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HomeMy WebLinkAboutBROOKS VANDERWOOD LT 48BBrooks Vand rwood Lot 48B #051 - 104-69 by DOC Co. dba ;SULLIVAN WATER WELL:5 P.O. BOX i170273, CHUOIAK, ALASKA 99567 · TELEPHONE 688-27~i9 OWNER OF LAND /~E~ ~'~tc BORE HOLE DATA DEPTH PERM,T NUMBE~~ Date of issue ~ - ~ 2~ ~. /~ T~INDENTtFICATIONNUMBER~- /0~ - ~, (~ ~E Method of Drilling: Depth of well: ~ Casing Type ~"7'~I Diameter ~ ~ Wall Thickness 0 o~ ~ inches inches, depth '40~' feet Liner Type: Casing 8tiokup A~ve Ground: ~, ~et Static ~ter Level (from ground level): ~ feet Pumping level: ~ after hm. pumping,, gpm Recover ~te: ~ ~pm Method of Tesfi.g'. Well Intake Opening Type: ~n End ~ O~n Hole ~ Scmen~; ~a~ ~et Stop~d ~t ~ Perorations S~ ~top~d f~t Depth: from .... 0 ~, to ~ f~t Pump Intake ~pth:. f~t Pump Size hp Brand Name Well Disinfe~ Upon Completion? ~es ~ No Method ~ Disinfe~ion: Comments: Ori,ier, Name ATTENTION: It is the responsibility of the property owner to submit a copy of the well [~g to the proper authority, Municipality of Anchorage: Department of Health & Human Services and/or Depadment of Environmental Conservation, MatSu Borough: Department of Environmental Conservation, I0/~0 S9~d N~AIqqRs 6G~BB9 I0:~ 666I/I0/I0 MUNICIPALITY OF ANCHORAGE Depa~ment of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 195650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WATER SUPPLY PERMIT Initial Date Issued: Sap 08, 2000 Expiration Date: Sap 08, 2001 Permit Number: SW000360 Legal Description: BROOKS VANDERWOOD LT 48B Design Engineer: 0000 None Required Owner Name: Ben B. Lee Owner Address: PO Box 670372 Chugiak, AK 99567- Parcel ID: 051-104-69 Site Address: Lot Size: 49514 SQ. FT. Total Bedrooms: 2 Permit Bedrooms: 2 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. Ail 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 DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 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: ~ ~ Date: ~~-"~ Date: ~-- F-~'~(~ MUNICIPALITY OF ANCHORAGE ~ ARTMENT OF HEALTH AND HUMAN SL ~CES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT /3 o,s ^.c s c4 ~ r'o o K' 5 -'"'~ TO SEPTIC ADSORPTION AddressF~GM ~ WELL -..,, TANK FIELD Phone(s) -- I Perm,t No. No. of Bedrooms WELL //q / ~ o~sc.,..,o. LOT LINE ~- / Lot J Block Subdivision ~¢~ ~ FOUNDATION ~0~/~ ToWosh~0, Range, Secuoo AS-BUILT DIAGRAM (~how location Se~ ~ ~]~ ~ /t~ ~. ~. Or,veway. waler bodies, etc.) TANKS U Manula~turer Gapaoty m ~aHons Material ~ No. ol Compaaments TYPE OF ~ TRENCH ~ BED ~ W. DRAIN ~ OTHER D~pth to p~pe bottom from Total depth from original grade onginal grade FllI aOOe~ adore or~m aOe Gravel Oepth beneath p~pe Gravel length Gravel w~dth TotaJ absoft,on area Distance between lines ~ ~/~ = J Installer ~ ~ ~ ~ ~ Date Installed WELLS jPRIVATE ~ OTHER 0dentifv) JJ~ OJassfficatJon (A,~,O) Tot~l Depth C~sed to FT FT Installe~ Date Installed: Scale:inspections Pe.ormed ~IA$~ / ~?;~jr '~ I cedify thal this inspection was pedormed according to all Municipal and Stale guidelines in elfect 0n this~t~ E~J~~1~ /o -- / z -- p; . . %%, ':; ¢',~,~O. : ?' ' Health Depa~menl Approval: ..... ¢ ; ate: '-013 (3/85) CHUGIAK, ALASKA 688,3199 " I'"DRILLING CO. WE SERVE ALL ALASKA POST OFFICE BOX 42 - CHUGIAK, ALASKA 99567 KODIAK, ALASKA 486-4826 DATE - STARTED ........................ :.-:--'----:.:"':..L:v.: ........................................... DEPTH OF WELL ....... :.:: ....... : .................................................................... STATIC LEVEL OF WATER FT ....... : ..... :..':.:....: ........... :'..:..:....: .................. DRAW DOWN FT ....... ; ..... ;..:....:: ...... '. ......................................................... GALS. PER HR ........ -:d::!~.....2.&2. ................................................................. KIND OF CASING 2~ .'_-'; :d: .... ':: ~ :-.:. .................................... KIND OF FORMATION: FROM ...................... FT. TO ....~ ................. FT...:2...>...: ..... .... ...::..:...'...~*~ "."~ 7.: FROM ' FT. TO i./ FT. -- · ._ ,) -2 FROM ...................... FT. TO .... :.:: .............. FT...:!:':2.:( ....................... FROM FT. TO ..:i!::i: .............. FT. FROM ....................... FT. TO . ~ c FT...:.:.7.:.~:.:-~- ....................... 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 ...................... FT .................................... FROM ....................... FT. TO ..................... :. FT .................................. FROM ....................... ET. 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 ........................ FT ................................. FROM ....................... FT. TO ........................ FT ................................. FROM ....................... FT. TO ....................... FT .................................. FROM ....................... FT. TO ........................ FT ................................. MISCL. INFORMATION: DRILLER'S NAME DEF'AR"FMEN'¥ OF HEAL'¥H AND ENVIRONMEIqTAL. F'ROTECTION 825 L .~REE] , ANCHORAGE, AK 9950 264-4720 PERM I T Iq(): DATE ISSUED: AF'PL. I CANT: ADDRESS: CONTACT F'HONE: 85()458 ()7/29/85 % S&S ENGINEERING PAUL. BROOKS SRB 196-X EAGLE RIVER, AK 99577 694-2979 L,.E(-]AL DESCR I F': I_ O'l" S I Z E: MAX BEDROOMS: SUBDIVISION: N/A SECT I ON: 9 TOWNSH I P: lA (SQ. FT. OR ACRES) 3 LOT: 48 15N RANGE: 1W BL. OC, I<: N/A L. isted below are the options available to you in designing your sept.ic: system. Choose the option that best Fits your site. DEPTI4 "FI'.') PIPE BOTTOM GRAVEL DEPTH (FT.) 'T'OTAL. DEPTH (FT.) GRAVEL WIDTH (FT.) GRAVEl.~ LENGTH (FT.) GRAVEL VOLUME (CU. YDS. TANK SIZE (GALS) SOIL. RATING (SQ..FT. /BR) "lrRENCH BED W. DR;!~ I ~ 4.0 4.5 4~0 5.0 0.5 3.5 9.0 5.0 7.5 2.5 17,0 5.0 38.0 34.0 41.0 19.4 21.5 30.4 000.0 **' 1,000.0 ** 1,000.0 ** 125 125 125 **TANK MUST HAVE AT LEAST TWO COMPARTMENTS I certif'y that: 1. I am £amiliar with the requirements For' on-site sewers and wells as set Forth by thee Municipality o~ 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 o¢ Alaska requirements For the set bac:k distances From any existing well, wastewater disposal system or public sewerage System on this or any adjacent or nearby lot. ~.4. I under, stand that this permit is valid For a maximum 'of 3 bednooms and any enlargement will require an additional permit. ' IF A [.IFT STATION IS INSTALLED IN AN AREA COVERED BY ~OA BUILDING (lODES, THEN (1) AN EL. ECTRICAL PERMIT AND INSPECTION MusT BE OBTAINED; (2) AS-BUIL. TS WILL NOT BE APPROVED WITHOUT AN ELECTRI.CAL INSPECTION REPORT; AND (3) THE ELEECTRICAL. WORK MLIST BE DONE BY A LICENSED ELECTRICIAN. SIGNED ~.,,. ~ /~ ~ ~. ~-~ ~ '` ~ ~DATE: _.