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HomeMy WebLinkAboutSKY RANCH ESTATES #2 BLK 1 LT 16ky Ranch states lock I Lot 16 015-302 -09 On-Site Wastewater Disposal System Permit Permit Number: Tax Code Number: Work Type: OSPl11346 01530209000 Septic MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Upgrade Permit Effective Dates: December 06, 2011 to December 05, 2012 Design Engineer: FLATTOP TECHNICAL SERVICES Subdivision: SKY RANCH ESTATES #2 Site Legal Address: SKY RANCH ESTATES #2 BLK 1 LT 16 G:2737 Owner/Address: MCLEOD lAN W & LINDA K 11700 PADDOCK LANE ANCHORAGE AK 995162318 Site Mailing Address: 11700 PADDOCK LN, Anchorage Lot Size in Sq Ft: 18911 Total Bedrooms: 3 This permit is for the construction of: N Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N 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 wastewater code requires inspections, during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction dud ~g freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: ~/~'~~ ~ Date: Issued By:~/~[/)/U/_~..~'/r)~ ~'~~'~ I?.-/ ~" Al/ MUNICIPALITY OF ANCHORAGE Community Development Department -- ~~~~--~ - Development Services Division On-Site Water & Wastewater Program Mayor Dan Sullivan Phone:907-343-7904 Fax:907-343-7997 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 0 t 5" - Property owner(s) Mailing address Site address -~ 'Legal description (Sub'd., Block & Lot) Lo ,,z lo"., ~ ! ~ I) Legal description (Township, Range & Section) 'Lot Size Sq. Ft. Number of Bedrooms THIS APPLICATION IS FOR: ([~ all that apply) Absorption Field [] · Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage [] THIS APPLICATION IS AN: Initial [] Upgrade [] Renewal [] ~THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: 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 property owner or authorized agent) Permit/Rush Fees: Date of Payment: Receipt Number: O Permit No. L~_~i0 Waiver Fees: Date of Payment:' Receipt Number: Waiver No. G:\Building\On Site\Forms\Client Forms\Permit App_010411 .doc (Rev. 1/11) 'OP TECHNICAL sERViCes CIVIL & ENVIRONMENTAL ENGINEERING * ENERGY CONSERVATION & ANALYSIS TED MOORE, P.E. PH.IFAX: (907)345-1355 E-Mail: tgmoore~gci.net December 5, 2011 14530 ECHO CANYON ROAD ANCHORAGE, AK 99516 M.O.A. DSD P.O. Box 19-6650 Anchorage, AK 99519 Dear Sirs: The purpose of this letter is to provide the required design narrative in support of our application for a permit to replace a collapsed septic tank on Lot 16, Block 1, Sky Ranch Estates, Unit #2, located at 11700 Paddock Lane. A site plan and specifications are enclosed for your review. We are requesting an expedited review and permit issuance because the original septic tank has collapsed and needs to be replaced ASAP. There do not appear to be any insurmountable issues in conforming to all applicable code requirements, and there will be no known impacts on adjoining properties. The contractor hopes to be able to install the new tank as early as Wednesday of this week. Please feel free to give me a call if you have any questions on this submittal. Sincerely, Ted Moore, P.E. SEPTIC o SYSTEM ooo LOT 14 LOT 15 SEPTIC AREA LOT 17 RETAIN EXISTING SOIL ABS. TRENCH INST. RETAIN EX STING DECO~MISSION COLLAPSED 100e-GALLON SEPTIC TANK DRIVE SEPTIC AREA INSTALL NEW --1250-GALLON SEPTIC TANK LOT 16, BLOCK 1 SKY' RANCH EST #2 UJ Z NOTE: LOTS IN THIS PORTION OF SUBDIVISION ARE SERVED BY A CLASS "A" COMMUNITY WATER SYSTEM ~ PADDOCK LANE i i i i i i LOT 16, BLOCK 1, SKY RANCH ESTATES #2 SEPTIC TANK REPLACEMENT SITE PLAN FLATTOP TECHNICAL SERVICES 14530 ECHO CANYON ROAD ANCHORAGE, ALASKA 99516 1 INCH = 40 FEET DRAWN BY TFM DECEMBER, 2011 NOTE: THIS IS NOT A SURVEYED PLAT. ALL LOCATIONS SHOWN ARE APPROXIMATE. ~fattop 'Tecfinica£$emices 145J0 ~,CftO Can~ ~ .