HomeMy WebLinkAboutGLEN EAGLE BLK 3 LT 5Glen Ea 9 le Block 3 Lot 5 #050-601-07 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP21128 PID Number: 050-601-07 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name JEREMY & BROOKE ALF ABSORPTION FIELD ® Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 23916 SUNNY GLEN DRIVE, EAGLE RIVER ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 0.6 GPD/SF 10 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 2 Ft. Gravel depth beneath pipe 8 Ft. Subdivision Block Lot GLEN EAGLE 3 5 Fill added above original grade VARIES 2.06 — 2.13 Ft. Gravel length 63 Ft. Township Range Section Gravel width 2 Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 1008 FtZ 1 NA Ft. Well -- 100'+ 25'+ TANK ® Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer EXISTING Capacity Gal. Surface Water -- 100'+ Material Number of compartments Lot Line -- 10'+ NA Foundation -- 10'+ LIFT STATION Manufacturer Capacity Gal. Remarks DIVERTER INSTALLED TO EXISTING & NEW FIELD. Alarm location Electrical installed by Tank to PIPE MATERIAL House to tank 3034 dra of 3034 Installer NORTHERN EXCAVATION eld Drainfieid 3034 CO/MT 3034 Inspector FWC BENCH MARK (Assumed elevation) 100 ft Inspection 1s 5/24/21 5/24/21 Location and description 2nd 3`d 5/25/21 4'" ICEMENT SLAB — DOG KENNEL ON-SITE WATER AND WASTEWATER SECTION APPROVALOF A. Conditional Approval: Date i •:t�,�1� , .....�: � Huffman. Septic SystemCurtis --� • CE 128991 lyv� Date Z7'Z ����slF�• .5/25/21, . •4P Amw 1�1F�PROFESSI�NP�-� Note: this approval does not include well permit requirements. (Nev ub/uuiu) PERMIT: OSP211128 PID: 050-601-07 8.1' EXISTING SEPTIC N TANK 46,690 S.F. e 100' PROTECTIVE RADIUS C • DIV 2.0'x42.2' CANT i Fkis nAG F7F<� B D BM `2� D , CO ( 1& MT E A ' 7o� TH21-1 Std SF ry 2 ry(0' 11.5'x18.0 COVERED PEN G 8.4'x26.4' DECH ,e MTF Co 4.3'x7.5' PORCH 2.0'x42.2' CANT \ 10' UTILITY 8c r- DRAINAGE EASEMENT 16.2'x12.2' LO SHED A—C=67.9' B—C=73.5' A—D=80,8' B—D=94,5' A—E=73.5' B—E=88.7' A—F=36.9' B—F=61,4' A—G=33.3' B—G=58.9' WEST 274.76' (COMPUTED & RECORD PLAT No. 75-5E FCO CO EXISTING HDPE SEPTIC TANK DCO DIV SEPTIC SECTION SCALEI NTS GLEN EAGLE BLOCK 3, LOT 5 PREPARED FOR: JEREMY & BROOKE ALF 23916 SUNNY GLEN DRIVE EAGLE RIVER, AK 99577 FIRST WATER CONSULTING 13030 Sues Way DATE: Anchorage, Alaska 99516 DRAWN: (907)350-9566 SCALE: firstwaterAK@gmail.com MT CO MT 93.81FlNAL GRADE 93.88 TH21-1 - 91.75 ORG/OL FILTER FABRIC ORIGINAL GRADE 1' 89.75 89.75 SM/GM SEWER ROCK 81.75 81.75 NO GRND.WTR. 5/10/2021 18' 75.75 BOH SUPPORT@SERVICES: F OF o e�� TH C * �— 5/27/2021 rtis Huffman wx KGLrs CE 128991 Alf FWCS 5/27/21' 1" = 30' �4oPzssio-t0 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP211128 Work Type: Septic Upgrade Tax Code Number: 05060107000 Site Legal Address: GLEN EAGLE BLK 3 LT 5 G:0160 Site Mailing Address: 23916 SUNNY GLEN DR, Eagle River Owner: ALF JEREMY L & BROOKE R Design Engineer: FIRST WATER CONSULTING This permit is for the construction of: Effective Date Expiration Date: Lot Size in Sq Ft: Total Bedrooms: t o s' Department 5/13/2021 5/13/2022 Q Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during_ freezing_ weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: Date: Issued By: Date: S 3 4 MUNICIPALITY ANCHORAGE Development Services DepartmentPhone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 050-601-07 Property owner(s) JEREMY & BROOKE ALF Day phone Mailinq address 23916 SUNNY GLEN DRIVE, EAGLE RIVER, AK 99577 Site address 23916 SUNNY GLEN DRIVE, EAGLE RIVER, AK 99577 Legal description (Sub'd., Block & Lot) GLEN EAGLE B3, L5 Legal description (Township, Range & Section) Lot Size 46,690 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (N all that apply) Absorption Field Fx� Initial ❑ Single Family (SF) El (w/wo ADU) Septic Tank 1:1Upgrade El Duplex (D) El Holding Tank ❑ Renewal - - - -- _❑ Multiple Dwellings Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. of property owner or authorized agent) Permit/Rush Fees: 459 S Date of Payment: 5L(,1.20;21 Receipt Number: 90(00 (0 0 Permit No. QS7 P 21 1 I2 g Waiver Fees: Date of Payment: Receipt Number: Waiver No. G:\Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com May 10, 2021 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC SYSTEM UPGRADE PERMIT LEGAL: GLEN EAGLE BLOCK 3, LOT 5 The property owner has requested we obtain a permit to upgrade the failed septic system of the above referenced lot. We propose to install one deep trench to serve the existing 4-bedroom residence. The design is based on the recent test hole conducted on May 3, 2021. No groundwater was observed at test hole excavation or monitoring. The slopes are moderate at 8-13% at the proposed upgrade location. The lot and area are served by private water. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211128, Rebecca Carroll, 05/13/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211128, Rebecca Carroll, 05/13/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211128, Rebecca Carroll, 05/13/21 4661 13030 Sues Way - Anchorage, Alaska 99516 Tel. 907-350-9566 firstwaterAK@gmail.com SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: GLEN EAGLE B3 L5 PERFORMED BY: FWCS / FWC - I CURTIS HUFFMAN CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE & MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 5/10/2021 DEPTH FEET OG SOILS 1 ORG/OL 2 3 4 SM/GM 5 6 7 8 9 10 11 12 13 14 15 16 17 BOH 18 19 20 Reading Date Gross Time Net Time Depth to Water Net Drop 5/7/21 30 min 6” 2” 30 min 6” 2” 30 min 6” 1 15/16” PERCOLATION RATE 16 (MIN / INCH) TEST RUN BEWTWEEN 4 & 5 FT PERC HOLE DIAMETER 6” PRE-SOAKED PRIOR TO TEST & ALL READINGS TO THE 1/16TH. GROUND WATER ENCOUNTERED: NO IF YES, AT WHAT DEPTH: NA DEPTH TO WATER AT MONITORING: DRY DATE: 5/10/21 TESTHOLE # 21-1 DATE PERFORMED: 5/3/21 SEE SITE PLAN FOR SLOPE & LOCATION COMMENTS: VERIFY GROUNDWATER MT AT TIME OF CONSTRUCTION PERFORMED FOR: JEREMY & BROOKE ALF 5/10/2021 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211128, Rebecca Carroll, 05/13/21 //�-�'�pp��l77yy—• I�/�_1 Municipality of Anchorage Development Services Department `'} t''�•� Building Safety Division On-Site Water and Wastewater Program. 4700 S. Bragaw St. P.O. Boz 196650 Anchorage. AK 995196650 Page' of 3 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: S WO-100 y5 PID Number: O CO - G 0 ) - 07 "—dethri 4 r orie f To rle5 Wastewater System: D New D Upgrade x3916 5�,„n Glen �i' qq5 ABSORPTION C FIELD Pha» LV•/ 5 1/` 9 _7 651/-;)9_7 Nu ow N Bwiaim+: O pro rrmA 0 Sha b Vwrh O Bwl Q Mw Cl QMw. LEGAL DESCRIPTION Sol RNilp rar ow+n now agMn� pax. P Ft• FI abAId sWdNran:/ 'jam 3 D+Pm Ddlom eom wlpnN pwfe: Gr" dnrxh b"*h Pipe J (�Ien Ca Ft. FI. Twwr:p Rwge- sec"M +dded+Eo« al g". fia.el L"h Ft. Fl. Well: D New ❑ Upgrade GevN.INrr r M.rowae.++' Oi+lwce DNwen e.++: Ft Ft Cb+wdcelgn(PMwe, e. Ci rar Depw: C rar w.wplm w«P"Mrwlr '. // FL FI Fill Ora+r. .we $Ire Wrw lwM' blrw o YtreLad' FL Tll%J4;-D E%C.A-J rlea PM aNN�r nbe..Land TANK CPM il. FL SEPARATION DISTANCES (8 septic ❑ Holding ❑ S.T.E.P. Other. To From Septic Tank Holding Tank PebnUPrtval Sever Line M^�'�""' , e F145_ i G c.p..ar 130DcN. We, o��ar% MNwa 1 E µ.nlaewrowlw.n+ s•+renwrw OQ f tStLatfl'on LIFT STATION�fDtLa L+r /LFawdrm 39 PwPp on4MN 'Purr Ilyh wNw N«mNN • F hCudwn da'+r �� Rwrwtr BENCH MARK LxNron w,d De Wyewr Tap of garage •Fla or /, \ENvelwm. rl eat- o;fl B oo Ff Engin tamp OF At ti r ' • ' , 17034 Eagle River Loop Road,IN { Inspections performed by: Dales: 1M S-aa qSh _ 2nd s-ro-oa DeveldpmeIt Services Department Approval T ` ROBERT C. COWAN Reviewed and by: Date: YZ/ez +�1`f•�CE-8301 � �� c;, approved .. <-- raer PERMIT N0.:WO.1o09S PACE 2 OF 3 Municipalityof Anchorage DEPARTMENT OF HEATH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 *Anchorage, Alaska 99519-6650 • Telephone: 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 5, BLOCK 3, GLEN EAGLE S/D P.I.D. NO. VS -0-601-07 — - — - — - — - — - - — - - — - — - — - — - — --� SUNNY GLEN DRIVE �F< I Z DOUBLE CLEANOUT C R�4Q7 I w (n vIL TMT ST2 NEW 1300 GALLON I w ` •• STI HDPE SEPTIC TANK r +Sri ENTIRE SYSTEM I --) SUMP_ �C ATI INSULATED TO rR� TRENCH f�cy\ A C0? 