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HomeMy WebLinkAboutDONALD C SCHROEDER #1 TR 5A Donald C. Schroeder #1 Tract 5A #050-521-17 Rick Mystrom. Mayor Municipality of Anchorage Department of Health and Human Services $25 "L" Street P.O. Box 19§650 Anchorage, Alaska 99519-6650 http://www.cLanchorage.aN.us December 30, 1999 HARROP AUDREY E & ROYAL C 25431 EAGLE RIVER ROAD EAGLE RIVER, AK 995779691 Subject: DONALD C SCHROEDER #1 TR 5A Permit # SW990070 PID # 5052117 The subject permit #SW990070 issued by this office for a single family well and/or on- site wastewater system, is due to expire 365 days after it's issuance on 27-Apr-99. If this is a well permit and you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If this is an on-site wastewater system and a licensed Professional Engineer has inspected the installation, the original as-built inspection report must be sent to this office for review, approval and documentation. All inspection reports must be submitted within 30 days of construction completion. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. However a new permit can be issued free of charge for a second year if the application for the renewal is received on or before the date of expiration of the original permit for which a fee was paid. When applying for a new permit after the original permit has expired or for more than a second year, the fees are: $320.00 for an on-site wastewater permit and $120.00 for a well permit. If you have any questions, please call this office at 343-4744. Program Manager On-site Services enc: Copy of Permit MUNICIPALITY OF ANCHORAGE Department of Health and Human Serv/ces On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (9O7) 343-4744 ON-SITE WATER SUPPLY PERMIT Initial Date issued: Apr27, 1999 Expiration Date: Apr 26, 2000 Permit Number: SW990070 Legal Description: DONALD C SCHROEDER #1 TR 5A Design Engineer: 0003 S & S Engineering Owner Name: Audrey Harrop Owner Address: 25431 EAGLE RIVER ROAD EAGLE RIVER , AK 99577-9691 Parcel ID: 050-521-17 Site Address: 025431 EAGLE RIVER RD Lot Size: 74488 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: [] Disposal Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage All construction must 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 engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. WATER STORAGE FACILITY SHALL BE IN ACCORDANCE WiTH AMC 15.55.070. Received By: Date: '//"' Date: 4-2 7-?q ROBERT C. COWAN, P.E. CIVIL ENGINEERS April19,1999 (907) 694-2979 FAX (907) 694-1211 SEWER & WATER MAiN EXTENSIONS SEWER&WATER INSPECTION ENGINEERiNGSTUDJES ,'~ND REPORTS WELL INSPECTION & FLOWTEST SOIL TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS Municipality of Anchorage Department of Health and Human Services Division of Environmental Services Onsite Services Section PO Box 196650 Anchorage, AK 995: RECEIVED APR 2.0 1999 Municipality of Anch~orage Dept. Heaith& Human ~ervices Reference: Tract 5A, Donald Schroeder #1 This is to request a water storage permit for the installation of a minimum of 500 gallons of water storage for the referenced property. The well was tested on April 14, 1999 and found to produce 245 gallons per day. This is slightly below the required 450 gallons per day for a three bedroom residence and water storage has become necessary !n order to obtain Health Authority Approval. As shown on the attached as built survey, the storage will be installed inside the building. Also attached is the Health Authority Approval request which may be held until completion of the water storage installation. Sincerely, RCC/skh Attachments 17034 NORTH EAGLE RIVER LOOP · SUITE 204 ° EAGLE RIVER, ALASKA 99577 f ., / , ~q.~U:iL~'l~/~corne~'s'. se.i; ~ 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 ___ -- ~PGRADE LEGAL DESCRIPTION LOCATION ~O. OF BEDROOMS lWell t /./ d~ Absorption area PERMIT NO. ~ DISTANCE TO: ] _ ' /, ~ ~ 4~ ~ Dwelling '.~' Manufacturer ~/~ ~ Material No. of compartments ~ ~ ~iq. capacity in gallons -I- H~ME"" -~ / Inside length Width Liquid depth , ~ ~ Dw~ ~ Manufact~ ~ Mate~~ Liquid capac~lons ~ Well Foundation Neare~tin~ PERMIT NO .... ~. ~;. No. oflines / Lengthofeach. ne...~.~ Totallength~flines .. ~.