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HomeMy WebLinkAboutTHUNDERBIRD HEIGHTS #1 BLK 8 LT 1oil4uu(innend A 4.tc�hAS 4 Elk 1% NJAI wk A & Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP231127 PID Number: 051-582-28 Dwelling: 0 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: 0 New Upgrade Name Paul Barrows ABSORPTION FIELD ❑ Deep Trench ❑ Wide Trench 0 Bed Mound Site Address 24410 Magpie Dr. ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 0.8 GPD/SF 2 Ft, LEGAL DESCRIPTION Depth to pipe invert from original grade l.5 Ft. Gravel depth beneath pipe 0.5 Ft. Subdivision Block Lot Thunderbird Heights #1 8 1 Fill added above original grade Gravel length Township Range Section 0.50-0.99 Ft. 38 Ft. Gravel width 15 Ft. Beds: Number of Lines 3 Distance between lines 5 Ft. SEPARATION DISTANCES To Septic Absorption Holding Sewer Lift Station Totat absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 570 Ft' Ft, Well 100+ 100+ 25+ T Septic ❑ S.T.E.P. ❑ Holding ❑ Other Existing Manufacturer Capacity Surface Water 100+ I 100+ Gal. Material u of compartments Lot Line 10+ 10+ NA Foundation 5+ 10+ I LIFT STATION Manufacturer Capacity Remarks Infultrator 500 Gal. Alarm location Garage Electrical installed by Installer PIPE MATERIAL House to tank D3034 Tank to drainfield D1785 JR's Drainfield D3034 CO/MT D3034 Inspector Areterra Consulting BENCH MARK (Assumed elevation) 100 It Inspection dates: 6/14/23 2nd 6/14/23 Location and description p 3d 6/15/23 4'h 6/20/23 Garage Slab ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp �. Conditional Approval: Date �� P 1 If 49111 'I` % �, KENNETH MI. DUF WAV AV ���s�F CE 711 Septic Syste 2does Approved Date r( ,� +� +4 Note�.'this approval not include well permit require ents ESS�� l AS—BUILT SYSTEM DETAILS/SITE PLAN Permit ❑SP231127 THUNDERBIRD HEIGHTS #1 BLOCK 8 LOT 1 PID# 051-582-28 10 Util Esmt 01 G f F DRIVEWAY E A -C=38.2' a H -C=28.9' 103.4 A -D=30.9' B-11=26.2' y J o =r m A -E=44.4' = B -E=38.7 A -F=52.4' f & u B -F=29.3' a A -G=62.8' B -G=41.7' y 500 GAL LIFT m 96.84 STATI❑N m 97.41 SCALE: NTS WATER LINE • FENCE FILTER FABRIC AND INSUL SEWER ROCK 45 AMP, OF AL W ����- PREPARED FOR: PAUL BARROWS 24410 MAGPIE DR. -9 TH * CHUGIAK, AK 99567 ,NNE S FIELD BOOKS COMPUTED: rn E CE -7I16 w� A4, BOUNDARY: N A oRnwN: KSD ■ STMNG N/A O Ec' K M D �� - - • -'� ��+' ASBUILT: SLS DAIS 26 2 �4a o E ._ +f Dwc FILE: moo: NW1865 k-0 — I ACAD FILE` FILE I " N°•` 23123 SCALE: 1' = 30' WW MM SCALE: NTS 18207 Stillwater Dr., Eagle River, AK 99577 907-351-5163 June 27, 2023 To Whom it may concern, The lift station at 22410 Magpie Cir was hooked up by a licensed electrician as per instructions and NEC Code. If you have any further questions feel free to contact me at 907-351-5163 Thank you, David R Stevenson Owner DRS Electric, LLC 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: OSP231127 Work Type: Septic Upgrade Tax Code Number: 05158228000 Site Legal Address: THUNDERBIRD HEIGHTS #1 BLK 8 LT 1 G:1865 Site Mailing Address: 24410 MAGPIE DR, Chugiak Owner: BARROWS PAUL C Design Engineer: ARC TERRA CONSULTING INC This permit is for the construction of: Effective Date: Expiration Date Lot Size in Sq Ft: Total Bedrooms: ,41"cnr - v DeI)artnient 6/14/2023 6/13/2024 20050 Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: As built survey to be completed once new field and lift station are installed. Received By: S S UID TO ''g c '1-YJ-Z� Date: Issued By: VL Date: 3 MUNICIPALITY OF ANCHORAGE 04n Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 051-582-28 Property owner(s) Paul Barrows Day phone Mailing address 24410 Magpie Dr. Chu2iak, AK Site address 24410 Magpie Dr. Chugiak, AK Legal description (Sub'd., Block & Lot) Thunderbird Heights #1 Block 8 Lot 1 Legal description (Township, Range & Section) Lot Size 20,050 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (N all that apply) Absorption Field ❑X Initial ❑ Single Family (SF) ❑X (w/wo AD U) Septic Tank ❑X Upgrade X❑ (D) E] Holding Tank ElRenewal ElDuplex Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. Dea Duffus (Signature of property owner or authorized agent) Permit/Rush Fees: Date of Payment: ( r% Receipt Number: 0 C> Permit No. 05%023 //2% Waiver Fees: _ Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231127, Curtis Townsend, 06/14/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231127, Curtis Townsend, 06/14/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231127, Curtis Townsend, 06/14/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231127, Curtis Townsend, 06/14/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231127, Curtis Townsend, 06/14/23 Municipality of Anchorage ;, 014 Community Development Department Page 1 of 3 On -Site Water & Wastewater Program 4700 Elmore St a P.O. Box 196650 Anchorage, AK 99519-6650 a httpl/www.muni.org/onsite • (907)343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP121093 