~~~~ . AF'PL.~CAN'T': % S.,.~ ENSZ~ERINB F~UL. BRDO~S ' SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG PERCOLATION TEST PERCOLATION TEST DATE PERFORMED: q -"Z.-.~' ,- ~ LEGAL DESCRIPTION: 1 3 4 5 8 SLOPE 10 11 12 13 14 15 16 17 18 19 2O No. ~457-E COMMENTS 8 '& ~ ENGINEERINffi ~ .~RB 196X 72-008 (6/79) P E IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop ~ ) ~ (minutes/inch) I I' PERCOLATION RATE TEST RUN BETWEEN FT AND FT Parcel I.D. 051-104-69 Municipality of Anchorage Development Services Department · -. Building Safety. Division., · On-Site Water and Was. tewater 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 Expiration Date: ~ - ~. -7- (D '3 GENERAL INFORMATION Complete legal description Brooks Vanderwood, Lot 48B Location (site address or directions) 20816 Helluva Street. Chugiak, AK 99567 Current Property owner(s) Carolyn Lee Mailing address 500 Jeanell St., #8, Carson City, NV 89703 Lending agency Mailing address Real Estate Agent Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. NUMBER 0F BEDROOMS: ~ Day phone (775) 883-8278 Day phone Day phone TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class __ 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 4 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. (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 x 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 Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) 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 wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm KND ENGINEERING, INC. Address 20441 Ptarmigan Blvd., Eagle River, AK 99577 Phone (907) 696.6111 Engineer s Printed Name Kenneth M, Duffus 5. DSD SIGNATURE / Approved for Disapproved. '.~ . bedrooms. Date 11 ~26~02 Conditional approval for bedrooms, with the following stipulations: Additional Comments Attachments: HAA Checklist Septic System Advisory Well Flow Advisory X Maintenance Agreements Supplemental Engineer s Report Other Original Certificate Date: / / 0:2._ (Rev. 01/02) '",i:.~.,~'~i~,~,~" · ' · · . ~,.:.,..~,~,~..=~,,~?~..,. . . , .... .:::;'% D.~stailed. NA ~': ~p 0n I~vel at .DatUm in. SE'PA~ION 'DISTANCES FROM WEEL ON:LOq~ :TO i, . ~ ' Septic:.tank/lift statio'n on. lot, ..'1'00'+ . On '~dji~i"16~:.'.."'~:~.iJ'0:~ Absorption'field on.. ot. 100!+'.. Date 171126102 Public.sewer main 75'+ .:i:.'Po'blic .gew~r manho e/c ean0Ut: 1,07+ '''';'':'' "" .......... :?.~.:~"-" ~.:,~.:.....~,~:.,. ,,:....:,~:,~?~.~.~,~?;,.~.~,... ..-: .~.~:.,:~.;...,~-~,~?.~..~.:.....>?... ....... · ..:.:,?~.¢~...:.?~..~:.. ~.~.:~ · SewA~./septic se~ice..li~e:..' 25~ :; ...... ' '" '~"'" ....... ' "'" ............ :' -"~ HoIding.'.~,ank'.~. 't8'0'~ ' ~ '~:~ :''~':' . . ,.~,:';ZJ~'~:._. ~'~.:;'{~.';.:":~'~? ,*'.t'.."¢.::';";~;.';~7;:;;~;~;/:~.::. f.~',:./' ~::? ..:~. ~.~:..;..~,"~:'i~.:'.