HomeMy WebLinkAboutLAKE RIDGE TERRACE TR B
Well Drilling Permit Number: SW Date of Issue
Parcel Identification Number: 051-3Z3 " 3S
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
~ ~''xUNICIPALITY OF ANCHORAG~
He ~ ~ and Environmental Prot~
Fourth Floor West
825 L Street
Anchorage, Alaska 99501
264-4720
INSPECTION REPORT ONLSITE SEWAGE DISPOSAL SYSTEM
LOC^T,ON SE. e.~ L~"" ¢;" I'~GAL DESCRIPT,ON'"Te' i~ ~ ~;a~ '"k'"'. 'SI
SEPTIC TANK:
DISTANCE ~ ("~.0
FROM WELL I
INSIDE LENGTH
~_~,A. NUMBER OF
MANUFACTURER ~ MATERIAL. r~ COMPARTMENTS
INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY J OOOGALLONS.
DISTANCE FROM
~ of Lines
ABSORPTION AREA __ %{'~ O SQ. FT.
DEPTII: TOP OF TILE TO FINISH GRADE q~'
T'LE DRAIN FIELD:~~
TOTAL LENGTH
WELL~JQ~"I' FOUNDATION %0 .NEAREST LOT LINE I 0 + ,OF LINE ~
DISTANCE BETWEEN LINES ~/~ TRENCH WIDTH~-IN. TOTAL EFFECTIVE
LENGTH OF EACH LINE
DEPTH OF FILTER
MATERIAL BENEATH TILE __~-- O IN. ABOVE TILE ~
. %-~
SEEPAGE PIT:
DIAMETER -- OR WIDTH LENGTH ,, DEPTH
Log Crib Rings Crib Size:I DIAMETER___DEPTH_ DISTANCE FROM: WELL
-- TOTAL EFFECTIVE
BUILDING FOUNDATION NEAREST LOT LINE.__ ABSORPTION AREA (WALL AREA)
.SQ. FT.
Well
Class: 0 Depth:
Well Distance To: Lot Line
Bldg: Sewer Line:
Pipe Materials:
~ of Bedrooms: ~ I
Installer:
Remarks: %~tJ J
Fl:Rflt ~ NO.
FIF'F'L I CFIN ]"
L (] ": FIT I Z I'.1
LEGFIL
HFIUF.: I CE HEN[:,F.: I CKL:;ON
SE END LLHER FIRE LK
TR B LFII<E F.:IDI]E TERR St.IBD
[:,EPFIRTMENT:- HEFIL]"H FIN[:, EN'v'I F.':ONHENTFII:'" )TECT I ON ..... -' ' '--
25±5 E. TUE:,OF;.'. R[:,.., FiI'.4CHF~F.:RGE., RK .... 3507
276-222:t.
J ~~.~ - - ,_-=. % If'" E=2 _-=.. ~,: P,-.,-II ~.: IF,,:. F" E:
,..~-~._-.,
,' -,,: ...... /,LSD/044_
'i"'T'PE OF SOIL HE,::, JF. E, TIJI'4 .:,T.':,]Efl I'-::, TRENE:H
LOT _IZE 6EIEIglF:i SI;!UFIRE FEET
i-"lFl:,.,;It'"tt..li'"l NLtME~ER I]F E~EDF.:OOMS =
_-,I_IL RRTII'.4G ,::S;! FT,-."I~]R)=
THE RE(;!UIREI)SI:::~E OF THE SOIL. RE:SORPTION S'¢STEH IS:
THE LENGTH DIMENSION IS THE LENGTH ,::IN FEET) OF' ]'HE 'TRENCH 17.IR [:,RFIII'.,IFIEL[:,.
T~E [:,EPTH OF R "FF.:ENCH OR PIT IS T,H,E [:,I¢~(!¢::::E E:ETHEEN TNE SUF.:FF, Z:E OF THE
GRI]IIJN[:, FIN[:, ]*HE BOTTO"I OF T-IE E:.:IE:R,,,RTIO~.,t. (FN FEET::,.
