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HomeMy WebLinkAboutDEARMOUN #2 BLK 1 LT 8DeArmoun Block Lo1- 8 #018-401-22 krxcv vowci 1 o1 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP191187 PID Number: 018-401-22 Dwelling: ❑ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ❑ Upgrade Name ROY LAMAY ABSORPTION FIELD ❑ Deep Trench ❑ Wide Trench ❑ Bed ound Site Address 3721 MATTHEWS DRIVE *ANCHORAGE, AK 99516 ❑ Other Phone Number of Bedrooms Soil Rating Total depth original grade 907-748-6370 4 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Subdivision Block Lot DEARMOUN #2; BLOCK 1, LOT 8 Ft. Fill added above original gr Ft. Gravel length Township Range Section Ft. Gravel width Beds: Number of Lines Distance between lines SEPARATION DISTANCES Ft. Ft. To Septic Absorption Lift Station Holding Sewer Torption area Number of trenches Dist. between trenches From Tank Field Tank Line Ft2otal Ft. Well N/A _ TANK [KSeptic ❑ S.T.E.P. ❑ Holding [:]Other Manufacturer Capacity 1530 Gal. Surface Water 100'+INFILTRATOR Material Number of compartments Lot Line 5'+ NA PLASTIC 2 Foundation 10 LIFT STATION Manufacturer Capacity Remarks OLD TANK DECOMMISSIONED PER UPC PER Gal. Alarm location Electrical installed by CONTRACTOR Installer PIPE MATERIAL House to tank D3034 Tank to D3034 drainfield RED DOG MASONRY Drainfield D30341EXIS'MG CO/MTD3034 Inspector GEG AND TIM ECKLUND W/MOA ONSITE BENCH MARK (Assumed elevation) 100.00 ft Inspection 151 6/13/2020 2nd - da:3rd Location and description - 4th _ TOP OF MH ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp oo�o�p UF Conditional Approval. Date o �� ...... -9s,4� ��oo 4 H �.......� ................. D D ' .. .......ess:... D��O Septic stem p Y Se S �% r Approved I`� � Date 53 �o9 rey A C —7953 _Oyt4 Note: this approval does not include well permit requirements. fession \ 84 4Pro #AECC8���OQQOo krxcv vowci 1 o1 PERMIT NUMBER: PARCEL ID NUMBER: I OSP 191187 018-401-22 A I B -I FCO 18.2 24.1 MH1 28.2 32.1 ST1 25.4 38.6 DBL1 30.7 42.2 DBL2 32.8 44.1 FCGO 17.2 43.9 NOTE: PIPE LOCATIONS ARE SHOWN PER AS -BUILT SURVEY AND SWING TIES WERE GENERATED IN AUTOCAD O' WAIVER REQUEST 10' UTILITY EASEMENT DB11 STI O 0 O PHYSICALLY MEASURED 10' TO FOUNDATION 3 FORMS DURING INSTALLATION O f FUTURE GARAGE C/O (FGCO) CONCRETE PAD KEYBOX PER AS -BUILT SURVEY EXISTING HOUSE /—EXISTING DRAINFIELD; EXACT LOCATION AND ORIENTATION IS UNKNOWN; ASSUMED BASED UPON MOA RECORDS AND PIPE LOCATIONS IM -1530 INFILTRATOR SEPTIC TANK .�tttttt A � i , J # : IG'A"N"SS'"NGINE"El"KING GROUIr Lt .1V * �1 i....:.....4....... i m a� m ENGINEERING o SALES a CONSULTING 0 3701E. TUDOR ROAD, SUITE 101- ANCHORAGE, ALASKA' PHONE (907) 337.6179- WEBSITE. wwwgamessengfmm�ngwm 0• w••• •• ••••.••••••• •.•••••••••• •••0 •• PREPARED FOR: PHONE NUMBER: PAGE NUMBER. J e neSS ROY LAMAY 907-748-6370 2 OF 3 ���%, E- 953 PROJECT/LEGAL DESCRIPTION: DRAWN BY: i?J �7 2- ,.•' 4v DEARMOUN #2; BLOCK 1, LOT 8 D.J.G. X1404......... ''P�N V TYPE OF WORK: DATE: LIC ENSE,rii`t���•• SEPTIC TANK RECORD DRAWING 4/18/2022 #AECC884 PERMIT NUMBER: PARCEL ID NUMBER: OP191187 RECORD DRAWING 018-401-22 ELEVATIONS SHOWN ARE CALCULATED BECUASE THE INITIAL BENCHMARK WAS REMOVED BY THE CONTRACTOR AFTER THE TANK WAS INSTALLED AND PRIOR TO FINAL GRADES BEING SHOT - GEG WAS PRESENT AND DID INSPECTIONS DURING THE INSTALLATION TOP OF MANHOLE = 100.00 MH ST1 FINAL GRADE = 98.7-98.4 TOP OF TANK AT INLET = 95.70 TOP OF TANK AT OUTLET = 95.66 2" INSULATION PER CONTRACTOR )INLET f _ OUTLET INVERT OF BUNG / AT INLET = 95.04 J INVERT OF BUNG AT OUTLET = 94.83 IM-1530 2-COMPARTMENT INFILTRATOR SEPTIC TANK „•�P���' ` ♦♦♦♦i .. ....F. 4... .....:.....o ENGINEERING = SALES CONSULTING// • 3701 E. TUDOR ROAD, SUITE 101'ANCHORAGE, AK 99507 'PHONE (907) 337-6179-FAX(907)338-3246- WEBSITE: twiw.gamesengneenng.cam ... ..... ... _J........... .............0 PREPARED FOR: PHONE NUMBER: PAGE NUMBER: o �n J #ifey A. amess ROY LAMAY - 3 OF 3 oj ��. j%� E-7 3 .'� LEGAL DESCRIPTION: DRAWN BY: ♦�♦� � ,?, ... I DEARMOUN #2; BLOCK 1, LOT 8 D.J.G. TYPE OF WORK: DATE: ♦� k%FESS\�P��� SEPTIC SYSTEM RECORD DRAWINGS 7/14/2020 LICENSE a CC aa, 0lk11a\\\+*� t� Municipality of Anchorage P.O. Box 196650 ® 4700 Elmore Road Anchorage, Alaska 99519-6650 ® (907) 343-7904 e Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Department On -Site Water and Wastewater Section Waiver#: OSV221024 COSA#: Permit#:OSP191187 PID#: 018-401-22 Legal Description: DeArmoun #2 Block 1 Lot 8 Engineer: Garness Engineering Group Applicant: Roy Lamay n�cnt S 1� < Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the north property line has been approved. The approved separation distance is 0.0 feet. See engineer's waiver request for justifications. This waiver approval applies to the existing absorption field only. Any future upgrade to the on- site wastewater disposal system will require all separation distances be met or another approval from this department. ■■mvvvmvmvmvvvvmvvvvvmvmvvmvmvvvvvmvvvvmvmvvvvvvvmvvmvmmvvvvvvvvvmvvvvvmvvvvmv� Waiver is Granted: X Waiver is not Granted: Date: 1 02 j a Approved by:x,�,U C-a-ZiX Name of Reviewer ■mmmvmmvvmvmvmvmvmmmvvvmvvvvmmmvvvmmvvavvmmvvmmvmvmmvvmvvvvvvmmvmmvavmmmvmmvvm� y 9 2 �� 00 2 `7 �C� ENGINEERING - SALES- CONSULTING LI � 2022 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref: Drainfield to Lot Line waiver request To whom it may concern: Ltd AC ell - G i3 gIIZ_1 The subject lot is served by community water and a private septic system. Per the design, the contractor was supposed to locate the NW corner of the drainfield to confirm its separation to the lot line. This was not completed. Based upon this fact the exact separation distance to the north lot line could not be determined. Therefore, we are requesting that your department issue 0' waiver from the existing drainfield to the north lot line. Justifications for granting this wavier are as follows: The adjacent lots to the north are served by AWWU water and sewer service (mapping attached). The encroachment has likely existed for the life of the system (installed in 1986). Letters of non -objection are attached. We are unaware of any adverse impacts this variance would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. 3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Website: www.gamessengineering.com MUNICIPALITY OF ANCHORAGE » n r Is Development Services Department Right of Way Section r Departmcu t ENCROACHMENT PERMIT R221133 THIS AGREEMENT, made this 12th day of April, 2022, by and between GARRETT MITCHELL LAMAY & RACHEL LAMAY and their heirs, administrators, and assigns, hereinafter called "PERMITTEE", and the Municipality of Anchorage, a municipal corporation organized and existing under its Charter and the laws of the State of Alaska, hereinafter called the "PERMITTER". WITNESSETH: WHEREAS, PERMITTEE is the owner of the following described real property: DEARMOUN #2, BLOCK 1, LOT 8, according to the official records thereof, on file in the office of the District Recorder, Anchorage Recording District, Alaska, and; WHEREAS, PERMITTER owns and/or maintains the real property more particularly described as follows: The TEN FOOT UTILITY EASEMENT, immediately along the north boundary of PERMITTEES property as shown on Plat No. 70-352, on file in the office of the District Recorder, Anchorage Recording District, Alaska, and; WHEREAS, PERMITTEE has placed a leach field upon the referenced real property which encroaches 5.0 feet upon the PERMITTER'S 10.0 -foot Utility Easement. NOW, THEREFORE, it is mutually agreed between the parties hereto that: 1. The PERMITTER, acting through the Director of Development Services Department, hereby grants to the PERMITTEE the privilege of allowing leach field to encroach 5.0 feet upon the PERMITTER'S 10.0 -foot Utility Easement, as shown on "Attachment A," included herewith. 2. The PERMITTEE agrees forever to indemnify, defend, save and hold harmless, the Municipality, its officers and employees, from any and all lawsuits, claims or actions brought to any person for or on account of damage to property or injury, disease, illness or death of persons, including all costs and expenses incident thereto, arising wholly or in part from or in connection with the existence of, alterations, maintenance, repair, renewal, reconstruction, operation, use or removal of the encroaching leach field, as placed upon the PERMITTER'S 10.0 -foot Utility Easement. 3. The PERMITTEE shall not assign or transfer any of the rights granted herein to another individual or company without first notifying and securing the approval of the Director of Development Services Department. 4. This Agreement and Permit grants PERMITTEE no interest in PERMITTER'S real property whatsoever, except only the encroachment rights described herein. 5. The PERMITTER reserves the right to revoke this permit upon twenty (20) days written notice to the PERMITTEE. The PERMITTEE agrees upon such notice of revocation, to move said encroachment(s) from the 10.0 -foot Utility Easement in which it is placed. Should the PERMITTEE refuse or fail to comply with said written notice, the PERMITTER may, without further notice to the PERMITTEE, remove or cause to be removed the encroachment(s), and the PERMITTEE hereby agrees to reimburse the PERMITTER for all costs incidental to the removal thereof. In addition to the mutual promises heretofore made, the PERMITTEE has paid the PERMITTER a one-time permit application fee of $120.00. The PERMITTER hereby waives the annual fee of $315.00. IN WITNESS WHEREOF, the parties hereto have hereunto set their hands and seal the day and year first hereinabove written. GRANTEE: Garrett Mitchell Lamay Owner Rachel Lamay Owner GRANTOR: MUNICIPALITY OF ANCHORAGE &_ l,,l,4,/ �Y-t Z • 20 2 Z John Snelson Right of Way Supervisor POST IN A CONSPICUOUS PLACE ALL WORK MUST BE INSPECTED Field Inspection Request required 2 working days in advance of starting work and 2 working days in advance for final inspeciton. Call (907) 343-8206 (voice recorder) for scheduling. Permit is not valid without the call-in and also must include the one -call ticket (utility locate) number. MUNICIPALITY OF ANCHORAGE - RIGHT OF WAY DIVISION 4700 ELMORE ROAD TELEPHONE (907) 343-8240 EMAIL: moarowrequests@muni.org RIGHT OF WAY PERMIT �1. )e[)artm11 R221133 Type: Encrchmnt Status: Issued Grid: SW2935 Date Applied: 03/11/2022 Date Issued: 03/11/2022 Issued By: claudia.pinard Construction Start Date: Last Updated: 03/11/2022 Last Updated By: claudia.pinard Permittee: LAMAY GARRETT MITCHELL & Work Order: Utility: Contact Person: Garrett LaMay (907) 748-6818 Primary Inspector: Mike Walters (907) 343-8197 Address/Loc: 3721 MATTHEWS DR, Anchorage - @ De Armoun Road. Legal Description: DEARMOUN #2 BILK 1 LT 8 G:2935 Original Work Description: Existing leach field encroaches approximately 5' into the 10' Utility Easement. The length of the bed is 30' in the easement. Fee Description Permit Quantity Amount 1 $120.00 Total Fees: $120.00 See reverse for requirements/remarks. I have read and understand both ,Sides of this permit. I agree to the terms and conditions; and I certify that all work will comply with federal, state, and municipal codes and regulfiCons and the provisiQns-gf thi$\permih Signature: Date: G% 1.3b _Z POST IN A CONSPICUOUS PLACE ALL WORK MUST BE INSPECTED �° n Field kM*cdon MMuest regAW 2 wort fn8 dep In advance of s wft work and 2 Wod tng days in advance for final hspedton. Call (907) 343-82M (vole re6order) for erdreduting. Permit is not valid without t1w es3Q-ks and also must include the orre-cd B*et (wily locale) number. MlUNIMPAUTY OF ANCHORAGE - RIGHT OF WAY DIVISION 4700 ELMORE ROAD TELEPHONE OM S43-8240 EMAIL-,org RIGHT 4F WAY PERMIT R221133 TYFa- Enac haltit Status: Issued Grid: SW2935 Dais Applied; 03111r2w Date Issued: 03/11/2022 issued Sr. daudla*iard Construction Start Date: Last Updated: 03M 112022 Last Updated By: daudrrard Pernhittee: LAMAY GARRETT MITCHELL & Work Order. Unity: Contact Person: Garrett LWAW (907) 748.6818 Primary Inspector: MOM Waters (907) 343-8197 AddresslLoa 3721 MATTHEINS DR, AndumVe - @ De Affwun Road. L.gal Description: DEARMOUN #2 BLK i LT 8 03:2936 Orighud Work Description: ExistkV leach field enanadas apprordmaWy F tato the W UWW Eassraw t. The WKA of the tad Is W In the I have read and and music kw! c Signature: Cue B 1 $120.18) Total Pees: "20A0 See reverse for requirenumtdrernarire. A work vAl WM* vA h federal, state, Date: 13 2 _ 2022-1112523-0 A Recording Dist: 301 - Anchorage S 4/1/2022 08:11 AM Pages: 1 of 4 1203-28D Grid 2935 EN22008 018-401-22-000 ENCROACHMENT PERMIT This permit is between Chugach Electric Association, Inc., an Alaska non-profit electric cooperative, (herein "Chugach"), whose address is P. O. Box 196300, Anchorage, Alaska 99519 and Garrett Mitchell LaMay and Rachel LaMay, whose address is 3721 Matthews Drive, Anchorage, Alaska 99516. 1. Easement. Chugach is the grantee or user of an easement for the construction and maintenance of electrical facilities, as follows: Dedicated by the plat of the subdivision known as De Armoun Subdivision No. 2, according to Plat Number 70-352, recorded on the 2411i day of November 1970, on file in the office of the District Recorder, Anchorage Recording district, Third Judicial District, Seward Meridian, Alaska, (herein "Easement") which pertains to the following described real property: The North Ten Feet (N 10') of Lot Eight (8), Block One (1), De Armoun Subdivision No. 2, according to Plat Number 70-352, recorded on the 24111 day ofNovember 1970, on file in the office of the District Recorder, Anchorage Recording District, Third Judicial District, Seward Meridian, Alaska. Permittee acknowledges the validity of the Easement. Permittee warrants and represents that Permittee is the owner of the fee simple interest in the land subject to the Easement and the following described real property to which the Easement is adjacent: Lot Eight (8), Block One (1), De Armoun Subdivision No. 2, according to Plat Number 70-352, recorded on the 24°i day of November 1970, on file in the office of the District Recorder, Anchorage Recording District, Third Judicial District, Seward Meridian, Alaska, (herein "Parcel"). 2. Encroachment. Permittee has constructed the following improvements on or within the real property subject to said Easement: A septic drain field with sewer cleanouts that encroaches approximately Four Feet (4') into the south side of said Easement for a distance of approximately Twenty Feet (20'). The homeowner is required to mark the location and depth of the septic pipes at such time that Chugach decides to underground the existing overhead electric facilities within said easement. (herein "Encroachment") Encroachment Permit - Page i of 4 eRecorded Document 3. Permit. Chugach hereby authorizes Permittee to construct and to continue the existence of the Encroachment in its existing location subject to the covenants set forth in this permit. 4. . Indemnification. Permittee shall indemnify and hold Chugach harmless from any claims for personal injury, property damage or other loss arising in any way from the continuation ofthe Encroachment. 5. No Expansion or Increase. Permittee shall not in any way expand or increase the extent to which the Encroachment occupies any of the real property encumbered by the Easement without the prior written consent of Chugach. Chugach has no obligation to provide such consent. 