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Home My WebLink AboutPALATERRA ADDN 2 LT 62 P A A 2MIAhi Lot 6 017- 151 -30 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON -SITE WASTEWATER INSPECTION REPORT Permit Number: OSP251296 PID Number: 017-151-30 Dwelling: 9 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑■ New ❑ Upgrade Name Colony Builders ABSORPTION FIELD ❑ Deep Trench ❑■ Wide Trench ❑ Bed El Mound Site Address 13492 De Palatis Cir ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 6.0 GPD/SF 11.5 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 11.0 Ft. Gravel depth beneath pipe 0.5 Ft. Subdivision Palaterra Addn 2 Block Lot 6 Fill added above original grade -1.0 Ft. Gravel length 20.0 Ft. Township Range Section Gravel width 5.0 Ft. Beds: Number of Lines N/A Distance between lines N/A Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches 1 Dist. between trenches N/A From Tank Field Tank Line 100 Ftz Ft. Well >50' >50' N/A N/A >25 TANK ❑ Septic ❑ S.T.E.P. ❑ Holding ❑■ Other Manufacturer Anchorage tank Capacity 1500 Gal. Surface Water >50' >50' N/A N/A Material Plastic Number of compartments 2 Lot Line >5' >10' N/A N/A NA Foundation > 1 0' > 1 0' N/A N/A LIFT STATION Manufacturer O re n co Capacity Integrated Gal. Remarks Alarm location Just north of FCO Electrical installed by Frontier Electric PIPE MATERIAL House to tank D3034 Tank to D3034 drainfield Installer Red Dog Drainfield D3034 CO/MT D3034 Inspector Justin Earls BENCH MARK (Assumed elevation) 100 ft Inspdection �5' 5/28/26 5/29/26 Location and description 2nd Nh Bottom of siding SE corner 3fd ON -SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp .,: l Conditional Approval: Date BenCE Septic System��0 12592i11er `% Approved Date 7/9/26 itlt7 pROFESS�ON�4� Note: this approval does not include well permit requirements. tKev ubiuziie) MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section �_� Fax: 907-343-7997 Well Log Permit Number: #OSP251 �j Date of Issue: 9/2/25 Date Started: 10/14/25 Date Completed: 10/17/25 Legal Description:Palaterra Addn 2 LT 6 G:2939 Property Owner Name & Address: Colony Builders Borehole Data: Depth (ft) Soil Type, Thickness & Water Strata From To Parcel Identification Number: 017-151-30 Is well located at approved permit location? Yes ❑■ No ❑ Casing Stick Up 0 2 Brown Silt w/Fine-Coarse Gravel 2 15 Brown Clay w/Fine-Coarse GravIN 15 85 Fine -Coarse Gravel w/Brown Cl 85 123 Grey Clay w/Fine-Coarse Graveld 123 140 Fine -Coarse Gravel Cobbl 140 143 Grey Clay w/Fine-Coarse GraveIE4 143 165 Fine -Coarse Gravel w/H20 (Dirty) 165 170 Fine -Coarse Gravel w/Grey Silt 170 186 Grey Clay w/Fine-Coarse Gravel 186 235 Fine -Coarse Gravel (Moist) w/Bra 235 250 Brown Clay & Fine -Coarse Gravej 250 255 Fine -Coarse Gravel w/Brown Siltd255 260 Fine -Coarse Gravel w/Brown Clah 260 281 Grey Clay w/Fine-Coarse Gravel 281 320 Fine -Coarse Gravel w/H20 320 327 LAT: 61.099547 LON:-149.7487-6 �ype of Drill Bit Used: Tricone Water Sample Results: Arsenic: N D ug/L Nitrates: ND mg/L Total Coliform Bacteria: negative colonies/100mL Method of Drilling 0 air rotary ❑ cable tool Casing type: A53B Ste Wall Thickness: .250 inches Diameter:6 inches Depth:324 feet Liner Type: — Diameter: — inches Depth: — feet Casing stickup above ground: 2 feet Static water