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Home My WebLink AboutSKYHILLS PH 3 BLK 3 LT 27kyhIIIs #3 Block 3 Lot 27 #011-122-59 Municipality of Anchorage Development Services Department •�'= `- Building Safety Division _ On -Site Water 8 Wastewater Program. 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ek.us (907) 343.7904 Onsite Wastewater Disposal System and/or Well Inspection Report page 1 of 3 Permit Number r5LZtA ba i K PID Number.fi t% - 1,201 - 69 Name: ALISHA TREVITHICK Wastewater System: ■ New D Upgrade Address: 8350 SKY MOUNTAIN CIRCLE a ANCHORAGE, AK.99502 ABSORPTION FIELD Phone: No. of ewrooms: (907) 242-4253 5 ■Deep Trench DShal$ow Trench Deed DMowW aOther LEGAL DESCRIPTION "°"" 1.2 '°'° °'"" ""' ebck: Lot: Subdivision: 3 27 SKY HILLS trD/se. a.ete Is pto. edt.m h.m '"' I erase R 11/11 R &W W d.eu 1«roU IWC c SEE DWG. R 3.1/3.1 R Township: — Range: — Secaon: — r• edad sew. er,ek,d Vd• SEE DWG. R 74 rt WELL: D New D Upgrade 5 NwM. d r� DM. e...., rwe 2 10 CbrY'wdbn A&C. p e0"'" fold ee..rptan er.e R R ►p rnd.Ne gyp. R R 638+ to. R D 3034/ F-810 ade,m $tow wd. tw.e Vg�\ R kwwv: oe1. RED DOG MASONRY '9713-14/2004'' a..kq weld Ake. a.wri OPWR R TANK SEPARATION DISTANCES ■Septic 0Halding 0S.TX-P. 13 Other To From Septic Tank M fkrr, �e Let Station NoMkp Tank /PrNo4 Ft= Veieaob~. ANCHORAGE TANK CwodV H rd , 1 1500 Well — — — — 25'+ STEEL Nwnbw d 000e.newree 2 Surface water too'+ 100'+ — — — LIFT STATION Lot Une 5'+ 1o'+ — _ _ $in in p0"" �'"sOOhire Foundation 5'+ 10'+ — _ _ e' l.'d WL Or d: we w e i4 Curtain Drain NONE KNOW �""'p �0k' °idAO°' kwv.dNrw e.noarwa °r' Remarks: BENCH MARK L.dbn .w a..wpa,,, TOP OF CMU ® GARAGE ® LOWEST POINT A.,. -.e nw.uw. 100.00 R eNWNEEWe UAL Inspections performed by: GEG, Ltd. Dates: 1st 9/13 2004 / . * 9 ......... .... .. .. .... ....... 2nd 9/14/2004 3rd 9/14/2004 ..... . ..e.. Go ess.: Development ervices Department ApprovalcE-7 Q .. a. ` a00'e Reviewed .67bonlInsr off` and approved by: Ote1ot�d CR-- 12/01) O 4p�° o�eeiooa is PERMIT NUMBERPARCEL ID NUMBER:: UMBER: SW040275 AS -BUILT DRAWING 011-122-59 APPROXIMATE LOCATION OF WATER LINE — ALTERNATE SITE WILL :QUIRE THE USE OF AN ST1 54.69 29.84 ST2 63.89 38.89 6BL1 66.70 41.50 DBL2 68.39 43.16 FD 79.79 53.13 C01 80.70 47.40 MT1 78.70 47.40 CO2 85.20 64.20 CO3 98.20 72.30 MT2 95.50 62.20 C04 99.20 65.10 1 - e NEW 1'500 GALLON SEPTIC TANK i TH11+ DELI / DSL2 4 --------------- to* unUTY EASEMENT �- — — — — — — — — — — — — — 10' UITLrTY EASEMENT d , A DRAINFIELDS GARNESS ENGINEERING GROUP, Ltd. p 4 CONSULTANTS & GENERAL CONTRACTOR$ Q' • • • • • • •' "' • •.. ' I L P vote. "t IN • M 01WAM Mf Roof • R4W (oo*M) IIn • W deIN� ' vtC twa, r IEPARED FOR: PHONE NUMBER' PAGE NUMBER: •• .•••• .......••• ALISHA TREVITHICK (907) 242-4253 2 OF 3 mess. - GAL DESCRIPnON: DRAWN B'r: oOeDi CE -7953 i1 SKY HILLS SUBDIVISION; LOT 27. BLOCK 3. PHASE 3. R.A.L. OQ e� •$Iy� ov PDATE-' Pr00 0 Blond AS BUILT DRAWING OF NEW SEPTIC SYSTEM 8/24/2005 P«. 01m) SW040275 AS -BUILT DRAWING 122-59' FINAL GRADE 98.10-99.10 STI ST2 TOP OF TANK INLET - 94.1 n U NEW 1500 GALLON INVERT of BUNG SEPTIC TANK AT INLET . 