The URL can be used to link to this page

Home My WebLink AboutGLENN VIEW ESTATES NORTH BLK 1 LT 18Glennview Estates North Block 1 Lot 18 #051-811-46 O 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 www.cLanchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: sw-030457 PID Number: 051-811-46 Name: Sudsbury & Son Wastewater System: [] New [] Upgrade ~dress: 10928 Eagle River Rd. Ste 122 ABSORPTION FIELD Phone: 696-1610 NumberofBedrooms: 4 m DeepTrench [] Shallow Trench r~Bed [~Mound [~]Other. Soil Rating: Total Depth from original grade: LEGAL DESCRIPTION 0.45 o.D/~t' 12 Ft. Block: Lot: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe: 2 18 Glenn View Est. North 2..4 Ft. 8 Ft. Township: Range: Section: Fill added above odginal grade: Gravel Length: 1-2 Ft. 85 Gravel wldth: Number of lines: Distance between lines: Well: [] New [] Upg 3 Fl. I -- Classil~cation (Private. A. B, C): Total Dep~:_~,..,,,,~ Cased to: Total absorphon area: Pipe Material: ~ Ft. Ft. 1360 F~ D3034/F-810 Ddller. ~ "~ate Drilled. Static Water Level: FI. Installer;. Sudsbury ~ Son Date Installed: 11/5-6/03 ~ GpMI PumpSetat:Ft. Casing Height Above Gmund:FL TANK SEPARATION DISTANCES []Septic [] Holding [] S.T.E.P. [] Other: T~__~o Septic Absorption Lift Holding ~ublicJPdvate danufacturer. Capacity: Tank Field Station Tank Sewer Une Anchorage Tank 1250 Gat. Malarial: Number of Compartments: we, 200+ 200+ ............ 25+ Steel 2 Surfac' Wata'Lo, U,e 5+100+ 5+100+ ............ ...........~~ / S,,.,: Oa~.~anula~u'or:LIFT STATION 'Pump on' level at; 'Pump off" leVI H,gh water atan"n al: Foundation 5+ 10+ ' ' .... ~n. ~ in.I in. "~lecldcal Inspections performed by: Curtain Drain Rereads: BENCH MARK Foundation 100 -?.... Inspections performed by: Alaska Rim Engineering,lnc Dates: Ist 11/5/03 ~_ '.. -nl~,.~ ~..J~/_ ..... 2nd 11/6/03 · Developme. p..t Services D~epart. l:qen, t ~pproval. ~ .,..f_.,~. - Reviewed and approved by: Date: {I".".)',~',' ·. "' .. '.'~'~ PERMIT NUMBER S~/030457 PI]) NUMBER 051-811-46 METER UTILITY SHADOWY SPRUCE DR. NAT'L GAl 1250 STEEL S[P"nC DECK RECOVEREDk ,/8-.~e,.- BLOCK (~ CAP w/YELLOW ~ ----- '~TRAN PAD · 0 / )94 :R /~... / PO.E COVERED ~ECK 64"+ TWO STORY 30' EXCLUSION NOTE: IT IS THE RESPONSIBILITY OF THE OWNER OR BUILDER, PRIOR TO CONSTRUCTION, TO VERIFY PROPOSED BUILDING GRADE RELATIVE TO FINISHED GRADE AND UTILITIES CONNECTIONS, AND TO DETERMINE THE EXISTENCE OF ANY .EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. PLAN ,A~"4$K~ P.O. BOX 2749 SITE ~-.. ,mr,vt PALMER, ALASKA 99645 ENC~~C. PHONE: (907)745-0222 I FAX: (907)746-0222 W.O. 03010581DATE: 4/19/04 ISCALE: 1"= 60' I FILE: 0.~0~058 LOT 18, BLOCK 1, GLENN VIEW ESTATES NORTH, PLAT No. 2003-42, ANCHORAGE RECORDING DISTRICT, ANCHORAGE, AK EASEMENTS OF RECORD OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. SHEET 1 OF 3 PERMIT NUMBER S~/030457 PID NUMBER 051-811-46 MT2 REPLA( SYSTEM LOT 1 1250 STEEL SEPTIC TSTH NAT'L' MT1 :or WOOD TH1 DECK ,B CANT. TYP. SEPTIC SYSTEM PLOT PLAN 'A' 'B' FNDCO 32.5 18.6 T1 38.7 26.4 T2 40.7 28.8 DBLCO 44.9 53.2 C01 49.3 38.7 MT1 51.3 41.8 C02 123.6 125.2 MT2 124 126 ALL DIMENSIONS IN FEET Dattun ~lev. / F. G, 99.25 /_capped / I eeptlc ~, \ [ abeo~on / ~et ~. 