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HomeMy WebLinkAboutSUN VALLEY HEIGHTS BLK 5 LT 2 Municipality of Anchorage Page DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: ..~v' (]'30o '8(0 PID Number: _01'70 Name;Wastewater System: [] New TAHk:~o~grade DAN ~ELLE ,OHMS · Address: 13~oo 'tAHoE' CmCLE/ /,.c~,, ~?.~/¢ ABSORPTION FIELD EX I 5TIN~ Phone:.~. ~2/'iI''~ INo OfL~edrooms LI Deep Trench [D Shallow Trench EIBed UMound BOther L E G A L D E S C R I PT I O N soil Bating: Total Depth from original grade: GPD/Sq. FI. Lot: 2, Block: ,~',~ONSuhdivisi°n:~//A j~L ~-- Y ~{~T.~ . D~! plh ir) pipe hotlom {rom original grade: Ft Gravel depth beneath pipe Ft. WELL: E;q¢TiN~ New [] Upgrade Gravelwidth: Number oflinos: Ft. FI SQ, Ft. Driller: Date Drilled: StalicWsterLevel Inslaller: ( I~.*~ "~J'~cn/~' SEPARATION DISTANCES 'r~Septic E3 Holding © S,T.E.P. F,om T~.k ~i~,d S~.~.io. ~..* S.*~U.., O1~/:) ~ Z"' 12,5'O wel~ ~2OO '.%, ~ EEL wa~ > to~~. .~ , LIFT STATION N.,4-. Lot , %.~ (4/¢7 size in ga,,ons: J M~nufac,urer: Line .20 Foundation iOI ~ "Purnp °n" level at: I "Pump °fr' 'eYe' ~t: IHigh water alarm at: Remarks: LbOu.~/¢ ¢[~,~o~J- V~-~/'/~' BENCH MARl(: Io0,0 Fi, ENGINEER'S SEAL ~'¢,, ,. i~-~:_h ,~ ~-~, Inspections performed by: FLA~OP TECfl 5~E~ Dates: 1st ~/2q/93 '~'~"~' .................... 2nd ~_~. ~...:... Reviewed and approved by: Date: 7- ~- ~._ 72-O13 (Rev 9191) MOA 25 Permit No. .~ LJ ~ ;5 OO '~___ Page 2- of ~ Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report LegalDescription: ,LoT '2¢ C 50IL A~3SoP, PTIoN 72-013 A (Rev 9/91) MOA 25 Flattop, Technical Service~ 14530 Echo Stree[ Anchorage, Alaska 99518 Permit No. 5k/ c~B OO ~ ~o Page -~ of 3 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-.4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description: LoT 2., BLK ,5-, SuN VALLE"/ PIDN0.:_O17°(o2'~ [ J INV~P,T ,~ ELEV ~f"t' ~ OUTLET ~.50 G~I.~O~ ~YERT / T.B. I4. CONCRETE' I ELEV Flattop Technical Services 14530 Echo Street Anchorage, Alaska 99518 PAGE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT NUMBER:SW930086 DESIGN ENGINEER:FLATTOP TECHNICAl, SERVICES OWNER NAME:OHMS DANIELLE HELENE & OWNER ADDRESS:13500 TAHOE CIR ANCHORAGE, ALASKA 99516 (UPGRADE) PERMIT DATE ISSUED: 5/05/93 EXPIRATION DATE: PARCEL ID:01706241 ' N LEGAL DESCRIPrIO : SUN VALLEY HEIGHTS BLK 2 5 LT LOT SIZE: 34368 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST 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 (iSAAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4329 OR 343-4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. 1 OF 5/05/94 SPECIAL PROVISIONS RECEIVED BY: ~7',~ ISSUED BY: //~c~-~ DATE: DATE: MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION ',¥ 0 6 19B;~ RECEIVED ~icdtop Technical Services 14530 Echo Street Anchorage, Alaska 9Or: it' S~PTtC T'~IV~ P,L=-PAACI.e. M~NT _~ lT-~ PI.AN I'l= qO, 5"193 I\tO T~: T'l~t~ L~ NoF A $~Fi~,'~'r'l~p PL,4F MUNICIPALITY OF ANCHORAOE ~ MUNICIPALITY OF ANCHORAGE DEPT., ,OF l'-"J. IJl & j/~'~ ~ DEPARTMENT OF HEAl-TH & ENVIRONMENTAL PROTEI~'IIV~N''v'E'~I':'I- i,.'