HomeMy WebLinkAboutBELLA VISTA #1 LT 35B
MUNICIPALITY OF ANCHORAGE
Department of Health & Human Services
DIVISION OF ENVIRONMENTAL SERVICES
343-4744
~L:~TIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
Parcel I.D. # ~)\ ?~--(.D-~ '~ - L-~L/~'',
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include lot, block, subdivision, section, township, range)
Lot 35B, Bella Vista ~/
Location (address or directions)
618 E. 79th
(b) Property owner A.H.F.C. ¢8082 Telephone' (home)
Mailing Address 520 w.. 34th/ Anchorage, Ak.
_ Business
(c) Lending Institution
Mailing Address
Telephone
(d) .Real Estate Company and Agent 2001 Realty/ Nancy Berqh-Pollock
Address 1345 W. 9th., Anchorage, Ak. 99501
Telephone 276-2001
(e) Mail the HAA to the following address: (or check hereJg~, if hold for pick up.)
List contact person and day phone number below:
S & S ENGINEERING
17034 Eagle River L~p Road No; 204
Eagte River, Alaska 99577
2. TYPE OF RESIDENCE
Single-Family [] Number of bedrooms 2
3, WATER SUPPLY
Individual Well::l~ Community [] Public []
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to th legality and status.
4. SEWAGE DISPOSAL
On-site [] Public ~ Community [] Holding Tank []
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to the legality and status.
72-025 (Rev. 7/88) Page I of 2
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MUNICIPALITY OF ANCHORAGE (MOA)
Health Authority Approval (HAA)
CHECKLIST - FEBRUARY 1984
343-4744
LegalDescription: ~'~"~' 1~
Well Classification -~/~~ If A, B, C, D.E.C, App d (Y/N)
WellLogPres~nt(~ ~ateCompleted ~ ~ Yield
Static Water Level '~ Pump Set At
Casing Height Above Ground ~ Sanitary Seal on CasingS)
.,.ctr,.a, ,n .e. e.s.on
To Soptic/Hol~in~ Tank on kot ~r] ; On ~djoinin~ kots
To Nearest Edge of Absorption Field on L~t ff/P ;On Adjoining Lots
To Nearest Public Sewer Line ~~ To Nearest Public Sewer Cleanout/Manhole
To Nearest Sewer Service Line on Lot ~,
Water Sample Collected by ~ ~/~~~ ;Date
WaterSam~l~TestResults .'" ' ~~~ ~~
Commen~~ ~{ ~{~ ~,~ ~q~ ~,. ~/~,~/j-~ d~ ~ ~"
'.B. S~NK DATA
Date In,ailed ~Size No. of Compartments
Standpipes(Y/N) ~S (Y/,) ~~Y/S) ~
Doprossion over lank (Y/~) ~~ ~~umpod ~
Pumpia~/Maintenanco Contact on Filo (Y/~) ~~ ; for ~
Holdin~ Tank Hi,h-Water Alarm (Y/~) ~ lomp~in~ Tank ~ormit (Y/~)
To Property .Line // To Disposal Field
To Water Main/S~ce Lmne .... ~~
~UNICIPALI~ OF A
' , - , ~? J
To Strea~nd,, .~ Lake or Major Drainage Course N
RECEIVED
72-026 (Rev. 7/88) Front Page 1 of 2
C. ABS( IPTION FIELD DATA
Soils in Absorption Strata
Date
Width of Field __
Square Feet of Absortion a
Depression over Field (Y/N)
Results of Last Adequacy Test
SEPARATION DISTANCE FROM
To Water-Supply Well
To Building Foundation
Lot
Type of System Design
Length of Field
Depth of Field
Gravel Bed Thickness
Statndpipes Present (Y/N)
Date of Last Adequacy
PTION FIELD:
To Pro Line
Lots
To Water Main/Service Line
To Stream, Pond, Lake, or Major Drainage Cour
To Driveway, Parking Area, or Vehicle Stora, Area
Comments
To Existing or Abandoned System on
'o Cutback (if present)
D. LIFT STATION
Date Installed
Size in Gallons__
"Pump On" Level
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
High Water Ala. a~ Level at Vent (Y/N)
Tested for/ Pumping Cycles during
Meets ~/(~A Electrical Codes (Y/N)
./~nts ____
~he_c_ k .Permitted Bedroom Rating Against HAA Request**
certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the
Test.
inspection.
Signed
Company
Date
MOA No.
S & S ENGINEERING
17034 Eagle River L;mp Road bio. 204
Eagle I~lver; Ala~ska 99577
Receipt No.
Date of Payment
Amount: $
72-026 (Rev. 7/88) Back
Receipt No.
