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HomeMy WebLinkAboutWILLIAMSON #2 BLK 3 LT 1Williamson #2 Block 3 Lot 1 #015-074-01 Municipality of Anchorage .;" • ., . Development Services Department Building Safety Division — On-Site Water and Wastewater Program, 4700 S. Bragaw St. P.O. Box 196650 Anchorage, AK 995138650 Page I of 3 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SW030403 PID Number. 015-074-01 Neme: Julian Gonzalez Wastewater System: ❑ New 0 Upgrade 5001 E. 98th Ave., Anchorage, 99507 ABSORPTION FIELD ptW : 14 n aesbowm: 3 13D 7r El st m TmmhOew ❑MwmF ❑oeWr. LEGAL DESCRIPTION sa Rawq: 0.8 TOW D.,A, hon erynM WM : Gp01F1' 7,31 m. Blotll LOL $YWMYwI: 3 1 Williamson #2 DWh W PPe hdIOA km Onge We : G," dwM h M POe: 3.37 FI. 3.94 Fr. Tmmhq: Rwps: sechan: /a eeFea &O Or P" gP :. Grewa Length: — 0.5.0.6 F,, 58.0 Fr. Well: ❑ New ❑ Upgrade 5.0 NunWo t `". D,IwK. h«w.an wW FI. NA . Clatwid I (P W. A e. C): TOW D"M: Cewtl W. TOW ehwrpwn wee: Pqe WWW: Existing Class A system I Fr. I FI 575 F,+ I ASTM D3034 D~ DOW o"Wd: SWW W" Le : WWI'.Acheson lntr ; FL Acheson Ent. 10/14/03 se FL Nw,nl„".. GAWP. TANK GPM Fr. SEPARATION DISTANCES ❑septic ❑Holding ElS.T.E.P. ❑Other. To Septic Absorption LIR Holding ublk9Prtvate 1tliMi1 b' From Tank Field Station Tank Sewer Line Anchorage Tank 1250 Gr. w« 200+ 200+ 200+ NA NA WWw. 10 ga. steel wn2 wW. sud' W" 100+ 100+ 100+ NA LIFT STATION LW TAW 25 6e 25 NA u Integral cM. .uww. Anchorage Tank FOUNOW 19 10­1_ 10 NA 'P n 0r1' WMI FL 'Poop Orr W eLo h "W Mw 44 ti 38 W. 51 M. C~ Dm NA NA NA NA nnp MoP2 OwcoPZO EWcbrW W t ry Curt Burgoyne ` : Lot is served by community water system. BENCH MARK Separation distances to wells on adjacent lots are (Ke4w1 w DewWul: Top of Manhole adequate (100 ft to private wells and 200 it to Mnhen: FL 97.36 Class A well). 'Lot line waiver to absorption field. E mp 49TH Cindy W. Ellis, P.E. a 10/9/03 Inspections performed by: y Dates: 1 _*.° 2nd 10/14/03 Development Services Department Approval inn C dyW. Ellis O Reviewed and approved by: Date: ! l- (- 3 CE-105 77 Ibml'rf� ...........CCS ssrrx,Wr"r. .!" Permit No. SW030403 Page 2 of 3 Date: 10/29/03 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description: LOT 1, BLOCK 3, WILLIAMSON #2 SUBDIVISION PID No.: 015-074-01 1,250 GALLON STEP TANK OLD TRENCH RETAINED \OLD SEPTIC TANK. *WDONED \ \ 1 C01�j 1 I I MT3i B I 1 A I p`l IS LOT SERVED 1 BY COMMUNITY WELL EXISTING ELL `100' RADI S EXISTING SHED OLD CRIB ABANDONED FENCED DOG RUN iX IMT1 /—EAST��98TH Al / EXISTING WELL 1100' RADIUS \ / MARK A B C DCOI 29.6' 17.1' --- 00O2 30.6' 18.7' --- STI 31.4' 20.4' --- ST2 34.2' 25.6' --- MH 35.6' 27.2' --- MTI --- 21.1' 45.2' MT2 --- 45.5' 19.7' MT3 25.4' 41.4' --- C01 53.0' 55.3' --- MT4 63.8' 63.3' --- C \\ MT2 — 1 I I I i i 5.0' WILLIAMSON /2 LOT 3 THIS LOT SERVED BY COMMUNITY WELL WILLIAMSON /2 LOT 2 THIS LOT SERVED BY COMMUNITY WELL EXISTING ADJACENT SEPTIC — EXISTING WELL 100' RADIUS APPROXIMATE LOCATION OF `v EXISTING WATER SERVICE LINE i PWSID 210639 i N U E — EXISTING CLASS 'A' WELL 200' RADIUS AE1 SCALE: 30' OF,A` 49TH i�r ..,/..r...... y Ci y W. Ellis (1Iif9:_, 10577 =AV Fn i Permit No. SW030403 Page 3 of 3 Dote: 10/29/03 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description: LOT 1, BLOCK 3, WILLIAMSON //2 SUBDIVISION PID No.: 015-074-01 89.66' 58.0' TRENCH N.T.S. Test hole l yh /5.6 ,q No water encolinfiered, � Velal��e &vin 91,97 = 1.25 0 PVC PIPE I 1,250 GALLON STEP TANK 10 GAGE STEEL I I I SEPTIC SECTION I N.T.S. I r-------------------------- -------------------------MT1 MTI--\4 MT2 I FINAL GRADE = 96.89' - 97.45' I 1.25.0 PVC W/ 0.25' ' HOLES AT 24O.C. NOTE: ORIGINAL GRADE FUER FABRIC 7 96.29' - 96.97' I L- 89.66' 58.0' TRENCH N.T.S. Test hole l yh /5.6 ,q No water encolinfiered, � Velal��e &vin 91,97 I FPOII : Fai-ESOf1 8n'ERPRISES FHOfE 117. : 907 3441 2715 Oct. 20 FOl DCT -79-03 07174 on TONS. CLP_CTRICHI INSPECTION REPORT MUNICIPALITY OF ANCHORAGE. BUILDING SAFETY DIVISION 33CO EAST TUDOR ROAD RAX 1 NAME ' ADDRESSO! t 4s �wG �PERMRN PHONEa LOTBLOCK 3 DSION ON tQQ w+snE COMM IONS: SUBM����R— roDAT! cu MidaG�r ifs I1IPE OF INSPECTION: g 3„iJX� REINSPECTION YEg NO NO NONCOIMPuANCE OB!!RVED CORR'CTIONS ESSENTIAL AS EXPLAINED &FLOW 1 WILL RE-EXAMINE AT NEXT IN3PlCTION I1 DO NOT eeuer, ...,........._ COMMENTS: (FOR INSPECTOR USE ONLY) / LLr' INSPECTOR OATL: / 1 WHEN CORRECTIONS ARE MADE PLEASE CALL FOR REINSPECTION DO NOT REMOVE THIS NOTICE 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 Upgrade Permit Number: SW030403 Legal Description: WILLIAMSON #2 BLK -3 LT --11 I U/q l"3- ob01-, Date Issued: Sep 29, 2003 Expiration Date: Sep 28, 2004 Parcel ID: 015-074-01 Design Engineer: 0844 Watkins Engineering, Inc Site Address: 005001 98TH AVE E Owner Name: Julian Gonzalez Lot Size: 14482 SO. FT. Owner Address: 2600 Cordova Street Total Bedrooms: 3 Permit Bedrooms: 3 ANCHORAGE. AK 99503 - 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: Issued By: Date: k)-3'03 Date: 2 9 09 Parcell.D. 015-074-01 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 SEWERIWELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Number SW 1036 403 Property owner(s) Julian Gonzalez - Barrow, AK Day phone 907-852-9209 Mailing address (1) c/o Tamera Kelly / Remax Properties, 2600 Cordova St., Anchorage, AK 99503 Mailing address (2) Zip Code Legal description (Lot, Block & Sub'd.) Williamson #2 SID, Blk 3, Lot 1 Legal description (Section, Township & Range) 5_D(7l f q2,l`' A ✓0, Lot Size 14,482 Aoce, Sq.Ft. THIS APPLICATION IS FOR: Number of Bedrooms 3 Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade ll 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 Family Dwelling and is in accordance with applicable Municipal Codes. i6 (Signature if property owner or authorized agent) Permit Fees: n ri Waiver Fees: Data of Payment: C1 Date of Payment: Receipt Number. qz�Receipt Number: (Rev. 74/00) Watkins Engineering, Inc RO Box 110443, Anchorage, AK 99511 (907)349-1851 cwellis®gd.net September 22, 2003 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 RE: Williamson #2 SID, Block 3, Lot 1 Sewer Upgrade Proposal To Whom It May Concern: Attached please find the application and supporting documentation for upgrading the onsite sewer system at the referenced 3 bedroom house in Anchorage. The existing system consists of a 1000 gallon steel septic tank and a 7 ft x 7 ft log crib installed in 1973, and a 76 ft x 6 ft effective deep trench installed in 1977. The drainfield and crib are now surcharged, and it is proposed to upgrade the system. The existing tank and crib are proposed to be abandoned in place. We propose to install a new 1250 gallon steel STEP tank and a 5 ft wide drainfield. The old drainfield will be retained as reserve. Mechanical problems have been experienced in the old drainfield, i.e. potential plugging of the piping. For this reason, the old drainfield will not be connected to the new system. However, it will not be abandoned, since it could be utilized in the future after solving the mechanical problems. The proposed design is based upon a test hole dug on September 12, 2003 to a depth of 15 ft. The soils log is attached. No water was encountered while digging the hole or after 7 days of groundwater monitoring. The soils encountered in the test hole were silt and silty sand, with pockets of clean sand and gravel. There were cobbles and boulders present, and the density of the silt increased with depth. A percolation test was performed between 6.5 and 7.0 feet. The percolation rate was measured at 7.5 minutes per inch, which warrants an application rate of 0.8 gpd/ ftZ. It is proposed that a conventional drainfield be installed between 3.5 and 7.5 ft. A lift station will be required. Sewer Upgrade Permit Application for Williamson #2 SID, 91k 3, Lot 1 Watkins Engineering, Inc.; September 22, 2003; page 2 Proposed Soil Absorption System: 3 Bedrooms x 150 gpd / BR = 450 gpd Application Rate: 0.8 gpd / ft2 Square Feet Required: 450 gpd / 0.8 gpd/ ft2 = 563 ft2 System Type: Shallow trench (5 -wide) Effective Depth: 4.0 ft Maximum Depth 7.5 ft Reduction factor = 0.5 Length Required = 563 ft2 / 5 ft x 0.5 = 56.3 ft Proposed Length: 56.3 ft This lot and adjacent lots to the north and east are served by a Class A public water system, PWSID 210639. The location of the water service line to the subject lot is not known and must be determined by the excavator to ensure adequate separation distance to the trench. The Class A well is greater than 200 ft away and the private wells are greater than 100 ft from the subject lot's septic tank and drainfield. There are no surface water concerns. I am not aware of any adverse effect that this upgrade would have on any adjacent properties' water and wastewater treatment needs. Thank you for consideration of this permit application. If you have any questions or need further information, please call me at 349-1851 or 360-3389 (cell). Yours truly, Cindy W. Ilis, P.E. President DESIGN CRITERIA: FOUND OVER 3 BDRM X 150 = 450 GPD (THII) GRADE SOILS = 450/0.8 = 563 SQ FT REQ'D -0.5 563/5 X (0.50) = 56.3' REQUIRED -2.5 ML n FILTER FABRIC .n AND INSULATION TRENCH: 7.5� DEEP 1.25'0 PIPE W/ 0.25'0 4.0 EFFECTIVE HOLES AT 24' O.C. 5.0' WIDE SM/ML DRAIN ROCK 56.3' LONG 5.0' -15.0 SPRINCHILLS ESTATES WILLIAMSON g2 SPRINCHILLS ESTATE LOT 14 LOT 4 LOT 12 WILLIAMSON 12 LOT 3 EXISTING WELL OLD CRIB 100' W )IUS — TYPICAL r — _ ___ SPRINGLOLTS13STA7; IN i 1 1� PROPOSED SEPTIC i / EXISTING HOUSE I WILLIAMSON J2 EXISTING EPTIC J LOT 2 EAST 9 8 T )f AVEA1 UE— r � I � I x I / \ � � � > I rI�------N—EXISTING WELL � 100' RADIUS SPRINCHILLS ESTATES- — o z J LOT 18 1 WILLIAAISON H12 EXISTING CLASS 'A' WELL i WTRACTSON 2 (200' WELL RADIUS) a LOT 37 %% r Septic Design Prepared For JULIAN GONZALEZ _��� F �F 0A� LOT 1, BLOCK 3 do��P' WILLIAMSON #2 SUBDIVISION 49TH '• yt �� _ Prepared By: DATE: 9/22/03E�� Watkins Engineering, Inc. PID NO. 015-074-01 / "in7o,Cindy W. Ellis, P.E., M.S. SCALE: 1"=100' /Io77 ind W. S• ANCHORAGE, ALASKA 99511-0443 DRAWN:0443 •— +40 PROFESSI PHONE: 349-1851; FAX: (907) 349-1934 CHECKED: CWE ONP� �� (907) `� EXISTING SHED EXISTING SEEPAGE PIT WILLIAMSON d2 TO BE ABANDONED LOT 3 EXISTING CRIB TO BE ABANDONED THIS LOT SERVED r — — — — BY COMMUNITY WELL MT, EXISTIN TRENCH i — — — TO RE RE 1�5E COs ------54. c—C� `�� MT FUT i I DOUBLE CO EXISTIN SEPTIC T , TO E AE NDON�ED� l j i r NEW 1,250\CALLON MT:I r STE TANK I �TH11 I THIS LOT SERVED TANK C.4. 