HomeMy WebLinkAboutBERGGREN LT 1ili 0 kwowl =wClAaQW3
Development Services Departrn_nt
Builciina Safety Division
On -Site water ' Wastewater Proy-rem
4?0x 3roxStreet
P.O. o 195550
Mark Begich A.ricl?orcge, AK 99519-6650
Mayor +-++vnvnunl gra%ensu:
(90?)343-7904
Pump Installation Log
Well Drilling Permit Number: SW_ Date of Issue:
Parcel Identification Number:_
Legal Description Property Owner Name & Address:
` it e. t j {-1 Dl.'O ��'L%2'i.i 'r�G♦..
/aVt&6, dfll�
Pump Installation Date: 8 -15"- 13
Pump Intake Depth Below Top of Well Casing: / 77feet
Pump Manufacturer's Name: j e t
Pump Model: 75 G 3 11 �;& i L
Pump Size 1Y41 hp
Pitless Adapter Burial Depth: !` feet
Pitless Adapter Manufacturer's Name:
Pitless Adapter Installer: -
Well Disinfected Upon Completion? Yes F] No
Method of Disinfection: 1
Comments: y
Anchorage Pump & Well Service
Pump Installer Name: 330 East 76th Avenue
Anchorage, Alaska 99518
Phone: 907-243-0740
Fax: 907-243-0742
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
Municipality of Anchorage Page / of
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: S'V✓ 97O/a �) PID Number: O! 7 O 9,:2 -aV
Name: / o F 3 //,JA C, 7'441 � L o
Wastewater System: 14 New ❑ Upgrade
Address: 1Soy P, -;r
A1.1C11Q1Q'A&C, Akl 99S0/- 22JZ
ABSORPTION FIELD
Phone:
7' 3 (o �
No. of Bedrooms:
1& Deep Trench ❑Shallow Trench ❑Bed ❑Mound ❑Other
LEGAL DESCRIPTION
Soil Rating:
I �
Total Depth from original grade:
�
�a
GPD/Sq. . Ft.
• `�
Lot: Block: Subdivision:
Depth to pipe bottom from original grade:
Gravel depth beneath pipe
1/,
QFC& (-RE-11
7, / Ft.
9 Ft.
Township:
Range:
--
Section:
—
Fill added above original grade:
1
Gravel length:
Ft.
13`8 Ft.
WELL: ❑ New EYE ❑ Upgrade
'
Gravel width: _
S'
Number f lines:
Distance between lines:
--,2, Ft.
Classification (Private, A,B,C): Total Depth: To:
Total absorptionarea: ,I,
Pipe material:
t. Ft.
S:6_ (0. 9 Y' SQ. Ft.
S'%M Q, &/n
Driller: a Drilled: Static Water Level:
Installer:
Date installed:
'7-
Ft.
ld,-Al")
Yield:ump Set at:
Casing Height Above Ground:
TANK
GPM Ft.
Fl.
\ SEPARATION DISTANCES
» Septic ❑ Holding ❑ S.T.E.P.
To
Septic
Absorption
Lift
HoldingPublic/Private
Manufacturer:
Capacity In gallons:
From
Tank
Field
Station
Tank
Sewer Linea
G /1 pkL Trq k'
1,2,5-6
Well-/
O /
oo,f
/
of 5,�
Material:
S7 L
Number of Compartments:
Surface
LIFT STATION
Water
/00 4-
/Do/ -
Lot
/
Size in gallons:
Manufacturer:
Line
Foundation
/ / _
(J/
"Pump on" level at: p off" level at:
High water alarm at:
Curtain
.//
Pump Mak odel
I Electrical Inspections performed by:
Drain
BENCH MARK
Remarks:
Location and Description:
T o- Ncwc --7C_ SAB
AT o/Xl
Assumed Elevation:
160
��.�0...r--.. �Rl
S & S ENGINE'E'RING
17034 Eagle River Loop Road, No. 2M�:.
7"aa-97
... ,.•....s.»..
