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AUTUMN RIDGE LT 11
Autumn Ridge Lot 11 #015-054-14 Municipality of Anchorage Page 1 of 3 Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SW030022 PID Number: 015-054.14 Crown Pointe Inc. Crown Wastewater System: New Amreaa P.O. Box 112313 Anch. AK 99511 ABSORPTION FIELD Phone: 345.6277 Nuh*✓ur Iia✓oerre. Six 6 Deep Trench LEGAL DESCRIPTION Sal Rauh: 1.2 Total Debut Iran ongn✓ brittle: GPDtFP 5.5 Ft. &ocl,: Lot: sultdwyon: Depth to pipe oo"orn can mbrn✓ brae». Grant oeph beneath ppe. 11 Autumn Ride 1.5 Ft. 4 Ft. Tov."sNp: Range: seam; FN stlaetl aao.e mg,nal bratle. Gray✓ L✓gth. 2.3 Ft. 120 Ft. Well: New ovalvnph. Nun*✓ d ansa. QMAnGe DeMeen kre. a 5 Ft. 2 >10 FL CLaWheDl.m (Pnv✓e. A B, C): Total OWn Gave w: out sasap.m ✓ea pe l✓.✓. Private 242 242 1,200 Fe ASTM 3034 PVC Dnner: Dare DnIIW: seuc Wal✓Lev✓ Wd✓. Dale inualieci. Alpine Drilling 61612003 198 Fl. Sanders & Sanders 2128.31312003 Y.✓d. Purry sd al Cowng Height Aoove Grd.rntl: TANK 15 GPM FI. >2 Ft SEPARATION DISTANCES ® Septic ❑ Holding ❑ S.T.E.P. ❑ Other. To Fran I Septic Tank Absorption Field OR Station Holding Tank ubbjCjpMate Sewer Urat martmer Anchorage Tank y 2,000 Wed >100, >100' NIA NIA >25' 1 Steel Two (2) sarace wale, >100' >100' NIA NIA LIFT STATION — NONE ON LOT Lot une >5' 4' NIA NIA Gal Faa.tlaWn >5' >10' NIA NIA wnpm a. unv . at. . wa✓ rma. N. M. N. None Noted Puny Make A Model Elw'" lnpx s wonneo by. Cutin Dr✓n R"1ef : BENCH MARK ora m W.p m. Back Door Threshhold 100.0 Ft. Engineer's Stamp OF 44� ew Inspections performed by: A. Harala Dates: 1" 2/28/2003 ; �`a to•0 2nd 31312003 r .... _....._ .. _......... Department of Health and Human Services approval �n� W •��: MICHAEL E. ANDERSON JJ Reviewed and approved by: Date: i 2 � � Z' 03 No. CE -438i 0 s f� •���`� ��.' (Rev lana) p'�,T ...�" ♦•', PVE..\� �•� 4 f3 Y ,98'4SZ M•BZ,90.00 N c 0 0'9C I Nt 0 o zz O N (• a a _ Z 1 � Q i •� � N � W W !' Ld S 8 e a b, m 1 z n W z 1 M Ay ® ,99'6CZ M.BZ,90.0 N � 3 I ►2 5 o rn E I �— cwi `5; � 1 I J r zZr zw I aS I " � . ry� W iZi W I O%- EeN !, I rN W I coo) I' uW oma L Oal nvonoo nh n pop Q J N g0 m0 OV,p'O0O Oi Oi Z N h U 7 UV 3 U J A_ O b, h I y G o E Z44 z I o,•••0 .••.• e.30• L-�000 ib ' a �0 5 00'07'07'E R.S? zli •j•Y i •i••S w u •••�9\\�.�� ••F U Z U 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. SW030022 U U PID No. 015-054-14 s u �D u 66.6 NORTH LEG 70.3 Dratnfletd Rock 60' (Trench Length) SOUTH LEG PROFILE AS -BUILT Swie: 1' • 10' N n S U MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 SOUTH BRAGAW STREET ANCHORAGE, ALASKA 99519-6650 SOILS LOG - PERCOLATION TEST PERFORMED FOR: Crown Pointe, Inc. DATE PERFORMED: 3/1/2003 LEGAL DESCRIPTION: Lot 11 Autumn Ridge Subdivision �jj'jj'j7'j� TEST HOLE # 51A SLOPE SITE PLAN II I I I I I II OG/OLPROJECT # 17 Silty Gravel W/Sand Clusters GM WAS GROUNDWATER ENCOUNTERED? Yes S L IF YES, WHAT DEPTH? 12' 0 DEPTH OF WATER 12' P AFTER MONITORING: E DATE: 3/8/2003 wm7 MICHAEL E. ANDERSON No. CEJ381 BOH @ 15' READING DATE GROSS TIME 2- DEPTH OF WATER NET DROP Start 3/1 3 3 14 8.75' 1 2:52 5 3.38' 5.38' .a 6 a • .. 9• 7- 3:03 8 8- 3.75' 5.25' d ' 4. 9- 10- 10II 3 3:14 11 ° .a 12 ° 17 Silty Gravel W/Sand Clusters GM WAS GROUNDWATER ENCOUNTERED? Yes S L IF YES, WHAT DEPTH? 12' 0 DEPTH OF WATER 12' P AFTER MONITORING: E DATE: 3/8/2003 wm7 MICHAEL E. ANDERSON No. CEJ381 BOH @ 15' READING DATE GROSS TIME NET TIME DEPTH OF WATER NET DROP Start 3/1 2:42 8.75' 1 2:52 10 3.38' 5.38' Recharge 2:53 9• 2 3:03 10 3.75' 5.25' Recharge 1 3:04 9.13' 3 3:14 10 4• 5.13' PERC RATE: 2 MIN./INCH PERC. HOLE DIAMETER: 8• TEST RUN BETWEEN 2.5 FT. AND 3.5 T. TEST PERFORMED BY: MEA I, MICHAEL F. ANDERSON, CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES ON THIS DATE: 12/10/2003 on ALPINP DRILLING a -e � r Ne A• O/ Rick Mystrorn Mayor FAX N0. : 907 345 0202 Dec. 10 2003 02:26PM P1 1�'� SN9: ,a1R� �7 -•M1'�` T N/f CT ASA.S VA !We !!r e!! .9stre!Veto r too r-�s:e.eaere e�Ya: a .i a VV1.IY. V-Ir„\V, •.VY,�-. Y..Y ..Y\11M1. VVf •eVVJ r.V. OJA :aWw ni-uwiaun. niaana tl9:l la'IJULV hrtn-J� eY ua Permit Number. #SW 030022 Date of Issue: -14-03 Date Started: 6-5-03 Date Completed: 6-6-03 Legal Description: Autumn Ridoe Lt 11 Property Owner Name & Address: Crown Polnt, Inc. PO Box 112.313 Ancheraoe. Alaska Parcel Identification Number: 015-054-14 Is well located at approved permit location? ® Ycs ❑ No 99511 Borehole Data: Depth. (ft) Method of Drilling ® air rotary ❑ cable tool Soil Type, Thickness & Water Strata From To Casing type: steel Stick-up 0 2 Wall Thiekness:._250_ inches silt 2 5 Diameter: 6 inches Depth: Z42 feet silty gravel gravelly silt Silt gravelly silt 5 21 85 92 21 85 92 99 Liner Type: Diameter: inches Depth: feet Casing stickup above ground: 2 feet