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T12N R4W SEC 2 LT 10
Onsite File T12N R4W Section 2 Lot 10 #012 - 131 - 31 Certified Drilling Log ® ULLIVANCO dba >=coLE WATER P.O. Box 670269, Chugiak, AK 99567 688-2759 OWNER OF LAND: Donavahn McRoberts ADDRESS: 2316 Raspberry Rd. LEGAL DESCRIPTION T12N R4W SEC 2 LOT 10 DATE: 8-15-19 PERMIT NUMBER: OSP191320 DATE OF ISSUE: 7-31-19 TAX IDENTIFICATION NUMBER 01213131000 Is well located at approved permit location: ❑Yes ❑No Method of Drilling: Mair rotary ❑cable tool Depth of Well: 205' Casing Type: Steel Wall thickness .250 inches Diameter: 6 inches, depth 205 feet Liner type Static Water Level: 43 feet Recovery Rate 80 ® gpm ❑ gph Method of Testing Air Well Intake Opening Type: ❑ open end ❑open hole ❑ Screened Start feet Stopped ❑ Perforations Start feet Stopped Grout Type: Bentonite Volume: 50lbs Depth: from 2 feet, to 42 feet Well Disinfected Upon Completion: ❑yes ❑ no Method of Disinfection: Chlorine 50 PPM Comments: Bore Hole Data Depth From To 0 2 2 4 4 28 28 39 39 81 81 99 99 197 197 205 Casing Stickup Overburden Sand & Some Gravel Silt & Gravel Sand Silt & Sand w/ Clay Silt & Sand Water Sand & Gravel Water Drillers Name: Cole Sullivan ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. Matsu Borough: Department of Environmental Conservation. www.sullivanwaterwells.com Pump Installation Log Well Drilling Permit Number: SW OSP191320 Date of Issue 7-31-2019 Parcel Identification Number: 01213131000 Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. MUNICIPALITY OF ANCHORAGE „tient • \ On-Site Water&Wastewater Program ra.,�1 PO Box 196650 4700 Elmore Road c ° t Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 http:!/www.muni.org/onsite C r t rp t n t 44';HOAaV, On-Site Water System Permit Permit Number: OSP191320 Effective Date: 7/31/2019 Work Type: Well Initial Expiration Date: 7/30/2020 Tax Code Number: 01213131000 Site Legal Address: T12N R4W SEC 2 LT 10 G:2127 Site Mailing Address: 2316 RASPBERRY RD, Anchorage Owner: MCROBERTS DONAVAHN P Lot Size in Sq Ft: 27442 Design Engineer: Total Bedrooms: 3 This permit is for the construction of: ❑ Disposal Field 0 Septic Tank 0 Holding Tank 0 Privy Q Private Well 0 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 Special Provisions: 1) This permit does not include any plumbing work inside the house or electrical work to power the well pump. Separate plumbing & electrical permits and inspections are required to complete this work. 2) To close out this permit, please submit the following: a) Well log b) Pump install log c) Water sample results for total coliform. nitrates and arsenic. Received By: if Date: 6 � Issued By: ��,C'Q �L2�,�p-�� Date: HI� MUNICIPALITY OF ANCHORAGE • Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 0 a- 15) .-e-31 - Goo Property owner(s) (-9p v\61JCJ\ V\ Y Y,CRO ,r Day phone 9 37o2a7- 0?3 3 Mailing address Q x �adl tt ) t 1 ( (i _ q6s-- Site address 16, 6*/.