HomeMy WebLinkAboutPATRICIA BLK 2 LT 1Patricia
Block 2
Lot 1
#012-464-20
Municipality of Anchorage
Development Services Department
Building Safety Division s A = r
On -Site Water and Wastewater Program, 4700 Elmore Road
P.O. Box 196650 Anchorage, AK 99507 Page of
www.ci.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: SW080221 PID Number: 012-464-20
Name:
Ali Family Trust
Wastewater System: ❑✓ New ❑ Upgrade .
Address:
3705 Arctic Blvd., Ste. 1334 Anchorage, AK 99503
ABSORPTION FIELD
Phone: 727-2912 Number of Bedrooms:
3
❑Deep Trench id Shallow Trench ❑Bed [I Mound El Other.
LEGAL DESCRIPTION
Soil Rating:
Total Depth from original grade:
1.2 GPD/Ftz
4.5 Ft.
Block:2 Lot: 1 Subdivision:
Depth to pipe bottom from original grade:
Gravel depth beneath pipe:
Patricia
2 Ft.
2.5 Fl.
Township: Range: Section:
Fill added above original grade:
Gravel Length:
0-1 Ft.
70 Ft.
Well: F1 New ❑ Upgrade
Gravel width:
Number of lines:
Distance between lines:
5 Ft.
2
>10 Ft.
Classification (Private, A, B. C):
Total Depth:
Cased to:
Total absorption area:
Pipe Material:
AWWLI Water System
Ft.
FL
547 Ftz
ASTM D3034 PVC
Driller.
Date Drilled:
Static Water Level:
Installer.
Glacier Excavating
Date Installed: C,ry
5/15-20a*C> AiEO
Ft.
.
Yield:
Pump Set at
Casing Height Above Ground:
TANK
GPMJ
FL
Ft.
SEPARATION DISTANCES
❑ Septic ❑ Holding m S.T.E.P. ❑ Other:
To
Septic
Absorption
Lift
Holding
ublic/Private
Manufacturer.
Capacity:
From
Tank
Field
Station
Tank
Sewer Line
Greer SE 1500
1,500 Gal.
Material:
Number of Compartments:
Well
N/A
N/A
N/A
N/A
N/A
Steel
Two (2)
SurfaceWater
>100'
>100'
>100'
N/A
LIFT STATION
Size:
Manufacturer.
Lot Line
>51
>10'
>5'
N/A
250 Gal.
Greer
"Pump on" level at:
"Pump ofr level at:
High water alarm at:
Foundation
>5'
>10'
>5'
N/A
42 in.
42 in.
44 in.
Curtain Drain
None
Noted
Pump Make & Model
Electrical Inspections performed by:
24" Turbine
I Municipality of Anchorage
Remarks:
STEP Tank is Constructed of 10 Gauge Steel.
BENCH MARK
Location and Description:
Absorption Trenches Covered with 2" Direct Bury Insulation.
Lower Level Concrete Slab.
Assumed Elevation:
100.0 Ft.
itamp
Inspections performed by: A. Harala Dates: 1St 5/15/2009 OF A ®Z 0
•
2nd 5/19/2009�P� •' ' ;qs ®�
Development Services Department Approval d
�'•�
49 Z
•9s ••• 0000 0000• ••.®1
Conditional Approval Date:
•.• 0090•••••. ........••• •.••�
MtCHAEL E. ANDERSON
acs
.� :E- 438) : ����e
e 0000..• L �
Reviewed and approved b . Date: '°RUFE5SO� '0'
�
(Rev. 04/06)
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Municipality of Anchorage
Page 3 of 3
DEVEOPMENT SERVICES DEPARTMENT
4700-Elmore-Road Anchorage, AK: 99519-6655 - 343-7904
-
On-Site Wastewater Disposal System or Well Inspection Report
Permit Number: SW080221
PID No. 012-464-20
98.9
W
U cnflin.shed
Existing
Grade Grade
1.5" PVC
Y93.1
1,500 Gallon
STEP Tank
88.8
Q
H 97.7
96.9
Finished Grade
---_,v— — Existing Grade
_-- -- -- _
Geotextile Fabric
-- --
& 2" Insulation
94.9 Drainfield Rock
94.9
92.4
84.4 35' (Trench Length)
Groundwater @ 87.9
NORTH TRENCH
N
Q
98.0
Finished Grade
96.9
Existing Grade
Geotextile Fabric
& 2" Insulation
94.9 Drainfield Rock
94.9
92.4
84.4 - 35' (Trench Length)
Groundwater @ 87.9 i
5/15/09
O� qp®�®
30 - 5/16" Diameter Holes @ 2.3'
SOUTH TRENCHAD
15 Holes Per Trench
0 49th '; ®s
.....c ..... ....... ........ .......: ...
�
PROFILE AS—BUILT
........................... ..............
®� ' MICHAEL E. ANDERSON
®®�®
No ScalePori
No. CE-4381 AV
®®�
11®®oawS®o ®®®®®
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4700 BRAGAW STREET ANCHORAGE, AK 99519-6650
DEPTH
(feet)
1
2
3
4
5
6
7
8
9
1
11
12
13
14
15
16
17
18
19
20
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION: LOT I, BLOCK 2, PATRICIA SUBDIVISION
PERFORMED FOR: ALI FAMILY TRUST
DATE: 5/14/09 PROJECT No.:
PARCEL ID#: TECHNICIAN: A. HARALA
TEST HOLE A
OB/OG
SILTY SAND
WITH GRAVEL
SM/GM
BOH @ 4.5'
SLOPE
CD
oll
AV
AN
19
49th.. !^1
......
MICHAEL E. ANDERSON
No. CE -4381 ' 4
•..
- 2—c? :
i�4;0
SITE PLAN
15' 31,
•
THA
WAS GROUND WATER ENCOUNTERED? NO
IF YES @ WHAT DEPTH? S
DEPTH OF WATER AFTER MONITORING: NONE LO 0%
DATE OF MONITORING: 5/11/09 r
0
DATE
READING
GROSS TIME
(MINUTES)
NET TIME
(MINUTES)
DEPTH To
WATER
(INCHES)
NET DROP
(INCHES)
TEST HOLE PRESOAKED PRIOR TO TESTING:
5/14
1
6:10/6:20
10
3.25"/11.50"
8.25"
2
6:21/6:31
10
3.38"/11.50"
8.13"
3
6:32/6:42
10
3.25"/11.38"
8.13"
4
6:43/6:53
10
3.13"/11.19"
8.06"
5
6:54/7:04
10
3.25"/11.38"
8.13"
6
7:14/7:24
10
3.25"/11.31"
8.06"
PERCOLATION RATE: 1.25 (MIN/INCH) PERC. HOLE DIA. 6 if (INCHES)
TEST RUN BETWEEN: 4.5 FT. and 5.5 FT.
COMMENTS: TEST HOLE PRE SOAKED PRIOR To TEST.
TEST RUN TO VERIFY PERCOLATION TEST RESULT.