6. No Interest in Real Estate Acquired. Permittee hereby acknowledges that the Encroachment and any additions thereto, even if in violation of this permit, has not and shall not in the future give rise to any interest or estate in the real property subject to the Easement or any other real property. Without in any way limiting the foregoing, Permittee acknowledges that the Encroachment is not adverse to any interest of Chugach and its continuation is entirely with the permission of Chugach for purposes of the common law doctrine of adverse possession. This permit creates no interest in the real property subject to the easement. 7. Modification of Utility_ Facilities. Ifthe electric utility facilities located within the Easement are upgraded, added to, replaced or reconstructed, Permittee shall pay that portion of Chugach's total costs for such modification which is reasonably attributable to accommodating or preserving the Encroachment. If such payment is not made within thirty (30) days of written demand for same, Chugach may terminate this permit in accordance with paragraph 9, below. R. Covenants Rumina with the Land. The obligations of the Permittee arising from this permit shall be covenants running with the land which shall burden the Parcel and the Permittee's interest in the land subject to the Easement and shall benefit the Easement. 9. Termination. Chugach may terminate this permit after the giving of thirty (30) days written notice of such termination if. a. The Encroachment is enlarged, increased or extended within the real property affected by the Easement. b. The Encroachment is damaged by any means to an extent of more than thirty percent (30%) of its replacement cost at the time of destruction. C. Permittee fails to make the payment described in paragraph 7, above. 10. Term. This permit shall, if not sooner terminated by Chugach, expire forty (40) years from the date hereof. Encroachment Permit - Page 2 of 4 2of4 eRecorded Document 2022-012523-0 I]. Entire Agreement. This written permit constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all other prior or contemporaneous agreements, oral or written, between the parties. No modifications, amendments, deletions, additions or alterations of the permit shall be effective unless in writing and signed by all of the parties hereto. CHUGACH ELECTRIC ASSOCIATION, INC. By: �i9&4k ✓' Karen Keesecker, Land Services Mgr. Chugach Electric Association, Inc. Date: 313r u eRecorded Document PERMITTEE: By: Garrett Mitchell LaMay Date:_ f 3 C:� 2 -?,– By Z By: Rachel LaMay Date: ->/Z;l ©/Z z Encroachment Permit - Page 3 of 4 3of4 2022-012523-0 STATE OF ALASKA ) ) ss: THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this ._Xa day of 1 lord, , 2022, by Garrett Mitchell LaMay.Ak �,► Public ,. �r'�Z!f��, JULIAJULIAN N. �-----_._ N N N. Zary Public in and for the State of Alaska �► Coow*Ww 6 Jub 17=1 commission expires: r<l i r j STATE OF ALASKA ) ) ss: THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this 2022, by Rachel LaM". " 7 ,9, Pubac ` 4-__. Stabs of AWke My comwAssloo EXPVft AdY » • 2023 STATE OF ALASKA ) ) ss: THIRD JUDICIAL DISTRICT } _ day of Mardi Gir i commission expires_ 1' The f regoin instrument was acknowledged before me this% day of 2022, by�c Karen Keesecker, Land Services Manager of Chugach Electric Association, Inc., an Alaska corporation, on behalf of the corporation. .`�0,.•� Notary Publi to and for the State of Alaska rr ,� My commission expires: 61 o' Z6 AFTER RECORDING RETt7RNN'i Chugach Electric Association, Inc. P.O. Box 196300 Anchorage, Alaska 99519-6300 Encroachment Permit - Page 4 of 4 4 of 4 eRecorded Document 2022-012523-0 Q.,alaska COMMUNICATIONS alaskacommumcations.com March 29, 2022 Garrett LaMay 3721 Matthews Drive Anchorage, Alaska 99516 Alaska Communications has no objections to the existing drainfield encroaching into the 10' Utility Easement located along the northern boundary of block 1, lot 8, Dearmoun Subdivision #2, otherwise known as 3721 Matthews Dr Anchorage, Alaska as depicted on the drawing provided by Tom H Dreyer from S4 Group. Alaska Communications currently utilizes this easement and has no objections to the encroachment. Alaska Communications hereby issues this letter with stipulations to allow the encroachments of the above mentioned into the easement. Acceptance, (your signature below), and use of this letter of non -objection by yourself, your heirs, your assigns, or your successors, will constitute agreement to the following stipulations: 1. Alaska Communications will be held harmless, now and forever, for any damages or injury to any person or property as a result of this encroachment. 2. Any Alaska Communications facility damaged or destroyed as a result of this encroachment will be repaired at no cost to Alaska Communications. 3. Any costs incurred by Alaska Communications for special construction necessitated by this encroachment will be bome by the property owner. 4. All applicable safety code regulations will be observed and maintained. 5. This letter of non -objection will in no way preclude Alaska Communications from full use and enjoyment of its rights within any portion of this easement. 