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Home My WebLink AboutMOUNTAIN VALLEY ESTATES BLK 3 LT 6Mountain Valley Esta Block 3 Lot 6 #050-641-01 Municipality of Anchorage Page ,/ of ._~__ DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: ~t,J g) L/d)i/~ ~ PID Number: /?.~'~ - Name: /-~.~,¢.,~,~, /.,,~...~,.,~,,.~ ~ /¢¢¢. Wastewater System: ~ New [] Upgrade Address: ,~/~,,~ ~.,,-...,,, ~.- ~.~.~,. ~-,..,.,. ABSORPTION FIELD Phone: ~',~ - ~' ~/~ J No. o! .~,~ooma: [] Deep Trench ~ Shallow Trench [] Bed [] Mound [] Other LEGAL DESCRIPTIO N so,, Rail.g: Total Depth from original grade: Lot: BlOCk: Subdivision: ~epth to pipe bottom from oflgint~l grade: Gravel depth beneath ptpe Townahlp~,,,,~,~ I Range~,~,/ I Section: Fill added above original grade: Gravel tength: ,~, ~' /, ~ ~t ~P'~-- Ft. WELL: ~ New [] Upgrade ar,ve, Cccx: ¢,..e.,¢~ ~-...v Number of lines: O~stancebelweenlines: SEPARATION DISTANCES /~l~Septic [] Holding [3 S.T.E.P. We, / ~'-/' /.~/ :'.,25'' .:¢'~.z-~ ~ .2- Surface Wa~er '~,~C~' "X~,~' + IO0' LIFT STATION LOt / Size In gallons: Line ~/"*/ ' '~/'3 · 4- /0 Foundation' ~'"~'~ '~,.~,* O "Pump °n' level at: Remarks: ..~ .4/~,/¢.~' .~-.~,.~.,,~,~' BENCH MARK Inspections pedormed by: ~'./~.~. ~. Dates: 1st 2nd ,~/'~./~ ~/' ~\ CtasZOl't~ E. wooo ....'~-. ~ Department of Health and Human Services approval ~. _-..~ .~11~11......~j Reviewed and approved b ate: Permit No. SWO40143 Page 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744 On-Site Wastewater Disposal S~tem and/or Well Inspection Report of 2 Legal Description: LOT 6, BLOCK 3, MOUNTAIN VALLEY ESTATES PID No.: O50-641-O1 SCALE 1'- 1OO' // SWING TIES ~ m-EAS£MENT I IA In I ~ 51.3' 66.1'I ---LEACH~ -TEST HoLEFIELD / 84.5' 116.21 · -MONITOR TUBE J o -SEWER CLEAN OUT 118.2' 140.4'] .~- --WELL (NaT TD SCALE) ~-,---~H., ,"; \ ,";",,__/ =il ','%IUUI .... /I ,A~,- h, IJL\,... ,oJ h,., "-.. '~.. TEST HOLE .2° 7/29/04- ENGINEER'S SEAL ~i~..,~oP.E..~oo~'~ 0;%2.. cE-,o~87 ..';~ 11/05/04 .FRI 15:21 FAX 9.07 249 1497 FORDttAM PROPERTIES O001 M-W Drilling, Znc. eP.O. Box l10378,Ancho~oge' AK 99511e e907-345-4000 · 907-345-3287 Foxe Job No.: 04-142 Project No.: N/A Pe~nlt No. $W040143 , · Well O~ner: Fordlmm Iflves~ments Comp~n~, LLC · LegelDe~crlpIk~n: Mountain Valley Esta~es~ Bloak 3~ Lo~ 6 _Eagle River. Al~ka · t/se of Dell: __ Domestic · WdIDe~lop~mt: Method: Air sur~e Note~: · Static v,~ter level (~) 5~' (~;~) (~low) lop of~g ~). tWelly~ldtestnt 10+ ga~om~m~ute(GPMF~)for + M~: A~lift Aour~ · Date of completion: 0S June 2004 ·Pump Install: Well Log I~:pth in feet from top of casing. Detalb of formations p~ne~r~tedT size of mstcrial, ~lor and hardn~L 0 TO 2.5 ' C~in~ stickup 2.5 TO 33 Sil~vel 33 TO 37 Silty g~yel: wet 37 TO 55 SilW~avel: d~h~d~gul~rocks 55 TO 66 Be~k: g~y-black? sil~tone argillite 66 TO 67 As a~ve: ~acture zone 67 TO 73 As a~ve: ~ 73 TO 105 As a~ve: black~ soft 105 TO 109 As above: lift.y, fmct~es~ wa~s~ps TO TO TO TO ; N~A Ceflifled TO ce~f~ Nos. I TO MUNICIPALITY OF ANCHORAGE Development Se~ices Department On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box lg6650, Anchorage, AK ~9519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT Initial Date Issued: May 25, 2004 Expiration Date: May 25, 2005 Permit Number: SW040143 Parcel ID: 050-641-01 Legal Description: ~,tOUNTAiN-~/~.EY ESTATES BLK~3 LT~6? Design Engineer: 0848 Eagle River Engineering Sen/ices Site Address: Owner Name: Fordham Investments, CO LLC Lot Size: 118579 SQ. FT. Owner Address: 21919 Bamlay Drive Total Bedrooms: 4 Permit Bedrooms: 4 Anchorage, AK 99577- This permit is for the construction of: [] DisposalField [] SepticTank [] Holding Tank [] Privy [] Private Well [] Water Storage Ail construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By:. ~.