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HomeMy WebLinkAboutPOLLOCK HOMESTEAD BLK A LT 3Pollock
Homestead
Block A
Lot 3
#017-112-50
• • .
Municipality of Anchorage
Development Services Department •= =":•
- -
Building Safety DMsIon
/
On-Site Water & Wastewater Program, 4700 South Bragaw SL
P.O. Box 196650 Andtorage, AK 99519-66M
www.d.anchorage.ek.us(907) 343-7904 Page 1 of 3
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number. SWO10020 PID Number. 017-112-50
Name:
TOM MILLER
Wastewater System: ❑New [3 Upgrade
Address:
925 CORAL LANE a ANCHORAGE, AK 99515
ABSORPTION FIELD
Phone:
No. of Bedrooms:
(907) 345-6844
3
O Deep Trench D Shallow Trench Deed O Mound O w
In
LEGAL DESCRIPTION
5oe "°en`Tea
0iptli nam
DPD/sa•
rt7�7
Lot: I Block:
Subdivision:
Dept, In piq Iatwm ft- er" rads:
1011,4:
3 A
T POLLOCK HOMESTEAD
rt
Township: — Range: —
Section: —
ry weed aemw se" peeve \
wgek
Ft. n
WELL: ❑ New
❑ Upgrode
C;—w wwuc
Number of ens
DLdance between en.e:
rt
rt
Cbeetbalbn AD.D
ieltl
comes Taift
Tell eleerptwn
L'qe md.ae
'z>z M—
rt
ao.
n
Dnten
Dat, Drdem
swum eller
+
adm ewteu.m
. m` eel k
ca" Lrlght wan aaw,m
TANK
DPY
rt
rt
SEPARATION
DISTANCES
OSeptic ■Holding 13S.T.E.P. Gather
To
Septic
Absorption
Uft
Holdingbne/Pdrat.
ManY1o01i1 .
ANCHORAGE TANK
copoc"Y ~ e0sw-
From
Tank
Field
station
Tank
sewer Line.
4000
Well
100'+
e94'+
—
—
25'+�
STEEL
Nero.. w 2
Surface water
100'+
100•+
—
—
—
LIFT STATION
Lot Une
5'+
m5'+/—
—
—
—
sin in gwwm
4000
ANCHORAGE A TANK
Foundation
50+
10't
—
—
—
W, red at
wap ehr r.d a:
HO waw slum at
I
N/A
N/A
N/A
Curtain Drain
No
KNOW
►wwv LaLw a
a.eutoa Ln.v.atere Wo, W.
Remarks: —EXISTING SEPTIC
TANK ABANDONED
BENCH MARK
LDwtan w D..erkuam
PER UPC.
NORTH SONA TUBE UNDER DECK
*WAIVER REQUESTED
Fwd o..auaw. 100.00 rt
eNaLwectts cut
�4So40
o0
o O
�t
r.
� OD
/
AWWC, INC.
o
N
Inspections performed by
Dates: 1st 3 1301
*.c.... ... .....:.'. �
2nd 3 is o1
�Q .. f y Cam S.
Department of Healt d Hu n S rvices approval
,
9
E 953 ,: got
Reviewed and approved by:
(R-. 12/010)
Date: '7O�-
Orooreosdot`
PERMIT NUMBER: ASPARCEL DRAWING PARCEL INUMBER:
SW010020 017-11 12-50
i
EXISTING DRAINFIELD\ \ N0 I NEW 4000
/ TOBE USED AS RESERVE SITE A ST c GALLON
HOLDING/SEPTIC
c TANK
ST I I INSTALLOVALVE
\ CLOSED
TEST HOLES EXCAVATED IN
I \ THIS AREA AND FOUND DEBRIS I \
In= IN THE LWOP= I \
\ OF THIS AREA I
U
OCLI
\I A B
ST1 20.3 14.8
I ST2 23.6 12.3
ST3 28.0 10.5
' I / ST4 34.7 11.3
MH 37.3 12.6
ALASKA WATER & WASTEWATER
--- —•-- CONSULTANTS, INC.
6901 DEBARK ROAD, SUTE 28 • ANCHORAGE. AX 9050.' PHONE (007)377-0179' FAX (907)306Ji41
PREPARED FOR: PHONE NUMBER:
TOM MILLER (907) 345-6844
LEGAL DESCRIPTION:
POLLOCK HOMESTEAD SUBDIVISON: LOT 3. BLOCK A.
AS—BUILT DRAWING OF SEPTIC SYSTEM UPGRADE
C.J.G.
1" = 30• ....
E NUMBER:
2OF3 �.
GGmess?
153
a
PERMrTNUMBER: AS -BUILT DRAWING 0NUMBER:
SWO 017
SWO1OO20 017-11 12-50
51 / 5f2 MN
for 0r f"—
Af W.Ef - 96b0
NSW 4000 ci& ON
Af IN.Ef
Af - 966..� .05 �u 5.f.U. TANK
vv""-'O63L, -r4'AJ4.
5/22/2001
DRAWN BY:
ALASKA WATER & NVASTONATER SCALE:C.J.G.
�--�-- - --- CONSULTANTS, INC.
6901 DEBARK ROAD, SUITE re • ANCHORAGE. AK 99504 • EHOW (907),537!179 • FAx (9071535-3246 N.T.S.
REPARED FOR: PHONE NUMBER: PAGE NUMBER:
TOM MILLER (907) 345-6844 3 OF 3
EGA. DESCRIPTION:
POLLOCK HOMESTEAD SUBDIVISION; LOT 3. BLOCK A.
!PE OF WORK:
SITE PLAN
r-- fop OF WX
Af QMef - 96,51
INSULATION
_mInor V"
Af O1JUT - 95.70
•
��`' f r•t Peri -
I >Civr1F�-T
16 907-277-3715 Anchorage Tank w Monday, February 19, 2001 11;50 AM
Page: 2 of 2 r
4,000 GALLON HOLDING ilk
UFTSTATION TANK.' � AWTAIL#i IC,
` law vammrm arms
T00@J •aaT rsa3Teaag aaOH +y OLL9999LO8 YYd W01 TOOVIVZO
MUNICIPALITY OFANCHORAGE
Development Services Department
On -Site Water 8 Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Permit Number: SWO10020
Legal Description: LLOCK BLK ALT 3
Design Engineer: 0041 AK Water & Wastewater Consultant
Owner Name: THOMAS P. & CATHLEEN T. MILLER
Owner Address: 925 CORAL LN
ANCHORAGE . AK 99515-3768
Date Issued: Feb 13, 2001
Expiration Date: Feb 13, 2002
Parcel ID: 017-112-50
Site Address: 015225 POLLOCK DR
Lot Size: 18253 SO. FT.
Total Bedrooms: 3 Permit Bedrooms: 3
This permit is for the construction of:
❑ Disposal Field F� Septic Tank Q Holding Tank ❑ Privy El Private Well Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified In Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ).
3_ The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
[6 -The following special provisions. .r
%THE ABSORPTION FIELD SHALL BE PERMANENTLY ABANDONED AS A PART OF THIS PERMIT APPROVAL"'
,'NO VALVE SHALL BE INSTALLED AFTER THE TANK UNLESS A WAIVER IS OBTAINED FOR THE
N ABSORPTION FIELD TO BE 98 FEET FROM THE WATER WELL AND LETTERS OF NON -OBJECTION
OBTAINED FROM THE UTILITIES UTILIZING THE EASEMENT THE ABSORPTION FIELD IS LOCATED WITHIN,
Received By:
Issued By:
Date:
Date: 2-13-01
Municipality of Anchorage
Development Services Department a
Building Safety Division ;'
/ On -Site Water and Wastewater Program SA ' T V
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
ON-SITE SEWERMELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 0/7— 112— 5-0 Permit Number SWD/0020
j fiOMASI IP C CATHLEfN T. N/LLER
Property owner(s) /gym / I � �� Day phone V10 -192a
Mailing address(1) IS-ZZS POLLOGk PRIVE MUCHOITA&E /3K
Mailing address (2) Zip Code 99�`�6
Legal description (Lot, Block & Sub'd.) Lo -L 3 T V-, • A �b (�oLk Su aPIy/sroN
Legal description (Section, Township & Range)
Lot Size 18,26-3 Acrese?
Number of Bedrooms 3
THIS APPLICATION IS FOR:
❑
Sewer Only ❑
Well Only
❑
Sewer and Well ❑
Water Storage
Sewer Upgrade
THIS PROPERTY CONTAINS:
13Hot
Tub ❑
Jacuzzi
1:1
Swimming Pool E]Water
Softening Unit
Therapy Pool ❑
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
A\A1WC -T (nc
(g+9rtatwevfpropert}wwneror suthorized.agsnt)
Permit Fees: 3 go..00 Waiver Fees: 11.5 •�
Date of Payment: 1-'31-01 Date of Payment:
Receipt Number: Receipt Number:
(Rev. 12/00)
ALASKA WATER & WASTEWATER
CONSULTANTS, INC.
January 30, 2001
Municipality of Anchorage
Developmental Services Department
Division of Environmental Services
On -Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Septic Tank Upgrade for Lot 3, Block A, Pollock Homestead Subdivision
To whom it may concern:
The existing 3 bedroom house is currently served by an on-site well and septic system. The
conventional septic system contains a 1000 gallon septic tank and a deep trench type drainfield.
The existing drainfield is in a state of failure. We are proposing that the existing 1000 gallon
septic tank be replaced with a 4000 gallon septic tank with a manhole installed on the second
compartment. The tank shall be with duel outlets, one outlet with a gravity flow outlet and the
other with the pressurized outlet. Both outlets are to be capped and the tank is to be used as a
holding tank for the present time. A valve box is to be installed after the holding tank for
possible future use of the existing drainfield. (A waiver will ke required.) The pressurized outlet
is for a possible innovative type septic system that may be designed and installed in the future;
C tot t.wt% L0'>.VV'
1. SURFACE WATERS: There are no surface waters within 100 feet of the proposed
upgrade.
2. TOPOGRAPHY: There are no slope concerns.
I am unaware of any adverse impacts this installation would have on adjacent wells or septic
systems. If yoy have any questions, please contact us at 337-6179. Thank you for your
.E., M.S.
r
NOTE: Attached is a site plan drawing, a design drawing„ and 04 page constnrction
specification letter which are all part of the design package for this septic system.
