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HomeMy WebLinkAboutSEAVIEW HEIGHTS BLK 3 LT 2AOnsite File Seaview Heights Block 3 Lot 2A #011-271-13 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP191531 PID Number: 011-271-13 Dwelling: ❑ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ❑ Upgrade Name Violet & Lynn Hulce Living Trust ABSORPTION FIELD ❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 6530 W. Dimond Boulevard Anchorage, AK ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 727-3300 2 Existing GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot Seaview Heights 3 2A Fill added above original grade Ft. Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line Ft2 Ft. Well >100' N/A N/A N/A >25' TANK M Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Greer Capacity 1,250 Gal. Surface Water >100' N/A N/A N/A Material Number of compartments Lot Line >5' N/A N/A N/A NA Plastic 2 Foundation >10' N/A N/A N/A LIFT STATION Manufacturer Capacity Remarks Tank is sized for 4 bedrooms. Gal. Alarm location Electrical installed by PIPE MATERIAL House to tank D3034 Tank to drainfield D3034 Installer Northern Excavation Drainfield Existing CO/MT D3034 inspector L. Tidwell BENCH MARK (Assumed elevation) 100 ft Inspection 15, 2/1/20Location and description dates: 2 nd m th Top of foundation near back door. 3m 4 ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp OF q ®tit Conditional Approval: Date •'�=®®� 49th ®............................................ �a MICHAEL E. ANDERSON �C ®� .AV , ®��T., NO. CE -4381 ,•' =m Septic Syste _- Appro �.. Date 2- L -2D �� F�;'••.•, Note: Note: this does include .2/3/20 ,,.°`F��'� 04 approval not well permit requirements. kmev voiuu_10) SEAVIEW HEIGHTS, BLOCK 3, LOT 2A PERMIT # OSP191531 PID # 011-271-13 A B\ C 2CO1 15.2 36.8 MH 16.6 37.5 SV 20.4 39.2 2CO2 23.5 40.8 CG3 _ 26.5 43.3 CO 18.0 26.8 MT 18.3 30.0 SHEDS EXIS ING-FIBERGLASS I -SEPTIC TANK'CRUSf%ED \ AND ABANCSONED PER- M.O.A. ERM.O.A. nBE. EXISTING TRENC'iITQ REMAIN IN SERVICE. 2 Bb M HOME MH y - -. C01 ( 200- -\ \ V CO2 B C NEW 1,2A LL0 G6N SE TI2_C \ SANK W120" M NWAY. !' VAR E -FENCE ~ 1PACT A PLAN AS -BUILT 0 50 100 WE ME FEET 1 "=50' _ 20' UTILITY EASEMEfN LEGEND CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE n LEGEND CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE SEAVIEW HEIGHTS, BLOCK 3, LOT 2A PERMIT # OSP191531 PID # 011-271-13 PROFILE AS -BUILT (NO SCALE) :• 49th MICHAEL E. ANDERSON �. No. CE -4387 r�•C:, H2O •r' �� �®@?ROFESSI•�o®oo 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 Wastewater Disposal System Permit Permit (Number: OSP191531 Work Type: SepticTank Upgrade Tax Code Number: 01127113000 Site Legal Address: SEAVIEW HEIGHTS BLK 3 LT 2A G:2322 Site Mailing Address: 6530 W DIMOND BLVD, Anchorage Owner: HULCE VIOLET G & HULCE LYNN A Design Engineer: FORGE ENGINEERING This permit is for the construction of: Effective Date: Expiration Date Lot Size in Sq Ft: Total Bedrooms: o ~�e:� r• m'partment 12/30/2019 12/29/2020 112240 ❑ 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. ��1� itieti Issued By: Date:. Date: /2 -30 