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HomeMy WebLinkAboutDELUCIA LT 13 MUNICIPALITY 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 On -Site Wastewater Disposal System Permit Permit Number: OSP241328 Work Type: SepticTank Upgrade Tax Code Number: 05114133000 Site Legal Address: DELUCIA LT 13 G:1259 Site Mailing Address: 22961 NEEDELS LOOP, Chugiak Owner: BRAZINGTON CLAYTON A Design Engineer: FIRST WATER CONSULTING This permit is for the construction of: Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: 10/18/2024 10/18/2025 17000 ❑ 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 Special Provisions: Prior to a future COSA, an easement will need to be established for access to the water well. Received By: 5 -S Issued By: IV L Date: Date: �' l 3 "_' z 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. 051-141-33 Property owner(s) CLAYTON A BRAZINGTON Day phone Mailing address 22961 NEEDELS LOOP, CHUGIAK, AK 99567 Site address 22961 NEEDELS LOOP, CHLIGIAK, AK 99567 Legal description (Sub'd., Block & Lot) IDELUCIA LOT 13 Legal description (Township, Range & Section) Lot Size 17,000 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (Z all that apply) Absorption Field ❑ Initial D Single Family (SF) RX (w/wo ADU) Septic Tank 0Upgrade RX Duplex ❑ (D) Holding Tank R Renewal ❑ 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. IF/ 6, ��_ _/f 1 11-6 C)C�/_C; 6 f I I I (Signature of property owner or authorized agent) Permit/Rush Fees: Z2 Date of Payment: q &1 /1, 4 Receipt Number: 3 25'7 Permit No. (�to2 q )32-B Waiver Fees: Date of Payment: Receipt Number: Waiver No. GAIDevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / FirstWaterAK@gmail.com ! !! September 27, 2024 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC TANK UPGRADE PERMIT LEGAL: DELUCIA LOT 13 The owner has requested that we obtain a septic permit to upgrade the existing aged steel septic tank on the above referenced lot. We propose to install a 1000-gallon HDPE tank per the attached design to serve the existing 3-bedroom residence. A 1500-gallon septic tank may be considered for current functionality and future consideration or flexibility. Groundwater was not noted in the MOA on-site record files and is not anticipated to affect the septic tank installation. If groundwater is encountered during installation that may affect this septic tank upgrade, an epoxy coated steel septic tank or other action may be required. The new septic tank manhole and cleanout must be accessible for future maintenance. The lot and area are served by private water and any encroaching wells, easements, … must be staked prior to construction. 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 OSP241328, Curtis Townsend, 10/18/24 24. 6 ' 34.6' 24 . 6 ' 34.6' 28.3' 24 . 3 ' 28.3' 24 . 3' RESIDENCE GARAGE 8'x12' SHED *PIPE NOT FOUND LOCATION PER 1989 HOLT AS-BUILT 24. 6 ' 34.6' 24 . 6 ' 34.6' 28.3' 24 . 3 ' 28.3' 24 . 