HomeMy WebLinkAboutSHANGRI-LA ESTATES EAST BLK 1 LT 4Onsite File
Shangri-La
Estates East
Block 1
Lot 4
#020-043-45
Municipality of Anchorage
On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP231083 PID Number: 020-043-45
Dwelling: ❑■ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ■❑ New ❑ Upgrade
Name
Colony Builders
ABSORPTION FIELD
El Deep Trench 9Wide Trench F-1 Bed El Mound
Site Address
16310 Mountain Breeze Dr
❑ Other
Phone
Number of Bedrooms
Soil Rating I
depth from original grade
(907) 345-0371
Five(5)
6 GPD/SF
JTotal
3.1 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
1.1 Ft.
Gravel depth beneath pipe
2.0Ft.
Subdivision Block Lot
Shangri-La Estates East 1 4
Fill added above original grade
4..2 Ft.
Gravel length
20 Ft.
Township Range Section
Gravel width
5.0 Ft.
Beds: Number of Lines
NSA
Distance between lines
N/A Ft.
SEPARATION
DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
Total absorption area
Number of trenches
1
Dist. between trenches
N/A
From
Tank
Field
Tank
Line
142 Ft2
Ft.
Well
>50'
>50'
N/A
N/A
>25
TANK ❑ Septic ❑ S.T.E.P. ❑ Holding •❑ Other
Manufacturer
Advantex/Anchorage Tank
Capacity
2,500 Gal.
Surface Water
>50'
>50'
N/A
N/A
Material
Steel
Number of compartments
2
Lot Line
>5'
>10'
N/A
N/A
NA
Foundation
>1 0'
>1 0'
N/A
N/A
LIFT STATION
Manufacturer
O re n co
Capacity
250 Gal.
Remarks
Alarm location
Electrical installed by
Wall @ Point B
Frontier Electric
PIPE MATERIAL House to tank D3034 Tank to
drainfield D3034
Installer
BTH Construction
Drainfield D3034 Co/MTD3034
Inspector M Jakubisin & B Schiller
BENCH MARK (Assumed elevation) 100 ft
Inspection 15t 9/25/23 10/4/23
n
Location and description
dates: 2
Top of Flashing @ NE Corner
3`d 4m
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
Engineer's Stamp
4 O �•
Conditional Approval: Date
Xr., ' ... k�
.49 OV
TH *rel
'.•
Septic System ��
Benjamin Schiller
�� �'c�` • CE 12592
Approved/X:Z_ Date
c'srF 9/19/24 , • ,01
`l�
9F�pROFESSIO�.�
No : this approval does not include well permit requiredent
(Rev 05/02/18) /
Benjamin Schiller
CE 12592
R
E
G
ISTEREDPROFE S S I O N A L E N GINEER
1"=50'
CO - CLEANOUT
2CO - DOUBLE CLEANOUT
FCO - FOUNDATION CLEANOUT
FS - FLOW SPLITTER VALVE
MH - MANHOLE
MT - MONITORING TUBE
SV - SEPTIC VENT
TH - TEST HOLE
LEGEND
PERMIT # OSP231083 PID # 020-043-45
SHANGRI-LA ESTATES EAST, BLOCK 1 LOT 4
A B
FCO 31.2
MH1 43.8
MH2 38.2
A B
2CO 68.1
CO1 71.4
MT1 73.2
CO2 72.5
36.7
56.7
68.2
88.3
79.7
81.1
97.2FEET
0 50 100
SA
N
D
P
I
P
E
R
D
R
5-BDRM HOME
9/18/2024
1
0
'
T
&
E
E
A
S
E
M
E
N
T
1130
1150
1170
1190
1210
20' LONG x 5' WIDE, 2'
EFFECTIVE DEPTH
ABSORPTION TRENCH
CO1
CO2MT1
MT2
2500-GAL STEEL EPOXY COATED
ADVANTEX TANK w/ 2 - AX20 PODS
TH1
TH-8A 2004
PROPOSED WELL
w/ 50' RADIUS
NEIGHBORING WELL
w/ 50' RADIUS
FCO
2CO
MT2 70.996.2
PLAN AS-BUILT
(NO SCALE)
MH1 MH2
VENTS
WELL w/ 50' RADIUS
PROPOSED WELL
w/ 50' RADIUS
NEIGHBORING ADVANCED
TREATMENT SYSTEM
PROFILE AS-BUILT
(NO SCALE)
PERMIT # OSP231083 PID # 020-043-45
SHANGRI-LA ESTATES EAST BLOCK 1 LOT 4
77.3 FINISH GRADE
20'
DRAINFIELD ROCK
MT
1
TH
#
1
NO GROUNDWATER 10/4/2023
70.0
72.0
CO
1
CO
2
63.1
70.0
72.0
73.1 ORIGINAL GRADE MT
2
Benjamin Schiller
CE 12592
R
E
GISTEREDPROFE S S I O N A L E N GINEER
AX-20 POD AND
MANHOLES
AX-20 POD AND
MANHOLES
FC
O
MH
1
MH
2
2500 GAL
SEPTIC TANK81.7
77.1
86.4
82.4
8/19/2024
LEGAL DESCRIPTION:
PERFORMED FOR:
DATE:PARCEL ID#:
SOILS LOG AND PERCOLATION TEST
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
DEPTH
(feet)
TEST HOLE 1
DATE READING START TIME NET TIME(minutes)
DEPTH toWATER NET DROP
PERCOLATION RATE: (MIN/INCH)
(inches)(inches)
DATE OF MONITORING
WAS GROUND WATER ENCOUNTERED?
