HomeMy WebLinkAboutT15N R1W SEC 18 LT 71T15N R1W
Sec 18
Lot 71
#051-172-05
• Municipality of Anchorage
-,?,
�''',-'
3_ Development Services Department :Caul:
\ Building Safety Division �V
On -Site Water and Wastewater Program, 4700 S. Bragaw St. \�
P.O. Box 196650 Anchorage, AK 99519-6650 Page
www.ci.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL. INSPECTION REPORT
Permit Number: SW030176 PID Number: 051-172-05
f
of
Name:
eHuls
MikeAddress:
Wastewater System: ❑New
'4
Upgrade
19111 Birchwood LOOD Chualak. AK. 99567
ABSORPTION FIELD
Phone: Number of Bedrooms:
• :: - r '
® Deep Trench O Shallow Trench 0 Bed 0 Mound 0 Other.
LEGAL DESCRIPTION
Son Rating:
0.6 GPO/Ft'
Total Depth from original grade:
7.83/7.69 R.
Block: Lot: SubdMsion:
71
Depth to pipe bottom from original grade:
3.83/3.69 Ft.
Gravel depth beneath pipe:
4.0 FL
Township: Range: Sedan:
► i
Fill added above onglnal grade:
0 Ft.
Gravel Length:
104 Ft.
Well: ❑ New ❑ Upgrade
Gravel wrath:
5.0 Ft.
Number of fines:
2
Distance between lines:
10 FL
Classification (Private, A. B. C):
Private
Total Depth:
Ft.
Cased to:
Ft
Total absorption area:
1040 FI'
Pipe Matenal:
D3034 & F810
Driller:
Date Drilled:
Static Water Level:
Ft
Installer:
Walker Const.
Date Installed:
1 0/19/2003
Yield:
GPM
Pump Set at:
Ft.
Casing Height Above Ground:
Ft
TANK
SEPARATION DISTANCES
El Septic 0 Holding :4 S.T.E.P. • Other.
To
Septic
Tank
Absorption
Field
Uft
Station
Holding
Tank
Pub nGPrivate
sewerLlne
Manufacture .
Anchorage Tank
Capacity.From
1250 Gal.
Well
100'+
100'+
NA
NA
25'+
Matenal.
Steel
Number of Compartments:
2
Surface Water
100'+
1001+
NA
NA
LIFT STATION
Lot Line
5'+
10'+
NA
NA
Size.
1250 Gal.
Manufacturer.
Orenco
Foundation
5' +
10'+
NA
NA
Pump on level at:
44" In.
Pump 0H level al:
42" In.
High water alarm aL
48" In.
Curtain Drain
NA
*50'+
NA
NA
Pump Make & Model
Franklin 2445040117-1/2hp
Electrcal Inspections performed by:
Remarks:
*none known
BENCH MARK
tank & field insulated
Location and Description:
Top of 4x6 beam holding up deck
Assumed Elevation:
100 Ft.
Engineer s Stamp
....+���\\1,,
•• OFA dw 11
r se, ••• •• eerie ee. ;.*•
• • ........... %
Inspections performed by: KND Engineering. Inc,Dates: 1st 6/18/2003
rid
2 6/25/2003/OS
I �c • en.lu1n PA L' .: •;
�, a• CE „t • \�,,�
/14 9Fo ••••, •''\,k•��.:
,`;;"` `2.•4
Developme t Services Department Approval "' 7�
Reviewed and approved by: Date: ��^T
(Rev. Ib'00)
_
KND
AS -BUILT SYSTEM DETAILS/SITE PLAN Permit SW030176
LOT 71, SEC. 18, T15N, R1W, S.M. PID#051-172-05
100
W
SEPTIC
EXISTING TAIIEL
E000 SPUTTER
ESUS
GAL S.T
L RADIUS (EXISTING)
TH03-
SLOPE-F
SCALE'
/
/
/
/
/
ELL RADIUS (EXISTING/)
/
/
A -C= 25.7'
B -C= 83.5'
A -D= 28.0'
B -D= 81.5'
A-E= 37.8'
B-E= 37.5'
A -F= 41.8'
B -F= 89.1'
A -G= 48.9'
B -G= 48.8'
A -H= -
B-H= -
OONITOR TUBE
FINAL GRADE
1250 GAL
S.T.E.P.
