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Home My WebLink AboutT12N R3W SEC 33 LT 127BT12N R3W SEC 33 Lot 1276 #018-262-14 e Municipality of Anchorage ; :� ••. Development Services Department r �I'1'': • Building Safety Division a•,�- On-Site Water and Wastewater Program, 4700 S. Bragaw SL P.O. Box 196650 Anchorage. AK 99519.6650 Page ( of 'L www.cLanchorage.ak.us (907) 343.7504 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: 5 W v 3 0 o v St PID Number. CAV Name. m.e (' i E 1 V a T 14 a Wastewaters stem:% New Upgrade Ada.aa: C40ZZOry (, G.F LE,n., ABSORPTION FIELD t 2q — ! V// WniraBatreotns: �Aeap Tr DSbaa.Tra.. 1388 DAtu.N Dom e LEGAL DESCRIPTION SoilRaa4 19. 4V o 6i Taal D.pd kana �:al ¢ad.: //•O FI Bktlt La: Tr SWdm'siarc 0•90. b&* Ewan k.r.l a5n4TIa: Grnet deFN baraR. pip.: TbwnalaV: /� Ranh: �1 Saetat 117/ -. FA amad ab" aipul O'ade: J, &"LwVft ( 2 \i s tns 40 S3 "4 I Z IN S FI. SCS 7_4FI. ® New rade Well: ❑UP9 ��t Ze0 "'""Ear of fua: Diatmveb.MMrMa: ' F,. ! Ft Cassifuricn (Privet., A B. CT trl V 4��i Total Delft �/� Z`- 'FL Chad W Z.3 o Ft Taal abaapWn vex �a / W FO Pr. Ltetmet 3 77?1{ Dno.r. �ht Dat. 03 SaEewetal...t kuaor. St-oSTlVaf��j. N Dal1, bw0red� !O Ft / /2 d3 m( r:.. Papsal u So as gMaga LLw.GanR 7_.0 073 •O(pz3 TANK GPAI toms IP10"4 t FL Ft SEPARATION DISTANCES gSepfic ❑Holding ❑S.T.E.P. ❑other, To Septic Absorption Lift Holding PA!cRdval R I Capx iy. From Tank Field Station Tank Sentlhe w r N on 12,90 Gal. W Was f r'F SOD of ��i� /+� 5 U f wianr l Hr,rc.r a Canc,nmems v0 5.�..t t Z Swrace wales foo`{ Ipof LIFT STATION La Lis ZD1� ZOr1f Sues N•Nacu.r G,y, Faa.detbn Id r'• ZorT •�p� M at PYnp df lavN of N,'b wales am Tat Cumin Drain �A/ N /✓Y' . N / , e �'!!` Pare YaY. a Abd E:Kbxal kupec^.om W.,,,d by.. Rem. a. nf� —ovBENCH MARK / fly �4`l Louao(n�atl D.arnpaat t'�l n4 d .+oT� I�CJuf Aawr..ad E'..va:mn: FL A�q ll , .��p��•OF Inspections performed by: Dates: let 4111210'> % *: 49TH" 2n ..�� 1 O X� �...:. ...... �f/ •a Develop t e ices Department Approval y • MICHAEL N. AA.'DERSCN / • Reviewed and approved by: Date:fF•`�/2�UW,.��`eoY.e 69 �t ROTESSiOK��— Permit No. SW030008 Page 2 of 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 System and/or Well Inspection Report Legal Description: LOT 1278, T12N, R3W, SEC 33 PID No.: 018-262-14 i i / � �0LE IUS NEST \ MT2 08 1 _ �I ��-- ---� MTI CO 'C06 C05 _- ' / BENCH MARK, DOOR STOOP _ CO2 COI \ CO2 \\ FCO \ — —'� B A B CRND. PIPE A� \ ELEV. ELEV. 2 58 99 92.0 FCO 1 i \ CO2 20 63 97.5 92.10 TCO 22 64 97.5 \ \ TCO 32 70 96.4 \ \ CO3 51 73 96.5 90.2 \ C04 51 73 96.5 90.2 / 11 VALyE 57 68 94.9 / OS 45 55 94.1 89.8 / M 85 53 94.1 / I C06 90 55 94.5 89.9 I C07 \ 62 75 94.2 89.8 I o C08I \ 98 73 93.1 89.8 1A T2 95 71 93.2 I � • < I I I 1 1 / ASBUILT °s I � \\ �� SCALE: 1'=40' fM pp} }Cps 102COr v.LK • 1,/J,•� • ••• AOF ,(\•�\� , Pu , �•. �M ••0 49, hrtr ryq K. w /TH im.. /0 •• 1.2m mav ' 0(9_' i MICHAEL N. ANDERSON: �1•' No. 469 °��'• ��1♦' :D6�•i Sf27 tyro "'Jake. N.Li _ue �� 3 In P O 0 LZW-l-Y.l.yei me 4q SINGLE FAMILY FRAME HOUSE I / 1�wiligh� Lane R THE INFORMATION REREON IS FOR TRE USE OF LENDNG NSMUTIOHS EPECNIGLLY TO BROW ANY CONFLICTS BETWEEN "STING STRIICTLRES AMU RATTED LOT LINES OR EASEMENTS AND IS NOT TOM ABED FpR PONTKONNO ADpT10Ny, STRUCTLRES OR FENCELNES N N r m N EASEMENTS OF RECORD. OTHER THAN THOSE SHOT N ON THE RECORDED RAT. ARE HOT NIOMR HEREON, NOTE: ANYFENCER SNIOMRARELOCATEDAPPROXIMATELYANDAREIDTTOEEUSEDTODETERMINEPROPERTYLINES OR LOCATE STRUCTURES. ANY PAVING 5HC;M%R MAY BE APPROV WTE OLE T09NOW COIDITION4. o �OFA� 4� •y 4c -W* .............................. S�.4", f1Aeq4— a SHANE A. HOLT.