HomeMy WebLinkAboutSKYWAY PARK ESTATES BLK 8 LT 14Skyway Park
Estates
Block 8
Lot 14
#019-102-11
ANCHORAGE, ALASKA
344-7714
SIX INCH WATER WELL DRILLED--.. ..OUT TO THE DEPTH OF 58 Tett.
DRILLED AT THE RATE OF 224.00 PER FOOT.
345-3468 &oIk o4dezed b Satan..P� Vac 344-5214 Steve S evon
PROPERTY OWNER V'
LOCATION OF WELL SITE Et.. 14 B.Lk. 8 Suh. Skgww/. Pack Cotate4
DRILLER Beiui,cz. G1auo Rampart DLitt/n.7 Wo4ko.
WELL LOG:
0--..-18' Ha.t4pan. R cemented paueL with 4eve rcL 4ma,LL bau,Ldeu.
18---52' A 4V2g gxcuueL. 40% c cuj. Uncle -4.
52---58' Watet beani:tg 4424. 4andg gvwe.L going tato a. good coa44e, and clean
watez bearing gtaue.L. Ontg 25 .fit. wa.tet 4-tandvtg o4 bottom, however, .th,ii
WeLL .Lo peadacutg. eight VM good qua.LLty. wate't.
Stet/. ca4.ing aLL the wag. down. 1/2 Hove Suhmelroiil,Le Puncp 4hou.Ld be placed
�i ve
,ft o. bottom.
Tmtn.L ca.<t o-' D.LLUdnq.: 524.00 peh /2 X 58 let: 81392.00
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
DEC 2 01985
RECEIVE[)
COST INCLUDES ALL. LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING.
WRITE CHECK PAYABLE: TO RAMPART DRILLING WORKS FOR THE SUM OF 51392.00
THANK YOU VERY MUCH.
BERNIE CLAUS OF RAMPART DRILLING WORKS
DATE Rugu4-t 6M, 1985
SERVICE CHARGEOF' P/2% PER MONTH WILL SE ASSESS D O Perk DUEACCOUNT .
P'i N_.1i u' ji :1I: tws :.N:; IF r'=!'V 1_ 1: 1- ""e Dr. Er'A lrhg d:.::: E11Ir1:U N=a: h p
DEPARTMENT T C HEALTH AND ENVIRONMENTAL )T E [.YF 1IJN
F325i L. STREET, ANCHORAGE, AK 991501
264-4720
E3::1rE.n: VI lF E F,2I iA:-1I._
P'ERMI'T' NO: 050327
DATE ISSUED: 06/19/1:35
•ARPLIGAI\I'1". SOLAR PLUS, INC.
ADDRESS: I.J.:+? EAST 77411 AVESUITE 2101
ANCHORAGE, ARC 9950
• CONTAC)1 PHONE: 3.q4--5.14.
LEGAL DESCRIP: SUDDIVISICIN: SKYWAY PARK ESTATES LOT: 14
SECT:(ON. 25 TOWNSHIP12N RANGE: 4W
LOT SIZE.: 1,39A (W.P'T. OR ACRES)
BLOCK: Gh
I certify that:
1. I -earn familiar with'the requirements f'Crr nn-sit'..e sewers and wells as set
forth by the Municipality of Anchorage (MOA) and the State cif Alaska.
I will install the system in accordance with all HOA codes and regulations,
and in compliance with the design criteria of this permit,
3. I will adhere to all MOA and State of Alaska requirement , for the set..bac k
distances from any existing well, wastewater disposal system or public
sewerage system on this or any ad.JaC exit. or nearby lot.
SIGNED
APP'I._ICAI'IT^ SOLAR "US, INC
ISSUED DY
k -151
MUNICIPALITY OF ANCHORAGE
WATER & WASTEWATER UTILITY
3000 ARCTIC BOULEVARD
PHONE 786-5540
LOT/TRACT I {
SUBDIVISION
SEWER 85 Oi46
CONNECTPERMIT 4c.,Uzy
'-/6' &g 4-I,CQ •',y1/
DATE OF APPLICATION 1.1.
