HomeMy WebLinkAboutSUE TAWN ESTATE #2 BLK 1 LT 7C)SI
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~.~./ 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
MAILING ADDRESS
LEGAL DESCRIPTION
LOCATION
DISTANCE TO:
ILiq. capacity in garlons1 IF HOMEMADE:
DISTANCE TO: J Well
Top of tile to finish grade . ]
Class DISTANCEDISTANCE TO: TO: Well Depth Building foundation
Absorption area
Inside length
Dwelling /~/(~ ·
Mater~_L~
W dth ·
PHONE
NO. OF BEDROOMS
PERM]T N .,
No. of compartments_.
Liquid depth
Dwelling PERMIT NO.
Liquid capacity in gallons
F°u ndati°n.~t)/~,~
Total length
M~ferml beneath tile
Material
Nearest lot line~) /
inches
Depth
Crib depth
PERMIT NO. ~t
Distance between lines~z~ /
Total effective bsorption area
PERMIT NO.
Total effective absorption area
Building foundation Nearest lot line
Driller Distance to lot line PERMIT NO.
Sewer line Septic tank Absorption area(s)
[] UPGRADE
OTHER
PiPE MATERIALS
SOl L TEST RATING
INSTALLER
REMARKS
DATE LEGAL
72-013 (Rev. 3/7B)
Permit ~
Location
Legal Description:
Type of Soil Absorption System Is:
Trench: Drainfield:
Maximum Number of Bedrooms: ,~
MUNICIPALITY OF ANCHORAGE
Department( i Health and Environmental ]rotection
825~L Street, Anchorage, AK. \~J501
264-4720
* * * HANDWRITTEN PERMIT * * *
WELL AND/OR ON-SITE SEWER PERMIT
~ ~hone~' Number . ~C~_~ ~ '
! Lot s ze:
Seepage Bed: ///Holding Tank:
Soil Rating(sq.ft/br)
DEPTH
The Required Size of the Soil Absorption System Is:
LENGTH ~ GRAVEL DEPTH (0'#WIDTH
The length dimension is the length(in feet) of the trench or drainfield. The
depth of a trench or pit is the distance between the surface of the ground and
the bottom of the excavation(in feet). There is no set width for trenches.
The gravel depth is the minimum depth of gravel between the outfall pipe and
the bottom of the excavation(in feet).
* * REQUIRED SEPTIC(HOLDING) TANK SIZE = /~00 GALLONS * *
Permit applicant has the responsibility to inform this department during th~
installation inspections of any wells adjacent to this property and the number
of residences that the well will serve.
* * * TWO(2) INSPECTIONS ARE REQUIRED * * *
Backfilling of any system without final inspection and approval by this department
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 feet
for a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a community sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
* * * PERMIT EXPIRES DECEMBER 1 9 8 3 * * *
I certify that:
(1) I am~familiar with the requirements for on-site sewers and wells as
set forth by the Municipality of Anchorage.
(2) I will install the/qsystem in accordance with codes.
(3) I understand th~ ~he on-site sewer system may require enlargement if
the r~idenc~/~s ~em~deled to include more that 3 besoms.
pplicant I /
SWP/024(1/81)
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG -- PERCOLATION TEST
J~ SOILS LOG
[] PERCOLATION
TEST
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2
3
4
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6-
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20-
't-o t 0 0
SLOPE
II
/
SITE PLAN
Gross Net Depth to Net
Reading Date
Time Time Water Drop
PERCOLATION RATE
(minutes/inch)
PERFORMED BY: '~JL'I I'~1 ~ 2~ /~,
TEST RUN BETWEEN FT AND FT
72-008 {6/79)