Loading...
HomeMy WebLinkAboutRAMSTAD LT 12COnsite File ��ND I I If- dr:t I -or "V L.) fr% IN C.-- BA 10 FR tr§ ei3�� D�pARTMENT O \��ALTH AND ENVIRONMENTAL [' MTECTION 825 L STREET, ANCHORAGE, AK 99501 264-4720 C3 NI —1-3, ." ��EL-7: �'" IFE Pi][ • T. PERMIT NO: 850347 DATE ISSUED: 06/24/85 APPLICANT: . RICHARDN. PARRY ADDRESS: BOX 105 . GIRDWOOD AK 99587 CONTACT PHONE: 783-2089 LEGAL DESCRIP: SUBDIVISION: RAMSTA0 LOT: 12 El SLOCK1 NA SECTION: 19 TOWNSHIP: 1ON RANGE: 2E LOT SIZE: 30000 (SQ"FT. OR ACRES) 1 certify that: 1. I am familiar with the requirements for on-site sewers and wells as set forth by the Munidipality of Anchorage (MOA) and the State of Alaska. 2. 1 will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria of thit permit. 3. % will adhere to all MOA and State of Alaska requirements for the set back distances frOm any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. SIGNED APPLICANT: RICAAR ISSUED BY wc�_•�_��� PARRY DATE: . / (77 ��/ L �o� /2C pet' 'A 0. QEF Ja�`O�Q���Pv `� 0 C'J. Al MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 A. WELL DATA n Well Classification PR 1u4re Well Log Present (g)N, Total Depth 1l < Cased to 70` Depth of Grouting Static Water Level Legal Description. L/ZU 19M57*.D VP -no iv R 2E s6c, If A, B, C, D.E.C. Approved (Y/N) Date Completed 7/26/$`S Yield o r/14 /V/i9 60 Pump Set At OA/v©e!//Il Casing Height Above Ground Z Sanitary Seal on Casing (ON) Electrical Wiring in Conduit ON) Depression Around Wellhead (Ya Separation Distances from Well: To Septic/Holding Tank on Lot INA To Nearest Edge of Absorption Field on Lot N/A To 100 i o Bares u t T N t Public Sewer ; On Adjoining Lots ; On Adjoining "Lots Nearest Public Sewer Line Cleanout/Manhole 1001+ Water Sample Collected by Water Sample Test Results Comments /00 <• To Nearest Sewer Service Line on Lot© J lil}1 rClfCK ; Date 106166 5/4-rl5F/c rot S' B. SEPTIC/HOLDING TANK DATA Date Installed Size Standpipes (Y/N) Air -tight Caps (Y/N) Foundation Cleanou /N) Depression over Tank (Y/N) Date Last Pumped Pumping/Maintenance Contract on File (Y/N) ; for Holding Tank High -Water Alarm (Y/N), Tempor. Holding Tank Permit (Y/N) No. of Compartments Separation Distances from Sept To Water -Supply Well To Property Line To Water Main/Service Line Course -> '6" Comments. II iTank: To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Page 1 _oft: RA -44574-0 s/1P C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Type of System Design Date Installed Length of Field Width of Field Depth of Field Gravel Bed Thickness Square Feet of Absorption Area Standpipes Pr ent (Y/N) Depression over Field (Y/N) ► Date of Last dequacy Test Results of Last Adequacy Test Separation Distance from Absorption Field To Water -Supply Well To Property Line To Building Foundation To Existing or Abandoned System on Lot ; On Adjoining Lots To Water Main/Service Line To Cutbank (if present) To Stream/Pond/Lake/or Major Drai ge Course To Driveway, Parking Area, or V- icle Storage Area Comments D. LIFT STATION Date Installed Size in Gallons Manh. Access (Y/N) "Pump On" Level at ' 'Pump Off' Level at High Water Alarm Level at i r. Vent (Y/N) Dimensi Tested for Electrical Codes (Y/N) Comments Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I ha a ked ve fied o conformed to all M anHAA guidelines in effect on the date of this inspection. Signed /�7GZGl Company Receipt No n Date l0 Lr g6. ECS P/IAC.- MOA No ieg' 'OZ /eO/£2 -v Date of Payment Amount $ 6..67 ii-rrhaFtit4 t-$ ! wat t -©G z WATER-ANtPGh 113 s r6 Pam/ �D/2!� Pb dzJ Page 2 of 2 72-026 (11/84) ...... t9 t♦ i74. r#146 • #....�.......:.. •••• • OY C REIDJR Well Owner Richard Parry r -Th M -VV DRILLING, Inc. F . . Box 10-378 • 10300 Old Seward Highway (907) 349-8535 ANCHORAGE, ALASKA 99511 DRILLING LOG Use of Well Dorreet is Location (address of: Township, Range, Section, if known; or distance main road 1.125 Rar:,sta3 Subd. Girdwood, Ak. Size of casing ` Depth of Hole 71 feet - sl.q- Static water level GO ft (a Cove) Screen ( ); Perforated ( (below) land )• Cased to 70 feet surface. Describe screen or perforationNone _ Well pumping test at 6'8 gallons per (}iouii) (minute) of drawdown from static level, Date of completion 7/26/55 WELL LOG Finish of well (check one) open end ); MUNICIPALITY OF ANCI-C ACE DEPT. OF HEALTH & for ENVIRON eieittML WiiallECTION400;' I X4: 1 OCT 2 81986 RECEIVED Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness TO TO65 65 TO 71 TO TO TO TO TO TO TO TO TO TO TO TO St ick tip Brom Silty Gravel (damp) 1120 Sand S Gravel �o�0 c6 bt s.s Co NP 11 CP.(Ica 3 - CONTRACTOR January 10, 1986 TO: Permit Applicant P.O. BOX 6650 ANCHORAGE. ALASKA 99502-0650 (907) 264-4111 TON Y.KNOWLES MAYOR • DEPARTMENT OF HEALTH & HUMAN SERVICES Subject: Permit # 850347 Lot 12B Ramstad Subdivision A permit issued by this Department for an individual well and/or on-site sewer system has expired as of December 31, 1985. Permits are issued on a calendar year basis by authority of Municipal Ordinance. A new permit must be obtained from this Department for any well and/or on-site sewer system not installed by the expiration date. If you have drilled the well, a well log needs to be sent to this Department for documentation of the installation and to close the permit. If a private engineer inspected the installation of the on-site sewer system the original as -built inspection report(three part form) must be sent to this office for review and approval,and for documentation. If there are any further questions, please call this office at 264-4720. Sincerely, gLo-at" Susan E. Oswalt Program Manager On-site Services SEO/ljw enc: Copy of Permit n MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date /t z t'/¢� 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) L 1243 f4MsT9 Tion/ 6'2I sEc. /9' Location (address or directions) BE Zu/6F( Rola-ME RD, AWL Of, /ris DR, 04' A C %E.SKA /7/Ghito9 (b) Applicant Name RICHARD P/RRV Telephone: Home Business 78'3-245". Applicant Address 80X 10S G/i Duita©D !-K 99,597 (c) Applicant is (check one): Lending Institution ❑ ; Owner/builderX; Buyer 0 ; Other 0 (explain); (d) Lending Institution Address (e) Real Estate Compariy a'rid Agent Address • • ° fi Telephone (f) Mail the HAA to the f©fo ing address: kfn t 2. TYPE OF RESIDENCE Single -Family LE Multi -Family 0 Other Number of Bedrooms 3 3. WATER SUPPLY Individual Well Community 0 Public 0 Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite 0 Public Community 0 Holding Tank Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11/84) "Th} Lit./ f i IPV L, 5. ENGINEERING FIRM PROVIDINta 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 4Ecs 14(c, Telephone S6/".50 17 Address 1100 L(/ 33.---06. 