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Home My WebLink AboutDENALI VUE LT 1Denali Vue Lot 1 #051 -134-04 Municipality of Anchorage On-Site Water and Wastewater Program • (907) 343-7904 Page 1 of 3 ON-SITEJ WASTEWATER INSPECTION REPORT Permit Number: OS r I gl 2-7 I PID Number: 051-134-04 Dwelling: ❑■ Single Family(SF) [' Duplex (D) ❑ Multiple (SF and/or D) Project: ❑� New ❑ Upgrade Name: Michelle Myers ABSORPTION FIELD Address ❑ Deep Trench ❑■ Shallow Trench ❑ Bed ❑ Mound PO Box 671818 Chugiak AK 99567 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 1 1.2 GPD/SF 9.7 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot 5.7 Ft.4.0 Ft. Denali Vue 1 Fill added above original grade Gravel length Township Range Section 0 Ft. 25 Ft. Gravel width Beds:Number of Lines Distance between lines SEPARATION DISTANCES 5.0 Ft. Ft. To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist.between trenches From Tank Field Tank Line 200 Ft2 1 Ft. Well >150' >150' N/A N/A >25' TANK E Septic ❑S.T.E.P. ❑Holding ❑Other Manufacturer Capacity Surface Water >100' >100' N/A N/A Anchorage Tank 1000 Gal. Material Number of compartments Lot Line >10' >10' N/A N/A Steel 2 NA LIFT STATION Foundation >10' >10' N/A N/A Manufacturer Capacity Curtain Drain None Noted Gal. Pump on level at Pump off level at High water alarm at Remarks Septic was designed for one bedroom ADU U in. in. in. in barn at the north end of the lot. Pump make and model Electrical Inspections performed by PIPE MATERIAL House to tank D3034Tank to D3034 Installer drainfield MM&M Construction Drainfield D3034 CO/MT D3034 Inspector MEA BENCH MARK (Assumed elevation)100 ft Inspection g' - i 7 28-072ndLocation and description dates: 3rd 4th Top of foundation COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp Conditional Approval: Date /skit' ; .F4-100 * •4 1H 1\ I•*9 Benja chiller : ��/' • e •. CE 12592 •.4t/ Approv ti.--- (4LDate 0-2:3-g til\�\OFES 4'\ Inspection Report_9-1-12.doc DENALI VUE, LOT 1 . PERMIT # OSP181271 PID # 051-134-04 I • S) II A B C I z I LU FCO 19.8 20.4 SV1 37.1 13.1 i u SV2 39.4 16.3 I <C 2C0 40.3 19.5 I W MT1 23.8 19.7 ots w CO2 22.7 20.7 s I o6 I 0 I 0 1 w U I U WATER SERVICE 1 q I o I N © I 1 1 1-BDRM ADU 1 I I FCOI © A 1 I I I I1 I • 1 I 1.000-GAL TANK1 1 4 • SV1 M CO I • I • • SV2 1 •. i • TH1 I I • 2C0 WPF i • • • I • I •• •• I • 1 • • I I I • 25'LONG x 5'WIDE,4'EFFECTIVE .. DEPTH ABSORPTION TRENCH • .ALTERNATE SITE �G J\� GE '� e NGINEE4ING ��..N„I4 .•P�,OF.•gC... 14 LEGEND ar',.,. •�. CO CLEANOUT 2C0-DOUBLE CLEANOUT i• .tE 49th I.n 0 FCO-FOUNDATION CLEANOUT L •� — FS-FLOW SPLITTER VALVE 'i.,'a MICHAEL E. ANDERSON : 0 20 40 MH-MANHOLE ♦ • No. CE-4381 �_. MT-MONITORING TUBE vj`r�.:**** , Aug 22.2078 ,,."<#4 7 = ME = FEET ♦,�Fz pROFESS..�*�•• 1"=20' SV-SEPTIC VENT TH -TEST HOLE DENALI VUE LOT 1 PERMIT # OSP181271 PID # 051-134-04 O0 N 0 LUL wu) N — ,- 99.2 — — — 95.0 ^ _,_ 93.9 94.5 7#' 1000 GAL 94.4 SEPTIC TANK ,1 I '.... — 90.1 01— °2 _ 99.2 ORIGINAL GRADE - ` •.,:w.'• " — �•'T :; •' '•�..::•.`•a':• p 93.9 . . . . :r ,j,,,:—'.••:.• ';‘ . J }R'••. • .a., • • •Y• ;:'y1 . 4 a .f . •� •: � •.....;:tJ...1 .� •.%l.:419• .' ..1 .----'::....e:::::.; �••:. .,'r•.'.':tt'• : tel.:•i.--!: '1'. it*;•.•,••."2:.... 4.. •M,�,•L 'y4 .•.;. ;� {' 'f '.'S' : ; • , . .. �_. i.: , . i.. t, i,, ' . « 'DiAIP1FIE4DROCK•. X : . .; •'• • • • • 89.9 25' 111\ 85.2 _ NO GROUNDWATER 7/24/07 ...\_,.44 OF ,14 ++ w •r 49`h ��MICHAEL E. ANDERSON �j Ar ilio%%swim— em., PROFILE AS-BUILT '..;�;� . NoAE2oa381 ..• ..,c,..47 (NO SCALE) + Fp p•.• •••.: oggiiirgili ANDERSON ENGINEERING .•�P�E,oF•./ xi,s , P.O. Box 240773 Anchorage, AK 99524 ?r?••''� .1,`•�••i Phone: 907-3522-7773 Fax: 907-677-7766ter° 49th i` �� .-.t4. . SOILS LOG - PERCOLATION TEST 07,A;MICHAEL E. ANDERSON 1 Li ay J,%.. No. CE-4381 ''.�'� DENALI VUE LOT 1 •♦.•••PFD ... ...0.P\,� . LEGAL DESCRIPTION: MM&M CONTRACTING ,•4,,PfliaiSS 2..• PERFORMED FOR: DATE: 7/24/07 PROJECT No.: PARCEL ID#: TECHNICIAN: T. KIMBROUGH TEMP: 58° DEPTH TEST HOLE 1 Type of Test: ® Percolation ❑Visual (feet) 1 47././ OB/OG SLOPE SITE PLAN 2 3 li 4 GM/GW 5 — 6 : • GRAVEL W/SAND AND SILT o o 8 9 -' 10 L 11 <5% 12 '. =':." • :,"•'' • DEPTH To 13 DATE READING G( ISS TIME NET{M NOTESTIME ) WATER NNETCDROP (INCHES) 14 - • BOH 7/24/07 TEST HOLE PRESOAKED PRIOR TO TESTING: 15 1 8:13 .38" 16 2 8:43 30 8.88" 8.50" 3 8:44 .50" 17 4 9:14 30 9.00" 8.50" 18 5 9:15 .75" 19 6 9:45 30 9.25" 8.50" 20 PERCOLATION RATE:3.5 (MIN/INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN: 3.0 FT. and 4.0 FT. WAS GROUND WATER ENCOUNTERED`? NO IF YES @ WHAT DEPTHS DEPTH OF WATER AFTER MONITORING: DATE OF MONITORING: COMMENTS: No IMPERMEABLE LAYERS ENCOUNTERED. TEST HOLE PRE SOAKED PRIOR TO TEST. ADEC SIZING @ 1.2 GPD/SF OR 125 SQUARE FEET PER BEDROOM. 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: 8/15/2007 • ‘:••• • .. r sz Cn; -� o •r ?TH y•7"1/4\ ..°�} Municipality of Anchorage �•�•_ Department of Health&Human Services �,•. , d �' -7:3 •MICHAEL E. ANC'rr2LCN -'� 825 L Street,Anchorage,AK 99502-0650 +j,•. CF-4361 ;•`? SOILS LOG-PERCOLATION TEST ��ff •• � .: 4fi aPROFESS\90�9 Performed For. MM&M Contracting Date Performed: 7/130 61A:0 Legal Description: Tract 1.Scimitar Unit No. 3 SLOPE SITE PLAN OG/OL 1 3 TESTHOLE NO. 1 4 See Site Plan • Well Graded Sands 6 with Grave! 7 8 SW Was Groundwater 9 Encountered? No. S If Yes,What Depth? L 10 Depth to Water O After Monitoring None P 11 Date: 9/9/01 E 12 Reading f Date Gross Net Depth To Net !I Time Time Water Drop 13 1 12-Jul 12:15 1" 2 1225 10 10.5" 9.5" 14 3 12:26 1" 4 12:36 10 10.75" 9.75" 15 5 12:37 1" 6 12:47 10 10.75" 9.75" 16 17 Bottom of 18 Hole Perc.Rate: 1.03 Min./Inch Perc. Hole Diameter. 6" 21 Test Run Between 5.5 Ft. and 6.5 Ft. Comments: Perc Cavity Presoaked Prior to Test. Performed By: Mike Anderson. I, Michael E.Anderson Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date: 9/10/01 4j;' L 1 �" /..,/ , Municipality of Anchorage ® , . „•, Department of Health&Human Services 0 v.:.MiCHAE. E. ANDERSON 825 L Street,Anchorage,AK 99502-0650 �0 4'..-:.• CE CE-4381 ,,•�c tar SOILS LOG-PERCOLATION TEST g�,f`'c_•., .•'�� 4,4, 'CO. pROrESS10N'-00 Performed For. MM&M Contracting Date Performed: 7� evOaz%' Legal Description: Tract 1. Scimitar Unit No. 3 SLOPE SITE PLAN OG/OL 1 . 3 TESTHOLE NO.2 4 See Site Plan 5 Well Graded Sands 6 with Gravel 7 1 8 SW Was Groundwater 9 • Encountered? No S If Yes, What Depth? L 10 Depth to Water 0 After Monitoring None P 11 Date: 9/9/01 E 12 Reading Date Gross Net Depth To Net Time Time Water Drop 13 1 12-Jul 12:20 1" 2 12:30 10 Dry 10" 14 3 12:31 1" 4 12:41 10 Dry 10" 15 5 12:42 1" 6 12:52 10 Dry 10" 16 , Bottom of 17 Hole 18 Perc.Rate: 1 Min./Inch Perc. Hole Diameter. 6" 21 Test Run Between 4.5 Ft.and 5.5 FL Comments: Perc Cavity Presoaked Prior to Test Performed By: Mike Anderson I,Michael F.Anderson Certify That This Test Was Performed In Accordance With Alf State and Municipal Guidelines In Effect On This Date: 9/10/01 MUNICIPALITY OF ANC - 01 ' c iw, ,- Aff 'ii,1 4 :•:' . 1 I AUG 1 I=A6, Community Development Department , a e: '47-343-7904 Development Services Division Fa ,917-343-7997 On-Site Water & Wastewater Program 1,d w A // g� ON-SITE SEWER/WELL PERMIT APPLI t le, Parcel I.D. 051-134-04 Property owner(s) Michelle Myers Day phone 250-0732 Mailing address PO Box 671818, Chugiak, AK 99567 Site address 19630 Kullberg Circle Legal description (Sub'd., Block & Lot) Denali Vue Lot 1 Legal description (Township, Range & Section) Lot Size 117,074 Sq. Ft. Number of Bedrooms 1 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field ❑X Initial X Single Family (SF) X (w/wo AD U) Septic Tank ❑X Upgrade ❑ Duplex (D) ❑ Holding Tank ❑ Renewal Multiple Dwellings n Privy n (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: 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: 50 Waiver Fees: Date of Payment: gl/Zit3 Date of Payment: Receipt Number: 0,q557o D Receipt Number: Permit No. 63/9/7/9-9/ Waiver No. Permit App_ - ::.,c EASEMENT THIS EASEMENT AGREEMENT is made by and between ARLEEN E. MYERS, an individual, as the owner of the Servient Parcel (hereafter"Grantors"), whose address is 9153 Aphrodite Drive, Anchorage,AK 99515 and MICHELLE E. MYERS, an individual, as owner of the Dominant Parcel (hereafter"Grantee", whose address is P. O. Box 871069, Wasilla,AK 99623 1. The parties recite that: A. The Grantors own real property located at Lot 2 Denali Vue Subdivision, Chugiak,Alaska,and legally described as: Lot 2,DENALI VUE SUBDIVISION, according to Plat No.205-152,records of the Anchorage Recording District, Third Judicial District, State of Alaska. The Grantors property as so described is hereafter referred to as the"Servient Parcel." B. Grantees own real property in Chugiak, Alaska, located adjacent to the Grantors. Grantees adjacent property is legally described as: Lot 1, DENALI VUE SUBDIVISION, according to Plat No. 205-152,records of the Anchorage Recording District, Third Judicial District, State of Alaska. Grantees property as so described is hereafter referred to as the"Dominant Parcel." C. Grantees desires to obtain from the Grantors, and the Grantors desires to grant to the Grantees a water line easement on the Grantors property. NOW,THEREFORE, in consideration of the mutual promises made herein, and for other good and valuable consideration, the receipt and sufficiency of which is acknowledged, the parties agree as follows: 2. Grant of Water Line Area Easement on Serviant Parcel: The Grantors, hereby grant and convey to the Grantees, and to its successors and assigns, an easement in and on the Servient Parcel for a water line easement which is particularly described as: An area 20 feet wide and approximately 400 feet long as set forth and described on the attached Appendix 1 Description/sketch Site Plan, by Anderson Engineering. This water line easement shall be for the purposes of installing, repairing and maintaining a water line from the Class C well located on Lot 3 across Lot 2 to Lot 1 as noted on the attached description and site plan. This easement shall not in any manner be dedicated for,or subject to, use by the public. With the exception of the limitations described above. Grantor shall retain the right to use the water line easement area for any purpose, not otherwise prohibited by law or the covenants, conditions and restrictions applicable to the property, provided that no action by Grantor or use of the waterline easement area shall result in any obstruction being placed in this area that would prevent the Dominate Parcel from being able to repair, replace, maintain the water line servicing the Dominate Parcel. 3 Run With Land: The easements granted and created by this Agreement are intended to and shall run with the land, with the benefit of the easement appurtenant to the respective Dominant Parcel and the burden of the easement appurtenant to the respective Servient Parcel. 