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HomeMy WebLinkAboutAUTUMN RIDGE LT 17Autumn kidge Lot 17 #015-054-20 Municipality of Anchorage Page 1 of 3 Development Services Department On -She Water and Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage. AK 99519-6650 www.ci.anchorage.sk.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. SW040199 PID Number. 015-054-20 N. Crown Pointe Inc. Wastewater System: New Adger P.O. Box 112313 Anch. AK 99511 ABSORPTION FIELD 345.6277 cif Five 5 Deep Trench LEGAL DESCRIPTION Sal R&L.aTo11Osp1h °rWviiW d° Bva c Lel Sub* on. 17 .5 GPDA'P DOPY. b pp e . ham pow ate. 11 n. Cx..+t drop e h ape. Autumn Ride 3 Ft. 8 Tp nYOPv R«V. s.ctpr F A eYMC.ew. cr9mr qr d FL Gruel L.VM 1-3 FL 100 Ft. Well: New 3 c4udra (Pr .. A, B. CF Tp"D&M Private cwdb Ft. 73M.Dwgp «.a 2 >16 FL "M«xw. 236 1412412001 235.5 1,600 Fe ASTM 3034 PVC Dr , M -W Dn Ing Date Dw.d sta W««L.w 197.2 FL Sanders & Sanders 7/16/2004 rwa Pero S.t w. C.xq Ae 43 a 20 C" Fr. >2 Ft TANK SEPARATION DISTANCES 0 septic ❑ Holding ❑ S.T.E.P. ❑ Other. To Septic Absorption Lift Holding bnop tvate r From Tank Field Station Tank Sewer Leta Anchorage Tank 1,500 wag >100, >100, NIA NIA >25'Steel Twa Lap� o (2) s.ee.w"« >100' >100' WA LIFT STATION — NONE ON LOT Lot L.« >5' >10, WA >5' >10' WA JNWA h In h c ro o. None Noted ""°''" ""°°" Ei c "ir;5;Z m.p«jp by. R«wlu: BENCH MARK Northwest Concrete Pile Cap Supporting Upper Deck 100.0 FL Engineees Stamp OF�A40 • Inspections performed by: A. Harala Dates: 1" 7/16/04 °! 49th 0 Department of Health 2nd 7116/04 and Human Services approval %-r �*,D�AEL E. ANDERSON f{ � Reviewed and approved by Date: 3 — e7 OS tl ,r1 No CE -4381 #�#�`el .. (R 1") 444 1U�Pi�� Permit Number. SWO40199Municipality of Anchorage Page 2 of 3 DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report ZIEMLAK CIRCLE PLAN AS -BUILT SCALE 1' - 40' PID No. 015-054-20 AUTUMN SUBDIVIS Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-0655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number. SWG40199 Page 3 of 3 PID No. 015-054-2u t NS U y y UU a ; ya s> 0 1,500 Gallon \\\ v Septic Tank = 93.6 9 .6 U f s - N I 90.1 0 u 82.0 NORTH LEG s 94.26 _ i U Drainfleld Rock 50' (Trench Length) SOUTH LEG ---._.................._........ PROFILE AS -BUILT % =""o.cmM39, ' No Scale �i �.A:''... ..••' C M -W Drilling, Inc. *P.O. Box 1103784Anchoroge, AK 99511• •907-345-4000 ♦ 907-345-3287 Fax* Groundwater Well As -Built & Loc a Well Owner.- L.E. H *Legal Descrlpt(un: Lot 17 Autue Job No.: 01-141C PermitNo.: Wp18li Project No.: NIA • Use ofWell: Monitor oraee •llo/eDepth: 236' • Casing Size. 6" •Cared To. 235.35' •Maverkt. A53Steel 0,0411 hleshod: Air Rotary Perf. • Well Campletlon• 07 en end X Screen Perforared Method.- * Screenl Perforation desITH—Prion: ethod:•Screen/PerforationdescrlptJOn: None •Croat Notes: (I) Sack- No. 8 brntonite granules ♦ IYell Derdopment: hfethod: Air surge Notes: a Static water level (SWI) 19721 kbov (below) top of casing (TOC). 4 Well yleld test at 20+ gallons per minwte (CPM)/RO!h Ow fOPH) Jor 1 hours With 100% Of drawdown (DD) from static level (S W4 •hfethod: Airlift • Date of eomplellan: 24 Apri12001 � Pump IAMB: NIA Depth In feet from to oftesin . Deli [Is of formations PcMdrsted,sircofmateria color and hardness. 