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HomeMy WebLinkAboutPARADISE VALLEY BLK 2 LT 13Paradise Valley Biock 2 Lot 13 #020-424-08 Municipality of Anchorage P.O. Box 196650 · 4700 Elmore Road Anchorage, Alaska 99519-6650 · (907) 343-7904 · Fax (907) 343-7997 http://www.muni.or.q/Onsite Development Services Department On=Site Water and Wastewater Proqram epartment **** VARIANCE/WAIVER REVIEW **** Waive~: OSPl11133 COSA#: Permit~: PID~: 020-424-08 Legal Description: Paradise Valley Block 2 Lot 13 Engineer: Spurkland En.qineerinq Applicant: David Twyman Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the foundation has been approved. The approved separation distance from the proposed driven piles to the existing field is 2.0 feet. A 7 foot waiver is approved for the proposed reserve field. · Waiver is Granted: X Waiver is not Granted: Date: ~'/~;//~/. App roved by: =/~e, o=f=~R=~~ Recft: 050629 Amount: $200.00 Date Paid: 6/29/11 **** VARIANCE/WAIVER REVIEW **** MUNICIPALITY OF ANCHORAGE Community Development Department Development Services Division On-Site Water & Wastewater Program Mayor Dan Sullivan Phone: 907-343-7904 Fax: 907-343-7997 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. OZO Property owner(s) Mailing address Site address -- Legal description (Sub'd., Block & Lot) Day phone Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms THIS APPLICATION IS FOR: ([~ all that apply) Absorption Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage [] THIS APPLICATION IS AN: Initial [] Upgrade [] Renewal [] THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature J~f property owner or authorized agent) Permit/Rush Fees: Date of Payment: Receipt Number: Permit No. Waiver Fees: C~©L-b Date of Payment: Receipt Number: Waiver No. O %~ G:\Building\On Site\Forms\Client Forms\Permit App_010411 .doc (Rev. 1/11 ) Environmental Consulting and Design SEPTIC SYSTEM DESIGN Paradise Valley Block 2 Lot 13 Municipality of Anchorage Development Services Department On Site Water and Wastewater Program 4700 Elmore Road Anchorage, Alaska 99519 June 28, 2011 Subject: Ladies and Gentlemen: Separation Distance Waiver 18640 France Circle The owners of the above referenced property would like to extend a second floor deck over there existing drain field. The deck will be supported by 4 6 inch piles driven into the ground until refusal. Current Conditions: The existing trench was inspected on June 20t~, 2011. The septic system was installed in September of 2003 and consists of a 1250 gallon steel septic tank and a deep trench subsurface absorption field. The trench is 75 feet long and has an effective depth of 7 feet. The system appears to be functioning adequately at this time. The piles will be offset a minimum of 2 feet from the edge of the existing drain field. Drainage patterns around the septic system will not be changed, no negative operational effects are anticipated. If you have any questions, or are in need of additional information, please contact me at 279-3916. Sincerely, Re60.~qe ~r¢~c~ ~'[ be A ~i~~ o~ ~ Spfirkland, P.E. 203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland~gci.net Municipality of Anchorage Page I of 3 Development Services Department On-Site Water and Wastewater Program 4700 South Bragaw Street PiO, Box 196650 Anchorage, AK 99519-6650 www, cl.