HomeMy WebLinkAboutMUIRWOOD PARK BLK 4 LT 4Muirwood P'ark
Block 4
Lot 4
#011-422-81
Certificate of On -Site Systems Approval
Parcel I.D. 011-422-81
Legal description Muirwood Park Block 4 Lot 4
Site address 7453 Park West Circle, Anchorage, Ak
Current property owner(s) Novakovich
Expiration Date: 9-6-2023
X The On-site system(s) is/are approved for 5 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or advisories:
By: Original Certificate Date:
9-22-22
This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
system(s) is/are in substantial compliance with municipal code. The Municipality of
Anchorage, Development Services Department (DSD) issues COSAs based upon
representations provided by an independent professional engineer. The Municipality of
Anchorage is not responsible for errors or omissions in the professional engineer's work.
ATTACHMENTS:
COSA Checklist X Well Flow Advisory
Absorption Field Advisory Nitrate Advisory
Tank Age Advisory Arsenic Advisory
Other
COSA Approval_June 2022
MMMUFUTY OF ° HC HORAGEE
'g �
Development Services Department t Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 011-422-81
Complete legal description MUirwood Park, Block 4 Lot 4
Location (site address) 7453 Park West Circle, Anchorage, AK 99502
Current property owner(s) Stephen & Lauren Novakovich Day phone
2. ON-SITE SYSTEMS SIZED FOR 5 BEDROOMS
3. TYPE OF WATER SUPPLY: ❑ Private Well ❑ Private Well serving 2 dwelling units
❑ Private Well serving 3+ dwelling units ❑■ Community Well or Public
❑ Water Storage
4. TYPE OF WASTEWATER DISPOSAL: [M-1 Private Septic ❑ Private Septic serving 2 dwelling units
❑ Holding Tank ❑ Community Septic or Public Sewer
5. SEPTIC TANK: ■❑ Steel ❑ Plastic ❑ Concrete ❑ Fiberglass
Age 18 - See advisory if steel older than 20 years
6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed Deep Trench ❑ Wide Trench ❑ Seepage Pit
Waiver request for:
Expedited review requested: ❑
Distance:
By applying for this entitlement, this property is subject to inspection by municipal On-site staff
to verify the accuracy of the information provided.
COSA Fee $ 55b
Date of Payment 911 la a C)"A'
COSA # DSC, ZZ-l�(�l
Waiver Fee $
Date of Payment
Waiver #
COSA Application—June 2022
Legal Description: Muirwood Park, Block 4 Lot 4
Parcel ID: 011-422-81
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system
A. WELL DATA
I log is filed with Onsite (or attached)
Date drilled _ Total depth ft
Cased to ft
❑ Sanitary seal is functioning correctly
❑ Wires are properly protected
Casing height (above ground) in.
Date of flow test for COSA
Static water level at beginning of test ft.
comments Property is served by public water.
B. TANK DATA
Measured operating fluid level in septic tank
48"
Date of pumping 9/20/22*
❑ Required maintenance completed, if AWWTS
comments: Around the Clock Pumping*
D. ABSORPTION FIELD DATA
Which system tested (date installed) 6/2/04
❑ ALL standpipes present per record drawing
Total measured depth from grade 12.6 ft (max)
Measured depth to pipe invert from grade 4.8 ft (min)
❑ N/A — pressurized field.
❑ Per record drawings, field is insulated.
❑ Monitor tubes go to bottom of effective.