1� i Jp j BY COMMUNITY WELL S 0. r i 10.85' i I� r WILLIAMSON /2 LOT 2 1.25'0 PIPE W/ J 0.25'0 HOLES MT AT 24' O.C. Q t0G EXISTING WELL / k SEr _100' RADIUS" .' APPROXIMATE LOCATION OF THIS LOT SERVED' EXISTING WATER SERVICE LINE BY COMMUNITY WELL .'PWSID 210639. CONTRACTOR `. .' TO LOCATE PRIOR TO EXCAVATION FOR NEW S .' EXISTING WELL 100' RADIUS EXISTING CLASS 'A' WELL ` r 200RADIUS r� E A S T 9 8 T H r EXISTING WELL i �f�100' RADIUS r r r Septic Design Prepared For JULIAN GONZALEZ LOT 1, BLOCK 3 WILLIAMSON #2 SUBDIVISION Prepared By: DATE: Watkins Engineering, Inc. PID NO. Cindy W. Ellis, P.E., M.S. SCALE: P.O. BOX 110443 DRAWN: ANCHORAGE, ALASKA 99511-0443 CHECKED: PHONE: (907) 349-1851: FAX: (907) 349-1934 AVENUE— WELL Amo*F 49TH 9/22/03 015-074-01 1"-30' �� Ci y W. Ellis •k ��. 0. 10577 .AM DJR CWE '1��\�PROFESSIO��� Performed For: Legal Description: Pzc C 1 17- 18 - 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.orglonsite (907)343-7904 Soils Log - Percolation Test idy W. Ellis CE-losn Julian Gonzalez Date Performed: Sept. 12, 2003 Williamson N2 S/D, Elk 3, Lot 1 Townshlp, Range, Section: Slope Site Plan Depth (Feet) OUTAN'0 0.5 IYIL 2.6 SGwe fCtC3ctl' 5111 0j- SCLm.cl + �ragd . �yytz. eobb�y awc� bcueclr�tp-. �' Vl. N, LL_aie cleFIlL, r WAS GROUND WATER ENCOUNTERED? No IF YES. AT WHAT DEPTH? Depth to Water After Monitoring? None Date: 9-19-03 S L 0 P E MENEEMMMMM ENOMMENNN NEENEENEEM NNEMENNEEM Reading Date Gross Time Net Time Depth to Water Net Drop 1 9115103 3:13 pm 0 6 — 2 3:43 30 1.8125 4.1875 3 3:48 0 6 — 4 4:18 30 1.9375 4.0625 5 4:20 0 6.125 — 6 4:50 30 2.125 4.0 PERCOLATION RATE 7.5 (nww4✓nrA) PERC HOLE DIAMETER e TEST RUN BETWEEN 83 Fr AND 7.0 FT COMMENTS 4 hr presoak p for to lest. Parc hole did not Intercept pockets of sand and gravel seen In the TH. Test N conservative. PERFORMED BY: Watkins Engineering, Inc. I Cindy W. Ellis, P.E. CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 9/19/03 Municipality of Anchorage MarkBcgich, Mayor CLQ s. �.. Building Safcty Divisiorl P.O. Box 196650 • 4700 Bragaw Street Anchorage, Alaska 99519.6650 • (907) 3#3.8301 • Rm (907) 343-80-00 littp://%%,%w.niiiiii.org 10/14/2003 Cindy Ellis, P.E. Watkins Engineering, Inc. P.O. Box 110443 Anchorage, AK 99511 Subject: Waiver Request for Williamson #2 Block 3 Lot 1 Waiver Request #WR030096 Parcel ID #015-074-01 S W030403 Dear Ms. Ellis: Your request for a waiver of the required 10 feet horizontal separation from the absorption field to property line has been approved. The approved separation distance is 4.0 feet. This waiver approval applies to the existing absorption field to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Daniel J. Roth Civil Engineer On -Site Water & Wastewater Program 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.ci.anchoragc.ak.us (907)343-7904 Waiver Review Worksheet WR#: 030096 PID#: 015-074-01 HAM Permit#: SW030403 Date Received: 10/14!03 Legal Description: Williamson #2 Block 3 Lot 1 Engineer. Watkins Enoineerina, Inc. PO Box 110443 Applicant: Julian Gonzalez Waiver Requested: 4 foot Lot Line Waiver from the East Lot Line to the Leach Field Criteria: Geology A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: Points: ............................................................................ one Waiver is Granted: Waiver is not Granted: List Conditions or Reasons for above: SEE ENG 1 A/6E)2 1,T L E /T,.V- R or - TU 17-7 ri C *tTIOAl FTUsnF1c*'?TIoav D4rF19 007- 1f, D3 4"C14ED Date:10119-1-03By: ji/9N Name of Reviewer "lose ........ ........................ ...................... ..................� Refit: 43127 Amount: $150.00 Date Paid: 1011412003 Watkins Engineering, Inc. P.0 Box 110443, Anchorage, AK 99511 (907)349-1851 cwellis@gcl.net October 14, 2003 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 RE: Williamson #2 SID, Block 3, Lot 1 Sewer Upgrade Waiver Request— Lot Line Waiver To Whom It May Concern: request a 4 ft lot line waiver to the east lot line of Williamson #2 SID, Blk 3, Lot 1, to facilitate the leach field installation. The permit is already approved; the permit number is SW -030403. believe that this encroachment will not adversely affect the adjacent tot's (lot 2) septic system requirements. The subdivision is on a public water system, and lot 2's water line is on the west side of the house (near the subject lot). The septic system for lot 2 is on the east side of the house — far from the subject lot. Thank you for consideration of this waiver request. If you have any questions or need further information, please call me at 349-1851 or 360-3389 (cell). Yours truly, Cindy Ellis, P.E. President GRL.,,ER ANCHORAGE AREA BOR,, -,IGH 0� "f Department of Environmental Quality �QP �,.. 3330 C Street 1\ C Anchorage, Alaska 99503 UQ INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME -,D- �I MAILING ADDRESS ..—VA�9—ISOX-9-6-:X PP,HONE LOCATION LEGAL DESCRIPTION �o - w..A .� SEPTIC TANK: e p , tey DISTANCE FROM WELL MANUFACTURER MATERIAL NUMBER OF COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY GALLONS. TILE DRAIN FIELD: �/%j / /n ( L TOTAL LENGTH/ DISTANCE FROM WEL 1, " FOUNDATION �N�E,/A�R/EEST LOT LINE Ao e�/ OF LINES (� NUMBER OF LINES A DISTANCE BETWEEN LINES N,11 TRENCH WIDTHZ IN. TOTAL EFFECTIVE ABSORPTION AREA 0.� SQ. FT. LENGTH OF EACH LINE a / t 1 DEPTH OF FILTER / DEPTH: TOP OF TILE TO FINISH GRADE V-6 MATERIAL BENEATH TILE 6 ABOVE TILE ' ` IN. WELL4414�4 TYPE CONSTRUCTION DEPTH DISTANCE FROM: BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION_, LOT LINE_ SEWER LINE , TANK , SYSTEM , CESSPOOL APPROVED. DISTANCES: OTHER SOURCES DISAPPROVED REMARKS INSTALLED BV: SEWER LINE DEPTH: PIPE MATERIAL: LsG'Li�[� LOT SLOPE: REMARKS: Form EQ -032 DIAGRAM OF SYSTEM 39 O y2 E—�fJr�uip��cH DAT ELC/�7L11 APPROV ED ` %CIO�1 # f� ,3J PERMIT NO. < 77465 ) HPPL-ICANT LFONARD W GREEN SRA' BOX 76X .LOCATION 0001 FAST 901H AVE LEGAL L1 B3 WILLIAMSON 02 1TYPE OF SOIL ABSORBTION SYSTEM -IS: TRENCH, IPDc x- 349-3191 LOT SIZE 18000 SQUARE FEET MAKIMUM NUMBER OF BEDROOMS = SOIL RATING <50 FT/BR)= 150 THE REQUIRED SIZE OF THE SOIL -ABSORPTION SYSTEM IS: IG•r .F TH �- +_� LF_t�l� STH= 4 - -r FeF=+ti EL C•EF,-F THE LENGTH DIMENSION IS THE LENGTH TIN FEET) OF.THE TRENCH OR DR:AINFIELD. THE DEPTH OP A TRENCH OR PIT IS THE DISTANCE_ BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR: TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF'ORAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION CIN FEET). F• F -i r K_ Fi CEm F_ P I— f—i rJ T CD FP T I Ce r-.1 A PACKAGE PLANT MAY BE INSTALLED AT THE PERMITTEE'S OPTION SUBJECT TO THE FOLLOWING CONDITIONS: 1. EITHER.: A CLAS I OR: II NSF APPROVED PLANT MAY BE INSTALLED. 2. A CONTINUOUS MAINTENANCE AGREEMENT IS REQUIRED. IF A MAINTENANCE AGREEMENT IS NOT KEPT CURRENT YOU MAY BE REQUIRED TO ENLARGE THE SOIL ABSORPTION SYSTEM AND/OR YOU MAY BE SUBJECT TO PROSECUTION. ---------------------------------------- --- 1 14 CD C fi ? I tJSAF•ECT I +3 !=. FeF-E F_FEID1_1 I REC• --- BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL RE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPO_,AL SYSTEM IS 100 FEET FOP. A PRIVATE WELL OR -200 FEET FOR A PUBLIC WELL." -,r OTHER PEOUIREMENTS L•1AY APPLY.°•'SPECIFICATIONS-AND CONSTFUCTION`DIAGRAMS ARE AVAILRRUE TO IN=URE PFOPER INSTALLATION. F•1-F_rl I T E" >4F• I FTF"c r_>f=-+=:F t•7REF'._ :L _LER : r I CERTIFY THAT 1.: I AN FAMILIAR: WITH THE REPUIRENENTITPR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. I WILL INSTALL.IHS SYSTEM -IN ACCORDANCE WITH THE CODES. 1: I UNOERSTANC THAT THE ON-SITE '=EWER SY=TEM' MAY -REQUIRE ENLARGEMENT IF THE RESIDENCE IS AS: REMODELEDD� TO INCLUDE MORE THAN 3 BEDROOMR,2 SIGNED:- - ______-__-- APPLICANT LEONARDW G^EEN (:] ISSUED BY 43. Civ'� DFPA-RTMFNT - HF.MI_TH ANn ENVIRONMENTAL F._'y,,TF.CTION825 Lhcdl,7 'L' STREET AN CHORAGE, HK. �!`_ 501 27972511 '- �e2�-7� r1r�— �• I TF_ _•Fe,li-=F e_ePiEt�iC-•E F'Ef='r'1 I ifi-e1s�o PERMIT NO. < 77465 ) HPPL-ICANT LFONARD W GREEN SRA' BOX 76X .LOCATION 0001 FAST 901H AVE LEGAL L1 B3 WILLIAMSON 02 1TYPE OF SOIL ABSORBTION SYSTEM -IS: TRENCH, IPDc x- 349-3191 LOT SIZE 18000 SQUARE FEET MAKIMUM NUMBER OF BEDROOMS = SOIL RATING <50 FT/BR)= 150 THE REQUIRED SIZE OF THE SOIL -ABSORPTION SYSTEM IS: IG•r .F TH �- +_� LF_t�l� STH= 4 - -r FeF=+ti EL C•EF,-F THE LENGTH DIMENSION IS THE LENGTH TIN FEET) OF.THE TRENCH OR DR:AINFIELD. THE DEPTH OP A TRENCH OR PIT IS THE DISTANCE_ BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR: TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF'ORAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION CIN FEET). F• F -i r K_ Fi CEm F_ P I— f—i rJ T CD FP T I Ce r-.1 A PACKAGE PLANT MAY BE INSTALLED AT THE PERMITTEE'S OPTION SUBJECT TO THE FOLLOWING CONDITIONS: 1. EITHER.: A CLAS I OR: II NSF APPROVED PLANT MAY BE INSTALLED. 