HomeMy WebLinkAboutSANDHILL LT 1Sandhill
Lot 1
#050-522-03
. Municipality of Anchorage
;
Development Services Department
Building Safety Division -
On -Site Water and Wastewater Program, 4700 S. Bragaw SL
P.O. Box 196650 Anchorage. AK 99519-6650 Page of
www.d.andtorago.akva (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number. SW020187 PID Number. 050-522-03
Bart or Corinne Browning
Wastewater System: Q New ❑ Upgrade
�.."
24842 Eagle River Rd, Eagle River
ABSORPTION FIELD
P�: 622-3159 K" alawva,r:
o u.., n.b, o sirbw rrwrn pa.a Oua.ir Ootn«:
LEGAL DESCRIPTION
alt "v0.8
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X 1 Sandhitl
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Well: ElNew E3 upgrade
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SEPARATION DISTANCES
Elsepuc ❑Holding ❑S.T.E.P. ❑Other.
To
Septic
Absorption
Lift
Holding
to
Fmm
Tank
Field
Station
Tank
Sewer Lkv
Anchorage Tank
1250 dr
W"
113'
110'
N/A
N/A
80'
Steel
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ewrw
>200'
>200'
N/A
N/A
LIFT STATION
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75'
38'
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37'
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N/A
N/A
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BENCH MARK
.arm r,awrryaa.
Top of Garage floor stab
wm.
500 Ft.
Engineer's Stamp
OF A`'l
Inspections performed by: Dan Ottenbreit Oates: 1r 9/4/2002
^' P� ••' � :455
1
9/102002
2n°
Development Services Department Approval
Reviewed and approved by
m toot Date
C. OttmlWt:
x'1007
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jl@y oil/IsN, ,.
Permit No. SW020187
Page __.Z_of_ 3
Nfi nicipality of Anchorage
Development Services Department
Building Safety DKIsbn
On-Sde Water and Y.'astemiter Program, 47CO S. Bragaw St
P.O. Box 19.650 Anchorage, AK 99519.6650 Page
wv%w.ci anchorage ak.us (9C7) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Legal Description: Lot 1,431eek-4-Sandhill
i r Q
113'
n � � 1250 gui
�'31,
—38
PID No.: 050.522.03
As built plan
Scale: 1"= 75'
of
Permit No. SW020187
Page 3 of 3
Dltuticipality of Anchorage
Development Services Department 1 �y;
Bulk.9ng Safety DMsbn
On-S1e Water aM Wastewater Progarr, 47CO S. Brag3N St
P.O. Box 19t'850 Ano'"2W, AK 99519-8;50 Page of
*w* CI 3nChV30e ak.us 190713317903
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Legal Description: Lot 1.-Bfeek-trSandhill PID No.: 050-522.0
Nlrtes
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Drainfield Frofile
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51' 60'
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Standpipe location plan Scale: 1' = 30'
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Certitf eb Log
by
Dec CO. dw
SULLIVAN WATER WELLS
P.O. BOX 670272, CHUGIAK, ALASKA 99567 • TELEPHONE 688-1750'
3 ) cJ,) l of t_ »17 s 7
OWNER OF LAND: _/1•^I ,C n ,� COt�IrJkJf f BORE HOLE DATA
ADDRESS:
LEGAL DESCRIPTION: SA' JO N?e-L L
DATE: —TT/ -
PERMIT NUMBER: (A;) 7 Date of Issue-i°� J 0
TAX IDENTIFICATION NUMBER: L O - �• n 3
Is well located at approved permit location? (Jes J No
Method of Drilling: t:t3ir rotary J cable tool
Depth of well ' FIL
Casing Type /.s Wall Thickness �s� inches
Diameter_ inches, depth 0 S feet
Liner Type:
Casing Stickup Above Ground: ON feet
Static Water Level /
feet
Recover Rale: gpm
Method of Testing: 1419 -
Well Intake Opening Type: � open end Lk peen hole
`/-,.j Screened; Start feet Stopped feet
;T) ;
J Perforations = ' Start ' feet' Stgpped feet
7-' 7 r Tc CNe
Grout Type: f r •^� • � Volume 04 ,J 1.
Depth: from i7 feet, to ^! J feet
Well Disinfected Upon Completion? 4 '?es D No
Method of Disinfection: `14LJ.'r.J
Driller's Name
ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality
of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. MatSu Borough:
Department of Environmental Conservation.
c
��r
Driller's Name
ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality
of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. MatSu Borough:
Department of Environmental Conservation.
Municipality of Anchorage
Development Services Department
• Building Safety Division
On -Site Water and Wastewater Program : '':''' .`` nOki-
P.O.
