HomeMy WebLinkAboutMOUNTAIN VALLEY ESTATES #1 BLK 5 LT 13
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
NAME
,4 L. l-f,
MAILING ADDRESS ~.~ p, ~ oL~C~ ~ L/
LEGAL DESCRIPTION
DISTANCE TO:
tIF HOMEMADE: ~ Inside length
welt !
DISTANCE TO; Well
No. of lines / Le ngt b~.~h~, ne
Top of tile to finish grade ~
Length
Width
Dwelling
Width
fi ]~'NEW- -
NO, OF BL~OOMS
No. of comp~nts
Liquid depth
PERMIT NO.
Material Liquid capacity in gallons
PERMIT NO,f _~0
Distance between lines
Total effective absorption area
PERMIT ~10.
Foundation/(¢)/__/_ Nearest I.o~.t ~_/~
Total I~J~o~li nes Trench .~ inches
Material beneath til~../ inches
Depth
Type of crib Crib diameter Crib depth Total effective absorption area
Well Building foundation Nearest lot line
DISTANCE TO:
Class Depth Driller Distance to lot line PERMIT NO.
DISTANCE TO: Building foundation Sewer line Septic tank Absorpt on area(s)
OTHER
PIPE MATERIALS (
SOl L T~'ST R'AT{NGt
REMARKS
DATE LEGAL
l't'-IE L.[i!:I",IC!il'H I1:, 1!: MEiN::S )101",I ti :S 'l"l..ll!i: L.liiiF,!i:!iTH ,:: ]1 I'.,I I::'I~:ET 1:, OF:' Till:::: TI:;;:i'!:I'.,IIi;:I '1
'IHK I'::,EI::"I"H CII:: F'I "I'I:;;:!:}:NE:H 0[;;: f::']:T :ii:!ii; 'Fl"llE Di(:ii;'l"f:lNC:[i!: Iii!',lfi:'t"l.,.ll:ii:l!:i:i'-,l THE: :i!;I..IF~:F:'I:::IC:E
G[-;i:Ot..ll'.,If) t::IN.D 'i'1.'t[!1 ['}~O'I"f'CYl 01::' "f'l...ll:i: t:!:i[:.Oii:I:::!',,/I:::!T:[()I'.,I ~:1 ]11'.,I I:':'[ii:[!i:"l').
'1'I"11})i: GI:;;:F:i',,,'[i::I.. DI:::I:::"I"H .1: :ili; THE: M :1: N :1: I','ll...l[~,'l DEI:::'TH OF::' l;~il';;:l:::l',,,'l!:iZ!.. I?,[?l"l,l[ii:t!!i:!'.,I I'H!:!i: OUTI:::'FII. L. f::' :!: Pi!i:
!:::ff',lD 'THE: E',EK!'I"OH 01::' 'I"H[~: [EXC:I:::I',,,'I:::IT:[Cd",I (::l:l'.,l
Dacezni)er 29~ 197~3
John ' -~ ?"I ,"
l~taz' J{outo 2 BO× 9354
~:aglo Rivor, Alaska 99577
:;!7a0351 '!or !:,~ l~lock 3 I-iountain Valley
~7~0971 Lot t3 }~lock 5 l,lountain Valley .~st
~7fl0:,3~ Lot 12 ~lock 5 ~iountain Valley i~;states ~1
~7[~0937 Lot 13 Z~lock 5 ~,iounhain Valloy Estates
issued by thi~ department for ~,~o-ll and/or
on tho po,rmi'k~ by aughori.'ty of l.Iunici!?al ordin;!alce,
Y.f you have ,!{:cill,~,~i. the we!l, a well lo%!' should be
date.
If there are a~'~.y further questions~ ploa~e contact
this office at 2~i4.~4720o
Sin~e~:oly,
,.7_'~ ~"..4 ..... ."Z.'; 2: "If- E:
F'ERMIT NO. ( 78E~S.r?:l. ::'
FIPPL I CKINT
LOCAT I ON
LEGAL
DEPRFCTME:NT OF I--IEBLTH AND ENVIROI'.,IMEN'f'F3L F'ROTEC:TION
825 "L." STREET, Ri'4CI-'IORFIGE,
264-472E~
S; EZ t-..~ EE IF;L'
JOHN L. I~IOF't.'..'INS
EAGLE RI',/ER
[..t]: B5 MT VFIL.LEY EST .'bJ..
