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HomeMy WebLinkAboutEKLUTNA HEIGHTS BLK 2 LT 8Dklutna H ight lock 2: Lot 8D ! - 06 ! -68  O Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program, 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 Page of www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: OSPl11212 PID Number: 051-061-68 Name: GMAC MORTGAGE LLC Wastewater System: [] New [] Upgrade Address: ABSORPTION FIELD Phone: Number of Bedrooms:3 [] Deep Trench [] ShallowTmnch [] Bed [] Mound [] Other: LEGAL DESCRIPTION Soil Rating: Total Depth from odginal grade: 1.2 GPD/Ft~ 9.5 Ft. Block:2 Lot: SD Subdivision: Depth to pipe bottom from odginal grade: Gravel depth beneath pipe: EKLUTNA HEIGHTS 3.5 Ft. 6 Ft. Townsl~ip: Range: Section: Fill added above odginal grade: Gravel Length: 0-1 Ft. 40 Ft. Well: [] New [] Upgrade erave~ width: Number of Ii .... I Distance between lines: 3 Ft. 1 .... Ft. I Classification (Private, A, B, C): Total Depth: Cased to: Total absorption area: Pipe Material: PUBLIC Ft. Ft. 480 Ft2 F810 & ASTM 3034 Driller: Date Drilled: Static Water Level: Installer: Date Installed: Ft. DEAN CONST. 9/28/2011 Yield: Pump Set at: Ft. Casing Height Above Ground: CPM Ft. TANK SEPARATION DISTANCES [] Septic [] Holding [] S.T.E.P. [] Other: T~To Septic Absorption Lift Holding *ublic/Pdvate Manufacturer. Capacity: Tank Field Station Tank Sewer Line ANCHORAGE TANK 1000 Gal. Material: · Number of Compartments: we, 200'+ 200'+ N/A N/A 25'+ STEEL 2 Surface Water 100'+ 100'+ N/A N/A ~ / LIFT STATION Size: Manufacturer: Lot Line 5'+ 10'+ N/A N/A 10'+ "Pump on" level at: "Pump ofF' level at: I High water alarm at: Foundation 5'+ N/A N/A in. in. in. Cur~in Drai. 50'+ 50 + N/A N/A Pump Make & Model Electrical Inspections pefforrned by: Remarks: EXISTING SYSTEM ABANDONED PER MOA BENCH MARK Location and Description: REQUIREMENTS. BOTTOM DOOR JAM ON SHOP Assumed Elevation: 100 Ft. Inspections performed by: LARS SPURKLAND Dates: 1st 9/28/2011 ~ --~ 2ed 9/28/2011 Development Services Department Approval Conditional Approval Date: ~"p Reviewed and approved by: ~ ~/-~£.~.,~ Date: /~,,/4/~/ I I LET 73 ~ ~YSTEi~ PER UPC REOUIREI~ENTSJ DEL C.O. E 24.5' 44.5' INSTALLE~ 3-BEDRO0~ SEPTIC SYSTE~ I000 GABON TANK % LENGTH 40 FE~ TOTAL DEPTH 9.5 ROCK DEPTH 6 COVER 4 I LOT 1  ~ L~T 3 LBT ~ I OEPART~ENT ~CU~ENrATION. A~ L~ONS SHOWN ARE SPURK~ND ENGINEERING EKLUTNA HEIGHTS BLK 2 LOT 8D SEPTIC SYSTEM ASBUILT 203 · 15TH. AVENUE ANCH. AK. 99501 GWAC WORTAGE LLC DATE: OCT. 25, 2011 (9o7) 279-391~ 21~15 SE~LERS fiR., CHUGIA~ AK 995~7 SHEET: 2/3 GRID: PERMIT ~2Pl11~1~ Piti ~ 051-061-68 EHBSL SflSCS~fl~6 Peep l-r'ench: 3' l,//cle ,10' Lon9 ]0' Max Beep 6 ' Se~er Rock lo IO00 gal Sepfic tank 0 SPURKLAND ENGINEERING [[ 803 Wt5th Ave Anchorage Ak 99501 ~75--~1~ EKI, UTNA HEIGHTS Biff( 2 LOT 8D GMAC MORTAGE LLC SEPTIC SYSTEM ASBUILT DATE, L1CT.25, 2011 8HEET~ $,~$ QI~ID~tqYlq¢I PERMIT tf 0SP111212 PARCEL ID If 051-061-68 EHB2L8DD$.DWG On-Site Wastewater Disposal System Permit OSPl11212 05106168000 Septic MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: Tax Code Number: Work Type: Permit Effective Dates: August 26, 2011 to Design Engineer: SPURKLAND ENGINEERING Subdivision: EKLUTNA HEIGHTS Upgrade August 25, 2012 Site Legal Address: EKLUTNA HEIGHTS BLK 2 LT 8D G:1461 Owner/Address: GMAC MORTGAGE LLC 1100 VIRGINIA DR FORT WASHINGTON PA 190340000 Site Mailing Address: 21615 SETTLERS DR, Chugiak Lot Size in Sq Ft: 26145 Total Bedrooms: 3 This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B,.,G~4~.red, sealed, and heated to prevent freezing. Special Provisions: A percolation test shall be conducted in the SM soil strata prior to construction. Please submit stamped and signed results with the As-built