HomeMy WebLinkAboutSKYHILLS PH 3 BLK 3 LT 21kyh1*11s #3
Block 3
Lot 21
#011-122-53
Municipality of Anchorage
Department of Health and Human Services
Building Safety Division
- On -Site Water and Wastewater Program, 4700 South Bragaw Street
P.O. Box 196650 Anchorage, AK 99519{650 Pagel of 3
www.ci.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM ANDIOR WELL INSPECTION REPORT
Permit Number. SWSW040128 PID Number. 011-122-53
"'"
Wastewater System: ® New ❑ Upgrade
Adbeu: iyAlanrl Ave 99501
ABSORPTION FIELD
PhOfM' NWAW at esdnana
® Deep TMXh 17 Shallow TWCh D Bed 13MXV4 ODow
swRw+p
TawDepNkemwgnYpWs
LEGAL DESCRIPTION
Wodk Lw: sjxlw lon:
It 21 Sky Hills Phaseft
Daps M ppe bnom kom orpnw Waft
4 Ft
Gr" deer bMwn qW-
R F,
TowNYp: ROW- 8W :
FA added above oVW Obe:
Gram LwpIR
Well: ❑ New ❑ Upgrade
Gt"VAde.
Nanbw of Ines:
D.w bet~ Wes
cWesif"M[Pinata. A B. C):
TOW Depen.
cbW W'
TOW absorption war
Ppe Mattaw.
Dnaer
Data Dnkd'.
SWa Wats, Lavw:
F1
Latalar
John Ha maier Homel
Data bled.
1115/2004
raU. Para sat r.
c.wr9 Nwotx Above Grw,m:
TANK
GPM FL
FI
SEPARATION DISTANCES
® Septic ❑ Holding ❑ S.T.E.P. ❑ Other.
To
From
Septic
Tank
Absorption
Field
Lift
Station
Holding
Tank
ubtien °vete
Sew Line
hlamo r
AnchTank
cpatr
2000Gw
200+
200+
Met"
Names of Cwproowar
2
was
Steel
saraoewater
100+
100+
LIFT STATION
La to
34.8
12.1
$ar
cat
MwalwArer
45
Prp wf Welat:
'Rnp atr IMI w:
Nph water at r at:
Foundstm
n
N
n00+
k447
"atp Make a Med"
EleWnal nepadi pwromod by
Rw"w"'BENCH
Revised site plan per as -built survey performed b
MARK
Location and Daaptbn:
Gastaldi Land Surveying on 4117106.
Garage Slab
/aMenod Elevwan:
100.0 FL
Engineer's Stamp
♦♦•••w�aa�t
..........
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P1�. •i�
♦i.
I � • J
Inspections performed by: Pannone Eng. Svc Dates: 1"111512004
a9TH
►.....;. ...... .......... ..:..... 0
2nd1110512004
Department of Health and Human Services a 1
p
"' "' " """""ne.- `°a
�. C) Sleven R %. Ponnone �i ar
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Reviewed and approved by: 1 73 1 Date:
(Rev. 11199) V
ar
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eeh ��ESStG�y♦•♦
•
PERMIT NO:SWO40128 RECORD DRAWING
WASTEWATER DISPOSAL SYSTEM
Lot 21, Block 3 Skyhills SID, Phase 3
1 i /
P.I.D. NO: 011.122-53
Steven R. Pannone
EPARED FOR:
PANNONE ENG. SVC, LLC
John Hagmeler Homes, LLC
P. O. BOX 102954
NEW PRIMARY SF
ANCHORAGE, ALASKA 99510
Anchorage, AK 99503
8.2
248.6789
50LFx8'EDxl27D
RECORD
NEWWATE, -
T7 1
��5%
'� t •,.
ti
: - LRJE /
t� M2
2.2 RESERVE SAS
s•
I
NEW 2000g
50LFx8'EDx127D
SEPTIC TANK
1
.0
ITH21-36
*FC
74.0
°
I
i
j
i
I
I
NEIN 6 BR
NOTES:
1) All work shall be performed in
II
HOUSE
accordance withAMC15.65.
accordance
I
I
2) Materials used shall be In
i
accordance with those specified in
1
AMC15.65, Wastewater Disposal.