3' RESIDENCE GARAGE 8'x12' SHED LOCATION PER 1989 HOLT AS-BUILT FIRST WATER CONSULTING DELUCIA LOT 13 DESIGN DETAILS: Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241328, Curtis Townsend, 10/18/24 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 O� NE T�IH (V I a T _Up JPGRADE Ll MAILING ADDRESS v IS - L\ LEGAL DESCRIPTION LOCATION NO, OF BEDROOMS DISTANCE TO Well 0 Asorption area Dwelling PERMIT NO. z Manufacturer Material 'i No. of compartments LU 3_ Liq. capacity in g allons IF HOMEMADE: inside length Width Liquid depth DISTANCE TO: Well Dwelling I PERMIT NO. _j 0 z O< Z Manufacturer Material Liquid capacity in gallons 3: �_ I a .j S DITANCE TO: Well Foundation — Nearest lot line — PERMIT NO. C' X :5 LU U -, u. z No. of lines Length of each line Total length of lines Trench width Distance between lines inches Top of the to finish grade Material beneath the Total effective absorption area inches Length Width Depth PERMIT NO. W a < Type of crib Crib diameter Crib depth Total effective absorption area Uj W Cn Well Building foundation Nearest lot line DISTANCE TO: Class Depth Driller Distance to lot line PERMIT NO. W DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER Q'it rt rl ,: PIPE MATERIALS 7T_ SOIL TEST RATING INSTALLER REMARKS 4� 5 s "e APPROVER, DATE LEGAL ? yy 72-013 (Rev. 3/78) (?:,-�� ^-^�� =~ '.... ' PERMIT NO. ( 78S257 ) �PPLIC�WT BOX Z-�6I H�CH688 2474 LOCHTIGO! DBLUCI8 S/� LEQHL L�2 D[�8CIR S/D LOT SIZE 30000 SQUFRE FEET TYPE OF SOIL 9B5ORBTIOW SYSTEM IS: TRENCH MHXINDM WUMBER OF BEDROOMS = ',i� SOIL RATING (5Q FT/RR)85 �_�����1�= �05 �����L_ E»Ei F���= � THE LE%TH DIMENSION IS THE LEW@TH (IN FE27) OF THE TRENCH OR �RHINFIEL� THE DEPTH OF S IS THE DISTHWCE BETWEEN THE SURFHCE OF THE 8ROUOD HWD THE BOTTOM OF THE EXCHYHTION (IN FEET). THERE 147 NO SET WIDTH FOR TRENCHER THE �RHYEL DEP�H IS THE 01I4,I1101 DEPTH OF PRHYEL BETWEEN THE 0UTFHLL PIPE HND THE BOTTOM OF THE EXC%HTION YIN FEETh PERMIT HPPLICHNT HH5 THE RE5PONSIFILITY TO INFORM THIS DEPPRTMENT DURING THE IM5THLLHTI3W INSPECTlONS OF RNY 690.10 HTJHCENT TO THIS PROPERTY FN[ T�E MUMBER OF RESIDENCES THAT THE WELL WILL SERVE. X 5 - § 0 < ':'i, �2iT FIN 1H: 40, T- 1 Kip A 1: 4" 6mv Fv NE �0 �` � --il ��] -zi ___ BQCKFILLING SYSTEV WITHO-T FINHL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MIMIMUM DI�T�NCE BETWEEN B HELL HND 5E@HGE DISPOSAL SYSTEM IS 110 FEET FOR R PRIVATE WELL/ QR 150 TO 200 FEET FROM A PUBLIC WELL DEP%DIN(? UPON THE TYPE OF PUBLIC HELL OTHER REQUIREMENTS MHY APPLY. SPECIFICHTIQWS H&D CONSTRUCTION QIHGRHMS 10E GVHILHRLE TO INSURE HTION I I CERTIFY THHT 1: I RM FHMILIHR WITH THE REQUIREMENTS FQR Q940ITE SEVERE, FWD WELLS PS SET FORTH BY T% MUNICIPALITY OF HI�CHORHGE. 2: I WILL INSTALL THE SYSTEM IN FCC8R&040E WITH THE C9TES, ]� I UNDERSTRWD THHT THE QN-SITE SEWER SYSTEM M8Y REQUIRE ENLVRTEMENT IF THE RESIDENCE IS REMODELED TO IhCLU0E MO?% THRN ] BEDROOMS- HAdI14:7'�iAl 0 Ef E GEO' -'CHNICAL Ef DEVEL. WENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster Earl Ellis 694-2774 SOIL LOG 688-2280 Soils Et Foundations Land Development Performed for: Name: 1141,2 P,(,/:5 fff'4 L , --jZ, /Z-f-S ", Tel. No. Mailing Address: Legal Description: Depth (feet) Soil Characteristics 0 1- All < "i J Fj 2 3 4 6- 7 8— zwvt/ Pl- 07- FZ- 1q111 9.- 10- 11- 12- 13 15 16 Ground Water Encountered: Yes No If yess what depth Proposed Installation: Seepage Pit _ Drain Field Comments: Performed by: Date: MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D.#F--~_~.- ~_~-\~_ - ~%_ ,-~% ~"~ HAA# ~'~c:~ ~ 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Lots 12 & 13; Delucia Subdivision; ~uaiOJ /?F~ ~ Location(address or directions) Needles D~ (b) Property owner Mailing Address (c) Lending Institution Mailing Address A.H.F.C.