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HomeMy WebLinkAboutSCIMITAR #2 BLK 3 LT 12Scimitar #2 Block 3 Lot 12 #051-132-66 FEB 10 Z�1 Municipality of Anchorage Community Development Department Page 1 of 3 On -Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP151043 PID Number: ( ❑ New © Upgrade Name: Coraene Brown ABSORPTION FIELD ❑ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address 20110 Tulwar Drive ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot SCIMITAR #2 3 12 Fill added above original grade Gravel length Township Range Section Ft Ft Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic- Absorption Litt Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line Ftp NA Ft. Well 100+ 100+ NIA NIA N/A TANK EI Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Anchorage Tank Capacity 1000Gal. Surface water 100+ 100+ NA N/A Material Number of compartments Lot Line 21.9 10 NA N/A .Steel 2 NA Foundation 12.9 27.9 NA NIA LIFT STATION Manufacturer _ Capacity Curtain Drain 50+ 50+ NA NIA Gal. Remarks TANK REPLACEMENT ONLY Pump on level at in. Pump off level at in. High water alarm at in. Pump make and model Electrical Inspections performed by Installer PIPE MATERIAL House to tank 3034 Tank to 3034 drainfield JRs Septic Pumping LLC Dminfeld 3034 GO/MT 3034 Inspector Pannone Engineering Services BENCHMARK (Assumed elevation) 1 00f - Inspdates: ec fa 03/02/15 Location and description Zm 3" 4' Top of Siding NW Corner COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineers Stamp Conditional Approval: Date • • • • • . ���9�r� /�g�Pq�G. *• TH .�� nevePEInnorae � 1 1 A Approved Date 3 " E � I •t�I 1 r \h��►\�' JJ 1bVC1AI V 11 RCpVI I_ 1-12I2A SEPTIC AREA (E) 2h • h� v /J �M M M o � LOT 12 4 BR x4- HOUSE / (E) 1 � WELL (E) IC AREA (E) NOTES: DRAWING PLAN M _�M 1 SEPTIC ARE1 E) \ DRAIN FIELD (E) W MI ' CO2 00O2 \ W Ca 'Cal A 1000g SEPTIC TANK (E) DECOMMISSIONED PER CODE / INSTALLED 1000g SEPTIC TANK WITH DCO J� /_Z7 07 P� a � i \ / /lt�/ PANNONE ING SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 SCIMITAR #2, BLOCK 3, LOT 12 CORAENE BROWN 20110 TULWAR DRIVE CHUGIAK, AK 99567 w'o mo EL. 10L6 NEW I000gM RIO. errs SEPTIC TANK Lsa.3 .. ••Steven .. annone� �' PF•, CE 8149 .•4�� �� cST ' • �i Scale 1'•=50' -.I.D. NO 051-132-66 'ERMIT NO 1 OF 1 A B C01 16.2 33.1 CO2 21.4 36.3 - DC01 23.4 37.4 DCO2 30.9 43.1 M1 31.7 44.3 NOTES: DRAWING PLAN M _�M 1 SEPTIC ARE1 E) \ DRAIN FIELD (E) W MI ' CO2 00O2 \ W Ca 'Cal A 1000g SEPTIC TANK (E) DECOMMISSIONED PER CODE / INSTALLED 1000g SEPTIC TANK WITH DCO J� /_Z7 07 P� a � i \ / /lt�/ PANNONE ING SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 SCIMITAR #2, BLOCK 3, LOT 12 CORAENE BROWN 20110 TULWAR DRIVE CHUGIAK, AK 99567 w'o mo EL. 10L6 NEW I000gM RIO. errs SEPTIC TANK Lsa.3 .. ••Steven .. annone� �' PF•, CE 8149 .•4�� �� cST ' • �i Scale 1'•=50' -.I.D. NO 051-132-66 'ERMIT NO 1 OF 1 On -Site Water and/or Wastewater System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP151043 Tax Code Number: 05113266000 Work Type: SepticTank Upgrade Permit Effective Dates: March 05, 2015 to March 04, 2016 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: SCIMITAR #2 Site Legal Address: SCIMITAR #2 BLK 3 LT 12 G:1261 Owner/Address: BROWN CORAENE B 2020 MULDOON ROAD #322 ANCHORAGE AK 995043669 Site Mailing Address: 20110 TULWAR DR, Chugiak This permit is for the construction of: N Disposal Field Y Septic Tank N Holding Tank N Privy Lot Size in Sq Ft: 46397 Total Bedrooms: 3 N Private Well N Water Storage All construction must 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 must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Ly 3I S/2ol.S MUNICIPALITY OF ANCHORAGE THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: 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. 