PID Number: 051-582-28 ❑ New ® Upgrade Name: PAUL BARROWS ABSORPTION FIELD 111 Deep Trench ❑Shallow Trench ❑Bed ound ❑ Other Address: 24410 MAGPIE DRIVE *CHUGIAK, AK 99567 Phone: (907) 688-3214 No. of Bedrooms: 3 soil Rating: GPD/Sq. Ft. Total Depth fmm nal grede: I Ft LEGAL DESCRIPTION Depth to pipe invert from original grade: Gra epth beneath pipe: R. Subdivision: THUNDERBIRD HEIGHTS #1 Block: Lot: 8 1 FlII added above original grade: �G n Gravel length: FL owns Ip: — ansa: _ Ye-07i—on: — Gmvel width: F°' Bed. Number of lines Distance between lines: R. SEPARATION DISTANCES Total abs im area: SD. Ft. Number of trenches: Dist. between trenches: Ft To From Septic Tank Absorption Field Lift Station Holding Tank Public/Private Sower Lines well 100'+ 0 - - 25'+ TANK ® Septic ❑ S.T.E.P. CHolding ❑Other Surface Water 100'+ — – – Manufacturer: ANCHORAGE TANK Capacity: 1000 Gvl. Lot Line s'+ I n V / _ — — N/A Material: Number of campmrmerds: STEEL 2 Foundation 5'+ LLJ - - LIFT STATION i Curtain Drain I NONE KNOWN Manufacturer. Gal. Remarks: OLD TANK WAS DECOMMISSIONED PER UPC. Pump on level at: -Pump off le High water alarm at; Pump Make & Electrical Inspections performed by: PIPE MATERIAL House to tank D3034 Tank to D3034 drainfield Installer JR,S Drainfield EXISTING CO/MT EXISTING Inspector GEG, Ltd. BENCH MARK (Assumed elevation) 100.00 Ft. Inspection Location and Dese6ptiom Dates: 1st 9/13/12 2nd — 3rd – 4th – BOTTOM OF SIDING NEAR FCO Community Development Department Approval Conditional approval: Date: ENWNEE"SEA, oo�o �o�Q�• '.•,� 4 T �p0o p.....' .......... ...............� .. . e .y........ness.....� QO"y,. '• CE 7953 ..• ebpO ' �/ ��ce4 �d4peap oesfsloo��O °O4opo�oo Approved: Date: Ll 'a'� v v' I PERMIT NUMBER: AS BUILT DRAWING PARCEL ID NUMBER: I OSP121093 051-582-28 WATER LINE EXITS FOUNDATION I APPROXIMATELY 2 FEET FROM THIS NORTHWEST CORNER AND I APPEARS TO HEAD NORTH OUT OF THE FOUNDATION PER PAUL BARROWS (HOMEOWNER)— EKLUTNA INC T16N, R1W, SEC36, E2NW4, NE4, NW4SE4, NESW4 GARNESS ENGINEERING GRQL7P, Ltd. >CONSULTANTS& GENERAL CONTRACTORS 1701 E. )UO ROAD. SUOE 101 • "W9 . W 99W7 • PHONE (907)M7-6179 • FM (907)006-3946 • WEBSOE: m.ga n ng9 r, q..am PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ••• ••••• ••. PAUL BARROWS 688-3214 2 OF 3 .J f A. ness LEGAL DESCRIPTION: DRAWN BY: 4Vo 9s 95 c°`6 THUNDERBIRD HEIGHTS #1; BLOCK 8, LOT 1 J.L.M. 1141 @ •.3J. 9�I ��ao TYPE OF WORK: DATE: ��QOOO�psiO q AS—BUILT DRAWING OF TANK UPGRADE 3/19/2014 (Rev. 01105) RAVEN COURT WATER KEY BOXES ;.a.., (APPROX. LOCATIONS) /— — — — — — — — / A 8 FCO 29.0 23.2 STI 26.5 27.7 / +++++++a ST2 22.8 33.8 / a + / + + + EXISTING f . DBL1 23. 34.8 // +a DRAINFIELD I +++++ 1 DBL2 25.1 34.6 / + + + + + / (ASSUMED WATER LINE LOCATION / + + + + ! I (EXACT LOCATION NOT KNOWN WITHOUT WATER LINE LOCATE). \ 4 SEPTIC INSTALL WAS INSPECTED \\\ +++a+++ I I BY MOA ENGINEER LES / THIS AREA IS BUCHOLZ ON 7/14/1980. / B \ \ + + + HEAVILY TREED. +++ \ I _ co1 •q THUNDERBIRD ^ `l a HEIGHTS /{1; BLOCK / STl DBL1&2 B. LOT 2 I . 4 ST2 a.. I EXISTING '.• 3 BEDROOM L., HOUSE A NEW 1000 GALLON SEPTIC TANK WATER LINE EXITS FOUNDATION I APPROXIMATELY 2 FEET FROM THIS NORTHWEST CORNER AND I APPEARS TO HEAD NORTH OUT OF THE FOUNDATION PER PAUL BARROWS (HOMEOWNER)— EKLUTNA INC T16N, R1W, SEC36, E2NW4, NE4, NW4SE4, NESW4 GARNESS ENGINEERING GRQL7P, Ltd. >CONSULTANTS& GENERAL CONTRACTORS 1701 E. )UO ROAD. SUOE 101 • "W9 . W 99W7 • PHONE (907)M7-6179 • FM (907)006-3946 • WEBSOE: m.ga n ng9 r, q..am PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ••• ••••• ••. PAUL BARROWS 688-3214 2 OF 3 .J f A. ness LEGAL DESCRIPTION: DRAWN BY: 4Vo 9s 95 c°`6 THUNDERBIRD HEIGHTS #1; BLOCK 8, LOT 1 J.L.M. 1141 @ •.3J. 9�I ��ao TYPE OF WORK: DATE: ��QOOO�psiO q AS—BUILT DRAWING OF TANK UPGRADE 3/19/2014 (Rev. 01105) TOP OF TANK AT INLET = 95.68 INVERT OF BUNG AT INLET = 95.01 FINAL GRADE = 99.77-99.93 ST1 ST2 ' NK / AT OUTLET LET OF TA 95.61 NEW 1000 GALLON SEPTIC TANK INVERT OF BUNG AT OUTLET = 94.76 GARNESS ENGINEERING GROUP, Ltd. � CONSULTANTS S GENERAL CONTRACTORS 3701 E. 3UWR R . SURE 101 r µO WE. M 9930) - NONE (907)337-8179 - FM (907}338-3216 • KBSRE: vwx.99mesron9lnserin9mm PREPARED FOR: PHONE NUMBER: PAGE NUMBER: PAUL BARROWS 688-3214 2 OF 3 QQO�p LEGAL DESCRIPTION: DRAWN BY: THUNDERBIRD HEIGHTS #i; BLOCK 8, LOT.1 PNB �QI TYPE OF WORK: DATE: PROFILE AS—BUILT 10/9/12 00 �I ........... reyr0eyGGarn'5�ess.: CE -79 3 F f gJ !