4. Duration of Easement: The easement granted and created by this Agreement shall be perpetual, except that this easement shall terminate if the Dominant Parcel is connected to a private or public water system bringing in water from other than the well on Lot 3 Denali Vue Subdivision. IN WITNESS WHEREOF, the parties have executed the Easement on the dates indicated below. ARLEEN E. MYERS. Dated: >-4 Arleen E. Myers /�v Owner, Servient Parcel MICHELLE E. MYERS l Dated: 8--R I- 1 b Miche'e E. Myers Owner Dominate Parcel STATE OF ALASKA ) ) ss THIRD JUDICIAL DISTRICT ) • The foregoing instrument was acknowledged before me this oZ k day of 2018, by Arleen E. Myers, owner of Lot 2 Denali Vue Subdivision. i 0111111////4 A, /G c ,�, � Notary Public i and for Alaska NOT �i i~ My Commission Expires: 1 o 'a-k ' 3�� I ARY PUBLIC.: STATE OF ALA -4' MAW ) ) ss THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this k day of , 2018, by Michelle E. Myers, Owner of Lot 1 Denali Vue Subdivision 011111110� � G) •�'gERLY � '' syr No Public,in and for Alaska ;'` Or . My Commis ion Expires: o iA ?w� AFTER RECORD * ,MYr P. chelle E.Myers.871069 11 Hi �i`'P 0.Box Wasilla,AK 99623 Municipality of Anchorage Page I of 3 Development Services Department On-Site Water and Wastewater Program 4700 South Bragaw Stree~ P.O. Box 196650 Anchorage, AK 99519-6650 www. ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SW010369 PID Number: 051-134-03 Name: MM&M Contracting, Inc. Wastewater System: New P.O. Box 670495 Chugiak, AK 99567 ABSORPTION FIELD ,.~,. 5' Wide Trench 688-1236 Soil Riling: Total Depth from odgifial grade: LEGAL DESCRIPTION 1.2 Gno~Ft' 7 p~. Block: Lot: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe: Tract 1 Scimitar No. 3 3 Ft. 4 FL Tm.vnship: Range; Seclien: Fill added above original grade; Gravel Length: 1-2 Pt. 38 pt. Grave] width: Number of lines: I Distance beh~en lines: Well: Municipal Water System 5 Ft. 1I F,. Classification (Private, A, B, C): Total Depth: Cased to: Total absorpddn area: Pipe Material; C 112 Ft. 112 p~. 380 pt2 ASTM 3034 PVC Ddller; Date Drilled: gafic Water Level: Installer: Date Installed: Sullivan WaterWells 5/97 75 pt. MM&M Contracting, Inc. 10114-15/2001 Yield:7 GriM IP"mgse~a':F,. I Caifing ggh,^~oveero.nd:2 Ft. TANK SEPARATION DISTANCES [] septic [] Holding [] S.T.E.P. [] Other: T~m~o Septic Absorptior Lift Holding ~ublicJPrivate n~anumcrurer: Gapac~ly~n,~allens: Tank Field Station Tank Sewer Line Anchorage Tank 1,000 wa/, >150' >150' NIA N/A >75' Steel Two (2) Sur~aceWat,,~ >100' >100' NIA N/A ~ J LIFT STATION -- NONE ON LOT Lot Line>51 >10' NIA N/A >5' >10' N/A NIA 'P.mp e.'~ew, a~: "Pump orr level at: I High water alarm al: Cudain Drain None Noted P.mp Make & Model Electrical Inepeclions performed by: ,e,,.rk~ BENCH MARK Finished Floor. 100.0 Ft. Engineer's Stamp Inspections per[ormed by: T.L. Kimbrouflh Dates: 1" 10/14/01 Department of Health and Human Services approval Reviewed and approved by: ff)./~_~ / /.,4.), /~./t~ Date: I-[g'-od, Permit No. SW010369 Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519~655 - 343-7904 On-Site Wastewater Disposal System or Well lnspecUon Report Page 2 of 3 PID No. 051-134-03 ^le S1 39.8 13.6 S2 31.4 14.16 C2 26.75 17.0 C3 25.9 17.75 C4 18.75 46.0 M1 19.83 48.83 TRACT 1, SCIMIITAR SUBDIVISION ADDITION NO. ,3 Class C Well WEST 2640.66 GLO S90°00'00"E 2648.51 N89°59'00"W 2640.66 BLM 33' Section Line Esmt 10'U PLAN AS-BUILT SCALE 1" = 60' Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On-Site Wastewater Disposal System or Well Inspection Report Permit No. SW010369 ~ ,/ ~/~ ~= / 98,31 97.69' p~c J ~--97,54 I I Page 3 of 3 PID No. 051-134~03 Geot:ex'l:l[e F~brlc Rock 92.60 100,47 96,97 PROFILE AS-BUILT Scale: 1" -- 20' MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-6650 SOILS LOG - PERCOLATION TEST DEPTH (feet) 1 2-- 3 4-- 5 6-- 7-- 8 9 LEGAL DESCRIPTION; TRACT I, SCIMITAR NO. 3 PERFORMED FOR: MM&M CONTRACTING DATF' IO/IZ+/2001 PROJECT No,: PARCEL ID#: TECHNICIAN: TEST HOLE # 3 ] OS/PT WELL GRADED SAND SOME GRAVEL sw WAS G*ROUlqD WATER ENCOUNTERED IF YES ~ WHAT DEPTH DEPTH OF WATER AFTER MONITORING DATE OF MONITORIBIG T.L. KIMBROUGH Type of Test: SLOPE No NONE ~ DRY 14 BOH 20 ~ MIgHAEL £, ANI]ERSl]N~t Professional Engineers Stamp: [] Percolation SITE PLAN SEE SITE PLAN 2% DATE READING GROSS TIME NET · MEI DV~/~TT~ROF INET 0ROF 10/I/+/01 TEST HOLE PRESOAKED PRIOR TO TESTING: I 12:20 11.0" 2 12:30 10 1.0" 10" 3 12:31 11.38" 4 12:41 10 1.38" 10" 5 12:42 10" { 6 12:52 10 Dry 10" PERCOLATION RATE: I (MIN/INCH) PERC. HOLE DIA. TEST RUN BETWEEN: 4.5 FT. and 5.5 FT. 6 _(1Nc~ms) COMMENTS: No IMPERMEABLE LAYERS ENCOUNTERED, 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 MUNICIPAL GUIDELINES 1N EFFECT ON THIS DATE: 12/30/05 ROM : COUNTRY REALTY PHONE NO. : 90?6881238 Oct. 02 2005 Oi:O1PM Pi OWNER OF LAND ADDRESS LEGAL DESCRIPTION~ DATE. Started PER.MiT NUMBER SULLIVAN WATER WELLS P.O, BOX 670~7~ CHUGfAK. ALASKA 96667 * TELEPHONE ~88-2759 DEPTH OF WELL /~// ~, STATIC LEVEL OF WATER FT. ~'/'~' KIND OF FORMATION: From Ft. to, Ft.. From ~ F,. ~o~'Z~ Ft. , F,4-J/) ~ C~,4, 1/ From. From /~- Fc to c~/Ft. C< ~ '7' .~ (~,~Jrcc From~F~. - Ft, to, FT. · ~ From~F~. F~o~ ~ ~, ,o~. ~ ~ 7¥ e 44 ~ From FL to Ft. ,, From From ~_Ft. to.~.~Ft. From ~r~m Ft. to Ft. From From.. Ft. to Ft. From ~:¥om Ft. to.__ Ft. From__ From ___ Ft. to , Ft. ' From From Ft. to Ft From _ __,Fi. to ,Ft. Ft. F~_ to__ Ft. FT. to Ft. · FL to , 'Ft.. Ft. to~___F~ F; tO__rFt. __ , Ft. to~F~. Ft. to FT. MISCL. I1VFORMATION: DRILLER'S NAME MEMORANDUM DATE: December 30, 2005 TO: Reviewer FROM: Mike Anderson, P.E. SUBJECT: Tract 1, Scimitar Subdivision Addition No. 3 Well and Septic System As-Built The house constructed on Tract 1, Scimitar Subdivision, Addition No. 3 was moved from its planned location due to a surveying error. In addition, the developer decided to install a Class C Well to allow for future development on the tract. The septic system was therefore moved to remain in close proximity with the new house and to provide a 150' separation distance from the well. It is unclear whether the design change was discussed with you prior to the change in the field. We have therefore paid the $115.00 fee to allow for an evaluation of the new location. Soil conditions encountered at the new location were identical to those encountered in Test Hole