HomeMy WebLinkAboutMEADOW BROOK BLK 1 LT 5Nte=dow ook lock I Lot 050-191 -34 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT PHONE [] NEW i DISTANCE TO: /Well Manufacturer Manufacturer WeN DISTANCE TO: No, of lines Length of each line Top of tile to finish grade ~ J Length ~: F-_ / ~f crib U~ . D I ST,~.N__C.~ TO: ...j JC~as~// ~ / DISTANCE TO: Absorptioa area Inside length Dwelling Dwelling Widtl~ Material Foundation Nearest lot line Total length of lines Trench widtb NO. OF BEDROOMS No. of compartments Liquid depth PERMIT NO. Liquid capacity in gallons PERMIT NO. Distance between lines Material beneath tile Total effective absorption area inches Width Depth PERMIT NO. Crib diameter Crib depth Total effective absorption area Well Building foundation Nearest lot line Depth Driller Distance to lot line PERMIT NO. Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MAT E R I A~S) D~/~- SOIL TEST RATING INSTALLE~ DATE LEGAL FIF'PL I Ci:::tNT DEF:'IIq DEL. UC I I::1 L 0 C Fi '1" I 0 N LECJFIL [>EPRF'.THENT HEF:iL. TH F. IN[:, EI'.,I'v'IRONMEIqTFIL. .OTECT 825 '"L." STREET, lat'.,ICHOF.:F:iGE., Fhk'.'. :S!:, EE il..,41 E: IF, e.' [I.....~ F:" CSi BOX 2::3:4 EF:IGL. IF: RI',,,'ER E;S, 4-:~:42.4 L.O'T 5 BL.K :L I'"IERE:,OHE:ROOK SUB LOT SZZE :~'99'_::,99 '.'-:]QLtI:::tF,~:E F:'EET 't"'¢F'E OF SOIL RBSOF.:F']"ION ::Il;'¢STIEH IS: ]"RENCH i'IFI;:<IHLIH I'.,It..II'"I[.:.'~EF,~: OF' BE[:,I:;;:OOi'IS = SOIL RI::~TING ,::Su:;! FT,.."BR)= :1.25 THE F.'.'EQU ]1 RE[;, :51 ZE (:iF THE SO I L I::IEL?,ORPT I ON S"r'STEH t "2;: THE LENG]"H [:.:, I I"IENg.'I: Ol",l 1:5 THE I...Ei",IG'FI~.I ,:: IIq FEET) (:iF THE TRENCH Cfi;.: [:'RFI I I",tF I EL.D. THE DEPTH OF FI TF.':ENCH OR PIT IS THE E:'tSTFINCE BETHEEN TFIE SURF'FICE OF THE GROLIND I::IND T'HE E',OTTOM OF 'I"H["~ E::'::E:F:I',,,'FITZQN ':::[i"4 FEET). -FHEF.:E I:.T, NO SET HII}TH FOR TF::Ei',tCHES. THE GRff,,,'EL DEPTH ]:S THE M.T.I'.,t.'[MIJM E:'E:'F'TH OF GF..'R',,,'EI... 8ETHEEI'.,I THE OU'[.FFIL. L PI I:::'E F:IN[> THE BO'TTOH OF THE E;:'::Cff,,"I::ITZCd'.,I '.':ZI",I FEET). F;': E: Cq iL..ti Z FEi: IEL' ii:D' ~i5 E£ F" -'F]E C: ']t'- II:':::~ il'-4 il---:: :rE;; Z ZL' ilF_Z = :::L. ,:Z, ,.~.D (E~ C:ii IF:It L. E_ C} thqt S; PEt'4:I'"I I T F~F'PL. I CF:II'.,IT HI::IS THE RESF'ONS I E: I L. ~: T"," TO INFORM ]"Fl I S E:,EF:'IaF.:Th'IENT DUR i'I'-,IG THE i'NS]'FILM::FFIEtN INSPECTIONS OF F'thl'¢ I.,JELLS RE:,,.TFICEI'.,IT TO ]"biZ'.:, F'ROPEF.:T~-r' FINE:' THE i'4UI"IEfiEF:'. O1:::' i':~:ESI[:'[.::NC:ES THFtT THE HEt...I.... !.,.!.~1..I._ 'E, ER'v'E. -il- I!-..Jt Ctl ":." ;;;2-' .":" %" II"q :=~ F" E CZ: T' Z C) ~"-,11S 11..'::~ E';~." E': It~." EiE ~.';-::." ILtl ]: il::;...':, ilT~_~"' E',RCKFILI...ING OF l::ll'.,l'-r' S"r'STEM I.,.II]'HOU]" F:'INF'IL INSF'EC:TZFiI'-,I RN[:' FtF'F'RO',,,'RL E:V'r' THiS [:'EF'R[;~t"i"i'IEi",I"F 14 :[ LL. BE SUE',JECT "FO F'ROSECUT I Oi",1. HINiMLtH DISI"F:II',tC[::". 8EI"HE:EI',I FI !4EL. L FqI',ID Fllq"r' OI",I-'.E;ITE '-:;IE.iqRGE DISPOSFtL Sh"STEM IS J. En3 FEET FOR I:1 PF::I',,"FITE I.,.IELL EiB: t. 5'3 TO 2EIE* FEET FROM FI F'UE:LIC 14ELL DEPENDING UF'OI'.,I TiaE Th':PE ,_-iF F'LtE:Li'C 14EL. L. M:[NIHI..IH E:,J:STF~I'.,ICE FRC3M l-.] F'i::::.