•a' oOG Prof asSiont �Z On -Site Wastewater Disposal 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: OSP121093 Tax Code Number: 05158228000 Work Type: Septic Upgrade Permit Effective Dates: May 30, 2012 to May 30, 2013 Design Engineer: GARNESS ENGINEERING GROUP LTD Subdivision: THUNDERBIRD HEIGHTS #1 Site Legal Address: THUNDERBIRD HEIGHTS #1 BLK 8 LT 1 G:1865 Owner/Address: BARROWS PAUL C 24410 MAGPIE DRIVE CHUGIAK AK 995675118 Site Mailing Address: 24410 MAGPIE DR, Chugiak This permit is for the construction of: N Disposal Field Y Septic Tank N Holding Tank Lot Size in Sq Ft: 20050 Total Bedrooms: 3 N Privy 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. Receive Issued MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Fax: 907- 343-7997 On -Site Water & Wastewater Program Mayor Dan Sullivan On -Site Sewer/Well Permit Application For A Single Family Dwelling Parcel I.D. 051-582-28 Property owner(s) PAUL BARROWS Day phone 273-7261 Mailing address 24410 MAGPIE DRIVE *CHUGIAK AK 99567 Site address 24410 MAGPIE DRIVE *CHUGIAK. AK 99567 Legal description (Sub'd, Block & Lot) THUNDERBIRD HEIGHTS #1; BLOCK 8 LOT 1 Legal description (Township, Section & Range) Lot Size Sq. Ft. Number of Bedrooms 3 THIS APPLICATION IS FOR: THIS APPLICATION IS AN: (®all that apply) Initial ❑ Absorption Field ❑ Upgrade Septic Tank Renewal ❑ Holding Tank ❑ Privy ❑ Private Well ❑ 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. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/Rush Fees: Date of Payment: Receipt Number: Q Permit No. Gs P 11 1093 Waiver Fees: Date of Payment: Receipt Number: Waiver No. (Rev. 01/11) May 22, 2012 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Rd. P.O. Box 196650, Anchorage, Ak 99519-6650 (907)343-7904 Ref: Proposed Septic Tank Upgrade for Thunderbird Heights #1; Block 8, Lot 1 To whom it may concern: The existing 3 bedroom house is served by public water and a private septic system. Due to the age of the septic tank (32 years) the property owner has requested to have it replaced. We are proposing to remove the existing septic tank and replace it with a new 1000 gallon septic tank. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. P.E., M.S. site plan drawing and a design drawing, which are all part ofthe design package for this septic system. (Contact G.E.G. Ltd for 7 page construction specification letter.) 3701 E. Tudor Road, Suite 101 *Anchorage, AK 99507-1259 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.gamessengineering.com SEPTIC TANK UPGRADE NOTE: THE CONTRACTOR SHALL HAVE THE EAST LOT ALL SURROUNDING LOTS ARE LINE FLAGGED BY A SERVED BY PUBLIC WATER. REGISTERED LAND SURVEYOR PRIOR TO CONSTRUCTION. RAVEN EXISTING 1000 GALLON SEPTIC TANK TO BE DECOMMISSIONED PER UPC. I EXISTING 3 BEDROOM HOUSE EKLUTNA INC T16N, R1W, SEC36, E2NW4, NE4, NW4SE4, NESW4 GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS 3N1 E. NWR R . SUITE 101 • Mlp1pRME. M 99597 • PHONE (907)337-8179 • FM (90)3]8-3316 • W®SIIE: w .9artwnen~n9.a PREPARED FOR: PHONE NUMBER: PAGE NUMBER: PAUL BARROWS 688-3214 1 OF 1 LEGAL DESCRIPTION: DRAWN BY: THUNDERBIRD HEIGHTS #1; BLOCK 8, LOT 1 PNB TYPE OF WORK: DATE: SEPTIC TANK UPGRADE 5/22/12 DRAINFIELD THUNDERBIRD HEIGHTS #1; BLOCK 8, LOT 2 1000 GALLON SEPTIC TANK i.,-uistrtev.siitsl v I MUNICIPALITY OF ANCHORAGE , 1 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 yt PHONE E57EW ❑ UPGRADE MAILING ADDRESS LEGAL DESCRIPTION LOCATION NO.OF BEDROOMS v Y DISTANCE TO: Well V Absorption area • 6:' Dwelling I 6 PERMIT NO. O i -z< Manufacturer Material No. of compartm��,,gqts W 1r f� s Q) Liq. capacity in gallons F IF HOMEMADE: IInside length Width Liquid depth ILI 10 V 6 Z DISTANCE TO: Well Dwelling PERMIT NO. O < Manufacturer Material Liquid capacity in gallons D DISTANCE TO: Well I� v(f �L Foundation Nearest lot line PERMIT NO. &UOt3r Lux 1 , .W.I LL Z No. of lines Length of each lineTotal length of lines Trench width Distance between lines H ? / /tc .16 inches / H Top of tile to finish grade . Material beneath the Total effectiveabsorption area o y f S inches 3/ Length Width Depth PERMIT NO. W a F a Type of crib Crib diameter Crib depth Total effective absorption area Wd in DISTANCE TO: Well Building foundation Nearest lot line _, Class Depth Driller Distance to lot line PERMIT NO. J 3Building DISTANCE TO: foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS _ /iS I �( c 1 SOIL TEST RATING OINSS INSTALLER ..s 1 Kr , REMARKS APPROVED DATE LEGAL -/Y-�"� i.,-uistrtev.siitsl v MUN I iG I r"" L_ I TY OF= Ar'JGH^^FZF=jCiE DEPARTMENT 6r HEALTH AND ENVIRONMENTAL �,<OTECTION 825 'L' STREET, A14CHORAGEP AK. 99501 264-4720 `_meq :iyoAr 0"-'S ITE SEWEFZ F}EFZM I T PERMIT NO. C 800235 ) APPLICANT JAI: CONST CHILKAT CT BOX 2511 694-3181 LOCATION RAVEN LEGAL LT.1 BLK.B THUNDERBIRD LOT SIZE 210000 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING (SQ FT/BR)= 85 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: r>EF=,'TH= o L_EhIGTH= 2S (3FZnVF-=L [?EF='TH= S THE LENGTH DIMENSIO14 IS THE LENGTH CIN 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 CIN 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). FRE:QU I FREE? SEPT -IC TFINK X10010 CGRLL_QNS 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 C 2 7 I NSP FEE GT I OMS FiFRFEE FREG2U I FRE© BACKFILLI14G 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. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F}ERM I T EXP I FRES [7EGEMF3aM :31r 1 aOO 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 THE CODES. 3: I U14DERSTAND THAT THE ON-SITE SE14ER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. SIGNED:---------------------------------------- Aool TPNGllT TGV 9'AIJCT ISSUED BY V4. 0 w r•� �� r�t I �� I r -'ALIT •T cl r- n r-41_ 1-11-:1 F-_ A r. ; I= - DEPARTMENT DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 'L' STREET, ANCHORAGE, AK. 99501 264-4720 I TE=.EWEt=: F•Et<:t•1 I -y- PERMIT PERMIT NO. { 79=1523 ) APPLICANT JAR; CONST. CHILKAT CT BOX 2511 694 3181 LOCATION MAGPIE LEGAL 1_1 B8 THUNDERBIRD HTS S/D LOT SIZE 21000 SQUARE FEET TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING {SQ FT,'BR)= 145 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: G■EI='TH= r LErAO-rf- ,-Z u1=:H'•:'EL L7EPTM= 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 EXCA41ATION (IN FEET). THERE IS 140 SET WIDTH FOP. TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). f?E1D,U I F:EC■ TAr-Jt< S=51=== 10"_ 0 UALLrir-.!r PERMIT APPLICANT HAS THE RESPON'=IBILITY 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. — — — -r W s -i ■�, ; _: ] I r-4 _. F• E i_ T I 1=1 r -J:. A E• E F _' E ID, L_1 I F - JE G■ — — — BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A !-JELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL; OR 1501 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC I -JELL. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F•EF:ty I T E:<:F• I F:E=. G■E��Et•1E-:ER = 1 . 1=� :� _=+ 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 14ITH THE CODES. 3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE /I SS REMODELED TOINCLUDE MORE THAN 3 BEDROOMS. S I G t I E D : __ice=o- =� �-1 �"_`_' A P P L I C A t JAK CONST. ISSUED BY_ _DATE_ O & E ENGINEERING & DEVELO�-MENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster Earl Ellis 694-2774 SOIL LOG 688-2280 Performed for. Name: ��, /y� �• COIVST,C 1/5 7-1 O� Tel. No any " 51 1 Mailing Address: C`NlC.i-AT C_ i �[�k %� '// y E!',C,GE Kli��/?<, Legal Description: Z07- �L oc L� � ,% /,!(J,t/pG/� �; i� !i, . S�/2' Depth (feet) Soil Characteristics •0 2 3 4 5- 6 6 0i5mlY Y 7 8 9 10 11 S14 ;—Y SA/15S 12 1. (5,44 t/ c 5, /OOS /7 PLOT PLAN do 5;c�4cr- 13 T /J�rnlJ�rY PERC. TEST 14d 15 16 Ground Water Encountered: Yes No If yes, what depth Proposed Installation: Seepage Pit_ Drain Field Comments: Russell Oyster 694-2774 O & E ENG,NEERING & DEVELOr HENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 SOIL LOG Earl Ellis 688-2280 Performed for. Name: U • 1- �oAl 'TQOC7-r0 n/ Tel. No. 6 95/- 3/8/ Mailing Address: GH���T ci • , Bo C -?S =//, E tc �r/E�, �i�- Legal Description: LoT /, F, h17 -C. .Sere. Depth (feet) Soil Characteristics O N/L .74 4 1 2 CO3V/4rz ")"�Ovos/ c5;,;.9Vc41 1311 CC -4T ,1� OE GGS j, 3 4 5 6. 7. 8. 9. 10 11 12 13 14 15 16 UP GAG,!/ P4CG gET'S y Z4AZSEF c5F Cevl,rr�— $"4aoy e�;A7ejd�—G <c7- J ,6 PVS1J-- /s mpE� �pEtS w<r�u �/difodS PLOT PLAN Mo Se -4L9 BorTvu mF PT Ground Water Encountered: Yes No L' If yes, what depth Proposed Installation: Seepage Pit_ Drain Field Comments: PERC. TEST MUMU AUTY OF AHCHO " GE i,( Development Services Department T Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 051-582-28-000 Expiration Date: Legal description THUNDERBIRD HEIGHTS #1 BLK 8 LT 1 Site address 24410 MAGPIE DR Chugiak AK 99567 Current property owner(s) Paul Barrows X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for Comments or advisories: 10/11/2023 bedrooms, with the following stipulations: Original Certificate Date: 7/11/2023 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 Services 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 work. ATTACHMENTS: COSA Checklist Absorption Field Advisory Tank Age Advisory Other X Well Flow Advisory Nitrate Advisory Arsenic Advisory COSA Approval June 2022 MUNICIPALITY OF ANCHORAGE Development Services Department g1 : Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 051-582-28 Complete legal description Thunderbird Heights #1 Block 8 Lot 1 Location (site address) 24410 Magpie Dr. Chugiak, AK Current property owner(s) Paul Barrows 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS Day phone 3. TYPE OF WATER SUPPLY: ❑ Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units © Community Well or Public ❑ Water Storage 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 11 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ® Bed ❑ Deep Trench ❑ 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 $ Z 0 %/ Waiver Fee $ Date of Payment K 2- 5' 2 `Z Date of Payment COSA # S C 2.3 Z �� Waiver # COSA Application June 2022 COSA Checklist Legal Description: _ Thunderbird Heights #1 Block 8 Lot 1 Parcel ID: 051-582-28 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system LL DATA ❑ Well log 3 with Onsite (or attached) Date drilled I