HomeMy WebLinkAboutSLEEPY HOLLOW #2 BLK 1 LT 15L.O
15
F'ERM S T NO.
C, EF'RRTI'IENT Of IItERLTH I-'IND ENVIITONMENTRI_ F'ROTECTION
825 "L" :STREET, FIi",ICHORFIGE, I=~I-(.
264-4720
( 8~:0544 )
FIP F'L. I CI::IN T
LOCI:IT t ON
L..EGRI ....
J'OHN GF,:OS:~ PO
L±5 B::L SLEIEPY HOLLOII4 ~::L :"; ;;
BOX :L±6:t,. ERGLIE RIVER' 99577
I_OT SSZE 999999
SQURI:~tE FEET
TYF'E OF SOIL.. RBSCiRPTION SYS]"EId IS: TRENCH
MFI::.:iIMUM NUHBER OF' BEDR001,1S = 7..':
SOS[. RFIT tNG
THE REQUIRED :SIZE OF THE SOIL RB'-:;ORF"FION SYSTEM I:E;:
THE LENEiTH E:,II'"IENSTI31",I IS THE LEI",!GTH (IN F'EET) OF THE TRENCI'4 OF,' DRRZNFIELE:,.
THE DEPTH OF R TREI",ICt4 OR F'ZT :('-2:; THE': E:'ISTRNCE BETI.qEEN THE SLIRFRCE OF THE
CiROUND F:INB, THE BE)TTOI"I OF:' THE E,w, CFI"/FITZON (IN FEE:T).
THERE IS NO :"--',El' 14I[:'TH FOR Tt~:EI",ICHES.
THE Gi:;.:FI',,,'EI_ DEF'TH SS THE i',iIl'.,lIMUtd DEPI'F.I OF: GRR',,,'EL BET!,.IEEN THE OUTF'RLL F'IF'E
RN[.':, THE BOTTOM OF THE EXCR',,,'FITZON (IN FEET::,.
PERHIT I.'iF'PI.~IC:RNT HRS THE: F..'ESPCINLSIBILITY TO INFORM THIS DEPFIRTMENT DURING THE
]:i'4STFILLFIT]:ON TNSPEC:]"SONS OF FtNY P~ELLS FID..'rFICENT TO II-.lIS F'RCIF'ERTY FIN[:, THE
I'.,IUMBER OF RESIDENCES; TI-IRT THE 14ELL II4SLL SERVE.
BFICKFILLING OF FINY SYSTEM II4ITHOUT FSNFtL IN'-Z, PECTIOI'.,I RND FIF'PROVRL E',Y THIS
[:,EF'FIRTMENT 1.4ILL BE SUBJIECT TO PROSECLITION.
HINII'dLIM C, ISTIRNCE BETI.4EEN R I.,IEI...L RN[:, RN"r' ON-SII'E SE!.,.IRGE DISPOSRI_. SYSTEM
::L00 FEET FO,R R PRIVRTE NELL OR :L50 TO 200 FEET FROM R PUBLIC: I,.IEL. L DEF'EI",II}II"~G
UF'ON THIE TYPE OF PUBLIC WELL.
IflII",IIMUM [:,IE;TRNCE FROM R F'RSVRI'E 14ELL TO I-] F'RIVRTE SEWER LSNE IS 25 FEET RI",ID
TO FI COMMLIi'.,tITY SEWER LINE I':-'; 75 FEET.
OTHER RIELT. IUIREMENTS MFIY I::IF'F'LV. :.:..;F'EI_-:IFICR"FIC~NS RI'.,ID COI'4S'FI:~:UC:TIFIN DIRGRFIMS RF.:EE
R',,,'RSI_.FIBLE TEl Ii'.,IE;URE F'ROF'ER INSTRIr__LHFITSON.
I C:ERTIFY THRT
:1..: I I':lt'l FRI'IILIRR I,.IITH THE F,'.EII..'.!UIREMENTS FOR ON-SITE SEWERS I::11",1[.~ 14ELLS RS SET
FORTFi E:Y THE MUNICIPFILITY OF FIi",ICHORFIGE.
;;2: I WILL SNSTRLL THE SYSTEM IN FIICCOR[:,FIIqCE klITH THE C0[:,E$.
].":: I UNC, Et'4'.E;]"FIN[) THFIT 'rile ON-SSTE SEI.,.IER SYSTEM I,tFIY F,'EIZIIUIRE ENLFII:~:'.GEMENT iF' THIE
RES I [:,ENCE_ I
-'F.'L I CANT JOb '4" GR.L]L:;:.:~ / (.t~ .
] ...... I .... E, %- "/ ..... '~ ~ x/' ", "
..-..::_
/
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchora~]e, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
SOILS LOG
[] PERCOLATION
TEST
PERFORMED FOR:
LEGAL DESCRIPTION:
2
3
5
6
7
8
9
SLOPE SITE PLAN
10
11
13-
14-
15-
16
17
18-
19
20
GROUND WATER ~
UNTERED? /%,/~9
O
P
E
IF YES, AT WHAT
DEPTH?
Gross Net Depth to I Net
Reading Date Time Time Water Drop
PERCOLATION RATE
(minutes/inch)
TEST RUN BETWEEN FT AND ~ FT
PERFORMED B /,/7. , CERTIFIED ~U.~ATE:_ &' - /7 '~ ;$
72-008 {6/79)
DOC Co, dba
WA TEI WtgLL 3
P.O. 6OX272, CHUGIAK, ALASKA 99567 ~ TELEPI4ONE688-2759
OWNER OF LAND \/0
ADDRESS ~_fl D ,6' CLtS~ / / (9 / 15~ .
