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HomeMy WebLinkAboutTHUNDERBIRD HEIGHTS #1 BLK 4 LT 32Thund rbird Heights lock 4 Lot 32 ! - 582 MUNICIPALITY OF ANCHORAGE Community Development Department Development Services Division On-Site Water & Wastewater Program Mayor Dan Sullivan Phone:907-343-7904 Fax:907-343-7997 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. O51 Property owner(s) Mailing address ~ Site address -- Day phone Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms THIS APPLICATION ([~] all that apply) Absorption Field [] Septic Tank ~' Holding Tank [] Privy [] Private Well [] IS FOR: THIS APPLICATION IS AN: Initial [] Upgrade g~ Renewal [] Water Storage [] THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of"property owner or authorized agent) Permit/Rush Fees: ,~k...-~.?- ./~¢_~2to.c_~¥-E~.-¥Waiver Fees: Date of Payment: ~\;~-(:k.~, \~, Date of Payment: Receipt Number: (_?-~ ,~.~,-'~ ~ {',~ Receipt Number: Permit No. E?~)¢ \~,k,~--'l,''~°'- Waiver No. G:\Building\On Site\Forms\Client Forms\Permit App_010411 .doc (Rev. 1/11 ) Slourt land Engineering Environmental Consulting and Design Municipality of Anchorage Development Services Department Building Services Division On-site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519-6650 I September l 5, 2011 Subject: SEPTIC TANK PERMIT APPLICATION Thunder Bird Heights #1 Block 4 Lot 32 Ladies and Gentlemen: We are submitting an application to replace the septic tank for this lot. The existing septic tank is 30 years old and the home owner would like to replace it. The submittal consists of one (1) drawing showing the present improvements on the lot and the proposed improvements of the lot, of which only the septic tank is subject to this permit application. There are no wells within one hundred feet of the proposed replacement site. The installation of this septic tank will not prevent wells and septic systems from being installed on the adjacent lots. There are no developed or natural surface / sub surface drainage courses within 100 feet of the proposed septic tank location. The proposed septic tank will not change the general slope of the area. Ponding and/or concentration of surface runoffwill not result from this installation. If you have any questions or are in need of additional information please contact me at 279-3916. Sincerelw Lars Spu~kland, P.E. 203 West 15th Avenue Suite 202, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (907) 276-6013, SpurklandEng~gci. net LITT~8 NOTE: THUNDER BIRD HEIGHTS IS SERVED BY ,4 CLASS A PUBLIC WATER SYSTEI~. 25 8 25 58 75 180 125 SCALE'. ~ ~ 50 FT. NOTE: TI'IlS IS NOT A SURVEYED PLAT. WELL ~ SEPTIC LOCATIONS TAKEN /'ROM ON-SITE WATER AND WASTE WATER OEPART/I~ENT OOCUI~ENTATION. All LOCATIONS SHOWN ARE APPROXIMATE. DIIUBLE j 4 FEET CITVER CLEANDUTS ~ / = ,i.E/-~_.= EXISTING LINE BENCH tJARK XXXXXXXXXXX ASSUMED ELEVATION I00' FI7UN~gA TIITN CLEANITUT SPURKLAND ENGINEERING 203 W 15TH. AVENUE ANCU. AK. 9950~ (907,) 279-3916 THUNDERBIRD HEIGHTS Jl BLK 4 LT 33 LARRY FRICK 27908 RAVEN CT., CHUG/AK, AK 99567 SEPTIC SYSTEM DESIGN DATE: SEPT. 15, 2011 SHEET: I/I GRID: NW1865 PERMIT # £$P]]]XXX PID # 05]-582-£3 T~gH#]B2L 32.DP/G ~"~",~ MUNICIPALITY OF ANCHORAGE' ~  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 NAME PHONE DISTANCE TO: ~ ~ Material No. of compartments ~ Z Manufacturer ~ ~ Inside length Width Liquid depth Liq. capacity in gallons t~ IF HOME'DE: Well Dwelling PERMIT NO. ~ ~ DISTANCE TO: O Z ~ Manufacturer Material Liquid capacity in gallons ~ Well ~ Foundation Nearest lot line PERMIT NO. J DISTANCE TO: ~ ~ ~ No. of lines Length of each line Total length of lines Trench width Distance ~t~en lines ~ Z ~ inches ~ Top of tile to finish grade Material beneath tile Total effective absorption area inches Length W~dth Depth PERMIT NO. ~ ~ Type of crib Crib diameter Crib depth Total effecti~ absorption area ~ Well Building foundation Nearest lot line m DISTANCE TO: Driller Distance to lot line PERMIT NO. ~ Class Depth m Building foundation Sewer line Septic tank Absorption area(s) ~ DISTANCE TO: DATE LEGAL 72-013 IRev. 3/78) PERM'Z'T NO. Of4--S I TE ( 810706 ) APPLICANT LOCATIOH LEGRL MLIr-.I I C I P_RL I T~" Oh Rf4OH~,RRGE DEPRRTMEHT~HERLTH RND ENVIROHMENTRL , ~OTECTION 825 "L' STREET~ RNCHORRGE, RI<. 9950& 264-4720 ~EL4EF2 PER£.I I T TYPE OF SOIL RBSORPTION SYSTEM IS: TREHCH MRXIMUM NIJMBER OF BEDROOMS = j? SOIL RRTING (S~] FT/BR)= 85 THE REQUIRED SIZE OF THE SOIL RBSORPTION SYSTEM IS: DEPTH= 9 LEI"4GTH= RR'-.."EL DEPTH= 6 THE LENGTH DIMENSION IS THE LEHGTH (IN FEET) OF THE TRENCH OR DRRINFIELD. THE DEPTH OF ~ TRENCH OR PIT IS THE DISTRNCE BETNEEH THE SURFROE OF THE GROUND RND THE BOTTOM OF THE E~CR'¢RTIOH (IH FEET). THERE IS NO SET ;4IDTH FOR TREHCHES. THE 6RR'¢EL DEPTH IS THE MIHIMUM DEPTH OF 6RRVEL BETNEEN THE OUTFRLL PIPE RND THE BOTTOM OF THE EXCRVRTION (IN FEET). ~ ~ NUMBER OF RESIDEHCES THRT THE WELL WILL SERVE. TklO ( 2 ) I t4SPECT I FJf4S ARE RESLI I RED BRCKFILLING OF RN9 SVSTEM WITHOUT FINRL INSPECTION RND RPPROVRL BY THIS DEPRRTMENT NILL BE SUBJECT TO PROSECUTIOH. MINIMUM DISTRNCE BETWEEN R NELL RND RN9 ON-SITE SENRGE DISPOSRL SgSTEM IS %88 FEET FOR R PRIVRTE NELL OR &58 TO 288 FEET FROM R PUBLIC HELL DEPEHDING UPON THE TYPE OF PUBLIC HELL. MINIMUM DISTRNCE FROM R PRIVRTE NELL TO R PRIVRTE SEWER LINE IS 25 FEET RND TO R COMMUNITY SENER LINE IS 75 FEET. OTHER REQUIREMENTS f'lR'¢ RPPL9. SPECIFICRTIONS RND CONSTRUCTION DIRGRRt'IS RRE RVRILRBLE TO IHSURE PROPER INSTRLLRTION. PERM I T F>~P I ~:FS DFCFr4BFR 3~,. fl 982 I CERTIFb' THRT %: I RM FRMILIBR I,IITH THE REQUIREMEHTS FOR ON-SITE SEI,IERS RND WELLS RS SET FORTH BM THE MUNICIPRLIT9 OF RNCHORRGE. 2: I NILL INSTRLL THE 5VSTEf'I IN RCCORDRNCE NITH THE CODES. ~: I UNDERSTRND THRT THE ON-SITE SENER SVSTEM MRV'REQUIRE EHLRRGEMEHT IF THE RESIDEHCE IS REMODELED TO I~.~CLUDE MORE THRN g BEDROOMS. RP~ICRNT NILBUR DITTBRENDER WILBUR DITTBRENDER RRVEN LOOP L~2 B4 THUNDERBIRD HTS SR2 BOX412 E.R, LOT SIZE 20000 S~.URRE FEET PERFORMED FOR: LEGAL DESCRIPTION: ' 2 3 4 5 6 7 8 · MUNICIPALITY OF ANCHORAGE ~SOIL$ LOG - PERCOLATION TEST SLOPE WAS·GROUND WATER ' S L ENCOUNTERED? O P DEPTH? Gross Nat O~pth to - Net . Reading Data Time '. Time Water : Drop PERCOLATION RATE (mlnute~linch) TEST RUN BETWEEN , FT AND , FT 14 15 16 17 18 '19- 2O COM'~ENTS 72-008 APPLIC"- T FILLS OUT UPPER HAI/'",ONLY Phone Property Oven,er ~~/ Buyer Zip Code Address ,* ' ' Phone Zip Code kddress Ty~e ~f Rest~nce ~Slngle Family Bedroo~ ~ Multiple Family ~ No. of ~ Other ' Water Supply ~ ~ndlvld~l ~ ~ A~ACH ~LL LOG. A w~l log Is required for'all wells drl~ed since June 1975. ' ~Communlty For wells ~llled prior to that date, give well depth (attach log If available). ~ Public Utility Sewer Disposal Year IndivMual Installed: pndivldl ~ When Connected to Public Ufillt~ - ~ ~/~ - ublic ~llity ~ Holding Tank .... NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Time Time Time Time Date Date Inspector Inspector Inspector Inspector ~ ~O' MUNICIP~LI~ OF AN~O~GE ~NVI~ONM~NTAL PgOTECTION SEP g c i. VEP. (~) APPROVED BEDROOMS '~ON~ITIONS OF APPROVAL ( ) DISAP~OVED ( ) OONDIT~NAL APPROVAL' ~oll~ Ra~lng ~ D~we~ lnstalle~ WeU To ~sorption A~ea Wel~ Log Received ~--J~' ~ Well to Tank Septic T~k Size DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE MUNICIPALITY OF ANCHORAGE (.