HomeMy WebLinkAboutMOUNTAIN VALLEY ESTATES BLK 1 LT 6AMountain
Valley Estates
Block 1
Lot
6A
#050-631-24
Municipality of Anchorage •'' `"
Development Services Department
Building Safety Division
' On-Site Water and Wastewater Program, 4700 S. Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650 Page / of 3
www.ci.anchorage.ek.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: 5 W x30332 PID Number: OSO— 631!- 2y
Name
Wastewater System: O New El Upgrade
Address: •5007 R14^/4Cavj2,r 54a6XI✓
ABSORPTION FIELD
Phone:��� n O Number of Bedroom:
6q e^
Ql Deep Trench O Shallow Trench Bed O Mound O Other;
LEGAL DESCRIPTION
Sal Rating: by
Total Depth from original grade:Cl
GPDIF12
Ft
Block: Lot: Subdivison:
6A
Depth to pipe bottom from onginal Wade:
Gravel depth beneath pipe: [''
S.
% W A E
S Ft.
✓ Ft.
Township: Range: Section:
Ful added above original grade:
Gravel Length: /�
�
Ft.
6 Fl.
Well: ❑ New Upgrade
Gravel width:
3
Number of Imes:
Distance between Imes:
—
Ft.
Ff.
Classification (Pnva; , B, C):
Total Depth:
cased to:
Total absorption area: 75.0
s O
Pipe Material: r�
Ft.
Ft.
/ " Ft'
Driller:
Date led:Slauc
ler Level'
Installer:
Data Installed:
I
Ft.
SWrlitcoz K
1 SEPT 0,3
Yield:
Pump Set al:
Casmg fight Above Ground:
TANK
GPM
Fl.
Ft.
SEPARATION
DISTANCES
P? Septic ❑ Holding ❑ S.T.E.P. ❑ Other:
To
Septic
Absorption
Lift
Holding
ublic/Private
fanurac-turer
uapacity.
From
Tank
Field
Station
Tank
Sewer Line
A teljoflferE AI/e
/7�jSQ Gal.
Well
/Ddf
75f
lenal:
Number ofmnmens:
Z
l0d.�.
,c
Surface water
/0Q='y-
/06�.
-
-
FT STATION
Lot Line
'D �.r.
' Q=4
r
¢e.
anu aaurer.
Foundation
y,/4
1 Q rf
'Pump on' levelal:
'Pump ofr level at:
High wa alarm at:
,5
In.
In.
In.
Pump Make &4doclet
Electrical Inspects performed by:
Curtain Drain
Remarks:
BENCH MARK
Location and Descnpbon:
�F
ssumed IevabOn.
Q.Q Fl.
E= amp
+�OFQ4�1�
.' • a 9,,
4C..00 *.
Inspections performed by:Aldrg.&� )1&r14 Dates: let 913103
i ' 4.60 of 11a ....._ p
d
rid
S 03
2fl
......�j�%...�... P
Development Services Department Approv
Steven WL_. O
�j�
•L o
�f PE 6456
��9F •..�,��,�..•
Reviewed and approved by: Date:
(Rev 17/00)
7;
td
ti
r
m
I>
C
m
3
m
—I
r
0
-*>
W
r-
0
r
z
m
V)
0
r
m
Existing Water
►-
�rrjCn
30Nth +
< �Zn
33 C+%<
Ln
M
3
W
r
W
D
n
3
�o
r
.+ ro O
Q
3
>n
O 3
33
3 e+ O
10
m
m
�C�D33CCn^��
OOSQ,Domr 6,0,
Q 3 A 31 57M f * c+ LZ
333 �+<�}-oNrpG
Qn0Q1+ -1 Ft=�o
'+ rF 3 3 N 3 3 V1 M --1
3 z0- o3 3 C �Fy
ro `mon<3S-
(D Q.h 3 h(0 CQ1 0
3 C) iE 3 O
O 3 r0 3 I
.Q+ _ tA 3 3 Fr30
:U rp [J M 3 h S
M 3 N Q -0- 3 _
i�n3� z^s3M
n ro �' p .n
rp S h N
r r0 vI o
C-)
:3 3 z
(p N 90
•t) F 0
O r0 O I 3
Q f 3 -
.+ �
3
N
3
A
S
A
3
x b
n 3O
O(D
...r.)
p
4 IP
�Clrl
Huse toL�`
Cp TI
O
n C
O 3
3 0-
:3 P
.30
N e+
no
m
Q. n
O P
3
rzp O
C 3
rn
in
3 3 0(D
< N NO
C+ N
rno° 3
ro fD
r- Q.
N
3
r0 O
r0
30
00
0 O
3 Ln
- I .+
0 ---1
is 3
N r0
3
n
S
R'
0
0
rn
v
N
0
0
70
Q
3
Q
0
0
3
h
C7 C7 Cl -1 -I
D
O O C
11
3 3
CU r s X, 7C
C
�npp
I ru
3
VI
m
D
N
C
.0
fU W 00 (IS
ID
X
A W
z
-1
rj
Q� V Wp
CD I�
Co w I
0
v
v
O
W
3
tO
(-7
�0
Q
3
O
c
C+
In
td
m
C+
f
�o
rp
3
N
N
-O
C+
n
-4
p
3
7C'
b[1
�0
1Z
O
3
C-)
N
O
3
O
C
4+
in
O r
V
q
° G
m
ZO
D'�UI.lAW Nt"
C
AV
� fD70=m
o
Zf�J
D D C6 < (6 C6 --
= rip P f rF� q+
r9
0
Ll
:l
c
r' 1 1
m N O '+ P
Z
P
o� �Z
n°'0 1 ��nt
0
T
ZN
3 �n --(o
I
40 40 Z
� �
NG -o
-� *��-'3 O 3 <+
Ij
N
Z
Q
14
o n .+ � X-
*Sr4�
cF in O
0 e+ f') N TI ft°
Q°30�r_mto
II
`ate
�.9J�#�
(nO3�3m 0 _
..-
NO W
�iS3�-eQ�
n 3 th no -Dn
DN
o
�OZ�
N
npeF 3305
�Al
0L-1
rn0
�h
3b7 U1
SO
p
0
33 3QO�D
3
m3C)
<
N -5
U1 D -3 m
\,"D3
---1 C+
p
3 I0
r
C+ N v
H70
-0 N X
m
0N 4.n
-i
-�
3 3 fO
w
D
n n L)
Z
z71� frl
5 0 3 Q
<
Z
Q oQ
mnm
70
p �
'i
^D Q
ON
3
-rj
M
v
H
m
Z
rp
p
(D
`0
3
%D
I I
p
CD w
p C
sC
c
C7 Z
n�
7C --4
lu
o
rl
Z
�+
r•`•z•)•Y.t
Q
D
O
„
�n
3
.3+
(n
o
3
O
w'
D
t
0
f l
- I
`°
CIO
`0
w
(o
3
n
3-
0
v
v
O
W
3
tO
(-7
�0
Q
3
O
c
C+
In
td
m
C+
f
�o
rp
3
N
N
-O
C+
n
-4
p
3
7C'
b[1
�0
1Z
O
3
C-)
N
O
3
O
C
4+
in
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water& Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Permit Number: SW030332
Legal Description: Mountain Valley Estates Block 1 Lot 6A
Design Engineer: 0838 North Rim Engineering
Owner Name: Jean Kan+vowski
Owner Address: 5007 Randi Court
Eagle River , AK 99577 -
qI3
Cl I o J Gl Pv�
Date Issued: Aug 26, 2003
Expiration Date: Aug 25, 2004
Parcel ID: 050-631-24
Site Address: 5007 Randi Court
Lot Size: 136343 SO. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
This permit is for the construction of.
❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ 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 engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By:
Issued By:
Date:
Date:10,3
Municipality of Anchorage
• Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
ON-SITE SEWERnNELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
LA
Parcel I.D. O SO- 63/—ice Permit Number SWU30372
Property owner(s) ZG*i l kAiewawS (44 Day phone G yz/-2POd
Mailing address (1) .5407 �L.f /7ALE,r
Mailing address (2) Zip Code 525 77
Legal description (Lot, Block & Sub'd.),,/ &11-filZ V.9LGEv 459 = S . A 4 B /
Legal description (Section, Township & Range)
Lot Size 3 34 Acres q.Ft.
THIS APPLICATION IS FOR:
Number of Bedrooms
Sewer Only A Well Only ❑
Sewer and Well ❑ Water Storage ❑
Sewer Upgrade 9
THIS PROPERTY CONTAINS:
Hot Tub ❑ Jacuzzi ❑
Swimming Pool ❑ Water Softening Unit ❑
Therapy Pool ❑
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 orpOKorized agent)
Permit Fees:, U w rl Waiver Fees:
Date of Payment: Q I__(3_t_`� Date of Payment:
Receipt Number: A D uz' Receipt Number:
(Rev. 12/00)
Northitim Engineering
17237 Bear Paw Circle
Eagle River, AK 99577
907.694-7026
907.830-4186
August 10, 2003
Dan Roth
MOA On -Site Water & Wastewater Program
4700 Bragaw St
Anchorage, AK 99519
RE: Mountain Valley Estates, Block 1, Lot 6A, South Fork of Eagle River
Dear Dan,
Please review the submittal for the water & sewer design for the existing single family
home. The entire subdivision is very large multiple -acre lots. The existing seepage cribs
have failed. I have included design plans & specs, design guidelines, & soil tests. If there is
need for additional information or clarification please give me a call.
Sincerely,
itK4
Design Enclosures
Mountain Valley Estates, Block 1, Lot 6A
SPECIFICATIONS & DESIGN GUIDELINES
NonhRim Engineering
Wastewater System Sizing: This is a single family home with 3 bedrooms; the owner
wants the septic system oversized for 4 bedrooms. The existing cribs have failed. This
requires a 1250 gallon septic tank. A new sewer service line & foundation cleanout shall
be installed. This is a large lot at over 3 acres; no adverse impacts are expected from
development. The neighboring subdivision lots are multiple -acre also. No water wells are
impacted by this upgrade. The lot to the north (Lot 5) is developed with no conflicts to the
existing septic system, property line or water well. Soil tests found typical soil for this
area; glacial till with varying amounts of silt. Some sand lenses were observed in the test
hole. An application rate of 0.8 GPD/FT2 was used for sizing the absorption trench. A 15
foot deep monitoring tube is monitoring the groundwater.
Specification Requirements: All components and work must comply with the Municipality
of Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and
Wastewater Regulations.
• Two compartment septic tank
• Watertight couplings on inlet & outlet
• 5 foot minimum between the tank and bed. 10 foot to property lines.
• 3 feet of cover or insulation is required for trench; an equivalent of 1" insulation for each foot
soil cover.
• Tank & solid pipe must be set on well compacted, stable soil
• 4 inch diameter cleanouts with airtight caps are required 1 to 4 feet from foundation wall, prior
to any 90 degree bend in 4 inch line, in each tank compartment, and two adjacent opposing
cleanouts between the tank and the absorption field, not more than 10 feet from the tank
positioned to provide cleanout access towards the tank and towards the absorption field.
• All cicanouts must extend to at least ground level
• In solid pipe runs, ASTM D-3034 may be used in lieu of cast iron
• Trench to be placed level, minimum of 4 feet to groundwater, 6 feet to bedrock from drain -rock
• Drain rock to be V2 inch to 2 V2 inch screened. Drain rock to be distributed uniformly
throughout the trench.
• Perforated pipe to be installed level with perforations down
• Silt barrier (filter fabric) to be installed above the drain rock
• Smeared trench sides must be raked or scarified before drain rock placement
• Backfill over drain rock must not be less than 36"
• The finish grade must be mounded to promote drainage over the bed
• Insulation must be placed over any pipe installed under driveways or parking areas
• Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS
ASTM D2661,
• Sewer Service Line is minimum 2% slope
• Septic Tank to be pumped every two years or when required
• Insulation board shall be extruded direct burial polystyrene (Dow Styrofoam 19 or equal)
• Crush or remove existing cribs. Replace any voids with clean fill material
L
3
0
U
d
S
u
a,
L
I -
a
N
Q
0
asn0 J
H wo
°�lea8 � N
L
U
Q
C)
c
+
, L G �
in
>1+-0E
uZu- >
+PtAtn0
CL a, +P °
V 1=1 _j �
M ,ja:pA 6ul:�slx3
m
W
F—
Q
w
W
J
ID
F--
Li
J
a.
CV)
0
r.
0
v
u
W
N
S
0
u
CL
O
a,
d)
L
Q)
S
4� J
U
d�
N o
O N
U
N
E Oa
O 4-
L N06
LN
U )
C j
N L
Fis
d
E3
u�, u
L a�
..
66
�o
S :p j
an,
+'
0
0) (6
+p z
E
00
s
Uap
a)JO1
d
+�
3 0
O d �� E
uS.
