI)ar,tment 5/13/2024 5/13/2025 22015 ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall 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 shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: ,S 7;0 Date: Issued By: Date: MUNICIPALITY F ANCHORAGE r Community Development Department -T Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON -SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 051-731-19 Property owner(s) Steven & Kathleen Stone Mailing address 22635 McManus Drive Chugiak, AK 99567 Site address same Day phone Legal description (Sub'd., Block & Lot) North Woods 134 L14 Legal description (Township, Range & Section) Lot Size 22,015 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) ❑x (w/wo ADU) Septic Tank x❑ Upgrade ❑x Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. 1�7)40 (Signature of property owner or authorized agent) Permit/Rush Fees: Z 2 5 Waiver Fees: Date of Payment: ZO Z Date of Payment: Receipt Number: Receipt Number: Permit No. Q S P 2 y I 0 83 Waiver No. Permit App_'- ::'-..:c Pannone Engineering Services LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve@panengak.com Mailing: P.O. Box 1807 Palmer, AK 99645 Telephone: (907) 745-8200 FAX: (907) 745-8201 Municipality of Anchorage Development Services Department On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, Alaska Subject: North Woods B4 L14 Septic Tank Upgrade Permit Request This is a design narrative for a permit to install a 1000-gallon septic tank to replace an existing 1000-gallon septic tank. The existing tank is 43 years old and is likely perforated and leaking, it will be abandoned per MOA code. Currently the lot is developed. The proposed replacement will be connected to the existing drain field. This lot and the surrounding lots are served by AWWU drinking water. There are currently no wells within 200’ of the proposed upgrade. 1. Septic Tank Design. A foundation clean out installed or repaired as needed. The tank will be located: 5’+ from any property line. 5’+ from any deck/stair support. 10’+ from building foundation. 10’+ from any water line. 100’+ from any surface water. 100’+ from any private wells. 200’+ from any public wells. The proposed installation will not affect the future development of this or the surrounding lots. If you have any questions or concerns, please contact me at (907) 745-8200. Sincerely, SRP Steven R. Pannone, PE, F. ASCE Owner/Civil Engineer 7 May 2024 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241083, Curtis Townsend, 05/13/24 FOR CONSTRUCTION Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241083, Curtis Townsend, 05/13/24 FOR CONSTRUCTION Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241083, Curtis Townsend, 05/13/24 ,,~.~ MUNICIPALITY OF ANCHORAGE DEF rMENT OF HEALTH AND HUMAN SERV, ,S ' Environmental Health Division · . 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 · ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Na~.eDISTANCES ~ "~ A ~___...~7.-,~4-.~.~,.