95.7 ~ O~et ~ev. 95.5 SEPTIC SYSTEM PROFILE SEPTIC ~ASK~ P.O. BOX 2749 '-., ~z~, ~ PALMER, ALASKA 99645 ENOCh. PHONE: (907)745-0222 FAX: (907)746-0222 W.O. 03010581DATE: 4,/19/04 ISCALE: 1"= 40' I FILE: 030~058 LOT 18, BLOCK 1, GLENN VIEW ESTATES NORTH, PLAT No. 2003-42, ANCHORAGE RECORDING BISTRICT, ANCHORAGE, AK EASEMENTS OF RECORD OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. SHEET 2 OF 3 PERMIT NUMBER $~/030457 PID NUMBER 051-811-46 ~ monitor tuba perforated 4' PVC ~ tee Note 1 ~ to~; -. x / ' solid 4' ABS. DIP,---~ or ~'C -~ch. 40! at .en.d of trench ~ 85' ± Nora 1: Inst~li all ~erforated PVC laval (~lthin 0.0i foot of came elevation) WIDE DRAINFIELD PLAN VIEW perforated hole ortentet~on (holes down) SECTION X-X TRENCH DETAIL Note 2: Place I minimum of 4-feet of ea.,~h cover or eq~iyulent) o~er ~bso~on ~enc~ ch of Ve~e~ ~o~ ~' (or sq.) may be ~b~tu~ for one f~t of e~ cover up ~ a m~ of two ~ches Note 3: ~ excava~on sh~ be no more 10 feet. Note 4: Not ~' ,4~ .. ........ ~4 ~' 49TH~'~ ~ .... ~. Chod~ A. L~et / ELEV. 99.25' ,~r?und surface .] L~v. 95.25' , undisturbed earth groundwater rmeablc leycl effective depth ELEV. 87.25' ELEV. ~ END TH TRENCH SECTION r emo~eable cap / non-perforated ~'C &bc~e eouplinf 4' PVC perforated · 6' interyalc in sewer rock MONITOR TUBE DETAIL SITE PLAN ¢4~"45z¢~ P.O. BOX 2749 '"-, /~/~ ~ PALMER, ALASKA 99645 ENG~IVC. PHONE: (907)745-0222 I FA×: (907)746'0222 W.O. 0301058]DATE: 4/19/04 [SCALE: nfs ]FILE: 0301058 LOT ~8, BLOCK ~, GLENN VIEW ESTATES NORTH, 'PLAT No. 2003-42, ANCHORAGE RECORDING DISTRICT, ANCHORAGE, AK EASEMENTS OF RECORD OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. SIgF. F.T 3 OF 3 MUNICIPALITY OF ANCHORAGE Deve/opment 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 Initial Date Issued: Oct 24, 2003 Expiration Date: Oct 23, 2004 Permit Number: SW030457 Parcel ID: 051-811-46 Legal Description: LGLENN VIEW ESTATES'-N'0-1~,~"I~'~(~CK 1 LOT 18 Design Engineer: 083~~m Engineering Site Address: NHN SHADOWY SPRUCE DRIVE Owner Name: SUDSBURY & SON Lot Size: 40093 SQ. FT. Owner Address: 10928 EAGLE RIVER ROAD #122 Total Bedrooms: 4 Permit Bedrooms: 4 EAGLE RIVER, A 99577- This permit is for the construction of: [] Disposal Field [] SepticTank Holding Tank [~ Privy r-] 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: 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. muni.org/onsite (907) 343-7904 ON-SITE SEWER/VVELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. O,,5"~-~/! --"~ Property owner(s)~(J ~{OUr'q Mailing address (1) ~, ~(2:)~*L¢::~ Mailing address (2) Permit Number ,SWO,~::::) Day phone~8'7 - (::P,~- [6 t6 Zip Code Legal description (Lot, Block & Sub'd.) L' i~, '~ \ ~ [~,VtVl'~ "~o~'t-'~-'l' ~ Legal description (Section, Township & Range) ~,~..~'~)1/ V/£~/ ~.,~ 7'~t7'E$/V~/~'/¢ Lot Size '~,O~ ::t.- Acres~'~.