HomeMy WebLinkAboutHILDRETH LT 10LI, O
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEAl.TH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
MAILING A DJ~ F~S ..~ ,
/) u /_cox. ,¢t
LEGAL [DESCRIPTION . i / /
~<~pZ // Manufacturer/~O_ ~ ( T¢ ~--¢
__~~ IF HOMEMADE: Inside length ~Widt~ Liquid depth
~ ~ ~ ~~ell I Dwelling PERMIT NO.
t--~ Manufacturer ~- / /~- [Material Liquid capacity in gallons
~f ~ IWelt/~ ~ Foundation-~/ /~/N~otline PER IT
~ I ,o. o, lines / I Lengtb~ch Ce~ ~sg
~ Top of tile to finis~rad~.~ Material beneath tile
inches
~ ~ Length Width Depth PERMIT NO.
< P ~ Type of crib Cr~am/~ Crib depth Total effective absorption area
~ / ~ /'/~
~ _[ DISTANCE TO: Well ~ Building foundation Nearest ~ot line
~ '-[~l~s ~ ,,,~ ~eRth Driller Distance to lot Hne PERMIT NO,
~ [ DISTANCE TO Building foundation Sewer line Septic tank Absorption area(si
OTHER
PIPE MATERIALS
SOiLTEST RA,iN 2// C
R EMAR KS
APPRO 'D
DATE LEGAL
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14F~:!_.I.. LOGS FIF:E FRE):;~UIF~:ED I:::ff',ll)i"IL.IST E~iE F;:E"FLIt'~:h,!E:I) l"O THE:
OF: '?lie t.'!E:L.L. CCff'IPLE:TION.
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SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L, Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
[] PERCOLATION
TEST
PERFORMED FOR:
LEGAL DESCRIPTION:
2
4
7
8
W/' /~"'/'/'~'~' /'~' S LO SITE PLAN
10
11
12
13
14-
15
16
17
18
19
2o
WAS GROUND WATER ~'/ ~/ S
ENCOUNTERED? ' ~ L
O
P
E
IF YES, AT WHAT
DEPTH?
Gross Net Depth to Net
Reading Date Time Time Water Drop
/
PERCOLATION RATE
TEST RUN BETWEEN
/f~) ',?~ (minutes/inch)
f'FT AND FT
COMMENTS
PERFORMED BY:
72-008 (6/79)
APPLr ',NT FILLS OUT UPPER HA' ONLY
Property Owner / /.~,! /' /~. .] } ~. //~(,1//(~.~ Phone
MailingAddress /./ ,'" /~/%xA, / y;:~ ~' / ,.~ /~ ~ /-'f~ ,// /</[/' ZlpCode/~ -~"/ /;~'~
Address Zip Code
Lending InstHution,~-~ /:~ ~ :~. ..
AddressRealty Co.&Agent"/':" ~' /~-"~/--'//~(/ }] I 1:¢/ /:~ ZipCoOe ' ~V/Phone
Address Zip Code
'rype o[ ~sidence ~) . J '
~noIo Famd~
~ Multiplo Famil~ ~o. of Bodrooms
~ Othor
Water
~i~dividual A~ACH WELL LOG. A well log is required for all wells drilled since June 1975,
~ Community For wells drilled prior to that date, give well depth (attach log if available).
~ Public Utility
Sewer ~posal q. ?
~ndividual Year individual Installed: / :/ :-'~
~ Public Ulility When Connected to Public Utility:
~ Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE.EST BEFORE ~OCESSING CAN BE INITIATED.
t
'7
- Dat~ . ~. / ~-~
~2-,~$- DEPT, OF H~t',LTH &
~NVIRONM~N1 AL PRO FECTION
RECEIVED
( ~PPROVED BEDROOMS 'CONDITIONS OF APPROVAL
Soils Rating Date ~wer Installed Well To Absorption Area /~ ~:-~ Well Log Received
72.023
January 4, 1982
Howard Erickson
Box 605
Eagle River, AK
99577
Permit {~ 811004
Subject: Lot 10 Hildreth S/D
A permit issued by this department for a well and/or sewer
system has expired as of December 31~ 1981.
Permits are issued on a calendar year basis, as stated on
the permit, by authority of Municipal Ordinance.
If you have drilled the well, a well log should be sent to
this department to document the installation date.
If an engineer inspected the installation of the on-site
sewer system, please have them send us the as-builts for our
files.
If there are any further questions, please call this office
at 264-4720.
Sincerely,
Sewer and Water Program
Enclosure: Copy of Permit