LEGAL DESCRIPTION
DATE-Started ~5/.? / Ended
PERMIT NUMBER
DEl'TH OF WELL .__~¢'~3 <3'_ ~:
/'~ · ___ STATIC LEVEL OF WATER FT. ._J ,ff .~
.~ ~.,::~. ,~ z ['/~&d-~DRAW DOWN FT, _~O /
~- ~/F' / GALS. PER HR
';7
KIN1) OF CASING ~ ~P
KIND OF FORMATION:
From () _Ft. to
From d2__Ft, to
From ')'~' Ft. to~4
From *<td'__Ft. to ,'~ 3 __Ft,
From ~'-.? Ft. to~'.'~ Ft.
From ~O~' Ft. to. dJ'~ff'~ Ft._
From
From
From Ft. to_ Ft. ~-
Fro,n "f~~'~ Ft. to I.~o? Ft._ ,J""tV-oO .~'
From / .~'.~ Ft. to_/'7 '9_Ft~
From Ft. to Ft. C~ rV~ F /~q t g'4z~ From
Frmn/7o Ft. to /~":J Ft,~~o ~ ~ From
Ft. to_ _Ft.
Ft. to Ft. c~/ F&~ From.
From Ft. to Ft
From Fi, to
From ...... Ft. to Ft.
From Ft to Ft
From Ft. to ....... Ft
From Ft. to Ft,
Erom Ft. to Ft.
From Ft. to ...... Ft.
From Ft. to
Ft. to
Ft. to
Ft. to Ft,
Ft. to
From Ft, to Ft. From_
Ft. to
From Ft, to Ft. From
__Ft .....
Ft ......
Ft
From Ft. to__Ft. From____
From Ft. to.___Ft. From
_Ft ....
Ft
Ft. to Irt.
.Ft to Ft.
Ft. to Ft.
MISCL. INFORMATION:
PERMIT NO.
DEPRRTMENT 13F: HERLTH FIN[) Ei'.I.'v'IF4:ONHENTFIL
825" %TREET, RNCHORRGE, RI-::;. ~'2- J..
264-4720
0 JJ~J 4 J.. J.. )
f:IF:'F'LICFII",IT JOHN L GR. 05S F'O BO~':',
L. OCFFF ~] 01"i.EFIGLE R I 'v'ER
I...EGFII .... I_ t5 B ::L SLEEF"T' HOLLOI-4 2.';?D LOT SIZE 50000 SQURRE FEET
HINIHLJM DIS]"RNCE 8E"I"I.,tEEi"I. FI HELL RI',ID FIN¥ ON-'.:.';ITE SEklFIGE DISPCISFIL '.Sh.'S-rEM IS
::LO0 [ZEE]' FOR FI PRI'v'R]"E HELL OR J.!50 TO 2100 FEET FROH R F'UE,'LIC HEL. L [:,EPEi'-I.DING
UF'ON THE.' Th.'PE OF' F'UBLIC HELL.
MINIMUH DIS. TRNCE FROH FI PR]:VFITE t4ELL.. TO Fi PRIVRTE SEIqER LINE IS; 2!.";i FEET f::lN[:,
TO R COMHUi'.I.IT'¢ SEI.qER LINE IS 75 FEET.
P.~ELL LOG:r:; FIRE REOUIRED RN[:, MUST BE RETUf~:NED TO THE D[EPRR]"MENT 1.4ITHIN ]'.0 DFI'¢S
OF THE HELL. COHPLETIOi'4.
OTI'IER RE."E!LIIREHENTS MFI'¢ RPPL.'¢, SF'ECIFICRTIONS RND CONSTRUCTION [:,IRGRf:IiVlS; FIRE
RVRILFIDL~E TO INSURE PROPER INS'T'RLL.RTION.
I C:ER'FIF:Y ]"HRT
J..: I FIM FF:IMILIRR IdiTH TIqE REQtJIREf'IENTS; FOR OI",I-SITE SIE!-,IEF?.S IqNE:' 1.4EL. I_S FIS S';ET
FORTH BY :'FIE MUNICIPRLIT'T' OF Ri"I.CHORRGE.
2: I HILL INS'f'FILL THE S'RS"f'E:i'd IN RCCORE:'RNC:E klITH THE CODES;.
S I GNED:
FtPPLICFINT ..)'OHN L GROSS
'v'4. 0
Applicant:
Location:
Legal Description: C l ~ . ~/
Type of Soil Absorption System Is:
Trench: Drainfield:
Maximum Number of Bedrooms: --~
~UNICIPALITY OF ANCHORAGE
Department v~ Health and Environmental .,rotection
825 L Street, Anchorage, AK. 99501
264-4720
* * * HANDWRITTEN PERMIT
~,,~L/~_~WELL AIN~~'PERMIT
/ C~-~C~ Mailing Address:
~C~'/~'~__ Phone Number:
The Required
Seepage Bed: __ Holding Tank:
soil Rating(sq.ft/br)
Size of the Soil Absorption System Is:
GRAVE[. DEPTH WIDTH
DEPTH LENGTH ,.
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 SIZETM 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 1 9 1 * * *
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 inst~ll the system in accordance with codes.
(3) I understand that the on-site sewer system may require enlargement if
the residencies, is remodeled to
~licant
include more
Issued by:
Date:
that 3 be~
SWP/024(1/81)