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HomeMy WebLinkAboutT15N R1W SEC 31 NW4NW4SW4NW4SW4 i ' MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENV, RONMENTAL PROTE CT~ON ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME 12,~ f~ .... I~_" , PRONE []NEW LEGAL DESCRIPTION LOCATION DISTANCE TO: Manufacturer area Liq. capacity in gallons IF HOMEMADE: Well DISTANCE TO: DISTANCE TO: Well No. of lines / Length Top of tile to finish grade Length Width Inside length Dwelling Foundatlon Total le~;/~of lines Material beneath tile .~; Depth Width Material NO. OF BEDROOMS PERMIT NO. Liquid depth PERMIT NO. Liquid capacity in gallons PERMIT Distance between lines ~,'//~, Total effective absorption area PERMIT NO. Type of crib Well DISTANCE TO: Depth DISTANCE TO: Crib diameter Crib depth Building foundation Building foundation Driller Sewer line Total effective absorption area Nearest lot line Septic tank Absorption area(s) Distance to lot line PERMIT NO, OTHER PIPE MATERIALS P-A~d/'~ ~,. SOIL TEST RATING INSTALLER REMARKS APPROVE ~ ~"~ DATE LEGAL PERMIT NO. APPLICANT DAVID H. BOYLE LOCATION UNK LEGAL ~ DEFHE. THENT .)~ HEHLTH AND EN~IRuNHENTHL ~OTEC:TION / , Cr . ET. ~e, 4-4,' ~ . , 26~7 HRbTIL. BL',,,'D ~,o,:,-,=4._~d PORTIOIN OF L-5 TtSN R±W LOT SIZE 3~660 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 4 SOIL RATING (SQ FTdBR)= 107 'THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: El:. ~F2 F' T H--- .cE--: L E ~'-41.3-f' !--1 = 2:~; ,3 [~': R".,-' E L [) E-."] F" T ~-I ='= ~ THE LENGTFI DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIEL. D. THE DEPTH OF A TRENCH OR PIT' IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAYRTION (IN FEET). THERE IS NO SET HIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFRLL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY HELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL HILL SERYE. .......... T~4E~ (2) I ~-4~:F"EE:]-IClf-~; REdE RE6:!LII ~:E[:, BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE. BETWEEN A WELL RND ANY ON-SITE SEHAGE DISPOSAL SYSTEM IS ±00 FEET FOR R PRIVATE WELL OR t50 TO 200 FEET FROM A PUBLIC HELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM R PRIVATE HELL TO A PRIVATE SEWER LINE IS 25 FEET AND TO R COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F"EF:I'-I I: T E)-¢F' l: F:ES [':,EC:EI--1BEF.: __~=: :.t... I CERTIFY THAT :1.: I RM FAMILIRR WITH THE REg~UIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF RNCHORAGE. 2: I HILL INSTALL THE SYSTEM IN ACCORDRNCE WITH THE CODES. Z.':: I UNDERSTBND THAT 'THE ON-SITE SEHER SYSTEM MRY REQUIRE ENLRRGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. ................. APF'LIC:R~.L~ DRYIZ[:, H. E. OTLE // ..... DOUGLAS A. STARK and ASSOCIATES, CONSULT,MNTS 957 Westbury Drive · Anchorage, Alaska 99503 · Phone: 277-4300 May 6, 1981 Date of Test: Rarcelr Test location~ Tes% me~hod:, Soil Test May 5, i981 David Boyle home, Chugiak (see attached map:) Boyle's lawn:- see map Backhoe hoIe dug Go, 12t -- no groundwater. Sample taken-at ~"., So~I quality such Ghat no peroolation~es'~ ~ec,essary (se,e a~tached laboratory gradationanalys~. Organization · Management · Enfineerinf · Surveying · Plannin~ · Human Resource Development ~. o~ kger ifiei riIling og by SULLIVAN WATER WELLS P. O. BOX 272, CHUGIAK, ALASKA 99567 · TELEPHONE 688-2759 OWNER OF LAND /~/~ ~: !/,7 L~' ¢~ , t, ~ DEPTH OF WELL .) O ,~ ADDRESS '~2(, c~ 7 '~c~/~'~ d~Z ~/Z) (':?~,~O~~ ~TIC LEVEL OF WATER FT: LEGAL DESCRI~ION ~ ~tt ~/~.~ J-~,~* .~'/ ~"~<6~W DOWN ~. DATE-StaRed ~ZTo/Z5 ,; Ended ~¢/~/'~'z I GA~.PERHR ~,C' KIND OF CASING ,", ,.~- t', ,' ~ PE~IT NUMBER KIND OF FORMATION: From d~-" Ft. to ~ Ft. From '" Ft. to '~'!'~"~ r~ Ft. From/,!:~ Ft. to,,)JO From Ft. to From. ~ t.;:. Ft. to ) '7 7 Ft. Z~ ~.?,¢~'d,,)c2 [(,~ From__ Frdm ~ ./ Ft. to t~ Y / Ft. ~o/'.'(~/~(.>~__~( ~'~'~ From From Ft. to Ft. ~ -~ , ,.