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Home My WebLink AboutVERN HAIK LT 10V Haik Lot 10 #0§1-06! -88 Municipality of Anehorage page Development Services Department On-Site Water and Wastewater 4700 South Bragaw P.O. Box 196650 An~. AK 99519-6650 www. ct.anchorage.ak, us (907) 343-7904 ON..~llfi WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPEClION REPORT Permit Number:. 5W_O~OOb7 PID Number, 051-061-8~ Name: Wastewater System: New MM&M Contractinq F.O. Sox 67049.5 Chuqlak, AK 99567 ABSORPTION FIELD Ptx3ne; .umbe~at,,.~,~,: 5' Wide Trench 688-1236 Three (3) LEGAL DESCRIPTION 1.2 c~re 8.0 ~t. 10 Vern Haik,,,, 4.0 .5 F,. 38 Well: Community Water 5.ystem c,-~e~,,,~: Numbe~o~l~nes: D A rt. r, 380 rf ASTM D3034 PVC r, MM&M Contracti~ 7114-15/2003 · ~,~: ~.., s.~.t I c..~ ~ .~ ~o~o ~ TAN K SEPARATION DISTANCES Septic T~ To Septic Absorption Lift Holding ~ublic/Primte Manufacture. Capace/~C,a,om: F~m~ Tank Fietd Station Tank SewerUne Anchorage Tank 1,000 >200' !>200' N/A N/A >25' Steel Two (2) S~*W~F~,,~.~ >100' >100' N/A N/A ~ s~. u~.~LIFT STATION Lo~u~ >5' >10. N/A N/A >D' >10. N/A NIA '"~P ~ ~'~ =: -e~p ~,~,,n o.,~n None Noted Pu~lp M~ke & Model ~'"'~: BENCH MARK ~-" Irtoular, ion Over DeFt. lc lank:. LocalmomxtDempaon: Finiehed Floor. lOO.0 Engineees Inspections performed by: T. Ktmbr~ugh Dates: 1~t .~Z/.I_~rZ2O_O~. ~~"}__. ~..~_.~ 2m 7/15/_20_0~ Departmentof Health and Human Servicesapproval Reviewed and approved by: __~,~x ~,/,~. Date: ~;~"~ Municipality of Anchorage Page 2 of 3 DEVEOPMENT SERVICES DEPARTMENT 4700 South Bmgaw Street Anchorage, AK. 99519-6655 - 343-7904 On-Site Wastewater Disposal System or Well Inspection Report Permit Number:. SW030087 PID No. 051-061-88 10 S1 S2 M1 C4 C5 150.51 Alternate Site I TH 2 M1 C5 · TH1 .C4 S2 'i'hme Bectroom t4ome A 25.0 27.6 49.4 26.8 49.8 17.9 20.9 24.0 43.8 23.5 N89 56'37"E' 151.83 I LOT 10, VERN HAIK SUBDIVISION '**~,~,'.";:'-'.-...~'_;~'~ I Municipality of Anchorage · DEVEOPMENT SERVICES DEPARTMENT 4700 South Bmgaw Street Anchorage, AK. 99519-6655 -343-7904 On-Site Westewater Disposal System or Well Inspection Report Permit Number:. SW030087 Page 3 of 3 PID No. 051-061-88 TBH=IO0.O0-~ .-, 98.4E i. _i u/ ~. 9~..1 ~-- 95.46~ 98.34 97.97 Septic TAnkI 95.E t-~4.57 94.15 97.19 (~eotexiite DccdnField Rock 80.35 90.35 / PROFILE AS-BUILT Scole: 1' = 10' 97.48 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 Initial Date Issued: Apr 17, 2003 Expiration Date: Apr 16, 2004 Permit Number: SW030087 ,~Legal Desci-iption: Vern Haik Lot 10 ~ Design Engineer: 0014 Anderson Engineering Owner Name: MM&M Contracting Owner Address: PO Box 670495 Anchorage, A 99567° Parcel ID: 051-061-88 Site Address: NHN Lot Size: 32207 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: [] Disposal Field [] Septic Tank ~ Holding Tank [--~ PtiW [] 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 Ddnking 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. Received By: l[,'{(~'~ ~Cy~l~ Date: Parcel I.D. 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/V~ELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Permit Number SWO,~O~' Properly owner(s) MM&M Contracting Mailing address (1) P.O. Box 670495 Anchorage, AK 99567 Mailing address (2) Legal description (Lot, Block & Sub'd.) . Lot 10, Vern. Haik Subd!vision Legal description (Section, Township & Range) Lot Size Day phone 688-1236 .Zip Code Acre~ THIS APPLICATION IS FOR: Sewer Only Sewer and Well Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub Swimming Pool Therapy Pool Number of Bedrooms Three {3) [] 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 authorized agent) Permit Fees: Date of Payment: Receipt Number: (Rev. 12/00) Waiver Fees: Date of Payment: Receipt Number: ANDERSON ENGINEERING · 