Nos. 1 and 2. Test Hole No. 3 was completed to verify soil conditions and is included for your review. We therefore revised the design to a 5' wide by 4' effective depth by 38' long trench to serve the three-bedroom home. The new location of the septic system does not conflict with other wells or septic systems in the area. Thank you for your assistance and please let me know if you have any questions. FROM : COUNTRY REALTY PHONE NO, : 9076881238 Dec, 29 2005 02:27PM P3 DEPT. OF ENVIRONMENTAL CONSERVATION DIVISION OF ENVIRONMENTAL HEALTH DRINI~NG WATER PROGRAM FRANK H. IOILIRKOWSKI, GOVERNOR 555 Cordova Anchorage, AK 9950l PHONE: (907) 269-7517 FAX: (907) 269-7650 ht~p ://v~vw.state. ak.u s/dee/ Arleen Myers M. M & M Contracting, Inc. P.O. Box 670495 Chugiak, Alaska 99567 October 1 I. 2005 Subject: Tri Scimitar, Class C Public Water System; Approval Process Dear Ms. Myers: On October 6, 2005 this office received your "Inventory and Source Registration F " erin for the Class C water system referenced above. This water system will serve no more than 24 people. Based on the information submitted, this system has been given approval to operate. Enclosed is a copy of the signed first page of the registration form. The PW'SID number assigned to this Class C public watsr system is 218745. Please ensure that this number is included on all drinking water analysis request forms that will be submitted to an approved water teSting facilities. This wil al ow the De artment tO re er ' · ' · .. P. p ply credit the Dep~rtment s file on the ex,sting public water system. This approval does not imply the granting of any additional authorizations, nor obligate any local, state, federal regulatory body to grant required authorizations. Any person who disagrees with this decision may request an ac~judicatory hearing in accordance with 18 ARC 15.195 - 18 AAC 15.340 or an informal review by the Division Director in accordance with 1 g AAC 15.185. Informal review requests must be delivered to the Division Director, 555 Cordova St., Anchorage, Alaska 99501, within I 5 days of the permit decision. Adjudicatory hearings request must be delivered to the Commissioner of the Department of Environnlental Conservation, 410 Wiloughby Avenue Suite 303. Juneau, Alaska 99801, with in 30 days of the permit decision. Ifa hearing is not requested wtthin 30 days, the fight to appeal is waived. Thank you for your cooperation on this project. If you have any questions, please contact me at 269-75 i 7 Enclosure: As Stated Cc: Jamie St~ze[, ADEC/EH/DW Pro,'am Sincerely, Environmental Technician II FROM : COUNTRY RERLTY PHONE NO. : 90?6881238 Dec. 29 2005 02:27PM P4 STATE OF ALASKA DEPARTMIgNT OF BNVIRONMKNTAL CONSBRVATION ~VE~ORY AND SOURCE ~GIST~TION ~O~ CLASS "C" PUBLIC WATER SYSTEM PUBLIC SVATER SYSTE~ NA~ ~D LOCATION: ~yst~ Name: ~ / . ~ ~/~//~-~ .. Legal Descrip~on of Prove~: ~ / N~be! o$ People S~wed Daily: ~ ~ Number og Se~ice Owner's N~e: .~./~ ~ ~~ ~ ~ ~( . ITEMS ~O~E~ ~OR ~-~x ifco~bi~. Prov~d~ wfi~ ~xpl~a~on itnot co~bt~. ~R~s~t~ otni~at~ ~d eolffom w~ter ~pl~s, ~di~ng ~os~ ~ont~s do not ~x~d ~ MCL s~t in ~AII ~o~ wat~ protection r~quimm~nt~ of 18 ~C 80.015 ~d on pa~ ~AI1 cross-colorlon r~uiremen~ oS 18 ~C 80.025 I~ted on page ~ · " OCl - PUBLIC W~TER SYST~ Ckcle Y~ or Yes WoH is ]o~t~d le~s ~ 50 horizon~l ~et ~ a s~ w~or so~e. ' .......................... Yes So~ ~es ~ infil~ation g~le~, spring, ra~ oa~t, ~ s~o ~ter. Yes So.ce r~'es ~ea~ent to meet rs~ired MCL'a set in 18 ~C 80.300. If ~swer is "Yes" to ~y of ~e above, ~on water ~sa~ent ~st be provided md ~e ke~ on page 5 ~der PUBLIC WATE~ SYSTEM SO~KCE T~ATM~ must be ad~osscd. If a~ ~wers are "No" con~ue ~ ~e 4. For Dopa~ent Uso Only ~C APPROVe: ~b ~a~r s~s~ b hereb~ gran~d Department approv~ to opera~. The follow~g pubic water sys~m identl~afion ~u~ber (PW$ID) ~ assigned to ~ts pubic water sys~m: ~itle) ~ (Date) ,.~age 3 of 6 (~ 3/02) August 5, 2002 Municipality of Anchorage George P; Wuerch, Mayor Building Safety Division P.O. Box 196650 · 4700 S, Bragaw Str~eet Anchorage, Alaska 99519-6650 ° (907) 343-8301 http://~x~v.ci.anchorage.ak.us MM&M Construction PO Box 670495 Chugiak AK 99567 Subject: On-Site Water and/or Wastewater Permit. Permit Number: SW010369 Dear MM&M Construction: An On-Site Water/Wastewater Pemfit, number SW010369, issued by this office for a single-family system, will expire on September 13, 2002. This permit was valid for 365 calendar days. If this was a well permit and the well has been drilled, a well log must be sent to this office for documentation of the installation and to close the permit. If this permit was for a wastewater disposal system, an original as-built inspection report must be sent to this office for review, approval and documentation. This as-built inspection report must be signed by the licensed Professional Engineer who inspected the installation of the system. As-built inspection reports are required to be submitted within 30 days of the completion of the system. If no system was installed under this permit, and you are still planning to install a well or wastewater disposal system, a new permit must be obtained from this office. A new permit for a second year may be issued for a fee orS100.00 if the renewal application is received on or before the expiration date of the original permit. When applying for a new permit, the fees are: $400.00 for a wastewater permit and $150.00 for a well permit. If you have any questions, please cai1 this office at 343-7904. Manager On-Site Water and Wastewater Program Enc: Copy of permit MUNICIPALITY OF ANCHORAGE Development Services Deparlmenf On-Site Water & Wasfewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT Initial Date Issue~d: Sep 13, 2001 Expiration Date: Sep 13, 2002 Permit Number: SW010369 Design Engineer: 0014 Anderson Engineering Owner Name: MM&M Construction Owner Address: PO Box 670495 CHUGIAK , AK 99567-0000 ParcellD: 051-134-03 Site Address: Lot Size: 1632193 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: [] Disposal Field [] Septic Tank [] 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 DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 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. ate: 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 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 051-134-03 Permit Number SWO I O~6q Property owner(s) MM&M Construction Mailing address (1) P.O. Box 670495 Chufliak, AK 99567 Mailing address (2) Zip Code Legal description (Lot, Block & Sub'd.) Tract 1, Scimitar Subdivision Unit No. 3 Legal description (Section, Township & Range) Lot Size 49.47 Acres. Acres/~5~ Number of Bedrooms Three Day phone 688-1236 THIS APPLICATION IS FOR: Sewer Only Sewer and Well Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub Swimming Pool Therapy Pool [] Well Only [] [] Water Storage [] [] Jacuzzi [] [] Water Softening Unit [] I certify that the above information is correct. I further certify that this application is being madefor a Single Family Dwelling a/.~ is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit Fees:'~ ~ .ese,pt.umber= (Rev. 12/00) Waiver Fees: Date of Payment: Receipt Number: September 10, 2001 Municipality. of.Anchorage ........................ Development Services Department On-Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Tract I, Scimitar Subdivision Unit No. 3 Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Tract I, Scimitar Subdivision Unit No. 3 intends to construct a three- bedroom home on the property. We are therefore requesting a permit be issued for the construction of a new septic system to serve the new home. The attached Site Plan and backup documentation identify the location and configuration of the new septic system and the parameters used in the design. Also identified on the plans is the location of the existing well on the lot and the test hole locations. Existing drainage patterns are shown and will not be altered by the development of the lot. The tract is more than 37.4 Acres in area and no conflicts are noted between wells and septic systems in the area. Two test holes were placed near the location of the new absorption trench. These holes indicated well graded sand with some gravel and a minor amount of silt. Percolation tests in the matedal resulted in rates between 1 and 5 minutes per inch. No groundwater was found during placement of the test holes, and none was noted during the monitoring pedod. We are therefore proposing to place a deep absorption trench system with 6' of gravel beneath the distribution pipe. The total depth of the trench will be 9'. The distribution pipe will be placed at 3' below the ground surface. The ground surface on the lot slopes as shown on the attached Site Plan with only shallow slopes near the proposed septic system site. The new absorption trench will be constructed on a fairly fiat surface in conformance with Municipal requirements and parallel to ground contours where possible. 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. 2. 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. · Tra~t I, Scimitar Subdivision No. 3 September 10, 2001 Page Two 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. TRACT 1 SCIMITAR UNIT NO. 3 Existing Well Three Lot Line Wide X De~th Abs. Trench 850'+ T0~o--~t Site TIt1 ~- VACANT NO~E.: See Area Map For House Location on Tract. TRACT 1, SCIMITAR SUBDIVISION UNIT NO. 3 DESIGN FACTORS: SYSTEM REQUIREMENTS: Three Bedroom Home Perc. Rate: 1 Min./Inch Avg. Application Rate: 1.2 GPD/SF Deep Trench System 1,000 Gallon Septic Tank 6' Drain Field Rock 3 Bedrooms X 150 GPD / 1.2 GPD/SF = 375 SF of Absorption Area 375 SFI12 SFILF -- 32 LF Trench Length Therefore: Construct An Absorption Trench 32' in Length by 3' Wide With 6' of Drainfield Rock Beneath the Distribution Lateral. Distribution Lateral to Be Placed 3' Below Existing Ground. Total Depth of Trench to Be 9' from Existing Surface. - Mound Over Trench if Necessary to Provide Minimum Cover of 3'. NOTE: Minimum 10' Separation From Lot Line. Minimum 4' Separation From Groundwater· Minimum 100' Separation From Well on Lot. TYPICAL DEEP TRENCH SECTION (NO SCALE) Grade Area Over Trench to Drain Away. Minimum 6' Separation From Bedrock. Municipali~ of Anchorage ~ Depa~ent of Health & Human Se~ices ~ ~ ~lC~,~L ~ ~E~SON 825 L Street, Anchorage, AK 99502~650 ~. ~ .. CE- 4381 .. Pe~o~ed For: ~&~ OonJ~ing DsJe Pe~o~ed: Legal Deso~pJion: T~c~ 1. Scimi~sr Unit No. 3 OG/OL TESTHOLE NO. 2 Well Graded Sands with Gravel SLOPE SITE PLAN See Site Plan 1 11 12 13 14 15 16 17 18 21 SW Was Groundwater Encountered? No If Yes, What Depth? Depth to Water After Monitoring None Date: 9/9101 Bottom of Hole Reading Date Gross Net Depth To Net Time Time Water [:)rap 1 12-Jul 12:20 1" 2 12:30 10 D~ 10" 3 12:31 1" 4 12:41 10 D~ 10" 5 12:42 1" 6 12:52 10 Dry 10" Peru. Rate: 1 Min./inch Peru. Hole Diameter: 6" Test Run Between 4.5 Ft. and 5.5 Ft. Comments: Peru Cavity Presoaked Prior toTest. Performed By: Mike Andemon. l, ' n Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date: 9110/01 Municipality of Anchorag~ Department of Health & Human Services 825 L Street, Anchorage, AK 99502-0650 SOILS LOG - PERCOLATION TEST Performed For: MM&M Contracting Legal Description: Tract 1. Scimitar Unit No. 3 3 4 7 TESTHOLE NO. 1 OG/OL Well Graded Sands with Gravel SLOPE SiTE PLAN See Site Plan 8 9 10 11 SW Was Groundwater Encountered? No' If Yes, What Depth? Depth to Water After Monitoring None Date: 919/01 S L O P E 12 13 14 15 16 17 Bottom of Hole