HomeMy WebLinkAboutFIRE LAKE BLK 3 LT 9AFire Lake
Block 3
Lot 7A & 9A
#015-361-20
015-361-27
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: OSP251233
Work Type: Septic Upgrade
Tax Code Number: 05136127000
Site Legal Address: FIRE LAKE BLK 3 LT 9A G:0453
Site Mailing Address: 18034 MACLAREN ST, Eagle River
Owner: ALBA RESTORATION LLC
Design Engineer: FORGE ENGINEERING
This permit is for the construction of:
Z Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy
Effective Date:
Expiration Date:
7/29/2025
7/29/2026
Lot Size in Sq Ft: 31450
Total Bedrooms: 10
❑ 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:
1. This property recently sold without the benefit of a COSA. Please apply for a COSA for this property per
15.55 and 15.65 in order to close out this permit.
2. Confirm location of water well on FIRE LAKE BLK 3 LT 7A prior to construction.
3. A test hole is required prior to construction of the absorption field, in the location shown on the site plan, to
confirm minimum separation to impermeable soil and seasonal high groundwater, as well as percolation
rate. Construction may proceed at your own risk prior to 7-day groundwater monitoring. If results require
a design change, construction shall stop pending approval of a change order. Please submit results with
the inspection report (or change order, if required).
Received By: Date:
j
Issued By: i/ Date:
MUNICIPALITY OF
Development Services Department
On -Site Water & Wastewater Section C*
ON -SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 051-361-27
Phone: 907-343-7904
Property owners) Alba Restoration LLC Day phone 907-521-9777
Mailing address 741 West 75th Ave #3, Anchorage, AK 99518
Site address 18045 Mendenhall St
Legal description Fire Lake, Block 3 Lot 9A
Number of Bedrooms 10
Engineering Firm Forge Engineering
Building Permit Number
Not Applicable ❑
APPLICATION IS FOR: APPLICATION IS AN:
(Z all that apply)
Absorption Field 0 Initial ❑
Septic Tank El Upgrade
Holding Tank ❑ Renewal ❑
Privy ❑
Well ❑
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
Distance:
Permit/Rush Fees: t Sq S Waiver Fees:
Date of Payment: 71141 Date of Payment:
Permit No. 02fl)33 Waiver No.
July 28, 2025
MOA Development Services, On-Site Water & Wastewater Program
4700 Elmore Rd
Anchorage, AK 99507
Subject: Fire Lake, Block 3 Lot 9A – 18045 Mendenhall St
Septic system design
Dear On-Site Services Engineer:
The owner of the above lot owns an 8-bedroom and a 2-bedroom house on this lot. The existing
septic system is too small to serve the bedroom count, so we are submitting this permit application
for the construction of a new septic system. The attached site plan identifies the location of the
home as well as the proposed septic location. No conflicts exist between this proposed system and
any other well or septic system, whether on this lot or adjacent lots.
The ground surface on the lot has a mild slope from the east to the west. There are no slopes greater
than 25% within 50 feet downslope of either the primary or alternate site. Contours are shown on
the site plan showing the grade and direction of flow. Stormwater drainage will not impact this
septic system. The new trench will be constructed parallel to the slope as much as possible.
The existing plot plan shows the gravel driveway in the area where the new septic system will go.
Although it’s possible that the drive will be shifted away from the septic in the future, we have
specified 4” of insulation over the trench while under the driveway. Typically, 1” of insulation is
considered to provide the same frost protection as 1’ of soil. With 4” of insulation, and 3’ of cover,
the lateral for the trench will have the same frost protection as minimally required for a public
sewer line (6’ of cover). This will be sufficient to prevent freezing under the driveway.
Wells on this and adjacent lots are shown. The new system will be a minimum of 100’ from all
wells and surface water, and more than 5’ away from the septic tank. Please refer to the attached
test hole log, plan and profile pages for the septic design. If this design is followed, there will be
no adverse impacts to adjacent properties.