051-132-66 Property owner(s) Corene Brown Day phone Mailing address 2020 Muldoon Road #322, Anchorage, AK 99504 Site address 20110 Tulwar Drive Legal description (Sub'd., Block &Lot) Scimitar #2, Block 3, Lot 12 Legal description (Township, Range &Section) Lot Size 46,397 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial F-1SingleFamily (SF) ❑X Septic Tank ❑X Upgrade (w/wo ADU) Duplex (D) F-1Holding Tank ❑ Renewal F-1Duplex Dwellings 1-1Privy ❑ (SF and/or D) Private Well El Water Storage F-1 Dis tance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes.,,---) of property owner or authorized Permit/Rush Fees: 011 ay� Waiver Fees: Date of Payment: 36115 p Date of Payment: Receipt Number:OO `33t1t Receipt Number: Permit No. 05P1516t, 3 Waiver No. Permit App_.: Dis tance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes.,,---) of property owner or authorized Permit/Rush Fees: 011 ay� Waiver Fees: Date of Payment: 36115 p Date of Payment: Receipt Number:OO `33t1t Receipt Number: Permit No. 05P1516t, 3 Waiver No. Permit App_.: Pannone Engineering Services LLC Steven R. Pannone, Principal Registered Professional Engineer E-mail: steveCa)oanengak.com March 4, 2015 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, Alaska 99519 Subject: Scimitar #2, Block 3, Lot 12 Emergency Septic Tank Upgrade Permit Request Ladies and Gentlemen: I am writing to request that a permit to install a new 1000 gallon Septic tank be issued for this lot. The proposed system will serve an existing 3 bedroom house. Currently the lot is developed. The existing septic system was designed and installed for four bedrooms. The existing tank has collapsed, placing the house out of service and is in need of replacement. This lot and the surrounding lots are served by private wells. There are no wells within 100' of this system. 1. Upgrade Tank Design. a. See Sheet 1 of 1 of the plan set 2. Surface Water: There is no surface water within 100 feet of the proposed system. The proposed systems will maintain at least 100 feet from all surface water and drainage ditches. 3. Topography: This lot slopes from south to north in the area of the tank replacement. The proposed installation will be located in the northeastern portion of the lot, next to the existing system. Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 1/2 East Manor Ave, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 Page 2 of 2 The proposed installation will not affect the future development of the surrounding or existing lots. There are no wells within 100 feet of the proposed septic location. If you have any questions or concerns, please contact me at 272-8218. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Attachments: Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 1/2 East Manor Ave, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 SEPTIC AREA (E) \ SEPTIC ARE E) \ DRAIN FIELD (E) \10008 SEPTIC TANK (E) DECOMMISSION PER CODE V10008 SEPTIC TANK (P) WITH DCO W-� w \ \ ti �2 •�Q rj\AA \� LOT 12 4 OR / HOUSE E1 \\ 77 WELL (E) NOTES EMERGENCY TANK REPLACE PLAN PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 SCIMITAR #2, BLOCK 3, LOT 12 CORENE BROWN 20110 TULWAR DRIVE CHUGIAK, AK 99567 �(G �F ALgs111 3/3/2015 Scale *:49TH+ */) ,••=so' .. .. .. ...... � P.I.D. NO .....! may-'....... •Steven R. Pannone.� 051-132-66 PERMIT N0. OSPxxxxxx �lP�•. CE 8149 .•�,� ('Ilif��DFESSIONP���_ Sheet 1 0F 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION oe*- 825 L Street - Anchorage, Alaska 99501 Telephone 264.4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME ` r/ PHONE ' NEW /V 7 'rC ` . ❑ UPGRADE MAILING ADDRESS a. %S� I SQ- LQ L' v - u s9�� , ,. 1- LEGAL DESCRIPTION LOCATION NO. OF BEDROOMS DISTANCE T0: Well_ / % 1 Absorption area _ / Dwelling rA PERMIT NO.•�. U y C N lU i Q LU~ Manufacturer Maters / No. of compartments Liq. capacity in gallons IF HOMEMADE: Inside length Wi th Liquid depth 6 z DISTANCE TO: Well Dwelling PERMIT NO. Oz FQ„ Manufacturer Material Liquid capacity in gallons w = DISTANCE TO: Well-/ _.1fy r Foundation / n�a Nearest lot li PERMIT J u. Z F Z w ;R No. of lines Length of each li e / , 3s - Total length of Ines Trench width - 6inches Distance between lines fTop x of the to finish grade r Material beneath the _ i Total effective absorption area _ As ��J C W Length Width Depth PERMIT NO. C7 Q I— as LU Type of crib Crib diameter Crib depth Total effective absorption area W DISTANCE TO: Well Building foundation Nearest lot line J Class Depth Driller Distance to lot line PERMIT NO. J Lu T. , DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS SOI L TEST RATI NG F�> U N INSTALLER REMARKS APPROVED DATE LEGAL [/ G -V IJ �1ICV. J//O/ APPLICANT DIANE W0�L,FEt LOCHTION PETERS CREEK LEGAL LOT 12 BILK ] S-CIMITAR SUB P.("I. BDX 10~706 HNCH LOT SIZE 0 ]4 46]97 SQUHRE FEET TYPE OF S3IL HBSQRPTION SYSTEM IS� DRHINFIELD 85 THE REQUIREDSIZE OF TH� SOIL HBSORPTION SYSTEM Tc,: ��F::,��� THE LB1GTH DIMENSION IS THE LENGTH (�N FEET) OF THE TRENCH OR DRH�NFIELD THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE.' D. GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). ��� ������� �� �^ C.-9 rCER ���_7 THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAY EL BETWEEN THE OUTFHLL'PIPE HND THE BOTTOM 8F THE EXCAVATION (IN FEE TX 1 FRAE-;wCA F=� -f- I C: �F:� r... V�- ����=::,!: 'j, PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM F �7 F:: Cii E Q �/ OF ANY WELLS HEALTH HND ENO'r. 1MEIN! THL\=4-OTECTION THAT 825 'L/ STREET/ HNCHORHGE, HK99-01 ` 264-4720 T,PERMIT' ��� No. APPLICANT DIANE W0�L,FEt LOCHTION PETERS CREEK LEGAL LOT 12 BILK ] S-CIMITAR SUB P.("I. BDX 10~706 HNCH LOT SIZE 0 ]4 46]97 SQUHRE FEET TYPE OF S3IL HBSQRPTION SYSTEM IS� DRHINFIELD 85 THE REQUIREDSIZE OF TH� SOIL HBSORPTION SYSTEM Tc,: ��F::,��� THE LB1GTH DIMENSION IS THE LENGTH (�N FEET) OF THE TRENCH OR DRH�NFIELD THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE.' D. GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). ��� ������� �� �^ C.-9 rCER ���_7 THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAY EL BETWEEN THE OUTFHLL'PIPE HND THE BOTTOM 8F THE EXCAVATION (IN FEE TX 1 FRAE-;wCA F=� -f- I C: �F:� r... V�- ����=::,!: 'j, PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE ' INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. ����I Cuft�_! F'! IEF ��Q 1�j 11 F<FE T-.'