0.6 4iVV/,-f 4g 97s-03 Date 6. DHEP APPROVAL; Approved for . Approved bedrooms by Disapproved Engineer's Seal 401117,6111111,11., ° rte.•° t •;.4-�0 Date rr •• iii-.. ••°.01 C. RER), JR. 1 . CE -2251 •: .•• kr. PlaiiSSVO• e \ �fps+'�' 7 Conditional Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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. Page 2 of 2 IlCIC 14 4 10 Ai CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. TELEPHONE (907) 562-2343 5633 B Street Anchorage, Alaska 99518 Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER ❑ PUBLIC WATER SYSTEM I.D.# X PRIVATE WATER SYSTEM i-EGc) 506/0 Name Zoo c,(J , 33271 AVE - Mailing Address Phone No. City State SAMPLE DATE: 0 Mo. C Day Zip Code SAMPLE TYPE: Routine ❑ Check Sample (for routine sample with lab ref. no ❑ Special Purpose Year SAMPLE NO. LOCATION 1 I L12-6 RW i5` D o/sr P 2 3 4 5 Time Collected Collected By ►740 jK TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: tie Satisfactory ❑ Unsatisfactory ❑ Sample too long in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. Date Received Time Received Analytical Method: VVC Membrane Filter * No. of colonies/100 ml. Lab Ref. No. 5 - Result* Analyst -7=2"6L 0 BACTERIOLOGICAL WATER ANALYSIS RECORD READ INSTRUCTIONS Membrane Filter. Direct Count Coilforml100m1 BEFORE COLLECTING SAMPLE Final Membrane Fier Result/�v CKo/il'f rmllOoml Reported By Date / _ v Verification: LTB BGB Time. TNTC = Too Numberous To Count OB = Other Bacteria a.m. • ALASKA ENVIRONMENTAL CONTROL SERVIri, INC. 1200 West 33rd Suite B ANCHORAGE, ALASKA 99503 (907) 561.5040 JOB L126 KAMS7/10 5/C) SHEET NO CALCULATED BY •tJ TX OF DATE lope/gg CHECKED BY DATE SCALE 1 i<T•• 20 ANCHORAGE WATER & WASTEWATER UTILITY //( 2242 Tony Knowles Mayor June 24, 1985 3000 Arctic Boulevard Anchorage, Alaska 99503 (907) Owned by the Municipality of Anchorage RE: Snow Valley L.I.D. To Whom It May Concern: Anchorage Water & Wastewater Utility anticipates going to bid on Snow Valley L.I.D. 60-3 within three months providing the necessary permits are acquired within that same time period. Attached is a map showing the prelimary alignment of the sanitary sewer lines. Should you have any questions feel free to call me at 786-5522. Sincerely, BARB RAYNES Engineering Technician II Anchorage Water & Wastewater Utility BR:tje attachment L.I.D. BOUNDARY v••••••• PROPOSED LATERALS PROPOSED TRUNK EXISTING SEWER GIRDWOOD/ALYESKA WASTEWATER TREATMENT FACILI 4891-4973 C" a I/ Municipality of Anchorage �r On -Site Water and Wastewater Program (907) 343-7904 Certificate of On -Site Systems Approval Parcel I . D. 075-092-56 1. GENERAL INFORMATION: Complete legal description RAMSTAD S/D; LOT 12C Expiration Date: (,-2;3-20*e_1 Location (site address) 905 ALYESKA HIGHWAY *GIRDWOOD, AK 99587 Current Property owner(s) SASHA SWIFT Day phone 415-847-3477 Mailing address Real Estate Agent Day phone 2. TYPE OF DWELLING: © Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual ❑ Individual Water Storage ❑ Holding Tank ❑ Community Class_Well ❑ Community ❑ Public Water System ❑ Public Sewer WaiverNariance request for: Distance Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ $280 Waiver Fee $ Date of Payment 3 —1 a_Z I Date of Payment Receipt Number ©7 q-L,UTn G Receipt Number COSA # OSC211116 Waiver # /y) 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101- Anchorage, Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: Zi In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. 6. DSD SIGNATURE System #1 Approved for -3 bedrooms System #2 Approved for Disapproved Conditional approval for bedrooms bedrooms, with the 1' \l ,1.1.. ....... Jeffrey Garn)ss. j'•, Ce -7953 ? G r fes s0�c #AECC884 \11y OFi(gr�//i ON-SITE g WATER AND P901 -ER �n PROGRAM I)%iI,,..... ... ". By: `—' Original Certificate Date: 3 -23-2� 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: COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist Legal Description: RAMSTAD; LOT 12C Parcel ID: 075-092-56 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA 01 Well log is filed with Onsite (or attached) Date drilled 7/26/85 Total depth 71 ft Cased to 70 ft Al Sanitary seal is functioning correctly © Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 3/5/21 Static water level at beginning of test 63.5 ft Comments B. TANK DATA Age of tank(s) years Tank type/material Measured operating fluid level in septic tank ❑ Standpipes/foundation cleanout per record drawing Date of pumping D. ABSORPTION FIELD DATA Which system tested (date installed) ❑ ALL standpipes present per record drawing Total measured depth from grade ft (max Measured depth to pipe invert from grade ft (min) ❑ N/A —pressurized field F1 Monitor tubes go to bottom of ctive. If not, state depth into effective ❑ Code -required soil c er over field ❑ System preso ed (Required if v ant for greater than 30 days prior to date of to 06ns introduced gallons ments/Deficiencies: COSA Checklist yellow sheet Well production at time of test 8.5+ gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes Al No A Coliform bacteria is Negative Nitrate 0.258 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by GEG, LTD. Date of Sample 3/5/21 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material / Comments: dequacy test date Results ❑ Pass For bedrooms Fluid depth prior to test in Water added gal New depth in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) If yes, enter date AWWU SEWER E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) ❑ Yes Septic Tank/Lift Station on Lot > 100' NSA Community Sewer Manhole/Cleanout > 100' F7Yes if No ft ❑✓ Yes if No ft Neighboring Tank > 100' ❑✓ Yes if No ft Private Sewer/Septic Line > 25' F,-/� Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No NSA ft Holding Tank > 100' ❑✓ Yes if No ft Neighboring Absorption Fields > 100' ft Animal Containment > 50' ❑✓ Yes if No ft ✓❑ Yes if No ft ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ❑✓ Yes if No ft ❑✓ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No ft Surface Water > 100' ❑ Yes if No Property Line > 5' ❑ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ❑ Yes if No ft Private Wells > 100' es if No ft Water Main > 10' ❑ Yes if No ft Community Wells 0' ❑ Yes if No ft Water Service Line > 10' ❑ Yes if No ft If septic t Is under driveway comment below From Absorption Field on Lot to: (Please enter distancesjf- s than required) Building Foundation > 10' ❑ Yes if No ft If absorption field is under driveway comment below Property Line > 10' ❑ if No ft Wells on Adjacent Lots: 10' Wa>Servi ❑ Yes if No ft Private Wells > 100' ❑ Yes if No ft WaIne > 10' ❑ Yes if No ft Community Wells > 200' ❑ Yes if No ft Sur > 100' ❑Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION o Qy• • certify that / have determined through field inspections and review of Municipal records that the above systems are in conformance with p C� MOA COSA guidelines in effect on this date. 0 4 /',Y7 . , , . , I . , , , , .: , . . COSA Checklist yellow sheet '•, ��fF�X--A---•D-o Hess: / CE -7953 '�� • coli 44�np�o f e s siono�o ttAECC884 SUBDIVISION: RP,4 aal 14 +1 STREET a O A LU a z 0 0 w a- m Z, a. w 3 w INDICA? NORTH BLOCK: s I o' -Zl ,as , a'�___-�.%1 a a 1 0 SEWER SERVICE LINE SKETCH - SHOW LOCATION OF CONTROL MlANHOLESICLEANOUTS LOT: t a C ALLEY SIZE MAIN: _S1— TYPE MAIN:D-X-P— CONNECT DEPTH AT MAIN CONNECT DEPTH AT Prop. Line ^ CON,N�E"CT LOCATION: t�or r.1A� n 7il�.� ArrsS_�t {u �L.� �}-GI�sS� diDH,t IF COMMENTS: ty--) –tC+-a `t'0 40"i -—_-•--- -._. _.._._._ INSPECTED BY: �efi—..-__.__^. _ DATE .� ... Ben Habeeker and Stacie Lordan P.O. Box 1234 Girdwood, Alaska 99587 Beed of Easement The Grantors, RICHARD NEIL PARRY and SUSAN LEO PARRY, husband and wife, whose address is P.O. Box 105, Girdwood, Alaska 99587, for and in consideration of the sum of Ten Dollars ($10.00) in the lawful money of the United States of America, and other valuable consideration in hand paid, the receipt and sufficiency of which is hereby acknowledged, do hereby grant, convey and warrant to Grantees BEN HABECKER and STACIE LORDAN, husband and wife, whose address is P.O. Box 1234, Girdwood, Alaska 99587, a pennanent appurtenant easement fon' the location, operation, access, maintenance, and deepening of Grantees' encroaching water well for a total distance of fourteen square feet: three and one half feet deep into Lot 12C Ramstad subdivision and four feet wide with the well casing at the center of the width, and including any associated piping and electrical lines from and to said well, all as shown on the attached Exhibit A ("the Easement") and also including the right to use water from said we] l for Grantees' adjacent property described on Exhibit B hereto. This easement does not grant the right to .replace the well, nor to add any other structures within the Easement. All access to the Easement shall be exclusively from Lot 13 PART 4 US SURVEY 3043 and not across any other portion of Lot 12 C, Rarnstad Subdivision. Said easement is -located on the following -described real property of Grantors, located in the Anchorage Recording District, Thir dicial District, State of Alaska: LOT TWELVE "C" (12C), "STAD Si7B.DIVISION, ing to Plat 86-17 , ubdivision of Lot 12B, RAMSTA -5ri7$DIVISION per Plat 68-11, filed in the Deed of Easement — Page 1 records of the Anchorage .Recording District, Third Judicial District, State of Alaska . This easement is intended to be appurtenant to the property described on Exhibit B and to run with the land described on Exhibit B. Dated this 11 day of June, 2014. STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) THIS IS TO CERTIFY that on the day of June, 2014, before me the undersigned Notary Public personally appeared RICHARD NEIL PARRY, who is known to me and to me known to be the person named in and who executed the above and foregoing, and he acknowledged before me that he signed the same freely and voluntarily for the uses and purposes therein mentioned. WITNESS my hand and official seal. ta6Vic in • d r Alaska My Commission expires: } t/1 5 ARMEE EPLEY Notary Public State of Alaska My Commission Expires September 11 , 2017 Deed of Easement — Page 2 SUSAN LEO PARRY STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) THIS IS TO CERTIFY that on the day of June, 2014, before me the undersigned Notary Public personally appeared SUSAN LEO PARRY, who is known to me and to me known to be the person named in and who executed the above and foregoing, and she acknowledged before me that she signed the same freely and voluntarily for the uses and purposes therein mentioned. WITNESS my hand and official seal. OSHA E EPLEY Nolory Public Stole of Aloska My COmmission Expires September 11, 201 7 Deed of Easement — Page 3 Notary PLWic in A&Wr Alaska My Commission expires: -t / i t / 1 I PART 4 / sC ...A .figOA \ exIsTm . HOUSE . . . . . . WELL ENCROACHE 2 4 1.3' INTO LOT 12CIN, r \�a . 4aQ 47,� LOT 12C PART 3 UNDER NO CIRCUMSTANCES SHOULD AN AS-WLT BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE LINES. THE SURVEYOR TAKES RESPONSISIUTY FOR THE INITIAL TRANSACTION ONLY AND ASSIMES FINANCIAL LIABILITY ONLY FOR THE COST OF 1HE SURVEY LISTED DISTANCES PREVAIL OVER SCALING, REPRODUCTM MAY CAUSE ERRDRS IN SCALE tar s1ITEY SURVEY TYPE SYMBOLS AXWAIM AS-IAMT SET MBARASPHALT FWAL STRUaRW AS -OMT DRAINAGE a F04ktD REBARy aWOODFENCE CONCRETE aior s ... �s-t�iu ... uIT s Y ... TOPoaR,�ntlr ASSUMED ELEV METAL FENCE ® *+pfio tEcac IS THE RESPONSIBILITY OF TTtE BUILDER OR OWNER, PRIOR TO ONLY THOSE IMPROVEMENTS ASOVE GROUND AND V &UX HALL BE DNSTRUCTION. TO VERIFY PROPOSED BUILDING GRADE RELATIVE SHOWW- FENCES, WM.LS, SEPTIC CLEANOUTS, SIDEWALKS. DRIVEWAYS. ) FINISHED GRADE AND UTILITY CONNECTIONS AND TO DETERMINE ETC„ ARE SHOWN IN THOR APPROXIMATE LOCATION, ONLY. SNOW iE EXISTENCE OF ANY EASEMENTS. COVENANTS OR RESTRICTIONS MAY PREVENT SOME IMPROVEMENTS FROM BEING SEEN AND LOCATED. HICK OO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. I ALL DISTANCES ARE RECORD UNLESS OTHERWISE NOTED. RVEY CERTIF1CAMON 01 F'repared by SPLAN ,�0Ow'r-. 1j4+>� Robert E. Johns, Jr. cue Assoc. �� t,0 • Professional Land Surveyors rew.e .r d : r. we anrn r 1700 Brink DdM W-=:. ..asend M w e+K of AV �•'� ANCHORAGE, ALASKA 49W oa..a.,.,iw. a¢.."d.., AV ,� 0* ' f Scala �„ ` 30, Rot. Lot S.F. Rm Plat Fae Na NGATM AS-•8U0.T ••••r:• ...�..... t.;... .......'� ►at t h+na r, twny of ma I ' >4 Dote Serve D-" b p E J Chetkod b�� wt be ... ......� y� 06106/14 '� CZ wmr.,otla, r .� ,.rac Roe H , •. .• a Date Dry 06/06/14 0"d: 4913 w o. 14-99 U STAtIGTildiE AS-TXI�T �� a 4121—S est a mwn t, MMW WWI ta.e t A� •' �•,,•� �� Legal D-WpUm � ., °d r�•.,.......••' Lot 13 PART 3 & PARS' 4 � � �� � US SURVEY 3043 Municipality of Anchorage On -Site Water & Wastewater Program (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 075-092-56 1. GENERAL INFORMATION Complete legal description RAMSTAD; LOT 12C Location (site address) Expiration Date: /1 ' 2 905 ALYESKA HWY *GIRDWOOD, AK 99587 Current Property owner(s) RICH & SUE PARRY Mailing address Real Estate Agent 905 ALYESKA HWY'GIRDWOOD, AK 99587 Day phone 441-1613 2. TYPE OF DWELLING: ▪ Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4. TYPE .OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System • 3 Day phone TYPE OF WASTEWATER DISPOSAL: Individual Or. -site Individual Holding tank Community On-site Public Sewer • WaiverNariance request for N/A Distance: - Received by: COSA to be released to the engineer, unless otherwise requested by the engineer: Date: /,2��i COSA Fee $ 5OSeI Date of Payment VaViCo Receipt Number ri gl,q 0 COSA # 35010/379 Waiver Fee $ Date of Payment Receipt Number Waiver # If more than 1 septic system is on the lot: COSA Checklist # of Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: A. WELL DATA Well type PRIVATE Date completed RAMSTAD; LOT 12C Parcel ID: 075-092-56 If A, B, or C provide PWSID# N/A 7/26/85 Sanitary seal (Y/N) YES Total depth 71 ft. Cased to 70 ft. FROM WELL LOG Date of test 7/26/85 Static water level Well production WATER SAMPLE RESULTS: Coliform n 0 colonies/100 ml. Arsenic: NC ug./L. B. SEPTIC/HOLDING TANK DATA Tank Type/Material Tank size gal. 60 ft. 6-8 gpm Nitrate V. r 5mg /L Date of sample: 8/1/2016 Number of Compartments Well Log (Y/N) YES Wires properly protected (Y/N) YES Casing height (above ground) 12+ in. AT INSPECTION 8/1/2016 61.6 ft, 6+ gpm Collected by- GEG, Ltd. PUBLIC SEWER Foundation cleanout (Y/N) Depression over tank (Y/N) Date of pumping C. ABSORPTION FIELD DATA Date installed Length ft. Total depth ft. Eff. absorptio Date of adequacy test Fluid depth in abso . 'in field before test in Elapsed e: min. Final fluid depth in. Pumper Date installed Cleanouts (Y/N) High water alarm Soil rating (g.p.d./ftbr ft2/bd Width System type ft. Gravel below pipe ft. ft2 Monitoring tube _ Depression over field For bedrooms Water added _gal New depth in Absorption rate >= g.p d Results (Pass/Fail) y rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off" level at r alar level at in. Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Nth On adjacent Tots 100'+ Absorption field on lot Public sewer main WA 75'+ Sewer /septic service line 25'+ Animal containment areas 50'+ On adjacent lots 100'+ Public sewer manhole/deanout 100'+ Holding tank 75'+ Manure/animal excrete storage areas 1001+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation Property line Absorption field Water main Water service line Surface water Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD •T TO: Property line Buil . • : ndation Water main Water service line Surface water Driveway, parking/vehicle storage C . r • rain Wells on adjacent lots PUBLIC SEWER F. COMMENTS 5a ea SEPARATION DISTANCE BETWEEN THE Ii _SERVICE UNE AND H2O LINE WAS NOT EVALUATED. G. ENGINEER'S CERTIFICATION 1 certify that 1 have determined through field inspections and review of Muntclpal records that the above systems are in conformance with MOA COSH guidelines In effect on this date. Engineer's Printed Name JEFFREY A. GARNESS Date (Rev. 10/12/12) kkk eSli i ��,.• * i • �! ems ji eE_7g � �- s//I1 t• F 4 LICENSEE 4• ESS: ���•• 4AECC884 As-Suitt Survey SUBDIVISION: RnowS- ni BLOCK: _, I LOT: I a C SEWER INSPECTION REPORT INDICAT NORTH STREET 41. i -rd 441 SEWER SERVICE LINE SKETCH + SHOW LOCATION OF CONTROL MANHOLESICLEANOUTS ALLEY SIZE MAIN: % �, TYPE MAIN :aP CONNECT DEPTH AT MAIN _ CONNECT DEPTH AT Prop. Line Q CONNECT LOCATION: .: :- , I8's0ra W_SST_ 4 Sakaeg Ft/ B lttaj4 ._ COMMENTS: tenant -C •t'o 40u to INSPECTED BY: H P. DATE .21—_C --1P7 CM Z O 002E 2 m 2 vw~-Oi O N d m Z Z CO m o o 0 0. 9' 3 m O OOD OD 2 aZ DZ p `coLIoy A 2 D D O Oyv yvv apt 9 00 OOZ iv Ea T. LI Z 3m39 9Ay 31� a<a mo3Z a2 am m Z ss3Haa X c(0 oO < N Z Oam as moo V A* mom al Om CM mF D J <-4 DM 933 oc -i r 0 Oil 0 C01 n D m Z. E O m r -I' m v r -i rn r 37' gz g. O 0 ❑ 04 Z O 30D -i C z I� m o i C s m i m v n N m > °- C 16) c