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HomeMy WebLinkAboutCLEARVIEW LT 3Clearview Lot 3 #015-242-42 • Mmllicipalit of Anchorage fi � Department of Health and Human Services 825 "L' Street Mayor ox Anchorage, Rick yP.O. B 196650 Ahe, Alaska 99519-6650 http://www.ci.anchorage.ak.us April 3, 2000 Archer Bishop III PO Box 11146 Knoxville, TN 37919 Subject: Clearview, Lot 3 SW990144 Parcel ID: 015-242-42 The subject permit #SW9901.ggissued by this office for a single family well and/or on- site wastewater system, is due to expire 365 days after it's issuance on June 16, 1999. If this is a well permit and you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If this is an on-site wastewater system and a licensed Professional Engineer has inspected the installation, the original as -built inspection report must be sent to this office for review, approval and documentation. All inspection reports must be submitted within 30 days of construction completion. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. However a new permit can be issued free of charge for a second year if the application for the renewal is received on or before the date of expiration of the original permit for which a fee was paid. When applying for a new permit after the original permit has expired or for more than a second year, the fees are: $320.00 for an on-site wastewater permit and $120.00 for a well permit. If you have any questions, please call this office at 343-4744. Sincerely James Cross, PE Program Manager On-site Services enc: Copy of Permit MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On -Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WATER SUPPLY PERMIT Upgrade Permit Number: SW990144 Legal Description: CLEARVIEW LT 3 Design Engineer: 0000 None Required Owner Name: Archer Bishop III Owner Address: PO Box 11146 Knoxville , TN 37939-0000 Date Issued: Jun 16, 1999 Expiration Date: Jun 15, 2000 Parcel ID: 015-242-42 Site Address: 008000 ALATNA AVE Lot Size: 45121 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: ❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑✓ Private Well ❑ Water Storage All construction must be in accordance with: The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: �lO / Date: t •.�e�'4 s y • r 4' y Y4grt � �J i ,e ASBUILT-NO CORNERS SET THIS DATE. 8Ei7ARD d ASSOCIATES LAND•SDr2VEYING 688-4566 y I 1 HEREBY CERTIFYY THAT 1 HAVE SURVEYED THE =ALV �FOLLOWING, DESj*50 PROPERTY�''• . ��`���� . Clearwater Swbd: Lot 3 btu%xe a o '., �`rA DAIE� +'�(� OF•A<q vt AND,THAT NO MU,AV. � tQ` ••, _': S INDICATEDI$IT�1 �7 -91 ,: 'f AESPOI�IEIUY,ORTH y i QgTH 9 OWNER�TQ, 6RlDt�'"e' }}' Is4'i• • •••. t � _ ✓ r� �,. Via• 'IF W4 I P Application must be tilled out completely MDLPart p AL17y ervi Nore:A on Si a SewerHea►t�h OF ANCHORAGE SORAGE /Welt Per Proe SINGLE FAMILY p r^tt Application p rty Owner Name WELLING Parcel wenttcatonn Numbed Mailing Address - Legal pescri �, Day Phone ption Lot Zip Code Lot Size V'�' , W I Section Block cres/SqFt . , sueaiv;e;e„ Number of Bedrooms r°wnsh° Inspections will be conducted by: y Ranga Does your house APProved Engineering!u l ll ` s \ � l^ contain any of the following: Flrm This a 9 ❑ Hot Tub o mu (permit fee included) oo� pplication is for: ❑Swim ❑ Sewer Only mmg POoI ❑Thera I cern ❑Sewer and Well py Pool EjJacuzzi certify that the above infor ❑ Sewer Upgrade �/ El Water Softener Unit this application is bein oration is correct. I further ) Well Only El o g made for a Sin certify that Water Storage _,- with applicable Municipa9� des. tly Dwellmy and ---Fees: --�-- Receipt #_ _)i_ (��/ Property owner/Well Driller Waiver Fees: �I 012 (Rev. VIM)' Receipt #�� Receipt # Waiver # ASBUILT-NO CORNERS SET THIS DATE SEWARD d ASSCCIATFS LAND SURVEYING 688-4566 �— CERTIFY CR1t3ED PROPERTY' ED THE FOLLOWING* 4D� �� OF A4q ro �� r � Clearwater SubV jhot 3 DATE$ W V. AND; THAT NO EDCIST E7tCEPf AS ' INO1CATt9� IT: ISS ftiE RESPONSIBILITY,• - THC OWNER TO D Tib EIf19TENC& t)F `ANY ORId is ::I ,• •••••• ••• ••• —' l— n IrASla�rlrsr �DRb`pR�ESTRICTIDNpS�'4r�� �* x�4D r � yryy ( � lv� f ,�R.91 �[A 1 .fi11M1YYV,StIW1•tFt .y Yd a F- f.691 j � : -4 '"�' v..F�,D�Rp��'(t' �i s�44i.. `�t �� • •.. a••T`SiI 74 17. .00 M ° egpali-ty of Anchorage Department of Health and Human Services R,ck Mystrorn. 825 "L" Street Mayor P.O. Box 196650 Anchorage. Alaska 99519-6650 hlip://www.d.anchorage.ak JS April 14, 1999 Archer W Bishop III Irrevocable Trust AW Bishop JR & S K Cotrustees -- 4823 Old Kingston Pike #140 Knoxville, TN 37919 Subject: Lot 3 Clearview Subdivision Permit # SW980060 PID # 015-242-42 The subject permit, issued April 13, 1999 by this office for a single family well and/or on- site wastewater system, has expired as of April 13, 1999. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. If you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If a licensed Professional Engineer has inspected the installation of the on-site wastewater system, the original as -built inspection report must be sent to this office for review, approval and documentation. All inspection reports must be submitted within 30 days of construction completion. When applying for a new permit, the fees are: $320.00 for an on-site wastewater permit; $120.00 for a well permit and $440.00 for a combined on-site wastewater and well permit. If you have any questions, please call this office at 343-4744. J$mes Cross, PE Program Manager On-site Services one: Copy of Permit A MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 . ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW980060 DESIGN ENGINEER:DUMMY COMPANY OWNER NAME:GRIFFITH CHARLES E OWNER ADDRESS:8000 ALATNA AVE ANCHORAGE, ALASKA 99516 PARCEL ID:01524242 LEGAL DESCRIPTION: CLEARVIEW LT 3 LOT SIZE: 45121 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 1 DATE ISSUED: 4/13/98 EXPIRATION DATE: 4/13/99 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. SPECIAL PROVISIONS: RECEIVED ISSUED BY: BY: DATE: ( �I DATE: 4 �� fly �f ay{i 'fi fI i z d ^� 99, PI�ow, ASBUILT-NO CORNERS SET THIS DATE SEWARD d ASSOCIATES LAND -SURVEYING 688-4566 I I HEREBY CERTIFY THAT 1 HAVE SURVEYED THE SCALD 40 ++SOF A4\\\ FOLLOWING DESCRIBED PROPERTYs iL�•.• ••....qS�O Clearwater-SubdI:ALot DATE, �::' ••:f• • (,_..� AND THAT NO EN IgT VICE"AS 7 1 91 ! : agTH 9�0 INDICATED .ITs'JS THE RESPMBIUTV OF THE f { a ..:... ... ... omm To THE STENO&Of p{RESTIpCT10NS y� : awl. wa 7.