HomeMy WebLinkAboutHUNDRED HILLS 1ST ADDITION BLK 5 LT 13Hundred Hills
#1
Block 5
Lot 13
#078-191-14
MUNICIPALITY OF ANCHORA F -j)ticrar
� �.
G n -Site Watar & Wasteviater Program �4� ,.
PD Bcx 196650 4700 Elmore Road f
moorage. AiasKa 9�51MB54 Phone; (907) 343-7-904 Fax: (947) 343-n97
hup:ffi" w.muni.orghneile
I. upill-rernvttr
On -Site Wastewater Disposal System Permit
Permit Number; OSP211383 Effective Data: 9)g 021
VY-ork Type;. 5eplic Renswal Expiration Data: 9 5 022
Tax Code N umber_ 07$ 19 114000
Site Legal Address; HUNDRED FILLS 1 STADDITION BLit 5 LT 13 G: 1160
Site ltillail ing Address; 525 WOLF DR, Eagle Giver
Own iar. MYERS KEVIN S Lot Size in Sq Ft: .600$2
Design Engineer: ErR T WATER CONSULTING Total Bedrooms: 4
Th is p arrri l t is to r the co rtstru ction of.
IBJ Disposal Field 0 Septic Tank ❑ Hold Ing To rik 0 priory 13 PTiwa te'Nell ❑ Water Storage
All construction shall bFa in accordance with -
1. The Eltached approved design -
2. Ail requirements specified irl Anchorage Municipal code Chapters 15.55 and 15.65 and the t:Ae of Alaska
Wasteweler Disposal Regulations (18AA 72) and Urinking Water Requlati ms (18AAC80)
3. The wsatewster d-9 squires insp ilon6 dwing the ir.stallistion- The engineer shall notiFy the Develupnwt
Services Cepa rtment per AMC 15-$5- Provide n¢ti1jcalior, by calling C-007) 343.7004 (24f7).
4. From. 06tober 15 to April 15, a subsurface sol absorpticn syslem orkder construction during freezing vweiRther
shall be eFther,
a. Opened and Closed on the same day, or
b. Cowered, seakgd, and heeted to prevent freezing
Received By--
I
ssued By; _6LM'--3wy-
91912021
...,
Date-
Data: ,o
MUNICIPALITY F ANCHORAGE
1; ,ate
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
ON-SITE SEPTICIWELL PERMIT APPLICATION
Parcel I.D. 078-191-14
Property owner(s) KEVIN S. MYERS Day phone 9072808010
Mailinq address PO BOX 771381, EAGLE RIVER, AK 99577
Site address 525 WOLD DRIVE, EAGLE RIVER, AK 99577
Legal description (Sub'd., Block & Lot) HUNDRED HILLS 1 ST ADD B5, L13
Legal description (Township, Range & Section)
Lot Size 66082 Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(N all that apply)
Absorption Field
®
Initial ❑
Single Family (SF)
(w/wo AD U)
Septic Tank
PAN
Upgrade ❑
Duplex (D) ❑
Holding Tank
ElRenewal
Multiple Dwellings ❑
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES
A WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees: % `/5
Date of Payment: 9/lo a0a
Receipt Number: 9001 5-5
Permit No. OSP a 1138 -3
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
G:\Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc
First Water
X'_ CO N8ULTING
13030 Sues Way, Anchorage, AIC 99516
907-350-9566 / firstwaterAK@gmail.corn
September 8, 2021
Municipalities of Anchorage
On -Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
RE: RENEWAL SEPTIC SYSTEM PERMIT #0SP191127
LEGAL: HUNDRED HILLS #1 B5, L13
The property owner has requested we renew the septic permit OSPI91127 for the above
referenced lot. Nothing has changed on the lot or adjacent lots that would affect the design as
permitted. The lot and area are served by private water. The design will not impact any of the
neighboring properties. Please contact us if you have any questions.
Sincerely,
Curtis Huffman, P.E.
MUNICIPALITY OF ANCHORAGE
Onsite Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http:/A w .muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP191127
Work Type: Septic Upgrade
Tax Code Number: 07819114000
Effective Date:
Expiration Date:
Site Legal Address: HUNDRED HILLS IST ADDITION BLK 5 LT 13 G:1160
Site Mailing Address: 525 WOLF DR, Eagle River
Owner: MYERS KEVIN S
Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING
This permit is for the construction of:
0 Disposal Field 0 Septic Tank ❑ Holding Tank ❑ Privy
,m�»t
c
n
I epartmeut
5/20/2019
5/19/2020
Lot Size in Sq Ft: 66082
Total Bedrooms:
❑ Private Well ❑ Water Storage
All construction shall 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 shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either: -
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Received By:Issued By: _fU"
Date: 5
Date:
MUNICIPALITY OF ANCHORAGE
A
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 078-191-14
Property owner(s) KEVIN S. MYERS
Mailing address PO BOX 771381, EAGLE RIVER, AK 99577
Site address 525 WOLD DRIVE, EAGLE RIVER, AK 99577
Day phone 9072808010
Legal description (Sub'd., Block & Lot) HUNDRED HILLS 1STADD B5, L13
Legal description (Township, Range & Section)
Lot Size 66082 Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field
®
Initial ❑
Single Family (SF)
(w/` o, AD U)
Septic Tank
®
Upgrade ®
Duplex (D) ❑
Holding Tank
❑
Renewal ElMultiple
Dwellings ❑
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES
A WAIVER REQUEST FOR:
Distance:
certify that the above information is correct. I further certify that this is, in accordance with
applicable Municipal Codes.