If not, state depth into effective 7.8
❑ Presoaked required if
(Required if house vacant or field not used for more
than 30 days prior to date of test)
Gallons introduced N/A gallons N/A date
Any rejuvenation treatment (past 12 months) N/A
If yes, enter date
Comments/Deficiencies:
COSA Checklist June 2022
Well production at time of test gpm
Water storage tank volume gallons
Well disinfected for coliform test? ❑ Yes ❑ No
❑ Coliform bacteria is Negative
Nitrate mg/L ❑ Nitrate less than MRL (ND)
Arser �_ ug/L ❑ Arsenic less than MRL (ND)
Collected by
Date
C. LIFT STATION
maintenance completed
Age of lift station _ years
Lift station material
Comments:
Adequacy test date 9/6/22
Results ❑ Pass
Fluid depth prior to test 0 in
Water added 968 gal
New fluid depth 12 in
Elapsed time 1440 min
Final fluid depth 0 in
Absorption rate ' 750 gpd
FIELD STATUS — POST RECOVERY
Effective depth (per record drawings) 96
Effective depth used 0 in
Effective depth remaining 96 in
in
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well on lot)
ank/Lift Station on Lot > 100'
Q
Community Sewer Manhole/Cleanout > 100'
❑Yes
if No ft
❑ Yes if No ft
Neighboring Tank > 100'
if No ft
Private Sewer/Septic Line > 25' ❑ Yes if No ft
Absorption Field on Lot > 100' ❑ Yes
if No
Holding an > 100' ❑ Yes if No ft
Neighboring Absorption Fields > 100'
Animal Con nt > 50' El if No ft
❑ Yes
if No ft
if No
ft
Private Wells > 100'
Manure/Animal Excreta Storage
Community Sewer Main > 75' ❑ Yes
if No ft
_
❑ Yes I �� ft
❑ N/A — Served by Community Well (not on lot) or Public Water
From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required)
Building Foundations > 10'
Q
Yes
if No
ft
Surface Water > 100'
Fil Yes if No _
Tank to Property Line > 5'
m❑
Yes
if No
ft
Wells on Adjacent Lots:
Field to Property Line > 10'
Fil
Yes
if No
ft
Private Wells > 100'
FN_1 Yes if No
Water Main > 10'
n
Yes
if No
ft
Community Wells > 200'
n Yes if No
Water Service Line > 10'
Yes
if No
ft
If tank or field is under driveway comment below
F. ENGINEER'S COMMENTS
ft
ft
ft
G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based
on procedures outlined in the Certificate of On -Site Systems Approval Guidelines, indicates that the on-site water
supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation, unless noted otherwise.
Name of Firm Forge Engineering
Engineer's Printed Name Benjamin Schiller, P. E.
COSA Checklist—June 2022
Phone (907) 522-7773
Date
/ W .. ...
�� • r Benjarr,'Schiller '
CE 12592
��PROFESSION ..�,
Municipality of Anchorage Page 1 of 3
Development Services Department
On-Site Water and Wastewater Program
4700 South Sragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
wvwv. cLanchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: SW030206 PID Number: 011-422-81
Crown Pointe, lnc. WastewaterSystem: New
Address:
P.O. Box 112313 Anch., AK 99511 ABSORPTION FIELD
345-6277 Five (5) Deep Trench
LEGAL DESCRIPTION soi, Rating: lo~al Depth from Original grade=
.9 ~o/~ 10 ~.
Block: Lot: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath p~pe:
11 Autumn Ridge 2 ~t. 8 ,t.
Township: Range: SecUon: Fill added above odginal grade: Gravel Length:
2'3 Ft, 53 ~t.
Well: A~U Gravel w~dth: Number of ~ines: [ Distance between lines:
3-5 ~. 1
Classifi~ on (P [vate, A, B, C): mTotal Depth: Cased to: Tota~ absorption area: Pipe Material:
848 F¢ ASTM 3034 PVC
Dr/ilar: Date Ddlled: Static Water Level: Instal/er; Date Instsrled;
a Sanders & Sanders 6/2-4/2004
Yield:GPM ,,J P.mp Set at:Ft, j Casing I ;eight AbOVeFt.*,o..~: TANK
SEPA~TION DISTANCES ~ Septic ~ Holding ~ S.T.E.P. ~ Other:
T~To Septic Absorption LiE Holding ~ub[ic/Pdvate iManufacturer: Capacity in GallJns:
F~om %
Tank Field Station Tank Sewer Line Anchorage Tank 1,500
w~, N/A N/A N/A N/A N/A Steel Two (2)
s~.w~, >100' >100' N/A N/A ~/ LIFT STATION- NONE ON LOT
Lot Une >5' >10' N/A N/A Oa~.
'ou.dation >5' >10' N/A N/A //~~ 'r~umP OW' level "b "~ump o~' ,owl ,t:~ m Hig. w~ter amarm a,:
c..~m ~,~ None Noted Pump Make & Modem i Eme~ricaJ inspections performed by:
BENCH MARK
Back Door Thmshhold Southeast Corner
100,0 Ft.
Engineer's Stamp
Inspections peRormed by: A. Hernia Dates: 1st 612104
2nd
614104
Depa~ment o~ealth ~nd Human Se~ices approval
Reviewed and approved by/ ~, ~.l~ ~ ~_~Date: ~/~/~
~- z
o~ o
~ oo
, , Municipality Of Anchorage Page 3 of 3
DEVEOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904
On-Site Wastewater Disposal System or Well Inspection Report
Permit Number: SW030206 PID No. 011-422-81
1,500 Go, t~on
Septic Tc~nk
94,9
99,3
Dr'cdn¢ie[d Rock
86,7~
3~' (Trench Length)
80,0
% 94,9
PROFILE AS-BUILT
Scale: 1"= 10'
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
Initial
Date Issued: Jun 20, 2003
Expiration Date: Jun 19, 2004
Permit Number: SW030206
Legal Description~GcTP'~i~ I~{
Design Engineer: 0014 Anderson Engineering
Owner Name: Crown Pointe, Inc.