#58689 520 East $4th Avenue Telephone'(home) Anchorage, Ak. 99503 Telephone . Business (d) Real Estate Company and Agent JACK WHITE COMPANY ATTN; Ly~da Banner (e) Address 10928 Eagle River Road Eagle River, Ak. 99577 Telephone 694-5500 Mail the HAA to the following address: (or check here P~,xif hold for pick up.) List contact person and day phone number below: S & $ ENGINEERING 17034 E=_~!e ~;~- Eagle River, Alaska 2. TYPE OF RESIDENCE Number of bedrooms Single-Family ~x 3. WATER SUPPLY Individual Well Community [] Public [] Note: If community well. s, ystem, must have wr.!tten confirmation from the State Department of Environmental ConServatibn attesting 'to th legality~and Status." 4. SEWAGE DISPOSAL On-site ~x Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-025 (Rev. 7/88) Page 1 of 2 5. 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 disposal system is in compliance with all Municipal and State codes, ordinance,s,, and regulations in effect on the date of this inspection. Name of Firm -t 7~3,~.. , E~jle River Loop Roa~ No. ~OA Telephone ,...a~,e River, Alaska 99577 Address Date 6. DHHS APPROVAL Approved for t/~:~uedrooms by Date / Approved .~ Disapproved Conditional , ,,~ .......... / The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated 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. 7/88) Back Page 2 of 2 Health Authority Approval (HAA) CHECKLIST - FEBRUARY 1984 343-4744 Legal Description: ,/--ot~ ~ ~ / -~.,' A. WELL DATA ~ ~ ~ ~_.~, ~L~.~-_~ ~ Well Classification ~"~,'rd~/~_ Well Log Present (Y/N) ~ Date Completed ~ ~ Yield TotaIDepth~~asedto ~O't Depth of Grouting Static Water Level / ZO Casing Height Above Ground I ..~ "'f Electrical Wiring in Conduit (Y/N) c1 Pump Set At L.2 ~ Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ! O0 'f ; On Adjoining Lots [ SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot To Nearest Edge o[ Absorption Field on Lot To Nearest Public Sewer Line /,-,)/¢, To Nearest Public Sewer Cleanout/Manhole / To Nearest Sewer Service Line on Lot 2 .~' Water Sample Collected by ~ '~ ~ ~_.~'//J,.~¢'t ~ ; Date Water Sample Test Results -~_ ¢-/L~'~ ~ ,-~'~ ~--~'¢'~ £ (1 ~ Comments B. SEPTIC/HOLDING TANK DATA Date Installed ~-~/.2-7~ Size Standpipes (Y/N) t~ Depression over Tank (Y/N) No. of Compartments Air-tight Caps (Y/N) Pumping/Maintenance Contact on File (Y/N) Holding Tank High-Water Alarm (Y/N) Foundation Cleanout (Y/N) ~ 64~ Date Last Pumped (~ - 2~ -~ ~ ;,or Temporary Holding Tank Permit (Y/~) ~ /,q SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply Well l ~ 0 To Building Foundation , To Property Line /. (2 lL To Disposal Field To Water Main/Service Line i 0 ~ 72-026 (Rev. 7/88) Front To Stream, Pond, Lake or Major Drainage Course Comments ~_~'~_ ~ J~'c.. Z) ~)/tA ,~ ¢_. Q/ bL4 ~a~e C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata _~ Date Installed ~-- /~- "~ Width of Field ~,~.¢f v __~/_~ ' 1 Square Feet of Absortion Area Depression over Field (Y/N) Results of Last Adequacy Test --/6r~' Type of System Design Length of Field Depth of Field / Gravel Bed Thickness Statndpipes Present (Y/N) Date of Last Adequacy ,Test SEPARATION DISTANCE FROM ABSORPTION FIELD: ! To Water-Supply Well To Building Foundation Lot ~ / P~ To Water Main/Service Line H To Property Line To Existing or Abandoned System on ;On Adjoining Lots '~o "~ To Cutback (if present) / r~O 'au ! {o t 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 Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Company Date ~, Niver Loop Roa~ No, 204 Alaska 9957~ MOA NO. Receipt No. c~zc~ Date of Payment Amount: $ Receipt No. Waiver Fee: $ Date of Payment 72-026 (Rev. 7/88) Back Page 2 of 2 CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. 