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Home My WebLink AboutNORTON PARK #2 BLK 4 LT 8 Rick Mystrom. Mayor Mtmi.cipality of :knchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 December 28, 1995 David L & Tressa J Bryson PO Box 111996 Anchorage, Alaska 99511 1996 Subject: Lot 8 Block 4 Norton Park Subdivision #2 Permit ~SW940431, PID ~016-211-56 The subject permit, issued November 14, 1994 by this office for a single family well and/or on-site wastewater system, has expired as of Now~mber 14, 199!5. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. If you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If a licensed Professional Engineer has inspected the installation of the on-site wastewater system, the original as-built inspection report must be sent to this office for review, approval and documentation. Ail inspection reports must be submitted within 30 days of construction completion. When applying for a new permit, the fees are: $320.00 for an on-site wastewater permit; $120.00 for a well permit and $440.00 for a combined on-site wastewater and well permit. If you have any questions, please call this office at 343-4744. On-site Services enc: Copy of Permit PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW940431 DESIGN ENGINEER:DUMMY COMPANY OWNER NAME:BRYSON DAVID L & TRESSA J OWNER ADDRESS:P.O. BOX 111966 ANCHORAGE, AK DATE ISSUED:il/14/94 EXPIRATION DATE:il/14/95 PARCEL ID:01621156 LEGAL DESCRIPTION: NORTON PARK #2 BLK 4 LT 8 LOT SIZE: 10890 (SQ. FT.) N73M~ER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AACS0). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 (24 HOURS) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: THF. EXISTING WELL ON THIS PROPERTY SHALL BE PROPERLY ABANDONED, AND VERIFYING DOCUMENTATION SHALL BE SUBMITTED TO THIS OFFICE. RECEIVED BY: ISSUED BY: DATE: DATE: I I 38.~. .V /5 I hereby certify thor t have ~rveyed the foik~e~ng d~tibed property, Lot e~ ~ ~ prem~ In qu~ ~d ~al ~ete ore ~ r~ ~an~n P~£m,art~:/~o 3 D£c. 1~79 LOCATION OF WELL BOROUGH STATE OF ALASKA DEPARTMENT OF NATURAL RESOURCES DIVISION' OF MINING & WATER MGMT WATER WELL RECORD SECTION QTRS SECTION TOWNSHIP []N []S RANGE []E []W MERIDIAN LOCATION/SKETCH: WELL OWNER: DEPTHS MEASURED FROM:l~;asing top []-]ground surface BORFHOLE DATA Material Type and Color Depth From To / / RECEIVE Oept, Health & Htjrfl~n St rvices WELL DEPTH: Death of hole: & / D~Pth of ?asigg: 6 / - /' ~'ATE OF COMPLETION ft DEPTH TO STATIC WATER LEVEL: ~ ~,~ ft below ,~. top of casing Date: .// / ~- ~;/ / ~'/ [] ground surface METHOD OF DRILLING: '7~] air rotary [] cable tool [] other USE OF WELL: ;~ domestic [] irrigation [] monitor [] public supply [] other CASING STICK-UP: ~-- ft. Diam: ~ in. to ~ / ft Casing type: .~--. /%,'" in. to ,~/ft WELL INTAKE OPENING TYPF:.~;~.~open end [] screened [] perforated [] open hole Depths of openings: __ to ft SCREEN TYPE: Diam: in. Slot/Mesh Size: Length: ft GRAVEL PACK TypE: Volume used: Depth to top: GROUT TYPE: Volume: Depth: from ftto ft DEVELOPMENT METHOD: Duration: / PUMPING LEVEL AND YIELD: ¢ /~ ft after / hrs pumping /~.