Owner Address: PO Box 112313
Anchorage, AK 99511-
Parcel ID: 01 i-422-81
Site Address: 7453 Park West CirCle
Lot Size: 40111 SQ. FT.
Total Bedrooms: 5 Permit Bedrooms: 5
This permit is for the construction of:
[] Disposal Field [] SepticTank [] 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 subsudace 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.
Parcel I.D.
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. cLanchorage.ak.us
(907) 343-7904
ON-SITE SEWERNVELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Permit Number SW 0 ~0 2 0 ~
Property owner(s) Crown Fointe: Inc, Day phone 34..6-.6277
Mailing address (1) P.O. Box 112313 Anchorage_ Ar. 99511
Mailing address (2) ~ q~, "~ P -C~ I(__. ~,A_)O .~'- ~.~i Y'-C~l(LTip COde
Legal description (Lot, Block & Sub'd.) Lot 4_ 15lock 4. Muirwood Far~ Sub41ivi.~ion
Legal description (Section, Township & Range)
Lot Size ~Oi l/ ~
THIS APPLICATION IS FOR:
Sewer Only
Sewer and Well
Sewer Upgrade
THIS PROPERTY CONTAINS:
Hot Tub
Swimming Pool
Therapy Pool
Acres/Sq. Ft.
Number of Bedrooms Fiw (5)
[] Well Only []
[] Water Storage []
[] Jacuzzi []
[] Water Softening Unit []
I certify that the above information is correct. I further certify that this application is being made for a
Single FamilY Dwelling and is in accordance with applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit Fees:
Date of Payment:
Receipt Number:
(Rev. 12YO0)
Waiver Fees:
Date of Payment:
Receipt Number:.
June 16, 2003
Municipality of Anchorage
Development Services Department
On-Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Su~e~:
Lot 4, Block 4, Muirwood Park Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The owner of Lot 4, Block 4, Muirwood Park Subdivision intends to construct a new
five-bedroom home on the lot. We are therefore requesting a permit be issued for the
construction of a new septic system to serve the home. The lot is served by the
Municipal water system. The attached Site Plan and backup docUmentatiOn identify the
location and configuration of the new septic system and alternate site and the
parameters used in the design. Also identified on the plans are the location of the
water service line, test holes and the septic systems on the surrounding lots. Drainage
arrows and spot elevations are shown indicating the current drainage patterns. The
drainage patterns will be maintained after construction.
The test holes placed near the location of the proposed absorption trench and alternate
site indicated clean sand with some gravel and varying amounts of silt and percolation
rates approximating 2 to 27 minutes per inch. We have averaged the percolation
rates and are using an application factor of .9 gallons per day per Square foot for the
absorp!!on trench. No groUndwater was found during placement Of the test holes and
none was noted during the monitoring period. We are therefore proposing to place a
1,500-gallon septic tank and a 53' long x 3' wide x 8' effective depth absorption trench.
The distribution pipe will be placed 2' below the existing surface and the total depth will
be 10' to. Sufficient fill will be placed over the septic tank and absorption trenCh to
prevent freezing.
The ground surface on the lot slopes as shown on the site plan from east to west at
Lot 4, Block 4, Muirwood Park
June 16, 2003
Page Two
varying slOpes. The absorption trench will be constructed at the front of the lot parallel
with the slope as much as possible in conformance with Municipal requirements. All
components of the new septic system will be constructed a minimum of 100' from any
surface water and 10' from the water service line on this and adjacent lots.
If the system is constructed in accordance with our design the following statements
apply:
The system, if constructed as designed, will have no adverse impact on the wells
in the area or those to be constructed in the future.
The system, if constructed as designed, will have no adverse impact on existing
septic systems in the area or those to be constructed in the future.
The system, if constructed as designed, will have no adverse impact on reserve
space, either surface or subsurface, on any lots located in the area.
The system, if constructed as designed, will have no adverse impact on drainage
patterns in the area. The current drainage pattern will be maintained.
Sincerely,
Michael E. Anderson, P.E.
Attachments
SCALE 1" = 100'
Z
49th
VACANT
This
Project
¸60
Z
O0
O-J
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Ill
I
LOT 4, BLOCK 4, MUIRWOOD PARK SUBDIVISION
DESIGN FACTORS: SYSTEM REQUIREMENTS:
Five Bedroom Home Deep Trench System
Perc. Rate: 1.7-27 MinJInch 1,500 Gallon Septic Tank
Application Rate: .9 GPD/SF (Avg.) 8' Drainfield Rock
750 GPD/.9 GPD/SF (Application Rate) = 833.3 SF Absorption Area
833.3 SF/16 SF/LF = 52.08 LF Trench Length
THEREFORE: Construct a 53' Long x 3' VVide x 8' Effective Depth Absorption Trench.
FI,o,w Line Elevation in Trench to be 2' BelOW Odginal Ground SUrface. TOtal Depth to be
10 Below Existing Ground. Maintain 10' separation FrOm water service Lii~e On Lot. Place
~'rOf Dire_ct Bu.ry Ins,u, lat, io~n and_2' of ~Fill ,O. ve_r Absorption Trench or Prov de Minimum 3' Of Cover to
event I-reez rig. ,~ or ~;over uver ~eptic lank.
Natural
Backfill
Geotextile
6" 4" Perforated
Holes Down)
~ock
TYPICAL DEEP TRENCH SECTION
(NO SCALE)
NOTE: Grade Are,a, Over Trench to Drain Away.
Minimum 6 Separati°n Fr°m Bedr0ck'
Minimum 4' Separation From Groundwater.
Minimum 10' Separation From VVater SerVice Line.
Minimum 100' Separation From Surface VVater or Streams.
Municipalit)' of Anchorage
Development Services Department/On-Site Water and Wastewater Program
4700 South Bragaw Street, Anchorage, AK 99516-6650
SOILS LOG - PERCOLATION TEST
Performed For: White Raven Development
Legal Description: Lot 4. Kincaid Park Subdivision
1
11
12
13
14
15
16
17
18
19
8
OG/OL
SM
15%-20%
Silt
GM/SM
SLOPE
North
South
No
Was Groundwater
Encountered?
If Yes, What Depth?
Depth to Water
After Monitoring
Date:
GP/SP/SW
None
2/28/02
3/4%1 ,,
Cobbles
BoSom of
Hole
Date Performed: 1/23/02
SITE PLAN
S
L
O
P
E
Reading Date Gross Net Depth To Net
Time Time Water Drop
23-Jan 2:48 9,13"
3:03 15 9.75" .63"
3:05 9.25"
3:20 15 9.81" .56"
3:22 9.25"
3:37 15 9.81" .56"
3:38 9.19"
3:53 15 9.81" .63"
Perc. Rate: 27 Min./inch Perc. Hale Diameter: 7"
Test Run Between 4 Ft. and 5 Ft.
Comr:nents: Test.Cavity was PreSoaked Prior to Test.
Performed Byi Alan Harala. I, Michael E. Anderson Certify That This Test Was Performed
In Accordance With All State and Municipal Guidelines In Effect On This Date: 3/2102
Municipality of Anchorage
Development Services Department/On-Site Water and Wastewater Program
4700 South Bragaw Street, Anchorage, AK 99516-6650
SOILS LOG - PERCOLATION TEST
Performed For: White Raven Development
Legal Description: Lot 4~ Kincaid Park Subdivision
OG/OL
TESTHOLE NO. t3A
SM
15%-20%
Silt
GM/SM
SLOPE
North
South
Date Performed: 1/23/02
SITE PLAN
1I
11
12
13
14
15
16
17
18
19
GP/SP/SW
3/4"-1"
Cobbles
Bottom of
Hole
Was Groundwater
Encountered? No S
If Yes; What Depth? L
Depth to Water O
After Monitoring None P
Date: 2/28/02 E
Reading Date Gross Net Depth To Net
Time Time Water Drop
23-Jan 3:10 7.5"
3:20 10 13.5" 6"
3:23 7.5"
3:33 10 13.38" 5.88"
3:34 7.5"
3:44 10 13.38" 5.81"
Perc. Rate: 1.7 Min./Inch
Test Run Between 7 Ft. and 8 Ft.
Comments: Prior to Test.
Performed By: Alan Harala, I';~ ~!~hael E. Anderson Certify That This Test Was
In Accordance With All State andi~'~i'ciPal Guidelines In Effect On This Date:
Municipality of Anchorage
Development Services Department/On-Site Water and Wastewater Program
4700 South Bragaw Street, Anchorage; AK 99516-6650
SOILS LOG - PERCOLATION TEST
Performed For: White Raven Development
Legal Description: Lot 4. Kincaid Park Subdivision
SLOPE
sM
20% Silt
SM/SP
North
South
Date Performed: 1/22/02
SITE PLAN
1
11
Was Groundwater
Encountered? No
If Yes, What Depth?
