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HomeMy WebLinkAboutMOUNTAIN PARK ESTATES BLK 10 LT 3A Mountain Park Estates Block 10 Lot 3A #017 - 441 - 55 • Municipality of Anchorage On-Site Water and Wastewater Program• (907) 343-7904 Page 1 of 2 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP 171102 PID Number: 017-441-55 Dwelling: • Single Family(SF) ❑ Duplex(D) ❑ Multiple(SF and/or D) Project: ❑ New l Upgrade Name: ABSORPTION FIELD CHUCK AND JAN FRASSA Address ❑ Deep Trench ❑ Shallow Trench ❑■ Bed ❑ Mound ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 0.8 GPD/SF 9.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot 3.0 Ft.6.0 Ft. MOUNTAIN PARK EST. BLK 10 LOT 3A Fill added above original grade Gravel length Township Range Section 0.5-1.2 Ft. 63 Ft. Gravel width Beds:Number of Lines Distance between lines SEPARATION DISTANCES 2.0 Ft. Ft. To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist.between trenches From Tank Field Tank Line 756 Ft2 1.0 Ft. Well 100'+ 100'+ I50'+ TANK El Septic ❑S.T.E.P. ❑Holding ❑Other Manufacturer Capacity Surface Water 100'+ 100'+ ANCH TANK 1250 Gal. Material Number of compartments Lot Line 10'+ 10' NA STEEL 2.0 Foundation 101+ 20'+ LIFT STATION 1 Manufacturer Capacity Curtain Drain UN UN Gal. Remarks Pump on level at Pump off level at High water alarm at in. in. in. Pump make and model Electrical Inspections performed by PIPE MATERIAL House to tank 3034 Tank to 3034 Installer drainfield MIKE ANDERSON, P.E. Drainfield3034 CO/MT3034 Inspector MIKE ANDERSON, P.E. BENCH MARK (Assumed elevation) 106.6 ft Inspectionect1.16-6-17 2. 6-6-17 Location and description es: 3,d 4th BACK DOOR SIL COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engirr,er's,S;atnp ten'.'.. —v.'S Am.,::‘ , 0 i: 4 tf. ._fa ll Conditional Approval: Date v�A<P•.•• i5 411 49TH W :.% •,,,i/5 /it.-o: MICHAEL N. ANDERSON ; �__ l� eO%:. CE-94 9 .;`�r>' Approved ( I __ :_rJ�l�� Date 3 - - '" 4 t 0 • ' , i r tib. 4 jEaSt- --z.- Inspection Report_9-1-12.doc Permit No. OSP171102 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description: MOUNTAIN PARK ESTATES, BLK 10, LOT 3A PID No.: 017-441-55 \ _ _ MARK A B C \ N CO1 30 17 ,. \ �N CO2 29 17 / \ N r ---X-0128 // -...„_4._ , \\ `� TCO2 73 / CO3 7ej / I 1 C04 39 .18 // I R ALPINE \,, C05 75 , 38 / MT 95 ' 66 / ,\ t CO6 76 I 39 ' // CO7 110 70 / C08 78 75 I // - / I \ 1 // EXISTING WELL i / / \ / _ _ _ \ TANK ND Cf�1B D 0/ SIONED c08 \\ Aill PERPC1/ II/ II \\\ \\ *0 / // II \ C04 • i / / 1 Po' 11 CO6 / _ _ M 1 1 CO5'�! �O3 _1 Ala ' ��BENCH, 00' SIL —'— \ \ 11 TCO / `� N C�O7 —' i CO1 iN —__ ____jeZ 10 T& a•- / `N �� \ / \ ,� \ / N \ \ \ / \ \ / \. \ \ \\\ // I \ - A I T \ i/ \ \\Z`A� 1"=50' (CO yr COil CO4 TC01 FCOS {r co. COT Mr CC8 ,,",a1 I I ! TCO2 l I ` 100 CRG. �,167676‘1"1/411,- .1-i 1 1 J C .7 � A.1 CCC .2 �LNAL CRATE - X100.5 �•••'\ OF /q/ ,. •�♦♦� 11110 / WNW '/ .^`1 _ •.•.•...�G11S tp ORC 7 •TER vA8f 11 =iff 49 T" %\• _ OA 1150 GALLON �.1 l CY/Su • 99 5 / STEEL.TANK mar.oc. 1`` • / 0• 511—N \ 9r 95.3 / 95.3 l.9 / 0 P'MICHAEL N. ANDERSON:/ - 0 #.1-) No. CE 469 •-. SEPTIC. SECTIO BOTTOM of THE HOLE ELEV BI• ,..,,yT�'\�- WATER 0 83'MAY 2017 4 44 -�SS\U 44• �'1II\f1Wi��. .t\-.. `° MUNICIPALITY OF ANCHORAGE .01„nr On-Site Water&Wastewater Program N° ` ^S.PO Box 196650 4700 Elmore RoadAnchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997http:/lwww.muni.org/onsite I chartntent On-Site Wastewater Disposal System Permit Permit Number: OSP171102 Effective Date: 5/31/2017 Work Type: Septic Upgrade Expiration Date: 5/31/2018 Tax Code Number: 01744155000 Site Legal Address: MOUNTAIN PARK ESTATES BLK 10 LT 3A G:2838 Site Mailing Address: 12500 ALPINE DR, Anchorage Owner: FRASSA CHUCK V & SANDRA J Lot Size in Sq Ft: 44456 Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING Total Bedrooms: 4 This permit is for the construction of: 0 Disposal Field 0 Septic Tank ❑ Holding Tank ❑ Privy LI Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: Date: IV(/ . Issued By: ').jt/ j-rl Date: J�3 (7/17/7 MUNICIPALITY OF ANCHORAGE Community Development Department `R, o; Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On-Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 017-441-55 Property owner(s) JAN FRASSA Day phone 3t4 z( Mailing address 12500 ALPINE DR ANCH, AK 99516 Site address SAME Legal description (Sub'd., Block & Lot) MOUNTAIN PARK ESTATES B 10, LOT 3A Legal description (Township, Range & Section) Lot Size 44,456 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (Z all that apply) Absorption Field ❑X Initial n Single Family (SF) ❑X (w/wo ADU) Septic Tank ❑X Upgrade U Duplex (D) ❑ Holding Tank n Renewal ❑ u�67 MUItiil pwellings ;/; g 1r- Privy ❑ ti � (SFar�!