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HomeMy WebLinkAboutROSEBERRY HIGHLANDS LT 3Roseberry Highlands Lot 3 #050-315-61 Municipality of Anchorage On-Site Water and Wastewater Program • (907)343-7904 Page / of 4/ ON-SITE WASTEWATER INSPECTION REPORT Permit Number: 05P/ 7/ 2 57 PID Number:_050 3/ S 6 I Dwelling: 0Single Family(SF) ❑ Duplex(D) ❑ Multiple(SF and/or D) Project:New 0 Upgrade Name: /7//0/11.4,AtA a t ABSORPTION FIELD Address �/ ❑ Deep Trench Shallow Trench 0 Bed ❑ Mound /1T i a /fief--47T C 12- ❑ Other Phone c� p Number of Bedroo s Soil Rating Total depth from original grade 22 l" y!�� 2 GPD/SF 7 5 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pi e Subdivision C p /1 / Block Lot 0• S Ft. Ft. �c7(W5 -/'�y' /1/O"/7Le'/v[J`r 3 Fill added above original grade Gravel length Township Range Section 0- / Ft. .So Ft. • Gravel width Beds:Number of Lines Distance between lines SEPARATION DISTANCES 5 Ft. — Ft. To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist.between trenches From Tank Field Lift Station Tank Line SQQ Ft2 / Ft. Well I TANK Septic 0 S.T.E.P. 0 Holding 0 Other /Wit /4 ? + A A /VA Z54 Manufacturer anufactur ,,11 n 'Capacity Surface Water Dd /0 '. 4 Ale/'I Q/t.4 6 4A7L /2 50 Gal. AIA /t/A' Material Number of compartments Lot Line 4 l Q /1/A. X1//9 NA T 61 L 2 Foundation /0/0 m /# N,4 LIFT STATION ,41/1 AU A Manufacturer Capacity Curtain Drain SO 14" SO /* Ai A NA Gal. Remarks Pump on level at Pump off level at High water alarm at in. in. in. Pump make and model Electrical Inspections performed by PIPE MATERIAL House to tank D Tank to !�a Installer drainfield/.��� SA n1 bEA s ' 1" E/2 S Drainfield 0 3034 co/Mrn 3jjti Inspector /(/ BENCH MARK (Assumed elevation) /�D ft l�[1rt' � "IA. Inspection �/r a Location and description /� A dates: 1 2 z 2 2 ` ff /�/QQ/� U OQ/Z 3"' q /ea 4th L./!'Nb./N6 COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL EngijiaSt Stamp•: At,Conditional Approval: Date �"0 co :./.�•_••••.. ..s'f '� 4 • b j . Irevorr W. Eooc we i Approved \-- ( -' eL4 Date Z - e ,„es0 P70/FESSIO�40. Inspection Report_9-1-12.doc _ —.i - - I ^ . ./ �° R 00.01 I r f I Exi$tin j 9; W 11 / \ ) 2 1\ \ \ -,.. \ I • New 1250 Gallon i ti� Septic Tankli c02 (4c,) S; B•rM f 1 DCO rb'SA % ' jA Alternate TO A Trench ;o J U ol-E3 yL ( o p o • i } 7; t ---,. -,„, T -TRACT A 0 \\\ 8111116- ' N'\‘‘ N\ � \__\ >�A Mr+on ---4111141 \\ AS-BUILT MEASUREMENTS A B \� ST1 41 71 \�, N ST2 48 75 ' \\ � DCO 52 77 \ �� �v C 002 103 1189 1 MT 90 118 0, - 0 NORTHRIM ii,..t.r. ,,,_ ROSEBERRY HIGHLANDS 1 60ENGINEERING SteveEng.com * 9m LOT 3 RECORD PO Box 770724 LAYOUT Eagle River. Alpo 99577 � . a+� ? es� WASTEWATER RECORD 907. 694. 7028 SEPTIC SYSTEM 9/20/18 irOf f tevation = 83.5' Foundation Cleanout tevation = 79.5' Tank Cleanouts Fin ade Opposing Cleanouts Between Septic Tank & Trench 4 Foot Cover tevation = 92' or Equal Elevation = 79' • r---*-To Mid-Point of Trench 1250 Gallon Steel / 'Anchorage Tank' Solid Pipe zion = 79.1' Monitor Tube 1-/hti0r` CO Slope Final Elevation = 73.5' opp I I & Original Grade _ 30 Filter� 1111111111 i Fabric !I!II ] � Elevation = 70' ,r. 1rr -LY- 7.5' 1-1-1P Elevation = 66' 41 it kirif1_ TH @ 59.5' Both Ends '3 'Y' ' '~ " E'STest Holes Dry Monitored On 2/20/18 1.....-5.0--' NOR THRI M .