4 E,l-� FCO TBM B c C OFA/NI H R I OLD 1250 GALLON GSM• CM I SEPTIC TANK (PUMPED. CRUSHED. AND ABANDONED) I N I I I I I ----------------------------------------- 10' UTILITY EASEMENT SCALE: 1• - 40• 2 0 -------------------------------P'C LOT 6 ROBERT C. COWAN J CE -8801 1`L .. I PERMIT NO. S W O a.0041S' PAGE 3 OF 3 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 5, BLOCK 3, GLEN EAGLE S/D P.I.D. N0. 0 SO - (30/ - 0 y ST 1 ST2 ,---102.0' FINAL GRADE NEW 96 8'1300 GALLON POLYETHYLENE SEPTIC TANK 2" INSULATION 96.5' N. T. S. A B C FCO 1 25.5 - 19.0 ST1 4 2. 0' —1. D - ST2 45.5 54.0 - DBL1 48.0 56.5 - DBL2 49.0 57.5 - TMT 49.5 59.0 - MT1 76.5 70.5 - 2" INSULATION 96.5' N. T. S. MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & 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: SW020095 Legal Description: GLEN EAGLE BLK 3 LT 5 Design Engineer: 0003 S & S Engineering Owner Name: JOHN & JANET TOENES Owner Address: 23916 SUNNY GLEN DRIVE EAGLE RIVER. AK 99577-9654 55/s/o z (, :5o pM Date Issued: May 07, 2002 Expiration Date: May 07, 2003 Parcel ID: 050-601-07 Site Address: 023916 SUNNY GLEN DR Lot Size: 46690 SO. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of. ❑ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ 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. S/9/02 EN6/A/er/z CaccEp Ati4 1s A+o✓iN4 SEPric Tf3ivI1 ro NE OPPOSITE SIDE OF 7HE DRIVE WAY TKE.v DESIGA/ SAiawS, PR Received By: Issued Issued By: Date: J% 7 /0 7 - �""". Y' —/�� Date: ! 7 G Z Municipality of Anchorage Development Services Department Building Safely Division On -Site Water and Wastewater Program 4700 South Bragaw Sl. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.sk.us (907) 343-7904 ON-SITE SEWERMELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. OTO — 601— 0 % Permit Number SW02007F Property owners) 1 o h n 9)J (I n t± TO e d e S Day phone & S'/- A 9 7 i Mailing address (1) e? 3 9 / (o S . a ay e'r le n IZ) r Mailing address (2) F_ O 1,9 'RQ r K Zip Code 9 q:5 7 Legal description (Lot, Block & Sub'd.) IL Legal description (Section, Township & Range) Lot Size 'TDrJ Acre Sq.Ft. 4 60 6 Y THIS APPLICATION IS FOR: Number of Bedrooms Ll Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ certify that the above information is correct. 1 further certify that this application Is being made for a Single Family Dwelling and Is in accordance with applicable Municipal Codes. / S i 5 ENGINEERING � 17054 Eapla Rlrar Loop Road No. 404 (Signature of property owner or authorized agent) Permit Fees: J"/ 0 0 • Waiver Fees: Date of Payment: _V-/-7 /a 2 Date of Payment: Receipt Number: 0 1 9 7 6 3 Receipt Number: (Rev. 12/00) TEALTHAUTHMN APPROWLS SEWERLWATER MAMEXTENSIM SEWERS WATER NSPECNON ENGINEERPLOSTUDIES ANDREPORTS WELL PSPECTION S PLOW TEST SITE PIANS SOIL TEST PERCOLATION TEST STRUCTURALS McKwICAL rSPECTIONS ENSUE WASTEWATER DMPOMSYSTEM OESN:N ROBERT C. COWAN, P.E. CMLENOINEMS (907)694-2979 FAX(907)694-1211 May 6, 2002 MUNICIPALITY OF ANCHORAGE Development Services Department P.O. Box 196650 Anchorage, AK 99519 REFERENCE: Lot 5, Block 3, Glenn Eagle Subdivision It is requested that you issue a permit to replace the septic tank serving the existing four bedroom dwelling on the referenced property. Per our investigation, we believe the septic discharge