~ Trenchwidt~__ Inches Distancebetweenlines ~ Top of tile to finish grade ¢ ~ ~ ' Materia~beneatht~ ~~ Total effect~a~or~ona~ Length Width Depth ~ /' / Crib depth ~~tal effective abso~area ~ ~ ~crib Crib diameter ~ Class ~ Depth Driller Distance to lot line PERMIT NO. ~ DISTAN~TO: Building foundation Sewer line ~ Septic tank¢ Absorption areE(s) OTHER 'Ir - AP~~ DATE LEGAL 72-013 Rev. 3/78) PERM I T NO. :IF F L, I L. tqNT .0 C R T I ON _EGFIL I",lUl--.~ :[ C: :E ~ F:tL._ 1: "l-"T' DEPBRTMENT OF HEBLTH BND ENV~RONf'IENTAL PROTECTION 825 '"L'" STREET., ~NCHORBGE., 264-4728 I-'- ~ ' ..HEL PRUETT _ P. 0. ERGLE RIVER RD TRT 5 R SCHROEDER S,.."D I_OT .., I ...E .:.qFl¢iFi¢:~ SC..!LIRRE FEET ,- - ',,:'- ,, ". c',,,- -, IS' F'¢F'E OF =,0 IL HE,_,UEF T II.IN _,T_-,TEM TRENCH MRXIMIJM N_IMBED OF BEDROOM'=; .= _.3"-: " F' ':: SC..! "'') ~' 'x'R SnlL F..HTIN.~ FT,.'E,F.. = ~.~.._ I"HE RELqLIIRED SIZE OF THE SOIL HE,_-,JRFTION S'¢STEM IS' [:, F_: F' T t-I = 1 2:' L_ E I'-.t L---~ 'IF H =:-_,-'=-- --'-',- g---J R F! '...' E L [:, E P T H :: THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR [:,RAINFIELD. THE [:,EPTH OF R TRENCH OR PIT ~IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE ENCAVRTION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL [:,EPTH IS THE MINIMUM DEPTH C(F GRAVEL BETWEEN THE OLITFALL PIPE AND THE BOTTOH OF THE E'?,CAVATION (IN FEET). PERMIT RPPLICANT HAS THE RESPONSIBILIT'¢ TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF AN'¢ WELLS R[:,..TRCENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THRT THE WELL WILL SERME. ........... T I...-! b:~ ,:'-..='--'::'- .":, ][ I"-.! S F" E C: T I ~z, r-,! :,,'--' FI Y.: E R E i_.n.. El I F-: E [:, BACKF:ILLING OF RN'¢ _-,~r_TEM WITHOLIT FINFIL IN':;PEE:TIFIN FIND FIF'PROVAL E'¥ THIS [:'EPFtF::TMENT W ILL BE SLIB..TECT TO PRIZr--SECUT I ON. HIN!MIJM [:,I.:,THNL. E E:ETWEEN R 14ELL RND RN'¢ ON-SITE SEWAGE [:,I'_-";POSRL =,~=,TEM IS 188 FEET FOR R PR I'¢RTE WELL OR 15El TO 208 FEET FROM R PUBLIC: WELL DEPENDING LIPON THE T'¢PE OF PUBLIC HELL MINIMUM DISTRNCE FROM R PRIVRTE WELL TO R PRI'v'RTE SEWER LINE IS 25 FEET RND TO R COMMUNIT'¢ SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MR'¢ APPL.'¢. SPECIFICRTIONS AND CONSTRUCTION DIFIGRAMS ARE A',,,'RILRBLE TO INSURE PROF'ER INSTRLL. RTION. I CERTIFY THAT :1.: IRM FRMILIAR WITH I'HE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET FORTH BY THE MLINICIPRLIT'¢ OF ANCHORAGE. 21: I WILL INSTALL THE S'¢STEM IN RCCOR[:,RNCE WITH THE CODES. ]:: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MA'¢ REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELE[:, TO INCLU[:,E MORE THFIN _-< BEDROOMS. $IGNE[:,' ~ FIF'F'LIC:FINT~RL F'RUETT =,_-,UEE., BY t. OL"fl r I TRT ~5 FI ';~..,~ROEDER .~/D -C.'EP TH ~-= 1~ LEFII] TI-! '---~ ~ ? m3RFt%~EL DG:Fa l~H = 6 - i="F'_RH[T I=IP~_I'_'.~INT Hi=rS ~ k"'E'5,PON'5[8[LITY To [HFORff rHP5 o~.r~.:~r c~[~ r~_ GRE/"ER ANCHORAGE AREA BOF" JGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE Oi~ FROM WELL INSIDE LENGTH MANUFACTURER ~41~R~O~/ MATERIAL INSIDE WIDTH .... LIQUID DEPTH __ NUMBER OF COMPARTMENTS .LIQUID CAPACITY GALLONS. SEEPAGE PIT: NUMBER OF PITS LINING MATERIAL ~ BUILDING FOUNDATION / DIAMETER /0~:~1 OR WIDTH /~ LENGTH ~ DEPTH ~:~' CRIB SIZE: DIAMETER~DEPTH DISTANCE FROM: WELL TOTAL EFFECTIVE NEAREST LOT LINE~ ABSORPTION AREA (WALL AREA) SQ. FT. ADDITIONAL ABSORPTION WELL: BUILDING FOUNDATION CESSPOOL APPROVED CONSTRUCTION NEAREST _ , LOT LINE , OTHER SOURCES DISAPPROVED NEAREST SEPTIC SEWER LINE , TANK REMARKS DISTANCE FROM: SEEPAGE SYSTEM DISTANCES: INSTALLED BY: PIPE MATERIAL: REMARKS: Form No. EQ-031 DIAGRAM OF SYSTEM ~ greal'er ANC~IORAgE AREA BOROUgh aNCHORAGE, ALASKA 99~O2 TELEPHONE 27~-8686 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT PERMIT NO. 2157 INSTALLATION OF: SEPTIC TANK aX OTHER COMPLETION DATE ANTICIPATED SEEPAGE PIT ~ / , DRAIN FIELD / NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION. TYPE MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK f I FOUNDATION TO SEEPAGE Pit ~ ~) t TO NEAREST LOT LINE. WELi' TO SEPTIC TANK 5(~ / ~RA,N ,:',EL,::,/~ / WATER MAIN TO SEPTI~TA~NK DRAIN FIELD / SEPTIC TANK, ~) SEEPAGE AREA SIZE ~ /~/"~ TYPE DIAGRAM OF SYSTEM DRAIN FIELD , SEEPAGE PIT SEEPAGE PIT , DRAIN FIELD ALSO CONSIDER AREA WELLS. SEEPAGE PIT f~) , DRAIN FIELD TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURbeD SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC: TANK AND SEEPAGE Pit FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH RE ATIONS REGARDING INSTALLATION, )~LTH ~UR~' THOR i~TY /// LICENSED DESIGNER I CERTI%~}THAT i AM FAMILIAR WITH THe REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE DESCR.