Inspection Report. If the results require a design change, construction of the system will stop pending On-Site review and approval. AMC 15.65.060.B.3 Issued By: ,/(~~ Date: IVIUNICIPALITY Community Development Department Development Services Division On-Site Water & Wastewater Program Mayor Dan Sullivan OF ANCHORAGE Phone: 907-343-7904 Fax: 907-343-7997 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. ....:, i Property owner(s) Mailing address Day phone Site address ¢".:_~ .,:,~ ':~ .'):,~-'~_~-~'-~ P.".., ~ (~h~,,,,I.4. Legal description (Sub'd., Block & Lot) Z.i.<~ ~,-~ ~ Legal description (Township, Range & Section) LotSize ~,.¢o, lq-~ Sq. Ft. Number of Bedrooms THIS APPLICATION IS FOR: ([~ all that apply) Absorption Field [Z], Septic Tank Holding Tank [] Privy [] Private Well [] Water Storage [] THIS APPLICATION IS AN: Initial [] Upgrade ,J~ Renewal [] THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: 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. (Sigrlat~re of property owner or ~utho-rizeo agent) Fees: Date of Payment: Receipt Number: Permit No. Waiver Fees: Date of Payment: Receipt Number: Waiver No. G:\Building\On Site\Forms\Client Forms\Permit App_010411 .doc (Rev. 1111 ) Environmental Consulting and Design SEPTIC SYSTEM DESIGN EKLUTNA HEIGHTS BLOCK 2 LOT 8D Municipality of Anchorage Development Services Department On Site Water and Wastewater Program 4700 Elmore Rd. Anchorage, Alaska 99519 AugustS, 2011 Subject: Septic System Installation Permit Ladies and Gentlemen: I am writing to request a permit to upgrade the septic system for the above referenced property. The proposed system will serve a 2-bedroom single-family residence. The existing septic system was installed in 1975 and did not meet COSA requirements. Soil logs, design calculations, a site plan, design drawings and construction specifications are enclosed for your review. Design Calcs: No groundwater observed to a depth of 17.5 feet below ground surface (8/5/2011) Soil Rating. From Testhole 7/21/11 1.7 min/in = 1.2 gal per sq.ft/day No. of Bedrooms 3 Required Area per Bedroom: 150/1.2 =125 sq.ft. Total area required: 125 x 3 =375 sqft System: We are proposing a 1000 gallon septic tank, and a deep trench absorption field. The absorption field will be 40 feet long and 2 feet wide and contain 6 feet (480 sq.ft, effective) of sewer rock. Soils: A test hole was excavated on July 21st, 2011. See the attached soil logs. Ground water was not observed. Surface Water: No surface waters were observed within one hundred feet of the proposed septic system. Topography: The lot in the area of the proposed septic system upgrade is generally level. The ground surface elevation varies by +/- 1 foot over the length of the proposed trench. 203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland~gci. net Environmental Consulting and Design I I Waivers: None required. The installation of this septic system will not prevent wells and septic systems from being installed on the adjacent lots. The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. If you have any questions or concerns, please contact me at 279-3916. Sincerely, Lars Spurkl~/nd, P.E. Civil Engineer 203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, Lspurkland~gci.net LOT ~0~ LOT 7~ , LDT 8D ~'~-~ I LOT 8C I L{]T ll~ I II~--L-~ ~"~"~ ~' CHUGIAK DR. I LOT 13 ~I I LOT 3 I G~I~ LOT I I I i~ I j NOTE~ EKLUTNA H~IGH~ SUBOIVISION SERVEO BY A C~SS A WATER SYSTE~. ~ ~ L~A~ONS TAKEN ~RO~ ON-SI~ ~A~R AND ~AS~ WATER OEPAR~ENT ~U~ENTATION. A~ LOCATIONS SHO~N ARE APPROXIMATE. ]./~ .......... ~:~..:.y~y...~..t...  .C ..... ~....~.~~.