+.d / 4r Ic oo¢ l w`` t�'rz x _ I#i4: �.:.;: 1$ 6918 tii MUNICIPALITY OF ANCHORAGE 0 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 C1., 've %/eS PHONE ❑ UPGRADE/ MAI LI NG ADDRESS LEGAL DESCRIPTION LOCATION / lejo NO. OF BEDROOMS , U DISTANCE TO: Well 00' ;.W�, Absorption area Dwelling PERMIT NO. v 6� p a Y a ZQManufacturer W� Material f No. of compartment y Liq. capacityin gallons 100 IF HOMEMADE: Inside length Width Liquid depth 6 Y J0Z DISTANCE TO: Well Dwelling PERMIT NO. S z < Manufacturer Material Liquid capacity in gallons O w = DISTANCE TO: Well n Vt'y Foundation Nearest lot line PERMIT NO. p W LL Z J z P x No. of lines Length each line r3 Total lengthIles,,Trench width inches Distance between lines F In Top of tile to finish grade V, Material beneath tile i Total effective absorption area v W Length Width Depth PERMIT NO. Q F as W Type of crib Crib diameter Crib depth Total effective absorption area W rn DISTANCE TO: Well Building foundation Nearest lot line J J Class Depth Driller Distance to lot line PERMIT NO. W � DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS TrL e. SOI L TEST RATI N 11 INSTALLER M REMARKS APPROVED - /� DATE LEGAL et 72-013 (Re�T.�/78) \. ,1 r ` I -F*-e ID F:::- F;;'I=l 13 FEE ./ DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ^ ' 825 'L' STREET, ANCHORAGE, HK. 99501 --�-��-� ^ 264-4720 L.j F= i i �r-4 r_- r -4-f3. I -r F= FEE L-A F= F.*P-,- F_ r-1 I Lt PERMIT NO. ( 810698 APPLICANT RICHARD E. YOVES ]951 APOLLO DR. 333-8682 LOCATION UNKNOWN LEGAL L3 CLEHRYIEW S/D LOT SIZE 108900 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = ] SOIL RATING (SQ FT/BR)= 113 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: :IL=:C'FS I������= THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD. 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 15 THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). ��F=Qu I F-, F=� ����I�� ������� �I���= :1-C-112-1121�3������r4� PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. ___ -FWID <:2 > I ":E. F=F= #=� _F I Cl N�� " F:; -:."F=- �����U I F-�_ FE C�- BHCKFILLING 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 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM H PRIVATE WELL TO H PRIVATE SEWER LINE IS 25 FEET AND TO H COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS HND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F='I= F;;?- M I -F ���I F:;:F=!F. ��KZ- �Irl E.* F= V-�. 2:1L, �����::L 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 ] BEDROOMS. SIGNED:________________________________________ HPPLICHNT RICHARD E. YOYES ISSUED BY _DHTE Y4.0 mFi::A' TP3v4t 13 HESL TH F44D EI`' J i P01tMM Tt1L. PRO TEC T I N ':-r STREE T: P&X14" , AK 5P9501 APS- ICM4T R iCtOIRP 1 VOYE, Li." T t i. F1f i 1-0s L3 CLEf" t 04 Wit} LOT s 1 Zt t _+ L#34E FEE! ,rr7:,E foF SOIL AWSOM T I on a e i M 11: TR'aJCN t fres t t M MR42CR OF SEDPOL N'i = 3 SOIL rZA T I is <1* i= i• ) = U3 i THE POYRRED '.51-E f -1F THE 9J IL i t ri sesTEm i s : i Tz� LES STH P Lh�£t '? ir3N 1S THE LEPjoTH 4 LN F '? OF ME TREAM�H ORi3 1MF i #?. 4THS CgEP TN iY A Tf iL',H 13R P I T I'=Hc T & V,; ri4U. M PE MEEN THE SlJWtP� OF T14ri. -- o.Ab fpm mc soT TOM f3F THE EkayA r t i3N < IN FEET). r# 3 -Jt E I'S NO 'SE T 1410 TH FSR' T`RUJ Q. +" '-_ DEPTH I p T iE M iN UPM DCPrH OF 13RRVO- SET14EEN n-9 fYJ int -1- P tr tu-p Tm $0 f rim cc mE of:i" T i fn 4 tM Fee o. ::LCEavala tit t_t�.QIP1111 PS" i T f f;'PL IGMT HRR RE'SPIMS181LETY TO MFIA 1 M 1 a OAR T.f." r OUR Eno T� L W; TRL.LR T 1 tiff - iaN` F*Fj,'T OX -6 OF ANY wLLs #3D.3io--zN f ro rm 1; Ppa;s� _l% THE ?-Xj48EjZ 131F PF-3trAttCoe; T TW WELL WILL 3FfZVV- t s . TEti win -our i` [ t - t t+t•-*jeL I i oN Ano FFFROYAL OY n4t,!; LARTMENT MILL. eC •J18tECT TO PRCr3F-0.tT10 to iN it�t1.�4 D i s TPdL" BE TI4EEN N I -OJ- t i�fG' Off �-5 I TE EkME 1 S'qr TEi'! i -t FEET FOR N PRIVATE i•lEi.L 13P tswa Psi f:EE T FRom A Fja L Neu- trill fj.01A ar. rl?� aF Pi BL IC 1•ou- t4 iN It UM DUSTMIDE Fi�3M R PR IVAM i}E - TO A PRIVATE �?ER: L THE I'S T i ro i1 +..tY-R•UN i N i L i HE I5 7'75-5 FEE T. - vla i- uN 3 fWE R0A i LREG PUNQ MriT eE f;m nJRwD ro TH£ ccpRR -"r w t TH iN n ' f3r Tim i�%L o-vt Le T t oft O iWR RE+'3U Ifi iEN rS h'1H l Y_ SPEC LF S Qf i r I w-; P140 f_`ONS Tib 1C T 1 ON v 1 ;-TM C Lf=i TO f N9jRE PRrffEP i NS Tt Jt -En r i m 'F �� � x `r ;x:f r TSE= s i`�E�;�-i t"l�i f , 3:L' E f=T iFV Ti•1HT L : I AM F AM f L I AR WITH T?iE REl) i f?�Et", Fj3R i3td-- � t TE �3 i��? w - us Ff7R TH IV THE PUN tC 1Pi-I. I TY OF i t4 ii �. Its' Tt�1.1. Tf # �4rt� FEi! i?V t3f''`aRmjcE iii i Tm THF -owes. 3 : t 1t Tinto T i A i #NE sm -s [ tE saopz '3' Tim t•1w Fiso i i w- Ewmowim T LF T# IS Tip L ti��i t�Rc TiV 3 ita#Qtt _ IMC f2 if."�mo e�t 64 i Y•4. i 1a3E�T�Si'�g3"P ��i3II��L�S7Q ��P3L'3�3 I30S 13oot STAR I1cwro A Alwcuo iAcov ALASKA 99502 344-7714 f 1,44 /-� 0 SIX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF DRILLED AT THE RATE OF 521.00 PER FOOT. PROPERTY OWNER lnl. & R'4' gaha no.behtz. 333-6723 310 Te t. LOCATION OF WELL SITE— Lt.3 JYdb, sub. DRILLER Be mie Uau4 of- kaapah t 14tt .Ing 004k.d. WELL LOG: AI.24 .r /1 u/ 4(?-. JLJ 4a -sag 22----56' Cou toe gtavet with 4eveaal mmaU ba•i.lr dad IN' CJ=-k- 56---91' .Ind__56 91' S:&44ga4 fAae Muer.. 15% cta -k. 91---105' R wet 4.i;L r= . , with a anuzU amount o4 wat eA bea t&g Muet at 105'. 105--124' Ha dpwa. R cemen ted gAaueL. 124-3701 Bed rock. R d ed.in, .en xyzji hock. lea epi bear in.g. 4ixe aateVfAonL 240 to 246 feet. One Q7 u e td. R pato" ape dock atom 288 to 294 4e.t Showa at .te," t One 9f R p&od ct Lon. _ To -tat wateA pwdw t a t4 Two gl,7 wtth. 260 Aet o�- wa z& 4.tandbig 'in c_aw iat . 1.6 gat4 jaeA boat at 260 feet: 416 gam ta 2e4e ue . 