Loading...
HomeMy WebLinkAboutKNIK VIEW ESTATES BLK 3 LT 2 & 3Knik View states lock Lot 2 & 051-043 -58 Municipality of Anchorage Page DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewaler Disposal System and/or Well Inspection Report Permit Number: ...~J~O~O.~/-J- PIDNumber: ~ I--~q ~ 0'~ Name: ~d ~~1 45' Waslewater System: ~New U Upgrade Address: _5 i O j H~~,'r~ E .4~,m~e./K'¢~5~ ABSORPTION FIELD Phone: "~ '" '---~-/~'l~' ~l'°/°f¢~d"°°m~:~ U Deep Trench U Shallow Trench ~Bed UJMound UOther I -- LEGAL DESCRIPTION so,,..,,..: 0. ~GPD/Sq. Ft. fotal Depth from originalgr,de~% WELL: ~ New ~ Upgra~ Gravel width: I~ Ft. Number~of lines: II eistance~betweent lines:Ft. Cla,sification(Private. A.B.¢): ~ Cased,o: Totalabsorpti0parea lSll Pipemateria,: Driller: ~ Date Drilled: Slatic Water Level: Installer: Date irmtafled: ~u ~t. TANK SEPARATION DISTANCES ~Septic ~ Holding ~ S.T.E.P. TO Septic Absorption Lift Holding >~blic/Privale Manufaclurer:~ Capacity in gallons: From Tank Field Station Tank Sewer Lines Surface w,t~ ~'¢ ~ ~ LIFT STATION I . ~ CurtatnDrain ~ '.~0~ 1~ ~{ ~ ~ Electrical Inspection~ performed by: Remarks: BENCH MARK Inspections performed by:~,~!e ~!~-,, A~.~k. 99577 Dates: 1st 2nd ~-JJ-OO Department of HeallAand Human Services approvm 72-013 trey. 9/91) MOA 25 PERMIT NO. SW000054 PAGE 2 OF 5 Munici~o, Lid~x/ ©9 Anchonc~ee DEPARTMENT OF HEALTH AND HUIWAN SERVICES ENVIRONMENTAL SERVICES DIVISION P,F1, ]3ox 196650 eAncho~-~ge, ALaske 99519-6650®Telephone: 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEP1 AND/OR WELL INSPECTION REPORT LEGAL LOT 2,4 BLOCK 5, KNIK VIEW ESTATES' P.I.D, NO, 051--045--05 / / LOT 15 / ,/ ~ / / / / / / / NEW 1250 GALLON SEPTIC TANK / / / / / / 2 U U <~ U / / PSi~MIT NO. SW000054 ?ACE [Vlunici~cki"c¥ o~' Ancho~'cQe DEPARTMENT OF HEALTH AND HUMAN SERVICES ENViRONmENTAL SERVICES DiViSiON P,B, Box 196650 O Anchora9e, ALaska 99519-6650 GTeLephone: 343-4744 ON-S~TE WASTEWATER D~SPOSAL SYSTE~ AND/OR WELL ~NSPECT~ON REPORT ~J LgSAL LOT 2,~ BLOCK 5, KNIK VIEW ESTATES ?.I.D. NO. 051--045-05 FINAL ST ST2 / 9 9.6' ~/.b': I GALLON ~97.3' ISEPTIC TANK CO 1 MT2 FFINAL GRADE C02 / MT1 CO3 94.8,~ x__ , 94.2 94.,5 94.7' A B FCO 3.0' 31.5' ST1 9.0' 29.0' ST2 15.5' 21.0' DBL1 17.0' 20.0' DBL2 18.5' 18.0' C01 18.5' 42.5' C02 82.0' 88.0' COS 82.5' 86.0' MT1 I9.0' `52.0' MT2 81.5' 89.5' A WATER FOUND 83.0' B.O.H. 87.0' L ORIGINAL GRADE N. T. S. EASEMENT AGREEMENT The undersigned, in consideration of mutual agreement ,vet.forth behm,, grant, convey and q[finn the following easement, effective this~__q.~# day of _~n a~_~ __ 2000, and agree the conditions and restrictions as follows: I4.'e, Frederick Dean Rew~olds and ~iudra Dean ReFt,.okts, husband m~d wife, herein after referred to as grantors, owners of the certain real proper(v herein after referred to as "Lot 2; Block 3; K)~ik View Estates Subdivision" grant to Fred Dean Reynolds mTd /tudra Dean Reynolds hereby referred to as the grantees, as owners of certain real property herein after referred to as "Lot 3; Block 3; Knik View Estates Subdivision" according to the official plat thereof, filed in the record o.f ,4NCItORAGE RECORDING DI,¥TRICT, 7hird,htdicial District, ,¥tale o fA laska. An easement for m~ on site wastewater absorption field to be placed on Lot 2; Block 3; K)~ik I.'?ew Estates Subdivision, together with the right to maintain the absorption.field to include reasonable egress and ingress for maintenance of the absorption area. The complete legal; beginning at the northern most proper(v con, er of Lot 2; thence I 6 feet S 41 °33' 22"I.; to the point of beginning thence S 47008' 12"Hz", 69feet thence S 43 ° 20' 30" ~; 43 feet thence N 46 o 51' 38" E, 69 feet thence N42 ° 16' 05" IV, 43 feet to point of beginning located within Lot 2, Block 3, Knik View 1.:~tates &tbdivision. ,qnd with said right to be effective upon the signing of this agreeinenl: It is understood and agreed that wastewater absorption field fi~r Lot 3; Block 3; Knik l.'~ew Estates Subdivision is to be provided by connection beginning on Lot 3; and extending onto Lot 2; Block 3. It is further agreed that th~ cost of maintenance of the sewer lines shall be bon, by the grantees. 7here shall be no charge.fi~r the use of the absorption fieM.fbcilities so brag as this easement is in effect unless a charge is arranged between the parties or their heirs, or assign& or successors in interest by separate written agreement. Grantors make no warran~ as to &e adequaqv of the ab,:orption field and shall nat be liable for any damages caused by the absorption field failing to work adequately. 7he grantors fitrlher covenant and agrees that the grantees shall have full, .free and uninterrupted use of said easement for reasonable domes,.tc use as long as such use does not create at, unreasonable, adverse impact upon the grantor& Failure to make use of the absorption field herein dezired shall not be deemed abanclonment of the said easement. 7he grantees fitrther agree to bear all cost, if m~y, for the operation, maintenance and/or abandonment of the on-site absorption fiekt. Page 2 Easement ARreement , ,.~, 0 q. I0 S & $ ENGINEERING 17034 Eagle River Leep Read N~. 204 Eagle River, Alaska 99577 ?. 7his easement from grantors to grantees shall be binding upon the inure to the benefit of the party hereto, his heirs, legal representative, successors and a&~igns, and shall rttn with the land. //14.AGrantee'' ~ Free'rick D~an Reynolds 'Audra Dean Reynolas/ &r Subscribed and sworn to before me this 53~{5]1x. day of c7~ ¢.4L ~/t~) 2000 for Frederick Dean Reynolds ~v commission expires ~: ......... for A udra Dean Reynolds of Alaska ~ NOTARY PUBLIC ~ ^.~.v commission e~pires .............. Sandra K. Hemphill ~ ~ k~ ~~s[i~n expires Jan. 22, 2003 ~ Notary ~;~)iC -- ROBERT C. COWAN, RE. ROBERT A. SHAFER, RE. Date: CIVIL ENGINEERS {907) 694-2979 FAX (907) 694-1211 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXIENSIONS , SEWER & WAT ER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSAL SYSTEM DESIGN Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 REFERENCE: The septic inspections for the referenced property were performed on ~-~-OO and ~-[/- dO · Prior to submitting the On-site W~isposal System and/gr Well Inspection Report we are waiting for the ~-~0/~5~,v~V to be completed. If we may be of further service please contact us. Sincerely, Robert C. Cowan, P.E. 17034 NORTtt EAGLE RIVER LOOP ' SUITE 204 · EAGLE RIVER, ALASKA 99577 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Date Issued: Apr 11,2000 Expiration Date: Apr 11,2001 Permit Number: SW000054 Legal Description: KNIK VIEW ESTATES BLK 3 LT Design Engineer: 0003 S & S Engineering Owner Name: Fred Reynolds Owner Address: 5101 Hatcher Cir. Anchorage, AK 99508- Parcel ID: 051-043-03 Site Address: Lot Size: 22173 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: ~¢~'_1 Disposal Field I¢~ Septic Tank I--'1 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 DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 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. Permit for 051-043-03 & 051-043-04 (Lot 2 & Lot 3) Received By: Issued By: Date: Date: ROBERT C. COWAN, P.E. CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 HEALTH AUTHORITY APPROVALS SEWER&WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS W~LL INSPECTION & FLOW T EST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSAL SYST EM DESIGN MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 2 & 3, Block 3, Knik View Estates S/D It is requested that you issue a permit to install a septic system to serve the proposed four bedroom dwelling on the referenced properties. A test hole was excavated and a percolation test was performed. The approximate location of the test hole is located on the attached site plan. At the time of excavation 10/6/99 water was found'fah~/after monitoring~the depth to water was at 10 feet. We do not anticipate any adverse effects on neighboring wells, septic systems, reserve areas or drainage patterns by the installation of the proposed septic system. The construction of this system will not prevent any future development on any of the adjacent properties. If you require additional information, please contact us. Sincerely, RCC/jhm Enclosure 17034 NORTH EAGLE RIVER LOOP o SUITE 204 - EAGLE RIVER, ALASKA 99577 SITE PLAN DESIGN kk ---,~ ~ , ...... 1" = 40~ SITE PLAN DETAIL SCALE 0 O© 1" = 100' NEW DESIGN SITE PLAN ~-4~c~ ,~ , ~ o~ . 0 ~ z~m~ ~ k k ~_.: , ,: ,: . l" = 50' SITE PLAN DETAIL /~ ~ Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: ,/~'/'klll[-_ (EN.%~ ~ ~k ROBERT C. coWAN i~ ~ Township, ~an~o, Section: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O SLOPE SITE PLAN '6o < / ~-¢% N / WAS GROUND WATER ~.,.//' ,,~ ENCOUNTERED? S IF YES, AT WHAT i ~ / oL DEPTH? p E Depth to Water After ~,,~ * Monitoring? v~ross-- Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE /~? (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN ~- FT AND ~' FT COMMENTS $ & S ENGINEERING ;': ' ' CERTIFY THCT THI TEST WAS ACCORDANCE WITH ~~&~[UIDELINES IN EFFECT ON THIS DATE. DATE: /~//¢'/, ¢¢ 72-008 (Rev. 4/~) PERFORMED IN EASEMENT AGREEMENT The undersigned, in consideration of mutual agreement set forth below, grant, convey and q[firm the .following easement, effective this ~' r~ day of ~ ~ tz c ~ 2000, and agree to the conditions and restrictions as follows: ~e, Frederick Dean Reynolds and Audra Dean Reynolds, husband and wife, hereto after referred to as grantors, owners of the certain real proper~ herein after referred to as 2; Block 3; Knik View Estates Subdivision" grant to Fred Dean Reynolds and Audra Dean Reynolds hereby referred to as the grantees, as owners of certain real proper(v herein after referred to as %at 3; Block 3; Knik ~ew Estates Subdivision' according to the official plat thereof filed in the record of ANCHO~GE ~CO~ING DI~T~C~ Third,Judicial District, ,Slate qf :i laska. An easentent for an on site wastewater absorption fieM to be placed on LOt 2; Block 3; Knik View Estates &tbdivision., together with the right to maintain the absorption.field to include reasonable egress and ingress for maintenance of the absorption area. The complete legal; beginning at the northern most property corner of Lot 2; thence ]6feet S 4] °33' 22'E, to the point of beginning thence S 47008' 12"I4,", 69feet thence S 43 ° 20' 30' E, 43 .feet thence N 46 ° 51' 38" E, 69 feet thence N42 ° ]6' 05' W, 43 .feet to point of beginning located within Lot 2, Block 3, Knik View Estates Subdivision. ,4nd with said right to be effective upon the signing of this agreement: It is understood and agreed that wastewater absorption.field for Lot 3; Block 3; Knik View Estates ,~ubdivision is to be provided by connection beginning on Lot 3; and extending onto Lot 2; Block 3. It is further agreed that the cost of maintenance of the sewer lines shall be born by the grantees. 