TEST PERFORMED BY ANDERSON ENGINEERING. I, MICHAEL E. ANDERSON CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE: 5/27/09
b 40unicipaii'�c ofAnc orage, Bui�itiari'.Safety QlAsion
_ 4700 Etmore •Roa
INFO & HELP (907) 343-8211
INSPECTION: VOICE (907) 343-8300 FAX (907)249-7777 ' www.mLini.org
Marne Bill Permit # 05-0888
Company Brickweil, Inc Inspection Notts 07-Nov-2078 PM
Address 10031 GEBHART DR Phone 440,9351
Grid SW2528
�.�"_-� -•.�.:"PATRICIAr LST 1 BK 2 TR n/a
Work Description 1894 scifti living, 479 sgft garage?
Permit Technician -
Ccarnments or Directions tater PM if possible. Excavator still trying to dig trozen gr: und.Please call-
rhanks
_
Inspection Type Eloorical:Underground
Electrical
Comments (for inspector Use ori{y):
1
•re.. .. .' .. .. ._..lice -
,
inspector r�.:.� date ! �7
A -.
f
MUNICIPALITY OF ANCHORAGE d
Development Services Department 161D'Tj6S l3 Ov
On -Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Renewal
Permit Number: SWO80221
Legal Description: PATRICIA BLOCK 2 LOTS 1 & 20
Design Engineer: 0014 ANDERSON ENGINEERING
Owner Name: ALI FAMILY TRUST
Owner Address: 3705 ARCTIC BLVD STE 1334
ANCHORAGE, AK 99503 -
This permit is for the construction of:
❑✓ Disposal Field ❑✓ Septic Tank
Date Issued: Oct 06, 2008
Expiration Date: Oct 06, 2009
Parcel ID: 012-464-20
Site Address: 10031 GEBHARDT DRIVE
Lot Size: 0 SQ. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
❑ 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.
5. The following special provisions.
\ HE MOA LETTER OF NON -OBJECTION TO ENCROACHMENT MUST BE SUBMITTED PRIOR TO THE
ASBUILT INSPECTION REPORT BEING APPROVED.
THE UPPER 6" OF THE MOUND SYSTEM IS TO HAVE TOP SOIL AND BE VEGETATED SUFFICIENTLY TO
PREVENT EROSION.
CO /Plot- () 5e/Ifc onto Goff
Received By:
Date: _1� v�J
Issued By: Date: l� 6
Municipality of Anchorage
® Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, Alaska 99519-6650
www.muni.org/onsite
(907) 343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 012-464-20
Property owner(s) Ali Family Trust
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S A E T Y
phone 727-2912
Mailing address 3705 Arctic Boulevard, Suite 1334 Anchorage, AK Zip Code 99503
Site address 10031 Gebhardt Drive Anchorage, AK
Legal description (Sub'd., Block & Lot)
Zip Code 99516
Patricia Subdivision, Block 2, Lots 1 & 20
Legal description (Township, Range & Section)
Lot Size 14,040 (Combined) Sq. Ft
THIS APPLICATION IS FOR (® all that apply):
Absorption Field
F--]
Septic Tank
Q
Holding Tank
❑
Privy
❑
Private Well
❑
Water Storage
❑
Number of Bedrooms Four (4)
THIS APPLICATION IS AN:
Initial
❑
Upgrade
❑
Renewal
0
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees: � 6 D Waiver Fees:
Date of Payment: Date of Payment:
Receipt Number: C6152-1 Receipt Number:
(Rev. 11/05)
ANDERSON ENGINEERING
P:O. BOX 240773.
ANCHORAGE, AK 99524
522-7773 677 -7706 -(FAX)
MEMORANDUM
DATE: May 11, 2009
TO: Deb Wockenfuss
FROM: Mike Anderson, P.E.
SUBJECT: Lot 1, Block 2, Patricia Subdivision
Septic System Permit No.
The owner of Lot 1, Block 2, Patricia Subdivision wants to place the entire septic
system on the lot and avoid the encroachment into Lot 20. We have revised the design
to place the system and alternate site entirely on Lot 1. A lot line waiver will be required
due to the limited size of the lot. The waiver request is attached along with additional
soils tests, a revised site plan and the design for the alternate site. The house was
constructed with only three bedrooms and the new system is designed for a maximum
of three bedrooms. Please modify the existing septic system permit to three bedrooms
and to allow the system to be placed entirely on Lot 1.
WAIVER FEES: 2-00
DATE OF PAYMENT:
RECEIPT NUMBER: 006 y 4 (�
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LOT 1, BLOCK 2, PATRICIA SUBDIVISION
DESIGN FACTORS: SYSTEM REQUIREMENTS:
Three Bedroom Home 5' Wide Pressurized Trench System
Perc. Rate: 1-5 Min./Inch 1,500 Gallon STEP Tank
Application Rate: 1.2 GPD/SF );5',,2grainfield Rock
3 Bedrooms X 150 GPD/1.2 GPD/SF (Application Rate) = 375SF Absorption Area
375 SF/5*.64(Red. Factor) = 48 LF Trench Length
THEREFORE: Construct 2-35' Long x 5' Wide x 2.5' Effective Depth Absorption Trenches at the
Location Shown. Flow Line Elevation in Trenches to be 2' Below Original Ground Surface. Total Depth
to be 4.5' Below Existing Ground. Provide 4' Cover Over Septic Tank and 3' Cover Over Absorption
Trenches. Maintain 10' Separation from Water Services in the Area.
Natural
Backfill
1'6"
Geotextile
Fabric
611 O 1" Perforated
PVC (Holes Down)
3/16" Dia. Holes
@ 1.5' O.C.
2'6"
5'
Drainfield Rock
TYPICAL 5' WIDE TRENCH SECTION
••
T OFN
(NO SCALE) �� ! P ........,.�_
- n
NOTE: Grade Area Over Trench to Drain Away. 49thMinimum 6'Separation From Bedrock. �...::�......¢..^. �..�Minimum 4 Separation From Groundwater. : �a o—>I.........................0
Minimum 10' Separation From Water Services in the Area. �� m MICHAELE.,ZWE ON
Minimum 100' Separation From Surface Water or Streams.- �0, No. cE-4381 _=
LOT 1, BLOCK 2, PATRICIA
SUBDIVISION
ALTERNATE SITE
DESIGN FACTORS: SYSTEM REQUIREMENTS:
3 Bedroom Home Shallow Bed System
Perc. Rate: 1-5 Min./Inch 3 Bedroom Advantex Treatment System
Application Rate: 5 GPD/SF 500 Gallon Add On Lift Station
3 Bedrooms X 150 GPD/5 GPD/SF = 90 SF Absorption Area
90 SF/10 SF (Width) = 9 LF Bed Length
THEREFORE: Construct an Oversized Shallow Bed 18' Long x 10' Wide as Shown Below.
Place Bottom of Bed 3' Below Original Ground Surface. Remove Organics and Fill and Place
Coarse Sand to Provide 4' Separation From Groundwater. Place Insulation and 2' of Cover
Over Bed or Mound Over Bed Minimum of 3'. Place 4' of Fill Over Tank.
Existing Ground
.5'
.5'
As Required
Natural Backfill
2" Insulation & 2' Cover Min.