~ ~:f--~ Issued B~ Date: Date: 0c[-14-03 12:57P Par'mit CounteP 907 343 8250 P.O1 Municipality of Anchorage Development Services Department Building Safety Division On-Site Waler and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.cLancho rage.ak.us (907) 343-7904 ON-SITE SEWEI~./WEt! PERM!T APPLICATION FOR A SINGLE FAMILY DWELLING Permit Number SW Mailing address (1) ~/~'/c? Mailing address (2). Legal description (Lot, Block & Sub'd.) Legal description (Section, Lot Size I I ~j~.. Day phone ~c~ Zip Code Number of Bedrooms THIS APPLICATION IS FOR: Sewer Only Sewer and Well Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub Swimming Pool Therapy Pool Well Only Water Storage [] Jacuzzi Water Softening Unit [] I certify that the above Inform~ation is correcL I further certify that this application is being made for a Single Family Dwell~g and ~ in accordance with applicable Municipal Codes. (Signature of property owner or outhorized agent) Permit Fees: o.,eo,.. ent' Waiver Fees: Date of Payment: Receipt Number: Eagle River Engineering Services Chastopher R. Wood, P.E. 10421 VFW Rd. Suite 201 (907) 694-5195 tel Eagle River, AK 99577 (907) 694-3297 fax May 21, 2004 Jim Cross, P.E. Manager, On-Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: Mountain Valley Estates B3 L6 Narrative & Permit Application Dear Mr. Cross: The proposed well and septic system will have very limited impact on adjacent properties for the following reasons: 1. The surrounding lots are large, allowing sufficient room for septic sites. 2. Immediate neighboring septic systems are all +30' distance. 3. Reserve space is adequate, and underlying soils are adequate for a future replacement drainfield, if necessary. 4. Drainage will not be affected and is not a major consideration in our design. This well and septic system will have little impact on adjacent lots, due to the large lot sizes. Neighboring wells and septic systems have been located and identified. Impact to future wells and reserved spaces will be minimal, or none. Drainage will not be affected by this design. If you have any questions please call our office at 694-5195. Principal \1997~04-026 N,'~.I:XX: EASEMENT -PROPOSED LEACH FIELD __ ~-EXIST~NG LEACH FIELD ~'~,~. I' · -Mo.rroR tuBE / / 86 / ~ / / / 182' / I WELL/SEPTIC SITE PLAN LEGAL: LOT 6, BLOCK 5 MOUNTAIN VALL~ ESTATES ~%% ...:~. OWNER: F ~ F PROPERTIES CONTRACTOR: F~F PROPERTIES ; ~'~~ "~.'~ EAGLE ~IV~ E~GINEE~ING ~ERVIC~ ~ · ct-~o*~ .".~ P.O. Bo~ ~78~4 EAGLE RIVER, AK. 99577 (90~) G94-5195 XAX: (90~) 694-829~ Eagle .iver Engineering ervices Christopher R. Wood, P.E. 10421 VFW Rd. Suite 201 (907) 694-5195 tel Eagle River, AK 99577 (907) 694-3297 fax SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM LEGAL: Mountain Vllley Est. L~ B3 April 28, 2004 A. GENERAL I. The well and septic plan is for a 4 bedroom single family residence only. 2. The drawing and or site plan shall be a part of this specification. 3. All materials and workmanship shall meet the Anchorage Department of 11ealth and State Department of Environmental Conservation requirements. 4. All soll tests are advisory to the design and are to be verified or modified in the field by the engineer. 5. All excavations and depths are advisory and are to be verified in the field by the contractor to meet Municipality of Anchorage, Department of Environmental Conservation requirements. 6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any adjacent multi-family wells. 7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer approval. g. Any remaining open test hole excavations shall be filled and monitor tube removed. B. SEPTIC TANK I. The sewer piping from the house shall be 4" PVC 3034 lald at 2% grade maximum - 1% minimum and insulated with 2" of burial foam if shallower than 3 R., with 2 ft. minimum. 2. Septic Tank shall be a minimum of 1,250 gallon tank of MOA approved construction, insulated, or place with 4' ofsoil cover, min. C. DRAINFIELD I. The drainfleld is to be placed as shown on the site plan. Contractor shall take extreme care ensure that 10'separtation distance is maintained between trenches, from the lot line, and from the house foundation. 2. The bottom of the drainfleld excavation shall be level, plus or minus 1.5", prior to placing gravel. 3. The total depth of the drainfleld excavation shall not exceed 7 ft. at any point in relation to natural ground surface. 