HomeMy WebLinkAboutEAGLE RIVER VALLEY RANCHETTES LT 14CEagle River
Valley
Ranchettes
Lot 14C-
#050-222-08
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http://www.muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP231290
Work Type: Septic 1 V 'P C,) ('p
Effective Date
Expiration Date
Tax Code Number: 05022208000
Site Legal Address: EAGLE RIVER VALLEY RANCHETTES LT 14C G:0054
Site Mailing Address: 18807 MAN O WAR RD, Eagle River
Owner: NEXT LEVEL POSSIBILITIES LLC
Design Engineer: FORGE ENGINEERING
This permit is for the construction of:
❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy
�o%�»cnt
' d l
Department
10/6/2023
10/5/2024
Lot Size in Sq Ft: 17955
Total Bedrooms: 3
❑ Private Well ❑ Water Storage
All construction shall be in accordance with:
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 wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either: -
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
T_SS LC J +-U �O rq
Issued By: /fl& �iu� �'s Oail1 Sen
Date:
Date: 10���272
MUNICIPALITY OF ANCHORAGE
Community Development Department Phone: 907-343-7904
Development Services Division Fax: 907-343-7997
On -Site Water & Wastewater Program
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 050-222-08
Property owner(s) Next Level Possibilities LLC Day phone
Mailing address 1211 Business Blvd #204, Eagle River, AK 99577
Site address 18807 Man O War Rd, Eagle River, AK 99577
Legal description (Sub'd., Block & Lot) Eagle River Valley Ranchettes Lot 14C
Legal description (Township, Range & Section)
Lot Size 17,955 Sq. Ft. Number of Bedrooms 3
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(M all that apply)
Absorption Field ❑ Initial r] Single Family (SF)
x❑
(w/wo AD U)
Septic Tank Q Upgrade IX
El
(D)
Holding Tank ElRenewal ElDuplex
Multiple Dwellings
❑
Privy ❑ (SF and/or D)
Private Well ❑
Water Storage ❑
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees:
Date of Payment: D =' -zo 2
Receipt Number: 000 b
Permit No. 0-5 P2_3 12_S D
Permit App_::- : -
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
M.lnicipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE CON PUANC
OSP23129Q Curtis Townsend, 10106
October 5, 23
GE
E E R I N G
PO BOX 240773
ANCHORAGE, AK 99524
522-7773
677-7766 (FAX)
FORGECIVIL.COM
MOA Development Services, On -Site Water & Wastewater Program
4700 Elmore Rd
Anchorage, AK 99507
Subject: Eagle River Valley Ranchettes L14C - Man O War Rd
Septic tank replacement
Dear On -Site Services Engineer:
The owner of the above lot intends to build a 3 -bedroom home on the property, but there is an
existing septic system on the lot. We are submitting this permit application for the replacement of
the septic tank, which is approaching end -of -life. The attached site plan identifies the location of
the home, water service line, and, septic location. The new septic tank will also be a 1000 -gallon
tank.
Since this lot and all adjacent lots are on a public water system, there are no conflicts between this
proposed tank and any well. The new tank will be a minimum of 5' away from the septic fields
and 10' from the home foundation. Please refer to the attached plan for the septic design. If this
design is followed, there will be no adverse impacts to adjacent properties.
Sincerely,
t
Benjamin Schiller, PE
it
s!t ter and Wastewater
EAGLE RIVER VALLEY RANCHETTES, LO t CODECOMPUAN!
OSP231297 Curtis Townsend, 10/0
E NG INING
OF A.sk �o
Benja i Schiller
`�'F�• CE 2592 .•k`v�%
8125123
FESSIONa�
LOT 14-A
MAIC O WAR STREET
SEPTIC PLAN
0 20 40
ME FEET
1.1=20'
NOTE:
THIS PROPERTY AND ALL SURROUNDING PROPERTIES ARE ON A
PUBLIC WATER SYSTEM.
