The URL can be used to link to this page

Home My WebLink AboutKINCAID HEIGHTS LT 10 Municipality of Anchorage Page i of~ DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: ,~' c'/,~'~ ,-~q~ PID Number: ~ll-- Name: ~ EI~,A r~t,~'r"/) }4 lcl4/q I~ ¢- Wastewater System: ~'New [] Upgrade Address: ABSORPTION FIELD Phone: · tHo-or,rooms: ~eepTrench ~Shallo~Trench ~Bed ~Mound ~Other LEGAL DESCRIPTION Soil Rating: /. A GPD/~. Total Depth from original~ ograde:/ Lot: Block: ' Subdiv~ion: Depth to pipe bottom from original grade: Gravel depth beneath pipe Township: Range: Section: l:ill added above original grade: Gravel length: WELL: ~ New ~ Upgrade Gravel width: :~ ~ Ft. Number~of lines: Distance__be~een lines:Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: Driller: ~--d Date Drilled: StatioWaterLevekF,. 'nstaller:A~C~ ~S*/ Datoinstalled: Yield: GPM IPump Sot at: Ft. }Ca~,na,ei,MA~ovoG,ound:Ft. TANK SEPARATION DISTANCES ~eptic ~ Holding D S.T.E.P. To Septic Absorption Lift Holding ~ubiic/Private Manufacturer: Capaci~ in gallons: LH From Tank Field Station Tank Sewer Lines ~ Material: ~ ~ "U~BOr O' Gom~monts: Wel~ . Sa.ace LIFT STATION Wator " ~ot ~ ~ [ Sixo in ~allons: ~ Manufacturor: Line I ~ j ~ "Pump on" level at: "Pump off" level at: High water alarm at: Foundation ~ Cudain Pump Make & Model ~ Electrical Inspections pe~ormed by: Drain I Remarks: BENCH MARK ENGINEER'~ SEAL Inspections performed by: ~ ~ Dates: 1st ~'/¢~ 2nd ~'. %, C~:-::::::2~ . J ,.- ",~ Department of Health and Human Services approval ~. · .~: '**~ . ,,~? ,:, Reviewed and approved by:z~~. ~ Date: ~-2F-~g .-:... 72-0t3 (Rev. 9/91~ MOA 25 / AE 22.5 / ~ " 54.2 C°~MT ~~ . ~ ~ ' ~ ~..~.~~ ....... ~.~.. ~E~C~ ~ ~' 205 W 15TH. AVENUE I I REKLAS CI~OLE I I DATE: AUG, 51, 1996 ANCH. AK. 99501 I I PAUL ~/C~EL¢O~ I I SHEET: 2/5 ORI~: 2222 Trenches; £' Wide 5' L on9 10' Deep 7. d' Se~er ~ Covsr INSU~TED 2000 9ol Septic tank Cleon Out SCALE BENCH MARK. BDTTDM SIDING ASSUMED ELEV. 100,00 TDBBEN SPURKLAND P.E. 203 WlSth Ave Anchopage Ak 99501 LOT 10 KINCAID HEIGHTS MICHAEL GERAGHTY REKLAS CIRCLE SEPTIC SYSTEM AS BUILT DATE: AUG. J1, 1996 SHEET: GRID: 2222 PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE / ~/~ /~JO~/ DEPARTMENT OF HEALTH AND HUMAN SERVICES ~-3~ - ~ P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE ~[ELL ZuKD WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW950398 DATE ISSUED:il/30/95 DESIGN ENGINEER:~ Ei[Ci~[ESLi~G ~¢~[m,~ ~,EXPIRATION DATE:il/30/96 OWNER NAME:GERAGHTY MICHAEL C & MISHEL OWNER ADDRESS:7134 LOWELL CIR. ANCHORAGE, AK 99502-1867 PARCEL ID:01112210 LEGAL DESCRIPTION: KINCAID HEIGHTS LT 10 LOT SIZE: 49749 (SQ. FT.) NUMBER OF BEDROOMS: 6 Ti{IS PERMIT: 6 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / 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 (iSAAC80) . 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 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: ISSUED BY: / 203 W 15th. Avenue, Suite 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 SEPTIC SYSTEM DESIGN LOT 10 KINCAID HEIGHTS Michael Geraghty No Ground Water or Impervious Layer to 19 ff. Use Standard Trench Soil Rating. 