HomeMy WebLinkAboutLILAC PARK BLK 2 LT 2
Tom Fink,
Mayor
N[unicipality of Anchorage
Department of Health and Human Services
$25 "L" Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
July 8, 1993
Susan M. Jayich
PO Box 111565
Anchorage, Alaska
99511 1565
Subject: Lot 2 Block 2 Lilac Park Subdivision
Permit ~SW920166, PID ~015-211-26
The subject permit, issued July 1, 1992 by this office for a
single family well and/or on-site wastewater system, has
expired as of July 1, 1993.
A new permit must be obtained from this office for a well
and/or on-site wastewater system NOT installed by the
expiration date.
If you have drilled the well, a well log must be sent to
this office for documentation of the installation and to
close the permit.
If a licensed Professional Engineer has inspected the
installation of the on-site wastewater system, the original
as-built inspection report must be sent to this office for
review, approval and documentation. All inspection reports
must be submitted within 30 days of construction completion.
When applying for a new permit, the fees are: $200.00 for an
on-site wastewater permit; $75.00 for a well permit and
$275.00 for a combined on-site wastewater and well permit.
If you have any questions
~h. Smi~, P. ~.
~rogram Manager
On-site Services
, please call this office at 343-4744.
enc: Copy of Permit
cc: Mountain Engineering
� .r„ rT3T5iq
i L% U STATE OF ALASKA
AUG 2 0 15bL RTMENT OF NATURAL RESOURCES
DIVISION OF WATER
ALASKA ONR/DIV OF WATER WATER WELL RECORD
BOROUGH aUBDI"ON LOT BLOCK sEcT101r QTTaaBECiION TOMMBHIP IIAOE ANIVOtAN
❑N ❑E
.Z 13S❑W
LOCATION/SKETCH: �^ 0.G WELL OWNM
--t 1
DEPTHS MEASURED FROM:❑casing top ❑grou nd surface
WELL DEPTH: DATE OF COMPLETION
BOREHOLE DATA: Depth
Depth of casUp; /T'?— ft 2_/ _-t/f
Material Type and Color - From TO
r -
DEPTH TO STATIC WATER LEVEL.•
42 O
3.
Z, c f ft below fit top of casing ❑ ground surface
Date: 1,;t V/ If ,
•
METHOD OF DRILLING: p air rotary ❑ cable toot
!3S"
❑ other
•
USE OF WELL: �J domestic ❑irrigation 13 monitor
j
(3 public supply ❑ Other—
therCASNGSTIrA-U
CASING STIrA-Uft. Diam:. 49 In. to&%4
14 z
/ 1p I>Casing
type: in. to ___ft
WELL INTAKE OPENING TYPE:)Wopen and ❑ screened
117:2-
p perforated ❑ open hole
Depths of openings: to ft
SCREEN TYPE- Diam: in.
�lotlAl[esh Ske: Lafgth:° 'fit;
GRAVEL PACK TYPEL
Volume used: Depth to top: .
GROUT TYPG^� Volume:
Depth: from to ft
DEVELOPMENT METHOD: �lr1
Duration:
PUMPING LEVE. AND YIELD: , �^�
7� ft after hra pumping J�Z_gpm
PUMP INTAKE DEPTH: ft HOr er: _
WELL DISINFECTED UPON COMPLETION? 1D YES ❑ NO
CONTRACTOR INFORMATION: _ ,{. ,c REMARKS: -
%
0 AL
egis usinessName
PLEASE MAIL WHITE COPY Of LOG TO:
7`"�- • 7 7i- DNRIDNISION OF WATER
!Signature of Authorizedespresen rveate PO BOX 77211.6
EAGLE RIVER AK. 99577-2116
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
PAGE 1 OF 1
ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT
PERMIT NUMBER:SW920166
DESIGN ENGINEER:MOUNTAIN ENGINEERING
OWNER NAME:JAYICH SUSAN M
OWNER ADDRESS:C/O MTN. ENG'G. 3868 SHANNON CIRCLE
ANCHORAGE, ALASKA 99508
DATE ISSUED: 7/01/92
EXPIRATION DATE: 7/01/93
PARCEL ID:01521126
LEGAL DESCRIPTION: LILAC PARK BLK 2 LT 2
LOT SIZE: 58686 (SQ. FT.)
NUMBER OF BEDROOMS: 5 THIS PERMIT: 5
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD / WELL SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
1. THE ATTACHED APPROVED DESIGN.
2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS
15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL
REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80).
3. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
DUE TO SECOND SOIL TEST WHICH SHOWS WATER AT 7 FEET, THE
ENGINEER MUST PROVIDE ADDITIONAL TESTING INFORMATION TO
CONFIRM THE ABSENCE OF GROUNDWATER TO A DEPTH AT LEAST 4.0
RECEIVED BY:~~f~~ ~ DATE:
ISSUED BY: ~~_~=_~ ~O~ DATE:
PERFORMED FOR:
LEGAL DESCRIPTION:
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2O
COMMENTS
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
625 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION ']'EST
[ ~?~'. CE- 7760 ~:'~' I
M % ,, -> ,..~
~Township, Range, SectJon:
SLOPE
WAS GROUND WATER
ENCOUNTERED?
SITE PLAN
S
L
IF YES, AT WHAT O
DEPTH? p
fleplhto Water After;, .-
~oniloring? k,,XDY"~-Date:
Reading Date Gross Net Depth to Net
Time Time Water Drop
~/~- I o ~.~ ~,~ 1,o"
PERCOLATION RATE [ ~ (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN ~'~ _ FT AND ~ FT
ACCORDANCE WlTH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
72-008 (Rev. 4~85)
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L' Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
LEGAL DESCRIPTION:
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~;~ '~1 ~'~['C~CI~ 'Z-. / ~ ~,~¢... Township, Range, Section:
SLOPE
SITE PLAN
S
IF YES, ATWHAT ~) / -~ ~-~'--
DEPTH? .~, ~:~ I . P
Oepth Io Water Aflerq,~ f ~(~Z ,
Monitorino? Bate:
Reading Date Gross Net Depth to Net
Time Time Water Drop
· z ) -
PERCOLATION RATE ~ (mmules/inch) PERC HOLE DIAMETER
L
72-008 (Rev. 4/85)