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SW020468 PID Number:, 020-424.08 Name: Serqio & Karl Guidea Wastewater System: New Address: 18640 France Circle Anch., AK 99516 ABSORPTION FIELD Phone: Number of Bedrooms: 301-6280 Four {4) Deep Trench LEGAL DESCRIPTION s~ Rating: Total Depth from original grade: B~ock: Lot: Subdivision: Depth Io pipe bottom from original grade: Gravel depth beneath pipe: 2 13 Paradise Valley 3-6 Township: Range: Section: F~ti added above o~iginal grade: Gravel Length: 0-1 Well: New Grave~ width: Number of lines: I D~stance between lines: Classitication (Private, A, Bo C): Total Depth: Cased to: Total a,'-.;-c,~i~on area: P~pe I~tatenal: Private 164' 164' 1,050 ~,, ASTM 3034 PVC Driller: Date Ddlled: Static Water Level: Installer; Date Installed: Denali Drilling 101612003 139' Owner Installed 9/6-7/2003 Yietd: I Pump Set at: I Casing I- sight Above Ground: SEPARATION DISTANCES [] Septic [] Holding [] S.T.E.P. [] Other:  Septic Absorption Eft Holding =ublic/Pdvate Manulaclurer; Tank Field Station Tank SewerUne Greer Tank 1,250 ua,ohs: Material: Number of Compartments: w~l >100' >100' N/A N/A >25' Steel Two (2) STATION NONE ON LOT Curtain Drain None Noted. /~ PumpMake&Medel Electncallnspectionsperformedby:. Remarks: BENCH MARK Locabon anti l..)escnption: Top of Block Wall at Northwest Building Corner. 89.0 Engineer's Stamp Inspections performed by:..John G. Rlees, P.E. Dates: 1st 9/6/2003' 2nd 9/7/2003 ~~.....~ Department of Health and Human Servicqs approval Permit Number; SW020468 Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street. Anchorage, AK. 99519-6655- 343-7904 On-Site Wastewater Disposal System or Well Inspection Report Page 2 of 3 PID No. 020-424-08 / / / , / / / litter Tee 51 7.1 20.4 15.2 ~28.2 32.3 I t 6.9 ~"~l 29.4 136.3 49.7 158.8 / / / / / / / C4' ! / ! / / / Four Bedroom Home 30' \ \ PLAN AS-BUILT SCALE 1' = 30' Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On-Site Wastewater Disposal System or Well Inspection Report Permit Number: SW020468 Page 3 of 3 PID No. 020.424-08 , 86.6 ~83.6 · 76.C / 75' Fc~brlc. Rock 89,7 (NTS) 70.0 PROFILE AS-BUILT Scale: 1" = 10' FROM :'ALPINE DRILLING FAX' NO. : 907 345 0202 Feb. 02 2004 Municipality of Anchoraee · Department of Health and Human Service~" 825 'L' Street RickMystmm P.O. Box 196650 Anchorage. Alaska 99519-6650 Mayor http J/w'wN.c{.an ¢horage.ak.us 03:10PM P1 Permit Number: #SW .020..468 Date of Issue: ..1~-26-02 Date Started: .10-5-03 Da~e Completed: t0-6-03 l.~al Descdpfion: Property O~nner Name & Address: Borehole Data: Soft Type, Thickness & Water Strata stick-up silt gravelly silt silly cobbly gravel gravelly silt silt silty sandy gravel & water sandy silt gravelly silt silly water sand & gravel Parcel Identification Number: 020-424-08 Is well located at approved permit location7 [~' Yes [] No Paradise Valley BIk2 it~ 1~ Sergio & Karl Guidea NHN France. Circle Alaska 99516 Depth (fi) Method of Drilling [~ air rotary From To Casing type: stee____l 0 2 Wail Thickness:,250 inches 2. 5 Diameter:. _6 inches Depth: .~64 feet 5 27 Liner Type:, 27 51 Diameter:., inches Depth:, fcct Casing sti~kup above ground: _2 feet 51 99 99 104 Static water level (from ground level): .~39 feet Pumping level: 164 feet afirer t04 107 _2 hours pumping _5 gpm 107 121 Recovery Rate: _5 gpm 121 160 Mefliod of Testing: .airlift I60 164 Well Intake Openi"g Type: -- [] Open End [-1 Open Hole [] Screened Start. feet Stopped feet [] Perforations Start. feet Stopped, feet Grout Type: bentonite ~ 8 Depth: 5~an_O feet Pump: Intake Depth~ feet size hp Brand Name 12] cable tool Volume: ~ Stopped ? feet Well Disinfected Upon Completion? [5(] Yes [-] No Method of Disinfection: Comments: Well Driller;. Alpine DE/ling & Enterprises PO Box 1~0496 Anchorage Alaska 99511 Attention: Thc well driller shall provide a wcll log to the property owner w//hin 30 d,~.y$ of completion and the property MUNICIPALITY OF ANCHORA GE 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 I WATER SUPPLY PERMIT Initial Date Issued: Nov 26, 2002 Expiration Date: Nov 26, 2003 Permit Number: SW020468 ~L'6'~i'D~"~'EFi~ti(fh:.".PA .1:~. DISE VALi-I~Y BLK: 2 LT:_13 ~ Design Engineer: 0062 Pannone Engineering Services Owner Name: SERGIO & KARl GUIDEA Owner Address: NHN FRANCE CIRCLE ANCHORAGE, AK 99516- Parcel ID: 020-424-08 Site Address: Lot Size: 17469 SQ. FT, Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: [] Disposal Field [] Septic Tank r--] Holding Tank r'-] 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: 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 SEWER/VVELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. Permit Number SWO20~6B Property owner(s) Sergio & Kad Guedea Mailing address (1). 