HomeMy WebLinkAboutMOUNTAIN PARK ESTATES BLK 11 LT 11Mountain Park
Estates
Block 1 1
Lot 11
#017-441 - 14
Municipality of Anchorage ."~"
Development Services Department :' ' ~:
Building Safety Division
On.Site Water and Wastewaler Program, 4700 S. Bragaw St.
P.O. Box 196650 Anchorage. AK 99519-6650 Page I
www.ci.anchorage.ak.u$ (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
"'~: A ~-~4¢ / ~/cut '~P-~f ~ Wastewater System: [] New [] Upgrade
LEGAL DESCRIPTION ~.~,.r'
SEPARATION DISTANCES ~septic r-I Holding n S.T.E.P. [] Other.
Septic Absorpfior LiE Hold[Ag Public/Private ~a,'~dac~rm: C~paob~
Tank Fietd Station Tank Sewer t-lne ~, ~ f L/'~.,6~ 1,,~ ~' ~e'~D
e--..' olc, \ / LIFT STATION
"'~"~': BENCH MARK
--.'"E~gineer'$ StamF ·
Inspections performed by: Dates: 1" I ! -I L~_O I
Developm~tServices/Depnrtm~nt Approval x,~ <, %. ...,.
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203 W AVENUE /
ANCN. AK. /
,(907) 27£-3915
PERNIT 1t S1,'010459
WOUNTAIN PARK ESTATE BLOCK 11 LOT 11
ARlfENE & JOHN BANKS
6154 E. tIUFFt, IAN ROAD
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PID # 017-441-14
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AS BUILT
16, 2001
SHEET: 2/~_ GRID:2838
NPEIIII~.BVG
MUNICIPALITY OF ANCHORAGE
Development Services Department
On-Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Nov 02, 2001
Expiration Date: Nov 02, 2002
Permit Number: SW010459 Parcel ID: 017-441-14
Legal Description: MOUNTAIN PARK ESTATES BLK 11 LT 11 P-501
Design Engineer: 0007 Tobben Spurkland, PE Site Address:
Owner Name: Arlene and John Banks Lot Size: 32800 SQ. FT.
Owner Address: 6154 E HUFFMAN ROAD Total Bedrooms: 3 Permit Bedrooms: 3
ANCHORAGE, AK 99516-2439
This permit is for the construction of:
[] Disposal Field [] Septic Tank [] Holding Tank [] Privy
[] Private Well
[] Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 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.
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
ON-SITE SEWER/~VELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D.
Property owner(s)
Mailing address (1)
Mailing address (2)
Legal description (Lot, Block & Sub'd.) ~' ~
Legal description (Section, Township & Range)
Lot Size '~ 2, ~00 .A~res/Sq. Ft.
I'~ 14.11j
Permit Number SWOI ~) ~ ~' CJ
Day phone ~ .//Z~-_ ~ 7~ '7.
Zip Code
Number of Bedrooms
THIS APPLICATION IS FOR:
Sewer Only
Sewer and Well
Sewer Upgrade
THIS PROPERTY CONTAINS:
Hot Tub
Swimming Pool
Therapy Pool
[] Well Only []
[] Water Storage []
Jacuzzi []
Water Softening Unit []
[]
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
(Signature of property owner or authori:~ed agent) ~
Permit Fees:
Date of Payment:
Receipt Number:
(Rev. 12/00)
Waiver Fees:
Date of Payment:
Receipt Number:
T.SPURKLAND P.E.
203 WEST 15TI I. AVENUE SUITE 203
ANC! IORAGF., At. ASH 90~01
(9O7) 279-3916
Fax (907)276-6OI3
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 South Bmgaw St.
P.O. Box 196650 Anchorage AK. 995169-6650
Subject:
Septic System Upgrade
Lot 11 Block 11 Mountain Park Estate S/D
PID 017-441-14
November 1, 2001
Gentlemen;
We request a permit to replace the existing 1000 gal. septic tank for this lot. The ground around the
tank has settled substantially, indicating partial collapse.