depth 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 Comments ft ft. B. TANK DATA Measured operating fluid level in septic tank 49" Date of pumping _ ❑ Required maintenance completed, if AWWTS Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) New Fv1 ALL standpipes present per record drawing Total measured depth from grade 2.99 ft (max) Measured' depth to pipe invert from grade ft (min) 0 N/A — pressurized field. ❑ Per record drawings, field is insulated. Q 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 Comments/Deficiencies: COSA Checklist June 2022 Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative rate mg/L ❑ Nitrate less than MRL (ND) ArsenicuglL ❑ Arsenic less than MRL (ND) Collected by Date C. LIFT STATION ✓❑ Required maintenance completed Age of lift station New years Lift station material Plastic Comments. 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) Effective depth used in Effective depth remaining in in E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' ✓❑ Yes if No Community Sewer Manhole/Cleanout > 100' ❑Yes if No ft ❑ Yes if No ft Neighboring Tank > 100' ❑ Yes if No ft Private Sewer/Septic Line > 25' ❑ Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No ft Holding Tank > 100' ❑ Yes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' ❑ Yes if No ft ❑ Yes if No ft ft If tank or field is under driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ❑ Yes if No ft ❑ Yes if No ft 0 N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' ✓❑ Yes if No ft Surface Water > 100' Yes if No ft Tank to Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will Field to Property Line > 10' ❑✓ Yes if No ft Private Wells > 100'✓❑ Yes if No ft Water Main > 10'✓❑ Yes if No ft Community Wells > 200' © Yes if No ft Water Service Line > 10'✓❑ 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 Arcterra Consulting Phone (907)-696-6111 Engineer's Printed Name Kenneth Duffus Date 1,I.Z4/a?3 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. 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 inland use, local soil characteristics, groundwater levels that may fluctuate during the year �.0 r and the water usage of the family being served by the system. The operational life of all well and septic rt systems are subject to these various and dynamic characteristics and are outside the control of the evaluator ■— of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will ■ function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen encroachments, deficiencies or discrepancies exist i R COSA Checklist June 2022 I 1 it = 30' RAVEN COURT 0 1:) 0 R-33o.nn NiRQ,�Q'nn"\A/ R7 7R' N89*59'00"W 15421' ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: THUNDERBIRD HEIGHTS ADD Nol LOT I BLOCK 8 PLAT 78-19 SURVEY CERTIFICATE: 1, John L. Schuller, Have conducted a physical survey of this property as shown on this drawing and that the improvements situated hereon are within the property lines and no enchroachments exist other than noted. Under no circumstance shoull any information on this drawing be used for construction of fences, structures, improvements, or for establishing boundary lines. EXCLUSION NOTES: It is the owners responsibility to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. WORK ORDER NUMBER: DATE: SCALE, E—MAIL, JUNE 23, 2023 1 =30' schuller0ok.net 23-061 DRAWN BY, 1CHECKEDBY; GRID NUMBER: BOOK SAGE JLS NW1 865 230203 4%N'bw stj'kA 0 F 4 L A �v 1) V -6-P 4q /A AWW <X -4 S .. or A < 49TH �•.�' 1 ,•� z .................. ......... C$0 z_ . .:.. .................. CD -JOHN L. SCHULLER.-* 0 q) LS -10408 '.je -\%Q1 A; 1831 Talkeetna Street AW Anchorage, Alaska 99508 1 AGW e \' 6 0 ,®, (907) 227-1455 office ssiO0k�l(907) 274-4992 fax MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 051-582-28 HAA # 1. GENERAL INFORMATION Complete legal description Lot 1; Block 8; Thunderbird Heights ! P1 Location (site address or directions) 24410 Magpie Drive Chugiak, AK Property owner Michael & Deborah .Lenihan Day phone 688-0326 Mailing address 24410 Magpie Dr. Chugiak, AK 99567 Lending agency Day phone Mailing address Agent Carole Bennett/Fortune Properties Day phone Address Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well Community well _ Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-M (Rev. 1/91) Front MOA 821 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is 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 in compliance.with all Municipal and State codes, ordinances, and regulations in effect on the date of/this inspection. Name of Firm Address Engineer's signature V Phone 3 ? 