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Home My WebLink AboutTUXEDNI PARK BLK 3 LT 6Tuxedni Park Block 3 Lot 6 #041-022-14 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division 825 "L" Street, Anchorage. Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name -K>—Noce AL.L4# DISTANCES TO FROM SEPTIC TANK ABSORPTION FIELD Aoc,e,s 4- D TYPE OF SYSTEM ✓nunrle) Pe,m,t NO NO of betl,Wms WELL1 WELL r- 1ao +- 88 ol63 5 LOT LINE (00, FT /.n added aW"t ung.nal gwoe LEGAL DESCRIPTION Oil— 4a" FT 6 — O Lo: Bltxh3 SuDOw Z U FOU4,0ATION 5 7 3 _ Farge. Seeuun �j � /� � C / T I z tJ . n -2. y y . V� f7 AS -BUIL IAGRAM tlnvtwaY wane, mrs ISnuw Wceuon dl wen. etc 1 septic syalem. prol ;J SEPTIC ❑ HOLDING Manu WClortr Capauty m gxwns AL.L4# moo Ma:er.a. No 01 Cpmpartment5 Z ST>✓cl_ TYPE OF SYSTEM TRENCH ❑ BED ❑ W. DRAIN ❑ OT Llelgn 10 p•Ve WI Wm Iron. lot" Deptn "on, ong•nal glade ur,g.na: yradv �/ / // FTOar FT /.n added aW"t ung.nal gwoe Gr "veldeem Wteallr p,pe Oil— 4a" FT 6 — O FT Oraventr:y:. T6 —0 &A3FT Gravrl w,aw 3� pa/ FT total at wo Vl,on arse I Destance Wlw en lints (=,7 z' SO FT WA Fl hume,P n .nes Son mung Prpe male", 25 SOFT CAST 1 Rota • R•>~F IPC rus:aaer p Q Dale mstanL•tl _ til L� �iN11Fw L� 2SC 1 Ps, 118A WELLS cr, ,21 PRIVATE ❑ OTHER (Identify) 4aa.laa:pr (A.b Cr i Dla, DpVlb Gaxv lu PiZ�JAT� uwvNew.�Fl uN�NowW Fl call, Inslaned Ins:.el•-_ —. -- .—_. CAU�WWv-L u�1'!-WO VA1 _ REMARKS: E� R .z 1 L Z. NC1 — CA 111 1 FA, cerhly that this inspection was peAurmed according to all Munlapat and Stale gindehnes in Idled on this 1/date. m//1 � q Health Department Approval: �%•IZ Dale / ) 2-013 )3.85) WELL moa �9 -le_ 1VUnf_,OI,' A TWA ti tiJCe!Ne cr CC -d793 �i�ayf0 PkafESSt��a',� M U N I C I P A L I T Y O F A N C H O R A G E Department of Health & Human Services 025 L Street, Anchorage, Alaska 99501 343 O N- S I T E S E W E R & S E P T I C T A N K P E R M I T Permit Number: 000163 Enlargement Date Issued: 08/19/88 Engineer Designed Owner Name: MIKE NORMAN Day Phone: Owner Address: 9740 COPPER DR. 3.3-,,995 ANCHORAGE, AK 99516 Parcel Id: 041-022-14 Lot Legal:`Subdivision: TUXEDNI PARK Lot: 6 Block: 3: Section: 6 Township: 12N Range: 2W Lot Size 2.0A (sq.ft. or acres) Max Bedrooms: This Permit: 2 Total Capacity: 5 SEPTIC TANK: Minimum total septic tank: capacity: 1,500 gallons. Each septic tank must have at least 2 compartments. Depth to top of septic tank(s) < 4.0 feet requires insulation over tank(s). ENLARGE EXISTING ABSORPTION TRENCH FOR 2 BEDROOM ADDITTION. PER ENGINEERS DESIGN 26' OF TRENCH WITH 6' OF GRAVEL AND 3' SOIL COVER. THIS PERMIT ISSUED FOR A SINGLE FAMILY RESIDENCE ONLY AND EXPIRES 12/31/88. NOTIFY DHHS PRIOR TO EACH INSPECTION. I CEPTIFY 1HAT: 1. 1 am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage (MOA) and the State of Alaska. 2. I will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit. 3. I will adhere to all MOA and State of Alaska requirements for the set back distances from any existing well, wastewater disposal system or public sewerage system on this or any adjacent'or nearby lot. 4. I understand that this permit is valid for a maximum of 2 bedrooms. I also understand a capacity of the total system is 5 bedrooms and any enlarge ent will req re an additional permit. --in1VI^Signed: �� oF (W�4v�rC�J DATE: 8 ��/ ------------------------------- C>r-----� i-- - (Owner ) MIk:E :MAD / ��l Issued by: -------- DATE: �_C �!