HomeMy WebLinkAboutROBIN HILL #1 BLK 3 LT 2BRobin Hill #1 Block 3 Lot 2B #017-392-06 Municipality of Anchorage `• Development Services Department �`Jt Building safety Division -•, '- r On Site Water and Wastewater Program, 4700 S. Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page I of 3 www.d.anchorage.ek.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. SWO50104 PID Number. 017-392-06 Nams Don 8 Suzanne Williams Wastewater System: ❑ New ❑ Upgrade Add,m 12851 Mountain Place, Anchorage ABSORPTION FIELD Pe°« Nume.rd eaamarr 3 O Deep Tremh D Snip Tmiph❑118d ❑MW -d ❑0"W set RE" Twl Depth ban orgnal or ft LEGAL DESCRIPTION 1.2 GPd:tt 11.4-12.2 Suedneipn: Depthb pp eoean rr°rn-9-w 9nde Greed depth beneath pW e °" 3 `°` 2B Robin Hill, Addn #1 6.4 - 7.2 F,. s.o Secoorc FA °dd eewa WO" 9n G,a" Lan9th' roenaliip R°"o° 0.4 Ft. 40 Gmelvrdth N~ Of Defame DeN.a Well. ❑ New ❑ Upgrade 3.0 Ft. 1 NA Pipe Mamrl cMWcetcn B q rda1 Dsa". pie°". raai a°eaWe^eraa 400 F,r ASTM D3034 FI. FL Date metaled p.w pD1ds0 Stec,_L_ i .Scott's Services 5114105 Ft ��, Pwrp Set at Gu tAeo.. Gmund 054JP93 TANK Ft El Septic ❑ Holding ❑ S.T.E.P. Sewer Line Anchorage Tank & Welding Matmri 88 steel LIFT STATION ada,nae., NA NA NA NA Rem 'IM Old tank abandoned In place. Old field abandoned in place due to reverse grade from tank. NA Gm Cindy W. Ellis Dates: lo1 5114105 Inspections performed by: 2"d 5/14/05 Developmeril Services Department Approval Reviewed and approved by: Date: jT1-1 (RV. 17,90) 4"-� ❑ Other: ePaatY 1000 Gal 2 M BENCH MARK floor 100.00 Ft 49LH 1dy W. Ellis CE.1os77 SEPARATION DISTANCES To Septic Tank Absorption Field Lift Station Hoklml Tank From wee 113 113 NA NA sed"w,m 100+ 100+ NA NA LdLM 58 30 NA NA FWndaear 40 54 NA NA Ft El Septic ❑ Holding ❑ S.T.E.P. Sewer Line Anchorage Tank & Welding Matmri 88 steel LIFT STATION ada,nae., NA NA NA NA Rem 'IM Old tank abandoned In place. Old field abandoned in place due to reverse grade from tank. NA Gm Cindy W. Ellis Dates: lo1 5114105 Inspections performed by: 2"d 5/14/05 Developmeril Services Department Approval Reviewed and approved by: Date: jT1-1 (RV. 17,90) 4"-� ❑ Other: ePaatY 1000 Gal 2 M BENCH MARK floor 100.00 Ft 49LH 1dy W. Ellis CE.1os77 WELL #2 Existing 3 BR house WELL #10 o°r / ca��ec50 Sump / / C01 Property Line AS -BUILT 3T2 Test / CO3 Hole o / o I � / \ MT1 / c C04 P �� / J10 I is IAIN Floce / Robin Hill #1, Blk 3, Lot 2B Record Drawing of Septic Upgrade Don & Suzanne Williams Watkins Engineering, Inc Parcel ID: 017-392-06 Permit No. SW050104 Cindy W. Ellis, P.E. P.O. Box 110443 June 7, 2005 Anchorage, Alaska 99511-0443 Scale 1 Inch = 30 ft Phone: (907) 349-1851, Fax (907) 349-1934 OF.A.0 qac..• � q� ?. c 49 RI y, ,...... ;.Css .11��..... '�0 •; •'..C, E - 15 10577 A B COI 58.7 42.2 STI 60.3 44.4 ST2 64.1 50.1 CO2 65.6 52.3 CO3 66.5 53.3 MTJ 77.6 84.3 CO4 78.8 85.1 Robin Hill #1, Blk 3, Lot 2B Record Drawing of Septic Upgrade Don & Suzanne Williams Watkins Engineering, Inc Parcel ID: 017-392-06 Permit No. SW050104 Cindy W. Ellis, P.E. P.O. Box 110443 June 7, 2005 Anchorage, Alaska 99511-0443 Scale 1 Inch = 30 ft Phone: (907) 349-1851, Fax (907) 349-1934 OF.A.0 qac..