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EAGLE RIVER VALLEY RANCHETTES LT 25B
Eagle River Vail Y Ranchettes Lot 25B #050- 223-18 Municipality of Anchorage On-Site Water and Wastewater Program • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP181235 PID Number: 050-223-18 Dwelling: ® Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New ® Upgrade Name: THOMAS R SCOTT ABSORPTION FIELD - EXISTING Address ❑ Deep Trench ❑ Shallow Trench ❑ Bed E Mound 18632 TWENTY GRAND ROAD, EAGLE RIVER ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 -- GPD/SF -- Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot -- Ft. -- Ft. Eagle River Valley Ranchettes 25B Fill added above original grade Gravel length Township Range Section -- Ft. -- Ft. Gravel width Beds: Number of Lines Distance between lines SEPARATION DISTANCES -- Ft. Ft. ToSeptic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line -- Ft2 -- Ft. Well 200'+ -- -- -- 25+ TANK ® Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Capacity Surface Water 100'+ -- -- -- ANCHORAGE TANK 1000 Gal. Material Number of compartments Lot Line 5'+ -- -- -- STEEL 2 NA LIFT STATION Foundation 10'+ -- -- -- Manufacturer Capacity Curtain Drain NA l -- NA -- Gal. Remarks Existing septic tank decommissioned per code, Pump on level at Pump off level at High water alarm at new tank installed, insulated & reconnected to existing in. in. in., crib/trench. New MT& COs installed in existing trench. Pump make and model Electrical Inspections performed by PIPE MATERIAL House to tank D3034 Tank to D3034 Installer Northern Excavation drainfield Drainfield -- CO/MT D3034 Inspector Mike N. Anderson / First Water Cons. Serv. BENCH MARK (Assumed elevation) 100 ft Inspection 9/10/2018 2�a 9/11/2018 Location and description 3'° 4th Bottom of Siding COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL ,-,,,7,---t-_ :‘..•40,,,,,,,,, �. .. Or A`;441,, 1 7 Conditional Approval: Date ,.'%'''`�':•' .4:..7./1••o i a� ;... /�.S•S . . — _ / • t4 •. MICHAEL N. ASN DERSON ..Z.44: (' •, CE 9469f ul- / i // •". ''�° Approve. t... — ,/ Date 1 3--E t�, 4 z••'';'•°,,s-`'-= Inspection Report ST copy 4.doc Permit No. OSP181235 Page: 2 of 2 Municipatity of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description: EAGLE RIVER VALLEY RANCHETTES LOT 25B PID No.: 050-223-18 0 0 (Y) M x x S 8959'15" E 133.0 is! °. a C>$�f34it''. C . Q '.l x ' deck .::, '..; /2.0 OH 20.5 32.0 A -L-1.-P5-..67= --- o :., o garage a0 N x 47.5 ' .\ 32.0 OO 16 0 3—BR HOUSE Lri ro x N gig A 68.0 m BI �crawlspace entry • deck 11 FCO x x ►t 25A o x z deck I I a x o Lot 24A in J _c il O CO O O X �CO O Z Lot 25B C/ D COs °CRIB MT A Z ci 1 Jo NEW 1000-GAL S.T. o NEW COs A-C=60.7' a. %-"NEW TRENCH MT = a O A-D=67,0' x x x x x x - B-D=27.7' 10' Utility Easement Lot 25C S 89'59'15" E 133.0 Lot 24C Lot 25D SCALE: 1" = 30' rFca FCO Tc02 �COIfCO2 SEPTIC SECTION `‘(Air oF At \ ! 9. 1 . 7 5 / • • 4<J t 96.o / INSOLATION /&,.1. .'�,,.' 1 CONNECTED TO EXISTING /*491H4 i N * T 93AV 1000 Cu.LON `mss CRIB & FIELD / `2N ' / STEEL TANK / / MICHAEL N. AND IR2ON. 4 No. CE 9489 v*4"i j NOTE: NEW MT INSTALLED 6' INTO THE 7' ED OF , %d/Z� Oc THE EXISTING TRENCH W/ 2 NEW COs. k L�SSI0,- ' Air ‘`_�441IP' a H'""""'k MUNICIPALITY OF ANCHORAGEmens On-Site Water&Wastewater Program \o. ,se, .aRri PO Box 196650 4700 Elmore Road Z.c ^�. Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 ,'N http:!/www.muni.orglonsite did. v 6 se's is �. _ .-_,/ I)up ti ttiirill 4"CNONP40 On-Site Wastewater Disposal System Permit Permit Number: OSP181235 Effective Date: 7/30/2018 Work Type: SepticTank Upgrade Expiration Date: 7/30/2019 Tax Code Number: 05022318000 Site Legal Address: EAGLE RIVER VALLEY RANCHETTES LT 25B G:0054 Site Mailing Address: 18632 TWENTY GRAND RD, Eagle River Owner: CHAMBERS JANIS V Lot Size in Sq Ft: 17955 Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING Total Bedrooms: 3 This permit is for the construction of: ❑ Disposal Field 0 Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 Water Storage All construction shall 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 shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: • /I"- Date: Issued By: ' ' ' ocutin Date: 30 1F MUNICIPALITY OF ANCHORAG vis • Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On-Site Water& Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 050-223-18 Property owner(s) JANIS