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HomeMy WebLinkAboutMOUNTAIN VALLEY ESTATES BLK 1 LT 16 MUNICIPALITY OF ANCHORAGE Hea. ~ and Environmental Prote, on Fourth Floor West 825 L Street Anchorage, Alaska 99501 264-4720 REPORT ON~SITE S~WAOE DISPOSAL SYS'FE2A Mrd- q7 ¢ SEPTIC TANK: NUMBER OF DISTANCE ?e°¢' I .~i[~;~.~c~%.~ COMPARTMENTS FP, OM WELL ___~ INSIDE LENGI'H_. '~ frHSIDE WlDI'H TILE DRAIN F1ELDi'7~--~-cq I DIS-FAINCE FROM WELL ~.0_¢~ ~.__FOUNDATION LIQUID DEPTH _.~__'~____ LIQUID CAPACITYJ~.)-~¢~'GALLONS. j TOTAL LE NGTH~c;, '$DI~.-NEAREST LOr LIME._._!.~£~_ .... OF LINE ¢ of Lines _[ _-- __ OIS'f ANCE BhTWEEN LINES ___.--~/_~--- TRENCH WID1 H_~-Q IN. TOTAL EFFECTIVE ABSOR?-TION AREA ~ ~ SQ, FT. LENG'FI4 OF EZACH LINE DEPTli OF FILTER DEPTIt: ~OP OF IiLK qO F:!bllStl GRADE . ~' ~ MATERIAl_. [~ENEAI't{ 'rILE ~ IN. ABOVE TILE ~ IN. SEEPAGE PIT: DIP, METER .... OR WIDTH ____ EENG'FId ., DEPTH Log Crib Rings BUIhDING F©UNDATIO W Crib Size: Dh'.\MEI'ER___DEPrH.-- DISTANCE FP, OM: WELL _ __ TOT,aL EFFECTIVE NEAREST LO]' LINE. ABSORPTION AREA (WALL AREA) SQ, FT. Well Distance To: Lot Line Bldg: Sewer Line: Pipe Materials: ~ of Bedrooms: Installer: .~.~. Remarks: ~.o~[ _$ON WELL DRILLil 1305 W, 45TH STREET ANCHORAGE, ALASKA 99..503 PHONE 2'72-9343 known; or distance main road ~O (..~1., '~--~c.g- L~ Loc(t~ion (addressp~: ,Township, Range, Section, if .. ~ , .. Size of casing ~" ? feet Cased to 8()' ? 1' Depth of Hole_~Or I* feet Static water level ~/ ft. (above) ~%~and surface. Finish of well (check one) open end ( ~); Screen ( ); Perforated ( ). Describe screen or perforation Well pdmping test at5% '~ gallons per (hour) C(~u~ for of drawdown from static level. hours with Jo I ft. Date of completion WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness I"'{F:I',:.:',IHI,JM I'.~l.,.IMli~fliii3<~ CIF {ilifl!ii[>f;?.t]Oi'"lEi; .... :l. 'I'HI~Z I:;~:tiiii(~:!t,,J I RE[:. '.E; I ;;:!]!iil OF 'l'I.41L~ SO I I.,,. FIS~i.~;ORI:z'T I ON :!~;"r'S'I'I?ZH 1 5;: 'I'FIE L..lili},lt3-1'H I} I MEl'.,Iri:.i I ON I f.-:; 'THE I...,l~]'.,ll3"l'H ,:i I I",t FEE'T) O1::' '[ HE TRENCH Cfi;ir [:,F('I:::I ! I'.,IF I Ii!ilL[:,. 't"HE [:,IEEi]::;'I'H (IF I::t 'TI-;:'.EI'.,!CH Ol:;.'.' F'IT ill,El THE DIS'I'FINCti.il liii:l~C't"l.,.IEEl'.~ THE tE~URI:;;'FiC:Ii!:i OF 'IHE. GRCIUN[:, I::IN[:, THE t!~:OTTCIM Ol;:' THE E',:-:',CI::I',?f:I'T ]: ON 'I'Hli~}:'.E I'.E!i; I'.,IO ~i;E'T I.,-IIE:,'TH FOR t'I...11:~i C:iRI::I',,,'EL. t}EI:;:'"I'H I S:.; THE M I N I MIJM I>E;]-::'TH CIt;:' GI~!F:I',?EL. t:ii:E"l'l.,.IL:]~i:iM 'l"l...llli~: OU'T'I-;;'I::ILI... 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E:liii: '.ii!;I,,.I[Ek)'EC'T 'TO I':'RO':iilI.CCUT' I O1",1. I'"11 i",l I MUM [) I :iii;'I"FINCE E:I~:"I"WE[i]",t t::1 .b.ll.!i:LL,. F:llql} 1::ll'4"r' (]t",!-.?, ::LOO l::'li:~:l:ii:'l' I:::'1]11;?, FI PI:;.".i',,,'I::I"t'E l,.Ifi]...,L Ol'k' ;~4:li:fil.~!l [:;'lii[l:'::"l' FOR I::1 I';"I...IEIL. IC I.,.IELI ..... I.,.IEL..I.., I...OGli!i~ I::IRliE I:~?,EI:;!I,..IIi';::L:]]:, F:INI> MIJ',:+.'71 I:~ii.F_;' [~:!l::/f'Ul~'.l",ll~:.'[:, ]"O '1'1"11~ I)EPF:IRTMIi~:]qT t.,.II'THIt",t O1':' Tl'"lliii: IAEI,...I.,,. C:OMF'L,,Iii:T I O1",t, O I]"'lliii]:;i: I:;i~l~:].:)l,J i I:,i'.EPIEI",tT:~i; t"'tFl"r' FIF'I:::'I,,,."r'. !'~;I:'EC ]t: F' I Cf:IT I I::l¥l::tIL. F:lli.~ll....li:~: ']'1:] :[I",J!