HomeMy WebLinkAboutTHE TABLELANDS BLK 4 LT 15The Tablelands
Block 4
Lot 15
#051-741-46
Municipality of Anchoragenn, .,
Development Services Department +s.
Building Safety Division
On -Site Water and Wastewater Program, 4700 S. Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650 Page of
www.ci.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION
REPORT
Permit Number: SW040067 PID Number: '85dl_86'Y=08 I-7 _
Name:
Troy Davis Homes Wastewater System: ❑° New ❑ Upgrade
Address:
1451 E. Parks Hwy, Ste 207, Wasilla, AK 99654
ABSORPTION FIELD
Phone: Number of Bedrooms:
357-9394 4
❑Deep Trench❑Shallow Trench ❑Bed ❑Mound Mother.
LEGAL DESCRIPTION
Soil Radng: 0.45
°tel D'epth from plginalgmde:
Block:4 Lot 1S Subtllvision:
The Tablelands
GPDIFt°
to Pipe bottom from original grade:
7.Q Ft.
Gravel tlepih beneath pipe:
Township: Range: Section:
2.9 Ft.
Fill added above original inal mtle:
9 9
4.0 .
Ft
Gmvel Length:
..
3.0 Ft.
134
Ft.
Well: New ❑Upgrade
cmvelwitlim
5.0
Number °`linea: Diataneebe(weanrne::
Classification e, A B, C): Total Depth: Cased to:
community well
Ft.
Total absorption area:
2 15 FL
Pipe
Pipe Material:
Ft. Ft.
Dfiller: Data Drilled: Static Water Level:
1370 F?
Installer:
Date Installed:
Ft
Roy Brown Constr.
4/15/04
- Yield: Pump Set at: Casing Height Above Ground
GPM Ft. Ft.
TANK
SEPARATION DISTANCES
Aseptic El Holding ❑S.T.E.P. ❑Other:
To Septic Absorption Lift Holding ublia'Ph r to
From Tank Field Station Tank Sewer Line
Manufacturer. Capacity:
Greer
1,250 Gal.
Well
ria
ria
ria
ria
ria
Material: Steel
Number of Compartrnents:
2
Surface Water
na
na
na
na
LIFT STATION
Lot Line
17'
25'
ria
ria
Size:
amu adurer:
Gal.
Foundation
18
16'
ria
ria
Pump on" -level at
'Pump or level at:
High water alarm at:
in.
In.
in.
Curtain Drain
ria
ria
na
na
Pump Make & Model
Electrical Inspections performed by:
Remelts:
BENCH MARK
Location antl Description:
Datum: Garage slab.
Assumed Elevation:
Ft
100.0
`��ea�aaq?y�
�(sOFA4q y,
............
�
Inspections performed by: Kent Sheets Dates: let 4/15/04
*' TH ;k
...... .. .............
2nd 4/15/04...
.`:................
Developme t Services Department Approval
r��': Mar L. Shreves ��
Reviewed and approved b
PP y Date:
�j'sr •. CE 9351
F v
LOT 14
yy�
TSTH14
.3c'
1, 50-GALSREN M S
SEP C TANK 0p3 a -O,Fbi
WX
CON 2 y <T 1 3
LOW 10
SP ITTEER 30 C 4
�9�90.
RP�P'(REPjM�N'(
TSTH15 JP jEyS EM CG
USO
_\MT1 MT2 C01 CO2 CO3 C04
- J A 19.4 A 30.9 A 72.0 A 72.5 A 59.2 A 66.4 /
1 8 52.0 8 59.6 S 37.7 6 38.8 8 26.4 8 39.7
C 70.0 C 76.7 C 32.8 C 34.5 C 26.7 C 42.5
1
1 40,000 S.F.
N
LOT 15
1 ����\���
/
LOT 16 ��N
1
/
TRACT B-2 \ \
171
— _ S85°2 '42"W /
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.
q�000DD04p�
OF AG 0�
SITE PLAN sa K P.O. BOX 2749
RtM PALMER,
Q �E °
�sirD��
AS BUILT ALASKA 99645
(AMENDED)ENO NEE INC. PHONE: (907)745-0222
7 d
FAX: (907)746-0222
°
49TH* ,° d0
°%°° �. °°°°.°°° ���
W.O. 0400122
DATE: 9/16/04 SCALE: 1" = 50' FILE: 0400122_WWAS
.... . G°l°:.°...°.°�
vQ�c°°
Ma L. Shreves°,��d
QQ
LOT 15, BLOCK 4, TABLELANDS SUBDIVISION,
CE 9351 v�ad
�QQQd�o4FQESS000dd�
PLAT No. 2004-25, ANCHORAGE RECORDING DISTRICT, ANCHORAGE, ALASKA
EASEMENTS OF RECORD OTHER H SE SHOWN ON THE
RECORDED PLAT ARE NOT SHOWN HEREON
2 s
0 0
c �
�S
<1\ Q
1, 50—GAL
�2
SEP C TANK 000 R0y6
7
X
00'\ 2 TH1
LOW CO
P ITTER PREP
C
30'
`C). O�
TSTH15 R P PO�MRN
MTI MT2
C01 CO2 CO3 C04
A 19.4 A 30.9
A 72.0 A 72.5 A 59.2 A 66.4
B 52.0 B 59.6
B 37.7 B 38.8 B 26.4 B 39.7
C 70.0 C 76.7
C 32.8 C 34.5 C 26.7 C 42.5
SEPTIC SYSTEM PLAN
VIEW
FIXED FINAL GRADE 103.19ft.
