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HomeMy WebLinkAboutMOUNTAIN PARK ESTATES BLK 2 LT 12Mountain Park Estates Block 2 Lot 12 #017-061-12 May 11 22 09:24p Anchorage Well & Pump Ser 9072430742 p.1 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Pump Installation Log Well Drilling Permit Number: Parcel Identification Number: 017_061 _ 12 Date of Issue: - - Legal Description MOUNTAIN PARK ESTATES Block 2 Lot 12 Property Owner Name & Address: MCEAHERN JAMES M & LORI K 6140 DE ARMOUN ROAD ANCHORAGE, AK 99516 Pump Installation Date: os - 09 - 2022 255 Pump Intake Depth Below Top of Well Casing: feet BERKELEY Pump Manufacturer's Name: B5P4JP07221-02 Pump Model: Pump Size: .75 hp 12 Pitless Adapter Burial Depth: feet MARTIN SON Pitless Adapter Manufacturer's Name: Pitless Adapter Installer: Well Disinfected Upon Completion? KYes C No Method of Disinfection: PELLETS Comments: Pump Installer Name: _ Company: Mailing Address: ANCHORAGE WELL & PUMP SERVICE 7640 KING STREET ANCHORAGE, AK 99518 907-243-0740 State: Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation. in r; Municipality of Anchorage On -Site Water and Wastewater Section • 907 343-7904_ ( ) age 1kY E 9, r "11t 4 ON-SITE WASTEWATER INSPECTION REPORT OCTA ,z �`'® Permit Number: OSP201244 PID Number: 017-061-12 Dwelling: X Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New FN Upgrade Name James Mceahern ABSORPTION FIELD 0 Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 6140 DeArmoun Rd *Anchorage, AK ❑ Other Phone Number of Bedrooms Soil Rating ITotal depth from original grade 907-440-9398 3 1.2 GPD/SF 13.0 Max Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade SEE DWG. Ft. Gravel depth beneath pipe 7.02/7.02 Ft. Subdivision Block Lot Mountain Park Estates 2 12 Fill added above original grade SEE DWG. Ft. Gravel length 15/15=30 Ft. Township Range Section N/A Gravel width 2.5/2.5 Ft. Beds: Number of Lines - Distance between lines - Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 420 Ftz 2 *10 Ft. Well 100,+ 100,+ _ - 25'+ TANK 19 Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Capacity Greer 1000 Gal. Surface Water 100,+ 100,+ _ _ Material Number of compartments Lot Line 5'+ 10'+ - - NA HDPE 2 Foundation 10'+ 10'+ _ _ LIFT STATION Manufacturer Capacity Remarks Old septic tank was decommissioned per UPC - _ Gal. {OSV201038 Alarm location Electrical installed by Installer PIPE MATERIAL House to tank D3034 Tank to D3034 drainfield A+ Home Services Drainfield D3034 co/MTD3034 Inspector Garness Engineering Group, Ltd. BENCH MARK (Assumed elevation) 95.37 ft Inspectiones: 15 9/28/20 2�e 9/29/20 Location and description 3rd 9/29/20 4" 9/29/20 TOP O F MH ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date �o60O� O�*O -.)Oe, r/e A Gar ess, Q . y _-�..-.p' p Q m C 7953 O9f04 c� (fl Septic System �' q p Approved Date /2 �(( ,? e, 40.12 Z. 7 crop Note: this approval does not include well permit requirements.aaecce4s4�DOppo'100 io..., nunni• o PERMIT NUMBER: OSP201244 MOUNTAIN PARK ESTATES; BLOCK 2, LOT 11A MINI&, wwom WELL rd ^•�77-- ! a DRIVEWAY e. da A. . a' EXISTING 3 BEDROOM HOUSE DBLV MH PROPOSED DRAINFIELD 30' UTILITY EASEMENT PARCEL ID NUMBER: 017-061-12 1 1 :LL RADIUS.. I 1 / / i i i i i MOUNTAIN PARK ESTATES; BLOCK 2, LOT 13 NEW 1000 GALLON HDPE GREER TANK EXISTING DRAINFIELD TO REMAIN IN PLACE FOR FUTURE USE t a' S •d. "'iN`h`Cr 'u,.,.:, .>a.,:-: t^s s.,.:., uuxmvix .u, v wh, e,.,. .0 r.:.,.•m. c....,.w. x, r.. '.?c.. .,f... =k.... 1re NY'.s.5..r Ltd �„ 1 24117M , _ ENGINEERING 4w SALES=CONSULTING v 9 ,,...N ...:.....9 .. ,,,�....... 1tr 3101 E. TUDOR ROAD, SUITE 701 'ANCHORAGE, AK 99507' PHONE (907) 3378770' FAX (907) 339J248' WEBSITE: wxw gamesxnginaerxig com ;..,.. �a..................... PREPARED FOR: PHONE NUMBER: PAGE NUMBER: t� �ffrey A Gamess Lv JAMES MCEAHERN 907-440-9398 2 OF 3 �jCi' CE 79 3` _AV LEGAL DESCRIPTION: DRAWN BY: ••�•j;:`�•'••�\P MOUNTAIN PARK ESTATES; BLOCK 2, LOT 12 P.N.B. A..........