- LB-6914 OLT.LB•6914 �I1.Fo _ O�G AS -BUILT SURVEY SCALE: l' -4a I HEREBY CERTIFY THAT I HAVE PERFORMED A MORTGAGEES INSPECTION OF THE FOLLOWING DESCRIBED PROPERTY. LOT 1278. SECTION 31, T 12 N. R 3 W. S.M. (PIAT NO. ") ANCHORAGE RECORDING DISTRICT. ALASKA AND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND THAT NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. DATED AT ANCHORAGE, ALASKA THIS _"RD DAV OF _MARCH 20)7 _ HOLT LAND SURVEYING 10/07, FB 12725 TEL 3155513 PKK \ 1 I � I I / 1 I BLOCK \ I w T. WALL / \ 1 •LL \ \'O \ _ I ` '1v I j S 89-57-A 1 "W /1 64.87' I / 1�wiligh� Lane R THE INFORMATION REREON IS FOR TRE USE OF LENDNG NSMUTIOHS EPECNIGLLY TO BROW ANY CONFLICTS BETWEEN "STING STRIICTLRES AMU RATTED LOT LINES OR EASEMENTS AND IS NOT TOM ABED FpR PONTKONNO ADpT10Ny, STRUCTLRES OR FENCELNES N N r m N EASEMENTS OF RECORD. OTHER THAN THOSE SHOT N ON THE RECORDED RAT. ARE HOT NIOMR HEREON, NOTE: ANYFENCER SNIOMRARELOCATEDAPPROXIMATELYANDAREIDTTOEEUSEDTODETERMINEPROPERTYLINES OR LOCATE STRUCTURES. ANY PAVING 5HC;M%R MAY BE APPROV WTE OLE T09NOW COIDITION4. o �OFA� 4� •y 4c -W* .............................. S�.4", f1Aeq4— a SHANE A. HOLT.- LB-6914 OLT.LB•6914 �I1.Fo _ O�G AS -BUILT SURVEY SCALE: l' -4a I HEREBY CERTIFY THAT I HAVE PERFORMED A MORTGAGEES INSPECTION OF THE FOLLOWING DESCRIBED PROPERTY. LOT 1278. SECTION 31, T 12 N. R 3 W. S.M. (PIAT NO. ") ANCHORAGE RECORDING DISTRICT. ALASKA AND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND THAT NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. DATED AT ANCHORAGE, ALASKA THIS _"RD DAV OF _MARCH 20)7 _ HOLT LAND SURVEYING 10/07, FB 12725 TEL 3155513 Rick Mystrom Mayor Municipality of Anchorage Department of Health and Human Services 825 'L' Street P.O. Box 196650 Anchorage, Alaska 99519.6650 http://www. d. a nchornge.ak.us Permit Number: #SW 030008 Date of Issue:! 3103 Parcel Identification Number: 018-262-14 Date Started: 3-7-03 Date Completed: 3-8-03 Is well located at approved permit location? ❑ Yes [3 -No Legal Description: T12M R3W Sec ;13 Lt 127 8 Property Owner Name & Address: Paul Stivaletta Twightlight Lane Anchorage, Alaska 99516 Borehole Data: Depth (ft) Method of Drilling ®air rotary ❑cable tool Soil Type, Thickness & Water Strata From To Casing type: steer - stick-up 0 2 Wall Thickness: M inches organics & silt 2 3 Diameter: 6 inches Depth: 233 feet gravelly sandy silt 3 42 Liner Type: stilt 42 48 Diameter. inches Depth: feet Casing stickup above ground: 2 feet silty gravel 48 82 Static water level (from ground level): 105 feet gravelly sandy silt wet 82 115 Pumping level: 260 feet after silty gravel wet 115 120 2 hoursum in P P g68Pm Cobbly silty gravel 120 170 Recovery Rate: gpm water sand & gravel silty 170 192 Method of Testing: a/rlif , gravelly silt 192 230 Well Intake Opening Type:: Bedrock 230 264 ❑ Open End ® Open Hole ❑ Screened Start feet Stopped feet ❑ Perforations Startfeet Stopped feet Grout Type: Bentonite #8 Volume: Lig Depth eertQt+ot_itunnrA 7 f e Pump: Intake Depth - feet Pump size hp Brand Name - Well Disinfected Upon Completion? ® Yea ❑ No Method of Disinfection: chlorine tablets RECEIVED Comments: Well Driller. Alpine Drilling & Enterprises APR 2 5 2003 PO Boz 110496 Anchorage Alaska 99511 MUNICIPALIWCFANCHORAGE "r-' :; :. t.:.