Sincerely,
Benjamin Schiller, PE
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP251233, Curtis Townsend, 07/29/25
Benjamin Schiller
CE 12592REGISTEREDPROFESSION A L E N GINEER
1"=50'
CO - CLEANOUT
2CO - DOUBLE CLEANOUT
FCO - FOUNDATION CLEANOUT
FS - FLOW SPLITTER VALVE
MH - MANHOLE
MT - MONITORING TUBE
SV - SEPTIC VENT
TH - TEST HOLE
LEGEND
FIRE LAKE, BLOCK 3 LOT 9A
FEET
0 50 100
8-BDRM DUPLEX
SEPTIC PLAN
7/8/25
MENDENHALL ST
10' UTILITY EASEMENT
438 436
434
432
430428
426
424
422
FIRE LAKE
ELEMENTARY
SCHOOL
HARRY J MCDONALD
MEMORIAL CENTER
VACANT
ALL NEARBY
WELLS SHOWN
WITH 100' RADIUS
DECOMMISSION EXISTING
TANKS
3000-GAL STEP TANK
(2) 65' LONG X 5' WIDE,
4' EFFECTIVE DEPTH
TRENCHES
2-
B
D
R
M
INSTALL FCO TH#1
MTMT
MT
MT
FCO
ENSURE 100' SEPARATION
FROM EXISTING WELL
EXCAVATE TRENCH, REMOVE
ALL ROCK AND BACKFILL WITH
IN-SITU MATERIAL
FCO
ENSURE 10' SEPARATION FROM
FOUNDATION TO TANK
CONFIRMATION
TEST HOLE TO BE
DUG PRIOR TO
INSTALLATION
ADD DRIVEABLE CAPS
OVER MT'S WHERE IN
DRIVEWAY
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP251233, Curtis Townsend, 07/29/25
FIRE LAKE, BLOCK 3 LOT 9A
TYPICAL TRENCH SECTION
(NO SCALE)
NOTES:
1. GRADE AREA OVER TRENCH TO DRAIN AWAY
2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2'
WITH 2" OF INSULATION
3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER
THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY
Benjamin Schiller
CE 12592REGISTEREDPROFESSION A L E N GINEER
DESIGN FACTORS:SYSTEM REQUIREMENTS:
1500 GPD PEAK FLOW
PERK RATE: 5.0 MIN/IN
APPLICATION RATE: 1.2 GPD/SF
5' WIDE TRENCH SYSTEM
3000-GAL STEP TANK
BOTTOM OF TRENCH: 7.5' BELOW GRADE (8.0' MAX)
FLOW LINE ELEVATION: 3.5' BELOW GRADE
1500 GPD / 1.2 GPD/SF / 5' WIDE * 0.5 RED FACTOR [4.0 DEEP] = 125.0 LF TRENCH REQUIRED
(130.0 LF SPECIFIED)
7/8/25
4'
6"
3'
GEOTEXTILE FABRIC w/ 4"
INSULATION UNDER
DRIVEWAY
DRAINFIELD ROCK
1 1
4 PVC w/ 1
8" ORIFICES
SPACED 6.5' OC
PROVIDE ADDITIONAL FILL TO
ACCOUNT FOR SETTLEMENT
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP251233, Curtis Townsend, 07/29/25
LEGAL DESCRIPTION:
PERFORMED FOR:
DATE: PARCEL ID#:
SOILS LOG AND PERCOLATION TEST
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
DEPTH
(feet)
TEST HOLE 1
DATE READING NET TIME
(minutes)
DEPTH to
WATER NET DROP
PERCOLATION RATE: (MIN/INCH)
(inches)(inches)
DATE OF MONITORING
DEPTH TO WATER AFTER MONITORING
5.0
6/25/25 1
2
3
4
5
6SM (SILTY SANDY GRAVEL)
Professional Engineers Stamp:
FIRE LAKE, BLOCK 3 LOT 9A
6/25/25 051-361-27
JANI QOSJA
159 8
16
OB
10
Benjamin Schiller
CE 12592REGISTEREDPROFESSION A L E N GINEER
PERC TEST LOCATION
TECHNICIAN: JUSTIN EARLS
165 8
16
NONE
7/2/25
COMMENTS:
SITE PLAN
2 3
16
USCS SOIL CLASSIFICATION WAS VISUALLY DETERMINED
7/8/25
MOISTURE NOTED AT TIME OF DIGGING?NO
2 2
16
2 2
16
2 1
16
2
2
159 8
1610 165 8
16
159 8
1610 165 8
16
159 8
1610 165 8
16
159 8
1610 165 8
16
159 8
1610 165 8
16
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP251233, Curtis Townsend, 07/29/25
MUNICIPALITY OF ANCHORAGE
K�l
Development Services Department �� % Phone: 907-343-7904
On -Site Water & Wastewater Section
May 7, 2025
ALBA RESTORATION LLC
741 WEST 75TH AVE. #3
ANCHORAGE, AK 99518
Subject: Legal Description: FIRE LAKE BLK 3 LT 9A
Dear Owner:
Our records show that this property recently transferred ownership without the benefit of a Certificate of On -
Site System Approval (COSA). This means the systems involved are out of compliance with Anchorage
Municipal Code 15.55 and 15.65 (AMC). A COSA is now required to be obtained for this property.