~D SYSTEM IS IN ACCORDANCE WITH SAID CODE.t.//~/~/~ /~/ APPLICANT'S SIGNATURE ~°~-~ ~~/{~'' GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL .QUALITY 3330 "C" Street ANCHORAGE, ALASKA 99503 Case # ;~'erformed For ~,~-m~ ~/le~ Dated Performed ~egal Description: ~'T-~,--~-~~ Subdivisi°n~\~,c~, This Form Reports Soils Log /~ Percolation Test - Soil Test Must Be Logged To 4' Below Proposed Seepage System Depth Feet Soil Characteristics It II 1' Was Ground Water Encountered?~ If Yes, At What Depth? Reading Date Gross Time Net Time Depth to H20 Net Drop I I ~rcol ation Rate Minute Proposed Installation: Seepage Pit Drain Field Depth of Inlet Depth to Bottom of Pit Or Trench ~MMENTS: . ~S~ ~ ~// ~ st Performed BY_z~_d~_~ MUNICIPALITY OF ANCHORAGE · 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. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 050-521-17 "HA~ ' ""~4i~C~ ~'~ L~_~' ~__~, 1. GENERAL INFORMATION Complete legal description Tract 5A, Donald Schroeder #1 Location (site address or directions) 25431 Eagle River Road Property owner Mailing address Lending agency Mailing address Agent Address Audrey Harrop 25431 Eaqle River Road, Alask~SA/Ann Morris 12832 Old Glenn Highway, Day phone 696-8047 Eaqle River, AK 99577 694-7030 Day phone Suite C-2, Eagle River, AK 99577 Day phone Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 TYPE OF WATER SUPPLY: Individual well XXX Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site ~,, Public sewer NOTE: xxx If community Wastewater System:'provide Written confirmatior~ from State ADEC attesting to the legality and Stat'~S"~)f S~tem'.~'~ ' ' · 12-025 [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 wastewat~r disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. S & $ ENGINEERING Name of Firm 17034 Eagle River Loop Road No. 204 Phone do ~ '-/- ~_.c/'7 ~' Eagle River, Alaska 99577 Address ?/~j ~ ~. ~ Engineer's signature , ' Date ~/J~t / '~ ~ DHHS SIGNATURE ~ Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments Date ~ -2 7- The Municipality of A~chorage 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 professiona! engineer's work. ?2-O2~(Rev. 1/91) Back MOA#21 Legal Description: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVI¢~f Environmental Services Division 825 L Street, Room 502. Anchorage, Alaska 99,501. Health Authority Approval Checklis~ept. ~~ ~ ~ ~ ~ ~~ Parcel I.D.: A. WELL DATA Well type _J~IL~"/",(-~ If A, B, or C, attach ADEC letter. ADEC water system number ~/~ Log present (Y~ h,~ Total depth .~ ~)"'J~ ' ~- Sanitary seal (~N) Date completed ~_~.,~_' ~' ~-~ '2/,3 '~ / '7,,~ Cased to V0/'/' Casing height (above ground) Wires properly protected (:~/N) ~Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform Date of sample: FROM WELL LOG AT INSPECTION Nitrate g.p.m. O, I 7 g.p.m. Od '7'¢~ Other bacteria Collected by: B. SEPTIC/HOLDING TANK DATA Date installed ~R,.~_~,- :~7.01~/~Yrank size Number of Oompartments / Oleanouts CN)_TY_.~ High water alarm (Y/N) /kJ//~ , C. ABSORPTION FIELD DATA"'.::',". Date:i~;'a;led '7"::~.';;:'¢/"'! Soil rating ,g.p.d./fForft'/bdrm) /~-~~y,tem~pe m/"/t~'/, Length .:Z~'~, ~' / Width.. ~.~.'~ ~ / Gravel thickness below pipe ~/Total depth /~ / Effective absorption area ~ ~ ~Monitoring Tube present,N) ~ Depression over field (Y~ ~ Date of adequacy test d- ?' ¢ f Results (Pass/Fail) ~ ~ S For ~ bedrooms Fluid depth in absorption field before test (in.); ~// Immediately aEer~ gal. water added (in.): ~// Fluid depth ~// (ins) Minutes later: '~ ~ Absorption rate = + ~ g.p.d. Peroxide treatment (past 12 months) ~/N) ~~~ If yes. give date -- 72-026 (Rev. 3/96)* Date installed Manhole/Access (Y/N) Size in gallons ~1 at* "Pump off" level at* *Datum E, SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: ~. . ~ ~ ~o /o/'~-3 Septic/holding tank on lot ~"0 ~,~,lb~,~./;r~. ,~,r,~..~ On adjacent lots Absorption field on lot Public sewer main Sewer/septic service line On adjacent lots .. /~ ~ ~ Public sewer manhole/cleanout F/,4, Lift station ~,~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation /~/~ / Property line /~/'~- Absorption field /'/,~ / Water main/service line J/~/~ Surface water/drainage /00 J-1~- Wells on adjacent lots "/~0 f3/- SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line _~2~~ ~~ Surface water ./_/)/~ ~ ~ Curtain drain ~'~/~ Building foundation ,,~) / .-~ Water main/service line Driveway, parking/vehicle storage area Wells on adjacent lots .