HomeMy WebLinkAboutGREAT LAND ESTATES #3 BLK 3 LT 10
~-~ ~) 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
NAME IPHONE ] NEW
V~Lo ,~ z~Z L-, "7"-/q z. ~ F 13c./:)'-- $-¢J[,,i [] UPGRADE
MAILING ADDRESS
LEGAL DESCRIPTION
NO. OF BEDROOMS
DISTANCE TO: [ Well //O /" Absorption area~ ¢ Dwelling , PERMIT NO.
~ ~ Manufacturer ~ ~ ~. ~. ~ Material~
~iq. copacitg in ~allons Inside length ~idth kiquid depth
0 Z ~ Manufacturer ~aterial Liquid capacity in gallons
~ Well Foundation Nearest lot Une~'~'~ PERMIT NO.
IZS" 2? /
~ ~ ~ Length of each line Total length of lin~s Trench width Distance between
Pines
z
~ Top of tile to finish grade / Material beneath the To al effe
t ct~ e absorption area
=
Length Width ' Depth PERMIT NO.
~ ~ Type of crib Crib diameter ~/~ Crib depth Total effective absorption area
, ~,
m Well Building foundation Nearest lot line
~ DISTANCE TO:
~ Class , Depth Driller Distance to lot line PERMIT NO.
~ DISTANCE TO: , Building foundation Sewer line Septic tanE Absorption area(s)
OTHER
PIPE MATERIALS
SOIL TEST RAT, NG ~q__
iNSTALLER
REMARKS
APP~OVE~ / , //] / DATE LEGAL ,~,~:~
,,~UNI~IPALITY OF ANCHORAGE
~ Department Eealth and Environmental'f~otectlon
825 L Street, Anchorage, AK. 99501
'~ 264-4720
* * * HANDWRITTEN PERMIT * * *
P.e~mit ~ ~),,~). ~ ON'SITE SEWER PERMIT
Lo. cation:
Legal Description :. ~ ,P> ~-/0
/ '
LOt Size: .... .. ~
Type of Soil Absorption System Is:
Trench: ~ ' Drainfield: __ Seepage~Bed: _, Holding Tank: :
M~xfmum Number ~f ~edrooms: ~ ·Soil Rating-(sq. ft/b~)
The-Required Size of the Soil.Absorption System Is:
UEPTH C~ .LENGTH '~",~ _':GRAVEL DEPTH '~ ' WIDTH,. ..--
The :length-dimension is ~he ~length(in -feet) of the trench-or drainfield' The
~epth 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 pipD and
the bottom of the excavation(in'feet).
/
* * REQUIRED SEPTIC(HOLDING) TANK:'SIZE = ~ 5 GALLONS * *
~ermit applicant has the responsibility to inform this department during the
in-s~'allation, inspections-.of-any-wells adjacent to_this property and the number
of'.residences that the well. will-serve.
* ** TWO(2)~INSPECTI~ONS.-~RE REQUIRED
Backfilling of ..any:system without final inspection and approval by this department
wiil be subject to prosecution.
~inimum-~distance between a well ~nd any on-site sewage disposal--system is 100 feet
for a private w~ll or 150 to 200~feet-.from ~.-public ~ell depending upon the type
of'public well. Minimum-distance'from a private.well to a,private sewer line
is~.-2,5 feet-'and to a-community sewer line is'75 feet.- .Well logs are required
an~d must be returned to,thim-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 .8 2 * * *
.I'.certify.that:
-' (!) I am.familiar with-the'-requ'irements'.for on-site~sewers and wells as
'set forth~by.the Municipality .of Anchorage.
(2) I~Will install, the system in accordance with codes. '
(3) ._I'-understand-that ~he on-site sewer system may. r~quire'~enlargement if
-'---.-the residence is remodeled to include mo~e that, 3~.bed~oms.
Applicant
Date:
SWP/O24 (1/81)
u
Russell Oyster
694-2774
Performed for:
O & E ENG,NEERING & DEVELO~ MENT CO.