• � q� ?. c 49 RI y, ,...... ;.Css .11��..... '�0 •; •'..C, E - 15 10577 FCO CO1 STI FINAL GRADE = 101.37 ST2 CO2 CO3 p9H41000 95.01 GALLON STEEL SEPTIC TANK 9121 K.T.S. MITI C01 FINAL GRADE = 101.19 - IO1.74 NOTE: ORIGINAL GRADE _ 100.69 - 101.41 VI PIPE FILTER FABRIC ` 9 SEWER ROCK A9.2A 91.28 89.28 NOTE: 40.0 RELITIVE DEPTH OF TRENCH TEST HOLE = 82.44 N.T.S. HATER 0 83.71 AS -BUILT Robin Hill #1, Blk 3, Lot 2B Record Drawing of Septic Upgrade Don & Suzanne Williams Watkins Engineering, Inc. Parcel ID: 017-392-06 Permit No. SW050104 Cindy W Ellis, RE Anchorage, Box 110443 June 7, 2005 Anchorage, Alaska 99511-0443 J uScale Phone: (907) 349-1851, Fax: (907) 349-1934 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water 8 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. SWO50104 Legal Description:: ROBIN HILL'#1 BLK 3 LT "2B' Design Engineer: 0844 Watkins Engineering, Inc Owner Name: DON S SUZANNE WILLIAMS Date Issued: Apr 28, 2005 Expiration Date: Apr 28, 2006 Parcel ID: 017-392-06 Site Address: 012851 MOUNTAIN PL Lot Size: 45782 SO. FT. Owner Address: 12851 MOUNTAIN PLACE Total Bedrooms: 3 Permit Bedrooms: 3 ANCHORAGE. AK 99516 - This permit is for the construction of: 0 Disposal Field E Septic Tank ❑ 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: ¢-Z-q-os Issued By. IS Date: 28 it 1—fT"r \ Municipality of Anchorage Development Services Department . Building Safety Division / On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 017-392-06 Permit Number SW Property owner(s) Don & Suzanne Williams Day phone Mailing address (1) 12651 Mountain Place Mailing address (2) Anchorage, AK Zip Code 99516 Legal description (Lot, Block & Sub'd.) Robin Hill #1, Bik 3, Lot 2B Legal description (Section, Township & Range) Lot Size 45,782 Acres Sq.Ft. THIS APPLICATION IS FOR: I,11MIi,U •• • u Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade Q THIS PROPERTY CONTAINS: Hot Tub ® Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ 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. re. (Signature of property owner or authdrized agent) Permit Fees: 01J Waiver Fees: Date of Payment: �'�Q� Date of Payment: Receipt Number. ���� a_ Receipt Number. (Rev. 12100) Watkins Engineering, Inc. P.0 Box 110443, Anchorage, AK 99511 (907)349-1851 cwellis@gci.net April 26, 2005 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 RE: Robin Hill, Addition #1, Block 3, Lot 213 Septic System Upgrade To Whom It May Concern: Attached please find the application and supporting documentation for upgrading the septic system for the referenced 3 bedroom house. The existing septic system was installed in 1979 and the drainfield is now surcharged. It is proposed to abandon the steel septic tank in place and to retain the drainfield for future use. The existing tank is