HomeMy WebLinkAboutMALINOIS LT 2Malinois
Lot 2
#015-143-07
Municipality of Anchorage •°
Development Services Department
Building Safety Division e. .
On -Site Water and Wastewater Program, 4700 S. Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650 Page of
www.ci.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: SW030191 PID Number: 015-142-25
1 -142-
Name
Name
Wastewater System: ® New ❑ Upgrade
Address:
I 1500 Daryl Ave. Anchorage AK 99515
ABSORPTION FIELD
Phone: Numberof Bedrooms:
276-1 1901 4
® Deep Trench ® Shallow Trench ❑ Bed ❑ Mound ❑ Other:
LEGAL DESCRIPTION
Soil Rating:
Total Depth from original grade:
0.6 GPD/FF
3.01/3.03 Ft.
Block: Lot: Subdivision:
Depth to pipe bottom from original grade:
Gravel depth beneath pipe:
2 Malinois
2.0 Ft.
1.01/1.03 Ft.
Township: Range: Section:
Fill added above original grade:
Gravel Length:
32N 3W 22
2.95/2.03 Ft.
180 Ft.
Well: ®New F1 Upgrade
Gravel width:
Number of lines:
Distance between lines:
5.0 Ft.
2
10 Ft.
Classification (Private, A, B, C):
Total Depth:
Chancre:
Total absorption area:
Pipe Material:
Private
146 Ft.
1 146 Ft.
1022 Fel
D3034 & F810
Driller:
Date Drilled:
Static Water Level:
Installer:
Date Installed:
Al inn
8/2/2003
1 86 Ft.
Whitters Const.
9/5/2003
Yield:
Pump Set at:
Casing Height Above Ground:
TANK
40 GPM
136 Ft.
2 Ft.
SEPARATION DISTANCES
® Septic ❑ Holding ❑ S.T.E.P. ❑ Other:
To
Septic
Absorption
Lift
Holding
Public/Private
Manufacturer:
aferny:
From
Tank
Field
Station
Tank
Sewer Line
Anchorage Tank
1250 Gal.
well
100'+
100'+
NA
NA
25'+
Material:
Steel
Number of Compartments:
2
Samoa. Water
100'+
100'+
NA
NA
LIFT STATION
Lot Line
5'+
10'+
NA
NA
ize:
anac
u urec
Gal.
Foundation
5'+
10'+
NA
NA
'Pump on" level at:
n.
"Pump ofP level at:
n.
Hig h water alarm at:
n.
Curtain Drain
NA
*50'+
NA
NA
Pump Make & Made l
Elechical Inspections performed by:
Remarks:
tank & field insulated
BENCH MARK
Location and Description:
Top of sono tube o caryti er¢ ore -
Assumed Elevation:
100 Ft.
Engineer's Stamp
OF 44 111111,
or h .••• ;;;.. ��•,j91,
Inspections performed by: KND Engineering Inc.Dates: l st 9 /4/2003
14
d
Development Services Department Approval
•91
. ••. •
=.
♦ T Ken I .: ,; f �S%
Reviewed and approved by: ate:
(Rev. 12/00)•1;o.
1 % �� r
FE
0
KDo
AE
Ln
i
M
rl)
KO
io
!D
A -D=14.2'
B -D=24.0'
A -E=11.2'
B -E=29.51
A -F=23,8
C -F=118.0
A -G=67.8'
C -G=33.5'
A -H=32.0'
C -H=116.3'
A -I=78,2'
C -I=37.0'
AS -BUILT SYSTEM DETAILS/SITE PLAN Permit SW030191
MALINDIS LOT 2 PID# 015-142-25
A
DRQ
CAL S.T.
n r_-7_
Rw
4
nw -7250 GA
'M
0 SEPTIC
g TANK
..... . . .. .....
Z.
