HomeMy WebLinkAboutJASMINE LT 2f
AML
tKev uo/uui a/
Municipality of Anchorage
On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3
ON-SITE
WASTEWATER INSPECTION REPORT
Permit Number: OSP231178
PID Number: 051-211-12
Dwelling: M Single Family (SF)
❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: 9 New ❑ Upgrade
Name
Troy Davis Homes
ABSORPTION FIELD
❑i Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound
Site Address
NHN Parks Creek Circle
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
(907)310-2501
Three(3)
1.2 GPD/SF
8.0 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
2.0 Ft.
Gravel depth beneath pipe
6.0 Ft.
Subdivision
Block Lot
Jasmine
2
Fill added above original grade
1.4 Ft.
Gravel length
32 Ft.
Township Range Section
Gravel width
3 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
384 Ft2
1
NIA Ft.
Well
>100'
>100'
N/A
N/A
>25
TANK ❑. Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer
Infiltrator
Capacity
1060 Gal.
Surface Water
>1
>100'
N/A
N/A
Material
Plastic
Number of compartments
2
Lot Line
25'
>10'
N/A
N/A
NA
Foundation
> 10'
>10'
NIA
N/A
TATION
Manufacture
Capacity
Remarks
Gal.
ZZ
Alarm location
Electra Iled by
PIPE MATERIAL House to tank D3034 Tank to D3034
drainfield
Installer
Precision General Contractors
Drainfield D3034 CO/MT D3034
Inspector B. Schiller
BENCH MARK (Assumed elevation) 100 ft
Inspection 1:t 9/7/23
9/8/23
Location and description
dates:
r
2 nd
m th
Top of Foundation @ B
3
4
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
Engineer's Stamp
Conditional Approval:
Date
'9c5'4�
49 TH
1
. ............
Benjarq'n-Schiller
r�y tr,, CE 12592 e`v
111e%* (. 12/10/24 y*,'Wr
Septic System
Approved ,--tet
Date1(0/20 iS
Note:
�lkRDEES�-�
this approval does not include well permit requirements.
tKev uo/uui a/
JASMINE. LOT 2
PERMIT # OSP231178
91.9
PID # 051-211-12
N
H
V�
F H �-,
N [ERIN G
CITTA
N N
OO
e 95.3 FINISH GRADE -� i- 93.9 ORIGINAL GRADE 20 v
2" FOAM INSULATION
DRAINFIELD ROCK
L 32' 85.9 85.9 1
�- ---�
NO GROUNDWATER 5/29/18
m
PROFILE AS -BUILT
(NO SCALE)
91.9
..,♦••.
Benja' Schiller'..
119�C/�l' C 912592 Aw
JASMINE, LOT 2
Benja i Schiller '
C 92
91112:.
�tl\��PROfESSiONP�'... �
PLAN AS -BUILT
0 50 100
FEET
1 "=50'
A
FCO
17.1
10.3
MH
23.6
18.8
SV
28.2
15.9
2CO
31.0
16.2
C01
61.9
39.7
MT1
63.5
40.6
CO2
40.9 69.9
MT2
37.0 73.1
LEGEND
CO - CLEANOUT
2CO - DOUBLE CLEANOUT
FCO - FOUNDATION CLEANC
FS - FLOW SPLITTER VALVE
MH - MANHOLE
MT - MONITORING TUBE
SV - SEPTIC VENT
TH - TEST HOLE
|
�
Lot 3B
O' UTILITY EASEMENT-
S
&SEWENT
----T
| | | `-10' T&E EASEMENT
/ | |
N
�
��"
K�� �
40,061 S.F
0' DRAINAGE EASEMENTS
SEPTIC PIP
/
/
Lot 4A . / Lot 48
15 UTILITY EASEwEMT
r /
'TREE U�
-/ /
|
|�1 STORYRESIDENCE
643
|RES IDENCE
' SEPTIC MAMHOLE-/
|.