•irZ4 ENGINEERING :41-•-.. TRENCH END VIEW RESEBERRY HIGHLANDS SteveEng. com #*:4sm , . *+� s . �.,.; SEPTIC TANK PROFILE LET 3 PO Box 770724 ' st... t,r Eagle River. Alaska 694.7028 99577 '•941 t.. 7 � r SEPTIC SYSTEM RECORD Dec real*: T�GA/ 9/20/18 SE 1 = 5 I 3 0f t S❑ILS LOG - PERC❑LATI❑N TEST \CRIER' M ENGINEERING Date Performed: 2/19/18 Performed For: Quinn Legal Description: Roseberry Highlands Lot 3 DEPTH (FEET) T.H. Location: See Attached Test /j% Organic 1 - ,. ,:;:, <.•.. Boring Location Map MA-t;', ,.•SAV A- , 2 - ,,+ SP Sand a': 4 - "° . . , W/ 5 - Gravel 6 - Groundwater? No 7 - Depth -- 8 - Water Depth 9 - After Monitoring. -- Date: -- 10 - # Date Gross Time Net Time Depth Net Drop 11 - 1 2/19 0 -- 6' -- 12 - 2 2/19 10 10 min. 2' 4 13 - 3 2/19 20 -- 6' -- 14 - 4 2/19 30 10 min. 2' 4' 15 - 5 2/19 30 -- 6' -- 16 - 6 _ 2/19 40 10 min. 2' 4' 17 - 7 2/19 40 -- 6" -- 18 - 8 2/19 50 10 min. 2' 4' 19 - 9 2/19 S0 -- 6' -- 20 - 10 2/19 60 10 min. 2' 4' 21 - Percolation Rate 2.5 min/in Perc Hole Diameter 6" Test Run Between 3' & 4' Comments: Performed By NorthRim Fng, I � CERTIFY THAT THIS TEST WAS Performed in Accordan e with All State/Municipal Guidelines in Effect ON THIS DATE. DATE: 7/�'cf NORTHRIM +•�'*O `� S + �� '. R❑SEBERRY HIGHLANDS TH5A ENGINEERING 'tit;'•' Mk � Cr *:4s •' SteveEng. cora -. • L❑T 3 Po Box 770724 amen .: .� Eagle River. Alaska 99577 •/air i T E S T H❑L E LOG 907.694.7028 GE❑TECHNICAL Date: GEOTECHNICAL ARCTIC PUMP & WELL INC. e Jim Sullivan V(j R PO Box 770197 � ane Eagle River,AK 99577 T. wts ) (907)688-2510 (907)243-2282 jim(darctiepump.com Pump Installation Log Well Drilling Permit Number: osp171251 Date Of Issue: 8/24/2017 Parcel Identification Number: Legal Description: Roseberry Hiland L3 Property Owner Name Address: Quinn Construction Lot: 3 PO BX 772641 Block: Eagle River AK 99577 Pump Installaion Date: 9/19/2017 Pump Intake Depth Below Top of Well Casing: 389 Feet Pump Manufacturer's Name Franklin Pump Model: 10FRD1P4-2W230 Pump Size: 1 HP Pitless Adapter Burial Depth: 9 Feet Pitless Adapter Manufacturer's Name B-10 Pitless Adapter Installer: u/k Well Disinfected Upon Completion? Yes Method of Disinfection: Chlorine Comments: Pump Installer Name: Arctic Pump &Well, Inc. Thursday,September 21.2017 °", "—""rra MUNICIPALITY OF ANCHORAGE �,,,:n f i . On-Site Water& Wastewater Program ``,� S.; PO Box 196650 4700 Elmore Road 1 Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax: (907)343-7997 '9 http://www.muni.org/onsite IVY J _�/ 1)i�l�arcmi tit 4NCNOPC' On-Site Wastewater Disposal System Permit Permit Number: OSP171251 Effective Date: 9/12/2017 Work Type: Septic Initial Expiration Date: 9/12/2018 Tax Code Number: 05031561000 Site Legal Address: ROSEBERRY HIGHLANDS LT 3 G:0155 Site Mailing Address: Owner: HIGHLAND LLC Lot Size in Sq Ft: 70999 Design Engineer: NORTH RIM ENGINEERING Total Bedrooms: 4 This permit is for the construction of: 0 Disposal Field 0 Septic Tank ❑ Holding Tank 0 Privy 0 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 Special Provisions: 1. To close out this permit, please submit: a) Pump install log b)Well water sample results for total coliform, nitrates and arsenic 2. Entire primary and alternate drainfields are not within the 30 foot radius of the percolation test. An additional perc test shall be completed at time of construction to confirm perc rate. If results require a design change, construction of the drainfield shall stop pending review and approval by on-site. Submit results of percolation test with inspection report. • Received By: � %�`"� Date: ?