. " I 1 -- .6
�
SCHEDULED COMPLETION DATE + ` 1 /
y_SINGLE FAMILY
G MULTI -DWELLING
No. APTS
C COMMERCIAL
BLOCK r INDUSTRIAL
TAX CODE `t'
BUILDING ADDRESS
OWNER — L
It 1 r
r`
GRID .) t ^ DRAWING No
11) r
\_ 1 �. N t- PHONE 3/(1
MAIL ADDRESS -J (}
CONTRACTOR• s.-' Q
(License & Bond required)
ISDN PROPERTY ONLY
0 MAIN TAP—TO PROPERTY LINE ONLY
(MOA or State ROW Permit Required)
S1 MAIN TAP & ON PROPERTY CONNECT
`(MOA or State ROW Permit Required)
ASSESSMENTS
O Paid previously
❑ Main extension agreement
O Subdivision agreement
❑ Extended connect agreement
O Pending—AMOUNTS
CONNECTION SIZE L` CHARGE$
INSPECTION FEE $
PERMIT FEE $
REIMBURSIBLE
NUMBER DEPOSIT$
TOTAL $
PERMIT ',SUED BY: ,
AID C CASH
CK#j i'7
IN ECT D
DATE:
REMARKS:
PERMITTEE (Please Print/
MAIL ADDRESS
PHONE
I HAVE READ THE CONDITIONS AND REGULATIONS ON THE REVERSE SIDE OF THIS PERMIT AND AGREE
TO COMPLY WITH THEM.
•
..% .
PERMITTEE SIGNATUFIE
BPOST IN A CONSPICUOUS PLACE AT THE JOB SITE
AWWU INSPECTOR
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ALASKA ENVIRON' -'NTAL
CONTROL SERVICL.,, INC.
1200 West 33rd Avenue, Suite B
ANCHORAGE, ALASKA 99503
(907) 561-5040
DB /-o7 /'-/ 06/-0 Cie 8 5,ryAJ,9y Wr 4&r
SHEET N0. OF q (�
CALCULATED BY /IQ /F ' Medi DATE 74-e
CHECKED BY 3 DATE
SCALE / ;30
0
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
yja(Q� nolo^' L
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING 1 614-3-
�
HAA # D4 bLR —
Expiration Date: 1 f— 3 0- 0
Parcel I.D. 019-102-11
1. GENERAL INFORMATION
Complete legal description Skyway Park Estates, Blk 8, Lot 14
Location (site address or directions) 1640 Shore Drive, Anchorage
Current Property owner(s) Johnie & Sandra Jones
Mailing address 1640 Shore Dr. Anchorage, AK 99515
Lending agency
Mailing address
Day phone 349-1770
Day phone
Real Estate Agent Kris Abegg (for buyer) Day phone 349-1200
Mailing Address
3111 C Street, Suite 555, Anchorage, AK 99503
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class Well
Public Water System
TYPE OF WASTEWATER DISPOSAL:
Individual On-site 0
❑ Individual Holding tank ❑
O Community On-site ❑
❑ Public Sewer
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are
valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with
new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.)
Certificates are valid for one year for properties served by Class A or B wells or a public water system. The
Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the
on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of
bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the
Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances,
and regulations in effect at the time of installation.
Name of Firm
Watkins Engineering, Inc.
Address P.O. Box 110443, Anchorage, AK 99511-0443
Engineer's Printed Name Cindy W. Ellis
Phone 349-1851
Date F11'6*
1'6*
5. DSD SIGNATURE t'• Cind f W. Ellis ;f
✓ Approved for 3 bedrooms. . CE -10577 ::*Gi
Disapproved. ossioru\�c 91
Conditional approval for bedrooms, with the following stip
Additional Comments
\�\Lt��'(Y OF" a=: ON-SITE • • 1-0:
d WATER -AND-- m
•
WASTEWATER
PROGHHAM •
•
o,919FN)])))»»))\` ,SEN\\,.\\\
Attachments:
HAA Checklist X Maintenance Agreements
Septic System Advisory Supplemental Engineer's Report
Well Flow Advisory Other
(Rev.01/02)
Original Certificate Date: L7 ` 3 / - 7
unicipa ity of Anchorage
Devetopment'Servrces Department
Building Safety Division
On Site Water & CNasfewa'ter Program
terTairITSvint
•. ' ox gwXCncho ge AK 39519 tSB'0
��'yH,E5ALTH
scrp ion' S Mk(
Parte ID
✓e pe
aeComp e9
ofa .ep '8
8 or provide
Sanitary sea
Cased
tE
wires proper y pro ec e.
slireareor
Casing height (above ground
a e -o test
S a Ic water eve
UctIOn
o Irgrmco onies
er accena 0 coloniesil'Ob mI:
Arsenic ♦. mg /I.
