HomeMy WebLinkAboutT15N R1W SEC 9 Lot 121B American Legion Post
' MUNICIPALITY OF ANCHORAGE
i " DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
_EGAL DESCRIPTION
LOCATION ~'~ ~ ~ ~ ~ "b NO, OF BEDROOMS
Well Absorption area Dwelling PERMIT NO,
IF HOME.DE:
~ ~ DISTANCE TO: Well Owelling PERMIT NO.
O Z ~ Manufacturer Material Liquid capacity in gallons
D We]l Foundation Nearest lot line
No. of lines ~ Length of each line Total length of lines/ / Distance between lines
Length Width Dept~ PERMIT NO.
~ ~ Type of crib Crib diameter Crib depth Total effective absorption area
~ Well ~uilding foundation Nearest Jot llne
~ DISTANCE TO:
~ Class Depth Driger Distance to lot line PERMIT NO,
~ Building foundation Sewer line Septic tank Absorption area(s)
DISTANCE
TO:
OTHER
PIPE MATERIALS
REMARKS
APPROVED DATE LEGAL
Permit
Applicant:
Location:
~U~I~IPALITY OF ANCNORAGE,.~
Department ! Health and Environmental ~rotection
825 L Street, Anchorage, AK. ~9501
264-4720
* * * HANDWRITTEN PERMIT * * *
W~ ON'SITE SEWER PERMIT
Mailing Address: ~, ~ //~
Phone Number: ~ ~--S~3~
Legal Description: 7--~ klb3 R.~ Lo~/2/~ Lot Size:
Type of Soil Absorption System Is:
Trench: ~/ Drainfield: Seepage Bed: Holding Tank:
Maximum Number of Bedrooms: soil Rating(sq.ft/br) ~
The Required Size of the Soil A~sorption System Is: '
DEPTH /o LENGTH ~-~ GRAVEL DEPTH Ac WIDTH
The length dimension is the length(in feet) of the trench or drainfield. The
depth of a trench or pit is the distance between the surface of the ground and
the bottom of the excavation(in feet). There is no set width for trenches.
The gravel depth is the minimum depth of gravel between the outfall pipe and
the bottom of the excavation(in feet).
* * REQUIRED SEPTIC(HOLDING) TANK SI. ZE = /~(:p cD GALLONS * *
Permit applicant has the responsibility to inform this department during the
installation inspections of any wells adjacent to this property and the number
of residences that the well will serve.
* * * TW0(2) INSPECTIONS ARE REQUIRED * * *
Backfilling of any system without final inspection and approval by this department
.will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 feet
for a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 2'5 feet and to a community sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
* * * PERMIT EXPIRES DECEMBER 31~ 1 9 8 3 * * *
I certify that:
(1) I am familiar with the requirements for on-site sewers
set forth by the Municipality of Anchorage.
(2) I will install the system in accordance with codes.
(3) I understand that the on-site sewer system may require
the residence is remodeled
and wells as
enlargement if
to include more that 3 bedrooms.
Issued by: ~.:~'~aJ:~'~-~
Date: ~//~ d/~%
SWP/024 (1/81)
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L, Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
[] PERCOLATION
TEST
PEREORMED FOR:
LEGAL DESCR,PT,ON: Tl$lg, ~/~, SC~ '~ ~'~
3-
4-
5
6
7
8
9
DATE PERFORMED:
SLOPE
SITE PLAN
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE
TEST RUN BETWEEN FT AND
COMMENTS ~o,'l ~r~.l 3'[Z' ~ I S ' F~'~ V;~.,,I .~ ~' ~S '~'/~d
PERFORMED BY: ~, ¢~ CERTIFIED BY:
(minutes/inch)
, FT
DATE:
72-008 (6/79)