~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECT~OL~NICiPALiTy OF ANCHORAGE : 825 LStraet-Anchorage, Alaska 99501 ' DEPT. OF H~LTil & E~IRONMENTAL P~:OT~ION ENVIRONMENTAL SANITATION DIVISION Telephone 2644720 OCT ~ g 1981 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES PFFFI~/C~ DIRECTIONS: Complete all parts o, page 1. Incomplete requ~ will not be preened. Please allow ten (10) days for processing. t' P O PROP~TYRESIDENTIIf~ifferen~ma~ve) ~ j PHONE ~. BUYER /~ I , ~ ~ PHONE · . MA~L~NG ADDreSS ADDRESS · · / / 4. REALTOR/AGENT ~~/ ~, ~~ J PHONE 5. LEGAL DESCRIPTION - /) ~ -- 6. TYPE OF RESIDENCE · {~ SINGLE FAMILY F'I MULTIPLE FAMILY 7, WATER SUPPLY i--I INDIVIDUAL' [~ COMMUNITY [] PUBLIC UTI LITY NUMBER OF~BEDROOMS r-I One [] Four [] Two [] Five C~""Th ree [] Six [] Other~ * ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM ~ INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY YEAR ON-SITE SYSTEM WAS INSTALLED. \.,~A '~-~ -~\ NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) ~ THIS SIDE FOR OFFICIAL USE ONLY : 1. TYPE OF RESIDENCE [] SINGLE FAMILY I-'1 MULTIPLE FAMILY NUMBER OF BEDROOMS [] ONE [] THREE [] FIVE [] TWO [] FOUR [] SiX [] OTHER 2. WATER SUPPLY [] INDIVIDUAL [] COMMUNITY [] PUBLIC UTILITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON -SITE []PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER .. DATE INSTALLED INSTALLER []Septic Tank or I--IHolding Tank Size: If Tank is homemade give dimensions: TYPE OF TANK TOTAL ABSORPTION AREA 4. DISTANCES WELL TO: SOILS RATING MANUFACTURER MATERIAL Absorption Area to nearest Lot Line Septic/Holding Tank IAbsorption Area ISewer Line INearest Lot Line 5.' COMMENTS DATE ~VED FOR ~' BEDROOMS [] CONDITIONAL APPROVAL {lette[.must acco~npany certificate) [] DISAPPROVED 72-010 (Rev. 6/79) MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I. D. 051-582-23 1. GENERAL INFORMATION Expiration Date: q1 )3 - 2© ZS Complete legal description THUNDERBIRD HEIGHTS #1 BLOCK 4, LOT 32 Location (site address) 27908 RAVEN COURT, CHUGIAK, AK 99567 Current property owner(s) ALBERT & JOYCE BELLINGER Day phone Mailing address Real estate agent 27908 RAVEN COURT, CHUGIAK, AK 99567 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ❑ Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ® Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ Date of Payment q 113 a Do2,7 Receipt Number 8-03 1 VY Waiver Fee $ Date of Payment Receipt Number COSA # QSG22 l (-j Ol 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY, ANCHORAGE AK 99516 Engineer's Printed Name CURTIS HUFFMAN, PE Date 4/12/2022 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the l` well and septic system. Therefore, any estimate of how long a system will function satisfactory ��Q:• • - • . ;1 �] for current or future occupants or guarantee that no unseen encroachments, deficiencies or j g-- •9 f� discrepancies exist can be given by First Water Consulting & F / *� TM •.* WfS .. ....... 