4. The drainfleld gravel shall be covered with typar fabric material. 5. Soil or a combination of soil and extruded board insulation to at depth of 3' or equivalent is to be placed over the leachfield. 6. The area over the drainfleld is to be finish graded or mounded to prevent ponding of surface water runoff. 7. The septic tank and leachfleld must not be closer than 100' to any existing private well, 150' to any Class "C" well, or 200 feet to any community well. RECOMMENDED LEACHFIELD DIMENSIONS: TOTAL DEPTtl = 7' GRAVEL DEPTH = 4' under pipe, 2" over pipe (4.5' total) DRAINFIELD LENGTtl -- 75' DRA1NFIELD WIDTtl = 5' SOIL RATING -- 0.8 GPD/~ BEDROOM CAPACITY = 4 total SEPTIC TANK -- 1250 gallons min. Twenty-four (24) hours notice required for all Inspections. ~LEresXDOCS\WPDOCSX2004\04-026drainfield- spec.doc EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 Eagle River, Alaska 99~// (907) 694-.5'195 ERES Project No.: 04-026 Calculated By: CW Date: 04128/2004 Legal: Mountain Valley Est. L6 B3 Single Family 4 Bedroom Dwelling TEST HOLE 1 & 2 Shallow Trench Subsmface Wastewater Disposal tin, eld Water use at 150 gallons per bedroom = 600 gallons Percolation rate = 6 minutes per inch Wastewater application rate = 0.8 gallons per day per square foot Required absorption area = 750 square feet Trench width 0/V) = 5 feet Gravel depth (D) = 4 feet Required length = Shallow trench factor * Required absorption area / W Shallow trench factor = ON + 2) / ON + 1 +2 D) Shallow trench factor = 0.50 Total Excavation Depth = 7.0 feet Required length = 75 feet 04-026_drainfieldCalc,xls 6:42 PM04/28/2004 Municipality of Anchorage Development Services Department Pu~ling Safety Division On-Site Water and Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 995 t 9-6650 ,. www. d.anchoraqe ek.u'~ Sods Log -Percolatton Test 3- 4- 6- 7- 8- E.co~rr~RED? /~ O IF *I:E$. AT V~,~AT DEPTH? ~lo/J~ T°w~ahlp' Range' Secfi°n: J~JA,'l ~/~/ ~ ~" '~ ~ T'/I-~fGt Site Plan 14- ~,, L~ y~"~/ ~.] ~ Reading Date Gross 'Time Net ~me Depth lO Water Net Drop 16- ~o~0~ o,: ~ U:~o 9 q ~-6" I 20- .~-i~ ...... X/ ...... I~O. n ~ (m~) PERC HOLE D~R PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GU~I~'LI~E$ IN EFFECT ON THIS DATE. DATE: Municipality of Anchorage Development Services Department Buikling Safely Division On-Site Water and Wastewater Program 4700 South 8mgaw SL P.O. Box 196t~0 A~chorage. AK 99519-6650 · www. d. ancho~qe,ak.u$ Soils Log - Percolation Test 6. 7. 8. 9- 10. 11. 12. 13- 14. 15- 16- 17. 18- 19- 20- Date Peffomed: T~shlp. Range. Se~ion: Site Plan ENCOUNTERED? --- I ReadingDate Crose Tume Net T~me Depth to Water Net Drop I ql~//~/ /?:ook,.~ z ""/ ( ~ ~ ~ ~./ ~ ,, q ~ ,,,,~ ~,,, ~./ g., S o gcg ,' ~ ~/ ~/ ~,,~ t~,~ ~y ~" F:'ERt"I;[ T NO. E:,E:F'FffE:TI"IENT Cfi= HEFti._'TH FIN[) EIqV.I:I:E:ONHEI",ITRL. Pf~:OTECT ]: ON E:25 "L '" Ei;:I"fE:EE':T., FINE:HOF;:I::IGE., FIK. i~..,Jt ~;T. L.. il ....... F:-~ ~"-a I[:::, C~ ~"-.~ ..... :.tEE; % %' lEE; L'.'E; FEE B,,.:.,! b?2::: IF~:: iF=`' EEC ~'~:: ii ',"ii % 'T ,:: 8 ;3 E~585 FIPF'L T CFINT L. OE:FIT :1:Ot",1 L. EGFIL. ECS I','l"r ',,,'RLL,E'¢ ESTF:ITEE; LOT S:[ZE T'¢F'E OF' SO]:L FIB'.SOF::F'TZEdq :S'T'::.;TEM IF.:;: TF:Ei",ICH I'IFt::.:',]:I"ILli'"I t'.,It..II"IE:EI:;.: C'd:: EE:.:I)F.:OCfl"I!E; :=: Z SCI]:L RflT:[I",tG '::E;L::! [::'T,.'"BR::'= 85 THE REQUIRIED S:[ZE OF THE: E;13IL I::IE:SOF:F'TION :?'r%TEM IS;: THE L. EI",II3TH [::' :[ I"IE:NL:., I Cd",l I 5 '1"HE LEI",tGTH ':: :[ l",i I::EE:T ::' t:~F' THE TRENCH OF.: [::'F:FI I NF t ELI::'. TPtE E:'EF"I'I"t OF FI TF:ENCH Ot~'. Pi'T ]:S; THE E:':[S:Tf~NCE BETHEEi",I THE S;URFFICE OF' THE G[~:OUNE:' FINE:' THE: BOTTOH OF' THE E;:':;CR',,,'FIT.T. ON ':: ]:N F'EET::'. TFIEF.:E ]:S NO E;ET P.I]:B'TH FOR TRENCHES. 't'HE GF4:FI',,,'EL DEPTH :IS THE t"'l:[~.,l:~t"'lt..If'l DEF'TH OF: L'!iF,i:FI',,,'EI... BETI.'.E:EN THE OIJTFFILL F':[F'E FII",ID THE BOTTCd"I OF THE E ;:':: C FI ',,,' R 'F .T. 0t",1 '.': :[. i"4 FEET ::'. PERM I T FIF'F'L :1: CFIIq'f' FIFIS THE: F4:ESF'I3hlS I E!