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HomeMy WebLinkAboutEAGLE RIVER VALLEY RANCHETTES LT 21AEagle River Valley Ranchettes Lot 21 A #050-223-25 t: Municipality of Anchorage :;'Ci . •. Development Services Department ' Building Safety Division — on-Site Water and Wastewater Program, 4700 S. Brogaw St. I 3 Pae of P.O. Box 196650 Anchorage, AK 99519-6650 9 www.cl anchorage.ak.us (907) 5417904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND10R WELL INSPECTION REPORT Permit Number: is O n2 / PID Number. — ZS ,�� Niew Wastewater System: t!3 rlew ❑ Upgrade 2N 2 Aft.. ABSORPTION FIELD ''Ar DR- ZS / O l7 _ 1 7 Number d B.d.rn. IOM rll I] TmSnNww Tle. Set b1rNa I] OIe.Y P b ✓ '7 6d RNNV idr DWI. ern aq+W per. 00 6 LEGAL DESCRIPTION p. GPDMe . Ft. BbU td slxd wn D.WI b P4. boars horn aprul wade &"at deWe b«raa. pp 5 6.o Ft ,-1 FI. ZI QArll • Sawn Fa eaeea Nwv. onpnN P•a• Gr.vN L.rgai Tver NW nn V FI. 3 1 FI. 7•• FIN ��. IM. Gr.vel wde'NuniMr d IN.f DIN.nC. b.l.sea C] Upgrade 3 1 N/A FL Well: ❑ New Ft. (Pmme. A e. Q TdN Cnsa b a..5OrF/ Me DFI. Ft, Fl SiNiC WN«L.N enlMl.r ON. 1'..Wl.aC SUC6. C1 13 D ffcw.k~ FL U R pumsNN ca" H.QNAeo..cmeJ TANK Q'� GPM FI. Ft. SEPARATION DISTANCES 01 Septic ❑ Holding ❑ S.T.E.P. ❑ Other: To Septic Absorption Ldl Holding uonFJPMate .aur.r. _ � Sewer Line R G N From Tank Field Station Tank �u dc«ro«vnw.. Mr«u1 well N/il N /q- N/A N/.4 N 1A 574 L F LIFT STATION WNN 'I•lo0 NlA• $v1eq N A tlo0 u. aclr« 1 Ld LM f• $ I 'f f� N N fi GN 'Pump on' I..r N •P. Or Hpa vN« r«m N Fw.aeaon } S 1 } I p ,a Jt/ /} I" e, pump Mak. a Erdncr tr*p ern p«f•'•a bF / A cairn d«n f So' t Sv N/1'! N R.rre. BENCH MARK NG C N t.ar�lxtn.na a.ra�«�. CnA)c i ti SoNo1uR,� Po ieYNH11. �• CLIC. SL•l /OO-OFL CHRXS GJDvb Dates: 1" OG Inspections performed by: 2ne/y/oG .01, CH=OP Development Services Department Approval CE1033T Date: 3 0 �"_ zb "••»...........� �fi Reviewed and approved by: . -. gz-~40' 16co t MT 2 z s -roP of Popck _ �C"LA N I I g til . ��oo c zyL II v '2 w ti 7H z V. Nu xII Ayo T1 if' T1 J 1 1250 AA1.7-4#JK C01 M 0 TP -1 b N N' a 0 il/B9's9 �W /7J. a ASBUILT SEWARI I HEREBY CERTIFY -THAT I HAVE SURVEYED THE SCALE, � FOLLOWING DESCRIBED PROPERTY' C T; DATE: TES AND THAT NO ENCROACHMENTS EXIST EXCEPT AS T'.2 N. -O 44.0 Y, Go 1 24.0 5?•0 VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB' ANY DATA HEREON BE USED FOR CONSTRUCTION mr 1 n.o ss.a x 16co t MT 2 z s -roP of Popck _ �C"LA N I I g til . ��oo c zyL II v '2 w ti 7H z V. Nu xII Ayo T1 if' T1 J 1 1250 AA1.7-4#JK C01 M 0 TP -1 b N N' a 0 il/B9's9 �W /7J. a ASBUILT SEWARI I HEREBY CERTIFY -THAT I HAVE SURVEYED THE SCALE, � FOLLOWING DESCRIBED PROPERTY' DATE: TES AND THAT NO ENCROACHMENTS EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THZ EXISTENCE OF ANY GRIDc EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB' ANY DATA HEREON BE USED FOR CONSTRUCTION OFFENCE LINES, OR FOR ESTABLISHING BOUND- ARY LINES. DRAWN jot OPIIER R WOOD CEM ct 9 EAGLE RIVER ENGINEERING 10421 VFW Rd., Suite 201 Eagle River, Alaska 99577 > (907) 694-5195 Fax (907) 694.3297 joa F 12,\/, RANCHefiGs LOT 2/2 SHEET NO. 3 OF CALCULATED BY G DATE CHECKED BY DATE W. i J_ 1 - IL i �'... ..... 6. 