~',,,'F:I'I"E I.,.!EL.I.. TU FI F'RI',,,'F:ITE SEHER LINE IE, 25 F'EET RI'.,I[:, '1"0 l::i COMHI. JNI'I"'-r' SE,WEF.': L. II",IE IS 75 FEET'. 0THEF.: F.:EQLIIF-':EMEI'.,ITS I"1F1'¢ FIF'PL"r'. SPECIFICFtTiONL:."; FIND E:OI',I:-':;TRUCTi'ON [:'TFIGRFIMS FIRE F:I',,,'R I MaE',L.E TO Z NSI..IRE F'F..'OF'ER I I',ISTFILLFIT Z ON. I CERTIF'.r: THF:I]' t: :[ F:ll"l I::'FII'I:[L.]:RR HITH "['FILE F.:E'ti:!LIIF..:EHEI',F[.S FOR Oi'.,I-::ql]"E SEHER!E; FIND t.,.IELLS F3S SET FORTH E:"r' THE HUN t C I F'FIL I T'¢ O1:: Ri",ICHOF.:RGE. ;'2: i ,WILl_. Ii",I".E;TIaLL THE S'¢'-:':TE!q ZI",! RCCOR[:'RNC:E HITH ]'PIE CODES. 3:: I L.tN[:,ERSTF~Nt} THFI]' THE ON-SITE SEI,.IER S'¢STEM MFI"¢ RE6.!UIRE EI",ILRRGEHEf",IT iF:' THE RESIDENCE ZS REHODELED TO INCLUt}E t'"IORE THRN .]: BE[:'ROOHS. ,~\:,GREA rjr ANCHORAGE AREA BOR~JGH Department of Environmental Qualitv ~'~ 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE FROM WELL INSIDE LENGTH MANUFACTURER __ --~Y/-P,I,~,~'Z MATERIAL NUMBER OF / COMPARTMENTS __INSIDE WIDTFI_ LIQUID DEPTN LIQUID CA PAC I TY~-2~GAL LON S. TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER OF LINES / ABSORPTION AREA DEPTFt: DISTANCE BETWEEN LINES __ TRENCH WlDTH,~ _ IN. TOTAL EFFECTIVE TOP OF TILE TO FINISI-I GRADE MATERIAL BENEATH TILE ~/~_ / ___IN. ABOVE TILE_ IN, WELL.: , / bb/~) t~'~'[ TYPE .~.~2 /f///v/I/L')/~l'~'~g CONSTRUCTION BUILDING FOUNDATION__ CESSPOOL APPROVED ___ NEAREST LOT LINE __ OTI-IE R SOURCES __ DISAPPROVED DEPTH NEAREST SEPTIC SEEPAGE SEWER LINE__, TANK SYSTEM._ REMARKS DISTANCE FROM: DISTANCES: INSTALLED BY: SEWER LINE DEPTH: PIPE MATERIAL:d~ LOT SLOPE: [REMARKS: DIAGRAM OF SYSTEM G.A.A.B. GRE~ ;R ANCHORAGE AREA BOB. JGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 INSTALLATION LOCATION LEGAL DESCRIPTION ~"~- ~T¢~'~ ~NSTALLATION OF: SEPTIC TANK SEEPAGE PIT ~ , D~AIN TYPE AND SIZE OF FACILITY TO SE SERVED ~ &/~ ~ ~~ FINANCED THROUGH SEWAGE DISPOSAL SYSTEM-- APPLICATION AND PERMIT OTHER TO BE INSTA LED COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION, BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE /~)d yp ~ ' . . SIZ~ ~ -- TYPE -- FOUNDATION TO SEPTIC TANK FOUNDATIGN TO SEEPAGE PIT .. DRAIN SEPTIC TANK TO SEEPAGE PIT WALl SEPTIC TANK ., SEEPAG PIT __ DRAIN WELL TO SEPTIC TANK ----~'~ SEEPAGE PiT DRAIN FIELD .,//~'~ ~ , ALSO CONSIDER AREA WELLS, WATER MAIN TO SEPTIC TANK , SEEPAGE PIT DRAIN FIELD TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT PITTED wI'rH AIRTIGHT REMOVABLE CAPS. CONFORM TO BOROUGH REGULATIONS rEGARDING INSTALLATION. I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ~NCHORAGE AREA NO, 28-68 AND THAT THE ABOVE : ,( Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www. muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. GENERAL INFORMATION Complete legal description Location (site address) Expiration Date: Meadow Brook S/D, Block 1, Lot 5 10942 Iditarod Circle, Eagle River, Alaska Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing Address James or Cynthia Steward _Day D~on~_(907) 240-5176, 862-2178 Day phone Audrey Mason of ReMax of Eagle River 11525 Old Glenn Hwy., Eagle River, AK 99577 Unless otherwise requested, COSA will be held by DSD for