2880 gal. pe -t 24 hook. t-iac Acme ava i,Labte. Rio this Vel.L jhouid iacAea ca to p wduc t ion. Latch u4e. Cae Hof, -,e Subme,%4tbLe l unp 4hou i.d be -in4tatted 15 4e- off bo.ttan. MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & Cort. o� DAtt Ging: $6000.00 Tota t. a miscoun t apptted air E v=a r i PROTECTION I <o Charge P ,, &e t Seat. MAY 16 1984 RECEIVED COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING. WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF 96000.00 THANK YOU VERY MUCH. BERNIE CLAUS OF RAMPAR DRILLING WORKS iZugrr4t 2nd, 1987 DA rE— D665 1201 P�OIU2 St. 99515 ANCHORAGEso ALASKA 344-7714 SIX INCH WATER WELL DRILLED ---------- OUT TO THE DEPTH OF 500 Feet. PROPERTY OWNER &- & filM- N0ha & flte'ZU'a) jeabeAt4 345-7102 LOCATION OF WELL SITE Lt- 3 Bd.k. Suh, i� a�-��• ) -c-,w". DRILLER BeJvUe Urte 4 a� RaMPOA—t PA. 4� iJo4k4 WELL LOG: Lvt4t a q. hlate�t G3ett deepencan 310 A ka 500 A. 310--500' Bedhock. SedunerLtcyul Mack �rhow.ingiLin cytea� o� �� ape waateJt lrvLo- duc t i ve j,i44u&e4. Theae aAea4 4how po ten tint Pt g�teaket water yield wd th u4e Of - We -U. The c.um, attue ptoduc tl oa of- th.ij V eU 4how4 150 to 180 9a-i-i-orw of- wa to t in a one hoeyt t ne wane. good guan Uq. during a 24 Nowt pzA,!xd. 19-1th, aevena.L wee -k4 u4e, VU4 NeJA 41Louid Zg4Aea4e and haid at the -top 180 gPH Mate. IEEE the new wa test bea�t- .ing f-Ld4u&e4 jhou" &each �w V-, . d afte a aero week4 u4e. Overt 300 .deet of- watvt atand i.ng .in &e4etre o4 botto n. 1.6 gaL orw o� waled Reit A. 480 ga-Uon4 o�- waled in. &eaenve. (On demand.) Sulme-u bte pmp bi4tmUed to 450 A. THANK YOU VERY MUCH. BERNIE CLAUS OF RAMPART DRILLING WORKS DATE �=e 16th, 1986 ` L,QJLt'�. /V SOILS LOG IV N • MUNICIPALITY OF ANCHORAGE 0 PERCOLATION DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST Pouch 6.650, Anchorage, Alaska 99502 276-2221 SOILS LOG - PERCOLATION TEST PERFORMED FOR:DATE PERFORMED: — LEGAL DESCRIPTION: SLOPE SITE PLAN DEPTH (FEET) I - 2- 3- 4 - 5- 6- 7- 8- 9- 10- 11 12- 13- 14- 15-40) 16- 17- 18- 19- 20 -q COMMENTS e we" C/ WAS GROUND WATER S ENCOUNTERED?L .0 P IF YES, AT WHAT E DEPTH? PERCOLATION RATE TEST RUN OCTWEEN FT AND Iminuteslinch) 2: FT Gross Net Depth to Not Reading Do's Time Time Water Drop j PERCOLATION RATE TEST RUN OCTWEEN FT AND Iminuteslinch) 2: FT (non C,57 p 5 JZ_- ) Municipality of Anchorage ' Development Services Department Building Safety Division On -Site Water &Wastewater Program 9665 South rage, St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904�Y_�fy,>. l R CERTIFICATE OF HEALTH AUTHORITY APPROVAL ��1+b FOR A SINGLE FAMILY DWELLING !� Parcel I.D. 015-242-42 HAA# � 2�(-)q 0 l (0 1. GENERAL INFORMATION Expiration Date: Complete legal description CLEARVIEW SUBDIVISION: LOT 3 Location (site address or directions) 8000 ALATNA AVENUE Current Property owner(s) Mailing address Lending agency Mailing address ROBERT CURTIS Day phone 243-4503 8000 ALATNA AVENUE * ANCHORAGE, AK 99516 Real Estate Agent DAWN STORM Day phone Day phone 265-9104 Mailing address COLDWELL BANKER FORTUNE PROPERTIES * 2525 C ST. ANCHORAGE. AK 99503 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3.'. -TYPE OF WATER SUPPLY: 0 Individual Well ❑ Individual Water Storage El Community Class Well ❑ Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site 0 Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. 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, based on procedures outlined In the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that 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(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ALASKA WATER & WASTEWATER CONSULTANTS, INC. Phone Address 3701 E. TUDOR ROAD, SUITE 101 ; ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, AKWWC, Inc. attempted to provide a thorough, conscientious engineering analysis of the system In accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that 'there are no hidden defects or encroachments. AKWWC, Inc. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE Approved for bedrooms. Disapproved. 337-6179 Date C1 (in 03 • Conditional aDDroval for bedrooms. with the fllowina stipulations: PROGRAM Attachments: / ip'�•, .. • •' HAA Checklist ✓ Manitenance Agreements Septic System Advisory Supplemental Engineer's Reort Well Flow Advisory Other By: Original Certificate Date: 0 — 02 — 0 3 (Rev. 1?/01) Municipality of Anchorage Development Services Department Building Safety Division OnSfte Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519.6650 www.d.anchorageak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: CLEARVIEW SUBDIVISION; LOT 3 Parcel ID: 015-242-42 A. WELL DATA Well type PRIVATE If A, 8, or C provide PWSID# N A Well Log (YM) 0) YES/ (72 NO 08/84 (DEEPEND IN '86) Date completed ®^ 1999 Sanitary seat (YM) YES Wires properly protected (YM) YES 0500 0124 19 Total depth W uIK ft. Cased to 92 40+ ft. Casing height (above ground) 023 in. AT INSPECTION *BYPASSED STORAGE FROM WELL LOG ® TANKS FOR THIS TEST.© •WELL #2 WAS TESTED ONLY1 THERE IS A METER Date of test 6/16/1986 1/14/2002 OUSELOCATED THE HOUSE PRIOR TO STORAGE TANKS 600 Static water level 00' ft. 56 ft, GALLONS OF STORAGE TANKS IN Well production 2.5 TO 3.09.p.m. 0.32+ g,p.m. CRAWLSPACE. PUMPED 1000 GALLONS FROM WELL IN 301 MINUTES. WATER SAMPLE RESULTS: UNABLE TO TAKE STATIC WATER LEVEL READINGS (D 0 00.85 BELOW 56 FEET DUE TO OBSTRUCTION IN WELL Coliform 00 colonies/100 mi. Nitrate 00.85 mgJL. 00 Other bacteria 00 colonies/100 ml. Arsenic: N/A mg./L. Date of sample: 9/16/03 Collected by: AKWWC, INC. B. SEPTICIHOLDING TANK DATA Tank Type/Material STEEL Date installed 9/2811981 Tank size 1 DOD gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation deanout (YM) YES Depression over tank (Y/N) NO High water alarm (YM) N/A Date of pumping 9117/2003 Pumper ANCHORAGE CESSPOOL C. ABSORPTION FIELD DATA Date installed 9/28/1981 Soil ratingp.d./ r ft9bdrm) 113 Length 25 ft. Width 3 ft. System type DEEP TRENCH Gravel below pipe 7.5 ft. Total depth 14+/- ft. Eff. absorption area 390 ft' Monitoring tube YES • Depression over field NO Date of adequacy test 114/02 Results (Pass/Fall) PASS For 3 bedrooms Fluid depth in absorption field before test U in. Water added 789 gal. New depth 23 in. Elapsed Time: 1 min. Final fluid depth 0 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YM & type) NONE KNOWN If yes, give date - D. UFT STATION Date installed "Pump on" level at in. Datum E. SEPARATION DISTANCES Size in gallons High water alarm level at in. Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot •100.7' Absorption field on lot 1009+ Public sewer main N/A Sewer /septic service line 25'+ *FROM EDGE OF STI TO EDGE OF WE #2 (TANK IS POINTED AWAY FROM WELL) On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout N/A Holding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parkinglvehicle storage 50'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION -,6rc U /.! I certify that I have determined through field inspections and 4 - review of Municipal records that the above systems are in • • . • • • • ' • • .. ' •' . • • "' • • ..