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HomeMy WebLinkAboutSTELIOES TR AOnsite File A new survey is required for a COSA. location (Electrical installed by PIPE MATERIAL House to tank EXIST( Tank to Installer lb drainfield D3034 A+ HOME SERVICES Drainfield D3034 CO/MT D3034 Inspector GEG AND MOA BENCHMARK (Assumed elevation) 100.00 ft Inspectionct15t 11/24/21 2�a 11/29/21 Location and description 3i° 11/29/2d 4'h11/30/2 BACK DOOR THRESHOLD ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp o6opp ,onditional Approval: Date / ................ Septic Systeme TO Ve rey�� orness:Approved f�/�% Date 2 0 C�-7953 01p" Note: this approval oes not include well permit requirements.°fess'W, oma #AECC884 (Rev 05/02/18) Municipality of Anchorage JAN `07 2022 On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP211323 PID Number: 017-422-30 Dwelling: X Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 0 Upgrade Name ALAN PEABODY ABSORPTION FIELD NORTH/ SOUTH El Deep Trench Wide Trench El Bed ❑Mound Site Address 12601 TURKS TURN STREET *ANCHORAGE, AK El Other Phone 907-345-6819 rNumber of Bedrooms Soil Rating Total depth from original grade 1.2 GPD/SF 4 (TO TOP OF SAND) Ft, LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe SEE DWG. Ft. 0.52 & 0.52 Ft. Subdivision STELIOES; TRACT A Block Lot Fill added above original grade Gravel length Township Range Section SEE DWG. Ft. 50 & 50 Ft. Gravel width 5 Ft. Beds: Number of Lines - Distance between lines - SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Ft. Dist. between trenches From Tank Field Tank Line 500+ Ftz 2 61+ Ft. Well 100'+ � 001+ 25'+ TANK IN Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Capacity Surface Water 1001+ 1 QQ'+ GREER TANK 1250 Gal. Material Number of compartments Lot Line 5'+ 10'+ NA HDPE 2 Foundation 10'+ 10'+ LIFT STATION Manufacturer Capacity Remarks OLD TANK WAS DECOMMISSIONED PER UPC PER CONTRACTOR Gal. location (Electrical installed by PIPE MATERIAL House to tank EXIST( Tank to Installer lb drainfield D3034 A+ HOME SERVICES Drainfield D3034 CO/MT D3034 Inspector GEG AND MOA BENCHMARK (Assumed elevation) 100.00 ft Inspectionct15t 11/24/21 2�a 11/29/21 Location and description 3i° 11/29/2d 4'h11/30/2 BACK DOOR THRESHOLD ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp o6opp ,onditional Approval: Date / ................ Septic Systeme TO Ve rey�� orness:Approved f�/�% Date 2 0 C�-7953 01p" Note: this approval oes not include well permit requirements.°fess'W, oma #AECC884 (Rev 05/02/18) PERMIT NUMBER: PARCEL ID NUMBER: OSP211323 RECORD DRAWING PARCEL I NUM — — — — — — — — — —10' UTILITY EASEMENT- -----'---------- DRIVEWAY ' GARAGE 2B HOUSE I l DBL / D / F 01 r H.#1 NEW 1250 GALLON HDPE GREER TANK T4 04 .7 RESERVE TRENCH ASSUMED LOCATION OF EXISTING BED PER ORIGINAL MT -LOCATION AND LOCATION OF RECENTLY INSTALLED MT & C/O DRAINFIELDS ®®OF J ®fie®® ,`PSE;,.. 8 ........ 4. .... ........ f ®•:n ::....I.N.............. ......... 0 J�ffre Garn s :41 C -7953 LICENSER ® ®SS p®®®4 #AECC884 9 Ltd ENGINEERING ;= SALES r, CONSULTING v •.,n -, .._, 3701 E. TUDOR ROAD. SUITE 101 'ANCHORAGE. AK 99507 -PHONE (907) 337-4179 -FAX (907) 338-3240 • WEBSITE: www gaznessenpn n g.wm PREPARED FOR: ALAN PEABODY PHONE NUMBER: PAGE NUMBER: 907-345-6819 2 OF 3 LEGAL DESCRIPTION: DRAWN BY: STELIOS; TRACT A D.J.G. TYPE OF WORK: DATE: I., SEPTIC SYSTEM RECORD DRAWING 12/28/2021 ASSUMED LOCATION OF EXISTING BED PER ORIGINAL MT -LOCATION AND LOCATION OF RECENTLY INSTALLED MT & C/O DRAINFIELDS ®®OF J ®fie®® ,`PSE;,.. 8 ........ 4. .... ........ f ®•:n ::....I.N.............. ......... 