Loading...
HomeMy WebLinkAboutRAMPART #1 LT 7Rampart #1 Lot 7 #015-071-10 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: OSP241367 Work Type: SepticTank Upgrade Tax Code Number: 01507110000 Site Legal Address: RAMPART #1 LT 7 G:2437 Site Mailing Address: 5620 E 99TH AVE, Anchorage Owner: FLORA LARS S Design Engineer: FIRST WATER CONSULTING This permit is for the construction of: Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: 10/28/2024 10/28/2025 16192 ❑ Disposal Field 0 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 it a. - ened and Icised on the safe day, or ¢! Covered, sealed, and heated to plrevent fCoezing Special Provisions: • Prior to construction, the edge of the seepage pit is to be located to ensure that the required separation will be met. —Received -By: T t,cr tO �C ()C, Date: Issued By. _ _ ,•,-r !/wry cam. Date: 4 Municipality of Anchorage I3pnrhnenr P.O. Box 196650 0 4700 Elmore Road Anchorage, Alaska 99519-6650 0 (907) 343-7904 0 Fax (907) 343-7997 http://www.muni.org/Onsite Development Services On -Site Water and Wastewater Program * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: WR890039 amended COSA# PID#: 015-071-10 Legal Description: Rampart #1 Lot 7 Engineer: First Water Consulting Permit#: OSP241367 Waiver WR890089 approval is amended for the septic tank upgrade. The approved waivers are: • Tank to the well on Lot 7 - 82' Tank to the well on Lot 6 — 79' This waiver approval applies to the proposed tank 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: Approved by: IN Name of Revie K owns **** VARIAN C E/WAIVER REVIEW **** Parcel I. D. 015-071-10 Phone: 907-343-7904 Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATIONr, ""' I Property owner(s) LARS S FLORA Day phone Mailing address 5620 E 99TH AVENUE, ANCHORAGE, AK 99507 Site address 5620 E 99TH AVENUE, ANCHORAGE, AK 99507 Legal description (Sub'd., Block & Lot) RAMPART #1 LOT 7 Legal description (Township, Range & Section) Lot Size 16,192 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial r_1 Single Family (SF) 0 (w/wo ADU) Septic Tank El Upgrade M Duplex ❑ (D) Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: �' Waiver Fees: Date of Payment: Receipt Number: Date of Payment: Receipt Number: Permit No. D W I `Y" 13 L+ Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / FirstWaterAK@gmail.com ! !! October 25, 2024 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC TANK UPGRADE PERMIT LEGAL: RAMPART #1 LOT 7 The owner has requested that we obtain a septic permit to upgrade the existing aged steel septic tank on the above referenced lot. For current functionality and future consideration or flexibility we propose to install a 1500-gallon HDPE tank per the attached design to serve the existing 4-bedroom residence. Groundwater was not noted in the MOA on-site file and is not anticipated to affect the septic tank installation. If groundwater is encountered during installation that may affect this septic tank upgrade, other action may be required. There is an existing waiver (WR#890039) of 82’ to the lot’s well & 88’ to adjacent well on Lot 6 to the referenced existing steel septic tank that was granted per the MOA record documents. It appears that this waiver should have stated that the well on Lot 6 to the tank on Lot 7 was 79’ based on the page 11 drawing of the current MOA documents that shows the wells and recent as-built survey. Also, it appears per Lot 7 & Lot 6 MOA records that some measurements of septic pipes were used. We are therefore requesting that this waiver be amended to 79’ from the proposed septic tank on Lot 7 to the private well located on Lot 6 to conform to what should have been issued previously and continued from the existing well to the proposed HDPE septic tank. Granting the continuation of this amended waiver is warranted per the rationale of the initial issuance, the improved material of the HDPE tank compared to the existing steel tank, the well is on the opposite side of the house there have been no known issues or influence over the past few decades from the previous existing steel tank. The lot and area are served by private water and any encroaching wells, easements, … must be staked prior to construction. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241367, Deb Wockenfuss, 10/28/24 2-STORY FRAME HOUSE LOT 7 16,193 sq. ft. 10' UTILITY EASEMENT DECK ASPHALT DRIVEWAY F E N C E LOT 6 UTILITY 30 ' REBAR WELL LOT 8 30 ' WELL EAST 99th AVENUE 35.4' 84.0' 24.2' 29.0' 11 .2' 55.0' EO EO EO EO EO EO 4.8' 30.9' 39 . 8 ' N 0 0 ° 0 3 ' 0 0 " W 1 3 4 . 9 5 ' N 89°57'30" E 120.00' S 0 0 ° 0 3 ' 0 0 " E 1 34 . 