HomeMy WebLinkAboutKENO HILLS #1 BLK 5 LT 1Keno Hills #1
Block 5
Lot 1
#020- 171 - 12
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program, 4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us (907) 343-7904 Page 1 of 3
On -Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: SW030017 PID Number: 020-171-12
NamesWastewater
'PEPPER'S CONSTRUCTION
System: ■ New E] Upgrade
Y
Address:
10224 W. FRONTAGE ROAD * EAGLE RIVER, AK. 99577
ABSORPTION FIELD
Phone: No. of Bedrooms:
(907) 694-9681 4
[]Deep Trench ❑ Shallow Trench ❑ Bed ❑Mound ■Other
LEGAL DESCRIPTION
Sail Rating: 6 DGPD/Sg.
Total Depth from adgia2 grad.:
MAX
Ft
Ft.
Block: Lot: Subdivision:
Depth to pipe bottom from original grade:
Gravel depth beneath pipe:
5 1 KENO HILLS W1
SEE DWG. Ft.
0.5+ Ft.
Township: Range: Section:
Pit added above original grade:
Gravel length:
— — —
SEE DWG. R.
40 n.
Gravel width: -
Number of lines:
Dielonce beMeen lines:
WELL: ■ New ❑ Upgrade
5 R.
1
— Ft,
ClassYcaHon (Private, A.B.C):
Total Depth:
Cased Ta:IBEaROCK)
Total absorption area:
Pipe motedal:
D 3034/ F-810
PRIVATE
300 Ft.
21 Ft.
200+ so. R
Driller.
Date Drilled:
Static Water Level:
Installer.
GEG, Ltd.
Dote installed:
3/7/2003
SULLIVAN WATER WELLS
3 11 03
12 Ft.
Yield:
Pump Set At:
Casing Height Above Ground:TANK
2.5 cPM
UNKNOWN Ft.
2 Ft.
SEPARATION
DISTANCES
❑ Septic ❑ Holding ❑ S.T.E.P. ■ other*
To
Septic
Absorption
Lift
Holding
Public/Pdvote
Manufacturer.
ORENCO SYSTEMS
Capacity in gallons:
1500
From
Tank
Feld
Station
Tank
Sewer Ones
Well
100'+
1 Oo'+
—
—
25'+
Material: _ FIBERGLASS
Number of comportments:
2
Surface Water
100'+
100'+
—
—
—
LIFT STATION
Lot Line
5'+
10'+
—
-
—
Size in gallons:
1500
Manufacturer:
ANCHORAGE TANK ORENCO SYSTEMS
'Pump on' level at:
Pump off' level at:
High water alarm at:
Foundation
5'+
10'+
—
—
—
TIMER
TIMER
46"
11
Pump Make k Model:
Electrical Inspections "domed by:
Curtain Drain
NONE KNOWN
#20 051 OS HHF
M.O.A.
BENCH MARK
Remarks:
Location and Description:
*THIS IS AN ADVANTEX TREATMENT SYSTEM
TOP OF MANHOLE LID
Aosumed Ekvogon:
100.00
Ft.
--REVISED
EMBED q..JO4
ENGINEER'S S L
006>0�
OF gab
o�
Inspections performed by: GEG, Ltd. Dates: 1st 3/7/2003
TM� ..... - ......... �.aO
2nd 3/7/2003
r .......`
3rd 5/13/2004
QO Je e A. r essr
Development Services Department Approval
�
0� s . -79.• foo
30�f�coo0
Reviewed and approved by: MW 17rvio Date: 0 /y
(Rev. 12/01)
�p0"PrafISSs;o�°o�
4OOD��p�
i
Jeri YoQ1, Mo/4, rlg5 CO/I'rl✓MPN 40.d C044'0115 Wert
PERMIT NUMBER: AS—BUILT D RA T 1 I N G PARCEL ID NUMBER:
SW030017 020-171-12
r,,,, °
---------- A!// -----
33' SECTION UNE EASEMENT
/ .:.-,•,�,.� . .f / -NEW WELL
1
ALTERNATE SITE �}
\ II M72 2
I
¢� NEW DRAINFIELD----
I Mit
"3
REVISED 11/19/041_,_
1 19 04
GARNESS ENGINEERING GROUP, Ltd.
-..--.. -. CONS€7LTANTS& GENERAL CONTRACTORS
RAL
PARED FOR: PHONE NU muL r�ac numocn:
PEPPER'S CONSTRUCTION (907) 694-9681 2 OF 3
\L DESCRIPTION:
KENO HILLS SUBDIVISION; LOT 1, BLOCK 15,
OF WORK:
AS -BUILT DRAWING OF NEW WELL LOCATION AND SEPTIC SYSTEM
–NEW 1500 GALLON
FIBERGLASS ADVANTEX
TREATMENT SYSTEM
%AM
51.49
31.36
54.50
41.46
82.01
63.53
79.75
61.68
54.71
160.55
55.87
1 70.62
X04
D
. ...^.
5.: ..
951
.• a O
PERMIT NUMBER: AS -BUILT DRAWING PARCEL ID NUMBER:
SWO3O017 020-171-12
TOP OF ADVANTEX POD TOP OF MANHOLE _
98.62 (AVG.) 100.00 (AVG.)
