HomeMy WebLinkAboutMOON LT 35AMoon
Lot 3§A
#018-182 - 27
Municipality of Anchorage
On -Site Water and Wastewater Program • (907) 343-7904 Pager of.
ON-SITE WASTEWATER INSPECTION DEC. '
"REPORT
Permit Number: bSP (K! $1 � PID Number: ON -`*-2 "O &
Dwelling: 4 Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New ❑ Upgrade
Name:
ABSORPTION FIELD
❑ Deep Trench 23 -Shallow Trench ❑ Bed ❑ Mound
Address
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
4
/12— GPD/SF
4r D Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
--• O Ft.
Gravel depth beneath pipe
Z rp Ft.
Subdivision Block Lot
AA(gtl✓t
Fill added above original grade I
. 0 Ft.
Gravel length
70 Ft.
PO4Cu ;��)
Township' Range Section
( !``� 3 I.t.i _Z_ 3
Gravel width -
S. O Ft.
Beds: Number of Lines
,8--
Distance between lines
I Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Tank
Line
Ft'
Ft.
Well
1170 pit-
Ivo 4
�t.4
Ttjr�_
TANK Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer /. +. Capacity
r t4 40t,- / 2 5-� Gal.
Surface Water
(tl 3� 1-
(VB t �
Material
--7L
Number of compartments
Z�_
Lot Line
Z p' �.
2 D,4-
NA
Foundationf�(F
ZJf�
LIFT STATION
Manufacturer
Capacity
Gal.
Curtain Drain
IJ
/
T•
Remarks
Pump on level at
n.
Pump off lea
in.
High water alarm at
in.
Pump mak model
Electrical Inspections performed by
PIPE MATERIAL Housetotank Tank to
F1, drainfield 3 V
Installer
N(1 ��-/L`,J�✓1. a..c Y'(.G✓�
Drainfield "%113L( CO/MT JI)JF
Inspector J�Aj%-e- 4A (4eV40 n PC�r
BENCHMARK (Assumed elevation) /Lr)3 ft
Inspectionq��
dates: 1 J-1 2"" 'L
Location and description
Vu.N u �VY F/C'J
li ±•tu r
3id 4h
ELOP TEPACOMMUNITYVTMENTAPPROVAL
®FA(4'k`••.
Conditional ApprovDate 1.2 (
y.~,�p�0'•,.�
�,4�91H•
' -A 50e;O
•• .... /g
l
i
...........
` ...............
�. MICHAEL N. ANDERSON:0 Ga
•
Cf,, 94¢9 o
Approved , 5�� Date2-3-'tp
Inspection R rt_9-1-12.doc
Permit No. OSP141317
Page 2 of 2
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
EDIV�RONMENTAL SERVICES DIVISION
P.O. Box 19665 nch�, Alaska 99519-6650 Telephone: 343-4744
On—Site stewater Disposer m an /or Well Inspection Report
Propofol MCI
Legal Description: T1 N, R3W, SEC 33, LOT 35A PID No.: 018-182-06
MARK
A
I \B
FCO
18
53 \
Col
106
TCol
11
5
TCO2
14
59 \
CO2
16
62 \
18
6
MT
25
75
C04
61
42
C05
32
84
V
I
� I
i
OLD STEZDD
BENCH, FOUNDATION /
FCO II \
A II \
Cal TI�
II \
/ I • 30 O 2/
�1
/ MT1 CO
ITHiT
TH#2 °
= 1 1 10 GAS EASEMENT PROPERTY LINE
\, 1I EDGE OF SLOPE >25%
- - - -
_ / 10 ME EASEMENT UILT
----- SCALE: 1"=50'
rao c01 TCM rc03 W4 M] cos la ..*"`x„',
o] j OF /I . � ,
f
�iXSUUtlON .0 ORC �'•. ..• un ,...�♦♦.
RN fOHRI k 1.U. 1
w x
9].8 LSM"TA W u.0 .... ..uuu... u..uu...... '.. .
iu ..
$RFl LANK xwe m[e
N$ �1 MICHAEL N. ANDERSON:
�1c No. �jE 9 69
�1 lll2f.