2 EPLAO MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 011-271-13 Property owner(s) Violet & Lynn Hulce Living Trust Mailing address 1410 W. 46th Avenue Anchorage, AK 99503 Site address 6530 W. Dimond Boulevard Anchorage, AK Day phone 727-3300 Legal description (Sub'd., Block & Lot) Seaview Heights, Block 3, Lot T'(N Legal description (Township, Range & Section) Lot Size 112,240 Sq. Ft. Number of Bedrooms Two (2) APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (M all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) ❑x Septic Tank ❑X Upgrade ❑X (w/wo ADU) (D) El Holding Tank ❑ Renewal EJDaplex Multiple Multiple Dwellings ElPrivy El and/or D) Private Well ❑ Water Storage ❑ 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. (Signature of property owner or authorized agent) Permit/Rush Fees: oL J� Waiver Fees: Date of Payment: Date of Payment: Receipt Number: 05'�T67D Receipt Number: Permit No. OSP16)1531 Waiver No. Permit App_.:- :- ; PO BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) December 28, 2019 MOA Development Services Department On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Seaview Heights, Block 3, Lot 2A – 6530 W. Dimond Boulevard Septic System Design Dear On-Site Services Engineer: The septic tank on the subject lot has failed and must be replaced. We are submitting this design and permit application for the construction of a new 1,000-gallon tank to serve the two-bedroom home on the lot. The attached site plan identifies the location of the home and the existing well and septic system along with the proposed septic tank. No conflicts exist between this proposed tank location and any other well or septic system on this lot or adjacent lots. The existing absorption trench on the lot will be located and its configuration determined during the placement of the new septic tank. The trench will then be tested for adequacy and continued use. Wells on this and adjacent lots are shown. The new tank location will be a minimum of 100’ from all wells and surface water, and more than 10’ from the house foundation and 5’ from any stair or deck supports. Please refer to the attached plan sheet for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Michael E. Anderson, PE 12/28/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191531, Rebecca Carroll, 12/30/19 160 155 165 200 195 190 185 200100 0 FEET 1"=100' NOTE: NO SURFACE WATER WITHIN 100' OF THE PROPOSED SEPTIC SYSTEM ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC SYSTEMS. CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND SEAVIEW HEIGHTS, BLOCK 3, LOT 2A W. DI M O N D BL V D . 12/28/19 WIRE FENCE 20' UTILITY EASEMENT SHEDS EXISTING WELL 2-BEDROOM HOME EXISTING WELL EXISTING WELL DECOMMISSION EXISTING SEPTIC TANK PER M.O.A. CODE. NEW 1,000 GALLON SEPTIC TANK w/20" MANWAY. EXACT LOCATION AND CONFIGURATION OF ABSORPTION TRENCH TO BE DETERMINED. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191531, Rebecca Carroll, 12/30/19 E PL A13 MUNICIPALITY OF ANCHORAGEU10 ;, Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 tems Approval Expiration Date: � c/—z0 zo Certificate of On -Site Sys Parcel I.D. 011-271-13 1. GENERAL INFORMATION Complete legal description 6530 W Dimond Boulevard Anchorage, AK Seaview Heights, Block 3, Lot 2A': Location (site address) Current property owners) Mailing address Real estate agent Violet & Lynn Hulce Day phone 541-980-9355 1410 W 46th Ave, Anchorage, AK 99503 Dave Windsor 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: L 4. TYPE OF WATER SUPPLY: Private Well 0 Water Storage ❑ Community Well ❑ Public Water System ❑ Waiver request for: Received by: Day phone 907-727-3300 TYPE OF WASTEWATER DISPOSAL: Private Septic', Holding Tank! ❑ Community i ❑ Public Sewer ❑ COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 4 `'iK 0 Date of Payment 113o la &16 Receipt Number 693iw,U • MMI - Date: Waiver Fee $ i Date of Payment 1 Receipt Number Waiver # Distance: 6. 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 for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Fore Engineering Name of Firm g g g Phone 907-522-7773 Address 1399 W. 34th Ave Suite 101, Anchorage AK 99503 Engineer's Printed Name Michael E. Anderson, P.E. Date 1/30/20 6. DSD SIGNATURE System #1 Approved for _y__ bedrooms System #2 Approved for Disapproved Conditional approval for bedrooms bedrooms, with the following stipulations: Br. f Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate. Advisory Septic System Advisory Arsenic Advisory_ Well Flow Advisory Other COSA Checklist blue sheet Legal Description: Seaview Heights, Block 3, Lot 2A Parcel ID: 011-271-13 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA ❑ Well log is filed with Onsite (or attached) Well production at time of test 7 gpm Date drilled 12/31/85 Water storage tank volume 0 gallons Total depth 253 ft Well disinfected for coliform test? ❑ Yes ❑ No Cased to Unknown ft RE Coliform bacteria is Negative ❑ Sanitary seal is functioning correctly Nitrate mg/L ❑ Nitrate less than MRL (ND) ❑ Wires are properly protected Arsenic 17.4 ug/L ❑ Arsenic less than MRL (ND) Casing height (above ground) '24 in. Collected by FORGE ENGINEERING Date of flow test for COSA 11/13/19 Date of Sample 11/13/19 Static water level at beginning of test 165 ft Comments Well information taken from water rights documentation B. TANK DATA Age of tank(s) <1 years Tank type/material Septic/Plastic Measured operating fluid level in septic tank New ❑ Standpipes/foundation cleanout per record drawing Date of pumping New Construction D. ABSORPTION FIELD DATA Which system tested (date installed) 5/29/79 ❑ ALL standpipes present per record drawing Total measured depth from grade 12.8 ft (max) Measured depth to pipe invert from grade 7.3 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) 2006 Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Tank Replaced 2/1/20 Adequacy test date 1/29/2020 Results Q Pass For 4 bedrooms Fluid depth prior to test 0 in Water added 697 gal New depth 54 in Elapsed time 1246 min Final fluid depth 0 in Absorption rate >600 gpd Any rejuvenation treatment (past 12 months) If yes, enter date m E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ❑✓ Yes Community Sewer Manhole/Cleanout > 100' Q Yes if No ft ❑ Yes if No Neighboring Tank > 100' ❑ Yes if No ft Private Sewer/Septic Line > 25' E✓ Yes if No Absorption Field on Lot > 100' ✓❑ Yes if No ft Holding Tank > 100' ❑✓ Yes if No Neighboring Absorption Fields > 100' 0 Yes if No. Water Main > 10'✓❑ Animal Containment > 50' ❑✓ Yes if No ❑✓ Yes if No ft ✓❑ Yes if No. Water Service Line > 10' 0 Yes if No Manure/Animal Excreta Storage > 100' —❑✓ If septic tank is under driveway Community Sewer Main > 75' ❑✓ Yes if No ft Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑✓ Yes if No ft Surface Water > 100' ❑✓ Yes if No. Property Line > 5'✓❑ 3 ft Yes if No ft Wells on Adjacent Lots: ft Absorption Field > 5' ❑✓ Yes if No ft Private Wells > 100' 0 Yes if No. Water Main > 10'✓❑ if No Yes if No ft Community Wells > 200' ✓❑ Yes if No. Water Service Line > 10' 0 Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' E✓ Yes if No ft If absorption field is under driveway comment below Property Line > 10' ❑ Yes if No 3 ft Wells on Adjacent Lots: Water Main > 10'✓❑ Yes if No ft Private Wells > 100' ❑✓ Yes if No Water Service Line > 10' ❑✓ Yes if No ft Community Wells > 200' ❑✓ Yes if No Surface Water > 100'✓❑ Yes if No ft F. ENGINEER'S COMMENTS Waiver requested for trench distance to property line G. ENGINEER'S CERTIFICATION l certify that / have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. COSA Checklist yellow sheet ,> OF too 49th �: �eeeeeesamaaasuueaaa�aaaeaaoaaneaeaaaa u$arane u E. ANDERSON a w Z Aw °sem No. CE -4381 ��� cf •®+0 2/4/20 °°°° C� F•�O+aesaeaaaaesa'°°°° PROFESS��N� ft ft ft ft ft ft ft ft ft ft Waiver#: Municipality of Anchorage P.O. Box 196650 0 4700 Elmore Road Anchorage, Alaska 99519-6650 ® (907) 343-7904 ® Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Proqram PID#: 011-271-13 17C �0 , P✓, i e- Department / XKXx COSA#:OSC201031 Permit#: Legal Description: Seaview Heights B3 L2A Engineer: Forge Applicant: Hulce Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 3 feet. This waiver approval applies to the Existing absorption field only. Any future upgrade to the on- site wastewater disposal system will require all separation distances be met or another approval from this department. ❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of non -objection have been received from the owner(s) of the affected adjacent property. Adjacent properties are not affected by this waiver. ■ a a a a a a a a a a a a a a a a a a a a a a a a a a e a a a as a a a a a c a a a a a a a a v a a v a v a v a a a a v c a s a a a a a a a a v aaaeaaI Waiver is Granted: X Waiver is not Granted. - Date: ranted:Date:=- ?-O 2 C7 Approved by: Name of Reviewer ■avaaaaavaaaveaaaacvavaa v a s a v a a a v a a a a a 0 0 a a 0 a a a a a e v a 0 a a a a v a v a 0 a a 0 a a 0 a a a a a a a v a a 01 February 4, 2020 UTE E E R I N G PO BOX 240773 ANCHORAGE, AK 99524 522-7773 677.7766 (FAX) FORGECIVIL.COM MOA Development Services, On -Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Seaview Heights Block 3 Lot 2A — 630 W Dimond Blvd Separation Distance Waiver Absorption Trench to Lot Line Dear On Site Services Engineer: OF Ik rte`,• '"� � 49 TM .`.... Benjakrr)-Schiller CE 12592 `ter 2/4/20 ,.'IC; �w ���.;�pROFESSIONP ,,� The septic system placed on this property was permitted and placed in 1979. The system has recently been inspected and found to comply with Municipal Code with the exception that the western end is around 3' from the property line. A waiver is required to allow the trench to remain in its current location. The underlying soil is very sandy, and the percolation rate was rated at 150 SF/bdrm. Effluent absorption is expected to be downward with little or no migration in a horizontal direction. Placement of the system at the location described above will have no adverse impact on the well or septic system on this or adjacent lots. We hereby request a lot line waiver be issued. Sincerely, Benjamin Schiller Arsenic Advisory Certificate of On -Site Systems Approval # OSC201031 Subdivision: Seaview Heights, Block 3, Lot 2A A water sample revealed an arsenic concentration of 17.4 micrograms per liter (ug/L). The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 ug/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Information on arsenic is available from the On -Site Water and Wastewater Program website (www.muni.org/onsite) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. k .m'.��x..a�.?^cr. r�`ws 4"�.'`''•"F='- ;Ms,h",'g'x MailinAddress P O�Box196650 *Anchorage; Alaska 99519 6650'Www mtim org �.�a k...�.... h��`��:�,r.�, "Y,�v,.ss�,c'wt.ae`,��z� "%:�,'�-,X.sx«"^i.�, < (nA m O -' 3 SCD V fes' 0 CD =3N 3 3 D O m n ? -•.m m -1 O• O m S 7 a � N N y n m CO CD D m CD z 3 'fl C 7Er 7 n• m -O m w�i. 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L mea - "<g �— m n' O N —0 -+• V1 - ? ; 0 m z O I I N _ n S m -4. m N �@ -�• 3 n m m m 3 7 O @_� n V) O t O X C ��. a w-nsvO3z0- m mm 0m 0 CD `D°v oma as 10., JQ o�ovcAv N -n (D'p `✓� p D a N I m so o•n m3 ncv ��NN �O -+•A Qv•• � N N N n (n CD 00 3 C* (a0CY) 4�a ry CD •O 3 O m C m m C O CNA CDj N to �o0 ��o T� 0 X O > D c o 3 CD n n m s o N m O Qa0000p0 m z J _ n• Q 10 p P4 VA -.0 co PA too w a N o: :� L4 L) G •� f� S 0 D z % o / N _ 2 ,99 ZoeM„9£ P z m m -` -----------f- 00 — t� �O (10\y7 r:C zC ,00.099 3„9£,9£.00 S n n 4. /f /f / GRAVEL DRIVEWAY' f a 00.09-V M„9£,9£.00 N 0 co ®� O C.)-� Q4 - ^► n � / 60 / f f 0' / MUNICIPALITY OF ANCHORAGE 0 DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION _ 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT �� NAM�E/t�'r��7/j ,y �`q M 1 '�✓CJ'1 — PHONE T 'c�`6 ❑NEW LJ l GRADE MAILINGAD DDOSS (} _ LEGALD RIPTION cc) LOCATION`= � ^^ , e O`- v` -/`Y-' `"W /v4P` NO. OF BEDROOMS -..® DISTANCE TO: Well v Absorption area r Dwelling PERMIT NO. wG Manufacturer C / Material No. of compartments -- ul Liq, capacity in gallons IF HOMEMADE: Inside length Width Liquid depth _OZ DISTANCE TO: Well Dwelling PERMIT NO. Tz H Manufacturer — Material Liquid capacity in gallons O W = DISTANCE TO: Well �O Foundatign *2- Nearest lot1111P.PERMI,ZNQr�El�, __�� q W u V 'j Z w _� No. of line / Len th of e i Total length of ! g g c Trench widtl / �inchas Distance betw. n lines 0 1 Q F � Top of tile to finish grade Material beneath the inches Total effec i abs rptio��narea �©t„s W Length Width Depth PERMIT NO. C7 Q� F LU Type of c fb Crib dia eter n h effective absorption area W U)DISTANCE TO: Well Building foundation Nearest lot line J J Class Depth Driller Di stance to lot line PERMIT NO. W DISTANCE TO: B oundation ewer line -s eptic tank Absorption area(s) OTHER LEGAL PIPE MATERIALS 1511 L TEST RATING -- �I INSTALLER — REMARKS 1 r h 'f` 4 1t APPROVED DATE L j 72-013'(Rev.3/78) 1�1 PERMlT HPPLICHNT HHS THE RESPONSIBILITY lD lNFORM THIS DEPHRTMENT DURING THE lNSTHLLHTICIN lNSPECTIUNS UF RNY WELLS HDJHCLNT TO THIS PROPERTY HN0 THE 1714UMBER OF RESlDENCES 1`101- 1 HHT 1 Q W: 31 �������X (IN kv 4 Vol CA IF Q 157 Rol K�z IM R. y X IT: H R > GHCKFILLlNG OF HNY SYSTEM WITHOUT FINHL IHSPECTlON HND 8PPROYHL BY THI� DEPR*TMENT WILL BE SUBJECT TO PROSECUTION MINIMUM DISTANCE BETWEEH 8 WELL RND FIN UN -SITE SEWHGE DISPOSHL SYSTEM IS i00 FEET FUR 8 PRIYHTE NELL/ OR 150 T0 200 FEET FROM 8 PUBLIC WELL DEPENDlNG UPON THE TYPE UF PUBLIC WELL UTHER REQUIREMENTS MAY HPP|.Y. SPECIFICHTlONS HND CONSTRUCTI0N DIRGRHMS Hk�E HVHILHBLE TU INSURE PRUPER INSTHLLRTION. �PEI W fv 0 !1 -1 kl� 0-2 Rol 1: TV! CA; Vol EY on; 117 1 w H Vol K M ��:'.8���� , I CERTIFY THHT 1: I 011 FHMILI01Q WITH THE REQUIREMENTS FOR ON~SITE SEWERS HND WELLS RS SET FORTH By THE MUNICIP8LITY UF HNCHURHGE. 2� I WlLL INST0LL THE SYSTEM IH HCCORDHNCE NITH TH� CODES ]� I UNDERST11,Y1 THE ON-SITE SEWER SYSTEM MAY REQUIRE I'M LHRGEMENT IF THE RESIDENCE IS REMODB.ED TO INCLUDE MORE THHN 4 8EDROOMS. V7 2 + "51 = i+ o b lav s CA c V1 A -' 3 �p N ` -hi IV + "51 = i+ o b + m s CA c V1 A -' 3 �p r ` -hi IV aA co1 � p, x r io r 1zr�� o N Qi %< b 4 m d 2 U s z- 4 m d 2 .zree� ��e� .�� .0 • F esu�r cel%1�% G �S'h���/ a � 14.1 +� ,V&6lVA'va *Ge 000,,.J /Q { G�lthiviL�t� �dl�Pt �sAGs�Se Vv lD a �,—� 2crri i Pi6Z 7 MUNICIPALITY OF ANCHORAGE PALITY OF ANCHORAGE DEPT. G F" -Al & { HE & ENVIRONMENTAL PROTECTIONENVIRON;vi NTiAL .,CTION 5. LEGALDESCRIPTION STREE'-LOCATION - - - - - _n) 6. TYPE OF RE IDENCE UM ER OF BE ODMS [K SINGLE FAMILY ❑ - One � �0ur ❑ Other _ ❑ Two ❑ Five El MULTIPLE FAMILY ❑ Three C7 Six 7. WATER_S�LY LTJ INDIVIDUAL* ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAG-E DISPOSAL SYSTEM - - - - - T---�4r� tS� INDIVIDUAL/ON-SITE`S "If individual/on-site, give installation date_ If system is over two (2) years old an adequacy test is I required ❑ PUBLIC UTILITY by this Department. FNOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. MUNICI DEPARTMENT OF H - 825 L Street - Anchorage, Alaska 99501 APR 2 ii�F ENVIRONMENTAL ENGINEERING DIVISION ; Telephone 264.4220 _!, , REQUEST FOR APPROVAL OF INDIVIDUAL' WATER AND SEWER ���� DIRECTIONS: Complete all parts on page 1-. Incomplete requests will not be processed. Please allow ten (10) days for processing. - 1. PROPERTY OWNE PHONE -r JE AAS _k 2 l} I MAILING ADDRES INp- - - - - - 1. L.V oriiQl C q-`60 PSK_.61HO _luswil PROPER Y RESIDENT (If different from above) - - - - C�4 t,te ► v� \ko YLOA �' �� U,� , r( -K ��e a- 2-77-3 S�_ 2. By YER -- - P O E .' L MAILI 3[D RESS 1 O - {I� 14-0 r �O _ _. k_ -3. LEN N ING INSTITUTION - -- - �0li sr -c�l/� (20 PHDNE MAILINGADDRESS - 1 - r. - u. e sS a �� J -4"� e) I� �l S 0_3 4. REALTO /AGENT %PHONE oN1 2-77- �S MAILI G ADDRESS r V 5. LEGALDESCRIPTION STREE'-LOCATION - - - - - _n) 6. TYPE OF RE IDENCE UM ER OF BE ODMS [K SINGLE FAMILY ❑ - One � �0ur ❑ Other _ ❑ Two ❑ Five El MULTIPLE FAMILY ❑ Three C7 Six 7. WATER_S�LY LTJ INDIVIDUAL* ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAG-E DISPOSAL SYSTEM - - - - - T---�4r� tS� INDIVIDUAL/ON-SITE`S "If individual/on-site, give installation date_ If system is over two (2) years old an adequacy test is I required ❑ PUBLIC UTILITY by this Department. FNOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY - INSPECTION APPOINTMENTS DATE RECEIVED - TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER ❑Septic Tank or ❑Holding Tank Size: If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES - WELL T0: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS LJ� APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE BY (Ti LEGAL DESCRIPTION 72-010 (Rev. 3/78) PERMIT AND CERTIFICATE OF APPROPRIATION LOS $826 k THE STATE OF ALASKA UNDER AS 46.,, t5:, THE AL.A-LS WATER USE: ACT, AND THE REGULATIONS ADOPTED IT, G.fZANTS TO: LYNN A HULCE AND VIOLET G HULCE — 6530 W'DIMOND BLVD ANCHORAGE, A& 99,02 THE RIGHT TO USE WATER FROOJOE FuLILOVIVI SGURA: A) DRILLED WELL. WITH 0 PRIOPITY DATE OF 12/31/1995 SOO.0 SALWY S .4 iNc.-a- trwp;,.L.ING JAN Oi TRkU DEC 31 THE LOCATION TO WHICH THIS UATAR"PIGHT APPERTAINN 19: W-2-0,1EAVIEW HEQHTS SURDIVk$ON, MOVING TO PLAT NQ 0-74 LID—li—THr—nRURUKP7r"REOORDIOG"OISTRICT, SAID LOT LOCATED WITHIN Ei/2SWl/4 SECTION 9, TOWNSHjP 12 NPRTH, RANGE 4 WEST, SEWARD MIDI,% THE LOCATION OF THE WATER SDURCE-iS A DRILLED WELL, 253 FEET DEPPA WITHIN THE ABOVE DESCRIBED PARCEL OF PROPERTY. THE - CONDITIONS THAT APPLY TO THIS APPROPRIATION ARE FOUND IN ATTACH— MENT Q,ATTACHED HERETO AND MADE A PART HEREOF. THE WATER RIGHT IS GRANTED SUBJECT TO THE PERTINENT STATUTORY PROVISIONS IN AS 46.0, AND ADMINISTRATIVE REGULATIONS IN 11 AAC 93, PAGE i PERMIT AND CERTIFICATE ICATE OF APPROPRIATION I -AS 8826 THIS CERTIFICATE" OF APPROPRIATION IS IS' ED -BY AUTHORITY CE AS 46 . i 5 a 0U AND ii AAC 93,130 ON ...... ...........� ._ �.__......,... , � �* AF'F'RCI1lE~!1 • ... .. a _.,. T tTLF {'... � C.�S'TON t F �i. AND ANDWATER l° AMAGE:'riFN STATE OF ALASKA 3 s .... __ ,JUDIC14L DIST Itl ? , THIS IS TO CERTIFY THAT ON BEFORE ME:: APPEARED Cz�UGc- S7�-�F ... -_�... f KNOWN By ME TO BE THE DIRECTOR OR AUTH,i:�9 FEES F�I»:F'k IERi IT l t�`F' OF THE DIVISIONOFAND WATER MANA�I:.MAT , T�E:F'ARTMZMT CSI"" NATURAL RESOURCES, AND ACKNOWLEDGED TO kik" THAT THII CERT'IF'ICA'T'E': OF AF'f'`'%t3PRIATION WAS VOLUN- TARILY EXECUTED ON DFi•IALF OF T'1 -t1;: STATE OF ALASKA. _ .._ i�t1T`A�Y� F''k L iCFCJF 'f'HI 5'T'A �r .r .. *VKJG 1 - PURSUANT TO AS 46, i 5 n i 60 ANY 4PF~41CA,BLE REGULATIONS THE. CERTIFICATE HOLDER SHALL. NOTIFY THE ALATKA DIVISION VISlt; N OF LAND AND WATER MANAGEMENT !1F'ON CHANGE" OF ADDRESS OR TRANSFERCF' ANY RAL PROPER T Y RELATED THERETO.. PAGE: 2 PERMIT AND CERTIFICATE OF APPROPRIATION LAS 8826 ATTACHMENT A CONDITIONS - THE HOLDER OF THIS CERTIFICATE SHALL: FOLLOW ACCEPTABLE ENGINEERING s,rANDARDS IN. EXERCISING *rHE WATER RIGHT GRANTED BY THIS CERTTFICAT-E.:, DEFEND AND INDEMN11"Y THE.'