FINAL GRADE
= 96.07+
2' INSULATION
TOP OF TANK� II I 94.00
94.07 II TOP OF TANK
INVERT OF PIPE
= 93.11 -
FILTER FABRIC
2' INSULATION -
TOP OF SAND -�
- 91.24 (AVG.)
BOTTOM OF
TRENCH =
88.74 (AVG.) -
REVISED 11/19/
APPROVED
5'�
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS
3701 E. ROAD, SUITE 101• ANCHORAGE, AK 99507 • PHONE (907)337-6179 ' FAX (907)330-3246
'.PREPARED FOR: - PHONE NUMBER:
PEPPER'S CONSTRUCTION (907) 694-9681
LEGAL DESCRIPTION:
KENO HILLS SUBDIVISION; LOT 1, BLOCK 5,
TYPE OF WORK:
PROFILE AS—BUILT DRAWING OF NEW SEPTIC SYSTEM
ORIGINAL GRAI
= 90.74
HIGH POINT
INVERT OF PIPE
= 91.90 (AVG.)
RELATIVE ELEVATION OF BOTTOM OF
TEST HOLE = 84.74 (TEST HOLE DRY)
DATE: 000bpp
11/18/2004 0! of
DRAWN BY:
C.J.G.
SCALE: �..••. f oI
C 4 -
N.T.S.
. . ...... ........
PAGE NUMBER:
3 OF 3 :.. . IQ.. . ` . cc:...
.0
Oct 24 05 06:08p
From +19078308507
P. Scott Peppers
Mon Oct 24 05:46:01 2005
907-694-9680
page 1 of 1
INSPECTION REPORT
MUNICIPALITY OF ANCHORAGE, BUILDING SAFETY DIVISION
4700 SOUTH BRAGAW
INSPECTION INFORMATION &HELP: S43-7882
X07 249-7777 www.muni.org/SSD/inspeotions.ufm
INSPECTION: VOICE 343-8300 INSPECTION. FA ( ) -
NAME: NG
COMPANY: ACCESS ELECTRICAL
PHONE#: 301-1646 PHONE#:
ADDRESS: 17267 ASHLAND DR
LOT 1 BLOCKS SUBDIVISION: KENO HILLS #1
COMMENTS or DIRECTIONS
CALL 1 HR S4 FOR ONSITE MTG
TYPE OF INSPECTION: Final Eleatrloal
PERMIT #: 04-1256
INSPECT DATE: 10/24/2005
PHONE #:
GRID C SW3438
COMMENTS: (FOR INSPECTOR USE ONLY)
��Eri�� i✓tKoM Io - I a - oS ! r.>� t��L--rf oc.1 ��(-ZK�c.-r�.[�,
DATE:
PRINTED NAME i -I!�' •�L ( �! .
10 O~
04.: ~4p Peppers
:'
by
DOC CO. dba
907-GS4-SGSO
SULLIVAN' WATER. WELLS...:.
P.O. B0X670272, CHUGIAK,. ALASKA 9.9567 · TELEPI:tONE688'2..7.5~.:' ' '.
IWNER OF LAND:
,DDRESS:
i '
. '...I .... '""' ': -"'"
.-....-..,. :.,. ,
.................. ' .:", ............ ~ t~: f,,~. ~; ;:-7/
s we~'l~a~d~b.ap~ved permit'~cali~' ~s 'J No
._,. ..................... :--_~ ,
~ethod of Drilling: :~{ota~, ~ cablgtool · .'
)~pth of wel~; ~ ~ ~
;asing Type ~ ~EE~ Wal. I T. bjckqes% ; ~ ~ D inches
1 ''-'. -'" ' · .'
}iA~te~F{~'~'~ .'. ". in~h~'s,.depth .~"[,~' : fe~t..
· - ~ . ::' ' ...:; '... -.
:iner~ype: "::~'~'"~' '"' :' -" "
;asing Stickup Above Ground: ~ ' feet
3tatic Water Level: /~' feet
~ecover Rate: ~ · ~ gpm
Method of Testing: ~/~
~ell Intake Opening Type: ~ o~n end ~hole ,
..... ,.. b,., ,...,. ~, i.. , .~.:'
J Scree~; -'.t' .-Start.- f~;.,: ..... ~t~ Stopp~fl-:~"..-.,:'... ;, ~t~tt
~ Perforations Sta~ fee .~)opped . feet
Grout Type:~c~ I Volume / bo ~'
Depth: [rom O feet, to ~O feet
Well Disinf~t~ Upon Completion? ~s O No
Method of Dis~nf~tion: ~au~,O~- b--O ~/~ '
BORE HOLE DATA
DEPTH
F~om To
.2P~
p.1
ATTENTION: It is the responsibility.o~ the I~'l~'erty owner to submit a'c~by of'the well log tO the proper 'adtho¢ity.. Municipality
of ~ch~age: :Deparlm~nt of H~hlth ~:'Hu~nan:Ser~Ices and/or Department of Environmental Conservatiom MatSi. l Borough:
Departmer~t of Envi~:6nm'ental C6hservation. .' · ..' · ' '"
., .1 ..... ...'.. .!.... ~..;-..;:
'i".i':": :,-:...'":-..~-, .'. ':.,.~- '- ': '.,,: '" ....... ' .... ' "' ' '""':" "' : ' ' '" "'"'"" ..... ' " " ...... "'""'?'" '"" ' ' '
t..- :.. .:-..,.,~' "· '... '.', .~..'..,:, · . .' .... . ~.:,i,-.'".~, ' :" :'-' '-"'.'"., .' ' '.' .'..~: ".~:~": · :."J- '-., · ". , ,'.;." .. '.' '. ' . . . ·
, · . ~ .:...'. · ::-.-. .......' .... ...,..:;,.'.. ..,:..:, .,, . ~'..~.,...,.,,... ;~:'f.: .o,' ;.,.'.;~,~,. ..,.:.. - ..
