The URL can be used to link to this page

Home My WebLink AboutCEA HILLSIDE SUBSTATION TR A GRF ''ER ANCHORAGE AREA BO 'UGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME ~/*¢?././~,~//6/Z ""/'/-/~ ' ~ MAILING ADDRESS~ >~' g'/~ ~ '- LOCATION ~'/-~'~;~/ (~'' -~" LEGAL DESCRIPTION --' '., DISTANCE / FROM W ELL.,'/'-/; ~''~ MANUFACTURER MATERIAL NUMBER OF COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH I_IQUID CAPACITY / / Z-~:'" GALLONS. SEEPAGE PIT: NUMBER OF PITS __ DIAMETER __ LINING MATERIAL ~ {,~zz~:~, CRIB SIZE: BUILDING FOUNDAT ON ~?' NEAREST LOT LINE ADDITIONAL ABSORPTION .OR WIDTH' ~' LENGTH'~'~::~ DEPTH " / /J/:/ :'. '.~. DIAMETER DEPTH c,- DISTANCE FROM: WELL ' TOTAL EFFECTIVE _~ ,- ABSORPTION AREA (WALL AREA) ~ / SQ. FT. WELL: TYPE //~A'/'z'~/'/"~"/': ~/,~<?z CONSTRUCTION ~/~'.'~/~'/-~ ~'///"~'~.~"~ ~' BUILDING // NEAREST /./ NEAREST ,~ FOUNDATION/X/ LOT LINE //' SEWER LINE //' CESSPOOL OTHER SOURCES APPROVED DISAPPROVED REMARKS -'~ Z' DISTANCE FROM: SEEPAGE - ~ , '/. SYSTEM . /'. ') ' DISTANCES: >~'/~'/¢ '~' ~' ~/ INSTALLED BY: ¢¢ PIPe MATERIAL: LOT SLOPE: REMARKS: Form No, EQ.O31 DIAGRAM OF SYSTEM T' '-w_ ~".- .. I' ~ ~ .... - ~ ~ '~ ~ ~ / ~;' ..~:', :,:.. ~ -. , DATE cf'/'~,/,~3 APPROVED ( * -'~ ~ ~"~ G.A.A.B. GRE. ~r ANCHORAGE AREA BO 'Jgh DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-456! SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT PERMIT NO. INSTALLATION OF: SEPTIC TANK SEEPAGE PIT , DRAIN FIELD ., OTHER ~'~;~t'~'~'/ TYPE AND SIZE OF FAC'LITY TO BE SERVED*~'~/ ~ ~ ~ ~' '~ ~'' ~' SOIL TEST RESULTS ~~ ~/~ NOT~, TH'~ PERMIT 1~ NOT VALI" WITHOUT ~OlL TEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE /~'~'~I '~'/~ P~''~ J? r"~ '~ / SEEPAGE AREA SIZE ~_ ?~ TYPE MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT '5 SEPTIC TANK , SEEPAGE PIT TO NEAREST LOT LINE. WELL TO SEPTIC TANK DRAIN FIELD / ~ WATER MAIN TO SEPTIC TANK DRAIN FIELD DRAIN FIELD ~" DRAIN FIELD / SEEPAGE PIT ALSO CONSIDER AREA WELLS. , SEEPAGE PIT SEPTIC TANK, /~ ~'~ _ , SEEPAGE PIT DRAIN FIELD TO RIVER, LAKE, STREAM, CAST )ROn INTO AND OUT Of SEPTIC TANK AND INTO CRIB CROSSING GAP Of EXCAVATION ~ FEET INTO UNDISTURBED SOil. 4 INCH D~AMETER CAST IRON S~PHON PIPES ON SEPTIC TANK AND SEEPAGE P~T GRAVEL BACKFILL ~ CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. DIAGRAM OF SYSTEM I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA B O ANCE NO. 28-61~ AND THAT THE ABOVE DESCRIBED DY EM IS ACCORDANCE WITH SAID CODE. GAAB-HD-I G 'rER ANCHORAGE AREA BORO,. I U,.,,~fiTMENT OF ENVIRONMENTAL QUALI~, 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: MAILING ,,,,....~.~ · . . ____ADDRESS~ ~i]~L.-2~:~__~ ;"'~'-'>'(" PHONE J LEGAL DESCRIPTION ~/~:_~__/>//,,"/,'IC'f,~, ~1 &" ~_ DISTANCE FROM WELl__ /~("" LIQUID CAPACITY_ ./Z"~.' ('~ ........ GALLONS. NUMBER OF . MAtERIAl '(~)- ~'c'~'/. COMPARTMENTS INSIDE LENGTH ......... INSIDE WIDTH DEPTH~ SEEPAGE SYSTEM: SEEPAGE PIT: ,~'~'"~ t/. NUMBER OF PITS ....... / OUIS DE DIAMETER ' __OR WIDTII ............ LENGTH , DEPTH LININ(.g MATERIAL_d~' _("' ~ ~(~rJX ~"'~ ........... DISTANCE FROM WELL Z~: r ..... BUILDING FOUNDATION. NEAREST LO] LJNE._~.Z__ __ :~ ........ TO1AL EFEECTIVE ABSORPTION AREA (WALL AREA) SQ. FT. TILE DRAIN FIELD: TOTAL LENGTH DISTANCE FROM WELl .......... ..