CO - CLEANOUT
2CO - DOUBLE CLEANOUT
FCO - FOUNDATION CLEANC
DV - DIVERTER VALVE
FS - FLOW SPLITTER VALVE
MH - MANHOLE
MT - MONITORING TUBE
SV - SEPTIC VENT
TH - TEST HOLE
Municipality of Anchorage
Department of Health and Human Services
�- Building Safety Division
On-Site Water and Wastewater Program, 4700 South Bragaw Street
P.O. Box 196650 Anchorage, AK 9951916650 Pagel of 3
www.ci.anchorage.ek.us (907) 343.7904
ONSITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number SWSW040116 PID Number 050-222-08
Nwnv
Wastewater System: ❑ New ® Upgrade
Address:
ABSORPTION FIELD
Ph" Numo.r Of Bod o
19 DW Trwch 0 Stan" 0 Bal O Maw° O Odw:
LEGAL DESCRIPTION
Soditfi
Total Depth rrom"rolW**
BIG& Lot, SuO"N
Doom to ppe bona" can aq�r Ond.:
DrwnM deph Dwr.lh pp.:
Tamp pr W: Hada":
Fi~fibv. or9nal?.d.:
Gmm Lrge[
Welt•. ❑ New Upgrade
Numbvo'"'
Divanoobe firw.'.
Dd.arraoon IPrn.r., A B. Cir.Tar
DpT:
Coal b
Tar.O.apbon w..
Pip. Mat"
Dray. 1
Dr. d+w:
SWie www L.
Ft
h.W4r
Charlie arr
D.I. h.trbd
/912004
Y,wd Pare Set r: t;.wn0 flwplt ADo r GraaM:
cPM F,. p,
TANK
SEPARATION DISTANCES
O Septic t] Holding ❑ S.T.E.P. ❑ Other.
To
Septic
Absorption
LM
Holding
ublio?rlvale
Mw.l.rmrw:
Cpwnr
From
Tank
Field
Station
Tank
Se Llne
Greer Tank & Welding1000
cr
Wall
200+
200+
280+
Lw.rw:
Steel
NM Wor6on wrnrww.
1
2
Sarao.wrw
100+
100+
LIFT STATION
La Lim
48.5
10.7
Sao:
Liw.xwdur
Got
F..
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26.1
'Pump ar lar* at:
•PWV ar loh K'
mv,"wwwmr.
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in
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50+
50+
Pmr Make & Model
El.a,;w h.p.,baM p.nam.d ar
Rw "
2" r1old Insulation over tank 8 post tank lines
BENCH MARK
La wN D..apuan
Trailer Deck & Threshold
Aswwrd Eawatq
100.0 Ft
Engineers Stamp
♦♦ �
Inspections performed b Pannone Eng. Svc Dates: 1"719/2004
2n°07/0912004
�..... ..............3..... 0
Department of Health a d Human Services approval
• "' "" ""
♦ ( %Steven R. Ponnone: r.
Reviewed and approved by: Date:
1Nw. 1+981
•j�' ' Ho. CE 8149
L%
••°
PERMIT NO: SW040116 RECORD D RAW I N G P.I.D. NO: 050-222-08
WASTEWATER DISPOSAL SYSTEM
Lot 14C Eagle River Valley Ranchettes
I
15B 14A 4F0
14B
I I I I f
AREA I I
\_ I I
-------------- —---------------L -------------
--
---------- — —NO WE US W/----------- f - r ----------
IN 200 FEET EXIST'G 3BR 1 4 C � EXIST G 8 AC WATER
v I LINE.
TRAI ER I I NO WEELLS W/
PIN 200 FEET
EXIST' 1000 g I I PROPOSED 1000g
SEPI C TANK. I I I SEPTIC TAN
15D ABANDONED 14 PLACE i A {� I DNERTER VAtVE
14 D
DC' 4 I I (DV)
EXIST'G CRIB 0 BE T FLOW SPLITTER
R USED v (FS) SEPTIC
NOTES: C C3 1 (AREA
1) All work shall be performed 8.5
, II III I
in accordance with AMC15.65. M I.II II NEW SYSTEM — 2EA
VEWAY E� 1 III III 2 II 1 30LFx5'ED, 9TD
2) Materials used shall be in 1xw �1 1 60LF TOTAL
accordance with those C2 1(17
specified in AMC15.65,
Wastewater Disposal. ZTH
3) Connect post tank line to MAN ❑ W
start of drain field, typical. I
4) Maintain 10' separation to CO A B
all lot lines and existing water DCl 21.0 37.6 NO WEELLS W/
lines. TI 28.2 32.9 IN 200 FEET 1
DESIGN:
5) Lots served by a DC2 37.7 28.8 SEPTIC 11 I PERC RATE: 10.5 MPI
community well. No wells DV 40.0 28.3 f AREA 11 I APPLICATION RATE: 188 SF/BR
within 200' of proposed FS 51.1 28.1
system. C1 48.0 29.8 11 10.8 GPD/SF
��������441, MI 59.1 48.0 II 1 3B HOUSE
II 1 REQ'D AREA: 564 SF
���•�� .....•. �1 C3 62.1 26.1 11 1 5' EFF'T DEPTH, 60 LF X 9' T.D.