FLOW SPLITTER GRADE 103.19ft.
CO 98.69 ft. / INSULATION
CO
/FINAL
CO CO
MT
-------------- ORIG. GRADE
100.19 ft.
1,250—GAL STEEL
97.99ft.
SEPTIC TANK 97.49ft.
o o d 7.29 ft.
ELEVATIONS SAME FOR BOTH TRENCHES. 97'29 ft.
DATUM: GARAGE SLAB = 100.0'.
4' 89.19
\9,319ft.
GW AT 87.86', 4/12/04.93.19
ft. 6' 87.19
SEPTIC SYSTEM PROFILE
q�g000pppd
��
AS BUILT A K
RIM AS
P.O. BOX 2749
ALASKA 99645
q A
•• •°..<qJ DQ
SEPTIC ENG EE INC.
PHONE:
P P(E
/F
(907)745-0222
P 5
FAX: (907)746-0222
-*'49TH o d0
W.O. 0400122 DATE: 9/7/04
SCALE: 1 " = 30' FILE: 0400122_WWAS
e° May L. Shrevese;°��
LOT 15, BLOCK 4, THE
TABLELANDS SUBDIVISION,
CE 9351 °vti=d
PLAT No. 2004-25, ANCHORAGE
RECORDING DISTRICT, ANCHORAGE, ALASKA
°
Q Q b
EASEMENTS OF RAREE
OTSHOWNHER THANTHOSESHOWN ON THE
Q�F� /ROFESSl�NP
L d
d4d��000��c'
ER OOSE
RECORDED PLATNOTECORD
HEREON.
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: Apr 20, 2004
Expiration Date: Apr 20, 2005
Permit Number: SW040067 �F k
14 "
Le al Descr' f GLEN 8f.i4rt�y
J*LD[A(¢67( a�� � Parcel ID: 051-801-08
•
9 ip ion.
N VIEW ESTATES NORTH TR F
Design Engineer:
0032 Alaska Rim Engineering
Site Address:
23210 WHISPERING BIRCH DRIVE
Owner Name:
TROY DAVIS HOMES
Lot Size:
40000 SQ. FT.
Owner Address:
NHN SAMBAR LOOP
Total Bedrooms:
4 Permit Bedrooms: 4
CHUGIAK , AK 99567 -
This permit is for the construction of:
❑✓ Disposal Field
❑✓ Septic Tank ❑ Holding Tank
❑ Privy
❑ Private Well ❑ Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received 4.
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/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcell.D.--0$ Permit NumberSW040067
Property owner(s) Troy Davis Homes Day phone 357-9394
Mailing address (1) 1451 E. Parks Highway, Suite 207
,S! TE
.A9a4in"c1dress (2) LAK- 23?32 wNt SPQR/uG 6t IPCN VR / ��lip Code 996�Tir7
Legal description (Lot, Block & Sub'd.) Lot 15, Block 4, The Tablelands Subdivision
Legal description (Section, Township & Range) Ae#A/ 49IRC14 DR1v6 C"kG/A*k 99 7
Lot Size 40,000 sgft Acres/Sq.Ft. Number of Bedrooms 4
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 of property owner or authorized agent)
Permit Fees: "&(q Waiver Fees:
Date of Payment: V Z- oDate of Payment:
Receipt Number: Lta Receipt Number:
(Rev. 12/00)
�Qaslea
Turn
Pingiuteeni ng, Ale.
Phone (907) 745-0222` . _._ ._.. ,. ., _..... ......
_ ...�,. _ _ , >: _ . _w., ; ._.. _., _.. ._,.:.. .,. - -- _. P.O. Box 2749.
Fax @ro ershsa.co 746-42199'"""' P0. Palmer, Alaska 99645
akdm@rogershsa.com
March 24, 2004
Mr. Dan Roth _
Municipality°of Anchorage
Development Service Department
Building Safety Division
On -Site Water"andWastewater Program
PO Box 196650,
Anchorage, AK 99519-6650
RE: Lot15, Block 4, The Tablelands Subdivision
On -Site Sewer Permit Application
AK. Rim Engineering Ref. No. 04=001`22
Dear Mr. Roth:
I to cc
3n review and a permit to install an'onsite septic system to serve
le
/a
esting
DESIGN SUMMARY
Soils _.
A test hole was excavated on February 25, 2004, and a monitor tube instalfed: A
percolation test was conducted in the same location on`the property on 1rebruary 26,-
2004. The attached Septic System Plot PI'an'shows the approximate location of the test
hole, labeled AKTH #1. The soils were rated'inthe field as SM1 silty sand;`underiain by
percolation rate of 32.2 minutes per inch which translates to a wastewater application
rk -n
rate of 0:45 gpd/sgft. In addition we'have enclosed'T'oliln Spurklani•J s "tesff hole logs
.< „a
labeled TS THT4 and T5TH15 T}ie proposed dralnfie wilt 6e'deslgned aroundthe 30'=
feet radius of thet'estholes. The locations offt'Wstholes are noted on the Septic
System'Plot'Pian.'
Groundwater was encountered at 12 feet below ground surface during the initial
excavation of TH AK#1. On 3/3/04, the monitor tube was probed and groundwafer was
detected at 12 feet 4 inches below ground surface.
Trench Design _
The following is a summary of the proposed design of the trench SAS:
Engineers • Planners • Surveyors
Mr. Dan Roth, MOA .
Page 2
Surrounding Properties
March 24, 2004
This property and the parent subdivision will be "served by community "water sysfern:'" " ` '" "
=Percolation rate:
32.2 minutes/inch
Soil application rate:
0.45 gpd/sgft
Number bedrooms:
4 -
Daily wastewater flow'.
600 gpd
Drainfield'.
"5 -wide type drainfield
Septic tank:
1,250 gallons
Minimum absorption area:
1334 sgft
-Tofai depth (max)'..-
__ .
$ ft -,U.,.,., _, _ e - _..�
Effective depth:
4 ft-
Width: `
5 ft
Reduction factor`.
0.50
Minimum length:
134 ft (2-67fttrenches)
Effective absorption area:
1,340 §qft
Topography _
,
Surface Water
There are no surface waters within 100 fieef of the'propose"d septic system.-
Surrounding Properties
This property and the parent subdivision will be "served by community "water sysfern:'" " ` '" "
We are unaware of any adverse impacts this installation"wouCd'"have
_..w. _
on adjaceni""welis or ' "
septic systems. If you have any questions regarding t15is
feport or'its rebommenda`tions .._
please feellhie to contact me.
Sincerely,
ALASKA RIM ENGINEERING, INC.
�����t't fr'
+i
4r :OATH
Mary L. Shreves/
m .Q
♦ Ma LNShroves •
Professional Engineer
CC: Troy Davis Homes11FE
AK Rim Engineering File No. 04=00122 "
_.
Attachments:.
,
• MOA On -Site Sewer /Well Permit Application Form
• MOA Soils Log — Percolation Test Form
"
• Septic System Plot P(an / Septic System betails
• Test Hole Logs (2), Tobin Spurkland
PERMIT NUMBER
PID NUMBER
/
I NlI X,59.96 LOT 13
\59.72
� 56.05_ i \
v� 54.20 13 G SE'(BPOK \\ X59.77
o. �y
�.
PROPOSED DRIVEWAY
15 —'
SET PPK P` ROPOSED
G\ \ TW TORY e ti LOT 14 \
O•
DWELLI
0
�1 \C his iHt4
56.40
5 El SEPEPTIC T NK 7 •f-
AK T
1 TH 5
1 Rao amass TRACT
'51.25 /
1 \
1
LOT 15
40,000 S.F. 15.29 /
1 BLOCK 4
1 0 0 til / N
1 LOT 16 COVERED
5/8" REBAR
MARKED \v TRACT B-2 /
OT 1 1 BESSE TYP. .9 / \
S85• 42"W /
— — 2.50' /
/ 1 60'
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.
OF A��i� SITE PLAN ALASA P.O. BOX 2749
��� (� ••.• .., qs, I� C RIMPALMER, ALASKA 99645
��P '.• ENC NEE INC. PHONE: (907)745-0222
FAX: (907)746-0222
7H ,I/00
A 9'rrrlA••.... Y J"% W.O. 0400122 DATE: 3/22/04 SCALE: 1" = -67-7F
r: Q
s' t Ma L. Shreves „ �•
CE 9351 LOT 15, BLOCK 4, TABLELANDS SUBDIVISION,
®� rF •.,
` 2
EASEMENTS OF RECORD RECORDING T, ALASK
PLAT No. HE
RECORDED PLAT ARE NOT SHOWN HEREON.
SHEET 1 OF 3
PERMIT NUMBER
1" = 40'
PID NUMBER
TW TORY
�\ DWELLI
vy
S TH14
\1250 GAL 01
EL §EPTIC T NK 7 9�,�
AK T
63
Jn
V'
LOT 15 \
40,000 S.F. %
SEPTIC SYSTEM PLOT PLAN
OOu
abs pilon
(... Dem Sha 2)
SEPTIC SYSTEM PROFILE
!! �-
��� OF ! SEPTIC �asx P.O. BOX 2749
�P�� ALgSl��i ENG EEru ,INC. PALMER, ALASKA 99645
ci) f I� PHONE: (907)745-0222
*.: 9 �i FAX: (907)746-0222
�...,TM•••• •'.*..% 04 SCALE: 1" = 40' FILE: 0400122
.��. W.O. 0400122 DATE: 3 22
% Mary . Shreves
Misr'• CE 9351 LOT 15, BLOCK 4, TABLELANDS SUBDIVISION,
� OFFS$ �t,,'``� EASEMENTS OF RECORD OTHERPLAT No. 2004-25, ANCHORAGE RECORDING
DISTRICT,
NTHOSSESHOWN NON ANCHORAGE,
AL
RECORDED PLAT ARE NOT SHOWN HEREON.