93.98 A I UPPEERRR TRENCH ORIGINAL GRADE - 97.11, 11 BOTTOM OF TRENCH- 86.1 RELATIVE EUVATION OF BOTTOM OF TEST HOLE O 77.59 FINAL GRADE ORICII 95.35-93.46 meat BOTTOM OF TRENCH- 84.59 OF PIPE 89.18 � I 190L—I GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS .TAI L 1AJAll AWA eu¢ M • Moa,oL MI Mel • ft" 00i} In • Ail "7W • v w.�r PREPARED FORPHONE NUMBER PACE NUMBER; j ALISHA TREVITHICK (907) 242-4253 3 OF 3 LEGA. DESCRIPDON: DRAWN BY: SKY HILLS SUBDIVISION; LOT 27, BLOCK 3, PHASE 3, 1 R.A.L. TYPE OF WORK: DATE: PROFILE AS -BUILT DRAWING OF NEW SEPTIC SYSTEM 1 8/24/2005 Imo. U,=) TOP OF TANK AT OUTLET - 94.09 91VEIii OF BUNG AT OUTLET - 93.70 —FINAL GRADE 92.34-92.76 FABRIC OF PIPE 87.68 0 ,0111-1 lla#or llark Begic16 Aituiicipalii3T of Anchorage P.O. Ikli 1lKirhN) • :lnchor,r„c,V:Islul SkASLLf.(65q • Tdcphonc 0)7) 3S&87601 • Ru 8X17) 343-ti-'INI 4701 Bnt,,mw $(reel • Aildlonr„q Alaska SH)517 June 13, 2005 Robert Sheldon 8350 Sky Mountain Circle Anchorage, AK 99502 uim.munlmrg Building Safety Division Subject: On -Site Water and/or Wastewater Permit. Permit Number: SW040275 Legal Description: Skyhills #3 Block 3 Lot 27 Dear Mr. Sheldon: ,o aei o, t , n \ S• lTv,/ An On -Site Water/Wastewater Permit, number SW040275, issued by this office for a single-family system, will expire on July 21, 2005. The permit is 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 $115.00 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: $460.00 for a wastewater permit and $175.00 for a well permit. If you have any questions, please call this office at 343-7904. Sincerely, t5ei�0_14 Daniel J. Roth Program Manager On -Site Water and Wastewater Program Enc: Copy of permit Community, Security, Prosperity MUNICIPALITY OF ANCHORAGE Development Services Department 113 1136//qRC1 , On -Site Water 8 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Date Issued: Jul 21, 2004 Expiration Date: Jul 21, 2005 Permit Number: SWO40275 Parcel ID: 011-122-59 Legal Description:-SKYHILLS PHASE 3 SUBDIVISION BLOCK 3 LOT 27 Design Engineer: 0855 Garness Engineering Group, LTD Owner Name: ROBERT SHELDON Owner Address: 8350 SKY MOUNTAIN CIRCLE ANCHORAGE. AK 99502 - Site Address: 8350 SKY MOUNTAIN CIRCLE Lot Size: 41348 SQ. FT. Total Bedrooms: 5 Permit Bedrooms: 5 This permit is for the construction of. Q Disposal Field 0 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, seated, and heated to prevent freezing. Received By: Date: 7/l,6 / �i�!<I��i��%��i�� • � . - tor.— Municipality of Anchorage Development Services Department — � Building Safety Division Onsite Water & 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. Property owner(s) AI I HA TREVfTHItyK C'Aa inEC� Permit Number Day phone __ 242-4 5z pMailing address (1) 7801 LADAFA PLACE • ANCHnaaFr•eu xM�g'iing address (2) obbb S Zip Code 9950V2- Legal 95012Legal description (Lot, Block & Sub •) SION PHASE 3 I nT o17 Legal description (Section, Township & Range) —NIA Lot Size 1411 34d Acre -0 . Number of Bedrooms THIS APPLICATION IS FOR: Sewer Only Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi El Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above Information Is correct. I further certify that this application Is being made for a Single Family Dwelling and Is In accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP Ltd. Permit Fees: �%O• Date of Payment: q'j Receipt Number. 