HomeMy WebLinkAboutSPENARD HEIGHTS ADDITION LT 17� c'k s
PA
Ir, MUNICIPALITY OF ANCHORAGE
On-Site Water&Wastewater Program �� 5
PO Box 196650 4700 Elmore Road
Anchorage,Alaska 99519-6650 Phone: (907)343-7904 Fax:(907)343-7997
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On-Site Water System Permit
Permit Number: OSP171259 Effective Date: 9/11/2017
Work Type: Well Initial Expiration Date: 9/11/2018
Tax Code Number: 01205221000
Site Legal Address: SPENARD HEIGHTS ADDITION LT 17 G:2026
Site Mailing Address: 3839 W 63RD AVE, Anchorage
Owner: MITCHELL VICKIE L & SWAFFORD WILLIAM Lot Size in Sq Ft: 17438
Design Engineer: Total Bedrooms: 4
This permit is for the construction of:
❑ Disposal Field 0 Septic Tank ❑ Holding Tank ❑ Privy El 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
Special Provisions:
To close out this permit, please provide the following:
1. Well log
2. Pump install log
3. Water sample results for total coliform, nitrates and arsenic.
Received By ,.0 c,; Date:
•
Issued By Date: ifuoi
i'VIUN C PAL TY • F ANC ORAGE
S
Community Development Department j s/ 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. fit` Dc--‘g, ;2.,(COO
Property owner(s) idr. _ cc xi b Q Day phone q07,550 S.(Y
Mailing address . s3Ck (,A.c(23L° A
Site address 'SS-Sill U3 tsz32 ,4f
Legal description (Sub'd., Block & Lot) tk AvcQ \fe:vesiits t,.JockithiCon Lot / 7
Legal description (Township, Range & Section)
Lot Size Sq. Ft. Number of Bedrooms _ L1
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
{a all that apply)
Absorption Field ❑ Initial Single Family (SF) ru
Septic Tank ❑ Upgrade ❑ (w/wo ADU)
Holding Tank ❑ Renewal Duplex (D) ❑
❑ 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.
• , 4
(Sig'a ure o pro.-.;1111 er or authorized agent)
Permit/Rush Fees: 21 54111 Waiver Fees:
Date of Payment: q/I/7 Date of Payment:
Receipt Number: 2 f Scigy Receipt Number:
Permit No. 3 P1 w,2s Waiver No.
Permit App_9-1-12.doc
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LEGEND: \ \ I
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———-LOT EASEMENT LINE GAS AND OTHER UTILITY LOCATIONS ARE APPROXIMATE. I (€.)-1
-SS--SEWER LINE SETBACK CALL 811 FOR LOCATES PRIOR TO DRILLING.
- S SEWER LINE SEPERATION DISTANCES AND SETBACKS PER / -6.
- -UNDERGROUND GAS LINE AMC 15.55.060 TO BE VERIFIED BY DRILLER I
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SPENARD HEIGHTS SUBDIVISION DRAWN BY: PS
CHECKED BY: SC
En-91 ''tert-1 IC LOT 17 DATE: 08/30/2017
caclllfrdvte oepLwtL,geuwey,y JOB NO: 15064
250 11 Street WELL SITE PLAN
Anchorage..AK:9.501 SHEET NO:
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LEGEND;
9 -PROPOSED WELL
O -SEWER MANHOLE LOT 18 LOT
75'SEWER MAIN
i'/ -POSSIBLE WELL LOCATION SETBACK 19A
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.-PROPOSED WELL BUFFER
----LOT EASEMENT LINE GAS AND OTHER UTILITY LOCATIONS ARE APPROXIMATE.
SS -SEWER LINE SETBACK CALL 811 FOR LOCATES PRIOR TO DRILLING.
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S -SEWER LINE SEPERATION DISTANCES AND SETBACKS PER
-UNDERGROUND GAS LINE AMC 15.55.060 TO BE VERIFIED BY DRILLER
LCG SPENARD HEIGHTS SUBDIVISION DRAWN BY: PS
CHECKED BY: SC
ant ..I"1 Inc LOT 17 DATE: 08/30/2017
a cl. echAte•ewi.ieeti.iq•ac,xoeyng JOB NO: 15064
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,Y- , ?POST IN A CONSPICUOUS PLACE
y I I.`ti ,. SEWER CONNECTION APPLICATION&PERMIT 1 gees`
te` GREATER ANCHORAGE AREA BOROUGH
-cam' 3500 TUDOR ROAD ANCHORAGE.ALASKA 99507 S.S.A.
' BOOK PAGE LOT SUBDIVISION GRID LOT , BLOCK
E 012 052 21 ..Spenard Heights 2026 17 2
CONNECTION STREET A LES
8839 West 63rd Avenue
CITY
j�E��.}�/�y fTLE STTAA,TE ZIP CODE Ir�i31AN0 LAT IMP. 1STNO.
Anchorage, AFr L.I.O. 7#
• PROPERTY OWNER NAME
i Vern. Rosch
PROPERTY OWNER ADDRESS '
230t) East 88th Avenue
CITY ra STATE
At.ZIP CODE PHONE CONNECDT�IONI DAZE
Anchorage,
lly..l i Y�.f 344-9422 1/{f�]I'J 1 F� I
NESS.. APT. NO.UNITS CONNECTION INFORMATION
!^ SI2E INCH/C O REF
CONNECT TO TRUNK CONNECT TO LAT. I
YES El NO 0 YES El NO El .
CONNE CTION,LOCATION .
I SERVICE STATUS
TRUNK SERVICE PROVIDED BY IAGENCYI,
. LATERAL ASSMT.: TRUNK ASSMT.: CON 4 CTIA/FEE: •
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DATE PAID • DATE PAID 1 AMOUNT PAID r 0113
+ CONNECTION
FE¢?AI �`NECT FE IBC IVDBYI .. DATE:
'
La I 23/74
Ia ddAGE1CONNECT AG • n:IA OUNT DEPOSIT AY OEPOST� .
CTVNT t - L.
MO.I OAT I YR. •
24 hour notice prior to inspccticn. x.11
09 PROPERTY 279-86136, ext. 231
PAYER NAME
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If: PAYER ADDRESS
CITY STATE ZIP CODE II
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BASIC PREM. TYPE ODE JBILI INDICATOR MEM
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BILLING AGENT I RATE CODE 11I ACCT NO
CUSTOMER BM1UNG NOME Il BILLING DATE
y DATE FWD.
T CORRECTED BILLING ADDRESS
CORRECTED BILLING ADDRESS
MM�gNTS
COhf°4I L,rvis /WO ei,n, __
FORM PW-023 {
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SEWER MAINTENANCE DEPT.
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