• •' conformance with MOA HAA guidelines in effect on this date. y G......g:... Engineer's Printe Na a JEFFREY A. GARNESS 7953 ` Z i7 O� �4*s�• P. ...... • c �p4 Date � rofse•lo� � L4115D. R . HAA Fee $ Waiver Fee $ Date of Payment ' 3 -03 11) 03 Date of Payment Receipt Number 924146 251 Receipt Number (Rev. 12/01) Municipality of Anchorage •••, ' Development Services Department Building Safety Division ...,. On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 995I9-6650 www.ci.anchorage.akus (907)343.7904 Water Well Advisory Health Authority Approval # 020023 During a recent Health Authority Approval on-site inspection and test of the potable water supply well on Block -, Lot 3 of Clearview subdivision, the well's productivity was determined to be 0.32 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3 -bedroom residence is 0.31 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Health Authority Approval. w l AbOVILr-NO CORNERS SET THIS DATE. SEWARD & ASSOCIATES LAND -SURVEYING 688-4566 I HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE= FOLLOWING DESCRIBED PROPERTY: 1"=40' s�OF A4gOM Clearview Subd.,Lot 3 DATE= AV.or "�•••"•••.!�s0� AND THAT NO ENCROACHMENTS EXIST EXCEPT AS 7-1-91 r� .•" '•.�' 0 INDICATED. IT IS THE RESPONSIBILITY OF THE.'E OWNER TO DETERMINE' THE EXISTENCE OF ANY GRID.,�`••••• ••••••• •••! EASEMENTS, COVENANTS, OR RESTRICTIONS 2740 WHICH DO NOT APPEAR ON THE RECORDED SUBDI-" : Duane Mark Seward : Q VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB' 22-15 l�;Q• •• ANY DATA HEREON BE USED FOR CONSTRUCTION `o OF FENCE LINES, OR FOR ESTABLISHING BOUND -4p ARY LINES. DMSxr�..��.'R Municipality of Anchorage ' Development Services Department Building Safety Division On -Site Water 8 Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 LA oa CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-242-42 HAA# 1. GENERAL INFORMATION Expiration Date: " G ' O Complete legal description r CLEARVIEW SUBDMSIONl_LOT 3 Location (site address or directions) 8000 ALATNA AVENUE • ANCHORAGE. AK Current Property owner(s) ARCHER BISHOP Day phone 257-0112 Mailing address c/o MARY COX w/ REMAX PROPERTIES Lending agency Day phone Mailing address Real Estate Agent MARY COX w/ REMAX PROPERTIES Day phone 257-0112 Mailing address 2600 CORDOVA DRIVE • ANCHORAGE, AK 99503 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 10 Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an Independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work. Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $2,IZS at, orprior to closing for the engineering services provided. 4. 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, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that 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(are) In compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ALASKA WATER & WASTEWATER CONSULTANTS, INC. Address 6901 DEBARR ROAD, SURE 28 • ANCHORAGE, AK 99504 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, AWWC, Inc. attempted to provide a thorough, conscientious engineering analysis of the system In accordance with ADEC and MOA DSD Guidelines 6 Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily Identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. A W WC, Inc. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report Is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. S. DSD SIGNATURE V Approved for 3 bedrooms. Disapproved. Phone 337-6179 Date 1 A40Z.. Conditional approval for bedrooms, with the fllowing stipulations: ' PROGRAM Attachments:O�'•. •'� HAA Checklist Manitenance Agreements ��l Septic System Advisory Supplemental Engineer's Reort �l� •_ Well Flow Advisory Other By: A„/ It/. Original Certificate Date: J (Oy (R". 13101) Municipality of Anchorage Development Services Department Building Safety Division a ... On.Ske Water 3 Wastewater Program 4700 South Bragaw, SL P.O. Box 195650 Anchorage, AK 99519.6650 www.d.andwrege.ak.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: CLEARVIEW SUBDIVISION* LOT 3, Parcel ID: 015-242-42 A. WELL DATA Well type A If A. B, or C provide PWSID# N/A Well Log (Y/N) m YES/ m NO 8/1984(pEEPENo IN 1296) Date completed (M-1999 Sanitary seat (YIN) YES Wires properly protected (YM) YES Total depth UOK ft. Cased to 40+ ft, Casing height (above ground) 18+ In. Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform oolonies/100 ml. Arsenic:�oa4_- mgA. '5-* z B. SEPTICIHOLDING TANK DATA * AT INSPECTION *BYPASSED STORAGE TANKS FOR THIS TEST. THERE IS A METER 1/14/2002 LOCATED IN THE HOUSE PRIOR TO STORAGE TANKS 56 ft, 600 GALLONS OF STORAGE TANKS 0.32+ IN ���' g.p.m. PUMPED 1000 GALLONS FROM WELL IN 701 MiNUtEL UNABLE TO TAKE STATIC WATER LEVEL READINGS 99 8 I BELOW 99 FEET DUE To OBSIRUCTK - WELL Nitrate • i .g2. mg /L. Other bacteria :x�nloniesl100 ml. Date of sample: 1 14/02'4' (Collected by: AWWC. INC. ►�rH o2,'it2 Tank Type/Material STEEL Date Installed 9/28/1981 Tank size 1000 gal. Number of Compartments 2 Cleanouts (YM) YES Foundation cleanout (Y/N) YES Depression over tank (YM) NO High water alarm (YM) N/A Date of pumping 1/16/2002 Pumper DENALI SEWER & DRAIN C. ABSORPTION FIELD DATA Date installed 2122/1981 Sob rating .p.d r ft%bdrm) 113 System type DEEP TRENCH Length 26 ft. Width 3 ft. Gravel below pipe 7.5 ft, Total depth 1 + - ft. Eff. absorption area300 ft' Monitoring tube YES Depression over field NO Date of adequacy test 1/14/2002 Results (Pass/Fag) PASS For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 789 gal. New depth 23 in, Elapsed Time: 1 min. Final fluid depth 0 In. Absorption rate k 450+ g.p,d, Any rejuvenation treatment (past 12 mo.) (YM 6 type) NONE KNOWN If yes, give date - D. LIFT STATION Date installed "Pump on' level at _fn. Size In gallons High water alarm level at rlafiim Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES FROM EDGE OF 5T1 TO EDGE OF WELL jX2 SEPARATION DISTANCES FROM WELL ON LOT TO: (TANK IS POINTED AWAY FROM WELL) Septic tankllift station on lot •100.7' On adjacent lots 100'+ Absorption field on lot 100'+ Public sewer main N/A Sewer /septic service line 25'+ On adjacent lots 100'+ Public sewer manhole/cleanout N/A Holding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water main N/A Water service line 10'+ Surface water 100'+ 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parkingIvehicle storage 50'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION ARW,. 