HomeMy WebLinkAboutFIREWEED HILL BLK 1 LT 6
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVlRONMENI'AL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME
MAILING ADDRESS
LEGAL DESCRIPTION
LOCATION
Well Absorption area
DISTANCE TO:
Liq. capacity in gallons IF HOMEMADE: ] Inside length
/
DISTANCE TO: Well / Dwellill!t
/
I .7PH° _1 J NEW
9 ':Lco2'f
Well
DISTANCE TO:
No. of lines Length of each line
~ of tile Io finish ~jrade
Dwellmg
Mat~riai
Foundation Nearest lot line
Total length o[ lines Trench whlth
Material beneath tim
NO. OF [;~DROOMS
PERMIT NO.
No. of com%tments
Liqu id depth
PERMIT NO.
in gallons
PERMIT NO.
Total effeclive absolption area
Type of crib
DISTANCE TO:
IClass
J DISTANCE TO:
' I PERMIT NO.
Width { 8' Depth I.~'.- ~ ] ~b~/'~¢'--(~-----~ ~'?t
Crib~_~i.c. m et~6diamete~ - F --I ~m'ii~lept I;__. ..... % .... ~tal ef fectiv~t:~o n area _~_~, ~,
Well , Building foundation Nearest lot I ne .~ l
Depth ~riller Distance to lot line J PERMIT NO.
OTHER
PIPE MATERIALS
D
SOIL TEST RATING
INSTALLER
REMARKS
APPROVED DATE LEGAL
72-013 (Rev, 3/78)
) 'J.d]O
J. tlVdlDINi'IW
I1~,~'~ Ib]l IP,.II ~ ~.": ~ IF::" r¢.'-h IL.... ]: '"11-' '%"~ I[Z]~ F2" d~7-'h l~,14l I[]~ ~b..I I[]]1 ~:;~: ~Z!h ~ E~
DEPARTMEIxlT OF: HEAL..]'H AND ENV.TRONMENTAL. PROTECTION
825 L. STREET, ANCHOF~AE'~E, Al'::: 9950 :L
264'-'4720
PERM I'T' NO:
DATE ISSUED:
APPL. I CANT':
A D D R E S S:
CONTACT PHONE:
L. EGAL. DESCR I F':
L 0 T 81 Z E:
MAX BEDROOMS:
840829
09/2.818ll.
AL. ASKA CLJSTOM HOME'] BUII..DERS
804 IE 15]"14:1~3
ANCHORAGE, Al..'.: 99503
276-5:];88
SUBDIVISION: FIREWEED'HILL4~I
SE:CT I (]lq: 3 TOWNSH I F': .1..l N
.1.32()0 (SQ. FT. (]IR ACRES)
2
LOT: 6 BLOCK: :1.
RANGE: 3W
L..iste(.t. I:..)elow are the options availab].e to you in des:i, gning ye) ur septic
system. , Cl~oose the Ol:)'Lion tha'[, best fi'L~ yoLtP site.
DEF:'TH TO F'IF'E BOTTOId (FI".) 4.0 ¢ 4.0
GRAVEl... DEF:']"H (F"I".)
TOTAL DEPTFI (FI",)
GRAVE:I.~ Wlfil'H (F"l",)
GRAVEL LENGTH (FT,)
GRAVEL. VOLUME (CU.YDS.)
TANK SIZE (GAL. S)
S[]II_. RATIIq['.3 (SQ,, F:'T, /BR)
1 **
0,, 5 / '-~ n
4.5/"// 6. ()
18. ()P/ 5.0
35 ,, 0 / 62.0
23',, 4 28 ,, 8
000,,0 ~* 1,00().() **
209 220
** GRAVEl... I...EI",IGTH > 75 F:'T, REQLIIIRE'."S MUL'T'IPLE RUNS (NE)]" IFX[.]EEDI. I".IG 75 F:']", EACH)
*-~E. TANK MUST HAVE A'T' LE.'".A3T TWO COMPARTMli~':NTS
I cer'f..iFy that:
.1.. I am fami].iai' with the requirements for' on-site sewer's and we].Is as set
£or'th by 'f..he Municipality of" Anchor'age (MOA) and the State o~' Alaska.
