HomeMy WebLinkAboutMILE HI #1 BLK 7 LT 10Mile HID #1
Block 7
Lot 10
#050-201-28
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On-Site Water & Wastewater Section Fax: 907-343-7997
Pump Installation Log
Well Drilling Permit Number: _______________ Date of Issue: ____-____-____
Parcel Identification Number: ____-____-____
Legal Description Block Lot Property Owner Name & Address:
Pump Installation Date: _____-_____-_____
Pump Intake Depth Below Top of Well Casing: __________ feet
Pump Manufacturer’s Name: ___________________________ Pump
Model: _____________________________________
Pump Size: ____________hp
Pitless Adapter Burial Depth: _________ feet
Pitless Adapter Manufacturer’s Name: _________________________
Pitless Adapter Installer: ____________________________
Well Disinfected Upon Completion?;;<HV No
Method of Disinfection: _____________________________
Comments:
Pump Installer Name: __________________________________
Company: ___________________________________________
Mailing Address: ______________________________________
City: ___________________ State: __________Zip: _________
Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation.
050 201 28
MILE HI #1 710
DUROCHER WESTON PAUL
12110 BUSINESS BLVD PMB 161 SUITE 6
EAGLE RIVER, AK 99577
07 17 2024
220
PD WATER SYSTEMS
4PWP07G 07C163P
.75
12
MARTINSON
PELLETS
ANCHORAGE WELL & PUMP SERVICE
7640 KING STREET
ANCHORAGE AK 99518
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: OSP131307
Tax Code Number: 05020128000
Work Type: Septic
Permit Effective Dates: September 11, 2013 to September 11, 2014
Design Engineer: ARC TERRA CONSULTING INC
Subdivision: MILE HI #1
Site Legal Address: MILE HI #1 BILK 7 LT 10 G:0058
Owner/Address: DAVIS RICHARD L & TERRY L
35467 KALIFORNSKY BEACH RD KENAI AK 996115811
Site Mailing Address: 22230 UPPER CANYON DR, Eagle River
This permit is for the construction of:
Y Disposal Field Y Septic Tank N Holding Tank N Privy
All construction must be in accordance with:
Lot Size in Sq Ft: 56849
Total Bedrooms: 2
N Private Well N Water Storage
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:
Date:
Date:
Municipality of Anchorage
P.O. Box 196650 • 4700 Elmore Road
Anchorage, Alaska 99519-6650 • (907) 343-7904 0 Fax (907) 343-7997
hftp://www.muni.org/Onsite
Development Services Division
On -Site Water and Wastewater Program
trent S,
1� e
ri
EMv
e artment
**** VARIANCE/WAIVER REVIEW ****
Waiver#: OSP131308 COSA#: Permit#:OSPI31307
PID#:050-201-28
Legal Description: Mile Hi #1. Block 7. Lot 10
Engineer: ArcTerra
Applicant: Rchard & Terry Davis
Your request for a waiver of the required 50 feet horizontal separation from the absorption field
to a 25% or greater slope has been approved. The approved separation distance is 35.0 feet.
This waiver approval applies to the proposed absorption field only. Any future upgrade to the
on-site wastewater disposal system will require all separation distances be met or another
approval from this department.
❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this
waiver.
❑ Notarized letter(s) of non -objection have been received from the owner(s) of the affected
adjacent property.
® Adjacent properties are not affected by this waiver.
........................................................................ a . . . . . .
Waiver is Granted: x Waiver is not Granted:
Date: l t Approved by: Zye
ame of Reviewer
...................................................... a.......................�
Rec#: 025907 Amount: $200.00 Date Paid: 9/4/2013
**** VARIANCEIWAIVER REVIEW ****
C
"
P
**** VARIANCE/WAIVER REVIEW ****
Waiver#: OSP131308 COSA#: Permit#:OSPI31307
PID#:050-201-28
Legal Description: Mile Hi #1. Block 7. Lot 10
Engineer: ArcTerra
Applicant: Rchard & Terry Davis
Your request for a waiver of the required 50 feet horizontal separation from the absorption field
to a 25% or greater slope has been approved. The approved separation distance is 35.0 feet.
This waiver approval applies to the proposed absorption field only. Any future upgrade to the
on-site wastewater disposal system will require all separation distances be met or another
approval from this department.
❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this
waiver.
❑ Notarized letter(s) of non -objection have been received from the owner(s) of the affected
adjacent property.
® Adjacent properties are not affected by this waiver.
........................................................................ a . . . . . .
Waiver is Granted: x Waiver is not Granted:
Date: l t Approved by: Zye
ame of Reviewer
...................................................... a.......................�
Rec#: 025907 Amount: $200.00 Date Paid: 9/4/2013
**** VARIANCEIWAIVER REVIEW ****
MUNICIPALITY OF ANCHORAGE
n:t_
Community Development Department 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. 050-201-28
Property owner(s) RICHARD & TERRY DAVIS Day phone
Mailing address 35467 KALIFORNSKY BEACH RD., KENAI, AK 99611
Site address 22230 UPPER CANYON DR., EAGLE RIVER, AK 99577
Legal description (Sub'd., Block & Lot) MILE HI #1 B7, L10
Legal description (Township, Range & Section)
Lot Size 56849 Sa. Ft. Number of Bedrooms
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Family
[]
Absorption Field
[�
Initial F-1Single
(SF)
Septic Tank
[
Upgrade �
(w/wo ADU)
Duplex (D)
F1Holding
Tank
❑
Renewal ❑
Multiple Dwellings
❑
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION
INCLUDES A VARIANCE / WAIVER REQUEST FOR:
SLOPE SETBACK
35'
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
property owner or authorized agent)
Permit/Rush Fees: 530.—
Date of Payment:
Receipt Number: 02!mo"i
Permit No. me 13 i3o1
Permit App_9-1-12.doc
Waiver Fees: MID,
Date of Payment: )q 13
Receipt Number: D227-501 7
Waiver No. Mc 1q) J 1'6o?
o Q+RCTERR9 ,
4P
September 3, 2013
AiicTERRA
CONSUI,TING, INC
212 E. 51" Ave, Anchorage, AK. 99503
Office (907) 868-3791, Fax (907) 868-3793
Municipality of Anchorage
Development Services Department
On -Site Water & Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
Subject: Upgrade Sewer Permit/ Slope Waiver— Mile Hi #1 Block 7, Lot 10
The absorption field of the subject property cannot be located. Subsequently, the
owner has requested we proceed forward to obtain a septic permit to upgrade
the septic system.
The general slope of this lot is from north to south at a grade of approximately 5-
10% over the septic area with slopes greater than 25%v 35'+ from proposed field.
On August 23, 2013 a testhole was performed to investigate soils and
groundwater. The results of this test are attached for your review. The proposed
upgrade will serve the existing 2 -bedroom house. We propose to install one deep
trench. Groundwater was not encountered at excavation or at monitoring.
The property and adjacent lots are served by private wells. There is no surface
water within 100' of the proposed system and there are no known curtain drains
within 50'. We do not expect there to be any adverse effect on adjacent lots by the
development of this system. If you have any questions, please contact me at 868-
3792 / FAX 868-3793.
Respectfully submitted,
ArcTerra Consulting, Inc.
ter:
Kenneth M. Duffus,.
Attachments: On -Site Sewer Application
Wastewater Absorption System Details/ Site Plan
Soils Log/ Percolation Test
20441 PTARMIGAN BLVD • EAGLE RIVER, AK 99577-8736 • PH (907) 868-3791 • FAX (907) 868-3793
WELL & WASTEWATER DISP❑SAL SYSTEM DETAILS/SITE PLA
MILE HI #1 B7, L10
Cabo
2
VACANT
BOUNDARY:
3� �o
J4219s�'F
STAKING: —
CHECKED:
R,
�0
ASBUILT: RJ
DATE:
9/4/ 1
533 5
S6I S "
NW58
ACRD FILE: 13194
JOB N.,
4 0
Pei exq¢��
Igc'•!9
6650 VACANT
,W
._
Re3p'06, 12352
0.
0 0
:' o
•.
