HomeMy WebLinkAboutMAJESTIC VALLEY ESTATES BLK 2 LT 2ic Valley
sta
Block 2
Lot 2
#050-731-04
JR ANCHORAGE AREA BOR"
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
'GH
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
DISTANCF._
INSIDE LENGTH INSIDE WIDTH
MATERIAL
NUMBER OF
COMPARTMENTS
LIQUID DEPTH
LIQUID CAPACITY Cg)~)g) GALLONS.
DEPTH:
NEAREST LOT LINE ~ /'OF TOTAL LINES LENGTH./cg.~ ~-
T RE N CF, W IDT H ~ I'"'N'~ TOT AL EFFE CTIVE
SQ. FT. LENGTH OF EACFI LINE // ~ z/t)'"
DEPTH OF FILTER
TOP OF TILE TO FINISH GRADE MATERIAL BENEATH TILE IN. ABOVE TILE IN.
WELL:
TYPE CONSTRUCTION DEPTH
BUILDING NEAREST NEAREST SEPTIC SEEPAGE
FOUNDATION__ LOT LINE___, SEWER LINE ___, TANK SYSTEM
CESSPOOL OTHER SOURCES
APPROVED . DISAPPROVED REMARKS
DISTANCE FROM:
DISTANCES:
DIAGRAM OF SYSTEM
INSTALLED BY:
SEWER LINE DEPTH:
PIPE MATERIAL'
LOT SLOPE:
REMARKS:
Form EQ-032
( erlifieil lrtlling
by
A & L DRILLING COMPANY
BOX 97, EAGLE RIVER, ALASKA 99577 · TELEPHONE 694-2588
OWNER OF LAND
ADDRESS
LEGAL DESCRIPTION "' ) ; /)' '.~.- '
DATE - Started . Ended
PERMIT NUMBER : : : i ; ;
GALS. PER HR
KIND OF CASING
DEPTH OF WELL
STATIC LEVEL OF WATER FT.
KIN[) OF FORMATION:
From
From
From
From :
From '
From
From
From
From
From__
From__
From
From__
From__
From
Fronl
From
Ft. to :
Ft. to.
Ft. to ~ Ft
Ft. to / ·' Ft
Ft. to ' : Ft.
__Ft. to ]': Ft
Ft. to '~ Ft.
Ft. to Ft
Ft. to Ft
Ft. to Ft
Ft. to Ft
Ft. to__Ft.
Ft. to Ft
Ft. to Ft
Ft. to Ft
Ft. to Ft.
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,
Frmn Ft. to.__Ft,
From Ft. to .... FL
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
PERMIT N0.
.~ .1.0 E.
I-,4tE L_ I-- FiNE
276-222t
ON~-'-'-'-J; I T'~
RPF'L I CANT
LOCFIT I ON
LEGAL
f'I~-ADEFRRI.MENT HEALTH AND ENVIRONMEN'FRL ':',oTb. L:T'ION Mu' ' ·
UDOR RD., RNCHORRGE, AK. S_ .J07 ~ ~'
I~EF~f,~ Z T
SPRUCE LANE
MRJE~TI ~ YRLLEY EST
L2 B2 '-
LOT SIi'ZE .. 55456 SQIJRRE FEET
TYF'E OF SOIL ABSORBTION SYSTEM IS: TRENCH
MR::',IMUM NUMBER OF' BEDROOMS = ~ SOIL AR'TIN6 (SQ FT,""BR,''= t25
THE F. EQ1JIF. E[ SIZE OF THE SOIL RESORPTION SYSTEM IS: ,-
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD.
THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE E>(CRVRTION (tN FEET).
]'HERE IS NO SET WIDTH FOR TRENCHES.
THE GRAVEL DEPTH I~ THE MINIMIJM DEPTH OF GRAVEL BETWEEN THE OLITFRLL PIPE
AND THE BOTTOM OF THE EXCAVATION (IN FEET).
BACKFILLING OF ~NM SYSTEM WITNOUT FINAL INSPECTION 8ND RPPROVRL BY THIS
CEPARTMENT NILL BE SUBJECT TO PROSECUTION.
MINIMUM DIST8NCE BETWEEN ~ WELL RND RN~ ON-%I"rE SEWAGE DISPOSAL SMSTEM I5
108 FEET FOR A PRIVATE WELL OR 2¢e FEET FOR ~ RUBLIC WELL
14ELL. LOGS 8RE REQUIRED AND MUST BE RETURNED TO THE ~PRRTMENT W~THIN gO DRYS
OF THE WELL COMF'LETZON.
.:,PE_.IFIC8TIONS AND CONSTRUCTION D/RGR8MS 8RE RVRIL8BLE TO INSURE PROPER
I NSTGLLRT I ON.
±: I AM FAMILIAR J.,.IITH THE REQUIREMENTS F]R ON-SITE ..Et.lEA=, AND NELLS FIS SET
FOR]'H E',Y THE Mur.,I'rCIP'RLITY OF RNE:HORF. IGE.
2: T WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
"g: i UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIC, ENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS,
E GEC. , CHNICALDEVEL
Box 90, Davis St., Eagle Rivar, Alaska 99577
694-2774 or 688-2280
'MENT CO.