DEPTH TO WATER AFTER MONITORING
IF YES @ WHAT DEPTH?
1.5
10/4 1
2
3
4
5
6GM (SILTY/SANDY GRAVEL,
BROWN)
Professional Engineers Stamp:
NO
SHANGRI-LA ESTATES EAST B1 L4
9/27/2023 020-043-45
COLONY BUILDERS
3:451
2
3
4
5
6
5"
1' OB
6:38
Benjamin Schiller
CE 12592
R
E
GISTEREDPROFES S I O N A L E N GINEER
12/19/23
PERC TEST LOCATION
TECHNICIAN:B. SCHILLER
11"
-
NONE
10/4/23
COMMENTS:
6" DIAMETER TEST HOLE PRESOAKED PRIOR TO TESTING
SITE PLAN
6 0
16"
5"7:13 11"6 0
16"
5"7:42 11"6 0
16"
5"8:39 11"6 0
16"
5"9:07 11"6 0
16"
5"9:21 11"6 0
16"
www.sullivanwaterwells.com
Pump Installation Log
Well Drilling Permit Number: OSP 231083 Date of Issue 9-25-23
Parcel Identification Number: 02004345000
Legal Description Property Owner Name & Address
Shangri-la Estates East Block 1 Lot 4 Colony Builders
16310 Mountain Breeze Drive
Anchorage, AK 99516
Pump Installation Date:
1-22-24
Pump Intake Depth Below Top of Well Casing:
210 feet
Pump manufacturer’s Name:
Franklin
Pump Model:
S10P4JP07231-03
Pump Size:
¾ hp
Pitless Adapter Burial Depth:
10 feet
Pitless Adapter Installer:
Pitless Manufacturer:
BTH Construction
Disinfected Upon Completion?
yes no
Method of Disinfection:
Chlorine 50 PPM
Comments:
Pump Installers Name:
Sullivan Water Wells
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
Merrill
Certified Drilling Log
OWNER OF LAND: Colony Builders
ADDRESS: 16310 Mtn. Breeze Dr.
LEGAL DESCRIPTION Shangri-la Estates East Block 1 Lot 4
DATE: 10/5/23
PERMIT NUMBER: OSP231083 DATE OF ISSUE: 9/25/23
TAX IDENTIFICATION NUMBER 02004345000
Is well located at approved permit location: Yes No
Method of Drilling: air rotary cable tool
Depth of Well: 220’
Casing Type: Steel Wall thickness .250 inches
Diameter: 6 inches, depth 44 feet
Liner type
Static Water Level: 42 feet
Recovery Rate 1.5 gpm gph
Method of Testing Air
Well Intake Opening Type: open end open hole
Screened Start feet Stopped
Perforations Start feet Stopped
Grout Type: Bentonite Volume: 250 lbs.
Depth: from 2 feet, to 42 feet
Well Disinfected Upon Completion: yes no
Method of Disinfection: Chlorine 50 PPM
Comments:
MOA Surface Seal
Bore Hole Data
Depth
From To
0 2 Casing Stickup
2 4 Fill
4 7 Overburden
7 12 Silty sand and gravel
12 22 Broken bedrock
22 78 Bedrock gray
78 121 Bedrock gray with sporadic fractures
121 161 Bedrock with quartz
161 220 Bedrock with fractures
Drillers Name: Cole Sullivan
ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority.
Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation.
MatSu Borough: Department of Environmental Conservation.