~ Number of Bedrooms ~ THIS APPLICATION IS FOR: Sewer Only ~ Well Only Sewer and Well [] Water Storage Sewer Upgrade [] THIS PROPERTY CONTAINS: Hot Tub [] Jacuzzi Swimming Pool [] Water Softening Unit Therapy Pool [] 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 ~f Property ow'i~eer or/ut~oorized agent) I Permit Fees: Date of Payment: Receipt Number: (Rev, 12/00) Waiver Fees: Date of Payment: Receipt Number: Phone (907) 745-0222 Fax (907) 746-0222 akrim @ rogershsa.com P.O. Box 2749 Palmer, Alaska 99645 October 14, 2003 Mr. Dan Roth Municipality of Anchorage Development Service Department Anchorage, AK 99519 RE: Lot lg, Block 1 Glenn Vi[w North Estates Subject: Permit Request - Design Narrative Dear Mr. Roth: The owner of the above r~ferenced lot is proposing a four-bedroom singly family residence. We are requesting a plan review and a permit to install a septic system to serve the proposed development. Soils A test hole was excavated and a percolation test performed by Alaska Rim Engineerin. g, Inc. on September 30, 2003. The approximate location of the test hole is located on the attached site plan and is identified as AKTHI. The soils were visually rate SM-ML. The percOlation test was washed due to heavy rains. The monitoring tube was checked, groundwater was observed in the monitoring tube. An additional test hole was excavated and a percolation test performed by Alaska Rim Engineering, Inc. on October 11, 2003. The approximate location of the test hole is located on the attached site plan and is identified as AKTH2. The soils were visually rate SM-ML The percolation test indicates the use of an application rate of 0.45 gal/day/sft. On October . 14, 2003, the monitoring tube was checked, groundwater was also observed in the monitoring tube. This confirms the previous ground water monitoring results. The developers engineer performed a soils investigation on January 12, 2002. The approximate location of the test hole is located on the attached site plan and is identified as TSTH. The soils were classified as silty sand (ML) with a perk rate of 5.5 min/inch and no groundwater at 12 feet. Engineers , Planners · Surveyors Lot 18, Block 1 Glenn View North Estates Permit Request - Design Narrative 10/14/03 Page 2 of 2 Topography The area around the septic field is basically flat with drainage to the north. Trench Design The dwelling proposed is a four-bedroom, with an estimated daily wastewater flow rate of 600 gallons per day. The wastewater application rate from the perk test is 0.45 gal/day/sft. The required absorption area is 1,333 square feet. Proposed is a deep trench with an effective depth of 8-feet and a length of 85 feet. Enclosed are drawings of the proposed system. Surrounding Properties There is no water wells within 200 feet of the proposed septic system. This property and its parent subdivision, Glen View North Estate is served by a community water system. Surface Waters There is no surface water within 100 feet of the proposed upgrades. We do not anticipate any adverse effects on the neighboring, septic systems, reserve areas or drainage patterns by the installation of the proposed septic system. Sincerely, Alaska Rim Engineering, Inc. Project Engineer Encl: Permit Application Permit fees Soil Log - Percolation Test (3) Site Plan (3) Cc: Client AK Rim File # 03-01058 LOT 6 VACANT LOT 5 UNDER CONSTRUCTION NO ~LL VACANT AK'TH2 RECOVERED REBAR 100.71 123. 20' BLDG. PAD POWER LOT 18 40,093 S.F. OSED DWELUNG SEIBACX S89'58'04"W 249.87'(R&:C) LOT 17 BLOCK 2 VACANT EXCLUSION NOTE: IT IS THE RESPONSIBILITY OF' THE OWNER OR BUILDER, PRIOR TO CONSTRUCTION, TO VERIFY PROPOSED BUILDING GRADE RELATIVE TO FINISHED GRADE AND UTILITIES CONNECTIONS, AND TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. SITE PLAN ~t~4SA'~ P.O. BOX 2749 '.