~ ,~UNDATION NEAREST LO1 LINE OF LINES NUMBER OF tINE DISTANCE BETWEEN LINES ..... WIDTH IN. TOTAL EFFE/C, TIVE ABSORPTION AR SQ. Ft. LENGTH OF EACEt LINE .... DEPTH: TOP OF TII. E TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH HLE IN. ABOVE TILE DISTANCE FROM ....~/ x WATER WELL.. TYPE/_~4-~,/// J..) .... DEPTH ,BUILDING FOUNDAIlON _'' _SAMPLE /~/¢'~'/,/.':, , NEAREST NEAREST SEPTIC SEEPAGE ,. OTHER LOT LINE =J~") ? "(~/(." __. SEWER LINE , TANK ..... CESSPOOl SOURCES DISTANCES: '."~ .' .,v/~ ~. -/~. DIAGRAM O[' gYSTEM / DATE TL... tNCHORAGE AREA · ROUGH 3/0 ltEALTH DEPARTMENT St. Anchorage, Ala~ 99501 . 279-2511 NAME OF APPLICANT )[~.~M ~ONZ~:t( MAILING ADDRESS q~ ~ h)~i~CPHONENO~'~ RESIDENCE ADDRESS LEGAL DESCRIPTION APPLICATION TO INSTALL: SEPTIC TANK TO SERVE THE FOLLOWING FACILITY FINANCED THROUGH PERCOLATION TEST RESULTS LOCATION OF INSTALLATION '""~, SEEPAGE PIT. ~'~,' DRAIN FIELD , OTHER. TO BE INSTALLED BY ANTiCiPATED DATE OF COMPLETION BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT THIS IS TO SERVE AS i~/lnS . ~/~O~J~/£'~_~ , PERMIT TO INSTALL A AS DESC~I~D3~. SIZE OF UNIT TO ,. SEPTIC TANK S~- /~ ~YPE SEEPAGE AREA __ ~ TYPE ~'~ DIAGRAM OF SY~ DISTANCES: Health Authority I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the above described system is in accordance with said code. TELEPHONE: 272-41t4 ALASKA GEOLOGICAL CONSULTANTS July 31, 1969 2227 SPENARD ROAD ANCHORAGE, ALASKA 99~O~ Mr John Konzek Star Route A, Box 471-J Anchorage, Alaska 99502 Re: Soil Percolation characteristics, Lot 6, Fairmount Subdivision Dear Mr. Konzek: This letter is to certify that an investigation of the soil percolation characteristics has been conducted on the above-mentioned property. It was determined at the time of the investigation that a percolation test was not necessary and the information enclosed herein reports the soil characteristics for the proposed sewer system. Location of the trailer house, water well, septic tank and cesspool excavation is shown on the attached Greater Anchorage Area Borough Health Department form. This investigation was made in accordance with the Greater Anchorage Area Borough Health Department specifications. Respectfully submitted, ALASKA GEOLOGICAL CONSULTANTS JAH:js El',C. James A .'Hamilton cc: .Greater Anchorage Area Borough Health Department GREATER ANCHORAGE AREA B6 HEALTH DEPAb:THENT 327 EAGLE STREET ANCHORAGE, ALASKA 99501 Performed For JohnKonzek Date Performed. July 3l, 1969 Legal Descvip-t-l-on':"Lot () Block Subd'ivlsion Fairmount This Form RepoPts a: So~--'~'/'J"Log X Depth -Percolation Test .Was Ground Water Encountered? If Yes, At What Depth %' 1 Reading Location Sketch Lo-t- Date Gross Time · ' ~in'ute' ' Ngt Time Depth To H20 t t Drop Proposed Installation: Seepage Pit X Drain Field Dept Of Inlet , Depth To Bottom Of Pit Or Trenc~ ~An~r~ COMMENTS: ' ' · ...... .. C~sspo. ol w~!! peT.fo~m adequately. Recommend extending cess~~~'~ to the_northwest to en;ou_p~r addiMgn/i 'gr~x)~l st(atu'm,w/~ich Wi'l'l i~sure'proper ip~sta[lati~on and functinn ~f the Oro~-i)se~t-i~eW~ system, ' " ~ GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality '% 3330 "C" Street Anchorage, Alaska 99503 274-4561 ~ ~'? Date Received ~9%- ~7~-~// ~ i ~ Time of Inspection //~,Z~ ~,~2 ~/ Date of Inspection !QUEST FOR APPROVAL OF DIVIDUAL SEWER & WATER FACILITIES FOR 1. Approval requested by: //~~/ Mailing Address: Phone: 2. Property Owner: Phone: Mailing Address: 3. Legal Description:~-~ 4. Location: 5. Type of facility to be inspected 6. Well Data: A. Type - ~ .