Loading...
HomeMy WebLinkAboutT15N R1W SEC 30 LT 81 b) DOC CO. ciba SULLIVAN WATER WELLS P.O. BOX 670272, CHUGIAK. ALASKA 99567 · TELEPHONE 688.2759 OWNER OF LAND ADDRESS LEGAL DESCRIPTION Z'°'i'~ ~;:'/ C\/-~Ch ~,/[~-~ -.~ ~) DATE- Started Ended ~/c? ,'~' PERMIT NUMBER -~{ ~ %~ ~ DEPTH OF WELL r~ ,~ ) STATIC LEVEL OF WATER Fr "" DRAW DOWN FT. O GALS. PER .R / KINI) OF CASING KIND OF FORMATION: From 0 Ft. to c~t. Ft. ~'/]~,~ot; '~ ...... " From C~ Ft. to ~ Ft. 0 ~')'~K~/3J~'D~','xj From__Ft. to From ~b Ft. to ]'¢ Ft. t~,5,4 ~ (~'-?_.dq' [ From Ft. to From t~;~. Ft. to 6© Ft. ff"'~) ~-. g~(~ft*) From Ft From Ft. to Ft. From__ Ft. to From Ft. to Ft. From Ft. to From~ Ft. to Ft. From __ Ft. to_ From Ft. to~ Ft. From~ Ft. to ~ From Ft. to Ft. From Ft. to_~ Ft. to From Ft. to Ft. hL~[j~ From Ft. to_ Ft From~Ft. to__ Munimpali~ ot ~noho~0~ From Ft. to Ft ~-,~ u~h ~ H~ Ra. ~ic~. to From Ft. to_ Ft. From Ft. to From. Ft. to_ Ft. From Ft. to From Ft. to Ft. From Ft. to Ft. Ft. Ft. Ft~ Ft Ft. Ft. Ft. Ft. Ft. Ft. Ft Ft, Ft Ft. Ft Ft, MISCL. INFORMATION: DRILLER'S NAME 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 SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW930023 DESIGN ENGINEER:DUMMY COMPANY OWNER NAME:DITTBRENDER WILBUR H & OWNER ADDRESS:15217 DARBY RD EAGLE RIVER, AK 99577 DATE ISSUED: 3/01/93 EXPIRATION DATE: PARCEL ID:05130232 LEGAL DESCRIPTION: T15N R1W SEC 30 LT 81 1 OF 3/01/94 2 LOT SIZE: 108900 (SQ. FT.) NUMBER OF BEDROOMS: 2 THIS PERMIT: 2 THIS PERMIT IS FOR THE CONTRUCTION OF: 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 (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4329 OR 343-4681 AFTER BUSINESS 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. SPECIAL PROVISIONS: PROPOSED WELL IS TO SERVE THE EXISTING SINGLE FAMILY RESIDENCE. THE EXISTING WELL MAY BE RETAINED IN USE PROVIDED NO CROSS CONNECTION OCCURS BETWEEN THE WELLS. PLEASE PROVIDE WRITTEN CONFIMATION AS TO THE EXISTING WELL MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 DISPOSITION WITH NEW WELL LOG. RECEIVED BY: ISSUED BY: DATE: DATE: PAGE 2 OF 2 0 ~J o ~VOS MUNICIPALITY OF ANCHORAGE ' 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 NAME PHONE~ [] UPGRADE LEGAL DESCRIPTION lot e~3l $~--.- 30 Y-l~/J /~ L W LOCATION I Li~' ~Pa_~'~gall°ns IF ,O~]EMADE: Insl,e length Width Manufacturer Material Well Founda~n~ t Nearest lot lin DISTANCE TO: [~) I ~,.0~ No. of lines 3 LTo~.p of tile to finish grade Length Width Depth Type of crib Crib diameter Well DISTANCE TO: Building foundation Class Depth Driller DISTANCE TO: OTHER Sewer line PIPE MATERIALS 1834-E SOl L TEST RATING INSTALLER REMARKS NO. OF BEDROOMS liT NO. No, of compartments Liquid depth PERMIT NO. Liquid capacity in gallons Distance be~tw~en lines Total effective abso ,.area IT NO. n area(si APPROVED 72-013 (Rev, 3/78) RECEIVED ' ' WATER WELL RECORD STATE OF ALASKA OEPARTM[NT OF NATURAL R£SOURES Division of Geologicol a GeophysJcul Surveys LOCATION CiF WELL WELL LOG .... Tb-p sort -- -- Gravel, ----~eeSs~on%-- ~i~n ia~e~s _. ~ay rock ~ite, red and ~ay rock Grey ~rock, some white, crevices ~wat er Top 8ottom Orllllns Permft No. A.D.L. No. S. OWNER OR WELL' Mr, Clyde Howerton Chugiak, Ak. Secfion No. 3 400 4. WELL DEPTH: (final) [ 5. DATE OF COMPLETION 400I,,. I 5 - 30 - 84 ff. WATER WELL CONTRACTOR'S CERTIFICATION: MaKnuson Drilling ~AA ~3_8~ ......... ~.0. Box 7~504 Eagle RiVer, 1984 Production of l½ GPM •c I0. STATIC WATER LEVEL: ft. / [:~Above or [~eelo, Iond ~_MUNICIPALITY OF ANCHORAGE ~_~ Department(' ~ Health and Environmenta? '~'7otection ~ 825 ~ Street, Anchorage, AK .