2. I will :i. nstall the system in acc:ordance w:i. th all MGA cc)des and r'egulat:i, or~s,
and :i.n compliance with the des:i, gn (:::r'iten:i.a (:~f this I:)er'm:i.t.
3. I wi].], adhepe to all M[]A and State of Alaska r'equ:Lpemer~ts for' the set bacl.::
distanc:es From any existing well, wastewater' d:Lsposa], system of public
sewerage sys't;.e¢l, on '[.his or any adjacent up near'by ].ot.
4. I under'stand that this penmit is valid for' a maximum o¢ 2 bedr'ooms and
any enlargement will require an additional per'mit.
IF A L. IFT STATION IS INSTAI..I..E:D IN AN ARI.?]A COVERED BY MOA BUILDING CODIES,
]"HEN (~) AN ELECTF~ICAL. F'ERMIT AND INSPECTION MUST BE OBTAINED; (2) AS.'-'BtJIL. TS
WIL..L. NO]" BE APPIROVED WITHOUT AN ELECTRICAL. INSF'ECTI[]N RE, PORT; AND (3) 'T'I-IE
EI...EC'TF~ICAL. W(]R!< MUST BE: DONE BY A I....ICENSED EELECTF~ICIAN.
APF:)L.,ICANT: ALASKA CUSTOM HOIdE BUII..DERS
4UNICIPALITY OF ANCHORAGE '
DEPARTMENT OF HEALTH AND ENV!RONMENTAL PROTECTION ~25 L. ~treet. A.-.~%~. Alesk, 99501 264-4720
SOILS LOG - PERCOLATION TEST
SOILS LOG
PERCOLATION
TEST
PERFORMED FOR:
DATE PERFORMED: ..~//~"~ ./' ~:~"~
LEGAL DESCRIPTION:,
2
6
6
7
~o/~ ST 05 OZ~
SITE PLAN
10
11
12
13
14
15
16
17
18
19
2O
,PERFORMED BY:
7E.,OOB
WAS GROUND WATER S
ENCOUNTERED? ~t 5
O
P
E
IF YES. AT WHAT
DEPTH? )~ ~ '
0 _=o
Date Gra~ Net D~oth to Net
Time Time Water Drop
1~2~ 25 -5~
itSZ ~ t,o~
PERCOLATION RATE I~ (minute~finch)
TEST RUN BETWEEN ~' ~' FT AND ~ FT
· C~,-~ ~' ~ tS'.
Municipality or A,]chorage
Development Services Department
Building Safely Division
On-Sile Water and Wastewater Program
,{700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage,ok.us
(907) 3,{3-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
1. GENERAL INFORMATION
Comoleleleaaldescrintion Lot 6, Block 1, Fireweed Hill
Location (site address o~' directions)
Curr. ent Property owner(s) Chris Moore Day phone
Ma. iling address"
Lending agency
Mailing address
Expiration Date: ~' - ~ ,~-o O,..~...
Subdivision
10840 Walnut Circle - Anchorage, Ak..99516
350-2156
i0840 Walnut Circle - Anchorage, Ak. 99516
Day phone
Real Estate Agent
Mailing Address
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 2
Day phone
3. TYPE OF WATER SUPPLY: .-
Individual Well
Individual Water Stora. ge
Community Class ~ Well
Public Water System
TYPE OF WASTEWATER DISPOSAL:
Individual On-site ~
Individual Holding tank []
Community On-site
[]
Public Sewer []
The Municipality of Anchorage De~'e]opmenl Services Depart'riehl (DSD) Issues Certificates of Health Aulhorlly
Approval (HAA) based only.upon the representallons given In paragraph 5 by an Independent professional civil
engineer registered In Ihe State of Alaska. Certificates of Health Authority Approval are required for the Iranst'er of
lille (except between spouses) for properties served by a single family/on-site wastewater disposal ahd/or wa[er
supply system. DSD also Issues HAAs upon request to homeowners. Certificates or' Health Authority Approval are
valid Ior 90 days from Ihe date of Issue Ior properties served by a private or Cla~s C well and may be reissued wlIh
new water sample results less Ihan 30 days old. (Certificates may be reissued for a period o1' up to one year with
valid water samples.) Cerlific~a~s are valid {'oi' one year for properties served by Class A or B wells or a public
water system. The Municipality o1' Anchorage Is no~ responsible for errors or omissions In the professional
engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As cerfified by my seal affixed hereto and as o~' the validalion dale shown below, I verify that my tnvesligalion,
based on procedures outlined In Ihe Health Authority Approval Guidelines for this applicafion, shows that Ihe
on-sile water supply and/or waslewater disposal syslem Is(are) safe, functional and adequate for the number of
bedrooms and type of structure Indicated herein. I fudher verify that based on Ihe Information obtained from the
Municipality of Anchorage files and from my Investigation and Inspeclion, 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 Installafion.
Nameo[Firm S & S Engineering
Address
17034 Eagle River Loop Rd. - Eagle
Engineer's Printed Name Robert C, · Cowan
5. DSD SIGNATURE
· V" Approved for ::2_
Disapproved.
Conditional approval [or
bedrooms.
Phone 694-2979
River,..~k..../. L99577
Da,e ,.,
~edrooms, ~ilh Ihe following slipulalions:
Additional Comments
Attachments:
HA& Checklist
Septic System Advisory
Well Flow Advisory
X
Maintenance Agreements
Supplemental Engineer's Report
O(her
Original Cedificate Date: .~"'o
Municipality of Anchorage
Development Services Department
Building Safety Dlvlalan
On-Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Ancflorage, AK 99519-6650
www.ci.anchorage.ak, us - -
(907) 343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
LegalDescflptlon: L-t~'T- ~a 0t-oeec I F,~4~we~,~ H-.L 'Y/~ParcellO:
A. WELL OATA
Wall type/O/~, ,V& r'~ If A, B, or C provide PWSID #
Date completed"'"/q S'¥ Sanitary seal {~/N) YaJ
Well ~ ~ Ye-j'
Wlres properly pn:~ectedi:~/N) Y~'J
Casing height (above gmund) o~q~ in.
FROM WELL LOG
Stetic water lavel ;..~"~,'/-~0 It
Wall production / 0 g.p,m.
WATER SAMPLE RESULTS:
Coliform O .colonies/100 mi.
Nitrate O, 3, mg./I.
Date of sample: .~/7,/0 '~
AT INSPECTION
B. SEPTIC~OLDING TANK DATA
Tank TypeJMaterlal ~.,~ r, ~- /
Tan~ see :/0° 0 gal. Numar of ~m~ ~
Found~on deano~ ~) ~4 J ~pmssion ~r ~nk (Y~ pa
oa~ ~'~mping t/~/ ~ Pum~r
C.ABsO~ON FIE~ OATA '
m~l dep~ ~
OUter bacteria 0 colonies/100 mi.
170~4 fagls Rlvm' Loop I~C, ad/~o. 204
Date installed )o/1. ~/g ,¥
Cleanoute (~/N) y,e. $
High water alarm (Y(~ ~v o
Date of adequacy
Fluid deplh in alosorl~on field before test q '/~ in. Water edded~ ] I gal. New dept~. ~' $~ in.
ElapsedTime:~3 min. FinalfluiddepU1 ~"~ in. Abaorpfion rote >= ~00 g.p.d.