SHEET 2 C
PERMIT NUMBER
perforated 4' PVC
"a Note 1
ae�er
rook
.olid 4' ABS. DIP.
m PVC Seh 40
Note 1: hateD ell mrfd
oreted PVC lou
(witbin 0. toot of none elevation)
`—noob
geaj:
tuetall monitor tube
at and of branch
budall closeout at
and of drain pipe
P 'it
x, X
2®67' f —
WIDE DRAINFIELD
PLAN VIEW
Insulation. N used
a" Note 2
TRENCH DETAIL
Note 2: P a minimum of 4 -feet d earth cover
(Etch l e te6ova os�ll o trench One
be mbotituted for one foot of amth covveery
up to a nerinum of two Inch" of insulation.
Note 3: Lartmum excavation hall be no more 10 fast.
Note 4: Not uead
riII111%%�Nx %
d vurla"
ELEV. 52.0'
°ate
insdetiou. 'Ve
earth
z
g
ELEV. 40.0'
4
3 x
sewer
4'
"ask
-• +4
elfeotive deptL
.;
ELEV. 44.07'
undisturbed
a
�highae"ansi high
... giuundwatar
m
ammcable
ELEV. 38.0
PID NUMBER
1 -Soot
E'b 5' t
U 0
perforatad PVC
hole orlantetion
(bake down)
SECTION X -X
""moveable
cap
ground eurfset
/// ///
newer rc
— coupDog
17c td
sewer reek
TRENCH SECTION MONITOR TUBE
DETAIL
SITE PLAN ALA K P.O. BOX 2749
C`'RIM PALMER, ALASKA 99645
ENC EE INC. PHONE: (907)745-0222
FAX: (907)746-0222
W.O. 0400122 DATE• .-i/99/n4 SCALE: nts I FILE: 04001
LOT 15, BLOCK 4, TABLELANDS SUBDIVISION,
PLAT No. 2004-25, ANCHORAGE RECORDING DISTRICT, ANCHORAGE,
EASEMENTS OF RECORD OTHER THAN THOSE SHOWN ON THE
RECORDED PLAT ARE NOT SHOWN HEREON.
SHEET 3 OF 3
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.org/onsite
(907)343-7904
Soils Log - Percolation Test
Performed For. Troy Davis Homes Date Performed: 2/25/04 & 2/26/04
Legai Description: Lot 5,Block4, The Tablelands Subdivision Township, Range, Section:
13
Depth
5ii�opd wlgraPel,
9CA �rtC0d ke';,,
�", YW , 4w)
101P e yt )
�al,0 W) eiH-aAd
9N])
WAS GROUND WATER
ENCOUNTERED? Yes
S
IF YES, AT WHAT DEPTH? 12 ft L
_ � W',�...ADeplon Water Ager o
//���� VV'��/// Monitoring? 124" P
j6CGA# � Cpbble. E
aws,e t 1M� i4, Date: 3/3/04
ChM Reeu,�';t•mpd q • t Z � oy CQ,�L,, nm d e_
15-
16-
17 -
COMMENTS
Reading
Date
Gross Time
Net Time
Depth to Water
Net Drop
1
2/26/04
1524
10 min.
5 8/16 in.
8/16 in.
2
--
1535
10
5 8/16
8/16
3
1546
10
5 7/16
7/16
4
—
1557
10
5 6/16
6/16
5
1608
10
5.5/16
5/16
6
1619
10
5 5/16
5/16
VhKUULArION RATE a2.2 (minutaMmh) PERC HOLE DIAMETER B In.
TEST RUN BETWEEN 4.5 FT AND 5.5 Fr
PERFORMED BY: Kent Sheets, AK Rim Engineering, Inc. I Mary L. Shreves, P.E. CERTIFY THAT THIS TEST WAS
PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:' 3/10/04
mar c5 U -t Uzi:iSa Troy Mavis Hm
Mar 25 04 09:43a Rick
8U'/35"/`J385
907-357-9641
Municipality of Anchorage ;•,t=NGweaassEAL11
Development Services Deparimenl
130,11na Safety Division r' .
on -via Water and Wastewater Program
4700 South Bragaw Sl
P.O. Boz 195690 Anchorage. AK 99519.56S0
—.d.2nchomoe.ax os j 1
19073340.7904
Soils Log - Percolation Test
ier'.ametl FPr At�C, 1C DEyc(i
-r_^�a I OeSrri Dtlan: �j L /n.I l �/J✓ �Date
7DaiePenonea:
Fe [ww�p.IRja�pla
L. v T 14 Z K 5 Sr—r—i'=r—� Bile P an
Oepo
O
PR -4 rA NI6�
Grass Time Net Time
DePih to water
Ne: oro:
FILL
-j-L- 02�t
t�>< C>A
tl
I
1
12
i3_i
iaorToLa.c or
9'1
tic LLC
I
I'
7 t
2:
P.
