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HomeMy WebLinkAboutALPINE VILLAGE BLK 3 LT 9Alpine Village Block 3 Lot 9 #014-133-09 certttteb 3Dritting T.og by WO CO. dbo SULLIVAN WATER WELLS C)ftaROFiwi.1• 6Ra.J Sin r r14 , .6 r w wE mFir.Qm c Lsms t: _QL4= 13? e) 9 — IsuMbcaladadappaadpamabcalm d UWA Zan* Mebw of Orin A* xAwy El carble bol Depihciw& (d l p / fnetret. deP•, I a % faal LbWTAW C!iMSGcb AbMBGMXI& �. rase suftym oLeaat 6P feel RaomwFiMm 0 mm Maffwd d�_LI!LL_ wleafr�lsloeope1*gTypec wand Oapenhde =tit. steed fisc SkWpad roar til Parforabom Stet teat st�ppet leer ,-d c tl� �1S Lal cot -13, .Z� rbh.e Depft feom D rest. fm a ° test v" O"amreeeed t4 m oompleim? 6,11rs a not - Whod of olsideciems C 14<a t..J AI C.gs..�rb — — /2��Eti2.J6v9.�rOP ..��.1b 60m c `� Lc1/�TLlie Dmert HMO wrENTK*t it is the mopo uM4 of We paopely oartrer lo mAxnl a copy of flier wet bQ b the propera idwity. MW**M tf A"dwraM vape *md of Health 6 t M non Swvbes andror Oeperhrta of Enrlonarettal ooraservation f1AatS1r Borou 3mmhom ofEnvkw nsntdoonaerrafm MUNICIPALITY OF ANCHORAGE Development Services Department Onsite Water 8 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WATER SUPPLY PERMIT Initial Date Issued: Jul 11, 2005 Expiration Date: Jul 11, 2006 Permit Number: SWO50219 Parcel ID: 014-133-09 Legal Description: ALPINE VILLAGE SUBDIVISION BLOCK 3 LOT 9 Design Engineer: 0000 None Required Owner Name: GRANT E. SMITH Owner Address: 511 LEDORA CIRCLE ANCHORAGE. AK 99515 - Site Address: 7340 BERN STREET Lot Size: 9425 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: ❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑✓ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by tailing (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. -THE INSTALLATION OF A WATER WELL SHALL MEET ALL THE ANCHORAGE MUNICIPAL CODE 15.55. PLEASE SEE THE ATTACHED SHEET "PERMIT REQUIREMENTS FOR A DOMESTIC WATER SYSTEM". IT IS THE BURDEN OF THE PROPERTY OWNER TO DETERMINE THIS WELL INSTALLTION WILL NOT AFFECT THE FUTURE DEVELOPMENT OF THE SURROUNDING OR EXISTING LOTS. WHEN THE WELL HAS BEEN COMPLETED AND SATISFACTORY WATER PRODUCTION HAS BEEN DETERMINED, THE WELL DRILLER SHALL PLACE AN APPROVED SANITARY SEAL ON THE WELL HEAD AND NO PITLESS ADAPTER OR PUMP SHALL BE INSTALLED UNTIL AN APPROVED WASTEWATER DISPOSAL SYSTEM HAS BEEN CONSTRUCTED. IF THERE ARE ANY QUESTIONS PLEASE CALL THE MUNICIPAL ON SITE WATER AND WASTEWATER PROGRAM AT 907-343-7904. Received By: Date: 7- //. v5 Issued By: ld: r' Date: I/ c— Municipality of Anchorage , o, Development Services Department ,';�'' ` Building Safety Division On -Site Water and Wastewater Program 4700 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. CII Permit Number SW Propertyowner(s) GAAnT V. SMiTy� Dayphone F10 -4-223-4_4Z6 Mailing address Stt LE-YRA CI.FL Zip Code 1515 t .. •e-. __ .. - Legal description (Lot, Block & Sub'd.) 409 9T $ i n,!!K -S Legal description (Section, Township & Range) Lot Size q42 S Acre q.Ft. Number of Bedrooms THIS APPLICATION IS FOR: Sewer Only ❑ Well Only Is Sewer and Well ❑ Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: Waiver Fees Date of Payment: 74105- /410 Date of Payment: Receipt Number: 49 Receipt Number. (Rev. 09/04) m FRq 1 . P r 1 11 10 I e U e� LOTS' BLOCK 3 HAS 0,425 SQ -FT- OF AREA 26.2% OF THE LOT IS COVERD tl Jun. 29 2005 05:26PM P1 �' '- �t=1VATE- SIF.IJti t� CO' F4}• -.