line has broken between the house and the septic tank. It appears that a portion of all septage from the house is being lost from the line, to the soils under the garage concrete slab. In addition to being an obvious health risk, it is undermining the structural integrity of the house. Our investigation also reveals that the septic tank has failed and so is acting as a source of contamination within its immediate vicinity. Because of these failures, the concerned family currently cannot use the household facilities. We do not anticipate any adverse effects on neighboring wells, septic systems, reserve areas or drainage patterns by the installation of the proposed septic tank. The installation of this septic tank will not prevent any future development on any of the adjacent properties. If you require additional information, please contact us. Sincerely,? ,IW Obert C. Cowan, P.E. RCC/bjj Enclosure 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER ALASKA 99577 1" = 40' DESIGN SITE -PLAN IIs' I I I xis Aga I I �z� mtl! m..am al CY'Y, I VV>Z mt0 I I I ♦tltlA W �p o i u I O t...III^nnn1 1 b I I I � I I I I I rn- I m 0 I IF '—` v 1` I I L. I x Ao >. 2 i I I $ o Z " I I I — 1^ z U 0o sn % I y m Z 5 C� I f zz o .. n/ 'a� I I i` I 72 O I C) I I C. o ^ I y i r l N >w H y Zr L I s Om $ I y I DI i qun l m I z l O 7 I I r N ~ I I r I I I D o$mo N p I4`L' I O I D�A I I �KN p I m 0 TI I I I ' Dm0 I I I / DmC ti rA Z N 0 O I ---J L-- ------------------- 15' UTILITY EASEMENT m I ' 'r pp[p 1 S& TEALTHAUDIONTY APPWNALS SEWERS WATER M WECTENSIONS SEWER&WATER INSPECTION ENGINEERRIGSTUMES ANDREPORTS WELL INSPECTION SFLOWTEST SRE PIANS SCILTEST PERCOLATION TEST STRUCTUML S MCRAI AL INSPECTIONS ONSITE WASTEWATER DISPOSALSYSTEM DESIGN ROBERT C. COWAN P.E. CMLENGINEERS (907)694-2979 FAX(907)694-1211 ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS REFERENCE: Lot 5, Block 3, Glenn Eagle S/D May 6, 2002 GENERAL: 1. The scope of this project includes the installation of a new 1300 gallon HDPE septic tank to serve the existing four bedroom residence located on the referenced property. 2. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The contractor shall be responsible for obtaining any necessary underground utility locates. 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: 1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 17034 NORTH EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER ALASKA 99577 Page 2 Lot S, Block 3, Glenn Eagle EN May 6, 2002 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 4. Septic tanks installed with less than 4 ft. of cover shall be insulated. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. MINIMUM MATERIAL SPECIFICATIONS: 1. Any septic tank proposed for installation must be constructed by a Municipal approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pike Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (IIDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam I-II or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). Page 3 Lot S, Block 3, Glenn Eagle E!D May 0, 2002 INSPECTION'S: Typically there will be a minimum of two (2) inspections required during the installation of the septic tank. These inspections will occur as follows: The first inspection must be conducted after the septic tank is set in place, but may not be backfilled until after this inspection. 