HomeMy WebLinkAboutUS SURVEY 3042 LT 89D T10N R2E SEC 19US SURVEY
3042
Lot 89b
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Isom minima :r 907 3 -_ - 0593 fer345-4700
O'illars styrturc:
Municipality of Anchorage
Development Swnrkes Depertm.nt
Striating Safety Division
13n-Srce Wafer and W Wewter Season
4700 South Beep* St,
P.Q. Boa 39663OAnChorug . A1C 94510.60
wwintaini.orgeouslie
{907} 343-1964
!Attention: aroperty owner shall provide a well log to the I
lDsn wsthi'i eo days of well campletian.
!kraal Pumbur, 08 P111084
Cfetc of isauc- 14.11V.I 161.2a11
niroet Idenut, .stiort (414ter: --
:, .reit lowc4 41approv44 permit laiadon7 (ytj Y,. -i or ( ) Na 1
WATER QUALITY TESTING
Conform fG Coi/100mL
Nitrates _ 13S mg/L
Arsenic ug/L
ed WOOS:HT ?TOZ ?? 'field OLT££aL Lld6 : ON Xktd 00 NOIIOf1dISN03 ASlldrl 6AIaeln : WOW
AUG -17-2011 02:18P FROM:
TO:3437997
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Pump Installation Log
�t'n
LOCATION: 01� 7 s
NALtE 1 1 'CC h✓/i 55tr-
OB 17)1I V
i .ot C , `Tap o'c. itka . n5
ABOVE GROUND
CASING
DATE:
iPitless
Adapter Manufacturer's Name: Qc Abe /I bt.--X
Pitless Adapter Installer: He ,V 1 ( if s c
PUMP TYPE St/ 661(1 ► b
1
MAKE t/01,/s/c,
MODEL. 1d 513°51402C--
SERIAL
Bo5y0c_
SERIAL t Pump
Motor
Stt ) ? O Sz. � )
DROP TYPE: Type yUc } / �
ColulltI'on� '/►�/t 11� l /l- ,/
POWER CABLE Two `): Si:. )). ,2 ii 64
CondlUon mGl,/
ELECTRICAL: Volts
Amp. 5F y, `7
WATER TANK: Typo
Sia.
WELL CASA Size ( Dio. Typo rc f
CASED HOLE: From % To /V v
INTAKE STRUCTURE: T.
From
OPEN HOLE: From
Ln�
To
To
well was disinfected upon completion.
method: calcium hypochlorite.
Zefty Drilling, Inc.
Water Well and Pump Service
Anchorage, Alaska
(907) 345-0593
Permit Number: OSP111064
Tax Code Number: 07513247000
Work Type: Well
Permit Effective Dates: May 16, 2011
Design Engineer:
Subdivision: US SURVEY 3042
On -Site Water System Permit
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
Initial
to May 15, 2012
Site Legal Address: US SURVEY 3042 LT 89D T1 ON R2E SEC 19 G:5012
Owner/Address:
PFENNINGER RITA
53603 COTTONWOOD HILL HOMER AK 996039622
Site Mailing Address: 226 GUNNYSACK MINE RD, Girdwood
Lot Size in Sq Ft: 10940
Total Bedrooms: 1
This permit is for the construction of:
N Disposal Field N Septic Tank N Holding Tank N Privy Y Private Well N Water Storage
All construction must 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 must notify the Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing.
Special Provisions:
1. The well shall be installed in accordance with Anchorage Municipal Code (AMC) 15.55.060.
Received By:
Issued By:
Date:
Date:
MUNICIPALITY OF ANCHORAGE
Community Development Department
Development Services Division
On -Site Water & Wastewater Program
Mayor Dan Sullivan
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. C 15 - -
Property owner(s) `� .1 { \hi iNL,..c.r mac,
Mailing address if, (.;k% CL V e
Site address "Z (,✓ mci
Phone: 907-343-7904
Fax: 907-343-7997
, Day phone
Legal description (Sub'd., Block & Lot) (,-e2.1-4--Y1 i p 2'�
Legal description (Township, Range & Section)
Lot Size z i 12-4- ; ° Sq. Ft. Number of Bedrooms
THIS APPLICATION IS FOR:
(® all that apply)
Absorption Field
Septic Tank
Holding Tank
Privy
Private Well
Water Storage
fl
Li
THIS APPLICATION IS AN:
Initial
Upgrade ❑
Renewal ❑
THIS APPLICATION INCLUDES A VARIANCE / WAIVER -13 QUEST FOR:
SLP /L,
I certify that the above information is correct. I further certify at this application is being made
for a Single Family Dwelling and is in accordance with applicable Municipal Codes.
X12
(Signature of property owner or a orized agent)
4 - e -L 1 c/?_,
Permit/Rush Fees: d.
Date of Payment: //// /
Receipt Number: ILO Q 63
Permit No. �'� 1110 C.
G:\Building\On Site\Forms\Client Forms\Permit App_010411.doc
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
(Rev. 1/11)
Note:
This is an A—Frame house.
Dimensions were measured at the
intersection of the roof eave and top
of wall, approximately 4.5' above grade.