+'LNd
al
W
N
I
SL5Uoal.
o
CLup
_0 3:L)
a,
°u
�` N
-OZ
ap
H
Watna,a,
6
o
a
+' 0
Z�NNCL+' >
F'
in
0 m Z x¢
L)
%
W
W
Q-; WMV
0
asn0 J
H wo
°�lea8 � N
L
U
Q
C)
c
+
, L G �
in
>1+-0E
uZu- >
+PtAtn0
CL a, +P °
V 1=1 _j �
M ,ja:pA 6ul:�slx3
m
W
F—
Q
w
W
J
ID
F--
Li
J
a.
CV)
0
r.
0
v
u
W
N
S
u
a,
L
i
Z
3
d
E Oa
O 4-
L N06
N
� L)
'((u :p
d
Q
u�, u
L a�
E L
N
Va
u d
S :p j
L
Q
U £ U)
=
0
0) (6
a,
La's0
C:
CL 4 �
a)JO1
n,N°'o
ass
3 0
O d �� E
uS.
+'LNd
al
W
N
I
SL5Uoal.
_0 3:L)
a,
N+' 3 L CCD 3
-OZ
C
Watna,a,
o
f- (D
C3M4' � �-P
o u+'
d
Z�NNCL+' >
F'
�ooa;,aa',daaso0
0 m Z x¢
L)
(n F-
W
W
Q-; WMV
n%Dr�
0
asn0 J
H wo
°�lea8 � N
L
U
Q
C)
c
+
, L G �
in
>1+-0E
uZu- >
+PtAtn0
CL a, +P °
V 1=1 _j �
M ,ja:pA 6ul:�slx3
m
W
F—
Q
w
W
J
ID
F--
Li
J
a.
CV)
0
r.
0
v
u
W
N
V)
W
f•—
Q
f'—
W
>- Q
w �,D
Q 0
J
Z
F— �C
Z U
D 0
0 J
2: PCI
3 -i
W 1H
H LL -
>C3
Z Y
W Z
_ Q
U ~
Z U
W H
LLJ
M
CV)
O
nn
is
W
N
M
O
0�
OD
�Z Ua
ZW Q0
W L :<
0
_ e
Zw
•- w
s
u
o,
L
~
�
s
Q
N
3
f'
Q
L
O
O
+'
0
O
a
%D
P4
4
�
O
(L
c
a
,
~
:•
u
O
H-
:.r• .
CL
N
N
�
a
N
O
(n L U
L
3
•1-'
+' d
N
CQ
li Li
IA
i-'
3
O
c
C5
U
_a
�-
rn
a
L)
Ln
�°
a
0
n,
CL
CL
+> L �
0; u Q, rn
a L
C5 o
U
l7 V
U
Cl) (�
o as a
O
X N O_
W u O >.
N
dIA
O
}' d
L N LN O.
c
L
Vl f-
4 S N �J U1
d
N
L0
0p�
0 033 30
(�
V
d
+' 0 £ d
tA Gil
d
d i
U
Q.-
` Q£4
UQ_OL00w
05
OW
OU
U
� � i
L
_ O CL
...
�
�� iJ 03 O �oii
O
NV dV N
S i
YcO��-
L O)N
W O_dN E
VN
l~ Y
I
O
C3 p u, aL_L
4LL03
zUN
+'d
d Q
z a 3 +' w a,
E°viN(n3(na�
A .;cu (`)40�J
l0
V)
W
f•—
Q
f'—
W
>- Q
w �,D
Q 0
J
Z
F— �C
Z U
D 0
0 J
2: PCI
3 -i
W 1H
H LL -
>C3
Z Y
W Z
_ Q
U ~
Z U
W H
LLJ
M
CV)
O
nn
is
W
N
M
O
0�
OD
�Z Ua
ZW Q0
W L :<
0
_ e
Zw
•- w
Municipality of Anchorage
Development Services Department
Building Safety Division
0 y,. On -Site Water and Wastewater Prografi
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchoraoe.ak us
(907)343-7904
Soils Log - Percolation Test
Performed For: TEAA( 1<*2W CW S K (�/ Date Performed:
Legal Description: A V/9Gr- I %i SI , LK. 0l St Township, Range. Secticn:
12-
'
OL
s
eet
0
L
13-
p
011A
14-
p
Date:O hZ 0
2-
�•
Z
16-
. o
•
Yrr
3-
c
4-°"
7tt
2
GP
5-
6
0
0
0j_ CA,
7-
p
a-
/0
G IK
9
P'
t• �
10-
'
11-
A
'D_ •
12-
'
GP
s
!
L
13-
p
Monitoring?
14-
p
Date:O hZ 0
15-
Z
16-
dT f
Yrr
117-
18-
7tt
2
3V„
19-"20-
6
1-7/4„
COMMENTS
L/ f%rlP
Site Plan
WAS GROUND WATER
ENCOUNTERED? ES
Date
Gross Time
s
IF YES, AT WHAT DEPTH? �s
L
Depth to Water After
p
Monitoring?
E
p
Date:O hZ 0
Reading
Date
Gross Time
Net Time
Depth to Water
Net Drop
03—
S>17103
Z
Z
dT f
Yrr
2
7tt
2
3V„
6
1-7/4„
P4 /r
p
2
/0
y�,r
PERCOLATION RATE � r (ninutesrinch) PERC HOLE DIAMETER 6”
TEST RUN BETWEEN q FT AND _y ' FT
_ n
PERFORMED BY: � Atin 6nW#1QWn5 I `] ,I4. k A CERTIFY THAT THIS TEST WAS
PERFORMED IN ACCORDANCE WITH ALL E AND Rt ICIPAL GUIDELINES IN EFS CT ON THIS DATE. DATE: r/ a3
(falitftrb Drilling TILag
by
A & L DRILLING COMPANY
BOX 97, EAGLE RIVER, ALASKA 99577 • TELEPHONE 694-2588
OWNER OF LAND JO HkJ 6 R DSS
ADDRESS
LEGAL DESCRIPTION G v 7L �L /C Z
DATE -Started Ended6- 7 w
PERMIT NUMBER
KIND OF FORMATION:
DEPTH OF WELL d 1-0 /
STATIC LEVEL OF WATER FT. 3
DRAW DOWN FT. /00
GALS. PER HR 600
KIND OF CASING 4 7& D
From 0 Ft. to 7 Ft.
T'P
From—Ft.
to
Ft.—
Ft.
FromFt. to - -eFt.
1611 0 T
From
Ft. to
Ft: _
From Ft. to -461 -Ft.
64#* CRAr✓EC
From
Ft. to-
Ft._
From4T Ft. to__i�_Ft.
N"
.From
Ft. to—Ft—
oFt—From
Ft-
FromSFt. to. SOD Ft.