9 3 ' ASPHALT DRIVEWAY LOT 6 LOT 8 LOT 4 EAST 99TH AVE LOT 5 LOT 3 FIRST WATER CONSULTING OTHER THAN NOTED, NO WELLS WITHIN 100' OF PROPOSED SEPTIC TANK RAMPART #1 LOT 7 DESIGN DETAILS: Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241367, Deb Wockenfuss, 10/28/24 Municipality of Anchorage Department of Health and Human Services Tom Fink, 825 "L" Street Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 August 14, 1989 Bruce Corwin, P.E. Corwin & Associates 1000 East Dimond Boulevard Suite 205 Anchorage, Alaska 99515 Subject: Waiver Request for Lot 7 Rampart Subdivision #1 Waiver Request fWR890039, PID @015-071-10 Dear Mr. Corwin: Your request for waivers of the required 100 foot separation of a septic system to a private well have been approved. The approved separation distances are: Lot 7's well to Lot 7's septic - 82 feet; Lot 7's well to Lot 8's septic - 79 feet; Lot 7's septic to Lot 4's well - 88 feet; Lot 7's septic to Lot 6's well - 88 feet. This waiver approval applies to the existing septic system to existing well separation only. Any future upgrade to either will require all separation distances be met or another approval from this department. Sincerely, Dan e oth - Civil Engineer On-site Services DJR/ljw MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION JUL 311989 0 Corwin & associates,inc. RECEIVED Consulting Engineers 1000 E. Dimond Blvd.. Suite 205 • Anchorage, Alaska 99515. (907) 522-1311 July 28, 1989 Mr. Dan Roth Municipality of Anchorage Department of Health & Human Services 825 L. Street, Fifth Floor Anchorage, Alaska 99501 SUBJECT: REQUEST FOR WAIVER OF WELL TO SEPTIC AND FIELD ON SEVERAL LOTS IN RAMPART SUBDIVISION Dear Dan: We have been retained by the owners of Lot 7, Block 1, Rampart Subdivision to resolve the issue of separation distance deficiencies between wells and septic systems in the neighborhood as they affect their lot. This is a combined waiver request, but it is our understanding that there is only one fee required. We have enclosed a sketch of the area to assist in the understanding of conditions affecting the subject property. This should also provide a benefit to you in your overall review of the situation. In short we are requesting a waiver of separation distance from the well on Lot 7 to the septic tank on Lot 7 from 100 ft. to 82 ft.. We are also requesting a waiver from the well on Lot 7 to the septic tank on Lot 8 from 100ft. to 79 ft. Next, we are requesting a waiver of the separation distance from the sewer system on Lot 7 from 100 ft. to 88 ft. from the well on Lot 4 and to 88 ft. from the well on Lot 6. If the requested waivers are granted, it will assist four lots in becoming in compliance with the Municipal ordinance. The basis for our waiver request is summarized below. We monitored the static water levels in six wells as follows: Lot 3 - 35 ft. Lot 4 - 29 ft. Lot 5 - 27 ft. Lot 6 - 35 ft. Lot 7 - 34 ft. Lot 8 - 33 ft. 7%31% i oS a/.300 .S9e-&d Mr. Dan Roth July 28, 1989 Page Two We further did a well yield test on Lot 7 and found the water level in the well stabilized at 45 ft. Though no well log exists for the well on Lot 7, the well on Lot 3 is 55 ft. deep, the well on Lot 4 is 60 ft., the well on Lot 5 is 73 ft. deep, the well on Lot 6 is 90 ft. deep, and the well on Lot 8 is 50 ft. deep. Our measurements show that the well on Lot 7 is approximately 80 ft. deep. All of the wells and lots were developed in the 1972 and 1973 timeframe and were approved installations by the Municipality inspections. Other previous waivers include one on Lot 6 which allowed the well on Lot 6 to be 78 ft. from the septic tank on Lot 6 and 88 ft. to the septic tank on Lot 7 (See HAA 1985 on Lot 6). The drainage from Lots 6, 7 and 8 is toward the street or from the well to the septic tank/sewer system area and not visa versa. This means that the contaminated water would have to travel uphill to get to the wells on these three lots. The drainage from the area of the septic tank/sewer system area on Lot 7 toward the well across the street on Lot 4 is such that it would move west on the street prior to reaching the well. We believe this drastically reduces chances for the sewer systems to contaminate any of the wells. The drainage from all septic systems cannot flow to the wells. The systems installed on these lots have satisfactorily performed four several years and the soil layers of the area consist of good quality sands, gravels and silty sands. We see no • reason why the sewage would not be fully treated within 20 ft. of the surface and definitely prior to reaching the static level of the wells. We are enclosing soils tests in the area to show the types of soils encountered. No well logs seem to exist for any of the wells. We are recommend that the requested waivers be granted and that the long standing situation of separation distances be resolved. We are also enclosing letters of non -objection from adjacent lot owners, Should you have any questions, please let us know. Vtruly 72 I & A ! "�v , INC. nice . Corwin, P.E. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION I ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 2644720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NA,MEI 1 t/t� `U ; �� • f 3" a -1 1� n A3 PHONE 3y ��]LL'l� PNEW Pi: UPGRADE MAILING ADDRESS -'S r—A B o BY—G T ter LEGAL DESCRIPTION 12 LOCATION -�vi /TS / IF/,or— NO. OF BEDROOMS UY DISTANCE TO: Well Absorption area Dwelling PERMIT NO. _ i ZZ W e. Manufacturer Material No, of compartments w Liq, capacity in gallons IF HOMEMADE: Inside length Width Liquid depth -410ZDISTANCE TO: Well Dwelling PERMIT NO. _ FQ- Manufacturer Material Liquid capacity in gallons D W = DISTANCE TO: Well/, Foundation Nearest lot line PERMIT NO. W!2 Z f. Z No. of lines Len t"e�hime g '�`-�c+ Total len9rh limos CC Trench d N inches Distance betw�'� i s N ' F- d Top of tile to finish grade Material beneath tile -1 t7` Inches Total effective absorption area W f7 Length Width Depth PERMIT NO.