-WELL- �`�� jr� ! � J.K•:- 'f 1tt: 1� T ' 89.59.00"w 130.00 r x 31,e0MC. PAO ,JEai. _ - - L. — ann_— ^, It PROPOSED o, F.F. ELEEVV5104.85 1 •si. � M S89159'00 -W 130.0.9 _c LUCERN AVENUE o L 2oNm RS -RURAL vy=rwrAL DLSTRICr D.L.M 10%PROPOSED ' PAVED DRIVE tc�4 I ' •' I•..l T•a e•la,ea N M1-YRYYI 60.0 rt fiM rue YeUwl[.0 rt-seW1 1133 R • s..r 7..a .ebek to m+YtY.t m.o rt I4ri.wa Mt ,vs1•a• a0sr.a.., "JX 1YlS1 A[.�Ol. aaY.Y W®Ye a• Nti 1010 Yin ft*" 7,111. pproperty lying adjacent thereto unless otherwise shown. That no 0 C3 1 Inch = 30 Feet • M S89159'00 -W 130.0.9 _c LUCERN AVENUE o L • 2oNm RS -RURAL vy=rwrAL DLSTRICr D.L.M ' .em Yen lural eY.slu 4usu Ise ,rw 7.6110 pM1-s•Wsl eAra MM1 M Ysa aY..t l.Wiy �IeUeY� f,t .uu e0 R-ecaY•I 7L50 M1 heti{' I ' •' I•..l T•a e•la,ea N M1-YRYYI 60.0 rt fiM rue YeUwl[.0 rt-seW1 1133 R • s..r 7..a .ebek to m+YtY.t m.o rt I4ri.wa Mt ,vs1•a• a0sr.a.., "JX 1YlS1 A[.�Ol. aaY.Y W®Ye a• Nti 1010 Yin ft*" 7,111. pproperty lying adjacent thereto unless otherwise shown. That no GRAPHIC SCALE: 1 Inch = 30 Feet • 6 D 1 30 60 premises question Linn or other easements on said property except as shown. /«•«.. ...«.. VERTICAL DATUM WAS ASSUMED �•-••«••••«•••�•�• FOR: Grant Smith Date 6/27/05 Scale 1" = 30' Legal Descriptioi L,t 9 Block 3 LanMark Grid Plot Flan f +�pr�0171711C�����= _ ��y„"`�'► ALPINE VILLAGE Xh .• a sY.nr:ar. a•.•. 2133 2500620 4030 Vanguard Drives Suite 203 SUBDIVISION Drawn by Field Book • Ancher�ae, Alaska 9511 (9071 56z-dpso D.L.M L hereby certify that the property described hereon has been surveyed��'a•OF that the improvements situated thereon heti{' by me, or at sty direction, and Are within the property lines and do not overlap or encroach on the y pproperty lying adjacent thereto unless otherwise shown. That no Q��••••••••4'9sf:, ���•' ••• imDrovelneDts on the Dvoperty lying aNaeent thereto encroach on the In and that there are no roadways, transmission *; 4918 *! premises question Linn or other easements on said property except as shown. /«•«.. ...«.. �•-••«••••«•••�•�• IL is the responsibility of the owner or builder, prior to construction, to verify proposed building grade relative to finish grade and utility v, CHARLES E. FORBES e ,� connections and to determine the existence of any easements, covenants. LS -7326 •�,:�� or restrictions which do not appear on the recorded subdivision plat sem•.• a4. ,f Listed distances prevail over scaling. Reproduction may cause distortion. f +�pr�0171711C�����= _ ��y„"`�'► rnL � P 4 CC: -I'• O z 0 Cl Ali <n -15' TR V NIL El 6-O S U u C/) w z U cc ltl co crw LU U) w 00 ZZ 1.HOrl3U N01103dSNl U3M3S Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 Certificate of On -Site Systems Approval Parcel I.D. 014-133-09 Expiration Date: 1. GENERAL INFORMATION Complete legal description Alpine Village, Block 3, Lot.9 Ldcation,(si[�-address) g ( 7340 Bern