I
3) Maintain 10' separation to all lot
II
'
lines and exist'g or proposed water
lines.
i
I
4) Lots served by AW WU Public
i
)----Scwo
Water System. No wells within 200'
1
INGTIES
of proposed system.
A B
I
I
FC 13.0 26.7
N
T1 63.5 46.8
E
DESIGN:
/
T2 71.1 60.3
DC 78.5 64.4
i
PERC RATE: 2 MPI
C1 107.0 86.1
I
APPLICATION RATE: 125 B
M1 106.5 84.1
i
1.2 GPOBF
r-
C2 79.5 45.6
..��1LIkaa,,,
�
8 BOR
x
M2 81A 48.4
��
P'( .............. ♦
'•
AREA:
RE D 750 SF
8' ED 50 LF, 17 T.D.
_
h --"'--••---_
••••• ��
i
3' WIDE x x
_- _ --""--
CD
1
780 SF TOTAL
i;� 49 TM_
2000 GAL. SEPTIC TANK
Steven R. Pannone
EPARED FOR:
PANNONE ENG. SVC, LLC
John Hagmeler Homes, LLC
P. O. BOX 102954
2204 Cleveland Ave
ANCHORAGE, ALASKA 99510
Anchorage, AK 99503
227-3522 P, 272-8218 Fax
248.6789
DATE_ 6-"6
RECORD
PERMIT NO:SWO40128 RECORD DRAWING DETAILS P.I.D. NO: 011.122.53
WASTEWATER ABSORPTION SYSTEM
Lot 21, Block 3 Skyhills SID, Phase 3
1110 NV310
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NOTES:
�*!! .••••• ••••••.,,
1) ALL WORK SHALL BE PERFORMED
CO ' �I
IN ACCORDANCE WITH, AND ALL MATERIALS
riL
SHALL CONFORM TO, AMC15.65.
49 . . ................�i
.
•
••
Steven R Pannone
PREPARED FOR:
Pannone Eng. Svc., LLC
P. O. BOX 102954
:
John Hagmeler Homes. LLC
d�•°•;
"ba'G'7J849 ( ,.•e�
2204 Cleveland Ave
ANCHORAGE, ALASKA 99510
•.
0044 % :.
Anchorage, AK 99503
248-8789
272-8218 PHONE & FAX
DATE: 11-29-04
,
RECORD
NOT TO SCALE
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
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Initial
Permit Number: SWO40128
Legal Description: Skyhills #3 Block 3 Lot 21 '
Design Engineer: 0062 Pannone Engineering Services
Owner Name: John
///p5 /006 P330
Date Issued: May 18, 2004
Expiration Date: May 18, 2005
Parcel ID: 011-122-53
Site Address: 7975 Skyhills Drive
Lot Size: 43635 SQ. FT.
Owner Address: 2204 Cleveland Ave, Ste 201 Total Bedrooms: 6 Permit Bedrooms: 6
Anchorage , A 99503 -
This permit is for the construction of:
❑,/ Disposal Field g Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specked 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.
"4 Date: 0
Issued By. �J4' � Date: 3 /18/04
Municipality of Anchorage
Development Services Department
Building Safety Division
Onsite Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-650
www.ci.anchorage.sk.us
(907) 343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. DI 1- f 2 Z -rl Permit Number SW
Property owners) John Hagmeier Homes LLC Day phone 248.6789
MaTwng address (1) 2204 Cleveland Ave Suite 201
Mailing address (2) Anchorage AK Zip Code 99303
Legal description (Lot, Block & Sub'd.) Lot 21 Block 3 Sky Hilts Phase 3
Legal description (Section, Township & Range)
Lot Size 49N8 yr{6 3S Acres/Sq.Ft.
THIS APPLICATION IS FOR:
Number of Bedrooms 6
Sewer Only ® Well Only ❑
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 Fees:
Date of Payment:
Receipt Number.
(Rev. 12M)
Waiver Fees: _
Date of Payment:
_A_ Receipt Number.
