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HomeMy WebLinkAboutSUNDI LAKE BLK 1 LT 9und i Lake Block 1 Lot 9 #011-131-09 Municipality of Anchorage t�,, Development Services Department Building Safety Dmsion On-Sde Water and Wastewater Program. 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page of www ci anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: S 1110 t0O 329 PID Number: oil - 131- 01 -lin qnlenon Wastewat er System: C] New Upgrade $it9 Svc Dr,Fe ABSORPTION FIELD ; pilar Mew« a eaoppma ^ i R/ Tn1W1 a S�Tn 0la o was � herr 995a�R� LEGAL DESCRIPTION t. rZ of D e Tda DWwean p^P•a V+w ermI Ea salowaal SLZA Lake Dapw n P"eamm Ran aw«a Via 2• b Fl. GlaM rpm e«rapl Ppa FI Tpwranp Ranpa Sampo Fe Wee lRPw alpn«Vae^ o- 1 Grwa Le -M 30 F1. F1. Well: �� ❑ New ❑ Upgrade C.e wae, '3+ F'. Mme«"Wa 1 Omann eanwrn arw FI CIIW tPmaa .CI Taal DOM Caaaer Tam amaWpn ana S 40 Pr"a"m" p vcr SCt,. 40 FL Fl Fe r Dwrr DIM Ga1ee SWC WI1ar LaM Mnlarr Dor$ Daa Warr" I gJ2,16- 8 ) 0'} FT .rr P nasal" Cwr rgaAap»Goar TANK GPM FL FI SEPARATION DISTANCES ❑ septic []Holding O$ S.T.E.P. ❑ Omer: To SepbC Absorption Lift Holding IuNcPnvate a°""r' CAW r G'r ISoo Flom Tank Field Station Tank Sewer tine IQ jAy1 Mil IDD ' 1001 Jy 2.51 yarn" Mme« a Garpan tb 2 l00' -t } 1;1.r. , sarw Wa« �00 t ICU i lnOit� _ .• 141 '' %I!'J:7 .., LIFT STATION lq Err gyp'+ 10'+ ID`} _ as I SOD ca a%j nctiarw e- TQA k �t 'Pump ai Wal" 'Pump pIr rrl a Man wa« rano « zl9 r FaIlOaean 5 101+ - N5 a UD r Pump M.r a Mopal Ermemi 1npeOena Pprnnae b/ Ca nDram �- ^•��i 71� Ortnen Aun 1 R"e«" 1 1 BENCH MARK i ri Epuum avCRw1 G. Sia � Aaarrre rvaeal 100) FE k -A AZ, 11, Inspections performed by: arl; J ur Dates: 1" z"° Bio �A,c' Development Services Department Approval �E27 : 49TH .. E - Conditional Approval Date: A / • LABS E. SFUS NO 11, 401. = ` Reviewed and approved by: +� Date:NO \\"` IR« ONwr / \ Well Well t ell LET 10 I _ Lax X INSTALLED 0££P TRENCH WITH: l / i 1500 DEEP BURML S.T.E.P. TANK',,.\ TRENCH LENGTH 50 FEET MACH WIDTH 2 FEET TRENCH DEPTH 12 FEET ROCK DEPTH 9 FEET LEVEL INSULATION 2 IN ` \ © COVER J FfET 4 ABANDONED EKISANC SEPAC Q - -1EM PER MOA COO£ LET 9 V Err - 13x ...... \ Pea ¢ Well SW/NC AES N A8 l.5' 1<.5 � D 9' 28' F 54' 71; vv� vv LET '8, .•� •....... P ............ \ w f 49th .Ct �... i.. LOT SB \ :.. . w �:tv � ... .. LARS�SPURKLAND p,% No. Ce-usoo� 25 0 25 50 75 107 125 150T. �i� •. Dar •P�..�•� SCALE, 1' = 50 F♦��h��.:��� SPURKLAND ENGINEERING LOT 9 BLOCK 1 SUNDI LAKE I I SEPTIC SYSTEM ASBUILT 203 W 15TH. AVENUE DATE. SEPT. /a 2007 ANCH. AK. 99501 JIM ANDERSON SHEET.• 213 GRID 2224 (907) 279-3916 11 8219 SUNDI DRIVE PERMIT # SVO60329 PID N 011-131-09 SundlakeBIL91.DW6 PRIMARY TRENCH N. Ts Standard Trench., 2' Wide 30' Long 1500 GAL STEP TANK 12' Deep 9' Sewer Rock 3' Cover (INsuLATE) NO SCALE ELEV.= 97.5' Silt Barrier— ELEV.= 88.5' 9 ft of Septic Rock Effective Monitor 3' Cover (2 -INCH INSULATION INSTALLED) ELEV.= +/- 100.5' NO SCALE 6' DEEP BURIAL 1500 GAL STEP TANK INSTALLED 2' STYROFOAM BLOCK INSTALLED ABOVE TANK BOTTOM TH ELEV.