1 min/in = Use 1.2 gal per sq.ft/day No. of Bedrooms 6 Required Area per Bedroom: 150/1.2 = 125 sq.ft.. Total area required: 6 x 125 = 750 sq. ft. Finish Floor Elevation 100.00 Ground Elevation at Absorption Field 94 Bottom Testhole 75 Top of rock 91 Bottom of trench 81 Effective Rock Depth 10 fit. Length of trench 750/20 = 37.5 ft. 3 feet of cover 6 feet above testhole SYSTEM CONFIGURATION STANDARD TRENCH TOTAL LENGTH 37.5 FT TOTAL WIDTH 2 FT TOTAL DEPTH 13 FT ROCK DEPTH 10 FT COVER 3 FT SEPTIC TANK 2000 gal. The installation of this septic system will not prevent development of the adjacent lots. Subdivision is served by public water. AWWU. There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots. The proposed septic system will not change the general slope of the area. Pouding and/or concentration of surface runoff will not result from this installation. N k TRACT A VACANT FOBBEN SPURKLAND P.E. II II 203 W 15TH. AVENUE ANCH. AK. 99501 f907) ~79-~91 ~ LOT 10 KINCAID HEIGHTS £EKLAS CIRCLE PAUL /dICHELSOHN SEPTIC SYSTEM DESIGN BATE: /dAY 27,195G SHEET: lis GRIB: 2222 TOBBEN SPURKLAND P.E. II II 20,3 W 15TH. AVENUE ANCH. AK. 99501 (907) LOT 10 KINCAID HEIGHTS REKLAS CIRCLE PAUL tdICHELSDHN SEPTIC SYSTEM DESIGN DATE: 4,1A Y 27, 1996 SHEET: 2/3 GRID: 2222 S tondord Trenches; £' Wide 27,5' Lon9 13' Deep 10' Sewer rock 3' Cover Cleon But 20 FT 2000 901 Septic tonk Cleon ZTut M/co Fi 140 Monltoc 10 Pt oF Septic NB SCALE Ex/st Ground 4' Min Cover ~ Tonk 2000 9oL septic tonk BE/VCH MARX GARAGE FLDDR ASSUMED ELEV, 100,00 TOBBEN 9PURKLAND P.E. II II 203 WlSth Ave Anchorage Ak 99501 ?77-~?lfl LOT 10 KINCAID HEIGHTS MICHAEl SERASH?Y REKLAS CIRCLE SEPTIC SYSTEM DESIGN ~^TE, MAY 2~ 1996 SHEET, GRID, 222~ T.SPURKLAND P.E. 203 W. 15th. AVE. SUITE 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 RECEIVED dUN 5 1996 MuniCjpaJity °t Anchorage Dept. Health & Human Services Dan Roth Municipality o£ Anchorage Division o£ Environmental Health Department of Health and Social Services 820 1 Street Anchorage, Alaska 99501 Subject: Lot 10, Kincaid Heights SW950398 June 5, 1996 Gentlemen; With reference to your "pink sheet" dated May 30, 1996. You are correct. The original design did not include a lift station. However in order to access the trench as shown by S&S, a lift station would have been required. The lot slopes are substantially steeper than the 3-5% shown on S&S siteplan. A ground slope of 20% from NE to SE is more accurate, placing the top o£ the rock of the original trench 8 feet below ground level. Also the mechanical room of the residence is in the SW comer of the house, making the proposed location much more desirable. The typo on the design sheet has been corrected from 16 to 13 feet. Yours PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16- 17 18 19 20 COMMENTS Municipality of Anchorage DEPARTMENT OF HEAL-TH & HUMAN SERVICES 825 "L" Street, Anchorage. Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LoTto Township, Range, Section: SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? S L IF YES, AT WHAT O DEPTH? p E Depth to Water Alte?.! .'~/.~/,~ ~ Monitor;no? ~ Date: Reading Date Gross Net Depth to Net Time Time Water Drop FIt,~ PP-~$~AI< ~ I 7¢.~ 1~ PERCOLATION RATE / (minutes/inch} PERC HOLE DIAMETER TEST RUN BETWEEN ~' FT AND ~ CZ.. FT ACCORDANOBW'T"'ALLB','ATBAND,,,,.,N,C,PA, ,.,,OEL,NE$,NE,,EOTON-,,,$D^TE. ':'AT,'. /",/¢'¢f0. 