The replacement of this tank will not have nny additional adverse effect on the adjoining properties.
Drainage patterns will not be changed by this replacement.
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205 W AYElvUE
AlvCH. AK. 99501
MOUlvTAllv PARK ESTATE BLOCK t! lOT Il
ARLEElvE & JOHlv BAlvKS
6t54 E. ItUFTWAlv ROAD
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SHEET.. 2/$ GRID: ,2838
PERMIT ~ SP/OIOXXX PI~ ~ 017-441°14 MPEIlII2,DP/G
MUNICIPALITY OF ANCHORAC-
DE .tTMENT OF HEALTH AND HUMAi, £R ES
Environmental Health Division
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Address
LEGAL DESCRIPTION
'TANKS
SEPTIC [] HOLDING
~ ~c /~90 o
TYPE OF SYSTEM
XTRENCt-I ~ BED [] W. DRAIN [] OTHER
Fill added above ong~nal grade~ Y_~
~. 25-' yc ~ 3o
Installer .... Dat~ Irls[~od
ELLS
'~ PRIVA'rE
[] OTHER ddentifv)
WELL
WELL
DISTANCES
SEPTIC ABSORPTION
TANK FIELD
t~t 1.5" /
-- LOT LINE ~ ,'
FOUNDATION .~¢¢~..¢.. !
AS-BUILT DIAGRAM (Show Iocahon o1 well. septic system, ploperty lines, for ndahon,
FT
~edormed by
~)ate
SRB '196x
I~unicipal and State guidelines in effect on tllia date:
Depa,lment Approval:
~-013
WATER WELL RECORD
STATE OF ALASKA
DEPARTMENT OF NATURAL RE$OURES
Division of Geologicol B GeophysicolSurveys
LOCAIlON OF WELt. (Pleose complete either la, lb or lc.)
~DISTANCE AND DIRECTION FROM ROAD
Street Address and Arco of Well Locoli,
Drilling Permit No.
A,D.L. No.
WELL LOG
Type
lB, WAFER WEL~ CONI'RACTOR"S CERTIFICAT
I ~ I/4qlrs Section No. l'owneh[PN[~ Ronge E~] Meridian
I-°t-°g-°f- s~ w~
Address:
Surfoce ~.. WELL DEPTH: (flnol) 5. DATE OF COMPLETION
'" ' , ' 7. USE; ~ Dome~lic ~ Public Supply ~ Industr~
" ~ ~ /" ~ ~rrigatlon ~ Recharge ~ Commerical
~ 8. CASING~ [~ Threaded ~ Welded
diem. /, in. fo , , /' ft. Depth Weight ,r"''
r · lbs./ft.
. __ diem. im to ft. Depth Sfickup fl.
9. F~NISH OF WELL:
Set belween ft. end ft.
I0. STATIC WATER LEVEL: ,
~ Above or ~ Below lend surface Dote
~L ~ II. PUMPING LEVEL below lend surfoce end YIELD
MelorJel: ~ Nee~ Cemenl ~ Other:
ON:
15. Wofer Temperature o ~ F ~ C
N unicipal,Cyo¥
Anchorage
P.O. B .,196650
ANCHORAGE, ALASKA 995'19-6650
(907) 264-4111
IONY KNOWLES,
MA YOR
DEPARTMENT OF HEALTH & HUMAN SERVICES
June 23, i986
Dan Mar Construction
2830 East 88th Avenue
Anchorage, Alaska 99502
Subject:
Lot 11 Block 11 Mountain Park Estates Subdivision
On-site Sewer & We].]. Permit #860058 - Issued February 25, 1986
On May 20, 1986, The Anchorage Assembly approved a new ordinance
regulating on-site wastewater disposal systems (septic systems).