3301 West 70t~ Place Day phone 529-1095 Mailing address (2) Anchorage, AK Legal description (Lot, Block & Sub'd.) Lot 13, Block 2 Paradise Valley Legal description (Section, Township & Range) Lot Size ~ Zip Code 99502 / 7; 4 4; ? Acres/Sq. Ft. Number of Bedrooms 4 THIS APPLICATION IS FOR: Sewer Only Sewer and Well Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub Swimming Pool Therapy Pool [--I Well Only I-'1 I~ Water Storage I'-I I--I Jacuzzi I'-] r-] Water Softening Unit r-'l I certify that the above information is correct. I further certify that this aPiSlication is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit Fees: ._'~'.,.~'('~ Date of Payment: Receipt Number: (Rev. 12/00) Waiver Fees: Date of Payment: Receipt Number: Pannone Engineering Services~ LLC Consulting Engineers (907) 272-821~ P.O. Box 102954 Anchorage, Alaska, 995 l0 (907) 272-8218 Fax November 17, 2002 Municipality of Anchorage Development Services Department On-Site Water & Wastexvater Program 4700 S. Bragaw Street P. O. Box 196650 Anchorage, Alaska 99519 Subject: Lot 13, Block 2 Paradise Valley Well & Septic System Permit Request Gentlemen: My fu'm was contacted to investigate the possibility of installing a new well and septic system on the above referenced lot. The record was researched to i'md the location of the surrounding wells and septic system. Two test holes were excavated on October 10, 2002 on the lot. The soils reports and a percolation test result are attached. Ground water was monitored for seven days. No bedrock or ground water was encountered in the test hole. The proposed upgrade and reserve area are located greater than 100 feet from any surface water. The lot is approximately ~ square feet in size. Lot 13 slopes to the south and west at approximately 6 percent in the area of the test holes. The proposed system will be located on the northeastern portion of the lot. The lot ~vill be served by a private well. The proposed upgrade is greater than 100 feet away from proposed and neighboring wells and 25 feet from the proposed water se~ice lines. The surrounding wells are located greater than 100 feet from the proposed installation. The proposed installation will not affect the future development of the surrounding or existing lots. See the attached design. If you have any questions or concerns, please contact me at 227-3522 or 272-8218. Sincerely, '~'t~even R. Pannone, P.E. Civil Engineer Attachments: C:\Work\ Letters\ 13-2Paradise valley.001.doc PERMIT ND, SW08 EXIST'G !! DESIGN DRAWING WASTEWATER DISPOSAL SYSTEM LOT 13, BLOCK 8 PARADISE VALLEY S/D ,, LDT UNDEVI -, //-~ ,, n WELLS \ 1',,4 P.I.I), ND, // ND WE SEPTIC DR LDT //-ND WELLS FIELD TD > / / / / / P --D Fx7'Ex3'W, RY FIELD TD LDT //-ND WELLS EI~ / / LOT UNDEVE //-ND WELLS DR EXIST'G WELL DESIGN' !8 EXIST'G SEPTIC 19 PREPARED FOR, Ser91o & Karl Oueclea 3301 Wesi: 70th PLace Anchoroge0 AK 99508 589-1095 349-6156 PERC RATE= 88 MIN/I~CH 850 SF/BR, 4 BR HOUSE I000 SF REQUIRED DEEP TRENCH SYS, 7.0' EFF. 75 LFx 7'EFTV, 10' TI]TAL DEPTH TOTAL AREA=lO50 SF 18509 SEPTIC TANK PANNDNE ENG. S:VC, LLC P. O. BOX 108954 ANCHORAGE, ALASKA 99510 227-3522 P, 272-8218 Fax DATE, 11-10-02 I DESIGN SCALE, 1'=60' I PERMIT NO, SW02 DESIGN DRA /ING DETAILS ~/ASTE~/ATER ABSORPTION SYSTEM LOT 13, BLOCK 2 PARADISE VALLEY S/D NOTE, 1) ALLWDRK SHALL DE PERFORMED IN ACCORDANCE WITH, & ALL METERIALS SHALL CONFORM TD AMC15,65, 2) SEE GENERAL NOTES ON SHEET 1. 