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HomeMy WebLinkAboutMINE'S END LT 93BOnsite File Mine's End Lot 93B PID# 075-093-59 (Formerly US Survey 3042 Lt 93A) • K Municipality of Anchorage; ® Development Services Department ^ Building Safety Division ' ^ • • • On -Site Water and Wastewater Program, 4700 S. Bragaw St. P.O. Boz 196650 Anchorage, AK 99519.6650 Page of www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SW 0503fofp PID Number: o'AS-093^- i+ Name. dim 6r aM Wastewater System: ❑ New ® Upgrade Address: 'PO Boy, 243 CirAWC4,AK `ii581 ABSORPTION FIELD IF Phone: Number of Bedrooms: -3 Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound ❑ Other. LEGAL DESCRIPTION $oil Rating: f.2 Total Depth from original grade: 5 G ,F� FI. Black: Lot: Depth lo pipe bottom tm raoriginal grade: Gravel depth beneath pipe: // ,�pSSubdiNsiu[ tA5 S'Ar Z 1 L7. 2 Ft. FI. Township: Range: Sedlom Fla added above original grade: Gravel LerlgM. 45 J FI. FI. L Well: ILKf4T1 ❑ New ❑ Upgrade Gravel width: 5 Ft, Numbwoflinea: Distance between lines: — Ft. classification (Private, ,C): Total Depth: Cased lo: Total absorption area: -r 345 Pipe Material: AszM - 303 FI FL FIs Duller. Date Odlled: Static Water Level: Installer. VISAN ConsT. Dale Installed: 1 1015105 Ft. Yield: Pump Set at: Casing Height Abe" Ground: TANK GPM FI. FL SEPARATION DISTANCES Septic ❑ Holding ❑ S.T.E.P. ❑ Other: To Septic Absorption Lift Holding PublicrPrivate Manufachaer. Capacity: [COO (OHO From Tank Field Station Tank Sewer line GNOQ GE _l< G.I. Wall } `p01 y Malarial: 5tQ.el Number of Compartments: % Surface Water N.0, AA _ LIFT STATION f 1 Size: Manufacturer. Lot Line i. `O } IQ '-� _ Gel. 1 f 'Pump are level at: 'Pump ofr I 1: High water alarm et. Fauntlallan } to j I �' in, in. in. Drain //11 N Pump Make a Model Electrical Inspections performed by: Curtain rt N A Remarks: f . _�_ Ink emid BENCH MARK Location an Description: Brei s f3allo1.. G /�c Assumed Elevation: Ft. q�y(C)o '��N� ��s�ed•eaRgs_ j 5 ki 4 Inspections performed by: L7ei5 Due a Dates: tat to ®5 2nd 1015 o 5 , K Development Services Departm nt A proval ,' F Reviewed and approved by: WY Date: —13-016,, (Rev.IL00J �f( r / yo eh\t INSTALLED NEW SYSTEM: 1000 GAL STEEL SEPTIC TANK f 5 f T Of£P 3.3 OOT ROCK = 3 FOOT COVER / I Tract A ABANDONED SWING TIES EXISTING SEPTICI , AC= 59' SC= 55.5' SYSTEM I' / I ' AD= 65' BD= 61.5' 11 Af= 71.5' B£= 68.4' A B / AF= 117' BF= 111.65' AG= 11&5 BG= 112 It if / ti 93 / WELL APPROX. 15.5 FEET ffl* PROPERTY LN!£ 10' CE Easement—�, Lot 93A ' I / �I 10' Gas Easement/ 20' Access Easement / 20' T&E Easement re Sore / QAl' .. t.I f' SPURKLAND �1 s No. CL -2 25 I� < 110pQ, f SSY ,60 2 P 25 50 75 Isar 125 150 ( 103 W a 7H. A rol LOT 93A US SURVEY 3042 I I SEPTIC SYSTEM ASBU/LTANCHI 203 W AK. AVENUE JIM BRAHAM DATE.• OCTOBER 27, 2005 107) AK. 9916 HOTTENTOT MINE ROAD SHEET. 2 3 GRID., 4812 /907) 279-39 f 6 an r 7 PERMIT # SVO50366 PID # 075-093-17 USSURVEY304293A2DVG 5-Wlde Trench 5' Wlde 48' Long 5' Deep 3,3' Sewer 3' Cover ELEV. = SH t NO SCALE ELEV.= 86.6' 3.3 Pt of Septic Rock Effecilve 0 0 � � 0 1000 gal Septic tank 3 c U Y � r.• Q j LC Monitor C(eanouts - - 3' Cover ECEV.= 93.5' NO SCALE ° ELEV = 80' 1000 gat, septic tank BENCHMARK BOTTOM OAS METER ASSUMED ELEVATION 100' I UBBLN NFUKKLAND F.L. 11LOT 93A US SURVEY 3042 I I SEPTIC SYSTEM ASBUILT 203 W15h Ave Anchorage Ak 99501 DATES OCTOBER 27, 2005 ?79-3916 H07TWO1 MINE ROAD SHEET+3/3 GRIDi 4912/5012 PERMIT I SWO50366 PARCEL ID / 075-093-17 USSURVEY304293A3.DWO / 94.0 Found 1" RPC LS -8218 �yott\\� Qd S6;,- S6�Sr1'p0 F T& oo , 989 Found 1 1/4" YPC 1-S- 10392 \ —20' T&E Easement \ 10' Gas Easement (Ser. No. 2001-088374-0) i/. i oQ ' 20' Access Easement ;2 �i Q� (Book 288, Page 263) ' CEA Easement (Book 2956, Page 252) h0N �C /N N N N / rCV 93 20' Access Easement (Book 288, Page 263) i i r , LSu 82118 RPC �' �' 10' Gas Easement 98'D (Ser. No. 2001-088374-0) / r r , N6�.J O s2. 46'1 "w 99' -015 i i l 20' T&E Easement / 107.0 Found 1" iron \ / Rod 0.4' A/OG eOk \ Ro4d \ JIM BFR AH AM 440 WEST BENSON BLVD. # 200 ANCHORAGE, ALASKA 99503 )RK ORDER NUMBER: GATE sGu JULY 27. 2005 1 1 03-S-05 NRB mEaaoJevaao 92 PFG 99.5 PROPOSED FINISH GRADE DRAINAGE EXCLUSION NOTES: It is the owners' responsibility to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. NOTE: It is the contractors responsibility to check top of foundation grade and building setbacks in relation to lotlines and esm'ts. M I SURVEY CERTIFICATION: LANTECH has conducted a physical survey of thl drawing and to the b abilities, all dimensior and correct. PLOT PLAN on OF: LEGAL DESCRIPTION: RB W/CAPD 51W RB O ALMON.MONUMENT & TACK p E— —X— X — HANG— r DECKS- RETE- 0 IALT— IC STANDPIPES—:F::2 R WELL— 0- 561-6626 — 561-6626 562-5291 PROPOSED LOT 93A, 1BElu Aa€ U.S.S. SURVEY 3042 d - 5_-C, r @ (a t 3� l MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade <!�P / �:3,I Date Issued: Sep 23, 2005 Expiration Date: Sep 23, 2006 Permit Number: SWO50366 Parcel ID: 075-093-17 Legal Description: US SURVEY 3042 LT 93 M3W2 TI ON R2E SEC18 Design Engineer: 0007 Tobben Spurkland, PE Site Address: Owner Name: JIM BRAHAM Lot Size: 10123 SQ. FT. Owner Address: PO BOX 243 Total Bedrooms: 3 Permit Bedrooms: 3 GIRDWOOD , AK 99587-0243 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 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 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. 5. The following special provisions. a.) Letter of non -objection for well in easement shall be submitted with the On -Site Wastewater Disposal System Inspection Report. Received By: Issued By: Date: 26 D ZZ =7 IMMIT Municipality of Anchorage o Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www. ci . anchorage. a k. us (907)343-7904 ON-SITE SEWERIWELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I. D. Iq Permit Number SW Property owner(s) Jinn Dro�Qrn Day phone '4133-22716 Mailing address Q.O. SOX 243` Gi,AwooA `tic 1950} Zip Code Site address 64t ,6k migm Rc . Zip Code Legal description (Lot, Block & Sub'd.) U 93A 1-15 SURVEY 3042 Legal description (Section, Township & Range) Lot Size 10, Q �) Acre Sq. F . THIS APPLICATION IS FOR: Number of Bedrooms Sewer Only [ Well Only ❑ Sewer and Well ❑ Water Storage El Sewer Upgrade hJ,/ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I 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/Rush Fees: `kpo - /VD Waiver Fees: Date of Payment: � 5/05- Date of Payment: Receipt Number: Receipt Number: (Rev. 09/04) Spaftoand EngoMee ong Environmental Consulting and Design SEPTIC SYSTEM DESIGN LOT 93A US SURVEY 3042 Municipality of Anchorage Development Services Department On Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, Alaska 99519 August 1, 2005 We are submitting an application for the installation of a septic system upgrade for this lot. The submittal consists of three (3) drawings showing the present improvements on the lot and the adjoining properties, (sheet 1/3), the proposed improvements of the lot, ofwhich only the septic system is subject to this permit application, (sheet 2/3), and a schematic of the septic system, (sheet 3/3). Soil logs and percolation tests of applicable testholes are also enclosed. The septic system design is based on the following: Replacement System Testhole 11 ft. deep No Groundwater Encountered Shallow Trench Soil Rating. From Testhole 7/18/05. 3.9 min/in = 1.2 gal per sq.8/day No. of Bedrooms 3 Required Area per Bedroom: 15011,2 =125 sq.ft. Total area required: 125 x 3 = 375 sqft Use 5 -wide System with 3.0 feet of Rock Length: (375/(5))'0.58= 43.5 feet Use 45 Feet SYSTEM CONFIGURATION 5 -WIDE TRENCH TOTAL LENGTH 45 FT TOTAL WIDTH 5 FT TOTAL DEPTH 5 FT ROCK DEPTH 3 FT COVER 3 FT SEPTIC TANK 1000 GALLON The installation of this septic system will not prevent wells and septic systems from being installed on the adjacent lots. There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots. The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. 203 West 15"' Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (907) 276-6013, SpurklandEng@gci.net 0 Lot 93A 9= Gm C 10D D No. 3p42 ti?� SuYJe`/ �bat�� pn 1m 150 / 200 250 300 �m = inn Fr 94 A 95A 95C 95a {S au49t /....h �............. ......... ........:....... ........... ioBB N SP n No. CE 2225 er)ml TOBBEN SPURKLAND P.E.920 I I LOT 93A US SURVEY 3042 90 I ( SEPTIC SYSTEM DESIGN 203 W 157H. AVENUE JIM BRAHAM DATE. AUGUSTS, 2005 ANCH. AK. 99501 HOTTENTOT MINE ROAD SHEET 1/3 GRID. 3243 (907) 279-3916 PERMIT / SW020XXX PID 016 -141 -XX USSURVEY304293A1.DWG PIMA. 31 '�'/� Lot 93A 9= Gm C 10D D No. 3p42 ti?� SuYJe`/ �bat�� pn 1m 150 / 200 250 300 �m = inn Fr 94 A 95A 95C 95a {S au49t /....h �............. ......... ........:....... ........... ioBB N SP n No. CE 2225 er)ml TOBBEN SPURKLAND P.E.920 I I LOT 93A US SURVEY 3042 90 I ( SEPTIC SYSTEM DESIGN 203 W 157H. AVENUE JIM BRAHAM DATE. AUGUSTS, 2005 ANCH. AK. 99501 HOTTENTOT MINE ROAD SHEET 1/3 GRID. 3243 (907) 279-3916 PERMIT / SW020XXX PID 016 -141 -XX USSURVEY304293A1.DWG l ton \ 10,T t IN�pTpALtEO Nf W SYSTEM: 15-W f TRfN SEPTIC TANKt i K 45,eB"f�T LgNG If" I \ L 5 5 FEET £EP 1 / ,'•�\ 3 FOOT ROCK 3 FOOT COVER L 5• \ f ;� T Tract A %ROOSEfj'� / < AGS' ! !'o / 10 ABANDON / EXISTING SYSTEM s 93 / 1 CE Easement---� Lot 93A ;X if 1 10' Gas Eas men 20' Acces asem/ent 20 T& asement� �.W,CE....... ISi.. \ tom,.••'' � � / regs4r •` 49th : .... O�\ N SPURKLAND �% No.�c -2 25 ti \ \ 25 0 25 50 75 IBS 125 150 \� I/amt AK. 995 1 TOBBEN SPURKLAND P.E. I I LOT 93A US SURVEY 3042 11 SEPTIC SYSTEM DESIGN I 203 W 15TH. AVENUE JIM GRAHAM DATE. AUGUST 1, 2005 ANCIL AK. 99501 HOTTENTOT MIN£ ROAD SHEET. 2/3 GRID: 3243 PERMIT # 5 -Wide Trench. - I H ; O 4 1000 gal Septic tank Cs w v z � o L5, 43 �W Long a Deep 3' Sewer rock 3' 5' Wide L5, 43 �W Long 5' Deep 3' Sewer rock 3' Cover Sil t 3FtofS Effective 49th iDCN SPURKLAND No. CE -2225 ND SCALE Si nr•rried�e TOBBEN SPURKLAND P.E.SEPTIC SYSTEM DESIGN 203 W15th Ave LOT 93A US SURVEY 3042 Anchorage Ak 99501 JIM BRAHAM DATE.- AUGUST 1, 2�5 .,,,, —., I/ nEwr aw ROAD SHEET, 3/3 PERMIT # SW0400XX PARCEL ID I XXX -XXX -XX USSURVEY304293AIM Municipality of Anchorage Development Services Department Building Safety Division Y T On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.danchorage.ak.us (907) 343.7904 Soils Log - Percolation Test Performed For: T' -- grZV,-arn Date Performed: 7/1812605 L=_al Description: lot 43A US SURVEY 3042 Township, Range, Section: ^ Depth (Feet 1- 2- 0 )1( 3- 1610, c. 1 0 "V 5- Ip1DI 6- t) /o 7- 12- 10- 17- 2C - Dlq S,ttyIsiir�y 'rrtimCI WAS GROUND NEATER �— ENCOUNTE.-sD? S IF YES, AT WHAT DEPiH? "" 0 De pth to Water After P Nionitoring? E ti.d.H. Date: 7/2(.105 Reading Date Gross Time Net Time Depth to N/ales Dle! Drs I � 18 11:22 I O 131it � tl;l8� �� 111:32 Ivm�n 13`t ZIf$u to /gam It 1t:92. 20 04;-i 113 /r- I t18 't 111:52- 130 min 13 t/ I Ol16tt 113/y" n 12:02 40 vh,n 13 %2 l l8 11117" I it 1 12: Ira 1 50vh,n 13 t/4 10 g/8 �� I 12:22 I 1 6r0.;,I Fc COLA, IOPI PATE FERC HOLE DIAf.IETE R TEST RUD19ENIMI 3 F. AND_FT �Dr: MENTS Pre Soak 4� l0.95 4w. PERFORMED BY: L ars Sf9 icklAAA I .tee &Lc�- CERTIF`( THAT THIS TEST V";AS PERFORMED IN ACCORDANCE WITH ALL STATE AND N !Ui IICIPAL GUIDELI ES IN EFFECT ON THIS DATE DATE: Z O 9075501630 TELALASKAOPERATIO TELALASKA OPERATIONS 12:13: 39 p.m. �11-22-2005 20 TeLklaska Inc. Operations Dept Outside Plant Engineering 201 E. 56th Ave Phone: (907) 563.2003 TOWNInc. 99518 Anchorage, AKPic (907) 550.1630 October 20, 2005 RE: Letter of Non -Objection Easement encroachment Lot93, U.S.S. 3042 Grid 4912/5012 Attn.: Jim Braham P.O. Box 243 Girdwood, Alaska 99587 To Whom It May Concern: TelAlaska, Inc. d.b.a. Eyecom in Girdwood does not have any facilities located in easement along eastern lot line of property Lot 93A, U.S.S. 3042 in Girwood, Alaska. Based on TelAlaska Inc.'s current facilities locations, future requirements, and actual location of private well located on property, TeWaska Inc. does not have any objections to easement variance for the private well on the above mentioned property owned by Jim Braham. If you have any questions of me or require any additional information, please contact me at 550-8682. Sinc e , � % Ro bi Nash. Outside Plant Engineer ACSM Alaska Communications Systems November 7, 2005 Spurkland Engineering Jim Braham 203 West 15"` Suite 203 Anchorage, Alaska 99501 ACS has no objection to the encroachment of the well, well house and deck into a platted easement located on Lot 93A, US Survey 3042, 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 bome 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, &regh Forema Outside Plant Engineering ACCEPTANCE: Grid # 4912/5012 KN)epaNneiN.De ILEC.OSP.EngimeflEngineeAFORMSINONOBJEC.DOC DATE: 600 Telephone Avenue Anchorage, Alaska 99503-6091 tel 907.564.1000 www.acsalaska.com A 2006-007058-0 A Recording Dist: 301 - Anchorage s 2/2/2006 3:17 PM Pages: 1 of 4 K A Illillllillllllllllllllllllllllillllilllllllllllillilllllllllllllllillllllllllllii 1 ENCROACHMENT PERMIT 1002-18C G-4912 EN05079 075-093-58 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 James H. Braham and Kathleen A. Peters, (herein "Permittee"), whose address is P.O. Box 243, Girdwood, AK 99587. 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 .S. Survey Number 3042, Lot 93A, according to Plat Number 2005-122, recorded on the 14th day of September 2005, 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 Southeasterly Twenty Feet (SE'ly 20') of Lot Ninety-three "A" (93A), U.S. Survey Number 3042 Subdivision, according to Plat Number 2005-122, recorded on the 14th day of September 2005, on file in the office of the District Recorder, Anchorage Recording District, Seward Meridian, Alaska, Permittee acknowledges the validity of the Easement. Permittee warrants 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 Ninety-three "A" (93A), U.S. Survey Number 3042 Subdivision, according to Plat Number 2005-122, recorded on the 14th day of September 2005, on file in the office of the District Recorder, Anchorage Recording District, Seward Meridian, Alaska, (herein "Parcel"). Page I of 4 I . Encroachment. Permittee has purchased or constructed the following improvements on or within the real property subject to said Easement: A well that encroaches approximately Five Feet (5') into said Easement for a distance of approximately One Foot (1'), a plywood well house with no foundation that encroaches approximately Six Feet (6') into said Easement for a distance of approximately. wo Feet (2'), (herein "Encroachment"). 3. Permit. Chugach hereby authorizes Permittee to continue the existence of the Encroachment in its 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. 5. No Expansion 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 law 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 pre -serving the Encroachment. If siu_•h navmant is npt madr tyithin thirty (In( rlavc nfjamtten demanyi for same, Chugach may terminate this permit in accordance with paragraph 9, below. 8. Covenants Running with the Land. The obligations of the Permittee arising from this permit shall be covenants running with the land which shall burden the Parcel and the Permittee'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. ia. The Encroachment is enlarged, increased or extended within the real property affected by the Easement. Encroachment Permit - Page 2 of 4 III IIIIIIIIIIIIII IIIIIIiil�illl�ll 2 of 4 2006.007058-0 b. The Encroachment is damaged by any means to an extent of more than thirty percent (30%) of its replacement cost at the time of destruction. C. Permittee fails to make the payment described in paragraph 7, love. 10. Term. This permit shall, if not sooner terminated by Chugach, expire forty (40) years from the date hereof. 11. Entire Agreement. 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 shall be effective unless in writing and signed by all of the parties hereto. CHUGACH ELECTRIC ASSOCIATION, INC. By: Edward M. Je 'n, P.E., Director, Engineering Services Division 9.- OZ _° 6 PERMITTEE By: i� 4 s ..--- James H. Braham Date: 1 /0-3 L0 6 1d4� Kathleen A. Peters Date:/ — O 3—UJ Encroachment Permit - Page 3 of 4 III IIIIIIIII IIII IIIIIIIIIIIIIIIII 3 of 4 2006.007058-0 STATE OF ALASKA ) ) ss: THIRD JUDICIAL DISTRICT ) 1 The foregoing instrument was acknowledged before me this day of PRINT PERMITTEES(S) NAME(S) STATE OF ALASKA ) ) ss: THIRD JUDICIAL DISTRICT ) %rte Jt ��CLGClU( ),�) ut ilt—e Nyi�ary ub�and for the State of Alaska My commission expires: /' �Thforegoing instrument was acknowledged before me thi 2 h j day of 200A by E(� Ll.)Q-l� P , irector, Engineering Services Division of Chugach Electric Association, Inc., an Alaska corporation, on behalf of the corporation. N ary Public in and for the State of Alaska V.� iaw-LE O My commission expires: Z/1 S 8 •'2 AFTER RECORDING RETURN TO: J)j 1Chugach Electric Association, Inc. P.O. Box 196300 Anchorage, Alaska 99519-6300 Encroachment Permit - Page 4 of 4 III IIIIIiIII I IIII Illilillllili I III 2006-007058-0 ., i MUNICIPALITY OF ANCHORAGE i 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- —//T—�— Y[)� /6 6i�0�4 PHONE 1:1 NEW [3-WGRADE MAILING ADDRESS max Y�'� G,e�iu®o LEGAL DESCRIPTION LOCATION ` 0 rTEa% 7'— A,1 6f,/2druvv NO. OF BEDROOMS UY DISTANCE TO: Well Absorption area I Dwelling -!U �' PERMIT NO. O'0®YSS F Z w tQ- Manufacturer l'LGrC�(� Materi No. of compartmentsh e 4 y Liq. capacity in gallons /000 IF HOMEMADE: Inside length Width r Liquid depth Y Jaz DISTANCE TO: Well Dwelling PERMIT NO, 2 Z FQ- Manufacturer - Material Liquid capacity in gallons O W = DISTANCE TO: Well / Foundation ( Nearest lot line ( PERMIT NO.+ GOYSS J LL Z F Z w No. of lines Length of eac I� e3 ) 'P Total length of lines 31' Trench width ,f 0 inches Distance between line��/ , / F o Top of tile to finish grade J of f Material beneath the r3e#Rs �/ Total effective�orption area w Length Width Depth - PERMIT NO. <I- wa Type of crib Crib diameter Crib depth Total effective absorption area - w vJ Well DISTANCE TO: Building foundation Nearest lot line Class.- Dgpth .1 V -moi !U /� On ' Distance to lot line PERMIT NO. . w � DISTANCE TO: Building foundation S war me Septic tank Absorption areals) OTHER PIPE MATERIALS C x -i-- ltrr c SOILTEST RATING INSTALLER REMARKS Fx/sT,yU__ 0 Q& RO 4�t A," �FNs�% moo i �i APPROVED DATE LEGAL - .. 72-013 (Rev. 3/78) PERMIT NO. h91J t-.1 I C= I � DEPARTMENT HEALTH AND ENVIRONMENTAL ECTION 825 'L' STREET, ANCHORAGE, AK. 99501 q;3Q 864-4720 ID"—:S I TE S-EL4EFZ Fz'EF:?M 7- < C 300455 U APPLICANT DICK REDMOND BOX 433 GIRDWOOD �� f LOCATION TOT SS LEGAL 0LOT - ZE S TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING'<SQ FTIBR)= 230 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: 6EF=-TF-i= �3- FLEt+iimTt-F= *� i csFzFFivEL C=.F=F= TF -1= 4 Dien S � 373�� E FEET THE LENGTH DIMENSION IS THE LENGTH CIN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A 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 IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF T14E EXCAVATION CIN FEET). EcEQRJ I FQ:EG '�F=FST I C —rF:l dt< I F ::lL l0G 0 C3nL-L- N- = ,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. --- TFRJCe C III IE~PF;CT I C}taE~ t=lFRE FREGQL.i I FR*EE> — BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. ,MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS '100 FEET FOR PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING ,UPON THE TYPE OF PUBLIC WELL. 'MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE I5 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE MVAILABLE TO INSURE PROPER INSTALLATION. CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET `1 TH BY THE MUNICIPALITY OF ANCHORAGE. ,;I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. SI UNDERSTAND THAT THE ON-SITE SEWER. SYSTEM MAY REQUIRE ENLARGEM&A IF THE 1DENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDRO tiblE- (UJ�IVE(2 -o ------------- T"4 n K t D W� i -L o F APPLICANT DICK REDMOND �901BY_�---------------DATE_Q-`-- ---- --ol � 4.F M w CONSTRUCTION TEST LNB T "One Test is worth a Thousand Opinions" 2204 Cleveland` Anchorage, Alaska 99503 277-0231 ACTL 80-13481 Performed for nAM zAnTp{� TgpNSATASXp REALTY, THTC Date Performed ,TTTrT�gpO� Legal Description: Portion of LOT 93 -,--of Girdwood--small tract group (see attached This Foran reports: SOILS_TEST PERCOLATION TEST XXX lot surve Depth Soil Characteristics 1.5 Pi n,.M Dcn4- 2,5 Brown Organic Silt Sandy Clayey Gravel with occassional cobbles & boulders. (Glacial Till) x:2.0 Bottom of Trench was Ground Water. Encountered If YES, What depth? NO M Reading I Date I Gross Time I Net Time I Depth to H2O , Net Drainage I Percolation Rate 7 Minute s/inch Proposed Installation: SEEPAGE PIT D7ZAIN FIELD XXXXXXX Depth of Inlet Depth to Bottom of Pit or Trench CO'T4ENTS: - -Required Seepage Rate: 230 ft. / Bedroom Test Performed by Bernard Nidowicz Data Certified Bv: James Ringstad, P.E. Date June 4, 1980 V 01 J .TV -5"r TRIO -Me -j't/N& '5jf4i3o p�c�rl. �-i34B f0,) � ti 10 r/ 1 Jam.;e noel Gown.: o ti� J� (,•.. 15hq.� � a` P Ot �yFa•,, • •,No,;: `�, R�ffSSCNP� �• � 1 ■ e 8oX oQ� Legal Description That portion of Y Group, U.S. EASEMENTS OF RECORD, OTHER THAN Survey No. 30,42, more particularly described as zo= THOSE SHOWN ON THE RECORDED reach the point of beginning, proceed from the most Westerly, PLAT, ARE NOT SHOWN HEREON. q NATE : 9-9� to the point SopP H { IN of beginning,; AS -BUILT SURVEY thence South 67'51'East thence Vi de„e e , 102.25' i 99.0' thenceLSdiNT.'W 102.25' to the point `YY ®BRASS —LOT SURVEY CERTIFICATION— — Q / )TPC, PIR Fnd BC. M6*1 - TSF pp� C f0,) � ti 10 r/ 1 Jam.;e noel Gown.: o ti� J� (,•.. 15hq.� � a` P Ot �yFa•,, • •,No,;: `�, R�ffSSCNP� �• � 1 ■ e 8oX oQ� Legal Description That portion of Lot 93 of Girdwood Small Tract Group, U.S. EASEMENTS OF RECORD, OTHER THAN Survey No. 30,42, more particularly described as follows; to THOSE SHOWN ON THE RECORDED reach the point of beginning, proceed from the most Westerly, PLAT, ARE NOT SHOWN HEREON. corner of said Lot 93 North 22 degrees 09 minutes East 76.0 ' to the point of beginning: from the point of beginning,; AS -BUILT SURVEY thence South 67'51'East thence 99.0 feet, thence N 22.09E 102.25' thence N67'51'W 99.0' thenceLSdiNT.'W 102.25' to the point of beginning. ®BRASS —LOT SURVEY CERTIFICATION— CAP MONUMENT o ,RM PIPE )TPC, PIR ❑ SURVEY NUM \ TACK � L®xxXxxxxx�IX®XM(xxxxxxx ANCHORAGE RECORDING DISTRICT EPARED BY: DOWLING 9 ASSOCIATES g04 EAST 15th Ave. SUI'PF 2. ANCHORAGE, ALASKA 99501 Residence of: DAT E >T E; SCALE: - W.O. - EB. GRID March 30 1980 BY: J 1 = 30 80-019 isc-1(80) Pg22 Girdwood V • � //u` '' 1 /+ler.:. L.. I. sE�T I C- Nare ; Sep!•i/a� .vol ra �I/Oe1.rHL � Z CLC- W Dcn t' Cir'L::, T -XD Ir, qQ UV.S A117d BC. Mo" • //f c4 Jan . •n,A.� ./ow'ny ��8 r \ Qp .............. Legal Description That portion of Lot 93 of Girdwood Small Tract Group, U.S. EASEMENTS OF -RECORD, OTHER THAN Survey No. 3042, more particularly described as follows; to THOSE SHOWN ON THE RECORDED reach the point of beginning, proceed from the most Westerly PLAT, ARE NOT SHOWN HEREON. corner of said Lot 93 North 22 degrees 09 minutes East 76.0 AS - BUILT SURVEY feet to the point of beginning: from the point of beginning, thence South 67°51 East 99.0 feet, thence N 22'09'E 102.25' thence.N67'51' W 99.0' thence LSE iN�; W 102.25' to the point of beginning. ®BRASS CAP MONUMENT LOT SUR1/EY CERTIFICATION o IRON pipe t y y�yy y�p� P STEEL PIN L SIMXXXXXXXXr®p,{�®Ki61XXXXXXX ❑ SURVEY NUe Q TACH (SFE DESCRIPTION ABOVE) ANCHORAGE RECOR01-NG DISTRICT T1 —$I ¢SPARED eY: DOWLING 9 ASSOCfATES g04 EAST 15th Ave. SUITE 2 Residence of, ANCHORAGE, ALASKA 99501 AT E: March 30 1980 BY: J 'c�'1" = 30' *0'80-019 EFc-1(80) Pg22 Flo' Girdwood i 9 + �¢ � 4•x,�. h !r; �:'�/ DRILLING, Inc., - r •V. 0. Box 4-1728 •: 2811 Dawson ,� y 7�, C 907-279-1741 -I - ALASKA 99509 . DRILLING LOG W?R Owner iia r,a +r 'p r tprs+ tv- Use of Well Dal 3 Location (address of: Township, Range, Section, if known; or distance main road S Size of casing Depth of Hole 1 FAfeet - Cased to Lf.?—feet Static water level ' tt ft--lbbove) .`,,,. (below) land surface. Finish of well (check one) open end Screen ( ); Perforated ( ). Describe screen or perforation Kano "? Well pumping test at--9a—gallons per (11o17i) ' (minute)' for --t hours wits+ 2`::_;L— ft. of drawdown -from static level. `_slrf emir.**^d t.ecau s t.bore was too ruch wntor to n;ereuro Date of completion-_14--an-7.0 n °fttt' 1hAr r :g. WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of'material, color and hardness b@0141t, —TO =t -+1 rt L rel 4 mak, X t9T0-_�20_ �Ait4este tilg�i R amn FSB a �m wet ®n i t!3liT0 ttApr r+�t,At TO TO ;'�ayGs �� +feather$ TO -- TO a TO' t TO . 8 -Contractor 0 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION t� DIVISION OF ENVIRONMENTAL HEALTH ®'i -i( -L) CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date > • 9. 1956 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) &rho* G. Laf 93� Grro[ewasof Sm�c(1 7raek rp�r•ci.r! Location (address or directions) U014 -IA let Mint jj&c P< Grro(wo CA (b) Applicant Name T T BrgA am Telephone: Home 75 3' 2L 76 Business Z71- 32/y Applicant Address P G- ar+z 2Y3 44idwaaat A1c 99657 (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder 12; Buyer ❑ ;Other ❑ (explain); (d) Lending Institution - h6me S'41 eiw i- 4~ Telephone 276- INS 1 Address (0O/ jr.Al tASo4 (e) Real Estate Company and Agent N.A, t ruin ante 1 Address Telephone (f) Mail the HAA to the following address: faCfor nitfe 'IA 2. TYPE OF RESIDENCE Single-FamilyIN Multi -Family ❑ Other Number of Bedrooms I - - 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® 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 (11/84) E 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 watersupply 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 _rld(66y 7744e4csa Servic4s Telephone Sys 13-05 Address IVS30 40CAO S¢ hoickonye Atc 99516 Date Septan 4-er 9, 19 Br; Wctivtr rerlri 941611-sytec a 4r Well -freneb : 9g1 of OF A4111144 *�?r 49TH *71 .....................: *. J ... .. .9�.?.ha • THEODORE F. MOORE ; r CE - 3589 pmtes�n'�o 6. DHEP APPROVAL Approved for, 0" Q bedrooms by^'� Date Approved e/ Disapproved Terms of Conditional Approval Engineer's Seal Conditional 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(11/89) VM4 arAurr or ANCHORAW DEPT. OF HEALTH & ENVIAONMEWAL PROTECTION fe SEP g RECEIVED A. WELL DATA • MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: Por iron Cy 4o L 93 rrtrdwoorf Small Traa%t �rrou� Well Classification PriyaEC If A, B, C, D.E.C. Approved (Y/N) N. A. Well Lo Present Y/N Date Completed 12! f8! 7 2 a * r ��� 9 ( ) P Yield a� by Total Depth I ft' 2 Cased to 16 2 Depth of Grouting Al. A. StaticWater Level -ca.% Pump Set At U4 Casing Height Above Ground 24 Sanitary Seal on Casing (Y/N) Y Electrical Wiring in Conduit (Y/N) Y Depression Around Wellhead (Y/N) Separation Distances from Well: To Se tic/Holdin Tank on Lot ae• v r P 9 ; On Adjoining Lots > (Cto To Nearest Edge of Absorption Field on Lot • On Adjoining Lots 7 (ocr To Nearest Public Sewer Line A, A. To, Nearest Public Sewer Cleanout/Manhole• A To Nearest Sewer Service Line on Lot NLA- Water Sample Collected by 71!r01 Date 91.51 86 Water Sample Test Results Sonet cif►+`!' + no to446r,► 8r- cp^w bate ilym . CommentsS}rAart(v lluHi/J:11 aaf T yyin ar olc4c4 1 #' ' drawa(0.0'% 0"d r� B. SEPTIC/HOLDING TANK DATA Date Installed 91 x,180 Size I vo-o f0i No. of Compartments 2 Standpipes (Y/N) Air -tight Caps (Y/N) Foundation Cleanout (Y/N) At Depression over Tank (Y/N) 14 Date Last Pumped 519186 Pumping/Maintenance Contract on File (Y/N) N.A. ; for X A_ Holding Tank High -Water Alarm (Y/N) M. A. Temporary Holding Tank Permit (Y/N) A A. Separation Distances from Septic/Holding Tank: To Water -Supply Well 9S• T' To Building Foundation b% To Property Line Ir To Disposal Field 5' To Water Main/Service Line AL r4- To Stream, Pond, Lake, or Major Drainage Course ::w 10o' Comments rd -10l -xys L wait«rr t* loft.( IN 09r' Fi alrrecot Ia,,-A .{ Page 1 of 2 72-026(r1/84) C. ABSORPTION FIELD DATA 0 Soils Rating in Absorption Strata 23O D ` /Bo(r n Type of System Design Trfn cb Date Installed 9 /25' /&2 Length of Field 3 Width of Field 30 " Depth of Field 6r, + over ai - 64,11 Gravel Bed Thickness Y Square Feet of Absorption Area ego Standpipes Present (Y/N) 'r Depression over Field (Y/N) N Date of Last Adequacy Test 9 /S'!8! Results of Last Adequacy Test Aeie'4f4th -pr ► bedrooa+ Separation Distance from Absorption Field: To Water -Supply Well P. 3 To Property Line 5' Pee ai - Wt, 1 E To Building Foundation To Existing -or Abandoned System on Lot Al. A. On Adjoining Lots > 30' To Water Main/Service Line N.A. To Cutbenk (if present) N, A. To Stream/Pond/Lake/or Major Drainage Course > 100' To Driveway, Parking Area, or Vehicle Storage Area 60 Comments Gr td .ebterlsAea 4r"cA wsi✓y^ ✓wpitrwa! /w 9i' 4vr s&VWA p sof w*4 %r "cA D. LIFT STATION Date Installed . Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Mahhole/Access (Y/N) — "Pump Off' Level at — Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request " I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed 9 T rUw"- Date 9/9/81f Company F'406%9 regi S404f MOA -No. 86-etf 8 a 06 - oo r3 ��•--�•�a Receipt No. OF A i+ Date of Payment y %%D 46 r �, r�Q•;:• , Amount: $ 5 . Op % 49TH S Engineer's Seal t.1S.�iirii..ii♦fi •u + : THEODORE F. MOORE00 Page 2 of 2 ! CE -3589 72-026 (11/84) Municlpallty of Anchorage September 17, 1986 ANCHORAGE, ALASKA 99519-6650 (907) 264-4111 TONY KNOWLES, MAYOR DEPARTMENT OF HEALTH & HUMAN SERVICES Ted Moore, P.E. Flattop Technical Services 14530 Echo Street Anchorage, Alaska 99516 Subejct: Lot 93 Girdwood Small Tracts Group, USS #3042 Waiver Request, WR86-136 Dear Mr. Moore: Your request for a waiver of the 100 foot separation required between the septic system and well on the subject lot has been granted. The separation between the septic tank and well has been waived to 86 feet and the separation between the absorption field and well has been waived to 98 feet. These waivers are vaild for the existing one bedroom single family dwelling only. Sincerely, Stephen S. Morris Civil Engineer On-site Services SSM/ljw 0 0 CIVR. & ENVIRONMENTAL ENGINEERING • ENERGY CONSER)MN W,ALVMAJYMCHORAGE THEODORE F. MOORE, P.E. DEPT. OF HEALTH'd(T�tllp ECHO ST. PH: (907) 345-1355 September 8, 1986 ENVIRONMENTAL PROTE ANCHORAGE, ALASKA 99516 ,SEP 101986 M.O.A. Dep't, of Health and Human Services P.O. Box 6-650 RECEIVED Anchorage, AK 99502 Attn: Steven Morris RE: Separation distance waivers Lot 93, Girdwood Small Tracts Dear Mr. Morris: By means of this letter I am requesting a waiver of the required well -septic tank separation distance down from 100 feet to 86 feet and the well -absorption trench separation distance down from 100 feet to 98 feet for the subject lot. To assist you in your review of this request I am enclosing copies of the septic system soils log, permit and as -built, the well log, and an as -built survey of the property, upon which the approximate location of the septic system is sketched. Also enclosed are the completed Health Authority Approval forms and water test report. When the well was drilled in 1972, the driller reported a well yield in excess of 50 gpm, coming from a stratum between 156 and 162 feet in depth. On the day of the adequacy test the static water level stood at 56 feet, and steady pumping at 7 gpm produced only one foot of drawdown. Potentially contaminated surface water would be prevented from reaching the aquifer by a stratum classified as sandy silt, situated between 41 and 80 feet in depth. A water sample taken on September 5, 1986 was tested and found to contain no coliform or other bacteria. A 31 foot long trench type on-site wastewater disposal system was installed in 1980. The soils were rated at 230 sq. ft./bdrm, and no water table was reported. Due to the small lot size (99' % 102'), the Municipality ruled that only a one bedroom system could ever be approved on this lot. The permit noted that the well -septic tank distance was waived to 90 feet. The approved as -built drawing indicates that the trench is 98 feet from the well. By triangulation on the day of my adequacy test, I determined that the septic tank c.o. is 88.7 feet from the well, and the cleanout at the end of the trench closest to the well is 99.3 feet from it. To test the adequacy of the system I added 238 gallons of water to the trench c.o., which caused a 15 inch rise in the fluid level there and a 3.5 inch rise in the fluid level in the septic tank. Over the next two and a half hours, I measured an absorption rate of 23 gallons per hour, this one bedroom system. There was no daylighting of effluent from the system. which is adequate for evidence of any past The lot slopes down to the west at approximately 5%, which, in the event of a system failure, would tend to carry any surface effluent away from the well. The relatively tight soil in which the system is located will increase the amount of filtration received by the effluent as it percolates downwards. The small lots to the north and to the south of this lot have neither wells nor septic systems, and the land to the west is Municipally owned and apparently unsubdivided at the present time. For the above reasons, I believe that the requested waivers can be granted without endangering public health. Please feel free to call me if you have any questions. cc. Jim Braham Sincerely, Ted Moore, P.E. 49tH • TFfEOOORE F. MOORE CE :3589• • ,.;�;`s a�4.C4 M��� r ' WO wl�k r Omw r B B d f✓. r r:xP i P iNr3 .rr$r= .. W f dr: TO / q� ((Q // R o r'� /or SUBJECT pg ,. _ • MESSAGE S-4�� vle i n CJ SJGNED REPLY U ]dQ a g �_ �- '37 SIGNED DATE RRdif�rm® 4S 471 SEND PARTS 1 AND 3 WITH CARBON INTACT • PMYPAK(WWS) YO1 PART 3 WILL BE RETURNED WITH REPLY. a �j t'). IN. OILS ANCHORAGE 5. LEGAL DESCRIPTION - MUNICIPALITY OF ANCHORAGE MUNICIPAW, OF • DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTI ONVIDEP,. .. 8 Ron:„ -,L , 825 LStreet -Anchorage, Alaska 99501 • ,r ��=(TION ENVIRONMENTAL ENGINEERING DIVISION r�'fP)� 3 m8o Telephone 264-4720 ® SINGLE FAMILY REQUEST FOR APPROVAL OF INDIVIDUAL RR EE cc� ���� FF WATER AND SEWER�FD RCTL�II1 DI RECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten 110) days for processing. 1. PROPERTYOWNER PHONE HerTann J. and Janis Donau Hastreiter (602)299-4034 MAILINGADDRESS since June 1975. For wells drilled prior to that date, give well 1602 East Fort Lowell - Tucson Arizona 85719 depth (attach log if available.) PROPERTY RESIDENT (If different from above) PHONE Mentors Bill and Gale ❑ 783-2945 2. BUYER by this Department. SV -1383 home James Braham and Kath Peters _ MAILING ADDRESS P. 0. Box 2292 Anchorage, Alaska 99510 3. LENDING INSTITUTION PHONE Peoples Bank and Trust Ann Roderick 279-7511 MAILING ADDRESS 644 West Avenue hora e Alaska 99501 4. REALTOR/AGENT PHONE Patti Zantek and Dan Zantek 276-4501 MAILINGADDRESS 1577 C Street, Suite #103 Anchoraae Alaska 99501 5. LEGAL DESCRIPTION Portion of Lot 93, Girdwood Small Tract Group, U.S.S. 3042 STREET LOCATION ��� 4 End of Hottentot Road 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS ® SINGLE FAMILY IM One ED Four ❑ Other ED Two ❑ Five ❑ MULTIPLE FAMILY ❑ Three Ell six 7. WATER SUPPLY IE INDIVIDUAL* *ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM ® INDIVIDUAL/ON-SITE** **If individual/on-site, give installation date ❑ If system is over two (2) years old an adequacy test is required PUBLIC UTILITY by this Department. [NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. A'�' o' q Lu cjc e �Z A �„ un) ie-uiv (Rev. 3i 18) iTHIS SIDE FOR OFFICIAL USE ONLY < INSPECTION APPOINTMENTS DATE RECEIVED TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTION-S.- IRECTIONS:1. 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 ❑INDIVIDUAL/ON-SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED (('' ❑Septic Tank or ❑ Holding Tank Size: If Tank is homemade give dimensions: INSTALLER SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL T0: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS _ DtA'110 'U C_h_.�'AAPPROVED FOR _�. BEDROOMS FD--'CONDITIONAL APPROVAL (letter must ac pany certificate) ❑ DISAPPROVED DATE /,i _ _ C•� BY (Title) - LEGAL DESCRIPTION ie-uiv (Rev. 3i 18)