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HomeMy WebLinkAboutTHE VILLAGES TIDE VIEW LT 15ol \ LAA....OUAI-) : � d f 72;Q13 (Rev. 3/78) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE li] jEW GJd C. 11 •C"5 , i3j_1CI�H ❑ UPGRADE MAI LIN/ G ADDRESS_ 'y �,fcam'S -D {— Ca"U9 IL Rm P . e_ LEGAL DESCRIPTION —% I-or5✓TF, LOCATION NO. OF BEDROOMS Well Absorption area Dwelling PERMIT NO. U Y DISTANCE TO: 7'C^C, :Z ' _ I— z Manufacturer Materj I No. of c mpartments w� 3- L•e� (^ S e e •, ti Liq. capacity in gallons 000 IF HOMEMADE: Inside length Width Liquid depth Y J DISTANCE TO: Well Dwelling PERMIT NO. 2/ Manufacturer Material Liquid capacity in gallons Well Foundption. Nearest lot lin PERMIT NO. 1211 DISTANCE TO: 4} J LL No of lines .C.. Length of each line, Total length of lines Trench width Distance between lines Se �, elvr u <a .irtel�es L Top tile finish. Material beneath Total of to grade s tile effective absorption area L 9• o cSeC (t} inches 67 fz Length Width Depth PERMIT NO. CL Type of crib Crib diameter Crib depth Total effective absorption area DISTANCE TO: Well Building foundation Nearest lot line .� J Class Re th �i ;� Driller Distance to lot line PERMIT NO. Lu DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER `✓� '^ PIPE MATERIALS SOI L TEST RATI NG •�^ �. GAS, S s INSTALLER Q ! I "' l7' l L�'MrQ Er REMARKS + 3v zi 44, APPR VE '") DATE LEGAL 72;Q13 (Rev. 3/78) ' DEF"'I"IF.`FC'(F-i':(( OF HEALTH ANDENVIRONMENTAL F'Fa�i"i'E��a'-Ti=i�•d Q. _ ' L' 1 -REE F, ANCHORAGE, hAK 995q' I ( 264-4720 n='o P-4 •--- =-- :11 �l`" f;- _-° E.-_ NAPEE--- yT PERMIT NO-.,,( 790126 1. APPLICANT GERALD LEE WINCHESTER 609 L. 75 ANCH NONr.._ LOCATION UNKI'l LEGAL fi=ll._ L_'1. 15 THE. VILLAGE T I DEV I Ekl LOT T I ZE. 6:1.:1_27 SQUARE FEET TYPE OF SOIL. 1= 1E;'_;ORBT I ON:`•r'_ STEM I S : CSE;:: =I I NF I ELD MAXIMUM NUMBER OF BEDROOMS == r-; SOIL RATING <SQ FT/E,R) = 125 THE REQUIRED SIZE OF THE: OIL. ABSORPTION SYSTEM IS: YE, [� = Q°-::8 r� - i;" 4 == - 90-1. _1- (= p.. A % " D=_ D_ ff=:n L -_ ir= ° -� .._� ::E:_ -tl THE LENGTH DIMENSION IS THE LEP•,{if`H (IN FEET: OF THE TRENCH H OR DRA I. NF I EL. D. THE DEPTH OF 9 TRENCH OR P I T IS THE DISTANCE BETWEEN THE SURFACE OF THE I F,:On_Ih' D f-ih•,ID THE BOTTOM OF THE EXCAVATION (IN FEET). -1- C- 1 F= 11'- ]r" !1= 6°-:9 0•-0 1 on !=u _ 01 a=N 129 F7 I=--- LEE -i; THE G6::i-IVEL DEPTH 15 THE MINIMUM DEPTH OF i.-1F::AVEL BE-F•i'•IEE:('',►. THE OUTFALL f=•I(....L. PIf 'E AND THE BOTTOM M OF THE EXCAVATION A ii iN (IN FEET). IE4=' BE-- ==R L-0 TIC F -7,-E= u E> ° C Imo' IF 1 i� _- 9-1=0 PON f*•=-= I PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM H I DEPARTMENT DURING THE INSTALLATION I r•,f:= PES T I ONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF: RESIDENCES THAT THE WELL WILL SERVE. IF n.=_J N P - r:- E 7 -_ u 1 14 (_° E" C2 IF "l 10! 9=1(FZ E= K Eo r`:u I?_n -1 FE I -:-- BACKFILLING BACKFILL._ING OF I-t1'',I'T SYSTEM WITHOUT FIi'• AL INSPECTION Fir• D APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT Ti i PROSECUTION. MINIMUM DIS1-Fii•CE: BETWEEN A WELL AND HI'•d`r ON-SITE SEWAGE DISPOSAL :: �` STEM K_`' 100 FEET FOR A PRIVATE (--(ELL: OR 150 TO 200 FEET FROM A PUBLIC WELL_, DEPENDING UPON THE TYPE: OF PUBLIC WELL. OTHER REQUIREMENTS L'11-I'T APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. 1=%L 1-1 DOI I h IF- I D! � :.- f(-- i( fly= F-_ 9-: 9 IDU -E: F;? _.=: f , AL 02 u"== n I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS Fif'•dD WEL.