1 certify that 1 have determined through field inspections and ; . y ;'* review of Municipal records that the above systems are in ......... conformance with MOA HAA guidelines in effed on this date. , • • , • • , • .. ........... , essr Engineer's Printed Name JEFFREY A. GARNESS ' 7953 ` „� • ... .. foo Date t 9/c2 �Pro eeele�� HAA Fee $ 3� 1� Waiver Fee $ Date of Payment 1 1 r�+U �- Date of Payment Receipt Number O�- Receipt Number (Rev. 17101) Municipality of Anchorage. Development Services Department ° Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 Water Well Advisory Health Authority Approval # 020023 During a recent Health Authority Approval on-site inspection and test of the potable water supply well on Block -, Lot 3 of Clearview subdivision, the well's productivity was determined to be 0.32 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3 -bedroom residence is 0.31 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Health Authority Approval. JALCUE Environmental Services Inc. ar�r�r�rr�rrrirrir� C &ERef.N 1020364001 Client PON Client Name Aarow Pump & Well Service Printed Date/time 01222002 19;40 ProjectName/N 8000A1mtnq Ax-ctne, CollectedDote/I'ime 01/182002 10:30 Client Sample ID 8000 AI"q C 1¢ac'V le W � Lot- 3 Received Date/time 01/182002 10:50 Matrix Ordered By PWSID Drinking Water 0 Technical Director Stephen C. Ede Released By �o*" Sample Remarks Parameter Results PQL Units Method Allowable Limits Prep Date Analysis Date Init Metals Department Arsenic 0.00440 0.00200 mg/L EPA 200.9 (<0.05) 01/22/02 1MP Not ara Dapartment Nitrate -N 0.2000 0.200 mg/l, EPA 300.0 (<10) 01/18/02 1DT Mierobiologyt_Leboratory Total Coliform 0 coVIOOmL SM18 92228 0) 01/18/02 SBII 8E0-1 EWO'd Z81-1 10£5185106 ASS 1Y1N31NO IAN3 3110itOSd MdZ1:80 ZO-ZZ-NYr -, JAN -16-02 O4:18PM FROM-CTIE ENVIROMENTAL SRV 9075615301 T-686 P.01/02 F-908 CUE Environmental Services Inc. Laboratory Division 200 W. Potter Drive Anchorage, AK 99518 Tel: (907) 562-2343 Fax: (907) 561-5301 CT&E Ref. #: 1020262001 Client POO: Client Name: AK Water & Wastewater Cons. Printed Datefriime: Project Name: We Collected DateRme: Client Sample ID: ClearView SID Lot 3 Received Datemme: Matnx: Drinking Water Technical Director. PWSID n/a Released Byhi Sample Remarks: `�— Na 01/16/02 16:25 01/14102 16.00 01/15/02 10:30 Stephen Ede Allowahle Prep Analysls Parameter Results POL Units Method Limits Date Date Ind Total Coliform (MF) 5 OB w/out call COV100 ml SM9222B 01/15/02 KAP Nitrate 0.99 0.2 mg/L EPA 300 10.0 01/15/02 JMP Arsenic 0.002 U 0.002 mg1L EPA 200.9 0.05 01/15102 JMP ,__31AR- 5-02 WED 4:18 PM GCI CABLE March 5, 2002 Dishop Archer 8000 Alatna Avenue Anchorage. Alaska 99516 Dear Mr. Archer, FAX N0. 9078688580 P. 2 Subject to your agreement to indemnify the company as set forth below, GCI Cable Inc. of Alaska has no objection to the well encroaching into the 10' utility easement on the north property line of Lot 3, Clearview Subdivision. Known as 8000 Alatna Avenue in city grid 2740. 'this letter of non -objection in no way precludes GCI Cable from full use and enjoyment of any rights it may have within any portion of the utility easement and or the right-of- way, including unlimited access for servicing its facilities. Also any additional and ' extraordinary costs incurred during any future required construction, repair or reconstruction of GCI's facilities to accommodate any or all of the encroachments shall be paid by the property owner. By signing below, you agree to indemnify and hold GCI Cable harmless, now and forever, for any damage, costs, expense (including reasonable attorney's fees), liabilities and injury to any person or property occurring as a result of the encroachment. Please indicate your acceptance by signing and returning this letter to myself at the address below. c Sincerely, Acceptance f�/1.4t (�� � �CINSN K S (Af�'ef OSP Design Engineer Date 5151 Falrbanks Street • Anchorage, Alaska 99503.9071786.9200 r^ tdo eervfces nrovfded bvGCI Cab/e. Inc. l.�icst�wb��r✓^ INC. ACSIM Alaska Communications Systems January 30, 2002 Jeffrey Garness Alaska Water s Wastewater Consultants 6901 Debarr Road, Suite 2B Anchorage, Alaska 99504 ACS has no objection to the encroachment of the existing well into a platted easement located on Lot 3, Clearview Subdivision, as depicted on the as -built drawing submitted. Acceptance and use of this letter of non -objection by yourself, your heirs, your assigns, or your successors, will constitute agreement to the following stipulations: 1. ACS will be held harmless, now and forever, for any damages or injury to any person or property as a result of this encroachment. 2. Any ACS facility damaged or destroyed as a result of this encroachment will be repaired at no cost to ACS. 3. Any costs incurred by ACS for special construction necessitated by this encroachment will be borne by the property owner. 4. All applicable safety code regulations will be observed and maintained. 5. This letter of non -objection will in no way preclude ACS from full use and enjoyment of its rights within any portion of its right-of-way. Sincerely, nom` 4ra*chmid, Foreman Outside Plant Engineering ACC TAN E: DATE:' Z� oZ AC&P #460 600 Telephone Avenue Anchorage, Alaska 99503-6091 tel 907.564.1000 www.acsalaska.com Jan 24 02 04:47p Municipal Light and Power 2635804 A u ►i i r, i to a i L i e1 h f ►:; 71 d MLP Engineering 1200 East First Aw e Anchorage Alaska 99501-1685 Phone 907-263-5408 Fax 907-263-5321 www.mlandp.com 24 January 2002 Jeffery A. Garness Alaska Water and Wastewater 6901 DeBarr Road, Suite 2-13 Anchorage, AK 99504 RE: Lot 3, Clearview Subdivision Request for letter of non -objection Mr. Gamess: Clearview Subdivision is not within the ML&P designated service area. Please coordinate with Chugach Electric Association on this matter. 