~:.'~: ~, . SEPA~TION'.. DISTAN'OES. F~OM }~E~T C/HOLDING ~ANK....O~' EOT;:TO::.:" '~' '"" *: "~:?':~';;;~.'?'.":,"~;' '" .' ~...':,: .,....? ...':.: ::.~::?.* :~.,?~.~ "F. '. Buildi~g fOundation. '5'+, Prope~y linB"?'~+ .. ~bsocpJJoh field Water. main '10'* .... ' ...... '" ....... ':';""~aJ~'se~i~'.line "~0;'+" Su~ace.water '.100~+. .., , ................ ,;;:. : -. .~.,.. ............. ;..;'.:;...".: , . .. · . Well~,o~ .~djacent lots. '~ 00f~ ...... SEP~TION-DISTANCE FROM AB'SORPT ON..~FIELD :ON.' LOT .TO: ,;.:;": ".~: ); ~.' '~ ~.; ~ ..~, ~. %-~ ~.L:~ '.~.:';, .: Prope~ .li~e 10'+ .B' main . ;-=~'~':~;:.:"~ ',.?'{= ,'~,,'~'d~;,~: ;~.~.~-,'.:.,.= .:,, :~,..-. wate~.:S~ice'line 10"+ Su~ace:.wat~r.'.":'t~.;~ ....... ;: "'": :"" ..................... '~' "' . DriVeway ..par~ng/veh c e'stora e .'~'.' ~:.~::',~:;:.'L~ ~: '~ ". ~.%,~,~'.:.::J,~ ~," · :" ~"~ .:~ "t '. '~. '~ ~ . ~ "~; '.' ' ' - cu~ain drain 50~+ Wells: On:adjacent',.'lots'..'L100~,. F."..'.COMMENTS : " .... ....... . ....................................... ~(.(~;;L.~;;~;¢.~.':;;:.~;.::.~:~q~ ef'~,;':~ '";?~?, ..'¢-r.::'* .~..'~,'~ .r~:...:?,,~..~.-. ~.......,. ¢.'~. _;:.;..:~..:L*.:-LF' ;h:' ' Hou~mi,vacan~' for past' 60 days., septic field.~mharged .wi. 2O00'galldn~ ~f Water and.:subsequeg~.~Med'.w/n .48'.'hour. Inte~eBiat~ 'elean°u{~b~8~n'~¢8a~¢d~;'C ~h0u't '~ n ~ :~'¢~-:~t~h~;*?'!,';'~ ~:· .':~..";~.d;..~.,':. ~. ".. · '"'"'"'":"" '"" ' '" .... "~' '"' "'"':' ":":' "' ..... :'":' '"'" "'" ~" ...... . . . ......... .. ,. ,.. ;: , ,..-~. .~: .. .?.,:~ :.,... ,, ..: . ..,,... ..... ..,~, .,,.., ~.~,' ~., e...ENGINEER s. CERTIFICatION ~ ....... ..,-.,.,.. ...... . ....... . .,,,.-4 .... -.,...... :,.,.,..,.., ....~: ~..,.. ......... .... ..... . . .. ....... . ..... . .. .. ... ..... : ......... . .. .... . .... . · ., .... . .... . .. ,. ~.~.... ~.,~ ~;' '~": :. ' ¢'? " ~¢ ~",'~'~ ': .... '~'l~ ~'~i~.i~..~'x.? ,.......~ ..... ... . ~~.. ......... · '~ ./7 ~:',..:..' .. .~'. ~.,.- .. ~ Foe ..'..$3l~:00 · ? .~.;:~..?~?:." :'~..,v".>: . .'~..~:~?: :~.~?:~'~:':%~:::~;:-:.':%:¢:~:~;s~.;~. ' ~.~;L.,?~:. '~?} +~;~::. ,~' ::~F;~-:,-.,.:,.-'~2~,:~:.~..,.?..:.:;~:F~..~.~..~ q ,.~.: :..~ . ~ato:6f:~'agm~nt· '1'~[0~ :." .':. :.' · · ."'". ''B~t~:;f.:~&~.:" ~- .. · ':,':. ~ .' · . · .: :.,.~.: .??. ~x..'.~. ..... ?~.~....~..?. ~".-::..~.,'..~;.~. z~;~?.:,~?b.¢.. · J ' .. ..;..~,:.- .... "....~ .~. ~:~ yu~*.[ .... ' ~.'" ~' .. · ." ~,~..~m~...:.'.: .o?~o?:~".7~.:::..:' .~ :' ...: ::. :?:~;'~':.~3~7S~,.~.~:~.~¢.:'": .':.~' '..~.' .'. (ROv:"~2/Oi~ .............. -~:~.' ......... ':..' '~ .L:~.+:¢~.. '~ ............ ?...~?::'.'.? .~..:',-...~.,. :...?,. r~.'.....~'~:~.:~'~x'?:.~'.: '.~.,'-~ ".. ':~.'/?.~. :'¢:.'~ ASBUILT I HEREBY CERTIFY .THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY: AND THAT NO ENCROACHMENTS EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS~ COVENANTS, OR RESTRICTIONS WHICH DO NOT APP~EAR ON THE RECORDED SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SI-IOluL.D ANY DATA HEREON BE USED FOR CONSTRUCTION OF FENCE LINES= OR FOR ESTABLISHING BOUND- ARY LINES. SCALE; DATE= GRID= FB: DRAWN= SEWARD & ASSOCIATES LAND SURVEYING 694-0829 OF A/~'.~,, ?"