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HomeMy WebLinkAboutUS SURVEY 3201 LT 28 T10N R1W SEC 9 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 [] NEW [] UEG"AD --- MAILING ADDRESS LOCATION NO. OF BEDROOMS ~ DISTANCE TO: IWell IAbs°rpti°narea Dwelling PERMITNO~i~.~ ~ ~ Manufacturer Material No. of compartments ~ ~ Liq. capacity in gallons Inside length Width Liquid depth IF HOME.DE: , ~ Weg Dwelling PERMIT NO. O Z ~ Manufacturer Material Liquid capacity in gallons O Well Foundation ~ I Nearest lot line ~ [0 I PERMIT NO ~ Length of each line Total length of lines I Trench width Distance between ]ine~ I No. of lines ~ Top of tile to finish grade Material beneath tile Total effective absorption area Length Width Depth PERMIT ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area ~ We~l Building foundation Nearest lot I~ne ~ DISTANCE TO: ~ CJass Depth Driller Distance to lot Hne PERMIT NO, ~ Building foundation Sewer line Septic tank Absorption area(s) ~ DISTANCE TO: PIPE MATERIALS SOIL TEST RATING~ APPROVED DATE LEGAL 72-013 (Rev. 3/78) MUNICIPALITY OF ANCHORAGE. ., Department~ c Health and Environmenta/~rotection ~ - 825 ~ Street, Anchorage, AK. ~9501 264-4720 * * * HANDWRITTEN PERMIT * * * Permit # ~ ~C~L4q~ c~ON-SITE SEWER PERMIT Location: ~/~ ~ Phone Number: Type of Soil Absorption System Is: Trench: Drainfield: Seepage Bed~ /Holding Tank: Maximum Number of Bedrooms: Soil Rating(sq.ft/br) The Required ~ize of the Soil Absorption System Is: DEPTH ~ LENGTH _,~?~ GRAVEL DEPTH &' 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). O~ ~/~/ ~/~ * * 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 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 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 ~1~ 1 9 8 3 * * * I certify that: (!) 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 the residence is remodeled to include more tha~ 3 bedroom~ SWP/024 (1/81) .... , · DEPT. OF ENVIRONMENTAL CONSERVATION BILL SHEFFIELD, GOVERNOR ~.phone:{9om 274-2533 Address: 437 "E" Street Suite 200 Anchorage, AK 99501 June 3, 1983 Environmental Control Services 1220 West 25th Avenue, Suite B Anchorage, AK 99503 SUBJECT: Bird Creek Camper Park Dear Sir: We have reviewed the plans and specifications for the subject'project. The project is hereby approved for construction for the items with which this Department is concerned. This letter constitutes the permit required by A.S. 46.03.720(a) for approval of sewerage systems. Sincerely, Bob Martin Deputy Director BM/djf STATE OF ALASKA DEPARTMENT OF TRANSPORTATION AND PUBLIC FACILITIES AIRSPACE PERMIT THIS AGREEMENT is entered into this [~'~ day of ~&%~ , 1983, at Anchorage, Alaska, by and between the State of A1Rska, Department of Transportation and Public Facilities, acting by and through its Commissioner, hereinafter referred to as the State, and Billy Johnston, hereinafter referred to as the Permittee. THAT the Permittee is desirous of utilizing a septic system occupying the airspace in, on, under or over the highway right of way within the following described area: Lot 28 of U.S.S. 3201 and adjoining Lot 6 of U.S.S. 3680. WITNESSETH that for and in consideration of the mutual benefits to be derived, the State and the Permittee agree as follows: (1) That the airspace shall be occupied for the purpose'of constructing and maintaining.a septic system, and for no other purpose or purposes, without the written consent of the State, subject to concurrence by the Federal Highway Administration and that the Permittee will not use the airspace for any purpose in violation of any law, munIcipal ordinance or regulation. (2) That any significant revision in the design or construction shall receive prior approval by the Department of Transportation and Public Facilities, subject to concurrence by the Federal Highway Administration. (3) That the State shall reserve the right to enter the ~area at any time as may be necessary for the purpose of inspection, maintenance or reconstruction of the highway facility. (4) That the Permithee shall not make or suffer any i alteration within said airspace without the written consent of the State. (5) It Js specifically agreed and understood that the Permittee shall not call on the State to make any improvements or repairs of any nature whatsoever to the facility~ but the Permittee hereby specifically covenants and agrees to keep the . same in good order and condition and to maintain said facility at its own cost and expense, and that no additional structures .will be built or permitted within said airspace without written consent of the State. ! (6) The Permittee agrees to hold and save the State harmless and indemnified from any injury, loss, claim or damage i to any person or personal property resulting from the use of i said facility. The Permittee further agrees to hold and save the State