pickup. NUMBER OF BEDROOMS: 3 Day phone (907) 622-3344 TYPE OF WATER SUPPLY: Individual Well [] Individual Water Storage [] Community Class ~ Well [] Public Water System [] TYPE OF WASTEWATER DISPOSAL: Individual On-site [] Individual Holding Tank [] Community On-site [] Public Sewer [] The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request tO homeowners. Certificates of On-Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I vedfy that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) 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(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Douglas T. Kenley, P.E. Address 9806 E. Northstar Circle, Palmer, AK 99645 Engineer's Printed Name Douglas T. Kenley DSD SIGNATURE Phone (907) 746-1073 Approved for .~-- bedrooms Disapproved. Conditional approval for bedrooms, with the following stipulations: S~'.' 0N-SITE ~ ~: ~ATER AND ~ ,. PROG~M .. .... .. Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory By: (Rev 11105) X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other ,~Z~L'*/v(-./~/-~'O rig in al Certifi cate Date: q -/fi--// Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastawatar Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL C'HECKLIST Legal Description: Meadow Brook S/D, Block 1, Lot 5 WELL DATA Parcel ID: 050-191-34 Well type Public If A, B, or C provide PWSID # Well Log (Y/N) completed Sanitary seal (Y/N) . Wires properly protect~f~ Date Total depth m .ff. Cased tom __ff. Casing he__ground) in. FROM WELL LOG ~CTION Date of-test ~ ~__ Static water level ~~..~--'~ ~__ ft. Well production g.p.m. ~__ g.p.m. WATER SAMPL~ Coliform ~ colonies/100 mL Nitrate mg/L Collected by: Al~'nic: ug/L date of sample: Tank size 1,0o0 gal. Foundation cleano_u.t (YIN) Y Date of pumping 5/16/11 C. A~ION FIELD DATA SEPTIC/HOLDING TANK DATA Tank Type/Material .. ' Septic/Steel Number of Compartments 2 Depression over tank (Y/N) .. N Pumper Date installed 5/5/83 Cleanouts (Y/N) Y High water alarm (Y/N) NIA JRs pumping Date: installed 1 i/7/75 Soil rating (g.p.d./ff2 or ~/bdrm) Length ' 33' ~' . · ft. Width 3 Total depth 10 ft. Eft. absorption area 396 ft2 Monitoring tube. Y Date of adequacy test , 6/14/11 Resultsl (Pass/Fail) Pass Fluid depth in abSOrpfion.~eld befor~test 0 'in. VVateradded 500 gal. Elapsed Time: .36 min. Final fluid depth 0 in. Any rejuvenation treatment (past 12 mo.) (YIN & type) N System type Trench ft. Gravel below pipe 6 ff. Depression over field N For 3 bedrooms New depth .0 irt. Absorption rate >= 450 g.p.d. If yes, give date ..... D. LIFT STATION Eo Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at . in. "Pump off" level at in. High water alarm level at ~'~~in. Datum ____ ~ Cycles tested ' Meets al~nts? SEPARATION DISTANCES ~ SEPARATION DISTANCES FROM WELL ON~..~..