The URL can be used to link to this page

Home My WebLink AboutT13N R3W SEC 33 LT 69BLoq'"' 6, Mark Beg Mayor Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Ellnare Road P.O. Box 196650 Anchorage, AK 99507 Ww .muni.ore/onsite (907) 343-7904 Pump Installation Log Well Drilling Permit Number: SW_ Date of Issue: Parcel Identification Number: Legal Description Property Owner Name & ddress: L fZ�ma` T/_3 R3 iN 5��. 93 � ori p to 47 s o,tAgz rl K g45°i Pump Installation Date: ^ '3 1 Pump Intake Depth Below Top of Well Casing: feet Pump Manufacturer's Name: Q A Cwt f Pump Model: '75"3" Pump Size �� t/ hp Pitless Adapter Burial Depth: O feet Pitless Adapter Manufacturer's Name: / Pitless Adapter Installer: I Well Disinfected Upon Completion." ,L\y x es J No Method of Disinfection: C IqL D Comments: Pump Installer Name: Ai1Cl401eWjf- W£I'' Pvrn�%�2�V1�i Attention: Tlie pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. FA ?' '"' 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 PH~'4-- 1650 []UPGRADE NAME ~mil Remus [~NEW MAILINGA~I~Po~S VI ~, AnchoTace Alaska LEGAL DE~I~TIS~, S~ TI~N, RDW Grid 183~ L A ON NO. OF BEDROOMS DISTANCETO: ]Well 110 ~ IAbs°~ti~rea Dwelli~s ~ PERMITN~8066~ ~Z Manufacturer S~se~ ~S~C Material~e~~ No, ofco~partments ~ ~ Liq. ca acity in gallons Inside length Width Liquid depth 1~O ~1 IF HOMEMADE: ~ ~ DISTANCE TO: Well Dwelling PERMIT NO. O ~ ~ Manufacturer Materia] Liquid capacity in gallons D Well Foun~ Nearest lot li~ ~t PERMIT NO, ~ DISTANCE TO: 130 ~--- ~= ~ ~ NO. of li~es Lengt~ ea~ine Total len~f ~s Trash ~h Distance between lines ~ Top oltil~to~ni~r.de Material ~ne~tilo inches ITot. I ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area ~ Well Building foundatio~ Nearest lot llne ~ DISTANCE TO: ~ Class Depth Driller Distance to lot [Jne PERMIT NO, ~ Building foundation Sewer line Septic tank Absorption area(s) ~ DISTANCE TO: OTHER PIPE MATERIALS Cast Iron & Perf Plastic Pipe SOl L TEST RATING 150 sq ft/bedEoom DATE LEGAL 72-013/Rev. 3/78) F'ERM~T NO. [:'EF'RR'FMENT OF?'FtEFILTH FIND EN',/IRONMENTFIL P~?FECTION · ' 825 '"L S'FREET., FINCHORI~GE, FiE. 26,4-472E~ 780664 > 3:4.4 'gF..,I It~RE FEE'F T'~'F'E 13F =,LIIL. HE.:,uF. ETkI[4 _,LJEfl IE;: FFEN_.H f'tR::'::If'ILIf'I ['4LfiE. EF. OF E:EE:,F.:OOM:5 :=.:.? 9]IL fi:FITING :'5;. Fl. E,F. ..... THE REI;!LIIRED 'qlZE OF THE ~,,FIIL I-IE,::,uF..FI I.N ..,'~_, E. fl I_ [:"~EF"TH= "-'-) L. Ehl,3]"I"-I= 4-C5 EJ~?~'-/EL- E- ELF ] THE LENGTH [)IMENSION IS TNE LENCFH ,'IN FEET~ )F THE TRENCH )F' DRFIINF!ELi:,. THE DEPTH OF Fl TRENCH OR PIT !S THE DI'STFINE:E E, E F[4EBI THE SURFFlCE OF THE GRCtI_IN[:, 8ND TNE BOTTGM OF THE E}::I]Ft',/R-[IGN (IN FEEl'::'. THERE=' IS NO SET ~,.II[:,TN FF¢_ . TRENd{z,.¢ ' -' '- THE GRfl',,,'EL [:,EPTH IS THE HINIMUM [:,EF'TH OF GRR',,,'EL E, ETHEEN THE OIJ1TRLL F_FE RND THE E:OTTOM OF THE E..-~Hcd]ILN (IN FEET). F'ERi','I I l" HI- F L I JtN f ~ 1 _ THE RE: F ult:: I ~ ~ L I 1 ~- TO I NFOI-tl',l TH I ~:; r:,EPFF. J'FIENI' DUR I ilL"~ l'}iE INSTFILLFITIGN ~it_FE_.rlJl_, OF tiNY ~.ELL_ FtDJ'FE:ENT TO THL{:, ~; F:_FEN'~ FIN[) TFlE ' :'= : ' - ': -,EF., E, NUME:E[4: OF RE-,I[-UL.E-, TH~T THE ['.tELL I'4ILL '": '"" .......... 