HomeMy WebLinkAboutMOUNTAIN MANOR BLK 4 LT 2Mountain
Manor
Block 4
Lot 2
#050-671-27
Municipality of Anchorage :; ' •.
Development Services Department
Building Safety Division
On-Sita Water and Wastewater Program, 4700 Elmore St.
P.O. Box 196650 Anchorage, AK 995196650 Page of
www ei.anchorage.ek.us (907)343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: SW OIDD410 PID Number: 0,50-ca-4141-
:liiZtit h
�� %2A i
Wastewater System: El New [3 Upgrade
Aaa eu 116136 S 'd1w e.. rev
ABSORPTION FIELD
i�
phone NumWr or Bsdoama
D Dap Tnnpn O 8lunaw TreMl I] Baa D Mourk 00~
LEGAL DESCRIPTION
Sod Rating
from
ToWDepphab
GPD/FII
FI.
elocaLot SuWd am
M '
Depth M pip, boo IMM M* o.
GnW depol i alh ppe
4 2 1 1DW n n r
FI.
FI
To zhlp Rarpe section
FJ amaa above mg," grana
Gravel LwVlh
FI.
FI.
Well: ❑ New ❑ Upgrade
Gravel elfin
Nuraba w ims
Diwlpa th,h~ Im
FI.
Ft
ClafMaCaOM(Pnran, Aa.Q
TOW Depth
C&WW
Total aeWrytow"a
pipe MalMN
FI.
FI
Fit
D~
Date DNlad
euap Wale, Level
M`INNr
CO(15kiu.L
Data Metalled
S 0
FI
►/� tOr�
TINA
Pump $•1 al
Caelnp lNgM AW" Gra.q
TANK
GPM
FI.
FL
SEPARATION DISTANCES
KSeptic ❑ Holding ❑ S.T.E.P. ❑ Other.
7o
Septic
Absorption
Lit
Holding
ub(IHPnvate
n" aLYfw •T
Aprq
'p'°n
1250
From
Tank
Field
Station
Tank
Sewer Line
Iqv% k
GN
Wag
r
loo+
1
425
Malahoa
IS
Num V Carper IS
a
56e.
surl.0 Wanr
N.O.
LIFT STATION
as nu .a✓ar
Lot Lme
51+
V
Gal
L
'Pump W. is a at '"W1
Mgt, water 0. at
faurgatgn
5 t
I M
M
Cunrn Drrn
N O
Pump WM a Elecurul Mpecawa pellamed by
r a
Rem.ne' MOA
�
BENCH MARK
Lauuan ane Daarnp.an
To Cenu� Sf�,'� Lnnc;n
cue to .u»rn�s
IevaaM.
!OO FL
('
Inspections performed by: (-1 J urkl 1 Dates: 1"
�IepDlnnZ'C�'�`�1�
the
Development Services Department Approval
,�`.�,�
, ; 49TH
Conditional Approval Date:
i
LARS . S?UAKIA. j
�'� •, ,, 15 0 ZZ
Reviewed and approved by: G ate:
(Rev eamel
NEW 1250
\
SViHG nrS /
A 0 /
C 1 16' 1 10'
0 11' 16.5'
[ 18' JI'
F 16 57 /
/ G 17 58.5 /
cr
F� --—————————————————————L—————————
\
�t-------------------------
\ ?jGF� NEIGHBORING WELLS >> 100' — — — — — — — — — ___
— —
INSTALLED DOUBLE
NCLEANOUTS fl
CONNECTED TO
EXIST DRAINFI£LD
+/- 5 FEET COVER
+ INSTALLED DOUBLE
TS
ruy..= +/-88.J
1250 GALLON SEPTIC TANK
IIS' V < G.V � !'.'' � LV T E A• b , + 1 .
