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Home My WebLink AboutTALISMAN HEIGHTS LT 2ola v5(r+NO('\ 4AUl=K4s �c),,-)- ots---n Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Mark Begich Anchorage, AK 99507 Mayor wv .muni.oro/onsite (907) 343-7904 Pump Installation Log Well Drilling Permit Number: SW_ Date of Issue: Parcel Identification Number: DDescription Legal Description Property Owner NA &Address: ?0 $o�C 112` H 9l a �f � '%�S� �i-YLJar25euJ � A�tcNoMGE A 995i/- 2'x-02 Pump Installation Date: ,e _ S� Pump Intake Depth Below Top of Well Casing: HLO feet Pump Manufacturer's Name:�i Su lv, �- pump Model: $ / 6 Pump Size 31 hp Pitless Adapter Burial Depth: f O feet Pitless Adapter Manufacturer's Name: Pitless Adapter Installer: /J%� Well Disinfected Upon Completion?X, Yes ❑ No Method of Disinfection: (p p.a� Comments: Pump Installer Name: (�PS 330 E/o %n CAWA- t, ✓9lc 4?q sl Sl Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. MUNICIPALITY OF ANCHORAGE //- 1111UtPAR I IV I VY F IVITALFROiEFjiviv ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME au�lSOni PHONE .. NEW ❑UPGRADE MAILING ADDRESS Y` LEGAL DESCRIPTION LOCATION i fw of R IJ NO.OF BEDROOMS z Uy DISTANCE TO: Well 010 Absorption area N �t ® Dwelling 53 PERMIT NO. 1Q,� ®0'33 i Q wFC4 Manufacturer QC—'C—' Material Lp w5 No. of compartments 19 rn Lie. ca acity in gallons C IF HOMEMADE: Inside length Width Liquid depth y JAZ DISTANCE TO: Well Dwelling PERMIT NO. Oz Manufacturer Material Liquid capacity in gallons ❑ w= DISTANCE TO: Well\\o Foundation Nearest lot line C J PERMIT NO. �o® ,33 j IL Z Z w ~ No. of lines Length of each li Total length of I' s a Trench width Z(o inches Distance between lines 0 �r R Fes- a Top of tile to finish grade I Rrtl vie) Material beneath tile tt 0inches Total effective absorption area W Length Width Depth PERMIT NO. O a l- wa Type of crib Crib diameter Crib depth Total effective absorption area w DISTANCE TO: Well Building foundation Nearest lot line J lass t Depth Driller Distance to lot line PERMIT NO. ,� w �+ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER J J PIPE MATERI S SOIL TEST RATING (L `-- INSTALLER at_t_ Litt REMARKS ®L to 1 Q u C R1 . tED DApTE1 y LEGAL 72-013 (Rev. 3/78) DEPARTPILN I OF 'lLHL- I H HNO tr'4V it°a_NPILry I Hl_ r 1 n�_ 1 J.W ill �� - )�_�� 825 L! "._%. REET, ANCHORAGE: AK. �-+9 _:, 264-4720 AA 107 I_ A_ A --A 64 E> ED 44 ---- on "E -F E. . E L4 E Fz> IF E = A _" r-1 I PERM IV NO. 780033 L,_icl APPLICANT JER(,=:'r'- RICHARDSON Po B X 10--356 F::LATT 34'.a 9-r-':r:.-,�L�S LOCATION ATION TALISMAN RC: i LEGAL L. TALISMAN HT'. SUBLOTE,T E 5.-a i.=G!IJRRL-= FEET TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING (50 FTZBR)== 150 THE REQUIRED =IEE OF THE SOIL ABSORPTION SYSTEM IS: :1-Inj@ P,A o � -IBA = =<=- THE LENGTH DIMENSION IS THE LENGTH fled FEET? OF THE TRENCH OR DRAINFI:ELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO _ET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). --_- _ ..._ FA ED F=- FA CA E= F", A_. FA 44 I CCA F' T• 1 ®_a P -A ------ A ------A PACKAGE PLANT MAY BE INSTALLED AT THE PEF MITTEE"S OPTION SUBJECT- TO THE FOLLOWING CONDITIONS: 1. EITHER H CLASS I OR 11 NSF APPROVED PLANT MAY BE INSTALLED. 