O O O
Drainfield Rock
Coarse Sand (See Specification)
As Required for Levelling
And Replacement of Fill and Organics.
In Situ SP Soil
1.75' 3.25' 3.25' 1.75'
Existing Ground
1" PVC
3/16" Holes
10 Each Lateral
TYPICAL BED SECTION
(NO SCALE)
NOTE: Grade Area Surrounding Bed to Drain Away.
Minimum 6' Separation From Bedrock.
Minimum 4' Separation From Groundwater.
Minimum 100' Separation From Surface Water or Streams. '
Minimum 10' Separation From Water Service Line.
49th
���.
Michael E. Anderson -"it
►6)�, :, No. CE4381 �_
♦�ZROFESSIC�P��•�
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT/4
P, .......... �i
4700 BRAGAW STREET ANCHORAGE, AK 99519-6650 `�' #
49th
..
SOILS LOG -PERCOLATION TEST 'syl ......�zc.
..... ............. ........
....--
MICHAEL E. ANDERSON
LEGAL DESCRIPTION: LOT I, BLOCK 2, PATRICIA SUBDIVISION �;0% No. CE -4381 �'W=
PERFORMED FOR: ALI FAMILY TRUSTX11 �Y(�' •�-
DATE: 5/8/09 PROJECT No.: •`•����ti� ����•'
PARCEL ID#: TECHNICIAN:
A. HARALA Professional Engineers Stam :
DEPTH TEST HOLE A
(feet)„
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
1
1
OB/OG
SILTY SAND
WITH GRAVEL
SM/GM
SLOPE
0
0
SITE PLAN
15' 1'
•
THA
WAS GROUND WATER ENCOUNTERED? No
IF YES @ WHAT DEPTH? S
DEPTH OF WATER AFTER MONITORING: NONE L 0%
SILTY SAND DATE OF MONITORING: 5/11/09
SM/ML
DATE
READING
GROSS TIME
(MINUTES)
NET TIME
(MINUTES)
DEPTH TO
WATER
(INCHES)
NET DROP
(INCHES)
TEST HOLE PRESOAKED PRIOR TO TESTING:
5/8
1
5:08
6.25"
2
5:18
10
14.38"
8.13"
3
5:19
6.50"
4
5:29
10
14.63"
8.13"
5
5:30
1 6.13"
6
5:40
10
14.1911'
8.0611"
PERCOLATION RATE: 1.25 (MIN/INCH) PERC. HOLE DIA. 6" (INCHES)
TEST RUN BETWEEN: 4.5 FT. and 5.5 FT.
COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST.
TEST PERFORMED BY ANDERSON ENGINEERING. I, MICHAEL E. ANDERSON CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE: 5/11/09
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4700 BRAGAW STREET ANCHORAGE, AK 99519-6650
DEPTH
(feet)
1
2-
3
4
5
6
7
8
9
10
11
12
13
14
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION: LOT I, BLOCK 2, PATRICIA SUBDIVISION
PERFORMED FOR: ALI FAMILY TRUST
DATE: 5/8/09 PROJECT No.:
PARCEL ID#: TECHNICIAN: A. HARALA
TEST HOLE B
FILL MATERIAL c1 npp
OG/PT
SILTY SAND
WITH GRAVEL
SM/GM
BOH @ 12'
O
0
C-0 .e-- I
•- P:V ............-�i
49th
.................................
MICHAEL E. ANDERSON
%NO. CE .6. 5 .•~
vifflaw
Professional Engineers Stamp:
SITE PLAN
15'
•
19'
WAS GROUND WATER ENCOUNTERED?
YES
GROSS TIME
(MINUTES)
IF YES @ WHAT DEPTH?
9.3'
NET DROP
(INCHES)
DEPTH OF WATER AFTER MONITORING:
DATE OF MONITORING:
9.0%
0
0%
5/11/09
4.25"
DATE
READING
GROSS TIME
(MINUTES)
NET TIME
(MINUTES)
DEPTH To
WATER
(INCHES)
NET DROP
(INCHES)
TEST HOLE PRESOAKED PRIOR TO TESTING:
5/8
1
6:11
4.25"
2
6:21
10
Dry
9.13"
3
6:22
4.13"
4
6:32
10
13.13"
9.00"
5
6:33
1 4.06"
6
6:43
10
13.00"
8.94"
PERCOLATION RATE: I.13 (MINANCH) PERC. HOLE DIA. 6" (INCHES)
TEST RUN BETWEEN: 4.5 FT. and 5.5 FT.
COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST.
TEST PERFORMED BY ANDERSON ENGINEERING. I, MICHAEL E. ANDERSON CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE: 5/11/09
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4710 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Initial
Date Issued: May 08, 2006
Expiration Date: May 08, 2007
Permit Number: SWO60080 Parcel ID: 012-464-01
Legal Description: PATRICIA SUBDIVISION BLOCK 2 LOT 20
Design Engineer: 0844 WATKINS ENGINEERING Site Address: NHN GEBHART DRIVE
Owner Name: GAZMEND ARAPI Lot Size: 7020 SQ. FT.
Owner Address: 2852 TELEQUANA #3 Total Bedrooms: 4 Permit Bedrooms: 4
ANCHORAGE. AK 99517 -
This permit is for the construction of:
Q Disposal Field Q 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 dosed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By:
Issued Byi
Date: CS' d`- 04
Date: S
Municipality of Anchorage
040
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FORA SINGLE FAMILY DWELLING
Parcel I.D. 012-464-aD-01 Permit Number SW
Property owner(s) Gazmend Arapi Day phone 350-8952
Mailing address (1) 2852 Telequana #3
CALL
Mailing address (2) Anchorage. AK Zip Code 99517
Legal description (Lot, Block & Sub'd.) Patricia SID, Blk 2, Lots 1 & 20
Legal description (Section, Township & Range)
Lot Size 7020+7020 Acres/Sq.Ft.
THIS APPLICATION IS FOR:
Number of Bedrooms 4
Sewer Only E Well Only ❑
Sewer and Well ❑ Water Storage ❑
Sewer Upgrade ❑
THIS PROPERTY CONTAINS:
Hot Tub ❑ Jacuzzi ❑
Swimming Pool ❑ Water Softening Unit ❑
Therapy Pool ❑
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
(Signature of
Permit Fees:
Date of Payment:
0�; YE.
owner or authorized agent)
Waiver Fees:
Date of Payment:
Receipt Number. Receipt Number.