/or D) 5 �7 Private Well U � ti �RUSH` �? itAk 16 .20U # Water Storage FI a MAY ZQ I7 D I� THIS APPLICATION INCLUDES A VARIANCE I WAIV QUEST FOR/:/:\„7/ ` a=., °I 6 8 L y �� J Distance: Ot I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. 441L (Signature of property owner or authorized agent) `ta\9( 1� yo Permit/Rush Fees: S(.061 rr "_�1"' Waiver Fees: Date of Payment: S f (v ll7 t.k IO?I6 Date of Payment: Receipt Number: () Receipt Number: Permit No. n5i)rl I I OZ Waiver No. Permit App__-: :_..c May 23, 2017 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 Re: New Septic system Legal: Mountain Park Est, Blk 3, Lot 3A To Whom it may concern: This is a request for a septic permit on the above referenced lot, the old system has failed and needs replacing. A new test hole was excavated in the backyard and found various types of sands and gravels, GM/SM. No water was observed during or after the 7 day monitoring BUT yesterday I was measured at 16' and has been shown on the revised soils log. The perc rate was measured at 13 min per inch and a simple deep trench has been designed. The house has a gray water system in the back and a leach field in the front yard, both wi ' the new system. A new 1250 gravity flow tank will also be installed. YZ15..FC kv.e w* The lot slopes to the iw sf�, p drawing. replacement at about 4-5 percent, see the This re lacement system will not impact any of the neighboring properties due to the lot layout. Please call me it'you have any questions. Sincerely �/"�'f/t Mike Anderson, P.E. 4661 Natrona Ave. Anch. Ak 99516 DESIGN CRITERIA: (TH 1) N MOUND OVER __GRADE 4 BDRM X 150 = 600 GPD 10 in occ 1 11., SOILS = 600/0.8 = 750 GPD FILTER FABRIC 750 GA/14 = 53' _2.0 4"0 PIPE I(1) TRENCH GM/SM SEWER ROCK 10.01 DEEP 7.0' EFFECTIVE -9.0 1 I 2 &'.0' WIDE 2.0' 53' LONG 19 SEPTIC FIELD SECTION fff / _ _ r / -ALPINE DR- ,'y` — `. `EXISTING WELL 1 ' 100' RADIUS WL 1 / I \ 1 r � 1 1 1 r 1 1 r . / Y I I / 1 ��� ,�� PROPOSED `/ DRAINAGE FIELD r /� IXISTING t \ `\ 0 //r OLD SYSTEM TO BE ` BEDROOM HOUSE thh6h:. , --------2.,/ pcN,MM,44'u .1 ,4 ,410 ` �e f _ 4, //. de 10' UTILITY EASEMENT 5f , PROPERTY ,E i 11 •-... •-•..�� I I I I 1 1 rr -BURLY DR_ 11 WELL j I <> . � // 1 ! 1 . 1 / 1 \ / . `. / .' f . / ' 'S `—L / / ---- if \ / � . / . . . . . // , / Sept:c Design Prepared for ��..,•1111t1ri.� JAN FRASSA ;.�P- � OF q�. ,�.` MOUNTAIN PARK ESTATES, BLK 10, LOT 3A M 49TH %\• '• •I.. Anchorage, Alaska � ,A' � , i..� Michael N. Anderson, P.E. �I, :MICHAEL N. ANDERSON; Z . DATE: 5/24/2017 �.� No. E 469 ' 4601 NATRONA AVE DRAWN: DJR .j ••: 7f ANCHORAGE,ALASKA 99516 •� • ' .117.'• ''�• 4' (907) (907) 727-8864/FAX: (907) 345-1391 SCALE: 1"=100' +41, ;; 44 1 // 1 • / I / 1 \ I / I / r / r / r / r / r / r / r r r r / r / rr / / EXISTING WELL 1 / 100' RADIUS i / 1 , it / 1 / 1 /' 1 // t' (3(.5i.vi roKs k s/Firm )34:0-TANK-Te-BE ' DECOMMISSIONED 4-5% ---C PER UPC CO - I �4ir .1 IM�hI I i' '5rei70rrO' I1 i! �\, 4 --r �r ' r, \� BEDROOM ,r 1 - HOUSEf 1 '' i—I, ' ' c•\ 4, % 11 L.-r F C ORS r i r TO TCO 11 I Ir, DCO, 'co -�- -------- . // `..--- — ---::><:").------' 1 CO r --�-r 4-5% ' O / _J /\ /# • — J SEPTINEW C TAN 250 GALLON �j�hd� 0� //,' / 11 - �_ / , I PROPERTY UNE �`� <' 1 MFM r Septic Design Prepared for siviiIIt•11% JAN FRASSA .4., :••• •'4�� OF 4Lq+r• MOUNTAIN PARK ESTATES, ELK 10, LOT 3A �� )\ ' �� • �:' 49TH �� :.I} ;% Anchorage, Alaska , ■ i • • Michael N. Anderson, P.E. DATE: 5/24/2017 I.-�1��:MICHAEL N. ANDERSON; 4601 NATRONA AVE DRAWN: DJR • 6 �. ANCHORAGE,ALASKA 99516 44+f���• •" ' • -'• (907) 727-8864/ FAX: (907) 345-1391 SCALE: 1"=30' 44 i �644 .,...`oaaoA OF Q14�ZI Municipality of Anchorage 1 .(ENGINE at''-ss� j • /r—` Development Services Department 49TH • ,4r • \. Building Safety Division f �,\ On-Site Water and Wastewater Program J f. t4 4700 Elmore Road ?, ' P.O. Box 196650 Anchorage,AK 99507 /I •y: MICHAEL N. ANDERSON ...4%-www.ci.anchoraoe ak.us rr 'r'�• •C 94 9 V ,�.__ (907)343-7904 4c......-..' .•. - Soils Log - Percolation Test 1u -IIefrsr,V, f�-•" �ZZtN.00� Performed For: A c..0 pi l=it a S 4. G._ Date Performed: CT' /0/ 'Z 49((y Legal Description: ril(.9v- 6 0 (),;: w1t, (~ 4 r' l&/U L 3,kownship.Range,Section: Supe Site Plan Depth (Feet) O,1`c-r - 1----ter ! f'------ / . 2- ( 4 -le- pt 0 LA 3- 4- I-it/ A/l 5- s Lo- 1 7- 8- WAS GROUND WATER ` 9- ENCOUNTERED? !' 0 S 10- IF YES.AT WHAT DEPTH? t Depth to Water After 0 1� P P 11- Monitoring? �� e 12- MAI Date: I(///7/7U - 13- .61744-h ?•- t.