Loading...
HomeMy WebLinkAboutPALATERRA ADDN 2 LT 7Lot 7 017- 151 -31 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 On-Site Water and Wastewater Section - (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP251266 PID Number: 017-151-31 Dwelling: 0 Single Family (SF) El with ADU F Duplex (D) r-1 Two Single Family Project: 9 New F] Upgrade Name Colony Builders ABSORPTION FIELD El Deep Trench n Wide Trench 9 Bed F-1 Mound Site Address 13468 DePalatis Cir E] Other Phone Number of Bedrooms Soil Rating Total depth from original grade 907-244-3269 15 0.5 GPD/SF 8.5 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 8.0 Ft. Gravel depth beneath pipe 0.5 Ft. Subdivision Block Lot Palaterra Addn 2 7 Fill added above original grade 2.1 Ft. Gravel length 75.0 Ft. Township Range Section Gravel width 20.0 Ft. Beds: Number of Lines 4 Distance between lines 5 Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches N/A Dist. between trenches From Tank Field Tank Line 1500 Ft2 N/A 11 Ft. Well >50' >50' N/A N/A >25 TANK 0 Septic [I S.T.E.P. El Holding R1 Other Manufacturer Anchorage tank Capacity 2500 Gal. Surface Water >50' >50' N/A N/A Material Epoxy-coated steel Number of compartments 2 Lot Line >5' >10' N/A N/A NA Foundation >10' >10' N/A N/A LIFT STATION Manufacturer Orenco Capacity Integrated Gal. Remarks Tank rated for 10' burial Alarm location SW corner of house Electrical installed by Frontier Electric PIPE MATERIAL House to tank D3034 o D3034 d d Installer Red Dog — rainfielTankt Drainfield D3034 CO/MT D3034 Inspector Jared Faris BENCH MARK (Assumed elevation) 100 ft Inspectes:tion 2/2/26 2/2/26 Location and description da2 nd Front door threshold 3,d 2/4/26 4th 2/4/26 ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date AWAW Ar 49 Septic Syste !..i .......... Benja4ila,Schiller 1w, CE 12592 Approved Date 3/13/26 \\% AM- te: this approval does not include well permit requirements. lk�, PROFESSO -.0- (Rev 05/02/18Y Benjamin Schiller CE 12592 R E G ISTEREDPROFE S S I O N A L E N GINEER 1"=50' CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND PERMIT # OSP251266 PID # 017-151-31 PALATERRA ADDN 2, LOT 7 A B FCO MH1 30.3 POD1 34.5 POD2 37.9 MH2 42.7 MT1 33.1 CO1 35.7 1.6 12.2 17.2 21.1 26.4 49.8 52.0 FEET 0 50 100 PLAN AS-BUILT 3/11/26 NON-DISTURBANCE SETBACK 10 ' U T I L I T Y E A S E M E N T 855 860 865 870 875 880 885 890 895 900 MT3 MT1 CO2 CO3 CO6 CO7 MH2 FCO 1500SF BED NORTHERN GEOTECH TEST HOLE 2500-GAL TANK w/ 2 AX20 PODS 5-B D R M H O M E MT2 CO4 MT4 CO8 ALTERNATE SITE UNDEVELOPED UNDEVELOPED EXISTING WELLTH#1 TH#2 CO1 CO5 MH1 POD2 POD1 CO2 40.8 CO3 45.9 CO4 50.7 MT2 52.9 MT3 92.6 CO5 90.6 CO6 88.4 56.8 61.9 66.5 68.9 90.0 88.1 85.3 CO7 86.0 CO8 84.4 MT4 82.3 82.0 79.6 76.9 A B BENCHMARK LOCATION PROFILE AS-BUILT (NO SCALE) 89.4 84.7 90.0 94.0 PERMIT # OSP251266 PID # 017-151-31 PALATERRA ADDN 2, LOT 7 AX-20 POD AND MANHOLES 89.2 Benjamin Schiller CE 12592 R E GISTEREDPROFE S S I O N A L E N GINEER 3/11/26 75' DRAINFIELD ROCK MT CO COMT 97.0 FINISH GRADE TH # 1 NO GROUNDWATER 8/20/25 86.9 77.9 86.4 94.9 ORIGINAL GRADE 2500 GAL SEPTIC TANK FC O MH 1 MH 2 AX-20 POD AND MANHOLES 86.9 86.4 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 hftp://www.muni.org/onsite On -Site Water & Wastewater System Permit Permit Number: OSP251266 Work Type: WellSeptic Initial Tax Code Number: 01715131000 Site Legal Address: PALATERRA ADDN 2 LT 7 G:2939 Site Mailing Address: 13468 DE PALATIS CIR, Anchorage Owner: COLONY BUILDERS INC Design Engineer: FORGE ENGINEERING This permit is for the construction of: Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: IVpartnrent 8/7/2025 8/7/2026 65693 Z