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Home My WebLink AboutSPRUCE ACRES LT 9 MUNICIPALITY OF ANCHORAGE DEPT. Of ~!ZALT~t & DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTEC~'J~Oi~i~,ENTAL P~,O~ECTiON APR 2 ENVIRONMENTAL ENGINEERING DIVISION TeJepho,e 264-4720 RE_6E!~ED REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10} days for processing. MAI LING ADDF~ES~ ' ~.,~ 2. BUYER MAILING ADDRESS PHONE PHONE PHONE 3. LENDING INSTITUTION J PHONE MAILING ADDRESS TREE~LOCATIONV ~.j ~ -- 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] One [] Four 'J~- SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY ~ Three [] Six [] Other 7. WATER SUPPLY -~ INDIVIDUAL~ ~ ATTACH WELL LOG. A well log is required for ali wells drilled [] COMMUNITY since June 1975. For wells drilled prior to that date, give well [] PUBLIC UTILITY depth (attach 10g if available.) 8. SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON-SITE~ ~ PUBLIC UTILITY If individual/on-site, give instalJation date If system is over two (2) years old an adequacy test is required by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78} THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY El INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED f-] PUBLIC UTILITY Conn'ection Verified LOG RECEIVED 3, Sr-'WAGE DISPOSAL SYSTEM , PERMIT NUMBER [] iNDIVIDUAL/ON -SITE DATE INSTALLED E3 PUBLIC UTILITY Connection Verified INSTALLER []Septic Tank or [] Holding Tank Size: If Tank is homemade ~ SOILS RATING : give dimensions: TYPE OF TANK ' MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCESwELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS ~APPROVEDFOR -.~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED -' ~' )- LEGAL DESCRIPTION 72-010 (Rev, 3/78) C _k4~!ll~__Jl_ & eEOLOelGAL. LAi~O~ RATORIF~ OF AI.ASK~ INC. P.O. BOX 4-1276 ~ 4649 BUSINESS PARK BLVD. ANCHORAGE, ALASKA 99509 Drinking Water Analysis Rep~ort for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER~ PUBL,~ WATER SYBTEM; Public Weler stem Name State .;~ Zip Code City Mo. ~ Day Year SAMPLE TYPE: [] Routine [] Check Sample (for routine sample with lab ref. no. ) [] Special Purpose SA~IPLE NO, LOCATION ~ I I ~-. ~:~'T' ~ ~"~1 ~l I [] Treated Water [] Untreated Water Time, ~{- Collected Collected/ By /.-~ 3 l I 4 [ I TELEPHONE (907) 279-4014 TO BE COMPLETED BY LABORATORY LABORATORY: NAME ADDRESS CITY Date Received Y- Z'~ Time Received /.~/0 :Analytical Method: [] Fermentation Tube ~Membrane Filter Lab Ref. No. Result* Analyst I ~ I ICl I ~ I [-~ READ INSTRUCTIONS BEFORE COLLECTING SAMPLE Form No. 18-310 (3-78) o6-1220 (b) BA~ERIOLOGICAL WATER ANALYSIS RECORD Rev. 1978 Presumptive 10mi 10mi 10rnl 10ml Membrane Filter: Direct C0gnt Final Membrane Filter Res~t$-'~ . Broth 48 hours~ Col]form/100ml unicipali o Anchor ¢ 3000 ARCTIC BOULEVARD ANCHORAGE, ALASKA 99503 (907) 277-7622 GEORGE M, SULLI VAN, MA YOR DEPARTMENT OF ENTERPRISE ACTIVITIES Sewer & Water Utility April 27, 1979 To Whom it May Concern: The below mentioned parcel is tied into our sewer system, and the main is maintained by A.S.U. Address: 3495 E. 84th Legal: Lot 9 Spruce Acres Tax Code: 014-231-34 Grid M of A: 2235 Grid A.S.U.: 5041 Dwg # of main line: i04 EWS Engineering Technician IV Anchorage Water & Sewer Utilities JGT:pc April 26, 1979 Greg Massengale 3495 East 84th Avenue Anchorage~ Alaska 99507 Subject: l~t 9 Spruce Acres Subdivision I have contacted S~;er utility and they have informed me that they have no record of Lot 9 Spruce Acres Su~tivision being connected to the public sewer. They do have record of 3495 East 84th Avenue being connected, which is located on Lot 7 Spruce Acres Sul~livision. If you have put the incorrect legal on the requsst fo~ please inform this office. If you are not connected to the public set{er, you will need to do so before final approval will be sent to the lending ageneyo If %here are any further questions~ please contact this office at 264-4720. Sincerely~ Robert Co Pratt~ Associate Specialis~ ~C?