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HomeMy WebLinkAboutSNOW VALLEY LT 23B7S7* 0`7)Z SZ Low ap Frip a o 0 0 0 0 0 0° o �r I ($ of o e oi ♦ NII nl GRE! =R ANCHORAGE AREA BOF UGH o`J 4b DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 �°4aio uw`�J SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT 4 NAME OF APPLICANT n- f t r INSTALLATION LOCATION LEGAL DESCRIPTION INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH SOIL TEST RESULTS COMPLETION DATE ANTICIPATED e MAI 0 d I SEEPAGE PIT_ DRAIN FIELD PERMIT NO OTHER 34/V-11;926 NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE (OC(/TYPE SEEPAGE AREA SIZE TYPE MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK SEEPAGE PIT TO NEAREST LOT LINE. WELL TO SEPTIC TANK DRAIN FIELD WATER MAIN TO SEPTIC TANK DRAIN FIELD DRAIN FIELD DRAIN FIELD SEEPAGE PIT ALSO CONSIDER AREA WELLS. . SEEPAGE PIT SEPTIC TANK, SEEPAGE PIT , DRAIN FIELD TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. G.A.A.B. OR LICENSED DESIGNER DIAGRAM OF SYSTEM 1 CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE APPLICANT'S SIGNATURE FORM NO. EO -016 i j E __ � I f_ _T 1 f i I 1 CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE APPLICANT'S SIGNATURE FORM NO. EO -016 5. LEG L DESCRIPTION DATE RECEIVED INSPECTION APPOINTMENTS fA�GJ LL f !'Uf-C"i/rOt�odl> TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR MUNICIPALITY OF ANCHORAGE Mq/���jJNICIPALITy OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIO�EPT. OFla'= i & 825 L Street - Anchorage, Alaska 99501. ENVIRONIJ,ENT'" ,-I • ENVIRONMENTAL SANITATION DIVISION., Telephone 264-4720 // REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEAS I�1U " DI RECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. P RT NERPHO f�iF�d V3 s �7 MAIL: IN ADDRESS PROPERTY RESIDENT (If different from above) PHONE - 8. SEWAGE DISPOSAL SYSTEM 6PHONE MAIL DDRESS UTION , PHONE Z-1 ADD S _ /fes 4.ALTO R/ T _ e� PHONE CPRS�J�J MAI LING AD KESS �o�? � 5. LEG L DESCRIPTION p 3 S rJ %- fA�GJ LL f !'Uf-C"i/rOt�odl> STREETLOCATIO 'z) lC/e�v%J 67 TYPE OF RESIDENCEMBER OF,BEDROOMS One El Four ❑ Other *X101 X SINGLE FAMILY 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** YEAR ON --SITE SYSTEI\�WAS INSTALLED. PUBLIC UTILITY I_ILD 2 NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ED 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 P? ----APPROVED FOR I BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE BY 72-010 ( Rev. 6/79) 5. LEGAL DESCRIPTION DATE RECEIVED INSPECTION APPOINTMENTS Sub. (USS 3043) TIMI TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR ❑ MULTIPLE FAMILY ❑ Three ❑ Six MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL PROTECTION DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 1981 ER COMMUNITY MAR 3 1 ENVIRONMENTAL 264-4720 N DIVISION Telephone RECEIVED depth (attach log if available.) -8. SEWAGE DISPOSAL SYSTEM REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts an page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTYOWNER - E31: PUBLIC UTILITY Being PHONE 243-5323 Jake & Sonny Thiele MAILING ADDRESS C/0 Jack White Co., 3201 C St., Anchorage 99503 PROPERTY RESIDENT (If different from above) - PHONE Same - On weekends 783-2944 2. BUYER PHONE Tom D. & Karen L. Macklin None MAILING ADDRESS C/O Jack White Co. 3. LENDING INSTITUTION Security National Bank (Nancy Karnowski) PHONE 276-6800 MAILING ADDRESS 880 H St., Anchorage 99501 4. REALTOR/AGENT Jack White Co. (Jack Vanden Berg yF/ N, r��1�'/ PHONE 277-1553 MAILING ADDRESS ' 3201 C St., Anchorage 99503 5. LEGAL DESCRIPTION Lot 23B Snow Valley Sub. (USS 3043) STREET LOCATION Danish Circle - lst cabin on left (driveway off main A yes lust before hardware store - left side, red metal roof & red 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS ❑ One ❑ Four ❑ Other C2r SINGLE FAMILY M Two ❑ Five ❑ MULTIPLE FAMILY ❑ Three ❑ Six 7. WATER SUPPLY ❑ INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ER 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** YEAR ON-SITE SYSTEM WAS INSTALLED. E31: PUBLIC UTILITY Being hooked up prior to closing. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) :abin. I 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ TWO ❑ FOUR ❑ SIX ❑ OTHER 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑ 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 %� n n � ❑ APPROVED FOR BEDROOMS Lk-- —CONDITIONAL APPROVAL (letter must accompan tificate) El DISAPPROVED DATE BY I 72-010 (Rev. 6/79)