Disposal Field Z 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 Special Provisions: A test hole is required prior to construction of the absorption field, in the location shown on the site plan, to confirm minimum separation to impermeable soil and seasonal high groundwater, as well as percolation rate. Construction may proceed at your own risk prior to 7-day groundwater monitoring. If results require a design change, construction shall stop pending approval of a change order. Please submit results with the inspection report (or change order, if required). Received By:� Date: Issued By: Date: U MUNICIPALITY OF ANCHORAGE A5 Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section ON -SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 017-151-31 Property owner(s)Colony Builders Inc Day phone (907)345-0371 Mailing address9420 Vanguard Dr, Anchorage, AK 99507 Site address NHN De Palatis Cir, Anchorage, AK 99516 Legal description Palaterra Addition 2, Lot 7 Number of Bedrooms Engineering Firm Forge Engineering i Building Permit Number Not Applicable F-1 APPLICATION IS FOR: APPLICATION IS AN: (N all that apply) Absorption Field M Initial Septic Tank Upgrade ❑ Holding Tank ❑ Renewal El Privy ❑ Well THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: Permit/Rush Fees: 192-6 Waiver Fees: Date of Payment! 712W2,5 Date of Payment: Permit No. N 2,51260(a Waiver No. C 0 41- PO BOX 240773 ANCHORAGE. AK 49524 522-7773 677-7766 (FAX) FORGECIVIL.COM January 23, 2026 MOA Development Services, On -Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Palaterra Addn 2, Lot 7 — NHN De Palatis Cir Septic system design Dear On -Site Services Engineer: The owner of the above lot intends to build a 5-bedroom home on the property, so we are submitting this permit application for the construction of a new well and septic system. The attached site plan identifies the location of the home as well as the proposed well, septic location and alternate site. No conflicts exist between this proposed system and any other well or septic system, whether on this lot or adjacent lots. The ground surface on the lot has a mild slope from the north to the south. The slope is mild in the northern half of the lot but gets much steeper on the southern half. The proposed system is in the northern half. There are no slopes greater than 25% within 50 feet downslope of either the primary or alternate site. Contours are shown on the site plan showing the grade and direction of flow. Stormwater drainage will not impact this septic system. The new trench will be constructed parallel to the slope as much as possible. We dug test hole near the proposed system and took a sample from the labelled strata that the system will be in. This sample came back as ML, per the attached lab analysis sheets. The previous test holes done in the subdivision (by Northern Geotechnical Engineering) show similar soils, with various ML layers down to 20'. They note a slight strata change, with the same soils classification, at closer to 12'. The DEC allows for soils classified as ML to use an application rate of 0.45 gpd/sf. Because this is a CAT III system we propose an application rate of 0.5 gpd/sf. We are requesting the approval of this design application. The proposed system is a shallow bed system, 20' wide x 75' long with a total depth of 8.5'. With a bed this wide and deep they will be unable to build it with machinery. It will have to be built by hand, with workers using shovels, eliminating the risk of over compaction by the equipment tracking over it. We are requesting the approval to construct the bed using this design. Wells on this and adjacent lots