C'CIi t; 2NNEC .} (3ouc06QS
From—Ft.
o
to—Ft—
Ft—
From
From 100 Ft. to /o t–Ft.
614e # gQ/f✓EL
From
Ft. to—Ft.—
oFt._From_f
From- lo`!_Ft. to—t(
66,*aebc K !C'0410
From
Ft. to
- Ft._
From1(?r Ft. to–POL-.Ft.
FRACTuQcO//d l6 All
From
Ft. to
Ft.
From.. o / Ft. i
From
Ft. to
Ft. —
FromC�) 5' Ft. to 22 Ft.
6f4C �� cfQ/
From -
Ft. to
Ft._
From-2dl Ft. tod4v Ft.
"EQ QoC K S"o< /O
From—Ft.
to
Ft. -
From Ft.
From Ft. to Ft.
From Ft.
From Ft.
From - Ft.
From Ft.
MISCL. INFORMATION:
l3 FT long I ca¢S
From—Ft.
to
Ft.
From
Ft. to
Ft.
From
- Ft. to
Ft.
From
Ft. to -
Ft.
From -
Ft. to
Ft..
From
Ft. to
Ft-
DRILLER'S NAME i • :'. -
a9 -77
9..,.0 IL-8 r-4 3 u--.- 0.-_ 1 _R_ "-e" a_l iF- F=i r -j n F* =_ F1 C E=_ LAC
S-
2516
OF HEALTH AND ENVIRONMENTAL PROTECTIONx'.:°;16 E. TUDOR RD., ANCHORAGE, AK. 9950.-'
276-2221
�-j IE L_ K_ F" E•_ Fes_ 0-1 �.I._.
PERMIT NO. 76899 :'j
APPLICANT JOHN GROSS BOX 1161. E. R. 694-9 10-1
LOCATION RANDI CT
LEGAL L6 ECL MT VALLEY EST LOT SIZE: 93217" SQUARE FEEl
MINIMUM DISTANCE BETWEEN H WELL AND ANY ON—SITE SEWAGE DISPOSAL.. SYSTEM is
100 FEET FOR H PRIVATE WELL OR 200 FEEL" FOR H PUBLIC: WELL.
WELL LOGS: ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN TO DAYS
OF THE WELL. COMPLETION.
SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE. TO INSURE PROPER
INSTALLATION.
I CERTIFY THAT
1: }: AN FAMILIAR WITH THE REQUIREMENTS FOR ON—SITE SEWERS AND WELLS AS SE: -L'
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
'•IGNED. ----------------------------------
21
RPOLIi-:- T JOHN GROSS
ISSUED
pv, •Zvi
C‘C.-/-'3Municipality of Anchorage ``On-Site Water&Wastewater Program <o
(907)343-7904 - S.11. E z
A ETV
,I
C")
figftal4
3
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL ) ,.5 -,
Parcel I.D. 050-631-24 Expiration Dat-.Oj
1. GENERAL INFORMATION
Complete legal description MOUNTAIN VALLEY ESTATES S/D; BLOCK 1, LOT 6A
Location (site address) 5007 RANDI COURT, EAGLE RIVER,AK 99577
Current Property owner(s) JEAN KARWOWSKI Day phone 229-0843
Mailing address 5007 RANDI COURT, EAGLE RIVER,AK 99577
Real Estate Agent Day phone
2. TYPE OF DWELLING:
• Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 4
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well U Individual On-site U
Individual Water Storage ❑ Individual Holding tank
Community Class Well ❑ Community On-site
Public Water System ❑ Public Sewer n
WaiverNariance request for: DRAINFIELD TO LOT LINE Distance: 1 FOOT
Received by: Date:
COSA to be released to the engineer,unless otherwise requested by the engineer.
COSA Fee $ S-5-6 -. Waiver Fee$ 22,S�
Date of Payment (//3119 Date of Payment LI/q/
Receipt Number 9 q6 76 Receipt Number d `t 630
COSA# 03C19/ 163 Waiver#
COSA Checklist
Legal Description: Mountain Valley Estates S/D; Block 1, Lot 6A Parcel ID: 050-631-24
If more than 1 septic system on lot: COSA Checklist# 1 of 1 Structure served by this system 1
'PER MOA RECORDS,THERE WAS A 1973 WELL DRILLED ON THE PROPERTY THAT WAS 125 FEET DEEP.A NEW WELL
PERMIT FOR THIS PROPERTY WAS ISSUED ON 11/9/1976.IT IS UNCLEAR IF THIS IS THE SAME WELL OR IF THERE WAS
ANOTHER WELL THAT EXISTS OR EXISTED ON THIS PROPERTY.NO RECORD OF DECOMMISIONING SOUL BE FOUND
A. WELL DATA AND THE CURRENT OWNER IS ONLY AWARE OF 1 WELL ON PROPERTY(SEE HOME OWNER'S QUESTIONNAIRE).
❑■ Well log is filed with Onsite (or attached) Well production at time of test 2.5+ gpm
Date drilledH11/5n6 Water storage tank volume N/A gallons
Total depth 240 ft Well disinfected for coliform test? ❑ Yes ❑■ No
Cased to 113 ft ; Coliform bacteria is Negative
❑■ Sanitary seal is functioning correctly Nitrate mg/L ® Nitrate less than MRL (ND)
❑■ Wires are properly protected Arsenic ug/L ® Arsenic less than MRL (ND)
Casing height (above ground) 18+ in. Collected by GEG, Ltd.
Date of flow test for COSA 6/15/18 Date of Sample 3/14/19
Static water level at beginning of test 33.4 ft.
Comments
B. TANK DATA C. LIFT STATION
Age of tank(s) 15.5 years ■ ' -• ired maintenance completed _---=
Tank type/material steel Age of lift sta i• years --
❑■ Standpipes/foundation cleanout per record drawing Lift station material
Date of pumping 3/25/2019 Comments:
D. ABSORPTION FIELD DATA Deep Trench
Which system tested (date installed) 9/3-5/03 Adequacy test date 6/15/18
❑� ALL standpipes present per record drawing Results E Pass For 4 bedrooms
Total measured depth from grade *8.6 ft(max) Fluid depth prior to test 13.5 in
Measured depth to pipe invert from grade *-3 ft(min) Water added 876 gal
❑ N/A—pressurized field New depth 23 in
❑ Monitor tubes go to bottom of drainfield. If not, state Elapsed time 195 min
depth into effective 4 feet
El Code-required soil cover over field Final fluid depth 16 in
E
Sy�C �u Absorption rate 600+ gpd
-pfeseek
(Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months) No
date of test)
Gallons introduced gallons If yes, enter date
Comments/Deficiencies:'MT only extends-4 feet below invert.*Most of drainfield has 3+feet of cover.