Inspections performed by:Doe, verDates:lst
2nd '2-2,2-97
/ ROBERT C. COWAN2Z,
CE - 8801'�
Department of Health.and Human Services approval
C
Reviewed and approved by: Date:10, IF
72-013 (Rev. 9/91) MOA 25
PERMIT NO. SW970122
PAGE 2 OF 3
Municipalit ofAnchora e
DEPARTMENT OF HEALTH AND HUNI�AN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 *Anchorage, Alaska 99519-6650 • Tele hone: 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WEELL INSPECTION REPORT
LEGAL LOT 1. BERGGREN S
P.I.D. NO. 017-092-34
E. 140 AVE.
n IIMT1
II II
ALT. SITE
II
I II TH DB
DB
II I
5T2
II II ST1
II I�
II
U �U MT2 FCO
NEW TRENCH
NEW 1250 GAL.
SEPTIC TANK
STING 100' WELL RADIUS
LOT 2
GRAVEL
DRIVEWAY
SCALE i" 0 40'
h
ROBERT C. COWAN
CE - 8801
U `I AW
WELL ,
Ow
W
O
w
�
E-4
Z m
E__4
E_4
W
B 100' WELL RADIUS
EXISTING
WELL
SCALE i" 0 40'
h
ROBERT C. COWAN
CE - 8801
U `I AW
WELL ,
PERMIT NO. SW970122
PAGE 3 OF 3
DEPARTMENT OF ANDhHUKAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Tele hone: 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR DELL INSPECTION REPORT
LEGAL LOT 1. BERGGREN S/D
STI ST2
�/ 97.2'
NEW
92.7'-""'
2.7' 1250 GAL
S.T.
MT1 = 96.5' MT
MT1 = 96.7,'\
C01 = 85.9'.
CO2 = 85.7'
MT = 81.1'
MT = 81.1'
FINAL GRADE
92.5'
C01
CO2
C01 = 96.5'
CO2 = 96.7'
THA BOH 75.1'
NO WATER FOUND
P.I.D. NO. 017-092-34
N. T. S.
ROBERT C. COWAN, P.E.
J EnGrn�� IRinG ROBERT A. SHAPER, P.E.
W CIVIL ENGINEERS
ASA (907) 694-2979
Date:
% �� ./ 7 FAX (907) 694-1211
HEALTHAUTHORITY RECEIVED
APPROVALS
J U L 28 1997
Municipality of Anchorage Municipality of Anchors
SEWER &WATER DEPARTMENT OF HEALTH AND HUMAN SERVICES Dept, ici altth & Human Services
MAIN EXTENSIONS 825 L Street
P.O. Box 196650
Anchorage, Alaska 99519-6650
14
SEWER & WATER
INSPECTION
REFERENCE: Lo -r I k (- (- 12 � r) S lb
ENGINEERING STUDIES
AND REPORTS The septic inIppecPions for t e referenced property were
performed on_71A-)-1017 and 7 z%17 Prior to submitting
the On-site Wastewater DisposaI System and/or Well Inspection
Report we are waiting for the�a�No�TrQti�gsg���r S�QvNV be
WELLINSPECTION
&FLOW TEST completed.
If we may be of further service please contact us.
SITE PLANS Sincerely, 1
ROAD DESIGN
Robert C. Cowan, P.E.
SOIL TEST
PERCOLATION
TEST
STRUCTURAL&
MECHANICAL
INSPECTIONS
ONSITE
WASTEWATER
DISPOSALSYSTEM
DESIGN
17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577
ry Io
AV eo)ql
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
PERMIT NUMBER:SW970122
DESIGN ENGINEER:S & S ENGINEERING
OWNER NAME:BENTON HOMES
OWNER ADDRESS:12000 INDUSTRIAL WAY, N-4
ANCHORAGE, AK. 99515
PARCEL ID:01709234
LEGAL DESCRIPTION:
BERGGREN LT 1
LOT SIZE: 40595 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT: 4
THIS PERMIT IS FOR THE CONSTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
PAGE 1 OF 1
DATE ISSUED: 6/05/97
EXPIRATION DATE: 6/05/98
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 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.