-..ire r Al ((p i 14- Reading Date Gross Time Net Time Depth to Water Net Drop 15- 10/iv/I(� /0Mivr l0 U 0%74 16- tr a i 745) 17- {f 18- (I /t 19-- - (27OfiOvri i (, `r 20- U11 PERCOLATION RATE / 3. (mmuleshnrh) PERC HOLE DIAMETER ,fes '' TEST RUN BETWEEN a FT AND 4` FT COMMENTS PERFORMED BY: rvt/ ,A , I CERTIFY THAT THIS TES W PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ,S 2c MUNICIPALITY OF ANCHORAGE DE ATMENT OF HEALTH AND HUMAN SER~,. JES Environmental Health Division 825 "U' Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Address TANKS [~ SEPTIC HOLDING TYPE OF SYSTFM DISTANCES  SEPTIC ABSORPTION WELL TANK FIELD __ LOT LINE FOUNDATION ¢0 AS-BUILT DIAGRAM ~Show Iocahon ol well, septic system, properly hnes. Joundal~on, drwoway waler bodies, etc } [~ TRENCl4 ~] BED ~V. DRAIN ~ OTHER WELLS ~ PRIVATE [] OTHER (Identify) [ REMARKS: I Date Health D epartn, enl Appr0~~~~ ~'A/e~ U.O ,J Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST (ENGiNEeR'S SEAL) PERFORMED FOR: ~Z~ DATE PERF~;''. LEGALDESCmPT~ON:~ d/~ lO,N~o~~nship, Range, Section: ~l~fl~ 12 13 14 15 16 17 18 19- 20- COMMENTS FILL SLOPE WAS GROUND WATER ENCOUNTERED? S L IF YES. AT WHAT O DEPTFI? p E Depth Io Water Afler Monilering? SITE PLAN Reading Date Gross Net Depth to Net Time Time Water Drop 30 /o PERCOLATION RATE /,"~,,-~ (m,nules/,nch) PERC HOLE DIAMETER ~ // TEST RUN BETWEEN '"~ FT AND ~ ,.~ FT BY: PERFORMED ) ;,~ I ;~"c~::t"/./~----~.~'x~CERTiFY THAT THiS TEST WAS PERFORMED iN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFEC ON THIS DATE. DATE: 72-008 (Rev. 4/85)  MUNICIPALITY OF ANCHORAGE 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 PHONE ~UPGRADE MAILING ADDRESS LOCATION NO, OF BEDROOMS . -' Well / Absorp rea PERMIT ~ DISTANCE TO: /::~ ;% Dwelling Manufacturer ~ Material - No~ ~f c~partments ~ Liq. capacity in galloes Inside length Width Liquid depth . - .~ IF HOMEMADE: ~ ~ DISTANCE TO: Well Dwelling PERMIT NO, O ~ ~ Manufacturer ~ - ~ Material Liquid capacity in gallons ~ Well Foundation Nearest lot line PERMIT NO, ~ ___DISTANCE TO: ~ ~ ~ No, of lines Length of each line Total length of lines Trench width Distance between lines ~ ~ inches ~ Top of tile to finish grade Material beneath tile Total effective absorption area ~ inches Length Width Depth PERMIT NO. ~--~ F- ~ype of crib Crib diameter Crib depth Total effective absorption area Well Building foundation Nearest lot line ~ DISTANCE TO: ~ Class Depth Driller Distance to lot line PERMIT NO. ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER ~ .~. i ~ i" i i J i i i APPROVED - ~ DATE LEGAL _, '72-013 (Rev. 3/78) Department 825 264-4720 * * * HANDWRITTEN PERMIT * * * Permit ~ , WELL AND/OR ON-SITE SEWER PERMIT ~pplicant: ~i/~ //~////~%~_.. Mailing Address: Location; Phone Number: ~ ct'/~7/'~ /7/7// Legal Description: Type of Soil ~sorption System Is: Trench: ~D _ Drainfield: ~ Seepage Bed: of Bedrooms; / Soil Rating(sq.ft/br) Maximum N~ber The Required Size of the Soil ~sorption System Is: MUNICIPALITY OF ANCHORAm~ : Health and Environmenta$ ~rotection Street, A~chorage, AK. ,501 DEPTH ...... LENGTH GRAVEL DEPTH WIDTH The length dimension is the length(in 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 minim%un depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HQq:D-I-N6~)~"ffANK SIZE = D--~ GALLONS * * 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. * * * TWO(2) INSPECTIONS ARE REQUIRED * * * Backfilling of any system without final inspection and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 1.50 to 200 feet from a public well depending upon the type of public well. Minim~ distance from a private well to a private sewer line is 25 feet and to a co,unity sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 8 3 * * * I certify that: (1) I am far~iliar 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 codes. (3) I understand that the on-site sewer system may require enlargement if the residenc~ is remodeled to include more that/~')bedrooms. ~"- ~gnea:~6'/~A~"'~t - ~- ' O//-/ ' '~ -~ -''~ '~ -- MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date ~)~..~-~7 GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicant Name ~/¢/t 4;:.'~ Telephone: Home Business Applicant Address (c) Applicant is (check one): Lending Institution []; Owner/builder []; Buyer []; Other (d) Lending Institution /~,~¢:~r;'¢r'~,~,, ,'~./¢.,~, l~-,,.'f:;¢.',,'~' Telephone ~?~. (e) Real Estate Company and Agent Address /? I:E' / X,(", }/, ~ ,~;', Telephone -?]'~" ?-'i (,. / (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family,~ Multi- Fa mily, y,y~her Number of Bedrooms WATER SUPPLY Individual Well'~[' Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite~ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (11~84) Page 1 of 2 ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this ir~_spe, c.,tion. --, Address Date Telephone Engineer's Seal DHEP APPROVAL Approved for /' ~rrn~V~condi&I Approva~isapprOv~/d Y / Conditiona~'*-~~''~ CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72 025 (11/84) ~~ HEALTH AUTHORITY APPROVAL (HAA) NOl~DaJ.OUd .