~,'~ C. Construction 7. Sewage Disposal System: A. Installed C. Septic Tank: 1. Size D. Seepage Pit: Be No. of bedrooms B. Depth D. Bacterial Analysis B. Installer 2. Manufacturer 1. Absorption Area 2. Material E. Disposal Field: Distances: A. Well to: Septic tank Nearest lot line B. Foundation to septic tank Total length of lines , Absorption area , Other contamination , Absorption area C. Absorption area to nearest lot line , Sewer Lines 'Q-034 (1/74) Page 1 of two pages Ka~ 1~, 1~7S Ss. Cbt!trine east Totem ires1 ty S16 E FIrm~d Line Anchorage AK 00603 SUO~ECT: Lot 6, FitMt Subdivision (Fritz Property) An Inspection vis made of the su~ect prol~rty it ~tch ttm ~ Ktstt~ s~ s~tm ~s ~ as fnt11~. Thts ~r~t vtll ~t apple t~ SubJKt lot for ~1~ ficllttt~. If ~u ~ve a~ fu~her questions, please ~ ~t ~st~ ~ ~11 ~. Sincerely, Les Buchholz, R.S. Smnttartin LB/st cc: 0intel 1300 W. Anchorage, AK 9~503 GREATER ANCHORAGE AKEA BOROUGH Department of Environmental Quality 3330 "C" St., Anchorage, Alaska 99503 - 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES 1. Type of Inspection: 2. Property Owner: Mai.ling Address: CMRO VA FHA ,~/.~,'f~,~Z/'~L ~-/~.~(/~.- . Da.y Phon,e Mailing Address: /~'~ y~'~.. . ,~.J. 4. Name of Lending Institution: CONV Da_~.~ Phone Mailing Address: Phone Name of Realtor or Agent: Mailing Address: · ,.2~/~,'.,~-(2../f~,~ Phone /o~__. D ~. .~7/ o Legal Description: Location: , ~/"7-~./1~ 7. Type of Facility to be inspected:'/~/J,z~,--t--~,~,~ No Bdrms /~ -,.~,~ · . 8. Water Supply Type of Supply: Public Utility Individual If Individual, number of dwellings presently served / If Individual, depth of well 9. Sewage Disposal System Type of System: Public Utility If Individual, date of installation Individual (on-site) EQ-O37 (}/74) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION Environmental Health Division ON-SITE SERVICES SECTION CASE REVIEW WORKSHEET CASE NUMBER: DATE RECEIVED: 89-034 June 6, 1989 SUBDIVISION OR PROJECT TITLE: COMMENTS DUE BY: June 19, 1989 A request for variance from Section 21.35.020.B and 21.40.080.F for a lot width of 129 feet (150 required), and 10 foot high chain link fence with an additional barbed wire of two feet ( maximum of 8 feet high allowed), (Lot 7 Fairmont Subdivision) ( ) PUBLIC WATER AVAILABLE ( ) PUBLIC SEWER AVAILABLE ( ) COMMUNITY WATER AVAILABLE 71-014 (Rev. 5/83) ZONING BOARD OF EXAMINERS & APPEALS REQUEST FOR COMMENTS ON VARIANCE RETURN COMMENTS TO: DEPARTMENT OF ECONOMIC DEVELOPMENT AND PLANNING ZONING & PLATTING DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 DATE: June 1, 1989 343-4267 CASE TO BE HEARD: July 13, 1989 The Municipality of Anchorage has received applications relating to the following: CASE #89-034 XXXX A request for variance from Section 21.35.020.B and 21.40.080.F for a lot width of 129 feet (150 required), and 10 foot high chain link fence with an additional barbed wire of two feet (maximum of 8 feet high allowed). A request for change of use An appeal for Attached are copies of the proposed variance. Please submit your comments in writing, specifying any requirements that your department or agency.may need. Comments MUST reach our office by June 19, 1989 in order to be included in staff recommendations. SPECIAL DISTRIBUTION: CASE: PETITIONERs REQUEST: LOCATION: CURRENT ZONE: 89-034 Elmer and Gail McDonald A Variance to permit a 129 foot lot width when 150 foot is required (AMC 21o40.080.F.1); and, to permit a 12 foot high fence (10 feet fence and two feet barbed wire) when an eight foot maximum height is permitted (AMC 21.35o020.B.39)o Lot 7, Fairmount Subdivision; located north of Rabbit Creek Road and west of Golden View Drive. R-6 ((Suburban Residential District (Large Lot)) RABBIT CREEK COM/~3NITY COUNCIL Municipality of Anchorage DEPARTMENT OF COMMUNITY PLANNING P.O. Box 196650 · Anchorage, Alaska 99519-6650 ZONING VARIANCE OFFICE USE RECEIVED BY: ~/'~' ' Verify Owner // A. Please fill in the information requested below. Print one letter or number per block, Do not write in the shaded blocks. 1. Case Number (IF KNOWN) I,~l~l-ld.~ld I I I I Iii!1111111 Petitioning for Abbreviated legal description (T12N R2W Sec 2 Lot 45 or Short Sub BIk 3 Lot 34) full legal on back page. IFtak Irlmlolulnltl I,~klbl I',loltl 17111111111111 I t I I11 I I I I I I IIIII lli I I ! I ! I ~ftl'~l o Petitioner's Name (Last - First) J~.lllmlelrl laplal ISlalil:~l Idcl~lolnlatllalsl I [ ! I I i I I il 11 I I I I 111 I !li III Petitioner's Representative or Contact Person Iolhl~lglalolhl I~.kldcltlrlilol IAIskl°NI I II1[I Address P.o. Box 140321 Address P.O. Box 196300 City Anchorage State Alaska City Anchorage State Alaska PhoneNo. 344-4041 Zip 99514 PhoneNo. 564-0780 Zip 99519 6. Current Zoning 10. Hearing Date 7. Petition Area Acreage t~ t~,t~l ,~1 11. Principal Tax No, I! i !1 11 I! 8. Grid Number 9, Traffic Analysis Zone 12. No. Parcels 13, Fee $ 350.00 14. Community Council Rabbit Creek I hereby certify that (l am) (l have been authorized to act for) the owner of the property described above and that I desire a variance in conformance with Chapter 21 of the Anchorage Municipal Code of Ordinances. I understand that payment of the basic variance fee is nonrefundableand is to cover the cost associated with processing this application, that it does not assure, approval of the variance. I further understand that assigned hearing dates are tentative and may have to be postponed by Planning Staff or the Zoning Board of Examiners and Appeals due to administrative reasons. May 30, 1989 SIGN Jim K. Topolski 'Agents must provide written proof of authorization. Land Services Manager Chugach Electric Association DATE 20-032 (Rev. 6/87) Page 1 145 th AV TR Al RABBI T TR ~ R-3 SL A 0 ~4-21 \ () T~C~ C,L 3EN WC: The Zoning Board of Examiners and Appeals may only grant a variance if the Board finds all of the' following six (6) conditions are met. Each condition must havea response in as much detail as it takes to meet the condition. Please use additional paper if there is not enough room here for your response. The applicant hereby alleges that: Special conditions exist which are peculiar to this land, structure, or building involved are which are not applicable to other land, buildings or structure in the same district. These special conditions are: Chugach must install a distributionkin this vicinity. The location has been chosen to allow for integratinq the new distribution feeders into the existinq system with minimal new line construction and have the least impact on the community residents. Strict interpretation of the provisions of the Zoning Ordinance would deprive the applicant of rights commonly