( ��'i TYPE OF WORK: DATE: LICENSE � +,1 "" E�, V •• RECORD DRAWING 10/23/20 #AECC884 rrlkas���� / is • • : is �� •• is • 1 is MOUNTAIN PARK ESTATES; BLOCK 2, LOT 11A MINI&, wwom WELL rd ^•�77-- ! a DRIVEWAY e. da A. . a' EXISTING 3 BEDROOM HOUSE DBLV MH PROPOSED DRAINFIELD 30' UTILITY EASEMENT PARCEL ID NUMBER: 017-061-12 1 1 :LL RADIUS.. I 1 / / i i i i i MOUNTAIN PARK ESTATES; BLOCK 2, LOT 13 NEW 1000 GALLON HDPE GREER TANK EXISTING DRAINFIELD TO REMAIN IN PLACE FOR FUTURE USE t a' S •d. "'iN`h`Cr 'u,.,.:, .>a.,:-: t^s s.,.:., uuxmvix .u, v wh, e,.,. .0 r.:.,.•m. c....,.w. x, r.. '.?c.. .,f... =k.... 1re NY'.s.5..r Ltd �„ 1 24117M , _ ENGINEERING 4w SALES=CONSULTING v 9 ,,...N ...:.....9 .. ,,,�....... 1tr 3101 E. TUDOR ROAD, SUITE 701 'ANCHORAGE, AK 99507' PHONE (907) 3378770' FAX (907) 339J248' WEBSITE: wxw gamesxnginaerxig com ;..,.. �a..................... PREPARED FOR: PHONE NUMBER: PAGE NUMBER: t� �ffrey A Gamess Lv JAMES MCEAHERN 907-440-9398 2 OF 3 �jCi' CE 79 3` _AV LEGAL DESCRIPTION: DRAWN BY: ••�•j;:`�•'••�\P MOUNTAIN PARK ESTATES; BLOCK 2, LOT 12 P.N.B. A..........( ��'i TYPE OF WORK: DATE: LICENSE � +,1 "" E�, V •• RECORD DRAWING 10/23/20 #AECC884 rrlkas���� / PERMIT NUMBER: OSP201244 RECORD D RAW I N G TOP OF TANK = 91.32 INVERT OF BUNG AT INLET = 90.68 FINAL GRADE = 87.50-87.97 TOP OF MANHOLE = 95.37 FINAL GRADE = 94.51-95.07 MH ST n I I , 2" INSULATION PER CONTRACTOR NEW 1000—GALLON H.D.P.E. SEPTIC TANK FINAL GRADE = 91.00-91.12 ORIGINAL GRADE @ HIGHEST POINT = 88.12 FILTER FABRIC �- INVERT OF PIPE = 82.46 f` p* BOTTOM OF TRENCH = 75.44 TIVE ELEVATION OF BOTTOM OF TESTHOLE = 68.62 (DRY ON 9/28/20) TOP OF TANK AT OUTLET = 91.34 PARCEL ID NUMBER: 017-061-12 INVERT OF BUNG AT OUTLET = 90.52 RIGINAL GRADE @ HIGHEST POINT = 90.65 FILTER FABRIC INVERT OF PIPE = 84.67 OF TRENCH = 77.65 RELATIVE ELEVATION OF BOTTOM OF TESTHOLE = 71.15 (DRY ON 9128/20) tiARNESS ENGINEERING GRIJUIr, Ltd x .t, sv4• ENGINEERING -- SALES o� CONSULTING 3701 E. TUDOR ROAD, SUITE 101 -ANCHORAGE, AK 99507 -PHONE (907) 3376179' FAX (907) 3383246' WEBSITE: vrvrx.gamesaengi—mg,wm PREPARED FOR: PHONE NUMBER: PAGE NUMBER: JAMES MCEAHERN 907-440-9398 3 OF 3 LEGAL DESCRIPTION: DRAWN BY: MOUNTAIN PARK ESTATES; BLOCK 2, LOT 12 P.N.B. TYPE OF WORK: DATE: PROFILE RECORD DRAWING 10/23/20 No ig effre X-Garness ." Q i AV �1♦,Jr •.;V 7:7953� "tai ,.' LICENSE�, \,►� ♦ �♦ #AECC884 DE ARMOURR D - - b b Ln un S85° 23' 45"W 116.67' EXISTING HOUSE SEE DETAIL S890 48'36"E 115.74' 1y EXISTING o HOUSE "N. O HOUSE DETAIL 1"=30' o�o0000�4 ��.OF. q.�-4��4n NOTES: 1. THIS DRAWING SHALL NOT BE MODIFIED FOR USE ASA PLOT PLAN WITHOUT THE EXPRESSED WRITTEN CONSENT OF LCG LANTECH. 2. SNOW AND ICE MAY CONCEAL MINOR SURFACE FEATURES. ORDERED BY: JIM MCEAHERN PARCEL #: 017-061-12-000 SURVEY CERTIFICATION: LCG LANTECH, INC HAS CONDUCTED A PHYSICAL SURVEY OF THE PROPERTY AS SHOWN ON THIS DRAWING AND CERTIFIES THAT THE IMPROVEMENTS LEGAL DESCRIPTION: ADDRESS: SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO ENCROACHMENTS EXIST AS—BUILT 6140 DE ARMOUN RD OTHER THAN NOTED OR SHOWN. EXCLUSIONARY NOTE: IT IS THE OWNERS' RESPONSIBILITY TO DETERMINE THE EXISTENCE OF LOT 12, BLOCK 2, ANY EASEMENTS, COVENANTS, RESTRICTIONS OR RIGHT-OF-WAY TAKINGS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY MOUNTAIN PARK ESTATES DATA HEREON BE USED FOR CONSTRUCTION, FOR ESTABLISHING PROPERTY LINES, OR FOR PLOT -PLAN PURPOSES. LEGEND: 250 H Street Anchorage, Alaska 99501 SEPTIC STANDPIPE O OVERRAN GRAVEL Q CG WATER WELL MAN HOLE Q OOD 515 1!:,' �"�a ..CONCRETE.,, - Survey Department Phone 562-5291 DRAWN DATE: 12/22/2021 WORK ORDER: 20029 Inc Mainline DRAWN BY: ADS/AP/SC PLAT: 2013-19 Phone 243-8985 CHECKED BY: SC GRID: SW2938 ahceu�etu/ie AECC 668 SCALE: 1" = 50' FB/PG: 817/45-48 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP201244 Work Type: Septic Upgrade Tax Code Number: 01 7061 1 2000 Site Legal Address: MOUNTAIN PARK ESTATES BLK 2 LT 12 G:2938 Site Mailing Address: 6140 DE ARMOUN RD, Anchorage