55 i 3 Waiver Fees• Date of Payment: Receipt Number. GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS - - June 14,2004 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Proposed Septic System for Sky Hills Subdivision Phase 3, Lot 27, Block 3 To whom it may concern: The proposed 5 bedroom house will be served by public water and a private septic system. Two test holes where dug on the property. The drainfield will be designed around the 30 foot radius of test hole 42. We arc proposing that a 1500 gallon septic tank and a dual 5 -wide trench type drainfield be installed. Comments regarding the design are summarized as follows: 1. SOILS: See the attached log which shows the soil classifications, groundwater monitoring, and the percolation test results. It is our opinion that due to the overall appearance of the soils, an application rate of 1.2 gallons/day/ft2 should be used. The insitu sandy soils will act as a sand filter. 2. TRENCH DESIGN: a. Percolation Rate: <I minutes/inch b. Proposed Application Rate: 1.2 gallons/day/ft2 c. Number of Bedrooms: 5 d. Design Flow: 750 gallons per day e. Minimum Absorption Area: 625 62 f. Total Depth: 1 I feet (max.) g. Effective Depth: 3.0 (max) feet h. Width: 5.0 feet i. Reduction Factor: .58 j. Minimum Length: (2 @ 37') 74 feet long total k. Effective absorption area = 637 ft2 3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507 Ph: (907) 337-6179 • Fax: (907) 338-3246 • Website: gamessengineering.com 3. SURFACE WATERS: There are no surface waters within 100+ feet of the proposed septic system. 4. TOPOGRAPHY: As can be seen on the attached topography site plan, the average topography in the area of the proposed drainfield is approximately 10-15% running northwest to southeast. In short, there are no slope concerns. I am unaware of any adverse impacts this installation would have on adjacent wells or septic any questions, please contact us at 337-6179. Thank you for your , M.S. NOTE: Attached is a site plan drawing, a design drawing, a topography site plan, a soils log, and a 7 page construction specification letter which are all part of the design package for this septic system. 3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507 Ph: (907) 337-6179 0 Fax: (907) 338-3246 • Website: gamessengineering.com SKY HILLS SUBOMSION PHASE 2: LOT 18 BLOCK 3 SKY HILLS SUBDMSION PHASE 2: LOT 17 BLOCK 3 CencAR EII I SKY HILLS SUBDMSION I PHASE 2;LOT 16 BLOCK 3 1 I I I I I 1 I I --------- ----------I SKY HILLS SUBDMSION PHASE 3: LOT 26 BLOCK 3 / SKY HILLS SUBDMSION / 4 PHASE 3; LOT 30 BLOCK 3 SKY HILLS SUBDMSION PHASE 3; LOT 26 BLOCK 3 / +9 I PROPOSED SKY HILLS SUBDMSION S BEDROOM NAI ICG— PHASE 3; LOT 29 BLOCK 3 I I I I THft I I L----------� PROPOSED SEPTIC SYTELI. (SEE PAGE 2 OF 2) SKY HILLS SUBDMSION PHASE 3; LOT 28 BLOCK 3 ------'F------------------- VACANT LAND F�� Uer_;(y an pcMn a ustp+� t;,jn d151anrs C recusutS paloe fu �unSln +l1un GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS L GENERAL CONTRACTORS 5701 F T1G100 d A0 SIIITF 101 ' AW-MA9G AA OOS07 . PW 4F (907)}}7-4179 • FAX PREPARED FOR PHONE NUMBER: ALISHA TREVITHICK 