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Home My WebLink AboutPREUSS #4 BLK 9 LT 1Preuss ./it4 Block 9 Lot ! .#050-572-59 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P,O, Box 196650 · Anchorage, Alaska 9951~6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Per:mit Number, / 0 PID Number:, N"~':./,~.~'.ort ,~.~ ,)/~.~ /~e~:/.f~k./ WastewaterSystem: ~New C]Upgrade ^~*"~ ABSORPTION FIELD ~ ~ of ~ LEGAL DESCRIPTION ~'"'"~ , WEL~ Q New. ~ Upgrade G~ ~m: 5EPARA~ON DISTANCES ~t~~ HoId~ng ....~ ~T.~P. Rereads: ~*~ ~.,./.~ ~ ;,, ~/.~..~ BENCH MARK De pa dment of Health and Human Se~ices approval Revi.wed and approved ~7~Date: ~B Permit No. Sw000349 :Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: ,343-4744 0n-Site Wastewater Disposal System and/or Well Inspection Report Legal DescdpUon: Lot 1, Block 9 Pruess #4 No.: 050-575-59 Lucos Ave. Scale 1°-40' i !' I 5.00 -- S89'59'00"E. 163.35' 40.03 = Hous'i~'t'::2'''::'" 45.08 I 30.00 I 65.00 ~ I S89'59'00'E 163.33' CNOT TO SCALE) S~ing T~e$ MONITOR TUBE SDNER C~ OUT EASEMENT LDkCH FIELD Deck Orivewoy 9-5-00 ENC~NeER'S SEAL ~....: .............. :....~ '~.~Z. LOUISA. eUmRA .:~ ....... MUNICIPALITY OF ANCHORAGE Deparfment of Heetth and Human Services On-Sire Services Program 825 L Street, Room 502 P.O. Box 196650. Anchorage. AK 99519-6650 (907) 343.4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Sep 01,2000 Expiration Date: Sep 01, 2001 Permit Number: SW000349 Legal Description: PREUSS #4 BLK 9 LT 1 Design Engineer. 0024 Eagle River Engineering Services Owner Name: Lauren & Young Beskow Owner Address: 20630 Lucas Ave. Eagle River, AK 99577- Parcel ID: 050-572-59 Site Address: 020630 LUCAS AVE Lot Size: 19600 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of; [] Disposal Field [] Septic Tank [] Holding Tank [] Privy [] PdvateWell [] Water Storage All construction must be in accordance with: 1, The attached approved design. 2. Ail requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Ddnking Water Regulations ( 18AAC80 ). 3. The engineer must notify DHHS at least 2 hours pdor to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to Apdl 15, a subsurface soil absorption system under construction during freezing weather must be either. A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By:~~'~'~''--' Date: Issued By: ~~ Date: Eagle River Engineering Services Louis Butera, P.E. (907) 694-5195 tel P.O. Box 773294 (907) 694-3297 fax Eagle River, AK 99577-3294 September i, 2000 Jim Cross, P.E. Manager, On-Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: Lot 1, Block 9, Pruess Addn #4 Narrative & Permit Application Dear Mr. Cross: The proposed septic tank upgrade will have very limited impact on adjacent properties for the following reasons: 1. The surrounding lots are have public water connections, allowing sufficient room for septic sites. 2. Immediate neighboring septic systems are all +30' distance. 3. Reserve space is adequate, due to absorption capacity of the soil in this area (GP). 4. Drainage will not be affected and is not a major consideration in our design. This is a septic tank replacement in the same area as the old tank which has structurally failed, no special considerations. If you have any questions please call our office at 694-5195. Sincerely, Louis Butera, P.E. \1997~00-057NAR FLEMIRG SURVEYING S£RV C-=S. 8Z21 DEL STREET ANCHORAGE, ALASKA 99e'02 PHON( 241,4e~0 ,LEGAL DESCRIPTID'# ' LOT / , ILOClC C~ ' ...j..