Owner: MCEAHERN JAMES M & LORI K Design Engineer: GARNESS ENGINEERING GROUP LTD This permit is for the construction of: Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: �1»cnt ter. Department 8/14/2020 8/14/2021 46750 Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall 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 wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing 3 Received By: ___,_---- Date: d Issued By: Date: 1�U 3 MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Fax: 907- 343-7997 On -Site Water & Wastewater Program Mayor Dan Sullivan On -Site Sewer/Well Permit Application For A Single Family Dwelling Parcel I. D. 017-061-12 Property owner(s) JAMES MCEAHERN Day phone 907-440-9398 Mailing address 6140 DEARMOUN ROAD *ANCHORAGE, AK 99516 Site address 6140 DEARMOUN ROAD 'ANCHORAGE, AK 99516 Legal description (Sub'd, Block & Lot) MOUNTAIN PARK ESTATES: BLOCK 2 Legal description (Township, Section & Range) Lot Size APPLICATION IS FOR: ( ®all that apply) Absorption Field Septic Tank Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Sq.Ft. Number of Bedrooms 3 APPLICATION IS AN: Initial ❑ Upgrade 19 Renewal ❑ THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR: DRAINFIELD TO DRAINFIELD 11 TYPE OF DEWELLING: Single Family (SF) (w/wo ADU) Duplex (D) ❑ Multiple Dwellings ❑ (SF and/or D) Distance: 10 FEET I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/Rush Fees: Date of Payment: //1'S/ LoLO Receipt Number: NO 0 13G Permit No. C S IP 2 0 1 2 L y Im Waiver Fees: 1 lo0, 7 5 Date of Payment: 3 tpzo Receipt Number: o(o 3G Waiver No. dS V,201 6 3$ (Rev. 01/11) \� Municipality of Anchorage \ � I)r. p:nnnrnt P.O. Box 196650 ® 4700 Elmore Road Anchorage, Alaska 99519-6650 a (907) 343-7904 a Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: OSV201038 COSA#: Permit#:OSP201244 PID#: 017-061-12 Legal Description: MOUNTAIN PARK ESTATES BILK 2 LT 12 Engineer: Garness Engineering Group Your request for a waiver of the required 14 feet horizontal separation from the absorption field to another absorption field has been approved. The approved separation distance is 10.0 feet. This waiver approval applies to the proposed absorption field only. Any future upgrade to the on- site wastewater disposal system will require all separation distances be met or another approval from this department. Waiver is Granted: X Waiver is not Granted.- Date: ranted.Date: 72.0 Approved by: Name of RevLeGver ............................................. 0 M M M M x ..... ............... 0 E- M- I **** VARIAN C E/WAIVER REVIEW **** Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201244, Deb Wockenfuss, 08/17/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201244, Deb Wockenfuss, 08/17/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201244, Deb Wockenfuss, 08/17/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201244, Deb Wockenfuss, 08/17/20 LL p �`cC Ln Z 71 0 -r LLJ .Ln m 00_ Q LLJ uj uj . • Q W cn > t- V �' J aQ F- • � ��� t3 v7 � � Ln(Yto T-- > rY • - G1C - w - V) ,�r jcr- PA• t,. - _ F _ #- C�,i .♦ _9 P LL ' ♦ CO w u D 46z 1 P4 U.J F- LL 0 !�lj Lli-�/) Ae:lL.Li co. 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Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: S k1 "4 OZ. 7- PID Number: C)It1 " 0r)1 - 1 Name: C Wastewater System: ❑ New Jr Upgrade Address: Oermc " ABSORPTION FIELD Phone: No. of Bedrooms: O Deep Trench KShallow Trench ❑ Bed ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating: ' Tr at Depth from Original grade: PD/S Ft. Lot: / Block: �10 Subdiviel�n: Dep 'o yips Donom Irom original9rede: Gravel depth beneatn Pipe u%l r7 . 1 Ft. 5 Ft Township: Ranger Section: Filldded above original gins a. lI 50 Gravel lengthh-: Ft. J t Ft. • WELL: [I New ❑Upgrade Gravel width: Number pf tines: Distance behrom lines: �. Ft. r Ft. Classification (Private, A.B,C): Total Depth: Cased To: Total absorptio a: Pipe met al:�i 0 " Ft. Ft. O Ft. . 