7here shall be no charge.for the use of the absorption fieM facilities so hmg as this easement is in effect unless a charge is arranged between the parties or their heirs, or assigns, or successors in interest by separate written agreement. Grantors make no warranty as to the adequacy of the absorption .field and shall not be liable for a~ty damages caused by the absorption field failing to work adequate}v. The grantors further covenant and agrees that the grantees shall have .full, .free and uninterrupted use of said easement for reasonable domestic use as long as such use does not create an unreasonable, adverse itnpact upon the grantors. Failure to make use of the absorption field herein desired shall not be deemed abandonment of the said easement. 7he grantees.fitrther agree ia bear all cost, if any, for the operation, maintenance and/or abandonment of the on-site absorption field. Page 2 Easement Agreement 7. 7his easement from grantors to grantees shall be binding upon the inure to the benefit qf the part),' hereto, his heirs, legal representative, successors and assigns, and shall run with the land. dfl, c,,~2Grantee: ~~~ Frederick l~ean Reynold~ &tbscribed and s~vorn to before me this 5gO']Jv. da), qf ~. ~-~ ')2000 for Frederick Dean Rgynold~ gdy commission expires Notary Public k ~ .for A udra Dean Reynolds I' NOTAR__Y_P_ UBLIC !Myc°''''nissi°n expires A Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 11Certificate of On -Site Systems Approval Parcel I.D. 051-043-58 Expiration Date: 1. GENERAL INFORMATION Complete legal description Knik View Est. Block 3, Lot 2&3 Location (site address) 21818 Rebecca Cir. Current Property owner(s) John & Amy Langley Day phone Mailing address Real Estate Agent PO Box 671909 Chugiak, AK 99567 2. TYPE OF DWELLING: Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual Fx� Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System El Public Sewer ❑ WaiverNariance request Received by: -DSC,/ Date: f COSA to be released to the engineer, unless otherwise requested by the engineer. - COSA Fee $o i 31S �' St II 6o Waiver Fee $ Date of Payment 11 /J//J--/ Date of Payment Receipt Number M�3� �i Receipt Number COSA # 05r,161 � I Waiver # f< 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. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone 6. DSD SIGNATURE 11� System #1 Approved for _q_ bedrooms System #2 Approved for bedrooms Disapproved Date 10/21/2015 Conditional approval for bedrooms, with the following stipulations: Original Certificate Date: 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 X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSAblueshmt r - c If more than l septic system is on the lot: COSAChecklist# i of Structure served by this system Certificate of. -On -Site Systems Approval Checklist tegalDescription: .Knik View Est. Block 3, Lot 2&3 Parcel ID: 051-043-58 A. WELL DATA Well type Public If A, B, or C provide PWSID # AWWU Well Log (Y/N) Date completed Sanitary seal (Y/N) _ Wires properly protected (YIN) Total depth ft. Cased to ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test Static water level Well production g.p.m. 9 - p.m -WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate mg/L Arsenic ug/L Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 0111/2000 Tank size 1;250 