6901 Debarr Road, Suite 2B * Anchorage, AK 99504
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com
I
I li 1 I
I I BLOCK z
, I FOREST RIDGE
i Il 1 I
lL-z-------------------------------
r--,�------------------ - - - - - - - - - - - - - - - - - - - - - - - - - --
1 GCA --- -----
LOT 5.RL/OCK B LOT 8LOT 7, BLOCK
POLLOCKOCK ,HOMESTEAD POLLOCKLOCK M POLLOCK HOMCSMAP
I / /
I --
loo.
I I
_ _, — \ I LOT E. BLOCK B
I LOT 4, BLOCK B \`\ EXISTING REE 1 —�`� \ ROLLOCK HOMESTEAD
1 1 POLLOCK HOMESTEAD \ BEDROOM HOUSE A / \ /
I
It
/ ♦ \ I , y \\ �/ 1
/ DOSTING
SEPTIC \ I LOT 4. BLOCK A
\PoLLOCK HOMESTEAD /
1 LOT Z. a K B\ I I
I POLI/DCK HO ESTFAD i \ ` / I I EW TANKPnC '
a l
(ZAJANTj I •LOT
I POLLOCK HOMESTEAD l \
1 I LOT 2, BLOCK B ' / % LOT 2, BLOCK A I , • I 0 '' spy I
I I POLLOCK HOMESTEAD 11.��1./ / POLLOCK HOMESTEADIQ�'—' ,
I
ARS `,- p'r' I I \ p /
� 1 OI
I l pal
LOT 1, BLOCK A 1 1 LOT 8, BLOCK A'- , ��•
POLLOCK HOMESTEAD I 1 POLLOCK HOMESTEAD
I I LOT 1, BLOCK B
I I POLLOCK HOMESTEAD I I
I I I I
' DATE: c ��� .a�i"•\ye ,•`a�\
1/30/2001
e V Yi (_ . DRAwN BY: Qh
ALASKA WATER & WASTEWATER C.J.G. siry�'ti.
CONSULTANTS, INC. SCALE:• ;,°,44
» L:
6901 DEBARK ROAD. SUITE iR • ANCNORA9e, AK 99504 • WOW f907)337-6179 • FAX 90)USE32A! 1 = 100
PREPARED FOR PHONE NUMBER: PACE NUMBER: �'• •• •• • LS
TOM MILLER 786-1922 1 OF 1 ( p e re A. am ss.-
LEGAL
s;LEGAL DESCRIPTION: 414 yJ —79 \F�j
POLLOCK HOMESTEAD; LOT 3, BLOCK ATYPE OF WORK:
�� use •., �cq
Vki\
SITE PLAN FOR PROPOSED SEPTIC/HOLDING TANK UPGRADE �•^^�?esio.o''��
THIS AREA AND FOUND OEBRI
PILES IN THE MAIORITY
OF THIS AREA
NOTE: CONTRACTOR SHALL HAVE
EAST UTILITY EASMEM FLAGGED
\ \
BEFORE CONSTRUCTION.
STING SEPTIC TANK
i
IN PUCE
NEW K
OGALLON
sj-C��
TANPOSED
(SEE NOTE)
VALVE
(CL
EXISTING DRANFlELD
M
TO BE USED AS A
RESERVE SITE
\
TEST HOLES EXCAVATED
IN---,, 1
THIS AREA AND FOUND OEBRI
PILES IN THE MAIORITY
OF THIS AREA
THE NEW SEPTIC TANK IS TO BE A 4000 GALLON
TANK WITH A MANHOLE INSTALLED ON THE SECOND
ARTMENT. THE TANK SHALL BE WITH DUAL OUTLETS.
DUTLET WITH A GRAVITY FLOW OUTLET AND THE OTHER
THE PRESSURIZED OUTLET. BOTH OUTLETS ME TO
sPPED AND THE TANK IS TO BE USED AS A HOLDING
FOR THE PRESENT TIME AN ALARM SHALL BE
N
1/30/2001GF "
0 4
s / 1 DRAWN BY:
FAi,SWA «'ATER & WASTEWATER c'J'c' oc�
CONSULTANTS. INC. SCALE:
6901 DEBARK ROAD. SUTE !B • ANCHORAGE, AK "SM • PHONE 9071537-0179 • FAX 907)33"266 1" = 30' 0
PREPARED FOR: PHONE NUMBER: PACE NUMBER:
TOM MILLER (907) 786-1922 1 OF 1 QQ �' J r A. Gar ess.'
LEGAL DESCRIPTION: Q ° 79
POLLOCK HOMESTEAD; LOT, 3 BLOCK, A O00% '' • .....•• ' `oqo
TYPE OF WORK: 04°d Pie F°f°IOoc
DESIGN OF PROPOSED SEPTIC/HOLDING TANK UPGRADE �DO00000
�I
STING SEPTIC TANK
N BE ABANDONED
IN PUCE
NEW K
OGALLON
sj-C��
TANPOSED
(SEE NOTE)
VALVE
(CL
THE NEW SEPTIC TANK IS TO BE A 4000 GALLON
TANK WITH A MANHOLE INSTALLED ON THE SECOND
ARTMENT. THE TANK SHALL BE WITH DUAL OUTLETS.
DUTLET WITH A GRAVITY FLOW OUTLET AND THE OTHER
THE PRESSURIZED OUTLET. BOTH OUTLETS ME TO
sPPED AND THE TANK IS TO BE USED AS A HOLDING
FOR THE PRESENT TIME AN ALARM SHALL BE
N
1/30/2001GF "
0 4
s / 1 DRAWN BY:
FAi,SWA «'ATER & WASTEWATER c'J'c' oc�
CONSULTANTS. INC. SCALE:
6901 DEBARK ROAD. SUTE !B • ANCHORAGE, AK "SM • PHONE 9071537-0179 • FAX 907)33"266 1" = 30' 0
PREPARED FOR: PHONE NUMBER: PACE NUMBER:
TOM MILLER (907) 786-1922 1 OF 1 QQ �' J r A. Gar ess.'
LEGAL DESCRIPTION: Q ° 79
POLLOCK HOMESTEAD; LOT, 3 BLOCK, A O00% '' • .....•• ' `oqo
TYPE OF WORK: 04°d Pie F°f°IOoc
DESIGN OF PROPOSED SEPTIC/HOLDING TANK UPGRADE �DO00000
1/30/2001GF "
0 4
s / 1 DRAWN BY:
FAi,SWA «'ATER & WASTEWATER c'J'c' oc�
CONSULTANTS. INC. SCALE:
6901 DEBARK ROAD. SUTE !B • ANCHORAGE, AK "SM • PHONE 9071537-0179 • FAX 907)33"266 1" = 30' 0
PREPARED FOR: PHONE NUMBER: PACE NUMBER:
TOM MILLER (907) 786-1922 1 OF 1 QQ �' J r A. Gar ess.'
LEGAL DESCRIPTION: Q ° 79
POLLOCK HOMESTEAD; LOT, 3 BLOCK, A O00% '' • .....•• ' `oqo
TYPE OF WORK: 04°d Pie F°f°IOoc
DESIGN OF PROPOSED SEPTIC/HOLDING TANK UPGRADE �DO00000
J BK0382OPGO896
• ENCROACHMENT PERMIT 1203-34D
G-3137
EN01013
This permit is between Chugach Electric Association, Inc., an Alaska non-profit electric
cooperative, (herein "Chugach'), whose address is P. O. Box 196300, Anchorage, Alaska 99519
and Thomas P. and Cathleen T. Miller of Anchorage (herein "Permittee'), whose address is 925
Coral Lane, Anchorage, Alaska 99515.
1. Easement. Chugach is the grantee or user of an easement for the construction and
maintenance of electrical facilities as follows:
Dedicated by the plat of the subdivision known as Pollock Homestead
Subdivision, according to Plat Number 69-76, recordcd on the 20' day of June,
1969, on file in the office of the District Recorder, Anchorage Recording District,
Seward Meridian, Alaska,
Described in that certain written instrument recorded on the 15th day of
September, 1953, in Book 96, Page 35, on file in the office of the District
Recorder, Anchorage Recording District, Seward Meridian, State of Alaska,
(herein "Easement") which pertains to the following described real property:
!' V.
TheaEast:Ten Feet (E 10') of Lot Three (3), Block "A", Pollock Homestead
Subdivision, according to Plat Number 69-76, on file in the office of the District
Recorder, Anchorage Recording District, Seward Meridian, Alaska.
Permittee acknowledges the validity of the Easement. Permittee wan -ants and represents that
Permittee is the owner of the fee simple interest in the land subject to the Easement and the
following described real property to which the Easement is adjacent:
Lot Three (3), Block "A", Pollock Homestead Subdivision, according to Plat
Number 69-76, on file in the office of the District Recorder, Anchorage Recording
District, Seward Meridian, Alaska,
(herein "Parcel").
2. Encroachment. Permittee has purchased or constructed the following
improvements on or within the real property subject to the Easement:
A septi"ystem that encroaches approximately Six Feet (6') into the Easement
for a distance of approximately Twenty-three Feet (23'),
(herein "Encroachment").
Encroachment Permit - Page t or4
UK0302OPG0091
3. Eermit. Chugach hereby authorizes Permittee to continue the existence of the
Encroachment in its current location subject to the covenants set forth in this permit.
4. Indemnification. Permittee shall indemnify and hold Chugach harmless from any
claims for personal injury, property damage or other loss arising in any way frortt the
construction or continuation of the Encroachment.
5. No Expansion or Increase. Permittee shall not in any way expand or increase the
extent to which the Encroachment occupies any of the real property encumbered by the Easement
without the prior written consent of Chugach. Chugach has no obligation to provide such
consent.
6. No Interest in Real Estate Acquired. Permittee hereby acknowledges that the
Encroachment and any additions thereto, even if in violation of this permit, has not and shall not
in the future give -rise to any interest or estate in the real property subject to the Easement or any
other real property. Without in any way limiting the foregoing, Permittee acknowledges that the
Encroachment is not adverse to any interest of Chugach and its continuation is entirely with the
permission of Chugach for purposes of the common law doctrine of adverse possession. This
permit creates no interest in the real property subject to the easement.
7. Modification of Utility Facilities. If the electric utility facilities located within the
Easement are upgraded, added to, replaced or reconstructed, Permittee shall pay that portion of
Chugach's total costs for such modification which is reasonably attributable to accommodating
or preserving the Encroachment. If such payment is not made within thirty (30) days of written
demand for same, Chugach may terminate this permit in accordance with paragraph 9, below.