0 TO 2 Casing stickup 2 _ TO _ 7Silt Ia ey_SmySl 7 TO _23 Silty gravel _ 23 TO 37 Sandy gravel ---�— ^- - 37 TO _ 4_2 Sandy gavel: damp 42 TO 56 Silt cla a Pavel 56 TO 59 Silt avel: damp - 59 64 TO TO 64 109 Sil , sank_gravel: brown damp Siler gravel: gray 109 TO 118 Sandy gravel: - Silt ravel: gray Sandy gravel: brown n Silty gravel & clay -- 118 128 _ 135 140 143 157 TO _ •O T TO TO TO TO 128 135 140 143- 157 178 Silty, gravelly clay Silty, sandy gravel: brown Job No.: 01-141C Permit No.: N/A Projec[No.: NIA Well Loe Continued Depth in feet from too orcissing, DNnasorformations penetrated,size ofmaterial, color and hardness. ► 178 TO 195 Clay_ 195 TO 205 Sand gravelly clay: damp 205 TO 215 _Sandy gravel: dam 215 TO 236 Gravel: coarse, slightly Sandy, water bearing TO -��— TO TO f—_—`_ --- TO TO - TO TO TO — _ W1tfA't ardJiFd CtinZtac rki{fSCtiL Nn'L$1lJ[->i7i—_— TO TO TO TO TO TO _ TO �' TOTO TO _ TO TO _ TO TO TO TO TO TO – TO TO TO TO TO _ MUNICIPALITY OFANCHORAGE Development Services Department On -Site Water 6 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Permit Number. SW040199 Legal Description:-Augumn Ridge Lot 17 Design Engineer: 0014 Anderson Engineering Owner Name: Crown Pointe, Inc. Owner Address: P.O. Box 112313 Anchorage , AK 99511 - 'Al)t, j04 112 -LO NcO,J lliuloy IOU Date Issued: Jun 17, 2004 Expiration Date: Jun 17, 2005 Parcel ID: 015-054-20 Site Address: 9478 Autumn Ridge Circle #44 Lot Size: 49547 SQ. FT. Total Bedrooms: 5 Permit Bedrooms: 5 This permit Is for the construction of: 0 Disposal Field E Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specked 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 e Date: Issued By. Date: (Z u Municipality of Anchorage • -- Development Services Department Building Safety Division Onsite Water and Wastewater Program 4700 South Bragaw St P.O. Box 196650 Anchorage, AK 99519650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWERIWELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. n v � — O S -1— Z—c Number SW Property owner(s) Crown Pointe, Inc. Day phone 3456277 Mailing address (1) P.O. Box 112313 Anchorage, AK 99511 Mailing address (2) Zip Code Legal description (Lot, Block 8 Sub'd.) Lot 17, Autumn Ridge Subdivision Legal description (Section, Township & Range) 't 14—ist/, hro kAi fu1 V1 Lot Size 49.547 SF Acres q.Ft. Number of Bedrooms Five (5) 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. m F_ mac,, (Signature of property owner or authorized agent) Permit Fees: 41, D a Waiver Fees: Date of Payment L' / 4/ - D y Date of Payment Receipt Number. 6 r -T� Receipt Number. (Rev. 12!00) ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 FAX June 14, 2004 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 17, Autumn Ridge Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer. The owner of Lot 17, Autumn Ridge Subdivision intends to construct a five -bedroom home on the property. We are therefore requesting a permit be issued for the construction of a new septic system to serve the home. The Site Plan and backup documentation identify the location and configuration of the proposed septic system and alternate site and the existing well on the lot. Protective well radii of the wells located on adjacent lots is also shown. Existing drainage arrows and the current drainage pattern are also identified on the Site Plan. The drainage pattern will be maintained after development of this lot is complete. Test holes placed during the development of the subdivision indicated silty gravel with some sand in the area of the absorption trenches. The accepting soils were tested and found to have percolation rates of 26 to 34 minutes per inch. An average application rate of .5 gallons per day per square foot was utilized in the design of the absorption trenches. No groundwater was found during excavation and none was noted during the monitoring period. Our design includes the placement of a new 1,500 -gallon septic tank along with parallel 50' long by 3' wide by 8' effective depth absorption trenches to collect and treat the sewage generated in the house. The bottom of the