~ From,)J'/ Ft. to Oc*".-~ Ft, /~,'i~"~;~r~l~ ?,i~,~ From From. Ft. to Ft ~ From__ From. Ft. to Ft. From From__Ft. to Ft. From From__Ft. to Ft. From From Ft. to Ft.. From From__Ft. to Ft. From__ From Ft. to Ft. ' From Ft. to Ft. Ft. to Ft. Ft. to Ft. Ft. to.__Ft, Ft. to Fr Ft. to Ft. Ft. to Ft. Ft. to. Ft. Ft. to_ Ft. Ft. to Ft. Ft. to Ft. Fi, to Ft. Ft. to Ft. ,- Ft. to Ft. Ft. to Ft. Ft. to Ft. ?' · Ft. to Ft, MISCL. INFORMATION: DRILLER'S NAME -o' Ft. · · -rom · Ft. to Ft. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION Complete legal description N~¼; ~¼; SW¼; NW¼; S;~¼; Section 31;'.T15N; RLW; S.M. Location (site add~'ess or directions) 13739 Knob Hill Drive Property owner Mailing address Lending agency Mailing address. Agent Address Boyle '¢ /t4'a 7/-..,Day phone Day phone Ray Heberer - RE/MAX OF EAGLE RIVER Day phone 694-4200 16600 Centerfield Drive/ Suite 201, Eagle River, Alaska 99577 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Unless otherwise requested, HAA will be held for pickup. NOTE: individual well xx× Community well Public water 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: XXX individual on-site Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attestin~ to the legality and status of system. 72-025 (Rev, 1/91) Front MOA ~21 iNsPECTION BY ENGINEER Si'A"I'EMENI' OF - -nd as of the validation date shown beloW, number of bedroOms 5. As certified by mY seal aifixed here!u ~ val application shoWS that the on-site water suPPly · this.ea,th,.t o_'_'t ,%;notiona, andade,uate'°rthe obtained'rom and/or wastew~o, ~ ~ herein, investigation ~nd inspection, the on-site water and type of structure indicated t f uAher ~%rffY that based on the information codeS, the Municipality of Anchorage flies and from system is in compliance with a~l Municipal And State supPlY and/or wastew&ter dispOSal inspectiOn, ordinanceS, ~nd repuiati°ns in effect on the dee of this . Phone Name o~ Firm ~e Date Address ~ka 995~ ...... DHHS SIGNATURE bedrOOmS. noroved ~or ~ _------- A~r , /~\ ' 'Lh the ~o~towing stipulationS: ~ ------ Disapproved' .~--~/)bedroomS, w,, . .¢.~ Add~ti~~ /g d~' ~ By: ~ Health and Human Se~iceS (oHHS) issueS Health AuthoriW o~ Anchorage De~adment o~ given in paragraph 5 above by an independent The MuniCipality ,ementS. Employees of DHHS do ApprOVa~ Ce~ificates based only upon the representationsnot professional engineer registered in the State ct Atask~. The DHHS does this ~s ~ cou~esy to purchasers of homes and their lending institutions in order to satis~ ce~ain tedeml ~nd state reqUir Municip~tiW of Anchorage is not errOrS or omissionS in the prdeSsional engineedS work. conduct inspectiOnS or ~nstyze dat~ before ~ ceKiticate is issued. The responsible for  Municipality of Anchorage ~ " Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description:~'°~ ~=:~ , S~.~ ~.~ [~ Parcel I.D. - ~ ~ [~ OO~ A. WELL DATA Well type ?¢~'~ Log present ~N) Totaldepth -~:~t If A, B, or C, attach ADEC letter. Date completed Cased to ~, ~;~ t ADEC water system number ~5 ~ ?.- -~,% Driller ~'~ v~<.~ Casing height Sanitary sea~) Wires properly protected~N) FROM WELL LOG Date of test Static water level Well flow Pump level AT INSPECTION SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot \ Public sewer main Sewer service line ; On adjacent lots ; On adjacent lots Public sewer manhole/cleano.ut Petroleum tank WATER SAMPLE RESULTS: Coliform ~ c~ ~ ~"~/t~ ~ Date of sample: I [' "~'~ Nitrate Collected by: B. SEPTIC/HOLDING TANK DATA Date installed ~'.~ ['-z~ ... ~ t. Cleano uts i~.