Cl:)PrTZT. IDWWTCT(1T\TQ -
RECEIVED B
ISSUED BY:
DATE: (/ p /q 7
DATE: Az _1 >-
'j YP'n
S&S1
�in��RrnG
May 20, 1997
ROBERT C. COWAN, P.E.
ROBERTA. SHAFER, P.E.
CIVIL ENGINEERS
(907) 694-2979
FAX (907) 694-1211
MUNICIPALITY OF ANCHORAGE
HEALTHAUTHORITY
Department of Health and Human Services
P
APPROVALS
P.O. Box 196650
Anchorage, AK. 99519
REFERENCE: Lot 1, Berggren Subdivision
SEWER &WATER
MAIN EXTENSIONS
Request you issue a permit to install a septic system for
the proposed four bedroom house on the referenced property.
SEWER & WATER
INSPECTION
A test hole was excavated and a percolation test performed.
The approximate location of the test hole is located on the
attached site plan.
ENGINEERING STUDIES
The monitoring tube within the test hole has been checked
ANDREPORTS
and found to be dry.
This property has enough area for a future septic upgrade
which can be seen on the attached site plan.
WELL INSPECTION
&FLOWTEST
We do not anticipate any adverse effects on neighboring
wells, septic systems or drainage patterns by the
installation of the proposed septic system.
SITE PLANS
If you require additional information, please contact us.
Sincerely,
ROAD DESIGN
lVobert
C. Cowan, P.E.
RCC/mg
SOIL TEST
Enclosure
PERCOLATION
TEST
MUNC'PALITY ANCHO1GE
ENVIRONMENTAL
SER VICES DIVISION
MAY 271997
STRUCTURAL&
MECHANICAL
INSPECTIONS
RECEIVED
ONSITE
WASTEWATER
DISPOSAL SYSTEM
DESIGN
17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577
1" = 50, SITE:—PLAN DESIGN
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UTILITY EASMENT
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RECORDED EASMENT
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PERFORMED FOR:
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG PERCOLATION TEST
Ro83t:LT Qii, N T Div
LEGAL DESCRIPTION: Lo T 1 13 EAe GG R i /V
DEPTH
�(FEkT} 2�9.r° C
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
h SoLT
4 1 ROBERT C, COWAN
C 8801 ?:�.• ..
DATE PERFORMEc.�•"D:'
Township, Range, Section:
SLOPE
/ 1 S ..)v
V F"1 1 WAS GROUND WATER IV 0
ENCOUNTERED?
GA4vil�L
F={N�
Sq�+p
IR 0.14.
S
IF YES, AT WHAT L
O
DEPTH? p
E
Depth to Water After c - /l p
g 7
Monitoring? i Date: /
.■■■1
.■■■1
.■.■1
.®21011
IM®EN
.IMEN1
1110I. NMI
Reading Date Gross Net
Time Time
Depth to Net
Water Drop
/0=C1
10,
ro 1H r1: �7
Imo' ab'
14
20 i . 6 41
PERCOLATION RATE �_ (minutes/inch) PERC HOLE DIAMETER
13 1y
TEST RUN BETWEEN q FT AND i 0 FT
COMMENTS ttv0 MOH1TOR+N G TVB� I n�%STr9t��i D. VSIN(, MT- a S Ty Tti
/V0/t.7-N l S.Pun k.IV n rr.sr- '00Lf,
PERFORMED BY: S & S ENGINEERING I �1 --=— CERTIFY THAT THIS TEST WAS PERFORMED IN
17034 Eagle River Loo �A $` A q �cl
ACCORDANCE WEJIO ��� k� a�i�OCiL71UMES IN EFFECT ON THIS DATE. DATE: 7
72-008 (Rev. 4/85)
s&S�
,in exinq
ROBERT C. COWAN, P.E.
ROBERTA. SHAFER, P.E.