-r�ct---- .� _ -- _ • UF( RIi-J�� 3 V,? -M worms gewl LAt4SLA5tANJ%n=> (vPc mxr> t"gzTc_ EXISTIsJ) x -mew-AA "'s 3 O" Cov TO ul TNtS ' ,,Csm A j Prpo oN ZG LF aF 7r -Ox q' Dr�-s� w/6' -o" SZV`Tic ROLL.. '%r4l Ort-SOePTtoN PtS —A wtu.. 6s 56 x 6 XZ = (,7Z . PIZD�cm µotic 6F 5 EC*Y%S w/ Sol` r-ft,'ivCr PrT ►Z.5 qd 5x IZS- d = 6Z Z- VE a T F SEWER SYSTEM LOCATION PLAN ?� 4 tHO.-A A. F:__H:2 CE Fr�.i55'•3. SECTIO lk SCALE - 0 — I11 DRAMN NORTH o-- PREPARED RFOR- � t1 �a •y I� 4• (J 3 I "TuxEDNE r'HR� Z%A NIP/RANGE Z Z \N 1 c tNt I/ N TE• THE ACCURACY OF LOCATION OF EXISTING FR OPERTY CORNERS. WELLS. AND SEPTIC SYSTEMS INDICATED IS NOT EXACT. DIMENSIONS INDICATED HAVE BEEN DETERMINED BY USE OF CLOTH TAPE AND NOT BY SURVEYING TECHNIQUES. DATE- 8/171185 ( SHEET 1 OF 1 WHITEWATER ENGINEERING CONSTN,UL;TUkt 11600 CANGE ROAD • ANCHORAGE. ALASKA • 99516 • PH. 345-7008 . ...—.. .. ...., sa•i's,u.a'•Y+'+•riasJnsY..•:.r... T':_:::::--�.. <:... _..�..._ ' 0 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: 1 ` m- ��''�n a�� DATE PERFORME TLAyaZV3f �� C� I F l LEGAL DESCRIPTION: I(b Township, Range, Section: f C SLOPE SITE DEPTH IFEIY) i , '. ofZC-rr�,NIGS WIT'" 2 I Zwr 113 4 5 6-. t Iz 7- 8 %• •. r 9 - to 10 :j 12- 13 2 13 14- is- 16- 17- is- 19 - 20 4151617181920 COMMENTS r,oP \t_Z'l=.fl��CY C�'czAv�t ANL Ili 49th THOM A. FISCH'-Z CE -6793 WAS GROUND WATER ENCOUNTERED? �JO IF YES, AT WHAT DEPTH? DepthW Water Aker Montt Moniturinp7_..�— I PERCOLATION RATE (mmutes/mth) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT PERFORMED BY: JM I�. CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE. It or Y -7 cf -r�� 72-008 (Rev. 4;85) GRE�.I ER ANCHORAGE AREA BOk JGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM t(�/,!Sr MAILING ADORESS�'r7�%-rt3PHONE !' j 2p -JC, LOCATION ti bf'"' LEGAL DESCRIPTION_l. SEPTIC TANK: DISTANCE �. / ,� �, /� /., NUMBER OF FROMWELL&L) MANUFACTURER c�� ^e�5. �-� -MATERIAL ; _&'0 COMPARTM��ENNTT�S INSIDE LENGTH INSIDE WIDTH_ LIQUID DEPTH LIQUID CAPACITYL^�ALLONS. TTL r-0RAI_NF IELD: sdF% / 7.._ _ TOTAL LEITH DISTANCE FROM WELL FOUNDATION a•a"Fr NEAREST LOT LINE �/ /OF LINES NUMBER OF LINES_ DISTANCE BETWEEN LINES TRENCH WIDTH JE' IN. TOTAL EFFECTIVE � SQ. FT. LENGTH OF EACH LINE ABSORPTION AREA g` DEPTH OF FILTER DEPTH: TOP OF TILE TO FINISH GRADE ___V f rMATERIAL BENEATH TILE 6 _IN. ABOVE TILE WELL: TYPE 11.(>�i�CONSTRUCTION �`'! � DEPTH DISTANCE FROM: BUILDING FOUNDATION = CESSPOOL I APPROVED NEAREST NEAREST ��''�� SEPTIC ___SEEPAGE /�-.F.�• LOT LINE SEWER LINE_L TANK��%,� SYSTEM . OTHER SOURCES DISAPPROVED REMARKS DISTANCES: INSTALLED BY: SEWER LINE DEPTH: PIPE MATERIAL LOT SLOPE: REMARKS: Form Eq -032 DIAGRAM OF SYSTEM DATE G.- 24PPROVED �\i�-�� " J f�tUt+7I C I.. FfL I TY OF AtJCF-. F?FiG - DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2510 E. TUDOR RD., ANCHORAGE. AK. 99507r� 276-2221 iOM—S I TE SE4JEFR PEFZtl I T PERMIT NO. < 76232 ) APPLICANT GRTFWRV CONSTRIIC 2543 KENSINGTON DR 337-1438 LOCATION COPPER. DR LEGAL L6 83 TUXEDNI PARK LOT SIZE 130000 SQUARE FEET TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH MAY,IMUM NUMBER OF BEDROOMS = 3 SOIL RATING <50 FT/ER)= 100 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: E>EPTH= 10 LEN'3-r t= 2oS C3FtFiYEL DEPTH= .