~ 1' L.T.'T"r' TO I I'.,tF:'ORI'"I 't"H :[ S E:,EF'FIF'.TMENT [::,L.I[E: 1' i",tG THE )'. N:STFILLFIT Z ON .T. N'.SF'EC:T ]: OF,IS OF FIN"r' I.,.IEI...L.:S FIE:'..I'IaCE:NT TO "i"H :t: S F'F'.OF'EF.:T'¢ FIND THE i"gJHE',EF-: OF' RE2q:[E:'ENC:EE; THFIT 1~HE I.'.IE:L.L 14:I:/.L :SEF.':',,,'E. ............... ""IF' lt-...~ C~ ,::: ;;~ ::, Z ~"-.~ "_:.:.5 F" EEC C:: *"if*' % E.'7.:~ t'..,~ :!~; FII iF~: E FL' ,~% ET.:~ IU :~': I1:;~: E:.S":. IE: .................... E:IaE:KF ]: LL. ]: I'-,IG (:iF' lql'.,l'¢ S:"r'STEH I.'.1:[ THOIJT F :[ iqFIL :[I",IS;i::'ECT :1: ON I::It",1[::' FIF'F:'Fe.O',,,'RL B'¢ 'lq"'l Z S; E:'EPRF;:THEi",IT P.I:[LL. BE SUB.:t'ECT TO PROSECLIT:[.ON. H i I",11 HUH [:':I: STFtI",ICE: BE'f'I.,.IEE':I",t FI FIE[...[... FINE:, Fli",l'¢ OI",I'-':E; :[ TE ::T:,E:HFIGE: [:' I '.SF'OSRI.... S;'T':E;TEH :[.e~O FEE:T FOF.: FI F'I~:I',,,'RTE P.IEL. I_. OR :LSE'~ TO ;L"'E'~E~ P-E:ET FF.:Old IZl F'LtBL]:C FIELL. DEF'E:I",ID]:NG UF'ON THE T"r'F'E OF PUE:L.:[C !-,.IEI....t .... i"i:I:NIHUH [:,ISTf::INC:E F'ROH R F'F.:I',,,'FITE HELL. TO FI PRI',,,'FITE :SE:I.,.E:I:~: L. iNE l':.'5', 2!.5 FEET FI i'.,I I::, TO FI COHHLINIT'-r' E;EHEI:;~: LINE IS 75 FEET. HELL LOGS FIRE t~EgiLIIREE:' Rt",IB' ['dUST BE RETLtI:~:NEi::' TEl THE: [.':,EF'I::t[;i:THIENT P.IITHtI",I 2'~:E~ OF THE I.,.!ELI... C.:OMF'LET I ON. OTHER I;i:I:Eg!Li ]: REMEI'.,ITS I"IFI¥ FIPF'L.'T'. 5;F'EC I F :r. CFIT :]: ()i'.,l?S FIN[::, COI'.,tS'f'F.:LIC:'¥'.'[ ON [::, :[ FIE:iRRHS RF..'E I:::I',,,'F:I .T. LFIBI..E TO Z I'.,IL:;IJF.:E F'F.:OF'EF: :[ NSTFtL..L. FIT :[ ON. ]: CEF.:T I F'"r' :L: t I::t1'"I F'FtI'fl]:L:[RR 1.4ITH THE RE:E:!LI:[F.:EHE":N'['S FOR OI",I-":E;ZTE SEt4ER:S FINE:, P.IEI..[..2; FIS SE]' F'OI~:TFI B'~" THE HUN :[ C :[ F'I:IL :[ T"r' OF FINC:HOF4'.IaGE. 2: :[ I.,.I]:L.L ;[t",t"2, TRI..J_ THE S'¢STE:t't :[.i",i FIC:C:OR[::'FINCE !.,.I:[TH THE CODIE:S. :!!.: :[ LINE:,ERSTFIt",t[::' THFIT THE C)I'.,I--S:r. TE :S[..:.'l.,.iEl:~: S'~".2;'T'EI','I i,'IFI'¢ F,::EQU:[F.:E IENL, FIF,.':GEHEI'-,IT :IF' THE Fi:ES :[ E.,ENCE ]:'.:S REI,iODEI...ED TO ]: NC:L. Ltt)E MORE THFII'.,I MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 82B L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SOILS LOG [] PERCOLATION TEST LEGAL DESCRIPTION: ~/'~'~' 1 2 3 4 5 6 7 8 9 10 11 12 13 14- 15- 16- 17 18 19- 20.- DATE PERFORMED: ~ ¢~'~ "~ ~ SL( SITE PLAN WAS GROUND WATER ~ 0 ~ ENCOUNTEREO? O P E IF YES, AT WHAT DEPTH7 Gross Net Depth to Net Reading Date Time Time Water Drop NO. 9.11 PERCOLATION RATE (minutes/inch) COMMENTS 72-008 (6/79) TEST RUN BETWEEN FT AND FT Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore 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. 0,;0_641_01 1. GENERAL INFORMATION Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing Address Expiration Date: / cO -.,,~ ff - /O 4730 Hiiand Road Eagle River, Alaska 99577 Mike & Coninne Tucker Dayphone(907) 622-1218 4730 Hiiand Road Eagle River, Alaska 99577 Day phone Sherri Sapp @ Re/Max of ER Day phone (907) 317-6302 11525 01d Glenn Hwy Eagle River, Alaska 99577 ......... -~nless-otherwise requested, GGSA will be held by-DSD forpickup; · - 2. NUMBER OF BEDROOMS: 4 TYPE OF WATER SUPPLY: Individual Well [] Individual Water Storage [] Community Class ~ Well [] Public Water System [] TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding Tank Community On-site Public Sewer The Municipality of Anchorage Development Services Department (DSD) issues Certificates of 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 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 Firm Pinard Engineering Phone(907) Address PO Box 871347 Wasiiia, Alaska 99687 Engineer's Printed Name Paul E. Pinard, P.E. 232-1347 DSD SIGNATURE ~ Approved for ~ Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: · . -.,~. 