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HomeMy WebLinkAboutRABBIT CREEK VIEW & HEIGHTS BLK 1V LT 9BOnsite File Rabbl*t Vi*ew & Heights Block i V • � i Formerly RCV&H Block 1V Lot 10A 020-521-15 Municipality of Anchorage On-Site Water and Wastewater Section - (907) 343-7904 Page 1 of 2 ON-SITE WASTEWATER INSPECTION REPORT Permit Number:.OSP241130 PID Number: 020-521-28 Dwelling: 9 Single Family (SF) r_1 with ADU El Duplex (D) M Two Single Family Project: IN New [I Upgrade Name MICHAEL STANFILL ABSORPTION FIELD 0 Deep Trench M Wide Trench n Bed FM Mound Site Address 15600 NICKLEEN ST [] Other Phone Number of Bedrooms Soil Rating depth trom original grade 3 2.0 GPDISF JTotal 0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade +0-5 Ft. Gravel; depth beneath pipe 1 Ft. Subdivision Block Lot ROBBIT CREEK HEIGHTS & VIEW BILK IV LOT z'D Fill added above original grade 2.5 Ft. GraveHength 47 Ft. Township Range Section Gravel width 5.0 Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES TO Septic Absorption Lift Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 235 Ft2 1.0 Ft. Well 50'+ 501+ 50'+ TANK W Septic [I S.T.E.P. 0 Holding Q Other Manufacturer Capacity ANCH TANK/ADVANTEX 15001 Gal. Surface Water 50'+ 50'+ Material Number of compartments Lot Line 110'+ 10'+ NA STEEL 2 Foundation 10'+ 101+ LIFT STATION IManufacturer capacity Remarks ANCH TANK 250. Gal. Alarm location NW CORNER Electrical installed by BRICKS ELECT Installer PIPE MATERIAL House to tank 3034' Tank to drainfield 3034 MIKE N ANDERSON Drainfield 3034 CO/MT3034 BENCH MARK (Assumed elevation) 100;; It Inspector MIKE N ANDERSON Inspdates: ection 1 st 3/20125 3/22/25 Location and description 2w 31d 4th TOP OF MH ON-SITE WATER AND WASTEWATER SECTION APPROVAL Eng !neers Stamp F Conditional Approval: Date 41 4 9 T �T- J Septic Syste V0 • MICHAEL N. ANDERSON Approved Date.w� e. nts. this approval does not include well permit requirem� }ii pP,pt�� j�'�-� kmev V;)lu,17 Permit No. OSP241130 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description: RABBIT CREEK VIEW & HEIGHTS BILK IV LT 9B TCO2 UMP BASIN PID No.: 020-521-28 NEW 1500 GALLON STEEL TANK W/ ADVANTEX POD AND PUMP BASIN ��l I C04 1 ` t WELL I \ \ BENCH, TOP OF MH � I 50' STREAM OFF SET ELEVATED DECD ASBUILT SCALE: 1"=50' SEPTIC SECTION WATER ® 95.5 OCT 2023 N.T.S. --2 .�,**"%ILYA 11♦ ♦ ` 0� q �P••'' ..�5♦♦ Ar 49 TH ': �♦�� MICHAEL N. ANDERSON: C_yj= No. CE 9469OA. �. •.,8-4-25 MARK A B C01 18 33.7 TC01 23.2 35.6 TCO2 28.4 40 PUMP BAST 32.4 36 MT1 33.8 27 MT2 77.1 29.1 TCO2 UMP BASIN PID No.: 020-521-28 NEW 1500 GALLON STEEL TANK W/ ADVANTEX POD AND PUMP BASIN ��l I C04 1 ` t WELL I \ \ BENCH, TOP OF MH � I 50' STREAM OFF SET ELEVATED DECD ASBUILT SCALE: 1"=50' SEPTIC SECTION WATER ® 95.5 OCT 2023 N.T.S. --2 .�,**"%ILYA 11♦ ♦ ` 0� q �P••'' ..�5♦♦ Ar 49 TH ': �♦�� MICHAEL N. ANDERSON: C_yj= No. CE 9469OA. �. •.,8-4-25 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 hftp://www.muni.org/onsite On -Site Water & Wastewater System Permit Permit Number: OSP241130 Work Type: WellSeptic Initial Effective Date Expiration Date: Tax Code Number: 02052115000 Site Legal Address: RABBIT CREEK VIEW & HEIGHTS BLK 1V LT 10A G:3241 Site Mailing Address: Owner: STANFILL KYLE MICHAEL 50% & Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING This permit is for the construction of: Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ill l 11 (' t)elm rtIII ent 7/ 12/2024 7/12/2025 Lot Size in Sq Ft: 37301 Total Bedrooms: 3 Q Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: Prior to installing new system, the percolation rate of the organic layer is to be determined. Submit change order if necessary. Received By: (S `'i f�%, 7✓ Date: _ — . j Issued By: r�f�----- Date: 7,2 MUNICIPALITY OF Development Services Department ��❑ On -Site Water & Wastewater Section ON -SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 020-521-15 Property owner(s) MICHAEL STANFILL Mailing address NICKLEEN ST ANCH AK Site address SAME Day phone Phone: 907-343-7904 Fax: 907-343-7997 Legal description (Sub'd., Block & Lot) RABBIT CREEK VIEW & HEIGHTS BLK 1V LT 10A Legal description (Township, Range & Section) Lot Size 37301 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field Fx_1 Initial I -XI Single Family (SF) 0 (w/wo ADU) Septic Tank El Upgrade ❑ Duplex ❑ (D) Holding Tank ❑ Renewal ElMultiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well t4 Water Storage ❑ THIS APPLICATION INCLUDES A 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: P- 12 Date of Payment: ���❑ y Receipt Number: OC�� Permit No. 5 2-`-i 1130 Waiver Fees: Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc May 5, 2024 Municipalities of Anchorage Development Services Dept. On-Site Water & Wastewater Section Anchorage, Alaska 99519 Phone 343-7904 Re: Septic & well permit Legal: RABBIT CREEK VIEW & HEIGHTS BLK 1V LT 10A To Whom it may concern: This is a request for a septic and well permit on the above referenced lot. A single test hole was excavated and found 3 feet of organics (OG) then silty gravel (GM) mixed with silty sands (ML/GM) to the bottom of the hole at ten feet. Water was observed at 4.5 feet, during the excavation and after the 7-day monitoring period. The perc rate was 10 minutes per inch. Due to the lot size and soils an Advantex system has been designed for the lot. The lot slopes at 3 to 4 percent towards the northwest. A small unnamed stream and wetlands exist on the south side of the site, see the site plan. This design will incorporate both the organic side-wall for absorption and the bottom of the system. This new well and septic system will not impact any of the surrounding neighbors, most are vacant. Sincerely Michael N. Anderson, P.E. 4661 Natrona Anch, Ak 99516 Ph 727-8864 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241130, Curtis Townsend, 07/12/24 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. MUNICIPALITY OF ANCHORAGE Development Services Department Phone:. 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Well Log Permit Number: # OSP2411130 Date of Issue: 7/12/24 Parcel identification Number: 020-521.1 Zt'� Date Started: 9/19/24 Date Completed: 9/20/24 Is well located at approved permit location_" Yes ® No ❑ Legal Description: Rabbit Creek View & Heights BLK 1V IT W G:3241 Property Owner Name & Address: ""`" Wckleen St. _-- — Anchorage, AK Borehole Data: Depth (ft) Soil Type, Thickness & Water Strata From To Casing Stick Up 0 — 2 Overburden _ 2 10 Grey Cla w/ Fine -Medium Gravel 10 15 Grey Silt & Fine -Coarse Gravel 15 19 Moist Grey Silt & Fine -Coarse Gravel 19 30 Grey Silt & Fine -Coarse Gravel 30 58 Medium -Coarse Gravel w/H20 Dirty 58 65 Grey Clay w/ Fine -Medium Gravel 65 84 Wet Grey Clay w/ Fine- "um Gravel 84 98 Fine -Coarse Gravel w/ H2O 98 104 LAT: 61.079361 LON: -149.726755 Water Sample