Static water level (from ground level): 198 feet Pumping level: 242 feet after silty gravel H2O 2 gpm 99 101 2 hours pumping 15 gpm gravelly silt 101 166 Recovery Rate: 15 gpm silty cobbly gravel 166 192 Method of Testing.is r IiH Well Intake Opening Type: ®fin End ❑ Open Hole ❑ Screened Start feet Stopped feet gravelly silt 192 236 water sand & gravel 236 242 ❑ Perforations Start feet Stopped feet Grout Type: bentonite Qranules Volume: Lbg Depth: Start 0 feet Stopped Z feet Pump: Intake Depth feet Pump sue hp Brand Name Well Disinfected Upon Completion? ®'Yes ❑ No Method of Disinfection: EhLdne , e4 Comments: Well Driller- Alpine Drilling & Enterprises PO Box 110496 Anchorage Alaska 99511 Attentiou: The well driller shall provide a well log to tho property owner within 30 days of completion and the property ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 December 10, 2003 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Lot 11, Autumn Ridge Subdivision Separation Distance Waiver Absorption Trench to Lot Line Dear On Site Services Engineer: The septic system on Lot 11, Autumn Ridge Subdivision was inadvertently placed within 4' of the south property line. The lot lines were not clearly marked during construction and the end of the trench was mistakenly placed within 10' of the property line. We are therefore requesting a waiver be granted allowing the trench to be at 4' from the southern line. A majority of the new trench will be a minimum of 10' from the lot line. Placement of the new absorption trench at the existing location does not impact wells or adjacent septic systems. We therefore recommend a waiver be issued allowing the new trench to be constructed at 4' from the east property line. Sincerely, 0 Michael E. Anderson, P.E. of .,... 8r i* MICHAEL E. ANDERSON i, N0. CE -4381 � t;7 12/11/2003 Alunieipality of Anehorage Mirk Begich, Mayor Buil(lit1g Safety M isiotl I',o. Box 196650 • 4700 11ragaw Street Anchonige, Alaska W519-66550 • (t)07) 343-A301 • rwx (1X)7) 343-8200 litti)://%%i%iv.iiitatti.org Michael E. Anderson, PE Anderson Engineering P.O. Box 240773 Anchorage, AK 99524 Subject: Waiver Request for Autumn Ridge Lot 11 Waiver Request # WR0301 IS Parcel ID #015-054-14 HAA030629 Dear Mr. Anderson: Your request for a waiver of the required 10 feet horizontal separation from the Well to the Absorption Field has been approved. The approved separation distance is 4 feet. This waiver approval applies to the existing Well to Absorption Field only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Jeffrey Poet Engineering Technician On -Site Water & Wastewater Program Municipality of Anchorage Development Services Department Building Sarety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 Waiver Review Worksheet WR#: 030116 PID#:015-054-14 Date Received: 12/11103 Legal Description: Autumn Ridge Lot 11 Engineer: Anderson Engineering P.O. Box 240773 Applicant: Crown Pointe. Inc. HA#:030629 Permit#: Waiver Requested: 4 foot separation distance from the Well to the Absorption Field Criteria: Geology Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: ........................... ................................................ mass Waiver is Granted: Waiver is not Granted: List Conditions or Reasons for above: Date: — %.Z — n 3 By: oe hof Reviewer ............... ........................ ...Y "bed ................................ Rec#: 45500 Amount: $160.00 Date Paid: 12/11/2003 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water 8 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT Initial Permit Number: SW030022 dLegal Description: AUTUMN RIDGE LT 11' Date Issued: Feb 14, 2003 Expiration Date: Feb 14, 2004 Parcel ID: 015-054-14 Design Engineer: 0014 Anderson Engineering Site Address: Owner Name: Crown Pointe, Inc. Lot Size: 46044 SO. FT. Owner Address: PO Box 112313 Total Bedrooms: 6 Permit Bedrooms: 6 ANCHORAGE, AK 99511 - This permit is for the construction of: [✓ I 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 catling (907) 343-7904 (24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: � -2 V-� Date: 2 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/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. )ls- 05q— /q Permit Number SW Property owner(s) Crown Pointe, Inc. Day phone 345.6277 Mailing address (1) P.O. Box 112313 Anchorage AK 99511 Mailing address (2) Zip Code Legal description (Lot, Block & Sub'd.) _Lot 11. Autumn Ridge Subdivision Legal description (Section, Township & Range) Lot Size 46 044 SF Acres/Sq.Ft. Number of Bedrooms _Six (6) 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 andel 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: ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 (FAX) February 5, 2003 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 