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Home My WebLink AboutGIRDWOOD ORIGINAL TOWNSITE BLK 1 LT 1A ~._j 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 PHONE [~ ~'~W NAME MAILING ADDRESS ~____., - ~._ LEGAL DESCRIPTION LOCATION DiSTANtE TO: Well Manufacturlr / ILq capacit ingalJons / · ' I' IF HOMEMADE: DISTANCE TO: IWell AbsorptioI area MateriTDwellitg Inside length W dth ) Dwelling i~! DISTANCE TO; No, of lines Length of each Top of tile to finish grade Width Crib diameter Foundation Total length of lines Material beneath tile Depth Crib depth Building foundation Length DISTANCE TO: Class Depth Driller Building foundation Sewer line DISTANCE TO: Material ~ f Nearest lot line Trench width inches NO, OF BEDROOMS PERMIT NO. No, of compartments Liquid depth PERM,T Liquid capac~ ~$1~ns PERMIT NO,. Distance between lines Total effective absorption area inches PERMIT NO. Total effective absorption area Nearest lot line Distance to lot line PERMIT NO. Septic tank Absorption area(s) OTHER ~E MATERIALS l¢~, SOIL TEST RATING REMARKS APPROVED ~ DATE LEGAL 72_0 l'~H ev.~3~78 ) F'ERMIT NO. RPPLICRNT LOCRTION LEGRL GEORGE HRNSON GIRDWOOD RLRSkR ERST STREET LOT ~R GIRDWOOD TOWNSITE S/D~ LOT SIZE t0000 SQURRE FEET TYPE OF SOIL RB=,ORPTION =,b-TEll IS: MR;',:IMUM NLIMBER OF BEDROOMS SOIL RRTING (SQ FT/BR)= 2~9 THE REQLIIRED SIZE OF THE SOIL RBSORPTION SYSTEM IS: B, EF"TH= ¢ LE~46TH= E'" 6RR'¢EL DEF'TI:= THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE DIST8NCE BETWEEN THE SURFRCE OF THE GROUND RND THE BOTTOM OF THE EXCRVRTION (IN FEET). THE TREPgICH ~410TH IS L3. E~}O FE~ !. THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFRLL PIPE RND THE BOTTOM OF THE EXCRVRTION (IN FEET). D:EQiJ IRED ~]EPTI ,~ TR~4t:~ SIZE-- ~,?.000 PERMIT RPPLICRNT HRS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING THE INSTRLLRTION INSPECTIONS OF RNY WELLS RDJRCENT TO THIS PROPERTY RND THE NUMBER OF RESIDENCES THRT THE WELL WILL SERVE. TWO ( 2 ) I NSPFC:T I C~,IS RRE REQIJ I RED BRCKFILLING OF RNY SYSTEM WITHOUT FINRL INSPECTION RND RPPROVRL BY THIS DEPRRTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTBNCE BETWEEN R WELL RND RNY ON-SITE SEWRGE DISPOSRL SYSTEM IS i00 FEET FOR R PRIVRTE WELL OR i50 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTRNCE FROM R PRIV8TE WELL TO B PRIVBTE SEWER LINE IS 25 FEET 8ND TO R COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MRY RPPLY. SPECIFICRTIONS RND CONSTRUCTION DIRGRRMS RRE BVRILRBLE TO INSURE PROPER INSTRLLRTION. F'ER~4 I T E:*:F' I ~:E$ B.E,]EMBER _~t .. -! 2~80 I CERTIF9 THRT t: IRM FRMILIRR WITH THE REQUIRENENTS FOR ON-SITE SEWERS RND WELLS RS SET FORTH BY THE MUNICIPRLIT9 OF RNCHORRGE. 2: I WILL INSTBLL THE SYSTEM IN RCCORDRNCE WITH THE CODES. ~: I UNDERSTRND THRT THE ON-SITE SEWER SYSTEM MRY REQUIRE ENLRRGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THRN ~ BEDROOMS. RPPLICRNT ~.~ LOCATION ~z.~ ~L. .__~ LOT SIZE LEGAL Z_ / ~ .~~,O ~ .~-~.~-.--,x~ TYPE OF SOIL RBSORBTION SYSTEM I~' SQUARE FEET MAXIMUM NLIMBER OF E, EDROOM=, = .~ SOIL RATING <SQ FT,-"BR)= THE REQUIRED SIZE OF THE SOIl. RBSORPTION SYSTEM IS: E>EPT, I= ~A LE[,GTH= ~/~ 8RR~"EL E.-EPTH= */~ THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF TI4E TRENCH OR DRRINFIEL[:,. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND RND 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 OUTFRLL PIPE AND THE BOTTOM OF THE EXCRVRTION (IN FEET). F-:E~_--Q-.U I REC. :SEPT I C F'ERMIT APPLICANT HAS THE RESPONSI~ILIT~ TO I~FORM THI~ DEPARTMENT [I_IRIN] THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE '4UMBER OF RESIDENCE_ THAT THE WELL WILL SERVE. TL40 ( 2 ) I [4SPECT IONS ARE REQt_i I REE:, BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AN[) APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWRGE DISPOSAL. SYSTEM IS 100 FEET FOR A PRIVATE WELL; OR i50 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ~0 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS RRE AVAILABLE TO INSURE PROPER INSTALLATION. PERI'I I T EXP I RES F-,~ECEMBER ~±-- ::L_'9- 80 ~ I CERTIF"r' THAT l: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET FOR~FH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE , DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 82B L Street - Anchorage, Alaska 99501 ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete request~ will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER PHONE Rosemary Redmond MAILING ADDRESS PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE George Hanson 783-2751 MAI LING ADDRESS 3. LENDING ~NSTITUTION I PHONE Secuirty National Bank MAILING ADDRESS 4, .REALTOR/AGENT I PHONE' MAILING ADDRESS 5. LEGAL DESCRIPTION Lot lA, 2A Girdwood Townsite STREET LOCATION East .Street - off of Glacier Creek Road 6. TYPE OF RESIDENCE NUMBER OF~BEDROOMS [] One [] Four [] Other ~}~ SINGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY [] Three [] Six 7. WATER SUPPLY INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY *ATTACH WELL LOG. A well log is required for all 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 1966 YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [~ ONE [~] THREE [~ FIVE [~] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLEO [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER []INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER [~]Septic Tank or [] Holding Tank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank IAbsorption Area Sewer Line I Nearest Lot Line WELL TO: Absorption Area to nearest Lot Line 5, COMMENTS [] APPROVED FOR BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany Certificate) [] DISAPPROVED DATE BY 72-010 (Rev. 6/79)