~01 ,'~ 264-4720 ~.~,~Of~l * * * HANDWRITTEN PERMIT * * * ~rmit WELL AND/OR ON-SITE SEWER PERMIT Location: Phone Number: ~ 7/'- //egal Description: ~.~/ J~c ~-/'5-/~/~ Lot Size: Type of Soil Absorption System Is: Trench: Drainfield: Seepage Bed': / Holding Tank Maximum Number of Bedrooms: o~ Soil Rating (sq. ft/br) /~ The Required Size of the Soil Absorption System Is:' DEPTH ~' LENGTH ~-~'~ GRAVEL DEPTH ~ ~ W I DTH /~ / 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 SIZE = /~ 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. * * * TWO(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 fo~ a private well or 150 to 200 feet from a public well depending upon the type o~ public well. Minimum distance from a private well to a private sewer line is: 25 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 3L 1 9 8 3 * * * I certify that:- (1) I am familiar with the requirements for on-site sewers and wells as 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 enlargement if Sig~ ~~z ~?~~~th '~remodeled~ to includeissuedmOreb~~tha~3 bedroo~. ~ ,% \, ~,//'-~pplicant' SWP/024(1/81) S & S ENGX~ZEERS. INC 7125 Old Seward Hwy. ~chorage, Alaska 99502 349 -6561 SOILS LOG PERCOLATION TEST SOILS LOG-'PERCOLATION TEST ~f~. :¢ ~-' ~ -' 10- ,o.'T. :L),C) / 11- WAS GROUND WATER ENCOUNTERED? t'.JO -o IE YES. AT WHAT DEPTH? 13- 14- 15- 16- 17- 18- Reading Date Time Time 49th JOHN C) lg- 20- COMMENTS. · E', :. TEST RUN BETWEEN OATE: }r0NICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMElff OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date (a) Le~ D_escription~_~(include l?_t, block, sub. division, section, township, range) Location (address or directions) (b) Applicants Name~__Z~-~/'7 Telephone - Home Business Applicants Address (c) Applicant is (check one) Lending Institution Buyer ~-~ ; Other ~ (explain); (d) Lending Institution 0wner/~4~N~r~; Telephone Address~ ' (e) Real Estate Co. & Agent Address Telephone (f) Mail the HAA to the following address: Type of Residence Single-Family~ Number of Bedrooms Multi-Family ~--~ Other (describe) Water Supply- Individual Wellz~ Community~--~ Public~ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status, Sewage Disposal 0nstte,~ Public ~--~ Community ~--~ Holding Tank ~-~ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1 of 2] 5. Engineering Firm Providin~ Inspections~ Tests~ File Search, Data and Information As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-sit~ water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that, based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the onLsite water supply and/or wastewater disposal system is in compliance with ail Municipal and State codes, ordinances, and regula- tions in effect on the date of this inspection. Name of Firm~ ' ~ . ~ ~-..,~C~ Telephon~ Address ~ R~US8, Ak~n~,~ ~. 