HomeMy WebLinkAboutLot 04
MUNICIPALITY OF ANCHORAGE
Department °f Health and Environmenta~ Protection
825 Street, Anchorage, AK. 3501
264-4720
* * * HANDWRITTEN PERMIT * * *
Permit ~ ~k~/OR ON-SITE SEWER PERMIT
Applicant: ~3, /£~ ~E~$~ Mailing Address: P.O. ~~ ~.~.
Location: Phone Number: ~ ~f - ~ ]2~
Legal Description: i-of ~ QI<~ ~('~3ood ~,'~,~ Lot Size:
Type of Soil Absorption System Is:
Trench: / Drainfield: Seepage Bed: Holding Tank:
Maximum Number of Bedrooms: ~ Soil Rating (sq. ft/br)
The Required Size of the Soil Absorption System Is:
DEPTH ( O LENGTH ~' GRAVEL DEPTH . ._q , ~ WIDTH ~ ~'~
The length dimension is the length(in feet) of the trench or drainfield. The
depth of a trench or pit is the distance between the surface of the ground and
the bottom of the excavation(in feet). There is no set width for trenches.
The gravel depth is the minimum depth of gravel between the outfall pipe and
the bottom of the excavation(in feet).
* * REQUIRED SEPTIC(HOLDING) TANK SIZE = ,~OdO GALLONS * *
Permit applicant has the responsibility to inform this department during the
installation inspections of any wells adjacent to this property and the number
of residences that the well will serve.
* * * TWO(2) INSPECTIONS ARE REQUIRED * * *
Backfilling of any system without final inspection and approval by this department
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 feet
for a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a community sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
* * * PERMIT EXPIRES DECEMBER 1 9 $ 3 * * *
I certify that:
(1) I am familiar with the requirements for on-site sewers and wells as
set forth by the Municipality of Anchorage.
(2) I will install the system in accordance with codes.
(3) I understand that the on-site sewer system may require enlargement if
the residence is remodeled to include more that 3 bedrooms.
Signe~: W' ~~5~~~F~~ Issued by:
Applicant '
Date: ~/~/~
SWP/024 (1/81)
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME
VO~L.E V bg~iEo~J
MAI LING A~R(~S ~(.~ '~"
L E~A L DESCRIPTION
bJ c l Woo
LOCATION
I Well
~ DISTANCE TO: ~
~ ~ Manufacturer
Liq. capacitx in gallons
I ~O~ ,r HOMEMADE:
~ ~ ~ DISTANCE TO: Well
O ~ ~ ] Manufacturer
~ DISTANCE TO: Well 2Z
Le t ~f e ch
~z~ N°'°fiines I ~g
~ I Top of tile to finish grade~_~)ll~
Length Width
Type of crib Crib diameter
Well
DISTANCE TO:
Class
D STANCE TO:
Depth
Building foundation
[] UPGRADE
AbsorPtion area I Dwelling
,~"" I Materia~
Inside lengt~ ~ I Width
Dwelling
Material
Nearest lot line
Trench~ ,,, inches
Founda~_n~ /
Total I e~.~t.,~o; I i n es
Depth
Crib depth
Total effective absorption area
Building foundation Nearest lot line
Distance to lot line
NO. OF BEDROOMS
PERMIT NO.
No. of c~_partments
Liquid d e p,~,
PERMIT NO.
Liquid capacity in gallons
PERMIT NO.
Dista nce~gt~ee n lines
eer
r line
Septic tank
OTHER
PIPE MATERIALS
~_'/ ~sr /~e0~J ~- ,'~ S T/~ D 2-?~-~)
SOILTES~3N~/~~)
INSTALLER
REMARKS
APPROVED
DATE
LEGAL
72-013 (Rev. 3/78)
S &S EtqGI~EI~S. INC
7125 Old Seward Hwy. Anchor(IgC, At(]ske 99502
i 349;.6561 i
SOILS LOG - PERCOLATION TEST
SOILS LOG
pERCoLATION
TEST
SI.OPt SITE PlAN
-10
11
12
13
14
15
2O
WAS (:;ROUND WA]fI~ /~-
E:NC()UNTERED? _,/~. ~. )
IF YES, Al WHAI
-~
~"'T ~:~
PERCOLATK)N HAll
TEST RUN BETWEEN
loc '
w
?.
'~ "7- -., ~-, .~- ~-t
Drop
72-008 (6/79)
DATE:
TO:
FROM:
SUBJECT:
icipality of Anchc
MEMORANDUM
April 27, 1984
Laura Crow
Environmental Health Division ~
Request for Refund - Account # 2460
Please make the necessary arrangements for a refund for the
following, the review and approval for this property is to be
completed by the State of Alaska Department of Environmental
Conservation not this agengy. The paperwork has been returned
to the application for proper processing by the State.
Denson & Denson Contracting Account # 2460
Box 966 Amount $45.00
Eagle River, Alaska 99577 Receipt # 287716
Lot 4A Block 600 Birchwood Airport Subdivision
Sewer and Water Other(health authority approval)
Laura J. Ward
Office Associate
Environmental Engineering Program
LJW/
cc: files
91-010 (4/76)
~ ~icipality of Anch~ age
MEMORANDUM
91-010 (4/76)
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