Depth to Water
After Monitoring None
Date: 2/28/02
S
L
O
P
E
12
13
14
15
16
17
18
19
3/4"-1"
Cobbies
49~h
}ttom of
Reading Date [Gross Net Depth To Net
Time Time Water Drop
23-Jan 1:52 8.5"
2:02 10 14.25" 5.75"
2:04 8.5"
2:14 10 14.5" 6"
2:15.' 8.5"
2:25~: 10 14.44" 5.94"
'2:30~ 8.5"
' 2:40'.'~. 10 14.5" 6"
With All State and MtJ~jcipal Guidelines In
· :,,:;:%"':L:;~.'~'.
Perc. Rate: 2 Min. 8"
' was Presoaked Prior to Test. ',',, ,,,
s Perf6'rr~J
3~2~02 ' :'
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION AND MATERIAL SpECiFICATiONS
SUBJECT: LOT 4, BLOCK 4, MUIRWOOD PARK SUBDIVISION
GENERAL:
The scope of this project includes the procurement and placement of a
new 1,500-gallon septic tank at the location shown on the site plan.
Work also includes the construction of a new absorPtion trench 53'
tong by 3' wide by 8' effective depth also at the lOCation Shown on the
Site Plan. The total depth of the trench will be 10' below existing
ground and the distribution pipe will be placed at 2' below the surface.
All components of the new absorption trench and septic tank must be
constructed a minimum of 100' from any surface water and 10' from
the water service line on this and adjacent lots. A minimum of 4' of
cover is required over the septic tank and 3' over the absorption
trench. In lieu of cover 2" of direct bury insulatiOn and 2' of cover may
be placed.
Construction shall be in accordance with the approved site plan,
design drawings, Municipal Permit with any special provisions or
conditions, and all applicable State and Municipal Wastewater
Disposal Regulations.
The Contractor shall be responSible for Obtaining all underground
utility locates and for the layout of the septic system and verification of
the locati°n of all lOt lines.
Unless specifically agreed otherwise, the contractor shall be
responsible for final grading areas subsequently depressed from Soil
settling. Property owner shall be responsible for revegetation of
affected areas unless specifically agreed otherwise.
Contractors installing wastewater disposal systems must be certified
by the Municipal Department of Health and Human Services for
system installations. Owners installing their OWn syStems must
receive prior approval from D.H.HiS. before beginning system
installation.
SEPTIC TANK INSTALLATION
1. A new 1,500-gallon septic tank must be procured from a certified
septic tank manufacturer if the exiSting tank is found to be defective.
2. A septic tank is to be constructed by a certified septic tank
manufacturer. Construction shall include two 4" cleanouts for pumping
access.
Lot4, Block 4, Muirwood Park
June 16, 2003
Page 2 of 3
3. The septic tank shall be sufficiently bedded to prevent settling or
shifting of the tankl
4. All standpipes on the septic tank shall extend a minimum of 12 inches
above final grade.
5. Tanks installed withOut 4' of cover shall have a minimum of 2" of direct
burial insulatiOn.
A foundation cleanout shall be inStalled one to four feet from the
building foundation. Two cleanouts are required between the tank and
the drainfield.
7. Final grading over the tank shall be such that a positive slope exists
away from the septic tank.
DRAINFIELD CONSTRUCTION:
1. The drainfield shall be cOnstructed to the dimensions shown on the
design. The bottom of the trench shall be Within 2,,of level.
Distribution piping must be placed level with perforations down atop a
level bed of drainfield rock. Rock shoUld then be placed over the pipe
to provide a minimum of 2" of cover.
3. A silt barrier or geotextile fabric must be placed between the drainfield
rock and the natural soil backfill.
4. Monitor tubes must be 4" in diameter and installed at the locations
shown on the design. The portion below ground must be perforated.
Contractor shall verifY the septic tank and drainfield are a minimum
100' away from any private water wells in the area, 150' from a Class
"C" Well or 200' frOm any community well.
6. Direct bury insulation must be placed over the distribution system if
less than 3' of backfill depth is available. Finish grade over the trench
must be mounded to prevent settlement or depressions.
7. Grade area surrounding the absorption trench to drain away.
A minimum 2' of accepting soil is required below the drainfleld rock for
a 5' wide trench. Contractor shall verifY this condition prior to
placement of the rock. All pockets of unacceptable materials must be
removed and replaced.