8. Covenants Running with the Land. The obligations of the Permittee arising from
this permit shall be covenants running with the land which shall burden the Parcel and the
Permittee's interest in the land subject to the Easement and shall benefit the Easement.
9. Termination. Chugach may terminate this permit after the giving of thirty (30)
days written notice of such termination if.
a. The Encroachment is enlarged, increased or extended within the
real property affected by the Easement.
b. The Encroachment is damaged by any means to an extent of more
than thirty percent (30%) of its replacement cost at the time of destruction.
c. Permittee fails to make the payment described in paragraph 7, above.
Encroachment Permit - Page 2 of 4
8K 03820 PG 0898
10. Term. This permit shall, if not sooner terminated by Chugach, expire forty (40)
years from the date hereof.
I. Entire A¢reement. This written permit constitutes the entire agreement between
the parties with respect to the subject matter hereof and supersedes all other prior or
contemporaneous agreements, oral or written, between the parties. No modifications,
amendments, deletions, additions or alterations of the permit shall be effective unless in writing
and signed by all of the parties hereto.
CHUGACH ELECTRIC
ZASIOTION, C.BIhibert
Executive Manager, - --- .
T & D Network Services
PERMITTEE
Thomas P. and Cathleen T. filler
By: ' I�art�o
Thomas P. Miller
Date: Date: O T
/J . - l �yy� J�
By:I��✓J /�Lt,1,40
Cathleen T. Miller
Date: l oD
STATE OF ALASKA )
) ss:
THIRD JUDICIAL DISTRICT )
The foregoing instrument was acknowledged before me this VZday of
/af.21 - , 2001, by �L�C� 'moi / //JC the Executive
Manager, T & D Network Services of Chugach Electric Association, Inc., an Alaska corporation,
on behalf of the corporation.
N
07
N65uy_PubIi6 in and for the State of Alaska
My commission expires V - /d -aa%
c; o
.%00
i
Encroachment Permit - Page 3 of4
BK0382OPGOB99
STATE OF ALASKA )
) ss:
THIRD JUDICIAL DISTRICT )
The fqr going instrument was acknowledged before me this lqday
of heri , 2001, by -thti.t.ns P. Will t;t-
the State of Alaska
f4 Conr*sion Fvkes
April 2.2003
STATE OF ALASKA )
) ss:
THIRD JUDICIAL DISTRICT )
T to fore oing instrument was acknowledged before me this 1 day
of 2001, by 00-46 1 tc h 7 • Kdlfr
.� Nota blic in for fit. a of asl�a
V1� My c ission ex ' ^9 April 2.20pp�,y'""�
AFTER RECORDING RETURN TO:
_ Chugach Electric Association, Inc.
Land Services Department
P.O. Box 196300
Anchorage, Alaska 99519-6300
027876 k
AIICHORAGE (L
RECORDIIIG DISTRICT
Encroachment Permit - Page 4 of 4
1001 AP 25 PM 2:29
REQUESTED BYG��
y
BK0382OPGOB99
STATE OF ALASKA )
) ss:
THIRD JUDICIAL DISTRICT )
The fqr going instrument was acknowledged before me this lqday
of heri , 2001, by -thti.t.ns P. Will t;t-
the State of Alaska
f4 Conr*sion Fvkes
April 2.2003
STATE OF ALASKA )
) ss:
THIRD JUDICIAL DISTRICT )
T to fore oing instrument was acknowledged before me this 1 day
of 2001, by 00-46 1 tc h 7 • Kdlfr
.� Nota blic in for fit. a of asl�a
V1� My c ission ex ' ^9 April 2.20pp�,y'""�
AFTER RECORDING RETURN TO:
_ Chugach Electric Association, Inc.
Land Services Department
P.O. Box 196300
Anchorage, Alaska 99519-6300
027876 k
AIICHORAGE (L
RECORDIIIG DISTRICT
Encroachment Permit - Page 4 of 4
1001 AP 25 PM 2:29
REQUESTED BYG��
e-12-01;10:57AM;CEA LAND SERVICES
Thomas and Cathleen Miller
925 Coral Lane
Anchorage, Alaska 99515
;7624652 0 1/ 5
FOWMG AL SWS "FW
April 6, 2001
Subject: Encroachment Permit for Septic System
Lot 3, Block A, Pollock Homestead Subdivision
Grid 3137,1203-34D, EN01013
Dear Mr. and Mrs. Miller:
Enclosed is the Encroachment Permit you requested for the septic system that
encroaches within the Utility Easement on the above referenced property.
Please review the EncroachmentPermit. If the conditions arc agreeable, please sign
the document where indicated, have your signatures properly notarized, and return
it to this office for full execution and recordation.
If you would like a conformed copy of the recorded document, please include $2.00
for the State Recorders' fee. The check should be made payable to Chugach Electric
Association, Inc. A self-addressed, stamped envelope is enclosed for the return of
the signed and notarized Encroachment Permit and the check for the conformed
copy fee.
All work within the easement area must be in compliance with the enclosed copy of
Chugach's Electrical Facility. Also enclosed for your use and information is the
Locate Call Center card and Chugach's RBat Is an Easement? handout.
If you have any questions, please call me at 762-4738.
Sincerely,
Chuck Couts, SR/WA
Right -of -Way Agent Il
Enclosure
Post -IN Fax Note 7671
DBte 75 1 pegs1. 3 -
TO
From /1 /_
L
Feer a b• a
Feer e
Chugach Electric Association, Inc.
5601 Minnesoto 06". P.O. Box 196300, Anchmoge. Alosto 995196300 • 19071563.7494 Fax 19071562-0027 • (8 00) 478-7494
w .chogochelecsric.eom • Inloachegochelectrie.com
ACS
Alaska Communications Systems
April 17, 2001
Jeffrey A. Garness
Alaska Water 6 Wastewater
6901 De Barr Road, Suite 2—B
Anchorage, AK. 99509
ACS has no objection to the encroachment of the existing septic system
into a platted easement located on Lot 3, Block A, Pollock Homestead, as
depicted on the as -built drawing submitted.
Acceptance and use of this letter of non -objection by yourself, your
heirs, your assigns, or your successors, will constitute agreement to
the following stipulations:
1. ACS will be held harmless, now .and forever, for any damages
or injury to any person or property as a result of this
encroachment.
2. Any ACS facility damaged or destroyed as a result of this
encroachment will be repaired at no cost to ACS.
3. Any costs incurred by ACS for special construction
necessitated by this encroachment will be borne by the
property owner.
4. All applicable safety code regulations will be observed and
maintained.
5. This letter of non -objection will in no way preclude ACS from
full use and enjoyment of its rights within any portion of
its right-of-way.
Sincerely,'('n ��
Greg -Schmid, C y Foreman
Outside Plant /Engine,
DATE:
Z3 vi
ACSP #
GS\ml\g:mswd/cor/nonob/pollock.doc
600 Telephone Avenue Anchorage, Alaska 99503-6091 tel 907.564.1000 w .acsalaska.com
ANCHORAGE NATER & WASTEWATER UTILITY
George 110 rch.
Alavor
Engineering Division
3000 Arctic Boulevard
Anchorage, Alaska 99503-3898
fax 907.562.0824
http.lAvww.awwu.ci.anchorage.ak.us
March 30, 2001
Thomas & Cathleen Miller
C/o Alaska Water & Wastewater
6901 Debarr Road, Suite 2-B
Anchorage, Alaska 99504
Re: Pollock Homestead, Block A, Lot 3 — Tax ID 017-112-50 (Grid 3137)
Dear Mr. & Ms. Miller:
Chrned by the
Municipality ojAnchorage
The Anchorage Water & Wastewater Utility received your request on March 29, 2001, for
a letter addressing AWWU's position regarding the existing septic system that encroaches
approximately 6' into the utility easement located on the east 10' of the referenced lot.
Submitted with the request was a property as -built drawing dated January 30, 2001,
depicting the location of the existing easement and encroachment.
AWWU water and sanitary sewer mains are not available to the referenced lot.
AWWU is not using and has no interest in the referenced utility easement and therefore
does not object to the encroachment.
Should you have any questions, please call the AWWU Planning Section at 564-2739.
Sincerely,
Hallie Stewart
Engineering Technician
\\a"vrile\Groups\EngineeringTIanning\Planning\I IMS\encroachmems\w-s-not available-Pollock.doc
APR- 2-01 TUE 10:12 AM GCI CABLE FAX N0. 9077869380 P. 2
March 30, 2001
Jeffrey A. Gamess, P.E., M.S.
Alaska Water & Wastewater Consultants, Inc.
6901 Debarr Rd, suite 2.9
Anchorage. Alaska 99504
Dear Mr. Garness,
Subject to your agreement to indemnify the company as set forth below, GCI Cable Inc.
of Alaska has no objection to the septic system encroaching into the 10' utility easement
on the east property line of Lot 3. Block A. Pollock Homestead Subdivision. Known a;
15225 Pollock Drive in city grid 3137.
This letter of non -objection in no way precludes GCI Cable from full use and enjoyment
of any rights it may have within any portion of the utility easement and or the right•of-
way, including unlimited access for servicing its facilities. Also any additional and
extraordinary costs incurred during any future required construction, repair or
reconstruction of GCI's facilities to accommodate any or all of the encroachments shall
be paid by the property owner.
By signing below, you agree to indemnify and hold GCI Cable harmless, now and
forever, for any damage, costs, expense (including reasonable attorney's fees), liabilities
and injury to any person or property occurring as a result of the en*achment.
Please indicate your acceptance by signing
address below.
Sincerely,
Qe(&eccaCo(90'
OSP Design Engineer
Date
myself at the
5151 Fairbanks Street • Anchorage, Alaska 99503.907 1786-9200
Cable services provfded byGCl Cable, Inc.
12/18/1996 16100 9075620053
March 30, 2001
Thomas & Cathleen Miller
15225 Pollock Dr.
Anchorage, AK 99516
To whom it may concern:
MENSTAR ENGINEERING*
PAGE 01/02
ENUAR Natural Gas Company
A OmagN W SEAGULL ENERGY CORPORATION
Enpineeelnp Department
401 E. Intemational Airport Road
P. O. Box 190288
Anchorage. Alaska 995194288
(907) 264-3740
FAX (907) 563.4085
ENSTAR Natural Gas Company has no objection to the encroachment of the septic system in
the 10' utility easement on the east side of Lot 3, Block A, Pollock Homestead Subdivision.
See attached as -built survey dated 1/30/01.