1 P�`� J k: I f 2 J 1 d U O W 44 I i, �. ; NJ ,,,po•A,ttHyps.wm�r.r� i 1 i •l P�`� ,,,po•A,ttHyps.wm�r.r� Y -45C ASBUILT SEWARD & ASSOCIATES LAND SURVEYING 694 I HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE= i FOLLOWING DESCRIBED PROPERTY= �'� t OF At t<rria�P�'�<ts�.yJ+ulyi®73fGoTr/�4 DATE: lopQ,. .... , '5�4 AND THAT NO ENCROACHMENTS EXfST EXCEPT AS 3��j 'w TF1 INDICATED. IT IS THE RESPONSIBILITY OF THE s :�;' 4 _ OWNER TO DETERMINE THE EXISTENCE OF ANY GRID""" ""' EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- �� '. Des"* Ms,kk So s.e i VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB: ALS �' �{•'* ANY DATA HEREON BE USED FOR CONSTRUCTION /y�e9 t�?q�'' 7'• ` �Ar OF FENCE LINES, OR FOR ESTABLISHING BOUND- DHAWNj r, �� ARY LINES. .ate b*v�.wT� MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water 8 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Renewal Date Issued: Jul 21, 2006 Expiration Date: Jul 21, 2007 Permit Number: SWO60214 Parcel ID: 050-223-25 Legal Description: EAGLE RIVER VALLEY RANCHETTES SUBDIVISION LOT 21A Design Engineer: 0848 EAGLE RIVER ENGINEERING SEI Site Address: 18932 TWENTY GRAND ROAD Owner Name: ROYCE MARTIN Lot Size: 17955 SO. FT. Owner Address: P.O. BOX 773326 Total Bedrooms: 4 Permit Bedrooms: 4 EAGLE RIVER. AK 99577 - This permit is for the construction of: 0 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 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. Date: �/23 �� sib • I� .) - � � - - /. Municipality of Anchorage Development Services Department ... Building Safety Division % I On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 ON-SITE SEPTIC/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 0 50 - 'AA -3 " C9 5 Propert, Mailing Site address Legal description (Sub'd, Block & Lot) Legal description (Township, Section & Range) Lot Size II Q65 Sq. Ft. THIS APPLICATION IS FOR (®all that apply): Absorption Field ET Septic Tank ET Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Code Number of Bedrooms t{ THIS APPLICATION IS AN: Code Clct5tl 'P(A Initial ❑ Upgrade ❑ / Renewal certify that theAXofve info aon is correct. I further certify that this application is being made for a Single Family elling a t"cVclan� with applicable Municipal Codes. (Signatureof property owner or authorized agent) Permit/Rush Fees: I) S' tN Waiver Fees: Date of Payment: 411 R tl nq Date of Payment: Receipt Number: $ 3 Receipt Number: (Rev. 11105) MUNICIPALITY OF ANCHORAGE Development Services Department Onsite Water & 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: Aug 04, 2005 Expiration Date: Aug 04, 2006 Permit Number: SWO50263 Parcel ID: 050-223-25 Legal Description: EAGLE RIVER VALLEY RANCHETTES SUBDIVISION LOT 21A Design Engineer: 0848 Eagle River Engineering Services Site Address: 18932 TWENTY GRAND ROAD Owner Name: ROYCE MARTIN Lot Size: 17955 SO. FT. Owner Address: P.O. BOX 773326 Total Bedrooms: 4 Permit Bedrooms: 4 EAGLE RIVER. AK 99577 - This permit is for the construction of: ❑✓ Disposal Field Q 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: Parcel I.D. Property 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 XO - 1--a-3 - -2'5 Permit Number SW phone 1-;7 - 8'(& &V Mailing address (1) ) 0 -'5:5 s -Co ij Stu Maffing-address (2) / - Zip Code -')g577-'q3a-G• Legal description (Lot, Block & Sub'd.) PP7 — Legal description (Section, Township & Range) pe�Zl�'t-- Lot Size _7T95S Acre<S .Ft. . Number of Bedrooms y THIS APPLICATION IS FOR: Sewer Only Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ certify that the above Information is correct. 