242-4253 LEGAL DESCRIPTION: SKY HILLS S/D PHASE 3; LOT 27, BLOCK 3 TYPE OF WORK: SITE PLAN FOR PROPOSED SEPTIC LOCATION ?S �: • T 1" = 100' .......... i E NUMBER: 1 OF 2,+ m '. of G rness.: 'j 710 +I, e,._ ..... '' a c°L- APPROXIMATE LOCATION OF WATER UNE A PROPOSED 3 BEDROOM HOUSE INSTALL a FOUNDATION CLEANOUT + INSTALL, NEW 1500 ALTERNATE SITE WILL GALLON SEPTIC TANK REOUIRE THE USE OF r T TH 1 4 AN ADVANTEX SYSTEMINSTALL 4 DOUBLE c CLEANOUTS INSTALL FLOW SPLITTER 1 10' CEA EASEMENT 10' UTILITY EASEMENT % PROPOSED DRAINFIELDS. INSTALL TWO 37' LONG. 5.0' WIDE AND 1I FEE - ADD 3' OF CLEAN WASHED SEWER C INSTALL TRENCHES PARALLEL TO SLOPE RATE LOCATION KEY BOX I d conlIQGCII/K; CGFof[/n .All Well Sfpa&w/4-n E(IS F7 -10 sUWh F, ge4lr irlyA llg1.ion 6/4/2004 0 oo�op� " O X r� - _ DRAWN BY: 4 GARNESS ENGINEERING GROUP, Ltd. A'r'c• �`Q ' `�' 00 CONSULTANTS 6 GENERAL CONTRACTORS � SCALE' 4 ;. 9 Q 7101 F TUDOR ROAD SUITF 101 • ANCHORAOF. AK 90507 • PHONF (001)771-6170 • FAX (007)JJR-JTG6 • „ — 40, ' • ' PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ALISHA TREVITHICK 242-4253•• • LEGAL DESCRIPTION: Z OF Z QO1p '..� ••re am s ; 0 SKY HILLS SUBDIVISION PHASE 3; LOT 27, BLOCK 3 TYPE OF WORK: 4e • • • E, o 0 c DESIGN DRAWING OF PROPOSED SEPTIC SYSTEM 4 �04op000000 :ll 4 dl 74-,�3�Z /Im co a -6Z ou / dl 1 I z� Ie 1 a� to -f- N O dl JN SV3 [l v 4uG 6Z W dolS� cr) I 11 bs Ltic'lb V- lz / '9�S / �I of I, 01 t7" dl 1 /n dl 4\&. 6�^/ / l9 l CY) 1 le _.__._ 3 N3W3St+� y -4'4 30b\NIVNO 10 � y _ �\ti:: -� gyp..._ .•�' \ � I �? % (o YGARNESS ENGINEERING GROUP, Ltd. per. '4 20p CONSULTANTS 6 GENERAL CONTRACTORS �� 3n1 L 10008 ROA 9U 101 • NONWAGE. M. YDS°) • EON[:DO) )- , Y A • fOt CW -W" • YEB3i1L q.Oen • • • • • • • • • • • • • • • • • •: • • •'0 SOIL LOG — PERCOLATION TEST LEGAL DESCRIPTION: SKY HILLS SUBDIVISION LOT27 BLOCK3 PHASE 3 OQ P e A. Go ness:• a PERFORMED FOR: AUSHA TREVITHICK DATE: 6-3-04 QQ o E-7953DEPTH. (feet) ==== ORGANICS �p0o d pr • fessl •°°\ goo ==_= TEST HOLE 1 �DO00000�� LOAM 2 SOI CLASSIFICATIONS ---- GW ORG 3 GP ML 5M GM CL 4 GC OL °- SW MH 5 °°°°°-_ SP CH t SM OH 6 SC P1141+12 7 00== DEPTH TO GROUNDWATER DATE ------------------------------------- ---------- 8 00 == DRY 6-3-2004 0 0° -= SW/FILL (Zy15 am 00 =- SITE PLAN 10 0°°0== 1'-100' °o 000 11 °o°Y__ °pO Baum- 12 - 13 2 13 °°0== 14- 15 4 15 0000°00 oO a 0' 00 16 Doo° a00 p0o0 00 0000 0000000 17 °0°0°0° 000 00:0°0000 0 °o°°o°° 18 00 00°0 00 00000 19 °0 O°o° 0 a00°00 20 000001 PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) o J00 00 21 pOe o"° TEST RUN BETWEEN 7.0 FT. AND 8.0 FT. 22 B.O.H. A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES 0 NO SOILS LOGGED BY: RYAN SMITH PERCOLATION TEST PERFORMED BY: ROBERT CAMPBELL COMMENTS: 'FILL ON NORTH SIDE OF TEST HOLE. TEST HOLE DUG ON SIDE OF HILL PERFORMED BY GEC, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERF RMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: Y Y aaa��a ��aaa Y ��a�a�ai eia �e■vaa�� f OF o 0 40 6GARNESS ENGINEERING GROUP Ltd. ��P,. CONSULTANTS 6 GENERAL CONTRACTORS .�� p 9 )Ol E I0001t pOW, SWfE 101 • M010RIG- M. NW7 • ft h - 60) 7- jn • rA - 90 -32M • -.LBSOG W—91—k O • • • •.... . • .. .. • ..... ... •' • •O SOIL LOG - PERCOLATION TEST D LEGAL DESCRIPTION: SKY HILLS SUBDIVISION LOT27 BLOCK3 PHASE 3 OOP •.