level (from ground level): 236 feet Pumping level: — feet after — hours pumping =gpm Recovery Rate: 10 gpm Method of Testing: Air Lift Well Intake Opening Type: ® Open End ❑ Open Hole ❑ Screened Start feet Stopped feet ❑ Perforations Start feet Stopped feet Urout type: bentonite volume: 2 baps Depth: 20 Start 2 feet Stopped 22 feet Well Disinfected Upon Completion? Yes No Method of Disinfection: Taba Comments: Well Driller: Dylan Kay ® ❑ Company: Hefty Drillinq, Inc. Mailing Address: P.O. BOX 112130 Anch., AK 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 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. Benjamin Schiller CE 12592R E GISTEREDPROFE S S I O N A L E N GINEER 1"=30' 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 # OSP251296 PID # 017-151-30 PALATERRA ADDN #2, LOT 6 A B FCO 7.4 MH 19.1 POD 21.3 A B C CO3 22.9 CO1 34.0 MT1 35.6 CO2 38.8 57.3 59.0 50.6 FEET 0 30 60 NOTE: ALL WELLS ARE SHOWN WITH 50' RADIUS PLAN AS-BUILT 7/9/26 NON-DISTURBANCE SETBACK 900 895 890 885 880 875 870 865 860 855 850 APPROX LOCATION OF EXISTING WELL 1500-GAL ADVANTEX FAP TANK ALTERNATE SITE NORTHERN GEOTECH TEST HOLE FCO EXISTING WELL RADIUS OUTSIDE VIEWPORT EXISTING WELL w/ 50' RADIUS 4-BDRM HOME 20' LONG X 5' WIDE, 0.5' EFFECTIVE DEPTH TRENCH CO3 TH#1 MT1 CO1MT2 CO2 TH#2 MH POD MT2 37.149.1 C 36.5 39.2 33.6 ALARM LOCATION PROFILE AS-BUILT (NO SCALE) 95.1 96.1 100.1 FC O MH PERMIT # OSP251296 PID # 017-151-30 PALATERRA ADDN #2, LOT 6 CO Benjamin Schiller CE 12592 R E GISTEREDPROFE S S I O N A L E N GINEER 1500 GAL ADVANTEX FAP TANK AX-20 FILTER POD 7/8/26 20' DRAINFIELD ROCK MT CO COMT MOA APPROVED SAND 91.5 FINISH GRADE TH # 1 NO GROUNDWATER 4/24/26 81.5 69.0 81.0 92.5 ORIGINAL GRADE 79.0 90.1 LEGAL DESCRIPTION: PERFORMED FOR: DATE:PARCEL ID#: SOILS LOG AND PERCOLATION TEST 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 DEPTH (feet) TEST HOLE 2 DATE READING NET TIME(minutes) DEPTH toWATER NET DROP PERCOLATION RATE: (MIN/INCH) (inches)(inches) DATE OF MONITORING DEPTH TO WATER AFTER MONITORING <1.0 1 2 3 4 5 6 ML (SANDY CLAY & SILT) Professional Engineers Stamp: PALATERRA ADDITION #2, LOT 6 5/29/26 017-151-30 BILL TAYLOR Benjamin Schiller CE 12592 R E GISTEREDPROFE S S I O N A L E N GINEER TECHNICIAN:JUSTIN EARLS NONE 4/24/26 COMMENTS: SITE PLAN USCS SOIL CLASSIFICATION WAS VISUALLY DETERMINED 7/9/26 MOISTURE NOTED AT TIME OF DIGGING?NO 20 21 22 23 24 GP (POORLY GRADED GRAVEL w/ 49% SAND) THIS TH WAS COMPLETED TO CONFIRM THE SOILS FOUND IN TH1. NO PERC TEST NEEDED. THE AREA AROUND THIS TH HAD BEEN CUT DOWN SEVERAL FEET FROM ORIGINAL GRADE. DEPTHS FROM OG MATCH TH1. Lot 6 Palaterra Addn. No. 2 Subdivision As Built 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 Existing House Detail Scale: 1" = 30' 0 60' GRAPHIC SCALE 0 30' GRAPHIC SCALE 6/18/2026 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 & Wastewater System Permit Permit Number: OSP251296 Work Type: WellSeptic Initial Tax Code Number: 01715130000 Site Legal Address: PALATERRA ADDN 2 LT 6 G:2939 Site Mailing Address: Owner: COLONY BUILDERS INC Design Engineer: FORGE ENGINEERING This permit is for the construction of: Z Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy Effective Date: Expiration Date: 9/2/2025 9/2/2026 Lot Size in Sq Ft: 95807 Total Bedrooms: y 