MUNICIPALITY OF ANCHORAGE �11,cr�r
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http://www.muni.org/onsite
Department
On -Site Water & Wastewater System Permit
Permit Number: OSP231083 Effective Date: 9/25/2023
Work Type: WellSeptic Renewal Expiration Date: 9/24/2024
Tax Code Number: 02004345000
Site Legal Address: SHANGRI-LAESTATES EAST BLK 1 LT 4 G:3239
Site Mailing Address: 16310 MOUNTAIN BREEZE DR, Anchorage
Owner: JOHNSTON CHRISTOPHER RYAN Lot Size in Sq Ft: 45624
Design Engineer: FORGE ENGINEERING Total Bedrooms: 4
This permit is for the construction of:
Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy Q 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:
1. A Category III Nitrogen -Reducing system is required on this property in accordance with Plat 11-62.
2. A test hole is required prior to construction of the absorption field to confirm separations to seasonal high
groundwater and impermeables, as well as confirm percolation rate. If results require a design change,
construction shall stop pending approval of a change order. Please submit results with inspection report (or
change order, if required).
Received By: L_ Date:
Issued By: _�ftn ..._ -�' Date: -z- z. 3
Community Development Department " 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. 020-043-45
Property owner(s) - C O L &v i . �°' "7 r n S Day phone (907) 345-0371
Mailina address 11471 Business Blvd #771533, Eagle River, AK 99577
Site address 16310 Mountain Breeze Drive, Anchorage, AK 99516
Legal description (Sub'd., Block & Lot) Shangri-La Estates East, Block 1 Lot 4
Legal description (Township, Range & Section)
Lot Size 45,624 Sq. Ft. Number of Bedrooms
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field
❑X
Initial El
Single Family (SF)
❑X
(w/wo ADU)
Septic Tank
❑X
Upgrade ❑
Duplex (D)
❑
Holding Tank
❑
Renewal ❑X
Multiple Dwellings
❑
Privy
❑
(SF and/or D)
Private Well
❑X
Water Storage
❑
THIS APPLICATION INCLUDES
A VARIANCE / WAIVER REQUEST FOR:
Distance:
certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
li
(Signature of property owner or authorized agent)
Permit/Rush Fees: -0/ y5 Waiver Fees:
Date of Payment: x/2/2'3 Date of Payment:
Receipt Number: 02-9 9 G n Receipt Number:
Permit No. 02io23 I2g3., Waiver No.
Permit App_::- : ,'-:c
May 1, 2023
MOA Development Services, On-Site Water & Wastewater Program
4700 Elmore Rd
Anchorage, AK 99507
Subject: Shangri-La Estates Block 1 Lot 4 – 16310 Mountain Breeze Drive
Septic System Permit Renewal
Dear On-Site Services Engineer:
The permit for the construction of a well and septic system on the subject property has expired. A
site visit was conducted and there have been no substantial changes to this lot or to the surrounding
area since the permit was originally issued. The current design and permit conditions meet all code
requirements. We therefore request the renewal of the permit for the well and septic system on this
lot.
Sincerely,
Benjamin Schiller, PE
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231083, Curtis Townsend, 09/25/23
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PQ Box 195850 4700 Elmore Road
Anchorage, Alaska 99519-6550 Phone: (907) 343-7904 Fax. (907) 343-7997
http://wvvw.muni.org/onsite
On -Site Water & Wastewater System Permit
Permit Number: OSP221053
Worts Type: WellSeptic Initial
Effective Date:
Expiration Date:
Tax Code Number: 02004345000
Site Legal Address: SHANGRI-LA ESTATES EAST BLK 1 LT 4 G:3239
Site Mailing Address: 16310 MOUNTAIN BREEZE DR, Anchorage
Owner: JOHNSTON CHRISTOPHER RYAN
Design Engineer: FORGE ENGINEERING
This permit is for the construction of:
0 Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy
3/15/2022
3/15/2023
Lot Size in Sq Ft: 45524
Total Bedrooms: 5
Q 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 t18AAC72j 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 [2417].
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. Coveted, sealed, and heated to prevent freezing
Special Provisions:
1. A Category III Nitrogen -Reducing system is required on this property in accordance with Plat 11-62.
2. A test hole is required prior to construction of the absorption field to confirm separations to seasona[ high
groundwater and impermeables, as well as confirm percolation rate. If results require a design change,
construction shall stop pending approval of a change order. Please submit results with inspection report (or
change order, if required).