E~rt Ellis
Russell Oyster 688-2280
694 2774 SOIL LOG Land Development
Soils 8 Foundations
Performed for: Name: CHARLES & POG~ANY DEVELOPMENT
Mailing Address: Box 363 Esale [Liver, Alaska
Legal Description: Lot 2 Blook/~MaJestic Valley Est~at~
S011 ~haracterj~Ic$
M'~-~-Stlt topsoil with roots and organics.
GM - Silty Sandy Gravel w/cobbles to 12"o
?el.
275 sq. ft./BE
200 Sqo ft./BE
GP~GM - Silty Sandy Gravel°
side of pit.
6 foot boulder in
i75 sq. fto/BR
GP - Sandy Gravel. Very loose material and overall quite coarse.
Cobbles to 18 inches common. All material very angular.
125 sq. fto/BR
]]
:L~
Bottom of Pit
Water Encountered: Yes__No~ If yes, what depth~
h"oMo~e~ ~stallatton: Seepage Pit__Or, tn
Colrments: Pit measured approximatelY 3' x 12' in plan area. All sides of
R~t~logged the ss~e. ,
Date: 6 Oct. 1975
by:
Pamel I.D.
1. GENERAL INFORMATION
Municipality of Anchorage ...:~:.;~ ~.
Development Services Department .~..
Building Safety Division
On-Site Water & 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 .b, UTHORITY
FOR A SINGLE FAHILY DWELLING ' v
o5o-731-o4 HA~
Expiration Date:
Complete legal description
Location (site address or directions)
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
MAJESTIC VALLEY ESTATES SUBDMSION; LOT 2, BLOCK 2,
26019 WHITE SPRUCE DRIVE * EAGLE RIVER, AK
NATIUE HARRISON AND PHILIP PRICE Day phone 694.-0923
26019 WHITE SPRUCE DRIVE * EAGLE RIVER, AK 99577
Day phone
Day phone
Un/ess otherwise requested, HAA will be held by DSD for pickup.
2, NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class 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 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 samples. (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.
Note:Alaska Water and Wastewater Consultants, Inc. shall be paid $ (~ at, or pdor
to closing for the engineering services provided.
/
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown be/ow, I verify that my
investigation, based on procedures outlined in the Health Autho#ty 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 fi/es and from my investigation and inspection, the
on-site water supply and/or wastewater disposal system is(are) in compliance with ali applicable Municipal
and State codes, ordinances, and regulations in effect at the time of installation.
NameofFirm ALASKA WATER &: WASTEWATER CONSULTANTS, INC. Phone 337-6179
Address 6901 DEBA~R ROAD, SUITE 2B * ANCHORAGE. AK 99504-
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Date
Engineer's Comments:
In conducting this evaluation, AKWWC, Inc. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines & Regulations, The reported results described the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readily identifiable features. The operational life of ali wefts and
septic systems depend on the local soils condition, groundwater levels that may
fluctuate durfng the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evatuator of the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. AKWWC, Inc. can therefore not provide
any wan'anty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this ropoct is for
the sole benefit of the owner listed above. Any reliance upon or use of this repor~ by any
other person or party is not authorized, nor will it confer any legal ¢fght whatsoever,
5. DSD SIGNATURE
V~ Approved for ~ bedrooms.
Disapproved.
Conditional approval for __
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
bedrooms, with the fllowing stipulations:
~ WATERAND : m'
PROG~M ;
.. ..
Manitenance Agreements
Supplemental Engineer's Reort
Other
O,ginal Certificate Date: ~' /
Municipality of Anchorage
Development Services Department
Building Safety OIv~lon
On-Site Water & Wasfewater Program
4700 ~ Br~g~v St.
P.O. Box 196650 Anchorage, AK 99519.6650
O
Legal Descrli~on:
A. WELL DATA
HEALTH AUTHORITY APPROVAL CHECKLIST
MAJESTIC VAIIFY SUBDIVISION; LOT 2, BLOCK 2 Parcel ID:
050-731-04
Well type t'~VA~ If A, B, or C provi;le PW$1D# N/A Well Log (Y/N)
Date completed 5/10/1976 Sanitary seal (Y/N) YES Wires pmpedy protected (Y/N)
Total depth ;230' ft. Cased tol00'-5"ft. Casing height (above ground)
*¥/;iL DEEPENED TO 410' IN NOVEMBER OF 1985 PER PREVIOUS HAA.
FROM WELL LOG AT INSPECTION
Date of test 5/10/1976 "9/27/2000
Static water level 110' ft. 309' ft.
Well I~XlUCtion 3 g.p.m. 1,0 g.p.m.
WATER SAMPLE RESULTS:
C~liform (~' colonies/100 mi.
Arsenic: N,/.A mg./L.
SEPTIC/HOLDING TANK DATA
Tank Type/Matedal
Tank size ~.000 gal. Number of Compartments 2
Foundation cieanout (Y/N) YES Depression over tank (Y/N) .NO
Date of pumping 5/10/2002 Pumper
ABSORPTION FIELD DATA
Date installed s/3/Ig7s
Langth 47 fl.
YES
YES
18'+ in.
Nitrate O..,~..~JL. Other bacteria ,2.'.'.'~ colonies/100 mi.
