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HomeMy WebLinkAboutSHANGRI-LA ESTATES-EAST BLK 1 LT 12AOnsite File dwM 0"&ha Rofthol am u MomAMESTM-a TMeb Formerly Lot 13. Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 2 ON -SITE WASTEWATER INSPECTION REPORT Permit Number: OSP221457 PID Number: 020-043-82 Dwelling: 0 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: 9 New ❑ Upgrade Name Joan Fregly ABSORPTION FIELD ❑ Deep Trench ❑■ Wide Trench ❑ Bed ❑ Mound Site Address 16364 Mountain Breeze Drive Other Phone Number of Bedrooms Soil Rating Total depth from original grade 1 6.0 GPD/SF 0.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade +0.5 Ft. Gravel depth beneath pipe 0•5 Ft. Subdivision Block Lot Shangri-La Estates East 1 12A Fill added above original grade 4.8 Ft. Gravel length 15 Ft. Township Range Section Gravel width 5.0 Ft. Beds: Number of Lines n/a Distance between lines n/a Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 75 FF 1 n/a Ft. Well 100'+ 100'+ 100'+ NA 25'+ TANK ❑ Septic ❑ S.T.E.P. ❑ Holding ❑i Other Manufacturer Orenco Capacity 1500 Gal. Surface Water 100'+ 100'+ 100'+ NA Material Number of compartments Lot Line 5'+ 10'+ 51+ NA NA HDPE (Advantex FAP) 2 Foundation 10'+ 10'+ 10'+ NA LIFT STATION Manufacturer Capacity Remarks Advantex FAP (CAT III) installed. Orenco 250 Gal. Alarm location House Electrical installed by Solid Ground Installer PIPE House to to ik ABS SCH40ASTM F628 Tank to PVC C900 DR18 drainfield Northern Excavation & Construction MATERIAL Diainfield PVCC900DR18 CO/MT 3034 Inspector PES BENCH MARK (Assumed elevation) 103.5 ft Inspdection v 02/08/23 d 02/08/23 Location and description 31" 02/15/23 2 411 02/16/23 See Site Plan, Bottom of house trim ON -SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date P,�,....,,.• *' 4A 7H .... .. . ....... erren an one ., CE 8149 •. 2024-02-12,.- Septic System Approved Date Z /Z 2pZ Note: this approval does not include well permit requirements. ki- VV/VG/ IU/ NOTES: RECORD DRAWING DRAWN LJC CHECKED ACP SITE PLAN r n n N — U)CA 2 O OJ N v N D Co (A N Ui (Jt W NJ W c0 100 O) O 0) '1V O O Oo c�2z�'�`)�n o1zo� �:prvO'C � N!?l O O !?l p !?1 O 00(v» Z O O C C O Q n � O � \ I \ I \ I I \ I I • i I I I �m I pa I I A� A y 41 o N Z� n \L I PANNONE ENG SVC LLC (C.1. 1088) REVISIONS P.O. BOX 1807 PALVER, AK 99645 OF PHONE (907) 745-8200 FAX (907) 745-8201 tea'•'•• it:'4a It! ':ik SHANGRI-LA ESTATES EAST BLOCK 1 LOT 12A •••• •••• •• JOAN FREGLY ••$seven onnoee CE 5149 SITE: NHN MOUNTAIN BREEZE DRIVE zoza.oz.o�' ANCHORAGE, AK I I 1 £ �I I/ 01/05/2024 CALE 1" = 50' I.D. NO 020-043-82 OSP221457 2OF2 I \ I O J \ N ,09"LLZ M"Vv,z�oOts \\ tq u c 25. io co v N O.\� 10 PIP \.'..n.. 0. Oo 5 0 1 0 o 'J�Te p Sp40 co O O O O O N �: \L pin: 'yO ' J Oo Q \ \ vv vv f \ \ Z�09� M«SZ,�boObS \ O " / � r r N J I ry z 6 4- O z C- -0 O c- C) U 3: O O cn O >_ o� o�®OoO� O n U U U) U N U = CL a Q c O -'4 00 c � Y 3 H n- c U a)3 0 o 0 N > O N N O N N 0 > O . r{ 4741 . o W ' Cam/] C O ' a • r-+ U ) U bl N O o CD ' w N v1 J so 0 O C c O Ol o L C U O- C T L o_ a� 0 0 L U O 1 d 0. O O -o - L U L N O N O O + L L N O U O U TC d O C _ O O Ua N C N C C o a� m O'- N L N � 0 `1 _c N _L E N N UO - E N N- O.n •.,O 3 0 OU"L N 0 N O 0) N 3 ,6 C tpc o= a)c O U� L)0-0 O�c N QUj U C O E Ln-oo U)= O'X - O U) C Z N O- O) o L O N 0 U cn a i i ,n U) �{ I N T N -0 O N N U v S C) --D MUNICIPALITY OF ANCHORAGE �1»cnt On -Site Water & Wastewater Program �oS�f PO Box 196650 4700 Elmore Road �- Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite IWLj v Depai-mient On -Site Wastewater Disposal System Permit Permit