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Home My WebLink AboutDEER HORN BLK 1 LT 2 NAME LEGAL DESCRIPTION LOCATION MUNICIPALITY OF ANCHORAGE ' ~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 2644720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT PHONE ~ 14~/q~'~75 [::]UPGRADE NO. OF BEDROOM~.~ No. of compartments Liquid depth PERMIT NO. Liquid capacity in PERMIT NO. Distance ~t~en lines inches Total ef f~ti~ abso~tion area inches Nearest lot line lot line PERMIT NO. DISTANCE TO: Manufacturer IF HOMEMADE: Inside lean,th DISTANCE TO: Well "~'//~ I Dwelling Manufacturer Well oundatiort Totallength oflines Width tile DISTANCE TO: No. ol line~ Length of each lin Top of tile to finish grade Length W~dth / ~ Type of crib. Crib diameter Crib depth DISTANCE TO: DISTANCE TO: Building foundation Sewer line IMaterial Nearestlothne Trench width Absorption area(si OTHER 72~v/!/3 {Rev. 3178'~ MATERIA S SOIL TEST RATING .~ REMARKS ~/3 ~ I~, ~' ORB 19~X, // / ' MUN I C I PAL I TY OF ANcHoRAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L STREET, ANCHORAGE, AK ~501 2&4-4720 PERMIT NO: DATE ISSUED: 840545 HAND WRITTEN 05/07/84 APPLICANT: ADDRESS: CONTACT PHONE: C/O S&S ENGINEERING CHUCK TANNER SRB l~&X EAGLE RIVER~ AK ~577 &94-297~ LEGAL DESCRIP: SUBDIVISION: DEER HORN LOT: 2 SECTION: 4 TOWNSHIP: 15N RANGE: 1W LOT SIZE: 28874 (SQ.FT. OR ACRES) BLOCK: I I certify that: 1. I am familiar with the requirements for on-sit~ sewers and wells as set forth by the MuniFipality 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. 5.. 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. IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES~ THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST DE OBTAINED; (2) AS-BUILTS ~ WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (5) THE ELECTRICAL WORK MUST BE-DONE BY A LICENSED ELECTRICIAN. SIGNED ~ APPLICANT: ENG NEERING CHUCK TANNER ISSUED BY _~_ _ _~.~.'~/~.~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street. Anchorage, Alaska 99501 264-4720 SOILS LOG -- PERCOLATION TEST I:~':~'~$OILS LOG [] PERCOLATION TEST PERFORMED FOR:~ LEGAL DESCRIPTION: I 2 8- 9- 13- 14- 15- 16- 17- 18- 19- 20- COMMENTS 72-008 (6/79) SLOPE DATE PERFORMED: SITE PLAN WASO"OUNDWATER /VD ENCOUNTERED? pO E IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE ~/~ (minutes/inch) TEST RUN BETWEEN FT AND FT .-, DATE:~~'~ ~'~ ~ [] SOILS LOG & E g eer ng lg6X, F.~GLE RIVER, A~e~SKA g9577 PHONE: 907/694-2979 SLOPE DATEPERFO M~ED: SITE PL~N~ ~- ,l vJ? ! 10 11 12 13 14 15 16- 17- 18- 19- 20- WAS GROUND WATER ENCOUNTERED? IFYES. ATWHAT ~ ' /'"/_ ~' DEPTH~ ~ C, s~o~s Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE RUN BETWEEN FT AND FT EST (minutes/inch) MUNICIPALITY OF ANCHORAGE DIVISION OF Eh~IROI~,iENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRO,'~,fENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1...General Information Application Date ~/~; t/ ('a) Legal. Description (include lot, block, sgbdivision, section, township, range) Location (fddress or directions) (b) Applicants NameZ/~:~/.~T?Z-~ {~;6) Telephone - Houe Applicants ~dress (c) Applicant is (check one) Lending Institution Buyer~--]; Other~ (explain); (d) Lending Institution Business ~ ; Owner/builder,~_ ; Telephone Address (e) Real Estate Co. & Agent Address Telephone Mail the HAA to the following address: Type of Residence Single-Famlly,~,. Number of Bedrooms Multl-Famlly~ Other (describe) Water Supply Individual Well ~ Community ~ Public ~ ~/O~"~J~4~D0~'~ ~'~qffA Note: If community well system, must ~ve ~itten coMl~a~ion from the State Department of Enviro~enCal Co~e~atton attesting to the legality aM status. Sewage Disposal Onstte ~ 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] Engineering Firm Frovidin~ Inspections~ Tests~ File Search~ Data and Information As certified by my seal affixed hereto and as of the validation date shown bel'ow, .