HomeMy WebLinkAboutABBOTT LOOP TERRACE BLK 2 LT 7OIq Og
-/.3
PERHIT NO.
DEPARTHENT ~? HEALTH AND EN¥IRONMENTAL r~ROTECTION
8~5 'L' ~TREET, RNCHORRGE, RK. ~501
264-4720
WELL PERI1 I T
RPPLICRNT LAWRENCE D. HRLKER ~37 BUGLE RNCH 9~507
LOCATION
LEGAL 'L? B2 ABBOTT LOOP TERRACE S?D LOT SIZE
~44-2405
SQUARE FEET
HINIHUH DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEH IS
:1.00 FEET FOR R PRIVATE WELL OR 150 TO 200 FEET FROH R PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL.
HINIHUH DISTAHCE FROH A PRIVATE WELL TO R PRIVATE SEWER LINE IS 25 FEET AND
TO A COHHUNITY SEWER LINE IS 75 FEET.
WELL LOGS ARE RE¢~UIRED AND HUST BE RETURNED TO THE DEPARTHENT WITHIN ~0 DAYS
OF THE WELL COMPLETION.
OTHER REQUIREHENTS HAY APPLY. SPECIFICATIONS RND CONSTRUCTION DIRGRRHS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
PERt~ I T EXP I RES DECEI~IE:ER
I CERTIFY THAT
i: I RH FAMILIAR WITH THE REQUIREHEHTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE HUNICIPRLITY OF RNCHORRGE.
2: I WILL~ THE SYSTEH IN ACCORDANCE WITH THE CODES.
SI GNED: _~~-~-- ~~~--,~ APPLICANT LAWRENCE D. WALKER
..............
V4, 0
'--- - CHUGIAKo ALASKA
688-3199
*;RILLING CO.
WE SERVE ALL ALASKA
POST OFFICE BOX 42 - CHUGIAK, ALASKA 99567
KODIAK, ALASKA
4864826
OWNER OF LAND I
ADDRESS 6')37
WELL-SITE Lot 7 Bk 2 Abbot loop ter.
DATE - STARTED ........... :......~.~.~!:~.~ .................................................
I)AT~ - ENDED ~ ..... 7~29-;3~
DEPTH OF WELL .......................................................................................
STATIC LEVEL OF WATER FT.....2.2.'......~.~:.~...?..c.~..l.!.~ ...............................
1 ¢30~ est.
DRAW DOWN PT ........................................................................................
G >UU -,~..
ALS. PER HR ...........................................................................................
KIND OF CASINO, ........'. ..........................................
KIND OF FORMATION:
0 3 Overburden
FROM ...................... FT. TO ...................... FI' ....................................
FROM ..........). ......... FT. TO .........1..f! ......... FT...F.,.~ n. f.! ...r%...c.,.r...~: y..e. 1
16 ____ 36 -- Silt & Gravel
FROM ...................... r I. lo ...................... I- I ....................................
FROM .......... ~..C? ....... FT. 62 t{ar nan
TO ...................... FT .......... ......................
'c'2 ~ Tf% 6{') Gravel .
FROM ................................................. FT ....................................
74 FT TO 81 ~T Larg+~ gravel-water
FROM ...................................................................... ~ ................
FROM ...................... FT. TO ............. : ........ FT .......... : .......... i ...............
FROM ...................... FT. TO ...................... FT ....................................
FROM ...................... FT. TO ...................... FT ....................................
FROM ...................... FT. TO ...................... FT ....................................
FROM ...................... FT. TO ..................... FT ....................................
FROM ....................... FI'.TO ....................... FT ..................................
FROM ....................... FT. TO ........................ FT .................................
FROM ....................... FT. TO ........................ FT .................................
FROM ....................... FT. TO ........................ FT .................................
FROM ....................... FT. TO ........................ FT .................................
FROM ....................... FT. TO ........................ FT .................................
FROM ....................... FT. TO ........................ FT .............. ~ ..................
FROM ...................... FT..TO .........,..;~L,.,FT ........ k .......................
FROM ....................... FT. TO .............. ~ ........ FT .................................
FROM ....................... FT. TO ........................ FT .................................
FROM ....................... FT. TO ....................... FI' ..................................
FROM ....................... FT. TO ........................ FT .................................
MISCL. INFORMATION: FU'',,: :;~;o:]lci L". ,~c~t t:co to ti:rotc, f*~et off t.c: w~rr,Dnty or tlc, xn:lrrantit ~ ir
DRILLER~ NAME ....................................................................................................
APPLI~"NT FILLS OUT UPPER HAI._:.,ONLY
Buyer
Address Zip
Type of Resi~nce
Single Family
~ulflple Family NO. of
~ Other
Sewer Disposal
~ Indlvid~l . Year IndlvMual Installed:
Public ~llity
Time Time Time Time
Inspector Inspector Inspector Ins~c4~
Field Notes: MUNICIPAUTY OF ANCHORAGE
RECEIVED
( ~APPROVED ~DROOMS *CONDITIONSOFAPPROVAL
( ) D~SAP~OVED
~its Rating Date ~wer Installed Well TO ~sorptlon Area Well Log Receiv~
Well to Tank Septic T~k Size
1. ~nis is an agreeaent between the Abbott Loop Hon~ (~,tncrs Assoc-
iation and the o;mer of lot '~ block ~ of ,'ibbott Looi~ Terrace.
2. For $1.60 and other considerations the und,.~gned=~~' - and his h~lrs
and assigns agree froze this day for~",rd to rest~-ict or prevent the
placement of:
a. A ,¢~p~ pit or disposal field wi .... n 120 feet from the ',,'ater
~ell located in thm S...",. cot. of lot .7 block Z, Abbott Loop Terrace.
' b. Sewers or.septic tanks within 80 feet of said
c. Any kind of contami,~tfon , ~' '-
,~i~n_.. 40 feet of said well.
3- %~nis agreement is intended to ~-u with the land and is prepared
at thc direct!on'of the Health D~pt., Gremt~r .~.uchcra-ge