HomeMy WebLinkAboutSKYLINE VIEW BLK 1 LT 23 NAME
MAILING A D O ~_.%
LEGAL DESCRIPTION
LOCATION
] Well f ~ Absorption area
I DISTANCE TO: / thl?
~ ~ Manufacturer ,
Liq. ~a~qcit.y in gallons [ Inside length
/ ~ C'~ IF HOME. DE: · ,
DISTANCE TO' IWell ~ ,/ IDwelling
~¢ Manufacturer
~ I I Well / Foundatio~ /.
~ ~ ~ ~ NO. of lines ¢ I Lengtl,%f%a~ ~[~e / Total
~ Top oftileto finish grade ~ /.~ Material beneath tile
~ I Length Width / Depth
~ Type of crib Crib diameter ~/~ Crib depth
LM ~ I //~1
~ DISTANOE TO: W~II / ' ~uildino foundation
~ I DISTANCE TO: ~uildino foundation Sewer
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTEiCTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
PHONE "~ EW
,~ ~Z ~"t/.~ [] UPGRADE
Dwelling
'Bo
Material
Width
VIE.
NO. OF BEDROOMS
PERMIT NO.
No, of compartments
Liquid depth
PERMIT NO.
Material Liquid capacity in gallons
Nearest lot line/o / PERMIT NO,
Trencb wid)fV//~- Distance between lines ~t/~,]
~'//~ inch es
Total effective absorptio~D~n area
PERM T NO.
Total effective absorption area
Nearest lot line
Distance to lot line
PERMIT NO,
Absorption area(s)
Septic tank
OTHER
PIPE MATERIALS
Pv'c
SOIL TESTRATING
INSTALLER
%'-- o.?
REMARK8
::? ,:/,
APPROVED/~/ / /
72-013 (R~./~/78~
DATE LEGAL
PERI"IIT NO.
FIPPL I CFINT
LOCFI'I" I OH
I...EG FII...
[:,EPI::IRI-'t"iENq" (.'iF' HEI:'ILTH FIN[:, IEI",I',,,' I ROi',II'"IENTF:II. I::'ROTECT 101'.~
825 "L." 'i:;TFi:EET., FII'.81'-IOI.;.'.FI(E., t:iK.
bt IE L_/L_ ~:~ If'..,~l iii>
( 82:E~648 ::,
IdL'r_.['.l-I::, II",IC . ~ ]:'-:5~ FE'RI'-~ ST., FII'-,IC:H. FII-:::.,
LZ11: BZ :BK'¢LII"4E ',,,'IEI.,~ S/L':, LO]" SIZE
T"r'F'E OF :BOIL. FIBtE;ORF'TIOI",! S"?STEt'"I IS: 'I'REI"4CI'4
i'"tFl::'::It"tI.Jl'"l NI.JHBEI.;.: ElF' E:EI)RO0t'"I'5 = ii:
SOIL F.:I::ITII",IG '.'.:E;,6! FT/E:R::,= l~.']E~
THE F.:EI;!I..III;,:E[:, SIZE OF "i'HE SOIL FIE:SOF,'ti.:'TIOI'.4 '-:;'¢S'I"EH 15:
[::, E::; F' '-If- H .... :::'.:.: L_ E ~'-.~t ,]ii T' 11q == 5:::3 Eii tF-: FIt "¢ FZ L_ [::, E:Z P ]- HI =: ,4
THE I._EI",I(~iTH DII"EI'.~IOt',! 1:5 THE L.EI",IGTI4 ,::IN FEE]':.', OF ]'FIE "FRENCH OR I)RFIII'.,IFIEL.I:,.
THE [.':,EPTH OF FI TREt",ICH OR PIT ]:'_.'~: THE DISTF~I',II.::E E:ETP.IEEN THE 2;LIRFFIC:E OF' THE
6ROIJi'4E:, Rt",I[:, THE BOTTOI"'I OF THE E},:CFI',,,'FITION ,::II"~ F'EET).