CIVIL ENGINEERS
(907) 694-2979
FAX (907) 694-1211
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION PRACTICES
and
HEALTHAUTHORITY
APPROVALS
MATERIAL SPECIFICATIONS
REFERENCE: Lot 1, Berggren Subdivision
SEWER & WATER
May 20, 1997
MAIN EXTENSIONS
GENERAL:
SEWER&WATER
1. The scope of this project includes the installation of
INSPECTION
a 1250 gallon septic tank and a leachfield trench to
serve the proposed four bedroom residence located on
the referenced property.
ENGINEERING STUDIES
2. Construction shall be in accordance with the approved
AND REPORTS
site plan and design drawings, Municipal permit with
any special provisions or conditions, and all
applicable State and Municipal Wastewater Disposal
Regulations.
WELL INSPECTION
& FLOW TEST
3. The contractor shall be responsible for obtaining any
necessary underground utility locates.
SITE PLANS
4. Unless specifically agreed otherwise, the property
owner shall be responsible for final grading areas
subsequently depressed from soil settling.
5. Contractors installing wastewater disposal systems
ROAD DESIGN
must be certified by the Municipal Health Department
for system installations. Owners installing their own
systems must also receive prior approval from the
Municipal Health Department.
SOI L TEST
SEPTIC TANK INSTALLATION:
PERCOLATION
TEST
1. A septic tank is to be constructed by a certified
septic tank manufacturer. Construction shall include
two 411 cleanouts for pumping access.
STRUCTURAL&
2 • The septic tank shall be sufficiently bedded to
MECHANICAL
prevent settling or shifting of the tank.
INSPECTIONS
3. All standpipes on the septic tank shall extend a
minimum of 12 inches above final grade.
ONSITE
WASTEWATER
DISPOSAL SYSTEM
DESIGN
17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577
Page Two
Lot 1, Berggren Subdivision
May 20, 1997
4. Septic tanks installed with less than 4 ft. of cover shall
be insulated.
5. A foundation cleanout shall be installed one to four feet
from the building foundation. In the line between the tank
and the leachfield there shall be two adjacent cleanouts
(unless an effluent pumping system exists within the septic
tank). These cleanouts shall be located on undisturbed
soil not more than 10 ft. from the tank. The first
cleanout, in line, shall be to clean toward the leachfield.
The second cleanout shall be to clean toward the septic
tank.
6. Final grading over the septic tank shall be such that a
positive slope exists away from the septic tank.
ABSORPTION TRENCH/DRAINFIELD INSTALLATION:
1. Excavate the proposed trench to the dimensions shown on the
design. The bottom of the excavation shall be within 2
inches of level. If the sidewalls of the excavation become
smeared, they must be raked or scratched (ruffed -up) before
gravel (sewer rock) placement.
2. Once the gravel is installed, the distribution pipe is to
be installed level with the perforations faced downward.
Gravel is then to be placed over the distribution pipe to
provide a minimum of 2 inches of cover over the pipe.
3. A silt barrier must be installed between the final gravel
layer and the native soil backfill. Ensure the silt
barrier covers the entire gravel surface before placing
backfill.
4. Monitor tubes shall be of four (4) inch diameter,
installed approximately in the locations shown on the
design, and extend a minimum of 12 inches above final
grade. The portion of the monitoring tube extending
through the gravel shall be perforated from the bottom of
the trench to the invert of -the distribution pipe. This is
equivalent to the effective depth of the gravel as noted on
the design.
Page Three
Lot 1, Berggren Subdivision
May 20, 1997
5. Backfill over the final gravel layer must not be less than
twenty-four (24) inches. Insulation must be installed when
the backfill depth is less than thirty-six (36) inches.
The finish grade over the trench must be mounded to prevent
the formation of a depression after settling.
MINIMUM MATERIAL SPECIFICATIONS:
1. Any septic tank proposed for installation must be
constructed by a Municipal approved septic tank
manufacturer.