TANK
SCALE' NTS
91.9p
FILTER rATRIC\
SEWER ROCK
TRENCH 1
.10NITOR TUBE
295.70'
50A'
FINAL GRADE
MONITOR TUBO
095.4
u
91.91
VANES
MONITOR TUBE
VARIES
SEWER ROCK
TRENCH 2
88.01 88.01
C11F�11�Ii�IClt in�IF-n.-nHIHIF�ICII� �t--t
54.0'
PREPARED FOR:
MIKE HULS
19111 BIRCHWOOD LOOP
CHUGIAK, AK 99567
(907) 688-3740
FIELD BOOKS
CE -7116
•
OFESSIO141."'
BOU'NARY: SEWARD
SCALE' NTS
CONPUTEO:
ACAO FIE 03046.DWG
'100 "°' 03046
ll N ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
(907)696-6111/FAX (907)696-8111
Rising Son Electric Inc.
July 15, 2003
907 622 6777 09/03/03 08140A P.001
Rising Son Electric, Inc.
14916 Woodland Drive
Eagle River, AK 99577
(907) 622-6777
Re: 19111 Birchwood Loop, Chugiak, AK 99567 - Mike Huls
To Whom It May Concern:
The lift station at the above referenced property has been wired in accordancc with NEC
and State/Local codes.
Thank you.
Sincerely, �!
Kevin S, Hombuckle, Owner
Administration License Number 1284
Specialty Contractor License Number 27285
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Permit Number: SW030176
Legal Description: tTI5N R1 W SEC 18 LT" 71;
Design Engineer: 0070 KND Engineering
Owner Name: Mike Huls
Owner Address: 19111 BIRCHWOOD LOOP
CHUGIAK , AK 99567-6609
0123- la�,,,�-
(6,1Z faM1A,
@(a& (vim.
Date Issued: Jun 09, 2003
Expiration Date: Jun 08, 2004
Parcel ID: 051-172-05
Site Address: 019111 BIRCHWOOD LOOP RD
Lot Size: 30492 SO. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
This permit is for the construction of:
❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
AH 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 DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 (24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
6/20103 t44. To L /FT vy3T/GNS wEter- A,ttff
C/LCLLii--TCO.
Received By
Issued By:
Date' 0/%/03
Date: C/9/0.3 4j
Parcel I D
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Property owner(s) MIKE HULS
Permit Number SW O 30 / 7G
Day phone 688-3740
Mailing address (1) 19111 Birchwood Loop, Chugiak, AK 99567
Mailing address (2)
Zip Code
Legal description (Lot, Block & Sub'd) T15N R1 W SEC18 LOT 71
Legal description (Section, Township & Range)
Lot Size_2-30ua7-- Acres/Sq.Ft. Number of Bedrooms 4
THIS APPLICATION IS FOR:
Sewer Only ❑ Well Only
Sewer and Well ❑ Water Storage
Sewer Upgrade
THIS PROPERTY CONTAINS:
Hot Tub 0 Jacuzzi
Swimming Pool 0 Water Softening Unit
Therapy Pool 0
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
(Sign t re of property owner or authorized agent)
Permit Fees: y0 0 Waiver Fees:
Date of Payment: WO Date of Payment:
Receipt Number: 36, SO 7. Receipt Number:
(Rev. 12/00)
IKNID ENGINEERING, INC.
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
(907)696-6111/FAX (907)696-8111
June 2, 2003
Municipality of Anchorage
Development Services Department
On -Site Water & Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
Subject: Septic Upgrade Permit — T15N, R1W, SEC18, Lot 71
Gentlemen:
The owner has requested we proceed forward to obtain a septic permit on the subject
lot. On May 20, 2003 one testhole was performed for the proposed system. The results
of this test are attached. The.general slope of this lot is flat.