~LCTION g rd L~W 2)) ENVIRONMENTAL ENGINEERING DIVISION /J ' ~ ~/ 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 t,~AY ~ ~ 1980 / ON.SiTE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT ~AME ~ ....... MAILING ADDRESS ............. ~ CFLEGAL DESCRIPTION - ~.O~*T,O. ' .o.o~.oo~ ~ DISTANCE TO: J~ F 3~.' ZO ' 7 qq_l :~ ~ ~._ U°'°flin? Lengthofes~hline~ ~ T°tollength°flines. 4. Trenchwi(Rh~ ~ inches DistanceTtJ;enlines OTHER ......... ~N~TALLER ~:~.,.oc~. ~,,,,o,o .~f ~'- / P, 72-013 (Rev. 3/78) December 31, 1.979 Peter Lent Star Route A Box 372-N Anchorage Alaska 99507 Permit {~ 790139 Subject: Lot 2 Block 5 Sun Valley Helghts Subdivision A permit issued by this department for well and/or sewer system has expired. Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal ordinance. If you have drilled the well, a well log should be sent to this department to document the installation date. If an engineer has ' a'~ · nsp~cted the on-site sewer system, please have for our files. installation of tile them send us the as-builts If there are any further questions, please contact this office at 264-4720. Sincerely, Les N. Bucbholz, R.S Senior Environmental SDeci~st LNB/ljw eric: Copy ef Permit I::'I!EIC'.M I T I",10. FII:"PL ]: C:I::IN-F I ..()CFI T ]: ( ) [",t l.J'~(!iFIL TYPl:[i: I:]]c' :ii;l::)]:!,. 1:::I[3?:i;ORE:I':[OI",I S"r':!i;l'El'l I:!:i;: 'TI:;U:~:i",ICI~I MI::I::':',]HUH I',IUHE:EI;?. O1= E:Ii!:DROOHS := 4 FIlE I..EI',IGTII D:!:I"II!!I",I!i!;IOI',I I:~i; 'I'I'IE L.[F]'-~l]i]'l.[ '::IN I::'li~:E'l') Of:' 'I']~E "lr'l;i:El',l(:::l.I THE [:,EF:'FH OF' FI TI,~:EI',ICH OR F:'II' I:i~ TI.~[!: [:,I:{!;TFII",ICI~ DEi'I.,.IEI:i;N THE :i;I..IRFFIC~i:: OF GR(:IUNI], FII',,I[:, THE [E~O'I"I'()M IL:IF "l'Hl'ii: I:'!:;:'::CFf,,,'f::ITIOI'.,I ,::]:N F:'I;:J:E:I'). TI..IIii:I:;~tE Itl:; i'-,IO ~i;ETl' I.,.I):I)TI.I FOR 'Tf;:'.fF:NCHi::!}i;. 'l'lff~: I]iF:Ffv'li~],,. I}EPT/.I IrE; THE MII'.,t:[MUH [:,i.:F:'TH OF' GI;¥::I',,,'EL E~.I't.,,IEEN 'I'IIIZ OI..ITI:::'FI!.I. F'ZI:F'E f:IN[:, TI'IE Ii3OTTOH OF' THF:: E',:.:',Cf:l'v'f::fT']:Ol'.,I ,::t:i',,I F'EF;i:FIIT I::IF:'I::'LICI::II'.,IT hll::l:i:; THE I;::Eti::;F'Oi',I:i!!;:i]3II.Z[-r'v '['O INFORH '['1-1:[ ::~; I}t:,:F:'F:II:;¥1"MI:~]'¥1' 1}l..IRIl'.,l(:!i TILE: IN:i~TI:::ILI..I:'ITI:ON XI'.,IL~;PEC'I'J:Oh,]~:!i; (')F Ffl",P-r' FIE[,L::i; F:ID.!FICIii]",IT ]O TI'II!i:; F'ROF:'ERT"r' NLIHli:ER OF RI'!?.~;IDEI',ICE!~; 'THFI'F THE I.',IEI..L I.,III..L, Df::ICI:::F:]:I L.Ii",l(il I:_]]:" I'::li",!"r' J;~'r':!;l'l~:["l I'Ii['[I"IOLIF F:'IBIf::IL IN~;I:~EC'T']]]IN FIN[) I:::IF:'PRO',,,'I:~I., !3"*' [:,]:f:F:'I::IRTMEF,IT I,,,lIl. l_ E:E{ ::];IJEkllii:(]:]" TO H :!i I",1 ]: HI Jrt D ]: :~;'l¥:lf,ICl:i{ t31i!:"I'I,!EE]',I FI I.,.IE],..[. F:IN[:, I:i[",1",; CIN-':'!; i TE :ii;F.:kll'::l(~ilii: [) ]: ::~PO::!;I::I[. :i?-,'_'!; I'EI't 1% ::Il?..;!) F'EET F:'C~R ~"1 PI:RI',,,'F:fI'[!!:HEI..I...; :15~E~ TO ;:?~iEl~) F:'I!iET FRI)M FI F:'I..IE',[..IC I,II:~],..I,. [:,EPENDII'.,IL!i IJI'::'ON 'I'I,IE I"./F'E OF:' 1::'I,I!!31.IC OTI.IEi]',:.'