7i Duller. Date Drilled: Stang Water Level: Installer / Lf- C) Date l su ad'. Ft. /, /� Yield: Pump Set at: Casing Height Above Ground: TANK GPM Ft. Ft. T! f SEPARATION DISTANCES ASeptic C3 Holding 0S.T.E.P. To Septic Absorplion Litt Holding blit/Private Manufacturer., Capacity In gallons: From Tank Fis Stnbn Tank Sewer Lints f —, Well- (�� ' �♦� y �i I / 1 Material: n Numberof ompartments: Watersi 1 # I00 I00 LIFT STATION Line tSize L 5)0, x z� In gallons: Manufacturer Foundation 40 /0 r x J� I ` "Pump on" level at: "Pu " level at: High water alarm at: Curtain" ^ Pump Make S Model ElxMcal Inspections perfor Drain IBJ e- Remarks: e%0 5P, ;I,-I��,li f a BENCH MARK 4-, 1 c,+dl jitej vJ f4 +h(' Location and Description: P. (-e-a61 d S� �,'�e_ u. usn, f1 5S Assufned Elevation: ENGINEER'S SEAL OF. A \. C.4 "1 Inspections performed by:Ja���✓ S� ����Dates:lst huy, X94 M ' s '<rr49 ►+ 2nd Irge fM.. ....... .......:. a p ppr al Department of Heilrvtate: V/ 1 / �. # 1517 E I ��9, 4.0......... Reviewed and approved by: t�, 1�� � ROr_SStCN�c 7z -0t3 (11". 9191) MOA 25 Permit No. SO 9402__75 Page 2- of 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 Leg P at Description: Q2 BL -k Z Moy v"rAlN PARk�STA PID No.: � 5 No li/ 5 x �. w TLc2 h 1"iglcl RECEIVED AUG 1 G 1994 Municipahtyf Anchor, Dept. Health & Human Sar SSurnlc_ El. 100d, 11� a �w 12 SO Gal 5ePt�c Mo2'Tube I :: • IfiI.4.N...s..i..if iW.:... F" Jams F. re Permit No. 5 W ?q-02% S Page 3 of J� 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 Legal Description: 1-•• 17-8 LkC Z M o U N TA IN PARK 1;5 T�j D No Report 72-017 A (M) - f � 7 .............go........................................... _.... _......... €............................ i ; 7 i .......................................... ........................................ ' I [ i i .( .... ... �..f....... ou5c ......... ......... .... 3................... i _._ ...;._. ;� � �� f Mon. •�� /v 06 (� • j I 1 + E j f I e ._ ' EI 97'7.. t •.. f..--- .. FB.�. .�, ._ I 7 3 ............................ ............ .... _...... ............................ .......................................... •........ .. STI C. Y5—�...M I Rc� �I LE 1 -tori Scale-! • E i ........ .___........_.._._......._._p......_......_........__._...._i...._._....._....._._._......._ E._ ...................._.... ._......i ' gN0NEE$'S SEAL I S. •' 'f' '• PW 9 -`49 J� RECEIVED*, AUG 1 611934 J> •.. 1917E �,��F,F..,•.......,..��a�-• 11 Nu E:c.paiity o. ;Ancnoraga ���c.��ti0fE5S\C vc Dept. Health & Heiman Services I 72-017 A (M) - Q" (ENGINEER'SSEAL) T � ; •u :,onff�y�yyY 1 r ��� Municipality of Anchorage r�� f ••�t�9 DEPARTMENT OF HEALTH 8 HUMAN SERVICES M• NIffN•• 1NFNfIf 825 `L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST � �- e it e ms % P"��i� PERFORMED FOR: DATE PERFORM ap U LEGAL DESCRIPTION: Township, Range, Section: c TH SLOPE SITE PLAN I.ffEETYI 1.�_F:FT� 2- 6 34 3- 4- 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 WAS GROUND WATER r IO ENCOUNTERED? IV IF YES, AT WHAT DEPTH? lkpth to W ur uur Monitoring? gate d 1i PERCOLATION RATE / (minutevinch) PERC HOLE DIAMETER y TEST RUN BETWEEN G FT AND ("5 5 FT COMMENTS r L---�T QQ 1C' / ./'r P/( aol/ kiell 1- )y tf?'! /-7 PERFORMED BY: CERTIFY THAT THIS T/HI1EST WAS PERFORMED IN de v ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) MIMI raw PERCOLATION RATE / (minutevinch) PERC HOLE DIAMETER y TEST RUN BETWEEN G FT AND ("5 5 FT COMMENTS r L---�T QQ 1C' / ./'r P/( aol/ kiell 1- )y tf?'