We have designed our system utilizing the existing testholes that were excavated for
the existing 4 -bedroom house. The lot is served by an individual well, located on the
southeastern portion of the lot. We propose to install two 5' wide shallow trenches.
Water was not encountered during the excavation or during monitoring.
There are no public or private wells within 200' of our proposed system location except
as noted. There is no surface water within 100' of the proposed system and there are no
known curtain drains within 50'. We do not expect there to be any adverse effect on
adjacent lots by the development of this system.
If you have any questions, please contact me at 696-6111/FAX 696-8111.
Respectfully submitted,
IID Engineering, Inc.
Attachments: On -Site Well and Sewer Application
Wastewater Absorption System Details/Site Plan
Soils Log/Percolation Test
WELL & WASTEWATER DISP❑SAL SYSTEM DETAILS/SITE PLAN
VEST
LOT 71, SEC, 18, T15N, R1W, S.M.
29.80 C77-75) (77-18) BLM 84-251
Cane m
KND
72A
279
/\ V7
•
/0/
279.78
VEST 329.78 C77-75)
10' Uta Esnt
266.64 C/2-208)
233 `IW] D
50 3
/
NO PUBLIC VEILS WPM 200' IT
PROPOSED SYSTEM.
ND PRIVATE VELLS VITHDI 200' OF
PROPOSED SYSTEM E%CEPT AS NOTED.
No SEPTIC SYSTEMS VITHIN Ear OF
PROPOSED YELL EXCEPT AS NOTED.
35
/
/
35
Vol 129
NM Not Gas Esnt Bk 73 Pg 879
VEST 55
93A
/ /
/-�g3p,
SUB93A
?g,�M, L9
1 ..r..y •••• .t”
DESIGN DETAILS
4 BDRM X 150 GPD = 600 GPD
600 GPD/0.6 GPD PER SQ. FT. (17.14 MIN/IN.)= 1000 SQ. FT
(1000/5'(W)) X .5(RF) (4.0' GRAVEL) = 100 FT. TRENCH
USE 2 TRENCHES - 50' (L) X 5' (W) X 4.0'(D)
Total depth of system Is 9.0' from original grade.
Total depth of gravel .below distribution pipe Is 4.0' .
NOTES!
1. INSTALL NEW 1250 GAL SEPTIC TANK. INSULATE IF <4' OF COVER.
2. CONTRACTOR WILL ENSURE MINIMUM 2% SLOPE INTO SEPTIC TANK.
3. ADDITIONAL FILL WILL BE ADDED OVER SYSTEM TO ACHIEVE
MIN. 3' COVER IF REQUIRED OR INSULATE WITH 2'HD BURIAL FOAM.
5. CONTRACTOR WILL ENSURE ALL SEPARATIONS TO ADJACENT
WELLS, SEPTICS, LOT LINES, FOUNDATIONS AND ALL OTHER SETBACKS.
PREPARED FOR!
MIKE HULS
19111 BIRCHWOOD LOOP
CHUGIAK, AK 99567
(907) 688-3740
Scales 1'= 100'
PAGE 1 OF 2
FIELD BOOKS
COMMA
BQBDARY: SEWARD
DRA"N` VBG
STAX0IG NA
*mac' KMD
ASBUILT. NA
DATE 5/31 /03
JL ID ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
DMC. FLE
NW1155
ACRD ° 03046.DWG
10B Na' 03046
(907)698-6111/FAX (907)696-8111
NG SEPTIC o
WASTEWATER DISPOSAL SYSTEM DETAILS
LOT 71, SEC. 18, T15N, R1W, S.M.
