HomeMy WebLinkAboutBOND ESTATES LT 15BOnsite File
The 1987 trench may not be tested for a 5 bedroom
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343.7904 Fax: (907) 343-7997
http://w .muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP221244
Work Type: Septic Upgrade
Tax Code Number: 01819126000
Site Legal Address: BOND ESTATES LT 15B G:3034
Site Mailing Address: 2710 DE ARMOUN RD, Anchorage
Owner: RUBY JAMES R & BECKY L
Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING
This permit is for the construction of:
Effective Date:
Expiration Date:
Lot Size in Sq Ft:
Total Bedrooms:
picnr
c
epall rrtnet�r
7/14/2022
7/14/2023
46540
Q Disposal Field 10 Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction shall 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 wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Special Provisions:
Proposed system too deep for soils information submitted. The Engineer shall do an additional test hole
prior to the construction of the septic field. Perc all the strata that the effective depth is in. Construction
may proceed at your own risk before the 7 day water monitoring is complete. Please submit stamped and
signed results with the As -built Inspection Report. If the results require a design change, construction of
the system will stop pending On -Site review and approval.
Received By: n`"f f k� Date:
Issued By: Date:
7147 2/
/ ZZ—
MUNICIPALITYc
OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 018-191-26
Property owner(s) Bobby Ruby
Mailing address 2710 DE ARMOUN RD, ANCH AK
Site address SAME
Day phone
Legal description (Sub'd., Block & Lot) BOND ESTATES LT 15B
Legal description (Township, Range & Section)
Lot Size 46,540 Sq. Ft. Number of BedroomsA 5
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field
Q
Initial ❑
Single Family (SF) 0
(w/wo ADU)
Septic Tank
0
Upgrade x
(D) ❑
Holding Tank
F-1Renewal
ElDuplex
Multiple Dwellings ❑
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees: 4' % 5a
Date of Payment: Z4�Z Z
Receipt Number: 006563
Permit No. 0 S Pl�� 1 Q y �
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
G:\Development Services\Building Safety\On Site Water and Wastewater\Forms\Clie nt Forms\Permit Application.doc
June 28, 2022
Municipalities of Anchorage
On-Site Water and Waste Water Section
4700 Elmore Rd
Anchorage, Alaska
Phone 343-7904
Re: New septic permit
Legal: Bond lot 15B
To whom it may concern:
This is a request for a septic permit on the above referenced lot. The original test
hole data was used for the new design of the old 1987 system. A new test hole will
be done at the time of construction to verify the different soil layers and total depth,
see the site plan. The new system will be slightly deeper than the old system due to
the slower application rate used. The slope of the lot flat in both directions with no
cut banks within 50 feet. This new 5-bedrooms system will not impact any of the
surrounding neighbors. A reserve area has also been shown with an application rate
of 2 gpd/sf.
Sincerely
Michael N. Anderson, P.E.
4661 Natrona
Anch, Ak 99516
Ph 727-8864
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP221244, Deb Wockenfuss, 07/14/22
SEPTIC FIELD SECTION
DESIGN CRITERIA:
7.0' EFFECTIVE
5 BDRM X 150 = 750 GPD
SOILS = 600/0.8 = 938 GPD
938 GA/14 = 67'
2.0' WIDE
67' LONG
(1) TRENCH
10.0' DEEP
13.0
(TH BY OTHES)
4.0
3.0
1.0
SW
SP
GW
ORG 1.0'2.0'
-10.0
-3.0
MOUND OVER
FILTER FABRIC
SEWER ROCK
3,3(
GRADE
1"=100'
PROPERTY LINE
EXISTING WELL
100' RADIUS
EXISTING HOUSE
REBUILD
EXISTING
DRAINAGE FIELD
SCALE:
DJRDRAWN:
DATE:
BOND ESTATES, LOT 15B
Anchorage, Alaska
BOBBY RUDY
6/27/2022
EXISTING HOUSE
SEPTIC
SEPTIC
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP221244, Deb Wockenfuss, 07/14/22
1"=50'
EXISTING SEPTIC
TRENCH TO BE
REBUILT AND
EXTENDED FOR 5
BEDROOM SYSTEM
WELL
EXISTING
HOUSE
EXISTING WELL
100' RADIUS
SCALE:
DJRDRAWN:
DATE:
BOND ESTATES, LOT 15B
Anchorage, Alaska
BOBBY RUDY
6/27/2022
SHED
SHED
SHED
DRIVEWAY
NEW 1500 GALLON PLASTIC
SEPTIC TANK MIN. 5' FROM
TRENCH AND 14' BETWEEN
TRENCHES,
NEW TEST HOLE REQUIRED TO
VERIFY SOILS AND TOTAL
DEPTH, PERC ALL SOIL LAYERS
WHICH IMPACT THE NEW
TRENCH
FCO
CO
DCO W/ NEW VALVECO
CO MT
FLAT AREA, NO
SLOPE WITHIN 50'
SEPTIC
SECONDARY CLASS
III SYSTEM, 40X2X5'
EFF. W/ APP. RATE
OF 2GPD/SF
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP221244, Deb Wockenfuss, 07/14/22
MUNICIPALITY OF ANCHORAGE
DE RTMENT OF HEALTH AND HUMAN SER ES
Environmental Health Division
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Name DISTANCES
J"~ J~'q~gd~"L'-~ ~~ ~ Tn SEPTIC ABSORPTION
~ 'FRO~~ TANK FIELD WELL
LEGAL DESCRIPTION _
~ ~ ~ FOUNDATION
Township, Range, Section
~[~ ~ ~ [' ~ ~' ~ d?veway,AS-BUILTwaterDIAGRAMbodies, etc.)(Sh°w local,on ot well. septic system, property hnes, loundat,on,
~ SEPTIC ~ HOLDING
Material No. gl Compadments
TYPE OF SYSTEM
~RENCH ~ BED ~ W. DRAIN ~ OTHER
Depth [~"~'p'e bottom from ~otal depth from original grade
or,gmal grade ~ FT ~ ET
Fill added above original grade Gravel depth beneath p~pe
Gravel length Gravel w~dth ~ m ~
i Total absorption area Distance between lines I
~ PRIVATE ~ OTHER (Identify)
Classification (A,B,C) 7oral Depth Cased to
~ FT FT
Installel Date Installed:
I 11034 Eagl~ River L~ RNd No. ~ Gedify that this inspection
Eagle River; Alaska 995~ ' ~ ~/~ ? was pedormed according to all . , ,.,?, -, ~,~.:' "'~.
Municipal and State guidelines in effect on~dale: ./
72-013 (3/85)
S & S ENG :1. NEI':ii.R :[ NC:.i
:1. *'(.'~ ]! 4 E ,, R. t....CiC}P .'1:t:2()4
[ii:(-:l(::iL. ti!i: R :[ VER ~ AK 995'?'?
I::' I"] Ci N E:: :t:~. 69 4 - 2 9 ? 9
C(]I'..I't'ACY'I" l:::'HOtqfii!:: :345-:]!;656
l....l!ii:C~Al... X}ESC::R I t:::']' :1. ON: I....C:¢1' 15B BOI',tD SI...IBD I V :[ S I C)N
!iJl:.'~:C] ::i!;3 v 'T' 121'..1 ,~ R3W
t....C)]' S ]: Z i!i!:: 4 4 ? ?' 2 ( SC! f::"t' C)R ACRt!i!:S )
MAX,. Ixli..lt'"l['::;ti']:l::~.'. C:q:::' B[i::.DRC]C)MS: 4
S 01 t .... R A '1' I lq G: 1 :::.!;(.) S (,.:! I:::' "1' / BI::;:
SC) :[ L.."fES'l I}l.'i!]:::']'H: 1 3 [:: ]'
t'..IC) t/,IA'TER I:::'RI:i!:SEIxII" :l:I"..I I'ES't" I"'IC}I...E.
