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HomeMy WebLinkAboutLEDOUX LT 7Ledoux Lot 7 #050-291-49 Sullivan 19076882259 p.1 Certttteb ;Drt'tttng dog by DOC co. db. SULLIVAN WATER WELLS P.O. BOX 670272, CHUGIAK, ALASKA 99567 -TELEPHONE 688-2759 OWNER OF LAND: L 14'-1) 1f; 5Jkj C JS % zie ADDRESS: LEGAL DESCRIPTION: 49 4t +1 T DATE: iai3� iv; PERMIT N MB Date of Issue- _ TAX IDENTIFICATION NUMBER:y� T �� Is well located at approved permit location? Qd�es O No Method of Drilling: it rotary ❑ cable tool Depth of well: Casing TypeQWall Thickness •a.+j`�J inches Diameter inches, depth / < feet Liner Type: .._,mMvJa Casing Stickup Above Ground: feet Static Water Level: I E f- feet Recover Rate:gpm Method of Testing: Well Intake Opening Type: pen end ❑open hole Screened; Start feet Stopped feet =t Perforations Start ��-��ffee Stopped n! Grout Type:/P3 51 t Volo e feet Depth: from f) feet`, toIJ/D feet Well Disinfected Upon Completion? 5rm ] Nowa Method of Disinfection: �'/ o%.ja �rr-*1 WATER QUALITY TESTING Colfform Ne m, C0111001ITtL Nitrates rrtg/L Arsenic ND ug/L 0 4;242 ",JG Se jLC']sf%3 L L) ae 6/',+JCL Driller's Name COLL ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality Of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. MatSu Borough: Department of Environmental Conservation. e a� Development Services Department Building Safety Division Pump Installation Date: � _ / 0 - I on-5ite Water & Wastewater Program 4700 Elmore Road Pump Manufacturer's Name: C ptA-[d P.O. Box 196650 Mark Begich Mayor Anchorage, AK 99507 www.muni.ora(onsite (907)343-7904 Pitless Adapter Manufacturer's Name: ^C fj v, yO v\ Pox Pump Installation Log Well Drilling Permit Number: SW12 Date of Issue: g193 2, Parcel Identification Number._�y�a Legal Description Le ot&y Lof - Property Owner Name & Address: Pump Installation Date: � _ / 0 - I Pump Intake Depth Below Top of Well Casing: / ?0 feet Pump Manufacturer's Name: C ptA-[d Pump Model: sOt71 �{�aGL Pump Size 3lq hp Pitless Adapter Burial Depth: IC) feet Pitless Adapter Manufacturer's Name: ^C fj v, yO v\ Pox Pitless Adapter Installer: WNtt-CO 6�1 i Well Disinfected Upon Completion? Yes ❑ No Method of Disinfection: Comments: Pump Installer Name: /j I, J p t, W k- e(W 0 Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. On-Site Water System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP121358 Tax Code Number: 05029149000 Work Type: Well Initial Permit Effective Dates: October 23, 2012 Design Engineer: Subdivision: LEDOUX Site LegalAddress: LEDOUX LT 7 G:0054 Owner/Address: LEDOUX EDWARD CASEY PO BOX 291 KIHEI HI 967530291 to October23, 2013 Site Mailing Address: Lot Size in Sq Ft: 8845 Total Bedrooms: 3 This permit is for the construction of: N Disposal Field N Septic Tank N Holding Tank N Pdvy Y Private Well N 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 Ddnking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must-notif~ the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Date: Date: Community Development DePartment Development Services Division On-Site Water & Wastewater Program MUNICIPALITY OF ANCH I J ' ~"" Phone: 907-343-7904 Fax: 9072343-7997 ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 0~'0-' ~.c~ ~_ L[O~ Propertyowner(s) ~/*~f~/~.~.~~~:.~'t Dayphone 7~/~ Mailing address ~[ ~f&~'~ ~ ~~ ~ ~ Site address ~ ~ ~ 7 ~ ~~ Legal description (Sub'd., Block & Lot) ~ ~ ~ ~ Legal description (Township, Range & Section) Lot Size ~ Sq. Ft. Number of Bedrooms ~ APPLICATION IS FOR: APPLICATION IS AN: ([] all that apply} Absorption Field [] Initial ~ Septic Tank [] Upgrade [] Holding Tank ' [] Renewal ' ' [] Privy [] Pdvate Well ,J~ Water Storage [] TYPE OF DWELLING: Single Family (SF) (w/wo ADU) Duplex (D).. Multiple Dwellings (SF and/or D) THIS APPLICATION INCLUDES A VARIANCE /WAIVER REQUEST FOR.' Distance: I certify that the above information is correct. I fudher certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: o~,c::b~ I ;>~o--I~ Waiver Fees: Date of Payment: '~O[lbll~- Dare'of Payment: Receipt Number: C:I.J~ ,~,3L~ C_ Receipt Number: Permit No. ~-p~ jOj~.