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Home My WebLink AboutT15N R1W SEC 9 LT 108A Well Owner Rod Perry Wall Log Alaska Now-Wall/Varn's Driillinll 12241 Avlon Anchorage, Alaska 99516 (907) 545-4417 Location Or' Well [' Borough I Subdivision Lot [Anchorage T15N R1W SECg LTl08 Well Log Block I PERMIT *$W940~ 14 N Range E Merdtan Section No Township S I W m Ft. Below Surface Well Depth (fi) Date et' CompieUon Malarial Type Top Bottom overburden, silty brn till, rock near surface (~ 7 bedrock, greenish 7 21 bedrock, gray, damp e $6'-~9B' 21 6G b.~dro_._ck, greenish 6¢ 9C bedrock, greenish, white streak, damp ge 10¢ bedrock, greenish 100~ clamp 145' 170 iray-whtte-green conglomerate 170 275 dam~ 170'-~80' ,5 gpm e 250'-250' 1/2 ~pm to 5/4 ~pm e 270' blowin~ with drfll Dept. Health 27q I g/,7/941 Drilling Method Use Irotary I Idor~.t,c 1 Casing Type Iwelded I Diameter (in,) 8 Finish of Well Type Diameter I ope. hole I I ~'1 Static Wit. ar Level Level (rtl) Date I 1271 I 9/19/e41 Depth (ft.) Weight (Ibs/Ig.) Pumping Level Below T of C (fl,) After (hrs) Pumping (g,p,m) Grouting yesl~ Material Nol~l I Pump H.P, Capacity SeLling Remerks Type submersible This well was drilled under my jumsdiction and this report is true to the best of my knowledge and belief, Authorized Representative V~.,.~5,L, Nowell Date Well Owner Rod Perry Well Log Alaska Now-WelllVern's Driilling 12241 Avlon Anchorage, Alaska 99516 I I IIAASS27 ] LoceLIon Of' Well Borough Lot Block Anchorage I Subdivision 08 Section N; TownshlP15N TIN R1WSEC9 LTl08 Well Leg FLBelow Surface I1eterlal Type Top Bottom Overburden - 0 13 Jbedrock gray (white streaks 19'-25') 13 50 .bedr°ck' gray Idamp 50 60 Igr~¥-green rock 60 180 damp 155' gray-green rock with white streaks 180 210 gray rock with white streaks 210 260 damp e 247'-250' PERMIT * SW940314 N Range E Merdian S RW W Well Depth (ri) Date of Complellon I 2eel I Drilling Method Use Ir°tory I Idomestic 1 Caning Type lwelded J Diameter (in,] Depth (fl,) Lo 14'6" Finish al' Well Type Diameter Iopen hole I I Static Wntnr Level Level fit,) Date Weight (lbs/fl) I Pumping Level Below T of C (fl,) After (hre) Pumping (g,p,m) I II I t 6routing Yes[~ Nol~l I Pump I Selling (fl) Remirks Material Capacity Type submersible 1 Iwell producing 1 gallon per hour. Recomend tracking with explosives. iThls well was drilled under my jurisdiction and this report Is b-ue Lo the best et my knowledge and belief. ~,ulhorlzed RepresenlaUve ferno~L. Nowell Date ROBERT C. COWAN, RE. ROBERT A. SHAFER, RE. HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSAL&YSTEM DESIGN July 31, 1998 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION PO Box 196650 Anchorage, Alaska 99519 REFERENCE: Lot 108; Section 9; T15N; RIW Enclosed is the as-built survey you requested on the above referenced property showing both wells. Both wells have proper well seals. The South East well on the property is low producing but is being reserved for future use and could become useful due to the large amount of water storage available in the well casing. If you require additional information, please contact us. Sincerely, Robert C. Cowan, P.E. RCC/skh Enclosure 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 <~ bJ >- Z ,§'D~ Ld , LOI 1U-I 31 Rick Mystrom, Mayor Municipality of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 http://www.ci.anchorage ak.us 343-4744 June 17, 1998 Rodric H & Karen M Perry 19123 Richner Road Chugiak, Alaska 99567 6727 Subject: TiSN R1W Section 9 Lot 108A (Lot 108) Permit #SW970117, PID #051-I44-65 The subject permit, issued June 3, 1997 by this office for a single family well and/or on-site wastewater system, has expired as of June 3, i998. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. If you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If a licensed Professional Engineer has inspected the installation of the on-site wastewater system, the original as-built inspection report must be sent to this office for review, approval and documentation. All inspection reports must be submitted within 30 days of construction completion. When applying for a new permit, the fees are: $320.00 for an on-site wastewater permit; $120.00 for a well permit and $440.00 for a combined on-site wastewater and well permit. If~have any questions, please call this office at 343-4744. Sincerely,/ /~ Ja~es Cross, P.E. Program Manager On-site Services enc: Copy of Permit cc: S & S Engineering Page: 1 Document Name: ENTERPRISE SERVER PARCEL: 051-144-65-000-99 CARD: 01 OF 01 RESIDENTIAL SINGLE FAMILY STATUS: RENUMBERED TO/FROM: 051-144-27-000-1 1 PERRY RODRIC H & KAREN M T15N R1W SEC 9 LT 108A 19123 RICHNER ROAD 0 CHUGIAK AK 99567 6727 SITE 20305 WHITE BIRCH RD LOT SIZE: 100,978 ---DATE CHANGED ....... DEED CHANGED .... ZONE : R6 OWNER : 02/06/97 BOOK: 2713 PAGE: 0532 TAX DIST: 022 ADDRESS: / / DATE: 10/04/94 GRID HRA # : 000000 PLAT: 970004 NOTES : REF 051-144-27 ................................. -ASSESSMENT HISTORY .......................... ---LAND-- FINAL VALUE 1996: FINAL VALUE 1997: FINAL VALUE 1998: EXEMPT VALUE 1998: --BUILDING ....TOTAL--- 0 0 0 0 0 0 --EXEMPTION--- 47,200 160,100 207,300 ..... TYPE ..... 0 0 0 STATE EXEMPT 1998: FINAL VALUE 1998: 0 -COMM COUNCIL- 207,300 Date: 6/17/98 Time: 11:55:34 AM ROBERTO. COWAN, P.E. ROBERT A. SHAFER, RE. HEALTH AUTHORITY APPROVALS SEWER & WATER INSPECTION ENGINEERING STUOIES SND REPORTS WELL INSEECTION &FLOWTEST ROAD DESIGN SOJLTEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ONSITE W~STEWATER DISPOSAL SYSTEM DESIGN Date; 7- IJ '~7 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 The septic inspections for the referenced property were performe~ on ~-I~-~ and 7~'~ . Prior to submittinq the On-site Wastewat~r. Dlsposal System and/or Well Inspection Report we are waiting for the ~0',4 /~J~// to be completed. If we may be of further service please contact us. Sincerely, Robert C. Cowan, P.E. 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 MUNICIPALITY OF kNCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PAGE ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW970117 DESIGN ENGINEER:S & S ENGINEERING OWNER NANE:PERRY RODRIC H & KAREN M OWNER ADDRESS:19123 RICHNER ROAD CHUGIAK, ALASKA 99567 DATE ISSUED: 6/03/97 EXPIRATION DATE: 6/03/98 PARCEL ID:05114427 LEGAL DESCRIPTION: T15N R1W SEC 9 LT 108 LOT SIZE: 108900 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST 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 (18AACS0). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS RECEIVED BY: ~-Z~ ~~ ISSUED BY: /~/~-~// DATE: Rick Mystrom, Mayor Municipality of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 August 25, 1995 Rodric H & Karen M Perry 19123 Richner Road Chugiak, Alaska 99567 6727 ,~ Subject: T15N R1W Section 9 Lot 108 Q-~Q~ ~ Permit 9SW940314, PID #051-144-27 The subject permit, issued August 25, 1994 by this office single family well and/or on-site wastewater system, has expired as of August 25, 1995. for a A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. If you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If a licensed Professional Engineer has inspected the installation of the on-site wastewater system, the original as-built inspection report must be sent to this office for review, approval and documentation. All inspection reports must be submitted within 30 days of construction completion. When applying for a new permit, the fees are: $320.00 for an on-site wastewater permit; $120.00 for a well permit and $440.00 for a combined on-site wastewater and well permit. If you have any questions, please call this office at 343-4744. Sincerely, ~a~es Cross, Program Manager On-site Services enc: Copy of Permit cc: S & S Engineering PAGE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW940314 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:WATTS RONNIE K & CAROL G OWNER ADDRESS:lg123 RICHNER CHUGIAK, ALASKA 99567 DATE ISSUED: 8/25/94 EXPIRATION DATE: PARCEL ID:05114427 LEGAL DESCRIPTION: T15N R1W SEC 9 LT 108 t~~ k[5%~I~' LOT SIZE: 108900 (SQ. FT.) NUMBER 0P BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST 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 (18A31C72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 (24 HOURS) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. 