4700 South Bragaw St. ` :-
P.O. Box 196650 Anchorage, AK 99519-6650 . r
www.cf.anchorage.ak.us
(907)343-7904
ON-SITE SEWERIWELL SUBMITTAL COMMENT SHEET
To: Daniel Ottenbriet
Legal description: Sandhili Subdivision Block I Lot I
The attached paperwork has been reviewed and is being returned for the following reasons:
® Original signature or stamp missing on Page 2 of 3 and Page 3 of 3
❑ Calculation error in design. _
❑ Additional soils information needed. _
❑ Water monitoring results Inadequate. I
ElDiscrepancy in Information submitted._ _ "F' �` "� D E
❑ Topographic information missing or inadequate. _
® Incomplete; missing Water Weil Loo
❑ Incomplete; missing _
❑ Additional adequacy test information needed.
❑ Water sample unacceptable. _
❑ Measured/proposed distances/dimensions missing. _
❑ Locations of all soils, percolation and water monitoring tests not shown.
❑ Proposed system too deep for soils information submitted.
❑ Well log required. _
❑ Omission in narrative.
❑ Insufficient fill over tank or field.
® Other. Please out drawings on page 2 of 3 and 3 of 3 on Development Services letter
head.
Name of reviewer. Dan
Date: 8-6-03
Please supply the necessary information and re -submit your request.
LEAVE THIS FORM ATTACHED TO THE PAPERWORK
Permit No. SW020187
Page 2 of 3
Municipality of Anchorage
DEPARTMENT OF HEALTH 8 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 1. Block 1. Sandhill
r•i
ro
PID No.: 050-522-03
As built plan
Scale: 1' = 75'
91W
'Permit No. SW020187
Page 3 of 3
Municipality of Anchorage
DEPARTMENT OF HEALTH & 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 1. Block 1. Sandhill PID No.: 050-522-03
� I
Standpipe location plan Scale: 1' = 30'
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Pr.11if..:d I',o(J I<..
Georgie P. 111uereh.
Mayor
May 12, 2003
Anchorage
Munieipa"'Y of Anchorage All-AmedcaCity
Building Safety Division
2002
Bart or Corinne Browning
1720 Kodiak St.
Anchorage AK 99504
Subject: On -Site Water and/or Wastewater Permit.
Permit Number: SW020187
Legal Description: Sandhill Lot 1
Dear Bart or Corinne Browning:
An On -Site Water/Wastewater Permit, number SW020187, issued by this office for a single-family
system, will expire on June 20, 2003. This permit was valid for 365 calendar days.
If this was a well permit and the well has been drilled, a well log must be sent to this office for
documentation of the installation and to close the permit.
If this permit was for a wastewater disposal system, an original as -built inspection report must be sent to
this office for review, approval and documentation. This as -built inspection report must be signed by
the licensed Professional Engineer who inspected the installation of the system. As -built inspection
reports are required to be submitted within 30 days of the completion of the system.
If no system was installed under this permit, and you are still planning to install a well or wastewater
disposal system, a new permit must be obtained from this office. A new permit for a second year may
be issued for a fee of $100.00 if the renewal application is received on or before the expiration date of
the original permit.
When applying for anew permit, the fees are: $400.00 for a wastewater permit and $150.00 for a well
permit.
If you have any questions, please call this office at 343-7904.
Sincer y,� ,
,�&V
Jame C
ross,, P.E.
Manager
On -Site Water and Wastewater Program
Enc: Copy of permit
P.O. Ilox 19G650 • Anchorage, Alaska 99519-66)50 • Telephone: (907) 3#3.8301 • Pas: (907) 343-5:00
4700 South Bragaw Strcet • Anchorage, Alaska 99507
lritp://c%ic-%v.ci.anchorage.nlc.us
MUNICIPALITY OFANCHORAGE
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 I WATER SUPPLY PERMIT
Initial
Permit Number: SW020187
Legal Description: SANDHILL LT 1
Date Issued: Jun 20, 2002
Expiration Date: Jun 20, 2003
Parcel ID: 050-522-03
Design Engineer: 0826 Dan Ottenbreit Site Address:
Owner Name: Bart or Corinne Browning Lot Size: 75309 SQ. FT.