5633 B STREET · ANCHORAGE, ALASKA 99518 · TELEPHONE (907) 562-2343 FEDERAL TAX I.D. #92-0040440 ANALYSIS REPORT BY SAMPLE for Work Order ~ 31932 Date Report Printed: FEB 13 91 @ 16:03 Client Sample ID:LOTS 12 & 13 DELUCIA S/D Client Name PWSID :UA Client Acct Collected FEB 11 91 @ 12:00 hrs. BPO ~ Received FEB 12 91 @ 14:10 hrs. Req # Pzeserved with :AS REQUIRED Ordered By S & S ENGINEERING SNSENGP PO ~ R. SHAFER Analysis Completed :FEB 13 91 Send Reports to: Labozatory Supe~yis, oL.L~:TEPHEN C. EDE 1)S & S ENGINEERING Released By :~ ~. ~ 2) = .... == === ============ ====== ======== ======== == === = == = = ==================== == ======~== = = ====== ======== = = ====== === ====== === ........... Chemlab Ref #: 910479 Lab Smpl ID: 1 Matrix: WATER Allowable Parameter Tested Result Units Method Limits NITRATE-N 1.? mR/1 EFA 353.2 10 Sample ROUTINE SAMPLE COLLECTED BY: RD.J. Remarks: 1 Tests Performed See Speclal Instructions Above UA=Unavailable ND= None Detected '* See Sample Remarks Above NA= Not Analyzed LT=Less Than, GT~Greater Than - ' MAR ~? '91 RECEIVED MAR 8 1991 Municipality of Anchorage Dept. Hea~th & Human ~rvio~ 17: 46, 9076941£51 ,_TACK WHITE/ER-" Post-ItTM branct fa~x transmittal memo 7671j # o* pagas ~ __ 'Co, ' Go, Dept, Phone ~ Fax ~ Fax ~ P.1 N ¢~PR-- ! $--9 ! THU 7 : 1 4 RE E APR 1 8 1991 MENT- M~i~ality ot Anchorage ~ASP24ENT GRANTING RIGHT OF ENCROACH ~,~it~&HumanSe~l~ Grant of an easement by Alaska Housing Finance Corporation as owner in fee simple of the following described parcels of real property: Lot 12, Delucia Subdivision, Anchorage Recording District, Third Judicial District, State of Alask% Plat % p-648 Lot 13, Delucia Subdivision, Anchorage Recording District, Third Judicial District, State of Alaska, Plat 9p-645 1. Lot 12, is an unimproved lot. Lot 13 has a residential dwelling constructed upon it. A portion of the septic system serving =he dwelling on Lot 13 encroaches on Lot 12. 2. Alaska Housing Finance Corporation, as owner of Lot 12 and grantor, hereby grants to the owner of Lot 13, grantee, an easement fcr encroachment of Lot 13's septic system on to Lot 12. This right of encroachment is limited to that portion of the system now encroaching on Lot 12 and only to the exten= of the encroachment as it exists on the date of this grant. No further encroachments may be placed on Lot 12 nor shall the above described encroachment be expanded without the express written consent of grantor. 3. Grantee shall have the right to repair the encroaching septic system, and reasonable righ=s of access to Lo= 12 for such purposes, so long as the repaired system does not expand the encroachment. In the event grantee replaces the septic system or drainage field, such replacements shall be located solely on Lot 13. In the event grantee removes any or all of the encroachment, the easement shall terminate as to that portion of the encroachment sO ramoved. 