3) lan l~f]'13 m f. P.I.D. ND, ]~AI ~I]IINON Z 1RD N¥393 1~] NV393 NOI/V~NAOJ P~nnone Eng. Svc., LLC P. D. BOX 102954 ANCHORAGE, ALASKA 99510 272-82187 PHONE 8, FAX DATE' 11-17-02 NOT TO SCALE RECORD PANNONE ENGINEERING S~C~ P.O. ~X 1~ ~O~GE~ ~ (~ ~7~S ~ DESCRIP~ON: T~STHOL~ 1 ~H Lot 13, Bloc 2 Paradise Vsll,~, 8/D > / / / / J / WAB GROUND WATI~ No I~ YES~ AT WHAT DKPTHP -0- DI~H TO WATER ~ MON1TORINO? -DI~- DATE: 11-902 TlmT HOU~ I I p~14 I 30 i~, 5/8' 3 3/~' 444 30 2 11/16 3 5/16' · 3 2 5/8 3 3/8' PEROI~TION RATE ~8 ~mlnll._~} ~ HOLE DIAMETER 6 inches TESTRUN ~ 6 FT and 7 FT PERFORMED BY: 8teven R. l~-fl--% P.E. I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL OUIDI/NES IN EFFECT ON THE DATE OF THIS TEST. LEGAL DESCRIFIION: OR SM/aM PANNONE ENGINEERING SERVICES P.O. BOX 102954 ANCHORAGE, AK 99510 { o7} 8ergio & Karl Ouedea Lot 13~ Bloc DATE PEIli~I~iED:. 10-.10-02 / / / / WA8 GROUND WATER ENCOUNTRRED? No IF YE8, AT V,~'IAT DH:PI'H? -O- DEIUTH TO WATER AFl'ER MoNrro~NO? DATE: 11-9-0~ PEROLATION RATE TE~T~~ 6 ~ 7 PT PERFO~ BY: 8tev~ R. l:~nnm~?-, P.E. I CRIk'IIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST. • • GE po • Municipality of Anchorage P .,` -` On-Site Water and Wastewater Program s ` (907) 343-7904 0SA 0, 1 ETA CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 020-424-08 Expiration Date: l ~ I ay 1. GENERAL INFORMATION Complete legal description PARADISE VALLEY BLOCK 2, LOT 13 Location (site address) 18640 FRANCE CIRCLE,ANCHORAGE,AK 99516 Current Property owner(s) DAVID F&ELISE B TWYMAN Day phone Mailing address 18640 FRANCE CIRCLE, ANCHORAGE,AK 99516 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 TYPE OF WASTEWATER DISPOSAL: 4. TYPE OF WATER SUPPLY: Individual Individual Well ® Holding Tank ❑ Individual Water Storage ❑ Community ❑ Community Class_Well ❑ Public Sewer ❑ Public Water System ❑ WaiverNariance request for: Distance: Received by: ,&4' /1sted i� Date: 4/. ./( COSA to be released to the engineer,unless othe r� by the engineer. COSA Fee $ 524 Waiver Fee $ Date of Payment 15/ 5712 Date of Payment Receipt NumberD Receipt Number COSA# 05C t 12A 5- Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ARCTERRA CONSULTING,INC. Phone 868-3791 Address 20441 PTARMIGAN BLVD.,EAGLE RIVER,AK 99577 Engineer's Printed Name KENNETH M.DUFFUS Date 4/24/2018 THIS COSA DOCUMENT CANNOT BE USED TO TRANSFER TITLE UNLESS ALL VENDORS(ENGINEERING,SURVEYING,CONTRACTORS,ETC...ASSOCIATED WITH THIS COSA ARE PAID IN FULL AT OR BEFORE CLOSING. 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 and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the 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 -a.- encroachments, encroachments,deficiencies or discrepancies exist. '41 �� OF AL r ,r 4,9TH // . . 0 6. DSD SIGNATURE / /- - =�! \c System #1 Approved for LI bedrooms. 0" ,..,..'EJ mac, KENt ET MB D I,i v System #2 Approved for bedrooms. °r' Ai FR lie"/ /0 o Disapproved. \ Plob-Essi00`• A. Conditional approval for bedrooms, with the following stipulations: ( Oi4` ,\` 'G �� •ti G� O*-S11ED 0 P1-) WA TGA�ERo� OGS (17 -`i c K / By: ----------7 'L......--- / Original Certificate Date: b- ---1 't The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheel_10-10-12.doc If more than 1 septic system is on the lot: COSA Checklist# of_ Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: PARADISE VALLEY BLOCK 2, LOT 13 Parcel ID: 020.424.08 A. WELL DATA Well type PRVT If A, B, or C provide PWSID# Well Log (Y/N) Y Date completed 10/6/2003 Sanitary seal (Y/N)Y Wires properly protected (Y/N) Y Total depth 164 ft. Cased to 164 ft. Casing height(above ground) 24+ in. FROM WELL LOG AT INSPECTION Date of test 1016/03 4.18-2018 Static water level 139 ft. 137 ft. Well production 5 g.p.m. 4.6 g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 mL Nitrate 2.109 mg/L Arsenic: ND ug/L Date of sample: (oI��- 1$ Collected by: ARCTERRA B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 917/2003 Tank size 1250 gal. Number of Compartments 2 Cleanouts(Y/N) Y Foundation cleanout(Y/N) Y Depression over tank(Y/N) N High water alarm (Y/N) N Date of pumping 4/1812018Pumper ISAACS C. ABSORPTION FIELD