(( // 1 / , Issued By: / f4 ," �_�/ Date: i 0/ n/ UN 11CElPAL TY OF I ;ANC • r': AGE ,- CommunityDevelopment Department ~' i' \'' p p one: 907-343-7904 Development Services Division "� - ax: 907-343-7997 On-Site Water & Wastewater Program a AUG G42011 ON-SITE SEWERMIELL PERMI .APPLICATIO ti Parcel I.D. 05'0— 6-70— 3 rS- � a 6 8 L°' Property owner(s) /7"Gf/C,i AJD L.Z. C Day phone 2e?- q?e6' Mailing address .35-/ C iifel-et r7 o'tt f zcA Site address /14r 4),,r ,(c.-cif et rtit., Legal description (Sub'd., Block & Lot) /i a.S.0-4etry / , i(4- f L3 3 Legal description (Township, Range & Section) Lot Size 70, f ?1 Sq. Ft. Number of Bedrooms '"f APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field Initial Single Family (SF) ? 1 (w/wo ADU) Septic TankYil Upgrade ❑ Holding Tank I] Renewal Duplex (D) El❑ Multiple Dwellings ❑ Privy E (SF and/or 0) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE /WAIVER REQUEST FOR: Distnce: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. 4 --- 44f44--. AM (Signature of property owner ora orized agent) Permit/Rush Fees: c$549 — Waiver Fees: Date of Payment: V2c4/i7 Date of Payment: Receipt Number: /� 635-dill) Receipt Number: t� Permit No. 3P/4251 Waiver No. Permit App_9-1-12.doc NCRT�-ZI V ENGINEERING MEMO Steve Eng, PE, PH P.O. Box 770724, Eagle River AK 99577 (907) 694-7028 SteveEngPE@gmail.com Date: 8/22/17 Number of Pages: S To: MOA On-Site Services Subject: Roseberry Highlands Lot 3 Septic System PermitDesign This is a new subdivision. Most of the neighbor lots are undeveloped. A new conventional septic system& 5'- wide trench is being utilized. Private water wells serve the area lots-an existing well is located on the lot. Please review the wastewater system design for the single family home. I have included design plans & specs, design guidelines, & soil tests. If there is need for additional information or clarification please give me a call. Thanks-Stew \bTEIM ENGINEERING Roseberry Highlands Lot 3 SPECIFICATIONS& DESIGN GUIDELINES Wastewater System Sizing: This is a new 4-bedroom, single family home. This is a new subdivision and most of the neighboring lots are not developed. These lots are large and are served by private water wells. No adverse impacts are expected from development. No conflicts to the other lots will take place by this septic system construction. A previous subdivision soil test revealed sandy soil with low silt. The test hole from the subdivision did not cover the entire area for the trench; a perk test will be completed prior to construction.An application rate of 1.2 GPD/FT2 with 0.5 reduction factor for utilizing a 5' wide trench.Trench Length=500 FT2/5'x .5 reduction factor=50'; 1 line @ 50'. Refusal was encountered @ 14'. Groundwater separation was maintained. Specification Requirements: All components and work must comply with the Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and Wastewater Regulations. • Two compartment, 1250 gallon septic tank. Watertight couplings on inlet & outlet. • 5' minimum