7— 6- / 7C� 6. DHHS SIGNATURE Approved for � bedrooms. Disapproved. Conditional approval for Additional Comments M Date a 7E-7953 o°1•k Garners ��C bedrooms, with the following stipulations: Date 5= / � -9 9 The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA #21 Municipality of Anchorage MAY 13 1999 DEPARTMENT OF HEALTH &HUMAN SERVteLiCgALITY OF ANC:HURAGE} i Environmental Services Division ENVIRONMENTAL SERVICES DIVISI — 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744 Health Authority Approval Checklist Legal Description: 1_0 --r I .1 6 . _ Parcel v'A A. WELL DATA Well type Ifs If A, B, or C, attach ADEC letter. ADEC water system number -,7— 1115C - Log present (Y/N) 14 &V Date completed Total depth Sanitary Cas Casing height (above ground) Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION Date of test Static water level Well production g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform Date of sample: B. SEPTIC/HOLDING TANK DATA Nitrate Collected by: Other bacteria Date installed & Tank size ( c'fl67 Number of Compartments Cleanouts (-VN) tac- Foundation cleanout ON) �r'� � Depression (Y/, fQo High water alarm (Y/,,ftj (v3 Date of Pumping Pumper C. ABSORPTION FIELD DATA Date installed %/4 ASoil ratin Length 8 Width Effective absorption area tic g �2 or 2/bdrr 6 =� E Gravel thickness below pipe System type ,t Total depth i6- Monitoring Tube present ON) 10S Depression over field (-Y&fJ c Date of adequacy test 14/161 Resultsss 1 ) Pty s S For bedrooms Fluid depth in absorption field before test (in.); ' Immediately after72€ gal. water added (in.): 31S Fluid depth ���r (ins) Minutes later: D0 Absorption rate =�0g.p.d. Peroxide treatment (past 12 months) (Yb (Qc Mss If yes, give date tcc C Epc jt1 72-026 (Rev. 3/96)'` Dgj%iw }lit t J-'—jvaev`r D. LIFT STATION N �t Date installed Manhole/Access (Y. High water alarm level at* "Pump on" *Datu Size in gallons off" level at* E. SEPARATION DISTANCES fly h tze- SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/htank on lot 7-,d;ct t On adjacent lots Absorption field on lot Z --Cls f Public sewer main Sewer /septic service line On adjacent lots Public sewer manhole/cleanout Lift station J SEPARATION DISTANCES FROM SEPTIC/TANK ON LOTTO: - g 1.4 - Foundation (v Property line�C) Absorption field i (1 Water main/service line 10 Surface water/drainage 16c)� Wells on adjacent lots 20617 7 " SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: `I G i - Property line 10 ..�" Building foundation Surface water foot $ Water main/service line Driveway, parking/vehicle storage area 4 Curtain drain i'lo:vi �t�wu �� Wells on adjacent lots c� F. ENGINEER'S CERTIFICATION I certify that 1 have determined thru field inspections ands_ in conformance with MOA HAA guidelines in effect on his d Signature Engineer's Name Date 5-1 �� HAA Fee Waiver Fee $ Date of Payment �/� /� / Date of Payment Receipt Numbe4 Receipt Number 72-026 (Rev. 3/96)* ire . , .` MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 0S 1 —:SZ'2 — Z e HAA # fa (71 C-', � a Iit3•7.11T,T_`-061zI Complete legal descriptionLoT I S� T�-w�DF�g�R� µn • S/D Location (site address or directions) 2't4 IO MAC -PSE C}hr6��G Property owner Mailing address SGM F , ov& . Dayphone 688- 9224- Lending 224 Lending agency 01°' Day phone N /�- Mailing address N A Agent �, (3o GuE-/ Fo2-r1JN& Pf1.oP'. -n ay phone 344 - 4}-09 W_t Address N1� 5& --7653 wk Unless otherwise requested, HAA will be held for pickup. CoaIA� A-6 a-yr 2. NUMBER OF BEDROOMS: 'P)Gv--Lit, 3. TYPE OF WATER SUPPLY: Wy # s6 -Z--7653 Individual well MoQ # 2A 2 - 8 166 Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA 121 S. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, l verity that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verity that based on the information obtained from the Municipality of Anchorage files and from my invest!qation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address Engineer's signature SF—P7=1 � v�+l� 1S t5 V ESS oW GAO of NSE;,tr t.��E, i-o�k wM cXPoicD " I�SP6t�-`Ed. V ftvPrioacW..ic7 Phone a1.LH . ArL. Date 337-6/79 Tgso4- //4-A OF AZ / .I w L"P.:• r+ '. 06 CE.7953 6. DHHS SIGNATURE I��DPROFESSICNP�+ Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: By: Additional Comments it tnr The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-023 (Rwr. 1/91) B=k MOA 121 _ Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: t-oT 1 ; g1G g Parcel I.D. A. Well Data Well type co" -WO %' 7 If A, B, or C, attach ADEC letter. ADEC water system number present (Y/N) Date completed Sanitary seWJ(Y/N) Date of test Static water level Well flow Pump levell Driller Cased to Casing Wires properly protected (Y/bjl) FROM WELL LOG SEPARATION DISTANCES FROM WELL Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line �g U pt is WATER. . KE RESULTS: / Nitrate ;On AT IN �$' 211156 0 Z C e g.p.m. rn z T -Mo rn Zn 00 adjacent lots a �, 0 ii4tc,ent lots Z 'ubllc sewer mantle _Petroleum tank _ of sample: Collected by: Other bacteria B. SEPTIC/HOLDING TANK DATA �. PI Lo PE -Z Pvwti0E2 Date Installed 7 /14160 Tank size 1000 Compartments 2 ' Cleanouts (Y/N) y 1✓5 CIS Foundation cleanout (Y/N) y ES Depression (Y/N) �a High water