II 1 600 SF TOTA
-leo
, M2 72.5 44.9 1000 GAL. SEPTI T
r ;1�. C4 78.6 57.0 5 A 11 I
' TM h I
e..... .............. ..t.....
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• PREPARED FOR: PANNONE ENG. SVC LLC
:Steven R. annone i
��� • ;��. Ms Zenda Harris P. 0. BOX 102954
♦ ': No. CE 8149
Au
Q��u 18807 Man—O—War Drive ANCHORAGE, ALASKA 99510
�♦ Anchorage, AK 99577 _
�1•,,,,�•... 441-9263 DATE:7105720, 272-8218 Fax
t� ,, RECORD
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NO WATER ON 7-10-04
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NOTE: 2' RIGID M9ULATION
OVER TANK AND POST -TANK
LINES.
SECTION
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Permit Number: SW040116
�HIOJ v 11,ocb
MUNICIPALITY OF ANCHORAGE
Development Services Department
Onsite Water& Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519.6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Initial
Date Issued: May 12, 2004
Expiration Date: May 12, 2005
Parcel ID: 050-222-08
Legal Description: IEAGLE RIVER VALLEY RANCHETTES LT.-14C.i
Design Engineer: 0062 Pannone Engineering Services Site Address: 018807 MAN -O -WAR RD
Owner Name: Zenda Harris Lot Size: 17955 SO. FT.
Owner Address: 18807 MAN O WAR ROAD Total Bedrooms: 3 Permit Bedrooms: 3
EAGLE RIVER. AK 99577-8336
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.
Date:
Issued By. dli Date:
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.enchorage.akus
(907) 343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. Permit Number SW
Property owners) Ms Zends Harris Day phone 411.9263
Mailing address (1)18807 Man -0 -War Road
Mailing address (2) Eagle River. AK Zip Code 99577
Legal description (Lot, Block & Sub'd.) Lot 14C Eagle River Valley Rancheftes
Legal description (Section, Township & Range)
Lot Size 0.48 Acres7Sq.Ft.
THIS APPLICATION IS FOR:
Number of Bedrooms _3
Sewer Only Cl Well Only ❑
Sewer and Well ❑ Water Storage Cl
Sewer Upgrade ED
THIS PROPERTY CONTAINS:
Hot Tub Cl Jacuzzi ❑
Swimming Pool ❑ Water Softening Unit ❑
Therapy Pool ❑
1 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 property owner or authorized agent)
Permit Fees:
Date of Payment:
Receipt Number.
(Rev. 12W)
Waiver Fees:
Date of Payment
Receipt Number:
Pannone Engineering Sert4ces, LLC P.O. Box 102954
Consulting Engineers Anchorage, Alaska, 99510
19071272-8218 (907) 272-8218 Fax
May 8, 2004
Municipality of Anchorage
Development Services Department
On -Site Water & Wastewater Program
4700 S. Bragaw Street
P. O. Box 196650
Anchorage, Alaska 99519
Subject: Lot 14C eagle River Valley Ranchettes
Septic Field Replacement Permit
Gentlemen:
My firm was contacted in regards to a failed septic field at the above referenced lot. The owner
has indicated the field is completely failed and sewage is spilling onto the ground. There is an
emanate health threat. The tank is being pumped on a daily basis to prevent back up of sewage.
