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Home My WebLink AboutMOUNTAIN PARK ESTATES #2 BLK 4 LT 9Mountain Park Estates #2 Block 4 Lot 9 #017-023-09 r■ 29%aas■rrmrw I Municipality of Anchorage Community Development Department Page 1 of On -Site Water and Wastewater Program DEC S 0 2015 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http:/Iwww.muni.orglonsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP151042 PID Number: 017-023-09 ❑ New Upgrade Name: James Kirkendall ABSORPTION FWkD - ❑ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address 13040 Foster Rd. Anchorage, AK 99516 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot Mountain Park Est #2 4 9 Fill added above original grade Ft. Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines I Ft. SEPARATION DISTANCES To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Lift Station Tank Line Ff I I Ft. Well 115.1 N/A N/A N/A N/A TANK p Septic [I S.T.E.P. ❑ Holding ❑ Other Manufacturer Anchorage Tank Capacity 1,250Gal. Surface Water 100+ 100+ N/A N/A Material Steel Number of compartments 2 Lot Line 33.8 N/A N/A NIA NA Foundation 12.5 NIA N/A NIA LIFT STATION Manufacturer Capacity Curtain Drain 50+ N/A N/A N/A Gal. Pump on level at Pump off level at High water alarm at RemarksTank replace only. in. in. in. Pump make and model - Electrical Inspections performed by PIPE MATERIAL Housetotank 3034 Tankto 3034 drainfield Installer A+ Homes Services Drainfield 3034 Co/MT 3034 inspector Pannone Engineering Services LLC. BENCHMARK (Assumed elevation) 100ft Inspection 1 � Location and description dates: fm h Top of front entry landing. 3w COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp ��^�►�►1\.moi' Conditional Approval: Date z'#:�*# s* 49 TH r � seven F . bn•rione' Approved Dates�1(1��lI1J�. _ �_]LdM(� Inspection Report_1-1-12.doc SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION WAS INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON—SITE WASTEWATER DISPOSAL SYSTEMS AND ATTACHED PES SPECIAL PROVISIONS. 2. SCOPE OF WORK: ABANDONED EXISTING 1,250g SEPTIC TANK PER CODE AND INSTALLED 1250g SEPTIC TANK. INSTALLED DCO. 3. BASED ON PERIODIC FIELD OBSERVATIONS AS REQUIRED BY AMC 15.65 THIS RECORD DRAWING REPRESENTS THE PROJECT AS CONSTRUCTED, BUT DOES NOT GUARANTEE THERE ARE NO HIDDEN DEFECTS BY THE CONTRACTOR. WELL (E) { i WELL (E) I ~ z w g w LOT 9 J WSW 7i 4BR (E) w�— W _� 77 u SEPTIC AREA (E) I -SEPTIC AREA (E) 17 1250 GAL SLr I IU TANK - `z DECOMMISSIONED PER CODE NEW 1250 GAL SEPTIC TANK INSTALLED W/ DCO I DRAIN FIELD (E) —CONDITION TO BE CONFIRMED AT TIME OF TANK INSTALLATION T1 \`DC I o —T2 18.80 T2 E) 26.30 M2 (E) 44.10 28.40 C1 (E) w 52.30 44.40 mw T# I O w J w C# 0 Www SEPTIC AREA (E) N\ �M'Al LEGEND W WATER LINE/ WELL RADIUS — SS — NEW SEPTIC DESIGN PARAMETERS PRIMARY/RESERVE SEPTIC SYSTEM NO. BEDROOM -4 TANK SIZE: 1250g NEW USED: NEW 1,250 GAL STEEL TANK NOTES: RECORD DRAWING DRAWN BY: NJC PLAN 7, 1& SEPTIC AREA A B T1 36.30 18.80 T2 42.90 26.30 DC 44.10 28.40 M 1 52.30 44.40 ABBREVIATIONS = TH TEST HOLE Qa o u wa FC FOUNDATION CLEAN OUT ow w w mw T# TANK CLEAN OUT NO.. C# CLEAN OUT NO. e9 z M# MONITOR TUBE NO. R.I. RIGID INSULATION DCO DOUBLE CLEAN OUT BFG BELOW FINISH GRADE - - 12509 X94.1 OG ORIGINAL GRADE - 7NEW SEPTIC TANK FG FINISH GRADE TS&V TOPSOIL & VEGETATE PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99590 PHONE (907) 272-8218 FAX (907) 272-8211 MOUNTAIN PARK ESTATES #2, BLOCK 4, LOT 9 JAMES KIRKENDALL 13040 FOSTER ROAD ANCHORAGE, AK 99516 Steven .R� Ponnope ?.. CE 8149 .•R Date P.LD NO DERMIT NO. OSP151042 Sheet 2 O 2 EI N `G WELL (E) W T GV\\ M�M� 't �M WELL (E) w W SEPTIC AREA (E) 1250g SEPTIC TANK (P) INSTALL DCO SEPTIC AREA (E) F E 17 COLLAPSED 1250g SEPTIC TANK (E) DECOMMISSION PER CODE WELL (E) DRAIN FIELD (E) \ z I CONDITION TO BE CONFIRMED 48R AT TIME OF TANK INSTALLATION w LOQ / HOUSE w W/ a o SEPTIC AREA (E) 1I✓ J _ W 7% / w O � N � O w —f-4 / M W --\N � SEPTIC AREA (E) iN\--M M \ 15 1 E) o / t WELL (.. ar WELL (E) I 3 NOTES:ate PANNONE ENG SVC, C, LLC QF A� \il( D3/3/2015 EMERGENCY TANK REPLACE P.O. BOX 100217 ANCHORAGE, AK 99510�F .... qts 11 PHONE (907) 272-8218 FAX (907) 272-8211 j* . Tti *�/ Scale �.... .. .. ..: � P.I.D. NO MOUNTAIN PARK ESTATES #2, BLOCK 4, LOT 9 / ;, ..... 017-023-09 JAMES KERKENDALL Steven R. Pannone / PERMIT NO. 13040 FOSTER ROAD ��IP�s. CE 8149 \�/ OsPxxxxxx PLAN ANCHORAGE, AK 99516 (11�9F�.......... Sheet Permit Number: Tax Code Number; On -Site Water and/or Wastewater System Permit OSP151042 01702309000 Work Type: SepticTank Upgrade Permit Effective Dates: March 03, 2015 to March 02, 2016 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: MOUNTAIN PARK ESTATES #2 Site Legal Address: MOUNTAIN PARK ESTATES #2 BLK 4 LT 9 G:2839 Owner/Address: KIRKENDALL JAMES O 13040 FOSTER ROAD ANCHORAGE AK 995163233 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 ?' Lf/jr- 6 /2 ' 00 Site Mailing Address: 13040 FOSTER RD, Anchorage Lot Size in Sq Ft: 20130 Total Bedrooms: 4 This permit is for the construction of: N 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. Covered, sealed, and