(Rev. 12100)
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Municipality of Anchorage
Development Services Department
Building Safety Division
yr On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.munl.orglonsite
(907) 343-7904
Soils Log - Percolation Test
Performed For. Gazmend Arapi Date Performed: 4/30/05
Legal Description: Patricia SID, Blk 2, Lot 20 Township, Range, Section:
Depth
Gross Time
Net Time
(Feet)
Net Drop
1- 2
4/30/05
organic:
1-
6-0
/.0
2-
S M
10:59-11:06
3
6-0
3.0
4-
11:07-11:14
5-
SP
6
-
6-
11:15-11:23
7-
7-
6-0
6
B-1
8
11:24.11:34
9-1 InL
11-1309
12-
1
18-
19 -
FL,
WAS GROUND WATER
ENCOUNTERED? Yes
8
IF YES, ATIAHAT DEPTH? 7 L
O
Depth to water After �7 P
Monttoring? / • 0 E
Date: 5-7' 05
V
Reading
Date
Gross Time
Net Time
Depth to Water
Net Drop
1- 2
4/30/05
10:48 -10:58
10
6-0
6
3-4
10:59-11:06
10
6-0
6
5-6
11:07-11:14
7
6-0
6
7-8
11:15-11:23
8
6-0
6
9-10
11:24.11:34
10
6-0
6
11-12
11:35-11:44
9
6-0
6
13-14
11:45-11:53
8
6-0
6
PERCOLATION RATE 1.5 (mn,ftWV4h) FERC HULE UwMt r cr< a
TESTRUNSETWEEN 2 FT AND 2.5 FT
COMMENTS SPsandfrorn Tto9's celeniquarry
PERFORMED BY: WalktrtsEngineedng.Inc. I k V flL CERTIFY THATTHIS TEST WAS
PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELI %
ES IN EFFECT ON THIS DATE. DATE: —/ 0-05
M 2005-038831-0
Recording Dist: 301 - Anchorage
A 6/10/2005 8:36 AM Pages: 1 of 4
A
IS( qll!I!Illlllllllllllfllll!Ilillill!III�IIIIIIU!IIIII!I!IIII!Illllllllllllllll
EASEMENT APPURTENANT
FOR CONSTRUCTION OF SEPTIC SYSTEM
In exchange for good and valuable consideration, receipt of which is hereby
acknowledged, the undersigned, Gazmend Arapi, Grantor, who is the legal owner of the
following described real property:
Lot 20, Block 2, Patricia Subdivision, Anchorage Recording District,
Anchorage, Alaska, Plat # 69-54.
does hereby sell, convey, and warrant to Gazmend Arapi, Grantee, as owner of the
following described real and adjacent property:
Lot 1, Block 2, Patricia Subdivision, Anchorage Recording District,
Anchorage, Alaska, Plat # 69-54.
a permanent septic easement and right-of-way with the right to erect, construct, install,
lay and thereafter use, operate, inspect, repair, maintain, replace, and rework all
necessary pipes, equipment, and/or other appurtenances required for construction of a
septic system and/or septic drain field, to be placed on, across and/or under a portion
of Grantor's property with the portion to which this easement applies or conveys more
particularly described in the drawing attached as Exhibit A, which drawing is
incorporated herein by reference.
It is understood and agreed that this easement and right-of-way shall give and
convey to the Grantee the right of ingress and egress upon the lands above described for
the purpose of constructing, maintaining and repairing the septic system or components
thereof.
EASEMENT APPURTENANT, Page I of 3
Lot 20, Block 2, Patricia Subdivision, Anchorage Recording District, Anchorage,
Alaska, Plat # 69-54.
It is further understood and agreed that the consideration above mentioned shall
be in full settlement of all claims, grants or rights of action accrued, accruing or to accrue
to the Grantor herein or his successors and assigns.
It is further understood and agreed that this instrument constitutes the entire
agreement between the Grantor and the Grantee, there being no oral agreements or
representations of any kind made between the Grantor and Grantee. That the easement
conveyed herein should be construed as an Easement Appurtenant to Lot 1, Block 2,
Patricia Subdivision, Anchorage Recording District, Anchorage, Alaska, Plat # 69-54 and
shall constitute a covenant running with the land for the benefit of the Grantee, his
successors and assigns and shall be a binding burden on Lot 20, Block 2, Patricia
Subdivision, Anchorage Recording District, Anchorage, Alaska, Plat # 69-54 and shall be
binding on the Grantor, and his successors and assigns.
EASEMENT APPURTENANT, Page 2 of 3
Lot 20, Block 2, Patricia Subdivision, Anchorage Recording District, Anchorage,
Alaska, Plat # 69-54.
nl Ililll III IIIIIIII�IIIJI!I
2 of 4
2006-038831-0
DATED, this _ day of June 2005.
--o G.
OL- end Arapi, Gr for
2852 Telequana, No. 3
Anchorage, Alaska 99517
STATE OF ALASKA )
) ss
THIRD JUDICIAL DISTRICT )
THIS IS TO CERTIFY, that on the j— day of June 2005, before me, the
undersigned, a Notary Public, in and for the State of Alaska, duly commissioned and
sworn, personally appeared GAZMEND ARAPI, and acknowledged that he executed the
foregoing instrument, knew the contents thereof, and the same was his own free and
voluntary act and deed.
IN WITNESS WHEREOF, I hereunto set my hand and official seal the day and year
first above written.
Notary Public in and for Alaska
My Commission Expires:
NNC'HU eF/Gc= Ali
EASEMENT APPURTENANT, Page 3 of 3
Lot 20, Block 2, Patricia Subdivision, Anchorage Recording District, Anchorage,
Alaska, Plat It 69-54.
�IIIIIIIIIIIIIIIIIIIIIIhIIII
3 of 4
2006.038831-n
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MUNICIPALITY OF ANCHORAGE
PLATTING AUTHORITY RESOLUTION NO. 2005-029
ANCHORAGE RECORDING DISTRICT
A RESOLUTION APPROVING AN AMENDMENT OF NOTE 2 ON PLAT 69-54 THAT STATES:
"ALL LOT PURCHASERS TAKE AND ALL LOT OWNERS HOLD THEIR LOTS SUBJECT TO
THE REQUIREMENT THAT ALL DWELLING UNITS PRESENTLY EXISTING AND THOSE
CONSTRUCTED HEREAFTER BE CONNECTED TO PUBLIC SEWER FACILITIES WITHIN
ONE YEAR AFTER SUCH FACILITIES BECOME AVAILABLE WITHIN 200 FEET OF THE
NEAREST LOT LINE," FOR LOTS 1 AND 20, BLOCK 2, PATRICIA SUBDIVISION, LOCATED
ON THE SOUTH SIDE OF WEST 100TH AVENUE AND EAST OF GEBHART DRIVE WITHIN
THE N''/2 SW'/, OF SECTION 13, T12N, R4W, S.M., ALASKA.
WHEREAS, a petition has been received from Gazmend Arapi to amend Note 2 on
Plat 69-54 that states: "All lot purchasers take and all lot owners hold their lots subject to
the requirement that all dwelling units presently existing and those constructed hereafter be
connected to public sewer facilities within one year after such facilities become available
within 200 feet of the nearest lot line," for Lots 1 and 20, Block 2, Patricia Subdivision,
located on the south side of West 100th Avenue and east of Gebhart Drive within the N'/,
SW'/. of Section 13, T12N, R4W, S.M., Alaska, and
WHEREAS, notices were published, posted and mailed and a public hearing was held
on November 2, 2005.