THF'F."E ....................... I':, Nr'l ':;ET I-.II['TH FF'¢4' TF."ENPHEC;
THE GRR'v'EL DEF'TH I'.'5 THE HIi'..III"II_IM E:,EPTH ~FC'GRR',,,'EL E:ETHEEt'-,I THE OU'I"FF:ILL. PIF'E
RND, "FHE En3TTI]M OF THE E:ql]R',,,'R]"I ON ,:: I ~$.. FilET ).
'-F tl--4] ~:Z~ .:] 2 'Z:. X ~"-.ll ~.; P E ,%: -F X
BFICKF'tLLING OF FIN'¢ S"r'STEM WITHOUT FINFIL TI"4SF'ECTZON FIND RPF'RO',,"FIL. Dh" THIS
BEF'FIRTMEN]" HILL. BE SUBJECT ]"O
HINIMUM £:'tSTFINCE BETHEEN R HELL RND
:[.00 FEET FOR R PRI'v'FI'f'E WELL OR 200(7~f~ET FOR Fi F'UB/~tC HELL
HELL LOGS FIRE REQUIRED FIN[." MUST DE,TURNED TO THE DEF'FIF..'THENT HITNIN ]:E'I [:,FI'OS
OF' THE HEI_L COMPLEI"ION.
SF'EF: I F :1: CF:I"f' IONS RND CFIN':;TRLICT I O1"~ E:' I FII~RFIMS FIRE FI',/FI I LFIBLE TO INSURE PF::OPER
]: N S T FII_ I_ IR T I 0 N.
F" E !~.;.': l]",,"i~ X 'T' %-" ~ E_ X E:. F'
t (]ER']' I F"¢ THFIT
:1.: I Ri"1 FRI'"IILIFIR HI'I"H THE REQUIREMENTS FOR ON-SITE SEHERS RND 1.4ELLS RS SE]'
FORTH Bt? THE MUNICIPRLIT'¢ OF FINCHOF.:FIGE.
2: I WIL..L INS'¥FILL 'THE S'T'STEH IN FICCORDFII'-,tCE HtTH ]'HE CO[:,ES.
::i:: I I.JNDERSTRND 'f'FtFI]" THE ON-SITE SE!.qER ?¢STEM I'"IR'T' REQUIRE ENLFIRGEMENT IF THE
RESIDENCE IS REMOE:,ELE[:, TO INCLUDE MORE ]"HRN 7_..': BEDROOMS.
FIPF'L I CRNT MFtlJR I CE HENDR I Ck':SON
I SSIJEE:, E: ~ .:__~.zL4-_..~-2z'_-~2~-' ..... :_.-_'~Z:7__""~_ _ ......... L: H/b. ..... Z.~
09, E GEC. ~CHNICAL ~ DEVEL-,,JMENT
Box 90, Davis St., Eagle River, Alaska 99577
694-2774 or 688-2280
Russell Oyster
694-2774
Soils g~ Foundations
SOIL LOG
Performed for: Name: "L%,,'~ ~'x~v~x~--~~'~
Mailing Address: ~77~ ~"~" ~'~ ~
Legal Description: ~'~,*~'%~ ~ ~'~. ~~~'~-
Depth (feet)
Soll CharaCteristic)
CO.
Ear/Ellis
688-2280
Land Development
Tel, No. ~'g,~ ~'2-c1~
2
lO
ll
16 ·
'Ground Water Encountered: Yes
Proposed Installation: Seepage Pit
Comments: x--~-~, < t-~,~:k> e~;~
No If yes, whet depth
Drain Field
Parcel I.D. #
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
051 ~2~3--3 ~'
GENERAL INFORMATION
Complete legal description
Location (site..addre~s or directions)
Prqp_edy Owner
Maili'n~ addrebs (,' (0'';l ¢
Lending agency
Mail[hg address -,
Agent
Address
Day phone ~ ? ~ -130o
Day phone
Day phone
NUMBER OF BEDROOMS:
TYPE OF WATER SUPPLY:
individual well
Community well
Public water
Unless otherwise requested, HAA will be held for pickup.
3
NOTE:
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
NOTE:
Individual on-site .
