HomeMy WebLinkAboutQUIET WOODS LT 6FQuiet Woods
Lot 6F
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ANCHORAGE. At.ASKA 99502-0660
(907) 264-4111
DUARTIIENT q: 11! AI: rI 1 NVIRONLIENT AL PHO 1 f. CT ION
:Permit #: 820398
•January 31, 1983
TO: Permit Applicant
Subject: Lot 6F Block 8 Quiet Woods Subdivision
A permit issued by this department for an individual well
and/or on-site sewer system has expired as of December 31,
1982.
Permits are issued on a calendar year basis, as stated on
the permit, by authority of Municipal Ordinance.
If you have drilled the well, a well log needs to be sent
to this department for documentation of the installation
date and to close the permit.
If a private engineer inspected the installation of the
on-site sewer system, please have them send us the as-builts
for our files and documentation.
If there are any further questions, please call this office
at 264-4720.
Sincerely
QU"'li-
Robert C. Pratt, R.S.
Acting Program Manager
Sewer and Water Program
RCP/ljw
enc: Copy of Permit
SWP/057
t1L1tyl I C I F Fl L_ I T toF Fltar �F:I=i rEE:
DEPARTMENT HEALTH WE) ENVIRONMENTAL 'OTECTION
825 'L STREET, ANCHORAGE, AK.. 99501
264-4720
ILIELL F'EF:t'1 I T
PERMIT NO. < 820348 ?
APPLICANT HARRY A MACKEY SR142BOYl 6365 CHUGIAK 688-2813
LOCATION WILDWOOD ST ER.
LEGAL L6F 68 QUIETWOODS LOT SIZE 12060 SQUARE FEET
MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEI-JRGE DI_POSAL SYSTEM IS
100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL.
MINIMUM DISTANCE FROM A PRIVATE IJELL TO A PRIVATE SEWER LINE IS 25 FEET AND
TO A COMMUNITY SEWER LIME IS 75 FEET.
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DRYS
OF THE IJELL COMPLETION.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
F•EF:rl I T E:.XF• I FR:E:E: L�EGEt•7E'•EF: = Z: 2'_^
I CERTIFY THAT
1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND IJELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I HILL JS ALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
APPLICANT HARRY AMMACKEY /
14
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Time
APPLIC�VT FILLS OUT UPPER HACONLY
Property owner
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Date
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Zip Code'
-76-7167
Mailing Address
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Date
Buyer
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Address
Zip Code
Inspector
Lending Institution/�
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Phone
Address
Zip Code
DEPT. OF HEALTH r
Realty Co. 6 Agent
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Phone
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Adtlress
C Zip Code
Legal Oescript n
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Street Location
( APPROVED BEDROOMS LL
Type of Residence
Family
r
( )DISAPPROVED
Pr9ingle
( ) CONDITIONAL APPROVAL'
❑ Multiple Family
No. of Bedrooms
DATE
❑ Other
8Y:
Water Supply
. Individual
,
ATTACH WELL LOG. A well log Is required for all wells drilled
since June 1975.
❑ Community
/�
\`
For wells trilled prior to that data. give well depth (attach log
If available).
❑ Public Ulltity
�.
Well to Tank
Sewer Disposal
f1 Wlvidual
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.
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Time
Time
Tim
Time
Date
Date
Date
Date
Inspector
Inspector
Inspector
Inspector
(CIPA M OF A)` CH61ZAf:r
Field Notes:
DEPT. OF HEALTH r
t70
JU,:
( APPROVED BEDROOMS LL
'CONDITIONS OF
APPROVAL
( )DISAPPROVED
( ) CONDITIONAL APPROVAL'
DATE
8Y:
Solis Rating
Date Sewer Installed
Well To Absorption Area
Well Log Received
Septic Tank Size
Well to Tank
�z CM