en[o_.ved by ott~er properties, i~n thy s~me distric,t u .n~er tb~ terms~otth,e,o.r.din_ance.,These rightsare: Ali of Fairmount SUDQiVlslon, on DO~n slaes o~ ~aDDi~ ~reeK Road, does not meet the minimum lot width required by AMC 21.40.080 F.1. The subdivision was recorded in 1960 prior to zoning of the area, and any conditional used allowed would necesitate a variance. The listed special conditions and circumstances do not result from the actions of the applicant and such conditions and circumstances, do not r0erely co, nstitute a, pecuniary (monetary) ha. rdship or inconvenience in that: The location is ~ne on±y avai-laD~e proper~y £n t~e area which meets the needs ~y ~h~ property owner. co~cern to Chu~ach. for the utility substation and is offered for sale The need to have a willing seller is of prime Granting the variance would be in harmony with objectives of the Zoning Ordinance and not injurious to the neighborhood or otherwise detrimental to public welfare for the following reasons: Distribution substationEare necessary and need to be located in areas where the consumers are. The requested Ten Foot (10') security fence is to prevent unwarrented access by curious or malicious actions. 5. Granting the variance _will .not~l~e. rmit a ,useth. at is not otherwise, l~ermitt_ed in the d:i~tr~c~n which the property lies in that: ~ U'C:Li~.r.y suDsr, at~.on ~.s a conct:].:::].ona.L use R-6 zone per 21.040.080 D.2. Thevariancegrantedisthe minimum variancethatwillmakepossibleareasonableu~e of,theland, buildingorstructureinthat: The utility substation will meet all set back requirements of the R-6 zone and will replace the existing abandoned housinq site which currently exists. 20-032 (Rev. 6/87) Page 3 / 89 B F 39 1 C. Additional documentation submitted: x 1. As-built or proposed site plan to scale 2. Building floor plans to scale x 3. Building elevations 4. Photographs x 5, Topography map of site 6. Building Permit 7. Other items D. Date discovered variance needed 5 / 17 E. Code citations involved: AMC 21. 35 020 AMC 21, 4O O8O AMC 21. AMC 21. AMC 21. AMC 21. F. The existing'situation is vacant lot, previously utilized by a mobile home, which burned and has partially been removed. G. Granting this variance would permit a utility substation to be constructed on the property, subject to a Conditional Use approval and allow a Ten Foot (10') chain link security fence with Two Feet (2') rolled razor band to be ~nstal%ed. qrQund thC perimeter of the substation Dad. H. ~ease moicate De,ow to theoe~t of your knowledge if any of these events have occurred in the last three years on the property. ReZoning Case Number Subdivision Case Number x Conditional Use Case Number 89-021 Zoning Variance Case Number Enforcement Action for Building/Land Use permit for I. Full legal description for legal advertisement (use separate sheet if necessary). Lot seven (7), Fairmount Subdivision, according to Plat P-567 on file in the office of the District Recorder, Anchorage Recording District, Seward Meridian, Alaska. 20-032 (Rev. 6/87) Page 2 Standing at rear of Lot Seven (7) looking south...telephone and power lines are on south side of Rabbit Creek Road i/we 'n~=~v a,_,~_horize ?"o~ ;;~-:c ............ , (Ckugach) ~o ac: on My/Our behalf :o o~ a co~di~ona! use %o ~be M-~icipa~i~y of ~chcra~e Zo~ ordinance so ~%a~ Lo~ Seve~ (7), Fai~mo~n; s~divis~on ma! ~e u;i~ized for construction of ~n e;ec~rica! s~s;a~ioz. WZ'~_~ESS STATE OF ALASKA T,R'T, RiD j-u'DTC%AL D!S_.