HomeMy WebLinkAboutHUNDRED HILLS 1ST ADDITION BLK 6 LT 3MUNICIPALITY OF ANCHORAGE C 11
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http://www.muni.org/onsite y .
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On -Site Water System Permit
Permit Number: OSP181414 Effective Date: 11/20/2018
Work Type: Well Renewal Expiration Date: 11/20/2019
Tax Code Number: 07827102000
Site Legal Address: HUNDRED HILLS 1ST ADDITION BLK 6 LT 3 G:1161
Site Mailing Address:
Owner: SLATONBARKER TONY & CARLA Lot Size in Sq Ft: 203215
Design Engineer: Total Bedrooms: 4
This permit is for the construction of:
❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy Q Private Well ❑ Water Storage
All construction shall 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 Drinking Water Regulations (18AAC80)
3. The wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Received B�
Issued By:
Date: Yi ;7//8
Date:
MUNMPAUTY OF ANCHORAGE
Developen Services De artment
p �4 . '� Phone. 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I. D. C) � S — ZZ j — O Z
Property owner(s) _M N Y °f' CA�� W-fjay phone 25 -7 ZZq
Mailing address ZP)
Site address -�4 AJ0 MAP t&kLF_ (*A -AV L (b?S_7'7
Legal description (Sub'd., Block & Lot) HVtvp
Legal description (Township, Range & Section)
Lot Size
Sq. Ft. Number of Bedrooms Al"
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field
❑
Initial
Single Family (SF)
X\
❑
(w/wo ADU)
Septic Tank
ElUpgrade
❑
Holding Tank
❑
Renewal
Duplex (D)
❑
Multiple Dwellings
❑
Privy
❑
(SF and/or D)
Private Well
Water Storage
❑
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
NC9 NE Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes„
(Signatu
property owner or authorized agent)
Permit/Rush Fees: Wei 1 4o. Ido Waiver Fees: _
Date of Payment: I I/U7fii� Date of Payment:
Receipt Number: 00705/2,, Receipt Number:
Permit No. & Waiver No.
0EP tBtAJ4
GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc