HomeMy WebLinkAboutHIDDEN HILLS BLK 1 LT 50// /2..I
Post-It" brand fax transmittal memo 7671 I #of pages ·
DEP/~
82~
ON-SITE SEWA( }RT
J/~NEW
ADDRESS
LEGAL DESCRIPTION
LOCATION NO, OF BEDROOMS
~ell ~ption area ~D~eHing PER~IT NO.
b~ I Ma~facturer ~ . ~Material , , No. ofc, ompartments
~' ILiq~ngallansl F H MEM DE nsd~l~n~th ------ J~d~l~ Lqudd~pt~
~11 lOO6 , o A : ~ _ ~ ~ z: __
DISTANCE TO- Well ~ Dwelling ~ _ PERMIT NO.
~ I Manufacm,e, ~ I Materia~ Liquid~apacity in gallons
a I ......... ,,Nell Foundation ~
~ ~ ~ ~ No. of lines ~ Length of each Hne Total length of lines ] T~cb width Dis[an~e between lines
~ ~ ~ To--de to finish gradez Material beneath tile Total effective absorption area
I ,7 inches
~ Length ~ Width / Dei~ ~ NO,
< ~ I Type of crib C~ib dF~ Crib depth Total effective absorption a~ea
~ ~ ~I B~ing foundation Nearest lot line
~ j DISTANCE TO:
~ IClass , Depth .~ ~ller ..~ D~stance to lot li~, ~IT NO.
~ ] ~ ....... ~ __ Building foundation Sewer line Septic tank I Absorption area(s)
__7~JDISTANCE TO: ~ _ /a~ ¢' _
OTH [-'R
PIPE MATERIALS
SOIL TEST RATING
INSTALLER
R EMAR KS
APPROVED
DATE LEGAL
DEPAI::RTHI~:Iq'I" OF:' HEAL.'I"H AND ENVIROIqMEIqTAL I='Iq[)TE[;TIOIxl
FI::?.5 I.... S'/'F~EET, AIq[',H(Z)RA(:;:~E:, AK 995C~ 1
264-472()
APF:'I.. :1: CAIq'I":
~ D D R E S !3 ;:
C[:)iq'I"AC'T l-HOI I1::. ,,
()'7 / 1 li!1185
BOB ALE INA C ~-~'-'z..-4/~--'Tff.,.__.., ~yt/C~.
:1.: 46 1 I"IAMPTBN
AIq[.,I"rIC) k(AE~E:~ AK c29[~ 16
· =,4,.,-'- 1 17()
I_EGAI.... DE:,,. ILl ~ I P"
LOT SIZE:
MAX BEDFII][]M[~:
SUBD I V I S ]: C)l,,I ,", H I DDE:N H ILLS
SEI:,T 101',1 ." 9 TONI',ISH I F:': 12.1',1
1040[71 (SQ.E'T', OR ACI~ES)
]LLOk, I... 1
RANGE :: 4W
I_:i. sted below ape the Ol::)t:i. ctns availal::,le to you :i.n designing your septic
system,, [',hc~ose -I'.he option ~;ha'L best f'its youp site.
DEI:::'TH TO F'IPE B[)'I"'TOM (1::'1':.) 4,, 0 z!., () Zl.,, ()
GI::;~AVEI_ DEF'TF.I (FT.) '7 ,, () 0.5 3 ,, 5
TO"I"AI.... DEP]]q (I::"T',) 1:1. ,, () ~.-- ~ 4 ,, 5 '? ,, 5
GRAVEl.... WIDTH (F']",) ,2,, 5 18,, 0 5,, ()
GRAVli:.].... I....ENI.'.;iTH (I="1".) 3 1, () ."" :155 ,, () 46, 0
GRAVli.:.I_ VOI_UME (CLJ ,, YDS. ) 2 1.6 ;:~]::~!; ,, 4 34 ,, :[
TANK !31 ZE (GAI....S) 1,0()(). 0 '~..~.' :1., 00(). () ,x.-~* J., ()00 ,, () .~..~.~.
!'.!;Oil. I::;~A'I'ING (S[;i,,F"I". /BI::;~) ;~..'..'.:1.2'~ 205 ,2:1.2
*~'~ 'I"ANI< MUST ["lAVE: AT L.I.EAS'I" TWCI COMPAI:~THEI',ITS
c e r' 'L :i. f y t h a t:
:1.'. I am ,~'am;i.].iar, w:i..l:.h the: Pequipemeni:.s for' on-...~;:i.t(c*: sewePs and wells as set
foi"i:.h by 'Lh[:~ Mun:i.c:i.l:~al:i.'l:.y caf Al']choPage (HOA) and 'l:.he S'Late of Alasl<a,,
2. I wi].l ins't, all the system :i.n accc:mdance with all MOA c:odes arid pegulat:i, or~s,
and :i.n cc:mil:)], ianc::e wi'Lb 'Llqe c:lesiglq ~r' J.t~l, :i.a i::~J' 'Lhis per. talC,,
3,, I w:i.].l ac:llqePe 't.o all MOA and [gH'..a'l:.e i::~'t' Alaska PeqLtiPemerrLs fop the ~.i~;et back
di~.iivl'.'&trqc:e!~ f'l'Oln any fy...q.,'J, stir]g wt.=9..1.]., 1,9,~?ts~;'l:.e:..q,'~,~'l'.t;'~.H- dJ.a~.posal system
sewepaCle system Ol] 'LhJ,~.[; t:,)l' ~:!l']y ad.jacerrL (::~[' near'by lot.