2. A CONTINUOUS MAINTENANCE AGREEMENT IS REQUIRED. IF A MAINTENANCE AGREEMENT IS NOT REPT CURRENT YOU MAY BE REQUIRED TO ENLARGE: THE: SOIL ABSORPTION SYSTEM AND/OR YOU MAY BE SUBJECT TO PROSECUTION. -g- t,J ED < a_ __. JE P -A F° EoC2l_ Y CAP—J' A=A F = E= FR lEw 9C! A_ B T F--"E---E-j, — BACKFILLING OF ANY SYSTEM WITHOUT FlNAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DI:_-FANC:E BETWEEN A WELL HtdD ANY ON -=ITE SEWAGE DISPOSAL. SYSTEM 'IS 100 F=EET FOR A PRIVATE WELL 1=1R 200 FEET FOR H PUBLIC WELL. WELL. LOGS 19RE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENT_ MAY APPLY. :_PECIFIC:ATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE. PROPER INSTALLATION I CERTIF'r THAT 1: I AM FAMILIAR WITH THE REQUIREMENT_ FOR ON-SITE SEWERS FORTH BY THE MUNICIPALITY OF ANCHORAGE:. L: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODE'_.. 3: 1 UNDERSTAND THAT THE Card --SITE SEWER SYSTEM MAY REQUIRE RESIDENCE I S Fr.F,NODELED JO DUDE MORE THAN 3 BEDROOMS. .IGNED ISSUED AND (.BELL'_ AS _,ET ENLARGEMENT IF THE: 0 DOtteit Drilling Co. BOX 10056 JOHN'S ROAD ANCHORAGE, ALASKA 99502 PHONE 344-1952 WELL LOG Mr. Jerry Richardson Anchorage, Alaska Legal description: Talisman Heights SB, Lot 2, Blk 0 Gravelly till 0 to 40 Bed rock 40 200 Static water level is at 20' from ground. Production is 2 GPM. Well drilled in June, 1978. R6.NI CONSULTANTS, INC. S024 CORDOVA Y BOX 6087 E ANCHORAGE, ALASKA 99502 • PH. 90]-2]9-0983 • TL%. 090-25360 ENGINEERS GEOLOGISTS PLANNERS SURVEYORS September 16, 1977 R&M No. 751235 Jerry Richardson P.O. Box 10-356 Klatt Station Anchorage, Alaska 99502 Subject: Soil Investigation for Sanitary Sewer System, Lot 2, Talisman Heights Subdivision, Anchorage, Alaska Dear Mr. Richardson: At your request of September 6, 1977, we conducted a subsurface soils investigation at the proposed location of the sanitary sewer system on the subject lot. The investigation complied with those procedures required by the Municipality of Anchorage, Department of Health and Environmental Protection. This investigation, which was accomplished on September 7, 1977, consisted of a test hole drilled to a depth of 20 feet below the existing ground surface. The test hole was sited according to your instructions and its location is shown in attached Drawing A-01. Drilling was accomplished with a rotary drill rig using continuous flight solid -stem auger with an outside diameter of 6 inches. A sample was taken at the depth shown on the soils log in Drawing A-01. The sample will be held in storage at our lab for approximately six months. In addition, all material brought to the surface by the augers was continuously monitored by an experienced engineering geologist. The topography at the drilling site is generally gently -sloping to the south. At the time of the investigation the site had original vegetation consisting of spruce and grass. The top of the test hole was located at original ground surface. The soils encountered in the bore hole are shown in the test hole log in Drawing A-01. The symbols used in Drawing A-01 are explained in Drawings B-01 and B-02. This log displays specific conditions encountered at the test location. However, subsurface conditions may vary in other parts of the lot without any apparent surficial evidence of the change. Groundwater was not encountered. Bedrock was not encountered. At the time the hole was drilled seasonal frost was not present, and permafrost was not encountered. A grain size analysis was performed on the sample taken between 9' and 10' showing the material to contain 9.3 percent silt. Based on this analysis, the soil was classified as borderline GW-qM and an attempt was made to perform a percolation test within the test hole. Over a ANCHORAGE FAIRBANKS JUNEAU VALOEZ WASILLA September 16, 1977 Mr. Jerry Richardson Page -2- time period of approximately 1/2 hour, 55 gallons of water were absorbed by the soil, leaving no water standing in the hole. It was therefore determined that a percolation test was not necessary and not feasible within the test hole on the subject lot. We appreciate this opportunity to be of service to you. Please contact us if you have any questions concerning this letter or if we can be of additional service. Very truly yours, R & M CONSULTANTS, INC. /011�� 9��/ n� Jeffrey M. Ayres Jim McCasZ in Brow;n, Ph. D. Staff Geologist Head, Earth Science Department gld Attachments: Drawings A-01, B-01, B-02, and Table 1 Lot 2, Talisman Subdivision Anchorage, Alaska Not to Scale Distance shown are approximate and have not been measured by surveying methods. DRAWN BY A4 "K DATE 9-13- PROJECT N0. /b123b CHECKED BY SCALE DRAWING N0. JMA see above A-01 !M CONSULTANTS, INC. TEST HOLE LOG Scale: 1"=3' ORGANIC SANDY SILT '0 W/SOYIE GRAVEL Broom, Dry, Medium Dense 2.01 SANDY GRAVEL W/SOME SILT (GM)- 9��p E"0..", Brown, Occasional Cobbles, k,. Dry, Medium Dense — — — — — — 5.0' SANDY GRAVEL W/TRACE SILT (GW -GM) Occasional cobbles Brown, Dense A I:-o:l I O — — — — — — 13.0' SILTY SAND W/TRACE GRAVEL (SM) Brown, Very Wet, Dense 16.0' SA14DY GRAVEL W/TRACE TO SOT E SILT (GM) Brown, Moist, Dense 20.0' T.D. Groundwater was not encountered. This log depicts subsurface soils observed within the test hole at the location shown. See Drawings B-01 and B-02 for explanation of symbols. LOCATION SKETCH AND TEST HOLE LOG JERRY RICHARDSON V � y LABORATORY TEST REPORT R&M CONSULTANTS, INC. TEST ON S,_t' cc t m R&M PROJECT NO. 751235 CLIENT/PROJECT Jerry Richardson/SSS LAB NO. SOURCE SUBMITTED BY J. Ayres FIELD NO. SAMPLED FROM DATE SAMPLED DATE REPORTED 9-8-77 LOCATION DEPTH DATE RECEIVED 9-8-77 GRAIN SIZE DISTRIBUTION PASSING SIEVE AS SPEC. RECEIVED 5" 4" 3" 2" 1 1/2" 100 1" 90 3/4" pi 65 3/8" 55 #4 #8 # 10 23 # 16 # 20 18 # 30 # 40 16 # 50 # 80 2 # 100 11 # 200 9.3 .02MM .005MM - - CLASSIFICATION UNIFIED I AASHO %+ 10 %+3 % GRAVEL % SAND % SILT % CLAY FSV LL PL PI CLASS TOTAL WT. TESTED GMS REMARKS DELETERIOUS MAT. MINUS *200 MESH SOFT FRAGMENTS COAL & LIG. OR LT.WT.PT. CLAY LUMPS STICKS & ROOTS FRIABLE PARTICLES SPECIFIC GRAVITY ABSORPTION FINENESS MODULUS SULFATE SOUNDNESS FREEZE—THAW RATIO FAA COMPACTION OPTIMUM MOISTURE_ MAX. WET DENSITY MAX. DRY DENSITY CORR. MAX. DRY DENSITY % FRACTURE METHOD NATURAL DENSITY NATURAL MOISTURE WEIGHT LOOSE WEIGHT RODDED L. A. ABRASION LOSS GRADE DEGRADATION VALUE THIN -ELONGATED - MOISTURE —PERCENT ORGANIC COLOR 007656 O MUNICIPALITY OF ANCHORAGE A�J* • Department of Health &Human Services y � DIVISION OF ENVIRONMENTAL SERVICES M}1 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcell.D.