· >' .... ~ . .., · ~.....',.:~..:.. .; ' ,;.;:,..~ ,' .:~'t~:-~'>>,..:4 .-',~ '.',. :.?: ,',r:' ..',C · :%' ..:'~,.,..'. ':: ." .~...; · ....,. ..,.. :..:. .'11~:... '...: '. . . .
· .. . . ~ . ..- .... · . --.'/..' . -.. ,.._g_.._ ... ~ ,....._
MUNICIPALITY OF ANCHORA GE
Development Services Department
On-Site Water & WaStewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
t/ 12. '3
ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT
Initial
Date Issued: Feb 06, 2003
Expiration Date: Feb 06, 2004
Permit Number: SW030017
[ L-e'~l ~D~'~C?ilSt i~':-.~iK E N O: ~I!;I~-~I.~LK ~.~5.'LT._-.'~I i~
Design Engineer: 0041 AK Water & Wastewater Consultan'
Owner Name: Scott Peppers
Owner Address: 10224 West Frontage Road
Eagle River, AK 99577-
Parcel ID: 020-171-12
Site Address: 017267 ASHLAND DR
Lot Size: 128502 SQ. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
This permit is for the construction of:
r~ Disposal Field r~ 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: ~
Date: ~___~~,~
ALASKA WATER & WASTEWATER
errs„=ramm.«m�sn++a:ama esaa..ae CONSULTANTS, INC.m”
January 3, 2003
Municipality of Anchorage
Development Service Department
Building Safety Division
On -Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
Ref: Proposed Well Septic System for Lot 1, Block 5; Keno Hills Subdivision
ADVANTEX' TREATMENT SYSTEM
To whom it may concern:
1. GENERAL: The proposed 4 bedroom Home will be served by a private well and septic
system. Two test holes were excavated on the property. We are proposing to design the septic
system around the 30 foot radii of these test holes. Due to the shallow bedrock and the desire to
minimize the size of the drainfield area we are proposing to use an Advantex treatment system
and a 5 -wide trench type drainfield. The well is to be located in the area shown on the site plan
and design drawing.
2. SOILS: See the attached log, which shows the soil classifications, groundwater monitoring,
and the percolation test results.
3. DRAINFIELD APPLICATION RATE: The intent is to install an Advantex Treatment
System that will allow the use of a small drainfield in the area around the 30 foot radii of the test
holes. A percolation test was perfonned in each test hole between the depths of 2.0 to 2.5 feet.
and found the rates were both <1 minute/inch. The Advantex system has received class III
approval and we are going to conservatively assume an application rate of 3.0 GPD/FT2.
4. TRENCH DESIGN:
a. Percolation Rate: <1 minutes/inch
b. Proposed Application Rate: 3.0 gallons/day/ft2
c. Number of Bedrooms: 4
d. Design Flow: 600 gallons per day
e. Minimum Absorption Area: 200 ft'
f. Total Depth: 2.0 feet (max.)
g. M.O.A. Approved Sand Filter Depth: 2.5+ feet
It. Effective Depth: 0.5 feet
6901 Debarr Road, Suite 2B — Anchoraee, AK 99504 —Ph: (907)337-6179 —Fax: (907)338-3246
i. Width: 5 feet
j. Minimum Length: 40 feet long
k. Effective absorption area: 200 ftZ
5. ORENCO PACKAGE SYSTEM: The STEP tank with the Advantex Treatment System will
be manufactured by Anchorage Tank & Welding to meet the latest design criteria established by
Orenco Systems, Inc. The point of contact at Anchorage Tank is Lowell McNutt. As with their
standard STEP tank, it is equipped with a high water alarm per M.O.A requirements.
6. SURFACE WATER: There is a drainage easement 100+ feet south of the proposed
drainfield: In short there are no concerns.
7. TOPOGRAPHY: The average topography around the proposed drainfield range from 10%-
15% slopes. In short there are no slope concerns.
8. CLOSING: - I am open to any suggestions from your department that would be an
improvement to the proposed system. I am unaware of any negative impacts that this installation
would impose on adjacent wells, or septic systems. If you have any questions, please call us at
ZI�n
.E., M.S.
NOTE: Attached is a site plan drawing, a topography drawing, a design drawing, an Advantex
detail, a trench detail, two soil logs, and a 7 page construction specification letter which are all
part of the design package for this septic system.
6901 Debarr Road, Suite 2B —Anchorage, AK 99504 — Ph: (907)337-6179 —Fax: (907)338-3246
LOT 7:' ASHLAND S/D
i
y
/rte
TRACT A; ASHLAND S/D '
'SF,PTIC'JJ%a
LOT 2; ASHLAND S/D// �J/
> .......
THpl, klt3 PROPOSED WELL \
t
TH#2
PROPOSED
4 BEDROOM
HOUSE
LOT 5, BLOCK 4; �� _ PROPOSED SEPTIC SYSTEM
(SEE DESIGN, PAGE 2 OF 4)
I
`I
1
KENO HILLS S/D \�G
II
I1
+ — -----------------------------
---I
1
j
IVI
----------�
/ \
I
1 1
V
1 +00WFII RArnus
I
V
I I I LOT 2, BLOCK 5;
I
I 1
I 1
V + KENO HILLS S/D
I
( !!
NO ENCROACHMENT CONCERNS
\ I J
LOT 6, BLOCK 4; �
I
! I 1
KENO HILLS S/D
I
I
I
Q 1
1 1
DATE:
1/3/2003
-
.).. .. ..
.• ....
'^
...... ..
DRAWN BY:
Z.T.G.
ALASKA WATER & WASTEWATER
CONSULTANTS, INC.
SCALE: -
-
1 — 100,
6901 DEBARR ROAD, SUITE 28' ANCHORAGE. AK 99506' PHONE (907)337-6179' FAX (907)338-321,6
r/
i^
PREPARED FOR PHONE NUMBER:
PAGE NUMBER:
SCOTT PEPPER 694-9681
1 OF 4•
/, ft ey A.
Go
�Ijn 9, C
7953 IiI"
LEGAL DESCRIPTION:
KENO HILLS SUBDIVISION; LOT 1, BLOCK 5
`P
+�"tlprofession°<'�
TYPE OF WORK:
PROPOSED WELL AND SEPTIC LOCATION
LZ
_1_1_.Z_1_ -Z-1— L1_G1�
ALTERNATE
FrA
I�1�11i#1 '
STALL DOUBLE
CLEKNOUTs—(
r0 I
PROPOSED
4 BEDROOM
HOUSE
i
f' SECTION LINE EASEMENT \
PROPOSED WELL \\
I
/
�O-
S /
FOUNDATION
PROPOS D 1500 GALLON
ADVANTEX TREATMENT SYSTEM
(SEE DETAIL PAGE 3 OF 4)
-PROPOSED DRAINFIELD. EXCAVATE A TRENCH THAT IS 2
FEET DEEPMAXIMUMBY 5 FEET WIDE BY 40 FEET LONG.
ADD 2.5 TO 3.0 FEET OF M.OA. APPROVED FILTER SAND
AND THEN ADD 0.5 FEET OF CLEAN, WASHED SEWER
DRAINROCK. (SEE DETAIL PAGE 4 OF 4).
NOTE: THE CONTRACTOR SHALL
HAVE THE SECTION LINE
EASEMENT AND THE CREEK
SETBACK FLAGGED BY A
REGISTERED LAND SURVEYOR_
PRIOR TO CONSTRUCTION.
-----------------
10' UTILITY EASMENT — -- — — --
1/3/2003
DRAWN BY: o �� ..........s°a
ALASKA WATER & WASTEWATER Z.T.G.
CONSULTANTS, INC.
«-_�=— scA�E` 50' ........ .. ... ............
_
6901 pE84RR R04D. SUITE 2B ' ANCHORAGE AK 99504' PHONE (90])33]-61]9' FAX (907)338-3246 _
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: p
SCOTT PEPPER (907) 694-9681 2 OF 4�'
�p J r Garn ss:
LEGAL DESCRIPTION: O o _ �G
KENO HILLS SUBDIVISION•' LOT 1' BLOCK 5
TYPE OF WORK: _ °�4P f'40fessloY�Q��
DESIGN OF PROPOSED WELL LOCATION AND SEPTIC SYSTEM �04p0000�
INLET _
FINAL
6" ABS F
6" ADS
GLUED
30 INCH
6" JIM CAP/—ADVANrEX INSULATED
fFYP.2)—\ . / AX20 PDD RISER
�pg�p EWEK
rp✓)@+ .RSOCK.
INLET _
Advan.Tex" _Treatment System
n. PE%AS THEOSS,
NOTE. THE BOARD BE
INSTALLED OVER THE SEPTICIOTANK do 4"
AX20 - Mode la
c ADVANTIX MANUAL
BEYOND ON ALL SIDES EXCEPT UNDER
THE AFILTER. THIS WILL ALLOW
40x94Pod
Or�o�Byslemsf _
Ll
FOR HEAT T
TO ESCAPE FROM TANK &
RISE TO THE FILTER ABOVE IT.
INLET _
FINAL
6" ABS F
6" ADS
GLUED
30 INCH
6" JIM CAP/—ADVANrEX INSULATED
fFYP.2)—\ . / AX20 PDD RISER
DATE:
1/3/2003
DRAWN BY:
ALASKA WATER & WASTEWATER Z.T.G.
