HomeMy WebLinkAboutKWIK LOG BLK 3 LT 4
Tom Fink,
Mayor
A&unicipality Anchorage
Department of Health and Human Services
825 "L" Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
May 20, 1994
Donald J. Hesson
PO Box 92963
Anchorage, Alaska
99509 2963
Subject: Lot 4 Block 3 Kwik Log Subdivision
Permit ~SW930107, PID #013-043-47
The subject permit, issued May 19, 1993 by this office for a
single family well and/or on-site wastewater system, has
expired as of May 19, 1994.
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. All 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
$440.00 for a combined on-site wastewater and well permit.
If you have any questions, please call this office at 343-4744.
Since~.eT~, / ~
Robert ~. Robinson
Acting Program Manager
On-site Services
PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE
]DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WELL SYSTEM PERMIT
PERMIT NUMBER:SW930107
DESIGN ENGINEER:DUMMY COMPANY
OWNER NAME:HESSON DONALD J
OWNER ADDRESS:P.O. BOX 92963
Anchorage Ak 99509
DATE ISSUED: 5/19/93
EXPIRATION DATE: 5/19/94
PARCEL ID:01304347
LEGAL DESCRIPTION: KWIK LOG BLK 3 LT 4
LOT SIZE: 11137 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONTRUCTION OF:
WELL SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
1. THE ATTACHED APPROVED DESIGN.
2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS
15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL
REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (iSAACS0).
3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4329 OR 343-4681 AFTER BUSINESS HOURS
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
PROPERTY OWNER MUST PROVIDE COPY OF WELL LOG AND
LABORATORY ANA~SIS FQR BA(~TERIA AND NITRATES.
ISSUED BY:
DATE:
(~ 'w/oOP
_S~'~ O/x/z>
£~A~o N
., ,, ? :$.BUILT
It,.is the respons,ib~.lity of the owner to der'er.
.~he. exist;eh'ce bf'.anY.easements, covenants,'or.
'$trictio~s"whtch.do' not appear on'tho Pecorded
divis.ion.,p~at.,Under no.cl'rc~stances:should any ~ : .
data horeon b~'used for construction or..for estab-
lishing bounda~y'or fen.ce lines. The surveyor take~
r~ponsibflit~ for the initial transaction only.· $~OWN
? L~G~ND .
LOT ~ BLOCK ~
' ~ ~EIA~ PRORCOR.~D
ANCHORAGE RECORDING DISTRICT
m~P~;~o' eY: ~NG ~ ASS~IATES ' . .
1426 HYDEfl STREET .
ANCHORAG E~ ALASKA 99501 R~W~ON ' DATE' B
' ~ SCALE: z [WO~ ~D~R: lYIng.K: IGR~D:
~! LOCAT ION
OF WELL
DZ~C~ONS:
ground surface []other:
BOR]~HODE DATA: Depth
type and color
SECT'{ON QTRS
REMARKS:
Municipality ol Anchorage
Der)t, Health & Hurnsn Services
STATE OF ALASF, A
DEPl%llT~NT OF NATUI~J%L ~sOURCES
DIVISION 0F GEOLOGICAL AND GEOPHYSICAL SURV£¥S
WATER WELl, RECORD
TOWNSIIIP
WELL DEPTII:
Depth of hole: /~.O ft
Depth of casing:~_~ft
/~/e $ .5or}
DATE OF COb~PLETION:
METIIOD OF DRII,LING: [~air rotary
~cable too] E]other:
USE OF WELL: ~domestic E]irrigation Gmonitor
[]pulolic supply [] other:
CASING: St.ick-up_./~l~ _ft. Diam: /¢9 in
WELL INTAKE: [] open end E~screened
[] perforated E~oper% hole
DOl')th,',~ of oponln(js; .......... t.o ....... ft:.
SCREEN TYI?Ei ........................................Diam: ................ in
Slot/Mesh Size:-- .................. I,ength: ft
Set Bot weell and ft
GRAVEl, PACK TYPE:
Volume used:
Depth to top:
GROUT TYPE: Volume:
Depth: f~om .......... ft to ......... ft
DEVELOPMENT NETHOD :_~ tO ,' £q q
PUMPIN{3 LEVEL AND YIELD:
_~/~ ft after /~ hrs pumping /f3 gpm
PUMP. ]NTAKI% DEPTH: ................. ft
Date l'ump ln.~ita].],ed -
|lorsspower:
WATER CHEMISTRY SAMPLE TAKEN? []yes ~]no
Well disinfected n'~on com_j)letion? ~]yes ~]~9
PLEASE MAIL WI{ITE COPY OF LOG WITHIN 45
DAYS TO:
· DGGS
PO BOX 77-2.116
EAGLE RIVER~ AK. 99577