2. The following pipe materials are approved for use in septic
system installations in the Municipality of Anchorage:
Type of Pipe Perforated Solid
Cast Iron Yes Yes
ASTM D3034 (PVC) Yes Yes
ASTM F810 (HDPE) Yes No
ASTM D2662 (ABS) Yes Yes
Use of a type of pipe other than listed above must be
approved by the inspecting engineer.
3. Insulation shall be at least 2" thick extruded direct
burial polystyrene (Dow Chemical Company Styrofoam HI or
equal).
4. Septic tank inlets and outlets shall be fitted with
watertight couplings (Caulder, Fernco, or equal).
5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N,
or equal) must be installed between the final leachfield
gravel, layer and the native soil backfill.
6. All leachfield gravel (sewer rock) shall be 0.5"-2.5"
screened gravel with less than 3% passing the #200 sieve.
7. When sand is being used as a filter material, its gradation
specifications must conform to current M.O.A. or D.E.C.
requirements, which ever requirement applies.
Page Four
Lot 1, Berggren Subdivision
May 20, 1997
INSPECTIONS:
Typically there will be a minimum of three (3) inspections
required during the iu.3tallation of the wastewater disposal
system. These inspections will occur as follows:
1. The first inspection must be conducted after the
excavation of ditches, pits, trenches, or beds and
before the installation of any gravel. A septic tank
may be set in place, but may not be backfilled before
this inspection.
2. The second inspection must be conducted after the
placement of the silt barrier, gravel, distribution
lines, standpipes, cleanouts, and insulation, but
before the placement of any other backfill.
3. The final inspection is to occur upon final grading of
the property.
Often there will be more than these 3 inspections required.
Especially with the installation of multiple trenches, sand
filters, pressurized (,..stribution systems, etc. Thus, the
inspecting engineer is :.o be contacted at least 24 hours prior
to the start of construction. If necessary, a pre -construction
meeting will take place on-site. The inspecting engineer will
not coordinate, direct or control in any way the contractors
activities.
The owner shall contract with the contractor to perform the work
outlined in these specifications and plans and in accordance
with the attached M.O.A. permit. There will be no contractual
arrangement existing between the contractor and S & S
Engineering. S & S Engineering shall be the owner's
representative and will inspect the work as stated above to
document the contractors activities. Final acceptance of the
contractors work rests with the owner and the M.O.A.
Page Five
Lot 1, Berggren Subdivision
May 20, 1997
S & S Engineering shall have no liability to the owner or to
others for acts or omissions of the contractor or any other
persons performing work on this project or the failure of the
contractor to carry out the work in accordance with these
construction documents. S & S Engineering's inspecting engineer
will not be responsible for the construction means, methods,
techniques, sequence, procedures or the safety precautions
incident to this project.
CONTRACTOR/INSTALLER
Municipality of Anchorage
Ilk,
0 Department of Health and Human Services.
Tom Fink, 825 "L" Street
Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650
January 9, 1989
Robert/Margaret Lewis
2470 Lyvona Lane
Anchorage, Alaska 99502
t
Subject: Lot 4tBerggren
Permit #880005,
343-4744
Subdivision
P.I.D. #017-092-34
A permit issued by this Department for an individual well
and/or on-site sewer system has expired as of December 31,
1988.
Permits are issued on a calendar year basis by authority of
Municipal Ordinance. A new permit must be obtained from
this Department for any well and/or on-site sewer system
not installed by the expiration date.
If you have drilled the well, a well log needs to be sent to
this Department for documentation of the installation and to
close the permit.
If a private engineer inspected the installation of the
on-site sewer system,.the orginal as -built inspection report
(three-part form) must be sent to this office for review and
approval, and for documentation.
When applying for a new permit, the fees are: $90.00 for
an on-site sewer permit; $50.00 for a well permit; $140.00
for a combined sewer and well permit.
If there are any further questions, please call this office
at 343-4744.