'T'HEI,;,'E I~; I'.40 SET I.,t[I)TH FOR TRENCHE':-;.
THE GI,:,'.FI',,,'EI._ [:,EF'TH IS THE I"'IINIHI..Ihl [:,EPTH OF GRFI',,,'EL BE-f'I.,EEN THE: OUTFFILL. F'IF'E
FIIq[:, TI.-IE E:OTTOM OF ]'HE E:,.,:CFIVF:rI-IOi'~ (II'-,I FEET).
F-: EE (:::~ Lt I F..': E: [) E; E; F:" -ii'" I E: 1- IR 11'-li II< :'5; I Z E] := ::ii._. (~'.~ ,:.} E~ (3 F~I L. L. ,:] If'-,~ EE;
PERI"I:[ T RPPL I CflltT HFI~; THE RE'_'~F'OI',I$ I E: I L.. I T'? TO I NFORt'I 1'I-41 ::5 [)EF'RRTI',lli~NT [:,I.JR I t',IG THE.:
i NS'TFII....L. FI'I' 101',1 I i',tSPECT 101'.5 OF FtN'¢ I.,ELL'B FII).;rFICEt.,IT TO TFII S PROF'ERT'¢ FIN[) THE
i,,IUI','IE:EF.: OF RESIDEt'.,ICES THI,:IT THE ~-,.IELL I.,.IILL SER',,,'E.
............... T' 11.,.li C) ( ;2 ) Z ii'4 :S 11:' E: E: -ii'- [ E, iq :5 i.:~ iF:;'.' E tl.4: lie (:.~ LI I
E:I,:IE:KF ]: L.L I I'.4G OF FIN"r' S"r'S"I'EI"'I 1.'.11 THOIJT F I NFIL I I",I:E, PECT 101",t FII'.4[:, FIPPF;'.ClVRL
[)EF'FIRTI"IEt"4T t.4IL.L BE E;UE:..TEC:T TO PROSEE:UT]:ON.
I'"IINIFIUf'I [)ISTFINCE BETP.IEEI'4 FI [,ELL. FIi",IE:, FIN"r' Oi",I-SITE :BE[,IF::IGE E.',ISPO2¥tL ~;"r'"BTEt"I I21
:L¢.~E~ FE:.'ET FOR FI PRI',/FrTE I.,.IEL. L OFt ±5~ TO ;.?~i~tZ~ FEI,ET FI,::'.Oi't FI F'LIE:LIC I.,.IELL [:,EPENE:,IN(~i
LIPON TPIIE T'¢PE OF PUE:L.I'C 1.4ELL.
I','IINIf,IUH I)~2BTRFICE FF.:Oi'I. FI F'F.:I',,,'FITE ~,.IELL TO FI PRI',,,'FITE ':;E!.,JEI:4.: I...Ii'.,IE I'5 25 FEET FIt',Il)
TO FI COi"lf,'ll...li'qIT'.r' SE!.4ER LINE IS 75 FEET.
I.,.IELL LOG2; FIRE F.:ES!LII[;.:EE:, FII'.,IE:, I','11..IS1' BE RE:TURI'.,IEE:, TO TI.-IE DEPI::IRTI"/Et'.,IT [,JITHIN }21 E:,FI'¢S
L-IF THE 14ELL COHF'LETInI',I.
OTHER F,'EE;!LIIREI"IEI'qTS I'IFI'T' FIPPL"r'. SPEC:IFICFITIONS FIN[:' COI',ISTI:dJCT:i:ON E:'IR(iii'~::F:II'"IS FIRE
R","FI I LFIBL. E TO Z I",I'.:;I.JF.:E PRI.]F:'EF.: ]: I'.,ISTRL.LFrT I
F" E£ F:: 11 .-ii I T E: ?4 F" ]: li:R EE :5 [::. F:i E: E If'.1 E'-' E: IF:-.: 3:5 ..... :1t_ :;, :E: ]i:
I CERT I I::'"r' 'T'HFrr
±: I FIt'1 F:FII,IILIFIR I.,IITPI THE F, EI;.,IJIREHEIqTS FOR Oi'-,I--.SITE SENEI.E; RIq[::, I,.IFI..L$ RS SET
F'ORTH E:'.r' THE I"11.J1'41 C I F'FIL. I T'¢ OF FII"4CHORFIGE.