between the tank and bed. 10' to property lines. • 3' of cover or insulation is required for trench; an equivalent of 1" insulation for 1' soil cover may be used. 2" Minimum thickness for insulation. • Tank& solid pipe must be set on well compacted, stable soil. • 4 inch diameter cleanouts with airtight caps are required 1' to 4' from foundation wall, prior to any 90 degree bend in 4 inch line, in each tank compartment, and two adjacent opposing cleanouts between the tank and the absorption field, not more than 10' from the tank positioned to provide cleanout access towards the tank and towards the absorption field. • All cleanouts must extend to at least ground level. • In solid pipe runs, ASTM D-3034 may be used in lieu of cast iron. • Trench to be placed level, minimum of 4' to groundwater, 6' to bedrock from drain-rock. • Drain rock to be V2 inch to 2 1/2 inch screened. Drain rock to be distributed uniformly throughout the trench. • Perforated pipe to be installed level with perforations down. • Silt barrier(filter fabric) to be installed above the drain rock. • Smeared trench sides must be raked or scarified before drain rock placement. • The finish grade must be mounded to promote drainage away from trench. • Insulation must be placed over any pipe installed under driveways or parking areas. • Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS ASTM D2661, • Sewer Service Line is minimum 2%slope. • Septic Tank to be pumped every two years or when required. • Insulation board to be extruded direct burial burialpozigstluviiiiiDow Styrofoam HI/equal) of at „:tt taiSteven W. Esq dr PROF ESS\ti+�'~ DESIGN NOTES: 1 . Total Depth of Trench is 7.5'. Terrain Slopes West. 2. Sewer Service Line minimum 2% slope. 3. Private Water Wells. 4. Check Well/Septic Separation Prior To Construction. 5. Place Trench Parallel To Contours. 6. Additional Perk Test Prior To - - uction. 7. Main .'n Minimu 10' Separation Between Se - er & Water Ser 'ce. T- O 'I Ilfl Iriv:i 01 - ;.o,os • ExiSti .i - • Wi l / \ \\ Ensure Driveway Has / 10% Slope Or Less _______\\ Maintain Separation From �'• Septic System • -• MT/Ci I 1 • New 1250 Gallon Some Slope Undulations Septk Tank r May Vary 15% To 25% I z 4' Alternate I , el,, ,_,f Trench �. \ '9 N, T. TRACT A o No Conflicts t:<,'N. - ,404,- -.___ _ sr a I :•' ' •"YIN. R❑SEBERRY HIGHLANDS 1 100 NOR THR/M ,e;-';;...'•" „. 'y ENGINEERING f.*'.49 ••• ' *1 LOT 3 PLAN j'''' ! LAYOUT PO Box 770724 • = Eagle River, Alaska 99577 + . �., WASTEWATER DESIGN t � 907. 694. 7028 SEPTIC SYSTEM Dot9/11/17 EEof 3 Foundation Cleanout Tank Cleanouts Fin ade Opposing Cleanouts Between Septic Tank & Trench per., 4 Foot Cover or Equal Mid-Point of Trench 1250 Gallon Steel 'Anchorage Tank' Solid Pipe Monitor Tube DESIGN NOTES: CO i9'h4� SSlope 1. Depth of Trench is 7.5'. � �PP I -� 2. Septic Tank & Solid Pipe to be Placed on Compacted, Stable Soil, Free from Boulders. 3, Sewer Service Line is Minimum 2% Slope & 3' Cover. 3 0 4. Water-Tight Couplings. Filter 5. See Specification Sheet. Fabric alltr 6. All Work To Conform to Municipality of Anchorage (AMC) F.-AV-CANON 7.5' Requirements & Specifications. Effective Depth X•• r 4' i7• f!Ye!Y� tregil OF �P` ;; NOR THRIM TRENCH END VIEW ROSEBERRY HIGHLANDS � ,�� ENGINEERING •,r :4 : SEPTIC TANK PROFILE � PO Box 770724 ! t LOT 3 Eagle River Alaska 99577 �0. e,.