4,, I undePsi:.and 'khat this p(,:;',"Pf]lit :i.!~:; va'J,:i.d for' a max:i, mum c:tf' 2 I])£f)CIPC)C:)flI~.S;
any ,:~rl].al-!:j,::.)mel]t w:i.]..1, r'(:.+)l::lLlir'e afl ,~.~dl:lJ.'Lioflal
]:F:' A LIF'T E;TA'I"IOIq ]'q. .I. I I-::~IAI....L..[:.D IN AN AREA [',OVL:]:;:ED BY MOA BUII....DING [:ODES,
THEN (1) AN E. LI:.LII"~.I. CAL. F~ERMIT AND ].N,M"I=C¢IOIq MUST BE OBTAIIqED~ (2) AS'-BUII....TS
N:[I._I_ NO"I" BE A[ f'ld VED WITIql]I. JT ~N EI_ECTRI[::AL IIq~I::'I~B:','I"ION F~EFq]RT; AND (3) 't"I'JE
EI...ECTRIC~L WOFd... HUST BE D[INE BY A LIk,E.N,:~E.D
AF:'F't...ICAN]": BOB AI_BINA
P.O. ~'i¢~'
,:. ~.',( '3650
ANCHORAGE. ALASKA 99502-0650
(~07) '26,~-4.1 I i
DEPARTMENT OF HEALTH & HUMAN SERVICES
January 10, 1986
TO: Permit Applicant
Subject: Permi~ # 850419
Lot 5 Block 1 Hidden Hills Subdivision
A permit issued by this Department for an individual well and/or on-site
sewer system has expired as of December 31, 1985.
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 original as-built inspection report(three part form) must be sent to
this office for review and approval,and for documentation.
If there are any further questions, please call this office at 264-4720.
Sincerely,
Susan E. Oswalt
Program Manager
On-site Services
SEO/ljw
enc: Copy of Permit
HEREBY CERTIFY THAT I AM A
REGISTERED LAND SURVEYOR AND
'THAT THIS PLAT REPRESENTS A
SURVEY MADE R~Y ME.
BELTAINE C. KOZL~tSKI 2241-S
ASSUMED DAi'UM
AS--BULL:
BUILDING LOC.~TION
t_OT 5 B LOCK
HIDDEN idll..L~; SUBDIVISION
Beltmine C. Kozlow?~ki
4620 Emer(]id Couri
Anchorege, AK. 99502
DATED:IO~I4-85 SCAt_E: I"= ~0'
PERFORMED FOR:
LEGAL DESCRIPTION:
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COMMENTS
[] SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ~ PERCOLATION
TEST
825 L. Street, Anchorage, Alaska 99501 264-4720
so,.s.o _
DATE PERFORMED:
SLOPE
SITE PLAN
CE 5130
WAS GROUND WATER S
ENCOUNTERED? ~ .~//~. OL
P
E
IF YES, ATWHAT
DEPTH? ~
J~l Gross Net Depth to Net
tReading Date Time Time Water Drop
PERCOLATION RATE (minutes/inch)
U
72-008 (6/79)
WATER WELL RECORD
STATE OF ALASKA
OEPARTMENTOF NATURAL EESOURES
Division of Geological a Geophysical Surveys
Drilling Permit No.
LOCATION OF WELL (Pleoee complete elthlr la~ lb or lc.) A.D,L. NO.
J~.TI 0 lQ Er-] Meridian
.-ilZ ] 8 .5 1 --o~-- of__cf __ sE] wE)
~ DISTANCE AND DIRECTION FROM ~OAD INTERSECTION~ ~. OWNER OF WELL:
Addres~:
Street Addresl and Aria of Welt Location ~}d
2. WELL LOG Feet Below
Surface ~. WELL DEPTH: {final) 5. DATE OF COMPLETION
-- Material TXp. ' Top Bottom I~,~ ff.
__ ~Fown to'2 soil 0 4 6. ~Coble tool ~Rotory ~Orlven
dlam._{h In. to~ ft. Depth Wllghf ~ ~' Ib~./ff.I
9, FINISH OF WELL:
, Slot/Mash Slze:~ L~ngth
Set bltwe~n ft. end fl.
.~C~. B~ekfllling Gr~vel peek
'~.,0~" ' (~ ~ Above or ~ Below land su~fece
/ ~'Y~ Equipment ulld:
II. PUMPINO LEVEL bllow Iond lurfoee end YIELD
'~ Moterlal: ~ Neat Cemenl ~ Other:
~, IS. PUMP: (if avollable) HP
Length of Drop Pipe ft. copoclty g.p.m.
D Subm. D Jif ~ C,ntriflcal D Other
14. REMARKS: '
JSailea ,: 10 gpm 1'or 4 hrs
16. WATER WELL CONTRACTOR'S CERTIFICATION:
15. Water Temperature o ~ F ~ C
This w~ll was drilled under my jurisdiction and this report Is lrue fo the best of my knowledge and belief;
Registered Business Name Contract License Number
~A u thoHze~' Representative "
Form OE-WWR (H/81) Copy Distribution: WHITE-SIDle DGQ~, PINK'Driller, CA~AEY-Cuatomlr