` 4y t f. •._ ENVIRON61ENTAL SERVICES DIVISION r ;:: �•"' i:. "t "� ° :' Attention: The well driller shall provide a well log to the property owner within 30 days of completion and the property y._ /2--0S MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT Initial Permit Number: SW030008 (Legal Description: T12N R3W SEC 33 LT 127B Design Engineer. 0088 Anderson Construction & Eng'g Owner Name: Prt{{ApU,� STIVALETTA Owner Address: ,Nt�tiQTWILIGHT LANE ANCHORAGE. AK 99516- < L`0 /2:e4o 3 31co Date Issued: Jan 13, 2003 Expiration Date: Jan 13, 2004 ParcelID: 018-262-14 Site Address: Lot Size: 48989 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of. 0 Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑✓ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either. A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: Date: 3 O.3 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 0/8 — 2iv((2 " 14 I, Permit Number SW030008 Property owners) V�Lrld 1 5'j V a,� �1'Dayphone 3ti S-�4Ss~L- Mailing address (1) NNIy TW/L /&HT LINE MememA6r. AK 993/6 Mailing address (2) Zip Code Legal description (Lot, Block & Sub'd.) yr — 12' 7 F> Legal description (Section, Township & Range) ]"12 NN t3 W S e rioN .33 Lot Size4%%, k cres/ _.F Number of Bedrooms THIS APPLI A�ION S 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 ❑ certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit Fees: 1±7 S 0 Waiver Fees: _ Date of Payment: 2 t7 Date of Payment: Receipt Number: O Z� $44 (\ Receipt Number: (Rev. 12100) Michael N. Anderson, P.E. Civil/Structural Engineering 4640 Shoshoni Avenue Anchorage, Alaska 99516 Phone 345-3377 Fax 345-1391 December 17, 2002 Municipality of Anchorage Department of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Re: BLM Lot 127B To Whom it may concern: This is a request for a new well and septic permit for the above residence. The test hole excavation found silty Sand with some gravel pockets for the full depth of 18 feet. The perc test was done at elevation 5 feet with a rate of 5.5 minutes per inch. No water was observed during the excavation or after the 7 day waiting period. This new system will be a deep trench with 7 foot effective and 54 foot length. The lots slopes gently to the northwest at about 2 percent. All the neighboring lots are developed with functioning on-site systems. This new system will not encroach on any of the neighboring systems or affect future development of their lots due to this upgrade. If you have any question please call me at 345-3377 Sincerely Mic acderson DESIGN CRITERIA: 4 BDRM X 150 = 600 GPD SOILS = 600/0.8 = 750 SO FT REO'D 750/14 = 54' TRENCH (1) TRENCH 9' DEEP 7' EFFECTIVE 2.0' WIDE 54' LONG EXISTING 100' WELL RADIUS � I L Q N 1 1 1 I EXISTING SEPTIC o L � a EXISTING 00' WELL RAE US BLM LQI 127A PROPOSED SEPTIC SYSTEM / PROPO �ED HOUSE O J I ELM LOT 713 ____,,FEXISTING 100' WELL RADIUS PROPOSED 100' WELL RADIUS Septic Design Prepared For PAUL STIVALETTA BLDI LOT 127B Anchorage, Alaska Prepared By MICHAEL N. ANDERSON, P.E. 4640 SIIOSIIONI DRIVE (907) 345-3377 / FAX (907) 345-1391 SCALE: 1"=200' JANUARY 