11, Autumn Ridge Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Lot 11, Autumn Ridge Subdivision intends to construct a six -bedroom home on the lot. We are therefore requesting a permit be issued for the construction of a new well and septic system to serve the new home on the property. The attached Site Plan and backup documentation identify the location and configuration of the new septic system and the parameters used in the design. Also identified on the plans are the well location, alternate site, test hole locations and well and septic systems on the surrounding lots. Drainage arrows are also shown and current drainage patterns will be maintained after construction. The test holes placed near the location of the proposed and alternate absorption trenches indicated tight silty gravel at the higher elevation with a percolation rate of 48 minutes per inch. At the lower levels a clean well graded gravel was found with percolation rates much faster. No ground water was found during placement of the test holes and none was noted during the monitoring period. We are therefore proposing to place a new 2,000 -gallon septic tank with two new 50' long by 3' wide absorption trenches with 10' of gravel beneath the distribution pipe. A flow splitter valve will be placed to provide even flow to each trench. The total depth of the trenches will be 12' below the surface with the distribution pipe at 2' below the surface. The alternate site will be a 5' wide shallow trench with 4' of gravel due to groundwater found during the monitoring period. The ground surface on the lot slopes at grades between 10% and 20% from north to south. The absorption trench will be constructed 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 in the area and 10' from water service lines. If the system is constructed in accordance with our design the following statements apply: Lot 11, Autumn Ridge February 5, 2003 Page Two 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 V 49th. ' .* VCHAEL E. ANDERSON No. CE-43si '41 okr 1 lS r,pv to 64.26 ' V-s,$0�� )3.20' ..E Rs2 / r` s 94. �� ` �g / / N i 41 s y� n i 'h I uo 1 ` �� •� V N LLI rl ' -• _ ZI J �} THIS PROJECT 1 Z a / O \ /: ': ` j j j ! AA,OO.00.00S ' •. : = r � �rn o I Ep i r 2 19 14-no ' I •.m,00.00.005 + _ ... 1 ., i 9�1r 1 ) iv ♦ (� d' q1 tnG v I "1 ;i !� N3 I49�htt}�i•. — `� / ! •" ^'.., ' 11' i; :�_„... .....................•. \ '— .88'l8Z o /j MICHAEL E, . Q t y m,00,oa s l I 8 '•; s�, N0. CE-4381 l )' e– C21 O ',` /... ESS�tl��:=` 1 O C5 CO N ' AREA SYSTEM PLAN o i Y I, , SCALE 1' = lool , J W W J U w Eu LOT 11, AUTUMN RIDGE SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Six Bedroom Home Deep Trench System Perc. Rate: 48 Min./Inch 2,000 Galton Septic Tank Avg. Application Rate: .45GPD/SF 10' Drain Field Rock 6 Bedrooms X 150 GPD 1.45 GPD/SF = 2,000 SF of Absorption Area i 2,000 SF/20 SF/LF = 100 LF Trench Length Therefore: Construct an Absorption Trench With Two Laterals Each 50' in Length by 3' Wide with 10' of Drainfield Rock Beneath the Distribution Lateral. Distribution Lateral to Be Placed 2' Below Existing Ground . Total Depth of Each Trench to Be 12' Below Existing Surface. A Flow Splitter Valve Will Be Required to Provide Even Flow to Each Trench. Cover Over Septic Tank a Minimum of 4' or 2" of Insulation and 2' of Cover. Cover Over Trench 3'. Natural 1.5' Backfill .5' 3' _ Geotextile Fabric 4 Perforated PVC (Slots Down) infield TYPICAL DEEP TRENCH SECTION (NO SCALE) NOTE: Grade Area Over Trench to Drain Away. Minimum 6' Separation From Bedrock. Minimum 10' From Lot Line. Minimum 4' Separation From Groundwater. Minimum 100' Separation From Wells in the Area. Minimum 10' Separation From Water Service Line. Municipality of Anchorage Department of Health & Human Services 825 L Street, Anchorage, AK 99502-0650 SOILS LOG - PERCOLATION TEST Performed For: BQb Klein Date Performed: Legal Description: L of 11. Awn Ridge Subdivision ,—� SLOPE 11 I PT/OL HGM/GP 3 TESTHOLE NO. 50 71 1SM Glazing 91 10 11 13 14 15 16 17 18 Sidewalls Was Groundwater Encountered? No If Yet, What Depth? Depth to Water After Monitoring None Date: 1/22/00 Medium Damp -31 Reading Date . Gross Time Net Time Depth To Water Net Drop 1 9 -Dec 1:10 1.5" 2 1:40 30 2.31" .81" 3 1:41 4 2:11 30 2.13" .63- 5 2:12 1.5- 6 2:42 30 2.13" .63" Bottom of Perc. Rate: 48 Min./Inch Perc. Hole Diameter: 6" Hole Test Run Between 4 Ft. and 5 Ft. Comments: Percolation Cavity Presoaked Prior to Testing. Performed By: A. Harala. I, RAMicbael F Anderson Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date: 1/20100 Municipality of Anchorage Department of Health & Human Services 825 L Street, Anchorage, AK 99502-0650 SOILS LOG - PERCOLATION TEST Performed For: Bob Klein Date Performed: Legal Description: Lot 11_ Autumn g*(ige Subdivision SLOPE 1 2 3 13 14 15 16 17 18 19 PT/OL GP/GW Golden to Light Brown Was Groundwater Encountered? Yes If Yes, What Depth? 