Acceptance and use of this letter of non -objection by yourself, your heirs, your assigns; or
your successors, will constitute agreement to the following stipulations:
ENSTAR will be.held harmless, now and forever for any damages or injury to any.
person or property as a result of this encroachment.
Any ENSTAR facility damaged or destroyed, as a result of this encroachment will be
repaired at no cost to ENSTAR.
Any costs incurred by ENSTAR for special construction necessitated by this
encroachment will be borne by the property owner.
All applicable safety code regulations will be observed and maintained.
This letter of non -objection will in no way preclude ENSTAR from full use and.
enjoyment of its rights within any portion of its right-of-way.
Sincerely,
ENSTAR Natural Gas Company
Drew Smith, Engineer
cc: File
r- -
Municipality of Anchorage
Development services Department
0
• 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
WR#: 010040 PID#: Cl7-1122So
Date Received: 677101
Waiver Review Worksheet
HAM _ Permit#: SW010020
Legal Description: Pollock Homestead Block A Lot 3
Engineer. Alaska Water B Wastewater Consultants, Inc.
6901 Debarr Rd. Suite 213 Anchornae, AK 99504
Applicant: Tom Miller
Waiver Requested: 94 feet separation distance from the well to the reserve drainfleld
n9sortprro^v r-&Lp To Eiisr PropeRTY Line o#L S'
Criteria:
Geology Points:
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
Total:
Waiver Is Granted: x Waiver is not Granted.
List Conditions or Reasons for above: S CK A 1TAS .4 CHAD
Date: By: P*V
Name of Reviewer
Rao#: waived Amount: waived Date Paid: N/A
v
WAIVER REQufsr
r�IW,91VER RE4uEsr NuHpFR WRO10040
WAIVER /¢ pEEr FROM THE ON -LOT ABSORPr1aAv TRE,vCH rig WArrR
WELL ~
SEPTIC PAM -
%NE 5EPr1L SvSTEM wqS Covf7YuCrED/N /VOv 1979 T1(E I16tORI°r/L
oaf TREvCH Wr}S INSPECTED t RPPKO✓ED Ar 14 FEET py TL{£ M.O. A.
THE AREA Is RELarwee4y FL -Ar HOwEvER r/ -/F ABSORPr/oA. rRF_"cj
1S Loc4rF_Q ntsr OF TIDE Lval-I IN gNEiriav AIH/CII Ivltt Par /
== HYDfflM4L ICIPL.Lr 1IP GR/401FA/T' FROM rMF_ wEL( IM quES i/Oq/.
RECEA/rLY A Pfifmtr wNS /fsuEo To CaNfr/ruer A pow/ab TANK
A -S rl4E 1419SORPI/Oa r/PE.vCH IA. QNEsr/oti Pugs NOr APSo)rI
rwr- otfar..glwoua.7- of t-j4TEn REQ"jxra. rHE Pz-64, /s To
USE THE f O00 6:ALLvA� SEPTIC r4WX As /4 //oLvIA,L- rn^AR
UNTIL THE F/fLO N4T RESrEc 7HE/V 1°ur A LIFr
ST r/ON IAS IIA�D UTILIZE_ ry f 400014P7-/4Pv PIF -LD 16-1$VAI, lffi'1
15 No Roorc ON THE PRcArrrr FOR /4NO7.4J&-R 9a50KPrt0.v F/£Lo
TK6 SOIL TKF ABSORPrr#A. Plel r PERCaLN rEs /A• ra is* *v ¢0 Af I&11A.Cy
OFaysr- 5sLr, &TAV64. TK/S TYPE OF SOIL TYPICAutr VERY
EFFECr/VE /A, r1rv/¢i"/A/& S6vr1c 7.9A.lt F_FfL keA.,r. (4, w rwoer ainw/
W OLL PA-rA -
T)4I= tuArF-R WELL 1A/ 0Wr-S7/0N Is 3-3 FEET PeF-P w)4ERE ©EPRoe
If ENCOwurEReO. rHE PREDOAilA/EAir S014 BErr-I_EA/ 6120uaD ruiex
ANO WHERE WMI-ER 15 EuC0u1✓r/=RED Is .4 CL.14Y10-MVE4. A'S LA}'EIQ /
TV OE CoAr-tAaa!r rKF. svarER OE/41t/A.6- A$ujFsx /45 *j� rum srwl-,C.
wnrr_zR LEVEL is 7 FC -ET a.srK i.14r6R F_NLOuur5K6D Ar 3 9 FEET
TKE kl*Mrl2 WELL I$ P0WlV G12AV1ENT- FROm� rkE AO1SoRPTro�v F1/'LO
OA//gN RPPRaA1K+4TE /Q A/e SLOPE. NATER SAMPLES FRok rKE I,FLL. I
Qu.F S T1 oA/ INPIeNrE NO D/4crE"XJA No N/ TRr}r65 DE7-Et1.19-6LE
S of R. O. f. C. S. P W Cr. for S. C. R. a
pa
wprEn 7-n BLE
39' - S' = 34�v = x,:.4f4.0 4:4•
SOIL SoMa r"iv"
PREpON/NENTLY CLAY 1 6,Y,4 PEI
- pFRµEA•B/c/tY
c'
W n )rnaLE GRAGIENr
NORI ZOA/TAL SEPARAr/O.v
iiR&17 TOTAL
C pNCL,,ts ro�v
6R#iv7- 14-,A/✓ER
4.3
F -A
2.8
/4.9
ALASKA WATER Fr WASTEWATER
CONSULTANTS, INC.
May 30, 2001
Municipality of Anchorage
Department of Health & Human Services
Division of Environmental Services
On -Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
MoA AffnOV�� 9C
t ✓A , �/� t rJ l 6'79 .
Ref: Waiver Request for Pollock Homestead Subdivision; Lot 3, Block A
D'-� '% I-LF—
The existing 3 bedroom house is served by a private well and holding tank with a reserve septic
system. We request you grant a 94 feet separation distance waiver from the well on the
referenced property to the reserve drainfield. The well that serves the subject property was
drilled on August 28, 1979, and the septic system was installed on November 5, 1979. The
following items are justification for the waivers:
Though the lot slopes toward the general location of the well, it would be very unlikely that
effluent would be able to surface from the system. There is a high water alarm on the tank
that would sound if the water levels were to rise. Also, there is a daylight basement in the
house which would flood completely before the level of the effluent reached the surface at
the drainfield.
The location of the septic system is in a very visible area so that if any effluent was to
surface, it would be noticed and the problem corrected.
The other path of contamination is subsurface migration wastewater should the tank begin to
leak. As can be seen on the attached 5 well logs, the aquifer appears to be confined below
various layers of hardpan, silt, clay, or mixtures of these soils. These have served to inhibit the
migration of untreated wastewater into the aquifer. Recent water sample results indicated
non-detectable nitrate levels, and no bacteria present. Based upon the aforementioned facts, it
appears that there is minimal risk associated with the 94 feet separation distance waiver.
In addition to the separation distance waiver from the well to the drainfield we are requesting a
lot line waiver from the east lot line to the drainfield. The drainfield extends to approximately 5
feet from the lot line. We have obtained letters of non -objection from the utility companies and
see no adverse impact associated with the encroachment.
If you have any
please contact us at 337-6179. Thank you for your assistance.
I.S.
6901 Debarr Road, Suite 2B • Anchorage, AK 99504
Ph: (907) 337-6179 " Fax: (907) 338-3246 * Website: akwwc.com
1WY-29-01 20:21 FRM-
CUE Environmental Services Inc.
CMEReLN
1012902001
AK Water A Wastewater Consultants Inc.
Client Name
Project NameM
L3:BAPollock Homestead
Cliest Sample ID
1.3; B A Polluck Homestead
Matrla
Drinking Water
Ordered BY
PWSID
0
7-118 P.02/03 F-6/4
Client PON
Printed DateMme
Collected DateMnw
Received Datell7me
Technical Director
�
Released BY iCJR'
05/29/2001 16:44
0525/2001 13:30
0525/2001 13:55
Stephen C. Ede
Sample Remarks:
Allowable Pcq Andysis Init
Panmeta
Results PQL Units Medial Laniu Dale Date
Nates Department
Nitrate -N 0.5000 0.500 mg/L EPA 300.0
Microbiology LaboratorY
Toml Coliform 0 0 col/l00mL SM18 9222B
4
(<10) 05/25101 SCL
05/25101 KAP
MUNICIPALITY OF ANCHORAGE
j a 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 PHONEy� NEWToG/� F-1 UPGRADE ADE
MAI LING ADDRESS
{�
LEGAL DESCRIPTION
2
LOCATION `'
NO. OF BEDROOMS
DISTANCE TO:
Well �l
.—r�V
Absorption area r
,i
Dwelling
PERMIT NO. '�-7
_ 79 0(� (/
V Y
11,
T
I-_ Q
Manufacturer ��_
Materia
No. of comp tme/nts
Lu
rn
Liq. c paOcity 'n Lions
IF HOMEMADE:
Inside length a�
Width
Liquid depth
J
DISTANCE TO:
Well
Dwelling
PERMIT NO.
z
ZZ
1
_ _ F
Manufacture real
Liquid cap y in gallons
OJ
W =
Z
DISTANCE TO:
Well :#
Foundation Nearest lot lin `� ,
PERMIT NO. ,
790(
J LL
Z
No. of lines
Length ARf each li a
Total length of lin ggs Trench wid a
Distance betwearn lines
W
h
�-:5
W .. inches
// U
FTop
of tile to finish grade
Material beneat the �'T
Total effect absorption area
0
J. A+ehm
W
Length
WidthDepth
NO. PERMIT
Qa F-
Wa
Type of crib
Cri diameter
Crib dept
T ective abs ption area
W
rn
DISTANCE TO:
WNL
Buildin on
Nearest lot line
.j
Clas
Depth
Driller
Distance to lot line
PERMIT NO.
J
W
DISTANCE TO:
Building foundation
Sewer line
Septic tan
Absorption area (s)
�
OTHER
PIPE MATERIALS 7
_,a
0 3
—
SOI L TEST RATING
INSTALLER
Ifs
REMARKS
0(2sr 666- rho
;
Lb 4e < 7-f'11 ci
t
3 1
J�*
n �
—
APPROVED p DATE LEGAL
OPLJ,� ILI�
rcUis IrreV.siyu) /
VNiGiPAUN OF ANCNORA'E
DEPT. OF TH Ci10!y
yjAL ^rk01-
DAILY DRILLING LOG FNVSRONM
SYREN BROS. DRILLING, INC.
2701 Eagle Street Anchorage, Alaska 99503 R� `6437
T
OWNER OF LAND .... gra ,g....mit .......Qt...&--_L,easgng----------- DEPTH OF WELL-----53---feet------------------------------------------------------------------------
ADDRESS.... i.._' ... r l t .--ve-'----. iinc_...... --x3---79_5.Q1........ STATIC LEVEL OF WATER FT.... -7 ---- f eet... From g ound level
WELL—SITE---`-._0t----3....Blk--...... P-alla kSLd _.---------------------- DRAW DOWN FT...............................................
DATE—STARTED.-. August 24,1979------------------------------------------------- GALS. pER HR...._5.. gallons per minute
................... ........... ........__ ------ . ..
DATE—ENDED--.August 289 1979 ..................................................... BIND OF CASING ... E?��-.-Grade B Steel Casing to °
---------
KIND OF FORMATION:
FT. TO ..........................
FT.........................................
FROM ..........................
FT. TO ..........................
FT .................................... .....
FROM.............
..........FT.
TO..
3
........FT........ Flll .................. FROM -------------
..---------- XT. TO_ -----------------------
FT ..............-- -- ..............
FROM.-
.........32...
-FT. TO-
4
-..-1�..............FT.-------........-------...�..
:gqt cla - ravel
gz...... FROM ..........................
FT. TO ..................
.... FT.-_ ......................
FROM ..........
34---
-.FT. TO.
3.9.............FT..GraVeljg
titer stra ,oM........................FT.
TO ..........................
FT ..... . .........._........._._.
FROM....
-----39----------
i•. TO.
------5.0...
..... at..Ciay/s.and/giavel FROM ...................
...FT. TO ..........................
r T.........................................
FROM ----------
50 ..........
FT. TO---------
5-2 ---------
=FT_ S.and/gra.--- strat<vROM.........................
FT. TO................._.......F'�'.
FROM ------
_i.132 ..........
FT. TO........5.3...------.-FT.-.Bedr0C4.-----------
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...............
MISCL. INFORMATION:
FROM............ . ........FT. TO......... .............FT........... ...................
FROM.............. .........FT. TO.....................FT.........................................
FROM-------------------------- FT. TO -------------------------- FT.........................................
FROM..........................
FT. TO ..........................
FT.........................................
FROM ..........................
FT. TO ..........................
FT .................................... .....
FROraI.
------..FT. TO--------------------------
FT ....... ..... ...............
DRILLER'S NAME----. tr. J e -.. ayren.........-.
y 1 (Tq 0 AS 0 T jnyl
E-"1 L-1 P' -.F :1 t_::1. F--> N L_ 1 _" "-r" e_: -A F=' 1=a P-.1 C-: -1 A- 1 F ." A.13- E--:-
DEPARTMENT ( HEALTH F=INE? EN'v'IR:ONMENTAL DTECTION
825, 'E.. STREET, RNC:HClRAGE: AK. _ 91.1-f9_t
?r_-,4-4',;2 0
F'-.1 IC, Cl C-4-- ' .?I: -...1=- _ 1 a -•-d FE F-- 1= 1=_ F; ,
PERlyJT NO.
APPLICANT
LOCATION
LEGAL �fa�r4'�S7,w vo
TYPE OF SOD ABSORPTION S'r'' TEPI I S : %lt�erYf/l,
SOIL RATING i',SQ FTr'BR?=
MAXIMUM NUMBER OF BEDROOME. = 3
ail y
L.CIT SI-ZE 70000 SQUARE Ft.t.i
THE REC:,'UIREL? SIZE OF DIE SOIL. ABSORPTION SYSTEM IS. � s
F> _ 'i F -i :. L_ FEE r-4 4: "T V-1 _- ` �� F� ", FE F..__ I ? I- F=l `C"' F 9
THE LENGTH DIMENSION I S THE LENGTH (IN FEET OFF- THE. TRENCH OR: DRA I NF- I ELC?.
THE DEPTH OF A TRENCH OR PIT 1'.': THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE E::<,C:A'MTION (IN FTSET?.
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRA'v'EL DEPTH 15 THE- M I N I MI.IM DEPTH OF GRA',1E1_ BETWEEN THE OUTFALL PIPE.
AND THE BOTTOM OF: THE E'XCW. ATION (IN FEET?.
F-- F Q L-1 1 E ^ 1== C, 'E: [-- F=' 7. T r T -"P' -d F-' JCP -_- 100
PERMIT APPL I CANT HAS THE RESPONSIBILITY TO I NFCiR:t'1 THIS DEPARTMENT DI_IR I N13 THE
INSTALLATION I NSPEC:T I Of•d5 OF ANY WELLS, ADJACENT TO THIS PROPERTY AND THE
NUMBER OF RESIDENCES THAT THE WELL. WILL SERVE.
7. I.•J V. o -V T: � .i P'-4 Eti F-=) Fw FE V--? F 4l F_B 1. F;' kc= C, �.
BACKFILLING OF ANY SYSTEM WITHOUT FINAL IN=PECTION ANF.,., APPRO'ML. BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN A WELL AND ANY OI' -a• -SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR A PRIVATE WELL; OR
:150 TO 200 FEET F Ri-Itl A PLIE E...I C WELL DEPENDING UPCjN THE TYPE OF PUBLIC WEL.L..
WELL LOGS ARE REC U I RED ANL? P1UST BE RETURNED TO THE DEPARTMENT HENT WITHIN 30 DAY'S
OF THE WELL. COMPLETION.
OTHER REQUIREMENTS MAY APPLY. = PEC ' T F I CAT" I ONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER T NSTAI_L.AT I ON.
-P' C > F=' -1 F' �_ G-, Fe i_. IC- _ !' 1 E F. �' - _ A_ � r" -.��
I CERTIFY THAT
1: 1 AM FAMILIAR: WITH THE R'EG1U I REMENT5 FOR ON-SITE SEWERS AND WELLS AS SET
FOR•fH BY THE MUNICIPALITY OF ANC'HORAGE:.
2: 1 WILL INSTALL THE SYSTEM IN AC:C:ORC?ANl'..F. WITH THE CODES.
<: I UNDERSTAND THAT THE ON-.tITE SEWER: S4"-�T'EM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE 15 REMODELED TO INCLUDE LUDE MORE THAN 3 BEDROOMS.
SIGNED : 41 -
ADPL I CANT
ISSUED BY/,u_-_.. ._ _..... _ Dil'CF _� a ._._��J V3. 2
••-._�!,
'ate i " �.
Lam,%CS.
L.CIT SI-ZE 70000 SQUARE Ft.t.i
THE REC:,'UIREL? SIZE OF DIE SOIL. ABSORPTION SYSTEM IS. � s
F> _ 'i F -i :. L_ FEE r-4 4: "T V-1 _- ` �� F� ", FE F..__ I ? I- F=l `C"' F 9
THE LENGTH DIMENSION I S THE LENGTH (IN FEET OFF- THE. TRENCH OR: DRA I NF- I ELC?.
THE DEPTH OF A TRENCH OR PIT 1'.': THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE E::<,C:A'MTION (IN FTSET?.
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRA'v'EL DEPTH 15 THE- M I N I MI.IM DEPTH OF GRA',1E1_ BETWEEN THE OUTFALL PIPE.
AND THE BOTTOM OF: THE E'XCW. ATION (IN FEET?.
F-- F Q L-1 1 E ^ 1== C, 'E: [-- F=' 7. T r T -"P' -d F-' JCP -_- 100
PERMIT APPL I CANT HAS THE RESPONSIBILITY TO I NFCiR:t'1 THIS DEPARTMENT DI_IR I N13 THE
INSTALLATION I NSPEC:T I Of•d5 OF ANY WELLS, ADJACENT TO THIS PROPERTY AND THE
NUMBER OF RESIDENCES THAT THE WELL. WILL SERVE.
7. I.•J V. o -V T: � .i P'-4 Eti F-=) Fw FE V--? F 4l F_B 1. F;' kc= C, �.
BACKFILLING OF ANY SYSTEM WITHOUT FINAL IN=PECTION ANF.,., APPRO'ML. BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN A WELL AND ANY OI' -a• -SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR A PRIVATE WELL; OR
:150 TO 200 FEET F Ri-Itl A PLIE E...I C WELL DEPENDING UPCjN THE TYPE OF PUBLIC WEL.L..
WELL LOGS ARE REC U I RED ANL? P1UST BE RETURNED TO THE DEPARTMENT HENT WITHIN 30 DAY'S
OF THE WELL. COMPLETION.
OTHER REQUIREMENTS MAY APPLY. = PEC ' T F I CAT" I ONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER T NSTAI_L.AT I ON.
-P' C > F=' -1 F' �_ G-, Fe i_. IC- _ !' 1 E F. �' - _ A_ � r" -.��
I CERTIFY THAT
1: 1 AM FAMILIAR: WITH THE R'EG1U I REMENT5 FOR ON-SITE SEWERS AND WELLS AS SET
FOR•fH BY THE MUNICIPALITY OF ANC'HORAGE:.
2: 1 WILL INSTALL THE SYSTEM IN AC:C:ORC?ANl'..F. WITH THE CODES.
<: I UNDERSTAND THAT THE ON-.tITE SEWER: S4"-�T'EM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE 15 REMODELED TO INCLUDE LUDE MORE THAN 3 BEDROOMS.
SIGNED : 41 -
ADPL I CANT
ISSUED BY/,u_-_.. ._ _..... _ Dil'CF _� a ._._��J V3. 2
PERFORMED
❑ SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION
TEST
Pouch 6650, Anchorage, Alaska 99502 276-2221
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION:
DEPTH
(FEET)
3
/ 5
/
S
Net
Time
ENCOUNTERED?
Net
Drop
L
1012-
_
P
P
t�
9
10-/
V
IF YES, AT WHAT
Ac
11
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131415
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14-
15
16
lb -
17
s192018-
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19-
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20
DATE PERFORMED: , Z
a t�aOf" �1
SLOPE
SITE PLAN
—1---T
WAS GROUND WATER
Date
S
Net
Time
ENCOUNTERED?
Net
Drop
L
1012-
_
P
P
t�
Eye
IF YES, AT WHAT
(
DEPTH?
-..
COMMENTS
JKAI„ti c _-.-TA,. ,
PERFORMED BY:
72-008 (7/76)
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
1012-
Iq'I-S
V�-o. o o
t
lb -
2-o. 4
2 -0.