It is our understanding that a private well serves this structure and is located on lot 7A and a septic system is
located on this lot 9A.
Please contact our office within 30 days to inquire how to obtain a COSA. The Onsite Water and Wastewater
Section will do what we can to help you make the private water and septic system approved to operate.
Sincerely,
Curtis Townsend
On -Site Water and Wastewater Section
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 PHONE [] NEW
R~_.~.~./' ~[~'-~"---~ ~'~'--~'~;~'~/ I~'UPGRADE
LOCATION NO, OF BEDROOMS
Well l. Absorption area Dwelling PERMIT NO, '"
~ ~, DISTANCE TO: ] /~O ~ '/] /~ / ~ / /
~ Z Manufacturer Material No, of compartments
~ [Liq. capacity in gationsV ' ~ I Insid~length ]~¢th Liquid depth
~ ~ ] D STAN-E T~ Well ' [Dwelling %} PERMIT NO.
~z ' ~ ~: I
~ ~ ~ Manufacturer ] Material Liquid capacitv in gallons
Q I Well ~ /' Foundation ¢ I Nearest lot line ~ PERMIT NO,~ .~,~
~ ~ [ DISTANCE TO: I /~ / ~0 ] /~ ~
~ ~ Z I No, of lines Lenoth of each kine Total length of ines ¢~rench width Distance between i~es
~ ~ ~e to finish grade Material beneath tile .. Total effective absorption area
~ I ~gth Width Depth PERMIT NO.
~ I Ty~ ¢ crib Crib diameter Crib depth I Total effective absorption area
~ ] Well Buildingfoundation t Nearestlotline
I TO: I
~ ]Class u ~ ~' Depth ~ Driller ~ d Di~t~.ee to lot line PERMIT NO.
~ J ~NCE TO Building foundation Se~er line / Septic t~nk Absorption ~re~(s)
/
OTHER
PIPE MATERIALS
SOIL TEST RATING
INSTALLER
REMARKS
APPROVED
72-013 (Rev. 3
MUNICIPALI
DATE
LEG~[
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,. ............. , II ,I, . I?f" P,I E:FITEC PI'IfL'INE: u uc,- _..,.,
, i,....~......~ .......... DO',::; '....ub ,"
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.... ~ ~ '[ ..... ~,.,.~ ...I..II ..... 4 .... E LFII'":K · '
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,_L, ~ E; I Z.E "~ ':?' ~' "-"~' ' ~
......,. , ,. TOI4N:3HI P: i._ N RFtNI3E: ;2H SECTION:
...,,-,,.., .~ ~..,, ,,.., ~ ~- r.,,=. ~, OF DE'.E:,RI3111M'.S = C', fi;C I L RFIT I NG = '='~i ':"~ ':'5 .... '
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~UNICIPALITY OF ANCHORAGE
Department Health and Environmental rotection
825 L Street, Anchorage, AK. ~J501
264-4720
?O ?) ~: HANDWRITTEN PERMIT * * *
Z~~ ~-SITE SEWER PERMIT
Permit
Applicant: .~','~ L~"]'-J~---~ Mailing Address:._. ~)~_~7 .~2~"~.,.