Number: OSP221457 Effective Date: 11/30/2022 Work Type: Septic Initial Expiration Date: 11/30/2023 Tax Code Number: 02004353000 Site Legal Address: SHANGRI-LAESTATES EAST BLK 1 LT 12 G:3239 Site Mailing Address: Owner: FREGLY JOAN Lot Size in Sq Ft: 40413 Design Engineer: PANNONE ENGINEERING SERVICES Total Bedrooms: 1 This permit is for the construction of: Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ 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 Received By: I SS Ljr, D ?O ic, S Issued By: Date: Date: 1 / 0 2.A 'Z—L_ MUMCPALITY 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. 020-043-53 Property owner(s) Joan Fregly Day phone Mailing address Site address NSN Mountain Breeze Drive Legal description (Sub'd., Block & Lot) Shangri-La Estates East, Block 1, Lot 12 Legal description (Township, Range & Section) Lot Size 40,413 Sq. Ft. Number of Bedrooms 1 APPLICATION IS FOR: APPLICATION IS AN:. TYPE OF DWELLING: (® all that apply) Absorption FieldX❑ Initial 0 Single Family (SF) X❑ Septic Tank X❑ Upgrade El(w/wo AD U) (D) El Holding Tank ❑ RenewalDuplex ❑ Privy ❑ Multiple Dwellings ❑ (SF and/or D) Private Well ❑ 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: .5 Waiver Fees: Date of Payment: l l q f a �2 Date of Payment: Receipt Number: 01(P 9 6n Receipt Number: Permit No. Q S P 22 1 Lf 0 Waiver No. Permit App_--'-:. ;:..,:c Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221457, Curtis Townsend, 11/30/22 DESIGN PARAMETERS i PRIMARY/RESERVE SEPTIC SYSTEM ^ _w _w —WATER LINE/ NO. BEDROOM: 1(150 gpd) V WELL RADIUS TANK SIZE: 1000gal _SS SS — NEW SEPTIC PERC RATE: <1 MPI SOIL RATING: 6 GPD/SF ABBREVIATIONS AREA RQD: 25 SF TH TEST HOLE SYS. TYPE: WIDE TRENCH 0.5' E.D. (P) PROPOSED MIN LENGTH: 5 LF (E) EXISTING Co CLEAN OUT NO. USE: DCO DOUBLE CLEAN OUT 15LFx5.0'Wx0.5'E.D.,0.0'T.D. FC FOUNDATION CLEANOUTFS W/ 1.0' SAND FLOW SPLITTER TOTAL AREA: 75 SF MT MONITOR TUBE NO. TYP TYPICAL I"=50' � S 11 _ ---L_ 3 PRIMARY/ RESERVE DRAINFIELD (P) WELL E 15LF x 5'W x 0.5'ED x 0.O'TD 96 LATERAL PIPE SHALL BE 1.5" W/ Y" HOLES 24" O.C. INSTALL ±1' OF SAND INSTALL MONITOR TUBE AT EACH END PROVIDE 3.0' COVER OR RIGID INSULATION 5.6 � 100 _ 10.01 6.0 1BR 104 S�TRUCTURE i O TH-2 k/ W 47.0, INSTALL 1500g ADVANTEX (P) W/ AUX PUMP VAULT \ INSTALL FOUNDATION CLEAN OUT BEFORE DEE HIGH / i jj� 100 - - 20' Access Easement (20136656) - ,�-------- - - - - -- - -- i- - - - - - - - - - ---��- - • 10' T&E 104 i NOTES: PANNONE ENG SVC LLC (C.1. 1088) REVISIONS DATE CHANGE ORDER P.O. BOX 1807 PALMER, AK 99645 OF 1/27/2023 PHONE (907) 745-8200 FAX (907) 745-8201 p'�''••• •' SCALE 1"=50' SHANGRI-LA ESTATES EAST, BLOCK 1, LOT 12 •••• • ••••••• P.I.D. NO 020-043-53 DRAWN DRM JOAN FREGLY ••meven onriwte PERMIT N0. SITE: NHN MOUNTAIN BREEZE DRIVE CE 8149 A& oSPxxxxxx SITE PLAN ANCHORAGE, AK pl SHEET 1 OF 2 NOTES & SPECIAL PROVISIONS:rJ � I 1. SCOPE AND SPECIFICATIONS: 1.1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MOA COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON-SITE WASTEWATER DISPOSAL SYSTEMS AND AND IN ACCORDANCE WITH AMC 15.65 AND 15.55. 1.2. CONTRACTED WORK WILL BE IN COMPLIANCE WITH MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) DIVISION 10 & DIVISION 20 AS APPROPRIATE. 1.3. SCOPE OF WORK: INSTALL NEW ADVANTEX, AND SOIL ABSORPTION SYSTEM. 1.4. GROUNDWATER WAS NOT ENCOUNTERED AT A DEPTH OF 4FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 4FEET BELOW EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY. 1.5. STRUCTURES DEPICTED ON THE SITE PLAN ARE BASED UPON ONE OF THE FOLLOWING: CONCEPTUAL PLOT PLAN DEVELOPED BY OWNER; A PLOT PLAN DEVELOPED BY RLS; OR A SURVEY AS -BUILT. 