2. The final inspection is to occur upon final grading of the property. The inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre -construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owmer shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER t -W DRILLING, INC. ., a DRILLING LOG Well Owner Use of Well Location (address of: Township, Range, Section, if known; or distance main road Size of casing Depth of Hole —feet Cased to feet Static water level 16 0 t. (above) (below) land surface. Finish of well (check one) open end Screen Perforated ( ,,, r Describe screen or perforation Well pumping test at gallons per (h6ur) (minute) for----L---hours with ft. of drawdown from static level. Date of completion WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness TO TO TO .TO ME, —TO - -TO TO TO TO TO NWNVA Certified Contractor Certificate No's. 814 & 973 2 - STATE 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 <T NEW L 1PHOnNE O h l ones p( / -I J E I UPGRADE MAILING ADDRESS - --------- - - - -- - _ - - - - - -- -1 1 4 N . �I - -- --- -- - LEGAL DESCRIPTION 1- 5 ISS SCA_ 1 �l S I O V � G �c��l � ---- LOCATION . ---- -_ — - _--- -- NO. OF BEDROOM J` l U Well Absorption area DISTANCE TO: �' ' f D elling P� 0 s�cl PERM IuV O� I Y P Z N F Manufa/�u�rer �/ � l7 , f f Ma r No. of comp�ts __LF Width Liu, ca acit in adons IF HOMEMADE: Inside length Liquid depth D Y DISTANCE TO: Well Dwelling PERMIT NO. _jU Z 2-F Manufacturer Material Liquid capacity in gallons D m= DISTANCE TO: WeilFo da ion S ep Nearest lot line -f- PERMIT 7 n Q 3 r J LL Z H ? w No. of lines Le�Cn th of each e Total len th of mr. st Trench �^jl dip J inches Distance betwee y�nes _ Material benea h tile. -_ -{/-g Total effe tive I'Drption area Top of the to finish grade p � inches 0 Length Width Depth PERMIT NO. w Type of crib Crib diameter Crib depth Total effective absorption area a a w W Well Building foundation Nearest lot line DISTANCE TO: U Class Depth Driller Distance oVt lin PERMIT NOr n 0137 137 _ DISTANCE TO: Building faoundatipn Sewer line' Septic tank 1 1 Q r Absorption area(s) OTHER — PIPE MATERIALS . - SOI L TEST RATING ri S I - -- - N/ INSTALLER 67) Whe-t� g -� REMARKS ED r D. C I'Asv6re er- l I i APPRO ED DA{"-TE LEGAL 'n nia ID.1/vr-rot 1 1 M11 4a ullv,S I :� 1, .11 i 1 !.l 1 , I 1 -1 F-,: r 4•:-: 1: c1 r, 1 :: : -1 1 IL r J. 1: -1 11 1 1 N Q p 1 , I it 11 f 1 1. 1 pit 1-1 Up An 1 1 of 1L 1 1 F 10 114 rd I1 I14 Nu 14 Wo F'11 I L.IFi r" F q1 PITI, K - r 60 1 N j11 F J 11:.: 1 I1I 1, 11 i !I 11[: 1 :1 1 1 lil-I j! F1 -Ii: 1 1: Ila 114 '.1 1 1 1, : E 1 1-1 1 1-1 1 1: H;! 1 f,?F,rd( F (', ; I I I :-i -1 - R; m I to I pli RI r)FT,j I i ij 1;(?( '1 1 rqF FF4 ul -F; 11 11 1 1 , ::!1 1 1 1 ir'l 1 11 1 1 IF !:� : :! I- !.::I'.'1 11 1(ard I I-1 != E 1: , 'a': . :1 '11111.- V a � : 11 1 0 [ ;h 0. 07, 0 U II,...._ I !NO 01 f! r4 hl!:1_ j A AI . j Fy 1 041 1 1 1 1 1 , 1. q 11-10 1 IF NFL L. M 11 1 Q 1-001 , 1; , !I V, p -. 111. N 55 1 - " 12 A - 1. WT n T% A " - VIVO j 114' 1 -,N 110 1 1 I.1 dhil.T V KFT Q I I I fl',! 1:.:11' 11 !='I 'It - 1: 1 !-i1.,' ;.,' I L. I_ I: 11-1 1 1 -QJ ;y:" K I? TWT I ....11_ F - n -: F - T f? I= Y7L 17 - W 1 71 0 1 y W " I A ri , A , 1:�: .! Of January 4, 1978 Brad Dickey Star Route Box 1613 Eagle River, Alaska 99577 Subject: Lot 5 Block 3 Glen Eagle Subdivision Permit #77787 A permit issued by this department for well and/or sewer system has expired. Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal ordinance. If you have drilled the well, a well log should be sent to this department to document the installation date. If there are any further questions, please contact this office at 264-4720. Sincerely, Health and Environmental Protection Sewer and [nater Section H W, A ;; II H H x H 0 A 0 1 4 1 H I a F it 4 0" 4 1' 1--n11 q0 - P pa 11 I 'I Ilk! I HI t 4 1 1 II::.1-11 1 H 1-1111:. I- ITY, 1 k'14-11,11 1'.1 1 1 11 l I I IN I I VIA I I­1r4I..:F1I.,IF­,I 111t 1 11 l::$I 0 - 0 0 H 0 N . 1 0114 0 .1. 0 11.7: 1 N--11 0 1 - '11 ::.1 0.4 .4 I fr-i I 15011) 11 1 1. 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I -., I I ::: -.1- . : I- '.:- -11 0 Ft E GEC.. ECHNI CAL Et DEVELJPMENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster Earl Ellis 694-2774 SOIL LOG 688-2280 Soils 6 Foundations Land Development Performed for: Name: �'ji�'��/' %� �� Y Tel. No. Mailing Address: S- /'. 