HomeMy WebLinkAboutSKY RANCH ESTATES #1 BLK 5 LT 26Sky Ranch
Estates
Block 5
Lot 26
#015-301-12
I/
NAME
MAILING ADDRESS
LEGAL DESCRIPTION
LOCATION
"' DISTANCE~O: I~p~(,~/ IAbs°rpd°n~r~a ' Dwelling
I ~ [Liq. capacity in 9aliens
DISTANCE TO:
DISTANCE TO:
¢]UNIClPALITY OF ANCNORAGE
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
IF HOMEMADE:
Material
No. of lines
Top of tile to finlsl] grade
Type of cril~,~
DISTANCE TO:
DISTANCE TO:
Well Dwelling
Foundatiorl Nearest lot line
}oS~D
Total length of Trench widJ?
Material beneath tile
NO. OF BEDROOMS
PERMIT NO.
Depth /'~ /~
Building f ou n da ti ~/n~/~_
Driller ~
Sewer line
Width
irib diameter
Well
Liquid depth
Liquid capacity in gallo/~s
PERMIT NO.
~t~ abs~ptiSn area
PERMIT NO.
Nearest lot line / //<
Distance to lot line 1PERMI'rNO. ]'Z~0{'~,~-,')-
Septic tank [Absorption area(s~
OTHER
PIPE MATERIALS
SOIL TEST RATIN6
REMARKS
72-013 (R~v/3/78)
F'ERHIT NO.
264. ,., 4 ?' 2]: 0
I::IF' F'I... I E:RNT
L.EuT R"l' :[ :: f',l
I~EI3F:IL
,.. l H Ft',,,'E
l ,:T
HFI::.::IHUf,1 NL.IttE[:k OF E, EI~.ROOII:: = :E.':
_,UII.. F::RTING ,::SLq F '~. E,k. -. :l.~ .....
'l'l'"lli:; RE:I}~UIF:E[::, =,I,:.E OF THE :,01L R[.,_,UI~j: [ILi"4 =,~.:-,FErl .r.=,:
"I"HE LENGTH DIr'IEi'.,I.SION IS THE LENGTH ,::IN FF';ET) ElF THE TI;.:ENE'.H O~: DR:FIINFIEt..D.
THE [;.',EP'I"I--I OF R TRENCH OR F'IT ]'.S THE [::.,ISTF:~NCE BETHEEN THE SI..JFIF'tqI::I~}: OF THIE
Gi'~:OUND FIND THE E:OTTOI"I OF THE E;qCFf,,,'FtTIOi'4 ,:.'IN FEET:).
THERE IS NO SET H~f::,'rH FO~:
THE GRR'v'EL DEPTH IS TH[:_' HINIHUH DIEPTH OF:' GRFIVEL BE-rb. IEEN THIS OUTFRL..I_.. PIPE
Ri',ID THE F.',OTTOH OF THE EXCR',/FITION ,::IN FEET).
-z,:, '-'.:= - ' < ..... Ill:[..-. f.,b, FFF. IfqENF DUR:[I'.,IG THE
F:'EF~:r'IIT MF F kl.L. Ithlr Hf:12~; THE Fd:..,FuN::,IE, ILI1 ~ TO INFOi~:f,1 "- '- ',-' '
':: : ..... ': "''*' " ': IHI.:, F'f.-FEF, i ~ I~N[:' THE
]i[~.:.TP [..t_HI IEN ItLFEL. TZ JN-., OF FIN'-/ I.,.IE:L.LE; FID.]FICENT TO '" ' ~' "';'" "' ' ;""'
NUHBEF: OF R[..:~[.ENL[.:., 'rHOT THE HE:LL. H]L..t ..... L.R~E.
BRCKF]:LLING OF FIN'¢ SYF.;TEf'I ,t4ITHOLFi" FINFIL INSF::'ECTION RND RF'PROVRL B"r' THIS
DEPFIF, q'HENT HILL BE SUB..TECT 'f'O PROSECUTION.
HZN:[I"IUH DI'E, TRNCE BETI.,.IEEN R klEL~t. FIr'ID FIN"? ON-~:'.=,ITE SEI4RGE DI'Lr, POSF:IL 2?*'STEH ]:~;
1OO FEET i':OR R PRI',/FITE HELL.= OR
:1.50 TO :-;~O0 FrEET FROf"I fl PUE:LIC NELL DEPEND]f',IG IJPON THE T'¢F'E OF F'IjE~L.[C 14E':l..t ....