Location: Phone Number:
Legal Description: ~' ~ ~ ' ~t Size:
Type of Soil Absorption System Is:
Trench: /Drainfield: _ S_~_eepage Bed~ Holding Tank:
Maximum Number of Bedrooms: ..~~ Soil Rating(sq.ft/br)
The Required Size of t~e Soil Absorption System Is:
DEPTH ~?'' '~ ~
LENGTH . GRAVEL DEPTH ~' 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 outfall pipe and
the bottom of the excavation(in feet). ~X~5~
· * REQUIRED SEPTIC(HOLDING) TANK SIZE TM /~--'~f]) GALLONS * *
Permit applicant has the responsibility to inform this department during the
installation inspections of any wells adjacent to this property and the number
of residences that the well will serve.
· * * TWO(2) INSPECTIONS ARE REQUIRED * * *
Backfilling of any system without final inspection and approval by this departme~
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 fe~
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 31, 1 9 $ 3 * * *
I certify that:
(1) I am familiar with the requirements for on-site sewers and wells as
(2)
(3)
S igne~:
set forth by the Municipality of Anchorage.
I will install the system in accordance with codes.
sewer system may require enlargement if
I understand that the on-site include more th~ bedrooms.
the mesideEce,i~ remodeled to
Applicant
/
SWP/024(1/81)
FFLI_.HN F SHAi'"IFIN CONST INC
i'"iLII'-.I :[ C: ]: F"RL_ I T"'r' '_-iF= RI'-.IC:HEqF.:Rm3E
[:,EF'RF.:TMENT i.- HERLTH RNE:, ENVIRONf'IENTRL .)TECTION
825 "' L STREET., RNC:HORIRGE., Ri,::. 995~-.:..'H
264-4720
SElL. lEE: F"EF-: I".1 I T
SR'I BOX 3465 KLONDIKE ST 9_'9.567 688--2658
L 0 iS: FI T I 0 N
LEGRL L9R E:~:-'~IGY'i~F: FIRE LRKE
TYF'E IZIF qlalL HE,_-,U~.FTION -,T_,TEM IS: [:"RRINFIELD
LOT SIZE 9999'~9 SO!UFIRE FEET
I1H,.,IIIJtl NUMBER i3F BE[:,ROOf'IS = .$
SOIL RRTING ,::S6! FT,,"BR)= '14Ct
THE RE.::qJIRE[:, SIZE OF THE SOIL HE,=,_F. FTIUN S"r'STEM IS:
E::" E F" 'lr' FI = .'~1: L E I%i mZi-F H= 82 G E:R'..." E L E:,EPTH=
'THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR [:'RRINFIELD.
THE DEPTH OF' R TRENCH OR PIT IS THE [:,ISTRNCE BETWEEN THE SURFRI_-:E OF THE
GROUND RN[:, THE BOTTOM OF THE EXCRVRTION (IN FEET).
T H E T F-: E ~-,! mS: H L.J I [:, T H I S 5. L__.'~ E'~ ~3 F E E 'IF ..
'THE GRFtVEL DEPTH 'IS THE MINIMUM DEPTH OF ORFt',,,'EL BETWEEN THE OUTFFtLL F'IPE
FIN[:, THE BOTTOM OF' THE EXCFfv'RTION ,:.'IN FEET.'.',.
Y.:"~;k--:'!mJ I I-~:FE) 2';EF'T I ~:: T FtI'-.Ik--'. $ I ZE= :.IL 5 v:~ ¢.::~
PEF.:MIT RF'PLICRNT HRS THE RE_,FUN:,IE, ILIT¢ TO INFORt'I THIS E:,EF'RF.:ThlENT [,_RINI3 THE
IN=,THLLMTIUN IN-',FEE. TIUN=, OF RNY WELLS R[:,..TRCENT TO THIS ' '¢ ' '
FRJPEF..T~ FINE:, THE
NIJMBER OF RE=,I[.EHL. E=, THFIT THE WELL WILL SERYE.
