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Home My WebLink AboutCRESTVIEW VILLAGE BLK 6 LT 31L OIb ooo WELL CONSTRUCTION LOG Well location: (address & leaal description) 8~ ~~0 ~e Depth of well ~ ft. Casing: depth ~ ft. diam. ~ in. Finish of well: (open-end, screen, perforated, open-hole, other) Well yield tested by (DumDina, bailing, air) at ~ gal/min, for ~ hours with ~ ft. of drawdown from static level. Date well completed ~.O~m~lO~,~? Nearest community A~c)~eage Location sketch or remarks IV~UNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION OCT 2 6 1977' RECEIVED DRILLER'S MATERIAL LOG Oepth below land surface in feet o 9 ~ tO ~1'~ L,'5' to~ ~...~_._tc 66 Give description of strata penetrated (size of material, color, hardness of drilling, end water content) brown ttZZ ~.to ~to ~to ~.to to ~to ~to ~to mto ~tO ~to ~to to to mtO F'EFi:M 11" 1'40. I'-11_11'-.I T C: ][ F"RL. ]: "'l"'"r" t-IF- RI'-,Ii.~:HC-:iF~.'RI2-iE: [:,EF'RRI"P1ENT , HERLI"H RND EN',,,' I R-INf'IENI'FtL O'T'EF:I" I ON 8';.'5 '"~" STREET, RNC:H :~RRGE., RK. ~9.-~-----~1 279-2511 L,JELL F'E F-"£'1 I 'T ( 77782 > RF'F'L I CRNI" LOF:R'I" I ON LEGRL [:,RNIEL S WILLIRMS '-'=,_-,~,~:lb ....... LR VIENTO DRIVE LRVIENTO DRIVE LOl" ~l BLb CRESTVIEW VILLRGE S LOT '=;IZE ±5200 SQURF.:E FEE'I" MINIMUM DISTRNCE BETWEEN R WELL AND RNY ON-SITE SEWRGE DISPriSRL SYSTEM iS tOO FEET FOR R PRIVRTE WELL OR'. 200 FEET FOR R PUBLIC WELL. WELL LOGS RRE REQUIF4E[:, RND MUST E:E RE-I'URNE[:, TO THE DEF'RF.:TMEN¥ WITHIN ~:0 DRYS OF 'tHE WELL COMPLETION. OTHER F.'.EL.~.UIREMENTS MRY RPPLY. SPECIF'ICRTIONS RN[:, C:ONSI"RUCI"ION [:,IRGRRP1S RF.:E R',,,'RZLRBLE TO ~'NSURE PROPER'. !NSTRLLRT!ON. I C:ERT'IFY 'T'HR'T l- I RM FRMILIRR WITH THE RE6!LIREMENTS FOR ON-SITE SEWERS RN[:, WELLS RS SE1" FORTH BY THE MUNIC:IPRLITY OF' RNCHORRGE. 2- I WILL INSTRLL THE SYSTEM IN RCCOR[:,RNCE WITH THE CODES. RPF'~/IC:RNT DRIqlEL E '~'~ELI~MS -- I S S U E [:, ' ~v~ ~-"/( D~'T~RECEIVED TIME ~ APPOINTMENTS DATE DAT~' (3 J p~' DATE /~ ~ I ~/ MUNICIPALITY OF ANCHORAGE MUNICIPALI~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION DEPT. OF ENVIRONMENTAL ~ 825 L Str~- Anchora~, Alaska 99501 ENVIRONMENTAL SANITATION DIVISIONJAN 1 6 i98'1 Telephone 264~720 ~l 8fi~TIO~8: Complete all part* on pa~ 1. In~ompl~t~ mqu~ ~ill not b~ pro~d. Plea,e allo~ ten (10~ dag~ for 1. PROPERTY OWNER PHONE Flnvd I. ~hilan~kl 349-2748 MAILING ADDRESS 8506 LaViento Anchorage, Alaska 99502 PROPERTY RESIDENT (If different from above) PHONE Same Same 2. BUYER PHONE David H, & Katherine L. Kaminski 344-8318 MAI LING ADDRESS 8301 Spruce Anchorage, Alaska 99507 3. LENDING INSTITUTION I PHONE Security National Bankm 276_6800 MAmLmN~ ADDRESS 880 H Street ARch0~aqe~ Alaska 99501 4. REALTOR/AGENT I PHONE 1021 W. 25th ~venue gnchora~e, ~laska 9~503 LEGAL DESCRIPTION Lot 31. Block 6, Crestview Village Subdivision STREET LOCATION 8506 LaVient~ 6. TYPE OF RESIDENCE SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF~BEDROOMS [] One [] Four [] Two [] Five I~1 Three [] Six [] Other 7. WATER SUPPLY [] INDIVIDUAL* 125' [] 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 YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) il. TYPE OF RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY 2. WATER SUPPLY [] INDIVIDUAL [] COMMUNITY [] PUBLIC UTI LITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM [] INDIVI DUAL/ON -SITE l--i PUBLIC UTILITY Connection Verified [--]Septic Tank or ['-]Holding Tank Size: If Tank is homemade give dimensions: TYPE OF TANK TOTAL ABSORPTION AREA 4. DISTANCES WELL TO: Absorption Area to nearest Lot Line THIS SIDE FOR OFFICIAL USE ONLY NUMBER OF BEDROOMs [] ONE [] THREE [] TWO [] FOUR [] FIVE [] SiX PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER DATE INSTALLED INSTALLER SOILS RATING MANUFACTURER MATERIAL Septic/Holding Tank IAbsorption Area Sewer Line [] OTHER Nearest Lot Line 5. COMMENTS [~APPROV ED FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) r--i- DISAPPROVED DATE 72-010 (Rev, 6/79) Time Date In sp 'mUNICIPALITY OF ANCHORAGE " 'DEPARTMENi,--~F HEALTH AND. ENVIRONMENTAL..