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Home My WebLink AboutELLEN COURT LT 10L-lO I Mw 1w ... MOU Gels stir R HourrE A A>CIIdQBa2A(UEs [�SLASIiA �:��®� ...344-7714 SIX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF 83 Peet,' . ^`'• DRILLED AT THE RATE -OF MIN ATEOFi7*OO+. ;&PER FOOT. - - c..;: 2718 . PR PER Y Mre ROA Tarles , O T OWNER . • •`a. :R : r:y',._a.�. 1 LOCATION OF WELL SITE Lt. Subs nali I Fa :. Bernie Claus of Rampart Drilling,Worke.'r:-*, .. .. `` • ,-� ,ae,ii�q, 82--640 k'ater bearing `gravel produoSng ten GPM with a 40 foot head: lump should be - -- - ----- -- ------ installed tan feet off bottom. Cased bottoms 83 feet* MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION Al .: DEC 5 1984 RECEIVED COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING. WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF $1411.00 ` THANK YOY VERY MUCH. BERNIE CLAUS OF RAMPART DRILLING WORKS DATE ---June.2Qthep6— SERVICE CHARGE 0 F IV,% PER MONTH WILL BE ASSESSED ON PAST -DUE ACCOUNTS. SIX INCH .-DRILLED ~NE CASED'OU' DE} DRILLED AT THE RATE .... . . -- ..-} PROPERTY OWNER ' ' Lt; DRlffL~R'{!(.L :.Bernie ~ of ~t 22~j Gravel ~30~ c~dereT~:?-. ::',' ..... " "'~'"~ "'"::':' ...... ' ~ A' ~.. , . , , .... ...... '2' -:~-_-' -. .*:'~.~:, ;, . ~.4' "; ' ' :' ' '"'--""; ''~''"' COST INCLUDES"ALL LABOR AND MATERIAL FOR COMPLb'iION OF_SAID DRILLING WRITE CHECK PAYABLE TO RAMPART DRILLING WOR'KS'F(~I~ THE _ ~.i::¢~i::'.: ....... . -.. ,. :-,..: THANK YOL VERY MU~H. '~'.4~ " DATE BERNIE CLAUS OF RAMPART DRILLING WORKS - SERVICE -CHARGE OF I'/z% PER MONTH WILL BE ASSESSED ON DUE AOC( PERMIT NO. AF'F'L I CANT LOCFIT I ON LEGRL [:,EPFIRTMENT OF HERI_TH FIN[:, ENVIRONMENTFIL PROTECTION 25:~0 E. TUDOR RD,.., IRNCHOR¢~GE., ~K. ~:~5;~';:' ,' 76404 ) RONRLD EHRLE.=,~ ~LLEN C:IRCLE L-'I£~ ELLEN CT. SUB SRR B:-'< LUT SIZE Z 49-.- 2.':7"':1.8 · 1E17'E-~.} ':>.;6~URRE FEE'!" MINIMUM DISTFINCE BETWEEN FI WELL_ RND FlN¥ ON-SITE SEI.4FtGE ~L00 FEET FOR FI PRIVFlTE NELL OR 2C4El FEET FOR Fl PUBLIC WELL. NELL LOGS FIRE REQUIRED RND MUST BE RETURNED TO THE DEPRRTMENT WITHIN ]:~D DFI"r'S L]F THE WELL. COMPLETION. , .... .r.; SPEC:IFIC:RTIONS RN[:, CONSTRUCTION [:I~L:~RRM_ FIRE FIVRILFIE:LE Tf] IN':;URE' PF.'~PE'R I NS'¥FILLRT I ON. I CERTIF'¢ 'FHflT :L: I FlM F'FIMILIRR NITH THE REQI. IREMENTS FOR UN-=,ITE SENERS FINE:, NELL:S FOR'FH ECr' THE MUNICIF'FILI"r"r' OF RNCFlORFlGE. 2: I NILL ~a[I-C;TFtLL THE S'WS'FEM IN FtCCOR[:,RNCE NITH THE CUDE'.-:,. ............ - ...... ..... FI,~,'~.,T R. ON~,L~.: EFIR'_E'-'-; ,-,.-*,~. ~-,,o~~.-~~~- .......... '" ...... _¢...',Z% .... MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date Nov. 29.1984 (a) Legal Description (include lot, block, subdivision, section, township, range) L-lO Ellen Ct. Subdivision Location (address or directions) Ellen Circle (b) Applicants NameJanice & George Ovi~tt Telephone -(~g 345-76~siness Applicants Address 522 E. OLd $~ybrook. Boise. Idaho 83~06 (c) Applicant is (chJck one) Lending Institution ~-~ ; Owner/builder .