-1S g h 2 \i--,<N 'R , ) p}V,G _ �r_____c G ----0 a, Legal description (Sub'd., Block & Lot) Ts( D .115, I('-{ C,..), C_e Lk- \U Legal description (Township, Range & Section) -1")'3.11) / `R/4 cc.) S"e C-� L.k (d Lot Size a 7 5fyaSq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (El all that apply) Absorption Field ❑ Initial Zi Single Family (SF) !(Zr (w/wo ADU) Septic Tank ❑ Upgrade ❑ Duplex (p) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well 1 X45 6 7 11 9 v � Water Storage Ili .� l JUL 2 4 2019 THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: _ 1 ti Distan h it 681. I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. CP. Aie,t:6A ni c ad, (Signature of property owner or authorized agent) Permit/Rush Fees: 6225-- Waiver Fees: Date of Payment: V TM Date of Payment: Receipt Number: P,Z. /$ ? Receipt Number: Permit No. C3P/g/32O Waiver No. G:\Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc BLM LOT 10 LOCATED WITHIN THE SE 1/4. SECTION 2, T 12N, R4W, SM. ANCHORAGE RECORDING DISTRICT, THIRD JUDICIAL DISTRICT. STATE OF ALASKA S2 , S1 CE 1/16 165.22'(P) COR.-1/— N 89°53'00"E 165.30'(R) 111-- �4 COR. 165.22'(P) RASPBERRY ROAD -1110 BLM PATENT b BK. 119. PG. 117 00 0 0 0 in ,n I \ I \ x �\ 33.00' I I \ l•--FENCE (APX) >, . f- rn ccoo 1 I I N W t\ O: tri tri U iri ori ODx I I '2 7 cocD ,_ x d d w w I I aW w w o i. I x °' Z o 0 M O o 0 .- d x A.C. DRIVE J I I m (V iN x m 0 • o 0 o I I I U o 0 x z z I I z z X I I GONG, 21 I x I I � 8.2'o I I xcD o Ix CONC. • I I x — N2.0' I15.4' I x x Ilu2,F. I 1 " = 20' x EXISTING BUILDING I 4 x N x x 10' 45.5' I 1 58.7' t x o I I YI UJ N I x x (V PI SHED I I v y 132.38' ' 33.00' d1 Y Y Y K Y x UI x K x N M M M K N .t ,t 1( R N 89°53'30"E 165.38'(R) 88 LEGEND ?r-oeoSe6Q \.0Q11 ) ©eon, -t oi si FOUND BRASS CAP MONUMENT Y� e.�� S c l \ 0_O (v- �ei �'��� S�eCc 'F'C�.,'�-t d YDS x CALCULATED POINT, NOTHING FOUND OR SET (R) RECORD DIMENSION PER BLM PLAT ACCEPTED Cme fil/4/&___ MAY 12, 1952 (M) MEASURED DIMENSION THIS SURVEY (P) SINGLE PROPORTION MEASUREMENT BB POINT SET BY BEARING BEARING INTERSECTION AS - BU ILT I HEREBY CERTIFY THAT I HAVE SURVEYED THE PROPERTY DEPICTED ABOVE AND THAT NO ��1•�11 GASTALDI LAND ENCROACHMENTS EXIST EXCEPT AS INDICATED. i., OF A w♦ SURVEYING, LLC IT IS THE RESPONSIBILITY OF THE OWNER TO • -�•••'"••• 4• � . JEFF A. GASTALDI, R.L.S. DETERMINE THE EXISTENCE OF ANY EASEMENTS, �. • �I_.. 61_ 'f- 2000 E. DOWLING RD.. SUITE 8 COVENANTS OR RESTRICTIONS WHICH DO NOT 49TH /\ =* j ANCHORAGE. ALASKA 99507 APPEAR ON THE RECORDED SUBDMSION PLAT. - • PHONE 248-5454 UNDER NO CIRCUMSTANCES SHOULD ANY DATA ' •"" '1 ,o . Jeffery A. Gostold : o a GRID DATE HEREON BE USED FOR CONSTRUCTION OR FOR •.• LS-6091 •: �1 ESTABLISHING BOUNDARY OR FENCE LINES. �a PP•..•x/22/2°'s.•,•,,§ 4 SW2127 7/22/2019 'aap a ANCHORAGE RECORDING DISTRICT. ALASKA . to essionol �4 got �o� F.B. JOB NO. �11 111111*� 19-01 BLML10 NOTE : NO CORNERS SET THIS DATE 0-02 SEE SHEET 8 A� ld 40 39 38 37 3 6 _MINELME■■■i■■■■■■■■■■■■■■■ ■■■■■■■■■■■■or ____■ ■■■■■®■■®®■�■®��■=■■■II® w ■=■■■■■®■ www MEMMEMMMEN■■■■■■■■■■■■■■■■■■_■. ��-- 0 ■I ■■I®■■■■■■■■■■N MEMEMEMEMEME� �• w — �i� `-L IA . ��_� ■www ■� C�� ECCE =■__- �ME[ alffi= ---- —0 ZMEEMEMEElmomm=�=_��� Ella ■�®iii®s,�----�..