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HomeMy WebLinkAboutKNOX Parcel AA 37/C7 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT PHONE [~NEW NAME MAILIN~ ADDRESS~ LEGAL DESCRIPTION LOCATION £ ¢~f'Absorption area DISTANCE TO: Liq. ~a~i,~a,I o., IF HOME.DE: inside length Manufacturer ' Well DISTANCE TO:I [ NO. of lines ~ I Len.th of ~cl)J~ Top o' tilO t~nish ~ralde Dwelling ¢%' I~i¢~ ~O, Material No. o~mpar tments Width Liquid depth PERMIT NO. DISTANCE TO: ~ [Class Depth DISTANCE TO: OTHER Material Liquid capacity in gallons PIPE MATERIALS SOIL TEST RATING INSTALLER REMARKS Nearest lot line NO, tthinches Distance ¢b~t~een lines Depth .. Crib depth Total effective absorption area Building foundation Nearest lot line Driller ) to lot line I PERMIT NO. I Absorption area(s) MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENViRONMeNtAL PROTECTION JUL 9 19 zt APPROVED DATE LEGAL F:'ERI'41 'T' NO: DATIE I S~StJED,', APPI..,. I CANT: ADDRES!.:~ ~ COIxlTACT F'NONE: LEGAL DESCRIP L..OT SIZE: LOT LOCATION: PlA X BEDROOM!.~; DEF'ARTMENT OF'" HEALTH AND ENVIRONMENTAL F'RO]'EGTIOI~I 1~125 L STREET, ANCI40RAGE, AP':; 99t501 264-4.720 E.} Ih4 .... '.~ ][ 'If"' IF%- ~7~ IE W E:'IR ~.~.: W IE L I[ .... IP tFZ F~,". ~,1t Z ]- 84()535 07/()2/R4 CI4ARI_OTTE REINDI_ SR BOX 8164 CHUGIAK, Al.,:: 99567 .];49-6561 SUBDIVISION: KNOX SECTI[)Iq: 35 TOWNSHIF': 16N 6, 2'IA (Iii(:',!. FT .. OR ACRES ) OFF EI<L,.LITNA ROAD I_OT: PARC A RANGE:: BI_OEK: NA List. e:d be].ow ape the options available 'L~ you in designing your sept,:i.c: system. Choose 'Lhe op'Lion that best £:i. ts y~ur' sitE. DEF:'TI4 TO PIPE BOTTOM (FT.) 4..0 4.0 4,0 GRAVIEL. DEPTH (F:T.) 4, 5 O. ',5 3,5 T[ITAI_ DIEF'TH (F"F.) Ill. 5 4. ~:!i '7 ,, 5 GRAVEL WIDTFt (FT.) 2.5 2.2.0 5.0 GRAVEL I_ENGTH (FT,,) 68.0 42.0 66.0 GRAVEl_ VOL.UME (CU.YDS.) 3~.4 34.,2 48,,B TANK SIZE (BALS) ~,250.0 ~.}~ t.250.0 ~'* 1,250.0 .~'~' 8011.,,. I:~A'~:I:NG (SQ.F]'. /BR) 152 152 '~* TANK MUST HAVE A'r' I_ErAST TWO CC)MF:'AR:I"MENTS I cert. ify 'Lhat." ;I,.I am ('amil:i.a~' wi"Lh the [,equirements~ fol* c)n,-site !sewers and wells.as s(~t FoPth by 'Lhe Hunicipal:i. ty of Anchorage (IdOA) and 'Ll-~e Sta'Le of Alaska. 2. I will instal], the systeill in accor'dar')c:e w:L'Lh all Hi]A codes and, r, egti].at:i, or]!~, arid iri compliance with ti~e design ceiter, ia of' this per, mit,, 3. I will adher'e to all HO~ and Sta'Le of' Alaska'r'equ:i.r'ements For the-set back distances fr'om any existing ~el]., wastewa'Lee disposal system or' public sewepage system on th:i.s on any adjacent oP near'by lot. 4. I understarld 'Lhat 'Lhis per'mit is w'..~lid for' a maximum of 4 bedr'ooms and any enlar, gement will r'eqt..tir'~::~ an addi'Lior~al per, mit. IF A L. IFT ~]"ATION IS INSTAI_I....ED IN AN AREA COVE;RED BY MOA BUILDING C(]DE!:3.~ TI-,IEN (1) AN IEL..E]C, TRICAL. PIEIRIdIT AND INSPEC,]"ION MUST BE OB'T'AINED; (2) AS-BLJILTS WILL..IqOT BE AF'F:'ROVIED WITHOUT AN EI_IECTRICAL INSIZ'E[;'I"IOI~I REF'ORT~ AND (3) 'T'HE~ IEI.,.IEC:;TR:I:CAL. WORK IdUST BE DON[~ BY A LICEIxlSIED ELECTRIE;IAN, S ]. bNE. D APPI,,..ICANT: 'CHA~GTTE REINDL ~ ~2 7125 Ol D SEWARI} HIGHWAY ANCHORAGE. ALASKA 99592 (907) 349,6561 P i!!! R C '() L A'i" ! 0 N SOH I OG LEGAL DESCRIPTION: SLOPE SITE PLAN O P 12- E [F YES, AT WHAT ~ ...... . DEPTH? .:' Net '. Drop Gross Net Depth to Reading Date Time Time Water . ~M%J'".....'" ~t;¢ r ;:-1''~ -[ 'r ..... ', ........ 4 L. DEPT~'- PERCOLATION RATE .......... (minules/Inoh) (FEET) TEST RUN BETWEEN FT AND FT m nLgOO(