! /-7 PERFORMED BY: CERTIFY THAT THIS T/HI1EST WAS PERFORMED IN de v ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) • iMunicipalit, T of Anchorage Department of Health and Human Services a Rick Mystrom, 625 "L" Street Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 June 12, 1997 Ted Moore, P.E. Flattop Technical Services 14530 Echo_Street Anchorage, Alaska 99516 Subject: Waiver Request for Lot 12 Block 2 Mountain Park Estates Subdivision Waiver Request OWR970023 , PID $017-061-12, HA970221 Dear Mr. Moore: Your request for a waiver of the required 10 foot separation between an on-site wastewater disposal system and a lot line has been approved. The waived distance is 0.5 feet from the septic system to the east property line common with Lot 13. This approval applies to the existing on-site wastewater disposal system lot line separation only. Any future upgrade to the on-site wastewater disposal system will require all separations be met or another approval from this department. If there any further questions or concerns regarding this waiver, please call our office at 343-4744. incerely, V v GLn1Et '`. mes P. Williams On-site Services ljw $7 n MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR# WR970023 PID# 017-061-12 HA# EA970221 Permit # Date Received: June 4, 1997 Legal Description: Lot 12 Block 2 Mountain Park Estates Subdivision Engineer: Ted Moore,P.E., Flattop Technical Services 14530 Echo Street, Anchorage, Alaska 99516 Applicant: Charles S Carla Richner r ASf� Waiver Requested: Lot- line waiver of05 feet from the septic system to the east property line common with Lot 13 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: SEE tNC4 47741L N7Fo A...;z z . M-4. Rec #: 02754/9203 Amount: $ 115.00 Date Paid: June 4, 1997 PAGE MUNICIPALITY OF ANCHORAGE fJr "I/r DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT 1 OF 1 II -n a.....r PERMIT NUMBER:SW940275 DATE ISSUED: 8/02/94 DESIGN ENGINEER:JAMES SIZEMOORE & ASSOCIATES EXPIRATION DATE: 8/02/95 OWNER NAME:ALASKA CORP OF SEVENTH DAY OWNER ADDRESS:6140 DEARMOUN RD ANCHORAGE, ALASKA 99516 PARCEL ID:01706112 LEGAL DESCRIPTION: MOUNTAIN PARK ESTATES BLK 2 IT 12 LOT SIZE: 46750 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM 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 DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 (24 HOURS) . 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. �SPECIAL'PROVISIONS:_ ENGINEER SHALL'PERFORM'ANOTHER PERC. TEST lCONSTRUCTION IN THE ACCEPTING SOIL STRATA A FOUR HOL RECEIVED ISSUED BY: AT THE TIME OF WITH A MINIMUM OF DATE: _— 3 DATE:_ - 2 - 5J¢ I-oT li (undeV�(.� I \ J ov N leo C) A, --w C� u yoLA5a �x ISt $e_ptiLj7� Install vaIve, D f a r r1 f ie1�l J • •. ��'�;� Jams i. Slcemoro Tw %' jit1517E : ��'o.• cu n cle,ve- 10PE� SWido K-1ilowr nFia16 J L-2 BL2, IA0UfJTAIN PAM J- STATES SUi�)DAV 151 O14 _ -5E_QT I C SYSTEM UPGRADE PLAN J:A—M ES 51-ZM 0 R .I Scale: f-71�5cc' — A gr-tj 1 rr_ GO' S�WidIeX5{t —rA ta;nPid G.O. E.a, hd � x i s t-; .7. ¢ir � L i t,,- orri+ar Tube b; Vert-cr Valve 5�LPerp, NiPe P l._ A N ---V 1 Exis+in- I" = 10, Ground r }N OF�44. °9 y -- a r ' # 1517E �: N 0 o 1 1 d Pipe a+ ) east /"-O' Pe rf: Drain, S -E -CT I O fel 1'l _ 3'-04 O" s e r R a� L12 BLL-j.MC)UNT.A-IW.._P_ARK_ ' 5TA-T_ES.-S 0.5 D.. - - - 5 E P_T *I C- S Y-5 TEM . UP -GRAD --P- LAI _. --J A'M r—S--S I ZE M OAE . I -S ca l e - 50,10 -Vo 0 o 1 1 d Pipe a+ ) east /"-O' Pe rf: Drain, S -E -CT I O fel 1'l _ 3'-04 O" s e r R a� L12 BLL-j.MC)UNT.A-IW.._P_ARK_ ' 5TA-T_ES.-S 0.5 D.. - - - 5 E P_T *I C- S Y-5 TEM . UP -GRAD --P- LAI _. --J A'M r—S--S I ZE M OAE . I -S ca l e - J: S i -P—c- �O�e iizEZ f/Itt�• pa/'f7 i � e7/ c � i C{e Tno,17c1�1 wi-t moo- S' P� mac, j,17 97'C- = * �� ���•�. re,�� 75 -X - Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: J� CiC'' / �,,{�•'/ LEGAL DESCRIPTION: IF T) 2 3 5 G L� IOIi 7 ✓ 9 DATE PE tf ��j Range, Section: SLOPE 10 WAS GROUND WATER o ENCOUNTERED? I� 11 S _ IF YES, AT WHAT L DEPTH? O 12 P J n,/ E 13 M nU�i p7 a AlurL � Balt. la 7 �' (4 14 8tfvf`e 04+ 16 17 18 19 20 PERCOLATION RATE —4-- (mmutesimch) PERC HOLE DIAMETER TEST RUN BETWEEN 14— FT AND FT (� .,Z • LgOMu •• ••Lh•io• fir..... �_t. Jomes F. Si:_.nore 41r, w SITE PLAN Reading Date Gross Net Time Time Depth to Water Net Drop t 7 6 .O t 0)" 4z t 8 s 6 " 141' 3. 3 7: COMMENTS PERFORMEDLf LF CERTIFY/THAT THIS lTEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4185) e r Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: L12— DEPTH 12 -DEPTH (FEET) 1®/Yja(J iLs 2 �7 3 4 5 b 6 7 8 9 •,' 10 it 12 •c . 