Holding tank
Community on-site
Public sewer
If community wastewater sy~stem, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev. 1191) Front MOA #21
o
STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is 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 in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
S & $ ENGINEERING
Name of Firm
17034 F. agie ~,iver Loop h~oad No. 204
Address Eagle River, Alaska
Engineer's s gnature
Phone
Date
DHHS SIGNATURE
v/ Approved for
Disapproved.
Conditional approval for
bedrooms.
bedrooms, with the following stipulations:
Additional Comments
L · 'f-",']li[:']i
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer reg istered in the State of Alaska. The DH HS does this as a courtesy to purchasers of homes
and their lending institutions in order to satisfy certain federal and state requirements. Employees of DH HS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
72-025 (Rev. 1191) Back MOA 1ff21
.VIRONMENTAL SERVIC~.~IC,,
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
Environmental Services Division
825 L Street, Room 502. Anchorage, Alaska 99501. (907) 343-,~z~C E J V~
Health Authority Approval Checklist
Legal Description: "F/~4<.'T- ~ '.,L~c~,,O (,.( "/'~/.~,¢c ( Parcel I.D.:
A. WELL DATA
Well type /O~tV4-F~L.
Log present (Y/g~ ,,v 0
Total depth u
Sanitary seal ~/N)
If A, B, or C, attach ADEC letter. ADEC water system number
Date completed ~' / q 7 ~'
Cased to u / ~< Casing height (above ground)
Wires properly protected (~,~'N)
~ rl/ ~/~ --c~t't~r'"'¢ ~p4,'~7~'~4,vT''. ~r~_ ~ ~'
Date of test
Static water level
Well production
WATER SAMPLE RESULTS:
Coliform
Date of sample: I ~;~ / ~' 3 [' ¢1 7
FROM WELL LOG AT INSPECTION
g.p.m.
Nitrate
B. SEPTIC/HOLDING TANK DATA
Date installed /o/ .3/7'7 Tanksize /o¢e
g.p.m.
Collected by:
Other bacteria ~
S & S ENGINEERING
1/0~4 Eagle River Loop Road No. 204
Eagle River, Alaska 99577
Number of Compartments '~ Cleanouts~N) ¥~-Y
Foundation cleanout ~/N) r¥ CZ 7 Depression (Y~ /,, O High water alarm (Y/~} /-,,
Date of Pumping l;~/tO / ¢J-I Pumper ~ rot-
C. ABSORPTION FIELD DATA
Date installed io/ ~/ 77 Soilrating (g.p.d./ft2o~ 1~o Systemtype "F~f..,
Length 'g ~) / r
Width 2, Gravel thickness below pipe ~' Total depth '/~
~ ~...f Depression over field (Y/N~'. ,~'
Effective absorption area %~/(2 ~ Monitoring Tube present ~/N) Y
Date of adequacy test ~ /,q" / 0 ~ Results (Pass/Fail) /3/}_ 5-_~ For ~ bedrooms
Fluid depth in absorption field before test (in.); ~ Immediately after5'-5' ~. gal. water added (in.):
Fluid depth I' ~ (ins) Minutes later: ~ O Absorption rate = z/,?0 "/ g.p.d.
Peroxide treatment (past 12 months) (Y/N) ~ ~ ,v~ ~: ,,~ ~ ~ If yes, give date
72-026 (Rev. 3/96)*
LIFT STATION
Date installed Size in gallons
Manhole/Access (Y/N) ~.
High water alarm level at*,~-~'''~- *Datum
"Pump off" level at*
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot
Absorption field on lot
Public sewer main
Sewer/septic service line
On adjacent lots
On adjacent lots
Public sewer manhole/cleanout
Lift station
)oo .4.
/
/oo '~
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO:
Foundation ~ '~ Property line 0 Absorption field io (~?,t~_
Water main/service line I o ¢- Surface water/drainage )0o 4. Wells on adjacent lots
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line O Building foundation /O 4- ~ Water main/service line
Surface water ! 0 ~ "/- Driveway, parking/vehicle storage area
Curtain drain ~ ~,''/c ~ ,~, o ~ ~,,~ Wells on adjacent lots
ENGINEER'SCERTIFICATION ~ ~t~[. ~/v~/L R~ ~¢ ~'r~O.
