HomeMy WebLinkAboutT15N R1W SEC 9 Lot 125
1~ MUNICIPALITY OF ANCHORAGE
I DEPARTMENT OF HEALTH & ENVIRONMENTAl. PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 "relephone 264-4720
-- ON-SITE SEWAGE DISPOSAl. SYSTEM AND/OR WELL INSPECTION REPORT
PHONE i -NEW
MAILING ADDRESS
LEGAL DESCRIPTION
LOCATION NO. ~EDROOMS
Well / Absorption area Dwelling / P~RMIT NO.
Liq. capacity in gallons ~ Inside length W~dth Liquid depth
~ DISTANCE TO: Well Dweiting PER~IT NO.
Length Width Depth PERMIT NO.
~ Well Building foundation Nearest lot ]ine
~ DISTANCE TO:
~ Cla~ ~ Depth Driller Distance to lot line PERMIT NO.
~ DISTANCE TO: Building foundation Sewer IJ~{j ~ Septic tank ( Absorption area(s)
OTHER
PIPE MATERIALS
SOIL TEST RATING --
INSTALLER
72-0' (Rev. 3/78)
'THE L. Et'.,I(3"FH [::,].'HENS:iON ]:S THE LE:NGTFI ,::IN FEET) ()1::' THE TRENCH OR
'fHI:E DEF'TH OF' R TRENCH OR F::':I:"I" :I:S THE D;[STF~NC:E E:ETI,.tEEI",I THE SIJF¥:'(:~C:E OF 1"HE
61:ROUND FIND THE: BOTTOH OF' THE EXCRMFIT;[ON '::;iN F'EET).
"T ~ E: T' ~::;i~: ~: t"',,~ C: ~'"-~ ~.,.9 ]:: E::" -~ ~--I ]: :~; ~SZ~ .. ~;[~ ~;~ ~E~ F" EEC E: T'.
THE G~RVEL. DEF'TH :iS THE FIZNZHLIffl DEF'TH OF' GRR',,,'EL BETI.,.IEEN THE OLITI::'FILL F';[F:'E
FIND THE EIcr'I'I"OH C)F::' 'T'HE: EXCI::IVATZOI'.,! (:[1'.4 F'EEET).
I::'E:F~:I'"I ;I: "I" FII::'I::'L.]:CFINT HFIS THE I';~:IE:E,,F:'Eq"JS:[B]:L;[TY TO :[NF:'OF;;!H 'fH]:S [:'EF:'FIFRTHEI"~I" DLIFiX[I",I(::J THE
INSTF:ILL. FYf'IOht ]:N:E;F'E:C:'I"IOI'.,!:i!i; OF RI",I"? F.IEL. LS FIE:'..:rACEt'.,IT' 'T'O 'THIS I:::'I:ROF'ERT'~.' Fq'.4D THE
I'.,II..II',IE~EF?. O1:::' RES:[DENCES THl:::rf T'HE klEL. L. kI:[L.L
8FICI::::F'IL.L:[I",iG OF::' I::li",lY SYSTEP1 I,.f:[THOUT FINRL INSPECT]:ON FIND FII::'PI:RO',,,'I:::IL BY" THIS
E:'EF'I::IF;.:THENT' I,.t:[LL BE 'L;;;L.ID..rECT 'T'CI PI:;;tOS:;ECI:J"I";[Oi'4.
H:[i'.,IIHUI"I D ISI¥::II'.,ICE I:~:E"FI,.IEEhl f::l I,.IEEL. L FIND ANY ON-'"'.:5:['fE SEPlFIGI!![ D ISPCE:::I::tL SYSTEH IS
:1..00 FEET FOR F! F'I:~r:[',,,'FITE I.,!EL..L OR :L50 TO ;200 FEET FROH FI F'I.JI:~IL:[C I,IEL. L [:,E!:;:'ENDING
UF'ON THE. TYF'E OF F'UBL.:[C: klEL.[
I'"IZF,IZf"ILIIfl [::, :[ :STFINC:E F'ROI'd IR F'RZ',,,'IaTE I,.IEL..L TO !::1 PF~'.Z',,,'F:ITE SE:I4EF4 L.:[NE ZS ;;~:5 FEET
TO I::~ COt'IFIUN:[TY SE:PIER L;[NE :iS 7'5 FEET.