= THE LENGTH DIMENSION IS THE LENGTH <IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF R 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). F2EG2U I F2EC> SEPTI C THINK S I =E= 1 U +Ei GALL�df+t5 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 200 FEET FOR A PUBLIC WELL. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PF-rsm I T �F t- I C> FOF-z Ot.tE YEFiF< F= Ft OM I SSUE I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: I UNDERSTAND THAT THE ON-SITE SEWER. SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. 5I GNED :---- PLICANT GATEWAY CONSTRUC ISSUED w eoniftuatiOn 961f -fag "O"s tett is worth a thousand opinions" 2204ClevelandAnchorag�J, Alaska 99503 n'_76 Performed For i�% v/iy CO( "y�t%CT/�N Date Performed `� G/ Lenal Oescrintion: Lot Block v< Subdivision 7UKE7WI JE;� This Form Renorts Soils Lon Percolation Test_ tenth 4- 6— 74V (::;j)2eY 8 — G�Av�L wu cam&P 10— /to S" F.��, �> 12— 14- 16- 4- 16— "t10 ( l)P-etlk� )tVl7r-Z� e 3� C 18- 20— Was Ground Water Encountered?� If Yes, At what Denth? M�N Readinq Date Gross Time Net Time Depth to H2O Net Dron' r- 1 r— Percolation Rate Minute Prnrosed InstaaTTatio : Seenaae Pit Drain Field Depth of Inlet I Dent To ottom Of Pit Or Trench ComMENTS: :3 �)3 �C/S Test Performed BT�i[tx't�_ Data Certified Date: M -W DRILLING,, Inc. ` P. O. Box 4-1224 • 1310C International Airport Road - - t = (907) 274.4611 - - ANCHORAGE, ALASKA 99509 fi t,i Yt DRILLING LOG Well Ow ..' Dort k. Locat>.on (address of: ` Township, Range, Section, if known; or distance main road Size of casing `' r Depth of Hole feet Cased tom" feet Static water level 50 ft. (ab'ove) (below) land surface. Finish of well (check one) open end (-,X ) • Screen '.Perforated "�^:°d"si'.'�'vYr N- a4 N la. 1za, s -Y_x rte, yi�t!^+� 4 ..t S?pe^ -t.w44 a -•M'-min eY•r33Y�-»t lvr'1drt'p- .a•rt+�*�Tia'. :^e•�l; i': on2 Describe screen or perforation :. Well pumping test atLa-' gallons per (}(o&r) -(minute) for L ----hours with ° 1t7G;o - •- - 'ft of drawdown from static level. 'Date of completion 1 Jun 75 WELL. LOG f Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness O. s TO Cwirc; TO TO 5 Organics :5TO 80 c 1 y `,ravel --. NO , TO 11(30 Small `;dravt: silt .r, Cl u7yp ' 100+ °Tpr_10 Gavelly lfar'dp.n.TZ S + _ 11 108 1 0 { , G7ater i Sa d -s -gravelly: vYa7.. >31tyr would not cle in up TO a Y ` 120 TO 138 Grave' ly Hardpans y Ftp f t4., 4 "! y; t < s :'t bt µ�. �..:b .. >U,i: i.'' -: . �, _"•, S'f r'"� l: # 138 Tp 140' t :Water_Giave.le "i S GPM. clean Y` 4 3140 ... 190 Gravelly Hardpan tt r y. �, k - .ar i� : - +r U . v�_;!tt aft 196 l0ater Gravels mediu good saturation cle+tf a w "' r >: ,SeY. � '� j, .✓'h afi. �-t Je' s '' I.a �x"r % ': [.'!• t _] + a F' y 's `1 -. } � � 1t; y"l�,y attar, n u f y TO 7' r, R .,' �,.,t.rr,x..4 t , +. x „ . 4�i t t�1} s`^� link > f t t t!' .�.• d t b... - tn4¢5 rrr-m` pyFt jer r 'jlG. r TO - n${, ( i N x :� ti`TO ''..i414A Ccrt'1f16d Contrictortt F� a : L. , t. ,. t 3—CONTRACTOR S..- r Vim, a �.� • a. - -. MU" I C I F"AL I TY CAF= n"l-_HCAFRnC3E DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTIO14 2510 E. TUDOR RD., ANCHORAGE, AK,. 