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Home My WebLink AboutGLACIER VIEW HEIGHTS BLK A LT 15 REMGlaci r View Heights Block A Lot 15 #050-491-07 MUNICIPALITY OF ANCHORAGE Community Development Department Development Services Division On-Site Water & Wastewater Program Mayor Dan Sullivan Phone: 907-343-7904 Fax: 907-343-7997 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 0.50 -~'][- by Property owner(s) ~'jm ~r;c~_.¢4~ Day phone Mailing address z~.~[/,~ qpp~,~ KO(r~.~ DJ,, ~A(rL6~6¢,; AK site address Legal description (Sub'd., Block & Lot) ~'L~. ~[~J] RE'~J~T,~ ~ 6L~, A Legal description (Township, Range & Section) Lot Size Sq, Ft, Number of Bedrooms ,~ ~ THIS APPLICATION IS FOR: ([~] all that apply) Absorption Field Septic Tank Holding Tank Privy Private Well Water Storage THIS APPLICATION IS AN: Initial I~ Upgrade [] Renewal [] THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes, ~'~~ ert owner (Signa{ure of prop y or authorized agent) Permit/Rush Fees: Date of Payment: Receipt Number: Permit No. Waiver Fees: Date of Payment: Receipt Number: Waiver No. G:\Building\On Site\Forms\Client Forms\Permit App_010411 .doc (Rev, 1/11) A SOILS LOG - PERCOLA/IUN DATE PERFORMED PERFORMED ~OR: dim BICKMAN LEGAL DESCRIPTION: GLACIER VIEW HEIGHTS~2 TEST HOLE ~ 1 DEPTH ORANGE TOPSOIL ,~RAY OW-SW ELL GRADED SAND AND GRAVEL LOT 15, BLOCK A SLOPE i18% TOWNSHIP RANGE SECTION T14N~ RIW SEC.16 SITE PLAN(NOT TO SCALE) SLOPE WAS GROUND WATER ENCOUNTERED? YES GM I~AYEY/SIJGHTYLY DAMP WATER TABLE DATA DATE WATER LEVEL 10/1912005 10.5 10/27/2005 15.3 12105/2005 14,6 05/31/2006 14.8 PERC TEST RESULTS :[EADtNG DATE GROSS TIME ,lET TIME DEPTH TO WATER NET DROP I 10/20/2005 t0:07 0:00 6' 8 0 2 10120/2005 10:37 0:30 6' 11 3/4 3 3/4 3 10/20/2005 10:40 0:00 6' 8 0 4 10120/2005 11:1D 0:30 6' 11 11/16 311/16 5 10/20/2005 11:11 0:00 6' 8 0 6 10120/2005 1t:41 6:30 6' 11 11/16 3 11/16 PERCOLATION RATE= 8 (MI'N/INCH) pERC HOLE DIAMETER=6I' TEST RUN BETWEEN 6 FT AND 7 FT COMMENTSL AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: (907) 694-5195 FAX: (907) 694-3297 ~~~~"~ SOILS LOG PERCOLATION TEST ..... PERFORMED FOR: JIM BICKMAN DATE PERFORMED~19/200_ 5 LEGAL DESCRIPTION: GLACIER VIEW HEIGHTS#2 TEST HOLE # 2 DEPTH (FEET) ORANGE TOPSOIL 21 22' LOT 15, BLOCK A SLOPE OULDERS WAS GROUND WATER ENCOUNTERED? YES TOWNSHIP RANGE SECTION T14N, R1W SEC.16 SITE PLAN(NOT TO SCALE) SLOPE WATER TABLE DATA DATE MATER LEVEL 10/1912005 NONE 10t27/2005 15.7 15/15/2005 15.7 0513112006 14.3 PERC TEST RESULTS READING DATE GROSS TIME NET TIME DEPTH TO WATER NET DROP 1 10/2112005 10:10 0:00 7' 3 5/8 0 2 10/21/2005 10:40 0:30 7' 6 2 3/8 3 10/21/2005 10:42 0:00 7' 3 5/8 0 4 10/21/2005 11:12 0:30 7' 6 2 318 5 10/21/2005 11:13 .0:00 7' 3 5/8 0 6 10/21/2005 11:43 0:30 7' 6 2 318 PERCOLATION RATE= 13 (MIN/INCH) FERC HOLE D~hr~! i::~-~'6" TEST RUN BETWEEN 7 FT AND 8 FT COMMENTS: SOJ . S BALZAR_LN! PERCOLATION TEST BY:. CHARLES BALZARINI I /.~rj~'/,'/,,..~,~.~ CERTIFY THAT THIS TEST WAS PERFORMED tN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ~"//~' • • '� Municipality of Anchorage r* i e " On-Site Water and Wastewater Program < 0.6'' (907) 343-7904 S �� Certificate of On-Site Systems Approval Parcel I.D. 050-491-07 Expiration Date: ! -U iq 1. GENERAL INFORMATION Complete legal description Lot 1 5 REM, Bk A, Glacier View Heights Location (site address) 22670 Mytrl Drive, Eagle River, Alaska 99577 Current Property owner(s)Brandy & Donald Arthur Day phone Mailing address 22670 Mytrl Drive, Eagle River, Alaska 99577 Real Estate Agent Steve Renner @ Keller Will.Day phone(907) 841-4223 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: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: � Date: A4 920/ COSA to be rel to the engineer,unless otherwise requested by the engineer. COSA Fee $ _S2.