• W L Type of crib Crib diameter Crib depth Total effective absorption area W DISTANCE TO: Well Building foundation Nearest lot line J J Class Depth Driller Distance to lot line PERMIT NO. DISTANCE TO: Building foundation Sewer line Septic tank Absorption steals) OTHER a PIPE MATERIALS V to SOIL TEST RATING INSTALLER REMARKS l a6 M :1 APPROVED DATE LEGAL A 111 2d iouta tnev.irrtsl 1 4 r� t I : 1.5 Man 11-1q-79 I APPLICA�i WILLIAM A STEPHENSON ISSUED B' _ _ _ _ -- _-------DATE__l_f _lcS��� V ,_l 1 '`� — t•y i_� t•a I �� I F• A l_ I T •,' r� F= F� f•.t r_ H C+ F' F=t �3 E DEPARTMENT OF 825 'L' HEALTH STREET, AND ENVIRONMENTAL ANCHORAGE, PRiTEC:TION AK. 99501 C�UL�t 264-4720 CAVO --="r TE �E!•1Ef= F~�F r1 I T PERMIT NO. ( 790650 ) APPLICANT WILLIAM A STEPHENSON SPA BOX 01-G EAST 99TH AVE =44-7001 LOCATION 5676 EAST 59TH LEGAL LOT 7 RAMPART SUB LOT SIZE 16200 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = xL,/ SOIL RATING <50 FT/ER)= 150 THE REQUIRED SIZE OF THE SOIL ABSSORPTION ',Cyj IS: / �� C•EF'TH= 1C_� LEf-�GTH= =SK GFA•:" EL E>EmF"1l Vl== t_• THE LENGTH DIMENSION IS THE LENGTH CIN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION CIN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL F'IF'E AND THE BOTTOM OF THE EXCAVATION CIN FEET). f<'ECPl_l I F�'Et6 :EE:EF}T I C TAt'-dtF '= I .=E= L►-i�=y� �E;ALL_�JC tS PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION IN'SP'ECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. --- TWi1 c_ ^ ? I VJ:H;F„E=I:--T I IDf-.1_• AF'E F=.EC—DU I F?EU• --- BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS• DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 15O TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F Er'fy I T E::F I F='E'= C•ECEf1E3EF= a:1.- 1_=+ :E+ I CERTIFY THAT 1: I AM FAMILIAR, WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN > BEDROOMS. APPLICA�i WILLIAM A STEPHENSON ISSUED B' _ _ _ _ -- _-------DATE__l_f _lcS��� V ,_l GK"TER ANCHORAGE AREA Br" HUGH 011Department of Environmental Quality 3500 Tudor Road Anchorage, Alaska 99507 �� INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAMEts���i1KI//P F F­+NF2 Q�ceeh MAILING �ADDRESS AQX '3 'r?rell- PHONE .Z'7'7'359G- LOCATION 11&V22n.0 19ah f! I9�Sf lPLEGAL DESCRIPTION 10_0�.2nn.T rL SEPTIC TANK: DISTANCE NUMBER OF FROM WELLMANUFACTURER ,C�h¢eh MATERIALyq*Qy- COMPARTMENTS INSIDE LENGTH -� INSIDE WIDTH LIQUID DEPTH � I IQUID CAPACITY -! z2 GALLONS. SEEPAGE PIT: NUMBER OF PITS DIAMETER __OR WIDTH2Y_, LENGTH,—?4'-77 DEPTH Id , LINING MATERIAL 14DJUILA5 CRIB SIZE: DIAMETEeLr— DEPTHG � DISTANCE FROM: WELL 97 TOTAL EFECTIVE BUILDING FOUNDATION , NEAREST LOT LINE_,. ABSORPTION AREA (WALL AREA) !D C7& SQ. FT. ADDITIONAL ABSORPTION WELL: TYPE 6466 '4JL0-1' CONSTRUCTION " �6 >-fLGGGi�nH DEPTH DISTANCE FROM: BUILDING NEAREST NEAREST i SEPTIC SEEPAGE FOUNDATION 3`� LOT LINESEWER LINE, TANK 6 SYSTEM 177 . CESSPOOL Va"!'.E.YAX . OTHER SOURCES /Unr/ eb,rOn APPROVED DISAPPROVED REMARKS DISTANCES: INSTALLED BY: Mah'g Lire PIPE MATERIAL: " inAl beela LOT SLOPE: REMARKS: �PMd Y QRrvel.., Form PW -026 DIAGRAM OF SYSTEM IG.A.A.B. GREAIER ANCHORAGE AREA BOR..,UGH 2216 DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. 3500 TUDOR ROAD POUCH 6.650 ANCHORAGE, ALASKA 99502 TELEPHONE 279.6666 SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT NAME OF APPLICANT(��M��q�"•S�lR .y�. MAILING ADDRESS nX H'y� .T '>V!N PHONE r3��i!• INSTALLATION LOCATION - 17PAl�T fox? -y- � J. LEGAL DESCRIPTION INSTALLATION OF: SEPTIC TANKL/ SEEPAG/E`PIT L-� DRAIN FIELD OTHER TYPE AND SIZE OF FACILITY TO BE SERVED -14 , `/jt-ml//j Fn lin l- %oa �yJ ! FINANCED THROUGH TO BE INSTALLED BY /AR X EY• - SOIL TEST RESULTS P. -No Ive- NOTE, THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED - - / 9172 - FINAL 7Z FINAL INSPECTION, 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE,� TYPE S��L�C/R L.CA'fAf SEEPAGE AREA S12E TYPE MINIMUM DISTANCES. REQUIREMENTS FOUNDATION TO SEPTIC TANK `5 FOUNDATION TO SEEPAGE PIT 26 DRAIN FIELD , SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK SEEPAGE PIT !� DRAIN FIELD LL_ TO NEAREST LOT LINE. WELL TO SEPTIC TANK `� O SEEPAGE PIT /CQ DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIIC JANK - �n I SEEPAGE PIT O ) DRAIN FIELDO/ �C' �] SEPTIC TANK. .°1,S SEEPAGE PIT DRAIN FIELD �. TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION S FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. HEA TH AUTHORITY OR LICENSED DESIGNER DIAGRAM OF SYSTEM 1 CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 26.66 AND THAT THE ABOVE DESCRIBED SYSTEM IS INACCORDANCE WITH SAID CODE. DATE / ISmo. APPLICANT'S SIGNATURE T. H.-1 10-30-72 ORGANIC SILT 22 oN W/SOME GRAVEL o� 1 SAND MEDIUM TO COARSE GRAIN, Loose to Med. Dense ucr.S lLNn �{.f �lCJ Z No Woter Table Il0 3 2.0! 12.0' William Creech Property Engineering a Geological Consultants LOG OF TEST BORING ANCNOKAO[ IAeeeANKe ALASKA .IYNfAY Anchorage Alaska DATE 10-30-72 ISCALE I" a 2' OWN BY G.A.W. ICHKO BY W.E.D. PROD. No. 26540-4 DWG NO. A -OI Municipality of Anchorage Development Services Department === Building Safety Division On-Sfte Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 t Anchorage. AK 99519-6650 j www.muni.org/onsfte (.�e (907) 343-7904 1�VVV` CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: RAMPART SUBDIVISION #1; LOT 7, Parcel ID: - D i / _/0 A. WELL DATA Well type PRNATE If A, B, or C provide PWSID# N/A Well Log (Y/N) NO Date completed 1972 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES Total depth 45+ ft. Cased to 40+ ft. Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 5/10/2006 Static water level ft. 38 ft. Well production N g.p.m. 4.2 g•p•m• WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate 391 mgJL. Other bacteria _colonies/100 ml. � Arsenic:-pr,1_ug./L. Date of sample: 5/10/2006 Collected by: GEG, Ltd. B. SEPTIC/HOLDING TANK DATA Tank Type/Material STEEL Date Installed 11/6/1972 Tank size 1250 gat. Number of Compartments 1 Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping 5/10/2006 Pumper MCDONALDS PUMPING C. ABSORPTION FIELD DATA F -BELOW EXISTING GRAD 11/20/1979 � Date installed 11/6/1e72 Soil rating (g.p.d./ft'or /bdrtn 150 _ System type TRENCH/CRIB Length 26/26 ft, Width 3/24 ft. Gravel below pipe 6/6 ft. 312 Total depth 014.08 12 ft. Eff. absorption area 606 ft' Monitoring tube YES Depression over field NO Date of adequacy test •'5/10/2006 esults (Pass/Fail) PASS For 4 bsd0rooms 46/ Fluid depth in absorption field before test 31 In. Water added 600 gal. New depth 35 In. 46/ Elapsed Time: 109 min. Final fluid depth31 in. Absorption rate >= 600+ g.p,d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date - **TESTED TRENCH. D. LIFT STATION Date installed "Pump on" level at _in. E. SEPARATION DISTANCES Size in gallons High water alarm level at Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot *82'+ On adjacent lots '79' Absorption field on lot *82'+ On adjacent lots '79' Public sewer main N/A Public sewer manholeldeanout N/A Sewer /septic service line 25'+ Holding tank N/A Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Building foundation 5'+ Property line "0' Absorption field 100'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots '88' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line "0' Building foundation 100+ Water main N/A Water service line 10'+ Surface water 1009+ Driveway, parking/vehicle storage 10'+ Curtain drain 50'+ Wells on adjacent lots '88' F. COMMENTS IS IN RIGHT—OF—WAY. SEE G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections andPIP,a'' 1 ! a vo review of Municipal records that the above systems are In "' ""• •' 0 conformance with MOA COSA guidelines in effect on this date. DO .J A. Ca ss.. Engineer's Printed Name JEFFREY A. GARNESS Q e E— : p Dateo 4ro/eas{oto o N;D�OOO�oo COSA Fee $ q 3D' W Date of Payment 6/1 F4 Receipt Number 2-3 1 (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number Municipality of Anchorage Development Services Department Buildhi; Safcly Dividor. On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.d.anchorage.ak.us 343-7904 .us n (907)343-7904 4111W CERTIFICATE OF HEALTH AUTHORITY PPROVAL FORA SINGLE FAMILY DWELLING Parcell.D. 015-071-10 HAA#�JUQ(n� 11. .,GENERAL INFORMATION ._ Expiration Date: - 9— 0 -9 Complete legal description RAMPART SUBDIVISION #1; LOT 7 Location (site address or directions) 5676 E. 99TH + ANCHORAGE, AK Current Property owner(s)JAMES-CARPENTER Day phone 346-2328' Mailing address 5.676 E. 99TH 0 ANCHORAGE. AK Lending agency Day phone Mailing address Real Estate Agent - F.S.B.O. Day phone Mailing address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 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 Health Authority =- Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered In the State of Alaska. Certificates of Health Authority Approval are required for the transfer -. of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or =: water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers - - work. — Ncte: Alaska Nlater and Wastewater Ccnsuttan!s, ,'.•tc. shall bo p;:.d s at, cr prior to closing for the engineering services provided. 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 ou!lined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and typo 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-sito 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 ALASKA WATER & WASTEWATER CONSULTANTS,. INC. phone 337-6179: Address 6901 DEBARR ROAD, SUITE 28 • ANCHORAGE, AK 99504 ; Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date 6• 3 r Engineer's Comments: In conducting this evaluation, AKWWC, inc. attempled to provide a thorough, d�o�44 conscientious an ng analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the lost, and separation A\ .•' distances measured to readily identifiable features. The operational life of all wells ander; septic systems depend on the local soils condition, groundwater levels that may �....:. .. ... ...... .. fluctuate during the year, and the water usage of the family being served by the system. Those conditions are outside the control of the eva!uatorof Nm system. Satisfactory test ...... . results do not guarantee future performance of the system, nor do they guarantee that Q r A. ness: 7n there are no hidden defects or encroachments. AKv/WC, Inc. can therefore not provide Q4 –79 `gip any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC crl,10A DSD. The content of this report is for ��4e Pr ' essie�o�� the sole benefit of the owner listed above. Any reliance upon or use of this report by any �4040ood other person or party Is not authorized, nor will it confer any legal fight whatsoever. 5. DSD SIGNATURE Approved for bedrooms. _. Disapproved. Conditional approval for bedrooms, with the fllowing stipulations: �j : ON-SITE WASTEWATER : Z_ Attachments: %��j�•, ���` ~ HAA Checklist Manitenance AgreementsJIJ/„i 11 t,” Septic System Advisory Supplemental Engineer's Reort Well Flow Advisory Other By; ���% �(�, /—rrG't Original Certificate Date: i (Re,. 