'T'H I S :1: S At"'..I UPGRADE OF:' 4 Bti::DRO(::iM TO THE [:i: × :[ S"I I NG SEP"I" :1: C; S¥S'f liii. kl
St'::'l:.ii:L: ). (41 .... CC:~lqi.) :!: 'f :1: CiI',IS ()R 11qS"I'RUC'T I OtqS:
'I' H :1: S :i: S AN I..!I::%RAX}I!~: I"0 AI:.I tiii: × I S"I" ]: I~1["; SYSTI!ii]¥1 I?q...l :[ C::H HAS I::'A :1: I....liii:C:,,
1
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
PERFORMED FOR:
LEGAL DESCRIPTION: ~-~
3
4
7
8
g
~0
~2
14
15
16
17
18
19
2O
Township, Range, Section:"T'[~ ~
SLOPE SI-I~E PLAN
WAS GROUND WATER k I
ENCOUNTERED? r''-JI.O
s
L
IF YES, AT WHAT O
DEPTH? p
E
Deplh to Waler AJJ~,,~.
MonitorinD?
..I I
Reading Date Gross Net Depth to Net
Time Time Water Drop
~ q~.~? ~o:,/~'~ ~ ~ ~/~ - ......
"z._ il: ~'^ ~o ~,~, I~?~" ?'/~"
PERCOLATION RATE ~'t~'2) (m,nute$/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN ~ FT AND __ FT
COMMENTS
p n ~n. .... ~7034 Eagle Etver Loop Road ;'~ ..... ,1.. ///~ /// /
Eagle KlYmr, ~,a ........ ~.~'/~-/ CERTIFY THAT T/YlIS TEy WAS PERFORMED IN
72-008 IRev.
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
I ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
I I UPGRADE
~' DISTANCE TO:
~ Manufactu~?~f -- ~~ / No. of compar~ts
L~ ~~allons IF HOMEMADE: Inside length Width Liquid depth
~ ~ DISTANCE TO: Well ~ ~ ~ Dwelling PERMIT NO.
~_~O Z ~ Manufacturer / - / ~'~ Material Liquid capacity in gallons
I DISTANCE TO:
~ ;~ N°'°fline° / Total'~l'~ Tren~th "inches Distancob~?n
; ~ Top o~e ~ ~sh~ grade ~rillEbe ne~%~ ~%~ile ~ inches Total effective absorption area
Leng~ Width ~epth / PERMIT NO.
~ ~ Tgpe of crib Crib diameto~ { Crib depth Total effectiue absorption area
m Well / Building foundation Nearest lot line
~ DISTANCE TO:
~ Class ~ ~ ~ Dep~, ~-~r Distance to lot line PERMITNO.
~ ~ DISTANCE TO: Building founCtion Sewer line Septic tank Absorption area(s)
OTH E R
PIPE MATERIALS
'2 ·
REMARKS
72-
Rev. 3~78)
PEF.:M I T NO.
[:,EF'RF.:TMENT, ._, HEAL. TH AND ENv I RONMENTRL, , .,_F TECT I ON
825 "L'" STREET., FtNCHOF.:AGE., AK.
264-4728
I-4ELL_ F'EF-:I-'"I :E T
,:: 82.:0887 ',
APPLICANT MARSHALL N BONE:,. SRA BO;:< 2112.: 9'~.507
LOC:AT I ON
LEGAL T±2NF.:2.:N S 2.:]. L"I._E, .. LOT '_-,I.-.E
99.99.'9'B. S6!UARE FEET
M]:NIMUM DISTANCE BETWEEN A NELL RN[." AN'¢ ON-SITE SEWAGE DISPOSRL SYSTEM IS
i00 FEET FOR A PRIVATE NELL OR "150 TO 200 FEET FROM A PUBLIC WELL [:,EPENE:,ING
IJPON THE TYPE OF PUBLIC NELL.