10• Ground Depth to Water 1 Water After Monitoring 10• Date: 1/22/00 2 Bottom of Hole ., j MICHAEL E. ANDERSON4(y 1#C- No. CE -4381 .ref ♦���i E� 12/8/99"%"`��� I Reading Date Gross Time Net Time Depth To Water ' Net Drop 1 9 -Dec 1:18 4" 2 1:19 1 10.13" 6.13" 3 1:21 4.13" 4 1:23 2 10.13" 6" 5 1:24 4- 6 1:26 2 9.94" 5.94" Perc. Rate: GT 1 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 Anderson Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date: 1120100 ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 11, AUTUMN RIDGE SUBDIVISION GENERAL: The scope of this project includes the procurement and placement of a new 2,000 -gallon septic tank at the location shown on the site plan and the construction of two new 50' long by 3' wide by 10' effective depth absorption trenches also shown on the Site Plan. The total depth of the trenches will be 12' below existing ground and the distribution pipe will be placed at 2' below the surface. A flow splitter valve will be required to provide even flow to each trench. All components of the new absorption trenches and septic tank must be constructed a minimum of 100' from the well on the lot and on 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. 2. 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. 3. The Contractor shall be responsible for obtaining all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. 4. 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. 5. 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.H.S. before beginning system installation. SEPTIC TANK INSTALLATION 1. A new 2,000 -gallon septic tank must be procured from a certified septic tank manufacturer. 2. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 3. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 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. Lot 11, Autumn Ridge Subdivision February 5, 2003 Page 2 of 3 6. 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: The drainfield shall be constructed to the dimensions shown on the design. The bottom of the trench shall be within 2" of level. 2. 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. 5. 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. 8. A minimum 2' of accepting soil is required below the drainfield 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: 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. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and solid). 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 fitted with watertight couplings (Caulder, Fernco, or equal). Lot 11, Autumn Ridge Subdivision February 5, 2003 Page 3 of 3 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 peotextile 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 • +1 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/WELL SUBMITTAL COMMENT SHEET To: Michael E.Anderson Legal description: Autumn Ridge Subdivision Lot 11 The attached paperwork has been reviewed and is being returned for the following reasons: ❑ Original signature or stamp missing on ❑ Calculation error in design. _ ® Additional soils information needed. Which test hole is which? Is 12 ft. deep trench designed 2 ft. into groundwater?? ❑ Water monitoring results inadequate. _ ❑ Discrepancy in information submitted. ® Topographic information missing or inadequate. What is the actual slope of the land in the area of the trenches and 50 feet downgradient of the upgrade site? ❑ Incomplete; missing _ ❑ Incomplete; missing ❑ Additional adequacy test information needed. ❑ Water sample unacceptable. _ ❑ Measured/proposed distances/dimensions missing. ❑ Locations of all soils, percolation and water monitoring tests not shown. ❑ Proposed system too deep for soils information submitted. ❑ Well log required. ❑ Omission in narrative. _ ❑ Insufficient fill over tank or field._ ❑ Other. Name of reviewer: dan Date: 2/13/03 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK George f'. 11'ucrch, Mayor November 22, 2002 Anchorage Aliniicipality of Anchorage All -America City Bttilding S.