25 0 25 50 75 1A7 125 150
SCALE, 1' = 50 FT. NNWiltM �yA� lCO^� stAa DICK Sura b
CONNECTED TO
EXISTING PIPING
5FURKLANDW 15TH. AGVENUENG I I MOUNTAIN MANOR BLOCK 4 LOT 2 I I SEPTIC SYSTEM ASBUILT
ANCH. AK. 99501 ELIZABETH HABZA DATE.' MAY 14, 1009
fcn7) 970—;ole 187J8 SALL WATER DRIVE: EAGLE RIVER. AK 99557 SHEET •1/1 GRID: NW 254
PERMIT # SVO90046 PID # 050-671-27 TBHB3L2DI.DVG
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water B Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Permit Number: SWO90046
Legal Description: MOUNTAIN MANOR BLK 4 LT 2
Design Engineer: 0007 SPURKLAND ENGINEERING
Owner Name: ELIZABETH HABZA
Owner Address: 18738 STILLWATER DR
EAGLE RIVER , AK 99577-7928
This permit is for the construction of:
❑ Disposal Field ❑? Septic Tank
,Allo 5 tv 3 : ,Oc
Date Issued: Apr 30, 2009
Expiration Date: Apr 30, 2010
Parcel ID: 050-671-27
Site Address: 018738 STILLWATER DR
Lot Size: 51202 SO. FT.
Total Bedrooms: 3 Permit Bedrooms: 3
❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
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 ( 18AAC80 ).
3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 ( 24 hours). ( Not required for a Water Supply Permit only).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By. Date: 30 D
Issued By. )Dn-(Y N61-7, j4&ft� Date: 7-:�
Municipality of Anchorage
--Development Services Department,;.,;; --
Building Safety Division
On -Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.orglonsite
(907) 343-7904
ON-SITE SEPTICMELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 056)-671-27
Propertyowner(s) EL?AeA He,6ZZ, Day phone G94-7-630
Mailing address 2Cioe LCqle Riuen , AI< zip Code 515"IT
Site address —5ync—ff1 p Zip Code
Legal description (Sub'd, Block & Lot) ��oLr. �a�� I�nDr 911 9 LT 7—
Legal
Legal description (Township, Section & Range)
Lot Size 5I ZOZ Sq. Ft.
THIS APPLICATION IS FOR (®all that apply):
Absorption Field
❑
Septic Tank
Holding Tank
❑
Privy
❑
Private Well
❑
Water Storage
❑
Number of Bedrooms 03
THIS APPLICATION IS AN:
Initial
❑
Upgrade
Renewal
❑
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
(Signature of prdperty owner or authorized agent)
Permit/Rush Fees:
S30 o-' Waiver Fees:
Date of Payment: V36O
Date of Payment:
Receipt Number. b S O$ (�� Receipt Number:
(Rev. 11/05)
Y . SpuM and Engonearong
Environmental Consulting and Design
April 29, 2009
Municipality of Anchorage
Development Services Department
Building Services Division
On-site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
Subject: SEPTIC TANK PERMIT APPLICATION
MOUNTAIN MANOR BLOCK 4 LOT 2
Ladies and Gentlemen:
We are submitting an application to upgrade the septic tank for this lot. The existing septic tank serving the
above referenced property has collapsed. The submittal consists of one (1) drawing showing the present
improvements on the lot and the proposed improvements of the lot, of which only the septic tank is subject
to this permit application.
There are no wells within one hundred feet of the proposed replacement site. The installation of this septic
tank will not prevent wells and septic systems from being installed on the adjacent lots. There are no
developed or natural surface / sub surface drainage courses within 100 feet of the proposed septic tank
location. The proposed septic tank will not change the general slope of the area. Ponding and/or
concentration of surface runoff will not result from this installation.
If you have any questions or are in need of additional information please contact me at 279-3916.
Si cerely, I
s p�y l
u land, P.E.
203 West 15r' Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (907) 276-6013, SpurklandEng�a�gci.net
/
/
/
/
NEW 1150
\l \
/
/
LF tt /
-----------------------L--------
— — — — ------------ — — — — — — — — —
NEIGHBORING WELLS_ s� 100'
\ NO elks$ ,A" .. 'C" W..: ....: T•.:.. zoo' •F ��-p-sv� s�p�;L •G h-
Loca�i.n • 4 FEET COVER
INSTALL DOUBLE
CLEANOUTS fl II II q II
INSTALL DOUBLE
CLEANOUTS
CONNECTED TO
EXISTING PIPING
CONNECTED TO
EXIST DRAINFIELD
1250 gat septic tank
Y:
rA,{;4!