01/25/02 Jeffrey A. Garness Alaska Water and Wastewater Consultants, Inc. 6901 Debarr Road, Suite 2-B Anchorage, AK 99504 To whom it may concern: ENSTAR Natural Gas Company A DIVISION OF9 EMC�ENE1RGie no Ineerin Da 401 E. International Airport Road P. O. Box 190288 Anchorage, Alaska 99519-0288 (907) 264-3740 FAX (907) 563.4085 ENSTAR Natural Gas Company has no objection to the encroachment of the well in the 10 foot utility easement on the north side of Lot 3, Clearview Subdivision. See attached as -built survey dated 01/15/02. Acceptance and use of this letter of non -objection by yourself, your heirs, your assigns, or your successors, will constitute agreement to the following stipulations: ENSTAR will be held harmless, now and forever for any damages or injury to any person or property as a result of this encroachment. Any ENSTAR facility damaged or destroyed, as a result of this encroachment will be repaired at no cost to ENSTAR. Any costs incurred by ENSTAR for special construction necessitated by this encroachment will be borne by the property owner. All applicable safety code regulations will be observed and maintained. This letter of non -objection will in no way preclude ENSTAR from full use and enjoyment of its rights within any portion of its right-of-way. Sincerely, ENSTAR Natural Gas Company Dave Titus, Engineer cc: File _ . ANCHORAGE WATER & WASTEWATER UTILITY George P. W Mayor Engineering Division 3000 Arctic Boulevard Anchorage, Alaska 99503-3898 http://www.awwu.ci.anchorage.ak.us January 25, 2002 Alaska Water & Wastewater Consultants, Inc. 6901 Debarr Road, Suite 2-B Anchorage, AK 99504 Re: Clearview, Lot 3 (Grid 2740) Encroachment into Easement Dear Property Owner: Municipality oJAnclwrage The Anchorage Water & Wastewater Utility received a request from Jeffrey Garness of Alaska Water & Wastewater Consultants, Inc. on January 21, 2002, for a letter addressing AWWU's position regarding the existing well that encroaches into the utility easement located on the north 10' of the referenced lot. An asbuilt drawing recerified on January 15, 2002, was submitted with the request. The referenced area is outside the AWWU water certificated area. Wastewater facilities are to be in accordance with the Hillside Wastewater Management Plan (HWMP). AWWU is not using the utility easement and has no objection to the encroachment. If you have any questions, please call me at 343-8009 or the AWWU Planning Section at 564-2739. Sincerely, � Hallie Stewart Engineering Technician G1EngineminglPlanning\PlanningWMS\cncroachmentsbasemenl-no w -s - no obi Clearview.doc ENCROACHMENT PERMIT 1203-24C G-2740 EN02004 015-242.42 This permit is between Chugach Electric Association, Inc., an Alaska non-profit electric cooperative, (herein "Chugach'), whose address is P. O. Box 196300, Anchorage, Alaska 99519 and Archer W. Bishop, Jr. and Sandra K. Bishop, (herein "Permittee'), whose address is 4823 Old Kingston Pike tt 140, Knoxville, IN 37919. 1. Easement Chugach is the grantee or user of an easement for the construction and maintenance of electrical facilities, as follows: Dedicated by the plat of the subdivision known as Ciearview Subdivision, accordingto plat Number 80-178, recorded on the 24° day of November 1980, on file in the office of the District Recorder, Anchorage Recording District, Seward Meridian, Alaska, Described in that certain written instrument recorded on the 15" day of June, 199'2, in Book 741, Page 498, on file in the office of the District Recorder, Anchorage Recording District, Seward Meridian, Alaska, (herein "Easement") which pertains to the following described real property: . The Northeasterly Ten Feet (NE'ly 10') ofLotThree (3), Clewview Subdivision, according to Plat Number 80-178, recorded on the 24th day of November 1980, on file in the Office of the District Recorder, Anchorage Recording District; Seward Meridian, Alaska. Permittee acknowledges the validity of the Easement. Permittee warrents and represents that Permittee is the owner of the fee simple interest in the land subject to the Easement and the following described real property to which the Easement is adjacent: Lot Three (3), Clearview Subdivision, according to Plat Number 80-178, recorded on the 246 day of November 1980, on file in the office of the District Recorder, Anchorage Recording District, Seward Meridian, Alaska, (herein "Parcel"). Page I of 4 Z0 39vd X00 AWW — 00ET89Z 60:91 Z00Z/i0/E0 2. Encroachment. Permittee has constructed or purchased the following improvement on or within the real property subject to said Easement: A water well that encroaches approximately Four Feet (4') into the Easement for a distance of approximately Two Feet (2'), (herein "Encroachment"). 3. a 't. Chugach hereby authorizes Permittee to continue the existence of the Encroachment in its proposed location subject to the covenants set forth in this permit 4. Indemnification. Permittee shall indemnify and hold Chugach harmless from any claims for personal Injury, property damage or other loss arising in any way from the continuation of the Encroachment. S. No Exrmnsion or Increase. Permittee shall not in any way expand or increase the extent to which the Encroachment occupies any of the real property encumbered by the Easement without the prior written consent of Chugach.. Chugach has no obligation to provide such consent. • 6. No Interest in Real Estate Acquired. Permittee hereby acknowledges that the Encroachment and any additions thereto, even if in violation of this permit, has not and shall not in the future give rise to any interest or estate in the real property subject to the Easement or any other real property. Without in any way limiting the foregoing, Permittee acknowledges that the Encroachment is not adverse to any interest of Chugach and its continuation is entirely with the permission of Chugach for purposes of the common low doctrine of adverse possession. This permit creates no interest in the real property subject to the easement. 7. Modification of Utility Facilities. If the electric utility facilities located within the Easement are upgraded, added to, replaced or reconstructed, Permittee shall pay that portion of Chugach's total costs for such modification which is reasonably attributable to accommodating or preserving the Encroachment. If such payment is not made within thirty (30) days of written demand for same, Chugach may terminate this permit in accordance with paragraph 9, below. S. Covenants e Land. The obligations of the Permittee arising from this permit shall be covenants running with the land which shall burden the Parcel and the Perrnittee's interest in the land subject to the Easement and shall benefit the Easement 9. Termination. Chugach may terminate this permit after the giving of thirty (30) days written notice of such termination if. a. The Encroachment is enlarged, increased or extended within the teal property affected by the Easement Encroachment Permit - Page 2 of 4 E0 39t1d XOD AM 00E189Z 60:91 Z00Z/10/E0 b. The Encroachment is damaged by any means to an extent of more than thirty percent (30'/0) of its replacement cost at the time of destruction. C. Permittee fails to make the payment described in paragraph 7, above. 