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Home My WebLink AboutALDERWOOD BLK 2 LT 3B1 LOT~ .~: SUBDIVISION TAX CODE ~lf/- ~..,/? ." ~' GRID MU"'C'PAL,~ O~ ANC,ORAGE SEWER 85 02b, ~~., CON~:, ECT PERMIT WATER & W~T~ATER UTILI~ ~SINGLE ~AMIL~ ~ ARCTIC BOULEVARD ~ ' ~ MULTI-DWELLING ~ONE ~ ~- ~T~;.~-- No. APTS, ~ COMMERCIAL ~'- / BLOCK r ~ ~ INDUSTRIAL ~_:. DRAWING No. , .,' ~ i~ HONE .. ASSESSMENT~ Paid pr~viou~y Main extension agreement Subdivision agmem~t Extend~ connect agr. ment Pending--AMOUnTS I PERMITJSSUED BY: -~l,.s~c;~='a~: -- - os, ,l I BU,LD,.G ADD.ESS OW. ER ~.~,.?; :.:~ MAIL ADDRESS CONTRACTOR: (License& Bond i~ ON PROPER'D' ONLY [] MAIN TAP--TO PROPERTY LINE ONI (MOA or State ROW Permit Retlui~ed) F1 MAIN TAP & ON PROPERTY (MOA or State ROW Permit Required) CONNECTION SIZE INSPECTION PERMIT REIMBURSlBLE NUMBER REMARKS: PERMIT'CEE (Please Print) '-~'~,~, , ,, ', ~" E ~t MAIL ADDRE~ I HAVE READ THE ~NDITIONS AND REGULATION~ TO COMPLY WITH ~. POST IN A CONSPICUOI: ~o2~ .o/~) CUSTOMER 'ON THE REVERSE SIDE OF THIS PERMIT AND AGREE PERMI'I'~EE SIGNAI'URE S PLACE AT THE JOB SITE MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION RECEIVED Shoot / o~ / TIME WATERWELL - TEST PUMP REPORT Owner ,/')~,'~h~ ~.~,~--.~4'~ Address ~ ~~ ~/~ Well Lo~tion ~ ~m/ ~A~ ~ ~~~ Well Information: Ttl. Dept~Depth of Casln~Screen From ~ To Casing Size ~ ~ Screen Dlam ~ Screen Slot Pump Information: Intake DePth~' Pump Size I/~ ~P '1 ~ S~g ~ Air Line Depth Drawdown ~~ . ~ Ay. Discharge ~~ GPM, Max. Static Water Level Pump On: Time _ -- Time/~ ~*~ Date ~~ Pump Off: Date ~7~ 0 Z SURVEYOR'S CERTIFICATION I HEREBY CERTIFY THAT I HAVE SURVEYED THE PROPEBTY DESCRIBED ON THIS PLAT AND THE IMPROVEMENTS SITUATED THEREON ARE LOCAIED AS SHOWN ON THIS PLAT. OATEO THI, . I /, DAY OF /~0~/. ,,~'. 'FOUNDATION DRAINAGE ARROWS NOTES: I. IT SHALL BE THE RESPONBI"ILITY OF THE BUILOER ON OWNER TO YENIPY TH* BUlLDI.G LOCATIO. S.OW. MEETS ALL BUBOIVISIO. COVE.A.TB A.O ZOH~.G ORDINANCES. THIS PLAT REPRESENTS THE PARCEL OF'PROPEffTY DEIC~IBED KLOI TAKEN FROM THE RECORDED PLAT DESCRIBING THAT PARCEL. INS~UMENTI RECO~ED PRIOR TO ~R AFTER THE FILING OF THE RECORDED PLAT ARE NOT SHOWN ON THIS PLAT. THE INFORMATION ON THIS PLAT 18 FOR THE U8~ OF ~ENDINe INtTITUTIONB SPEClFICA:.LY TO SHOW ANY CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINE9 OR EASEMENTS ~ THE PLAT 1S NOT TO BE USED FOR POBITIONIUG ADDITIONAL STRUCTURES OR FENCES. BESSE, EPPS 8~ POTT$ 2220 E. 88th. AVE. 349-6452 ANCHORAGE, ALASKA 99507 $49-645 owe. NO. Sheet -'-' "- Date: .~,,~-- 7,~~ ~,~. WATERWELL - TEST PUMP REPORT Owner ~ ,~Z~ Address ~ ~~ ~ ~ we. LocateD. ~ ~--/ ~c~ ~ ~~~ ~~' Well Information: Ttl. Dept~Depth of Casin~Screen From ~ To Casing Size ~ ~F Screen Diam ~ Screen Slot Pump Info~ation: Intake Depth ~ Pump Size J~ .~Y~ /~',~ _ ~, ~. Air Line Depth Pump On: Time /~ ~ate ~Pump Off: .Time t ~ ~O Date WATER ~ FLOW W~ REMARKS ~ 'REMARKS TIME LEVEL "~ GPM t&~ ~./- ~ ~,~ // ,, ~ Z i"',, ~ g -~_ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions). '(b) Applicant Name ~)~V~) ~;:)0~,//-/¢'A~ Telephone: Home Z¢~- 7~'~° Business Applicant Address 4~'~'~ /~&Z-¢'.,~)~ ~,~. ,/~/~.