MATERIAL SPECIFICATIONS:
Lot 4, Block 4, Muirwood Park
JUne 16, 2003
Page 3 of 3
1. Septic tanks must be constructed by a municipally approved septic
tank manufacturer.
2. The following pipe materials are approved for use in septic system
installations in the Municipality of Anchorage:
Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated
and solid), ASTM F810 Or H~D~P.E. (Perfo~atedl bu! not SOlid) and
ASTM D2662 or A.B.S. (perforated and sOlid)i
3. Insulation shall be at least 2" thick extruded direct burial polystyrene
(Dow Chemical Co. Styrofoam HI or equal).
4. Septic tank inlets and outlets shall be tiffed with watertight couplings
(Caulder, Fernco, or equal).
5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed
between the final drain rock layer and the native soil layer.
6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing
the #200 sieve.
INSPECTIONS:
Municipal Ordinance requires a minimum of two inspections. These
inspections must be conducted under the supervision of a professional
engineer registered in the State of Alaska. The first inspection must be
conducted after the excavation of trenches, beds or pits and before the
installation of any gravel. A septic tank may be set in place, but may not
be backfilled.
The second inspection must be conducted after the placement of the
geotextiie fabric, gravel, distribution piping, standpipes, cleanouts and
insulation. No backfill should be in Place at the time of inspection.
Contractor shall provide a copy of all field survey layout and construction
notes for use in preparing the certified as-bUilt of the cOmPleted system.
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 E!more Road
P.O. Box 196650
Anchorage, AK 99519-6650
w"vcw.m uni.org/onsite ,
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEI"'IS APPROVAL
FOR A SINGLE FAHILY DWELLING
O
Parcel I.D. 011-422-81
1. GENERAL INFORMATION
COSA# ~-~ /I
Expiration Date: ~"~ '~
Complete legal description MUIRWOOD PARK; BLOCK 4, LOT 4
Location (site address) 745.3 PARK WEST CIRCLE *ANCHORAGE, AK
Current Property owner(s) CAREY MILL
Day phone C/O AGENT
Mailing address
4100 CARAVELLE DRIVE *ANCHORAGE, AK 99502
Lending agency
Day phone
Mailing address
ReaLEstate Agent
Mailing address
GORDON SLOANE W/ REMAX Day phone 244-.3581
110 W. 58TH AVE. SUITE 100 *ANCHORAGE, AK 9950.3
Unless Otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 5
3, TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well [] Individual On-site []
Individual Water Storage [] Individual Holding tank []
Community Class Well [] Community On-site []
Public Water System [] 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 upon request to homeowners. Certificates of On-Site Systems
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 samples. (Certificates may be reissued for 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.
4, STATEMENT OF !NSPECT~ON BY ENGINEER
As certified by my sea/affixed hereto and as of the validation date shown below, ! verify that my
investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application,
shows thst 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 furt,her veri~, that based on the
infom;ation obtained f'om the Municipality of Anchorage Nes 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.
Address 5701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Phone
Date
337-6179
Engineer's Comments':
In conducting this evaluation, GEG, LtD. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported 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 during 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 encroachments. 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.
DSD SIGNATURE
~ Approved for ~ bedrooms.
Disapproved,
Conditional approval for
bedrooms, with the following stipulations:
ON, SITE ".
,_ : WATERAND
: V '.ASTEWATER .
..., ". ,-, .'
PROuRAM . .-.
Attachments: COSA Checklist
Septic System Advisory
Well Flow Advisory
(Rev. 11105)
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
Original Certificate Date: ~ - ~'''''- //
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 Elmore Road
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
CHECKLIST
Legal Description: MUIRWOOD PARK; BLOCK 4, LOT 4 Parcel ID: 011-422-81
A. WELL DATA PUBLIC WATER
Well type __ If A, B, or C provide PWSID# ~ Well Log (Y/N)
Date completed Sanitary seal (Y/N). Wires properly protected (Y/N)_.--/
Total depth ft. Cased to _ _ft. . Casin h
Date of test FROM WELL LOG ~ ~CTION
Static water level ft. ~ ft.
Well production · _.-.-'""'~ g.p.m, g.p.m.
WATER SAMPLE R~S~~~.
Coliform / colonies/100 mi. Nitrate mg./L. Collected by:
~ ug./L. Date of sample:
B. SEPTIC/HOLDING TANK DATA
Tank TyPe/Material SEPTIC/STEEL Date installed 6/2-4/04
Tanksize 1500 gal. Number of Compartments 2 Cleanouts (Y/N) YES
Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A
Date of pumping 10/15/10 Pumper. ALASKA SEWER &: DRAIN
ABSORPTION FIELD DATA
Date installed 6/2-4/0,*
Length 53 ft.