1.4ELL LOGS FIRE RE(i:¢J:[REE:, F:IhlD Plt..IST BE F?.ETUf~tNED TO Tile [:,EF'FIFitTP1ENT Iq;['I"HZhl ;;~:E~ DRYS
O1::' THE FIELL. C:OI'qI::%ETICIN.
O'fHI~EF;;: RE[QUIRE:I'dEI",ITS HFIY F:IF'PLY. SPEC:ZFIC:RT]:OhlS I::IND COI'-,ISTRLIC"rloIq D:[Ft6RFIFIS FIRE
FIVFI:[I.,..FIE~LIE TO :[f.,ISURE PF;'.OF'EF: ZI'.,ISTRI...LFIT:[C~N.
:i: C:EF?T]:FY TI:"IF:IT
::L: Z FIH F:¥:IHZL..:[FII,';~'. I,.I:[TH THE F~:E(;!U:[t';?..E:I'IE¥,ITS FOil: Oi'.,I.....SZTE~ :BEHEF~:S FIND I,II:i[L.L.S F:IS SET
FOI:;iSr'H BY THE HU['.,I
2: :[ I,J:[LL :[NSTFILL THE SYSTEH ]:1'.,I FICCOF:DF:iIqi::::E H:[TH THIE CODE:ii!:.
7ii:: .~ UI'.,IDI:E[;?.ZTI:::iND THF:IT
FRI:ES]:D[£NI::::E :['.E; F;?.EHODEL. ED TO ]:NC:L. UDE
V4~ Er
January 4, 1982
Russell S. Harmon
7929 E. 3rd
Anchorage, AK 99504
Permit ~ 811095
Subject: T15N R1W S. 9 L125
A permit issued by this department for a well and/or sewer
system has expired as of December 31, 1981.
Permits are issued on a calendar year basis, as stated on
the permit, by authority of Municipal Ordinance.
If you have drilled the well, a well log should be sent to
this department to document the installation date.
If an engineer inspected the installation of the on-site
sewer system, please have them send us the as-builts for our
files.
If there are any further questions, please call this office
at 264-4720.
Sincerely,
Sewer and Water Program
Enclosure: Copy of Permit
F'ERMI'T
DEF'I:~RTMENT C'c' HEFIL.]"H FIND ENVIRONMENTFIL. ~"°CFf'E:C:TION
E,';Z5 '" S~TREE"r'., laNCHORFtGE:., FIK. 9~ .... J.
~ ~ 264-47;20
NO. '( 811095 )
F~F'F'L. ICF~NT ROSSELL S. HFIRMON '?929 E. ]:RE) FINCH 99504
L. OCFIT t ON E: t RCHI4CJO[:,
LEGI::tL. TtSN Ril~Ft S. 9 Li.25 L. OT S;',tZE
950E~0 SQUF~RE FEET
TYPE [)F' SOIL. FIE:SORPTION S"r'STEM IS: DRf~INFIEL. D
MF~NIMtJH NL.IMBE:t~! OF 8EDROOH'Z~ = 4
SOIL RFrl~INEi (GQ FT,.,'BR)= 280
THE REQUIRE[:, SIZE OF THE SOIl_ F~SSORP'TION S"r'STEM IS:
Et E-. F" 'lr- t--~ :-== :ET., it_. E-Z: ~"-~lt C~i ""IF' ~--.~ == J.. :.1_ .'E~" (:.'-'.ii R [-:ql %? El' It_.. ltL::, E F' '"'[- F-~ == !!~5
THE LEI'.,IG"rH DIMENSION IS THE LENGTFI ':.'IN FEET) OF:' THE TRENCH OR DRFIINI=IELD.
THE DEPTH CIF F:I qREN .H .L. F'ZT' Z.:, THE L Z.:,THt.,IC.E. : ..........
...... ;' '" ...... :" " ..... L,E[I..IEEN THE 9..RF:'Fff:E' OF ]'HE
GIROUND FiND THE: BO]"TOM OF T'HE EXCFIVF~TZON (Zf',l FE:ET).
'THE GRFIVEL DEI::'"['H IS THE MINIML.IM [)EF'TH OF GRB',/EL E~ETWEEN THE OUTFFILL PIF:'E
laND THE BOTTOM OF THE E)'~CF:IVFiTION (IN FE:ET).