_,, BHCKFILLING OF HNY SYSTEM WITHQUT FINHL IINS PEEC- TIOQ HND HPPRQVHL BY THIS > DEPHRTMENT WILL BE SUBJECT TQ PROSECUTIQN. MINIMUM D' STANCE BETWEEN H WELL HND HNY ON�SITE SEWHGE DISPOSHL SYSTEM IS 100 FEET FOR H PRIVHTE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM H PRIVATE WELL TO Ai PRIVATE SEWER LINE IS 25 FEET AND TO H COMMUNITY SEWER LINE IS 75 FEET. WELL LOG�� ARE RE�QUIRED AND MUST BE RETORNED TQ THE DEPARTMENT WITHIm 30 DHYS OF THE WELL COMPLETIQN, OTHER REQUIREMENTS MAY APPLYSPECIFI CHTIONS HND CONSTRUCTION DIH8RHMS ARE HYHILHBLE TO INSURE PROPER INSTALLATION. Fr- EE Owl I -'r ��F' 1 F;i� FEE� EE P1���� I CERTIFY THAT 1� I HM FHMILIHR WITH THE REQUIREIMENTS FOR ON~SITE SEWERS HND NE�LS GS S�T FORTH BY THE MUNICIPALITY OF ANCHORAGE 2: I WILL INSTALL THE SYSTEM IN HCC8RDHNCE NITH THE CODES ]: I UNDERSTAND THAT THE ON-SITE SENER SYSTEM MHY REQUIRE ENLARGEMENT IF THE RE5IDEN(-E IS REMODELED TO INCLUDE MORE TH8tJ ] BEDROOMS. 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F �:-i "Ia `tj 'k6'- (= raO!a Ifv4- C", I -• `ei ,�.-.� { _.,... 3" t'£ i _�� '�-__.. x�f � P"�S._> _ L�-��_� _ ._rte {�.<�3. _.S _ •� �_'.=�i���_ { SS F Film tm F I,- t fop W : 111 i I'S' -Y' �'�' i li !� •t r t'de, i t y .:3y�{ y Ft '!3', i R '-t. {.r _Zau._ � 5.: A � Fit. = i �. ,- x c� F. rg t , 1� r?t e } L`_4:` /' rsr r n t 2 WIN 3`lj:�ii •5'{ i1•?� F'.F�f`d F: F-.: �€ Fi�_f j `( s t'p #- u -i- n o F -`3 4" P �aT•.� L`'a�` 6 %i i fu f -t e: 3 " » � I is._ '?. i .? �� {i i i� i4§ .{.•{�.{d�- _Ft��F;...x._ t t c ,. i! � i i� �s P� - t 3: l w - S _. i tJtE'_{r .aft-s�-lt� 'K"y;�rl k"y�s°. t:S�•k-n�3`!� `-�:j•ps- —I =r.,��:=afi , s i r MIRY t•r�3r i':r t f }- 3F0y� y i FHAH >i G -f t i it j, - '[ g_yvt o }'__}:£.t •{3 s._ -t .y i':' jj({�-�-,it`�'>tiy. .<��,,rr5-v''s_szf{ fv�d="- � g MUNICIPALITY OF ANCHORAGE • ae DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG PERCOLATION TEST PERFORMED FOR: 0a a iKZ96 LEGAL DESCRIPTION: 93 1 DEPTH 2 3 4 5 6 7 8 9 10 11 12- 13- 14- 15- 16- 17 - 18- 19 20 COMMENTS A��� e /1' K -) C f "-//'2 SLOPE xSOILS LOG ❑ PERCOLATION TEST DATE PERFORMED: 2<P t,c / QlTm DI nni WAS GROUND WATER rj/`-d f S ENCOUNTERED? L J L 0 P IF YES, AT WHAT` ( E DEPTH? Q Reading Date Gross Time Net Time Depth to Water Net Drop i PERCOLATION RATE��� (minutes/inch) TEST RUN BETWEEN FT AND FT In PERFORMED BY: S & u Engineering CERTIFIED 72-008 (6/79) DATE LOCATION OF WELL (Please complete either Ia. lb or In I WATER WELL RECORD STATE OF ALASKA DEPARTMENT OF NATURAL RESOURES Division of Geological 8, Geophysical Surveys Drilling Permit No. rlr . ;- 1, 1 , ", �".— Date' Authorized Representative Form 02-WWR (11/81) Copy Distribution: WHITE -State DGGS, PINK -Driller, CANARY -Customer la Ia. Borough Subdivision Lot Block lb. 1/4qtrs. ­ ­ ­ I— Section No. Township N Range mri,d Ia E [] -of-of-of-S❑ W[] AND DIRECTION le. DISTANCE AND DIRECTION FROM ROAD INTERSECTIONS 3. OWNER OF WELL: Address: Street Address and Area of Well Location T; 2. WELL LOG Feet Below Surface 4. WELL PTH: (final) 5. DATE OF COMPLETION Material Typeft Top Bottom 6. Cable tool ❑Rotary E] Driven E] Dug Auger ED Jetted 0 Bored❑Other: 