CONSULTANTS, INC, SCALE`
6901 DEBARR ROAD. SUITE 29 . ANCHORAGE. AK 99506' PHONE (901)33) 6119 ` FAX (901)33832L6 N.T.S.
PREPARED FOR. PHONE NUMBER: PAGE NUMBER:
SCOTT PEPPER (907) 694-9681 1 3 OF 4
LEGAL DESCRIPTION:
KENO HILLS SUBDIVISION; LOT 1, BLOCK 5
TYPE OF WORK:
DETAIL OF ADVANTEX TREATMENT SYSTEM
BIOTUBE -
SCREENED
VAULT
EFFLUENT
PUMP
9500 GALU
FIBERGLASS
UFTSTATION
a TH ''7."Q
`-�y . arne s:'�
IO sf 79
a
0
404eC F'rOfes5i0X` -
oDODOOoo�
�pg�p EWEK
rp✓)@+ .RSOCK.
INLET _
OPTIONAL
SUDE SECTION
OF 8" PIPE
OVER THIS CONNECTION
TO PROVIDE
Ll
'. SHEER PROTECTION—
' EXTEtJD TO
BRIDGE EXCAVATION
DATE:
1/3/2003
DRAWN BY:
ALASKA WATER & WASTEWATER Z.T.G.
CONSULTANTS, INC, SCALE`
6901 DEBARR ROAD. SUITE 29 . ANCHORAGE. AK 99506' PHONE (901)33) 6119 ` FAX (901)33832L6 N.T.S.
PREPARED FOR. PHONE NUMBER: PAGE NUMBER:
SCOTT PEPPER (907) 694-9681 1 3 OF 4
LEGAL DESCRIPTION:
KENO HILLS SUBDIVISION; LOT 1, BLOCK 5
TYPE OF WORK:
DETAIL OF ADVANTEX TREATMENT SYSTEM
BIOTUBE -
SCREENED
VAULT
EFFLUENT
PUMP
9500 GALU
FIBERGLASS
UFTSTATION
a TH ''7."Q
`-�y . arne s:'�
IO sf 79
a
0
404eC F'rOfes5i0X` -
oDODOOoo�
I(
I. . 0
I ' MT
-FROM ADVANTEX
TREATMENT SYSTEM
1
-------==------ -------------1
I
I
I CO
I
O I
------------------------------J
MT
-40 FEET LONG. - -
03
MIM
JAR
FILTER FABRIC FINAL GRADE
INSTALL BRACING AND INSULATION -
STAKING AS NEEDED T
�5 FEET
ALASKA WATER R WASTEWATER
CONSULTANTS, INC.,l=s " -
6901 DEBARR ROAD, SUI TE 29 •ANCHORAGE. AK 99506 • PHONE (907)53]-6179 - FAX (907)339-3266
PREPARED FOR: PHONE NUMBER:
SCOTT PEPPER (907) 694-9681
LEGAL DESCRIPTION:
KENO HILLS SUBDIVISION; LOT 1, BLOCK 5
TYPE OF WORK:
DETAIL OF PROPOSED DRAINFIELD
ADD 0.5 FEET
OF EFFECTIVE
ADD 2.5 TO 3.0
FEET OF FILTER
FEET DEEP
MAXIMUM
J BY: Tj .z.T.c.O�1gN.T.S.NUMBER: p4 OF 4P. ffP. A. (i lI1 P.SR
ALASKA WATER & WASTEWATER
— - CONSULTANTS.JNC. _ •__-- .:-x�=
SOIL LOG - PERCOLATION TESTI .
LEGAL DESCRIPTION: KENO HILLS SUBDIVISION; LOT 1, BLOCK 5
PERFORMED FOR: SCOTT PEPPER DATE: 10/2/2000
DEP_ Z_
(feet==== =E
ORGANICS TEST HOLE #1.
7 BEDROCK
B.O.H.
8
9-
10-
11 1011
12
13
14
16-
17-
18—
I
GROUNDWATOER I DATE
------------------------------------ ---------- q�--
/ PROPOSED WELL '\
-- ----=--=----�- ----- --- ----------------
TH#1 ♦1
1 /
____ TH#2 * /
PROPOSED
4 BEDROOM
HOUSE
\-------
_____
SITE PLAN _
1"=1D0'
DATE
READING
CLOCK
TIME
NET TIME
(MINUTES)
CLASSIFICATIONS
NET DROP
(INCHES)
rrSOIL
yr
GW
O.
■GP
ML
M
--PS FPSZ
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CIL
�P.�ER
r
r
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SWSM
l�CH
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r
r
�y16
'SiYSt7i
�
f1114�!SC
7 BEDROCK
B.O.H.
8
9-
10-
11 1011
12
13
14
16-
17-
18—
I
GROUNDWATOER I DATE
------------------------------------ ---------- q�--
/ PROPOSED WELL '\
-- ----=--=----�- ----- --- ----------------
TH#1 ♦1
1 /
____ TH#2 * /
PROPOSED
4 BEDROOM
HOUSE
\-------
_____
SITE PLAN _
1"=1D0'
DATE
READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
PQ�ED
--PS FPSZ
�P.�ER
---
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e50RgE0
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,0
2
19 PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 2.0 FT. AND 2.5 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES ® NO
SOILS LOGGED BY: JEFF GARNESS PERCOLATION TEST PERFORMED BY: SUSAN OSWALT
COMMENTS:
PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS VpS ERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: I7
ALASKA WATER & WASTEWATER
CONSULTANTS, INC -
3901 OEBARR ROAG, SURE 28 c ANCHORAGE. M. 99504 • PHONE (907)337-6179 • FA%:907 336-3246 •`WEBSRE: ak...com
SOIL LOG — PERCOLATION TEST
LEGAL DESCRIPTION: KENO HILLS SUBDIVISION; LOT 1, BLOCK 5
PERFORMED FOR; SCOTT PEPPER DATE: 10/2/2000
DEPTH
(feet) ORGANICS ITEST. HOLE #21
1
SOIL CLASSIFICATIONS
2
GW ORG
GM GM.' CL
4 GC OL
ism
SW MH
5 SP CH
; OH .