= 81.1' BENCH MARK GARAGE SLAB ASSUMED ELEVATION 100 FEET I SPURKLAND ENGINEERING I I SUNDI LAKE BLOCK 1 LOT 9 I I SEPTIC SYSTEM AS -BUILT I 203 W15th AveDATE- SEPTEMBER 10, 2007 Anchors a Ak 99501 8219 SUNDI DRIVE 9 AM ANDERSON SHEET, 3/3 GRID, 2221 PERMIT,/ SW06OJ29 PARCEL ID{ 011-131-09 5undiLaketllLYJXwg Municipality of Anchorage Development Services Department /i Building Safety Division Onsite Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: Lars Sourkland Legal description: Sundi Lake Block 1 Lot 9 ❑Permit QC.O.S.A. ®Inspection Report The attached paperwork has been reviewed and is being returned for the following reasons: 1. Driveway over trench. No driveway was shown on permit or Inspection report in trench area. Name of reviewer. teff Date: February 15, 2008 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK k: gpa Mand Enuoulc aToung � on Environmental Consulting and Design �� J SEPTIC SYSTEM DESIGN SUNDI LAKE BLOCK I LOT 9 Municipality of Anchorage September 5, 2008 Development Services Department On Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, Alaska 99519 Subject: As -built Inspection Report "Pink Sheet" February 15, 2008 Ladies and Gentlemen: The driveway over the drain field has been abandoned. The area has been top soiled, seeded and is covered with a thick layer of grass. If you have any questions or concerns, please contact me at 279-3916. Sincerely, l 2, A4 Lars Spurk , P.E. Civil Engineer 203 Nest 15r" Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, LspurUand`^agci.net July 9, 2007 Municipality of Anchorage Development Services Department On-site Water and Wasterwater Program 4700 So. Bragaw Street POB 196650 Anchorage, Alaska 99519-6650 907) 343-7904 Sir, I'm referring to permit number SW060329 issued October 5, 2006. Address is 8219 Sundi Drive, Anchorage, Alaska 99502, (907) 243-4754, Spurkland Engineering did the design and will oversee the installation of the new tank and disposal field. I'm the owner and will be responsible for the actual installation, my experience in the construction industry both on the slope and in the lower 48 will allow for a professional installation, along with the oversight by Lars Spurkland I feel this job will be completed in a timely and competent manner. /? 11-17 P19 Sundi Drive Anchorage, Alaska 99502 (07) 243-4754 MUNICIPALITY OF ANCHORAGE Development Services Department ''ll On -Site Water& Wastewater Program 'l 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT�\\„ 1161 Upgrade 'J" Date Issued: Oct 05, 2006 Expiration Date: Oct 05, 2007 Permit Number: SWO60329 Parcel ID: 011-131-09 Legal Description: SUNDI LAKE BLK 1 LT 9 Design Engineer: 0007 SPURKLAND ENGINEERING Site Address: 008219 SUNDI DR Owner Name: JIM ANDERSON Lot Size: 30900 SO. FT. Owner Address: 8219 SUNDI DRIVE Total Bedrooms: 4 Permit Bedrooms: 4 ANCHORAGE, AK 99502 - This permit is for the construction of: ❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specked 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 DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: 10 C a Co Date: Municipality of Anchorage Development Services Department Building Safety Division Onsite Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 www.muni.org/onsite (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 01/- Is I -Oq Property phone 24i-V15q Mailing address Zip Code Siteaddress SZII S�anA; Prije Zip Code gi9So7- Legal description (Sub'd., Block & Lot) Sundi Llko Slk I Lok q Legal description (township, Range & Section) Lot Size -SQ U Sq. Ft. THIS APPLICATION IS FOR (® all that apply): Absorption Field ❑ Septic Tank �( Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Number of Bedrooms y THIS APPLICATION IS AN: Initial ❑ Upgrade �( Renewal ❑ certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and Is in accordance with applicable Municipal Codes. (Signature of droperty owner or authorized agent) Permit/Rush Fees: Date of Payment�7 zZ Receipt Number. le2 0� (Rev. 11105) Waiver Fees: Date of Payment Receipt Number. uMmd \t UUU CCCJJJ rJ _ Environmental Consulting and Design SEPTIC SYSTEM DESIGN SUNDI LAKE BLOCK 1 LOT 9 Municipality of Anchorage September 18, 2006 Development Services Department On Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, Alaska 99519 We are submitting an application for the upgrade of the septic system serving this lot. The submittal consists ofthreet3) drawings showing the present improvements on the lot and the adjoining properties, (sheet 1/3), the proposed improvements of the lot, of which only the septic system is subject to this permit application, (sheet 2/3), and a schematic of the septic system, (sheet 3/3). Soil logs and percolation tests of applicable test holes are also enclosed. The septic system design is based on the following: No Ground Water to a Depth of 18 feet. Soil Rating. From Testhole 09/13/06. <I mintin = 12 gal per sq.tl/day No. of Bedrooms 4 Required Area per Bedroom: 150/ 12 =125 sq.fl. Total area required: 125 x 4 -500 sgft Bottom Rock At 12 feet Top Rock At 3 feet Rock Depth 9 feet Total Bed Length 500 /18 - 27.8 feet USE 30 FEET SYSTEM CONFIGURATION 1500 DEEP BURIAL S.T.E.P. TANK TOTAL LENGTH 30 FT TOTAL WIDTH 2 FT TOTAL DEPTH 12 FT ROCK DEPTH 9 FT INSULATION 2IN. COVER 3 FT (MIN) The installation of this septic system will not prevent wells and septic systems from being installed on the adjacent lots. There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots. The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. 203 West 1516 Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (907) 276-6013, SpurklandEng@gci.net /-j LDF17B / 1 LOT 7A LOT 10 , LOT 6A _ LOT 9 ____ LOT 8 _ - - LOT SB-, 50 0 50 laa 150 av cw 700'�•�� ^N" p\..�• SCALE+ 1' = 100 FT i ���i�� SPURKLAND ENGINEERING LOT 9 BLOCK 1 SUNDI LAKE SEPTIC SYSTEM DESIGN 203 W 15771. AVENUE JIM ANDERSON DATE.• SEPT. 18, 2006 ANCH. AK. 99501 8219 SUNG/ DRIVE SHEET. 1/3 GRID: 2224 907 279-3916 PERMIT #SV020XXX PID # 016 -141 -XX SundlakeBIL91.DVG Well I Well i LOT 10 E� Area WTALL DEEP TRENCH/ 071N: / "'! L '•. / 1500 DEEP BURP[ ST.C.P. TANK / I / TRENCH LENGTH 50 FEET TRENCH 0707H 2 EEFT SLOT _ L TRCRCH DEPTH 12 TEST \ ROCK DEPTH 9 FEET LE PWAATRNH 2 IN \ TH COVER J W J MOWN E1750NG MIX LOT 9 � v SIEM PLR MOA CWE SL -13Z \ �AreoIc i ¢ Well J LOT �8� Ai'..e- LOT SB 25 0 25 50 75 100 125 150 SCALE+ I' = 50 FT. 49th LABS tPUPoCUw No. CE -11500 ITOBBEN SPURKIAND