99507 276-2221 W ELL PEF2M I T PERMIT NO. < 76219 ) APPLICANT GATEWAY CONSTRUCTION LOCATION COPPER DR LEGAL L6 B3 TUXEDNI PARI: SURD MINIMUM DISTANCE BETWEEN A WELL AND 100 FEET FOR A PRIVATE WELL OR 200 WELL LOGS ARE REQUIRED AND MUST BE OF THE WELL COMPLETION. SPECIFICATIONS AND CONSTRUCTION DIA INSTALLATION. / F• E F1 Ul I T NA Fl L. I a 2543 KENSINGTON DR 337-1438 LOT SIZE 113000 SQUARE FEET I%TE SEWAGE DISPOSAL SYSTEM IS p� PUBLIC WELL. TO THE DEPARTMENT WITHIN 30 DAYS AVAILABLE TO INSURE PROPER, YEFFFz FROM I SSLJEE: I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIRED T FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. SIGNED:__ �1L1_� ��s s= y ==----------------- A ICANT GATEWAY CONSTRUCTION ISSUED BY- _Jf6,,Le LtLL---------DATE- _1,5-- ------ n INSPECTION APPOINTMENTS DATE RECEIVED 1610 c TIME TIME TIME DATE DATE tt \\ qq C7 s�\�4 t'1_f �Yt`• 6. TYP F RESIDENCE DATE INSPECTOR INSPECTOR ^ INSPECT ❑ MULTIPLE FAMILY ��11 Y1 MUNICIPALITY OF ANCHORAGE 1'1` N l'Y Ci DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 1 825 LStreet -Anchorage, Alaska 99501 NON \ ENVIRONMENTAL SANITATION DIVISION 1" Telephone 264-4720 R E C E v E REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACkk ES D DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be Processed. Please allow ten (10) days for processing. 1. PR PERTYOWNER PHONE fi Sn A -'/saw MAILING ADDRESS7A R j 30 1�ilon� fiC i 5'95S� PHOPERTY RESIDENT III different from above) PHONE 2. BUYER PH NE MAILING ADDRESS 3. LENDING INSTITUTION PHONE MAILING ADDRESS 9. REALTOR/AGENT PHONE /—t e/✓tea ,.� Czsso� t� Flo-sso MAILING ADDRESS 5. LEGAL DESCRIPTION 1610 c STFjFET LOCATION , O e 6. TYP F RESIDENCE NUMBER OF,BEDROOMS SINGLE FAMILY ❑ One ❑ Four O Other ❑ MULTIPLE FAMILY ❑ Two ❑ Five Three ❑ Six 7. WATER SUPPLY X INDIVIDUAL' ' 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 UTILITY depth (attach log if available.) & SEWAGE DISPOSAL SYSTEM ❑ INDIVIDUAL/ON-SITE" 7 7 YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLICUTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED - nen IA— 6/79) 3q7 Q� 1/nt �I3� 1 Uvr� t9 ac CGt �� l ti' (: 1%1 rL (�4L'I "LL CXA THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLEFAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED 1 INSTALLER ❑Septic Tank or EJ Holding Tank Size: I 60 If Tank is homemade give dimensions: SOILS RATING / (] TYPE OF TANK MANUFACTURER C/ TOTAL ABSORPTION AREA 4. DISTANCES WELL TO: MATERIAL T Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line _ Absorption Area to nearest Lot Line 5. COMMENTS M—APPROVED FOR �_ BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE 9 —ri— O BY 72010 (Rev. 6/79) ro�'- ��uiiiC1pa11ty / \ 825 HO STREET .i ANCHORAGE, ALASKA 99501 of (907) 264411 1 ,[y {'1 P1p'�or ge "' '' OEOR(�E M11, SULLIVAN, 6-L.A 1'aill 11 1 (Asv �� h1AVOR m PARTMIN t D1 III At Tii AND ENVILIONhIENTAL PROTECTION September 4; 1980 Charlotte Snyder 3730 Rhone Circle Anchorage, Alaska 99504 Subject: Lot 6 Block 3 Tuxendi Park Subdivision Approval for your individual sewer and water facilities cannot be granted until the following items have been completed: (1) The water analysis report be delivered to this department from Chem Lab, 5633 B Street, for our review. (2) A well log submitted to this department for our review. (3) The septic tank