2. A CONTINUOUS MAINTENANCE AGREEMENT IS REQUIRED. IF A MAINTENANCE AGREEMENT IS NOT KEPT CURRENT YOU MAY BE REQUIRED TO ENLARGE THE SOIL ABSORPTION SYSTEM AND/OR YOU MAY BE SUBJECT TO PROSECUTION. ---------------------------------------- --- 1 14 CD C fi ? I tJSAF•ECT I +3 !=. FeF-E F_FEID1_1 I REC• --- BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL RE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPO_,AL SYSTEM IS 100 FEET FOP. A PRIVATE WELL OR -200 FEET FOR A PUBLIC WELL." -,r OTHER PEOUIREMENTS L•1AY APPLY.°•'SPECIFICATIONS-AND CONSTFUCTION`DIAGRAMS ARE AVAILRRUE TO IN=URE PFOPER INSTALLATION. F•1-F_rl I T E" >4F• I FTF"c r_>f=-+=:F t•7REF'._ :L _LER : r I CERTIFY THAT 1.: I AN FAMILIAR: WITH THE REPUIRENENTITPR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. I WILL INSTALL.IHS SYSTEM -IN ACCORDANCE WITH THE CODES. 1: I UNOERSTANC THAT THE ON-SITE '=EWER SY=TEM' MAY -REQUIRE ENLARGEMENT IF THE RESIDENCE IS AS: REMODELEDD� TO INCLUDE MORE THAN 3 BEDROOMR,2 SIGNED:- - ______-__-- APPLICANT LEONARDW G^EEN (:] ISSUED BY 43. Civ'� a GRE. ER ANCHORAGE AREA BO'_"UGH C11�� Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM // NAME ld'fgrI AI ING ADDRESS 9 G/-- PHONE 3 566 FY• II LOCATION LEGAL DESCRIPTIO94neelO✓S5IA. 9 3�L SEPTIC TANK: �% ye C) DISTANCE L/�" Ifi l� /�cyv �CF�/ NUMBER OF FROM WELL �rlyt2 MANUFACTURER MATERIALCOMPARTMENTS INSIDE LENGTH INSIDE WIDTH �— LIQUID DEPTH � I IQUID CAPACITY601!20 GALLONS. SEEPAGE PIT - NUMBER NUMBER OF PITS DIAMETER OR WIDTHLENGTHLLj . DEPTH . Goy CO2716 I LINING MATERIAL(, uFf, 6A CRIB SIZE: b>81DIAMETER!LDEPTH_ DISTANCE FROM: WELLLLS�. / TOTAL EFFECTIVE�) BUILDING FOUNDATION_, NEAREST LOT LINE ABSORPTION AREA (WALL AREA) 'Va15 SQ. FT. ADDITIONAL ABSORPTION WELL: &/4y1ln- If TYPE CONSTI BUILDING NEAREST FOUNDATION LOT LINE CESSPOOL w ,��N 6VI UCTION OTHER SOURCES • Sr�1.tilQ law,e. G/z v/7' r NEAREST SEWER LINE , APPROVED DISAPPROVED REMARKS M PIPE MATERIAL: LOT SLOPE: 2 07 ' Form No. EQ -031 DEPTH DISTANCE FROM: SEPTIC SEEPAGE TANK , SYSTEM_ G.A.A.B. ' GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. 7170 "C" STREET ANCHORAGE, ALASKA 99507 TELEPHONE 274.4561 SEWAGE DISPOSAL SYSTEM — APPLICATION AND PERMIT NAME OF APPLICANT v y'�?I�F'CJ MAAIIILLLII�NG ADDRESS `n 9Vf SleL PNONE"1 INSTALLATION LOCATION• LEGAL DESCRIPTION L" 7/ -/ ` z , GR INSTALLATION OF: SEPTIC TANK SEEPAGE PIT DRAIN FIELD OTHER TYPE AND SIZE OF FACILITY TO BE SERVED `� S�.Lr•/� ��y FINANCED THROUGH TO BE INSTALLED BY SE=lF SOIL TEST RESULTS ;7fz1�//`fin NOTE, THIS PERMIT IS NOT VALID WITHOUT_SQIL TEST i COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. /tn0� St7L S�FcrL (LYvC�Fft= Fx -11: `- SEPTIC TANK SIZE �� TYPE SEEPAGE AREA SIZE TYPE MINIMUM DISTANCES, REQUIREMENTS DIAGRAM OF SYSTEM FOUNDATION TO SEPTIC TANK `s FOUNDATION TO SEEPAGE PIT 'vo DRAIN FIELD ` / SEPTIC TANK TO SEEPAGE PIT WALL /-J I / SEPTIC TANK '� SEEPAGE PIT DRAIN FIELD TO NEAREST LOT LINE.(. WELL TO SEPTIC TANK _"'��N� SEEPAGE PIT DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK , SEEPAGE PIT DRAIN FIELD / • `_ / SEPTIC TANK. .12S SEEPAGE PIT /aa DRAIN FIELD -� TO RIVER. LAKE. STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING OAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. 1 CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE GH ORDINANCE C / B-6� AND DESCRIBED SYSTEM IS IN ACCORDANCE WITHITN SAID CODE. DATE �j // APPLICANT'S SIGNATURE 1, ^' FORM NO. EQ -010 ABOVE e �IIIUII��p'pB NAME OF APPLICANT INSTALLATION LOCATION LEGAL DESCRIPTION GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99303 TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACILITY TO BE SERVED ,�(LING ADDRESS `rch SEEPAGE PIT DRAIN 'y✓l S"Z2p Tx -r l FINANCED THROUGH TO BE INSTALLED BY SOIL TEST RESULTS /Z'3- 7 , NOTE, COMPLETION DATE ANTICIPATED PERMIT NO. OTHER PERMIT IS NOT VALID WITHOUT SOIL TEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE 7So TYPE MINIMUM DISTANCES. REQUIREMENTS FOUNDATION TO SEPTIC TANK 1!3- FOUNDATION FOUNDATION TO SEEPAGE PIT —/1 , DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL /�/ SEPTIC TANK SEEPAGE PIT O DRAIN FIELD TO NEAREST LOT LINE. WELLTO SEPTIC TANK DRAIN FIELD SEEPAGE PrT ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK SEEPAGE PIT DRAIN FIELD 10 SEPTIC TANK, SEEPAGE PIT o6242 DRAIN FIELD TO RIVER, LAKE. STREAM. AREA SIZE �"w A 6 TW e�/6 CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 8 FEET INTO UNDISTURBED SOIL. 41NCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. G.A.A.B. V OR LICENSED DESIGNER DIAGRAM OF SYSTEM 1 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANC OR AREA BOROUGH OR CE NO. 28.68 AND THAT THE ABOVE DESCRIB "STEM IS IN ACCORDANCE WITH SAID CODE. DAT/-" APPLICANT'S SIGNATURE FO M. . EO -014 ("I (4"1 GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" Street ANCHORAGE, ALASKA 99503 Case # Performed For Fenneth Peat Dated Performed July 3.0, 3.973 Legal Description: Lot / Block S Subdivision I.,)jLI-1*1- n/ This Form Reports Soils Log x Percolation Test /Jo - Soil Test Must Be Logged To 4' Below Proposed Seepage System - Depth Feet Soil Characteristics, a,' 2 4 5 7 8 9 10 11 12 13 14 -a^,Gnd Water Encountered? no If Yes, At What Depth? S�010 c� F JJJ—j Reading Date Gross Time Net Time Depth to H2O Net Drop Overburden Sandy, UUMV111 J /•/ .J A e _ "• 5,/ v I ZLi Poor3„y graded sando -� — 0 o and gravel q 'SP Poorly graded sande -a^,Gnd Water Encountered? no If Yes, At What Depth? S�010 c� F JJJ—j Reading Date Gross Time Net Time Depth to H2O Net Drop r c+rw is L. lun It CI LB 19'nUv6• Proposed Installationy Serlian/: Pit i- Drain Field Depth of Inlet 14:51 ___Depth to Bottom o Pit or Trench COMMENTS: Recommend at le$s� square feet of surfneA nrnn nn�+" hnA y.nn Test Performed _ Uate Certif ed BY; Date: Plat Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni.org/onsite (907)343-7904 �,rzrv>Z— CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-074-01 COSA# ©_GG 121006 Expiration Date: /-///3,//3 1. GENERAL INFORMATION Complete legal description Williamson Subdivision No. 2, Block 3, Lot 1 Location (site address) 5001 East 98th Avenue Anchorage, AK 99507 Current Property Owner(S) Holly D. and Daniel A. Willman Mailing address Lending agency Mailing address 5001 East 98th Avenue Anchorage, AK 99507 Day phone Day phone Real E s1&tt 1Aggr}tt Day phone * ,Mailing Address. UnlesB othelivrse rpqudsl@f,_ COSA will be held by DSD for pickup. o ,.- 2. NUM0PP'0 BEI i200MS: Three (3) 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: IndiVidual-Well ❑ Individual On-site ❑✓ Individual Water Storage ❑ Individual Holding Tank ❑ Community Class A 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 On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional 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 Anderson Engineedng Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. 5. DSD SIGNATURE /' Approved for 3 bedrooms. Disapproved. Phone 522-7773 Date 1/10/2012 An 6 ANDERSON CE -4381 1 Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: acK Original Certificate Date: �� 3h2 (Rev 11M) Municipality of Anchorage • '� Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Lot 1, Block 3, Williamson Subdivision, Addition No. 2 Parcel ID: 015-074-01 A. WELL DATA pmw `,, �1t;A Well type -4— If A, B, or C provide PWSID # 2106A Well Log (Y/N) Date completed _ Sanitary seal (Y/N) _ Wires properly protected (Y/N) Total depth ft. Cased to ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform colonies/100 mL ft. Nitrate mg/L ft. g.p.m. Arsenic: _ ug/I Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material STEP/Steel Date installed 10/14/03 Tank size 1,250 gal. Number of Compartments 3 Cleanouts (Y/N) Y Foundation cleanout(Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) Y Date of pumping 1/2/12 Pumper A Plus Home Services C. ABSORPTION FIELD DATA Date installed 10/14/03 Soil rating (g.p.d./ftz or ftZ/bdrm) .8 SF/BDRM System type 5' wide Trench Length 58 ft. Width 5 ft. Gravel below pipe 3.94 ft, Total depth 7.31 ft. Eff. absorption area 575 ft' Monitoring tube Y Depression over field N Date of adequacy test 1/6112 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 18 in. Water added 612 gal. New depth 25 in. Elapsed Time: 1,20 min. Final fluid depth 18 in. Absorption rate >= 450 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed 10/14/03 "Pump on" level at 44 in. nahm Bottom of Tank Size in gallons 250 Manhole/Access (Y/N) Y "Pump off' level at 36 in. High water alarm level at 51 in. Cycles tested 5 Meets alarm & circuit requirements? Y E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOTTO: Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer /septic service line Holding tank Animal containment areas Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5. Property line >5' Absorption field >5' Water main N/A Water service line >10' Surface water >100' Wells on adjacent lots >100' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 6-- Building foundation >10' Water main NIA Water Service line >10' Surface water >100' Driveway, parking/vehide storage >5' Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS: `""Lot Line Waiver Issued. Abandoned Absorption Trench Remains on Lot for Future Use if Required. Trench is Not Connected to STEP Tank..C,ugently in Use. COSA Fee $ `t 7 U � `7 Date of Payment I.Ll /2 ) /� �t Receipt Number 9 Ujc7 (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number G. ENGINEER'S CERTIFICATION (ij�• ' 49M * �� 1 certify that I have determined through field inspections and review of Municipal records that the above systems are in A Y 00 •"+ " '� tU�o�� o l...............