within 100 ft of the well. Any portion of the drainfield which is within 100 ft of the well will be abandoned. There are 2 wells on the property; only well #2 is currently in use. It is proposed to install a new 1000 gallon steel septic tank and a deep trench drainfield. The proposed design is based upon a test hole dug on April 18, 2005. The hole encountered gravel, silt, and sand to a total depth of 19 ft. The drainfield is proposed in the sand from 8 to 13 ft. There was frost in the test hole from 3 to 4 ft, which may be the source of groundwater at 17.7 ft after 7 days of monitoring. A percolation test conducted between 8.5 ft and 9 ft resulted in a rate of 1.7 minutes per inch. An application rate of 1.2 gpd/ftZ is used in the design. The soil log is attached. Proposed Soil Absorption System: 3 Bedrooms x 150 GPD/BR = 450 GPD Drainfield Type: Deep trench Application rate: 1.2 gpd/ ft' 450 GPD / 1.2 gpd/ftZ = 375 ftZ required Maximum Depth: 13.0 ft Effective Depth: 5.0 ft Length Required: 37.5 ft Design Length: 40 ft Sewer Upgrade Permit Application for Robin Hill #1, Blk 3, Lot 2B Watkins Engineering, Inc.; April 26, 2005; page 2 There are no surface waters or private wells within 100 ft of the proposed septic system. I am not aware of any adverse effect that this upgrade would have on any adjacent properties' water and wastewater treatment needs. Thank you for consideration of this permit application. If you have any questions or need further information, please call me at 349-1851. Yours truly, Cindy . Ellis, P.E. President 3 I Ik, U " / Existing / I 2 B Septic System Proposed WELL # t / Septic System \I / 3SRry�se Tes� \Hole / Gazeb / b b WELL#10 � R R JO i \r ! N QJ' C Ia J i JI � 3 I Appx. 1 of WEL I WELL I z / 3 ° septic \ / area �ivQ nTTPJTIace� WELL / �I I 9 8I \ Robin Hill #1, Block 4 ocation $I I I Lo Robin Hill #1, Blk 3, Lot 2B Appx. location I \ of WELL o 2A septic �\ \ area \ \ \ Proposed Septic Upgrade - Site Plan Watkins Engineering, Inc. o' oF.q C''`'.t;;, .. ���J�'V Don &Suzanne Wilgliams / Existing / I 2 B Septic System Proposed WELL # t / Septic System \I / 3SRry�se Tes� \Hole / Gazeb / b b WELL#10 � R R JO i \r ! N QJ' C Ia J i JI � 3 I Appx. 1 of WEL I WELL I z / 3 ° septic \ / area �ivQ nTTPJTIace� WELL / �I I 9 8I \ Robin Hill #1, Block 4 ocation $I I I Lo Robin Hill #1, Blk 3, Lot 2B Proposed Septic Upgrade - Site Plan Watkins Engineering, Inc. o' oF.q C''`'.t;;, .. ���J�'V Don &Suzanne Wilgliams ac�Q. Parcel ID: 017-392-06 49 -... Z...` �u Cindy W. Ellis, P.E. P.O. Box 110443 6% ''•. " e "os i'uS�' April 25, 2005 Anchorage, AK 99511-0443 �' Scale P - 100' Phone: (907) 349-1851 Fax: (907) 349-1934 `� WELL, ' #2 Existing septic tank to be abandoned in-place. Existing 3 BR house WELL #1 o Property Line Test Hole 4/18/2005 Organics Loam 2.0 SM 30 GM/ML 8.0 Sand SM Water v (may be from 17 melting frost) 19.0 BOH +,yvOA��` ea. Sump c I ob Proposed diverter valve 40 ft long Wroposed 10k0 gal Test c0 & septic tank \ Hole MT a m I Gazebo / J` Proposed Trench 4" perf pipe 5 ft sewer rock MOUNIAIN Place DESIGN DETAILS 3 BR, 450 GPD 1.2 gpd/ft2 Requires 375 ft2 Deep Trench 5 ft effective 40 ft long Max 13.0 ft deep t�oa3_,•.. Robin Hill #1, Blk 3, Lot 26 o OF At Septic Upgrade Watkins Engineering, Inc. ... ';ewgS l.. Don & Suzanne Williams .0:'49TH y,:`?