'T f,4C~ (-..="':" .":" Z tN.=-F E-L- F :[ C~ F-k:7 R F.' E: F:"F:. .... l::,l ~ I F-': E: [:' E:RCKFILLING GF RN"r' S"/STEM [,IITliOUT FINFlL INE, PECTION fiND HFFF.. HL E,'r TIII~, " ' ':-' ' FR_:EE. UTI-N. DEF'Ia[;t. TMENT [4ILL BE :,IJE, JE_.I TIZI ''-'- ' - I"tINIHLJM DtSTRNCE BE'I}EEN FI [4ELL FINE) RN'¢ ON-SITE SEI,.IRGE DISF:'O:SRL SYSTEM IS :I.E~8 FEEl" FOR R PRIVRTE [,ELL~ OR 15~} TO 2e,~, FEET FROH R PUBLIC 1.4ELL DEPENDING UPON THE 'F'¢PE OF PUBLIC I,ELL O-FHER REI;!UIREf'IENTS f'lFfT' RPPL"L SPECIFICRTICINS fiND CONSTRUCTION DIFIGRt:~I"IS RRE FIVRILGBLE TO I[GURE PROPER iNSTRL. LRTION. F::'EK:P1 I "F EE...-,,F Z K.E._. [)~C:Ef-IBEtE: 2c::L.,, il_., I _.ERIFz THflT i: I Rf't FFtMILIRR kllTH THE RE~?UIREMEf'ffS FOR ON-SITE SEHE[~'.S RN[> HELLS FlS FORTH Bk" THE HUNZCIPflLIT'¢ OF RNCHORRGE 2: Z I.,~ILL INSTFILL I'HE E;YSTEM IN RCCOR[:,RNCE klITH THE CODES. 3: Z UN[:,EFSTRND 'THRT THE ON-'SITE SEt.4ER P¢STEM HRY REI~!UIRE ENL. FIRGEMENT IF THE RESI[)ENCE IS REHODELED TO INCLUDE MORE THRN 3 BEDROOMS. S 113NED: ..................................................................... BRUSS 1940 POST PHONE & ASSOCIAT£$ ROAD ANCHORAGE ALASKA 99501 ¢907.~ 279- 5033 BERNARD BRUSS P.E. CONSULTING CIVIL ENGINEER 28 June 1978 Invoice 7810628 Mr. Emil Remus Laurel St Anchorage Alaska Dear Mr. Remus: Attached are three copies of a 1978 Sewer Improvement Drawing as requested by you at a cost of $150. This drawing should be submitted ~o the Municipality for approval before work is started. Sincerely yours, (/'N, :~'~) ~ SOILS LOG MUNICIPALITY OF ANCHORAGE [] PERCOLATION DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST Pouch 6,650, Anchorage, Alaska 99502 276-222~ SOILS LOG -- PERCOLATION TEST PERFORMED FOR: Emil Remus, Laurel St Anchorage AlaskaoatE PERFORMED: 22 July 1978 LEGAL DESOR,PT'ON: Michelle Subdivision Lot 69B (SW~,NW~,sec33.,T13NR31~ SM) 1 2- 6- 7- 8- ®- 11- 12 14 15 16 17 18 19 2O Spi__l Description ~rown s~d with wood eor~s vege~atzon Clean Brown sand, some tan s~nd~ dry, SP SLOPE SITE PLAN WAS GROUND WATEF~res at ENCOUNTERED? i~ '~' r§h? ilty silt IF YES, AT WHAT DEPTH? Table at 13 Ft om of pit 13 ft Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND FT COMMENTS 14 ft long trench excavated down to depth of 13 Ft. Water found at 13 Ft. Clean brown-tan s~d found do~n to 1Oft at soil rating n~' 15~ ~n ~t p~ b~_ ~ ,,~ ~ ~tw~n h-9 ft for !each_ 72-008 (7/76) L~URE ST. ............... r2r- -I N 0 o 06;30" V'/ - 131.93 NO°O6'30"W - 263.83 VI ST. PEFd"1I T FFLI _.l-WI t_L' 7 FIT I ON LEGFtL Ir.1 IUt ~-& % iCZ: .~ ,-'~'~-~ L_ ~ T' "m" [:,EF'FhRTMENT L :'~:2P; '" L' Et'lI L ~i Ei'l_ _ V I _, FF. EEi' "HEFILTH Ffiq[:, EN!,,,'IRONf'IENTRL/- '[~!TEI_-:TIL'd'.,I C, TREET FII'.~ '2. F EIF~ FIGE., =t -:: L_,SgE: %3:3: T:L~N R2~N GRID 5'108 ',/I _-,TF~.E.E"I L. El'f' '51 Z EZ MINIfdUH .C, ISTRNCE BE'T!