HomeMy WebLinkAboutMOUNTAIN PARK ESTATES BLK 2 LT 11AMountain Park
Estates
Block
Lot 11A
#017-061-46
Permit Number:
Tax Code Number:
Work Type:
On-Site Water & Wastewater System Permit
OSP131073
01706146000
WellSeptic
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 Effective Dates: May 15, 2013 to May 15, 2014
Design Engineer: ANDERSON ENGINEERING
Subdivision: MOUNTAIN PARK ESTATES
Site Legal Address: MOUNTAIN PARK ESTATES BLK 2 LT 11A G:2938
Owner/Address: GEUSS ARTHUR P JR &
GEUSS ARTHUR PO BOX 112347 ANCHORAGE AK 995112347
Site Mailing Address:
Lot Size in Sq Ft: 65325
Total Bedrooms: 4
This permit is for the construction of:
Y Disposal Field Y Septic Tank N Holding Tank N Privy 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 Drinking Water Regulations (18AAC80).
3. The wastewater code requires inspections during the installation. The engineer must notify 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:
MUNICIPALITY OF ANCHORAGE
Community Development Department
Development Services Division ~
On-Site Water & Wastewater Program
Phone: 907-343-7904
Fax: 907-343-7997
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 017-061-46
Property owner(s) Arthur P. Gauss & Arthur P. Gauss Jr.
Mailing address P.O. Box 112347 Anchorage, AK 99511
Day phone
Site address DeArmoun Road Anchorage, AK 99516
Legal description (Sub'd., Block & Lot) Mountain Park Estates, Block 2, Lot 1 lA
Legal description (Township, Range & Section)
Lot Size 65,325 .Sq. Ft. Number of Bedrooms Four
APPLICATION IS FOR:
([~ all that apply)
Absorption Field []
Septic Tank []
Holding Tank []
Privy []
Private Well []
Water Storage []
APPLICATION IS AN:
TYPE OF DWELLING:
Initial [] Single Family (SF)
(w/wo ADU)
Upgrade []
Duplex (D)
Renewal []
Multiple Dwellings
(SF and/or D)
THIS APPLICATION INCLUDES A VARIANCE I WAIVER REQUEST FOR:
Absorption Trench to Slope >25% Distance: 25'
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:
Date of Payment: ~¢?/?~
Receipt Number:
Permit No.
Waiver Fees:
Date of Payment:
Receipt Number:
Permit App_9-1-12.doc
DeARMOUN ROAB
o.
MOUNTAIN PARK
ESTATES SUBDIVISION
LOT 11A, BLOCK 2
65,525 S.F.
a.c. DRIVE
G
EL. ~ 820
PROPOSED BUILDING
~) ,250 Gallon
50' Long x 5' Wide MT t'~
x 4' Effective Depth
Absorption Trench
~TH2
(~TH3
30' UTIL ESMT,
S 89'58'56"E 166.82'
SITE PLAN
SCALE 1~ = 50'
Existing
Well
z
LEGEND
CO - Cleon Out
MT - Monitor Tube
TH - Test Hate
FSV - Flow Splitter Valve
FCO- Foundation Cleon Out
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 (FAX)
April 30, 2013
Municipality of Anchorage
Development Services Department
On-Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject:
Lot 11A, Block 2, Mountain Park Estates Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The owner of Lot 1 lA, Block 2, Mountain Park Estates Subdivision intends to construct
a new four-bedroom home on the lot. We are therefore requesting a permit be issued
for the construction of a new well and septic system to accommodate the home. The
attached Site Plan and backup documentation identify the location and configuration of
the proposed well and septic system along with the alternate site. Also identified on the
plans are the existing wells and septic systems on surrounding lots. No conflicts exist
between the proposed well and septic system and wells or septic systems on adjacent
lots. Drainage arrows are shown on the site plan showing the grade and direction of
flow on the lot. The drainage pattern will not be changed as a result of this project.
The test holes placed on the lot in the area of the absorption trench and alternate site
indicates silty sand with gravel (SM). The percolation rate of the soil was determined to
be between 1 and 5 minutes per inch. No groundwater was found during the placement
of the test hole and none was noted during the monitoring period. An application rate of
1.2 gallons per day per square foot was used in the design of the absorption system.