2. CONSTRUCTION SPECIFICATIONS: 2.1. ALL EXCAVATION DEPTHS ARE ADVISORY. THEY ARE TO BE VERIFIED AND MAY BE MODIFIED BY THE ENGINEER IF ACTUAL FIELD CONDITIONS VARY FROM THOSE USED TO PREPARE THE DESIGN 2.2. EXCAVATE THE DRAIN FIELD. BOTTOM OF EXCAVATION SHALL BE LEVEL AND SCARIFIED. RECORD ELEVATIONS AT BEGINNING, MIDDLE AND END OF TRENCH BOTTOM. CONSTRUCTION EQUIPMENT SHALL NOT OPERATE ON THE FLOOR OF THE EXCAVATION. ANY MATERIAL COMPACTED BY THE OPERATION OF THE CONSTRUCTION EQUIPMENT SHALL BE REMOVED AND REPLACED WITH UNCOMPACTED MATERIAL. 2.3. PLACE THE SEWER ROCK TO THE SPECIFIED DEPTHS. DO NOT CONTAMINATE SEWER ROCK WITH NATIVE MATERIAL OR SPOILS FROM EXCAVATION. LEVEL ROCK SURFACE TO t1" PRIOR TO INSTALLING THE PERFORATED PIPE. 2.4. ALL PIPE SHALL BE PVC CONFORMING TO ASTM D3034 OR ENGINEER APPROVED EQUAL. MINIMUM SOIL COVER SHALL BE 3 FEET OVER THE PIPE AND 4 FEET OVER THE SEPTIC TANK. ONE INCH OF INSULATION MAY BE SUBSTITUTED FOR 1 FOOT OF SOIL COVER. 2.5. ALL INSULATION SHALL BE 2" THICK DOW HI -40 INSULBOARD OR ENGINEER APPROVED EQUAL. CENTER INSULBOARD WIDTH OVER SEPTIC TANK OR LINES. 2.6. GEOTEXTILE SHALL BE MIRAFI 140S OR ENGINEER APPROVED EQUAL. LAP ALL JOINTS 2 FEET MINIMUM. 2.7. COVER THE DISTRIBUTION PIPE WITH A MINIMUM OF 2" OF SEWER ROCK AND COVER WITH GEOTEXTILE BEFORE PLACING INSULATION AND BACKFILL. 2.8. MATERIAL USED AS FILL SHALL BE CLEAN AND FREE OF ORGANICS, TRASH AND CONSTRUCTION DEBRIS. 2.9. SLOPE ALL FILL MATERIAL TO DRAIN AT 2% MINIMUM SLOPE AND 3:1 MAXIMUM SLOPE AND IN SUCH A MANNER THAT PONDING AT OR NEAR THE DRAIN FIELD DOES NOT OCCUR. THE FILL SHALL BE LEFT AT 6" HIGHER THAN SHOWN TO ALLOW FOR SETTLEMENT. SEED SURFACE AFTER COMPLETING INSTALLATION AS PER MOA CODE. 2.10. RECORD THE FINISH GROUND ELEVATION OVER THE BEGINNING, MIDDLE AND END OF SYSTEM. 2.11. MAINTAIN 5' SEPARATION BETWEEN PERCOLATION HOLE AND THE DRAIN FIELD TRENCH. 2.12. EXPOSE, PUMP AND FILL LOG DISPOSAL CRIB OR CONCRETE TANK WITH SOIL TO ABANDON IAW WITH MOA CODE IF NEEDED. 3. CONTRACTOR RESPONSIBILITIES: 3.1. THE CONTRACTOR SHALL FAMILIARIZE THEMSELVES WITH THE SITE CONDITIONS AND LOCATIONS OF ALL LOT LINES, EASEMENTS, WELLS (E & P), SEPTIC SYSTEMS (E & P) AND SHALL MEET MINIMUM SEPARATION DISTANCES OR AS NOTED. 3.2. THE CONTRACTOR (BOTH WELL AND SEPTIC SYSTEM CONTRACTORS) SHALL HAVE ANY WELL LOCATION AND SEPTIC LOCATION STAKED AND ANY LOT LINE AND WELL RADIUS SHOWN ON THE PLAN WITHIN 30 FEET OF THE PROPOSED SYSTEM STAKED BY A REGISTERED LAND SURVEYOR BEFORE STARTING THE WORK. 3.3. THE CONTRACTOR IS RESPONSIBLE FOR ALL R.O.W. AND OTHER REQUIRED PERMITS, OTHER THAN THE ATTACHED. 3.4. THE CONTRACTOR SHALL CALL FOR LOCATING OF ALL BURIED UTILITIES. 3.5. THE CONTRACTOR SHALL PROVIDE 24 HOUR NOTICE TO THE ENGINEER PRIOR TO START OF WORK. ALL SURVEYING AND LOCATES SHALL BE IN PLACE PRIOR TO NOTIFYING THE ENGINEER. 3.6. THE CONTRACTOR SHALL NOTIFY THE ENGINEER OF ANY DISCREPANCY BETWEEN THE APPROVED DRAWINGS AND SITE CONDITIONS/LIMITATIONS POTENTIALLY CAUSING THE NEED TO MODIFY THE DESIGN. 3.7. AT THE COMPLETION OF THE WORK, THE CONTRACTOR SHALL SUBMIT RED -LINE AS -BUILT DRAWINGS TO THE ENGINEER. THE RED -LINES SHALL INCLUDE PIPE LENGTHS, ORIGINAL GROUND ELEVATIONS, PIPE ELEVATIONS, AND TANK ELEVATIONS. 3.8. THE CONTRACTOR SHALL PROVIDE PHOTOGRAPHS OF THE SYSTEM INSTALLATION TO INCLUDE BOTTOM OF EXCAVATION, TOP OF PIPE WITH CLEAN -OUTS AND MONITOR TUBES INSTALLED, INSTALLED TANK AND FINAL GRADING. 