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HomeMy WebLinkAboutSCHROEDER LT 13S,chrocder Sto Lt t blocL /— MUNICIPALITY OF ANCHORAGE� �� Pn� to r DEPARTMENT OF HEALTH & ENVIRONMENTAL PROT1,'ION r/t �crcd ENVIRONMENTAL ENGINEERING DIVISION �2 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT 0 -�----- PHONE NEW NAME —�9 —� ❑UPGRADE MAILING ADDRESS r-1 / /�, ll,'✓ C,G—JC����f- L F�rCoL—L V \ 1 UL—�,e �QSI« �CCT�7� LEGAL DESCRIPTION LOCATION NO. OF BEDROOMS Well / Absorption arep Dwelling / DISTANCE TO: /d-7� PERMIT NO. �B�I UY F Z CL Manufacturer Material No. of compartments rn w NIF Liq. capacity in gallons Inside length HOMEMADE: — — Width ����� Liquid depth Well Dwelling PERMIT N0. Z DISTANCE TO: _ 0z< Manufacturer _ . Material Liquid capacity in gallons 0 - Well I Foundation( / 6/ Nearest lot link PERMIT NO. 7eI�/g9 J 2 DISTANCE TO: i 5 --- J w w z No. of lines Length of each line Total len th ofPlines Trench vvidlttr inches Distance between lines Z w F" ' Cc N / Top of tile to finish grade / & ``-1. Material beneath rile / r GlL 8 inches - Total effective absorption area 93.40 a _ Length Width Depth PERMIT NO. C7Total Q - Type of crib Crib diameter Crib depth effective absorption area o. — a —— w ui Well Building foundation Nearest lot line DISTANCE TO: Class Depth Driller Distance to lot linE� J TITOwBuilding foundation Sewer line Septic tank areals) DISTANCE TO: OTHER PI�P�ATERIALS b5AJ SOIL TEST RATING - INSTALLER REMARKS L 0 �4 ra ` �e 't - U9 cnff Ao _ (� f ipF- �y/,1 `e d APPROVED DATE LEGAL H Ill:m,pm APATKAK 051210>11. - PFJOA I r I11O1'1. ICAN-1 . III q; , F P-1 E I I F, A " 0 11 T 113 1 L. I -I Y "M 1 JAI r 114 PI ..1.1 d 1 IS I ) HO I R T I I E 41 F D HI I kk ME E y4npFR_I,A I ]:ON I MADECT A MW ()F Voly 111 ::, 05 1 11}.1(11 1-LdI TO -1.1..1.1. FOROPTAMP V11% 11 V: PA&HAR Mi RENTWENCIN THrYI . I . I'll::: HF�J-l— 14P.A. ; Ei: f'.o, 1 1:1'd_ I E 1 YON Mll) I 11. 1? WE 11; FE OR FA RE TL, u-. !!� -:,1 -;n tj 0 Ei- E GE®T .0 HNI CAL Ef DEVELC Russell Oyster 694-2774 Soils Et Foundations Performed for: Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-22.80 SOIL LOG MENS" CO. Earl Ellis 688-2280 Land Development Name: 41, l4R's on/ Tel . No. 6 9 � - 3S -�5 / Mailing Address•������, Legal Description: 1-6 1' /5 'Sc✓,,, Depth feet 0 UFus, )-r Soil Characieristia 4/V . C3 1_'A7N / CD Q5 -, l IqL _-51sti1aP Sic. /t/C-o, 7 fl 10._ /v ,g,ZC0_S ST. 12, _ 13 14�� �f' �%�I�. � � C�o�k'.-<s� �.yc/Q, C� �-�nrc�/ 3s Lj`1�� ✓l. � 15 C Ground Water Encountered: Yes_ No k� If yes, what depth` Proposed Installation: Seepage PitDrain Field Comments: Performed by: I «rrt,ftrb l5rtfftn�I+J+) M � MU`Y L, , h.CH0RAG[ E)}' DEPT. C; DOC Co. dba ✓I' �i\9., LHON SULLMN WNFER WLLLSUiq ,:) P.O. BOX 272, CHUGIAK, ALASKA 99567 o TELEPHONE 688-2759 f V REC ED OWNER OF LAND DEPTH OF WELL ADDRESS _ STATIC LEVEL OF WATER FT LEGAL DESCRIPTION DRAW DOWN FT. —— DATE - Started Ended GALS. PER HR — PERMIT NUMBER -. — KIND OF CASING KIND OF FORMATION: From Ft. to Ft.. From Ft. to ----Ft. From Ft. to - Ft.. From - Ft. to Ft.. From Ft. to Ft. From—Ft. to Ft. Ft. From --_—Ft. From—Ft. to Ft. From__—Ft. to Ft. From Ft. to Ft. _Ft. From Ft. to From to