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Home My WebLink AboutW G PIPPEL BLK 2 LT 8 W2 Rick Mystrom, Mayor Mtmicipality of Anchorage Department of Health and Human Services 825 %" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 August 13, 1997 John E & Waltraut Thomson 17343 Santa Maria Drive Eagle River, Alaska 99577 7531 Subject: Lot 8 W104~ Block 2 W G Pippel Subdivision Permit #SW960250, PID #050-101-11 The subject permit, issued ~gust 13, L99~ by this office for-a single family well and/or on-site waste~ater system, has expired as of August 13, 1997. A new permit must be obtained from this office fora well and/or on-site wastewater system NOT installed by the expiration date. If you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If a licensed Professional Engineer has inspected the installation of the on-site wastewater system, the original as-built imspection report must be sent to this office for review, approval and 8o. cumentation_ Ail inspection reports must be submiCted withim 30 days of construction completion. When applying for a new permit, the fees are: $320.00 for an on-site wastewater permit; $120.00 for a well permit and $440.00 for a combined on-site wastewater and well permit. If you have any questions, please call this office at 343-4744. J~es Cross, P.ET. P~ogram Manager On-site Services anc: Copy of Permit MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PAGE 1 OF ON-SITE WELL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW960250 DESIGN ENGINEER: OWNER NAME:THOMSON JOHN E & WALTRAUT OWNER ADDRESS:iT343 SANTA MARIA DR. EAGLE RIVER, AK. 99577 DATE ISSUED: 8/13/96 EXPIRATION DATE: 8/13/97 PARCEL ID:05010111 LEGAL DESCRIPTION: W G PIPPEL BLK 2 LT 8 W140' LOT SIZE: 20400 (SQ. FT.) ArLTMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION 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 AMD 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AACS0) . 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 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: SUBMIT WELL LOG AND ASBUILT OF WELL LOCATION WITHIN 30 DAYS OF WELL COMPLETION; AND ENSURE WELL IS INSTALLED ANY SOURCE OF CON~ RECEIVED BY: ISSUED BY: IREATER THAN 100 FT. FROM ~INATION __(IE~cTSEPTIC SYSTEMS) . DATE: DATE: ,0'~ ¢"~/~"~/,~' ~'-.-~.-- L /_.~':~ ASBUILT-NO CORNERS SET THIS DATE. SEWARD & ASSOCIATES LAND SURVEYING 694-082 I HEREBY CERTIFY ,THAT I HAVE SURVEYED THE SCALE: FOLLOWING DESCRIBED PROPERTY: ~o~. ,,c'/,~,~-,C ...c-~',.~'~'~/~,~'-..,~-~ ~o~--,~,<e_.~.~ - DATE: / / .~',,,:\ '". ....... ,-,.o AND THAT NO ENCROACH'MENTS EXIST EXCEPT AS ,~./~z,~,.~,,,~''' ~ND~CAT~D. ~T ~S THE RESPONSIS~UTY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY SRID: · E EME,TS, COVENANTS, 0R RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB: ~,'~'.. LS-~9]8 ..'~'~ff ANY DATA HEREON BE USED FOR CONSTRUCTION ..Y-.~'- OF FENCE LINES, OR FOR ESTABLISHING BOUND- DRAWN~ ARY LINES, ~_.,.,~ '~ ~.,~.~,~.~ ' LOT 2 LOT 5 2 DWELLINGS ON LOT i 15X 2 [0 '0 cSAETIP~)~ B~,' 116.00 116.00 4 SINGLE FAMILY DWELLING 116.00 116.00 ASSUME WEST PROP CORNERS OF W 1/2 LOT 8 AT 100.00 FARM AVE WELL LEGAL: OWNER: DATE: SCALE: UPGRADE WO PIPPEL,.W140' THOMSON 06/04/96 I" 100' LOT 8, BLOCK 2 [] TEST HOLE · MONITOR TUBE o - SEWER CLEANOUT ,¢ - WELL EASEMENT ~ -- ELEVATION Gp~',TER ANCHORAGE AREA BOROU-C~H HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 2'/9-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: ADDRESS . . LEGAL DESCRIPTION /~"~'~' ~'--~//~"'"~ ,,~C:~ DISTANCE FROM WELL LIQUID CAPACITY J GALLONS. MATERIAL ~L/~,~j~/,~ ~:~,/~7'-- NUMBER OF / COMPARTMENTS INSIDE LENGTH INSIDE WIDTH DEPTH___ SEEPAGE SYSTEM: NUMBER OF PITS LINING MATERIAl NEAREST LOT LINE SEEPAGE PIT: / OUTSIDE DIAMETER OR WIDTH /~ / , LENGTH .