P.E.I I LOT 9 BLOCK 1 SUNDI LAKE I I SEPTIC SYSTEM' DESIGN I 203 W 15TH. AVENUE DATE- SEPT. 18, 2006 ANCH. AK. 99501 JIM ANDERSON Inn?1 "7n_:o.r 8219 SUND/ DRIVE SHUT. 2/3 GRID: 2224 PERMIT # PID q NUnCflLOKeLULYUfWU w 0 c a a Q Q 45 PRIMARY TRENCH a N T'S 3 0 o a a Standard Trench: 2' Vide 30' Long 1500 GAL STEP TANK 12' Deep 9' Sewer Rock 3' Cover (INsuu>t) NO SCALE Mont for 3' Cover (INSULATE) Silt Barrier 9 ft of Septic Rock 1500 GAL STEP TANK Effective NO SCALE ♦�1 �.:.....49th�� • �� LASPURKLAND ♦ c .�. 0. CE -11500 444 SPURKLAND ENGINEERING SUNDI LAKE BLOCK 1 LOT 9 SEPTIC SYSTEM DESIGN 203 W15th Ave 8219 SUNDI DRIVE DATE, SEPT. 18, 2006 Anchorage Ak 99501 XM ANDERSON SHEET, 313 GRID- 2224 279-3416 PERMIT / SW060OXX PARCEL ID / XX Sund2okeB10J.dwg Municipality of Anchorage Development Services Department Building Safety Division yr OnSdeWater and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Ancrwrage, AK 995195650 www.ci enchoraoe.ak us (907) 343-7904 Soils Log - Percolation Test Performed For. Jim /iAdtrt5on Legal Description: Sw r J i lake Di k 1 1 1 1 1 Depth H Township. Range. Section: WAS GROUND WATER ENCOUNTERED? �O 8 IF YES. AT WHAT DEPTH? Depth EOWater After D P Monitoring? E Daft: O6 i � I i r?9THY i r • • • . kkt�.fCll!�dl . , L.ARS If. SPURKLME)1 00 :W 4 Reading Date Gross Time I Net Time I Depth to Water I Net Drop PERCOLATION RATE G l "ft"~) PERC HOLE DIAMETER TEST RUN BETWEEN S FT AND. `},5 ^ PERFORMED BY: 1 ar'S _row r Wg„ a I L�AjO —�) IIAI-r CERTIFY THAT THIS TET YVAS PERFORMED IN ACCORDANCE WITA ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: f 0(0 ]� MUNICIPALITY OF ANCHORAGE `. ! (/ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME t o_ PHONE NEW % 1/ti r✓/lX� aq3v3 ❑UPGRADE MAILING ADDRESW LEGAL DESCRIPTION LOCATION - S�� C NO. OF BEDROOMS �- V Well Absorption area r DISTANCE TO: O L {- I Dwelling PERMIT NO. Y FZ m Q F Manufacturer Mater'i�l-� O No. of compartrygnts N Liq. capacity in�allons r� /U IF HOMEMADE: Inside th 6ti /� Width ,._.... Liquid q d depth <7 �-' J t7Z DISTANCE TO: Well Dwelling - PERMIT NO. S F Manufacturer Material Liquid capacity in gallons w= DISTANCE TO: Well �� -j' Foundation O {- Nearest lot line PERMIT NO. -7 •� d� Z Z No. of lines - " Length of each line Total length of lines c3c) Trench width Distance betty a lines rT aches Q 0 Top of rile to finish grade -�— Material beneath the Total effectiv absorptio aear.. (fjinches w dth Depth PERMIT NO. Qa H W ° b diameter Crib depth Total effective absorption area rn a ll Building foundation Nearest lot line W Clth Driller Distance to lot line r / PERMIT NO. `7 l'o a �3 lding foundations _�. Sewer line -r_ /d Se tic tank p Absorption area(s) f- t5O 140 OTHER PIPE MATERIALS ..�I L CIA !s i gL SOI L TEST RATING ¢ d OGl INSTALLER D -Z)i e. 3 , e REMARKS YCLv f b is t P APPROVED 7 a DATE LEGAL n_mz rao„ znu� � ^ ��. -������ �-� �� , ' DEPHRTME@T [��HERLTH 8ND ~ ENVIRONMENTHL �/TECTION u« ' 825 /L' STREETHNCHQRHGE/ HK99501 2111��l —4720 ���-- �� P�RMIT MO APPLICANT 9500 LENNOX DR 99502 2�I 61]8 LOCRTION SUNDI LEGHL L9 B1 SUNPI LK SUB !OT �IZ� 3I280 S�URRE FE�T TYPE SYSTEF! TR. END ; � � MAXIMUM NUM8ER OF BEDROOMS � 4 SUIL RHTING T�|E R�QUIRED SIZE OF THE SOlL HBSORPTION SYSTEM IS� ���- rj����=E:, T�E LENGTr I MIENS.'