««................� conformance with MOA COSA guidelines in effect on this date. 00 �,,%MX HAX-t'ANIXMN : o Engineer's Printed Name Michael E. Anderson, P.E. �, f�.�4 ,04381 ® �r ,�/_ff_rZ.;•��,�, Date 5/1512009 COSA Fee $ `t 7 U � `7 Date of Payment I.Ll /2 ) /� �t Receipt Number 9 Ujc7 (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number 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 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FIAMILY DWELLING Parcel I.D. 015-074-01 1. GENERAL INFORMATION HAA # Expiration Date: Complete legal description Williamson #2 S/D, Block 3, Lot 1 Location (site address or directions) 5001 E. 98th Ave., Anchorage, AK 99507 Current Property owner(s) Stephan Bergbauer Day phone 336-9629 Mailing address Lending agency Mailing address 5001 E. 98th Ave., Anchorage, AK 99507 Day phone Real Estate Agent Nate Baer, Dynamic Properties Day phone 727-1130 Mailing Address 3111 C Street, Suite 100, Anchorage, AK 99503 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well ❑ Individual Water Storage ❑ Community Class A Well Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site 0 Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an Independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority 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 HAAs upon request to homeowners. Certificates of Health Authority 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 Health Authority 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. Watkins Engineering. Name of Finn g• Inc. Phone 349-1851 Address P.O. Box 110443, Anchorage, AK 99511 Engineers Printed Name Cindy W. Ellis Date 5. DSD SIGNATURE _Z Approved for _,Z bedrooms. Disapproved. 9- 8-05 c491H Idy W. Ellis CE • Iosn Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By: I0' �r n _ Original Certificate Date: (Rw. 011M Municipality of Anchorage • Development Services Department Building Safety Division Onsite Water & Wastewater Program ' • . 4700 South Bregaw St. P.O. Box 198850 Anchorage, AK 99519.6650 www.muni.org/onsfe (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Williamson 02 SO, Slock 3, Lot 1 Parcel ID: 015-074-01 A. WELL DATA Wen" A If A. B, or C provide PWSID # 210m Well Log (YM) Date completed _ Sanitary seal (YIN) _ W:.'P7h.ih.*t rotected (Y/N) Total depth ft. Cased to R. (above ground) in. FROM WELL LOO AT INSPECTION Date of test Static water level Well production g.p.m. g.p.m. WATER SAMPL ULTS: Coliform colonies/100 mL Nitrate mg.A. Other bacteria colonies/100 ml. vdfgco� mg.A. Date of sample: _ Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material steel 10 ga. Date installed 10/14/03 Tank size 1250 gal. Number of Compartments Y Cleanouts (Y/N) Y Foundation cleanout (YM) DCO Depression over tank (YM) n High water alarm (YM) Y Date of pumping 9/8/2005 Pumper Denali Pumping C. ABSORPTION FIELD DATA Data installed 10/14/03 San rating (g.p.d.e or fe/bdrm) 0_B System type shallow trench Length 58.0 ft. Width 5.0 ft. Gravel below pipe 3.94 ft. Total depth 7.31 ft. Eff. absorption area 575 ftp Monitoring tube Y Depression over fleid n Date of adequacy test NA Results (Pass/Fail) For _ bedrooms Fkitd 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.) (YM & type) If yes, give date D. LIFT STATION Date Installed 10114103 Size in gallons 1250 STEP Manhole/Access (YM) Y `Pump on" level at " in. 'Pump ofr level at 38 in. High water alarm level at 51 In. Datum bottom of tank Cycles tested NA Meets alarm ti circuit requirements? Yea E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankllfit station on lot NIA Absorption field on lot Public sewer main Sewer /septic service One On adjacent kits On adjacent lots Public sewer manhole/deanout Holding tank SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Building foundation 19 Water main 100+ Wells on adjacent lots 100+ Property line 25 Absorption field 12 Water service One 50 Surface water 100+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property One 8" Building foundation 10 Water main 60 Water Service One 25 Surface water 100+ Driveway, parkkg/veNde storage 45 Curtain drain NA Wells on adjacent lots 100+ F. COMMENTS not tested, because it is less than 2 yrs since installation. G. ENGINEER'S CERTIFICATION`e. n, I car* that I have determined through Bold inspections and � 491d review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name Cindy W. Ellis CI Y w• Ellis CE • losn Date 9/8/05 '� _•........ ct HAA Fee $ 1a Date of Payment o� Receipt Number (Rev. 12101) Waiver Fee $ Date of Payment Receipt Number 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 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-074-01 1. GENERAL INFORMATION HAA # 0770 ICJ 7 Expiration Date: It— G -04- Complete O4 - Complete legal description Williamson #2 SID, Block 3, Lot 1 Location (site address or directions) 5001 E. 98th Ave., Anchorage, AK 99507 Current Property owner(s) Julian Gonzalez Mailing address Lending agency Mailing address Real Estate Agent Mailing Address P.O. Box 29, Barrow, AK 99723 Day phone 907-852-9346 Day phone Tamera Kelly, ReMax Properties Day phone 276-2761 2600 Cordova St., Anchorage, AK 99503 Unless otherwise requested, HAA will be hold by DSO for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well ❑ Individual Water Storage ❑ Community Class A Well ID Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site Q Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an Independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority 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 HAAs upon request to homeowners. Certificates of Health Authority 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 thevalidation date shown below, I verify that my Investigation, based on procedures outlined in the Health Authority 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 Watkins Engineering, Inc. Phone 349-1851 Address P.O. Box 110443, Anchorage, AK 99511 Engineer's Printed Name Cindy W. Ellis Date 5. DSD SIGNATURE _1z Approved Approved for 3 bedrooms. Disapproved. Conditional approval for bedrooms, with the following 49TH* Idy W. Ellis CE -10577 _. Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other By: &,/Z / % O —i� t Original Certificate Date: 11-6 —63 (Rw. 01102) Municipality of Anchorage Development Services Department Building Safety Division Onsite Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196550 Anchorage, AK 995194650 wwwm mi.orglonsite (907) 3437904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Williamson #2 SID. Block 3. Lot 1 Parcel ID: 015-074-01 A. WELL DATA 2 10 Well type A If A. B, or C provide PWSID #rt0m Well Log (Y/N) Da�B eo feted _ Sanitary seal (YIN) _ Wires property protected (Y/N) Total depth Cased to 0. Casing height (above ground) in. FROM AT INSPECTION Date of test Static water level Well production g.p.m. WATER SAMPLE RESULTS: Collfortn mg A. Other bacteria oolonies/100 ml. Arsenic: mg A. Data of sample: _ Collected : S. SEPTICIHOLDING TANK DATA Tank Type/Materlal 4108110 ga. Date Installed 10/14113 Tank 4ize 1250 gat. Number of Compartments 2 Cleanout# (YIN) Y Foundation clepnout (YM) 22R Depression over tank (YM) n High water alarm (YIN) Y Date of pumping NA Pumper C. ABSORPTION FIELD DATA Datalnstalted 10/14/03 Son rating (g.p.dile or ttrAxfrm) 0_8 System typa shallow trench Length 58.0 fL Width 5.0 ft. Gravel below pipe 3.94 fL Total depth 7.31 fL Eff. absorption area 575 fe Monitoring tube Y Depression over geld Date of adequacy test NA - new Results (Pass/Fall) For _ bedrooms F on fletd before test _ in. Water added_ gal. New depth_ In. Elapsed Time: _ min. Final fluidrep Absorption rate >- g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, g v D. LIFT STATION Date installed 10/11/03 Size In gallons Integral Manhole/Access (YIN) Y 'Pump on" level at 44 In. 