• e r Garne PERFORMED FOR: AUSHA TREWTHICKO�� 7 DATE: 6-3-04 , DEPTH (feet) �__=440�d ofessl0^0�� TEST HOLE 2 ��00000��a SOIL CLASSIFICATIONS 2 ---- o o' GW ORG i GM CL ORGANICS a GC OL SW MH 5 SP CH •m", SM . OH 6 SC TMfl 7M%2 GROUNDWATER DATE DO60°Op _________________________ __________ 8— 00-.0600 DRY 6-3-2004 00 p -.p6 Do.p°00 Y %' 9 Doenp600 00°n°o° tSITE PLAN uoo poop 100 10 -.060606 1 00 o p 000 0� 000o 00.0-.00 1, °on°o° 100.0.0-0100, a0-.pe00 12 °0000 0 -0ao-c SW o 00.0°o0 13 °o n°o° D0.0°o0 06 0000 °°C coop 14 00°0600 00 0600 0p .°600 Do. o f O° 00.0000 16 °0 n°0° 006 0600 0� 0000 op.p°OO 17-0,0,00 n00o Dop o° On 00 000 0° 18 B.O.f,. 19 PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 8.0 FT. AND 9.0 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES ONO SOILS LOGGED BY: RYAN SMITH PERCOLATION TEST PERFORMED BY: ROBERT CAMPBELL COMMENTS: THE NATURAL SAND INSITU SOILS WILL ACT AS A SAND FILTER PERFORMED BY GEG, Ltd. I, JEFFREY A. CARNESS. CERTIFY THAT THIS WAS E ORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: '7(2-1/04- Municipality of Anchorage Development Services Department • �.r Building Safety Division Onsite 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: harness Engineering Group, Inc. Legal description: Sky Hills Subdivision Phase 3. Block 3. Lot 27 The attached paperwork has been reviewed and is being returned for the following reasons: ® Original signature or-starttp missing on application and stamps ❑ Calculation error in design. _ ❑ Additional soils information needed. _ ❑ Water monitoring results inadequate. ❑ Discrepancy in information submitted. ❑ Topographic information missing or inadequate. ❑ 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. A cross-sectional drawing of the drain field_showing the plan Name of reviewer: Julie Makela. P. E. Date: 7/21/2004 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK MUNICIPALITY,OF Development Services Department 1 On -Site Water & Wastewater Section Parcel 1. D. 011-122-59 ANCHORAGE Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Phone: 907-343-7904 Fax: 907-343-7997 Expiration Date: 1-3-;0z( Complete legal description Skyhills Phase 3, Block 3, Lot 27 Location (site address) 8350 Sky Mountain Circle Anchorage, AK Current property owner(s) Robert & Marne Sheldon Day phone (907) 830-1984 Mailing address Real estate agent 8350 Sky Mountain Circle, Anchorage, AK 99502 Lindsey Larson 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) DaYp hone (907) 227-3490 3. NUMBER OF BEDROOMS: 5 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ❑ Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System 0 Public Sewer', ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 55-0 Waiver Fee $ Date of Payment 1/3 1a6 Date of Payment Receipt Number ('j Djobo Receipt Number COSA # 05C 9(, Q06 Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below,, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm Forge Engineering Phone 907-522-7773 Address 1399 W. 34th Ave Suite 101, Anchorage AK 99503 Engineer's Printed Name Michael E. Anderson, P.E. Date 1/3/20 6. DSD