pumped with a receipt submitted to this department. (4) An adequacy test be performed on the existing leaching area. This test will determine if the system is adequate according to National Standards. A listing of private firms performing the test is enclosed. This report needs to be submitted to this department for our review. If there are any further questions, please call this department at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw cc: Lee llouston and Associates 101 Benson Boulevard 99503 /"MUNICIPALITY OF ANCHORAGF-4,, \ DEPARTMENT .F HEALTH AND ENVIRONMENTAL ?ROTECTION �•, ��,\ 825 L Street, Anchorage, Alaska 99501 279-2511, ext. 224, 225 „✓,�'6- Date Received: March 14, 1977 O 1st Inspection: Time l- 2nd Inspection: Time Date �'�- r, i r CS Date Inspector I;); , Inspector REQUEST FOR APPROVAL OF.INDIVIDUAL SEWER AND WATER FACILITIES 1. Lending Institution Request: National Bank of Alaska Mailing Address: Post Office Box 3-3859 Phone: 2. Property Owner: Dr./Mrs. John Snyder Phone: Mailing Address; 3730 Rhone Circle, 3. Legal Description: Lot 6 Block 3 Tuxedni Park Subdivision 4. Single Family Residence: (x) Multiple Family Residence: ( ) 5. Well Data: Type Individual Construction Number of Bedrooms: Number of Bedrooms: Depth Bacterial Analysis 279-2506 z 21 272-4528 3 Well Log Filed ( ) 6. Sewage Disposal System: On-site system (>4 Public Utility Permit # 76232 Installed 1976 Installer Septic Tank Size Manufacturer Absorption Area Soils Rate 7. Distances: Well to Septic Tank to Sewer Lines Nearest Lot Line Absorption Area to'Nearest Lot Line Material to Absorption Area Page Two Department of Health and Environmental Protection . ' Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 6 Block 3 Tuxedni Park Subdivision Comments: Affadavit Attached: ( ) Approved: Disapproved: Department Worksheet: Letter Attached: ( ) Date: --R ) 1 % 7 Date: MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH G MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL PROTECTION �l• DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2510 East Tudor Road, Anchorage, Alaska 99504 276.2221 MAR 1 ? 1977 1 REQUEST FOR APPROVAL OF RECEIVED INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO VA FHA CONV XXX 2. Property Dr. 6 Mrs. John Snyder Mailing Address: 3730 Rhone Circle Anchorage Day Phone: 272-4528 or 337-2471 3. Name of Buyer: Same as above Mailing Address: Day Phone: 4. Name of Lending Institution: NATIONAL BANK OF ALASKA - Mt¢. Loans Mailing Address: P.O. Box 3-3859 -Anchorage Phone: 279-2506 ex 21 99501 5. Name of Realtor or Agent: none Mailing Address: Phone: 6. Legal Description: Lot 6 Block 3 T ux dni Park s/n Location: 000 CooperLDeiveT vehicular access from Tudor Road - Type of Facility to be Inspected: Single Family Residence No. Bdrms. 9 8. Water Supply Type of Supply: Public Utility Individual XX If Individual, number of dwellings presently served unknown If Individual, depth of well 9. Sewage Disposal System 77001(7/76) tinknnwn Type of System: Public Utility Individual (on-site) XX If Individual, date of installation 1976 --? hWCIPALIi( O. ,NCII0UP.G2 DEPT. O 1I" ' LT. 18 ENVI.