V. CHAMBERS Day phone 907-650-0348 Mailing address 18632 TWENTY GRAND STREET, EAGLE RIVER, AK 99577 Site address 18632 TWENTY GRAND STREET, EAGLE RIVER, AK 99577 Legal description (Sub'd., Block & Lot) EAGLE RIVER VALLEY RANCHETTES LOT 25B Legal description (Township, Range & Section) Lot Size 17955 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) x Absorption Field 111 Initial n Single Family (SF) (w/wo ADU) Septic Tank [ 1 Upgrade Duplex (D) [l Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ S 2"1 `�8 Water Storage 7 " ' In g 1 ���b�1( 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• •roperty owner or authorized agent) 2 uS ii Permit/Rush Fees: o215'r III c1 3Lt`t` Waiver Fees: Date of Payment: '"1 12-1Re GIG 10x1 Date of Payment: Receipt Number: 22-1S3S Receipt Number: Permit No. c(Jev$ L2S Waiver No. Permit App_9-1-12.doc Michael N. Anderson, P.E. Civil/Structural Engineering and Construction 4661 Natrona Ave. Anchorage,Alaska 99516 Phone 345-3377 Fax 345-1391 July 27, 2018 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 Re: New Septic Tank Permit&Conditional COSA Legal: EAGLE RIVER VALLEY RANCHETTES LOT 25B Per discussions with MOA On-Site staff,we are requesting a conditional COSA with the attached septic tank upgrade design for permitting. The existing septic tank was installed without permit 20+years ago and is under an existing deck. The 1972 crib monitoring tube is visible, but the 1977 trench monitoring tube or location is unknown at this time. The 1977 trench will be located, a monitoring tube installed and field adequacy test performed at time of septic tank installation. If necessary, a new field will be installed. Per discussions with MOA,the following is required: $20,000.00 will be escrowed to perform this work. No money will be released until MOA final approval. A new as-built survey is provided. Work must be completed within 30 days of the Conditional COSA being issued. All engineering fees must be paid prior to closing. The MOA will need a letter from title stating that all these requirements prior to issuance of the Conditional COSA. The lot and area is served by public water and this system will not impact any of the neighboring properties due to the lot layout. Please call me if you have any questions. Sincerely, /M/L Michael N. Anderson, P.E. 4661 Natrona Anch, Ak 99516 Ph 727-8864 DECOMMISSION EXISTING S.T. & INSTALL NEW 1000—GALLON SEPTIC TANK PER CODE. LOCATE & MARK WATER SERVICE LINE PRIOR TO CONSTRUCTION. TWENTY GRAND ROAD '1!' 0 0 cr) co S89°59'15" E 133.0 e N • asphalt.-; P 4 J _ G deck32.0 2.0 OH o 20.5 ,:.55''6. . o 0 N garage N tri ( 47.5 0 32.0 I N° 1 Story Frame House ' 01 68.0 crawlspace entry •i deck Ixvcaku, i q x - 'Feb •eck II �, 0 Lot 25A � Apr, clean out �:. cos .c o Lot 24A OIx)C- NIA) cM/E __,I �— .1° 'ram• y O — — . �f dec Z 2018 IS TANK UPGRADE: Z Decommission existing septic tank , per code&install new 1000-gallon of MEN• •t 25B tank maintaining 10'+from foundation,&5'existing field. Area — A Y'PPOx• served by public water. -t S'iv storage LOG � � 'DCG K• 10' Utility Easement S 89°59'15" E 133.0 l Lot 25C I 1 Lot 24C ( Lot 25D I Septic Design Prepared for ."411` kN JANIS V. CHAMBERS A�.OF. A� 1 EAGLE RIVER VALLEY RANCHETTES LOT 258 �`�, •�_ .�' Eagle River, Alaska # *.49 •. * .0 Michael N. Anderson, P.E. DATE: 7/27/2018 .MICHAEL N. ANDERSON. se DRAWN: BMW — FIRST WATER y No. 948D / 4601 Nate, Ave. 00 CONSULTING SERVICES , . • .7• ?�r�i. Anchorage, Alaska 99516 1 •, (907)727 8864/FAX: (907)345 1391 SCALE 1" = 30' N v`�=t MUNICIPALITY OF ANCHORAG and Environmental Fourth Floor West 825 L Street Anchorage, Alaska 99501 279-2511, x 224, 225 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM I SE~IIC TANK: DISTANCE ~9F~(-~'~'I'~ ~ FROM W£LLI'-'O ~ ~ MANUFACTURER ................ MATERIAL NUMBER OF COMPARTMENTS __ INSIDE LENGTH INSIDE WIDIH ........... LIQUID DEPTH LIQUID CAPACITY__ GALLONS. DISTANCE FROM WELL ~'"~'~X~rOUNDATION .... TOTAL LENGTH ___NEAREST LOT LINE ......... OF LINE ~/'~ # of Lines _ / DISTANCE BETWEEN LH'4ES ~ TRENCH WIDTH''~ IN. ABSORPTION AREA (~ ~ ~ SQ. FT. LENGTH OF EACH LINE ~'~ / DEPTti OF FILTER ~ ¢ DEPTH: TOP OF TILE TO FINISH GRADE ___~_ MATERIAL BENEATH T LE. ___ ~. ABOVE TILE TOTAL EFFECTIVE IN, sEEPAGE PIT: Log Crib Rings BUILDING FOUNDATION DIAMETER OR WIDTH LENGTH Crib Size: DIAMETER___DEPTH NEAREST LOT LINE __ DEPTH DISTANCE FROM: WELL TOTAL EFFECTIVE ABSORPTION AREA(WALL AREA) SQ. FT Well Class: Dept~: Well Distance To: Lot Line Bldg: Sewer Line: Pipe Materials: # of Bedrooms: Installer: Remarks: G V ANCHORAGE AREA BOR `i T141ENT OF ENUiAONYIENTAL QUAL 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 271-8686 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM (.% MAILING / NAME / I /Q G I JJX C'. L' L� L ! ,C ADDRESS!, r �r� /—/%�lr ,�� v i� PHONE r,�.r,r�ni �.'�I✓%r nv't� ;7S F3 iv Lrl F'%/ �S IF(:di f1FCf RIPT1(]N SEPTIC TANK: DISTANCE F?OaA 17. A i:AAATFPIAI .S?/3C'I< f�r/ f: I� /O C(IMPGRTBER OFMTi / / t! LIQUID LIQUID CAPACITY I C' D GALLONS. INSIDE LENGTH ✓ - INSIDE WIDTH DEPTH t. SEEPAGE SYSTEM. SEEPAGE PIT: NUMBER OF PUS %1 OUTSIDE DIAMETER OR WIDTH '— LENGTH DEPTH LINING MATERIAL h D ` .DISTANCE FROM WELL1r'Mr`I r"���_,. BUILDING FOUNDATION Y6 NEAREST LOT UNE a �� TOTAL EFFECTIVE ABSORPTION AREA (WALL -AREA) v� C7 SQ. FT. TILE DRAIN FIELD: )ISTANCE FROM WELL ,IUMBER OF 4BSORPTION BETWEEN FT. LENGTH OF / - - - - TOTAL LENGTH NEAREST LOT LINE - -, OF LINES TRENCH WIDTH - IN. TOTAL EFFECTIVE CH LINE - - ):PTH: TOP OF Tll'c TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH ALE IN. ABOVE TILE WELL��/ DISTANCE FROM WATER -TYPES '° _'.Xx' zAk„+ice'DEPTH ,BUILDING FOUNDATION. SAMPLE , NEAREST NEAREST - SEPAC SEEPAGE OTHER .OT LINE , SEWER UNE—. TANK , SYSTEM , CESSPOOL , SOURCES_ )ISTANCES: DIAGRAM OF. SYSTEM - t o i� y5r - �tr:,•'� - ivJpJ`)O o: cc .aI'..ol 03 4 Y � - �� ✓/ �, ,yam �i � J / v� PERMIT NO. APPLICANT LOCATION LEGAL ON--$ I TE SEi4ER UPBRAC~E PERI--1 I T ??668 ) LBRRY SMITH TWENTY GRHND LT. 25-8 Em R. VALLEY RANCHETTE LOT SIZE 17955 SQUBRE FEET fYPE OF SOIL ABSORB'TION SYSTEM IS: TRENCH MR~-,IMUM NUMBER OF BEDROOMS SOIL RATING (SQ FT/BR)= 220 IHE REQUi~E~ 51ZE UF I'HE SOiL HBSORH"flON SYSIEM-I~: [)EP'i-H---- ~ LE[~O-FH= 4-? GRAVEL DEP1-H= 7 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE OROUND 8ND THE BOTTOM OF THE EXCAVBTION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRBVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFRLL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). F"RCKRGE PLRNT OPT I O~'-t A PACKAGE PLANT MAY BE INSTALLED BT THE PERMITTEE'S OPTION SUBJECT 'rD THE FOLLOWING CONDITIONS: i. EITHER R CLASS I OR II NSF BPPROVED PLANT MAY BE INSTALLED. 2. R CONTINUOUS MAINTENANCE AGREEMENT IS REQUIRED. IF A ~RINTENANCE AGREEMENT IS NOT KEPT CURRENT' YOU MAY BE REQUIRED TO ENLARGE THE SOIL ABSORPTION S~l~EM AND?OR YOU MBY BE .¢iIBJECT. TO PROSECUTION. TWO ( 2 ) I ~'-~SF"E~3-F I OI'.IS RRE REQLi I RED BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND RPPROVBL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN R WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR R PRIVATE WELL OR 200 FEET FOR A PUBLIC NELL, OTHER REQUIREMENTS MBY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PERI'I I T E.XP I RES DEE:EMBER ,Z-~I_. 1977 I CERTIFY THAT l: I BM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN BCCORDBNCE WITH THE CODES. ~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE I'HRN ~ BEDROOMS,_ _ IuNED O ~ E GL:~ECHNICAL 8' DEV(~IPMENT Box 90, Davis St,, Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster 694-2774 Soils Et Foundations Perfomed for: SOIL LOG Name: Z~,~'7-7- ~ ~'/v//7"/-/ Matltng Address:Z~ZO~ Legal Description: L~r Depth (feet) CO, Earl Ellis 688-2280 Land Development Tel. No. Soll Characteristics o 1 2 5 7 8 lO ll 12~ 16 Ground Water Encountered: Yes NO ~ If. yes, what depth Proposed Installation: Seepage Pit Comments: H///7'~A~ Z~'~//~/~6 Drain Field /%PoM ~qz3P~-8 o~-b/7-' Date: Mo mu, V )u 4 P 4l MUNICIPALITY Or ANCHOP.AGE MUNICIPALITY OF ANCHORAGE DEPT.':- _. ,.. DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECfIONnCY ,T -TION 825 L Street - Anchorage, Alaska 99501 • ,,kr ENVIRONMENTAL ENGINEERING DIVISION Telephone 264-4720 R E C E l V�S REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIE DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER PHONE Wilbeifn L. Dixon 694-2603 MAILING ADDRESS Box 7-20 Grand Road 99577 PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE Gerry Chambers COMMUNITY MAILING ADDRESS 3. LENDING INSTITUTION PHONE National Bank of Alaska 265-2883 MAILING ADDRESS Pouch 7-025 99510 4. REALTOR/AGENT PHONE MAILING ADDRESS S. LEGAL DESCRIPTION Lot 25B Eagle River Valley Ranchettes Subdivision STREET LOCATION Twenty Grand Street 