HomeMy WebLinkAboutTract A (9)
i MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONIViENTAL PROTECTION
ENVIRONIVIENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME
LEGAL .,~.%~ I PT I 0 N J
LOCATION
~~ ~f Absorpt~ area /~ Dwelling NO. OF BEDROOMS
PE T
~ /Manufacturer
L ~ /-~O~.~t~ ~ 'T/-bV/(. Mate~, No. of compartm~nt~
ILia, capacity in gallons .. _ _
7 '~-~ IF HOME,DE: Inside lengt~ Width Liquid dept~
~ ~ DISTANCE TO: Well ~ ~elJing
~ ~ ~ PERMIT NO.
O ~ ~ Manufacturer
// Material Liquid capacity in gallons
~'~ No. oflines / Lengthen,ne Total len~in~ Trench wi~ inches
. -~ Distance between lines
~ [~ Top of tile to finish grade ~ i- Material beneath tile / ~' inches / ~g) ~
Total effective absorpti~area
Length Width Depth
~ ~ Type of crib Crib diameter
~ ~ Crib depth Total effective absorption area D[P'F. OF H~ALTiI &
~ ' ENVIRONMENTAL PROTECTIQN
~ DISTANCE TO: Well Building foundation Nearest lot line
~ Class Depth Driller.~ PERMIT,~ ~ I ,",
" ~ J'-% A' ~nla~'~ / ~ Distance to lot line ., _
DISTANCE TO: Septic tank Absor ' 8~ ~(
OTHER
PIPE MATERIALS
INSTALLER I
REMARKS ~ '~
MUNICIPALITY OF ANCH' ~GE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTEL'~ION
~"~'~ L STREET., ANCHORAGE ~K
_,4-4, ~8
PERMIT NO .'
[:'ATE - ISC,~ ~ED'
FFLICHNT.
ADDRESS:
CONTACT PHONE ·
84042?
CYRIL KIEHL
SRA BOX 60~5
EAGLE RIVER, ~K
GD4-~O
PERr'I 3' T ~ ~
LEGAL DE_,L. RIP: SUBDIVISION: FTHRMI..,HN LOT: TR.A BLOCK: NB
SECTION: 17 TOWNSHIF': i~N RANGE: ±W
I-'
LOT SIZE: ~R "S;t FT. OR ACRES)
I1H,*~ BEDROOMS: 4
LISTED BELOH ARE THE OPTION5 AVAILABLE TO YOU IN DE~I~NINiJ YOLIR SEPTIC:
'="~ JFTIUN THAT BEST FITS YOUR SITE.
-,~-,TEM. CHOOSE THE c ' '
DEPTH TO PIPE BOTTOM (FT.)
GRAVEL DEPTH (FT.)
TOTAL DEPTH (FT.)
GRAVEL WIDTH (FT.)
GRAVEL LENGTH (FT.)
GRAVEL VOLUME (CU. YDS. )
TANK.SIZE (GALS)
SOIL RATING (SQ. FT./BR)
TREt-~C:H BED- !--~. E:,RR I t-~
4.0 4.0 4.0
10.0 0.5 ~.5
t4.0 4.5 7.5
2.5 EO, O 5.0
70. 0 .57:0 i.Si. 0 m.
t., 250. 0 mm i., 250. 0 *:a t,,250. 0 mm
284 2:4~
:+"+' =r,:-:tn,r_L LENGTH } 75 FT. REQUIRES MULTIPLE RUNS (NOT EXCEEDING ,"7'5 FT. ERCH)
:+::+~ TFtNK F]LIST HAyE FIT LEFtST TWO COMPARTMENTS
£ CERTIFY THAT:
I AM FAMILIAR WITH THE.REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET
FORTH BY THE-MUNICIPALITY OF ANCHORAGE (MOA) AND THE STATE OF ALASKA.
2. I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH ALL MOA CODES AND REGULATIONS~
AND IN COMPLIANCE WITH THE DESIGN CRITERIA OF THIS PERMIT.
· '~. I HILL ADHERE TO ALL MOA AND STATE OF ALASKA REQUIREMENTS FOR THE SET BACK
DISTANCES FROM ANY EXISTING WELL, WRSTEWRTER DISPOSAL SYSTEM OR PUBLIC
SEWERAGE SYSTEM ON THIS OR ANY ADJACENT OR NEARBY LOT.
4. I UNDERSTAND THAT THIS PERMIT IS VALID FOR ~ MAXIMUM OF 4 BEDROOMS RND
AN9 ENLARGEMENT WILL REQUIRE AN ADDITIONAL PERMIT.
F R LIFT STATION IS INSTALLED IN BN AREA COVERED B9 MOA BUILDING CODES,
'HEN .(~) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) BS-BUILTS
!ILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORTs AND <~) THE
LEC:TRICRL WORK MUST BE [)ONE BY R LICENSED ELE_.TRIL. IMN.
I GNED r X
....
....