4, THE CONTRACTOR SHALL SIGN THE FOLLOWING: I CERTIFY THAT ALL WORK WILL BE PERFORMED IN ACCORDANCE WITH THE APPROVED PERMIT, AND ANY AND ALL CHANGE ORDERS, AND THAT THE AS -BUILT REDLINES ARE TRUE AND ACCURATE REPRESENTATION OF THE PROJECT AS CONSTRUCTED. CONTRACTOR: BY. , SOILS LOG TEST HOLE 2 OR/ ORGANICS 1 OL 2 SANDY / GP/SM POORLY GRADED 3 GRAVEL 4 BOH 5 — 6 — 7 - 8 - WAS GROUND WATER 9 - ENCOUNTERED? N 10 IF YES. AT WHAT DEPTH? -DRY' PERCOLATION TEST 11 DEPTH TO WATER AFTER PEROLATION RATE <1 (min/inch) 12 MONITORING? -DRY' PERC HOLE DIAMETER 6 inches DATE: 1/16/2023 13 — TEST RUN BETWEEN 2 FT AND 3 FT DATE PERFORMED: 1/9/2023 COMMENTS: Test hole excavated by NORTHERN EXCAVATING PERFORMED BY: PES. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST. NOTES: PANNONE ENG SVC LLC (C.1. 1088) P.O. BOX 1807 PALNPER, AK 99645 PHONE 907 745-8200 FAX (907) 745-8201 REVISIONS OF �Q'•'' *'••.. even a 8149 ii DATE 12/14/2022 FOR CONSTRUCTION 0 © WATER A BSORBED OO QUICKLY O ACCURATELY i P.I.D. NO 020-043-53nnoee DRAWN DRM PERMIT N0. OSPXXXXXX NOTES SOILS LOG SHEET 2OF2 11 DEPTH TO WATER AFTER PEROLATION RATE <1 (min/inch) 12 MONITORING? -DRY' PERC HOLE DIAMETER 6 inches DATE: 1/16/2023 13 — TEST RUN BETWEEN 2 FT AND 3 FT DATE PERFORMED: 1/9/2023 COMMENTS: Test hole excavated by NORTHERN EXCAVATING PERFORMED BY: PES. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST. NOTES: PANNONE ENG SVC LLC (C.1. 1088) P.O. BOX 1807 PALNPER, AK 99645 PHONE 907 745-8200 FAX (907) 745-8201 REVISIONS OF �Q'•'' *'••.. even a 8149 ii DATE 12/14/2022 FOR CONSTRUCTION SHANGRI-LA ESTATES EAST, BLOCK 1, LOT 12 JOAN FREGLY SITE: NHN MOUNTAIN BREEZE DRIVE ANCHORAGE, AK SCALE 50 P.I.D. NO 020-043-53nnoee DRAWN DRM PERMIT N0. OSPXXXXXX NOTES SOILS LOG SHEET 2OF2 040.002 Client: Pannone Engineering Services Project: Shangra-La, Lot 12 C Date: January 13, 2023 Z Crowther Associates Particle Size Distribution Table (percent passing subject sieve size) Sample Source Lot 12 Sieve Size Percent Finer 3 inch 100 1-1/2 inch 100 3/4 inch 94 #4 73 #l0 27 #40 16 #100 15 #200 15 0.02 mm xx Classification Silty Gravelly Sand (SM) Invoice 185 1632 Bellevue Circle /Anchorage, Alaska 99515 Telephone (907) 349-2198 /E mail. Crowther@alaskaxet Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221457, Curtis Townsend, 11/30/22 % - VJ/VL/ IU) Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 2 of 2 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP201133 PID Number: 020-043-54 Dwelling: 0 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: F8_1 New ❑ Upgrade Name Joan Fregly ABSORPTION FIELD El Deep Trench 0 Wide Trench ❑ Bed [:1 Mound Site Address 16364 Mountain Breeze Dr ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 6.0 GPD/SF 4.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 3.5 Ft. Gravel depth beneath pipe 0.5 Ft. Subdivision Block Lot Shangri La Estates East 1 13 Fill added above original grade 1.5+ Ft, Gravel length 30 Ft. Township Range Section Gravel width 5.0 Ft. Beds: Number of Lines N/A Distance between lines N/A Ft. SEPARATION DISTANCES To Septic Absorption { Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank I Field I Tank Line 150 Fl? 1 N/A Ft. Well 100'+ 100'+ NAI NA 25'+ TANK ElSeptic ElS.T.E.P. [:1 Holding 9 Other Manufacturer Orenco Capacity 1500 Gal. Surface Water 100'+ 100'+ I NA NA Material Number of compartments Lot Line i 51+ 10'+ NA NA NA Plastic 2 Foundation 10'+ L i 10'+ I NA NA LIFT STATION Manufacturer Capacity I Remarks Orenco Advantex Orenco 250 Gal. Alarm location House Electrical installed by Solid Ground PIPE MATERIAL House to tank 3034 Tank to3034 Installer drainfield Northern Excavation Drainfield 3034 Co/MT3034 Inspector Pannone Engineering BENCH MARK (Assumed elevation)1282 ft ection im 06/12/20 Inspection d 06/15/20 Location and description 3,d 2 41h Bottom of House Trim ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp A � -,qN Conditional Approval: DateA oF. 0. q & T . a Suver F; t=aririore CF 8.149 Septic Syste �-� Approved .