. I:;?.E(;!UIRI:~:MEI'.,Ff':iil; I'"II::IV FII':'F:'i,V, Fi;F:'IXC!'F:ICI::IT]:OBIt~i; F:IND C()NIiF'f'R!.,IC]'IOI'.,I I)II:::lGl:;i]::ff,'t'.!!; I::I',,,'f:'IILFIB'LE TO II',,l:!i;I. JF..'li!: F'ROF'f~:I~: II'.I':*:;TFfl,LFfI'ICIN. GRE' ER ANCttORAGE AREA B0r Department of Environmental Quality 3500 Tudor Road Anchorage, Alaska ,99507 UGH INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LOCATION MAILING ADDRESS ~<~10 LEGAL DESCRIPTION ~ SFPTIC TANK: DISTANCE FROM WELL ~ INSIDE LENGTH NUMBER OF -MANUFACTURER¢~B~Lff~-~,~:e',~ (~-[) · MATERIAL~'£/ (~Zzt /~'["~' COMPARTMENTS ~'~ '"~ INSIDE WIDTH__ ~ LIQUID DEPTH ~ LIQUID CAPACITY /~--'-~-~) __GALLONS. SF. EPAGE PiT: NUMBER OF PITS i/ DIAMETER_ OR WIDTH'~-./', LENGTH ~,~ DEPTH ~ ' LINING MATERIAL -'2J g/D~(/~C~' - CRIB SIZE: DIAMETER__DEPTH . DISTANCE FROM: WELL /~ · z4/,~r/,s ' TOTAL EFFECTIVE BLJILDING FOUNDATION~'?, NEAREST LOT LINE ~0 /-t' , ABSORPTION AREA (WALL AREA) ~0~.~ SQ. FT. ADDITIONAL ABSORPTION WELL: TYPE ~.-~)/~/~)//~J / ~/V/ _CONSTRUCTION BUILDING NEARFST FOUNDATION__ LOT LINE CESSPOOL ., OTHER SOURCES APPROVED DISAPPROVED NEAREST SEWER LINE REMARKS DEPTH DISTANCE FROM: SEPTIC SEEPAGE TANK __ SYSTEM DISTANCES: INSTALLED BY: \J~l/ / / PIPE MATERIAL: LOT SLOPE: REMARKS: ~'" P-;' I[ 22,?'I DIAGRAM OF SYSTEM DATE "~'~; ~,-5'; Iq )'Z.__ APPROVED _/,~(*fl.4.,~¢~ (), 4~(I,q/?,./f.f.]'-' G.A.A.B, Form PW-026 GRE.,-.,ER ANCHORAGE AREA BOROUGH SEWAGE DISPOSAL SYSTEM --. APPLICATION AND PERMIT MAILING ADDRESS . LEGAL DESCRIPTION INSTALLATION OF: SEPTIC TANK TyPE AND s~zE o,, F^C,Ln-~, TO ~E sERw~ FINANCED THROUGH ~' SO'L TEST RESULTS .--~/ CO" PLET'O" DATE ANT,~I pA,~ D NOTE= THIS PERMIT 15 NOT VALID WITHOUT ~OIL TEST FINAI~ INSPECTION: 24 HOUR NOTICE RI[QUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEFARTMENT AUTHORITY WILL BE ~LIBJECT TO PROSECUTION. SEPTIC TAN~{ TO SEEPAGE PIT WALL //~--/ wELL To ,,,,,,,',- c','A,,,,<.SEEPAG, r,,T__/__C_d GREATER AN(:.;HORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO, SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT · . . , TEST RESULTS ~ II~ NOTE, THIS PERMIT l~ NOT VALID WITHOUT ~IL PF~IT~ flNF YFAR FINAL· IN~PECTION~ 14 HOUR NOTI~ REOUIRED, BACKFILLING OF AN~ ~YSTEM WITHOUT FINAL INSP[flTION ~Y I'H~ HEALTH D~PARTMENT AUTHORI~ WILL BE ~UBJEGT TO ~EPTIC TANK SIZE 5 ft. FOUNDATION TO SEEPA(~E PIT 20 ftc DRAIN FIELD 10 DRAIN FIELD ALSO CONSIDER AR~A W~LLS, ~0 sEPtic TAN~. 25 ft,, SEE.AG. ~,T 100 ft.., DRAIN FIELD 50 ft.. ~f~, TYpES_t~] OT CO~'r~J~SEEPAGE AF(EA. SIZE TYPE HEALTH AUTHORITY R&M Civil Engineers ENC lEERING & GEOLOGIC L CONSULTANTS 229 EAST51st AVE.- P.O. BOX 6087- ANCHORAGE, ALASKA 99503 TELEPHONE 90?