¢~ ! ~ ~ ~ TO SEPTIC ABSORPTION WELL AddressFROM ~ TANK FIELD Per~~ N° °' B~°ms WELL ~0'¢ Z~/~ Township, Range, Section AS-BUILT DIAGRAM tShow location of well septic system, property hnes, foundation, ~anufacturer Capacity m gallons ~ ' ~t~.a~ ~ o~ Co,..a~;n~ ~ ~/ 2¢ Z¢~ TYPE OF SYSTEM ~ TRENCH ~D ~ W. DRAIN ~ OTHER ~p~h to p~pe bottom from Total depth from original grade ~ ~ or,gin~araee ¢.~ FT / FT Fill added above original grade Gravel depth beneath ptpe / , Gravel ~dth ~ 7otal absorpt ...... ~ . j~j ~ Distance between lines /~ , /~,/~ ~ ~ --~ ~ PRIVATE ~THER (Identifv~ %~-- ' ~ ~%* / - nstalle~ Date Installed: ~ ~ ER'S SEAL . A e ekl~ia~Dl~G cmily t at Ibis inspe ion was pedormed according to ag ~ *. .... ;; "~' 72-013 (3/85) DEPARTMENT OF:r HEAL.'I"H AND ENVIF:~:ONHE}F[AL. PROTECTIE}N 264-'4.720 , 87' 007 '7 U P G R A D E 05 / :i. 2 L..EGAL D E:iii;C R I F' ',', LC)] 8 ;[ ZE ',~ :[7034 EAGLE RIVER LC]OF::' ROAD NO,, 204 EAGLE R:[VER, Al< 99577 694"-- 29'79 SUBDIV]:SION~ NORTH WOODS !iPi;!iiil{lT;'!" ii ()H ~, 4 'T'C)WNSH 1[ P ~ 1[ 5H 22000 (SQ,, FI',, OR ACF;'.IES} L.O T = :[ 4 R A NG!i![: ;[ W B L. 0 C K :: I (:::er"Lify that, l}. ,: ]i f:?tf¥1 ~' afT~ ii. ]. ;}. let P ~\~ J. '('.. h t }'](.}}} I" (.}};,c]Ll :i. {" ~}}HJ]E~,I'!'k ~!i~ f (D!' /:){"l...-s :J. t E.} ~6.~w({.:.}t" '~; ,'~d']Cl ~{.:.:~ ]. J. !!~. a~ .. d L).... and the State I::~f' Alaska,, for'th ,.,,¢ ~, ,e I ,.. .,.cipaiity of' Ar'ichor'age '"""} 2. I ~.~:i. I I :[r'n~cL.al I the system in accor'derice w:i.'L.h al 1 MOA c:cH:Jes arid pegt.ttat :i. or~s~ and in comp.[. ~.ar'H::e with the design c::t- i'Ler'ia (::)f' %["~:J.s per, mit,, t Mill adhel-e t.o ail MOA au'"~d State of Alaska r'equir'smsr'lts for' the se'L back (::[i?[~i~r'H:::E. si~ f'l"c:,¢~'~ any existing ~,,le].l, wastet,,~a't:.er' disposal system or' publ:i.c se~/4,:¢.H"a98 system en 'Lt"li~iii of any adjac:en'L hr' near'by lo'L,, IF:' A LIF::"I" S'FATION ils INSTAL.I..ED IN AN AREA COVEF;:ED BY MOA 'T'HE'F (1) AN I.L.I::.~..~,I~..,.CAL PERHIT AND INSPECTION MUST BE ,, ...... ..... ...... ,~.~',:;..~ .......... .... ........~ .............. ~.. ............. ...... Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: L/ ,~/3t ,~_.',~j~..5/,~,t~~ / /t../ ~. DATE PERFORMED: LEGAL DESCRIPTION: LoT/~ ~c ~ /~ I~T°wnship, Range, Section:~/S'~/' ~[~,,, SLOPE SITE PLAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19~ 20- WAS CROUND WATER ENCOUNTERED? S IF YES, AT WHAT ~./ OL DEPTH? p E Depth to Water After Monitorino? ~' Date: I- N :/ Gross Net Depth to Net Reading Date Time Time Water Drop / / ' ~ /~ ,, ~ ~" ,/~" I PERCOLATION RATE /..'/O (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN ~,,~, ~' FT AND ~' ¢ FT COMMENTS ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINE~ E~CT ON THIS DATE. DATE: 72-008 (Rev, 4/85) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST /* PERFORMED FOR: (,~ ~3t 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19- 20- Township, Range, Section{ // ¢~1 , /~-/c~., ~c_ ¢ SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? S L IF YES, AT WHAT t DEPTH? ~ 0 P E · ' D? --Date: Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE __ (minutes/inch) PERC HOLE DIAMETER __ g TEST RUN BETWEEN FT AND FT COMMENTS ~/¢.. ~ I ,~.l '~.lt~ /-10¢-~ ~..~¢/57/~.