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y!N) Y Depression over tank (Y/N) N High water alarm. (YIN) N Date of pumping 3/17/2015 pumper Alaska Sewer & Drain C. ABSORPTION FIELD DATA Date installed 9/11/2000 Soil rating (g.p.d./ft2 or ft2/bdrm) 0.5 GPD/SF System type Bed Length 69 ft. - Width 19 ft. Gravel below pipe 0.5 ft. - Total depth T ft..: Eff. absorption area 1311 ft2 Monitoring tube Y Depression over field N Date of adequacy test ID/21/2015 Results (Pass/Fail) Pass For 4 bedrooms Fluid depth in absorption -field before test 1 in. Water added 628 gal. New deptl 4 in. Elapsed Time: 180 min. Final fluid depth 1 in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) No If yes, give date I D. LIFT STATION Date installed Size in gallons "Pump on" level at in. "Pump off' level at in. Datum Cycles tested E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot — Public sewer main Sewer /septic service line _ Manhole/Access (YIN) _ High water alarm level at Meets alarm & circuit requirements? On adjacent lots On adjacent lots Public sewer manhole/cleanout Hplding tank Animal containment areas Manure/animal excrete storage areas SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 5+ Water main 10+ Water service line 10+ Wells on adjacent lots 200+ ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water Service line 10+ Surface water 100+ Curtain drain 50+ Wells on adjacent lots 200+ F. COMMENTS G. ENGINEER'S CERTIFICA' ON I certify theYM^have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in e#ect on this date. Engineer's Printed Name Steven R. Pannone Date 10/21/2015 COSA canary sheet_2-6-15.doc Absorption Feld 5+ Surface water 100+ Water main 10+ Driveway, parking/vehicle storage 110+ I Parcel I.D. 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 l CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING -' °q'~-°~-%c~ COSA# GENERAL INFORMATION Complete legal description Location (site address) Expiration Date: Knik View Estates, Block R Lot 2 2~818 Rebecca Circle, Chugiak, AK 99567 Current Property owner(s) Mailing address Lending agency Mailing address Fred & Audra Reynolds PO Box 671616, Chugiak, AK 99567 Day phone 8-~o-2q.8q Day phone Real Estate Agent Mailing Address ~, "; .. ~r · , .;Unless othb~kw~s¢, requested, COSA ,~2./NUMBER OF B~DROOMS: 3, ~BE 0FW~TER ,SUPPLY: 'ih'dividU'ai";We]l ' Individual Water Storage Community Class ~ Well Public Water System Raney Hardman/ReMax Eagle River Day phone. 694%200 166oo Centerfield Drive, Eagle River, AK 99577 will be held by DSD for pickup. 4 TYPE OF WASTEWATER DISPOSAL: [] Individual On-site [~ [] Individual Holding Tank [--] [] Community On-site [--] [] Public Sewer [--1 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 On-Site 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 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. Name of Firm Pannone Enqineering Services, LLC Phone 272-82:[8 Address P.O. Box loo2:~7, Anchorage, AK 9c)~;lO Engineer's Printed Name Steven R. Pannone, P.E. Date 6/2/1~. Engineers Comments: In conducting a~ adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DSD Guidelines & Regulations. The reported results describe ~e performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. PES can therefore not provide any warranty for future performance nor give any estimate of how long the system will continue to meet the operational requirements of the MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized nor will it confer any legal right whatsoever. 5. DSD SIGNATURE ~/ Approved for /-dL bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: PROGRAM %%:.. ..... Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: ~_~-/'.~ "// Municipality of Anchorage D elopment Services Department Building Safety Division On-Site Water & 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 CHECKLIST Legal Description: KniktView Estates'~ock =~ Lot 2 Parcel ID:. o~x-o,.~.~x'~ / WELL DATA Well type AWWU Date completed. Total depth__ Date of test IfA, B, or C provide PWSID # .. Sanitary seal (Y/N). Cased to ft. FROM WELL LOG Well Log (Y/N) Wires properly protected (Y/N) Casing, height (above ground) AT INSPECTION in. Static water level Well production WATER SAMPLE RESULTS: g.p.m. g.p.m. Coliform colonies/lO0 mL Arsenic: ug/I B. SEPTiCl ~_,I-~G TANK DATA Tan k Type/Material .Gr~r Steel Tank size. =.2~o gal. Foundation cleanout (Y/N) Y Date of pumping 61~/~o=..~ C. 'ABSORPTIONFIELD DATA Nitrate mg/L Date of sample: Number of Corn partments =_ Depression over tank (Y/N) __N Pumper. Sanitary Pumpers Collected by: Date installed Cleanouts (Y/N) ..Y.. High water alarm (y/N) N/A Date installed eJh/2ooo Length 6q Total depth _4=5- ft. Soil rating (g.p.d./ff2 or ~/bdrm) o.,; ft. Width.. =-9 ft. Eft. absorption area x=a.=, ft2 Monitming tube Y System type Bed Gravel below pipe ..o.~; Depression over f'~ld N Date of adequacy test ~ Fluid depth in absorption field before test _o in. Elapsed Time: _o min. Final fluid depth, o_ in. Any rejuvenation treatment (past 12 mo.) (Y/N & type) Results (Pass/Fail). Pass For .~ bedrooms N Water added=.=o0 gal. New depth_o in. Absorption rate >= 6.00+ g.p.d. If yes, give date LIFT STATION "Pump on" in. Datum SEPARATION DISTANCES Size in gallons "Pump off" level at Cycles t;T~ SEPARATION DISTANCES FROM WELl Septic tank/lift station on lot Absorption field on lot Public sewer mai in. (Y/N) h water alarm level at Meets alarm & circuit requirements? Building foundation 3.o+ Surface water Wells on adjacent lots 2oo+ On adjacent lots acent lots Public 3ut Sewer ine Holding tank containment areas Manure/animal excrete storage SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation ;, Propertyline ~o+ Water main ~.o+ Water service line ~.o+ Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line o Water Service line =.c+ Curtain drain .. None Known Date of Payment Receipt Number (Rev. 11/05) Absorption field =.o' Surface water Water main Driveway, parking/vehicle storage in. F. COMMENTS .Water system is AWWU. Engineer's Printed Name Steven R. Pannone, P.E. Date , --- COSA Fee $ Z_~ ~ 0 -- Waiver Fee $ (~'-- ~' -- ii Date of Payment (~ ~Z.~/.3/~,/.~, Receipt Number I ? I ? I ? I ? I / ~00, ? ? ? I ? ? / / I / / I GRID NWf558 '.,',,g. 49 TH~ "~'f ...... '. S~NEA. HOLT .z , ........... THE INFORI~U~,TION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOWANY CONFLICTS BETWEEN IF. XISTING STRUCTURES AND PLATTED LOT LINES OR EASEt,IENTS AND IS blOT TO SE USED FOR POSITIONING ADDITIONAL STRUCTURES OR FENCELINE~S. EASEMENTS OF RECORD. OTHER THAN THOSE SHOWN ON THE RECORDED PLAT. ARE NOT SHOWN HEREON.