-279-0483 TELEX 090-35419 Geologists Land Sorveyors JAMES W. ROONEY, P. E. MALCOLM A. MENZIES, P.E., LS. JAMES H. WELLMAN, P.E. RALPH R. MIGLiACClO September 27, 1972 R & M No. 26540-33 1VLr. ]ay Cowdery 8040 Lake Otis Parkway Anchorage, Alaska Re: Test Hole and Soil Log Report for Sanitary System Lot 2, Block 5, Sun Valley Estates S/d, Anchorage Dear Mr. Cowdery: We are submitting herewith the test boring results and our comments regard[Lng soil conditions encountered at the subject site. This investigation was per~orraed in accordance with your request o~ September 21, 1972 and those procedures out- lined in a lebter dated Septeraber 13, 1971 by Mr. Rol~ Stric]~[and oJ] the Greater Anchorage Area Borough Department o~ Environmental Qua]L{'ty. A single tes~ hole was put down withLn the Lot 2 area ~or the purpose o~ defining general subsurface soil conditions ~or the proposed sanitary system. Excavation was accomplished with a tractor-mounted backhoe and the test hole was extended to a total del~th oF 17 [eet below ground surface. The [inal log prepared ~or the test hole has been included in Drawing A-01. Ground water was not encountered in the test hole. We appreciate being given this opportunity to be o~ service to you. Should you have any questions with regard to the above, please do not hesitate to contact us. Very truly yours, R & M ENGINEERING & GEOLOGICAL CONSULTANTS es W. Rooney JWR:wb Enclosure xc: Greater Anchorage Area Borough ANCHORAGE FAIRBANKS JUNEAU 'F.H. - I 9-25-72 ORGANICS ORGANIC SILT, WITH TRACE GRAVEL 2.51 SILT, WITH FINE SAND SOME GRAVEL Med, Dense ( S M ) ./ / SANe, TO MEO UM GRAIN (SP) No Water Table Note: Hole excavated with tractor Send seams interbedded from 2 to 4." thick. mounted backhoe. 2.5 to 15.5 feet Jay I~..~.? Engineering ~ Geo~ogica~ Con,,~u~tonts LOG Cowdery Property OF TEST E~ORING Alaska ~ATE 9~25-72 ISCALe I" = ~' IowN ~Y 6.A.W. ]CH~O BY W.E.D ]PRo,~. NO. 26540-~31r)we NO. A-hi MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environrnental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # ~'r~ \ "~ - t('~f r~ ~:)-- - ~, ~ HAA# ~.~ ~o~ ~ ~),~ L\~\ 1. GENERAL INFORMATION Complete legal description Lot2; Bloc~ 5; Sun Valley HeighY;s Location (site address or directions) 13500 Tahoe Cir¢6¢ Property owner Mailing address Lending agency Mailing address Day phone Day phone Agent B~bara P~k~r JACK WHITE COMPANY Day phone 563~5500 Address 3201 C S~r¢.¢~ #700 Anchorage, Ak. 99503 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 4 "~ 3. TYPE OF WATER SUPPLY: Individual well -.~ Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: NOTE: Individual on-site Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025{Rev. 1/91) Front MOA~21 5. STATEMENT OF INSPECTION BY ENGINEER 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 application 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 Address Engineer's signature S & S ENGINEERING EagJe River, Alaska 99577 Phone Date DHHS SIGNATURE Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments By: J OhYk( ,,.~'¢kt ,1'7-/ Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS 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. 