INSTALL ZABEL
2000 SPLITTER
SLOPE=FLAT
Y)
U
U
M. D
CE -7116
PREPARED FOR:
MIKE HULS
19111 BIRCHWDDD LOOP
CHUGIAK, AK 99567
(907) 688-3740
OTE:
RIOR TO
CONSTRUCTION
CONTRACTOR
SHALL HAVE
WELL RADIUS
MARKED BY
LAND SURVEY • F
Scale! 1'= 20'
PAGE 2 OF 2
FIELD BOOKS
COIIPUIED:
BWNOARY: SEWARD
DRAVDD VBG
STAION4
NA
CHEMED: KMD
ASBULT:
NA
OA1E:
5/31/03
OWC. F1IL
(Da NW1155
"0"D' 03046.DWG
'108 " 03046
14�N,D ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
(907)698-8111/FAX (907)896-8111
ENGINEERING, INC.
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
11
Performed for: Mike Huls
SOILS PERCOLATION TEST
OF'A(•g�i1
0*rip
.A ;
...•i....� Ji' ;.. •
} O
• r^ �- � • W
•
J••,.. CE711 3�:
Date Performed: 5/20/03
Project: T15N, R1W, SEC18, LOT 71
1-
2-
3-
4-
5-
6-
7-
8-
9-
10-
11-
12-
13-
14-
15-
16-
17-
18-
19 -
Depth
(Feet)
Org/OL — w/topsoil
SM/GM —dense, gray, damp
w/cobbles to 1'
B.O.H.
HOLE PRESOAKED
20- PRIOR TO TEST
TEST HOLE # 03-1
SEE ATTACHED SITE PLAN
FOR HOLE LOCATION
Was Ground water encountered? NO
Depth to water after monitoring? DRY
What depth? NA
Date? 5/29/03
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
1
5/21/03
1:00
-
6"
-
2
1:30
30 min
42/16"
114/16"
3
1:31
-
6"
-
4
2:01
30 min
44/16"
1 12/16"
5
2:02
-
6"
-
6
2:32
30 min
44/16"
112/16"
*
Water
Added
Percolation Rate 17.14 (min/in) Perc Hole Diameter 6"
Test Run Between 4 feet and 5 feet
I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in
effect on this date.
GREA.SR ANCHORAGE AREA BOR.JGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME4/ /ht/ e/e, MAILING ADDRESS SI 7/7 ('Li 'IGAHONE bo-L,G
LOCATION I' Irl! G/U ihriej .WCITh 1041GAeREl CRIPTION I- Sae /9 T/6-4/ )0 I lid
SEPTIC TANK:
DISTANCE g.�a�
FROM WELLS
•
MANUFACTURER.c)are.--MATERIAL Smial
NUMBER OF
COMPARTMENTS
INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITYA-5-4ALLONS.
/ ^ �� % TOTAL LENGTH
DISTANCE FROM WELL _116 FOUNDATION a,( NEAREST LOT LINE /6 OF LINES 3371,77 -
NUMBER OF LINES _- DISTANCE BETWEEN LINES TRENCH WIDTH IN TOTAL EFFECTIVE
ABSORPTION AREA �O°tali SQ FT LENGTH OF EACH LINE
�7�DEPTH OF FILTER
/
DEPTH: TOP OF TILE TO FINISH GRADE � MATERIAL BENEATH TILE I(2'- IN ABOVE TILE - IN
WELL:
TYPE)ppr
K;I CONSTRUCTION GP S/•��L�l✓ DEPTH DISTANCE FROM:
BUILDING NEAREST NEAREST SEPTICSEEPAGE ^�
FOUNDATION��.pp LOT LINE SEWER LINE TANK SIRS SYSTEM J/4s>c
CESSPOOL OTHER SOURCES
APPROVED DISAPPROVED
REMARKS
DISTANCES:
INSTALLED BY•t4'4-
SEWER LINE DEPTH,
PIPE MATERIAL:
C s
LOT SLOPE• /'i e ,
REMARKS
Form EQ -032
DIAGRAM OF SYSTEM
DATE
A.'
v, te,*
_r- .`civ._
t4
v‘1
Me.w Wet1
c_oCFI zl 0M
TRa;le
/APPROVED
RC it Loaf,
Pr
G.A.A.B.