Veronica Pope
GE 2022.03.15
ReceivedBy: 16:3111:39-08'00 f '
Issued By:
Date:
Date: 3A 512 6 �2'
MUNICIPALITY OF ANCHORAGE
Community Development Department _ 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. 020-043-45
Property owner(s) Ryan Christopher Johnston Day phone (907) 345-0371
Mailing address 11471 Business Blvd #771533, Eagle River, AK 99577
Site address NHN Mountain Breeze Drive
Legal description (Sub'd., Block & Lot) Shangri-La Estates East, Block 1 Lot 4
Legal description (Township, Range & Section)
Lot Size 45,624 Sq. Ft. _ Number of Bedrooms 5
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field
❑X
Initial FX]
Single Family (SF) 0
(w/wo ADU)
Septic Tank
IN
Upgrade ❑
(D) El
Holding Tank
❑
RenewalDuplex
❑
Multiple Dwellings ❑
Privy
❑
(SF and/or D)
Private Well
❑X
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.
(Signature of property owner or authorized agent)
Permit/Rush Fees: -t82o
Date of Payment: 3 1 U ? U
Receipt Number:
Permit No. 0_SP2210ti3
Permit App__- : -
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
March 15, 2022
MOA Development Services, On-Site Water & Wastewater Program
4700 Elmore Rd
Anchorage, AK 99507
3/15/22
Subject: Shangri-La Estates East, Block 1 Lot 4 – Mountain Breeze Dr
Septic system design
Dear On-Site Services Engineer:
The owner of the above lot intends to build a 5-bedroom home on the property, so we are
submitting this permit application for the construction of a new well and septic system. The
attached site plan identifies the location of the home as well as the proposed well, septic location
and alternate site. No conflicts exist between this proposed system and any other well or septic
system, whether on this lot or adjacent lots.
The ground surface on the lot slopes toward the north at or under 20%. There are no slopes greater
than 46% within 100 feet downslope of either the primary or alternate site. The current design
meets the requirements for slopes between 25% and 46%. Elevations are shown on the site plan
showing the grade and direction of flow. Stormwater drainage will not impact this septic system.
The new trench will be constructed parallel to the slope as much as possible.
Due to subdivision requirements, our design proposal includes a Category III nitrate reducing
septic system. Wells on this and adjacent lots are shown. The new system will be a minimum of
50’ from all wells and surface water, and more than 5’ away from the septic tank. The alternate
site is located more than 8’ away from the primary site.
Please refer to the attached test hole log, plan and profile pages for the septic design. If this design
is followed, there will be no adverse impacts to adjacent properties.
Sincerely,
Benjamin Schiller, PE
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP221053, Rebecca Carroll, 03/15/22
SHANGRI-LA ESTATES EAST, BLOCK 1 LOT 4
PERMIT # OSP231083 Cc- PID # 020-043-45
,v
1130
/
TH-8A 2004
/ 20' LONG x 5' WIDE, 2'
/ EFFECTIVE DEPTH
ABSORPTION TRENCH
/ 1150
TH1 —8
/ CO2
/ rC01 2C0 MT2 LOT 4
/ LOT S 2500-GAL STEEL EPDXY COATED
ADVANTEX TANK w/ 2 - AX20 PODS
VENTS
° O NEIGHBORING ADVANCED
PROPOSED WELL
MH1 MH2 TREATMENT SYSTEM
'
W�"50' RADIUS `�. J
`r
FCO
i
1170
B /
A ,_ �
L T" /
5-BDRM HOME. /
/
\ 1190
1 WELL w/ 50' RADIUS ` - NEIGHBORING WELL
w/ 50' RADIUS J
LOT 9A
Ss PROPOSED WELL
w/ 50' RADIUS /
1210 /
LEGEND
..�OF
i p', • •"'`•;gall, A B CO - CLEANOUT
��TM �.�79*��� PLAN AS -BUILT
�••• •, „•„ (NO SCALE)
•'5•�i • �... Benja i Schiller : �/ 0 50 100
F CE 2592
j`�sT • /1 B/2024 .•�� FEET
OPROFESiONP`.: 1"=50'
FCO
36.7
31.2
MH1
56.7
43.8
MH2
68.2
38.2
2CO
88.3
68.1
C01
79.7
71.4
MT1
81.1
1 73.2
CO2
97.2
72.5