~ ~CALD ]' = ]00 F~ SPURK~ND ENGINEERING E~UYNA HEIGHY~ H~ ~ LOT 6D SEPTIC SYSTEU DESIGN 20~ · ~STH. AVENUE ARCH. AK. ~50~ G~AC ~ORTAGE LLC DATE: AUGUST 8, 20~ (907) 279-3916 21615 SETTLERS DR., CHUG/AK, AK 99567 SHEET: I/3 GRID: 1461 PERMIT ~ OSP]llOXX PID ff 051-061-68 EHB~L 8~SC]O0,D~G N LET 73 BANOONEXISTING SEPTIC YSTEM PER UPC REOUIREI~ENTSJ LDT 81) CHUGIAK ~R, INSTALL ..T-BEflRO01~ SEPTIC SYSTEI~ 1000 GALLON TANK LENGTH 40 FEET WIDTH 2.0 FEET TOTAL DEPTH 10 fEET ROCK DEPTH 6 FEET COVER 4 FEET % \ LOT 8C LDT 3 LDT 8 NOT, EKLUTNA HEIGHTS SUDDIVISION S~ VEO DY A CLASS A WATER SYSTEM. WELL IS GREATER THAN 200' FROM PROPOSED SEPTIC SYSTEM NOTE: THIS IS NOT A SURV~ED PLAT. WELL k SEPTIC LOCAITONS TAKEN f'ROl~ ON-SITE WATER AND WAST£ WATER DEPARTMENT DOCUMENTATION. ALL LOCATIONS SHOWN ARE APPROXII~A TE. SCALE: 1' = SO FT. LIlT 1 SPURKLAND ENGINEERING 203 W 15TN. AVENUE ANON. AK. 99501 (sox) EKLUTNA HEIGHTS BLK 2 LOT 8B GkfAC kfORTAGE LLC 21613 $£tTL£R$ DR., CHUG/AK, AK 9936)' SEPTIC SYSTEM DESIGN DATE: AUGUST 8, 2011 $1-1££T: ~//$ OR/D: 145 PERMIT #£SPlllOXX PID # 051-061-68 EHB2L8DSCSO. DP/G ~eep Tnench: ~' ~/i~e 40' Long 10' Max Beep 6 ' Sewer Rock 4' Cove~ Silt Bot"t"ier' - Effective NO SCALE /-- Cleanouts:----~it°r 6,0 Pt o£ Septic Rock NO SCALE o 1000 gal Septic tank -00 lO00 gal, septic tank SPURKLAND ENGINEERING J J 203 ~15~h Ave Anchorage Ak 99501 279-3916 EKLUTNA HEIGHTS BLK 2 LOT 8B GklAC blORTAGE LLC 21615 SE'ITL~R$ DR., CHUGIAK, AK 99567 SEPTIC SYSTEM DESIGN DATE: AUGUST 8, £01I SHEET: $/J GRID:N~/1461 PERklIT if OSPXXXXXX PARCEL ID if 051-061-68 EHB2LSDD$.DICG Performed For: Legal Description: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.ci.anchoraqe.ak.us (907) 343-7904 Soils Log - Percolation Test EKL~'TNA ~E.-ig-~T5 FSLKZ LOT gD Township, Range, Section: Slope Site Plan 2- 3- 4- 5- 6- 7- 8- 9- 10- 11- 12- 13- 15- 16- 17- 20- COMMENTS Lo~ J ~ilJc B.o.~, WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Water After Monitoring? Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE ~ (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN /~ FT AND 7 FT PERFORMED BY: L,~ ~('~pl..I/'~)~,~ , /~ ~~~ CERTIFY THAT THIS TESTWAS PERFORMED IN ACCORDANC~ WITH ALL STATE AND MUNICIPAL ~U~D~I~INES IN EFFECT ON THIS DATE. DATE: Performed For: Legal Description: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.ci.anchoraqe.ak.us (907) 343-7904 Soils Log - Percolation Test BOB BROCK EKLUTNA HEIGHTS BLK 2 LT 8D Slope ,., Township, Range, Se~ion: ' Site Plan 2- 3- 4- 5- 6- 7- 8- 9- 10- 11- 12- 13- 14- 15- 16- 17- 18- 19- 20- COMMENTS PRE-SOAKED WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT DEPTH? L O Depth to Water After p Monitoring? E Date: Reading Date Gross Time Net Time Depth to Water Net Drop 9/28/11 10:50 AM 0 MIN 13.5" 8.125" 9/28/11 11:00 AM 10 MIN 13.5" 5,375" 8.0625" 9/28/11 11:10 AM 10 MIN 13.5" 5.43" 8.125" 9/28/11 11:20 AM 10 MIN 13.5" 5.375" 8.0" 9/28/11 11:30 AM 10 MIN 13.5' 5.5" 8.0" 9/28/11 11:40 AM 10 MIN 13.5" 5.5" 8,0" 9/28/11 11:50 AM 10 MIN 5.5" PERCOLATION RATE 1.8 (minutes/inch) PERC HOLE DIAMETER 6 TEST RUN BETVVEEN 4 FT AND 5 FT PERFORMED BY: Lars Spurkland I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 9/28/11 $RE,'~'ER ANCHORASE AREA BOr-USH Depart me nt ;~ 3E;;ir~rne:;ntal Q ualit Y Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE FROM WELL INSIDE LENGTH MANU FACTU RER ~C~ ~t~_~/ INSIDE WIDTH MATERIAL S7~'(¢'/ NUMBER OF COMPARTMENTS LIQUID DEPTH __.LIQUID CAPACITY /~)~) GALLONS· SEEPAGE PIT: NUMBER OF PITS / BUILDING FOUNDATION__ DIAMETER OR WIDTH /~,// CRIB SIZE: DIAMETER NEAREST LOT LINE__ ADDITIONAL ABSORPTION LENGTH /~,~ DEPTH DEPTH_~Z~_ DIS'TANCE FROM: WELL TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) '~' SQ. FT. WELL: TYPE /i~ I' 0 ~:~ f~ CONSTRUCTION BUILDING NEAREST FOUNDATION __ LOT LINE CESSPOOL OTHER SOURCES APPROVED DISAPPROVED ¢tr,,~,/~'~:~ L/~-~ DEPTH DISTANCE FROM: NEAREST SEPTIC SEEPAGE SEWER LINE TANK , SYSTEM REMARKS DISTANCES: DIAGRAM OF SYSTEM INSTALLED BY: 7 PIPE MATERIAL, LOT SLOPE: REMARKS: Form No. EQ-031 GRE,' ER ANCHORAGE AREA BOr'-UGH 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-51TE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: iNSiDE LENG'I~t ...... ~NSJU~:WlU1H ................ UqU~D DEPTH .......... LJqU~DCAPACI'rY~~ GALLONS, SEEPAGE PIT: IJNING MA1ERI/\L ........ CRIB SIZE: DIAMETER . _.DEPTH DISTANCE FROM: WELL TO/AL. E~FECTIVE ..~ ~ J~LJ1L [)~NG [ OUNt)A~ ION , . , NEAREST LOT LINE ...... ABSORPTION AREA (WALL AREA) SQ. FT. DEPTH .......... DISTANCE FROM: NEAREST ~ NEAREST SEPTIC ~ SEEPAGE t CESSPO(-)I , O'l FIER SOLJt~,CFS t\Pt~ROVI I} [.)ISAPPROVED . REMARKS DIS I /\FJC L.S: DIAGRAM OF SYSTEM LOI .%I()PI : . _. RLMt\I/i(,S: ....... GREATEr ANCHORAGE Area BorOUgh DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 PERMIT NO. SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT INSTALLATION LOCATION INSTALLATION OF! SEPTIC TANK SEEPAGE Pit DRAIN FIELD FINANCED THROUGH TO BE INSTALLED BY /~//)~/~/~ ~ ~ OTHER NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED FINAL iNSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE TYPE J ~"~" /"~'~'W/ & TYPE DIAGRAM OF SYSTEM FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT SEPTIC TANK TO SEEPAGE Pit WALL SEPTIC TANK ~ TO NEAREST LOT LINE. WELL TO SEPtiC TANK DRAIN FIELD MINIMUM DISTANCES, REQUIREMENTS , DRAIN FIELD ., SEEPAGE PIT '~ p , DRAIN FIELD , ~ SEEPAGE ~. WATER MAIN TO SEPTIC TANK , SEEPAGE PIT DRAIN FIELD SEPTIC TANK, /~ SEEPAGE PIT , DRAIN FIELD TO RIVER. LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. ] CERTIFY THAT [ AM FAMILIAR WITH THE REQUIREMENTS OF G/~A~ ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DATE APPL'CANT'SS'GNAT RE ' Box 90, Davis St., [main Rk-:,. ^ .~ol.~ 90577 .... Stffvayir,g Performed for: Russe# Oysto,~ 694 2774 Civil Engineering Soils 8 Foundt~tions 5 6 8 10 ll 12 Ground Nater Encountered: '~s. No Proposed Installation: Seepage Pit Drain Field Comments :~,-~ ~%'<~,:','~_c2¥_').. ~]]';-:'q?~b~,..._£ '~$' '~ x~ yes, what depth DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE / 3501 C STREET, SUITE t334 / ANCHORAGE, ALASKA 99503 STEVE COWPER, GOVERNOR 5~3-6775 PUSI o: To Whom It May Concern: According to the records on ?ile in this office, the DAWN Water System is ~n compliance with the State o? Alaska Drinking Water Regulations. Please note that departmental records indicate that the public water system was installed prior to the 1978 implementation oF the Alaska Drinking Water Plan Review regulations. No as-built plan's have been reviewed or approved by the department, nor are any necessary. Since the system has submitted acceptable water samples on a regular basis and received a satisfactory sanitary survey evaluation by the department, the system is acceptable under the standards in eFFect at the time oF installation. An oFFicial '"CertiFicate to Operate" may be issued upon receiving a complete set oF as-built plans. Any expansion o¢ the water system after 1978 will require plan review and the issuance oF a "CertiFicate oF Operation" permit. VEC:pkk Sincerely, Vera E. Craig Environmental Field O??icer Municipality of Anchorage Development Services Department BUilding Safety Division On-Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D: 051-061-68 GENERAL INFORMATION Complete legal description EKLUTNA HEIGHTS BLOCK 2 LOT 8D Location (site address) 21615 SETTLERS DR., CHUGIAK, AK COSA # O~__~ 11~ ~ u~ ~ Expiration Date: ,_~./'~.,,,,~7-- Current Property oWner(s) GMAC MORTGAGE LLC Mailing address Day phone 2, m Lending agency Mailing addr.e, ss, Real E'~tate Agent ":, i,.,~;,,. BOB BROCK