6. DSD SIGNATURE ' • . • .. • • • • �" • • Curtis Huffman System #1 Approved for 3_— bedrooms �f��F��u;•, CE 128991� System #2 Approved for bedrooms �l>PROF S oNa�``� ` Disapproved Conditional approval for bedrooms, with the following stipulations: j C'�C7-i-i G A jo a w -} `- i l I S 3 S o 1 C�m dV Q t,uti." OF J� ON-SITE WATER AND MPROGKAM o By: ( Orifi,F Z Z 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 Legal Description: THUNDERBIRD HEIGHTS #1 BLOCK 4 LOT 32 Parcel ID: XXXXXX If more than 1 septic system on lot: COSA Checklist # _of _ Structure served by this system A. WELL DATA — PUBLIC WATER — CLASS A PWSID #21156 ❑ Well log is filed with Onsite (or attached) Well production at time of test _gpm Date drilled Water storage tank volume_ gallons Total depth _ft Well disinfected for coliform test? ❑ Yes ❑ No Cased to _ft ❑ Coliform bacteria is Negative ❑ 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. Comments B. TANK DATA Age of tanks) 10 years Tank type/material SEPTIC /STEEL Measured operating fluid level in septic tank 50" ® Standpipes/foundation cleanout per record drawing Date of pumping 4/13/2022 D. ABSORPTION FIELD DATA Which system tested (date installed) 7/15/1981 ® ALL standpipes present per record drawing Total measured depth from grade 3_3 ft (max) (GRADE) Measured depth to pipe invert from grade 3.3 ft (min) ❑ N/A – pressurized field Nitrate _mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by_ Date of Sample C. LIFT STATION ❑ Required maintenance completed Age of lift station _ years Lift station material. Comments: Adequacy test date 4/13/22 Results 0 Pass For 4 bedrooms Fluid depth prior to test 4 in Water added 600 gal New depth 7 in ❑ Monitor tubes go to bottom of effective. If not, state Elapsed time <30 min depth into effective 1' PER SHOTS PERMIT SHOWS 6'ED ® fluid depth 4 in Code -required soil cover over field * Final— ❑ System presoaked Absorption rate 600 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N date of test) If yes, enter date Gallons introduced gallons Comments/Deficiencies: *DCO/SUMP SHOTS & AT GRADE. 2012 COSA SHOWED 52" IN SUMP WITH 3 3' OF COVER W/ NO KNOWN FROST ISSUES. RECENT TESTING & ELEVATIONS SHOW 1' ED IN RUSTED CAST IRON SUMP FW'i; 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 if No Community Sewer Manhole/Cleanout > 100' If absorption field is under driveway comment below ❑ Yes if No ft ❑ Yes if No Neighboring Tank > 100' ❑ Yes if No ft Private Sewer/Septic Line > 25' ❑ Yes if No Absorption Field on Lot > 100' ❑ Yes if No ft Holding Tank > 100' ❑ Yes if No Neighboring Absorption Fields > 100' F. ENGINEER'S COMMENTS Animal Containment > 50' ❑ Yes if No ❑ Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' _ ❑Yes if No ft El 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' ® Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ® Yes if No ft Private Wells >' 100 _ ®Yes if No .Water Main >..10' ® Yes if No ft Community Wells > 200' ® Yes if No Water Service Line > 10' ® 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' ® Yes if No ft If absorption field is under driveway comment below Property Line > 10' ® Yes if No _ ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells >' 100 _ ®Yes if No ft 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 G. ENGINEER'S CERTIFICATION I certify that 1 have determined through field inspections and review �y `•¢��[ of Municipal records that the above systems are in conformance �`.•,� ��� with MOA COSA guidelines in effect on this date. .. ........ 0 .... ....�..�.`... . Curtis Huffman CE 128991 �l®F�pROFESSI* -* ft ft ft ft ft ft ft ft _