MT2
96.2
70.9
2CO - DOUBLE CLEANOUT
FCO - FOUNDATION CLEANOUT
FS - FLOW SPLITTER VALVE
MH - MANHOLE
MT - MONITORING TUBE
SV - SEPTIC VENT
TH - TEST HOLE
SHANGRI-LA ESTATES EAST, BLOCK 1 LOT 4
TYPICAL TRENCH SECTION
(NO SCALE)
NOTES:
1. GRADE AREA OVER TRENCH TO DRAIN AWAY
2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2'
WITH 2" OF INSULATION
3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER
THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY
Benjamin Schiller
CE 12592R
EGISTEREDPROFE S S I O N ALENGINEER4" PERFORATED PVC
(HOLES DOWN)
DRAINFIELD ROCK
6"
6"
3' - 6"
2'
DESIGN FACTORS:SYSTEM REQUIREMENTS:
750 GPD PEAK FLOW
PERK RATE: 1.2 MIN/IN
APPLICATION RATE: 6.0 GPD/SF
5 - WIDE TRENCH SYSTEM
2500-GAL ADVANTEX TANK
w/ 2 - AX-20 FILTER PODS
BOTTOM OF TRENCH: 6' BELOW GRADE
FLOW LINE ELEVATION: 4' BELOW GRADE
TOP OF TRENCH: 6" ABOVE GRADE
750 GPD / 6.0 GPD/SF /5' WIDE * 0.7 RED FACTOR (2' EFF DEPTH) = 17.5 LF TRENCH REQUIRED
(20 LF SPECIFIED)
3/15/2022
GEOTEXTILE FABRIC
5'
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP221053, Rebecca Carroll, 03/15/22
7
8
LLf,�a' il.d\! uP1»iVYr. ✓!—! eil.. fLi\IMVi{..Vll�V �+.'+. � W.s.vIU1T
: -SITE WATER AND WASTEWATER PICC nb
W4,F S0 UTt1 nRAGAW ANCHORAGE,. AK 5
`SOILS LOG - PERCOLATION TEST
PROJECT #.
PIrR1=ORMEa FOR: WIRTech.In+r DATE PERFORMED: 7104124x_ �
LEGAL RESCRIPT16N,, n!• Hack 3, 5 ao d L9 EUt s `h I Islo
TEsr HOLE #BA . SLOPE
�er" i OL
t Ar
Lig
f
Q ,
,A
WAS GRMkWWATI:R
DATE
• 1 , •Y
tio
t •n
L
M.
V��,j.1ty Gravel
DEPTH OF WATER
j y Sand.
AF'T'ER 11.01�EITORING:
" "•• : _- - E
DAM
V1112004
Z
Recharge
�f.
r�, a
2
t3i3'!
a�
ad
ri
Ow
< <i
4
x • �.
10 '
`.
„
i a .
017
salt - 1
L
t Ar
Lig
f
Q ,
,A
WAS GRMkWWATI:R
DATE
EIVCQifI�I'F<�Eti� .,,-
tio
DE]"TH OF
WAATM
L
IF YES-, MiAT DEPTH? ._._____
0
DEPTH OF WATER
Noe P
AF'T'ER 11.01�EITORING:
" "•• : _- - E
DAM
V1112004
SITE PLAN
i2WING
DATE
GRM
7 ti Ii
NET
TIE
DE]"TH OF
WAATM
NET
DROP
m
714
alto
8"
t
Z
Recharge
�f.
0:21
2
t3i3'!
a�
Ow
3
0142.
10 '
„
017
At
.
4
i2WING
DATE
GRM
7 ti Ii
NET
TIE
DE]"TH OF
WAATM
NET
DROP
SFaeF
714
alto
8"
t
"20.
Recharge
0:21
2
t3i3'!
10
3
0142.
10 '
„
PfiRO RATE, MIN.IINCH• PERC. HOLE 0lAIIE3f l�' �"
TEST RLIN: EIETWEEKd 0 --__FT, AND—AL--F-T.
COI t r1T5i Jes# Hole.Pre Snaked Prior h Percolation TesF.
Tess FI F1FOfiM[ts BY: ER S NIIEi�SflhF 1, ojr-HAEI. E. 6fiICiER4tiht, CdJTIFY THAT Tail TEST WAS PMFORMEO Iii ACo4MANCE
111TH ALL STATe AND MUNICIPAL: GUJoEGN6 ON; THIS 'DATE: 1116/2004
MUNICIPALITY OF ANCHORAGE
ADVANCED WASTEWATER TREATMENT SYSTEM
MAINTENANCE AND REPAIR AGREEMENT
THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and
entered into as of this '" Day ofG,�, of 20�, by and d between
b+5'1- l '� herein the "OWNER," and the Municipality of
Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code
(AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this
Agreement agree as follows:
1. Advanced Wastewater- Treatment Systems. The Municipality grants permission to the
Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS),
described as Advantex Waste Water Treatment System
located at (legal description)
Shangri-la Estates East B1 L4
2. Maintenance, Repairs and Alterations.
(Owner is required to read, understand and initial each section)
Throughout the term. of this Agreement, the Owner shall enter into a service agreement 4
with an AWWTS service and maintenance provider approved by the Municipality or the
manufacturer's representative. The AWWTS shall be maintained in a satisfactory
condition capable of performing as designed and producing treated septic effluent in
accordance with the equipment's approval for operation in the Municipality.