~-~ , DEPTH D,STANCE. FROMWEL, .BU,LD,NGEOUNOAT'ON /~ / ,.~/~ so. E~. TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) TILE DRAIN FIELD: DISTANCE FROM WELL , FOUNDATION , NEAREST LOT LINE. NUMBER OF LINES DISTANCE BETWEEN LINES TRENCH WIDTH TOTAL LENGTH ., OF LINES. IN. TOTAL EFFECTIVE ABSORPTION AREA SQ. FT. LENGTH OF EACH LINE DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER ~AATERIAL BENEATH TILL ! WATER : TYPE. ..L~'/~'/~-/~ ~ DEPTH · BUILDING FOUNDATION-- SAMPLE t.~-- ~'~')~/ NEAREST / SEPTIC //~ / SEEPAGE ,~/ ~ ' ~ SEWER LINF ~) TANK . SYSTEM ,'~ CESSPOOL LOT LINE IN. ABOVE TILE.-- ,4/d NEAREST ~ OTHER ~ , SOURCES__ DISTANCES: DIAGRAM OF SYSTEM \ \ \ \ \ DATE APPROVED /--~ '~A LT H AUTHORITY GREATE ANCHORAGE AREA' )ROUGH HEALTH DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 279-2511 SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT NAME OF APPLICANT RESIDENCE ADDRESS LEGAL DESCRIPTION APPLICATION TO INSTALL: SEPTIC TANK TO SERVE THE FOLLOWING FACILITY FINANCED THROUGH PERCOLATION TEST RESULTS MAILING ADDRESS PHONE NO. LOCATION OF INSTALLATION ~I¢~'77z~-~,~ SEEPAGE PIT. DRAIN FIELD , OTHER TO BE INSTALLED BY ANTICIPATED DATE OF COMPLETION BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT . THIS IS TO SERVE AS -~L~L~ , PERMIT TO INSTALL A ~ AS DESCRIBED BELOW. sIZE OF UNIT TO BE, SERVED · SEPTIC TANK SIZE ~:~ TYPE r'~'~/77~,f~,"~"SEEPAGE AREA ~ ~>~ , TYPE DIAGRAM OF SYSTEM eaith Authority I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No, 28-68 and that the above described system is in accordance with said code. DATE ¢ APPLICANTS SIGNATURE ~f~, / . _ Soils Rating 72.023 Date Sewer Installed Well To Absorption Area Well to Tank ~r ~'~,~ Well Log Received Septic Tank Size ApPLIr'kNT FILLS OUT UPPER HAr'"ONLY Address Zip Code Realty Co. & A~nt Phone Address Zip Code ~ Single Family ~ Multiple Family NO. of Bedfoo~ Other Water Supply ~ Individual A~ACH WELL LOG. A w~l log is required for all wells drilled since June 1975. ~ Community For wells drilled prier to that date. give well depth (attach log if available). ~ Individual Year Individual Installed: ~ Public Utility When Connected to Public Utility: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Date Date Date(~, Date Inspector Inspector Inspector Inspecto/ ~ ~ Field Notes: MUNICIPALITY OF ANCHORAGE 'h( ~ ) APPROVED BEDROOMS 'CONDITIONSOF APPROVAL ( ) DISAPPROVED ( ) COND,T'O"AL APP"O AL' Soils Rating Date Sewer Installed Well To Absorption Area / / ¢/ Well Log Received Well to Tank ~- ~.~., Septic Tank Size 72-023 January 31~ 1983 Thomas N9 Hawkins Box 20 Center St. Eagle River, AK 99577 Subject: Lot 8 Block 2 WG Pippel Subdivision Approval for the be granted until individual sewer and water facilities cannot the following items have been completed: The water analysis report needs to be submitted to this office from tile Chem Lab~ 5633 B Street~ for our review. The septic tank pumped %;itt a receipt submitted to this department. Please notify this Department for a reinspection when the noted discrepancies have been corrected° If there are any further questions, please call this office at 264-4720. Sincerely, Jim Roberts Associate Environmental Specialist JR48/p/Et1 MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORA(~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION DEPT, OF HEALTH & ' 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL P~OTECTION ENVIRONMENTAL ENGINEERING DIVISION NOV 1,~';1978 Telephone 264-4720 .EOUEST A...OVA. DIRECTIONS: Complete all parts on page 1. Incomplete requesls will not be processed; Please allow ten (10) days for processing. ,. p. OPE.TVOWNE. . PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE MAILING ADDRESS 