Date of sample: 8/26/2002 Collected by: AKIffWC, INC.
Soil rating (g.p.d./ft~r,(~) 125
Width 3 ft.
Totaldepth s6.6 fl. Eff. absorptionersa 376 ft~ Monitoring tu~l;' yES
Date of adequacy test 9/26/2000 Result-, (Pass/Fell). PASS
Fluid depth in absorption field before test O' in. Water added 6.88 gal.
Elapsed Time: 10,]5 min. Final fluid depth 0.' in. Absorption rate >=
Any rejuvenation treatment (past t2 mo.) (Y/N & type) NONE KNOWN
Date installed 5/3/1976
Cleanoute (y/N) YES
Hlgh water alarm (Y/N) N/A
JR'S PUMPING
J eAT SUMP. MF,.,A~URED IN
System type TRENCH
Gravel below pipe 4 ft~
Depression over field NO
For 3 bedrooms
New depth 51.5in.
4504- g.p.d.
If yes, gtve date
D. LIFT STATION
Data installed
'Pump on' level at in.
Datum
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Size in gallons
'Pump off' I,~'-,el et
G~/d e s tast~
Holding tank
Septic tank/lift station on lot100'+
Absorption field on lot 100'+
Public sewer main N/A
Sewer/septic service line 25'+
Manhole/Acc~<; (Y/N)
High water alarm level at
Meets alarm & circuit requirements?
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/ctaanout
N/A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+
Water main 10'+ Water sen;ice line 10'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line '1 '+ Building foundation 10'+
Water service line ' 10'+ Surface water 100'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
COMMENTS
N/A
Absorption field 5°+
Sudace water 100'+
in*
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
review of Municipal race.Is that the above systems em/n
conformance with MOA HAA guidelines in effect on this date,
Engineer's Pdnted Name
Date E'/-2,°/<&t-
d~fPKEY A. OARNESS
~*WNVER f WRO000881
Water main 10'+
Ddveway, parldng/vehlrJe storage 10'+
Waiver Fee $
Date of Payment
Receipt Number
CT&E Ref.~
Client Name
Praj~t Name/~
Matrix
Ordered By
Ssr~ole Remarks:
10254111001
AK Water & Wastewatet Consultants Inc.
t.ot 2, Blk2: Majestic Valley
Outside Hose B~
Drinking Water
Ail Dale~lnmes nee Abskm Standard Time
~rSnled Datt~flme 09/03~2 8:37
Collected Dnt~I~ '08~6~002 14:05
R~elved DaI~I~ 0g~2 16:20
IAmits I~te I~te Init
Ni~Ic-N
0.386 0.200 ~ EPA 300.0 f<'q0) 08/26/02 JDT
Total Coliform 3 OB, No Coli
col/I OOmL 5MIS 9222B
08/26/02 KAP
09/19/00 ~ 16:29 F.~, $$90t99 ~,'!~TA ~AL ESTAT~ ER . . ~002
,. :..........,..,..:
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.= , . ,. · ~.,~.h ~: .~.. ,~ ~. . .,.... . . ., ~ -. ~ ..~.~,,,..,..~*~,..
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· . . .~. ~ , : ~ ~ ·
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MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
DMsion of Environmental Services
On-Site Services Section
P,O. Box 196650 Anchorage, Alaska 99519-6650
(9O7) 343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILLY DWELLING
Parcel I.D.# 050-751-04 HAA# F~.~'C-~
I. GENERAL INFORMATION
Complete legal description MAJESTIC VALLEY ESTATES SUBDIVISION: LOT 2. BLOCK 2.
Location (site address or directions) 26019 WHITE SPRUCE DRIVE EAGLE RIVER. AK 99577
Property owner
Mailing address
Lending agency
Mailing address
DIANE BAUER
16635 CENTERFIELD DRIVE
Day phone~
EAGLE RIVER. AK 99577
Day phone
Agent LAURA HAMILTON W/ PRUDENTIAL VISTA Day phone
Address 16635 CENTERFIELD DRIVE EAGLE RIVER. AK 99577
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
Individual well xxx
Community well
Public water
NOTE:
(907/ 689-6507
If community weft system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding Tank
Community on-site
Public sewer
NOTE:
XXX
If community wastewater system, provide written confirmation from State ADEC
ing to the legality and status of system.
72-025 (Rev, 1/91 ) Front MOA ~1 Computer Version
Note: Alaska Water and Wastewater Consultants,/nc,. shaft be paid $1,150.00 at
or prior to, closing for the engineering services providea.
5. STATEMENT OF INSPECTION BY ENGINEER
As cedified by my seal affixed hereto and as of the validation date shown below, I verity that my
investigation of this Health Authority Approval application 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 verity 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 in compliance with all Municip ,al. and State codes, ordinances, and regulations in effect
on the date of this inspection. ,,,~',~
Name of Firm ALASKA WA:]:E-~ &/~,~SZ'¢E/~AYER CONSU_LTANTS, INC. Phone f907) 337-6179
Engineer'sSignature ( .-~V~t~ __Date /o/q/CC'
,f
IUVlIV ~ / /
In conducting this evaluation, AI, WVC, /n~. a~e.n~ted to provide a thorough, conscientious engineering analysis
of
the
system in accordance with ADEC and MpA 'DHI¢IS Guidelines & Regulations. The reported results described the
performance of the system under the conditions encountered at the time of the test, and separation distances
measured to readily identifiable features. The operational life of all wells and septic systems depend
on the local soils condition, ground water levels that may fluctuate during the year, and the water
usage of the family being served by the system. These conditions are outside the control of
"~ft ..... ""~-'-¢ ......