13 14 15 16--.., 17- 18 --^ 19 20 COMMENTS S y I f -,f/ san�r, (-a V e ( GM wole SLOPE f;-_ n m;-Za 6:0ss�as 7. faemore j ` .#, 1517 E DATE PERFORMED:—t7— PERFORMED 7 - WAS GROUND WATER N(� ENCOUNTERED? S IF YES, AT WHAT L DEPTH? O P E DepN tD Wmer IWerN,(�/yo Monitoring? "' ^'Dale: F'Iii4 =����►mmm� llaLiliTfYa, .� • Lfc iylL•L�©��—� PERCOLATION RATE _L_ (mmute5/nnch) PERC HOLE DIAMETER TEST RUN BETWEEN _�,P FT ANDFT PERFORMED BY: T� WM4l CERTIFY THAT THIS TEST TTJWWAS PERFORMED IN v ifACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) PROBABLE IMPACTS TO ADJACENT PROPERTIES A) WELLS: The proposeds disposal syustem is designed in accordance with current Municipal Wastewater Disposal Regulations. The proposed drainfield replaces an existing drainfield that has become saturated and consequently has failed. The separation distances from the wells on adjacent properties is greater than 100 ft., and since the new drainfield essentially parallels the existing failing drainfield, there should be no new impacts on the existing wells. B) WASTEWATER SYSTEMS The new drainfield essentially parallels and replaces the failing existing drainfield. Therefore there should be no new unacceptable impacts on the adjacent wastewater systems. C) RESERVED SPACE/SURFACE AND SUBSURFACE The existing drainfield will have time to rejuvinate after construction of the new replacement drainfield. Therefore the replacement field should not adversly immpact adjacent properties. D) DRAINAGE The location of the drainfield dos not interfere with any drainage. The area disturbed during construction will be graded and sloped so as to not pond water. James Sizemore & Associates Civil Engineers & Surveyors 6410 Switzerland Drive Anchorage, AK 99516 (907) 345-1572 WASTEWATER DISPOSAL SYSTEM SPECIFICATIONS LOT 12. BLOCK 2 MOUNTAIN PARK ESTATES SUBDIVISION 1.0 GENERAL: 1.1 The scope of the project consists of installation of a diversion valve between the existing septic tank and the existing disposal trench and installing a new five foot wide drainfield. 1.2 Construction shall be as shown on the approved site plan and design drawings. Deviations from the drawings shall be co-ordinated and approved by the engineer conducting the inspections. 1.3 All construction procedures and material used to construct the system shall comply with Municipal and State regulations. 1.4 Unless specifically agreed otherwise, the homeowner shall be responsible for finish grading areas after the soil is compacted. Placement of topsoil and reseeding all areas disturbed by construction is also the responsibility of the homeowner. 3.0 SOIL ABSORPTION DRAINFIELD: 3.1 The soil absorption system shall be coonstructed by excavating a 5' wide by 51' long trench located as shown on the approved site plan. The South end of the trench shall be five foot below existing ground level. 3.2 The bottom of the excavation shall be level. Any compacted or smeared surfaces shall be raked to allow for proper infiltration 9this includes both sides & bottom of trench. 3.3 A total of 4.0 feet of sewer rock shall be placed inn the bottom of the excavation with the perforated distribution pipes laid level and with at least 3.5 feet of sewer rock below the invert of the pipes. Sewer rock shall be 0.5 - 2.5" screened gravel, with less than 3 % passing the #200 sieve. 3.4 Cleanout pipes and monitor tubes shall be 4" diameter and installed in locations shown on the drawings. The portion of the monitor tube extending through the sewer rock shall be perforated. 3.5 Approved filter fabric shall be placed over the top surface of the sewer rock. A minimum of 2 feet of soil cover is to be placed over the filter fabric. If the soil cover thickness is less than 3 feet, two inches of rigid, burial type insulation will be placed over the entire top surface of the sewer rock. 4.0 INSPECTIONS: 4.1 A minimum of three engineering inspections will be required during construction of the system. One after excavation of the trench prior to placement of sewer rock, one after placement of the sewer rock and the perforated distribution piping, and the piping has been connected to the discharge line from the septic tank but prior to placement of the filter fabric. The third inspection will be after final backfill and grading are complete. 