~; ..... ~T ............................. ~ CHECKLIST - FEBRUARY 1984 / ...... ~ 264-4720 A, WELL DATA If A, B, C, D.E.C. Approved (Y/N) Well Classification Well Log Present (Y/N) Total Depth Static Water Level Date Completed Yield Cased to Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot jrt7 Depth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ·; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments ~,~"...~. ~/;¢/ Z,,~,A/,4 ~",~P ~',l+z-¢'~',~./.?~ ¢f'./'2x2 t4/,¢/~/ .~,"'r/'¢ SEPTIC/HOLDING TANK DATA Date Installed w//~t"7 ./~:7 Standpipes(Y/N)-/: :~? Depression over Tank (Y/N) Size ~-~-~ No. of Compartments ~ _ Air-tight Caps (Y/N) : Foundation Cleanout (Y/N) -- A/ Date Last Pumped to/'~ Pumping/Maintenance Contract on File (Y/N) ~//,'~- ;for Holding Tank High-Water Alarm (Y/N) ///z~ Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: / To Water-Supply Well {071 To Building Foundation To Property Line /~ ~ To Disposal Field / ¢/ TO Water Main/Service Line ~/~ / ' - .I ''' '~ / I" To Stream, Pond, Lake, or Major Drainage Page 1 of 2 72-026(11184) C, ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed / ¢~' ¢ Width of Field Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test/~ Separation Distance from Abs/orption Field: To Water-Supply Well To Building Foundation To Water Main/Service Line .,~(~/._/L To Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course ~//~ To Driveway, Parking Area, or Vehicle Storage Area ..~ Type of System De: Length of Field Depth of Field Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy Test c"',--.; b TO Property Line To Existing or Abandoned System on D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N! Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Date Company ReceiptNo. (L~O/- ~),~- 2_,, Date of Payment Amount: $ Q IAI333 i MOA No. Page 2 of 2 72-026 (11/84) NOlJg)/O~d 1VIN-~WNOBIAN)I g~ON~NV ~O /~I1V~I~INA~I Engineer's Seal WELL DATA !!NVIRONMENTAL PROP'U~ ION OCT MUNICIPALITY OF ANCHORAGE (MOA) .EALT. AUT.OR,TYAPPROVA'(.AA RECEIVED CHECKLIST - FEBRUARY 1984 264-4720 LeClalDescription: /o~,,-,~,././~Zz/',/,,~ Well Classification Well Log Present (Y/N) Total Depth ,,)~ Cased to Static Water Level ~~lJ~;~ '~- il'il I '1- / Casing Height Above Ground IfA, B, C, D.E.C. Approved (Y/N)_ Date Completed /~/~.~ /¢_..~,-..~.~4~ Yield Depth of Grouting Pump Set At __ I /~ ;On Adjoining Lots Electrical Wiring in Conduit (Y/N) ~' Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ' '~.~' ; On Adjoining Lots To Nearest Public Sewer Line d/~- To Nearest Public Sewer Cleanout/Manhole ,~/,~l. To Nearest Sewer Service Line on Lot Water Sample Collected by _ _,~ . ._~.,;.'~./¢~'~ ,, 4/ ;Date Water Sample Test Results Comments _ ~~ ~/~ . ~/.y, ~F ~7~ SEPTIC/HOLDING TANK DATA Date Installed /¢/0 7 Size /¢)f~lD _ No. of .Compartments ~"~/k./~-- '~ Standpipes(Y/N)_ Y (/) Air-tightC~ps(Y/N) ~' FoundationCleanout(Y/N)'i/~ /~/ Date Last Pumped 1 0//./ 7/~' ~ Temporary Holding Tank Permit (Y/N) To Building Foundation L_~¢ ~ '/ To Disposal Field To Stream, Pond, Lake, or Major Drainage Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) ,~////?- Separation Distances from Septic/Holding Tank: To Water-Supply Well _.~ To Property Line 7~ / To Water Main/Service Line .~)/-'¢- Page 1 of 2 72-026¢~/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed -~ Width of Field Square Feet of Absorption Area Depression over Field (Y/N) t/'~'/ Results of Last Adequacy Test ~'~//"~ Separation Distance from Absorption Field: To Water-Supply Well /3¢/,"/'~ O Type of System Design Length of Field Depth of Field Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy Test To Property Line To Building Foundation Lot 9// /- ~7-"" . , .... .~ ~, .... ~ ;un Adjoining Lots To Water Main/Service Line ,.~(")/¢ To Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments ~__~ C~..4~.~ ~.,'l?.t'.~ ¢,'.4~., ,..~ ~'~.,¢~ To Existing or Abandoned System on LIFT STATION /,~,//~ Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that~av~hecked, verified, p,~ conformed to all MCCA and,HAA guidelines in effect on the date of this inspection. Signed L/~_/.,¢-,¢'/~ Date lO //~./3/~ Company / MOA No. Receipt No. Date of Payment Amount:, Page 2 of 2 72-026 (11/84) Engineer's Seal CONSUL]~NG EHGINEEfl 203 W. 15Ih AVE "C" SUITE 203 ANCHOf~,GE, ALASKA ~9501 TELEPHONE: (907} 279-3918 DAVE WIRTH REMAX REALTY 2600 CORDOVA ANCHORAGE, ALASKA 99503 OCTOBER 20, 1986 NOVEMBER 3, 1986 INVOICE FOR PROFESSIONAL' SERVICES RENDERED HEALTH AUTHORITY APPLICATION INSPECTION AND TESTING .... ... -- .:- . ...... ' .i': !-v._--:. ,' ..-:'!_- .... -. . .>. :- ..... - ..... :' ': ....... AHFC'=:::':- . '-.-~ .... .-- '::. .... i: ..~'.: · . ..: --._}_; -... ....... :...? ..~';,_,-.-,~_-.~1'.::.'..' -j--.- - · ': ........... ~.---.- :: ~.- ..... . .... : '[ . .. '. :..' - ' '. ' - .- : ...... . - -:.;.~'~-:~.12:'2;2:.2_ :' . - .-, .....- ............... ' ............ - ................ : .... "' :' '-- '-PL...-..-..{h.~; ~:-::~. ' ' t:..t~:~.