HomeMy WebLinkAboutSKY RIDGE LT 20
Sky Ridge
Lot 20
#015-275-20
Development Services Department
Building Safety Division
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On -Site Water & Wastewater Program a
4700 Elmore Road
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P.O. Box 196650 Q
MaikBegich Anchorage, AK 99507 s E T Y
Mayor www.muni.org/onsite
(907) 343-7904
Pump Installation Log
Well Drilling Permit Number: - O�P GS Date of Issue:
Parcel Identification Number:
Legal Description ` ` Property Own7r N�me & Address:
�ak 2U
Pump Installation Date:
Pump Intake Depth Below Top of Well Casing: a 56 feet
Pump Manufacturer's Name: ay, a 6,-)
Pump Model: �j (� `� — 330
Pump Size ) , `-) hp
Pitless Adapter Burial Depth: ) 3 feet
IPitless Adapter Manufacturer's Name: C c vv6 t( 8-10
Pitless Adapter Installer: N L I I �
Well Disinfected Upon Completion? [T Yes ❑ No
Method of Disinfection: C;� lov Ac\t J S
I Comments:
Pump Installer Name: Johnny Kay
Hefty Drilling, Inc.
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On-Site Water & Wastewater Section Fax: 907-343-7997
Well Log
Permit Number: #__________ Date of Issue: ________ Parcel Identification Number: __________________
Date Started: _________ Date Completed: _________ Is well located at approved permit location? Yes No
Legal Description:_________________________________________________________________________
Property Owner Name & Address: _______________________________________
_______________________________________
_______________________________________
Borehole Data: Depth (ft)
Soil Type, Thickness & Water Strata From To
Method of Drilling air rotary cable tool
Casing type: _________
Wall Thickness: inches
Diameter: inches Depth: feet
Liner Type: _________
Diameter: inches Depth: feet
Casing stickup above ground: feet
Static water level (from ground level): feet
Pumping level: feet after
hours pumping gpm
Recovery Rate: gpm
Method of Testing: _________
Well Intake Opening Type:
Open End Open Hole
Screened Start feet Stopped feet
Perforations Start feet Stopped feet
Grout Type: _________ Volume: _________
Depth: _________ Start feet Stopped feet
Well Disinfected Upon Completion? Yes No
Method of Disinfection: Comments:
Well Driller: _____________________________
Company: _____________________________
Mailing Address: _____________________________
Water Sample Results:
Arsenic: _________ ug/L
Nitrates: _________ mg/L
Total Coliform Bacteria:_________ colonies/100mL
Attention: The well driller shall provide a well log to the
On-site Water and Wastewater Section within 30 days of
completion.
Lot 20, Sky Ridge Subdivision
Land Surveying
Land Development Consultants
Subdivision Specialists
Construction Surveying
124 E 7th Avenue
Anchorage, Alaska 99501
(907) 306-8104
mail@S4AK.com
AEC#173042
Group
S4 Asbuilt
11/21/2023
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
On -Site Water System Permit
Permit Number: OSP231063
Work Type: Well Initial
Tax Code Number: 01527520000
Site Legal Address: SKY RIDGE LT 20 G:2634
Site Mailing Address: 11198 SKY RIDGE DR, Anchorage
Owner: HULTQUIST HOMES INC
Design Engineer: PANNONE ENGINEERING SERVICES
This permit is for the construction of:
Effective Date
Expiration Date:
Lot Size in Sq Ft:
Total Bedrooms:
»cnt
�0 Sof,
Department
4/21/2023
4/20/2024
❑ Disposal Field ❑ 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 By: SS Ute I -0F S Date:
Issued B 2 r 29 Z 3
Y� Date:
5
MUNICIPALITY OF ANCHORAGE
Community Development Department f`-� Phone: 907-343-7904
Development Services Division Fax: 907-343-7997
On -Site Water & Wastewater Program
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel 1. D. 015-275-20
Property owner(s) Hultguist Homes, Inc. Day phone
Mailing address 12570 Old Seward Highway Anchorage, AK 99515
Site address 11198 Sky Ridge Drive
Legal description (Sub'd., Block & Lot) Sky Ridge Lot 20
Legal description (Township, Range & Section)
Lot Size 20,932 Sq. Ft. Number of Bedrooms 5
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field
❑
Initial X❑
Single Family (SF)
X❑
ADU)
Septic Tank
ElUpgrade
El(w/wo
Duplex
ElHolding
(D)
Tank
ElRenewal
ElMultiple
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: A2.2 Sc- Waiver Fees:
Date of Payment: L/ /!2/ 3 Date of Payment:
Receipt Number: 00..5y 16 Receipt Number:
Permit No. C),5P'2---2-j063 Waiver No.