trenches will be 11' below the surface. The distribution pipe will be 3' below the surface. A flow splitter valve will be placed to assure even flow to each trench. A minimum of 3' of cover will be placed atop the trenches and a minimum of 4' of cover will be placed atop the new septic tank. The ground surface on the lot slopes at 13% grades from north to south. The absorption trenches will be constructed parallel with the slope of the ground surface as Lot 17, Autumn Ridge June 14, 2004 Page Two much as possible in conformance with Municipal requirements. The new septic system will be constructed 100' from all wells and surface water. It will also be constructed a minimum of 10' from any water service in the area. 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. 2. 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. 3. 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. 4. 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 49th 'kN* MICHAEL E. ANDERSON 1< No. CE -4381 \fir. \ �� � .•�• ,�.�Q�r \\' ew THIS PROJECT CLASS 'B' WETLANDS Troes AREA MAF SULE1'a1W Trees qv" Brush ((T) ZIEMLAKaa8' CIRCLE 388' �i NEL E ANDERSM No. EE-42et 1 2001-143 AUTUMN RIDGE SUBDIVISION LOT 17 49.547 S.F. 99.>,. pROPON"O OU�L 1 373' x 28.9 u ac * 3 Wde V. soKtN x S [ SO* tp ,ot �O of"i 1 W23 w 24 enat� Site Nt E 69 62 S \ \ 's \' � E5�• 350' E` 20. �dL SITE PLAN SCALE 1' = 40' 350' LOT 17, AUTUMN RIDGE SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Five Bedroom House Deep Trench System Perc. Rate: 26 - 34 Min./Inch 1,500 Gallon Septic Tank Application Rate: .5 GPD/SF 6' Drainfield Rock 5 Bedrooms X 150 GPD/.5 GPD/SF (Application Rate) = 1,500 SF Absorption Area 1,500 SF/16 SF/LF = 93.75 LF Trench Length THEREFORE: Construct 2 - 50' Long x 3' Wide x 8' Effective Depth Absorption Trenches. Flow Line Elevation in Trenches to be 3' Below Original Ground Surface. Total Depth to be 11' Below Existing Ground. Place Flow Splitter Valve to Insure Even Flow to Each Trench. Provide 3' of Cover Over Trenches and 4' Over Septic Tank or Provide 2" Insulation and 2' of Cover. Maintain 100' Separation Between Open Surface Water and Septic Tank and Absorption Trenches. Natural 2'6" 1 Backfill Geotextile Fabric 6" 4" Perforated PVC (Holes Down) 8'0" 3' F—t TRENCH Drainfield Rock (NO SCALE) NOTE: Grade Area Over Trench to Drain Away. Minimum 6' Separation From Bedrock. Minimum 4' Separation From Groundwater. Minimum 100' Separation From Wells In the Area. Minimum 100' Separation From Surface Water or Streams. Minimum 10' Separation From Water Service Line. U Municipality of Anchorage�•�,� -U. Department of Health & Human Services 4'� *. ,weHAEL e. ANoOsow 825 L Street, Anchorage, AK 99502-0650 F s . a-4381 SOILS LOG - PERCOLATION TEST 6 �fq�••. .•' �� •.....• 6i� re PROFESSI0�'�e Performed For. Bob Klein Date Performed: 41%i2�%9� Legal Description: Lot 17. At Ri a Subdivision SLOPE SITE PLAN ■ 1I I OG/PT 8 Date Gross Time Net Time 3 Net Drop TESTH.O NO. 23 4 If Yes, What Depth? L 5 . Depth to Water O 6. 6.32" After Monitoring None P 11 3:09 GM 7 Med. Dense .. 30 6.25" 8 Date Gross Time Net Time 9 Net Drop Was Groundwater Encountered? No S 14 If Yes, What Depth? L 10 2 Depth to Water O 16 6.32" After Monitoring None P 11 3:09 Date: 1122/00 E 12 Date Gross Time Net Time 13 Net Drop 1 14 5.07" 15 2 3:08 16 6.32" 1.25" 17 3:09 18 Bottom of Reading Date Gross Time Net Time Depth To Water Net Drop 1 6 -Dec 2:38 5.07" 2 3:08 30 6.32" 1.25" 3, 3:09 5.07" 4 3:39 30 6.25" .1.18" 5 3:40. 5.07" 6 4:10 30 6.25" 1.18" Hole 19 Pert. Rate: 26 MinAnch Perc. Hole Diameter: 6 . .Test Run Between 4 Ft. and 5 Ft. Comments: Percolation Cavity Presoaked Prior to Testing. . . Performed By: A- Harala. I, Michael F And mna . Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date: 1/20100 �At-lit h A,•- 491H it o �.... w .o.. .. �.. `/ Municipality of Anchorage do1.•;�-_j Department of Health & Human Services 0, o� AUCHAEL !. ANDERSON�+:���pb 825 L Street, Anchorage, AK 99502-0650 C6 `% . CE -4301 SOILS LOG - PERCOLATION TEST e���®® pROFESStO�� oo� Performed For: Bob Klein Date Performed: 4i�t�oo Legal Description: Lot 17. Autumn Ridne Subdivision SLOPE 1 7 8 9 1 19 OG/PT GP 15. Boulders Was Groundwater Encountered? No If Yes, What Depth? Depth to Water After Monitoring None Date: 1/22/00 GM ' Tan _J Bottom of Hole Perc. Rate: 34 Min./Inch . Perc. Hole Diameter: 6" Test Run Between 5 Ft. and 6 Ft. Comments: Percolation Cavity Presoaked Prior to Testing. Performed By: A. Harala. I, Michael Anderson Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Dale: 1/20/00 Reading Date Gross Time NetDepth Time To Water Net Drop 1 12 -Dec 3:59 4.5". 2 4:29 30 5.44" .94- 3 4:30 4.5" 4 5:00 30 .5.44" .94- 5 5:01 4.5" 6 5:31 30 5.44" . .94" 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 WATER SUPPLY PERMIT Initial Permit Number: SWO10139 Legal Description: T12N R3W SEC 15 NE4 PTN Date Issued: May 29, 2001 Expiration Date: May 29, 2002 Parcel ID: 015-051-04 Design Engineer: 0014 Anderson Engineering Site Address: 005400 ABBOTT RD Owner Name: LH CONSTRUCTION Lot Size: 2214155 SQ. FT. Owner Address: 5400 ABBOTT ROAD Total Bedrooms: 0 Permit Bedrooms: 0 ANCHORAGE , AK 99507-4364 This permit is for the construction of: E Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy 0 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. 5. The following special provisions. THIS PERMIT ISSUED FOR AN EXPLORATORY WATER WELL ONLY. UPON COMPLETION OF THE WELL AND SATISFACTORY WATER IS ENCOUNTERED, THE WELL DRILLER SHALL PLACE AN APPROVED SANITARY SEAL ON THE WELL CASING AND NO PITLESS ADAPTOR OR PUMP SHALL BE PLACED IN THE WELL UNTIL A WASTEWATER DISPOSAL SYSTEM HAS BEEN CONSTRUCTED. THIS PERMIT ISSUED FOR PROPOSED LOT 17 AUTUMN RIDGE SUBD. Received By: Issued By: Date: L—)' rI c Date: j- — _3o — ®/ Municipality of Anchorage .Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/VVELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 0 1 ~---' O-5~'] -- 0 ~r Permit Number SW Property owner(s) LH Construction Mailing address (1) 12130 Regency Ddve, Suite 201 Eagle River~ AK 99654 · M'a~-~address (2) ~'~00 tqB~IT' ROtOr) Zip Code Legal description (Lot, Block & Sub'd.) Proposed Lot 17t Autumn Ridge Subdivision Legal description (Section, Township & Range) TI ZIv I{ 3 I,v $ E(...1~' ll/~' ~ Lot Size 45,704 SF Acres~ Day phone 522-1616 PTA/ Numbe. r of Bedrooms Test Well 2~214,15'5" THIS APF LICA~rlON IS FOR: Sewer Only I--] Well Only Sewer and Well Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub I--] 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: Date of Payment: Receipt Number: (Rev. 12/00) Waiver Fees: · Date of Payment: Receipt Number: e\ t Irll~V ! ..)'19 ~velopment Information: Municipality of Anchorage - • -� Development Services Department, = i Building Safety Division 0501 „ On-Site Water & Wastewater Program 4700 Bregaw Street P.O. Box 196650 Anchorage, AK 99519.6650 r www.muni.org/onsite Cj hl\ (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE4FAMILY DWELLING Parcel I.D. 015-054-20 COSA# 05G /O /D 87 1. GENERAL INFORMATION Expiration Date: C1 ` LL 10 Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address AUTUMN RIDGE S/D: LOT 17 9478 AUTUMN RIDGE ' ANCHORAGE. AK ► 99507 EREC do LISA ISAACSON Day phone 9478 AUTUMN RIDGE • ANCHORAGE. AK ► 99507 Day phone 344-6117 JERI JEFFREY W/ PRUDENTIAL Day phone 762-3108 3801 CENTERPOINT DRIVE, #200 + ANCHORAGE, AK • 99503 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 ❑ I 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 INSPECTION BY ENGINEER As certified by my seat ab9zed hereto and as of the validation date shown below, 1 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 13(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. 