HomeMy WebLinkAboutKIRK LT 1
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Environmental Health Division
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Name DISTANCES
~ ~ ~'~ ~ Tn SEPTIC ABSORPTION
~d~FROM~ TANK FIELD WELL
LEGAL DESCRIPTION LOT LINE P/o / ~/~ / ~" '
LotI Block Subdivision
/ I ~/~ ~' ~ ~ ~, FOUNDATION ~ ~ '
Township, Range, Section AS-BUILT DIAGRA~ (Show Iooation of well, sepbc system, ~ropedy lines, loundation,
~/~ ~ ~ / ~ ~ ~, ~ driveway, water bodies, etc.)
TANKS ~ ~
Manufacturer Capacity in ~allons
M~eri~l No. of Comp~men~s ~ ~ ~
TYPE OF SYSTEM ~
TRENCH G BED W. DRA N OTHER
Depth tO pipe bottom from Total depth from original grade ~ ~
original grade ~ FT ? FT ~ X
Fill added above original grade Gravel depth beneath pipe
Gravellength Gravel width ~ ~
Total absorption area Distance between lines X
Number of lines Soilrating~ J~ SQ FT Pipe material~r~ 'o' ' ; ~'/' / / ~
WELLS ~ ~ Lr?
~ PRIVATE ~ ~ OTHER (Identifv) -..x ~
/
/
Eagle River AK 99577
~~ caddy thai Ih~s ~nspe~ on was pedorme~ according to all
Municipal and Slate guidelin, in elfect onthis date: ~ ~ ~ ~
Health
Depadment
Approval:
72-013 (3/85}
~ ( J bJi' i E:) P .)
~qunicipa~ity of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
PERFORMED FORi
LEGAL DESCRIPTION:
6
7
8
9
10
11
12
13
Township, Range, Section:
SLOPE
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Depth Io Water Alter
.onitoring?
14
15
16
17
18-
19-
20-
Gross Net Depth to Net
Reading Date
Time Time Water Drop
~;¢J7~ ~o ~ ~ ~ t,l~
TEST RUN BETWEEN ~ T AND ~ FT
' I' I ka 99577
72-008 {Rev. 4/85)
by
DOC Co, dba
SULLIVAN WATER WELLS
P.O. BOX 670272, CHUGIAK, ALASKA 99567 · TELEPHONE 688.2759
ADDRESS i o :7%/~
LEGALDESCRI~ION--,4;'t J r%it('td~ O0~.~dD
DATE-Started ;' ' ' ;: ':~ Ended
PERMIT NUMBER
STATIC LEVEL OF WATER Fl-.
DRAW DOWN FT.
GALS. PER HR __ /
KIND OF CASING
KIND OF FORMATION:
From ;; Ft. to ~>? Ft. ~/~,,!, ,~J G a 'i c, i~ . From Ft. to Ft
From ,7~ Ft. to Ft. r) ,~t~'/~ /2:. o,;~z/:::', ,d :From Ft. to Ft
From ~:~ Ft. to ~'7 Ft. ///~ff~/eT~,~ fi Coho ff~g From .Ft. to Ft.
From ,)' ,,. Ft. to
From.~ Ft. to Ft.
[~, i~ ~Z. From Ft. to Ft
-
From -3 [ Ft. to" G .Ft. ~"T ~ ~ ~,/~],aff~rom~Ft. to~.Ft.
From / / Ft. toC~'~;'~ Ft. ([2~:q/ x, {~;~r~,d~-t From~
From 0'-::~, Ft. to~/ ~ 0 Ft. ,/~-Z,r,9 /%q*~.J , ~ /'; ;~ ~.~: ~?,-~'~"From Ft. to Ft.
From [iO Ft. to [..~[ Ft. /~4'~2,~'J(; ~Zg~6r'b'57~ From~Ft. to Ft.
From ]'~'/ Ft. to,~
From - Ft. to Ft.
From_ Ft.
From ~ Ft. to Ft. _ From~. to Ft.
From Ft. to__Ft.- g~ ~'~ V~ Ft.
From~ Ft. to Ft.
From .Ft. to _F, Fr ,~t Ft
MISCL. INFORMATION:
DRILLER'S NAME ~" ' ' '
unicipality of Anchorage
Department of Health and Human Services
" 825 "L" Street
Tom Fin~,
Mayor P.O. BOX 196650 Anc..horage, Alaska 99519-6650
343-4744
January 9, 1989
Kasey Correia
PO Box 771658
Eagle River, Alaska 99577
Subject: Lot 1 Kirk Subdivision
Permit #880157, P.I.D. ~050-581-27
A permit issued,by~this Department ~'or an individual well
and/or on-site sewer system has expired as of December 31,
1988.
Permits are issued on a calendar year basis by authority of
Municipal Ordinance. A new permit must be obtained from
this Department for any well and/or on-site sewer system
not installed by the expiration date.
If you have drilled the well, a well log needs to be sent to
this Department for documentation of the installation and to
close the permit. ~
If a private engineer inspected the installation of the
on-site sewer system, the orginal as-built inspection report
(three-part form) must be sent to this office for review and
approval, and for documentation.
When applying for a new permit, the fees are: $90.00 for
an on-site sewer permit; $50.00 for a well permit; $140.00
for a combined sewer and well permit.
If there are any further questions, please call this office
at 343-4744.
Sincerely,
Daniel J. Roth
Acting Program Manager
On-site Services Section
DJR/ljw
enc: Copy of Permit
M U N I C I P A L I T Y 0 F A N C H 0 R A G E
Depar'tment c~f Healt:h & Human Sepv.ices
825 L St~eet, Anc:hopage, Alaska 99501 .]143-47R0
CIN--SI'I"E SEWER & SEP'T'IC "FANI< & WELL. F:'EF:,"MIT
Pep.mit Number': ,.c38C~15'7
Date
Engineer' Designed
O~,,.~nep Name.· KASEY CORREIA
Ortner' Addpess: PO BOX 771658
EAGLE RIVER, Al<
99577
Papcel Id,: 050-.581-27
Lot. L..ega].: Subdivision: KIRK L.o{: 1 Block:
Sect.:Lan~ :32 ]"c~wr~ship: 14N Range
Lo'L Size 12'.Z~812 (sq. ~t,. o~' acpes)
Hax Bedr'ooms; This F'er. mit,: 3 Tot. al Capac:ity~
Day
696-0846
INSTALL F'ER ENGINEERS DESIGN A TRIENCH 'TYPE: ABSI]RPTION SYSTEM.
LENGTH: 42'; GRAVEL DEF'TH: 5'; MAXIMUM DIEF:'TH: 9'
T'HIS PERMI]" I!.:~ ISSt.JED FOR A 3 BEDROOM SINGLE F'AMIL. Y RESI'DENCE
[)NL..Y AND'EXI::'IF~ES :L2/31/88. IqOT]:F'Y DHHS PF;'.IC)R TO ALL INSF'EC'TIONS
I CERT'II='Y THA'T:
1. I am familiar' with 'Lhe reciui?ement, s fop on-.sit, e sewer's and wells as set
¢o~'f..h by the Mun:LciPali-Ly o¢ Ant:borage (MOA) and t. he State c)f A].as!-::a,
,: .... I will inst. all t. he systef il"l acccmdance with ali MOA cc)des and r'egulat.:i.c)ns,
and in compliar~c:e with the des:i, gn cpi'Ler'ia o~' this pepmil:,,
3. I w:L].], ac:lher'e 't'..c) all MOA and State (:)f Alaska pe(::tuir'emer~ts ¢(::m t. he set back
d:i.s'Lances f'r'om any ex:i. st:i. ng we].l, wsst. ewa'Ler' disposal system op public
~ewer'age system on 'Lhis ot" any adjacent (::)P neapby lot.
I unde~*~'Land tha'L t. his per'mi'L :i.s valid f'cg~' a maximum of 3 bedrooms,, I
also under'star'~d t. hat the capacity of' the t. otal system is 3 bedr. ooms and
any enlar'gement will r'equipe:, an addit, ional pe~*mJ.t.
Issued Bv
SEPTIC TANK: Minimum total septic tank c:apacit, y: 1,000 gallons. Each septic
t. ank must have a'L least. 2 compar'tment, s. Dep'Lh 'Lo t.c)p of' septic t. ank(s) < 4,,0
¢ee.t pE, cjt..tir'es inst..tla{~or') ovep
WELL: Leg riit..t~t, b(f~ ~iLiblll¢.t.t. ed t.o Mur'~:i. cipal:Lt.y of Anc:hor. age Depar.{ment of Igealt. h
~).l]d Hu. liiaFI Sepvic:es w&thin 5()days of well comple'Lion.
SCALE .
PERFORMED FOR:
LEGAL DESCRIPTION:
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5
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9
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19
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Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
DATE
Township, Range, Section:
SLOPE SITE
- /
WAS GROUND WATER
ENCOUNTERED?
S
L
IF YES, AT WHAT O
DEPTH? p
E
Depth 1o Water After
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE ((2-~7 '-~(minutes/inch) PERC HOLE DIAMETER If) g
TEST RUN BETWEEN ~ T AND ~ FT
$ & S ENGINEERIN~
72-008 (Rev. 4/85)
MON~2
LEGEND
NOTES
N OTAR'¢S ACKNOWLEDGEMENT
MY CO~J$$~N EXPIRES
SURVEYORS CERTIFICATE
DTI000849 ' ' ~
LOTS
KIRK SUBDIVISION
1986"956