Sincerely,
Daniel J. Roth
Acting Program Manager
On-site Services Section
DJR/ljw
enc: Copy of Permit
MUNICIPALITY OF ANCHORAGE
Department o{ Health & Human Services
825 L Street, Anchorage, A1aska 99501 343-4720
ON-SITE SEWER & SEPTIC |A�� & WELL PE�MlT
Permit Number: 880005
DaLe Issued: 01/25/88
Uwner Name: RUBEPT & MARGRARET LEWlS Dav Phone:
�wner Address: 2470 LYYONA LANE 276-6543
ANCHOR�GE, AK 995S2
Parce1 ld: �l7-09�-34
Lot Lega1: Subdivision: BERGGREN Lot: 1 Block: N/A
Section: 33 Township: 12N Range: 3W
Lot Size 4059� �sq./t. or acres>
Max �edrooms: This Permit: 4 Total Capacity: 4
** Sravel lenqth / 50 �eeL requi'es multiple soils tests.
** Gravel lengLh > 7� �eet requires multiple runs (not exceeding 75 �L each>.
LIFT STAlION: I[ a 1i{/station is insta]1ed, a high waLer alarm must be
connec�i'�d lo U�e residence.
SEPlIC TANK: Minimum LoLal septic Lank capaci+�: 1,250 gallons. Each septic
Lank musL have atleast 2 compartments. Depth to Lop o� septic tank(s) < 4.0
{eet requires insulatjon over tan�(s).
WELL: Log must be submitted to MunicipaliLy o{ Anchorage Department of Health
and Human Services with�n 30 days o{ well completion.
THIS PERMIT REPLACES PERMIT #87O216.
'77�� �
, '
Perm�t Numbe,: 88o0;5 Page �
Mu�1.�.c�.�3c�.L�t ' ---� P.O. B�... 196650
' \ ANCHORAGE, ALASKA 99519-6650
of (907) 343-4200
Anchorage ) -5WkX X,% Tom Fink
MAYOR
DEPARTMENT OF HEALTH & HUMAN SERVICES
January 8, 1988
Robert J./Margaret Lewis
2470 Lyvona Lane
Anchorage, Alaska 99502
Subject: Lot 1 Berggren Subdivision
Permit #870216, Tax #017-092-34
A permit issued by this'Department for an individual well
and/or on-site sewer system has expired as of December 31,
1987.
Permits are issued on a calendar year basis by authority of
Municipal Ordinance. A new permit must be obtained from this
Department for any well and/or on-site sewer system not
installed by the expiration date.
If you have drilled the well, a well log needs to be sent to
this Department for documentation of the installation and to
close the permit.
If a private engineer inspected the installation of the on-site
sewer system, the original as -built inspection report (three-part
form) must be sent to this office for review and approval, and
for documentation.
Effective January 1, 1988, a new fee schedule is in effect.
When re -applying for a new permit, the new fees are; $90.00 for
an on-site sewer permit; $50.00 for a well permit; $140.00 for
a combined sewer and well permit.
If there are any further questions, please call this office at^
343-4744. ,r00
Sincerely,
t�.........
Robert W. Robinson
Program Manager
On-site Services
RWR/ljw
enc: Copy of Permit
U►�
(OL.
- MUNIC
PALITY OF
ANC /ORAGE
/«�w^~
Department
of Health & Human
Ser�ices
. 825 L Street
, Anchorage, Alaska
9950 1 343-472S
a-�� �7~l
,/
Permit
Number: 87O216
Date
Issued: 08/17/87
`
Owner
Name: ROBERT J. & MARGARET
LEWIS
Day Phone:
Owner
Address: 2470 LYVONA LANE
27�-6543
ANCHORAGE, AK
99502
Parcel Id: 017-092-34
LotLega1: Subdivision:
BERGGREN SUBDIVISION
Lot: 1
Block: -
Section: 35
Township: 12N Range:
3W
Lot Size 40596 (sq.[t.
or acres>
Max
Bedrooms: This Permit:
4 Total Capacity:
4
SEWER
SYSTEMS: Listed below
are the options available
to
you in designing your
sewer
system. Choose the option
that best [its
your siLe.