• Parcel ID: 017-392-06 ? .... •.. . G�!.�.......:. CindyLLIS W. Ellis, P.E. DV W. 77 P.O. Box 110443 v�.•; '••..�"ce - +os�7 April 25, 2005 Anchorage, Alaska 99511-0443 )4 .,. •........•• Scale 1 inch = 30 ft •..,,...•-,< Phone: (907) 349-1851, Fax (907) 349-1934 / �eptrench / ft efV / / c• / 0 U / r.r.� / / DESIGN DETAILS 3 BR, 450 GPD 1.2 gpd/ft2 Requires 375 ft2 Deep Trench 5 ft effective 40 ft long Max 13.0 ft deep t�oa3_,•.. Robin Hill #1, Blk 3, Lot 26 o OF At Septic Upgrade Watkins Engineering, Inc. ... ';ewgS l.. Don & Suzanne Williams .0:'49TH y,:`?• Parcel ID: 017-392-06 ? .... •.. . G�!.�.......:. CindyLLIS W. Ellis, P.E. DV W. 77 P.O. Box 110443 v�.•; '••..�"ce - +os�7 April 25, 2005 Anchorage, Alaska 99511-0443 )4 .,. •........•• Scale 1 inch = 30 ft •..,,...•-,< Phone: (907) 349-1851, Fax (907) 349-1934 Municipality of Anchorage Development Services Department Building Safety Division a1 On -Site Water and Wastewater Program 4700 South Bragaw Sl. P.O. Box 196650 Anchorage, AK 99519-6650 www.munl.org/onsite (907) 343-7904 Soils Log - Percolation Test Performed For. Don & Suzanne Williams Date Performed: 4/18/2005 Legal Description: Robin Hill #1, Blk 3, Lot 2B Township, Range, Section: 1- Depth (Feet) QJOa/1fC5 IEcGr LC2In Net Time Depth to Water 2- 2 1-2 Tan/lo3os%. 3:14-3:24 21 3 6 .D 4- 610 10 5- AltL 5-6 6- 3:36-3:46 10 7- 6 7-8 $ 3:47-3:57 S. D `9- $1"11 10- 11- 12- 13- 14- 15- 16- 17- 18- 19 A 19. o COMMENTS Unable 14 WAS E ENCOUNTERED? ED? (/v�_t`��o-��It� IF YES, AT WHAT DEPTH? - " L Depth to Water After F Monitoring? _17.7, E Date: aT i26-05 Reading Date Gross Time Net Time Depth to Water Net Drop 1-2 4/19105 3:14-3:24 10 6-0 6 34 3:25 - 3:35 10 6-0 6 5-6 3:36-3:46 10 6-0 6 7-8 3:47-3:57 1 10 6-0 6 9-10 3:58-4:08 10 6-0 6 11-12 4:09-4:19 10 6-0 6 PERCOLATION RATE 1.7 (.mi kcb) PERC HOLE DIAMETER e TESTRUNBETWEEN 8.8 FT AND 9.0 FT J - PERFORMED BY: Watkins Engineering, Inc. I (if9%!i OKI, CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDE NES IN EFFECT ON THIS DATE. DATE: f 2S�o5 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 PHONE VJi.1! 4 NEW UPGRADE MAILING ADDR ESS1�00 ^ L -i ina 4_ I - A:fig LEGAL DESCRIPTI 1 I LOCATION eW ©� NO. OF BED OMS Uy DISTANCE TO: Well O� Absorption rea Tot Dwelling PE T 0�� �+ () I (� I-_ Z wF Manufacturer Material l e� No. of compar ents H Liq. �a�agity�gallons Inside length CC1J IF HOMEMADE: Width Liquid de 0 y JAZ DISTA Dwelling O E Q ufacturer Material Liquid capacity in gallons w= DISTANCE TO: Well (00+ LL 6O© + Foundatin�oS + Nearest lot li PERM ( J LL Z Z w No. of lines Length of a I�n/ Total length.o • ' s/ Trench width