heated to prevent freezing. Received Issued By By: du Date: Date: �� RUSH MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program 5610M11111WNTMUT"T�L�tl�ia:�•lrr_��re_�u•�.i Parcel I.D. 017-023-09 Property owner(s) James Kirkendall Mailing address 13040 Foster Road, Anchorage, AK 99516 - Site address 13040 Foster Road Day phone Legal description (Sub'd., Block & Lot) Mountain Park Estates #2; Legal description (Township, Range & Section) Lot Size 20,130 Sq. Ft. Number of Bedrooms 4 Block 4, Lot 9 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) ❑X (w/wo ADU) Septic Tank 1ZUpgrade ❑X Duplex ❑ (D) Holding Tank ElRenewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Dis tance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. Permit/Rush Fees: Date of Payment: 3 3Z1 5 Receipt N umber: 02-0-79G Permit No. 0SP15104 Z Permit App_,'.:. Waiver Fees: Date of Payment: Receipt Number: _ Waiver No. ftnnone Engineering Services uc Steven R. Pannone, Principal Registered Professional Engineer E-mail: steveftPanengak.com March 3, 2015 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, Alaska 99519 Subject: Mountain Park Estates #2, Block 4, Lot 9 Emergency Septic Tank Upgrade Permit Request Ladies and Gentlemen: I am writing to request that a permit to install a new 1250 gallon Septic tank be issued for this lot. The proposed system will serve an existing 4 bedroom house. Currently the lot is developed. The existing septic system was designed and installed for four bedrooms, and the condition of the existing field will be verified at the time of installation. The existing tank has collapsed, placing the house out of service and is in need of replacement. This lot and the surrounding lots are served by private wells. There are no wells within 100' of this system. 1. Upgrade Tank Design. a. See Sheet 1 of 1 of the plan set 2. Surface Water: There is no surface water within 100 feet of the proposed system. The proposed systems will maintain at least 100 feet from all surface water and drainage ditches. 3. Topography: This lot slopes from east to west in the area of the tank replacement. The_ proposed installation will be located in the eastern portion of the lot, next to the existing system. Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 1/2 East Manor Ave, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 Page 2 of 2 The proposed installation will not affect the future development of the surrounding or existing lots. There are no wells within 100 feet of the proposed septic location. If you have any questions or concerns, please contact meat 272-8218. Sincerely, Steven R. Pannone, P.E. Owner/Civil Engineer Attachments: Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 1/2 East Manor Ave, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 W i WELL (E) III 3 M �M \ /`� SEPTIC AREA (E) M AA \ W_W— 17 SEPTIC AREA (E) WELL (E) ?� 7% INSTALL SEPTIC TANK (P) INSTALL OCO E COLLAPSED 12508 SEPTIC TANK (E) DECOMMISSION PER CODE WELL (E) - DRAIN FIELD (E) \ w 4 IR CONDITION TO BE CONFIRMED HOUSE AT TIME OF TANK INSTALLATION w 1� LOT (E) w /s� I a SEPTIC AREA (E) 1I WSW 7% s' / > w o � o O —�M \ J-4w� W SEPTIC AREA (E) 1 / - WELL (E) WELL (E) NOTES: PAMONE ENG SVC, LLC _—SOFA \\ Date EMERGENCY TANK REPLACE P.O. BOX 100217 ANCHORAGE, AK 99510 C� " "'� gsll, 3/3/2015 PHONE (907) 272-8218 FAX (907) 272-8211 j Gip �y'++ Sc' le SD /*� 4 / TIH .... .. .. .... P.I.D. NO MOUNTAIN PARK ESTATES #2, BLOCK 4, LOT 9c / e17-023-09 JAMES KERKENDALL /' Steven R. Pannone PERMIT NO. 13040 FOSTER ROAD ) cs CE 8149 , .•_r� OSPxxxxxx PLAN ANCHORAGE, AK 99516++�klk�.....I... � � Sheet \�\"�� 1 OF 1 -"IUNICIPALITY OF ANCHORAGE., Hea A and Environmental Protea Dn ` Fourth Floor West 825 L Street Anchorage, Alaska 99501 264-4720 NAM INSPECTION REPORT ON-SITE SEWAGE [DISPOSAL SYSTEM fi .'_�`•'" MAILING ADDRESS t -/ PHONE LOCATIONS LEGAL DESCRIPTION SEPTIC TANK: DISTANCE FROM WELL INSIDE LENGTH a �G q � NUMBER OF MANUFACTURER ; MATERIAL�COMPARTMENTS to - INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY��GALLONS. TILE DRAIN FIELD: _ p TOTAL LENGTH ell DISTANCE FROM WEL ;rl r FOUNDATION— f —NEAREST LOT LINE OF LINE t # of Lines {� DISTANCE BETWEEN LINES°' TRENCH WIDT's' IN. TOTAL EFFECTIVE ABSORPTION AREA Ff SQ. FT. LENGTH OF EACH LINE DEPTH OF FILTER F DEPTH: TOP OF TILE TO FINISH GRADE MATERIAL BENEATH TILE _ AA—ABOVE TILE IN. SEEPAGE PIT: DIAMETER OR WIDTH—, LENGTH—, DEPTH Log Crib _Rings_ Crib Size: DIAMETER__DEPTH DISTANCE FROM: WELL . — - TOTAL EFFECTIVE BUILDING FOUNDATION_, NEAREST LOT LINE ABSORPTION AREA (WALL AREA) SQ. FT. Well Class: Depth: Well Distance To: Lot Line Bldg: Sewer Line: Pipe Materials: # of Bedrooms: S- Installer: Remarks: i i i f DATE � F � APPR T �'n _ JI 41 IT f DATE � F � APPR T ' 11-11 R_J r-, ��T 7- u-ru Cu F::- f9i VA�F�� ^�� (� ~^DIPHRTM�NT ' HEHLTH HND E�VIRONME�THL� �TECTION D� � 825 STREET/ ANCHORAGE., HK. 264-4720 p/lA_' —11 -T—E ��FE F�" F-?.. 11-1 1 —0—* PERM.1T NO ( 77-10]0 ) 1 J~ APPLICANT EXCHVHTING ]126 E 72ND HNCH ]44�2911 LOCHTION FOSTER DRIVE�� LEGHL L B 4 MT PARK EST #2 LOT SIZE:,. 2013,'0 SQUHRE FEET � TYPE OF SOIL HBSORBTION SYSTEM IS� TRENCH MHXIMUM NUMBER OF BEDROOMS = 5 SOIL RHTING (SQ FT/BR)= 150 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: ��= �� F��= � THE LENGTHDIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD. THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND HND THE BOTTOM OF THE EXCHVHTIQN (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRHVEL DEPTH IS THE MINIMUM DEPTH OF GRHVEL BETWEEN THE OUTFALL PIPE HND THE BOTTOM OF THE EXCAVATION (IN FEET). �F:H L_�� H PHCKHGE PLANT MAY BE INSTALLED HT THE PERMITTEE'S OPTION SUBJECT TO THE FOLLOWING CONDITIONS: 1. EITHER H CLASS I OR II NSF APPROVED PLANT MAY BE INSTHLLED. 2 H CONTINUOUS MAINTENANCE AGREEMENT IS REQUIRED. IF H MAINTENANCE AGREEMENT IS NOT KEPT CURRENT YOU MAY BE REQUIRED TO ENLARGE THE SOIL ABSORPTION SYSTEM HND/OR YOU MHY BE SUBJECT TO PROSECUTI(M. —0-11-4CU �a I 0---q IF.::-- C: 7- 1 C) Ir -A Fl IF;!' FE F,. FEE fC.-'g RJ 1 H:R ll�� BHCKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION HND APPROVAL BY THIS DEPHRTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN H WELL AND ANY ON~SITE SEWAGE DISPOSHL SYSTEM IS 100 FEET FOR H PRIVATE WELL OR 200 FEET FOR H PUBLIC WELL OTHER REQUIREMENTS MHY HPPLY' SPECIFICATIONS HND CONSTRUCTION DIAGRAMS FIRE HVHILHBLE TO INSURE PROPER INSTALLATION. ��Ii � H 1 _11- ��P-11 FE. E.—E. F-" I CERTIFY THAT 1: I HM FHMILIHR WITH THE REQUIREMENTS FOR ON~SITE SEWERS AND WELL5 AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTHLL THE SYSTEM IN ACCORDANCE WITH THE CODES. ]� I UNDERSTAND THAT THE ON—.SITE SEWER SYSTEM MHY REQUIRE ENLHRGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THHN 5 BEDROOMS. � SIGNED: NG eonstauation gest yasr "Ons ton is worth a showand opinions" 2204 Cleveland Anchorage, Alaska 99503 Performed For Schachle Excavatina Date. Performed 11-92-27 Leal description: Lot Block 4 Subdivision Mountain Park Estates Sub. This Form Renorts Soils Loq Yes Percolation Test_ Add. #2 neoth FeetSoil Characteristics rganic and FeY—t 2- 4 — Brown Silty Gravel 6- 8- 10— Brown Slightly Silty Sandy. Gravel 12 — 14- 16 4- 16 is— Bottom of test hole 20— Was Ground Water Encountered? No If Yes, At what Depth? It. i•� inn_ M� Readinq Date Gross Time Net Time Depth to H2O Net Dron' F -- Percolation Rate Minute Proposed Insta-TTat50—nSeenace Pit Drain Field _ Depth of Inlet Dept o ottom Of Pit OrTrench CAmVENTS: 150 Sq. Ft. drainage area required per bgdrnnm from minus 8.5 to 16'. Test Performed By %% Data Certified By: CTL Date. 11-22-77 January 3, 1978 Schacle Excavating 3126 East 72nd Avenue Anchorage, Alaska 99502 Subject; Lot 9 Block 4 Mountain Park Estates 4#2 Permit 4#771031 A permit issued by this department for well and/or sewer system has expired. Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal ordinance. If you have drilled the well, a well log should be sent to this department to document the installation date. If there are any further questions, please contact this office at 264-4720. Sincerely, Health and Environmental Protection Sewer and Water Section CJ 9 ell #-_n f' -"E :A: 1-0' -T °-e CO E_ �-� W � � _ 1E -✓I a_: -IF 9 0 ® w �= 1 D : (�C� �1 E Ef=A(-:TteIp-j'T" HEALTH FINdD EI'.d',•'IFCir-dt-lENdTAL ?E-�TEC:TION � 825 "1--' TF:EE:T, ANCHORAGE, AIS::. � 2.64-4-720 I ICAN ]" :Si=:HACL_.E. E: (;AVFITIN GE 72N E- ANdC:H L.0(..'FITIC.1Nd FOSTER DRIVE --- J i....E:(: Ai.... L._ :: F, °# MT1='AF:k:: E l" #2 LOT IZ ; 41:.-:E_, '= QUARE F-EE:"f i.;. T' 'i='E:. E:iP' SOIL AB: OF::E.T I OI'A SY` TE:f-I IS: TRENCH tIFG<;It'U.at'i NdIJN'Ek.k.F: j �F' E E: [ (;i;afitl = SOIL F WiTT'tdG = _ 150 THE F:E1LFI.'RE-"D SIZE OF. THE: Ci T:I._, Hh:Si.-jF:F'TION SY,—;CEf1 IS: - F--fl:� 7E- ci li-m" #-# ° IEE 9._. r... F. IF=° _-$ I"I-IE LENGTH DIMENSION I S THE LENGTH I Nd FEET OF THE TRENCH OR E; RA I NdFI EL..I:). THE:' C-EPTH OF' A TF."T E:'PI OR, PIT IS THE DI' TMIC:E BETIJEENd THE '_;UF:FFIC:E OF' THE GROLIN D FIND THE: BC.i"f'TOI''1 OF THE EXCAVATION ATIONd ( IhI FEET'.,.[. .1 FIE RE I::; NO SET WIDTH FOP: TF:F:NdC l-iE:=;. THIS CiI=A'v'Erl.._ L:ic:C'l"(i I'=; THE MINdIMUfi DEPTH OF i_;E=AVEL BETWEEN THE OUTFALL F'IF'E FINdI:) "i"F If: BOTTOM OF 'THE: E::<,C;AVATIONd (IN FEET). Nr-° N":=.:: �W ®4_9 ::k� U=" E= N: =a °-o tl: � -� _�.. � m`:: �' 1==9 �'-"9 �•== _ :T „='„ E-: == :'�_ �=� a�=-� �=��o � �i 9=-9 �.__ 6._.. n=:=n N" -"N r=� A F'FIE:::I::'AGI-- F'1._ANdT MAY BE INSTALLED AT THE PERMITTEE,' OPTION SUBJECT TO THE Ff.il.-LOWING CONDITIONS: IONS: a..EITHER A CL.A:: I � �F: :I: T: NSF APPROVED PLANT f lA',' E k=: :[ Nd' T FILLE D. AnCNTN_ONTENNCeNFI I'NEN IS NOT KEPT C:UF:i:ENT YOU NAY BE. R'El-!UIF:E:D TCI EN I-ARGE. THE E;1 -11L FIF,"_-;OP"PTIONd SYSTEll AN D, --OF' YOU ilAY BE SUBJECT JECT TCS PROSE CUT 1011-1. ...__ ._......