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 6 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 guaranteethat 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 fisted above. Any reliance upon or use of this report by any other person or party Is not authorized, nor will confer any legal right whatsoever. 5. DSD SIGNATURE Approved for -Zbr� bedrooms. Disapproved. 337-6179 Date 1 mail 0,19", Conditional approval for bedrooms, with the Glowing stipulations: Attachments: / COSA Checklist l Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: (Rw. 11105) J¢ff aA'-Gortfess: /E-7953 ,• �o ONSITE WATER AND WASTEWATER �• • PROGRAM ; Original Certificate Date: 6-17-0 \ Municipality of Anchorage ., Development Services Department Building Safety Division ° _ On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: AUTUMN RIDGE S/D; LOT 17 Parcel ID: �J 1 = (9.5-q -ao A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# NIA Date completed 4/24/2001 Sanitary seal (Y/N) YES Total depth 236 ft. Cased to 235.5 ft, FROM WELL LOG Date of test 4/24/2001 Static water level 197.2 ft. Well Log (YIN) YES Wires properly protected (Y/N) YES Casing height (above ground) 24+ in. AT INSPECTION 6/3/2010 199 ft. Well production 20 - g.p.m. 6.3+ g.p.m. WATER SAMPLE RESULTS: Coliform d colonies/100 mi. Nitrate Q t/y&g./L. Other bacteria 0 colonies/100 ml. Arsenic: A) o ug./L. Date of sample: 6/3/2010 Collected by: GEG Ltd. B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 7/16/2004 Tank size' 1500 gal. Number of Compartments E 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 7/13/2009 Pumper A+' HOME SERVICES C. ABSORPTION FIELD DATA F-BELOWEXISTING CRAOE Date installed 7/16/2004 Soil rating .p.d./f r ft'/bdrm) 0_5 System type DUAL TRENCH (2 ® 50) Length 100 TOTAL ft, Width 3 ft. Gravel below pipe "8 ft. ••11.4 Total depth **11.6 ft. Eff. absorption area 1600 ft' Monitoring tube YES Depression over field NO Date of adequacy test '"6/3/2010 Results (Pass/Fail) PASS For 5 bedrooms Fluid depth in absorption field before test 3 in. Water added 770 gal. New depth 9 In. Elapsed Time: 120 min. Final fluid depth 2 in. Absorption rate >= 750+ g,p,d, Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date - :*MONITORING TUBES ONLY EXTEND 48 INCHES BELOW INVERT. TOTAL. DEPTH ,IS CALCULATED, •••TESTED NORTH TRENCH ONLY. SOUTH TRENCH WAS DRY. D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N "Pump on' level at in. "Pump off" level High water alarm level at Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main N/A Public sewer manhole/cleanout N/A Sewer /septic service line 25'+ Holding tank N/A Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption + Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main N/A Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineers Printed// Name JEFFREY A. CARNESS Date b 14 I O �w00000 i COSA Fee 5 / Waiver Fee S Date of Payment%/ y 11/0 Date of Payment Receipt Number D 7 of O % Receipt Number (Rev. 11105) Tft r Aalrr "POONA! \� • �•v • 1 rrAr.lr aw.a ti Zst Js- to x - •, iCAR? o { � 11 IOC .At S' •1 ..r . rAYf /G to n \ N b / l .a r^ �r ry 63.824 jA(' 511 23. 578 00' iwoW SURVEY curnmA miatEll�y l -pored by PWT PLAN OF "74 Robert E. johns, Jr-*. & Assoc.. f� r-mfinsstt'-lni i.ond Surveyors �.............« ...MI r..�-...........r.