DATA Date installed 9/7/2003 Soil rating (g.p.d./ft2 or ft2/bdrm) 0.6 System type DEEP TRENCH Length 75 ft. Width 3 ft. Gravel below pipe 7 ft. Total depth 10.5 ft. (Measured 4/18/18) Eff. absorption area 1050 ft2 Monitoring tube Y Depression over field N Date of adequacy test 4-18-2018 Results(Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 28 in. Water added 700 gal. New depth 42 in. Elapsed Time: 1410 min. Final fluid depth 27 in. Absorption rate >=600 g.p.d. Any rejuvenation treatment(past 12 mo.) (Y/N &type) N If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access(Y/N) "Pump on" level at in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main 75'+ Public sewer manhole/cleanout 100'+ Sewer/septic service line 25'+ Holding tank 100'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 10'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water Service line 10'+ Surface water 100'+ Driveway,parking/vehicle storage 10'+ Curtain drain 50'+(NONE KNOWN) Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. i� OF AL Engineer's Printed Name KENNETH M.DUFFUS 1 * # Date 4/24/2018 * A,9 TL APP"W41.1Or -411W" COSA canary sheet_2-6-15.doc % KENNETH M. lr / 7 8 / 47 phOOEss1oroti ..� Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage. AK 99519-6650 www,muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 0Z 0" I'~"~'0~ 1. GENERAL INFORMATION cos^# Expiration Date: I I - P- 5'- CO .. Complete legal description Location (site address) Current Property owner(s) · Mailing address Lending agency PARADISE VALLEY BLOCK 2, LOT 13 18640 FRANCE CIR. *ANCHORAGE~ AK 99516 TED KUNEWA Day phone 18640 FRANCE CIR. *ANCHORAGE~ AK 99516 Day phone 351-1593 Mailing address Real Estate Agent Mailing address LAYNE GUNTER W/ KELLER WILLIAMS Dayphone 225-B583 101 W. BENSON BLVD SUITE 503 *ANCHORAGEf AK 99505 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site ~ Individual Holding tank Community On-site [~] Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs ~pon request to homeowners. Certificates of On-Site Systems Approval are valid for 90 days from the date of issue for properties served by a pdvate or Class C well and may be reissued with new water samples. (Certificates may be reissued for a pedod of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or waslewater 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 Engineer's Comments: In conducting this evaluation, GEG. LtD. attempted to previde a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidefines & Regulations. The repotted results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate durfng the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encreachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE J~/' Approved for bedrooms. Disapproved. Conditional approval for __ ~,~,:'k'~Y OF ," ~,., ,,~'.~)Y" . · ..... .. ~; ON-SITE ~ WATERAND : ~ : WASTEWATER bedrooms, with lhe fllowing stipulations~ ~ PROG~M Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: (Re~, 11/05) Municipality of Ancho. rage Development Services Department Building Safety Division On-S~te Water & Wast*water Program 4700 Bragaw Street P.O, Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-79CH CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Descdption: PARADISE VALLEY; BLOCK 2, LOT 1`3 Parcel A. WELL DATA Well type PR~VAT~ IfA, B, or C provide PWSlD# N/A ~ Well Log (Y/N) YES Date completed 10/6/0.3 Sanitary seal (Y/N) YES Wires'properly protected (Y/N) YES Total depth 164 ff. Cased to 164 ft. Casing height (above ground) 18+ in. FROM WELL LOG AT INSPECTION ~ Date of test 10/6/O3 8/3/09 : Static water level 139 ff. 135 ft. Well production 5 g,p.m. 5.21 g.p.m. WATER SAMPLE RESULTS: Coliform 0 , colonies/100 mi. Nitrate ~.82 mg./L, Other bacteria 0 colonies/100 mi. Arsenic: ND ug./L, Date of sample: 7/22/09 Collected by: 0EG Ltd, CJ SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Tanksize 1250 