Pannone Engineering Services, LLC P.O. Box 102954
Consulting Engineers Anchorage, Alaska, 99510
(907) 272.8218 227-3522 (907)M-8218 Fax
May 13, 2004
Municipality of Anchorage
Development Services Department
On -Site Water & Wastewater Program
4700 S. Bragaw Street
P. O. Box 196650
Anchorage, Alaska 99519
Subject: Lot 21, Block 3 Sky H171s S/D, Phase 3
Septic System Permit
Gentlemen:
My firm was contacted to design and install a new septic system for the referenced lot. We
conducted a field investigation to locate existing wells and septic system before designing the
proposed system. Two test holes were excavated in September of 1999 for the system design,
which is on file with your department. No ground water was encountered. No bedrock was
encountered in the test hole.
The lot is 40,478 sq ft in size. Lot 21 slopes to the east at a rate of approximately 1-2 percent in
the proposed septic area. The proposed installation will be located on the eastern portion of the
lot on a relatively flat area. The proposed location is greater than 200 feet away from any wells.
This lot is served by AWWU water service. The proposed system will be greater than 10 feet from
the water service lines. The proposed installation will not affect the future development of the
surrounding or existing lots. See the attached design.
Please contact me at 272-8218 or 227-3522 if you have any questions about the proposed
installation.
Sincerely,
Steven R. Pannone, P.E.
Attachments:
C\WORKII.C(TGRS121JSKYI11LLSM 1 DOC
PERMIT NO: DESIGN DRAWING
P.I.D. NO:
WASTEWATER DISPOSAL SYSTEM
Lot 2`1 3 SKYHILLS SUBDIVISION
01
in accordance with AMC15.65.
�I
/Block
r '
TH21-3A
accordance with those
I
30.
1 .05x
t �F.
I
OPOSED PRIMARY
I
D NFIEID
LFx8•ED. 12'TD
PROPOSED RESERVE
DRAINFIELD
�7L 16.0
50LFxB'ED.1211) SJO
i
i PROPOSED
i
—ai
10.0
WATER UNE
\
1
PROPOSED 2000g
SEPTIC TANK
I
I
I 13.7
l 1
5��--
57
1
��
1%
TH
21-38
20
fWl
NOTES:
1) All work shall be performed
01
in accordance with AMC15.65.
�I
2) Materials used shall be in
i
accordance with those
I
specified in AMC15.65.
I
Wastewater Disposal.
I
3) Connect post tank line to
I
start of drain field, typical.
4) Maintain 10' separation to
all lot lines and existing water
lines.
5) Lots served by AWWU Public
I
Water System. No wells within
I
200' of proposed system.
I
I
�4 Jr T ii}�1
1
vd b 57.
57
ien K. rannone p s
r � JOHN HAGMElER HOMES. LLC
rN�o. C�E,�78�149 r 2204 CLEVELAND AVE.
�!'(K�LJ.•rf��� ANCHORAGE. AK
248-6789
LOT
DESIGN:
PERC RATE: 2 MPI
APPLICATION RATE: 125 SF/BR
1.2 GPD/SF
6 BR HOUSE
REO'D AREA: 750 SF
LOT 24 SK RR� 0.58
E"EFF'T DEPTH. 65 LF X 9' T.D.
780 SF TOTAL
2000 GAL. SEPTIC TANK
PANNONE ENG. SVC, LLC
P. 0. BOX 102954
ANCHORAGE, ALASKA 99510
227-3522 P. 272-8218 Fax
DESIGN
P.I.D. NO:
PERMITNO: DESIGN DETAILS
WASTEWATER ABSORPTION SYSTEM
Lot 21 Block 3 SKYHILLS SUBDIVISION
NOTES:
1) ALL WORK SHALL BE PERFORMED
IN ACCORDANCE WITH. AND ALL MATERIALS
SHALL CONFORM TO. AMC15.65.
2) MAINTAIN 30' SEPARATION FROM ALL
SLOPES GREATER THAN 25%.
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49TH 10
iSleven R. Pannone 1 . PREPARED FOR: Pannone Eng. Svc.. LLC
�. o�•...E 8149 f� JOHN HAGMEIER HOMES. LLC P. 0. BOX 102954
� � ` L + �. 2204 CLEVELAND AVE. ANCHORAGE. ALASKA 99510
• & �'r ANCHORAGE. AK
�i •'"••• •~"" •� 2ae-6789 272-8218 PHONE &FAX
4Nh',� • NOT TO SCALE DESIGN
Lo
FROM : PR4UU ENG SVC PHONE NO. : 2?2 8218 May. 18 2004 05:33AM P2
I
Municipality of Anchorage
Department of Health & Human Services
825 L Street, Anchorage, AK 99502-0650
SOILS LOG - PERCOLATION TEST
Performed For. Bnh Kirin Date Performed: 9/24/99
Legal Description: 1 et 21. Block .i Sky Hills Pho-e. 1I
SLOPE � SITE PLAN
IF OWT
2 ru
dP
3 �' t
TEETH LF No 23. -B U
4
s
g
Fine Sand
7 Some S"t
a SP
Was Groundwater
9 Encountered? No S
If Yet. What Depth? L
10 Depth to Water 0
After Monitoring None P
11 Date: 10/10/99 E
13
Date Gross
Time
Net
Time
14
1
24 -Sep 11:13
15
-1-
2
11:25
10
Fine Sand
16
11:26
Clean
17
4
SP
16
5.625' 5"
5
19
Bottom of
6
1 11:47
Hole
VaR
Reading
Date Gross
Time
Net
Time
Depth To Net
Water Drop
1
24 -Sep 11:13
-1-
2
11:25
10
6" 5"
3
11:26
.625"
4
11:36
10
5.625' 5"
5
11:37
.75"
6
1 11:47
1 10
5.75' 5"
Perc. Rate: 2 MinAnch Pere. Hole Diameter: 6"
Test Run Between 7 Ft. and 8 FL
Comments: Percolation Cavity Presoaked Prior to Testing.
Performed By: Fe Candersn I. MishaAll gndfit n Certify That Thy Test Was Performed
- In Accordance With AN State and Municipal Guidelines In Effect On This Date: 1012of99
FROM : PAtNOtE ENG SVC PHONE NO. : 272 8218 May. 18 2004 05:34(X'1 P3
Municipality of Anchorage
Department of Health & Human Services
825 L Street, Anchorage, AK 99502-0650
SOILS LOG - PERCOLATION TEST
Performed For. R^h KI -In Dale Performed: 9124/99
Legal Deseriptlon: 1112Ck a sky HI.!e PhaaR In
SLOPE SITE PLAN i
11 4 1 OG/PT
F ne Sand
7 Some Snt
8 SP
10
11
13
Fine Sand
Clean
SP
Was Groundwater
Encountered? No
K Yet. What Depth?
Depth to Water
After Monitoring None
Date: 10/10/99
94.rL
Reading,
Date Gross
Time
Net
Time
Depth To Net
Water Drop
1
24 -Sep 9.14
.75'
2
9:24
10
'5.7S' 5"
3
9:25
•.625'
4
9:35
10
5.625' 5'
5
936
.75'
6
9:46
10
5.75' 5'
19Bottom of Perc. Rate:2 MinJinch Pere. Hole Diameter. 6'
Hole Test Run Between 7 Ft. and 8 Ft.
Comments: Percolation Cavity Presoaked Prior to Testing.
Performed By:d y.,,=Ed an�wcandw Inn i, MI haclr F AndXAnn, Certify That Thio Test Was Performed
In Accordance With All State and Munldpet Guidelines In Effect On This Date: 1020199
FROM : PA CE ENG SVC PHo E N0. : 272 8218 Hay. 18 2004 05:34AM P4
SKY HILLS SUBDIVISION, PHASE III
PERCOLATION RATE SUMMARY
LoVBIock
Number
Testhole
Number
Perc. Rate
MinJlnch
LotBlock
Number
Testhole
Number
Parc. Rate
MinJlnch
Lot 5, Block 2
TH-A
2
Lot 25, Block 3 .