Results: Arsenic: Nitrates: , Total Coliform Bacteria: Method of Drilling ®airrotary ❑cabletool Casing type: A53B Wall Thickness:•250 inches Diameter: 6 inches Depth: -194 .feet Liner Type: — Diameter: _ _ inches Depth: _feet Casing stickup above ground: 2_feet Static water level (from ground level): 0 feet Pumping level: feet after hours pumping -=- gpm Recovery Rate:2, 0 wpm Method of Testing: Air Lift Well Intake Opening Type: ❑ Open End ❑ open Holli ❑ Screened Start _fc4et Stopped „____feet Cl Perforations Start `f<{ct Stopped _feet Stan Well Disinfected Upon Complc Method of Disinfection: Tabsc Well Driller: Company: Mailing Address: Yes No ugr2 m&'L coionicsl100ml. Attention: The well driller shall provide a well log to the On-site Water and Wastewater Section within 34 days of completion. WL W L WL W L WL 1"=200' PROPERTY LINE PROOSE NEW WELL 50' RADIUS -JAMIE A V E - PROPOSED 3-BEDROOM HOUSE SCALE: DJRDRAWN: DATE: RABBIT CREEK VIEW & HEIGHTS BLK 4H, LT 15A Anchorage, Alaska TARAS ILNITSKIY 12/21/2023 PROPOSED 4-BEDROOM ADVANTEX SEPTIC VACANT 10' UTILITY EASEMENT DESIGN CRITERIA: 1.0' EFFECTIVE 3 BDRM X 150 = 450 GPD SOILS = 450 GPD/2.0GPD/SF = 225 SF 225SF/5*0.87 = 40 LF OF TRENCH 5.0' WIDE 40' LONG (1) TRENCH 5.0' DEEP W/ 2' OF MOA FILTER MATERIAL -10 (TH#1 ) -3.0 GM/ML ORG MOUND OVER W/ 6" FILTER FABRIC & 2" INSULATION ‘3,3(: TOPSOIL & SEED WATER 4.5' OCT 2023 3:1 +3.0 -3.0 TANK BUOYANCY IF REQ. 5,000 LBS CONCRETE (6YD)ML LAYER 5.0' VACANT VACANT 24" MOA FILTER MATERIAL REMOVE ALL ORGANICS 12" DRAIN ROCK SMALL UNNAMED CREEK 10' UTILITY EASEMENT -1.0 +0.5 ‘#2& SMALL UNNAMED CREEK Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241130, Curtis Townsend, 07/12/24 1"=50' PROPERTY LINE 50' STREAM OFF SET SCALE: DJRDRAWN: DATE: RABBIT CREEK VIEW & HEIGHTS BLK 1V, LT 10A Anchorage, Alaska MIKE STANFILL & STANFORD MILLER 6/2/2024 D R I V E W A Y NEW ROUND 1500 GALLON ADVANTEX TANK W/ PUMP BASIN, 10' FROM THE FOUNDATION & 5' FROM FIELD/DECK TYP. BALLAST W/ 6 YDS OF CONCRETE IF WATER OBSERVED MT TH#1 FCO 10' UTILITY EASEMENT TCO ST R E A M F L O W VACAN T SECOND PERC TEST REQUIRED ORGANIC LAYER PRIOR TO INSTLLATION MT 2-3% 15' WET LANDS OFF SET 2-3% 2-3% 10' UTILITY EASEMENT 10 ' U T I L I T Y E A S E M E N T JAMIE AVE NI C K L E E N S T Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241130, Curtis Townsend, 07/12/24 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241130, Curtis Townsend, 07/12/24 MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this 13 Day of 0-3v h3 G of 20114, by and between kteu . AtG14A4,t- stAt�lcRl. , herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as A m aNSM Y, C. G*4yentN located at (legal description) P-A"f Vie W ? W 4.% 0 35' 1r, L- l 10A 2. Maintenance, Repairs and Alterations. O er is required to read, understand and initial each section) ughout the term of this Agreement, the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. �It shall be the responsibility of the Owner during the. term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). a�_Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. C20-- Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Page 1 of 3 Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. . Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60,030. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS, The Municipality will give at least 24-hour notice. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. &__ Owner agrees toxnaintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. The term of this Agreement shall begin on the ,date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue while the AWWTS is operational or until title is transferred. 4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of 3 OWNE (signature) Date: LY Ml-fc- micrWL- 4>TA4,aPtC _(print name) STATE OF ALASKA )ss, THIRD JUDICIAL DISTRICT The foregoing instrument was acknowledged before me this &_ day of 7Url 6- 20_L4, by n NOTAR'?PUBLIC t6R—ALAS JCk, My Commission expires: All to L5 MUNICIPALIU: By: _ 01 J-1 (signature) C-U �J N 6�0 -(print name) Slam of,41aska NOTARY PUBLIC Kaselyn Esgu LMy COMMh6m Date: Title: (—,i v-'L t-- L—C— (rev. 05/18/2018) Page 3 of 3 MUNICIPALITY OF ANCHORAGE t� Development Services Department Phone: (907)343-7904 On -Site Water & Wastewater Section Fax: (907)343-7997 Parcel ID 020 -521-28 Certificate of On -Site Systems Approval OSC251331 Expiration Date: 7/7/2026 Legal description RABBIT CREEK VIEW HEIGHTS BLK 1V LT 9B Site address 15600 NICKLEEN ST Current property owner(s) STANFILL KYLE MICHAEL 50% & X The On-site system(s) is/are approved for 3 bedrooms 0 Conditional approval for bedrooms, with the following stipulations: Comments or conditions: Original Certificate Date: 8/14/2025 This Cpdificatb of On -Site Systems Approval (COSA) is intended to demonstrate the subject ;Pevelopment m(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, 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 utu , Development Services Department On -Site Water & Wastewater Section Phone: 907-343-7904 Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 020-521-' ?,_% Complete legal description RABBIT CREEK VIEW & HEIGHTS BLK 1V LT Location (site address) 15600 NICKLEEN ST ANCH AK Current property owner(s) MIKE STAN FI LL 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS Day phone 3. TYPE OF WATER SUPPLY: Q 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: ❑o Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel © Plastic ❑ Concrete ❑ Fiberglass Age NEW - See advisory if steel or fiberglass older than 20 years 6. ABSORPTION FIELD: R AWWTS ❑ Bed ❑ Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ 7Waiver Fee $ Date of Payment W04 Date of Payment COSA # 05C ZSl 13 ( Waiver # COSA Application_Apr2025.doc COSA Checklist Legal Description: RABBIT CREEK VIEW & HEIGHTS BLK 1V LT 9B Parcel ID: 020-521-28 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system _ A. WELL DATA 0 Well log is filed with Onsite (or attached) Date drilled 9/20/25 Total depth 104 ft Cased to 104 ft ❑� Sanitary seal is functioning correctly ❑� Wires are properly protected Casing height (above ground) 36 in. Date of flow test for COSA NEW Static water level at beginning of test 0 ft. Comments B. TANK DATA Measured operating Fluid level in septic tank 'NEW Date of pumping NEW 0 Required maintenance completed, if AWWTS Comments: 'ADVANTEX PRE-SET LEVELS D. DISPOSAL FIELD DATA Which system tested (date installed) 3/20/25 R ALL standpipes present per record drawing Total measured depth from grade 3.5 ft (max) Measured depth to pipe invert from grade ft (min) X N/A — pressurized field. ❑ Per record drawings, field is insulated. 