Street Anchorage, AK 99507 Current Property ow.ner(s) James G. DreeSZen Day phone Mailing address 7340 Bern Street Anchorage, AK 99507 Real Estate Agent TYPE OF DWI 41 G: i` singletdamily (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: Three Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual ❑ Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community Public WV for .0\/C}Pm ❑ Ptlhlir_. SP_.W P_.r I^ F. Waiver/Variance request for: R,; jived bvtDate. C 1: A o be releaso to the engineer, unless otherwise requested by the engineer COSA Fee $ L( 7 0 • Waiver Fee $ Date of Payment J,ob A3 Date of Payment Receipt Number �} /V' 0 96 Receipt Number COSA 4 CJ 5C (.31 GW 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. Name of Firm Anderson Engineering Phone 522-7773 Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Date 10/1/2013 ®®® W % "Mit 4g_k alllmeee... `o m warz 6. DSD SIGNATURE A *e � c. T m,osoR ,. System #1 Approved for bedrooms �„ :6oe<: ..... System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the following %EL E. AND%R£M CE -4381 a, 0 By: f G-� 9 Original Certificate Date: a 3 They y nchorage 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 COSA blue sheet ' ., 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: Alpine Village, Block 3, Lot 9 A. WELL DATA Well type Private If A, B, or C provide PWSID # Date completed 7/12/05 Sanitary seal (Y/N) Y Total depth 121 ft. Cased to 121 ft. FROM WELL LOG Date of test 7/12/05 Static water level 68 ft. Well production 20 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate N/D mg/L Arsenic N/D ug/L Date of sample: 9/9/13 B. SEPTIC/HOLDING TANK DATA Tank Type/Material Tank size gal. Number of Compartments Foundation cleanout (Y/N) Date of pumping Parcel ID: 014-133-09 Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) >18 in. AT INSPECTION 9/11/13 44.2 ft. 4.8 g.p.m. Collected by: Anderson Eng. AWWU Sewer Depression over tank (Y/N) Pumper Date installed Cleanouts (Y/N) High water alarm (Y/N) C. ABSORPTION FIELD DATA Date installed Soil rating (g.p.d./ft2 or ft2/bdrm) System type Length ft. Width ft. Gravel below pipe ft. Total depth ft. Eff. absorption area fe Monitoring tube Depression over field Date of adequacy test Results (Pass/Fail) For _ bedrooms Fluid depth in absorption field before test in. Water added gal. New depth in. Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed "Pump on" level at Datum Size in gallons in. "Pump off' level at E. SEPARATION DISTANCES WELL ON LOT TO: Cycles tested Septic tank/lift station on lot N/A Absorption field on lot N/A Public sewer main >75 Sewer /septic service line >25' Animal containment areas >50' SEPTIC/HOLDING TANK ON LOT TO: Building foundation Property line Water main Water service line Wells on adjacent lots ABSORPTION FIELD ON LOT TO Property line Water Service line Curtain drain F. COMMENTS Building foundation _ Surface water Wells on adjacent lots Manhole/Access (Y/N) in. High water alarm level at Meets alarm & circuit requirements? On adjacent lots N/A On adjacent lots N/A Public sewer manhole/cleanout >100' Holding tank N/A Manure/animal