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GREENBROOK BLK 1 LT 3
C,Q.0c, mm, - #on—�es- 53 Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT 53 Permit Number: OSP191413 PID Number: 017-023-20 Dwelling: © Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name Chad La Rue ABSORPTION FIELD ❑ Deep Trench F-1 Wide Trench El Bed El Mound Site Address 6901 Callaway Cir. ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade (907)-631-2078 4 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot Green Brook 1 3 Fill added above original grade Ft. Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Lift Station Tank Line Ftz Ft. WellTANK [Z Septic [:1S.T.E.P. E]Holding E]Other 100'+ NA NA NA NA Manufacturer GREER Capacity 1250 Gal. Surface water 1001+ NA NA NA Material Plastic Number of compartments 2 Lot Line 101+ NA NA NA NA Foundation LIFT STATION Manufacturer Capacity Gal. 10,+ NA NA NA Remarks Alarm location Electrical installed by PIPE MATERIAL House to tank Tank to D3034 drainfield D3034 Installer Northern Excavation Drainfield CO/MT D3034 Inspector Arcterra Consulting BENCH MARK (Assumed elevation) 100 ft Inspection�, dates: 1 10/8/19 2�d 10/8/19 Location and description Yd 41h Bottom of door frame ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: DateMr +•��P�.�'"'" `'�•.ay 1♦ s• 49Ikt ... r r Septic System/� (� Approved ti L�'� Date 4i a~r %KENNE M. DUF U5Aff ���♦'f`ft� CE 7118 Ar Note: this approval does not include well permit requirements.#ll;����♦� (Rev 05/02/18) iavr�� AS -BUILT SYSTEM DETAILS/SITE PLAN Permit OSP 191413 GREENBROOK BLOCK 1 LOT 3 PID# 017-023-53 4 -BEDROOM HOUSE L A -C=13.4' B -C=23.4' 0 99.73 99.73 A -D=16.2' B -D=27.2' o oo O v NOTES: NO PUBLIC WELLS WITHIN 200' OF PROPOSED SYSTEM. NO PRIVATE WELLS WITHIN 200' OF PROPOSED SYSTEM EXCEPT AS NOTE NO SEPTIC SYSTEMS WITHIN 200' OF PROPOSED WELL EXCEPT AS NOTED. PROPERTY SERVED BY CLASS "A" WE �OFALI, \ jo�* 49TH *� KEN -NET S / CE -7 W� Atf Ar 1 \ o ssio'o ' 1250 GAL SEPTIC TANK PREPARED FOR: Chad La Rue 6901 Callaway Cir. ANCHORAGE, AK (907)-631-2078 FIELD BOOKS BOUNDARY: N /A STAKING: N /A ASBUILT: _ DWG. nM* AGAD FILE' FILE COMPUTED: DRAWN: KSD CHECKED: KMD DATE: 10/3/11 GRID: 2839 JOB No.: 19_07.2 SCALE: 1" = 20' SCALE: NTS IC _I O J N U C L7 Cn Nd-C a W CL W C o 6 Q O N Q '� Y N p, c p N O U N Q co O)0 .-. p, 0- S Oco C d' C� O m O1m L L p� L C N m Q O CA r ~ O Ch '= C p O O C Q :E 3 0 0 0 U) aco o Y3���U(D W gca c O a) Q Law ` O ? m 00'56 3„6 �,ZOoOS o a° ° o E o `• a c et o C� ma n�UE >,-o w� Ww 1N3WDSdE] .1.1 nun A6 m z ca� m o� 0) c b co o .N OT Ch y� -p N O...L C 2 C O U to NN @ N •� N N C i/1 O O o C O O _ O CA N N _j a) �°7O aUi t.rn��� O -C) O ca Y W m --E •O� �.LO..LO.. N � U O E N - �p Cco Q _0 z (D a ~ O W s O -o U 0-C � O a N ca co W NL..� c O-G�'O c3 LD N m N O ci CQ w = 00 Q (a ca m :S > L O w rn 0 -1 A d cA� co r 2 0o. I� a N g6� in °y �2� m d- c o.cJV o• X20 CNC) o U) >0) ADW �/. > 0 ._..i ® '�� J `r a .0 ®� ,. 00 ® ► 41 00 N Q` AMW co a ®S • REG r► a �- '� ce) J U) H o CL o u6 V U r: z LO ce) it n mo Of Co S� \ z a �o Oaco w� MD 0-) ni ow i 0e N o M w 13 or o Y O\ X51 LL °Zi -j W U) M S U 2w<. tip U)a BfiZt79 N,,svn"rr MUNICIPALITY OF ANCHORAGE / On-Site Water&Wastewater Program .s. `%‘ PO Box 196650 4700 Elmore Road Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 ` � http://www.muni.orglonsite ` epartment 4HCHOR;°. On-Site Wastewater Disposal System Permit Permit Number: OSP191413 Effective Date: 10/3/2019 Work Type: SepticTank Upgrade Expiration Date: 10/2/2020 Tax Code Number: 01702353000 Site Legal Address: GREENBROOK BLK 1 LT 3 G:2839 Site Mailing Address: 6901 CALLAWAY CIR, Anchorage Owner: LARUE COLLEENE M & CHAD R Lot Size in Sq Ft: 49043 Design Engineer: ARC TERRA CONSULTING INC Total Bedrooms: 4 This permit is for the construction of: ❑ Disposal Field 0 Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 Water Storage All construction shall 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 wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: /Z % — Date: / loI19Issued By: PILLUCP, Date: MUNICIPALITY OF ANCHORAGE Development Services Department '\ Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 017-023-53 Property owner(s) Chad & Colleene LaRue Day phone 907-631-2078 Mailing address 6901 Callaway Circle, Anchorage AK 99516 Site address 6901 Callaway Circle, Anchorage Legal description (Sub'd., Block & Lot) GREENBROOK Blk 1 Lot 3 Legal description (Township, Range & Section) Lot Size 49,043 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) 0 (w/wo ADU) Septic Tank Upgrade 0 Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. ih,f/ ' • (Signature of propel, ner or authorized agent) Permit/Rush Fees: 02 Waiver Fees: Date of Payment: q/17//q Date of Payment: Receipt Number: �} IP L/775- Receipt Number: Permit No. D�SPI9i /I3 Waiver No. G:\Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc • vokcTERR� ARC ERRA CONSULTING, INC 20441 Ptarmigan Bld,Eagle River,AK 99577 Office(907)696-6111,Fax(907)868-3793 995» September 13, 2019 Municipality of Anchorage Development Services Department On-Site Water& Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Septic Tank Upgrade Permit- GREENBROOK BLK 1 LOT 3 The owner has requested we proceed forward to obtain a septic permit to upgrade the aged septic tank on the subject lot. The proposed upgrade will serve the existing 4-bedroom house. The adjacent lots are served by community water system with no wells within 200' of the proposed tank placement. There is no surface water within 100' of the proposed tank. We do not expect there to be any adverse effect on adjacent lots by the development of this tank. If you have any questions, please contact me at 696-6111/FAX 868-3793. Respectfully submitted, ArcTerra Consulting,Inc. APed_ • .,41,4.1 Kenneth M. Duf s, P.E. Attachments: On-Site Sewer Application Wastewater Absorption System Details/Site Plan 20441 PTARMIGAN BLVD • EAGLE RIVER,AK 99577-8736 • PH(907)868-3791 • FAX(907)868-3793 DESIGN SYSTEM DETAILS/SITE PLAN GREENBROOK BLOCK 1 LOT 3 PID#017-023-53 C C C /- %-/ / E cn • / //j W KEY BOX //%//!/j/ }' ///DRIVE WAY// • D APPROXIMATE ////// /// // // � /j b LOCATION` 11/ /// ./ 1j • T— // 1.//' / �// // /// /� 11/ 7 j// ./1/ 09'./. :;•// !/ // �/ 4-BEDROOM 9// HOUSE Q 1 REMOVE AND REPLACE / EXISTING TANK WITH 1250 GA Q TANK 10'FROM BUILDING 2:INSTALL 2 POST TANK LO CLEAN OUTS Q 0 . • C Z •'cos C EXISTING TANK r MT •COs so NOTES: SCALE: 1"=30' NO PUBLIC WELLS WITHIN 200'OF PROPOSED SYSTEM NO PRIVATE WELLS WITHIN 200'OF PROPOSED SYSTEM EXCEPT AS NOTED. NO SEPTIC SYSTEMS WITHIN 200'OF PROPOSED WELL EXCEPT AS NOTED. PROPERTY SERVED BY CLASS'A"WELL SYSTEM PREPARED FOR: ..mi.": `\ Chad La Rue AP-.) O A�� 6901 Callaway Cir. ROTEAlrA j�J� 'V" 11 ANCHORAGE,AK titIt* `�A ,� �4, '`f; (907)-631-2078 5.1 v° �� °,\ ,* 4 /N�d V / it-1 ��' ., �j / FIELD BOOKS coMPu7ED: a II u. 1 �M1 . cs . { � BOUNDARY:N/A DRAWN: KSD Z 1 �"' �; - /p I51.j '/ BOANDA N/A CHEMED' K M D / t'� ,) \ \�� }Essto, .. ASBUILT: _ DATE 10/3/19 I� '`~�^� . 0�1 \`�� cRID: 0 \�� �c 11 D . RLE 2839 R/!'O�SULT I N�� • \ 6l°� ACAD FIE' FILE ,108 N 19072 fR AK.9957'1 • l i "-- - 1HUFFMAN — — - —_RC -A PEc /e- i� -Wei/''`2 I. /997"0-&s I`'�z -p re) . ' 5 2 J 14 Gt __/1(4' 6 9 / ,L--. • e 7 r•-.,._,,,/ . I \ \" i2 Y (1t I I ` 1 N NORTH J 4 1 to I (1.-0,..> 4114106 ,,'*>.. , • 3 ' r----- 4 N • s CN /,�firvfr • Ell 26 %,.. •' I 5 6 5 y 9 •U H - 12 QUIP. I 24 I ir -- 7 2 4 '' • Ii Q Q • • O t,( = 'O Cr 2 z k, ra 5 4. 1 .3'•• ,•c V Cr ,� c �- 5 5 6 Z i9 t6 w 1 -1 • ? 4.',• oi . 0 ' J Li_ )., 1 t � . , 16 t . i 9 ) *P ••• . (7. 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A q, .