SIGNATURE System #1 Approved for 5 bedrooms System #2 Approved for. bedrooms Disapproved Conditional approval for bedrooms, with the following stipulations: `-� ON -Sir a ATEP AND S. ;PRpG„AAA' ':- F Original CertificateDate: l r 7-- W The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other I COSA Checklist blue sheet Legal Description: Sky Hills Phase 3, Block 3, Lot 27 If more than 1 septic system on lot: COSA Checklist # A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Comments Public Water system of Parcel ID: 011-122-59 Structure served by this system Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Date of Sample B. TANK DATA C. LIFT STATION Age of tank(s) 15 years ❑ Required maintenance completed Tank type/material Septic/Steel Age of lift station years Measured operating fluid level in septic tank 47° Lift station material ❑ Standpipes/foundation cleanout per record drawing Comments: Date of pumping One Stop - 1/3/20 D. ABSORPTION FIELD DATA DEEP TRENCH Which system tested (date installed) 9/14/2004 Adequacy test date 12/27/19 ❑ ALL standpipes present per record drawing Results R/ Pass For 5 bedrooms Total measured depth from grade 11.6 ft (max) Fluid depth prior to test 36/0 in Measured depth to pipe invert from grade 8.7 ft (min) Water added 1013 gal ❑ N/A — pressurized field New depth 36/0 in ❑ Monitor tubes go to bottom of effective. If not, state Elapsed time 0 min depth into effective FE-1Code-requiredsoil cover over field Final fluid depth 36/0 in ❑ System presoaked Absorption rate '750 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) _ date of test) Gallons introduced gallons If yes, enter date Com ments/Deficiencies: Lower trench is full of water. Upper trench is dry. Fluid levels did not change during and after test. COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) - Community Water System Septic Tank/Lift Station on Lot > 100' ❑ Yes if No NA ft Community Sewer Manhole/Cleanout > 100' ❑ Yes if No NA ft Neighboring Tank > 100' ❑ Yes if No NA ft Private Sewer/Septic Line > 25' ❑ Yes if No NA ft Absorption Field on Lot > 100' ❑ Yes if No NA ft Holding Tank > 100' ❑ Yes if No NA ft Neighboring Absorption Fields > 100' NA Animal Containment > 50' ❑ Yes if No NA ft ❑ Yes if No ft if No ft Community Sewer Main > 75' ❑ Yes NA if No ft Manure/Animal Excreta Storage > 100' ❑ Yes NA if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' Q Yes if No ft Surface Water > 100' Q Yes if No ft Property Line > 5' Q Yes if No ft Wells on Adjacent Lots: ® Absorption Field > 5' Q Yes if No ft Private Wells > 100' Q Yes if No ft Water Main > 10'✓0 ft Yes if No ft Community Wells > 200' Q Yes if No ft Water Service Line > 10' ✓� Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ®✓ Yes if No ft If absorption field is under driveway comment below Property Line > 10'✓Q Yes if No ft Wells on Adjacent Lots: Water Main > 10' 0 Yes if No ft Private Wells > 100' 0 Yes if No Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Surface Water > 100' Q Yes if No ft F. ENGINEER'S COMMENTS Splitter valve was reset to insure even flow to each trench. Testing after the valve was reset indicated flow to each trench. 