25 0 25 50 75 100 125 150
SCALE, 1' = 50 FT.
5PURKLANDW 1157H. AVENUE ENGINEERING
(I MOUNTAIN MANOR BLOCK 4 LOT 2 I I SEPTIC SYSTEM DESIGN
ANCH. AX. 99501 EUZABETH HABZA DATE: APRIL 29, 1009
/om) 970—TQIR 18718 STILL WATER DRIVE. EAGLE RIVER, AK 99557 SH££T••1/1 GRID. NW 254
PERMIT # SV090XX PID # TBHB3L2DI.DV&
Yu SPHTkUSfld
Environmental Consulting and Design
Single Family On-site Wastewater Disposal System
Construction and Material Specifications
Subject Property: MOUNTAIN MANOR BLOCK 4 LOT 2
Date: April 29, 2009
General:
1. The owner shall contract with a contractor to perform the work outlined In these
specifications and plans in accordance with the attached MOA permit. There Is not
contractual arrangement between the contractor and the Engineer. The Engineer shall
be the owners representative and will Inspect the work to document the contractors
activities. Final acceptance of the contractors work rests with the owner and the MOA.
2. The scope of the work includes the installation of a new 1250 gallon septic tank. The
location of the drain field is shown on the attached site plan drawings. All components of
the proposed septic system must be constructed a minimum of 100 feet from any surface
water or water wells in the area. A minimum of 4 feet of earthen cover is required over
the septic tank. If less than 4 feet of cover is available, 2 -inch thick, 40 psi, direct bury
board foam shall be installed directly over the septic tank and all Installed piping.
3. Construction shall be in accordance with the approved site plan and design drawings and
any special provisions noted on the Municipal well and/or septic permit. All materials,
components, workmanship and construction practices shall comply with the Municipality
of Anchorage's latest ordinances regarding wells and septic systems, as well as MOA,
Development Services Department, On-site Water and Wastewater Program (DSD)
policies.
4. The contractor Is responsible for obtaining all underground utility locates, layout of the
proposed system, and verifying and maintaining all required separation distances to lot
lines, surface water, wells, steep slopes, etc.
S. The property owner shall be responsible for final grading any depressions formed from
settlement of ball material. The property owner Is also responsible for vegetation of
all areas disturbed by septic system installation activities.
6. Contractors Installing wastewater disposal systems must be certified to do so by the MOA
DSD, On-site Water Wastewater Program. Property owners Installing their own systems
must receive advanced approval from MOA DSD prior to system Installation activities.
7. The contractor shall ensure that ALL materials being used are In compliance with the
most current guidelines established by the Municipality of Anchorage. Refer to
"Standards and Specifications for Component Parts and Materials Used In the
Construction of On-site Wastewater Disposal Systems", Dated December 2000, as
provided by MOA DSD, On-site Water and Wastewater Program.
203 West 15'h Avenue Suite 203, Anchorage, AIC 99501, Phone: (907) 279-3916
Fax: (866) 354-1597, LspurklandCagci.net
Ail SPUMand EROOOROMHO
Environmental Consulting and Design
Septic Tank Installation:
1. A new septic tank, of the size specified in the design drawings, shall be procured from a
qualified manufacture/supplier if the existing septic tank is found to be defective.
Construction shall Include two 4" diameter deanouts for pumping access.
2. The burial rating of the tank shall be adequate for the actual burial depth encountered.
3. The tank shall be level and sufficiently bedded to prevent settling of shifting of the tank.
4. All standpipes on the tank shall extend a minimum of 12inches above the final grade.
S. Tanks Installed with less than 4 feet of cover shall be Insulated.
6. The sewer service line from the house to the tank shall have a minimum slope of 2%
unless prior approval is obtained from the engineer.
7. The inlet and outlet lines from the tank shall be bedded in drain rock or the soil shall be
sufficiently compacted to prevent future settlement of the soil.
S. Septic tank inlets, outlets and cleanouts shall be fitted with water tight couplings.
9. A cleanout shall be Installed 1 to 4 feet from the foundation.
10. Post tank deanouts shall be installed per MOA requirements. Does not apply to
pressurized lines.