alarm (Y/N) Alarm tested (Y/N) '%J /A - Date of pumping (,v,14/RS Pumper pLD Mc Dok✓a.4-0S SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: _M� c!o 70 � Well(s) on lotOn adjacent lots ^L� Foundation s To property line 25�t Absor� n field 5 Water main/service line >I 1901 1 Surface water/drainage N.1.4 o. Z lei g K NoT 72.026 (3193)' Front CONTINUED ON BACK PAGE C. LIFT STATION fl 0 Date 11„ Size in gallons Itzi Vent (Y/N) High water alarm level _ Meets MOA electrical codes SEPARA lot FROM LIFT STATION TO: (YM) 'Pump off" Level at Cycles tested On adjacent lots Surface water 3 s D. ABSORPTION FIELD DATA Date Installed 7 I m-16 0 Soil rating (CPij{FV) s System type Length ZS r amCl u. 4Wi o dth 36, Gravel thickness 5 p -ror Total depth IO �51� s Total absorption area 3 Cleanout present (Y/N) 'Y I. b Depression over field (Y/N) ►� _ Date of adequacy test 6 14- Results (pass/fail) 'pA SS for 13 Bedrooms H c X Water level in absorption field before test 16>V4 1OCA4.E-5 - After test ° cs Peroxide treatment (past 12 months) (Y/N) A If yes, give date ►JIB —W� SEPARATION DISTANCE FROM ABSORPTION FIELD TO: 'tx) q µ�D bo 1 �ac�s p > T �1 Pj Well on lot N, A On adjacent lots 1� Property line Zo �= teu�w- Q.U o To building foundation lAr = To existing or abandoned system on lot n3IA On adjacent lots >> 1 O Cutbank [ G Water main/service line I0 an" Surface water f,4 JA Driveway, parking/vehicle storage area 3g�= Curtain drain E. ENGINEER'S CERTIFICATION 1 certify that I have checked, verified, or 0 Signature ���////✓ A PFS WSPE-r-Too fu—fW1 7/14 -/Bo to all MOA and HAA guidelines in Engineers Nam6/1/-, P✓S Date 6 Jq- 9S HAA Fee $ VOD • C/D Date of Payment C Receipt Number ! rr �57� 72-026 (3/93)' Back Waiver Fee $ Date of Payment Receipt Number. -•6969..- �°ROFESSIO�IA this .•UK IUNC 1.1 um i r VK l uNr. rKVra 1 i CJ'• aU 100004YU • ."2-7 4::d�11Lt-Np. I `w .ot141 � t8 SET THIS DATE.7ff4j9ri?u4 ILAM ftRMWVrvr_ e HEREHY CERTIFY THAT I HAVE SUltVEYED 7NE SCALE -0 — '0=WING. DESCRIBED FROMM: THA NO�NCROAC MICATIM • IT 19 TW RESP0N9'IBILIT'P OF THE 5-24-9I NNER TO DCMVIINE THE EXISmM OF ANY GRItW A.SU NTS. COYEKWSy OR RESTRICTJONS . Nu 1865 MICH DO NOT APPEM ON TM RECOPM SUBDI SION PLAT. UNDER;N0 CIRCt1NSTAHM SFR11U >c 20-10 i'f Dm HERM 9E USEp FOR COnI>I rmx- otl r.• FENCE WNE% OR FOR ESTABL.tS1'►IN6 BMW- GRAMYtf+ .�><�s�L�►� • IHSS dt 4::d�11Lt-Np. I `w .ot141 � t8 SET THIS DATE.7ff4j9ri?u4 ILAM ftRMWVrvr_ e HEREHY CERTIFY THAT I HAVE SUltVEYED 7NE SCALE -0 — '0=WING. DESCRIBED FROMM: THA NO�NCROAC MICATIM • IT 19 TW RESP0N9'IBILIT'P OF THE 5-24-9I NNER TO DCMVIINE THE EXISmM OF ANY GRItW A.SU NTS. COYEKWSy OR RESTRICTJONS . Nu 1865 MICH DO NOT APPEM ON TM RECOPM SUBDI SION PLAT. UNDER;N0 CIRCt1NSTAHM SFR11U >c 20-10 i'f Dm HERM 9E USEp FOR COnI>I rmx- otl r.• FENCE WNE% OR FOR ESTABL.tS1'►IN6 BMW- GRAMYtf+ .�><�s�L�►� • IHSS Parcel I.D. # MUNICIPALITY OF ANCHORAGE • 'Y DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 051-582-28 HAA # t1 CA l 1. GENERAL INFORMATION Complete legal description Thunderbird Heights, Lot 1 Block 8 T16N R1W Sec.2 Location (site address or directions) 24410 Magpie Property owner' AHFc Day phone 561-1900 Mailing address 520 E. 34th Avenue, Anchorage, AK 99503 Lending agency N/A Day phone Mailing address Agent Sharon Mimch/ReMax of Eagle River Day phone 694-4200 Address 16600 Center Field Dr., Eagle River AK 99577 = . Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 .......... -- ................_......._._ _ _ ......... ------ ----------------- -- ... 3. TYPE OF WATER SUPPLY: Individual well — --- — Community well X .. .. ._....�..-rr-._.ua.- r-.-w�wa..w.� wr—.r.wu..n�. •A::>.r_.ar....FYY. ...1r.... w.aanrw.....ur�_. Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. - 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site X Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA e21 tzv vow rove (Ls •Ne) smu •)lJom sjaaul6ue leuolssajoJd eqj ul suoisslwo Jo sJoJJa Jo; epsuodsaJ lou sl 96eJoyouy ;o A1lledlolunyy a41 panssl sl eleoilpiao a 9Jo;aq elep azAleue Jo suopoadsul lonpuoo jou op SHHO 10 saaAoldw3 •sluawaJlnbaJ olels pue leJapa; ule;jao A;sl;es olJapJo ul suoljnl!;sul 6ulpuol Jlayl pus sawoy;o sJaseyoJnd of AselJnoo a se slyl saoP SHHa e41 LNsely jo alels 8141 ul paJ9lsl6aJ Jaaul6ua leuolssajoJd juapuadapul ue I(q anoge g ydeJ6eJsd ul uanl6 suo!leluasaJdaJ eyl uodn Aluo paseq salEay!;Jao IenoJddy Aluoylny yllEaH sonss! (SHHa) saolnuaS uewnH pue ylleaH;o luawjtedao a6eJoyouy;o�l!ledlownyy e 4 L _ aleQ .A8 molle1ndlls butmollol eqj ql!m 'swooJpaq �j tw0b?-%,% w �o�ss3jo�d ! qqZ .. ...••••...�y� 01 -w sin 13� .....HIi.�J ...• — sluawwo01euoll!PPt/ Joj IenoJdde Ieuolllpuo0 panojddes)p _.. _ _..._........ •swooJpaq' Joj panaddy. 3H(11VNJIS SHHO 09 .sir ��, .......•• add. _ � ... -. �.: ..eiir43lS. -.. .• �•..ti._.I<4*7q 1i.-�Q.wir'wrN-...J'�..anw_a�'+...r.YA...^.•F-.4 s--:..-v::aCy+.er�. 'YMY I+�aL 1Sfti:�w�Yw-..