~" I~//~ ~/~T ~ ~1~7~ /~/ S & S ENGINEERING ~ ~ ~ PerFOrMeD BY: ':7::4 :aCa ::v~- L~ :~ ;~. A~ ~// ~ / cem~FY ~A~ m~s TeST WAS P~F~MeD'm 72-008 (Rev. 4/85) /' / SUBJECT: DAT~: SHEET BY OF ~ I , = SC,~LE I SCAI~E e - ' " 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 ~ IPHONE EW MAI LING ADDRESS LOOAT, ON 3 Mater' ~ Liq cap~a ohs IF HOMEMADE: Inside length Width Liquid deptlq ~ ~ DISTANCE TO: Well Dwelling PERMIT NO. O ~ ( Manufacturer Meteriel Liquid capacity in gallons = el Foundation~ Nearestlot~(~ PERMI N . ~ ~ Top of tile to finish ~rade Material beneath tile Total effective absorption aroa ~ inches Length ~idth ~ Deoth P[~MIT ~0. ( ~ Type of crib Crib diameter Crib depth Total effective absorption area m Well Building foundation Nearest lot line ~ DISTANCE TO: ~ Class , Depth Driller Distance to lot line PERMIT NO, ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS INSTALLER/  LEGAL 72-013 PERMIT NO. F~PPL I CF!NT LOCRT I ON LEGRL DEF'FIRTME:NT ur HEFtLTH RND E!",IVIRONMENTRL F:'ROTEC]"ION 825 "'L'" STREET., RNCHORRGE., FtK. 2.6,':!.- 4 ?;;.2 E~ F'RFINK BETHERD PETER"S C'REEK L t4 B 4 NORTH WOODS S,,"D SRR BOX t698K 995~'? LOT SIZE ...... IL F.E,::,UF.F , IdN ..... ,.:,! EM .I=,: [:'RF!tNFIELE:' MRXIMU,~'I NUME:EF~' iF EED~":-P1': ........ = ':;niL RRTING ':S2 FT,. E,F ........ ~.~.~ THE REQUIRED SIZ~ THE SOIL RE:SORPTION SYSTEM IS: THE LENGTH DIMENSION IS 'THE LENGTH (IN FEET) OF 'THE TRENCH CLR DRFIINFIEL. D. THE [:,EPTH OF FI TRENCH OR PIT IS THE DISTFINCE BETHEEN -['HE SURFF!CE OF THE GROUN[:, RNE:, ]"HE BOTTOH OF THE EXCFI',/RTZON (IN FEET:). THE GRF!',/EL DEPTH IS THE MINIMUM DE:F'TH OF GRFI',,,'EL BETHEEN THE OUTFRL. L PIPE FIND THE BOTT()H OF ]"HE EXCFWRTZON ,::IN FEE:T). F'ERMIT RPPLtCF!NT HFIS THE RESPONSIE:ILITY TO INFORM 'THIS E:'EPRRTMENT DURING THE INS-['F~LL. RTION :[N:.'.E;PFCTZONS OF' FINY WELLS F~D..THCENT 'TO TF'IIS PROF:'E:RTY F~ND THE NI...I.~'IBER OF: .RESIDENCE:.S 'THRT '['HE F.IELL f4ILL SERYE BF!CKFILLING OF:' FINY SYSTEM I.,.IITHOUT F!NFIL INSPECTION Rt'.,l[:, FIPPF:O',/FIL BY THIS DEF'PIRTMEI'.~T HILL BE SUBJECT 'TO PROSECUTION. MINIMUM DIS]"FINCE BETHEEN FI HELL FIND FINY ON-SiTE SEWFIGE DtSPOSFIL SYSTEM t~, :LSE~ FEET FOR FI PRI',/FITE HELL OR ±5C'~ "FO ;::'EIEl FEET FF:'.OM Fl PUBLIC WELL [:'EPEN[:'tNG UPON THE TYPE OF' PUBLIC NELL MINIMLIM DISTRNCE FROM R PRIYATE HELL TO la PRIVFITE SEWER LINE IS.: 25 FEE'T RN[:, 'TO F! COMFIUNITY SE'WEF.: [..:[NE IS 75 FEET. OTHER REQUi'REHENT:E; MFIY FIPF'LY. SPECIFICFtTIONS FIND CONSTRUCTION E:,IRGRR!"IS RRE R',,,'I::iILRBLE TO :ENSURE PROPER INSTFIL. LRTION. IF-:" E E~." ~"q Z 'T' EE >-:: F:" :E ![&:: E:E S [:. E£ C: E.: ~'l E,", EE F-." ~2: :dL .. :::~,...".ES, ,",~: ! C:ERT I FY THFI"f' :1: I F4M FFIMtL. IFIF. I WiTH 'T'HE REC.!UIREMENTS FOR ON-SI~f'E SEHERS RN[:' [4ELLS RS SET FORTH E:Y THE MUNICIPRLITY OF:' RNCHOF.:FIGE. 2: I HILL INSTFtL..L 'THE SYSTEM IN RCCORDf~NCE NITH 'THE: COD, ES. 2: t UNDERSTRNE:, THRT THE ON-SITE :.~i;EP.IER SYSTEM MFIY F.'EQUIF.:E: ENLF:!F.:GEMEN!' IF' '['HE: RESIE:,ENCE ~~~~INCI2:UE:,E' MORE: TFIF!N 2]: e,E:[:,ROC, MS. 2; I GNP][:,: ....... ~ ,dUNiCIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Pouch 6-550, Anchorage, Alaska 99502 276-222~ SOILS LOG -- PERCOLATION TEST SOILS LOG PERCOLATION TEST PERFORMED FOR'. LEGAL DESCRIPTION: __.