HomeMy WebLinkAboutT15N R1W SEC 9 LT 77BOnsite File
T15N R1W SEC 9
Lot 77B
PID# 051-103-34
PO. BO~( 6650
f907) 264-.~I 11
DEPARTMENT OF HEALTH & HUMAN SERVICES
January 10, 1986
TO: Permit Applicant
Subject: Permit # 850029
T15N R1W Section 9 Lot 77
A permit issued by this Department for an individual well and/or on-site
sewer system has expired as of December 31, 1985.
Permits are issued on a calendar year basis by authority of Municipal
Ordinance. A new permit must be obtained from this Department for any
well and/or on'site sewer system not installed by the expiration date.
If you have drilled the well, a well log needs to be sent to this
Department for documentation of the installation and to close the permit.
If a private engineer inspected the installation of the on-site sewer system
the original as-built inspection report(three part form) must be sent to
this office for review and approval,and for documentation.
If there are any further questions, please call this office at 264-4720.
Sincerely,
Susan E. Oswalt
Program Manager
On-site Services
SEO/lJw
enc: Copy of Permit
I)IEF:'ARTMIEN]" OF t'"IIEAL/I"H AND ENVII::~C)I',IMIENTAL..
EI27.',5 I_ STRE]ET, ANC, I'IE)RAGE:
2.64-4720
I:::IERM I:T' NO: 8, .,~. ,: ~
DATE I SE~UI!!i]'.): "2/04/85
A F:'F:'L. I C;AIq'I":
ADDRE,E~S:
COI,I'fAC1 t lt(.),ll ......
F:'L[)Y)3
P 0 BE)× '7'7()6;:?,:2
EAGI_IE R I VEEI:I, AK
688-';.26 :L 3
9 9 5 '7' '7'
SUBD I V
SE[7'f' I ON: 9 'T'C)WNSH I F:'
L.OT S I ZE: 1,. 5A (SQ. F::'T., E{R A[:F~ES)
I_OT LOCATION: IxlORTHSHORE ROAD
MAX BEDROOMS~ 3
List. ed
sy~rt:.em. Chc)c)se) the i:.ha'L best
1,5 N
I_,..) 1 . '77
RANGE: :l.W
),.LUL, I ..... hlA
'La yau :i. I] dEHEJ i gr't i I"~i~] yot..U" i:~E!I::)'L i c:
:i.'t:.~;~ ye)ur' site,,
DIEF:']]"i T'C) P]:F:'E BOTT'C)M (F:T',,) 4- 4.0 4.,, 0
GRAVE]- I)IEPTH (F::'T
]"CI"I'AL. DEF:'T'I'I (F=T.)
GFd~VEI- WIDTH (F:T,,) ~,,5 :L4.0 5,, 0
GRAVEL LE]qG'f'I'I (F-l".) ~,, () 2S. 0 . 28.0
GRAVE]_ VOLUME (CU.YDS.) :1.3.4 14.6 2(),.8
TANI< SI ZE (GAL.S) :L,,, )
SOIL, RATING (
· ~..~ "f'AIxlK MUST HAVIE A'I' I..J::/-.h::~l "FP RTMEr-NTS
I c: e r' t :L ~' y t. h a'L:
:1.,, I am familiar wi'Lb the r'~ u:i.r, emer'rLs
fc:)r,t.h by the IYh..tr~ :L c: :i, pa].:i.
2. I w:i. ]. :1. :i. nst, al ]. 't:.l"l.:~:! s in ac:c:c
ar'id :i,n c:c)ml::l:l,:i, ar~ce ~,~:i.t,h e des:i, gn c:r'
::~,, :[ P~i].]. ;:~(Jh(EH"E:~ t.c:] ~:~].]. MO and S'l:.a'Le
sev,~er'age sys'Lem (::H') 't:.h:i.~i~ CH" any adjac:errL
4,, I unde:H"st, ar'ld tl"wat this :JePmit :i.s va.].:i.d for'
al'ly EH"~].ar'g6mieH']t. w:i.].], r'~ ::lu:i.r'~::¢ an
(MOA) and 'Lhe State c:)f Alaska,,
wit. h a].I M[)A codes and r'E.)gLl].at.:J. Elf'HB~,
c:) [' 'L', h :L s p ~:~ r' m i 'L ,,
d :i. s p (::)s a 1 s y s t ¢,:~m c'.:}r' p u b I ;i. c:
~ r' b y 1 mt..
p e) r m i t..