11. In areas with high ground water, the septic tank shall be sufficiently anchored to resist
buoyancy forces when there Is not adequate soil cover to resist uplift force. The
contractor shall refer to the engineer for direction regarding this matter.
12. The tank backfill shall be graded sufficiently to ensure positive drainage away from the
tank.
13. All holding tank and lift stations shall have an audible and visible alarm Inside the
residence being served.
14. All lift stations shall be wired in compliance with all MOA guidelines and the Uniform
Electrical Code. A municipal electrical permit and Inspections must be obtained where
required by the MOA.
15. The contractor shall verify that the septic tank/lift station is a minimum of 100 feet from
any residential water well, 150' from any class `C well and 200 feet from any community
water wells. Additional separation distances must also be maintained.
16. The contractor shall remove or abandon the existing tank In compliance with the Unform
Plumbing Code.
Inspections:
1. A minimum of one Inspection Is required by the Municipality of Anchorage. These
Inspections must be conducted under the supervision of a Professional Engineer licensed
to practice In the State of Alaska.
2. The septic tank may be set In place, but may not be backfilled.
3. The contractor shall provide a legible copy of all field notes relating to system layout and
construction to the engineer for the use In preparing the record drawings.
4. The contractor shall coordinate all inspections with the Engineer. A minimum of 24 hours
notice is required prior to the start of construction. If necessary, a preconstruction
meeting will be held on-site.
203 West 151e Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (866) 354-1597, Lspurkland@gci.net
`IUNTCIPALITY 01-1 ANCHORAGE
lleaa and Envi, -mmental PrOtOc )n
Fc) u r t 1-'21-oor West -
825 L Street
Anchorage, Alaska 99501
264-4720
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
I C f1 I
[A GAI, F'l SC, RIP
IA PI IC I Ak K:
NUMBER OF
COMPARTMENTS.
L10 1D DLPF 1 1. 10 t J 11) CAPACITYIALLONS.
TILS U(t;�IN I H
TOTAL_ LENGTH
� -OF I INE
iW j "
kOi �"J : t �'
+ f 0rJOAN11 AW T LG I Lljr
I ION I
of Tki NCH IN. TOTAL EFFECTIVE
C)r j I
So' 11. t f W" 1 11 "'C f I
LINE
I IA Illi 0; f I t T i p
r'lAl I, klh! fi[ '\JF/\ [H TILT IN, ABOVE TILE ------- I N.
[ii %1[, I LP - __ - OR WIDTH LF'4C, f1-1 ___ DEPTH
1,o(j Crib P i ll(J'l Crib Size H __I)LH I I DISTANCE FF!OM: WELL
cf I F ("I I v L
/,FSOIWI ION ARTA (WALL AREA) F T.
7 >
L uI e To Lot Lint_ d4-
I a t
-A
I Pedl
---- ---- - - ------
�.d U 01 � K t .. X F2 �
DEP�RTi'lENT DF
3
to
h"WHAFRA60 HK
T�E �E�eIRE� 1,0E 011 THE SUAL HBSORPTION SYSTE�� IS�
:-. 0 it.~G� i 44 1 S -1 - b" = -4. 05
71 AE LU6iH ulHEWSION IS THE 0461 H (IN FEET) 01`7 THE TRENCH OR FORA INFIEux
Bl[ 1E1TH #F H TRENCH OR Fill 04 THE DISTHNCE BETWEEN THE SURFHCE OF TbE
6HOUN0 Hm/) T�E 1:�;UTTUM OF THE ION (IN FEET)
lHERE l� NV SET WI�TH FOR TRENCHES
TH� GRHvEL DEPTH IS [HE MlNIMUM DEP[H OF GRHYVL BETWEEN THE OUTFHLL PIPE
HND ME BUAUM 0F THE EXCHVHTlUN (IN FEE[).