6. Alaska Communications is under no obligation to restore any structure damaged as a result of Alaska Communications full use and enjoyment of its rights within any portion of easements or right-of-ways. Please sign both copies, retain one copy for your use and return the other to Alaska Communications. Sincerely, /CGGQ:d�Y,� /9�Q�LyLd Russell Tolentino, Network Engineer II, Outside Plant Alaska Communications Outside Plant Engineering, MS#14 600 Telephone Ave. Anchorage, AK 99503 ACCEPTANCE SIGNATURE: Grid SW2935 RCWC DATE: -3/2 1/7 Z VVI,U'31YII CI I VCIUIIC IW. VV•tVUl'VG-MOD I'+Df 5-O"V_Iy IJSCVGI,JG�J — . 0//. � 'GCI March 28, 2022 Garrett LaMay 3721 Matthews Drive Anchorage, AK To whom it may concern, Subject to your agreement to indemnify the company as set forth below, GCI Communication Corp has no objection to the existing leach field encroaching into the easement of Lot 8, Block 1, De Armoun Subdivision No. 2, also known as 3721 Matthews Drive, city grid 2935, GCI WO# 22-0980-09. This letter of non -objection in no way precludes GCI Communication Corp from full use and enjoyment of any rights it may have within any portion of the utility easement and or the right-of-way, including unlimited access for servicing its facilities. Also, any additional and extraordinary costs incurred during any future required construction, repair, or reconstruction of GCI's facilities to accommodate any or all the encroachments shall be paid by the property owner. By signing below, you agree to indemnify and hold GCI Communication Corp harmless, now, and forever, for any damage, costs, expense (including reasonable attorney's fees), liabilities and injury to any person or property occurring as a result of the encroachment. Please indicate your acceptance by signing and returning this letter to me at the address below. Sincerely, DOcuSigned by: Signature � 6"W"s .0- C�A 848A37D16E7E4DA... Date ALEX SLAVENS GCI I OSP Design Data Management Delivery Engineering 907-868-1049 ENSTAR Natural Gas Company March 25, 2022 Garrett LaMay 3 721 Mathews Drive Anchorage, AK 99516 Subject: Letter of Non -Objection — Leach Field Encroachment Lot 8, Block 1, DE ARMOUN SUBDIVISION NO. 2 To whom it may concern: ENSTAR Natural Gas Company A DMSION OF SEMCO ENERGY Engineering Department, Right of Way Section 401 E. International Airport Road P. 0. Box 190288 Anchorage, Alaska 99519-0288 (907)277-5551 FAX (907) 334-7798 ENSTAR Natural Gas Company (ENSTAR) has no objection to the existing leach field encroachment located within a ten feet (10 FT) utility easement dedicated by and located within Lot 8, Block 1, Plat No. 70-352, DE ARMOUN SUBDMSION NO. 2, filed in the records of the Anchorage Recording District, Third Judicial District, State of Alaska. Acceptance and use of this letter of non -objection by yourself, your heirs, your assigns, or your successors, will constitute agreement to the following stipulations: • Landowner/Contractor working near ENSTAR gas facilities shall contact the Alaska Digline, Inc., (907) 278-3121 or 811 for line locating two (2) business days prior to any related excavation. This service is free of charge. • ENSTAR will be held harmless, now and forever for any damages or injury to any person or property as a result of this encroachment. • Any ENSTAR facility damaged or destroyed, as a result of this encroachment will be repaired at no cost to ENSTAR. • Any costs incurred by ENSTAR for special construction necessitated by this encroachment will be borne by the landowner. • This letter of non -objection will in no way preclude ENSTAR from full use and enjoyment of its rights within any portion of its right-of-way. If you have any questions, please feel free to contact me at 334-7944 or by email at james.christopher@enstamaturalgas.com. Sincerely, James Christopher Right of Way & Compliance Technician ENSTAR Natural Gas Company Lc S89'56'00"E 100.00'(R) Co+ RR N69-�ti UU W(H&M) 09.75'(M) 100.00'(8) } Found RB held Found RB held for line 0 r7 0 Matthews Drive Legal Description: . Asbuilt Lot 8, Block 1, De Armoun Subdivision No. 2 Survey Certification: I hereby certify that ❑ Mortgagee's Inspection was performed on the described property. Notes: It is the owner's responsibility to determine the existence of any easements, covenants, or restriction which are not on the recorded subdivision plat. This ❑sbuilt shall not be used for construction or for establishing property lines. Checked by. C8 Drown by: AR Scale: 1" = 20' Jab: 2018-47 Field Book: 144 Plat: 70-35 9 44Q��Q�Oa .F - OF AL�Snp 4 9TH Thomas H. Dr r,' o LS -762 i-samr� e Legend: (M) Measured (C) Computed (R) Record Plat Set Rebar 0Q Found Rebar 0 Water n Septic 0 Wood Deck Concrete Fence Grid: 2935 2 Dote: 5/27/2020 MUNICIPALITY OFANCHORAGE On -Site Water & Wastewater Program PoBox 1snson 470mElmore Road Anchorage, Alaska Seo1g'aGno pn 904 Fax: (nnr)a13-7an7 Permit Number: OSP191187 Work Type: SepUoTenkUpgrade Tax Code Number: 01840122000 Site Legal Address: DEARyWOUN#2BLK 1 L 8 G:2035 Site Mailing Address: 3721 k4ATTHEVVSDR, Anchorage Owner: LAk8AYROY Design Engineer: GARNESGENGINEERING GROUP LTD This permit isfor the construction of: Effective Date: Expiration Date: Lot Size in Sq Ft Total Bedrooms: 613/2019 61212020 1-1Disposal Field 10 Septic Tank [] Holding Tank []Privy El Private Well M Water Storage All construction shall beinaccordance with: 1. The attached approved design. 