`, 6
-1 4A
5A ,
PERCOLATION RATE 40 (minutes/inch)
TEST RUN BETWEEN FT AND __ FT t
60J wv�'A
CERTIFIED BY:_ ( " '�_ DATE:
Parcel I.D. 017-112-50
Municipality of Anchorage
On -Site Water and Wastewater Program
(907) 343-7904
Certificate of On -Site Systems Approval
1. GENERAL INFORMATION
Expiration Date: I' - y - i
Complete legal description POLLOCK HOMESTEAD; BLOCK A, LOT 3
Location (site address) 15225 Pollock Drive
Current Property owner(s) Jean Miller
Mailing address
Real Estate Agent
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:
Individual Well
&
Individual Water Storage
❑
Community Class Well
❑
Public Water System
❑
WaiverNariance request for: NIA
Day phone 887-3632
Day phone
TYPE OF WASTEWATER DISPOSAL:
Individual
&
Holding Tank
❑
Community
❑
Public Sewer
❑
Received by: Date: 810116
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ Eq ( �6
Date of Payment �! 3 201 �o
Receipt Number 76 4
COSA # [�7SC t l 3 38
Waiver Fee $
Date of Payment
Receipt Number
Waiver #
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm Garness Engineering Group, Ltd. (GEG) Phone (907) 337-6179
Address 3701 E. Tudor Road Suite 101, Anchorage AK, 99507-1259
Engineer's Printed Name Jeffrey A. Garness Date
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 systems on the
deters 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 on 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 systems.
These conditions can vary, and are outside the control of GEG. Satisfactory test results do not
guarantee future performance of the systems; 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. The content of this report is for the sole benefit of the
person/party who retained GEG. Reliance upon the information provided in this report by any other
person or party, including but not limited to subsequent property purchasers, is not authorized. In
short, GEG disavows any legal duty to anyone other than the personiparty who paid for this report.
6. DSD SIGNATURE
System #1 Approved for bedrooms
System #2 Approved for bedrooms
Disapproved \Qp��� (OFjNC.
Conditional approval for bedrooms, with the follo4stieulations:
J UN -SITE
rinr€RAPID m
+� WASTEWATER z -
Original Certificate Date:
The Municipality of Anchorage Development Serv(ces 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 Ste Alaska. Alaska. The Municipality
of Anchorage is not responsible for errors or omissions in the professional engineer's work. ...
7. ATTACHMENTS:
COSA Checklist _ Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
CASA blue sheet &1-12Eoe
Qpvtse
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: POLLOCK HOMESTEAD; BLOCK A, LOT 3
A. WELL DATA
Well type PRIVATE If A, B, or C provide PWSID# N/A
Date completed 8/28/79 Sanitary seal (Y/N)—
Total depth 53 ft. Cased to 52 ft.
FROM WELL LOG
Date of test 8/28/79
Static water level 7 ft.
Well' production 5 g.p.m.
WATER SAMPLE RESULTS:
Coliform q colonies/100 ml. Nitrate -NQ- mg./L.
Arsenic: NO ugJL. Date of sample: 1/1_g
–STEP TANK W/ OUTLE
B. SEPTICIHOLDING TANK DATA
Tank Type/Material STEP
Parcel ID: 017-112-50
Well Log (Y/N) YES
Wires properly protected (YM) YES
Casing height (above ground) 18+ in.
AT INSPECTION
7/15/16
16.9
5.8+ g.p.m,
Collected by: GEG. Ltd.
AS HOLDING TANK OR SEPTIC TANK
Date installed 3/13-16/01
Tank size 4000 gal. Number of Compartments E Cleanouts (Y/N) YES
Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N)
Date of pumping 7/11/2016 Pumper ISAACS PUMPING SERVICE
C. ABSORPTION FIELD DATA
Date installed 11/5/1979 Soil rating (g.p.d./feor /bdr 85
Length 43+23=66 ft. Width 3 ft.
System type
TRENCH
Gravel below pipe 2.5 ft.
Total depth *5.5+ ft. Eff. absorption area 330 ft2 Monitoring tube YES Depression over field NO
Date of adequacy test 7/1 B/16 Results (Pass/Fall) PASS For 3 bedrooms
Fluid depth in absorption field before test 9 in. Water added 563 gal. New depth **30 in.
120/1405, ***24/16
Elapsed Time:. _ min. Final fluid depth _ in. Absorption rate >= 450+ g,p,d
Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE If yes, give date
**3 INCHES ABOVE THE LATERAL LINE INVERT ***3 INCHES BELOW THE LATERAL LINE INVERT
IN ORDER TO ACHEIVE ADEQUATE ABSORPTION THE SYSTEM MUST BE FILLED TO 1009 CAPACITY.
HOUSE HAD SEEN VACANT SINCE EARLY JUNE. GEG PRE–SOAKED WITH 596 GALLONS ON 7/15/16.
TRENCH WAS DRY UPON ARRIVAL ON 7/15/16 AND LIQUID LEVEL ROSE 26 INCHES (1 INCH BELOW INVERT
OF LATERAL). AFTER 2 HOURS THE LIQUID DEPTH DROPPED TO 17 INCHES IN THE "109WOWKITIJAR&
D. LIFT STATION
Date installed Size in gallons Manhole/Access
"Pump on" level at in. "Pump off level
E. SEPARATION DISTANCES
level at
Cycles tested Meets alarm & circuit requirements?
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankAift station on lot 1001+
Absorption field on lot
Public sewer main
Sewer /septic service line
On adjacent
On adjacent lots
Public sewer manhole/cleanout
Holding tank
100'+
100'+
100'+
Animal containment areas 501+ Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO
Building foundation 51+ Property line 51+ Absorption field UNKNOWN
Water main 101+ Water service line 10'+ Surface water 1001+
Wells on adjacent lots 1001+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line _ Building foundation 101+ Water main 101+
Water service line 101+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
is
*WAIVER #010040
**PROPERTY OWNER PAID TO HAVE THE WATER SERVICE LINE LOCATED. SEE ATTATCHED PHOTOS
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSH guidelines in effect on this
date,
Engineer's Prin ed ame JEFFREY A. GARNESS
Date 316
(Rev. 10/12/12)
LEGEND
•
-X X-
0 30
/
I INCH - 30 FEET
GRAVEL DRIVEWAY
WOOD DECK
STAIRS
SEPTIC STANDPIPE
SEPTIC TANK MANHOLE
6 -FOOT WOOD FENCE
O WELL
�I a
2 �
m
D
j � 3
M
O o
25' Z
NOTES
1. PROPERTY IS SUBJECT TO EASEMENTS, SEE PLAT OF RECORD & TITLE
REPORT FOR MORE INFORMATION.
2. THE EASEMENTS SHOWN HEREON WERE INCLUDED IN A TITLE REPORT
PREPARED ON MAY 3, 2010 BY ALYESKA TITLE GUARANTY AGENCY OF
ALASKA, INC., FILE NO.: 00029687-001-KEM.
3. A RIGHT OF WAY BLANKET EASEMENT EXISTS IN FAVOR OF CHUGACH
ELECTRIC ASSOCIATION IN BOO 96 AT PAGE 35.
4. SEE PLAT OF RECORD (PLAT No. 69-76) FOR PLAT NOTES.
S. ALL MEASUREMENTS ARE IN FEET UNLESS OTHERWISE NOTED.
POLLOCK DRK
N 8958'25" E 64.00'
k
STAIR 28.5
STAIR
� 2 -STORY
N HOUSE o
22g•
STANDPIPE 4.0' 6.0
LOT 3 $ PTIC TANK
BLOCK A W/rcLEANours
U
14.4
��taaraatt�, S 89'58.25" W 139.00'
4p* SE (IF
* 49th 9•f *•,�L CERTIFICATION
....e .. ..•.. .....................�
• 1 HEREBY CERTIFY THAT 1 HAVE SURVEYED THE FOLLOWING DESCRIBED
^•••.•.........• ............................0 PROPERTY: LOT 3, BLOCK A, POLLOCK HOMESTEAD SUBDIVISION, PLAT 69-76,
c s •BRADFORD J. RMCKEY• j �o i ANCHORAGE RECORDING DISTRICT, ANCHORAGE, ALASKA, AND THAT NO
LS t 1229 ;• �� ENCROACHMENTS EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBIUTY OF THE
�j �'fy''•., $ 21- 0 ••••' y�� i OWNER TO DETERMINE THE EXISTENCE OF OF ANY EASEMENTS, COVENANTS, OR
.... ...RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED
T.
♦•♦++��%lits �+••••� CONNSSTR UC OF FENCES, OR FOR ESTABLISHINUNR NO CIRCUMSTANCES SHOULD ANY OF THE DT TE BOU DAR HEREONSEDFOR
ImmHATTENBURG
DILLEY& LINNELL
AS -BUILT SURVEY LOT 3, BLOCK A
Engineering Consultants
POLLOCK HOMESTEAD SUBDIVISION
• ENGINEERING • EARTH SCIENCE
PLAT 69-76, ANCHORAGE RECORDING DISTRICT
• SURVEYING • PUNNING
ANCHORAGE, ALASKA - -
• PROJECT MANAGEMENT • ENVIRONMENTAL
DATE:
DRAWN BY: SHEET:
5-20-2070 - JOT 1 OF 1
(807)889 -2120 -ANCHORAGE
(807)7405930-PALMER www.NOLALASKA.cbN
SCALE:
1" = 30' I CHECKED BY: &/R JOB NO.: - 10-10.5
Municipality of Anchorage e
Development Services Department
Building Safety Division 5 r
On -Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 0171 1250 COSA# U-� % e, � C; Asa,
1. GENERAL INFORMATION Expiration Date: 1 -7 -
Complete
-7 -Complete legal description POLLOCK HOMESTEAD; BLOCK A LOT 3
Location (site address) 15225 POLLOCK DRIVE *ANCHORAGE, AK
Current Property owner(s) TOM MILLER
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
Day phone
15225 POLLUCK DRIVE *ANCHORAGE, AK
Day phone
MARK SOQUET W/ SOQUET REALTY Day phone
4155 TUDOR CENTRE DRIVE *ANCHORAGE, AK
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 3-
3. TYPE OF WATER SUPPLY:
786-1053
561-1616
TYPE OF WASTEWATER DISPOSAL:
Individual Well
Individual On-site
❑
Individual Water Storage
❑
Individual Holding tank
0
Community Class Well
❑
Community On-site
❑
Public Water System
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer
of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or
water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems
Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may
be reissued with new water samples. (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 a`iixed 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. Phone 337-6179
Address 3701 E. TUDOR ROAD. SURE 101 • ANCHORAGE. AK 99507
Engineer's Printed Name JEFFREY A. GARNESS. P.E. Date
Engineer's Comments:
In conducting this evaluation, GEG, LID. attempted to provide a thorough,
conscientious engineering analysis of the system In accordance with ADEC and MOA
DSD 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 06 of all wells and
septic systems depend on the local soils condition, groundwater levels that may
Ituctuate 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 the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, LTO. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report Is for
the sole benefit of the ownerlisted above. Any reliance upon or use of this report by any
other person or party Is not authorized, nor will it confer any legal right whatsoever.