Waiver Fee: $
Date of Payment
Page 2 of 2
, INC.
FEDERAL TAX ID fl 92-0040440
ANALYSIS REPORT BY SAMPLE ior Work Order % 12295
Date Report Printed: MAR 27 89 & 10:36
Client Sample ID:L35B, BELLA VISTA
PWSID :UA
Collected MAR 22 89 @ 11:45 hrs.
Received MAR 22 89 @ 14:00 hrs.
PreserYed with :NONE
Client Name : S & S ENGR
Client Acct: SNSENGP
P.O.% NONE REC'D
Req ~
Ordered By :
Analysis Completed :MAR 24 89 Send Reports to:
Laboratory Supe~vSsor :STEPHEN C. EDE 1)S & S ENGR
Released : 2>
Special
Instruct:
Chemlab Rei #: 4616 Lab Smpl ID: 1 Matrix: WATER
Allowable
Parameter Tested Result/Units Method Limits
NITRATE-N ND(0.10) mE/1 EPa 353.2 10
Sample ROUTINE SAMPLE.
Remarks: SAMPLE COLLECTED BY RP.
1 Tests Performed ' See Special instructions Above UA=Unavailable
ND= None Detected ** See Sample Remarks Above
NA= Not Analyzed LT=Less Than, GT=Greater Than
" U
,Time .... Time ~ ~e
Date Date Date
Inepecto~ Inepector Inepec{or ./~//
Oomments Conditional Approval
Date Sewer I~stalled Permit No. Septic Tank Size
Soils Rating ' Well To Absorption'Area Well Log Received
Well to Tank
A..uCA.T F LLS LOW .. LF O.L
Prope~ Owner
Lending Institution ,,~ ~, ~. ,. ~ Phone
Real~ - ' ' Phon
Street Location, ~te ~r ~ *~- ~~ .
Ty~f Residence
-~lngle Family
~ Multiple Family No. of Bedrooms ~ '
~ Other
~ndlvldual A~AOH WELL LOG. A well Icg Is required for all wells drilled since June
B Community 1975. Fo~ wells drilled prior to that date, give well depth (attach Icg if
~ Public Utlllt~ available.) .....
~ubllc Utility i
~ Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE PROCESSING CAN BE INITIATED.
January 18, 1982
John & Roberta Hollenberg
c/o Dennis Spear
6701E. 4th Avenue ~8
Anchorage, AK
Subject: Lot 35B, Bella Vista
Dear Mr. & Mrs. Hollenberg:
ApDroval for the individual sewer and water facilities cannot
be granted until the followinq items have been completed:
" Expose the well for our inspection to determine proper
construction, also to insure minimum distance requirements
are met between the well and sewer system.
The outside water tap was frozen. Please call this office
to make arrangements to have an inspector to meet you at
the site.
Please notify this department for a reinspection when the
noted discrepancies have been corrected. If there are any
further questions, please call this office at 264-4720.
Sincerely,
Robert C. Pratt
Associate Environmental Specialist
TIME
DATE
INSPECTOR
DIRECTIONS:
THIS SIDE FOR OFFICIAL USE ONL~
INSPECTION APPOINTMENTS
TIME
DATE
NSPECTOR
1. TYPE OF RESIDENCE
[] SINGLE FAMILY
[] MULTIPLE FAMILY
2. WATER SUPPLY
INDIVIDUAL
[] COMMUNITY
[] PUBLIC UTILITY
Connection Verified
3. SEWAGE DISPOSAL SYSTEM
[] INDIVIDUAL/ON -SITE
[]PUBLIC UTILITY
Connection Verified
I--ISeptic Tank or []Holding Tank
Size: If Tank is homemade
give dimensions:
TYPE OF TANK
TOTAL ABSORPTION AREA
DATE
TIME
DATE
INSPECTOR
NUMBER OF BEDROOMS
[] ONE [] THREE [] FIVE
[] TWO [] FOUR [] SIX
PERMIT NUMBER
DEPTH OF WELL
[] OTHER
DATE DRILLED
LOG RECEIVED
PERMIT NUMBER
DATE INSTALLED
NSTALLER
SOILS RATING
Near~st Lot Line
4. DISTANCES
WELL TO:
Absorption Area to nearest Lot Line
MANUFACTURER
MATERIAL
'Septic/Holdi ng Tan k
Absorption Area [Sewer Line
E~ APPROVED FOR '
[] CONDITIONAL APPROVAL (letter must accpp~hy c~rtificate)
[] DISAPPROVED
LEGAL DESCRIPTION
72-010 (Rev. 3/78)
DATE:
TO:
FROM:
SUBJECT:
MUNICIPALITY OF ANCHORAGE
MEMORANDUM
May 15, 1989
Department of Economic Development and Planning
Zoning and Planning Section
Department of Health and Human Services
On-site Services Section
Request for Comments on Subdivisions
May 19, 1989
The Environmental Services Division, On-site Services Section,
of the Department of Health and Human.Services has reviewed
the following cases and has' these'comments:
S-8798: Lots 20, 21 Eaglewo0d Subdivision %4 - Vacation only
No objection.