- gpm PUMP INTAKE DEPTH: ft Horsepower: WELL DISINFECTED UPON COMPLETION? E~YES [] NO CONTRACTOR INFORMATION: Registered Business Name . ~ // Signature of Authorized Respr~entative 6ate REMARKS: PLEASE MAIL WHITE COPY OF LOG TO: DNR/DIVISION OF MINING & WATER MGMT PO BOX 107005 ANCHORAGE AK 99510-7005 8 O.H ~Zi~C)~ RECEIVED AUG 1 6 1996 Municipality of Anchorage Dept. Health & Human Services oc~ o~ GREATEt'~ ',NCHORAGE AREA ~ t ~EALTH DEPARTMENT fl] 13a7 Eagle St.Anchorage, Alaska 99501 279-2511 :,_SEWAGE DISPOSAL SYSTE~ - APPLICATION NAME OF MAILING RESIDENCE ADDRESS .L, OCATION OF INSTALLATION ,/~> APPUOA no. TO ~.STaLL: ~ ~k~ . S~~aA,. F~ELO . OTHEa TO SERVE THE FOLLOWING FACILITY FINANCED THROUGH TO BE INSTALLED BY PERCOLATION TEST RESULTS ,'~':/ ,'~--'~ ~- ANTICIPATED DATE OF COMPLETION BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT. THIS IS TO SERVE AS :I:' ~;&~ , PERMIT TO INSTALL A DIST~ / C. F/ HEALTH AUTHORITY Or LICENSED DESIGNER I certify that I alii familial' with tile l'equirelllelats of Greater Allctl,ol'age Are~ Bqrotlgh Ol'dillallCe No. 28-68 and that the ab°vedescl'lbed systen] lslnacc°rdancewlthsald c°de',z~~-7)] d}[~ DATE ~/::/:'/:K APPLICANT SIGNATURE !7 / - ' ' ' ':~ : ..... r T'"~-'~'~me Time Date Inspector Date Inspector / Date Inspector Comments Cc Date Sewer Installed Permit No. Septic Tank Size Holding Tank Size Soils Rating Well To Absorption Area Well Log Received Well to Tank APPLICANT FILLS OUT LOWER HALF ONLY ¢~ : , . ' ¢,.. . ) - Street Location ¢[3 Type 9f Residence ~SingeFam y D Multiple Family No, of Bedrooms · [] Other Wate. gSupply ,t~ Individual [] Community [] Public Utility_ Sewage Dlsposal ~ Individual Public Utility I~ Holding~ Tank ATTACH WELL LOG, A well Icg ts required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach Icg if available._) Year Individual Installed: When Connected to Public NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATE[). and Mrs. Davi('t Fi. Reynolds ARchorage, AK 9950? ~':3ub~ect: Lot ft Nile ~, Norton Par1< Sub. Approval :fo}7 tl'}e individual ,qewer and wa'hot faci]it'~ies {lnnn¢)t be granted until t!~a :following items '))ave h,';e~ com~'~]eted: ,~ne top of tho well. casin,q sealed witl~ a :~anJ.'hary seal so that it i~ water tigh'h. water nllalysis report needs to loc .~lbmi. tqed to tbj...q O:~:FJ.c!~ f~?£)Wt thE.', Chem l,ab, 5633 B Shroai:, :Pot our review. Plea,qe notify 'L~Ilji~3 de)>arfiment for a reinspec, tion when the llo~ed discrepancies have been corrected. !f t3~ere are any ftlFtller questions, please cE~]_I 'this office a't 26d.-4'720. Sincerely, RP33/!'~/EH ]~,.o'bor-k C. Prat: h Associate gnv±ronmental Specialist CHEMICAL & G£ LOGICAL LABORATORIES ,... ALASKA, INC~ ' TELEPHONE (907)-279.4014 ANCHORAGE INDUSTRIAL CENTER 274-3364 5633 B Street Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER WATER SYSTEM: Water System Name I,D, NO, . :' , .f i: i,i ~ Phone No. Mailing Address ,, City State Zip Coda Mo. Day Year SAMPLE TYPE: [3 Routine rD Check Sample (for routine sample with lab ref. no. E'~ Spectal Purpose [] Treated Water [] Untreated Water SAMPLE NO. I I I I LOCATION Time Collected Collected By TO SE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: [] Satisfactory [] Unsatisfactory [] Sample too long in transit; sample should not be over 48 hours old at examination to indicate reliable results. Please send new sample, Date Received Time Received Analytical Method: [] Fermentation Tube [] Membrane Filter Lab Ref. No. Result* Analyst *No ofcoronies/10Oml or No o[ Positive porlions READ INSTRUCTIONS BEFORE COLLECTING SAMPLE 06-1220 (b) Rev. 1978 BACTERIOLOGICAL WATER ANALYSIS RECORD Date Collected Source Date Received Time Recelva(~ __ p,mo Lab. No. Presumptive 10mi 10mi 10mi ]0mi 10mi 1.Omi 0,1mi .,. 