........ T I-.-I I_-). ':: '; ::, F;
Z I I'-.ISF"EC:T I m_-m[-,IS F-:E F-:Em_--!LI I F~-"EE:, ........
BRIZ:KFILLINI3 OF RNY SY'-'iTEM WITHOLIT FINRL IN_-,FEUTIF~N AND RFFF._ ~L BY THIS
[:,EF'FtRTMENT WILL E:E SUBJECT TO PR. OSEZ_TI_'N.
PIlNII'"IUM DISTRNCE BETWEEN R WELL RND ANY ON-SITE SEWRGE DISF'OSRL SYSTEH IS
· '100 FEET FOR R F'RIVRTE WELL OR 150 TO 2E~0 FEET FROM R PUBLIC WELL [:,EPENDING
UPON THE TYPE OF PUBLIC WELL
HINIMUH DISTRNCE FROM R PRIVRTE WELL TO R PRIYRTE SEWER LINE IS 25 FEET' FIN[:,
TO R COHr,IUNITY SEWER LINE IS 75 FEET.
OTHER REC..!UIREMENTS WRY RPPLY. SPECIFICRTIONS RN[.', CONSTRUCTION [:,IRGRRMS RRE
RVRILRBLE TO INSURE PROPER INSTRLLRTION.
F"EF~:I',I I T' E:-::P T F~E$ E:,,Em-:EI"IBEF;~: ---=:::L..
I CERTIFY THRT
±: I FII"I FRMILIRR WITH THE REO!UIREMENTS FOR ON-SITE SEWEF.:S RN[:', WELLS RS SET
FORTH BY 'THE I"IUNIC:IF'RLITY OF RNCHORRGE.
2: I HILL INS'TFILL THE SYSTEM IN RCCORDRNCE WITH THE CODES.
2:: I UNDERSTRN[:, THRT THE ON-SITE SEWER SYSTEM MFIY REQUIRE ENLFIRGEMENT IF' 'THE
RESIDENCE IS REPIO[:,ELE[:, TO INCLUDE MORE THRN 5 BEDROOMS.
· '"~kISSUE[:' BY ~/ ._[:,RTE_ M b,~e-T ~.) 1 L) ?-/~ 'v'4.
7125 0Id Seward I-~.. Anchorage, Alaska 99502
· · 349-B561
;.
SOILS LOG -- PERCOLATION .TEST
~/ SOILS LOG
PERCOLATION
TEST
PERFORMED FOR: '~'~, {~ ~'~
LEGAL DESCRIPTION:
O-0,5
!
2
4
5
6
.7
9
SLOPE
SITE PLAN
1
10
11
12
13
14
15
16
17
18
19
6~/~V~-'"/... /~U/7'h/ ..~/~-'T Z4~..~UNTERED?
IF YES, AT WHAT
OF
1834,.E
Reading Date Time Time
Depth to
Water
Net
Drop
20
COMMENTS
PERCOLATION RATE
TEST RUN BETWEEN
FT AND -- FT
PERFORMEDBY:~jI ~, ~,l'~Jl~ ,"~ CERTIFIEDS¥: DATE:
SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
PERCOLATION
TEST
.EREORMED EOR: V
LEGAL DESCRIPTION: [.0~ qA j IC~LOC,(~. ~, L)PPiZ/~ I=I/2E L,q,~.E %dtT.
1
2
3
4
6
7
'-----8
9
10
11
12
13
14
15
16
17
18
19
20
5 I L:-F ToP
SLOPE
WAS GROUND WATER S
~-;IOTY C~ Pr~4b ENCOUNTERED? /Jo L
O
E
IF YES, AT WHAT
DEPTH?