~cftora~g, .~¢. 99516 Lot 16, Block 1, Sky Ranch Estates, Unit 02 11700 Paddock Lane Septic Tank Replacement Specifications 1.0 General: 1.1 The scope of the project consists of properly decommissioning a collapsed 1000-gallon steel septic tank and replacing it with a new approved 1250-gallon steel septic tank located as shown on the site plan. 1.2 Construction shall be as depicted on the approved site plan and design drawings. Minor deviations f~om these drawings may be allowed or required by the engineer conducting the inspections. All construction procedures and material specifications shall conform to Municipal and State requirements. 1.3 The installer shall be responsible to obtain any necessary utility locates, and to work around any buried utilities. 1.4 The installer shall provide adequate cover material and rough grading over the tank to ensure that proper drainage is achieved after settlement and that there are no residual depressions. 1.5 The homeowner shall be responsible for fmish grading after the soil is compacted, as well as placement of topsoil and reseeding all areas disturbed by the construction. 1.6 The electrical service to this home is via a relatively low (approxim_a_tely 10 feet above ground) overhead electric line that passes directly over the present septic tank. The excavator wi!! need to exercise particular care in working around this potentially hagardous sit_:a#on. L 7 Due to the presence of an existing concrete walkway~ the wastewater line coming from the house will need to cross a corner of excavation for the existing tanl~ To minimize the potential for settlement under the line~ this portion of the original excavation shall be back~!!ed with clean non- frost-susceptible material~ with each 12-inch lift mechanicall~ compacted_- 2.0 Septic Tank: 2.1 The existing 1000-gallon steel septic tank must be properly decommissioned by thoroughly pumping, removing the top and backfilling with soil. 2.2 The new 1250-gallon steel, 2 compartment septic tank shall be Municipally approved and set level on undisturbed soil. Each compartment shall be equipped with a watertight manhole cover and a 4" cleanout. If the tank is buffed less than 4 feet it shall be insulated with 2 inches of rigid insulation plus 2 feet of soil cover. 2.3 Double cleanouts shall be installed in the ASTM D-3034 waste line both upstream and downstream of the tank, and within 5 feet of the tank. 2.4 A "Bull-Run" diverter valve shall be installed to allow septic tank effluent to be diverted to the original seepage pit, as needed. 3.0 Inspections: 3.1 A total of 3 engineering inspections will be required during the course of the project: (1) initial discussion with the contractor to finalize the location of the tank and construction procedures, (2) after the tank is set level and piping connected but prior to backfill, and (3) after rough backfill and grading is complete. The installer shall coordinate the timing of the inspections with the engineer sufficiently far in advance to ensure the availability of the engineer.  MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION I ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAl. SYSTEM AND/OR WF-LL INSPECTION REPORT /[~'U PG RAD E LOCATION ~ -- -~ ~ NO. OF BEOROO~ Well Absorption area Width I- 2 Manufacturer , t~,~,.49 Material ~F' /Liq. capacity in gallons l iF HOMEMADE: Ilnsidelength DISTANCE TO: Well~-~4/~.