4. Grantee, hereby indemnifies and holds harmless grantor from any and all claim~, demands, lawsuits, settlements, damages, costs and expenses, including attorney's fee~, suffered or incurred by grantor as a result of any personal inju~, death or property damage arising out of the encroachment. 5. This easement shall terminate one year after the date on which public sewer service becomes available to Lot 13, but shall terminate on the date Lot 13 is connected to public sewer service if such date is earlier. 6. The costs of maintaining, repairing, replacing or removing the encroachment shall be borne solely by grantee. 7. The right of encroachment provided for herein shall run with the land and be binding upon and inure to the benefit of the owners of Lots 12 and 13, their respective heirs, devl.~e~, successors a~d assigns, DATED this %~'. day of ALASKA HOUSING FINANCF. CORPORATION Grantor - Lot 12 Grantor - Lot 13 Property Disposition officer Page 1 Of 2 pages APR-- 18--9 I THU ? : 15 [02 Ih2 180 ACKNOWLEDGMENT STATZ OF ALASKA ) THIRD JUDICIAL COURT ) THIS IS TO CERTIFY that on this I~day of ~ , 1991 personally appeared before me Nola Cedergreen,-~nown to me to be the person described on an~ who executed the within grant of easement and acknowledged that she signed the same as her free and voluntary act and deed for the uses and purposes therein mentioned. GIVEN UND£R MY HAND and official seal the day and year last above written. ~ Public in '~nd for_Ala My Commission exDire~: ~-~&5%-- After recording return to; AH¥C Antn: Gil Lulay AHFC #58659 /,i I S T R; C T Tran~A~a~km REQUESTED BY. Title APR il '9i i4:07 ATTY GENERAL ANCH. 907-276-36g? P04/5 EASEMENT ~OR USE AND MAINTENANCE OF W~'LL Grant ~{ an easement made by Corporation as owner- in fee simple of parcels of real property: Alaska Housing Finance the ~ollowing described Lot 12, Detucia Subdivision, Anchorage Recording District, Third Judicial District, State of Alaska Lot 13, Delucia Subdivision, Anchorage Recording District, Third Judicial District~ State o~ Alaska 1. Lot 12 is an unimproved lot. Lot 15 Mas a residential dwelling constructed upon it. The wat~rwell serving l. ot i5 is located on Lot 12. This grant of easement is intended to define th~ rights and obligations of ~he ~wners ~f Lo~s 12 and IU with respect to the use and maintenance o~ the waterweli. 2. AHFC, as owner of Lot 1~ and grantor, grants to the owner of Lot 12, as grantee, a permanent and pe~petuaI easement to opera~e, maintain, repair and supply electricity t~ the well and to draw as much water as grantee may reasonably need for residential purposes. The easement shall allow grantee to pass to and {rom grmntor's land for said purposes and to perform all o~her acts necessary to take and use water ~rom the well. Grantor a~rees that it will keep the well and rights o~ access granted hGr, e~n unencumbered so as t~ allow grantee free use and access to the well during the tmr-~ o~ this easement. 5. Grantee shall bear. all costs associated with the operation, maintenance and repair of the well and waterlines. 4. Grantee hereby indemnifies and holds harmless grantor from any and all claim~, demands~ lawsuits, settlements, damages, costs and expenses, including attorney's fees, suffered or incurred by grantor as a re~oit o~ any personal injury, death or property damage arisingin connection with the waterweil or waterlines. APR 11 '91 14:07 ATTY GEHERAL AHCH. 90?-2?6-369? 