FWCS = Brent Western
(Signature of property owner or authorized agent)
Permit/Rush Fees: 07 Q5—
Date of Payment: W;209
Receipt Number: 0530Rb
Permit No. �Sl�l q ll a2�
Waiver Fees:
Date of Payment`.
Receipt Number:
Waiver No.
GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc
Michael N. Anderson, P.E.
Civil/Structural Engineering and Construction
4661 Natrona Ave. Anchorage, Alaska 99516
Phone 345 -3377 / Fax 345 -1391
Support Services
Brent M. Western
907-440-4601
April 23, 2019
Municipalities of Anchorage
Departments of Health and Human Services
P.O. Box 196650
Anchorage, Alaska 99519-6650
Fax 249-7847
RE: SEPTIC SYSTEM UPGRADE TANK & ADDITIONAL BEDROOM
LEGAL: HUNDRED HILLS 1ST ADD. BLOCK 5, LOT 13
To whom it may concern:
The owner has requested that we obtain a septic permit to upgrade the septic tank and increase
the size of the leachfield by one bedroom on the above referenced lot. Utilizing existing test hole
and ground water data, it is proposed that an additional shallow trench (55L x 5W x 3ED
6OG) be installed with the existing 66 trench.
The slope at the proposed trench location is 7-10% and there are no cut banks within 50 feet. The
lot and area is served by private water and this system will not impact any of the neighboring
properties due to the lot layout. Please contact Brent M. Western or me if you have any
questions.
Sincerely,
Michael N. Anderson, P.E.
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP191127, Rebecca Carroll, 05/20/19
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP191127, Rebecca Carroll, 05/20/19
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP191127, Rebecca Carroll, 05/20/19
'
97
Nm
"let
\OA
Oil \11IN
Municipality of Anchorage Page i of 2.
DEPARTMENT OF HEALTH AND HUMAN SERVICES ..
(Grin
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: sW9301z(p PID Number' 078/9//q
Name:
Wastewater System: , New ❑ Upgrade
Address:
Nc 85 Q ax :96,90
ABSORPTION. FIELD
71he.be;.
6;46-c. e- /24 ve-R--t,4 995-77
No. of Bedrooms:
3
❑ Deep Trench hallow Trench ❑ Bed 0 Mound 0 Other
LEGAL DESCRIPTION
Soil Rating:
0.8 GPD/Sq. Ft.
Total Depth from original grade:
Co I
Lot: Block: Subdivision:
IS S // ,WDREO f//LLS / STA -PP.
Depth to pipe bottom from original grade:
2 Ft.
Gravel depth beneath pipe
3 Ft.
Township:
Range:
Section:
Fill added above original grade:
(9— Ft.
Gravel length: //__//
Wr0 Ft.
WELL: 5 New 0 Upgrade
Gravel width:
Ft.
Number of lines:
/
Distance between lines:
O Ft.
Classification (Private, A,B,C):
Plzt v4r&
Total Depth:
1E0 Ft.
Cased To: .7
/ Ft.
Total absorption area:
��. SQ. Ft.
Pipe material: F'/O pe7eF•
45744 /7.303'/ P. V. C.
Driller:
-SU LC_ l V /T N I7/2../GCE- S
Date Drilled:
/`lit
Static Water Level:
q%S Ft.
Installer:
SoUTff F0121c CO,S7-
Date installed:
C. -26' -Qc-/
K
Yield:C(/
<6.5 -TAN
•� GPM
. Pump Set at: ,,// Ft.
Casing Height Above Ground:
iZ r/ f Ft.
SEPARATION DISTANCES
c21 Septic 0 Holding ❑S.T.E.P.
To
From
Septic
Tank
Absorption
Field
Lift
Station
Holding
Tank
Public/Private
Sewer Lines
Manufacturer:
/a,QCHOR.AC 6 % c)AJK.
Capacity in gallons:
/COO
Well'
/42
/5(,'
2.61*
Material:
Sweet.
Number of Compartments:
2.