1291) Municipality of Anchorage Development Services Department Building Safety Division On -Site Water b Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519 650 www.cl.anc orage.ak.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: RAMPART S/D A1: LOT 7 Parcel ID: 015-071-10 A. VVELL DATA Weil type PRIVATE If A, B, or C provide PWSIDa N/A Date completed UNKNOWN Sanitary seal (YM) YES Total depth 43+ R. Cased to 40+ ft. FROM WELL LOG Date of test Static water level R. Well production g.p.m. WATER SAMPLE RESULTS: Col form 0 colonies/100 mt. Nitrate 3.47 mg./L. Well Log (YM) NO Wires properly protected (YM) YES Casing height (above ground) 12+ in. AT INSPECTION 1/28/2003 38 ft. 4.5+ g.p,m. Other bacteria 0 colonies/100 ml. Arsenic: N/A mgA. Date of sample. 1/23/2003 Collected by: AKWWC. INC. B. SEPTIC/HOLDING TANK DATA Tank Type/Material STEEL Date installed 11/6/1972 Tank size 1250 gal. Number of Compartments 1 Foundation cleanout (Y/N) NS Depression over tank (YM) NO Cleanouts (Y/N) YES High water alarm (Y/N) N/A j, Date of pumping 1/28/2003 Pumper CHUGACH PUMPING hC. ABSORPTION FIELD DATA 11-201979/ j Date installed 11—e-1972 Soil rating (g.p.dAio bdr ) 150 System type DEEP TRENCH/CRIB Length 26/26 ft. Width 3/24 R. Gravel below pipe 8/6 ft. 312 Total depth -112e 10 ft. Eft. absorption area606 R' Monitoring tube YES Depression over field NO — �Il Date of adequacy test 1/28/2003 Results (Pasa/Fail) PASS For 4 bedrooms Fluid depth in absorption field before testN0 In. Water added 760 gal. New depth 48 in. 11 Elapsed Time: 198 min. Final fluid depth 41 in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YM & type) NONE KNOWN If yes, give date *TESTED TRENCH ONLY **NOT FIELD MEASURED D. LIFT STATION Date installed "Pump on' level at _in. E. SEPARATION DISTANCES Size in gallons High water alarm level at in. Cycles tested Meets alarm 8 circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic lankAlft station on lot 082'+ Absorption Held on lot e82'+ Public sewer main N/A Sewer /septic service line 25'+ On adjacent lots 079' On adjacent lots '79' Public sewer manhole/cleanout N/A Holding tank N/A SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Building foundation 5'+ Property line ee0' Absorption Held 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots $88' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line ee0' Building foundation t0'+ Water main N/A Water service line 10'+ Surface water t00'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 088' F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and * : ! ' X* review of Municipal records that fire above systems are in conformance wfth MOA HAA guidelines in effect on this date. .. .. ................. J ese Engineers Printed Name JEFFREY A GARNESS CE 95 Date H a .. .......... •�c. HAA Fees 37,6." Date of Payment a I 11410-3 Receipt Number 03 (Rev. 12101) Waiver Fee $ _ I JCJ o0 Date of Payment Receipt Number n�iliiOg W")Ct7/q Municipality of Anchorage Development Services Department • +� Building Safety Division On-Sitc Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 Waiver Review Worksheet WR#: WR030014 PID#: 015-071-10 HAM HA030083 Permit#: Date Received: 2114103 Legal Description: Rampart #1 Lot 7 Engineer. Jeffrey A. Garness. PE Alaska Water & Wastewater Consultants, Inc. Applicant: James Carpenter Waiver Requested: 0 feet from drainfield to lot line Criteria: Geology Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: ..........................................................................a...@ Waiver is Granted: L/ Waiver is not Granted. List Conditions or Reasons for above: Date: 2 — D 3 By: ............... .................... ..................... ......................� Rec#:13 408 Amount: $150.00 Dale Paid: 2114103 Sent By: Alaska Water and Wastewater Con; 907 338 3248; Feb -19-03 3:12PM; Page 111 ALASKA. WATER & WASTEWATER - -------'--'-- CONSULTANTS. INC. February 3, 2003 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water & Wastewater Program S t, t'T' P.O. Box 196650 No WT` Anchorage, Alaska 99519- 50 / P Ref: Waiver Request r Rampart Subdivision #1; lot 7 The existin edroom house is served by a private and septic system. The existing drainlield s encroaching the right of way road eascm nt. We request you grant a 0 foot separation distance waiver from the existing draintel o the north lot line on the referenced property. See the attached right of way encroachment permit. If you have any gpastions, please contact us at 337-6179. Thank you for your assistance. P4, M.S. 6901 Debarr Road, Suite 2B • Anchorage, AK 99504 Ph: (907) 337-6179 • Fax: (907) 338-3246 0 Website: akwwc.com r SENT BY:STEWART TITLE OF AK _: 2- 6-07 3:15PM i • E. 99 AVk %V S 37 a 0#0100. SJ • ExAsrlevo :STRUCTUQE TIT.E/ADHIN- 9073434786:# 1/ 1', I.., vv of La-.Av nu.uiu r.ut - d �ae eS,41 77 Av.w nr 89.5i 'w © D . D ' 6 moo � 00%4,21,. VP ft 4xljMUM smumyn;ffm FUMPYb M/Mn Mr0VmilwofOKOWOnOaArN owpr*p. reNp pgNdll�ONPMn1ACONr•d O r jw�p� ram NO•Yrfr •Mbwaa�ar�epar�nsornonaq.aarr►�awnr.Mnwro o.caIWtpMree am •^ Mian wW.