5. DSD SIGNATURE
_1Z Approved for __3_ bedrooms.
Disapproved.
Conditional approval for
Attachments:
COSA Checklist
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
bedrooms, with the flowing stipulations:
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
VVAt CR r%11✓
1A1neTCWi5TFR
By: Original Certificate Date:
(Ra. 11/05) '
Municipality of Anchorage
• Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: POLLOCK HOMESTEAD BLOCK A, LOT 3 Parcel ID: 0171 1250
A. WELL DATA
Well type PRIVATE If A, B, or C provide PWSID# N/A
Date completed 8/28/1979 Sanitary seal (Y/N) YES
Total depth 53 ft. Cased to 52 ft.
Date of test
Static water level
FROM WELL LOG
8/28/1979
7
ft.
Well Log (Y/N) YES
Wires properly protected (Y/N) YES
Casing height (above ground) 12+ in.
AT INSPECTION
5/5/2010
SURFACE ft.
Well production 5 g.p.m. 5.76 g.p.m.
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 ml. NitrateC. 10 mg./L. Other bacteria_colonies/100 ml.
Arsenic:` -5- Vug./L. Date of sample: 5/5/2010 Collected by: GEG Ltd.
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material STEEL/HOLDING TANK Date installed 3/13-16/01
Tank size 4000 gal. Number of Compartments 2 Cleanouts (Y/N) YES
Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (Y/N) YES
Date of pumping 5/5/2010 Pumper ISAACS PUMPING SERVICE
C. ABSORPTION FIELD DATA
Date installed 11/5/1979 Soil rating (g.p.d./ftzorft2/bdrm 85 System type TRENCH
Length 43+23= 66 ft. Width 3 ft. Gravel below pipe 2.5 ft.
Total depth * ft. Eff. absorption area 330 ft2 Monitoring tube YES Depression over field NO
Date of adequacy test ** Results (Pass/Fail) FAIL For 3 bedrooms
Fluid depth in absorption field before test — in. Water added — gal. New depth — in.
Elapsed Time: — min. Final fluid depth — in. Absorption rate >= N/A g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date —
*MONITORING TUBE WAS NOT FUNCTIONAL.
**TRENCH WAS OBSERVED ON 5/5/10 AND WAS FOUND TO BE SURCHARGED.
D. LIFT STATION
Date installed
"Pump on" level at in.
E. SEPARATION DISTANCES
Size in gallons Manhole/Access
'Pump off- !2ye aHigh water alarm level at in.
Cycles tested Meets alarm & circuit requirements?
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 100'+
Absorption field on lot '94'+
Public sewer main N/A
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/cleanout N/A
Sewer /septic service line 25'+ Holding tank 75'+
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main N/A Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line
'0'+
Building foundation
t0'+
Water main N/A
Water service line
10'+
Surface water
100'+
Driveway, parking/vehicle storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
G.
*WAIVER #010040
COSA Fee _` d
Date of Payment
Receipt Number
(Rev. 11/05)
Waiver Fee $
Date of Payment
Receipt Number
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS = _
May 25, 2010
Municipality of Anchorage
Development Service Department
Building Safety Division
On -Site Water & Wastewater Program
P.O. Box 196650
Anchorage, Alaska 99519-6650
(907)343-7904
Ref: Request for Waiver Amendment (#WR010040) from the Absorption Field on Pollock homestead,
Block A, Lot 3 to Lot Line:
The existing 4 bedroom house is served by a private well and septic system. An updated as -built survey
was developed for the subject lot and it was discovered that the absorption field has a 0 foot separation
distance between itself and the east lot line. We request you amend #WR010040 to approve a 0 foot
separation distance from the absorption field to the east lot line. The following items are justification for
the waiver:
• The location of the neighboring septic system has adequate distance between them with the amendment
to the waiver.
• The existing encroachment has existed for almost 31 years.
Based upon the aforementioned facts, it appears that there is minimal risk associated with the 0 foot
separation distance waiver.
If you have anAquestions, please contact us at 337-6179. Thank you for your assistance.
P.E., M.S.
3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507-1259
Ph: (907) 337-6179' Fax: (907) 338-3246' Website: www.gamesscngincering.com
LEGEND NOTES
0 GRAVEL DRIVEWAY 1. PROPERTY IS SUBJECT TO EASEMENTS, SEE PLAT OF RECORD h TITLE
® WOOD DECK REPORT FOR MORE INFORMATION.
2. THE EASEMENTS SHOWN HEREON WERE INCLUDED IN A TITLE REPORT
® STAIRS PREPARED ON MAY 3. 2010 BY ALYESKA TITLE GUARANTY AGENCY OF
ALASKA, INC., FILE NO.: 00029687-001-KEM.
• SEPTIC STANDPIPE 3. A RIGHT OF WAY BLANKET EASEMENT EXISTS IN FAVOR OF CHUGACH
SEPTIC TANK MANHOLE ELECTRIC ASSOCIATION IN BOOK 96 AT PACE 35.
1. SEE PLAT OF RECORD (PLAT No. 69-76) FOR PLAT NOTES.
-x x- 6-FOOT WOOD FENCE 5. ALL MEASUREMENTS ARE IN FEET UNLESS OTHER'MSE NOTED.
POLLOCK DRIVEN
N 89 58'25' E 64.00'
0 301 rX
�. _,., �
14.4'
srA1
^ 2-STORY I
h WOOD
X_X HOUSE 4
" $
v SEPTIC 4.0' 8 0 , a
STANDPIPE -
• I
LOT 3
o
--WELL BLOCK A w�c EANTo""iJ?s I o n
SEPTICTj
STANDPIPE p
Q 7 w8' I p
p SHED SEptici
to
STANDPIRE
I
a P
SHED
g � I
25' I
.<
.�,••`W,t, S 89'58'25' W 139.00'
E OF AC 44
*;' 49tH * ♦i� CERTIFICATION
...........:.....�
• • I HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOMNC DESCRIBED
0.••••..........•••.........•••••......... ••.` PROPERTY. LOT 3. BLOCK A POLLOCK HOMESTEAD SUBDIVISION, PUT 69-76.
♦. o ;•BRADFORD J. RINCKEY:1 4o - ANCHORAGE RECORDING DISTRICT, ANCHORAGE, ALASKA, AND THAT NO
♦♦%�•.,• LS 11229 •.: Q°�� ENCROACHMENTS EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE
♦ Fq 5-21'E7 g� • OYMER TO DETERMINE THE EXISTENCE OF OF ANY EASEMENTS, COVENANTS, OR
♦, 4. RESTRICTIONS TMICH DO NOT APPEAR ON THE RECORDED SUBDIVISION
•
Es ,".**UNDER
NOCIRTANCEH F THE DAHERE USED FOR
4� ••ROF SFOR ESTABLISHING
Imm HATTENBURG DILLEY& LINNELL AS-BUILT SURVEY LOT 3, BLOCK A
Engineering Cons5itants POLLOCK HOMESTEAD SUBDIVISION
• ENGINEERING • EARTH SCIENCE PLAT 69-76, ANCHORAGE RECORDING DISTRICT
• SURVEYING • PLANNING ANCHORAGE. ALASKA
• PROJECT MANAGEMENT • ENVIRONMENTAL
DATE: S-2O-2O IO DRAWN BY: SHEET:
rvoiJee.- aIm.ANCHORAce JDT l OF I
(907)7M8 _PA m Ww'w..IWLALA9KACdA SCALE: 1, - 30' CHECKED BY' BJR I JOB NO.: 10-105
Encroachment Easement
This Easement and associated covenants shall become effective on the date recorded, shall run with
the land and shall inure to and be for the benefit of all owners and future owners of the subject real
properties subject to the conditions set forth below.
This Easement is between Charles E. Morris and Jacqueline A. Moms, husband and wife, whose
address is 15311 Pollock Drive, Anchorage Alaska 99516, hereinafter referred to as "Morris" and are
the owners of the following described real property:
Lot 4, Block A, POLLOCK HOMESTEAD SUBDMSION, according to the official plat thereof,
filed under Plat Number 69-76, records of the Anchorage Recording District, Third Judicial District,
State of Alaska,
And
Thomas P. Miller and Cathleen T. Miller, husband and wife, whose address 15225 Pollock Drive,
Anchorage Alaska 99516, hereinafter referred to as "Miller" and who are the owners of the following
described real property:
Lot 3, Block A, POLLOCK HOMESTEAD SUBDMSION, according to the official plat thereof,
filed under Plat Number 69-76, records of the Anchorage Recording District, Third Judicial District,
State of Alaska,
WHEREAS, Miller have a septic system with a drain field that encroaches approximately 1 foot onto
the real property of Morris for a distance of approximately 30 feet and;
WHEREAS, the parties desire to provide for the continued existence, use, access, maintenance and
operation of the septic system in its present location.
NOW, THEREFORE, for and in consideration of the conditions and covenants contained herein, the
parties do hereby agree as follows:
1. Morris grants to Miller a encroachment easement through and over four (4) feet of Lot 4
running along the mutual property line, to allow the continued existence, access, maintenance
and operation of the septic system in its present location. This easement begins 27 feet north
of the south comer of the mutual property line, runs north for the length of the drain field
(approximately 34 feet) and extends into Lot 4 by a distance of 4 feet to the east of the mutual
property line.
2. The Owners of Lot 3 indemnify and hold the Owners of Lot 4 harmless for any claims of
personal injury, property damage or other loss arising in any way from the continuation of the
encroachment and easement.
Page 1 of 3
3. No expansion or increase: The Owners of Lot 3 shall not in any way expand or increase the
extent to which the encroachment occupies the real property of Lot 4 without the prior written
consent of the Owners of Lot 4..
4. Allowance for access for operation, testing and maintenance: The Owners of Lot 4 agree not
to restrict access to the easement or to disturb the easement in a way that is detrimental to the
operation of the septic system.
