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Home My WebLink AboutMEADOW RIDGE ESTATES NORTH ADD BLK 6 LT 4On -Site Water and/or Wastewater System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP161036 Tax Code Number: 05153123000 Work Type: SepticTank Upgrade Permit Effective Dates: March 09, 2016 to March 09, 2017 Design Engineer: GARNESS ENGINEERING GROUP LTD Subdivision: MEADOW RIDGE ESTATES NORTH ADD Site Legal Address: Owner/Address: Site Mailing Address: MEADOW RIDGE ESTATES NORTH ADD BLK 6 LT 4 G:1462 ANDERSON ROBERT D & TAMARAH A 24959 HOMESTEAD ROAD CHUGIAK AK 995670000 24959 HOMESTEAD RD, Chugiak This permit is for the construction of: N Disposal Field Y Septic Tank N Holding Tank All construction must be in accordance with: Lot Size in Sq Ft: 20957 Total Bedrooms: 3 N Privy N Private Well N Water Storage 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. Receive( Issued B MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Fax: 907- 343-7997 On -Site Water & Wastewater Program Mayor Dan Sullivan On -Site Sewer/Well Permit Application For A Single Family Dwelling Parcel I.D. 051-531-23 Property owner(s) ROBERT ANDERSON Day phone 250-8424 Mailing address 24959 HOMESTEAD ROAD *EAGLE RIVER, AK Site address 24959 HOMESTEAD ROAD *EAGLE RIVER, AK Legal description (Sub'd, Block & Lot) MEADOW RIDGE ESTATES NORTH ADDITION; BLOCK 6 LOT 4 Legal description (Township, Section & Range) Lot APPLICATION IS FOR: Single Family (SF) ( PqalI that apply) (w/wo ADU) Absorption Field ❑ Septic Tank Multiple Dwellings Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Sq. Ft. Number of Bedrooms 3 APPLICATION IS AN: Initial ❑ Upgrade Renewal ❑ THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR: TYPE OF DEWELLING: Single Family (SF) (w/wo ADU) Duplex (D) ❑ Multiple Dwellings ❑ (SF and/or D) Distance: — I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/Rush Fees: oil's Date of Payment: 31311 5o c l Receipt Number: 6$165� Permit No. P ) to 1 D 3(o Waiver Fees: Date of Payment: Receipt Number: Waiver No (Rev. 01/11) GARNESS ENGINEERING GROUP, Ltd OIVIL&ENVIRONMENTAL ENGINEERS a March 2, 2016 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref: Proposed Septic Tank Upgrade for Meadow Ridge Estates North; Block 6, Lot 4 To whom it may concern: The existing 3 bedroom house is served by a private well and septic system. The existing septic tank is in a state of failure and needs to be upgraded. We are proposing to decommission the existing tank and install a new 1250 gallon septic tank. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. P.E., M.S. 3701 East Tudor Road, Suite 101 *Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.gamessengineering.com 9 RICLIN; LOT 8 CP� COMMUNITY WATER AAEIC REA MEADOW RIDGEESTATESNORTH ADDITION; BLOCK 6, LOT 3 EXISTING FCO RICUN; LOT 7 12'/�PpP PROPOSED 1250 GALLON SEPTIC TANK WITH DOUBLE CLEANOUTS AFTER THE TANK EXISTING 1000 GALLON SEPTIC TANK TO BE DECOMMISSIONED PER UPC r EXISTING TRENCH EXISTING 3 BEDROOM HOUSE �4 DRIVEWAY TONJESS ESTATES; BLOCK 3, LOT 11 COMMUNITY WATER/Ey`'�� P GARNESS ENGINEERING GROUP, Ltd k�w CIVIL & ENVIRONMENTAL ENGINEERS 3701 E MMR ROM, SURE 101 • P HOWE, .U( 99507 • F E (907) 307-61'!9 • FM (907) SJfi-3216 WE6611E: `w.9ameuen91iva5ng.cwn PREPARED FOR: I PHONE(90NBER: PAGE NUMBER: ROBERT ANDERSON 72M 