Owner Address: 1720 Kodiak St. Total Bedrooms: 4 Permit Bedrooms: 4
Anchorage , AK 99504 -
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 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: I- 2 F - 0 z -
Issued By: ��/l 1�L/' / ✓a -t// Date: ( –a O 0.2—
Municipality of Anchorage
Development Services Department
1 Building Safety Division
\ On -Site Water and Wastewater Program „
4700 South Bragaw St
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 05*243-000 Permit Number SW U 2 O 1 7
Propertyowner(s) PZi v -a' C= 0r ay phone J b7 -;.;,Y- 31Sq
Mailing address (1) /190 KsLr-K- Plicls 14K
Mailing address (2) Zip Code q 45 0 4
Legal description (Lot, Block & Sub'd.) Lot 1,8ieel*4, Sandhill Subdivision
Legal description (Section, Township & Range) Section 23, T14N, Rt W
Lot Size 75,309 Acre Sq.Ft Number of Bedrooms I
THIS APPLICATION IS FOR:
Sewer Only ❑ Well Only ❑
Sewer and Well 10 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
Permit Fees: S�� • DU Waiver Fees:
Date of Payment: Date of Payment:
Receipt Number. a1 O �,a Receipt Number.
(Rev. 12!00)
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.muni.org/onsite
(907)343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 05052203.000 Permit Number SW
Property owner(s) BMA. - nr Day phone 31 rri
Mailing address (1) 1-) z0 k o A n t 'St- A nt'l, YZ k
Mailing address (2) Zip Code Cl ase U
Legal description (Lot, Block & Sub'd.) Lot 1, Block 1, Sandhill Subdivision
Legal description (Section, Township & Range) Section 23, T74N, R1W
Lot Size 75,309 Acres/Sq.Ft. Number of Bedrooms 4
THIS APPLICATION IS FOR:
Sewer Only
❑
Well Only
❑
Sewer and Well
ED
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
Permit Fees: Waiver Fees:
Date of Payment:
Receipt Number.
(Rev. 12/00)
Date of Payment:
Receipt Number:
On -Site Sewer/Well Permit Application
For Lot 1, Block 1, Sandhill Subdivision
Eagle River, Alaska
This is an application to install a new septic system and water well for a single family residence.
Table of contents:
This page: Design of septic system & narrative description of impacts to adjacent properties.
Page 2: Site plan
Page 34: Leach field cross section and septic system notes
Page 5-7: Copies of Leach test results and soil logs (Originals are on file at Municipality of Anchorage
for Sandhill Subdivision, submitted in November 1992)
Page 8: Ground water monitoring tube logs
Design of septic system:
a. A shallow trench was selected for this septic system because of water table depth found at 7.5'
below ground surface at test hole 7 in 1992. Thus bottom of leach field elevation was selected
at 3' below surface level.
b. The proposed house will have four bedrooms.
c. The leach tests results in test hole 7 indicated a 8 minute per inch percolation rate at the
planned bottom of drainfield elevation.
d. Proposed drainfield will be4h;cQ 5' wide shallow trenches with 6" of gravel below the
perforated pipe to keep the bottom of drainfield 4' above maximum seasonal water level.
e. Calculations for proposed shallow trenches: 150 gpd/bedroom / (0.8 gpd/SF) • 4 bedrooms =
750 SF of drain area. Trench area per linear foot = 5' width = 5 SF/LF. Required trench length
= 750 SF required drain area / 5 SF/LF =150 LF. Two trenches @ 75' =150'.
f. Calculations for reserve: 150 gpd/bedroom / (0.6 gpd/SF) • 4 bedrooms = 1000 SF. Trench
area per linear foot = 5' width + (i' depth " 2 sides) = 7 SF/LF. Required trench length= 1000
SF required drain area / 7 SF/LF = 143' LF.
2. Narrative description of probable impacts to adjacent properties:
a. Although some of the property lines are within 100' of the proposed well and septic system, all
the adjacent lots have existing wells and on-site septic systems. Except for the septic system
shown on Lot 3 , all adjacent wells and septic systems are more than 200' away from the
proposed well, and septic system and reserve.
On Site Sewal Well Permit Appliation Page 1 Jure 18, 2002 For Lot 1, Block 1 Sen&ill Subdivision
/ Proposed \
well
14 \
0
I+
T
sN
. F
C
0O
h
0
f''1
0
N
3
3
Scale: I"= 50'
On -Site Sewer/Well Permit Application Page 2 June Ig, 2002 For Lot 1, Qloek 1 Sendhill Subdivision
�4' ABS Threaded
,,, cap & Fitting BackFill with
taken
^=�"a Mound back Fill Soil
S.."'ace For drainage From top 2'
of excavation
5'
Drainfield cross section
Septic System Construction Notes:
1. Septic Tank.
a. Septic tank shall be constructed by a Municipality of Anchorage (MOA) certified septic tank
manufacturer.