'egl A. Garness..
the evaluator of the system. Satisfactory test results do not guarantee future performance
of the system, nor do they guarantee that there are no hidden defects or encroachments.
AVWVC, Inc. can therefore not provide any warranty for future estimate of how long the
system will continue to meet the operational requirements of the ADEC or MOA DHHS.
The content of this report is for the sole benefit of the owner listed above. Any
reliance upon or use of this report by any other person or parO/ is not authorized,
nor will it confer any legal right whatsoever.
6, DHHS SIGNATURE
/,-'~ Approved for ~
Disapproved
Conditional approval for
bedrooms
bedrooms, with the following stipulations:
Additional Comments
Date
The Municipality of Anchorage Depadment of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of
homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of
DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of
Anchorage is not responsible for errors or omissions in the professional engineer's work.
72-025 (Rev. 1/91) Back MOA ¢Y21 Computer Version
Legal Description:
RECEIVED
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
Environmental Services Division OCT '[ 0 200
825 "L" Street, Rm 502 Anchorage, Alaska 99501 (907) 343-4744
MUNICIPALITY OF ANCHORAGE
Health Authority Approval Checklist ENVIRONMENTAL SERVICES DIVISION
MAJESTIC VALLEY S/D; LOT 2, BLOCK 2, Parcel I.D.:
050-731-04
If A, B, or C, affach ADEC leffer. ADEC water system number
5/10/76
A. WELL DATA
Well Type PRIVATE
Log present (Y/N)
Total depth
Sanita~ seal (Y/N)
YES Date completed
*230' Cased to 100'-5" Casing height (above ground)
YES Wires propedy protected (Y/N).
*WELL DEEPENED TO 410' IN NOVEMBER OF 1985 PER PREVIOUS HAA.
FROM WELL LOG ATINSPECTION
5/10/76 9/27/00
110' 309'
3 g.p.m. 1.0
Nitrate 0.5 mq/L Other bacteria
Collected by: A.W.W.C., INC.
N/A
Date of test
Static water level
Well production
WATER SAMPLE RESULTS:
Coliform o
Date of sample:
9/27/00
B. SEPTICIHOLDING TANK DATA
Date installed 5/3/76 Tank size
Foundation cleanout (Y/N) YES
Date of Pumping 4/4/2000
C. ABSORPTION FIELD DATA
Date installed 5/3/76
Length 47' Width 3'
18"+
YES
g.p.m.
1000 Number of Compartments 2 Cleanouts (Y/N) YES
Depression (Y/N) NO High water alarm (Y/N) N/A
Pumper JR'S PUMPING
Soil rating (g.p.d./ft2 o~
125
Gravel thickness below pipe
*AT SUMP. MEASURED IN FIELD.
System type TRENCH
4' Total depth *6.6'
Effective absorption area 376 SQ. FT. Monitoring Tube present (Y/N) YES Depression overfield (Y/N).
Date of adequacy test 9/26/00 Results (Pass/Fail) PASSED For
Fluid depth in absorption field before test (in.); 0" Immediately after 688
Fluid depth 0" (ins) Minutes later: 1055 Absorption rate =
Peroxide treatment (past 12 months) (Y/N) N/A If yes, give date
72-026 (Rev. 3/96)* Computer Version
NO
3 Bedrooms
gal. water added (in.): 51.5"
450+
D. LIFT STATION ~
Date installed Size in.Q_ga~'~ ..................
Manhole/Access (Y/N) ~ ~_ Pump off level at*
Hig~~ *Datum
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot
Absorption field on lot
Public sewer main
Sewer/septic service line
100'+ On adjacent lots 100'+
100% On adjacent lots 100'+
N/A Public ,,~ewer manhole/cleanout N/A
25'+ __. Lift station N/A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Foundation 5' + Property line 5'_+
Absorption field
Water main/service line 10'+ Surface water/drainage 100'+ Wells on adjacent lots 100'+
SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO: I,SEE LOT LINE WAIVER REQUEST LETTERI
'1' Building foundation 10_'+ Water main/service line__ 10'+
Property line
Surface water
Curtain drain
100'+
NONE KNOWN
F. ENGINEER'S CERTIFICATION/
I certify that I h)~TE~d~ ~rmip~h~u field inspections and review
of Municipal r~cor~l, at/t¥/~(bo~e systems are in conformance
w, th MOA Ha gf, on ,his data.