¥'~--'~ Waiver No. Permit App_9-1-12,doc LOT 3 (^w~u S~ER) LOT 8 (AWWU SEWER) ,( PROPOSED LOT 4 (A~WU SEWER) N~O'OO'OO"E 70.~' 10' T& E & DRNNAGE EASEMENT LOT 5 (AWWU SEWER) 586.8 OVERHANG 585,8 LOT 6 (AWWU SEWER) LOT 7- 8,845 TBM~-TOP OF 5/8" REBAR EL 580,0 585.6 EDGE OF LEGEND 104.8 EXISTING ELEVATION 103.0 PROPOSED ELEVATIOI EAGLE RIVER ROAD -- SURFACE DRAINAgl LOT COVERAGE = 22,1~ PLOT PLAN X AS BUILT SCALE 1' = 30' (;;RID NW55 ProJeot No. 12-191B1 Lang (907) 522-6476 Registered Land Surveyors (907) 522-4525 ken~langsurvey.eom / Jonathar~gangsurvey.eom 11500 I:h3~l Avenue, Anchorage, Alaska 99515-5049 & Associates, inc. Phone Fux I hereby oerllfy that I have surveyed the following deserlbed properly:. LOT 7, LEDOUX SUBDIVISION (PLAT 2011-68) Anehorags Rsoordlng DIsfrlot, Alaska, and that fha Improvements elluated thereon are within the properly lines and do not eneroaeh onto the properly adJaeenf thereto, fhaf no Improvements on the properly I/lng adJaoent thereto eneroaeh on rite surveyed premises and that there are no roadways, fronsmlsslon Ilnes or other visible easements on said properly exoepf aa indlaated hereon. Dated this the ~/~1~ Day of ~=r~:~ , '~.~VZ. , at Anahoraga, Alaska If la the rosponslblllly of the owner fo determine the exlstsnos of any easements, oovenants, or re~trloflon8 whloh do not appear on the recorded subdivlslon plat. Municipality of Anchorage On -Site Water & Wastewater Program - (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 050-291-49 Expiration Date: 2 �S 1. GENERAL INFORMATION Complete legal description LEDOUX S/D; LOT 7 Location (site address) Current Property owner(s) Mailing address Real Estate Agent 18909 EAGLE RIVER ROAD, ANCHORAGE, AK, 99577 MIDNIGHT SUN CONSTRUCTION Day phone 3861 SCENIC VIEW DRIVE, ANCHORAGE, AK, 99504 2. TYPE OF DWELLING: Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: Day phone 727-1433 TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual On-site ❑ Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer 0 Received by:'!s COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ to S.�A Date of Payment 11119-113 Receipt Number /11 0/0 d Zy COSA # OS C 13 !'S 86 J Date: r'%: ✓ 7* i Waiver Fee $ Date of Payment Receipt Number 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. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK, 99507 Engineer's Printed Name Engineer's Comments: JEFFREY A. GARNESS, P.E. In conducting this evaluation, GEG, La). attempted to provide a thorough, conscientious engineering 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 test, and separation distances measured to readily identifiable features. The operational life of all wells and 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. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or 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. 6. DSD SIGNATURE System #1 Approved for 3 bedrooms. Phone 337-6179 Date F t /it 113 14T.... .......... ..y. !Cy A Wess,- CE-7953 ,•O Pr o f e s sio�°oma System #2 Approved for bedrooms. OFiq&C rrrr/ Disapproved. = ON-SITE Conditional approval for bedrooms, with the following stipul i*S: .,..