~;'~ ," -' -: .' '-': _..-:-x.-' '..-'- .-:-:-.'.-'{:-.'.->-'..-:- :::'. .' '. ' ...-:"--::::':".:::: -'_~ - ~',[[][?,.~ SOIL'TEST AND GROUNDWATER MONOTORING.'..[:[. ;3):~::' WELL - DID NOT PRODUCE SUFFICIENT WATER TO TEST THE -' ' · ''~-~';'-SYSTEMS. WATER HAD TO BE SEPTIC :':7:::a GROUNDWATER . : ~HANK ~OU - . Terms: Net 30 days from posted date. past due accounts. ( 12% annually ) 1% service charge on all 203 W, 1 ,~lh AVE "C" SUITE 203 ANCHORAGE. ALASKA 99~,0~ '1E[3~ PHON£: [907) 279-3916 RESIDENTIAL WELL INSPECTION LEGAL: LOT 3 & 4, BLOCK 10, MOUNTAIN PARK LOCATION: 125b0 ALPINE OWNER: ALASKA HOUSING FINANCE CORPORATION TYPE OF WELL: WELL LOG AVAILABLE: INSTALLATION REQUIREMENTS MET: SINGLE FAMILY YES PUMP YIELD: DATE OF INSPECTION: TEST PROCEDURE: 3-4 GALLONS PER MINUTE . ... ir '. ~ : -~' -~ ._ 'i.' ..'. . . OCTOBER'14,: 1986 ' WELL WAS ' PUMPED AT A CONSTANT RATE OF '.-~-:-.:';-:;.-:i': : '-' . ' GALLONS PER ~ MINUTE WHILE THE ~DRAWDOWN WAS.' [['~{'~7~!?'~!?~/f'MONITORED WITH'AN ACOUSTIC PROBE'. 'STATIC WATER LEVEL WAS FOUND AT' :.--~ ......... ~ .... 195 FEET BELOW TOP-OF- CASING..· WATER LEVEL WAS RECORDED~ EVERY:BO --~¥~4r~,?f~?- GALLONS PUMPED~ ·AFTER 150 GALLONS WELL WAS DRY AT 285-~'FEET IN ~".~4~%J:~-~ 110 -~ MINUTES wTHE WELL RECOVERED- TO ~- 266 '~ FEET,C~[ 30%'~ OF-~'- TOTAL ~?:~_['[j~L'.%"['. DRAWDOWN. ~-RECOVERY RATE DURING THIS~ TIME' PERIOD IS .27/~.G~LONS' ~..r~._: ~,t:.~.~_:.. ER MINUTE... · · ~ ~ ........ . ...... ~.,,..~.~.~-;~.,.. - ' . _.~_:.- ....... ~ ..... --, -~?~.[{>¥~.-. ". f~ ' '.. ~.~ '. , " OCTOBER 14~'- 1986. TEST WAS" NEGATIVE' ' ~ - ' -' -' x-r~:~?. .... ..~ ~-~'~'*' TEST 'RESULT :~ ~" ......... ~ THIS ~. wEnnqt7 MEETS.bQ~ THE.;~~ REQUIREMENTs' j' ~[['r 't,~k[[. [':[~[?. MUNICIPALITY 'OF ANCHORAGE FOR A ONE BEDROOM HOUSE. THE' ~LL -'~-~ ::~: ~':-PRODUCES 350 GALLONS MORE OR LESS DURING A'~24 HOUR ~ PERIOD, '. 150'"'[. -:?:[:[~-'[~'-q-~:%~:'i:-~GALLONS MORE OR LESS CAN BE STORED IN THE WELL CASING.~':- - ;--. [[-~:-~ .-- :~- ..... The '-MunicJ. pal requirement for' well fl6~"i'~=l'Lb~['~6~f'=-=~¥ per bedroom per 24 hours. This well surpasses this requirement. ~:"[~'~[ '"<: '-'~ Th~~ assessment of the condit'i'~'n"of' this well[:'applies, only .to [~ ~e':~ - conditions as of. this date. The, flow rate of the well' may change ..... ' due to subsurface conditions that--may not be observed from the ~ ~:~_ surface, - and changes, in land use'and' other'~'factors~- that- 'ma~" '['[[,~.' ' impact the conditions of the aquifer feeding the~well../ : ~-.' - ~ ~...' ~ '...~ ~ · ~, . ~ ~ ~ .... ~ .~ · CONSULTING ENGINEER 03 W. 15th AVE "C" SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE: (907) 279-3916 SEPTIC SYSTEM ADEQUACY BLACK WATER SYSTEM TEST LEGAL: LOT 3 AND 4, LOT 10, MOUNTAIN PARK ESTATE LOCATION: 12500 ALPINE DRIVE OWNER: ALASKA HOUSING FINANCE CORPORATION RESIDENCE: SINGLE FAMILY, ONE BEDROOMS WELL: PRIVATE, ON SITE SEPTIC SYSTEM: DATE OF PUMPING: FROM MUNICIPAL RECORDS: NO RECORDS. TANK: 1000 GAL. FROM PUMPING ABSORPTION SYSTEM: CRIB ABSORPTION AREA: SOIL RATING: INSTALLATION DATE: 1969 OCTOBER 17, 1986. ISAACS PUMPING DATE OF TEST: OCTOBER 16, 1986 TEST PROCEDURE: SYSTEM WAS INSPECTED AND MEASURED ON OCTOBER 14. TANK WAS FOUND WITH FOUR FEET OF COVER AND 54 INCHES OF LIQUID. CRIB WAS FOUND 10 FEET DEEP AND WITH 5 INCHES OF LIQUID. 150 GALLONS OF WATER WAS ADDED TO THE CRIB, THIS CAUSED THE WATER DEPTH TO INCREASE 8 INCHES. ON OCTOBER 16 480 GALLONS WERE ADDED TO THE CRIB. EVERY 100 GALLONS CAUSED THE WATER LEVEL TO RISE 6 INCHES. FINAL WATER DEPTH WAS 40 INCHES. AFTER 18 HOURS WATER DEPTH WAS 21.5 INCHES~NDICATING THAT 318 GALLONS HAD BEEN ABSORBED IN 18 HOURS O~42~ALLONS IN 24 HOURS. TEST RESULT: THIS SYSTEM MEETS THE OPERATIONAL REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE The operational life of all septic systems depends on the local soil conditions, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this septic system. We can therefore not give any estimate of how lon~.~.~b~, system will continue to meet the operational A- rem~so'~-f~Municipality and State. · .... w ':Y ~,,,~,, . CONSULTING ENGINEER TELEPHONE: (907) 279-3916 SEPTIC SYSTEM ADEQUACY GRAY WATER SYSTEM TEST LEGAL: LOTS 3 AND 4, BLOCK 10, MOUNTAIN PARK ESTATE LOCATION: 12500 ALPINE OWNER: RESIDENCE: WELL: SEPTIC SYSTEM: ALASKA HOUSING FINANCE CORPORATIO~N~,..~u%~ SINGLE FAMILY, ONE BEDROOM PRIVATE, ON SITE FROM MUNICIPAL RECORDS: TANK: STEEL, 5.00 GAL. ABSORPTION SYSTEM: CRIB ABSORPTION AREA: UNKNOWN SOIL RATING: UNKNOWN INSTALLATION DATE:TANK: NOV. 1983, CRIB 1969 DATE OF PUMPING: OCTOBER 17, 1986. ISAACS DATE OF TEST: OCTOBER 16, 1986. TEST PROCEDURE: SYSTEM WAS INSPECTED AND MEASURED ON OCTOBER 14, 1986. TANK WAS FOUND 3.5 FEET OF COVER AND WITH 39 INCHES OF LIQUID. CRIB WAS 10.5 FEET DEEP AND WITH 16 INCHES OF LIQUID. STANDPIPE WAS 5 FEET LONG WITH 1.5 FEET ABOVE GROUND, INDICATING DEPTH OF CRIB TO BE 7 FEET. 150 GALLONS OF WATER WAS ADDED TO THE CRIB. THIS CAUSED THE WATER LEVEL TO RISE 3.25 INCHES. ON OCTOBER 16, 470 GALLONS OF WATER WAS ADDED TO THE CRIB. EVERY 100 GALLONS CAUSED THE WATER LEVEL TO RISE 3 INCHES. THIS INDICATES THAT THE CRIB AREA IS 53 SQUARE FEET, WHICH AGAIN INDICATE THAT THE CRIB IS A STANDARD LOG CRIB 8X8X7 FEET. THE 470 GALLONS OF WATER CAUSED THE WATER DEPTH TO REACH 35.75 INCHES. 