Permit App__- : -
Pannone Engineering Services LLC
Steven R. Pannone, Principal
Registered Professional Engineer
E-mail: steve@panengak.com
Mailing: P.O. Box 1807 Palmer, AK 99645
Telephone: (907) 745-8200 FAX: (907) 745-8201
11 April 2023
Municipality of Anchorage
Development Services Department
On-Site Water & Wastewater Program
4700 Elmore Road
P. O. Box 196650
Anchorage, Alaska 99519
Subject: Sky Ridge Lot 20
Well Permit Request
Well Design Narrative
This is a design narrative for a permit to install a private well to be issued for this property. Currently the lot is
undeveloped. This lot and the surrounding lots are to be served by public sewer. Currently there are no sewer mains
or private septic systems within 100’ of the proposed installation.
1. Initial Well Design.
The well will be located: 100’+ from any sewer main.
100’+ from any on-site septic system.
25’+ from any private sewer lines.
The proposed installation will not affect the future development of this or the surrounding lots.
If you have any questions or concerns, please contact me at (907) 745-8200.
Sincerely,
SRP
Steven R. Pannone, PE, F. ASCE
Owner/Civil Engineer
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231063, Curtis Townsend, 04/21/23
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DATE 12/31/2023 TIME 12:00 AM INSPECTOR
SCHEDULED
SUBDIVISION SKY RIDGE BLOCK/LOT/TRACT LT 20/
INDICATE NORTH Vr
Sec
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VL%A Qev4
Lak i
3I, of 4" Pvc
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'7 b 4 " Q'/ C.
tills 5�(Y RIclyt br.
SIZE MAIN:
TYPE MAIN:
DEPTH AT MAIN:
AT PROP, LINE:
CONNECT LOCATION: ' [ p f N w
COMMENTS: Ct vj,.4C4w l�,AeC o bel, Ot S�
o f .cr ,
(e2' OE "U C Pro oS !4u
INSPECTED BY: ; C /
DATE: VIVO
MUNICIPALITY OF
i t
' xi. 3.�n
Development Services Department
On -Site Water & Wastewater Section -'
Parcel I.D. 015-275-20
Certificate of On -Site Systems Approval
Legal description SKY RIDGE LT 20
Site address 11198 SKY RIDGE DR
Current property owner(s) HULTQUIST HOMES INC
Expiration Date:
Phone: 907-343-7904
Fax: 907-343-7997
7/3/2025
X The On-site system(s) is/are approved for 5 bedrooms
_ Conditional approval for bedrooms, with the following stipulations:
Comments or advisories:
By: Original Certificate Date: 7/15/2024
This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
system(s) is/are in substantial compliance with municipal code. The Municipality of
Anchorage, Development Services 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 work.