~ /_ Eagle River Engineering Services Louis Butera, P.E. P.O. Box 773294 (907) 694-5195 tel Eagle River, AK 99577-3294 (907) 694-3297 fax SPECIFICATIONS FOR SEPTIC TANK REPLACEMENT LEGAL: Lot 1, Block 9, Pmess Addn//4 6/8/99 A. GENERAL !. The site plan drawing shall be a part of this specification. 2. All materials and workmanship shall meet the requirements of Anchorage Department of Health and Environmental Protection Permit. TIlE SEPTIC TANK I. Septic tank construction shall be a 1250 gallon steel two compartment tank approved by the Municipality of Anchorage. 2. Septic tank is to be installed level on original base material. 3. Ali connections are to be made with caulder couplings. 4. The existing tank is to be pumped, removed and disposed of by burial onsite. 5. New tank to be provided ~vith 2 cleanouts after tank. \1997~00-057spec · /,'~ 't ~' MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVlRON[VlENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME .,.~-~ . PHONE ,PGRADE MAILING ADDRESS ~ ., ~ / J-// LEGAL DESCRIPTION / I Well Absorption area Dwelling PERMIT NO. DISTANCE TO: ~ z Manufacturer ~ ~ ~ ~ ~ ~- .~/ /~ ~ Material No. of compartments Liq. capacity in gallons Inside length Width IF HOMEMADE: Liquid depth ~Z~ ~ DISTANCE TO: Well ~~ Dwelling PERMITNO. O Z ~ Manufacturer Material Liquid capacity in gallons ;~ ' No. of lines / Length °~h 'i~ ~ Total Izt~` I~ Tron~idth~ inches Distance~2e~ne' ~ ~ Top 9~ti]e~o finis~ grad~ ~e~l ~t~ tile ~ '-- ~ /Z '-- ZZZ ' ~ If'inches Total effective absorption area ~ Length Width Depth / PERMIT NO. ~<~ Type of crib Cr,'~-__._~e e - (~ :// ~depth_ Total effective absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: ~ ~ Class ~ ~ /. ~t~ /'/~ ~ Driller Distance to lot line PERMIT NO, ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) PIPE MATERIALS ~ DATE LEGAL et/. · ~. ' Department, "~'~i%~-~ ~v~~ ~rotection ~ 825 ~ Street, Anchorage, AK. '~501/~'~ /~ / ~/ I 264-4720 C~ Permit# ~_~/~ ***HANDWRITTEN PERMIT*** ~'~ Location: Phone Number: ~~ Legal Description: //~ .~e~ Lot Size: Type of Soil~sorption System Is: Trench: ~ Drainfield: Seepage Bed: __ Holding Tank: Max~ N~ber of Bedrooms: ~ ~ Soil Rating(sq.ft/br) / The Required Size of the Soil ~sorption System Is: ' DEPTH ,?" LENGTH ~ GRAVEL DEPTH ~ WIDTH The length d~ension is the length(in feet) of the trench or drainfield. The depth 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 minim~ depth of gravel between the outfall pipe and the bottom of the excavation(in feet). ~~~/.__/ * * REQUIRED SEPTIC(HOLDING) TANK SIZE = ' ' GALLONS Pe~it applicant has the responsibility to info~ this department during the installation inspections of any wells adjacent to this property and the n~ber of residences that the well will serve. * * * TW0(2) INSPECTIONS ARE REQUIRED * * * Backfilling of any system without final inspection.and approval by this departmen- will be subject to prosecution. ~inimum distance between a well and any on-site sewage disposal system is 100 fee for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this 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 3 * * * I certify that: (1) I am familiar with the requirements for on-site sewers and wells as .. set forth by the ~unicipality of Anchorage. . (2) I wi~l~ install ~e system in accordance with codes. ~ (3) I/Cnd~s~,and/~t the on-site sewer system may require enlargement if ~he~/~/~ ~emodeled to include more thai 3 bedroomy/~ Sign~/~/////~j~ Issued by: ~~-F%~ pplicant ~ V .... S~rP/024 (1/81) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST /~' SOILS LOG [] PERCOLATION TEST · E~A, ~ESCRIPTION~ ~ / 7 8 9 I0 11 12 13 14 15 16 17, 18- 19- 20- -/ SLOPE ENCOUNTERED? E IF YES, AT WHAT