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 Special Provisions: Test holes are required prior to construction of the absorption field, in the locations 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). C C) I G 7/ 2-cz S r—i F LD C S Zo 2 Received By: rr 0C Date: Issued By: L Date: J MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section ON -SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 017-151-30 Property owners) Colony Builders Inc Day phone (907)345-0371 Mailinq address 9420 Vanguard Drive #A, Anchorage, AK 99503 Site address NHN De Palitis Cir, Anchorage, AK Legal description Palaterra Addn #2, Lot 6 Number of Bedrooms` y Engineering Firm Forge Engineering Building Permit Number P Z- r--- � o J b Not Applicable ❑ APPLICATION IS FOR: APPLICATION IS AN: (® all that apply) Absorption Field 0 Initial 0 Septic Tank F. Upgrade ❑ Holding Tank ❑ Renewal ❑ Privy ❑ Well 0 THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Permit/Rush Fees: f$2_0 Date of Payment: i012_f Permit No. 05P 25P& Waiver Fees: Date of Payment: Waiver No. Distance: Cp-�Z GE E E R I N G May 4, 2026 PO BOX 240773 ANCHORAGE. AK99524 522-7773 677.7766 (FAX) FORGECIVIL.COM MOA Development Services, On -Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Palaterra Addn #2, Lot 6 —13492 DePalatis Cir Septic system design Dear On -Site Services Engineer: The owner of the above lot intends to build a 4-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 on the north side of the lot but gets steeper the farther south it goes. Where the proposed septic system is located the slope is around 25%, shortly after it gets steeper. A steep slopes analysis is attached that shows that even though there are slopes greater than 25% within 50' the effluent from the trenches will not daylight. 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. Wells on this and adjacent lots are shown. The new system will be a minimum of 50' 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. The soils encountered on this lot are somewhat unusual for the area. The proposed trench is positioned with our TH#1 on one side, and an additional test hole will be excavated on the opposite side to confirm the presence of similar gravelly soils, rather than the clay and silt typically found on nearby lots. Sincerely, Benjamin Schiller, PE L LOT 8 OT 8 APPROX LOCATION OF EXISTING WELL v LOT 7 -BDRM F NORTHERN GEOTECH TEST HOLE kS FCO 0 ........... MT .......... co 0 CONFIRMATION TH: TH#1 H#1 20'LONG X 5'WIDE, 05EFFECTIVE DEPTH TRENCH ........ ALTERNATE SITE NON -DISTURBANCE SETBACK LOT 6 E H 6 IN EEB ING SEPTIC PLAN A **49 Im •0 30 60 PIP FEET • • ' Benja i �c Schiller 1"=30 CE 2592 4/26 • NOTE: SSO k�,'2'PROFE ALL WELLS ARE SHOWN WITH 50'RADIUS � PROPOSED WELL 1500-GAL ADVANTEX FAP TANK EXISTING WELL RADIUS OUTSIDE VIEWPORT LEGEND CO-CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE FCO 0 ........... MT .......... co 0 CONFIRMATION TH: TH#1 H#1 20'LONG X 5'WIDE, 05EFFECTIVE DEPTH TRENCH ........ ALTERNATE SITE NON -DISTURBANCE SETBACK LOT 6 E H 6 IN EEB ING SEPTIC PLAN A **49 Im •0 30 60 PIP FEET • • ' Benja i �c Schiller 1"=30 CE 2592 4/26 • NOTE: SSO k�,'2'PROFE ALL WELLS ARE SHOWN WITH 50'RADIUS � PROPOSED WELL 1500-GAL ADVANTEX FAP TANK EXISTING WELL RADIUS OUTSIDE VIEWPORT 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 ADDIN #2, LOT 6 C DESIGN FACTORS: SYSTEM REQUIREMENTS: 600 GPD PEAK FLOW 5'WIDE TRENCH SYSTEM PERK RATE: <1 MIN/IN 1500-GAL ADVANTEX FAP SEPTIC TANK APPLICATION RATE: 6.0 GPD/SF 600 GPD / 6.0 GPD/SF / 5'WIDE * 1.0 RED FACTOR [0.5 DEEP] = 20.0 LF TRENCH REQUIRED (20.0 LF SPECIFIED) BOTTOM OF TRENCH: 11.5'BELOW GRADE FLOW LINE ELEVATION: 1 1.0'BELOW GRADE TYPICAL TRENCH SECTION (NO SCALE) NOTES: 1. GRADE AREA OVER TRENCH TO DRAIN AWAY 2. PROVIDE TOF 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 -�-QF WWI .......... .......... • Benja Schiller CE 12592 W4126 A AW PROFNS160—t� - LEGAL DESCRIPTION: PALATERRA ADDITION #2, LOT 6 PERFORMED FOR: BILL TAYLOR DATE: 4117126 PARCEL ID#: 017-151-30 DEPTH (feet) — � ; 1' OB TEST HOLE 1 l DATE READING NET TIME (MINUTES) DEPTH TO WATER (INCHES) NET DROP (INCHES) 4/17/26 1 0:30 4 8 10 8 6 6 2 0:30 4116 1016 66 3 0:30 416 1Q16 616 4 0:30 4116 1016 66 5 0:30 4 8 1011 66 6 0:30 4 6 1016 6 6 PERCOLATION RATE: <1.0 (MIN/INCH) 10 SITE PLAN 12 °ry'± PERC TEST LOCATION 13 14 15 {. 16 g. , GP (POORLY GRADED GRAVEL 17 w/ 49% SAND) SEE MATERIAL TEST REPORT 18 19 20 ;.a 21 22 1; 23—f Via{ NO MOISTURE NOTED AT TIME OF DIGGING? NONE DEPTH TO WATER AFTER MONITORING 4/21-/26 DATE OF MONITORING COMMENTS: USCS SOIL CLASSIFICATION WAS VISUALLY DETERMINED TECHNICIAN: JUSTIN EARLS Northern Geotechnical Engineering, Inc. - Report No: MAT:26-1392-1 Terra Firma Testing Issue No: 1 11301 Olive Lane, Anchorage, Alaska 99515 Phone: (907) 344-5934 1 www.nge-tft.com Hcg4 fT Material Test Report Client: Forge Engineering, Inc. Project: 10346-26 Forge Eng. Material Testing Reviewed By: Andrew Fortt, Engineer, P.E. Date: 4/22/2026 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. Sample ID 26-1392-1 Date Sampled 4/17/2026 Location Palaterra Addn 2, Lot 6 Diameter 600 200 100 60 20 6 2 600 200 100 50 i mm i um 100 80 70 ca >, a 60 N 50 CC a v m 40 °i a� 30 a 20 10 0 Sieve Size 6" 3" 1" 1/2" #4 #10 #20 #60 #200 3/4" 1/4" #40 #100 BOULDERS COBBLES GRAVEL (51 %) SAND (45%) SILT/CLAY COARSE I FINE COARSE MEDIUM FINE 0% 0% 23.3% 27.2% 14.4% 20.3% 10.7% 4% Liquid Limit: N0101 11111 Plastic Limit: "PI"°'i�> Plasticity Index: "P("°^-Pf b�) Linear Shrinkage (%): Drying By: Oven Date Tested: 4/22/2026 Tested By: Nic Cropper Sieve Size 6in 3in 1 in %in 'hin 3/8in %in No.4 No.10 No.20 No.40 No.60 No.100 No.200 % Passing 100 100 81 77 67 63 55 49 35 23 15 9 6 4.0 Limits D85: 32.0828 D60: 8.2540 D50: 4,8838 D30: 1.4109 D15: 0.4348 D10: 0.2683 Cu:30.76 Cc: 0.90 Form No: 18909, Report No: MAT:26-1392-1 O 2000-2026 QESTLab by SpectraQESTcom Page 1 of 2 Northern Geotechnical Engineering, Inc. - e Report No: MAT:26-1392-1 Terra Firma Testing Issue No: I 11301 Olive Lane, Anchorage, Alaska 99515 Phone: (907) 344-5934 1 www.nge-tft.com NO 17 Client: Forge Engineering, Inc. Project: 10346-26 Forge Eng. Material Testing Material Test Report Reviewed By: Andrew Fortt, Engineer, P.E. Date: 4/22/2026 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. Sample details Sample ID 26-1392-1 Date Sampled 4/17/2026 Location Palaterra Addn 2, Lot 6 Other Test Results Description Method Result Limits Cu ASTM D2487 30.76 Cc 0.90 Procedure ASTM C1 17 A Water Content (%) ASTM D2216 3.7 Date Tested 4/17/2026 Tested By Paul Santillana Group Code ASTM D2487 GP Group Name