OF A,., *4
XEMTH MPS/
... . ... Adr
4eonsslovh -AV
9
> FINAL GRADE
SEWER ROCK
TRENCH 1
90,
FINAL GRADE
SEWER ROCK
TRENCH 2
9FFERTFRT�
— 90, —
PREPARED FOR1
JOHN & GINNA BALDIVIEZ
P.O. BOX 200273
ANCH., AK 99520
(907)276-1801
FIELD BOOKS COMPUTED:
EOUNDA . Wim+;
VBG
STMING: CHECKED:
KMD
ASBUILT, MM..
7/31/
M. RLE.. GRID:
2637
ACRD "LE-' 02077.DWG 10B No.;
02077
0
ZE
SCALE- 1' = 50'
MNIMR TUBE n n mENMIT-a
..jup VARIES
ON
8 T
LOT
TUBE
SCALE: NTS
LtUl W) ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
08/02/2004 17:05 9076968111 KND INVESTMENTS PAGE 02
TO:
Mu ® C
Department z
1. P.O. Box 18rS.+ . .
Rick Mystrom ..
Mayor
Permit Number: #SW 030191 Date of Issue: 6-17-03 Parcel Identilleation Number. 015-142-25
Date Started: 8-1-0A Date Completed: 8.2.03 Is well located at approved permit location? ® Yes [] No
Legal Description: T12N R3 W Sec 22 Lot 39
Property thmer Name & Address: John & Ginna Ba(diviez
11385 Totem (load
Anchorage Alaska 99516-1657
Borehole Data:
SOU Type, Thickness & Water Su:m
Depth (ft)
Prom To
Method of Drilling ® air rotary ❑ cable tool
Casing type: sleel
stick-up
0
2
wall Thickness: .250 inches
sr7ty sand
2
12
Diameter: 6 inches Depth; 146 feet
gravelly silt
12
33
Liner Type:
sandy gravelly silt
gravelly silt
sandy silty gravel
sandy silt
_
1tY gravel
33
36
45
57
75
36
45
57
75
104
Diameter:. inches Depth: feet
Casing stickup above ground: 2 feet
Static water level (from ground level): 8¢_feet
Pumping level: 146 feet after
in 4o m
2 hours Pt>mPggP
.�
Recovery Rate: 40 gpm
silt
104
121
Method of Testing: air ff
silly gravel wet
121
128
Well Intake Opening Type:
aN
water sand & gravel
128
138
138
146
®fin End ❑ Open Hole
Screened Startfeet Stopped feet
Perforations Start feet Stopped feet
Grout Type: bentonite # 8 Volume: s a$
.Depth: Start_0 feet Stopped P fat
Pump: Intake Depth feet
Pump size hp Brand Name
Well Disinfected Upon Completion? ® Yes ❑ No
Method of Disinfection:
Comments:
Well Driller. Alpine Drilling & Enterprises
PO Box 110496
Anchorage Alaska 99,511
Attention: The well driller shall provide a well log to the property owner within 30 days of completion and the property
08/02/2004 17:05 9076968111 KND INVESTMENTS
ARROW PUMP & WEII SERVICE/ LLC �
P.O. BOX 110496
Anchorage, AK 99511 sb(
Office: (907) 346.9355 • Fax (907) 333.8976 7
E-mail: aarowpumpandwellsvc0hohhalLoom
r—CUSTOMER
�/Aaa`� iONtl 3,2/
L
_J L
I JOB SITE _
PAGE 03
QN OO U
6491
Ink You
SIGNATURE
Q Hereby AckrrW0119e me S8118tadory Completlon of the Above Dounbed Work.;
TERM& ACCOUNTS PAYABLE AT 111TH OF MONTH FOLLOWBIG PURCHASE.
SEAVICE CHARGE AT RATE OF 1.5% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS.
{
•
�� ARMF46MA
.. 21;
■r��®mac-mss'
._.-
r��
PAY THIS AMOUNT
Ink You
SIGNATURE
Q Hereby AckrrW0119e me S8118tadory Completlon of the Above Dounbed Work.;
TERM& ACCOUNTS PAYABLE AT 111TH OF MONTH FOLLOWBIG PURCHASE.
SEAVICE CHARGE AT RATE OF 1.5% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS.
q It4J03 `-fpm
MUNICIPALITY OF ANCHORAGE C�
Development Services Department �
On -Site Water & Wastewater 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 Issued: Jun 17. 2003
Expiration Date: Jun 16, 2004
Permit Number: SW030191 Parcel ID: 015-142-25
Legal Description: �T' 3.
',
Design Engineer: 0070 KND Engineering Site Address: 011315 TOTEM RD
Owner Name: JOHN & GINNA BALDIVIEZ Lot Size: 214500 SQ. FT.
Owner Address: 11315 TOTEM ROAD Total Bedrooms: 4 Permit Bedrooms: 4
ANCHORAGE, AK 99516-1657
This permit is for the construction of:
0 Disposal Field [v] 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.
Received By:
Issued By:
Date: '�//8/e 7
Date:
x/743
Municipality of Anchorage
+e Development Services Department€
Building Safety Division
On -Site Water and Wastewater Program A £ F-
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 SjNGLE FAMILY DWELLING
J lS 1 `iZ- Zs 4
Parcel I.D. Permit Number SWO30/9/
Property
phone 276-1801
Mailing address (2) Zip Code
Legal description (Lot, Block & Sub'd.) Malinois, Lot 2 . dlc6n-t 17,N Q 3W SA 2 LC-{ �9
Legal description (Section, Township & Range)
Lot Size d Acres/Sq.Ft.
Number of Bedrooms 4
THIS APPLICATION IS FOR:
Sewer Only
❑
Well Only
❑
Sewer and Well
®
Water Storage
❑
Sewer Upgrade
❑
THIS PROPERTY CONTAINS:
Hot Tub
❑
Jacuzzi
❑
Swimming Pool
❑
Water Softening Unit
❑
Therapy Pool
❑
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
re of property owner or authorized agent)
Permit Fees:
Date of Payment:
Receipt Number:
(Rev. 12/00)
Waiver Fees:
5/7--3 3 Date of Payment:
D31o20% �� Receipt Number:
ND ENGINEERING, INC.
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
1/FAX (907)696-8111
May 29, 2003
Municipality of Anchorage
Development Services Department
On -Site Water & Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
Subject: New sewer/well permit — Malinois, Lot 2
Gentlemen:
The owner has requested we proceed forward to obtain a septic permit on the subject
lot. On October 17, 2002 and on March 28, 2003 testholes were performed for the
proposed system. The results of these tests are attached. The general slope of this lot is
from southeast to northwest at a grade of approximately 3-10%.
We have designed our system utilizing the testholes that were excavated for the
proposed 4 -bedroom house. The lot will be served by an individual well, located on the
northeastern portion of the lot. We propose to install two 5' wide shallow trenches.
Water was not encountered during the excavation or during monitoring.
There are no public or private wells within 200' of our proposed system location except
as noted. There is no surface water within 100' of the proposed system and there are no
known curtain drains within 50'. We do not expect there to be any adverse effect on
adjacent lots by the development of this system.
If you have any questions, please contact me at 696-6111/FAX 696-8111.
Respectfully submitted,
Attachments: On -Site Well and Sewer Application
Wastewater Absorption System Details/Site Plan
Soils Log/ Percolation Test
(WELL & WASTEWATER DISP❑SAL SYSTEM DETAILS/SITE PLANT
MALINDIS LOT 2
�N.
K� D
7\
ALL LOTS SERVED WITH COMMUNITY WATER
NO PUBLIC WELLS WITHIN BOO' CF
PR13PCSED SYSTEM.
NO PRIVATE WELLS WITHIN 200' OF
PROPOSED SYSTEM EXCEPT AS NOTED.