7. USE: ❑Domestic E] Public Supply ❑ Industry 0 irrigation ❑Recharge E] commerical Test Well E] Other: 8. CASING: E] Threaded Welded I diam. in. to- ft. Depth Weight Zc il'-" pft 0 diam. in. to ft, Depth Stickup ft. 9. FINISH OF WELL: Type: Diameter' Slot/Mesh Size: a Length -jx Set betweenri ft. and Backfilling Gravel pack 10. STATIC WATER LEVEL: ❑Above or Below land surface Date I:j Equipment used: J. 11 - PUMPING LEVEL below land surface and YIELD ft. after I hrs. pumping 9 -P.M. ft. after hrs. Pumping g.p.,. 12.GROUTING Well Grouted: El Yes [] No Material: 0 Neat Cement El Other: MUNICIPAU DEPT, F 13. PUMP: (if available) HP ENVIRON,'A'1iN AL PROTEC ION Length of Drop Pipe ft. capacity -9 P.M Subm. ❑ Jet 0 Centrifical EJ Other 14. REMARKS: 16. WATER WELL CONTRACTOR'S CERTIFICATION: 15. Water Temperature -0 E] F ❑ C This well was drilled under my jurisdiction and this report is true to the best of my knowledge and belief; Registered Business Name Contract License Number Address rlr . ;- 1, 1 , ", �".— Date' Authorized Representative Form 02-WWR (11/81) Copy Distribution: WHITE -State DGGS, PINK -Driller, CANARY -Customer MINIMUM DISTANCE BETWEEN H WELL HND ANY OW -SITE SEWH8E DISP[GHL SYSTEM IS 100 FEEA FOR H PRIVATE WELL OR 150 TO 203 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM H PRIVATE: WELL TO H PRIYHTE SEWER LINE IS 25 FEET RNED TO H COMMUNITY S. -EWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED HND MUST BE RETURNE[) TO THE DCPHRTMENT WITHIN ]0 DHYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MHY APPLY. SPECIFICHTIONS HND CONSTRUCTION DIHGRHMS HRE AVAILABLE TO PROPER INSTHLLHT�ON Fol 1=7 A 10 1 -1 K 1.4 By 1 EEL AN 10 W Cl FEE WN E3 EsE. �, I CERTIFY THHT U I HM FAMILIAR WITH THE SEWERS HND WELLS HS SET FORTH BY THE 11UNICIP0-ITY OF HN�HORHGE 01: I WILL INSTHLL THE SYSTEM IN ACCORDANCE WITH THE CODES. SIGNED: .,.-,~~~~~-~~~_~.�~~�.~~�~.~_-��~�_~^_ APPLICANT DIHNE NOELFEL ISSUED BY_~�_ DHTE . 2`��r\ �~�_~~�_~~_~~_�_~_~ _��_��_u��V4.0 -y yxZ� ^ DEPRRTM�NT`8//HE1,91.01 AND ENVIRONMEPITHL`pf4-OTECTI ID, N STREET, HNCHORHGE, HK99501 264~4728 NF� rl��_� / PERMIT NO ( 820261 > HPPLICHNT DIANE WOELFEL PO BOX 10~706 99511 LOCATION TULWHR DRIVE 688-]970 LEGA~ L 12 B ] SCIMITHR LOT SIZE FEET MINIMUM DISTANCE BETWEEN H WELL HND ANY OW -SITE SEWH8E DISP[GHL SYSTEM IS 100 FEEA FOR H PRIVATE WELL OR 150 TO 203 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM H PRIVATE: WELL TO H PRIYHTE SEWER LINE IS 25 FEET RNED TO H COMMUNITY S. -EWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED HND MUST BE RETURNE[) TO THE DCPHRTMENT WITHIN ]0 DHYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MHY APPLY. SPECIFICHTIONS HND CONSTRUCTION DIHGRHMS HRE AVAILABLE TO PROPER INSTHLLHT�ON Fol 1=7 A 10 1 -1 K 1.4 By 1 EEL AN 10 W Cl FEE WN E3 EsE. �, I CERTIFY THHT U I HM FAMILIAR WITH THE SEWERS HND WELLS HS SET FORTH BY THE 11UNICIP0-ITY OF HN�HORHGE 01: I WILL INSTHLL THE SYSTEM IN ACCORDANCE WITH THE CODES. SIGNED: .,.-,~~~~~-~~~_~.�~~�.~~�~.~_-��~�_~^_ APPLICANT DIHNE NOELFEL ISSUED BY_~�_ DHTE . 2`��r\ �~�_~~�_~~_~~_�_~_~ _��_��_u��V4.0 I'IUIVv_ir/ALi I T Ur AIAL NUKAUt Department ` Health and Environmenta' )rotection 825 L Street, Anchorage, AK. �-5�501 264-4720 # # # Permit #HANDWRITTEN PERMIT # # WELLPERMIT ^i/i--3�-sEyei Applicant: �(SC go, C,t.)b EL r=- e !