All septic systems constructed afteL" the effective date of this
ordinance are subject to the provisions of this ordinance.
Our records show that you currently bold a permit for the installation
of a septic system. We strongly urge that you contact this office
prior to constructing your system. Any changes in the code that could
impact the construction requirements of your septic system will be
identified and brought to your atteution. Please contact the
Environmental Services Division at 264-4720.
Thank you for your cooperation.
Sincerely,
Snsan E. Oswalt
Program Manager
On-site Services
SEO/SSM/ljw
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C ,~,MI:'AJTATION StqEE:T
DATE:
SHEET
BY
CKD
OF
0
SUBJECT: ~.//
C',-,,vlPUTATION SHEET
DATE:
SHEET
BY
CKD
OF
/-07- =
O~-~OSlrV
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
DATE PER FORMED'
PERFORMED FOR:
LEGAL DESCRIPTION: ~ / / C~ /,/ //~'-/LJ~./'....O~-,/~J,~ /~'Z:)~. ship, Range, Section: ,/~. /~)
222
2
3
4
5
6
7
8
9
10
11
12
13
14~
15
16
17
WAS GROUND w^'rER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Deplh to Waler Aller /-)/~/~
monilorJno? q~. / ~': Dale:
treading Date
Time
/o
1o ,' io/j
Net
Time
Depth to
Water
Net
Drop
PERCOLATION RATE ~ ~) -- (mmutes/~nchJ PERC HOLE DIAMETER ~:~ '/'''
~, - ..... - ....... ~ V CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ~LL' S~~J~AL GUIDELIN~F~CT ON THIS DATE. DATE' ~ ~ ff~ ~
72-008 (Rev. 4/85)
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 'L' Street, Anchorage, Alaska 99502-0650
SOILS LOG k PERCOLATION TEST
DATE PER FoRr~
LEGAL OESCRmTION:Z// ~5;// /4//T/g/~/~{~[( ~-'T Township, Range, Section: /~_~
!
SLOPE SITE
1
2
3
5
6
7
8
9
lO
11
12
13
14
15
16~
17
18
Z 6
.AN
Gross
Time
1°//5 Z) -
Net
Time
PERCOLATION RATE ~0 (mmutes/,nchJ PERGHOLE DIAMETER ~' ';
TEST RUN BETWEEN ~ FTAND ~FT
COMMENTS. .~Z, ~~5"~ 7-E , ~, ~ /~ cc ~.
PERFORMED BY: ~i 106X
::~ ;l~ ;>[',(~i' A! [~]:~ ~0()~ CERTIFY THAT TitlS TEST WAS PERFORMED IN
ACCORDANCE WI~EL S~ATE AND MUNiCiPAL GUi ELIN~ EFFECT ON THiS DATE. DATE: ~ ~ /~ ~
72-008 (Rev. 4/85)
Net
Drop
/3/,,.
:~/¢ ,,
WAS GROUND WATER
ENCOUNTERED?
S
IF YES, AT WHAT L __
DEPTH?
fleplh Io Waler Afl~r
Monitoring? ~ Dato:~-/~'~ .
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAl_
OF ON-SITE SEWER AND WATER FACILITY
264-4720
GENERAL INFORMATION
(a)
Legal Description (include lot, block, subdivision, section, township, range)
Z l/ /74// £:',2 7-'
?