151,35
0040•
Le 1
�3 9 S75.5
o
39.81
72352
^`21 b0•
S
n` TO.56 q0• JPO
VACANT
_
"ER �A 'q L=119.12 4]. 0 ^= 6y a
ORTVC Na6' 00' 0 'E d�59.�6as an
d-
u". R a AzAD Cz�eo �o
409 cA
+b
Gp
N
No
GRAPHIC SCALE 4
0 50 100
"=100'
d
VACANT
SCALE: 1
VACANT
9
o�
5
§ cal,el V=- 100'
PAGE 1 OF 3
NO PUBLIC WELLS WITHIN 200' OF
PROPOSED SYSTEM.
NO PRIVATE WELLS WITHIN 200' OF
PROPOSED SYSTEM EXCEPT AS NOTED.
NO SEPTIC SYSTEMS WITHIN 200' OF
PROPOSED WELL EXCEPT AS NOTED.
��_`
AW �� of AL4 ,
�co
r 1
/ * TH * �I
/ KENNETH ` E -7 1 M.1 U JOV
� . C
47
1 \ $�
FESSIot3A=
DESIGN DETAILS
2 BDRM X 150 GPD = 300 GPD
300 GPD/1.2 GPD PER SQ. FT, (2,4 MIN/IN.)= 250 SQ. FT
(250 / 2X6' ED (6' GRAVEL) = 21 FT. TRENCH
USE 1 TRENCH - 21 (L) X 2' (W) X 6'(D)
Total depth of system Is 9' from original grade.
Total depth of gravel below distribution pipe is 6'
NOTES:
1. CONTRACTOR & ENGINEER TO VERIFY INTEGRITY OF SEPTIC TANK AND
REPLACE AS REQUIRED. INSULATE TANK IF <4' COVER,
2. INSULATE TRENCHES WITH 2' HD BURIAL FOAM.
3. CONTRACTOR WILL ENSURE MINIMUM 2% SLOPE INTO SEPTIC TANK.
4. ADDITIONAL FILL WILL BE ADDED OVER SYSTEM TD ACHIEVE
MIN, 3' COVER IF REQUIRED.
5. CONTRACTOR WILL ENSURE ALL SEPARATIONS TO ADJACENT
WELLS & SEPTICS,
PREPARED FOR1 rip
RICHARD & TERRY DAMS
22230 UPPER CANYON RD.
EAGLE RIVER, AK 99577
FIELD BOOKS
COMPUTED:
BOUNDARY:
DRAM:
BMW
STAKING: —
CHECKED:
KMD
ASBUILT: RJ
DATE:
9/4/ 1
DNG. flit=:
GRID:
NW58
ACRD FILE: 13194
JOB N.,
13194
(I�li,'7■■1111
Rryf'VSULTING, 00
U
WASTEWATER DISPOSAL SYSTEM DETAILS
MILE HI #1 137, L10
�
1393 S%3o
OQ PPER
.. cT
I TA PERMANENT L-1
3 `..HAR .ICADE PREVENT
� M PA KING./. IVING
d
i SP1".....
0 3c?p co . L�
RAGE X ..0 I] MISSION. .
EXIS 'fNGS.T.
�...__t X... .....PER CGDE .&..
APPR .. ............. LL. NEW.......
ULD C B .......... . ... 1000 . S.T. ... .
INSULATED 0 / W F
UNDER DRIVE, o
3c�♦ o
x
p�\ o
a o /Fl
h
EXISTING S.T,
\ FLAG ALL WELL RADII & EASEMENTS PRIOR TO CONSTRUCTION
Scalel 1'= 30'
�trr� PAGE 2 OF 3
A44 \, PREPARED FOR:
RICHARD & TERRY DAMS CT$
/ �. 22230 UPPER CANYON RD. Sfl�
RRPuff* Tx * EAGLE RIVER, AK 99577KENNETH M. DFIELD BOOKS covauiED:BOUNDMV: DRAMN: BMW����� VMING: CNECNED: KMD/ VAmul�T.. RJ DACE: 9/4/13Dxc. e: GRID: NW58' l/l ' LTING
AcAD nL , 13194 doe No.: 13194
40%+ SLOPE
SLOPE ANALYSIS
MILE HI #1 B7, L10
PROFILE SECTION
35.0'
EXISTING GRADE 5-14% SLOPE
25% SLOPE
�70k'*
A 0 OF AL4 t,
*:4. TH* *0
KENNETH M. D S /
CE -711
Atr
JW11kOFE S100y
_4pl
SCALE:1 "=10'
PREPARED FOR;