Any mjuvenafion treatment (past 12 mo.) (Y/N & type) ,M)~/(& A, ~'0~,~./ If yes, give date --
System type
Gravel below pipe ~ o -~- fl.
ff. Eft. absorption area
test~Z/~/O'z- Resulte'~Fall) I~"~f For ~- bedrooms
D. UFT STATION
Data installed Size in gallons Manhole'
'Pump on' level at in. *P~igh water alarm level at
Datum ~...------"'"'"'~ycles tasted Meets alarm & circuit requirements?
E. SEPARATION DISTANCES
7
SEPARATION DISTANCES FROM WELL ON LOT/tTO:
Septic lank/lift station on lot /t~o ~
Absorption field on lot
Public sewer main
Sewer/septic service line
/0 0 ¢4-
tn.
On adjacent lots
Public ~er ~nhol~deano~
Holding ~nk ~/~
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation -~'/'+'
Water main /./ /4'
Wells on adjacent lots / QO '
Property line 5"' -/- Absorption field
Water service line /O -/- Surfacewatar /0o /--~-
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Prope~'y line I O 4- Building foundation /0 ~ Water main
Water Sewice line I0 ~ Surfacewatar / ~ 0 ~
Driveway, pafldngNehicie ~torege
Wells on adjacent lots / Oe
Curtain drain 1~ ~'"'~ &,~e~,,~
· F. COMMENTS.. .... ., .~ ~
G. ENGINEER'S CERTIFICATION ~'~ ~''
m~w of Mun~pal ~ ~at ~e
~a~ ~ MOA H~ gu~lines
HAA Fee $.
Data of Payment
Receipt Number
(~ev.
Waiver Fee $
Date of Payment
Receipt Number
FEB-OI-2002 FRI 02:00 PM I£GISIRTIVE RUDIT 907 561 1452 P. Ol
I
iI
· ' · ~,, ..... :,[.' th~.e~stence.o~'any ;'l
E E OF ECORD, OTHER THAN '.. 'strlct~ons wht~E do.not' appear od.the
THOSEpLAT,·ARE. NOT'SHOWNIHEREON.$HOWNI:q[I THE 'RECORDED:l,.. .1'. dtvi!s~on plat..Under no 'cirdum~c'6~;'~
· .'...:'.'....'..... .... ]i data. h.e~eon.be u'sed, for.coh~truct'3on':6
i'; ' :. ..- · . ...l~shm~.beun~:~. .. e~.~ence.'lmes.:The:'[
L(
res~onsLbtl{tg: fo, l?' the
ANCHORAGE RECORDING DIST, RIC,T, .. II. ,.- R[Vl$:0~$ ' I: .l.:.I OAT£ I BY .
MUNICIPALITY OF ANCHORAGE
DEPARTMEr~ r OF HEALTH AND ENVIRONMENTAL PRUTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF iNSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date
1. GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, range)
J.-~ 81. ~[R~LI, IEF-f) ~JLL_5 T/2~ /~J~cU' ,-,~C.
." Iroc.~.,ort. (;d, dre, ss"qr directions)
,.Apprl,c,a.h,t. ua.m.'.~,~.O.N~.E. Telephone: Home ,
ApplicantAddress ~001 fi. I~EN$O~,I ~-NCH,
% (c)'..APl~lic'~n~ i~"(~'t~ech~o~e): Lending Institution []; Owner/builder ~['; Buyer []; Other [] (explain);
' ' ,'. "' .~ ' ,~*
(d) Lending Instjtutibn I¥[r'~ Telephone
Business
(e)
Address
Real Estate Company and Agent
Address
Telephone
(f) Mail the HAA to the following address:
TYPE OF RESIDENCE
Singte-Family,~' Multi-Family []
Number of Bedrooms '~
Other
WATER SUPPLY
Individual Well ~ Community [] Public []
Note: If corn munity well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
OnsiteJ~ 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.