-~'''''~ Septic tank/lift station on lot ~ On adjacent lots AbSOrption field on lot ~ Se~er/septic service line Animal containment areas 50+ ft. On adjacent lots Public sewer manhole/cleanout Holding tank Manure/animal excrete storage areas 100+ ft. SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Buiidingfotmdafion 5ft. Property#ne 10+ff. Absorptk~fiekl 15 ff. Water main 1 0+ ft. Water service line 10+ ft. Surface water 95 ft. Wells on adjacent lots 200+ ft. COSA Fee $ Date of Payment Recent Number (Rev.,4/,~l~ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10+ ft. Building foundation 30 ft. Water main 1 0'i' ft. Water Service line 10+ ft. Surface water 95 ft. Driveway, parking/vehicle storage Curtain drain None known to exist Wells on adjacent lots 200+ ft. COMMENTS /" ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and. review of Municipal records that the above systems are in ~,,¥ ~,p~,',~) ~,~~ , ..._~r~ conformance with MOA COSA guidelines in effect on this date. Engineer's Pdnted Name Douglas T. Kenley P.E. ~J~C~ -- Waiver Fee 0~o' t ~/ ('.~. Date of Payment i c.~ {~ ~ Receipt Number ./z)//',4/~©D, SoP. 's ~ ~1GbLJIL ?" No do~s ~T. I hereby certify that I have surveyed the following described ~property, Lot Addition II~£~,DoW ~0o/C .~, ~c~ recordingl Precinct, Alaska, i and that the improvements situated thereon are withlnl the property line,I and .do nos' 0verlra.p O~ encroach on the property lying adjacent thereto, that no Improvements.on property lylng adjac,nt theret° encroach on the premises In question and that there are no roadways, transmission lines other visible easements on said property except as indicated hereon. Anchorage, Alaska ~~), Municipality of Anchorage '~,,,,~"'~, ~ ~i~'; P.O. Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 · (907) 343-7904 ® Fax (907) 343-7997 http:llwww.muni.orqlOnsite Development Services Department On-Site Water and Wastewater Pro.qram **** VARIANCE/V~AIVER REVIEW **** Waive¢: OSPl11256 COSA#: OSCl11333 PID#: 050-191-34 Legal Description: Meadow Brook Block 1 Lot 5 Engineer: Dou.q Kenle¥ Permit~: Applicant: James and Cynthia Steward Your request for a waiver of the required 100 feet horizontal separation fi.om the absorption field and tank to the surface water has been approved. The approved separation distance is 88' to the tank and 95' to the absorption field. This waiver approval applies to the existing absorption field only. Any future upgrade to the on- site wastewater disposal system will require all separation distances be met or another approval from this department. waiver is Granted: X Waiver is not Granted: Rec#: N/A Amount: Date Paid: **** VARIANCE/WAIVER REVIEW **** Douglas T. Kenley, P.E. 9806 E. Northstar Circle, Palmer, Alaska 99645 (907) 746-1073 September 18, 2011 Deb Wockenfuss Municipality of Anchorage On-site Services Department P.O. Box 19665,'2- Anchorage, AK 99519-6650 Re: Request for a Waiver Meadow Book S/D, Block 1, Lot 5 Project # 11113 MOA On-Site Services Representative: The septic system on the above-referenced property was installed in 1975. A record of inspection dated November 7, 1975, on file with the Municipality of Anchorage (MOA), shows that the existing leach field is only 95 feet from the adjacent Meadow Creek. This letter serves as a request for a waiver of the separation distance from the required 100 feet as recently requested by On-Site Services at the MOA. It is our opinion that a waiver of separation distance is warranted due to the length of the drainage path that effluent discharged from either the