P.5
WAS GROUND'NATER
ENCOUN'EREO? Np
5 I
IF YES. AT W MAT DEPTH?
DePtb ra Water Aher
MonilDnng7 nl _. E
Dale �- O
Reaaing
Date
Grass Time Net Time
DePih to water
Ne: oro:
FILL
-j-L- 02�t
t�>< C>A
tl
l:lO
9'1
a 1$ -30
7 t
13'
L
6
�Ana,�a.A�wn wire IV (mYdei m PERC MOLE DIAUEIER (D Y
t ESTRUNDETWEEN z FT AND FT
-%O^uED BY1. 5, 1 1. S. CERTIFYTt1ATT-ItS7ESTI'u.&
''C'?OR.tEO:N ACCORDANCE WITH ALL STATE ANO MUNICIPAL
GUIDELINES IN EFFECT ON THIS DATE, 0.47E 3 -.27-0Z.
Mar 25 04 09-:16a Troy Davis HM 9073579395 P.5
Mar 25 04 09:42a Rick 907-357-9641
ii P•2
Pericrmed
Legal Oe4c.
Municipality of Anchorage
Development Services Deparimenl
BUildrlg Safety Division
On -Site Water and Wase *r Progiam
/4700Soo018r29aWSL
P.O. Box IS6650 Anchorage. AK 99514-6550
wv+l, d. a nc W Iaoe.aR.US
(507) 3737901
Soils Log - Percolation Test
Bessie Engineering,
Loi:K; Block]}; Tablelands Sube
ROBERT C. COWAH
CE -8801
1it1, fwii, uni,
2/10/05/ - E
sas # /
SEE SITE PLAN
WAS CP.OD:A WAT-A
E xcO .E._
;01 No
n a s
[FYES.AT~TMP.Tr0 E
D<plh to C6k: Alnr 0
alanenlna? llrY EI f Ell
D:N07./18/04 I
Ra -dog
Depth
flet Time
Depth to Wafer
(Feet)
�rRanics
1-
2-
o.l
II I I
3-
i
4-
0
5-
LX -1
.�
0
77 E`I
6-
1
7.
i
JGM
-
8-
1D-
jp
I
12-
O
13-
i 3-
14--
1a_
BON
ROBERT C. COWAH
CE -8801
1it1, fwii, uni,
2/10/05/ - E
sas # /
SEE SITE PLAN
WAS CP.OD:A WAT-A
E xcO .E._
;01 No
n a s
[FYES.AT~TMP.Tr0 E
D<plh to C6k: Alnr 0
alanenlna? llrY EI f Ell
D:N07./18/04 I
Ra -dog
Dxte rao:i Time
flet Time
Depth to Wafer
NelDrop
7-tio4041 0 1
II I I
f0wnz'',2.
-
0
LX -1
10
77 E`I
�/ , 4
,p I
jp
r. :•.txa�r�n rue _m. oewrvmc> ,( F=ee FctE DIAbIET E4 6�
T PUN S=—iF=fl
CC`MiMENTS ] —I--•
BY: SSS Engineering ]Robert C. Cowan cERTIFYTIiATTF.lSTc Tp7.e.S
b`I A(;CORDA:ICE C11TH Pit STATE F:VD D.W:I1ClPAL Gt110EL1flES'.PI -6FFECT Off 7HIS DATE. DATE: '2-/j 16/0'1
• Municipality of Anchorage
On -Site Water and Wastewater Program
(907) 343-7904
Certificate of On -Site Systems Approval
Parcel I.D. 051-741-46-00 Expiration Date: / 0
1. GENERAL INFORMATION
Complete legal description The Tablelands Block 4 Lot 15
Location (site address) 23232 Whispering Birch Dr.
Current Property owner(s) Robert Schmidt & Genavie Holen Day phone 830-4598
Mailing address 23232 Whispering Birch Dr. Chugiak, AK 99567
Real Estate Agent Day phone
2. TYPE OF DWELLING:
❑ Single Family (w/wo ADU) fQ , ? 3, � n x
F-1DuplexL9Iih
❑ Multiple Dwellings (Single Family and/or Duplex)
JUL 4 V CUIV
3. NUMBER OF BEDROOMS: 4
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
❑
Individual
0
Individual Water Storage
❑
Holding Tank
❑
Community Class Well
❑
Community
❑
Public Water System
❑
Public Sewer
❑
Waiver/Variance request for:,
Received by:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ 526.00
Date of Payment ���cc1 Ow
Receipt Number d?o
COSA# orb" 141311
Date:
Waiver Fee $ _
Date of Payment
Receipt Number
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 Alaska Rim Engineering, Inc. Phone 745-0222
Address 9131 E Frontage Rd. Palmer, AK 99645
Engineer's Printed Name Charles A. Leet, PE
6. DSD SIGNATURE
I� System #1 Approved forf bedrooms
System #2 Approved for bedrooms
Disapproved
Date
y PS.
a*• 1 %�� ••.e••.k
..