'P.O. BOX 240773 - ANCHORAGE, AK 99524 522-7773 522-6779 (FAX) April 12, 2003 Municipality of Anchorage Development Services Department On-Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 I Subject: Lot 10, Vern Haik Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Lot 10, Vem Haik Subdivision intends to construct a three-bedroom home on the lot. We are therefore requesting a permit be issued for the construction of a new septic system to serve the home. The subdivision is currently served by a community water system. The attached Site Plan and backup documentation identify the location and configuration of the new septic system and alternate site and the parameters used in the design. Also identified on the plans are the test hole locations and septic systems on the surrounding lots. Drainage arrows are shown indicating the current drainage patterns. The drainage patterns will be maintained after construction. The test holes placed near the location of the proposed absorption trench indicated well graded sand with gravel and a pemolation rate of 1 to 5 minutes per inch. No ground water was found during placement of the test holes and none was noted during the monitoring period. We are therefore proposing to place a 1,000 gallon septic tank and a new 40' long by 5' wide by 4' effective depth absorption trench. The total depth of the trench will be 7' below the surface with the distribution pipe at 3' below the surface. Sufficient fill will be placed to prevent freezing of either the septic tank or the absorption trench. The ground surface on the lot slopes as shown on the site plan from south to north at varying slopes. The absorption trench will be constructed parallel with the slope as much as possible in conformance with Municipal requirements. All components of the new septic system will be constructed a minimum of 100' from any surface water and wells in the area and 10' from the water service line on the lot. If the system is constructed in accordance with our design the following statements apply: ]. The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. Lo~ 10, Vern Haik April 12, 2003 Page Two The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, Michael E. Anderson, P.E. Attachments 1 4B ~ 6B, 11 VACANT 5 3 ." 7 ~.94 114) 296.94 5 ~ 8 AREA MAP 150.51 / TH2 ~ ~'~. o-5~ · Alternate Site I I · TH1 4 40' Long x 5' Wide t' [ I x 4' Eft. Depth ~ Absorption Trench i 12' I.I 1,000 Gallon °'5°/' lO' ,! Three Bedroom I Home - ;,; :;,';..::, · 2% ~ ¥.¥':: - 'i:'~'; :~/;.;-~-: ~":'x '.i ¢:F~:-:.¥;., N89 56'37"E 151.83 SCALE 1" = 30' SITE PLAN LOT 10, VERN HAIK SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: 3 Bedroom House Perc. Rate: I - 5 Min.llnch Application Rate: 1.2 GPD/SF 5' Wide Trench System 1,000 Gallon STEP Tank 4' Drain Field Rock 3 Bedrooms X 150 GPDII.2 GPD/SF (Application Rate) = 375 SF of Absorption Area 375 SFI5 LF (Width)* .5 (Red. Factor) = 37.5 LF Trench Length Therefore: Construct a 40' Long X 5' Wide Absorption Trench With a 4' Effective Depth. Flow Line Elevation in Trench to be 3' Below Original Ground Surface. Total Depth to be 7' Below Existing Ground. -Maintain 10' Separation From Water Service Line on the Lot. Place 2" of Direct Bury Insulation and 2' of Fill Over Absorption Trench or Provide Minimum 3' of Cover to Prevent Freezing. Provide 4' of Cover Over Septic Tank. 6If 410II Natural Backfill Geotextile Fabric 4" Perforated PVC (ASTM 3034) Drainfield Rock '5'0" NOTE: TYPICAL WIDE TRENCH SECTION (NO SCALE) Grade Area Over Trench to Drain Away. Minimum 6' Separation From Bedrock. Minimum 4' Separation From Groundwater. Minimum 100' From Wells in the Area. Minimum 100' Separation From Surface Water or Streams. PROJECT ~: M031~ PERFORMED FOR: MUNICIPALITY OF ANCHORAGE · DEPARTMENT OF HEALTH & HUMAN SERVICES 825 L STREET, ANCHORAGE, AK 99502-0605 SOILS LOG - PERCOLATION TEST PAUL MYERS / MM&M CONSTRUCTION DATE PERFORMED: -01-1003 .3-- 5-- 6-- 7-- 8-- 9-- 18 lEGAL DESCRIPTION: LOT 10, VERN HAIK SUBD TEST HOLE # 1 MEDIUM COMPACTED WELL GRADED SANDS WITH GRAVELS & LITTLE FINES- SW SLOPE SITE PLAN See Site Plan SEE ASBUILT WAS GROUNDWATER ENCOUNTERED? NO S L IF YES, WHAT DEPTH? O DEPTH OF WATER None P AFTER MONITORING: E 4/11/03 DATE: READING DATE GROSS NET DEPTH OF NET TIME TIME WATER DROP Start ~.