0 J�ffre Garn s :41 C -7953 LICENSER ® ®SS p®®®4 #AECC884 PERMIT NUMBER: OSP211323 RECORD DRAWING TOP OF TANK AT INTLET = 94.97 INVERT OF BUNG AT INLET = OF MH = 98.89 FINAL GRADE = 97.71-97.92 ST2 NEW 1250 GALLON H.D.P.E. GREER SEPTIC TANK PARCEL ID NUMBER: 017-422-30 NO GROUNDWATER WAS NOTED IN THE TANK HOLE DURING EXCAVATION PER CONTRACTOR 2" INSULATION TOP OF TANK AT OUTLET = 94.95 INVERT OF BUNG AT OUTLET = 94.15 ORIGINAL GRADE AT NORTH HIGHEST POINT = 93.45 IT FINAL GRADE = 94.21-95.31 SOUTH __ T.H.#1 FILTER FABRIC T OFINAL GRADE = 93.36-93.81 ORIGINAL GRADE AT HIGHEST POINT = 92.70 TOP OF SAND = 89.45 FILTER FABRIC o.sz' TOP OF SAND = 88.70 .4 :':•K :i:;:;a INVERT OF PIPE = 89.97 5, 0.52' BOTTOM OF EXCAVATION = 87.45 INVERT OF 5• PIPE = 89.22 BOTTOM OF EXCAVATION = 86.70 RELATIVE ELEVATION OF BOTTOM OF T.H. = 82.95 RELATIVE ELEVATION OF BOTTOM OF T.H. = 82.20 GARNESS ENGINEERING GROUP, Ltd ENGINEERING A ON 1 TIN slut L. I UUUR ROAU, SUI It 101 -ANCHORAGE, AK 99507 -PHONE (907) 337-6179 -FAX (907) 33&3246 • WEBSITE: w .gamessengine PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ALAN PEABODY 907-345-6819 3 OF 3 PROJECT/LEGAL DESCRIPTION: DRAWN BY: STELIOS; TRACT A D.J.G. TYPE OF WORK: DATE: �,, SEPTIC SYSTEM PROFILE RECORD DRAWING 1/24/2022 AV AV T.H.#1 ..... ...... ............... .... o a—. 0 0 rey �.�•• ess •1� ,'. CE -7953 • iAlF ♦♦ C�,p • • . 1 Z 2 ,,•`� fit. LICENse 4o%FESSO #AECC884 �`"` / 11:24 5C M Thu, 21 AM oil ':F IWi I )13'2azz Thu, Jan 13, 11:13 AM L-> -, a Z) There was two old ones over there we decommission both of them I I I I r 1r . � spay sae ;- 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://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP211323 Work Type: Septic Upgrade Tax Code Number: 01742230000 Site Legal Address: STELIOES TR A G:2840 Site Mailing Address: 12601 TURKS TURN ST, Anchorage Owner: PEABODY ALAN B & SHARON M Design Engineer: GARNESS ENGINEERING GROUP LTD This permit is for the construction of: Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy Effective Date Expiration Date: Lot Size in Sq Ft: Total Bedrooms: n J. t�epartrnent 8/6/2021 8/6/2022 98881 ❑ 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 Received B Issued By: �'� Date: g/ ! 2, Y• // Date: 4 sa r�r'' �p��, S'.rr.nyj4��.;N..m�,, E,r'�''a 3i �j'.`�� IN I L,, TIM %J NILR401 Development Ser\.lices Department � � Phone 907-343-7904 On-Site Water &. Wastewater Section � Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 017-422-30 Property owner(s) ALAN PEABODY Day phone 907-345-6819 Mailing address 12601 TURKS TURN STREET *ANCHORAGE, AK 12601 TURKS TURN STREET *ANCHORAGE, AK Site address Legal description (Sub'd., Block & Lot) STELIOES; TRACT A Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms J,26EDRODti1 HOUSE) APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field 0 Initial El Single Family (SF) Q (w/wo ADU) Septic Tank Fx� Upgrade Z Duplex (D) ❑ Holding Tank ❑ Renewal ❑ 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: 5 9 Waiver Fees: Date of Payment: g�3�21 Date of Payment: Receipt Number: Receipt Number: Permit No. OS P l 13 2 3 Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Clie nt FormsTermit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211323, Rebecca Carroll, 08/06/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211323, Rebecca Carroll, 08/06/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211323, Rebecca Carroll, 08/06/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211323, Rebecca Carroll, 08/06/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211323, Rebecca Carroll, 08/06/21 - --------- --- ���a�1s N�n1 s�&nl rN O Q) Ll� LO z �j . zt Lu > < z Q n- aur297- LIU O Z Q) OC ull LLII < 0 z �4 Lij LU - --------- --- ���a�1s N�n1 s�&nl rN Q) Ll� LO LL Lu > < z n- aur297- LIU Z Q) LLII < 0 z �4 Lij LU < LLI uj Uj CL < M i--Ij kr- LU i -i > Lij of z < < v) U- �A uj G u-2 Q U-1 < r. - __j w c - ne- ffiaf �-, u, :a I _J 00 < Lu 0 10 < Uj LLJ clg� --,I wj. Ln LU x < < > wt O Z ce c< ZL pc ZL ZL Cc Q4 cx- 4 CL 4 J Of 0 LL: 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 PHONE [] NEW Pad (l~j~ m~ Pyramid Excavating -~-/(o-~:Y-/O ~,UP(mADE LEGAL DESCRIPTION DISTANCE TO: Iwell /~0' I Abs°rbti°n area~o' Dwelling ~<~Z Manufacturer A~ChOr~5~ Material~,c~el N°.