~PROTECTION 825 L Street, Anchoraoe. Alaska 99501 264-4720 Date Received: November 7, 1977 9:30 a.m. #2: Time #3: Time 11-10-77 Thursday Date Date Willis Insp Insp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES Lending Institution Request: United Bank Alaska Mailing Address: 645 G Street 99501 Phone: 276-1911 2. Property Owner: Ok Sor Stokes Phone: 344-1857 Mailing Address: 8506 La Viento 99502 3. Legal Description: Lot 31 Block 6 Crestview Village Subdivision 4: Single Family Residence: (x) Number of Bedrooms: Three Multiple'Family Residence: ( ) Number of Bedrooms: 5.. Well System: Individual Well (x) Community/Public System ( ) e Permit # Depth of Well 66' Well Log on File Construction Sewage DispOsal System: On-site System ¢~.) Permit # Installed Septic Tank Size Absorption Area Bacterial Analysis Installer Manufacturer Soils Rate Material Distances: Well to Septic Tank to Absorption Area to Sewer Line Nearest Lot line Absorption Area to Nearest Lot Line Page Two Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 31 Block 6 C~ ~ bdivis-i~nn- Comments: Affadavit Attached: ( ) Letter Attached: ( ) - ~ ~k~~ Date', [~_~ APproved: ~[__ ,~, ~.3~; ' - ' I ' r ! Disapproved: Date: Department Worksheet: ' '~=-quest for Approval of Individual Sewer and Wat~Faci~i~[i~es · "~--'MUNICIPALITY OF ANCHORAGE,,_,, l Ol ~ Department of Health and gnvzronmental!.,Pro~'~on. '"'~ ' 825 L Street, ~chorage, Alaska 99'~'~ ,,~.'. ,r-.-~..~ · Mailing Address: ~~ ~ &~ ~/~ ~~ Phone: Name of Buyer: Mailing Address: Phone o Lending Institution: Mailing Address: Phone: ~P~-/~// Realtor/Agent: Mailing Address: ~/¢ ~ .~"- -~---. o Legal Description: . .~,~/ Street Location: ~O Single Family Residence: Multiple Family Residence: ( ) Number of Bedrooms: o Water Supply: * Individual Well ~>~ Public/Community System If Individual Well, well depth ~~ &~( If Community System, name of system ( ) Sewage Disposal System: *~n-site System ( ) If On-site System, date of installation: Public System *NOTE: A well log is required on ALL wells drilled since 6/75. ** If on-site sewer system is over two(2) years old, an adequacy test is required by this department. A fee of $25.00 must accompany each reques,t before processing can be initiated. 3/77 - MUNICIPALITY OF ANCHORAGF . J DEPARTME OF HEALTH AI~ ENVIRONMEN ~- 82~'-- L Street//~q. horage, Alask'~a ~ 279-25~~,o-/224 or 225 ' [~ ~ .~ Date Received: Date -U-77 Date PROTECTION 99501 May 26, 1977 Time Date Insp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES Lending Institution Request: Lomas and Nettleton Company Mailing Address: 4449 Business Park Boulevard Phone: ~' 2232 2. Property Owner: Daniel K. Williams Phone: Mailing Address: % Town and Country Realtor, 3. Legal Description: Lot 31 Block 6 Crestview Village Subdivision 4: Single Family Residence: ( ) Number of Bedrooms: Multiple Family Residence: ( ) Number of Bedrooms: 5. Well System: Individual Well ( ) Community/Public System Permit # Construction Bacterial 6. Sewage Disposal System: On-site System Permit # Well Log on File ( ) Inst~lled Public Utility Installer Septic Tank Size Manufacturer Absorption Area Soils Rate Material Distances: Well to Septic Tank to Absorption Area to Sewer Line Nearest Lot line Absorption Area to Nearest Lot Line ~page. Two ~ ~ Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 31 Block 6 Crestview Villaqe Subdivision Comments: Affadavit Attached: ( ) Letter Attached: ( ) Approved: ~_~ Date: ~/~7 ? _ ate: v Disapproved: ~ . _ , , , ,. ........... Department Worksheet: ?~UNICfPALiT,' OF '" , DEPT. MUNICIPALITY OF ANCHORAGE OEe^. ME.T OF .E^'T. ^.O e.OTECT O. 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 REQUEST FOR APPROVAL OF ~ E C INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO VA ~(,,. FHA 2. Property Owner: ~ ~_ ~ ~. -~vlailing Address: ~~/ ~ Day Phone: 3. Name of Buyer: ~ff~ Mailing A~d~essl Name of Lending Institution' Mailing Address: Y///~.~ ~/.~.~..~.~.~//2.~, ~. Phone:~_ ~/_~// §. Name of Realtor or Agent:~7~-/~. Mailing Address: Phone: 6. Legal Description: ~,/~/ _,~/~-~ ~ ~ _~~c/'-~ ?.~~ Location: ~7511~ ~ 7. Type of Facility to be Inspected: 8. Water Supply No. Bdrms. Type of Supply: Public Utility If Individual, number of dwellings presently served If Individual, depth of well Sewage Disposal System Type of System: Public Utility If Individual, date of installation .Individual Individual (on-site) 72-003(3/76)