are shown. The new system will be a minimum of 100' from all wells and surface water, and more than 5' away from the septic tank. The alternate site is located more than 6' away. Please refer to the attached test hole log, plan and profile pages for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Benjamin Schiller, PE 2500-GAL w/ 2 AX20 UNDEVELOPED 1500SF BED, MT': WITHIN 1' OF COF NORTHEF GEOTECF HOLE ALTERNATE SITE � LOT 7 NON -DISTURBANCE SETBACK ENGINEERING �49TM *1 Benja i Schiller CEnei92 • G�<0'" 126 ,tl14' P40 E-SSIONP�� SEPTIC PLAN 0 50 100 FEET 1"=50' C� U a �_ rEVELOPED LEGEND CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE PALATERRA 2, LOT 7 DESIGN FACTORS: 750 GPD PEAK FLOW PERK RATE: 96 MIN/IN APPLICATION RATE: 0.5 GPD/SF SYSTEM REQUIREMENTS: 20' WIDE BED SYSTEM 2500-GAL SEPTIC TANK w/ 2 AX20 PODS 750 GPD / 0.5 GPD/SF = 1500 SF BED REQUIRED (1500 SF SPECIFIED) 20' WIDE X 75' LONG BOTTOM OF BED: 8.5' BELOW GRADE FLOW LINE ELEVATION: 8.0' BELOW GRADE E' rl f-%\ 11 M- A E'11'11 T 1 11 A I A I f 11 1 T/ TYPICAL TRENCH SECTION (NO SCALE) NOTES: 1. GRADE AREA OVER TRENCH TO DRAIN AWAY 2. PROVIDE T OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2' WITH 2" OF INSULATION 3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY C 0 -0-� )RAINFIELD E N G I N E E R I N G of ..... ••, Benja n Schiller • •' �'F�• CE 12592 kite S;GES516 '�. !� Co a-IL DEPTH (feet) 1- 2- 3- 4- 5- 6- 7- 10 11 12 13 14 15 16 17 18 1 SOILS LOG AND PERCOLATION TEST E N G I N E E R I N G LEGAL DESCRIPTION: PALATERRA ADDN 2, LOT 7 PERFORMED FOR: COLONY BUILDERS DATE: 8 / 13 / 2 5 PARCEL ID#: 017 -151- 31 TEST HOLE 1 OB ML (CLAYEY SANDY SILT) aSAMPLE LOCATION ML (SANDY SILT) SEE MATERIAL TEST REPORT NO MOISTURE NOTED AT TIME OF DIGGING? NONE DEPTH TO WATER AFTER MONITORING 8/20/25 DATE OF MONITORING DATE READING NET TIME (MINUTES) DEPTH ToWATER (INCHES) NET DROP (INCHES) 1112 Fo 0 PERCOLATION RATE: (MIN/INCH) SITE PLAN TECHNICIAN: JUSTIN EARLS COMMENTS: USCS SOIL CLASSIFICATION WAS VISUALLY DETERMINED EXCEPT WHERE NOTED Report No: MAT:25-1285-1Issue No: 111301 Olive Lane, Anchorage, Alaska 99515 Client:Forge Engineering, Inc. The testing services reported herein have been performed to recognized industry standards and relate only to the items inspected. Unless otherwise noted, no other warranty is made.Should engineering interpretation be required, NGE-TFT will provide upon written request. This report shall not be reproduced in full, without the prior written approval of NGE-TFT. Sean Totzke, MOA #: 076 / ICC #: 5310982Reviewed By:8/21/2025Date: 7293-252025 Material TestingProject: Northern Geotechnical Engineering, Inc. - Material Test Report Terra Firma Testing Phone: (907) 344-5934 | www.nge-tft.com Max Waters8/15/202510.8A Particle Size Distribution 863/8in 82¼in 80No.4 87½in 1001½in 90¾in % Passing Limits 64No.60 60No.100 56No.200 67No.40 75No.10 71No.20 Drying By:OvenDate Tested:8/19/2025 Sample Details 25-1285-1Sample ID Sample #1Location Result Cc Other Test Results MethodDescription LimitsCuASTM D2487 Procedure ASTM C117Water Content (%)ASTM D2216Date TestedTested By Sieve Size ASTM C136 Tested By:Amir Mack Page 1 of 2© 2000-2025 QESTLab by SpectraQEST.comForm No: 18909, Report No: MAT:25-1285-1 Comments mm µm 100 60 20 6 2 600 200 100 50 1 1/2" 3/4" 1/2" 3/8" 1/4" #4 #10 #20 #40 #60 #100 #200 Sieve Size COBBLES 0% GRAVEL (20%) COARSE 9.8% FINE 10.2% SAND (24%) COARSE 4.6% MEDIUM 8.4% FINE 11.3% SILT/CLAY 56% Diameter mm µm 100 60 20 6 2 600 200 100 50 1 1/2" 3/4" 1/2" 3/8" 1/4" #4 #10 #20 #40 #60 #100 #200 Sieve Size COBBLES 0% GRAVEL (20%) COARSE 9.8% FINE 10.2% SAND (24%) COARSE 4.6% MEDIUM 8.4% FINE 