ANWAAM., I WOULA "S"1200"I-3: Q "I`�11,14 u<: � X Ybfk?�== S. AR 55125 Q 0011. .k.Cl h; 50:
~~.. 1:1 MI: 8������.�,: 4. .g=il 11 11 , 11 , A� Cs who
H PH�KH6E PLHNT MHY BE 1145310LLED HT THE PERMITTEE'S OPTILAA SUBJECT TU THE
FUL�OWING C0N1/111U149;:
1. EIlHER H CL PUSS I OR lI NSF APPROVED PL. ANI MHY BE INSTHLLED.
2 R Coro TINUMUS MHINTENHNCE HGREEMENT IS REQUIREM IF H MHINTENHNCE
HGREEMENT IS NOT KEPT CURRENT YOU MAY BE REQUIRED TO ENLHRGE THE SOIL
HBSORPl|QM SYSTEM ANDY (W YOU MAY BE SUBJECT TO PROSECUTION
~..... ...... ..... ..... -��.... .... ..... �... ..... �~... ~.... ... ... ..... .... ��~�~-... ....... —
YA11:1 X CM410 911 Fit tic Q WH ill Q I A Q F7 421
8QCKFliNG UF 10 "1 SYSTB1 WIlHOUT FINHL INSHE CT]ON HND HPPROOFR. BY THlS
DEPHVlNENT WILL BE SU8JK0 TU PROSECUTION,
NINIMbM DIS|HNCE BE[WEEm H WELL HND ANY ON~SITE SEWHGE DISPOSAL. SYSTEM IS
i00 Ft -ET F0R H I-RIVHTE WELL OR 200 FEET F0R A PUBLIC WELL
WL LOGS HRE REQUiFRED 1 -IND MUST BE RET|jRNED TO THE DT WITHIN Z0 DHYS
OF lUN�
d11 MA%, HPPL.YAND CONSTRUCTION DIHGRHMS HRE
HVHlLH8[G TU IN4dRE PRU|'ER INSTRLLHTI0N.
1 0�101-m0,-1 41 1AW :1. k0bab
0 Et E GEO'e r-CHNI CAL Et DEVELlueMENT CO.
Box 90, Davis St., Eagle River, Alaska 99577
694-2774 or 688-2280
Russell Oyster Earl Ellis
694-2774 SOIL LOG 688-2280
Soils Et Foundations Land Developffwnt
Performed for: Name:
Tel. No.
Mailing Address:
Legal Description: Z' i;",H
Depth (feet) Soil Characteristics
0
2
3
4
5
6
7
e
96
8
9
10
11
12
13
15
16 4 -
Ground Water Encountered: Yes No ate" If yes, what depth
Proposed Installation: Seepage Pit Drain Field
Comments:
Performed by: Date:
This well is producing __,— gallons of water per hour.
MOON DRILLING
SR BOX 668, BOGARD RD.
PALMER, ALASKA 99643
TELEPHONE 743.4071
Lot Blk. Sub.
INVOICE Set Dump @ — feet.
INV OICE NO.
DATE
YOUR P. o. NUMBER
TERMS
WELL LOG SALESMAN
DEPTH CABIN FORMATION
IN FT.
DEFT. CASIN FORMATION DEFT. CABIN FORMATION
IN FT.
IN FT.
101
201
—2
102 -'
202 --
—3
103
203
—4
104
204
--5
108
205---
06-8
-6
108
208
ry
107
207
® 8
l08
20a
s 9
109
209-
10
110
210-
11
111
211—
Z12
112
-212-
18-113—
— 213
14 —
134
—214-
15, _
118
218
X18
118
—216-
17
117
217-
17_1813e
-to
-118-
216
_19
119
219—
,20'120—
—�220
_21
121
221
_22
122
222
28 ��
—24
128
223
124
224
_26
126
226
26
lee
226
_27
127
227
_28
128
22a
—.29
129
229
8o ��
180
_ 280
_81
131
281
_32
182
282
88
138
288
_84
184
284
_a6
186
235—
_36
las
las
_87
187 "
237
asase
tae
39
139
239
—40
140
—240-
41
141
241-
-42
142
242
148
248
- 244
A
5. LEGAL DESCRIPTION
Dr rE RECEIVED
INSPECTION APPOINTMENTS
TIME �^
TIME
TIME
DATE
�; --z / ^
DATE
DATE
INSPECTf/
INSPECTOR
INSPECTOR
❑ Two ❑ Five
ANC"
MUNICIPALITY OF ANCHORAGEOP
�r,,,,��``,,NNIGIPA�-I� HEA�TN &
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTW91. OP 'OVA
825
825 L Street - Anchorage, Alaska 99501
ENgIRONMENIA L
�� 1931
Z l'
ENVIRONMENTAL SANITATION DIVISION
.,.UN
Telephone 264.4720 CC [('� JE�,D
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEIIWB� etLTTIES
❑ PUBLIC UTILITY
depth (attach log if available.)