_--• 0— L"•I Cd 9-6�°-4 "- 9--ol 1---? FEE F --i° IEE A_ -n V_._V I IE4.". E- I f: I C I -- 'I LING ,"If:IC:E::I-:I:L...L_.ING OF ANY SYSTEM IJITHOUT FINF"L INSPECTION FIND AF'F'F:ClVAI... BY THIS I:-_F'FIF:TMENJT WILL BE SUBJECT TO PROSECUTION. MI NI 11LIN DISTANCE BETWEEN H WELL AND ANY OV -J --SITE SEWAGE r; ISF'OSAL SY_STEM I -1.00 FEET FOR A PRIVATE WELL OR '2-.01 FEET FOR A PUBLIC WELL_. OTHE:E : REi�?U I FEMEV-JT S FIFI'r' APPLY. SPECIFICATIONS AND CONdS"fRLIC:T I ONd D I. AGFtAM' FII .,E FIVA I LFIE.E._E TO INSURE PROPER INSTALLATION. `I..: I AI' l FAil I L. I AF: WITH THE F:Ei-!i. I I F:EIIENdT_; FOR ON-SITE SEWERS AND WELLS F SET, F'OR TI -1 BY THE MUNICIPALITY OF ANdC:PIOF:AC,E. 1 WILL INSTALL THE SYSTEM IN F9C:COF:DAN CE WITH THE: CODES. I I_Irar E'F:_ T'F0-41" -PIAT THF. ONd-'.-I'TE SEWER SYSTEM Efi MAYF:E:C:!(IIE:E ENLARGEMENT IF THE RESIDENCE IS REMODELED TO I NdCIJ._lr:lE t IDRE: THANd 5 BEDROOMS,. f7 I_ I CFINd'T CHFIt::L :AVAT I. Ndi.-; 67o121i21 d it on g6SE JR�7 "One ten is worth a thoasand opinions" 2204 Cleveland Anchorage, Alaska 99503 Performed For Schachle Excavating Date, Performed 11-99-77 Legal 9escrintion: Lot 9 Block a Subdivision Mountain park_Fpt *�Q � This Form Renorts Soils Loq Yes Percolation Test— tenth Feet Soil Characteristics 2- 4— Brown Gravelly Silt 6- 8 10 — Brown Slightly Silty Sandy Gravel 12- 14- 16 2- 14- 16 18 - Bottom of test hole 20— Was Ground Water Encountered? No If Yes, At what Depth? M� i M��r��v Readinq Date Gross Time Net Time Depth to H2O Net Dron Percolation Rate Minute Proposed InstaaTTatio : Seenaae Pit Drain Field _ Deoth of Inlet Dept o ottom Of Pit Or Trench COMMENTS: 150 Sq. Ft. drainage area required per bedroom from minus 8' to 161. a Test Performed By 4Lo&e,o %�- Data Certified By: CTL Date: 11-22-77 _ �y -A 1�� ^'' ' DEPH�TMENT U� HEHLTH HND ENVIRONMENTHL PR�TECTIUN STREET/ HNCHORHGE/ HK99501 264�4720 X�F. f 0 J"`0* PERMIT NO ( 77i044 ) HPPLICHNT �]] E 11TH HNCH 274 2484 L/}CHT7UN FOST�R RUHD L�GHL L9 B4 MT PHRK ESTHTES #2 LOT SIZE 201]0 SQUHRE FEE7 HlNlMUM DISTRNCE BETWEEN H WELL HND ANY ON-SITE SEWHGE DISPUSHL SYSTEM IS 1�0 FEET FOR H PRlVHTE WELL OR 200 FEET FOR H PUBL{C WELL Wi�LL LUGS HRE REQUIRED HND MUST BE RETURNED TO THE DEPHRTMENT WITHIN ]0 DHYS VF lHE WELL COMPLETION 0iHER HEQUlREMEN[S MHY HPPLPECIFICRTIONS HND CONSTRUCTION DIHGRHMS vRE HVfl. LHBLE lD INSURE PROPER INSTHLLHTIUN. l CEHTIFY THHT FRMILIHR WITH l'HE REQUIREMENTS FOR UN�SITE SEWERS HND WELLS HS SET FORTH BY THE MUNICIPHLIT� OF HNCHQRHbE 2� l WlLL lNSTHLL THE SYSTEM lN HCCORDHNCE WITH 11 1E CODES SIGNED� _^............. .... �......... l�SUB) ......... .......�� Y]0 v WELL CONSTRUCTION LOG P'C-cp r 01 tR\-t `f� Drilling Co, A `'��t/A [„l � Fl�ji�l ��¢y USGS no. OriIler�k /'f t`Trtli q14 Type of rig .1?0 Yft'1),I abate well completed /f - �•� /% ,� — Well owner �.a7>' A P,$ a/ ��Nearest community 1�10un)Ii/t/✓ nn�� Well location: (address & legal descriptio�f`o�I�sr%in.tl !,2%Jr1- Location sketch or remarks ZFS 74 rte- < S ell I t) Aj 5� 4 e- X Depth of well r^! ft. Casing: depth ft. diam. in. Static water level J +k' ft. (above, below) land surface. Date f ^� %4�LL '7 Finish of well: (en -end screen, perforated, open -hole, other) Describe intervals and size: Well yield tested by ( um Li gg beiIing, air) at l gal/min. for � hours with U ft. of drawdown from static level. DRILLER'S MATERIAL LOG Depth below surface in land feet Give description of strata penetrated (size of material, color, hardness of drilling, and water content) to (`1 1lt/' 'AV,r� ?p'-5 to 3-0 / S?uta �r/Jr/:'�7/�/At 7t) to 7^5t �r44 �jNf /-r--_ t Y W,4 -S-14 c/ 1 / J ti ^P �' o /v r . to to to to to to -- to to to to to to to to to to to September 23, 1377 #761728 Charles Rulley 333 East llth Avenue Anchorages Alaska 99591 Subjects Permit Expiration Dear Mr* iii. bey A permit issued by this department for well and/or on-site sewer installation on Lot 9 Block 4 Mountain Park Estates Subdivision #2 has expired since the issue date exceeds eine (1) year, In the event you stili. plan to install the well and/or on- site serer systems, a neva permit is reTaired. The original soil test may be used to obtain a current; permit. If the well has been drillecd$ a. well Jog should be sent to this de-partment to document the installation date. if you have any questions regarding the above matt;ere Tease do not hesitate to contact this office immediately at 264=- 47200 Sincerely$ Robert C. Pratt, R.S. Sanitarian RCP/ljh MINIMUM DI HL SYSTEM IS 100 FEET 1 OR H PRIVHTE WELL WELL LOGS INE REQUIRED HND MUST WITHIN 20 DHYS GF THE NELL COMPLETION. SPEClFIC8TlONS RND CONSTRUCTION URE PROPER �NSTHLLHTlON. POZZ09-1 X r - OTT"IT.. Z 12, to (J IN W 141 I CERTIFY THHT 1- I HM FHMILlHR WITH THE REQUIR F OFF-SITE SEWERS AND WELLS AS SET FORTH 841 THE TINT CIPRLITY OF HNCHOR 2� I W�LL INSTRLL THE SYST�M IN HCCO�nHNC��WITH THE CODES DHTE_. Parcel I.D. 017-023-09 1 11. �J'✓d1 v" fm B 9 JOMunicipality of AnchorageOn-Site Water and Wastewater Program 1 7 2�1 (907) 343-7904 'n Certificate of On -Site Systems A GENERAL INFORMATION Expiration Date: 7-7-1:1 Complete legal description Mountain Park Estates #2 Block 4 Lot 9 Location (site address) 13040 Foster Road Current Property owner(s) Kirkendall, James Day phone Mailing address Real Estate Agent 13040 Foster Road Anchorage, AK 99516 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual 7 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver/Variance request for: Distance: Received by: :4 )J ,e COSA to be released to the engineer, unless COSA Fee $ 526o Waiver Fee $ Date of Payment 31 Date of Payment Receipt Number 6&ctm Receipt Number COSA # Q 2CI?IN(o 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. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time of the lest, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The Content of this report is for the sole benefit of the owner listed above. Name of Firm Pannone Engineering Services LLC Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone 6. DSD SIGNATURE System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved Phone (907)272-8218 Date 3/14/2017 §�eveIt .'A6AA6ne E-8149` Conditional approval for bedrooms, with the following stipulations: By: Original Certificate Date: 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. ATTACHMENTS: el COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet � . - If more than 1 septic system is on the lot: COSA Checklist # + of Structure served by this system 1 Certificate of On -Site Systems Approval Checklist Legal Description: Mountain Park Estates #2 Block 4 Lot 9 A. WELL DATA Well type Private If A, B, or C provide PWSID # Date completed 12/13/1977977 Sanitary seal (y/N) Y Total depthf), Cased to 98 ft. S� � FROM WELL LOG Date of test 12/13/1977 Static water level 58 Well production 10 ft. g.p.m. Parcel ID: 017-023-09 Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) 16 in. AT INSPECTION 3/7/2017 108 3.9 WATER SAMPLE RESULTS: Coliform Neg colonies/100 mL Nitrate J A mg/L Arsenic AL ug/L Date of sample: 3/7/2017 Collected by B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Tank size 1250 gal. Number of Compartments 2 Foundation cleanout (Y/N) Y Date of pumping 3/8/2017 C�_1-b3d:7;ilL�I:I�t rl rZ`�1 PES ft. g. p. m. Date installed 3/4/2015 Cleanouts (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N Pumper A+ Home Services Date installed 11/29/1977 Soil rating (g.p.d.Iftz or ftz/bdrm) 150 SF/BDRM System type Deep Trench Length 63 ft. Width 3 ft. Gravel below pipe 6 ft. Total depth 14 ft. Eff. absorption area 750 ftz Monitoring tube Y Depression over field N Date of adequacy test 3/7/2017 Results (Pass/Fail) Pass For 4 bedrooms Fluid depth in absorption field before test 11 in. Elapsed Time: 170 min. Final fluid depth 11 Water added 624 gal. New depth 12 in. in. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed N/A "Pump on" level at in. Datum E. SEPARATION DISTANCES WELL ON LOT TO: Size in gallons _ "Pump off"level at Cycles tested Septic tank/lift station on lot 100+ Absorption field on lot 100+ Public sewer main 75+ Sewer /septic service line 25+ Animal containment areas 50+ in. Manhole/Access (Y/N) _ High water alarm level at Meets alarm 8 circuit requirements? On adjacent lots 100+ On adjacent lots 100+ Public sewer manhole/cleanout 100+ Holding tank 100+ Manure/animal excrete storage areas 100+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5+ Property line 5+ Water main 10+ Water service line 10+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water Service line 10+ Surface water 100+ Curtain drain 50+ Wells on adjacent lots 100+ F. COMMENTS G. ENGINEER'S CERTIFICATION I 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 Printed Name Steven Pannone Date 3/15/2017 COSA canary sheet _2-6-15.doc Absorption field 5+ Surface water 100+ Water main 10+ Driveway, parking/vehicle storage 10+ in. CJ r C ( 84521 Lot 17 I Lot 8 — N89°56'06'W 183.00 30 i Chain link fence (typ 76. Z 25.7 C 21 LU O Septic ventso O Well m O O O W cLn m � O Lot 9W 0 T LO Lot 16 C c 1.7 ;' ° Septic vents o W r° 2.7 OH ° Q O Z i I� •- N Z LL 24.0 SCALE: 1 "= 30' Shed shed N89056'06"W 183.00 30 Lot 15 I Lot 10 REVISED 3-28-17 ADDED SEPTIC VENTS d, k AS -BUILT NO CORNERS SET THIS DATE I hereby certify that I have performed a Mortgagee's inspection OF 11 of the following described property: LOT 9. BLOCK 4, •A(q MOUNTAIN PARK ESTATES SUBDIVISION No.2 f7 • ••• Anchorage Recording Precinct, Alaska, that the 49th"9 0 and *•• * / 0*.* improvements situated thereon are within the property lines I f• / • • / 00- and ce not overlap or encroach on the property lying adjacent thereto, p or no improvements property the property lying .•p1.. .Fred Walatka: / adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other ,� siF • • 3255 – S • •-to y visible easements on said property except as indicated hereon. �'o • •ao ` 11 Dated at Anchorage, Alaska day EASEMENTS OF RECORD, OTHER THAN 1 ssio"AV this 15th of March ,2017. THOSE SHOWN ON THE RECORDED \\�� FRED WALATKA & ASSOCIATES PLAT ARE NOT SHOWN HEREON. FS 17-1 pg 33 Engineers and Surveyors BE(907-248-1686) Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Nitrate Advisory Certificate of On -Site Systems Approval # OSC171096 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 4, Lot 9 of Mountain Park Estates subdivision. This inspection revealed a nitrate concentration of 12.1 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. �► ULLIVAN WATER WELLS Drilling • Piling • Pumps P.O. Box 670269 Chugiak, AK 99567 P:(907)688-2759 F:(907)688-2259 Pannone Engineering 13040 Foster Rd. Anchorage, AK 99516 Well Camera Report Camera set and surveyed to 60'. Two passes revealed no perforations or cracks. Thank you, Cole Sullivan Date: 3-30-17 MUNICIPALITY OF ANCHORAGE �fi� • Department of Health & Human Services M DIVISION OF ENVIRONMENTAL SERVICES M��t 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D. # "� /-� —6G 7 -o 9 HAA # 11AL 6,3ZC 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) 21,/_^,K 1 I . 