'Pump oft level at IL_ In. High water alarm level at 51 in. Datum bottom of tank Cycles tested NA Meets alarm & circuit requirements? Yes_ E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: t Septic tan�Iot On adjacent kits Absorption field On adjacent lots Public sewer main Public eewer out Sewer /septic service line Holding tank SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Building foundation 19 Property line 25 Absorption field 12 Water main 100+ Water service line 50 Surface water 100+ Wells on adjacent lots 100+' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 6' Building foundation 10 Water main W Water Service One 25 Surface water 100+ Driveway, parkIngt ahide stwne 45 Curtain drain NA Wells on adjacent lots 100+' F. COMMENTS /V,0jr- /M/n -most )V I- i,1 t&S&M#xt A& Enefodchwgoo'- pirnht. *Separation to Class A well is 200+, to private wells: 100+. Lot line waiver &j1psorption G. ENGINEER'S CERTIFICATION I cer* that I have determined through Bald inspections and review of Municipal records that the above systems are in cordbinrance with MOA HAA guidelines in effect on this date. Engineer's Printed Name Cindy W. Ellis Date 11-3-03 �; -7 Date of Paymery Receipt Number (Rev. 12101) Waiver Fee S _ Date of Payment Receipt Number fdy W. Ellis CE -lstm field. S 89052'10"W 95.00' EAST 9STH AVENUE FENCELINES. OFA '�• �' � ter- � 49 TH ............................... ° SHANE A. HOLT e `- LS-6914 • G AS -BUILT SURVEY (NO CORNERS SET THIS DATE) SCALE: 1' • 30' HEREBY CERTIFY THAT I HAVE PERFORMED A MORTGAGEE'S INSPECTION OF THE FOLLOWING 1. BLOCK 3. WILLIAMSON SUB. NO. 2 HORAGE RECORDING DISTRICT, ALASKA AND THAT VISIBLE IMPROVEMENTS SITUATED THEREON ARE iIN THE PROPERTY LINES AS NOTED AND NO VISIBL ROACHMENTS EXIST EXCEPT AS NOTED. EASEMENTS OF RECORD. OTHER THAN THOSE SHOWN ON THE RECORDED PUT, ARE NOT SHOWN HEREON.(UNLESS INDICATED) JOATED AT ANCHORAGE, ALASKA THIS _33rtl_ DAY OF OCTOBER 2003 NOTE: ANY FENCELINES SHOWN ARE LOCATED APPROXIMATELY AND ARE NOT TO BE USED TO DETERMINE PROPERTY LINES HOLT LAND SURVEYIN 131, FBT08-7 OR LOCATE STRUCTURES. TEL. 3455513 ANY PAVING SHOWN MAY BE APPROXIMATE DUE TO SNOW CONDITIONS Parcel I.D.# MUNICIPALITY ANCHORAGE • DEPARTMENT OF HEALTT H &HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 015-074-01 HAA p lA a.21 ®'421 1 1. GENERAL INFORMATION Complete legal description Lot 1; Block •3; Williamson Subdivision #2 Location (site address or directions) 5001 E. 98th 'Avenue An ho ag.p. AK ■`Pro a owner' ' Diane Brozovsky _W rt' Day phone' 522 '3620 .: _p Mailing address C/O Remax Properties. Attn:. Alin -Ward Lending agency ' Day phone Mailing address' Ageni . - Alan Ward/Remax Properties Day phone 257-0117 Address ' 2600 Cordova St. Anchorage, AK 99503 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well Community well XX Public water NOTE: If community well system, provide written confirmation from State ADEC attest - Ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XX Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-07 MW.1/ip Fw MOAn1 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 of this Health Authority Approval application shows that the ori -site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. l further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations In effectA1b".!Q4tgis i ect!Phone n. C Name of Firm tpwater C su.'r 33 74/7 / Alaska Water & W?stewater Consultants, Inc,.. . .j 11 be PAID $ MIS- °= ..prior to, closing for the cngineering`5eMdes Provided. 6. DHHS SIGNATURE r t� /� Approved for :Et EI; bedrooms. Disapproved. Conditional approval for Additional Comments By: bedrooms, with ttie following stipulations:. ItITIC Date S- 2 6 9 9 The Municipality of Anchorage Department of Health and Human Services (DHHS) Issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct Inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. rlm=MW.1M) e+k wwm Municipality of Anchorage 4**v gG19 k` !� DEPARTMENT OF HEALTH & HUMAN SERryQ` X99 Environmental Services Division 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) Health Authority Approval Checklist Legal Description: LOT 1, BLOCK 3, WILLIAMSON /2 Parcel I.D.: 015-074-01 A. WELL DATA Well type CLASS 'A' If A, B, or C, attach ADEC letter. ADEC water system number 210639 Log Present (YM) Total depth San" seal (Y/N) Date of test Static water level Well production WATER SAMPLE I Coltiorm / Date completed FROM WELL LOG B. SEPTICiHOLDING TANK DATA Nitrate Casing height (above Wires Properly P►a(Y/N) Collected by: AT Other bacteria 9.p.m. Date installed 7/7/73 Tank size 1000 Number of Compartments 1 Cleanouts (YM) YES Foundation cleanout (Y/N) M — INSIDEDepresslon (Y/N) NO High water alarm (Y/N) N/A Date of Pumping 9/11/98 Pumper A+ C. ABSORPTION FIELD DATA 7/7/73 Date installed 6/29/77 Soil rating (g.p.d.N or R'/bdrm) 150 FT SO System type PR/TRENCH Length 76' Width 3' Gravel thickness below pipe 676' Total depth 14.5' 468/ Effective absorption area 900 Fr SQ Mw toning Tube present (YM) YES Depression over field (YM) NO Date of adequacy test 7/21/99 Results (Pass/Fall) PASS For 3 brooms Fltdd depth in absorption field before test On.); — Immeolatey after1583 gal, water added On.): 33.5 Fluid depth 27 Ons) Minutes later. 245 Absorption rate a 450+ e.p.d. Peroxide treatment (past 12 months) (YM) NO B yea, give date 72-026 (Rev. 3/98)• D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level E. SEPARATION DISTANCES `Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main line Size In ar "Pump ofr level at* On adjacent adjacent lots Public sewer manhole/deanout Litt station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation 5'+ Property line 5'+ Absorption field 5'+ Water main/service line 25'+ Surface water/drainage too'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 3'+/— Building foundation 20'+ Water mairdservk a line 25'+ Surface water 1009+ Driveway, parldnghrehide storage area 30'+ •. .�.1. .. it F. ENGINEER'S CERTIFICATION Signature EngineeesNam6 v dtrrr¢T n. LAWLRA Date A /! OF 9 HAA Fee $ "xT -— Date of Payment di+olbi K Receipt Number J as-/ ( 72.026 (Rev. 3MB)' 0-7953'•.,• .• Waiver Fee $ / /' J! JW Date of Payment RecelptNumber AUG -03-99 04:26 PM KENNETH G LANG 9073224623 In CN.UN-LW FENCE, r,,.,.» Lot 1 L sa'. I l.r anEo—; I eX Lot 4 r� k "-RxcED 000 RUN EP r BEAN -Oars P.02 10' LITIL Y EASEMENTS AsAy��x •' , �i NiW�•/•.. S 89'S2'10'W 95,00'. ft PLOT PLAN _ ASBUILT SCALE le - 30' GRID 2437 project No. 99-117 Kenneth G. Long 11500 Daryl Avenue, Anchorage, Alaska 99515 Registered Land Surveyor 90or (907) 522-6176 Phone OFA7)) 522-4625 Fax . •, 4 I hereby certify that I have eurveyW the following described property: '��•''� '9s Lot 1, Weak 3. wlwemoon Subd., Addn. No. 2 Anchorogo 1111009rdlig District Alaska, and that the Improvements altuoted * 48I� • "iz thereon are within the property Nnes and do not encroach onto the property .............................. adjacent thereto, that no Improwmento on Me property tying adjacent thereto Omoech an the surveyed promisee and that then aro no roodwwooyyee, transmission .............................. linos er other visible easements on sold property except as I"cated heron. KENNETH G. LING: Doled this the S of A:1&LIST �' - .i= of Anchorage, Alaska LS 5202 N Is the rosponotblilty of the owner to determine the oxtelenoo of any '''••••••.•••• easements, covenants, or restrictions which do not appear on the recorded 89MXL subdivision plat. s CANT Lot i 14At12 s.1. CA t t Z`.TusY �. I' W000 fume Pae' — °' t • e. :ora 1'G�T ;,f, cc lot 2 AsAy��x •' , �i NiW�•/•.. S 89'S2'10'W 95,00'. ft PLOT PLAN _ ASBUILT SCALE le - 30' GRID 2437 project No. 99-117 Kenneth G. Long 11500 Daryl Avenue, Anchorage, Alaska 99515 Registered Land Surveyor 90or (907) 522-6176 Phone OFA7)) 522-4625 Fax . •, 4 I hereby certify that I have eurveyW the following described property: '��•''� '9s Lot 1, Weak 3. wlwemoon Subd., Addn. No. 2 Anchorogo 1111009rdlig District Alaska, and that the Improvements altuoted * 48I� • "iz thereon are within the property Nnes and do not encroach onto the property .............................. adjacent thereto, that no Improwmento on Me property tying adjacent thereto Omoech an the surveyed promisee and that then aro no roodwwooyyee, transmission .............................. linos er other visible easements on sold property except as I"cated heron. KENNETH G. LING: Doled this the S of A:1&LIST �' - .i= of Anchorage, Alaska LS 5202 N Is the rosponotblilty of the owner to determine the oxtelenoo of any '''••••••.•••• easements, covenants, or restrictions which do not appear on the recorded 89MXL subdivision plat. Alaska Water & Wastewater Consultants, Inc. 6901 Debarr Road, Suite 2-B — Anchorage — Alaska 99504 Phone (907) 337-6179 — Fax (907) 338-3246 Consulting Engineers August 9, 1999 Municipality of Anchorage Department of Health &: Human Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Subject: Lot Line Waiver for Lot 1; Block 3; Williamson Subdivision #2 To whom it may concern: Request you issue a property he waiver on the subject property for the separation distance between the leachfield and the north property line at three (3) feet. We do not anticipate any adverse effects by issuance of this waiver, (please see attached asbuilt survey) If you have any questions, please contact us at 337-6179, or 244-9612. JAG/gd E., M.S. Municipality of Anchorage s Department of Health and Human Services 825 "L" Street Rick Mystrom, P.O. Box 196650 Anchorage, Alaska 99519-6650 Mayor hhp:/Iwww.ci.anchorage. ak. us AK Water & Wastewater Consultants, Inc. ATTN: Jeffrey Garness, PE 6901 De Barr Road, Suite 2B Anchorage, AK 99504-0000 August 25, 1999 Subject: Waiver Request for WILLIAMSON #2 BLK 3 LT 1 Waiver # WR990060 Lot Line Request for Parcel ID 015-074-01 Dear Engineer: Your request for a waiver of the required 10 feet horizontal separation of the on-site wastewater disposal system to the lot line has been approved. The approved separation distance is 3 feet. This waiver approval applies to the current on-site wastewater disposal system and lot line separation only. Any future upgrade to the on-site wastewater disposal system and lot line will require