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 w~stewater disposal system is in compliance with all Municipal and State codes, ordinances, and regula- tions in effect on the date of this inspection. Name of Firm ~ ~ ,~ ~.:?¥-.-.?~,~.. Telephone C,' A' Condition ) Terms of Conditional Approval / CAUTION THE ML~ICIFAL~TY OF A~NCHORAGE DEPARTMENT OF HEALTH AND ENViRON%[EN~rAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY ~.N INDEFENDEN"r PROFESSIONAL ENGIh~ER 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 REQUIRE- MEN'rs. EMPLOYEES OF ~{EP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. THE MUNICIPALITY OF A,NCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIOh~ IN THE PROFESSIONAL ENGINEER'S WORK. (DIIEP SEAL) [Page 2 of 2] 7 -19 -84 ae Wall Classification ~ Well Log Present (Y/N) Total Depth Cased to Static Water Level Ca.sing Hsight Above Ground · ': Elect~ical Wiring in Conduit (Y/N) Sepgr. ~ati~n Distances f~cm wall: To ,Septic/Holdir~3 Tank on Lot ~ MUNICIPALITY O~ ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 Legal Description: MUNICIPALITY OF ANONOP. AC~ DEPT. OF HEALTH & ENVIRONMENTAL PROTECTIO~ SEP 1. If A, B, cr C, D.E.C. Appro~asd(Y/N) Date Ccmple ted Yield Depth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) Dep=ession A~ound wallhead (Y/N) ; On Adjoining Lots To Nsanest Edge ~f Absorption Field on Lot Z&;O ~ TO NeareSt Public Sewer Li~e Water Sample Collected By Water Sample Test Rssults ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot SEPTIC/HOLDING TANK DATA Dep=ession over Tank (¥~ Date Last Pumped Pumping/Mainte.~T. ce Cc~tract on File (Y_/~//~ ; fo~ . Holding Tank High-Water Alarm (Y/N~///~ Temporary Holding Tank Permit (Y/N) Separation Distances frcm Septic/Holding Tank: To Water-Supply Wall ~(~ ~ ~ To Property Line /~i) ,~ To Water Mair~Se~vice Line ~--O -~ To Building Foundation To Disposal Field To Stream, Pond, Lake, cr Major Drainage Receipt Date P a id: --__~.~__- Amount: [Page 1 of 2] 2-15-84 Ce ABSORPTION FIELD [I~TA Date In.~talled ~___Z~_~_~/ Length of Field Width of Field/W"~n~ 'F Depth of Field m ,~,1 Bed Thickness Field ~a~ Date of Last Adsquacy Test ,~ ~.~ Results of Last Adequacy~'Test /~J ~ ~ Separation Distanne from Absorption Field: TO ~ater-Supply Wall ~ -~ To P=g~erty Line /~ / To Buildirg Foundation ~'- ! To Existirg or Abandoned System cn Lot /V' / ~ ; On Adjoining Lots To Water ~ai~/Bervi~e ~.ine 2~ ~- ~o Cutba~(~f · o S~e~/~or~/~e/or ~jo~ ~i~ ~ ~'/, F~ ' To Driveway, Parking Area, or Vehicle Storage A~ea D. LIFT STATION Date ID~talled Si~e in Gallons · "Pu~p On" Level at High Water Alarm Level at Tested for Electrical Codes(Y/N) / ~ Ma~.hole/Ae~ss (Y/N) /~ ! /4/~ off' Level at ~' ; I~ Vent (Y/N)' Pumping Cycles during Adequacy Test. Meets MOA Cca~ents ** Check Permitted Bedroom Rating AGainst HAA Request ** certify thg~'f-~ave d~ecked, verified, or confczn~ed to all MOA HAA Guidelines in effect si~d Date I ~...~..~..".,,',. . Ccmpaay- / 'MOA No; ' ~,'?,~?-.;.. / L'~2q-.;%. · / · / · " ~RB 19~X, .------~ .---_ ..... [P~ge 2 of 2] ~ ~-'"'"""~" 2-15-84 240 129 RS' TNH) I S 8g'58'2g'E 85g, 419 I0" , · (See Note ~,} ~ , ~ 5 85,460 S.F. 7' (~F BEARING I I · 659.85 TNH 76' 3Po.- .............. .NEST-- 59" $3t9.5~" AS; '5 / 4 3 2 . t 0 0 '0 I 00 S.F. ~ 3B,g3g S.F. 2 ~. ze.,4.' sr O~. 28,770 S.F. Z 15' £1ect~,c ~ Telec [&mt S 8g'53'O4'N (.