-01-03 10:35 10" 1 10&5 10 25" 9.75' Recharge 10:~,5 10 25" 2 10 55 10 .5" 9'/5" Recharge.. 1055 10" 3 11.05 10 ... PERC RATE: 10~J MIN./INCH PERC. HOLE DIAMETER: 6" TEST RUN BETWEEN &,$ FT. AND 55 FT. COMMENTS: N01MPERMEABLES ENCOUNTERED / HOLE PRESOAKED PRIOR TO TEST TEST PERFORMED BY: T.L. KIMBROUGH I, MICHAEL E. ANDERSON, CERTIFY THAT TH~S TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES ON THIS DATE: I 2-- 5-- 6-- 7-- 8-- 9-- ' PROJECT #: PERFORMED FOR: 18 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES 825 L STREET, ANCHORAGE, AK 99502-0605 SOILS LOG - PERCOLATION TEST PAUL MYERS ! MM&M CONSTRUCTION LEGAL DESCRIPTION: LOT 10, VERN HAIK SUBD TEST HOLE ~ 2 MEDIUM COMPACTED WELL GRADED SANDS WITH GRAVELS & LITTLE FINES - SW SLOPE DATE PERFORMED: SITE PLAN See Site Plan SEE ASBUILT COMMENTS: WAS GROUNDWATER ENCOUNTERED? IF YES, WHAT DEPTH? DEPTH OF' WATER AFTER MONITORING: DATE: NO S L 0 None P E 4/11/03 CROSS NET DEPTH OF NET READING DATE TIME TIME WATER DROP Start &-01-03 10:z, 0 I0" 1 1050 10 .25" 9.75" Recharge 10:50 10" 2 10.50 10 .25" 9.75" Recharge 11.00 10" 3 11:10 10 ..25" . 9 1~," PERC RATE: , 10~ MIN./INCH PERC. HOLE DIAMETER:. 6" TEST RUN BETWEEN, &.S FT. AND 55 FT. NO IMPERMEABLES ENCOUNTERED / HOLE PRESOAKED PRIOR TO TEST TEST PERFORMED BY: T.'L. K~M@ROUGH I, ,MICHAEL E. ANDERSON, CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES ON THIS DATE: ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: GENERAL: 1. LOT 10, VERN HAIK SUBDIVISION The scope of this project includes the procurement and placement of a new 1,000-gallon tank at the location shown on the site plan. Work also includes the construction of a new absorption trench 40' long by 5" wide by 5' effective depth also at the location shown on the Site Plan. The total depth of the trench will be 7' below existing ground and the distribution pipe will be placed at 3' below the surface. All components of the new absorption trench and septic tank must be constructed a minimum of 100' from any surface water or wells in the area and 10' from the water service line on the lot. A minimum of 4' of cover is required over the septic tank and 3' over the absorption trench. In lieu of cover 2" of direct bury insulation and 2' of cover-may be placed. Construction shall be in accordance with the approved site plan, design drawings, Municipal Permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. The Contractor shall be responsible for obtaining all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. Contractors installing wastewater disposal systems must be certified by the Municipal Department of Health and Human Services for system installations. Owners installing their own systems must receive prior approval from D.H.H.S. before beginning system installation. SEPTIC TANK INSTALLATION A new 1,000-gallon septic tank must be procured from a certified septic tank manufacturer if the existing tank is found to be defective. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. Tanks installed without 4' of ~;over shall have a minimum of 2" of direct burial insulation. Lot 10, Vern Haik April 12, 2003 Page 2 of 3 A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts are required between the tank and the drainfield. 