Reading Date Gross Net Depth To Net Time Time Water Drop 1 12-Jul 12:15 1" 2 12:25 10 10.5" 9.5" 3 12:26 1" 4 12:36 10 10,75" 9.75" 5 12:37 1" 6 12:47 10 10.75" 9.75" 21 Peru. Rate: 1.03 Min./Inch Perc. Hole Diameter: 6" Test Run Between 5.5 Ft. and 6.5 Ft. Comments: Perc Cavity Presoaked Pdor to Test. Performed By: Mike Anderson. I, i h er on Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date: 9/10/01 5 / / / /6 GLO 264B.51 (72--188) I I 2J / 2 (~R) ¸J - J T#A£T I N~: No Conflicts with ~rounding Wells or Septic Systems. -I AREA MAP 1" = 100' Rick Mystrom, Mayor Municipality of Anchorage Department of Health and Human Services 825 "L" Street P,O, Box 196650 Anchorage, Alaska 99519-6650 http://www.ci.anchorage.ak.us 343-4744 September 18, 1998 Skyline View Corp PO Box 670351 Chugiak, Alaska 99567 0351 Subject: Tract 1 Scimitar Subdivision #3 Permit #SW970325, PID #051-134-03 The subject permit, issued September 19, 1997 by this office for a single family well and/or on-site wastewater system, has expired as of September 19, 1998. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. If you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If a licensed Professional Engineer has inspected the installation of the on-site wastewater system, the original as-built inspection report must be sent to this office for review, approval and documentation. Ail inspection reports must be submitted within 30 days of construction completion. When applying for a new permit, the fees are: $320.00 for an on-site wastewater permit; $120.00 for a well permit and $440.00 for a combined on-site wastewater and well permit. If you have any questions, please call this office at 343-4744. P~og .ram _Maria ~ger On-site Services enc: Copy of Permit PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL SYSTEM PERMIT PERMIT NUMBER:SW970325 DESIGN ENGINEER: OWNER NAME:MM&M CONTRACTING OWNER ADDRESS:P.O. BOX 670495 CHUGIAK, ALASKA 99567 DATE ISSUED: 9/19/97 EXPIRATION DATE: 9/19/98 PARCEL ID:05113403 LEGAL DESCRIPTION: SCIMITAR ~.TR~ LOT SIZE: FT.) NUMBER OF BEDROOMS: 0 THIS PERMIT: THIS PERMIT IS FOR THE CONSTRUCTION OF: WELL SYSTEM 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) kND DRINKING WATER REGULATIONS (18AAC80). 3, THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: TEST WELLS / .o % % ii BLOCK DHI CONSULTING* ENGINEERS CI~L · SURVE~G · Telephone: (907)~-3 ~85 Fox: DENALI VIEW SUBDMSION AQUIFER TEST PUMPING. & WELL LOCATIONS #.0. 96298 COMP. rILE 298CTD2D SCALE1"----300' DATE 6--5--97 ~ ~J'c~ 9UlO± I TO',::J £8£T PP£ .~06 DNI±]nSNO IH ~] N~gS:TO ~66T-ST-60 FROM : MMM CONTRACTING PHONE NO. : 6881238 S~p. 24 1998 10:01AM Pi SULLIVAN W ............... P,O, BOX 670~?~, C~HUOIAK, ALASKA 9956? · TELEPHONE ADDRESS LEGAL DESCRIPTION .~'C~*~ / 7'~/~ PERMIT NUMBER~ Date of Issue TAX INDENTIFICATION NUMBER Is well located at approved permit location? JZ~ [~ No Method of Drilling: t~"'mta~ I~l cable tool Depth .of Well'. ~L P O Casing Type _~Wall Thickness '.u~ inches Diameter ~'~ /' nchea, depth ,,,~ ~ feet Casing Stickup Above Ground: ~ feet Static Water Level (from ground level); ~ feet Pumping, level:,,, feet after. 'hr$, pumping _._ gpm Recover Rate: ~ gpm Method of Testing: .~! ~, ., Well Intake Opening Type; [~1 Open End I~ Open Hole Screened; Start ~J~erforatlons Start feet Stopped feet feet Stopped ~ o~,. feet Volume _~ feet, to ....... feet feet Brand Name Depth: fp0m 0 Pump Intake Depth: _. pump Size hp Well Disinfected Upon Completion? 4~'~es [] No BORE HOLG DATA DEPTH Driller's Name ATTENTION: It is the responsibility of the property owner to eubml~ a copy of the well 10g to the proper a~thorlty. Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation, MatSu Borough: Department of Environmental Conservatiort, PAGE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND NUM3tN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL SYSTEM PERMIT PERMIT NUMBER~~~ OWNER NAM~T~t~i~:~'~.I~RED ~ I OWNER ADDRESS:P.O. BOX 670351 CHUGIAK, ALASKA 99567 DATE ISSUED: 5/12/97 EXPIRATION DATE: PARCEL ID:05113403 LEGAL DESCRIPTION: LOT SIZE: 0 (SQ. FT.) NUMBER OF BEDROOMS: 0 THIS PERMIT: 0 THIS PERMIT IS FOR THE CONSTRUCTION OF: WELL SYSTEM 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 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. 1 OF 5/12/98 RECEIVED DATE: ISSUED BY: DATE: M~¥~06-1997 10~ 1~ LOT 7" 5.48 S=29.'J4:~ . -' ' ..... ..L*=3459 .' ...... BRISTOL ENVIRONMENTAL ] ............ 5.17. AC~ ' ' ' . " $,c41.74X .._ ' L=4691 ' '; ." ;"--"" ."'l..' .' , ' .......... -- ..... k.-'- · . .... ' 1.04' LOT ; 1 3.15 AC. ................ L.=..t625 ~-L=98.36' " ......... ..'" =08'13'38' / mL~'8*~.O'4' ·: .... T=49.26'. .......... ' ~ A-17'.00'00" .... . ".R=685.00' , T~43,34~-- LC=98.28o ,/'" ~._L=225.98. A =1727"2~ LOT 16 .T=114.~7" /. LC=226,10' · - ..15'7.25 LOT 15 :' ""/ ' LOT S 1.20 AC, .,,'"" L=206 P. 134 ?'"'~ 1020 60 LOT I LOT 10 1.37. AC: '$=19.g1~ L=393 ',. LOT 14 LOT 23 ~ '1~ TOTAL P. $4 ...... ~OT ~. S ~"20l. 08 ~l ~ '*~,~.,. L=75 ! 230.00* /. '.. :' ...... : ............ l ' Il~ .17 AC. "I ..... .' ' ' S=41.74~ L=4691 • • cos- C• Q`' • Municipality of Anchorage • On-Site Water and Wastewater Program 1.,jJ' (907) 343-7904 $A ETY Certificate of On-Site Systems Approval Parcel I.D. 051-134-04 Expiration Date: ( ").3 ig 1. GENERAL INFORMATION Complete legal description Denali Vue, Lot 1 Location (site address) 19630 Kullberg Circle Chugiak, AK 99567 Current Property owner(s) Michelle Myers Day phone Mailing address P.O. Box 671818 Chugiak, AK 99567 Real Estate Agent Day phone 2. TYPE OF DWELLING: 0 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 0 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received by: — -� Date: 0)31i COSA to be released to the engin ,unless otherwise requested by the engineer. COSA Fee $ f Waiver Fee $ Date of Payment 7—3b '1a Date of Payment Receipt Number 02.061 lb Receipt Number COSA# OSC t8 131 to 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 Forge Engineering Phone 522-7773 Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Benjamin Schiller, P.E. Date 7/30/18 "tr Al‘‘ *: 49i 1\ •* 6. DSD SIGNATURE • System #1 Approved for l bedrooms � Benja chiller j c's ••. CE 12592 •• `47;_„4/ System#2 Approved for bedrooms to sl4. 