6. DHEP Approval // - ~~~' 5'2~ Approved for ~ bedrooms By~ ~~~ Approved ~ Disapproved __ Condition~ __ Te~s of Conditional Approval CAUTION THE 'MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONmeNTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK. (DHEP SEA,L) RR4/ej/D18 [Page 2 of 2] 7-19-84 A® M cxP X OF (MOa) CHECKLIST - FEBRUARY 1984 Well Classification Well Log P~esent~¢/N) Date Cc~pleted Total Depth Static Water Level //O / Pump Set At Casing Height Above Ground Electrical Wiring in :Conduit~N) Separation Distances f~cm Well: If A, B, o~ C, D.E.C. Approved(Y/N) Depth of Grouting. Sa'nita~y Seal on.Casing .~/N) DepreSsion Around Wellhead To Septic/Holding Tank on Lot /~4D ~ ; On Adjoining Lots To NeaEest Edge of Absorption Field~o}~ LOt /¢~ / ; Oa AdjoiMing Lots TO Nearest Public Sewe~ Li~e ~/~ ___ To Nea~es.t Public Hewer Cleanout/Manhole ¢//~- ._ . TO Nearest Sewer Serv}.ce T?~ne o_n LOt B. SEPTIC/HOLDING TANK DATA Date Installed /~ Size /~---~) No. of Compartments Standpipes~/N) Air-tight Caps ~N) Foundation Cleanout ( ~Y~-~ Depression over Tank (Y~ Date Last Pun~ed /%/~:~/ Pumping/Maintenance Contract o~ Fi.le (Y~)//~-'.; fo~ Holding Tank High-Water Ala~ (Y/N) /~ ' Temporary Holding Tank Permit (Y/N)/~'/~ Separation Distanoes f~cm SePtic/Ho~6clT~ Tank: To Water-Supply Well ./~.~ TO P~operty Line Li~ To ~ter ~in/~=vi~ co t, TO Building Foundation To Disposal Field To Stream, Pond, Lake, or Major D~ainage [Page 1 of 2] 2~15-84 ~,,,.,NICIPALITY OF ANCHOk~AGE : DEPF, OF HEALTH & [NVIRONMENTAL PF, O fECI'ION C'. ABSORPTION FIELD DATA _nj f JUl ~ ¢,' ?'"' Soils Rating in Absorption Strata //~---"~-z/7/'~/Z.-'Type o£ $,/~stem. Desi, g~ Date Installed /~:'3 Length of FieldR~ C~1~¢c~: Width of Field f~ r Depth of Field ~ / Gravel Bed Thickness Square Feet of Absorption A~ea 7~.~ Standpipes P~esent~N') Depression over Field (Y~'~ (..Date of Last Adequacy Test Results of Last Adequacy Test /~//~ Separation Distance f~om Absorption Field.' To ~ate~-Su[Jply Well /~/D / To P~operty Line To:Building FoUndation ~ / - To Existing or Abandoned System cn Lot . ~L) /-.~- ; On Adjo. in~ng Lots 3'~) f~ To'i'WaterM'~in/~.?'vice Line /"/~ -F To Cutbank(if, present) To St~e',.am/Pond/LaR~/c~ Major D~ainage Course TO D~igeway, Pa~king A~ea, o~ Vehicle Stc~age A~ea :~) ~ Do LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alazm Level at Tested for Electrical Codes(Y/N) Conm~nts Dimensions Manhole/Access (Y/N) "Puml0 Off" Level at ~//// Vent (Y/N) Pu~ng~y~eles du~ing Adequacy Test. //~ Meets MOA ** Check Permitted B~d~oom Rating Against HAA ~quest certify thj~ave checked, verified, or confo~msd to all MOA HAA Guide~lines in effect on the ~ of/~/,~/~/on. ,f////,~.,~,~¢ .,~... ~, -'"'"~"~":"~,: .~ ~%~. ~ t / s.~ ,~.x, ~: ' X~' T~:,,. ~? ~, *,,.~. /:r ~.