We are proposing to place a new 1,250-gallon septic tank and a 50' long by 5' wide by
4' effective depth absorption trench to treat and dispose of the effluent generated in the
house. The elevation of the distribution line in the absorption trench will be 4' below the
surface and the total depth will be 8'. A minimum of 3' of fill or 2" of insulation and 2' of
fill will be placed over the absorption trench and 4' over the septic tank.
The ground surface on the lot in the area of the septic system slopes to the southeast
at a 20% grade. The new trench will be constructed parallel with the slope as much as
possible in conformance with Municipal requirements. The new septic system will be
constructed a minimum of 100' from all wells and any surface water and 10' the
Lot 11A, Block 2, Mountain Park Estates Subdivision
April 30, 2013
Page Two
proposed and existing water services in the area.
If the system is constructed in accordance with our design the .following statements
apply:
The system, if constructed as designed, will have no adverse impact on the wells
in the area or those to be constructed in the future.
The system, if constructed as designed, will have no adverse impact on existing
septic systems in the area or those to be constructed in the future.
The system, if constructed as designed, will have no adverse impact on reserve
space, either surface or subsurface, on any lots located in the area.
The system, if constructed as designed, will have no adverse impact on drainage
patterns in the area. The current drainage pattern will be maintained.
Sincerely,
Michael E. Anderson, P.E.
Attachments
ANDERSON ENGINEERIN
P~O. BOX 240773
ANCHORAGE, AK 99524
522-7773 677,7766 (FAX)
May 9, 2013
Municipality of Anchorage
Development Services Department
On-Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject:
Lot 11A2, Block 2, Mountain Park Estates Subdivision
Absorption Trench to Slope Waiver
Dear Onsite Services Engineer:
Lot 11A, Block 2, Mountain Park Estates Subdivision has limited area for construction
of a septic system due to a steep slopes to the south. The developer of the lot has
located the house on the flattest area of the lot further reducing the area available. We
have located an area with acceptable soils, but it is situated slightly more than 41' from
a break in grade greater than 25% The alternate site is 25' from the break. We are
therefore applying for a waiver allowing placement of the absorption trench at this
location. The soil encountered in the test holes is clean well graded sand (SW) which is
very good for the absorption of septic effluent. No migration of effluent is expected to
occur to the steep slope. The 25% slope when extended downward from 2' above the
proposed distribution line does not daylight.
Sincerely,
Michael E. Anderson, P.E.
Attachment
9A
®
Exlsting
Well
I 10.00
Utility ~sement
I 10.00
AREA MAP
SCALE 1~ = 60'
DeARMOUN ROAD
Proposed
10' ROW ESMT. ~ Well
A.C. DRIVE
N 65'11 '52"E
MOUNTAIN PARK
ESTATES SUBDIVISION
LOT 11A, BLOCK 2
65,525 S.F.
PROPOSED BUILDING
50' Long x 5' W~de MT
x 4' Effective
~TH3
~1,25~ Gollon
Septic Teak
~A
(~TH2
30' UTIL, ESMT.
S 89'58'56"E 166.82'
SITE PLAN
SCALE 1~ = 50'
Existing
Well
LEGEND
co - Cleon Out
MT - Monitor Tube
TH - Test Hole
FSV - Flow Splitter VoJve
FCO - Foundotfon Cleon Out
LOT 11A, BLOCK 2, MOUNTAIN PARK
ESTATES SUBDIVISION
DESIGN FACTORS: SYSTEM REQUIREMENTS:
Four Bedroom Home 5' Wide Trench System
Perc. Rate: 2.5 Min./Inch 1,250 Gallon Septic Tank
Application Rate: 1.2 GPD/SF 4' Drainfield Rock
4 Bedrooms X 150 GPD/1.2 GPD/SF (Application Rate) = 500 SF Absorption Area
500 SF/5 SF/LF*.5 (Red. Factor) = 50 LF Trench Length
THEREFORE: Construct a 50' Long x 5' Wide x 4' Effective Depth Absorption Trench at the
Location Shown. Flow Line Elevation in Trench to be 4' Below Original Ground Surface. Total Depth
to be 8' Below Existing Ground. Provide 4' Cover Over Septic Tank and 3' Cover Over Absorption
Trench. In Lieu of Cover Place 2" of Insulation and 2' of Cover Over Trenches and Tank.