Signature
Engineer's Nar~e . JEFFREY A. GARNESS
Date /0/<
Driveway, parking/vehicle storage area 10'+
Wells on adjacent lots 100'+
'~0~.'/...,. ~E-7955 .,...'. ~,~,~.~
HAA Fee ~ ~,'~_ D,'(~. ~'~
Date of Payment /~) -~/D --~'~
Receipt Number ~ ('c> ,~-~(~' ~
72-026 (Rev. 3/96)* Computer Version
Waiver Fee $
Date of Payment
Recaipt Number
//,.5-,
18:§5 FRO~-CTE ENVIRONMENTAL 5615301 T-892 P.01/01 F-582
CT&E Environmental Services Inc.
Laboratory Division
200 W. Potter Drive
Anchorage, AK 99518
Tel: (007) 562-2343
Fax: (907) 561-5301
CT&E Ref. #:
Client Name:
Project Name:
Client Sample ID:
Matrix:
1005869001
AK Water & Wastewater Cons.
Majestic Valley L2 B2
Drinking Water
PWSID n/a
Client PO#:
Printed Date/Time: 10/02/00 18:45
Collected Date/Time: 09/26/00 15:20
Received Date/Time: 09/28/00 10:30
Technical Director: Stephen Ede
Released
Sample Remarks:
Allowable Prep Analysis
Parameter Results PQL Units Method Limits Date Date init
Nitrate 0.6 U 0.5 mg/L EPA 300 10.0 09/28/00 SCL
ALASKA WATER & WASTEWATER
Octobcr 4, 2000
Municipality of Anchorage
Department of Health and Human Services
On-Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Lot Line Waiver for Majestic Valley Subdivision; Lot 2, Block 2
To whom it may concern:
We request that your department issue a 1 foot lot line waiver from the property line to the
existing drainfield. The instalation inspection report dated 5/3/76 states that the drainfield is 6
feet away from the northwest lot line. An as-built survey done by Robert C. Johnson shows the
end of the drainfield to be 1 foot from the same lot line.
I am unaware of any adverse impacts this waiver would have on adjacent wells or septic systems.
If you have any~/~estions, please contact us at 337-6179. Thank you for your assistance.
'ncer
6901 Debarr Road, Suite 2B * Anchorage, AK 99504
Ph: (907) 337-6179 * Fax: (907) 338-3246 ' Website: akwwc.com
MUNICIPALITY OF ANCHORAGE
Department of Health & Human Services
On-Site Services
Waiver Review Worksheet
WR#: WR000088 PID#: 050-731-04 HA#: HA000507
Date Received: October 10, 2000
Legal Description: Majestic Valley Estates, Lot 2, Block 2
Engineer: Alaska Water & Wastewater Consultants, Inc.
6901 Debarr Road, Suite 2-B, Anchorage, AK 99504
Applicant: Diane Bauer
Waiver Requested: 1 foot lot-line waiver
Permit#:
Criteria: 1.
Geology
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
2. Special Conditions:
3. Other:
Points:
Total:
Waiver is Granted:
List Conditions or Reasons for above:
Waiver is not Granted: .
Date: ./~) '/2."~2 O
Rec#: 06383 Amount: $115.00
(-~ aJ;~¢'¢ f Reviewer
Date Paid: 10110100
Rick Mystrom. '
Mayor
Mtm c paUty of Anchorage
Department of Health and Human Services
825 "L" Street
P.O. Box t96650 Anchorage. Alaska 99519-6650
http://www.ci.anchorage ak.us
AK Water & Wastewater Consultants, Inc.
ATTN: Jeffrey Gamess, PE
6901 De Barr Road, Suite 2B
Anchorage, AK 99504-
October 12, 2000
Subject: Waiver Request for MAJESTIC VALLEY ESTATES BLK 2 LT 2
Waiver # WR000088 Lot Line Request for Parcel ID 050-731-04
Dear Engineer:
Your request for a waiver of the required 10 feet horizontal separation of the on-site wastewater
disposal system to the lot line has been approved. The approved separation distance is 1 feet.
This waiver approval applies to the current on-site wastewater disposal system and lot line
separation only. Any future upgrade to the on-site wastewater disposal system and lot line will
require all separation distances to be met or another waiver approval from this department.
If there are any further concerns or questions regarding this waiver, please call our office at
343-4744.
Sincerely, //~~
JeffPoet ~
Engineering Technician III
On-Site Water Quality Program
MuNIcIPALITY' OF ANCHORAGE ;0 '~(~
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
;: ::: 'r' DIViSl0N'oF ENVIRONMENTAL HEALTM:'::: ::~ i:: !':::: =~:
CErTiFiCATE OF i'NSPEcTi~)N FOR~'HEALTH AUTHoRi~r'~'~PR'0~!
· ' .~ :'"' _; . . , _ ,'. ;~ .... .,: :t/j',.:... ~ .., . '.
· - '. '. '... ' :: ..../'.....', , ',' ·
· .' ..'. :~'.".,:,:'."/ '.':' ..- '...' · · . , - :. - ::'"' i.'"'/, ,.'"-'-:-" · ,: ::' ~:-'"~.:¢,:~':' i~::!:::' .
Single-Family~ Multi-Family[] Other
Number of Bedrooms '~ '.?, ,.. ..... · i.:~ "
3. WATER SUPPLY "' -'
Individual Well [~ Community [] Public []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL.