C:, Fz
AK. ?Y..-]h5 ~3 '.'L _~
SR2 BOX 9]:54
I..OT SIZE 9249E? SQtJRRE FE:ET
'TYF'E Of:' SOIL FIE:SORBTION SYSTEM IS: DRFIINFIEL[:'
MF:tXIMUM NUMBEr4'. OF' BEDROOMS
.SOIL RATING (SQ I;:T/E:R):" i40
]'HE REQUIRED SIZE OF THE SOIL. FIBSORPTION SYSTEM IS:
I::, ~ F::' T' It-! == -=t IL EE r'-.I Ci "r I--I == ~; '.:;-'."~ G F-: Ft ',,..' F£ It ..... [:, EZ F' T It-Il
THE LENG]"H DIMENSION IS THE LENGTH (IN FEET;:, OF '['PIE ]'f4.'.ENCA OR DRAINFIELD.
THE DEPTtt OF R 'TRENCH OR PI]' IS THE DISTANCE IE,'E'F!.,.IEEN THE SIJF4:FACE OF THE
GROUND AN[::, 1'HE BOTTOM OF' THE EXCRVRTION ,;.'IN FEET).
THE C~F4'.AYEI.. DEF'TH IS THE MINIMUM DEF:'TH OF GRAVEL BFZT!,.IEEN 'THE: OUTFALL. F'IPE
FIND THE BOTTOH OF THE EXCBVFITZON <IN FEET;:'.
PE:RMIT FIPF'LICAN'f' HAS THE RESPOI.'ISIBIL I]'Y TO INF:ORM "II-.tiS DIEPRRTMENT DIJRIr.'IG THE
INSTALLATION INSPECTIONS OF RNY 14ELLS A[:,JACENT TO THIS PROF'ER]"Y FIND ]'HE:
NUMBER OF RESIDENCES THAT THE NELL I,IILL SERVE.
BACKFILLING OF FINY SYSTEM WITHOUT FINAL II'4SPEC]'ION RN[:, RI::'PF.'.BYRL. BY THIS
DEPAP. THENT I.,.IIL[_ BE SUBJECT TO PF.:OSECUTION.
MINIMUM I}ISTANCE BETWEEN A !,CELL FIN[) AIqV ON-.SITE SEI,.IRf3E DISF'OSAL S"r'S]'EM IS
i~)E~ FEET FBR A PR'.IVRTE P'IIEL. L..~ OR
:'1.58 TO RE10 FEET FROH R PUBLIC 14ELL DEPENDING UPON THE TVI='E OF FtlBLIC NELL
OTHER REQUIREMEN]"S MAY RPPLY. SF'ECIFICRTIONS AND CONSTRUCTIOI",I [:'IRGRAMS ARE
RVRIL. ABLE TO INSURE PROPER INSTALL. ATION.
I CERTIFY THAT
i: I AH FAMiLIFIR WITFI THE REQUIREMENTS FOR ON-.S'iITE SEI,'IERS RND WE;LL.S I:IS SE.']]'
F'ORTH BY THE MUNICIPALITY OF FINCHORAGE.
2!:: I P'IILL INS'fF~LL 'FI-'IL:: SYSTEM IN ACCORDANCE WITH THE CODES.
3:: I UNDERSTFIND TklAT THE ON'-SITE SEWER SYSTEI'd MAY REQUIRE ENLFIRGEMENT IF' THE
RESIDENCE IS REMODELED TO INC:I_UDE MORE THFIN Z; BEDROOMS'].
....... ..................... ¢
~tF'F'L I C:Ffl'.'IT JOHN I_. HBF'K I NS CTU
O F~ E GEO 'MENT CO.
'CHNICAL E~ DEVEL,~
Box 90, Davis St., Eagle River, Alaska 99577
694-2774 or 688*2280
Russell Oyster Ear/Ellis
694-2774 SOIL LOG
SoUs Et Foundations Land Development
Perfomed for:
Legal Description: ,,
pepth (feet)
2
5 ,
6
?
8~
9.~
10
11.
GroUnd Water Encountered: Yes ~ No ,
Proposed Installation: Seepage Pit~
co~nents:____._L~.~r-~c;.~ ~,-~r~,,.K.z.__~</"~.~ .
