HomeMy WebLinkAboutSPENARD HEIGHTS ADDITION LT 16 ,„H' ""'`,,F MUNICIPALITY OF ANCHORAGE v,-,,,,r
On-Site Water& Wastewater Program ` S�;
I1re PO Box 196650 4700 Elmore Road •
Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997
http://www.muni.org/onsite --
I)epart ii.•nt
On-Site Water System Permit
Permit Number: OSP171286 Effective Date: 9/27/2017
Work Type: Well Initial Expiration Date: 9/27/2018
Tax Code Number: 01205220000
Site Legal Address: SPENARD HEIGHTS ADDITION LT 16 G:2026
Site Mailing Address: 3819 W 63RD AVE, Anchorage
Owner: SINCLAIR JOHN S Lot Size in Sq Ft: 17438
Design Engineer: Total Bedrooms: 2
This permit is for the construction of:
❑ Disposal Field ❑ Septic Tank El Holding Tank El Privy Il 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.
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Received By: , Date: - if~ aI 7
Issued By: eQw Date: 7/2 7 2 0/ 7
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Community Development Department
^',! f 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. 0 I a. O 5 c O °O II /
Property owner(s) `�6�c. .ti 5i ; cel Ai(Z Day phone 9° 7 a 6 9 I e-{° yO
Mailing address 3 g 147 W 6 3 ! `4
Site address 5/3 o'N, c Aa4I ov r
Legal description (Sub'd., Block & Lot) 4L r orc-Q. )-.;�y�f s vt_e 4- 1 to
Legal description (Township, Range & Section) ,1
Lot Size Sq. Ft. Number of Bedrooms ("1--
APPLICATION
ZAPPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(tE all that apply)
Absorption Field E Initial B. Single Family (SF) J.
❑ (wlwo ADU)
Septic Tank
❑ Upgrade
Holding Tank ❑ Renewal Duplex (D) El❑ Multiple Dwellings ❑
Privy ❑ (SF and/or D)
Private Well E
Water Storage ❑ .
THIS APPLICATION INCLUDES A VARIANCE /WAIVER REQUEST FOR:
Distance:
I certify that the above information is co ect. I further certify that this is in accordance with
applicable Municipal Codes.
--2 .
(Signature property owner or authorized agent)
Permit/Rush Fees: l �j Waiver Fees:
Date of Payment: q
a/[Date G 61O Date of Payment:
Receipt Number: a 1 c7q a Receipt Number:
Permit No. ect.Ill - ,c Waiver No.
Permit App_9-1-12.doc
LOT 13 LOT 13
100'SEWER
SETBACK 200'EXISTING
WELL BUFFER
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N89° 57' 39"E 116.21
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, ,, LOT15
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LOT 17 0 /;,';•;/;,', LOT 16 ; /',';/'
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111 / // / / ,� / / / / ,/ ,/ / / O
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100' PROPOSED /',///'//,////,
WELL BUFFER > / / / / / y / ' / / ' / /
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I75'SEWER MAIN EXISTING il c..r) I
SETBACK HOUSE /
1 PROPOSED WELL w
SITE LOCATION MI . •
I /100'SEWER
R SETBACK /
I25'SEWER .; /
SETBACK I
1\ 589° 55' 50"W 116.21
'100'SEWER /
SETBACK
WEST 63RD AVE. /
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LEGEND: / 100'SEWER
0 —PROPOSED WELL _ , — . 1
SETBACK
0—SEWER MANHOLE
'://:";://-POSSIBLE WELL LOCATION ,��M,y below. 2� 1
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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. f1
-SEWER LINE SEPERATION DISTANCES AND SETBACKS PER
—UNLDERGROUND GAS LINE AMC 15.55.060 TO BE VERIFIED BY DRILLER i
1
SPENARD HEIGHTS SUBDIVISI N DRAWN BY: PS
C G ^ CHECKED BY: SC
ant-arli ID.0 LOT 16 DATE: 09/19/2016
250 II St ct
WELL SITE PLAN JOB NO: 15064
Anchor age.4K 99501 SHEET NO:
PARCEL# 01205220000 SCALE: 0 �
P 1907:243-N9S3
I-t90/)24:1-56291 '4°.
MUNICIPALITY OF ANCHORAGE SEWER 86 0 415
z. ,1CONNECT CONNECT PERMIT
•
E iiiiig.. , DATE OF APPLICATION 42.2/R(
e 1401.OF • SCHEDULED COMPLETION DATE
WATER&WASTEWATER UTILITY Q SINGLE FAMILY
,' 3000 ARCTIC BOULEVARD O MULTIDWELLING
PHONE 786-5557 No.APTS
2
0 COMMERCIAL
LOTlT�}A6T ! BLOCK 41- _ _ 0 INDUSTRIAL
SUBDIVISION 11E14174 g`0 14-E I!r H r,t
TAX CODE 0 12-6:Z-7-0 GRID 2O7-c. DRAWING No. 7g Z
i BUILDING ADDRESS 7 7 11 W ''' '' Ad
OWNER LIA s-1"114-1Z r, (.T t 0 C.Lr( A' L LCh Cr PHONE
MAIL ADDRESS 32 19 1.J &'3 4" AVE
CONTRACTOR:ILIA/4C..tet [^•LA ASSESSMENTS
• (License&Bond required)
yi ON PROPERTY ONLY 0 Main extension agreement
❑ MAIN TAP—TO PROPERTY LINE ONLY O Subdivision agreement
(MOA or State ROW Permit Required) 0 Extended connect agreement
' ❑ MAIN TAP&ON PROPERTY CONNECT 0 Pending
O R-O
((MOA-W orNO.State ROW Permit Required)
PERMIT ISSUED BY;
• CONNECTION SIZE 4 r! CHARGES
INSPECTION FEE S tO f lij PAID 0 CASH
PERMIT FEE S S - .n CKI i7
REIMBURSIBLE INSPECTED BY:
NUMBER DEPOSITS ,
TOTAL $ 1 J DATE: S.21i10
REMARKS. /`
PERMITTEE(Please Prmt)F. 4•-+rLCC C0 tr.7 it en t4►6}pN i
_ 24 ' L.*4c
MAIL ADDRESS 11.11 L ,( 2.101.I ! A k_ "t 1'= b r
•
I HAVE READ THE CONDITIONS AND REGULATIONS ON THE REVERSE SIDE OF THIS PERMIT AND AGREE
TO COMPLY WITH THEM f
i.
/ PE-MI TEE SIGNATURE
POST IN A CONSPICUOUS PLACE AT THE JOB SITE
Bei"R"mei
AWWU INSPECTOR
9 D -d L 9 —000 LOT:
f SUBDIVISION: 5pei,o led }j,e.;c h,_.5. ----,,77 ./1 BLOCK: 02 J(A
A 3$ ? 63 '6
iSTREET ALLEY
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.. .,..---.-.Z...'---.7.P.>:
}. Z V .Po
wit INDICATE
NORTH t
Lu
N SEWER SERVICE LINE SKETCH
u: SHOW LOCATION OF CONTROL MANHOLES/CLEANOUTS
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' SIZE MAIN: TYPE MAIN: CONNECT DEPTH AT MAIN CONNECT DEPTH AT Prop. Line _
d� ��—
,, CONNECT LOCATION:°Z II Wes-t- 0'F -.—(=VF
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Ili COMMENTS: Ty5&A I Pipe U C ' ech ihJ4o 2y.i57 /1,-'7 `7 �c��,
?`"T� INSPECTED BY: Alan r _!'I ;115` DATE: 5jalleec,
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