` Mailing Address : Location: (Wo- (� Phone Number: b r6 -3g % V Legal Description: L. a 3 SC ( M ( 7CL f Lot Size: /aC1 Type of Soil Absorption System Is: Trench: Drainfield: - Seepage Bed: Holding Tank: Maximum Number of Bedrooms: Soil Rating(sq.ft/br) DEPTH The Required Size of the Soil Absorption System Is: LENGTH GRAVEL DEPTH WIDTH The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE GALLONS Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. # # # TWO(2) INSPECTIONS ARE REQUIRED # # # Backfilling of any system without final inspection.and approval'by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 u 2 # # I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I_will _install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if the residence is remodeled to include more that 3.b rooms. .Signed: Issued by: Applicant ° Date: SWP/024(1/81) MUNIWAUTY OF ANCHORAGE Depart— ent Of gealth And Protection 825 L Streat, Artchoraga, AK, 9950 f- 264-4720q I°[;lt OWR I TTEN PERMIT �- WELLAte. ��� �F� Pt:PMf i pl cants; i `l ! re_= I j r i -P t to Ya _ P= j' } t¢ teq I�? r E .hype of Soil , Goi:ption gystelft Is: 1 ``w--VrLc DrainfieId seapaqa RoLding Tank: F PlaxiM A NMbar tit Lieclron, trt C 1rha Required S z* of the soil fq,50cpt Lon cyst 1iYU, eli- ension i-4 the length{in feet;) ` f the tuenah or + rai-flfteld, "I depth cue- 5 ierT='nch or pit ils the di.Gtaxtca bg?tween t'ile.. `S qct a'-�e of the round :i the bottom of t hQ amcavation (i a . _�h�iet� i� n� get 4�L��i� �*�� �x��ia�k.�€s G et :peen tha out t_ r1_''Ifa gravel s�i$�7i=Ca'i i,'-.`. the C:t_Lf13.s`11i.�Li1 s�e;�tky [jY s�rr�Vet. between � * 'ttj P'7_pn iltil F t=hettorti of ch,� exca-a,it:icinfi.r, ts} i REQUIRED SEPTICINHOf®Dma) I`ANK SIZE 'm GALLONS �A P eMit applicant has tiro req onsibil.it<y to infomt thio daPACt Tent during thq iLI. $ ci i l! lTl s t}C C tjitr P,i 3.nY t,. ',3r�1€i1� flY� � f?�cJ�3���Y :�Y1 -8�(t �i�� Ej of ret7ld, iMc s 11,hata Vhca c,mll will PECTIONS ARE REQUIRED f-Acle;TC _Ll ige4 of ally ;Ystem wir_i huh final ; r9-e-Ct 1Qrk 40ri approval' by rids, de -p, i :fk11s� %.i�, iia LGL{fJ$l. - A'ii1�ICf1?iid { t t P1G botEweort -a 4v.-sli ziod any on-site sa�_,w.l e t'k..Laposal sy`'`.tel-ft is 10". fOr a Private ' eLl 01 150 to 200 fe*t £rom a public tell d{vpe aging upon the <if public well, M1r,1lAVjA dLstancn troi`it' a prtVata well to a private :aewai I'll i u 2S Leet and to a co.r' unity >_we -c line lq a fQat. well 1094 ara raqum: ►s k aDd ,sari -11-- ble E,'u _n.x tO t -h1_8 , ._Pa�rtment. with r, �Ls days OC the tell c9niplar,.c, ._L l Ot~har roquiremants may appjy. �N�:i�trw��if�ti� and ioft3trtic_ti�n a�l.�g�,�ama t PERMIT EXPIRES 0r;CO}iUSER 311 1 9 ids 1 c8rtify that: g{l) am Car-ri a—r with the requireFQr`nts, for on-si3_5 trams and woljw set forth by th;r wilcipa City of Anchoragc.. E (2) 1 will. install the y t*rA in with h A -_Odell. i ) X Llt',dei"etarid that; t ha on-61'be sews—r sYstem rainy the rfedidenco id remideled to in-Clu • Mora that: 3 e- Coot s G� f AtipLieaTit< a l4oveirn_)er 7, 17ii3 Ja res & %)iane o.oeifel p. u. 13ox 12 Chuaialc, AK 3'9567 Subject.