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HomeMy WebLinkAboutTUXEDNI PARK BLK 1 LT 2Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP231348 PID Number: 041-022-02 Dwelling: 0 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: 9 New ❑ Upgrade Name Deborah Wrigley ABSORPTION FIELD RE Deep Tren❑chOt❑ Wide Trench El Bed FJ Mound Site Address 9551 Chenega Dr Phone Number of Bedrooms Soil Rating depth from original grade Four(4) 1.2 GPD/SF JTotal 9.3 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 2'3 Ft. Gravel depth beneath pipe �� Ft. Subdivision Block Lot Tuxendi Park 1 2 Fill added above original grade 2.5 Ft. Gravel length 36.0 Ft. Township Range Section Gravel width 3.0 Ft. Beds: Number of Lines NIA 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 504 FF Ft. Well >100' >1 00' N/A N/A >25' TANK RI Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Greer Capacity 1,500 Gal. Surface Water >100' >100' N/A N/A Material Plastic 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 Orenco Capacity 250 Gal. Remarks Deep burial tank. Alarm location Electrical installed by In Garage Wire Up AK PIPE MATERIAL House to tank Tank to D3034 grainfield D3034 Installer Northern Excavation Drainfield D3034 CO/MT D3034 Inspector M. Jakubisin BENCH MARK (Assumed elevation) 100 ft Inspection 15` 2/14/24 2/16/24 Location and description dates: 2nd Top of Foundation @ Point C 3m 4"' ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp k, Conditional Approval: Date �49 A,`'�fi 101 .• • H :9 � Septic System Approved ��-�� Date 2 Benjaq Schiller Aw 92 9/27/24 .���Aw Note: this approval es not include well requirements. k�'s� k %FPR0FESS00__1ft—_ permit (Rev 05/02/18) ALTERNATE SITE Benjamin Schiller CE 12592 R E G ISTEREDPROFE S S I O N A L E N GINEER 1"=50' 36' LONG x 3' WIDE, 7' EFFECTIVE DEPTH ABSORPTION TRENCH CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND TH#1 PERMIT # OSP231348 PID # 041-022-02 TUXEDNI PARK, BLOCK 1 LOT 2 A B FCO 12.1 MH1 MH2 A B C C 6.4 28.3 31.5 MT1 CO1 MT2 40.8 39.5 70.3 CO2 73.6 24.8 24.0 26.6 25.7 44.8 47.9FEET 0 50 100 FCO CHE N E G A D R I V E 4-BDRM HOME PLAN AS-BUILT 9/12/24 870 860 850 840 840 NEW WELL NEW 1,500-GAL STEP TANK MIN 10' SEPARATION TO FOUNDATION MT1 MT2 NEIGHBORING SEPTIC POND 100' FROM STANDING WATER NEIGHBORING WELL RADIUS TH#2 CO1 CO2 MH2 MH1 BM PROFILE AS-BUILT (NO SCALE) 95.4 90.1 96.5 100.5 FC O MH 1 MH 2 PERMIT # OSP231348 PID # 041-022-02 TUXEDNI PARK, BLOCK 1 LOT 2 1500 GAL STEP TANK 101.9 FINISH GRADE 36' MT TH # 2 GROUNDWATER @ 83.4 2/21/24 90.1 97.1 CO CO 82.9 90.1 97.1 99.4 ORIGINAL GRADE MT 97.3 Benjamin Schiller CE 12592 R E GISTEREDPROFE S S I O N A L E N GINEER 9/12/24 DRAINFIELD ROCK OUTLET LINE ADAPTED TO 4" AT START OF TRENCH FOR GRAVITY FEED 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 2 DATE READING START TIME NET TIME(minutes) DEPTH toWATER NET DROP PERCOLATION RATE: (MIN/INCH) (inches)(inches) DATE OF MONITORING WAS WATER ENCOUNTERED? DEPTH TO WATER AFTER MONITORING IF YES @ WHAT DEPTH? 