Onsite ~ 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,
72-025 (11~84~
Page 1 of 2
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NOII~HOdNI ON~ ~1~0 'HO~V3S ~11~ 'SIS~1 'SNOI10~dSNI DNIOlAO~d ~ld DNI~NIDN~ '9
MuNICIPALI'f¥ OF ANCHORAFNI~NICIPALITY OF ANCHORAGE (MOA)
£NVi~,ONMENTAL SERVICES DIV~TH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
DEC; 1 6 1987 264-4720
Legal Description: ~
RECEIVED
WELL DATA
If A, B, G, D.E.G. Approved (Y/N)
Well Classification
Well Log Present (Y/N)
Total Depth ~
Casing Height Above Ground . ?2/'
Electrical Wiring in Conduit (Y/N)
Separation Distances from Well:
To Septic/Holding Tank on Lot //~ /
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line
Cleanout/Manhole /""/~
Water Sample Collected by
Water Sample Test Results
Date Completed . ////'¢.~- Yield
Cased to /,ca ' .~-" Depth of Grouting
Pump Set At
Sanitary Seal on Casing (Y/N)
Depression Around Wellhead (Y/N)
; On Adjoining Lots
~//,,~ / ; On Adjoining Lots f-/¢' o /
To Nearest Public Sewer
To Nearest Sewer Service Line on Lot ~-~ ~- /
Comments
B. SEPTIC/HOLDING TANK DATA
Date Installed
Standpipes (Y/N) ,/~ Air-tight Caps (Y/N) _
Depression over Tank (Y/N)
Pumping/Maintenance Contract on File (Y/N) ~-//~
Holding Tank High-Water Alarm (Y/N) .'~,/~
Separation Distances from Septic/Holding Tank:
To Water-Supply Well //,.2
To Property Line
To Water Main/Service Line
Course ~ / aa
Size /¢~,.~ ~ / No. of Compartments
Foundation Cleanout (Y/N)
Date Last Pumped
;for ./~'/~
Temporary Holding Tank Permit (Y/N)
To Building Foundation
To Disposal Field ¢'J "~'~ ~
To Stream, Pond, Lake, or Major Drainage
Comments
Page 1 of 2
72-026(11/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed
Width of Field
Square Feet of Absorption Area
Depression over Field (Y/N)
Results of Last Adequacy Test ~-~,
Separation Distance from Absorption Field:
To Water-Supply Well -///.2
To Building Foundation ,.,:-2,~''/
Lot ,/~'./'~
To Water Main/Service Line
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments
¢~"'/¢'-¢~4 Type of System Design
Length of Field
Depth of Field
Gravel Bed Thickness
Standpipes Present (Y/N)
Date of Last Adequacy Test
To Property Line ~'Y
To Existing or Abandoned System on
; On Adjoining Lots /- ..Pc,
To Cutbank (if present)
LIFT STATIO~//~
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
Comments
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have .checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signed ~'2/~~ Date /¢2t/~g'~/~ ~
Company /->~'/~' d~J MOA No.
Receipt No. ~d/ --OO ~
Date of Payment ~ -/& 7
Amount: $ / ~ ~ ~
Eagle River Engi6o~ring Services
P. O. Box 773294
Eagle River, AK 99577
694-5195
Page 2 of 2
72-026 (11/84)
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL ~p-\(:~:~C)-
OF ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date December 4, 1986__
GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, range)
Lot 2, Block 2 Majestic Valley Estates TlqN R1W Sec.
Location (address or directions)
Eagle River
Applicant Name Dawson Lindblom
(b) Telephone: Home 694-4899 . Business
Applicant Address P.O. Box 770677 Eagle River, Alaska 99577
(c) Applicant is (check one): Lending Institution []; Owner/builder~]; Buyer []; Other [] (explain); .
(d) Lending Institution City Mortgage Telephone 26.~-2379
(e)
(f)
Address P.O. Box 2117 Plaza 7,
Real Estate Company and Agent N/A
Address L N/A
#532 Eagle River, Alaska 99577
Telephone N/A
Mail the HAA to the following address:
pickup b.~ engineer
TYPE OF RESIDENCE
Single-Family [] Multi-Family []
Number of Bedrooms _
Other
WATER SUPPLY
Individual Well E] Community [] Public ~]
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
Onsite [] 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 PROVIDIN~ ~NSPECTIONS, TESTS, FILE SEARCH, DA._, AND INFORMATION
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this I-~alth
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
wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on
the date of this inspection.
Name of Firm Telephone
Address F~GLE R!VER ENG~[',].r-F-RING ,SERVICES
//~/^ /~-~,- -EAGLE RIVER, AK 99577
Date
P. O. BOX 77:J;"94
694-5195
DHEP APPROVAL
Approved for ~ bedrooms by
Approved ~ Disapproved
Terms of Conditional Approval
Conditional
CAUTION
The MuncJpality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional
engineer 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 requirements. Employees of DHEP do not conduct inspections or
analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the
professional engineer's work.