�lli(% Date r::....... '�.�``� Note: this ap oval does not include well permit requirements.�������'° % - VJ/VL/ IU) cn m n p_ _ _ co D CC){ o �7 C or X rl A m< vz mFnpu1 r-oo omzZo=D �:�E zoC)L,,o � N o, o m 0 c r- -1 Z Z m O O z m D o ; r -M N T� mp D r n �m 1 a S1 m 0 A 4 N K A O 9 nrn o i O O� 0 NOTES: RECORD DRAWING -i � w c O�Ocn � cn D cn -0 -+ z -u -<z0mDpLu n cn r D n -+room D O r.. zcnmi=xZ �[ D n D � N x >cn Cn N N N mD n N � "n �'� b N STI O �0 �O, �cn C7 in a� O -P C4 mo N 00 om O C14 C4 (0 \! A 0 m; -per 0) p: C° m a S1 m 0 A 4 N K A O 9 nrn o i O O� 0 NOTES: RECORD DRAWING I I I � D O C DC X G i �-Tj �n { C m C) I �\ >m mz N my� n I\•I \ D I I \ oll"I m 3 co z gZ 4�1 oma\ z I Of m IrnI nJ X o \ I m I N tul b> W \ D1,97��o0 m 7:' o0�pco to m m o ocn--ozz I I (-,I+-�LlFn F, F 'O� rnF-0-ice r- m < o cn EZ oon. ry { I ( I I I I I II I I PANNONE ENG SVC LLC (C.I. 1088) P.O. BOX 1807 PALUER, AK 99645 PHONE (907) 745-8200 FAX (907) 745-8201 K cn D cn -0 5 z � -<x0mD0m zcnm—;uz- -i � w c O�Ocn � cn D cn -0 -+ z -u -<z0mDpLu D cn r D n -+room D O r.. zcnmi=xZ �[ D n D 1 N x >cn Cn N N N mD n Z Om �'� O cnm U1� -� n STI O �0 �O, �cn C7 D CO O -P C4 W N 00 O O C14 C4 (0 \! A 0 -per 0) C° M CA cc) V N UP — 10 N -• -- O O -P N 41 O O I I I � D O C DC X G i �-Tj �n { C m C) I �\ >m mz N my� n I\•I \ D I I \ oll"I m 3 co z gZ 4�1 oma\ z I Of m IrnI nJ X o \ I m I N tul b> W \ D1,97��o0 m 7:' o0�pco to m m o ocn--ozz I I (-,I+-�LlFn F, F 'O� rnF-0-ice r- m < o cn EZ oon. ry { I ( I I I I I II I I PANNONE ENG SVC LLC (C.I. 1088) P.O. BOX 1807 PALUER, AK 99645 PHONE (907) 745-8200 FAX (907) 745-8201 K cn D cn -0 5 z � -<x0mD0m zcnm—;uz- -i � w c O�Ocn � cn D cn -0 -+ z -u -<z0mDpLu 0 cn r D n -+room D O r.. zcnmi=xZ �[ D n D 1 C0 ;u -<� �cnm< DD DNp m x >cn Cn r �0 �cnm� z-GIJD DNp <n CZj-0 m p- -imp _ Wim.. mD m O- -cM;o _.. Wim.. OOM Z Om �'� cnm U1� -� n STI O �0 �O, �cn C7 D omcl) Ko^ or+FT�� 0 U) KLO-cn� rrrnm �� O� m O ��o rc�rm� ° Oct rl O -1 z p { to Fri z p m m o m p O Ln cn r*i p m � SHANGRI LA ESTATES EAST B1 L13 DRAWN LJC JOAN FREGLY SITE: 16364 MOUNTAIN BREEZE DR SITE PLAN ANCHORAGE, AK St— R. Pcm m CE -8149 ('aa C. ' REVISIONS -1. 06/09/2021 SC05/28/21 ALE 06/15/2021 1 " = 60' P.I.D. NO 020-043-54 PERMIT NO. OSP201133 SHEET 1 OF 2 11 ii� 111111111111,1111111111111111111 Permit Number: #SW201133 Date of Issue: 6-10-2020 Parcel Identification Number: 02004354000 Date Started: 11-25-2020 Date Completed: 11-30-2020 Is well located at approved permit location? x Yes ❑ No Legal Description: Shangri-La East Block I Lot 13 Property Owner Name & Address: Joan Fregly Michelsohn & Daughter #3410 Belchen Drive Anchorage, Alaska. 99517 Borehole Data: Depth (ft) Method of Drilling x air rotary ❑ cable tool Soil Type, Thickness & Water Strata From TO Casing type: steel stick up 0 2 Wall Thickness:.250 inches bedrock 2 307 Diameter: 6 inches Depth: 43 feet Liner Type: -- Diameter: inches Depth: feet Casing stickup above ground: 2 feet Static water level (from ground level): 26 feet Pumping level: 300 feet after 2 hours pumping 1 gpm Recovery Rate: 4 gpm I Method of Testing: air Well Intake Opening Type: ❑ Open End x Open Hole ❑ Screened Start feet Stopped feet ❑ Perforations Start feet Stopped feet Grout Type: bentonite chips Volume: Jbi Pump: Intake Depth feet Pump size - hp