�!-■■■��i�,����.■■■■■ :. ■■■■■■■■■■i■■■■■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■ ... .. .. .. .. 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SEVEIMIkIUH�' " .. . ■■■■■■_■■■■■■3�■■■=■=====■======■_■■■■■■■■■■■■■■■■■_� 0-02 MUNICIPALITY OF ANCHORAGE DATE MADE NEW CONN. REPLACEMENT CONN. WATER CONNECTION - Location on Record ACCT. NO. TYPE OF MAIN ( ) SHOW SKETCH ON REVERSE SIDE NAME ADDRESS I I THAW PLATEINUT I PERMIT NO. LOT BLOCK ADDITION 5 ec a TL�N �J L -C-+' in SIZE CONN. DATE MADE NEW CONN. REPLACEMENT CONN. LOCATION: ALLEY ❑ STREET El TYPE OF MAIN ( ) SHOW SKETCH ON REVERSE SIDE CORP STOP I I THAW PLATEINUT I PERMIT NO. OTHER: x I X GALVANIZED BUSHING I I COMMENTS: BROKEN MAIN, EXT. CONNECTION, I EXTRAPIPE 3 PART UNION SERVICE CLAMP X COPPER PIPE Y KEY BOX THAW WIRE DISCONNECTS TIME READY: PIASPP�CP,�h`1 0. II' I I 1p A3lltl V H1HON p 31t101ONI�A9 NOIltlOOI 3 Il 30IAH3S ONtl X09 A3N A-B.Q69 .H) BSO -Lf M A31JIS r #M#2 * � Ari TAX CODE No. 012-131— 3 1 v I N MUNICIPALITY PROPERTY Name Plat No., S u b d.= Residential ❑ commerial I GRID No. Y OF ANCHORAGE — SEWER UTILITY Address. 3u-rH WOCQ) ❑ Industrial 3 /(a `KA S P mw� ARK ❑ No. of units CONNEC INT Main Tap On Property ❑ Permit No. Drawing No. rf3 Size Main Type Insulation ❑ Cleanouts Type Connect Agent Inspector_ Comments Connect Location ASSESSMENTS + L.I.D. No.....Private Dev. No. Subd. Agreement ❑ No. Sewer Agreement El No. I Ra T. E. DYE TEST Positive D Negative ❑ N.S.A. L Page No. M.H. No,, Billing A &on& O Roll No. Tested is y ummenTS Date Cycle I?D,rtNo �� � ��a�-ago-4 Lot.......Block Pch o n )Q4u) LD t ID 0 z A31�V a104uow IOJIUOO 10 uoiJo�o� nnoys qolo�s Ae U011oOo-1 aui-1 aOinJaS IlAZ83d08d NOII —7r"%*IeYtr-, kJ; sluawwoo 1338iS w i �-g � y � � � � i� w ���� � i` ti,�ti +Y "�� � +r � ra■.�-f - �� =N ^'* }rte �+�` -posr- fN ACONSPICHnHR Pf Arr: SEWER CONNECTION APPLICATION affi, - REATER ANCHORAGE ARE yyBOROUGH, j T Y 3500TUDOR ROAD ANCHORAGE, ALASKA 99507 AE� BOO} } J F RAC' &1I 1 O r GRID ■ t OT .YCONNECTION STREET ADDRESS CITY ATE ZIP CODE" 'T&VTK Im LAT. IMP. DIST. NO. w Raw 0s PROPERTY O •.EI NAME # w lv�Orr + r ► PROPERTY Y i+ E ►DDRE , k s � G if r' CITY„. � QIP COD A -41— E P NE NO. ON ECTIC r F J# R ' # 7 a RE APT. NO. UNITS / I N ECT I SIZEa INCH/C.O. REQ '4'- CONNECTTOTRUNK COIF ECT TO LAT. a 4 ,, YES NO YES. A1C , CONNECTION L�ODATION .oY+r # 4 r i i' r#E! E 777Sz�/ Y *! T 1 r s f' S.S.A. ,BLOCK INFORMATION x~ 4 TRUNK NK SERV ICE PROVIDED BY (AGENCY): r 1p pLATERAL ASSIAT. w 1 # r RUN ASSMT,. CONNECT ON FEE: yT r / � d% *1 r Wrti.'�r •fir . r WL t i + + h k r } �y .y 'J” Rr DATE PAID DATE PAID.4 � t ,, AMOUNT LAID w.` CONNECTION FEE PAID BY: '�`; r CCINEC7' PSE RECEIIEDBY: w DATA • F }*+ .