DEPTH? SITE PLAN .P F Gross Net Depth to Net Reading Date Time Time Water Drop (minutes/inch) PERCOLATION RATE COMMENTS TEST RUN BETWEEN FT AND ,/,~T EXCAVATION ROBERT A. SHAFER WORK August 8, 1983 CIVIL ENGINEER 694-2979 ERA Bowden Realty ATTENTION: Beryl Gilbert 2600 Seward Highway Anchorage, Alaska 99503 Dear Mr. Gilbert, Reference: Lot 1: Block 9: Pruess Subdivision #4 A sewer system adequacy test was performed on the system located on the referenced property as you requested. The septic tank ,_was u~p_g/~ped and verified to have a capacity in excess of 1000 gallons. The seepage pit was charged with 800 gallons of fresh water and after a period of 24 hours all the water which ha~ been added to the crib remained in the crib. It can be concluded from this test that the septic tank is adequate for the th~e.e be~roo~ residence located on this property, h~we~-~_~e~'~_._p~-_~pp~ars to have complete f~il~d._ It will---~ecessary for you to have an absorption area upgraded before it can be considered adequate for a three bedroom house. If we may be of further service, please do not hesitate to contact ~.s. CC: Municipality of Anchorage Department of Health and Environmental Protection SRB 196X EAGLE RIVER, ALASKA oGR'- iTER ANCHORAGE AREA Be' :iUGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME ~o[,*, ~1'"'~ z. ~r¢~,c,( LOCATION LqcA~ A~'~ ~- ~)oN~o$ MAILING ADDRESS~--~ -~.,o~*~) ~ct~. ~.~) ~J~'. PHONE LEGAL DESCRIPTION ~' ! ~C¢~ ~ /~¢¢ SEPTIC TANK: DISTANCE FROM WELl MANUFACTURER MATERIAL. NUMBER OF COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH__ .LIQUID CAPACITY. /g~OO GALLONS. SEEPAGE PIT: NUMBER OF PITS LINING MATERIAL BUILDING FOUNDATION ADDITIONAL ABSORPTION DIAMETER ~'6 OR WIDTH If¢l, LENGTH /~, DEPTH ~' CRIB SIZE: DIAMETER DEPTH ~ DISTANCE FROM: WELL TOTAL EFFECTIVE , NEAREST LOT LINE ABSORPTION AREA (WALL AREA) .SQ. FT. WELL: TYPE <"~rz', ~. EO CONSTRUCTION ~T/t ~J D~p BUILDING NEAREST NEAREST FOUNDATION I.~'"' LOT LINE SEWER LINE CESSPOOL OTHER SOURCES APPROVED DISAPPROVED REMARKS DEPTH "'~--~ ~"- ~ DISTANCE FROM: SEPTIC SEEPAGE TAN K //g) ~ SYSTEM /-~0 ~ DISTANCES: INSTALLED BY: PIPE MATERIAl · LOT SLOPE: REMARKS: Form No, EQ-031 DIAGRAM OF SYSTEM DATE APP ROV E~.~.A.B~~'~ R&M EN6, . IEERING & GEOLOGI(L :L CONSULTANTS 229 EAST 51st. AVE. - P.O. BOX 6087 ' ANCHORAGE, ALASKA 99503 TELEPHONE 907-279--0483 TELEX 090-35419 Civil Engineers Geologists Land Surveyors JAMES W. ROONEY, P. E. MALCOLM A. MENZIES, P.E,, L.S. JAMES H. WELLMAN, P.E. RALPH R. MIGLIACClO E'nglneering Geologist. October 6, 1973 Mr. Mike Fitzpatrick General Delivery Eagle River, AK No. 36678 OCT' --1973- ~PT. OF ~NVI}~ONM~NTAL RE: TEST HOLE AND SOIL LOG REPORT FOR SANITARY SYSTEM LOT 1 BLOCK 9, PRUESS SUBDIVISION, EAGLE RIVER Dear Mr. Fitzpatrick: We are submitting herewith the test boring results and our comments regardin§ soil conditions encountered at the subject site. This investigation was performed in accordance with your request of October 2, 1973 and those procedures outlined in a letter dated September 13, 1971'by Mr. Rolf Strickland of the Greater Anchorage Area Borough Department of Environmental Quality. A single test hole was put down within the Lot 1 area for the purpose of defining general subsurface soil conditions for the proposed sanitary system. Excavation was accomplished with a tractor-mounted backhoe and the test hole was extended to a total depth of 14 feet below ground surface. The final log prepared for the test hole has been included in Drawing A-01. Ground water was not encountered in the test hole. We appreciate being given this opportunity ~o be of service to you. Should you have any questions with regard to the above, please do not hesitate to contact ns. Very truly yours, R & M ENGINEERING & GEOLOGICAL CONSULTANTS JWR:ls xc: Greater Anchorage Area Borough Eagle River ANCHORAGE FAIRBANKS JUNEAU NOTE: Organics Sand Sandy Gravel w/occasional cobble (sw) Gravelly Sand (SW) No Water Table 0.0~ 0.5' 1.0' 10.0, 14.0 T.D. 1) Water well drilled to 265'. 