72-008 fRev. 4/85) T.SPURKLAND P.E. 203 W. 15th. AVE. SUITE 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 RECEIVED MAY 2.9 1996 Municipality of Anchorage Dept. Health & Human Services Municipality of Anchorage Division of Environmental Health Department of Health and Social Services 820 1 Street Anchorage, Alaska 99501 Subject: SW950398 Lot 10, Kincaid Heights, PID 01112210 May 27, 1996 Gentlemen; Due to elevation conflicts and the need for a lift station to install the septic system as originally designed, a revised design is submitted. The location of this system is down slope from the residence, thereby eliminating the need for a lift station. A soil test was performed at the suggested location. Yours ROBERT C. COWAN, RE. ROBERTA. SHAFER, P.E. November 21, 1995 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 HEALTH AUTHORITY APPROVALS SEWER&WATER MAiN EXTENSIONS SEWER &WATER INSPECT[ON ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ONSITE WA~TEWATER OESIGN · ~,/,': MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 10, Kincaid Heights Subd. Request you issue a permit to drill a well and install a septic system to serve the proposed six bedroom house on the referenced property. A test hole was excavated and percolation test performed. The approximate location of the test hole is located on the attached site plan. At the time of exOavation no water was encountered in the test hole and after seven day ground water monitoring, the monitoring tube was found to be dry. This property has enough area for a future septic upgrade which can be seen on the attached site plan. We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the installation of the proposed septic system. There are no points of contamination within the proposed well radius which can be seen on the attached site plan. If you require additional information, please contact us. Sincerely, · Cowan, P.E. cc/gk Enclosure 17034 NORTH EAGLE RIVER LOOP - SUITE 204 ' EAGLE RIVER, ALASKA 99577 =50' SCALE [-~ SITE PLAN I DESIGN ~ 0 -~-- ~ ZO ~ ~ ~o ~,~ ' 0 ROBERT C. COWAN, RE. ROBERTA. SHAFER, RE, HEALTH AUTHORITY . APPROVALS SEWER&WATER UAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROADDESIGN SOILTES¥ PERCOLATION TEST STRUCTURAL & MECHANI¢~AL INSPECTI£ NS ONSITE WASTEWATER DISPOSAL SYSTEM DESIGN ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 REFERENCE: Lot 10, Kincaid Heights Subd. November 21, 1995 GENERAL: 1. e e De The scope of this project includes the installation of a 2000 gallon septic tank and leachfield trench to serve the proposed six bedroom residence located on the referenced property. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. The contractor shall be responsible for obtaining any necessary underground utility locates. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. ~EPTIC TANK INSTALLATION: A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. Ail standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 17034 NORTH EAGLE RIVER LOOP ' SUITE 204 . EAGLE RIVER, ALASKA 99577 Page Two Lot 10, Kincaid Heights Subd. November 21, 1995 e e Septic tanks installed with less than 4 ft. of cover shall be insulated. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: me Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed-up) before gravel (sewer rock) placement. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. Page Three Lot 10, Kincaid Heights Subd. November 21, 1995 Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. MINIMUM MATERIAL SPECIFICATIONS: Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. e Se The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast Iron ASTM D3034 (PVC) ASTM F810 (HDPE) ASTM D2662 (ABS) Yes Yes Yes Yes Yes No Yes Yes Use of a type of pipe other' than listed above must be approved by the inspecting engineer. Insulation shall be at least 2" thick extruded direct burial PolYstyrene (Dow Chemical Company Styrofoam HI or equal). Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. Ail leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the ~200 sieve. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements. Page Four Lot 10, Kincaid Heights Subd. November 21, 1995 INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3o The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre-construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. Page Five Lot 10, Kincaid Heights Subd. November 21, 1995 S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: P~TL~/~.~' ~n ~¢'t}4/.p ..~'~C. LEGAL DESCR~PTtON:ZO+ I O j X'",',,,,c,~,',/ /'/,,.~. 1 2 3 4 5 6 7 8 9 10~ 11 12 13 14 15 16 17 18 19- 20- DATE PERFORME~: //--/-- ~ - Township, Range, Section: SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? : /1/O IF YES, AT WHAT DEPTH? Depth lo Water After Monitoring? N I Reading Date Gross I Net Depth to Net Time Time Water Drop I I0~'' //-/'~ q:/~ 0 I0" y:/~ I /~" ~/~ ~ : ~1 ~ / ~ ~ v/~ _ PERCOLATION RATE ~ (minutes/,nch) PERC HOLE DIAMETER '[EST RUN BETWEEN ~' FT AND '~ FT COMMENTS S & S ENGINEERING ~ -~~" ~f~-- CERTIFY THAT THIS TEST WAS PERFORMED IN PERFORMED BY: ~/-~4 Eagle River Loop Road No. 204 ACCORDANCE WlTl~Je ~,~'~/jl~s~llJ~i~i~L GUIDELINES IN EFFECT ON THIS DATE. DATE: // / ~1 / ~ ~ 72-008 (Rev. 4/85) MunicipalityofAnchorage REQUESTFORVOUCHER CHECK Health & Human Services FROM: (DEPARTMENT) TO: MUNICIPAL CONTROLLER · DATE: December 11, 1995 1. R 37493 THIS SECTION FOR ACCOUNTS PAYABLE USE ONLY 1099 VOUCHER NO. PAYMENT DT. V VENDOR NO. REFERENCE NO. INVOICE DATE INVOICE NO. CHECK NO. CHECK DATE PREP APPR REQUESTTHATAMUNICIPALITYOFANCHORAGECHECKBEISSUEDTO: Name S & S Engineering 17034 Eagle River Loop Road, Suite 204 Address Eagle River, Alaska 99577 2. THISPAYMENTISFORTHEFOLLOWING(SUBSTANTIATIONATTACHED): Lot 10 Kincaid Heights S/D: Applicant applied for a On-site wastewater disposal system and well permit to install on the property. However, the property is being serviced by public water and the applicant is planning to connect to the public water supply therefore the well permit portion is not needed. / 3. DISPOSITION OF CHECK: (1) ~MAILTO PAYEE (2) [] MAIL TO PAYEE W/ATTACHMENT (3) [3 NOTIFY PAYEETO PiCK UPIN TREASURY Name: Phone NO.: 4. ACCOUNTS TO SE CHARGED: AUTHORIZED USE ONLY (6) [] NOTIFY DEPARTMENT EMPLOYEE WHEN CHECK IS READY IN FINANCE Name: Org. No.: Phone No.: ITEM ENTER ALL POSITIONS OF ACCOUNTING DISTRIBUTION NO. DESCRIPTION Or /CC A~Ob , Task : Opt ' Cast Ctr. WA/WO AMOUNT 1 On, S .re Wz]i P_~:m',t 57(' '" :9:4'2'3: ' ' ~ 120 00~ J .... ~?..: -, 120 5. TOTAL AMOUNT OF CHECK $ 6. SIGNATURES (~ ~ ~ ~C~-~ ~'(~'-~-.