SEPTIC SECTION es � . t ......_,�\�
10-
11 -
la
13-
14-
15-
16-
17-
18-
19-
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Elmore Road
P.O. Box 196650 Anchorage, AK 99507
www.ci.anchoraqe.ak.us
(907)343-7 904
Soils Log - Percolation Test
O=e`For: `LalJ A-VfrA «µ t9✓1. Date
4 1
0s4�.
C'7 A,
W( '*Ovl k
(2�v 9V j�-
a0 XPi,
Township, Range, Section:
WAS GROUND WATER `, L
ENCOUNTERED?
S
IF YES, AT WHAT DEPTH? FZ L0
Depth to Water Aftert P
Monitoring? to E
Date:? y >y
-d
e••
e � i'i
r49TH
�....
e.a. ae?1
0 MICHAEL N. ANDERSON ; ct
i •, CE- 9469
✓J .
>
fir®
PERCOLATION RATE C- (mintesAnch) PERC HOLE DIAMETER to
PERFORMED BY: m/ -4A I CERTIFY THAT THIS TEST AS
PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: / .2 IF f Af
FEB -3-2016 02:14P FRLlpli
TtO:343799- P.212
1"tb rDrl'On1gr Inc.
STATE OF ALASKA
DEPARTMENT OF NATURAL RESOURCES
DI VISION OF MINING, LAND & WATER
1.'7t't Weff Drill%i�3 and -Pimp Senwi
WATER WELLLOC
j(tt.hOr'rttfi, 'Ala Jta 0,17) ?45 -OSA,
Drilling Staned:09_/mala Completed: .Qg/_a1 4-
City/Borough: Subdivision: BLOCK
LOT
Propeny Owner None& Address: CourtneylYMoon
3940 E. 142nd Ave
nchorage
35
Anchorage, AK 99516
Meridian __Township - 12N lunge 311W4 ,_ Seciion 33 __ t/4 of �/4 of _—%4 of _ _ V4
BOREHOLE DATA{from top of easingpepth
Drilling method: { X) Air rotary, ( ) Cable tail, Other
Material; Type, Calor & wetness ( From To
Weil use: ( ) public supp Y. i (X) Domestic, Other
stickup
0
2
Depth of hole: vg00ft, Casing stickup: _ 2 _.fT
Casingrypc:Sliel _ Thickness: .250 inches
Casing diameter: 6 inches Casing depth: 100 ft
overburden
2
5
Liner type: DiaTrtcter:-____inches Depth. III
Stnrc water (from top of casing): 61 ft on 09 / 03 12014
slit & gravel
5
ao
Pumping level & yield: — feet after _— hours at — gpm
Recovery rate: __. 2j_ gpm, Method of testing: airlift _
moist gravel
So
90
,Development method: _-airlift Duration: R tqurh®u
gravel w/ H2O
90
95
Well intake opening type: ( x) Open and, ( ) Open hole, Other
Screened: Start: ft, Stopped. ft
1 Screen type: ______ SloT/mesh Sim .
coarse gravel w/ H2O
95
100
Performed; Stan: _ ft, Stopped: � R
Start: _ R, Stopped: _ ft
Note: ........... ..._...................................................................................
Grout type: ;Iant011it8 _ volume—=—
Depth; from rou SGrfacB , to
Pump intake depth: _ ft
Pump size: hp, Brand name:
Was well disinfected upon completion? (X) Yes, { ; No
,
Method of disintection:.Calritiii—H.y... chtrita.ioblorine)...
Driller comments/ disclaimers: ............................................................
ri0 a
..................-......... .......
...................................................._
............................................................................................................
..
ASC �i {
Well drillernamC...JohnnY......... ...... ....... ................... I ....... .......... ....
Company name: ...HAffy!,DfI,II10&,.!nc.....................................
Mailing address:... ( f\kUia �G ............