PERMIT f~F:'PL.I CFINT HFIE: THE: RESF'ONS IE:I L I'TY "FEi INFORM '¥H I S B, EF:'F}RTMEN"F Dt...IR I NG THE
I NS"f'F~LL.P~T I ON I NSPE.".CT ~ 07-,1'.'~ OF F:~N"r' I.,.IEL. LS F~DJF~CENT 'TO TFII E; F'ROF'E:RT¥ FINE:, 'THEE
I",ILIM[3['ZR OF RESI[:'E:NC:ES 'r'HFIT THE HEL. L HIL. L !i'~EF?,,,'E.
1.3FICKFILLING OF FIN~.? SVSTEEM NITFIOIJT I::'INRL. INSPECTION F~ND F~PPROVF~L.. B'Y THIS
E:,EPF. IRTIqE'NT HILL 8E SLIBJECT 'TO P'ROSECUTZON.
MINIMLIM DISTlaNCE 8ETI^IEEN F~ 14ELL. FIND FIN¥ ON-SITE SE].,.IFIGE DISPO:i'=':FIL S'T'S"FE:M IS
:1.~0 F'EET FOR Ft PRIVF~TE L,.IELL (."iR: :1.50 1"0 2'.ELS1 FEET FROM FI PLIBLZC WELL. DEPEN[:,INC~
L.IPON "FHE 'TYPE OF PUBLIC: HELL.
MINIMLtM DIS'TFtNC:E FROM FI PRI'v'Ff'I"E HELL. TO FI PRIVFITE SEWER LINE IS 25 FEET 8NE)
"FO R COMMt. INIT',' SEI.,.IER LINE tS '?5 FEET.
OTHER REQUIREMENTS.; HF¥.r' F~PPL'.r'. SPECIF'ICfa]'IONS f~N[:' CONST'RLICTION [:'IFIGRFIMS FIRE:
Ff',,,'~aILI~E:LE TO INSURE F'ROPER INSTF~LLFITION.
I C:ERTIF'"r' THST
::L: I FIH F'FIMILIF"~F,' HITH THE".' REQUIREMENTS FOR ON-SITE S"EHERS RN[) I.,.IELLS', FIS SET
F'ORTH [3'? THE MIJNICIPFIL. IT'~.' OF: FINCHORFIGE.
2.: I HILL INS'TFILL THE S"r'STE'M IN FtCC:ORDFINCE WITH THE: C:O[:'ES.
}]:: I UNDER'.'STF~ND THFtT THE ON-SITE SEWER S"?STEM MF~'T' RE('::!LIIRE ENL. FIRGEMENT IF' THE
RESIDE'.'NCE IS REMODELED TO INCLL.IDE MORE THFIN 4 8E[:'ROOM:.:5.
N)'i;.l[i"!Ui"l t. IlJI'IP.,I-:I,? ,:iF' k~F.'Ol;:CIl'Ji',l'~ .: 4
RETUAN TO:
STATE OF ALASKA
DEPARTMENT OF NATURAL RESOURCES
Or)lling Permit NO,
'~ 5. 1--~ Cable tool ['"~ Rote ry [~ Drlven [~J Dug
, [~ Auger [--~ Jet ted [~ Bored F'-I Other:
6, USE: [~Oo~stlc [~Publlc Supply [] industry
F~ Irrlgat ion []Recharge []Commercial
[~ Test Well [~ Other:
7. CASING: [] Threaded [~Welded
[~Above ~-~Below lend surface
12. GROUTING: Well Grouted: [] Yes E~O
[] Jet []Other:
APPLIC >tT FILLS OUT'UPPER HAL ONLY
Property Own~;~' ~:~4~ ~:,' ?~ 5 ~ L /~/~/2 {~3/2/~} Phone
Address Zip Code
Realty Co. & A~nt Phone
Address Zip Code
Legal Description
Street Locatl~
Type of Resl~nce
~Slngle Family
Water Supply
~ Individual A~ACH WELL LOG. A w~l Icg Is required for all wells drilled since June 1975.
~ Community For wells drilled prior to that date, give well depth (attach log If available).
~ Public Utility
Sewer Disposal
~ Individual Year Indlv~ual Installed:
~ Public Utility When Connected to Public Utility:
~ Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED,
Time Time Time Time
Date Date Date Date
Inspector inspector Inspector Inspector
Field Notes: I{ MUNICIPALITY OF ANCHORAGE
ENVIROi& :r,.A. ,O ?,-TION
RECEIVED
~ ~ ~ Well to Tank Septic T~A Size ~ ~ ~
72.023 {3182)