~-~.; Buyer ~-~ ; Other ~ (explain); (d) Lending Institution Colonial Mortgage Telephone 562-2181 Address 701E. Tudor, Anchorage, Alaska (e) Real Estate Co. & Agent Address 4.80 W. Tudor, #103, Anchorage, Alaska Telephone 276-4663 (f) Mail the HAA to the following address: Maryann Osborne - ERA Bowden, Inco 480 W. Tudor, #103 Anchorage~ Alaska 99505 2. Type of Residenca Single-Family~-] Number of Bedrooms 3. Water Supply. Individual Well ~ Multi-Family~--~ 3 ERA Bowden, INc, Maryann Osborne 99503 Other (describe) Community~--~ Public~-] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. Sewage Disposal Onsite ~-~ Public ~ Community i . i 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 1 of 2] 5. Engineerin~ Firm Providing Inspections~ Tests~ File Search, Data and Information m 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, ordinances, and regula- tions in effect on the date of this inspection. Name of Firm Ocean Technology, Ltd. Address 2502 W. Northern Lights Blvd, A~chora~e. Date 11/29/84 (ENGINEER SEAL) DHEP Approval Approved for /~/~,~_YE bedrooms Approved Z Disapproved Conditional Terms of Conditional Approval CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COLrRTESY TO PURC~kSERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. EMPLOYEES OF DHEF 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. (DHEP SEAL) RR4/ej/Di8 [Page 2 of 2] 7-19-84 WET,r. DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AiFi~HORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL pROTECTION Well Classification ~;dB ;'~ Well Log P~esent !Y/N) ~_~ Total Depth ~.~ ! Cased to Static Water Level ;W~A'~b~A; Casing He ight Above Ground ~ ~3 ~ Electrical Wiring in Conduit (Y/N) ~ Separation Distances from Well: To Septic/Holding Tank on Lot ~//~ If A, B, C~' C, D.E.C. Approved(Y/N) Date Completed ~ -,~- ~ Yield_z~?~ Depth of Grouting Sanitary _Seal on Casing (Y/N? ~ ~0~ Arognd Wellhead ~ ; On Ad]oini~gV' Lots ~/~ TO ~a~st Edge of ~sorption Fiel~ on Lot ~/~ ; ~ Adjoining ~ts ~/~ To Newest Public ~= Line 7~' ~ ~ ' To ~est ~blic ~r Clean, t/Manhole /~' ~ To ~est ~= ~rvi~ Li~ on ~t ~ ~ Water S~le Collected ~y ~ ~~ ; ~te //-/~-~ Water S~le Test ~sults B. SEPTIC/HOLDING TANK DATA Date Installed Standpipes (Y/N) Depression over Tank (Y/N) Size Air-tight Caps (Y/N) Date Last Pumped No. of Compartments Foundation Cleanout (Y/N) Pumping/Maintenance Contract on File (Y/N) ; for Holding Tank High-Water Ala=m (Y/N) Temporary Holdir&3 Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Building Foundation To Disposal Field To Stream, Pond, Lake, cr Major D~ainage To Water-SupplyWell To Property Line To Water Main/Service Line Course Comments p~ LlO ~C~ ~ V%/~ ~ Receipt % Date Paid: Amount: [Page 1 of 2] 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absorption A~ea Depression over Field .!.Y/N) Results of Last