$�/ te �.' rake T'907.694.7028 ;' SEPTIC SYSTEM DESIGN 8�22�17 rim SE 1• = 5 , I •3 of 3 SE T SOILS LOG -- PERCOLATION TEST Date Performed:ormec : 8/15/07 _HG;INEERING Performed For: Lee Coy Legal. Des`r,ption: Roseberry_ Highlands Lot 3 (Previously Roseberry Ridge Highlands Lot 2) wpm •; { i '' " lI Organic See Location Map SP � 4 Sand (� \d/ Grovel . • .• Low Silt Slope < 107. Cobbles i3roundwater2 No • Depth none Water Depth C. After Monitoring. Dry Date• 10/15/07 10 - # Dote [rosy Time Net Time Depth Net Drop • - 1 8/15 0 - 4 I 2 8/15 5 6 min, - 3 8/15 10 -- 4" Q 4 8/15 16 6 rein, 10' - .q Refusal it Large Cobbles ~ 8/15 �0 __ q' i._. 6 8/15 P6 6 min 10' E ' 1� i - Percolation Rate 1 rein,/inch Perc Hale Diameter C Test Rur, Between 4' ctr.d 5' _ _ ".r'.r^der -t s: river 5D'! Sand F. + `,• r^et�l Ry NorthRirt Erg, I s- L CERTIFY THAT THIS TEST WA . ! •t'r-' 1- Crrneci ir•i Accordant e with ALL State/Municipal Guidelines in L i .1•J THIS DATE. DAT[ 8/15/07 ��ywx�A rs NCR. 7HRIM hP� TESTHOLE LEG ENGINEERING GEU I ECHNICAL t, 170724 .s...cry. • r• Riv sf• Alaska 935T ♦ r + .,� ��� y Roseberry c��eberry Highlo�ndc � /720 Lot 3 8/15/07 Oct 17 08 08:00a Sullivan Wafer Wells 907 688 '27.59 p,3 by SULLIVAN WATER WELLS BOX ~272, OHUGIAK, ALASKA ~5~7 ,TELEPHONE OWNER OF LP~D: BORE HOLE DATA ~ DEPTH ACORE$S: PERMtT NU~ER: ~ Date of I~e~-E-J ~I St*t~ Wat~ Level: ~Z ' Pe".C°~M feet i W~I Int~e Op~i~ Type: Q o~n on en ~de .... ! ' ' Q Scr~; St~ feet Sloped , feet ~ Peri.aliens Sta~ ~ ~et Sloped feet Well Disl~f~ Upon O0~l~ion? ~ ~ NE Comments: ! ,,, Driller's Name ATTENTION: It Is the responsibility of the property owner to submit a copy of the well Icg to the proper authority. Mun.c pa ty of Ankhs;rage: D~partment of Health & Human Services ~nd,/m' Department of Environmental Con~ati~q. Ma/$u Borough; Depertmer, t of Envlronmentsl Conse~alion. 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 ON-SITE WATER SUPPLY PERMIT Initial Date Issued: Sep 11, 2008 Expiration Date: Sep 11,2009 Permit Number: SW080'193 Parcel ID: 050-315-22 Legal Description: ROSEBERRY RIDGE ESTATES #1 TRACT A Design Engineer: 0000 ZZ - NONE NEEDED Site Address: NHN MOUNT MAGNIFICENT CIRCLE Owner Name: ROSEBERRY RIDGE ESTATES, LLC Lot Size: 649452 SQ. FT. Owner Address: 10230 RONALD PLACE Total Bedrooms: 0 Permit Bedrooms: 0 EAGLE RIVER, AK 99577- 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. 5. ~~rovisions. Municipality of Anchorage Development Services Department Building S~lfely D~s~on On-Silo Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AJaska 99519-6650 www.muni.oq~/onS~te (90?) 343-7904 ON-SITE SEWERJWELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 05031522-000 Property owner(s) Roseberry Ridge Estates, LLC Day phone (907) 360-7157 Mailir~ address 10230 Ronald Place, Eagle River, AK Zio Code 99577-8769 Site address Mount Magnificent Circle, Eagle River Zip Code 99577 Legal deSCription (Sub'd., Block & Lot) Roseberr~ Estates #l.