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HomeMy WebLinkAboutGLACIER VIEW HEIGHTS BLK A LT 3 REM NAME MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT ~//~ PHONE We~l Absorptioa area D~STANC5TO: I~/~ ~ ~/ ~ Manufacturer Inside length O ~ IF HOMEMADE: Dwelling DISTANCE TO: Manufacturer Well Foundation DISTANCE TO: No. of lines Length of each line Total length of lines Top of tile to finish grade Material beneath tile Width Length Depth NO, OF BEDR~.~MS PERMITNO. ,o~r.z/Ot¢,/,// ~, Dwelling Materi,~· No. of compa~ments~ s Type of crib Crib diameter Crib depth Well Building foundation DISTANCE TO: IWidth Liquid depth PERMIT NO. Liquid capacity in gallons Material Nearest lot line PERMIT NO. Trench width Distance between lines inchesinches Total effective absorption area PERM T NO. ;lass Depth Driller Building foundation Sewer line DISTANCE TO: OTHER Total effective absorption Nearest lot line - Distance to lot line Sept c tank area PERMIT NO. Absorpt on area(s) PIPE MATERIALS SOIL TEST RATING INSTALLER REMARKS APPROVED J DATE LEGAL 16 F'ERMIT NO. .... w~._.. 14. :L1 PIONEER HOME RPPL t CRNT M I TCHELL ~' MFtF. r I E MFtLONE "':'"~' L. OL-:RTION MILE 4.. R E. R. _ . ~ p ', LOT SIZE LEL-iRL L~: BLF,]K R bLR_.IEF-: ',/IEN HTS TYF'E OF SOIL RBSOF.:PTION _-,T_-,TEfl IS DRRINFIEL~i, SEI.,.IE ,F..: L~F"~_31F~-.F4E:,E F EF.~'I ][ T 344-4550 26t00 SC'JRRE FEET t',IRN!MUM NUMBER OF E:E£)ROOMS = -'.': SOIL RRTING ,"~.] FT,.'E,F..- THE REQLIIRED .:,I¢.E OF ]"HE SOIL HB:,UF. FTILN :,~_,TEM IS: C.,EF-TH:= ~ LE[~L-~TH= '"'-"--'~ ,'-~F.'R%."EL [:"EF'TH THE LENGTH DIMENSION IL--., THE LENGTH ,'IN FEET':, OF THE ]F...EN_.H r]F.'. L":,RRINFIEL.[:,. THE [EF]H OF FI TF'.ENCH OR PIT IS THE [:,ISTRNCE BETHEEN ']-HE SUF.:FRCE OF THE GROUND RND THE BQ]'TOM OF THE EXCFtVRTION ,'IN FEET). THE GF.'.RVEL DEPTH IS THE MINIMUM DEF'TH OF' GRR',,,'EL BETHEEN THE OUTFRLL PIPE RND THE BOTTOM OF THE EY, CRVRTION ,'IN FEET:). f~: E ~i:., El ][ F: E [:. S E F' m I C: m Fl ["-.~ 1--% '-- I ...~: -- PERMIT HFF_ICBNT HRS THE RESPONSIBILtT'¢ TO INFORM ]'HIS [)EPRRTMENT [:,URING THE INSTRLLRTION INSPECTION':; OF RN'¢ WELLS RDJRC:ENT TO THIS F'F.'.OF'EF.:T'¢ RN[:, THE NUMBER OF RESIDENCES THRT THE NELL WILL SERVE. T [--~ C, ,:'. ~_---" .":, I ~'-.~ Z-=~ F" E,2:-r I L~ 1" &_ F~ ~-. E - -- E:FI]:KFILLING OF RN'¢ .:,~_-,TEM WITHOLIT FINRL INSPECTION RND RF'F'RO',,,'RL BY THI_, DEPRF.:TMENT WILL. BE SUBJECT Tn PRQSEL-:LI'rION. ,- -- t~ I "~ MINIMLIM DI:,THN_.E BETWEEN R WELL RND RNY EN-_,ITE SEWRGE DISF'OSRL S¥S'TEH IS :tOF~ FEET FOR R F'RT',,,'RTE 1.4ELL LR :'LDO TO .':.'00 FEET FRnM R F'~IB~ IFf WELL DEPENDING IJF'L]N THE TYPE OF PUBLIC WELL. MINIMLtH DISTFtNCE FROM R PRI',,,'RTE 14ELL TO R F'RIVRTE SEWER LINE 'rs '2~ FEE'[.' RNE:, -- II ' '~ '- , ' TEl R L:UMM_N'rT~ _-,EHEF.. LINE IS ~5 FEET. OTHER REQUIREMENTS I"tR'¢ RF'F'L¥. spEcIFICRTIONS RN[:, ]:ON'STR_CTtL]N D'rRGR. RMS RRE R'v'R'rLRE,'LE TO INSURE PF._FEF. INSTRLLRT'rON. F'E F..."