°fc°mpartments ~ ~ Liq. capacity in gallons Inside length Width Liquid depth , ~ Well Dwelling PERMIT NO. 0 ~ ~ Manufacturer Material Liquid capacity in gallons : Well Foundation Nearest lot ,ine_~ SO ~ DISTANCE TO: '¢O' NO. of lines Length of each I ne Total length of I'nes. Trench wi t Length Width Depth PERMIT NO. ~ ~ Type of crib :rib diameter Crib depth Total effective absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: ~ Class Depth Driller Distance to lot line PERMIT NO, m Building foundation Sewer line Septic tank Absorption area(s) ~ DISTANCE TQ: OTHER PIPE MATERIALS~ SOIL TEST RATING APPROVED DATE LEGAL 72-013 (Rev. 3/78) Permit MUNICIPALITY OF ANCHORAGE~ Department/~? Health and Environmenta~ ?rotection 825 '~ Street, Anchorage, AK. ~9501 ~d~ 264-4720 ~oSLo2- HANDWRITTEN PERMIT * * * · ~ ON-SITE SEWER PERMIT t~,~ gJ~iC. Mailing Address: Applicant: Location: negar Description: ~/FLC D ~sJ ~/~ Lot Size: Type of Soil Absorption System Is: Trench: Drainfield: Seepage Bed: ~/ Holding Tank: Maximum Number of Bedrooms: ~ ~ Soil Rating(sq.ft/br) ~ ~O ~v~, [.~/ The Required Size~/ of the Soil Absorptio~ystem, & ; Is: ' /~ ~, DEPTH /~ LENGTH ~A-/ GRAVEL DEPTH ,~- 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 ~ipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE = [0©o 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 * * * certify that: (1) I am familiar with the requirements for on-site sewers set forth by the Municipality of Anchorage. (2) (3) Signe~: and wells as I will' install the system in accordance with codes. I understand that the on-site sewer system may require enlargement if the residence is remodeled to include more that 3.bedrooms. Applicant SWP/024 (1/81) Date: ~/3~)/~ ~'ln the event that a Iiff~ station is instalied art lgj~aJ,,.~mJt and inspection must be 6Ta}~l~ As-buiits cannot be approved un- til the electrical inspection is received in this office, The electrical work mast be pe formed by a licensed electrician." ,:/ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L Street, Anchorage, Alaska 99501 264~4720 ~ SOILS LOG - PERCOLATION TEST PERCOLATION TEST iER FOF, MED FOR: EGAL DESCRIPTION: T,',',,-'~ ,b, ~.:,'~: ~% 10 11 12 13 SLOPE IF YES, AT WHAT DEPTH? SITE PLAN Reading q5 - AL DESCRiPTiON: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 2644720 [] PERCOLATION TEST SOILS LOG - PERCOLATION TEST DATE PERFORMED: SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Gl i i i i q 1- i-7-q--~ Net Net DATE: iORMED BY: r CERTIFIED BY: A.t. AS~A ENVIRONMENTAL CONTRO~ SERVICES, INC. 12'.OO' West 33rd Avenue Suite B ANCHORAGE, ALASKA 99503 Phone 276-1361 SHEET NO ~ OF CHECKEE BY DATE SCALE ALASKA ENVIRON~dgNTAL CONTROL SERVIOE$, INC. 1200 West'33rd Avenue Suite B 'ANCHORAGE, ALASKA 99.503 Phone 276-1361 MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING HAA # '.~ .~ O~ ('")('"h / o~ ~ 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include 10t, block, subdivision, section, township, range) Tract A; Stelioes Subdivision Location(address ordirections) 12601 Turks Turn, Anchorage, Alaska (b) Property owner Mailing Address (c) Lending Institution Mailing Address Paul L. Henderson NBA ATTENTION: Telephone: (home) Telephone Ruth LeBarr 503-899-1334 Business (d) RealEstate Company and Agent VISTA REAL ESTATE/Jim Pitts Address 3000 C Street, Anchorage, Alaska 99503 Telephone 344-9603 (e) Mail the HAA to the following address: (or check here~, if hold for pick up.) List contact person and day phone number below: S & S ENGINEERING/694-2979 17034 Eaqle River Loop Road, Suite 204 Eaqle River, Alaska 99577 2. TYPE OF RESIDENCE Single-Family;~: Number of bedrooms ¢-.-, 3. WATER SUPPLY Individual Well ~ Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site EX Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. Page 1 of 2 IeUO?,!puoo le^oJdd¥ leUO!~!puoo ,~o sbuJe/ pe^oJddes!Q /~ pe^oJddv ~.~.~.1~/' Xq SLUOOJpeq (~;~F:~-~/-~JOJ pe^oJddv '3¥AOWdd¥ SHHd '9 euoqdele± wJ!~ jo eweN Well Classification '~; "~-' h Well Log Present (Y/N) ~ Date Completed Total Depth~ f Cased to ~o f Static Water Level ~ / [MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) CHECKLIST - FEBRUARY 1984 CIPALITY OF ANCHOraGe343.4744 ENVIRONMENTAL SERVICES DIVISION Legal Description: (-~?~'~'~ Depth of Grouting Pump Set At If A, B, C, D.E.C. Approved (Y/N) /~)/~' ~ J~'~'~' Yield ~ .~_. ,~/~AA Casing Height Above Ground ! ~- "~' Electrical Wiring in Conduit (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot J To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results Comments Sanitary Seal on Casing (Y/N) u~ Depression Around Wellhead (Y/N) h) ; On Adjoining Lots / bO / ; On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole B. SEPTIC/HOLDING TANK DATA Date Installed ~ ~ -¢-6~ Size ( :25'Dff/~[ No, of Compartments StandpipeS (Y/N) ('t Air-tight CaPs (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contact on File (Y/N) Holding Tank High-Water Alarm (Y/N) hJ/~. Temporary Holding Tank Permit (Y/N) , SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply Well ! ~ O ' To Building Foundation To Disposal Field / O To Property Line To Water Main/Service Line Foundation Cleanout (Y/N) Date Last Pumped ;for To Stream, Pond, Lake or Major Drainage Course 72~)26 (Rev. 7/88)Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 2.. ~,0 ~/~ ~' Type of System Design Date Installed ~' -- -aF -- ~ -% Lerigth of Field .~ Width of Field .,~. z¢ i ~ Depth of Field ~ Gravel Bed Thickness f' -,)- Square Feet of Absortion Area ~ (¢ z.~ ~ Statndpipes Present (Y/N) Depression over Field (Y/N) fxJ Date of Last Adequacy Test Results of Last Adequacy Test _~-~:.~t.*:~.?c~£qt -- -~fDo~ /~,~,('~(FE:X:::)A/~ SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well I (c~ 0 To Property Line ~'-0 .~L To Building Foundation ¢~ To Existing or Abandoned System on Lot /~/~ ' ; On Adjoining Lots (' O0 /-iL To Water Main/Service Line [(.2 1c- To Cutback (if present) /'-2,/~ To Stream, Pond, Lake, or Major Drainage Course / cPO ~ To Driveway, Parking Area, or Vehicle Storage Area ~--0 ~ 1C Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at H'~-,.~i/'~ Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Company Date MOA No. ~ & $ ~;NGINEERING 17034 Eagle River Loop Road No. 204 Eagle River, Ala~ku 9~577 Receipt No. Date of Payment Amount: $ 72-026 (Rev. 7188) Back Receipt No. Waiver Fee: $ Date of Payment Page 2 of 2 APPLIC IT FILLS OUT UPPER HAU ONLY O~ner Buyer Address Zip Code LegalOescription T~V~ ~ ~ ~ ~ [ ~0~ ~(~t~ Street Locati~ ~ ~ ~-~ C. ~-t ~ ~ ~) Individual A~ACH WELL LOG. A w~l log is required for all wells drilled since June 1975. depth (attach ~ Public Utility ~ ~(~ ~ Sewer Disposal ~C~, L~ ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Time i Time Time Date Date Date Date Inspector Inspector Inspector inspector Field Notes: j DEPT, OF HEALTH ( ~.)_APPROVED BEDROOMS 'CONDITIONS OF~ APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received Well to Tank Septic Tank Size 72-023(31~) CErTiFicATE OF iN~I~.-~TION George Ste~£°e° - Stat ~OUte A BO~ 393A Tt2N R3W Se=tion 2~ t~ SJl St~ h~ t~W% (TraCt SINGLE FAMILY RE$1OENCE MULTIPLE FAMILY RESIDENCE C~X iNOiVIDUAL ~ cOMMUNITY/pUBLIC HOLDING TANK (Maintenance ReqU mdt C~ CONDiTiONAL AI~ROVAL (~ At~leMd) 0 Ol~Id~ROV ED C~ OTHERiD~bel SEAL