I ce~ify that I have determined thru field inspections and review of Municipal re~'~¢~stems
in conformance wit~ MOA HAA gui¢lines in effect on this date. ¢~ ,,"
Signature =~ ~ ~/~ t~
~ :!i~ : : ::
Engineer's Name ~ 8 ~/t j-' ~ ~ ~
Waiver Fee $
Date of Payment ....
Receipt Number__
HAA Fee $.
Date of Payment ~'~~
Receipt Number
72-026 (Rev. 3/96)*
Rick Mystrom,
Mayor
Municipality ofAnchOrage
Department of Health and Human Services
825 "L" Street
P,O. Box 196650 Anchorage, Alaska 99519-6650
907-343-4744
January 28, 1998
Robert C. Cowan, P.E.
S&S Engineering
17034 Eagle River Loop Road
Eagle River, AK 99577
Subject:
Waiver Request for Tract B Lake Ridge Terrace
Waiver Request #WR970078, PID #051 ~3~ 38 #HA970573
Dear Mt'. Cowan:
Your request for a waiver of the required 10 foot horizontal separation of an on-site
wastewater disposal system to a property line has been approved. The approved separation
distance is 0 feet.
This waiver approval applies to the existing on-site wastewater disposal system lot line
separation only. Any future upgrade to the on-site wastewater disposal system will require
all separation distances be met or another approval from this department.
If there are any further concerns or questions regarding this waiver, please call our office at
343-4744.
Sincerely,
Donna C. Mears
Civil Engineer
On-Site Water Quality Program
WR~ WR970078
Date Received:
Legal Description:
Engineer:
~ MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On-site Services Section
Waiver Review Worksheet
PID# 051--3~-38
December 26, 1997
Tract B Lake Ridse Terrace
HA~ HA920573 Permit
99577
Robert C. Cowan, P.E., S & S Ensineering
17034 Eagle River Loop Road, Suite 204, Eagle River~ Alaska
Gary Droubay ~
Applicant:
Waiver Requested: Lot line waiver of 0 feet from the absorption field to
the log line
Criteria: 1. Geology: Points:
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
TOTAL:
Special Conditions:
3. Other:
Waiver is Granted:
List Conditions or Reasons for above:
. ,
Waiver is NOT Granted:
Date:
Nanfe of Reviewer
Rec ~: 03385/5802 Amount: $ 115.00 Date Paid: 12-26-97
ROBERT C. COWAN, P.E.
HEALTH AUTHORITY
APPROVALS
SEWER &WATER
MAIN EXTENSIONS
SEWER&WATER
INSPECTION
ENGINEERING STUDIES
AND REPORTS
WELL INSPECTION
& FLOWTEST
SITE pLANS
ROAD DESIGN
SOILTEST
PERCOLATION
TEST
STRUCTURAL &
MECHANICAL
INSPECTIONS
ONSITE
WASTEWATER
DISPOSAL SYSTEM
DESIGN
December 30, 1997
CIVIL ENGINEEP. S
(907) 694-2979
FAX (907) 694-1211
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
P.O. Box 196650
Anchorage, AK 99519
REFERENCE: Tract B; Lakeridgc Terrace
West Lakeridge Drive
Request you issue a Health Authority Approval on the referenced property and grant a waiver for the
horizontal separation distance between the leaclffield and the property line at 0 feet..
We do not anticipate any adverse effect on thc adjacent properties. The proper~ line is adjacent to an
old road right-of-way that is not being used, (see attached asbuilt survey).
If you require additional information, please contact us.