^.ON Uir:li. i -, .CTION MAR 14 1917 RECEIVED W NATIONAL HANE: OF ALASKA Fifth Avenue - ............................................. .................... _..... BRANCH DISCLOSURE STATEMENT - - REAL ESTATE LOANS NOT FOR ACQUISITION OF DWELLING Borrow'er's Name......................Charlotte ............. A. Snyder ..... ........................................................................................ Address000 Copper Drive ............................................................................................................................................... Regarding proposed loan in the amount of $ .....208x000:00......,.,., . COSTS TO BORROWER NOT PART OF FINANCE CHARGE A. Mortgage Recording Fee...............................S 36.00 B. Title Insurance Premium...............................S 1113.50 C. Credit Report.................................................S 28.00 D. Real Property Taxes.....................................S —0— E. Reserve Account For Taxes And Insurance S 2611.78 F. Appraisal Fees................................................S poc G. Fee For Preparation of Deeds, Settle- ment Statements or Other Documents ......... S —0— H. klAka.i t- RRs...........ARTS...fee......................S 25.00 I. Survey or Other............................................S poc TO COMPUTE FACTOR FOR OBTAINING ANNUAL PERCENTAGE RATE USE: TOTAL OF LINE 7 X 100 FACTOR' TOTAL OF LINE 3 "Refer to conversion table for annual percentage rate. ANNUAL PERCENTAGE RATE 10.250 % MONTHLY PAYMENT Principal & interest 1,825.35 1/12 annual taxes 228.98 1/12 annual hazard ins. 150.67 1/12 annual PMI 26.00 TOTAL PAYMENT: 2,231.00 1. NOTE AMOUNT S 208,000.00 2. LESS WITHHELD FINANCE CHARGE S 4,240.86 Net Loan Proceeds S 203,759.14 Other Charges Financed (if any) S —0- S 203,759.14 3. Ah10UNT FINANCED (1.2) PREPAID FINANCE CHARGES A. Origination or Loan Fee S 2,080.00 B. Loan Discount Paid byBuyer ....................... S C. Loan Discount Paid by Seller ....................... S D. Interest From 3/1/7/77 To One Month Prior To First Payment......... S 808.86 Commitment fee 1,040.00 E. FYAttr;AT4*'4 ................. S 312.00 1st yr PMI fee 4. TOTAL PREPAID FINANCE CHARGES S 4,240.86 5 Finance Charge Withheld From Loan (H e-0 S4 ,140.66 Enter In 2 Above , FINANCE CHARGES NOT PREPAID A. Interest % Per Annum ....................... S449,126.00 B. FHA Insurance Premium or Other Guaranty of Default Insurance .15 %Per Annum S 3,120.00 C. Finance Charges will Begin to Accrue on (Date) 4-1-77 6. TOTAL UNPAID FINANCE CHARGES........ 5452,246.00 7. TOTAL FINANCE CHARGE (4 + 6) S 456,486.86 B. TOTAL OF PAYMENTS 0 + 6) S 664,486.86 PAYMENTS: The total of payments will be payable in 360 installments of S 1,825.35 commencing May 01, 1977 and continuing on the same day of each month thereafter until fully paid. 4X LATE CHARGES: A late charge of} 6 will be made for any payment more than fifteen (15) days past due. SECURITY: Borrower's indebtedness is secured by a deed of trust or mortgage upon the house and lot commonly known as Lot 6, Block 3, Tuxendi Park S/D and is legally described in the security instrument, a copy of which will be provided to the borrower. This security interest secures other and future advances and indebtedness and covers after-acquired property attached or affixed to the premises. Regardless of any other existing agreement with bank, this indebtedness will not be secured except as herein indicated or in the attached Security Agreement. I received a copy of this disclosure statement and have not yet signed any documents eevid or securing the proposed loan. Date Parch 16 1977 Borrower Charlotte A. Snyder R.E. 601 (1.70) NATIONAL BANK OF ALASKA Fwm AFpeved OMB Ne. 63-R1501 A. U.S. DEPARTMENT OF HOUSING AND ..w BAN DEVELOPMENT DISCLOSURE/SETTLEMENT STATEMENT B. TYPE OF LOAN: 1. Q FMA Z• j= FMHA 3. CONV. LININS. 