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS fX SINGLEFAMILY ❑ One ❑ Four ❑ Other ❑ Two ❑ Five ❑ MULTIPLE FAMILY Three ❑ Six 7. WATER SUPPLY ❑ INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM **If individual/on-site, -l- installation date OPt— K. INDIVIDUAL/ON-SITE** give SGA—D .on ❑ PUBLIC UTILITY st-is regufred t NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY INSPECTION APPOINTMENTS DATE RECEIVED TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE ❑ SINGLEFAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON-SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATEINSTALLED INSTALLER ❑Septic Tank or ❑Holding Tank Size: /�� If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER C-11 \ TOTAL ABSORPTION AREA MATERIAL I K 4. DISTANCES WELL T0: Septic/Holding Tank - Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS U_—APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE BY (TitleI LEGAL DESCRIPTION 72-010 (Rev. 3/78) MUNICIPALITY OF ANCHO) Departm of Health and Envi-r.onmen . Protection 825 L Street, Anchorage, Alaska 99501 264-4720 t for Approval of Individual Sewer and Water Facilities 1. Property Owner: W161)eatd 3/,,;eoJ Mailing Address:/d✓y_ = v?� t .+o t �Q�'hone: 4, 1r _oiG a 3 2. Name of Buyer:e� �5! ��/ 00-H Pl«J Mailing Address: _ Phone: 3 0 5 6. 7. Lending Institution: A) IJ A Mailing Address: 7�" Jo 2.,! AA)Ci . A Phone: .Z GJ - IHS Realtor/Agent: Mailing Address: Legal Description: Street Location: Phone: Single Family Residence: (s/( Number of Bedrooms: 3 Multiple Family Residence: ( ) Number of Bedrooms: Water Supply: *Individual Well ( ) Public/Community System (✓j If Individual Well, well depth If Community System, name of system 8. Sewage Disposal System: *'tn-site System (0 Public System ( ) If On-site System, date of installation: *NOTE: A well log is required on ALL wells drilled since 6/75. **If. on-site sewer system is over two(2) years old, an adequacy test is required by this department. A fee of $25.00 must accompany each request before processing can be initiated. 3/77 !J 0 1 i #i: Time 11 Date Insp Wi �UNICIPALI TY OF ANCHORAG� DEPARTMENT - HEALTH AND ENMONMENTA&ROTECTION 82t L Street., Anchorage, Alaska 99501 279-2511, ext. 224 or 225 // Date Received; Auguat--2-r -^---- D a. M. #2: Time .�6�_�-glYL_ #': Time An - 77 Thursday Date A-�-71���2 Date s T* S Insp n I -- -- -Y� Lam.--- REQUEST FOR APPROVt"+L Oi;' i:ND- IDU'AL SEWER AND WATER L'ACILITIES Manufacturer Gly f Absorption Area 1. Lending Institution Request: Peoples Bank and Trust__-_�_-_W___ Mailing Address: Pouch 7-007 -99510Phone: 279-7511 2. Property Owner: Larry A./Betty Smith _ Phone: 278-9591 Mailing Address: Star Route A Box 64-E_ 99507_ w _ 3. Legal Description: Lot 25-8 Eagle River Valley Ranchettes Subdivision 4: Single Family Residence: (K) Multiple Family Residence: ( ) 5. Well System: Permit # Construction Individual Well ( ) Number of Bedrooms: Three Depth of Well Number of Bedrooms: Cor.aminity/Public System (x) Weil Log on File ( ) Bacterial Analysis 6. Sewage Disposal System: On-site System (x& Permit # Public Utility ( ) Installed _ 1_°L_Zr�)Installer Septic Tank Siz:: _ j Manufacturer Absorption Area Soils Rate Material CSC3 (I r C" 7. Distances: Well to Septic Tank _ to Absorption Area to Sewer Line to Nearest Lot Line Nearest Tot ]line Absorption Area JC) MUNICIPALITY OF ANCHORAGE rl ® DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION \\ 825 L Street., Anchorage, Alaska 9950.E 279-2511, ext. 224, 225 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: 2. 3. 51 5. VA 91 a Property Owner:-- Larry A. and Betty Smith Mailing Address:_-- SRA Box 6-4-E, Anch. Ak. 99507Day Phone:__ 2788-9591__ Name of Buyer: Wilbern Land Penelope J. Dixon 264-1244 (his) Mailing Address: 516 N. Price, Anch. Ak__ Day Phone:_- 276-4511 (hers) --Ext. 1883 Name of Lending Institution: PEOPLES BANR & TRUST CO.-- —__-- __---------_.__..-__-_-- -- -.-- Mailing Address:— Pouch 7-007, Anch. Ak. 99510 Phone:__ 279-7511 Hylen Co. Realtors/Betty Smith Name of Realtor or Agent:---_-- ---_-----_--- ---_-- __-----__-_-- 4060 B St. Anch. Ak. 278-9591 Mailing Address:_ >—_-_--___ Phone:__-___.