b. Septic Tank shall have a minimum 1250 gallon capacity, have a four -inch or larger diameter
standpipe with an airtight cap providing effective access to each compartment, and a cleanout
installed one to four feet from the building foundation, and in the line between the tank and the
distribution system there shall be two adjacent cleanouts. The cleanouts shall be located on
undisturbed soil not more than ten feet from the tank. The first cleanout in the line shall be to
clean the line toward the distribution system and the second cleanout will be oriented to allow
cleaning toward the septic tank. Clean outs and standpipes shall be capped airtight and shall be
easily located year round.
c. Septic tank must be installed only in an area that will continue to be readily accessible to a
pump truck. The point of access for the pump truck must be no more than 100 feet from the
septic tank. The ground surface at the point of access for the pump truck must not be more than
I I feet higher than the bottom of the septic tank.
d. Septic tank shall be installed level and on compacted or undisturbed soil and have at least 2' of
soil cover. Provide one inch of insulation over septic tank if it has 3'-4' of soil cover and two
inches of insulation if it has 2'-3' of cover.
e. Cleanouts and standpipes shall be minimum 4" diameter pipe made of any of the following
materials:
i. Cast iron
ii. PVC conforming to ASTM D3034
iii. ABS conforming to ASTM D2662
f. Insulation shall be polystyrene, recommended by the manufacturer for direct burial, Dow
Chemical Styrofoam or equal.
g. Septic tank installation shall conform to Uniform Plumbing Code.
2. Leach Field and Piping
a. Pipes shall be minimum 4" diameter pipe made of any of the following materials:
i. Cast iron
ii. PVC conforming to ASTM D3034
On -Site Sewer/Well Permit Application Page 3 June 19.2002 For Lot I. Block I Sandhill Subdivision
Solid 4' ABS
'=Cr
c
Perforated /
Foam instil.
-
Sewer
4' ABS pipe
\\/
2.
ibG o 0 o c
>°o°°°°c
0 0 0 0 0 0 0 0 0
of „'0°00O°o°0°0°0°
t t o 0 0 0 0 0 0
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5'
Drainfield cross section
Septic System Construction Notes:
1. Septic Tank.
a. Septic tank shall be constructed by a Municipality of Anchorage (MOA) certified septic tank
manufacturer.
b. Septic Tank shall have a minimum 1250 gallon capacity, have a four -inch or larger diameter
standpipe with an airtight cap providing effective access to each compartment, and a cleanout
installed one to four feet from the building foundation, and in the line between the tank and the
distribution system there shall be two adjacent cleanouts. The cleanouts shall be located on
undisturbed soil not more than ten feet from the tank. The first cleanout in the line shall be to
clean the line toward the distribution system and the second cleanout will be oriented to allow
cleaning toward the septic tank. Clean outs and standpipes shall be capped airtight and shall be
easily located year round.
c. Septic tank must be installed only in an area that will continue to be readily accessible to a
pump truck. The point of access for the pump truck must be no more than 100 feet from the
septic tank. The ground surface at the point of access for the pump truck must not be more than
I I feet higher than the bottom of the septic tank.
d. Septic tank shall be installed level and on compacted or undisturbed soil and have at least 2' of
soil cover. Provide one inch of insulation over septic tank if it has 3'-4' of soil cover and two
inches of insulation if it has 2'-3' of cover.
e. Cleanouts and standpipes shall be minimum 4" diameter pipe made of any of the following
materials:
i. Cast iron
ii. PVC conforming to ASTM D3034
iii. ABS conforming to ASTM D2662
f. Insulation shall be polystyrene, recommended by the manufacturer for direct burial, Dow
Chemical Styrofoam or equal.
g. Septic tank installation shall conform to Uniform Plumbing Code.
2. Leach Field and Piping
a. Pipes shall be minimum 4" diameter pipe made of any of the following materials:
i. Cast iron
ii. PVC conforming to ASTM D3034
On -Site Sewer/Well Permit Application Page 3 June 19.2002 For Lot I. Block I Sandhill Subdivision
iii. ABS conforming to ASTM D2662
iv. Perforated pipe used only as drainficld pipe and the bottom portion of monitor tubes
maybe HDPE pipe conforming to ASTM F810
b. All horizontally laid perforated pipe in a subsurface disposal field and the bottom of the
excavation must be level.
c. Insulation must be placed over any wastewater line or pipe, over which a driveway, parking or
vehicle storage area may be constructed or elsewhere which has less than 4' of cover. Provide
one inch of insulation for pipes with 3'-4' of cover and two inches of insulation for pipes with
2'-3' of cover.
d. All pipe and leach field shall have a minimum of 2' of cover.
e. Sewer rock shall be rock measuring 0.5 to 2.5 inches in diameter with no more than three
percent of the material passing a number 200 sieve screen.
f. Blueboard Insulation shall be polystyrene, recommended by the manufacturer for direct burial,
Dow Chemical Styrofoam or equal, at least 2' wide.
g. Filter fabric shall be Typar 3401, Mirafi 140N or equal.
h. All piping shall be installed in conformance to Uniform Plumbing Code.