. �4.1 x 8.5. DECK
|
| W
GRAVEL
| 5' T&E EASEMENT
N 8953'24^W ' ���-------�
PARKS CREEK CIRCLE
Lot 1
MOTES GROUND LEVEL IMPROVEMENTS SHOWN ARE APPROXIMATE. OAJ[ OF SURVEY: xx SEPTEMBER 2825
PLOT PLAN AS BUILT —2�— SCALE GRID NW 1059 ProJect No. 125—Z��9AIP.O. Box 210005
Lang & Associates, inc. Anchorage, Alaska 99521-0005 Z'6 -Aqk, 5T,
(9071522-6476 F'1`1�kkll
Professional Land surveyors stirvey@langsume�y.coni '-F
I hereby certify that I have surveyed the following described property:
LOT 2. JASMINE SUBDIVISION (PLAT No. 2022-36) 49
Anchorage Recording District, Alaska, and that the improvements situated thereon are
within the property lines and do not encroach onto the property adjacent thereto, that
no Improvements on the property lying adjacent thereto encroach on the surveyed
01)
premises and that there are no roadways, transmission lines or other visible JONATH C. LANG
easements on said property except as indicated hereon.
Doted this the Day of
at Anchorage, Alaska
It Is the responsibility of the owner to determine the existence of any easements, O�ZSSIONP&
covenants, or restrictions which do not appear on the recorded subdivision plot. State of Alaska AECC963
Authentisign ID: A7099C54-9A1 9-F01 1-BB3D-00224822F75A
Wheaton Water Well,
1190 N. Wasilla-Fishhook Road
Wasilla, AK 99654
(9071376-2041
Name:
8C
Troy Davis Homes
Address:
1689 S Knik Goose Bay Rd. #400
City:
Wasilla State:
AK
Zip Code: 99654
Well Site:
007TRC G:1059
Lot/Block: 2
Additional:
Jasmine Subdivision
Well Depth:
145 ft.
From:
To:
Formation:
0
2
stick up
Below Ground:
143 ft.
2
32
dirt/gravel
Above Ground:
2 ft.
32
43
water/gravel/dirt
Gal/Min:
2gpm
43
132
green bedrock
132
145
green bedrock
Static Level:
Casing:
47' 6" of 6 in. x.25 in. steel"
Liner Pipe:
N/A
Screened:
N/A
Perforated:
43-45'
Grouted:
Grouted
Depth:
20'+
Develop. Method:
Air
Use of Well:
Residential
Drilling Method:
Rotary
Misc:
well chlorinated to 50 ppm
Other:
flowrate to be determined at Aquafir Test
Date Drilled:
2/20/2020 Driller:
Brandon Moore
[lei
Pump Installation Log
Well Drilling Permit Number: (/;l'- 2 ;// F k.- Date of Issue:
Parcel Identification Number: Cis 12A .1117&11�2
Legal Description Block Lot Property Owner Name & Address:
/Y
Pump Installation Date: �-,5—
Pump Intake Depth Below Top of Well Casing: feet
Pump Manufacturer's Name:
Pump Model:
Pump Size: hp
Pitless Adapter Burial Depth: feet
Pitless Adapter Manufacturer's Name:
Pitless Adapter Installer:
Well Disinfected Upon Completion? 0 Yes 0 No
Method of Disinfection:
Comments:
Z
Pump Installer Name: 1/
Company:
Mailing Address:
Citv:za 1//,2- State:! Zip:
Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation.
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 & Wastewater System Permit
Permit Number: OSP231178
Work Type: WellSeptic Initial
Tax Code Number: 05121112000
Site Legal Address:
Site Mailing Address:
JASMINE LT 2 G:1059
Owner: TROY DAVIS HOMES INC
Design Engineer: FORGE ENGINEERING
This permit is for the construction of:
Effective Date:
Expiration Date
�0�
Q Willie�
Del)ai-tnaent
Lot Size in Sq Ft:
Total Bedrooms:
7/11/2023
7/10/2024
40061
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
Received By: ftn C' (-- Date:
Issued By: I Date: ( 23
3
MUNICIPALITY 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. 051-211-12
Property owner(s) Troy Davis Homes Day phone (907) 310-2501
Mailing address 1689 Knik Goose Bay Road #600, Wasilla, AK 99654
Site address NHN Parks Creek Circle
Legal description (Sub'd., Block & Lot) Jasmine Subdivision, Lot 2
Legal description (Township, Range & Section)
Lot Size 40,061 Sq. Ft. Number of Bedrooms 3
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field
Q
Initial 0
Single Family (SF) 0
Septic Tank
Q
Upgrade ❑
(w/wo ADU)
Holding Tank
El
Renewal El
Duplex (D) ❑
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: Z 0 Waiver Fees:
Date of Payment: 6 ? Y 'ZO2 3 Date of Payment:
Receipt Number: 0 0 % (4) Receipt Number:
Permit No. 05f 73 Waiver No.