- iso. 12, Block 31 sc:ilmlitar Subdivision r'1 a�a�r_oval for Liza individual sewer and dater facilities cannot be granted until the f©llOWin it^:n have i�eeri cc,nLllet� is .tie top of t, e well casing should be sealed so that it is water tight. i`he perliit for the inUf the on -Site SCUcc syste;ll ;will expire uecember 31, 1382. We have not received the (as�builts of `tale installation in this offic'-- _'L a privat c'nCf Il ineer is�oected tilt' Sy Stcli', P3 ea5e send us the report L 1 t oursalfas and review. 0- C, case noti.iy this 1.3e'_ artment for a I:eiYisocction vholl tile / noted discrepancies have been cor:roctc{7. it there art any further gijestions, please call tilis otfice at 2t3,(.-4720. 5incerelY, Cory 'iiliis, R." Acting Seew(I-r is Mater ,)ro<jrw'ki tianacjcr C d13/e j/El Z Z— APPLIC 4T FILLS OUT UPPER HAL ONLY Time J Property Owner itn'� `� G%f;>.ntJ'� �✓U�:-J_f /=cr �. Time Time FPhe Mailip, Address {�, ��JX 1 - ' <. VCr l h ic: '�. Zip Code `; } Buyer of P-) Date. Address ..'- /Ic; G Zi 1 1- Tj<_� C.t.) - (%! a t4'i;�'v 7_� L_ J 0 ,. � p Code -7 `-1 to .-� .._ Lending Institution M 6 f k - - Phone Address-- , --- �Ul iA.� F�.)�': &'-iTl�--, ;�!i, J 1 7 Zip Code Realty Co. & Agent j� f -r flq � , f., ;�.I ! ,.� :- Phone s Address P0. &A °t (t - Zip Code ` , ') 604 V ,1 Legal Description 12- 373 r Inspector Street Location t ,v! 11JACL t� Field Notes: Type of of Residence p� P,1;LUA:MS ZS!ngle Family n Oaf ❑ Multiple Family No. of Bedrooms— D Other Water Supply ( APPROVED BEDROOMS •CONDIT�I , OF APPROVA it Individual ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. ❑ Community For wells drilled prior to that date, give well depth (attach log if available). ❑ Public Utility Sewer Disposal - Individual Year Individual Installed: I .Public Utility When Connected to Public Utility: Date Sewer Installed_ 10— V —L�JlI' ❑ Holding Tank Area 110 NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date. 773 Inspector - Inspector Inspector Inspector Field Notes: MUNICIPALITY OF ANCHORAGE p� P,1;LUA:MS DEPT. OF I!Fi:LT!I ,: ENVIRON,M-NTAL PRO-, ECITIOK n Oaf , ,,,.. r .E L D 1�ivc �7 ( APPROVED BEDROOMS •CONDIT�I , OF APPROVA ( ) DISAPPROVED ( ) CONDITIONAL APPPBOOVAL' �...^�2 DATE 7a3, BY: Soils Rating Date Sewer Installed_ 10— V —L�JlI' Well To Absorption Area 110 Well Log Received Well to Tank Septic Tank Size �� Parcel I.D. 051-132-66 Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 r Certificate of On -Site Systems Approval eA'ys tae 1. GENERAL INFORMATION Expiration Date: (� - _a _�-- i _5 Complete legal description Scimitar #2, Block 3, Lot 12 Location (site address) 20110 Tulwar Dr. Current Property owner(s) Coraene Brown Mailing address Real Estate Agent Day phone 2020 Muldoon Rd. #322 Anchorage, AK 99504 2. TYPE OF DWELLING: D Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3, NUMBER OF BEDROOMS: 3 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Fx� individual 0 Individual Water Storage El Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 52(0• e Waiver Fee $ Date of Payment &(18 � 5 Receipt Number (33$RiJ(7 COSA # OW16/679 Date of Payment Receipt Number Waiver # 5. 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. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone 6. DSD SIGNATURE !