11.3% SILT/CLAY 56% 0 10 20 30 40 50 60 70 80 90 100 Perce ntage Pass i ng (by mass ) Report No: MAT:25-1285-1Issue No: 111301 Olive Lane, Anchorage, Alaska 99515 Client:Forge Engineering, Inc. The testing services reported herein have been performed to recognized industry standards and relate only to the items inspected. Unless otherwise noted, no other warranty is made.Should engineering interpretation be required, NGE-TFT will provide upon written request. This report shall not be reproduced in full, without the prior written approval of NGE-TFT. Sean Totzke, MOA #: 076 / ICC #: 5310982Reviewed By:8/21/2025Date: 7293-252025 Material TestingProject: Northern Geotechnical Engineering, Inc. - Material Test Report Terra Firma Testing Phone: (907) 344-5934 | www.nge-tft.com 8/20/2025Nic CropperNP (Non-Plastic)NP (Non-Plastic)Not Obtainable8/20/2025Nic CropperSandy siltMLResultGroup Code ASTM D2487 Other Test Results MethodDescription Limits Group NameTested ByDate TestedLiquid Limit ASTM D4318Plastic LimitPlasticity IndexTested ByDate Tested Page 2 of 2© 2000-2025 QESTLab by SpectraQEST.comForm No: 18909, Report No: MAT:25-1285-1 Comments DEPTH (feet) 1- 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 SOILS LOG AND PERCOLATION TEST E N G N E E R I N G LEGAL DESCRIPTION: PALATERRA ADDN 2, LOT 7 PERFORMEDFOR: COLONY BUILDERS DATE: 8 / 13 / 2 5 PARCEL ID#: 017 -151- 31 TEST HOLE 2 aSAMPLE LOCATION ML (GRAVELLY SILT) SEE MATERIAL TEST REPORT NO MOISTURE NOTED AT TIME OF DIGGING? NONE DEPTH TO WATER AFTER MONITORING 8/20/25 DATE OF MONITORING DATE READING NET TIME (MINUTES) DEPTH TOWATERNET (INCHES) DROP (INCHES) Fo 0 PERCOLATION RATE: (MIN/INCH) SITE PLAN TECHNICIAN: JUSTIN EARLS COMMENTS: USCS SOIL CLASSIFICATION WAS VISUALLY DETERMINED EXCEPT WHERE NOTED Report No: MAT:25-1285-2Issue No: 111301 Olive Lane, Anchorage, Alaska 99515 Client:Forge Engineering, Inc. The testing services reported herein have been performed to recognized industry standards and relate only to the items inspected. Unless otherwise noted, no other warranty is made.Should engineering interpretation be required, NGE-TFT will provide upon written request. This report shall not be reproduced in full, without the prior written approval of NGE-TFT. Sean Totzke, MOA #: 076 / ICC #: 5310982Reviewed By:8/21/2025Date: 7293-252025 Material TestingProject: Northern Geotechnical Engineering, Inc. - Material Test Report Terra Firma Testing Phone: (907) 344-5934 | www.nge-tft.com Paul Santillana8/15/20257.7A Particle Size Distribution 79¾in 74½in 713/8in 971½in 1006in1003in % Passing Limits 62No.20 61No.40 61No.60 63No.10 66¼in 63No.4 60No.100 60No.200 Drying By:OvenDate Tested:8/19/2025 Sample Details 25-1285-2Sample ID Sample #2Location Result Cc Other Test Results MethodDescription LimitsCuASTM D2487 Procedure ASTM C117Water Content (%)ASTM D2216Date TestedTested By Sieve Size ASTM C136 Tested By:Amir Mack Page 1 of 2© 2000-2025 QESTLab by SpectraQEST.comForm No: 18909, Report No: MAT:25-1285-2 Comments mm µm 600 200 100 60 20 6 2 600 200 100 50 6"3" 1 1/2" 3/4" 1/2" 1/4" #4 #10 #20 #40 #60 #100 #200 Sieve Size BOULDERS 0% COBBLES 0% GRAVEL (37%) COARSE 21.5% FINE 15.0% SAND (4%) COARSE 0.9% MEDIUM 1.3% FINE 1.6% SILT/CLAY 60% Diameter mm µm 600 200 100 60 20 6 2 600 200 100 50 6"3" 1 1/2" 3/4" 1/2" 1/4" #4 #10 #20 #40 #60 #100 #200 Sieve Size BOULDERS 0% COBBLES 0% GRAVEL (37%) COARSE 21.5% FINE 15.0% SAND (4%) COARSE 0.9% MEDIUM 1.3% FINE 1.6% SILT/CLAY 60% 0 10 20 30 40 50 60 70 80 90 100 Perce ntage Pass i ng (by mass ) Report No: MAT:25-1285-2Issue No: 111301 Olive Lane, Anchorage, Alaska 99515 Client:Forge Engineering, Inc. The testing