HomeMy WebLinkAboutSKY RIDGE LT 14Sky Ridge
Lot 14
#015-275-14
MUNICIPALITY OF ANCHORAGE
Amf
Development Services Department 4 Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Pump Installation Log
OSP241175 7 22 24
Well Drilling Permit Number: Date of Issue: - -_
Parcel Identification Number: 015 -275 - 14
Legal Description Block Lot
Sky Ridge LT 14 G:2634 1 114
Pump Installation Date: 8 -14 -24
172
Pump Intake Depth Below Top of Well Casing:
Grundfos
Pump Manufacturer's Name:
1 OSQE07-240
Pump Model•
.75
Pump Size:
hp
Property Owner Name & Address:
Hultquist Homes
feet
12'8"
Pitless Adapter Burial Depth: feet
Campbell B10 Style
Pitless Adapter Manufacturer's Name:
Hultquist
Pitless Adapter Installer:
Well Disinfected Upon Completion? ® Yes ❑ No
Method of Disinfection: Tabs
Comments:
Dylan Kay
Pump Installer Name:
Hefty Drilling, Inc.
Company:
P.O. Box 112130
Mailing Address:
Anchorage AK 99511
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: #__________ 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.
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: OSP241175
Work Type: Well Initial
Tax Code Number: 01527514000
Site Legal Address: SKY RIDGE LT 14 G:2634
Site Mailing Address: 11093 RED SKY CIR, 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:
7/22/2024
7/22/2025
21204
❑ 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
Reseeded -By: Date:
Issued By: Date: 7/Z- Z/�c�
4
MUNICIPALITY OF
Community Development Department Ufa
Development Services Division
On -Site Water & Wastewater Program
Phone: 907-343-7904
Fax: 907-343-7997
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I. D. 015-275-14
Property owner(s) Hultquist Homes, Inc.
Day phone
Mailing address 12570 Old Seward Highway Anchorage, AK 99515
Site address 11093 Red Sky Circle
Legal description (Sub'd., Block & Lot) Sky Ridge Lot 14
Legal description (Township, Range & Section)
Lot Size - 21,204 —Sq. Ft. Number of Bedrooms
4
APPLICATION IS FOR: APPLICATION IS AN:
TYPE OF DWELLING:
(ED all that apply)
Absorption Field ❑ Initial RX
Single Family (SF) RX
(w/wo ADU)
Septic Tank El Upgrade El
Duplex ❑
(D)
Holding Tank R Renewal R
Multiple Dwellings ❑
Privy ❑
(SF and/or D)
Private Well RX
Water Storage R
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.
S T;?__P
(Signature of property owner or authorized agent)
Permit/Rush Fees: -,I?,
Date of Payment: '517Z6A_ q
I
Receipt Number: Oc--�q 6 --
Permit No. Q,-P2_q 1122
Permit App_-'- '- I
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
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
25 June 2024
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 14
Well Permit Request
Well Design Narrative
This is a design narrative for a permit to install a private well 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, P.E., F. ASCE
Owner/Civil Engineer
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241175, Deb Wockenfuss, 07/22/24
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Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241175, Deb Wockenfuss, 07/22/24
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2.2. SCOPE OF WORK: INSTALL WELL IN ACCORDANCE WITH THE ATTACHED DESIGN AND SPECIFICATIONS.
-- FEET
-- FEET
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241175, Deb Wockenfuss, 07/22/24
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: (907)343-7904
On -Site Water & Wastewater Section Fax: (907)343-7997
Certificate of On -Site Systems Approval
OSC251012
Parcel ID 015 -275-14
Legal description SKY RIDGE LT 14
site address 11093 RED SKY CIR
Current property owner(s)
Expiration Date: 8/14/2024
HULTQUIST HOMES INC
X The On-site system(s) is/are approved for
4 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or conditions:
By: "/ (/ v Original Certificate Date:
1/14/2025
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
MUNICIPALITY OF ANCHORAGE
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. 01527514
Complete legal description Sky Ridge L14
Location (site address) 11093 Red Sky Cir.
Current property owner(s) Hultquist Homes
2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS
Day phone
3. TYPE OF WATER SUPPLY:❑ Private Well ❑ Private Well serving 2 dwelling units
❑ Private Well serving 3+ dwelling units ❑ Community Well or Public
❑ Water Storage
4. TYPE OF WASTEWATER DISPOSAL: ❑ Private Septic ❑ Private Septic serving 2 dwelling units
❑ Holding Tank❑ Community Septic or Public Sewer
5. SEPTIC TANK: ❑ Steel ❑ Plastic ❑ Concrete ❑ Fiberglass
Age - See advisory if steel older than 20 years
6. ABSORPTION FIELD: ❑ 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 $ 12. o
Date of Payment
COSA # 0S 2S(ol 2
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.
In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in
accordance with ADEC & MOA 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.
Name of Firm
Phone
Engineer’s Printed Name
Date
MUNICIPALITY OF ANCHORAGE
WATER & WASTEWATER UTILITY
3000 ARCTIC BLVD.
PHONE: (907)564-2762
BLOCK/LOT/TRACT: LT 14/
SUBDV: SKY RIDGE
TAX CODE: 01527514000
WASTEWATER S241163
CONNECT PERMIT
DATE OF APPLICATION: 7/5/2024
SCHEDULED COMPLETION DATE: 12/31/2024
R SINGLE FAMILY
R DUPLEX
E] COMMERCIAL
GRID: SW2634 E] MULTI -DWELLING No. APTS 0
STREET ADDRESS: 002801 E 112TH AVE , AK
OWNER: HULTQUIST HOMES INC
PHONE:
MAIL ADDRESS: 12570 OLD SEWARD HIGHWAY ANCHORAGE, AK 995150000
PERMITTEE (Please Print) HULTQUIST HOMES INC
PHONE
MAIL ADDRESS 12570 OLD SEWARD HIGHWAY ANCHORAGE, AK 995150000
SIGNATURE EMAIL
POST IN A CONSPICUOUS PLACE AT THE JOB SITE
INSPECTOR COPY
Lot 14
Sky Ridge Subdivision
As Built
Land Surveying
Land Development Consultants
Subdivision Specialists
Construction Surveying
AEC# 173042
S4
Group
124 E 7th Avenue
Anchorage, Alaska 99501
(907) 306-8104
mail@S4AK.com
01/02/2025