L.Ojt1( rD65Cannec e -D
iNOT FILA-Pinw- Ccnoi
:un '
24 -an j2 .Sv'/
F °'r 0.._q F'-1 :1: E:: :.F: F_,. F=i L_ :1:...r.. "-" a"_:a F ' p i rJ a....' F-1 L) F F=i a:::'q &:::::
(/ LL33 - - 5.7 --)to
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION k.)
:.10 ft:. TUDOR RD., ANCHORAGE, AK. 99507276-221.. ,3 ti
HF .F.....L.. t=-1FJF:+ CH"-1-5J::...T E. �;: ;F"?_I 1F_= F : FF=°r_:F'F1 _r....1.
PERMIT NCI. 76270 ) O
vj
APPLICANTAL METCALF SRABO 711 - L.HUCiIAk.'. Id' �Nt'..
LOCATION 1.6 '1I IN ON B I RCHWOOD LP SOUTH
LEGAL LtY-SEC: 18 rifSN RAW LOT SIZE 24750 SQUARE FEET
7)
TYPE OF SOIL ABSCIREITION SYSTEM IS: TRENCH
MAXIMUM NUMBER OF BEDROOMS = 4
SOIL EATING (SG! FT/BR)= 125
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
L E P' ..1.. F -F = r1..2 L. Er C -+r c T F -I == !e t i:3 F+~' IFI ° k_: L_ r::+1 F ..r..1 fl .M:: ..:_q
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR cR:AINFIE:L..D.
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 GF:A':+EL.. BETWEEN THE. OUTFALL PIPE
AND THE BOTTOM OF THE EXCAVATION (IN FEET).
FQ. r•~ a_: La 1 RC r_^_ r__a E5:' F• r 1 a_:= ...r_ f INI r•:._ =: Tr ? E z .._. i... =" E i i '3 iR Y . 1...... u.:u 1'-, I °: -!:,;
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN H WELL AND ANY ON-SITE SEWAGE DISPOSAL. SYSTEM IS
1€11 FEET FOR A PRIVATE WELL OR 200 FEET FOR A PUBLIC WELL.
WELL. LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS
OF THE WELL COMPLETION.
SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER
INSTALLATION.
F, F:::: F it m i '"1" ti: "H 1_. i p r a::;a f _ 0.O -r r : • E.' F=1 F : F F^ a_' Fi TL "=:=: s1._M u
I CERTIFY THAT
1: 1: AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELL.:-: AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE:.
I WILL INSTALL.. THE SYSTEM 1:N ACCORDANCE WITH THE CODES.
3: I UNDERSTAND THAT THE ON-SITE _EWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS RE ' • .SLE I> TO INCLUDE MORE: THAN 4 BEDROOMS.
SIGNED:_
APPL.IC4 L TCALF
ISSUED BY___. _ !•4! __
H,Y Ir(ll.i4L( I Ilaill I Ly
3331) "L" SLrcu1
Anchorage , J\1dSLd 95503
Sol l,S LOU - I'I!ROI,A'I'ION TEST
Perfrrnhed for N.r. Al ,'.etc .lf
Legal DescripLion:_tot _ 1 :Lc:. l�
This form reports: Solis7l 1 o -'--Ac
, Perarlation test
Dep til
Feet
1 - S, (250)
2 - SP (1to) 15 - Gh (150)
3 - SP (150) 16 - at (150)
Date Pcrforru:d July-, 1 1076
l 5P (150)
5 - SP (150)
6 - SP (150)
- GP (150)
8 - c';; (125)
C (125)
10 - g;) (175)
11 - G':! (121,1)
12 - G`' (125)
13 - (125)
In -
T (125)
- Was ground water encountered? T?o
Reading
Da to
Gross Time
opc
If yes, at what depth?
Net Time
Depth to «'n ten
Net Drop
Percolation rote
Proposed .i ris Lal Talion.