______ - Legal Description: --Lot 25-B, Eagle River Valley Ranchettes Location:------ 20 Grand Road-- ---------------- ------ -- Type of Facility to be Inspected: Single Famil; Water Supply Type of Supply: Public Utility__— If Individual, number of dwellings presently served If individual, depth of well Sewage Disposal System Type of System: Public Utility --- If Individual, date of installation 72-003{3/76) Residence 3 _ —No. E3drms. ndividuaf ___ Community_ Individual (on-site) XX % "ep a- traent of I'eaJ th ai)d. Env rcmr,*ent a I Protection Request for 7?pprcvaj- Individual S�_wer and hater Facilities Legal Description: Lot 25-B Eagle River Valley Ranchettes Subdivision Comments: Affadavit Attached: Letter. AtLached-. Approved: L Da to Disapproved: Date: Department Worksheet: D1. -CAN LeD co 4Q T+ 8 MUNICIPALITY OF ANCHORAGE Development Services Department -- Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 050-223-1 1. GENERAL INFORMATION Expiration Date: �/ -2 q r Z .S Complete legal description EAGLE RIVER VALLEY RANCHETTES LOT 25B Location (site address) 18632 TWENTY GRAND STREET, EAGLE RIVER, AK 99577 Current property owner(s) THOMAS R. SCOTT Day phone Mailing address Real estate agent THUNDERBIRD - RRQ 4/26 5PM ST UPGRADE 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 3 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 $,650 Date of Payment LIA/,- a. I If Receipt Number 80623.5 Waiver Fee $ Date of Payment Receipt Number COSA# 05G2.2115C� 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 4/22/2022 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 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, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the _�1�\\\� system and maintenance. The operational life of all well and septic systems are subject to - c0!� $1, these various and dynamic characteristics and are outside the control of the evaluator of the •' well and septic system. Therefore, any estimate of how long a system will function satisfactory ���Q: • • ; for current or future occupants or guarantee that no unseen encroachments, deficiencies or / g•' ':9 discrepancies exist can be given by First Water Consulting & j * : � TH FWC5 r . .:�: 6. DSD SIGNATURE •� % •. Curtis Huffman .i System #1 Approved for 3 bedrooms ����F��s•, CE 128991% 0 lE,�' • •4/22/2 •'F� r System #2 Approved for bedrooms�` EWQA�4 Disapproved Conditional approval for bedrooms, with the following stipulations: By: - OrI�Zt �l Cer8fj _caste Datc�-,<,' � Zq 2 The Municipality of Anchorage Development Services Division (DSD) issues Cej�fi®tes��of�V�M9"@MyAtgms Ap�V@ (COSA) based only upon the representations given in paragraph 5 by an independent professional civil enginea� �isterY%3? �_. Vt;Aa yot�laskarn. 31ie Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. �nr1 PRO( //ii ER �0-o SAM �o 7. ATTACHMENTS: /J/�J���TSERVICESO�,�� COSA Checklist X Nitrate Ad'v/4WrP)))11))�1 Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist Legal Description: EAGLE RIVER VALLEY RANCHETTES LOT 25B Parcel ID: 050-223-18 If more than 1 septic system on lot: COSA Checklist # _of _ Structure served by this system A. WELL DATA – PUBLIC WATER ❑ Well log is filed with Onsite (or attached) Date drilled Total depth _ft Cased to _ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) — in. Date of flow test for COSA Static water level at beginning of test _ft. Comments B. TANK DATA Age of tank(s) 4 years Tank type/material SEPTIC / STEEL Measured operating fluid level in septic tank 50" ® Standpipes/foundation cleanout per record drawing Date of pumping 4/15/2022 D. ABSORPTION FIELD DATA Well production at time of test _gpm Water storage tank volume_ gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate _mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by_ Date of Sample C. LIFT STATION ❑ Required maintenance completed Age of lift station _ years Lift station material Comments: Which system tested (date installed) 1977 / 1972 Adequacy test date 4/20/2022 ® ALL standpipes present per record drawing Results E Pass For 3 bedrooms Total measured depth from grade 9.6'/ 10.7 ft (max) Fluid depth prior to test 3 in (CRIB & TRENCH Measured depth to pipe invert from grade 4..S'/ 4.7 ft Water added 450 gal BELOW LATERAL) (min) ❑ N/A – pressurized field New depth +2 in (TRENCH INTO LATERAL) ❑ Monitor tubes go to bottom of effective. If not, state Elapsed time 1440 min depth into effective CRIB TRENCH MISSING VED TED IR Final fluid depth 3 In (CRIB & TRENCH — C&T) ® Code -required soil cover over field Absorption rate 450 gpd ❑ System presoaked Any rejuvenation treatment (past 12 