13, 2003 OVER 3RIC OF at `>>< 9 *•49TH*• :A! .00� MICHAEL N. ANDERSON 00 / / / / / / / m 1 1 1 1 1 1 1 I / I / / I / / / / ,/--30' TEST HOLE DIUS — TYP NG WELL '-- RADIUS DOUBLE CO— TANK CO - DOUBLE \� rn— EXISTING WELL 100' RADIUS RY SEPTIC SYSTEM SEPTIC SYSTEM -PROPOSED 1.250 GALLON SEPTIC TANK W y - A 9F -ORM NO�SC ````• oPROPOSED - T W I L I G H T L A N E - M / / / / / / / / I I 1 i 1 1 1 1 1 1 1 1 Septic Design Prepared For PAUL STIVALETTA BLM LOT 1278 Anchorage, Alaska Prepared By MICHAEL N. ANDERSON, P.E. 4640 SIIOSIIONI DRIVE (907) 345-3377 / FAX (907) 345-1391 SCALE: 1"=30' JANUARY 13, 2003 WELL 1� 1 1 1 1 1 I I I I / / / 6 OFt X% �h: •� s�.1�1 *:*49TH GV *�/ �y,/j,//,�•�, ie '.tlJ✓C�. i0 F MICHAEL N. ANDERSON : 'k- / i •. C 9ys9 ,.•�� / �1.��r�� • 11 �/UTi.•:w��.: (E *kA� OF.q a Municipality of Anchorage . y '•.� (r DEPARTMENT OF HEALTH & HUMAN SERVICES 825-L' Street. Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST •� io!- MICHAEL N. ANDERSON ; ftr , (� U moi•, CE- 469 PERFORMED FOR: • �5�1 tl le "r0 � DATE PERFORM14?'� / e7'��••• SO\� LEGAL DESCRIPTION: VLM 1.O4 (2 ;z B TOWnahlp, Range, Section: r-D—EPT-H-1 SLOPE SITE PLAN (FEET) 1Or''1 tU �-7-71 _ 1 2 K1 4- 5-- 5 e Y C 7 7uh/Ci CraYc( 6- 7- 8 8 9- t011to - 11 12- 13- 14- 15- 16- 17- 16--- 19- 20 213141516171920 COMMENTS 0t WAS GROUND WATER —t ENCOUNTERED? INC:, S T WHAT L O P E v Me gam0 1 v IF YES, A DEPTH? Depth to Wa Monitoring? ®=mm PERCOLATION RATE S, (minutesnmh) PERC HOLE DIAMETER TEST RU//N BETWEEN FT AND Ml FT e• r l (P T r r n^ ry. S y S PERFORMED BY: </1.tJev4eyf I CERTIFY THAT THIS T/�ST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: Zai L' 72-008 (Rev. 4ia5) PERCOLATION RATE S, (minutesnmh) PERC HOLE DIAMETER TEST RU//N BETWEEN FT AND Ml FT e• r l (P T r r n^ ry. S y S PERFORMED BY: </1.tJev4eyf I CERTIFY THAT THIS T/�ST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: Zai L' 72-008 (Rev. 4ia5) ® Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904. Certificate of On -Site Systems Approval Parcel I.D. Ul4S - 2(v2^ IL Expiration Date: 1. GENERAL INFORMATION °r� t SAFETY -.2 0. - /S - Complete legal description T 'c'c- -5 fry 12� Location (site address) �-rCJ S[ rw/rrt 4 V } L6(r� C, Current Property owner(s) '54 n4wl n Day phone Mailing address 1-10,5 0. I-Vi., 14 k N Real Estate Agent 2. TYPE OF DWELLING:. Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 2L 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well [ Individual Individual Wafer Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Received by: /)�JmAn�_ Date: / COSA to be released to the engineer, less otherwise requested by the engineer. �a/�' t t ?W/s COSA Fee $ S-2 Waiver Fee $ _ Date of Payment 1'3 S ( 9L115'1 Date of Payment Receipt Number ' d / Receipt Number, COSA-# ne'�c 51 O 1 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. NameofFirm Mie r/ AfAilison Phone 727 -`651t -A( Address H6b ( &4+fif t`ti A,e („J4I1-e Engineer's Printed Name Ni%rt'oe Date 111k -111A;-- 6. 