~,l) High water alarm (Y~ Date of pumping I I ~ cl t Pumper SEPARATION DIST/~NCES FROM SEPTIC/HOLDING TANK TO: Other bacteria 17034 Eagle River Loop Road No. 204 Eagle River, Alaska 99577 Tank size ~ c~:;> Compartments Foundation cleanout~N) ~ y Depression (Y~ Alarm tested (Y/N) Well(s) on lot t~>~ ~ '+- On adjacent lots To property line I'~ ~'~' Absorption field Surface water/drainage ~ ~ ~> ~,c, c:) [~' Foundation '7~ ~ Water main/service line 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE LIFT STATION Date installed Size in gallons Vent (Y/N) High water alarm level Meets MOA elec~ Manufacturer Manhole/Access (Y/N) ,~ "Pump on" level at .---~-~-'~ump off" level at Cycles tested Surface water D. ABSORPTION FIELD DATA Date installed Length ~'~ I Width ~/-'¢" Total absorption area Z~. Depression over field (Y/(~ Result~fail) Peroxide treatment (past 12 months) (Y/~) Soil rating /'O "'l Gravel thickness '~' ¢ Total deptl~ Cleanouts present (~N) / Date of adequacy test // for (".~") /---/y/o/..-'/~.! If yes, give date bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot ~,~' c:, ~ x''- On adjacent lots \'C) ~;~ t+-- Property line To building foundation 'bo ~ 4-' To existing or abandoned system on lot Cutbank Water main/service line Surface water [(;,~C> ~ J~ Driveway, parkJng/vehicle storage area Curtain drain ¢3'/t,~ t ' , ~ IE. ENGINEER S CERTIFICATION ,.,,r.J~'r'A ~o ~¢¢t.,,,~-r-.e~J ~,JA-¢ I certify that I have checked, verified, or conformed to all MOA and HAA ~, of this inspection. Signature Engineer's Name Date S & S ENGINEERING 17034 Ea~le Rivet' Loop Road No. 204 Eagle ~Jver, Alasl(a ~57=] HAA Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/91) Back MOA Waiver Fee: $ Date of Payment Receipt Number CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561-5301 ANAL¥SID RESULTS io~: INVOICE $ 40445 Chemlab Rei.$ 91.6263 Sample S I Matrix: WATER Client Sample ED PW$ID Collected Received L5 NWl/4 NWl/4 SWI/4 ~IW1/4 SWI/4 SECSi* UA NOV 20 91 ~ lO:O0 NOV 29 91 @ 16:40 AS REQUIRED Client Name :S & S ENGINEERING Client Acct :SNSENGP BPOS : ReqS : Ordered By :R. SNAFER POS :NONE RECEIVED Analysis Completed : NOV 22 91 Send Reports to: Laboratory Supervisor : STEPHEN C. NDE 1)S & S ENGINEERING Released By : ~ 2) Parameter Results Ur~.t s Method Allowable Limits NITRATE-N ND(O.IO) ~/1 EPA 353.2 lO Sample ROUTINE SAMPLE COLLECTED BY: RAY. 'TILN RLW SM. Remarks: i Tests Performed ' See Special Instructions Above UA~Unavailable ND= None Detected *' See Sample Remarks Above NAr Not Analyzed LT:Less Than, GT-Gzeatez Than Member of the SGS Group (SociOtO Gdndra[e de Surveillance) S07 RO~ D~t~iw 10~ 1991 City ~::~-~Fd~e 11401 Old Glenn ~wy. ~utte 9110A E~le .,~ve~r, Alaska 99577 RECEIVED DEC 1 8 1991 Munimpatity of Anchorage Dept H'ea th & Human Services ~ SU,J;,J~ tO ~ti~fa~O~ ~l~tion of ~al r~ir i~_ ~Y, I j%e~pe(n:fully, Joel b -- APPLIC/' IT FILLS OUT UPPER HALF-ONLY Propertv Ownell ?~') / /~./ .~ ~' ~, Phone Address Zip Code Lending Institution/.~) /~ ~9~'~~/ ~~7~ ~ Phone Realty Co. & Agent ~ Address ZiP Code , Street 'Type of Residence Single Family ~ Multiple Family No. of Bedroor~s ~ /-- ATTACH WELL LOG. A well log is required for wells drilled since June 1975. ~_G~m~i~l~y For wells drilled prior to that date, give well depth (attach log if available). t~] Public Utility Sewer Disposal When Donnected to Public Utility: NOTE:THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date ~/~ Inspector Inspector Inspector Inspector ~ ~vt.o,'~,,~'.~rA, ,; ,,. ~' C~ (7) APPROVED BEDROOMS (~_~¢~__ ~2~~ 'CON ITIONS OF APPROVAL September 8, 1983 David H. Boyle 2607 Arctic Blvd. Anchorage, AK 99503 Subject: T15N, R1W, $31, Portion Lot 5 Approval for the individual sewer and ~ter facilities cannot be 9ranted until the following items have been completed: 'i'he water facilities were not turaed on at the time of the schedaled inspection. Please call this o~f_ice for an6ther appointnlent. Please notify this Department for a reinspection when ' ~ noted discrepancies have been corrected° If there are any tels further questions, please call ' ' * office at 264-4720° Sincerely, LSC1/ej/E2 Lynn ~' ~, Coad P© ~f~ H 6-650 ANCHORAGE, ALASKA 