0N-SITE WATER AND WA~T~WAT~ PROG~M Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory X By: (R, er. 11105) Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Elmore 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: A. WELL DATA Lot 6, Bk 3, Mountain Valley Estates Parcel ID: 050-6/+1-01 If A, B, or C provide PWSID # ~ Sanitary seal (Y/N) Y Cased to 56.6ft. Well type Pvt Date completed 6/8/0/+ Total depth 109 ft. FROM WELL LOG Date of test 6/8/06 Static water level 5 5 ft. Well production 1 O+ g.p.m. WATER SAMPLE RESULTS: Coliform ~) colonies/100 mL Nitrate 0,~7~ mg/L Arsenic: J~P ug/L date of sample: ?/12/10 B, SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Tank size 1250 gal. Foundation cleanout (Y/N) Y Date of pumping. 7/1/+/1 0 C. ABSORPTION FIELD DATA Date installed 6/9/0/+ Soil rating Length 75 Total depth 8 ft. Date of adequacy test Fluid depth in absorption field before testO, O in. Elapsed Time: 2_10 min. Final fluid depth0 o O Any rejuvenation treatment (past 12 mo.) (Y/N & type) Well Log (Y/N) ¥ Wires properly protected (Y/N) casing height (above ground) AT INSPECTION 55.9 ft. .3..3 g.p.m. ' Y 18+ in. Other bacteria *colonies/100 m L Collected by: Pinard Enz-i n~.~.~--i ng Date installed 6/9/0Z Numberof.Compartments ? Cleanouts (Y/N) y Depression over tank (Y/N) 1~ High water alarm (Y/N) ~A Pumper Sanitary Pumper¢ (g.p.d./ft2 Width 5 ft. Eft. absorption area ?50 ft2 Monitoring tube Y ?/1 2/1 0 Results (Pass/Fail) ~ System type .qhn!!o~ ?ten_ch Gravel below pipe /, ft. Depression over field ~I For /+ bedrooms Water added ?00gal. New depth0.0 in. in. Absorption rate >= 600+ g.p.d. l~on~ gno._~yn If yes, give date D. LIFT STATION ~A Date installed "Pump on" level at ~ in. Datum E. SEPARATION DISTANCES Size in gallons "Pump off" level at~ Cycles tested in, Absorption field on lot Public sewer main Sewer/septic service line Animal containment areas Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: SePtic tank/lift station on lot 1 O0 ' + 100'+ 75'+ 25'+ 50'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: On adjacent lots 100 ' + On adjacent lots 1 O0 ' + Public sewer manhole/cleanout 100 ' + Holding tank ~A Manure/animal excrete storage areas 100 ' + Building foundation 5'0 ' + Property line 10 ' + Absorption field _50 ' + Water main 1 {3 '.-I- water service line 10 ' + Surface water Inn, + 'Wells on adjacent lots 100 ' + in. SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10 ' -I- Building foundation 2_5 , +. Water main 10 ' + Water Service line 10 ' + Surface water 100 ' + Driveway. parking/vehicle storage Curtain drain . ~^ Wells on adjacent lots I n~3, + F. COMMENTS review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Paul E. Pinard, P.E. COSA Fee $ /7~ ~ 0 Waiver Fee $ Date of Payment "~- .~ ~ - /O Date of Payment Receipt Number / ~ ~ c~ -~ _~ Receipt Number (Rev. 11/05) sG~i Ref.# Client ~ame Pro~eet Name/# Clieat Sample ID MatI ix Saml ~1e Remarks: Patterer H~dness as CaCO3 Waters De~artment To~d Nitrate/Nilrite-N Mic~obiolocJ~ Iaabor&~o~ar E. d iColiform Printed Date/Time Collected Date/Time Received Date/Time Technical Director 1103386001 Pinard Engineering 6/3 Mountain Valley 6/3 Mountain Valley Drinking Water 07/23/2010 16:24 07/12/2010 11:!0 07/12/2010 12:45 Stelshen C. Ede Allowable Prep Analysis Results L00 Units Me~hod Container ID Limits Date Date Init 116 5.00 mg/L SM202340B C 07/13/10 07/14/10 KD( 0.978 0.100 mg/L SM204500NO3-F B 07/12/10 AY( 10.0 mg/L SM20 2320B D 07/12/10 LP 20.0 ug/L EP200.8 ,C 07/13/10 07/14/10 KDC 1.00 ug/L EP200.8 C (<6) 07/13/10 07/14/10 KDC 5.00 ug/L EP200.8 C (<10) 07/13/10 07/14/10 KI)C 3.00 ug/L EP200.8 C (<2000) 07/13110 07/14/10 KDC 0.500 ug/L EP200.8 C (<5) 07/13/10 07/14/10 KDC 500 ug/L EP200.8 C 07/13/10 07/14/10 KDC 0.100 mg/L EPA 300.0 D (<250) 07/20/10 07/21/10 SDP 2.00 ug/L EP200.8 C (<100) 07/13/10 07/14/10 KDC 10.0 mg/L SM20 2320B D 07/12/10 LP 1.00 umhordcm SM20 2510B D 07/12/10 LP 1.00 ug/L EP200.8 C (<1300) 07/13/10 07/14/10 KDC 0.100 mg/L EPA 300.0 D (<2) 07/20/10 07/21/10 SDP 10.0 mg/L SM20 2320B D 07/12/10 LP 250 ug/L EP200.8 C (<300) 07/13/10 07/14/10 KDC Priv ate Individual Analysis AI~ flinity 93.0 !