-rrm Awn m Original Certificate Date: The Municipality or Anchorag)Develop,emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the represenatations 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. ATTCHMENTS: COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other (Rev. 11105) If more than 1 septic system is on the lot: COSA Checklist # of Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: LEDOUX S/D; LOT 7 Parcel ID: 050-291-49 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES Date completed 10/27/2012 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES Total depth 195 ft. Cased to 195 ft. Casing height (above ground) 24+ in. FROM WELL LOG AT INSPECTION Date of test 10/27/2012 — Static water level 158 ft. Well production 18 g.p.m. — g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate NO mg./L. Collected by: GEG, Ltd. Arsenic: ND ug./L. Date of sample: 10/1/2013 B. SEPTIC/HOLDING TANK DATA PUBLIC SEWER Tank Type/Material Date installed Tank size gal. Number of Compartments _ Cleanouts (Y/N) Foundation cleanout (Y/N) _ Depression over tank (Y/N) _ High water alarm Date of pumping Pumper C. ABSORPTION FIELD DATA Date installed Soil rating (g.p.d./ftor ft2/bdr System type Length ft. Width ft. Gravel below pipe ft. Total depth ft. Eff=absorptio ea ft2 Monitoring tube_ Depression over field Date of adequacy testResults (Pass/Fail) For bedrooms Fluid depth in absor ' n field before test in. Water added _gal. New depth in. Elapsed T' —min. Final fluid depth in. Absorption rate >= g.p.d. Arfy rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed "Pump on" level at in. Size in gallons Manhole/Access (Y/N) "Pump off" level at wa er alarm level at in. Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot N/A On adjacent lots N/A Absorption field on lot N/A On adjacent lots N/A Public sewer main 75'+ Public sewer manhole/cleanout 100'+ Sewer /septic service line �S * Holding tank N/A Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: IPUBLIC SEWER Building foundation Water main Wells on adjacent lots Property line Absorption Water service line Surface w SEPARATION DISTANCE FROM ABSORPTION Property line _ Water service in drain . F. COMMENTS -W G. ENGINEER'S CERTIFICATION Surface water Wells on adjacent lots 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. Engineer's Printed Name JEFFREY A. GARNESS Date(/ 3 (Rev. 11/05) TO: Water Driveway, parking/vehicle storage OF A .,:... 7 T::-ifl:_71.i....:'.* fr p. Gar ess:' CE .•' w� �Pr o f e ssio� o� WHITTERS' EXCAVATING AND LANDSCAPING 13945 Knob Hill Dr. EAGLE RIVER, ALASKA 99577 (907) 696.0822 JOB /0 7 LCJOUf SHEET NO. OF CALCULATED BY 0"I ""✓�� I rF� DATE CHECKED BY 5k�5 n,'F;t PRODUCT 2041(3g1a SM)M I (WdW) ltcSSe,.reF� i LOT 3 (AWWU SEWER) LOT 8 (AWWU SEWER) i LOT 4 LOT 5 (AWWU SEWER) (AWWU SEWER) — 10' TBE AND DRAINAGE EASEMENT — — — —m — — _ — 1 STORY RESIDENCE LOT 6 (AWWU SEWER) WELL SHARED DRIVEWAY AY LOT 7 8.845 S.F. 1 �.cc C5 x-15' TBE EASEMENT DR=A'Y BIKE PATH 1 _ - EDGE O—F PAVEMENi� . EAGLE RIVER ROAD PLOT PLAN AS BUILT X SCALE 1" = 30' GRID NW55 Project No. 12-191/B7 Lang & Associates, Inc. 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 (907) 522-6476 Phone Registered Land Surveyors (907) 522-4625 Fax ken®langsurvey.com / jonathan®langsurvey.comOF..A pap v �� ........... �s�o I hereby certify that 1 have surveyed the following described property:O LOT 7, LEDOUX SUBDIVISION (PLAT 2011-68) O�P fi X00D Anchorage Recording District, Alaska, and that the Improvements situated thereon are >~ 49L * f within the roe lines and do not encroach onto the ' """"""', property �Y property adjacent thereto, that no improvements on the property tying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visible • ••; .. easements on said property except as indicated hereon. QO KENNETH G. LAN o LS -5202 Dated this the Day of OGZ59�m� itu' at Anchorage, Alaska ���'•.l� i?•.•' �G It is the responsibility of the owner to determine the existence of any easements, ��ppRaFfSSIONAt� covenants, or restrictions which do not appear on the recorded subdivision plat. p40ppo�a