Maintain 100' Separation from Private Wells in the Area.
Natural
Backfill
5'
t
Geotextile
--Fabric
4" Perforated
PVC (Holes Down)
Drainfield Rock
TYPICAL 5' WIDE TRENCH SECTION
(NO SCALE) ~,~-~Cc:....~......'~. ~?~.
NOTE: Grade Are,a, Over Trench to Drain Away.
Minimum 6, Separation From Bedrock. ~..,~......~.....,,~..:,.2,¢~..&.,,,~
Minimum 4 Separation From Groundwater. ~ .......................................
Minimum 100', Separation From Private Wells in the Area. ~;-";."~
Minimum 100 Separation From Surface Water or Streams:
~ouaJ1 uo¢,dJosqv
0
Z
~--
U') Z
<~>
4700
DEPT[I
1
2
3
4
6
7
8
9
11
2O
jVlUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
BRAGAW STREET ANCHORAGE, AK 99519-6650
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION:
PERFORMED FOR:
DATE: 5/IZ./£011
PARCEL ID#:
OB/OG
SILTY SAND
WITH G RA//EL
SPI
BOH @ 18'
MOUNTAIN PARK ESTATES, BLOCK 2, LOT I IA
PROJECT No.:
TECHNICIAN:
I TESTHOLE1
KYLER AND KAl'df'dY HOWLETT
A. HARALA
WAS GROUND WA rER ENCOUNTERED?
IF YES E/ WHAT DEPTH?__
DEPTIt OF WATER Al: rER MONITORING:
SLOPE
NO
DATE OF MONI'i ORING: $/15/'201
E
SITE PLAN
SEE SITE PLAN
DEPTH TO
DATE READING GROSS TINE NET TINE WATER NET DROP
(MINUTES) (MINUTES) (INCHES) (INCHES}
TEST HOLE PRESOAKED PRIOR TO TESTING:
5/15 1 2:11/2:21 10 .50"/4.75" 4.25"
2 2:22/2:32 10 .75"/4.75" 4.00"
3 2:33/2:43 10 .62'/4.62' 4.00"
4 2:44/2:54 10 .62"/4.62" 4.00"
5 2:55/3:05 10 .50"/4.50" 4.00"
6 3:06/3:16 10 .62"/4.62" 4.00"
PERCOLATION RATE: 2.5.(MiN/iNCH) PERC. HOLE DIA. 7" _(INCHES)
TESTRUN BETWEEN: 4.5 FT. and 5.5 .FT.
COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST.
TEST PERFORMED BY ANDERSON ENGINEERING. I, MICHAEL E. ANDERSON CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE: 5/5/2012
4700
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
BRAGAW STREET ANCHORAGE, AK 99519-6650
LEGAL DESCRIPTION:
PERFORMED FOR:
DATE: 5/6/2015
PARCEL ID#:
DEPTH
(fbet)
OB/OG
1
2
3
4
5 WELL GRADED SAND
WITH GRAVEL
6 sw
7--
SOILS LOG - PERCOLATION TEST
MOUNTAIN PARK ESTATES, BLOCK 2, LOT IIA
11
20
BOH @ 18'
PROJECT No.:
TECHNICIAN:
CROWN POINTE HOMES. INC.
Iv]. ANDERSON
SLOPE
SITE PLAN
WAS GROUND WATER ENCOUNTERED? NO
iF YES ~ WHAT DEPTH~ ~
DEPTH OF WATER AFTER MONITORING: NONE i SEE SI'I E PLAN
DATE OF MONITORING: 5/9/2013.