PERFORMED FOR:
LEGAL DESCRIPTION:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15-
16
17
18
19
20-
E~ SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONIVIENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
,%,/L-/"'? O~---~¢/-fv' / 6 S
SLOPE
PERCOLATION
TEST
DATE PERFORMED:
SITE PLAN
F_ ~;T_+
WAS GROUND WATER
ENCOUNTERED?
0
P
E
IF YES, AT WHAT
DEPTH?
Reading Date Gross Net Depth to Net
Time Time Water Drop
/
3 )o, lit
PERCOLATION RATE ~ 0 (~inutes/inch)
TEST RUN BETWEEN ~ FT D -'~ Z. FT
COMMENTS
PERFORMED
72-008
Rick Mystrom.
Mayor
Mtmicipality of Anchorage
Department of Health and Human Services
825 "L" Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
June 27, 1996
Alaska USA Federal Credit Union
PO Box 196613
Anchorage, Alaska 99519 6613
Subject: Tract A Ptarmigan Addition
Permit #SW950120, PID ~050-362-29
The subject permit, issued June 16, 1995 by this office for a
single family well and/or on-site wastewater system, has
expired as of June 16, 1996.
A new permit must be obtained from this office for a well
and/or on-site wastewater system NOT installed by the
expiration date.
If you have drilled the well, a well log must be sent to
this office for documentation of the installation and to
close the permit.
If a licensed Professional Engineer has inspected the
installation of the on-site wastewater system, the original
as-built inspection report must be sent to this office for
review, approval and documentation. All inspection reports
must be submitted within 30 days of construction completion.
When applying for a new permit, the fees are: $320.00 for an
on-site wastewater permit; $120.00 for a well permit and
$440.00 for a combined on-site wastewater and well permit.
If you have any questions, please call this office at 343-4744.
SiTerely' fi
J~e~ Cross, P.E.
Program Manager
On-site Services
enc:
Copy of Permit
Cyril & Lois Kiehl
2020 Muldoon Road #335
Anchorage, Alaska 99504
PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WELL SYSTEM (UPGRADE) PERMIT
PERMIT NIIMBER:SW950120
DESIGN ENGINEER:DUMMY COMPANY
OWNER NAME:KIEHL CYRIL & LOIS
OWNER ADDRESS:9439 WREN CIR
ANCHORAGE, ALASKA 99577
DATE ISSUED: 6/16/95
EXPIRATION DATE: 6/16/96
PARCEL ID:05036229
LEGAL DESCRIPTION:
PTARMIGAN TR A
LOT SIZE: 410400 (SQ. FT.)
NU1MBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONTRUCTION OF:
WELL SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
1. THE ATTACHED APPROVED DESIGN.
2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS
15.55 ~ 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL
REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80).
3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT)
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
RECEIVEDBY:~.~.~--~
ASBUILT~NO CORNERS SET THIS DATE.
I HEREBY CERTIFY 'THAT I HAVE SURVEYED THE
FOLLOWING DESCRIBED PROPERTY:
AND THAT NO ENCROACHMENTS EXIST EXCEPT AS
INDICATED, IT IS THE RESPONSIBILITY OF THE
OWNER TO DETERMINE THE EXISTENCE OF ANY
EASEMENTS~ COVENANTS, OR RESTRICTIONS
WHICH DO NOT APPEAR ON THE RECORDED SUBDI-
V~ION PLAT, UNDER NO CIRCUMSTANCES SHOULD
ANY DATA HEREON BE USED FOR CONSTRUCTION
OF FENCE LINES, OR FOR ESTABLISHING BOUND-
ARY LINES.
DATE; .
GRID.'
DRAWN;
ertifiei ,rilling
DOC Co, ~lba
SULLIVAN WATER WELLS
P.O. aOX ~l~Y~?2, OHUO,AK, ALAIKA ~'e~l? ', TELEPHONE
STATIC [,,EVI{I OF WATER
p , [ ' - ~,PERHR _ .
KIND OF FORMATION: [ '~, ...............................
. - ' From ...........
From ......... Fl. to ...... Ft. _ .....
From ...... F¢. to ....... Ft,
From ...... Ft. to ...... Ft.
From ..... Ft. to ......... Fi.
From ....... .Fl to
F,,,. ..... F,.,,, ...... .uF, ......... !.!..1~_~ ........
De Unlcipallty ot 4n
From F! to Fl . 8 ....
From ......... F~, Io_
From..:~_Fl. ~o .......
,. '
From . -Ft to . . F~. - '
' ........ From*. F~ t~ ..... FI. ' '
From ...... Ft. ~o . . Fl ...... '*
From ....... Fl to F{
From ..... Ft to .... Fl
From ....... Ft, to ........ Ft,
From ..... Fl. to .......... F¢
MISCL, INFORMATION:
From ._
From ...... FL ~o .... i ...... F! ..............
From ......... Fi, to ....... Fl.
From .......... Fl, to ........ Ft,
,, From ..... ~.Ft to