Page 2 of 2
72-025 (1 ~/84)
WELL DATA
MUNICIPALITY OF ANCHORAGE (MOP,)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST- FEBRUARY 1984
264-4720
Legal Description: ,Z..~,t-~
U~ /l~,~
Well Classification /~¢/C / vL¢/ 7~_./~: If A, B, C, D.E.C. Approved (Y/N)
Well Log Present (Y/N) .,-// Date Completed ////'~-¢' (-¢.~"¢~'"'~/~'~t~ '¢-¢'~'/~ Yield
Total Depth ~//d~ / Cased to /Co / -'~- "~'"Depth of Grouting /v/~
Static Water Level ~5-~f: ~ /¢-,¢./~,.~ /~/~ ~,¢' ~.~,.,L,? Pump Set At
/3 "/,~. Sanitary Seal on Casing (Y/N)
~/'~- Depression Around Wellhead (Y/N)
Casing Height Above Ground
Electrical Wiring in Conduit (Y/N)
Separation Distances from Well:
To Septic/Holding Tank on Lot
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line
Cleanout/Manhole
Water Sample Collected by ~_s?~
Water Sample Test Results
Comments
; On Adjoining Lots f-,-¢.,o /
¢-/I ~ / ~ ; On Adjoining Lots /'/¢,0"
To Nearest Public Sewer
To Nearest Sewer Service Line on Lot -r,A.¢' /
~---~'f/.'.'c.¢-.',~'~ ;Date /~/'~"~¢
B. SEPTIC/HOLDING TANK DATA
/o~' ~..¢~ /, '~ No. of Compartments
Air-tight Caps (Y/N) 2" Foundation Cleanout (Y/N)
Date Last Pumped
Size
Date Installed
Standpipes (Y/N)
Depression over Tank (Y/N)
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/Holding Tank:
To Water-Supply Well ?/,~A."
To Property Line ~'"/,c,
To Water Main/Service Line '?/~' /
Course *-/ 6~ ~
· for ,"¢*~
Temporary Holding Tank Permit (Y/N)
To Building Foundation '~ / /
To Disposal Field ¢',.5- '
To Stream, Pond, Lake, or Major Drainage
Comments
Page 1 of 2
72-026(11/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed /'~' 74;'
Width of Field 9/
Square Feet of Absorption Area ~-77¢ ¢~ ~--'
Depression over Field (Y/N) /¢-/
Results of Last Adequacy Test .-'~ 7z7-.~ .,'~ ~-~-
Separation Distance from Absorption Field:
To Water-Supply Well "~//'-~ /
To Building Foundation 7~/
Lot
To Water Main/Service Line
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments
Type of System Design
Length of Field z¢ 2 / ¢-,
Depth of Field ¢'' ~
Gravel Bed Thickness z/" ~
Standpipes Present (Y/N)
Date of Last Adequacy Test
.Y
To Property Line
To Existing or Abandoned System on
; On Adjoining Lots ~-~'~ · /
To Cutbank (if present)
LIFT STATION ~
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
Comments
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Date /~//¢2/.¢4'
MOA No. ~'-'.7--¢.2z ¢' ¢-
Signed
Company
Receipt No.
Date of Payment
Amount: $
Eagle Rivsr Engineering Services
Page 2 of 2 P.O. Box 773294
Eagle Riv0r, Al( 99577
694-5195
72-026 (11/84)
!:~ '~ DATE RECEIVED
INSPECTION APPOINTMENTS ~'~../~//~.~.~.~.~/~ 6--/7
~,,TIM E TIME TIME
DATE DATE DATE
I NSP ECTOR INSPECTOR INSPECTOR
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
825 L Street - Anchorage, Alaska 99501
ENVIRONMENTAL SANITATION DIVISION
Telephone 264-4720
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all parts ou page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
1, PROPERTY OWNER ~ PHONE
MAILING ADDRE88
PROPERTY RESIDENT (If different from above) PHONE
2. BUYER PRONE
MAI LING ADDRE88
3. L~NDIN~INSTITUTION ~ PHONE
I
MAILING ADDRESS
4. REALTOR/AGeNT ~ PHONE'
MAILING ADDRE88
5. LEGAL DESCRIPTION
STREET LOCATION
6. TYPE OF RESIDENCE NUMBER OF~BEDROOMS
[] One [] Four
~ SINGLE FAMILY [] Two [] Five
[] MULTIPLE FAMILY ~ Three [] Six
I~] Other
7. WATER SUPPLY
INDIVIDUAL*
[] COMMUNITY
[] PUBLIC UTILITY
* ATTACH WELL LOG, A well log is required for all wells drilled
since June 1975, For wells drilled prior to that date, give well
depth (attach log if available,)
8. SEWAGE DISPOSAL SYSTEM
I~ INDIVIDUAL/ON-SITE**
[] PUBLIC UTILITY
YEAR ON-SITE SYSTEM WAS INSTALLED.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010 (Rev. 6/79) ~c,~
/
THIS SIDE FOR OFFICIAL USE ONLY J
1, TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2, WATER SUPPLY
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTILITY
Connection Verified LOG RECEIVED
3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[] INDIVI DUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY
Connection Verified INSTALLER
[]Septic Tank or []Holding Tank
Size: /~7~3L/2 If Tank is homemade SOILS RATING
give dimensions:
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line
I
WELL TO:
Absorption Area to nearest Lot Line
5. COMMENTS
[~/~PRov ED FOR ~ BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED
DATE
72-010 (Rev. 6/79)
June 21, lq~2
Art an~t Varen Layton
· qubject: Lot 2 Block 2 li,!ajestie
Approval for the in,-tivi,.luai sewer and water facilttier~ cannot
be grante(] until t'he following items have been completed:
~e water analy~tis report neects to be sttbmitt~ed to this
offJ. c~ from the Che~ Z,~b, 5633 I% Street, :for our review.