50-84241 OF 1 LEGAL DESCRIPTION: DRAWN BY: MEADOW RIDGE ESTATES NORTH ADDITION; BLOCK 6, LOT 4 D.J.G. TYPE OF WORK: DATE: �. SEPTIC SYSTEM DESIGN UPGRADE 3/2/2016 MEADOW RIDGE ESTATES NORTH ADDITION; BLOCK 6, LOT 5 CSEPTIC ARES COMMUNIN WATER MEADOW RIDGE ESTATES NORTH ADDITION TRACT C A. DROFESSIolPo MUNICIPALITY OF ANCHORAGE / DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME �1 ll-/VenjC PHONE NEW ❑ UPGRADE MAILIN DDRES$ 1 /. LEGAL ESCCRIP ' ki'dr7 X LOCATIY � �� 1111 NO. OF BEDROOMS 1-3 W I Absorption area/ Dwelling / / (lJ P MIT NP. - mel Uy DISTANCE TO: J�% / - le F Z Manufacturer p Material No, o ompartmsSts G a a w� C,/VG�Y rn Llq. cap G�ty ivallons J IF HOMEMADE: Inside length Width Liquid depth Well Dwelling PERMIT NO. C7 zDISTANCE TO: O G Manufacturer Material Liquid capacity in gallons 2 H W��L7 Foundation Nearest lot line P MIT O. wz DISTANCE TO: lines Trench width Dista a between I' J LL z No. c lines Length of each li l Total length of ?� inches F z � F Top of tile to finish grade Material beneath file �Z inches Total effective abs tion rea `Y O Length Width Depth PERMIT NO. Lu Q F- Type of crib Crib diameter Crib depth tion Total effective absorption area as W LU rn Well Building foundation Nearest lot line DISTANCE TO: Class Depth Driller Distance to lot line PERMIT NO. J J LU Building foundation Sewer line ' Septic tank Absorption area(s) DISTANCE TO: OTHER PIPE MATER SOIL TEST RATING A9 r. �. INSTALLER�%� REMARKS, ()�� 1 f / - oI1- n , i 1 O / N 'a N. 16 1 APPROVED DATE LEGAL 61 72-013 (Rev. 3/78) MUN1L1t'AL11Y UI- ANUHUNAUt Department Health and Environmental ^rotection 825 Street, Anchorage, AK. _501 264-4720 n ' # # HANDWRITTEN PERMIT Permit # /J WEb6--AND/OR ON-SITE SEWER PERMIT Applicant: - Mailing Address: Location: Phone Number: h/ Legal Description: 0% q{gfe %aA.0)&9L=1 Lot Size: Type of Soil Absorption System Is: Trench: -4— Drainfield , Seepage Bed: Holding Tank: Maximum Number of Bedrooms: -.3— Soil Rating(sq.ft/br) figD The Required Size of the Soil Absorption System Is: DEPTH LENGTH SO/ GRAVEL DEPTH -4S-- WIDTH The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(H9t-�) TANK SIZE GALLONS # # Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. # # # TWO(2) INSPECTIONS ARE REQUIRED # # # Backfilling of any system without final inspection and approval by this department. will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet. for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * PERMIT EXPIRES DECEMBER 31, 1 9 3 3 I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if the residence is remodeled to include more that3 bedro Signed: Issued by: Applican �^7 Date: E of SWP/024(1/81) SOILS LOG — PERCOLATION TEST PERFORMED FOR: 4 <? ZZ C 2 J A S• DATE PERFORMED: LEGAL DESCRIPTION: /– n / ��o Cit_ �' /�?SIC/o U DEPTH ' j SLOPE SITE PLAN 1 (FEET) /moi / H—H--�---I MI SOILS LOG ✓✓✓ -- MUNICIPALITY OF ANCHORAGE , (� 1 PERCOLATION DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: 4 <? ZZ C 2 J A S• DATE PERFORMED: LEGAL DESCRIPTION: /– n / ��o Cit_ �' /�?SIC/o U DEPTH ' j SLOPE SITE PLAN 1 (FEET) /moi / H—H--�---I 7 8 Si� I3. �� r0 we 9- 10- 11 1011 12 13 14- 15- 16- 17 4151617 18- 19- 20- COMMENTS 81920COMMENTS F 1 WAS GROUND WATER S ENCOUNTERED? .i_ L O P IF YES, AT WHAT E DEPTH? Reading Date Gross Time 3 All S�?ick a�d.1 ray-eI 4 ,L9 5 ArA 6 7 8 Si� I3. �� r0 we 9- 10- 11 1011 12 13 14- 15- 16- 17 4151617 18- 19- 20- COMMENTS 81920COMMENTS F 1 WAS GROUND WATER S ENCOUNTERED? .i_ L O P IF YES, AT WHAT E DEPTH? Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE TEST RUN BETWEEN FT AND (minutes/inch) — FT PERFORMED BY: , let, '4' CERTIFIED BY: DATE: 72-008 (6/79) ro ,y L . �•. ..... ._. . s. ,.....r rr>rr •.. .. ...a ,. ....••.0 ear. r r rRi•.c.V l '1 U-14 Pk5 ,L. riEET, ANC:WRROE, FiK. L'e.4-4720 F°' a F~: m l 7- "Ri4I T W.J. { a'f 3 CSE )> Litt' -4 FSLIC 6 tEFfJC .It)GE Sm. LOT SIZZE� '---iX*RE FEET OF SCUL fW5WPTICIN SY57 M IS: PRAINFIELD HLIK NUSEV OF E;€L*fjrtS = SOIL RAIIND r iQ F T r'f >= 1 REQVIRED SIn Of TM SOIL MISORVTIQU SYSTEM IS: iW LENCi'IH Vjt%?*IQN 15 THE LEMTH <114 FEET> OF THE TREW-H M MfJ FMV. HE 13EVIN OF A 1KW44 jA PIT IS THE 015TANC:E M I EN THE t-U�:M-S ($F I !PAX -44D HW 7M £�?=TTCIM OF THE EXVf$VHlICSF# 01`t FEET AE I-Af4iVSL DEPT 3 IS THE MINIMR-1 CPEPTH OF GK%A�,TL EC141EEEOI THE CUT€€&L F#F'E IRE &C -11 70M OF THE E Xf:FtM I ON 0V MIX �"•`tt:l' 1` €=�E��< '�I� �''1' � �- i 1=#t-��: '� Ii � E�� =#. ��-eft ��#..._;i.�, �t-•f4=- IT f!ffl-ICTNT HF6 THE RESPONSIFIL)TY TCF INFORM THIS GEPRRTMENT DURING THE ILLATION INSPEC:TICFl+15- M ANY WELLS RDJPX:E'NT TO THIS PROPERTY RNP THE tF° CIF kESIL+€NCE5 THFsT THE NELL WILL &ERVE. I t+4!5- Fz> E�i +L: i I tol"!E'. 1:4fwt E fiz E; G4 1�.# a r;,> E r C:l ?.1_lL I NG OF fiM* S4STEM M THOUT FI NFC,- I,fC-�FECT I CEN HM _ APPRpVFiLPY THIS. MIENT WILL BE SLEUEC.•T TO F'RCI{EC!ITION. -- ILti Pl!:.Jfft:E f:E'IWEEN A WELL RW RIN M—SITE SENROE bl#-r C'-zA.. SYSTEM 15 E -T Ftk A PRIVftTE WELL CSS; i50 TCF FEET FROf H FIE:LIC: HELL E?EFENL?1NCt Tmi TYF'E OF' F•tiMIC• WELL. IL44`D12r%1 KE FPCO4 k PRIVRTE WELL TO H FRIYME SEWER LINE IS 25 FEET HND C -Ci MLINITY 5 -EMR LINE IS 75 FEET. f REC.tU I REMENTSS MHY WFL Y. SPE C:I F I C AT I ONS F04D CE# Cr TRLIC:T 1 CtN DIAGRRFM HRE AME TO )NSME PROPER INSTFiL.LHT1ON. TJFY THAT RM FAMILIW WITH THE REPU1REM€NT5 FM ON-SITE `.EWEKS RM) WELLS AS SET E.Y THE MLINI C I PAL 1 1 Y OF A:HGRRsE. THAT THE M- .ITE SEWER SYSTEM MW REGUIF:E ENLFRG-EMENT t N E SIE ItitltxE t3 0 I1d[:LL T >E Fit E H1 dd E:EISfiClC •. - - - k-------------- F APP I CHNT DL WIM M. F RAW, 0 IF THE Y4. 0 F:�x0E DEPARTMENT [i HEALTH AND ENVIRONMENTAL JTECTION 825 'L' STREET, ANCHORAGE/ 99501 264~4720 Cl ir-4~~�EF 1~F EE ��FE &-A EF_ Fe fz# E'F.�Jwl 17' PERMIT NO. ( 8]0]28 ) APPLICANT DUHNE H. FRANK. 2101 ROOSEVELT DR. 248-]82] LOCATION LEGAL LOT 4 BLK 6 MEHDOWRIDGE SUB LOT SIZE 999999 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: DRHINFIELD MAXIMUM NUMBER OF BEDROOMS = ] SOIL RATING (SQ FT/BR)= 150 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: ��F"l- " - � ��" -- 7`�4 C3 F..a F:l l-.0 F71 ��F:" T'"� � THE LENGTH DIMENSION 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 AND THE BOTTOM OF THE EXCAVATION (IN FEET). T I -A EE ��EZ " L4 U -al_ " 1E I—=. 15. �oz-00N F=F=F7_f_' THE GRAVEL. DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). I F-"F_U-'- I C-' -IF Fl r-4 ��I ::--' WE �C-1 C-9 C3 0 Fl lL__ L_ K7_1 Ir-4� PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. Ic" :R "N "ES F:1 Fc F= ��I F.. F -"r_-- BHCKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN H WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR H PRIVATE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM H PRIVATE WELL TO H PRIVATE SEWER LINE IS 25 FEET AND TO H COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. ��I -T' �� 3- -1 I CERTIFY THAT i: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ]� I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN I BEDROOMS. SIGNED APPLICANT DUHNE H. FRANK ISSUED ~ �� ~ ~~�~�DHTE�.