NO SEPTIC SYSTEMS WITHIN 200' OF
PROPOSED WELL EXCEPT AS NOTED.
��.QF..AL.gS
'i1 Q1 TH�
11 CE 7118 a /
sslov� i
wv��J
DESIGN DETAILS
4 BDRM X 150 GPD = 600 GPD
600 GPD/0.6 GPD PER SQ. FT. (24.0 MIN/IN.)= 1000.0 SQ. FT
(1000/5'(W)) X 0.88(RF) (1.0 GRAVEL) = 176.0 FT. TRENCH
USE 2 TRENCHES - 88' (U X 5' (W) X 3'(D)
Total depth of system Is 3' from orlginal grade.
Total depth of gravel below distribution pipe is 1.0' .
NOTES,
1, USE 1250 GALLON SEPTIC TANK. INSULATE TANK IF <4' COVER.
2. INSULATE TRENCHES WITH 2' HD BURIAL FOAM,
3. CONTRACTOR WILL ENSURE MAXIMUM 2% SLOPE INTO SEPTIC TANK,
4. ADDITIONAL FILL WILL BE ADDED OVER SYSTEM TO ACHIEVE
MIN. 3' COVER IF REQUIRED.
5. CONTRACTOR SHALL VERIFY ALL SETBACK AND SEPARATION
REQUIREMENTS.
PREPARED FOR:
JOHN & GINNA BALDIVIEZ
P.O. BOX 200273
ANCH., AK 99520
(907)276-1801
FIELD BOOKS
BOUNDARY: _
STAKMO: _
ASBUILT: _
ONO. RLE:
ACRD ""' 02077
COMPUIEO
DRAYM:
CHECKED:
DATE:
ORD:
JOB NS.: 02077
Scale) 1'= 100'
PAGE 1 OF 2
ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
LOT 2
1
i
I
i
I
1
1
1
Is
I
R
I
�
I
I
i
1
i
1
4 i
I
N W57'52 R M..W' _
-----------------------------------
ALL LOTS SERVED WITH COMMUNITY WATER
NO PUBLIC WELLS WITHIN BOO' CF
PR13PCSED SYSTEM.
NO PRIVATE WELLS WITHIN 200' OF
PROPOSED SYSTEM EXCEPT AS NOTED.
NO SEPTIC SYSTEMS WITHIN 200' OF
PROPOSED WELL EXCEPT AS NOTED.
��.QF..AL.gS
'i1 Q1 TH�
11 CE 7118 a /
sslov� i
wv��J
DESIGN DETAILS
4 BDRM X 150 GPD = 600 GPD
600 GPD/0.6 GPD PER SQ. FT. (24.0 MIN/IN.)= 1000.0 SQ. FT
(1000/5'(W)) X 0.88(RF) (1.0 GRAVEL) = 176.0 FT. TRENCH
USE 2 TRENCHES - 88' (U X 5' (W) X 3'(D)
Total depth of system Is 3' from orlginal grade.
Total depth of gravel below distribution pipe is 1.0' .
NOTES,
1, USE 1250 GALLON SEPTIC TANK. INSULATE TANK IF <4' COVER.
2. INSULATE TRENCHES WITH 2' HD BURIAL FOAM,
3. CONTRACTOR WILL ENSURE MAXIMUM 2% SLOPE INTO SEPTIC TANK,
4. ADDITIONAL FILL WILL BE ADDED OVER SYSTEM TO ACHIEVE
MIN. 3' COVER IF REQUIRED.
5. CONTRACTOR SHALL VERIFY ALL SETBACK AND SEPARATION
REQUIREMENTS.