31/1,/ 626 Location (address or directions) �v (b) Property owner , 1� Telephone : (home) Business Mailing Address (c) Lending Institution Telephone Mailing Address (d) Real Estate Company and Agent Address Telephone qo /) 3'q 6 603 (e) Mail the HAA to the following address: (or check here PY; if hold for pick up.) List contact person and day phone number below: I L& 2. TYPE OF RESIDENCE _ Single -Family [F Number of bedrooms g /�a-- y/u��etn 3. WATER SUPPLY al5Z71iPe 4,43 Individual Well Qr 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 M Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty 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. Name of Firm ��^ Telephone Q�� eo�'/�-`SS�� f A Address�� Vv - e:- Date l z` )Y- i5-6 "� •�F' A 4 JF TH !e• •.•ee• •e•••••6 r•i. ��dd •eeeeu •.�( LEROY'6,rREID, JR. •.• CE - 2251 pAW 6. DHHS APPROVAL Approved for _5 bedrooms by Date December 27, 1988 Approved XXX Disapproved Conditional Terms of Conditional Approval NOTE: The well for this propertyrpeets the existing codes for the State of Alaska and the Municipali-b�Abf Anchorage. However, nitrates are present in the drinking water. Test results for this lot are 4.7 mg/l The EPA maximum concentration for nitrate contamination is 10.0 mg/l., It is recommended that this well be sampled annually to ensure continued water quality. CAUTION 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 ordertosatisfy certain federal and state requirements. Employeesof DHHS do notconduct 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 A. WELL DATA ` Well Classification �f J�tT If A, B, C, D.E.C. Approved (Y/N) Well Log Present(Y/ ) Date Completed I Yield GA� 1 �►' n, Total Depth q t Cased to f Depth of Grouting V14 Static Water Level %� I Pump Set At�►r MUNICIPALITY OF ANCHORAGE (MOA) M Health Authority Approval (HAA) M j CHECKLIST - FEBRUARY 1984 i 343-4744 Legal Description: �� 7 `�:906� /hi «c I< E s -f. _ 13, t J e3 w 52G Casing Height Above Ground Iew Sanitary Seal on Casing&N) — Electrical Wiring in Conduit �VN) SEPARATION DISTANCES FROM WELL: > !� To Septic/Holding Tank on Lot �� / ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot � ; On Adjoining Lots ld� To Nearest Public Sewer Line V�aTo Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected by A 1, L If�j r1Pf t ; Date Water Sample Test Results (1L1��794 I i Comments I/(/�it'l I' lirw TC S _� Depression Around Wellhead (Y/by B. SEPTIC/HOLDING TANK DATA Date Installed i+'' Size%�"Co No. of Compartments Standpipes6)N) Air -tight Caps/N) Foundation Cleanout (Y(9 Depression over Tank (Y�9 Date Last Pumped l2 �� _J_Ac-5 ? r i(� 3 Pumping/Maintenance Contact on File (Y6 ; for 09 Holding Tank High -Water Alarm (Y/N) —Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water -Supply Well t o To Building Foundation To Property Line to To Disposal Field — To'Water Main/Service Line To Stream, Pond, Lake or Major Drainage Course �dD `- Comments 72-026 (Rev. 7/88) Front Page 1 of _2 fV � �t (q't�u( e5L:V- C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata ( 5-0 Type of System Design Date Installed -act- 171> Length of Field r9 Width of Field Depth of Field Square Feet of Absortion Area Depression over Field (Ya _ Gravel Bed Thickness _ Statndpipes Present &N) Date of Last Adequacy Test�- Results of Last Adequacy Test A,!*yATe SEPARATION DISTANCE FROM ABSORPTION FIELD: I / To Water -Supply Well J9® To Property Line To Building Foundation �� r To Existing or Abandoned System on N �P Lot �% lT � ; On Adjoining Lots / To Water Main/Service Line 1V To Cutback (if present) To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area i ' l<< e_ .- �� ' �Cve( Comments IFT STATION Date ed Dimensions Size in Gallons Manhole/Access (Y/N) "Pump On" Level at "Pump Off' Level at High Water Alarm Level at Vent (Y/N) Tested for Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments *'Check Permitted Bedroom Rating Against HAA Request" I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in�,AW,gpt�he date of this inspection. ®� A4 Signed CompanyG/ Seal Date MOA No �y •e o °°°°a°°°w°V'/•°• LEROY C. REID, JR. GE - 2251 2a` r app _ Receipt No. (0 \12 G�" Receipt No. tA*A 3P *9 Date of Payment /� —c}- 3 —'�� Waiver Fee: $ Amount: $ .o v Date of Payment 72-026 (Rev. 7/88) Back Page 2 of 2 r i 1�1'11�Y��i rM' Y Time APPLI('..