Mailing AddresSl Unless otherWise Ce~lue steO, oOSA will be held by DSD for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class A Public Water System 3 Well Day phone Day phone 261-7603 TYPE OF WASTEWATER DISPOSAL: [] Individual On-site [] [] Individual Holding Tank [] [] Community On-site [] [] Public Sewer [] The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in' the State of Alaska. Certificates of On-Site Systems 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 COSAs upon request to homeowners. Certificates of On-Site Systems Approval are valid for 90 days from the date of issue for properties served by a pdvate 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 professional engineer's work. 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 Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (~re) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I [urther vedfy 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. Spurkland Enginneering Name of Firm 'Address 203 W. 15th Ave., Ste 202, Anchorage, AK 99501 Engineer's Printed Name Lars Spurkland bedrooms. DSD SIGNATURE Approved for Disapproved. Conditional approval for Phone 279-3916 Date 8/11/2011 .~ ...,.~-,.-,.~-,.~.\\ - bedrooms, with the following stipulations: By: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: / ~-/~,~'//// / / (Rev. 11/05) Municipality of Anchorage Development Services Department Building Safety Division On-Site Wa[er & Wastewater Program 4700 Elmore Road P.O. Box '196650 Anchorage, AK 9~519-6650 www.muni.org/on~site (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST LegalDescdption: F-.kL~,n~, ~el~14'T5 ~IK Z Lo+ SD ParcellD: 051-O~,I-G~ WELL DATA._. ?ub~c Well type /~ Date completed '" Total depth ~ ft. Date of test IfA, B, or C provide PWSID # Sanitary seal (Y/N) '- Cased to -- ft. FROM WELL LOG Well Log (Y/N) '"' Wires properly protected (Y/N) Casing height (above ground) AT INSPECTION m g.p.m. ~ g.p.m. Static water level Well production WATER SAMPLE ~L SULTS: Coliform ~ colonies/100 mL Nitrate -- mg/L Arsenic: --- ug/L date of sample: -- -B. _SEPTIC/HOLDING TANK DATA : Tank TypelMatedal A~lc~l~q,. T,,k / $[,,1 Tank size [000 gal. Number of Compartments Foundation cleanout (Y/N) ¥ Date ofl~umping, /~¢a/ Collected by: ~ Date installed ~/g~'l Z Cleanouts (Y/N) ~ Depression over tank (Y/N) /V~ High water alarm (Y/N) Pumper "-' C. ABSORPTION FIELD DATA. Date installed Length Total depth °~5 ft. Date. of adequacy test Fluid depth in absorption field before test -- in. Elapsed Time: ~ min. Final fluid depth Any rejuvenation treatment (past 12 mo.) (Y/N & type) Soil rating ~ or ff2/bdrn~) 1,7.. ft. Width ~ ft. Eft. absorption area [{~) ft2 Monitoring tube Results (Pass/Fail) -'- Water added ..-' gal. New depth -- in. in. Absorption rate >= g.p.d. If yes, .give date '-- System type P~--e~,~ T~{I~ & Gravel below pipe ~ ft. ~/ Depression over field ~ '~ For ~ bedrooms D. LIFT STATION "Pump on" le "Pump off" level a High water alarm leve in. Datum Cycles tested ~ Meets alarm & circuit re~Jirements? SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot ""- On adjacent lots ~ Absorption field on lot ~ On adjacent lots "'- Public sewer main "'- Public sewer manhole/cleanout SewerJseptic service line '-- Holding tank Animal containment areas ,---- SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Manure/animal excrete storage areas - " Building foundation 5~ Property line 5 ~ Water main lO t~ Water service line t I Absorption field 5 '~ Surface water iOOf+ ~/V'.O,~ Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Water Servico line , Curtain drain 50-~ Building foundation |O Water main ' Surface water I OO + ('/V, Driveway, parking/vehicle storage Wells on adjacent lots F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in confonwance with MOA COSA guidelines in effect on this date. Engineer's Printed Name L AN5 ~.