_ Alu ninum ND Antimony ND 4:28 Calcium 32500 Chl~ride 0:456 ChrOmium ND COi Alkalinity ND Conductivity 243 Cop~ 527 Fluo~de ND ItCCI3 Alkalinity 93.0 IronI ND Negative I 100mL SM20 9223B A 07/12/10 DL£ Negative I 100mL SM20 9223B A 07/12/10 DLC PINARD ENGINEERING P.O. Box 871347 Wasilla, AK 99687 (907) 357-ENGR (3647) ADEQUACY TEST LOCATION: Lot 6, Block 3, Mountain Valley Estates APPLICANT: Mike & Connie Tucker 4730 Hiland Road Eagle River, Alaska 99577 SEPTIC TANK TYPE/SIZE: Steel/1250 Gallons, per MOA Records ABSORPTION SYSTEM: Shallow Trench, per MOA Records DAILY FLOW: 4 BEDROOMS x 150 GAL/BR = 600 Gallons JOB NUMBER: 10-183 DATE OF TEST: 7/12/10 FIELD STAFF: PJ Pinard NUMBER OF BEDROOMS: 4 SCUM: 0.0' SLUDGE: Minimal NEEDSTO BE PUMPED: Yes No XX CURRENTLY IN USE: Yes XX No TEST DATA Time Flow Volume Cumulative Septic Tank Septic Soil Absorption System Comments Rate Volume Tank PM (GPM) (GALs) (GALs) Liquid Level A Level Monitor A SAS Monitor A SAS * Tube 1' Level Tube 3* Level 2:05 3.3 - 4.0' 0.0' Start Flow - Meter 278900 2:20 3.3 50 50 4.1' 0.1' 0.0' 0.0' 278950 2:35 3.3 50 100 4.1' 0.0' 0.0' 0.0' 27900 3:05 3.3 100 200 4.1' 0.0' 0.0' 0.0' 279100 3:35 3.3 100 300 4.1' 0.0' 0.0' 0.0' 279200 4:05 3.3 100 400 4.1' 0.0' 0.0' 0.0' 279300 4:35 3.3 100 500 4.1' 0.0' 0.0' 0.0' 279400 5:05 3.3 100 600 4.1' 0.0' 0.0' 0.0' 279500 5:35 - 100 700 4.1' 0.0' 0.0' 0.0' Stop Test - 279600 RECOVERY Date Time SAS MT1 SAS MT2 *ALL MEASUREMENTS IN FT. TEST: PASSED XXX FAILED COMMENTS: System appears to be operating satisfactorily. There was no measureable liquid in the SAS MT prior to or at any time during the test. Reviewed by: Paul Pinard Date: 7/14/19 PINARD ENGINEERING P.O. Box 871347 Wasilla, AK 99687 (907) 357-ENGR (3647) WELL FLOW TEST LOCATION: Lot 6, Block 3, Mountain Valley Estates DRILLER: M-W Drilling DATE WELL COMPLETED: 6/8/04 WELL DEPTH: 109' JOB NUMBER: 10-183 DATE OF TEST: 7112/10 FIELD STAFF: PJ Pinard STATIC WATER LEVEL (top of casing): 55.9' Elapsed Static Flow Cumulative Time Time Water Rate Gallons Remarks (Minutes) Level (~lpm) Pumped 1:35 PM - 55.9' 3.3 Start Test - Meter 278800 1:50 15 56.5' 3.3 50 278850 2:05 30 56.4' 3.3 100 278900 2:20 45 56.5' 3.3 150 278950 2:35 60 56.6' 3.3 200 279000 2:50 75 56.5' 3.3 250 279050 3:05 90 56.4' 3.3 300 279100 3:20 105 56.5' 3.3 350 279150 3:35 120 56.5' 3.3 400 279200 3:50 135 56.2' 3.3 450 279250 4:05 150 56.5' 3.3 500 279300 4:20 165 56.4' 3.3 550 279350 4:35 180 56.4' 3.3 600 279400 4:50 195 56.5' 3.3 650 279450 5:05 210 56.5' 3.3 700 279500 5:20 225 56.5' 3.3 750 279550 5:35 240 56.4' - 800 Stop Test 279600 RECOVERY All well protection features are adequate. 5:40PM 5 55.9' Average Flow Rate: 3,3 gpm Comments: DURING THIS TEST, TIS WATER SUPPLY WELL WAS CAPABLE OF PRODUCING 3.3 GPM. THIS TEST DOES NOT CONSTITUTE A WARRANTY OR GUARANTEE THAT THE WATER SUPPLY SYSTEM WILL CONTINUE TO FUNCTION AND PRODUCEAT THIS RATE. £L../., Reviewed by: Paul Pinard '~'~/~i~' Date: 7/14/10 Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.munLorg/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Expiration Date: 1. GENE~L INFORMATION ~mplete legal description Z,~ ~P~ ~r~,~ ~~ Lo~fion (site address) ~z~ ~~ ~.~ ~. ~ Cu~ent Pm~y o~e~s) ~,~ ~o ~ ~ ~'~ phone Mailing address Lending agency Day phone Mailing address Real Estate Agent Day phone, Mailing Address Unless otherwise requested, COSA wlTI 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 TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual, Holding Tank Commumty On-site [] Public Sewer The Municipality of Anchorage Development Sen/ices 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 AJaska. Certificates of On-Site Systems Approval are required for the transfer of tit~e (except between spouses) for properties sen/ed by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeewaers. Certificates of On-Site Systems Approval are valid for 90 days from the date of issue for properties sen/ed 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.) Cert~cates are valid for one year for properties sen/ed by Class A or B walls or a public water system. The Municipality of Anchorage is not responsible for eh'ors 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-Sita Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system Is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ./~,,,,..,-~-~.,,..