Box 90, Davis St., Eagle River, Alaska 99577
694-2774 or 688-2280
Name:
SOIL LOG
Tel. No,
Earl Ellis
688-2280
Mailing Address:
Legal Description: Z~7"
Depth (feet) Soil Characteristics
6__
7__
8__
9__
11__
PLOT PLAN
12__
14__
PERC. TEST
15__
16__
Ground Water Encountered: Yes
Proposed Installation: Seepage Pit
Comments:
No / If yes, what depth
Drain Field
Performed by:
~ work sh~ll be done as shown
modified, or a~Icred wi~}~;~*:~ first
obt~Ng a valid change
I
I0
/0
I
0
I$
/
c::,
DOC Co. dba
P, O, BOX 272, CHUGIAK, ALASKA 99567 o TELEPHONE 688-2759
OWNER OF LAND
ADDRESS , · ·
LEGAL DESCRIPTION
DATE - Started
Ended
PERMIT NUMBER
DEPTH OF WELL '~"J ~)
STATIC LEVEL OF WATER
';'DRAw DOWN FT.
GALS. PER HR t' 7[[:'?""
KIND OF CASING ,'~, '¢-;
KIND OF FORMATION:
From~ r Ft. to 4 Ft.
From -.'~ Ft. to-' -~' _Ft._
From Ft. to Ft.
From ,~' Ft. to .:i ~, Ft. __
From Ft. to.__Ft.
From ~ ~' Ft. to , Ft.
From· Ft. to :' : Ft.
From Et. to Ft,
From 'i~: Ft. to ~ ~' Ft.
From Ft. to.__Ft.
From / ' Ft. to: ; ;
From Ft. to Ft.
From / i Ft. to /~.i:' Ft.
From__Ft. to Ft.
From .' t. to~~; Ft.
From___Ft. to __Ft.
From _Ft. to Ft.
From
From
From
From
From
From
From
Ft. to _Ft.
Ft. to___.Ft
Ft. to___ Ft,
Ft. to___Ft
Ft. to__Ft.
Ft. to Ft.
Ft. to Ft
Ft. to Ft
__Ft. to__Ft
Ft. to__Ft
Ft. to Ft
Ft. to .Ft.
Ft. to Ft
Ft. to Ft
Ft. to Ft.
Ft. to Ft.
Ft. to.__Ft
MISCL. INFORMATION:
/ ,
::~: ...,~,.~ ,,~ ~-~.~;7,..;, J / ~'~ ' ' :"
:
DRILLER'S NAME :' f ' , '
~_ ~ . APPLI¢'-'~NT FILL~ OUT UPPER HAf"'~ ONLY
~C ~.. , ~ P~one
Buyer
-
Lending Institution /~,~,~
Address ~--~ ~.~_ "--' ,~
Realty Co. & A~nt
Address ~'
Zip Code '~.~>42 /
Zip Code
Phone
~Z~ ~/~-t
Phone
Legal Description /~-(,7~ ~"//=~"" .~ .,~.-0 7"- /' 0
Street Location ~_~J~:~/J~ ~--.'/-~/?/"~ /--~'~/~..~"/~'~'~'*
Type of Residence
~e Family
[] Multiple Family No. of Bedrooma ~
[] Other
Water Supply
[~l~dividual
[] Community
[] Public Utility
ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975.
For wells drilled prior to that date, give well depth (attach Icg if available). :
Sew~er D~[cposal
~,"rndividual Year Individual Installed:
[] Public Utility When Connected to Public Utility:
[] Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
Time Time Time Time
Date Date Date
Inspector Inspector Inspectoh
Field Notes:
,~._ MUNICIPALITY OF ANCHORAGE
~'~,,,,ow~ .~a.oo.s 'CO.a~T~O.S
( ) CONDITIONAL APPROVAL*
DATE ~ {' ~ ~ ~ '~ / --
Soils Rating Date ~wer Installed Well To Absorption Area Well Log Received /~;':,:~ > _~: ,
Well to Tank Septic T~k Size