1r'- /A;-- 6. DSD SIGNATURE System #1 Approved for _jL_ bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms Fde a a Nze � o A9T ly a � �a vc��ed �bc s t �/a �Atppl r1' -n ' with the following stipulat By: �L� /N , h Original Certificate Date: I — .2, () _ ( The unlc all of Ap� age Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSH) 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 CCSAWueeheetr - I. c If more than 1 septic system is on the lot: COSA Checklist # of Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: 1-12-14 (2 3 (10 -7m G T73 L v � ( Z �L 6 Parcel ID:_ Of f� — 7, A. WELL DATA pp Well type v a Fv If A, B, or C provide PWSID # Well Log (Y/N) Y_ Date completed / 1 3 G 5 Sanitary seal (Y/N) Wires properly protected (Y/N)_ Total depth 2(y ft. Cased to 7 5Oft. Casing height (above ground) Vlf in. FROM WELL LOG Date of test Static water level Well production ZT g.p.m. AT INSPECTION 1 ?Z a iS D (o ft. _1 0 g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate ^4 P mg/L M J Arsenic J4_ ug/L Date of sample:11-1-4Collected by: B. SEPTICIHOLDING TANK DATA Tank Type/Material Ci � -P c Date installed I Z U Tank size 1'r 4 Q gal. Number of Compartments 2 Cleanouts (Y/N) Foundation Cleanout (Y/N) T Depression over tank (Y/N) High water alarm III iPl) o----_ Dateofpumping 5 /1% Pumper_S Ct,t C. ABSORPTION FIELD DATA Date installed ?h 3, Soil rating (g.p.d.M2 or ft2/bdrm) System type * W"t' Length S (O ft. Width Z10 ft. Gravel below pipe ft. Total depth ft. Eff. absorption area fe Monitoring tube Y Depression over field IV Date of adequacy test Results (Pass/Fail) W v 4 For bedrooms Fluid depth in absorption' field before test in. Water added 8 0 gal. New depth—/—' -L in. Elapsed Time: I min. Final fluid depth in. Absorption rate >= Gt9 C2 Y- g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date Novi -v tv'?"('J 'e'1741 D. LIFT STATION Date installed _ "Pump on° level at Datum in. E. SEPARATION DISTANCES WELL ON LOT TO: Size in gallons Cycles tested r Septic tank/lift station on lot 100 Absorption field on lot too Public sewer main N/ Sewer /septic service line ff rJ o Animal containment areas too E SEPTICIHOLDING TANK ON LOT TO: in. High water alarm level at in. Meets alarm & circuit requirements? r On adjacent lots f9 0 On adjacent lots toot d' Public sewer manhole/cleanout r Holding tank Manure/animal excrete storage areas f t9o' r + i r r Building foundation 2 R f- Property line Z �'F Absorption field field --! :--"3 Y- Water main Water service line t ✓0e •�- Surface water %0-0 14 - Wells on adjacent lots l v 0 t F ABSORPTION FIELD ON LOT TO: Property line Z S l+ Building foundation 2 r I r Water Service line C fiD % Surface water rb 0 Curtain drain _d a Wells on adjacent lots —LO—0 t F. COMMENTS S ®Q `-rr TV e'Ae S W Q 'F � )1', v �0 r c At 0 v -fel y 4 A,eiry l Lv a ei T p�d-e 4 CA l'L4 G. ENGINEER'S CERTIFICATION MW / certify that I have determined through rreld 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 game . N4 t t'•V� @2( %l ok JT(!W Date t / / S COSA brown sheet_10-10-12.doc Water main a It c Driveway, parking/vehicle storage 90 u(v Municipality of Anchorage Development Services Department / Building Safety Division on-site Water and Wastewater Program , A , 1, 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. cx `tti'— Zfo2r/H COSA# Expiration Date: Z GENERAL INFORMATION Complete legal description L„ 4 12q 6 , T / pnr fL 15 L0 , Sri 33 Location (site address) i4DN �FW I u iT UI► Current Property owners) PoU 74-v v a (r11gt Day phone R Z q- 2 d // Mailing address 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: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System TYPE OF WASTEWATER DISPOSAL: j� Individual On-site ❑ Individual Holding Tank ❑ Community On-site ❑ ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of Onsite 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 engineers 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 Onsite 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. l 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. NameofFirm Mirk4r/ A(_AWrj r/ajN Phone Address `l:/KU .4 Engineer's Printed Name M, r-% q, cf.r r 4, Date L a :Pt 5. DSD SIGNATURE Approved for �_ bedrooms. Disapproved. / MICHAEL N. ANND[RSCN�w. Conditional approval for bedrooms, with the following stipulations: Attacnments: COSA Checklist X Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Report Nitrate Advisory Other By. Original Certificate Date: (Rw. 1IMS) A. B. C Municipality of Anchorage Development Services Department Building Safety Division ° Onsite Water d Wastewater Program 4700 Bragaw Street P.O. Box 198850 Anchorage, AK 99519.6850 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: /2 7'2l4 1� i W) �i e r t< 33 Parcel ID: �/ ii - 2 (0 2- /�/ WELL'DATA Well type JPr r46:c/ If A, B, or C provide PWSID Well Log (Y/N) YC S . Date completed JLVp 3 Sanitary seal (Y/N) -Y— Wires properly protected (Y/N) Total depth 7 W ft. Cased to Casing height (above ground) Zi -D in. FROM WELL LOG AT INSPECTION Date of test ----414/0 State water level ft. / v 3 ft. Well production ?• O g.p.m. S.o 9•P•m• L• •••� �s� WATER SAMPLE RESULTS: i Coliform _P_coionhW100 mL Nitrate �_ M91L Other bacteria colonies/100 mL Arsenic: /i) mgA Date of sample:/ Pi Collected by: M AJA . SEP 110 HOLDING TANK DATA Tank Type/Material 41 -cc Date installed Z Tank size f? 49'0 gal Number of Compartments —2= Cleanouts (Y/N) Y Foundation deanout MINI) Depression over tank (Y/N) rA High water alarm (YM) e Date ( pumping 4-o Pumper 'v s ft -L Tic, cho t a' „r ABSORPTION Fl DATA Date kistalled Y&LO5- Soil rating (g.p.d.e or fe/bdrm) D.S{ System type 0teo- � ,th 1-7 I Length TL ft. Width 2, D ft. Gravel below pipe . fl ft. Total depth ._L ft. Eff. absorption area 22�_ft? Monitoring tube �_ Depression over field Date of adequacy test 44 G 0 Results (Pass/Fall) PO4 For _ bedrooms r� Fluid depth in absorption field before test in. Water added Y W gal. New depthA in. Eta Time: Time: 3 G O min. Final fluid depth * in. Absorption rate >= v o .p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) If yes, give date D. LIFT STATION Date installed 'Pump on" level at _ in. E. SEPARATION DISTANCES Size In gallons Cycles tested SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot /00 Absorption field on lot fled r+ - Public sewer main Sewer /septic service line / oy rqc- Animal containment areas toe, (4. High water alarm level at in. Meets alarm & circuit requirements? On adjacent lots 10c) '4 - On adjacent lots l o c?' -f. Public sewer manhole/deanout t, Holding tank - N a Manurefanimal excrete storage areas /vy /oc SEPARATION DISTANCES FROM SEPTiCkX%lgflG TANK ON LOT TO: Building foundation ?,CF r 4- Property line 2 S �+� Absorption field—2 0 f -f Water main Water service linet / V 0 ! Surface water, / u r t Wells on adjacent lots /0 4. SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Z S Building foundation 2 5' /- Water main Water Service line r v d r.f- Surface water ! 