3.3 2/14 1 2 3 4 5 6 GM (SILTY GRAVEL) Professional Engineers Stamp: YES TUXEDNI PARK B1 L2 2/14/2024 041-022-02 ALEX SNEGIREV 9:41 1 0 1630:00 Benjamin Schiller CE 12592 R E GISTEREDPROFE S S I O N A L E N GINEER PERC TEST LOCATION TECHNICIAN:M. JAKUBISIN & J.OPHEIM 7 0 16 16' 16' 2/21/24 COMMENTS: SITE PLAN 6 0 16 USCS SOIL CLASSIFICATION WAS VISUALLY DETERMINED 9/12/2024 BOH 1 0 16 10:00 3 1116 3 6 16 3 116 2 14 16 3 0 16 10:06 1 0 16 10:0010:16 1 0 16 10:0010:26 1 0 16 10:0010:36 1 0 16 10:0010:46 1 0 16 10:0010:56 4 11 16 4 6 16 4 1 16 3 14 16 4 0 16 4 0 167 3 0 16 OB M-W Drilling, Inc. ♦P.O. Box 110389♦Anchorage, AK 99511♦ ♦907-345-4000♦ Job No. 24-110 Permit No: OSP231348 GROUNDWATER WELL LOG Well Owner: Deborah Wrigley Use of Well: Domestic Site Description: Legal Description: Well Coordinates: 9551 Chenega Dr., Anchorage, Alaska Tuxedni Park Subdivision, Block 1, Lot 2 Lat: 61.160612 Long: -149.703207 CONSTRUCTION Drill Method: Air rotary Hole Size: 6” Well Depth: 76.13’ Casing Material: A53B steel Casing Size: 6” Wall: .250 Cased to: 76.13’ Well Completion: Open end: X Screen: Liner: Perforated: Method: Screen/Perforation Description: Grout Notes: 2 sacks (50#ea) of bentonite Well Development: Air surge Well Disinfected : Yes Method: Chlorine bleach Yield Test at 20 GPM for 1 hour(s) with 100% of drawdown (DD) from static level (SWL). Method: Air lift Static Water Level (SWL): 29’ Start Date: 3/29/24 Completion Date: 3/29/24 Test Pump Date: n/a Final Pump Install Date: WELL LOG Depth in feet from top of casing. Details of formations penetrated, size of material, color and miscellaneous details. 0 TO 3 Casing Stick up 3 TO 10 Gravel: pad fill 10 TO 22 Gravel: sandy, medium, brown 22 TO 31 Sand: wet, fine 31 TO 60 Gravel: sandy, wet 60 TO 76 Water gravel: medium to coarse, 20gpm 76 TO 80 Sand: wet, heaving Kris G. Westberg Vice President, M-W Drilling, Inc. Alaska Gen Contr Lic #1000 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 Pump Installation Log Well Drilling Permit Number: _______________ Date of Issue: ____-____-____ Parcel Identification Number: ____-____-____ Legal Description Block Lot Property Owner Name & Address: Pump Installation Date: _____-_____-_____ 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?  Yes  No Method of Disinfection: _____________________________ Comments: Pump Installer Name: __________________________________ Company: ___________________________________________ Mailing Address: ______________________________________ City: ___________________ State: __________Zip: _________ Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation. x Lot 2, Block 1 Tuxedni Park Subdivision 82,378 Sq. Ft. +/- 9551 Chenega Drive 2 Story Wood Frame House With Attached 3 Car Garage EG W T T TT T T E E E SS SS S SCSC N8 9 ° 5 6 ' 5 3 " E 1 8 8 . 1 6 ' N00° 00' 00"E 359.23' N00° 06' 37"W 444.01' N6 9 ° 2 6 ' 5 7 " W 1 0 8 . 7 3 ' L=15 1.4 4 R =30 5.0 0 1 0 0 ' W E L L RA D I U S 10 ' U T I L I T Y E A S E M E N T 2.5' x 5.0' U.G. TELEPHONE & POWER EASEMENT E D G E O F P A V E M E N T DIRT DRIVEWAY 20 ' U T I L I T Y E A S E M E N T LOT 1 OH U OH U OH U OH U OH U OH U OH U OH U OH U OH U OH U OH U OH U OH U OH U OH U OH U 10' UTILITY EASEMENT 10' UTILITY EASEMENT 10' UTILITY EASEMENT 10 ' U T I L I T Y E A S E M E N T 10' UTILITY EASEMENT30' SEE "DETAIL A" "DETAIL A" SCALE 1" = 30' LOT 1, BLOCK 4 STUCKAGAIN HEIGHTS SUBDIVISION PLAT #67-41 LOT 2 HILLSIDE NORTH SUBDIVISION ADDN. NO. 4 PLAT #92-36 LOT 7 BLOCK 1 ℄ C H E N E G A D R I V E 70. 