__,_~Tract A__.. Legal description (Township, Range & Section) TI4N RIW Lot Size ..... ~?,45_2_~Sfl. Ft. Number of Bedrooms N/A THIS APPUCATION IS FOR ([] all that apply): Absorpti~ Field Septic Tank Holding Tank Privy Private Well Water Storage THIS APPLICATION IS AN: Initial ~ Upgrade ~ Renewal [] This Application is for We 3 wells required for the Aquifer Test for Preliminary Plat S-11628-3 Roseberry Ridge Highlands. I certify that the above information is correcL I further certify that this application is being made for a Single Family Dwelling and is in acc~:lance with applicable Municipal Codes. {Sil}nature o~ property o~r~r or aulho~e~gent) Permit/Rush Fees: Date o~ Payment: Re~eipt Number: Waiver Fees: Date o( Payment: Receipt Number: .%.% r~ ~ ~o~ L 5'"'"' ~/I ~'~ ~z ~ 0© C~~ ~ Municipality of Anchorage • On-Site Water and Wastewater Program (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 050-315-61 Expiration Date: i -D5 1. GENERAL INFORMATION Complete legal description Roseberry Highlands Lot 3 Location (site address) Mt Magnificent, Eagle River,AK Current Property owner(s) Quinn Day phone 229-4966 Mailing address same Real Estate Agent Quinn Day phone 229-• •.6 . 9 10 77 2. TYPE OF DWELLING: cV ' Single Family (w/wo ADU) a S . C.018 ❑ Duplex �Q ti ❑ Multiple Dwellings (Single Family and/or Duplex) w vi 68L9 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class C Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Received b :_ Date: / 2<// COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ to d1 30 Date: Date of Payment 91Oi,!/I g Date of Payment Receipt Number 66A314,62 Receipt Number COSA# 600 YlaaV 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 NorthRim Engineering Phone 694-7028 Address PO Box 770724, Eagle River Engineer's Printed Name Steve Eng Date 9120/2018 6. DSD SIGNATURE '0 I ^• 4!+I.� ' d • System #1 Approved for 11 bedrooms. :)., •••••• t cy. W. Eng System #2 Approved for bedrooms. o2;s �•�, v .. Disapproved. i;;i;9r...`1iflp /Z%4°4. C); Conditional approval for bedrooms, with the following stipulations:' \G ��1(Y OF�tryCN.) ON-SITE 24* WATER AND rn - :-:;11<- r�� WASTEWATER o ` c� PROGRAM .; SERV BY - -/d, - Original Certificate Date: �S �/r---- The Municipality of Anchorage Devlopment Services Division(DSD)Issues Certificates of On-Site Systems Approval(COSA)based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska.The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 9-1-12.doc 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: /F0 sF aT jZ/Z / /T7 C, 'LAND J L 3 Parcel ID: Q 5-65/Sc f A. WELL DATA Well type P If A, B, or C provide PWSID# Well Log (Y/N) y Date completed ?ft i/o S"Sanitary seal (Y/N) y Wires properly protected (Y/N) Total depth Liao ft. Cased to T f ft. ( Casing height (above ground) / in. FROM WELL LOG AT INSPECTION Date of test Vi t/0 8 NEi.J Static water level 2 ft. ft. Well production / 5 g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform C colonies/100 mL Nitrate /VA mg/L Arsenic Alb ug/L Date of sample: 7,6QCollected by: a.4,,G07, B. SEPTIC/HOLDING TANK DATA / Tank Type/Material SEAL' / STEL- Date installed 2/2//lP Tank size /2.50 gal. Number of Compartments 2. Cleanouts (Y/N) Foundation cleanout(Y/N) y Depression over tank(Y/N) A High water alarm (Y/N) / A) Date of pumping /l/,e/w) Pumper C. ABSORPTION FIELD DATA Sn c jtoc..i Date installed / I> Soil rating (9' p.d.fft2 or ft2/bdrm) System type 7—re.4c A Length 0 ft. Width .5 ft. Gravel below pipe 4.71 ft. Total depth 75 ft. Eff. absorption area 500 ftMonitoring tube y Depression over fieldDate of adequacy test AJfi),) Results (Pass/Fail) P For ,1 bedrooms Fluid depth in absorption field before test in. Water added gal. New depth in. Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d. Any rejuvenation treatment(past 12 mo.) (Y/N &type) If yes, give date D. LIFT STATIONi\ A Date installed Size in gallons Manhole/Access (YIN) "Pump on" level at in. "Pump off' level at in. High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: r Septic tank/lift station on lot /Q0' L. On adjacent lots /00 "'- Absorption field on lot /06 ` t On adjacent lots /6Q rt Public sewer main /66 "-f Public sewer manhole/cleanout /60 11- Sewer/septic service line 0-S '' Holding tank /4 .0 t - Animal containment areas S 0 (4' Manure/animal excrete storage areas / Co �'- SEPTIC/HOLDING TANK ON LOT TO: r Building foundation /0 'f Property line /0 -- .. Absorption field l� * 1_4.. Water main /Q `1' Water service line /0 Surface water /U� f Wells on adjacent lots MO /-74- ABSORPTION FIELD ON LOT TO: / r fi Property line /I '7' Building foundation /� Water main / 0 f" Water Service line /Q �'f" Surface water (a)7 r-� Driveway, parking/vehicle storage /C r' Curtain drain 5Q Wells on adjacent lots /OG 41— F. COMMENTS G. ENGINEER'S CERTIFICATION - t . I certify that I have determined through field inspections and • �. review of Municipal records that the above systems are in 4I ..'1� conformance with MOA COSA guidelines in effect on this date. ': ''. _ Engineer's Printed Name ! enV_ / !7 oeH.AN s 4 Date 7/�G / I r n /� � C ., u� t� `T'`.sJ .- COSA yellow sheet_2-6-15.doc MT . Mg GN \ -- /F/ N F1, X.-^ \ Ci \I N F \ / v Spo . 2 N 08'30 04\ 7 cam. -t i'• 0 4 0 , sm -. •N 03-12.55"E 119.92' `?- • -<r• Z1.8; \ ,Z'9Z fr wq4‘.. 0 ---- is.,. ,. '� ,z• 9z 1194, 0 _.. 1 �`F _moop00\, 4 -To O,Qm • i` ii n 1N-C6 / ek r ° Tmqy � \ SC\\0� rw Z V r co \ � --1 N W o / (T \ rn -A+ C:1) m _ / m: oo / e ' rn128.2 � / N `N 14S — OA • or oo / / w w / / / S / 14'26.01"tiy 334944,/ / / / t- 0 -0 0, x` A x N - O c) > co> o -z-I I- 0 O n O "°.'.........y... 8 2 o- �S•6 0 Z�4 0�5 M (SS: n C d� I - D to 0 LN)�DyS a •• In • WS 5' o ijk ? D_ r r co0- �' • Ox Zf �N r N s. PLOT PLAN AS BUILT X SCALE 1" = 50' GRID NW 0155 Project No. 17-296/B5 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associates , inc . (907) 522-6476 Phone (907) 522-4625 Fax c., AL' Professional Land Surveyors kenOlangsurvey.com Ac .... JonathanOlangsurvey.com I hereby certify that I have surveyed the following described property: ,#,,,, Z •" LOT 1, ROSEBERRY HIGHLANDS (PUT 2014-58) Q : 49TH 1 Anchorage Recording District, Alaska, and that the Improvements situated thereon are '‘ '..37. *(ti within the property lines and do not encroach onto the property adjacent thereto, that 0 rye Jam^....eA0 no improvements on the property lying adjacent thereto encroach on the surveyed 0'� KENNETH G. LAN,11 : premises and that there are no roadways, transmission lines or other visible Q�, easements on said property except as Indicated hereon. .. Dated this the �_\ Day of 4-=3 yup , at Anchorage, Alaska Qh ,o ' _5 O•z. to v QQRO�SSIONAL 40 It is the responsibility of the owner to determine the existence of any easements. 0400��a covenants, or restrictions which do not appear on the recorded subdivision plat. AECC963