72"025 (Rev. 1/91) 8ack MOA k~21 Municipality of Anchorage Department of Health & Human Services HEALI'H AUTHORITY APPROVAL CHFCKLIST Legal Description: A_,df~-~')~!r'~~L~~,s Parcel I.D. A. WELL DATA Well type CJ Log present (Y/N) Total depth Sanitary seal (Y/N) __If A, B, or C, attach ADEC letter. /~1 Date completed ~ Cased to_ FR~O WELLLOG Static water level Well flow . . . Pump level SEPARATION DrSTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main Public sewer service line ADEC water system number Driller Casing height Wires properly protected (Y/N) AT INSPECTION ; On adjacent lots On adjacent lots _ Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform ~5~0/'~ Nitrate ~,~-~'t"5.'C~'P~?~ C ~ ~/], fl Date of sample: (o - / ~) ~ ~' I Collected by: B. SEPTIC/HOLDING TANK DATA Date installed ~ - .~_~,'~ "~ ~,- _Tanksize Cleanouts (Y/N) _ (~ Foundation cleanout ¢¢~N) ~/' High water alarm (Y/N) ~/~ Date of pumping Other bacteria Compartments _ Depression (Y/N) Alarm tested (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: A Well(s) on lot /k_l __On adjacent lots To property line / ¢2 Surface water/drainage Foundation_ Water main/service line 72-026 (Rev. 3/91) Front MOA 21 CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) __ __~ump on" level at High water alarm level Meets MOA electrical codes (Y/N) ~% SEPARATION DISTANCE FROM LiFT ST~ON TO: Well on lot On adjace%ots D. ABSORPTION FIELD DATA Date installed ~_-- ~ ~--- ~ - ~ ~, Soil rating Length ~ Width Manufacturer Manhole/Access (Y/N) "Pump off" level at Cycles tested Surface water Total absorption area Depression over field (Y/N) Results (pass/fail) ()¢~. Peroxide treatment (past 12 months) (Y/N) ~0 ~/~ ~ System type Gravel thickness [ ] ~" Total depth Cleanouts present (Y/N) L.~ Date of adequacy test for /-../L bedrooms If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Wellonlot / ~- ~ 3L On adjacent lots ,/ -~-~ -~ Propertyline To building foundation ~ 2. To existing or abandoned system on lot On adjacent lots Surface water Curtain drain / Cutbank /,,)/~1 Water main/service line Driveway, parking/vehicle storage area '$ E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in e of this inspection. Signature Engineer's Name Date S & S ENGINEERING 17034 Eaole RjrVeF L~I~ Roa~ ~agle Ri~er, Alaska 99577 FIAA Fee $ / ¢0 Date of Payment Receipt Number 72-026 (Rev, 3191) Bsck MOA 21 Waiver Fee: $ Date of Payment Receipt Number - ' INSPECTION APPOINTMENTS '~IME TIME TIME MUNICIPALI~ OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPT. OF 1',TALTH & ) DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTE~ONMEi~] ,, 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL SANITATION DIVISION MAR 2 8 1980 Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SE~,~I~ DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed, Please allow ten (10) days for processing. ~. OPERTYrOWNER ~ PHONE MAILING ADDRESS ~R~ERTY RESIDENT (If different from above) PRONE 2, BUYER PHONE MAILING ADDRESS ~ LENDIN~ INSTITUTION ~ PHONE ~EALTOR/AGEN'r ¢~ ~ PHONE ~"," LEGAL DESCRIPTION 6, TYPE OF RESIDENCE ~JUMBER 0F~EEDROOMS~ [] One '[~ Four t,~ SINGLE FAMIL. Y " ~.