2) Test Hole excavated with tractor-mounted backhoe. Engineering ~, Geological Consul rants ANCHORAGE FAtF~BANKS ALASKA OO.~AU DATE SCALE 1"=2! IDWN mY JRS ICHKDBY RR [PRO&NO. 36678 Ic'we NO. A_Ol LOG OF DRILLING by A & L DRILLING COMPANY / DRAW DOWN FT. GALS. ~ER HR ....... ~f.o. ........................................ i ...... KIND OF CASING ............................................................. ~ROM._~ ................. ,-.~. To .5'7 ~T3~0 ~' ~ .............................................. FROM ........................ FT. TO ........................ FT ............................... ~o~..f.7 ............. ~. ~o._~.C~ ............. ~..._~:~_ .~ ~ ~ ~ ~ ~ FROM ........................ FT. TO ........................ FT .............. ' ......... ( ....... · o....J.e.~ .......... ~.._C_¢..~..~...~[4 ~ a~ c FRO~..~'-/ ................. ~T. FROM ........................ FT. TO ........................ FT .............................. ~o~_.~.~. ........... ~. ~o._...LE3 ......... ~....~.t~.~..~.¢~ ~%o~ ........................ ~. ~o ........................ ~: .............................. ~o~ /~} ....... ~.~o..2~.3 ......... ~.5'.0~ 9 ~o~ ........... ~ ............................ FROM ........................ FT. TO ............FT .............................. ............................................................... F~OM ...................... FT. TO ........................ FT ............................... ~o~2~ ......... ~. ~o....>.~ ........ ~.~?~_'c~..~0 ~f~X~?.?~....?~;?. .................... ~ ............................... MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. # CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING ,~L.~ _ ~--'1 '_~- ,~"'I NAA # ~ ~ .C-2.°t ~3 ~ (~) ~ 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot I; Block 9; Preuss Subdivision '~ Location (address or directions) 20630 Lucas Street, Ea~le River, Alaska (b) Property owner MGIC Telet~h?~e: (home) Business Mailing Address (c) Lending Institution First Nationa~ Baltk of Anchorag-Eelephone 265-3810 Mailing Address Anchorage, A,~ska ATT~NTION; ~isa (d) Real Estate Company and Agent ~E/MAX OF EAGLE RIVER - Ray Heber~.r Address 16600 C~_n~_rfx'~d Drive.; Sui~_ 201~ Eagle. R~u~.r~ A~k~ 99577 Telephone 694~4~00 (e) Mail the HAA to the following address: (or check here ~, if hold for pick up.) List contact person and day phone number below: S ~ S ENG~NEERZNG/~94-~g79 17034 Eagle River Loop Road, Suite 204 Eagle River, Alaska 9957'7 TYPE OF RESIDENCE Single-Family [] Number of bedrooms 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. SEWAGE DISPOSAL On-site,~ Pub c [] 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. z~-o~s (R~. 