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Home My WebLink AboutKAREEN LT 9L~' ~ ~b¢ .. 011 ,.~r..~::. ~. : ..... :' ' '~ ;:'i ' ' I MUNICIPALITY OF ANCH .? i:! ": !ii, ..':.:-.::' ] CONNECT PERMIT DATE OF APPLiCATiON ----~-~g[ - ~-'~ sc,EDULED CCMPLET'ON DATE - 3000 ARCTIC BOULEVARD PHONE ¢-7.8¢~.~' ~]~> b- -" ' --2 LOT/TRACT ~ .~ ._ BLOCK SUBDiViSiON ~/< IL/.-4'.z ,EL ~ MULTI-DWELLING NO, APTS_~ [] COMMERCIAL [] INDUSTRIAL TAX CODE ~/"L-~' '__/~GRID _ 7~' ' ' -- DRAWING No. BUILDING ADDRESS ~ __~/'~___~L- / ' ~ } '~' ~ h' ..% ,, : . ,-/ ~!:~/¢¢PHONE .... MAiL ADDRESS ASSESSMENTS CONTRACTOR:-~" ~ '--;' ~'-~ "' (License & Bond required) . E~ON PROPERTY ONLY E~ MAIN TAP--TO PROPERTY LINE ONLY (MOA or State ROW Permit Required) Q MAIN TAP & ON PROPERTY cONNECT (MOA or State ROW Permit Required) ~ Paid previously Q Main extension agreement ~ Subdivision agreement [] Extended connect agreement Q Pending--AMOUNTS ~ CONNECTION SIZE ,~-/ _'CHARGE $ iNSPECTiON FEE $ PERMIT __FEE REIMBURSIBLE DEPOSIT NUMBER ~ERMIT ISSUED BY: ~ CASH (Z~PAID DATE: PERMIT-tEE (Please Print) ,_~, ~.~ I ~ ::: :":: :- ........... ' ..... -'~ ':" :"' ~' "~';" ' MAILAODRESS ~ ~!1 ~ ..... .~ERMtT',~i,~D AGREE !~ · -. I HAVE READ THE CONDITIONS AND REGU~''E'T ONs ON THE REVERSE slOE OF '1 ~l~ '"~" ~OST IN A c~SPICUOUS pL--~CE AT THE ,JOB SITd AWWU INSPECTOR WATER & WASTEWATER UTILITY 3000 ARCTIC BOULEVARD PHONE 786-5540 LO T/TB.&,C,,,T~ TAX CODE ~/~2~.J~ RID SCHEDULED COMPLETION DATE [~SINGLE FAMILY ~ MULTI-DWELLING No. APTS _ [] COMMERCIAL BLOCK [] INDUSTRIAL DRAWING BUILDING ADDRESS OWNER /J)', I1,¢," MAIL ADDRESS CO NTRAC'~'OR:'-~/,¢'.: ':"rC, (~,'~. [License & Bond resulted) [] ON PROPERTY ONLY ~ MAIN TAP--TO PROPERTY LiNE ONLY ~MOA or State ROW Permit Re(: Jired! MAIN TAP & ON PROPERTY CONNECT MOA or State ROW Permit ReGuired) ASSESSMENTS Paid ereviously Main extension agreement Subdivision agreement Extended oonnect agreement Z}cPending--AMOU NTS .~'_- ' CONNECTION SIZE ~ '"' CHARGES INSPECTION FEE $ PERMIT FEE $ REIMBURSIBLE NUMBER DEPOSIT $ PERMI%ISSUED BY: PAID ~ CK INSPECTED BY: 'TS,-,-,,, DATE: PERMITTEE (Please Print) i¢'~ ,/'?¢* ~f .',,~" PHONE I HAVE READ THE CONDITIONS AND REGULATIONS ON THE REVERE SIDE OF T~ PERMIT AN~ A TO COMPLY WITH THEM. // /~ // POST IN A CONSPICUOUS PLACE AT THE JOB ~ ,o-o2~ ,o~4) AWWU INSPECTOR CONTROL SERVIC"~, INC. 1200 West 33rd Aven.~, Suite B ANCHORAGE, ALASKA 99503 (907) 561-5040 SHEET NO OF DATE CHECKED BY DATE (907) 243-2282 KEN JOHNSON KEN'S COMPANY WATER WELL DRILLING PUMP SALES & SERVICE 30 YEARS ALASKA DRILLING 3163 LINDEN DRIVE ANCHORAGE, ALASKA 99502 J~flViES R. WILLIA~iS 4444 A2ViES AVENUE # A .ANCHORAGE, ~i. LASKA 99508 Lot 9 Kareen Subd, JULY 22, 1985 ( ~ko 349-2945 ) ( Air Guard road & Rasberry ) ~¢ATER ~'~LL LOG 0 ft to 4i ft 41 ft to 69 ft 69 ft to 89 ft 89 ft to 100 ft 100 ft to 102 ft 102 ft to 118 ft 118 ft to 122 ft 122 ft