~CT } --~ ..... ~--:--,. .... +~< ~ day of ~. be_~or~ m~_, tke undersigned, a No~a---y -=~'-:D.~iic ~ =nd ~o- ~_cw~ tO me and ;o me .~Ac%~ tc De ~e ~v~cu=~ w~~ t~e fcr~c~ ~s~ent and ac~9~Z~ ~d and sealed the s~me ~s ~ ac{ ~d~eed ~o~ the uses and o~pcsem taerezn menuzcn~, IN ~MS WC~OF, i have h~reto set m~- k~ud and official seal the day ~d ye~ tlr.~ ~ove . My co~ssion exptrem, Standing at rear of proposed fence (substation pad) on Lot Seven (7 , looking south GR~:.A,TER ANCHORAGE AREA BORO!~H HEALTH DEPARTMENT 327 EA~LE ST. ANCHORAGE, ALASKA 99S01 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME_ LOCAT SEPTIC TANK: D STANCE FROM WELL LIQUID CAPACITY ~"~ ~') NUMBER OF .COMPARTMENTS_ MATERIAL_ .~_Z~.~-- ~'~ / ~ INSIDE WIDTH__ -- DEPTH___ _GALLONS. INSIDE LENGTH__ SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS_ / OUTSIDE DIAMETER LINING MATERIAL- ~ ~ ~"J-' / NEAREST LOT LINE_ '-- ~ _OR WIDTH__/- '~ DISTANCE FROM WELL_ /'~"~ / TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA). / / LENGTH -~.-~) . DEPTH~' , U,LD,NG FOUNDAT,O ':2 TILE DRAIN FIELD: DISTANCE ,~/EEN LINES- ABS~,K)N AREA_ SQ. ~ DEPTH: TOP OF TILE TO FiNiSH GRADE_ TOTAL LENGTH OF LINES iN. TOTAL EFFECTIVE DEPTH OF FILTER MATERIAL BENEATH TILE_ _IN. ABOVE TILE,~ WELL: .... ~ , TYPE /~"'~.-,~<~,'~',~--~ DEPTH. NEAREST ~ LOT LINE,-'-'~6) "' "/--~' SEWER L'NE-- DISTANCE FROM ._ - /~,~,~_ WATER -- '- -, BUILDING FOUNDATION.~'"~'~ SAMPLE / ~ ~ NEAREST SEPTIC /~ (/ SEEPAGE //,~ / OTHER TANK-'"' ~ ,/~'--" SYSTEM CESSPOOL SOURCES - DIAGRAM OF SYSTEM ,. DISTANCES: DATE GREATE[ Case N o. ~ ~ ~ \NCHORAGE AREA ROUGH HEALTH DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 279-2511 SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT NAME OF APPLICANT~-'/~//''' /~z~ MAILING ADDRESS~/),¥,z~."Z~-~ ~/,~'. PHONE NO. RESIDENCE ADDRES~'~'~¢~'/~-~' ¢~' '~/'~" LOCATION OF INSTALLATION-Z'C~f~/ LEGAL DESCRIPTION ~" ., SEEPAGE PIT z-~I DRAIN FIELD ~., OTHER. APPLICATION TO INSTALL: SEPTIC TANK TO SERVE THE FOLLOWING FACILITY FINANCED THROUGH -- TO RE INSTALLED BY,~'~~ Ld~>~'~ ANTICIPATED DATE OF COMPLETION~C~--~'~' ~t~ PERCOLATION TEST RESULTS - BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT THIS IS TO SERVE AS ,'- AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED ~-"~'---.~"~'~'~"*'~';"~'""/ ,.. SEPTIC TANK SIZE ,~''-5~'2 TYPE ,~.Z~..~EEPAGE Al: ,TYPE DIAGRAM OF SYSTEM DISTANCES: HEALTH AUTHORITY OR LICENSED DESIGNER I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the above described system is in accordance with said code. APPLICANTS SIGNATURE REATER ANCHORAGE AREA BOROUGH HEALTH DEPARTMENT 327 EAGLE STREET ANCHORAGE, ALASKA 99501 Performed For .~r Lr,,,,~ Legal Description: Lot This Form Reports a: S~Log ~ L~ ~, ~ m ~ ~ ~ [ i~L %Date Performed ! _ .~T(,I~j I°l'~/n Block . Subdivi%ion .., ~ercolation Test Depth Feet Soil Ch ara,c,t e~'ls.t ic~ Was Ground Water Encountered? _ If Yes, A~ Wha~ Depth _ Location Sketch Reading Date Gross Time Net Time Depth To H20 Net Drop ercolatioh [ate' 1"! .... ~[nut~ ................... Proposed Install'ation:' Seepage Pit ~ Drain Field Depth Of Inlet .p- ~' ))ep%h To Bottom Of~ '~it Or !'rench~ COMMENTS: [g~.~ ,~ . $ I ~ ~ . ~-I ~ , / ~ ~ ~ ~ .... ' ................. Test Performed B~:. = ~g~o _ : ,,