MINIMUM DISTANCE FF.:OM A PRIVATE NELL TO A PRIVATE SEWER LINE IS :"5 FEET AND
TO A COt'"IHUNITY SEWER LINE IS 75 FEET.
NELL LOGS ARE REQUIRED AN[:, MUST BE RETURNED TO THE DEPARTMENT WITHIN 2.:0. [:,RYS
OF THE WEEL COMPLETION.
OTHER REQUIREMENTS MAY APPL'¢. ':-';PECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AYAiLRBLE TO INSURE F'ROPER INSTALLRTIOFL
I CERTIF'Y' THAT
REHENT=, FOR LN-=,ITE SEHERS ANE:, WELLS RS SET
::L · I A M F A M I L I a F.: W I T H T H E F.:E 6! U I ' ' '- n '-
FORTN B"r' THE MUNICIPALI T'¢ OF HNL. HUF. M-~E.
;.:Z: I WILL INSTALL THE .S'¢STEM IN ACCOR[:,ANCE WITH THE CO[:,ES.
S I '3NE[:': ~~.~--~ ........
AF'F'LICaNT MARSHALL N E:ON[:' ~
'v'4. 0
MUNICIPALITY OF ANCHORAGE
/. Department ~f Health and Environmenta" Protection
825 ,~ Street, Anchorage, AK. j9501
264-4720
* * * HANDWRITTEN PERMIT * * *
/~/~.~ '.~//.~..~,=~k-/OR ON-SITE SEWER PERMIT
Applicant: . . ~~ Mailing Address:
Permit
Location: Phone Number:
Legal Description: ,~ /~-~ 2~/~ Lot Size:
Type of Soil Absorption System Is:
Trench: Drainfield: Seepage Bed: Holding Tank:
of Bedrooms: ~_~ Soil Rating(sq.ft/br)
Maximum
Number
The Required Size of the Soil Absorption System Is:
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 = /.~5~0 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 31, 1 9 8 3 * * *
I certify that:
(1) I am familiar with ~he requirements for on-site sewers and wells as
set fort )y the .~hicipality of Anchorage.
I wi. .~,~ system in accordance with codes.
I un, ~t the on-site sewer system may require enlargement
the 's~-modeled to include more that 3 bedroo~s.
Issued by ,
S igne~:
fort~
((2)
3) un.,~r s. ~ t~ if
SWP/024 (1/81)
I')[P/\ItI'Mi ~'.t ()t Ill AL.TI-lAN[) I-NVI/,~r,[,~ll "~JlAI ['I~'£)I-EC i ii
<Permit #: 821191
.January 31, 1983
TO: Permit Applicant
Subject: Lot 15-B Bond Subdivision
A permit issued by this department for an individual well
and/or on-site sewer system has expired as of December 31,
1982.
Permits are issued on a calendar year basis, as stated on
the permit, by authority of Municipal Ordinance.
If you have drilled the well, a well log needs to be sent
to this department for documentation of the installation
date and to close the permit.
If a private engineer inspected the installation of the
on-site sewer system, please have them send us the as-builts
for our files and documentation.
If there are any further questions, please call this office
at 264-4720.
Sincerel~
Robert C. Pratt, R.S.
Acting Program Manager
Sewer and Water Program
RCP/ljw
enc: Copy of Permit
SWP/057
PERMIT NO.~" ~' · '
APF'LICANT MARSHALL BOND
LOCATION
LEGAL LT, tS-'B BONE:.' S,."D
l',llbll'-.I I E: 1~ r'~F-IL_ I -ir't-' C,-'mF.- Rr-JC:H,-~:RGiE
DEF'RRTMENT HEALTH AND ENVIRONMENTAL .:uTECTION
825 "L"' STREET,, ANCHORAGE., FI[(. L~.9501
264-4728
SEL,JER PE~: f-1 I 'T
C,,."O S&S EN6 7125 OLD SEWARD
LOT SIZE L=~9999 S(;'.UARE FEET'
T'¢FiE OF SOIL ABSORPTION SYSTEM/4IS: ~:H
~. =,W FT/BR) = 90
THE REQUIRED SIZ~F' THE SOIL RBSO~~,~~ .SYS_ TEM IS:
B'EPT'Ft= 8 LEf48TH=: ~4 ,B~:R%-'EL B'EPTH:: 4
THE LENGTH DIMENSION IS THE LENGTH (IN FEET> OF THE TRENCH OR DRRINFIEL. D.