6 SC
BEDROCK
7
8
9
10
11
12-
13.
14-
15-
16-
17-
18 -
DEPTH TO
GROUNDWATER
DATE
DRY'
10/2/00
DRY
10/11/00
DATE
READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
RgF,�
2000
Pg50
.
1� 2
19� PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 2.0 FT. AND 2.5 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES ®NO
SOILS LOGGED BY: JEFF GARNESS PERCOLATION TEST PERFORMED BY: SUSAN OSWALT
PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WASI PERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE:
Contit'4ibrn5 have, beer "ref.
I' Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.cl.anchorage.ak.us
(907)343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcell.D. 020-171-12 HAA# d�Fq
1. GENERAL INFORMATION Expiration Date:—L — 3 i —o6
Complete legal description KENO HILLS SUBDIVISION #1; LOT 1, BLOCK 5,
Location (site address or directions) 17267 ASHLAND DRIVE * ANCHORAGE. AK 99516
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
ROBERT & VICKI LUNDGREM
Day phone 694-9681
5706 FLAGSTONE CIRCLE * ANCHORAGE, AK 99502
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 4
Day phone
Day phone
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
Individual On-site
0
Individual Water Storage
❑
Individual Holding tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of 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 samples. (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.
Name of Firm GARNESS ENGINEERING GROUP, Ltd.
Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.
Engineer's Comments:
In conducting this evaluation, GEG, Ltd. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readily identifiable features. The operational life of all wells and
septic systems depend on the local soils condition, groundwater levels that may
fluctuate during the year, and the water usage of the family being served by the system_
These conditions are outside the control of the evaluator of the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, Ltd. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listad above. AnyjptLmj2e upon or use of tblsrspert-ley-a[ry
Phone 337-6179
Date f° — oc
P .Je C )'A, -Beefiness:
CE -7953 0�
c
Oils',.%z����Ao
otherperson orparty t authorized,il�ill it confer afiYlqrt whatsoever. I V
SD SIGNATURE Mai ha3 co��y QOM i{)qi ih� Co i�t'an5
X Approved for oedrooms. 'lI av- BMW I0/Z/5
es beef) I'r'le �
Conditional approval for
bedrooms, with
stipulations:
Attachments:
Chtecklist Maintenance Agreements J�0NT SENA
Septic System Advisory Supplemental Engineer's Report
Well Flow Advisory Other
By. Original Certificate Date:
(Rev. 12101)
Municipality of Anchorage
• '"` Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ei.anchorage.ak.us
(907)343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: KENO HILLS SUBDIVISION #1; LOT 1, BLOCK 5 Parcel ID: 020-171-12
A. WELL DATA *CASED TO BEDROCK
Well type PRIVATE If A, B, or C provide PWSID# N A Well Log (Y/N)
Date completed 3/11/2003 Sanitary seal (Y/N) YES
Total depth 300 ft. Cased to *21 ft.
FROM WELL LOG
Date of test 3/11/2003
Static water level 12
Well production 2.5
WATER SAMPLE RESULTS:
YES
Wires properly protected (Y/N) YES
Casing height (above ground) 18 in.
AT INSPECTION
10/21/2005
34" BTOC ft,
3.9 g.p.m.
Coliform 0 colonies/100 ml. Nitrate 0.613 mg./L. Other bacteria 6 colonies/100 ml.
Arsenic: N/A mg./L. Date of sample: 10/14/05 Collected by: GEG, Ltd.
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material ADVANTEX/FIBERGLASS Date installed 3/7/2003
Tank size 1500 gal. Number of Compartments E
Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO
Date of pumping NEW
C. ABSORPTION FIELD DATA "BELOW FINAL GRADE
Date installed 3/7/2003 Soil rating Oid. r ft2/bdrm) 6_0
Cleanouts (YIN) YES
High water alarm (Y/N) YES
System type SHALLOW TRENCH
Length 40 ft. Width 5 ft. Gravel below pipe 0.5+ ft.
Total depth 6.58/5.08 ft. Eff. absorption area 200 ft2 Monitoring tube YES Depression over field NO
Date of adequacy test NEW SYSTEM Results (Pass/Fail) For_�db werrts
Fluid depth in absorption field before test _ in. Water
Elapsed Time: _ min.
in. Absorption rate >=
New depth _in.
treatment (past 12 mo.) (Y/N & type) If yes, give date
...
D. LIFT STATION
Date installed 3/7/2003 Size in gallons 1500 Manhole/Access (YIN) YES
"Pump on" level at TIMER in. "Pump off' level atTIMERin. High water alarm level at 46" in.
Datum BOTTOM OF TANK Cycles tested NEW Meets alarm & circuit requirements? YES
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 100'+ On adjacent lots 100'+
Absorption field on lot 100'+ On adjacent lots 100'+
Public sewer main N/A Public sewer manhole/cleanout N/A
Sewer/septic service line 25'+ Holding tank N/A
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 10'+ Building foundation 10'+ Water main N/A
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
p•v. r 'I
I certify that l have determined through field inspections and Q e ,4 T'•�
review of Municipal records that the above systems are in
conformance with MOA HAA guidelines in effect on this date.
Engineer's Printed Name JEFFREY A. GARNESS 11009 E -
Date z�62 ja e^e t0
S �n Prni
HAA Fee $ C)
Date of Payment
Receipt Number
(Rev. 12101)
Waiver Fee $
Date of
Receipt Number
ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND
REPAIR AGREEMENT
MEMORANDUM OF UNDERSTANDING
BETWEEN -MUNICIPALITY OF ANCHORAGE
AND
THIS MEMORANDUM OF UNDERSTANDING made and entered into as of this
-> day of ( �' � )t ,t of 20(. j by and
herein the "OWNER," and the Municipality of Anchorage, herein the
"MUNICIPALITY." In consideration of the mutual covenants contained herein, the
parties to this Memorandum of Understanding agree as follows:
1. ADVANCED WASTEWATER TREATMENT SYSTEMS. Municipality
grants permission to Owner to utilize and operate an Advanced Wastewater
Treatment System (AWWTS), described as located
III -
at Il
<t1r�t i� ti�S ' 1 f t t< Anchorage, Alaska.
2. Definitions.
A. Alteration. Any change to the design or function of an AWWTS that
includes the installation or removal of any parts, components or pieces
not included in the original construction permit and design. Prior to
performing any alterations to an AWWTS the owner must obtain a
Wastewater Disposal System Construction Permit from the Municipality
pursuant to Anchorage Municipal Code (hereinafter, "AMC") 15.65.
B. Certificate of On -Site Systems Approval. An approval by the
Municipality of existing water and wastewater disposal systems given at
the time of property sale and title transfer in accordance with AMC 15.65.
The term begins on the date of approval by the Municipality of the installed system and
shall continue while the AWWTS system is in use or operational or until the property is
sold or title is transferred by owner and a new certificate of On -Site approval is issued to
the new owner or transferee of the property.
5. Alterations, Installation and Removal of Additional Equipment. Owner agrees
not to make any alterations, removal of parts or additions to the AWWTS without a
Construction Permit from the Municipality.
6. Maintenance and Repairs.
A. Throughout the term of this Memorandum of Understanding, the Owner shall
maintain AWWTS in good repair. In addition, it shall be the responsibility of the
Owner during the term of this Memorandum of Understanding, and any extensions or
renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2)
maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs.
Further, Owner agrees to comply will all applicable ordinance, laws, regulations,
rules and orders for the AWWTS.
B. Omer agrees to provide the Municipality a written schedule of routine
maintenance and repairs which have been performed on the system pursuant to the
terms and conditions contained in the Owner's AWWTS Operating Permit. This
schedule shall be submitted to the Municipality annually upon the renewal of the
permit. The schedule of maintenance and repair contained in the Owner's AWWTS
Operating Permit is: 1 :-i i,ti.
C. Owner acknowledges that the fine schedule for failing to maintain and repair an
AWWTS are codified in AMC 14.60.
Owner:
Anchorage: Purchasing Officer
C. Any attempt to amend, modify, or change this contract by either an
unauthorized representative or unauthorized means shall be void.
9. Jurisdiction: Choice of Law. Any civil action arising from this Memorandum of
Understanding shall be brought in the Superior Court for the Third Judicial District of the
State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and
obligations of the parties under this Memorandum of Understanding.
10. Severability. Any provisions of this Memorandum of Understanding decreed
invalid by a court of competent jurisdiction shall not invalidate the remaining provisions
of the Memorandum of Understanding.
OWNER:
By.. c „
Date:
MUNICIPALITY:
By:
Title:
Date:
STATE OF ALASKA )
) ss.
TI3IRD JUDICIAL DISTRICT )
f:
The foregoing instrument was acknowledged before me this day of
20 ,rh b}% ! '` Z l tir. i '7 the of
on behal of the Municipality of Anchorage.
NO ARY PUBLIC FOq ALASKA <
My Commission expires:
/jy`
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
a www.ci.anchorage.ak.us
(907)343-7904
Lsn
CD�!>oNA-t_ 4-&A
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Ar
Parcel I.D. 020-171-12 HAA# `V
1. GENERAL INFORMATION Expiration Date: /7 r d
Complete legal description KENO HILLS SUBDIVISION #1; LOT 1, BLOCK 5
Location (site address or directions) 1.7267 ASHLAND DRIVE * ANCHORAGE, AK 99516
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
GEORGE STECKO
Day phone 349-1183
2406 FANTAIL CIRCLE * ANCHORAGE, AK 99515
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 4
3. TYPE OF WATER SUPPLY:
Individual Well
E
Individual Water Storage
❑
Community Class Well
❑
Public Water System
❑
Day phone
Day phone
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
E
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 samples. (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. 1 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 GARNESS ENGINEERING GROUP, Ltd. Phone
Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Engineer's Comments:
In conducting this evaluation, GEG, Ltd. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readily identifiable features. The operational life of all wells and
septic systems depend on the local soils condition, groundwater levels that may
fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, Ltd. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any legal right whatsoever.