(UblLESS INDICATEE NOTE: ANY FENCELINE$ SHOWN ARE LOCATED APPROXIMATELY AND ARE NOT TO BE USED TO DETERMINE PROPERTY LIblE. S OR LOCATE STRUCTURES. AS-BUILT SURV:'=Y 1~=30' I HEREBY CERTIFY THAT I HAVE PERFORMED A MORTGAGEE'S INSPECTION OF THE FOLLOWING DESCRIBED PROPERTY, LOT 3~ BLOCK 3, KNI}( VIEW ESTATES ANCHORAGE RECORDING DISTRICT, ALASI(A AND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTEO. OATEO AT ANCHORAGE, ALASKA TH[S_23RD DAY OF JANUARY 2001 HOLT LA~D SURVEYING 8025A,,89-68,-~-'71 TEL, 345-55t3 Apixalsal Company d/0es,tn (907) 562.2424 Uniform Residential Appraisal Report tMaJn F~e Un. 63-63-6-0345344LADD1 Pane #31 '11-103 F~e# the ~d~/c~e~t ~th an acc~ate, and ad~quat~ $~p~or'~, cCd, on of t~ ~rkel v¢~ of the sublet 21818 Rebecca Ckde City Chugiak State Ak ~p Code 99567 0',~'~' of Pubic Fi~ord Re,/no',ds, Audra/Fred edck Lots 2& 3 Knlk View Estates ^ss~ss0r's Par~ # 051.O43-58 2011 FI.E. Taxes $ 5 989.56 View Estates {~ap Ref~'ence NW 1558 C~ns,ds Trecl t.01 T~ ~ Vac~ Sp~alA~ms~s $ ~ ~ ~D HOA$ N/A ~ ~e ~ra~ac~ ~ ~ (d~) Velera~ ~eEs Ada~ Internal User-~y VA approved LePer r sa~ In ~ ~'~'e ~ ~r lo ~ e~ ~te of ~s a~rais~? ~Y~ ma ~et ~me ~s [] d~d [] (Id not a~e the go.act for sa~ for the subject p~¢(~se ba~sacC~. ~n ~ resets of ~ ane,~s~s of the ~ontract for s~e of v,~y ~ ar~'ygs was no~ The sees contract overall appears to be b/p!col for the market. Cen~'eclPdce$ 425,000 OateofCootrecL 5/23/2011 IsLheFope,tys¢-~t.~o'*T,~oll)Ubrigrec~xd? [~]Yes I'-INo 0alaSeurce(s) MOApropertymcord Is there any linandal assl$1aflce [loan cha~ges, sa!e concessions, gift (x downpaym~t assisbnce, ~.) to be pald by any party o~ be~aTf of the bo(rowe~? []Yes and des(-n'b~ 6'8 {~ae~s to be pa{d. none see sa~es a.qreement ~ppra~sal faclorso PRICE AGE Ore-Urlt 75 ~- 250 Low Ne'.,flhborhood boundaries Include: Nodh Peters Creek South Peters Creek and the bluff/ocean lo the west. 450 Red. The sublect pe'4:lhborhood is located 20 mi~es northeast of downtown .N~chora.qe and 2 Influences in ciose I',~ rkel Coediliop.q ('lr, cltJo~n4j suppolt f~ the above co~du~ons) 2-4 I~t o Cornm~dal 1 12 Other 22 ~ hborhocd Is censfdemd to be average. There are no known adverse The market has remafned stab!e for several years. Loan discounls and tnterest bu' Please see attached 1004 MC addendum. Cbssif[~afJnfl R-7 Area 43 933 SF Shap~ Irmflu!ar Z~ng D~cript'en (intermediate Rural ReskJential) View Average Pubr~ Oiher(desc,'~) Public (Yd'er[de~n~e) O{f-silelmpr(,Yernei~ts-Type Pub~ P~ate Wat~ ~ ~ S~ PaW ~ ~,Y~ ~Ho FEI,~Z~ Z~C F~Map~ 02~05105B FEE~I,~p~te 9-18-1987 ~ere am ~ ~ ~ as-bu[~ su~y prov~ed. ~m~ s~e a of o[~r bis ~ t~ immediate area. Om [] 0m v,~,lh Accesser Concrete Stab Four[lal~ Vla~s Concrete Block-Ave Cpt/Lam-Ave+lGd #0IS[oI~ 2 FgJBesa'nff~ [] Partiai~s~'r¢~[ F.~rd'totWa[~ OSB/TI-11 Gypsum-Good Basen~t Area No~e Corr Wood-Ave+/Good Casement-Ave Bath Wa~s col 'ri~.eJPia stfo-Ave-lG Year Bui~ 2000 I~l'este~on Ho/Yes Nene lO [] Se~ne~t ,Scre~ no # er Cars Sla~'s Other Gas P. cr~ # of Cars Poor [] $cut~e Pat~o~)ec~ [~ Pa'ch Covered # el Cars Hnist~ [] Hea,~l ~Mdual Othff Pool 0',.~ [] DeL [] Bait. Tn [] Dir~as~ [] ~,':oo',',,a','~ [] Vlasher~'1]ryer [] 0'Jh~ (dss~dbe) Basa'r~t R~h R~hed area Dbove grade conl~ns: 8 Rooms 4 Bedrooms 2.5 Ba~h(s) 2,779 Square teat of G~oss Ur{nil Area Abo~'~ G~ade Addilio~al f~iur~s Am enitles: bathroom w';th Jacuzzi and extra shower, o0en balcony above stairweL 0cecile 1~ COr~[~ofl of ~le Overall cond]tk)n Is t' ci tO the mad(et, i provkfed. No deferred maintenance o~' func. l~o~3T tnadequac. J. es noted. s ~t [] ~{o If Yes, tf No, describe Freddie Mac Form 70 March 2005 Page I of 6 Fannie Mae Form 1004 March 2005 Fo~m 1004-- '¥~nTO fAL' appraisal so,#am by e la mode. Inc. -- 1.800-ALAMODE Municipality of Anchorage 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.ci .anchorage .ak .us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 051-043-03 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address HAA # I'/A Ot O0'¢ 2. Expiration Date: .,4--/,.