~/~0 ~'1~ F. ENGINEER'S CERTIFICATION I certify that I have' determined thru field inspections and review of Municipal recor~ in c°nf°rmance w~.Zp/~ide/~ .s in effect °n this date' ~ Engineers Name /0/~/~ '~7'''' ~ ~ ~',,/~ :~i~iI [ems are HAA Fee $ ~ D"~' /_~ Receipt Number , Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* CT&E Environmental Services Inc. CT&E Ref.# Client Name Project Name/# Client Sample ID Matrix Ordered By PWSID 991097001 S & S Engineering N/A Tract 5A Donald Schroder #1 Drinking Water 0 Sample Remarks: Client PO# Printed Date/Time 03/26/99 13:51 Collected Date/Time 03/23/99 10:40 Received Date/Time 03/24/99 16:00 Technical Director: Stephen C. Ede Released By~~ Parameter ResuLts PQL Units ALLowabLe Prep AnaLysis Method Limits Oate Date Init Tota[ CoLiform Nitrate-N 0 o.766 cot/lOOmL 0.500 mg/L SM18 9222B 03/24/99 KAP EPA 300.0 10 max 03/24/99 03/25/99 SCL tlEA[IHAU~IIORIIY APPROVALS BEWEn & WMER MNN EXIENSlONS " 8EWER & WAIER INSPECIION ENGINEERING S~/UDIES AND REPOR[8 WElL INSPEC lION & FLOW IES[ SItE Pi ANS flOAO OESIGN $OILTES[ PERCOIAIION IES[ SlflUCtUflAL MECl IANICAI. INSPECTIONS (3HSITE WASIEWAIER DISPOSAL $~1~ IEM I~SlGN ROBERT C. COWAN, hE. ROBERT A. 8HAFER, RE. CLIENT: LEGAL DESCRIPTION: '~"~/~/-~ Z~ WELL DEPTIt: ~-_:~ / CASING ~EPTtI: ~ ~ DATE DRILLING COMPLETED: ~[~ ~' ~ DRILLER: CIVIL ENGINEERS (007) 004-2070 WELL FLOW TEST DATA F,,,x(eo7) 09442tl MISC. D/~TA: TEST DATA: CLOCK TIME 11 CASING IIEIOtlT: /8 ~'/ SANITARY SEAL: WIRES IN CONDUIt:" %/~ _~-~ GRADING O.K.: ' ' BACTERIA AND NITRAI'E S~MPLES cOLLECTED (date): '..~/~'~'/ MEY[~R READING (GAL! Il PuMpING RATE (GPM) DEPTH TO WATER (ET) '. 2~_z ,,wi ,~, 4- .... 3.7 !1 .3,. ~3 527- 5ToP REMARKS JL[ {' /' Z-/--M/-?- TOP z ~3f, ~'zz. 5'- ! ~ ~.RRENTLY PRODUCES O-1'7 GPM WITH A ~: ~. DRAWDOWN TESTED BY:~~' FLOW RATE NOT GUARANTEED--SUBSEQUENT VARIATIONS CAN OCCUR. 17034 HORRI EAGLE RIVER lOOP · St lITE 2.04 · EAGI.E RIVER, AI.ASKA 99577 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519.-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # i~ - ~.-~ - I'-') 1. GENERAL INFORMATION Complete legal description Tract SA... Do~d C. Schroeder Sub~vi~i0r~ Eaqle River, 'AK Location (site address or directions) Mile 6.2 Eagle River Road #I Property owner Mailing address Norman Lee Day phone HC83 Box 1722 Eagle River, AK 99577 696-1327 J Lending agency Mailing address Agent Teresa Romines/ DON MCKENZIE REAL ESTATE Address 13135 Old Glenn Hwy. Suite 100 Ea~le River, Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water Day phone Day phone 694-9035 AK 99577 NOTE: 3 ~ XXX 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: XXX 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 m,y 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 of this inspection. Name of Firm ~ Phone ~ Address ~;~g~ AR-i~av~; L°J~ Rea~d Ne¢~ ,. Engineer's signature ~ Date 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) ~sues Health Authority Approva~ Certificates based only upon the representations given in paragraph 5 above by an independent I~;ofessional 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 omissior'~ in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA ~21 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description,:~~ A. Well Data Well type ~'~¢.~ d ,o,-~(,..- Log present (Y~ ~ Total depth "~'~"'~ ~ '~ Sanitary seal (~) '.~ ~,~ ~-.-.. Parcel I.D. Date of test Static water level Well flow Pump level1 If A, B, or C, attach ADEC letter, ADEC water system number Date completed ~'~¢-~o.lz.- ~.~'1'~ z~ Driller Cased to ,~::~ ~' Casing height Wires properly protected ~/N) ~/ FROM WELL LOG AT INSPECTION J g,p.m. SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot \ Public sewer main Sewer service line ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform ~ Nitrate Date of sample: ,~'$ a ~ /~ 17.~ ~'~ / B. SEPTIC/HOLDING TANK DATA ~ ,~ o Other bacteria Collected by: Date installed Cleanouts ~N) y High water alarm (Y~J~ Date of pumping Tank size ~ c> ~ ~ Compartments ~Ioundation cleanout (Y/~ ~ ,.~ Alarm tested (Y/N) -"- ~ z.~.- Pumper ~- SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: ~ Well(s) on lot 1~, ~ ~ On adjacent lots ~ ~ ~ ~ '{''' Foundation To property line ~. c~ ~ ~ Absorption field ~r' ~ Water main/service line Surface water/drainage \ O C) 72-026 (3/93)* Front CONTINUED ON BACK~AGE;~ C. LIFT STATION Date installed Manufacturer Size in gallons Manhole/Access (Y/N) _..