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Home My WebLink AboutWYNTER PARK #1 BLK 2 LT 3 MUNICIPALITY OF ANCI4ORAGE DEPARTMENT OF NEALTH & ENVIRONMENTAl. PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELl_ INSPECTION REPORT MAILING ADDRESS LEGAL DESCRIPTION DISTANCE TO: LOCATION -1PHONE Liq. ca IF HOMEMADE: DISTANCE TO: Well Dwelling Manufacturer Well No. of lines Len Ill of each Ii e Top of tile to finish grade Width Total length of Ii es Material beneath tile Type of crib Crib diameter Crib depth I Well Building foundation DISTANCE TO: Class Driller DISTANCE TO: Building foundation Sewer llne OTHER PIPE MATERIALS SOIL TEST RATING INSTALLER . REMARKS [] UPGRADE Material Neares~'iot I i 7~,~ Trench width NO. OF BEDROOMS PERMIT NO. No, of compartmo~s ~ Liquid depth PERMIT NO. Liquid capacity in gallons Total e~octiue absorodon area PERMIT NO. Total effective absorption area Nearest lot line Distance to lot line r PERMIT NO. Septi~ tank / Absorption area(s) APPROVED~..~~. ~ DATE 72-~3 (R~v.(2¢¢'8) v LEGAL FERHI1 NO. FIPPL. ICSNT EDklFIRD SF'FIRI<S LOCFIT I ON PETERS CREEK L. EGF:I[.. LZ,': B~ b.f"r'NTER F'~I::IRK 'I"='PE OF SOIL I::IE:SORF'TION S'¢STF.<H IS: MRXIMUM NUHBER OF BE[:,R. OOHS = THE REQL~IRED SIZE OF THE SOIL RBSORPTION E:,EFRRTHENT OI IEFILTPI FIND ENVIRONMENTRL P T'EC:TZON ~ Q '~,, _ ....... i545 S. FIIiI'T'T ~:SE1) ~'( v~~ ' LOT :5IZf 24.500 .S6¢_IRFqS F'E~' _LIL _,T_d EH IS: TPIE LE;NGTPI DIMENSION I.S; THE LENGTFI <IN FEET) OF THE TRENCH OR DRRINFIELD. THE [:,EF'TH I_-IF Fi , -' _ '':-~ ~ ', ....... , .... IREN...H 'IF' PIT .[_ THE [. ]..=,] HNL. E E, ET[,IEEfl I'HE 2;URFFIC:E OF TPIE 3['.'_NE:, FIN[:, THEBIjl]utl" ' -' OF THE E::..',Cfl',,,'RTII3N <IN FEET..,.' 'T E.-~ EE T' 1:,77,: IFS; I"-,~ C I-.-.I b..! I [> -F H I ~S 5. THE GRF:I'v'EL [:,EF'TH IS THE I"IlNIHUH DEPTH OF GRRVEL BETP.IEEN THE OUTFRLL PIPE RND THE BOTTOH OF THE E',:.:',CR',,,'RI"ION (IN FEET). F:'ERH :[ T I- IF F. L t L.I- N I [ IH_, THE FIE_. F yi'l_ I E I L I T T TEl I IqFORM TH I S [:,EF'FIFE~I"MENT I.':,UR I NG 'I"HE Itl_ I ][..L..H'fI_N Il,l_[ F...I'I_N_:, OF' RN"r' [.fELL:, FI[:'JI::II_-:ENT TID THIS F'F.:OF'ERT? RIq[:, THE N..hlE.','ER OF F.E::,IDENLE'_-, T[.4R'F THE [,.fELl.. klILL SERVE. 'l' I....l [.la .:' ;:2.". ':. I f ,1 _. tl E L- T I mi t" ~1 _,, Il:Il I;E: rE7 E, FII-.kF].LLINI..'~ I_-IF FIN"r' q,,c'-'-,. : .... ~q,F-'~:'[:'C',,'~ll EffT' 1HI.=, -~-FEH [,~ITHCIIJT FINFiL IN-,[EL. lION fiN[:' . ............... DEF'RF~!TFIENT [',IILL EE-,-~,..,,-,..,.c' tr:,'m--'r TO F[~J=,EL. LITION. HINIMLIM DISTflNC:E E~E'FI.,IEEN R kiel...[.. RND RN'¢ ON-SITE '..=.,Et.,IRGE DISF'O'SFI[... SYSTEM IS lO0 FEET FOR F:I PRIVATE blEL. L OR 15CIl TO 200 F'E]ET F'ROH R PUBLIC [,JELL [:,EPEN[)INCi UPON THE T'?'PE OF PUBLIC 14ELL. HINIP'IL.IM [)ISTFINCE FROH R PRI',,,'RTE klELL ]'0 R F'RIVRTE SENER LiNE IS 25 FEE]" RND TO FI COMHUNI'T'¥' SEFJER LINE IS 75 FEET. OTFIEF~:'. REI..'