18 HOURS LATER THE DEPTH WAS 33 ~~ HAT TEST RESULT: THIS SYSTEM, BY ITSELF, DOES NOT MEET THE CODE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE. TOGETHER WITH THE BLACK WATER SYSTEM IT IS SUFFICIENT FOR THE DWELLING. The operational life of all septic systems depends on the local soil conditions, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this septic system. We can therefore not give any estimate of how long the system will continue to meet the operational requi-- rements of the Municipality and State. APPLK ~T FILLS OUT UPPER HAl, ONLY FropertvOwnar l,t/// .... 2 ~,,,/' /! /~' / / ~ ~ ,.~L.'.~ Phone Buyer , Address Z~p Codo Lending Institution Phone Address Zip Code Street Locati~ / Type of Residence ~Single Family ~ Multiple Family No. of Bedrooms~/'7 ~ Other Water Supply 'lndividual ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. Community For wells drilled prior to that date, give well depth (attach log if available). ~ Public Utility ;)~/7~ ' /~ '7/~¢'O~ . Sewer Disposal ~ Public Utility When Connected to Public Utility: ~ 14or!lng Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Time Time Date Date Inspector Inspector Time Date Inspector Field Notes:g/ ( ~:~ ~ ~b'4DrrloNAL APPROVAL' DATE ~c~ MUNICIPALITY OF ANCHORAGE DEP-L OF HE/",LTil ?, ENVIRONM2N1 Al. PROT[CflON 0''''~ "!9f~3 ,RECEIVED 'CONDITIONS OF APPROVAL r ::.) ~_t_/', ' ' ,.'-))'-~ '- ~' '~,~; '""~'- Soils Rating Date Sewer Installed Well To Absorption Area Well to Tank / ~ Well Log Received Septic Tank Size 570 W. 53rcl Ave. ANCHORAGE, ALASKA 99502 (907) 562-0436 BILLTO ~ ADDRESS' CUSTOMERS ORDER NO, ORDER TAE£N 8Y CITY JOB INVOICE PHONE HELPE~ JOB NAME AND LOCATION O DAY WORK DESCRIPTION OF WORK ~ CONTRACT ~ EXTRA QUANT. DESCRIPTION OF MATERIAL USED AMOUNT HOURS LABOR AMOUNT MECHANICS HELPERS I hereby acknowledge the satisfactory completion of the above described work: I TOTAL LABOR SIGNATURE DATE COMPLETED N HAWTH O RNE- EN GINEERIN G NltAWTHORNE ~ ENGINEERING 7127 Old Seward tt,ghwa'x Anch.~ AK 99502 344 ~ 471 t ! ~IC 80ULEVARD A N C:~+.I (H ~A-G.Eh-,,~A S K a 99503 90".1~ ~-~'~1=~,09 MUt~/tclP/,~LITY OF ANCHOR/\GE .~h¥i~O,NM~NI'i~L PROf~C1 ION. -6Z ~ ADDRESS PHONE CASH CF~ CHARGE DATE/ TIME DESCRIPTION ' CAPACITY AMOUNT S~.T~C TAHK ~ ? ' ' HOURLY RATE Midnight Pumping Co. Anchorage, A~ N HAWTH 0 RNE-EN G INEERIN G October 24, 1983 4~q~"1'-"~"'1~ T I C BOULEVARD Nb'AWFHORNE - EN©INEFR]NG Anch., AK 99502 Mr. Robert Robinson Anchorage Department of Health and Environmental Protection 825 L Street Anchorage, Alaska 99501 Regarding: Lot 3 and 4, Block 10, Mountain Park Estates Owner: Mr. William Heilesen Dear Mr. Robinson, On October 19, 20 and 21, 1983, I performed an adequacy test on the above named property according to your office's published criteria. Details and measurements are included below. The residence is a one bedroom house located on the two lots. Grey water is discharged to a cesspool while toilet wastes (black water) are handled in a separate system, which includes a septic tank and a seepage pit. I have marked the approximate system locations on the enclosed copy of the as-built survey. GREY WATER SYSTEM: 500 gallons of clear water were added to the grey water cesspool (seepage pit) on both October 19 and October 20, 1983, over approximately a twenty five minute period each day. This action apparently cleaned out some clogged pores because the initial water level (before adding water) was 7¼ inch lower the second day and an additional 3¼ inch lower the third day. Based on my measurements the grey water disposal cesspool drains adequately for the entire flow of a three bedroom house. BLACK WATER SYSTEM: 500 gallons of clear water were added to the black water seepage pit on both October 19 and October 20, 1983 over approximately an 11 minute period each day. The first day the water level rose 23½ inches while adding water and had dropped back 14½ of those inches by the second day. The second day the 500 gallons caused the water level to rise 25 inches and that had dropped back 21 inches by the third day. The septic tank level remained at 62 inches below the surface throughout the first day's test and at 65½ inches throughout the second day's test. The black water system is not intended to handle 500 gallons per day (more like 50 gallons plus or minus) so I feel it is adequate for the toilet flow. Please call if you have any questions. Neil Hawthorne NH/pe // NO. 613- S LOT SURVEY CERTIFICA'rlON ~ ., It ia the responsibility of the oe builder, prior to con~?uctlpr~: W pro~ buD.S graae remuVe ~hed ~de ~d u~lllty W de.rinSe ~e exl~,nce of men~. covenant, or do not ap~ on ~e ~ord~ s LEGEND: Iron Pipe · Steel Pin Lot-~-, Block ~ .m Survey Hub 6 T~k Anchorage' Reoordincj Precinct, Alaska ~=------.