Total depth .12.91 ft.
~*BELOW EXISTING GRADEI
Soil rating (g.p.d./ft2o~ 0.9 System type DEEP TRENCH
Width 3-5 ft. Gravel below pipe 8 ft.
Eft. absorption area 848 ft2 Monitoring tube YES Depression over field NO
Date of adequacy test 7/29/1 1 Results (Pass/Fail) PASS
Fluid depth in absorption field before test DRY in. Water added 1090gal.
Elapsed Time: 0 min. Final fluid depth DRY in. Absorption rate >=
Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN
For 5 bedrooms
New depth DRY in.
75O+ g.p.d.
If yes, give date
D. LIFT STATION
Date installed
"Pump on" level at in.
~ ~ Cycles tested.
SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot
Size in gallons Manhole/Access (Y~.~.) J
"Pump off" leve_La~. High water alarm level at
Meets alarm & circuit requirements?
PUBLIC WATER
in.
On adjacent lots
Absorption field on lot On adjacent lots .--.-
Public sewer main ~nhole/cleanout
Sewer/septic service line ~ ~ Holding tank
Manure/animal excrete storage areas
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field
Water main 10'+ Water service line. '10'+ Surface water.
5'+
100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation. 10'+
Water service line '10'+ Surface water 100'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
*PER MIKE ANDERSON, P.E. INSPECTION REPORT
Water main 10'+
Driveway, parking/vehicle storage ' 10'+
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. GARNESS
Date ~/2'/II
COSA Fee $ L./
Date of Payment
Receipt Number
(Rev. 11105)
Waiver Fee $
Date of Payment
Receipt Number
/
C
~0
~C
0
Z
4t4SKA.~sEWE_R&24 HOUR EMERGENCYSERVICE
/J~ ~ ~ ~. ., ,.
; ~.~ ---~ --%,.~ ',,.~
PO Box 221914 · Anchorage, AK 99522-1914 o Office 248-9551 - Fax 248-95S9
YOUR PROFESSIONAL SEWER & DRAXN CLEA~NI~G SERVICE
LICENSED L,L,C. INSURED
Date
Customer Name
Power Snake
Steam Thawing
Hydro Jet Cleaning
Sewer Line Camera
Service Call
Septic Pumping
Extra Man
Parts/Tax
TOTAL :.~-~ '->' ':f ~-
#46180
[] Camera Inspection
[] Install Clean Out
[] Hydro-Jetting
[] Vacuum Truck
[] Steam Thawing
[] Excavation
[] Install New Toilet
PO#
~\/:
Technician v:, ' : ': .... ,-No Warranty.
Customer na r
NOT RESPONSIBLE FOR CR'~KED'~R'BRO~N PORCE~IN FIXTURES OR LOST OR BROKEN CABLES IN DRAIN LINES.
CUSTOMER AGREES TO PAY FOR DAMAGED~ BROKEN CABLES, JET HOSES ETC. DUE TO FAULTY PLUMBING, AS
WELL AS ANY AND ALL OTHER FEES INCURRED ATTHE TIME OF SERVICE.
There will be a $30.00 charge on all NSF checks. A collection f~ of 40% will be added if sent to collections.
PAYMENT DUE ON RECEIPT
Address 7453 Park West Circ.
Borrower Novakovich
Appraisal Services Company
Uniform Residential Appraisal Report
City Anchore.qe
Owner of Public Record Mills
File No. F2156
Case No.
State Ak ZipCode 99502-1891
County M.O.A.
Mulrwood Park S/D
Aasesaofs Pamel# 0114228100001 Tax Year 2011 R.E, Taxes 300e
Sand Lake Area Map Reference SW2123 Census Tract
PUD HOA $ 145
0023.01
Refinance Transaction
Lender/Client Alaska USA Mortgage Co. Address P.O. Box196850~ Anchora!]e~ Alaska 99519-6850
~ offered for sale or has it been offered for sale in the twelve months pdor to the effective date of this
, under contract for the
oct within the last t'#elve months.
No other transfer found
did not snalyze the coned for sale for the subject purdlase transaction. Explain the results of the analysis of the contract for sale or why the analysis was not
Data of Contract 06/2011 Isthe ~sellerthe , Assess/Mis
Is there any financial assistance (loan charges, sale concessions, gift or downpayment assistance, etc.) to be paid by any par~ on behalf of the bon'ower?
he ~tal dollar amount and describe the items to be paid. None Found. It is noted that seller ag raes to allow buyer early occupancy w/
earnest money of $15~000 to become non-refundable & released to seller upon buyer's occupancy. Early occupancy pro-rated for June
~ 08/'1/2011.
ect's nbrd, is currentt
relative balance.