Adequacy Test Type of System Design Length of Field Depth of Field Gravel Bed Thickness Standpipes P~esent (Y/N) Date of Last Adequacy Test Separation Distanc~ from Absc~ption Field: To Water-Supply Well To Building Foundation Lot To Water Main/Service Line To P~operty Line To Existing or Abandoned System cn ; On AdjoiningLots To Cutbank(if .present) To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes(Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Cora~ents ** Check Permitted Bedrocm Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA on the d~. of this/~pection. Signed ~ ~t~ ~D~ate t//~ /~. KB1/d5/s [Page 2 of 2] 2-15-84 ~II~I~IPAI I~Y (.JJ' '~,, DEPT, O~ I-'.SALTH & ~- MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL pROTECTiON DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION " % 82B L Street-Anchorage, Alaska 00501 SEP I 4 1979 ) ENVIRONMENTAL ENGINEERING DIVISION REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete ali parts on page 1. Incomplete reques~ will not be processed, Pl~a~e ~ll~'t~ (10) ~ay~ for ~0ce~J~ . ~ 1. PROPERTY OWNER I PHONE ~AILING ADDRESS PROPERTY RESIDENT (If different from above) PHONE 2. BUYER MAILING ADDRESS 3. LENDING INSTITUTION PHONE ~AILING ADDRESS 4. REALTOR/AGENT PHONE MAILING ADDRESS S. LEGAL DESCRIPTION J..oT- /o Cou,"e 7- I TR EET LOCATI ON ,p=2==t- cz mc_L. 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS ~ SINGLE FAMILY [] MULTIPLE FAMILY [] One [] Four [] Two [] Five ~] Three [] Six [] Other~ 7. WATER SUPPLY INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY * 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 available,) 8. SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON-SITE** ~ PUBLIC UTILITY **If individual/on-site, give installation date If system is over two (2) years old an adequacy test is required by this Department, NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED, 72-O10(3/78) THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED ' ' INSPECTION APPO.INTMENTS ~ ; ., TIME ' ~'" ~TIME · TIME ~ ' DATE,'. DATE DATE ' I NEPECTOR -' INSPECTOR 'blRECTIONS= ' 1. TYPE OF RESIDENCE I-'1' SINGLE FAMILY [] ONE r-'l THREE [] FIVE [] OTHER ,[] MOLTIPLE. FAMILY , [] TWO [] FOUR- ,_1'-I SIX · WATER SUPPLY PERMIT NUMBER ~ INDIVIDUAL! DEPTH OF WELL {~],~ COMMUNITY DATE DRIt~L~D · ' ' [~ PUBLIC UTILITY Connect on Verified, 'LOG RECEIVED ~' ~ ' ~ PERMIT NUMBER ~ - ' 3~ SEWAi3E DI~POS.~L SYSTEM · -' [] INDIVI DUAL/ON -SITE DATE INSTALLED []PUBLIC. UT L TY ' ,(~onnactlon Verified INSTALLER []Septlo T~ank-0r [] Holding Tank Si;~,;.,..~ If Tank is homemade ~OILS RATING 'OF'TANK TYPE ' MANUFACTURER TOT~,L ABSDRPTION AREA = MATERIAL 4.;DISTANCE8,-' '-~-~EL~'Tt3: ~ Septlc/Holdlng~Tenk. · Ab~orptlon Area Sewer Line [ I{Jearest Lot Line Absorptlo~ Area tO nearest Lot Line , ' CO ENT'" ~""'APPROVED FOR -'~ BEDROOMS [] CONDITIONAL APPROVAL (letter must ac ly certificate) [] DISAPPROVED LEGAh DESCRIPTI~)N 72-010 /78)