services reported herein have been performed to recognized industry standards and relate only to the items inspected. Unless otherwise noted, no other warranty is made.Should engineering interpretation be required, NGE-TFT will provide upon written request. This report shall not be reproduced in full, without the prior written approval of NGE-TFT. Sean Totzke, MOA #: 076 / ICC #: 5310982Reviewed By:8/21/2025Date: 7293-252025 Material TestingProject: Northern Geotechnical Engineering, Inc. - Material Test Report Terra Firma Testing Phone: (907) 344-5934 | www.nge-tft.com 8/20/2025Nic CropperNP (Non-Plastic)NP (Non-Plastic)Not Obtainable8/20/2025Nic CropperGravelly siltMLResultGroup Code ASTM D2487 Other Test Results MethodDescription Limits Group NameTested ByDate TestedLiquid Limit ASTM D4318Plastic LimitPlasticity IndexTested ByDate Tested Page 2 of 2© 2000-2025 QESTLab by SpectraQEST.comForm No: 18909, Report No: MAT:25-1285-2 Comments 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 Iis Day of �c of 20 , by and between 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 pennission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as Advantex system located at (legal description) Palaterra Addn 2, Lot 7 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) i Throughout 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). Owner agrees that only maintenance and repair personnel approved by the Municipality YXl or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. Owner acknowledges that regular maintenance of an AWWTS reduces the potential r 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. .41 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 to maintain 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 CIANIXTIr". LION STATE OF ALASKA THIRD JUDICIAL DISTRICT (signature) ,print name) ss. Date: The foregoin instrument was acknowledged before me this day of A 0f� N NOTARY PUBLIC FOR ALASKA My Commission expires: "t Notary Public SARA DONOVAN State of Alaska hiy commission Expires 07/16/2028 MUNICIPALI By: —(signature) C-" � S 1-\,.> �.­,S 6--,.-,0 (print name) Date: Title: L (rev, 05/18/2018) Page 3 of 3 MUNICIPALITY OF ANCHORAGE 3� Development Services Department Phone: (907)343-7904 On -Site Water & Wastewater Section Fax: (907)343-7997 Parcel ID 017 -151-31 Certificate of On -Site Systems Approval OSC261062 Expiration Date: 10/9/2026 Legal description PALATERRA ADDN 2 LT 7 Site address 13468 DE PALATIS CIR Current property owner(s) COLONY BUILDERS INC X The On-site system(s) is/are approved for 5 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or conditions: By: Original Certificate Date: 4/6/2026 This C ifi ac to �f On -Site Systems Approval (COSA) is intended to demonstrate the subject Sys m(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, D velopment Service Department (DSD) issues COSAs based upon representations provided by an dependent 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 V -IMNICIPALITY 0 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 Parcell.D. 017-151-31 Complete legal description Palaterra Addn 2, Lot 7 Location (site address) 13468 DePalatis Cir ., Colony Builders Current property owners) 2. ON-SITE SYSTEMS SIZED FOR BEDROOMS Day phone 907-244-3269 3. TYPE OF WATER SUPPLY: RE Private Well serving # 1 dwelling units El Other Non-public well as regulated by MOA R Water Storage FJ Community Well or Public 4. TYPE OF WASTEWATER DISPOSAL: A Private Septic R Private Septic serving 2 dwelling units R Holding Tank F-1 Community Septic or Public Sewer 5. SEPTIC TANK: nN Steel n Plastic n Concrete n Fiberglass Age NEW - See advisory if