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HomeMy WebLinkAboutWYNTER PARK #1 BLK 1 LT 31'NAME MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAl-. PROTECTION ENVIRONMENTAL ENGINEERING DIVISION ,,~_~ 825 L Street- Anchoraue, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NEW ~4AI LING ADDR ESS ~.~ LEGAL DESORIPTION CT LOCATION Well Absorption area BISTANOE TO: Ma~ufacturor DISTANCE TO: [Inside length Dwelling Dwelling [~UPGRADE N~LpE), OF BEDROOMS PERMIT NO. No, of lines line Foundation, of lines Length Width Type of crib Crib diameter Crib depth Well Building foundation DISTANCE TO: Class Depth Driller DISTANCE TO: Building foundation Sewer line OTHER PIPE MATERIALS SOIL TEST RATING th PERMIT NO. Material Liduid capacity in gallons PERMIT NO. Total effective absorp, tion ar PERMIT NO, Total effective absorption area Nearest lot line Distance to lot line / PERMIT NO. Septic tank I Absorption area(s) 72-013 (Rev. 3/78) Department MUNICIPALITY OF: ANCHORAGE ~ Health and Environmenta? _ Street, Anchorage, AK. Permit ~ ~ ~ 0%~(~ Applicant: ~©tr){-~C~ Location: Legal Description: ~- ~/ ~7 Type of Soil Absorption System Is: Trench: '/ Drainfield: Maximum Number of Bedrooms: 2~ ~rotection ~9501 825 264-4720 * * * HANDWRITTEN PERMIT * * * ~:~i),/OR ON-SITE SEWER PERMIT <' C>J'~/S~- Mailing Address: Phone Number: _ ~<{ ~ Lot Size: DEPTH Seepage Bed: Holding Tank: Soil Rating(sq.ft/br) The Required Size of the Soil Absorption System Is: /C~h ,LENGTH .~-~Lh~GRAVE'- 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). * * REQUIRED SEPTIC(~) TANK SIZE : [c~'c]>C, 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 31~ 1 9 $ 2 * * * 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 reside nc e is remodeled Applicant and wells as enlargement if to include more that 3 bedrooms. Date: SWP/024(1/81) & ENGINEERS, INC. s 7125 OLD SEWARD HWY. ANCHORAGE, ALASKA 99503 349 -6561 SOILS LOG - PERCOLATION TES1 2 3 5 6 7 8 9 - ~--~10 - 11 13- SITE PLAN WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT A_~,A 14- 15- 16- 17- 1g- 20- COMM E N TS ,~e'. I'erJ Reading OaJe TEiT RUN BETWEEN .~'~5" - FT AND 7 FT '~ 7' CERTIFIE 72-008 (§/79) Type of Resi~nce ingle Femlly Water Supply ~ individual A~ACH WELL LOG, A w~l log is required for all wells drilled since June 1975. Community For ,~t Public Ullllty wells drilled prior lo that date, give wel~depth~ (attach log if available). Individual Year Individual i.stailed:_ Public Uglity When Connected to Public Utillty~ NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspcctor Inspector Inspector Field Notes: MUNICIPALITY OF C,C'[ I fi 1982 RECEIVED (~ ) APPROVED BEDROOMS *CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL' Soils Rating Date Sewer Installed Well TO Absorption Area Well Log Received Well to Tank Septic Tank Size