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HomeMy WebLinkAboutSHEETS LT 13 PETERS CRK TERR TWNHMS PH 3,_ �; -.� - i ;,' f a �y Q\'.orrt-0 MUNICIPALITY OF ANCHORAGE 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 \� \i�` pNSCIY PHONE (�� a,'�� NEW ❑UPGRADE MAILING ADDRESS LEGAL DESCRIPTION LOCATION++\\ p `X'bb nE'sTegp 9 -we p Gg1N-D1'e. NO. OF BEDROOMS Uy DISTANCE TO: Well Absorption area Dwelling PERMIT NO. I k) nZ wpa Manufacturer Material£L No, of compartments N Liq. capacity in gallons i 4 Inside lengt IF HOMEMADE: Width �! lV Liquid depth NIB 6 J t7Z DISTANC Well Dwelling PERMIT NO. 0 Z FQ- Manufacturer Material Liquid capacity in gallons C1 J DISTANCE TO: ® Foundation h d- Nearest lot line PERMIT NO. © 5 Ct Pi ul u Z No. of lines 7Lengtb of eac liny� Total length of nes 16 �L Trench tyWth J C� aches Distance between lines Q h p Top of tile to finish grade\ Material beneath tile �� 51 ® inches Total effective absoorrpYon area $ Q LU (7 Length Idth Depth PERMIT NO. a N wa Type of crib C b di eter Crib depth Total effective absorption area W N DISTANCE TO: Welt III I Building foundation Nearest lot line ss��yy �WZJ \y Depth Driller Distance to lot line PERMIT NO. W DISTANCE TO: Building foundation Sewer line Septic tank Absorption areas) OTHER Vc PIPE MATERIALS SOIL TEST RATING Q t.6 it Cp P 4 t INSTALLER t_t_C ' Quo " REMARKS 110 VIED ( DATE LEGAL ,2-013 (Rev. 3/78) I 1-0 k-0 Ci' -,.9 T c:_- 1. F-, F1 01 (111-11 V, WY oil His W: numn huxCHORACIF.., 14::. :1;:M E E: 1:5 FIT 14 EEC 1:1 WEE: 10 WRX DUJA PEF!1­11:I.*T NO. APPL. I (DANT WILEY Df; NS -P-1 1-00-1"Ff ON EYWiLF: Fn!IVF-'F-.! L.EEGAL Seq) 966 F:FIGLE RIVF-.:F! I OT f ''i-VE E OF ABSCHYTICSN SYSTEM IS: TRENC11 tqR>1IV1UJ,1 NUME:ER OF_ E':EDROOM'.. = '5 am. print-Ici THE: R, F, Q ki If OF THF'.: fjOIL F1B,.",,ORPTION I.S.: W P_ P/ 3,/ 12,, R -Ti MIQ QUE R L_ Q PA K3 -1 -, I - 4=- 7', -.-Eo 0 f -1 F�, 11, -,F-, 0- -1 -IME LF.".NGTH I)IMEENSION 1�; THE"'. 1, ENGTH <)14 'I"RE-11CIA OR THF,* DfPT1-1 OF A TRUIGH r)R 15 THE DI, TAh1GF F*_TWFFJ,1 THE GROUND AhID THE E'.OTTOM OF i'HE f-.:.,.cFivFrrI(.IN <IN Fl-:F:T). THEERIE 115, NO WIDTH F"Of,'?. TF`.EP-4CHE`.'.;. THE-' P,EPTH IS THE: MINIMUM DEPTH OF GRA%�F-T, E.`F,1'WUEN THE' OUTFALL. PYF`F,­ FINE? THF BOTTOM OF' THE: 0N FEET). FE C.".1 0 ... j Y W FEE V*- -17 kol 01 K so; X 127 Q — ::I€_ W-� �,�s F-1 P, - P. _... C_,:o p,, - I PINFIMIT farumorr Jim, THE Fvq,",PON'_-.'.TPIf_,VfY TO Ih1F0E-':M DFPF1RTte1FNT [A-IRUK'i THF: 1: rd' '_','T A L I. ATIOt.-I Of"' ANY F1DJYiGFNT TID THP -.'i PROPERTY Fif-11f) -f[-IF: t-JUMBIEF.': OF THAT THE.. WELL WILL. —F" 14 KV c: too on X 1%8 IF-: IF:P F.,__. C'., —if— I ICJ VA K fou FW Fz­ FE: G"T L fil x H K. -F. V:B F:AGf-,,'.'F'ILLING OF ANY SYME11 WITHOUT FUIFIL. IJ-,1'S:PFCTIC'IN AND F1PPF,.0VF1L R`r' THI!,-'� _,(. IENT E suB,wrr vci Pf� sEarrIot MINIMUM PETk1E3EN A 1*11, ANI) AhlY `�.,EWACMT DISPOSAL WITTEM Q:; - IR A F,RIVATF WFLI....; OR 100 FFEUT Fi- 1 e - UPOt-4 THE TYPE OF 50 TC.i F"El..'r F -ROM A PI-IRL'IC IrIFT.I.- [:,"Epf-- OTHER. MAY i"W"PL.M. AND Aly'Fill-ABL.E.