9 ' 73 . 2 ' 29 . 9 ' EG S 38.8' 26 . 5 ' 43.5' 22 . 2 ' 9. 3 ' 4.9' 2.3' 10 . 1 ' 8.3' 16 . 2 ' 34.3' 26 . 4 ' 6.7' 19 . 1 ' 11.3' 11.5' 17 . 1 ' 12 . 1 ' 12.9'4. 3 ' 21.6' 5. 6 ' PREPARED BY: FRONTIER SURVEYS, LLC 650 W. 58th AVE. SUITE E, ANCHORAGE, AK 99518 907-460-1686 DRAWN BY: CHECKED BY: DATE: SCALE:GRID: SW2042 1.Excepting for gross negligence, the liability for this survey shall not exceed the cost of preparing this survey. Dimensions to property lines are plus/minus 0.1ft. 2.This document is created by Frontier Surveys for the purpose of an as-built survey for Alexander Homes only. 3.This document is based on Plat No. 67-103, Anchorage Recording District. General Notes DisclaimerLegend 1. This survey complies with the ASPLS Mortgage Location Standards. The survey represents visible improvements and conditions at the time of the survey. This document does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may reveal. It is the responsibility of the Owner to determine the existence of any easements, covenants, or restriction which do no appear on the record plat. Under no circumstances should this document be used for construction or for establishing a boundary or fence line. RS 1" = 40ft 09/23/2024 24-187BH Scale 1" = 40' AN AS-BUILT SURVEY OF LOT 2, BLOCK 1 TUXEDNI PARK SUBDIVISION 9551 CHENEGA DRIVE CONTAINING: 82,378 Sq. Ft. +/- (RECORD) RECORD PLAT: 67-103 R E GISTEREDPROFESSIO N A L L A N D S U RVEYORRachel N. Shoemake No. L.S. - 14646 Sep 24, 2024 DRAWING ID: Gas Meter Electric Meter G E Septic Water Well S W SC Septic Cover Wood Deck Concrete E Elec. Pedestal Tel. PedestalT Telephone Pole Overhead Utility MUNICIPALITY OF ANCHORAGE �l»cnt On -Site Water & Wastewater Program fie , ; ;_. Is, PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite I�epartmenc On -Site Water & Wastewater System Permit Permit Number: OSP231348 Effective Date: 10/12/2023 Work Type: WellSeptic Initial Expiration Date: 10/11/2024 Tax Code Number: 04102202000 Site Legal Address: TUXEDNI PARK BLK 1 LT 2 G:2042 Site Mailing Address: 9551 CHENEGA DR, Anchorage Owner: WRIGLEY DEBORAH E Lot Size in Sq Ft: 82378 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 i J Special Provisions: • A test hole is required prior to construction of the absorption field, in the location shown on the site plan, to confirm minimum separation to impermeable soil and seasonal high groundwater, as well as percolation rate. Construction may proceed at your own risk prior to 7-day groundwater monitoring. If results require a design change, construction shall stop pending approval of a change order. Please submit results with the inspection report (or change order, if required). 