~p~r ~l~x~ COSAFee $ ,, Date of Payment Receipt Number Waiver Fee $ Date of Payment Re~ipt Number (Rev. 4/10) LOT 7B 33' U.I LLI 33' 22_9 S89° 55' 26"W 0 198.14' . ~ N89° 55'30"E 198.09' CHUGIAK DRIVE LOT 8C UNDER NO ORCUMSTANCES SHOULD AN AS-BUILT BE USED FOR CONSTRUCTION OR FOR ESTABUSHING BOUNDARY OR FENCE UNE~ ~IE SUR~EYOR TAKES RESPONSIBIUTY FOR THE INITIAL ~RANSACTION ONLY AND ASSUMES FINANCIAL UABILITY ONLY FOR THE COST OF THE SURVEY. USTED DISTANCES PREVAIL OVER SCAUNG. R£PROOUCTION MAY CAUSE ERRORS IN SCALE. B~ot su.~ SURVEY TYPE FOUNDA3~3N AS-BUILT [] ~..OT ~... AS-~LT... ~OT su~-~.., ta,oeu~Y [] A,~-~IJfl. T . . . ~ ~ ~ ~ ~A~ ~LT... ~ ~ ~ PLOT PLANS ~ LOT SUR~YS IT iS ~E RESPONSIBIU~ OF ~E BUILDER OR O~ER, PRIOR TO C~S~UC~, TO ~RI~ PROPOS~ BUI~ING GRADE RELA~ TO RNI~ED GR~E AND U~U~ CONNEC~ONS AND TO DE~RMINE ~E EXIS~NCE ~ ANY ~~. CO~N~ OR RES~IC~ONS ~ICH DO NOT APPE~ ON ~E RECOROED SUBDI~SION PLAT. SURVEY CERTIfiCATION PLOT PLAN SYMBOLS SET RE:BAR ~ ~o DRAINAGE ~ ASPHALT FOUND REBAR o C o WOOO FENCE ~ CONCRETE ASSUMED ELEV. X Y. Y, METAL FENCE ~ WOOD DECK NOTE: ONLY THOSE IMPROVEMENTS ABOVE GROUND AND VISIBLE W~LL BE SHOWN. FENCES, WELLS, SEPTIC CLEANOUTS, SIDEWALKS, DRIVEWAYS, ETC., ARE SHOWN IN THEIR APPROXIMATE LOCATION, ONLY. SNOW MAY PREVENT SOME IMPROVEMENTS FROM BEING SEEN AND LOCATED. ALL DISTANCES ARE RECORD UNLESS OTHERWISE NOTED. Prepared by Robert E. dohns, dr. & Professional Land Surveyors 1700 Brink Driv~ ANCHORAGE, ALASKA 9950~ Assoc. Rec. Lot S.F. Rec. Plat File No. IDrawn by:.REJ c~. ~. I _ I SWL I :NW14611w'°' 11-393 FOUNDAll~N AS-BUILT FINAL S1RUC*RJRE AS-BUILT Scale: Date Surveyed: Date Drawn: Legal Description: 1" =40' 11/10/11 11/11/11 EKLUTNA HEIGHTS BLOCK 2 LOT 8D MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D.# 051-061-68 HAA# HA88-0524 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 8D Block 2 Eklutna Heights Subdivision Location(addressordirections) SR 2 Pioneer (b) Property owner Mailing Address (c) Lending Institution Mailing Address Street, Chuqiak, Alaska 99567 Ron Schult-z SR 2 Pioneer Street, Centrust Telephone: (home) 688-3451 Business Chuqiak, Alaska 99567 Telephone (d) Real Estate Company and Agent Carolyn .Mc Phee % Re/Max of Eagle River Address 16600 Centerfield Drive, Eagle River, Alaska 99577 Telephone 694-4200 (e) Mail the HAA to the following address: (or check here r-l, if hold for pick up.) List contact person and day phone number below: 2. TYPE OF RESIDENCE Single-Family,:Ix Number of bedrooms two (2) 3. WATER SUPPLY Individual Well [] Community Dx Public [] Note:' If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site I~x Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (Rev. 7/88) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name0fFirm S & S Engineering Telephone 694-2979 Address 17034 Eagle. River Loop Road, Suite 204, Eagle River, Alaska 99577 Datell-19-88 Engineer's Seal ate October 12, 1989 Disapproved XX Conditional Terms of Conditional Approval This 1988 property has not and is t~herefore met the Conditional Approval of December 6, now disapproved. The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev, 7/88)Back Page 2 of 2 MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcell. D.# (~-~/ ~'/ ~L/~ NAA# /'L//od~-~"'4'~ 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 8D; Block 2; Ek~utna Heights Sub.vision (b) Location (address or directions) SR 2 Pioneer Street~ Chu,qiak, Atas~ Property owner Ron Schultz 99567 Telephone: (home) 688-3451 Business Mailing Address same as above (c) Lending Institution 'CENTRUST Mailing Address Telephone (d) RealEstate Company and Agent RE/MAX OF EAGLE RIVER - Carolyn McPhee Address 16600 Centerfield Drive, Eagle River, Alaska 99577 Telephone 694-4200 (e) Mailthe HAAtothefollowing address:(orcheck here ~,ifholdforpickup.) Listcontactperson and day phone numberbelow: S & S ENGINEERING/694-2979 17034 Eagle River Loop Road~ Suite 204 Eagle River: A~.a~ka 99577 Ordered by Carolyn McPhee 2. TYPE OF RESIDENCE Single-Family [2~ Number of bedrooms 2 3. WATER SUPPLY Individual Well [] Community~ Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. sEWAGE DISPOSAL On-site [] Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (Rev. 7/88) Page 1 of 2 ~ ~o ~ e~ed '~JOM s,Jeeu!6ue leUO!SSejoJd eql u! suo!sS!LUO Jo sJoJJe Joj elq!suodseJ jou s! e6eJoqouv jo h1!led!o!un~ eqi'penss! s! eleo!J!lJeo e eJojeq elep eZhleUe Jo suo!loedsu! lonpuoo lOU op SHHQ jo seeholdtU3 'slueuJeJ!nbeJ elelS pus leJepet u!elJeo hiS!leS ol Jap Jo u! sUO!lnl!iSU! 6u!puel J!eql pus se~uoq lo sJeseqoJnd ol hselJnoo e ss s!qj seop SHHO eqL 'e~selV lo elelS eql u! peJels!6eJ Jeeu!6ue leUO!SSeloJd luepuedepu! us hq e^oqe ~ qdsJSsJed u! UeA!6 suojlelueseJdeJ eql uodn hlUO pessq peleo!tpeo i~^oJdd¥ hl!Joqln¥ qlleeH senss! (SHHQ) seo!^Jes uetunH pus qlleeH to lueuJ1JedeQ e6eJoqou¥1o hl!led!o!un~ eq/ leUO!:Hpuoo el~a sseJppv . (:~., ':~ MUNICIPALITY OF ANCHORAGE (MOA) ,¥~ ,1.~'~Jl,~.,~ Health Authority Approval (HAA) :,(~?~*,,~:'~' ~,~.~[f-~' CHECKLIST- FEBRUARY 1984 9~"~ ~?~: ~ / i~'~ 343-4744 ~': .~ ~":~ ' Legal Description: ~ A. WELL DATA Well Classification ~ Well Log Present (Y/N) Date Completed If A, B, C, D.E.C. Approved(~N) Yield Total Depth__ Cased to Depth of Grouting Static Water Level Pump Set At Casing Height Above Ground Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on LOt ~4;~ ~Jc ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot "~..420 Jd ; On Adjoining Lots To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected by ; Date Water Sample Test Results Comments '~, ~,.~,~-~- ~,~. ~ '~.--\ \,¢/t""~ t B. SEPTIC/HOLDING TANK DATA Date Installed ~"l~-'"'~r' Size ~ [:;t,'2~ Standpipes ~'N) "/ Air-tight Caps (~N) Depression over Tank(~N) ~ Pumping/Maintenance Contact on File (Y/N) No. of Compartments ~/ Foundation Cleanout ~i~N) i~/~ate Last Pumped ; for Holding Tank High-Water Alarm (Y/N) ~//&' Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: "~_.--4:~c~ I ~r To Building Foundation ~. ~ ~ To Disposal Field ~.~'- L,==. To Stream, Pond, Lake br Major Drainage Course ~, ~;;;>~ t Comments~/C'~,~>r-5 ~;;>~:::~'~ '"'~Z--' ~ ~ To water-Supply Welf'.i~ ~ To Property Line To Water Main/¢eCv!ce.L~ine 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absortion Area Depression over Field~N) Results of Last Adequacy Test 7' Type of System Design Length of Field Depth of Field Gravel Bed Thickness Statndpipes Present {~f~;~'N) Date of Last. Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well To Building Foundation Lot P/~G~- To Water Main/Service Line ; On Adjoining Lots To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments ''~ To Property Line I ~ ~ Jr" To Existing or Abandoned System on To Cutback (if present) D. ',FT STAT,O. A Date Installed "Pump On" Level High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at ___~Vent (Y/N) uacy Test. **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Company Date MOA No. 17034 Eagle River Loop Road No. 204 Eagle River, Ala. sk~. 99577 / Receipt No. Date of Payment Amount: $ 72-026 (Rev. 7/88) Back Receipt No. Waiver Fee: $ Date of Payment Page 2 of 2 ~-~L,MUN ICI PALITY OF ANCHORAi ,2'-~ DEPARTHEI' OF HEALTH AND ENVIRONfiEN'I 825 L Street, Anchora~r~. Alaska 264-4720 PROTECT ION 99501 Date Received: December 15~ 1977 #1: Time 2:30 ~.m. #2: Time 2:30 p.m. #3: Time Date 12-20-77 Tuesday [)ate 12-21-77 Wednesday Date Insp 4~lz Insp ~ ~ L~.