•• Charles A. Leet . >
T�•• CE10480 ••�p�
Conditional approval for bedrooms, with the following stipulations:
By: Original Certificate Date: ` 3
Theuniap ly nchorage 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
COSAbluesheel r -
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:
A. LL DATA
Well type
Date completed _
The Tablelands Block 4 Lot 15
Total depth ft.
Date of test
Static water level
If A, B, or C provide PWSID #
Sanitary seal (Y/N)_
FROM WELL
to ft.
Well production / g.p.m.
WATER SAMPLE
Coliform _Lcolonies/100 mL Nitrate mg/L
ug/L Date of sample:
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Greer/Steel
Parcel ID: 051-741-46-00
Well Log
Wires properly
Casing hoight(above ground) in.
ft.
Collected by:
Date installed 4/15/04
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 5/22/14 Pumper Sanitary Pumpers
C. ABSORPTION FIELD DATA
Date installed 4/15/14 Soil rating (g.p.d./ft2 or ft2/bdrm) 0.45 gpd System type 5' wide Trench
Length 134 ft. Width 5 ft. Gravel below pipe 4 ft.
Total depth 8.75 ft. Eff. absorption area 1370 ft2 Monitoring tube Y Depression over Feld N
Date of adequacy test 7/11 /14 Results (Pass/Fail) Pass For 4 bedrooms
Fluid depth in absorption field before test 11/24 in. Water added 900• 7.5128.5 gal. New depth in.
i/�
Elapsed Time: 1440 min. Final fluid depth 13 i`n2S P4l�bsorption rate , 600+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) N 0. & • If yes, give date
ATION
Date installed ze-ia..g Il,
"Pump on" level at in. "P
data Cycles tested
E. SEPARATION DISTANCES
WELLON LOT TO:
level at
Meets alarm & circuit
Septic tank/lift statin t On adjacent lots
Absorption field on lot On adjagan
Public sewer main wer manhcle/cleanout
Sewer /septic service li Holding tank
Ania ontainment areas Manure/animal excrete storage areas
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation Property line 17 Absorption field 101
Water main Water service line >1 O Surface water >1 OO
Wells on adjacent lots N/A
ABSORPTION FIELD ON LOT TO:
Property line25' Building foundation 16 Water main >10'
Water Service line O Surface water >100' Driveway, parkinglvehicle storage >25'
Curtain drain >50' Wells on adjacent lots N/A
F. COMMENTS
G. ENGINEER'S CERTIFICATION
l certify that if have determined through field inspections and �o%�_
review of Municipal records that the above systems are in _? (�•""'�ASjrI�
conformance with MOA COSA guidelines in effect on this date.
Engineer's Pr' ted Name Charles A. Leet, PE 9TH •• ••
Date 5 rarits A.
E0680 to
1 . \?
V�
COSA brown sheet 10-10-12.doc
ral
.--1
[�
\
\
z
w0
f-
Q
W
/
\
c�
N ? w FK
V;O
w O
N
)f')
C7
a
/
N
? wz
a
r
p
"t
m W W
\
a O
w
w m
.-
U 2�
~Q
/
•-
\
z N ZW
22
o�
oo
Q 0
W
Z
j
O.
O
z
L4j
a¢ �Lr)
U-
a ZQ
F
a v
Q
N
NOO
WE~
Oa 00
mZ
z
E-
w
NMON
Q-O (nQ
\ O<U
�'!
��`C,.
Qi �U
w
O
v
¢�J
I
W
/\
\U.IJ
Wim-
\ �L'i
wo Dc��°
w 'j .
2 0 J
wF Nz �� U 4
°�� S�
N
w 0z
=
F o a N
�O z
wo
O w
t0
Nyn
X �^�
t\
:II
� -Z O
�O� AZO
O
SON
zF S
awpp0ppp...
S
E-� Ow
m�� wU
OU
w z
^
Ogo^
Lei
Wmm0
~
OW O0 w
\
:O
wN}
.--I O
O
N p
w]_ z
UN}
z,w
m QO) p
`
J
Q
wUNO
W�
�ai�W
¢3 �N
Z¢U'
+ J(e) w^
* O
i:i�ri
fnN
0W
0o ri¢�
foo
x
0)
aW�yj
V)
Q=Wm
0-0
Lu
ao
'C2
i N/ lwi
zaF
\ Fo
a \Oa
*w �ti�0
v
\ ,�
J
/
*oy
��w
woo
�a�
-JO
Qa2 w
d.
wC�W�of00
QZJg W 2W
o
if) 3 '�.:::;:
^
w a}
U Ov
*
ywow
=w� ��d via
F> >x
NZN OW
zzm
o
0_
ti
ti
O
a-
=3:mo X: V)w
O
-JIa"U OI-w
\
W.
ao�Os
F Q
w
zzw
ANO
z
o�
�m� :..'d�
O
NZ •J
Q z U
W ¢F
OV) ¢-mw
--ECY)
QmN
•
F-OWZ 0 ZO
=�TQ
�K�/ O \
OJW
> UO
w
�NJrF
NOS w z0
p
v=im
�II
tt��
W
H
~W~�OWp
�SJ•'�O)fl ..;;::
'o
3
J
e ON0
x
x /r0'�FZ)
Z I
NF,ii
=oma c�oo�
�Uvmi o�ao3
aww
zoa
0.' W
`
j W
Q
O
}Sd�N XQ�
F-
F=ZYq- 03
\ \
t� 'O\'/ 55
�6?