~Z'b~ ~i:::rJb',~,q [] Two ~ Five 7, WATER SUPPLY ' _~_, ~ ~.~/~ Three ~ Six ~ COMMUNITY ~ PUBMC UTILITY Other * ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled orior to that date, give well aepth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM .~[~ INDIVIDUAL/ON-SI'rE'~ [] PUBLIC UTI LITY /d¢7~ ~/~-GAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SiX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER []INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER []Septic Tank or [] Holding Tank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4, DISTANCESwELL TO: Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line Absorption Area to nearest Lot Line 5, COMMENTS [~APPROVEDFOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must ~pan¥ certificate) []~ DISAPPROVED DATE ,' 5-- ~L.~,__~ BY~ 72-010 (Rev, 6/79) DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE DISTRICT OFFICE 3601 C STREET, SUITE 322 ANCHORAGE, ALASKA 99503 August 6, 1991 WALTER J. HICKEL, GOVERNOR 563-6775 FOR: S & S Engineering PWSID 213962 My review of the records on file in this office reveals that the Sun Valley Heights Subdivision Class A Public Water System, is in compliance with the provisions of 18 AAC 80.080, State of Alaska Drinking Water Regulations. Sincerely, j/,~// Lead Engineer 'rim~ Date Time line Date Date inseeotor inspector Inseector Comments Conditional Approw[I Date Sewer Installed Soils Rating Permit No, Seetic Tank Size ) ,~. ~'~ Holding Tank Size Well To Absorption Ares Well Log Received Well to Tank APPLICANT FILLS OUT LOWER HALF ONLY Property Owner ~"~' ~1 ~- ~'~U l['~ ~ ¢'e~ ~-JC'- Me,,,.gAddreee° 995 7 Address Address Realty Co. & Agent Address Legal Description ~- 0 ~ ~'~ ~'~ iO ~ ~<- Street Location /~/fL¢ /~U "~:[ ~ o ~_~ Type~gf Residence · ~kSIngle Family No. of Bedrooms ~ El Multiple Family El Other Phone Phone Phone Water' Supply ~lndlvldual/0 r'6 19'7 5- Community E3 Public Utillt:/ S ew,a~g e Disposal K'~- Individual E~ Public Utility E3 Holdln~ Tank ATTACH WELL LOG, A well Icg is required for all wells drilled since June 1975. For wells drilled cnor to that date, gwe well depth (attach ~og if available,) Year Individual Installed: / ~ 7 ~/ When Connected to Public Utility:_ NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 264-4111 GEORGE M. SULLIVAN, MAYOR DEPAR'IMENTOF HEALTliAND ENVIRONMENTAL PROTECTION April 7, 1980 Rhodi Karella % Totem Realty 724 East 15th Avenue Anchorage, Alaska 99501 Subject: ]hot 2 Block,5 Sun Valley Heights Subdivision Peter/Les:~;ie :Lent 1 Approval for your individual sewer and water facilities can not be granted until the following items have been completed:  (1) ~e~permif. for the installa,t, ion of an on-.site sewer n~ ['~3~%em has expired as of December 31, 1979. We.have ~ (/~% received tile as-builts=of the installation in ~_~r this office. If an engineer inspected the system, please send us the report for our review and files. (2) The septic tank pumped with a receipt submitted to 'this office. Please have the number of gallons pumped from the tank to verify its size. If there are any further questions, please contact this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw *~?