3. Required Inspections
a. Contractor shall prepare for, and coordinate with engineer, two inspections during installation
of on-site wastewater disposal system.
b. The first inspection must be conducted after the excavation of ditches, pits, trenches or beds
and before any gravel is placed in the ditches, pits, trenches or beds. A septic tank may be set in
place, but may not be backfilled before this inspection.
c. The second inspection must be conducted after the placement of the filter material, gravel,
distribution lines, standpipes, cleanouts, silt barriers and insulation, but before the placement of
any other backfill.
d. Contractor shall notify MOA at least two hours prior to each inspection.
On -Site Sewer/Well Permit Application Page June 19,2002 For Lot 1, Block I Sandhitl Subdivision
X,
190/1.1 LOC
MUNlC1PALITY OF ANCHORAGE TION rincot.ATION
DE►ApTMENT OF 11EALTH ANO ^IN" "S ME 284 io GTEC
TEST
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SOILS LOG — PERCOLATION TEST
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nmE0 Fon' r
repro pit.
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DEPARTMENT OF IIEALTII AND ENVIRONMENTAL PROTECTION
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Municipality of Anchorage
Development Services Department
• Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St. s ♦ i r
P.O. Box 196650 Anchorage, AK 995195650
www.ci.anchorage.ak.us
(907)343-7904
ON-SITE SEWER/WELL-=SUBMITTAL;COMMENTSHEET.
To: banial Ottenbreit
Legal description: Sandhill Subdivision Lot 1
The attached paperwork has been reviewed and is being returned for the following reasons:
® Original signature or stamp missing on Soils Tests
❑ Calculation error in design. _
❑ Additional soils information needed. _
Water monitoring results Inadequate. For reserve site
❑ . Discrepancy in information submitted.
❑ Topographic information missing or inadequate.
❑ Incomplete; missing
❑ _.Incomplete; missing _
❑ Additional adequacy test information needed. _
❑ Water sampleunacceptabie. _
2 Measured/proposed distances/dimensions missing. brainfield to lot lines
❑ Locations of all soils, percolation and water monitoring tests not shown.
[3 Proposed system too deep for soils information submitted. _
❑ Well log required. _
❑ Omission in narrative. _
❑ Insufficient fill over tank or field._
❑ Other. _
Name of reviewer. Jeff Poet
Date: 6-12-02
Please supply the necessary information and re -submit your request.
LEAVE THIS FORM ATTACHED TO THE PAPERWORK
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Municipality of Anchorage •
On-Site Water and Wastewater Program o2`,� s
t c_ (907) 343-7904
S ti rr r
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 050-522-03Expiration Date: I ^ 12 t.E?
1. GENERAL INFORMATION
Complete legal description Sandhill Lot 1
Location (site address) 24842 Eagle River Rd, Eagle River, AK
Current Property owner(s) Browning Day phone 854-2149
Mailing address same
Real Estate Agent Owner Day phone 854-2149
u<35789
. 10
2. TYPE OF DWELLING: r, M
® Single Family (w/wo ADU) // _ \1
ra-❑ Duplex J
❑ Multiple Dwellings (Single Family and/or Duplex) ted' A /
°l. ti g Ci
3. NUMBER OF BEDROOMS: 4
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well ® Individual
Individual Water Storage ❑ Holding Tank ❑
Community Class C Well ❑ Community ❑
Public Water System ❑ Public Sewer ❑
Received by: Date:
12/( P
COSA to be released to the engineer,unless othe ise requested by the engineer.
COSA Fee $ SiP-( Date:
Date of Payment Li—;S—lr Date of Payment
Receipt Number 0(iga91. Receipt Number
COSA# 05CF«<PWaiver#
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 NorthRim Engineering Phone 694-7028
Address PO Box 770724,Eagle River
Engineer's Printed Name Steve Eng Date 4/25/20.18
76,
•
•.':``'-' aS,,
_ 4.
6. DSD SIGNATURE
System #1 Approved for ( bedrooms. y 4•
`4
System #2 Approved for bedrooms. ' e. ,(s�Jv �. :
Disapproved.
L /2s.vie.
Conditional approval for bedrooms, with the following stipulations:
J� ON-SITE
WATER AND .
WASTEWATER oz
PROGRAM
By: •
Original Certificate Date:
The Municipality of Anchorage Devlopment 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
dvisory_Septic System Advisory Arsenic Advisor C:,
Well Flow Advisory Other • •
-
COSA blue sheet 9-1-12.doc ` '
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: . ->//A6y/LL L 0r / Parcel ID: 056 52203
A. WELL DATA
Well type P If A, B, or C provide PWSID# Well Log (Y/N) /
Date completed 7//7/a Z Sanitary seal (Y/N) Wires properly protected (Y/N) y'
Total depth 290 ft. Cased to /05 ft. r Casing height (above ground) Z4/ in.
FROM WELL LOG AT INSPECTION
Date of test. 7/7/6 I(//Z//f
Static water level /30 ft. Si? ft.
Well production 3 g.p.m. 417L- g.p.m.
WATER SAMPLE RESULTS:
Coliform colonies/100 mL Nitrate • 3S mg/L '1
Arsenic t 0 ug/L Date of sample:
LI"2` -le Collected by: a ty1�
y
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material --.F_Prf C /STL-E'L Date installed 7/074 Z
Tank size /250 gal. Number of Compartments Z / Cleanouts (Y/N) YFoundation cleanout(YIN) I Depression over tank(Y/N) /V High water alarm (YIN) /V
`1
Date of pumping -7I rl-1 Pumper 4 e,
C. ABSORPTION FIELD DATA
stialloc,,
Date installed r//O/02 Soil rating (g.p.d./ft2 or ft2/bdrm) C'• 8 System type 7 q.1c-A
Length 2€ 75-i ft. Width 5 ft. Gravel below pipe a. -s ft.
Total depth 3 ft. Eff. absorption area 7gO ft2 Monitoring tube y Depression over field N
Date of adequacy test i//2/"i Results (Pass/Fail) I For V bedrooms
Fluid depth in absorption field before test 6 in. Water added 64O gal. New depth / in.
Elapsed Time: 2 0 min. Final fluid depth d in. Absorption rate >_ '00 g.p.d.
Any rejuvenation treatment(past 12 mo.) (Y/N &type) (J/JJ('' If yes, give date
D. LIFT STATION /A/'4
Date installed Size in gallons Manhole/Access (Y/N)
"Pump on" level at in. "Pump off' level 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 /oO On adjacent lots /a
Absorption field on lot /Oaf,- On adjacent lots /al() (1"
Public sewer main /0C 1f" Public sewer manhole/cleanout • /0a
Sewer/septic service line 2 "�4- Holding tank /60 ri'•
Animal containment areas 56 ('f" Manure/animal excrete storage areas /0 C '¢
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation /Q it- Property line /O 11— Absorption field S 14-
/
Water main / ''+` Water service line /0 -� Surface water /0.0 'f'
Wells on adjacent lots /DIf"
ABSORPTION FIELD ON LOT TO:
Property line /D rf Building foundation r' /`t- Water main /a `,`
Water Service line /0 Cf- Surface water /a 0 1'f" Driveway, parking/vehicle storage /O '74-
Curtain
'r'Curtain drain /JA/ Wells on adjacent lots (0 d ''F
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and , '`.�".� 1
•
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this date. ) %Oft-_' ' ' ... �••°�1`
.
411111.1
Engineer's Printed Name / � �l�G
e_05-e_05- • e-
Date 105 /r
COSA yellow sheet 2-6-15.doc
•
s
o POST IN A CONSPICUOUS PLACE ,t>>c n t
/ �4 �, •
ALL WORK MUST BE INSPECTED N`, `
f Field Inspection Request required 2 working days in advance of starting work r,
t C , / and 2 working days in advance for final inspection. Call(907)343-8206 --.-" :-,;:.,4,-,--#r ;.
�� / (voice recorder)for scheduling. Permit is not valid without the call-in and also {+ '' ;
/ must include the one-call ticket(utility locate)number. I)e P a r t til(t ti t
MUNICIPALITY OF ANCHORAGE
RIGHT OF WAY DIVISION
4700 ELMORE ROAD
TELEPHONE(907)343-8240
RIGHT OF WAY PERMIT ` '„R R181522
Type: Encrchmnt Grid: SW0262 Date Issued: 6/5/2018
Construction Start: Last Update by: PWMER
Last Updated: 06/05/2018
Permittee: BROWNING BART G&CORINNE M
Contact Person: Steve Eng,694-7028/830-4186 Primary Inspector: J.Sauerbrey 343-8044
Site Address: 24842 EAGLE RIVER RD,Eagle River-@ Cates Avenue
ii
Legal Description: SANDHILL LT 1 G:0262
Original Work NW,.,
Description: Encroachment of a stand pipe from septic 5'into 33'Drainage Easement. t
Financial Summary
Fee Description QTY AMT
Permit 1.00 115.00
Total Fees: 115.00
See reverse for requirements/remarks.