►__E AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. I WILL. INSTALL TALL_. THE SYSTEM IN ACCORDANCE WITH TI_( THE CODE' : I ►.JI'•dDEF::_;`FHND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF FF"il•= RESIDENCE 15 REMODELED TO INCLUDE CL -I ICE MO RE THAN 6 BEDROOMS. SIGNED: ____._.__..___._.._----__--.___..___._.___.___. APPLICANT a GERALD LEE WINCHESTER -_ ___.____-. I �:_� UEC: E'r'_._ _ �--•_-_-- _-.._.___._______ ._ _--_--G:N=1-FE ��ff r-1 ur-.1 I G'� "� ice' Eel C_ 'I _'-'•r' a1 F t•=H r-4 Cl -1 �.l � t=i 1:3 E DEPARTtIEN) JF HEALTH AND ENV I RC �NMENT'h'_ . PROTECTION 825' 'L' STREET, ANCHORAGE, Atm. 99501 264-4720 i ELL. a�'r� L-ftit a TE _•EWEF• FEF ---M I T PERMIT NO. < i APPLICANT �.Piti �d � !�� ., 6 Q ! /�• �. %.J LOCATION LEGAL LOT 'SIZE (p ( / Z_? SQUARE FEE TYPE OF SOIL ABSORBTibN SYSTEM IS:; c4-rv% MAXIMUM NUMBER OF BEDROOMS � �O I L RATINGA�: =.C! FT�'BR'r THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:. CaEE: F•TFi= 4P L_Er4l:3T"i= / F---- f=1 EL_ CtiEF-TYa �-1= 1 THE LENGTH DIMENSION I S THE LENGTH (,IN FEET? OF .THE TRENCH OR DP..A I NF I EL•D:. THE DEPTH OF A TRENCH , OR PIT .I S THE DISTANCE BETWEEN THE SI iRFA%:E OF THE GROUND AND THE BOTTOM, OF THE Ei CAVATION (IN FEET.). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE,EXCAVATIiN (IN FEET). F:ECllt-1 I FEC> :=.EF• -r I c_ TF=jr-.IL•_-: = I `E= '�-® ®®' L._L_Clr-.1 PERMIT APPLICANT HAS THE RESPONSIBILITY TO INF+RM THIS DEPARTMENT DURING THE I NSTALLAT I ON I NSPECT I ONS OF ANY WELLS ADJACENT TO THIS PROPERTY, AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. --- T�--icl < 2: :1 I r -a _.FEC~ -T a s=ir -4s; HF; -:-E F_EC U I F•ECti -- BACKF I LL I N13 OF ANY SYSTEM WITHOUT FINAL INSPECTIOta AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINI MUM DISTANCE BETWEEf•J ' A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS FEET FOR A PRIVATE WELL; OR 150 TO i 2 0 FEET FROM A PUBLIC: WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN S0 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATIiN. ' F•EFP'-1 I T E: :F- I F'E'D ClEIGEC•lE:EF-: -- _=s I CERTIFY THAT is I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS _ET FORTH BY THE MUNICIPALITY OF ANCHORAGE. : I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. : I UNDERSTAND THAT THE ' C iN-'SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS F;Et-1 FLED_ TQ, INCLUDE !DE MORE THAN 8 BEDROOMS. I GNED : Applicant ISSUED BY DAT PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 1E 1E 17 1E 1� 2( ® SOILS LOG MUNICIPALITY OF'ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST Pouch 6650, Anchorage, Alaska 99502 276-2221 SOILS LOG - PERCOLATION TEST E1,11 COMMENTS PERFORMED BY:7%1P�iC �• 72-008 (7/76) DATE PERFORMED: T�-� SLOPE SITE PLAN :r AS GROUND WATER S VCOUNTERED? An L. O P YES, AT WHAT E EPTH? Reading Date Gross Time Net Time Depth to Water Net Drop ERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND FT CERTIFIED DATE: W/6 MUNICIPALITY Ci" ANCHORAGE DEPT. 01- 1: - i - EItiVIROIN�1%",L'.NT,\L P:_; -CTION WELL CONSTRUCTION LOG J Drilling Co.- USGS no. Driller, Urn Nowell: —Type of rig s Date well completed REUVVE D Well owner Qrzad Nearest community ARA -h a;6�0 Well location: (address & legal description) ± 15 V±11;ftgelt Ti4e-view Location sketch or remarks Depth of well 2i ft. Casing: depth 3() 1 t . diam. in. Static water level 92 ft. (above, below) land surface. Date Finish of well: jP!