- 1T FILLS OUT UPPER HA" .. _. DNLY _ Property Owner -� _ e Sam & Barbara Lazenby 545-7549 „ Maili;gAddress Zip Code Buyer L� �1 I - S. Address Inspector Zip Code Lending Institution - Phone Address Zip Code Realty Co. & Agent Merilyn Price, Century 21 Heritage Homes Pho1333 Address 207 E. Northern Lights,Anchorage Zip Code 99503 MUNI DEPT. HEALTH" DEPT. O ENVIRONM°NTAL PROTECTION Legal Description Mt. Park Estates #2, Lot 9, Block 4 Street Location APR 1 Type of Residence IR Single Family ❑ Multiple Family No. of Bedrooms _ ❑ Other 'CONDITIONS OF APPROVAL Water Supply 3X Individual ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. ❑ Community For wells drilled prior to that date, give well depth (attach log if available). ❑ Public Utility Sewer Disposal El Individual Year Individual Installed: 18.78 ❑ Public Utility Date Sewer Installed When Connected to Public Utility:; )F Holding Tank Well Log Received®� Septic Tank Size S-� 0 NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. r i 1�1'11�Y��i rM' Y Time Time Time Time C C)( "'ti �C' �. Date Date Date Date L� �1 I - S. Inspector Inspector Inspector Inspector Field Notes:n,z - -0 JI-0 X<7✓�� OF ANCHORAGE �` /L n MUNI DEPT. HEALTH" DEPT. O ENVIRONM°NTAL PROTECTION APR 1 RECEIVED ( 5-) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CON ITIONAL APPROVAL' DATE BY: Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received®� Septic Tank Size S-� 0 C7 1 Well to Tank 72-023 (3M) B111ZI I I of Sq. Ft. 2:392 E Heat 113al tst. :73000 AHFC g Liv. Rm 1st FI 11962nd F11196 8 GHWBB 1PTIt. Din. Garaue/Carnort E Poss 13al2nd. Z4UUU AKUSA Util. [A Gas [x] Bsmt. [x] Refrig Rec. Veh. Parking Yes ALASKA MLS [ x] Crpt Grid Bath I [x] Well [ ] Comp,_ [)10rapesEl. Rabbit Creek Residential [)]View Jr. Henshew LOT SIZE (check one) Rev. 6/81 UTILITIES ❑A) Under %x Acre f Insl R # - View of city ❑A) Public Water R9 B) %-1 Acre Earthtones t/o, circular CR B) Well ❑ C) 1 - 5 Acres ❑ C) Public Sewer ❑ D) Over 5 Acres [RD) Septic Tank IR E) Elec e165, List Date p. Date a,82 Terms 000 9 116 1 82 12 r 16 NF/Assume B111ZI I I of Sq. Ft. 2:392 E Heat 113al tst. :73000 AHFC g Liv. Rm 1st FI 11962nd F11196 8 GHWBB 1PTIt. Din. Garaue/Carnort E Poss 13al2nd. Z4UUU AKUSA Util. [A Gas [x] Bsmt. [x] Refrig Rec. Veh. Parking Yes • Fan. Rm. [] Mr. [ ] PatiO [ x] Crpt Grid Bath I [x] Well [ ] Comp,_ [)10rapesEl. Rabbit Creek �[ ] Swr [ x] Dspsl. [)]View Jr. Henshew [Aseptic [ :�Q Fence [:4 DishW Hi. _e_=ce Owner Sam & Barbara Lazenby Ph Legal Mt. Park Estates 2 Lot 9 Block 4 f Insl R # - View of city & mountains, excepts nice 5 E for large family. Fifth bedroom used as office, does not have closet installed. Earthtones t/o, circular crushed rock drive. no four wheel necessary. Appraised. The BLUE NUMBER is the MAXIMUM NUMBER of characters, including spaces, whether using pica or elite typewriter. Any copy beyond the maximum number of characters de- noted by the blue numbers will not appear on the listing. I-V I, vj4til �t\X6 rEfl Y/rr Owner, by signature below, requests that this listing not be placed '} with the Multiple Listing Service. "`A.0 Eu,�fly°s Owner: Sign Yes [ X] NC. Exchange NO Possession Date j 1 Owner: Reason for Selling etnl cirne Owner hereby employs — Heritage Homes & stments, Inc. r hereinafter referred to as "Agent," sole and exclusive agent to sell that certain real property described as Mountain Park Estates #2. Lot 9, BIOCK 4_ Anchorage Recording District, State of Alaska, for the price of $LaC' on the terms of $ — NFSlIIrie cash, balance payable: -- _ and to accept a deposit to bind a prospective buyer. Owners merchantable title shall be secured by a policy of title insurance, issued by �ygsponsible company, to be furnished and paid for by Owner. Owner agrees to obtain a preliminary commitment for title insurance within lull days after execution of this agreement. Interest, taxes, rents, insurance and assessment will be prorated to tI-tw da of closing. Q Q�T1his agency shall continue irrevocably fyro)he full period beginning 16 ept. , 1X , to midnight 16 Dec. 19� . Owner agrees to pay Agent Wo percent of the selling price as co�p,y�nsation if the property is sold or transferred by anyone, including Owner, during the contract period or if sold or transferred within 7U days after expiration of that period to anyone who negotiated during the period of this agreement with Agent or any other person authorized by Agent to sell or negotiate for the sale of the property. If an earnest money offer meeting the price and terms state�ribove is received and presented to Owner prior to the expiration of a ALASKA tWIROWnTAL COnTnOL SbUINS, InC. 6ngineerinq & Cnuironmental Studies MAY 18 1983 C21 HERITAGE HOMES/MARILYN PRICE 207 E NORTHERN LIGHTS SUITE 102 ANCHORAGE AK 99503 SELLER — LAZENVY BUYER—LAWERENCE SUBDIVISION—MOUNTAIN PARK ESTATES #2 BLOCK -4 LOT -9 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN UNKNOWN AREA. THE SYSTEM IS CAPABLE OF ACCEPTING 750 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 900 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 5 BEDROOM HOME. 771—z4vv—�—'0 D (�,� SEPTIC TANK ADEQUA Y THE EXISTING SEPTIC TANK VOLUME OF 1500 IS ADEQUATE FOR THIS 5 BEDROOM HOUSE. 