[ ON S THE LFNGTH(IN FEET) OF THIE TRENCH O� DRHINFIELD TF DEPTH OF H T�FNCH OR PIT IS THE DISTHNCE BETNEB� THE SUR -11C-- if GROUND AND THE �OTTOM OF THE EXCHYHTION (IN FEET) THERE IS Nn SET WIDTH FOF TRENCHES. THE GRHYEL DEPTH IS THE MlNIMUM DEPTH OF GRHVEL BET!IEEN THE OUTFHLL PIPE RND THE BOTTOM OF THE EXCHVHTION (IN FEET) ����F ITZ. ;7--- If-- Is—���g��� PERMIT RPPLICHNT HHS THE RESPDMI8IL SITY TO INFORM THIS DFPRRT��FNT D�RI�G THE INSTHLLRTlON INSPECTIUNS OF R@Y WELLS HDJRCENT TO T�IS PROPERTY RND T�E � HyM8ER OF RESIDENCES THHT THE SERVE, �U, 4 A L=.������� 8HCKFILLING OF HNY S9STEM WITHOQT INSPECTION HND RPPROV9L BY THIS DEPHRTMENT WILL BE SUBJECT TO PROSECUTION. � �INIMUM DISTRNCE BETWEEN H WELL HMD HNY ON-SITE SEWHGE DISPOSRL SYSTEM IS � 100 FEET FOR R PRIVHTE WELL/ OR � 150 TO 200 FEET F11 -1.0M H PUBLIC WELL DEPENDING UPOM THE TYPE �F PUBLIC WELL WELL LOGS ARE REQUIRED AND MUST BE RET;RNED T0 THE DEPARTMENT WITHIN ]0 DHYS OF THE WELL CnMPLETIGN OTHER REQUIREMENTS MAY APPLY. SPECIFICHTION, HND C0NSTRUCTION DI8GRHMS HRE HVRILHBLE TO INSURE PROPER INSTHLLHTIOW. I CERTIFY THHT 1� I HM FHMILIHR WITH THE REQUIREMENTS FOR ON-SITE -F-HMS,GND NELLS HS SET FORTH BY THE MUNICIPRLITY OF HNrCHORRGE. � 2� I WILL INSTHLL THE SYSTE� IN HCCORDH�CE I'll. 1, THE CODES I� I UNDERSTHND THHT THE DN -SITE SEWER SYSTEM MRY REQUIRE E�LHRGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THHN 4 BEDROOMS ^ " /�. ' X' / / i°^` ^ ° V HPP�ICHNT Y����NE TIPTON vV~-� ISSUED �YZz � ' / OFFICE: A77-1433 �L i RESIDENCE: 277.7762 J, :CIVIL ENGINEERING AND LAND SURVEYING 3107 W. 29TH AVENUE • ANCHORAGE, ALASKA 99503 NAY 3, X978 Ms. Yvonne Tipton 9500 Lennox Dr. City 99502 Dear No. Tipton': On April 29, 1978 this firm conducted a soils investigation on your lot in the Sundi Lake area. ,The legal description is Lot 9, Block 1, Sundi, Lake Sub. One test.pit.was dug to,a depth of 17 feet -using a backhoe. This was . done by Newton Excavating. The sub -surface conditions are as follows$ Death Material S.F. per Bedroom . of 1 Topsoil & Organic material 350 1� 8' Silty, Gravelly Sand 250. 81 .. 101 Gravelly, Sandy Silt ' P50 10'- 11, Sandy, Clayey Silt 350 111- 14' Clean Fine Sand 125 14t- 17, Coarse Sandy Gravel w/trace of Silt 85 The it was'.left open for P about P 1 hour an d no trace ofound Ovate � r was observed. Because of the quality of the gravel at -the bottom of the pit .no percolation test was performed. The results of this soil test indicate that a see system PaB'e Y m could be / designed usingfigure of 8 a � 5 a .f. per bedroom. H owever to be conservative T wou1 d recommend that a figure of 125 s.f. per bedroom be used. This figure is for design only and subsequent inspection by Municipality personnel at the time of construetion.lnay cause this figure to change. The depth of this drain field shall be"st least -14 feet so as to gat into the most desirable material.. A]1 construction .o£ drain f'ield.'