~�'V4�0 �7��—~-�~ —�--~��~^~c�� - ��--- w xSOILS LOG MUNICIPALITY OF ANCHORAGE ❑ PERCOLATION DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: jzz e �'�/ �/ J DATE PERFORMED:z 41 LEGAL DESCRIPTION: ( `"' � ��-'L�"C�i �� S TF10�F�) 1 � v 2 u. 3 p)l 4-- 5 e 6 7 8 9 10 11 12 13 41516 14- 15- 16 17 81920 18- 19- 20 COMMENTS 69� �I1 7 y Net O i 5 WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? SITE PLAN PERCOLATION RATE TEST RUN BETWEEN FT AND 'G'7 ZO/x/2/&1 G- Tl��ri 08�,}I` r ��In,J,, PERFORMED BY: CERTIFIED ee77 �11� le`j iGVT 72-008 (6/79) (minutes/inch) FT !IT /' ICjf';-<%Li DATE. ',Z3_&.5 Gross Net Depth to Net eading Date Time Time Water Drop G JAI r:y PERCOLATION RATE TEST RUN BETWEEN FT AND 'G'7 ZO/x/2/&1 G- Tl��ri 08�,}I` r ��In,J,, PERFORMED BY: CERTIFIED ee77 �11� le`j iGVT 72-008 (6/79) (minutes/inch) FT !IT /' ICjf';-<%Li DATE. ',Z3_&.5 jqj MUNICIPALITY OF ANCHORAGE i� • DEPARTMENT OF HEALTH & HUMAN SERVICES a Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519.6650 (907) 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILLY DWELLING Parcel I.D. # 051-531-23 HAA # M9010050 GENERAL INFORMATION App Complete legal description MEADOW RIDGE FCTATFS NORTHA I OT 4. BLOCK 6. Location (site address or directions) 74959 F HOMFSTFAD ROAD CHUGIAK. AK 99567 P.O.rov .,eW, owner KRISTEN CADY Day phone Ale_XMIQISTOT;3� Mailing address :•. 671464 CHUGIAK,:. 99567 Lending agency Day phone Railinaddress Agent TFRRI COSE wl RFMAX PROPERTIES Dayphone (907) 276-2761 Address 96000 COROOVA STRFET ANCHORAGE- AK 99503 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water 3 xxx 211431 NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site xxx Holding Tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC Ing to the legality and status of system. 72-025 (Rev. 1197) Front 1610A#21 Computer Version Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $850.00 at, or prior to, closing for the engineering services provided. 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, l verify that my investigation of this Health Authority Approval application 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 Insp ction, the on-site water supply andfor wastewater disposal system is in compliance with all Municip nd State codes, ordinances, and regulations In effect on the date of this Inspection. Name of Phone _(907)337-6179 Engineer's Signature C/ Date` 2 / i3 /40i in conducting this evaluation, AWWC, In ate ted to provide a thorough, conscientious engineering analysis of the system In accordance with ADEC and M ADN S Guidelines & Regulations. The reported results described 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 soils condiddri, groundwater levels that may fluctuate during the year, and the water o�oo usage of the lamily being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance c of the system, nor do they guarantee that there are no hidden defects or encroachments. qs AWWC, Inc. can