10. I=. This permit shall, if not sooner terminated by Chugach, expire forty (40) yeah from the date hereof. 11. Entire Agm ment. This written permit constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all other prior or contemporaneous agreements, oral or written, between the parties. No modifications, amendments, deletions, additions or alterations of the permit." be effective unless in writing and signed by all of the parties hereto. CHUGACH ELECTRIC ASSOCIATION, INC. PERMRTE.E Archer W. Bishop, Jr, and Sandra K. Bishop Lee ThibcM Executive Mer Aallss W. BKop, Fr. T&D Network Services Aw"W- Date• 3 `/ �Q Date: .a. •��'0� Date: "�-D • �"" Encroachment Permit - Page 3 of 4 00 3Oid >= AM -- 60E18SZ 60:91 Z00Z/IVE0 STATE OF A — N ) ) ss: THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this day of RPl^rv4el 200y3by Are -Ince- LIQ Mr-dra 3 hQP Notary PdWk in for the State of My commission expires: STATE OF ALASKA ) ) ss: THIRD JUDICIAL DISTRICT ) The forego' g instrumrn was acknowledged before me this / day of JAR C, by l td; [ I ; rn ean;eti� R Ac.'t,;nl Executive Manager, Transmission and DistributionNetwork Services of Chugach Electric Association, Inc.. an Alaska corporation, on behalf of the corporation. ,rpi A A�- !°L61�� 4 Notary Public in and for the State nfAlav�cao O ' jL My commission expires: ` % oe AFTER RECORDING RETURN TO: Chugach Electric Asaoclation, Inc. P.O. Box 196300 Aneborage, Alaska 99519-6300 f Encroachment Permit - Page 4 of 4 9; 00ETBSZ 60:91 Z00Z/10/E0 Parcel I.D. # MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVALFOR A SINGLE FAMILY DWELLING I r - O 1,5"— R V'V- — a.— HAA # � - 9 / r✓ �! 1. GENERAL INFORMATION Complete legal description Lot 3; C.2ean.view Subdivision; Location (site address or directions) 8000 Atatna Property owner John & Ma,P.i.nda. Roben.t6 Day phone 345-7102 Mailing address X000 Aeatwa Lending agency vay Piles"c Mailing address Agent Ray Dahp DYNAMIC PROPERTIES Day phone 279-7611 Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: XX Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XX Holding tank Community on-site Public sewer — NOTE: 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 #21 5. 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. I further verify that 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. Name of Firm Phone 40 =?%f 5 $ Et 4GINEERING Address ,1 giver Loop Road No Engineer's signature Eagle River, Alaska 99577 Date log •o• se•aa • •t • Na 1457 y' 6. DHHS SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for bedrooms; with -the following -stipulations: Additional Comments fi031W"fiWEP1 WVIA" CAUTION 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. 72-025 (Rev. 1/91) Back MOA 021 Municipality of Anchorage Department of Health &Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: oaf 4-J& t(h1l 5• �• Parcel I.D. A. WELL DATA Well typee ! If A, B, or C, attach ADEC letter. ADEC1 water system number Log present (Y/N) Date completed:d t,,114:186 Driller Y��b�a0'I�S Total depth 5r 7 Cased to 1 2 Casing height / Z f Sanitary seal (Y/N) Wires properly protected (Y/N) 4 Public sewer main `"r-" Public sewer manhole/cleanout - 11A Public sewer service line tJ 1j4 Petroleum tank ONe. n)owN WATER SAMPLE RESULTS: Coliform `-%6fAC- Qe Nitrate ���►MC-!Uf � Other bacteria Z e1,D Date of sample: Z7 Z ' (�( Collected by: B. SEPTIC/HOLDING TANK DATA Date installed �I __Z 8 -e ( Tank size / one) Gra Compartments Z Cleanouts (Y/N) Foundation cleanout (Y/N) Depression (Y/N) High water alarm (Y/N) 'T'Jq Alarm tested (Y/N) — Date of pumping --1- -1/ to*dome, SCI'V1 cC S SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Wel I(s) on lot too '+ On adjacent lots 100 f Foundation � 'f To property line to + Absorption field :E Water main/service line n Surface water/drainage / QC2 72-026 (Rev. 3/91) Front MOA 21 CONTINUED ON BACK PAGE FROM WELL LOG AT INSPECTION < a Date of testZ Static water level "' Z 0 a / n r- ? Well flow Z 9.p -m. g.p.m. C �- Pump level c SEPARATION DISTANCES FROM WELL TO: o Z Septic/holding tank on lot /00 t ; On adjacent lots ! OD t Absorption field on lot 100 t ; On adjacent lots 100 + Public sewer main `"r-" Public sewer manhole/cleanout - 11A Public sewer service line tJ 1j4 Petroleum tank ONe. n)owN WATER SAMPLE RESULTS: Coliform `-%6fAC- Qe Nitrate ���►MC-!Uf � Other bacteria Z e1,D Date of sample: Z7 Z ' (�( Collected by: B. SEPTIC/HOLDING TANK DATA Date installed �I __Z 8 -e ( Tank size / one) Gra Compartments Z Cleanouts (Y/N) Foundation cleanout (Y/N) Depression (Y/N) High water alarm (Y/N) 'T'Jq Alarm tested (Y/N) — Date of pumping --1- -1/ to*dome, SCI'V1 cC S SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Wel I(s) on lot too '+ On adjacent lots 100 f Foundation � 'f To property line to + Absorption field :E Water main/service line n Surface water/drainage / QC2 72-026 (Rev. 3/91) Front MOA 21 CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent(Y/N)u High water alarm level Meets MOA electrical codes (Y/N) Manufacturer Manhole/Access (Y/N) I at "Pump off' level at Cycles tested SEPARATION DISTANCE FROM LIFT STATIN TO: Well on lot D. ABSORPTION FIELD DATA On adjacent Surface water Date installed "- Z r C� Soil rating System type Length Zia -Width 3 6 Gravel thickness Total depth 1 s Total absorption area 3R O Cleanouts present (Y/N) V4 Depression over field (Y/N) N Date of adequacy test - H-51 Results (pass/fail) ko for 3 bedrooms Peroxide treatment (past 12 months) (Y/N) trR If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot f foo 't On adjacent lots I Inc t Property line / D * To building foundation (D ,f To existing or abandoned system on lot A JJA On adjacent lots 1 DD t Cutbank A I f 116 Water main/service line / O JI f Surface water JW f Driveway, parking/vehicle storage area 6;_0 Curtain drain 1J A E. ENGINEER'S CERTIFICATION 1 certify that 1 have checked, verified, or conformed to all MOA and HAA guidelines in effect s inspection. !