COSA Checklist yellow sheet
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. 1 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.
Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179
Address 3701 E. TUDOR ROAD, SUITE 101 *ANCHORAGE,AK,99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date -1(�
1 9
Engineer's Comments:
In conducting this evaluation,GEG provided an engineering evaluation of the well and/or septic system in accordance with the **SU 1 iii.
guidelines and regulations established by the Municipality of Anchorage and industry practices.The reported results describe the .4% OF 4-7`**
condition of the system/s on the date/s of the evaluation.Separation distances were measured to readily identifiable features. i• ti, 4 Io. A
Hidden defects or encroachments may exist that were not identified during the evaluation.The operational life of all wells and septic a C,' , • .
systems depend on a variety of variables including,but not limited to.soil conditions,groundwater levels(that may fluctuate during `)_ #
the year),quality of construction(materials and workmanship),and the water usage of the family utilizing the system/s.These * g �� '\
conditions can vary,and are outside the control of GEG.Satisfactory test results do not guarantee future performance of the �I •�
systems;therefore,GEG makes no warranty(express or implied)regarding the future performance of the well or septic system. l+"
GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the %...,,.,..,-r f, , •
current systems fail.The content of this report is for the sole benefit of the person/party who retained GEG.Reliance upon the ,: ey a fess =
information provided in this report by any other person or party,including but not limited to subsequent property purchasers,is not # 0� : CE 795
authorized.In short,GEG disavows any legal duty to anyone other than the person/party who paid for this report. • S % V:
,• -e .,..t�J'L I.•P�F�.
•6. DSD SIGNATURE4.11R! CN
LICENSE �Ir�`S`���8•••
76System #1 Approved for LI
bedrooms. #AECC884
System #2 Approved for bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulatiofts: ON-SITE
WATER AND
WASTEWATER
PROGRAM �;
�?
SFRY\CF_
By: Original Certificate Date: IC-9 _i 9
The Municipality or Anchorage Develop,emt Services Division(DSD)issues Certificates of On-Site Systems Approval(COSA)based only
upon the represenatations 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. ATTCHMENTS:
COSA Checklist Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
(Rev.10/12/12)
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' Community Sewer Manhole/Cleanout> 100'
0 Yes if No ft ['Yes if No ft
Neighboring Tank> 100' Q Yes if No ft Private Sewer/Septic Line >25' 0 Yes if No ft
Absorption Field on Lot> 100' ['Yes if No ft Holding Tank> 100' Z Yes if No ft
Neighboring Absorption Fields > 100' Animal Containment> 50' El Yes if No ft
Q Yes if No ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' Q Yes if No ft ✓]Yes if No ft
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10' Q✓ Yes if No ft Surface Water> 100' ['Yes if No ft
Property Line > 5' �✓ Yes if No ft Driveway/Parking > 0' ✓Q Yes if No, comment
Absorption Field > 5' QYes if No ft Wells on Adjacent Lots:
Water Main > 10' Q Yes if No ft Private Wells > 100' E Yes if No ft
Water Service Line > 10' ['Yes if No ft Community Wells >200' Q Yes if No ft
From Absorption Field on Lot to: (Please enter distances if less than required)
Building Foundation > 10' Ill Yes if No ft Driveway/Parking > 0' Z Yes if No, comment
Property Line > 10' 0 Yes if No 1 ft Wells on Adjacent Lots:
Water Main > 10' ['Yes if No ft Private Wells > 100' ✓❑Yes if No ft
Water Service Line> 10' Z Yes if No ft Community Wells >200' I✓ Yes if No ft
Surface Water> 100' Q Yes if No ft
F. ENGINEER'S COMMENTS
*Drainfield standpipes are —3 feet from North property line and —5 feet from West property line.
Portion of drainfield inside 10' utility easement. See attached letter of non-objection from utility
companies. Requesting 1 foot lot line waiver to drainfield.
�,,,,„.4 .4 .-o. ,%,\,,
G. ENGINEER'S CERTIFICATION ,f7/\c.... 4
oQ- Sip
/certify that/have determined through field inspections and review 'k ••" „1.- �O0
of Municipal records that the above systems are in conformance with Q : 4 • Hiiiii Q
MOA COSA guidelines in effect on this date. 0 I
i D
• e f•/,. A. Garn:ss.: 0
OQo4 CE--' �_O
c�O
%
COSA Checklist yellow sheet 4%,apro f ess+O�oo
MECC884 00��000�
al A
GARNESS ENGINEERING GROUP, Ltd
ENGINEERING SALES CONSULTING
March 20, 2019
Municipality of Anchorage
Development Services
On-Site Water & Wastewater Program
4700 Elmore Roade
Anchorage, Alaska 99507
Phone: (907) 343-7904
Reference: Drainfield Lot Line Waiver Request for Mountain Valley Estates S/D;
Block 1, Lot 6A
To whom it may concern:
The 4 bedroom house on the referenced property is served by a private well and septic system.
Per MOA records, the septic system serving the subject property was installed in September of
2003. We have performed a well flow test and septic adequacy test on the referenced property
and found them to both to meet MOA requirements. We have recently obtained an as-built
survey performed by Mark Seward, RPLS and based upon the survey, the drainfield does not
meet the 10 foot separation distance to lot lines. Based upon scaled measurement on this
survey, the cleanout on the Northeast end of the drainfield is approximately 3 feet from the
North lot line and the cleanout on the Southwest end of the drainfield is approximately 5 feet
from the Northwest lot line. Based upon this survey, the drainfield is also within the 10' utility
easement. We have requested letters of non-objection from the utility companies for this
encroachment. We are requesting 1 foot lot line waivers from the northwest and northeast lot
lines to the drainfield. We are unaware of any adverse effects on the adjacent properties with
the granting of this waiver.
Please do not hesitate to call us at 337-6179 if you require further information. Thank you for
your assistance.
e1y,
Je'rzi,, arn: '.E., M.S.
Pre (sent
3701 East Tudor Road,Suite 101 'Anchorage,Alaska 99507-1259
Phone: (907)337-6179*Fax: (907)338-3246*Website: www.garnessengineering.com
&T'A
NON-OBJECTION TO EASEMENT ENCROACHMENT DOCUMENT
By this document Matanuska Telephone Association, Inc. (MTA) declares that it has no objection to the
existing encroachment of the drainfield within the platted utility easement on Lot 6A Block 1 of Mountain
Valley Estates, Lots 6A & 8A, Block 1 A Resubdivision of Mountain Valley Estates, Lots 6, 7 & 8, Block 1
(73-152) filed as Plat Number 99-20 in the Anchorage Recording District, State of Alaska.