� System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved Date 3/17/2015 Ei �1ev� it. * 15611nor CE -8149 Conditional approval for bedrooms, with the following stipulations: By: Original Certificate Date: The Muffcipal o Ara rage 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 blue sheet ° ., > If more than 1 septic system is on the lot: COSA Checklist # i of 1 Structure served by this system 1 Certificate of On -Site Systems Approval Checklist Legal Description: Scimitar #2, Block 3, Lot 12 Parcel ID: 051-132-66 A. WELL DATA Well type Private If A, B, or C provide PWSID #, Date completed Gl3/1982 Sanitary seal (Y/N) Y Total depth 682 ft. Cased to 94 s. Date of test Static water level Well production FROM WELL LOG 6/3/1982 124 0.2 ft. Well Log (Y/N) Y Wires properly protected (YIN) Y Casing height (above ground) 12+ in. AT INSPECTION 3/13/20.15 46 ft. 0.2 g.p.m. WATER SAMPLE RESULTS: Coliform ,A colonies/100 mL Nitrate ,ND mg/L n Arsenic h% gug/L Date of sample: / d O 5 Collected by: A— � B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 3/5 dot S Tank size 1,000 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation, deanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date'Qf pumping New Pumper: C. ABSORPTION FIELD DATA Igl6ti981fi z z 85 SHEIR Shallow Trench Date inslalled��Soil rating (g.p.d./ft or ft /bdrm) System type Length38` ft. Width 5 ft. Gravel below pipe 25_St. Total depth S: ' 'ft. Eff. absorption area 265 flz Monitoring tube Y Depression over field `N Date of adequacy test 3/13/2015 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 0 in.. Water added 453 gal. New depth 10 in. Elapsed Time: 100m'in. Final fluid depth .0 in. Absorption rate a= 450+ g,p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) No If yes, give date D. LIFT STATION Date installed "Pump on" level at Datum Size in gallons in. "Pump off' level at Cycles tested E. SEPARATION DISTANCES Manhole/Access (Y/N) in. High Water alarm level Meets alarm S circuit requirements? WELL ON LOT TO: Septic tank/lift station on lot 100+ On adjacent lots 100+ Absorption field on lot 100+ On adjacent lots 100+ Public sewer main 75+ Public sewer manhole/cleanout 100+ Sewer /septic service line 25+ Holding tank 100+ Animal containment areas 50+ Manure/animal excrete storage areas 100+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 5+ Absorption field 5+ Water main 10+ Water service line 10+ Surface water 100+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: Property tine 10+ Building foundation 10+ Water main 10+ Water Service line 10+ Surface water 100+ Driveway, parking/vehicle storage 10+ Curtain drain 50+ Wells on adjacent lots 100+ F. COMMENTS Water system has a 1,000 gallon holding tank. G. ENGINEER'S CERTIFICATION I certify that' 1 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. Engineer's Printed Name Steven R. Pannone Date 3/17/2015 COSA brown sheet 10-10-12.doc in. Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 Water Well Advisory Certificate of On -Site Systems Approval (COSA) # 151089 During a recent COSA on-site inspection and test of the potable water supply well on Block 3, Lot 2 of Scimitar #2 subdivision, the well's productivity was determined to be 0.2 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3 -bedroom residence is 0.31 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. r. I SCALE: 4U-00 Reduced m ry0 0 , NO OP FA EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. F8 15,Z W 23 30 / .Ill �* ' 49th00 *�/ p .Fratl Wala tka: �'I BE AS•SUILT NO CORNERS SET THIS DATE