00 t4- Driveway, parkingWehide storage SO ':- Curtain drain N 44, Wells on adjacent lots /o a rA F. COMMENTS G. ENGINEER'S CERTIFICATION r p:�• • • •' I certify that I have determined through field inspections and * 49TH 9+1� review Of Municipal records that the above systems are in •••• conformance with MOA COSA guidelines in effect on this date. io Engineer's Printed Name Mt (�a c % ;� ; MICHACt�N : / CE 4 Date ii z q COSA Fee S qDate of Payment Receipt Number (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number SCS ReEN 1071082001 Client Name Mike N. Anderson. P.E. Project Name/N Lot 127B Sample Client Sample ID 4051 Twilight Lanc Marta I Drinking Water P\1'SID Sample Remarks A8 Datev Ilmes arc Alaska Standard Time Printed Date/time 03/28/2007 14:01 Collected Date?Me 03/16/2007 8:00 Received Datefrime 03/16/2007 11:14 Technical Director Stephen C. Ede Allowable Prep Analysis Results POL Unit. Method Conuina m Limit. Date Data Ini1 Parameter Metals by TCP/MS ND 5.00 uS/L EP200.8 C (<10) 03/21/07 0322107 TK Arsenic Waters Department TotalNitrat&itrito-N ND 0.100 mg/L EPA 353.2 D (<10) 03/17/07 JDS Hicrobioloav Laboratory Tout Coli(otm 0 coV100mL SM209222D A (<I) 03/16(07 DPT 011W 164.87' as 4 Twiliolht Lane in N t` m N L% N iT O 0 O FA THE IS FOR THE LISE OF LENDING INSTIIONS EXISTING STRTUCTURESEON AHD PLATTED LOT LINES OR EASEMENTS ANDS NOT TO BESPECIFICALLY USED FOR POSITIONING ADDITIONALEN ST STRUCTURES OR FENCELINES. EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED RAT. ARE HOT SHOWN HEREON. NOTE ANY FENCFLINES SHOWN ARE LOCATED APPROXIMATELY AND ARE NOT TO BE USED TO DETERMINE PROPERTY LINES OR LOCATE STRUCTURES ANY PAYING SHOWN MAY BE APPROXIMATE DUE TO SHOW CONDITIONS OF A °OQ v ............ 9�p� C SHANE A. HOLT: y LS -6914 4'� ASEUILT SURVEY SCALE: 1' • 40' I HEREBY CERTIFY THAT 1 HAVE PERFORMED A MORTGAGEE'S INSPECTION OF THE FOLLOWING DESCRIBED PROPERTY. LOT 1278. SECTION 33, T 12 N. R 3 W. S.M. 1 PLAT NO. 66-391 ANCHORAGE RECORDING DISTRICT. ALASKA AND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND THAT NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. DATED AT ANCHORAGE, ALASKA THIS _23RD_ DAY OF MARCH 2007 HOLT LAND SURVEYING 1040]. F8 127.25 TEL. 3455513 SINGLE FAMILY FRAME HOUSE r m N DECK \ 1 3 i 0 ' In a I � O O Z / ,BLOCK \ I nET. WALL / \ 1 \ \ / / WELL D \ 9 9L 1 '• 1 S 89P57/3111W / 164.871 I � Twiliolht Lane in N t` m N L% N iT O 0 O FA THE IS FOR THE LISE OF LENDING INSTIIONS EXISTING STRTUCTURESEON AHD PLATTED LOT LINES OR EASEMENTS ANDS NOT TO BESPECIFICALLY USED FOR POSITIONING ADDITIONALEN ST STRUCTURES OR FENCELINES. EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED RAT. ARE HOT SHOWN HEREON. NOTE ANY FENCFLINES SHOWN ARE LOCATED APPROXIMATELY AND ARE NOT TO BE USED TO DETERMINE PROPERTY LINES OR LOCATE STRUCTURES ANY PAYING SHOWN MAY BE APPROXIMATE DUE TO SHOW CONDITIONS OF A °OQ v ............ 9�p� C SHANE A. HOLT: y LS -6914 4'� ASEUILT SURVEY SCALE: 1' • 40' I HEREBY CERTIFY THAT 1 HAVE PERFORMED A MORTGAGEE'S INSPECTION OF THE FOLLOWING DESCRIBED PROPERTY. LOT 1278. SECTION 33, T 12 N. R 3 W. S.M. 1 PLAT NO. 66-391 ANCHORAGE RECORDING DISTRICT. ALASKA AND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND THAT NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. DATED AT ANCHORAGE, ALASKA THIS _23RD_ DAY OF MARCH 2007 HOLT LAND SURVEYING 1040]. F8 127.25 TEL. 3455513