12/5/2023 Change Order#1 Increase design to 4 bedrooms. pry Date: Issued By: k"/r l�l/�i-, Date: 2 Z MUNICIPALITY OF ANCHORAGE Community Development Departments --' fr` Y Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWERIWELL PERMIT APPLICATION Parcel I.D. 041-022-02 Property owner(s) Deborah Wrigley Day phone Mailing address 7200 Big Mountain Drive, Anchorage, AK 99516 Site address NHN Chenega Drive, Anchorage, AK 99507 Legal description (Sub'd., Block & Lot) Tuxendi Park, Block 1 Lot 2 Legal description (Township, Range & Section) Lot Size 82,37$ Sq. Ft. Number of Bedrooms is w APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (N all that apply) Absorption Field ❑X Initial ❑X Single Family (SF) ❑X Septic Tank ❑X Upgrade F](w/wo AD U) Holding Tank ElRenewal ElDuplex (D) El 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:.H�gZO Waiver Fees: Date of Payment: o lit Z Date of Payment: T—� Receipt Number: _ n 9 � 1 Receipt Number: Permit No. 05P2 1-3 y'3 Waiver No. Permit App_'- ::-.,_c CC) October 6, 2023 PO BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) FORGECIVIL.COM MOA Development Services, On -Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Tuxendi Park, Block 1 Lot 2 - Chenega Drive Septic system design Dear On -Site Services Engineer: The owner of the above lot intends to build a 4 -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. The ground surface on the lot slopes fairy uniformly toward the road at about 5-15%. 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. Wells on this and adjacent lots are shown. No conflicts exist between this proposed system and any other well or septic system, whether on this lot or adjacent lots. 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 6' away. Please refer to the attached test hole logs, plan and profile pages for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Benj amin`Schiller, PE TUXEDI PARK, BLOCK 1 LOT 2 LOT 3 LOT 7 r � � { r \ NEW WELL f - rj I \ rJ NEIGHBORING " SEPTIC NEIGHBORING X, 3 WELL RADIUS BLOCK 4 LOT 1 di ;4-BDRM�1iOME NEW 1,500-GAL STEP TANK \ POND TH#1 i / MIN 10' SEPARATION TO / FOUNDATION f / I FCO_ 1 00'FROM STANDING WATER / _ / ® Z4#2, T � \ -'f 36' LONG x 3' WIDE, T EFFECTIVE ALTERNATE SITE ; DEPTH ABSORPTION TRENCH CONFIRM 100' SEPARATION TO LOT 2 SURFACE WATER I BLOCK 1 LOT 1 � r _ I E 1, j l---------------- BLOCK 4LOT 2 ',. ENGINEERING _ Of _ LEGEND��� CO - CLEANOUT �?:''' *: 49 T �: �0 SEPTIC PLAN 2C0 -DOUBLE CLEANOUT �b. ".- 611,.9 • • • • FCO - FOUNDATION CLEANC FS- FLOW SPLITTER VALVE Benja i MH - MANHOLE CE 20 50 100 MT -MONITORING TUBE •11/16/23,.- �Fo , • • • • FEET SV - SEPTIC VENT 1 "=50' TH -TEST HOLE TUXEDNI PARK, BLOCK 1 LOT 2 Cc Z DESIGN FACTORS: SYSTEM REQUIREMENTS: 600 GPD PEAK FLOW T DEEP TRENCH SYSTEM PERK RATE: 3.33 MIN/IN 1,500-GAL STEP TANK APPLICATION RATE: 1.2 GPD/SF 600 GPD / 1.2 GPD/SF / T DEEP / 2 SIDES = 35.7 LF TRENCH REQUIRED (36 LF SPECIFIED) BOTTOM OF TRENCH: 9' BELOW. GRADE (>6' FROM GROUNDWATER) FLOW LINE ELEVATION: 2' BELOW GRADE �"'�"'�E ADDITIONAL MIN 6" FILL OUNT FOR SETTLEMENT ILE FABRIC RATED PVC (HOLES DOWN) _D ROCK 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 ENGINEERING l • • ' • • Benjar , Schiller • •' I �F •• CE 125922115124 •��i ,�lil,��PROFESSIONP�� � 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 to WATER NET DROP PERCOLATION RATE: (MIN/INCH) (inches)(inches) DATE OF MONITORING WAS WATER ENCOUNTERED? DEPTH TO WATER AFTER MONITORING IF YES @ WHAT DEPTH? 