4. [:J VA S.MCONV. INS 6. FILE NUMBER 7. LOAN NUMBER 34479 If the Truth -in -Lending Act applies to this transaction, a Truth -in -Lending statement is attached as prc4e 3 of this form. 6. MORTG. INS. CASE NO. C. NOTE: This toren is furnished to you prior to settlement to give you information about your settlement costs, and again after s=ttlement to show the actual costs you have paid. The present copy of the form is: M ADVANCE DISCLOSURE OF COSTS. Some items are estimated, and are marked "(e)". Some amounts may change if the settlement is held on a date other than the date estimated below. The preparer of this form is not responsible for errors or changes in amounts furnished by others. The advance disclosure of prorations of taxes and assessment is based upon the assumption that taxes and assessments.,are not delinquent. ® STATEMENT OF ACTUAL COSTS. Amounts paid to and by the settlement agent are shown. Items marked "fp.o.c.)" were vaid outside the closin • they are shown here for D. NAME OF BORROWER Charlotte A. Snyder 3730 Rhone Circle Anchorage, Ak. 99504 E. SELLER Refinance F. LENDER National Bank of Alaska P. 0. Box 600 Anchorage, Alaska 99510 G. PROPERTY LOCATION 000 Copper Drive Anchorage,N Ak. 99502 6/3 Tuxedni Park SID H. SETTLEMENT AGENT NBA I. DATES LOAN COMMITMENT ADVANCE DISCLOSURE PLACE OFSETTLEMENT NBA- 5th * Gambell Br. SETTLEMENT 3/16/77 DATE OF PRORATIONS IF DIFFERENT FROM SETTLE - MENT 3.17.77 J. SUMMARY OF BORROWER'S TRANSACTION K. SUMMARY OF SELLER'S TRANSACTION 100. GROSS AMOUNT DUE FROM BORROWER: 400. GROSS AMOUNT DUE TO SELLER: 401. Contract sales price 101. }Lo]iiXYa(s let Mtg. Payoff in 402. Personal property 102.7G7:Y)6137 171 443.75 403. 103. Settlement charges to borrower (from line 1400, Section L) 8,055.14 404. Adjustments for items aid b seller in advance: I P Y 1h 105. 405.City/town taxes to adjustments for items paid by seller in advance: 406. County taxes to407. Assessments to 106. Cit /town taxes to 408. to 107. County taxes to 409. to 108. Assessments to 410. to 109, to 411. to 110' to 420. GROSS AMOUNT DUE TO SELLER 111. to 112. to NOTE: The following 500 and 600 series sections are not required to be completed when this form is used for advance disclosure of settlement costs prior to settlement. 120. GROSS AMOUNT DUE FROM BORROWER: 179 498.89 100. AMOUNTS PAID BY OR IN BEHALF OF BORROWER; 500. REDUCTIONS IN AMOUNT DUE TO SELLER: Payoffo first mortgage loan 201. Deposit or earnest money 502. Payoff of second mortgage loan 201. Principal amount of new loons 0 0 203. Existingloon(s) taken subject to 503. Settlement charges to seller /from fine /400. Section L1 204• Prepaid commitment 504. Existing loon(s) taken subject to 205. -redits to borrower for items unpaid by seller: 505. 506. City,rtown taxes to $07. 07. Count taxes to 508. 208. Assessments .-to 509. 