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HomeMy WebLinkAboutROBERTS BLK 2 LT 13Rob rts Block 2 Lot 13 #010-106-25 06/17," 20116 21:39 907-345-x!202 ALF'11HE DRILLING PAGE 01l0 1 Alpine Drilling & Enterprises eH Log Permit Number: OSS 161224 ]gate of Issue: 6-18-16 Pareeli Identification Number: 01010625000 Pate Started: 10-3-16 date Completed.- 1,9-9-15 Ts well located at approved permit location? x Yes ❑ No Legal Description; Roborts Block 2 Lot 13 Property Owner Name & Address: Dreezen Jarnss G & Hutson Aaron G PO Box 110663 _ Anchorage, AlRske 99511 Borehole Data, Nplh (fa) Method of brilli ng x air rotary ❑ cable tool Soil Type, Thickness & Water Strata From ro - Casur.g type: _Tteej Nall Thickness:. --_!50 incites Diameter: _fi inches Depth: 139 feet Liner Type: _ Diameter: . itaehes Depth: feet Casing stickup above ground: 2_ feet Static water levet (ftom g our)d level): ; fort Pampi➢1,4level: 135 feet. after - 2 fours pumpilig SU-+- gpm. Recovery Rate: 50 + gptra Method of 'Vesting: aar Ji Well Intake (Opening Type: x Open End ❑ Open Hole © Screened Start feet `3topped _-- feet. ❑ Perforations Start feet Stopped_. feet Graaf "type: bentonite mules Volume: I Deot11; Start 0 feet Stopped ? feet Pump: intake Depth feet Pump size lap Brand Natne Well Disinfected Upon Corxrpletitan°? xyes ❑ 1_�O Method of Disinfection: clrlorirte tablets Comments: —� 'Well Driller: ,Alpine Drilling & nterprises O Poi 110496 Anchorage .IK 99511 stack-uly 0 q gravelft", 2.5 5 Organics cit salt 5 54 sanely sill 54 91 �gF avelly silt ?I 133 water sand d: ;ravel 1 3 139 WATER QUALITY TESTBR G Coliform !v CoV iOOmL Rtil`raYe� �1—�_____ L Arsenic 3 a. Ug/L 1 i2`�'19 ARCTIC PUMP & WELL INC. Jim Sullivan PO Box 770197 - Eagle River, AK 99577 E�pPIEII XAIEB SYSI[HS ` � g sots a stavar (907) 688-2510 (907) 243-2282 I 1 Installation/` ,iF CY Well Drilling Permit Number: osp151224 Parcel Identification Number: 1010625000 Date Of Issue: 8/18/2016 Legal Description Roberts B2 L13 Property Owner Name Address: Jim Dreeszen Lot: 13 PO BX 110663 Block: 2 Anchorage AK 99511 Pump Installaion Date: 10/13/2016 Pump Intake Depth Below Top of Well Casing: 110 Pump Manufacturer's Name Franklin Pump Model: 10SDQP-1.5HP-3RC Pump Size: 1.5 HP Pitless Adapter Burial Depth: 10 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, October 20, 2016 On-Site Water System Permit MUNICIPALITY OF ANCHORAGE Development Services Department Qn-Site Water & Wastewater Program 4700 Elmore Road, PQ Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP161224 Tax Code Number: 01010625000 Work Type: Well Initial Permit Effective Dates: August 18, 2016 to August 18,.2017 Design Engineer: Subdivision: ROBERTS Site Legal Address: ROBERTS BLK 2 LT 13 G:1629 Owner/Address: DREESZEN JAMES G 50% & HUTSON AARON G 50% PO BOX 110663 ANCHORAGE AK 995110663 Site Mailing Address: 3404 INDIANA ST, DUPL 2, Anchorage Lot Size in Sq Ft: Total Bedrooms: epartment 6820 6 This permit is for the construction of: N Disposal Field N Septic Tank N Holding Tank N Privy Y Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Special Provisions: iTo close this permit please submit: 1. Well Log 2. Pump Install Log 3. Water sample results Received By: ~. ~'~~~ Date: Development Services Division Community Development Department On-Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. Ol O/0~:~ Property owner(s) ,..J c,.¢.~.~ ~ b ~ ~ ~ ~ Day phone Mailing address ¢~ O O ~ ~ ¢ ~ ~ ~ Site address i'¢ ¢¢'~ & 5 '~ Legal description (Sub'd.. Block & Lot) &¢ 13 2 Legal description (Township, Range & Section) Lot Size ~ ¢~ 8 Sq. Ft. Number of Bedrooms APPLICATION IS FOR: (1~ all that apply) Absorption Field [] Septic Tank [] Holding Tank ' [] Pdvy [] Private Well [~ Water Storage [] APPLICATION IS AN: Initial Upgrade Renewal TYPE OF DWELLING: Single Family (SF) (w/wo ADU) Duplex (D). Multiple Dwellings (SF and/or D) THIS APPLICATION INCLUDES A VARIANCE I WAIVER REQUEST FOR: Distance: I certify that the abo_g.veJRfermatioTfl~correC-'t.