tank or leach field would take in order to reach the creek. The septic system is positioned on the north side of the residence and the creek is located to the south of the residence. We have taken field measurements of the drainage path effluent would have to take if it were to travel towards the creek in either direction around the exterior of the residence and provide the following: The drainage path around the east side of the residence measured approximately 120 feet in length, from the nearest point of the septic system (tank cleanout) to the nearest point on the creek. The drainage path is affected by the residence itself and a natural berm that lies between the creek and the leach field. The drainage path around the west side of the residence measured approximately~_--o~eet in length again, from the nearest point on the septic system (leach field) to the nearest point on the creek. The drainage path is affected by the residence itself and the natural slope of the land. We have attached a site plan of the property that shows the flow path from the area of the leach field and tank to the creek along both sides of the residence. We understanding from our recent conversations with you that this waiver may be obtained without a fee due to the fact that the system has been on file at the MOA since 1975 with the recorded separation distance between the septic system and creek at less than 100 feet. We appreciate your consideration of this request. Sincerely, ~ l_ ,'~' Doug Ken'lJey,~. E. tJ cc: James Steward Drainage Path 98.5' // , / ~ IDtTAROD C~RCLE Drainage Path 119' GRAVEL PARKING ~- _E FAMILY BEDROOM DOUGLAS T. KENLEY, P.E. civi, E.g, .... AS-BUILT cumin-: Steward, James LEC.~ Meadow Brook S/D, Block 1, Lot 5 ~ORESS:10942 Iditarod Circle, Eagle River, AK IPID NUMBER: 050--191--34 .... ~/1~/11 I ........ oTK 1 ..... ~K I ..... 1"= 50'I .......... 11113 ISHEET 1 of 1 DAT~:IECEIy ED INSPECTION APPOINTMENTS i~ ~dr'~ I,.J L, J qC'~ I TIME . TIME TIME DA'I-E DATE DATI: MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH &  DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIO[~vIP, ONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 (~t ENVIRONMENTAL SANITATIONTelephone 264-4720 DIVISION 0CT 71979 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWE~XI~I~I~I~"~ DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed, Please allow ten (10) days for processing. 1. PROPERTY OWNER I PHONE ~errill ~y~ch Relocatlo~ Management, ]:nc. (Damro~) I MAILING ADDRESS PROPERTY RESIDENT (If different from above) PHONE ·" PHONE 2. BUYER Ronald Collins MAILING ADDRESS Post Office Box 7329 99577 3. LENDING INSTITUTION [ PHONE MAILING ADDRESS 4. REALTOR/AGENT I PHONE Elliot Lawson % Jack White CompanyI 277-1553 MAILING ADDRESS 3201 C Street 99503 5, LEGAL DESCRIPTION Lot 5 Block 1 Meadowbrook Estates Subdivision STREET LOCATION 3150 Iditarod Circle, Eagle River, Alaska 99577 6. TYPE OF RESIDENCE NUMBER OF~BEDROOMS [] One [] Four [~ SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY ;~ Three [] Six [] Other 7. WATER SUPPLY [] INDIVIDUAL~ :~ COMMUNITY [] PUBLIC UTILITY * ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give Well depth (attach log if available.) --~,' SEWAGE DISPOSAL SYSTEM ~ INDIVIDUAL/ON-SITE~ [] PUBLIC UTILITY 11-7-75 YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED, THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE [~ SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OFBEDROOMS [] ONE [] THREE [] FIVE [] TWO [] FOUR [] SIX [] OTHER 2, WATER SUPPLY [] INDIVIDUAL [] COMMUNITY [] PUBLIC UTILITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM []INDIVIDUAL/ON -SITE []PUBLIC UTILITY Connection Verified []Septic Tank or [] Holding Tank Size: )O~_20 If Tank is homemade give dimensions: PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER DATE INSTALLED INSTALLER SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Absorption Area to nearest Lot Line Septic/Holding Tank Absorption Area Sewer Line INearest Lot Line 5. COMMENTS DATE [~ APPROV ED FOR -'~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED ~ 72-010 (Rev, 6/79) October 16, 1979 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO VA 2. Property Owner: Merrill Lynch Relocation Mgt. Inc. Mailing Address: n/a 3. Name of Buyer: Ronald Collins MailingAddress:~P:O. Box 7329, Ea~le River, AK 4. Name of Lending Institution: not yet established Mailing Address: 5. Name of Realtor or Agent: FHA (Damron) Day Phone: CONV XXXX n/a Legal Description: Location: Day Phone: n/a Phone:. Jack White Company ..... Elliot Lawson MailingAddress:_3201 c Street~ Anchorage~ 99503 Phone: 277-1553 Lot 5~ Block 1~ Meadowbrook Estates Eagle River .... take Eagle R%~er Road to Eagle River Loop Road turn left and go to Kantishna Drive (sign on electric pole)...turn left and take next left into Iditarod Circle .... home is at back of cul-de-sac street with Jack White sign on it. 7. Type of Facility to be Inspected: 8. Water Supply Type of Supply: Single-Fam. Home No. Bdrms. 3 Public Utility xxxxx Individual If Individual, number of dwellings presently served n/a If Individual, depth of well Sewage Disposal System Type of System: If Individual, date of installation n/a Public Utility. 11-7-75 Individual (on-site) XXXXX ADDRESS OF HOME TO BE CHECKED ..... 3150 Iditarod Circle .... Eagle River, AK 72-003(3/76) S i' A I ~ M ~ N October 1.9, 1979 Elliot Lawson % Jack White Company 3201 C Street Anchorage, Alaska 99503 Subject: Lot 5 Block 1 Headowbrook Estates Subdivision Approval for the individual sewer and water facilities can not be granted until the foil. owing items have been completed: (;) The cleanout on the septic tank needs to be raised above ground level. ~ ~ The septic tank pumped with a receipt submitted to this office. Please notify this department when the above noted descrepancy has been corrected for a re-inspection. If there are any further questions, please contact this office at 264-4720. Sincerely , Robert C. Pratt, R.S. Associate Specialist RCP/ljw October 4r 1979 A].aska .~3ank of Conu~erce Pouch 7-.012 /~chorage, Alaska 99510 Attention: Louise Subject: Meaf~o,~brook Water Supply The subject water system is approv~ by this ~!~apartment. If ther~ are a_ny further questions, pleaee contact this office at 264-~47~0, Sincerely, Les N. Buchholz, R.So Senior Environmental Specialist