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Home My WebLink AboutSKY RIDGE LT 29Sky Ridge Lot 2 9 #015-275-29 www.sullivanwaterwells.com Pump Installation Log Well Drilling Permit Number: OSP 241264 Date of Issue 8/21/24 Parcel Identification Number: 01527529000 Legal Description Property Owner Name & Address SKY RIDGE LT 29 Hultquist Homes 11109 Skyridge Dr. Anchorage, AK 99516 Pump Installation Date: 9/30/24 Pump Intake Depth Below Top of Well Casing: 196 feet Pump manufacturer’s Name: Grundfos Pump Model: 10SQE07-240 Pump Size: 3/4 hp Pitless Adapter Burial Depth: 14 feet Pitless Adapter Installer: Pitless Manufacturer: Disinfected Upon Completion? yes no Method of Disinfection: Chlorine 50 PPM Comments: Pump Installers Name: Sullivan Water Wells Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. Merrill White Raven MUNICIPALITY OF ANCHORAGE WATER & WASTEWATER UTILITY 3000 ARCTIC BLVD. PHONE:(907)564-2762 BLOCK/LOT/TRACT: LT 29/ SUBDV: SKY RIDGE TAX CODE: 01527529000 GRID: SW2634 STREET ADDRESS: 011109 SKY RIDGE DR , AK OWNER: HULTQUIST HOMES INC MAIL ADDRESS: 351 E 104TH AVENUE ANCHORAGE, AK 995152601 WASTEWATER CONNECT PERMIT DATE OF APPLICATION: 9/4/2024 SCHEDULED COMPLETION DATE: 12/31/2024 0 SINGLE FAMILY ❑ DUPLEX ❑ COMMERCIAL ❑ MULTI -DWELLING No. APTS 0 PHONE: (907)522-3204 CONTRACTOR: Hultquist Homes Inc ASSESSMENTS ❑ Repair Existing Service ❑ Main Line Extension Q On Property Only ❑ City Tap Have Been Levied ❑ Hydrant Only ❑ To Be Levied ❑ Main Tap - To Property Line Only ❑ Cured in Place Pipe Comments: ❑ Main Tap & On Property Connect ❑ Disconnect Row No. Qj E]R & R - Main Tap Only Owner Staff CONNECT SIZE 4 in ISSUED WWTGV INSPECTION FEE $112.00 ® PAID ❑CASH PERMIT FEE $77.00 ❑ CHECK RCC $1.64 OTHER REIMBURSABLE DEPOSIT $0.00 INSPECTED BY W NUMBER TOTAL $190.64 DATE REMAKKS INSPECT SEWER SERVICE CONNECT PERMITTEE (Please Print) Hultquist Homes Inc MAIL ADDRESS 351 E 104th Anchorage, AK 99515 SIGNATURE EMAIL PHONE (907)522-3204 POST IN A CONSPICUOUS PLACE AT THE JOB SITE., INSPECTOR COPY DATE 12/31/2024 TIME 12:00 AM INSPECTOR SCHEDULED SUBDIVISION SKY RIDGE BLOCK/LOT/TRACT LT 29/ INDICATE NORTH 8pno+t 2112 �� 2�°E t55` c�E y."Pdc Sky 4�Pic, i 4oc �a r SIZE MAIN: TYPE MAIN: DEPTH AT MAIN: AT PROP. LINE: 9 �� CONNECT LOCATION: (q+ S W COMMENTS:CGvt�+4 I✓1 �G�� 7 S �� V krowt 60 I t Q- 54ub 1 rya'S - J \402,c< INSPECTED BY: WCA Certified Drilling Log OWNER OF LAND: Hultquist Homes ADDRESS: 11109 Sky Ridge Dr. Anchorage, AK 99516 LEGAL DESCRIPTION Sky Ridge Lot 29 DATE: 8/28/24 PERMIT NUMBER: OSP241264 DATE OF ISSUE: 8/21/24 TAX IDENTIFICATION NUMBER 01527529000 Is well located at approved permit location: Yes No Method of Drilling: air rotary cable tool Depth of Well: 204’ Casing Type: Steel Wall thickness .250 inches Diameter: 6 inches, depth 204 feet Liner type Static Water Level: 108 feet Recovery Rate 50 gpm gph Method of Testing Air Well Intake Opening Type: open end open hole Screened Start feet Stopped Perforations Start feet Stopped Grout Type: Volume: Depth: from feet, to feet Well Disinfected Upon Completion: yes no Method of Disinfection: Chlorine 50 PPM Comments: Bore Hole Data Depth From To 0 2 Casing Stickup 2 4 Overburden 4 39 Silty sand and gravel 39 78 Silt and sand 78 98 Silt and clay 98 144 Silt and gravel 144 189 Silty sand and gravel 189 204 Sand and gravel Drillers Name: Cole Sullivan ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. MatSu Borough: Department of Environmental Conservation. 