NOW, THEREFORE, BE IT RESOLVED by the Platting Authority that:
The Platting Board makes the following findings of fact:
a. Lots 1 and 20, Block 2, Patricia Subdivision front onto the south side
of West 100th Avenue. Public sewer is located on the north side of
100th Avenue in Olympic Drive and Poseidon Drive which is within 200
feet of the petition lots' north property boundary. The request would
allow development of the lots to be served with an on-site septic
system.
b. Most of Patricia Subdivision is impacted by wetlands classified as Type
B wetlands on the Anchorage Wetlands Management Plan. Type B
wetlands have a fairly high degree of biologic and/or hydrologic
function with site development limitations. With the exception of two
dwelling units, the subdivision is undeveloped. The note was placed
on the plat in 1969. The poor soil conditions resulted in the
subdivision being very unlikely for on-site sewage disposal systems to
function properly.
C. The applicant proposes to construct a dwelling on Lot 1 and install an
on-site septic system on Lot 2. Both lots are in common ownership.
d. The Corps of Engineers determined that the petition lots consisted of
uplands and a 404 permit is not required for the proposed residential
development of these lots.
Notting Authority
Rewlutm No. 2DOS-029
Page 2
e. Soils information has been submitted on MOA On -Site Water and
Water Services (OSWWS) for Lots 1 and 20. A permit for the proposed
on-site septic system has not been issued due to the existing plat note.
f. AWWU has recommended that no lot be permitted to tap into the sewer
line north of West 100th Avenue. AWWU has issued permits to provide
public water to the property.
g. Public sewer is most likely to be extended from the main lines located
along the south boundary of Patricia Subdivision within Washington
Avenue. There currently are no plans to extend the utility in the
foreseeable future.
h. The amendment to the plat note would allow the lots to be developed
with an on-site septic system; however the septic system would be
required to be abandoned at such time that public sewer is available
within 200 feet from a location other than the main lines located within
West 100th Avenue.
Amending the plat note addresses the unique circumstances of this
request and does not necessarily set a precedent for any requests to
amend the plat note in the future due to the undue hardship
associated with the development of these lots.
The Platting Board APPROVES an amendment of Note 2 on Plat 69-54 to
state: "All lot purchasers take and all lot owners hold their lots subject to the
requirement that all dwelling units presently existing and those constructed
hereafter be connected to public sewer facilities within one year after such
facilities become available within 200 feet of the nearest lot line, provided that
Lots 1 and 20, Block 2, Patricia Subdivision are not required to connect to
public sewer facilities north of West 100th Avenue to comply with the intent of
this note," subject to:
a. Placing a note on the plat stating: "Direct vehicular access to West
100th Avenue from Lots 1 and 20, Block 2, Patricia Subdivision is
prohibited."
b. Recording a resolution with the District Recorder's Office.
APPROVED by the Anchorage Platting Authority this 2nd day of November 2005.
— 94A_ =ZL
Tom N lson
Secretary
Rnum b: YuMItrLO.r Mt...a.
Im bl, NAY s o.»bvermt
PO.Bw ;
McMy.." AN vO5lPebw
M. MrMn Otjnw
r1� fu. -.0 -
Bruce Phelps
Chair
Cases S-11416-1
'ET4V TO
..TTENTbN OF:
Regulatory Branch
South Section
POA -2005-1063-8
DEPARTMENT OF THE ARMY
U.S. ARMY ENGINEER DISTRICT, ALASKA
P.O. BOX 6898
ELMENDORF AFB, ALASKA 99506-0898
JL 18 M
Mr. Gamend Arapli
2852 Telequana Drive, 13
Anchorage, Alaska 99517-1514
Dear Mr. Arapli:
This is in response to your request for a Department of the Army
(DA) jurisdictional determination for proposed residential development
in Lots 1 and 20, Block 2, Patricia Subdivision, along the southern
edge of 100`", between Olympic and Gebhart, Wetland Unit 60A,
Municipality of Anchorage Wetlands Atlas Map 76, located within section
13, T.12 N., R.4 W., Seward Meridian, Latitude 61.129, Longitude
-149.916, Anchorage, Alaska.
Based on our review of the information you furnished and available
to our office and our field inspections on June 28 and July 13, 2005,
we have determined that your proposed project would not involve
placement of dredged and/or fill material into waters of the United
States (U.S.) under our regulatory jurisdiction. Therefore, a DA
permit is not required.
However, should you decide to alter the method, scope, or location
of your proposed activity, please contact this office for a
determination of DA jurisdiction and, if applicable, the required DA
authorization.
Your proposed project was reviewed pursuant to Section 404 of the
Clean Water Act. Section 404 of the Clean Water Act requires that a DA
permit be obtained for the placement or discharge of dredged and/or
fill material into waters of the U.S., including wetlands, prior to
conducting the work (33 U.S.C. 1344).
For regulatory purposes, the Corps of Engineers defines wetlands as
those areas that are inundated or saturated by surface or groundwater
at a frequency and duration sufficient to support, and under normal
circumstances do support, a prevalence of vegetation typically adapted
for life in saturated soil conditions.
This approved jurisdictional determination is valid for a period of
five (5) years from the date of this letter, unless new information
supporting a revision is provided to this office before the expiration
date. Should you desire to appeal this approved jurisdictional
-2 -
determination, please contact this office to request additional
information on the Administrative Appeals Process.
Nothing in this letter shall be construed as excusing you from
compliance with other Federal, State, or local statutes, ordinances, or
regulations that may affect this work. For informational purposes, a
copy of this letter is being sent to the agencies and individuals on
the enclosed list.
Please take a moment to complete and return the enclosed
questionnaire. Our interest is to see how we can continue to improve
our service to you, our customer, and how best to achieve these
improvements. Upon your request, you may also provide additional
comments by telephone or a meeting. We appreciate your efforts and
interest in evaluating the Regulatory Program.
We appreciate your cooperation with the Corps of Engineers'
Regulatory Program. Please refer to file number POA -2005-996-8, Klatt
Bog,in future correspondence or if you have any questions concerning
this determination. You may contact me at 753-2712, or by mail at the
letterhead address, ATTN: CEPOA-CO-R-S.
Sincerely,
Mary Lee Plumb-Mentjes
Project Manager
Enclosures
DISTRICT: Alaska
FILE NUMBER: POA -2005-1063
Lateral Extent of Jurisdiction: (Reference: 33 CFR parts 328 and 329)
❑ Ordinary
Iligh Water Mark indicated by:
❑ Iligh Tide Line indicated by:
❑
clear, natural line impressed on the bank
❑
oil or scum line along shore objects
❑
the presence of litter and debris
❑
fine shell or debris deposits (foreshore)
❑
changes in the character of soil
❑
physical markings/characteristics
❑
destruction of terrestrial vegetation
❑
tidal gages
❑
shelving
❑
other:
❑
other.
❑ Mean high Water Mark indicated by.
❑ survey to available datum; ❑ physical markings; ❑ vegetation lines/changes in vegetation types.
❑ To the limit of the wetland boundaries
Basis For Not Asserting Jurisdiction:
The reviewed area consists entirely of uplands.
Unable to confirm the presence of waters in 33 CFR part 328(axl, 2, or 4.7).
Headquarters declined to approve jurisdiction on the basis of 33 CFR part 328.3(ax3).
The Corps has made a ease -specific dctemtination that the following waters present on the site are not Waters of the United States:
❑ Waste treatment systems, including treatment ponds or lagoons, pursuant to 33 CFR part 328.3.
❑ Artificially irrigated areas, which would revert to upland if the irrigation ceased.
❑ Artificial lakes and ponds created by excavating and/or diking dry land to collect and
retain water and which are used exclusively for such purposes as stock watering, irrigation, settling basins, or rice growing.
❑ Artificial reflecting or swimming pools or other small ornamental bodies of water created
by excavating and/or diking dry land to retain water for primarily aesthetic reasons.
❑ Water -filled depressions created in dry land incidental to construction activity and pits excavated in dry land for the purpose of
obtaining fill, sand, or gravel unless and until the construction or excavation operation is abandoned and the resulting body of water
meets the definition of waters of the United States found at 33 CFR 328.3(x).
❑ Isolated, intrastate wetland with no nexus to interstate commerce.
❑ Prior converted cropland, as determined by the Natural Resources Conservation Service. Explain rationale:
❑ Non -tidal drainage or irrigation ditches excavated on dry land. Explain rationale:
❑
Other (explain):
DATA REVIEWED FOR JURISDICTIONAL DETER1111NATION (mark all that apply):
HMaps, plans, plots or plat submitted by or on behalf of the applicant.
Data sheets prepared/submitted by or on behalf of the applicant.
❑ This office concurs with the delineation report, dated , prepared by (company):
❑ This office does not concur with the delineation report, dated , prepared by (company):
❑ Data sheets prepared by the Corps
❑ Wetland boundary map prepared by the Corps
Alaska District's Approved List of Navigable Waters
U.S. Geological Survey Ilydrologic Atlas:
U.S. Geological Survey 7.5 Minute Topographic maps:
U.S. Geological Survey 15 Minute Topographic maps:
USDA Natural Resources Conservation Service Soil Survey:
National wetlands inventory maps:
State/Local wetland inventory maps: Municipality of Anchorage Wetlands Atlas 2004
FEMA/FIRIst maps (Map Name & Date):
100 -year Floodplain Elevation is: (NGVD)
Aerial Photographs (Name & Date):
Other photographs (Date):
❑ Advanced Identification Wetland naps:
® Site visit ]Datc(s)]: 6/28/05 by A. Muth, 7/13/05 by M.L. Plumb-hlcntjcs
❑ Previous dctemtination(s) (File number and date of response letter]:
Applicable1supporting case law:
Other information (please specify):
Signature //
'Wetlands a e identified and delineated using the methods and criteria established in the Corps Wetland Delineation Manual (87 Manual) (i.e.. oceurrence of
hydrophytic vegetation, hydric wilt and wettand hydrology).
"Me teen "adjacent" means bordering, contiguous, or neighboring. Wetlands separated from other %iters of the U.S. by man -nude dikes or barriers, natural river
berms, beach dunes, and the like arc also adjacent.
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JURISDICTIONAL DETERMINATION
U.S. Army Corps of Engineers
DISTRICT: Alaska
FILE. NU51BER: POA -2005-10634
PROJECT LOCATION INFOIUIIATION:
State: Alaska
Borough: Municipality of Anchorage
Center coordinates of site (latlong in degree decimal format): Lat. 61.129' N., Long. -149.916° W.; Sec. 13. TA 2 N, R.4 W., S.M.
Approximate size of area (parcel) reviewed, including uplands: 0.41 acres. .
Name of nearest waterway: Klatt Dog ditch
JURISDICTIONAL DETERMINATION
hlelhod: Office determination
Onsite detcr tination
Date Form Completed: 7/14/05. -
Jurisdictional Determination (JD):
❑ Preliminary JD - Based on available information, ❑ there appear to be (or) ❑ there appear to be no `waters of the United States" and/or
"navigable waters of the United States" on the project site. A preliminary JD is not appealable (Reference 33 CPR pari 331).
® Approved JD — An approved JD is an appealable action (Reference 33 CFR part 331).
Check all that apply.
❑ There are "navigable waters of the United States" (as defined by 33 CFR part 329 and associated guidance) within the reviewed area.
Approximate size ofjurisdictional area:
❑ There are "waters of the United States" (as defined by 33 CFR part 328 and associated guidance) within the reviewed area.
Approximate size of jurisdictional area:
(] There are "isolated, non -navigable, Intra -store waters or wetlands" within the reviewed area.
❑ Decision supported by SWANCC/bfigratory Bird Rule Information Sheet for Determination of No Jurisdiction.
BASIS OF JURISDICTIONAL DETERMINATION:
A. Waters defined under 33 CFR part 329 as "navigable waters of the United States":
❑ The presence of waters that are subject to the ebb and Bow of the tide andhor are presently used, or have been used in
the past, or may be susceptible for use to transport interstate or foreign commerce.
B. Waters defined uader33 CFR part 3283(a) as "waters or the United Slates":
❑ (1) The presence of waters, which are currently used, or were used in the past, or may be susceptible to use in
interstate or foreign eommtcrce, including all waters which are sub+ecl to die ebb and now of the tide.
(2) The presence of interstate waters including interstate wetlands .
❑ (3) The presence of other waters such as intrastate lakes, rivers, streams (including intermittent streams), mudflats, sandflats, wetlands,
sloughs, prairie potholes, wet meadows, playa lakes, or natural ponds, the use, degradation or destruction of which could affect interstate
commerce including any such waters (check all that apply):
❑ (i) which are or could be used by interstate or foreign travelers for recreational or other purposes.
❑ (ii) from which fish or shellfish are or could be taken and sold in interstate or foreign commerce.
❑ (iii) which are or could be used for industrial purposes by industries in interstate commerce.
(4) Impoundments of waters otherwise defined as waters of the US.
❑ (5) The presence of a tributary to a water identified in (1) — (4) above.
Q (6) The presence of territorial seas.
❑ (7) The presence of wetlands adjacent to other waters of the US, except for those wetlands adjacent to other wetlands.
Rationale for the Basis of Jurisdictional Determination (applies to any boxes checked above). Ifthejurisdictional wateror wetland is not
itselfa navigable waterofthe United States, describe connection(s) ra the downstream navigable waters. IfB(I) or B(3) is used as the Basis of
Jurisdiction, document navigability and/or interstate commerce connection (i.e.. discuss site conditions, including why the waterbody is
navigable and/or how the destruction of(he waterbody could affect interstate or foreign commerce). If B(2, 4, S or 6) is used as the Basis of
Jurisdiction, document the rationale used to make the determination. If B(7) is used as the Basis of Jurisdiction, document file rationale used to
make adjacency determination:
MUNICIPALITY OF ANCHORAGE
Development Services Department ti Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 012-464-20
Legal description PATRICIA BLK 2 LT 1
Site address 10031 GEBHART DR
Current property owner(s) NIBBE ROD & NANCY
Expiration Date: 4/4/24
X The On-site system(s) is/are approved for 3 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or advisories:
By:
Original Certificate Date: 4/4/23
This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
system(s) is/are in substantial compliance with municipal code. The Municipality of
Anchorage, Development Services Department (DSD) issues COSAs based upon
representations provided by an independent professional engineer. The Municipality of
Anchorage is not responsible for errors or omissions in the professional engineer's work.