:1:1= A I_ I F:'T' S'T'AT' I Ol'q I S I NS'T'~.'tl, ..lED I N AN ARIEA C',OVlEI::;'.E:D BY MOA BU I I....D I txlG CODES,
T'HE:N (1) ~1',1 EL..E:CTTFR;I:CAI .... :I;T ~BID INSF'ECYf']:EIN MUST BE (3BTAI hIED; (2) AS-':E~U:I:L.TS
W,II....I-NOT I3E AF:'F:'ROVE{O WITHOUT Ahl. EI_E!;C;TF;'.ICAI.. INSF'IECTION REI='t]ff:';'.T; AN!} (3) THE:
E].,ECTF:?.ICAL IAI[)I::;:K MUST BE DE)NE:.BY A L. IC;E]',ISE!:D E:L.E:CTRIC).:Alxl,
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L, Street, Anchorage, Ataska 99501 264-4720
SOILS LOG - PERCOLATION TEST
SOILS LOG
PERCOLATION
TEST
LEGALDESCR'PTION: ~r 7~S ~L~.)
2
13
14
20
PERFORMED B*:."-./'~,-,**
DATE PERFORMED:
SLOPE
SITE PLAN
WAS GRO""D WATER
ENCOUNTERED? O
P
E
IF YES, AT WHAT
DEPTH?
Gross Net Depth to Net
Reading Date Time Time Water Drop
p-E,~C:~-E~T4~ RATE ~
TEST RUN BETWEEN ] , FT AND 7~ FT
CERTIFIED
72-008 (6/79)
GRrATER ANCHORAGE AREA BOROUGH
HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION ~, ~>~(~ LEGAL
SEPTIC TANK:
DISTANCE FROM WELl
LIQUID CAPACITY_
GALLONS.
k~//~/~ ~'J~')'-2"~~'~ NUMBER OF /
. COMPARTMENTS
MATERIAL
INSIDE LENGTH -- INSIDE WIDTH / DEPTH_
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS__ / OUTSIDE DIAMETER
LINING MATERIAL~-''~/~'~ '
NEAREST LOT LINE ~
OR WIDTH /~-~ /
~ LENGTH /'/'~/ /, DEPTH
DISTANCE FROM WELL ./~') /
J/'~" BU LD NG FOUNDATION ~''~
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ~3 (~'"~ ~) SQ. FT.
TILE DRAIN FIELD:
DISTANCE ?~OM WELL_
TOTAL LENGTH
FOUNDATION_ ~ NEAREST LOT LINE_ , OF LINES_
SQ. FT. LENGTH OF EACH LINE
DEPTH: TOP OF TILE TO FINISH GRADE
DEPTH OF FILTER MATERIAL BENEATH TILE
IN. ABOVE TILE
WELL: -~,~-'7 ~16~'.,,~'"~
TYPE , DEPTH '~
LOT LINE /~ ~ NEAREST / SEPTIC
~ , SEWER LINE ~ ~ ,TANK
DISTANCE FROM f WATER /~ NEAREST
· BUilDiNG FOUNDAT ON"Ze ,'- SAMPLE
¢~ ~..~__ SEEPAGE /~ / OTHER
, SYSTEM ~', CESSPOOL ~ , SOURCES
DISTANCES:
~c~ >/~
DIAGRAM OF SYSTEM
DATE
GREATEI, ANCHORAGE AREA.
HEALTH DEPARTMENT
327 Eagle St. Anchorage, Alaska 99501
9ROUGH
279-2511
Case No. /~r;-,~7
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
RESIDENCE ADDRESS CL'~,-o~-. ~-~ ~' LOCATION OF INSTALLATION P~;-TZ
APPLiCATiON TO INSTALL: SEPTIC TANK , ~, SEEPAGE PIT ~ , ~L~
FINANCED THROUGH ~ TO BE INSTALLED BY
BELOW TO BE PILLED OUT BY HEALTH DEPARTMENT
THIS IS TO SERVE AS ,PERMIT TO INSTALL A
· AS DESCRIBED BELOW, SIZE OF UNIT TO BE SERVED t~
· SEPTIC TANK SIZE _.~.Z2I~..~-q'YPE ~ SEEPAGE AREA.
DISTANCES:
Health Authority
TYPE 3~'/~/'.~ <'
DIAGRAM OF SYSTEM
I certify that I am familiar with the requirements of Greater Anchorage Area B, oroug~Jaa)~ce.~,o? 28-68 and that the
s ribed s' stem is in accordance with said code, ~ x~ ~,'~/~/'///~'~. ~/. "
above de c y ~..~/../.~¢".,,¢.¢,.c.~,:',,-,,.-...,...,__~. ,