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. COSA Checklist yellow sheet . .. 6 .9th. i MICHAEL E. ANDERSON No. CE -4381 1/3/20 �a so•,(�\�3 ft ft Municipality of Anchorage Development Services Department Building Safety Division Onsite Water 8 Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.G.anchorage.ak.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 011-122-59 HAA# I. GENERAL INFORMATION Expiration Date: Complete legal description SKYHILLS SUBDMSION PHASE 3 LOT 27 BLOCK 3 Location (site address or directions) 8350 SKY MOUNTAIN CIRCLE + ANCHORAGE AK 99516 Current Property owner(s) ALISHA TREvfTHICK Day phone _(907) 242-4353 Mailing address 7801 LADAFA PLACE • ANCHORAGE AK. 99507 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing address Unless otherwise requested. HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 5 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage El Community Class Wel Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site N Individual Holding tank El Community On-site El Public Sewer 11 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 samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions In the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER t my As certified by my seal axed hereto and as of the validation date sho cedures outlined in the Health Authority Approval Guidelines s fofy rthis application, investigation, based on pro tewater disposal system is(are) safe, functional and adequate shows that the onsite water supply and/or was for the number of bedrooms and type of structure indicated herein. 1 further verify that based on the information obtained from the Municipality ofAnchorage riles 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 Uma of installation. S ENGINEERING GROUP, Ltd. Name of Finn GARNES Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 Engineers Printed Name JEFFREY A. GARNESS. P.E. Engineers Comments: In conducting this evaluation, GEG, Ltd. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. outsideThese conditions are hevaluatorsystem. SadstOcfOrY results do not guaranteefuture performanceof thesysttem, nor do they guarantee that test there are no hidden defects or encroachments. GEG, Ltd. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report sb an r the sole benefit of the owner listed above. Any reliance upon or use of this repo y y other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE ("1 �� Phone 337-6179 Date Zq o Approved for —6—. bedrooms. 1ttllllt(Itffryf Disapproved. \k'��C <,��Fy�.Q%,��i� Conditional approval for bedrooms, with the following sns: o•?G� v . nNs .u0 y Attachments: Checklist Maintenance Agreements HAA HAASupplemental Engineer's Report Septic System Advisory Well Flow Advisory Other Original Certificate Date: By. 4q4065 -- (Rev 11)01) Municipality of Anchorage •, Development Services Department Building Safety Division O"Ke Water b Wastewater Program ' • ' 4700 South Sragaw St P.O. Box 196650 Anchorage, AK 9951 &6650 www.ci.anchorage.ak.