�.. t •Too o M....n. PA=PA. • 1`1 {( + ANCHORACE. ALA ALASI(A fA 119504 �'�"'•"'-'�"'•• / th SnrAc RK. I.Pt ,.r Nor:. Plol r10 Nn fOtYMAIION AR�RIAL7 / N a P 1 ( 4.1.r r ..,.....--.-•+1..1 note :nrveI*'r 6..V Ly~ a !%mr..a by M4Yw Y M. M M M O M ERT JR. / MR JR. w...sw•.-+...w..•r+v... l� � Celt Crown �^ rA M• WC INM tTRUfrRRK AS-PIrIT 4� 4 1-!' 1.'� _ 6 -Vo )0 2417 6:1481 11.63 t I.... r..r. w. A.-Y.-.er'IM 1 •�( L•SN U.nnIFVm: A..•p..1 w.. In M l-' M rO /IIRI.11� ,-'� 10J 17 Autumn Ridge Subdivision fm fRvLY SURVEY hn --- - _— — SYMBOLS ❑ f0~1UH AS -MAT -""" • 13 rYMt rm=we A:-!rI,.T 'irT Rr•AR r � ORNNAIX i;` AW4ALT n lM:Nr• Cly ' U f101 KAY... AS-Rll ... LO RRN,Y ... IrrYyTu..r ! 6YNAR o u ••' TFTrr PENOr; u nOnORErS MY j.n lyzm&r • yRC "Wo% Ut L (I AaS216MI ELT . •Y -•1w METAL fTNK [ wtfo0 DEtlt PLOT PLANS •r LOT SURVEYS N, 'm! — Il15 THE RLSPONSIEfluTr CY THE SIJII.OER Ok %:-fV IER PRKAR TC ONLY IYOpC IMPRC\SHrNT3 ARCVC. DAWND AMC, v1aRlLC M+LL et CONSTRUCTION• 70 v!.KIRY 1•ROA'O!KU H'AWIN6 INtAOL. IirA.A'. Iw *PIC"- F►NOFM w J.tS. 3ACRTIS QCAIlCUT:L JCrYYAl.K=. r10'V9WAY:t TO rlNIIHM ORADQ ANLI VPL1rY C(INN4C'"lWti AMI' W NATLI(MINC •1C-. A•A 'AW)WY IN THFIR A"NOXIMATE IU'.ATION. UPILY SNON THC EIESICNC[ Of ANY CA]CMCNTt. CUW.NANry !Rr FY.L11RI1: TY)NR MAY RRLWtOT RAMC w+►R.IKMGNTw FROM 19EINO WY'N ANO t.00AYEU. I!`M O NOT APPF Art O 7MC RFC. UFyOwuS,�N+1 I IAfALL Q19T) Arrlr RCQQ"!P 1fNI_L!1 Nr1TF, O 1 UNOCR ND CIROJMSTANCEO LHntrtl AN A'+••OIRI.T Or, 11[61' FOR rJ)NSRY)CTRM OR FOR r$TAtYJOHRIC LIomARY IRI FENrx LNI:S. THE SURWYOR TA9E2 SESPONSiViLiv rOR TLE MATAI. TRANSACTION ONLY AND ASSIAAr1 rMANCIAL LIAZIILPTY ONLY FIM' THC LOFT OF 'RIE LiIRVEI'. LISTED DISTANCES PREVAIL. -)VER V.NJNO RT1•RCOUI:T(N MAY CAI¢C CHINMS N Lr:AIC. Municipality of Anchorage • Development Services Department Building Safety Division On -Site Waterand Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsfte (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-054-20 1. GENERAL INFORMATION Complete legal description Lot 17, Autumn Ridge Subdivision COSA # n(p 0.313 Expiration Date: _ _ / O — Z. 0 — 0 Co Location (site address) 9478 Autumn Ridge Circle Current Property owner(s) Wesley W. and Barbara L Clubb Day phone 229-1886 Mailing address 9476 Autumn Ridge Circle Anchorage, AK 99516 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: Five (5) 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site 0 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 Onsite 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. DSO also issues COSAs upon request to homeowners. Certificates of On-Sfte 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 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 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 cn-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 Finn Anderson Engineering Phone 522-7T73 Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. 6. DSD SIGNATURE Approved for bedrooms. Disapproved. Date 7/18/2006 Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checidist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Z2,2�� Original Certificate Date:?— 02 0 ' 0 G (RY. 11AS) Municipality of Anchorage • Development Services Department ` Building Safety Division On -Site Water & Wastewater Program 47W Bragaw, Street P.O. Box 196650 Anchorage, AK 99519.6650 www.munLwg/wrsne (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Lagal Description: Lot 17, Autumn Ridge Subdlvision Parcel ID: 015-054-20 A. WELL DATA Wen type PrMata If A, B. or C provide PWSID S _ Date co npieted 4/24/01 Sardtary seal (YIN) Y Total depth 238 fL Cased to 22�5 ft. FROM WELL LOG Date of test 4/24/01 Static water level 197.2 It. Well production 