-l'furthe¢.cad, jfy that this is in accordance with applicabl_e ~uJ3ic~~--~. .... (Signature of pro.owner or authorized agent) -"' _ 't' Waiver Fees: Permit/Rush Fees._.& Date of Payment: ~ Data'of Payment: Receipt Number: 0~-~'~(/~, Receipt Number: Permit No. 0,.~lO J {z:) j~'/~j' Waiver No. Permit App_9-1-12.doc .L33~1.I.S VN¥1aNI 00'~9 M,,OOZOoOON 00'~;9 M,,OOZOoOON I Ltl II n,,' 0 0 DATE OF APPI,;ICATION: 0~30~0~ BLOCK/LOT/TRAC~: BL, K 2 / LT 13 / SUBDtVISIOI~.: ROBERTS TAX CODE: 0~01062.5000 GRID: SW1629 SC.EDUL COMP .E'nO. D^TE: [] CO~:-RClAL [] MULTI-DWELLING No. APT8 STREET ADDRESS~ , AK OWNER: DREE~7.EN JAMES G PHONE: MAIL ADDRESS: PO BOX ?'I0663'ANCHORA(3E;A'K~995110663 CONTRACTOR ..~J~;~,~ee~.j ASb'ES~MENT$ [] Repair ~sang Se~ ~ M~n Line ~ensl0n ~ O~ Pmpe~ On~ ~ Ct~ Tap ~ ~e ~n Levled ~ H~nt O~ . · . ~ TO Be Levied ,~' Main Tap - To Pm~ Une Only Commen~: '~" ~ Main Tap &On Pmpe~C~n~ R~ No~ , OONNEOT ~ 4iff ISSUED ~r INSPECTION FEE $ 103.00 ~ PAID ~ C~H P~RMIT FEE $ 72.~ ~ CHECK~ $ 0.00 ~ ~ER REIMBUR~BLE DEPOS~ $ 0,00 iNSPECTED BY~ NUMBER TOTAL $ 175.00 REMARKS PERMITEE (Please Print) DREESZEN JAMES G MAIL ADDRESS PO BOX 110663 ANCHORAGE, AK 995110663 SIGNATURE PHONE POST IN A CONSPICUOUS PLACE AT THE JOB SITE INSPECTOR COPY DATE SCHEDULED 12/31/2014 TIME 12:00 am INSPECTOR SUBDIVISION ROBERTS BLOCK/LOT/TRACT BLK 2 / LT 13 I1-,11~ 31~TE NORTH HI 5/14 II / / II II INSEPECTED BY: DATE: Mayor Ethan Berkowitz Anchorage Water & Wastewater Utility Engineering Division August 5, 2016 Board Chair David M. Richards James Dreezen PO Box 110663 Anchorage, AK 99511 Re: ROBERTS BLOCK 2 LOT 13 (Grid SW1629) Request for Letter of Non-objection to Encroachment (Tax ID~ 010-106-25) The Anchorage Water and Wastewater Utility received a request from you on August 5th, 2016 in regards to a proposed well site into the Water Easement along the east property line bordering of 3404 Indiana Street (Legal Description Roberts BIk 2, Lot 13). The Water Easement is 20 feet wide and is recorded by Book 820 Page 904 with the Alaska State Recorders Office. See attachments. AVVWU is currently not using the Water Easement however AWWU requests the placement of the well in the western portion of the Water Easement while still creating a 75 feet separation with existing AWWU sewer main along the west property line of 304 Indiana Street. This request is based on the ability to extend AWVVU public water main to the north in the future and minimize conflict. AVVVVU hereby issues this letter with stipulations to allow the encroachment of the proposed well encroaching into the Water Easement, the property owner(s) agrees to the following: 1. AVWVU will be held harmless, now and forever, for any damages or injury to any person as a result of the encroachment; 2. The property owner(s) shall call for utility locates before excavation in the ROW; 3. All applicable codes and regulations will be observed and maintained within the ROW; 4. This letter will in no way preclude AWWU from full use and enjoyment of its rights within any portion of the ROW; 5. The property owner(s) shall pay any additional and/or extraordinary costs incurred to accommodate the encroachment during any future required construction or reconstruction of AVWVU facilities; 6. AVVWU's non-objection does not imply other approvals that may be required for this encroachment; and, 7. AVWVU does not provide a position for any other parcel or utility impacted by the encroachment. Should you have any questions, please call the AVVWU Planning Section at 564-2739. Sin ~cer~.