~ Address ~'t)O~, E:. ~ Engineers PHnted Name bedrooms. 5. DSD SIGNATURE Approved for Disapproved. Conditional approval for $200 to be escrowdd for septic tank pumping. Work to be completed ~ ~99n as road conditions perait. Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report · Other Odginal Certificate Date: 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: ~-o,-~, ~',~,?~ .,.-/~,~,x~-~,~/~-~Y'4~'4~'~',-~' .~',,~ A. WELL DATA Parcel Well type Date completed ~/..~/~ Total depth /e~' ft. IfA, B, or C provide PWSID # Sanitary seal (Y/N) '/ Cased to .~'- ~ .ft. Well LOg (Y/N) Wires properly protected (Y/N) Casing height (above ground) in. Date of test Static water level FROM WELL LOG AT INSPECTION Well production gp.m. WATER SAMPLE RESULTS: Coliform ~ colonies/100 mL Arsenic: ~,z, mg/l Nitrate ~',7',~' mg/L Date of sample:'~/'?~, Other bacteria ~" coloniesll00 mL Collected by: ~':'~' B. SEPTIC/HOLDING TANK DATA Tank Type~Matedal Tank size /~,.~r',e gal. Number of Compartments Foundation cleanout (Y/N) Date of pumping :W...~,,,.~. Date installed ,/¢/~Z Cleanouts (Y/N) ~/ High water alarm (y/N) Z/~ C. ABSORPTION FIELD DATA Date installed ~://f,~ ~' Soil rating (g.p.d.lft2 or ~/bdrm) .~. ,~ Length ~".~"' ft. Width .4-" ft. Gravel below pipe ~/' Total depth · ft. Eft. absorption area ?'~'o ft~ Monitoring tube Y' Depression over field Date of adequacy test ,ob-,o ~r~x~,,-,,,' Results (Pess/Fail) ~ For '"" bedrooms Fluid depth In absorption field before test ~ in. Elapsed Time: ~' min. Final fluid depth ~ Any rejuvenation treatment (past 12 mo.) (Y/N & type) System type.~'~'.*'~-~-- ft. Water added '--' gal. New depth ~ in. in. Absorption rate >= ~' g.p.d. ~ If yes, give date .-~ D. LIFT STATION Date installed 'Pump on' level at in. E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Size in gallons Manhole/Access (Y/N) 'Pump o.'~ V/~ ~-~ at Cycles tested Meets alarm & circuit requiraments? Septic tank/lift station on lot Absorption field on lot Public sewer main Sewer/septic service line Animal containment areas in. On adjacent lots On adjacent lots Public sewer manhole/cleanout Holding tank Manure/animal excrete slorage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation ..~'~" Property line ~'/Y'" Absorption field Water main /~ '~/ Water service line /~ '" / Surface water Wells on adjacent lots /~'~ ~' / SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation ~? · Surface water /~ ~ '~ / Wells on adjacent lots /~ ~' '~ / Property line Water Service line Curtain drain ~--o ~'~' F. COMMENTS Water main ."e */ D~eway, parking~ehicie storage 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 t~ date. Enginear's Print.e~ Name ~~',~,-~'~ ~.~'s 7~'' ''~'~'~z'~.'''~ , .. Date of Payment c2/'2-~/4C~ Date of Payment Receipt Number '~5'~ Receipt Number (Rev. 11~05) Municipality of Anchorage Development Services Department Building Safety Division __~i~ On-Site Water and Wastewater Pro 4700 South Bragaw St. ~ P.O. Box 196650 Anchorage. AK 99519-6650' www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHOR TY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. ~)5"~ - ~,'/- ,~/ 1. GENERAL INFORMATION Complete legal descript, ien ~"~,r.~,,,,~ LOcation (site address or directions) Current Prol~erty ' '~ ' '~ owner(s) ~.,,'.+,¥ Mailing address :',~ lq x,~ ,,~,~-~,,~,,, Z:),~. Lending agency Expiration Date: Day phone ~".~-z~' ~'t~e Day phone Mailing address Real Estat? Agent · Mailing Address ,. Un/ess otherwise req~ :s~ed, HAA will be held by DSD for pickup. .o~ NUMBER OF BEDROOMS: '~ Day phone TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Public Water System Well TYPE OF WASTEWATER DISPOSAL: ,~ Individual On-site [] Individual Holding tank '[] [] Community On-site' [] [] Public Sewer [] The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a pedod of up to ope 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 sea ='a~her~to and as of the validation date shown below, I verify that my investigation, based on procedures outline'd in t~ ,Health Authority Approval Guidelines for this application, shows that th.e site water supply and/or wast~w~te{~:d..