20 g.p.m. WATER SAMPLE RESULTS: Calftm 0 colonies1100 mL Nitrate •316 mg& Arsenic: NID mgA Date of sample 7/5/06 B. SEPTIC/HOLDING TANK DATA Tank TypelMaterial SeptlrJSteel Tank sae 1.500 gal. Number of Compartments 2 Well Log (YM) Y W res properly, protected (YM) Y Casing height (above ground) 24 in. AT INSPECTION R Other bacteria 0 coloniesH 00 mL Collected by: J. Anderson Date installed 7/1&04 Cleancuts (Y/N) la Foundation cleanout (YM) Y Depression over tank (YM) N High water alarm (Y/N) N Date of pumping 715= Pumper A Plus Home Services C. ABSORPTION FIELD DATA Date installed 7/18/04 Soil rating (g.p.d.A1:2 or fl'/bdrm) •5 GPD/SF System type Deep Trench Length 100 fl. Width 3 JL Gravel bekau pipe 8 it Tabd depth 11 fl. E0. absorption areaL6 fe Monitoring tube Y Depression over field N Date of adequacy test Results (Pass/Faiq For _ bedrooms Fluid depth in absorption Geld before test in. Water added gal. New depth in. Elapsed Time: min. Final fluid depth m. Any rejuvenation treatment (past 12 mo.) (Y/N d type) 0 Absorption rate >= g.p.d. If yes, give date D. LIFT STATION Date installed Size in go&= 'Pump an' level at _ in. 'Pump oft' level at _ in. Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tanlM station on lot >1W Absorption field an lot 3.100 Manhole/Access (Y" High water alar level at in. Meets alarm A chars imi merMs9 On adjacent lab ).1ar On adjacent lots >100' Public sewer main WA Public sewer nwholeldeanout WA Sewer /septic service ilne >2' Holding tank WA Animal containment areas Now Manumlanimal excrete storage areas None SEPARATION DISTANCES FROM SEP7ICMOLDING TANK ON LOT TO: Building foundation >S Property Iina>S Absorption tiel Water main >11 Water service line �1a Surface water Wells on adjacent lob >100' >1tr SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property Una >10' Building foundation 3.10' Water main >10' Water Service ane >IV Surface water 301W odyewar, perk owhide storage >2S Curtain drain None NOW Wells an adjacent lots 3.100' F. COMMENTS: Last Certificate of Heaeh Autirorlty Approval Issued March 9. 2001 O. ENGINEER'S CERTIFICATION I cerfily that I have determined through field inspections and review of Munk/pal mcoWs that the above systems are in cadbrm= with MOA COSH guidelines a etled on M date. Engineer's Printed Name Michael E. Anderson, P.E. F _ .r,k r_=t Date of Payment Receipt Number g3�1 t g Receipt Number ;r 4,cflc�W SM fr# Municipality of Anchorage .'a•a !� ' Development Services Department Building Safety Division Onsite Waterand Wastewater Program 4700 South Bragaw Sty •' P.O. Box 196650 Anchorage, AK 99519650 www.ci.anchorage.ak.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015.054-20 HAA # nSlaoSt} Expiration Date: iWe1w,4Ct1013uL•ltt111J Complete legal description 44 Location (site address or directions) Current Property owner(s) Crown Pointe, Inc. Day phone 345.6277 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address P.O. Box 112313 Anchorane, AK 99511 Unless otherwise requested, HAA %771 be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System Five 5 Day phone Day phone 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 5 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 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 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 Appro•.-J : f.-- 0,13 applicetion, shows that the on- site water supply and/or wastewater disposal system is(are) safe, :,,-A Oran and ad,squate 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 Finn Anderson Engineering Phone 522.7773 Address P 0 Box 240773 Anchorage AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Date 3/5/2005 5. DSD SIGNATURE ,_jL Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By: �a / Original Certificate Date: 3 el — os— QW. ,wm Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water 8 Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 9951986W www.ci.enchorage.ak.