Page 1 of 2 72-025 111,84)
ENGINEERING FIRM PROVID, ..~ ,..,SPECTIONS. TESTS, FILE SEARCH, L ,.'~, ,ND 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 ~C~' //V'~--~z Telephone .~[
DHEP APPROVAL
Approved for 2
Approved /~
Disapproved Conditional
Terms of Conditional Approval
CAUTION
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional
engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or
analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the
professional engineer's work.
Page 2 of 2
72-025 { 11/84)
WELL DATA
MUNICIPALITY OF ANCHORAGE
MUN]¢IP^UTY OF ANc~TH AUTHORITY APPROVAL (HAA)
DE¢~. OF HF^LTH & CHECKLIST- FEBRUARY 1984
ENVIRONMENTAL PROTECTION 264-4720
~NOV r~ ~ Legal Description:
T) 2 N
RECEIVED
Well Classification J,N~01U{~,,~g/~/-- If A, B. C, D.E.C. ~proved (Y/N)
Well Log Present~'¥['t~ DateCom/pleted ~K/'I(0/,/~/~/~ . Yield
Total Depth ~-0F~ Cased ~ ~ '~ Depth of Grouting
Static Water Level ~,~ ',~ Pump Set At /~,-,~ /-~
q / Sanitary Seal on Casing ~N)
Depression Around Wellhead (Y/~
Casing Height Above Ground
Electrical Wiring in Conduit t~/N)
Separation Distances from Well:
To Septic/Holding Tank on Lot
; On Adjoining Lots
; On Adjoining Lots
leo ''''~-
To Nearest Edge of Absorption Field on Lot J ~
To Nearest Public Sewer Line ~//~1' To Nearest Public Sewer
Cleanout/Manhole ~V/~I~ To Nearest Sewer Service Line on Lot
Q. RhlT'C[.t¢cK ; Date
Water Sample Collected by
Water Sample Test Results
B. SEPTIC/HOLDING TANK DATA
Date Installed
Standpipes ~N)
Depression over Tank (~'J~
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N) ~t.///~-,
Separation Distances from Septic/Holding Tank:
TO Water-Supply Well 00
To Property Line
TO Water Main/Service Line
Course ) 0(~ /
Comments "~ '-~'~
Size 1000 No. of Compartments
Air-tight Caps(~N) Foundation Cleanout (~,,,N)
Date Last Pumped
N/A ;for /1///~-
Temporary Holding Tank Permit (Y/N)
To Building Foundation / ~ /
To Disposal Field t,~ /
To Stream, Pond, Lake. or Major Drainage
c6 E oF
Pagelof2 ' ~ '~
72-026(11/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed
Width of Field / / ~/-
Square Feet of Absorption Area
Depression over Field ,(Y~)
Results of Last Adequacy Test
,..
Type of System Design ~:,~
Length of Field
Depth of Field
Gravel Bed Thickness
Standpipes Present ~N)
Date of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well
To Building Foundation
Lot /~//~F
TO Water Main/Service Line /'~//~ To Cutbank (if present)
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, P~,~ing Area, or Vehicle Storage Area / ~)/'~"'~
To Property Line ] (~ /
To Existing or Abandoned System on
; On Adjoining Lots -"~O/''/-
/
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Comments
Dimensions
Manhole/Access (Y/N)
"Pump ~__
~..-~Went (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
** Check Permitt BeE~edroom Rating Against HAA Request **
I certify that I hav,~ ~n~.~c k, gd~y,e/rified,,.-)or conformed to all MO.A and. HAA guidelines in effect on the date of this inspection.
Signed Q,gl~~ Date ~ //~7/<~.~"'
Company ~ f/~'~--~...~ //1/~,, MOA No ' ~:~,.,~--~)ZY
Receipt No. ~L,~(,.~ '~
Date of Payment
Amount: $
Page 2 of 2
72-026 (11184)
ALASKA ENVIRONMENTAL
CONTROL SER~''~r'', INC.
