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Home My WebLink AboutSKYLINE VIEW BLK 2 LT 9AOnsite File Skyline View Block 2 Lot 9A #051-192-57 ASBUILT I Abba UTA: LAND SURVEYING 694-0829 7 E : . I HEREBY CERTIFY THAT I HAVE SURVEYEDD THE SCCAI FOLLOWING DESCRIBED PROPERTY: DATE. ....... AND THAT NO FNCR646rMENTS EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THET H OWNER TO DETERMINE THE EXISTENCE OF ANY GRID: EASEMENTSr COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT, UNDER NO CIRCUMSTANCES SHM Duane Merk Sawa -d _D FB* Ls — P, g§ MY DATA HEREON BE USED FOR CONs'rRUCTION OF FENCE LINES, OR FOR ESTABLISHING BOUND- ARY LINES. DRAWN- MUNICIPALITY OF ANCHORAGE / DEPARTMENT OF HEALTH & ENVIRONMENTAL PFIOTECTION (i ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL. INSPECTION REPORT [] UPGRADE -- MAI LING ADDRESS ,,/~ fl ~ . LOCATION NO. OF DISTANCE TO: ~We,I tOO Absorption are~._ -- ~elli"~ ~9 ~--' PERMIT_~.O. ~ ~~ No. of co~ments ~-~' D Manufacturer ~ Liq. ca?c~ons IF HOMEMADE: Inside ,~ Wid~ ~__ Liquid.de~h ~ ~ DISTANCE TO: Well ~ Dwelling .... PERMIT N~. ~ Manufacturer -, Material __ Liquid capacity in gallons ~~-- ,o. of lineb n ~ Length of eac~ Total length o,~ Trench widtl_~nches Distance~,es "~ ~ Top of tile to finish grade Material beneath tile Total ef~[ive ~7~ area ino. Length Width Depth PERMIT NO. ~N Type°fc~CribdiameterD._ ~ Cribdepth ~ Well Buildin f .~~ Nearest lot line ~ DISTANCE TO: . . CI~ Depth ~ Driller ~ Distance to lot line PERMIT ~O.~ ~ 0~ Septic tank~ Absorption area~ / ~ 0 " DISTANCE TO: Buildingfou,~tio~O Sewer line~ ~O~ ~ 0 0 OTHER PIPE MATERIALS SOIL TEST RAT~G/ INSTALLER ~ REMARKS f ..~. _ 72-013 v. 3/78) f'll::'l;:'L )] (~.:1:;:t1",I"1 I !])I::I:IT ]] IJ'i, :lit: I, %even A. dohnson P.O. Box 76 Chugiak, AK 99567 Phone: 907-688-3085 SOILS LOG 1'3 PERCOLATION TEST SOILS LOG - PERCOLATION TEST PERFORMED FOR: ' ~")~,. ~Y J J~ -/ ~ i~' ,~' 1 2 3 5 6 7 8 9 10 11 12 13- 14- 15- 16 17 18 19 2O COMMENTS PERFORMED BY: 72.008 SLO SE I ENCOUNTERED? IF YES, AT WHAT DEPTH? SITE PLAN /,4 o ge. f4 L E o O P E -,3"-' PERCOLATION RATE {minutes/inch) TEST RUN BE'rWEEN FT AND ~ FT Gro~e Net Depth to Date Time Time Water This well is producing--~allons oF ,ater per hour. MOON DRILLING SR BOX 668, BOGARD RD, PALMER, ALASKA 99645 TELEPHONE 745-4071 INVOI¢~ Lot~ BIk ~Sub WELL LOG Set pump @_ _ feet. ~S~NVOICE NO._ DATE YOUR P. O. NUMBER TEl[MS SALESMAN DEPTH DEPTH DEPTH LNFT. CABIN FORMATION IN FT. CASIN FORMATION IN FT. CA$1N FORMATION __1 101 201 102 202 ~2 103 203 Me 104 204 ~4 105 205 ~5 106 ~e 107 207 7 --8 108 208 109 209 9 _--10- 110 210 111 211 11 ~12 112 212 113 213 __18 114 214 14 --15 11§ 215 ~.~16 116 216 ,. 117 217 NOTE: Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA ff21 STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein, lfurtherverifythat based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. NameofFirm ~'J¢~-~"/ v'~,.[~-.oA¢ "~.