Poorly graded gravel with sand Tested By Nic Cropper Date Tested 4/22/2026 Liquid Limit ASTM D4318 Not Obtainable Plastic Limit NP (Non -Plastic) Plasticity Index NP (Non -Plastic) Tested By Nic Cropper Date Tested 4/22/2026 Comments Forge Engineering dropped off material on 4/17/26 to NGE lab. Form No: 18909, Report No: MAT:26-1392-1 0 2000-2026 QESTLab by SpectraQESTcom pane 9 of 9 870 875 880 885 890 895 900 0+00.00 0+50.00 0+97.00 865 870 875 880 885 890 895 0+00.00 0+50.00 0+97.00 1"=10'SLOPE CROSS SECTION PRIMARY SEPTIC TRENCHES Benjamin Schiller CE 12592REGISTEREDPROFESSIONA L E N GINEER 46 % AN GL E OF EF F L U EN T INF L U E N C E PALATERRA ADDN 2, LOT 6 6.0 FEET 0 10 20 8/22/23 46% ANG L E OF EF FLUE N T I NFL U E N C E 6.0 ALTERNATE SITE TRENCHES Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251296, Curtis Townsend, 09/02/25 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 13 Day of :-SLA--1 of 20 2.6 , by and between (-Lb Ick..5 P , 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 permission 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 6 2.Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) 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 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 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. 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 OWNER: BY _(signature) si nature) Date II �j D f tto jltiS 1 J- (print name) STATE OF ALASKA ) ss. THIRD JUDICIAL DISTRICT ) o �// 31Zr, The foregoing,- instrument was a cnowledged before me this �- day of 20�, by /V jeflo 0h, OTARY PUBLI FOR AL SK =TATB OF AWKA My Commission expires:1* �� NOTAW PUBUC Cher" Cramer W Co remnion Expires Jul 4, 2030 MUNICIP1 By: (signature) (print name) Date: 2 Title: C l V( L C ti C ('-"' 12- (rev. 05/18/2018) Page 3 of 3 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: (907)343-7904 On -Site Water & Wastewater Section Fax: (907)343-7997 Parcel ID 017-151-30 Certificate of On -Site Systems Approval OSC261253 Expiration Date Legal description PALATERRA ADDN 2 LT 6 Site address 13492 DE PALATIS CIR Current property owner(s) COLONY BUILDERS INC X The On -site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or conditions: No comments By: Curtis Townsend Original Certificate Date: 7/22/2026 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 Development Services Department On -Site Water & Wastewater Section ANCHORAGE Phone: 907-343-7904 Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 017-151-30 Complete legal description Palaterra Addn 2, Lot 6 Location (site address) 13492 De PalatlS Clr Current property owner(s)Colony Builders Day phone 2. ON -SITE SYSTEMS SIZED FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY:❑ Private Well serving # dwelling units ❑ Other Non-public well as regulated by MOA ❑ Water Storage ❑ Community Well or Public 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 NEW - See advisory if steel or fiberglass older than 20 years 6. ABSORPTION FIELD: * AWWTS ❑ Bed ❑ Deep Trench FE-1 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 $ 1 "'" Waiver Fee $ Date of Payment I �J O z Date of Payment COSA # S CZL G l �S 3 Waiver # COSA Applicalion_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: 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