****************************************************************************************
Please be advised that MTA through the issuance of this document does not forfeit any of its rights to the use
of the area cited. In the exercise of these rights MTA will, if needed, upgrade, maintain, repair, and/or replace
buried or aerial telecommunications facilities within the easement. Any repairs that may be required to the
encroachment as a result of utility construction will be borne by the property owner of record. This document
does not authorize the placement of any additional encroachments within the easement area. Property owners
are required to obtain utility locates before doing any kind of work in the utility easements and will be liable
for any damages caused by their construction work in the easements.
This document is in no way an agreement to vacate any portion of the utility easement and should not be
interpreted as such.
Issued for Matanuska Telephone Association,Inc. this 26th day of March, 2019, by,
(
e.J.41 v Ilk I - , Jessica Burnett, Right of Way Agent
THIS IS TO CERTIFY,that on this 26th day of March, 2019, before me the undersigned, a Notary Public in and
for the State of Alaska, duly commissioned and sworn as such, personally appeared Jessica Burnett known to
me and to me known to be the individual named in and who executed the foregoing instrument and
acknowledged to me that he signed and sealed the same as a voluntary act and deed for the uses and purposes
therein mentioned.
IN WITNESS WHEREOF, I have hereunto set my hand and official seal the day and year first above written.
.--4
OFFsou. cam^
`F :, Molly Sparrow
No blic in and for Alaska
► Y Public State of Alaska My commission expires: q ( '% I as
P.O Box 3550 Palmer,Alaska 99645 mtasolutions.com 907.745.3211
From: To:93383246 03/25/2019 15:33 #066 P_001/001
ENS14R ENSTAR Natural Gas Company
A DIVISION OF SEMCO ENERGY
Natural Gas Company Engineering Department
Right of Way Section
P.0.Box 190288
Anchorage,Alaska 99519-0288
(907)277-5551
FAX(907)334-7798
March 25,2019
Jean Karwowski
5007 Randi Court
Eagle River, Alaska 99577
Subject: Letter of Non-Objection
I.6A B1 Mountain Valley Estates
To whom it may concern:
ENSTAR Natural Gas Company has no objection to the existing septic drainfield encroachment into the
ten feet(10 FT)wide utility easement,lying adjacent to and coincident with the Randi Court right-of-way
and situated on Lot 6A, Block 1,Mountain Valley Estates,according to Plat No. 99-20,records of the
Anchorage Recording District,Third Judicial District, State of Alaska.
Acceptance and use of this letter of non-objection by yourself,your heirs,your assigns,or your
successors,will constitute agreement to the following stipulations:
• Landowner/Contractor working near ENSTAR gas facilities shall contact the Alaska Digline,
Inc., (907)278-3121 or 811 for line locating two(2)business days prior to any related
excavation. This service is free of charge.
• ENSTAR will be held harmless,now and forever for any damages or injury to any person or
property as a result of this encroachment.
• Any ENSTAR facility damaged or destroyed,as a result of this encroachment will be repaired at
no cost to ENSTAR.
• Any costs incurred by ENSTAR for special construction necessitated by this encroachment will
be borne by the land owner.
• All applicable safety code regulations will be observed and maintained.
• This letter of non-objection will in no way preclude ENSTAR from full use and enjoyment of its
rights within any portion of its right-of-way.
Sincerely, / / C---1-)
Andrew Fraiser
Right of Way&Permitting Supervisor
ENSTAR Natural Gas Company
•
3 r Anchorage Water & Wastewater Utility ,�,�j►
i•T Engineering Division :�W���y
anY M `"
Mayor Board Chair
Ethan Berkowitz Aaron D. Dotson
March 26, 2019
Jean E. Karwowski Declaration of Trust
22424 Birchwood Loop Road #211
Chugiak, AK 99567
Re: MOUNTAIN VALLEY ESTATES BLK 1 LT 6A, Grid (SW0658)
Request for Letter of Non-objection to Encroachment (Tax ID# 050-631-24)
The Anchorage Water and Wastewater Utility received a request from your representative
Garness Engineering Group on March 25, 2019 in regards to an existing drainfield
encroaching within the 10 Utility Easement along the west property line of MOUNTAIN
VALLEY ESTATES BLK 1 LT 6A.
AWWU is currently not using this Utility Easement and has no objection to the encroachment.
AWWU hereby issues this letter with stipulations to allow the encroachment of the existing
drainfield within the easement, property owner(s) agrees to the following:
1. AWWU will be held harmless, now and forever, for any damages or injury to any
person as a result of the encroachment;
2. The property owner(s) shall call for utility locates before excavation in the easement;
3. All applicable codes and regulations will be observed and maintained within the
easement;
4. This letter will in no way preclude AWWU from full use and enjoyment of its rights
within any portion of the easement;
5. The property owner(s) shall pay any additional and/or extraordinary costs incurred to
accommodate the encroachment during any future required construction or
reconstruction of AWWU facilities;
6. AWWU's non-objection does not imply other approvals that may be required for this
encroachment; and,
7. AWWU does not provide a position for any other parcel or utility impacted by the
encroachment.
Should you have any questions, please call the AWWU Planning Section at 564-2739.
ly,
Iaul Ha her
Engineering Technician III
Anchorage Water & Wastewater Utility -4',,;,- Clearly
3000Arctic Boulevard•Anchorage Alaska 99503
Phone 907-564-2774•Fax 907-562-0824•wiw.awwubg �i'.....
MATANUSKA ELECTRIC ASSOCIATION, INC.
LETTER OF NON-OBJECTION
April 9, 2019
Garness Engineering Group,Ltd
Sonja Blewett
3701 E Tudor Road, Ste 101
Anchorage, Alaska 99507
Re: Jean Karwowski: Lot 6A, Block 1, Mountain Valley Estates, Plat 99-20, Anchorage Recording District
Dear Ms. Blewett,
MEA has no objection to the encroachment of a septic vent pipe, located five feet, more or less, into a ten
feet utility easement as shown on the attached drawing, dated 7/10/18, subject to the following conditions:
1. The improvement will in no way restrict or limit the current or future ability of MEA to fully enjoy the
benefits of the easement for any and all utility purposes that it presently enjoys under the easement,
excluding a buffer area two feet(2 ft) in diameter from the center of the subject well improvement.
2. MEA will be held harmless by the landowner from liability for any and all damages or injury to any
person or property that may result from the existing and future use of the easement by MEA, its
contractors, or assigns.