/ljw #1: Time Date Insp '~-'~NICIPALITY OF ANCHORAGE~'-~--~ DEPARTMEN ~ HEALTH AND. ENVIRONMENTA ~ROTECTION 825 L Street, Anchoraa~. Alaska 99501 · 264-4720 Date Received: October 26, 1977 9:30 a.m. #2: Time #3: Time 10-27-77 Thursday Date Date Pratt Insp Insp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES Lending Institution Request: First Federal Savings and Loan Mailing Address: Post Office Box 4-2200 Phone: 274-6561 2. Property Owner: Mailing Address: John W. Klingbeil III Star Route A Box 1553I 99507 Phone: 344-0785 3. Legal Description: Lot 9 Spruce Acres Sudivision 4: Single Family Residence: (x) Multiple'Family Residence: ( ) Number of Bedrooms: Three Number of Bedrooms: Well System: Permit # Construction Individual Well (x) Community/Public System ( Depth of Well 99f Well Log on File Bacterial Analysis Sewage Disposal Permit # Septic Tank Size Absorption Area System: On-site System ( ) Public Utility Installed Installer Manufacturer Soils Rate Material (x) Distances: Well to to Sewer Line to Nearest Lot Line Septic Tank Nearest Lot line to Absorption Area Absorption Area P'age Two ~ ~ ~ Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 9 Spruce Acres Subdivision Comments: Affadavit Attached: Approved: ~..O~ Disapproved: Letter Attached: ( ) Date: Date: Department Worksheet: '~IUNICIPALITY OF ANCHORAG'~ q'lO'~ Departmen~ of Health and Environmental Profec~i~,,~,, ,',:, .. 825 L Street, Anchorage, Alaska 99~Q~; .~ ~,., Property Owner: ~./Z/ ~/, Mailing Address: / ~ -ill Phone 2 o 3 o Name of Buyer: Mailing Address Mailing Address: Phone: 4. Realtor/Agent: Mailing Address: 5. Legal Description Street Location: Phone: Single Family Residence: (~'/Number of Bedrooms: Multiple Family Residence: ( ) Number of Bedrooms: 7. Water Supply: *Individual Well (my Public/Community System ( ) If Individual Well, well depth If Con, unity System, name of system 8. Sewage Disposal System: *~n-site System ( )dublic System~( ) If On-site System, date of installation: *NOTE: A well log is required on ALL wells drilled since 6/75. ** If on-site sewer system is over two(2) years old, an adequacy test is required by this department. A fee of $25.00 must accompany each request before processing can be initiated. 3/77 06-1220(a)/ Rev. 1973 DATE ALA,e"'"~"'~PARTMENT OF HEALTH AND SOCIAL S["---~'~ DIVISION OF PUBLIC HEALTH INDIVIDUAL AND SEMI-PUBLIC BACTERIOLOGICAL'-WAT£R ANALYSIS OPPICE INDIVIDUALly\ SEMI-PUBLIC [] CHLORINE RESIDUAL PPM COMPLETE THIS SECTION ONlY IF WATER IS AN INDIVIDUAL SUPPLY SAMPLE COLLECTED BY "\~ ~,1~ '~'J,~, I~' C-~,~ DATE COLLECTED ., '~, k!- '-J'? TIME COLLECTED Diameter of Well Well Casing MaleriaJ Diameter Length of Drop Pipe Offset in PUMP LOCATION: [] In Well [] Basement On Top [] In Basement [] Room [] Yes [] No READ INSTRUCTIONS ON REVERSE SIDE BEFORE COLLECTING SAMPLE" Ana]ysls snows this Water SAMPLE TO be: [] Satisfactory Questionable [] Sample too long in trans~t~ sample s~ould not be over 48 hours old at exam~natbn to indicate reliable results. Please send new sample. [] Boltle broken in transit, please send new sample. SANITARIAN'S REMARKS This amllysJs indicotes Coliform O*'g~nJsms to be: f~.s~n, i ~ ? Lactose Broth I0cc 10cc 10cc 10cc 10cc 1.0¢c 1.0cc 24 Hours 4~ Hours ~ , 064220 (b) BACTE~IoLOGi'(~AL~ WATER ANALYSIS RECORD