TH-A
2
TH-B
2
TH-B
2
Lot S. Block 2
TH-A
2
Lot 26, Block 3
TH-A
2
TH-B
2
TH-B
2
Lot 7, Block 2
TH-A
20
Lot 27, Block 3
TH-A
2
TH-D,
20
TH-B
2
Lot 8, Block 2
TH-A
15
TH.-C
2
TH-B
15
Lot 28, Block 3
TH-A
2
Lot 9, Block 2
TH-A
2
TH-B
S
TH-B
2
TN -C
1.7
Lot 10, Block 2
TH-A
12'
Lot 29, Block 3
TH-A'
2
TH-8
12
TH-B
5
Lot 21, Block 3
TH-A
2
Lot 30, Block 3
TH-A
3.3
TH-S
2
TH-B
2
Lot 22, Block 3
TH-A
2
Lot 31, Block 3
TH-A
3.3'
TH-B
2
TH-B
S
Lot 23, Block 3
TH-A
2
Lot 32, Block 3
TH-A
1.7
TH-B
2
TH-B
5
TH-C
2
Lot 33, Block 3
TH-A
1.25
Let 24, Block 3
TH-A
2
TH-B
1.25
TH-8
2
Tract A
TH-A
2
TH-B
2
PC0 0&060
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D.
1. GENERAL INFORMATION
Complete legal description Lot 21 Bk 3 Sky Hills Phase 3
Location (site address) 7975 Skyhills Drive Anchorage AK
F
COSA # O Co O 2 I
Expiration Date: 6 - .S- n 7
Current Property owner(s) John Hagmeier Homes. LLC Day phone 248-6789
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address
2204 Cleveland Ave Anchorage, AK 99517
Unless otherwise requested, COSA wilt be held by DSO for pickup.
2. NUMBER OF BEDROOMS: 6
3. TYPE OF WATER SUPPLY:
Individual Well
❑
Individual Water Storage
❑
Community Class Well
❑
Public Water System
19
Day phone
Day phone
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
Individual Holding Tank ❑
Community On-site ❑
Public Sewer ❑
The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an Independent professional civil
engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues COSAs upon request to homeowners. Certificates of 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 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 Pannone Enoineering Servires, LLC Phone 272-8218
Address P.O. Box 102954, Anchorage, AK 99510
Engineer's Printed Name Steven R. Pannone, P.E. Date 611106
Engineers Comments: In conducting an adequacy lest, l attempt to provide a thorough, conscientious engineering analysis of the system in
accordance with htOA DSD Guidelines d Regulations. The reported results describe the performance of the system under the conditions
encountered at the time of the test, and separation distances measured to readily identifiable features. ����•aaaa
The operational life of all wells and septic systems depend on the local soil condition, ground water
levels that may fluctuate during the year, and the water usage of the family being served by the system.
These conditions arc outside the control of the evaluator of this system. All systems eventually fail and 00
satisfactory test results do not guarantee future performance of the system, nor do they guarantee that C a n •w 00
there arc no hidden defects or encroachments. PES can therefore not provide any warranty for future $• —00
performance nor give any estimate of how long the system will continue to meet the operational
requirements of the MOA DSD. Thc content of this report is for the sole benefit of the owner listed Steven R. Pannone
above. Any reliance upon or use of this report by any other person or party is not authorized nor will it ���'A N, CE 8149 11
confer tt ♦4f4
DSD SIGNATURE
5�apE�al•`�•
✓ Approved for _6 bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
Attachments:
COSA Checklist X
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
PROGRAM
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
un
By: t// / G!% Original Certificate Date: r 5, 0 �o
xn« t,Ast oe-
Municipality of Anchorage
• Development Services Department °
Building Safety Division
On -Site Water 6 Wastewater Program " '
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-850
www.muni.org/onsite
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
A. WELL DATA
Well type AYt7fllt
Da plated _
Total depth
Date of test
Static water level
Web pro91iedg
If A, B, or C provide PWSID 0 _
Sanitary seal (Y/N)
Cased to ft.
FR LL LOG
ft.
9.p -m.
RESULTS:
Well Log
Wires pS>Dpefty p (Y/N)
height (above ground) in.