+ ; NAME "1V LV 1l.1rnL111 v:-ciiv VLlVlLL ave and Environmental Prott,., ,!on Fourth Floor West 825 L Street Anchorage, Alaska 99501 264-4720 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LING ADDRESS ZMM PHONE 2Y -q --S- -(1 5 V V LOCATION `T``"�- (��� IM CM&M LEGAL DESCRIPTION �� - SEPTIC TANK: DISTANCE NUMBER OF _ FROMWELL0,10MM, MANUFACTURER Or reeC_MATERIAL L COMPARTMENTS I (RSD INSIDE LENGTH TILE DRAIN FIELD: INSIDE WIDTH LIQUID DEPTH n c LIQUID CAPACITY(a--d-CcALLONS. TOTAL LENGT I �C� f DISTANCE FROM WELL C-OrnMFOUNDATION 67 1 NEAREST LOT LINE__ ���OF LINE �l # Of Lines _� DISTANCE BETWEEN LINES —TRENCH WIDTHS�, IN. TOTAL EFFECTIVE ABSORPTION AREA g SQ. FT. LENGTH OF EACH LINE �® ( DEPTH OF FILTER // DEPTH: TOP OF TILE TO FINISH GRADE . MATERIAL BENEATH TILE -1(%C. -IN. ABOVE TILE fT. IN. SEEPAGE PIT: DIAMETER OR WIDTH—, LENGTH_, DEPTH Log Crib _Rings_ Crib Size: DIAMETER___DEPTH DISTANCE FROM: WELL TOTAL EFFECTIVE BUILDING FOUNDATION_, NEAREST LOT LINE ABSORPTION AREA (WALL AREA) SQ. FT. Well Class:CoWkyL1 Depth: Well Distance To: Lot Line _ Bldg: Sewer Line: Pipe Materials: C..T� �IgSjiC # of Bedrooms: Installer:. Remarks: SAI DATE 3 APPROVED -- ;N r i i I L I I 7i f I I r• i 11ij11 1 �— I- I I I II I 11-12r— DATE 3 APPROVED -- ;N �� ������� DEPARTMENT OF�u `FoLTH RND ENVIRONMENTHL PRlr/ECTI uuuz 825 /L' STREET, HNCHORHGE, HK� 9950-1. ^ 264-4720 �p A_E_. ����� L i F: �' C �F f E > F--. IF-- F--1" Pro PERMIT NO. ( 790089 HPPLICANT LQCKWOOD HOMES INC 4611 BUSINESS PARK 2/4,����//��/ LOCATION CHLLOWHY CIRCLE LEGAL L] B1 GREENBRO8K S/D LOT SIZE 54000 SQUHRE FEET TYPE OF S8IL HBSORBTION SYSTEM DRHINFIELD MAXIMUM NUMBER OF BEDROOMS SOIL RATING (SQ FT/BR)= 285 SYSTEM IS THE RE8UIRED I OF THE 50IL H8S ���_y * F-1 9-77w_ THE LENGTH DIMENSION IS THE LEN{ITI (IN FEET) OF THE TRENCH OR DRHINFIELD. THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCHVHTION (IN FEET). 17 #-1 F=- E.-7- PAR #--,- t-0 ���_F F1 1. <:F� C-3' ��FEE"� THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). PERMIT APPLICANT HAS THE RESPONSIBILITY T8 INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TQ THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. EEC:: -IF F-3 P4,E; Fl F;? E� �HE G� L-1 1 F- FF F'- BHCKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION HND APPROVAL BY THIS �DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN H WELL AND ANY 8N -SITE SEWAGE DISPOSAL SYSTEM IS �100 FEET FOR H PRIVATE WELL/ OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL � �OTHER REQUIREMENTS MAY APPLY. SPECIFlCHTIONS AND CONSTRUCTION DIA -GRAMS HRE AVAILABLE TO INSURE PROPER INSTALLATION. ����"Ir -F FEE. ��I FR 1E %7--, E -a E--_ C--- EE"M EF. E--. F.�_ J.- 77� I CERTIFY THAT 1: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AP -Ci WELLS HS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ]� I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE E THHN 4 BEDROOMS. SIGNED:_..-`-~~~~____~~_ �%CHNT OD HOMES INC V] C ISSUED ~..... 2 ~ o'olk-Hv��L A. V �-IL» -ir �B,-, ff""Io��V-1, �01 A -A lr::_ ` DEPHRTMENT 0~_�HLTH � 'L' AND ENVIRONMENTHL �` /ECTIOW `~ 825 STREET, ANCHORAGE., AK. 99501 264-4720 k������� _"EF E-7 �4 1E. V,����� PERMIT NO. ( 771005 ) APPLICANT'L. SRH E}#X 71-L ]44 8588 LOCATION HILLSIDE 8. J�]9RM[0N LEGHL L] B1 QREENBROOK LOT SIZE 54000 SQUARE FEET TYPE OF SOIL HBSORBTI0N SYSTEM IS: TRENCH � MAXIMUM NUMBER OF BEDROOMS = I SOIL RHTING (SQ FT/BR)= 285 � THE REQUIRED SIZE QF THE SOIL ABSORPTION SYSTEM IS� THE LENGTH DIMENSION IS THE LENG7'H (IN k F*E OF THE TRENCH OR r..,-RAINFIELD. THE DEPTH OF A "f*RENCH OR, PIT IS THE DIS4 N_:E BET41EEN THE SURFACE OF TTIE � THERE IS NO SET WIDTH R TRENCH THE GRAVEL DEPTH IS THE MINIMUM D WEEN THE OUTFALL PIPE � HND THE BOTTOM OF THE EXCAVATION -r 1 (D PA A PACKAGE PLANT MAY BE INSTALLED �T HE PERMITTEE'S OPTION SUBJECT TO THE FOLLOWING CONDITIONS: ~-^ � 1. EITHER H CLASS I OR II NSF APPROVED PLANT MAY BE INSTALLED. 