, If yes, what depth
m Drmin Field ~-
Perfo~ed by:_
PERMIT
L:,EPf;tRTMENT [)~ *ElZlLTH FIND ENViP).OI'.,IMEN"I'PtL F f'EE:TION
~",2:5 '" L' .:;TREET., FII'.,ICHORF~EiE., FtK.
264-47'-20
( 780g'~:7 >
RPPLICRNT
LOOf'l'lON
LE~L
JOHN L. HOPKINS
JOHNNY DR
I_&~ 85 M'l" VHLLEY EST ~
ERGLE RIVER
LOT SIZE 92490 SQUI:~RE F'EET
MINIMUM I)IST~NC:E BETHEEN f WELL fiND RN¥ CIN-SI]E SEWRI]E DISPOSRL 2;'¢S'I'EM
~Ol:'J F~E"I' FUR R PRI',/~'rE NELL.: OR
~L50 TO R00 FEET FROM P~ PUBLIC WELL DEPENDING UPON ]'HE TgPE OF PUt3LiC 1.4~L,L.
WELL LO(~:~; FIRE REQUIRED RND MUST BE RETURNED TO THE DEPRR"FMENT WITHIN
OF ]HE WELL COMPLETION.
OTHER REQUIREMENTS M~'¢ RPPL'Y. SPECIF1CIYTIONS fiND CONSTRUCT'ION [:,I~GR~MS
~VHiLHBLI5 '10 iNSURE PROPER iNS"I'PILLFtTION.
I CER] IF'¢ I'HBT
l: I F~M F~MILIRR WITH THE REQLIIREMENTS FOR ON-SITE SEHERS FiND HELLS RS SET
FORTH B'¢ THE MUNICIP~L.I'i'Y OF 8f.,ICHORHGE.
2: i HILL INS'f'RLL THE 5'¢S'TEM IN FICCORDRNCE t4tTH THE CODES.
',,,'ii:. 2
Dr
Dr
We
Well location: (address & legal description)
Depth of well
Static ~ater level ft.
Finish of ~e~: (open-end, screen, perforated,~, other)
Describe intervals and size'
WeII yield tested by (pu.ping, bailing,~at ¢~ gal/min.
for 3~ honrs w th~ _ft. of drewdow, from static level.
WELL CONSTRUCTION LOG
ling Do.___~ D,/~ D;v~//./~y USDS no.
Location sketch or remarks
DRILLER'S MATERIAL LOG
Del)th helow land Dive description of strata penetrated
snrface in feet (size of material, color, hardness of drilling, and water content)
O to
----to
Time
Date
'rime
Date
Date
inspector InsPector Inspector
Conditional Approval
Comments
MUNICIPALITY OF ANCHORAGE
P'~T C~ ~!F'Lr~t n.
ENvh,.-.~ :1.'/',-' ,o [ ? .1
RECEIVED
Date Sewer Installed
Soils Rating
Permit No.
Well To Absorption Area
Well to Tank
Septic Tank Size
Holding Tank Size
Well Log Received
APPLICANT FILLS OUT LOWER HALF ONLY
Property Owner
Mailing Address
David B. Bart
SR2 Box 81166,
Chugiak, AK 99567
tPhone
94-4733
Buyer Kenneth P. Perrier
Address U~IR BOX 9588, USAF Hospital,
Elm~ndorf APB, AK
99506
Lending Institution Alaska Ba]lk of Commerce
Address Eagle River Branch
Realty Co. &Agent Commonwealth AREA, Inc,, Nyrna Johnstom
AddressP, O. BOX ~49, Eagle River, AK 99577
Phone
694~5056
Phone
694-9555
Legal Description Mouu~tain Valley Es'gates ~1, Blk 5, LOt 13
street Looa.on NHN Johnny Drive
Type of Residence
E-~ Single Farnlly ~
E] Multiple Family NO. of Bedrooms
[] Other --,
Water Supply Bi Individual
E] Community
[] Public Utility
SewaRe Disposal E4- Individual
[] Public Utility
E] Holdin~Tank
ATTACH WELL J..OG, A well icg is required for all wells drilled since June
1975. For we,U,C:,d,d~/t~ tl~at date, give well depth (attach Icg if
available,l /~' , ,~,~/-,-~. ,¢
Year Individual Installed: 10 - 3 t ' 7 9
When Connected to Public Utility:
as corselette6 ozl in t~j~z and new t')l.t~ers mOVed in l~llgll~t 1.~~~,