/
aj')j0•
F
w•1J mN
} ¢ O
owi`'
waa
W
N
WOD O00 pWIn
UZJN 2
\
k\
wU 0
q
* X /2J�
J
f�V
0 I
rJ2 awC!
�¢WO ��2p
zw�3
Fwo
tiFO
oz�
J
O
O
}.Om HOH
mF- 6 w�
WU�Z Q
W
\`
zi U a
3>
f--i �,.�
�w n
o
\� 1L
p w
lk1
SZ o�
o
4
U o
z
w I
7wm oo¢
o¢ Mx Sw
wo 3 �j
�a w�SF'" 3
o
op
m�v�i
m
I
¢
p
�r
mow'- mQ Y
O
WO_ W On
SAO V)
O
rJ `�\
!•
O !
F �F-w.
z wMm�
Q O•-
X
in V)0
QU
wW3
v=i0
Z
ow ao1z��
wmz NO�QC9Narz
zao
d¢
-?Ja rQ
z
m�
orn000 H-WO00
WOO
wz
b�f
O\
c�F�M
R00o
W
w ^�,..�
vicQ
<� I
05UU}zoa0m
zf2omg02oaiEw
=ow
•�4:•••°•
°
`'ryy�s 4
•1•°•°.Py�l
/ .-I
\ N\ F-'�'\ `y\
ma�3
J .....
K�wa
NUw
N
/j�\-�/-\
/ U O
\\
V\—{1 it
O
'-)
LL
U�O N N
yajw \
wpo Zoe
CQQ
�
pN�ilQf }
�a� im�rca'da
a'K �v0)aawo°
�3m
4. �•
Li°
.4
.0 1
m •� o
OV)ODUr)O7
U)\ M1�`
/
O �V) ZoW
Nz
OOK
�• =I :
~
•� N
N•
J
\ r 1
a mwz C O
f
c1 111
Z UK�n' 3¢JF
z0=
za¢
^
°•
a•y�
• K Q
Q
O
I i
L, I
OO¢OOOK OO
8-0000r015; J
��F
Q' •n�
Q
e U' e•°4�
C�
UNN�NWNf/I¢N
���
xaz•�
�u •
•'°lS1�o- i
°RSG h
z�cv ri aui�
wo¢
-
N
LL
d'
N
LO
O
O
7
U
LU
O
a
N
0
O
0
O
C
m
m
U
U Q
U
O
0 a Q
U C)O
W LU
m Q
a
zO W
� a
11
0.
LO
Cl. N
Q
T z
O
E a
w c
T
J
d 0
�
�
U O
❑
N X
Q
Q
Q
N
Y
UO
z
z
O
z
m
>
❑
❑00
-O
O
u 0
❑ 0 w a U
c
mm
O
N
a
a
v
}
z
0
N
0
N
0
N
❑F-
7
N
c
> O
E w
O
N
L
O
CDJ
m> U
LL LU
J W
LL
�FOco
o
O L
UI-Q�
~ m.
LL
U) (D
J z F-
J—
m
CO
W 2
z z z
■❑ ❑
C
Cl. N
O U
C c
.Q m
E a
T
d 0
T
U O
Y
N X
Q
O W N
N
N
1
N
LL.
>>
T
>
>
U U c
o c �: U
N
z Co cnn
�i a
u 0
❑ 0 w a U
m
I-
O
J
J
0
0
N
0
N
0
N
0
N
U
c
E
LL
o
j
Ea
c
w
U
0000=
L
L
L
L
N
U
U
U
U
O
O
LO
co
N
co
O
N
N
N
LO
N
p
W
O
(0
N
co
V
co
co
co
N
cLO o
N
N
N
N
N
a
) G
J
U% L
Q C
d
(n
co m r
0
C
J
in L
N
c
N L
LO
LO
l0
Ln
W
LO
10
LO
O
ul�
CO
LO
CO
N
J J C
N
N
N
N
N
N
N
N
N
C6
LO
LO
t0
0
0
Q
d
O
N
co
o
u
-? > L
F-
LO
l0
V
LO
I�
t`
Lq
c0
co
L
LO
LO
g
LO
U) T
v
o
v
g
v
O c
_l J
L
C
d
U)
N >
J
Un
. .-.
Co
CO
N
C )
CO
0
U> O
ON
C(Om
V
comm
O 0)
O
N
N
n
N
Lo
N
>
N
N
N
N
aJ E
0000
0
o m Q
OLO0LOLn
F rn
UO
M
0
0
Cl)
V
V
�O�j
z z z
■❑ ❑
C
Cl. N
O U
C c
.Q m
E a
o
d 0
U O
N X
Q
O W N
N
1
N
LL.
L
T
O CoO.
U U c
o c �: U
(n d U N ❑
z Co cnn
�i a
u 0
❑ 0 w a U
m
E
O
J
J
L
Q
`o
U
m
LL
C
O
V
d
O
N X
1
N
LL.