It shall be the responsibility of the Owner during the terns of this Agreement to pay for all
repair(s), maintenance, adjustmnent(s), replacement costs, and inspection costs. This
includes an annual maintenance fee (typically $400 to $600).
�t
Owner agrees that only maintenance and repair personnel approved by the Municipality
or the manufacturer's representative will inspect and make any necessary maintenance,
repairs or permitted alterations to the system.
Owner acknowledges that regular maintenance of an AWWTS reduces the potential
failure of the system, which could include sewage backup and costly repairs or drainfield
replacement,
Owner acknowledges that the Municipality may request records of maintenance and
repairs from the manufacturer's representative or maintenance provider.
Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be
assessed in accordance with AMC 14.60.030.
ArOwner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS. The Municipality will give at least 24-hour notice.
Owner agrees that any sale or transfer of title of the property will not occur without a new
Certificate of On -Site Systems Approval.
Owner agrees that the AWWTS installation and maintenance requirements as provided
G
by the AWWTS vendor/installer and approved by the Municipality are the governing
guidelines for the construction, maintenance and repair of the Owner's AWWTS.
Owner agrees to maintain remote monitoring of the AWVAITS as required by the
i
AWWTS approval.
3. Term. The term of this Agreement shall begin on the date of approval by the
Municipality to operate the installed system, or upon transfer of title, and shall continue
while the AWWTS is operational or until title is transferred.
4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this
Agreement shall in no way constitute a waiver of the provisions, nor in any way affect
the validity of the Agreement or any part hereof, or the right of the Municipality
thereafter to enforce every provision hereof.
5. Amendment. This Agreement shall only be amended by authorized representatives of
the Owner and Municipality. Any attempt to amend this agreement by either an
unauthorized representative or unauthorized means shall be void.
6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be
brought in the Superior Court for the Third Judicial District of the State of Alaska at
Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the
parties under this Agreement.
7. Severability'. Any provisions of this Agreement decreed invalid by a court of competent
jurisdiction shall not invalidate the remaining provisions of the Agreement.
IV'IUNICIPALITY OF ANCHORAGE
ADVANCED WASTEWATER TREATMENT SYSTEM
MAINTENANCE AND REPAIR AGREEMENT
THIS MAINTENANCE AND REPAIR AGREENIENT, herein the "AGREEMENT" made and
entered into as of this I Day of of 20 4-, by and between
r j -C , herein the "OWNER," and the Municipality of
Anchorage, herein the "MUNICIPALITY". in accordance with Anchorage Municipal Code
(AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this
Agreement agree as follows:
1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the
Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS),
described as Advantex Waste Water Treatment System
located at (legal description)
Shangri-la Estates East B1 L4
2. Maintenance. Repairs and Alterations.
(Owner is required to read, understand and initial each section)
Throughout the term of this Agreement. the Owner shalt enter into a service agreement
with an A`NFWTS service and maintenance provider approved by the Municipality or the
manufacturer's representative. The AWWTS shall be maintained in a satisfactory
condition capable of performing as designed and producing treated septic effluent in
accordance with the equipment's approval for operation in the Municipality.
It shall be the responsibility of the Owner during the term of this Agreement to pay for all
repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This
includes an annual maintenance fee (typically $400 to $600).
Owner agrees that only maintenance and repair personnel approved by the Municipality
or the manufacturer's representative will inspect and make any necessary maintenance,
repairs or permitted alterations to the system.
Owner acknowledaes that regular maintenance of an AWWTS reduces the potential
failure of the system, which could include sewage backup and costly repairs or drainfield
replacement.
Owner acknowledges that the Municipality may request records of maintenance and
repairs from the manufacturers representative or maintenance provider.
Owner acknowledges that the line for failing to maintain and repair an AWWTS may be
assessed in accordance with AMC 14.60.030.
Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS. The Municipality will give at least 24-hour notice.
4— Owner agrees that any sale or transfer of title of the property will not occur without a new
Certificate of On -Site Systems Approval.