!.4ELL LOGS RF?.E REQUIi':~'.ED FIND i"ltJST BE RETUP..NED "rLq THE r..',E:PFIR'I"f,IENT klZTHZN :¢:O [;,F¢,.%
OF' THE .14EI..L COHPLETION.
O'I"I-.{ER RE6!LIIF.:Ef,IENT2; MR"r' FIF'F'L.'T'. %PECZFICFITION2; RND, COI",I'.STF.:UCT ): ON F.;,IRGF..'FIf'I'.:.i; FIRE
F:I',,"RIL. RBLF 'FO INSURE PROPEI~: ~N:'7, TFE. LFITION.
I
FORTI4 E,'"r' THE MUNIC:IPRLIT'T' OF Ri'4CI'"IORRC'iE.
2: I 14ILL INSTI--ILL THE S"r'L'7, TEH IN RE:COI;?DRNCE ,t4ITl-I THE
:?,: I Izli~',IDE;t~:fSTFIND 'rHRT THE ON-'.:.;ZTE %EHEFr L=,'T'STEH i'4FI'¢ f~:EC..!uIr4:E ENL.FiF.':~3EHENT IF THE
I:~.E.SIf~4ENE:E 'I'.~; .~.'.Ef"IO[:,EI_ED TO INE:I..LI[:,E; HO[~:E THFIN Z.': E:E[::'ROE$~;.
I~L. II~::Ri".,IT '['I-IEII~tF-4S. I'IFISt3N ~/
'/_
C:EI(:'I"[ F;r' "rHFIT
I Fli"l FflHILIIqF). t.,.lI'rH '['PIE kEg. UIREflEi'4T= F.F.: LIN ..I I E ...,LHLF:L~, FIND I. tE:.LI..: ....
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
Pouch 6650, AncJ~orage, Alaska 99502 776-2221
SOILS LOG - PERCOLATION TEST
PI!RFORMEO
LEGAL DESCRIPTION:
DATE PERFORMED:
SOILS LOG
PERCOLATION
'rEST
1
2
3
4
5
6
7
8-
9-
10-
11
13-
14-
15-
- 16-
17-
18-
19-
20-
COMMENTS ,7/, .~, c?:/ ~',' , : '_
SLOPE SITE PLAN
L
WAS GROUND WATER
ENCOUNTERED?
IF YES, ATWHAT
DEPTH?
Time
Net
Time
Net
Drop
/ ? -7-,
Reading Date
- , '-,:::
PERCOLATION RATE / (minutes/inch)
TEST RUN BETWEEN ' FT AND . ~ FT
: ' ' ~,~ E~/:,' / '~ ~ ~.2__.~:~_L
PERFORMED BY: ~2/',, " -~' //'"''" ' '-:'
7;! 008 (7/76)
DATE RECEIVED
. APPOINTI~ENT~
TIME TIM TIME
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTE~iPALiTY OF ANCHORAGE
825 L Street - Anchorage, Alaska 99501 DEPT. OF H~ALTII
ENVIRONMENTAL p::O [ECTION
ENVIRONMENTAL SANITATION DIVISION
Telephone 264-4720 ~i}~ ~ 6 198~
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SE~
DIRECTIONS: Complete all parts on page 1, Incomplete requests will not be processed. Please allow ten (10) days for processing,
PROPERTY~ESIDENT(Ifdifferent from above) - - PHONE
~BUYER PHONE
MAILING ADDRESS
LENDING INSTITUTION PHONE
~AItlNGADDRESS
E. LEGAL DESCRIPTION
STREET LOCATION
6, TYPE OF RESIDENCE
~/~iNG LE FAMILY
[] MULTIPLE FAMILY
7. WATER SUPPLY
~ INDIVIDUAL**
[] COMMUNITY
[] PUBLIC UTI LITY
NUMBER OFtBEDROOMS
[] One [] Four
[] Two [] Five
,.~' Three [] Six
E~] Other
* ATTACH WELL LOG. A well log is required for all wells drilled
since June 1975. For wells drilled prior to that date, give well
depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM
/..~'INDIVIDUAL/ON-SITE** /~'/7C'~ YEAR ON-SITE SYSTEM WAS INSTALLED.
[] PUBLIC UTI LITY
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
THIS SIDE FOR OFFICIAL USE ONLY
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 UTi LITY
Connect[on Verified LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[]INDIVIDUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY
Connection Verified iNSTALLER
[] Septic Tank~..or [] Holding Tank
Size: j(~Q2 If Tank is homemade SOILS RATING
give dimensions:
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL . .~~
4. DISTANCES WELL TO: 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 a~pany certificate)
[] DISAPPROVED
DATE BY ~_~////~
72-O10 (Rev. 6/79)