gal. Number of Compartments 2 Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO Date of pumping 7/31/2009 Pumper ABSORPTION FIELD DATA Date installed 9/6-7/03 Length 75 ft. ~*~ELOW EXISTING GRADEl Soil rating (g,p.d.lft=o~ Width 3 ft. Date installed 9/6-7/03 Cleanouts (Y/N) YES High water"alarm (Y/N) A+ HOME SERVICES System type. TRENCH Grave! below pipe 7 ft. Depression over field NO For 4 bedrooms Newdepth 29 in, ,gp.d, Totaldepth '10.58 ft. Eft. absorption area 1050 ft~ Monitoring tube**YES Date of adequacy test 8/3/09 Results (Pass/Fail) PASS Fluid depth in absorption field before test 15 i in. Water added 655 gal. Elapsed Time: 1010min. Finalfluid.depth 15 .in. Absorption rate>= Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN **NEW STEEL MONITORING TUBE 600+ If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access ~ ~ 'Pump on" level at In, "Pump off" lev~-~----~igh water alarm level at In. ~ Cycles tested Meets alarm & circuit requirements? Ee SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot 100'+ Public sewer main N/A Sewer/septic service line 25'+ Animal containment areas. 50'+ 100'+ On adjacent lots 100'+ On adjacent lots 100;+~ Public sewer manhole/cleanout N/A Holding tank N/A Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Water main N,/A Water service line. 10'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Water service line 10'+ Curtain drain NONE KNOWN Building foundation 10'+ Surface water 100'+ Wells on adjacent lots, 100'+ Absorption field 5'+ Surface water 1'00'+ Water main N/A Driveway, parking/vehicle storage 10'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name JEFFREY A. CARNESS Date COSA Fee $ ~ ~ Date of Payment Receipt Number (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number, PLAT NO. 87-16 PARADISE VALLEY SUBDIVISION LOT 13, BLOCK 2 17,469 S.F. 1"=20' / / / / / / / / / / / / / SEPTIC SYSTEM EXISTING BUILDING AS-BU I LT CASTALDI LAND SURVEYING, LLC JEFF A. GAST~I, R.L.S. '.ooo F.., DOWlJNG RO., SUITE 8 ANCHORAGE, ALASKA 99507 PHONE 248-5454 GRID DA'n[ ~5~8 8/11/2o09 F.B, JOE) HO. 05-20 PV5132 CERTIFY THAT I HAVE SUR~ THE -- ' DEPICTED ABOVE AND ll~AT NO ENCROACHMENTS EXIST EXCg~ AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO 4E THE EXISTENCE OF ANY F_..~SE]~IENTS OR RESTRICTIONS ~ICH DO NOT ON THE RECORDED SUBOMSION PLAT. CIRCUMSTANCES SHOULD ANY DATA BE USED FOR CONSIRUCllON OR FOR SHING BOUNDARY OR FENCE UNES. ANCHORAGE RECORDING DISIRICTo ALASKA NOTE'. NO CORNERS SET THIS DATE. 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 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 020-424;08 HAA# Expiration Date: GENERAL INFORMATION Complete legal description Lot 13, Block 2, Paradise Valley Subdivision Location (site address o~' directions) 'FY'ance Circle Current Property owner(s) Mailing address Lending agency Merit Homes P.O. Box 111982 Anchora.qe, AK 99511 Day phone 301.6280 Day phone. Mailing address Real Estate Ageht · .' "' Mailing Address Unless ofherwise requesfedl HAA will be held by DSD for pickup. NUMBER OF BEDROOMS: TYPE ·OF WATER SUPPLY: Individual Well .Individual Water Storage Community Class ~ Public Water System Four (4) Well Day phone TYPE OF WASTEWATER DISPOSAL: [] Individual On-site [] [] Individual Holding tank r"l [] · ' Community On-site r-'i [] Public Sewer ~ The Municipality of Anchorage Development Services Depadment (DSD) Issues Certificates o~ Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Cedificates of Health Authority Approval are required for the transfer of title (except between spouses) for propedies served by a single family on-site wastewater disposal and/or water supply system. DSD.also issues HAAs upon request to homeowners. Cedificates of Health Authority Approval are · valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Cedificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. :, !l ~Sanita~y seal :" ,ICased to :16,