~"I :I T' F-:--=." F' :[: FL'-. F:S r:,EL-:E~",IE~EF-=-" .72: ::L.., :.1_"_-,.. ...... I CERTIFY THRT l: I RM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND b.IELLS RS SET FORTH B'¢ THE MUNICIPRLIT'¢ OF RNCFIORRGE. .2: I 14ILL INSTRLL THE SYSTEM IN RCCORDRNCE WITH THE CODES. _-<: I I. JNDERSTRND THRT TFIE ON-SITE SEWER SYSTEM MFI¥ REQUIRE ENLRRGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THRN 2: BEDROOMS. RPF'LICRNI" MITCHELL 8: MRRIE MRLONE ',RTE ~_~ ~ ISSUED B'T'---V- .......... [ .............. ¥'-~V ~ ,~ ~, DATE RECEIVED ,e'" ." INSPF~TION APPOINTMENTS INSPECTOR~ ~ ' ~UNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE k TIONAnchorage,'Alaska 99501 825 L Street - ENV RO. "TAL SA. TAT O" D WS O" Telephone 264-4720 )IRECTIONS: Complete all parts o~ page 1. Incpmplete requests will not be proceed. Rease ailow ten (10) days for processing. J PHONE 1. PROPERTY OWNER MAILIN¢ ADDRESS EROPERTY RESIDENT (If diffarant from above) PHONE 2. BUYER MAILIN~ ADDRESS 3, LENDIN~ PHONE INSTITUTION MAILINQ ADDRESS I PHONE 4; REALTOR/AGENT~ ~~ MAILING ADDRESS 5. LEGAL DESCRIPTION Loc $ STREET LOCATION 6. TYPE OF RESIDENCE SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF~BEDROOMS [~] One [] Four ~ Two [] Five [] Three [] Six [] Other 7. WATER SUPPLY ~ INDIVIDUAL* [] COMMUNITY. / ~) 7~' [] PUBLIC UTILITY * ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM ~ INDIVIDUAL/ON-SITE** /~ 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/~ NUMBER OF BEDROOMS 1. TYPE OF RESIDENCE [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX :~ERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED ~ERMIT NUMBER 3, SEWAGE DISPOSAL SYSTEM J~]INDIVIDUAL/ON -SITE DATE INS'I~ALLED E]PUBLIC UTILITY Connection Verified INSTALLER []Septic Tank or [~Holding Tank Size:_ . If Tank is homemade SO~LS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank iAbs0rption Area iS.wer Line JN.r~st Lot L,ne WELL TO: Absorption Area to nearest Lot Line 5, COMMENTS [] APPROVED FOR BEDROOMS [] CONDITIONAL APPROVAL {letter must accompany certificate) [~DISAPPROVED DATE BY ALASKA erlUiRonml~nTAL CONTROL $1~RUICeS, Irlc. t~n§ineefin~ 8 ~nuJronmental $1udJes MAY 22 1981 ABM ESCROW 410 DENALI STREET ANCHORAGE AK 99501 SELLER - MALONES SUBDIVISION-GLACIER VIEW HEIGHTS BLOCK-A LOT-3 THE TYPE OF ABSORPTION SYSTEM IS A PIT WITH AN UNKNOWN AREA. THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 2 BEDROOM HOME. 1220 Lgcst 251h/~uenue ,, An&oraq¢, Alaska 99503 ,. (907) 276-1361 lC i00o '