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Home My WebLink AboutS E POTTER LT 206- , ` 6 72-O'1`3'(Rev. 3/78) MUNICIPALITY OF ANCHORAGE ;.'. DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99507 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE NEW ❑UPGRADE r—�' , MAILING ADDRESS3 C9a� P j ' L GAL DESCRIPTION �y–'''C/�7 Q 19 (I fe: Sib _ LOCATION Rbt�4b NO. OF BEDROOMS O DISTANCE TO: Well 3 3l Absorption/area Dwelling p f PERIO. ^ (( g Y w F Manufacturer�2 Mat " I Tear 4_ No, of compartm nts w Liq. ap it lions Inside length Width Liquid depth IF HOMEMADE: G Y J DISTANCE TO: Well Dwe ing PERMIT NO. Z'1 S Z F Manufacturer Material Liquid capacity in gallons o Well v Founda ion Com/ Nearest lot liney,,/ PERMIT ry Q {� Igo 08 w= DISTANCE TO: `� O C`7 Q W u O w No. of lines Length of ea h ling g Total lent of,, nes Z13(0 Trenc i h Distance betJp�a Ines F Z inches N ~ -Top of rile to finis ade Material beneath rile/, / Total effe a abs r tion area 7 e6` inches Length Width Depth PERMIT NO. LJ H Type of crib Crib diameter Crib depth Total effective absorption area M W 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 area(s) OTHER v� PIPE MATERIAL$ SOIL TEST RATING INSTALLER C-0 REMARKS F ��aa ry3 7-40 G Lil I PPROVE DATE LEGAL 7 %4V 72-O'1`3'(Rev. 3/78) DEPARTMENT OF HEALTH '325 ; F' STREET, PEF=:'ll NO. 7ta�=' S ; re APPLICANT _TAMES ALBRIGHT LOCATION LAKE OTIS LEGAL L2 SE POTTER SURD TYPE OF SOIL ABSORBTION SYSTEM MAXIMUM NUMBER OF BEDROOMS AND ENVIRONMENTAL PROTECTION ANCHORAGE, AK. 9nni 264-4726 °_, E-_ t4E= F == F" E= FZ P1 a -r 3262 SPENARD ROAD LOT SIZE � l.fi:43v Own 274--8561 1 34776 SQUARE i T T ' 'P•JC:i-I SOIL RATING (SQ FT/BR)= 85 THE REQUIRED SIZE OF THE 'SOIL AB SORPTIP z�.-fEll IS: THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELE THE DEPTH OF A TRENCH OR PIT 15 THE DISTTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION ON FEET:. THERE IS• NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE FALL PIPE AND THE BOTTOM OF THE EXCAVATION :IN FEET;. F'E=CAtJ a FZE_.Eti 00 En F" [. a o_. I-F•iVA hC ._. a ;"EO C3 FAt_L_CAr4 PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCE'S THAT THE WELL WILL SERVE. .._--- _E9.°.!CA °' ly To a tA=.F>EEClT a CDP4" FAF=:E= Fes.°E=rzi-i a F .ECA 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 166 FEET FOR A PRIVATE WELL: OR 156 TO 266 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND C:ONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F='FrFRrl .1 "f- EFT :F°'• a FR E_' .. E>E A E=rlE?:E=FZ lnfl r I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS FORTH BY THE MUNICIPALITY OF ANCHORAGE. I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: I UNDERSTAND THAT THE -ON-SITE SEWER, SYSTEM MAY REQUIRE RESIDENCE IS REMODELED TO INCLUDE MORE THAN S BEDROOMS. SIGNED: IPP JAMES AL,;IGHT ISSUED BAIANIN/jof �tr - --- o IL<2: AND WELLS AS SET ENLARGEMENT IF THE V3 ., (� SOILS LOG O MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION El PERCOLATION 6 • TEST Pouch 6.650, Anchorage, Alaska 99502 276-2221 SOILS LOG - PERCOLATION TEST PERFORMED FOR: �J1� DATE PERFORMED: 1 b D LEGAL DESCRIPTION: "�'�' Patter �w" �IULSM SLOPE SITE PLAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 ?Ml e �� C") S /g S PERFORMED BY: 72-008 (7/76) WAS GROUND WATER `fyQ n S ENCOUNTERED? i/\i L O IF YES, AT WHAT If E DEPTH? 1 r j I WAS GROUND WATER `fyQ n S ENCOUNTERED? i/\i L O IF YES, AT WHAT If E DEPTH? Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE TEST RUN BETWEEN CERTIFIED BY: (minutes/inch) FT AND FT a I"I r7V' OCo 130 r y --i — lZD.O(' I �`-i• Oo 0 7 1 ctD h4 - Zo . Cb l G ®F �L4�13 Gerald V. Randall Jr. NO. 4053-S e %ByFOP�°�O•we�°°e°°�SJa ROFESSIONAL VPN LOT SURVEY CERTIFICATION: IT IS THE CONTRACTOR'S RESPONSIBILITY LEGEND: 1 HEREBY CERTIFY THAT I HAVE SURVEYED THE TO CHECK TOP OF FOUNDATION IN RELA- • 5/8 REBAR RECOVERED PROPERTY SHOWN AND DESCRIBED HEREON AND TION TO FINISH GRADE AND BUILDING o 5/8 REBAR SET THIS THAT THE IMPROVEMENTS SITUATED THEREON SET BACKS IN RELATION TO LOT LINES ARE WITHIN THE PROPERTY LINES AND NO AND EASEMENTS. SURVEY ENCROACHMENTS EXIST. D 2'5(2" HUB & TACK SET LEGAL DESCRIPTION: ❑ EXISTINIS ELEVATIONS Prepared by: GERALD V. RANDALL, JR. Reg. Land Surveyor 1135 WEST 8TH AVE., SUITES f�T 1'lYy�t�-�r 2----- DATUM ASSUMEDPhone: 279-7414 SCALE: lu ANCHORAGE, ALASKA 99503 S� �. hO��- Slp 9114-176 �D c6-otcr Jk.COwUC-QY GQWVOToes S 11-a ��il'1 m 0 O e MUNICIPALITY OF ANCHORAGE ` MUNICIPALITY OF ANCHORAGE DEPT. OF i:',`,I.1H & _ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTtp,I'SAi"NWENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 • SEP 13 1979 ENVIRONMENTAL ENGINEERING DIVISION Telephone 264-4720 RR �� RFA�ILITIEEE �� EE DD WATER AND SES REQUEST FOR APPROVAL OF INDIVIDUAL WEWR DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. - 7. PROP�$TY OWNER PHONE ci es .MULTIPLE FAMILY MAILING DRESS /1Z—/91 / PROPERTY ESI DENT (if different from above) PHONE 0.2 7 Looicy is .9�eal q 2. BUYER J NL2 PHONE rnc�s since June 1975. For wells drilled prior to that date, give well MAILING ADDRESS 3. LENDING INSTI UTI 4AJ6 PHONE MAILING ADDRESS 4. REALTOR/AGENT PHONE 2_7 MAI LING ADDR ESS ��W 5. LEGAL DESCRIPTION STREET LOCATION SO[/Ttf of 4&Are /} / 0/7S 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS 71Other El One ,Four ❑ SINGLE FAMILY ❑ Two ❑ Five .MULTIPLE FAMILY ❑ Three ❑ Six 7. WATER SUPPLY - >il 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. SEWAG 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. 72-010(3/78) /old LirK� OW5 . THIS SIDE FOR OFFICIAL USE ONLI INSPECTION APPOINTMENTS DATE RECEIVED - TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE ❑,/,SINGLE FAMILY Vqd" MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE EJ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY 1 INDIVIDUAL I),y/COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED V3. S WAGE DISPOSAL SYSTEM INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED v� INSTALLER ❑Septic Tanyk or ❑ Holding Tank -Size: ( Z JanIf Tank is homemade give dimensions:- SOILS RATING TYPEOFTANK MANUFACTURER - TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank sorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE e�' aG- BY (Title) LEGAL DESCRIPTION 72-010 (Rev. 3/76) r� A b e i.t,' i 1 �. •� 30��d AQP s� Srl;r ET � 1 % . A��l HJ A�F, ALASKA(99501 x.907) 261-41 11 September 20, 1979 James R. Albright Star Route A Box 1584-X Anchorage, Alaska 99507 Subject: Lot 2 Potter Subdivision Dear Mr. Albright: This department can not approve your.request for sewer and water approval until we know the location of the sewer system on the neighboring lots. The neighboring sewer system needs to be 150 feet away from your well. If there are any further questions, please contact this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw cc: Spokane Mortgage 3201 C Street - Suite 250 99503 l l ,)W.1 L F£CNO September 20, 1979 James R. Albright Star Route A Box 1584-X Anchorage, Alaska 99507 Subject: Lot 2 Potter Subdivision Dear Mr. Albright: This department can not approve your.request for sewer and water approval until we know the location of the sewer system on the neighboring lots. The neighboring sewer system needs to be 150 feet away from your well. If there are any further questions, please contact this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw cc: Spokane Mortgage 3201 C Street - Suite 250 99503