¢'- (2,/ GENERAL INFORMATION Complete legal description Lot~ '2 & 3, Block Location (site address or directions) NHN Rebecca Circle Current Property owner(s) Sudsbury & Sons 11239 Aurora Street, Residential/Jeannie Mee 11432 Business Blvd.~ Suite 3, Knik View Estates Dayphone696-1610 Eagle River, AK 99577 Day phone 6, Eagle Day phone 696-8817 River, AK Unless otherwise requested, HAA will be held by DSD for pickup. NUMBER OF BEDROOMS: 4 99577 o TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class__ Public Water System Well TYPE OF WASTEWATER DISPOSAL: [-] Individual On-site [] r'-] Individual Holding tank [] [] Community On-site [] [] Public Sewer [] The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 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 vaiid 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 less than 30 days old. (Ce~ificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. S & $ ENGINEERING Eagle River, Alaska Name of Firm Address Engineer's Printed Name P, obert: C. Cowan, P.g. DSD SIGNATURE X' Approved for 4 Disapproved. Conditional approval for Phone t~ 0 z./,, _ p ~, 7~ Date //~0/o/ bedrooms, with the following stipulations: Additional Comments Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory By: Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: (Re','. 12/00) Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST · Legal Description: ~7~ Z~ ~;I' ~/t~ ;~; ~/Vt~-.//~Z~~7'- Parcel ID: WELL DATA Well type~ If A, B, or C provide PWSID # Well Log (Y/N~.~ Date cOmpleted _ , ~ Sanitary seal (Y/N) . Wires ~otected (Y/N) Total depth' ~ ft. Cased to __..___~: ~height (above ground) in. test Date of Static water level j ;:p.m. ft' Well production , g.p.m. Colif°~,,,/ colonies/100 mi. · mg./I. Other b*acteria.~ colonies/100 mi. B. SEPTIC/HOLDING TANK DATA Tank'Ty~e/M~terial ~ Date installed TankSiZe ~".ga;:'~, ~Number of Compartments ~'~. Cleanouts (~N) .F0undafionclean.ogt~)Ni~:~ Depression over tank (Y/~.~/~) High water alarm (Y/N) ~'//,~r Date of pumPing /~/~-~" Pumper C. ABSORPTION FIEI. D DATA Date installed ~f/~//~ Soil rating ~ or ~/bdrm)~o ~' System type~ ~ Length ~q' ft. Width ?/q ft. Gravel below pipe ~::2. ~'- ft. Total depth ....;~ f. Eft. absorption area]~!] ~ Monitoring tube _~ Depression over field ,/q~) ~,:t,; ;~:~ :nM: :ys ~::: o n~ R~ For bedrooms · ~, ' p' ield ~n. Water added, gal.. New depth __. in. Elapsed Time; __~.~.,~'-/' Final fluid depth .... in. Absorption rate >= g.P.d. Any rejuven ' reatment (past 12 mo.) (YIN & type) if yes, give date LIFT STATION / Date installed ~//~/....,~n gallons "Pump on" level at~'in. "Pump off" level at ~ Datum J . Cycles tested in. E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift Station on lot ~ Absorption field on lot J Building foundation ~" ' Water main ~/~) /~ Wells on adjacent lots ~ if. Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements'? On adjacent lots On adjacent Iot~ Public sewer manhole/cleanout Holding tank SEPARATION DISTANcEs FROM SEPTIC/HOLDING TANK ON LOT TO: Property line ~' ~- Absorption field Water ser~i~e line /O/'~ Surface water SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 0 ! Building foundation Water Service line ,/~)/~- Surface water // Curtain drain/~/~/~f/"~V~&fJ'/~ Wails on adjacent lots ~ ! Water maim Driveway, parking/vehicle storage F. COMMENTS ENGINEER'S CERTIFICATION I certify that I have determined througti .field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name Date ., H.AA Fee $ Date of Payment Waiver Fee $ Date of Payment Receipt Number 00'00~$ .~.%~S-.:) ! ~l~$/l I ~fl ~,£0 Receipt Number