7/30/18 •Ig' Disapproved �e``t= Conditional approval for bedrooms, with the following stipulations: • • ON-SITE 1;_ WATER AND n 3 WASTEWATER c PROGRAM `l r By: Original Certificate Date: S 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. ` _1 • 7. ATTACHMENTS: L t,�r: COSA Checklist X Nitrate Advisory. Septic System Advisory Arsenic Adviso?yl Well Flow Advisory Other COSA blue sheet S '• .. c If more than 1 septic system is on the lot: COSA Checklist# l of 2.- Structure Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: Denali Vue, Lot 1 Parcel ID: 051-134-04 A. WELL DATA Well type C/Private If A, B, or C provide PWSID# 215745 Well Log (Y/N) Y Date completed May 1997 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 111.5 ftCased to 1 1 1 .5 ft Casing height (above ground) 48 in. FROM WELL LOG AT INSPECTION Date of test May 1997 7/27/18 Static water level 75 ft. 74.7 ft. Well production 7 g.p.m. 4.4 g.p.m. WATER SAMPLE RESULTS: Coliform Neg colonies/100 mL Nitrate 2.44 mg/L Arsenic ND ug/L Date of sample: 7/23/18 Collected by: Forge Engineering B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 10/14/01 Tank size 1 000 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping 4/11/17Pumper JRs Pumping C. ABSORPTION FIELD DATA Date installed 10/15/01 Soil rating (g.p.d./ft2 or ft2/bdrm) 1.2 GPD/SF System type 5' Wide Length 38 ft. Width 5 ft. Gravel below pipe 4 ft. Total depth 8-9 ft. Eff. absorption area 380 ft2 Monitoring tube Y Depression over field N Date of adequacy test 6/5/17 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 450 gal. New depth 0 in. Elapsed Time: 1440 min. Final fluid depth 0 in. Absorption rate >= 450 g p d None Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes. give date D. LIFT STATION 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 100' On adjacent lots 100' Absorption field on lot 100' On adjacent lots 100' Public sewer main >75' Public sewer manhole/cleanout >100' Sewer/septic service line >25' Holding tank >75' Animal containment areas >50' Manure/animal excrete storage areas 100' SEPTIC/HOLDING TANK ON LOT TO: >5'Building foundation Property line >5 Absorption field >5 Water main Water10' service line >10' Surface water >100' Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO: Property line 1 Building foundation 10 Water main >10 Water Service line Surface water 100>10' Driveway, parking/vehicle storage >10' Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS G. ENGINEER'S CERTIFICATION ��i\\Nc tv I certify that I have determined through field inspections andtQ � review of Municipal records that the above systems are in �,P'•.• 4 conformance with MOA COSH guidelines in effect on this date. %0 .• •• '•9 �� Engineer's Printed Name Benjamin Schiller, P.E. •O �i=' ; Date 8/2 8 /� Benja• chiller• ' . • 1O l .• CE 12592 •c((470.4:9;� d'f•.•:8/21/18 .•' i l Iw-PROFESSl4Nt COSA brown sheet 10-10-12.doc If more than 1 septic system is on the lot: COSA Checklist# 2- of Z- Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: *Denali Vue Lot 1 (Barn Septic) Parcel ID: 051-134-04 A. WELL DATA Well type C/Private If A, B. or C provide PWSID# 21 8745 Well Log (Y/N) Y Date completed May 1997 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 111.5 ft. Cased to 1 11 .5 ft. Casing height (above ground) 48 in. FROM WELL LOG AT INSPECTION Date of test May 1997 7/27/18 Static water level 75 ft. 74.7 ft. Well production 7 g.p.m. 4'4 g.p.m. WATER SAMPLE RESULTS: Coliform Neg colonies/100 mL Nitrate 2.44 mg/L Arsenic ND ug/L Date of sample: 7/23/18 Collected by: Forge Engineering B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 7/24/07 Tank size 1 ,000 gal. Number of Compartments 2 Cleanouts (Y/N) _ Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping 7/17/18 Pumper JRs Septic C. ABSORPTION FIELD DATA Date installed 7/24/07 Soil rating (g.p.d./ft2 or ft2/bdrm) 150 SFIBDRM System type 5' Wide Length 25 ft. Width 5 ft. Gravel below pipe 4 ft. Total depth 9 7 ft. Eff. absorption area 250 ft2 Monitoring tube Y Depression over field N Date of adequacy test $/10/1$ Results (Pass/Fail) Pass For 1 bedrooms Fluid depth in absorption field before test 0 in. Water added 735 gal. New depth 0 in. Elapsed Time: 1 ,440 min. Final fluid depth 0 in. Absorption rate >= 600 g p d Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION 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 >1 00' On adjacent lots >100' Absorption field on lot >100' On adjacent lots >100' Public sewer main >75' Public sewer manhole/cleanout 100' Sewer/septic service line >25' Holding tank >75' Animal containment areas >50' Manure/animal excrete storage areas >100' SEPTIC/HOLDING TANK ON LOT TO: Building foundation Property line >5 Absorption field >5 >100' Water main 10 Water service line 10 Surface water Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO: >10' Property line >10 Building foundation >10 Water main Water Service line 10 Surface water 100 Driveway, parking/vehicle storage Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS *Additional barn septic designed for 150 GPD, tested with 735 gallons of water. G. ENGINEER'S CERTIFICATION _�-....