~2 3- 4 ~5 6 7 8 9 Lot-/~ 8/k 4- SLOPE I~urde~ DATE PE.FORMED: SITE PLAN 10 11 12 '13 WAS GROUND WATER ENCOUNTERED? ~*~ ~ ' pO E IF YES, AT WHAT DEPTH? 14 15 16 17 18 19 2O COMMENTS PERFORMED BY: 2_50 .~. Gross Net Depth to Net Reading Date Time Time Water Drop ALASKA IIUIROnm nTAL CONTROL I[1C. April 6, 1982 Bethard Construction SRA Box 1698K Anchorage, Ak. 99507 Dear Mr. Bethard: On April 5, 1981, I checked to see if water was standing in the three homes in Block 4. Below are my co~nents: Lot 14- Sump pipe is dry. All standpipes are in place. Lot 15- Sump pipe dry but standpipe broken off. Lot 17- Sump pipe dry but standpipe broken off. I also checked ~th~9~.water level in the sump pipes on Lots 34 Block 3 and Lot l~ock 1. The water depth on Lot 34 was 34 inches down from 41 inches on January 28, 1982. On Lot 16 the water level was 12 inches down frcm 25 inches on January 28, 1982. It appears that the water traveling through the ground is dropping drastically. If there is no increase during break up then it appears that the systems may be good. If you have any questions please let me know. Sincerely President 1220 U Jest 25th Auenu¢ ,. Anchora§e. Alask(~ 99503., (9071 276-1361 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 H87-0033 Application Date GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 14 Block 4 North Woods Subdivision Location (address or directions) (b) Property Owner Dick Brown Telephone: Home Mailing Address 17034 Eagle River Loop, Suite 201 (c) Lending Institution Telephone Mailing Address (d) Business 694-2388 Eagle River 99577 Real Estate Company and Agent Vista Realty/TArget Realty Address Eagle River Telephone (e) Mail the HAA to the followina address: or: Check here r'q, if hold for pick up. List contact person and day phone number below. S & S Engineering 17034 E gle River Loop, Suite 204 Eagle River Alaska 99577 TYPE OF RESIDENCE Single-Family []xx Number of Bedrooms three (3) WATER SUPPLY Individual Well [] Community l'gxXPublic [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite [~:X~Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page I of 2 72-025 tRey 8/86~ Front ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION 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 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 disposat system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. NameofFirm S & S Engineerinq Telephone 694-2979 Address 17034 Eaqle River Loop, Suite 204 Eaqle River, Alaska Date Engineer'sSeal This department has received written confirmation form the engineer regarding the Conditional Approval of January 26, 1987. The corrections have been accomplished and an inspection has been completed by the engineer. (See attached copy of as-builit inspection report). The subject property meets with Municipal standards is now a'pprovedo DHHS APPROVAL Approved for three (3}bedrooms by Approved XXXXXXXXXXXDisapproved Conditional Terms of Conditional Approval Date May 21, 1987 CAUTION 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. Page 2 of 2 72-025 fRev 8/86) Back ROBERT A. SHAFER May 19, 1987 CIVIL