3. MEA will be held harmless by the landowner for any and all liability arising out of or relating to any use
of the easement by others under a Letter of Non-Objection.
4. The landowner will be liable for any damages caused to MEA facilities by the improvement in the
easement.
5. The landowner will be responsible for any special construction costs incurred by MEA due to the
improvement in the easement.
6. The landowner will assure compliance with all applicable safety codes relating to the improvement in
the easement.
7. Use of this letter by the landowner, their successors or assigns will constitute acceptance of these
conditions.
8. Alteration of these conditions shall invalidate this letter.
9. This letter is not effective unless it is recorded in the Anchorage Recording District before ownership of
the referenced property is changed from the above named landowner.
Sinc; -ly,
\� 4
Man L•.- �: ,
Land Servi.-s Ma's: IliSTATE OF ALASKA)
THIS IS TO CERTIFY that on this 9th day of April, 2019, before me, the undersigned, a Notary Public in
and for the State of Alaska, duly commissioned and sworn as such, personally appeared
lKnown to me and to me known to be the individual(s) named in and who executed the foregoing instrument
and acknowledged to me that he/she/they signed and sealed the same as a voluntary act and deed for the
uses and purposes therein mentioned.
IN WITNESS WHEREOF, I have hereunto set my hand and official seal the day and year first above written
`'---7--;:: --5----� 5---26-26Z0 nium,."",,,,
J
'n <Zy�r
�- J I .
' :
b
3 ��
`�
. Q-
'7-..
•
2 \. .'
\+-',,.N s
p9 •
%%% b
_ .c-•.
7,
N` S'ar
,
) ;:)'
if
(I
e ,
/
\.
.,,
,..,...s.:ez ...., ,E,,,,,,a:24,,
ASBUILT SEWARD & ASSOCIATES LAND SURVEYING 694-0824
I HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE:
FOLLOWING DESCRIBED PROPERTY: _� � , OF A / gb
/-'2 `i ll.-•S1''�� L0T-ij �=�; - DATE- .‘.4„ ,
AND THAT NO ENCROACHMENTS EXIST DCCEPT AS �� 47A0-..• - ,: .-•4-94
•
INDICATED. IT 1S THE RESPONSIBILITY OF THE � v . •.• O rn
OWNER TO DETERMINE THE EXISTENCE OF ANY GRID:
f:y7,.EASEMENTS, COVENANTS, OR RESTRICTIONS sGv6s� 1e�sWHICH DO NOT APPEAR ON THE RECORDED SUBDI- yDuo MerL Seward �l is
VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB: ft t. ... LS-s9 3 41' .1
ANY DATA WEREOW RE USED FOR CONSTRUCTION .
7/... 6� #t, ?k,.'}•Jul ` �4
OF FENCE LINES, OR FOR ESTABLISHING BOUND- ' ' c?'r� t •
ARY LINES. DRAWN: 't� � *o+r
•
,q+
•
wA [ss./�1�
f
i
N1• 6
a`I•
• �t
a`
` ncaSl2 '/E/yAp5/7
ASBUILT SEWARD & ASSOCIATES LANL SURVEYING 694-082q
I HEREBY CERTIFY THAT I HAVE SURVEYED THE ..57=7"'
<,00e�m
FOLLOWING DESCRIBED PROPERTY: oOF R 1 4 a�
"7",% �//fi/,!4/•l��: ,S La.774,„R.d:1 • DATE. .m s 4
AND THAT NC ENCROACHMENTS'EXIST E*CEPT AS Z ,?/71' 9 •••• .„I� .-•
INDICATED. IT IS THE RESPONSIBILITY OF THE i • 4 rrs 1
OWNER TO DETERMINE T E DESISTENCE OF ANY GRID
EASEMENTS, COVENANTS., OR RESTRICTIONS6,sS` f
WHICH DO NOT APPEAR ON THE RECORDED SUBDI- - $ w:,.a Aut.Sawa+4 A
VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD F$ ¢# iS-Aag
ANY DATA HEREON BE USED FOR CONSTRUCTION 7A/4:>
l,,.'..4.7/tel- Yes
OF FENCE LINES, OR FOR ESTABLISHING BOUND- DKAWN 3+� t:,aW.i'•
ARY LINES. /4f7
,..--• ••'-i
!' • ',1'
.,.
..,. .
.. .,
,,..
• Gcl
,„.
Ail ;
Jetlitt K.acv.p..5.iki ,
5007 RAikdi Co.iii
litimigiv kiwi. .411asi,4 94,1'577 •)->,'
,:.,..
it c 1.ctipt ot NtrimdAtircritir;
q,
i)car 3c-An
Subject in rf.Kit aQ11,31101TIL IQ itadtillitify OW f..01)4pail:0 Zik,IkCi forth beinw. A A A
Cookrtionitatiott Coq)ht no objwilion tto Ibe Orn 'ape caltielling .' . into Ow lir
Wilily taxi-not of I ot t)A, I klock 1, Mottotain Vailley rikt.lita,also knowo as 54)07 Ramti ,.
•:.
Count,city wid SWixtlkk C;t'I NV(MI I WOO! IS_
1 llis kilo a non-Orainft in INI way rireclutlrA(4)('1 iCuiyinmoicigion (.'.1.4p Writ Ain u.w•
and atjoyotent of am! tights it luny lutve within any pection of the:utility ettitlikellt kW 4xt
;hit ri0i-uf-way, 104;1141kt unlimiletl 3COM fir ifiet*ing itS ikilitits_ Also aity
odd itiosul arid oitAkirdineiry chests ilKilittd duslits.&to futust ricttuived etanefinsaiion,,teplir
or tttiNWLVIFIX.1k141 Of ifkl's facilities to noconirtWatc any or*A or the 0Timehmaits siva!
by.paid by itu qty (wolves-
By Nigrtiq NitisA% ".14:14)VW lo iffy and trold(JCI(..7411111114314i4411i0f1 COT harmiew
now an4I fottvor,for any ikuuksv, ‘-otil.),expenv(ittchtdillg re4Lionsibk anOrnerS ite10,,
liabiihtioti and itijUry to all.pors(ke ot pooped)ixVittlit* EIN a Pt malt of the mrotozinrtnt.
Please indicate your aak-4.`t olive by signing timi griuntain*this lcdef lo ritZ SI INC litiatirmt
haYok.
Sint:VIA:2 th,,,,,,,-.7/',1,1a:,„• ..„,
VKo ,./.