THE DEPTH OF ~ TRENCH OR PIT .IS THE DISTANCE BETWEEN THE SURFFiCE OF THE
GROUND AND THE BOTTOM OF THE EXCaVaTION (IN FEET),
THERE :IS NO SET MIDTH FOR'TRENCHES.
THE 6RAVEL DEPTH IS THE r'IlNIHUH DEPTH OF GR~VEL BETWEEN THE OUTF~L.L PIPE
~ND THE BOTTOM OF THE EXCAVATION (IN FEET).
PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE
INSTALLATION INSPECTIONS OF 8N¥ WELLS ADJACENT 'fO THIS PROPERTY 8ND THE
NUMBER OF RESIDENCES THAT THE WELL WILL SERVE.
TF~O <2) I [4SPECTI EmNS I--tRE REG~(] I ~:E;C~
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN ~] WELL AND ANY ON-SITE SEWAGE [:,iSPOSAL SYSTEM IS
~00 FEET FOR ~ PRIV8TE WELL OR i50 TO 200 FEET FROM R PUBLIC: WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL.
MINIMUM DISTANCE FROM R P~IVRTE WELL TD R PRIVATE SEWER LINE IS 25 FEET
TO R COMMUNITY SEWER LINE I$ 75 FEET.
OTHER REQLII REMENTS MAY ~PPL'¢. SPECI FICBT IONS AND CONSTRUCT ION [>IRGRRf'IS I~
AVAILABLE TO INSURE FE.FEE INSTALLATION.
F'ERf-1 I ~' E>,;P I E:i=~ [:.BE:EMBER ]:l...
I E:ERTIFY THAT
i: I 8M FRMIL. IBR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
3: I UNDERSTAND ]"HBT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENL, RROEMENT IF THE
RESIDENCE IS REMODELED TO INC:LUDE MORE THAN ~ BEDROOMS.
APPL. ICRNT MRRSHAL. L BO~, /
PERMIT NO.
DEPARTMENT L HEALTH AND ENVIRONMENTAL ...:OTECTION
825 'L' STREET, ANCHORAGE, AK. 99501
264-4?20
C~r-~--'__~.ITE ~.EL-]ER PER£"I IT
< 82119i )
APPLICANT
LOCATION
LEGAL
MARSHALL BOND
LT. i5-B BOND S?D
C?O SiS ENG 7125 OLD SEWARD
LOT SIZE 99999 SQUARE FEET
TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH
MAXIMUM NUMBER OF BEDROOMS = ~ SOIL RATING (SQ FT/BR)=
?
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
90
[:,EF'TH= :3 LEI~4GTH= 34 GRR'-.~EL [:'EPTH= 4
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD.
THE DEPTH OF R 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).
REL~,U i" F-:E[:, _C. EF'T I C: TANK $ I ZE= lp3£tF_-i GRLLON~_-~
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.
TLdCm <2> I [-4SF'ECTI CmN_-~. RFJE F:Emi41_II ~:E[:,
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTRNCE BETWEEN 8 NELL RND ANY ON-SITE SEWRGE. DISPOSRL 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 R PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND
TO A COMMUNITY SEWER LINE IS 75 FEET.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
F'EF-.'r.1 X T E:-=:F' ! F;:ES E:,ECEr'IBEF-: _~-~1..
I CERTIFY THAT
t: I 8M 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 THE CODES.
~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS.
ENGINEERS, INC.