Depth to Pipe Bottom
({t):
Gravel Depth
({t): 4.0
0.5
2.O
Total Depth
(�t>: 10.0
7.0
8.0
Gravel Width
5.0
Gravel Length
(ft): 104.0 **
50.0
126.0 **
Gravel Volume (cubic
yds>: 43,4
48.2
58.4
Soil Rating Used (sq [t/brm>:
207
213
225
**
Gravel length > 50 {eet
requires mu1tzp1e soils
tests.
**
GraveJ length > 75 feet
requires muliiple runs
(not
exceeding 75 {t each/.
SEPTIC
TANK: Minimum total septic
tank capacity:
1,250 gallons.
Each septic
tank
must have at least 2 compartments.
Depth to
top o�
septic tank(s) < 4.0
feet
requires insu1aLion over
tank(s).
LlFT
STATIQN: I/ a li/t station
is instaIled, a
h1gh water
alarm must be
connected
to the residence.
WELL:
Log must be submitted
to Municipality o/ Anchorage
Department o{ Healih
and
Human Services withi: 30
days of well completion.
R
`MUN1C PALITY OF ANC .ORAGE
DepartmenL o{ Health & Human Servzces
825 L Stre�t, Anchorags, Alaska 9950l 343-4720
ON-SITE SEWER & WELL PERMIT
Permit Number: 870216 Page 2
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8,0006q 64
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SEWER
SYSTEM
LOCATION
PLAN
LOT
BLOCK SUBDIVISION
SECTION/ TOWNSHIP RANGE
T1 zN R3 W Etc 3 5
lo"
SCALES
NOTE,
100 THE ACCURACY OF LOCATION OF EXISTING
PROPERTY CORNERS, WELLS, AND SEPTIC
DRAWN BYE SYSTEMS INDICATED IS NOT EXACT.
tx9a frtsia*ca—
00
NORTH L. O
ar DIMENSIONS INDICATED HAVE BEEN
.......... ........ .......
DETERMINED BY USE OF CLOTH TAPE AND
NOT BY SURVEYING TECHNIQUES.
0 e J. Corwin 4.:j
'
CE -5083
PREPARED FORS
5
So*
DATE, SHEET or
PERFORMED FOR
(EN R'S SEAL) ---
�i �7 t z
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES r'
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST `
y �
l
DATE PERFORMED:
LEGAL DESCRIPTION: �Z.lr ` i f- f " r 1 t/' " . ! /', j I Township, Range, Section: I 1 � Ni
.F
—�I SLOPE SITE PLAN
DEPTH
(FEET)
i� I �L
r
3-
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
IZaJ c3 -E alGsr,b�
' r - JQ0," : (WAS GROUND WATER
I ENCOUNTERED? )�1I
S
L
r I IF YES, AT WHAT O _ __. - ..._
DEPTH? P
E
Depth to Water Atter
Monitoring? _ Date:
MUNICIPALITY OF ANCHOR,4
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTIO
AUG 131987
Reading Date Gross
Time
Net
Time
Depth to
Water
Net
Drop
N
<J
7
3 q3
I
MUNICIPALITY OF ANCHOR,4
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTIO
AUG 131987
Reading Date Gross
Time
Net
Time
Depth to
Water
Net
Drop
<J
7
3 q3
20 RECEIVED PERCOLATION RATE (90 (minutes/inch) PERC HOLE DIAMETER 11
1
TEST RUN BETWEEN �J �/� — FT AND '0" FT f
COMMENTS <%O f l 3 U 5 U G_ (� 00, p:li?'t %
'�1�� , J �lt)��'�� %it �"af� i y'p � Q ��. CC./ li� n"-r„� �D /�.5 , �/•�. �r�' ��r':•�'
L/f Q 1� 1 , CERTIFY THAT THIS TE T WAS PERFORMED IN
PERFORMED BY: ld �?