1 OF 8/25/95 SPECIAL PROVISIONS: RECEIVED BY: ISSUED BY: ~ DATE: DATE: ROBERT SHAFER, P.E. ROGER SHAFER, P.E. August 06, 1994 CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 HEALTHAUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & PLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 'L' Street P.O. Box 196650 Anchorage, Alaska 99519-6650 REFERENCE: Lot 108; Section 9, T15N, R1W Request you issue a permit to drill a w~ll and install a septic system to serve the proposedthreebedr(x~aho~seon the referenced proper~¥. A test hole was excavated and a percolation test performed. The approximate location of the test hole is located on the attached site plan. At the time of excavation water was encountered at 10 feet and after seven day ground water monitoring water was again found at 10 feet. This property has enough area for a future septic upgrade which can be seen on the attached site plan. We do not anticipate any adverse effects on neighboring properties by the installation of the proposed septic system. If you have any questions, review, please contact us. R~R/rt A. Shafer, P.E. ~J~s/nsu/jk or require additional information for your 17034 NORTH EAGLE RIVER LOOP *' SUITE 204 · EAGLE RIVER, ALASKA 99577 f'8c^t.E= 50' I SITE PLAN I 50' PATENT R.O.W. RESERVE BK.~01, PG.337 0¢- 4,, 1"SO~L~= 50' I SITE PLAN GRAVEL ROAD OF- .Zzu~ '~ -< z z~ Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: '~.C~"~ LEGAl DESCRIPTION: L-O'T [0~); TIS J; lW: ?~¢_~,ffTownship. Range, Section: 1 2 3 4 5 6 7 8 9- 11 13- 14- 15 16 17 18 19 2O COMMENTS SLOPE SITE PLAN WAS GROUND WATER I/Er- ENCOUNTERED? S IF YES, AT WHAT DEPTH? p E Deplh to Water After /,,, Monitoring? t',-.-, Date: 8/~]?~/', , Gross Net Depth to Net Reading Date Time Time Water Drop q.' O ( ?,~ - ~ Y~ · 'O~ 3,~*~ q" 2~/~' ,'1o ~,~ ~'/~ ~" PERCOLATION RATE ~ (minutes/~nch) PERC HOLE DIAMETER __ TEST RUN BETWEEN ~ FTAND L~,(~ FT PERFORMED BY: S & $ ENGINEERING 17034 Eagle River I.o~p ~aa~ ~{~. ~.,~4 CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL ~{)I~E~I~I~A~i~i~--~(~)ELINES iN EFFECT ON THiS DATE. DATE: 72-008 (Rev. 4/85) ON-SITE WASTEWAT~ DISPOSAL SYSTEM (~ST~[~TION PRACTIC~ and MAT~IAL SPECIFICATIONS Lot 108; Section 9, T15N, R1W, S.M. The scope of this project includes the installation of a 1000 gallon septic tank and an absorption bed to serve the proposed three bedroom residence for the referenced property. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The contractor shall be responsible for obtaining any necessary underground utility locates. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. On all leachfield mound systems, the property owner shall be responsible for ensuring a satisfactory vegetation growth over the mounded area. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: 1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 3. Ail standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 4. Septic tanks installed with less than 4' of cover shall be insulated. Page Two Lot 108; Section 9, T15N, R1W, S.M. August 06, 1994 A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10' from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. BED INSTALLATION: Excavate the proposed Bed Area to the depth shown on the design. The bottom of the excavation shall be within 2 inches of level. If the bottom of the excavation becomes smeared, it must be raked or scratched (roughed-up) before gravel (sewer rock) placement. If a sand layer is required, place sand over entire excavation to the required depth shown on the design. The top of the sand layer must be within 2 inches of level. Sewer rock shall be placed uniformly throughout the entire bed. Perforated distribution pipe must be installed level with perforations down. Gravel depth below the perforated pipe shall be a minimum of six (6) inches. Gravel depth above the perforated pipe shall be a minimum of two (2) inches. The total gravel depth throughout the entire bed shall be a minimum of twelve (12) inches. The perforated distribution pipes must be no more than six feet apart. The distance between the outermost perforated distribution pipes and the sidewall of the absorption bed must be no more than three feet. Silt barrier material must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. Monitor tubes shall be of four (4) inch diameter and installed at the locations shown on the design. The portion of the monitor tube extending through the gravel depth shall be perforated six (6) inches below the bottom of the horizontal distribution lines. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finished grade over the bed must be mounded to prevent the formation of a depression after settling. Page Three Lot 108; Section 9, T15N, R1W, S.M. August 06, 1994 MINIMt~4 MA'£~.z(IAL SPECIFICATIONS: 1. Any septic tank proposed for installation must Municipally approved septic tank manufacturer. 2. The following pipe materials are approved for installations in the Municipality of Anchorage: be constructed by a use in septic system Type of Pipe Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). A permeable nontoxic silt barrier (Typar 3401, Mirafi 140/N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements. Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: 1. The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. Page Four Lot 108; Section 9, T15N, R1W, S.M. August 06, 1994 2. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required, especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre-construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractor's activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractor's activities. Final acceptance of the contractor's work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Date: July 14, 1995 To: .//~f~.Z°ning and Platting Division, CPD From. ~L.cT,..mtnes Cross, P.E., Program Manager, On-Site/Water Quality Subject? Request for Comments on Cases due 7/14/95. The Environmental Services Division, On-Site Services Section has reviewed the following cases and has these comments: S-9773 Lot 108A, Section 9 (T15N, R1W) A copy of the well log and an as-built inspection report of the permitted septic system must be submitted. VACATION OF RIGHT-OF-WAY OR EASEMENT APPLICATION Municipality of Anchorage DEPARTMENT OF COMMUNITY PLANNING & DEVELOPMENT P.O. Box 196650 Allc!!,~t,@ge, Alaska 99519-6650 r~ A, Please fill in the information requested below. Print one letter or number per block. OFFICE USE REC'D BY: VERIFY OWN: AFFIDAVIT:. POSTING: 0. Case Number (~F KNOW~). Street Address 1. Vacation Code Tax I.D. Number 2. Abbreviated Description of Vacation (EAST 200 FEET SOME STREET). Isl~l~l~l~l I~1~1'1 Io1~1 I~1~1~1,1,,,I,1=-I~1 Ivl,l~lJ ~ via I~l~tol I I~1~1~1 I~1o1'1 Io1~1 Id~l,l~-I'-'t I~1,1~1~1~1 I~1~1 ~:- ~-~1~1 3, Existing Abbreviated legal description (T12N R2W SEC 2 LOT 45 OR SHORT SUB BLK 3 LOT 34). ~x ~1~1 I~1~1~} I~1~1 I~1 I~1~1~-I I~ Io1~1 I I I I I I I I I I I I I IIIIIIIIIIIIII IIIIIIIIIII 4. Petitioner's Name (Last - First). I~1~ ~1~ I~1 I~1o1~1~1~1,1~1 I I I I I I I IIIIIIIIIIIIIIIIIIIII 5. Petitioner's Representative. I~1~1~1~1~1 I~o~ IIIIIIIIIIIII IIIIIII IIIIIII Address: / <7 /Z .~~'1-~,.- ,~o,~3/ .., Address:. City: ~A~[~; State: A~ City: State: Zip Code: ~ ~'~'(o '~ Phone No. ~ ~: ~ - ~/~'~ Zip Code: Phone No. Petition Area Acreage. c1' .3o/ ~ 7. Proposed Number Lots. 8, Existing Number Lots. 9. Written JustificaUon. 10. Grid Number. IIIIIII 11. Zone. Illllll 12. Fee $ 13. Community Council B. I hereby certify that (I am) (I have been authorized to act for) the owner of the property described above and that I desire to vacate it in conformance with Chapter 21 of the Anchorage Municipal Code of Ordinances. I understand that payment of the basic vacation fee is nonrefundable and is to cover the costs associated with processing this application, that it does not assure approval of the vacation. I also understand that additional fees may be assessed if the Municipality's cost to process this application exceed the basic fee. I further understand that assigned hearing dates are tentative and may have to be postponed by Planning Staff, Platting Board, Plannin~ommission,,or thee Assembly due to administrative reasons. Date:~,-)~UC~4~/l~l r ~ ~*~ ~ ( Signature 20-019 (Rev. 9192)* Front *Agents must provide wdtten proof or authorization. MUNICIPALITY OF ANCHORAGE OFFICE USE COMMUNITY PLANNING AND DEVELOPMENT P.O. Box 196650 REC'D BY: Anchorage, Alaska 99519-6650 PRELIMINARY PLAT APPLICATION Please fill in the information requested below. Print one letter or number per block. 