~. ~oo Sanks Planning Engineer Anchorage Water & Wastewater Utility (~) Clearly 300OArcttcBouleva'd ·Anchorage, Alasl~ 9950~ ',,~~ Phone 907-$64-2774 * Fax 907-562-0824 · www. awwu, bE MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Parcel I.D. 010-106-25 Certificate of On -Site Systems Approval / I Expiration Date: I l 2 Legal description ROBERTS BLK 2 LT 13 Site address 3404 INDIANA ST Anchorage AK 99503 Current property owner(s) DREESZEN JAMES &HUTSON AARON X The On-site system(s) is/are approved for 6 bedrooms Conditional approval for Comments or advisories: L'2 bedrooms, with the following stipulations: Original Certificate Date: 8/1/2023 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA Approval_June 2022 MUNICIPALITY OF ANCHORAGE r' Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 01010625000 Complete legal description ROBERTSBLK 2 LT 13 Location (site address) 3404 INDIANA ST Current property owner(s) DREESZEN JAMES 2. ON-SITE SYSTEMS SIZED FOR 6 BEDROOMS Day phone 230-6321 3. TYPE OF WATER SUPPLY: ❑ Private Well 0 Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ❑ Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank 0 Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: Vi Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ 1� 11 Date of Payment COSA # 0S c 2- 3 1 L __ T Waiver Fee $ Date of Payment Waiver # COSA Application—June 2022 COSA Checklist Legal Description: ROBERTSBLK 2 LT 13 Parcel ID: 01010625000 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA ❑■ Well log is filed with Onsite (or attached) Date drilled 10/4/16 Total depth 139 ft Cased to 139 ft ❑■ Sanitary seal is functioning correctly ❑■ Wires are properly protected Casing height (above ground) 36 in. Date of flow test for COSA 7/31/23 Static water level at beginning of test 16.1' ft Comments PUBLIC SEWER SYSTEM B. TANK DATA Measured operating fluid level in septic tank Date of pumping ❑ Required maintenance completed, if AWWTS Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) ❑ ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) If yes, enter date Comments/Deficienci COSA Checklist June 2022 Well production at time of test 10+ gpm Water storage tank volume0 gallons Well disinfected for coliform test? ❑ Yes ❑■ No ❑■ Coliform bacteria is Negative Nitrate 1.52 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L XArsenic less than MRL (ND) Collected by NRimEng Date 6/12/23 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date _ Results ❑ Pass Fluid depth prior to test Water added gal New fluid depth in Elapsed time min Final fluid depth in in Absorption rate gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) Effective depth used in Effective depth remaining in in E. SEPARATION DISTANCES From Private WeII on Lot to: (Please enter distances if less tha5 required a if community wall on lot) Septic Tank/Lift Station on Lot > 100' ❑ Yes if No ft Surface Nater > 100' Community Sewer Manhole101eanout > 100' _R Yes if No ft E Yes if No Neighboring Tank > 140'[]■ Yes if No ft Private Sewer/Septic Line> 5' ■❑Yes if No Absorption Field on Lot 100" ❑■ Yep if Na ft Holding Tank 140' Q es if No Neighboring Absorption Fields > 100' Animal Containment > 50' ❑■ 'des if No ❑■ Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ❑■ Yes if No .. _ ft r■ Yes if No ❑ N 1 — Served by Community Well (not on lot) or Public Water From SeptiOHold ing Tank and Absorption Fields) on Lot to; (Please enter distances 0less than required) ft ft ft fl. ft Building Foundations > 10' ❑ Yes if No ft Surface Nater > 100' ❑ Yes if No ! ft Tank to Property Line> 5' ❑ Yes if No ft Wells on Adjacent Lots: Field to Property Line > 10' ❑ Yes if No ft Private Wells > 100' ❑ Yes if No ft Water Main > 10' ❑ Yes if No � ft Community Wells > 240' ❑ Yes if No ft Water Service Line > 10' ❑ Yes if No fit F. ENGINEER'S COMMENTS If tank or field is under driveway comment below G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed thereto 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, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Larne of Firm NarthRim Engineering Phone 694-7028 Engineer's Printed Namo Steve Eng Date 7131123 AW Ar o * * en Steve Eng CE-6256_�A 7•/31%2 COA Checklist June 2022