.and septic tank..installation shall _cn ply wHit�y.;Mici}s bepartment of Health and E nvironm�ntax �gtgto Y J °°°° t, 4Ds� xf we mnv be Of flirth'er aesiOtan in thi V V s , " h .pro iect, pleaa��C a 5 /s 11 �4.t.V,.dw.,.,; / �� sbe,,.t, �a.d/c. , .fnOpre)V, Ij � . •• .., E� 7r �. i t�",,�(�n� Fred Walark, 1� f'' �' 2; C1 4 f��./J'' f} OjN . NO.1267-1: M -W DRILLING, INC. DRILLING LOG Well Owner Ivone` Tipton Use of Well Dom. Location , (address of: Township, Range, Section, if known; or distance main road Lot 9 Block 1 Sundi Lake Subdivision Size of casing 6� Depth of Hole 250 feet Cased to 250 feet Static water level ft. (RR�e) (below) land surface. Finish of well (check one) open end ( ) Screen (', );, Perforated (. ) Describe screen or perfora io N A Well pumping test at_allohs er (hour) (minute) for hours with ft. of drawdown from static level. to Date of completion 7Z27/78 WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness ____0__T0 243 Existing well 243 To -2-44. 6 Boulder 244.6To 245.5 Clay & gravel: silty sandy 245.�fO 250 Si lt .water gravel TO To TO TO TO TO r TO - TO - TO " TO - -1-CUSTOMER MAE a ' % For...._ .................................. .............................. ......... ........................ . Location -7 Datecompleted.................................................4....................... ............................. �7 2 MUNICIPAL," Depth of we11..........EPC-':F"AN NORAOG ........ J Size of casing.. ... ........ _ ............. ... ..AP.R1 Distance. to water .......... .................. .............. ....................................... E.��.� Distance to water while pumping...:....................................................at rate of................................................gallons per hour. 0 DELTA DRILLING COMPANY '�- SRA 80% 394 8 ANCHORAGE. ALASKA 99507 .................... I............................... Driller Formation .from I o 7 � I v � - I 0 DELTA DRILLING COMPANY '�- SRA 80% 394 8 ANCHORAGE. ALASKA 99507 .................... I............................... Driller )� MUNIC NCHORAUL C MUNICIPALITY OF ANCHORAGE DEPT ' I I T`;11 DEPARTMENT OF HEALTH &ENVIRONMENTAL PROTF�j iR,PINit'ENTN I'"):'CTI0N' 825 L Street - Anchorage, Alaska 99501 APR 1 ENVIRONMENTAL ENGINEERING DIVISION een,-f4 t;1 -4i1 NUMBER OF BEDROOMS Telephone 264-4720 - E EE t V� EE D; E- One ❑ FourE:1 Other REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEAFR�ACfL1 �_ Two ❑ Five DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. - 'F?!U Three ❑ Six 1. PROPERTY OWNER�, Zee PHONE ko h /r *ATTACH WELL LOG. Awell log is required for all wells drilled r ❑ COMMUNITY MAILING ADDRESS S --C 9 Su h ' ❑ PUBLIC UTILITY PROPERTY RESIDENT (if different from above) PHONE 8. SEWAGE DISPOSAL SYSTEM **If individual/on-site, give installation date 9: �q INDIVIDUAL/ON-SITE** 2. BUYER PHONE by this Department. MAI LING ADDRESS 3. LENDING INSTITUTION PHONE C MAI LING ADDRESS Jy 'eap 4. REALTOR/AGENT PHONE MAILING ADDRESS 5. LEGAL DESCRIPTION C STREET LOCATION 6. TYPE OF RESIDENCE AW een,-f4 t;1 -4i1 NUMBER OF BEDROOMS E- One ❑ FourE:1 Other SINGLE FAMILY �_ Two ❑ Five ❑ MULTIPLEFAMILY- 'F?!U Three ❑ Six 7. WATER SUPPLY pSl INDIVIDUAL* *ATTACH WELL LOG. Awell log is required for all wells drilled r ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well IMS ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM **If individual/on-site, give installation date 9: �q INDIVIDUAL/ON-SITE** If system is over two (2) years old an adequacy test is required ❑ PUBLIC UTILITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) �aa THIS SIDE FOR OFFICIAL USE ONLY ,. s INSPECTION APPOINTMENTS DATE RECEIVED -� TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 7. 