2. All requirements specified hnAnchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska VVaehawuher Disposal Regulations (18AAC72)and Drinking Water Regulations (18AAC8O) 1 The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65.Provide notification bycalling (AO7)343'7004(24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall beeither: a. Opened and Closed onthe same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: 1) An insulated, 20" diameter (minimum) manway riser is required on the first compartmentufthe septic tank, hn accordance with 16.65.2O5F1 2) During construction, the northwest corner of the existing drainfield shall be located to confirm separation to the north property line. If it indetermined that the field is less than 10ft from the property line and encroaches onthe utility easement, a waiver and encroachment permit shall be obtained prior to closing out the permit. 3)COSAO8C1O1342was not prior hotitle transfer of property. Anapproved COSAshall be obtained once the tank isreplaced and inorder 10close, out this permit. Received By: Date: L/ Issued By: Date: (073 /11 MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Fax: 907- 343-7997 On -Site Water & Wastewater Program Mayor Dan Sullivan On -Site Sewer/Well Permit Application For A Single Family Dwelling Parcel I.D. 018-401-22 Property owner(s) ROY LAMAY Mailing address 3721 MATTHEWS DRIVE "ANCHORAGE, AK 99516 Site address 3721 MATTHEWS DRIVE `ANCHORAGE, AK 99516 Legal description (Sub'd, Block & Lot) DEARMOUN #2: BLOCK 1, LOT 8 Legal description (Township, Section & Range) Lot Size APPLICATION IS FOR: ( ® all that apply) Absorption Field ❑ Septic Tank Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Day phone 907-748-6370 Sq. Ft. Number of Bedrooms 2 - WANTS 4 BEDROOM SEPTIC APPLICATION IS AN: Initial ❑ Upgrade Renewal ❑ THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR: N/A TYPE OF DEWELLING: Single Family (SF) (w/wo ADU) Duplex (D) ❑ Multiple Dwellings ❑ (SF and/or D) _ Distance: - I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/Rush Fees: 02 A Waiver Fees: Date of Payment: 61'q �/�I 11p Date of Payment: Receipt Number: n, 6 `i Std Receipt Number: Permit No.y � to`Q C C g Waiver No. (Rev. 01/11) Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191187, Rebecca Carroll, 06/03/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191187, Rebecca Carroll, 06/03/19 J�. 0 0 31:xo LL my ma E (D m 0 h MW cy- O LO C7) 00 Z CU m 04 0 0 31:xo cn my ma V) (D C- r C. G. Lo- '02 cq C'4 E O cl 0 M ci w v 0 G C3 - 41 ® Lo u O L? to 0 - a 0 U U. 6 04 Q) > V) (D C- '02 04 % ~ MUNICIPALITY OF ANCHORAGE ~ DE~RTMENT OF HEALTH AND HUMAN SER~ES Environmental Health Division .." 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 o.-s,T, s.w^6~ ~.s.os~ S~ST~ ~.~O. W~L~ ,.S.~C~,O. ~ I ~ ~ SEPTIC ABSORPTION WELL Phone(s) P WO olBedrooms ~ ~. LOT LINE ~'.. ~o, 8 1~'°*~ t I~u~°'v'~'°" ~ar~o~ ~o~,o~,o,~/1, lq['- ?~N ~ W ~ Z? A~-BUIL.. ~G.AM (Show coat on o, well. septic system, property ~SEPTIC D HOLDING TYPE OF SYSTEM ~pth to p,pe bottom horn T°ta' depth fr°m °rioina' grade FT 0-5 FT ~ FT ~' Fl ~ PRIVATE g OTHER (Idenlilv) Classification (A,B,C) .j?:. Tm~ D~[~ FT Ca~d to FT REMARKS: Municipal and State guidelines in elle. o. Ihi A ~ ~13(3/85) DEF'AR'T'MEr,J'I ~ HJ:A_TH '-IND EN%,IRONMEN ~ Al_ "/nq~OTECTION 8,~ L STRr:.E. ~ ANCHORAGE~ Ak: 99~J)1 ~.~ 6 z.I.- 472'. 0 PERMIT NE].' DATE ISSUED: APF:'L I CAN [': ADDRESS: CONTACT PHONE: LEGAL DEGCRIP: LOT SIZE: 860:571 UPGRADE 10/03/86 BILL RODGERS 3721 MATHEWS DRIVE ANCHORAGE, AK 99516 276-6552 ~ECT ION. ~-7 FOWNSH1F 14500 (SQ.FT. DR ACRES) c:er ti ~U that: 1. I am Familiar with the requipements Fop on-site seweps and wells as set rot. th by the MunicipaIity oF ~nchoPage (MOA) and the State o£ Alaska. I w~I] install the ~ystem in accordance wi~h all MOA codes and pegulations, and ~n corelli, lance with the design criteria eF this permit. I wzll adhere to all MOA and Sta{e o~ Alaska requipements £or the set back distaeces Fr. om any existing well, wastewater disposal system or public sewerage system on this or any adjacent o~- nearby lot. IF: A I_IFT STATION IS INSTALL_ED IN AN ARE~ COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND 'INSPECTION MUST BE OBTAINED~ (2) AS-BUILTS WILL NOT BE:_' APPROVED WI]HOU] AN ELECTRICAL iNSPECTION REPORT; AND (3) THE ELECTRICAL. WORK MUST BE DONE BY A LICENSED ELECTRICIAN. APF)LICANI: BILL RE)DGERS ! ~oUmD BY > SEWER SYSTEM LOCATION PLAN Municipality o! Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: A~O~~- ~.-.~ ~ 5 DATE PERFORMED: LEGAL DESCRIPTION: '~:r~r~0U~ ~-~ ~L ~ blO0~kownship, Range, Section: 3 ~ly qr~ ~J e~l~les 4 9 10 6 11¸ 12 SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? 13 14¸ 15L 16- 17- 18- 19- IF YES, AT WHAT DEPTH? Reading Date Gross Net Depth to Net Time Time Water Drop ~- iz.'l~ t z:z? - .~o/. ~-o ./0 3 ~:z~/z~3~ -- .~o/.~1 .o~ ~ z:qt/~.'~ - .~o/. ~z ,o~ 20- PERCOLATION RATE JrT' ~1 (minutes/inch) PERC HOLE DIAMETER TEST RUN I~ETWE ' ACCORDANCE WITH ALL STATE A~ MUNICIPAL GUIDELINE~N EFFE( 72-008 (Rev. 4/85) ~" ~ FT AND b' 0 FT r' ~ -~ERTIFY THAT THIS TEST WAS PERFORMED IN ; THIS DATE. DATE: ~R -~NC~.ORAG~ A~, ANCHORAGE I)e. tx~riment o~ Environmental ( ~OO Tudor ~oad ~ Pouc~ ~a 99~SPECTION REPORT ON-SITE SE BOROU SYSTEM N? 938 NAME LOCATION MAILINg ,~j~- ~.