_
city:. Anchorage _ -- steno: nx zip 995f 6
Phone number . ( 907 ) 345��59 faX:3454700
Alaska stare leu• requires that a copy of this wall log be sem to the
Depanoent orNatoml 11murces within 45 days; faxes are
MeLighle. (.AK statutcs 38.D5.02f:. 38.4)5.035. 41.08.020,
46.15,020 and .AK regulations 1 I AAC 93.(401.
DNR/ Division of Mining. Land and Nater,
350 W 7th Avenue. Suite 1020
Anchorage, AK )9501- 3562
Pbonc (907)2(9-8619 and tax (9071269-8947
Within the City of Anclto Cit is required that a copy of the well log be
sent to the appropriate city }Vice within 60 days and that another copy of
the well log be sent to the wclroperty owner within 30 days.
Permit Number: O5P141317 �
Date of Issue: AqJLr3k?20x,__
Parcel identification Number: _ __-
Is well located a4 epproved permit locinion? ( X) Yes or ( )N0
PPR -27-2015 11:52P FROM:
TO:3437997
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Elmore Road
P.O. Box 196650
Mark Beglch Anchorage, AK 99507
Mayor wratim uni.o rg onsite
(907)343.7904
Pump Installation Log
Well Drilling Permit Number:''3W' 051)1q 17
Parcel Identification Number:
Date of Issue:
Ivry
P.1/1
Legal Description L-,4 JS
T
/Wt/ R3►✓ ti?
Pump In
Ration Date: q l - 7 _ 15
Property Owner Name & Address:
Coctrkneti fl'b°n
Moo r; wi d Are
.e cf,",
Pump Intake Depth Below Top of Well Casing: jet feet
Pump Manufacturer's Name: (r v"a� 4 5
Pump Model: /Q 5 wt.- U7 - _200
Pump Size fr1 hp
?Riess Adapter Burial Depth: /ti feet Q
Pitless Adapter Manufacturer's Name: C owl itNa VS' to
Pitless Adapter installer: Artetcrrya v•I
Well Disinfected Upon Completion? 'n` Yes No
Method of Disinfection:
Comments:
Pump Installer Name:
Attention: The pump installer shail provide a pump installation log to the DSD within 30 days of pump installation,
Permit Number:
Tax Code Number:
On -Site Water & Wastewater System Permit
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
OSP141317
01818206000
Work Type: WellSeptic Initial
Permit Effective Dates: August 28, 2014 to August 28, 2015
Design Engineer: ANDERSON CONSTRUCTION & ENG'G
Subdivision: T12N R3W SEC 33
Site Legal Address: T12N R3W SEC 33 LT 35 G:3035
Owner/Address: MOON COURTNEY D & JESSE R
3940 E 142ND AVE ANCHORAGE AK 995160000
Site Mailing Address: 3940 E 142ND AVE, Anchorage
This permit is for the construction of:
Y Disposal Field Y Septic Tank N Holding Tank N Privy
Lot Size in Sq Ft: 108900
Total Bedrooms: 4
Y Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing. —.
Special Provisions:
The entire subsurface disposal field and/or alternate is not within a 30 foot radius of a percolation
test. The Engineer needs to do an additional percolation test prior to the construction of the septic
Feld. Please submit stamped and signed results with the As -built Inspection Report. If the results
require a design change, construction of the system will stop pending On -Site review and
approval. AMC 15.65.060.B.3
Received By:
Issued By:
Date:
Date: Z�
MUNICIPALITY OF ANCHORAGE
Community Development Department
Development Services Division
On-Site Water & Wastewater Program
Phone: 907-343-7904
Fax: 907-343-7997
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. ~t~¢
Property owner(s)
Mailing address
Site address
Day phone'~l~
Legal description (Sub'd., Block & Lot)
Legal description (Township, Range & Section) ~- (k/q' ~ ~{.O ~r c, ~ Lo~ ~'
Lot Size / 0o, Ou O Sq. Ft. Number of Bedrooms ~
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
([] all that apply)
Absorption Field
(w/we ADU)
Septic Tank [~ Upgrade []
Duplex (D).