EP
an k yp rswienal r'
tan size g'^z„ a u
unatfon "clean
artments
epressron over tank (Y[N)
ae o .pumping
Da a rn aIle
Lengt
o.a _yep
umper
lS7P.3".`A w-iaa, s "a K':.""..• a<':3,: e>1'sd"m'^�'..Yrn�s'. Lr f9's,1 ,., ::.r?:c?:
of rating (g.p../ftor ft2/bdrm) System type
ft. Gravel below`pipe` ft
ft' Monitoring tube _ _ Depression over field
Far : - bedrooms
a er aided New depth_ in.
A•sorphon rate >_ g'.p.d.
rare
_absorptio
aeo a•equacy es Results('
ul. •ep in'a.sorption field •efore est in
•%tea " ���"+��' ,, ,�av� a a``�'
apse• ime: min.. mal uid •ep
ny re uvenation freafinen past 2 Mei) M & type
yes, give ate
Date ins
Pump on level at
Sizein gallons ` Manhole/Access (Y/N)'
Pump o' e - High water alarm level at
• �'' ` "- Cycles tested Meets alarm & circuit requiremen
SEPARATION DISTANCES ` i
�+r�'.:a'%,u ,^-n. 4"�km6F Wi;?
SEPARATION DISTANCES FROM WELL` ON LOT TO:
rit lif lof NA
Septic fanWllfCstation on lo#
On adjacent lots NA
Absorption field on lot NA On adjacent lots NA...
Public manhole/
cleanout 100+
"Holding tank
Public sewer main 100+
Sewer /septic service line
SEPARATIO
DISTANCES PROM SEPTIC/HOLDING TANK ON LOT TO:
Building fo on `"Property line Absorption field
Surface,water
Water main Water service line , .,... ...,,..,
Wells on adjacent lots
SEPARATION "DISTAIJCCE FROM ABSORPTION FIELD
Property line NA
Wa{er Service, me
Curtain drain
} h
F. C'OMMENTSx
Building foundation Water m
Surface water
Dnveway parking/vehicles
Welfs oh adjacent lots
ENGINE R'8 CERTIFICATION
ds
I certify (hat 1 have determined through field inspections and
review of Municipal records that the above systems are in
corfo'rmance with MOA HAA guidelines in effect on ti,s date.
rntedName Cindy W. this
17-04
Date of Payment
Waiver Fee $
Date of Payment
Receipt Number
r
m`
0
CC
6
3
O
0
U
08-27-04 08:34AM FROM-CT&E ESI, SGS ENV SERVICES 9075615301 T-848 P.02/03 F-362
SG$
SGS Ref.#
Client Name
Project Name/N
Client Sample ID
Matrix
PWSID
1045314001
Watkins Engineering
Skyway Park Est. Blk 8, Lot 14
Skyway Park Est. Blk 8, Lot 14
Drinking Water
0
All Dates/Times are Alaska Standard Time
Printed Date/Time 08/24/2004 6:56
Collected Date/Time 08/19/2004 14:00
Received Date Time 08/19/2004 14:34
Technical Director Stephen. Ede
Released Bly
�/�
Sample Remarks:
Parameter
Results
PQL
Units Method
Waters Department
Nitrate -N
Microbiology Laboratory
Total Coliform
2.29
0
0.100
mg/L EPA 300.0
Container ID Allowable Prep Analysis
Limits Date Date bit
B (<=10) 08/20/04 Al
co1/100mL SM209222B A (<t1) 08/19/04 DIC
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date / -e-er
1. GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, range)
,r -.o'/" /'f 01:06e e jm'6vss/
Location (address or directions)
/W0 5/kieg
(b) Applicant Name,0442/-L'.L___L/L Ale• Telephone: Home 1 Business 31/3/4 52-15/Applicant Address //f if 7Y d �O/ /�� /�c. 97... at
(c) Applicant is (check one): Lending Institution 0 ; Owner/builder)&(; Buyer 0 ; Other 0 (explain)•
(d) Lending Institution
Address
(e) Real Estate Company and Agent
Address
Telephone
Telephone
(f) Mail the HAA to the following address:
CC( \\ \.ti LSV fl K)ecko).7
2. TYPE OF RESIDENCE
Single-Family70 Multi -Family 0 Other
Number of Bedrooms -�
3. WATER SUPPLY
Individual Well Community 0 Public 0
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
Onsite ❑ PublicX Community 0 Holding Tank 0
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page 1 of 2
72-025 (11(04)
5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DA IA AND INFORMATION
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health
Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained
from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal systern is in compliance with all Municipal and State codes, ordinances, and regulations in effect on
the date of this inspection. / ,.-
Name of Firm At tedee..1N/[wive. � hne. f Telephone ` 71 `0
Address/Z"tIJ G/ )3'-`�7rve 1"u FT" f 446/.. /1A: 77S
Date
6. DHEP APPROV L =i
,7 q �c.5 � / ..