60)(/ 9�/ , F/l�cr_ J<'l�'r--C,-7 7 Legal Description: -� '' , f,'t c A/ t_- 1'J�, Death (feet) Soil Characteristics 0 ., 1 2 3 e-, 11 U 5 6 -- Al 8 9 t 10 11 12 13 14 15 16 Al 0 Ground Water Encountered: Yes No '-- If yes, what depth Proposed Installation: Seepage Pit Drain Field Comments: _ Performed by: / L %L i'( Date: `% ' 7; %. MUMCIPALITY OF Development Services Department On -Site Water & Wastewater Section S ANCHORAGE Phone: 907-343-7904 Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 050-601-07 Expiration Date: 1. GENERAL INFORMATION Complete legal description GLEN EAGLE BLOCK 3, LOT 5 Location (site address) 23916 SUNNY GLEN DRIVE, EAGLE RIVER, AK 99577 Current property owner(s) JEREMY & BROOKE ALF Mailing address Real estate agent Day phone 23916 SUNNY GLEN DRIVE, EAGLE RIVER, AK 99577 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or. Duplex) 3. NUMBER OF BEDROOMS: 4 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ® Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ Q +' 1 b3 (2, MH) Date of Payment 54 a 1 Receipt Number S-/ y 2 51 s �-°1 COSA # (3,S C a I i a'I I 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY, ANCHORAGE, AK 99516 Engineer's Printed Name CURTIS HUFFMAN, PE Date 5/22/2021 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to `+ JQ k l these various and dynamic characteristics and are outside the control of the evaluator of the r t well and septic system. Therefore, any estimate of how long a system will function satisfactory /�rg�Q: • • • . '1•,9 ��� for current or future occupants or guarantee that no unseen encroachments, deficiencies or J discrepancies exist can be given by First Water Consulting & FTH WE ' * . ....•:* r WE � . 6. DSD SIGNATURE % Curtis Huffman 1 System #1 Approved for bedrooms �r��F��s••• CE 128991 .��p �l 5S HP�'ti� System #2 Approved for bedrooms ,1� PROFSSO \\\` Disapproved Conditional approval for bedrooms, with the following stipulations: `�lllll(l((rrrrr��( N -SITE �� r T �<WgST_:V, ND ^ r ME pG�'AM Jo -o C\o= 1V. Original Certificate Date: SS- 27— 2 The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other Legal Description: GLEN EAGLE BLOCK 3 LOT 5 Parcel ID: 050-601-07 If more than 1 septic system on lot: COSA Checklist # —of _ Structure served by this system A. WELL DATA ® Well log is filed with Onsite (or attached) Date drilled 4/12/1978 Total depth 160 ft Cased to 101 ft ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 4/29/2021 Static water level at beginning of test 73 ft. Well production at time of test 3.8 gpm Comments B. TANK DATA Age of tank(s) 19 years Tank type/material SEPTIC / PLASTIC Measured operating fluid level in septic tank 47" ® Standpipes/foundation cleanout per record drawing Date of pumping 4/29/2021 D. ABSORPTION FIELD DATA Which system tested (date installed) NEW SYSTEM ® ALL standpipes present per record drawing Total measured depth from grade 12.1 ft (max) Measured depth to pipe invert from grade 4.1 ft (min) ❑ N/A – pressurized field ® Monitor tubes go to bottom of effective. If not, state depth into effective Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ® No ® Coliform bacteria is Negative Nitrate _mg/L ® Nitrate less than MRL (ND) Arsenic _ ug/L ® Arsenic less than MRL (ND) [F�W�'t�'S� Collected by �- Date of Sample 4/29/2021 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date NEW SYSTEM Results 2 Pass For bedrooms Fluid depth prior to test _ in Water added gal New depth in Elapsed time min ® Code -required soil cover over field Final fluid depth in ❑ System presoaked Absorption rate gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N date of test) If yes, enter date Gallons introduced gallons Comments/Deficiencies: FW�� E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ® Yes