Holding Tank [] Renewal ' []
, Multiple Dwellings
Private Well []
Water Storage []
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
I certify that the above information is correct. I further certify that this is in aocordance with
applicable Municipal Codes.
nau /X'
(Sig I 'e of property owner or authorized agent) L-(q LO t ~
Permit/Rush Fees: ~-G ~ ,~- ~.t~- ~ '~ ~l~ + ~ ~ 5 ~1
Date of Payment' ~d~l~",/;'~'C~-~-- ?'~-L--% Waiver Fees:
· ----"','.'r/ ' C.~_~"J,'-J~- Dare'of Payment:
Receipt Number~~ - Receipt Number:
Permit No. Plq, I;5 t"l Waiver No.
Permit App_9-1-12.doc
Michael N. Ander'son,'P.E.
Civil/Structural Engineering & Construction
4661 Natrona Avenue
Anchorage, Alaska 99516
Phone 345-3377
Fax 345-1391
Aug 7, 2014
Municipalities of Anchorage
Departments of Health and Human Services
P.O. Box 196650
Anchorage, Alaska 99519-6650
Fax 249-7847
Legal:
Proposed Moon Subdivision Lot 35A Septic
T12N, R3W, Sec 33, Lot 35&
To Whom it may concern: /'~ /~,
This is a request for a septic pen]tit on the above referenced lot. The 2.5 acres is~oeing subdivided and the
original septic in on the new ~acant lot 35A. A test hole was excavated on Lot 35g~to 16 feet revealing silty
gravel for the entire depth. The perc rate was 4 minutes per inch with water observed during excavation at
11 but after the 7 day waiting period it was measured at 1 ~.lfeet. A shallow 5 wide trench has been designed
for the primary and secondary due to the water table and the surrounding neighbors which have a water
table.
The lot slopes to the south at about 2 to 5 percent then breaks over the south shoulder to greater than 25
percent as the drawing shows. This new system will not impact any of the neighboring properties due to the
large lot sizes and good soils.
Please call me if you have a~ty questions.
Sincerely ~
Michael N. Anderson, P.E.
DESIGN CRITERIa:
4, BDRM X 150 = 600 GPD
SOILS =. 600/1,2 =,500 GPD
500 GA/5XO.7 =
70
(1) TRENCH
4.0' DEEP
2.0' EFFECTIVE
5.0' WIDE
70' LONG
(THRU1)
1.0 ~_~ ORG
14
~i,~.l~M OU N D OVER
~-GRADE
R FABRIC
_2.0_~4~ PIPE
-4,0-~ ~SEWER ROCK
SEPTIC RELD SECTION
-DEARk4OUN ROAD-
LOT?29
HOUSE
/~'COT-30..x
T12N, R3W, SEC 33
LOT 31
WELL
100' RADIUS
'' HOUSk
PROPERLY LINE
FIELD
CREEK
SETBACK
Septic Design Prepared for
COURTNEY & JESSE MOON
T12N, R3W, SECTION 33, LOT 35 (PROPOSED MOON SUD. LOT35A)
Anchorage, Alaska
Michael N. Anderson, P.E.
4661 NATRONA AVE
ANCHORAGE, ALASKA 99516
(907) 345-3377 / FAX: (907) 345-1391
DATE: 8/5/2014
DRAWN: D JR
SCALE: 1"=300'
j
· ~ ~ \1 /-PROPERLY LINE
/ I
~ ~ ~ I DECOMMISSIONED T~ ~
~ I k', ' PER ~E UPC '~
i~ ~ ~APPROX SLOPE 'x. ~ //
· ~ X / ~N~ 1,000 GALLON
~ ~ ~, '~ / NO~: ~DffiONAL I~ERC REQUIRED PRIOR TO CON~. SEPT~ANK
~ ....... ---- ~ PROPER~ LINE
Septic Design Prepered for
COURTNEY & JESSE MOON
Anchora~o, Alaska ~ ............ x .....
...............
ANCHO~GE,4661 NATRONA AVEAm~ 99516 DRAWN: D JR
(907) 345-3377/F~: (907) 345-1391 SCALE: 1"=50'
4-
5-
6-
7-
8-
9-
10-
11-
13-
15-
17-
18-
19-
20-i__
Pen~ormed For:
COMMENTS
u v'¢-1 .