~/5~te septic tank pumped v;ith a receipt r~ul-mitte~l ko t'bis
departmer)t.
nil~dequacv test ~leeds to performed on
existinq
leachir~g a~ea. ~'his test will ~leterrniue if ~t.l~e sV~tem i~
adequate a~]cording to Nation,ti F;tandards. a ]].sting of
privnte firms performing the test is enclos(~d. This re[port
nee~]s to be submitted to this office for our reviev;.
P].e~se notify this Det~srtment ro~. ~ re;[~'w3r~(~ction wh~.~n the
~oted di~(~r~, ...~pm~c~e~, .... l-~v~ been (3~rre(~-t~] . T.F .... there are ~tlV
further questions, please call this offic(~ at
~tncere]y,
Robert C. Pratu
Associate Environmental Specialist
~,.P 14 5/p/Eli
EXCAVATION
ROBERTA. SHAFER
WORK
June 23, 1982
CIVIL ENGINEER
694-2979
Totem Realty
ATTENTION: Bob Wamboltz
P.O. Box 91].
Eagle River, Alaska 99577
Dear Mr. Wamboltz,
Reference: Lot 27 Block
Majestic Valley Subdivision7
Art Layton Property
A sewer system adequacy test was performed on the system
located on the referenced property as you requested. The
septic tank was pumped and verified to have a capacity of
1000 gallons. The absorption trench was tested by a continuous
flow of 534 gallons of water over a period of 24 hours
without any adverse effect on the system.
It can be concluded from this test that the waste water
disposal system serving the three bedroom residence located
on this property is currently functioning adequately. However,
the system cannot be guaranteed against subsequent failures.
If we m~y be of further service, please do not hesitate to
call.
S in~'~'~e~, /
cc: Municipality of Anchorage
Department of Health and Environmental Protection
SRB 196X EAGLE RIVER, ALASKA
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchoca~9~,. Alaska 99503 274-4561
'x~i~A'.~'~e Received May 19, 1976
~ __ \q~q Time of Inspection
O~\~k~¥o INDIVIDUAL SEWER & WATER FACILITIES ~
FOR ~/~ ~s
Cony.
1.Approval requested by: Alaska Mutual Savings Bank % Chris Anderson
Mailing Address: Post Office Box 1120, ,9510 Phone:
2. Property Owner: Gary Pogany - Charles Wade Phone: 694-2334
Mailing Address: Lower Fire Lake
3. Legal Description:
4. Location:
Lot 2 Block 2 Majestic V_alley Estates
6.5 miles up Eagle River Road
5. Typ6 of facility to be inspected Single Family No. of bedrooms 3
6. Well Data: Individual
A. Type B. Depth
C. Construction
D. Bacterial Analysis
7. Sewage Disposal System: On-site system
A. Installed
B. Installer
C. Septic Tank: 1. Size
2. Manufacturer
D. Seepage Pit: 1. Absorption Area
2. Material
E. Disposal Field: Total length of lines
Distances:
A. Well to:
Septic tank _~Db
, Absorption area
//5/, Sewer Lines
Nearest lot line
, Other contamination
B. Foundation to septic tank
, Absorption area
C. Absorption area to nearest lot line
EQ-034 (1/74) Page 1 of two pages
Page 2 of two pages - Rec. it for Approval of Individual ~ Jr & Water Facilities
Legal Description Lot 2 Block 2 Majestic Valley Estates
Comments
Approved
~_.¢.~' (~, 7~ ~,~,.~/ Disapproved Date
Approval ~Valid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
certify that the information contained in this request for approval to be a true and
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED Date
EQ-034 (1/74)
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" Street, Anchorage, Alaska 99503 - 274-4561
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES
1, Type of Inspection: CMRO VA
2. Property Owner: . Gary Pogan¥/Charles !.lade
Mailing Address: Lower Fire Lake
FHA
Day Phone
CONV
694-2334
3. Name of Buyer: Bo1~ P, lakney
Mailing Address:
4. Name of Lending Institution:
Mailing Address: P.o. Box Z12O
5. Name of Realtor or Agent:.
Mailing Address:
_372 E Northern Li.,t~t$ Anchorage 337-945].
-."- Day Phone
Alaska Mutual Saving,~; ]~anl.'.- .... (.'hris Anderson
Anchorage Phone 274-35~] '~2~
Phone
6. Legal Description: 1, 2 B 2 Majestic Valley Eotatc,
Location: 6.5 Pfiles up Eagle ]liver Road, Turn ].eft on Berry Hill Roar[ and
right on Spruce Lane.
Type of Facility to be inspected: SP No. Bdrms. 3
Water Supply
Type of Supply: Public Utility Individual
If Individual, number of dwellings presently served One.
If Individual, depth of well
Sewage Disposal System
Type of System: Public Utility
If Individual, date of installation
Individual (on-site)
EQ-037 (1/74)