__
Surface
/00 11"
/00'7"
LIFT STATION
--
--
LotSize
Line
/0 -/-
/0'4-
s:
Manufacturer:
Foundation
NOT
/.0
NOT
/N
"Pump on" level at:
"Pump II at:
High alarm at:
Curtain
Drain
KNOWA-)--
Pump Make & Model
Electrical Inspections pertormed by:
NONE
Remarks: J✓v(,�oa (2,f �)P/� % er e
BENCH MARK
Location and Description:
Ta? aF weu
k//
ed, /e - 20
-'LL i e,/S dg e i c i /—P
c -m / /e/Y. e ,N� d `
Assumed Elevation: /00.00
0000
-�/ a
-
ENGINEER'S SEAL
S & $ ENGINEER! -
17034 Eagle River Loop Road, No. 204
Inspections performed by: Eagle River, Alaska 99577 Dates:1st s -26-9 y
2nd s -2s-9N/„7.\
..
Department of Heal • • 4 H : n - rvices approval
Reviewed and approved by/ ` / / c Date: 20 i
72-013 (Rev. 9/91) MOA 25
Permit NoW930126 Page 2 of 2
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
LegaDescription:HUNDRED HILLS SUBDIVISION, BLOCK 5, LOT 1,1D No.: 07819114
l
POWER
POLE
001 CO2
100.6'
102.2,
NEW NEW
1000 GAL
SEPTIC
TANK
102.0'
001 CO
CO2
COI
rco
• 86.0' NO WATER FOUND
A B
FCO 139.0 48.
C01 142.5 47.
CO2 148.0 45.
CO3
004 156.0 a56.0 17.
MT 155.0 18.
ENGINERS'SEAL
SCALE 1" = 40'
\ ELL
00' WELL RADI
A
10' DRAINAGE
ESMT
72-013 A (1/93) •
QIrrti(tr1 IQug
DOC Co. dba
SULLIVAN WATER WELLS
P.O. BOX 870272, CHUGIAK, ALASKA 99587 • TELEPHONE 688.2759
OWNER OF LAN[) \f,yAJ'E DEPTH OF WELL /c1)
U° 3a i a-(0
ADDRESS STATIC LEVEL OF WATER FT l<
LEGAL DESCRIPTION 1.3 iL. . DRAW DOWN FT.
DATE • Started Ended <//c/1 GALS. PER HR -..) u
PERMIT NUMBER KIND OF CASING ,? /J
1
KIND OF FORMATION:
From <0 Ft to >> Ft S "t)6 Sri C.L J,PFrom Ft to FI
From .- . Ft to `F Ft. 7) Jr::/-.) Qr= N From Ft to Ft.
From Ft. to JJ Ft. etc i "SJL �,rf LFrom Ft to . Ft.
From _/ Ft to`4`v, Ft ri,14'L,;lr"ff�l t{n3) U4�1c 1Fiom Ft. to Ft.
Fromf / ;; • Ft di.t= " �G ,/ijit lAdLI ✓ F ?di Ft to Ft-ot
%—Ft. to��I
From / 4 Ft. to / 1 1 Ft. /' � h ✓/i/ V From Ft. to Ft.
From. t 1 (-1 Ft. to / i .A Ft. /31:.:4)/ oC /�. From Ft. to_ Ft.
Frotni/t- , '. Ft to t 7 .i Ft. 8.)6-/./ )(.4_ l/%%i-c.-M .4.4 --)From Ft. to Ft.
r,-4 ri,-r!
From Ft. to Ft .5(ria 11-4 I 2- (.4)6 ( From _Ft. to Ft.
From hFt to j .1 Ft L3i=: d°.: C /{; From Ft to Ft.
From— Ft to Ft From Ft to Ft
From _Ft. to Ft. From Ft to Ft
From Ft to Ft From Ft to Ft
From Ft to FtFrom _ Ft to Ft
Ft.From Ft. to Ft.
Ft. From Ft. to Ft.
FtFrom Ft to Ft
From -
From
From
Ft. to
Ft. to
Ft to
MISCL. INFORMATION: t-^^ �^
6
C .-Si.A-)6
DRILLER'S NAME
STATEMENT OF NON -OBJECTION FOR ENCROACHMENT
WITHIN UTILITY EASEMENT
Matanuska Electric Association, Inc. (MEA) has no objection with the location of
a septic leach field within the utility easement
dear the easterly boundary of the following property;
Lot 13, Block 5, HUNDRED HILLS FIRST ADDITION SUBDIVISION, according
to Plat No. 90-11, Anchorage Recording District, State of Alaska.
This non -objection is conditioned by the stipulation that MEA will be held
harmless from any and all damages to the encroachment that may result from the
existing and future use of said easement.
by:
Matanuska Electric Association, Inc.
General Manager or is Representative
7/-/
/ / Date
MEA ACKNOWLEDGEMENT
STATE OF ALASKA
) SS.
THIRD JUDICIAL DISTRICT
The foregoing agreement was acknowled ed before me this
day of (7[//7 , 19 , by kr, / 4;7. .
333.1/1214.1
_1g')
No ary Public or the State of Alaska
My commission expires: ? -y If _ 9�
MRTRMUSKR TELE. RSSOCI TEL
Rug 15'94 7:03 No.001 P.02/04
Matanuska Telephone Association, Inc.
P.O. SOX 3550 PALMER, ALASKA 996454550 PHONE (907) 745-9510 Real Esme and Pro; yes Section
FAX (907) 745.6.090
Thomas R. btinnich
President/C.E.O.