all separation distances to be met or another waiver approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-4744. Sincerely, Jeff Poet Engineering Technician III On -Site Water Quality Program MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Waiver Review Worksheet W16Q 99LbLj0PID# 015-074-01 HA# BA990424 Permit # Date Received: August 20, 1999 Legal Description: Lot 1 Block 3 Williamson #2 Engineer: Jeff Carness, PE, Alaska Water 6 Wastewater Consultants, Inc. 6901 De Barr Road, Suite 2B, Anchorage, Alaska 99504 Applicant: Diane Brozovsky Waiver Requested: LOt line waiver from the leachfield and the north orooerty line of 3 feet. Criteria: 1. Geology: Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Waiver is Granted: Waiver is NOT Granted: List Conditions or Reasons for above: Date: By: Name of Reviewer Rec #: #05251/7892 Amount: $ 115.00 Date Paid: 8-20-99 Fu�ATU . •TELECOMMUNICATIONS August 9, 1999 600 Telephone Avenue • Anchorage, Alaska • 99503-6091 • 907 564-1000 Alaska Water & Wastewater Consultants, Inc. 6901 Debarr Road, Suite 2B Anchorage, Alaska 99503 ATU Telecommunications has no objection to the encroachment of the septic system into the northern platted utility easement, nor any objection to the garage encroachment into the north-western platted easement located on Lot 1, Block 31 Williamson Subdivision, as depicted on the as -built drawing submitted. Acceptance and use of this letter of non -objection by yourself, your heirs, your assigns, or your successors, will constitute agreement to the following stipulations: 1. 2. 3. 9. 5. ATU will be held harmless, now and forever, for any damages or injury to any person or property as a result of this encroachment. Any ATU facility damaged or destroyed as a result of this encroachment will be repaired at no cost to ATU. Any costs incurred by ATU for special construction necessitated by this encroachment will be borne by the property owner. All applicable safety code regulations will be observed and maintained. This letter of non -objection will in no way preclude ATU from full use and enjoyment of its rights within any portion of its right-of-way. GS\ml\g:mswd\cor\nonob\willism.doc DATE: 19 FROM : ALASVA LATER 8 WRSTEWATER AuSust 9,1999 PHONE NO. : 9OT-M 246 A,r9. 09 1999 05:18PM P2 %W % r ��-- ......� Jeffrey A. Garneas, P.E., MS. Alaska Water & wastewater Consultants, lnc. 6901 Debarr Road, Suitc 28 Anchorage, Alaska 99503 Dear Mr. Gamess, Subject to your agreement to indemnify the Company as set forth below, GCT Cable Inc. of Alaska has no objection to the septic system encropchlttg into the 30' utility easement on the north property Hne, and no objection to the grange encroaching into the 10' utility eftsernent on the west side of Lot 1, Block 3, liiRiamson Subdivision Addition No. 2. K=%;u as $001 East 9e Avenue In City grid 2437. This letter of Con-objcction in no way procludes GCI Cable Lrorn full use and egjoyment of any rights it:r..y have within aryportion of the utility easement end or the right.of- way, including unlimited access for servicing Its facilities. Also any additional and extraordinary costs inetared during any fetus required conswction, repair or reconstruction of OCI's facilities to accommodate any or all of the eneroachruents shall be paid by the property owner. By signing below, you agree to hdcatnify and hold GCI Cebic forever, for any damage, costs, expense (including reasonable t and injury to any person or property oocurring as a result of the Please indicate your acceptance by signing address below. Sincerely, cikvalon' OSP Design Bacineec 89S Date 0 now and fees), liabilities the 6i6i FairbanksStr"t • Arlohorage,Ataskot 90503 • 807/T864260 CAN* Swek se DMVftd bY0Cl Cable. Im. f%Ktric August 10, 1999 CHUGACH ELECTRIC ASSOCIATION, INC. Alaska Water & Wastewater Consultants, Inc. 6901 DeBarr Road, Suite 2B Anchorage, Alaska 99504 Attention: Jeffrey Garness Subject: Encroachment Permit Request for Septic System Lot 1, Block 3, Williamson Subdivision #2 Grid 2437, 1203-15A, EN99050 Dear Mr. Garness: Chugach has received your request for an Encroachment Permit on the above referenced property. Your request is being reviewed by Chugach's Distribution and System Protection Department. I anticipate having a response to you within the next ten working days. This time frame is tentative and may be extended if additional review is required. If you have any questions, please call me at 762-4738. Sincerely, Chuck Couts, SR/WA Right -of -Way Agent cc: (via: E -Mail) Louis Mass, Standards Engineer (via: E -Mail) James Wilson, Manager, Dist. Standards & Support 5601 Minnesota Drive • P.O. Box 196300 • Anchorage, Alaska 99519-6300 Phone 907-563-7494 • FAX 907.562-0027 .a:.4 aJ, DaJU073 #ENSTAR E"31NEERINw PAGE 01/02 August 19,1999 ALASKA WATER & WASTEWATER CONSULTANTS, INC. Jeffrey A. Garners, P.E., M.S. 6901 Debarr Road, Suite 2B Anchorage, Alaska 99504 Dear Mr. Gamess: ENSTAR Natural Gas Company 401 E. International AirportRd P O Box 190288 Ancharasc, Alaska 9931902ss Engineering Dept. Fax (907)163.4oss ENSTAR Natural Gas Company has no objection to the septic system, shed, fenced dog run, or the northwest comer of the garage that encroach into the 10 foot utility easement along the north and west property line of Lot 1, Block 3 Williamson Subdivision #2, as shown on the attached asbuilt. These easements are not being used by "ENSTAR". If you plan, on any type of excavation on or near this property please contain the Locate Call Center Center at 278-3121 for an underground locate of the gas facilities. You may contact me at 264-3743 if you have any further questions concerning this encroachment Si e�r�ely yours, as Westervelt Right -of -Way Agent r :352 i�Pc468 ENCROACHMENT PERMIT 1203-15A G-2437 EN99050 This permit is between Chugach Electric Association, Inc., an Alaska non-profit electric cooperative, (herein "Chugach"), whose address is P. 0. Box 196300, Anchorage, Alaska 99519-6300 and the Diane M. Brozovosky of Anchorage (herein "Permittee"), whose address is 5001 East 98' Avenue, Anchorage, Alaska 99516. 1. Easemen . Chugach is the grantee or user of an easement for the construction and maintenance of electrical facilities as follows: Described in that certain written instrument recorded on the 27th day of August, 1952, in Book 78, Page 52, on file in the office of the District Recorder, Anchorage Recording District, Seward Meridian, State of Alaska, Dedicated by the plat of the subdivision known as Williamson Subdivision Addition No. 2, according to Plat Number 71-187, recorded on the 18th day of August, 1971, on file in the office of the District Recorder, Anchorage Recording District, Seward Meridian, Alaska, (herein "Easement") which pertains to the following described real property: The West Ten Feet (W 10') and the Northerly Ten Feet (N'ly 10') of Lot One (1), Block Three (3), Williamson Subdivision Addition No. 2, according to Plat Number 71-187, on file in the office of the District Recorder, Anchorage Recording District, Seward Meridian, Alaska. Permittee acknowledges the validity of the Easement. Permittee warrants and represents that Permittee is the owner of the fee simple interest in the land subject to the Easement and the following described real property to which the Easement is adjacent: Lot One (1), Block Three (3), Williamson Subdivision Addition No. 2, according to Plat Number 71-187, on file in the office of the District Recorder, Anchorage Recording District, Seward Meridian, Alaska, (herein "Parcel"). Encroachment Permit - Page 1 of 4 a►' 3526rGG69 2. Encroachment. Permittee has constructed the following improvements on or within the real property subject to the Easement: A shed that encroaches across the Easement on the north side of the Parcel for a distance of approximately Eight Feet (8'), a fenced dog run that encroaches across the Easement on the north side of the Parcel for a distance of approximately Twenty Feet (20'), a septic system that encroaches approximately Seven Feet (7') into the Easement on the north side of the Parcel for a distance of approximately Three Feet (3'), a garage that encroaches approximately One Foot (1') into the Easement on the west side of the Parcel for a distance of approximately Six Feet (6'), (herein "Encroachment"). 3. Permit. Chugach hereby authorizes Permittee to continue the existence of the Encroachment in its current location subject to the covenants set forth in this permit. 4. Indemnification. Permittee shall indemnify and hold Chugach harmless from any claims for personal injury, property damage or other loss arising in any way from the construction or continuation of the Encroachment. 5. No Expansion or increase. Permittee shall not in any way expand or increase the extent to which the Encroachment occupies any of the real property encumbered by the Easement without the prior written consent of Chugach. Chugach has no obligation to provide such consent. 6. No interest in Real Estate Acquired. Permittee hereby acknowledges that the Encroachment and any additions thereto, even if in violation of this permit, has not and shall not in the future give rise to any interest or estate in the real property subject to the Easement or any other real property. Without in any way limiting the foregoing, Permittee acknowledges that the Encroachment is not adverse to any interest of Chugach and its continuation is entirely with the permission of Chugach for purposes of the common law doctrine of adverse possession. This permit creates no interest in the real property subject to the easement. 