__ ................. ~_ ~. ,s,o . Municipality o~ Anchorage MEMORANDUM Gk,.~TER ANCHORAGE AREA BOROUGh :DEPARTMENT OF ENVIRONMENTAL QUALITY 3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686 DATE RECEIVED: INSPECT: TIME: REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES FOR ADDRESS: .r?~r%Z /('/ . / ( PHONE: ,?.7~'" /~/.~ 2. PROPERTY OWNER: r~t(,~?z~f~,q~J~ PHONE: BACTERIAL ANALYSIS~"/d"')2 ~,, '~' SEWAGE DISPOSAL SYSTEM: SEPTIC TANK (IF HOMEMADE, SHOW DIAGRAM ON BACK) 3. MANUFACTURER 4. INSTALLER APPROVAL REQUES1 FOR SEWER & WATER FACILITIEs PAGE TWO SEEPAGE PIT 1. SIZE 2, LINING C. DISPOSAL,FIELD 1 NUMB[R~ F 'LINES 2] TOTAL L~ REQUIRED MEASUREMENTS A. WELL 'FO SEPTIC TANK B. C. D. E, F. G. H. WELL 'FO SEWER LINE ..... WELL TO PROPERTY LINE J~ F~ WELL TO OTHER POSSIBLE CONTAMINATION FOUNDATION 1'0 SEPTIC TANK ~ FOUNDATION 1'0 SEEPAGE PIT ~"~ SEEPAGE PIT TO PROPERTY LINE =~ 8. COMMENTS: DISAPPROVED: APPROVAL/VALID FOR ONE YEAR FROM DATE SIGNED. GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY MUNICIPALITY OF ANCHORAGE Department of Health and Hmnan Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Date: To: From: Subject: April 15, 1998 Zoning and Platting, CPD James Cross, P.E., Program Mm~ager, On-Site/Water Quality Request for Comments on Subdivisions M April 2, 1998 The Environmental Services Division, On-Site Services Program, has reviewed the following cases and has these comments: S-10246: Mountain Park Estates, Lot 3A Block 10 No objections. S-10247: T15N R1W section 17 Lot 7A No objections provided any on-site wastewater disposal system serving this property have ADEC approval. MUNICIPALITY OF ANCHORAGE COMMUNITY PLANNING AND DEVELOPMENT P.O. Box 196650 / REC'D BY: Anchorage, Alaska 99519-6650 PRELIMINARY PLAT APPLICATION OFFICE USE A. Please fill in the information requested below. Print one letter or number per block. 1. Vacation Code 2. '['ax Identification No. 3. Street Address 5. EXISTING abbreviated legal description (T12N R2W SEC 2 LOT 45 OR SHORT SUB BLK 3 LOTS 34) full legal on back page. ~.~-~ .~ ~,_:~ ,~ , o~,o~, ~-~,. ,.,,~,~ ~- ~-,~L,I.~I~I.~I,~I I I I I I ' IIIIIIIIII. IIIIIIIIIIIIIIIIIIIIIIII 6, Petitioner's Name (Last - First) FI, I~I&,,I I~-IJ,~L~L--I~I I I I I IIIIIIIIIIII 7. Petitioner's Representative d~,,,~ II ' I IIIIIIIIU~ II Address ~-~ ~<:)~ //.~c::~ ~-. Address <?...~'/~- City ,~lq~/ State /AK City ~f.)~AF State Phone# ,.7c/.5'- ff~ ?~/' Zip c~c~ // Phone# 8. Petition Area Acreage 13. Fees 9. Proposed 10. Existing 11. Grid Number 12, Zone Number Lots Number Lots 14. Community Council /'~'~ ' '~'~"&~"-' Date: I hereby certify that (I am) (I have been authorized to act for) the owner of the property described above and that I desire to subdivide it in conformance with Chapter 21 of the Anchorage Municipal Code of Ordinances. I understand that payment of the basic subdivision fee is nonrefundable and is to cover the costs associated with processing this application, that it does not assure approval of the subdivision, I also understand that additional fees may be assessed if the Municipality's costs to process this application exceed the basic fee. I further understand that assigned hearing dates are tentative and may haveto be postponed by Planning Staff, Platting Board, Planning Commission, or the Assembly due to administrative reasons. " Signature *Agents muet provide wri~en proof of authorization. i · J~ C'l ~' x / .~ eoo.; 781 5 ,-10 g~- 77 VICINITY MAP pI~T OF MOUNTAIN PARK ESTATES SUBDIVISION LOT 3A, BLOCK 10 A RESUBDIViSION OF LOTS 5 AND 4, BLOCK 10, MOUNTAIN PARK ESTATES SUBDIVISION, PLAT# P-501 DTIO~111§-' q 8 ' 7 7 S-10246 • •(L 4- Municipality of Anchorage 0 E On-Site Water and Wastewater Program '''` -1-111 l . (907) 343-7904 5 f C T V CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 017-441-55 Expiration Date: C' _a9 _I F 1. GENERAL INFORMATION Complete legal description MOUNTAIN PARK EST S/D BLOCK 10, LOT 3A Location (site address) 12500 ALPINE DR,ANCHORAGE, AK 99516 Current Property owner(s) CHUCK AND JAN FRASSA Day phone Mailing address SAME Real Estate Agenthone u567 8 ��7 2. TYPE OF DWELLING: ,`v ® Single Family (w/wo ADU) a ❑ Duplex MAR 1 g 2018 3 111Multiple Dwellings (Single Family and/or Duplex) ,l ti `` 3. NUMBER OF BEDROOMS: 4 16 8 L 9 '' 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 ❑ Waiver/Variance request for: Distance: Received by: Date: 