Permit App__- : :—'.,:c
June 26, 2023
MOA Development Services, On-Site Water & Wastewater Program
4700 Elmore Rd
Anchorage, AK 99507
Subject: Jasmine, Lot 2
Septic system design
Dear On-Site Services Engineer:
The owner of the above lot intends to build a 3 -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 propo sed well, septic location
and alternate site.
The ground surface on the lot slopes moderately down away from the road, at a fairly uniform rate.
There are no slopes greater than 25% within 50 feet downslope of either the primary or alternate
site. Contours 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.
Existing test hole locations are approximate, and the locations and separation from adjacent wells
will be confirmed at the time of installation. If a new test hole is needed it will be excavated and
tested prior to construction of the trench.
The new system will be a minimum of 100’ from all wells and surface water, and more than 5’
away from the septic tank. The alternate site is located more than 12’ away. Please refer to the
attached test hole logs, plan and profile pages for the septic design. If this design is followe d, 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
OSP231178, Curtis Townsend, 07/11/23
ALTERNATE SITE >12' AWAY
Benjamin Schiller
CE 12592REGISTEREDPROFESSION A L E N GINEER
1"=50'
32' LONG x 3' WIDE, 6' EFFECTIVE
DEPTH ABSORPTION TRENCH
CONFIRM PROXIMITY TO TH#2 OR
DIG CONFIRMATION TH
1000-GAL
SEPTIC TANK
CO - CLEANOUT
2CO - DOUBLE CLEANOUT
FCO - FOUNDATION CLEANOUT
FS - FLOW SPLITTER VALVE
MH - MANHOLE
MT - MONITORING TUBE
SV - SEPTIC VENT
TH - TEST HOLE
LEGEND
2CO
TH#2
JASMINE, LOT 2
FEET
0 50 100
FCO
PARKS CREEK CIRCLE
3-BDRM HOME
650
SEPTIC PLAN
6/22/23
CO2
15' T&E EASEMENT
10' T&E EASEMENT
10
'
D
R
A
I
N
A
G
E
E
A
S
E
M
E
N
T
660
640
670
NEW WELL
CO1 MT1
MT2
TH#1
CONFIRM SEPARATION FROM
NEIGHBORING WELLS DURING
INSTALLATION
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231178, Curtis Townsend, 07/11/23
JASMINE, LOT 2
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 12592REGISTEREDPROFESSION A L E N GINEER
4" PERFORATED PVC (HOLES DOWN)
DRAINFIELD ROCK
3'
1'
1'-6"
6'
DESIGN FACTORS:SYSTEM REQUIREMENTS:
450 GPD PEAK FLOW
PERK RATE: 2 MIN/IN
APPLICATION RATE: 1.2 GPD/SF
6' DEEP TRENCH SYSTEM
1000-GAL SEPTIC TANK
BOTTOM OF TRENCH: 8' BELOW GRADE
FLOW LINE ELEVATION: 2' BELOW GRADE
450 GPD / 1.2 GPD/SF / 6' DEEP / 2 SIDES = 31.3 LF TRENCH REQUIRED (32 LF SPECIFIED)
GEOTEXTILE FABRIC
6"
6/22/23
INSULATION
PROVIDE ADEQUATE SOIL SO THAT
COVER REQUIREMENT IS MET AFTER
SETTLEMENT
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231178, Curtis Townsend, 07/11/23
LEGAL DESCRIPTION:
PERFORMED FOR:
DATE:
PARCEL ID#:
SOILS LOG AND PERCOLATION TEST
TECHNICIAN:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
DEPTH
(feet)
PROJECT No.:
TEST HOLE #1
SLOPE
SLOPE
SITE PLAN
See Site Plan
DATE READINGGROSS TIME
(minutes)
NET TIME
(minutes)
DEPTH to
WATER NET DROP
TEST HOLE PRESOAKED PRIOR TO TESTING:
PERC. HOLE DIA. (INCHES)PERCOLATION RATE: (MIN/INCH)
TEST RUN BETWEEN: FT. and FT.