24 Hours 48 Hours Confirmatory 24 Hours 48 Hours EMB Multiple Tube Report: Membrane Filter= Direct Count Verification: LTB Final Membrane Filter Results Reported By roth 24 Ilour$~, Brotl~ 48 houri= 10mi Tubes Positive/Total 10mi Portions Collform/Z00ml Collform/lOOral DATER ECEIVED INSPECTION APPOINTMENTS TIME TIME TIME 0 0 , DATE~-~ L~2, L/4/~ I~ DATE , ~ MUNICIPALI~ OF ANCHORAGE Z' DEPT, OF HEALTH & ~UNICIPALITY OF ANCHORAQE ENVIRONMENTAL PROTECTION DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION OCT 1 ? 1979 ENVIRONMENTAL SANITATION DIVISION REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing, 1. P~PERTY OWNER ~ PHONE MAILING A~DR E~S BESID~T PHONE PROPER'rY (If different from above) 2. BUYER PHONE 3, LENDING INSTITUTION PHONE MAIL~G ADDRESS 4, REALTOR/AGENT PHONE MAILING ADD~ESS 5. LEGAL DESCRIPTION ;TREET LOCATION 6, TYPE OF RESIDENCE [~ SINGLE FAMILY [] MULTIPLE FAMILY [] One [] Four ~} Two [] Five [] Three I-~ Six [] Other 7. WATER SUPPLY INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY * ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975, For wells drilled prior to that date, give well depth (attach Icg if available.) 8. SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PFIOCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2, WATER SUPPLY [] INDIVI DUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified; LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] IN D IVI DUAL/ON -SIT E DATE INSTALLED []PUBLIC UTILITY Connection Verified ~'-Jl--""t (p INSTALLER F-ISeptic Tank or [] Holding Tank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS [~"~'APPROVED FOR '~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) ~] DISAPPROVED ~ DATE BY 72-010 (Rev. 6/79) o'S ~_ P.O. BOX 4-1276 4649 BUSINESS PARK BLVD. ANCHORAGE, ALASKA 99~09 · ~ . D~nking :Wa-tel Analysis Report for Total Coliform IlacteHa TO BE COMPLETED BY WATER SUPPLIER (~ , I.D. NO. Pul~llc Water ~'tem N~me ' ""T, ~ ' Mailing Addree~ ' n City State Zip Code Mo, Day Year SAMPLE TYPE: [] Routine %, [] Cheek Sample (~or routine sample with lab ref. no. [] Special Purpose [] Treated Water E} Untreated Water SAMPLE NO. LOCATION Time Collected Collected By TELEPHONE (907) 2794014 TO BE COMPLETED BY LABORATORY LABORATORY: NAME ADDRESS Date Received Time Received CITY _/o. Analytical Method: Fermentation Tube ~,~f Membrane Filter Lab Ref. No. Result* J I-q-J I J Analyst READINSTRUCTIONS BEFORE COLLECTING SAMPLE Form No, 18-310 (3-78) O6-1220 [b) Rev. 1978 BAC'rERIOLOGICAL WATER ANALYSIS RECORD Date Collected Source Date Received .Time Received p,rn, Lab, NO, ~resumptlve 1Omi 1Omi ~.Oml 1Omi 1Omi ].,Omi 0.1mi 24 Hours 48 Hours ' 3onflrmatory ~.' 48 Hours EMB Broth 24 hours= Multiple Tube Report: Membrane Filter: Direct Count Verification: LTB Final Membrane Fllter.