Brand Name Well Disinfected Upon Completion? x Yes ❑ No Method of Disinfection: chlorine tablets Comments: Well Driller: Alpine Drilling & Enterprises PO Box 110496 Anchorage AK 99511 MONORMUMV00 Development Services Department k Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Pump Installation Log Well Drilling Permit Number: 201133 Date of Issue: 6 _ 10 _2020 Parcel Identification Number: 020 043 _54ow Legal Description Block Lot Property Owner Name & Address: I Joan Frealy!Michelsohn and Daughter Const. Shangri-La East 1 13 3410 Balchen Dr., Unit A I Anchorage, AK 991517 Pump Installation Date: 04/ -14 -2021 Pump Intake Depth Below Top of Well Casing: 290 Pump Manufacturer's Name: Goulds Pump Model: 7SH10 Pump Size: 1 hp Pitless Adapter Burial Depth. -N/A feet Pitless Adapter Manufacturer's Name: N/A Pitless Adapter Installer:N/ Well Disinfected Upon Completion? 0 Yes 0 No Method of Disinfection: chlorine Tablets Comments: PLEASE SAVE FOR COSA. Pump Installer Name: Company: Aarow Pump & Well Service, LLC Mailing Address:P.O. Box 110496 City: Anchorage State: AK Zip: 99511-0496 feet Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation. b It 6i Cf) F - w 0 m0 V) C-4 MI. 00 0 0 0) C14 04 to 0 04 n Ion :-�. C) m --f� Q 11) E Q) 0 L- C > hi 0 '0 0 -o n E -0 0 0 W 0) -0 E 0 J- -0 1 Q) c :2 C: =$ a- - _j =; i :3 r- a 0 (D 0 c 0 0 0 (1) (1) L- > 0 0 CN LL < El- V) a_ 0 o C) Lo a) rn C— c: — CS 0 CL -� 'L -00- ro F C- 0 x cn rL-.0 C,3 0 51 0 .0 0 0 5 0. m c a. Ct) CD w a rJy0 Q) 0 LL- cn 0 IL E 10, u: 0 vi m h Q) "E CL co C: 0. 2 C.: (D 0 < CD cn 0 W D bl) , 0, -0 z 0 _ . 0 < C) 0--o (D -0 N ct C 0 a) 0 (D C (a -Y C14 Q) .0 O*X CIO C14 04 MUNICIPALITY OF ANCHORAGE 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 .' �. i.:. Permit Number: OSP201133 Work Type: WellSeptic Initial Tax Code Number: 02004354000 Effective Date: Expiration Date: Site Legal Address: SHANGRI-LA ESTATES EAST BLK 1 LT 13 G:3239 Site Mailing Address: 16364 MOUNTAIN BREEZE DR, Anchorage Owner: FREGLY JOAN Design Engineer: PANNONE ENGINEERING SERVICES This permit is for the construction of: 6/10/2020 6/10/2021 Lot Size in Sq Ft: 40178 Total Bedrooms: 5 FA 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 Received B) Issued By: Date: & IO /.2,0 Date: 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 i Parcel I.D. 020-043-54 Property owner(s) RICHARD HARVEY Mailing address 22036 LAKE SENECA RD, EUSTIS FL 32736 Site address NHN MOUNTAIN BREEZE DRIVE Day phone Legal description (Sub'd., Block & Lot) SHANGRI LA EST EAST B1' L13 Legal description (Township, Range & Section) Lot Size 40,178Sq. Ft. Number of Bedrooms 5 APPLICATION IS FOR: (® all that apply) Initial N Absorption Field ❑x Septic Tank ❑X Holding Tank ❑ Privy ❑ Private Well ❑x Water Storage ❑ APPLICATION IS AN: TYPE OF DWELLING: Initial N Single Family (SF) ❑X . ' (w/wo ADU) Upgrade ❑ D;uplex (D) ❑ Renewal ❑ Multiple Dwellings ❑ (SF and/or D) 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. re of property owner or authorized agent) Permit/Rush Fees: 99Of &1:5. Date 15- Date of Payment: Jo2�0 %old aG Receipt Number: Gro'N& 06 Permit No. 015P21611B3 Permit App_-'-:. :_.,:c: Waiver Fees: Date of Payment: Receipt Number: Waiver No. r: COVID-19 2570 DISCOUNT APPLIED Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201133, Deb Wockenfuss, 06/10/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201133, Deb Wockenfuss, 06/10/20 DHI Consulting Engineers 3705 Arctic Blvd Suite 993 Anchorage, Alaska 99503 To: Steve R. Pannone Pannone Engineering Services, LLC (907) 745-8200 Municipality of Anchorage Onsite water and wastewater DHI Consulting Engineers, Dee High (Engineer) gives Steve Pannone permission to use Test hole log# L1381, performed 4/4/11, for design of septic system on Lot 13, Block 1 Shangra- La Estates East Subd. Unrestricted use of soils log is given with this letter • ,Lee High 6/6/2020. June 6, 20 907-240-5782 dhiconsultingeng@gmail.com W.O.