L
N N
O O
m
7 0 C
LLL)
0.
o
N
3
w
F"
J
`0 ❑
Ci 11
� *
c
Ill
Municipality of Anchorage
• Development Services Department
Building Safety Division eY
On -Site Water and Wastewater Program `
4700 South Bragaw St.
P.O. Boz 196650 Anchorage, AK 99519-6650"
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 051-6e"68HAA #_
Expiration Date: /17
1. GENERAL INFORMATION
Complete legal description Lot 15, Block 4, The Tablelands Subdivision, Plat No. 2004-25, Anch. Recording District
Location (site address or directions) 2321? Whispedng Birch Drive
Current Property owner(s) Troy Davis Homes Day phone 357-9394
Mailing address 1451 E. Parks Hwy, Ste. 207, Wasilla, AK 99654
Lending agen-cy AK USA Da hone 689-3240
Day —
Mailing address 12155 Old Glenn Hwy, Ste. 101, Eagle River, AK 99577
Real Estate Agent ReMax of Eagle River (Audrey Mason) Day phone 696-3887
Mailing Address 16600 Centerfield Drive, Ste. 201, Eagle River, AK 99577
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 4
3. TYPE OF (NATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
❑
Individual On-site
❑✓
Individual Water Storage
❑
Individual Holding tank
❑
Community Class A Well
0
Community On-site
❑
Public Water System
❑
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 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 reissued with
new water sample results. (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 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 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 AK Rim Engineering, Inc.
Address PO Box 2749, Palmer, AK 99645
Engineer's Printed Name Mary L. Shreves
5. DSD SIGNATURE
Approved for 41 bedrooms.
Disapproved.
Conditional approval for
Additional Comments
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
By:
5�-5U
(Rev. 01102)
5� I1�5 1cPg� .
Phone 745-0222
bedrooms, with the following stipulations:
r
ON-SITE
D . m.
WASTFIA/ATFR
PROGRAM
'c1Y13GY �\
X Maintenance Agreements
Supplemental Engineer's Report
Other
Original Certificate Date: ��_
LU 1' 1 U
R BAR wj C -/ FOUND ,5/8"
ao947- IEW LOT 13
{�
w
PEDES ALS ..
�
�RCK 9"� -
�0 AO
5A DRIVEWAl""'
Y /VALVE N
— eA . LOT 14
t5 1 NAIURAC
GAS
COVEFFEIi' i a� ^ UNDEft09f51115" m
DECK s o UTILITIES
`Sy�7W0 STOtt' �
DWELLITJ"G : �
CANT
S
0
a0. SO DECK O`
Ns O. RISERC- O•
BASIS' OF BE " "t^ TYPtGAL ` .
Fl20Ad 1�tE tC" LOT 13"?O W CLEAN -
NW` 001:6�t torill NIG p
O
S65`12340w 508:35'(R) (TYPICAL)
/
- LOT 15
` 40,000'-F
BLOCK."(4
LOT 16
TRACT
LOT 11
.S85020,42"W
LEGEND" �:m .._.. N �3_ ... w� . 2.W(MC)
(((R ECORD) MEASURED) j /
(C� (CALCULATED) /
NOTES: THIS
'
1 THI$_5URVElr`I2pI2Sj`�`°j
2. THIS'DOCUMENT DOES NOT CONSTfTUTE A BOUNDARY SURVEY &, IS SUBJECT TO ANY -
INACCURACIES THAT A'SUOSEOUENT BOUNDARY -SURVEY MAY DfSCC�SE.
EXCLUSION "71"("i'S` _ ..
OR RESTRICTIONS WHIC`F( DO NOT` APPEAR ON `fF{E R MOED SU DIVISION PIAT. UNDER NO CIRCUMSTANCES SFIOUlO
ANY'DATA HEREON �BE USED FOR �COR$TRUC ONy OR FOR ESTABL�5HING' BOUNDARY' OR FENCE TUNES.
AS-601LT P.O "aw, u�
�E O q� atll PALMM, A�"! PAGE 1 of t
SqP,.• :1J`F ENG EE IAC PHONE. (907)745—'ii22
o -.-49TH* * :9 FA)(i' (907)7461-Z)121 FIELDB00'K"0�r='14
0. '0400122 DATE S f "Ill04 SCALE t" 50' FILE:04—OOT22AS
I N HER E6Y i" Pllii "t"H `P` 1 i1Y 1L .", A'" RMA';,_ .,.
. .. INSPECTfO7J Oht"THE POLL-POLL
n Rob J. Farmer : o G DES{ RISED PROOE"RTY
10515-5 LOT 15, �L OCZ d; tii Tilt ll+Ii�StJgisp „
"vim s PLAT No. °20 54 25, ANCHORAGE I C(3 t15iF1G biS?RiC% ANC � K
fuitnx� ��° EASEMEN' OJ.
1 fSl i fi ,u.
RECORbELS 'RLAf11 iJti s�rt�i i R,
ALASKA. PHIS 81W 0AY Off`' SEPTEi�16Eq. 1004.