ATTACHMENTS:
COSA Checklist X Well Flow Advisory
Absorption Field Advisory Nitrate Advisory
Tank Age Advisory Arsenic Advisory
Other
COSA Approval_June 2022
MUNICIPALITY OF
01
Development Services Department
On -Site Water & Wastewater Section
ANCHORAGE
Phone: 907-343-7904
Fax: 907-343-7997
Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 012-464-
Complete
12-464
Complete legal description PATRICIA BLOCK 2, LOT 1
Location (site address) 10031 GEBHART DRIVE, ANCHORAGE, AK 99515
Current property owner(s) ROD & NANCY NIBBE Day phone
2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS
3. TYPE OF WATER SUPPLY: ❑ Private Well ❑ Private Well serving 2 dwelling units
❑ Private Well serving 3+ dwelling units ® Community Well or Public
❑ Water Storage
4. TYPE OF WASTEWATER DISPOSAL: ® Private Septic ❑ Private Septic serving 2 dwelling units
❑ Holding Tank ❑ Community Septic or Public Sewer
5. SEPTIC TANK: ® Steel ❑ Plastic ❑ Concrete ❑ Fiberglass
Age 14 -See advisory if steel older than 20 years — 10 GAUGE STEEL PER MOA IR
6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ® Wide Trench ❑ Seepage Pit
Waiver request for:
Expedited review requested: ❑
Distance:
By applying for this entitlement, this property is subject to inspection by municipal On-site staff
to verify the accuracy of the information provided.
COSA Fee Waiver Fee $
Date of Payment 3 Z zo Z- 3 Date of Payment
COSA # 0_c:,—_2 2, 10 6a Waiver #
COSA Applicalion.doc
COSA Checklist.docx
COSA Checklist
Legal Description: PATRICIA BLOCK 2, LOT 1 Parcel ID: 012-464-20
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____
A. WELL DATA - PUBLIC &/OR CLASS “A” WATER
Well log is filed with Onsite (or attached)
Date drilled Total depth ft
Cased to ft
Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) in.
Date of flow test for COSA
Static water level at beginning of test ft.
Well production at time of test gpm
Water storage tank volume NA gallons
Well disinfected for coliform test? Yes No
Coliform bacteria is Negative
Nitrate mg/L Nitrate less than MRL (ND)
Arsenic ug/L Arsenic less than MRL (ND)
Collected by
Date
Comments __________________________________________________________________________________
B. TANK DATA
Measured operating fluid level in septic tank NA
Date of pumping 3/27/2023
Required maintenance completed, if AWWTS
Comments: STEP – NA / Float Levels….
C. LIFT STATION
Required maintenance completed
Age of lift station 14 years
Lift station material 10-Gauge Steel per MOA IR
Comments: Per code at install. L&S Serviced.
D. ABSORPTION FIELD DATA
Which system tested (date installed) 5/20/2009
ALL standpipes present per record drawing
Total measured depth from grade 5.4+ ft (max)
Measured depth to pipe invert from grade ft (min)
N/A – pressurized field.
Per record drawings, field is insulated.
Monitor tubes go to bottom of effective.
If not, state depth into effective APPEARS
Presoaked required if
(Required if house vacant or field not used for more
than 30 days prior to date of test)
Gallons introduced gallons date
Any rejuvenation treatment (past 12 months) N
If yes, enter date
Adequacy test date 3/27/2023
Results Pass
Fluid depth prior to test 1 in (MT1 PER MOA IR)
Water added 450 gal (MT1 PER MOA IR)
New fluid depth 6 in (MT1 PER MOA IR)
Elapsed time 30 min (MT1 PER MOA IR)
Final fluid depth 1 in (MT1 DRY NEXT DAY)
Absorption rate 450 gpd
FIELD STATUS – POST RECOVERY
Effective depth (per record drawings) 30 in
Effective depth used 1 in
Effective depth remaining 29 in (MT1 PER MOA IR)
Comments/Deficiencies: Only tested MT1 / north trench. No change in fluid levels in south MT2 trench closest to STEP tank.
MT2 south trench had approximately 2’ of fluid. Fields and tank insulated per IR & owner said there has be no known frost
or freezing issues.
COSA Checklist.docx
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) - NA
Septic Tank/Lift Station on Lot > 100’
Yes if No ft
Neighboring Tank > 100’ Yes if No ft
Absorption Field on Lot > 100’ Yes if No ft
Neighboring Absorption Fields > 100’
Yes if No ft
Community Sewer Main > 75’ Yes if No ft
Community Sewer Manhole/Cleanout > 100’
Yes if No ft
Private Sewer/Septic Line > 25’ Yes if No ft
Holding Tank > 100’ Yes if No ft
Animal Containment > 50’ Yes if No ft
Manure/Animal Excreta Storage > 100’
Yes if No ft
N/A – Served by Community Well (not on lot) or Public Water
From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required)
Building Foundations > 10’ Yes if No ft
Tank to Property Line > 5’ Yes if No ft
Field to Property Line > 10’ Yes if No ft
Water Main > 10’ Yes if No ft
Water Service Line > 10’ Yes if No ft
Surface Water > 100’ Yes if No ft
Wells on Adjacent Lots:
Private Wells > 100’ Yes if No ft
Community Wells > 200’ Yes if No ft
If tank or field is under driveway comment below
F. ENGINEER’S COMMENTS
Site served by AWWU water – AWWU connect card & aerial snip attached.
G. CERTIFICATION & 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, indicates that the on-site water
supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation, unless noted otherwise.
Name of Firm FIRST WATER CONSULTING Phone 907-350-9566
Engineer’s Printed Name CURTIS HUFFMAN, PE Date 3/30/2023
Comments: This investigation was completed in compliance with MOA guidelines, regulations,
and best industry practices / methods. The assessment of the condition of the well and septic
applies only to the conditions as of the day tested. The flow and absorption rates may change
due to subsurface conditions that may not be observed from the surface, changes in land use,
local soil characteristics, groundwater levels that may fluctuate during the year, quality of
construction (workmanship & materials), the water usage of the family being served by the
system and maintenance. The operational life of all well and septic systems are subject to
these various and dynamic characteristics and are outside the control of the evaluator of the
well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory
for current or future occupants or guarantee that no unseen encroachments, deficiencies or
discrepancies exist can be given by First Water Consulting &
3/30/2023
DATE SCHEDULED 7-17-03 TIME INSPECTOR
SUBDIVISION PATRICIA BLOCK/LOT/TRACTBLK 2 T 1
INDICATE NbRTH
SIZE CONN 1"
_�?DOMESTIC ONLY
['
BOTH FIRE & DOMESTIC
CORP. STOP
❑ FIRE LINE ONLY
❑
FIRE HYDRANT ONLY
CURB STOP C TOC
DATEOFTAPE 7111p163
BY
�A�2✓t .,l
I_I h%Y
FT. COPPER PIPE
SIZE MAIN a, ) A,)
❑
ALLEY
[^STREET ❑ EASEMENT
1 1/4" OR 2" KEY BOX
TYPE MAIN ()e{P
EXCAVATOR
FT. THAW -WIRE
DISCONNECTS ❑ YES Li
NO
SIZE OF DISCONNECT
THAW-PLATE/NUT
COMMENTS
KEARNY CONNECTOR
KEY BOX LOCATION 3 9
Uo-�-
aQa+M
!Od✓C l U2 b
4AjdJ3
t- a -P
OTHER
rurtb
e�till�r
b„�_f /�� -
_
INSPECTION REPORT
LINE BLOWN OUT / /
❑ INSULATED INSPECTOR
❑ K.B. & T.W. -OK AFTER
BACK -FILL DATE / /
❑ OPEN BORE FLUSH / /
COMMENTS
❑ 200 LB. TEST. / /
❑ MAIN CHLORINATED / /
❑ CHLORINE FLUSHED
y OK TO TURN -ON ❑ DO NOT TURN -ON
-7146a
Municipality of Anchorage
\. •. Development Services Department �.