DI RECTI ONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing..
1. PROPERTYOWNER
q ox��
Ng::r' INDIVIDUAL/ON-SITE**
PHONE
MAILING ADDRESS
PROPERTY RESIDENT (If different from above)
PHONE
2. BUYER
PHONE `.
MAILING ADDRESS
3. LENDING INSTITUTION
PHONE
Sr9 err cc�s��C
2_77—YS�
MAILING ADD SS
4. REALTOR/ GENT
PHONE
MAI LING ADDRESS
2-7o Z L) /o 9j -v3
5. LEGAL DESCRIPTION
STREET LOCATION
6. TYPE OF RESIDENCE
NUMBER OF,BEDROOMS
SINGLE FAMILY
❑ One Four ❑ Other
❑ Two ❑ Five
ED MULTIPLE FAMILY
❑ Three ❑ Six
7. WATER SUPPLY
t03r— 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
Ng::r' INDIVIDUAL/ON-SITE**
�F t7 YEAR ON-SITE SYSTEM WAS INSTALLED.
❑ PUBLIC UTILITY
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010 (Rev. 6/79)
LOAF
79.Mn (Rwv WWI)
�L.
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE
❑ SINGLE FAMILY
❑ MULTIPLE FAMILY
NUMBER OF BEDROOMS
❑ ONE
❑ TWO
❑ THREE ❑ FIVE ❑ OTHER
❑ FOUR ❑ SIX
2. WATER SUPPLY
❑ INDIVIDUAL
❑ COMMUNITY
❑ PUBLIC UTILITY
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
!
1 '
INSTALLER
❑Septi Tank or ❑ Holding Tank
Size: If Tank is homemade
give dimensions:
SOILS RATING
TYPE OFTANK
MANUFACTURER
TOTAL ABSORPTION AREA
MATERIAL
4. DISTANCES
WELL TO:
Septic/Holding Tank
jAbsorption Area
Sewer Line
Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
Fr APPROVED FOR _ BEDROOMS
❑ CONDITIONAL APPROVAL (letter must accompany certificate)
❑ DISAPPROVED
DATE
/ Lq—r
BY
I
LOAF
79.Mn (Rwv WWI)
�L.
r Pp
W
825 "L" STREET
ANCHORAGE, ALASKA 99501 ---
(907) 264-4111
\A i% GEOHGE M. SULLIVAN, �n1 I.
/i MAYOR -lid !-4f�/,hl ��
>^
kdTf
[)L PAR T MENT OF HEALTH AND ENVIHONMEN1AL PROT EC TION `�J ��C %106 f
June 26, 1981 c_'..r CV -n -
lhis - i 1" /9(,_.��
Marva Okeefe
Ted Taylor
Re/Max Properties
2702 Gambell Street
Anchorage, Alaska 99503
Subject: Lot 2 Block 4 Mountain Manor Subdivision
On June 25, 1981, I was at the above location to draw
a water sample. I met Mr. Williams, who was performing
a well production test. He informed me that the well on
the property had no water, but there was water in the
house.
This department prior to sampling will need to know the
location of the well or water source, which supplies
the subject property with water.
There is a strong possibility that the water_ source would
not be approved, either because of its source or its
protective .radius from a sewer,system.
If there are any further questions, please call this
office at 264-4720.
Sincerely,
Robert C. Pratt, R.S. P,6
Associate Specialist
RCP/ljw
cc: Safeco Title
804 East 15th Avenue 99501 '_}r�
e5V 7-D / b~ /
,r
MUNICIPALITY OF ANCHORAGE
122 IL 4 d V'
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTININICIPALITY OF ANCHORAGE
826 L Street - Anchorage, Alaska 99601
0*
DEPT. OF I IEALTH &
ENVIRONMENTAL 'I'ZOTECTION
ENVIRONMENTAL ENGINEERING DIVISION
=RESIE
E FAMILY
" Telephone 264.4720
JAN 18 1979
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEW�ElE.