7~,8) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by mysealaffixed hereto and as of the validation date shown below, I verify that my investigation of th is Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functionaland 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. $ & S ENGINEERING 17034 Eagle River Loop Road No. 204 Eagle River, Alaska ~y577 Name of Firm Address Date Telephone 6. DHHS APPROVAL Approved for ~f bedrooms by Approved ,//~,~.. Disapproved Terms of Conditional Approval Conditional 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 order to satisfy certain federal and state requirements. Employees of DHHSdo not conduct inspections or analyze data before a certificate is issued. The MunicipalityofAnchorageis not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 7/88) Back Page 2 of 2 WELL DATA Well Classification MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) CHECKLIST - FEBRUARY 1984 343-4744 Legal Description: ~.~' \ Well Log Present (Y/N) Date Completed If A, B, C, D.E.C. Approved (Y/N) Yield Total Depth Cased to Depth of Grouting Static Water Level : Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot ~ I..~ To Nearest Edge of Absorption Field on Lot ~ lJ~ ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected by Date Water Sample Test Results Comments ~--'~ ~ (-~,_) ,~ \~--'\ .~>~ -, ~-~~ ~~, SEPTIC/HOLDING TANKDATA~ ~. 4~ ~ ' Date Installed '~/~ ZI~ No. of Compartments ~ Standpipes~N) ~ Air-tight Caps ~N) ~ Foundation Cleanout (Ye ~ Depression over Tank (Y~ ~ ~ Date Last PumPed ~ -~ - ~ ~ ~umpin~/MaintonancoContacto~=F[lO{Y/~/p ~/~ ;for ~ ~ ~oldin~ Tank Hi~h-Wator Alarm (Y/~) Tomporaw Holdino lank ~ormit (Y/~) To Water-Supply Well To Property Line To Water Main/Service Line SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Stream, Pond, Lake or Major Drainage Course ,Comments ,?.¢~ ~_4¢~¢~'ot.~ ~'lr~ , To Building Foundation To Disposal Field 72-026 (Rev, 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed I Width of Field Square Feet of Absortion Area Depression over Field Results of Last Adequacy Test Length of Field ~,,-~.. Depth of Field Gravel Bed Thickness ~,5' '~-~'¢' (~'- Statndpipes Present(~/N) Date of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well "~¢~o ~-~ TOLotBUilding Fou nd~l~.~ ~'~--~ To Property Line To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments .-~ C'~-~--~(-~/ ~ To Existing or Abandoned System on ; On Adjoining Lots To Cutback (if present) r'"%/~::'/ D. LIFT STATION Dat~talled Size in "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Pumpi~acy Test. **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed S & S ENGINEERING 17034 Eagle t~ivor Loop Eoad No. 204 Company ~n,,l~ River: Alaska 9957? Date .~ ~ ~-- ~ ~~'~ ' MOA No. Receipt No. Date of Payment Amouot 72-026 (Rev. 7/88) Back Receipt No. Waiver Fee: $ Date of Payment Page 2 of 2 APPLIC,' ILLS OUT UPPER HALr _)NLY Pror~rtv Owner Stephen E. Pritchard Phone Mailing Addre~ Star Route Box 5617: EaGle River Ak. ZtpCode 99577 694--9646 Buyer Jim and Gloria Davis Address 3409 A~O, Anchorage, Ak. ZipCode 99503 Lending Institution Home Savings and Loan Assoc. Phone Address 535 D Street, Anchorage, Ak. Zip Code 272-1451 Rea~tyCo.&A~,t ~nd~ ~an_~/ Totem RealtY P.O. Box 911, Eagle River. Phone 694--94 1 E. Gi~ber~ ERA Bowden, 2602 Seward Highway 337-7159 Address . Zip Code Legal Description Lot 1, Block 9, Preuss Subd. Street Locatio~ Lucas Street Type of Residence [~ Single Family [] Multiple Family No. of Bedrooms 3 [] Other Water Supply ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. ~ Individual [] Community For wells drilled prior to that date, give well depth (attach log if available). [] Public Utility Sewer Disposal X~ Individual 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 Date Inspector Inspector Inspector Inspector ( ) CONDIT~NAL~PPROV~ / %~/~ ~ ~ - ~ Soils i Date ~wer Installed Well To Absorption Area Well Log Received , ~t~__ /~1'~ ~ WelltoTank Septic T~k Size 72-023 (3182) ! ~ DAX.,~,R EC EIV E D