Building Safety Division
_ On -Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 012-464-20 COSA* NA 0x10 l! Vy
Expiration Date: C./lo
1. GENERAL INFORMATION
Complete legal description Lot 1, Block 2, Patricia Subdivision
Location (site address) 10031 Gebhardt Drive
Current Property owner(S) Ali Family Trust Day phone 727-2912
Mailing address 3705 Arctic Boulevard, Suite 1334 Anchorage, AK 99503
Lending agency Day phone
Mailing address
Real Estate Agent Day phone
Mailing Address
Unless otherwise requested, COSA will be held by DSD for pickup
2. NUMBER OF BEDROOMS:
Three (3)
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
❑
Individual On-site❑
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 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 Onsite 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 Onsite 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 Engineering Phone 522.7773
Address P.O. Box 240773 Anchorage, AK 99524
Engineer's Printed Name Michael E. Anderson, P.E. Date
5. DSD SIGNATURE
_>,"' Approved for 3 bedrooms.
Disapproved.
OF At'lit
AFL E ANDERSON
a-4381 .'o
Conditional approval for bedrooms, with the following stipulations:
Attachments:
COSA Checklist _X
Septic System Advisory
Well Flow Advisory
Arsenic Advisory
Maintenance Agreements
Su lemental En i r' R
VV g nee s epos
Nit to Advisory Other
By: L
ta" IM)
Original Certificate Date: 3 O�
Municipality of Anchorage y ,.•• ••,,'
• 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. Blod(2. Pamela subdivision Parcel ID: 012464-20
A. WELL DATA
Well type AYhNU
Date completed _
Total depth fL
Date of test
Static water level
If A. B, or C provide PWSID #
Sanitary seal (Y/N) _
Cased to ft.
FROM WELL LOG
Well production
WATER SAMPLE RESULTS:
Coliform colonies/100 mL Nitrate mg/L
Arsenic: _ ugA Date of sample:
Well Log (YIN)
Wires properly protected (Y/N)
Casing height (above ground) in.
AT INSPECTION
ft.
9 -
p.m -
Other bacteria
Collected by:
colonies/100 mL
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material STEPMteel Date Installed 5118/07
i
Tank size ` 1.500 gal. Number of Compartments T� (2) Cleanouts'(YM) Y
Foundation cleanout (YIN) Y Depression over tank (Y/N) N High water alar (Y/N) Y
Date of pumping New Pumper Construction
C. ABSORPTION FIELD DATA
Date installed 5/1&2012009 Soil rating (g.p.d./ft= or fe/bdr)1.2 GP System type 5' Wide Trench
Length 70 ft. Width 5 ft. Gravel below pipe 2.5 ft.
Total depth 5.5.5 ft. Eff. absorption area a? fe Monitoring tube Y Depression over field N
Date of adequacy test New Const. Results (Pass/Fail) For bedrooms
Fluid 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) N If yes; give date
D. LIFT STATION
Date installed 5/182009 Size in gallons 250
Manhole/Access (YIN) Y
'Pump on' level at 42 in. 'Pump off" level at 42
in. High water alar level at 44 in.
Datum Top of Tank Cycles tested 2
Meets alarm 8 circuit requirements? Y
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
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 None
Manure/animal excrete storage areas None
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation >5• Property line >5'
Absorption field i5'
Water main NIA Water service line
>70 Surface water >100,
Wells on adjacent lots >20(r
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 110' Building foundation >10' Water main >10'
Water Service line >10' Surface water >100'
parking/vehicle Driveway, arkin >25
y p storage
Curtain drain None Noted Wells on adjacent lots
>200'
F. COMMENTS: Property is Served by AWWU Water System.
G. ENGINEER'S CERTIFICATION
I certify that 1 have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this date.
Engineer's Printed Name Michael E. Anderson, P.E.
Date 6m2009
COSA Fee $�
Date of Payment S
Receipt Number
(Rev. 11/05)
Waiver Fee $
Date of Payment
Receipt Number
A
' 4918
0
M
a)
a
M
I
6
N
O
OJ
2
I $
30.0'
WEST 100TH AVENUE
16.5' PUBLIC USE
1.5' X 8.8'
14.1' o
LOT 2
0
n
120.00' /--WOODEN FENCE
,
55.0' N
Q
MANHOLE
10' DRAINAGE do UTILITY EASEMENTS
LOT 20
CONTROLS
LOT 19
PLOT PLAN AS BUILT X SCALE 1' - 30' GRID SW 2528 Project No. 05-112
TWO STORY
-.ASPHALT'-
^ WOOD FRAME
DRIVEWAY.
N RESIDENCE
24.7'
40.1'
7.1'
LOT 2
0
n
120.00' /--WOODEN FENCE
,
55.0' N
Q
MANHOLE
10' DRAINAGE do UTILITY EASEMENTS
LOT 20
CONTROLS
LOT 19
PLOT PLAN AS BUILT X SCALE 1' - 30' GRID SW 2528 Project No. 05-112
Lan &Associates inc.11500 Daryl Avenue, Anchorage,
Lang s (907) 522-6476 Phone
Registered Land Surveyors (907) 522-4625 Fax
Alaska 99515-3049
o
kglanglsOalaska.net / IclangisOalaska.net
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1 hereby certify that I have surveyed the following described property.
LOT 1, BLOCK 2, PATRICIA SUBDIVISION
Anchorage Recording District. Alaska, and that the Improvements situated thereon aro
within the property lines and do not encroach onto the property adjacent thereto, that
no Improvements on the property lying adjacent thereto encroach on the surveyed
promises and that there aro no roadways, transmission lines or other visible
easements on sold property except as Indicated hereon.
Dated this the ZO4t, Day o1 Mn�Y �y�•, of Anchorage, Alaska
It Is the responsibility of the owner to determine the existence of any sasemen}a,
covenants, or restrictions which do not appear on the recorded subdivision plat.