2� H CONTINUOUS MAINTENANCE HGREEMENT IS REQUIRED. IF H MAINTENANCE � AGREEMENT IS NOT KEPT CURRENT YOU MAY BE REQUIRED TO ENLHRGE THE SOIL ABSORPTION SYSTEM HND/OR YOU MAY BE SUBJECT TO PROSECUTION. ���� a-- ;2 > I I n Fe CE 1_� 71 F-:� E_- rC--- BHCKFILLING QF ANY SYSTEM WITHOUT FINAL INSPECTION AND HPPROVHL BY THIS �DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN H WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS '100 FEET FOR H PRIVATE WELL OR 200 FEET FOR H PUBLIC WELL OTHER REQUIREMENTS MAY APPLY. SPEC IFICHTIONS AND CONS TROCTION DIAGRAMS ARE AVHILFIBLE TO INSURE PROPER INSTALLATION. ' ���I-1 1 F" 1 V-7 F_:, c-, �=—_ P-8 FE. E-,--: F�? :3: -1 �fF:fl _17 71 I CERTIFY THAT 1� I HN'FHMILI | WITH THE REQUIREMENTS FOR QN�SITE SEWERS AND WELLS HS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ]� I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE THAN ] BEDROOMS. HPPLICrNT LOCKWOQD PHILLIP ���� ISSUED BY- �_~____DHTE�~�l~�.��.-�...-�_l__ \''I0 ' ` ���I IF F:'f-_#L_ 1 1"-0 CA F=' 0=�. P-4�" !�'_) IFM` H-3, F -E ` DEPHRTMENT OF HEALTH HND ENVIRONMENTAL PROTECTiON 825 'L' STREET/ ANGHORHG�/ HK. 99501 264-4720 GH* ���E i -PA F=-- F��' J7 "'T", PERMIT NO. ( 7710]8 ) HPPLICHNT OQD HOMES 1601 E DIM8ND ]448588 LOCA TION CHLLHWHY CIRCLE LEGHL L] Bi GREENBROOK SL�/� LOT SIZE 50 SQUHRF FEET TYPE OF SOIL HBSORBTION TRENCH MHXIMUM NUMBER OF BEDROOM,_:: SOIL RHTlNG( T��R)� 285 THE REQUIRED SIZE OF THE 50IL HBSQRPT�QN SYSTEM �����-#:= � THE LENGTH DIMENSION IS THE I-JENGTH 0N ETQF THE TRENCH OR DRHINFIELD. THE DEPTH 0F H TRENCH OR PIT WCE BETWEEN THE SURFHCE AF THE GRQUND HND THE B0TTOM OF THE EXIN FEET) THERE IS NO SET WIDTH FOR TRENC THE GRHVEL DEPTH IS THE MINIMUM 't)F GRf)VEL BE THE OUTFHLL P7PE F�ND THE BQTTOM OF THE EXC TIO EE�>. �PJ 'IF- E___�� ������ H PACKAGE PLANT MAY BE IN' THLLED AT THE PERVIITTEE'5 0PTIQN SUBJECT T8 THE FOLLOWINQ CONDITIONS: 1. EITHER H CLASS I OR II NSF APPROVED PLANT MAY BE INSTALLED. 2. H CONTINUOUS MAINTENANCE AGREEMENT IS REQUIRED. IF H MHIWTENANCF HGREEPlENT IS NOT KEPT CURRENT YOU MHY BE REQDIRED TO ENLARGE THE SOIL ABSORPTION SYSTEM HND/OR YOU MHY BE SUBJECT TO PROSECUTION. I pk-A.,S.- Fm F:L ]L 0 -.,q R::;? �����F=-.� BHC --'-'FILLING OF ANY SYSTEM WITHOOT FINAL INSPECTION HND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN H WELL AND ANY 8N -SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR G PRIVATE WELL OR 200 FEET FOR H PUBLIC WELL OTHER REQUIREMENTS HAY APPLY. SPECIFICATIONS HND CQNSTRUCTION DIHGRHMS HRE HVAILHBLE TO INS\JRE PROPER INSTHLLHTIQN. ����� ��� ���� I CERTIFY THAT 1: I HM FHMILIHR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WB -LS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2� I WILL INSTHLL THE SYSTEM IN ACCORDANCE WITH THE CODES. ]� I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS G�ff_,kOELED TO MORE THAN I BEDROOMS. or a �on��zue�ian Sre-;it Zab "Ona test is worth a thousand opinions" 2204 Cleveland Anchorage, Alaska 99503 CPerformed For Les Pace gate Performed 8/25/76 Legal Oescrintion: Lot 3 Block 1 Subdivision Gree�k This Form Renorts Soils Lon yes Percolation Test yes Denth Feet Soil Characteristics OpS01 2 — 4- 6- 8- 10- 1 12 0- 12 — Silt (ML) 14----- Bottom of Test Hole 16— Ct8 20— Was Ground Water Encountered? No Ir Yes, At what Denth? No bedrock encountered Readinq Date Gross Time Net Time Depth to H2O inches Net Dron' inches 8 24776 0 2 0 8/25/76 Saturate] for 24 hrs 87-2S/76 - 0 _ 20 _ 8/25/76 _ 3.0_ 5 — 3 8/25/76 _hrs — 3.5 hrs 5-7Z8 _ 7 8 8/25/76 4.0 hrs 6-5/8 3/4 Percolation Rate 111/40 `tinute Prnnosed Installation: Seenaae Pit Drain Field _ (� Deoth of Inlet Depth To Bottom Of Pit Or Trench cr)mVENTS: 285 square feet drainage area required per bedroom. Perc test.performed from minus 5 to 7 feet. Tes t Performed Byova s� %>- � %G '� _ Data Certi f i ed By: CONSTRUCTION TEST james D, Mack0ate'i 8/25/76 hAB Tcd UC PTO 10 � —Ifvj�- 4 AcA(-s OQZ-Y GE 8�i • -� Municipality of Anchorage ° On -Site Water and Wastewater Program 4 (907) 343-7904 5 7 Y CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 017-023-53 Expiration Date: Oy 1 a N O 1. GENERAL INFORMATION Complete legal description Greenbrook Block 1 Lot3 Location (site address) 6901 Callaway Cir. Current Property owner(s) Chad