therefore not provide any warranty for future estimate of how long the ' system will continue to meet the operational requirements of the ADEC or MCA DHHS. ' , ... ..... The content of this report Is for the sole benefit of the owner listed above. Any rellance upon or use of this report by any other person or part' is not authorized nor wiIt confer any legal ll whatsoever. �Ql? f ey A. arness. s DHHS SIGNATURE CE -7953 Approved for_3 bedrooms Conditional approval for bedrooms, with the following Date 2 —Z 3 —O/ The Municipality of Anchorage Department of Health and Human Services (DHHS) Issues Health Authority Approval Certificates based only upon the representations given In paragraph 5 above by an Independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending Institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct Inspections or analyze data before a certificate is Issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA #21 Computer Vereton Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 80 OV Street. Rm 502 Anchorage, Alaska 99501 (907) 343.4744 Health Authority Approval Checklist Legal Description: MEADOW RIDGE EST. LOT 4. BLOCK 6. Parcel I.D.: 051-531-23 A. WELL DATA Well Type COMMUNITY ff A. S, or C. attach ADEC letter. ADEC water system number Log present (YM) Date completed Total depth Cased FROM WELL LOG height (above ground) Wires property protected (YM) AT INSPECTION Date of test Static water level _ 1 e on g.p.m. 9.p -m. WATER SAMPLE RESULTS: Coliform B. SEPTICIHOLDING TANK DATA Date installed 8/22/83 Tank size 1000 Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (YIN) YES Depression (YM) NO High water alarm (YIN) N/A Date of Pumping 1/05/01 Pumper JR'S PUMPING C. ABSORPTION FIELD DATA *SUMP ONLY EXTENDS 23" BELOW INVERT (MEASURED IN FIELD). Data Installed 8/22/83 Son rating .p.d tt Wrm) 100 System type TRENCH Length 38' Width 2.5' Gravel thldmess below pipe •4' Total depth e' Effective absorption area 304 SQ.Ff. Monitoring Tube present (YIN) YES Depression over field (YIN) NO Date of adequacy test 1/05/01 Results (PaSe/Fail) PASSED For 3 Bedrooms Fluid depth in absorption field before test (In.); 4_ Immediately atter 706 gal. water added (in.): Fluid depth 2" (Ins) Minutes later. 1320 Absorption rate - 450+ PeroAde treatment (past 12 months) (YIN) NONE KNOWN 1f yes, give data — i2-=(Wv.3W CxWJW VWdM D. LIFT STATION Data Installed Manhole/Access (Y/N) 'Pump on' High water alarm level ar E. SEPARATION DISTANCES *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Septidholding tank on Absorption field on Public sewer Size in 'Pump air level at' COMMUNITY WATER On adjacent Public sewer manhole/deanout Lift station SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Foundation 5'+ Property One 5'+ Absorption field 5'+ Water mairdservloe line 10'+ Surface water/drainage 100'+ Wells on adjacent lots 200'+ SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO: 'SEE ATTACHED LETTER Property line '5'+ Building foundation 10'+ Water malNservlce line 10'+ Surface water 100'+ Driveway. paridrVvehide atorege area 50'+ Curtain drain F. ENGINEER'S Icerd&that ll of Munldpal qq wO MOA HA, field Inspectlons and review systems are In conformance Nr fh/s date. Engineer'sNe e i %JEFFREY A GARNESS Date I=- �13 0, C¢'._ HAA Fee Date of Payment /) I RecelptNumber (j � rt.