&ty Divisimi 2002 Century Development PO Box 112313 Anchorage AK 99511-2313 Subject: On -Site Water and/or Wastewater Permit. Permit Number: SW010493 C Legal Description: Autumn Ridge Lot 11 Dear Century Development: An On -Site Water/Wastewater Permit, number SW010493, issued by this office for a single-family system, will expire on December 21, 2002. This permit was valid for 365 calendar days. If this was a well permit and the well has been drilled, a well log must be sent to this office for documentation of the installation and to close the permit. If this permit was for a wastewater disposal system, an original as -built inspection report must be sent to this office for review, approval and documentation. This as -built inspection report must be signed by the licensed Professional Engineer who inspected the installation of the system. As -built inspection reports are required to be submitted within 30 days of the completion of the system. If no system was installed under this permit, and you are still planning to install a well or wastewater disposal system, a new permit must be obtained from this office. A new permit for a second year may be issued for a fee of $100.00 if the renewal application is received on or before the expiration date of the original permit. When applying for a new permit, the fees are: $400.00 for a wastewater permit and $150.00 for a well permit. If you have any questions, please call this office at 343-7904. &cerel,,y,,,,' Dan Roth Civil Engineer II On -Site Water and Wastewater Program Enc: Copy of permit P.O. Brix 196650 • Anchorage, Alaska iY9,519-6650 • Telephone. (907) 343-8:301 • 1'ux: (907) 343-8200 4700 Srntth Bragavv Surd • Anchorage, Ahasha 90.507 11 lit 11)://ttitiv.cLasichnntrc.alt.us MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water 8 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT Initial Permit Number: SWO10493 Legal Description: AUTUMN RIDGE LT 11 Design Engineer: 0041 AK Water & Wastewater Consultarr Owner Name: •L-&4MN6. Ccs. +� Deo�lo�naen� Owner Address: PoT,*t 112313 ANCHORAGE , AK 99546 99SA-2113 Date Issued: Dec 21, 2001 Expiration Date: Dec 21, 2002 Parcel ID: 015-054-14 Site Address: Lot Size: 46044 SO. FT. Total Bedrooms: 5 Permit Bedrooms: 5 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 catling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By. Issued By: Date: 12,12, Municipality of Anchorage • Development Services Department ,•`I: Building Safety Division - On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ok.us (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 015*. 054 " /4 Permit Number'5LV010473 Mailing address (1) P.O. BOX 773471 i EAGLE RIVER. AK Mailing address (2) Zip Code 99577 Legal description (Lot, Block & Sub'd.) LOT 11: AUTUMN RIDGE SUBOMSION Legal description (Section, Township & Range) NIA Lot Size 044 AcrestSq.Ft. Number of Bedrooms THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well 0 Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ 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. ALASKA WATER & WASTEWATER CONSULTANTS, INC. Permit Fees: -'-� g q O, O D Date of Payment: "L-19-0 / Receipt Number. / 3 i? 3 7 Waiver Fees* Date of Payment: Receipt Number. ALASKA WATER & WASTEWATER CONSULTANTS, INC. `----M^-R�•-^� December 17, 2001 Municipality of Anchorage Development Services Department On -Site Water R: Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Septic Upgrade for Lot 11, Tract A, Autumn Ridge Subdivision To whom it may concern: The proposed 5 bedroom house is to be served by a private well and septic system. A number of test holes were excavated in the area and logged by Michael E. Anderson on the twenty-second of January, 2000. We propose that a 1500 gallon septic tank and a dual deep trench type drainfield be installed. Comments regarding the design are summarized as follows: 1. SOILS: Seethe attached logs which show the soil classifications, groundwater monitoring, and the percolation test results. The proposed design is outside the thirty foot radius of the test holes so we are prpposing that a confirmation test hole be excavated during the installation of the system. It is our opinion that due to the soils evaluations and percolation rates given by Mr. Anderson, an application rate of 0.45 gallons/day/ftz should be used. 2. TRENCII DESIGN: a. Percolation Rate: 35 and 48 minutes/inch b. Allowable Application Rate: 0.45 gallons/day/ftz c. Number of Bedrooms: 5 d. Design Flow: 750+ gallons per day e. Minimum Absorption Area: 1667 ft2 f. Total Depth: 10 feet (max.) g. Effective Depth: 8.5 h. Width: 2.5 feet i. Reduction Factor: N/A j. Minimum Length: 100 ft (2 x 50 feet each) k. Effective absorption area= 1,700 ftz 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Far: (907) 338-3246 * Website: akwwc.com 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic upgrade. 4. TOPOGRAPHY: As can be seen on the attached topography site plan, the topography of this property contains a slope that averages 23%. The topography slope ranges between 11 % and 33%. There is only a small portion that contains a slope of 33% and it can be eliminated with fill. See attached topography map for details. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179, or 244-9612. Thank you for your assistance. P.E., M.S. NOTE: Attached is a site plan drmving, a design drmving, a topography site plan, 3 soils logs, and a 7 page construction specification letter which are all part of the design package for this septic system. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwe.com U / zI {„ LLJ AUTUMN RIDGE S/D: / Ld IL_IUI LOT 6, HANSHEW❑HEICHTS S/D !1 Qi 04 coHo� fJI COHOE . �7 © s T 7, U AUTUMN RIDGE S/D; LOT 9, SEIm SLOT 8NDE �< AUTUMN RIDGE S/D; LOT 10, '��e2 r��( �d1!I•l:1d11 r n+ -n O -PROPOSED 3 BEDROOM HOUSE AUTUMN RIDGE S/D: LOT 12, 714-71 O AUTUMN RIDGE S/D; LOT 7, 01e AUTUMN RIDGE S/D: LOT 13, 0 14-38 O OTH-37 PROPOSED SEPnc SYSTEM (SEE DESIGN, PAGE 2 OF 2) LPROPOSED CONFIRMATION SITE TEST HOLE Tract A 12/ 12 DRAWN BY. C v 41 ALASKA WATER & WASTEWATER SCALE* CONSULTANTS, INC. 1" = 100, 600) OFRARR ROAD. SURE 7R • AWHORAGF. A6 00306 • F F (007)117-0170 • FAX (007)316-3266 ` i PREPARED FOR PHONE NUMBER: PAGE NUMBER: G� .......... ? MASTERPIECE HOMES c/o KELLY HEITSTUMAN 884-1234 1 OF 2 1 f IS Go ess_.: ? LEGA. DESCRIPTION: 79$3 p� i AUTUMN RIDGE SUBDIVISION; LOT 11, TRACT A. a�,°/,^' •., �4`F3 SITE PLAN FOR PROPOSED WELL AND SEPTIC SYSTEM LOCATIOIN ' rFIV�E:SEDROOMUSE ALTERNATE SITE WILL REQUIRE AN WNOVATNE� TYPE SEPTIC SYSTEM 052 ic6i, TTH 500 TH-510 ALASRA `WATER & WASTEWATER CONSULTANTS, INC. PREPARED FOR: PHONE NUMBER: MASTERPIECE HOMES c/o KELLY HEITSTUMAN 884-1234 LEGAL DESCRIPTION: AUTUMN RIDGE SUBDIVISION; LOT 11. TRACT A TYPE OF WORK: DESIGN DRAWING FOR NEW SEPTIC SYSTEM 12/17/2001 'AWN BY: J.W.M. ALL, 1" =40' GE NUMBER: 2OF2 li•PI:bSUFIa 1500 TANK INSTALL TH049 LUTrvt PROPOSED DRAINFIELD. EXCAVATE TWO TRENCHES THAT ARE EACH 12 FEET DEEP (MAXIMUM). BY 2.5 FEET WIDE. BY 50 FEET LONG EACH. ADD 8.5 FEET OF CLEAN, WASHED. SEWER DRAINROCK. INSTALL TRENCHES PARALLEL! TO SLOPE CONTOURS e fre A. a ess: —79 A a�j �liw��_ ...• '�••G Sod TLJ� 350r� 348 346 344 Z � coDRS :- - "' 38 0 a i 73 % S` o ,..� crs ,-nl- F i t, 390- t; r Trnrf Municipality of Anchorage Department of Health & Human Services 825 L Street, Anchorage, AK 99502-0650 SOILS LOG - PERCOLATION TEST Performed For: Bob Klein Date Performed: Legal Description: 1 nt 17 e, 1, mn Rinne Subdivision RI OPE SITE P _ 1 2 3 4 5 — 6 — 7 13 14 15 16 PTIOL TEsiHOLE14o a9 SM SM Fine Graded Dense Was Groundwater Encountered? No If Yes, What Depth? Depth to Water After Monitoring None Date: 1/22/00 3qo--_G8 12� - -�-_ 44_1111 sq_fl.__ `I 31 L 12/8199 Reading Date Gross Time Net Time Depth To Net Water Drop 1 9 -Dec 1:07 3.12" 2 1:37 30 4.12" 1" 3 1:38 3.06- 4 2:08 30 3.94" .88" 5 2:38 3.06" 6 3:08 30 4' .94" Bottom of Porc. 35 Min./Inch Perc. Hole Diameter: 6" Hole Test Run Between 4 Ft. and 5 Ft. Comments: Percolation Cavity Presoaked Prior to Testing. Performed By: AA H� ralla. I, Michael F. Anderson Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date: 1/20/00 Municipality of Anchorage Department of Health & Human Services 825 L Street, Anchorage, AK 99502-OG50 SOILS LOG - PERCOLATION TEST Performed For: Bob Klein Date Performed: 1218/99 Legal Description: I of 11 Autumn Ridge Subdivision SLOPE 1 PT/OL 2 GM/GP 3 TESTHOI E NO. 50 4' 5 6 — 7 8 9 10 11 12 13 14 15 16 17 18 19 SM Dale Gross Time Glazing U Sidewalls 9 -Dec 1:10 Was Groundwater 1.5" Encountered? No If Yet, What Depth? 2.31" 81" Depth to Water 1:41 After Monitoring None Date: 1122100 Medium Damp ElE Reading Dale Gross Time Net Time Depth To Net Water Drop 1 9 -Dec 1:10 1.5" 2 1:40 30 2.31" 81" 3 1:41 1.5" 4 2:11 30 2.13' .63" 5 2:12 1.5" 6 2:42 30 2.13" .63" Bottom of Perc. Rate: 48 Min./Inch Perc. Hole Diameter: 6" Hole Test Run Between 4 Fl. and 5 Ft. Comments: Percolation Cavity Presoaked Prior to Testing. Performed By: AA Harala. I, Michael F Anderson Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date: 1/20100 Municipality of Anchorage Department of Health & Human Services 825 L Street, Anchorage, AK 99502-0650 SOILS LOG - PERCOLATION TEST Performed For: Bob Klein Date Performed: 12/8/99 Legal Description: I of 11 Autumn R rine Subdivision 10' SLOPE SITE PLAN 1 1 4" PT/OL 1/22/00 1 10.13" 6.13" 3 T <� 2 4.13' 4 1:23 2 10.13' 6" 5 06 3 4" 1:26 2 9.94' 5.94" TF$THOLE NO. 51 4 5 GP./GW 6 Golden to 71 Light Brown — 8 9 10 11 12 13 14 15 16 17 18 19 Was Groundwater Encountered? Yes If Yes, What Depth? 10' Ground Depth to Water 9 -Dec 1:18 Water After Monitoring10' 1 4" Date: 1/22/00 Bottom of Hole 1, Reading Date Gross Time NetDepth Time To Net Water Drop 1 9 -Dec 1:18 1 4" 2 1:19 1 10.13" 6.13" 3 1:21 4.13' 4 1:23 2 10.13' 6" 5 06 1:24 4" 1:26 2 9.94' 5.94" Perc. Rate: GT 1 Min./Inch 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 E. Anderson Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date: 1/20/00 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/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-054-14 1. GENERAL INFORMATION COSA# (' $�O:.:�IeO Expiration Date: I — a / -- O 9 Complete legal description Lot 11, Autumn R(dge Subdivision Location (site address) 9413 Nickell Circle Anchorage, AK 99507 Current Property owner(s) Brent and Constance Wells Day phone Mailing address 9413 Nickell Circle Anchorage, AK 99507 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: six (6) 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 Onsite 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 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.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Date 10=008 .................. .MICHAEL E ANDERSON 6. DSD SIGNATURE P s- CE -4381 •� �`V Approved for SrK bedrooms. `dP fqE'• �c"y"��• Al Disapproved. ,111 i>\O�Se to0e��•o Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: v Original Certificate Date: /O (R•+. tips) Municipality of Anchorage Development Services Department s� Building Safety Division On -Site Water & 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 CHECKLIST Legal Description: Lot 11, Autumn Ridge Subdivision Parcel ID: 015-054-14 A. WELL DATA Well type Prlvete If A, B, or C provide PWSID # _ Well Log (Y/N) Y Date completed 6/6/2003 Sanitary seal (Y/N) Y Wireserl ro p p y protected (YM)y Total depth 242 fL Cased to 242 ft. FROM WELL LOG Date of test 6/6103 Static water level Well production 199 ft. 15 Casing height (above ground) >19 in. AT INSPECTION 199 f. g.p.m. 5.9 g.p.m. WATER SAMPLE RESULTS: Coliform o colonies/100 mL Nitrate •577 mg/L Arsenic: NID mgJ1 Date of sample:9/29ro9 B. SEPTIC/HOLDING TANK DATA Tank Type/Material Sep9rJSteel Tank size 2,0oo gal. Number of Compartments Two Foundation cleanout (YM) Y Depression over tank 61N) N Date of pumping 9127n008 C. ABSORPTION FIELD DATA Date installed 3/3R0o3 Other bacteria 0 colonies/100 mL Collected by: J. Davis Date Installed 2128M03 Cleanouts (YM) Y High water alarm (YM) N Pumper: Isaacs Pumping Service Soil rating (g.p.d./ft2 or ft2/bdmm)1.2 GPDISF System type 5' Wlde Shallow Trench Length 120 ft. Width 5 ft. Gravel below pipe 4 R Total depth ft. Eff. absorption area 1200 ft' Monitoring tube Y Depression over field N Date of adequacy test 10/1=8 Results (Pass/Fail) Pass For 6 bedrooms Fluid depth In absorption field before test o ' In. Water added 905 gal. New depth .. _01n. Elapsed Time: o min. Final fluid depth 0 in. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N Absorption rate >= goo 9 P d If yes, give date D. LIFT STATION Date Installed Size in gallons Manhole/Access (Y/N) •Pump on' level at _ In. 'Pump ofr level at _ In. High water alarm level at In. Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot >tcu' 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 None Manure/animal excrete storage areas None SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Building foundation >S Property line >5' Absorption field >S Water main N/A Water service line >70' Surface water >100' Wells on adjacent lots >100• SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 4'•••• Building foundation >10' Water main >10' Water Service line >10' Surface water >100' Driveway, parking/vehicie storage >2T Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS: • See Lot Une Waiver. 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 Michael E. Anderson, P.E. Date 10/17/9007 COSA Fee $ d Waiver Fee $ _ Date of Payment O (9 O — Date of Payment Receipt Number_ EY3�3 Receipt Number _ (Rev. 11/05) 49- .v Municipality of Anchorage �� Development Services Department C Building Safely Division On -Site Water and Wastewater Program ' 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchoragc.ak.us (907)343-7904 Waiver Review Worksheet WR#:30 0115 PID#: 015-051.14 HAM 030629 Permit#: Date Received: 12111/03 Legal Description: Autumn Ridge Lot 11 Engineer: Mike Anderson Anderson Engineering . P.O. Boz 240773 Anchorage Ak.99524 Applicant: Cromn Pointe, Inc. Waiver Requested: 4 feet separation distance absorption field to property line. Criteria: Geology Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: ............................................................................... Waiver is Granted: z' Waiver is not Granted: List Conditions or Reasons for above: Date: 12--11- 0 3 By: :Woe of Reviewer ........................................................................... Rec#: 45500 Amount: $150.00 Date Paid: 12/11/03 ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 FAX MEMORANDUM DATE: October 18, 2008 TO: Jay Crewdson, P.E. FROM: Mike Anderson, P.E. SUBJECT: Lot 11, Autumn Ridge Subdivision Certificate of On Site System Approval (COSA) We have made the following revisions in accordance with your comments: 1. The signed surveyor As Built is attached. 