Sincerely,
17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577
DETAIL "A" \ '"~
SCAL~ ~" = 5¢\ g \
AP~R OXqM A'~
LOWER LAKE
GARY DROUBAY -
EXO. U..~ON NOTE~: It ~ U~e a~mer~' re~pon~l*bl/it~, to dete~e
~fch do not ~pp~ar on ~¢ recorded ~bdl~;on
Under no c;r~m~anc~ ~ould ~y d~ta h~eon be used for
c~stmc~on or f~ est~l~;ng p~op~ty
I.A~O & CONSTRUCTTON SURVEYORS-PLAI~NERS-ENC;INEER5
440 WEST BENSON BLVD # 103 /
NCHORAGE. ALASKA 99505 t(g07)
OF-: LEGAL DE$CRIPIION:
TRACT b
LAKE RIDGE TERRACE
LEGEND: SET FmND
HUB ~ TA~ ~
~-- ~X -'- X ~
W~ ~-
SUBDI~SION
MUNICIPALITY OF ANCHORAGE
Department of Public Works
Street Maintenance Division
Public Works
ENCROACHMENT PERMIT 19980290
TillS AGREEMENT, made this .2fiff'/~ day of B-a-a, 19 ~ , by and between the Fire
Lake Flying Club, Incorporated, and their heirs, administrators, and assigns, hereinafWr called
"PERMITTEE", and the Municipality of Anchorage, a municipal corporation organized and existing
under its Charter and the laws of the State of Alaska, hereinat~er called the "PERMITTER".
WIT'NES SETH:
WHEREAS, PERMITTEE is the owner of the f,ollowing described real property:
TRACT B, LAKE RIDGE TERRACE SUBDIVISION, according to the
official records thereof`, on file in the office of the District Recorder,
Anchorage Recording District, Alaska,
and;
WHEREAS, PERMITTER owns and/or maintains the real property more particularly
described as f,ollows:
THE RIGHT OF WAY OF WEST LAKE RIDGE DRIVE immediately to the
southwest of the PERMITTEE'S property, as 'shown on Plat # 1-P-549, on file
in the office of'the District Recorder, Anchorage Recording District, Alaska,
and;
WHEREAS, PERMITTEE has placed a leach field trench and a fence upon the above-
described real property which encroach upon the PERMITTER'S West Lake Ridge Drive Right of
Way.
NOW, THEREFORE, it is mutually agreed between the parties hereto that:
The PERMITTER, acting through the Director of Public Works, hereby grants to
the PERMITTEE the privilege of allowing their leach field trench and fence to
encroach upon the PERMITTER'S West Lake Ridge Drive Right of Way, as
shown on "Attachment A", included herewith.
The PERMITTEE agrees f,orever' to indemnify, def,end, save and hold harmless,
the Municipality, its officers and employees, from any and all lawsuits, claims or
actions brought by any person for or on account of damage to property or injury,
disease, illness or death of persons, including all costs and expenses incident
Nq _to!o"-O fl X; 0 1 d ,+I,N N'N'N !
thereto,, arising wholly or in part from or in' connection with the existence of,
alterations, mainte0ance/tepair, renewal, reconstruction, operation, use or removal
of the encroaching leach field trench and fence, as placed upon the
PERMITTER'S West LakeRidge Drive Right of Way.
The PERMITTEE shall not assign or transfer any of the rights granted herein to
another individual or company without first notifying and securing the approval of
the Director of Public Works.'
This Agreement and Permit grants pERMITTEE no interest in PERMITTER'S
real property whatsoever, except only the encroachment rights described herein.
The PERMITTER reserves the right to revoke this permit 9pon twenty days (20)
written notice to the PERMITTEE. The PERMITTEE agrees Upon such notice of
revocation, to move said encroachment(s) from the west Lake Ridge Drive Right
of Way in which they are placed. ShOuld the' PERMITTEE refuse or fail to
.comply.with said written notice, the PERMITTER may, without further notice to
the PERMITTEE, remove or cause to be removed the encroachment(s), and the
PERMITTEE hereby agrees to reimburse the PERMITTER for all costs incidental
to the removal thereof.
In addition to the mutual prOmises her6119fore made, the PERMITTEE hereby promises to pay
the PERMITTER a 'one-time permit fee of one hundred dollars ($100.00)..
IN WITNESS WHEREOF, the parties hereto have hereunto set their hands and seals the day
and year first hereinabove written. '
Grantee:
Grantor: MUNIC~ALITY OF ANCHORAGE
Ri~t of W~ay Permit Manager
,19950290-01/28/9S
STATE OF ALASKA )
)SS,
THIRD IUDICIAL DISTRICT )
THIS IS TO CERTIFY that on this 2 77~/~ day of ~-~ oo.t-~7 , 19 y~ , before
me, the undersigned, a Nota.~q~ Public in and for the State of Alaska, duly d0mm{ssioned and sworn as
such, personally appeared · f.,o,ct ~_ ~. Go o ~/~ ,, o o r- , known to me to
be the Right of Way Permit Manager for the Municipality of Anchorage, Alaska, who executed the
foregoing instrument, and he acknowledged to me that he executed said instrument as the free and
voluntary act and deed of said corporation for the uses and purposes therein mentioned, and that he
was authorized to execute said instrument.