S-8802:
Lot 3A Roehl Subdivision
DHHS has a record of a sewer system and well on
each lot. We have no objection to the proposed
subdivision, but will require that both wells and
, sewer systems be maintained in compliance with
Municipal ordinances.
S-8804:
~ This lot h~
Lot 35B Bella Vista Subdivision %1
~ecehtlY £sSUed ~'-Conditi°nal Health
Authority approval which requires either a new well
be drilled or a connection made to public water.
The Conditional is valid until July 1, 1989. We
will require that the Health Authority be satisfied
prior to final plat.
~usan Oswalt
On-site Services
SO/ljw
\CATION OF RIGHT-OF-WAY OR OFFICE USE
EASEMENT APPLICATION
· Municipality of Anchorage REC*D BY:
DEPARTMENT OF COMMUNITY PLANNING VERIFY OWN:
P.O. BOX 6650
Anchorage, Alaska 99502-0650
A. Please fill in the information requested below. Print one letter or number per block. Do not write in the shaded blocks. ~"
0. Case Number (IF KNOWN) 1. Vacation Code
2. Abbreviated Description of Vacation (EAST 200 FEET SOME STREET)
3. Existing abbreviated legal description (T12N R2W SEC 2 LOT 45 OR SHORT SUB BLK 3 LOT 34).
4. Petitioner's Name (Last- First)
Address~-~ (~ ~ )(. ~ ~"')/ t~ ~)
Phone No. ~I:~(~L[' -~~Bill Me
5. Petitioner's Representative
,v o/ ~Ic]l~ldlekb-klelel~l I I I I I.I. I
Address'~(~) ..~OX JOICO6 ~
City . .f~..~_~(' [_ State ~~_.~
Phone NO.'~ ~- q~ Bill Me
6. Petition Area Acreage 7. Proposed Number 8. Existing Number 9. Traffic Analysis Zone
Lots Lots
12.
Grid Number 11. Zone
13. Community Council
Date:
20-019 Front(4/851
I hereby certify that (I am) (I have been authorized to act for) the owner of the property described above and that I desire to
vacate it in conformance with Chapter 21 of the Anchorage Municipal Code of Ordinances. I understand that payment of
the basic vacation fee is nonrefundable and is to cover the costs associated with processing this application, that it does
not assure approval of the vacation. I also understand tha/La~dditional fees may be assessed if the Municipality's costs to
process this application exceed the basic fee. I further u~erstand that assigned hearing dates are tentative and may have
to be postpOned by Plan ning Staff, Platting Board, P~mng Com mission, or the Assam bly due to administrative reasons.
'/~
Signature NOLA CEDERGREEN
S 880 4 I~¥ 2, 2, 1989
*Agents must provide v~R~pL~fT~a~~lTI0N
OFFICER
Housin9
FINANCE CORPORATION
520 East 34th St.
Anchorage, AK 99503
(907) 561-1900
P.O. Box 101020
Anchorage, AK 99510
APRIL 21, 1989
Mr. Jerry Weaver
Municipality of Anchorage
Room 515 - Hill Building
Anchorage, Alaska
RE: AHFC File 8082
Lot 35B, Bella Vista Sub #1
Dear Mr. Weaver:
This is a request by Alaska Housing Finance Corporation for the vacation of
a portion of the West utility easement. Our property encroaches into this
easement (see attached asbuilt) and you advised this procedure to vacate.
This must be done in order for us to be able to finance this property. We
are reqeusting a vacation of the east one foot of the West 10 foot utilty
easement. Of all the utility companies, only Sonic Cable is within Lot
35B, verified by physical locates April 21, 1989. Attached are verifications
from each utility company.
Attached is a check for $500 payable to the Municipality of Anchorage to
cover the application fee.
Thank you for all the assistance you have given in this matter, both to
myself and my real estate agent. We appreciate your concern and hope to
have the vacation complete in a short time as you indicated.
Very t~uly yours,
Property Disposition Specialist
Attachments: asbuilt survey
Plat 68-27
Check for $500
Application
This request is being hand delivered this date by AHFC designated agent
880 MAY 3 2 1989
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