HomeMy WebLinkAboutHIGHLAND TERRACE #5 TR 1-ENAME
MA~ LI N~-~AI~ DR ESS ,
LEGAL DESO~IPTION
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
82.5 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-81TE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
PHONE
[] UPGRADE
Well ! Absorption area / Dwelling
DISTANCE TO: ~:>~ ~/- Ma.Lecial
Manufacturer
Liq. in gallons IF HOMEMADE: Inside lengt.__~h. W dth
Well Dwelling
DISTANCE TO:
Manufacturer Material
DISTANCE TO: Well / /,5'- /''~' Foundationef~2~ ¢ Nearest lot line~?~,0 ~
No, oflines / [Lengt,ofW~. Totallen~l~,es Tr~n~,~,~j, i,,~b.s
Top of tile to finish grade ~.~ ¢ .~ Materialbeneatb tile m:~>
inches
Length Width 3epth
NO. OF BEDROOMS /~¢¢~L
PERMIT NO, ~;:Vh
No. of compartments .,~....
Lie uid deptl,~...~
PERMIT NO.
Liquid capacity in gallons
PERMIT NO, ,/~
Distance between [ines
Total effective absozl~Jon area
PERMIT NO.
Type of crib Crib diameter ib depth
Well Building foundation
DISTANCE TO:
Class
DISTANCE TO:
Total effective absorption area
Nearest lot line
Driller Distance to lot line PERMIT NO.
Sewer line Septic tank Absorptioe area(s)
OTHER
PIPE MATERIALS
SOIL TEST RATING
REMARKS
LEGAL
MUNICIPALITY OF ANCHORAGE
Department ~ Health and Environmenta. ~rotection
825 ~ Street, Anchorage, AK. ~9501
264-4720
* * * HANDWRITTEN PERMIT * * *
(~)¢
Permit # "~l~_o.Cl] WELL AND/'~,,. ON-SITE SEWER PERMIT
Applicant: ~-/ ~L/ /~~ Mailing Address:~f~//
Holding Tank:
Soil Rating(sq.ft/br) /~
Location:~ ~ ~- _ Phone Number:
Legal Description: ~6/ ~ ~-//g~/~
Type of Soil Absorption System Is:
Trench: / Drainfield: Seepage Bed:
Maximum Number of Bedrooms: ~
The Required Size of the Soil Absorption System Is:
DEPTH /~ LENGTH '-:~'?' GRAVEL DEPTH ~" WIDTH
The length dimensJ, on is the length(in feet) of the trench or drainfield. The
depth of a trench or pit is the distance between the surface of the ground and
the bottom of the excavation(in feet). There is no set width for trenches.
The gravel depth is the minimum depth of gravel between the outfall pipe and
the bottom of the excavation(in feet).
* * REQUIRED SEPTIC(HOLDING) TANK SIZE = /D~ GALLONS * *
Permit applicant has the responsibility to inform this department during the
installation inspections of any wells adjacent to this property and the number
of residences that the well will serve.
* * * TWO(2) INSPECTIONS ARE REQUIRED * * *
Backfilling of any system without final inspection and approval by this departmen-
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 fee'
for a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a community sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
* * * PERMIT EXPIRES DECEMBER 1 9 8 3 * * *
I certify that:
(1) I am familiar with the requirements for on-site sewers and wells as
set forth by the Municipality of Anchorage.
(2) I will install the system in accordance with codes.
(3) I understand that the on-site sewer system may require enlargement if
the residence is remode~to include more ~ 3 bed~s.
Signe~: ~,~,-'-~, 2, ,~'""'2'L~/',5?-..)//f Issued by~/~{~~ '
SWP/024(1/81)
PERFORMED FOR:
LEGAL DESCRIPTION:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15-
16
17
18
19
2O
COMMENTS
SOILS LOG
MUNICIPALITY OF ANCHOBAGEr,= ~-, r:~ n
DEPARTMENT OF HEALTH AND ENVIRONME~N~A~,'.J(~E~',~I~ ~Lt ~*~RCOLATION
825 L. Street, Anchorage, Alaska 99501 ~2~-~720
SOILS LOG - PERCOLATIONtl E'~T AUG 1 0
0 C--L, F'~rr',,I
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Gross I~
Reading Date Time Ti
re~-
"· ';~ PERCOLATION RATE
~,,"¢';!!'i,::;':~ ,' ,:- TEST RUN BETWEEN
PERFORMED BY; .....
72-008 (6/79)
Depth to
Water
(minutes/inch)
FT AND FT
CERTIFIED I~~/
Net
Drop
PERFORMED FOR:
1
2
3
4
5
6
7
8
9
10
/V-L )
/[~ SOILS LOG
[] PERCOLATION
TEST
11
12
13
14
15
16
17
18
19
2O
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
.~ .'.~
Date
PERCOLATION RATE
TEST RUN BETWEEN
Gross
Time
Net Depth to
Time Wate~
_-
(minutes/inch)
Net
Drop
COMMENTS
PERFORMED BY:
72-008 (6/79)
~ SO~ $ tOG
MUNICIPALITY OF ANCHORAGE
P¢IEN r oF HEALTH AND ENVIHONMENIAI. PI:;OIECTIONt- '
TESF
825 L. Street, Anchocage, Alaska 99501 25,%4720
SOILS LOG-PERCOLAIlON TESI'
6 -,
i
11~
/<
12
15
18-
20 -
SLOPE
I I1
I II
OWNER OF LAND
Al)DRESS
LEGAL t)ESCRIPTION
[)ATE - Started
PERMII NLJMBER
KIND OF FOI{M,\TION:
r
J;FOTll . Fl. ti) J:t _ J l(~iI1 !'~ i~,
From [:! to. FI.
From }:( [o .. irt. t ]'~)m ]q h)
J'I'OII1 }"| I0 ]:t }'I'IHq~ ~ t !;:
M!SCL. INFORM ,Vi ir}N:
APPLIC NT FILLS OUT UPPER HA[ ONLY
t~operty Owner t~' ~. ?.t,, ~: ~.-' ~- . . ""~ t / '
,/
Mailing Addre~ ;'~ 4~* '"- - ¢' - -, ~¢' '/ '
~.,;,.:, ~ ~2 2 r:.2~'¢~ f~' .~_ . ~ ,,~ ,. ~;~ Zip Code ~ S"-
Buyer 'L.7
Phone
Address Zip Code
t.ending Institution
Address Zip Code
Phone
Phone
t. egal Description
Street t.ocation
Type of Residence
/~,:Single Family
FI Multiple Family No. of Bedrooms
[] Other
Water Supply
~/~Q. Individual
17] Community ("
[] Public Utility ~.('q ~'
Sewer Disposal
/,.~ Individual
E~ Public Utility
L~ Holding Tank
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).
Year Individual Installed:
When Connected to Public Utility:
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
Time
[)ate
Inspector
Field Notes:
l'ime
Date
Inspector
Date
Inspector
Time
J Inspector
J bu,'ll .
? 7."C!VED'
( ' " ) APPROVED BEDROOMS
( ) [)ISAPPROVED
( ) CONDITIONAL APPROVAL*
[)ATE '
'CONDITIONS OF APPROVAL
Soils Rating
72.023 (3182)
Date Sewer Installed
Well To Absorption Area
Well to Tank ~' /..
J Well Log Received
Septic Ta.qk Size ~' .~ . ** ' ~ ',
,: :?' /