-6 Waiver Fee $ Date of Payment 02— --f' Date of Payment Receipt Number Z)d (,�3 Receipt Number COSA# DSCt el'J3 1 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 Pinard Engineering Phone (907) 232-1347 Address PO Box 871347, Wasilla, Alaska 99687 Engineer's Printed Name Paul E. Pinard Date 10/i/VOF 4�1s� 7. AASyC9 47. l��7 L___,. _• 0v T' k9tl* 4c 9L°' ✓`, .. •'i 70' 1,4 ta® _-7,...---%'-_, 6. DSD SIGNATURE ktt x,a X 1" : . c S *` oPat -E; Pinard o System#1 Approved for.3 bedrooms <n;;=.p€ -4793 : 444 41 System#2 Approved for bedrooms �.�F4,�'""`-,\.. ,��` ��pROFES5\v_ilp` Disapproved ''°�r9®®Bf' Imo(?(1.?. Conditional approval for bedrooms, with the following stipulations: G � ON-SI i E G;, s WATCR ANn z -, WASTEWATER O. PROGRAM 4 - oo�FNT�R�1G��, _ r BY: . 5..1-- I� - Original Certificate Date: /0 _p L 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 • ' ` COSA blue sheet r '- .•: c 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: Lot 15 REM, Bk A, Glacier View Hts Parcel ID:050-491-07 A. WELL DATA Well type Pvt If A, B, or C provide PWSID# NA Well Log (Y/N) Date completed 6/6/13 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Total depth 165 ft. Cased to 164 ft. Casing height (above ground) 18+ in. FROM WELL LOG AT INSPECTION Date of test. 6/6/13 9/27/18 Static water level 120 ft. 124.6 ft. Well production 15 g.p.m. 4.0 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate ND mg/L Arsenic ND ug/L Date of sample: 9/20/18 Collected by: Pinard Engineering B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 8/13/13 Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) Foundation cleanout(YIN) Y Depression over tank(YIN) N High water alarm (YIN) N Date of pumping 9/19/18 Pumper Alaska Quality Septic C. ABSORPTION FIELD DATA Date installed 8/14/13 Soil rating (g.p.d./ft2 X1 r 0.8 • System type Deep Trench Length 49 ft. Width 2 ft. Gravel below pipe 5.9 ft. Total depth 10.4 ft. Eff. absorption area 578 ft2 Monitoring tube Y Depression over field N Date of adequacy test 9/27/18 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 720 gal. New depth 0 in. Elapsed Time: 180 min. Final fluid depth 0 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) None Known If yes, give date D. LIFT STATION NA Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off" level at in. High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 1001+ On adjacent lots 100 + Absorption field on lot 100'+ On adjacent lots 100' + Public sewer main 25 '+ Public sewer manhole/cleanout .100'+ Sewer/septic service line 10'+ Holding tank 75 '+ Animal containment areas 501+ Manure/animal excrete storage areas 100' + SEPTIC/HOLDING TANK ON LOT TO: Building foundation 51+ Property line 51+ Absorption field 51 + Water main 101+ Water service line 10'+ Surface water 100' + Wells on adjacent lots 1 00 + ABSORPTION FIELD ON LOT TO:• Property line 10'+ Building foundation 10 + Water main 10'+ Water Service line 10'+ Surface water 100' + Driveway, parking/vehicle storage 1 0'+ Curtain drain 50'+ Wells on adjacent Iots100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION liv.OF ct. 000000000 I certify that / have determined through field inspections and .*'CV•. review of Municipal records that the above systems are in * /fit7± ;:x *•te conformance with MOA COSA guidelines in effect on this date. 4 .. 46. ., . " • 'r Engineer's Printed Name Paul E. Pinard r Paul E. Pinard ; Date 10/2/18 `°�;. CE -4793 .•,(,.s.",0 ��ROFESS\ONW<` �i /1 COSA yellow sheet_2-6-15.doc