= Mft. Wr comp" venom Wens on r Waiver Fee Date of Payment Receipt Number Municipality of Anchorage Development Services Department • +� Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343.7904 Waiver Review Worksheet WR#: WR010011 PID#: 051-531-23 HAM NA010050 Permit#: Date Received: 2/14101 Legal Description: MEADOW RIDGE ESTATES NORTH ADD. BLOCK 6 LOT 4 rS1 arr Engineer. JEFFREY A. GARNESS, PE, ALASKA WATER & WASTEWATER CONSULTANTS, INC. 6901 DEBARR ROAD, SUITE 2B, ANCHORAGE, ALASKA 99504 Applicant: KRISTEN L. CADY Waiver Requested: LOT LINE WAIVER OF THE END OF THE ABSORPTION TRENCH TO THE EAST LOT LINE OF 5 FEET Criteria: Waiver is Granted: Geology A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation List Conditions or Reasons for above: Points: Total: Waiver is not Granted: Date: 2 — z3 By: PRIV Name of Reviewer Rec#: 0756 Amount: 115.00 Date Paid: 2/14101 02/23/01 Jeffrey A. Gamess, PE Alaska Water & Wastewater Consultants, Inc. 6901 Debarr Road, Suite 2B Anchorage, Alaska 99504 Subject: Waiver Request for Meadow Ridge Estates North Add Block 6 Lot 4 Waiver Request #WRO10011 Parcel ID #051-531-23 Health Authority Approval Number HA010050 Dear Mr. Gayness: Department of Public Works Your request for a waiver of the required 10 feet horizontal separation from the on-site wastewater disposal system to property line has been approved. The approved separation distance is 5.0 feet. This waiver approval applies to the existing on-site wastewater disposal system to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, 5Vrv(?' Daniel J. Roth Civil Engineer On -Site Water & Wastewater Program Municipality of Anchorage Y George 1: 1Yucrch. Mayor Bttilditlff Svdet-v Divisiotl P.O. Iiox 196650 • 4700 S. Brngmc Slrcet Anchorage, Alaska 99519.6650 • (007) 343.&301 hIIp:ffiti e.cl.nnehoragemLits 02/23/01 Jeffrey A. Gamess, PE Alaska Water & Wastewater Consultants, Inc. 6901 Debarr Road, Suite 2B Anchorage, Alaska 99504 Subject: Waiver Request for Meadow Ridge Estates North Add Block 6 Lot 4 Waiver Request #WRO10011 Parcel ID #051-531-23 Health Authority Approval Number HA010050 Dear Mr. Gayness: Department of Public Works Your request for a waiver of the required 10 feet horizontal separation from the on-site wastewater disposal system to property line has been approved. The approved separation distance is 5.0 feet. This waiver approval applies to the existing on-site wastewater disposal system to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, 5Vrv(?' Daniel J. Roth Civil Engineer On -Site Water & Wastewater Program ALASKA WATER F& WASTEWATER CONSULTANTS, INC. January 15, 2001 Municipality of Anchorage Public Works On -Site Water & Wastewater P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Lot Line Waiver for Lot 4, Block 6, Meadow Ridge Estates S/D - North Addition To whom it may concern: We request that your department issue a 5 foot lot line waiver from the east property line to the existing drainfield. I am unaware of any adverse impacts this waiver would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. .E., M.S. 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com FROM : Im CONSTRUCTION FAX NO. : 907-688-7010 Dec. 29 2000 11:26AM P2 i ,?�2 ej i ,c• Vl 1. :j 1� :.1 �- f 1 ti?ecer�i�le�. 12.2Q•BB(��; 9-3-Q3�)�! 