NON -OBJECTION TO EASEMENT ENCROACHMENT DOCUMENT
By this document, Matanuska Telephone Association, Inc(MtA)., declares that it bas no objection to the
placement of the following encroachment within the _Private Y_ Platted utility easement(s)
located onproperty described as Lot: 13, Block Five (S), Hundred Ili.11s
Subdivis ion , Township _13N
Range IW -, Section 1'0 Seward , Meridian
Third Judicial District. _ Anchorage - Recording
District. Alaska a_ Well and Underground Water System. b. X . Under or Above
Ground Septic System. c. Fence. d. Structtiue. f.
Other
****s**************K*ss•sN■***s*■Yt*****M*****Zss•a**************sss*****i******
Please be advised that Matanuska Telephone Association, Inca through the issuance of this
document does not forfeit any of its rights to the use of the utility ea'ierueut(s) cited. In the exerc=ise
of these rights the utility wilt. if needed, upgrade, maintain, repair, andlor replace buried or aerial.
telecommunications facilities within the easeinent(s). Any repairs that may be required to the
encroachment as a result cif utility construction will be borne by the property ower of record. 'This
document does not authorize the placement of any additional encroachments within the a setne.'tt
area(s).
PLEASE NOTE: This dotuuieut is, in no way, an agreement to act any portion of the
platted utility easeuieut(s), and should not be interpreted as such by buyers, sellers. governmental
agencies, lenders, Realtors, title companies, and/or underwriters,
SPECIAL, CONDI11ONS:
None
The original of this document is retained and recorded by Matanuska Telephone Association, Inc- Copies
will be provided to the customer. Upon the return of the oriinal document from the Recorder's Office.. a
copy reflecting the Soak and Page of the recording will be sent to the last known address of the
requesting party. Future copies may be obtained Trona the Real Estate and Properties Supervisor_ MTA
Plant Services Building, Palmer, Alaska
Page 1 of 2 Page(s)
•
•
MRTANUSKA TELE. ASSOC' TEL:907-746-9646
MTA Easement Encroachment Document
Aug 15'94 7:04 No.001 P.03/04
Issued for Matanuska Telephone Association, Inc_, this 11th of Juj.v
199 4 , by
THIS IS TO - • '1 , that on this 11 t h day of ally_
19 94 , before me the undersigned, a Notary Public in and for the State of Alaska, personally appy
Bernadette 2:Lmmerman _to me
personally known and to me known to be the individual described in and who excemed the foregoing and
acknowledged to me that she signed and sealed the carne freely and voluntarily for the uses and purposes
therein mentioned-
. yam,.. •,...,.
IN WITNESS WUERE OF, I have hereunto set my hand and affixed my Oficial s1 the day and
': ....• -: ve r ni•this certificate, first above written_
`-'GRA tI'OR(S) ADDRESS:
MAiAruska 'Leleldict a A.qsncaa `nn„ Pn
P. 0. Box 3550
Palmerr Alaska 99645--3550
Aviv Commk.on Expires: Ff.679/
GRANTEE(S) ADDRESS:
Phvliss Janke
P. 0. Box 770567
Eagle idver, Al,aska_9577•-D567
PLEASE RETURN TO:
Bernadette Zimmerman
Real Estate and Properties Supervisor
Matanuska Telephone Association. Inc.
Post Office Box 3550
Palmer, Alaska 99645-3550
BZJC:\Forms\EEDNOFOR NO3
2
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT
PERMIT NUMBER:SW930126
DESIGN ENGINEER:S & S ENGINEERING
OWNER NAME:JANKE JOSEPH F
OWNER ADDRESS:NC 85 BOX 9690
EAGLE RIVER, AK 99577
PARCEL ID:07819114
LEGAL DESCRIPTION: HUNDRED HILLS 1ST ADDITION BLK
5 LT 13
LOT SIZE: 66082 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
PAGE 1 OF 1
DATE ISSUED: 5/27/93
EXPIRATION DATE: 5/27/94
1. THE ATTACHED APPROVED DESIGN.
2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS
15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL
REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80).
3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4329 OR 343-4681 AFTER BUSINESS HOURS
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
RECEIVED BY:
ISSUED BY:
DATE:
5( Z?/ c�
DATE:/'7%.7j
HEALTH AUTHORITY
APPROVALS
SEWER & WATER
MAIN EXTENSIONS
SEWER & WATER
INSPECTION
ENGINEERING STUDIES
AND REPORTS
WELL INSPECTION
& FLOW TEST
SITE PLANS
ROAD DESIGN
SOIL TEST
PERCOLATION
TEST
STRUCTURAL &
MECHANICAL
INSPECTIONS
ROBERT SHAFER, P.E.
ROGER SHAFER, P.E.
May 24, 1993
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
825 L Street
Anchorage, AK 99519-6650
CIVIL ENGINEERS
(907)694-2979
FAX 694-1211
REFERENCE: Hundred Hills Subdivision, Block 5, Lot 13
We request you issue a permit to drill a well and install a
septic system to serve the proposed 3 bedroom house on the
referenced property.
Two test holes were performed on the property on October 26,
1992. The approximate locations of the test holes are
located on the attached site plan. The monitoring tubes
within the holes have been checked and found to be dry.
This property has enough area for a septic upgrade which can
be seen on the attached site plan. We do not anticipate any
adverse effects on neighboring properties by the installation
of the proposed septic system.
If you have any questions, or require additional information
for your e iew, please contact us.
Sinerely
/
ON SITE
WASTE WATER
DISPOSAL SYSTEM
DESIGN
RAS/LSU/lsu
hafer, P.E.
17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: C::3'L 1 1's
DATE PERFORMED:
LEGAL DESCRIPTION: LA-) ki..19PE9 \'11t.1,5 Township, Range, Section:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
DEPTH
T
P7
f/t,/1
• O,
SLOPE
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Depth to Water Alter `\k
Monitoring?
SITE PLAN
N
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
10.2(0-i2
4 \ • 2-°-
---
21(4"
/€3,IV
2-
4`,3L
(c>FalItJ,
' +3N
-
I,/€3,-
3
v
PERCOLATION RATE 1 (mrnulesiinch) PERC HOLE DIAMETER "
TEST RUN BETWEEN FT AND ( FT
COMMENTS
PERFORMED BY s & g ENGINEERING
CERTIFY T HAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITHI,054I Iav iJb�i,;ipARL (itgIb�LIR9S IN EFFECT ON HIS DATE. DATE:
Eagle River, Alas a
72-008 (Rev. 4/85)
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION 'TEST
PERFORMED FOR:
DATE PERFORMED: I
LEGAL DESCRIPTION: L. -I3 N Township, Range, Section:
0, we? SLOPE
e%00 4
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17-
18
19
20
PTH
PCl
11 /►-�I�st�-�
�.
c:). Pc--;
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Depth to WaterAfter
Monitoring? 0 N) Dal • l°?
s
L
0
P
E
SITE PLAN
1
N
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
1
1n 2.14,-92
`,2v
—
3' �"
2
',3br
1�t11,1,
6
1 2..
`-*-)
47
(4,"
I3/6'
zi-
6
5'•
41/5"
1, /6'
PERCOLATION RATE
7
(minutes/Inch) PERC HOLE DIAMETER
TEST RUN BETWEEN FT AND FT
COMMENTS
S & S ENGINbERING
PERFORMED BY:_4Q34
pp agIleabtar Loop Road, No. 2 ' q
ACCORDANCE WITI-FAi��QSTAW'ANID MkUNICIPAL GUIDELINES IN EFFECT 0 THIS DATE. DATE —2 (C, — 1
CERTIFY THAT THIS TEST WAS PERFORMED IN
72-008 (Rev. 4/85)
ONSITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION PRACTICES
and
MATERIAL SPECIFICATIONS
REFERENCE: Hundred Hills Subdivision, Block 5, Lot 13
GENERAL:
1. The scope of this project includes the installation of a
1000 gallon septic tank and a 5' wide drainfield to serve
the three bedroom residence proposed for the referenced
property.
2. Construction shall be in accordance with the approved
site plan and design drawings; Municipal permit with any
special provisions or conditions; and all applicable
State and Municipal Wastewater Disposal Regulations.
3. The contractor shall be responsible for obtaining any
necessary underground utility locates.
4. Unless specifically agreed otherwise, the property owner
shall be responsible for final grading areas subsequently
depressed from soil settling. On all leachfield mound
systems, the property owner shall be responsible for
ensuring a satisfactory vegetation growth over the
mounded area.
5. Contractors installing wastewater disposal systems must
be certified by the Municipal Health Department for
system installations. Owners installing their own
systems must also receive prior approval from the
Municipal Health Department.
SEPTIC TANK INSTALLATION:
1. A septic tank is to be constructed by a certified septic
tank manufacturer. Construction shall include two 4"
cleanouts for pumping access.
2. The septic tank shall be sufficiently bedded to prevent
settling or shifting of the tank.
3. All standpipes on the septic tank shall extend a minimum
of 12 inches above final grade.
4. Septic tanks installed with less than 4 ft. of cover
shall be insulated.
page 2
Hundred Hills Subdivision, Block 5, Lot 13
5. A foundation cleanout shall be installed one to four feet
from the building foundation. In the line between the
tank and the leachfield there shall be two adjacent
cleanouts (unless an effluent pumping system exists
within the septic tank). These cleanouts shall be
located on undisturbed soil not more than 10 ft. from the
tank. The first cleanout, in line, shallbe to clean
toward the leachfield. The second cleanout shall be to
clean toward the septic tank.
6. Final grading over the septic tank shall be such that a
positive slope exists away from the septic tank.
ABSORPTION TRENCH/DRAINFIELD INSTALLATION:
1. Excavate the proposed trench to the dimensions shown on
the design. The bottom of the excavation shall be within
2 inches of level. If the sidewalls of the excavation
become smeared, they must be raked or scratched (ruffed -
up) before gravel (sewer rock) placement.
2. Once the gravel is installed, the distribution pipe is to
be installed level with the perforations faced downward.
Gravel is then to be placed over the distribution pipe to
provide a minimum of 2 inches of cover over the pipe.
3. A silt barrier must be installed between the final gravel
layer and the native soil backfill. Ensure the silt
barrier covers the entire gravel surface before placing
backfill.
4. Monitor tubes shall be of four (4) inch diameter and
installed approximately in the locations shown on the
design. The portion of the monitoring tube extending
through the gravel shall be perforated from the bottom of
the trench to the invert of the distribution pipe. This
is equivalent to the effective depth of the gravel as
noted on the design.
5. Backfill over the final gravel layer must not be less
than twenty-four (24) inches. Insulation must be
installed when the backfill depth is less than thirty-six
(36) inches. The finish grade over the trench must be
mounded to prevent the formation of a depression after
settling.
page 3
Hundred Hills Subdivision, Block 5, Lot 13
INSPECTIONS:
Typically there will be a minimum of three (3) inspections
required during the installation of the wastewater disposal
system. These inspections will occur as follows:
1. The first inspection must be conducted after the
excavation of ditches, pits, trenches, or beds and
before the installation of any gravel. A septic
tank may be set in place, but may not be backfilled
before this inspection.
2. The second inspection must be conducted after the
placement of the silt barrier, gravel, distribution
lines, standpipes, cleanouts, and insulation, but
before the placement of any other backfill.
3. The final inspection is to occur upon final grading
of the property.
Often there will be more than these 3 inspections required.
Especially with the installation of multiple trenches, sand
filters, pressurized distribution systems, etc. Thus, the
inspecting engineer is to be contacted at least 24 hours prior
to the start of construction. If necessary, a pre -
construction meeting will take place on-site.
MINIMUM MATERIAL SPECIFICATIONS:
1. Any septic tank proposed for installation must be
constructed by a Municipally approved septic tank
manufacturer.
2. The following pipe materials are approved for use in
septic system installations in the Municipality of
Anchorage:
Type of Pipe
Perforated Solid
Cast Iron Yes Yes
ASTM D3034 (PVC) Yes Yes
ASTM F810 (HDPE) Yes No
ASTM D2662 (ABS) Yes Yes
Use of a type of pipe other than listed above must be
approved by the inspecting engineer.
page 4
Hundred Hills Subdivision, Block 5, Lot 13
3. Insulation shall be at least 2" thick extruded direct
burial polystyrene (Dow Chemical Company Styrofoam HI or
equal).
4. Septic tank inlets and outlets shall be fitted with
watertight couplings (Caulder, Fernco, or equal).
5. A permeable nontoxic silt barrier (Typar 3401, Mirafi
140N, or equal) must be installed between the final
leachfield gravel layer and the native soil backfill.
6. All leachfield gravel (sewer rock) shall be 0.5"-2.5"
screened gravel with less than 3% passing the #200 sieve.
7. When sand is being used as a filter material, it's
gradation specifications must conform to AMC 15.65.060D.
Municipality of Anchora
On -Site Water and Wastewater Progra
(907) 343-7904
Certificate of On -Site Systems Approva
Parcel I.D. 078-191-14
Expiration Date: i -oma "1 iO
1. GENERAL INFORMATION
Complete legal description Hundred Hills #1, Block 5, Lot 13
Location (site address) 525 Wolf Dr.
Current Property owner(s) Michelle & Zoran Yankovich Day phone
525 Wolf Dr. Eagle River, AK 99577
Mailing address
Real Estate Agent Day phone
2. TYPE OF DWELLING:
E 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 E Individual E
Individual Water Storage ❑ Holding Tank ❑
Community Class Well ❑ Community ❑
Public Water System ❑ Public Sewer ❑
WaiverNariance request for: Distance:
Received by:
COSA to be released to the engineer, unless otherwise requested by the =ngineer.
Date: ,7/0)2)/ %
COSA Fee $ ✓ - Waiver Fee $
Date of Payment ( 11 ! )(40 Date of Payment
Receipt Number bc032-Olin Receipt Number
COSA# O€LIL 4 a" /e Waiver#
5. STATEMENT OF INSPECTION BY ENGINEE"''R'
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 test,
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 sale 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
System #2 Approved for
Disapproved
Conditional approval for
By:
Phone (907) 272-8218
Date 6/12/2016
4.OFAtgkt
Aeco ..7 v
*: 43TH� /\ •*'/
fif \S
bedrooms % • • Steven R. 'onnone
bedrooms ��9•, CE -8149 , �?
kt "
bedrooms, with the following stipulations:
_fir
J� ON-SIT:
`sc
WATER AND
m WASTEWATER -
PROGRAM)
<,o
Original Certificate Date: ( -2-524(47
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only
upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality
of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA blue sheet f c
If more than 1 septic system is on the lot:
COSA Checklist # 1 of 1
Structure served by this system 1
Certificate of On -Site Systems Approval Checklist
Legal Description: Hundred Hills #1, Block 5, Lot 13
A. WELL DATA
Well type Private
Date completed' 4/1994
Total depth 180 ft
Date of test
Static water level 95 ft.
Well production g.p.m.
WATER SAMPLE RESULTS:
Coliform Neg ` colonies/100 mL Nitrate 0.138 mg/L
Arsenic ND ug/L Date of sample 5/3/2016
Parcel ID: 078.-191-.14
If A, B, or C provide PWSID # Well Log (YIN) Y
Sanitary seal (Y/N) Y Wires properly protected (YIN) Y
Cased to 128'$ ft.
FROM WELL LOG
4/1994
3.5
B. SEPTIC/HOLDING TANK DMA
Tank Type/Material Septic/Steel
Casing height (above ground) 12+ in.
AT INSPECTION
5/3/2016
93
4.6+ g.p.m.
ft.
Collected by: •PES
Date installed 5/25/1994
Tank size 1,000 gal. Number of Compartments 2 Cleanouts (Y/Nt) Y
Foundation cleanout (YIN) Y Depression over tank (Y/N)N High water alarm (Y/N) N
Date of pumping &%(/)01 &Pumper: Ti-ICTiLIC /�'�n/c,;,.,.. IP
C. ABSORPTION FIELD DATA
Date installed 5/25/1994 Soil rating (g.p.d./ft2 orft2/bdrm) 0.8 GPD/SF
Length 66 ft. Width 5 ft.
Total depth 6.2 ft. Eff: absorption area 569 ft2 Monitoring tube Y Depression over field
Date of adegyacy test 5/3/2016 Results (Pass/Fail) Pass For 3 bedrooms
System type Shallow Trench
Gravel below pipe 3 ft
Fluid depth in absorption field before test 0 in. Water added 466 gal. New depth 0 in.
Elapsed Time: 110 min, Final fluid depth 0 in: Absorption rate. >= 450+ g p.d
Any rejuvenation treatment (past 12 mo.) (Y/N & type) No If yes, give date
D. LIFT STATION
Date installed Size in gallons
"Pump on" level at in. 'Pump off level at in.
Datum Cycles tested
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot 100+
Absorption field on kit 100+
Public sewer main 75#
Sewer /septic service line 25+
Animal containment areas 50+
Manhole/Access (Y/N)
High water. alarm level at
Meets alarm & Circuit requirements?
in.
On adjacent lots 100+
On adjacent lots 100+
Public sewer manhole/cleanout 400+
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+
Weon adjacent lots 100+
ABSORPTION FIELD ON LOT TO:
Property line 10+ Building foundation
Absorption field 5+
Surface water 100+
10+ Water main 10+
Water Service line . j,0+ Surface water 100+
Curtain drain 50+ Wells on adjacent lots 100+
F. COMMENTS
Survey on File
Driveway, parking/vehicle storage 10+
G. ENGINEER'S CERTIFICATION
I certify that l 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
6/12/2016
COSA canary sheet 2-6-15.doc
4
le to.
ilsannune
•. • CE -8149 : 3
Parcel I.D.
1.
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
y- -
/q/ -/q
GENERALINFO,RMATION
Complete lega)tscriptidn.1/7/uA/f ReA MCI- s 47 .00P .S tor /3
Locatien (site'address•ordirec{ions) 5.23 VJjJC AfztvE
Current Property owner(s) Tic(lll( 01111. ilk. -BEV Peer Day phone
✓J n9
Mailiri address.:-•": •• 1PO 'tel( 441 hi/tut-ant t ay 9�
Lending agencfr ""' (J is
Day phone
Mailing address
Real Estate Agent t--1 /4 / OCe. fsk Day phone 6-P7-ea76'
Mailing Address 130406•49-7A( '!/J(A 0l` EaCGF giveie
Unless otherwise requested, HAA will be held by DSD for pickup.
HAA # hS 05 -
Expiration Date: vZ. - 3 - O G
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class Well
Public Water System
3
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
Individual Holding tank
Community On-site
Public Sewer
2
.0
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are
valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with
new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.)
Certificates are valid for one year for properties served by Class A or B wells or a public water system. The
Municipality of Anchorage is not responsible for errors or omissions in the 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 Health Authority Approval Guidelines for this application, shows that the on-
site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of
bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the
Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances,
and regulations in effect attI the time of installation. .
Name of Firm Aloe +4POP, /C�.•tq• Phone 6i 94' 7Co?di
Address /%a37 RPnr etrc(4, •
Engineer's Printed Name STC✓C Ent G Date /6/a 7/as
casOFq�,3
r4-.; '
r tip: • . r ••.911/
e*149L #'000 *7
5. DSD SIGNATURE ' c{ Steven W. En ;' W'�
✓ Approved for J �s4 •, PE 6256 c.
Disapproved. bedrooms. 11;1j��3.�a;Sc ..."
Conditional approval for bedrooms, with the following stipulations:
Additional Comments
mac?.
? ON-SITE • ci;
WATER AND : r"=
is : WASTEWATER '
PROGRAM
•
tai o'htrYlSLr`- VI/\
Attachments:
HAA Checklist X Maintenance Agreements
Septic System Advisory Supplemental Engineer's Report
Well Flow Advisory Other
(Rev 01102)
Original Certificate Date: 1 1 — 3 -0,5-
Legal Description:
A. WELL DATA
Well type P /
Date completed 1-(/941
Total depth /id ft.
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.clanchorage.ak.us
(907) 343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
//U4(1Dva //fad' a./ sack. S LA-1-
Date
or
Date of test
Static water level
Well production
If A, B, or C provide PWSID #
Sanitary seal (Y/N)
Cased to fab ft.
FROM WELL LOG
(1/941
ft.
2-10 gp�R
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 ml.
Arsenic: = mg./I.
to
°» tibri
" }ate
Parcel ID: 0 7 g- f g) - 1 4f
Well Log (YIN) Y
Wires properly protected (YIN) �/
Casing height (above ground) /' in.
AT INSPECTION
/Q/s/a s
7( ft.
Nitrate 0.5. mg./V1440U
Date of sample: /O/, f dS
g.p.m.
Other bacteria1'
� colonies/100 ml.
Collected by: Airy r'1 Por
B. SEPTIC/HOLDING TANK DATA /
Tank Type/Material4AJ(Il{OR CC TAF/Jc737 6C_ Date installed .s .SJ99'
Tank size /000 gal. Number of Compartments Z Cleanouts (YIN)
Foundation cleanout (Y/N) Y Depression over tank (Y/N) a High water alarm (YIN) 47,4
Date of pumping 617/oS Pumper 3 . R- s
C. ABSORPTION FIELD DATA
7
Date installed-T//23AV Soil rating (g.p.d./ft2 or.itabdmr) �• fr System type Traisf CK
Length 66 ft. Width -S ft. Gravel below pipe -' ft.
Total depth C ft. Eff. absorption area✓% ft2 Monitoring tube '7/ Depression over field
Date of adequacy test /a/-s/ds Results (Pass/Fail) 743J' For 3 bedrooms
Fluid depth in absorption field before test , in. Water added4/Slfgal.-f- New depth 2 in.
Elapsed Time: ea' min. Final fluid depth ,,(in " Absorption rate >= 445-0*' g.p.d.
/
Any rejuvenation treatment (past 12 mo.) (Y/N & type) n 0 If yes, give date
D. LIFT STATION N/!}
Date installed Size in gallons
'Pump on' level at n. 'Pump off level at in.
Datum Cycles tested Meets alarm & cir
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot /0a'# On adjacent lots
On adjacent lots
Manhole/Access (Y/N)
High water alarm level
Absorption field on lot
/ea'#
Public sewer main WA
r
Sewer /septic service line ..2S 1"
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK
requirements?
Am et
in.
/00'4.
Public sewer manhole/cleanout
Holding tank AdA
Building foundation ZS-
Water
SWater main Ai/A
ON LOTTO:
Property line /0 ''r Absorption field
r
Water service line 2.S r" Surface water
Wells on adjacent lots /06't
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
5
Property line /0 't Building foundation .0S- t Water main . V4
Water Service line 23-114 Surface water /0 O f Driveway, parking/vehicle storage Z S
i
Curtain drain /%NtL Wells on adjacent lots /00 f
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that 1 have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA HAA guidelines in effect on this date.
Engineer's Printed Name 57-E✓C ea 6
Date /Q/.77/4r
HAA Fee $ 11;C '6%
Date of Payment
Receipt Number
(Rev. 12/01)
fob as
Waiver Fee $
Date of Payment
Receipt Number
Scale' 1'•60'
EaSEw4rin OF rFM1. J' OI1•41MW
bat MOWN OH lit ita0CILD
•iAI PRE WASA N HOW..
' a 7414.
•• f4stzu
4i Ilea W", `4;", '
Fb05-5, pgS354
SE
Note: Found 5/8" rebar at Lot comers
AS -BUILT AND LOT STAYED THIS DATE
thereby wily that lithos perbrmed • RartppeeY t apemen
of the bvdw`q Caseated property. Lot 13 Brae
Hundred Kr Subdviabn, 1st Mdrvn
TitDfs-
hryrnarnenb stated thereon ere widen the property thee
and do not overtop or encroach on the property lying
erg/wont Bank, Tel M Improvements on the property tyhg
adjacent thereto enao•di on the premises In nation end
T•1 Cave «e M roadways. irenamswn bees or Wier
vis ibl• easements on wk properly except ss heated
hereon
Dred el Anthem*. Alaska
6W 13E1 day o! Oat! .2035
FRED W4 ATI(A i ASSOQATES
Engineers end Surveyors
(607-246-1E66)