Location (address or directions)
(b) Applicant Name ._~ ~.ld ~4._~ ~<!- Telephone: Home ,-/~¢¢¢~ <~ (~ Business
Applicant Address ~-~;'~ ¢~ ~¢q'~'~ /¢7~/,JC~t~.F, ~¢,~"OF
(c) Applicant is (check one): Lending Institution []; Owner/builder []; Buyer []; Other [] (explain); __ __
(d) Lending Institution ~-~'~ y5¢(~, ~'///¢¢~.'~'/,~c¢¢--¢~
Address
Telephone
(e) Real Estate Company and Agent
Address
Telephone
(f) Mail the HAA to the following address:
$ & $ ENGINEERING
SRB 196X
EAGLE RIVER, AK 9952'7
TYPE OF RESIDENCE
Single-Family/~, Multi-Family []
Number of Bedrooms _ '~)
Other
WATER SUPPLY
Individual Well~ Community [] Public ~
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
SEWAGE DISPOSAL
Onsite/~, Public ['3 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 {11/84)
ENGINEERING FIRM PROVIDh,,,~ INSPECTIONS, TESTS, FILE SEARCH, D~A AND INFORMATION .r
As certified by my seal affixed hereto and as of tile 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 ot 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 ~ ~ ,~ ~J~'J~F-~f~¢,,~ Telephone 6 t¢~"' L~¢/~-:~
Address S[~ B '~96X
Date
DHEP APPROVAL
Approved ,~ Disapproved¢~¢J/ / -- ~onditiona, ~'~
Terms of Oonditional Apl~roval
CAUTION
The Muncipality of Anchorage Department of Health and Environmental Protection ([:)HEP) 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 (1
WELL DATA
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264-4720
MUNICIPALITY OF ANCHoP,~GE
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
, es r,pt,oe: EOE!VED --
Legal
Well Classification
Well Log Presentd~/N)
Total Depth \"1 ~ '
Static Water Level
Casing Height Above Ground
E:lectrical Wiring in Conduit~N)
Separation Distances from Well:
Cased to _ \L~I~;
V~¢'
If A, B, C, D.E.C. Approved (Y/N)
Date Completed ~-~,-:1 ~ ~ Yield __
__ Depth of Grouting -
Pump Set At
Sanitary Seal on Casing ~:~/N)
Depression Around Wellhead (Y~;[~
To Septic/~ Tank on Lot t co
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line _ ~l/~ To Nearest Public Sewer
Cleanout/Manhole - 14/~ To Nearest Sewer Service Line on Lot
Water Sample Collected by ~ ~' ~'~ ~;:~-~=~-'J¢'~ ; Date c3'~'~- ~"
Water Sample Test Results
; On Adjoining Lots
_; On Adjoining Lots
Comments
B. SEPTIC/~N(!YTANK DATA
Date installed '5- t.~
Standpipes C/N) Air-tight Caps
Depression over Tank (Y~'~
Pumping/Maintenance Contract on File (Y/N) _
Holding Tank High-Water Alarm (Y/N) t'3/
Separation Distances from Septic/N~Tank:
To Water-Supply Well
To Property Line _ \
To Water Main/Service Line __
Size ~, ¢h.¢¢ No. of Compartments
Foundation CleanoutCN)
el;ate Last Pumped I"~¢~t,~
; for ~ ¢//'
Temporary Holding 'rank Permit (Y/N) _
Course
To Building Foundation ~- '~ ~
To Disposal Field _ ~' ~
'Fo Stream, Pond, Lake, or Major Drainage
Comments
Page 1 of 2
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
Separation Distance from Absorption Field:
To Water-Supply Well L c::,~
To Building Foundation
Lot
To Water Main/Service Line
Type of System Design
Length of Field
Depth of Field
Gravel Bed Thickness
Standpipes Present ¢i~/N)
Date of Last~ Adequacy Test
To Property Line
To Existing or Abandoned System on
; On Adjoining Lots "~O
To Outrank (if present)
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
Comments
Page 2 of 2
72-026 (11/841
** Check Permitted Bedroom Rating Against HAA Request **
I certify th~ I~a~j~l~rj~.or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signed ~ ~9~ Date /~/~ /~
/
Company~.~LE ~VE~¢ ~~MOA No. ~ ~ - ~ .3
Date of Payment q ' ~'~ x~,'~ ...... ~¢¢ ~-
Amount:$ ~ ~ ~ ~'~" ~ ~' %~'"