COMMENTS:
(inches)(inches)
Jasmine Subdivision - Lot 2
Troy Davis
01/26/18
C. Johansen
Development Services Department
4700 Elmore Road Anchorage, AK 99519-6650
Municipality of Anchorage
DATE OF MONITORING:
WAS GROUND WATER ENCOUNTERED?
DEPTH OF WATER AFTER MONITORING:
IF YES @ WHAT DEPTH?
No
NONE
1/26
0" / 6"
0.4 6
4 5
-
-
OB
silty sand
w/ some gravel (sp-sm)
12:15/12:17 1
12:18/12:20 2
2:05 6"
2:10 6"
12:21/12:23 3
12:24/12:26 4
2:12 6"
2:10 6"
12:27/12:29 5
12:30/12:32 6
2:12 6"
2:12 6"
0" / 6"
0" / 6"
0" / 6"
0" / 6"
0" / 6"
Professional Engineers Stamp:
Jan 14, 2020
5/29/18
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231178, Curtis Townsend, 07/11/23
LEGAL DESCRIPTION:
PERFORMED FOR:
DATE:
PARCEL ID#:
SOILS LOG AND PERCOLATION TEST
TECHNICIAN:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
DEPTH
(feet)
PROJECT No.:
TEST HOLE #2
SLOPE
SLOPE
SITE PLAN
See Site Plan
DATE READINGGROSS TIME
(minutes)
NET TIME
(minutes)
DEPTH to
WATER NET DROP
TEST HOLE PRESOAKED PRIOR TO TESTING:
PERC. HOLE DIA. (INCHES)PERCOLATION RATE: (MIN/INCH)
TEST RUN BETWEEN: FT. and FT.
COMMENTS:
(inches)(inches)
Jasmine Subdivision - Lot 2
Troy Davis
01/26/18
C. Johansen
Development Services Department
4700 Elmore Road Anchorage, AK 99519-6650
Municipality of Anchorage
DATE OF MONITORING:
WAS GROUND WATER ENCOUNTERED?
DEPTH OF WATER AFTER MONITORING:
IF YES @ WHAT DEPTH?
No
NONE
1/29
3.3 6
4 5
-
-
OB
silty sand
w/ some gravel (sp-sm)
10:30/10:40 1
10:41/10:51 2
10
10 3"
10:52/11:02 3
11:03/11:13 4
11:14/11:24 5
11:25/11:35 6
0" / 3"
0" /3 18" 3 18"
10 3"0" / 3"
10 3"0" / 3"
10 3"0" / 3"
10 3"0" / 3"
Professional Engineers Stamp:
Jan 14, 2020
5/29/18
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231178, Curtis Townsend, 07/11/23
Wheaton Water Well, Inca
1190 N. Wasilla-Fishhook Road
Wasilla, AK 99654
(907)376-2041
Name:
Troy Davis Homes
Address:
1689 S Knik Goose Bay Rd. #400
City:
Wasilla State:
AK
Zip Code: 99654
Well Site:
007TRC G:1059
Lot/Block: 2
Additional:
Jasmine Subdivision
Well Depth:
145 ft.
From:
To:
Formation:
0
2
stick up
Below Ground:
143 ft.
2
32
dirt/gravel
Above Ground:
2 ft.
32
43
water/gravel/dirt
Gal /Min:
2 9P m
43
132
green bedrock
132
145
green bedrock
Static Level:
Casing:
47' 6" of 6 in. x .25 in. steel"
Liner Pipe:
N/A
Screened:
N/A
Perforated:
43-45'
Grouted:
Grouted
Depth:
20'+
Develop. Method:
Air
Use of Well:
Residential
Drilling Method:
Rotary
Misc:
well chlorinated to 50 ppm
Other:
flowrate to be determined at Aquafir Test
Date Drilled:
2/20/2020 Driller:
Brandon Moore
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: OSP201007
Work Type: Well Initial
Tax Code Number: 05121110000
Site Legal Address: 007 TR C G:1059
Site Mailing Address:
Owner: TROY DAVIS HOMES INC
Design Engineer: FORGE ENGINEERING
This permit is for the construction of:
(e) j - - L -L
Effective Date
Expiration Date:
Lot Size in Sq Ft:
Total Bedrooms:
ri
k
Dep a tmcnt
1/24/2020
1/23/2021
846219
❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy d 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: f'
Issued By:
Date:- f Zo2-u
T
Date: `�
P0 Ak- ,.