# 05716 DHI CONSULTING ENGINEERS 800 E. DIMOND aL~. SUI~ 3-545 ANCHORAGE, ALASKA 99515 SOILS LOG-PERCOLATION ~ST ~ TEST HOLE LOG ~ L13B1 PERFORMED FOR: ANCHORAGE DEVELOP. & CONST. DA~ PERFORMED: 4/14/11 ~GAL DESCRIP~ON: LOT 15, BLOCK 1 SHANGRA-LA ESTATES EAST SUBD. ~ SLOPE Sl~ PLAN ~ ~ ORGANICS ~...~,~..; SAND ~ FROZEN SILT -- SM 2 ~ ' "~' SANDY GRAVEL W/ SOME SILT. V ~ ~ "~ BOULDERS TO 14'. MEDIUM TO .. ., HARD DIGGING. 5 ¢'.' /.~ BROWN SOIL, Ll~LE CLUMPING, 6 /, ~: ~ ~ 7 /,./.., 8 /"~*- WAS GROUND WA~R S 9 ~'' ~'~ ENCOUN~RED ? NO L ~' /' IF ~S. AT ~AT p 10 '" B.O.H. FRACTURED DEP~ ? E BEDROCK DEP~ OF WA~R 11 AFaR MONITORING ? NONE DATE: ~Y 16. 2Oll 12 ~. ~/1~/~ 133. 4/14/11 4:o5:17 14 5. ~/14/~1 ":':~ 15 17 PERCOLA~ON RA~: 0.60 (MINU~S/INCH.)PERCHOLE DIAMETER; 6" ~ST RUN BET~EN: 5.5 FT. AND 4,0 COMMENTS: THIS TEST HOLE INFORMATION IS PROVIDED TO COMPLY WITH THE SUBDIVISION APPROVAL PROCESS AS OUTLINED IN AMC 15.6.180.B.1. ANY USE OF THIS DATA FOR ANY OTHER PURPOSE. INCLUDING THE DESIGN OF AN INDIVIDUAL SE~IC SYSTEM IS STRICTLY PROHIBITED. WITHOUT THE WRI~EN CONSENT OF THE ENGINEER OF RECORD.  ALL SOILS WERE PRE-SOAKED PRIOR TO STARTING THE PERCO~TION TE~. PERFORMED BY: DHI CONSULTING ENGINEERS. I DEE HIGH CER~ THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 2/07/06 716CSSZD 1. 4/14/11 4:00 4;02:,36 2:36 12" 12' PRE SOAK 2. 4/14/11 4:02:36 .3, 4/14/11 4:05:17 4, 4/14/11 4,:08:09 6" 5. 4/14/11 4:11:25 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Parcel I.D. 020-043-54 Certificate of On -Site Systems Approval Expiration Date: _ q �/5 z2 1. GENERAL INFORMATION Complete legal description Shangri La Estates 16 B1 L13 Location (site address) 16364 Mountain Breeze Dr Current property owner(s) Joan Fregly Mailing address Real estate agent 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 Day phone Day phone 4. TYPE OF WATER SUPPLY: COSA Fee TYPE OF WASTEWATER DISPOSAL: Private Well El Private Septic R Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee Waiver Fee $ Date of Payment 611-A I Date of Payment Receipt Number 001636- Receipt Number COSA # 03G 2113 03 Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) 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 (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Reliance on this report by another person is at their own risk. Pannone Engineering Services LLC highly recommends buyers hire their own engineer to evaluate this report. Name of Firm Pannone Engineering Services Phone (907) 745-8200 Address P.O. Box 1807 Palmer, AK 99645 Engineer's Printed Name Steven R. Pannone P.E. 6. DSD SIGNATURE y System #1 Approved for �_ bedrooms System #2 Approved for bedrooms Disapproved Date -2169S2_E� Conditional approval for bedrooms, with the following stipulations: BY Original Certificate Date: The Municipality of Anc rage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet 11 1z �m ��--- ONSITE g WATER AND 0 WAS] LV 01 BY Original Certificate Date: The Municipality of Anc rage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet COSA Checklist Legal Description: Shangri La Estates East 131 L13 Parcel ID: 020-043-54 If more than 1 septic system on lot: COSA Checklist # 1 of 1 Structure served by this system 1 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled "30'020 Total depth 307 ft Cased to 43 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 24 in. Date of flow test for COSA Static water level at beginning of test 26 ft. Comments B. TANK DATA Age of tank(s) <1 years Tank type/material Measured operating fluid level in septic tank N/A ❑ Standpipes/foundation cleanout per record drawing Date of pumping New D. ABSORPTION FIELD DATA Shallow Trench Which system tested (date installed) ❑ ALL standpipes present per record drawing Total measured depth from grade 5.5-6.Oft (max) Measured depth to pipe invert from grade ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: New COSA Checklist yellow sheet Well production at time of test 4.0 gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes R No ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by PES Date of Sample M1�020 C. LIFT STATION ❑ Required maintenance completed Age of lift station <1 years Lift station material Plastic Comments: New Adequacy test date New Results PPass For 4 bedrooms Fluid depth prior to test in Water added gal New depth in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' P/1 Yes if No Community Sewer Manhole/Cleanout > 100' Q Yes if No ft [V Yes if No Neighboring Tank > 100' Q Yes if No ft Private Sewer/Septic Line > 25' Fv-1 Yes if No Absorption Field on Lot > 100' 0 Yes if No ft Holding Tank > 100' R Yes if No Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' 0 Yes if No Q Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' Yes if No ft 0 Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No ft Surface Water > 100' ft ft ft ft ft Q Yes if No ft Property Line > 5' P/1 Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' 0 Yes if No ft Private Wells > 100' ✓v Yes if No Water Main > 10' Yes if No ft Community Wells > 200' 0✓ Yes if No. Water Service Line > 10' Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' 2 Yes if No ft If absorption field is under driveway comment below Property Line > 10' 0 Yes if No ft Wells on Adjacent Lots: Water Main > 10' 0 Yes if No ft Private Wells > 100' El Yes if No Water Service Line > 10' Q✓ Yes if No ft Community Wells > 200' R Yes if No Surface Water > 100' Q Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION l certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. zjdC !.5"" COSA Checklist yellow sheet ft ft ft ft MT --CN ICTPALITY OF ANCaO-;RAGE WAS77ENVA6UR TREA" W -N -T SVS -TEM MAINTE NANCEMNIP RX -FAM AGRE M,.F..N-T' REE, EEN N T d d ThIS MA.LN-TENANCE AND RJ-"P4,!,.R,AG3 R.1v -, rr -.1 n ilat "AG .P, Dav cyt jltcr,-md inl-o as of Lbis Ir rci'ii ih'ClViF.-NEFL-, a3d At: unict-3,13 -ixl An forage, here-jr, thg "MUN I CiPA Ana-borapr Nfun-"Cipsl C-ldt (AN4,C) 1 15.653:65. In mo i c(Yven,-,;alls cowJi.ed herminlv)iz par. i :, m ibis AWonn r. at -,!:! c F -5s --'o Divs T -C AM Val.) l-e'd Wast-eware'l. 711 c J -barmd F, I N P. 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Qw-irg, of Lw A,ny uivil aQnmla7T-S - f --- , ---A ��l , ' - ,i7� TCJTj AgmClllo! , . iall 15, OTOughl in lie SUPOw COUK on tho TA&I.Inktizial & !bs Sivis of,AlvSk, u-, I fig,f - "S ,F'N.Trlkt� Urialc! Lhis k . 7. puly P'nLilIwisions of US Agreemcm, decrced iavali,,d cc�lzri ctf cFarnzvt,-.i in',evild.a1!.2 the n,=, ,ning . 'OsAcnis _ pro (rev. 05/18/2018) Page 2 of 3 OWNER: - By: � (signatuie) Date: (print name) STATE OF ALASICk) ) ss. THIRD JUDICIAL DISTRiCT) The forcaoinc, instrument vas acknowledged before me this 20cl,l by lqlc�01(13 NOTARY PUBLIC FOR ALASKA My Commission expires: �Aw �Q MUNICIPALITY: By: & _(signature) Date: (print name) Title: VIA day of JOUR� -1