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HomeMy WebLinkAboutMOUNTAIN PARK ESTATES BLK 8 LT 14Mountain Park Est. Block 8 Lot 14 #017-391-28 Municipality of Anchorage Community Development Department Page 1 of 3 On -Site Water & Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907)343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number. OSP161266 PID Number. 017-391-28 ❑ New 0 Upgrade Name: JIM 8 KAREN EMMEL ABSORPTION FIELD ■ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address: 13121 RIDGEVIEW DRIVE'ANCHORAGE, AK ❑ Other Phone: No. of Bedrooms: Soil Red, Total Depth from Frlglnalg2ae: 952-7657 3 0.6 GPDrsa. PL 10 (MAX') Ft. LEGAL DESCRIPTION Depth to pipe lnven from original grade Gravel dapm beneath pipe: SEE DWG. FL 4 PL Subdivision: Block: Lot: Fill added above onamal grade: Gravel kmur: MOUNTAIN PARK ESTATES 8 14 SEE DWG. 75 FL Ft. owns Ip:Flange: Section: _ Gravel Witco, BealsNumaroffires. Distance between linea: 5 FL I - - Ft. SEPARATION DISTANCES Total abswptbn arae: 750 umbermtranmea: 1 Dist. between trancbee: - T° Septic Absorption Lift Holding Public/Private Prom Tank Field Station Tank Sewer Lines SD, FL FL Well 100'+ 100'+ _ 25'+ TANK ■ Septic Cl S.T.E.P. ❑Holding Cl Other ManuracWrer Capacity: Surface Water 100'+ 1001+ - - GREER 1000 Gat Lot Line 5'+ 101+ - - N/A Material: Numterotcwnpa,tmanta: STEEL 2 LIFT STATION Foundation 5'+ 1o'+ - Curtain Drain NONE KNOWN Manufacturer c Gel. Remarks: OLD SEPTIC TANK DECOMMISSIONED PER UPC. -Pump on' level at: 'Pury,tlavela° fHeh,ameralarmat VOID OF EXISTING SEPTIC TANK WAS FILLED WITH SOIL. Pump Make B Mcdel' Electrical lnspecil perumal by BOTTOM OF TRENCH INSPECTED BY MOA EMPLOYEE TIM ECKLUND ON 10/26/2016 PIPE MATERIAL House to tank D3034/EXISTING Tank to D3034 drainfeld Installer WILCO EXCAVATION, LLC Drainfield D3034 CO/MT D3034 Inspector GEG, Ltd. BENCH MARK (Assumed elevation) 100.00 Ft. Inspection Lowt"n and Daacripmn: Dates: 1st 10/25/2016 2nd 10/26/2016 3rd 10/26/2016 4th - GARAGE SLAB ENGINEER'S SEAL Community Development Department Approval too * Conditional approval: Date: �y ANGam ss .... r (�C -7953 `- "! -� .•'� : �F...,fit 14 14411 PROFESS\�P:•� Approved: w 1 Date: �t 1��liviiiiskii _• unEcceeEa Inepedun Reparl it. PERMITNUMBER: RECORD DRAWING PARCEL ID NUMBER OSPI: OSP1612661266 017-391-28 1 BUL RUN VALVE O 11 X1!1 r\1 BOTTOM OF TRENCH WAS INSPECTED BY MOA EMPLOYEE TIM ECKLUND ON 10/26/2016 OLD SEPTIC TANK WAS )ECOMMISSIONED PER UPC PER CONTRACTOR ALL WELL RADAII WERE PROFESSIONALLY SURVEYED IN PRIOR TO CONSTRUCTION 1000 GALLON `+- IPTK%TANK .1&21 _EXISTING HOME A I B C ST1 54.4 62.5 88.81 ST2 61.4 70.1 95.5 DBL1 51.5 58.7 85.1 DBL2 51.9 59.4 85.9 DBL3 63.3 71.8 96.9 DBL4 63.9 71.7 96.3 C01 57.7 59.7 61.4 CO2 110.6 90.0 74.7 MT, 59.9 61.5 82.4 MT2 109.8 89.1 73.9 BRV 76.9 69.7 79.7 1 BUL RUN VALVE O 11 X1!1 r\1 BOTTOM OF TRENCH WAS INSPECTED BY MOA EMPLOYEE TIM ECKLUND ON 10/26/2016 OLD SEPTIC TANK WAS )ECOMMISSIONED PER UPC PER CONTRACTOR ALL WELL RADAII WERE PROFESSIONALLY SURVEYED IN PRIOR TO CONSTRUCTION 1000 GALLON `+- IPTK%TANK .1&21 _EXISTING HOME FCO GARNESS ENGINEERING 1` '.:::. •:') ::' �. DECK CIVIL & ENVIRONMENTAL ENGINEERS 3101 E IUDOR ROM, SlR1E 101 • ANC110RMaE. AK'gW • AIpE 1'1Q/)4lfilA • FA%(9�/) }i&�i18•Ng91Ew�p�p�.mn PREPARED FOR: PHONE NUMBER: 1 � DRIVEWAY '�� KAREN EMMEL 952-7657 2 OF 3 PROJECT/LEGAL DESCRIPTION: T.H.#1 SHED MOUNTAIN PARK ESTATES; BLOCK 8, LOT 14 L.K.B./D.J.G. TYPE OF WORK: DATE: � RECORD DRAWING ,tr 11/212016 CO2 <. . FCO GARNESS ENGINEERING GROUP, Ltd CIVIL & ENVIRONMENTAL ENGINEERS 3101 E IUDOR ROM, SlR1E 101 • ANC110RMaE. AK'gW • AIpE 1'1Q/)4lfilA • FA%(9�/) }i&�i18•Ng91Ew�p�p�.mn PREPARED FOR: PHONE NUMBER: PAGE NUMBER: KAREN EMMEL 952-7657 2 OF 3 PROJECT/LEGAL DESCRIPTION: DRAWN BY: MOUNTAIN PARK ESTATES; BLOCK 8, LOT 14 L.K.B./D.J.G. TYPE OF WORK: DATE: � RECORD DRAWING 11/212016 S.... LICENSE 11\VASIka* • #AECC884 N PERMIT NUMBER: RECORD DRAWING PARCEL ID NUMBER: 017-391-28 T.H.