A..iy„,,..iitic. '1 40,1., - I .,•„6,'
4iriktAs foid
Is4nrittet
Outnite ritini I)exign a Mu Nfaiwernvni
0(11 Coriutimiattion Corp
5151 Faithanks St
Aachen/iv, AK 99503
907-8614416$ 0010e
907464-X9M Fax
•
. ,
POST IN A CONSPICUOUS PLACE 1-1,1 e rt t
ALL WORK MUST BE INSPECTED No • .o
t'1`-- Field Inspection Request required 2 working days in advance of starting work ti • r;
and 2 working days in advance for final inspection. Call(907)343-8206 .;
(voice recorder)for scheduling. Permit is not valid without the call-in and also J : .ii. 'r; ::
must Include the one-call ticket(utility locate)number. Department
MUNICIPALITY OF ANCHORAGE
RIGHT OF WAY DIVISION
4700 ELMORE ROAD
TELEPHONE(907)343-8240
RIGHT OF WAY PERMIT R191285
Type: Encrchmnt Grid: SW0658 Date Issued: 4/11/2019
Construction Start: Last Update by: PWMER
Last Updated: 04/10/2019
Permittee: KARWOWSKI JEAN E DECLARATION
Contact Person: Jean E. Karwowski, 694-2840/229-0843 Primary Inspector: 120(//LQ 3-82 6
Site Address: 5007 RANDI CT, Eagle River-@ Birdsong Drive
Legal Description: MOUNTAIN VALLEY ESTATES BLK 1 LT 6A G:0658
Original Work
Description: Encroachment of a septic drainfield pipe 9'into the 10'Utility Easement along the west property
boundary.
Financial Summary
Fee Description QTY AMT
Permit 1.00 120.00
Total Fees: 120.00
See reverse for requirements/remarks.
I have read and understand both sides of this permit. I agree to the terms and conditions;and I certify that all work will
comply with federal,state,and municipal codes and regulations and the provisions of this permit.
Signature: Q-..- -7\,Q/Lt,�-t�w,.� - Date: C).(1).1_7 1 7 a/
• 4WNICIPALITY OF ANCHORAGE
DEPARTMEN HEALTH AND ENVIRONMENT�ROTECTION
825 L Street, Anchorage, Alaska 99501
264-4720
�_- Date Received: October 19, 1977
#1: Time 10:30 a.m. #2: Time
Date 10-21-77 WXX Psiday Date
Insp Willis Insp
#3: Time
Date
Insp
REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES
1. Lending Institution Request: First National Bank of Anchorage
Mailing Address: Post Office Box 720 Phone: 276-6300
2. Property Owner: (zross Construction Phone: 694-9138
Mailing Address: Box 1161 Eagle River 99577
3. Legal Description: Lot 6 Block 1 Mountain Valley Estates Subdivision
4: Single Family Residence: (x)
Multiple Family Residence: ( )
Number of Bedrooms: �P
Number of Bedrooms:
5. Well System: Individual Well (x) Community/Public System ( )
Permit # -49Y7 Depth of Well 240' Well Log on File (te�
Construction O Qpg cweo L" �Z�`�� Bacterial Analysis
6. Sewage Disposal System: On-site System (x�a
Permit #
Installed
Public Utility ( )
Installer cxn
Septic Tank Size ( 0 O U Manufacturer
Absorption Area Soils Rate Material
o VIL't S
7. Distances: Well to Septic Tank p
p [ Do � to Absorption Area ty o d
r
to Sewer Line Nearest Lot line 3<D Absorption Area
1
to Nearest Lot Line C)
Page Two
Department of Health and Environmental Protection
Request for Approval of Individual Sewer and Water Facilities
Legal Description: Lot 6 Block 1 Mountain Valle _Estates
Comments:
Affadavit Attached: ( )
Approved:
Disapproved:
Department Worksheet:
Letter Attached: ( )
Date:
Date:
�D
WNICIPALITY OF ANCHORAGE.
Department of Health and Environmental Protection' '
d 825 L Street, Anchorage, Alaska 99501
264-4720
equest for Approval of Individual Sewer and Water FacilAies
1. Property Owner: f�S S �C3/ti STj�/l%/a
Mailing Address: 6,,5z z-�e��/Ul%Phone:
2 . Name of Buyer:
Mailing Address: Phone:
3. Lending Institution: a41 /r
Mailing Address: /% Phone:
4 . Realtor/Agent :
Mailing Address: 4l'� �e-Ahone:
5. Legal Description: X 6 T (� 5 L' -7
Street Location:
6. Single Family Residence: (X) Number of Bedrooms: -,Joe
Multiple Family Residence: ( ) Number of Bedrooms:
7. Water Supply: *Individual Well O Public/Community System ( )
If Individual Well, well depth {Q
I£ Community System, name of system
8. Sewage Disposal System: On-site System Public System ( )
If On-site System, date of installation:
*NOTE: A well log is required on ALL wells drilled since 6/75.
If on-site sewer system is over two(2) years old, an adequacy
test is required by this department.
A fee of $25.00 must accompany each request before processing
can be initiated.
3/77
�1
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
Date Received Jan. 31 1974
Time of Inspection LO;00
Date of Inspection
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
Veterans Administration
1. Approval requested by: John Gross
Mailing Address: 5505 Kinney Hill Drive, Eagle River Phone:
2. Property Owner: Phone:
Mailing Address:
3. Legal Description: Lot 6, Block 1, Mountain Valley Estates
4. Location: Hiland Drive five miles from Glenn Highway
5. Type of facility to be inspected Single family dwell No. of bedrooms 3
6. Well Data:
A. Type uriiieu
C. Construction Standard
7. Sewage Disposal System:
A. Installed
C. Septic Tank: 1. Size
B. Depth 125'
D. Bacterial Analysis Satisfactory
B. Installer Duane F Gorder
2. Manufacturer
D. Seepage Pit: 1. Absorption Area 2. Material
E. Disposal Field: Total length of lines
8. Distances:
A. Well to: Septic tank 100' , Absorption area 100' Sewer Lines
Nearest lot line Other contamination
B. Foundation to septic tank , Absorption area
C. Absorption area to nearest lot line
EQ -034 (1/74) Page 1 of two pages
Page 2 of two pages - Reost for Approval of Individual Ar & Water Facilities
Legal Description Lot 6, Block 1, Mountain Valley Estates
Comments
Approved1-7' + K Lc' Disapproved Date 3/6/73
Approval Valid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
L cerLI Ty U1dL Lfle Irll ur"fila uivii uuii La irmu irn wnu rauuaz� 1vr aN F. vvu, w
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED
EQ -034 (1/74)
Da to