[~- Phone Address ~ ~ /~ ~ ~ ~ ~ Engineer's signature ~ ~ / Approved for ~ Disapproved. Conditional approval for bedrooms. DHHS SIGNATURE bedrooms, with the following stipulations: Additional CommentsNote.. The well for this property meets existing State and Municipal Codes. There are nitrates present. It is suggested that a periodic te~-/-mg- ~ Lo i~u~ ti~ w~lls continued suitability. Nitrate concentration is 5.41 mg/1. EPA max~[[um ,concentration is 10.0. mg/-1. The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72K)25 (Rev. [/91) Back MOA ~21 Legal Description: A. WELL DATA Well type ~, Log present (Y/N) Total depth Sanitary seal (Y/N) Date of test Static water level Well flow Pump level Municipality of Anchorage /~ Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST If A, B, or C, attach ADEC letter. ADEC water system number Date completed I ~ ~'¢~ Driller Cased to [ LIL ~ Casing height Wires properly protected (Y/N) FROM WELL LOG g.p.m. AT INSPECTION 72- SEPARATION DISTANCES FROM WELL TO: Septic/h~ank on lot ~ ~,~:~ Absorption field on lot Public sewer main Sewer service line ; On adjacent lots_ ; On adjacent lots Public sewer manhole/cleanout I"//'A' Petroleum tank '~"~ WATER SAMPLE RESULTS: Coliform Date of sample: Nitrate t~ '2-. Collected by: Other bacteria B. SEPTIC/HOLDING TANK DATA Date installed ~'/~ / 7"¢ Cleanouts (Y/N) ? High water alarm (Y/N) Date of pumping Tank size I ~ Foundation cleanout (Y/N) ~'¢/A- Alarm tested (Y/N) ~ ?-- Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot 1-0 ~ To property line .~/_¢~ Surface water/drainage On adjacent lots Absorption field Compartments y Depression (Y/N) , Foundation ~ 7 Water main/service line '~/C) 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) High water alarm level Meets MOA electrical codes (Y/N) "Pump on" level at Manufacturer Manhole/Access (Y/N) "Pump off" level at Cycles tested SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed ~/t///'7 ~ Length ~ Width Total absorption area Depression over field (Y/N) Results (pass/fail) '"~ Peroxide treatment (past 12 months) (Y/N) Soil rating I01~ System type '"~ C~ Gravel thickness _ ~ Total depth J Cleanouts present (Y/N) Y Date of adequacy test i¢/?.(~/~, 7_._ for ~ If yes, give date bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot ! % To building foundation On adjacent lots Surface water On adjacent lots '~ /6,'~;~ Property line__ ~ /"J [~ To existing or abandoned system on lot Cutbank ~'10~' ~-- Water main/service line Curtain draih Driveway, Parking/vehicle storage area E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on:the date of this inspection. Date HAA Fee $ /~, Date of Payment ~'/ Receipt Number 72-028 (Rev. 3/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO, 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561-5301 ANALISI$ RESULTS for INVOICE ! 60073 Chemlab Re£.t 92.5906 Sample t i Natrix: WAIER Client Sample ID ~ 19362 STARFLOWZR - EAGLE DINER PWSID : UA Collected : OCT 27 92 ~ lO:O0 h~a. Received : 0al 27 92 ~ 11:30 h~s. Preserved with : AS REQUIRED Client Name :TOBBEN BPURKLAND, P.E. Client Mot :~OBBENS EPOI : P0t :NONE RECEI~D Rsq! : Ordered By Analysis Completed : OCT 28 92 Send Reports to: Laboratory Supervisor : S~TEPNEN C. EDE i)IOBBEN SPU~LAND, P.E. Parametez Results Units .................................................................................................................................... ~I~tI~-~ 5,41 ~/1 Sample ROUTIN~'SAMPLE COLLECTED BY: STUART. Remarks: I lents Performed ' See Special Instructions Above UA-Un~veilable ND- None Detected *' See Sample Remarks Above NA- Not Analyzed LT-Less Than, GT-G=eatez Than ~'~,~'~ B~S Member of the SGS Group (Sool6t6 G6n6rale de Survelltance) Date Date Date Inspector Inspector Date Sewer