~ LU Foundatio~ ,~, st lot line h width Top of tile to finish grade Length Total length of lin~. ~ Material beneath tile Depth PERMIT NO. No, of compartments Liquid depth PERMIT NO, PERMIT NO.~) O/ Distance beF~n lines T° tel e f f~ect ive~' ,°~P ~.~n ?~ PERMIT NO. Type of crib Crib diamete~ Crib depth Total effective absorption area Well Building foundation Nearest lot line DISTANCE TO: CI~},,~,/~ ~ Depth Driller Distance to lot line [PERMIT NO. DISTANCE TO: Building foundation Sewer line Septic tank 1 Absorption area(si OTHER PIPE MATERIALS REMARKS 72-013 (ReV~ 3/78) DATE LEGAL PERMIT NO. ~PPLICRNT MONTE 8CHESON SRR BOX ~28'-D tOCATION PBDDOCK LBNE LOT ~6 BLK i SK'¢ RRNCFI EST. i r'IUN I C ! P~-IL I TY CmF F=II'-,ICHORF'ICtlS ~ ~'"-~J DEPFIRTMENT OF HERLTH FIND ENVIRBNMENTF1L PROTECTION 825 'L~ STREET, RNCHORAGE., RK. 9~501 ~.~i]~j ~44-4658 LOT SIZE 189~.~. SOURRE FEET P~PE OF SOIL RBSORPTION S'PSTEM IS: TRENCH MKtXIbIUM NUMBER OF BEDROOMS SOIL RRTING (SO FT?BR)~. l?.~ tHE REQUIRED SIZE OF THE SOIL. FIBSORPTION S'¢SI'EM IS: DI~S P T H ~-= ~1.-I LEI'-IG TH = 2~5 OR Ft'~'E L ~)EPTH= ?. -~5 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIEI.D. ]'HE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFRCE OF' THE GROUND AND THE BOTTOM OF THE EXCAVWFION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF OR~VEL BETWEEN THE OUTFRLL PIPE RND THE BOTTOM OF THE EXCRVBTION (IN FEET>. )ERMIT 8PPLICBNT HBS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING THE I'NSTRLLBTION INSPECTIONS OF 8N¥ WELLS 8DJRCENT TO THIS PROPERTV ~ND THE {LIMBER OF RESIDENCES THBT THE WELL WILL SERVE. ~RCKFII.LING OF ANY SYSTEM WITHOUT FINRL INSPECTION RWD RPPROVRL BY THIS :,EPRRTMENT WILL BE SUBJECT' TO PROSECUTION. IlNIMUM DISTANCE BE'rHEEN R WELL AND RN¥ ON-SITE SEHRGE DISPOSRL SYSTEM IS .08 FEET FOR Ft PRIVRTE WELL OR 150 TO 200 FEET FROM R PUBLIC WELL DEPENDING ~PON THE T'~PE 0F PUBLIC WELL. IINIMUM DISTANCE FROM R F'RIVRTE I.~EL[.. TO R PRIVRTE SEWER LINE IS 25 FEET RND '0 FI COHHLINITY SEWER LINE I~ 75 FEET, ~THER REQUIREMENTS WRY RPPLY. SPECIFICRTIONS AND CONSI'RUCTION DIRORRMS RRE ~VRILRBLE TO INSURE PROPER INSTRLLRTION. F'ERM X T EXP I RES DECEMBEER .'-~ ~C.. CERTIFY THAT .. I RM FRMILIRR WITH ]'HE REQUIREMENTS FOR 0N-SITE SEWERS RND WELLS RS SET ORTH BY THE MUNICIPRLITY OF RNCHORRGE. :: ! MILL INSTRLL THE SYSTEM IN RCCORDRNCE WITH THE CODES. :: ! UNDERSTRND THRT THE ON-SITE SEHER SYSTEM WRY REQUIRE ENLRROEMENT IF' THE '.ESIDENCE IS REMODELED TO INCLUDE MORE THRN ~ BEDROOMS. RPPLICRNT MONTE RCHESON " /'¢4. 0 · . Op.,) QGRF" -'ER ANCHORAGE AREA BOP"UGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME /7/oo'Z) (~'///,~7-- MAILING ADDRESS~'~'P~ ~-/¢r~ ? PHONE LOCA'FION,/~/.~.)('./¢ /~,41.,0 ~Q.¢~/=-. LEGAL DESCRIPTION,,Z. /,¢ ~.X-''~ // SEPTIC TANK: DISTANCE ~ ¢)-)~:-~. NUMBER OF FROM WELL(,~'//~ MANUFACTURER ,'~',.~C /~ MATERIAL '-~"7,~'~ COMPARTMENTS ~ u.~ /~'4'¢//5" INSIDE LENGTH INSIDE WIDTH -- .LIQUID DEPTH -- LIQUID CAPACITY /,~oo GALLONS. SEEPAGE PIT: NUMBER OF PITS I DIAMETER -- LINING MATERIAL _Ph//~/~ ~ BUILDING FOUNDATION ~ ADDITIONAL ABSORPTION OR WIDTH CRIB SIZE: DIAMETER NEAREST LOT LINE ~<P-/- . LENGTH---, DEPTH ~ // DEPTH ~/' <D~ISTANCE FROM: WELL TOTAL E~'FECTIVE ABSORPTION'AREA (WALL AREA) ,~/~ SQ. FT. WELL: TYPE ~'¢¢~'m ~ (A'2~']-A~,/~. CONSTRUCTION ..... DEPTH BUILDING NEAREST NEA RF~S-T~ SEPTIC FOUNDATION LOT LINE ~)¢ ~//~ ~,.~SEVVE/R LINE /<p-jL~ TANK cEsspooL AP P R (?,~V~-4~' _ DISAPPROVED REMARKS DISTANCE FROM: SEEPAGE SYSTEM DISTANCES: INSTALLED BY: /-/¢¢t'¢ PIPE MATERIAL: LOT SLOPE: REMARKS: Form No, EQ-031 DIAGRAM OF SYSTEM G.A.A.B, SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT GREATER ANCHORAGE AREA BOROUGH INSTALLAT}ON LOCATION LEGAL DESCRIPTION IN.CiTALLA'rlON OF: SEPTIC TANK TYPE aND SIZE OF faCILITY tO BE SERVED FINANCED THROUGH SEEPAGE PIT_ , DRAIN FIELD . , OTHER TO BE INSTALLED bY ~'~'~'~'~'~'~'~/~'/~'~'* ~'~-/~'~ ' NOTE~ THI~ PERMI"r IS NOT VALIID WITHOUT ~OlL TEB7 SEPTIC TANK TO SEEPAGE PIT WALL WATER MAIN TO SEPTIC TANK --.. SEEPAGE SEEPAGE AREA SiZE 4 INCH DIAMETEr CAST ]RON SIPHON PIPES ON SEPT[C TANK AND SEEPAGE PIT F}TTED WITH Al RTIGHT REMOVABLE CAPS. GRAVEL BAC~KFI LL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. I CERTfFY THAT ] AM FAMILIAR WITN THE REQtJIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE FORM NO, EQ-0~ 6 '/7- 50~ PROPOSED DW '7 ?. ~;iIt'ta tho Contract~ Grad~. 'lop of Foundation as o,l,rso of-blocK J_,L1NG I hereby certity that I have surveyed the following described property: /C3Z- /6, ~O~'/(~ / ,~/CJ/ /f~/9,q/E.I/ Z-,5 Z-/) Z- o~ Anchorage Recording Precinct, Alaska, and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on prop- erty lying adjacent thereto encroach on the premises m .question and that there are no roadways, transmlssian lines or other visible easement~ on said property except as indicated hereon. Dated at Anchorage, Alaska~ FBED WALATKA & ASSOCIATES Engineers and Surveyors .! ·. , ~ D~T~=~RECEiVED = INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR I NSPEC~.~ %¢.~, MUNICIPALITY OF ANCHORAGE MUNICIPALLY' OF ANCHOP, AGE  DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION DEPL OF  825 L Street - Ancborage, ENVJRONM~NI'AI. ~, 6~TECTION Alaska 99501 (ENVIRONMENTAL SANITATION DIVISION MAR 2 8 1980 Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND PI RECTIONS~ Complete all parts o~t page 1, incomplete requests will not be processed, Please allow ten (10) days for processing, 1, PROPERTY OWNER PNONE James York __ MAILING ADDRESS 11640 Paddock Lane PROPERTY RESIDENT (If differe~t from above) PHONE 2. BUYER PHONE Zielinski 349-1975 MAILING ADDRESS 11640 Paddock Lane 3. LENDING INSTITUTION PHONE Alaska Pacific Bank 274-9661 __ ~-AI LING ADDRESS 101 West Benson Boulevard 99503 ~'. REALTOR/AGENT PHONE Clyde Lower 277-155: MAILING ADDRESS 3201 C Street 99503 LEGAL DESCRiPTiON LOt 16 Block 1 Sky Ranch Estates Subdivision #2 TREET LOCATION 11640 Paddock Lane 6, TYPE OF RESIDENCE NUMBER OF~SEDROOMS [] One [] Four [~ SINGLE FAMILY [] Two r-] Five [] MULTIPLE FAMILY ;{~X Three [] Six [] Other 7, WATER SUPPLY [] IND[VI DUAL* * ATTACH WELL LOG. A well Icg is required for ~11 wells drilled ×~ COMMUNITY since June 1975. For wells drilled prior to that date, give well [] PUBLIC UTI LITY depth (attach Icg if available.) 8, SEWAGE DISPOSAL SYSTEM [~× INDIVIDUAL/ON-SITE** [973 YEAR ON-SITE SYSTEM WAS INSTALLED. [] PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUI-'ST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) 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 Connection 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: I ~)~)~3 If Tank is homemade SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATEF~IAL "~ 4. DISTANCESwELL TO: Septic/Holding Tank Absorption Area ine Nearest Lot Line Absorption Area to nearest Lot Line a' APPROVED FOR .7 BED.OOMS [] CONDITIONAL APPROVAL (letter must accompany/ertificate) [] DISAPPROVED 72-010 ( Rev, 6/79) RE2 REID ENVIRONMENTAL ENGINEERING 9RA BOX 1584R ANCHORAGE, ALASKA 99507 April 4, 1980 Municipality of Anchorage Department of Heal th and Environmental Protection 825 L Street Anchorage AK 