4.2. The contractor shall coordinate with the engineer at least 24 hours prior to start of construction. GRE!``fR ANCHORAGE AREA BOrA"IJGH C�n Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME T�en (DFVr.Is MAI LING7iDORESSb�3 je'q DH'f1NF LOCATION / LEGAL DESCRIPTION- L-IZ i°Z%//>t )et A ES7rR/�5�� SEPTIC TANK- ! �G�n/G 1✓�!f PP%n/c w #&_1 1plv oe ly uL 1-1-7/16- DISTANCE 9-7/9SDISTANCE mC/rF�4j�P0' _/� /, /�`{/ `,.�.,c�� / NUMBER OF FROM WELL MANUFACTURER Ki MATERIAL GL�COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH I IQUID CAPACITY,/elep GALLONS. SEEPAGE PIT: NUMBER OF PITS-!-. DIAMETER OR WIDTH t? ,-LENGTHZ¢ DEPTH S L/1�y io° r�crire LINING MATERIAL J CRIB SIZE: DIAMETER _DEPTH L DISTANCE FROM: WELL , ' TOTAL EFFECTIVE BUILDING FOUNDATION_, NEAREST LOT LINE S ABSORPTION AREA (WALL AREA) S/& SQ. FT. _ r ADDITIONAL ABSORPTION -5C;1 Z (Spar%'='i°�P tO /-Z' I WELL: lile/ %)7 Al Tim v O TYPE ;✓ 7' CONSTRUCTION BUILDING NEAREST NEAREST FOUNDATION -,LOT LINE SEWER LINE CESSPOOL OTHER SOURCES APPROVED DISAPPROVED DISTANCES: //�^ INSTALLED BY: 4<rEr/' -CXr I PIPE MATERIAL: _Z 17 CQ LOT SLOPE: ^ REMARKS: Ower O/ 4eT- I Z 'V wx /nr� Form No. EQ -031 REMA z 6d IA)M DATE 7-/t-^ DEPTH DISTANCE FROM: SEPTIC SEEPAGE TANK , SYSTEM_ DIAGRAM OF SYSTEM /C' APPROV 3or NAME OF APPLICANT INSTALLATION LOCATION LEGAL DESCRIPTION GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 ••C•• STREET ANCHORAGE, ALASKA 99503 TELEPHONE 2744561 SEWAGE DISPOSAL SYSTEM — APPLICATION AND PERMIT INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACILITY TO BE SERVED PIT ADDRESS PERMIT NO. fm -2 OTHER FINANCED THROUGH TO BE INSTALLED BY / cs� 1 e11Q T/ Z ��/�/ BOIL TEST RESULTS 17- NOTE1 THIS PERMIT IS NOT VALID WITHOUT SOIL TEST 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. SEPTIC TANK S12E TYPE MINIMUM DISTANCES. REQUIREMENTS FOUNDATION TO SEPTIC TANK 5 - FOUNDATION TO SEEPAGE PIT DRAIN FIELD SEEPAGE AREA S12E SEPTIC TANK TO SEEPAGE PIT WALL c ff4yt'�o 17 SEPTIC TANK SEEPPAIAGE PIITZ 7 OORAYN FIELD TO NEAREST LOT LINE. FrH.P�O W xer'. V4 /z P -t, ✓1� WELL TO SEPTIC TANK T SEEPAGE PITT /'/14557 r DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK DRAIN FIELD SEEPAGE PIT SEPTIC TANK. DO • SEEPAGE PIT 4^ DRAIN FIELD ( D a .1 TO RIVER. LAKE. STREAM, CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP C EXCAVATION S FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PI FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REG LATIONS REGARDING INSTALLATION. r'leeew O.A.A.B. OR LICENSED OR 1 CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. -13- / � APPLICANT'S SIGNATURE DATE � FORM NO. E0-01 S i�X/Ss wG'CA/ 10 DIAGRAM OF SYSTEM ANCHORAGE ARRA B,PROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE �Gtit Performed for Glac Legal Description: Lot This form reports: Sots Depth Feet 2- Jep;:rcment of tnv1rv,,,,,enta1 l(YY..Vy 3330 "C" Street Anchorage, Alaska 99503 SOILS LOC - PI:ROLATION TEST or Excavatin 2. Block 2. Mtn. Park states 3 - Silty Sand with some Gravel and Cobbles 225 Sv/BR 4 _ 5- 6 Sand 150 S''�' B 7 Sand and Gravel 125 SF Bit r•, 9- 10 - Silty Sand 250 S.F/BR 11 - 12 12' Bottom of Pit 13 - to Performed 8/21/74 test 14 - Was ground water encountered?. No -If yes, at what depth? Reading Date . Gross Time Net Time Depth to water Net Drop Percolation rate minute. Drain Field Proposed installation: Seepage Pit _ _--�----------- bapth of Inlet Depth to hotton of pit or trench COt.UTHTS: _ 3-badraom_Y ua a.