months) N (Required if vacant for greater than 30 days prior to date of test) If yes, enter date Gallons introduced gallons Comments/Deficiencies: AT GRADE C&T PIPES. MOA ADVISORY. SPOKE WITH OWNER. SEPTIC NEEDS UPGRADE SOONER THAN LATER & TO EXPECT TESTHOLE / SYSTEM IN SE CORNER. SHE BOUGHT HOUSE FROM MOTHER IN DRIER 9/2018 TIMEFRAME. FWES k� 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 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' 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 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 Property Line > 10' ® Yes if No Water Main > 10' ® Yes if No Water Service Line > 10' ® Yes if No Surface Water > 100' ® Yes if No F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION _ ft If absorption field.is under driveway comment below _ ft Wells on Adjacent Lots: _ ft Private Wells > 100' ® Yes if No ft _ ft Community Wells > 200' ® Yes if No ft l certify that l 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 .. .. ....•.. ..• .... ..........� . Curtis Huffman �� �'F� •, CE 128991 •��� � OFESSIO���'�p ft ft Municipality of Anchorage Development Services Department Building Safety Division > a F r Y On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Septic System Advisory Certificate of On -Site Systems Approval # OSC221159 During a recent- adequacy test on the septic system for Lot 25B of Eagle River Ranchettes subdivision, 3 inches of standing water below lateral was observed in the absorption field. This indicates that approximately 98% of the absorption area is inundated. Although this system passed the adequacy test, the remaining life expectancy may be limited This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval • • * • t� Municipality of Anchorage P• E( On-Site Water and Wastewater Program (907) 343-7904 ��ET Y CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 050-223-18 Expiration Date: 10-3 rl c( 1. GENERAL INFORMATION Complete legal description EAGLE RIVER VALLEY RANCHETTES LOT 25B Location (site address) 18632 TWENTY GRAND ROAD,EAGLE RIVER,AK 99577 Current Property owner(s) THOMAS R SCOTT Day phone Mailing address 18632 TWENTY GRAND ROAD,EAGLE RIVER,AK 99577 Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) El 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 ❑ Waiver/Variance request for: Distance: Received by: - Date: /D/Y/$ COSA to be relea o engineer,unless otherwise requested by the engineer. / COSA Fee $ £2L 2 7?+ 1 `/2gN Waiver Fee $ Date of Payment 7 2 7- g Date of Payment Receipt Number 2-2.72 3S- .s Receipt Number COSA# CSC ( cI 37'2_ 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 ANDERSON CONSTRUCTION & ENGINEERING Phone 345-3377 Address 4640 SHOSHONI DRIVE,ANCHORAGE,AK 99516 Engineer's Printed Name MICHAEL N.ANDERSON,PE Date 10/02/2018 O;- �i 1. OW' "").• .,* •.1" q A el •• •...01: O O O O..p 11) 6. DSD SIGNATURE . d I. •,?r*o•s•o• r4 A;MI,....: -!....•HAEL tNi k'kbERgbN ; System #1 Approved for bedrooms. ���,•, •�„.0 , �� 9,4iS;9 , System#2 Approved for bedrooms. d4I't)• �vJ7Ji • 0•;�3;' Y pp , F„,p . C' Disapproved. �%���00 q-� Conditional approval for bedrooms, with the following stipulations: G\Q::\OO-CTNYEG- OF,���tisiTE � .R AND m=WTEWATER oRAM 4'1-SERvI6- ce By: t vv1_ � l Original Certificate Date: �,© ,3 1 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 bluesheet 10-10-12.doc 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: EAGLE RIVER VALLEY RANCHETTES LOT 25B Parcel ID: 050-223-18 A. WELL DATA - PUBLIC WATER Well type If A, B, or C provide PWSID #_ Well Log (Y/N) Date completed Sanitary seal (Y/N)_ Wires properly protected (Y/N) Total depth _ ft. Cased to ft. Casing height(above ground) in. FROM WELL LOG AT INSPECTION Date of test Static water level ft. ft. Well production g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform _ colonies/100 mL Nitrate mg/L Arsenic: ug/L Date of sample: Collected by:_______ B. SEPTIC/HOLDING TANK DATA-TO BE INSTALLED Tank Type/Material SEPTIC/STEELDate installed 9/10/2018 Tank size 1000 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 NA-NEW TANK Pumper C. ABSORPTION FIELD (New trench MT installed 6'into the 7'ED-*Fluid levels include missing 1'ED) Date installed 1977/1972 Soil rating (g.p.d./ft2 or ft2/bdrm) 220 System type_DEEP TRENCH/CRIB Length 48 /18 ft. Width 3 /18 ft.Gravel below pipe 7/7 ft. (New trench MT installed 6' into the 7' ED) Total depth 