5. This easement shall run with the land and be binding upon and inure to the benefit of the owner's of Lots i2 and 15 and their- respective heir. s, devisees, successor~ and assigns. DATED this day of ALASKA HOUSING FINANCE CORPORATION Grantor- Lot 12 Or. antee- Lot 15 By; Nola Cedergreen pr~operty Disposition O~icer ACKNOWLEDGMENT STATE OF ALASKA ) ) ss. THIRD JUDICIAL COURT ) THIS iS TO C~RTIFY that on this day o~ .. ~, 1~91 personally appear, ed Oe.~ore me Nola Ceder~r'een, known to m~ to be the person described in and who e;4ecuted the within grant and voluntary act and deed for the uses and guppo.ses thep~n mentioned. GIVEN UNDER ~Y HAND and official seal the day and year last above written. Notary Public in and for Alaska My commission expires~ APPLICANT FILLS OUT UPPER HAL,- ONLY Property Owner Buyer , Address Zip Code Phone ,/;..;., :?' .,', 'l '? 'i Lending Institution Address .~ ..,: . / ~. ~/,/ ~_ /~ ,..;~:~ Zip Code Realty Co. & Agent Address Zip Code Phone Phone Legal Description Street Locatio~ Type of Residence [~' Single Family F~ Multiple Family No. of Bedrooms : Other Water Supply ,t~ Individual .... ~'~, !i~,:.~ // ~] Community - ~ Public Utility Sewer Disposal ~-~ Individual ~: Public Utility : Holding Tank ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if availa~'ie~'--''~ Year Individual Installed: When Connected to Public Utility: NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time ~ Time Time Date Date Date Date ~:~/ Inspector Inspector inspector Inspector Field Notes: ~ ~ .~. ~ ,~ -'~ % . APPROVED BEDROOMS DISAPPROVED 'CONDITIONS OF APPROVAL Soils Rating Date Sewer installed Well To Absorption Area j_ Well to Tank L ''~ O Well Log Received 72-023 (3f82) ADEOUACY TEST WAI'E R AfAr} SEWER !NSPEC 1 ION WEt [. INSPECT!ON'S AiND FLOW TEST SllE PL/,Nb ROAD DESIGN SOIL T[$T ON SiTE WASTE WATER D}SPOSAL SYSTEM DESIGN EXCAVATION WORK. ROBERTA. SHAFER December 19, 1983 CIVIL ENGINEER 694-2979 Arlene Mau!din P.O. Box 772203 Eagle River, Alaska 99577 Reference: Lot 12 & 131 DeLucia Subdivision A sewer system adequacy test was performed on the system located on the referenced property, as you requested. The septic tank was pumped and verified to have a capacity of 1000 gallons, r£he absorption trench was tested by a continuous flow of water over a period of 48 hours with- out any adverse effect on the system. It can be concluded from this test that the waste water disposal system serving the three bedroom residence located on this property is currently functioning adequate 5- However~ the system cannot be guaranteed against subsequent failure. A well inspection was also informed and it was noted that the well casing needed to be equipped with ~n adequate sanitary seal and the well wires placed into conduit. This work was performed and the well casing no%; meets all Municipal code requirements. 'flow test was also performed on this well, per your request and it was termined that the well has a static water level of approximately 90 et. After draw do%~n of the water to ap?roximgtely26 ~ the recovery te of this well appears to be approximately ~O gallons per hour. 'r6'~ be of furthe~ service pi. ease do not hesitate to contact us. If we , Sincerel'y, , ~:',.~./"/ ./ ...' %/?/, /.~ (/" , //'...' · / ~/"' ~AS/ss / ' / cc: k~n]czpalitv of Anchorage Dcpart. m~}nt of Health and Environmental ]~rotection SRB 190X EAGLE RIVEH. A, A.,KA 9q!i7'!