Installed Permit No. Septic Tank Size / ~t~ Sells Rating Well To Absorption Area Wail Log Received Well to Tank APPLICAN'r FILLS OUT LOWER HALF ONLY Address Phone Realty Co. & Agent Address ~¢p~ Residence ~Single Family D Multiple Family No. of Bedrooms Q Other Wat~Supply '~ Individual A~ACH WELL LOG. A well log is required for all wells drilled since June ~ Community ¢¢ 1975. For wells drilled prior to that date, give well depth (attach log ~ Public Utility available.) ~ew~e Disposal / ~' ~ Individual Year Individual Installed: ~ Public Utility When Connected to Public Utility: ~ Holding Tank _ NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED, Pratt MUNICIPALITY Ci AF!CIIORAGE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF, HEALTH& ENV RONMENTALPROTECTIQN,, . ,,.. r "i:;'G,L-CTION 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL ENGINEERING DIVISION '~"--' Telephone 264-4720 DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER PHONE Paul Meyers 695-2980 VIAl LING ADDRESS PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE Mike Sears 279-1223 MAILING ADDRESS 3',"LENDING INSTITUTION I PRONE First National Bank of Anchorage MAILING ADDRESS 'Post Office Box 720 99510 4. REALTOR/AGENT PRONE Darlene Nicolaysen % Sun Realty 694-2509 MAILING ADDRESS Post office Box 1201 99577 5. LEGAL DESCRIPTION Lot 9 Block 2 Skyline View Subdivision ;TREET LOCATION Columbine 6. TYPEOF RESIDENCE SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF BEDROOMS [] One [] Four [] Two [] Five [] Three [] Six [] Other 7, WATER SUPPLY {[[~ INDIVIDUAL* [] COMMUNITY [] PUBLIC UTI LII'Y *ATTACH WELL LOG. Awell log is required for al wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM [~× INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY **If individual/omsite, give installation date If system ~s over two (2) years old an adequacy test is required by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE NITIATED, 72-010(3/78) THIS SIDE FOR OFFICIAl. USE ONL-', DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME ~ATE DATE DATE ~'NSPECTOR INSPECTOR INSPECTOR DIRECTIONS". 1. TYPE OF RESIDENCE NUMBER OF BEDROOMB [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX 2, WATER SUPPLY PERMIT NUMBER [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified.. -- INSTALLER []Septjc~Ta_nl~ or [] Holding Tank V C~-~'-~ Size:. / ¢,_2CYO If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL Absorption Area to nearost Lot Liao 5, COMMENTS E~,'~"APPROV ED FOR ,.~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY (Title) ~'~ LEGAL DESCRIPTION ' ~ ICIPALIIY OF ANCttOI{AOE D{;partment of liea].th and l!;nvironmental Pcotection 825 L Street, Anchorage, Alaska 99501 ' ' 279-2511, ext. ~24, 225 for Approval of Individual Sewer ami Wate~ Facilities; Property Owner: Mailing Address: Phone: Name of Buyer: :_~.~/~/.~ Mailing Address: Phone Lending Institution: Mailing Address: Realtor/Agent: Street Location Single Family Residence: ~ Number of Bedrooms: Multiple Family Residence: ( ) Number of Bedrooms: Water Supply: * Individual Well ~) Public/Conmmnity System If Individual Well, well depth If Community System, name of system Sewage Disposal System: On-site System ../-("~ Public System ( If On-site System, date of! i. nstal, lati~m: * NO TE: 3177 A we. Il ].og .i.s requJ, red on ALL we].is dril.]ed since 6/75.