HomeMy WebLinkAboutT15N R1W SEC 5 LT 74 E2R:/.u.)
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~"i MUNICIPALITY OF ANCHORAGE
~ DIVISION
· DEPARTMENT OF HEALTH & ENVIRONMENTAL PROI~ct;TION
ENVIRONMENTAL ENGINEERING
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME PHONE ~ []NEW
DISTANCE TO: /~" ~ / '
~ IF HOME,DE:
~ DISTANCE TO: ~.~) ~. Nearest lot llne~ ~ - P E R M IT N O~~
~ No. oflines¢ ~thofeachllne Total length oflines Trench width Distance between lines ~
~ ~ ~ Top of tile to finish grade ~ Material beneath tile Total effective absorption area
~ ~ ~' inches
INSTALLER ~ /~ ~:~ ~.
- /
72-013 (Rev. 3/78)
PERMIT NO. (
RPPL I CRNT
LnCRT I FiN
LEGRL
['.-iLil'-.i :[ C T E'__RL ]C T%-" ~ljF Rf-.IC:H ~r3~RRi.aE
DEPRRTMENT 0 "'4ERLTH RND ENYIRONNENTFIL I )TECTION
825 "L' STREET., RNCHORRGE., PK.
264-4720
C,i~4--S T TE SE~-IER F'Ei:~-:~-'I ][ T
83:0024 )
[:'AN SEVERIN B:4 "~'-'-',
bLM_.IER RD
E±,."2 LT 74 T±5N RiW SEC 5
LOT SIZE
68:3-;2593:
~'~ SQURRE FEET
TYF'E OF _,uIL HB_,ORFTIuN _,'r_,TEIt '-' TRENCH n
· ,-" ,,I ,.~'%...[5 .~--' ~ ,.~_ ~,_,~,..F.e~.,_ , ....
I1H~'~tM_M NUMBER OF E:EDROOMS = 6 SOIL RRTING ,'SQ FT¢.E,R)-
THE REQLIRED SIZE 0F THE =,JIL RBSORPTION _,¢_,TE~I IS:
[:'EPTH= :_:: LEf-~GTH= 24----< 13RR%-~EL [)EPTI4= 4
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRFIINFIELD,
THE DEPTH OF R TRENCH OR PIT IS THE [:,ISTFtNCE BETHEEN THE SURFRCE OF THE
GROUND RND THE BOTTOM OF THE E,"4CRVRTION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFRLL PIPE
FIND THE BOTTOM OF' THE EXCRVRTION (IN FEET).
RELqLI~ ]I F~:E[:. SEPT l- C: TRP--II-(
F'ERMIT RPF'LICRN'F HRS THE F..E_F_N_IBILITY TO I[IFuRI1 THIS [:,EPRRTMENT DURING THE
INSTRLLRTION INSPEE:TIONS OF RNV WELL='], RD..TRCENT TO THIS FROFERT.r RN[:, THE
'I_tiB, ER AF RESIDENCES THRT THE WELL WiLL _,ER,E.
'--'" -' '- '-- ' -'=' ' -' - - ' ' 'F ¢- BY '-
EHbKFILLINL~ OF RNY _~Y_,TEi'I WITHOUT FINFIL IN_,FEL. TION RND HFFRJ~,HL THI=,
DEF'RRTMENT WILL BE SUBJEL-:T TO PROSEC:UTION.
MINIMUM DISTRNCE BETWEEN R WELL RND RNY ON-SITE SEWRGE DISPOSRL SYSTEM IS
100 FEET FOR R PRIVRTE WELL OR t50 TO 200 FEET FROM R PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL.
MINIMUM DISTRNCE FROM R PRIVRTE WELL TO R PRIVRTE SEHER LINE IS 25 FEET RND
TO R COMMUNITY SEWER LINE IS 75 FEET.
OTHER REQUIREMENTS MRY RPPLS. SPECIFICRTIONS 8ND CONSTRUCTION DIRGR8MS PRE
RVRIL8BLE TO INSURE PROPER INSTRLLRTION.
PEF:i'-'I ]; T E:~'::F' :[ RES [:.EC:EI-4BEF-: --.3:1.. 1"---~- E:--?-
I CERTIFY THRT
±: I RM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET
FORTH BY THE MUNICIPRLITY OF RNCHORRGE.
2: I WILL INSTRLL THE SVSTEM IN RCCORDRNCE HITH THE CODES.