~'~sal system is(are) safe, functional and adequate for the numoer or bedrooms and type of structure ind ~alL~lerein. I further verify that based on the information obtained from the Municipality of Anchorage files and fro~ 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. Eagle River Engineering Services Phone ~'~/- ~'~',~'" Name of Firm i~421 VFW ~;., ~u;te Address I= =~1~ P, Jver. AK 995'77 Engineer's Printed Name ~,,~/=r~,~=,.,~" ~ ~./~,.c, Date .~ ./'~.~/'~ ~ DSD SIGNATURE I.,,'" Approved for /'~ Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipu Additional Comments Attachments: , HAA Cl~ckli~t Septic System Advisory Well Flow Advisory Maintenance Agreements · Supplemental Engineer's Report Other Original Certificate Date: '~' ~ /'TL ' 0 ~ (Rev. 01/02) Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST ' Legal Description: A. WELL DATA Well type ~,..~-,,'~ IfA, B, or C provide PWSID # Date completed _.~,,~'f~' Sanitary seal ~N) y'.,,5'~ Total depth /~? ft. Cased to ~__~_~_, ft. FROM WELL LOG ft. g.p.m. Date of test ~,/':~./~' Static water level ,..,~-,5"- Well production WATER SAMPLE RESULTS: Coliform O colonies/100 mi. Arsenic: -' rog.Il. B. SEPTIC/HOLDING TANK DATA Nitrate (~ O.t l~mg./L Date of sample: Depression over tank (Y~:)-~ Pumper A/Ih Tank Type/Material ~'/'~'~'~.- Tank size ~ gal. Number of Compartments Foundation cleanout ~)N) y',~:~ Date of pumping AJ [,~- ABSORPTION FIELD DATA Date installed ~ Length ;~5" fl. Soil rating (g.p.d./ft~ or ft~lbdrm) ..~.3" Width ~" ft. Parcel ID: <:~3-~- Well Log (~N) Wires properly prote~, ted (~N) Casing height (above ground) AT INSPECTION gp.m. in. Other bacteria {~ colonies/100 mi. Collected by: Date installed Cleanouts ~N) ~'~= High water alarm (Y~) System type ,~ r ~ Gravel below pipe ~ ft. Total depth 'g" ft. Date of adequacy test ~ ',~ Fluid depth in absorption field before test -- in. Elapsed Time: -- min. Final fluid depth ~ in. Any rejuvenation treatment (past 12 mo.) (Y/N & type) Eft. absorption area ~¢'0 ft~ Monitoring tube ~,e'.~ Depression over field ,,~'~ Results (Pass/Fail) '" For ~ bedrooms Water added .-- gal. New depth -- in. Absorption rate >= "' g.p.d. -- If yes, give date ~ ~ Cycles tested SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Eo LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) 'Pump on" level at in. "P ~U~,l~F level ~m level at Meets alarm & circuit requirements? On adjacent lots On adjacent lots Public sewer manhole/cleanout Holding tank Septic tank/lift station on lot /~' 1" ' Absorption field on lot /~-~' ~ Public sewer main .' ,X-~'''' Sewer/septic service line v-~3- ~ SEPARATION DISTANCES FROM SEPTIC/ ...... TANK ON LOT TO: Building foundation ~-~ ' Water main ,' ~',~ ' Wells on adjacent lots ,'-,'~' ' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: in. Property line '~' ' Water Service line -~/~ ' Curtain drainv' ,~r'o" F. COMMENTS Property line .~,',f.-' Absorption field Water service line ,','~ ' Surface water ;,' ~'~ · Building foundation 'r~' ' Surface water .., .,'~'~ ' Wells on adjacent lots -'/e~ ' Water main v/'~ ' Driveway, parking/vehicle storage G. ENGINEER'S CERTIFICATION I certify that I have determined through held inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. · Engineer's Printed Name ~"~,~,~/'~,~'~,.~,,,~ ~ ,~,~.-~ Date HAA Fee $ Date of Payment ,~,/~' Receipt Number (Rev. 12./01) ¥~w, er Fee $ . Date of Payment Receipt Number ASBUILT I HEREBY CERTIFY .THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY~ AND THAT NO ENCROACHMENTS EXIST EXCEPT AS INDICATED. IT I$ THE RESPONSIBILITY OF THE OWNE~ TO DETER~JlNE THE EXISTENCE OF ANY EASEMENTSf COVENANTS~ OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOUt ANY DATA HEREON BE USED FOR CONSTRUCTION OF FENCE LINF_~, OR FOE ESTABLISHING BOUND- ARY LINES. SEWARD & SCALEs DATE, GRID; FB; !DRAWN,