ACCORDANCE WITH ALL STATE AND MAL GUIDELINE EFFE T N THIS DATE. DATE: /c v
i
72-008 (Rev. 4/85)
AW—
sca/e
alit,s
Richard cam. s
fee *�O
W �
'so
0
o3
`yle
l�/C/f�TT .STREET ,
`p 010
6
— 70,4/f7. Esn>•t -
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w M�IAwN<i ^ PM APOfew. f/74.7�-*
*15
Te W.4 Aebrr
w/ / %: "M. Cep
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19
6�2,
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no
I HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING
DESCRIBED PROPERTY' 1-0T
1, eii "dW MAP,
AND
THAT THE PROPOSED
IMPROVEMENTS AND DRAINAGE PATTERNS ARE AS SHOWN
HEREON.
P/!t/11I►�p fI/1� Mr Afm a*# tawio
.
t
ICuff-f
�c
ti/a
1
TER
LAND
suRvErog
K. 49
SHT. 01,CA
87 -/
JOB NO.
I
4n4a
I
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L 04010
QRAiA41161 AAAdW
CYCYA r1V*5 AA*00 ON AJJAlM9P Al NK
IT IS THE RESPONSIBILITY OF THE OWNER OR BUILDER,
PRIOR TO CONSTRUCTION, TO VERIFY PROPOSED BUILDIN
GRADE RELATIVE TO FINISH GRADE AND UTILITIES
CONNECTIONS, AND TO DETERMINE THE EXISTENCE
OF ANY EASEMENTS, COVENANTS, OR RESTRICTIONS
WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION
PLAT.
PLOT PLAN
LOT /
MIY46 qEN 51164t
(P 77 -Z35)
m 19 " x L�z x t� " L_ Xn� k__l r- " " I— " 11 m " 9_3�
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 '| STREET, ANCHORAGE, HK. 9� 1
279-2511
�F- l -r FEE !F. l—= L-4 FEE F.." F="F—= F.."I -1 3:-r
PERMIT NO. ( 77655 )
APPLICANT JOHN BERGGREN 5941 ARCTIC BLVD. 278-1223
LOCATION PICK TT ST.
LEGAL LOT#� BERGGREN �UBD� LOT SIZE 49500 SQUARE FEET
�^
TYPE OF SOIL HBSORBTION SYSTEM IS: TRENCH
MAXIMUM NUMBER OF BEDROOMS = 4 SOIL RATING (SQ FT/BR)= 165
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
:�L;R lL_E—="f_3-F"= __t -=-, C-3 F;?- " v F= I F=* _r��= �
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIEL[>
THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE EXCAVATION (IN FEET).
Q U I f;? I=— U -N F= F= -F- I CZ.- -ir Fl N K �1 2- E:= �;2�10 �" L_ L_ C-1 1"4'H.
H PACKAGE PLANT MAY BE INSTALLED AT THE PERMITTEE'5 OPTION SUBJECT TO THE
FOLLOWING CONDITIONS:
1. EITHER H CLASS I OR II NSF APPROVED PLANT MAY BE INSTALLED.
2. H CONTINUOUS MAINTENANCE AGREEMENT IS REQUIRED. IF H MAINTENANCE
AGREEMENT IS NOT KEPT CURRENT YOU MAY BE REQUIRED TO ENLARGE THE SOIL
ABSORPTION SYSTEM AND/OR YOU MAY BE SUBJECT TO PROSECUTION.
________________________________________
F=* I=— f--.- -T I ID ":E; F -I FR E" FR C_! U I F E� C -N
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN H WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR H PRIVATE WELL OR 200 FEET FOR H PUBLIC WELL
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
���M 17" �X F=" I FR. E= -!E- Lu E=- EF 11-10 FEE FR. =<:IL , ���"F
I CERTIFY THAT
1: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
]: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS.
SIGNED: - ----- --
APPILTCANT., JOHN BERGGREN
��y^'~ 7 -�
ISSUED B\/ -y / ^���_ �-� _DHTE__<S___�___+��� Y]�0
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