DEPTH TO
DATE READING GROSS TildE NET TiNE WATER NET DROP
(PIINUTES) (HINUTES) (INCHES) (INCHES)
TEST HOLE PRESOAKED PRIOR TO TESTING:
5/12 ] 3:14/3:24 I0 1.38"/5.00" 3.62"
2 3:25/3:35 l0 1.50"/5.00" 3.50"
3 3:36/3:46 10 ] .75"/5.25" 3.50"
4 3:47/3:57 10 1.38"/4.88" 3.50"
5 3:58/4:08 10 1.50"/5.00" 3.50"
6 4:09/4:19 10 1.75"/5.25" 3.50"
PERCOLATION RATE: 2.8 (MIN/INCH) PERC. HOLE DIA. 8" ~'INCHES)
TEST RUN BETWEEN: 4.5 FT. and 5.5 FT.
COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST.
TEST PERFORMED BY ANDERSON ENGINEERING. 1, MICHAEL E. ANDERSON CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WiTH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE: 5/5/2012
4700
DEPTII
(l~et)
1
2
3
4
5
6
7
8
9
11
20
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
[3RAGAW STREET ANCHORAGE, AK 99519-6650
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION:
PERFORMED FOR:
DATE: 5/1&/2011
PARCEL ID#:
OB/OG
SILTY SAND
WITH GRAVEL
SPI
MORE DENSE
WITH DEPTH
BOH @ 18'
I'"IOUNTAIN PARK ESTATES, BLOCK 2., LOT I IA
PROJECT No.:
TECHNICIAN:
KYLER AND NANNY HOWLFTT
A. HARALA
SLOPE
SITE PLAN
WAS GROUND WATER ENCOUNTERED? NO
IF YES @ WHA' ' DE 'TH:(
DEPTH GE WATER AFTER MONITORING: N01,~E 5 °fig
E
DEPTH TO
DATE READING GROSS TIME NET TIME WATER NET DROP
(NINUTES) (PIINUTES) (INCHES) (INCHES)
TEST HOLE PRESOAKED PRIOR TO TESTING:
5/14 1 3:52 1.13"
2 4:22 30 4.88" 3.75"
3 4:23 1.25"
4 4:53 30 5.00" 3.75"
5 4:54 1.13"
6 5:24 30 4.88" 3.75"
PERCOLATION RATE: 8 (MIN/INCH) PERC. HOLE DIA. 6" (INCHES)
TEST RUN BETWEEN: 6.0 FT. and 7.0 _FT.
COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST.
TEST PERFORMED BY ANDERSON ENGINEERING. I, MICHAEL E. ANDERSON CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE: 9/10/2007
4700
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
BRAGAW STREET ANCHORAGE, AK 99519-6650
LEGAL DESCRIPTION:
PERFORMED FOR:
DATE: 5/[A/201[
PARCEL ID#:
DEPTH
(feet)
OB/OG
2
3
5 SILTY SAND
WITH GRAVEL
6 sr,i
7
8 COBBLES TO 2"
9
SOILS LOG - PERCOLATION TEST
MOUNTAIN PARK ESTATES, BLOCK 2, LOT IIA
11
20
BOH @
PROJECT No.:
TECHNICIAN:
[ TEST HOLE3 }
KYLER AND KAMMY HOWLETT
A. HARALA
SLOP,
SITE PLAN
WAS GROUND WATER ENCOUNTERED? NO
IF YES ~ WHAT DEPTH? ~
E
DEPTH TO
DATE READING GROSS TIMf NET TIME WATER NET DROP
(MINUTES) (MINUTES) (INCHES) (INCHES)
TEST HOLE PRESOAKED PRIOR TO TESTING:
5/14 1 6:17 .75"
2 6:47 30 7.25" 6.50"
3 6:48 1.25"
4 7:18 30 7.50" 6.25"
5 7:19 1.00"
6 7:49 30 7.25" 6.25"
PERCOLATION RATE: 4.5.(MiN/iNCH) PERC. HOLE DIA. 6" (INCHES)
TEST RUN BETWEEN: 5.0 FT. and 6.0 FT.
COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST.
