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Home My WebLink AboutEAGLE RIVER VALLEY RANCHETTES LT 4Ble ive f 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 I [] UPGRAD£ LEGAL DESCRIPTION NO. OF BEDROOMS Liq. capacity in gallons Inside length Width Liquid depth iO0~ IF HOME.DE: . ~ ~ DISTANCE TO: Well Dwelling ~ PERMIT NO. O ~ ~ Manufacturer Material Liquid capacity in gallons ~ i WeH Foundation Nearest lot line I PERMIT NO. ~ ~ ~ NO. of lines I Length o~a I~e Total length~o.of lines ?renc~i~ inches Distance baden lines ~ Top of tile to finish grade Material beneath tile Total effective absorption area Length Width Depth PERMIT NO. ~ ~ Type of crib Crib diameter Crib depth Total ef fecti~ absorption area m Nell ~uilding foundation Nearest lot line ~ DISTANCE TO: ~ Class ~epth Driller Distance to lot line PERMIT NO. ~ ~uilding foundation Sewer line Septic tank Absorption area(s) ~ DISTANCE TO: . PIPE MATERIALS REMARKS , 7' APPROVED DATE LEGAL 72-013 (Rev. 3/78) PERMIT HO. . hl~_lr4 I ~ T~L I T'~r' ~_-~F DEPRRTMENT Ur HERLTH RND ENVIRONMENTRL r ,..OTECTION 825 'L~ STREET., RNCHORRGE., RK. 9~501 264-4720 C, r4--~ I Ti ~EI,-IER F"~RP1 I ~'. ( 78829i > flPF'LICRNT LOCflTION LEGRL GRRY DE~RDn~c BOX 1886 ERGLE RIVER r. IRN 0 HRR ST L4B ERGLE RIVER VRLLEY RRNCHET LOT SIZE TYPE OF SOIL flBSORBTION SYSTErl IS: DRfllNFIELD Mfl,'.'-',IMUH NUMBER OF BEDROOf'1S = ~: 694 2114 17855 SQURRE FEET SOIL RflTING <SQ FT?BR)= ~10 THE REQUIRE[:, SIZE OF THE SOIL flBSORF'TION SYSTEM IS: C, EF'TH=I~:/ LFr-J,3TI4= fl '~-=:Ei. 8 6BR~BL C, EF"TH= THE L~NGTH D~MEN~ZUN L, THE LENGTa-(ZN FEET) OF THE TRENCH THE DEPTH OF ~ TRENCH OR P~T ~S THE ~5T~NCE BETHEEN THE SURFRCE OF THE GROUND RND THE BOTTObl OF THE EXCFIVRTION <IN FEET). THE TRFf4~314 P~IDTH IS 5. E4E~;Z~ FEET THE GRRVEL DEPTH IS THE MI[.~IHI_IM DEPTH OF GRRVEL E:ETHEEN TH~IITFRLL PIPE RND.THE E:OTIOH OF THE E~C~¢RTION <IN F~ET) . ,~ -, PERMIT flF'PL[~flNT H~ TH~ D.E~PON~IBILITY TO INFORM TH[~ D~P~RTM~NT DUR.[NQ TH~ ]N~TflLL~T[ON [N~F'~CT[ON~ O~ ~N'¢ H~LL~ ~DJflC~HT TO TH[~ PROPERTY fiND TH~ NUMBER O~ R~[D~NCE~ THaT TH~ H~LL HILL TI-.~L--' ( .':--" ) I 1'-4SPE~CT I 0[-4S FIRE F.'ELq U I F-:EC, BRCKFILLING OF RNY SY'-5TEM HITHOUT FINRL INSPECTION RND RPPROVRL BY THIS DEPRRTMENT HILL BE SUBJECT TO PROSECUTION. MINIMUH DISTRNCE E:ETHEEN R HELL fiND tiNY ON-SITE SEHflGE DISPOSRL SYSTEM IS 100 FEET FOR Fi PRIVFiTE HELL.~ OF,: ~.50 TO 200 FEET FF,:OM R F'UBLIC NELL DEPENDING UPON THE TYPE OF PUBLIC HELL OTHER REQUIREMENTS HRY RPPLY, SPECIFICRTIONS FiND CONSTRUCTION DIRGR'RHS RRE RVRILRBLE TO INSUF,:E PROPER IHSTRLLFtTION. PEF.:r4 I T E::<P I F.:E$ E:.,ECEr. IBEF-: 3--- i.. I CERTIFY THRT 1: I tim FRHILIRR HITH THE REQUIREMENTS FOR ON-SITE SEHERS fiND HELLS tis SET FORTH BY THE HUNICIPRLITY OF flNCHORRGE. 2: I MILL INSTRLL THE SYSTEM IN RCCORDRNCE HITH THE CODES. 2:: I UNDERSTRND THRT THE ON-SITE SEHER SYSTEM HRY REQUIRE ENLRRGEMENT IF THE RESIDENCE IS F:Ef~3~ELED TO INCLUDE HORE THRN _~ BEDROOMS. SI GNED: .... _~__-~'__~-~~--~/~-- ........ · -'0 Et E GEO ,.:CHNICAL 'Russell Oyster 694-2774 Soils Et Foundations 8' DEVEL_~'~2MENT CO. Performed for: Name: Natltng Address: Legal Description:, /--~, Depth (feet) Sol]'~h~ractertstlcs .-Box 90, Davis St.~ Eagle RiVer, Alaska 99577 694-2774 or 688-2280 ~ ~ E~rl El~is i SOILi LOG eaa-2~o I: ° I Land Development ~ Proposed Installation: Seepage Ptt Co~nents: Performed by: Ground Water Encountered: Yes No If yes, what depth : Dratn Fteld ~ 7 , ,. ' 12 15 6~g4.2774 Soils ~ Foundations Performed for: 'O Er E GEG'"'ECHNICAL Er DEVE[""~PMENT CO. Box 90. Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Earl G/is SOIL LOG Land Development / I Soil Characteristic) Mailing Address: Legal Description: Ur,- ~/~ pepth (feet) 4 '5 6 7 9 10 11 13., 1~, 15 16 Ground Water Encountered: Yes No Proposed Installation: Seepage Ptt~ Comments: c~- ,'/~ ~" If yes, what" Drain Field depth ' MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 82E L Etre~t - Ancho~. Almka g9501 ENVIRONMENTAL ENGINEERING DIVISION Telephone 264-4720 ._.~ _. ..... REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete al! part~ on pa~e 1. Incomplete r~l..~'4 will nd be p '- Ii. PROPE~Y OWNER PHONE ~,AI LINC.~DDRESS PROPERTY R~IDENT (If different from a~) ~ PHONE I~ 6UYER PHONE ~ LENDING tNSTITUTION ~ I PHONE ~AILINB ADDRE~ ~ R~LTO~AGENT ~ PHONE MAI~NG ADDR~ ' LEGAL DESCRIFTION STREET LOCATION 6. TYPE'OF RESIDENCE NUMEER OF BEDRO(~M$ One I--I Four ~-] Other ~ SINGLE FAMILY Two [] Five I--I MULTIPLE FAMILY ,~ Three [] Six WATER SUI~LY [] INDIVIDUAL" ~ COMMUNITY [] PUBLIC UTILITY EEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE** [] 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 dep.th (attach log if available.) °'If individual/on-site, give installation dete If system is over two (2) years old an adequacy test is required by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCE~ING CAN BE INITIATED. 72.01013178) ~,,": THIS SIDE FOR OFFICIAL USE ONLY . ~ DATE RI~CEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDflOOM~ [] SINGLE FAMILY [] ONE *Fi THREE [] FIVE Fi 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 [] INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER []Septic Tank or [] Holding Tank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4, DISTANCESwELL TO: Septic/Holding Tank IAb~orption Ar.a ]Sewer Line ! Nearest Lot Line Absorption Area to near~t Lot Line 5. COMMENTS ~ APPROVED FOR '-'~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED LEGAl DESCRIPTION 72-010 (Rev. 3/78) MUNICIPALITY OF ANCHORAGE ', DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ~;"- ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone CERTIFICATE OF INSPECTION SEWER AND WATER FACILITIES 1, PROPERTY OWNER - -' MAILING ~(DDRESS 2. LEGAL DESCRIPTION 3. TYPE DWELLING SINGLE FAMILY RESIDENCE MULTIPLE FAMILY RESIDENCE I--i OTHER (Describe) 4. WATER SUPPLY r-1 INDIVIDUAL '~fi~ COMMUNITY/PUBLIC 5. SEWAGE DISPOSAL ~ INDIVIDUAL/ON-SITE r--I PUBLIC UTILITY r'-I HOLDING TANK (Maintenance Required) ~{ APPROVED FOR BEDROOMS I-'1 CONDITIONAL APPROVAL (See Attached) DISAPPROVED SEA. L '..