ENGINEER 694-29Z9 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN Municipality of Anchorage Department of Health and Human Services 825 L Street Anchorage, Alaska 99501 REFERENCE: Lot 14~ Block 4; Northwoods Subdivision A conditional Health Authority Approval was issued on the referenced property on January 26, 1987. An on-site sewer permit #87007 was issued to upgrade this system to satisfy the conditions of the HAA. Attached is a copy of the on-site sewage disposal system inspection report for the work performed under the upgrade p~rmit. Since all conditions of the conditional HAA have been satisfied, we request you issue a final HAA at this time. SRB 196X EAGLE RIVER, ALASKA 99577 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date January 20, 1987 GENERAL INFORMATION (al Legal Description (include lot, block, subdivision, section, township, range) Lot 14; Block 4; Northwoods Subdivision Location (address or directions) (b) Applicant Name Dick Brown Telephone: Home Business 694-2388 Applicant Address 17034 Eagle River Loop Road¢ Suite 201, Eagle River, ~,las]~ 9957? (c) Applicant ts (check one): Lending Institution []: Owner/builder []; Buyer []; Other r~ (explain); Bank foreclosure (d) Lending Institution Telephone Address (e) Real Estate Company and Agent Vista Realty/Target R~l ty Address Eaqle River ~ Alaska lelephone (f) ~ the HAA to the following address: S & S ENGI~ERING 17034 Eagle River Loop Road, S~]{te 204 Eaqle River, Alaska 99577 TYPE OF RESIDENCE Single-Family [~ Multi-Family [] Number of Bedrooms 3 Other WATER SUPPLY Individual Well [] Community [] Public'F''l' Note: If community well system, must have written confirmation from the State Depar[ment of Enwronmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite [] Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (i 1/84) Page 1 of 2 ')JJOM 9,JS@U!6U@ leUO!S'ssJoJd eLI; U! SUO!$S!UJO Jo sJozl8 JOJ elq!suodsaJ )ou s! 86eJoqouv ,to Xl!led!ofunlAI eq/'penss! s! emo!,t!Ueo e 8Jo~eq e~ep eZXleU~ Jo suo!;oedsu! lonpuoo ~,ou op d~]HO ,to seaAOldtU~] 's~uetueJ!nbaJ am~s pue lemp@,t u!mJao X,tsp, es o~ Jap]o u! suof~n~!~su! 5u!puef ~!eql pue setuoq ,to sJeseqoJnd o~ XSelanoo e se s!q~, saop cE]HQ eqL 'e~selV ,to emlS eq~ u! paJem!SeJ ]eeu!Sue leUO!SSe,to]d ~uapu@depu! ue ~q e^oqe ~ Llde~§e~ed u! ue^!§ suo!m~,uaseJd@~ eq~ uodn ,~lalOs peseq sap~o!,t!peo [e^oJddv X),Hoq~n¥ q~leaH senss! (d=!HO) uo!~omoJ8 le~UeLUUOJ!AU:J pu~ qlleeH Jo )uatulJedeo a6eJoqouv ,to ~!led!ounfAI NoI&nVo leUO!l!puoo p8^o i drlp~-~'~- ~ ~'~2~2 SHHG 'Xe~aATAP aq~ ~o UOT~od ~q~ ~o IeAoma2 a~e%Tssassu pino~ ~T an~ ~se~ uT_ sT sTq~ ~I 'ea~ qsua~$ aq% euoqdele.L ssaJpp¥ · uo!loedsu! sfql ,to e),ep uo loe,tje u? suo!%~ln§eJ pu~ 'seoueu!p~o 'sepoo elelS pue I~d!o!unl~ lie ql!t~ eoUe!ldt.uoo u! ]o/pue Klddns Je%~ el!s-uo eql 'uo!~oedsu! pue uo!le~!lseAu! X~ ~o~ pue selfJ eSeJoqouv to X%!l~d!o!unw eq~ ~o]~ peu!~lqo uofm~Jocuf eq~ uo peseq mql ~!JaA Jeq~n¢ I 'u!eJeq pemo!pu! eJnlonJls ;o edXl pu~ s~ooJpaq to Jeq~nu eql Joi emnbep~ pu~ I~UO!louni 'ales s! ~elsKs leSOdS!p Jem~else~ Jo/pu~ ~lddns qll~eH s~q~ ~o uo~i~6!lse~u~ ~ mq~ X~HeA I '~oleq u~oqs amp UO!l~Pflea eq~ ~o s~ pu~ OleJeq pex~;e lees X~ Xq pe~i!peo sv .g ITY F ANCHORAGE ~I~NICIPAL O ( c~,O%~.'IrEALTH_ AUTHORITY APPROVAL (HAA) ~.~-.~ ~ <~O~CHECKLIST FEBRUARY 1984 o~ h~',:,~c" ' ~ ._ ,~,% ~%O 264-4720 Legal Description WELL DATA Well Classificatior Y~ .~. ~:;~. ~>V ~,7~ ~ I~ A, B, C D.E.C. Approved (Y/N) Well Log Present (Y/N) Date Completed Yield Tot~'~'l"D~ Cased to Depth of Grouting Static Water Le~eL...~~ Pump Set At Casing Height Above Gr~ Sanitary Seal on Casing (Y/N?N.~)..~ Electrical Wiring in Conduit (Y/N) '~ ~ Depression Around....~/efl/Tead (Y/N) Distances from Well: Separation To Septic/Holding Tank on Lot ~-'"--~Q_n Adjoining Lots __ To Nearest Edge of Absorption Fieldon~..~~- ..; On A..d~--~-- To Nearest Public Sewer Line ~ To Nearest Public Sewer Cleanout/Manhole~ To Nearest Sewer Service Line on Lot"'~ Water Sam pie C~d~by : Date Water Sa~st Results Gem-'~ents B, SEPTIC/HOLDING TANK DATA Date Installed/c:~ - ~ Standpipes (~N) Depression over Tank (Y~) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well To Property Line / To Water Main/Service Line Course ~//~ Size /c,c,c, No. of Compartments Air-tight Caps (¢N) Foundation Cleanout (Y/I~ Date Last Pumped : for Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Comments Page I of 2 72-026(11/84) c: ABSORPTION FIELD DATA J:~3///3 ~ Soils Rating in Absorption Strata ~--~J~> Type of System Design Date Installed / ~ - ~ - ~ t Length of Field Width of Field ~ t~.. Depth of Field ,~Gravel Bed Thickness '~(~'(~ Standpipes Present (~}'N) Date of Last Adequacy Test Square Feet of Absorption Area Depression over Field (Y/~ Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot To Water Main/Service Line i c~ t..f / To Property Line ./~ To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) ~/~ To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify$ & sthatEN~INEER~ul h av_e_c_bge.,.ked, verified, or conformed to all M(~A and HAA guidelines' ' in effect on the date of this inspection. Sig~4 ~.gL: R[¥- Co ~tver, Alask Receipt NO, /~ Date of Payment *mount: $ Page 2 of 2 .,.~' 72-026 (11/84) Time Time ,~e Date Dete Date Inspector lnepector Inepector Comments Conditional Approval Date Sewer Installed Permit No. Septic Tank Size Holding Tank Size Soils Rating Well To Absorption Area Well Log Received Well to Tank APPLICANT FILLS OUT LOWER HALF ONLY · Property Owner Be~hard ConstrUct±on, Inc; Phone MaillngAddress SRA BOX 1698-K, Anchorage, AK 99507 345-1615 Buyer Walter and ~fitzi Crow · Address 2369 ~access, Anchorage, AK 9950~ Lending Institution Peoples Bank and Trust Phone 644 W. 8th, Anchorage, AK 276-8080 Address Realty Co. & Agent RE/NA~ Properties, Inc., ATTN: Will Eason... Phone ~2702 Gambell St., suite 101, An~hora§e, AK 99503 276-2761 Address r Legal Description . ROt 14, Block 4, North: I4oods .... - , NI'-IN ~c~{anus Drive Street Location Type,pf Residence 'E~ Single Family [] Multiple Family No. of Bedrooms 3 [] Other Water Supply ~ Individual 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.) Sew~ . I~ Individual Year Individual Installed: 1 98 IL [] Public Utility When Connected to Public Utility: [] Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING 0AN BE INITIATED.