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Home My WebLink AboutSKYLINE VIEW LT 6ol MUNICIPALITY OF ANCHOFIAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVlRONMENI'AL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAl. SYSTEM AND/OR WELL INSPECTION REPORT MAILING ADDRESS LEGAL DESCRIPTION LOCATION rPHONE ] Well / . DISTANOE TO: / 'J- Manufacturer ~ - ' [Liq, capacity in gallons ~ IF HOMEMADE ~f_)(~ 0 I _~'~u~: _ DISTANCE TO' IWell ~_~ DISTANCE TO: / I / ~ '~ ~ / ~' ! Top of tfl~o finish grade ~ ~ Type of crib Crib diameter JClass Depth JAbsorption area OTHER PIPE MATERIALS SOIL TEST RATING INSTALLER REMARKS J[] NEW ~,,~J PG R A D E NO. OF BEDROOMS '-Dwelling ,,, PE ~ I Material ..... No, of compartments Inside length -~ Liquid dep~l~ welling PERMIT NO. /~ ]-Material 'Liquid capacity in gallons F~ndation ,~ I ~ J~s~ot line / J ~~~ Material beneath tile ' z ~ctive absorption Building foun¢~0m~ ~es~t I~-- ~ ewlil' ptic tank bsolption area(s) PERMIT NO~ ~.lLl[~ I ~-': I I :IL I T'-r' OF- RNr.2:H, RIF~GF£ DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 "L"' STREET., ANCHORAGE., AK. 995~1 264-4728 ( ~2E~861 ) RPPLICRNT L. OCRTION LEGRL TOM GRUSO?SCHMII}T BROS SKYLINE VIEW RCRE 6 BOX 3-202 ECB RNCH 9950± LOT SIZE 999999 SQURRE FEET TYPE OF SOIL RBSORPTION SYSTEM IS: TRENCH MRXIMUM NUMBER OF BEDROOMS SOIL RATING (SQ FT?BR)= 125 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: [:, EF' T~-- 12 L EE[-J G-Fi4 = 27 6 F~: R'..." E L ['-~E P TI4 = ;~ I'HE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD. ]'HE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETWEEN THE SI..IRFRCE OF THE GROUND RND THE BOTTOM OF THE E×CRVRTION (IN FEET). ]'HERE IS NO SET WIDTH FOR TRENCHES. ]'HE GRR'¢EL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFFILL PIPE RND THE BOTTOM OF THE E~<CRVRTION (IN FEET). F-: E:,=-., U ! E."EE-~ SEF'T I ~]: TR~-~-:] '=_~ I ZE= :L,~'~00 PERMIT RPPLICRNT HRS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING THE INSTRLL. RTION INSPECTIONS OF RNY WELLS RDJRCENT TO THIS PROPERTY AND THE NUMBER OF RE'=;IDENCES THAT THE WELL WILL SERVE. BRCKFILLIN6 OF ANY ':.';YSTEM WITHOUT FINAL INSPECTION RND APPROVAL BY THIS DEPRRTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTRNCE BETWEEN R WELL AND ANY ON-SITE SEWRGE DISPOSRL SYSTEM IS 100 FEET FOR R PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM R PRIVATE WELL TO A PRIVATE SEWER: LINE IS 25 FEET AND 'TO A COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MAY RPF'LY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS; ARE AVAIL. ABLE TO INSURE PROPER INSTALLATION. RES [)EC:EPIE:ER _~-:-- 2t..,, 21_ 9 8 2 I CERTIFY THRT t: I RM FAMILIAR WITH ]'HE REG!UIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET FORTH B°¢ THE MLINICIPRLITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ~: I UNDERSTFIND THAT THE ON-SITE SEWER S'¢STEM MAY RE~2UIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO. INCLUDE MORE THAN ~ BEDRODMS. .z__~¢.~¢ RF'PLICRNT ~ 'rOM GRLISC~'S,]:HMIDT BROS CONST __ ~' .¢/~.; ¢? I SSIJED B t . _['RTE ............ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST '~ SOILS LOG [] PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 3 4 SLOPE lO 11 12, 13,- WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? DATE PERFORMED: 12' ' ~'~' I / SITE PLAN 16 17 18 19 20 COMMENTS PERFORMED ~,,.~.r,~ :. 72-008 (6/79) Reading Date Gross Net Depth to Net Time Time Water Drop ! PERCOLATION RATE ii~/ / (minutes/inch} TEST RUN BETWEEN -- FT /1~ .Tz-- FT ;/W? APPLI¢ NT FILLS OUT UPPER HAl ONLY Property Owner T]'].o~las Lo G~.uBe Mailing Address 1~,,O. }Box .3-202 E,CB Phone Anchorage, Alt Zip Code 99501 Buyer Address ~ Zip Code Phone Lending Institution Address Zip Code Phone Realty Co, & Agent Address Zip Code Legal Description Acre 6 Skyline View Estates Street Locatio~ Type of Residence IX Single Family 3 [] Mulliple Family No, of Bedrooms FJ Other ..-' Water Supply ~~ ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. ~--'Community For wells drilled prior to that date, give well depth (attach log if available). ~3 Public Utility S e w.,~ Disposal [~' Individual Year Individual Installed: ¢-'~ ~(~.,.) [] Public Utility '" When Connected to Public Ulility: L~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspector Inspector Inspector Field Notes: -~-~A PP ROVE D BEDROOMS ) DISAPPROVED ) CONDITIONAL APPROVAL' 'CONDITIONS OF APPROVAL Soils Rating Date Sewer Installed Well To Absorption Area Well to Tank Well Log Received Septic Tank Size 72-023 (3/82) APPLI~' ·NT FILLS OUT UPPER HA' ONLY Buyer / ] J// n ..... ( }) '" '~z(. (-;2 Address Zip Code Lending Institution Phone Address Zip Code Realty Co. & Agen[ Phone Address Zip Code Type of Resi~nce : Multiple Family No. of Bedroon~. : Other Water Supply .~, Individual A~ACH WELL LOG. A we~l ~og is required for all wells drilled since June 19~5. ~ Communi[y For wells drilled prior to that date, give well deplh (attach log if available), ~ Public Utility i~ Individu~l Year Individual Installed: ~ Public U[ility When Connected to Public Utility: ~ Holding Tank NOT~: TH~ IN~P~CTION F~ MUST ACCOMPANY ~ACH R~ST B~FOR~ ~OC~91NG CAN BE INITIATED. Time Time Time~f~/~ ~ Time /, Field Notes: /~ ~ , :~iCIPALI'[Y OF ANCHORAGE { ~,ov~ ~oo~ B 3 ~ ~ ~ ~ ~ .~o~,~,o~ o~ ~ow~ ( ) DISAPPROVED Soils RaUng Da~e ~wer Installed Wel~ To Absorplion Area Well Log Received b~ -" ~ ~ Well Io Tank Septic T~k Size 72.023 (3182)