0.09 8/7 1 2 3 4 5 6GM (SANDY GRAVEL) Professional Engineers Stamp: NO TUXEDNI PARK B1 L2 8/7/23 041-022-02 ALEX SNEGIREV 3:45 0 1 2 0:20 Benjamin Schiller CE 12592REGISTEREDPROFESSION A L E N GINEER PERC TEST LOCATION TECHNICIAN: M Jakubisin 6 1 2 - NONE 8/14/23 COMMENTS: SITE PLAN 6 0 16 USCS SOIL CLASSIFICATION WAS VISUALLY DETERMINED 8/11/23 GM (SILTY GRAVEL) 0 1 2 0:28 6 1 2 6 0 16 0 1 2 0:31 6 1 2 6 0 16 0 1 2 0:33 6 1 2 6 0 16 0 1 2 0:34 6 1 2 6 0 16 0 1 2 0:33 6 1 2 6 0 16 SAMPLE TAKEN FROM 13 - 17.5 (SILTY GM) LAYER Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231348, Deb Wockenfuss, 10/12/23 c'o z- L,. SOILS LOG AND PERCOLATION TEST E N G I N E E R I N G LEGAL DESCRIPTION: TUXEDNI PARK BI L2 PERFORMED FOR: ALEX SNEG IREV DATE: 2/ 14/2024 PARCEL ID#: 041-022-02 DEPTH TEST HOLE 2 (feet) 1 IIIIIIII OB DATE READING START TIME NET TIME DEPTH TO WATER NET DROP (MINUTES) (INCHES) (INCHES) 2 2/14 1 9:41 30:00 1 s 7 -9- 6 %6 3 2 10:06 10:00 1 -s 4 s 3l%6 4 3 10:16 10:00 1 -s 4 -L 16 3 %6 PERC TEST LOCATION 5 '1 4 10:26 10:00 1 16 4 is 3 %6 6 5 10:36 10:00 116 316 214/6 6 10:46 10:00 1 -9-6 4-1 3 %6 7 .' 8 GM (SILTY GRAVEL) 7 10:56 10:00 1 is 4 -s 3 %6 PERCOLATION RATE: 3.3 (MIN/INCH) 9 10 SITE PLAN 11 - 12 - 13 14 15 ' 16 BOH 17 18 19 YES WAS WATER ENCOUNTERED? 16' IF YES a, WHAT DEPTH? DEPTH TO WATER AFTER MONITORING - DATE OF MONITORING TECHNICIAN: M. JAKUBISIN & J.OPHEIM COMMENTS: USCS SOIL CLASSIFICATION WAS VISUALLY DETERMINED MUNICIPALITY OF ANCHORAGE o Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 041-022-02 Legal description TUXEDNI PARK BLK 1 LT 2 Site address 9551 CHENEGA DR Current property owner(s) ALEXANDER HOMES LLC Expiration Date: 9/17/2025 X The On-site system(s) is/are approved for 4 bedrooms _ Conditional approval for bedrooms, with the following stipulations: Comments or advisories: By: Original Certificate Date: 9/30/2024 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 Ot "s Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 041-022-02 Complete legal description Tuxedni Park Block 1 Lot 2 Location (site address) 9551 Chenega Drive, Anchorage, AK 99507 - Current property owner(s) Alexander Homes Day phone (907) 830-6211 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY: 0 Private Well R Private Well serving 2 dwelling units 0 Private Well serving 3+ dwelling units El Community Well or Public M Water Storage 4. TYPE OF WASTEWATER DISPOSAL: RN Private Septic R Private Septic serving 2 dwelling units F-1 Holding Tank M Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel FN_1 Plastic n Concrete n Fiberglass Age NEW _ See advisory if steel older than 20 years 6. ABSORPTION FIELD: 0 AWWTS F] Bed E] Deep Trench [k Wide Trench F-1 Seepage Pit Waiver request for: Expedited review requested: 0 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 Waiver Fee $ Date of Payment C1 I/-;?- /-i Date of Payment COSA # 05C2, � / 3 9 -2— Waiver # COSA ApplicationJune2022 3.65 9/17/24 N/A N/A N/A Benjamin Schiller, P.E. (907) 522-7773