if No Community Sewer Manhole/Cleanout > 100' ® Yes if No ft ® Yes if No Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' ® Yes if No ® Yes if No ft ft If septic tank is under driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ® Yes if No ft ® Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Surface Water > 100' ® Yes if No Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: ® Yes Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Water Service Line > 10' ® Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ® Yes if No ft If absorption field is under driveway comment below Property Line > 10' ® Yes if No _ ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells > 100' ® Yes if No ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION I certify that / have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. .� . TM • ......... . .. . . . . . . . .� . • �.. Curtis Huffman •: 4 v FO 91.������® i ��� pROFESSIONP .ANAW ft ft ft ft ft ft ft ft 0 - 0 0 O Lot 4 O Z 9` F OP%G Lot 5 46,690 S.F. PIPES 0 o \ 8.1'x8.1' SHED � I PROTECTIVE RADIUS ` � WELL 0 2' CANT O / 84.8' N 11.5'x18.0' COVERED PEN \ 8.4'x26.4' DECK '. 4.3'x7.5' v' PORCH 10' UTILITY & 2.0'x42.2' CANT � �_ DRAINAGE EASEMENT 16.2'x12.2' SHED WEST 274.76' (COMPUTED & RECORD PLAT No. 75-56) — — 275.00' (RECORD PLAT 73-85) — Lot % 10' UTILITY EASEMENT Lot 6 I � I m / O / O Lot 5C 15' UTILITY & DRAINAGE EASEMENT MORTGAGE SURVEY _X_ SCALE –J –= 50'– GRID – SW 0160Project No. 21_ 331LA1 ____ 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associates, i n c e (907) 522-6476 Phone (907) 522-4625 Fax �Qo�oo0O��4 Professional Land Surveyors ken®iangsurvey.com v OF A �p jonathan®langsurvey.com 4' '' oP' �. I hereby certify that I have surveyed the following described property:*% -7 LOT 5, BLOCK 3, GLEN EAGLE SUBDIVISION (PLAT No. 73-85) 4'Y(/) 49TH* Q� Anchorage Recording District, Alaska, and that this Mortgage Location Survey is a"""""' """ representation of the conditions that were found on the date the survey was performed. Q This survey does not constitute a boundary survey and is subject to any inaccuracies Q that a subsequent boundary survey may disclose. The information contained hereon shall � &;00 KENNETH KENNE194 TH LA ., Cv not be used to establish any fence, structure, or other improvements. ��L�-'iC�i� 44FA�' LS -5202..• Dated this the � 1_ Day of----?`�Li,"1 -------- '�_Y'4 1 _, -at Anchorage, Alaska Q � ,o . • 0 0 40�ROFFSSIONN- \Y It is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. AECC963 1y♦s y �I I►S 61 a P uy N • '� Municipality of Anchor e On -Site Water and Wastewater Progra AUG 2 5 2016 (907)343-7904 Certificate of On -Site Systems Parcel I.D. 050-601-07 1. GENERAL INFORMATION Expiration Date: / 2 -2 c1 Complete legal description Glen Eagle, Block 3, Lot 5 Location (site address) 23916 Sunny Glen Drive Current Property owner(s) Janet G TOeneS Day phone Mailing address 23916 Sunny Glen Dr, Real Estate Agent 2. TYPE OF DWELLING: Q Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS:. 4 4. TYPE OF WATEReUPPLY: Individual Well Individual Water Storage _ Community Class Well Public Water System WaiverNariance request for: Received by: COSA to be released to the engineer, unless COSA Fee $ 5210 Date of Payment $�� Receipt Number Q-g-lggc, COSA# 05clW 3&3 le River, AK 99577 Day phone TYPE OF WASTEWATER DISPOSAL: 1] Individual 0 ❑ Holding Tank ❑ ❑ Community ❑ ❑ Public Sewer ❑ Date: requested by the engineer. Waiver Fee $ _ Date of Payment Receipt Number. Waiver # +� IN 5. STATEMENT OF INSPECTION BY'�EI�GaER As certified by my seal affi ed hereto and as of the valid dated own below, I verify that my investigation, based on procedures outlined in the Certificate of On Approval Guide as fort s application, shows that the on-site water supply and/or wastewater disposal system is (are) sa I and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all welts and septic systems depend6hthe local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty for future performance, -nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone 6. DSD SIGNATURE System #1 -Approved for _V__ bedrooms System #2 Approved for bedrooms Disapproved Date 8/24/2016 S1i:veri.' a (fig CE 81491 tit' ....