3/2 d//� COSA to be released to the engineer, unless otherwise requested by the engineer. S� �� Q a COSA Fee $ vZ / = Waiver Fee $ Date of Payment 'jl l°1 [/, Date of Payment Receipt Number Receipt Number COSA# O C-\$I(`g 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 MIKE N ANDERSON,P.E. Phone 727-8864 Address 4661 NATRONA AVE. Engineer's Printed Name MIKE N ANDERSON, PE Date 03/15/18 H V J C.a i,a or, o : o �o 'V n - SIGNATURE ,,J • 6. DSD SIGN ` ` .. \ - w MICHAEL V:.ANDERSON• e I System #1 Approved for c:[-94 Y pp y bedrooms. �,-.,� , , r System #2 Approved for bedrooms. ` � , (, /",�`�'�y" Disapproved. Conditional approval for bedrooms, with the following stipulations: ANC/yo • \NN. PER o: P61 �} RPG 'fv1iciif7 ;R • Original Certificate Date: S Z 0 1� The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet_10-10.12.doc • If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system _ Certificate of On-Site Systems Approval Checklist Legal Description: MOUNTAIN PARK EST S/D BLOCK 10, LOT 3A Parcel ID: 017-441-55 A. WELL DATA Well type Private If A, B, or C provide PWSID# Well Log (Y/N) Y Date completed 12-17-86 Sanitary seal (Y/N)Y Wires properly protected (Y/N) Y Total depth 404 ft. Cased to UN ft. Casing height(above ground) 24+ FROM WELL LOG AT INSPECTION Date of test 12-17.86 3-12-18 Static water level 160 ft. 152 ft. Well production 3.0 g.p.m. 2.2+ g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 mL Nitrate 0.148 mg/L Arsenic: ND ug/L Date of sample: 3-12-18 Collected by: Mike Anderson B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC 1 STEEL Date installed 6-6-17 Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout(Y/N)Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping NEW Pumper NEW C. ABSORPTION FIELD DATA—1985 SYSTEM TESTED Date installed 6-6-17 Soil rating (g.p.d./ft2) 0.8 System type Deep Trench Length 63 ft. Width 2 ft. Gravel below pipe 6.0 ft. Total depth 9 ft. Eff. absorption area 756+ ft2 Monitoring tube Y Depression over field N Date of adequacy test NEW Results (Pass/Fail) NEW For 4 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 >= NEW g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) UNKNOWN If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off' level at in.High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: 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 50'+ Holding tank NA Animal containment areas 1001+ Manure/animal excrete storage areas 100'+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 10'+ Property line 20'+ Absorption field 10'+ Water main 100'+ Water service line 50'+ Surface water 100'+ Wells on adjacent lots 100'+ ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water Service line 50'+ Surface water 100'+ Driveway, parking/vehicle storage 50'+ Curtain drain 50'+(None Known) Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION ��°�kkk se ri I certify that I have determined through field inspections and 47.* review of Municipal records that the above systems are in • 49TH conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name MIKE N. ANDERSON, PE % -�..;MICHAEL N. ANDERSON � s° CE-949 •:��� • Date 0311912018 �A FD°'�� � •�`xto�, COSA canary sheet_2-6-15.doc dL ,p9¢z E OR/V ---...„...< z� W 9000 0 .. a Cass \ r ad •Is, 2A o 'o Z' 87.7' 3A 12.x12' 5,.5, o 0 A• in 2 STORY h .'' �'Y' HOUSE ry oQ. CO ro' /S . 11.3. . 0 76'C 0 2 )5 �. AS'HALT C / (v CONC 0 PAD e a CO ,CO Oi 40 Pi L 88.399. — r‘,IV 80 SO'p0" vi, : 10, 2 1 0fABLOCK 7 c.,,-'-- BLOCK LEGEND / ,.., ----- 6j.s ,`jO 3•\ \S e> 2" AL. CAP ON #5 REBAR i 0, \ ty \ \ • #5 REBAR O 1.25" PLAS. CAP ON #5 REBAR Q- WELL \ \ \ \ O SEWER CLEAN OUT O POWER POLE GUY WIRE I hereby certify that on accurate survey of the improvements on the following described property. LOT 3A, BLOCK 10, ASBUILT SURVEY MOUNTAIN PARK ESTATES SUBDIVISION was made on May 6, 1998, and that said improvements situated thereon are within the property lines and do not overlap ��``���\ or encroach on the property lying adjacent thereto and that no �. improvements lying adjacent thereto encroach on the premises in ,r.`� . . .q�...e, k question, except as shown, and that there are no visible or platted Aze,Q' • roadways, transmission lines or other easements except as shown. jco.• �1/ .•T�Ti It is the responsibility of the owner to determine the existence I- TH /\ • * 9 of any easements, rights–of–way, covenants, or restrictions . . /. / which do not appear on the subdivision plat. Under no circum– stances should any data hereon be used for construction or for establishing boundary or fence lines. /, �'. Je •my A. - •rs DRN. DATE 'O •. No.L -117•. 'c�4/ JAH 3/20/18 I'l�,pF�p ,e9 � p' .;' CKD. JAH SCALE 1"=50' 5 Stantec ilk GN \.��- F.B. 306 JOB# 55 700 \NN��� 5 2515'A Street Phone:(907)276-4245 PLAT# GRID 2838 Anchorage,Alaska 99503