HomeMy WebLinkAboutKWIK LOG BLK 3 LT 14
Tom Fink,
Mayor
/ unicipality of Anchorage
Department of Health and Human Services
825 "L" Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
May 23, 1994
Daniel F. & Betty A. Deering
807 East 73rd Avenue
Anchorage, Alaska 99518 2820
Subject: Lot 14 Block 3 Kwik Log Subdivision
Permit #SW930109, PID #013-043-31
The subject permit, issued May 21, 1993 by this office for a
single family well and/or on-site wastewater system, has
expired as of May 21, 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.
Acting Program Manager
On-site Services
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 PERMIT
PERMIT NUMBER:SW930109
DESIGN ENGINEER:DUMMY COMPANY
OWNER NAME:DEERING DANIEL F & BETTY A
OWNER ADDRESS:821 E 73RD AVE
ANCHORAGE, AK 99518
DATE ISSUED: 5/21/93
EXPIRATION DATE: 5/21/94
PARCEL ID:01304331
LEGAL DESCRIPTION: KWIK LOG BLK 3 LT 14
LOT SIZE: 11134 (SQ. FT.)
NUMBER OF BEDROOMS: 2 THIS PERMIT: 2
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 (18AAC80).
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:
RECEIVED BY: ~i 3P &Z---~-~. ~ DATE:
ISSUED BY: DATE:
DEPA/tTI~EN~.~ OF NATUtLAL I~ESOURCES
DIVISION OF GEOLOGICAL AND 'GEOPH¥SICAL SURVEYS
WATER WELL RECOP/D
LOCATION OF ~]LL
BOROUGH I SUBDIVISION
~:,'~ ~l", "~,, .~
DIreCTIONS:
~L/L GT~ BLOCK
.
MP~ASURING POINT:
~ground surface ~] other:
BORflHOLE DATA:
'~aterfal type and color--
E]top of casing
Depth
DOpUTT:~
CONTRACTOR INFORMATION:
Registered Business Name"
Signature of P%-J'~horiz~d Representative
Date
~ELL OWNER
MERIDIAN
WELL DEPTH:
Depth of
Depth of casing:__~ ~ ft
DATE OF COb~LETION:
METHOD OF DRILLING: ~]air rotary
~cable too! ~]other:
USE OF WELL: ~domestic ~Jrrigation ~monitor
supply S other:
CASING: Stick-up /.,:g ft. Diam: ..(. in
WEI, L INTAKE: [] open en~!
~ perforated
Depths of openings: t ~
~ screened
~open hole
SCREEM TYPE: Diam: in
Slot/Me£h Size: Length: ft
Set Between and ft
GRAVEL PACK TYPE:
Volume used:
Depth to top:
GROUT TYPE: Volume:
Depth: from ft to ft
DEVELGPldENT NETHGE:
Dura21on:
PUt, PING LEVEL ~4D YIELD:
___~j~ft after__f _hfs pumping 7 gpm
PUbiP INTANE DEPTH:____.ft Horsepower:
Date Pump Installed -
WATER CHEMISTRY S,%24PLE TAKEN? ~ yes ~no
Well disinfected ur>on comj~letion? ~ yes~pp
PLEASE MAIL WIIITE COPY OF LOG WITHIN 45
DA YS TO:
DGGS
PO BOX 77-'2116
EAGLE RIVER, AK. 99577