-.-- Vent (Y/N) "Pump on" level at "Pump~ water alarm level Cycle~Jee~'"'"'- High Meets MOA electrical codes (Y/N) ~ SEPARATION DIST~J~6'E'F'~OM LIFT STATION TO: ~ On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed ~ ~'Z~ ~5 ~ Length ~'~t5 ~' ) , Width Total absorption area '~) 2. ~ Date of adequacy test 5'"'--/?-- ~ ~ Water level in absorption field before test Peroxide treatment (past 12 months) (YA~3 Soil rating (GPD/FF) I ..~, 5- Gravel thickness Cleanout present (~N) Results ~[~-ail) /~'$ System type~C/~ /-~ / Total depth /2- / Depression over field (Y~) ,,-J for 3' After test // If yes, give date 'J~///~ Bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot '~, ~ On adjacent lots To building foundation On adjacent lots ~ ~ .e- Cutbank Surface water Curtain drain Property line TO pxisting or abandoned system on lot '~"7 I ~' Water main/service line I Driveway, parking/vehicle storage area '1 ~ ENGINEER'S CERTIFICATION I certify that I have checked, verified, orconf~w¢~ to all MOA and HAA guidelines in eff?.c..(.~ t,~..,,;~{~ inspection. ........... ' ~;~t,~ ....... HAA Fee $ ~ ~ ~ Date of Payment F~.ceipt Number. Waiver Fee $ Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE MEMORANDUM WATER WELL ADVISORY HEALTH AUTHORITY APPROVAL During a recent Health Authority Approval on-site inspection and test of 'the po'hab!e water supply well on $~mt Block --- of p~m&IO c. SLqRD~D£~ ~/ Subdivision, the well's productivity was determined to be .3~ gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a ~ bedroom residence is .~/ gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Health Authority Approval. NT: ~ ~_~_~ HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION .r ENGINEERING STUDIES AND REPORTS WE LL INSPECTION & FLOW TEST S~TE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL& WELL RECOVERY TEST DATA CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 TEST PROCEDURE: 1) Draw water down to pump. 2) Shut pump off 15-60 min. -record time -record meter reading 3) Turn pump on. Drawdown. 4) Shut pump off. -record time -record meter reading 5) Calculate gal./min, recovery. MISC. DATA: Casing Height: Sanitary Seal?: Wires in Conduit?: Grading O.K.?: Pump Depth: Samples Taken?: Date: ~"~1~ ~ TEST DATA.' START TIME: %~.~ ~o STATIC WATER LEVEL: TRIAL PUMP TIME ,, METER ' GAL'/~.-- ~ ~"' OFF ~ % = ~ ~ ,. ~,,, MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN RESULTS: WELL CURRENTLY PRODUCES: ~?.0 ~P~ FLOW RATE NOT GUARANTEED--SUBSEQUENT VARIATIONS CAN OCCUR! 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 ROBERT SHAFER P E ROGERSHAFER, PE WELL LOCATION (legal): TEST DATE: ~-%~-%~ TESTED BY: WELL DEPTH: ~-% ~ ~ WELL DRILLER CASING DEPTH: ~o~ DATE DRILLED CT&E Ref.# Client Sample ID Matrix Commercial Testing & Engineering Co. Environmental Laboratory Services ~~'~-~'~-~'~-~,J~'J~'~'J~'~JJ~ LABORATORY ANALYSIS REPORT 94.2369-1 TRACT 5A DONALD C SCHROEDER WATER ClientName S 8: S ENGINEERING WORK Order 78536 Ordered By RJS Printed Date 05/20/94 ~ 17:00 hrs. Project Name CollectedDate 05/17/94 ~ 16:00 hrs. Project# ReceivedDate 05/18/94 ~ 12:45 hrs. PWSID UA Technical Director STEPHEN C. EDE Released By: Sample Remarks: ROUTINE SAMPLE COLLECTED BY: RAY. Parameter QC Allowable Ext. Results Qual Units Method Limits Date Anal Date Init Nitrate-N 0.10 U mg/L EPA 353.2/300.0 10 05/18/94 CMR * See Special Instructions Above ** See Sample Remarks Above U = Undetected, Reported value is the practical quantification limit. D = Secondary dilution. UA = Unavailable NA = Not Analyzed LT = Less Than GT = Greater Than 5633 B Street, Anchorage, AK 99518-1600 -- Tel: (907) 562-2343 Fax: (907) 561-5301 ENVIRONMENTAL FACILITIES IN ALASKA, COLORADO, FLORIDA, ILLINOIS, MARYLAND, NEW JERSEY, OHIO, UTAH, WEST VIRGINIA 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. # 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lOt, block, subdivision, section, township, range) Tract 5A, Donald C. Schroeder #1 Location(address ordirections) Mile 6.3 Eagle River Rd. (b) Property owner A.H.F.C. 827019 Telephone · (home) Mailing Address 520 E. '.34th Anchorage, Alaska ' (c) Lending Institution" Telephone Mailing Address Business __ (d) Real Estate Company and Agent Re/Max Address ]6600 ~ente~field D~'ive Telephone 694-4200 of Eagle River- Doc Crouse Eaa'le River: A1 ~]~a 99577 (e) Mail the HAA to the following address: (or check here~.f hold for pick up.) List contact person and day phone number below: S & S 170.14 Eagle River Loop Road No. 204 ,=._,. D: .... A,..u..