209. to Credits to borrower for items unpaid by seller: 210. to 211. to 510. Cit /town taxes to 212. to 511. County taxes to 20 TOTAL AMOUNTS PAID BY OR IN BEHALF OF BORROWER 1209,040.00 Assessments to _511. 513. to 300. CASH AT SETTLEMENT REQUIRED FROM OR PAYABLE TO BORROWER: 514. to ' 515. to 301. Gross amount due from borrower (front line 120) 179 498.89 520. TOTAL REDUCTIONS IN AMOUNT DUE TO SELLER: 600. CASH TO SELLER FROM SETTLEMENT: 02. Less amounts paid by or in behalf of borrower (from line 220) ( ) 209,040.0 601. Gross amount due to seller (from line 420) 602. Less total reductions in amount due to sellerffrom line 520 ( ) 03. CASH (Q REQUIRED FROM) OR fE3PAYABLE TO) BORROWER: 29,541.13603. CASH TO SELLER FROM SETTLEMENT HUD -1 (5-75) e" CHARLOTTE Al SA ER . (A-� NATIONAL BANK OF ALASKA r-1 L. SETTLEMENT CHARGES PAID FROM BORROWER'S FUNDS 700. SALEVBROKER'S COMMISSION►asedee FAce S r✓•r^ !• % r/i ;4f I.i'• I L ALTC' 701. Total commission paid by seller Division of commission as follows: 702. $ to X. 703. S to 704. 800. ITEMS PAYABLE IN CONNECTION WITH LOAN. �:: i ^. , . 801. Loan Origination % 802. Loan Discount r ^ % • 803. Appraisal Fee to r ; 804. Credit Report to 805. Lenders inspection fee 806. Mortgage Insurance application fee to ! r. 807. Assumption/refinancing Assumption/refinancingfee 808. Alaska Realt Tax Service 809. Un erwriting ees to: 810. Commitment fees to: 7.:r;rcrr :-• p,• .r 811. 900. ITEMS REQUIRED BY LENDER TO BE PAID IN ADVANCE. 0E.86 901. Interest from c,z to "3 53.52 /day 902. Mortgage insurance premium for I mo. to r TTR . CZJI;._T�Al.Ty2 (:I 903. Hazard insurance premium for 1Its- to C -117 01-F AD+. ;iS.17 :, .C..r, 904. raj? 'F cPITs'.ly^ ] rs.to .CG 905. 1000. RESERVES DEPOSITED WITH LENDER FOR: ✓o^A M1 1001. Hazard insurance r%(•c mo. S Sr, F mo. 1002. Mortgage insurance r-') mo. $S 2 r 0 0 /mo. 1003. City property taxes mo. RS /mo. 1004. County property taxed! mo. RS 197.9p /mo. A655.76 1005. Annual assessments mo. S / mo. 1006 Flood Insuranceo mo. R$ ,C,0 Mo. .f:t 1007. va _:ras rLr!? mo. mo. .C(, 1008. mo. ili mo. 1100. TITLE CHARGES: 1101. Settlement or closing fee to 1102. Abstract or title search to it a examination to 1104. Title insurance binder to 1105. Document preparation to !` 1106. Notary fees to 1107. Attorney's Fees to (includes above Items No.: c 1108. Title insurance to ''CI'FTTY T-ITTF TFUST CO.0i: r 1JLSFL / 1113.5s _ (includes above Items No.: 1 1109. Lender's coverage S 1110. Owner's coverage $ 1111. 1112_ 1113. 1200. GOVERNMENT RECORDING AND TRANSFER CHARGES 1201. Recording fees: Deed S I1c' ; Aloitao a �etl =•� Releases S 2r. - l"1202. 1202.it / n /stamns, Deed S . modcasp 1203.03. StaOtt ps Deed S Marlgag 12 1300. ADDITIONAL SETTLEMENT CHARGES 1301, Survey to 1302. Pest inspection to 1303. Final Inspection Fee 1304. 1305. 1400. TOTAL SETTLEMENT CHARGES !entered on lines 103 and 503. Sections! and K) NOTE: Under certain circumstances the borrower and seller may be permitted to witive the 12 -day period whit occur between advance disclosure and settlement. In the event such a waiver is node, copies of the statemen executed as provided in the regulations of the Department of Housing and Urban Development, shall be attachr port of this form when the form is used as a settlement statement.