%5A open -hole, Wa;&b 84J�11111 to Describe intervals and size: recovery of 5 gpm %when bailed do mi to Well yield tested by S&M �,pjkag-K bailing, j±t1g: at gal/min. 207t for 2 hours with ft. of drawdown from static level. DRILLER'S MATERIAL LOG Depth below land surface in feet Give description of strata penetrated (size of material, color, hardness of drilling, and water content) 0t i, to 4 diftiiMN-' B.r brawn tlll eebble.9 grG! a -Y "-_c grave, bard to f i. -ray ---black decom:po ed 2@ surface I to 100 rock gray -black 1 On to 19n rock yath streaks of white & light green 190 black rock comSlOmer ate (gray clay -stone type rock) to see:pa�gD_ @z 1001-105, -to- most H20 coming Aom 190t to 207t -to- -to- -to- _t -to- _t 0- _t _t t0 t0 -to - _t t0 to r +1 JAYS HAMMOND, GOVERNOR x DEPT. OF ENVIRONMENTAL CONSERVATION/ 338 DENALI SREET MACKAY BUILDING, ROOM 1206 SOUTIICENTRAL REGIONAL OFFICE ANCHORAGE, ALASKA 99501 P� April 26, 1979 Gerald Lee Winchester 609A East 75th Anchorage, Alaska 99502 Subject: Lot 15 the Villages - Tideview Subdivision Dear Mr. Winchester: We have received and reviewed a site plan showing the pro- posed location of a Class C well on the subject lot. The well is to serve a duplex and is hereby approved for the features with which this department is concerned, providing a 150 foot separation is maintained between the well and any nearby septic tanks or drainfields. The following infor- mation must be submitted to this office before water is served from the well: 1. The results of an analysis for coliform bacteria. 2. The well log and well yield information. Please feel free to contact me at 274-5527 if you have any further questions regarding our review of this proposal. cc: DHEP imc 18-06 L H Sincerely, 4uV_"_(9 Nom`-' James O. Starr Environmental Engineer Certificate of On -Site Systems Approval Parcel I.D. 020-091-60 Legal description THE VILLAGES TIDE VIEW LT 15 Site address 16831 Tideview Dr Anchorage Current property owner(s) Russel Dick Expiration Date: The On-site system(s) is/are approved for 6 bedrooms Conditional approval for Comments or advisories: bedrooms, with the following stipulations: Original Certificate Date: 3/31/2023 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA Approval—June 2022 Certificate of On -Site Systems Approval Application 1. _GENERAL INFORMATION Parcel I.D. 020-091-60 Complete legal description The Villages - Tide View Lot 15 Location (site address) 16831 Tideview Dr. Anchorage, AK Current property owner(s) Russel Dick Day phone 2. ON-SITE SYSTEMS SIZED FOR 6 BEDROOMS 3. TYPE OF WATER SUPPLY: ❑ Private Well ® Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ❑ Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ® Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ 2� 'J�i Waiver Fee $ Date of Payment J Z 3 / 2° Z- 3 Date of Payment COSA # Waiver # COSA Application June 2022 Legal Description: COSA Checklist The Villages Tide View Lot 15 Parcel ID: 020-091-60 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA 0 Well log is filed with Onsite (or attached) Date drilled 1979 —Total depth 217 ft Cased to 30 ft 0 Sanitary seal is functioning correctly © Wires are properly protected Casing height (above ground) 31 in. Date of flow test for COSA 3/6/23 Static water level at beginning of test 98 ft. Comments _ ATA Measured operating fluff a tic tank Date of pumping ❑ Required maintenance completed, if AWWTS Comments: ABSORPTION FIELD DATA Which s m tested (date installed) ❑ ALL standpip resent per record drawing Total measured depth fro rade ft (max) Measured depth to pipe