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 PERMITNUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED Piles 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON-SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATEINSTALLED INSTALLER ❑SepticlT�anc.J17k or ❑ Holding Tank size:_��If Tank is homemade give dimensions: SOILS RATING / dG TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL _ 4, DISTANCES WELL TO: Septic/Holding Tank - Absorption Arca Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS �^ APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must ac any certificate) ❑ DISAPPROVED DATE II /y� BY (Tiflels LEGAL DESCRIPTION 72-010 (Rev. 3/78) 8/. s Sed 2"X2" Hub s Sel %Z' Re6uv ii I ge- sed 4=/e-78d%� i � ftud Walatka d NO. 3255-5 a P��fCSSIOYAI �� av SGAurC I"• qor F8 '77-3 ? 44 nrA rim 90.0 All Sld EX 88.e C—o�i-n-e-S �T nig Ems, 3 3,'Z80 s. 4-- Z Co 3 ZG3 i1 60 tv N 2 Iq �� o v/ Na;pkbo.-s wet/ I PROPOSED DWELLING LOCATION NOTE': It is the contractor's responsibility to check Top -of Foundation in relationship to Finiib (;rade. "Pop of Fiuwlafion as indicated is one course of block abovo Finish Grade. . I hereby certify that L have surveyed the following describcd FAKE. Anchorage Recording Precinct, Alaska and that the improvements situated thereon are within the nroperty lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements s a n prop- erty lying adjacent thereto encroach on 'h ctnses in question and that there are no roadway � e .,nission lines or other visible easements on said pro!! r except as indicated hereon. Dated at Anchorage, Alaska this—e li.Tl.! day of -1 U.J , 1977 FRED WALATKA & ASSOCIATES Engineers and Surveyors 1 / m/ eee. a N m IV 8/. s Sed 2"X2" Hub s Sel %Z' Re6uv ii I ge- sed 4=/e-78d%� i � ftud Walatka d NO. 3255-5 a P��fCSSIOYAI �� av SGAurC I"• qor F8 '77-3 ? 44 nrA rim 90.0 All Sld EX 88.e C—o�i-n-e-S �T nig Ems, 3 3,'Z80 s. 4-- Z Co 3 ZG3 i1 60 tv N 2 Iq �� o v/ Na;pkbo.-s wet/ I PROPOSED DWELLING LOCATION NOTE': It is the contractor's responsibility to check Top -of Foundation in relationship to Finiib (;rade. "Pop of Fiuwlafion as indicated is one course of block abovo Finish Grade. . I hereby certify that L have surveyed the following describcd FAKE. Anchorage Recording Precinct, Alaska and that the improvements situated thereon are within the nroperty lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements s a n prop- erty lying adjacent thereto encroach on 'h ctnses in question and that there are no roadway � e .,nission lines or other visible easements on said pro!! r except as indicated hereon. Dated at Anchorage, Alaska this—e li.Tl.! day of -1 U.J , 1977 FRED WALATKA & ASSOCIATES Engineers and Surveyors