Municipality of Anchorag,e .
Development Services Depar[ment
Building Safety Division
· P.O. Box 196650 Anchorage, AK 99507 .,, ~,.
~.cLanchoraqe.ak.us
(907) 343-7904
Soils Log- Percolation Test I '1[~'-. .......
Date PeRormed:
~3~ ¢~ ~ ~+~ Township, Range, Se~ion:
WAS GROUND WATER
ENCOUNTERED? ~/~ ~
S
IFYES, ATWHATDEPTH? ~ L
Depth to Water After pc)
Monitoring? ~ E
Reading Date Gross Time Net Time Depth to Water Net Drop
PERCOLATION RATE ~' (minutes~nch) PERC HOLE DIAMETER
TEST RUN BETWEEN '7...-- FT AND "~ FT
PERFORMED BY: I\~./~ I CERTIFY THAT THIS TES~-~/AS/
PERFOR~,D ~ ACCORDANCE W~T, A~, STATE A,D ~U,~O~PAL GUiDeLinES ~N EF~EC~ O, T~S DATE. DAT~: ~',/?//¥
MUNICIPALITY OF ANCHORAGE
��
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section �'^ Fax: 907-343-7997
Parcel 1. D. 018-182-27
Certificate of On -Site Systems Approval
Expiration Date: O N 3 0 '� G 19
1. GENERAL INFORMATION
Complete legal description MOON LT 35A
Location (site address) 3910 E 142ND AVE, ANCH AK
Current property owner(s) COURTNEY MOON Day phone
3U d — �S_32
Mailing address SAME
Real estate agent Day phone
2. TYPE OF DWELLING:
Fx_1 Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
12
,56�
3. NUMBER OF BEDROOMS: 4 o
4. TYPE OF WATER SUPPLY: TYPE OF STEZ4F
P N L:
Private Well 0 Private
LxY0,9
otic
Water Storage ❑ Holding rd
❑ a
Community Well ❑ Community ge 9 5
Z
Public Water System ❑ Public Sewer
Waiver request for: Distance:
Received by: 4 Date: V1714b
it
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ Eso. D0 Waiver Fee $
Date of Payment CGf i 9 Date Payment
of
Receipt Number Receipt Number
/
COSA # C)SC 19131 W 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 MIKE N ANDERSON, P.E. Phone 727-8864
Address 4661 NATRONA AVE ANCH AK
Engineer's Printed Name MIKE N ANDERSON, P.E. Date 8-23-19
OF Al Xj
49TH
6. DSD SIGNATURE d.......
J4 (ij° e. •o • o... °.......•
System #1 Approved for bedrooms 0� �^ o MICHAEL N. ANDERSON ; id
System #2 Approved for bedrooms CE- 469
Disapproved�4p 'y�/.1.�''��ti�
p''OfSiC
Conditional approval for bedrooms, with the following stipulatidt���a����
By: a4r_a'vz,0,# Ori9 inal Certificate Date:
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the
representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is
not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA Checklist blue sheet
COSA Checklist
Legal Description: MOON LT 35A Parcel ID: 018-182-27
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 913/14
Total depth 100 ft
Cased to 100 ft
All Sanitary seal is functioning correctly
❑ Wires are properly protected
Casing height (above ground) 24+ in.
Date of flow test for COSA 4/15/19
Static water level at beginning of test 68 ft.