invert fro rade ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced _gallons date Any rejuvenation treatment (past 12 months) If yes, enter date Comments/Deficiencies. COSA Checklist June 2022 Well production at time of test 4.0 gpm Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ❑Z No © Coliform bacteria is Negative Nitrate— mg/L ✓❑ Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Arcterra ConsultinL Date 3/6/23 C. LIFT STATION ❑ Required maintenance completed A e of lift station years Lift station ma Comments: Adequacy test date Results ❑ Pass Fluid depth prior to test in Water added gal New fluid depth in Elapsed time min Final Fluid depth in rption rate gpd FIELDS US — POST RECOVERY Effective depth record drawings) Effective depth used in Effective depth remaining In E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' ❑ Yes if No ft Community Sewer Manhole/Cleanout > 100' ❑ Yes if No NA ft ./❑ Yes if No Neighboring Tank > 100' ✓❑ Yes if No ft Private Sewer/Septic Line > 25'�/❑ Yes if No Absorption Field on Lot > 100' ❑ Yes if No NA ft Holding Tank > 100' Yes if No Neighboring Absorption Fields > 100' Water Service Line > 10' ❑ Yes if No Animal Containment > 50'✓❑ Yes if No Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' © Yes if No ft 0 Yes if No ❑ N/A - Served by Community Well (not on lot) or Public Water eptic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations _ ❑ Yes if No ft Surface Water > 100' ❑ Yes if No Tank to Property Line > 5' Yes I ft Wells on Adjacent Lots: Field to Property Line > 10' ❑ Yes if No ft vate Wells > 100' ❑ Yes if No Water Main > 10' ❑ Yes if No ft Community We _ ❑ Yes if No Water Service Line > 10' ❑ Yes if No ft If tank or field is under driveway commen F. ENGINEER'S COMMENTS ft ft ft ft li, ft ft ft G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm Arcterra Consulting Phone (907)-696--6111 Engineer's Printed Name Kenneth Dul'fus Date -f'12!•1,3 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. ♦;♦�*��` ■0 k#+,` The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The r L- flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year r {7 and the water usage of the family being served by the system. The operational life of all well and septic R 4 g systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen encroachments, deficiencies or discrepancies exist. I♦ KENNETH M. c 7T16ESSN COSA Checklist -June 2022 R1114Y1liss � I hereby certify that 1 have surMod the 1101W ing described prop*rty. Lot 15 Flock OF 44'—*%% THE YILLlIGE TIDE VIEW 5uU. Anchorage"kotovdingl-PI JO,, Alaska, end that 4m, 04@ s ,� the improv*mertts situated thwean are within the property lines end do not overlap or y�419 • a �� encroach on the property lying ediaaitt thereto, that no improvements on propertyT�lying adjacent thereso encroach on the premises In question and that there are no roadways, �e ••N es• •«rswrr +• +transmission lines or other visible easements on said property except as Indicated hereon. a t.ea o es• • Ms•s leer tM++a ser 1 rera }1ildOnatl Anchorage, Alaska Zeg Det_. lg93 `,4d• e• .