TEST PERFORMED BY ANDERSON ENGINEERING. l, MICHAEL E. ANDERSON CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE: 5/5/2012
MUNICIPALITY OF
o
Development Services Department
On -Site Water & Wastewater Section
Parcel I.D. 017-061-46
ANCHORAGE
Certificate of On -Site Systems Approval
1. GENERAL INFORMATION
Phone: 907-343-7904
Fax: 907-343-7997
Expiration Date:
Complete legal description MOUNTAIN PARK ESTATES BLOCK 2, LOT 11A
Location (site address) 6100 DE ARMOUN ROAD ANCHORAGE, AK 99516
Current property owner(s) NICHOLAS & ILAH PYSZ Day phone
Mailing address
Real estate agent
DE ARMOUN ROAD ANCHORAGE, AK 99516
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
Day phone
3. NUMBER OF BEDROOMS:
4
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Private Well
®
Private Septic
Water Storage
❑
Holding Tank
❑
Community Well
❑
Community
❑
Public Water System
❑
Public Sewer
❑
Waiver request for: Distance:
Received by: Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ 5ff D `l Waiver Fee $
Date of Payment 11 %6-l'- o Date of Payment
Receipt Number L3/5-/`? / Receipt Number
COSA # 65Can 16oq 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 FIRST WATER CONSULTING Phone 907-350-9566
Address 13030 SUES WAY, ANCHORAGE, AK 99516
Engineer's Printed Name CURTIS HUFFMAN, PE Date 1/14/2020
Comments: This investigation was completed in compliance with MOA guidelines, regulations,
and best industry practices / methods. The assessment of the condition of the well and septic M k
applies only to the conditions as of the day tested. The flow and absorption rates may change �,�
due to subsurface conditions that may not be observed from the surface, changes in land use,.r • • • • •
local soil characteristics, groundwater levels that may fluctuate during the year, quality of its" b • •
construction (workmanship & materials), the water usage of the family being served by the •�`
system and maintenance. The operational life of all well and septic systems are subject to �•• ••• ��
these various and dynamic characteristics and are outside the control of the evaluator of the *; _49 TM ;
well and septic system. Therefore, any estimate of how long a system will function satisfactory • • • • • • • • • • • • ••v�
for current or future occupants or guarantee that no unseen encroachments, deficiencies or
discrepancies exist can be given by First Water Consulting & F5 • • • • • • • • • • • • • • • • •
}
Curtis Huffman
6. DSD SIGNATURE �� Fc/ ••• sf CE 128991 .••�/
F�. • 1/14/2020•.\'
System #1 Approved for -1- bedrooms ,1,; pROFESS10Na��
System #2 Approved for bedrooms
Disapproved
Conditional approval for bedrooms, with the following stipulations:
0N_Si
v
ER AN
ZZ V1A.Q-rr-1.< PROO , AAA-
E�
J 1
SERV
B • X Original Certificate Date: r -Z. Z- Z OZ
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
Isle W-UMM3
Legal Description: MOUNTAIN PARK ESTATES BLOCK 2 LOT 11A Parcel ID: 017-061-46
If more than 1 septic system on lot: COSA Checklist # _of _ Structure served by this system
A. WELL DATA
® Well log is filed with Onsite (or attached)
Date drilled 5/27/2013
Total depth 298 ft
Cased to 298 ft
® Sanitary seal is functioning correctly
® Wires are properly protected
Casing height (above ground) 24+ in.
Date of flow test for COSA 1/13/2020
Static water level at beginning of test 253 ft.