Comments
B. TANK DATA
Age of tank(s) 2014 years
Tank type/material STEEL
Measured operating fluid level in septic tank 48
❑ Standpipes/foundation cleanout per record drawing
Date of pumping 8/12/19
D. ABSORPTION FIELD DATA
Which system tested (date installed) 9/2/14
9 ALL standpipes present per record drawing
Total measured depth from grade 6.5 ft (max)
Measured depth to pipe invert from grade 2-5 it (min)
❑ N/A — pressurized field
❑ Monitor tubes go to bottom of effective. If not, state
depth into effective
Well production at time of test 5+ gpm
Water storage tank volume 0 gallons
Well disinfected for coliform test? ❑ Yes ❑ No
❑® Coliform bacteria is Negative
Nitrate 0.405 mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L V Arsenic less than MRL (ND)
Collected by MNA
Date of Sample 8/15/19
C. LIFT STATION
❑ Required maintenance completed
Age of lift station years
Lift station material
Comments:
Adequacy test date 8-16-19
Results F/ Pass For 4 bedrooms
Fluid depth prior to test 4 in
Water added gal(- OC,
New depth 8 in
Elapsed time 1440 min
Al Code -required soil cover over field Final fluid depth 3 in
❑ System presoaked Absorption rate 600+ gpd
(Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) UN
date of test) If yes, enter date
Gallons introduced gallons
Comments/Deficiencies:
COSA Checklist yellow sheet
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'
0
Yes
Community Sewer Manhole/Cleanout > 100'
Q✓ Yes
if No
ft
M Yes
if No ft
Neighboring Tank > 100' M Yes
if No
ft
Private Sewer/Septic Line > 25' F✓ Yes
if No ft
Absorption Field on Lot > 100' E✓ Yes
if No
ft
Holding Tank > 100' ❑✓ Yes
if No ft
Neighboring Absorption Fields > 100'
✓v Yes if No ft
Water Main > 10'
Animal Containment > 50' Yes
if No ft
R✓ Yes
if No
ft
✓] Yes if No ft
Water Service Line > 10'
M✓
Yes
if No
Manure/Animal Excreta Storage > 100'
If septic tank is under driveway comment below
Community Sewer Main > 75' E✓ Yes
if No
ft
M Yes
if No ft
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10'
0
Yes
if No
ft
Surface Water > 100'
0✓ Yes if No ft
Property Line > 5'
❑✓
Yes
if No
ft
Wells on Adjacent Lots:
Absorption Field > 5'
✓V
Yes
if No
ft
Private Wells > 100'
✓v Yes if No ft
Water Main > 10'
✓V
Yes
if No
ft
Community Wells > 200'
✓] Yes if No ft
Water Service Line > 10'
M✓
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'✓Q Yes if No ft Private Wells > 100' Yes if No
Water Service Line > 10' Yes if No ft Community Wells > 200' Yes if No
Surface Water > 100'✓Q Yes if No ft
F. ENGINEER'S COMMENTS
G. ENGINEER'S CERTIFICATION •° ,iz
I certify that I have determined through field inspections and reviewIt 9 T_?
of Municipal records that the above systems are in conformance with �
p d ... 0 0.. .Y tl D 4 @ 0 0 O B. v.
MOA COSA guidelines in effect on this date.'
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1 3035
I BFB
I AB -2015
Legal Description
Lot 35A MOON SUBDIVISION
I hereby certify that the property described
33'
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direction, and that the imiprovements are within
the property lines and do not overlap or encroach
WELL
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BOBBYR BURNETT
2941 Carriage Drive
Anchorage, Alaska 99507
` (907) 350-5541
property lying adjacent thereto encroach on the
premises in question and that there are no
roadways, transmission lines or other easements
on said property except as shown.
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/A BOBBY F. BURNETT .SSS��� /
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Date
Scale
Grid
Drawn by
Field Book
85/19/2019
1 1" = 40'
1 3035
I BFB
I AB -2015
Legal Description
Lot 35A MOON SUBDIVISION
I hereby certify that the property described
hereon has been surveyed by me, or at my
direction, and that the imiprovements are within
the property lines and do not overlap or encroach
on the property lying adjacent thereto unless
otherwise shown. That no improvements on the
BOBBYR BURNETT
2941 Carriage Drive
Anchorage, Alaska 99507
` (907) 350-5541
property lying adjacent thereto encroach on the
premises in question and that there are no
roadways, transmission lines or other easements
on said property except as shown.
.dP:1b•-6-"k\
OF AL,46"A
®*
/A BOBBY F. BURNETT .SSS��� /
r LS -5464
i