IN~qPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE NSPECTOR INSPECTOR INSPECTO~{~ MUNICIPALITY OF ANCHORAGE ~UN~CIPALI~ OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTI~PT. OF HEALTH & 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL PROTECTION ENVIRONMENTAL SANITATIONDIVISION AL~0 ~ 0 ~9~1 Telephone 264-4720 REOUEST FOR APPROVAL OF INDIVIDUAL WATER AND S~~I~I~ DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be proc~sed. Please allow ten (10) days for processing, MAILING ADDRESS P~OPE~TY ~ESIDENT (if different from above} I PHONE ~ PHONE z .uw. ~ ~ MAILING ADD~ES8 ~ 3. LENDI~ INSTITUTION PHONE MAILINGADD~ESS ~. 'REA'LTOR/AG ENT PHONE / ~AILING ADDRESS 5. LEGAL DESCRIPTION CI.o F-.K/E P-,. ~:' .,~o p6 P,L~b STREET LOCATION ~ T I I~ LO c. K q SINGLE FAMILY MULTIPLE FAMILY 7. WATER SUPPLY [j2~] INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY ~UMBER OF BEDROOMS One ~ Four = Other * 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.) 8. SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON-SITE** ]~'7¢ YEAR ON-SITE SYSTEM WAS INSTALLED. [] PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79)~'~ THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS ~ SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2, WATER SUPPLY [] INDIVI DUAL DEPTH OF WELL f~l COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3, SEWAGE DISPOSAL SYSTEM P'~RMIT NUMBER []INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER [~]Sept[c Tank or [] Holding Tank Size:_(¢%¢) ~ _ If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL ( 4. DISTANCES Septic/Holding Tank Absorption Area ! Sewer Line I Nearest Lot Line I WELl_ TO: Absorption Area to nearest Lot Line 5. COMMENTS [~[;~APPROVED FOR .~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION Environmental Sanitation Division ' 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 CERTIFICATE OF INSPECTION · SEWER AND WATER FACILITIES 1. PROPERTY OWNER Stephen :E. Pritchard MAILING ADDRESS St:ar Route Bo× 5617 99577 2. LEGAL DESCRIPTION Lot 1 Block 9 Preuss Subdivision 3. TYPE DWELLING SINGLE FAMILY RESIDENCE MULTIPLE FAMILY RESIDENCE OTHER (Describe) · · . 4. WATER SUPPLY .. ,. ,. ~ INDIVIDUAL EX] COMMUNITY/PUBLIC 5. SEWAGE DISPOSAL · ~ INDIVIDUAL/ON-SITE fi_3 PUBLIC UTILITY [~3 HOLDING TANK (Maintenance Required) ~ APPROVED FOR three BEDROOMS ED CONDITIONAL APPROVAL (See Attached) ~ DISAPPROVED OATE. I BY (TITLE) 72~014 (3/78) GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR VA 1. Approval requested by: Mailing Address: 2. Property Owner: Mailing Address: . SMILEY'S REALTY pLO. BOX 1086 Eagle River AK.. Fitzpatrick 115/74 3. Legal Description: Lot l= Block 9 Pruess 4. Location: Co~ne~ of ~,,~ Ave and Donalds Plame 5. Type of facility to be inspected ~ingle 6. Well Data: A. Type Drilled C. Construction Standard 7. Sewage Disposal System: Phone: 694-2114 Phone: A. Installed C. Septic Tank: D. Seepage Pit: B. Depth No. of bedrooms 3 D. Bacterial Analysis Satisfactory 1973 1. Size 1000 qals 1. Absorption Area Total length of lines B. Installer 2. Manufacturer Stack Steel 2. Material Log crib E. Disposal Field: Distances: A. Well to: Septic tank Nearest lot line B. Foundation to septic tank eg, C. Absorption area to nearest lot line llO' , AbsorPtion area 130' , Other contamination , Absorption area , Sewer Lines EQ-034 (1/74) Page 1 of two pages ';P~ge'2 of two pages - ReViewS'st for Approval of Individual ~/er & Water Facilities Legal Description Comments Appro~ /z~ Disapproved Date ~//7~ , Approval Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date £Q-034 (]/74)