~i;UI:;?,E I:'RCII::'[~]:;i: II",I:~i;TI::IL, L,,I::ITII]N. GF~iA,r.R ANCHORAGE AREA BOROUGH DEP/LR~,-~MENT OF ENVrRONMENTAL QUALITY Case 3330 "C" Street ANCltORAGE, ALASKA 99503' Performed For ~O~bL~/A~^ Legal Description: Lot IL Block This Form Reports Soils [Log_ Depth Feet Percolation Test Soil Tes~ Must Be l!ogged To 4' Below Proposed Seepage System Soil Chm~acteristics ~/kl Dated Performed ~,1,~.t-~?~ If Yes, At What Depl~h?? Ground Water Encm)untered? /kJ~ Reading Date / Gross Time Net Time Percolation Rate _~_/L~ MinuLe Proposed Installati(~)m: Seepage Pit Drain Field Depth of Inlet .................. ~.~ Depth to Bottom o}~-Pit Or Trenc~i' Test Performed BY ~jACC4f~r ~U~,~j~.~m_~ Date Cer. tified BY: Date: MUNICIPALITY OF ANCHORAGE MUNICIPALITY DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIOI~P'F. OF I ;'~ALTi~ &  825 L Street - Anchorage, ENVIRONM£NI';kL Alaska 99501 I ENVIRONMENTAL ENGINEERING DIVISION FEB 1 197'9 Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SE~l:l~=~dl~i~'~ I~ DIRECTIONS= Complete all parts on page 1. Incomplete requests will not be processed, Please allow ten (10) days for processing, 1, PROPERTY OWNi~R PHONE -- William E. Johnston 694-9766 MAILING ADDRESS P. O. Box 334, Eagle River, AK 99577 ._ PROPERTY RESIDENT {If different from above) PHONE Sa_me 2, BUYER PHONE Cynthia L. German 694-3261 MAILING ADDRESS P. O. Box 1631, Ea~le River, AK 99577 _ 3. 'LENDING INSTITUTION J PHONE Alaska Mutual Savings Bank (Charles Steig~le) 6~4-9571 _ MAILING ADDRESS P. O, Box 1068, Eaqle River, AK 99577 4. REALTOR/AGENT J PHONE Myrna Johnston, AREA, Inc. RealtorsI 694-9555 MAI LING ADDRESS P. O. Box 249,..E..a.ql.e RiveT, AK ..9.957.7 ..... 5. LEGAL DESCRIPTION MoUntain Valley Estates Lot 16 Block 1 /~,~ ~ /-,~','//~,~,o/ /~ STREET LOCATION Birdsong Drive, Eagle River 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] One ]~ Four ~ SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY [] Three [] Six Other WATER SUPPLY Drilled Nov. 1977 :J~ INDIVIDUAL* 80 Feet * 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 J~ INDIVIDUAL/ON-SITE** **If individual/on-site, giva installation date 9/'15/77 . If system is over two (2} years old an adequacy test is required [] PUBLIC UTI LITY by this Department. 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 INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR I NSP ECTOR 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 [] INDIVI DUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY 4"~ '~ "7 Connection Verified INSTALLER []Septic Tank or []Holding Tank ~'. ¢)./ Size: /~-~,~~1) If Tank is homemade SOILS RATING give dimensions: ~.~ TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line I WELL TO: Absorption Area to nearest Lot Line [~APPROVEDFOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY (T~ LEGAL DESCRIPTION 72-010 (Rev. 3/78) 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 DIRECTIONS: Complete all parts on page 1, Incomplete requests will not be processed, Please allow ten (10) days for processing, 1, PROPERTY OWNER I PHONE William E. JohnstonI 694-9766 MAI LING ADDRESS Box 334 99577 PROPERTY RESIDENT (If different from above) PHONE 2, BUYER PHONE Same MAILING ADDRESS 3." tENDING INSTITUTION PHONE Alaska Mutual Savings Bank 694-9571 MAILING ADDRESS Post Office Box 1120 99577 4. REALTOR/AGENT Myrna Johnston, Area Realtors 69~-9555 MAI LING ADDRESS Post Office Box ~.4..9 9957,7. 