.!UIREMENTS MFI'¢ flF'PL"r'. SF'ECIFICRTIONS fiND CONSTRIJI_-:TION DIFIGRRHS F:IRE F:fv'RIL. RBLE 'FO INSURE F'R. OPER INSTRLL. RTION. F EZE,LI I I T' [£,',1- X r-.E__, [) E C: [:':" F"I E: E E:': ~:::[ .... :L_. c. I CERTIFY THRT :1.: I RM FFIMI[..IFIR [4ITH I'PtE RELT.!UIREHENTS FOR ON-SITE SEbIERS RN[:, P.IELL. LS FI!E; SET FORTN B'T' THE HUNIE:IPRLIT"¢ OF FINCHORRGE 2: I PIIL. L INSTRLL THE S'.¢S"rEM IN RCCORDRNCE NITN THE CODES. '-'.":: I UN[:,ER5;TRN[:, 'I"HFIT THE CIN-SI: E SE[4ER S'¢'_-TTE£,I HR'-/ RE6~UIRE ENLRRGEP1ENT II=. THE RESIDENC:E IS; REMODELED TO INCLI )E MORE THP1N '.'; BEDROOMS. .... 1 tiNED . RF'F'L. I Z FIN'i" I SSI. jEE:, E,N. E[:,[ ~:B, _,F ~ IRk. z, MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST /~ SOILS LOG [] PERCOLATION TEST 2 3- 4- 7- 8 10 13 14 17 18 20- COMMENTS PERFORMED BY: 72-008 (6/79) SLOPE SITE PLAN WAS GROUND WATER ~ ENCOUNTERED? J~'~' E IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND , FT /z~-~,'?~',~, /-,¢, ~.~. ~,-~¥ J,;o~ ~ ,~,~-J~. ~ ) I Time Time ,e Date Date Date Inspector Inspector Inspector Comments Conditional Approval I-5-71" Date Sewer Installed Permit No. Septic Tank Size Holding Tank Size Soils Rating Well To Absorption Area Well Log Received Well to Tank APPLICANT FILLS OUT LOWER HALF ONLY Property Owner ~ L~ %' P'~" P--,I<. ~-~ Phone Mailing Address .-~ ~. Buyer /P/I T -J Address Lending Institution /C'//._¢ Legal Descriptlon,.~.. -'~dL.~"./......~ ,¢~.~',,~ ~ , ~ ~,..~.~_.,~/"~..- Street Lesatlon Ty p ¢..~of Residence d3 Single Family [] Multiple Family No. of Bedrooms [] Other Water Supply ~. Individual ATTACH WELL LOG. A well Icg is required for all wells drilled since June Community 1975. For wells drilled prior to that date, give well depth (attach Icg If [] Public Utility/ available.) Sewage Disposal *'B Individual Year Individual Installed: [] Public Utility When Connected to Public Utility:· FJ Holding Tank NOTE: THE IN, SPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. DAI=E RECEIVED / INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR MUNICIPALITY OF ANCHORAGE e DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER , PHONE MAILING ADDRESS PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE MAILING ADDRESS MAILING ADDRESS 4, REALTOR/AGENT PHONE MAILING ADDRESS S. LEGAL DESCRIPTION 6. TYPE OF RESIDENCE NUMBER OF~BEDROOMS ~ One ~ Four ~ SINGLE FAMILY ~ Two ~ Five ~ Three ~ Six MULTIPLE FAMILY [] Other 7. WATER SUPPLY [~) INDIVI DUAL* * 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 L[TY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM ~ iNDiViDUAL/ON.SiTE** ~/~1~ J~/ .YEAR ON-SITE SYSTEM WAS INSTALLED. [] PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) THIS sIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUI~IBER 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: ]~--.-~"~ IfTankishomemade SOILSRATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL n~~ Ae~r~rea Sewer Line 4. DISTANCES Septic/Holding Ta Nearest Lot Line WELL TO: Absorption Area to nearest Lot Line 5, COMMENTS I~-"~A~P P R OV E D FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED 72-010 (Rev. 6/79)