I have read and understand both sides of this permit. I agree to the terms and conditions;and I certify that all work will
comply with federal,state, and municipal codes and regulations and the provisions of this permit.
Signature: Date: / 1 \l�.,.-.�_ 7____ f
•
... .. , .• -----• that t have surveyed
' r
I hereby oertity yea .
`'4 described property: lot 1.
� 'S�'?S (� !�` the following 6 •
Q9�0- rd E»! '...r.
$andhlll Subdivision. Eagle 12iver,
Aochorsge ng Eagle District.
s o :>�F�� V....� r,�:
Alaska and that no encroachments
exist except as Indicated heron. This
Aa-built will only show the easements,
‘PS: covstnanis. or restrictions that appear
I on the recorded subdivision plot /93-116:
A.9S\`"rsubdivisionunder no circumstances should any data
fii3j--.\` hereon be used for oonatnsotion or for
\\ establishlog boundal7 or fence linea,
E unless noted.
ik .\
\ `\ `•j Dated at Eagle River, Alaska ^C •
i • ::•\�. This dal of �tt/vVQ 20 SG.+
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a P)3s\ 7 ci' . I. Anthony P. oneta
e49 !✓\ s�4i i •.04♦., No. 10393 'i.�
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Lis.......,:mais±11AS—BUILTSCALE: 1" = 50' Prepared By:
Saudill ' DATE: 6/01/05 Anthony P. Boneta
. ' -t--- BRAWN BY: _-AP-B-• __ ---_
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4 41
MUNICIPALITY OF ANCHORAGE `° s
( .,, )
Development Services Department7 -
r �r
' , dor', 'l.
Right of Way Section , v
Department
ENCROACHMENT PERMIT R181522
THIS AGREEMENT, made this 7th day of June, 2018, by and between Bart Browning and
Corinne Browning and their heirs,administrators,and assigns, hereinafter called"PERMITTEE",and
the Municipality of Anchorage, a municipal corporation organized and existing under its Charter and
the laws of the State of Alaska, hereinafter called the"PERMITTER".
WITNESSETH:
WHEREAS, PERMITTEE is the owner of the following described real property:
SANDHILL SUBDIVISION, LOT 1, according to the official records thereof, on file
in the office of the District Recorder, Anchorage Recording District, Alaska, and;
WHEREAS, PERMITTER owns and/or maintains the real property more particularly
described as follows:
The ONE HUNDRED AND SIXTY FOOT RIGHT OF WAY OF EAGLE RIVER
ROAD, immediately to the north of PERMITTEES property as shown on Plat No. 93-
116, on file in the office of the District Recorder, Anchorage Recording District,
Alaska, and;
WHEREAS, PERMITTEE has placed a septic standpipe upon the referenced real property
which encroaches 5.0 feet upon the PERMITTER'S 33-foot BLM Section Line and Drainage
Easement.
NOW, THEREFORE, it is mutually agreed between the parties hereto that:
1. The PERMITTER, acting through the Director of Development Services
Department,hereby grants to the PERMITTEE the privilege of allowing a septic
standpipe to encroach 5.0 feet upon the PERMITTER'S 33-foot BLM Section
Line and Drainage Easement, as shown on"Attachment A," included herewith.
2. The PERMITTEE agrees forever to indemnify, defend, save and hold harmless,
the Municipality, its officers and employees,from any and all lawsuits,claims or
actions brought to any person for or on account of damage to property or injury,
disease, illness or death of persons, including all costs and expenses incident
thereto, arising wholly or in part from or in connection with the existence of,
alterations, maintenance, repair, renewal, reconstruction, operation, use or
removal of the encroaching septic standpipe,as placed upon the PERMITTER'S
33-foot BLM Section Line and Drainage Easement.
3. The PERMITTEE shall not assign or transfer any of the rights granted herein to
another individual or company without first notifying and securing the approval
of the Director of Development Services Department.
4. This Agreement and Permit grants PERMITTEE no interest in PERMITTER'S
real property whatsoever, except only the encroachment rights described herein.