0 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 Comments/Deficiencies: COSA Checklist May2025.docx Well production at time of test 10+ cpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes FE No 0 Coliform bacteria is Negative Nitrate mg/L N Nitrate less than MRL (ND) Arsenic ug/L FNI Arsenic less than MRL (ND) Collected by MNA Date 7/7/25 C. LIFT STATION H Required maintenance completed Age of lift station 'NEW years Lift station material Comments: NEW ADVANTEX SYSTEM Adequacy test date NEW Results 0 Pass Fluid depth prior to test NEW 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) 112 in Effective depth used 0 in Effective depth remaining 12 in E. SEPARATION DISTANCES From Well on Lot to: (Please enter distances if less than required) Septic Tank/Lift Station on Lot > 100' ❑ Yes if No *50+ ft Neighboring Tank > 100' ❑✓ Yes if No_ ft Disposal Field on Lot> 100' ❑Yes if NoX50+ ft Sewer Manhole/Cleanout > 100' ❑✓ Yes if No _ ft Sewer Service/Septic Line > 25'[Z] Yes if No _ ft Holding Tank > 100' ,/❑ Yes if No _ ft Neighboring Disposal Fields > 100' Animal Containment > 50' ❑✓ Yes if No _ ft ❑ Yes if No _ ft Manure/Animal Excreta Storage > 100' Sewer Line/Main > 100' ❑✓ Yes f No _ ft ❑✓ Yes if No _ ft ❑ 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) Tank to Foundation > 10' p✓ Yes if No _ ft Surface Water > 100' ❑ Yes if No *5� ++ ft Field to Foundation > 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/Service Line > 10' M Yes if No _ ft F. ENGINEER'S COMMENTS * ADVANTEX SYSTEM Wells on Adjacent Lots: Wells > 100' Community Wells > 200' ❑✓ Yes if No _ ft ❑✓ Yes if No _ ft If tank or field is under driveway comment below 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 ofFirm MIKE ANDERSON PE. Engineer's Printed Name SAME COSA Checklist_May2025.docx Phone 727-8864 Date 8/12/25 OF A \q\ ..y •Er o19T H* ••' �. V' MICHAEL N. ANDERSON ' . k. �• CE- JAMIE AVENUE In ro N 89 °59' 59"E 242.75' 10' T&E ESM T 0 co " = 50' GRAVEL 1 D/W DECK 34.0' w O MH .. MH z W WELL MH •" o E = U) N VAULT � V) 0 0') 0')W = 7.0 r_1►'r? N 1.5' x 7' 120.9' 92.0' CANT ;� 0' W 17.3 17.3 C; N W DECK LC) (n N • SEPTIC ►— � 00 PIPE 0LOT 9�yP) .W�Z_I► � � BLK 1 V w o U I 8d 0 SO \ o STS r- Fq 4 cli_ ST SO, M SFTe � qct 10' UTILITY ESMT N89044'07"E 253.98' , I , 30 30 ANCHORAGE RECORDING DISTRICT, ALASKA =FND ALUMINUM MONUMENTAS-BUILT OF: RABBIT CREEK VIEW & HEIGHTS U = FND 5/8" REBAR w/ PLASTIC CAP LOT 9B BLOCK 1V PLAT 2024-23 SUR SURVEY CERTIFICATE: I John L. Schuller Have conducted a +O FI `� _ N L A pVU� AN physical survey of this property as shown on this drawing and that the ,/ , �"� °� improvements situated hereon are within the property lines and no Of Al,•. • . ' y� , enchroachments exist other than noted. Under no circumstance should / .• 49TH r, any information on this drawing be used for construction of fences, , • , , ,ziH, , , , , , , • • , , , , , • , .. • ° z �--� structures, improvements, or for establishing boundary lines. , � a C� / 4 EXCLUSION NOTES: It is the owners responsibility to determine � .. ' : ' ' ' ' ' ' ' ' ' ' ' ' .. ' ' ' the existence of an easements, covenants or restrictions which , co L. SCHULLER.• o, do nota ear on the recorded subdivision lat. LS —1040 8.,,, pp p � � c�,, •. • • • , . • �� / 1831 Talkeetna Street WORK ORDER NUMBER: DATE: SCALE: E-MAIL; ` �0, �. , . d Anchorage, Alaska 99508 JULY 4, 2025 1 =50 schullerakOgmail.com Ar s _ DRAWN BY: CHECKED BY GRID NUMBER: BOOK AGE: `\ O f eS na\ \- ••► (907) 227-1455 office 25 073 JLS SW3241 250230 ��� sl ���+ (907) 274-4992 fax