HomeMy WebLinkAboutLAKE RIDGE TERRACE BLK 2 LT 7
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WELL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW930286
DESIGN ENGINEER:DUMMY COMPANY
OWNER N/~2VlE:HARMS HARVEY D & CHERYL
OWNER ADDRESS:P.O. BOX 670071
CHUGIAK, AK 99567
PAGE 1 OF 1
DATE ISSUED: 8/11/93
EXPIRATION DATE: 8/11/94
PARCEL ID:05131520
LEGAL DESCRIPTION: ~E:~!]~D~E:~'TERRACE BIlK '12 LT '~
LOT SIZE: 27963 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT: 4
THIS PERMIT IS FOR THE CONTRUCTION OF:
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 ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4329 OR 343-4681 AFTER BUSINESS HOURS
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
RECEIVED BY:
ISSUED BY:
DATE:
DATE:
SO:'
~.~ '....*s,~yG¢%.; .~r I
nJdez, prior to constrnct. Jo~. t.o x, or~y - .... ~ ~-
~ed grade al:.d utdiW COi~I~PctioI!s and
dc~erlni~e the exi~Mnce of aDy ease-
e~]ts, covenant.s, or rastrictions which
not appear on the zecorded subdivi-
LOT SURVEY 'CERTIFICATION LEGEND'
~ Brass Cop Monument
O Iron Pipe
e Sleel Pin
[] Survey Hub 8, Tack
of ~, Block % Area --- Sq. Ft.
~m--f~3ZP--~~~! % u Eb D.
at File No. Zoning District__
nchorago Recording District, Alaska[ R~WS,O:m
DICIdHfON-OSWALI)-WRLCH-LC Resider,
ce of:
( ertifiei Drifting
by
DOC Co. dba
SULLIVAN WATER WELLS
P.O. BOX 670272, CHUGIAK, ALASKA 99567 * TELEPHONE 688-2759
ADDRESS
DATE-Started Ended
PE~IT NUMBER
DEPTH OF WELL ~ ,; ,D
STATIC Level OF WAter F'r.
~'~)RAW DOWN FT.
GALS. 'PER HR
KIND OF CASING
KIND OF FORMATION:
From ~ Ft. to Ft. ~ ~ j ,, ,.3 (: ,~ j'- ~ <., t< ,3/o From
From ~x Et. to ~' ,,, Ft. O CJ~/''y '~ ~m~ From
From Et. to ~ Ft. ,~(<' ? ,.~'d-o'~ a (>~d~rom
From ~3 ,Et. to 7~ Ft. ~d)~C ~' ,~Z~~j~a From
From ~O Ft. to ~O Ft. ~,~C/c /~',~'~ From.
From (~"~ Ft.
From ~ Ft.
Fr°m (,(~'" Ft.
From ~.'~.~ Ft.
From Ft.
From,~-~'~ Ft.
From9 7-0 Ft.
From~ ~" Ft.
From -- Ft.
From Ft.
From Ft.
From Ft.
to Ft From
to Ft. From
to .Ft. From__
to Ft. From
MISCL. INFORMATION:
Et. to Ft.
Et. to Ft.
__Et. to Ft.
Ft. to___Ft.
Et. to Ft
Et. to Ft.
Et. to Ft.
Et. to Ft..
Ft. to Ft..
Ft. to Ft._
Ft. to~Ft.
· Et. to Et,
Et. to Ft.
Et. to Ft.
__. ,.RECEI.VED
Ft. t~O0w_~F
~to-- Ft.
Dept. Hefilth ~ Human ~er-v~es
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
Name ~r~a o~/t5 ~a~A~.~ Ma~l ng ~ .......
Location kO~)&.~ ~L k~ Legal Description ~ .~O~ ~_ ~ ~K ~ _. L~:~.~
SEPTIC TANK: Distance f~om well Mate~ial~/ . N~em of compaPtments
._ ...... .
Liquid capacity, /d,~gallons. Inside length~nsid~ wxdth Liquid depth
SEEPAGE SYSTEM: Seepage Pi~: Nu~e~ of pits_:/ Outside diamteP
~ length,~ / depth lining material ~<~e / . Dmst~ee
well ~ building fo~datlon /~z ~ nearest lot l~ne ~ Total effective
absorption a~ea (wa11 a~a) ~ sq.
~I~.~8~_N- FIEL_~: Distance f~om well , fo~dation , nearest lot line_
T~tal len~h of lin~ Nu~em of lines Distance between lines T~nch
width__ in. Total effectiv~ ~somption a~ea ...... sq. ft, Length of each line
Depth: Top of tile to finish g~ade Depth of filteP ~ePial beneath
}~EL~: ..... , aeptn -, dist~ fmom building fo~dation ~/ , nearest
lot line ~O', neaPest sewe~ llne,..~ , septic tank ...~/~, seepage system ~
DIAGRAM OF SYSTEM
qo ~
/ t lth A th°ritY
GREATER ANCHORAGE AREA BOROUGH
INSPECT:
TIME:
REQUEST FOR APPROVAL OF
DEPARTMENT OF ENVIRONMENTAL QUALITY
3500 TUDOR ROAD
ANCHORAGE, ALASKA 99507 //~x/~
279-8686
DATE RECEIVED:
INDIVIDUAL SEWER AND WATER FACILITIES
FOR
1. APPROVAL REQUESTED BY:
2, PROPERTY OWNER:
4, TYPE FACZLZTY TO BE INSPECTED:
NUMBER OF BEDROOMS:
WELL DATA:
A. TYPE
B. DEPTH
C. SIZE
D. CONSTRUCTION
E.
BACTERIAL ANALYSIS
SEWAGE DISPOSAL SYSTEM:
A. SEPTIC TANK (IF HOMEMADE, SHOW DIAGRAM ON BACK)
~. SIZE t,~O %~[.
3 'MANUFACTURER ~t~.-~--_ ~ ' G¢~
4. INSTALLER
APPROVAL REQUESi :OR SEWER & WATER FACILITIL
PAGE TWO
SEEPAGE PIT
1. SIZE
2. LINING
C. DISPOSAL FIELD
1. NUMBER OF LINES
2. TOTAL LENGTH
REQUIRED MEASUREMENTS
A WELL TO SEPTIC TANK
B
C
D
E
F
G
H
WELL TO SEEPAGE PIT
WELL TO SEWER LINE
WELL TO PROPERTY LINE
WELL TO OTHER POSSIBLE CONTAMINATION
FOUNDATION TO SEPTIC TANK ~4!-
FOUNDATION TO SEEPAGE PIT
SEEPAGE PIT TO PROPERTY LINE
COMMENTS:
APPROVED: ~ ~.~- ," '~ -~ .~. ~i)~- DISAPPROVED:
DATE: ~'1, , IC;!"I"'L¢- ~ DATE:
APPROVAL VALID FOR ONE YEAR FROM DATE SIGNED.
GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY