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HomeMy WebLinkAboutMADELINE LT 9B UNITED STA~ES POSTAL SERVICE OFIqC~AL BUSINESS SENDER IN~I~UCT~ON8 Print your name, addresl, and ZIP Code In the · Complete Items 1, 2, 3, and 4 on the re.v...m'ee. · Attach to front of arttde ff q)ace permne, o~hewVlae nfflx to back of article. · Endorse a~tl~e "Rehlm Receipt fleq~sted" odJaoent to number. PENALTY FOR PRIVATE Munici:ality of Anchorage Health and Human Services On-smte Services Section PO Box 196650 825 L Street, 9502 Anchorage, Alaska 99519-6650 ldl3::):ild Nldlq.l.31:l Ol.I. S3k~lOO 1:861. Rlnr 'LLS; m,o:t Sd PS Form 3800, June 1985 ~U,S.G.P.O. 1989.234.5§5 oTM 0 ~ ,~ ~ ~ . STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE, DERTIEIED MAIL FEE, AND CIIARGES FOR ANY SELECTED OPTIONAL SERVICES. (see front) 1. It you want this receipt poslmarked, stick the gummed slub to the right of lhe return address reaving the receipt attached and present tho adicle at a post office service window or hand it to your rural carrier. (no ex'Ira charge) 2. If you do not want this receipt postmarked, slick the gummed stub to the right of the return address of the arllcle, date, detach and retain the rece~[.q, and mai/the article. 3. It you want a return receipt, write the codified mail number and your name and address on a return receipt card, Form 3811, and attach it lo the front ut the arlicle by means of the gummed ends it space per- mits. Otherwise, affix to back of article. Endorse front of article RETURN RECEIPT REQUESTED adjacent to the number. 4. If you want delivery restricted lo the addressee, or to aa authorized agent of lhe addressee, endorse RESTRICTED DELIVERY on the front of the arlicle. 5. Enter tees for lhe services requested In the appropriate spaces on the front ol this receipt, if return receipt is requested, check the applicable blocks in item 1 of Form 3811. 6. Gave this receipt and preseot it if you make inquiry. ,;. U.S,G.RO. 1989-234-e55 T(~m Fink, Mayor N unicipality of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 October 8, 1992 CERTIFIED MAIL Thomas W. Ross HC 78 Box 3150 Chugiak, AK 99567 Subject: Revocation of Permit #SW920105 Mr. Ross: This notice is to-advise you that the permit issued for Lot 9B, Madeline Subdivision has been revoked. Permit revocation is based on the fact that a duplex was constructed instead of a single family dwelling as was specified on the permit application. Under AMC 15.65 the Municipality has no authority to issue permits for multifamily well and septic systems. Permits for multifamily well and septic systems must be applied for through the Alaska Department of Environmental Conservation (ADEC). I strongly recommend you make application with ADEC upon receipt of this notice. Please be advised that it was noted the well cap which is currently in use does not appear to conform with current code requirements. This will be a concern for ADEC when you apply for a Class C well certificate. If you wish to discuss this revocation please do not hesitate to contact my office, our telephone number is 343-4744. Since~e, ly,//7 . // Daniel N. Bolles On-Site Services cc: John Smith, P.E., Manager On-Site Services Public Works, Building Safety ADEC, Western District Office S&S Engineerin db/199 Municipality of Anchorage Page ~ of-~'?~- DEPARTMENT OF HEALTH AND HUMAN SEF:IVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343.-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: Add~ Phone: LEGAL DESCRIPTION ~j~ Block: Subdivision: Township: Range: Section: PID Number: Wastewater System: AB~ [] Deep 'french [] Shallow T Soil Rating: /,~.~ GPE Depth to pipe botlom Irom original Fill added above original [] Upgrade :)N FIELD Bed [] Mound []Other Total Depth from original g~_.~e: I Gravel depth beneath pipe O.~/ Gravel length: WELL: "~" New [] Upgrade ~.-~~1 Cl~.l.~sif[catiOnDriller: (Private, A,B,C): TotaIDate Drilled:Depth: Yield: GPM Pump Set at: Ft. ICased To: Total absorption Ft. Static Water Level: Installer: Casing Height Above Ground: Ft. Ft. Ft. Number of lines: lce~.~w~en lines:Ft. Date installed: TANK [] Holding [] S.T.E.P. SEPARATION DISTANCES To From Well Surface Water Lot Line Foundation ateriah in gallons: "Pump Curtain Pump Make & Model Drain Capacity in gallons: Number of Comparlments: LIFT STATION Remarks: Manufacturer: "Pump off" level at: Electrical Ins IHigh water alarm at: BENCH MARK Location and Description: Assumed Elevation: E N G ~lJ~ I~.~:.~.,~-.~ L _ ~. ¢.',.,:. ~,,,.. S & S ENGINEERIN6 , / ~,e,;' ' Inspections performed by:,~n*~.gl-,iver Loop,cad. No. ~es: l st_~¢~ ~ '~"~"~ Department of Health and Huma~Ser~ces approval I ,~ ~,~ Re~ie~,ed and approved b~: _~ :-TI .... ~: ~ .... I ~ /~P¢///~/~ /.~ ~ ~/~/~ ~ / , I/ Permit No. ~----~ [/.-[~ ~-4:~ I (:~ ,~ Page ~ of ~ Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAl. SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report 'L-C'J"T' E::~ ~'~__ PID NO 72-013 A (Rev. 9/91) MOA 25 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PAGE 1 OF PERMIT NUMBER:SW920105 DESIGN ENgINEER:S & S ENGINEERING OWNER NAME:ROSS THOMAS W & OWNER ADDRESS:HC 78 BOX 3150 CHUGIAK, ALASKA 99567 PARCEL ID:05128174 LEGAL DESCRIPTION: MADELINE LT 9B DATE ISSUED: 5/27/92 EXPIRATION DATE: 5/27/93 LOT SIZE: 41566 (SQ. FT.) NUMBER OF BEDROOMS: 6 THIS PERMIT: 6 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM 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 FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS RECEIVED BY: DAT . :.f- 2. 7- 72 May 14, 1992 ROBERT SHAFER, P.E. ROGER SHAFER. P,E. OIVIL ENGINEERS (907) 694-2979 FAX 694-1211 HEALTR AUTHORITY APPROVALS SEWER &WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL }NSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN zuniclpality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street Anchorage, AK 99519-6650 REFERENCE: Madeline Subdivision, Lot 9B We request you issue a permit to drill a well and install a septic system to serve the proposed 6 bedroom house on the referenced property. Two test holes were excavated and percolation tests performed on the above referenced property. The approximate location of the test holes are located on the attached site plan. Water was encountered at 9' during excavation of the first test hole and after seven day water monitoring. There was no water encountered during excavation of the second test hole, although water was found after seven day water monitoring at 11' This property has enough area for future septic upgrades, which can be seen on the attached site plan. We do not anticipate any adverse effects on neighboring properties by the installation of the proposed septic system. If you have any questions, or require additional information for your review, please contact us. Sincerely, Roger J. Shafer, P.E. RJS/lsu 17034 EAGLE RIVER LOOP1 SUITE 204, EAGLE RIVER, ALASKA 99577 ,1"= 40' SCALE DESIGN SHIMS S TREE T Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: DATE PERFC LEGAL DESCRIPTION: ~ ,/~'1;::)~1~1.-~-I I,J ~.- ,~-----~'~, Township, Range, Section: ~ ~ SLOPE 5 6 7 8 9 10 11 12 13 14 15- 16 17 18 19 2O COMMENTSJ'~~~? SITE PI. AN WAS GROUND WATER -,.~__..,~ ENCOUNTERED?~ ' ' IF YES, AT WHAT ~'~ I O DEPTH? ! P E nepth to Water Alter ,,,~/~/~,~ Monitoring? . ~ / Dale: Gross Net Depth to Net Reading Date Time Time Water Drop ¢ ' ~O'. ~c~ t~ ~¢~,, ~" ~ io'~ " ~/~ ~'/" PERCOLATION RATE '~ (mmutes/~nch) PERC HOLE DIAMETER TEST RUN BETWEEN ~ FT AND ~ FT PERFORMEDBY:~&a~,t.~,,',-~.~,~t, hc'-~. ~,.,.,~,..~.-..-~ I '~//~V/'~ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE M~¢~[~b~P~¢ ~ES IN EFFECT ON THIS DATE. DATE: ~a~lo Iliver, Alaska 99577 72-00~ (Rev. 4/85) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13 14- 15- 16 17 18 19 2O COMMENTS '~ ~:) '~---~'~-----~ DATE PERFORMED ~Township, Range, Section: SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT / OL DEPTH? p E Deplht°WaterAller //' Nlonilorill§? Bale: Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE _'~ _ (minutes/inch} PERC HOLE DIAMETER ~ 11 '/~- ~/ ,)/~/'"% CERTIFY THAT THIS TEST WAS PERFORMED IN PERFORMED BY: ~ ACCORDANCE WI~0~ ~agle River, Alasl(a 99577 72-008 (Rev. 4/85)