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST AutumnLegal Description: Lot 17, : •as Subdlv* • i A. WELL DATA Well type E&& if A, B, or C provide PWSID S _ Date completed 4124M_ Sanitary seal (YIN) y I Total depth M ft. Cased to _2&4—ft. FROM WELL LOG Date of test 412/11001 Static water level 1972 fL Well production 20 g.p.m. WATER SAMPLE RESULTS: Well Log (YAV) Y Wires property protected (YIN) Y Casing height (above ground) _ 4 in. AT INSPECTION fL g.p.m. Coliform _Q—colonies/100 ml. Nitrate 0. (78mg.A. Other bacteria __L oolonies/100 mi. Date of sample: 214!2005 Collected by: MEA B. SEPTIC HOLDING TANK DATA Tank Type/Material SeoticMW Date Installed 711 5 11 0 0 4 Tank size x.500 gal. Number of Compartments j Cleanouts (YM) Y Foundation cleanout (YIN) Y Depression over tank (YIN) y High water alarm (YIN) N Date of pumping Pumper New Construction C. ABSORPTION FIELD DATA Date installed YR511004 Soli rating (g.p.d.ifte or ft Abdrm) A GPDISF System type D"o Trach Length 100 fL Width 3 fL Gravel below pipe 8 R Total depth y It. Eft. absorption area Jhg0 ft Monitoring tube Y Depression over field N Date of adequacy test Results (Pass/Fal) For _ bedrooms Fluid depth in absorption field before test _ in. Water added_ gal. New depth_ in. Elapsed Time: _ min. Final fluid depth _ In. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN E type) N If yes, give date D. UFT STATION Date installed 'Pump on' level at _ in. Datum Size in gallons 'Pump ofr level at _ in. Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankilift station on lot >IW Absorption field on krt >/W Public sewer main WA Sewer /septic service line >2S Manhole/Access (YIN) High water alarm level Meeh alarm b circuit requirements? On adjacent lots >100' On adjacent kris >1W Public sewer manhole/cleanout WA Holding tank WA SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Building foundation W Property line >�' Absorption field W Water main WA Water service Ane NG Surface water >IW Wells on adjacent lots >1 W SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line >10' Building foundation >10' Water main >10' Water Service line >10' Surface water >IW Driveway, parkingNeNde storage >25' Curtain drain None Noted Web on adjacent lots MW F. COMMENTS G. ENGINEER'S CERTIFICATION arr�e.>�P,,: I certify that I have determined through field inspections and �a �, 49th review of Munkdpal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. LA110122 Engineer's Printed Name Mlchaei E Anderson. P.E'' OE -4301'u Date 3W HAA Fee $ 57 s1 Waiver Fee $ Date of Payment 3— -1— O s Date of Payment Receipt Number 6 V VV 9 Receipt Number (Rev. 1M in. 10' T. k E. ZIEMLAK 49,547 S.F. "= 40' AS -BUILTI HEREBY CERTIFY THAT I HAVE SURVEYE THE PROPERTY DEPICTED ABOVE AND THAT N ,4� GASTALDI LAND ENCROACHMENTS EXIST EXCEPT AS INDIC ED. OF SURVEYING, LLC IT IS THE RESPONSIBILITY OF THE OWNER TO ��A� JEFF A. GASTALDI, R.L.�P; 88TH AVENS ETERMINE THE EXISTENCE OF ANY EASE ........ • '•., sf / ENTS, # EOVENANTS OR RESTRICTIONS WHICH DO OT : *�..49M........ ;*/ ANCHORAGE,4726WEST ALASKA 99 PEAR ON THE RECORDED SUBDIVISION LAT. • �, PHONE 248-5454 UNDER NO CIRCUMSTANCES SHOULD ANY HEREON BE USED FOR CONSTRUCTION 0 DATA /,. .... ....... .......r FOR # 2, Jeffery A G°staldi: AV GRID DATE 2a37 3/3/2005 ESTABLISHING BOUNDARY OR FENCE LINE!. ANCHORAGE RECORDING DISTRICT, ALAS e, #�'. *.•�LS-6091 ••; h��� Aa�D�o�......1�pOe F.B. JOB NO. NOTE: NO CORNERS SET THIS DATE. +��� '& 05-02 ARS17 .