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 PA N N O N E E N G S V C , L L C ( C . I . 1 0 8 8 ) Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241175, Deb Wockenfuss, 07/22/24 PA N N O N E E N G S V C , L L C ( C . I . 1 0 8 8 ) 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