99502-0650 (907) 264-4111 TONY KNOWLES. MA YO R DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION June 16, 1983 David H. Boyle 2607 Arctic Boulevard Anchorage, Alaska 99503 subject: Carol Creek Water Supply T15N R1W Section 31 Portion Lot 5 Enclosed is a copy of a let%er from Mike Mathews, D.E.C, disapproving the subject water supply. Prior to our approval, by the State of Alaska, Conservation. the water supply must be approved Department of Environmental If there are any further questions, please call this office at 694-2131 or 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw eric. PO BOXSI5 SOU~HCENTRAL REGIONAL OFFICE / ~ K~IAK ALASKA 99615 (907) 48~3350 MUNICIPALI~ OF ANCHORAGE SOLDOTNA. ALASK~ 99~69 AUG 2. 4_/982 [] P.O. BOX 1709 VALDEZ, ALASKA 99686 (907) 835-4698 RECEIVED P.O, BOX 1064 WASILLA, ALASKA 99687 (907) 376-5038 August 20, 1982 Dept. of Health & Environmental Protection 825 L Street Anchorage, AK 99501 ATTENTION: Les Bucholtz Dear Mr. Bucholtz: There are substantial deficiencies in the Carol Creek Community water system which will require a major rework to correct. Needless to say this department cannot give health approval for the Carol Creek Community water system in its current state. If you have any questions feel free to contact me at this office. Sincerely~ MM/er cc: Alice Bowles P.O. Box 302 Eagle River, AK 99577 Mike Mathews Environmental Field Officer 18-09 L H IVIUNICIPALITY OF ANCHORAGE I~F!¢i,,:..¥<,~ ;~/& HO1 !Cf ION DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska g9501 / ~ ~ ? . , -, ENVIRONMENTAL ENGINEERING DIVISION Telephone 264-4720 ~%. ~ ,. , ~ ~ ~,: ,,~ .. REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES ,I RECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER PHONE 688-2450 David H/Mary L. Boyle MAILING ADDRESS Knob Hill Drive (Box 140 99577) PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE Refinance MAILING ADDRESS 3. LENDING INSTITUTION I PHONE National Bank of Alaska % Kathy Claiborne I 276-1132 MAI LING ADDR ESS Pouch 7-025 99510 4. REALTOR/AGENT [ PHONE MAILING ADDRESS 5. LEGAL DESCRIPTION T15N R1W Section 31 Lot 5 TREET LOCATION Knob Hill Drive 99577 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] One [] Four [] Other__ ~ SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY :~ Three [] Six 7. WATER SUPPLY ~ INDIVI DUAL* * 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 UTI LITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM ×~ INDiVIDUAL/ON-SITE** [] PUBLIC UTI LITY **If individual/on-site, give installation date 1968 If system is over two (2) years old an adequacy test is required by this Department. NOTE: THE INSPECTION FEE IVIUST ACCONIPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) THIS SIDE FOR OFFICIAL USE ONLY ' i DATE RECEIVED iNSPECTION APPOINTMENTS TIME TIME TIME DATE DATE 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 UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER E~INDIVIDUAL/ON -SITE DATE INSTALLED E~PUBLIC UTILITY Connection Verified INSTALLER []Septic Tank or []HoldingTank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4, DISTANCESwELL TO: Septic/Holdin§Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS [] CONDITIONAL APPROVAL (letter must accompany certificate) [~J-//'DISAPPR OV ED BY (Title) ////~ LEGAL DESCRIPTION 72-010 (Rev, 3/78) 907) Jun~ 23, 1978 David H. ~oyle 2607 Arctic Boulevard Anchorage, Alaska 99503' Subject: T15N R1W Section 31 Lot 5 The water supply serving your residence is not approved by this department. Therefore, before we may grant approval, the water supply must be from an approved source. This would include: (1) Drilling a well to meet local and state health regulations. (2) Arrange to have the Carol Creek water supply treated properly with chlorine and also a filtration treatment. If there are any further questions, please contact