harmless and indemnified from any injury, loss, claim, or damage occurring in connection with any future sale of the above ~described property. The State will not keep said facility insured against any insurance risk and the Permittee will make no claim [of any nature against the State by reason of any damage in the !event same is damaged or destroyed by any cause. (7) This Agreement is not to be construed as permission to construct the septic system. The Permittee shall secure all i necessary permits and certificates which may be ~equired. ~ Nothing in the transfer of use or any rights granted to the . :~iPermittee under the above-mentioned Permit shall be construed ~ to have granted to the Permittee any right to convey, assign or, in any way, transfer any rights in said property without prior approval by %he State, subject to the concurrence of the Federal Highway Administration. ~i If any provisions or covenants of this Airspace Permit are ilviolated then this Airspace Permit shall be revoked and null and 'ivoid if said violation is not corrected after the Permittee has iireceived written notification by the State of said violation or ilnoncompliance and has had a reasonable time to correct said' !violation to conform to this Permit. The Permit will be revokable in the event that the airspace facility ceases to be used or is abandoned, and the provisions of ~ this Permit may be in writing altered, changed, or amended by :,mutual consent of the parties hereto. The State, however, : reserves the right to terminate this Permit by 90 days written .inotice to the last known address of the Permittee if said property 'is needed for highway purposes. IN WITNESS WHEREOF the parties hereto have set their hands and seals the day and year in this Agreement first above written. RECOMMENDED FOR APPROVAL: R~i~nal ~hief RightfUl Desi~and Constructi~ Centr~egion '~ Way Agent STATE OF ALASKA DEPARTMENT OF TRANSPORTATION AND PUBLIC FACILITIES / ~egiofial Direct6~ .../.~? Design and Construction Central Region Pe~it~ee Concurrence of Federal Highway Administration per letter dated May 6, 1983 Permittee INDIVIDUAL ACKNOWLEDGEMENT STA~E OF ALASKA ) ~(tl ) ss. JUDICIAL.DISTRICT) EMEMBERED that on this~'/~ day of h~ 1 8~Eb~o~e me the undersigned, a. NT~.~ar~ Pub~ic~ Of ~taska,' personally appeared ~.~ ///~/~/~ A/~ ~~f~., k~o~ %o me to be the ' entical person' w~ekecuned~n~/zoregolng Agreement and ~ acknowledge~to ~e ~at ~he? ~ signed the same as ~ ~free and voluntary act and deed with full knowledge 6f its contents, for the uses and purposes therein expressed. IN WITNESS ~EREoF, I have hereunto set my hand/and affixed the Seal of my Office the day ~ year fi written. ~y ~mmi~ion Exptr~ ~. ~//~]'' March 1, 1986 ./'~ My Co~ission Expires: ~ ~¢1 ACKNOWLEDGMENT OF DIRECTOR DESIGN & CONSTRUCTION STA~ OF ALASKA ) · . ) ss. UDIO AL DIST IOT) _BE IT REMEMBERED that on this ,/~-~ day of 198~ before me the undersigned, a Notary Public of the State of -2- Alaska, personally appeared~ Director, Design and Constr~ction, known to me to be the identical person who executed the foregoing agreement and he acknowledged to me that he executed the same for and on behalf of the State of Alaska, Department of Transportation ~hd Public Facilities, with i.full authority so to do, and for the ~ses and purposes therein !.expressed. . ii IN WITNESS WHEREOF, I have here~nto' set.my ~ and affixed iithel Seal of my Office the day and y~r~first abo~ritten., A-_ ot y ublic A eska/ Airspace Permit ASP-31-2-006-1 -3- 1 2 3 6 7 8 9 10 11 ~2 ~3 15 ~6 17 18 19 20 21 22 23 24 27 28 29 3O 31 32 BEFORE THE STATE OF ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION CONSENT AGREEMENT Whereas, the Alaska Department of Environmental Conservation and William N. Johnson (hereinafter "Applicant"), are desirous of resolving a disputed matter, it is therefore acknowledged that: 1. Applicant will be responsible for the camper park wastewater system near Bird Creek, Alaska, more specifically identified as a wastewater system, located on Lot 28 of USS 3201 and adjoining Lot 6 of USS 3680. 2. The applicant has received an Airspace Permit from the Alaska Department of Transportation (ASP 31-2-006-1) to install a' wastewater system within the highway right-of-way. 3. As a condition to the approval (A.S. 46.03.720) of the wastewater system described in~] above, the applicant agrees to provide space for an approvable wastewater system (moving the Drinking Water Well, if necessary) in the event of right-of-way permit termination. 4. If the Applicant transfers, sells, or leases the system to another party, he shall incorporate a copy of this agreement into the documents of transfer or lease. William N. John~S'qb-fi - ~' ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION ROBERT M^RTIN DEPUTY DIRECTOR ENVIRONMENTAL QUALITY OPERATIONS Dated: _~/~Z~9_]~~ _