WITNESS my hand and o~cial seal on the day and year first above written.
...N~6~AR~C?UI~LIC indan~' f-'6'r-A1 aska .-
My Commission Expires: ,~lyCommiu~on Expire,:
April 4, 1998 ~
STATE OF ALASKA )
THIRD JUDICIAL DISTRICT )
THIS IS TO CERTIFY that on this ,gg'Ph day of dr> UCcc- t~ , 19 ~'g' , before
me, the undersigned, a Notary Public in and for the State of Alaska, duff commissioned and sworn as
such, personally appeared ..J". ~'-~c v ~r'O O J4~ ,~ , known to me to
be the individual(s) named herein ~ho 'executed thd foregoing instrument, and he/she/they
acknowledged that he/she/they did so freely and voluntarily for the uses and purposes therein
mentioned, and on oath stated that he/she/they was authorized to execute said instrument.
WITNESS 'my hand and official seal on the day and year in this certificate first above written.
My Commission Expires: ,UyCommI~,ro, ~. ~r~..
April 4, 1998 :
19980290-01/28/95
~ ,~ ~ (LIFf STATION)
I" ,. . /
,., DETAIL "A'~ ( / ',% ~~/, q
,. ..'.. ... .' ~ . .. . . ;: .
L' ',' .... ~ ¢;'.;-~':
...., ~ - , · .,
. · .. . .
.' ~ ~, , ...... ..,. ,~ . ~ '. . ~ ~ ' '~' .. ,. ,...,.:
. .. ,~. , . 6~, . ,. ~ .' . ~,.~;~, · ~?,.. ,., g ' ,,.,~
: ': . "~, ~ ' ' . 2~ Z ~ ... · - ~ ' '
~Z ~. ' : ~ ~ ~" ~ "~ ........ ( ~ '
..... ~, . ,~ ..... ' ': . A % 8~. ...---~~'----- / :..:':" . ~ . ..... '~'"' ' ,
..... ~ % L' Dre er, 9~ .-
' ~-..~'.:" "" ' ' '~e ~C~ /'z ~ % ' . ' /~'., ~s-~2o2 ..",~%~
,, ,~ ..:,: · ./__ ' . . . ,
· ~ ~ . -~., ..*:.::- } , ~ , .. ,. : -~-~. ~..~. '.~.,~'.'. . .-. ~2. : · ~ .
~~~ EXCLUStO~ NOIES: It I~ the owhersj fespbnslblll~y to determine LECEND: SET
the existence ol any easements, covenants, or restrJctio,a 5~8"R8 W/OAP~ , 5/8' R~ 0
' ~ '.: ;',;': '; ' y ' which do no~ appear on the recooded subdMsion plat. NOfE: 3.25" AL.UON. ~MENJ
.; ',,, ~':;+:,:,. ,'GARY DROU~A . Undek no clrcumetoncee shoud any data hereon be used for HU9 & lACK ~ ' ·
' ' ' ;"("':' ;' :; ' conBtroctlon or for eetobllshlng property Ilnem FkNCE- x ·
_;:.,,_,,,,:;.,t>.,;~,~ ;: ,. ,, : . . , .: , -. SURLY CER31FICA~IOH= LAN~CH ,hos conducted d i~RHA~-
~n are wlthl~ tl~e ~roperty lines and no encroach- ASPHALI-
~ents exlst'.othe~ thon doted. ' ' OEA~L- , ~
: .... .' 'AS=BUiLT: OF: LEoAL DESCRIPTION: WAERSKPMC ~LL-StANDPPES' ~,'.-h~'
'LAND:& CONSTRUCTON SURVEYORS-PLANNERS-ENONEERS "'?,;'; '(. :.r .' . . ; : ' '.