7. Final grading over the tank shall be such that a positive slope exists away from the septic tank. DRAINFIELD CONSTRUCTION: The drainfield shall be constructed to the dimensions shown on the design. The bottom of the trench shall be within 2" of level. 2. Distribution piping must be placed level with perforations down atop a level bed of drainfield reck. Rock should then be placed over the pipe to provide a minimum of 2" of cover. 3. A silt barrier or geotextile 'fabdc must be placed between the drainfield rock and the natural soil backfill. Monitor tubes must be 4" in diameter and installed at the locations shown on the design. The podion below ground must be perforated. Contractor shall verify the septic tank and drainfield are a minimum 100' away from any private water wells in the area, 150' from a Class "C" Well or 200' from any community well. Direct bury insulation must be placed over the distribution system if less than 3' of backfill depth is available. Finish grade over the trench must be mounded to prevent settlement or depressions. Grade area surrounding the absorption trench to drain away. A minimum 2' of accepting soil is required below the drainfield rock for a 5' wide trench. Contractor shall verify this condition pdor to placement of the rock. All pockets of unacceptable materials must be removed and replaced. MATERIAL sPECIFICATIONS: 1. Septic tanks must be constructed by a municipally approved septic tank manufacturer, The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and solid). Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Co. Styrofoam HI or equal). Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). ' Lot 10, Vern Haik April 12, 2003 Page 3 of 3 ' 5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed between the final drain rock layer and the native soil layer. 6. Ail drain rock shall be .5" to 2.5" in diameter with less than 3% passing the #200 sieve. INSPECTIONS: Municipal Ordinance requires a minimum of two inspections. These inspections must be conducted under the supervision of a professional engineer registered in the State of Alaska. The first inspection must be conducted after the excavation of trenches, beds or pits and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled. The second inspection must be conducted after the placement of the geotextile fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No backfill should be in place at the time of inspection. Contractor shall provide a copy of all field survey layout and construction notes for use in preparing the certified as-built of the completed system. . 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 .. CERTIFICATE OF 'HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 51-061-88 GENERAL INFORMATION Complete legal description _ 'Expiration Date: Lot 10, Veto Halk Subdivision 'z.t%qO LoCation (site address or directions) West of Monron Street Current Property owner(s) MM&M Contracting Mailing address Lending agency Mailing address Real Estate Agent Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. NUMBER OF BEDROOMS: . Three'13) P.O. Box 670495 Chuqlak, AK 99567 Day phone 688-1236 Day phone Day phone TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class _A Well Public Water System [] [] [] [] TYPE OF WASTEWATER DISPOSAL: Individual On-site [] 'Individual Holding tank [-~ Community On-site [] Public Sewer [] ' The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued With new water sample results less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public Water system. The Municipality of Anchorage is not responsible for errors or omissions In the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER e As certified by my seal effixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined'in