7. Modification of Utility Facilities. If the electric utility facilities located within the Easement are upgraded, added to, replaced or reconstructed, Permittee shall pay that portion of Chugach's total costs for such modification which is reasonably attributable to accommodating or preserving the Encroachment. If such payment is not made within thirty (30) days of written demand for same, Chugach may terminate this permit in accordance with paragraph 9, below. 8. Covenants Runnine with the Land. The obligations of the Permittee arising from this permit shall be covenants running with the land which shall burden the Parcel and the Permittee's interest in the land subject to the Easement and shall benefit the Easement. Encroachment Permit - Page 2 of 4 Pr470 9. Termination. Chugach may terminate this permit after the giving of thirty (30) days written notice of such termination if: a. The Encroachment is enlarged, increased or extended within the real property affected by the Easement. b. The Encroachment is damaged by any means to an extent of more than thirty percent (30%) of its replacement cost at the time of destruction. C. Permittee fails to make the payment described in paragraph 7, above. 10. Term. This permit shall, if not sooner terminated by Chugach, expire forty (40) years from the date hereof. ]I. Entire Agreement. This written permit constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all other prior or contemporaneous agreements, oral or written, between the parties. No modifications, amendments, deletions, additions or alterations of the permit shall be effective unless in writing and signed by all of the parties hereto. • �� ,,- CHUGACH ELECTRIC `.tksEcc ,; ASSOCIATION, INC. 3itle: eN.Bj +✓' :;; �� Ott"C• r' - General Manager f.•Y�9�lI j. ���;�; Date: JLLA1 r' STATE OF ALASKA ) ) ss: THIRD JUDICIAL DISTRICT ) PERMITTEE Diane M. Brozovosky By: Diane M. Brozov sky Date: 9-2-3-55 The foregot�S instrument was acknowledged before me this 12?day of It -C. t.� , 1999, by Eugene N. Bjomstad, the General Manager of Chugach tElectric Association, Inc., an Alaska corporation, on behalf of the corporation. �'0!Z�'tS' L Q.COG,o� Notary Public in and for the Sta�of I kGQ� �:' My commission expires �? s AUB 1.\'J -Ir a Encroachment Permit - Page 3 of 4 'moi 0 F �� 3r`52�►P��+ll STATE OF ALASKA ) ) ss: THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this 3�3dax of ,q&ge1S� ..1999,by Olgae_�- Rr-dze7VA p Notary alic in and for the State of Alaska My commission expires 0 / coo AFTER RECORDING RETURN TO: Chugach Electric Association, Inc. Land Services Department P.O. Box 196300 Anchorage, Alaska 99519-6300 053948 AilOPORAGE RECORDINu" DISTRICT Encroachment Permit - Page 4 of 4 1999AU24 AH11:40 a\j.CU REQUESTED BY GC S MUNICIPALANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. M 0/9— CGS %y- D t T Z i4. � 1 tr HAA #4JLA N cr013 7 1. GENERAL INFORMATION Complete legal description I, 0 ' I r [3 V_ 3F \bi it t a- "A Location (site address or directions) �° U I I� c% c9 u, Property owner C ci el' e ct. r.s #. Day phone N Mailing address Lending agency Day phone Mailing address t }. Agent I- t-'-% �.0 J �uc1i � �c i tLL}t Day phone X76 -�1%1• l IJ U Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water 1/0,P-1 o6 t q NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: / Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72 -Mi"" 1191) FWt MoA621 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of t0his inspection. Name of Firm _ 41 61) f" <3D D 6[ACIM C If a phone Address v20 3 i >/ / 6 "I Id Engineer's signature 6. DHHS SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for Additional Comments M Date_ Ild'71 bedrooms, with the following stipulate .ns: � Date ' a S The Municipality of Anchorage Department of Health , Human Services (DHHS) Issues Health Authority Approval Certificates based only upon the representaains given in paragraph 5 above by an Independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct Inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 724M0Wv.w1J e.aa Maa.xi .Y• t7. _i bedrooms, with the following stipulate .ns: � Date ' a S The Municipality of Anchorage Department of Health , Human Services (DHHS) Issues Health Authority Approval Certificates based only upon the representaains given in paragraph 5 above by an Independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct Inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 724M0Wv.w1J e.aa Maa.xi Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825*V Street, Room 502 • Anchorage, Alaska 99501• (907) 343-4744 Health Authority Approval Checklist r � rl■ � �_ t • ' A. WELL DATA Well type (+A ` if A. B. or C, attach ADEC letter. ADEC water system number Log present (YM) Taal depth Sanitary seal (YM) Date of tat Static wear level Well production WATER SAMPLE RESULTS: Coliform Date of sample: Date completed Cased to FROM WELL LOG Nitrate Casing height (above ground) Wires Property Protected (YIN) Collected by: AT INSPECTION (iiiM.<`TTC1 B. SEPTIC/HOLDING TANK DATA Date installed IJ76 Tank size /" Number of Compartments Cie snouts (Y"_y Foundation cleanout (YIN) k_ Depression (YM) P4 High water alarm (YM) Date of Pumpingyfi, Pumper 04 C. ABSORPTION FtELLD DATA 144 Date installed / 7 7 4 Soil rating (&p.dIN' or ft=/bdrm) _LL`r System type 404cv;k 40;kt_fA��tC !�7 lits Width`1A –:!V Gravel thickness below pipe Taal deptb'� y Effective absorption Monitoring Tube presen4Y"–)( Depression over field (Y" Date of adequacy test Results (Pass/Fwl) F For -S bedrooms Fluid depth in absorption field before test (in.):-.t3p— immediately afteral. water added (in.): Fluid depth 64t ma.) Minutes later: IR49 Absorption rate > r0ic:> p.d. Peroxide treatment (past 12 months) (YRS �— If yea, give date NJ LAt Q�cor'P C � n &P•14"1 m �' B. SEPTIC/HOLDING TANK DATA Date installed IJ76 Tank size /" Number of Compartments Cie snouts (Y"_y Foundation cleanout (YIN) k_ Depression (YM) P4 High water alarm (YM) Date of Pumpingyfi, Pumper 04 C. ABSORPTION FtELLD DATA 144 Date installed / 7 7 4 Soil rating (&p.dIN' or ft=/bdrm) _LL`r System type 404cv;k 40;kt_fA��tC !�7 lits Width`1A –:!V Gravel thickness below pipe Taal deptb'� y Effective absorption Monitoring Tube presen4Y"–)( Depression over field (Y" Date of adequacy test Results (Pass/Fwl) F For -S bedrooms Fluid depth in absorption field before test (in.):-.t3p— immediately afteral. water added (in.): Fluid depth 64t ma.) Minutes later: IR49 Absorption rate > r0ic:> p.d. Peroxide treatment (past 12 months) (YRS �— If yea, give date NJ LAt Q�cor'P D. LWr STATION Date installed Manhole/Access (Y/N) High water alarm level at* _ Cycles tested E. SEPARATION DISTANCES "Pump on" level at* "Pump off' level at* *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot W%. : On adjacent lots Absorption field on kit NZA : On adjacent kits Public sewer main N�/4• Public sewer manholeldeanout 1A Sewer /septic service line N/A Lift station 1414 SEPARATION DISTAICE,S.FR M SEP71C/HOLDING TANK ON LOT TO: ,?CFR ��ll � y� Building foundationProperty line Absorption field /to %�. ►�- Water main/service line �!o f Surface water/drainage NIP Weds on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: •r , Building foundation Water mainiservice line �i♦D Sur6ce water _ Nt Driveway, parkinghnehicle storage ares / Curtain drain Wells on adjacent lots �!(f7 / Property line /� Y F. ENGINEER'S CERTIFICATION K / certify that 1 have determined thru field inspections and review ofAdsoncipal reear#�Otpt iae'alftW sj+Mps are in conformance with MOA HAA guidelines in eJj n this date. � , , •. signature -- - - -- ftii'; �•..7, Engineer's Name 4 ,J 4 ki 0. K LSC G �.. •• y ` 1' Date ;t�er,1,. ��...._ •�:�_�" HAA Fee S v ' _ Waiver Fee S Date of Payment 4.444, d Dam of Payment Receipt Number © e Receipt Number Rev. 9/95 OSS: haawk.doc 41-1D MUNICIPALITY OF ANCHORAGE O DEPARTMENT OF HEALTH b HUMAN SERVICES AUM Division of Environmental Services ffs On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING y Parcel l.D.# QLE- 07N- dl HAA# 0M'If11t�In 1. GENERAL INFORMATION Complete legal description Location (site address or directions) Sea 1 L= R 8 " Property owner Ec� Teat -S. Day phone 3Y6 - Sl02/8 ti Mailing address 5uo 1 !- F8- st, I - I z.5 o u Lending agency Mailing address Agent Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well Community well \1 Public water Day phone Day phone NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site V Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. n-025(Aw.1l9p From MOA,21 S. 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I furtherverify 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm J o �l� u r Jp✓✓ I/..(.aw'c�s' �L= Phone A _ _ ✓ _ / f- r J. Address Engineer's signature 6. DHHS SIGNATURE X. Approved for bedrooms. Disapproved. Date Conditional approval for bedrooms, with the following stipulations: Additional Comments By: .�.