~ ~ ADDRESS ~-/~'"q PHONE LEGAL SEPTIC TANK: DISTANCE FROM WELI~P'~/~/-'//C'/'CZ// / LIQUID CAPACITY .//~//~O----" GALLONS. MATERIAL' ~'~/~'~ NUMBER OF COMP4RTMENTS ~ ~y-~-~. ~ ,4~,~7 ~z ~t~ LIQUID INSIDE LENGTH INSIDE WIDTH. DEPTH SEEPAGE SYSTEM: SEEPAGE PiT: NUMBER OF PITS f OUTSfDE DIAMETER ~'"/~ OR WIDTH / LINING MATERIAL~' ~-~ ~:~x~ /~ ~s,z~/~.OiSTANCE FROM WELL NEAREST LOT LINE TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ., LENGTH -~/ , DEPTH ~ / , BUILDING FOUNDATION ~' / , so. ET. TILE DRAIN FIELD: y//~tOlAj L LENGTH DISTANCE PROM WELL FOUNDATION ~ LINE ,OF LINES NUMBER OF LINES DIS/LANCE BETW~EEJ~S TRENCH WIDTH IN. TOTAL EFFECTIVE ABSORPTION AREA ,./~~S~ FT~ LENGTH OF EACH LINE ~FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE WELL: TYPE~,/~'/'/~/~'/' , DEPTH ~ DISTANCE FROM ~......~' WATER , BUILDING FOUNDATION, SAMPLE ~ , NEAREST ,/NEAREST / SEPTIC / SEEPAGE / ~.~- OTHER LOT LINE , SEWER LINE ., TANK , SYSTEM ~' , CESSPOOL_ , SOURCES DISTANCES: ~'~ / /- .T~ T ~1.~ I, DATE DIAGRAM OF SYSTEM APPROVED HEALTH AUTHORITY Pu gU • Municipality of Anchorage 7 On -Site Water and Wastewater Program (907) 343-7904 Jut 16 2018 Certificate of On -Site Systems Approval �1 5 Parcel I.D. 018-401-22 Expiration Date: , <<Q 1. GENERAL INFORMATION: Complete legal description DEARMOUN #2; BLOCK 1, LOT 8 Location (site address) 3721 Matthews Drive *Anchorage 99511 Current Property owner(s) William and Joyce Rodgers Day phone Mailing address Real Estate Agent 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class C Well ® Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee $ 152,Co Waiver Fee $ Date of Payment 9'lud,tib Date of Payment Receipt Number 150 Receipt Number COSA # 05C II 13"Z Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm: Garness Engineerinq Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101- Anchorage, Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: 3 6 In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system o U r in accordance with the guidelines and regulations established by the Municipality of Anchorage and o �•. industry practices. The reported results describe the condition of the system/s on the date/s of the O P� evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells �4 ; T and septic systems depend upon a variety of variables, including but not limited to, soil conditions, . . . groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the Q fr system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of PQ CE— the well or septic system. GEG makes no representation whether an alternative well or septic system Q s can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to ea r 4 P ofe perform the evaluation. Reliance upon the information provided in this report by any other persn`��Illllt(((((/� party (including subsequent property purchasers) is not authorized, nor will it confer any ``l�h'ahtHQ�(/� whatsoever. �y 6. DSD SIGNATURE `v� System #1 Approved for i bedrooms J System #2 Approved for bedrooms JJ� Z (jc� �J-c., Disapproved Conditional approval for bedrooms, with the foil' w p t�1-) lions: I r b P 2.(- 4-,, ao U l I o aid p aye_J co S 1 I- 7a,, -k (Ai aD JLt 4 1 ash 044ro\Jj By: lu'( c/U\ 04'L� Original Certificate Date: 51311-1 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 Septic System Advisory Well Flow Advisory COSA blue sheet 10-10-12.doc Nitrate Advisory Arsenic Advjsory.� q ti Other 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: A. WELL DATA Well typecoMMUNITY Date completed Total depth DEARMOUN #2; BLOCK 1, LOT 8 If A, B, or C provide PWSID# 211936 Sanitary seal (Y/N) ft. Cased to ft. Parcel ID: 018-401-22 Well Log (Y/N)— Wires properly protected (Y Casing height (abo rour d) in. FROM WELL LOG AT INSRECTION Date of test Static water level Well production a. D. g.p.m. WATER SAMPLE RES Coliform colonies/100 ml. Nitrate mg./L. Collected by: epic: ug./L. Date of sample: B. SEPTIC/HOLDING TANK DATA 32 YEAR OLD STEEL SEPTIC TANK MAY BE APPROACHING THE END OF IT'S USEFUL LIFE. 44" OF LIQUID IN TANK ON 7/12/18. Tank Type/Material SEPTIC/STEEL Date installed 10/7/86 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping 7/12/18 Pumper ARM SERVICES C. ABSORPTION FIELD DATA I 'BELOW EXISTING GRADE AT MONITORING TUB Date installed 10/7/86 Soil rating p.d./ Zor ft2/bdrm) 200 System type BED Length 50 ft. Width 24 ft. Gravel below pipe 0.5 ft. Total depth *5.7+ ft. Eff. absorption area 1200 ft' Monitoring tube YES Depression over field NO Date of adequacy test 7/7/18 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 0 in. Water added 944 gal. New depth 3 in. Elapsed Time: 120 min. Final fluid depth 0 in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) **NONE KNOWN If yes, give date - 2026 GALLONS PRE-SOAK PERFORMED ON 7/6/18 *`HOME IS REPPORTED TO HAVE BEEN VACANT FOR 15 YEARS D. LIFT STATION Date installed_ "Pump on" level at in. Size in gallons Manhole/Access (Y/N) "Pump ofF' level atwa er alarmlevel at in. Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: COMMUNITY Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main sewer manhole/cleanout Sewer /septic service line Holding tank containment areas Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation •5'+ Property line 5'+ Absorption field 5'+ (ASSUMED) Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+&200'+ PUBLIC SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line .x101+ Building foundation 104 Water main 10'+ Water service line 104 Surface water 100'+ Driveway, parking/vehicle storage 104 Curtain drain NONE KNOWN Wells on adjacent Iots100'+ & 2004 PUBLIC F. COMMENTS 'MET CODE AT TIME OF INSTALLATION "PER 1986 INSPECTION REPORT - UNABLE TO PHYSICALLY MEASURE. DRAINFIELD MAY BE IN 10' UTILTY EASEMENT G. ENGINEER'S CERTIFICATION / certify that / have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Prined N me JEFFREY A. GARNESS Date —T / 8 (Rev. 10/12/12) L1l;LNSL ■\\\\X111'— VAECC8B4 Monitoring Summary for DEARMOUN II Public water system ID#AK2211936 Population: 80 March 1, 2018 Community Water System, Ground water (Sanitary Survey 1 (Every 3 years 108/21/2015 12018 — 00 . . COLIFORM (TCR) SPDS001TCR I i sample(s) quarterly 01/30/2018 Quarterly, according to Sample Siting Plan LEAD AND COPPER SPDS001PC 5 sample(s) every 3 years 08/17/2015 2018 (Submit materials evaluation & Sampling pool selection prior to ' sampling) WL001 WL DEARMOUN II SOC SPWL001 1 sample(s) quarterly P Oq Y 03/17/2004 Submit 2017-2019 SOC Online ` Waiver Renewal Application by September 30, 2018 NITRATE SPWL001 1 sample(s) annually 01/30/2018 2019 VOC SPWL001 1 sample(s) per 3 year period 107/13/2016 j Between 2017 and 2019 INORGANICS SPWL001 1 sample(s) per 9 year cycle 03/17/2004 I Between 2011 and 2019 ARSENIC - SINGLE SPWL001 1 sample(s) per 9 year cycle 106/03/2011 Between 2020 and 2028 RADIUM 226 AND SPWL001 1 sample(s) per 9 year cycle 07/13/2016 ( Between 2017 and 2025 228 1 1 TOTAL GROSS SPWL001 1 sample(s) per 9 year cycle 107/13/2016 Between 2017 and 2025 ALPHA j CCR - CERTIFICATION PAGE 109/30/2017 ;This can be corrected by completing the 2017 consumer 1 j confidence report certification page 1 CCR - SUBMITTAL 106/30/2018 I CCR - CERTIFICATION PAGE 09/30/2018 j "NSF = No sample found 1) Periods are three years in length. The current period is 1/1/2017 - 12/31/2019 and the next period will be 1/1/2020 - 12/31/2022. Cycles are nine years in length. The current cycle is from 1/1/2011 - 12/31/2019 and the next cycle is 1/1/2020 - 12/31/2028. 2) Periods for radionuclides (gross alpha, radium 226/228, and uranium) are three or six years in length. The current 6 year period is 01/01/2014 - 12/31/2019, the next 6 year period will be 01/01/2020 - 12/31/2025. Cycles for radionuclides are nine years in length. The current cycle is from 01/01/2017 - 12/31/2025 and the next cycle is 01/01/2026 -12/31/2034. 3) WL (well) or TP (treatment plant) is the entry point to the distribution system, except for raw water samples and WL (well) is the raw water tap. DS (distribution system) is the home and buildings that receive water from a piped water system. 4) Water quality parameters are tested in order to conduct a corrosion control study. Please contact your engineer, health corporation, or certified laboratories for assistance. 5) Lead/Copper samples on an annual or 3 year schedule should be collected in month of warmest water temperature. 6) Water systems with multiple water sources that do not combine before entering the distribution must take one sample from each entry point to the distribution and may do a composite sample according to 18AAC80.325(17), 18AAC80.315(4). 7) SOC waiver renewal forms are due every three year period. SOC waiver, new and renewal, forms can be found at http://www.dec.alaska.gov/eh/dw/publications/forms.html. 8) Each public water system is required to have a water operator (or operators) certified at or above the drinking water treatment and drinking water distribution level assigned to the system. To check on current level of certification for your water operator please see the Alaska Certified Water/Wastewater Operator Database maintained by the Division of Water: https:Hdec.alaska.gov/Applications/Water/OpCerUHome.aspx? GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3500 Tudor Road, Anchorage· Alaska 99507 279-8686 Date Eecetved Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAl. SEWER & WATER FACILITIES FOR 1. Approvel .a ested By: 2. Prooertv Owner: Lagal D. scription, ,/~ ~ ~, I, 5. Type of Facility ~o be Inspected: Number of Bedrooms: 5. Well Data: Phone.' Phone .' A. T.vpe /YJf/J./)~/~'.cv B. Depth C. Construction D. Bacteria] Analysis Sewage Disposal System: A. Installed~ B, Insteller ~C~~ C. Septic Tank: 1. Size /D~O 2. ~anufacturer D. Seepage Pit: 1. Size/~ ~ ~& 2. Material E. Disposal Fie]d: Tot. al Length of Lines Distances: A. Well To: Septic Tank~g~ Absorption Area , Sewer Lines · Nearest Lot Line , Other Contamination B. Foundation to Septic Tank "~ AbsOrption Area C. Absorption Area to Nearest Lot Line ~ / ReqUest for Approval of Page Two 9. Comments: Sewer & Water Apnroved Disapproved Date Approval Valid for One Year From Date Signed Greater Anchorage Area Borough, Department of Environmental ~ualtty DIAGRAM OF SYSTEM, ! certify that the information contained in this request for approval to be a true and accurate representation of the sub.iect sewer and water facilities located at: Signed Date