10.5+ ft. Eff. absorption area 6601504 ft2 Monitoring tube Y_ Depression over field N Date of adequacy test 9/10/2018 _ Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test *61 28 in. Water added 720 gal. New depth 71 /39 in. Elapsed Time: 1440 min. Final fluid depth *62/30 in. Absorption rate >= 450 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: - NA/ PUBLIC WATER Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer/septic service line Holding tank Animal containment areas Manure/animal excrete storage areas SEPTIC/HOLDING TANK ON LOT TO: Building foundation 10' _ Property line 10'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 200'+_ ABSORPTION FIELD ON LOT TO: - TBD Property line 10' Building foundation 10'+ Water main 10'+ Water Service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage _10'+___ Curtain drain 50'+(None Known) Wells on adjacent lots 200'+ F. COMMENTS G. ENGINEER'S CERTIFICATIONOF� - J.>!C�‘k I certify that I have determined through field inspections and ••:-v review of Municipal records that the above systems are ino*;•49TH • Sc conformance with MOA COSA guidelines in effect on this date. ' '-1'�'• •••• Engineer's Printed Name MICHAEL N.ANDERSON,PE • MICHAEC'N. ANDERSCN CE 9469 •.firs Date 1010212018 �4 .9F•-��` t!� �••• l l O pR 0, bt'c';.� COSA canary sheet_2-6-15.doc TWENTY GRAND ROAD — 8474G 0 0 co M x S 89°59'15" E 133.0 x 01, :„. a. a co aaphait N v 4 , x _ 32.0 2.0 OH od 20.5 --eck Y -55:6-{��o Q '. . ..1 N garage N O 47.5 0 in I o 32.0 LO x � \ N 1 Story Frame House `�' CO I • 8.0 68.0 `crawlspace entry • deck ° - - Lot 25A - clean out deck D U) Lot 24A O int x O ✓-- ram. .--- ° ° O dec 0 z septic °m ° z Lo chain link fence(typ) vents cri (t'p) Lot 25B aa storage x x x 10' Utility Easement Lot 25C I S 89°59'15” E 133.0 I Lot 24C I Lot 25D I I ,o,\\\vt RECERTIFIED 9/26/2018 A 1 I � AS-BUILT NO COR T IS DATE �c OF • . �,q / �Q•• •S,� I hereby certify that I have performed a Mortgagee's Inspection ( of the following described property: Lot 25B, IF/ �)• 49th , ••. r Eagle River Valley Ranchettes ••• •• Anchorage Recording Precinct,Alaska,and that the �+• izabeth L. Wolatkc. /• improvements situated thereon are within the property lines and do not overlap or encroach on the property lying i �`ri�„•• 8036 - LS •• ..q- gm adjacent thereto,that no improvements on the property lying i /PFo • • • o y '� adjacent thereto encroach on the premises in question and ,' ��F. . . „ . •�� that there are no roadways,transmission lines or other `�`"`�� visible easements on said property except as indicated hereon. SCALE: 1"= 30' n` , 30_j , Dated at Anchorage,Alaska EASEMENTS OF RECORD, OTHER THAN this 18th day of June 2018 THOSE SHOWN ON THE RECORDED FRED WALATKA&ASSOCIATES,L.L.C. PLAT ARE NOT SHOWN HEREON FB 18-6, pg 59 Engineers and Surveyors UNLESS OTHERWISE NOTED. FB 18-4, pg 25-26 MB 907-248-1666 C an dAtaKZ1 GSA • c,E B V-t-. ;f _'� Municipality of Anchorage °p On-Site Water and Wastewater Program (907) 343-7904 • S A 1 ili 2' S A ETY CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 050-223-18 Expiration Date: Ct -3 d-( e 1. GENERAL INFORMATION Complete legal description EAGLE RIVER VALLEY RANCHETTES LOT 25B Location (site address) 18632 TWENTY GRAND ROAD,EAGLE RIVER,AK 99577 Current Property owner(s) JAMS V.CHAMBERS Day phone Mailing address 18632 TWENTY GRAND ROAD,EAGLE RIVER,AK 99577 Real Estate Agent Day phone 2. TYPE OF,DWELLiNG: Z Single Family (w/wo ADU) iil ❑ Duplex 111:11\ ' 1Ir ' ❑ Multiple Dwellings (Single Family and/or Duplex) �!.‘67)0A 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual Individual Water Storage ❑ Holding Tank 0 Community Class_Well 0 Community 0 Public Water System ® Public Sewer 0 Waiver/Variance request for: Distance: Received by: / Date: ?NM COSA to be releas o t gineer,unless otherwise requested by the engineer. i 1�?it r � COSA Fee $ (:-.--;2(64-2-7q 4" 1"i j =- 128t Waiver Fee $ j + Date of Payment `-1 J1 !2. .1 g Vii=', 14%1 Date of Payment Receipt Number 22--)??.)-5- Receipt Number COSA# ( ..`_` 12.) i 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 ANDERSON CONSTRUCTION & ENGINEERING Phone 345-3377 Address 4640 SHOSHONI DRIVE.ANCHORAGE.AK 99516 Engineer's Printed Name MICHAEL N.ANDERSON,PE Date 07/27/2018 • • Gam+ee .