7125 OLD sEWARD HWY,
ANCHORAGE, ALASKA 99503
;549 - 6561
.... u -50 t1_5 LOG
PERCOLATION
TEST
SOILS LOG - PERCOLATION TEST
PERFORMED FOR:
LEGAL DESCRIPTION:
1
2
3
4
5
6
7
8
9
SLOPE
SITE PLAN
\
t ·
10
11
12
14
18-
2O
COMMENTS
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTEP
S
L
0
P
E'
Gross
Time
Net
Time
Reading Date
Depth to
Water
Net
Drop
PERCOLATION RATE
TEST RUN BETWEEN
FT AND
(minutes/inchl
__ FT
72-008 (6/79)
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
Parcel I.D. #
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
1. GENERAL INFORMATION
Complete legal description
Lot 15B; Bond EstateS
Location (site address or directions)
Property owner
Mailing address
Marshal Bond
~710 De~rmoun Road
HO04 Box 9985 Palm~r,
Anchora_q¢, AK
Day phone
AK 99645
746-6122
Lending agency
Mailing address
Day phone
Agent
Address
Day phone
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS:
TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
NOTE:
4
XXX
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer ~
NOTE:
XXX
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev. 1/gl) Front MOA #21
5. 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~hisfi~spection.
Name of Firm ,,-~-/<~/ Phone
Address ...... aul. E;ver Looi:~l~ad/l(Io. 2~ _~'~" .- - /
· Eagle River, Ala k~a 9~5 '/~'.-.//--/~' /-~
Engineer's signature ~ , ;s~-__-~/.~~ Date.
"'":;-:/ "-'/-
' · ,~.~./,'..~~;~,.. ,~..~1.~ * 'ii.
-
· ~.T~ , .~,~ -~..T,.,,
~;~,., · ...... .~ .~.~?' .
DHHS SI~NATUR£ · c// "~'~"~'~":~ '
/-"'~Approved for ,,c:j[. bedrooms.
Disapproved.
Conditional approval for
bedrooms, with the following stipulations:
Additional Comments
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations g~ven in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS 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 wc,'k.
(Rev. 1,~1) B~ck MOA ~1
Municipality of Anchorage
Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description:
A. Well Data
Well type
Log presenl~N)
Parcel I.D.
Total depth /
Sanitary seal ~1)
If A, B, or C, attach ADEC letter. ADEC water system number /L~/~
Date completed ~'/~/~$ Driller /H -~' /.,~/~..//,.~r~
Cased to /3 ~ ~ Casing height
Wires properly protected(~/N)
FROM WELL LOG
Date of test
Static water level
Well flow
Pump level1 ~//~
SEPARATION DISTANCES FROM WELL TO:
Septic/l~aaik~ tank on lot /(_~C) ~'-~
Absorption field on lot / 0 0 ~'7~
Public sewer main r~ r~
Sewer service line Z~'/Y"-
AT INSPECTION
g.p.m. ~, 0
Iz~ '
; On adjacent lots
; On adjacent lots
Public sewer manhole/cleanout
Petroleum tank
WATER SAMPLE RESULTS:
Coliform ,(~//00~ ~ Nitrate
Date of sample: ~-~ / CP_~/~. ~
/O ~,~',//,,~' Other bacteria
Collected by:
B. SEPTIC,~I~-BIN~ TANK DATA
Date installed ~'"~-~
Cleanouts Y~)
High water alarm (Y~.