La Rue Day phone Mailing address 6901 Callaway Cir. Real Estate Agent Patricia Baker Day phone (907)-751-2500 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System 4 TYPE OF WASTEWATER DISPOSAL: Individual ❑ Holding Tank ❑ ❑ Community ❑ ry Public Sewer ❑ WaiverNariance request for: Distance: COSA to be released to the engineer, unless COSA Fee $ 550 1Waiver Fee $ Date of Payment 1 I 114 1 I Date of Payment Receipt Number CA �-01 Receipt Number COSA # C) Sc ASI 5`�'I Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ARCTERRA CONSULTING INC. Phone 696-6111 Address 2044.1 PTARMIGAN BLVD., EAGLE RIVER AK 99577 Engineer's Printed Name KENNETH M_DUFFUS Date 4i Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future +-� \ � occupants or can ArcTerra guarantee that no unseen OF encroachments, deficiencies or discrepancies exist. AW, "c ./ f r1 n T Ft 6. DSD SIGNATURE System #1 Approved for System #2 Approved for Disapproved. Conditional approval for bedrooms. bedrooms. bedrooms, with the following stipulations: .``i,��k`Y`oFAAIt -,. ON-SITE �.�...__ \AI T€R AN WASTEWATER o HKU(iKAM i __ , 1/1))MM) 1, biliq Original Certificate Date: 11 The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory _ Arsenic Advisory _ Well Flow Advisory _ Other COSA b:ue shee;_10-10-12.dcc Legal Description: COSA Checklist Greenbrook Block 1 Lot 3 Parcel ID: 017-023-53 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Comments B. TANK DATA Age of tank(s) New years Tank type/material Plastic Measured operating fluid level in septic tank NA IN Standpipes/foundation cleanout per record drawing Date of pumping NEW D. ABSORPTION FIELD DATA Which system tested (date installed) 2/78 ALL standpipes present per record drawing Total measured depth from grade 7.6 ft (max) Measured depth to pipe invert from grade 2.6 ft (min) ❑ N/A — pressurized field Monitor tubes go to bottom of effective. If not, state depth into effective Structure served by this system 1 Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes 0 No ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L [:]Arsenic less than MRL (ND) Collected by Date of Sample C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 9/12/19 Results ❑✓ Pass For 4 bedrooms Fluid depth prior to test 0 in Water added 600 gal New depth 0 in Elapsed time 165 min 0 FICode-requiredsoil cover over field * Final fluid depth in 171 System presoaked Absorption rate 600 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) _ date of test) Gallons introduced gallons If yes, enter date Comments/Deficiencies* Shallowest portion of field at slump end (2' cover) with no known freezing issues in 40+ years of operaton COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' L✓ Yes if No Community Sewer Manhole/Cleanout > 100' Yes if No ft ❑ Yes if No ft Neighboring Tank > 100' ❑ Yes if No ft Private Sewer/Septic Line > 25' ❑ Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No ft Holding Tank > 100' ❑ Yes if No It Neighboring Absorption Fields > 100' Surface Water > 100'[]✓ Yes Animal Containment > 50' ❑ Yes if No ft Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ❑ Yes if No ft C] Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) BL.0ding Foundations > 10' 2 Yes if No ft Surface Water > 100' QYes if No ft Property Line > 5' ✓v Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ❑✓ Yes if No ft Private Wells > 100' C]✓ Yes if No ft Water Main > 10' ❑✓ Yes if No ft Community Wells > 200' F/� Yes if No ft Water Service Line > 10' F,/]Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' L✓ Yes if No ft If absorption field is under driveway comment below Property Line > 10' ❑✓ Yes if No ft Wells on Adjacent Lots: Water Mair: > 10' ❑✓ Yes if No ft Private Wells > 100' Q Yes if No ft VVwe'r Service Line > 10' QJ Yes if No ft Community Wells > 200' Q Yes if No ft Surface Water > 100'[]✓ Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION I certify that t have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. COSA