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
0571-'211010
Parcel I. D--6fi--22'f ='rQ
Property owner(s) Troy Davis Homes Day phone 310-2501
Mailing address 1689 Knik Goose Bay Rd #400, Wasilla, AK 99654
Site address NHN Jasmine Road Chugiak, AK 99567
Legal description (Sub'd., Block & Lot) Jasmine Subdivision, Lot 2 (Proposed)
Legal description (Township, Range & Section) Tract C, 007 Subdivision
Lot Size 846,219 Sq. Ft. Number of Bedrooms TBC
APPLICATION IS FOR: APPLICATION IS AN:
TYPE OF DWELLING:
(M all that apply)
Absorption Field ❑ Initial 0
Single Family (SF) ❑X
Septic Tank ❑ Upgrade ❑
. (w/wo ADU)
Holding Tank 1:1Renewal F-1Duplex
(D) ❑
Privy ❑
Multiple Dwellings ❑
(SF and/or D)
Private Well ❑X
Water Storage ❑
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
i 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: �S
Date of Payment: I /a/ Igo 26
Receipt Number: o ft5bb
Permit No. 05 P2 61 WI7
Permit App_.;- :- :' .. c;
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
January 23, 2020
MOA Development Services Department
On -Site Water & Wastewater Program
4700 Elmore Rd
Anchorage, AK 99507
Subject: 007 Subdivision, Tract C
Proposed Jasmine Subdivision — S1.2406
Aquifer Test Wells
Dear Onsite Services Engineer:
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPUANG
OSP201006, Deb Kbckenfuss, 01/241
Jasmine Subdivision is composed of 1.1 Lots and I Tract and is located off of Jasmine Road in
Chugiak. It is surrounded by developed lots with onsite private wells. The lots proposed for the
subdivision are in excess of 40,000 square feet and are proposed to have on site wells and septic
systems.
Three wells are proposedforplacementin the subdivisionon proposed Lots 1, 2 and 11. The wells
will be placed at sites which will represent standard locations relative to septic system sites and
home sites on typical lots in the subdivision. Each well will be pumped in accordance with AMC
15.55.060F 1 to establishthe sustainedy ieldas determinedby the well driller. Waterqualitytesting
from each well will be accomplished in accordance with AMC 15.55.060172. A formal report
including sustained yield results for each well will be submitted once all data is gathered and
analyzed. The well locations have been determined with the assistance of Jim Munter, the
hydrogeologist for the project.
Permit applications are attached for placement of the three wells in the subdivision. We hereby
requesty ourapproval to complete the well and waterstudyto determine the capacityof the aquifer
to support the proposed wells for the subdivision.
The location of the wells and the proposed location of the houses and septic systems on the lots
will not impact adjacent properties
Sincerely,
Michael E. Anderson, P.E.
Attachments
ECLl-ZZS-GO6 b6E6-LSE-L06
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MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: (907)343-7904
On-Site Water & Wastewater Section Fax: (907)343-7997
Ul
Certificate of On -Site Systems Approval
OSC251402
Parcel ID 051 -211-12
Legal description JASMINE LT 2
Site address 23081 PARKS CREEK CIR
Expiration Date: 8/18//2026
Current property owner(s) BYLER CONTRACTING
X The On-site system(s) is/are approved for 3 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or conditions:
No comments
By:Original Certificate Date: 9/19/2025
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 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
Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 051-211-12
Complete legal description Jasmine Lot 2
Location (site address) 23081 Parks Creek Circle
Current property owner(s) Byler Contracting
2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS
Day phone 907-357-3073
3. TYPE OF WATER SUPPLY: 0 Private Well serving # 1 dwelling units
❑ Other Non-public well as regulated by MOA ❑ Water Storage
❑ Community Well or Public
4. TYPE OF WASTEWATER DISPOSAL: X Private Septic ❑ Private Septic serving 2 dwelling units
❑ Holding Tank ❑ Community Septic or Public Sewer
5. SEPTIC TANK: ❑ Steel FO -1 Plastic ❑ Concrete ❑ Fiberglass
Age 2 - See advisory if steel or fiberglass older than 20 years
6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed FO -1 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 $ ? S
Date of Payment V3/A
COSA # 0 SC ZSI qa L
Waiver Fee $
Date of Payment
Waiver #
COSA Application_Apr2025.doc
COSA Checklist
Legal Description: Jasmine Lot 2
Parcel ID: 051-211-12
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system 1
A. WELL DATA
Adequacy test date New
0 Well log is filed with Onsite (or attached)
Well production at time of test 2 gpm
Date drilled 2/20/20 Total depth 145 ft
Water storage tank volume N/A gallons
Cased to 47.5 ft
Well disinfected for coliform test? ❑ Yes 0 No
0 Sanitary seal is functioning correctly
0 Coliform bacteria is Negative
❑ Wires are properly protected
Nitrate 0.32 mg/L ❑ Nitrate less than MRL (ND)
Casing height (above ground) 24 in.
Arsenic ug/L 0 Arsenic less than MRL (ND)
Date of flow test for COSA 2/20/20
Collected by Forge Engineering
Static water level at beginning of test 25* ft.
Date 8/18/25
Comments * Measured by Forge Engineering on 9/19/25
B. TANK DATA
Measured operating fluid level in septic tank New
Date of pumping New
❑ Requ ance completed, if AWWTS
Comments:
D. DISPOSAL FIELD DATA
LIFT STATION
❑ Requi aintenance completed
Age of lift stationears
Lift station material
Comments:
Which system tested (date installed) 9/8/23
Adequacy test date New
0 ALL standpipes present per record drawing
Results ❑, Pass
Total measured depth from grade 9.4 ft (max)
id depth prior to test in
Measured depth to pipe invert from grade 3.4 ft (min)
Wate dded gal
171N/A — pressurized field.
New fluid th in
0 Per record drawings, field is insulated.
Elapsed time min
❑ Mom {�es_gQto bottom of effective.
Final fluid depth in
If not, state depth into effective--,
Absorption rate d
oaked required if
FIELD STATUS — POST RE VERY
(Requir house vacant or field not used for more
than 30 days p ' to date of test)
Effective depth (per record drawi s
Gallons introduced gallons date
Effective depth used in
Any rejuvenation treatment (past 1 ths)
Effective depth remaining in
If yes, enter date
Comments/Deficiencies: System was not put into use until home was recently finished
COSA Checklist_May2025.docx
in
E. SEPARATION DISTANCES
From Well on Lot to: (Please enter distances if less than required)
Septic Tank/Lift Station on Lot > 100'
Sewer Manhole/Cleanout > 100'
R Yes if No
Sewer Service/Septic Line > 26[j] Yes if No
Holding Tank > 100' Yes if No
Animal Containment > 50' Yes if No
Manure/Animal Excreta Storage > 100'
V Yes if No
❑ N/A — Served by Community Well (not on lot) or Public Water
From Septic/Holding Tank and Disposal Field(s) on Lot to: (Please enter distances if less than required)
ft
ft
ft
ft
l<
Tank to Foundation > 10'
H Yes
if No
ft
Neighboring Tank > 100'
n Yes
if No
ft
Disposal Field on Lot > 100'
[E Yes
if No
ft
Neighboring Disposal Fields > 100'
Tank to Property Line > 5'
0
n Yes
if No
ft
Sewer Line/Main > 100'
E Yes
if No
ft
Sewer Manhole/Cleanout > 100'
R Yes if No
Sewer Service/Septic Line > 26[j] Yes if No
Holding Tank > 100' Yes if No
Animal Containment > 50' Yes if No
Manure/Animal Excreta Storage > 100'
V Yes if No
❑ N/A — Served by Community Well (not on lot) or Public Water
From Septic/Holding Tank and Disposal Field(s) on Lot to: (Please enter distances if less than required)
ft
ft
ft
ft
l<
Tank to Foundation > 10'
0
Yes
if No
ft
Surface Water > 100'
Yes if No ft
Field to Foundation > 10'
E
Yes
if No
ft
Wells on Adjacent Lots:
Tank to Property Line > 5'
0
Yes
if No
ft
Wells > 100'
n Yes if No ft
Field to Property Line > 10'
0
Yes
if No
ft
Community Wells > 200'
lm Yes if No ft
Water Main/Service Line > 10'
no
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 Forge Engineering
Engineer's Printed Name Benjamin Schiller, P.E.
COSA Checklist_May2025.docx
Phone (907) 522-7773
Date 9/19/25
OF ACq�y�l
'.� e _ r°
Benjarri wSchiller
CE 12592Awe
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