Date of pumping / /
Tank size /2 ~-O
Foundation cleanout (~N)
~r.-~ (__ Compartments
Depression (Y(~
Alarm tested (Y/N)
Pumper /~OTO - /~
SEPARATION DISTANCES FROM SEPTIC/H~=I~rTANK TO:
Well(s) on lot /C~O/7~ On adjacent lots
To property line //d_~ ('7~- Absorption field
Surface water/drainage /~)~ rT'~
Foundation /0~
Water main/service line
72-026 (3/93)* Front CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed
Size in gallons
Vent (Y/N)
"Pump on" level at
Soil rating (GPD/Ft2)
High water alarm level
Meets MOA electrical codes (Y/N)
SEPAF~~FI STATION TO:
._.~ot On adjacent lots
D. ABSORPTION FIELD DATA
Date installed ~ / !~r /
Length
Total absorption ama
Date of adequacy test
Water level in absorption field before test
Peroxide treatment (past 12 months) (Y/N)
Manufacturer
Manhole~
~les tested
Surface water
Width ~-, ~' / Gravel thickness
,~'~ (~ ~' Cleanout present ~N) ~'/"~'-..g
..-~//~/~ Resu~~ail)
~ After test
,.,-/
//.~ 0 ""/~/~ System type 'T-/'~"LJ c__ H
/ Total depth ~ /
Depression over field (Y~__)~ ..,'.-J o
for ~-' _~.~ Bedrooms
/~,~/,..) £ J~/~2(_2/.,O/,-) If yes, give date ,/~J//~
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot /~...~(--~ "'/'~
To building foundation ~o /
On adjacent lots ,~ C2 '--~
Surface water
Curtain drain
On adjacent lots / (___.~ ry._ Property line
To existing or abandoned system on lot
Cutbank /Jo ~" /~~~"-Water main/service line
Driveway, parking/vehicle storage area ,~ ~
E. ENGINEER'S CERTIFICATION
Na~~EERING
Engin~fs
'~l ~g,e k,ver L~p eoa~N
Date ~gle River, Alaska 99577
HAA Fee $ ,.-~). ~
Date of Payment
Receipt Number
72-026 (3/93)' Back
Waiver Fee $
Date of Payment
Receipt Number
APPLIC-NT FILLS OUT UPPER HA! ONLY
Property:O:-,,ner ¥" ~,) /¢,~,~? ~;p,. J~i'_.,~7. ~.<.L~.:...I~,,'~ Phone
. ._, /' .:. ~, . / ', ..-,
Mailing Addre~ .~/~
Buyer
Address Zip Code
Lending Institution ' /;{~c.~_...:..::':':r..() _:~:,. ~, ~'~ :~z:'~ .:?,-.. ~. Phone
Address Zip Code
Realty Co. & Agent Phone
Address ~.X (~ Zip Code
Legal Description ~-"~'~' _~ /~J ~ ~~ ~'~ ~57 ,~ ..~s~_.~/~l ~,~. -.
Street Locat m ~ , ~
J),: ................. ...... t) .,. ... ~ ~: .... :-, ~-~' /~., ~_,.,,
Type of Resi~nce
~ Single Family
~ Multiple Family No. of Bedroo~
~ Other
Individual O.X
~ ~ C~.n,ty '"~.~q2~x ~ACH W~LL LOO. ~ ~ ,~, ~ ~.q.~r~d f~,., ~.mm, d~,m~d ,~n~ J... ~?~.
For wells drilled prior to that date, give well depth (atlach Icg if available).
~ Public Utility
Sewer Disposal ~ ~:.~,,
~ Individual Year Individual Installed:
~ Public Utility When Connected to Public Utility:
~ Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED.
Time Time Time ,. , Time
Date Date Date ~'i-~,Ax ,x~ ~-- Date
- ,._ > .~
Insp~tor ' ,?
Inspirer Inspirer Inspirer ~ ,~
~eld Notes: ~.~ ~~~ / MUNICIPALITY OF
~ k/.J ~--4 :'i'.,'~v ~ ' /I EN~:~ ~, ~,~:~
' ' ' ' ,, <~ ,~x~ FEB '~ 4
....... , ....... RECEIVED
~ ~ .,s~.~ow~
15~~
Soil~ R~ling Date ~wer Installed Well To Absorption Area (~ ,:-i - Well Log Received /
~ O~ .~- ~ _ X~ WelltoTank ,1 ~r~ {{ Septic T~k Size
' INSPECTION APPOINTMENTS .
TIME TIME TIME
DATE DATE DATE
INSPECTOR INSPECTOR INSPECTOR
MUNICIPALITY OF ANCHORAGE '' CIPALITY OF ANCHORAGE
825 L Street - Anchora~, Alaska 99501 E~IEONMEN~AL F~:OTE~tO~
ENWRONMENTAL SANiTATiON D~WS~ON ~AY 2 ? 19~0
Telephone 264-4720
DIRECTIONS: Complete all parts on page 1. Incomplete requ.~ will not be proceed. Please allow ten (10) days for processing.
1. PROPE~OWNER . ~ PHONE
PROPERTY RESIDENT {If different from abov~ ~r~ ~ PHONE
2. BUYER ~ _ ' PHONE
3. LENDING INSTITUTION ~ ~ PHONE
MAILING ADDRESS
MAI LING AD~R ES~
5,' I:E~AL DESCRIPTION
....
6, TYPE OF RESIDENCE
SINGLE FAMILY
MULTIPLE FAMILY
7. WATER SUPPLY
~ INDIVIDUAL*
[] COMMUNITY
[] PUBLIC UTILITY
NUMBER OF~BEDROOMS
[] One [] Four
~ Two [] Five
[] Three [] Six
[] Other
~ ~--~,~,~ ATTACH WELL LOG. A well log is required for all wells drilled
since June 1975. For wells drilled prior to that date, give well
depth (attach log if available.),~/,~' /o~b~
8. SEWAGE DISPOSAL SYSTEM
~INDIVI DUAL/ON-SITE**
YEAR ON-SITE SYSTEM WAS INSTALLED.
[] PUBLIC UTI LITY
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED·
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE
rtl. SINGLE FAMILY
[] MULTIPLE FAMILY
2. WATER SUPPLY
INDIVIDUAL
[] COMMUNITY
[] PUBLIC UTI LITY
Connection Verified
3. SEWAGE DISPOSAL SYSTEM
[] IN DIVI DUAL/ON -SITE
[]PUBLIC UTILITY
Connection Verified
[]Septic Tank or [] Holding Tank
Size: If Tank is homemade
give dimensions:
[] ONE
'E~Y' TWO
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
NUMBER OF BEDROOMS
PERMIT NUMBER
[] THREE [] FIVE
[] FOUR [] SlX
DATE I NSTAL.LED
INSTALLER
SOILS RATING
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCES
WELL TO:
Absorption Area to nearest Lot Line
[] OTHER
Septic/Holding Tank IAbsorption Area
Sewer Line
Nearest Lot Line
5. COMMENTS :.~.
[]~;]--- DISAPPROV ED
DATE
APPROVED FOR BEDROOMS
CONDITIONAL APPROVAL (letter must accompany certificate)
72-010 (Rev. 6/79)
] unicipality
Anchorage
825 "L" STREET
ANCHORAGE, ALASKA 99501
(907) 264-4111
GEORGE M. SULLIVAN,
MAYOR
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
May 30, 1980.
Judy/Pat Mulligan
% Realty Center
8301 Arctic Boulevard
Anchorage, Alaska 99502
Attention: Skip Minder
~Subject: T12N R3W Section 33 Lot 15
Approval for the individual sewer and water facilities
can not be granted until the following items have been
completed:
(1)
The water analysis report be delivered to this
department from Chem Lab, 5633 B Street, for
our review.
(2)
The well casing extended twelve(12) inches above
ground level. A cement vault needs to be built
around the well casing at ground level.
(3)
A 1,000 gallon septic tank needs to be installed.
Prior to the installation, a permit needs to be
obtained from this department.
(4)
An adequacy test 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 our review.
Judy/Pat Mulligan
May 30, 1980
Page Two
In the event the adequacy test fails, an upgrade of the
sewer system will be required. A soils test will need
to be performed and a permit obtained from this department
prior to the upgrade.
If there are any further questions, please call this office
at 264-4720.
Sincerely,
Robert C. Pratt, R.S.
Associate Specialist
RCP/ljw