� ° ••i i I•°Z•�'1 a 1 ° o a o 0 0 0 0 e o• u a•r 6. DSD SIGNATURE e"° °•° ° .. •aw e,o-o.e mi CHAEL'>N.:°ANDF CE-o System #1 Approved for bedrooms. �� � °, 449 • °:•` System #2 Approved'for bedrooms. '`D o • •)(,(4.2. t • • Disapproved. • �*°''a \���1 "�- • Conditro•nal •approval for bedrooms, •with •the following •stipulations: d it% S 94c — 1c ik.(27.Aoly (l1N( OPG Pte, S d VeY -o WATER Grn "•I� WASTEWAT D �' PROGRAM ER RAM \llf Gc- y: 0 Original Certificate Date: a 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: ct,11;COSA Checklist X 4Jate Advisory Septic System Advisory Arsenic Advisory' Well Flow Advisory Other ' • COSA blue sheet_10-10-12.dx . 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: EAGLE RIVER VALLEY RANCHETTES LOT 25B Parcel ID: 050-223-18 _ A. WELL DATA - PUBLIC WATER Well type If A, B, or C provide PWSID# Well Log (Y/N) Date completed Sanitary seal (Y/N) Wires properly protected (Y/N) Total depth ___ft. Cased to ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test Static water level ft. ft. Well production _ g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate mg/L Arsenic: _— ug/L Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA –TO BE INSTALLED Tank Type/Material SEPTIC/STEEL Date installed unknown_ Tank size 1250 gal. Number of Compartments unknown Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank(Y/N) N High water alarm (Y/N) N Date of pumping Pumper C. ABSORPTION FIELD DATA - TBD Date installed 8.26-1977 Soil rating (g.p.d./ft2 or ft2/bdrm) 220 System type DEEP TRENCH Length.48 ft. Width 3 ft. Gravel below pipe 7_ ft. Total depth _ ft. Eff. absorption area 660 ft2 Monitoring tube Depression over field Date of adequacy test TBD Results (Pass/Fail) For bedrooms Fluid depth in absorption field before test in. Water added gal. New depth in. Elapsed Time:_min. Final fluid depth in. Absorption rate >= 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: - NA/ PUBLIC WATER Septic tank/lift station on lotOn adjacent lots Absorption field on lot_ On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer/septic service line Holding tank Animal containment areas Manure/animal excrete storage areas_ SEPTIC/HOLDING TANK ON LOT TO: -TO BE INSTALLED Building foundation 5' Property line 10'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 200'+ ABSORPTION FIELD ON LOT TO: -TBD Property line_10' Building foundation 10'+ Water main 10'+ Water Service line 10'+ _ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain 50'+(None Known) Wells on adjacent lots 200'+ F. COMMENTS --�� OF 4 '\ee G. ENGINEER'S CERTIFICATION r� '•• .e: %47•' �i%47b! - moi.• . •� I certify that 1 have determined through field inspections and ;:*.:49TH Wk. ••.*{� review of Municipal records that the above systems are in / , ,� conformance with MOA COSA guidelines in effect on this date. • • •• �, 9••MICHAEL N. ANDERSCN ,+d Engineer's Printed Name MICHAEL N.ANDERSON,PE e��.••_ C 9469 "4-4) •./ 24//K.• Date 07/27/2018 ROfrS a- COSA canary sheet_2-6-15.doc TWENTY GRAND ROAD _ 8474G 0 o co co x S 89°59'15" E 133.0 N 1. aphait,.:.•. . C 1 x 1 d deck N... :.. �,_. `.� 32.0 H o 20.5 C- ' ,=0 0 J . Ngarage Ni /200 47. O � x 5 32.0 )d CO N 1 Story Frame House `Y' i" X ! \crawl pace entry 68.0 s. deck II a —" x _ o deck I - o Lot 25A 0 clean outer' et, r Y o Lot 24A 1 ram. �' N— o p x Septic deck O z vents ;, z chain link fence (typ) `n o Lot 25B X storage 10' Utility Easement — — — a - - - Lot 25C I S 89°59'15" E 133.0 I Lot 24C I Lot 25D I I A 1 It AS-BUILT NO CORNERS SET THIS DATE �� OF • . �,q 1 �Q2•• S� a/ I hereby certify that I have performed a Mortgagee's inspection �� of the following described property: Lot 25B, 0.5i• 49th /\ •. , Eagle River Valley Ranchettes • II/ 4- i- . �'• � �•'7r Anchorage Recording Precinct,Alaska,and that the X�+ '. lilabeth L. Wolatka . �� / improvements situated thereon are within the property lines . and do not overlap or encroach on the property lying 7, 4' • 8036 — LS •• c�� adjacent thereto,that no improvements on the property lying 6Fo•• • o ,up' adjacent thereto encroach on the premises in question and O�SSIONAL•�� that there are no roadways,transmission lines or other `,1`"` � visible easements on said property except as indicated hereon. SCALE: 1"= 30' ,, Z Z• 1 -, Dated at Anchorage,Alaska EASEMENTS OF RECORD, OTHER THAN this 18th day of June 2018 THOSE SHOWN ON THE RECORDED FRED WALATKA&ASSOCIATES,L.L.C. PLAT ARE NOT SHOWN HEREON Engineers and Surveyors UNLESS OTHERWISE NOTED. FB 18-4, pg 25-26 MB 907-248-1666