excrete storage areas >100' G. ENGINEER'S CERTIFICATION l certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Michael E. Anderson, P.E. Date 10/1/2013 COSA brown Sheet 10-10-12.doc Absorption field Surface water Water main Driveway, parking/vehicle storage AK @. ANDENON GE -4381 r GRAPHIC SCALE; 1 Inch = 30 Feet 5 0 1SO p FOR: Jim Dreeszeii : - Data Scale Legal eseriptiol 7/26/2007 f' = 30' Lan MBi aria l's wilt LOTO, BLOCx 3 HAS kill z7©Iz7 8350 Vanguard Urive, Suite 203 0,425 Sq -FT. OP AREA Aacnora e, plaakfl 08507 (soy sss-8050 6ra'T by Ld .PgSed orsiv£•� r 230 I hareby certify that the property deacribod hereon has. been surreysd by � eraxithin tb.e property linea and do not overlap or encroach an the z � + 2 S89'59'00"W 1:10.00 It is the of the enaa 6r 'builder, prior to construction, f P O of connections and to determine the eriatenee of any easements, coveaants, -- aG3 !� Q 35.7 n e.x i 0 W EYJ P x0V E n O O z o dY ¢k w rad l ®w1 589'59'00"W 130,00 w o I LU,CEEN AVENUE GRAPHIC SCALE; 1 Inch = 30 Feet 5 0 1SO p FOR: Jim Dreeszeii : - Data Scale Legal eseriptiol 7/26/2007 f' = 30' Lan MBi aria l's wilt .&{yiaaarinr & su **,c. ICC. kill z7©Iz7 8350 Vanguard Urive, Suite 203 ur) Aacnora e, plaakfl 08507 (soy sss-8050 6ra'T by Ld .PgSed orsiv£•� r 230 I hareby certify that the property deacribod hereon has. been surreysd by � eraxithin tb.e property linea and do not overlap or encroach an the property fyutg 9d,�acaiai thereto unless otherwise chows. That no � + D lines or other easoments on Paid praparty except as shown. It is the of the enaa 6r 'builder, prior to construction, f .povedsbuildj to verify proposed bnifding gmdo relative to finish grade and utility connections and to determine the eriatenee of any easements, coveaants, -- or restrictions which do not appear on the recorded subdivision plat. Q a W GRAPHIC SCALE; 1 Inch = 30 Feet 5 0 1SO p FOR: Jim Dreeszeii : - Data Scale Legal eseriptiol 7/26/2007 f' = 30' Lan MBi aria l's wilt .&{yiaaarinr & su **,c. ICC. kill z7©Iz7 8350 Vanguard Urive, Suite 203 Aacnora e, plaakfl 08507 (soy sss-8050 6ra'T by 8ieid $nOk D.L.M, 230 I hareby certify that the property deacribod hereon has. been surreysd by me, or at mp direction, and that the improvements situated thereon eraxithin tb.e property linea and do not overlap or encroach an the property fyutg 9d,�acaiai thereto unless otherwise chows. That no i pruvamants an the property 1,yi1g adjacent thereto encroach on the + premyaas in quaaticn and that there aro no road'vW, tra njssioa lines or other easoments on Paid praparty except as shown. It is the of the enaa 6r 'builder, prior to construction, f .povedsbuildj to verify proposed bnifding gmdo relative to finish grade and utility connections and to determine the eriatenee of any easements, coveaants, -- or restrictions which do not appear on the recorded subdivision plat. -. ... Listed distances prevail aver scan" ,.. ... .. .... .-...,. Lot 9 Block 3 ALPIZJB VILLAGE SUBDIVISION 4��9%%1���^, L CHARLES E. FORBES CS -7326 . . Reproduction may cause dLStPYftioe��`olessianfl��a�'�4 60/50 30VJ >iNVHNtl3 0b09Z99L06 I9:9S L00Z/0E/L0