the Health Authority Approval Guidelines for this application, shows that the on-sit~ Water supply and/or wastewater disposal system is(are) safe, functionaLand adequate for the number of bedrooms and type of structure ihdicated herein. I further vedfy 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(are) in compliance with all app!icable Municipal and State codes, ordinances, and regulations in effect at the time of InstallaUon. Name of Firm Anderson Engineertnq Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name.Michael E. Anderson, P.E. DSD SIGNATURE ~'"" Approved for Disapproved. Conditional approval for Phone 522-7773 bedrooms. Date 8119/2003 bedrooms, with the following stipulations:' · Additional Comments Attachments: HAA Checklist Septic System Advisory Well Flow Advisory By: Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date:' ~ --'~ 0 0 _~ Legal Description: A. WELL DATA Well type Class A Date completed Total depth Municipality. of Anchorage Development Services Department BUilding Safety Division · On-Site Water & Wastewater Program 4700 South Bmgaw St. P.O. Box lg6650 Anchorage, AK 99519-6650 www. ci.anchorage,ak, us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Lot 10. Veto Halk Subdivision IfA, B, orC provide PWSlD # Sanitary seal (Y/N) Cased to __.ft. FROM WELL LOG Date of test Static water level Well preductlon g.p.m. WATER SAMPLE RESULTS: Coliform __.colonlesfl00 mi. Date of sample: Parcel ID: 051-o61.ss Well Log (Y/N) Wires properly protected.(Y/N) Castng height (above ground) AT INSPECTION in. Nitrate . mg./I. Collected by: , , g.p.m. SEPTIC/HOLDING TANK DATA .Tank Type/Material .Septic/Stol, Other bacteria colonies/100 mi. Date installed 7114/2003 Tank size 1,0(~0 gal. Number of Compartments ~ Foundation cleanout (Y/N) Y Depression over tank (Y/N) l~ Date of pumping ...... Pumper NewC0nstmction ABSORPTION FIELD DATA Date Installed 711S/2003 Soil rating (g.p,d./~ or ft2/bdrm) 1.2 GPD/SF Length ~.. fl. Width ~i ,. . ft. Total depth _8 fl. Eft. absorpUon area 3_8Ofl2 Monitoring tube Y Date of adequacy test. Results (Pass/Fall) Fluid depth in absorption field before test In. Water added Elapsed Time: min. Final fluid depth in. Any rejuvenaUon treatment (past 12 mo.) (Y/N & type) N Cleanouts (Y/N) y High water alarm (Y/N) H System type..~ Wlde Trench. Gravel below pipe ,.~ ,. Depression over field N gal. Absorption rate >= If yes, give date ft. For. ,, bedrooms New depth in, g.p.d. O. LIFT STATION Date installed 'Pump on' level at Datum · Size in gallons 'Pump oH level at Cycles tested in. E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot NIA Absorption field on lot Public sewer main NIA sewe~/septic service line NIA ' * In. Property line >10' Water Service line Curtain drain None Noted F. COMMENTS ~t is ,~rved ~ Dawn water wstem, G, -,ENGINEER'$ CERTIFICATION I certify that I have deten'nlned through field inspections and. review of Munidpal records that the above systems are in conformance with MOA I-IAA guidelines in effect on this date. Engineer's Printed Name Michael E. Andersol~. P.E. Date 8/19/2003 Building foundation >10' Surface water Wells on adjacent lots. Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? On adjacent lots On adjacent lots N/A Public sewer manholelcleanout ~/A. Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Property line >5' Absorption field =,.5' Water main >10' .Water service line. >1~ Surface water >100' Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Water main Driveway, paddng/vehicie storage HAA Fee $ '~* ~'J 5 Waiver Fee $ Date of Payment ~l iq lO~ Date of Payment Receipt Number ~0 ~IU ~.~ Receipt Number (R~v. 12/oo) PHOHI~ NO. : 9~?G881~38 Ju I. 28 2003 09: 46AM P2 %:.'~ o-~.,::~, · . . ..'