steel or fiberglass older than 20 years 6. ABSORPTION FIELD: A AWWTS ljm� Bed EJ Deep Trench r_1 Wide Trench R Seepage Pit Waiver request for: Distance: Expedited review requested: n 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 # D S' C L � ( 0 (0 L Date of Payment Waiver # COSA Application—Apr2025.doc COSA Checklist_May2025.docx 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. DISPOSAL 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: 3DODWHUUD$GGQ/RW   ■ 1$ ■ ■ ■ ■  ■  +HIW\'ULOOLQJ    :HOOGLVLQIHFWHGDQDGGLWLRQDOWLPHDIWHULQLWLDOVDPSOHGDWH 1(: 1(: ■   ■ 1$ COSA Checklist_May2025.docx 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 ft Neighboring Tank > 100’Yes if No ft Disposal Field on Lot > 100’Yes if No ft Neighboring Disposal Fields > 100’ Yes if No ft Sewer Line/Main > 100’ Yes if No ft Sewer Manhole/Cleanout > 100’ Yes if No ft Sewer Service/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 Disposal Field(s) on Lot to:(Please enter distances if less than required) Tank to Foundation > 10’Yes if No 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’Yes if No ft Surface Water > 100’Yes if No ft Wells on Adjacent Lots: 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 ■■ ■■ ■■ ■ ■ ■■ ■■ ■ ■■ ■■ ■ )RUJH(QJLQHHULQJ   %HQMDPLQ6FKLOOHU3(  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 •� Day of of 20,;W, by and between herein the "OWNER," and the Municipality of Anchorage, herein th "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 Svstems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as eA ' located at (legal description) t--. 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) f Throughout 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 T� repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This ��` includes an annual maintenance fee (typically $400 to $600). ?�--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. 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 4, 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 i 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 a 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 to maintain 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 By: (signature) print name) Date.- STATE ate: STATE OF ALASKA ) )ss, THIRD JUDICIAL DISTRICT ) The foregoi=iinsmens was cknowledged before me this Kday of 20W by EKATIHERINE A. HALVORSON FU LIC FOR/ALASKA tary Public te of Alaska My Cotx iss' expires: p%6 Yl i�i�`}Z�'� ! n Expires Dec 7, 2029 (signature) ;print name) f16Date: f Title: (rev. 05/18/2018) Page 3 of 3 50' � � Arc 32.45' ROW Rad.50.00' DePaladis Cir i O' c V A— k 4r I Lot 8 I 011� ti 25 t.,� I � 6 ✓L �J ' W ti 24,2,0 rj �`V siurrveyuni`gF g• D� ti 0 30 60 9,1,1Qo,y1 6 OV � ° o• 26,3, House US SURVEY ?s• - S S 3�1, ss. FEET y y ti ni V ISI, Lot 6 of M I _ _ _ 0.. !4Cq ll ( ) — LEGEND �ED IL �,�Q►• ' • • • • • • ' i� *• H *�r 0 Clean Out ' o c I OS Septic Lid - cn a pistu� bony CP Septic Vault rr Jeremy A. Hurst ' Well ��; , LS- 179 . J� i 00' MM, W I 111 p'��fESSIONA����+ NOTES -All dimensions shown are grid bearings and ground distances, record boundaries are per Plat No. 2021-81. -49th Star has conducted a physical survey of the property and all details shown on this Asbuilt Survey are correct. Under no circumstances should any data hereon be used for establishment of property lines. -It is the owners responsibility to determine the existence of any easements, covenants, or restrictions; no title research performed. AS BUILT SURVEY 49th Star Surveying PO Box 738 Lot 7, Girdwood, AK 99587-0738 _ _ _ _ _ _ _ U7��tnrr� C'»��-li��;ni��-. A AA 7 fan7iQoi_rzi 11 N 89'38'32" E 60.49'