'440 WEST BE~SON BLVD. ~ I03. ' ., : ';;,'.':.~ :'.. ' ,"
ANCHORAOE,'ALASKA 9950~ ' (907) 5~2=529J 'TRACT B ' '
UBDiVISION.:
WORK ORDER NUMBE~: D~m . ' .
JULY ¢l JBg6 s"~"=20O' (fax)561-6026 'LAKE RIDGE TERRACE S
BAB J KEN NW 0553 ~6~/34-35 38 ""," :: : _
DAT~ RECEIVED
TIME TIME TIME
DATE DATE DATE
INSPECTOR INSPECTOR I NSPECTOR'~
NJUNICIPALITY OF ANCHORAGE
MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH &
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTEOTII~VJRONMENTAL P,~OTECTJON:
82~ L Street - Anchorage, Alaska 99501
ENVI ON ENTAL SANITATION DIVISION MAR g
Telephone 264-4720
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWE~ FAC1
DIRECTIONS: Complete all parts ce page 1. Incomplete requests will not be processed, Please allow ten (10) days for processing.
I, PROP~TYOW~R ~ ~ ~ t~ ~/ --' ' --
MAILING'~DDR~SS ~ ~ , ~ I % J'
PROPERTY RESIDENT If different f~ above} PHONE
MAI LING ADDRESS
3. LENDINGINSTITUT~.F . PHONE
MAILING ADDRESS
4. REALTOR/AGENT~ ~ - ~ ~, - ~,~ J PHONE
STREET LOCATION
6, TYPE OF RESIDENCE NUMBER OF~BEDROOMS
[] One [] Four
[] SINGLE FAMILY [] Two [] Five
~ MULTIPLE FAMILY ..,.-~' Three [] Six
[] Other
7. WA'i'ER SUPPLY
INDIVIDUAL*
COMMUNITY
[] PUBLIC UTILITY
*ATTACH WELL LOG. A well Icg is required for all wells drilled
since June 1975. For wells drilled prior to that date, give well
depth (attach Icg if available.)
8. SEWAGE DISPOSAL SYSTEM
~ INDIVIDUAL/ON-SITE**
[] PUBLIC UTILITY
YEAR ON-SITE SYSTEM WAS INSTALLED.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010 (Rev. 6/79)
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2, WATER SUPPLY
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTILITY
Connection Verified LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[] I NDIVI DUAL/ON -BITE DATE INSTALLED
Connection Verified INSTALLER
[]Septic Ta.,nk or [~Holdin9 Tank
Size' / 4cU
· If Tank is homemade SO~LS RAZING
give dimensions: //00
TYPE OF TANK MANUFACTURER
4, DISTANCESwELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line
Absorption Area to nearest Lot Line
5, COMMENTS
[] APPROVED FOR BEDROOMS
[] CONDITIONAL APPROVAL {letter must accompany certificate)
I~'~' DISAPPROVED
DATE BY ~,~
825 "L" S']'REET
ANCHORAGE, ALASKA 99501
(907) 264-4111
GEORGE M. SUL. t_IVAN,
MAYOF[
DEPAF]I.'MENI OF FIEALTI4 AND ENVIRONMENTAL PROTECTION
March 27, 1981
Maurice Hendrickson
% Gillian Goodgame
Century 21 - Sleeper
8050 Old Seward Highway
Anchorage, Alaska 9950~
Subject: Tract B Lake Ridge Terrace Subdivision
Approval for the individual sewer and water facilities
cannot be granted until the following items have been
completed:
(1) The water analysis report needs to be delivered 'to this
office from the Chem Lab, 5633 B Street, for our
review.
(2) A well log submitted to this department for our review.
(3) A four(4) inch cast iron cleanout needs to be installed
to the sewer system.
(4) The septic tank pumped with a receipt submitted to this
office.
(5)
An adequacy test needs to be performed on the existing
leaching area. This test will determine if the system
is adequate according to National Standards. A listing
of private firms performing the test is enclosed. This
report needs to be submitted to this department for
review.
If there are any further questions, please call
at 264-4720.
Sincerely,
Robert C. Pratt, R.S.
Associate Specialist:.
RCP/LJW