99501 Attn: Sewer and W~ter Program On April 3-4, 1980, I performed an adequacy test on the seepage pit located on Block 1, Lot 16, Sky Ranch Estates //2. The total amount of water absorbed into the ground during the test was 325 gallons instead of the required 450 for a three bedroom house. Based upon the test information the system is inadequate. The absorption rate indicates a soils rating of 300 sqft/ bedroom vs the 250 sqft/bedroom at construction. The existing system is adequate for a 2.2 bedroom home. To upgrade the system approximately 300 sqft of added capacity is needed. ML ,CIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTIQN 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO_ 2. Property Owner:_ James York VA FHA_ CONV_ xXX Mailing Address:- 116/+0 Paddock Lane 3. Name of Buyer: Zielinski Day Phone:. N^ Mailing Address: 116L~o Paddock Lane 4. Name of Lending Institution: A]~aska Pacific Bank Mailing Address: 101 W Benson (clty) 5. Name of Realtor or Agent: Clyde Lower Mailing Address: 3201 C St Anch. Ak, 0~ 6. Legal Description: Lot 16 Location:~ 16/+0 Pacl~k Lane Day Phone:3J~q- 1975 Phone:__2_?/+-9G~l Phone:~7?~l 555 7. Type of Facility to be Inspected: 8. Water Supply Type of Supply: Single Fanj_l¥ No. Bdrms. ~ Public Utility ,Individual Commun5 tlr If Individual, number of dwellings presently served If Individual, depth of well Sewage Disposal System Type of System: Public Utility. If individual, date of installation - 1 c)?~ Individual (on-site) XXXXX 72-003(3/7G) 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 264-4111 GEORGE M.$UkLIVAN, MAYOR April 4, 1980 Clyde Lower % Jack White Company 320] C Street Anchorage, Alaska 99503 Subjec~ 16 Bloc]~ 1 Sk~ch Estates Subdivision ( James York ~ rop~.~r.k~y// ~he adequacy test performed on the sewer system serving the above subject property has failed. Therefore, before this department may send approval the lending agency, an upgrade will be required. A permit will need to be issued prior to ~he upgrade. to To upgrade the existing system, the specifications are as follows: add twenty(20) feet of trench with nine(9) feet of gravel backfill to the existing seepage pit. If there are any further questions, please contact this office at 264-4720. Si~ncerely, /? Associate Specialist eC~/ljw CC: Alaska Pacific Bank Mortgage Loan Department 101 West Benson Boulevard 99503 M~"UNICIPALITY OF ANCHORAGE ~PARTMENT OF HEAL. TH AND ENVIRONMEN'FAL PI~OTECTION '~~ 825 L Street, Anchorage, Alaska 99501 2'79-2511, emt. 224, 225 REQUEST FOR APPROVAL OF Inspection: T~me _~ ,~ ~ __.~% ,q_q~ Date /_/_ J~P/_ ~ A_/;~Z'QT.~y Inspector /~ ~/O.&~ INDIVIDUAL SEWER ~D WATER FACILITIES 1. Lending Institution Request: First National Bank of Anchorage Mailing Address: Post Office Box 720 99510 Phone: 276-6300 x 482 2. Property Owner: Mailing Address; J. Lewis Phone: Legal Description: Lot 16 Block 1 Sky Ranch Estates %2 4. Single ~'amily Residence: (x) Number Multiple Farai].y Residence: ( ) Number 5, We].l Data: Type Comm__u_n_ity ~_~_ Depth Cons'~ruction of Bedrooms: of Bedrooms: Bacterial Analysis 2 Well Log Filed[ ( ) .Sewage Disposal Permit It System: On- site~. ~/,~ sys ~.em Installed (x) Public Utility ( ) Installer ~'~/d~¢f" d°'"c;'~..F .... SepEJ. c Tank Size ._j/'Od)¢) Manufacturer' Distances: Well to Septic Tank _ d~.~fZ~_~ to Absorptior~ Area oewez Lirle S Nearest Lot Line Absorption Area to Nearest Lot Line Page Two ~'" · ' DeparP. men'h of Health and Environmen'tal Protection Request for Approval of Individual Sewer and Wa%er Pacilities Legal Description: Lot 16 Block 1 'Sky Ranch Estates ~2 Affadavi% Ak%ached: ( ) Letter A~tached: ( ) DisapproVed: Date: Departmen~ Worksheet: :. />d..O..d2 ..... 