Ft. Ft. _Ft. From From Ft. to Ft._ From to Ft. _Ft. Froin—Ft. From—Ft. to Ft. From —Ft. to Ft. From Ft. to Ft. -Ft. to Ft. From—Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. MISCL. INFORMATION: From Ft, to— Ft. From Ft. to ----Ft. From--- Ft. to_ Ft. Froin -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. From Ft. to Ft. Froin—Ft. to -Ft. — From Ft. to— _Ft. Froin -Ft. to Ft. From Ft. to Ft. — From Ft. to— Ft. DRILLER'S NAME � :LXX PxI�I r L MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTEp1DIQ1NIPALITY OF ANCHORAGE 825 L Street - Anchorage, Alaska 99501 DEPT OF _I 1 ENVIRONtJE T:;' I AECTION ENVIRONMENTAL ENGINEERING DIVISION *0 Telephone 264.4720 I',AIAY 3 19BO REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEIq P/CjI]V.rED DI RECTI ONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allowten(10) days ffo.•rllproocessing. - - 1.. PR q PERTY OWN. R—j—f - - PHONE - MAIj l G ADDRES _ PROPERTY RESIDENT (If different from abelve)1- — PHONE v2Cce Iq. 2. BUER--/� f PHONE MA G A ESS � 0 �'9 K � ,2 � C--> V r te . A �c • �' � � � � 3. LE ING INSTITUTION �E e PHONE T. MqlG ADDRg$S 1 4. REA TOR/AGENT —&�--PHONE MAI / 0 019-1 L/ Y -16 .� �j(r� or W (C to V S 5. LEGAL ESC IPTION 7© / SCLI''C�C'CfC�y �S� f C�rlcceSe6q c>7/ STREET LOCAT N —r lira dC 6. TYPE OF RESIDENCE - NUMBER OF BEDROOMS - SINGLE FAMILY ❑ One ❑ Four ❑ Other_ ❑ Two ❑ Five ❑ MULTIPLE FAMILY Three ❑ Six 7. WATER SUPPLY INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available,) 8. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE** **If individual/on-site, give installation date If system is over two (2) years old an adequacy test is required ❑ PUBLIC UTILITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. /G -u IvIJ//O/ 72-010 (Rev. 3/78) THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED— - - INSPECTION APPOINTMENTS TIME —- TIME TIME DATE DATE DATE - - - - INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS ❑ SINGLE FAMILY ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ MULTIPLE FAMILY ❑ TWO ❑ FOUR ❑ SIX - 2. WATER SUPPLY - PERMIT NUMBER ❑ INDIVIDUAL DEPTH OF WELL ❑ COMMUNITY DATE DRILLED ❑ PUBLIC UTILITY Connection Velified� LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER ❑INDIVIDUAL/ON -SITE DATE INSTALLED ❑PUBLIC UTILITY — Connection Verified INSTALLf_R p91 EJ Septic TaOk or ❑Holding Tankt} SOILS RATING - .Size: f bU If Tank is homemade give dimensions: _. TYPE OF TANK MANUFACTURER J TOTAL ABSORPTION AREA 4. DISTANCES -- MATERIAL Septic/Holding Tank Absorption AreaSewer. Li le _ Nearest Lot Line W E L L TO:� Absorption Area to nearest Lot Line - - - - 5. COMMENTS CEJ --APPROVED FOR BEDROOMS ❑ CONDITIONAL_ APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE -. BY (Title) - -- LEGAL DESCRIPTION - - - - - -- - -- - - - - - - - 72-010 (Rev. 3/78) OT N. 89" 5015" E. SE6.PACwE 'CREAK fI d' 0, (b� p d m i l J of 0 �ppR°� J 'j,"p'� / o U1 ( J 117 J 4'Z' o PROP, 1 S-roRY p— — – -- _ -- – -- 0 0 FKAM� pwE�llN�� 10. 75F r LT Q d. PROP, WELL 10` J IV ul N N M A R C U S _ -- — ---- - -- PLOT FLAN loT 13 1 Sr HF-ovveR S�>gpIVISION Tp ©E C3V1IT BY RUSTIC HC>MES OF AL-ASKA PRAWN 13Y 90 /1L L,AR50N APRIL. L6, 19`19 5T'�:CET