�+r •rrao a. «r men at fin. a. t, w • . yr . xt mer M IN•ad aM• anio/ooMreYa,NY�i•+pbolA•,M•IMe Mtiq . • a aww MaOMracaA riyipayy 1•tian. M i owe T-SW79-100 "'noa�r�c" L. ov sr�r� u L. (-A MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRON161ENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date 8� 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address 74 tions ��� • ' w ,G - � (b) Applicant Name d T �eeSCC Telephone: Home34G_f 763 Business Applicant Address �� L! "' �yE It (c) Applicant is (check one): Lending Institution ❑ ; Owner/b WderX ; Buyer ❑ ;Other ❑ (explain); - (d) Lending Institution Address C24 (e) Address Telephone — Real Estate Company and Agent A/8 NG (f) Mail the HAA to the following address: 2. TYPE OF RESIDENCE Single -Family Multi -Family ❑ Other Number of Bedrooms 3. WATER SUPPLY ��� Individual Well y0 Community ❑ Public ❑ Note: It community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL • Onsite X Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 Of 2 72-025111.941 n 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATIOlp r I 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 shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address Date _ 6. DHEP Approved Approved Telephone S6 s1O� Engineer's Seal Zg -'. 45'�> Terms of Conditional Approval— r� ,� olo�P CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an Independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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. Page 2 of 2 72025 (1 b84) MUN!CIPALITY OF ANCHORAGE r� ' DEPT. OF HEALTH 8 MUNICIPALITY OF ANCHORAGE (MOA) EN'✓IRONMENTAL PROTECTION HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 RECEIVED Legal Description: i?an, Pail- '01 A. WELL DATA Well Classification -TNblV10V"_ If A, B. C, D.F-C. Approved (Y/N) Well Log Pre ''tt ((Y//•N)) .'.' N a Completed ` AI A21aW AI Yield Total Depth � Cased o UAK116 W)lJ Depth of Grouting rNO UJ ill Static Water Level _-__L/A/l�ZVOWAI Pump Set At (.[A, -A -AIV WN Casing Height Above Ground �Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N) A Separation Distances from Well: q ✓ ' , T To Septic/Holding Tank on Lot L ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot /OG ; On Adjoining Lots /Gb To Nearest Public Sewer Line Z✓©/W4 To Nearest PubTic Sewer Cleanout/Manhole %✓6Ni� To Nearest Sewer Service Line on Lot Water Sample Collected by r5aw/ ; Date Water Sample Test Results B. SEPTIC/HOLDING TANK DATA Date Installed 1�%Z- Size S� No. ofvCorm�partments �{A�i(/VGl✓fJ Standpipes (Y/N) YLS Air -tight Caps (Y/N) 7 G� Foundation Cleanout (Y/N) Depression over Tank (Y/N) dn6o Date Last Pumped Z 7125 Pumping/Maintenance Contract on File (Y/N) for Holding Tank High -Water Alarm (Y/N) J, a Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: ` To Water -Supply Well S6QG To Building Foundation �8 To Property Line To Disposal Field To Water Main/Service Line Q X1}/1✓ To Stream, Pond, Lake, or Major Drainage 1' ,. "<e Page 1 of 2 72-026(11,84) �.- ..... .. �� _ . 1 l C. ABSORPTION FIELD DATA /'r 0 Ck�rd) CA /A Soils Rating in Absorption–Syt-r�at�a ,,� Type of System Design Date Installed 1 T_ yl'C�t✓Sq _4Q it"Length of Field Q Width of Field Depth of Field 161 G Gravel Bed Thickness %% 4 Square Feet of Absorption Area wocu M Standpipes Present(Y/N) Depression over Field (Y/N) AID of Last Adequacy Tes(�tw/% g� Results of Last Adequacy Test �C t�t7e t pE' ci rse Separation Distance from Absorption Field: To Water -Supply Well SOC To Property Line 1 / To Building Foundation --rty To Existing or Abandoned System on / Lot ^�_QN� ; On Adjoining Lots -6 Q/�- To Water Main/Service Line —A" To Cutbank (if present) /" 4DNZ To Stream/Pond/Lake/or Major Drainage CourseAl�H.X To Driveway, Parking Area, or Vehicle Storage Area _ /01, Comments D. LIFT STATION Date Installed &OVAE Dimensions Size in Gallons "Pump On" Level at — High Water Alarm Level at Tested for Electrical Codes (Y/N) _ Comments Manhole/Access(Y/N) "Pump Off” Level at •• Check Permitted Bedroom Rating Against HAA Request •• Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Date Company MOA No. Receipt No. ?�yci'Jcil7 �� OF p \ • Date of Payment"Z–$5 P(�„••••,••, p� i . Amount: $ �5 A'*y: 49TH Page 2 of 20 CE -4488 J 4 n-026nt.ea� . AnR...r,.r Engineer's Seal r 6. LEGA DESCRIPTION ... DATE RECEIVED INSPECTION APPOINTMENTS Sao 7 r, ' TIME 6. TYPE OF RESIDENCE TIME TIME ❑ One Four ❑ Other SINGLE FAMILY ❑ Two ❑ Five ❑ MULTIPLE FAMILY ❑ Three ❑ Six Ci A,• c Pi DATE INDIVIDUAL' DATE DA E since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM 5 - N %-9 \ M INSPECTOR - INSPECTOR INSPECT R GE MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH L ENTAL PH OT=CYTON \ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTWRONM • 1 826 L Street - Anchorage, Alaska 99601 MAY 7 `, 1981 r o7C: I ENVIRONMENTAL SANITATION DIVISION Telephone 2644720 RECEIVED REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten 110) days for processing. 1. PROPERTYOWNER/1 � A I PL ft PHONE Qrl`NQ N MAILING ADDRESS _ PROPERTY RESIDENT (It different from above) PHONE 2. RPHONE '5L6 MAILING ADDRESS 3. LENDING INSTITUTION PHONE MAILING ADDRESS� 4. REALTOR/AGENTPHONE l�0NAJ �% eto�— e -a MAILINGADDRESS O L(/ i rt/ ✓ v a- �J M o niC� w-. cam. p 6. LEGA DESCRIPTION STREET LOCATION Sao 7 r, ' 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS �( ❑ One Four ❑ Other SINGLE FAMILY ❑ Two ❑ Five ❑ MULTIPLE FAMILY ❑ Three ❑ Six 7. WATE SUPPLY INDIVIDUAL' ' ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE" YEAR ONSITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72010 (Rev. 6/79) 72010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLICUTILITY Connection Verified PERMITNUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON-SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATEINSTALLED I _� INSTALLER ❑Septic Tank or ❑Holding Tank Size: , yIf Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 1,-? 