5. DSD SIGNATURE
Approved for bedrooms.
Disapproved.
337-6179
Date 5-f 7
X Conditional approval for 4 bedrooms, with the fllowing stipulations:
At the time of title transfer the new property owner Shad sign the nttacbed
Maintenance Agreement which shall he returned t -n chis office befeae --
unconditional approval iq jcc,pciMen n f A r• i be 'ns1=911ed,
well wires properly protected and add•rinnal f.31 $laee4 ever s3staeme
Attachments:
HAA Checklist ✓
Septic System Advisory
Well Flow Advisory
Manitenance Agreements
Supplemental Engineer's Reort
Other
BOriginal Certificate Date:
(Rev. 1MI)
Municipality of Anchorage
• Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: KENO HILLS SUBDIVISION #1; LOT 1
A. WELL DATA *CASED TO BEDROCK
Well type PRIVATE If A, B, or C provide PWSID# N/A
Date completed 3/11/2003 Sanitary seal (Y/N) YES
Total depth 300 ft. Cased to *21 ft.
FROM WELL LOG
Date of test 3/11/2003
Static water level 12
Well production 2.5
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 ml. Nitrate 0.01 mg./L.
Parcel ID: 020-171-12
Well Log (Y/N) YES
Wires properly protected (Y/N) ***NO
Casing height (above ground) 24 in.
AT INSPECTION
g.p.m.
Other bacteria 0 colonies/100 ml.
Arsenic: N/A mg./L. Date of sample: N/A Collected by: GEG, Ltd.
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material ADVANTEX/FIBERGLASS Date installed 3/7/2003
Tank size 1500 gal. Number of Compartments E
Foundation cleanout (Y/N)***NO Depression over tank (Y/N) NO
Date of pumping NEW Pumper
C. ABSORPTION FIELD DATA BELOW EXISTING GRAC
Date installed 3/7/2003 Soil rating 02> ft%drm) 6.0
Cleanouts (Y/N)
High water alarm (Y/N) YES
System type 5—WIDE TRENCH
Length 40 ft. Width 5 ft. Gravel below pipe 0.5+ ft,
Total depth 2.0 ft. Eff. absorption area 200 ft2 Monitoring tube YES Depression over field NO
Date of adequacy test NEW SYSTEM Results (Pass/Fail) For—bgdroGm
Fluid depth in absorption field before test _ in. Water ad New depth _in.
Elapsed Time: —min. epth _ in. Absorption rate >= g.p.d.
enation treatment (past 12 mo.) (Y/N & type) If yes, give date
**WILL BE INSTALLED WHEN PANEL IS MOUNTED ® THE HOUSE.
***WILL BE DONE WHEN THE HOUSE IS CONSTRUCTED
D. LIFT STATION
Date installed 3/7/2003 Size in gallons 1500 Manhole/Access (Y/N) YES
"Pump on" level at TIMER in. "Pump off' level at- IMERin. High water alarm level at 46" in.
Datum BOTTOM OF TANK Cycles tested NEW Meets alarm & circuit requirements? YES
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot
100'+
Absorption field on lot
100'+
Public sewer main
N/A
Sewer /septic service line
25'+
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/cleanout N/A
Holding
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption Feld 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 10'+ Building foundation 10'+ Water main N/A
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
tr�a:ar_elc�_�
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA HAA guidelines in effect on this date.
Engineer's Printed Name JEFFREY A. GARNESS
Date 57/1 -7/04 -
HAA
/1'1/04 -
HAA Fee $ 011
Date of Payment
Receipt Number
(Rev. 12!01)
Waiver Fee $
Date of Payment
Receipt Number
...................
P A. essr
4s —7953
t1.er_ � cPAo
Oct 18 05 04:56p
P. Scott Peppers
907-694-9680
4
C*]
ASBUILT
HEREBY CERTIFY THAT I HAVE SURVEYED THE
-OLLOWING DESCRIBED PROPERTY:
'/E/t/o �Y/GG%tGO�dO.• �/O,/ GoT/ 6'.f%S
NO THAT NO FNCROACHMEN�i EXIST EXCEPT AS
NDICATED. IT IS THE RESPONSIBILITY OF THE
IWNER TO DETERMINE THE EXISTENCE OF ANY
'ASEMENTS, COVENANTS, OR RESTRICTIONS
!HIGH DO NOT APPEAR ON THE RECORDED SUBDI-
'ISION PLAT. UNDER NO CIRCUMSTANCES SHOULD
NY DATA HEREON BE USED FOR CONSTRUCTION
IF FENCE LINES, OR FOR ESTABLISHING BDUND-
RY LINES.
i
6bWJUW
& ASSOCIATES LAND SURVEYING 694
-0:16
�? R
t �� ... q e
4B:
�.... .7`
Dune Merk Sew d
LS -5919 44:x�'�Ilk
1- cv l X'al
m
121
P
SO0'06'O0"E 270.06 (1~)
L.SOO'13'OO"E 269.51 (M)
10' UTIUTY' ~AS'EME~N~ '
I
I
~ d