��XA\\ I certify that I have determined through field inspections and ��P„' ..I:, f 4� review of Municipal records that the above systems are in o) . `4� .9 #j conformance with MOA COSA guidelines in effect on this date. %*:'49 lli �\ ••*9/ Engineer's Printed Name Benjamin Schiller, PE V'"" 'kw-. • 8/21/18 0 ...r: .. . . .. .. . . Date 4 . Benja chiller . / f+ yam. CE 12592 'kA �4C�J'l. 8/21/18 ci 1`l;PROFESS\O' W\\\\ COSA brown sheet 10-10-12.doc PLAT NO. 2005-152 DENALI VUE SUBDIVISION LOT 1 117,074 S.F. ,o. ).•4) ,S‘ e, C °it/1- LOT 8 12506 /..>> o'o x>ets, •F, 9F OV 0,,. nl ' '76‘6.!O tiT / N 02 0.9 Sia `0j .> 04) i \ / nt \ LOT 113 r / LOT 7 I go \ \ 1 1 1 1r 1 co I 1 I 111 1 I 1 p I I ! o I I I • I I I W q) I I N 1 / •• (.0 v I I st / (.3 Q M I I I N i I o�c� / N I G 74.0.1 N r n vii I 2 I lE�U — La inLa I w I a0 _PSN G� / La 1 I p_ z"a 47.r I , o I N I. z `v I • k. I •• / v. ) SEPTIC SYSTEM 1 = 50' R¢So.Oo / / ?p.ORa y6 414C / ,, SMTa')(,o / -, \ �A.0 \ 38 O, / ' o / \ Qom. iv v ' U o° G ) N57 M ,.) N / ,:..., O� �ry 30 ti` a' 2 '� ,.' ry� Q' , ' ' Q v co p ,.„. V Jv r } -i' riiiiiiiaS. o /#/ O Lc, I it I k ( I 1 vy x FENCE (APX) LSHED O0 Off" X�—X- O n CO 0 w I 300.o a s K) 33' SECTION LINE ESMT. o T20' T. & E. ESMT. z — .7 — BUILDING DETAIL 12' TRAIL ESMT.— 10' UTIL. ESMT. 30.7 •* • S 89°59'56"E 184.04' SCALE: 1"=20' NOTE: PROPERTY IS SERVED BY A WELL ON LOT 3. AS —B U I L T I HEREBY CERTIFY THAT I HAVE SURVEYED THE PROPERTY DEPICTED ABOVE AND THAT NO ,�� 114,, GASTALDI LAND ENCROACHMENTS EXIST EXCEPT AS INDICATED. . • ....•OFA• A� .. SURVEYING, LLC IT IS THE RESPONSIBILITY OF THE OWNER TO ,Q-..•• ' '••.S .. JEFF A. GASTALDI. R.L.S. DETERMINE THE EXISTENCE OF ANY EASEMENTS. • • 49TH i� •••:?.* • 2000 E. DOWLING RD.. SUITE 8 COVENANTS OR RESTRICTIONS WHICH DO NOT ANCHORAGE, ALASKA 99507 APPEAR ON THE RECORDED SUBDIVISION PLAT. - 41 0 PHONE 248-5454 UNDER NO CIRCUMSTANCES SHOULD ANY DATA ,0 • Jeffery A. Gostaldi • HEREON BE USED FOR CONSTRUCTION OR FOR f-6f91 ••: Q. GRID QATE ESTABLISHING BOUNDARY OR FENCE LINES. �• -e'a7 ••• °,; NW1261 6/19/2017 ANCHORAGE RECORDING DISTRICT, ALASKA •�$ �essiono'°' 4� F•B• JOB NO. �,, NOTE: NO CORNERS SET THIS DATE DENALI 1 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. ~51-13~03 1. GENERAL INFORMATION Expiration Date: Complete legal description Tract 1, Scimitar,Subdivision, Addition No. 3 Location (site address or directions) Kullberg Road Current Property owner(s). MM&M Contracting Mailing address P.O. Box 670495 Chufllak, AK 99567 Lending agency Mailing address Day phone 688-1236 Day phone Real Estate Agent Mailing Address Day phone Unless othenvise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: Three {3) 3. TYPE OF WATER SUPPLY: Individual Well Individual Water stOrage Community Class C Well Public Water System TYPE OF WASTEWATER DISPOSAL: [] Individual On-site [] [] 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 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 less than 30 days old. (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. Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Westewater 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 Tract 1. Scimitar Subdivision No. 3 Legal Description: A. WELL DATA Well type Class C Date completed 5/t011997 Total depth 112 ff. Data of test Static water level Well production WATER SAMPLE RESULTS: Coliform 0 colonies/100 mi. Date of sample: 8125/2005 B. SEPTIC/HOLDING TANK DATA Tank Type/Material SeptictSteel Tank size 1,000 gal. Foundation cleanout (Y/N) _Y Date of pumping C. ABSORPTION FIELD DATA If A, B, or C provide PWSID # 218745 Sanitary seal (Y/N) _Y Cased to 112 ff. FROM WELL LOG 5fl011097 75 ft. g.p.rn. Nitrate 1.44 mg.ll. Collected by: TLK Number of Compartments _2 Depression over tank (Y/N) N Pumper New Construction Date installed q"q-OI Length 38 ff. Total depth 8-10 f. Date of adequacy test Soil rating (g.p.d./fi= or ~lbdrm) 1.2 6PDIEF Width 5 ff. Parcel ID: 051-134-03 in. Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) 24 AT INSPECTION g.p.m. Other bacteria 0 colonies/100ml. Date installed t0114/200t Cleanouts (Y/N) Y High water alarm (Y/N) N System type 5' Wide Trench Gravel below pipe- ~ - J-~ f. Eft. absorption area 380 ~ Monitoring tube Y Depression over field N Results (Pass/Fail) For bedrooms Fluid depth in absorption field before test__ in. Water added gal. Elapsed Time:__ min. Final fluid depth in. Absorption rate >= Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date New depth in. g,p.d. D. LIFT STATION Date installed "Pump on" level at __ in. Datum E. SEPARATION DISTANCES Size in gallons "Pump off" level at__ in. Cycles tested SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tanldlift station on lot >150 Absorption field on lot >t50 Public sewer main. N/A Sewer/septic service line >75 Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? On adjacent lots >150 On adjacent lots >150 Public sewer manhole/cleanout NIA Holding tank NIA SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Property line >5' Water service line >10' Building foundation >fi' Water main N/A Wells on adjacent lots >150' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation >10' Surface water >tfi0' Wells on adjacent lots >t50' Absorption field >5' Surface water >100' Water main >10' D~iveway, parking/vehicle storage Property line >10' Water Service line >10' Curtain drain Nons Noted F. COMMENTS Pro~edv Served by Class C Well, G. ENGINEER'S CERTIFICATION Ice. rfify that I have determined through 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 Pdnted Name Michael E. Andemon. P.E. Date t2/3012005 HAAFee $ 5-?..5.0- 4- //$~ --,~x.. ~-,~*L--,,J WaiverFee$ Date of Payment /2- -.~o- ~ Date of Payment Receipt Number ~_~1.~'"~ .~::h~ Receipt Number (Rev. 12/00 . in. FROM : COUNTRY REALTY PHONE NO. : 90?G881238 Oct. 02 2005 01:02PM P2 Z Sullins I~dve __ Street ........ I