1 further certify that this application is being made for a Single Fam y Dw Ing and is in accordance with applicable Municipal Codes. (Signature of property owner or guthorized agent) Permit Fees: `t GD • 6 Waiver Fees: Date of Payment:y'1DS Date of Payment: Receipt Number: 7-1:730 Receipt Number: (Rev. 12/00) Eagle River Engineering Services Wood, P.E. Christopher R. 10421 VFW RD. Suite 201 (907) 694-5195 tel Eagle River, AK 99577 (907) 694-3297 fax July 31, 2005 Dan Roth Manager, On -Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: Eagle River Valley Ranchettes Lot 21A Narrative & Permit Application Dear Mr. Roth: Eagle River Engineering Services (ERES) was contracted to design a well and septic system at the above referenced property. The proposed well and 4 bedroom septic system will have very limited impact on adjacent properties for the following reasons: 1. The surrounding lots are all connected to Public Water, so this lot and neighboring lots have room for septic systems and alternate sites 2. Immediate neighboring septic systems are all +30' distance, and no private (or community) wells within 200' of the proposed septic system. 3. This permit is for a septic system only. 4. Drainage will not be affected and is not a major consideration in our design. Installation of the new deep trench septic system on this lot will not adversely affect the septic systems or reserve areas on adjacent lots. If you have any questions please call our office at 694-5195. Sincerely, E4hne'r R ENGINEERI G SERVICES CWoo , P.E. Principal X2003105-098SEPTICNARRATI VE TWENTY GRAND 30' SEPTIC+30'T � S 89'59'15"E 133.00' LEGAL: EAGLE RIVER VALLEY RANCHETTES LOT21A : �P��•'9S1�, OWNER: ROYCE MARTIN CONTRACTOR: MARTIN CONSTRUCTION Of.*. J013# 05-098WS I DATE: 08/04/05 1 SCALE 1 "=30' 0 .. . .. . . ...... An .CHRISTOPHER R. WOOD. 4:EACLE RIVER ENGINEERING SERVICES �� CE -10387 AP.O. Box 773294EACLE RIVR, AK 9977 go' , .. •� (9 7) 694— 5195 FAX. 5(907) 694-3297 ,1���V�: =''� S 89'59'15"E 133.00' P PO ED 0 OINSTALL !' EV AY Lot 21 A — — — EASEMENT v — PROPOSED LEACH FIELD 1. NO SURFACE WATER +100'. NEW 1 In Lot 2. NO KNOWN CURTAIN 3. NO SEPTICS WITHIN 3'X63' lIi TRENCH . `– 21 B SEPTIC+30' 4. NO WELLS +200' d— PROPI oF11114 BEDROOM Lot I HOUSE —� 22B I I SEPTIC+ 30' TH-2 I MIN 51Z5 O I c I MIN Ln O I o o 1 - I INSTALL NEW LO 0 1250 GAL. TANK O p PROPOSED ClTH 1 WATER LINE z ✓ O 3'X63 RESERVE SITE z ---------------------------- 10' UTILITY EASEMENT VXISTING ALVE BOX LEGAL: EAGLE RIVER VALLEY RANCHETTES LOT21A : �P��•'9S1�, OWNER: ROYCE MARTIN CONTRACTOR: MARTIN CONSTRUCTION Of.*. J013# 05-098WS I DATE: 08/04/05 1 SCALE 1 "=30' 0 .. . .. . . ...... An .CHRISTOPHER R. WOOD. 4:EACLE RIVER ENGINEERING SERVICES �� CE -10387 AP.O. Box 773294EACLE RIVR, AK 9977 go' , .. •� (9 7) 694— 5195 FAX. 5(907) 694-3297 ,1���V�: =''� S 89'59'15"E 133.00' Lot 22D Lot 21 C SEPTIC+30'1 Lot 20C ® — TEST HOLE — — — EASEMENT v — PROPOSED LEACH FIELD 1. NO SURFACE WATER +100'. • — MONITOR TUBE_ o — SEWER CLEAN OUT EXISTING LEACH FIELD ©_ DRNEWAY 2. NO KNOWN CURTAIN 3. NO SEPTICS WITHIN DRAINS 30' UNLESS NOTED 4' — WELL 4. NO WELLS +200' WELL /SEPTIC SITE PLAN oF11114 LEGAL: EAGLE RIVER VALLEY RANCHETTES LOT21A : �P��•'9S1�, OWNER: ROYCE MARTIN CONTRACTOR: MARTIN CONSTRUCTION Of.*. J013# 05-098WS I DATE: 08/04/05 1 SCALE 1 "=30' 0 .. . .. . . ...... An .CHRISTOPHER R. WOOD. 4:EACLE RIVER ENGINEERING SERVICES �� CE -10387 AP.O. Box 773294EACLE RIVR, AK 9977 go' , .. •� (9 7) 694— 5195 FAX. 5(907) 694-3297 ,1���V�: =''� Eagle River Engineering Services Christopher R Wood, P.E. roger VFW Rd. Suite 2or (907) 694-5195 tel Eagle River, AK 99577 (907) 694-3297 fax SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM LEGAL: Eagle River Valley Ranchettes Lot 21 A July 31, 2005 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 I lealth and State Department of Environmental Conservation requirements. 4. All soil 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. 8. Any remaining open test hole excavations shall be filled and monitor tube removed. 9. It is the responsibility of the contractor to obtain any lot line staking or well radius staking, etc... by a licensed surveyor prior to installation of any component of the septic system. Although not required, it is highly recommended, and is purely the responsibility of the contractor if any component of the wastewater system is installed too close to any lot line, house foundation, well radius, surface water, or any other object which the MOA requires specific setback requirements. B. SEPTIC TANK 1. The sewer piping from the house shall be 4" PVC 3034 laid at 2% grade minimum, and insulated with 2" of burial foam if shallower than 3 fl., with 2 ft. minimum. A foundation cleanout shall be installed within 4' of the house foundation. 2. The septic tank shall be an Anchorage Tank 1,250 gallon 2 chambered septic tank. Contractor may submit alternate tank and for approval, as long as it meets MOA requirements. Two opposing alter - tank cleanouts shall be installed. C. TRENCI[ 1. The trench is to be located as shown on the site plan. 2. The total depth of the initial trench excavation is to be 10' max. relative to existing ground elevation at ground water monitor tube. The bottom of the trench shall be level, plus or minus 1.5". 3. A 6 foot layer of sewer rock is to be placed over the native sand and gravel. The 4" effluent piping is to be laid on top of the gravel layer with, with 6" additional gravel added as follows: 4" along sides of effluent pipe, and 2" of gravel cover over the piping. 4. The completed trench gravel and piping is to be covered with typar fabric material. 5. Soil or combination of soil and extruded board insulation to a depth of +3' or equivalent is to be placed over the leachfield. Soil shall be contoured over the trench to prevent runoff from ponding. Continued on next nage \\Eres\docs\W PDOCS\2005\05-098trench- spec.doc Eagle River Engineering Services Christopher R Wood, P.E. 10421 VFW Rd. Suite 201 Eagle River, AK 99577 Continued: RECOMMENDED LEACIIFIELD DIMENSIONS: (907) 694-5195 tel (907) 694-3297 fax TOTAL DEPTII = 9.5' GRAVEL DEPTII = 6' under effluent pipe, 2" over pipe TRENCH LENGTH = 63' TRENCH WIDTII — 3' SOIL RATING= 0.8 GPD/fl? BEDROOM CAPACITY= 4 SEPTIC TANK= 1,250 gallons EFFLUENT PIPE— 4" diameter of Muni and Engineer approved materials and construction Twenty-four (24) hours notice required for all inspections. \\Era\docs\WPDOCS\2005\05-098tmch• spec.doc EAGLE RIVER ENGINEERING SERVICES 10421 VFW RD Suite 201 Eagle River, Alaska 99577 (907)694-5195 