1 I' •• w( or ' � � air \�•..M. 3 . • rA i I'0.it. A •, Fred Woial4a ,p •, NO. 32534 R �� artsslollA�� EASEMENTS O` RECORD, OTHER THAN � ou^",u ~ TYa ocMcncn ice.•'. _.. SI Cd Cry re rl'iC ,13\ 4O .0 I Cuc, s S Font t.oT LWp WAIVI•- aw"'oo_ Ls rI I�a AS -BUILT NO 00119 S SET THIS DATE I hereby certify that I have performed s MortaCtes in- spection of the following degcribed properly: __!L0 71 w_ f'/C�l: •,:. /+9.•:,:r:•r,;ty' /t•r.:1�,es_�d �•r 9,�G�1 r/nrr�l, rlrilii�%n., Anchorage Recording preclnc% Alaska, and that the Improve- ments situated thereon are within the property linea and do not overlap orencroachon the property lying adjacent there- ereto en oath onmtho premises n rovements on question andgthatathere are no roadways, lrnnemWion lines or other visible easements on said property except soIndiented hereon. Dated at Anchorage, Alaska this--¢ "'r ,lay *I r-L'/4—__r._.. 19 �� x•n„n mat A•,•a•A P. Aac/1rrA'rTQ ,c• Vl 1. :j i 1 ti?ecer�i�le�. 12.2Q•BB(��; 9-3-Q3�)�! 1 I' •• w( or ' � � air \�•..M. I'0.it. A •, Fred Woial4a ,p •, NO. 32534 R �� artsslollA�� EASEMENTS O` RECORD, OTHER THAN � ou^",u ~ TYa ocMcncn ice.•'. _.. SI Cd Cry re rl'iC ,13\ 4O .0 I Cuc, s S Font t.oT LWp WAIVI•- aw"'oo_ Ls rI I�a AS -BUILT NO 00119 S SET THIS DATE I hereby certify that I have performed s MortaCtes in- spection of the following degcribed properly: __!L0 71 w_ f'/C�l: •,:. /+9.•:,:r:•r,;ty' /t•r.:1�,es_�d �•r 9,�G�1 r/nrr�l, rlrilii�%n., Anchorage Recording preclnc% Alaska, and that the Improve- ments situated thereon are within the property linea and do not overlap orencroachon the property lying adjacent there- ereto en oath onmtho premises n rovements on question andgthatathere are no roadways, lrnnemWion lines or other visible easements on said property except soIndiented hereon. Dated at Anchorage, Alaska this--¢ "'r ,lay *I r-L'/4—__r._.. 19 �� x•n„n mat A•,•a•A P. Aac/1rrA'rTQ M MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 0 20 \ ` LII - � I HAA # kA (IS "') (V21110 1. GENERAL INFORMATION Complete legal description Lot 4; Btock 6; Meadowntidge Estatea nnAn nr`�cili\ Location (site address or directions) 24959 E. Homestead Road Chugaak,''ve-. AK 99577 Property owner puane Fn.anf Day phone 688-4151 Mailing address P.O. Box 670993 Chugaak. Lending agency Day phone Mailing address Agent Theresa Romana/ Ptanmagan Real Estate. Day phone 694-2321 Address 12801 U2d Glenn Hwy Eagle Raven., AK 99577 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual well Community well XXX Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XXX Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA R21 5. 6. STATEMENT OF INSPECTION BY ENGINEER M 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 application 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. S & S ENGINEERING 6i�'44/,2 y7 Name of Firm Address Engineer's signature DHHS SIGNATURE Approved for )bedrooms. Phone Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments Date _ 1 3 c The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. G _. 72-025�Rev. 1/97) Back MOA 021 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: �� i IJ�IL l t-kt_o Pc.