to 137 ft i37 ft to 160 ft 160 ft to 178 ft 178 ft to 187 ft 187 ft to 193 ft i93 ft to 196 ft 196 ft Brown sandy silt Wet Brown sand Blue clay Sandy clay Sand with silt ( weeps 10' head ) Heaving fine sand..25 ft Same with trace of clay Same with some coal seams Heaves 25 ft..fine dirty sand Trace of clay & fine sand Dirty fine sand Heaves..8' to 10 ' Fine gray & silty sand..heaves 4 ft Ned° gray & dirty fine sand with coal H20 approx ].5 GPM..heaves 6 ft. Clean med~ gray & sand Static water level 72 ft. G,.L. ~- Test bailed at 20 GPN 12 ft. drawdown with good recovery Bottom stable ( left 'two ft. material ) Clearing rapidly TOTAL CASING 197 ft 11~ ino i, AuNICtPAUI'Y OF DSPT. OJ: HEALTH & ENViRoNMENTAL p~OTSC~tO~ 'ERM I T NO,: ~A'/'E IS!,3UED: DEPAR'TMEI'4T OF' .dI~IAL'FH AND I~i]xtVIROIgMEi]xlTAL 8~ .... L c ....... . ........ A x I'; '"IORAGF~ AK 99,50 ,,:.64 -4 7.:~.0 iPPL I CAN]":~ JAMES WILLIAMS ~DDRES,"!~: 1506 ERMINE STREE]" AN(] HO F~A(31~: ~ AK 99504 :ONTAC;T F:'HONE: :];49'"'~2945 EGAL. ]D[:.,:~I..,Fs I P 0 T ,,.~ 12:1.:. GUiF. ID I M I S I O1',1 ." I<AREEN ,'-'~l::.l.., r I ON: 3 'I"[)WNSI-I:I: F' ': J.,::..t',l ([13E:!,, I::"l",, I]R E L[.)CI ...... 0 1. :1: ~.~'il ,~'afl'~:i.].:i.&p 14i'Lh the Pequ:i. Pc.qner~ts for' o].....:i!~:i.'l:.(.:.? !-:~ebJel'S and wells as set l'or,{h by 'Lhe I',lun~.c:i.l::~ali.Ly of Ancl]oPage (MOA) and 'l:.he c ..... ,:l.a~e. of Alaska. ;~:~,, ]: Wi. ]. ]. :i. llS~.g~]. 1 'Lhe sys'Lem il"l ,'~:x(::(::l:)pclar'H:e.) wJ.'[.h al. 1 MOA co(:le~ and and J.r'l I:::omp].iar'lce with 'l',.he des:i, gl] c::l":i.i:.ep~a of l:.his pepm:i,t. " ' 3,. I will adhePe to all MOA and ,M. Ate, of ~laska i'~:.H~l.~ipelll~n'[.~[~; fop tine set back dj, star'ices l'i"om any (,~>lJ. stJ. rlg Ne].].~ ~ast~aNat. Bp disposal Byst, e~l or' pub].ic MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL GENERAL INFORMATION (a) OF ON-SITE SEWER AND WATER FACILITY 264-4720 ' Application Date Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicant Name '~/~ uJl~.~.l,~)-/y Telephone: Home ,~- ?,)00~ Business Applicant Address ~..d. ~a~ ,~:~..-~00.~ /~//;, ~ (c) Applicant is (check or, e): Lending Institution []; Owner/builder.~; Buyer []; Other [] (explain); (d) Len din g Institution' ~ ,. ,.~-¢'~¢' Address ? ~ / ,2-~ ,~"~:'""~2 ~ ~'"~Z~//~ (e) Real Estate Company and Agent Address Telephone Telephone (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family'~ Multi-Family [] Number of Bedrooms Other WATER SUPPLY Individual Well~( Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite [] Public'~ Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11/84) ENGINEERING FIRM PROVID: INSPECTIONS, TESTS, FILE SEARCH, E ~. AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is 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 in compliance with all fvlunicipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm ~ '~' Telephone Address /'~£,'~ /J .,~4'~.