ERES Project No.: 05-098 Calculated By: CW Date: 7/31/2005 Legal: Eagle River Valley Ranchettes Lot 21A Single Family 4 Bedroom Dwelling Deep Trench Subsurface Wastewater Disposal Field Water use at 150 gallons per bedroom - Percolation rate = Wastewater application rale = Required absorption area = Trench width (W) _ Gravel depth (D) TEST HOLE 1 e00 gallons 15 minutes per Inch 0.8 gallons per day per square foot 750 square feet 3 feet e feet Required length - Required absorption area 12 / D Required length = 750 / 2 / 8 Required length = 63 feet Total Excavation Depth = 9.5 feet 05-098_trenchCalc 9:23 PM7/31/2005 Municipality of Anchorage, NGINE ). Development Services Department *- �s9 itA Building Safety Division On -Site Water and Wastewater Program 4700 South Brngaw SL P.O. Boz 196850 Anchorage, AK 9g5I"S50 t1l. CHMSTOPHER R. WOOD ^ rww.d.Mhoraoe ek uA%. CE (907) 343.7904 •.'n,107 ,v.wr Soils Log -Percolation Test SSION�•G Performed For. Royce M.'rf "/) r Legal Desulption: Date Performed: G ^7ff (� •Ytr Un!Ic�QMTy Qfl�S t !1 Township. Range. Section: 7 (N /✓. )! I IJ 5l'C slmn,. Depth (Feet TOT i'bL L 1J, o Sr f 2- 3- i'ii' _Iun 4 13- h r�i 14- � F 18- 19 - COMMENTS WAS GROUND WATER f ENCOUNTERED7 :l 9 IFYES,ATWHATDEPTH7 /E L Depth M WererARer o Ie0nlloArrg7 P E Reading Date I Gross Time PERCOIAnoN RATE TESTRUNBETW£ENFT AND PERFORMED SY: ry fZl, S rA JCPO � I ' PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN Net Time I Depth to Water V Net Drop PERC HOLE DIAMETER T' CERTIFY THAT THIS TEST WAS, ON THIS DATE, DATE: 212 0 Municipality of Anchorage Development Services Department Building Safety Division • Y1 Onsite Water and Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 995196650 www cI.snchoraoe ek.us (907) 343.7904 ^Soils Log - Percolation Test Performed For. pey{L MP( 11 (N Date Performed:_71Zns /r5 Legal Description: LAW, I��dil �/allFy �1,n14f1iFStri?I/1 Township, Range, Section: 714 A( Rlv %« 7 I lio l-{;' Z Oon f"'( 5 4 toPST 1 a rad ar+(� (7InJ1°� 75% 5"'Id U/91 -mo 6; r 1 WAS GROUND WATER ENCOUNTERED? N 0 S IFYES.ATW1tATDEPTH7 _AJIA L Depth to Water After D Monitoring? 7rLjl,4 P E Data: Reading Date Gross Time Net Tine Depth to Water Net Drop 1 /a9/r 10:l0 0• 5V 0. a o �. i 6 6 s.►� s ��. 3 lo, j7 O, 5 6"" 0: 4 'ID:;q _Y 5' 11 5- /y. 5 jo.35 0" 5'6 O rrn,ZnT,v...n,. r,0.. ynmuj PERC HOLE DIAMETER TESTRUN6ETWEEN S.S FT AND 6.5� FT PERFORMED BY: C. Lr� / I« Pit' +� n f I �.���' yjJ'Y CERTIFY THAT THIS TEBT WAB PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ? (1 • .rt u • Municipality of Anchorage On-Site Water and Wastewater Program (907) 343-7904 s A C T Y CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 050-223-25 Expiration Date: 1J^^ 1. GENERAL INFORMATION Complete legal description EAGLE RIVER VALLEY RANCHETTES SID, LOT21A Location (site address) 18932 TWENTY GRAND ROAD, EAGLE RIVER, AK 99516 Current Property owner(s) JEREMY WHITE Day phone Mailing address 7702 CERVANTES LN, SPRINGFIELD VA, 22153 Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ® Public Sewer ❑ Waiver/Variance request for: Distance: Received by: X/141(--- Date: .S-- /l /)2 COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 6701(0 Waiver Fee $ Date of Payment " I l l(q Date of Payment Receipt Number itie Al(get) Receipt Number COSA# a 5 Gl 7 11% 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 MIKE N ANDERSON, P.E. Phone 727-8864 Address 4661 NATRONA AVE. Engineer's Printed Name MIKE N ANDERSON, PE Date 04/11/17 ..'c- Ire ~,° �� q1 "O°O O o L (.00 ° 6. DSD SIGNATURE ' ° N. AND:RSCN :° °"" t :,ik.,i-IAEL ' (� t . CES 9^-b4 System #1 Approved for l bedrooms. �� ,� irn 9- System #2 Approved for bedrooms. tilk‘elP1:pSuv Disapproved. Conditional approval for bedrooms, with the following stipulations: '•; OF 4/ . ONSITE , WATER AND r" y, WASTEWATER z PROGRAM "•'T' N BY "�. — — Original Certificate Date: j 7 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 Ad'ispry;:`, rt' Well Flow Advisory Other .• e ti • COSA blue sheel_10-10.12.tloc , �' F 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: EAGLE RIVER VALLEY RANCHETTES SID, LOT2IA Parcel ID. 050-223-25 A. WELL DATA Well type If A. B, or C provide PWSID # Well Log (Y/N) Date completed Sanitary seal (YIN) Wires properly pr• - ed (YIN) Total depth ft. Cased to ft. Casing he's- ,above ground) FROM WELL LOG AT INSPECTION Date of test Static water level I ft. ft. Well production g.p.m. g.p.m. WATER SAMP - 'ESULTS: Colifor • colonies/100 mL Nitrate mgiL rsenic ug/L Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC I STEEL Date installed 9113/2006 Tank size 1250 gal. Number of Compartments 2 Cleanouts (YIN) Y Foundation cleanout(Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping 5-5-17 Pumper Alaska Quality Pump C. ABSORPTION FIELD DATA — 1985 SYSTEM TESTED Date installed 9/13/2006 Soil ratingg.p.d./ft2 r ft`/bdrmj 0.8 System type DEEP TRENCH Length 68 ft. Width 3 ft. Gravel below pipe 6.0 ft Total depth 10 ft. Eff. absorption area 750+ ft2 Monitoring tube Y Depression over field N Date of adequacy test 5.5-17 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 6 in. Water added 600+ gal. New depth 10 in. Elapsed Time: 4 HRS min. Final fluid depth 8 in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) UNKNOWN If yes, give date D. LIFT STATION Date installed Size in gallons ManhoiefAt-Ce-ss (YIN) "Pump on" level at in. "Pu p-eff"-tevel at in.High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main ; i • sewer manhole/cleanout Sewer/septic service line Holding tank Anim_ . . nment areas Manure/animal excrete storage areas SEPTIC/HOLDING TANK ON LOT TO Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water Service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain 50'+(None Known) Wells on adjacent lots 100'+ F. CO IP • iw 1. , max . • G. ENGINEER'S CERTIFICATION 4" 17' ,r .• „l io 41 Y ` P I certify that l have determined through field inspections and *;4 r H -;c f oo review of Municipal records that the above systems are in 1/1 conformance with MOA COSA guidelines in effect on this date. :� I •• MICHAEL N. ANDERSCN ;.� Engineer's Printed Name MIKE Y. ANDERSON, PF. rf f•.• C -9469 •'`• '• > Date 0511112017 r''Fo••S '/ .f. • •S'•4' COSA canary sheet_2-6-15.doc u�f Municipality of Ancli • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street on B 196 ox 650 Anchorage, AK 99519-6650 \� www.muni.orglonsRe (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 01--s(p-X* ,25 COSA# M()Qq Expiration Date: o 1. GENERAL INFORMATION Complete legal description 9A -64F, RIVE -le- ih4>_LEY i2+1 N[ ftF_T7'i<S L n I A Location (site address) f::7Y_._W .._ EA [-.