`� Conditional approval for bedrooms, with the following stipulations: Original Certificate Date: `l "Z-0 /F The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Septic System Advisory Well Flow Advisory COSAhluesheetf :. c Nitrate A vi g,ory Arsenic A vlsory Other If more than 1 septic system is on the lot: COSA Checklist # —'of i Structure served by this system Certificate of On -Site Systems Approval Checklist. Legal Description: Glen Eagle, Block 3; Lot 5 Parcel ID: 050-601-07 A. WELL DATA Well type Private If A, B, or C provide PWSID # Well Log (Y/N) Y Date completed 4/12/78 Sanitary seal (Y/N) Y Wires properly protected (YIN) Y Total depth 160, ft. Cased to 100'7 ft. Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 4/12!78 6/23116 Static water level 100 ft 79' ft. Well production 4 g,p,m, 3.54 g.p.m. WATER SAMPLE RESULTS: Coliform Neg colonies/100 mL Nitrate 0.219 mg/L Arsenic ND ug/L Date of sample: 8/4/2016 Collected by: PES B. SEPTIC/HOLDING TANK DATA r Tank Type/Material Septic/5te4 lL P f 0.5 i Date installed 5/10/2002 Tank size 1,300 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (YIN)N High water alarm (Y/N) N / Date of l O It%. Pumper SYLS 1� y� 'I pumping _ C. ABSORPTION FIELD DATA Date installed 4/28/1978 Soil rating (g.p.d./ftp or ft2/bdrm) 175 sf/bdrm System type Deep Trench Length 74 ft. Width 3 ft. Gravel below pipe 5 ft. v` Total depth ft, - - Eff. absorption area 740 ftp Monitoring tube Y Depression over field N— 6/23/2018 Date of adequacy test - 5 esults (Pass/Fail) Pass 4 For _ bedrooms S /Fluid depth in absorption field before test 34 m. Water added 629 gal. New depth 41 N in. ' SH Elapsed Time: 770 mins Final fluid depth 34/a in. Absorption rate >= 600+' - g.p.d. No Any rejuvenation treatment (past 12 mo.) (YIN & type) If yes, give date D. LIFT STATION Date installed "Pump on" level at Datum Size in gallons _ in. "Pump off' level at Cycles tested E. SEPARA'f N DISTANCES WELL ON LOT TO: Septic tankflift station on lot 100+ Absorption Feld on lot 100+ Public sewer main 75+ Sewer /septic service -line 25+ Animal containment areas 50+ SEPTIC/HOLDING TANK ON LOT TO: Manhole/Access (Y/N) in. High water alarm level at . in. Meets alarm & circuit requirements? On adjacent lots 100+ On adjacent lots 100+ Public sewer manhole/pleanout 100+ Holding tank 100+ Manure/animal excrete storage areas 100+ Building foundation 5+ Property line 5+ Absorption field 5+ Water main 10+, Water service line 10+ Surface water 100+ Wells on adjacent lots 1001 ABSORPTION FIELD ON LOT TA=< Property line 10+ Building foundation 10+ Water main 10+ Water Service line 10+ Surface water 100+ 'Driveway, parking/vehicle storage 10+ Curtain drain. 50+ Wells on adjacent lots 100+ F. COMMENTS *Bottom of monitor tube had 4" Of Sludge. ` c� 5 �G110 S u 2 X r?e s Z/5" � ,4- -6c)" 0,6 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 COSAguidelines in effect on this date. Engineers Printed Name Steven Pannone Date 8124/2016 COSA canary sheet_2-6-15.doe 41re,-r-7 e>, -Z /6 - ASBUILT SEWARD S I HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE' FOLLOWING DESCRIBED PROPERTY: 6tev.r�6'.r✓�zGors.Q;'a ANO THAT NO ENLIt'04CHMETITS EXIST EXCEPT AS DATE• B/�s INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EOSTENCE OF ANY GRID-�/6Q EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB: �Q y/ ANY DATA HEREON BE USED FOR`CONSTRUCTION OFFENCE LINES, OR FOR EMABLISHING BOUND- 0 , ARY LINES. 0