~ ~ ~5~'~ ~ (c) Applicant is (check or'e): Lending Institution []; Owner/builder'S; Buyer []; Other I-I (explain); (d) Lending Institution AL~AS~ ~-~'A Telephone (e) Real Estate Company and Agent Ad dress Telephone (f) Mail the HAA to the following address;~ '"-'Pc, TYPE OF RESIDENCE Single-Family~ Multi-Family [] Number of Bedrooms ~ Other WATER SUPPLY Individual Well~ 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 [] 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 I of 2 72-025 (11/84) ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION 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 regulations in effect on the date of this inspection. /~'~"~ Name of Firm Telephone 6. DHEP APPROVAL C.o,~,,~rl'/o,~,R'v--.j.._._ ~ "~' ~'/'~ Date "~"4~(-'~' Approved for --"'"' bedrooms by · Afi~r.e~d ~'~;c.~. p r c. vc. ~ Conditional ~ Terms of Conditional Approval ,~_.~,~ ,,~ ~.4,~ ~¢:~.,~-,-~ ~ ~,,.,-~','~-- CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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. Page 2 of 2 72-025 (11/84) '""'MUNICIPALITY OF ANO'IORAGE DEPT. OF HEALTH & MUNICIPALITY OF ANCHORAGE (MOA)ENVIRONiV~NT,~L ,ROTECTIOH HEALTH AUTHORITY APPROVAL (HAA) MA[~ 0 3 ~ ' CHECKLIST- FEBRUARY 1984 264-4720 Legal Description: WELL DATA Well Classification '~'~/k/~'E'' If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y~__.~ Date Completed M'd"~'~z"'~'u'/ Yield('~ Total Dept~ ~ ' Cased to~ ~ ~/~ Depth of Grouting Static Water Level ~ ~.)t Pump Set At ~ Casing Height Above Ground ~* Sanitary Seal on CasingS) Electrical Wiring in ConduitS) Depression Around Wellhead Separation Distances from Well: To Septic/Holding Tank on Lot /~ ~ ' On Adjoining Lots / To Nearest Edge of Absorption Field on Lot /~ ~ On Adjoining Lots To Nearest Public Sewer LJne~ ~r To Nearest Public Sewer Cleanout/Manhole ~ ~' ~ / To Nearest Sewer Service Line on Lot Water Sample Collected by ~ ~' ~/~ · Date est Res ts Comments~'~ ~/~ ~'~ ~-~, ~ ~~ ~t~ SEPTIC/HOLDING TANK DATA To Property Line To Water Main/Service Line Course Comments ,,db Date Installed Standpipes (YO Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) ~/'/~· Separation Distances from Septic/Holding Tank: / To Water-Supply Well Size UMXM~ No. of Compartments Air-tight Caps (Yi~I Foundation Cleanout (YO Date Last Pumped Temporary Holding Tank Permit {Y/N) To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Page I of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date InStalled Width of Field Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well /~'~ To Building Foundation Lot To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments ,~/o ,,+~'#/~/" d~/ Type of System Design Length of Field Depth of Field Gravel Bed Thickness Standpipes Present (Yg Date of Last Adequacy Test To Property Line To Existing or Abandoned System on · On Adjoining Lots To Cutbank (if present) LIFT STATION , / ~/(///'~ Dimensions Size in Gallons ~ Manhole/Access (Y/N) "Pump On" Level at ~ "Pump Off" Level at High Water Alarm Level at ~ Vent (Y/N) Tested for ~during Ad~Pump~ les during Adequacy Test. Meets MOA Electrical Codes (Y/N) ~ Comments ** Check Permitted Bedroom Rating Against HAA Request ** ~ I certify that I h~e~~ie~d, or conformed to all MOA and NAA guidelines in effect on the date of this inspection. Signed~"~--~ - ~"~/'~"'"'-'- ..,~'~ '~-' Date Company Receipt No. Date of Payment Amount: $ MOA No. ~:~-5'":O ~/' Page 2 of 2 72-026 (11/84)