HomeMy WebLinkAboutBIRCH HILLS TERRACE #2 BLK 4 LT 5
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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 PERMIT
PERMIT NUMBER:SW950020
DESIGN ENGINEER:DUMMY COMPANY
OWNER NAME:CAMILLI ROBERT H & CYNTHIA A
OWNER ADDRESS:IT418 KAHILTNAR
EAGLE RIVER, AK 99577
DATE ISSUED: 2/17/95
EXPIRATION DATE: 2/17/96
PARCEL ID:05014149
LEGAL DESCRIPTION:
BIRCH HILLS TERRACE #2 BLK
4 LT 5
LOT SIZE: 52482 (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 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT)
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 PROVI~S:
ISSUED BY:
FI: REI3^LE.'.' 'ST.
( ertifie Drilli.g
DOC co. MAY1995
C ~h ~ o~ Anchorage
P,O. BOX 670272, CHUGIAK, ALASKA 99567 · TELEPHONE 688-2759
i
OWNER
OF
LAND
ADDRESS / ':~'~ ': ~ / < [<- '''+ ~d [ L~ 7'. ,.,_ .
LEGAL DESCRI~ION ~,', ? ~ ~'~ .~ '/-~
DATE - Started Ended
PERMIT NUMBER
STATIC LEVEL OF WATER FT.
'i)ffAW DOWN' FT.
GALS. PER HR
KIND OF CASING
KIND OF FORMATION:
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MISCL. INFORMATION:
DRILLER'S NAME