#1 TOP OF TANK AT INLET = 93.21 INVERT OF BUNG AT INLET = 92.77 ORIGINAL GRADE AT HIGHEST POINT= 98.12 — RELATIVE ELEVATION OF BOTTOM OF TESTHOLE = 82.12 T.H. DRV ON 10/15/1016 FINAL GRADE = 97.21-97.44 ST1 ST2 f TOP OF TANK AT OUTLET = 93.21 NEW 1000 GALLON SEPTIC TANK INVERT OF BUNG AT OUTLET = 92.58 MT CO rFINAL GRADE = 97.43 - 98.52 FILTER FABRIC INVERT OF PIPE = 92.12 �.•�E OF , GARNESS ENGINEERING GROUP, Ltd CIVIL 8: ENVIRONMENTAL ENGINEERS 3701 E. NOOK ROAD. SUITE 101 • rWCHORAGE, rV(9950]' PIgNE (80])33]$1]9' FA%(90)133&3248'blEBSITE wwxAemmaergneeng.mn .•... 1 ........... ..... �.. /. PREPARED FOR: PHONE NUMBER: PAGE NUMBER: I C� '. / Ge @S: KAREN EMMEL 952-7657 3 OF 3 ���%�; C 7 3 PROJECTILEGAL DESCRIPTION: DRAWN BY: �♦ F •••.,•1 II L ••." MOUNTAIN PARK ESTATES; BLOCK 8, LOT 14 L.K.B. 1*4 p/ . j. TYPE Of WORK: DATE: ;"1 `SS\ •\ � RECORD DRAWING 11/2/2016 #AECNC864 1 • e: On -Site Wastewater Disposal 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: OSP161266 Tax Code Number: 01739128000 Work Type: Septic Upgrade Permit Effective Dates: October 24, 2016 to October 24, 2017 Design Engineer: GARNESS ENGINEERING GROUP LTD Subdivision: MOUNTAIN PARK ESTATES Site Legal Address: MOUNTAIN PARK ESTATES BLK 8 LT 14 G:2838 Owner/Address: EMMEL JAMES N & KAREN S REVOCABLE TRUST EMMEL J N & K S/TRUSTEES 12741 SHELBURNE ROAD ANCHORAGE AK 99516; Site Mailing Address: 13121 RIDGEVIEW DR, Anchorage Lot Size in Sq Ft: 21900 Total Bedrooms: 3 This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy N 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. Received By Issued By: IV ZK -L 10 Zy W16 Municipality of Anchorage M= P.O. Box 196650 • 4700 Elmore Road Anchorage Alaska 99519-6650 • (907) 343-7904 Y Fax (907) 343-7997 http:/Iwww.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program **** VARIANCE/WAIVER REVIEW **** Waiver#: OSV161124 COSA#: Permit#:OSP161266 PID#: 017-391-28 Legal Description: Mountain Park Estates Block 8 Lot 14 Engineer: Garness Engineering Group Applicant: Karen Emmel Your request for a waiver of the required 5 feet horizontal separation from the absorption field to the test hole has been approved. The approved separation distance is 0.0 feet. See engineer's letter for waiver request. 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 owners) of the affected adjacent property. ® Adjacent properties are not affected by this waiver. ..................... ........................................................ Waiver is Granted: X Waiver is not Granted: Date: lf7 2Y .?bApproved by: %k� lx'U� Name of Reviewer ............................................................................... **** VARIANCE/WAIVER REVIEW **** 9 MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Fax: 907- 343-7997 On -Site Water & Wastewater Program Mayor Dan Sullivan On -Site Sewer/Well Permit Application For A Single Family Dwelling Parcel I.D. 017-391-28 Property owner(s) KAREN EMMEL Day phone 952-7657 Mailing address 13121 RIDGEVIEW *ANCHORAGE, AK Site address 13121 RIDGEVIEW *ANCHORAGE AK Legal description (Sub'd, Block & Lot) MOUNTAIN PARK ESTATES; BLOCK 8 LOT 14 Legal description (Township, Section & Range) Lot Size Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DEWELLING: ( Pall that apply) Initial ❑ Single Family (SF) Absorption Field ® ® (w/wo ADU) Septic Tank ® Upgrade ❑ Duplex (D) ❑ Holding Tank ❑ Renewal Multiple Dwellings ❑ ❑ (SF and/or D) Privy Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR: tV _�e5\ \A0\e 4-o ° `�� e Distance: I certify that the above information is correct. I further certify that this is in accordance with " applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/Rush Fees: 15 (A Date of Payment: Receipt Number: O 14 S2.Gt Permit No. ISP! to 12(0'" Waiver Fees: Date of Payment: A o) a q 16 Receipt Number: Oq Waiver No. 0 SV 1( 112 (Rev. 01/11) WIN r - pp GARNESS ENGINEERING GROUP, Ltd •.CIVIL &ENVIRONMENTAL ENGINEERS+ October 24, 2016 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref: Proposed Septic System Upgrade for Mountain Park Estates, Block 8, Lot 14 To whom it may concern: The existing 3 bedroom house is served by a private well and septic system. The drainfield is in a state of failure and needs to be upgraded. We are proposing to install a new 1000 gallon septic tank and 5 -wide type drainfield. One testhole was excavated on the property and the drainfield is designed within its 30 foot radius. Comments regarding the design are summarized as follows: 1. SOILS: See the attached 2016 logs which show the soil classifications, groundwater monitoring, and the percolation test results. During the excavation of the testhole it was noted that the SP -SM layer was encountered at 5 feet below existing grade. However, during the excavation of the perk bench, the GM layer was encountered down to 7 feet. Due to this fact, a percolation test in the SP -SM material was not performed. In short, we are proposing to use the percolation rate of the GM material for the entire trench. Given the visual (see attached soil sample) percolation rate of the SP -SM material (less than 30 min/inch) a 0.6 application rate throughout the trench should be conservative. We would also like to note that a percolation test was performed in the GM material at 3 feet below grade but did not perk. We do not believe this is an accurate representation of the GM material, however, it should be noted there are pockets of impermeable ML (above the proposed septic system). 2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications. 3. SURFACE WATERS: There are no surface water concerns. 4. TOPOGRAPHY: As can be seen on the attached design drawing, the average topography around the proposed drainfield is 0-5%. 5. WAIVER: We are requesting that your department issue a variance from the required separation distance from T.H. to drainfield from 5 feet down to 0 feet. During the excavation of the trench any sluffing that occurs near the T.H. will be excavated out and compacted as to ensure minimal impact on the proposed drainfield. We are also requesting that your department allow for the drainfield to be installed near the existing tank given that we are requiring the existing tank area to be filled with pit -run gravel. We are unaware ofla0y adverse impacts this installation would have on adjacent wells or septic systems. If you have any cues ions, please contact us at 337-6179. Thank you for your assistance. 3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com MOUNTAIN PARK EST —�� BLOCK LOT \ 1 � \ I 100' WELL RADIUS 11 Y -MOUNTAIN PARK MTATES; OO 1 1 BL05j�.5 LU `5 W I \\ 100' WELL RADIUS _ I 1 \\ \ I \ \ MOUNTAIN PARK E�TATES; \ \\ \\ BLOCK L07 B MOUNTAIN PARK ESTATES; BLOCK LOT 161 I 1 I \ p A CS—EPTIC ARE / I MOUNTAIN PAR15/ESTATES BLOCKS T 151 I, \ I/ \ A \ 0 MOUNTAIN PARK ESTATES; BLOCK 4 LOT 6 1 1 1 1 �\ 1 \ 1 1 1 I \ I I \ 1 \ L 1 /�1 1 ioo•wELLIRAOI / \ i�-T ('MOUNTAIN PARK4`FATES; O 1 SOCK B LOT 1� / \�-- —F TdO WE I. R I S RAD / \ I / OUNTAIN BLOCKAyyk ,BATES; i gf i _MOUNTAIN PARK ESTATES; BLOCK5LOT5 / \ MOUNTAIN PARK ESTATES; \\ \ \ 11 \ BLOCy SLOT 413 \ \\ \\ \\ r1 I \\ I 160MLI RADIUS I\ I / MOUNTAIN PARK ESTATES \ \ \ BLOCK51-OT 4A UNTAIN PARK ESTATES; \ BLOCKS _____________- I \II \\\\ \ GARNESS ENGINEERING GROUP, Ltd CIVIL & ENVIRONMENTAL ENGINEERS 3701 E. TUDOR ROAD. SUITE 161' ANCHORAGE, AK 99597' PHONE (907) 337-6179' FAX (907) 336 31x6' WEBSITE. ww garnessengineerinq=m PREPARED FOR. PHONE NUMBER: PAGE NUMBER: KAREN EMMEL 952-7657 1 OF 2 PROJECT/LEGAL DESCRIPTION. DRAWN BY: MOUNTAIN PARK ESTATES, BLOCK 8, LOT 14 D.J.G./L.K.B. TYPE OF WORK: DATE: SITE PLAN 9/13/2016 LICENSE #AECC884 --.1.4h^ PYOFESS�� o U DESIGN CRITERIA: NUMBER OF BEDROOMS: 3 GALLONS PER DAY (GPD): 450 PERCOLATION RATE/S: 30 MIN/INCH PROPOSED APPLICATION RATE: 0.6 MINIMUM DRAINFIELD SO.FT.: 750 FP DRAINFIELD DESIGN: MAXIMUM DEPTH: 10 FEET WIDTH: 5 FEET LENGTH: 75 FEET EFFECTIVE:4 FEET ACTUAL SOFT.: 750 FP EXISTING TRENCH WITH 4 FEET OF EFFECTIVE PER THE 1978 INSPECTION REPORT. CONTRACTOR SHALL CONFIRM EXISTING TRENCH LOCATION (BY A PROFESSIONAL LOCATOR USING A TRANSMITTER) PRIOR TO CONSTRUCTING OF THE PROPOSED DRAINFIELD TO ENSURE SEPARATION DISTANCE BETWEEN DRAINFIELDS, (. I ) I GES, Ltd. HAS A 8 PAGE SPECIFICATION PHONE NUMBER: 952-7657 LETTER THAT PERTAINS TO THIS DESIGN. TO NOTE: THE CONTRACTOR OBTAIN A COPY OF THE LETTER CONTACT SHALL HAVE THE NORTH LOT GES. BY PROCEEDING FORWARD WITH THIS LINE, AND ALL WELL RADII INSTALLATION, THE ENGINEER, WELL DRILLER FLAGGED BY A REGISTERED CONTRACTOR AND PROPERTY OWNER AGREE LAND SURVEYOR PRIOR TO THAT THEY HAVE READ THESE SPECIFICATIONS AND AGREE TO ACCEPT THE CONSTRUCTION. TERMS AND CONDITIONS OUTLINED. 0-5% 0-5 % GARNESS ENGINEERING GROUP. Lid PREPARED FOR: KAREN EMMEL PHONE NUMBER: 952-7657 PAGE NUMBER'. 2 OF 2 PROJECT/LEGAL DESCRIPTION: 7� MOUNTAIN PARK ESTATES; BLOCK 8, LOT 14 �� PROPOSED 1000 GALLON ',/ SEPTIC TANK, INSTALL DOUBLE TYPE OF WORK: -` CLEANOUTS BEFORE AND 10/14/2016 // AFTER TANK 9 O/G EXISTING TANK SHALL BE MOVED AND PROPERLY DECOMMISSIONED. VOID S SHALL BE FILLED WITH PIT -RUN GRAVEN EXISTING FCO EXISTING HOME O _-_--- ` DECK w ' a 5 10% .- SHED j GARNESS ENGINEERING GROUP. Lid PREPARED FOR: KAREN EMMEL PHONE NUMBER: 952-7657 PAGE NUMBER'. 2 OF 2 PROJECT/LEGAL DESCRIPTION: DRAWN BY: MOUNTAIN PARK ESTATES; BLOCK 8, LOT 14 D.J.G./L.K.B. TYPE OF WORK: DATE'. �, DESIGN 10/14/2016 = 40' 41 e � "Vy A. e rness i W m CE -795 =e 0 LICENSE O,°111mv&* #AECC884 GARNESS ENGINEERING GROUP, Ltd CIVIL & ENVIRONMENTAL ENGINEERS 3701 E. TUDOR ROAD. SHITE 101' ANCHORAGE, AK 89507' PHONE 1R071 3076179 - FAX S0713Y32AE - MBSNE; rxw.ymmeagmemp mn SOIL LOG - PERCOLATION TEST LEGAL DESCRIPTION: MOUNTAIN PARK ESTATES; BLOCK 8, LOT 14 PERFORMED FOR: DEPTH (feet) ORG/LOAM 1 JIM EMMEL 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 GM DATE: 9/1/2016 TEST HOLE #1 - LOWER BENCH SOIL CLASSIFICATIONS DEPTH TO GROUNDWATER DATE DRY 9/1/2016 DRY 9/7/2016 IIIIIIIII 9/8/2016 II�III!11 U//�I E1� 111111111 !1111111! V.M • DEPTH TO GROUNDWATER DATE DRY 9/1/2016 DRY 9/7/2016 DRY 9/8/2016 DATE READING CLOCK NET TIME WATER LEVEL NET DROP TIME (MINUTES) READING (INCHES) 10/18/2016 1 3:20 - 6" 2 3:50 30 4.5" 1.5" 3 3:50 - 6" 4 420 30 4.5" 1.5" 5 4:20 - 6" - 6 4:50 30 4.5" 1.5" DURING THE EXCAVATION OF THE T.H. TH LAYER WAS ENCOUNTERED AT 65 FEET. HOWEVER, DURING THE EXCAVATION OF THE PERCOLATION BENCH, ONLY THE GM MATERIAL WAS ENCOUNTERED DOWN TO 7 FEET. THEREFORE, A PERCOLATION TEST WAS NOT PERFORMED ON THE SM MATERIAL AND ONLY THE GM MATERIAL WAS PERKED. SEE DESIGN LETTER IN REGARDS TO THE *UPPER BENCH" PERCOLATION RATE 20 (MIN./INCH) TEST RUN BETWEEN 7 FT. AND 8 PERC. HOLE DIA. 6 (INCHES) FT. 20 1 1 A FOUR HOUR PRESOAK WAS PERFORMED: ® YES ❑ NO SOILS LOGGED BY: DAVID GARNESS PERCOLATION TEST PERFORMED BY: LANDON BRUCE COMMENTS: PERCOLATION READINGS ARE WITHIN 1/16 OF INCH. PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PER RM D IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 2 7to 4�_Pat E1) 4"UNICIPALITY OF ANCHORAGE r 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 \ �Lx1nrn1F_\ PHI�ONEA,,`` NEW 'J�Tn . 44-9446 ❑UPGRADE MAILING ADDRESS (1 N 0y `S -1 LEGAL DESCRIPTION . 90 l-- \4 �- 8 MT LOCATION NO. OF BEDROOMS 1 Un ij 3 U M DISTANCE TO: Well \ 1� t - Absorption area I Dwelling �� I PERMIT NO. p —L 8C)-633 t G Manufacturer ��� Material %-ME L- No. of compartments LU F ^ w Liq. capacity in gallons �O IF HOMEMADE: Inside length t Width A Liquid depth JA G Y DISTANCE TO: Well Dwelling PERMIT NO. JAZ =Z F Manufacturer Material Liquid capacity in gallons w = DISTANCE TO: Well Z Foundation Nearest lot line A PERMIT NO. j Y- 2 No. of lines Length of each line t Total length of Ii t es Trench width Distance between lines . I M F Z w(C) b inches �1 -A F Top of tile to finish Material beneath the grade r I. L{ p It Total effective aks tion area inches Length idth Depth PERMIT NO. UJ (7 I i F Type of crib ri ameter ` Crib depth Total effective absorption area wa N DISTANCE TO: Well Buildingfo d ion Nearest lot line lassA Depth Driller Distance to lot line PERMIT NO. r SE 3 DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER W PIPE MATERIALS 3O7S-A- YLMMO. SOIL TEST RATI NG ^ INSTALLER REMARKS a ti Lh A Ito( c. L. 3 L G L A ED1DATE1 p LEGAL n � t - IS & 1\� 3 w MU" 10 I Pf�IL- I TY OF=' Fi/ C3FiC}RF-iC'aE � t DEPARTMENT RLTH AND ENVIRONMENTAL TION 825 'WREET, ANCHORAGE, AK. 9(.rj2��� 264-4720 . , {(.ec, �- --' �t+i— I TE SSEWER P r PERMIT NO. [ 780333 ) C) : qq;� ra 1-r3-7k RPPLIGANT JIM $MMEL SRR BOX 1592- 507 no 4-9446 LOCATION CRESTVIEW 1-ra �� LEGAL L 14 B 8M PARK ESTATES LOT SIZE 20000 URRE FEET TYPE OF SOIL RBSORBTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING (SQ FT?BR)= 160 II�� THE REQUIRED SIZE OF THE SOIL RBSOON SYSTEM IS O vY. E>EF"TH- E ILEh1C3-r"1 C3FZI,-4VEL E E:F�I-r"= THE,LENOTH DIMENSION IS'THE LENGTH CIN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE -IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFRLL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). REGtU I REEFlT E? n3'I IG TFI1'4K �5 I 2�E_ �Li10iO r. nL_L_C]F-as PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. TW01 C 2 ? I t+i F'ECT I C]NS~ DIRE REGlU I F2EE? — — BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN R WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE'WELLS OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F•ERM I T E>{F' I RE S E>ECaEME�ER 3:3r 1sA r�:B I CERTIFY THAT 4 1: I RM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3 I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. SIGNED:- -e z-- --------------- APPLICANT JIM EMMEL ISSUED BYJ,� � �" . -DATE- g ---,,91- - ;� V3. 2 r GARY PLAYER VENTURES CONSULTING GEOLOGIST BOX 476-M, STAR ROUTE A • ANCHORAGE, ALASKA 99507 • PHONE 344-7071 SOILS LOG Performed for Location NOCK 14 i40' �3 -2-5' E 4�-evM 0 2 4 6 18 20 Soil Type Water Level Date -3/4-hg Remarks Total Depth of Excavation ��l r Material at Total Depth Groundwater Bedrock ( ) Not Reached �ot Reached Depth, if Reached 12— Classification 2Classification Method' {/visual ✓( ) Sieve Analysis �' �enrcv�vtw. fZp.�e = �11 eeAt\Aov-,,r M Depth, if Reached Gary F. Player, Consulting Geologist vw vv uv env a �) c vci G lit (G O {, ' C. ('�coluj�w w�CAJa\ Q�CN_I)'Vj1,j0\< eAZAV', j 3.5 — 16. S c,, ccu: e1 S W Total Depth of Excavation ��l r Material at Total Depth Groundwater Bedrock ( ) Not Reached �ot Reached Depth, if Reached 12— Classification 2Classification Method' {/visual ✓( ) Sieve Analysis �' �enrcv�vtw. fZp.�e = �11 eeAt\Aov-,,r M Depth, if Reached Gary F. Player, Consulting Geologist 60, kA9 I W0 I R Fl HE . .. ..... ;1 4iiii F: I:;:. T. . .Fl T FI -I 1"' llhl- I'E Al'AlWED L.. 1 -1 ll:-.'-: I'l I.J 1'.j 1. C .1. F.. I. -I L VT.I J I.... 1:::11,.4 .......... .... ... . rm --- elk 1000 91,�Lf N • Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 Certificate of On -Site Systems Approval Parcel I.D. 017-391-28 Expiration Date: 1. GENERAL INFORMATION: Complete legal description Mountain Park Estates: Block 8, Lot 14 Location (site address) 13121 Ridgeview Drive *Anchorage, AK 99516 (?�—tssLj4-OL-4-7- 2-7-/7 Current Property owner(s) Karen & James Emmel Day phone 952-7657 Mailing address Real Estate Agent 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ W aiverNariance request for: Received by _ Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 5 Waiver Fee $ Date of Payment j 7'1 Date of Payment Receipt Number 0 15-S DO (7 Receipt Number COSA# (iSL 1 %t 730 Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm: Garness Enaineering Group. Ltd (GEG) Phone: 907337-6179 Address: 3701 East Tudor Road, Suite 101- Anchorage, Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: cib I In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or parry (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. 