\ -S Parcel I.D. A. Well Data Well type A` Log present(Y/N) _ Total depth Sanitary seal (Y/N) CJ�;_/-Is- 3/-- ;1r3 If A, B, or C, attach ADEC letter. ADEC water system number. Date completed Driller Cased to Casing height FROM WELL LOG Wires properly protected ON Zt143 I Date of test <n M Static water level 0 Well flow g.p.m. g.p.m. r®ri o iA Pu ell I-p� CA SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot 2a �` Absorption field on lot _ Public sewer main Sewer service line WATER SAMPLE RESULTS: Coliform sample: 2o��k Nitrate ; On adjacent lots On adjacent lots Public sewer manhole/cleanout Collected by: Other bacteria B. SEPTIC/HOLDING TANK DATA -71 Date Date installed Tank size l 0o t] Compartments Cleanouts 6)N) `/ Floundation cleanout (&N) Depression (Y,t61}/ High water alarm (Y& N Alarm tested (Y/N) Date of pumping 12 - t I — 5 Pumper S/e • GESS�� t - SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: ��Well(S) on lot 2�o On adjacent lots To property line / 0 1 y Absorption field Surface water/drainage / DO / �- S' Foundation Water main/service line /D 72-026(3/93)• Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent(Y/N) High water alarm level _ Meets MOA electrical codes SEPARA I on lot "Pump on" level at FROM LIFT STATION TO: D. ABSORPTION FIELD DATA Manufacturer Manhole/Access (Y/N) at tested On adjacent lots Surface water Date installed M (63 Soil rating (GPD/Ft2) \ 0 cam` System type Length �`�( Width L Gravel thickness '41 Total depth Total absorption area 3 J,6� `t Cleanout present ON) _Depression over field (Y/ISL) Date of adequacy test I � 3 .-9 3 Results/fail) for 3 Bedrooms Water level in absorption field before test // (�p After test U Peroxide treatment (past 12 months) (Y6 054d k -(A( -If yes, give date `yLp SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 2d ( On adjacent lots ', A- Property line 13 To building foundation To existing or abandoned system on lot �� n On adjacent lots o Cutbank r_v t A- Water main/service line Lo Surface water Driveway, parking/vehicle storage area Curtain drain E. ENGINEER'S CERTIFICATION 1 certify that 1 have Signature conformed to all MOA and HAA guidelines in effect on the date of this inspection. --------------- 'i r' Date / Eagle River, Alaska 99577 HAA Fee $ 3 Date of Payment GJ — �L` Receipt Number ;Z 5 2� %�✓�� 72-026 (3/93)' Back Waiver Fee $ Z Date of Payment Receipt Number_ 0 Time APPLIC NT FILLS OUT UPPER HAL ONLY Time Property Owner r G- �i '-' Date Phone Mailing Address f, U -, '! - =.i-� /:;.� - - - ,�. ( ;-' -,_Zip CodeI Inspector Buyer Inspector _ Field Notes: Address Zip Code Lending Institution Solis Rating Date Seter In ailed Phone Address Septic Tank Size 4611tro Zip Code Realty Co. & Agent Phone Address Zip Code Legal Description _CJ `rlE-A,<-)CC,),l/�k a—. J Street Location Type of Residence �gle Family ❑ Multiple Family No. of Bedrooms'`' ❑ Other Water Supply ❑ Individual ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. [-Y-Community For wells drilled prior to that date, give well depth (attach log if available). ❑ Public Utility Sewer Disposal _ Ld-Tndlvidual Year Individual Installed: ❑ Public Utility When Connected to Public Utility: ❑ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REOUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspector Inspector Inspector Field Notes: ( G)✓RRTSAOVED BEDROOMS ( ) DISAPPROVED ( ) CONDITIONAL AP AL' DATE BY: _ 'CONDITIONS OF APPROVAL Solis Rating Date Seter In ailed Well To Absorption Area Well to Tank Well Log Received Septic Tank Size 4611tro 72023 (3192)