5. No interest in real estate acquired: The Owners of Lot 3 agree and acknowledge that this
encroachment and easement have not and in the future will not give rise to any interest or
estate in the real property of Lot 4.
6. This easement shall run with the property described herein and shall be a benefit to and
binding upon the undersigned and any person who shall hereafter acquire title to said property.
7. Term: This easement shall be in effect until such time as there is no further need for or use of
the existing septic system described, such as connections being made to public sewer. In the
event that the existing drain field is replaced, the replacement drain field would be constructed
within the property boundaries of Lot 3 and this easement will terminate. In the event that this
easement is found to interfere with any financing for which Lot 4 is to be the security, the
owners of Lot 3 agree to cooperate with the owners of Lot 4 to mitigate the interference and
remove any objection of a future lender and shall be required to remove the encroachment if
same becomes necessary to satisfy the objection of a future lender. In the event that the
easement becomes an issue as to public health regulations, the owners of Lot 3 shall be
required to take such action as is necessary to resolve the issue as to public health regulations,
including removal of the encroachment at no cost to the owners of Lot 4.
Attachments:
As -built survey, Block A, Lot 3, Pollock Homestead Subdivision, Certified 21 May 2010
As -built survey, Block A, Lot 4, Pollock Homestead Subdivision, Certified 19 August 2005
Page 2 of 3
DATED:5 I a$ I1O z �— -
Thomas P. Miller
/ /e
Cathleen T. Miller
STATE OF ALASKA )
) ss.
THIRD JUDICIAL DISTRICT )
The foregoing instrument was acknowledged before me this 42 day of
2010, by Thomas P. t een T. Miller.
IL
Notary Public in and Qbr Alaska
My commission expires:
a ' aWA -A-
STATE OF ALASKA
THIRD JUDICIAL DISTRICT
Charles E. Morris
) ss.
The foregoing instrument was acknowledged before me this �2.� day of"
2010, by Charles E. and Jacqueline A. Morris.
Notary Public in and f ' Alaska
.My co.-mmission expires:
Record in the Anchorage Recording District
Page 3 of 3
Municipality of Anchorage
Development Services Department
0 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#: 010040 PID#: 017-112-0 HA#: Permit#: SWO10020
Date Received: 6/7/01
Legal Description: Pollock Homestead Block A Lot 3
Engineer: Alaska Water & Wastewater Consultants, Inc.
6901 Debarr Rd, Suite 2B Anchorage, AK 99504
Applicant: Tom Miller
Waiver Requested: 94 feet separation distance from the well to the reserve drainfield
At35oRPTroiv FIC -00 Tv r -,}ST PRoprreT'f L/uF of y If
Criteria:
Geology Points:
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
Total:
......................... 0 0 0 0 0 0 0 M 0 9 a N ...... 0 0 0 M a 0 N 0 0 0 0 0 0 0 0 E ..... \ 0 0 .. 0 0 ... \.■ 1
Waiver is Granted: x Waiver is not Granted:
List Conditions or Reasons for above: s EI' ATT19 CK CO
Date: �— 2 0 —O/ By: D1¢AJ
Name of Reviewer
......................................................... a 0 0 0 U M 0 a 0 0 E E ...... 0 0 0 1
Rec#: waived Amount: waived Date Paid: N/A
IW %*
CR4v[L DRIVEWAY
WOOD DECK
STAIRS
SEPTIC STANDPIPE
SEPTIC TANK MANHOLE
X- 6 -FOOT WOOD FENCE
/
/
�
�
a.
z�
25' 1
NOTES
1� PROPERTY IS SUBJECT TOEASEMENTS, SEE PLAT OFRECORD & TITLE
REPORT FOR MORE INFORMATION,
2�THE EASEMENTS SHOWN HEREON WERE INCLUDED |NATITLE REPORT
PREPARED ON MAY l 2010 B, 4LYESKA TITLE GUARANTY AGENCY OF
ALASKA, INC., FILE NO.: 00029587-001-KEH,
3, A RIGHT 0F WAY BLANKET EASEMENT EXISTS IN FAVOR OF CHUGACx
ELECTRIC ASSOCIATION IN BOOK 96 AT PAGE 35,
*, SEE PLAT OF RECORD (PLAT No. 59-76) FOR PLAT NOTES,
5� ALL MEASUREMENTS ARE IN FEET UNLESS OTHERWISE NOTED.
I to
"OLLOCK DRIVE
N 89*5825^ E
LOT 3
BLOCK A,
CERTIFICATION
.��
m °vv
HOUSE
SEPTIC 4
STANDPIPE
ST
I HEREBY CERTIFY THAT | HAVE SURVEYED THE FOLLOWING DESCRIBED
PROPERTY: LOT 3, 8U}O( A, POLLOCK HOMESTEAD SUBNwSI0x, PLAT 50-76,
ANCHORAGE RECORDING DISTRICT, ANCHORAGE, ALASKA. AND THAT NO
ENCROACHMENTS EX/3T EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE
OWNER TO DETERMINE THE EXISTENCE OF OF ANY ExSEWENT3, CUvENAMr5, OR
RESTRICTIONS WHICH D0 NOT APPEAR ON THE RECORDED SUBDIVISION PLAT,
UNDER NO CIRCUMSTANCES SHOULD ANY OF THE DATA x[R[0N BE USED FOR
CONSTRUCTION OF FENCES, OR FOR ESTABLISHING THE BOUNDARY.
Engineering Consultants POLLOCK HOMESTEAD SUBDIVISION
ENGINEERING EARTH SCIENCE PLAT 69-76, ANCHORAGE RECORDING DISTRICT
SURVEYING PLANNING ANCHORAGE, ALASKA
PROJECT MANAGEMENT ENVIRONMENTAL DATE: DIAWN BY: SHEET:
f907 5r,4-2120 -ANCHORAGE 5-20-2010 JDT I OF I
(907) 746-5230 - PALMER WWW.HDLALASKA.COM SCALE: 30' CHECKED BY 3jR JOB NO-: 10-105
5
Time
Time me �—
—�
Date —
Date
Date
� �, �
Inspector Inspector
Inspector
——
Comments
Conditional Approval�—
l
Date Sewer installed
Permit No.
Septic Tank Size %�—
Holding Tank Size
Soils Rating
Well To Absorption Area
Well Log Received
Well to Tank
APPLICANTFILLSOUT LOWER HALF ONLY
Property Owner 0AOMy—��- %/8 t �`? Phone —
Mailing Address
Buyer Vim-
Address
Lending Institution Y -57 —�— Phone —
Address
--��-- 4
Realty Co. & Agent ' F F u 7 C1 J -i—�" Ct — Phone
Address
Legal Description 3 1 13-u 1< TZ -a -0 -c -f< 5tJ 3, -- —
Street Location
—
TypeResidence --��—
I�Single Family
El Multiple Family No. of Bedrooms
❑ Other-- — �®
Watgr$upply
;?5 Individual ATTACH WELL LOG. A well log is required for all wells drilled since June
❑ Community 1975. For wells drilled prior to that date, give well depth (attach log if
❑ Public Utility —_� available)
Sew Disposal
Individual Year Individual Installed: -:27 _--
❑ Public Utility When Connected to Public Utility:--.
❑ Holding Tank----
NOTE: THE INSPECTION PRE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
5. LEGAL DESCRIPTION//`l
DATE RECEIVED
INSPECTION APPOINTMENTS
-14,
TIME
TIME
T�MF
NUMBER OF,BEDROOMS^
(lam -
Imo,.,
_.r Ct
1 50
DATE
DAT[IN
IE
7. WATER SUPPLY
I� INDIVIDUAL"
INSPECT R
INSP CPECTO`1R
{CIPALITY OF ANCHORAGE
❑ PUBLIC UTILITY
DEPT. OF HEALTH &
MUNICIPALITY OI' ANCHORAGE
ENVIRONMENTAL PROTECTION
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
• 825 L Street - Anchorage, Alaska 99501
NOV ^ 1979
ENVIRONMENTAL SANITATION DIVISION
Telephone 264.4720
RECEIVED
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
1. PROPERTYOWNER
PHONE
%
J�f��/��
MAILING ADDRESS
-
/' Y -F—
PROPERTY RESIDENT (If different from above)
PHONE -
2. BUYER /�
PHONE
T/�`le
MAILING ADDRESS
3. LENDING INSTITUTION / �-` �
PHONE -
MAILING ADDRESS �� k
4. REALTOR/AGENT
PHONE
MAILING ADDRESS
5. LEGAL DESCRIPTION//`l
STREET LOC TION`/
-14,
"I e7 STrc•'2_�/
K
6. TYPE OF RESIDENCE
NUMBER OF,BEDROOMS^
;E�— SINGLE FAMILY
❑ One ❑ Four ❑ Other
❑ Two ❑ Five
❑ MULTIPLE FAMILY Three ❑ Six
7. WATER SUPPLY
I� INDIVIDUAL"
* ATTACH WELL LOG. A well log is required for all wells drilled
❑ COMMUNITY
since June 1975. For wells drilled prior to that date, give well
❑ PUBLIC UTILITY
depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM
_
E4 INDIVIDUAL/ON-SITE**
C7
) YEAR ON-SITE SYSTEM WAS INSTALLED.
❑ PUBLIC UTILITY
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010 (Rev. 6/79)
vo
W_LtP "
72-010 (Rev. 6/79)
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE'
❑ SINGLE FAMILY
❑ MULTIPLE FAMILY
_NUMBER OF BEDROOMS
❑ ONE
❑ TWO
❑ THREE ❑ FIVE ❑ OTHER
❑ FOUR ❑ SIX
2. WATER SUPPLY
❑ INDIVIDUAL
❑ COMMUNITY
❑ PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM
❑INDIVIDUAL/ON -SITE
❑PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DATE INSTALLED
f(_
INSTALLER
-�
❑Septic Tank or ❑ Holding Tank
Size: lt9e)�i If Tank is homemade
give dimensions:
SOILS RATING
TYPE OF TANK
MANUFACTURER
-
TOTAL ABSORPTION AREA
MATERIAL
_^
4: DISTANCES --
WELL T0:
Septic/Holding Tank
Absorption Area
Sewer Line
—
Nearest Lot Line
Absorption Area to nearest Lot Line
E7 5MMENTS
APPROVED FOR BEDROOMS
❑ CONDITIONAL APPROVAL (letter must accompany certificate)
❑ DISAPPROVED
DATE
72-010 (Rev. 6/79)
Novembor 19, 1970
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