this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Sanitarian RCP/ljh J MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL ENGINEERING DIVISION Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES ;)IRECTIONS: Complete all parts on page 1, Incomplete requests will not be processed. Please allow ten (10) days for processing, 1, PROPERTY OW ER PHONE~ M Al L~T~G ADDRESS PROPERTY RESIDENT If different from above} PHONE PHONE MAI LING ADDR ESS 3. LENDING INSTITUTION PHONE MAILING ADDRESS 4. REAL'j'OR/AGENT PHONE MAILING ADDRESS 5. LEGAL DESCRIPTION STREET LOCATION 6, TYPE OF RESIDENCE SINGLE FAMILY [] MULTIPLE FAMILY NL~MBER OF BEDROOMS [] One [] Four [] Two [] Five ~ Three [] Six [] Other 7. WATER SUPPLY . [] INDIVIDUAL* ~ ;30~J ~";' * ATTACH WELL LOG. A well log is required for all wells drilled [] coMMuNiTY c~' / since June1975, For wells drilled prior to that dat~ giv~ well [] PUBLIC UTI LITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM ~ INDIVIDUAL/ON-SITE** [] PUBLIC UTI LITY **If individual/on-site, give installation date If system is over two (2) years old an adequacy test is required by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONL , DATE RECEIVED INSPECTION APPOINTMENTS INSPECTOR//'~ ij INSPECTOR INSPECTOR DIRECTIONS: 1, TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [~-'"~H R EE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2, WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DR I LLE D [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] INDI VI DUAL/ON -SITE DATE INSTALLED Connection Verified INSTALLER [Z~Septic Tank or []Holding Tank Size: ]¢L')O If Tank is homemade SOILS RATING give dimensions: TOTAL ABSO~P.T,,ION AREA MATERIAL 4, DISTANCESwELLTO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5, COMMENTS [] APPROVED FOR BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) DATE BY ( 72-010 (Rev. 3/78) !~ ~ MUNICIPALITY OF ANCHOR~AD~. ~ ~f~"l ' 825 L Street, Anchorage, AlaSka , [[~)j ' 264-4720 "/~uest f6r Approval of Individual Sewer and Wate~~aci~l'~es 1. Property Owner: David H. Boyle & ~ary L. Boyle Mailing Address: 000 Kno5 Hill Drive, Ea~le River, AlaskaPhone: 688-2450 (Box 140, EaEle River, Alaska 99577) Name of Buyer: N/A (Refinance) Mailing Address: Phone: e Lending institution. Mailing Address: Realtor/Agent: Mailing Address: Legal Description: Street Location: National Bank of Alaska Pouch 7-025, Anchorage, Alaska (Attention: Kathy Claiborne) N/A 99510 Phone: 276-1132 Phone: Lot 5, Sec. 31, T15N, R1W, SM. 000 Khob Hill Drive, Eagle River, Alaska Single Family Residence: (X) Number of Bedrooms: 3 Multiple Family Residence: ( ) Number of Bedrooms: Water Supply: * Individual Well (x) Public/Community System If Individual Well, well depth Spring Fed If Community System, name of system ( ) Sewage Disposal System: *~Dn-site System (X) Public System ( ) If On-site System, date of installation: Estimate 1968 *NOTE: A well log is required on ALL wells drilled since 6/75. ** If on-site sewer system is over two(2) years old, an adequacy .test is required by this department. A fee of $25.00 must accompany each request before processing can be initiated. 3/77 POUCH 6-650 ANCHORAGE, ALA, 8I<A 99502 (907) 264-dll 1 ,' June 23, 1978 David H. §oyle 2607 Arctic Boulevard Anchorage, Alaska 99503' Subject: T15N R1W Section 31 Lot 5 The water supply serving your residence is not approved by this department. Therefore, before we may grant approval, the water supply must be from an approved source. This would include: (1) Drilling a well to meet local and state health regulations. (2) Arrange to have the Carol Creek water supply treated properly with chlorine and also a filtration treatment. If there are any further questions, please contact this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Sanitarian RCP/ljh GRID N W454 Adjoining Page No, Adjoining Tax aoo~ Ne.