- No groundwater or bedrock_trLgQAateseli__ 215 square feet required per bedroom Performed' 6y:A.7lopton� Certified[3y:ConstructionSp�t,Uate:_B,(22/� Mies IT: i:aoi Lab :.Q•04J (6/74) MUNICIPALITY& H ANCHORAGE • DEPARTMENT OFFHEALTH &HUMAN SERVICE$ 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 l.D. # 01-70(011-2, HAA# 41Ft 9404 1 Iia -Q 1. GENERAL INFORMATION Complete legal description -L 12- 6L ITZ- M(hyPLzi n Ra, -h- F S�{� Location (site address or directions) (6 / 4ey 0& /- r—r22oclo 7 %S n7� Property owner 412 6lTa /I><' e52yeell, 0,9)rA Mailing address 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 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_ 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. 724M Mw.1121) Front MOA 121 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 Fir /�rI1�J%fir' —Phone /m Address (0// -Jr (Jrf}—P�� ���/✓� l�%�' w �� Engineer's signatureZZG,/�/1�Pil<7�y�C� Date 6. DHHS SIGNATURE Approved for bedrooms. Disapproved. By: Conditional approval for bedrooms, with the following stipulations: Additional Comments 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 engineers work. mass (Ft«. 1/91) Baa MOAm Legal ® Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST II A. Well Data n L Well type Pr!09 �— If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) /V Date completed Driller Total depth Cased to Casing height Z Sanitary seal (YM) FROM WELL LOG Date of test Static water levet Well flow Pump IeveN SEPARATION DISTANCES FROM WELL TO: Wires properly protected (YM) Y AT INSPECTION 2-17 .p.m. .0 / g.p.m. ¢n' Septictholding tank on lot ](00, ; On adjacent lots Absorption field on lot ; On adjacent lots _ Public sewer main Public sewer manholeh Sewer service line Petroleum tank ti0 0 ):!�, /00 / /Ong WATER SAMPLE RESULTS: Coliformy Nitrate Otherbacteria Date of sample:, r:7 )12',4— Collected by: B. SEPTIC/HOLDING TANK DATA Date installed A' J 1 24- Tank size _ Zr0 Compartments Cleanouts (YM) _ Foundation cleanout (YM) 'yDepression (Y/N) AJ `/ High water alarm (Y/N) �v 14 Alarm tested (YM) /^ Date of pumping SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot On adjacent lots IOl� Foundation 1 r To property line 7 S Absorption field % 7_ Water //mairdservice line _ % (7 Surface water/drainage )IJ O ii o b fir—/" 1/& , rtazarwat•Fmm CONTINUED ON BACK PAGE A x n 05 IT7 V yZ .0 c mo A T rri D �o Coliformy Nitrate Otherbacteria Date of sample:, r:7 )12',4— Collected by: B. SEPTIC/HOLDING TANK DATA Date installed A' J 1 24- Tank size _ Zr0 Compartments Cleanouts (YM) _ Foundation cleanout (YM) 'yDepression (Y/N) AJ `/ High water alarm (Y/N) �v 14 Alarm tested (YM) /^ Date of pumping SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot On adjacent lots IOl� Foundation 1 r To property line 7 S Absorption field % 7_ Water //mairdservice line _ % (7 Surface water/drainage )IJ O ii o b fir—/" 1/& , rtazarwat•Fmm CONTINUED ON BACK PAGE C. LIFT STATION Date installed Manut acxu r Sae In gallons Manhole/Access (Y/N) Vent (Y/N) on" level at "Pump oft" Level at High water�ya evet Cycles test Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA s p Date installed /� u 9 �1' J2 zhoil rating (GPD/Ft2) ` ° 7 — System type Length 5 I s Width S Gravel thickness ✓2- 5 - Total depth s o Total absorption area Cleanout present (Y/N) Depression over ie (Y/N) �L Date of adequacy test Resuhs (passltal) for 5 Bedrooms Water level in absorption field before test /V G /7 P After test Peroxide treatment (past 12 months) (YIN) If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot To On adjacent lots 5 0 / Property line / To building foundation To existing or abandoned system on lot On adjacent lots /C)C / Cutbank N 61i E' Water maWservice line r Surface water 00 Driveway, parkingNehide storage area /mom Curtain drain /V C2 fl? zf E. ENGINEERS CERTIFICATION I certify Ihat 1 have checked verifed, a conformed to all MOA and HAA guidelines k Signature � ^ 6 Enginee Namejpr?% Eel Date HAA Fee $ 306 ! a Waiver Fee $ Date of Payment Date of Payment AUG 16 19.4 Recent Number 2100 �7�� Receipt Number r° c c :bry of Anchnrngn • eatth 8 Human Services 72-026 rM• Back