Approved for 1#14.- ,_4 _ bedrooms by Y\ I�Zt( /y.-64---t-c--C..1-e_6 6te /c;`?7 'c C.,`� . -----
Approved 7..— Disapproved s/ _ _ Conditional �'-
Terms of Conditional Approval
CAUTION
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional
engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or
analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the
professional engineer's work.
Page 2 of 2
72-025 (11/Od)
A. WELL DATA
Well Classification
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
0:1A13)3 JHECKLIST - FEBRUARY 1984
264-4720
Legal Description: i_0,7'/ &OC(/ V
5x447-5' _71.9),,0 X377 S
98610 g 330
N01103108d 1V1N3WNOLIIAN3
'8 H11V3H dO '1d3C1
aevtioproNv 40 A.LI1Yd101Nf110tf
??/i/6- If A, B, C, E C. Approved (Y/N)
Well Log Presen (Y N) Date Completed 6 6'5- Yield
Total Depth Si/ Cased to sa-' Depth of Grouting ______I
Static Water Level Pump Set At
Casing Height Above Ground /' 8- i Sanitary Seal on Casing &N)
Electrical Wiring in Conduit &N) Depression Around Wellhead (Y
Separation Distances from Well: �/
To Septic/Holding Tank on Lot N/� On Adjoining Lots
To Nearest Edge of Absorption Field on Lot—�0/—; On Adjoining Lots
To Nearest Public Sewer Line /% To Nearest Public Sewer
Cleanout/Manhole jai -/- To Nearest Sewer Service Line on Lot
-39.S
Water Sample Collected by de5 14' W/6�/ ; Date /t-1-4--C-
Water
-
Water Sample Test Results 5 if%- °T4�l
Comments 7abeie -s____6,4:.'
B. SEPTIC/HOLDING TANK DATA �//I A �7WDuc seta
Date ailed Size - No of Compartments
Standpipes ( Air -tight Caps (Y/N) Foundation Cleanout (Y/N)
Depression over Tank ( Date Last Pumped
Pumping/Maintenance Contract o ile (Y/N) ; for
Holding Tank High -Water Alarm (Y/N! Temporary Holding Tank Permit (Y/N)
Separation Distances from Septic/Holding Tank:>"----„,„
To�u'ding Foundation
To Water -Supply Well
To Property Line To Disposal F7ela
To Water Main/Service Line ToStre na,,Pond, Lake, or Major Drainage
Comments
Course
Page 1 of 2
72-026(11/84)
Ly� B S� 5K�✓ / let' ear.
C. ABSORPTION FIELD DATA
Sol sating in Absorption Strata
Date Instal
Width of Field
Square Feet of Absorption Area
Depression over Field (Y/N)
- $,Pad felt -kg
Type of System Design
Length of Field
Depth of Field
Gravel Bed Thickness
Standpipes Present (Y/N)
Date of Last Adequacy Test
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water -Supply Well . Property Line
To Building Foundation To Existing or Abandoned System on
Lot ; On Adjoining Lots
To Water Main/Service Line To Cutbank (if prese
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments
D. LIFT STATION
Date Ins
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
ing Cycles during Adequacy Test. Meets MOA
Electrical Codes (Y/N)
Comments ��-
** Check Permitted Bedroom Rating Against HAA Request ..
1 certify that I err) verified,
Signed I�—
Company ,+gC5
Receipt No
Date of Payment
Amount: $
Page 2 of 2
72-026 (11/84)
l a--(`6-gS ch
1/40-0
or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
d�
Date /2'7
"-4
MOA No 85-:°4--r
stAstp. voe.Nol: a0°. r
800 *4� Engineer's Seal
C. Reid, Jr. t
, 2251E �c a"