# n'1-�y�-HAA# ki:ic)9C-) � 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision Location (address or directions) (b) Property owner Mailing Address F township, range) Telephone: (home)��_&aBusiness J_/ (c) Lending Institution zVA Telephone / /r Mailing Address (d) Real Estate Company and Agent Address Telephone (e) Mail the HAA to the following address: (or check here M,, if hold for pick up.) List contact person and day phone number below: 2. TYPE OF RESIDENfiE Single -Family C9" / Number of bedrooms 3. WATER SUPPLY Individual Well Q Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. i 4. SEWAGE DISPOSAL On-site Q/ Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-025 R.V. 7/88) Page 1 of 2 5. 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 66P,- `K �vL�• Telephone. 52Z –131 Address /D Date IN J. camio 7o Engineer's Seal 6. DHHS APPROVAL Approved for J _ bedrooms by r��,��/� Date v%6 Approved Disapproved Conditional —_ Terms of Conditional Approval The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated 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 orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 7788) Back Page 2 of 2 �d MUNICIPALITY OF ANCHORAGE (MOA) �p F F j Health Authority Approval (HAA) A _ \�P--�sF. CHECKLIST - FEBRUARY 1984 d 343-4744 •'yam / Legal Description: Zot /�CCI�l22Iye A. WELL DATA [!s I ,{�%� Well Classification n" V�� If A, B, C, D.E.C. Approved (Y/N) " -�� Well Log Present (Y/N) Date Completed . �1 -- Iai(lk Yield' Total Depth�Cased to ��Depth of Grouting IAL Static, Water Level i�E Pump Set At �/ 2, SanitarySeal on Casing Y/N Casing Height Above Ground 9 ( ) Electrical Wiring in Conduit (Y/N) / Depression'Around Wellhead (Y/N) /v SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot /4120 74 ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot I—A® ¢ ; On Adjoining Lots To Nearest Public Sewer Line A2A To/Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot �✓ Water Sample Collected byy%; Date Water Sample Test Results Comments B. SEPTIC/HOLDING-TANK DATA Date Installed 06417-e Size1694�') No. of Compartments�a- L/ Foundation Cleanout Y/N Standpipes (Y/N) l Air -tight Caps (Y/N) ( ) Depression over Tank (Y/N) N Date Last Pumped r49 -_*A -Z Pumping/Maintenance Contact on File (Y/N) ; for X /Z Holding Tank High -Water Alarm (Y/N) —Ao /A— Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water -Supply Well lQQ /� To Building Foundation To Property Line To Disposal Field To Water Main/Service Line "P'.5 i To Stream, Pond, Lake or Major Drainage Course /4?4— Comments 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata /� Type of System Design 77`�/2� Date Installed % Length of Field Width of Field Depth of Field Gravel Bed Thickness t Square Feet of Absortion Area �� Statndpipes Present (Y/N) r _ Depression over Field (Y/N) D�e of Last Adequacy Test � g.3 �2 C11 If' Results of Last Adequacy Test v SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well `UCS 24- To Property Line — 75 To Building Foundation �573 I To Existing or Abandoned System on Lot A--�21+ ; On Adjoining Lots AfI4 _ To Water Main/Service Line % s To Cutback present) Allm' To Stream, Pond, Lake, or Major Drainage Course X 2 1 _ To Driveway, Parking Area, or Vehicle Storage Area 3,-) /.7/ -- Comments •f' Comments D. LIFT STATION Date Installed — Size in Gallons "Pump On" Level at High Water Alarm Level at — Tested for Meets MOA Electrical Codes Comments '"Check Per ii a Bedroom Ra i I certify that/f h v c eckee( inspection. Signed Date MOA No. z Dimensions Manhole/Access�(Y/N —"PumgS3W eC vel at Vent(Y/N) HAA Request" , or conformed to all MOA and Receipt No. Date of Payment / l Amount: $ 72-026 (Rev. ]/88) Back Receipt No. _ Waiver Fee: $ Date of Payment Page 2 of 2 Pumping Cycles during Adequacy Test. �,�'n effect on the date of this Engineer's Seal PROJECT: 7 2 /��ll�I�1aLC1li% DATE of TEST: / 2✓ lCi LOCATIO;! OF QFLI (Legal OescriPtiOn): 13 4! 1-- tl ce i HELL DEPTH: –FT. CAS IXG: _FT SCREEN: (2`�JEW1111DATE ORILLIIIG COMPLETED: / L- 7e— DRILLER: STATIC '.MATER LEVEL (Top of Casing): I�t-5 FT Elapsen time �incel Clock Pumping Started/ Depth to Oraxdoiin/ PunpingI Rena! Tine Stopped, (gin. taater, ft. Recovery Rate, CP'i 1 l•O� 0 S s rl 0 0 Start 10 j In i -TO-1 330I d e-- 35 35 j p 4 Sri 50 I �5 5 Z p t hour 4 if l 40 120 2 hours I I ibu i 180 hours)l 210 I S 4 hours RECO'ERY 0 60 (1 hour) nours j i CORWIN & ASSOCIATES, INC. 1000 E. Dimond Blvd. Suite 205 ANCHORAGE, ALASKA 99518 (907) 522-1311 CALCULATED BY DATE G CHECKED BY DATE_ ADEQUACY TEST q67a. o STV :_2 CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. 5633 8 STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FEDERAL TAX ID # 92.0040440 ANAL'iSIS REPORT BY SAMPLE lor Mork War A 19430 Bate Rocoit N_intcri: JAF1 !'i 90 e 1.3:49 Client Saarple IMALISIMAM HIM :01, Collected JAl? 23 90 Q 1.0:40 his. Recezvo't J1,F! 23 90 c� 15:00 hrs. c*eserre2. with :AS REQUIRED li li%1•��5� Cou-ploted :JAY, LY 90 L.xb0. atony Supsrvlso:•: :STEPHEN C. SDE Rel.eas0d Byr ru- j Special Instruct: Chomlab Ref 9 9229 1'araneter Tested NIT@.ATE-N Lob SUP1 ID: 1 Matzix: WAIER Sample ROMiIiE SAMPLE Ronarhs: SA,dPLE COLLECTED by W. Client Flaws CORWIN & ASSOC Ulan,. Acct : CGRl74 tiP P.0.� ;IONE RECEIVED Req r Ordered By Send Reports to: 1)CORWIN & A;SOC 2) Allowable Result Uuits Method L-sr:d is 1.S 1q/1 EFA 353.2 10 i 'Pests Pezformeu Seo Speclai Instruction Above UA -Unavailable i@- 140110 Detected "' See Sample Berexrks Ab0r0 NA- ltot Analysed LT -Less Than, OY=Sroater :than • Cha-"�x-�� n^�i �;�o iLy 5. LEGAL DESCRIPTION MUNICIPALITY ' MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & OF HEALTH & ENVIRONMENTAL PROTECTIodWIRONMENTAL PROTECTION DEPARTMENT 825 L Street -Anchorage, Alaska 99501 s ENVIRONMENTAL ENGINEERING DIVISION S Ell� � 9 1978 Telephone 264-4720 RECEIVED REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTYOWNER ®x INDIVIDUAL* PHONE Robert Lutje since June 1975. For wells drilled prior to that date, give well 344-4602 MAILING ADDRESS 8. SEWAGE DISPOSAL SYSTEM Star Route A Box 31L 99507 ®x INDIVIDUAL/ON-SITE** PROPERTY RESIDENT (If different from above) PHONE 2. BUYER by this Department. PHONE Jerry/Marie Richardson 349-1666 MAILING ADDRESS Post Office Box 10-356 99511 3. LENDING INSTITUTION PHONE Alaska Mutual Savings Bank 274-2551 MAILING ADDRESS 