6. DSD SIGNATURE System #1 Approved for -� bedrooms System #2 Approved for bedrooms #AECC884 Disapproved Conditional approval for bedrooms, with the following stipulations: `Z, 03�-SiT� T, WASTEWATER =; PRO Iw By: Original 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 —7a— Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA bWe sheet 10-10-1z.da If more than 1 septic system is on the lot: COSA Checklist If of Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: Mountain Park Estates; Block 8, Lot 14 parcel ID: 017-391-28 A. WELL DATA J'Reasonable to believe cased to 40'+ based upon surrounding well logs) Well type Priwte If A, B, or C provide PWSID# N/A Well Log (Y/N) Yes Date completed 4/1978 Sanitary seal (Y/N) Yes Wires properly protected (Y/N) Yes Total depth 176 ft. Cased to`Unknown ft. Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 4/1978 8/5/2016 Static water level 146 ft. 150.1 ft. Well production 12 g.p.m. 2+ g.p.m. WATER SAMPLE RESULTS: 1 Coliform n ,V colonies/100 ml. Nitrate '-T � � g./L. Collected by: GEG, Ltd. Arsenic:/ " Qg./L. Date of sample: 8/16/2017 B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 10/25-26/2016 Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) Yes Foundation cleanout (Y/N) Yes Depression over tank (Y/N) No High water alarm (Y/N) N/A Date of pumping New Pumper - C. ABSORPTION FIELD DATA �Bdow Flna1 Grade Date installed 10/25-26/2016 Soil rating OiDvor ft /bdrm) 0_6 System type Deep Trench Length 75 ft. Width 5 ft. Gravel below pipe 4 ft. Total depth *9.3+ ft. Eff. absorption area 750 ft2 Monitoring tube Yes Depression over field No Date of adequacy test New Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test = in. Water added =gal. New depth =in. Elapsed Time: = min. Final fluid depth = in. Absorption rate >= 450+ g,p,d, Any rejuvenation treatment (past 12 mo.) (YM & type) None Known If yes, give date - (Drainfield was dry upon inspection on 8/15/2017) Information on the 1978 trench on record with MOA D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N)_ 'Pump on" level at in. "Pump off' level ata er alarm level at Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main Sewer /septic service line Public sewer manhole/cleanout 100'+ Holding tank Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots :9 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 5'+ Curtain drain None Known Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION i OF.q� i certify that I have determined through field inspections and y I Y review of Municipal records that the above systems are in ...... "• ' ' '"' "' • • .. conformance with MOA COSA guidelines in effect on this date. t7 f y A. uie s: A. GARNESS �Q Engineer's Printe Name JEFFREY CE— 9 Date q�%11� JGc FoG #AECC884 (Rev. 11/05) Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 Nitrate Advisory Certificate of On -Site Systems Approval # OSC 161530 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 8, Lot 14 of Mountain Park Estates subdivision. This inspection revealed a nitrate concentration of 7.96 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. Municipality of Anchorage On -Site Water & Wastewater Program ^ (907)343-7904 >CU;O n 1 CERTIFICATE OF ON-SITE SYSTEMS Parcel I.D. 017-391-28 1. GENERAL INFORMATION Complete legal description Location (site address) Current Property owner(s) Mailing address Real Estate Agent Expiration Date: 2 -1 l0 -I I MOUNTAIN PARK ESTATES; BLOCK 8, LOT 14 13121 RIDGEVIEW DRIVE*ANCHORAGE JIM & KAREN EMMEL Day phone 952-7657 13121 RIDGEVIEW DRIVE*ANCHORAGE 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: Day phone TYPE OF WASTEWATER DISPOSAL: Individual Well i® Individual On-site E Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ WaWerfVananoe request for. _NIA Distance: Received by� �Date: COSA to be released o the engineer/unless otherwise requested by the engineer. COSA Fee $ 5-:2 d Waiver Fee $ Date of Payment ��- Date of Payment Receipt Number X538 Receipt Number COSA # �Cl �r� a Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, 1 verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179 Address 3701 E. TUDOR ROAD, SUITE 101 *ANCHORAGE, AK, 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date It tf 111. Engineer's Comments: In conducting lhisevaluaiion, GEGpovidedan engineering evaluab'an ofthe well andlorseptic system in accordance with the guidelines andregulations established by the MunkipaldycfAnchorage andindushypractices. The reportedresults describe the condition of the systems on the datek of the evaluation. Separation distances were measured to maddyidentfiable feature. Hidden defects orencmachmenfs may lha(were idenfifod 1, 4V exist not during the evaluafion.The operationalfile atoll wells and septic 41, systems dependon a vanatyof vdriablesinGuding, but notlimrtedto, soilcondNons, gmundwaterlemis(that mayguctuale during the yea4, quality of construction (materials and workmanship), and the water usage of the family utliving the systems. These * ;� 4 conditions can vary, and am outside the cannot of SEG. Satisfactory test results do not guarantee future performance of the ■ .e:. . . systems; therefore, GEG makes no, warranty (express orimplieog regarding the future performance of the well or septic system. .I 0 GEG makes no representation whether an aftemative well orseptic system can be installed on the property in the event either of the /,,,,,1 •,' current systems fail. The content of this report is for the sale benefit of the persoNparty who retained GEG. Reliance upon the information in this report by including t e t�� (ja eSs 4�i pmvided any otherperson orparty, but not limited no subsequent properlypumhasers,isnot ♦61�:, 4rz �� C 7953 authorized. In short, GEG disavows anylegal duty to anyone other than the person1party who paid forthis report. rJ1T ,Y 6. DSD SIGNATURE ♦����FO ppp!,.�........!.�1P���1 System #1 Approved for bedrooms. LICENSE' 1it"S"1�11• #AECG884 System #2 Approved for bedrooms. Disapproved. 'uu(i 1ttrf10F `; kl v6, Conditional approval for bedrooms, with the fallowing P� stipulat p �� ON SITE ^ 71 V I I - -' o STE\NATER c) PROGRA Original Certificate Date: I I- ( � — JC-)— The Municipality or Anchorage Develop,emt Services Division (DSD) issues Certificates of Onsite Systems Approval (COSA) based only upon the represenatations 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 engineers work. 7. ATTCHMENTS: COSA Checklist - Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other (Rev. 10112n2) Q='Ji -D v ,1)1�11b 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: MOUNTAIN PARK ESTATES; BLOCK 8, LOT 14 Parcel ID: 017-391-28 A. WELL DATA *PER SURROUNDING WELL LOGS. Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES Date completed 4/1978 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES Total depth 176 ft. Cased to *40+ ft. Casing height (above ground) 1'2+ in. FROM WELL LOG Date of test 4/1978 Static water level 146 ft. Well production 12 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Arsenic: ND<5 ug./L. B. SEPTIC/HOLDING TANK DATA Tank Type/Material Nitrate 7.98 mg./L. AT INSPECTION 8/5/2016 150.1 ft, 2+ g.p.m. Collected by: GEG. Ltd. Date of sample: 8 /2 /2016 STEEL Tank size 1000 gal. Number of Compartments 2 Foundation cleanout (Y/N) YES Date of pumping NEW Depression over tank (Y/N)NO Pumper — Date installed 10/25-26/2016 Cleanouts (Y/N) YES High water alarm (Y/N) N/A C. ABSORPTION FIELD DATA *BELOW FINAL GRADE Date installed 10/25-26/2016 Soil rating Cfp.d.r ft2/bdrm) 0_6 System type DEEP TRENCH Length 75 ft., Width 5 ft. Gravel below pipe 4 ft. Total depth *9.3+ ft. Eff. absorption area 750 ft2 Monitoring tube YES Depression over field NO Date of adequacy test NEW Results (Pass/Fail) PASS For E bedrooms Fluid depth in absorption field before test NEW in. Water added NEW gal. New depth NEW in. Elapsed Time: NEW min. • Final fluid depth NEW in. Absorption rate >= .450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N R type) NONE If yes, give date — INFORMATION ON THE 1978 TRENCH IS IN MOA RECORDS D. LIFT STATION Date installed. "Pump on" level at in E. SEPARATION DISTANCES Size in gallons Manhole/Access (Y/N Pump off' level High water alarm level at in. Cycles tested Meets alarm & circuit requirements? SEPARATION.DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ 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'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation Water main Wells on adjacent lots 5'+ 10'+ _ Property line 5'+ Absorption field 5'+ _ Water service line 10'+' Surface water *100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Water service line 10'+ Building foundation 10'+ Water main 10'+ Surface water *100,+ Driveway, parking/vehicle storage 5'+ Curtain drain. NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS *SEE ATTACHED MOA WETLANDS MAP 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. Engineer's Printed Name JEFFREY A. GARNESS Date 111 /D lit, (Rev. 11105) Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 Nitrate Advisory Certificate of On -Site Systems Approval # OSC161530 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 8, Lot 14 of Mountain Park Estates subdivision. This inspection revealed a nitrate concentration of 7.98 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. I dot 15 I N82°15'01"E 189.91 30 1 Septic e rw 2 StoN N well a Ftaoe .o Nojse / 2.0011 deck 1 I t � G@"Je1 drNewaY 1 rj !r Vot 0 i f shed f / r i f s IJ � 1 / I 5 1689 °3816 � E N� ,CIA O�t� Gj I of 13 to to tri 0 W _O Co 0 N O ii 11 RECERTIFIED 11-316 'Y,f�/ AS -BUILT NO COR ERS SET THIS DATE I hereby certify that I have performed a Mortgagee's inspection of the following described property: LOT 14. -BLOCK 8. MOUNTAIN PARK ESTATES SUBDIVISION Anchorage Recording Precinct, Alaska, and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto that no improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska this 11th tlay of August .2016 FRED WALATKA & ASSOCIATES Engineers and Surveyors (907-248-1666) .OF , A` •y 49th00 00 /••••• #4 .Fred Wal atka. / SCALE: 1"=30' if 3255 — S Je�� l,�o'•. oy� EASEMENTS OF RECORD. OTHER THAN THOSE SHOWN THE RECORDED ON PLAT ARE NOT SHOWN HEREON. FB 16-10, pg 37 BE I of 13 to to tri 0 W _O Co 0 N O ii 11 RECERTIFIED 11-316 'Y,f�/ AS -BUILT NO COR ERS SET THIS DATE I hereby certify that I have performed a Mortgagee's inspection of the following described property: LOT 14. -BLOCK 8. MOUNTAIN PARK ESTATES SUBDIVISION Anchorage Recording Precinct, Alaska, and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto that no improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska this 11th tlay of August .2016 FRED WALATKA & ASSOCIATES Engineers and Surveyors (907-248-1666) 5. LEGAL DESCRIPTION DEPT. OF ALT:- & MUNICIPALITY OF ANCHORAGE IOt E DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTI ONNVIRQNMENT _ -i ECTION 825 L Street - Anchorage, Alaska 99501 • FEB 6 11-j-1-9 j ENVIRONMENTAL ENGINEERING DIVISION 6. TYPE OF RESIDENCE Telephone 264-4720 RECEIVED REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTYOWNER },� PHONE <ICstvL � 7. WATER SUPPLY ry� MAILING ADDRESS * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well PROPERTY RESIDENT Of different from above) PHONE 2. BUYER PHONE MAILING ADDRESS ❑ 3. LENDING INSTITUTION PUBLIC UTILITY PHONE MAILING ADDRESS 4. REALTOR/AGENT PHONE MAILING ADDRESS 5. LEGAL DESCRIPTION IOt STREET LOCATION j V �f ui 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS SINGLE FAMILY ❑ One ❑ Four ❑ Other ❑ Two ❑ Five ❑ MULTIPLE FAMILY Three ❑ Six 7. WATER SUPPLY - 4 INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) S. SEWAGE DISPOSAL SYSTEM f ] INDIVIDUAL/ON-SITE** **If individual/on-site, give installation date fU ❑ If system is over two (2) years old an adequacy t st is required PUBLIC UTILITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) THIS SIDE FOR OFFICIAL USE ONLY INSPECTION APPOINTMENTS DATE RECEIVED , TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE ❑ SINGLEFAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON-SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATEINSTALLED INSTALLER S ❑Septic Tank or ❑ Holding Tank Size: 1090 If Tank is homemade give dimensions: SOILS RATING I (f O TYPE OF TANK MANUFACTURER /�i'u.✓•"� TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS M- APPROVED FOR �� BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE r BY (Title) LEGAL DESCRIPTION 72-010 (Rev. 3/781