+ 4 r r F } + r5 �y � f , + ' ■ Y M S ata fA do� AFL h. M AGENCY CO NEC'i` A E T AMOUNT—DEPOSIT 1 y #y+ a Mr R k Iti 1 F t2AWCm Ar w am r+ 8`1 f &mrl 1X11"tIVI } t F r # rR e L #« J Y J f PAYER ADDRESS F N * i M 4L p CITY `ATE ZIP CODE • w �r BASIC PREM. TYPE BILL CODE BILL INDICATOR FILE I f � � r« e � _LF •# 4s ` r � "f 1! BILLING AGENT RATE CODE ACCT. N O. F ~ �+ o { CUSTOMER BILLING NOTICE k t h DATE FWD, ,4 CORRECTED ECTED BILLINC ADDRESS x— + CORRECTED BILLING ADDRESS 4 � lkALif''Oikm�am% r+ ■ L+aw 11 *f %7 Laf J1% 1 Qm 41 it 40 s Act) iz � t ,r . ORM O3 PW-. t SEWER MAINTE F L + r �Olt/ — - 4 Os NANCE DEPT. - } ■ #A Y r } �y .y 'J” Rr DATE PAID DATE PAID.4 � t ,, AMOUNT LAID w.` CONNECTION FEE PAID BY: '�`; r CCINEC7' PSE RECEIIEDBY: w DATA • F }*+ .+ 4 r r F } + r5 �y � f , + ' ■ Y M S ata fA do� AFL h. M AGENCY CO NEC'i` A E T AMOUNT—DEPOSIT 1 y #y+ a Mr R k Iti 1 F t2AWCm Ar w am r+ 8`1 f &mrl 1X11"tIVI } t F r # rR e L #« J Y J f PAYER ADDRESS F N * i M 4L p CITY `ATE ZIP CODE • w �r BASIC PREM. TYPE BILL CODE BILL INDICATOR FILE I f � � r« e � _LF •# 4s ` r � "f 1! BILLING AGENT RATE CODE ACCT. N O. F ~ �+ o { CUSTOMER BILLING NOTICE k t h DATE FWD, ,4 CORRECTED ECTED BILLINC ADDRESS x— + CORRECTED BILLING ADDRESS 4 � lkALif''Oikm�am% r+ ■ L+aw 11 *f %7 Laf J1% 1 Qm 41 it 40 s Act) iz � t ,r . ORM O3 PW-. t SEWER MAINTE F L + r �Olt/ — - 4 Os NANCE DEPT. - } ■ '- W5�1 4 I " : � � , NC:P � � � aR � � - � . - . / * � � v! , d ��. � a � & ¥ � } � � � �f � f i - ■ � ■ ■ � � NC:P � � � aR � � - � . - . / * � v! | ¥df ��. � a � & ¥ � } � � � �f � f i ! AV WA ��/���� /."'J� ƒO GROEIR no: 13040280 OPF.K1 DATE: 10/31/91 CUSTOMER SE RV I COP -E NAMEI REBI:SGI-IKE T 7:�i ADDR 0-7 nairun MA (126 RY4SPBER.R.Y.L, R F to"I A W 0 0 M: A j:) t `YPE SERVIC-Es. R ES I F I X I 0:"m D. AI Is. ACTOIVE :sU R�D lVil-S ON- i4 - SEUTAS,ON` - # 13 , 0 C EC -,2-,T,1'0- R4U -l< E Y B 0 X'LO G i -2 a � a a 13 P T H AT M A I N 0,00 Ael"' -LINE'l Sso I . I IG' "WER, LOC: 27 FR SE COR CO 40 .f t APPT DATE/TIM-11 116-1/ 1 G./ 9: ACCOUNT : 12131%31.000054 OPE"R s. WWGJT (HOM r r y 7 GROEIR no: 13040280 OPF.K1 DATE: 10/31/91 CUSTOMER SE RV I COP -E NAMEI REBI:SGI-IKE T 7:�i ADDR 0-7 nairun MA (126 RY4SPBER.R.Y.L, R F to"I A W 0 0 M: A j:) t `YPE SERVIC-Es. R ES I F I X I 0:"m D. AI Is. ACTOIVE :sU R�D lVil-S ON- i4 - SEUTAS,ON` - # 13 , 0 C EC -,2-,T,1'0- R4U -l< E Y B 0 X'LO G i -2 a � a a 13 P T H AT M A I N 0,00 Ael"' -LINE'l Sso I . I IG' "WER, LOC: 27 FR SE COR CO 40 .f t APPT DATE/TIM-11 116-1/ 1 G./ 9: ACCOUNT : 12131%31.000054 OPE"R s. WWGJT (HOM E 7 ; 000 ---*0010"-o0000 (WORK)- r 000-0-00""0000 DWEI.L I NOS # 00 1 *011R.J. 0 lv2, 127 SIZE A 0800 �FR NE coy or- C 0 S I Z E lal 4„ W ATE R oar-4; N DEPTH AT MAIN -1 0200 AT PRUP LINE: 0100 ti 0"0 0"19 *r* wa*a *4100 *+#f w9ag .Fav a6** *0019 a*ra *arm res* awes aY�6 am" ate* a:s mems 4bodoe. 0.016* 0'a "r aaae Fabo "rw •000 Dass aww 0M19 "be &a" 410060 wa adw" aaaa aaaw wrws "W* *Y"iFa 0006 "00 a"ir rias Mas 00" 0.040* 19*t0 *M"F0 *0116 Maine MEMO afw *0190 a*a0 044w Ga"g0 Fwo Mfr 0w00 *ate #"Fig" as" 0660 adn+ **rag ++*+ aw* #6F6 06190 FI"we •a0w whiffs "Ob 019416 res 00000 aaaw me" rt66s s 1":*6 R V I top E let WATE-R, COMPLETED (aJ 0 R K T Y P E'll L m T-.- - P. 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