I am writing to request an immediate issuance of a septic field replacement permit for this lot. A
single test hole was excavated on May 3, 2004 on the lot. The soils report and a percolation test
result are attached for the test hole. No bedrock or ground water was encountered in the test
hole.
The lot is approximately 0.48acres in size and is served by the AWWU Community Water
System. Lot 14C slopes to the south at approximately 1 to 2 percent in the area of the septic
system. The proposed installation will be located in the southern portion of the lot. A new 1000 -
gallon septic tank will be installed to serve the new drain field. The existing drain field will be
left in place and connected via a diverter valve for future reuse. The existing tank will be crushed
and abandoned in place. Both systems are located greater than 200 feet from any wells serving
this lot and water system. The proposed location is greater than 10 feet from the water service
lines. The other surrounding wells are located greater than 200 feet from the proposed
installation. The proposed installation will not affect the future development of the surrounding
or existing lots. See the attached design.
If you have any questions or concerns, please contact me at 227-3522 or 272-8218.
Sincerely,
Steven R. Pannone, P.E
Attachments:
PERMIT No: DESIGN DRAWING
WASTEWATER DISPOSAL SYSTEM
Lot 14C Eagle River Valley Ranchettes
158
Wv-- ---"W----W-
WO---
—� Ew/ ----- -- C
IN 200 FEET I1
EXIST'G 38R
TRAI R I
EXIS 000gI Y
SEPTIC TANK..
WDON IN ol.ACE
EXIST'C CRIB IN
FAILURE. TO BE
P.I.D. NO: 050-222-08
1 4 B
1
I
I
1
I
I
I
L------------
Y EXIST C 8------------
AC WATER
UNE.
1 NO WEELLS W/
IN 200 FEET
(-PROPOSED 1000g
I SEPTIC TAN
LDIVERTER V
R VJLV
NOTES: LkV
2 PROPOSED EA
1) All work shall be performed I 16.3 1 REPLACEMENT
in accordance with AMC15.65. 1 w II I SYSTEM - 2EA
VEWAY 1 I .3130LFx5'ED, 9'TD
2) Materials used shall be in 1Z Tal 16OLF TOTAL
accordance with those 2
specified in AMC15.65,
Wastewater Disposal. TH1
3) Connect post tank line to
start of drain field, typical.
4) Maintain 10' separation to
all lot lines and existing water
lines.
5) Lots served by a
community well. No wells
within 200' of proposed
i �
�s 49TM
wen R. Panno
No. CE 8149
0
N ❑ W
NO WEELLS W/
IN 200 FEET
/SEPTIC
II
1 PERC RATE: 1-5 MPI
/ SEA
11
1 APPLICATION RATE: 125 SF/BR
11
1 1.2 CPD/SF
II
1 4 SR HOUSE
Il
1 REO'D AREA 500 SF
11
I RF -0.58
5 A0
U
1 3' EFF'f DEPT�bO}�j X 6' T.D.
1300 SF TOTAL TUC 1 1250 CAL SE
p
I
LFAKLU rUK: PANNONE ENG. SVC, LLC
Ms Zendo Harris P. 0. BOX 102954
18807 Mon -O -war Drive ANCHORAGE, ALASKA 99510
Anchorage, AK 99577
441-9263 227-3522 P. 272-8218 Fox
DATE_ 5-8-04 DESIGN
PERMIT NO:
DESIGN DETAILS
P.I.D. NO: 050-222-08
WASTEWATER ABSORPTION SYSTEM
Lot 14C Eagle River Valley Ranchettes
NOTES:
1) ALL WORK SHALL BE PERFORMED
IN ACCORDANCE WITH, AND ALL MATERIALS
SHALL CONFORM TO. AMC15.65.
2) MAINTAIN 30' SEPARATION FROM ALL
SLOPES GREATER THAN 25%.