~.577 2. TYPE OF RESIDENCE Single-Family [~ Number of bedrooms 3 3. WATER SUPPLY Individual Well ~ Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site:~ 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 (Rev, 7/88) Page 1 of 2 ~ ~o ~ ~6Sd '>lJO~ s,Jeeu!§ue ISUO!SSejoJd sql u! SUO!SS!LUO JO SJOJJG JOJ elq!suodseJ lou s! e§eJoqou¥ jo Xl!lgd!o!unw eq.L'Penss! s! m, soWt~eo e eJoieq m, sp ezXleUS Jo suo!loedsu! ~,onpuoo lou op SHHa to seeXOldLU=l 'slueLueJ!nbeJ e~,sls pug IsJepe~ u!e~,Jeo X,tsp, ss ol JepJo u! suo!lnl!lsu! §u!puel J!eql pug sewoq ~o sJeseqoJnd ol ~sm, Jnoo e se s!qt seop SHHQ eq.L 's>lSSl¥ ,to elelS eqt u! pe]m,s!SeJ Jeeu!§ue ISUO!SSeio,d luepuedepu! us Xq e^oqs S qde~Se~ed u! us^!6 sUO!lSlUeseJdeJ eq~, uodn ,{lUO pessq PelsowJeo IS^oJdd¥ X1Noq3n¥ qlleeH senss! (SHHO) seo!^Jes UsLUnH pus qtlseH ~o lueLulJsdea e§s~oqou¥ ~o Xl!led!o!unlAI eq.L IS^oJdd¥ ISUO!l!puoo ~o swJe.L ISUO!l!puoo peAoJddss~Q ~ ~- peAoJddv ~, ~o~ po^oJddv 'lVAO~lddV SHHQ '9 /-~66 u~SUlV '.foAIH ollbH el~a sse~ppv I,O;~ 'oN peo~ dool .m;~.qf 016e3 I~;0Z t · uolloedsul s~ql ~o el~p eql uo ~oe~e ul suolmln6e~ pu~ 'seou~ulp~o 'sepoo els~S pus Isdlolun~ I1~ ql~ eousHd~oo u~ s~ ~els~s Issods~p ~e}s~elss~ ~o/pus ~lddns ~els~ el~s-uo eql 'uo~loedsul pus UO~I~B~seAu! ~w wo~ pus seH~ e6s~oqouv ~o ~l!lsd!o~un~ eq~ woJ~ peu~slqo uo!~ew~o~u~ awl uo peseq 1sql tipeA Jeq~Jnj I 'u~eJeq pelso!pu! e~nlonJls to ed~ pus smooJpeq jo Jeqmnu sql Joj elenbeps pus leUO!loun~ 'etes s! welsAs i~sods~p JelSMelS~M Jo/pug ~lddns Jel~M el!s-uo awl 1sql SMOWS ISAoJddv ~l!Joqlnv q~lSeH si ql ~o uoRe6~lsenul ~m 1sql ~Jan I '~oleq u~oqs eleP uo!lsPllen aql to se pus oleJeq pexwe ISeS ~m tq pewl~eo sv NOI~aOdNI ON~ ~O 'HOa~S ~31d 'S~S~l 'SNOIIO~dSNI ~NIQIAOBd ~ald ONla~NION~ '~ MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) CHECKLIST- FEBRUARY 1984 343-4744 Legal Description :'~..~'~'~-~ A. WELL DATA Well Log Present (Y/~ I-~ Date Completed ~'~~ Total Depth~'~. ~ Cased to~t-~ Depth of Grouting Static Water Level Casing Height Above Ground \~'~ Electrical Wiring in Conduitc~/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line I'~/,t~ To Nearest SeWer Service Line on Lot If A, B, C, D.E.C. Approved (Y/N) ~ ~ '~ Yield Pump Set At Sanitary Seal on Casing([~)'N) Depression Around Wellhead (Y~j) ; On AdjOining Lots \ ~_,c'~ ~ ~ ~c~' ; On Adjoining Lots ~ ~c:> ~.~ To Nearest Public Sewer Cleanout/Manhole r3/,'~ Water Sample~Collected by '~~ ~ I~::~~ ; Date \ O ,-- \ q .-" <~-..~ Water Sample Test R;sults ~~~~ ~ ~~ ~ ~ Comments ~~~ ~ ~ ~~ ~ [~~, B. SEPTIC/J=I-~EDtI~ TANK DATA Date Installed ~74c(z-, 1~'/3 Size ~ No. of Compartments Standpipes(~N) ¥ Air-tight Caps~N) Depression over Tank (Y/~ ~ Foundation Cleanout (Y/d~ r''J Date Last Pumped ~5--'7.,,';-p ~ ES~ ~ , for "----- Pumping/Maintenance Contact on File (Y/N~; Holding Tank High-Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: I To Water;Supply Well t,~ ~ To Property Li.n~ ~ . ~,,_,,...,~ 4-' To Water Main/S'er~ice.~Line ~ ~ ~'~ To Stream, Pond, Lake or Major Drainage Course Comments -"~_ ~\~-~ ~~ To Building Foundation To Disposal Field 72-028 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed "7 Width of Field Square Feet of Absortion Area Depression over Field (Y~' Results of Last Adequacy Test Type of System Design Length of Field Depth of Field J Gravel Bed Thickness Statndpipes Present<~N) Date of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well ! To Building Foundation ""-/-..-~ Lot r~"7' 1 To Water Main/Service Line '~. To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area To Property Line ; On Adjoining Lots To Cutback (if present) To Existing or Abandoned System on Comments D. LIFT STATION Date Installed Dimensions ~ Manhole/Access (Y/N) "Pump On" Level at ~ "Pump Off" Level at High Water Alarm Level at ~ Tested for PumpingS. ~. Meets MOA Electrical Codes (Y/N) . . Comments **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect inspection. $ & $ ENGINEERING Signed Company Date MOA No. 17034 Eagle River Loop Road No. 204 Eagle River, Alaska 99577 Receipt No. Date of Payment Amount: $ 72-026 (Rev. 7/88) Back Receipt No. Waiver Fee: $ Date of Payment Page 2 of 2 ~- DEPARTMENT OFHEALTH b ENVIRONMENTAL -ROTECTIO ((~W~)] ~ ' ' MUN~IPALt~ OF ~H " kk~~// ENVI~N~ENTAL ENGINEERING