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: OSP241264 Work Type: Well Initial Tax Code Number: 01527529000 Site Legal Address: SKY RIDGE LT 29 G:2634 Site Mailing Address: 11109 SKY RIDGE DR, 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: 8/21/2024 8/21/2025 20294 ❑ 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 Rece�y: 51S, tAe J `1"o Issued By: Date: Date: 4 MUNICIPALITY OF Community Development Department Development Services Division On -Site Water & Wastewater Program ANCHORAGE Phone: 907-343-7904 Fax: 907-343-7997 ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 015-275-29 Property owner(s) HuRquist Homes, Inc. Day phone Mailing address 12570 Old Seward Highway Anchorage, AK 99515 Site address NHN Sky Ridge Drive Legal description (Sub'd., Block & Lot) Sky Ridge Lot 29 Legal description (Township, Range & Section) Lot Size - 20,294 —Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (Z all that apply) Absorption Field F Initial FX Single Family (SF) 191 (w/wo ADU) Septic Tank El Upgrade ❑ Duplex El (D) Holding Tank ❑ Renewal Multiple Dwellings El Privy ❑ (SF and/or D) Private Well FX Water Storage F 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. IsTZ>-P (Signature of property owner or authorized agent) Permit/Rush Fees: 3 C" -0 Date of Payment: Receipt Number: Waiver Fees: Date of Payment: Receipt Number: Permit No. 7, Waiver No. Permit App_'-'- '- '-'.,:c ; 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 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 29 Well Permit Request 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 16 August 2024 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241264, Deb Wockenfuss, 08/21/24 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241264, Deb Wockenfuss, 08/21/24 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241264, Deb Wockenfuss, 08/21/24 MUNICIPALITY OF ANCHORAGE lhw Development Services Department Phone: (907)343-7904 On -Site Water & Wastewater Section Fax: (907)343-7997 Certificate of On -Site Systems Approval OSC251056 Parcel ID 015 -275-29 Legal description SKY RIDGE LT 29 site address 11109 SKY RIDGE DR Expiration Date: 9/30/2025 Current property owner(s) HULTQUIST HOMES INC X The On-site system(s) is/are approved for 4 bedrooms By: Conditional approval for bedrooms, with the following stipulations: Comments or conditions: Original Certificate Date: 2/25/2025 This Cer(ficate of On Site Systems Approval (COSA) is intended to demonstrate the subject systeim(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, IWV elopment 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. 01527529 Complete legal description Sky Ridge L29 Location (site address) 11109 Sky Ridge Dr 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 $ % Waiver Fee $ Date of Payment COSA # 05G 2.5-10 56 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: 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' Community Sewer Manhole/Cleanout > 100' Mi Yes if No ft O■ Yes if No ft Neighboring Tank > 100'■❑ Yes if No ft Private Sewer/Septic Line > 25' Q Yes if No ft Absorption Field on Lot > 100' Q Yes if No ft Holding Tank > 100' QYes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' Q Yes if No ft 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 Pannone Engineering Services Engineer's Printed Name Steven R Pannone P.E., F. ASCE Phone 907-745-8200 COSA Checklist June 2022 Date 2/19/25 ❑i Yes if No ft Community Sewer Main > 75' Yes if No ft Manure/Animal Excreta Storage > 100' 0 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 Surface Water > 100' es if No ft Tank to Property Line > 5' ❑ Yes if No ft Wells acent Lots: Field to Property Line > 10' ❑ Yes if No Private Wells > 100' ❑ Yes if No ft Water Main > 10' Yes if No ft Community Wells > 200' ❑ Yes if No ft W Ice Line > 10' ❑ 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 Pannone Engineering Services Engineer's Printed Name Steven R Pannone P.E., F. ASCE Phone 907-745-8200 COSA Checklist June 2022 Date 2/19/25 Lot 29, Sky Ridge Subdivision Land Surveying Land Development Consultants Subdivision Specialists Construction Surveying 124 E 7th Avenue Anchorage, Alaska 99501 (907) 306-8104 mail@S4AK.com AKCAN 173042 Group S4 Asbuilt 1/31/2025