:;,,Tail of Inlet - .
GOi11 LETS:
minute.
cepage Pit Ural r field
.
UepLl1 to Lot (um of pit or trend,
put -rot -mod LyAr• o /�� � ':I:rl:ifi rl Oy
..caG�G ,r{I A. Drdh' i,
I (1 udo (n/ VA)
/241-1
I chi rl. A. 1-31-.:11n. P. :.
Qlrrtifir? Brining Drug
by
A & L DRILLING COMPANY
BOX 97, EAGLE RIVER, ALASKA 99577 • TELEPHONE 694-2588
OWNER OF LAND R �. rn Er ci
DEPTH OF WELL
6/
ADDRESS �J STATIC LEVEL OF WATER FT
/
LEGAL DESCRIPTION L. 7 i $ FC i r� sr) SYU g l (A) DRAW DOWN FT I S
Ended GALS. PER HR
DATE • Started /`}/ 7 6
PERMIT NUMBER
i
KIND OF CASING L)
KIND OF FORMATION:
From O Ft. to / Ft d� /`J,?e ttivQ tl ti"" From Ft to Ft
From I Ft to S(" Ft 7'
j/' From Ft to Ft
From A_ Ft. to /1 Ft. `�C/- PI `Y t 6 / ietq.,a4 From Ft to Ft
!7
From 0 / Ft to a j Ft. P From Ft to Ft
From ac.
Ft to 37 Ft 5/9w0 ll" 6Kpvet From Ft to Ft
From 3 7 Ft. to .TS' Ft. CCMY it CgAtie L From Ft. to Ft.
From cc- Ft. to 6 Ft. S "v 4 6e4Js L d-LUfi rcRm Ft. to Ft.
From 6? Ft. to Ft. L'Z4 i *beefa 4 From Ft. to Ft.
From Ft. to Ft i From Ft to Ft.
From Ft. to Ft From Ft. to Ft
From Ft to Ft. From Ft to Ft
From Ft. to Ft. From Ft to Ft
From Ft to Ft. From Ft to Ft
From Ft to Ft. - From Ft. to Ft
From Ft. to Ft. From Ft. to Ft.
From Ft. to Ft. From Ft. to Ft.
From Ft to Ft From Ft to Ft
MISCL. INFORMATION: p7
(t: (JET"
i
,f'fT l i..
DRILLER'S NAME
nvpsi i r_,` 1 •IFIL.... I TW C) Fr El C7.4 3Ia IRC3E
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 'LSTREET, ANCHORAGE, AK. 99501
264-4720
6.4EL_L P EFM I T
PERMIT NO. ( 800029 )
APPLICANT CURTIS CHRISTIE PO BOX 493 EAGLE RIVER 99577 688-3078
LOCATION SOUTH BIRCHWOOD LOOP ROAD
LEGAL T15N R1W SECTION 18 LOT 71 LOT SIZE 24750 SQUARE FEET
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 R PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL.
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
F EPM I T E PI I FEES C^Ec EMI3EFF :9 .
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 THE CODES.