2: I FIILL. ]:I'..ISl"FtLL. 'FHE 2-5'./:~;TEI',I ]:iq FICI,i:ORE:,FtI'.,ICE !.,.IITH TI,-IE I.:.':O[:,ES.
]:: I UNI,::,ERSTFIN[.':, TFIFIT THIE ON--SITE SB4ER 6'.r'STEI'"I l,"lR"r' RES!I'..IIRE Ei",ILFII;.:GEi"IEI",IT IF THE
,q:ESIC'EN(;:E I~.-', I,;;:Ei"lOD, EI_.EC, TO INCLUr.:,E HORE THFII',I 2: BE[:,F..'OOI.,I:L
:~; I GI'-,tEI):
'¢4.
Permit
M'INICIPALITY OF ANCHORAGE
Department o tealth and Environmental '
Applicant:
Location:
Legal Description: ~7 ~ /
Type of Soil Absorption System Is:
Trench: L~~ Drainfield:
Maximum Number of Bedrooms: 3
)tection
825 L Street, Anchorage, AK. 99~01
264-4720
* * * HANDWRITTEN PERMIT * * *
WELL AND/OR ON-SITE SEWER PERMIT
~/~~ Mailing Address:
Phone Number:
,ot Size:
Seepage Bed: I Holding Tank:
Soil Rating (sq.ft/br)
The Required Size of the Soil Absorption System Is:
DEPTH ~ LENGTH ._~_ O' GRAVEL DEPTH ~3~ 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 = /OOo GALLONS * *
Permit applicant has the responsibility to inform this department during the
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 31, 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 system in accordance with codes.
(3) I understand that the on-site sewer system may require enlargement if
the residence is remodeled to include more that 3 bedrooms.
Signe~, ~ Issued by, ']~--I/A~~
Ap5
Date: ?~ /</L- ~>
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
SOILS LOG
[] PERCOLATION
TEST
PERFORMED FOR:
LEGAL DESCRIPTION:
2
3
7
SLOPE
10
11
12
13
14
15
16
17
18
19-
2O
COMMENTS
WAS GROUND WATER
ENCOUNTERED?
I'-t12~L'~IF YES, AT WHAT DEPTH?
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE //~ (minutes/inch)
TEST RUN BETWEEN FT AND FT
DATE:
72-008 (6/79)
rm
0
0 0 0 0 0 0 0 0 0 0 0
g 0 0 0 0 0 0 0 0 0 0 ~ ~0
APPLI~
· . )
Propelb' Owner
Buyer
fiT RLLS OUT UPPER HAl ONLY
Zip Code
Address Zip Code
Phone
'-..', :., -:
Lending Institution
Address
Realty Co. & Agent
Address
Zip Code
Zip Code
Phone
Phone
Legal Description
Street Locati~
Type of Residence
S
inCe Family
Multiple Family
[] Other
Water Supply
t~' Individual
L~ Community
[] Public Utility
No. of Bedrooms
/ ATTACH WELL LOG, A well log is required for ail wells drilled since June 1975.
For wells drilled prior to that date, give well depth (attach log if available).
Sewer Disposal [~ Individual
[] Public Utility
~ Holding Tank
Year Individual Installed: ~
When Connected to Public Utility:
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
Time Time Time Time/'/, ~'~'/~LJ ~//'~--~.~
Inspector Inspector Inspector inspector
~ C.o. .~
'CONDITIONS OF APPROVAL
( )DISAPPROVED
( ) CONDITIONAL APPROVAL'
BY: __? ~
Soils Rating
72.023
Date Sewer Installed
Well To Absorption Area
Well 10 Tank
Well Log Received
Septic Tank Size