--. ~/M', PALMER, ALASKA 99645 E~V~~-~NC' PHONE: (907)745-0222 I FAX: (907)746-0222 w.o.O.~010581DATE: 10/14/031SCALE: AS NOTEDI FILE: 0.~01058_WW LOT 18, BLOCK 1, GLENN VIEW ESTATES NORTH, PLAT No. 2003-42, ANCHORAGE RECORDING DISTRICT, ANCHORAGE, ALASKA SHEET 1 OF 3 VACA1 f 1" = 30' 2 LO TSTH DBLCO AKTH2 1: I SEPTIC TANK BLDG. SETBACK TWO DWE RECOVERED S89'58'04"W 249.87'(R&C) I'~1 /'-'//'-"1/ "-) LOT SEPTIC SYSTEM PLOT PLAN 40, 17 I= 10' mba · t I= I0' mba · ~ ~ = x 0/4' ~r ~ s~Uo ~ at of 2 pe~t (1/4' ~ SEPTIC SYSTEM Conventional Single Family Residential PROPOSED SEPTIC SYSTEM DESIGN Leo=t ~.c.~,.. LOT 18, BLOCK 1 GLENN VIEW NORTH ESTATES ~-,, RIM ~ ENG~~_~N~. P.O. BOX 2749 PALMER, ALASKA 99645 PHONE: (907)745-0222 · FAX: (907)746-0222 ~ to/14/oa Comp]eted Alaska Rim En~ineerin~, Inc. ~,. n,~ SHEET 2 OF S Not* ~ ~1~ I~rfor~ted PVC leval (~lthin O.O1 foot ot .~e elmtlon) WIDE DRAINFIELD PLAN VIEW perforated PVC lu~e orientotion (~ole, ~own) SECTION X-X ex~.h EL~V. g7.' ~ r.move·Me oap ~e~me~me /~ee Not· 2 ea~er if used ~ 6' TRENCH DETAIL '"'"'""-"-'-'"' ("'"""" I "-'"'" I I>a .ubetituted for one foot of e~'th oo~mr .'[, up to · ~-,-4mVm of two lnche, of lnmflatioz~ Note 3: ~poR from trench excavati°n to Be u~ed for cover. Note 4: ~ne maximum excavation depth fi'om ~ &,r·do .'hr, Il bo 12 feet** MONITOR TUBE TRENCH SECTION DETAIL Conventional Single Family Residential PROPOSED SEPTIC SYSTEM DESIGN Legat ~,,~o. LOT 18, BLOCK 1, GLENN VIEW NORTH ESTATES P.O. BOX 2749 PALMER, ALASKA 99645 PHONE: (907)745-0222 FAX: (907)746-0222 De sli, n 10/14/03 Completed Alaska Rim Engineering, Inc. _~.~ D,to ,~HEET 3 OF 3 Performed For: Legal Description: Municip:?lity' of Anchorage Devel°pr~;~[· Services Department 8u~dlng Safety Oivls[on On-Site Water and Wastewater Program 4700 South Rragaw SL P.O. Box 196650 Anchorage. AK 99519-6650 www.ci.a nchoraqe.ak.us (g07) 343-7904 Soils Log - Percolation Test ~'/-~'N VIE ~5' ~ u'L--r~ $ I~ Slope 0 3- u-'-/roc.~ ~ 5. 6- 7- ~ ~ 9- ~3- ~o~o ~ o ~ ~4. 15. 16. 17- 18- 19- 20- COMMENTS _,,...,~ ... .. '''.~...' '-,~.,'] .[',.~"' [:;,.'(ENGINEE.R.~.S'SEA'L)' ~ . ." '-:: "~..: ',~ '%'v" '..,.~ · .... · ....... -\ ; 5 ":' ',' ..;': .'"'"" ~ "' % . '" ~..~ ,', . '.~ ...,... ..~, · ~-. ,, ~o _.-.....{:.':~ ~ .' · .% , ,.t~. ,~ ...:.. ~, .... . . ,:, ¥.-,_-,..-.,...~"~ .~, . Township, Rangel Section: Site Plan WAS GROUND WATER ENCOUNTERED? H D S IF YES. AT WHAT DEPTH? L o Depth to Water A~ler p Monitoring? d'r'~ E Reading Date · Gross Time Net Time Depth lo Water Nel Dfc= t/:lo "~o ~Z° I I i PERCOLATION RATE ,~'. ~ (mind,cuing) PERC HOLE OIAMETER ~:) TEST RUN BEI%'VEEN ~ FT ANO H FT PERFORMED BY: ¢'~"..._.~ J ~ "~ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: I/2.~/C) Z- /: 13 I I SQ.II. I I PERC, I t'*)Tl"l- 1.1 RATE I-'~ ___ / / \ / { / \ %/ ~ ~ ~ERC. ~ ~ "!.':'.' '". / /- _ ~.:~_..