HomeMy WebLinkAboutEKLUTNA HEIGHTS BLK 1 LT 2 E2 REM1
MUNICIPALITY OF ANCHORAGEYT�
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
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LJ.HPGRADE
MAILING ADDRESS
LEGAL DESCRIPTION
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LOCATION
NO. OF BEDROOMS
Well r
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Absorption ar�a
Dwelling �® i
PERMIIT NO.
V
DISTANCE TO:
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Manufacturer
Material
No, of co�artments
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Liq. cap,city ingallons
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IF HOMEMADE:
Inside length
Width
Liquid depth
Z
DISTANCE TO:
Well
Dwelling
PERMIT NO.
a
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Manufacturer
Material
Liquid capacity in gallons
DISTANCE TO:
Well 17 ,
Foundation ,/� r
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Nearest lot line �O/
PERMIT NO.
W x
w LL V
No. of lines
Len th of eacr line
g
Total len,9th of lines
S
Trench idth _
Distance between lines
F Z w
2
Z
!p inches•
Top finish
Material beneath tile
%
Total effective absorption area
¢F
of tile to grade
"%
a
45(/- inches
Zg
Length
Width
Depth
PERMIT NO.
w
C7
d F
Type of crib
Crib diameter
Crib depth
Total effective absorption area
CL
I
y
Well
Building foundation
Nearest lot line
DISTANCE TO:
_j
Class
Depth
Driller
Distance to lot line
PERMIT NO.
J
W
DISTANCE TO:
Building foundation
Sewer line
Septic tank
Absorption areas)
OTHER
PIPE MATERIALS
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SOIL TEST RATING
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INSTALL
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REMARKS
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APPROVED DATE LEGAL
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72-013 (Rev. 3/78) *A
r-ILJrA 10 1 F=IIF=IL- I -Fke OF= "NOHOFP:r-iOEE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 `L' STREET, ANCHORAGE., AK 99501
264-4720
—Y -
PERMIT NO. 780520
APPLICANT THEODORE SIDOR PO BOX 67 CHUGIAK 99567
LOCATION OFF EKLUTNA DR
LEGAL L2 (Ele,2) 81 EKLUTNA HTS Se'D LOT SIZE 21500 SQUARE FEET
TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH
MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING (SO FT/BR)= 240
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
THE LENGTH DIMENSION IS THE LENGTH IN FEET) OF THE TRENCH OR DRAINFIELD.
THE DEPTH OF A TRENCH OR PIT 15 THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE EXCAVATION (IN FEET).
F? Ez CA 11 il F? F= UN *r. E—:: F=• —r 1 0 —F " r-4 K wE,: I
PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE
INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY ANCA THE
NUMBER OF RESIDENCES THAT THE WELL WILL SERVE.
—r 94 0 < I t-.1:=• Fm E= C_: —r 10 f=1 F;?. EFE FZ F= 0 U I F;;? Er C-0
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM Is
100 FEET' FOR A PRIVATE WELL; OR
150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
]F--, F= FR M I "T E:= F-" I Fz? F=!F. C- U 1-2. U M ENE F, 2-:."1._.• :1L OF.4 '» O.P.
I CERTIFY THAT
1: 1 AM FAMILIAR WITH THE REQUIREMENTS FOR ON—SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: 1 WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
3: 1 UNDERSTAND THAT THE ON—SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF, THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS.
SIGNED: -----------------
ICANT THEODORE SIDOR
ISSUED Br ------ ------ — - — __._____DATE_L V 3. 2
0 £t E GEC `HNI CAL & DEVEL,.. MENT CO.
Box 90, Davis St., Eagle River, Alaska 99577
694-2774 or 688-2280
Russell Oyster Earl Ellis
694-2774 SOIL LOG 688-2280
Soils £t Foundations Land Development
Performed for: Name: cQ,,,A e Tel. No.
Mailing Address: <;,w l"
Legal Description: Z_�r
Death (feet) Soil Characteristics
0
2
3
6
7
8
10
12
13%3i�
15
�.
16
Ground Water Encountered: Yes No _If yes, what depth
Proposed Installation: Seepage Pit Drain Field
Comments: ��s' n��� trZ2ZF--6 !/Y f,4e-9102(
Performed by: l " i s C/, . y-�ur2 Date:., a •� e� , I L?7g