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HomeMy WebLinkAboutNORTH WOODS BLK 4 LT 22 " '"'% MUNICIPALITY OF ANCHORAGE '  DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ~ ENVIRONIVIENTAL 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 ~O, OF BEDROOMS I Well Absorption flrea Dwelling j ~ DISTANCE TO: ~/~ PERMIT NO, ~ ~ Manufacturer Material No, of compartments ~ Liq. capacity in gallons Inside length Width Liquid depth jl~)~) IF HOMEMADE: ~O ~ DISTANCE TO: Well ~/~ Dwelling PERMIT NO. O Z ~ Manufacturer ~ '//1 Material Liquid capacity in gallons ~ Well Foundation Nearest lot line PERMIT NO. ~ ~ DISTANCE TO: ~ No, of lines Length of each line Total length of lines Trench width Distance between lines ~ -- Top of tile to finish grade ~ Material beneath the Total effective absorption area D inches PERMIT NO. m Length ~1c Width ~jl ~ Depth ~/ &// ~R~v6~ ~ ~ Type of crib Crib diameter TotaJ effective absorption area  ,,~ Crib depth DISTANCE TO: Well ~/~ Building founda~ion~ ~ ~ Nearest lot line / ~ / Class Depth Driller Distance to lot line PERMIT NO. Building foundation Sewer line Septic tank Absorption area(s) ~ DISTANCE TO: OTHER ~ PIPE MATERIALS CVc SOIL TEST RATING ~ ~ ~O~ 56 INSTALLER .~:~.. ac. ' ~.¢~ I ,~Il .......... tt; t ' ' 72-013 . ,~ MUNICIPALITY OF ANCHORAGE /-~ Departmen~ ~f Health and Environmental! ~otection 825 ~ Street, Anchorage, AK. 99501 · ' 264-4720 "~ ~ * * * HANDWRITTEN PERMIT * * * Permit ~ ~/-- ~EPL AND/OR ON-SITE SEWER PERMIT Applicant: ~n~, ~ ~o~ ~Mailing Address: ~k~ ~/~©~ Location: PR~ C~e~ Phone Number: ¢ <~-~37 Legal Description: L~ ~ c~ ~~.~ot Size: ~ Type of Soil Absorption System Is: Trench: Drainfield: Seepage Bed: ~ Holding Tank: Maximum Number of Bedrooms: ~ Soil Rating(sq.ft/br) ,~. /~ . The Required Size of the Soil Absorption System Is: DEPTH ,.__~.. LENGTH GRAVEL DEPTH Azz WIDTH The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfalt pipe and the bottom of the excavation(in feet). · * REQUIRED SEPTIC(HOLDING) TANK SIZE = /~O GALLONS Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the nun~ber of residences that the well will serve. · * * TWO(2) INSPECTIONS ARE REQUIRED * * * Backfilling of any system without final inspection and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. · * * PERMIT EXPIRES DECEMBER 1 9 2 * * * I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if the residence is remodeled to include more that 3 bedrooms. Signe~: ~/~/~/~l~/L/zu'~ Issued by:~/~~~ Applicant ~ Date: ~/~.//~ ~ , SWP/024(t/81) PERFORMED FOR: LEGA' DESCR,PT,ON= 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19- 20- MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG- PERCOLATION TEST SLOPE DEPTH? SOILS LOG PERCOLATION TEST SITE PLAN Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE TEST RUN BETWEEN COMMENTS 8 & $ ENGtNEERINGI PERFORMED BY..: .~,I[2F~ ~(~R~ CERTIFIED r~GLE RIVER, ALASKA 995"~ PH. 694-2.979 72-008 (6/79) //~// ~ minutes/inch) FT AND , FT Time ' ~ Time ,'e Inspector Inspector Inspector Comments Conditional Approval t' (~)~Approved Bedrooms ( D}-~Proved Date Sewer Installed ~ ~ ~ ~ Holding Tank Size Soils Rating Well ~o Absorption Area Well Log Received Well to Tank APPLICANT FILLS OUT LOWER HALF ONLY ProPe~y Owner '~-~" ' ~~ --~ ~ ....... Phone Address Lending Institution Phone Address Realty Co. & Agent / Phone Address Type_~idence ' ~Single Family ~ Multiple Family No. of Bedrooms ~ Other Water Sup~ ~ividual A~ACH WELL LOG. A well log is required for all wells drilled since June D Community 1975. For wells drilled prior to that date, give well depth (attach log if ~ Pub~ Utility available.) Sewa~sposal ~'~ ~ Individual Year Individual Installed: ~ Public Utility When Connected to Public Utility:. ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOM~:E~CH REQUEST BEFORE PROCESSING CAN BE INITIATED.