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Home My WebLink AboutBROADWATER HEIGHTS BLK 3 LT 13Brocxdwater Heights Block 3 Lot 13 #050 - 131 - 72 �'`1I�C UHUPAUTY OF ,, H CHO Development Services Department On -Site Water & Wastewater Section-� Parcel I.D. 050-131-72 Certificate of On -Site Systems Approval Phone: 907-343-7904 Fax: 907-343-7997 Expiration Date: CCA 1 � i � noo 1. GENERAL INFORMATION Complete legal description Broadwater Heights, Block 3, Lot 13 Location (site address) 11745 Broadwater Drive Eagle River, AK Current property owner(s) Debra DarboUs Day phone (907) 538-1053 Mailing address Real estate agent 11745 Broadwater Drive Eagle River, AK 99577 Chris Swires 2. TYPE OF DWELLING: ❑® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: Prion+o Wall Water Storage Community Well Public Water System Day phone (907) 830-0073 TYPE OF WASTEWATER DISPOSAL: ❑C Private Septic 1K ❑ Holding Tank ❑ ❑ Community ❑ ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 660 CDyio - Waiver Fee $ Date of Paymdnt z�;� a Date of Payment Receipt Number Receipt -Number-----------, - COSA # 0SG20132..5 Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm Forge Engineering Phone (907) 522-7773 Address 1399 W 34th Ave Suite 101, Anchorage, AK 99503 Engineer's Printed Name Michael E. Anderson, P.E. Date 7/8/2020 qt `• 49th .'0�� 6. DSD SIGNATURE`' System #1 Approved for 3 bedrooms '`MIC.................................. S System #2 Approved for bedrooms��-..,.��8�20 7/8/20 Disapproved Disapproved � °�� R Fr1SS Conditional approval for bedrooms, with the following stipulations: ,icutt (W11,. ' By:P�Ij" 0_aMX Original Certificate Date: ! 1�A10 0 The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist Septic System Advisory Well Flow Advisory COSA Checklist blue sheet X Nitrate Advisory Arsenic Advisory Other COSA Checklist Legal Description: Broadwater Heights, Block 3, Lot 13 If more than 7 septic system on lot: COSA Checklist # of A. WELL DATA OR Well log is filed with Onsite (or attached) Date drilled 6/29/98 Total depth 260 ft Cased to 25 ft OR Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 33 in. Date of flow test for COSA 7/7/20 Static water level at beginning of test 17.9 ft. Comments B. TANK DATA Age of tank(s) 14 years Tank type/material SEPTIC/STEEL Measured operating fluid level in septic tank 50 Parcel ID: 050-131-72 Structure served by this system Well production at time of test 7.7 gpm Water storage tank volume None gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate 4.41 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by FORGE ENGINEERING Date of Sample 7/2/20 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material ❑ Standpipes/foundation cleanout per record drawing Comments: NA Date -of pumping-101l_5L.197.9_ne_-Stop Pumping__..______.___ _ ___._ _,___, _ --------- 11----�---..--,-,..-11-1-..----_--�1----'---_-..--�-,--r-I.- D. ABSORPTION FIELD DATA 5' Wide Shallow Trench ._ Which- system tested (d 7/3106 ate installed) Adequacy test -date _ 7/6/20 ❑ ALL standpipes present per record drawing Results E✓ Pass For 3 bedrooms Total measured depth from grade 7.9 ft (max) Fluid depth prior to test 4 in Measured depth to pipe invert from grade 3.9 ft (min) Water added 517 gal ❑ N/A — pressurized field New depth 16 in ❑ Monitor tubes go to bottom of effective. If not, state 1440 depth into effective Elapsed time min ❑ Code -required soil cover over field Final fluid depth 4 in ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet Absorption rate '450 gpd Any rejuvenation treatment (past 12 months) If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' 0 Yes Community Sewer Manhole/Cleanout > 100' Q Yes if No ft M Yes if No ft Neighboring Tank > 100' 0✓ Yes if No ft Private Sewer/Septic Line > 25' F✓ Yes if No ft Absorption Field on Lot > 100' Yes if No ft Holding Tank > 100' Fv Yes if No ft Neighboring Absorption Fields > 100' ft Water Main > 10' Animal Containment > 50' 21 Yes if No ft F/ Yes if No ft ft Water Service Line > 10' F71 Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway comment below Community Sewer Main > 75' 0✓ Yes if No ft FZ] Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No ft Surface Water > 100' ® Yes if No 94 ft Property Line > 5' ❑✓ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' 7 Yes if No ft Private Wells > 100' F71 Yes if No ft Water Main > 10' ✓Q Yes if No ft Community Wells > 200' F✓ Yes if No ft Water Service Line > 10' F71 Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' El Yes if No ft If absorption field is under driveway comment below Property Line > 10' 0 Yes if No ft Wells on Adjacent Lots: __.._Water_.Main_? _.__._Pr_ivate.Wells.> 1.00 _- Water Service Line > 10' Q Yes if No ft Community Wells > 200' EJ Yes if No ft Surface Water > 100' ✓� Yes if No ft F. ENGINEER'S COMMENTS See Waiver No. WR080012. G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. W&1111%14 OF 44 ,.' 49th ...... mno........$........ an.... u...U.. ®�t MICHAEL E. ANDERSON No. CE -4381 ' F 7/8/206 Fes' COSA Checklist yellow sheet�� p�0� .'SC l , \, o � _o 49 TH 0 0�oi°NSHANE A. HOLT el 000 Q� LS -6914 Q�� A .la o �ofessiona\ �'od ��DOOoo�� SURVEY ORDERED BY: CHRIS SWIRES C9) REMAX THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES. EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT , ARE NOT SHOWN HEREON ( UNLESS INDICATED) NOTE: FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. THE SURVEY DATA AND MEASUREMENTS HEREON ARE PREPARED FOR THE OWNER OF RECORD AS OF THE DATE OF THIS SURVEY. ANY USE OF THIS DRAWING BY THIRD PARTIES IS PROHIBITED UNLESS WRITTEN PERMISSION IS PROVIDED. AS-BU/L T SURVEY 1" =20' NO CORNERS SET THIS DATE I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY LOT 13, BLOCK3, BROA D WA TER HEIGH TS ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED- DATED AT ANCHORAGE,ALASKA THIS 3RD DAY OF JULy , 2020 74697, FB 725--3 S HOLT LAND SURVEYING 9309 GROVER DRIVE ANCHORAGE,AK 99507 345-5513