1. Vacation Code 2. Tax Identification No. 3. Street Address 4. NEW abbreviated legal description (T12N R2W SEC 2 LOT 45 OR SHORT SUB BLK 3 LOTS 34). 5. EXISTING abbreviated legal description (T12N R2W SEC 2 LOT 45 OR SHORT SUB BLK 3 LOTS 34) full legal on back page. 6. Petitioner's Name (Last - First) I[lllll[lll/lilllllll City '~ a,~ State Phone# ~ ~'- ~') ~ ~,/ Zip 7. Petitioner's Representative Address -~'~ ~.~ City State Phone # Zip 8. Petition Area Acreage ~,Propos.eql~ ~ber Lots 10. Existing 11. Grid Number Number Lots ~v~/ z52 12. Zone 13. Fees 14. Community Co.n°, B. I hereby certify that (I am) (1 have been authorized to act for) the owner of the property described above and that I desire to subdivide it in conformance with Chapter 21 of the Anchorage Municipal Code of Ordinances. I understand that payment of the basic subdivision fee is nonrefundable and is to cover the costs associated with processing this application, that it does not assure approval of the subdivision. I also understand that additional fees may be assessed if the Municipality's costs to process this application exceed the basic fee. I further understand that assigned hearing dates are tentative and may have to be postponed by Planning Staff, Platting Board, Planning Commission, or the Assembly due to administrative reasons. *Agents must provide written proof of authorization. LOT l' ,/j- ? 2 98,0 Please check or fill in the foflowing: 1. Comprehensive Plan -- Land Use Classification Residential Commercial Parks/Open Space Transportation Related 2. Comprehensive Plan-- Land Use Intensity Special Study Marginal Land Commercial/Industrial Public Lands/Institutions Dwelling Units per Acre ~'P,~4~fl. Alpine/Slope Affected Alpine/Slope Affected Industrial Special Study Environmental Factors (if any): a. Wetland 1. Developable 2. Conservation 3. Preservation b. Avalanche c. Floodplain d. Seismic Zone (Harding/Lawson) D. Please indicate below if any of these events have occurred in the last five years on the property. Rezoning Subdivision Conditional Use Zoning Variance Enforcement Action For Case Number Case Number Case Number Case Number Building/Land Use Permit For Army Corp of Engineers Permit E. Legal description for advertising. F. Checklist ~ Copies of Plat (Long Plat) 30 Copies of Plat (Short Plat) Reduced Copy of Plat (8 ~/~ x 11 ) Certificate to Plat Aerial Photo / / Housing Stock Map / Zoning Map Fee Drainage Plan Tope Map 4 Copies Soils Report 4 Copies . Pedestrian Walkways Landscaping Requirements Waiver Water: Sewer; Private Wells Private Septic Community Weft Community Sys. Public Utility Public Utility Please check or fill in the following: 1, Comprehensive Plan ~ Land Use Classification [Z3'~esidential [3 Commemial ~ Parks/Open Space [] Transportation Related Marginal Land Commercial/Industrial Public Lands/institutions Alpine/Slope Affected Industrial Special Study 2. Comprehensive Plan- Land Use Intensity: Dwelling Units per Acre: //~' ~ // .'~ ~,~ Alpine/Slope Affected E~ Special Study 3. Environmental Factors (if any): a. Wetland ~ 1. Developable ~3 2. Conservation [] 3. Preservation [] b. Avalanche ~ c. Floodplain ~3 d. Seismic Zone (Harding/Lawson) [] Please indicate below if any of these events have occurred in the last five years on the property. ~ Rezoning Case Number: [] Subdivision Case Number: [] Conditional Use Case Number: ~ Zoning Variance Case Number: [3 Enfomement Action For ~3 Building/Land Use Permit For Legal Description for Advertising. F. Attached written statement in accordance with AMC 21.15.130.B. stating reasons in support of the vacation. G. Checklist Waiver ~ 30 Copies of the Vacation Request ~3 Reduced Copy of Vacation (8 1/2 x 11) E3 Certificate of Plat ~3 Fee ~3 Topo Map 4 Copies ~ Soils Report 4 Copies ~ Aerial Photo ~ Housing Stock Map E3 Zoning Map ~ Water: [] Private Wells ~3 Sewer: [] Private Septic 20'019 (Rev. 9/92)* Back ~3 Community Well [] Community Systems [] Public Utility E~ Public Utility ®