~' /¢~ _.~///'~ z¢, Date :/cd~/~ Approved for /":/~/~L¢_.~%~ _ bedrooms "~ .L~-,~A.._~_ ate Approved ~(./' Disapproved Conditional % ) Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (1 MUNICIPALITY OF ANCHORAGE (MO~.~ HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: WELL DATA Well Classification Well Log Presently/N) Date Completed Total Depth /~'~ / Cased to /'¢~ / Static Water Level ~ ¢p7 ~'- ¢// Casing Height Above Ground Electrical Wiring in ConduitCN) Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot / To Nearest Public Sewer Line Cleanout/Manhole _ Water Sample Collected by Water Sample Test Results ~'/¢)¢/$/¢/¢~'7~.~/ Comments (~) /.~)~_./_L. /;~t If A, B, C, D.E.C, Approved (Y/N) Depth of Grouting Pump Set At Sanitary Seal on Casing(~N) Depression Around Wellhead ,'v//~¢ ; On Adjoining Lots v///¢ ' On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot ,/~' //'//--'cc'A/ ;Date 2> SEPTIC/I'fOLDING 'rANK DATA ~')//~./~_ Date I nsta"~ffe~ Size No. of Compartments Standpipes (Y/N) ~. Air-tight Caps (Y/N) Foundation Cleanout (Y/N) (Y/N)%~ Date Last Pumped Depression over Tank Pumping/Maintenance Contrac ~N) ; for Holding Tank High-Water Alarm (Y/N) ""~'"%~ Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: ~...~undationTo To Water-Supply Well BuTM To Property Line To Disposal Fi~.~ To To Water Main/Service Line Strea~P.~nd, Lake, or Major Drainage Course Comments Page 1 of 2 72-026('11/84) var SlaalAI '~se//,3enbapv ~ (N/X) lUeA lB la^a9 ,,JJO dLund,, (N/A) sseo3V/eloque[AI SUO!SUaLU!Q elUaLUmOO (N/A) sePOO leOHlOal3 JOj palse.L '~~~ laAa-I mJelV .leleM q8!1-4 le la^a"l ,,uo dLund,, '-'--...~.~Olle9 u! az!s .Q sluauuuJoo Be Jr ei~Jols alo!qoA JO 'BoJV 6u!)]Jed 'AeMaApa O/ agJnoo eBeu!eJC] Jofew Jo/aNeq/puod/uUeaJ1S o/ -----"~Jd J!) ~tueqino o.L --- au!9 aOIAJaS/UlBIAI JaleM o± "',~1o-1 fiu!u!ofpv ua: ----- ua tuelsAc3 peuopueqv ~o 15u!ls!x~ az "~ uo!lepunoa 15mplln~ o/ ---- eu!q ~p~doM'O'4~ ..... IleM Xlddns-JeleM O.L ' ].9a.L ,~oenbop¥ ]~ee-I ,to a~eC] ~"~ (N/A) plm=J Ia o uo~ sa]dec] (N/A) lua9aJcl sed!dpue~9 '"~eej'¢ uon, dJosqv ~.o ]@e=l eJenbs ---- sseU~lO!q/pa~] laA~JO ----- Pla!a 1o qldac] ~pla!4 lo qlP!M ---- pla!4 1o q16ue-I '~.~eIeUl eleC] u6~seCl melsXS 1o edXj. e~e~lS uoBdJosq: u! ~,g:~,~.,?,.~ V/-F~//~_L( V.LVCI C!'1':11.-I NOIJ. dklOSg¥ '0 Sheet WATERWELL - TEST PUMP REPORT Owner ~-~?,'f~-:~' .~?! (~'~_~/~-.~' Address Well Location ~ ~ ~~/ ,'.~'(~'L~ ~'~/~ ~ Well Information: Ttl. Depth /~_Depth of Cas ng ~ Screen From ~ To Casing Size ~ ~/ Screen Dlam '~ Screen Slot Pump Information: Pump On: Remarks*f~/~ ~.~'~ ~/~J'~'.,~.'~. /~'~/~' ~ ~ ~ '~ ~ ~C ~ Intake Depth !'9~ Pump Size ~ ~/~ ~ Air Line Bepth ~'~ Static Water Level ~ ~ ~' Av. Discharge ~ GPM, Max. Drawdown ~ Time /~ J~ Date ~/~/~/ Pump Off: Time/~ /~ Date~/~' _ i · ,/~-~ .... WATER ~4.B..7¢~ - FLOW TIME LEVEL ~ GPM REMARKS J.E,~CE~., ..~:~.E-- ~ REMARKS