DIVI~IO~EpT. OF HEALTH & '~ . Telephon~ ~-4720 ~IRONMENTAL PROTECTION REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND ~~8l~!, ES 1. PROPERTYOWN~ ~ ' I PHONE MAI LING ADDRESS PROPERTY RESIDENT (If different fromabove) 2.. BUYER ' ) ' . ' PHON~ MAILING ~DDRESS - - ' - -- ' - -- ~: ~DING INSTITUTION MAI LING ~DDR E~S 4. REAL~R/AGENT / ~ " j PHONE' M~LING ADDRE~ _ _ I S.TYPE OF RESIDENCE '- ,- NUMBER dF B~DROOMS ....... v' ~ - ~' One D Four ~ Other SINGLE FAMILY ~ MULTIPLE FAMI LY ~ Two ~ Fi,va ~ Three ~ Six 7. WATER SUPPLY , -' ~ I NDIVI DUAL* * ATTACH WELL LOG, A well log is required for att wells drilled ~ COMMUNITY since June 1975. For wells drilled prior to that date, give well ~ PUBLIC UTI LITY depth (attach 10g if available.),, 8, SEWAGE DIS~OSAL SYST~ .... ~ INDIVIDUAL/ON-SITE** **If individual/on-site, give insta lation date, ~ . If system is over two (2) years old an adequacy test is r~uired ~ PUBLIC UTILITY by this Department. NOTE:THE INSPECTION FEE MUST AccoMpANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED, THIS SIDE FOR OFFICIAL USE ONLY INSPECTION APPOINTMENTS DATE INSPECTOR DIRECTIONS: DATE RECEIVED TIME TIME DATE DATE I NSP'ECTOR I NSPECTO R 1; TYPE OF RESIDENCE [] SINGLE FAMILY · '-[] MU,LTl p~LE FAMILY 2. WATER SUPPLY [] INDIVIDUAL ' ' [] COMMUNITY [] PUBLIC UTI LITY Connection Verified 3.~ SEWAGE D~S~OSAL SYSTEM r--I I N DIVI DUAL/ON -SITE [~PU BL'IC UTI LITY Connection Verified I--1Septic Tank or [] Holding Tank Size: ~ If Tank is hpme.made give dimensions: TYPE OF TANK TOTAL ABSORPTION AREA 4. DISTANCES WELL TO: Absorption Area to nearest Lot Line NUMBER OF BEDROOMS [] ONE [] THREE i I' FIVE [] TWO [] FOUR [] 'SlX PERMIT NUMBER _ [] OTHER DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER DATE INSTALLED INSTALLER SOl LS RATING 'MANUFACTURER MATERIAL 5. COMMENTS ~ APPROVED FOR I--I CONDITIONAL APPROVAL (letter mus [] DISAPPROVED DATE I B Y ~~__.~ LEGAL DESCRIPTION BEDRO()MS company certificate) 72-010 (Rev. 3/78) DAVID A. SLENKAMP ROBERT A. SHAFER MECHANICAL ENGINEER 694-9055 June 6, 1981 CIVIL ENGINEER 694-2979 MUNICIPALITY OF ANCHO' ~.:>E DEPT. OF HEALTH ENVIRONMENTAL F;.O'i'EC ~ Greatland Realty ATTENTION: Marianne Box 633 Eagle River, Alaska 99577 jUN 'J 2 1981 RECEIVED Dear Marianne, Reference: Tract 5A: Donald Schroeder Subdivision; Gertraud Pruett Property A sewer system adequacy test was performed on the system located on the referenced property as you requested. A new standpipe had to be installed in the crib in the seepage pit before a percolation test could be performed. The septic tank was pumped and verified to have a capacity of 1000 gallons. The seepage pit was charged with approximately 400 gallons of fresh water and after a period of 24 hours 224 gallons had percolated out of the crib. It can be concluded from this test that the septic tank is adequate for the three bedroom residence located on this property. However, the seepage pit is only adequate for approximately 1.5 bedrooms. I regret to inform you that it will be necessary for you to have'the system upgraded with the addition of a new absorption area. Since the existing seepage pit is located only 80 feet from the well it is necessary that the new absorption area be installed a minimum distance of 100 feet from the well and adequate to serve the three bedroom residence located on this property. The existing seepage pit should be abandoned and filled in. If we may be of further assistance, please do not hesitate to call. S inccre~ly, cc: Lomas and Nettleton Municipality of Anchorage Department of Health and Environmental Protection SRB 196X EAGLE RIVER, ALASKA ~- ~,~,'~ D EPARTMEF s25 Time. ].: }[ m. #2: Date 9-1 /-77 Wednesday '~UNICIPALITY OF ANCHORAGE ~F ltEALTH AND ENVIRONMENT L Street, Anchorage. Alaska. 264-4720 PROTECTION 99501 Date Received: Time Date 9 Thursday Insp. ~lis~ September 12, 1977 #3: Time ~ Pm Insp ~2~}~___ REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES Lending Institution Request: Mailing Address:' Pouch 7-007 Peoples Bank and Trust 99510 Phone: 2. Property Owner: Herman J.Rose R. Eller Phone: Mailing Address: Post Office Box 998 99577 694-2711 3. Legal Description: Tract 5A Schroeder Subdivision #1 4: Single Family Residence: (x~ Multiple Family Residence: ( ) Number of Bedrooms: Number of Bedrooms: Three Se Well System: Individual Well (x~ Community/Public System ( ) Permit # Depth of Well Well Log on File ( ) Construction ~4~.. '~'~ Bacterial Analysis e · Sewage Disposal System: On-site System (~x Public Utility ( ) Permit ~ Installed ~ ~ ~//~7~Installer _~ ~~~/ Septic Tank Size ~%~2~] Manufacturer ~k3~~uu*\ / Area ~ ~-~. Soils Rate Absorption Distances: Well to Septic Tank to Sewer Line &/ Nearest Lot line to Absorption Area ~0 Absorption Area to Nearest Lot Line REALTORS® REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES 1. Type of Inspection: CMRO VA 2. Property Owner: ELLER, Herman 5. Mailing Address: Name of Buyer: FHA CONV × P.O. Box 921, Eagle River Pruett, Carl A. Day Phone 694-9768 Mailin,~ Address: ~ Day .P.h.o.n.e .Name of Lending Peoples Ban.k..an~ Institution: Trust [lail~ng Address: PO Box 4-1141~ ~chorage Phone 33 5. Name of Realtor or Agent: ANTHONY, Richard D. Mailing Address: P.O. Box 249, Eagle River Phone 694-9555 Legal Description: Tract 5A, Schroeder #1 kocation: Mile 6 1/2 out the Eagle River Valley Road, left side, log house. AREA Realtors sign on side of house. Type of Facility to be inspected: Septic & Well No. Bdrms. 3 Water Supply Type of Supply: Public Utility ~ Individual If Individual, number of dwellings presently served 1 If Individual, depth of well 400 feet Sewage Disposal System Type of System: Public Utility × If Individual, date of installation: Will Individual (on-site) In excess of two years. require percolation test. REALTOR® AREA, INC. REALTORS [] Anchorage "C" St. Office 3300 C Street (907) ~78-2525 [] East Anchorage [] Eagle River Eastgate Office Parkgate Office 5437 E. Northern Lights P.O, Box 249 (907) 278-25~5 1907) f~4~C~555 P~ge Two Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Tract 5A Schroeder 91 Affadavit Attached: ( ) Letter Attached: ( ) Approved: Date: Disapproved: C~~ ~~Q~ Date: Department Worksheet: October 10, 1977 ~leman £11er P. O, ~ox 998 Eagle [~tver, Alaska 99577 Re: Tract 5 Sch~eder Subdtvtslon el on-slte se~er Dear ~r. E11er, The exJsttng on-s~te s~er s~s~ wtll be a11o~d to ~1n as ts untll such the syst~ needs ~ be u~raded or ~placed, At that tt~ It w111 be ~ces~ry to ~elocate the syst~ ~ the ~1nt~ ~qu1~d dtsta~e f~ the well. if there a~ any questions, pl~se ~n~ct ~ at 264-4720. $tncerely, Joseph S. Blatr, £nvtronmental Servtces t4anager Area Inc. Realtors Peoples Bank and Trust JSlVea REALTORS' PAL '[Y C)F /:~!'JC:i; .,;~,- ~.:,, D[:P'F. OF tI[:Ai iJfl ~: EHVIRONME q AL [:~©[[ C.i tC,['~I REALTORS® September 14, 1977 Municipality of Anchorage Dept. of Health & Evvironmental Protection 825 ~ Street Anchorage, Ak. 99501 Attention: Mr. Joe Blair RICHARD D. ANTHONY Col. USA (Retired) Associate Broker Area, Inc. Realtors Parkgate Professional Bldg. Eagle River, Alaska 99577 Bus. (907) 694-9555 Res. (907) 694-9807 Dear Mr. Blair: Reference is made to Tract 5A, Schroeder Subdivision, Addition # 1, Currently owned by Mr. Herman J. Eller. Mr. Eller has sold his property and it has come to our attention that his existing septic system does not meet the Municipality requirements. According to the Form no. EQ-031, Mr. Eller's log crib is 80 ft. away frOm his well. The log crib is on a slope facing Eagle River Road. Because of the topography of the land and the manner in which the crib is situated, it is requested that an ex- ception be made which would allow approval of the existing system. Time is of the essence in this transaction. I would appreciate an initial telephonic response prior to your written response. Pleas~act~e by calling 694-9555. COL (Ret) USA Associate Broker P. S. Mr. Cory Willis was most helpful this afternoon in providing me with information regarding the solution of this problem. He suggested that I write you for assistance. REALTOR® [] Anchorage "C" St. Office 3300 C Street (907) 278-2525 [] East Anchorage Eastgate Office 5437 E. Northern Lights (907) 337-9424 [~a;le River Parkgate Office P. O. Box 249 (907) 694-9555 [] Wasilla P, O. Box 1970 Wasilla, Alaska (907) 376-2234 AS-BUILT ~ ! hereby, cert~ tl~t ! have sm'v~ed the ~ollow~r~ described property: 77L'~T'~ ,.~ ~, Anchorage Recording Precinct, Alaska, and that ~e improvement~, situated thereon lu'e 'within the property lines and do not overh~p or encroach on the property lying ~djacent thereto, that no improvements on prop- erty lying _sd~acent thereto encroach on the prem/ses in ~uestion and that there are no roadways, transmission hnes or other Visible mmements on said property except a,~ indicated hereon. D~ted ~t E~le River, AlaSka Romuer c. ~OHNSON ;d',e