Dimensions Irre,qular (No Survey Supplied) Area 40~111 +-sf Shape Irreg. View Ave
Classification R-lA ~ residential use
describe.
Nons
0200050740D FEMA Map Date 09/25/2009
describe.
~ adverse site conditions or external factors {easements, encroachments, environmental conditions, land uses, etc.)? ~1 Yes ~] No If Yes, describe.
ect site is rollin w/some lawn & landscape front to rear and is partly .
fenced. No survey of any kind submitted for appraiser's review. Typical easements are assumed.
Public Private
~ of Stories 2
Foundation Walls Cc/G
Extarior Walls WdBv/G Walls Sr/G
Basement Area Ronf Surface Cs/G Trim/Finish Wd/G
BasementFinish 87% Alum/Gd Bath F~3or Comp/Cb'Ave
2SCustom Vc/A Ct/G
Year Built 2004 Storm Sash/Insulated Yes/G None
4 Settlement Screens Yes/G # of Cars 3
Attic None Amenities
Stairs Fuel Gas Fence # of Cars 3+
Scurde Porch Ce # of Cara
Heated Other Other CcPatioRw
Finished area above grade contains: 11 Rooms 4 Bedrooms 4.0 Bath(s) 3~959 Square Feet of Gross Livin,q Area Above Grade
Additional feature4
Dascdhe the condition of the
External.
baseme~ and
is a custom des~ned & buiEtwo sty.
Insp. noted as ave+togood. No Functional. No
descdbe
describe
Freddie Mac Form 70 March 2005
Fannie Mae Form 1004 March 2005
Produced by CtickFORMS Software 800-622-8727 Page 2 of 25
Mm _cipality of A_nchorage
Development Se rvices 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.l~11-422-81
1.
GENERAL INFORMATION
Complete legal description Lot 4, Block 4, Muirwood Park Subdivision
Locatior ¢,site address or directionsi 7453 Park West Oircle
HAA# 0q 0qSS
Expiration Date:
V /- -
Current Property owner(s) Crown Pointe, Inc.
Day phone 345-6277
Mailing address
P.O. Box 112313 Anchorafie, AK 99511
Lending agency
Day phone
Mailing address
Real Estate Agent
Day phone
Mailing Address
Unlees otherwise requested, HAA will be held by DSD for pickup.
2. NUIVIBER OF BEDROOMS: Five (5)
TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class
Public Water System
Well
TYPE OF WASTEWATER DISPOSAL:
[] Individual On-site []
[] Individual Holding tank []
[] Community On-site []
[] Public Sewer []
The Municipality of Anchorage Develoament Services Department (DSD) tssues Certificates of Health Authority
Approval (HAA) based only upon the reeresentations given in paragraph 5 by an independent professiona: 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 ay a single family on-site wastewater disposal and/or water
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 reissuec with
new water samale results less than 30 days old. (Certificates may be reissued for a period of up to one year with
valid water samples.) Certificates are valid for One year for ~roperties served by Class A or B wells or s oublic water
system. The Municipality of Anchorage is not resoonsible for errors or omissions in the r)rofessional engineer's
work.
4. STATEf~ENT OF INSPECTION BY ENGINEER
As certified by my seat affixed hereto one as of the validation date shown below, I verify that my investigation
based on 3rocedures outlined in the Health Authority Approvat Guidelines for this aootication, shows that the on-
site water supply and/or wastewater disposal system is(are} safe, functional and adequate for ~ne number of
bedrooms and type of structure indicated herein. I further verify that based on the ~nformation obtained from the
Municieaiity 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 aoo[icable Municipal and State codes ordinances
and regulations :n effect at the time of installabon.
Name of Firm Anderson Enaineerinq
Address P.O. Box 2407'73 Anchorage, AK 99524
Engineer's Printed Name Michael E, Andersen, P.E.
DSD SIGNATURE
Approved for ~ bedrooms.
DisapBroved.
Conditional approval for
Phone 522-7773
Date
bedrooms, witch '(he following stipulations:
By:
Additional Comments
Attachments:
HAA Checklist
Septic System Advisory .
Welt Flow Advisory
Maintenance Agreements
Supplemental Eng'neer s Report
Other
um
Dtion field >5'
. SUrf~cewate~ ~100"
~ystems are in
guidelines in effect on this
Waiver Fee $
Date of Payment
· ;~: ~.~.~ Receipt Number