1. Type of Inspection: M NI_h'ALITYO- %Nt. O AGE DEPARTMENT OF H[:ALTlt ,',ND E?IV',Ii(I,~gMENTAL P ~OTE(~1?~I~(~'hALII" ' ; , r:_ · ~ , ~ . D~PT O, i, ' 279-7511, ,"t 22,~ 225 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES VA _____FHA 2. Property Owner: Mr. & .Mrs. J. Lewis Mailing Address: NHN Paddoc~C Lane Day Phone: 3. Name of Buyer: James R. & Carol A. York Mailing Address:__ P'O' Box 168 ____ Day Phone;__3~4_4-~4_09_6_or 2_7_.-4z~.~.58 4. Name of I_ending Institution:_ First National Bank of Aq~ho_ra~ Mailing Address: P.O. Box 720 Phone: 276-6300 ext 482 5. Name of Realtor or Agent:_ Clyde~L_o_w?r~ of Jack Wh%.t ¢_.Co. Mailing Address: 3201 C. St. (Calais Office Cenp~5_~e: 277-1_5_53-- .... 6. Legal Description: Lot 16 ~lk 1 Sky=anch Estates #2 Location: NHN Paddock Lane Type of Facility to be Inspected: Single Family Water Supply COMMUNITY Type of Supply: Public Utility If Individual, number of dwellings presently served If Individual, depth of well Sewage. Disposal System Type of System: Public Utility If Individual, date of installation P.S. Please contact above mentioned realtor to gain access. Yours Truly, Paula M. Cranmer Loan Processor No. Bdrms.__ 2 ,individual _lndividL~al (on-site) X 72-003(3/76) GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 1. Approval requested by: Mailing Address: .__~)~1 2. Property Owner: ~)q'~,O0., (~ [~'~'~o~, ×~<~. Phone: 4. Location: . ~F~ ~lmkA,~r~. ~ ~ 5. Type of facility to be inspected ~,,~[o ~n~x~ No. of bedrooms 6. Well Data: ~ Date Received c~ckc~ Time of Inspection Date of Inspection c~,~, REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR A. Type C. Construction Sewage Disposal System: A. Installed / C. Septic ~kl D. Seepag~P-i~c: D. Bacterial Analysis B. Insta'mer 1. Size 2. Manufacturer 1. Absorption Area 2. Material E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank , Absorption area , Sewer Lines Nearest lot line , Other contamination B. Foundation to septic tank ., Absorption area C. Absorption area to nearest lot line EQ-034 (1/74) Page 1 of two pages Page 2 of two pages - Ret st for Approval of Individual S ~.r & Water Facilities Legal Description c~-~,~f ~l~, _ A1 ~r ~ I .~x~ ~-~c~ ~'~ Comments Approved ~~,_~/~ Disapproved Date /<~ Appro(~r~Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" Street, Anchorage, Alaske 99503 - 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES MUNi~.I;ALII¥ O? ANCIIORAG5 DE?/\~TMENr OF IfEA[!H & JAN © 0 !g'Tfi RECEIVI I) 1. Type of Inspection: 2. Property Owner: Mailing Address: CMRO VA FHA Billy D. Underwood c/d Esther ~unn, Dynamic Realty 3380 C Street, Anchorage CONV xxx Day Phone 279 7611 3, Name of Buyer: James C, Lewis and wife~ Sandra C. Lewis Mailing Address: 4. Name of Lending Institution: Mailing Address: 5. Name of Realtor or Agent: Mailing Address: 11913 Southlake Day Phone Houston, Texas Clyde Lower-277 1553 First National Bank of Anchorage P. O. Box 720 Phone 279-4481 x 231 Esther Bunn~ Dynamic Realty 3380 I'C" Street Phone _ 279 7611 6. Legal Description: _ Location: Lot 16, Block 1. Skyraq~h Est~tem ~tN Paddock Lane 7, Type o'f Facility to be inspected: _~L_ngie Family R~rl~m-~ 8. Water Supply Type of Supply: Public Utility Community If Individual, number of dwellings presently served If Individual, depth of well 9. Sewage Disposal System Type of System: Public Utility If Individual, date of installation No. Bdrms. 2 Individual Individual (on-site) Septic Tank EQ-037 (1/74)