Owner agrees that the AWWTS installation and maintenance requirements as provided
by the AWWTS vendor; installer and approved by the Municipality are the governing
guidelines for the construction, maintenance and repair of the Owner's AWWTS.
Owner agrees to maintain remote monitoring of the AWWTS as required by the
AWWTS approval.
I Term. The term of this Agreement shall begin on the date of approval by the
Municipality to operate the installed system, or upon transfer of title, and shall continue
while the AWWTS is operational or until title is transferred.
4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this
Agreement shall in no way constitute a waiver of the provisions, nor in any way affect
the validity of the Agreement or any part hereof, or the right of the Municipality
thereafter to enforce every provision hereof.
5. Amendment. This Agreement shall only be amended by authorized representatives of
the Owner and Municipality. Any attempt to amend this agreement by either an
unauthorized representative or unauthorized means shall be void.
6. Jurisdiction: Choice of Laws. Any civil action arising from this Agreement shall be
brought in the Superior Court for the 'third Judicial District of the State of Alaska at
Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the
parties under this Agreement.
7. Severability. Any provisions of this Agreement decreed invalid by a court of competent
jurisdiction shall not invalidate the remaining provisions of the Agreement.
/ - - n it n;Il 1nl
OWNER:
By: (signature) Date: 7-
;J Q (print name)
STATE OF ALASKA )
ss.
THIRD TUDICIAL DISTRICT )
The foregoing instrument was aeknow.ledged before me this J nL_ day o f ,:t)L- p refig jZ
20,1�4., by • L o
NOTARY PUBLIC FOR ALASKA
My Commission expires:
MUNICIPALITY:
signature) Date:
Notary Public
ARA DONOVAN
State of Alaska
M} -L11 i ifnission Expires 07/16/2026
(print name) Title:
/-- - -- nci1nr1,%n10\ n- -- It - rte
OVVT%ER:
By: (sigtlattue)
(print name)
STATE .OF ALASKA ).
ss.
THIRD JUDICIAL DISTRICT )
Date: 2 J?
l
The foregoing instrument was acknowledged before me this,9,9 day of �pT dn
20 by r
NOTARY PUBLIC FOR ALASKA NOTARY PUBLIC
My Commission e.Npires: SARA DONOVAN
STATE OF ALASKA
My COMMISSION EXPIRES July 16.2024
----------------------------------
MUNICIPALITY:
By (/� (signature)
(print name)
Date: aJ Z z 3
Title: , C t v�� E ^-G ��-��
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: (907)343-7904
On -Site Water & Wastewater Section Fax: (907)343-7997
Certificate of On -Site Systems Approval
OSC241384
Parcel ID 020 -043-45 Expiration Date: 8/19/2024
Legal description SHANGRI-LAESTATES EAST BLK 1 LT 4
Site address 16310 MOUNTAIN BREEZE DR
Current propertyowner(s) COLONY BUILDERS INC
X The On-site system(s) is/are approved for 5 bedrooms
By:
Conditional approval for bedrooms, with the following stipulations:
Comments or conditions:
No comments
Original Certificate Date:
3/20/2025
This rtificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
syr em(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage,
Development Service Department (DSD) issues COSAs based upon representations provided by an
independent professional engineer. The Municipality of Anchorage is not responsible for errors or
omissions in the professional engineer's submittal.
ATTACHMENTS:
COSA Checklist X Well Flow Advisory
Absorption Field Advisory Nitrate Advisory
Tank Age Advisory Arsenic Advisory
Other
MUNICIPALITY OF
Development Services DepartmentX�v
On -Site Water & Wastewater Section
ANCHORAGE
Phone: 907-343-7904
Fax: 907-343-7997
Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 020-043-45
Complete legal description Shangri-La Estates East, Block 1 Lot 4
Location (site address) 16310 Mountain Breeze Drive, Anchorage, AK 99516
Current property owner(s) Colony Builders, Inc.
2. ON-SITE SYSTEMS SIZED FOR 5 BEDROOMS
Day phone 907-345-0371
3. TYPE OF WATER SUPPLY: 0 Private Well ❑ Private Well serving 2 dwelling units
❑ Private Well serving 3+ dwelling units ❑ Community Well or Public
❑ Water Storage
4. TYPE OF WASTEWATER DISPOSAL: ■❑ Private Septic ❑ Private Septic serving 2 dwelling units
❑ Holding Tank ❑ Community Septic or Public Sewer
5. SEPTIC TANK: ❑■ Steel ❑ Plastic ❑ Concrete ❑ Fiberglass
Age 1 yr -See advisory if steel older than 20 years
6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ■❑ Wide Trench ❑ Seepage Pit
Waiver request for:
Expedited review requested: ❑
Distance:
By applying for this entitlement, this property is subject to inspection by municipal On-site staff
to verify the accuracy of the information provided.