3. LENDING INSTITUTION PHONE MAI LING ADDR ESS 5. LEGAL D~SCRIP~ON, / 6. TYPE OF RE IDE [] SINGLE FAMILY ~ MULTIPLE FAMILY NUMBER OF BEDROOMS [] One /~ Four [] Two [] Five [] Three [] Six [] Other 7. WATER SUPPLY ~ iNDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled [] COMMUNITY since June 1975. For wells drilled prior to that date, give well [] PUBLIC UTI LITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM ~ INDIVIDUAL/ON-SITE~ [] PUBLIC UTILITY **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 INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72~)10(3/78) #1: Time Date Insp MUNICIPALITY OF ANCHORAG~'~ · · DEPA. RTME 825 2:3~/.m. 2-1-~ Wednesday Pr~t~ !0F HEALTH AND ENVIRONMEN L PROTECTION L Street, Anchorao~. Alaska 99501 264-4720 Date Received: January 30, 1978 #2: Time I~ ~ ~3: Time /~;~ Date ~_;~-~ ~ Date Insp ~,~A/~ Insp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES Lending Institution Request:. % Executive Realty, Myrtle Mailing Address: Post Office Box 293 99577 Phone: 694-3053 2. Property Owner: Mailing Address: Michael T/Doris Gorder 7521 East 36th Avenue Phone: ~ 3. Legal Description: E½ Lot 8 Block 2 Pipple Subdivision Single Family Residence: ( ) Number of Bedrooms: Multiple Family Residence: ~x) Number of Bedrooms: Four Well System: Permit ~ Construction Individual well ~ Community/Public System ( ) Depth of Well Well Log on File Bacterial Analysis ( ) 6. Sewage Disposal System: On-site System ~ Public Utility ( ) Permit ~ Installed Installe~ Septic Tank Size Manufacturer Absorption Area Soils Rate Material 7. Distances: Well to Septic Tank to Absorption Area to Sewer Line Nearest Lot line Absorption Area to Nearest Lot Line Rage ~wo Department of Health and Environmental Protection Request for Approval of individual Sewer and Water Facilities Legal Description: Comments: E% Lo% 8 Block 2 Pipple Subdivision Affadavit Attached: ([) Letter Attached: ( ) Approved: Disapproved :~_ C, Date: Date: Department Worksheet: THIS SIDE FOR OFFICIAL USE ONLY ~.- DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE }ATE I NSPECTO INSPECTOR INSPECTOR / 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [~ MULTIPLE FAMILY [] TWO FOUR SIX PERMIT NUMBER 2, WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL ~ COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER ~INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER [~Septic Tank or [] Holding Tank Size:/,~-OO If Tank is homemade SOILS RATING give dimensions: TYPE OF .M. ANUFA TU E TOTAL ABS(~R PTION ~,R EA MATER~,L ~, 4. DISTANCES Septic/Holding Tank Absorption Area Sewer Line [ Nearest Lot Line WELL TO: I Absorption Area to nearest Lot Line E]~APPROVED FOR ~1~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED LEGAL DESCRIPTION 72-010 (Rev. 3/78) MUNICIPALITY OF ANCHORAGE AND E.,,, ..... ;;, .'_' ..... oa~,Anchorage, AlaskaggS04 2~e'~22~ ~F,~ .~' 'Z-~' REOUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES Type of Inspection: C~M.R~~VA ~, FHA ~,/ONv Property Owner: ,' )~? '~¢" [!Ld'~t~)_ E + ~.u~ .~":~-1~~ Mailing Address: '7~ / ~ 3~ ~$ ~ ~ Day Phone: ~Y:;' 3. Name of Buyer: - ~:) ..... Mailing Address: '(? Day Phone: 4. Name of Lending Institution: Mailing Address: -' , ~ Phone: 5. Name of Realtor or Agent: (~,/~o Mailing Address: Lecqal Description: Location: Type of Facility to be Inspected: Water Supply Type of Supply: Public Utility If Individual, number of dwellings presently served ,Individual If Individual, depth of well Sewage Disposal System Type of System: Public Utility. Individual (on-site) If Individual, date of installation 72-003(3/76) INDIVIDUAL SEWAGE AND WATER FACILITIES Water,.Analysls: e. Casing Size .... ~ x d. Distance from Fell to closest exlstine om pmoposed: 