�..�s�w�Si.riaW\Yw�:w�wMGr�-y -also eJnjeu61ss1aau16u3 LLS66 XV 'saATH aT6p2 'b6Z£LL XOg .O.d ssaippv 56T5-669 auoyd saorAaas 6uraaacrl5u9 :[anTH aT62g w11d 10 OWEN •uo13oadsul slyl jo elep eqj uo loalle u1 suolieln5aJ pue'saoueulpJo 'sapoo ejsjs pue Iedquny4 Ile yllm eouelldwoo u1 s) walsAs IESodslp Jejemalsem Jo/pue Alddns Jalsm ells-uo aU3'uoljoadsul pue uoqu611sanul /(w woJj pue salt; 96eJoyouy jo 4j11edaunNl ayl woJj paulejgo uollmiojul8141 uo paseq jeyl /41J9nJ9ylJnj I •Malay paleolpul aJnjoruls jo ed/4 pue swooJpaq joJagwnu aylJoj alenbape pue Iewpounj'ajes sl welsAs IesodslP Jajsmalsem Jo/pue Alddns Jajem ells-uo ayl jugj smogs uopeolidde Ienaddy Aluoylny 411saH slyl 10 u011e6ljsanul Aw jeyj A;uan I 'molaq umoys 818P u0ljeP11en eyj 10 se pus OIOJ914 paxlj;e Ieas /(w Aq pallpeo sy U33NION3 AS N01103dSNl d0 1N3W31V1S 05 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: r41.b6CR1AW 4166f75 ioNiznrsecs Parcel I.D. —05 / - 59Z -Z8' A. WELL DATA Well type A If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) a& Date completed Total depth — Sanitary seal (Y/N) —' Date of test Static water level Well flow Pump level 'Driller — Casedto — Casing height FROM WELL LOG SEPARATION DISTANCES FROM WELL TO: Wires properly protected (Y/N) AT INSPECTION o 0 /V A W ti ti ti g.p.m. 9.p2 ,� V Septic/holding tank on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/cleanout Public sewer service line Petroleum tank WATER SAMPLE RESULTS: Coliform ti�� Nitrate Date of sample: B. SEPTIC/HOLDING TANK DATA Collected by: Other bacteria Date installed Tank size Compartments Z Cleanouts (Y/N)� .!_ Foundation cleanout (Y/N) Y Depression (Y/N) High water alarm (Y/N) Al Alarm tested (Y/N)' yA Date of pumping -dag 00riya.SE 5in,Cd PUNPEo) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot _Z/1Q On adjacent lots —Foundation 1,0 To property line 25- " Absorption field �o � -Water main/service line Surface water/drainage 72.029 (Rev. 3/91) From Mon 21 - - CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent(Y/N) High water alarm level _ "Pump on" level at — Meets MOA:ele64rical •codes (WN) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot D. ABSORPTION FIELD DATA On adjacent lots Manufacturer;_ Cycles s (Y/N) _'.'Pump off" level at _ Surface water I, Date installed'12���y1zsvo Soil rating 95F72189 System type %26NCH i Length 3 / Width -�� Gravel thickness S Total depth y Total absorption area Cleanouts present (Y/N) l' Depression over field (Y/N) All Date of adequacy testT,Q� Results (pass/fail) PASS for bedrooms Peroxide treatment (past 12 months) (Y/N) ND If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot WA On ad acent tots A"/A Property line �a To building foundation 5 To existing or abandoned system on lot &v/1 On adjacent lots f le / Cutbank A114 Water main/service line do n Surface water N/.e Curtain drain -`*,ff -4v reo.0- E. ENGINEER'S CERTIFICATION Driveway, parking/vehicle storage area '`iD "' I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect of this inspection. took7.�he`¢ate OF A4. tt vci! Signature Engineer's Name ,���% ��^• W ! tGu S C. °U:Cfd IV 0� Date .—/�/s� • �� 6� o� ., Ci: 6-.735 r' it Fo'•....•7C. HAA Fee $ Waiver Fee: $ Date of Payment f�l & �� Date of Payment A 3 5' d n Receipt Number r Receipt Number 72-026 (Rev. 3191) Beck MOA 21 5. LEGAL DESC IPTION r DATE RECEIVED d�/ INSPECTION APPOINTMENTS TIME TIME TIME SINGLE FAMILY ❑ One ❑ Four ❑ Other V ❑ Two ❑ Five DATE Three ❑ Six DATE / DATE INSPECTOR EX COMMUNITY INSPECTOR / INSPECTOR depth (attach log if available.) MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPT. OF H=ALTH & \ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTI¢NVIRONMENTAL KOTECTION • 1 825 L Street - Anchorage, Alaska 99501 OCT 3 0 1980 ENVIRONMENTAL SANITATION DIVISION Telephone 26411720 R� C D REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER AC T E J Y� DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY WNER PHONE / MAILING ACfDRESSt PROPERTY RESIDENT (If differe t from ab ) PHONE 2. BUYER 1 100, PHONE G %3s� MAI N ADDRESS f /, f 3. LENDI/N—GG INST TU ION, „ PHONE MAILING DDR ES 4. REALTOR/ GENT PHONE / V MAILING ADDRESS 5. LEGAL DESC IPTION r d�/ STREET`L/OCATION 1 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS SINGLE FAMILY ❑ One ❑ Four ❑ Other ❑ Two ❑ Five ❑ MULTIPLE FAMILY Three ❑ Six 7. WATER SUPPLY ❑ INDIVIDUAL' ' ATTACH WELL LOG. A well log is required for all wells drilled EX COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM X INDIVIDUAL/ON-SITE" YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE Cl 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 E3 PUBLIC UTILITY Connection Verified PERMIT NUMBER DATEINSTALLED 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 WELLTO: Septic/ Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS GtJ�­APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE BY 72-010 (Rev. 6/79)