~¢~[ts. 10mi Tubes Positive/Total 1Omi Portions BGB UNUPALITY OF ANCHORA C- .0E-11AILED o 0A Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section - Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 016-211-56 1. GENERAL INFORMATION Complete legal description Norton Park #2 B4 L8 Location (site address) 322 W 123RD Ave Expiration Date: _ q—Co 20W Current property owner(s) John Hagmeier homes LLC Day phone _, Mailing address 2204 Clevland Ave Anchorage., AK 99517 Real estate agent 2. TYPE OF DWELLING: [K] Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 5 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well F1 Private Septic U Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer [� Waiver request for: Distance: ;�;=Received by: Date:f9 a -v — COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 6-5 Waiver Fee $ Date of Payment %wy 20116 Date of Payment Receipt Number 0lfo� Receipt Number COSA # 05C 1 �'i j&()1q Waiver # 5. 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 Certificate of On -Site Systems 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. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Reliance on this report by another person is at their own risk. Pannone Engineering Services LLC highly recommends buyers hire their own engineer to evaluate this report. Name of Firm Pannone Engineering Services Address P.O. Box 1807 Palmer, AK 99645 Engineer's Printed Name Steven R. Pannone P.E. 6. DSD SIGNATURE Phone (907) 745-8200 Date OF AC A System #1 Approved for 5 •Steven . onnone bedroomsF2 ��•. System #2 Approved for CE 8149 bedrooms s . �l Disapproved Z�foi> ssiaN � �O�e�®so��`` -� Conditional approval for bedrooms, with the following stipulations: Sri �.AIATI--fid i`ip m WASiTEV'.ATER -i J , NUO ,' Awl 6�_ -, ,SN SEW 1i3)1J}�?1`-r B7. Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist . X Nitrate Advisory Septic System Advisory Arsenic Advisory_ Well Flow Advisory Other COSA Checklist blue sheet Legal Description: Norton Park #2 B4 L8 If more than 9 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 11121M Total depth 61 ft Cased to 61 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 24 in. Date of flow test for COSA 7/16/19 Static water level at beginning of test eft. Comments B. TANK DATA Age of tank(s) years Tank type/material Measured operating fluid level in septic tank ❑ Standpipes/foundation cleanout per record drawing Date of pumping D. ABSORPTION FIELD DATA Which system tested (date installed) ❑ ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 016 - Structure served by this system Well production at time of test 30 gpm Water storage tank volume n/a gallons Well disinfected for coliform test? ❑ Yes ❑✓ No FIC Coliform bacteria is Negative Nitrate •364 mg/L ❑ Nitrate less than MRL (ND) Arsenic 48507 ug/L ❑ Arsenic less than MRL (ND) Collected by Pannone Engineering Services Date of Sample 12/12/19 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date Results ❑ Pass For bedrooms Fluid depth prior to test in Water added gal New depth in Elapsed time min Final fluid depth in Absorption rate god Any rejuvenation treatment (past 12 months) If yes, enter date Arsenic Advisory Certificate of On -Site Systems Approval # OSC191602 Subdivision: Norton Park #2, Block 4, Lot 8 A water sample revealed an arsenic concentration of 48.5 micrograms per liter (ug/L). The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 ug/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. information on arsenic is available from the On -Site Water and Wastewater Program website (www.muni.org/onsite) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout > 100' ❑ Yes if No ft M Yes if No ft Neighboring Tank > 100' ❑ Yes if No ft Private Sewer/Septic Line > 25'✓❑ Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No ft Holding Tank > 100' EDYes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' El Yes if No ft ✓Q Yes if No ft. Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' M,/ Yes if No ft ✓❑ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No ft Surface Water > 100' ❑ Yes if No ft Property Line > 5' ❑ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ❑ Yes if No ft . Private Wells > 100' ❑ Yes if No ft Water Main > 10' ❑ Yes if No ft Community Wells > 200' ❑ Yes if No ft Water Service Line > 10' ❑ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' 0 Yes if No ft If absorption field is under driveway comment below Property Line > 10' ❑ Yes if No ft Wells on Adjacent Lots: Water Main > 10' ❑ Yes if No ft Private Wells >100' _ El Yes if No ft Water Service Line > 10' ❑ Yes if No ft Community Wells > 200' ❑ Yes if No ft Surface Water > 100' ❑ Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. / COSA Checklist yellow sheet OF aC�s,�f-�� Steven (?. Pannone e F '. CE 8149 �,-� 0 0 SUV ICS CONNECTION RECORD roparty Omar feircoa tax —2 73' 55 -3 6, D m Date lnopcctor4��/-,,�Ill— AP� Iication, Yen— No Applicotion, Yev_ No I =ATI(XI SKE= FA NORTON PARK ADDITION, LOT 8, BLOCK 11,910 S.F. WEST 123RD AVENUE 0 M UNIT NO. 2 4 N 90°00'00"E 83.00' 0 1n HUFFMAN ROAD AS—BU I LT I HEREBY CERTIFY THAT 1 HAVE SURVEYED THE PROPERTY DEPICTED ABOVE AND THAT NO GASTALDI LAND ENCROACHMENTS EXIST EXCEPT AS INDICATED. SURVEYING, LLC IT IS THE RESPONSIBILITY OF THE OWNER TO JEFF A. GASTALDI, R.L.S. DETERMINE THE EXISTENCE OF ANY EASEMENTS ZOOO E. DOWLING RD., SUITE 8 COVENANTS OR RESTRICTIONS WHICH DO NOT ANCHORAGE, ALASKA 99507 APPS ON THE RECORDED SUBDMSION PLAT. PHONE 248-5454 UNDER NO CIRCUMSTANCES SHOULD ANY DATA GRID DATE HEREON BE USED FOR CONSTRUCTION OR FOR SW2730 12/5/2019 ESTABLISHING BOUNDARY OR FENCE LINES. ANCHOA3AGE RECORDING DISTRICT, ALASKA F.B. JOB NO. NOTE: NO CORNERS SET THIS DATE 19-03 NPA284 1 "=20' ®®®lss®� . OF A4 #4 ® m 0. � • gyp t® . JefeL A. Gastalai 12 —6091 5/2019 v •a P afesstaaal l' , V) Size Connect Type PAST Depth at Stub ? Depth at Structure Size Main Type Approved ❑ Riser Locate New Connection ❑ Replacement Connection ❑ % Grade Couplings ❑ Backwater Valve ❑ Type Bedding ❑ Type Compaction Insulation ❑ Type Cleanouts Type Location WATER: Municipal ❑ C.A.U. ❑ Private ❑ Temporary Construction Rate Type Residential ❑ Type No. of Units MUNICIPALITY OF ANCHOR GE —SEWER UTILITY Form No. S229(4-76) SEWER CONNECTION:On Property, Location Record Imp. Dist No. Permit No.A 1,-.5fZ Industrial W /�' �D. >� UE. acct. No.:�6 Subdivision,4 ORTD/J �� 7F':ZAddress—Lot S Block ,# _F Location: Alley 1771 Street ❑ �R/>A/ s , C0R&ASn /-_E140. � SZ Rb%75 i�� D L�ai(_rG( t (Sketch on Bock) Size Connect Type PAST Depth at Stub ? Depth at Structure Size Main Type Approved ❑ Riser Locate New Connection ❑ Replacement Connection ❑ % Grade Couplings ❑ Backwater Valve ❑ Type Bedding ❑ Type Compaction Insulation ❑ Type Cleanouts Type Location WATER: Municipal ❑ C.A.U. ❑ Private ❑ Temporary Construction Rate Type Residential ❑ Type No. of Units ASSESSMENTS Commercial ❑ Type Imp. Dist No. Sub. Agreement Industrial ❑ Type Lateral Assmt. ❑ Control Manhole Location Trunk Assmt. Ext. Agreement Trunk Imp. Dist. ❑ Type Elevation Approved Grid. Assessments Paid ❑ Comments: Comments: 4C-1; yr Connection Made By: •"r Inspection By: ate W10) coo•is 1 9 (n m m c) Oc, Z Z m m z > m > z 0 . On 0 z0 z m > vn m rC m > =j 0 , > C: 0 Cl) moo -u Z> c � 0 m 90 n -V M m AAROW WELL AND PUMP SERVICE, LLC Re: Norton Park :� Block 4 Lot 8 A flow test was done on the above located well on July 15'h of 2019. The flow rate was considerably less than when the original well was drilled. It was decided to redevelop the well at that time. The well was redeveloped and a .40 screen installed on July 161- With airlift, the well flow was estimated at 30 gpm. David Harper Aarow Pump & Well Service, LLC ~ ~]?'133~33~ ~Street~.~(hchorage, Alaska 99503 274-4561(Fj~ ~~~~~~~)~'~ ~ ~ Time of Inspection ~..,~-~~ Date of Inspection ~- ~~'~,~(~ )IVIDUAL SEWER & WATER FAClLITIESFoR Mailing Address: k~k,L~ ~L~~ ~~~~,Phone: 2. Property Owner'. I~o~3q ~.~, ~ Phone'. Mailing Address: Legal Description: Location: c_3q 5. Type of facility to be inspected ~L~ 6. Well Data: A. Type C. Construction Sewage Disposal System:]~c)-~O~ A. Insta~l~6~ _ C. Septic~ank: 1. D. Seepage Pit: 1. Size Absorption Area B. Depth D. Bacterial Analysis B. Installer /o_~x~ 2. Manufacturer 2. Material E. Disposal Field: Total length of lines Distances: A. Well to: Septic tank Nearest lot line , Absorption area , Other contamination , Sewer Lines B. Foundation to septic tank C. Absorption area to nearest lot line EQ-034 (1/74) , Absorption area Page 1 of two pages Page 2 of two pages - Ret Legal Description t for Approval of Individual r & Water Facilities Comments Approved Disapproved Date Approval~Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74) GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" St., Anchorage, Alaska 99503 - 274-4561 REQUEST FOR APPROVAL OF . INDIVIDUAL SEWER & WATER FACILITIES 1. Type of Inspection: 2. Property Owner: Mailing Address: 3. Name of Buyer: Mailing Address: CMRO Rober% Scott VA x FHA P.Oo PooX 4:-~292 Anchorage, AK Gregory Klingel CONV Daz Phone 344-8663 3444 E. 18th. Anchorage, ~{ 99501 Phone 274-3469 4. Name of Lending Institution: The Lomas & Nettleton Corapany, Mailing Address: 4449 Business Park Blvd. Phone 274-7661 5. Name of Realtor 0r Agent: Louise Cook/Selective Realtx Mailing Address: 1515 East Tudor Rd. Phone 279-8624 6. Legal Description: Lot 8, Block 4, Norton Park Subdivision Location: NHN 123rd. Street, Anchorage, ~ 7. Type of Facility to be inspected: 8. Water Supply Type of Supply: Public Utility Individual If IndividUal, number of dwellings presently served If Individual, depth of well ? 9. Sewage Disposal System Type ~of S~stem: Public Utility Individual If Individual, date of installation ? Single Faraily No. Bdrms. 3 X (on-site) .x 4.1