~',o v~, 343-4744 Employee ~-~ Phone No. Approving Authority 7. INSTRUCTIONS a. To be used only when payment cannot be made by purchase order, travel expense report, travel authorization or petty cash. b. Must be approved by department head unless approval authority is delegated in accordance with Policy and Procedure 24-7. c. Retain carbon copy for your file. 40-001 (Rev. 2/91) MOA #15 : MUNICIPALITY OF ANCHORAGE Department of Health & Human Services On-Site Sewer/Well Permit Application NOTE:Applicafionrnustbefilledout~o_mpletely, /~ .SINGLE F~MILY DWELLING ' Property Owner Name Mailing Address Legal Description Parcel Identification Number Day Phone ..C' r~ ,~ ~ I / '7 (2 Zip Oode Lol Block Section Township Lot Size , a / , ' ' Acres~'~J Inspections will be conducted by: Number Df Bedrooms: ~o >( Approved Engineering Firm L_~ ~ ~.z~ ¢~.~ ~:~ ¢~z::zL Municipality (permit fee included) ~ Does your house contain any of the following: Hot Tub, Swimming Pool, Therapy Pool, Jacuzzi, or Water Softener Unit? If yes, which one? This application is for: Sewer Only :.8~er}~nd Well ~ ~ ~ewer Upgrade Well Only I cedi~ that the above information is correct. I fu~her cedi~ that this application is being made for a Siogle Family and in accordance with applicable Municipal codes, . S & S ~GINEERING /~ / ~ ~ ?~ ~ ~C,, ~ ~ ~~ 170~ Eagle River Loop Road No. 204~ ~ ~ ~~ ~ ~ ~ p~%~ ~ ~,~b ,~-~[-fi~agle Riv~, Alaska~wner~ell Driller 72-012 ~Rev. 10/~6) Municipality of Anchorage ~ OS-- DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Services Division Telephone: 343-4744 ON-SITE SERVICES FEE DOCUMENTATION Date Paid: tY"-"~'~ -- ~::~t~"'"- Permit Number: Name of Payer: (.N,ame off Check) ,~' ~ ..~ ~-----~-~c~_~~ 2 ' Receipt #: /-'// 7/-/- M. ailing Address: ~Off~of qheck) ..~/' Legal Description (s): ~ ~ 01496 Type of Payment: (Indic~ate Amount I~aid) ~' ~C")/_.~LO ..~ealth Authority: fi--- ~/~c/T~' ~,/) Excavator Permit: 'Sewer & Well Permit: Well Permit: Sewer Permit: Copy Request: 72-034 (Rev. I0/87) Engineer Permit: Pumper Permit: Well Driller Permit: Tank Manufacturer: (Waste Treatment) DISTRIBUTION: WAIVERS: Lot Line: Well to Tank: Well to Field Field to Surface Water Tank to Surface Water WHITE--MASTER FILE CANARY--PROGRAM FILE ROBERT C. COWAN, P.E. ROBERTA. SHAFER, RE. HEAl.TH AUTHORI'IY APPROVALS SEWER&WATER . MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOWTEST SITEPLANS ROAD DESIGN SOILTEST PERCOLATION TEST ST R [,tOT U PAL & MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSALSYSTEM DESIGN December 7, 1995 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 RECEIVED MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 DEO g 1995 Municipality of Anchorage Dept, Health & Human Services REFERENCE: Lot 10, Kincaid Heights Subdivision Request you revise the permit issued to drill a well and install a septic system to serve the proposed four bedroom house on the referenced property. It has been brought to our attention that city water service is at the referenced property and the property owner intends to connect. Please revise the referenced permit to onsite sewer only and refund $120.00 for the well permit application. If you require additional information, please contact us. Sincerely, Robert C. Cowan, P.E. RCC/gk Enclosure 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 z I o.%_