~ 2-15-84 CASE NUMBER: S-8680 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION Environmental Health Division SUBDIVISION OR PROJECT TITLE: Lots 1, 2 Coleross Subdivision CASE REVIEW WORKSHEET / j [ DATE RECEIVED: COMMENTS DU.E~Y~, / September 17, 1987 Oct~o~9~ 1987 _l~' fT'~l' ( ) PUBliC WATER AVAILABLE ( ) PUBLIC SEWER AVAILABLE ( ) COMMUNITY WATER AVAILABLE 71-014 (Rev. 5/83) / PRELIMINARY PLAT APPLICATION OFFICE USE Municipality of Anchorage REC'D DEPARTMENT OF COMMUNITY PLANNING P.O. Box 6650 V~=RIFY OWN Anchorage, Alaska 99502-0650 A. Please fill in the information requested below. Print one letter or number per block. Do not write in the shaded blocks. Case Number (IF KNOWN) Vacation Code 2. New abbreviated legal description (T12N R2W SEC 2 LOT 45 OR SHORT SUB BLK 3 LOTS 34). 3. Existing abbreviated legal description (T12N R2W SEC 2 LOT 45 OR SHORT SUB BLK 3 LOT 34) full legal on back page. fl,kl,q Pi,P{ I kFI I 1°1 I 1'$1 Idzl I I I 4. Petitioner's Name (Last- First) IIIIII / Address .~ '~ ~- z~oX ~-/~ City ~"//Gz_~' ~),v£,~. State Phone No. ,~/ou _ _?~/~' Bill Me 5. Petitioner's Representative Address /'~ ~' c'-7ox' ~ 7D 72c] City ~_j,z/~,~,/~ State ,~/C, Phone No. ~,~- .~5~ Bill Me 6. Petition Area 7. Proposed Acreage Number Lots II I S 86"80 OCT 1_ 2 1987 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 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 tentalive and may be have to postponed by Planning Staff, Platting Board, Planning Comm ss on, or the Assembly due tg~ '..~, 'a"d' mJ ° J'st r:'a'liy e" reasons. ~'"'~./~"~? ~ ~ ,~u~ ~, .. '!' Date: ? %r ¢,¢j tI '1 .... .... :' Signature *Agents must provide written proof or authorization. Existing 9. Traffic 10. Grid Number 11. Zone Number Analysis Zone Lots C. Please check or fill in the following: 1, Comprehensive Plan -- Land Use Classification Residential Commercial Parks/Open Space Transportation Related 2. Comprehensive Plan -- Land Use Intensity Special Study 3. Environmental Factors (if any): a. Wetland 1. Developable 2. Conservation 3. Preservation Marginal Land Commercial/Industrial Public Lands/Institutions Dwelling Units per Acre Alpine/Slope Affected D. Please indicate below if any of these events have occurred in the last three years on the property. Rezoning Subdivision Conditional Use Zoning Variance Alpine/Slope Affected Industrial Special Study Case Number Case Number Case Number Case Number Enforcement Action For Building/Land Use Permit For Army Corp of Engineers Permit Legal description for advertising. b. Avalanche c. Floodplain Seismic Zone (Harding/Lawson) Checklist /'~30 Copies of Plat ~"/~Reduced Copy of Plat (8'/2 x 11) ~'"'~Certificate to Plat ~'"'~o~o Map 3 Copies ~'~Soils Report 4 Copies -4~-~Aerial Photo '""~Housing Stock Map /,--""~o n in g Map Water: Sewer: Private Wells Private Septic Waiver Community Well Community Sys. Public Utility Public Utility Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST 1 .2 3 4 5- 6- 7 8 9 10 11 12- 13- 14- 15- 16 17 18 19 20- SITE PLAN Township, Range, Section: WAS GROUND WATER 7..~ ~, ENCOUNTERED? , IF YES, AT WHAT & j I~ DEPTH? pO E Deplh lo Waler After Monitoring? Dale: L Reading Date Gross Net Depth to Net Time Time Water Drop __ (minutes/inch) PERC HOLE DIAMETER PERCOLATION RATE TEST RUN BETWEEN FT ,AND PERFORMED BY: ~'~ /~'~ J~ ~1I~ I ACCORDANCE WITH ALL STATE AND MUNICIPAL GDIDELI~ES IN~FFECT ON THIS DATE. DATE: 72-008(Rev. 4/85) ~ ~[~ RPT ~ 9 ~OQ7 FT CERTIFY THAT THIS TEST WAS PERFORMED IN