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allpw ten (10i days for processing.
1. PROPERTY OWN
l �t 4 err
7. WATER sup!py-
PHONE
MAILING ADDRESS
* ATTACH WELL LOG. A well log is required for all wells drilled'
PROPERTY RESIDENT (If different from above)
since June 1875. For wells drilled prior to that date, give well
PHONE
f 7/
dNv kCA I 4k,
S. SEWAGEDISP SYSTEM
2. BUYER
**If individual/on-site, give installation date$_.
PHONE
Q
❑ PUBLIC UTILITY
by this Department.
MAILING ADDRESS
3. LENDING IN TITy TION
1 /�
�as+, �7
PHONE
�7 q h
MAILING ADDRESS
4. REALTOR/ GENT
PHONE
r
��� ✓
J
MAILING /0ADDRESS Y /-- lAti .
S. LEGAL DESCRIPTION
122 IL 4 d V'
STREET LOCATION
S. TYPE
NUMBEROF B GROOMS
=RESIE
E FAMILY
❑ One our ❑ Other
E:1, Two ElFive
1:1 MULTIP AMILY
❑ Three ❑ Six
7. WATER sup!py-
C;-'�INDIVIDUAL*
* ATTACH WELL LOG. A well log is required for all wells drilled'
❑ COMMUNITY
since June 1875. For wells drilled prior to that date, give well
PUBLIC)JITILITY:
depth (attach log if available.)
S. SEWAGEDISP SYSTEM
INDIVIDUAL/ON-SITE**
**If individual/on-site, give installation date$_.
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.
THIS SIDE FOR OFFICIAL USE ONLY
INSPECTION APPOINTMENTS
DATE RECEIVED
TIME
TIME
TIME
DATE
DATE
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
❑ ` PUBLIC UTILITY
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
f
INSTALLER
❑Septic Tank or ❑ Holding Tank
Size:IfTank ishomemade
give dimensions:
SOILSRATING '
TYPE OF TANK
MANUFACTURER
TOTAL ABSORPTION AREA
MATERIAL
.f
4. DISTANCES
WELL TO:
Septic/Holding Tank
Absorption Area
Sewer Line
Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
s-
&,/APPROVED FOR t1 BEDROOMS
❑ CONDITIONAL APPROVAL (letter must accompany certificate)
tj—DISAPPROVED
DATE :L . �/`
BY iTitle)
LEGAL DESCRIPTION
72.010 (Rev. 3/78)
January 26: 1979 uO� � LmUr
Everett uon eg gar
1042 Vast 6th Avenue
Anoliorage, Alaska 99501
;subjects roar 2 alock 4 mountain Kanor Subdivision
ltois Fielders Property
Approval for your ins i viClual sewer anal water ruoilitia
will racrt 'ba grantee, until ttie iellavinki itamse have baa
mplof s
(Z) A gall 109 i.s SObMi:ttOd tO tia s del rt aunt.
{ } ,he toll of tilewell or,sinq is saa,,jl ars «ittz a sanitary
seal encs tilat it is avatar tight,
i With jAm"'Paround
4i
rVi.ousbtype soil so that: it. slopes
away from tha well causing,
{ j
The well oas.ixer is extan4j t olvc (1 ) inches absav+s
rtaxxc►rr1 levol.
{ [ Y:xpoae they troll for our instA ertion to determine prof er
construction, al.sa, to insure thn minimum distance
requirements aro svat between your well and saw6r ,nystcera.
{ he mept.iea tank is rawed WWI a rOaui Pt Sub itt*cl to
this ,office:.
{ I A four. {4} in0h Cast iron cleanout be installed to "e
naptic tangy; or leaachinq area*
{ } h percolation tact .tilt lanerfarmsd On hoes aeacistin leeching
areaa. This wi.lidetermine if tha sysYtOn is adequate
According to National Staandarde, A liatt. Of Pr v*tcfir"
ahr, 13axfoM., the test is Osalnss A.