PREPARED FOR:
JOHN & GINNA BALDIVIEZ
P.O. BOX 200273
ANCH., AK 99520
(907)276-1801
FIELD BOOKS
BOUNDARY: _
STAKMO: _
ASBUILT: _
ONO. RLE:
ACRD ""' 02077
COMPUIEO
DRAYM:
CHECKED:
DATE:
ORD:
JOB NS.: 02077
Scale) 1'= 100'
PAGE 1 OF 2
ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
0
WASTEWATER DISPOSAL SYSTEM DETAILS
MALINOIS LOT 2
1 �
SCO
10'
10'
T
ZABEL
\/OSPLITTER FC
a
PROPOSED
1250 GAL S.T.
"409 T *
�- .. Amin M. uur
1 CE -7118 ,fat 010
'•7'S$$tDiy�Aw
9
PREPARED FOR
JOHN & GINNA BALDIVIEZ
P.O. BOX 200273
ANCH„ AK 99520
(907)276-1801
FIELD BOOKS DDuvurm:
BouNuwr: _ DPAWN:
JSG
STAKMiG: — CNECKO:
KMD
A UIM. _ mm,
28 MA
DWG. FILE: GRID:
2637
Aw FILE: 02077.DwG JOB N'
02077
0
6
M
Scalel 1'= 20'
PAGE 2 OF 2
=.11 LVJ ENGINEERING
20441 PTARMIGAN BLVD,
EAGLE RIVER, AK 99577-8736
D ENGINEERING, INC.
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
Ce' 7175
SOILS PERCOLATION TEST
Performed for: Lang & Associates, Inc. Date Performed: 3/28
Project: Malinois Lot 2 TEST HOLE # 2003-1
Depth
(Feet) SEE ATTACHED SITE PLAN
Org/OL-brown silty overburden
w/organics
SM-GM/ML - med dense, gray,
w/cobbles to 8"
silt & density increasing
w/ depth
B.O.H.
HOLE PRESOAKED
PRIOR TO TEST
FOR HOLE LOCATION
Was Ground water encountered? NO What depth? NA
Depth to water after monitoring? NO Date? 4/8/03
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
1
3/29/03
1:00
7"
-
2
1:30
30 min
411/16"
25/16-
3
*
1:31
7"
-
4
2:01
30 min
410/16"
26/1611
5
2:02
7"
-
6
2:32
30 min
411/16"
25/16"
Water
Added
Percolation Rate 12.99 (min/in) Perc Hole Diameter 6"
Test Run Between 3 feet and 4 feet
I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in
effect on this date.
Performed for: Lang & Associates, Inc. Date Performed: 3%2$�3�0`�
Project: Malinois Lot 2 TEST HOLE # 2003-2
Depth
1-
2-
3-
4-
5-
6-
7-
8-
9-
10-
11-
12-
13-
14-
15-
16-
17-
18-
19-
20-
Org/OL-brown silty overburden
w/organics
SM-GM/ML - med dense, gray,
W/ cobbles to 8"
silt & density increasing
W/ depth
B.O.H.
HOLE PRESOAKED
PRIOR TO TEST
SEE ATTACHED SITE PLAN
FOR HOLE LOCATION
Was Ground water encountered? NO What depth? NA
Depth to water after monitoring? NO Date? 4/8/03
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
1
3/29/03
1:00
7"
-
2
1:30
30 min
27/16-
49/16-
9/16"3
3
1:31
7"
-
4
2:01
30 min
2 8/16"
4 8/16"
5
2:02
7"
-
6
2:32
30 min
28/16-
48/16-
8/16"*
*
Water
Added
Percolation Rate 6.67 (min/in) Perc Hole Diameter 6"
Test Run Between 3 feet and 4 feet
I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in
effect on this date.
V D ENGINEERING, INC.
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
. Kenneth M. Dufffis
C'. CE 7116
SOILS PERCOLATION TEST # `� �'•.