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•PREPARED
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i
FOR:
Ms Zendo Harris
Pannone En g. Svc., LLC
♦ F
♦: • 810.49
P. 0. BOX
♦ ,+' �ii
18807 Man -O -war Drive
E.102954
ANCHORAGE, ALASKA 99510
ALAS
441-9263 AK 99577
272-8218 PHONE &FAX
DATE,
5-6-04 1DESIGN
NOT TO SCALE
U
SOILS LOO - PERCOLATION TEST
PANNONE ENGINEERING SERVICES
P.O. BOX 102954
ANCHORAGE. AK 99510
(907) 272-8218
PERFORMED FOR: Ms Zenda Harris DATE PERFORMED: 5/3/04
LEGAL DESCRIPTION: lot 14C Eagle River Valley Ranchettes
TEST HOLE I SLOPE
OR Organks
1
2
3
4
5
6
7
g
9
10
It
12
13
14
IS
16
17
16
19
20
Su
Gw
am/SM
BOH
Brown silt w/
Sand
TEST
Sand 6 Gravel
well graded
�; 49LN
ven R. Pon
No. CE B1
Gravely, Sandy WAS GROUND WATER
SILTS with ENCOUNTERED? No
Cobbles 6 bolders
IF YES, AT WHAT
DEPTH? -0.
'
DEPTH TO WATER AFTER
MONITORING? Dry
DATE: 5-10.2004
bLum
TEST HOLE
READING DATE OROM
TME
NET
TINE
DEPTH OP
WATER
HLT
DROP
5-3-0 11:30
6'
1200
30
31/8-
2 7 6-
12:00
6-
-
12:30
30
31/8-
2 7
12.30
—
6'
-
1 X00
30
31/8-
2 7
PEROLATION RATE 10.5 (min/inch) 1
TEST RUN BETWEEN 6 FT AND 7 FT
COMMENTS: Test hole excavated by Charlie Barr Contracting. Test Hole was presoaked before perc test.
PERFORMED BY: Steven R. Pannone. P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDAI
GES-=�TER ANCHORAGE AREA BOR0�LC-YH
HEALTH DEPARTMENT 39
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
;; - cam' p/�j✓
rt L/ MAILING
NAME ADDRESS �Oii /rOl+ � PHONE
�yNrl— e5
LOCATION --Z n ��� /�'l�i4� LEGAL DESCRIPTION
sum
SEPTIC TANK:
NUMBER OF /
DISTANCE FROM WELL���%�'�' �l MATERIAL STC�L COMPARTMENTS
LIQUID F
LIQUID CAPACITY �Xzl� GALLONS. INSIDE LENGTH INSIDE WIDTH DEPTH
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS OUTSIDE DIAMETER "- OR WIDTH �� /, LENGTH / DEPTH /
LINING MATERIAL ��h���t%C ZZe—e, DISTANCE FROM WELL BBUILILDING FOUNDATIO •L
NEAREST LOT LINE �� TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
cJa 0 v7 SO. FT.
TILE DRAIN FIELD:
DISTAN/OFES—
ABSORP
NUMBE
DATION , N
LINES / TRENCH WIDTH
SO, FT. L%NGTH OF EACH
TOTAL LENGTH
OF LINES_
AL EFFECTIVE
TOP OF TILE TO FINISH GRADE 'BEPHOF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE
WELL'DISTANCE FROM%��24 DEPTH BUILDING FOUNDATION. SAMPLE -.WATER NEAREST
TYPE /�4�'-�''
NEAREST B
SEPTIC SEEPAGE v- OTHER 4�
LOT LINE SEWER LINE--TANK--SYSTEM CESSPOOL—. SOURCES_
DIAGRAM OF SYSTEM
DISTANCES:
t 1
F r
14
:
1 ;
DATE
GAAD-JID-2 IGREATEN ANCHORAGE AREA :)ROUGH CaseNo.
IIEALT11 DEPARTMENT
327 Eagle St. Anchorage, Alaska 99501 279.2511
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
A
NAME OF APPL
MAILING ADDRESS
!{0
RESIDENCE ADDRESS LOCATION OF INSTALLATI
%� U t
LEGAL DESCRIPTION 4 tA 0 10MA "gun-cC
-_ PHONE NO.6 =.253
APPLICATION TO INSTALL: SEPTIC TANKy' , SEEPAGE PIT , DRAIN FIELD , OTHER
TO SERVE THE FOLLOWING FACILITY 3
FINANCED THROUGH_ TO BE INSTALLED BY Eclat L
PERCOLATION TEST RESULTS ANTICIPATED DATE OF COMPLETION_ moi' P
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
THIS IS TO SERVE AS M0Al I `- *ZFt X 2 -, PERMIT TO INSTALL A _
AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED
, SEPTIC TANK SIZE X00 h TYPE APC SEEPAGE AREA TYPE
DISTANCES: �yy p(�
2 - A Ja Ce ac.r C_
-AU, c ,u e�
Health Authority
I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the
above described system is in accordance with said code.