SIGNED:
APPLICANT CURTIS CHRISTIE
ISSUED BY DRTE_�_t L �______ V4. 0
MANN S113110141
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POST OFFICE BOX 42 - CHUGIAK, ALASKA 99567
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MUNIGIPAGITYOF ANCWORAGE
_MLNICIPALITY OF ANCHORAGE:,
DEPAR_TMENTIOVHEALTH&ENVIRONMENTALPROTC 1F ONMENTAL PnJI_CTIOIs
DEPT. OF J I_ALTii &
-S$GL Street--Anohorape°AleekeB8861 _ _
MAR
ENVIRONMENTAL ENGINEERINGrDIVISION
Telephone 264-4720
RE(1UEST FOR APPRQVA LAF INDIVIDUAL WATERAND SE
1 0 1980
DIRECTIONS: Complete -ell parts onpage i. Incomplete regdeste will not be processed. PlaasealloW ten=(10) deyafor processing:
PHONE
A PROPERTY OWNER.- - -- _16fl-28 14'/(e
uMAILINGADDRESS
r -,X ►Ib L.a v4Yr VllovN, ,5f63N9
-
____-_-3-0)(-11
E 7—Y RESIDENT (If Ifferent. from abovef - g
4lrb1 /. 6 SSovm' 6ik+ef/ . CI USMK: j 14/_4 41 ..q 456 7 6 n01E- 7$
BU ER= \-
C-birtt$ _17 -1: -alit- rtc?" ccoM ttL b1Aytf
PHONE
MAILING-A®DRESS-- -
[� Q i35r 443
S.. CIsap If1G INSTITUTION
A AtKA MvTuAv -_
AL4sot4. 99077
ILING: ADDRESS_'
i200 A_lA 4eteM'ra
PlEAITOR/AGENT
PHONE
MAYLINOAODRESS-=-- -
701019S -
PHONE :-
S LSZIA'L DESCRIPTION
'T/W Rio/ s" ie ler 7/
-STREET +LOCATION :=
tie /.4 50 ore/
S TYRE:OF RESIDENCE
ISI SINGLE FAMILY
d MULTIPLE FAMILY
nrtfacuavd Enid, eitia, / G 44
NUMBER OF BE ROOM
In - One I Four ❑ Other
❑ Two f❑- Five
0 Three 0 Six
T. WATER SUPPLY
1$1 INDIVIDUAL"
p COMMUNITY
)<] PUBLLC UTILITY
1. SEWAGE DISPOSAL- SYSTEM-"-
-- fZ9 INDIVI DUAL/ON S1TE4
0 PUBLIC UTILITY
ATTACH -WELL LOG. A well leg-lareqtilhedlor all wells drilled•_
since Juhe 1976, For wells drilled prior. to tltatdate, give well
_depth (attach log if available.)
*If individual/on•site, give installation date
If system is over two (2) years old, an adequacy; test is required
by this Department.
NOTE: THE INSPECTLON FEE MUSTACCOMPANY EACH REQUEST BEFOREPROCESSING CAN BE INITIATEQ
THIS S1DE FOR OPFIC-IAL USE -ONLY_
INSPECTION APPOINTMENTS'
'INSPECTOR-
.
-- _
1119-ECTIONS;: -:
TIM
DATE RECEIVED -'-
:INSPECTOR:::-
Nib
- 4
YPE-OF RESIDENCE
L7 -SINGL FAMILY
0_ -MULTIPLE -,FAMILY`
S. WATER SUPPLY
0 ='-INDIVIDUAL
0 - COMMUNITY
0 =PUBLIC UTILITY _-
Connection Verified
NUMBER0FBFDROOMS
0 ONE 0 THREE O FIVE' 10 OTHER
0 TWO 0 FOUR 0 SIX
PERMIT MUM B ER - -
DATE IDR ILLED
-LOG RECEIVED .-
3 SEWAGE DISPOSAL SYSTEM
OINDIVIDUAL/ON SITE
°PUBLIC UTILITY
Connection Verified
L Septi -Tank or C] Holding Tank
Site.,— I� -If Tank -is homemade
1v dimensions:
TYFE QP='I'ANK-
3raTA L-A138019PTI QN'AR EA
A-6§TANCES -
DATE INSTALLED-- - -
M0INSTALLER_-
SOI LS RATING -
MANUFACTURER
MAYERIAL
Septic/HOlding Tenk=
Absorption Area -
Sewer Lina:-_
-Nearest Lot Line
Aboorptioti Areatoneerest-Lot-Line =
5:-'CDfiNMENT$
Lel =APPROVED POR BEDROOMS
0 - CONDITIONAL APPROVAL (lettermust accompany certificate)
- DI_SAPPI fOV:E13 '
`DA
,LEGAL ,DESCRIPTION
-- -
t201 D (Mev. 3/78)