- 'ff) INSUP,.E PROPER 1:1 Q vW1 Fit K F;,,_,, -1_ I CEI TIFY THAT 1: 1 AM FAMILIAR. WITH THE: REQUIREMENTS F`01,! we Tom MUNICIPFLITY OF FWAMOFTME. ;': 1 PULL INSTAU. THE S"r'STRI IN ACCOM)FINE:�"[.Jj'f+J j*Jr.]f'-'. -t-R, IF -�iF'MPIT IF THE. UNI)E'Un .41) THAT THE ON . -SITE SIE1,11-R MY WGUIP.L: F _f RET SIDEINCE: IS FARKIDEL.F1) TO T.Ninthre PIS ,.iF:E THAl'.4 5, d�6 I ........ . ....... .... .. .... 19PAL. I CANT W1: 5' 1) F: P-413 EE 1-1 F, -Y, V3. GREATER AWCIMACi_ PM -A L'OROD� Department of LnvironmeIt. al Quality 3330 "C" Street �,. Anchorage, Alaska 99(13 SOILS LOG - PERM A`i'ION TEST -_.SPR.LNE_CR_ hate Perfor { -Z6 75 Performed for SCK._ �K.C+�V�44�1N6 _ - _..._ -.. _ q Legal Description:___ _.91'__��--_---_-�{��5 SuI�Es�o�a_ - - - lhis form reports: soils log » _ Percolation 1esi: Depth Feet o�� 2 �. 3- 4 12 - 13 - 14 - sp' GW— CM 155 670,00 Was ground water encountered? _ -NCi If yes, at what depth? Reading Date Gross Time Piet Time Depth to Wni-ed- iJet Ilro1 S -C) I _._.CAV"J%�_- ..__S.S_f.eev�_.__. - .7Q_?Q.S5/119- ...-- Gnu-- Zo® --- tI__-- - -- -- - - - Percolation rate minute. Proposed installation seepage Pit _ Drain Field __ _ Depth of Flet Depth /to bottom of pit or trenci _ _- CON"IEfJTS�1GSS1C't:er !4 -+- 4-+_ -7S'.21a EQ -040 (6/74) 5. LEGAL ESCR 10 MUNICIPALITY OF ANCHORAGE DEPT. OF (HEALTH & DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTEA y6WNMENTAL P OTECTION STREE OC 10 825 L Street - Anchorage, Alaska 99501 , • AUG 13 1919 6. TYPE OF RESIDENCE ENVIRONMENTAL ENGINEERING DIVISION ❑ SINGLE FAMILY Telephone 264.4720 RECEIVED REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPETY 0WIN R PH N *ATTACH WELL LOG. A well log is required for all wells drilled ,. a % 2 �c ley depth (attach log if available.) 8. SEWAGE �DISPOSAL SYSTEM E9� INDIVIDUAL/ON-SITE** MAILING A ESS PROPERTY RES DE T (If different from above) - PHONE 2. BUYtFf NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. PHONE MAILING ADDRESS 3. LENDI IIT ON / �/i�e� PHONE MAILINGA DRESS`.J � %I C 4. REALTOR/AGENT PHONE MAILING ADDRESS 5. LEGAL ESCR 10 STREE OC 10 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS ❑ SINGLE FAMILY ❑ One ❑ Four ❑ Other ETwo I—(YMULTIPLE FAMILY El Three 0 Six SSix 7. WATER SUPPLY ❑ INDIVIDUAL* *ATTACH WELL LOG. A well log is required for all wells drilled ,❑, COMMUNITY PUBLIC UTILITY since June 1975. For wells drilled prior to that date, give well ley depth (attach log if available.) 8. SEWAGE �DISPOSAL SYSTEM E9� 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'V//off THIS SIDE FOR OFFICIAL USE ONLY INSPECTION APPOINTMENTS DATE RECEIVED TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY MULTIPLE FAMILY NUMBER OF BEDROOMS . ❑ ONE ❑ THREE 11K FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ fL0 L^(�/ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3.SS WAGE DISPOSAL SYSTEM L INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER ❑Septic Tank or ❑Holding Tank Size: If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank- Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS V, APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE , / �� —r—? C? BY (Title) r— Ir LEGAL DESCRIPTION , 72-010 (Rev. 3/78)