. 'HOLD IT HARMLr.-S9 FROM ANY AND ALL CLAIMS, Dr,-".M'(-iNDS} l LSGA-L A&16,0-, LO -Sl, LIABILITY AND EXPENSE FOR INJURY TO OR.D.� I ATT'Fl-,OF'l -0:-E--kS0NN AND -PA-MAGIZS TO OR LOSS 6F PROPERTY ARISING OUT OR, . 'CQKNT;;l0T . ED WITH THI-7 EXERCISE OF 71-1E WATER RIGHT GRANTED BY CE IF 1 GAT E,. COMPLY WITH ALL APPLJOADLE L&NE , lZ , fi,'GULAT IONS AND . CONDITIONS. PAGE 3 PERMIT A.ND CERTIFICATE OF. APPROPRIATION LAS 'OO2 6 Thts .ts.16 Certrlty-that ih� Olr'1Q #, $f'xi9 `COt iE OOPY of the oriagina1 as., -the sap vPPewrs ]n th.2. f, les ofoffs w n e d �•i�� 'tiAii!-fn ne Date THE STATE OF ALASKA UNDER AS 46, 15, THE ALASKA WATER USE ACT, AND THE. REGULATIONS ADOPTED UNDER IT, GRANTS TO: LYNN A HULCE AND VIOLET G HULCE 6530 W DIMOND BLVD ANC:f••IORAGE, AK . • .x'9502 THE. RIGHT TO USE. blh'1'EJ`Z FROM THE FOLLOWING SOURCE: A) DRILLED WELL WITH A -PRIORITY DATE OF 12/31/1985 50030 GAL/DAY .FOR SINGLE I}WEI�L�t�G r JAM, 01 T!• RU DEC 31 THE LOCATION '1'0 WHICH THIS WATER RIGHT APPERTAINS IS: LOT 2-A, SEAVIEW HEIGHTS SUDDIVISION, ACCORDING FILED Its THE ANCHORAGfw RECORDING" DIST'RIC*I, ._;AlD_:<LDl-': L-QCA'rED t�i'iJIG i;1 /; SW1 r4 SECTION 5+, ._T�7k��.5'f 1x -1 I�FCTF�Tf�1, 't11`!(�E 4 WEST, SEWARD MERI�! D7AN. THE LbCATION OF WATER SOURC—E IS A DRIL WITHIN THE ATJOVE DESCF�'IBEID rARCEL O �-�t�t�p�� LED WELL, 253 FEET DEEP',. TI -11'" CONDITIONS -:THAT 'AP'P'LY TO THIS ()pnOF=uATION ARE F"CiUtgD Its AT'TACH•- MEN'r A, ATTACHE' D HERETO AND MADE, A P,)R-r HER1:0F. THE WATER RIGHT' IS GRANTED SUBJECT TO Tf••IE PERTINENT STATUTORY:. PROVISIONS IN AS 46 15, AND ADMi;CNISTRI).TIVf� RECYIJL.A'f'IONS :[N 11 -AAC 93, PAGE 1 S T -A T, E O- F A L A 9 K A DEPARTMENT OF -.NATURAL RESOURCES DIVISIDN. OF' LAND AND WATER MANAGEMENT 3601 C ST., - PO BOX 107005 ANCHORAGE, AK. 99510-7005 PHONE. 907-762--2270 LYNN 'A HULCE AND VIOLET G HULCE 6530 W DIMOND*BLVD ANCHORAGE, PK. 99502 07/26/1988 CERTIFIED MAIL. -00- RETURN RECEIPT REQUESTED RE: WATER RIGHTS CERTIFICATE LAS 8826 ENCLOSED 19 YOUR CERTIFICATE OF APPROPRIATION ENTITLING YOU TO. TJIE USE OF PUBLIC WATERS FOR BENEFICIAL ["URPOSES IN THE QUANTITY AND AREA AS SHOWN ON THE CERTIFICATE. THIS WATER, RIGHT WILL CONTINUE IN F"F"FECT FOR AS LONG As YOU CON.- TINUE YOUR WATER UNE. SEE SECTION 46.15.140 OF THE ENCLOSED WATER USE ACT COVERING "ABANDONMENT, FORFEITURE, AND REVERSION OF AFPROPRIAT IONS n THIS WATER RIGHT IS APPURTENANT TO THE LAND AND WIL.L. BE CONVEYED ALONG WITH TITLE WHEN THE LAND IS SOLD UNLESS IT IS SPECIFICALLY EXEMPTED -A IF THE WATER RIGHT IS TO BE S. E'VERED FROM THE LAND, SOLD, OR A LT E.' R EP SUBSTANTIAL.1Y, THE APPROVAL. OF THE DEPARTMENT (IF - NATURAL RESOURCES MUST BE ACQUIRED, SEE SECTION 46.15.160, "TRANSFER AND CHANGE OF APPROPIRIATIONSO. THIS CERTIFIrATE SHOULD rqr.-:-REC-oRDED IN THE RECORDING DISTRICT IN WHICH YOUR APPROPRIATION IS LOCATED. ILAGER EX;'YJV -eo BILL WRIGHT NATURAL RESOURCE OFFICER ENGLOSURES