1200 .lest 33rd Auenue, Suite B • Anchorage, Alaska 99503 • (907) 276-1361 X/ 5. LEG L DESCRIPTION t wit N STREET CATI`O MUNICIPALITY OF ANCHORAGE 6. TYPE OF RESIDENCE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION825 SINGLE FAMILY ❑ One Four ❑ Other ❑ Two ❑ Five L Street - Anchorage, Alaska 99501 E 7. WATER INDIVIDUAL* INDIVIDUAL* ENVIRONMENTAL ENGINEERING DIVISION since June 1975. For wells drilled prior to that date, give well Telephone 264-4720 depth (attach log if available.) REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. PROPE TY OV qER l/ Y. o A 5 2Q3 PHONE 4 9 -SS MAILIN FADD SS O NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. P QORCTY RESIDENT (If different from above) PHONE 2. BUYER PHONE MAILING ADDRESS - 3. LE DING INSTITU ION w boa PHONE e MAIING ADDRES ri • 'AV, 4. REATOR/ GENT PHONE MAI LI N'Dy1Et E(i /7 Q /'p O � I CJA 1) Aa �0 . _. Ul_ G qe 5. LEG L DESCRIPTION t wit N STREET CATI`O M J u- 6. TYPE OF RESIDENCE NUMBER OF BEDRO MS SINGLE FAMILY ❑ One Four ❑ Other ❑ Two ❑ Five ❑ MULTIPLE FAMILY ❑ Three ❑ Six 7. WATER INDIVIDUAL* INDIVIDUAL* *ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM **If individual/on-site, give installation date INDIVIDUAL/ON-SITE** If system is over two (2) years old an adequacy est is required ❑ PUBLIC UTILITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 1 72-010(3/78) c � .{�,5%e�►r�#74 r S ��P - �,/I r /y A,Pv�nr G5G � Ot THIS SIDE FOR OFFICIAL USE ONLY INSPECTION APPOINTMENTS DATE RECEIVED , TIME TIME - TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR Cl SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIM-ED I NaU� 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER ❑Septic Tank or ❑ Holding Tank Size: If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot e Lin Absorption Area to nearest Lot Line 5. COMMENTS R] APPROVED FOR 4— BEDROOMS ❑ CONDITIONAL APPROVAL (lett must accompany certificate) DISAPPROVE DATE BY( itle) LEGAL DESCRIPTION c -v i v �nev. 0116j MUNICIPALITY OF ANCHORA%F ® DEPARTMED�� F HEALTH AND ENVIRONMENT' ?�arr c i I ON 825 Street, AnchoraaP. Alasnu- 99501 264-4720 Date Received: March 31, 1978 #1: Time 11:150^_,,a.n. #2: Time #3: Time Date '3- onday Date Date Insp P t Insp Insp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES 1. Lending Institution Request: Home Federal Savings & Loan Association Mailing Address: 535 D Street 99501 Phone: 272-1451 2. Property Owner: Charles Rubey Phone: Mailing Address: % Carol Gibson, 376-3404 3. Legal Description: Lot 9 Block 4 Mountain Park Estates #2 4: Single Family Residence: (x) Multiple Family Residence: ( ) Number of Bedrooms: Five Number of Bedrooms: 5. Well System: Individual Well (x) Community/Public System ( ) Permit I Construction Depth of Well 99' Well Log on File (x) Bacterial Analysis 6. Sewage Disposal System: On-site System (x) Public Utility ( ) Permit # Installed Installer Septic Tank Size/a p� Manufacturer Absorption Area Soils Rate 7. Distances: Well to Septic Tank to Sewer Line to Nearest Lot Line Nearest Lot line Material to Absorption Area Absorption Area 3. Lending Institution: �� % �Q s�-z Iti Phone: Mailing Address: ri cl �(��/�, �tic%/�%�� f%s/�> }1 4. Realtor/Agent: L/"-'� / Mailing Address: &L Phone: 5. Legal Description: Street Location: 6. Single Family Residence: () Number of Bedrooms: Multiple Family Residence: ( ) Number of Bedrooms: 7. Water Supply:.,_ *Individual Well (/i) Public/Community System ( ) If Individual Well, well depth ff / If Community System, name of system Sewage Disposal System: *tn-site System (X) Public System ( ) If On-site System, date of installation: *NOTE: A well log is required on ALL wells drilled since 6/75. **If on-site sewer system is over two(2) years old, an adequacy .test is required by this department. A fee of $25.00 must accompany each request before processing can be initiated. 3/77 MUNICIPALITY OF ANCHORAGL 3 _7� Department of Health and Environmental Protection 825 L Street, Anchorage, Alaska 99501 <� I 264-4720 quest for Approval of Individual Sewer and Water Facilities �/� � X, 1. Property Owner: Q S Mailing Address: �s/� //�vf i� Phone: 2. Name of Buyer: Mailing Address: Phone: 3. Lending Institution: �� % �Q s�-z Iti Phone: Mailing Address: ri cl �(��/�, �tic%/�%�� f%s/�> }1 4. Realtor/Agent: L/"-'� / Mailing Address: &L Phone: 5. Legal Description: Street Location: 6. Single Family Residence: () Number of Bedrooms: Multiple Family Residence: ( ) Number of Bedrooms: 7. Water Supply:.,_ *Individual Well (/i) Public/Community System ( ) If Individual Well, well depth ff / If Community System, name of system Sewage Disposal System: *tn-site System (X) Public System ( ) If On-site System, date of installation: *NOTE: A well log is required on ALL wells drilled since 6/75. **If on-site sewer system is over two(2) years old, an adequacy .test is required by this department. A fee of $25.00 must accompany each request before processing can be initiated. 3/77 ._......-.-�-...-«......,...+,r.�..�..:... x-a.,n..e- r..x,:ra.n::e� .,.,.,..��._..:.a .�.:._t...; .:.,,.....o..'O_-e;i:.J.&a„_,. ._ ......,.. ».i.. .c t:�. .. .. _,... :...,........,..... a.... ,-_.. _ ... Page Two . Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 9 Block 4 Mountain Park Estates #2 Subdivision Comments: Affadavit Attached: ( ) Letter Attached: ( ) Approved: Date: Disapproved: Date: Department Worksheet: