HomeMy WebLinkAboutPOTTER HIGHLANDS PH 2 BLK 3 LT 6Potter Highlands Ph 2 Block 3 Lot 6 #020-281-77 Municipality of Anchorage On -Site Water and Wastewater Program • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP151324 PID Number: 020-281-77 Dwelling: X Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: N New ❑ Upgrade Name: Crown Pointe, Inc. ABSORPTION FIELD EI Deep Trench WShallow Trench El Bed ❑ Mound Address P.O. Box 112313 Anchorage, AK 99511 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 229-1886 Five 5.0 GPD/SF 6 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. 4 Gravel depth beneath pipe 2 Ft. Subdivision Block Lot Potter Highlands No. 2 3 6 Fill added above original grade 1.5 Ft. Gravel length 21 Ft. Township Range Section Gravel width 5 Ft. Beds: Number of Lines Distance between lines I FL SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 150 Fe One Ft. well >100' >100' >100' >75' >25' TANK ❑ Septic ❑ S.T.E.P. ❑ Holding N Other Manufacturer Advantex/Anchorage Tank Capacity 2,500 Gal. Surface Water >100' >100'NA NA Material Number of compartments Lot Line >5' >10' NA NANA Steel Two Foundation >5' >10' NA NA LIFT STATION Manufacturer Capacity Curtain Drain None Noted Gal. Remarks Pump on level at in. Pump off level at in. High water alarm at in. Pump make and model Electrical Inspections performed by Dependable Services Installer PIPE MATERIAL House to tank D3034 draainfed D3034 Sanders & Sanders Drainfield F810 co/MT Inspector MEA BENCH MARK (Assumed elevation)100.0 it Inspdates: 1 3/23/16 3/24/16 Location and description Zed 3'" a Lower Level Door Stoop. COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL OF .. r l Conditional Approval: Date AV*:. 49TH♦ r....,...... .fit... p....... .............. V .MICHAEL E. ANDERSON•: `t• CE -4381 •: Approved `- Date —7 ^ 1 i- : ,+���t6\"����� Inspection Heport_y-11-12.doo O N d biJ a (p � c d /� �l em®um eammn •p Fes- 0 Gy \ b� c c v 'S'`Jj ❑ `oma EM \\ $ Z m I -y Uv 0 I I I I LLJ rn \ as \ b z� O`^ w OW o Cf) JQ J Zz ®" SON Q Lu °'a —� m ��s 1—�i Ln UWY o 0 =t� II K W O O y w awQ • \ \L U m O N ^� W of WN U M^ ❑ o w o J o a n < m o m V N V O N_ N N N N Ci 16 (V N a M M 16 h N N M = IL�� : � H\���� a Z •Z>gb 8'9Z ��� ❑ [ ♦x,6- • Al Permit Number: OSP151324 Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report POTTER HIGHLANDS NO. 2 BLOCK 3, LOT 6 Page 3 of 3 PID No. 020-281-77 Scale: NONE 21' AS -BUILT 92.4 7710'12915 21:33 977-345-9262 ALPINE DRILLING PAGE 71/71 Alpine Drilling & Enterprises Well Log Permit Number; #8R'954324 Date of iissne: 9-22_7 Parcel Identification Number. 02028977000 Date Started.'t G_18-95 Date Completed: 101-191-1y' is well located m approved, permit location? x 'Yes i -No Legal Description. Potter Highisnds Phase 2 Block 3 Lot 6 Property Owner Name & Addrem- Potter Cr6ak Development t -LC - Crown Pointe PC) Box 112343 Anchorage, Alaska 99511 Borehole Data: Depth (ft) — Method of Drilling x air rotary r] cable toot --- -- Soil Type, Thickness & Water Strata From To -- --- Casing t pe: s,- gi Stick-up 0 organiC6� & silt 2 Crravrlly,silt 3 2 3 36 Wall Thickness:.250 inches Diameter: 6 inches Depth: al feet Liner Type,: _,— Diameter: ­ iacbas Depth: ___ fedi silt 56 6i Caslasticicup above ground: 2 teat Static water level (froth ground level); 81 feet yrarelly silt 61 37 silly gravel 87 bedrock 97 97 246 pumping level --,2 W feet after 10'hours pumping ! gpm Recovery Rate. ¢ gpm Method of Testing: jjlr Well Intake Opaning Tylr:: Open Fnd x Open Hale ❑ Screened Start _ feet Stopped feet Perforations Start._�m„, feet Stopped _ — feet grout Type: bentonitanulec volume: 1, ate t tom___. Start 0 f t. t ed ?feet Pump: Intake Depth feet Pump size _ hp Brand Name _ Well Disinfected Upon Completion? x Yes ff No Method of Disinfection: Chlorine taE�ts WATER QUALITY TESTING Comments: GolffcfrnCoU1001M. riifTl�te6 .. nVL Arsenic �J� V4e13 Driller: ,Alpine Drdlling- & Enterprises PO.Box 110496 Anchorage AK 99511 i Ji �Q!lEiCil�'�Yill� lJ 01/15/^015 00:44 907-345-0202 ALPINE DRILLING PAGE 0310E Development Services Department Building safety Division On -Site Water ,& Wastewater Program or"` $`',• 4700 Elmore Road 4 P.O. Box 196650 n MarkBegich Anchorage, AK 99507 g" E T T Mayor www muni omlansite (907)343-7904 PUMP {t�, Installation Log W 161Jolq Well Drilling Permit Number: S -di Date of Issue: Parcel Identification Number: Legal Description�i p PSoperty�Ol N & Address: ?Other (1ipnyldo ipDDWW 1 �.�i5 Pump Installation Date: q aa�{ Pump Intake Depth Bekrw Top of Well Casla}l; Aa feet Pump Manufacturer's Name: C ovl A5 Pump Medel: � l p Pump Size I bp Pitless Adapter Our'ial Depth: N feet PRIM Adapter Manufacowe{r's Name: 61A, Pitless Adapter installer: iJ I ft 4 Well Disinfected Upon Completion? ( Yes 0 No Method of Disinfection: Comments: Pump Installer Name; Aarow Pump a Well Service P.0- Boz 110496 Anchorage, AK 99511-0496 Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation, am 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 Permit Number: OSP151324 Tax Code Number: 02028177000 Work Type: WellSeptic Initial Permit Effective Dates: September 22, 2015 to September 21, 2016 Design Engineer: ANDERSON ENGINEERING Subdivision: POTTER HIGHLANDS PH 2 Site Legal Address: POTTER HIGHLANDS PH 2 BLK 3 LT 6 G:3638 Owner/Address: POTTER CREEK DEVELOPMENT LLC 3230 C ST FIRST FLOOR ANCHORAGE AK 995030000 Site Mailing Address: 19186 POTTER HIGHLANDS DR, Anchorage Lot Size in Sq Ft: Total Bedrooms: This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy Y Private Well N Water Storage lh�purtnaent ©� 3- 2,3 -IS- L2�3� 59848 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: Minimum 7 day water monitoring must be provided. Construction may proceed at your own risk before the 7 day monitoring is complete. 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.4 Received Issued By: N d/ Date: Municipality of Anchorage P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 hftp://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program pent J V Department **** VARIANCE/WAIVER REVIEW **** Waiver#: OSV161021 COSA#: Permit#:OSP161324 PID#: 020-281-77 Legal Description: Potter Highlands Ph 2 B3 L6 Engineer: Anderson Engineering Applicant: Crowne Pointe. Inc Your request for a waiver of the required 50 feet horizontal separation from the absorption field to the excessive slope has been approved: The approved separation distance is 20.0 feet. This waiver approval applies to the proposed absorption field only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of nonobjection have been received from the owner(s) of the affected adjacent property. ® Adjacent properties are not affected by this waiver. ............................................................................... Waiver is Granted: X Waiver is not Granted: Date: -3117Approved by: (� ....................................................... Reviev er **** VARIANCE/WAIVER REVIEW **** OSV! 6/OZI Permit App_9-1-12.doc .3117116 os3z.26 s� 21 S MUNICIPALITY OF ANCH07, Community Development Department ? }� 4 atij Development Services Division ax: 343 7 On -Site Water & Wastewater Program �y A ti ON-SITE SEWER/WELL PERMIT APPLICATI pr 5 e 9 5 Parcel I.D. 020-281-77 Property owner(s) Crown Pointe, Inc. Day phone 229-1886 Mailing address P.O. Box 112313 Anchorage, AK 99511 Site address NHN Potter Valley Road Anchorage, AK 99516 Legal description (Sub'd., Block & Lot) Potter Highlands Ph 2, Block 3, Lot 6 Legal description (Township, Range & Section) Lot Size 59,848 Sq. Ft. Number of Bedrooms Five (5) APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial 0 Single Family (SF) 0 (w/wo ADU) Septic Tank El Upgrade F1Duplex (D) F1Holding Tank ❑ Renewal F-1 Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A� VARIANCE / WAIVER REQUEST FOR: _Tf Le rm_ Distance:0 1 certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. C. (Signature of property owner or authorized agent) p Permit/Rush Fees: 50 -r o?t6-f ��� Waiver Fees: oil Date of Payment: q -Ig -ts Date of Payment: —1� " Receipt Number: (� (P G Receipt Number: �� Ma�ey ,�s�>�ed. OSv cleyea Permit No. O'r P 16 132y Waiver No. 0F5V 1e1130 OSV! 6/OZI Permit App_9-1-12.doc .3117116 os3z.26 s� 21 S ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) September 18, 2015 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 6, Block 3, Potter Highlands Subdivision No. 2 Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer The owner of Lot 6, Block 3, Potter Highlands Subdivision No. 2 intends to construct a new five -bedroom home on the lot. We are therefore requesting a permit be issued for the construction of a new well and septic system to accommodate the home. The attached Site Plan and backup documentation identify the location and configuration of the proposed well and septic system along with the alternate site. None of the lots surround this lot are developed. The subdivision was only recently platted and recorded and this is the second lot in the area to be developed. . Drainage arrows developed from the ground surface contour shown on the site plan generated for the subdivision are shown on the site plan showing the grade and direction of flow on the lot. The drainage pattern will not be changed as a result of this project. The test hole placed on the lot in the area of the absorption trench and alternate site during the subdivision phase indicates well graded sand which the engineer has designated GW in the zone specified for the absorption trench. The percolation rate of the soil was determined to be 4.5 minutes per inch. No groundwater was found during the placement of the test hole to a depth of 19' and none was noted during the monitoring period. An application rate of 5.0 gallons per day per square foot was used Z%V00 in the design of the absorption system. We are proposing to place a new 1-,55�gallon Advantex Treatment Tank and a 21' long by 5' wide by 2' effective depth absorption trench to treat and dispose of the effluent generated in the house. The elevation of the distribution line in the absorption trench will be 4' below the surface and the total depth will be 6'. A minimum of 3' of fill or 2" of insulation and 2' of fill will be placed over the absorption trench and 4' over the septic tank. The ground surface on the lot in the area of the septic system is virtually flat with a Lot 6, Block 3, Potter Highlands Subdivision No. 2 September 18, 2015 Page Two slight slope to the south at a shallow grade. The new trench will be constructed parallel with the contours of the slope as much as possible in conformance with Municipal requirements. The new septic system will be constructed a minimum of 100' from all wells and any surface water and 10' the proposed and existing water services in the area. If the system is constructed in accordance with our design the following statements apply: The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, Michael E. Anderson, P.E. Attachments °• 49th _°.. MICHAEL E. ANDERSON No. CE -4381 . 0 C-) D m m u cn 0 z cn O V VWN z °wr 1' a On m �l �m • 5 �L V W O N N Oo� ooK, V N O N F N T S � NS O s ��rrlz �9�N,O3 �j O -__- H No o.. m�pOo 9 \ —1 3 �p D 2�S 3 z cn O 1' a N Oo� ooK, � s ��rrlz �9�N,O3 € m�pOo 9 \ c 2�S g»moo c o- 3 0 m � F c \ O c 9x" J ` Sump" S V O m POTTER HIGHLANDS SUBDIVISION NO. 2 C013`I LOT 6, BLOCK 3 DESIGN FACTORS: SYSTEM REQUIREMENTS: Five Bedroom Home Perc. Rate: 1-5 Min./Inch Application Rate: 5 GPD/SF 5' Wide Trench System 2,500 Advantex Treatment Tank 2' Drainfield Rock 5 Bedrooms * 150 GPD/Bedroom = 750 SF Absorption Area 750 SF/5 GPD/SF/5 SF (Width) *.7 (Red. Factor)= 21 LF Trench Length THEREFORE: Furnish and Install a Five Bedroom Advantex Treatment System with a 2,500 Gallon Steel Tank and 2-AX20 Pods. Construct a 21' Lang x 5' Wide x 2' Effective Depth Absorption Trench at the Location Shown. Distribution Line to be Placed at 4' Below the Surface. Total Depth of Trench to be 6'. Maintain 100' Separation From All Private Wells and any Surface Water in the Area. Place a Minimum of 4' of Cover Over the Treatment Tank and 3' of Cover Over the Absorption Trench. 5' IA TYPICAL 5' WIDE TRENCH SECTION (NO SCALE) 10 NOTE: Grade Area Over Trench to Drain Away. i Minimum 6' Separation From Bedrock. �.... Minimum 4' Separation From Groundwater. 0 Minimum 100' Separation From Private Wells in the Area. Minimum 100' Separation From Surface Water or Streams. �j MICHAEL E. ANDERSON . NO CE4381 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 BRAGAW STREET ANCHORAGE, AK 99519-6650 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: POTTER HIGHLANDS #2, LOT 6, BLOCK 3 PERFORMEDFOR: CROWN POINTE HOMES, INC. DATE: 3/10/16 PROJECT No.: PARCEL ID#: TECHNICIAN: M. ANDERSON DEPTH TEST HOLE A (feet) 1 OB/OG 2 3 4 5 SILTY GRAVEL WITH SAND 6 GM 7 8 9 10 11 12- 13- 14- 15— 2131415 BOH @ 15' 16- 17- is- 19- SLOPE 6171819 SLOPE WAS GROUND WATER ENCOUNTERED? NO 26' 32' IF YES @ WHAT DEPTH? J GROSS TIME (MINUTES) DEPTH OF WATER AFTER MONITORING: NONE 0 NET DROP (INCHES) DATE OF MONITORING: P 3/10 1 12:32/12:42 10 2.38"/5.13" 2.75" COMMENTS: TEST HOLE PRE SOAKED DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DEPTH To WATER (INCHES) NET DROP (INCHES) TEST HOLE PRESOAKED PRIOR TO TESTING: 3/10 1 12:32/12:42 10 2.38"/5.13" 2.75" 2 12:43/12:53 10 2.25"/5.00" 2,75" 3 12:54/1:04 10 2.25"/5.00" 2.75" 4 1:05/1:15 10 2.38"/5.13" 2.75" 5 1:16/1:26 10 2.50"/5.25" 2.75" 6 1:27/1:37 10 2.25"/5.00" 2.75" PERCOLATION RATE: 36 (MIN/INCH) PERC. HOLE DIA. �(INCHES) TEST RUN BETWEEN: 4 FT. and 5 FT. TEST PERFORMED BY ANDERSON ENGINEERING. 1, MICHAEL E. ANDERSON CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE: 5/11/16 e Municipality of Anchorage DEPARTMENT OF HEALTH a HUMAN SERVICES 825 " L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST P ER FORMED FOR: f-1"iT7e 1 CGr-fx T}E=7-><-2 �r� n� LG �• DATEPERFORMEO! OCn-O�,-9i LEGAL DESCRIPTION: Township, Range, Section: SLOPE SITE PLAN 20 ORC:AN i c•S 6w/ LOOSE, tilC,t\ COurFNT OF WELL. GRAOED SANG pe/ COMMENTS # spy WAS GROUND WAFER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Wrier Nle, Maniterinp7 4rq Djts S L O P E PERCOLATION RATE —QQa_ Im+nutevmchi PEAC HOLE DIAMETER (:J TEST RUN BETWEEN 1� FTAND (J -FT PERFORMED BY: ti4T h/ I F Q >_ "�-r�ERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE '/'—. Y _5 f, 9 -re ME PERCOLATION RATE —QQa_ Im+nutevmchi PEAC HOLE DIAMETER (:J TEST RUN BETWEEN 1� FTAND (J -FT PERFORMED BY: ti4T h/ I F Q >_ "�-r�ERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE '/'—. Y _5 f, ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 FAX March 11, 2016 Lo -(-�I Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 6, Block 3, Potter Highlands Subdivision No. 3 Absorption Trench to Slope Waiver Dear Onsite Services Engineer: Lot 6, Block 3, Potter Highlands Subdivision No. 2 has steep slopes to the west of the proposed house location. The developer of the lot intends to place a system with gravity flow. We have located an area with acceptable soils, but the primary sites must be placed at 20' from a slope greater than 25%. The area has been lightly graded and the organic layer removed to create the flat spot for both the house and septic site. No more than 1' of material has either been removed or relocated. The new septic system will be constructed entirely in undisturbed material and in a consistent absorptive lense of material. The distribution lines in the trenches will be placed at 4' below the surface. The 25% slope when extended from the sidewall of the trenches does not daylight less than 50' from the trench. We are therefore applying for a waiver allowing placement of the primary trench at the location shown. The soil encountered in the test hole is silty gravel with sand (GM) which is very good for the absorption of septic effluent. No migration of effluent is expected to occur to the steep slope. Sincerely, Michael E. Anderson, P.E. Attachment I I i i � I I I I f ,x j I G Q I , ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT BETWEEN MUNICIPALITY OF ANCHORAGE AND Crown Pointe Homes, Inc. THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this &Day of of 20, by and between Crown Pointe Homes, Inc. , herein the "OWNER;' and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this Maintenance and Repair Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as Advantex Treatment System located at (legal description). Lot 6, Block 3, Potter Highlands Subdivision, Phase 2 2. Definitions. Alteration. Any change to the design or function of an A W WTS that includes the installation or removal of any parts, components or pieces not included in the original construction permit and design. Certificate of On -Site Systems Approval (COSA). An approval by the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with Anchorage Municipal Code (hereinafter, "AMC') 15.65. These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. Maintenance and Repair. The scheduled and as needed replacement of existing parts, components and pieces of an AWWTS that were included in the original design which would allow the AWWTS to continue to perform as designed. Permit. An On -Site Wastewater Disposal Permit as required by AMC 15.65 to construct and operate an AWWTS. 3. Term. The term of this Maintenance and Repair Agreement shall begin on the date of approval by the Municipality to operate the installed system or issuance of a COSA, and shall continue while the AWWTS is in use or is operational or until the property is sold or title is transferred by the owner and a new COSA is issued to the new owner or transferee of the property. 4. Alterations, Installation and Removal of Additional Equipment. Prior to performing any alterations to an AWWTS, the owner agrees to obtain an On-site Wastewater Disposal Permit from the Municipality in accordance with AMC 15.65. 5. Maintenance and Repairs. A. Throughout the term of this Maintenance and Repair Agreement, the Owner shall maintain their AWWTS in a satisfactory condition capable of producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. The owner shall enter into a service aereement with an AWWTS service and maintenance provider approved by the municipality and the manufacturer of the AWWTS for the entire term of the AW WTS. In addition, it shall be the responsibility of the Owner during the term of this Maintenance and Repair Agreement, and any renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs. B. Owner agrees to comply with all applicable ordinance, laws, regulations, rules and orders for the AW WTS. C. Upon request by the Municipality, the owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system. When a record of maintenance is documented and maintained by the system vendor, the owner agrees to allow the Municipality access to this information. D. Owner acknowledges that the fine for failing to maintain and repair an AW WTS may be assessed in accordance with AMC 14.60 for improper discharge. E. Owner agrees that only maintenance and repair personnel approved by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the system. F. Owner agrees to grant the Municipality reasonable access to test and inspect the A W WTS upon 24 hours written notice. G. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. H. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. 6. Nonwaiver. The failure of either party at any time to enforce a provision of this Maintenance and Repair Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Maintenance and Repair Agreement or any part hereof, or the right of such party thereafter to enforce each and every provision hereof. 7. Amendment. A. This Maintenance and Repair Agreement shall only be amended, modified or changed by a writing, executed by authorized representatives of the parties, with the same formality that this Maintenance and Repair Agreement was executed with, and such writing shall be attached to this Maintenance and Repair Agreement as an amendment. B. For the purposes of any amendment modification or change to the terms and conditions of this agreement, the only authorized representatives of the parties are: a. Owner: Crown Pointe Homes, Inc. b. Municipality: Director, Community Development or designated authority C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. 8. Jurisdiction: Choice of Law. Any civil action arising from this Maintenance and Repair Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Maintenance and Repair Agreement. 9. Severability. Any provisions of this Maintenance and Repair Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining STATE OF ALASKA THIRD JUDICIAL DISTRICT The foregoing instrggmen; was 20_15-, by W s!, W and Repair Agreement. Date: name) ss. ed before me this 45 - day of r �/ NOTARY PUBLIC FOR ALASKA My Commission expires: 0911VICOW7 MUNICIPALITY: By: L� x4t;� (signature) Deb 61jo 95 (print name) NpTgRy' o NT BLIG y- i�'�'� ,?p� OF Date: R g �✓� Title: C— Parcel I.D. 020-281-77 Municipality ®f Anc On -Site Water and Wastewater (907) 343-7904 Certificate of On -Site Systems Ap 1. GENERAL INFORMATION USHI `A� �fGC ep JUL 0 8 2016 IY�� 5 l f E i YA Expiration Date: 1 l% ` I I Complete legal description Potter Highlands No. 2, Block 3, Lot 6 Location (site address) 19186 Potter Highlands Drive Anchorage, AK 99516 Current Property owner(s) Crown Pointe Inc. Day phone Mailing address P.O. Box 112313 Anchorage, AK 99511 Real Estate Agent Day phone 2. TYPE OF DWELLING: Il Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: Five 4. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System WaiverNariance request Received by: COSA to be relea o the TYPE OF WASTEWATER DISPOSAL: I] Individual 0 ❑ Holding Tank ❑ ❑ Community ❑ ❑ Public Sewer ❑ requested by the engineer. Date: COSA Fee Waiver Fee $ Date of Payment �`((�/(� Date of Payment Receipt Number Receipt Number COSA# 5l'& /IQ AL/ 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 Anderson Engineering . Phone 522-7773 Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. 6. DSD SIGNATURE System #1 Approved for 'bedrooms ./ —1s )ate: 7/8/2016 System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the following QELE ANDERSON CE -1381 By: M Original Certificate Date: 60 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 Nitrate Advisory Septic System'Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet t'- c 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: Potter Highlands No. 2, Block 3, Lot 6 A. WELL DATA Parcel ID: 020-281-77 Well type Private If A, B, or C provide PWSID # Well Log (Y/N) Y Date completed 10-19-15 Sanitaryseal (Y/N) Y Wires properly protected (Y/N) Y Total depth 246 ft. Cased to 101 ft. Casing height (above ground) >1811 in. FROM WELL LOG AT INSPECTION Date of test 10-19-15 Static water level 81 Well production 4 g.p.m.m. g•p• WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate 2.47 mg/L Arsenic ND ug/L Date of sample: 6/27/16 Collected by: Anderson Engineering B. SEPTICIHOLDING TANK DATA Tank Type/Material Septic/Steel/Advantex Date installed 3/23/16 Tank size 2,500 gal. Number of Compartments 2 Cleanouts (YM) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) Y Date of pumping New Pumper Construction C. ABSORPTION FIELD DATA Date installed 3/24/16 Soil rating (g.p.d./fe or ft2/bdrm) 5 GPD/SF System type 5' Wide Length 21 ft. Width 5 ft. Gravel below pipe 2 ft. Total depth 7.5 ft. Eff. absorption area 150 ft2 Monitoring tube Y Depression over field N Date of adequacy test New Const. Results (Pass/Fail) For 5 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.) (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. SEPARATION DISTANCES WELL ON LOT TO Manhole/Access (Y/N) in. High water alarm level at Meets alarm & circuit requirements? in. Septic tank/lift station on lot >100' On adjacent lots >100' Absorption field on lot >100' On adjacent lots >100' Public sewer main >75' Public sewer manhole/cleanout >100' Sewer /septic service line >25' Holding tank >75' Animal containment areas >50' Manure/animal excrete storage areas >100' SEPTIC/HOLDING TANK ON LOT TO: Building foundation >51 Property line >5r Water main >100, Water service line >10' Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO: Property line >10' Building foundation >10' Water Service line >10' Surface water >100' Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS Absorption field >51 Surface water >100' Water main >10' Driveway, parking/vehiclestorage >10' G. ENGINEER'S CERTIFICATION v I certify that i 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. so Michael E. Anderson, P.E. 71 Engineers Printed Name /•••• Date 7/8/2016 io �4. COSA brown sheet 10-10-12.doc AEL E. ANDERSON CE -4381 PLAT NO. 2017-32 POTTER HIGHLANDS SUBDIVISION, PHASE 2 LOT 6A, B LO C K 3 60,275 S.F. 1 "_50' IJ REVISED 4/26/2017 ADDED NEW LEGAL DESCRIPTION AND BOUNDARY. AS -BU I LT I HEREBY CERTIFY THAT I HAVE SURVEYED THE PROPERTY DEPICTED ABOVE AND THAT NO GASTALDI LAND ENCROACHMENTS EXIST EXCEPT AS INDICATED. SURVEYING, LLC IT IS THE RESPONSIBILITY OF THE OWNER TO JEFF A. GASTALDI, R.LS. DETERMINE THE EXISTENCE OF ANY EASEMENTS 2000 E. DOWLING RD., SUITE 8 COVENANTS OR RESTRICTIONS WHICH DO NOT ANCHORAGE, ALASKA 99507 APPS ON THE RECORDED SUBDIVISION PLAT. PHONE 248-5454 UNDER NO CIRCUMSTANCES SHOULD ANY DATA GRID DATE HEREON BE USED FOR CONSTRUCTION OR FOR SW3638 1 7/11/2016 ESTABLISHING BOUNDARY OR FENCE LINES. ANCHORAGE RECORDING DISTRICT, ALASKA F.B.JOB N0. NOTE: NO CORNERS SET THIS DATE 16-01 PHS263 OF 49!H *�>P m : Jeffery A. Gastaldi o` a . LS -609)/ m' a6J.4w BUILDING DETAIL SCALE: 1 "=20' � y N Z D rn m cm zo as m m InN g � G) C m��� - wo o�oycav"'� O> V pp xc ooagmm— m = �z ;zu Two o z c�Clo%"5o�c�mngam o m mAIm+C3 n m COC MQz� � m0�om Lm - M z taovlp o 0 o z uj o p m o c S o v; z p ,� rn a znc vv? -4m�tn va � Cmgz � n� vyAoz p orno-3 0 Mo mDDSop=1"F�c-it m ■ I • V N ?0. o 10 11 D2$• eU 14$ 42. o ` ` S 0 o �K E v n z 0 Fn %. I-zz oR c 49& V I m X 0 _ 0) � Si D,^ o Ar V/ p c.n 0cil o a GJ C7 Y ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT BETWEEN 7MUCIPALIITY OF ANCHORAGE AND �% LIr THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this Day of of 2(4(o, by and between herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this Maintenance and Repair Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as Advantex Treatment System located at (legal description). Lot 6, Block 3, Potter Highlands No. 2 2. Definitions. Alteration. Any change to the design or function of an AW WTS that includes the installation or removal of any parts, components or pieces not included in the original construction permit and design. Certificate of On -Site Systems Approval (COSA). An approval by the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with Anchorage Municipal Code (hereinafter, "AMC") 15.65. These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. Maintenance and Repair. The scheduled and as needed replacement of existing parts, components and pieces of an AWWTS that were included in the original design which would allow the AWWTS to continue to perform as designed. Permit. An On -Site Wastewater Disposal Permit as required by AMC 15.65 to construct and operate an AWWTS. 3. Term. The term of this Maintenance and Repair Agreement shall begin on the date of approval by the Municipality to operate the installed system or issuance of a COSA, and shall continue while the AWWTS is in use or is operational or until the property is sold or title is transferred by the owner and a new COSA is issued to the new owner or transferee of the property. 4. Alterations, Installation and Removal of Additional Equipment. Prior to performing any alterations to an AWWTS, the owner agrees to obtain an On-site Wastewater Disposal Permit from the Municipality in accordance with AMC 15.65. 5. Maintenance and Repairs. A. Throughout the term of this Maintenance and Repair Agreement, the Owner shall maintain their AWWTS in a satisfactory condition capable of producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. The owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the municipality and the manufacturer of the AW WTS for the entire term of the AW WTS. In addition, it shall be the responsibility of the Owner during the term of this Maintenance and Repair Agreement, and any renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs. B. Owner agrees to comply with all applicable ordinance, laws, regulations, rules and orders for the AW WTS. C. Upon request by the Municipality, the owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system. When a record of maintenance is documented and maintained by the system vendor, the owner agrees to allow the Municipality access to this information. D. Owner acknowledges that the fine for failing to maintain and repair an AW WTS may be assessed in accordance with AMC 14.60 for improper discharge. E. Owner agrees that only maintenance and repair personnel approved by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the system. F. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. G. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. 8. Jurisdiction: Choice of Law. Any civil action arising from this Maintenance and Repair Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Maintenance and Repair Agreement. 9. Severability. Any provisions of this Maintenance and Repair Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Maintenance and Repair Agreement. OWNER: r By: 117C L 1 �- (signature) Date: I 6 GC C -'r T � � IC r (print name) STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this day of _t , 2Q�, by CcstL 1—. e4t- ff C2 NOTARY PUBLIC FOR ALA NOr::", a My Commission expires: NetCMyryre MUNICIPALITY: By: (signature) Date: (print name) Title: H. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. I. Owner agrees to provide and maintain a telephone connection to the AWWTS as required by the AWWTS approval. 6. Nonwaiver. The failure of either party at any time to enforce a provision of this Maintenance and Repair Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Maintenance and Repair Agreement or any part hereof, or the right of such party thereafter to enforce each and every provision hereof. 7. Amendment. A. This Maintenance and Repair Agreement shall only be amended, modified or changed by a writing, executed by authorized representatives of the parties, with the same formality that this Maintenance and Repair Agreement was executed with, and such writing shall be attached to this Maintenance and Repair Agreement as an amendment. B. For the purposes of any amendment modification or change to the terms and conditions of this agreement, the only authorized representatives of the parties are: a. Owner: '!tom FL b. Municipality: Director, Community Development or designated authority