:fiterett Honegger
J&nuary 26, 1979
Page Two
t f
Your application shows this number of bedrooms exceeds
the number the sewer system was originally approved f'or,
therefore, an upgrade will be required.
t ) Connect to the pulnl,ic sewer which is available to
You.
Notify this department for a re -inspection when descrepancies
have been corrected. Xf there are any further questions,
please contact this office at 264-4720,
Sincerely,
Robert C, Pratt t R.S.
Associate Specialist
RCP/I jw
Cc: Alaska Statebank
310 East Northern sights Boulevard 99503
/ MUNICIPALITY OF ANCHORAGE
DEPARTME1 OF HEALTH AND ENVIRONMENT PROTECTION
825 L Street, Anchoraap.. Alaska 99501
264-4720
Date Received: January 26, 1978
#1: Time #2 Time #3: Time
Date Date Date
Insp Insp Insp
REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES
u-)LOJ L)4 hcx Pwf t , P - (. f �
L0.
1. Lending Institution Request: Peoples Bank and Trust
Mailing Address: Pouch 7-007 99510 Phone:
2. - Property Owner: Fielder Construction Company Phone: 694-9759
Mailing Address: Box 851 Eagle River 99577 -
3. Legal Description: Lot'2 Block 4 Mountain Manor Subdivision
4: Single Family Residence: (x) Number of Bedrooms: Three
Multiple Family Residence:'( ) Number of Bedrooms:
5. Well System: individual Well (x) Community/Public System ( )
Permit # Depth of Well 36' Well Log on File
Construction Bacterial Analysis
6. Sewage Disposal System: On-site 'System (x)'. Public Utility ;( )
Permit # Installed 1977 Installer
Septic Tank Size Manufacturer
Absorption Area Soils Rate Material
7. Distances: Well to Septic Tank to Absorption Area
to Sewer Line Nearest Lot line Absorption Area
to Nearest Lot Line
Page Two
Department of Health and Environmental Protection
Request for Approval of IndividualSewer and Water Facilities
Legal Description: Lot 2 Block 4 Mountain Manor Subdivision_
Comments
Affadavit Attached: (') Letter Attached: ( )
Approved: Date:
Disapproved: Date:
Department Worksheet:
*.equest
MUNICIPALITY OF ANCHORAGE
Department of Health and Environmental Protection
825 L Street, Anchorage, Alaska 99501
264-4720
for Approval of Individual Sewer and Water Facilities
1. Property Owner:
Mailing Address:
2. Name of Buyer:
Mailing Address:
3. Lending Institution:
4.
5.
Mailing Address:
Realtor/Agent:
Mailing Address:
Legal Description:
t % Co /c/.cr C
2
I
Street Location: S" f / /( WQ/ ��f�
1-1
Phone: G9 - 9 (
Phone:
Phone:
Phone:
Single Family Residence: �) Number of Bedrooms:
Multiple Family Residence: ( ) Number of Bedrooms:
J
7. Water Supply: *Individual Well (X Public/Community System ( )
If Individual Well, well depth 3C
If Community System, name of system
8. Sewage Disposal System: *tn-site System ) Public System ( )
If On-site System, date of installation: ft 7 2 -
*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 $25.00 must accompany each request before processing
can be initiated.
3/77
STATE". ENT
CHUGIAK, ALASKA
688-3199 1 DRILLING CO.
WE SERVE ALL ALASKA
POST OFFICE BOX 42 -CHUG I A K, ALASKA 99567
DATE
L,
I J
KODIAK, ALASKA
486-4826
DATE
DESCRIPTION
CHARGES
CREDITS
BALANCE
PREVIOUS BALANCE
BALANCE DUE
1112% SERVICE CHARGE AFTER 30 DAYS
STATE RAE NT
CHUGIAK, ALASKA
6883199A$ DRILLING CO. S
WE SERVE ALL ALASKA
POST OFFICE BOX 42 - CHUGIAK, ALASKA 99567
KODIAK, ALASKA
486-4826
DATE - -
DATE
DESCRIPTION
CHARGES
CREDITS
BALANCE
PREVIOUS BALANCE
t
BALANCE DUE
11/2% SERVICE CHARGE AFTER 30 DAYS