3:: I UNDERSTRND THRT THE ON-SITE SEHER SYSTEM MRY REL.]UIRE ENLRRGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THRN 6 BEDROOMS.
RPPLICRNT DRN SEVERIN
................. .....
I'~l lEI:, :" ~ .... ~-- ~
',/4.
O & E ENG..~IEERING & DEVELO~.vlENT CO.
Box 90, Davis St., Eagle River, Alaska 99577
694-2774 or 688-2280
Russell Oyster
694-2774
i.~,.? .~/
Performed for: Name: - / ·
P. o.
Mailing Address: ·
' Z: Y.~.. ./-.~: '/V,
Legal Description:
SOIL LOG
/:: L/ /"~ ~ t A~ Tel. No.
Earl Ellis
688-2280
Depth (feet)
Soil Characteristics
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
z /:'/" ·
Ground Water Encountered: Yes
Proposed Installation: Seepage Pit
Comments'
.,)
PLOT PLAN
PERC. TEST
No_ /'""' If yes, what depth.
Drain Field__
Performed by: ' ' ,r ' r ~ I , ,',' / Date: ' '
CONSTRUCTION AND OPERATION CERTIFICATE
ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION.
PUBLIC WATER SYSTEM-
APPROVAL TO CONSTRUCT
Plans for the construction of
.pub c water system located
, Alaska, submitted in accordance with 18 AAC 80.].00
nave been reviewed and are
[]' approved.
[] conditionally approved (see attached conditions),
'.../'/~Z.-:-. ,. "
f construction has not started within two years of the approval date, this certificate is void and. new
plans and specifications must be submitted for review and approval before construction.
APPROVED CHANGE ORDERS
Change (contract order no, Approved by Date
or descr ptive reference)
The "APPROVAL TO OPERATE" section must be completed before any water is made available to
the public.
APPROVAL TO OPERATE
The construction of the public
water system was comoleted on (date]. The system is hereby
granted interim approval to operate for 90 days following the completion date.
As-built plans submitted during the interim approval period, or an inspection by the Department has
confirmed the system was constructed according to the approved plans. The system is hereby granted
final approval to operate.
BY TITLE DATE
0 0 0 0 0 0 0 0 0 0 0 0
ir ' "' ' APPLI¢-hNT FILLS OUT UPPER HA?-h ONLY
Phone
Address Zip Code
Phone
Lending Institution~
Realty Co. & Agent
Address Zip Code ,
Street LOcation ' ~ ? ,' ' ·
~ype of Residence
[] Other :
Water Supply
, ATTACH WELL LOG. A we~l Icg is required for all wells drilled since June 1975.
[~-ffldivid ual
[] Community : For wells drdled prior to that date, give well depth (attach og f avallable).;~
[] Public Utility
Sewer Disposal Year Individual Installed: ~f) ~
[] Individual --- ·
~i~ic When Connected to Public Utility:
Uglity
ng Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
Tim~ Time Time
Time
Date Date Date Date
Inspector Inspector Insp~tor Inspector
Field Notes:
( ~"~PPROVED BEDROOMS ~ *CONDITIONS OF APPROVAL
( ) DISAPPROVED
CONDITION L PRO L*
DATE ·
Date wer nstalled Well To Absorption Area Well Log Receive~d._ ___
Soils R at ing~//
Well to Tank Septic Tank Size ,
72.023 (3/~)
5~C-.
N
LEGEND
CER~FICATE OF SURVEY
hereby certl~ that I have surveyed the fallowing described prope~h/=
Anchorage Recording Dlstrlctt Alaska, and that the Improvements situated thereon are within
the proper~ lines and do not overlap or encroach on the property lying adjacent thereto,
that no improvements on, the property lying adjacent thereto encroach on the premises in
question and that there are no roadwoys~ transmission lines or other vlllble easements
on said property except os indicated hereon.
Oated at Anchorage, Alaska, this //~ . day of ,'4,~,~//--- 19 ~'-~
c~.,~. F~d. Set
Brass or Al. Monument ~ (~
Iron Pipe · ~
Rebar · 0
Hub 8, Tack I a
Nail ~ G
ti~ '.. ...'L~-~
Revisions
,~.,4// A: ~' .~'~:~.~J*~->~'7'~ -5-~-<'P",~g~:~/,'f/ Survey title
Book no.
Checked by ~'./<4. City grid
ALASKA TECH
~*03 Weet 15th Ave
Anchorage, Alasl~a 99~01
Tel. 276- 8218