Distance between link inches F Top of tile to finish grade 1 Material beneath the Total effe tiv�ebs rption area inches w Length Depth RMIT N0. (7 Q I— Lau °� Typ crib Crib diameter Total a tive absorption area _ zz w Well DISTANCE TO: ndation Nearest lot line JCla J Depth Driller Distance to lot line PER 1 ' wBuilding foundation DISTANCE TO: Sewer line Septic/t�yly� lot ar Absorption OTHER SPIPE MATERIAL�r ' SOIL TEST RATING C 0 INSTALLER REMARKS r O 1 APP OVED �.,,,�,�� DATE LEGAL �` 1?� oil HEZ oil 1 M 107 Hit ���-11F, 1 ic:�:: �11 144 ;TV 1: 10 Eic ­ :1. ill oil PD, �����U Q VH "E, PERMIT HPPLICHNT HHS THE RESPONSIBILITY TO IHFORM THlS �O INSTGLLHTION INSPECTlQNS OF GNY NELLS HDJHCENT TO THIS ~ ��� � 47: � � R� 17x-mv W� ��!��1 ��KA� ' DEPHRTMENT COO HEHLTH HND ENVIRONMENT�L PROTECTION STREET/ HNCHORHGE/ RK� 99501 , 264�4720 OF HNY SYSTEM WITHOUT FINHL INSPECTION HND //^/�J �4��� ������� WILL BE SUBJECT TO PROSECUTlOM PERMIT NO ( 790552 ) ~~~ HPPLICH@T RHY`B9R BUI1 E ]49 646 LOCHTION MT PLRCE FOR R PRIVHTE WELL/ OR LEGFI! LQT 2B BLK ] ROBIN HILLS UNITt1- � i50 TO 200 SI-.:!UHRE FEET TYPE OF SOIL TRENCH TYPE OO PU8LIC WELL NELL LOGS MAXIMUM SOIL RHTING DEPHRTMENT (SQ FT/BR)= 210 THE REQUIRED SIZE OF THE SOIL HBSORPTION SYSTEM IS: �����-V �1 � �O� ���������� �� �������� OTHER REQUIREMENTS �����Ell THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD THE DEPTH OF H TRENCH OR PIT IS THE DISTHNCE 8ETWEEN THE SURFHCE OF THE GROUND HND THE BOTTOM OF THE EXCHVHTION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES THE GRHYEL DEPTH IS THE MINIMUM DEPTH OF GRHYEL BETWEEN THE OUTFALL PIPE RND THE BOTTOM OF THE EXCHVHTION (IN FEET), oil HEZ oil 1 M 107 Hit ���-11F, 1 ic:�:: �11 144 ;TV 1: 10 Eic ­ :1. ill oil PD, �����U Q VH "E, PERMIT HPPLICHNT HHS THE RESPONSIBILITY TO IHFORM THlS DEPARTMENT DURING THE INSTGLLHTION INSPECTlQNS OF GNY NELLS HDJHCENT TO THIS FROPERTY HND THE �UMBER OF RESIDENCES THHT THE WELL WlLL SERVE. -11...��-.11 1,: "F'. lot Q KEE 10Eh� BHCKFILLING OF HNY SYSTEM WITHOUT FINHL INSPECTION HND HPPROVRL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTlOM MINIMUM DISTHNCE BETWEEN H NELL HND HNY Ohl -SITE SEWHGE DISPOSFT. SYSTEM IS 100 FEET FOR R PRIVHTE WELL/ OR i50 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OO PU8LIC WELL NELL LOGS FIRE REQUIRED HND MUST BERETURNED TO THE DEPHRTMENT WITHIN 20 DHYS OF THE NELL COMPLETION. OTHER REQUIREMENTS MAN" HPFl. 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LEGAL DESCRIPTION DATE RECEIVED INSPECTION APPOINTMENTS TIME _ TIME TIME DATE DATE DATE 6. TYPE OF RESIDENCE INSPEC R INSPECTOR MUNICIPALITY OF ANCHORAGE r i. is MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL r .: IECTION DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 1 m 17 1980 • ' F�() ENVIRONMENTAL SANITATION DIVISION RECEIVED K Telephone 264-4720 FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES REQUEST DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. PHON 1. PROPERTYOWNER 3[[ E _'V�3 T 1�1 S MAI LINGADDRE S PROPERTY RESIDENT (It different from above) PHONE PHONE 2. BUYER - INDIVIDUAL/ON-SITE** MAILING ADDRESS 3. LENDING INSTITUTIO A.t PHONE cu2 l4JC>!cpxi, Ak 74-�8ao XUt2— MAILING ADDRESS F05— C6 �% 5'0 PHONE 4. REALTOR/AGENT MAILING ADDRESS 5. LEGAL DESCRIPTION y CK Cv3!dy rls STREET CATIORN !v 04lA 4090e 6. TYPE OF RESIDENCE NUMBER OFBEDROOMS ❑ One ❑ Four ❑ Other J?