7 4. DISTANCES WELL TO: SePtic/Holding Tank Absorption Area Srlivef Line Nearest Lot Line Absorption Area to nearest Lot Line S. COMMENTS APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE BY 72010 (Rev. 6/79) 5. LEGAL DESCRIPTION G.or 7 ///4^�Pt3/1'I DATE RECEIVED NSPECTION APPOINTMENTS k�Z4-C dnlJ_L e TIME TIME TIME DATE DATE DATE INSPE OR INSPECTOR INSPECTOR ❑ Three ❑ Six 7. WATER SUPPLY ANINICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL PROTECTION DEPARTMENT OF HEALTH 8 ENVIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 89801 • NOV 61979 ENVIRONMENTAL SANITATION DIVISION RECEIVED Telephone 264.4720 8. SEWAGE DISPOSAL SYSTEM REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. IMomplate requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OY(NER H YEAR ON-SITE SYSTEM WAS INSTALLED. PHONE MAILING ADDRESS 57/?, -1 /3 OK g/ G- 9 S STS 7 NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATEQ PROPERTY RESIDENT Of different from above) PHONE $676 64S 991-71 2. BUYER PHONE MAILING ADDRESS 3.LENDING ; N '-C, MAILING ADDRESS -70 w 6 77Y Ck l Sz)` / 4. REALTOR/AGENT 46 MAILING ADDRESS SiI/ W Ndv�TilG�ti G/TSS 5. LEGAL DESCRIPTION G.or 7 ///4^�Pt3/1'I S 4/-3 STREET LOCATION 5 67 r:; iST 91777Y 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS ❑ One (K Four ❑ Other f4 SINGLE FAMILY ❑ Two ❑ Five ❑ MULTIPLE FAMILY ❑ Three ❑ Six 7. WATER SUPPLY A INDIVIDUAL' ' ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well Cl PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM / 7'2 1�1 INDIVIDUAL/ON-SITE" YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLICUTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATEQ 72010 (Rev. 6/79) 40 Y/ v, 72010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY I - 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS ❑ SINGLE FAMILY ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ MULTIPLE FAMILY ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY PERMIT NUMBER ❑ INDIVIDUAL DEPTH OF WELL ❑ COMMUNITY DATE DRILLED ❑ PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER ❑INDIVIDUAL/ON -SITE DATE INSTALLED ❑PUBLIC UTILITY Connection Verified INSTALLER ❑Septic Tank or ❑ Holding Tank Size: -AA -5 If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA - MATERIAL r 4. DISTANCES Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line WELLTO: % Absorption Area to nearest Lot Line 5. COMMENTS r APPROVED FOR _— BEDROOMS 21,CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE it — / 72010 (Rev. 6/79) n GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 1. Approval requested by Date Received 5-/7/74 Time of Inspection % O O Date of Inspection ��� la i 1 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER 8 WATER FACILITIES FOR Mailing Address:' Phone: 179->37/ 5. Type of facility to be inspected -31A16,10' FA/i. No. of bedroom?: / 2. Property Owner: Phone: ,$;t1- 97,5�7 Well Data: Mailing Address: 3. Legal Descriptior 4. Location: Al //r✓ F ass' 5. Type of facility to be inspected -31A16,10' FA/i. No. of bedroom?: 6. Well Data: A. Type B. Depth C. Construction D. Bacterial Analysis 7. Sewage Disposal System: A. Installed 2 B. Installer / / KC .. C. Septic Tank: 1. Size /25 21 M ►gufacturer 67r'04' ' D. Seepage Pit: . 1. Absorption Area 2. Mat>•rial �d E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank_, Absorption area —, Sewer Lines Nearest lot line Other contamination B. Foundation to septic tank /' % , Absorption area C. Absorption area to nearest lot line / Z JI EQ -034 (1/74) Page 1 of two pages. / 1/-1� Page 2 of two pages - Re,, -est for Approval of Individual . .ier & Water Facilities Legal Description ->2 JA) e-/ i 5 5.' z ec/ 1-d✓ 4 4 vdy>„ tt'04'5'_ — sapproved Date Approval Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM 0 I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED EQ -034 (1/74) Date ENCROACHMENT PERMIT THIS AGREEMENT, made t:ls _day of ANCHORAGE, Grantor, and •___D_Miel Laplante Grant^c, 19$7,', between WITNESSETH: The Grantor does hereby grant an Encrcachm^nt Permit In the following de:•cribed Public Right-of-'Viy or Easement Area to %'Jit: _ Rampart Subdivision_ U11Lot 7.f, located within the Northeast 114, Section 15, T12N, R3W S.M. Alaska Grid 2437 1 t1t'. CrCrO,^,Ci:rf ent It��rCt)y aUtROrI7.eU IS LD t�1$_S �TIOV:InCJ: That portion of the septics stem within east 99th Ave. as shown on attachment_ "A" _ _ •^ lil !:0t1li'!.prd210n Ci t 715 perlr,. ine (,ranteC a ;tees .oat �e %7,1 InUerl:nt y and hol, (rtrrtic:rs th^ Cr.r.tor at any ,rid til claims v:hieh may arise or be caused tty the Cori-Ltl'4Ct;r,n, alteration or mn;ntenance and existence of the a-,ovc described or for ant, dnrrzgcr; whits -over i'r151n^ out Cf the granting of this permit. (if-.! Grnntor . c: crvc?, the r;ght to revok^ VAs permit upor. twenty (20) days written notice to the Gra.^.te,_,. Tho Grantee, agrees upon sale notice of revecati(in, to Imm_diatNy move salt: ercroaclhm;rt from the easement, street or public right-of-way. Should the Granted recuse or fait to cornply with said written notice, the Grantor, may without further notice to the Grantee, remove or cause to be removed the encroach- ment, and the Granton hereby agrees to reimburse the Grantor for all cost incidental to thz removalth:reof. The Grantee hereby agrees to pay an annual fee of $10.00. IN W1 i NESS %YHcREOF, the parties hereto have hereunto set their hands and st•als the day and year first above written. Grantee: _ J?1.12 � (�tr62: Grantor: ANCIIORAGE 42 ell AAAAA-1. ector,/ u IC arts P . STATE OF ALASKA ) �� THIRD JUDICIAL DISTRICT ) BEFORE ME, the ut:dersigncd, a Notary Public in and fc,• Alaska, duty corn- riie cnc;t a''id ,-�v o/rr -is sucyii, t!IISdev pers/o .o'{.P. :•.n : ;vj V o•:;n {c: M.': fe U,e t:crso:t c�.