4. REALTOR/AGENT PHONE Bonnie Mehner % Jack White Company 277-1553 MAILING ADDRESS 3201 C Street 99503 5. LEGAL DESCRIPTION Lot 2 Talisman Heights Subdivision STREET LOCATION Turn left on Patrick Road off of De Armoun Road 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS El One ❑ Four El Other ®x SINGLE FAMILY ❑ Two ❑ Five ❑ MULTIPLE FAMILY Rk Three ❑ Six 7. WATER SUPPLY ®x INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM ®x INDIVIDUAL/ON-SITE** **If individual/on-site, give installation date 1978 If system is over two (2) years old an adequacy test is required ❑ PUBLIC UTILITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) NOTE: Bonnie will hand carry when completed. THIS SIDE FOR OFFICIAL USE ONLY 4 INSPECTION APPOINTMENTS DATE RECEIVED o TIME TIME TIME DATE DAl"E DATE INSPECTOR - INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLICUTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified _ PERMIT NUMBER DATE INSTALLED C��•-") INSTALLER ❑Septic Tank or ❑ Holding Tank Size: 1600 If Tank is homemade give dimensions: SOILS RATING ) _n TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELLTO: Septic/Holding Tank Absorption Area Sewer Line Nearest LotLine Absorption Area to nearest Lot Line 5. COMMENTS APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE r/ BY (Title) 16`� 7r7 �L LEGAL DESCRIPTION 72010 (Rev. 3/78) GREATER ANCHORAGE AREA BOROUGH_. IPALI Department of Environmental Quaff N OF ANCHORAGE 3330 "C" St., Anchorage, Alaska 99503 I "._XAPROTEcnON 6. Legal Description: Lot 2 Talisman Heights Location: turn left on Patrick Rd off Upper De armoun 7. Type of Facility to be inspected: home No. Bdrms. 3 8. Water Supply Type of Supply: Public Utility Individual XX If Individual, number of dwellings presently served 1 If Individual, depth of well 9. Sewage Disposal System Type of System: Public Utility Individual (on-site) XXX If Individual, date of installation Summer 1978 EQ -037 (1/74) REQUEST FOR APPROVAL OF SEP 19 1978 INDIVIDUAL SEWER & WATER FACILITIES ECEIVED j� 1. Type of Inspection: CMRO VA FHA CONV XX 2. Property Owner: Robert Lutje Mailing Address: SRA # 31L Day Phone. 344-4602 3. Name of Buyer: Jerry & Marie Richardson Mailing Address: PO Box 19-356 Day Phone 349-1666 4. Name of Lending Institution: Alaska Mutual Savings and Loan Mailing Address: Phone 274-2551 5. Name of Realtor or Agent: Rennie Mahn or Mailing Address: 3201 C Street Phone 277-1553 6. Legal Description: Lot 2 Talisman Heights Location: turn left on Patrick Rd off Upper De armoun 7. Type of Facility to be inspected: home No. Bdrms. 3 8. Water Supply Type of Supply: Public Utility Individual XX If Individual, number of dwellings presently served 1 If Individual, depth of well 9. Sewage Disposal System Type of System: Public Utility Individual (on-site) XXX If Individual, date of installation Summer 1978 EQ -037 (1/74) 00tober 2, 1970 12£)t747,'t MY star Route A Box subject; jE,:ct; ;Lot i Tall5wan, t`'feightti;3 ..3£,id'.re we any P7"L-Cr+.x.".' your 100A approval 5"f`:q'aOsst, you will nand to B:n?nit chi well loq to r.hiB department. `k'V {.x51 ro ciY:-`§". anY WOMOssf please cont,ot this Mice at 264-0e0. i21c=b*="e.ln 1503 ``ls3st 31 Avenue 99;5C3`-' 3201 C Stryot 99103