-�SINGLE FAMILY ❑ o ❑ Five ❑ MULTIPLE FAMILY Three ❑ Six 7. WATER �SUP LY * ATTACH WELL LOG. A well log is required for all wells drilled LS INDIVIDUAL* ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGEDI OSAL SYSTEM J f YEAR ON-SITE SYSTEM WAS INSTALLED. INDIVIDUAL/ON-SITE** ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 7 i on 72-010 (Rev. 6/79) 1441,7- / ¢/j--10. QQ� _v' T Ce�_ r__� THIS SIDE FOR OFFICIAL USE ONLY 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'•r m -� r INSTALLER r Y� ❑Septic Tank or ❑ Holding Tank Sire:_ , __. 0 If Tank is homemade give dimensions: SOILS RATING �z 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 ti--APPROVEDFORBEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE rte,BY( (x.... , : ; I , (i )" y ji-1 I � , �� /i �I .—...��66 V)ISVIV '3`JVHOHONV - Cyp — Y — 1 4L6C6LZ :auoyd 3ItlOS i �03Wf1SStl �� l� -, i.L7 I I� i� v 5311f1S"9AV H181S9M9CLL WL11V0 .. -T-] JoAaAJnS Puel 'Bad of 'IIVONVH'A OlV839 :A9 Paiedaid SNOIIVA313 ONIISIX3 ❑ :NOIldIHOS30lV931 13S >oviv snH,.ZK.Z O '1SIX3S1N3WH0VOa0N3 A3Aaf7S 'S1N3W3SV3 (INV ON (INV S3NIl A1a3dOad 3Hl NIH11M 3HV SIH113S atl83a 8/5 o S3NIl 101 Ol NOIIVI3H Ni SNOV9 13S 9NIOltf19 (INV 3OVa0 HSINlJ 01 NOIl NO3H3Hl031Vf11IS S1N3W3AOHdWI 3H11VH1 ONV NO3a3H 0381HOS3O (INV NMOHS A1H3dOHd 03a3AO038 13V0313 8/9 • -V13H NI NOIIVONno:j 30 d01 >103HO 01 - 3Hl O3A3Aaf1S 3AVH 11VHl AdIIH30 A83H3H :ON3931 All`II91SNOdS38S,a010VH1N00 3H1 SI lI =NOIlV0I3I1a30 A3Auns im 00 ova - ,00'_��'_�J.__.. I J o� i ,2G L����N P c C�^Gocaaao.+p•oJ Oaij, V'e n+ `7 � �� V> e 'ON eve 0190 • Z rte: us a A 21; yO • -•.�a -%,o IV Iice V � i'Qi^9 L0911 ie)4F'+Oh6'%I !''a4>'/ii� {v P 415 ����a o�Y��• e� l January 23, 1180 Don willians 7700 Anda Lane Anchorage, Alakka 97950" Subject; Lot 213 Block 3 Robin Hills Subdivision ka,proval for your im'lividual serer: and crater facilities can not be granted until the following ite.ls have leen completed (1) he water analysis report be delivere(I to this office from. Chein Laky, 11,633 B Street, for our review. (2) A well log su�initted to this deWlrtment. (3) Expose the well for our inspection to determine pr6per wonstruction, also to insure the minimum distance requirements are met between your well and seFrer system. Please notify this department for a re -inspection when the noted descrepancy has been. corrected. If there are any further questions, Please contact this office at 264-4720. Slincerely, Robert C. Pratt. R.S. .Associate f3pecia.lis,t 1" j�/l jW cc-. Security National Bank .1_44ertgeg Loan 7epa.rt went SO m street 99501