•.crlC.^C. to itnfl Y.'S^,7 CY:v'CUa'7 tnr a'ro.e irsinl etch zr..J nL` ::I:ro,:;:cl'.;ed to rte t.h.�Z ;)/_ elcned and sealed the s>ame fr,";y zodvo'unt:;' 1?y ic: ta_ t:Sts and purpose: tri in mentioned. this L day of My Commission Expires: -��41q app^gyred WITH -SS my hind and notarial ^;al STATE OF ALASKA ) ) ss: THIRD JUDICIAL DISTRICT ) ti� -M7T2`,ft AMSTA BEFORE 1.1F, the undersigned, a Notary Public In and for Alaska, duly missioned and sworn as such, this day personally appeared LEE 1BQOI,ui,1rN mUNtGpAt_ Er..YGtuED2 F0 R.TNE murJICtPAC.try t7F 14 CegC1E to me renown ana Known to me to ae one person acscnoea in ana woo executca ute above instrument and F1E ac'<nowledged to me that NE signed and sealed the same freely and voluntarl y or the uses and purposes t ercln mentioned. WITNESS my hand and notarial seal this o95lu d::y of Vuaq� 1981. LtyCnmmissioaicxpires: /a1/W83 'i SPECIAL POWER OF ATTO"NEY KNOW ALL MEN BY THESE PRESENT: THAT 1, r _: � 1, /.. '/ i,r !, of .'lnchorn; Ala::I:n have r:,:Jc, eonstitutnd and a,,)poin and be these presents do :Hake, constitute an:d appoint �� • _ ! i;' _ _. OF Anchor -'L Ai::,La, r;y true and lawful attorney, for oe, and in my name, to make, se.-ai and dq-O lvar, to Largoin, Con- tract, agree for, purchase, receive, and trl:e lands, ter;rm" ts, heredita- ments anti accept the seizing and possession of ail lends and deeds and other assurances, in the law therefore, and to lease, le:, demise, bargain,, soli, remise, release, convey, mortgige and hypothecate lands, tone. -lents and here- ditan;ents, upon such terms and conditions, and under such eoveoaras a.^.,j he shall think fit; and also for me in ny name, and .:s my act and dr_cd, to sign., seal, executed, deliver and acknowledge suzh deeds, lease:. ar,d assignment of leases, covenants. indentures, agreements, morg:Ce5, hypothtcat ions, bands, notes, receipts, evidences of debts, releases and satisfaction of murtgaget, judgments, and other debts, and such other instruments in writing of whatever kinds and nature as may be necessary orprcperty in the premises, specifically given for use in connection with the sale of the following property: c w GIViIN' AND G%ANTING unto said attorney full power and authority to tfc, and perform all and every act and thine •rrhatsoaver regaisite and neccs:•ary to be done in and about the premises, as fully and to all intents .:nd purpoeus as I m;ght or could do if personally present, with f:11 p�w:.r of substitu- tion or revoca'ion, herety ratifying confirming all that n.y ',air! att:rrney, -r his sutstitutes, shall lawfully do or e•tu:.e to be dine a/ .,;.-too nr Lf••••: . premise.. WITNcS: goy hand and seal this _-- riay C STATE OF ALA'KA } THIRD JUDICIAL DISTRICT ) THIS 1S TO CERTIFY that on this q2-2 day of/fesA-, 19 S'f , before mc, the undersigned, a Notary PUbiic in and for the State of Alaska, duly Con mis;iancd and sworn as such, personally appearedDr�^1_A. 4AF1(}nr'�', i.nn:an to roc and tomo e known to be the. individual d3scribed in and who executed the fure_joina instrument, and he acknewledPic [o e that _he signed and sealed the same_ freely and voluntarily far the uses and purposes therein mentioned. 11.1 WITNESS WHEREOF, 1 have hereunto sct my hard arid official seal thu day ar,G year first hereinabove written. Notary PuDlie in and for Ala,Kl ---- _ M'/ r-o.^•.i s5;o%r •.t,tni acs: (r�IR �N !/ � �l}�f_ 1! 1 jIi'il'1 i II o'I!1 1 !II11 I .: i or 1 1 j 1 j ER 5 T I i 9x9 rrt L3 5 -- . (.,.t A2 EATI CR i.l •-I .__• _—ter .tea—:__- _ ._. — i 1 .)i A i;�;.i1t II t., i 1 1 .I ..,_: fSCA�.E'i,�.�jc/ _ l i. I 1' 1 i I •' I , j l i-1 1 I ;' , 1 ; i I li _ I. I II I : 1 �.-I I_ 1 III:i 11.I .I.,� I ,I ! 11 ..Illi iL 1 it ! j i 1.: . .i I I I � � I ! .; 1 ..�.. .I-1 I •j.; : : : �! �-: ; i I 1 i 1 I IIi�I;I 11'�!i .i IIII!iI /o'C!T/L °CSMiTj 1'IIi ;1 I .... :_ I'/l/ %�..5.:%SEI .i.�LO.00 , I.l � .1 1 i ,_ �; 1� -►�� Ij I , 1 1 - Ii :1i1I 11 i Illli I I i'i! I � II il'i 1 i ;I ' I I 1'1 IIII I11 , As Suitt Of BREAi!/FC P/PE ONLY I 1 :• ' No Corners Set This Date. Book No. 75B Pave No. //% ! I ! � ..y�viceOpDD • : 1 ' 1 hereby Cert'r ify tht!/atrS.O I have sumayed the following described property, Lot., -Block /?Ar/Anchorage recording Precinct, Alaska, and that 1' �i the improvements situated thereon an within the property lines and do not overlap or • ' t�GA do e• encroach on the property lying adjacent thereto, that • no Improvements on, property I T7 fV� 1e�ll -" lying adjecsnt thereto encroach on the premien in question and that there are no roadways.--- ire asl.•ev„n•..••YnVNNN.w�u• (1 - transmission tins$ or other visible nwmenu on said property except as Indicated hexon. ✓ r ! rl f' �51 �fi•'i-r....1) NNN4„N.,,b•R•!a” .1 i � , 1 ! { t j : I I ' 1 I 1 i � ' '�.i�l'i I i � I �r' . Iwma Hildonen • `al�s��"I III.. or MAY )95r! , ! : ; , i 1 I 0 �q •., s•y rte. , . Anchorage , Alaska 1 I I ( C� �A ,,,•e N•, *�7 a i s .•i , r• rJ. � I- � y^ r / TM • '.•___r-i�."'^r!lwr.'t'M".,� •"Yp=en—.M •/t .-.+a"Y+r^`.'�*!e�' �;r p.