1200 West 33rd A~ ,u , Suite B
ANCHORAGE, ALASKA 99503
(907) 561-5040
~HEET NO.~ OF
CALCULATED BY DATE
CHECKED BY DATE
~ I~ 20~
/
O,'c/~
'x
72'
wELL
WA1 Er~WELL. TEST PI~P hEr, ORT
Well Location /~.-(/~/ Z:2..~..oc.-~ /,. ,/.~/~ ~'
Well Information: Ttl. Depth _.~OJr Depth of Casing ~-~-~ Screen
Casing Size ~/'/' Screen Dlam -
Pump Information:
Pump On:
Sheet of
Date:
From/~//~ To ~
Screen Slot
Remarks
Intake Depth ~_Puml) Size ~c2. /~z? ~.~-~lz~/~ ~<~-~. Air Line Depth
Static Water Level /~-~"~a~ Av. ~acharge ~ GPM, Max. Drawdown
Time /TrO~),~, Date Pump Off: ~.~O_~Tlma /'~,~/~,-. Date~l~r
WATER PIEZO- FLOW WATER PIEZO- FLOW
TIME REMARKS TIME REMARKS
LEVEL TUBE GPM LEVEL TUBE GPM
7.'~o /*o -' ' ~
fi&u xicip ,- y ..o. E 196650
ANCHORAGE, ALASKA 99519-6650
Of (907) 264-4111
A xchora e
MA YOR
DEPARTMENT OF HEALTH & HUMAN SERVICES
February 11, 1987
Jeff Kaitchuck
Engineering Technician
Alaska Environmental Control Services, Inc.
1200 West 33rd Avenue, Suite B
Anchorage, Alaska 99503
Subject: Lot 6 Block 1 Fireweed Hills Subdivision
Waiver request Number WR87015
Dear Mr. Kaitchuck:
Your waiver request dated February 2, 1987 for the above
mentioned parcel has been approved. The required separation
of 100 feet from the well on Lot 7 serving the house on Lot 6
to the septic tank on Lot 7 has been waived to 83 feet.
This waiver applies to this existing septic tank and well
separation. If the owner of Lot 7 upgrades the existing septic
system in any way, another waiver approval may be required from
D.H.H.S.
Sincerely,
Daniel J. Roth
civil Engineer
On-Site Services
ALASKA ~idlROFIlTIeFITAL COFITROL S~RuIC~$, IFIL
~nqincerinq $ ~naironmenlo[ $1ucJics
i~uN~C{PALITY OF ANCHORAOE
v,'},!'t d~'~, 2 i(i~,.Jz~. OF HEALTH &
~E6 6 tqm7
R~: ),()/ G. l;Ioci< I . Fireweed Hi I]s Stl} divi
geoLogi t:a] corld~ti OlU~ f'o] ]ows:
Thc war:(.', table
Poi[ii V~!lu ,
5.o %48
2.()/, ~'~'
ihau 60%
~) "2 ?
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
Permit #: 840829
January 31, 1985
TO: Permit Applicant
SUBJECT: Lot 6 Block 1 Fireweed Hill Subdivision
A permit issued by this Department for an individual well
and/or on-site sewer system has expired as of December 31,
1984.
Permits are issued on a calendar year basis by autho=ity
of Municipal Ordinance. A new permit must be obtained from
this Department for any well and/or on-site sewer system not
installed by the expiration date.
If you have drilled the well, a well log needs to be sent
to this Department for documentation of the installation
and to close the permit.
If a private engineer inspected the installation of the
on-site sewer system, the original as-built inspection report
and the yellow copy must be sent to this office for review
and approval, and for documentation.
If there are any further questions, please call this office
at 264-4720.
Sincerely,
Keith E. Bandt, Supervisor
Environmental Engineering Program
KEB/ljw
enc: Copy of Permit
SWP/057
HIS AGREEMEN~ made and entered into this ~'~k~day of
July, 1985, by and between, HOME SAVINGS & LOAN-~OCIATION,
a state chartered savings and loan association of 1001 E.