� 1 zMosr8"sl00 P& ` vewr titi ,i � Z � s o x c• ka' 3•sn, ar vti A ANAM E b• r O ' • pAitKr•+4 • P4, SCALE / rr '60 r Jr' ARFA �r 03 M .. IND �O U tt � 7 � m 0 4 4 (I. WEL EQal / Zo' y f s; r a0i}� Drivewm, /n ert1cmen4' ES1Ai Rcco r4 ed On 414 P� So R� 'rc�. \ A, 0 At Built d,Q Book No, Page No. Oct. r I hereby certify that 1 have surMod the 1101W ing described prop*rty. Lot 15 Flock OF 44'—*%% THE YILLlIGE TIDE VIEW 5uU. Anchorage"kotovdingl-PI JO,, Alaska, end that 4m, 04@ s ,� the improv*mertts situated thwean are within the property lines end do not overlap or y�419 • a �� encroach on the property lying ediaaitt thereto, that no improvements on propertyT�lying adjacent thereso encroach on the premises In question and that there are no roadways, �e ••N es• •«rswrr +• +transmission lines or other visible easements on said property except as Indicated hereon. a t.ea o es• • Ms•s leer tM++a ser 1 rera }1ildOnatl Anchorage, Alaska Zeg Det_. lg93 `,4d• e• .� 1 zMosr8"sl00 P& ` MUNICIPALITY OF ANCHORAGE T WATER & WASTEWATER UTILITY 3000 ARCTIC BLVD. PHONE:(907)564-2762 BLOCK/LOT/TRACT: LI ib/ SUBDIVISION: THE VILLAGES TIDE VIEW TAX CODE: 02009160000 GRID: SW3336 WASTEWATER S1Z�OSG CONNECT PERMIT DATE OF APPLICATION: 04/19/2012 SCHEDULED COMPLETION DATE: 12/31/2012 ® SINGLE FAMILY ❑ MULTI -DWELLING No. APTS 1 ❑ COMMERCIAL STREET ADDRESS: 16831 TIDEVIEW DR Anchorage, AK 99516 OWNER: THEIS LYNNE D & SCOTT M PHONE: MAIL ADDRESS: 16831 TIDEVIEW DR #A ANCHORAGE, AK 995160483 CONTRACTOR :5Cotf5 ASSESSMENTS XJ Repair Existing Service ❑ Main Line Extension ❑ On Property Only ❑ City Tap X❑ Have Been Levied ❑ Hydrant Only ❑ To Be Levied ❑ Main Tap - To Property Line Only Comments: ❑ Main Tap & On Property Connect Row No. ❑ Disconnect ❑ R & R - Main Tap Only ULNner Sta CONNECT SIZE 4 i ISSUED WWGEH INSPECTION FEE $ 98.00 ❑ PAID ❑ CASH PERMIT FEE $ 63.00 ❑ CHECK# $ 0.00 ❑ OTHER REIMBURSABLE DEPOSIT$ 0.00 INSPECTED BY NUMBER TOTAL $ 161.00 DATE y Z REMARKS PERMITEE (Please Print) THEIS LYNNE D & SCOTT M PHONE MAIL ADDRESS 16831 TIDEVIEW DR #A ANCHORAGE, AK 995160483 SIGNATURE POST IN A CONSPICUOUS PLACE AT THE JOB SITE INSPECTOR COPY DATE SCHEDULED 12/31/2012 TIME 12:00 am INSPECTORI/ SUBDIVISION THE VILLAGES TIDE VIEW BLOCK/LOT/TRACT LT 15 / INDICATE NORTH 4e3l IVne 700 55 �yzp�cp `l SIZE MAIN: TYPE MAIN: DEPTH AT MAIN: AT PROP. LINE: CONNECT LOCATION: COMMENTS: GO"A GJ7 O07 RLf/J{LL� 1-1 Lmj& INSEPECT DBY: y spa DATE: v z3.z jr C1�':' MUNICIPALITY OF ANCHORAGE WASTEWATER " 11 CONNECT PERMIT S101685 WATER & WASTEWATER UTILITY DATE OF APPLICATION: 12/23/2010 3000 ARCTIC BLVD. PHONE:(907)564-2762 SCHEDULED COMPLETION DATE: 12/31/2010 BLOCK/LOT/TRACT: LT 15/ INGLE FAMILY SUBDIVISION: THE VILLAGES TIDE VIEW MULTI -DWELLING No. APTS v ❑ COMMERCIAL TAX CODE: 02009160000 GRID: SW3336 STREET ADDRESS: 16831 TIDEVIEW DR Anchorage, AK 99516 OWNER: TAMIMI JAWAD H MAIL ADDRESS: PO BOX 4638 YIGO, GU 969294638 PHONE: CONTRACTOR John's Excavating ASSESSMENTS ❑ Repair Existing Service ❑ Main Line Extension ❑ On Property Only ❑ City Tap © Have Been Levied, ❑ Hydrant Only ❑ To Be Levied ❑ Main Tap - To Property Line Onlyo p 1 I ` Comments: X❑ Main Tap & On Property Connect R ,� ` ❑ Disconnect ❑ R & R - Main Tap Only caner Staff' CONNECT SIZE 4 I I C.pO \'41 IS S1{1ED WWLGN �LCr INSPECTION FEE $ L� PAID ❑ CASH PERMIT FEE $ 63.00 d CHECK# $ 0.00 ❑ OTHER REIMBURSABLE DEPOSITS 0.00 INSPECTED BY CL 5'L NUMBER TOTAL$ 46}60 DATE �51.001 REMARKS PERMITEE (PIeqFqPnnt), John's Excavating AK 99507 PHONE (907)563-1635 POST IN A CONSPICUOUS PLACE AT THE JOB SITE INSPECTOR COPY DATESCHEDULED 12131/2010 TIME 12:00am INSPECTOR SUBDIVISION THE VILLAGES TIDE VIEW BLOCKILOTTFRACT LT151 INDICATE qORTH y QIP a� o o8 lob SIZE MAIN: /Z�/ TYPE MAI - DEPTH AT MAIN: _,e% AT PROP. LINE: CONNECT LOCATION: D. COMMENTS: -ip-te4wkk Aiw b' %s INSEPECTED BY: C L k �1 DATE: Sb/ �m%1YhL eILGii�e 1r� 1 ,B 46 )A4! vow4x