~ ---- '"1' MunicipaliW of Anchorage Development Se~ices Depa~ment On-Site Water and Wastewater Program 4700 South Bmgaw St. P.O. Box 196650 Anchorage, AK 99519~650 Soils Log - Percolation Test Date Legal Description: . ~ ~, ~~ ~ Township, Range, Se~ion: 2- 3- 4- 6- 7- 8- 9- 10- 11- 12- Slope Site Plan WAS GROUND WATER ENCOUNTERED? $ IF ~tES, AT WHAT DEPTH? I. Depth to Water After , O P Monlto~ng? E Date: 14- 15- 16- 18- 20- COMMENTS Reading Date Gross Time Net T~e Depth to Water Net Drop -E7 PERCOLATION RATE [~;~3 Imlnutes/'~_.h) PERC HOLE DIAMETER TEST RUN BETWEEN ~" FT AND. (~ FT PERFORMED BY: I~---~rt~-, L-~ CERTIFY THAT THIS ,TE~S.T AS. PERFORMED IN ACCORDANCE WITH ALL STATE AND . MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: [~)(ll ~V~..~ Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 South Bmgaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchoraqe.ak.us (907) 343-7904 Soils Log - Percolation Test Performed For: ~::~, , t.., U~ (~1 ~,.~.ft~ Date Performed: LegalDescription: _'L.t~:) '1~! ~ I~vl~V;~__j~j~-~, Township, Range, Section: Slope Site Plan l, 10- 11- 12- 13- 14- 15- 16- 17- 18- 20- COMMENTS WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? L Depth to Water After O Monitoring? E Oa,e:f l,,lo Reading Dale Gross Time Net Time Depth to Water Net Drop ., PERCOLATION RATE (minutes/mc.h) TEST RUN BETVVEEN FT AND ,-JJ ,..J PERC HOLE DIAMETER FT PERFORMED BY: ~¢_.j3 ~~_-- I ~ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDAI~CE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: Parcel I.D. GENERAL INFORMATION . ~.'5'/,,/¢, I O?J~, 1t1'31,4 Complete ]legal des. cription Lot 18.-Biod~j. Glenn View Estate North L°cation (sit6a~Jdressor. directions) '~.--E ~"l ~,~x.. (~(~OWL,J Current Properly owner(s) Sudsbu~ & Sons Mailing address ' ~ ~ 7 ~ ~., ~ ~ Lending agen~ 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. muni.org/onsite (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Expiration Date: Day phone 696-1610 IZA. qq Day phone Mailing address Real Estate Agent Day phone Mailing Address Un/ess otherwise requested, HAA wi//be held by DSD for pickup. 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 Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or wate'r supply system. DSD also issues HAAs upon request to homeowners.~Certificates 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 sarfiple .results. (Certificates may be reissued [or a period 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. 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 Health Authority 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 Ar~chorage 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 Alaska Rim Engineering, Inc.. Address P.O. Box 2749; Palmer, AK 99645 Engineer's Printed Name Charles A. Leet, P.E. DSD SIGNATURE ,~' . Approved for 4 Disapproved; . ~ Conditional approval for bedroOms.. Phone 907-745-0222 Date 4~5~04 .. bedrooms, with the following stipulations: Additional Comments Attachments: · HAA Checklist Septic System Advisory Well FloW Advisory ! X .~ ,' : ..~_',.'~ AND * ' - ~)))))))H. . Maintenance Agreements . : ' .'· - Supplemental Engineer's R~Po~ ~ " .. Other " .