COSA Fee $ t -`-?
Date of Payment
COSA #LI c�Ctj Lf�
Waiver Fee $
Date of Payment
Waiver #
COSA Application—June 2022
1.5
220 N/A
44
24
42
N/A N/A
N/A
Benjamin Schiller, P.E.
(907) 522-7773
MUNICIPALITY OF ANCHORAGE
ADVANCED WASTEWATER TREATMENT SYSTEM
MAINTENANCE AND REPAIR AGREEMENT
THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and
entered into asofthis t ` Day of ��c r c- of 20 � 5 by and between
f3 r:A to L.. At GV , herein the "OWNER," and the Municipality of
Anchorage, herein the "MUNI 1PALITY", in accordance with Anchorage Municipal Code
(AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this
Agreement agree as follows:
1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the
Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS),
described as Advantex
located at (legal description) I�
2. Maintenance, Repairs and Alterations.
(Owner is required to read, understand and initial each section)
Throughout the term of this Agreement, the Owner shall enter into a service agreement
with an AWWTS service and maintenance provider approved by the Municipality or the
manufacturer's representative. The AWWTS shall be maintained in a satisfactory
condition capable of performing as designed and producing treated septic effluent in
accordance with the equipment's approval for operation in the Municipality.
It shall be the responsibility of the Owner during the term of this Agreement to pay for all
repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This
includes an annual maintenance fee (typically $400 to $600).
Owner agrees that only maintenance and repair personnel approved by the Municipality
or the manufacturer's representative will inspect and make any necessary maintenance,
6�repairs or permitted alterations to the system.
Owner acknowledges that regular maintenance of an AWWTS reduces the potential
failure of the system, which could include sewage backup and costly repairs or drainfield
replacement.
(rev. 05/18/2018) Page 1 of 3
Owner acknowledges that the Municipality may request records of maintenance and
repairs from the manufacturer's representative or maintenance provider.
Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be
assessed in accordance with AMC 14.60.030.
Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS. The Municipality will give at least 24-hour notice.
Owner agrees that any sale or transfer of title of the property will not occur without a new
Certificate of On -Site Systems Approval.
Owner agrees that the AWWTS installation and maintenance requirements as provided
by the AWWTS vendor/installer and approved by the Municipality are the governing
guidelines for the construction, maintenance and repair of the Owner's AWWTS.
Owner agrees to maintain remote monitoring of the AWWTS as required by the
AWWTS approval.
3. Term. The term of this Agreement shall begin on the date of approval by the
Municipality to operate the installed system, or upon transfer of title, and shall continue
while the AWWTS is operational or until title is transferred.
4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this
Agreement shall in no way constitute a waiver of the provisions, nor in any way affect
the validity of the Agreement or any part hereof, or the right of the Municipality
thereafter to enforce every provision hereof.
5. Amendment. This Agreement shall only be amended by authorized representatives of
the Owner and Municipality. Any attempt to amend this agreement by either an
unauthorized representative or unauthorized means shall be void.
6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be
brought in the Superior Court for the Third Judicial District of the State of Alaska at
Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the
parties under this Agreement.
7. Severability. Any provisions of this Agreement decreed invalid by a court of competent
jurisdiction shall not invalidate the remaining provisions of the Agreement.
(rev. 05/18/2018) Page 2 of 3
OWNER:
B (signature) Date:
a Cyt t k U✓\. -k- `(print name)
STATE OF ALASKA )
ss.
THIRD JUDICIAL DISTRICT )
The foregoing instrument was acknowledged before me this 'P, day of mg -meq ,
20.L! ,by-�,L)�4KjyjkY�"O,/Y,,
�Iti r��c�lrr_f-Z1 QA Dl. 4%6 oaf-ldC�b
�x P, E 09 f ,--a9
NOTARY PUBLIC FOR ALASKA SARA D Notary Public
Public
My Commission expires: Icy ',) ONOVAN
State of Alaska
My Commission Expires 07/16!2028
(signature) Date: Cj
;print name) Title:
(rev. 05/18/2018) Page 3 of 3
Lot 4, Block 1,
Shangri La Estates East Subdivision
As-Built
Land Surveying
Land Development Consultants
Subdivision Specialists
Construction Surveying
AEC# 173042
S4
Group
124 E 7th Avenue
Anchorage, Alaska 99501
(907) 306-8104
mail@S4AK.com
05/14/2024