Benson Boulevard, Anchorage, Alaska 99508, hereinafter
referred to as "HS&L", and GEORGE ROY PERKINS and LORI C.
PERKINS, husband and wife of 10800 Walnut Circle, Anchoraqe,
Alaska 99516, hereinafter referred to as "PERKINS":
W I TNES SETH:
THAT WHEREAS, PERKINS are the owners of Lot' Seven (7),
Block One (1), FIREWEED HILLS SUBDIVISION, Accordinq to the
official plat thereof, filed under Plat No. 70-248, records
of the Anchorage Recording District, Third Judicial District
State of Alaska; and,
WHEREAS, HS&L, has financed construction to RONALD
G. DRAVES, and DONALD TIDRINGTON of a single family residence
upon Lot Six (6), Block One (1), FIREWEED HILLS SUBDIVISION,
According to the official plat thereof, filed under Plat No.
70-248, records of the Anchorage RecordingDistrict, Third
Judicial District, State of Alaska; and,
W~EREAS, the well for use in the construction of the
single family residence upon Lot Six (6), Block One (1), was
erroneously placed upon Lot Seven (7), Block One (1) belonqin~
to the PERKINS; and, '
WHEREAS, after numerous negotiations, the parties have
agreed to the establishment of a permanent easement to provide
ownership of and access to the well located upon the PERKINS
property to Lot Six (6), Block One (1) upon the followinq
terms and conditions, which the parites hereto desire to reduce
to writing:
NOW THEREFORE, for and in consideration of the payment
by HS&L to PERKINS of the sum of TWO THOUSAND SIX HUNDRED TEN
and No/100 ($2,610.00) DOLLARS, and the terms and conditions
to be kept and to be performed by the respective parties
to this agreement, the parties do hereby agree as follows:
1. HS&L shall pay to PERKINS, the sum of TWO THOUSAND
SIX HUNDRED TEN and No/100 ($2,610.00) DOLLARS, concurrent
with the execution of this agreement, receipt of which is
hereby acknowledged by PERKINS;
2. That HS&L, its successors and assiqns, shall
be and hereby granted and perpetual easement, over and upon
Lot Seven (7), Block One (1), FIREWEED HILLS SUBDIVISION,
According to the official plat thereof, filed under Plat No.
· . 70-248, records of the Anchorage Recording District, Third
Judicial District, State of Alaska where the well providin~
water to Lot Six (6), Block One (1), FIREWEED HILLS SUBDIVISION,
is presently located and installed, for the purpose of makinq
inspection of, or repair to the well, pump, and connecting
lines; .
3. That HS&L, its successors and assigns shall
have the right of egress, ingress and regress, over and upon
Lot Seven (7), Block One (1) FIREWEED HILLS SUBDIVISION
for t~he purpose of making inspection of, or repair to the well,
pump and connecting lines;
4. That upon completion of the pending foreclosure
proceedings against Lot Six (6), Block One (1), FIREWEED MILLS
SUBDIVISION, or upon the sale of said real property, H$&L
will insure that Alpine Drilling is paid the sum of $980.00
an no more, for the well pump, installed in the well located
upon Lot Seven (7), Block One (1), which provides water to
Lot Six (6), Block One (1), FIREWEED HILL~ SUBDIVISION;
5. That the parties hereto stipulate and aqree
that there is no way that a well can be placed upon Lot Six
(6), Block One (1), FIREWEED HILLS SUBDIVISION as a result of
the existing septic locations and that in the event, for
whatever reason, the well located upon Lot Seven (7), Block One (1),
FIREWEED HILLES SUBDIVISION, which provides water to
Lot Six (6), Block One (1), FIREWEED HILLS SUBDIVISION, should
ever need to be replaced or new water lines installed,
that HS&L, its successors and assigns shall have the
right to enter upon and replace or redrill the water well
and lines in their approximate present location~ FS&L
agrees that in so far as is possible, entry upon Lot Seven