~-'-~:.C'k MUNICIPAL I TY OF ANCHORAGF. '~.~.~X ~. ~PARTMEr OF HEALTH AND ENVIRONMEN REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER 1;ACILITIES// 1. Lending Institution Request: _~po~ne M~rt~age~o~a~ ~i]-i~9 Add~ess: 3201 C ~reeB ~i~e 250 ~o~e: 277-,05 2, Property Owner: Hubert/Leah Niemoth Phone: ~lailin¢3 Address: % Shennum Realty 279-3511 L~gal Description: Lot 2 Block SJ.ng[e Family Residence: (x) Multiple Family Residence: ( ) 5 Sun Valley Heights Subdivison Number of Bedrooms: _ ~'~//_ Number of Bed]?ooms: Well System: Analysis Individual well ( ) Conm~unity/Pub]_ic System ~x) Permit ~ __~ Depth of Well ,/~ Well Lo~ on Fil C ons'kruc'~ion __~~acterial 6, S{ewage Disposal Sysl%em: On-S.Lte Sys'~em Cx~ Public Utmllty ( ) Permit = .// Installed ~ Instal/er ~J K~~_~ .......... ~ , -- ,_ ~- Septic Tank Size 7P 5- 0 ~ Manufacknrer .<~ ~ ~ Absorption Area __ ~-~ ~_ soils Rate ~ Dis'gances: well to to Sewer Line ' Nearest Lot line / Absorption Area Pe,~e Two Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 2 BloCk 5 Sun Valley-Heights Subdivision Affadavit Attached: Letter Attached: ( ) Disapproved: _ , , .7/~ ~'/,. :-, ~', ~ ,~,. ~, .. ~_L~ ~' Department Wor~snee~: ' ' ~xr~/' (.,,-x MUNICIPALITY OF ANCHORAGE ~,,r",~;i~Oxx~ DEPARTMENT OF ENVIRONMENTAL QUALITY ~'~ ,~ ~.)" ~ Sewer and Water Section, Fourth Floor, 825 L Street, Anchorage, Alaska ~l~t' ,>" ".'~b ~[~%0 Attention: Laura Harrison 9950]. ~o~'-~ :~ ~* REQUEST FOR APPROVAL OF 1. Ty~of Inspection: CMRO VA FHA CONV XX 2. Property Owner: NIEMOTH, Hubert & Leah Mailing Address; -R~m~wn F~/~ ~(;~ 3. Name of Buyer: PETER' C~. & C. LESLEY LE~ Phone Mailing Address: Day Phone 4. Name of Lending Institution: SPOKANE MORTGAGE CO. Mailing Address: 3201 'C" Street~ Suite 250, Anch., Ak.Phone 5. Name of Realtor or Agent: SHENNUM REALTY Mailing Address: __ Phone 277-0543 279-3511 6. Legal Description: Lot 2, Block 5, Sun Valley Heights, Anchorage, Alaska Location: NHN Tahoe Circle, Anchorage, Alaska Off DeArmoun Road on Tahoe Circle 7. Type of Facility to be inspected: 8. Water Supply Type of Supply: Single Family Public Utility individual No. Bdrms. __~, Community 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 1973 Individual (on-site) XX EQ-037 (1/74) June 2]., 1977 Spokane Mortgage Company 3201 C Straet Suite 250 Anchorage, Alaska 99503 Subject: Lot 2 Block 5 Sun Valley tieig'hts Subdivision A test was recently done on the sewer ~ystem, which proved to be inadequate for s. four (4) bedroom residen(:e. Before we (:an send an approval an upgrade will n(~ed to be oompleted. Before any construction begins, a permit ~ust be obtained from 'this office. If there are any questions, please eontaet this office at 279-2511, extension 224 or 225. Sincerely, Robert C. Pratt, R.S. Sm'~itarian RcP/lJh Shennum Realty (Ilubert Niemoth Property) 236 East 5th Avenue 99501