ATTACHMENTS:
COSA Checklist X Well Flow Advisory
Absorption Field Advisory Nitrate Advisory
Tank Age Advisory Arsenic Advisory
Other
COSA Approval_June 2022
Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 01527520
Complete legal description Sky Ridge L20
Location (site address) 11198 Red Sky
Current property owner(s)
2. ON-SITE SYSTEMS SIZED FOR 5 BEDROOMS
Day phone
3. TYPE OF WATER SUPPLY: ME Private Well ❑ Private Well serving 2 dwelling units
El Private Well serving 3+ dwelling units ❑ Community Well or Public
R Water Storage
4. TYPE OF WASTEWATER DISPOSAL:E] Private Septic 0 Private Septic serving 2 dwelling units
F Holding Tank FE Community Septic or Public Sewer
5. SEPTIC TANK: E] Steel n Plastic F1 Concrete n Fiberglass
Age - See advisory if steel older than 20 years
6. ABSORPTION FIELD: F-1 AWWTS R Bed R Deep Trench R Wide Trench 0 Seepage Pit
Waiver request for:
Expedited review requested: FN
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 $_ 1
Date of Payment L
COSA # 0 S C Z_
Waiver Fee $
Date of Payment
Waiver #
COSA Application—June 2022
COSA Checklist_June 2022
COSA Checklist
Legal Description: Parcel ID:
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____
A. WELL DATA
Well log is filed with Onsite (or attached)
Date drilled Total depth ft
Cased to ft
Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) in.
Date of flow test for COSA
Static water level at beginning of test ft.
Well production at time of test gpm
Water storage tank volume gallons
Well disinfected for coliform test? Yes No
Coliform bacteria is Negative
Nitrate mg/L Nitrate less than MRL (ND)
Arsenic ug/L Arsenic less than MRL (ND)
Collected by
Date
Comments __________________________________________________________________________________
B. TANK DATA
Measured operating fluid level in septic tank
Date of pumping
Required maintenance completed, if AWWTS
Comments:
C. LIFT STATION
Required maintenance completed
Age of lift station years
Lift station material
Comments:
D. ABSORPTION FIELD DATA
Which system tested (date installed)
ALL standpipes present per record drawing
Total measured depth from grade ft (max)
Measured depth to pipe invert from grade ft (min)
N/A – pressurized field.
Per record drawings, field is insulated.
Monitor tubes go to bottom of effective.
If not, state depth into effective
Presoaked required if
(Required if house vacant or field not used for more
than 30 days prior to date of test)
Gallons introduced gallons date
Any rejuvenation treatment (past 12 months)
If yes, enter date
Adequacy test date
Results Pass
Fluid depth prior to test in
Water added gal
New fluid depth in
Elapsed time min
Final fluid depth in
Absorption rate gpd
FIELD STATUS – POST RECOVERY
Effective depth (per record drawings) in
Effective depth used in
Effective depth remaining in
Comments/Deficiencies:
COSA Checklist_June 2022
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well on lot)
Septic Tank/Lift Station on Lot > 100’
Yes if No ft
Neighboring Tank > 100’ Yes if No ft
Absorption Field on Lot > 100’ Yes if No ft
Neighboring Absorption Fields > 100’
Yes if No ft
Community Sewer Main > 75’ Yes if No ft
Community Sewer Manhole/Cleanout > 100’
Yes if No ft
Private Sewer/Septic Line > 25’ Yes if No ft
Holding Tank > 100’ Yes if No ft
Animal Containment > 50’ Yes if No ft
Manure/Animal Excreta Storage > 100’
Yes if No ft
N/A – Served by Community Well (not on lot) or Public Water
From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required)
Building Foundations > 10’ Yes if No ft
Tank to Property Line > 5’ Yes if No ft
Field to Property Line > 10’ Yes if No ft
Water Main > 10’ Yes if No ft
Water Service Line > 10’ Yes if No ft
Surface Water > 100’ Yes if No ft
Wells on Adjacent Lots:
Private Wells > 100’ Yes if No ft
Community Wells > 200’ Yes if No ft
If tank or field is under driveway comment below
F.ENGINEER’S COMMENTS
G.CERTIFICATION & 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, indicates that the on-site water
supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation, unless noted otherwise.
Name of Firm Phone
Engineer’s Printed Name Date