1. ewe~. lmne %0 x %!,,) ~2,. -S~ptic tank, , ~ ' _ / 3. Seepage Area 5. Property Line / x/ a. Age of system ~, ,J' h · Other sources of possible contamination, i.e., creeks, lakes, houses, barn~ drainage ditch, etc. Septic tank capacity in gallons,, 1. If "home made" show diagram on reverse side of this form. d.' Disposal field or seepage pit size and type 1. Distance to property line to house foundation i e. Percolatio~ Tear.suits f. Percolation Test performed by , Use the reverse .side of this form to show diagram. Diagra~ should include ]<~he foJ_lowing infoPmatlon: p~operty lines~.well location, house location, ~pt~[c tank location, disposal area location, location of percolation test, an% direction of ground slope. 9. The h~ox~t~on on this form is true and correct to the best of my knowledge, Signature 'of Applicant Date $'[~ned T.~ BE FILLED OUT BY HEALTH DEPAET~.~ENT PERSONNEL ~-~he~ above described ~anitary facilities are hereby approved, subjec~ ......... ~llowing con~&~ons: The above described sanztary' facll~tles' ' ' are dxsapproved' for the following re asons: Approval ~s valid for one year following the date of approval.. CPJ: cw REQUEST FOR APPROVAL OF INDIVIDUAL SEWAGE AND WATER FACILITIES (Fill out in Triplicate) · of person requesting approval ~~ 5, Water, Analysis: a. Bactar,~ all b. Detergent Well data: d, Distance from well to closest existing or proposed: 3, Sae~ase A~ea~/~ . 5. Property Line_ ~<--/ · houses~ barn~ drainage ditch, etc. Sewage disposal sys%em. b. Other sourses of possible contamination, i.e., creeks, lakes~ A g e o f s y s t e m ~~/~ Septic tank capacity in gallons /~70 Name of septic tank manufacturer q~/-~j~,~, ~ 1. If "home made" show diagram on reverse side of this form· Disposal field or seepage pit size and t~e 1. Distance to property line to house foundation f. Percolation Test performed by Use the reverse ,side of this form to show diagram. Diagram should include _~he foilowing information: p?operty lines~ .well location, house location, ~ptic tank location, disposal area location, location of percolation test, an~ direction of ground slope. 9. The information on this form is true and correct to the best of my knowledge, Signature of Applican~ '6'at e Signed TO BE FILLED OUT BY HEALTH DEPAETf~ENT PERSONNEL ~--~'he above described sanitary facilities are hereby approved, subject to, th, e, +~llowing ' ' , , ~ . cond~{o~s Conditions: The above described sanitary facilities are disapproved for the following - . of approval. ., ~ CPJ: ow 2, 3. 5, ~'] ': REQUEST FOR APPROVAL OF (Fill out in Triplicate) b. Deta~sent " Well data: d. Distance from well to closest existi proposed: t. Eewer line .... 3. Seepage Ar, ea~., 5 · Property ~ne, 6. Ot~e~ so~es Sewage disposal system. /~/ ' b. Septic Tank capacity in gallons c. Name of septic tank manufactu~9~ ~(/~c~/~ ~-~?~.~.~3:- . 1. If "home made" show diagram on reverse side of this form. d.' Disposal field om seepage pit size and t~e 1. Distance to prope~y line to house ~ndatzon f · f. Percolation Test performed by ~J Use the reverse .side of this form to show diagram. ' ~he foi%owing infor~ation: ~operty lines~.well location, house location, ~t{c tank location, disposal area location~ location of percolation test, at~ direction of ground slope. Diagram should include The l~,£o~.,~ion On this forD is tr,f%e and correct to the best of my knowledge. S.z~na%uPe Pp ~ -- · T__O, BE FILLED OUT BY HEALTH DEPARTMENT PERSONNEL ~ The above described sanitary facilities are hereby approved, subject to the " ....... ~6'llowing cond~'ions: Conditions. The above described sanitaryfaczlztles' ' ' are disapproved for the following FY-"' -" '"" "-" ~'"- ?" ": ' Appz~oval is valid for one year following the date of approval. CPJ:cw