�. &'_t� Date 11 ITW The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct Inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 77M5 (P.. M) BWk MOA821 Municipality of Anchorage lah Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L�lr3K3 W�S�+L Parcel I.D.o 1d — Oiq — a A. Well Data Well type t -le -n A If A, B, or C, attach ADEC letter. ADEC water system number 2 / 0 6 ?,!a Log present (YM) completed Driller Total depth Cased to Casing height Sanitary seal (Y/N) Wires property protected (Y/N) SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot On adjacent lots Absorption field on lot ; On adjacent lots Public sewer main sewer manhole/cleanout Sewer service line Petroleum tank WATER SAMPLE RESULTS: Coliform Nitrate Other bacteria Date of sample: Collected by: B. SEPTICIHOLDING TANK DATA Date installed ►G 7 Z Tank size Cleanouts (YM) 1 Foundation cleanout (Y/N) 4 FIV Depression (Y/N) High water alarm (YM) arm testa (YM) Date of pumping 4 �r 3 9 3 Pumper A+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot ty/A On adjacent lots l%} Foundation f Z To property line �? 10 Absorption field > /0 Water maintservice line Surface water/drainage IN !'O 7z-026(W3)'F=t CONTINUED ON BACK PAGE FROM WELL LOG AT INSPECTION ` n n o < Date of test t T "' Static water level Well flow g.p.m. g.p.m. rl'1 w 0 o Pump levell o c Z SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot On adjacent lots Absorption field on lot ; On adjacent lots Public sewer main sewer manhole/cleanout Sewer service line Petroleum tank WATER SAMPLE RESULTS: Coliform Nitrate Other bacteria Date of sample: Collected by: B. SEPTICIHOLDING TANK DATA Date installed ►G 7 Z Tank size Cleanouts (YM) 1 Foundation cleanout (Y/N) 4 FIV Depression (Y/N) High water alarm (YM) arm testa (YM) Date of pumping 4 �r 3 9 3 Pumper A+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot ty/A On adjacent lots l%} Foundation f Z To property line �? 10 Absorption field > /0 Water maintservice line Surface water/drainage IN !'O 7z-026(W3)'F=t CONTINUED ON BACK PAGE C. LIFT STATION "�^ Date Installed Manufacturer Size In gallons Manhole/Access (Y/N) Vent (YM) 'Pump on' level at 'Pump oft' Level at High water alarm level tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed lg710 117 7 Soil rating (GPD/F?) 300 ` System type e-4 Length 7L Width 35 Gravel thickness �o Total depth 12.—/ Total absorption area 90o Cleanout present (Y/N) Depression over field (Y/N) LZ Date of adequacy test "134,9 13 ,9 Results (pass/fail) for 3 Bedrooms Water level in absorption field before test ID After test o2 7 Peroxide treatment (past 12 months) (Y/N) t1_1 If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot `7 /4 On adjacent lots N1i4 Property line _ i / 0 To building foundation > /'D Two lexisting or abandoned system on lot P4�� On adjacent lots 1 3a Cutbank 0 Lr e Water main/service line 7 / O Surface water r`i O Driveway, parking/vehicle storage area i Z Curtain drain N 10 E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect &nthe d'ate'ol this inspection. Signature • Engineers Name e) �� -e k Let atdC ��_ �, ; r t `e ✓. Date tl ✓ `i c—1 993 � f c e4 C' HAA Fee $ c3w Ir Date of Payment Receipt Number o25�9.,3!54 007L 72-028 (387)' Sack Waiver Fee $ Date of Payment Receipt Number, •'1 c]o! 1gru LLX P.1iil!H.1!'.'I L.ITY(1 i ..': C'i I(J!t!\'.'. VFPA111 .1AT OF N' t.'t?u hPlvi: t0, cl: 4T(::. P I I J 1:.:.:'l ON CN V!P0 N%!ENTAL EFt f:!NCE RI NG : IVI::I Cd..' Teia7hr.f.^ ?1i4-37YO irQUEST i OR CPi'! OV"L. OF INDIV!DUAL VIATER Ai•!!) 'EIr:EFi FAMUT, r;CIlCTtiriJu: Co- 'I'.xia x:! pa -v. On i:r9: 1. Lxur:p:n a mjvesIi wdi rut be r—cssuJ. Pic,--^ a !ow M.,, (1'3i r, ivs ro. p••r ., IAO:3v N rF.. LF t.L ri-S-R I J I I I,%- n fF1 i:rT.1.00A7I I c. Tvfc o;- f:eslract: P:U:'.1i;Lit OF 6'turli'J-1 SINGLE FAf:11(.Y J One ❑ Four ❑ Ovier— ❑ Two ❑ Fi•:o ❑ MULTIPLE FAfiILY 1� TLrPP ❑ c: 7. :VAT!11 SUPPLY I CD I`171V!OUAt.' 'ATTACH 6'.ELLLOG.Aw,'-1'!c,is:e(;uirdsola;Iwdisdlili^± I %U".'�lUNiTY � 1 sin'�c June ?575. Fm'r:vlls d�illyd prig to that c04!,% 4'. ve v:cil I _ C... �I$Lt"' UTILITY dr,p;h (at'e.;!• l0'1 I(ty?i1.li �.1 1 SyvA^C Ulbl"ML SYSTC(4 ----"—' ( XI INDWIDU.AL/CN SITG' • "If indivuival;on-site, p;ve insla!lat!on deL� Ifs\'tl?'p is cvAr two "D IT ill C I � if) Ld,(19bfY t^..p is rOtIU'red [7 f'!I^.LIC UTILITY !1 t by th.s G: ;xii-.m.cm. J � NOTE: THL' IN^I'ECTIUN PCS C.IUSTA000I i^P,1:Y EACH RGOI:cST ItEFURE I'POCLSS;NG CAN C. !!I:ITIAI-C-D. i` �� )LI 911 $ 1/7, F v - '--�----_-_-----'--'--,.--'_--'�-~-__`'--'--,---__-'_�- �--� -- - --'----'' ' ~ IT TI, 2. 1."'ATER SUPPLY PER ED C01�'MUNITY DATE DRILLED TYPE OF TANK lk.!AN'jFA';TuI [I TOTAL AlISOI-O" IX! AREA MATERIAL 01 U!SAt'PROVED 11 &0 --7& GREATER ANCHORAGE AREA BOROUGH 66,hlL&i . Department of Environmental Quality M4 61ULc WLQl nta4 3330 "C" Street, Anchorage, Alaska 99503 274-4561 enib 4 � p�y� Date Received Sept er 16, 1976 ,,,• J� 2 "(1LJ � 1� ��o Time of Inspection Date of Inspection �{ REQUEST FOR APPROVAL OF a� INDIVIDUAL SEWER & WATER FACILITIES S' FOR Conv. 1. Approval requested by: Alaska Pacific Bank Pat Jones Mailing Address: Post office Box 420 Phone: 276-3110 x 34 2. Property Owner: Terry J. Schreiner Phone: 349-1303 FiMIng Address: 5001 East 90th Avenue 3. toga] Description: Lot 1 Block 3 Williamson Subdivision #2 vocation: S. Type of facility to be inspected Single Family No. of bedrooms 2 6. Well Data: Community Well A. Type B. Depth C. Construction D. Bacterial Analysis 7. Sewage Disposal System: On-site system A. Installed C. Septic Tank: 1. Size B. Installer 2. Manufacturer D. Seepage Pit: 1. Absorption Area E. Disposal Field: Total length of lines 8. Distances: 2. Material A. Well to: Septic tank , Absorption area Sewer Lines _. Nearest lot line Other contamination - B. Foundation to septic tank Absorption area C. Absorption area to nearest lot line EQ -034 (1/74) 0j - Page 1 of two pages pgge 2 of two pages - Regt�t for Approval of Individual Sit- & Water Facilities "tegalDescription Lot 1 Block 3 Williamson Subdivision $2 Comments Approved Disapproved Date //1-2 2 4 Approval,Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED EQ -034 (1/14) Date A" 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION \ 2510 East Tudor Road, Anchorage, Alaska 99504 276.2221 \' REQUEST FOR APPROVAL OF i IN DI VI DUAL SEWER and WATER FACILITIES S\ C f' C I V 1. TypeofInspection: CMRO VA FHA CONVXXX 2. Property Owner: Schreiner, Terry J. DDS Mailing Address: 5001 E. 90th Ave., Anch AkDay Phone: 349-1303 3. Name of Buyer: Green, Leonard and Beverly Mailing Address: 7968 Resurrection, Anch AkOayPhone: 276-1735 - Alaska Pacific Bank 4. Name of Lending Institution:- Mailing Address: P.D. Box 420 99501 —Phone: 276-3110 Ext 34 5. Name of Realtor or Agent: Gene's Realty ( Barb Hill Mailing Address: Phone: 272-6494 6. Legal Description: Lot 1, Blk 3 Williamson S.D 112 Location: off O'malley road on to Our Road bearing right into E. 90th 7. Type of Facility to be Inspected: Single Family No.Bdrms. 2 8. Water Supply Type of Supply: Public Utility Individual Community Well If Individual, number of dwellings presently served Unknown If Individual, depth of well 9. Sewage Disposal System Type of System: Public Utility Individual (on-site) Septic If Individual, date of installation 1973 72.003(3176) u GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality _ W 330 "C" Street, Anchorage, Alaska 99503 274-4561 ,LwL�'; C Date Received z- z 7 _ ,rfJ• Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR 1. Approval requested by: Mailing Address: &&K y,,�hone: 2-79--zZa& 2. Property Owner: qzlf .Q/G Phone. Mailing Address: e. 9D �' 3. Legal Description: Z/ AO:3 4p 4. Location: 5. Type of facility to be inspected.��,,�c No. of bedroomso�� 6. Well Data: ' A. Type C. Construction 7. Sewage Disposal System: tVr-P?- %` ' A. Installed .Ccs 73 B C. Septic Tank: 1. Size D. Seepage Pit: B. Depth D. Bacterial Analysis OV 5a, Installer 2. Manufacturer 1. Absorption Area '/L S 2. Material E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank , Absorption area Sewer Lines —, Nearest lot line Other contamination B. Foundation to septic tank Absorption area C. Absorption area to nearest lot line EQ -034 (1/74) Page 1 of two pages GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" St., Anchorage, Alaska 99503 - 274-4561 '.REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES 1. Type of Inspection: CMRO VA xx FHA CONV 2. Property Owner: Roger Doughty Mailing Address: 5001 East 90th Street it .Day Phone 344-4462 �•• 3. Name of Buyer: Terry J. Schreiner Mailing Address: 30-300 G Cherry Drive Day Phone 75 -2220 4. Name of Lending Institution: National Bank of Alaska Mailing Address: Boz 3-3859 Phone 279-2506 5. Name of Realtor or / Agent: Randyyarnell ( 2 111 A_A r- % �f Mailing Address:. Phone 272-4568 �T 6.. Legal Description: Lot I, Block 39 Williamson Subdivision #2 Location: 5001 East 90th Street 7. .Type of Facility to be inspected: SFR No. Bdrms. 2 8. Water Supply Type of Supply: Public Utility Individual Community XX If Individual, number of dwellings presently.served If Individual, depth of well 9. Sewage Disposal -System Type -of System: Public Utility Individual (on-site) X% If Individual, date of installation Unknown Return to: Leann Denn National Bank of Alaska Boz 3-3859 Anchorage, Alaska 99501 Inge 2 of two pages - Re'�%:st for Approval of Individual '�)er & Nater Facilities Legal Description Comments Approved, �ctocu Disapproved Date Approval;Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained 1n this request for approval to De a true ano accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED EQ -034 (1/74) Date t