Checklist yellow sheet • Municipality of Anchorage =p s On -Site Water and Wastewater Program (907)343-7904 s,' ` . CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 017-023-53 1. GENERAL INFORMATION Complete legal description GREENBROOK BLOCK 1 LOT 3 Expiration Date: 7 -20 -1 -7 - Complete -.20-1 Location (site address) 6901 CALLAWAY CIRCLE, ANCHORAGE AK 99516 Current Property owner(s) DONALD & CYNTHIA THOMAS TRUST Day phone Mailing address 6901 CALLAWAY CIRCLE, ANCHORAGE AK 99516 Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class A Well Public Water System 4 TYPE OF WASTEWATER DISPOSAL: ❑ Individual ❑ Holding Tank ❑ ® Community ❑ ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: Date: COSA to be released to the engineer, unless othe i ested by the engineer. COSA Fee $_ 52,ro " Date of Payment Receipt Number COSA# — 05C151L 4 Waiver Fee $ Date of Payment _ Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ARCTERRA CONSULTING, INC. Phone 868-3791 Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M. DUFFUS 8/1712015 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface; changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the - evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future r OFA occupants or can ArcTerra guarantee that no unseen. w L , encroachments, deficiencies or discrepancies exist. Aw 10,—�rA 0Tif� '4x� 6. DSD SIGNATURE _System #1 Approved for Lp— bedrooms. System#2 Approved for bedrooms. Disapproved. P� IQ!1Z3S / wR�/ oN� i By: � Original Certificate Date: 7 TheniQf li f orage Development Services Division (DSD) issues Certificates of Onsite Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA bim sheet 10-10-12Am If more than 1 septic system Is on the lot: COSA Checklist # of Structure served by this system _ Certificate of On -Site Systems Approval Checklist Legal Description: GREENBROOK BLOCK 1, LOT 3 Parcel ID: 017.02353 A. WELL DATA — CLASS A Well type A If A, B, or C provide PWSID # 210346 Well Log (Y/N) Date completed Sanitary seal (Y/N) Y Wires properly protected (YIN) Total depth _ft. Cased to _ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test Static water level ft. ft. Well production g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 mL Arsenic: ug/L Nitrate _ mg/L Date of sample: B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC 1 STEEL Tank size 1250 gal. Number of Compartments 2 Foundation cleanout/(Y/N) Y Depression over tank (Y/N) N Date of qumginq 7'%a /5- Pumper A t C. ABSORPTION FIELD DATA Collected by: Date installed 211978 Cleanouts (Y/N) Y High water alarm (Y/N) N Date installed 2/1978 & 1979 Soil rating (g.p.d./ft2 or fe/bdrm) 285 System type DEEP TRENCH Length (90'+40'1 130 TOTAL ft. Width 3 ft. Gravel below pipe 5 ft. Total depth 7.1 ft. (Measured 7/2o/15) Eff. absorption area 1300 ft2 Monitoring tube Y Depression over field N Date of adequacy test 7120115 Results (Pass/Fal) PASS For 4 bedrooms Fluid depth in absorption field before test 0 in. Water added 600 gal New depth 3 in. Elapsed Time: 1_0 min. Final fluid depth 0 in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed "Pump on" level at _ in. Datum Size in gallons "Pump off" level at _ in. Cycles tested E. SEPARATION DISTANCES - PUBLIC WATER WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main Sewer /septic service line Animal containment areas SEPTIC/HOLDING TANK ON LOT TO Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? On adjacent lots On adjacent lots Public sewer manhole/cleanout Holding tank Manuretanimal excrete storage areas Building foundation 5'+ Property line 51+ Absorption field 51+ Water main 10'+ Water service line 104 Surface water 100'+ Wells on adjacent lots 2001+ ABSORPTION FIELD ON LOT TO: Property line 101+ Building foundation 10'+ Water main 104 Water Service line 101+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain 50'+ (NONE KNOWN) Wells on adjacent lots 200'+ F. COMMENTS Shallowest