(7), Block One (1) for repair or maintenance to the water well
and system shall be made over and upon a strip of real property
commencing at the Northeast common corner of the boundary
line between Lot Six (6), Block One (1), and Lot Seven (7), Block
One (1), thence northeasterly along the radius of the boundary
line of Lot Seven (7), Block One (1) a distince of thirtv
seven feet, thence northwest eight (8) feet, thence in a
straight line back to the common boundary line between Lot
Seven (7), Block One (1), and Lot Six (6), Block One (1),
thence south to the point of beginning. AccordinglY,
said parcel of real property is rectangular in shade apDroximatelv
thirty-seven (37) feet by eight (8) feet and includes the
present well location and all connecting lines thereto;
6. That in the event any disturbance of the surface
is made by entry upon Lot Seven (7), Block One (1), the surface
shall be restored to its original condition and form after entry
by HS&L, its successors and assigns;
7. That PERKINS hereby release HS&L, its successors
and assigns, from any and all loss, claim, demand or liability
as a result of the placement of the water well in question
upon Lot Seven (7), Block One (1) and will not, either
by themselves, or in conjunction with any other Derson or entity,
make or cause to be made any claim therefore whatsoever;
8. That the parties stipulate and agree that
payment of the sum of TWO THOUSAND SIX HUNDRED Ten and
No/100 ($2,610.00) DOLLARS is payment to PERKINS for any
and all damage(s) PERKINS has incurred in this matter but
that HS&L makes no admission of any responsibility for the
same, the same being expressly denied;
9. That HS&L shall be solely responsible for the
payment of any and all legal costs or other expenses, includina
recording fees incurred in the preparation, execution or recordina
of this document;
10. That this agreement shall attach'to and be
a covenant running with Lot Six (6), Block One (1), FIREWEED
HILLS SUBDIVISION, as hereinabove described;
This agreement shall inure to the benefit of and be bindin~
upon the heirs, executors, administrators, successors and
assigns of the respective parties hereto.
IN WITNESS WHEREOF,the parties have caused these presents
to bc ~xecut~d on the ~ay and year first hereinabove written.
-2-
HOME SAVINGS & LOAN
ASSOCIATION
Vice Presi [~n% ymo . ~eerin
STATE OF ALASKA )
)ss:
THIRD JUDICIAL DISTRICT )
THIS IS TO CERTIFY that on this ~3 day of July, 1985,
before me, the undersigned, a Notary Pu~ic in and for the State
of Alaska, duly commissioned and sworn as such, personally
appeared GEORGE ROY PERKINS, and LORI C. PERKINS, known to me and
known to be the identical individuals named in, and who
executed the foregoing instrument, and they did acknowledqe
to me that they signed and sealed the same freely and voluntarily
for the uses and purposes therein stated.
WITNESS MY HAND and Notarial Seal the day and year last
above written.
~otary Public in ~.nd
~My commission exDires: ~..)-[G'--1/~3C;
STATE OF ALASKA )
) ss:
THIRD JUDICIAL DISTRICT )
THIS IS TO CERTIFY that on this 2~day of %-~\~\~ , 1985,
before me, the undersigned, a Notary .D.-u-~ic in and'fo? the State
of Alaska, duly commissioned and sworn as such, personallw
appeared~-~~ ~, ~C~i ~ to me personally know~n, who,
being by m~ du%ly sWorn did say that ~ is the
of HOME SAVINGS & LOAN ASSOCIATION, and that saio
instrument was signed and sealed in behalf of said association, by
authority of its Board of Directors, and ~__did acknowledge
said instr~ent to be the free act and de~d ~f said association.
WITNESS my hand and Notarial Seal the day and year last
above written.
Notary PubIic 'in and f~gr ~Claska
My commission expires :~~_~