-r F Qt a=te Ar__ Current Propertyowner(s) DhtiID WA72_t.)C--?P_ Dayphone aSJ- 1943 Mailing address Lending agency Mailing address Day phone 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: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site ❑ Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues COSAs upon request to homeowners. Certificates of Onsite Systems Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage 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 time of installation. Name of Firm EA CTt - Kt Vlx A1C-1NyEK* I1(Gr- Phone Address 10111) VSA -1 all 7E a.o / EA CTLG 2t ✓CM— Engineer's Printed Name (ttietS—roPrtE72.4k>n0b 5. DSD SIGNATURE Approved for Disapproved. 4— bedrooms. Conditional approval for bedrooms, with the following stipulations: Additional Comments 31� WATT • AND rn- ,.,.,.t• Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By; Original Certificate Date: L6 101 J (Rev. I IM5) 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: F_,4f-rL_E 1z11/Er__ yAi_LsY PAI' l(fK_F SParceIID: 090'22-32$: A. WELL DATA LOT 21 A Well type _ Date completed _ Total depth ft. Date of test If A. B, or C provide PWSID W_ Sanitary seal (Y/N) _ Cased to ft. FROM WELL LOG Li Static water level Well production Q g.p,m, WATER SAMPLE RS: Coliform colonies/100 mL Nitrate Well Log (Y/N) Wires properly Casing heo"96ove ground) in. ft. mg/L Other bacteria colonies/100 mL emc: mgll Date of sample: _ Collected by. B. SEPTIC/HOLDING TANK DATA Tank Type/Material STS L_ Date installed 2 // 3/0 G Tank size 4a.50 gal. Number of Compartments _t�_ Cleanouts (Y" yh" 5 Foundation cleanout&#J�5_ Depression over tank../ (Y@) a ) High water alarm (W10 A/O Date of pumping /1 1A -A- Pumper /VQt ) 5 H5/L.rn C. ABSORPTION FIELD DATA Date installed 17 1/.; Soil ratingp.d./ft or ftZ/bdrm) „p$ System type iiET� T� �s i(ff Length fnA ft. Width 3 ft. Gravel below pipe fn.o ft. Total depth 9_�_o ft. Eft. absorption area -15011' Monitoring tube L Depression over field Date of adequacy test R/1Q 'c- Results (Pass/FeM _Qk5 S For, bedrooms Fluid depth in absorption field before testtie-in. Water added NAgal. New depths In. Elapsed Time: JA- min. Final fluid depth AA in. Absorption rate >= ZOO g.p.d. Any rejuvenation treatment (past 12 mo.) (A'69 type) Vy If yes, give date V/4 D. LIFT STATION Date installed Size in gallons "Pump on' level at _ in. 'Pump off" DatumCycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Manhole/Ac High water alarm level at in. Meets alarm & circuit requirements? Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main �D U`Pttbfic sewer manhole/cleanout Sewer /septic s e fi Holding lank Animal containment areas Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation f 5 Property line fi S Absorption field f5 Water main f 10 Water service line 'F 10 r Surface water -Y"Io0 Wells on adjacent lots f lov SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 4110 r Building foundation -t-10, Water main 410 i Water Service line 41o' Surface water -" 0 o Driveway, parking/vehicle storage f,1 p r Curtain drain -t-95o I Wells on adjacent lots t 1 VV 1 F. COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that 1 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 r t1 lz-tSTOY'tf I� W �� Date & ;Z COSA Fee $ Date of Payment Receipt Number /a (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number CEAW c