portion of field at sump end (2' cover) with no known freezing issues the past 30+ years of operation. G. ENGINEER'S CERTIFICATION I certify that t have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name KENNETH M. DUFFUS Date 8117/2015 COSAcanary sheet 2-6-15.doc =ten low >mm ;01 z0 °�o0 0 z =� m; mmo M09 z Am Om v -1 i 0 O 1 N 0 co w �m F'°si o;n� 3 25 ni Mss N � u It m5 20 i ��m?f?oo D W Lj. 3m �m lax = O C ri o aOM a o �.cd �o fP m vn: Cos to low 5. W 259 Z 0 M,n 0W v. Os30 va M ino °qoa F0 a as m�mg�$ si y 3m ns a>> O ig N -I oCl 50 cu m ao=Vzas �CA Sisg� ° c m W 1� 10' UTILITY EASEMENT >0002'19"E 195.00 I-fliez, 8 R� \52000 O 1 F4 or 25 ni Ir7n � u It nnrno o Y W 1� 10' UTILITY EASEMENT >0002'19"E 195.00 I-fliez, 8 R� \52000 O 1 F4 or .a MUNICIPALITY OF ANCHORAGE • Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES .343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel l.D. # C 0 - X2 5 - S3 HAA # "Q Alm a{ 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) L3 Bi GREENBROOK Location (address or directions) r 101 MzAWAY CIRCc.E Axid) AK 99sl(o (b) Property owner WAITER t Ju ' ALEXAADER . Telephone: (home) 345.2252 Business 274- 3602 Mailing Address 6401 Cg4LAW4q CIRCLE Qn(Gtl ' At< 9RSlio (c) Lending Institution 1H /4Telephone Mailing Address (d) Real Estate Company and Agent Fo r kkcn e Pr&.e er fig - i4tine &ecicw,Fy Address 3000 A Cf A'ACA&C5cg4 Ak '995'03 Telephone (e) Mail the HAA to the following address: (or check here a if hold for pick up.) List contact person and day phone number below: 2. TYPE OF RESIDENCE Single -Family IX Number of bedrooms _ y 3. WATER SUPPLY Individual Well ❑ Community Public ❑ Note:. If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status.` 4. SEWAGE DISPOSAL - - On-sitelg Public ❑ Community ❑ Holding -Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (Rev. nes) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional .and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm F% 7F cM/ r faf Secs Telephone Address A6C.hy,-ctge A4C 99S1� Date Oc�o�e� 3. 1990 •. Ar if...•••••.••••s•.,�............ .. ............:......... ® Engineer's Seal THEODORE F. aA00RE� • It A� ,••. CE - 3539 Q5t ®' �YprolessiU-11r, 6. DHHS APPROVAL Approved for bedrooms by Approved ^ Disapproved Conditional Terms of Conditional Approval CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in orderto satisfy certain federal and state requirements. Employees of DHHS do notconduct inspections oranalyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 7/88) Back Page 2 of 2 01p %A\ ��Ct S'c%A\ VMUNICIPALITY OF ANCHORAGE (MOA) ��P� • Health Authority Approval (HAA) ``�,�CHECKLIST - FEBRUARY 1984 343-4744 A. WELL DATA Legal Description: L3, 8i 6RL-EN RfzooK S/D ,, tr Well Classification C(cr.ts A Cor�.runrl,i If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) Total Depth Cased to Static Water Level Casing Height Above Ground Date Completed Electrical Wiring in Conduit (Y/N) Depth of Grouting SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results Yield Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole ; Date Comments DFC te0-er of Cormliunce crf74ac�ed B. SEPTIC/HOLDINGTANK DATA Date Installed 2/73 Size 12SO No. of Compartments Standpipes (Y/N) Yc5 Air -tight Caps (Y/N) YES Foundation Cleanout (Y/N) V95 Depression over Tank (Y/N) No Date Last Pumped Y W % by A f Pumping/Maintenance Contact on File (Y/N) tAIA ; for iq A Holding Tank High -Water Alarm (Y/N) HTemporary Holding Tank Permit (Y/N) N SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water -Supply Well > 200' To Building Foundation 16' Ft? 0M C.O. To Property Line 65' FRoM C•0 . To Disposal Field 17 FROM C.Q. To Water Main/Service Line To Stream, Pond, Lake or Major Drainage Course Comments 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 2185 r7 / (3ARM Type of System Design TRL-N(I4 Date Installed 2/79 UPGRR1)E 1479 Length of Field 90 + 4ko' Width of Field 31 Depth of Field S Gravel Bed Thickness 51 Square Feet of Absortion Area 1300 +a` Statndpipes Present (Y/N) YE5 Depression over Field (Y/N) N Date of Last Adequacy Test 9/S -/go Results of Last Adequacy Test Adeq&tctFe 4�, r y bedroon, SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well '7 2001 To Property Line 20 To Building Foundation 25` To Existing or Abandoned System on Lot ; On Adjoining Lots To Water Main/Service Line > 10' To Cutback (if present) To Stream, Pond, Lake, or Major Drainage Course >100' To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION N.A. Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) *'Check Permitted Bedroom Rating Against HAA Request" "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Vk Signed Company F71aa -klv Tec�7n)ca( SPi vtc-el -_ ✓ STEVE COWPER, GOVERNOR Lj s r DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE WESTERN DISTRICT OFFICE 563-6775 3601 C STREET, SUITE 322 ANCHORAGE, ALASKA 99503 September 18, 1990 FOR: Flattop Techincal Service Attn: Mr. Ted Moore PWSID: #210346 According to the records on file in this office, the Greenbrook Water System is in compliance with the State of Alaska Drinking Water Regulations. Sinc rely, VERA E. CRAIG Environmental S cialist VEC:pf i. a I LfI "N L MUNICIPALITY OF ANCHORAGE 0TFCoU�l DEPTOF 14 . -ALTH & il 31 rQ t A I I ch 0 r' Mk ENVIRONMENTAL KOTECTION 'DEC $REQUEST FOR AiTR0VA1, GF'Ni) IV I L'U'AL SEIY�RRUCEVVED IDIT;E— (soil papo lnco!�plctn !�qouZs will not !Jr orocisaseo. Pase e.i,ow ton (,.0) days for Pic-cassing. ri CN, ov�! Lockwood Homes, Inc. M.AILI"G AUDRESQ, c/o Area Realtors i FRCipEM Y RUYCENT if diffprpr,,, from ,bow) CtNF j.2' Esus F -P Walter D. and Judy L. Alexander Walter Work 274-3602 ifol/AlLINIGADDRES" 1 3821 Caravell, Anchorage, AK 99502 '. LEN"DINIGH, .,3,! 1 flofv Alaska Mutual Savings Bank ATTN: DEBBIE JOHNSON 274-3561 1 ADI-jk�SS P. 0. Box 1120, Anchorage, Alaska T Dee Turner Area Realtors MAI LING A I ll =SS LEGAL 1A STREET LOCA Circle, Anchorage, AK G. TYPE OF tiESIDENCE li fg SINGLE FAMILY El ko',ULTIPLE FA(,AILY LJ iNDIVIDUAL' 1—i PUBLICU-1-11-111Y YL -XX 1INDIVIDUALIONSITE" f -..)"PURL 1CU1-!LlTY 99510 278-4606 Nr,f;BCR OF BEL)ROONIS ED One )�Xj- l=our Fiva El Three EJ six /vTT1\Cl1 VVELL LOG. A well log is required ' fiol all wells rlri!ied si nu, -;uoe 127, 5. !--of :"ells di ; filled pi i o, to t;,. at dais, e, zj ive wall depth WUI-ch !cig if aVailaWc-) '�*li gi-ve installa,tion, If sys,,lan., is cvo, 1�,jo !2) years old arl ad--joacy test is required hr, zh�D'o'-'I'ment. I NISPECT! ON FF F M., I 1ST ACCON'LPAN' V 'EAC -11 R ECA.IEST BE MR E pf-A Ess! N, G-1- GPIN D E i IN I 'I 1i -1''-'I_ D. ---------- ........ . 12/11/79 I rills S1111. 1100 W WIN USIT WAY, IOH A1"[ 0I1\I , f.i'.1 i f'; I [I N 5PA ) . I � N PI CI OR D1lr,hc ILnd;; --- 1. lY('I OF i -11.1 :PJCC! -- NO! OF I-A-_Dk(A)r�S'- �_] srn!ciL:_ 1=Fyh4!f.Y n ON FIVE Cl k�,nlr.11i'l_l-FAP0l!I.Y C7 Two I -Ours [_I SIx V1 11 i'I'I Ui"'I 1' 4. ,)I;:1,1:,, �.ptit/Hard nc7 Tvli: Hh..�rption!\ �a--�Srl.r Linu...,.��,� i gir,.r [at I.ut Lli,a..�� 1' -I I 1!)- �_ I ___ . visa l: Llan l,rca is n �Ic.=,! Lc,. L 112 i (�^PPPUVI f? rOH 47- I:CDt,U(,I1hS P.IIPIA)V;\k. pa lei I1111i1 x;,!o(fll eny C.;I'iifice I(') k , I i I 1 ❑ INIDI ViDUAL )F Yf(orvde%L ----- - I-1 COMI IUNITY ----------------------- DATE DRILLHE) Crnlb:ciiG,1 ifiar!.--_-_--- --- .._... — --- - --- -- - --- OG RFOfIVfD ` F1'Ir/`(,r. DISPW;A1, DATi.: Ihd S'I'ALI.1'D IJ 111..1 I Coli) ecli(lil Val lig-:I I_J��Cd I]LIC re; k or 1-ioldlnn ;a l-, - --_!f rardt is lionw ade ------- -----'-----'-----___-- SOILS RAMI NCi give dilncnsions: MANUFACTURE[,' lufP,l. l l T:�I P.iiLA_._-._--_____-________—_. 1 0.,A1 f;HIFlI_ 4. ,)I;:1,1:,, �.ptit/Hard nc7 Tvli: Hh..�rption!\ �a--�Srl.r Linu...,.��,� i gir,.r [at I.ut Lli,a..�� 1' -I I 1!)- �_ I ___ . visa l: Llan l,rca is n �Ic.=,! Lc,. L 112 i (�^PPPUVI f? rOH 47- I:CDt,U(,I1hS P.IIPIA)V;\k. pa lei I1111i1 x;,!o(fll eny C.;I'iifice I(') k , I i I 1