� •..• •.• O• �•� i Iff X49 49, • Signature •, iia River Loop Road Na. 204 '.a Engineer's Name o y . ZZ' A? Datei-e 4 ` f '• Ar dW r HAA Fee $ 717-1) �� Waiver Fee: $ Date of Payment S� Date of Payment Receipt Number 7iZ�c -143q Receipt Number 72-026 (Rev. 3/81) Back MOA 21 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date 7 /3a 1ad- - 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) of 3 r'(ear hew S/D Location (address or directions) (b) Applicant Name Tattn Rcb e4r Telephone: Home -311,6-- 7r©z Business 2-71 -55 2? Applicant Address P GV o A t a s<rt Q A�eT_Anr h,&,- eq!e Atc 99j -z, - (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder ® ; Buyer ❑ ; Other ❑ (explain); (d) Lending Institution A (al ka r"1k a( &,,-2 k Telephone y9 — S29CA::> Address t v go atfa((cy (fid (e) Real Estate Company and Agent IV, h, Refr;7a/?crhq Address Telephone (f) Mail the HAA to the following address: 2. TYPE OF RESIDENCE Single -Family ® Multi -Family ❑ Other Number of Bedrooms 3 3. WATER SUPPLY Individual Well ® Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite 10 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. Page 1 of 2 72-025 (11184) 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION 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 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. I further verify that 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. Name of Firm rlc4D 1 ecAnica r Telephone —� Address %'��30 T;caro Sf r Ao+cliocew, , A 99stc Date Enginq,(�r OF A4 jr Q) 49TH •.-� a .*a O6 6609.6 .006 66f 66909 / I. THEODORE F. MOORE ;jr CE - 3589 .•' L Ar jr 6. DHEP APPROVA�` Approved for <' bedrooms by al-Y11lill'�L �' +` �" toLl 6 Approved Disapprove Conditional —� Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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. Page 2 of 2 72-025 (11/84) A. MUNICIPALITY OF ANCHORAGE (MOA) # �ALTH AUTHORITY APPROVAL (HAA) of H�\r_\A3, & CHECKLIST - FEBRUARY 1984 v1v`G14h\\�0? NEFeR��1ot 004 264-4720 M Op1,1N; NSP Nps, Legal Description: �Nv 1 WELL DATA Well Classification r rfOc�e If A, B, C, D.E.C. Approved (Y/N) N,A o.6 7,0 0'1 meers"rr Well Log Present (Y/N) i Date Completed ,A'eAe P,ned G� Yield » per Total Depth 5'GG Cased to l 2 ti' Depth of Grouting N, 4 Static Water Level = 2-3r7 Pump Set At y 2 ` Casing Height Above Ground i8 Sanitary Seal on Casing (Y/N) Y Electrical Wiring in Conduit (Y/N) K Depression Around Wellhead (Y/N) K Separation Distances from Well: To Septic/Holding Tank on Lot I ; On Adjoining Lots .> 100' To Nearest Edge of Absorption Field on Lot 13S' ; On Adjoining Lots 100` To Nearest Public Sewer Line N,A. To Nearest Public Sewer Cleanout/Manhole N• 1$• To Nearest Sewer Service Line on Lot A. Water Sample Collected by >^ � 1 ; Date 7 / ZB 186� Water Sample Test Resultsy — no Colr�'em o� o�cr bcrC�rr ` Comments Ncw l �vr well deeAe�inw ccA16,c4e--< I IJ B. SEPTIC/HOLDING TANK DATA Date Installed 9/ 2 S / Size I UGo 10 / No. of Compartments Standpipes (Y/N) Air -tight Caps (Y/N) Y Foundation Cleanout (Y/N) N Date Last Pumped 712 q %8K - Depression over Tank (Y/N) P Pumping/Maintenance Contract on File (Y/N) N(A• ; for N(A, Holding Tank High -Water Alarm (Y/N) N, A. Temporary Holding Tank Permit (Y/N) n,� Separation Distances from Septic/Holding Tank: To Water -Supply Well 125 ` To Property Line '> 1Q To Water Main/Service Line Course Comments Page 1 of 2 72-026(11/84) To Building Foundation i i✓s' To Disposal Field To Stream, Pond, Lake, or Major Drainage C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata I t3 Cf `/B�(rin Type of System Design TreaC �S Date Installed 9/2& /b 1 Length of Field e,5" Width of Field �6" Depth of Field 111 + Gravel Bed Thickness 7..5 Square Feet of Absorption Area 390 Standpipes Present (Y/N) Depression over Field (Y/N) N Date of Last Adequacy Test 7/ 22 /8< Results of Last Adequacy Test Ale a ctet Separation Distance from Absorption Field: To Water -Supply Well 13S ` `` To Property Line O ! To Building Foundation q 7' J52001C- 0 • f 30 ` S111rn 17ear���ns) To Existing or Abandoned System on Lot N114• ; On Adjoining Lots 301 \ To Water Main/Service Line hi A. To Cutbank (if present) NIA, (Sys 4MI ^T -W s ©fie J To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION N,H Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) _ Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at ** Check Permitted Bedroom Rating Against HAA Request ** Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed �C-ct`•r"�-- Date Company FlefLA4 %cj��ar/ S4r MOA No. S5''OS Z Receipt No. G 0 /�4 Date of Payment436/a :�Q� .• •s,��� % Amount: �l •9 Engineer's Seal DD '*49TH e o ........................., a..................;... THEODORE F. MOORE ; 0 Page 2 of 2 ®# .•.• CE - 3589 % Ar All lk 72-026 (11,84) Pri>f$SSifft♦� Time J Time ie Date Date Date Inspector Inspector Inspector Comments Conditional Approval 0,2; ....... ,, .. m 1-1 A,,7 ovad Bedrooms ( ) C^-d:tlonal Approval Cate (a Date Sewer Installed Permit No. Septic Tank Size �dc� Holding Tank Size Soils Rating I Well To Absorption Area Well Log Received Well to Tank APPLICANT FILLS OUT LOWER HALF ONLY Property Owner D. Phone Mailing Address '70! Ak i c/ 5 /3 Buyer SA m „ Address Lending Institution 44av"I C' '1`1-r4 Phone -7 -Z' Cwci, Address Realty Co. & Agent Phone Address Legal Description 3 v( LL 5 j ' +:S ""j Street Location TypeResidence Single Family 3 ❑ Multiple Family No. of Bedrooms ❑ Other Water upply Individual ATTACH 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 if ❑ Public Utility available. Sewqge 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. April 27, 1962 John D. and Malinda S. Roberts 701 C 5t., Box 46 Anchorage, AK 99513 Subject: Lot 3, Block 1 Cleaview Subdivision Approval for the individual sewer and water facilities cannot be granted until the following .items have been completed: Exposed electrical wires to the well head are in violation of the Municipality of Anchorage codes and must be encased in conduit. ° The water analysis report needs to be submitted to this office from the Chem Lab, 5633 B Street, for our review. A four (4) inch cast iron cleanout needs to be installed to the septic tank and/or leaching area. 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. Sincerelyi, r Robert C. Pratt Associate Environmental Specialist RP90/p/EH