AT INSPECTION
oolonies/100 ml Nitrate mg/L Other
mgfl
B. SEPTICIHOLDING TANK DATA
Date of sample: _ Collected by:
Tank Type/Material Anch Tank Stael
Tank size 2000_ gal. Number of Compartments 2
Foundation cleanout (YIN) I Depression over tapk (YM) H
Date of pumping )a1,) — [ L 1 PuUp /�ct�✓11
C. ABSORPTION FIELD DATA
Cleanouts (Y/N)
fL
g.p.m.
oolonies/100 mL
High water alarm (Y/N) WA
Date installed 111512884 Soil rating (g.p.d.e or fe/bdrm) l,2_ System type Deeo Trench
Length 50 ft. Width ] ft. Gravel below pipe 8 ft.
Total depth 12 ft. Eff. absorption area Info Monitoring tube Y Depression over field
Date of adequacy test -ke UJ Results (Pass/Fall) Pass For ¢ bedrooms
Fluid depth in absorption field before test = in. Water added `gai. New depthin.
CTOElapsed Time: _ min. Final fluid depth _ in. Absorption rate >= W T g.p.d.
Any rejuvenation treatment (past 12 mo.) (YIN 8, type) No If yes, give date
LIFT STATION
'Pump on"hu-1
Datum
E. SEPARATION
SEPARATION
Septic tankAlft a
Absorption field
Public sewefm.
Size in gallons
at _ in. _ 1 -Pump ofr "t,4 _ in.
ON LOT TO:
Manhole/Access (Y/N)
High water alarm level at
Meets alarm a circuit requirements?
On adjacent lots
On adjacent lots
sewer manhole/deanout
septic service line Holding tan
anal containment areas Manurelanimal exrxe forage areas
SEPARATION DISTANCES FROM SEPTICMOLDING TANK ON LOT TO:
Building foundation 45 Property line�4 Absorption field (f+
Water main 100+ Water service line 25+ Surface water 100+
Wells on adjacent lots 200+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 12 Building foundation 44 Water main too+
Water Service line 25+ Surface water 100+ Driveway, parkinglvehx* storage 1
Curtain drain None Wells on adjacent kits 200+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certiy that I have determined through field inspections and r'
review of Municipal records that the above systems are in
conformance with MOA COSH guidelines in effect on this date.
j ni�:c
Engineer's Printed Name Steven R Pannone, RE Q� i� N, C-- E'D ,A 7
Date eie�—•( ��•
COSA Fee $ 51 r `J_O
Date of Payment Z
Receipt Number
(Rev. 11/05)
U 6�
Waiver Fee $ _
Date of Payment
Receipt Number
in.
99-140
SKYHILLS SUBDIVISION,
LOT 21, BLOCK
43,635 S.F.
111=40'
OF A4 11
.
:..497ti.........'S: * i
:. ..e......... r......a
' . Jeffery o aI r
P�
•.� LS -6091 •�' O� t"
a
GASTALDI LAND
SURVEYING, LLC
JEFF A. GASTALDI, R.LS.
4726 WEST 88TH AVENUE
ANCHORAGE, ALASKA 99502
PHONE 248-5454
IGRID 2222 I DATE 17/2006
F.B.
08-03 I JOB N0.
SHS3213
PHASE 3
3
BUILDING DETAIL
SCALE 1"a20'
I HEREBY CERTIFY THAT 1 HAVE SURVEYED THE
PROPERTY DEPICTED ABOVE AND THAT NO
ENCROACHMENTS EXIST EXCEPT AS INDICATED.
IT IS THE RESPONSIBILITY OF THE OWNER TO
DETERMINE THE EXISTENCE OF ANY EASEMENTS.
COVENANTS OR RESTRICTIONS WHICH DO NOT
APPEAR ON THE RECORDED SUBDIVISION PLAT.
UNDER NO CIRCUMSTANCES SHOULD ANY DATA
HEREON BE USED FOR CONSTRUCTION OR FOR
ESTABLISHING BOUNDARY OR FENCE LINES.
ANCHORAGE RECORDING DISTRICT, ALASKA
NOTE: NO CORNERS SET THIS DATE