-,.IEEN R P~ELI.. RND FINY ON-E;ITE EiEHIRGE [:,ISF'OSRL S'.r"STEf'I tS iE'"Z~ FEET FOR R PRIVRTE NELL.~ OR :1_5C'~ TO 200 FEET FF:'.Offl Fi PUBLIC HELL DEPEN[:'ING UPON THE T'T'F'E OF' PUE:I..IC I-,.tELL. NELL LOGS RRE REQUIRED FIND i"tUST BE RETURNE[:' TO THE DEPFIRTMENT !.,.IITI-IlN ]~0 DR"r'E; OF ]'NE NELL COf'IF'LETION. OTHER RE(-]UIREMENTS i'lFl"," FtPPL."r'. SPECIFICBI"IONS RND CONSTF.'.UC]'ION [."IRGRRi'"I~.;; RF:E flVfllLFIBLE TO INSURE PROF'ER INSTRLI~FI~ION. I L-:ERTIF"r' TI-IFIT 1: ]' Fli"l FRi"tILIFtR NITI-I THE f4:EQUIREi"IENT~; FOR JN-:.,I FE $E!.,.IERS FINE:' I-JEt_LE; FITJRTH B"r' THE i"IUNI_.IPBLIT~ OF Hi',IE. HI..IRH.~E 2:: I NILL. II'4.:TFILL THE _,¢_,TEi'I IN FI_-C-F.'DFINF:E I.,.tITN THE L-:OE. EE;. RF'F'L I C:RNT Et,II L F.:EMU S i .m,:.',UE[ EfT' ............ [:'~TE // SIX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF ~15o00 DRILLED AT tHE RATE OF PER FOOT. Ilk. ~ lt. ?,~ PawJ~¢¢, /lAzzoL~ 99507 944-1650 PROPERTY OWNER LOCATION OF WELL SITE. DRILLER /~e2n, J~ ~ WELL LOG: 0 .... 27 ' Sa. ad. 780651 WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING. ,¢21.q6. O0 THANK YOU VERY MUCH. DATE' BERNIE CLAUS OF RAMPART DRILLING WORKS SERVICE CHARGEOF lY2% PER MONTH WILL T DUE ACCOUNTS. MUNICIPALITY OF ANCHORAGE MUNICIPALITY' OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION DEPT OF U~,LT'''{., 8 825 L Street- Anchorage A aska. 99501 EFtVJRONi;~N1-AL'.. >£ Li'.~r rCTION~ ~ ENVIRONMENTAL ENGINEERING DIVISION ADP ~ ~l,~ ~/ Telephone 264-4720 m/~ ~ ..... ~ SEW REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND .~(~ DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing· 1. PROPERTY OWNER PHONE MAILING ADDRESS PROPERTY RESIDENT (If different from above) ~ PHONE PHONE PHONE 2. BUYER PHONE MAILING ADDRESS 3. LENDING INSTITUTION MAILING ADDRESS MAI LING ADD~ESS · S. LEGAL DESCRIPTION 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] One [] Four [] Other__ ~' SINGLE FAMILY ~E]. Two [] Five [] MULTIPLE FAMILY [~ Three [] Six 7. WATER SUPPLY ~r' INDIVIDUAL~ * ATTACH WELL LOG. A well log is required for all wells drilled [] COMMUNITY since June 1975. For wells drilJed prior to that date, give well [] PUBLIC UTI LITY depth (attach log if availablm) 8. SEWAGE DISPOSAL SYSTEM ~ INDIVIDUAL/ON-SITE~ [] PUBLIC UTILITY **If individual/on-site, give installation date L,,~tl.:.,B ~,__. t..._..t, NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED I NSPECTI ON APPel NTM ENTS . TIME TIME TIME DATE CATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 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 UTI LITY Connection Verified_ LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER [~Septic~nk or [] Holding Tan~ Size: ) ~ If Tank is homemade SOILS RATING give dimensions: [ ~ (~ TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCESwELL TD: Septic/Holding//O Tank Absorption[ ~ '-~ Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS ~PPROVEDFQR ~_~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED ~~ DATE BY (T~ C LEGAL DESCRIPTION J 72-010 (Rev. 3/78)