5. The PERMITTER reserves the right to revoke this permit upon twenty(20)days
written notice to the PERMITTEE. The PERMITTEE agrees upon such notice
of revocation,to move said encroachment(s)from the 33-foot BLM Section Line
and Drainage Easement in which it is placed. Should the PERMITTEE refuse or
fail to comply with said written notice, the PERMITTER may, without further
notice to the PERMITTEE, remove or cause to be removed the encroachment(s),
and the PERMITTEE hereby agrees to reimburse the PERMITTER for all costs
incidental to the removal thereof.
In addition to the mutual promises heretofore made,the PERMITTEE has paid the PERMITTER a
one-time permit application fee of $115.00. The PERMITTER hereby waives the annual fee of
$300.00.
IN WITNESS WHEREOF, the parties hereto have hereunto set their hands and seal the day
and year first hereinabove written.
GRANTEE: GRANTOR: MUNICIPALITY OF ANCHORAGE
1 e u ��
Bart Browning J L. Frost, Jr.
Owner fight of Way Supervisor
•
C •.,- r
Corinne Browning
Owner
G:Land Use Permitting and Enforcement Right of Way Letters Encroachment.LON.Denials.etc S SandhiU.Lot I.Browmng.ENC.docx
STATE OF ALASKA )
)ss.
THIRD JUDICIAL DISTRICT )
THIS IS TO CERTIFY that on this 7th day of June,2018, before me,the undersigned,a Notary
Public in and for the State of Alaska,duly commissioned and sworn as such,personally appeared Jack
L. Frost, Jr., known to me to be the Right of Way Supervisor for the Municipality of Anchorage,
Alaska, who executed the foregoing instrument, and he acknowledged to me that he executed said
instrument as the free and voluntary act and deed of said corporation for the uses and purposes therein
mentioned,and that he was authorized to execute said instrument.
WITNESS my hand and official seal on the day and year first above written.
01111104e/ r� �! ,�
`41I it 7. R�B�2c NOTARY My and for
Commission Expires: 0
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STATE OF ALASKA )
)ss.
THIRD JUDICIAL DISTRICT )
a
THIS IS TO CERTIFY that on this //'day of , 2018, before
me,the undersigned, a Notary Public in and for the State of Alski,duly commissioned and sworn as
such, personally appeared Bart Browning, known to me to be the individual(s) named herein who
executed the foregoing instrument, and he acknowledged that he did so freely and voluntarily for the
used and purposes therein mentioned, and on oath stated that he was authorized to execute said
instrument.
WITNESS my hand and official seal on day and year first above written.
' 1 ,
0111111/0/ Ci
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/.'i-•• My Commissc Express�1 NOTARY U IC in and �r Al�sk L'/ e lc(
:NOT
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G.Land Ilse Permitting and Enforcement Right of Way'Letters Encroachment.LON.Denials,etc S Sand/nil.Lot 1.Browning.ENC.docx
STATE OF ALASKA )
) ss.
THIRD JUDICIAL DISTRICT )
THIS IS TO CERTIFY that on this //'r day of ,
2018, before
me, the undersigned, a Notary Public in and for the State of A afika, duly commissioned and sworn as
such,personally appeared Corinne Browning,known to me to'be the individual(s)named herein who
executed the foregoing instrument,and she acknowledged that she did so freely and voluntarily for the
used and purposes therein mentioned, and on oath stated that she was authorized to execute said
instrument.
WITNESS my hand and official seal on theAy and year first above written.
y
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�\\\4:•• ' KC•••`.r My Commission EExpires:///a-1 LIC in /
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01110110
G:Land Use Permitting and Enjarcement Right of Way Letters Encroachment.LON.Denials.etc SSandhill,Lot 1.Brow•ntng.ENC.docx
;"., thereby certify that 1 have surveyed
6 �,SO . rd (?E.,� /R-.., the following described property: Lot. I.9y\\ Sandhill Subdivision. Eagle River,
•SB O (�21,k.c V,'•.I t'e Anchorage Recording District,
( Alaska and that no encroachments
�\ axial except as indicated heron. This
As-built will only show the easements,
i \,�S. covenants. or restrictions that appear
.`,•��C' F �
•�s 1 on the recorded subdivision tet d3-116,
` p?;�. ,-• under no circurnatences should any data
1,43'-.• ` hereon be used for construction or for ;
establishing boundary or fence lines.
j \� unless noted.
N. -\
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\ Dated at Eagle River, Alaska
5
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This day of _�t�� 20 QJ
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AS—BUILT Survey Lot 1 SCALE: 1" = 50' Prepared By:
Sandhill Subdivision DATE: 6/01/05 Anthony P. Boneta
Plat # 93-116 DRAWN BY: APB 1
Affacktp A