5. LEGAL DESCRIPTION Lot 16 Block 1 Mountain Valley Estates Subdivision STREET LOCATION Mile 5.3 Hiland Road, dark green raised ranch on Birdsong Drive 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] One ~ Four ~ ~INGLE FAMILY ~ [] Two [] Five [] MULTIPLE FAMILY [] Three [] Six [] Other 7. WATER SUPPLY INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY * ATTACH WELL LOG. A well log is required for all wells drilled since June 1975, For we s drilled prior to that date, give well depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITF~ [] PUBLIC UTILITY **If individual/on-sit~ g~ve installation date If system is over two (2) years old an adeouacy test is required by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAE BE INITIATED. 72-010(3/78) THIS SIDE FOR OFFICIAL USE ONLY f'!L~ ~ ' DATE RECEIVED .... MENTS J~,~ DATE DATE DATE I NSPECTOB I NSP ECTOR ~NSPECTOR DIRECTIONB: 1. TYPE/OF RESIDENCE NUMBER OF BEDROOMS L~ SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [~"'FO U R [] SIX PERMIT NUMBER 2, WATER SUPPLY I~,/INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED NWAGE DISPOSAL SYSTEM PERMIT NUMBER DIVIDUAL/ON -SITE DATE iNSTALLED []PUBLIC UTILITY Connection Verified INSTALLER [~;;~eptic Tank or []Holding Tank Size: {,,~'-'~ If Tank is homemade BOILS RATING give dimensions: ~i~ _.~~'- TYPE OF TANK MAhlJ. J.F. ACTUR ER. TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Rolding Tank ^bsorption Area Sewer Line I Nearest Lot Line 1 WELL TO: Absorption Area to nearest Lot Line [] APPROVED FOR BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate} [] DISAPPROVED DATE BY (T~ ~. ~ LEGAL DESCRIPTION 72-010 (Rev. 3/78) ]: .L,.th i~loor FROM '~ ;;; SUBJECT 'C,o'I?. ].6 ]~lock 3.. ~¢iou'o.'b. ain Valley },.;s-ba.~bs-o ,q-ctS¢ivisio~3 DATE 2 / MEB AGK : '.PI.ease make arrangements for a re.~und z'e~arding the a'ktachoc~ paporwork~ ~¢e haw:; d. one an inspection within a yemr¢ an~2{ this (rid no't require u.s doing anoeher inspection a't bhis .L~.c~.~pv. ,,~:70379 ~.4y~.na ~ohnston Post Office hex 2119 99577 $25.00 Sewer anrl ~,~ater other '~'hank you. SIGNED "~%~t t X Laura ; ~E~Y 2 6 4,-- 4 7 2 0 J~edJf~orm ~, 4S 471 SEND PARTS 1 AND 3 WITH CARBON INTACT - PART 3 WILL BE RETURNED WITH REPLY Poly Pak (50 sets) 4P471 DETACH AND FILE FOR FOLLOW-UP Municipality of Anchora% Environmental Protection 825 L S{reet Anchorage, Alaska 99501 REQUE.ST,FOR APPROVAL' OF INDIVIDUAL SEWER & WATER FACILITIES .'.]' Type of Inspectio. Q: .CMRO'__ VA FHA CONV .x' 2. Property Owner: William E. Johnston Mailing Address: Box 334, Eagle River, AK Day Phone694-9766 3. Name of Buyer: Wiliiam E..'Johns~on Mailin§ Address: Same Day Phone 694-9766 ,~me of Lending institution: Ak Mutual S.avings-Bank P. O. Box 1120 .- Mailing Add?ess: Eagle River, AK 99577' Phone 694-95'71 Name of'Realtor or Agent: Myrna Johnston, AREA, Inc. Realtors. P. O. Box.249 · ~iai]ing' Address: Eagle River, AK 99577 Phone 694-9555 Legal Description:' · M~ountain Valley· Est. Block 1, Lot 16 Location: Mile 5.3 Hiland Rd. Dark green raised ranch on Birdsong, Drive (left.side) .Type of Facility.to be inspect'ed: Water Supply . Type Of Supply: . Pub'li'c Utility Single 'Fam-.ily No. B. dr~ls. 4 Individual x: If' Individual,'number of dwetli'ngs, pre~ehtly served If Individual, depth of well 80 ft. Sewage Disposal'System Type,of S~stem: Public Utility "individual (on-site) X ....... ± ...... I.~ Individual,, date of installation September 1977