®dF�pROFESS1eNP�
Performed for: Lang & Associates, Inc. Date Performed: 10
Project: Malinois Lot 2 TEST HOLE # 2002-1
1-
2-
3-
4-
5-
6-
7-
8-
9-
10-
11-
12-
13-
14-
15-
16-
17-
18-
19-
20-
Depth
Org/ML—brown silty overburden
w/organics
GM/ML — med dense, gray,
w/cobbles to 8", GP/SP
pockets & smearing
ML - tan, moist, smearing
visually impermeable
B.O.H.
HOLE PRESOAKED
PRIOR TO TEST
SEE ATTACHED SITE PLAN
FOR HOLE LOCATION
Was Ground water encountered? NO What depth? NA
Depth to water after monitoring? NO Date? 10/24/02
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
1
10/18/02
1:00
6"
-
2
1:30
30 min
412/16"
1 4/16"
3
1:31
6"
-
4
2:01
30 min
413/16"
13/16"
5
2:02
6"
-
6
2:32
30 min
412/16"
14/16"
*
Water
Added
Percolation Rate 24 (min/in) Perc Hole Diameter 6"
Test Run Between 4 feet and 5 feet
I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in
effect on this date.
Municipality of Anchorage
Development Services Department
Building Safety Division s
On -Site Water and Wastewater Program
4700 South Bragaw St. A 'T
P.O. Box 196650 Anchorage, AK 99519-6650
www.cl.anchorage.ak.us
(907) 343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel l.D. 015-142-25 HAA #
Expiration Date: q - "
1. GENERAL INFORMATION
Complete legal description Malinois Suhd_ Lot 2
Location (site address or directions) ((3$5 TCi&yn 20 AIA, gash
Current Property owner(s) John & Ginna Baldiviez Day phone 276-1801
Mailing address P.O. Box 200273 Anchorage AK. 99520
Lending agency Day phone
Mailing address
Real Estate Agent Day phone
Mailing Address
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 4
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
®
Individual On-site
Individual Water Storage
❑
Individual Holding tank
Community Class Well
❑
Community On-site
Public Water System
❑
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 4 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. (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
p&ofessional engineer's work.
00V
4. 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 Health Authority 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 .ND FNAINFFRING,Phone.91
�.• 1' a •,� . ,. ..
Engineer's Printed Name Kenneth M_ Duffus Date 7/31/2004
Engineer's Comments:
This investigation was completed in compliance with
ADEC and MOA regulations. 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 and the water usage
of the family being served by the system. The operational
life of all well and septic systems are subject to these
various and dynamic characteristics and are outside the
control of the evaluator of the well and septic system.
Therefore, KND can not give any estimate of how long a
system will function satisfactory for current or future
occupants or can KND guarantee that no unseen
encroachments, deficiencies or discrepancies exist.
5. DSD SIGNATURE
Approved for �— bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
Attachments:
HAA Checklist X Maintenance Agreements
Septic System Advisory Supplemental Engineer's Report
Well Flow Advisory Other
By: Original Certificate Date: r
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PLOT PLAN AS BUILT X SCALE 1”=50' GRID2637 Project No. 02-178
Lang & Associates, inc. 11500 Daryl Avenue, Anchorage, Alaska 99515-3049
(907) 522-6476 Phone
Registered Land Surveyors (907) 522-4625 Fax OF A
www.langsurvoyare.com / Info®longsurveyors.com ,!
1 hereby certify that I have surveyed the following described property: �Q
LOT 2, MALINOIS SUBDIVISION (PLAT 2003-77 49 -IB
Anchorage Recording District, Alaska, and 1 the improvements situated thereon aro
wtihin the property lines and do not encroach onto the property adjacent thereto, that
no Improvements. on the property lying adjacent thereto encroach on the surveyodL
promises and that there aro no roadways, transmission linos or other visible easements
on sold property except as Indicated hereon.
Dated this the 30� Day of Tom_ , S004, , of Anchorage. Alaska R Is the responsibility of the owner to determine the existence of any easements,
covenants, or restrictions which do not appear on the recorded subdivision plat.
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