Well production at time of test 4.3+ gpm
Comments
B. TANK DATA
Age of tank(s) 7 years
Tank type/material SEPTIC / STEEL
Measured operating fluid level in septic tank 49"
® Standpipes/foundation cleanout per record drawing
Date of pumping 1/13/2020
D. ABSORPTION FIELD DATA
Which system tested (date installed) 5/17/2013
® ALL standpipes present per record drawing
Total measured depth from grade 10.8 ft (max)
Measured depth to pipe invert from grade 6.7 ft (min)
❑ N/A — pressurized field
® Monitor tubes go to bottom of effective. If not, state
depth into effective
® Code -required soil cover over field
❑ System presoaked
(Required if vacant for greater than 30 days prior to
date of test)
Gallons introduced gallons
Comments/Deficiencies:
Water storage tank volume NA gallons
Well disinfected for coliform test? ❑ Yes ® No
® Coliform bacteria is Negative
Nitrate y Z2 mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L ® Arsenic less than MRL (ND)
Collected by Fw=cs
Date of Sample 1/10/2020
C. LIFT STATION
❑ Required maintenance completed
Age of lift station years
Lift station material
ROTA 171 TA- =1
Adequacy test date 1/13/2020
Results JZ Pass For 4 bedrooms
Fluid depth prior to test 20 in
Water added 640 gal
New depth 28 in
Elapsed time 1440 min
Final fluid depth 19.5 in
Absorption rate 600+ gpd
Any rejuvenation treatment (past 12 months) N
If yes, enter date
Fwts
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'
® Yes if No ft
Wells on Adjacent Lots:
Community Sewer Manhole/Cleanout > 100'
® Yes
if No
ft
® Yes
if No
Neighboring Tank > 100' ® Yes
if No
ft
Private Sewer/Septic Line > 25' ® Yes
if No
Absorption Field on Lot > 100' ® Yes
if No
ft
Holding Tank > 100' ® Yes
if No
Neighboring Absorption Fields > 100'
Surface Water > 100'
® Yes
Animal Containment > 50' ® Yes
if No
® Yes
if No
ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' ® Yes
if No
ft
® Yes
if No
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10' ❑ Yes if No *4.25 ft Surface Water > 100'
ft
ft
ft
ft
ft
® Yes if No ft
Property Line > 5'
® Yes if No ft
Wells on Adjacent Lots:
Absorption Field > 5'
® Yes if No ft
Private Wells > 100' ® Yes if No
Water Main > 10'
® Yes if No ft
Community Wells > 200' ® Yes if No _
Water Service Line > 10'
® 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'
® Yes
if No
ft
If absorption field is under driveway comment below
Property Line > 10'
® Yes
if No
_ ft
Wells on Adjacent Lots:
Water Main > 10'
® Yes
if No
ft
Private Wells > 100' ® Yes if No —ft
Water Service Line > 10'
® Yes
if No
ft
Community Wells > 200' ® Yes if No
Surface Water > 100'
® Yes
if No
ft
F. ENGINEER'S COMMENTS
*MOA 2013 WAIVER.
G. ENGINEER'S CERTIFICATION
l 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.
Aw
Q'•
..........•:'
Curtis Huffman /
b �°F•• CE 128991 •`��
��t®a °ROFESSI�NPAqw
ft
ft
GREENHOUSE
FROU Lar a
PLAT NO. 2013-20 4_
MOUNTAIN PARK ESTATES SUBDIVISION
LOT 11 A, BLOCK 2
65,325 S.F.
DeARMOUN ROAD
9
N 85.11'52"E
GASTALDI LAND
SURVEYING, LLC
JEFF A. GASTALDi, R.LS.
2000 E. DOWUNG RD., SUITE
ANCHORAGE, ALASKA 9950'
PHONE 248-5454
GRID DATE
SW2938 10/25/2013
JOB NO.
1 i_nC 1/DCT i 64
i
I HEREBY CERTIFY THAT I HAVE SURVEYED THE
PROPERTY DEPICTED ABOVE AND THAT NO
ENCROACHMENTS EXIST EXCEPT AS INDICATED.
TT IS THE RESPONSIBIUTY OF THE OWNER TO
DETERMINE THE EXISTENCE OF ANY EASEMENTS
COVENANTS OR RESTRICTIONS WHICH DO NOT
APPEAR ON THE RECORDED SUBDIVISION PLAT.
UNDER NO CIRCUMSTANCES SHOULD ANY DATA
HEREON BE USED FOR CON5,iR4(C7TMOR. FOR
ESTABUSHING SOUNDARY OR FENCE LINES.
ANCHORAGE RECORDING DISTRICT. ALASKA
NOTE. NO CORNERS SET THIS DATE.
The location of the slnjch.lrtrs}a:
shown on this record Ory sn
"" 't�Go s
By.
Date: T /
BUILDING DETAIL
SCALE: 1 "=20'
119=40'
BOAS�B
FAB
:''..•..., ..........81
a eflery b. Goslaidl � o` �
Ls -x091 ,1AV
A �P