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: SKYHILLS SUBDIVISION PHASE 3• LOT 27 BOCK 3 Parcel ID: 011-122-59 A. WELL DATA Well type If A, B. or C provide PWSID# _ Date completed Sanitary goalggLL + pwr M Cased to R. FROM WELL LOQ Date of test Static water level ft, Well production g.p.m. WATER SAMPLE RESULTS: Coliform colonles/100 ml. Nitrate mgJL. S. SEPnCfHOLDING TANK DATA PUBLIC WATER protected (Y/N) Casing height (above ground) in. AT INSPECTION PUBLIC WATER sample: Collected by: Tank Type/Mate" STEEL Tank size 1500 gal Number of Compartments 2 Foundation cleanout (YIN) —YES Depression over tank (YM) NO Date of pumping NEW Pumper C. ABSORPTION FIELD DATA "M.OW FML VW Date Installed 9/13-14/2oD4 Soo rating 4pA ftibdrn) 1_2 ft. g.p.m. PUBLIC WATER Date installed 9/13-14/2004 Cieanouts (Y/N) YES High water alarm (Y/N) N/A NORTH TRENCH / System type SOUTH TRENCH Length 37/37 ft, With 5 ft. Gravel below pipe 3.07/3.09 ft. Total depth 9.24 .75 ft. ER. absorption area 625+ fe Monitoring pm- YES Depression over field NO Date of adequacy test NEW Results (Pass/Fd) _ Fluid depth In absorption field before test _ in. Water added Elapsed Time: —min. ........... - -- -- — (past 12 Mo.) (YIN 3 "a) For 5 bedrooms New.depth _in. Absorption rate » g.p.d. If yes, give date t D. LIFT STATION Date installed Size in gallons 'Pump an" level at _in. E. SEPARATION DISTANCES High water alarm level at in. Cycles tested Meets alarm & circuit requiremerAs? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tanklltit station on lot On adjacent Absorption field on lot On PUBLIC WATER Public sewer main Public sewer manhole/cleanout $awe c service line Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property the 5'+ Absorption field 5'+ Water main 70'+ Water service line 101+ Surface water 100'+ Wells on adjacent lots t 00'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: 10 Property line 10'+ Building foundation 10'+ Water main r Water service line 10'+ Surface water 700'+ Driveway. parkinglvehide storage 5'+ Curtain drain ,NONE KNOWN Wells on adjacent lob 10W+ F. COMMENTS G. ENGINEER'S CERTIFICATION Ami.: - 1 certify that I have determined t►wugh field inspections and 1 ......;r* review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date.:.... P '• y Engineer's Printed Name JEFFREY A GARNESS •a ' ' e • Date 8�2 c� �pr•t••d HAA Fee $ i Date of Payment 9'`L Receipt Number D737y0 (Rev. 12101) Waiver Fee S Date of Payment Receipt Number 09/09/2005 09:38 9072432081 LO 00 0 r- ch a� 0 0 0 CD Ia., Lot 26 SCALE 1"=40' FRED WALATKA & ASSO . ° �e PAGE 01 8267Q Sky Mountain Circle Lot 28 I ml LOT 27 0 W� 41,348sf a, SEPTIC VE WI NTS - F—I OI SEPTIC VENTS ---------------------------------- I------1Q'PEA-Easement_------------------ N89°53'28"E 265.45 EASEMENT 3 OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE p OT SHOWN HEREON, Fb05.4, PH 71 Reeer'f ?-8-05,0-r AS -BUILT NO CORNERS SET THIS DATE 1 nemby oenity dual I have perbmnd S ►bnpapea'a Mpoaw Of me blbwlnp dmeloed pmperq:—LQjZLELOCK 3. SKY HILLS. PHASE kPr mm alwered mermn are w"in the properly On" and do ml averiap ar w moa,A on me property Mno ed*ef dwreb," no Wom ermM on dro pmpuM IIkV edA.wnl Mmro en„oe<n on me Promlaea in 4ussYan end that mem ere np roadway; transm"w Wm 0,ome, H,Ide maemenie on aero PMPGrtY eapepl r hdlwced Aerear4 Defied el Anchorage, Absae deyor eepmmee. Loos' FRED WALATKA d ASSOCIATES Emhe end Sure m