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Home My WebLink AboutSKY RIDGE LT 10SKY RIDGE Lot 10 015-275-10 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: #__________ 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 "Sf,. PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 ^� http://www.muni.org/onsite s Ueharurrent On -Site Water System Permit Permit Number: OSP251107 Effective Date: 4/22/2025 Work Type: Well Initial Expiration Date: 4/22/2026 Tax Code Number: 01527510000 Site Legal Address: SKY RIDGE LT 10 G:2634 Site Mailing Address: 11174 RED SKY CIR, Anchorage Owner: HULTQUIST HOMES INC Lot Size in Sq Ft: 20472 Design Engineer: PANNONE ENGINEERING SERVICES Total Bedrooms: 5 This permit is for the construction of: ❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy 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 Received By: S v /' Date: Issued By: k, Date: Z 2- Zo i7- S� MUNICIPALITY OF ANCHORAGE Rk)5\'A ............... . . . . . . Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section ON -SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 0 15-275-10 Property owner(s) Hultquist Homes, Inc. Mailing address Day phone 12570 Old Seward Hwy Anchorage, AK 99515 Site address NHN Red Sky Circle Legal description Sky Ridge Lot 10 Number of Bedrooms 5 Engineering Firm Pannone Engineering Services, LLC. Building Permit Number❑ Not Applicable APPLICATION IS FOR: APPLICATION IS AN: (_M all that apply) Absorption Field ❑ Initial Septic Tank ❑ Upgrade ❑ Holding Tank ❑ Renewal ❑ Privy EJ Well R. THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Permit/Rush Fees:7 T Date of Payment: Permit No. 0SP049107 Waiver Fees: Date of Payment: Waiver No. Distance: 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 Anchorage, Alaska 99519 Subject: Sky Ridge Lot 10 Initial 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 to the north, east, and west are to be served by AWWU sewer services. Surrounding lots to the south are currently served by private septic. Currently there are no sewer mains or private septic systems within 100’ of the proposed well location. 1. Well Design. The well will be located: 100’+ from any sewer main and or sewer system manhole . 100’+ from any on-site septic system. 25’+ from any private sewer lines and or clean outs. 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, PE, F. ASCE Owner/Civil Engineer 16 April, 2025 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251107, Curtis Townsend, 04/22/25 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251107, Curtis Townsend, 04/22/25 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251107, Curtis Townsend, 04/22/25 DEVELOPMENT SERVICES D P RTIVIENT Qn-Site Water and Wastewater Section �; ,!1 Fax: 343-799-' LT. vv Nv. t`. un .IJ r Well Decommissionin Legal Address: Subdivision 3,pk Z.\ %E Block Lot %0 T R Section Lot On -site Water & Wastewater Section certified contractor performing the well decommissioning: Name: Signature: � Company: i-/Ll Nl�-1�mc,. Well decommissioning date 15 Method of decommissioning: AMC 15.55.0601-1 a. ❑ b. ❑ C. Location: Use the space below to provide a drawing of the property showing the following items: • North arrow • Decommissioned well location • Location of other water wells on the property Two separate swing -tie distances for each well shown on the drawing Note: The swing -tie distances shall be measured from either permanent structures or the property comers. i� pU h ��3g 4T 56 b 53 OS O EXISTING VIELL TO BE j� DECOMMISSIONED W W r N N W O N O N (n O b m LOT 119 . In 20,472 50 Fr LOT 11 LOT 5 10 TELEPHONE el ELECTRIC EASETAETJr N89'48'55"W 119.80' — — TRACr EF—A2 L.,d 0—ri ti— Lot 10, Sky Ridge Subdivision Drown by. AK Scale: 1' = 30' Grttl: S4Y2634 Job: 2025-32 I Plat 2022-57 1 Oat., 4/10/25 LO1.12Dt1( ',D N , -Tar 2)�� wq B Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Well 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 OSC261005 Parcel ID 015 -275-10 Expiration Date: Legal description SKY RIDGE LT 10 site address 11174 RED SKY CIR Current property owner(s) HULTQUIST HOMES INC X The On-site system(s) is/are approved for 5 bedrooms By: 5/16/2026 Conditional approval for bedrooms, with the following stipulations: Comments or conditions: Original Certificate Date: 1/23/2026 This ertifiat ce of On -Site Systems Approval (COSA) is intended to demonstrate the subject s tem(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. 01527510 Complete legal description Location (site address) Sky Ridge L10 11174 Red Sky Current property owner(s) Hultquist Homes Day phone 2. ON-SITE SYSTEMS SIZED FOR 5'+ BEDROOMS 3. TYPE OF WATER SUPPLY: FE -1 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 X 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: Distance: Expedited review requested: ❑ 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 $ _2'-:) , 0 Date of Payment t d` i ❑' 4� COSA # (), ) C 2-(—,- 1, UC ❑ 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. Name of Firm Phone Engineer’s Printed Name Date 1/12/2026 Pannone Engineering Services Steven R Pannone P.E., F. ASCE 907-745-8200 Lot 10, Sky Ridge Subdivision Asbuilt Land Surveying Land Development Consultants Subdivision Specialists Construction Surveying AEC# 173042 S4 Group 610 E 5th Avenue Anchorage, Alaska 99501 (907) 306-8104 mail@S4AK.com 0 30' GRAPHIC SCALE 11/6/2025