2. Sheet 1/3 of the inspection report indicates the total depth of the trench from original grade at 5.5'. It also indicates 2' to 3' of fill was added above original grade making the new total depth 7.5' to 8.5'. The COSA checklist has been changed to reflect this depth. Y NICKELL A CIRCLE 2001-143 AUTUMN RIDGE SUBDIVISION LOT 11 46,044 S.F. (N+9 I SNOW STORAGE ESMT. L N 69.56'04"E 199.64- 20' T. do F_ FrUT_ BUILDING DETAIL SCALE: 1 "=20' A.C. DRIVE 10' T. do E. ESWT. J T wcu :EXISTING 31.W e n of M n 111=40' AS -13U I LT I HEREBY CERTIFY THAT I HAVE SURVEYED THE PROPERTY DEPICTED ABOVE AND THAT NO GASTALDI LAND SURVEYING ENCROACHMENTS EXIST EXCEPT AS INDICATED. JEFF A. GASTALDI, R.L.S. IT IS THE RESPONSIBILITY OF THE OWNER TO 4726 WEST 68TH AVENUE DETERMINE THE EXISTENCE OF ANY EASEMENTS, ANCHORAGE. ALASKA 99502 COVENANTS OR RESTRICTIONS WHICH DO NOT PHONE 248-5454 APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA GRID DATE HEREON BE USED FOR CONSTRUCTION OR FOR 2437 6/30/2004 ESTABLISHING BOUNDARY OR FENCE LINES. ANCHORAGE RECORDING DISTRICT, ALASKA F.B. JOB NO. 03-20 ARSII NOTE: NO CORNERS SET THIS DATE. E N 43.4' 25.0' FENCE (APX) SEPTIC SYSTEM *sililklimr, f �� Q��' • OF.. A4 s•# AV 0 0. e . J•ft�A. Gas raldl �a J9. S R� % •.• LS -6091 �: At. ^•Op'•••..•.•••. AyJ� 3 N 0 r 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.cl.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-05414 1. GENERAL INFORMATION 41�C. HAA# 0'_�0(o7_Sj Expiration Date: 3— 12--0 LA Complete legal description _ .Lot 11. Autumn Ridge Subdivision g41z Location (site address or directions) Nickell Circle 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 Anchorage, AK 99511 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: Six (6) 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Day phone Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site 19 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 seat 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. 1 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 Anderson Engineering Phone 522.7773 Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Date 12/1V2003 rte,` '•+`9'�� EtiJ'I°•dFF`i`r _!.._ 49th jjK ;MICHAEL E. ANDERSON 5. DSD SIGNATURE ��� No. a-4381 •� "" rf Approved for bedrooms. "'"'•"'"' haaR�ss;�:• Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other By: � Original Certificate Date: (Rw. 11/00) j Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lot 11. AutumnRidoe Subdivision Parcel ID: 015,05414 A. WELL DATA Well type Private Date completed GIM3 Total depth -W-ft. Date of test Static water level Well production if A, B, or C provide PWSID # _ Well Log (Y/N) Y Sanitary seal (Y/N) Y Wires properly protected (YM) Y Cased to 242 ft. FROM WELL LOG 198 ft. g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate -JIL mg./I. Date of sample: 121912003 Collected by. MEA B. SEPTICIHOLDING TANK DATA Tank Type/Material SeotIct teel Tank size 2.000 gal. Number of Compartments Y Foundation cieanout (Y/N) Y Depression over tank (YM) N Date of pumping C. ABSORPTION FIELD DATA Pumper New Construction Casing height (above ground) tin. AT INSPECTION ft. Other bacteria Q colonies/100 ml. Date installed 27=03 Cleanouts (Y/N) Y High water alarm (Y/N) N Date installed 3I31T003 Soil rating (9.p.d.M2 or fe/bdrm)1.2 GPDISF System type T Wide Shallow Length 120 ft. Width ft. Gravel below pipe 4 ft. Total depth 6-11 ft. Eff. absorption area 200 fe Monitoring tube Y Depression over field N Date of adequacy test Results (Pass/Fad) 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.) (Y/N &type) N If yes, give date D. LIFT STATION Date installed "Pump on" level at _ in. Datum Size in gallons "Pump off' level at _ in. Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot >100' Absorption field on lot >100' Public sewer main WA Sewer /septic service line >25' Manhole/Access (YIN) High water alarm level at Meets alarm & circuh requirements? On adjacent lots >100' On adjacent lots >100' Public sewer manhole/cleanout WA Holding tank WA SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Property line >5' Absorption field >S Water main WA Water service line MW Surface water >100' Wells on adjacent lots AW SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 4' Building foundation >10' Water main >10' Water Service line >10' Surface water >100' Driveway, parking/vehicle storage >2F Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through Held inspections and a review of Municipal records that the above systems are in j; •y conformance with MOA HAA guidelines in effect on this date. 0„ Engineer's Printed Name Michael I Anderson. RE ��i 1� Date 12!1012009 HAA Fee $ 375 + / Sb Date of Payment /Z ' /1-05 Receipt Number (Rev. 12MO) Waiver Fee $ Date of Payment a' AEL E. 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