% r
DATE APPLICANTS SIGNATURE
y
5. LEGAL DESCRIPTION
DATE RECEIVED
INSPECTION
APPOINTMENTS
6. TYPE OF RESIDENCE
NUMBER OF\BEDROOMS
TIME
❑ One ❑ Four ❑ Other
TIME
TIME /
❑ MULTIPLE FAMILY
W Three ❑ Six
7. WATER SUPPLY
❑ INDIVIDUAL'
DATE
[Kr COMMUNITY
DATE
OAT
depth (attach log if available.)
INSPECTOR
INSPECTOR
INSPECTO
❑ PUBLIC UTILITY
MUNICIPALITY OF ANCHORAGE
•
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
825 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 requests will not be processed. Please allow ten (10) days for processing.
1. PROPERTYOWNER
V
PHONE
!1 Q
MAILING ADDRESS
h 1 ,\
\ ` W
PROPERTY RESIDENT (If different
from above)
PHONE
�A
2. BUYER
^
PHONE
MAILING ADDRESS
3. LENDING INSTITUTI%
.i
PHONE
MAILING ADDRESS\
1
1
4. REALTORIAGENTPHONE
-
-
MAILING ADDRESS
10
5. LEGAL DESCRIPTION
C
STREET LOCATION
\
CU-`Jl
6. TYPE OF RESIDENCE
NUMBER OF\BEDROOMS
Q� FAMILY
❑ One ❑ Four ❑ Other
SINGLE
❑ Two ❑ Five
❑ MULTIPLE FAMILY
W Three ❑ Six
7. WATER SUPPLY
❑ INDIVIDUAL'
' ATTACH WELL LOG. A well log is required for all wells drilled
[Kr COMMUNITY
since June 1975. For wells drilled prior to that date, give well
❑ PUBLIC UTILITY
depth (attach log if available.)
B. SEWAGE DISPOSAL SYSTEM
INDIVIDUAL/ON-SITE"
YEAR ON-SITE SYSTEM WAS INSTALLED.
❑ PUBLIC UTILITY
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010 (Rev. 6179)
A
W
' THIS SIDE FOR OFFICIAL USE ONLY
1. 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
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM
❑INDIVIDUAUON -SITE
❑PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DATE INSTALLED
INSTALLER
CiLSeptic Tank or ❑ Holding Tank
Size: 100V If Tank is homemade
give dimensions:
SOILS RATING
TYPE OF TANK
MANUFACTURER
TOTAL ABSORPTION AREA
MATERIAL
4. DISTANCES
WELL TO:
Septic/Holding Tank
Absorption Area
Sewer Line
Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
CJ APPROVED FOR J BEDROOMS
❑ CONDITIONAL APPROVAL (letter must accompany certificate)
❑ DISAPPROVED
DATE
�'l�r�rt
BY .—
za-oin (nev.6/79I
1
EXCAVATION ROBERT A.SHAFER
WORK CIVIL ENGINEER
694.2979
August 30, 1983
Dynamic Realty
ATTENTION: Katie Nash
P.O. Sox 1796
Eagle River, Alaska 99577
.Dear Katie,
Reference: Lot 14C; Eagle River valley Ranchettes
A sewer system adequacy test was performed on the system located
on the referenced property, as you requested. The septic tank
was pumped and verified to have a capacity of 1000 gallons. The
seepage pit was charged with approximately 800 gallons of fresh
water and after a period of.24 hours approximately.:519-gallons..
had percolated out'of the crib.
It can be concluded from this test that the waste water disposal
system serving the three bedroom trailer located on this property
is currently functioning adequately.* However,'the system cannot be
:guaranteed against subsequent failure.
If.we may be of further service, please do not hesitate to contact
use
cc: Municipality of Anchorage
Department of Health and Environmental Protection
SRB 19GX EAGLE RIVER. ALASKA