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE
TEST RUN BETWEEN
A/ o
)
COMMENTS '~L~?E ,~7' ,Pi?- ~ ~%
(minutes/inch)
FT AND __ FT
PERFORMED BY:
72-008 (6/79)
DATE:
G~CATER ANCHORAGE AREA BOROI'~H
HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
614
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
DISTANCE FROM WELL
LIQUID CAPACITY
ADDREssMAILING .~.3/./~_~/.../../..~_~.~.....;.~_. ~..~,~_.. PHONE~..~_~_..~,~
LEGAL DESCRIPTION /~-~'-~-~-' .~'~_~-; ,.,"~,~- ~..~..-J~/,~=
GALLONS.
NUMBER OF
MATERIAL ~ ~')~7 '-~-c~"~/-~ '~ c'~-;-~' COMPARTMENTS
INSIDE LENGTH //&J INSIDE WIDTH ~ /'
LIQUID
DEPTH
SEEPAGE SYSTEM:
NUMBER OF PITS / _OUTSIDE DIAMETER ~ OR WIDTH
L,N,NG MATER,A, ;1 .O,S ANCE FROM
NEAREST LOT LINE (~ ~ /
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
LENGTH/~/: , DEPTH ~
BUILDING FOUNDATION
SQ. FT.
TILE DRAIN FIELD'. /'~_//'/,/~'
DISTANCE FROM WELL ~ , F~I~O DATION , NEAREST LOT LINE
- \
TOTAL LENGTH
OF LINES
IN~F ECTIVE
DEPTH: TOP OF TILE TO FINISH GRADE
DEPTH OF FILTER MATERIAL BENEATH TILE
IN. ABOVE TILE
W E L L:
TYPE ~,~/~-~-Z' , DEPTH ~ i
LOT LINE /~ /~ NEAREST SEPTIC
SEWER LINE~ ~
. , . TANK
DISTANCE FROM
, BUILDING FOUNDATION./'~') /7/~ WATER
SAMPLE //~'~ , NEAREST
~'/ / SEEPAGE / ---'(-~/~/~/~. OTHER.~dZ/~..~'.
, SYSTEM /z/)~/~ , CESSPOOL ~/ , SOURCES~J~
DISTANCES:
DIAGRAM OF SYSTEM
DATE APPROVED~"~-------~'~'"~'~'~ ~' HEALTH AUTHORIIY '
GREATEI ANCHORAGE AREA ' DROUGH
HEALTH DEPARTMENT
327 Eagle St. Anchorage, Alaska 99501 279-2511
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
Case No.
,~ o
NAME OF APPLICANT
RESIDENCE ADDRESS
LEGAL DESCRIPTION
APPLICATION TO INSTALL: SEPTIC TANK
~ /~ ~¢~r~'~- MA,,,NG AOORESS ?~,~~ . PHONE NO
u~", SEEPAGE PIT ~, DRAIN FIELD , OTHER
TO SERVE THE FO~LOW,NG FAC, L?[ ~_T ~Z£~ ~
FINANCEO THROUGH ~-~,/t~ TO BE INSTALLED BY
PERCOLATION TEST RESULTS ['~ C'~/~''~ ANTICIPATEB DATE OF COMPLETION' --c"~ ,~,..~2.~..¢.2~./~.~d.
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
THIS IS TO SERVE AS ¢;~'~7-'2, /(~:"~/~--~ , PERMIT TO INSTALL A
AsDEscRIRED B Lo~b-~W. SIZE OF UNIT TO BE/SERVED
· SEPT,C TAN. S,ZE /'~7~'> TYPE ~'~,~'.~SSEEPAGE AR~A
DIAGRAM OF SYSTEM
DISTANCES:
~/~./
Health Authority
]~certi£y that I am £amilia~ with the requ~¢ments of G~eater Anchorage A~ea Borough O~dJ~ance No. 28-68 and that the
above described system is in accordance with said code.
DATE
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DTI000333
106-12
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S¢cton 36 T0w~hn 5Xorth Range 2 Wes Seward Mend~
Area: 35 69 Acres (l~,ng Tract A ) ~re Lake, Alaska
D'Tt000335
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