~ - Original Certific.ate Date: '~/2' ~/(~)z~ (Rev. 01/02) Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.orglonsite (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST ! lz]loq Legal Description: Lot 18,-B~c-'k-~, Glenn View Estates North Parcel ID: 051-811-46 ;A. WELL DATA Co Well type Date completed Total depth ft. Date of test Static water level Well production . ~ ..Cefll~m colonies/100 mi. Arsenic: mg./I. SEPTIC/HOLDING TANK DATA Tank Typ~/Material Anchorage Tank Steel 'Tank size .1.250 . .gal. F6undati0n'cl'~nout (Y/N) Y Date of PumPing New .. ABSORPTION FIELD DATA If A, B, or C provide PWSID # Well Log (Y/N). Sanitary seal (Y/N) Wires prop Cased to ft. Casin~:~'~ht (above ground)' ft' g.p.m, g.p.m. cotonies/~O0 Nitrate __ mg./I. Date of sample: Number of Compartments 2 Depression over tank (Y/N) N "Pumper Other bacteria Collected by: Date installed 11/5-6/03 Cleanouts (Y/N) Y High water alarm (Y/N) NA Date installed 11/5-6/03 Soil rating (g.p.d./ft2 or ft=/bdrm) .45 Length 85 ft. Width 2-3 ft. Totaldepth 12 .ft. Eft. absorption area 1360 ft2 Monitoring tube Y Date of adequacy test NA Results (Pass/Fail) NA Fluid depth in absorption field before test NA in. Water added NA gal, Elapsed Time: NA min. Final fluid depth NA in. Any rejuvenation treatment (past 12 mo.) (YiN & type) NA System type Deep Trench' Gravel below pipe 8 Ii ift. Depression ov[er field N ii For 4 'bedr0'0ms Newd~pth NA! in. Absorption rate >= NA I g.p d. If yes, give date. 'I LIFT STATION · i il il ~ Date installed Size in gallons M I /Acces "Pump on" level at in. , [ · Cycles tested Meets a arm & c rcuit requirements? · E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot ..... On adjacent lots ~'~ ' ' Absorption fi'eld on 10t , , Public sewer manhole/cleanout Public sewer main ~e Holding tank i - I , · ,SEPARATION DISTANCES FROM SEPTIC/HOLDING ~I'ANK ON LOT TO: ~]:" -' Property line 5+ ] i ~ Absorption field. 58+. Building foundation. 5+ Water main '10+ Water service lirie' ,10+ S ce water 100+ Wells on adjacent lots,, NA i ~:: !i' ,D LOT, TO: SEPARATION DISTANCE~ FROM ABSORPTI?N FIEL ON Propertyline 10+ Building founi:lation lO+ · Water m in 10+ :" Water Service line lO+ 'i Surface water 100+ i Driveway, parking/vehicle s!orage Curtain drain NON KNOWN Wells on adjacent lot§ NA F. COMMENTS G; ENGINEER,S CERTiFiCATiON I certify th'"at I ha'ye determinbd through field ins, pectio'n,s, and review of Municipal records that the above systems are in conformance with MOA U.~ A g,idelines in effect on this.date. ,.., ¢~'.1 ,, , ' , i II~ :~.._.. ~ , ]:, i ' ' Engineer's Printed Name Charles A. Leet, iP.E. , Date 4/19/04 :: ~ i - ~\'~"~"~"'~'~' HAAFee $~ i,, .' .I i-I ,, walver,~-ee $ Date of Payment lJ~{'~'"~ 0 '" "' , Date 'of Payment Receipt Number ~"bC"~'t Receipt Number (Rev. 12/01) ' ~'~ ''~ [I SHADO FY SPRUCE__ _ _. 0o uJ ~.,., \ 135.B 1~ ~ ,~_.ECOV~ED LOT 19 ~2' HUB 0 0 EXCLUSION NOTE: IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY E/~SEMENTS. COVENANTS. OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED' SUBDIVISION PI~T. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE LINES. ' 'P.O. Box · '-.~, m~ ~ PALMER, .ALASKA- 99645 £A'~~NC. PHONE: (907)745-0222 FAX: (907)746-0222 F.B. 04-04 W.O. 0301058 [DATE: 4/7/04 [ SCALE: 1" =-'40' FILE: '0301058-AS I J-iEREBY CERTIFY THAT I HAVE PERFORMED A MORTGAGE. INSPECTION ON THE FOLLOWING DESCRIBED 'PROPERTY: mLOT 18,' ,BLOCK 1,' GLENN VIEW ESTATES :NORTH, ia ' PLAT' No. 2003.42, ANCHORAGE' RECORDING DISTRICT, ANCHORAGE, ALASKA EASEMENTS OF RECORD OTHER THAN THOSE SHOWN .ON,iT HE · RECORDED PLAT-ARE' NOT SHOWN HEREON. DATED "AT PALMER, ALASKA, THIS 12th DAY OF APRIL, 2004 ......