(:~S Insp ........ ' ~ ~, ' ~ '~ '"E REQUEST FOR APPROVAL OF INDIVIDUAI, SEWE[ AND WATER PAC, ILIPI 5S 1. Lending Institution Request Mailing Address: Phone: 2. Property Owner: Robert A. Johnson Mailing Address: Box 75 Pioneer Street 99577 Phone: 688-3141 3. Legal Description: Lot 8D Block 2 Eklutna Heights Subdivision 4: Single Family Residence: (x) Number of Bedrooms: MultipIe Family Residence: ( ) Number of Bedrooms: Well System: Permit ~ Depth of Well con. uc o Individual well (x) Conununity/Public System ( ) 150' Well Log on File Bacterial Analysis ~_~ Sewage Disposal System: On-site System (x) Public Utility Permit # Installed 1974 Installer %gQl~ ~ Septic Tank Size [~)(PO Manufacturer ____~)_~--~__ ~ Absorption Area Soils Rate Distances: Well to Septic Tank to Sewer Line ___.~;4- Nearest Lot line to Nearest Lot Line Material to Absorption Area Absorption Area Page Two Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 8D Block 2 Eklutna Heiqhts Subdivision Comments: Affadavit Attached: (i) Approved :~/~ ~~~ Disapproved: Letter Attached Da ts: / ~/~/7 Date: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMFNTAL PROTECTION 25i0 East Tudor Road, Anchorage, Alaska 99504 ~ ~ ~ FHA Day Phone:_ ~ 'REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES Type of Inspection: cMRO VA Property Owner: _~ J~'~'J~ ~ ~"~//'~"~/ Mailing Address: ~ :7~'~' J~/~//~r' 3. Name of Buyer: Mailing Address: 4. Name of Lending Institution: Mailing Address: 5. Name of Realtor or Agent: Mailing Address:. 6. Legal Description: ~/¢¢~" Day Phone: . Phone: Phone: Location: 7. Type of Facility to be Inspected: 8. 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 t~'/4~¢¢- ~'~ 2~ No. Bdrms, Individual Individual (on-site) (£ ' 55 35 c~ PIONEER STREET ~ N 0© 05'lO"W 296.94 131.97 I6q.97 CD /0 }64,98 Civil Engineering Soils El- Foundations uN i/v'2EFING 8' D£V, ELOP/ZEtVT CO. Box 90. Davis St., Eagle River, Alaska 99577 6°..4-2774 or 333-5240 SOIL LOG Ead Ellis 333-5240 Surveying Land Development Performed for: Name: Mailing Address: Legal Description: ~ ~. ~ (feet_~ 0 Tel. No. ~g~] Soil Characteristics 2 3 4 5 6 7 8 g 10 11 12 Ground Water Encountered: Yes No Proposed Installation: Seepage Pit__ Drain Field Comments._\ ,~x ...., ,~ ,~ ( ... ~. , ~ If yes, what depth ~'N ~cUI]I)Wtl)E D 3A 4A 5/:, N 89' 55'23" E 594.17 435,72 158.45 ~ '/B 7C s~.,~ 19e. lA ~ l~?.te ~[ ~ ~97.99 g 8D ' s 8C I 8B 33133 ~ CHUGIAK OR~VE Al)ON. LEGEND: RONALD d. ~ULOT CHUQIAK CHARLENE K. SCHULOT CH~IAN FII~T NATIONAL BANK OF ANCNORABE '~. /~T~ '.? ~ '.' SO~l~f~ed ~nd sworn before me this ....... ~ day of ~,ry for Alelk, ~My &~mls ...... NOTE: AB OF THE DATE OF APPROVAL OF MIS P~.AT THE PLATTING AUTNOR{TY OET]~R~NEO THAT FUI¥~IBR CONSTRUCTION CHUOACH DRI~ AND gO'UGH ~EET WAS AT T~T ACCEPTANCE OF DEDICATION BY The /'~ol~m~ _hereby accepts f~r public uses ~d for public p~poses the real property dedicated on this plot Including, but not limited to the easementa~rlghfs-of- woy~ olleyl~ roadways,thoroughfare~ and parks shown hereon. Doted et Anchorage, Alaska, this :20'e- day of~.~ i97~. Mfs,t: City Clerk OF City Man(sger or Borough Clerk Borough Mayor PLAT APPROVAL Plat approved by the Borough Platting Aufhorlty this DT1000278 CONTAINING S LOTS, 4.05 ACRES MORE OR LESS. PLAT OF LOTS 7B, 7C, 8B, 8C, $ 8D, BLK. 2, EKLUTNA HEIGHTS SUBDIVISION A SUBDIVISION OF LOTS 7A ¢ SA, BLK. 2, EKLUTNA HEIGHTS SUBDIVISION LOCATED IN THE SE I/4t BEC. SI TISNI RIWI $.M,iALASKA , DATE: OCTOBER 1975 SCALE: I'* : I00' DRAWN B.M.$. SHEET: J OF I F SUR VE YOR 'S CE R T IFICA TE PI A ? APPROVAL / CE R TiFICA T[ OF OWNERSHIP at)(I DE D/CA TION NO/ARY ACKNOWL£DGEMEN1 DT1000279 1983-994 / ~A lA ~ CHUGIAI~ ~ , ~ DRIVE ; ;;' //'; ; [ 1/4