RICHARD & TERRY DAVIS
22230 UPPER CANYON RD.
EAGLE RIVER, AK 99577
FIELD BOOKS
C010pu O:
BOUNDARY
MA":
BMW
STAKING
CHECKED:
KMD
RJ
DAM'
9 4 1
MIDI
NW58
13194
PAGE 3 OF 3
\\Server\storage\WELL & SE C — Filed by Legal\Mite 11 j1 SD\Mile Mi Ili n 11ele i inc iulu—.=+ • i`— --- ..___.._..,
�RcTERRq
ARC 1 irimA
CONSUI,TING, INC
1, s 212 E. 51" Ave, Anchorage, AK. 99503
Office (907) 868-3791, Fax(907)868-3793
Ew nM. es5i1—@j6
SOILS PERCOLATION TEST
Performed for: Richard & Terry Davis Date Performed:
Project: Mile Hi #1 B7, LIO TEST HOLE# TH 13-1
Depth
Org/OL
SM/GM —sp/gp pockets mod
dense, trace of silt, sand increasing
w/ depth & cobbles to 6"
HOLE PRESOAKED
20- PRIOR TO TEST
Kenneth
CE
SEE ATTACHED SITE PLAN
FOR HOLE LOCATION
Was Ground water encountered? NO What depth? NA
Depth to water after monitoring? NO Date? 8/30/13
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
1
8/23/13
1:00
6"
-
2
1:10
10 min
111/16"
45/16"
3
*
1:11
6"
4
1:21
10 min
1 12/16"
44/16"
5
1:22
6"
-
6
1:32
10 min
114/16'
42/16"
7
*
1:33
-
6"
-
8
1:43
10 min
114/16'
42/16'
9
1:44
6"
-
10
1:54
10 min
114/16'
42/16'
11
*
1:55
6"
-
12
2:05
10 min
1 15/16'
4 1/16'
*
Water
Added
Percolation Rate 2_4 (min/in) Pere Hole Diameter 6"
Test Run Between 4 feet and 5 feet
I, Kenneth M. Duffus, certify that this test was performed in accordance with all State
and Municipal guidelines in effect on this date.
TrOffirb Dritting i[og
by
DOC Co. dba
SULLIVAN WATER WELLS
P.O. BOX 670272, CHUGIAK, ALASKA 99567 • TELEPHONE 688.2759
OWNER OF LAND %< {i.,'_ r/i -:a1 j jf ,• r.
ADDRESS 1 i%) ! i' a', ..... .i PO
. t.
LEGAL DESCRIPTION ' ° , i r l Zvi t r� "} F
DATE - Started Ended j /,7"),
PERMIT NUMBER
KIND OF FORMATION
DEPTH OF WELL j, -,j
STATIC LEVEL OF WATER FF.
DRAW DOWN FT.
`r
GALS. PER HR }
KIND OF CASING
From
Ft. to
Ft.
" "'°fl'
" { T ' `
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Ft. to
Ft.
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` From
FL to
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i -. = Ft. to 1
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=n'; - r J
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- t t-_.
=''-'I
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to
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"
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' �'; °
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From
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-" °
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.
MISCL. INFORMATION:
�
R E C E I V E D
RECEIVED
'
OCT 51992
=
Murticipaiay of Anchorage
Dept. Health & Human Semi
DRILLER'S NAME
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WELL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW920303
DESIGN ENGINEER:DUMMY COMPANY
OWNER NAME:DAVIS RICHARD L & TERRY L
OWNER ADDRESS:22230 UPPER CANYON DR
EAGLE RIVER, ALASKA 99577
PARCEL ID:05020128
LEGAL DESCRIPTION: MILE -HI #1 BLK 7 LT 10
LOT SIZE: 56849 (SQ. FT.)
NUMBER OF BEDROOMS: 2 THIS PERMIT: 2
THIS PERMIT IS FOR THE CONTRUCTION OF:
WELL SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
PAGE 1 OF 1
DATE ISSUED: 9/22/92
EXPIRATION DATE: 9/22/93
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 FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
RECEIVED BY:
ISSUED BY:
n Z le -
DATE:
DATE: F-
i
November 3, 1970
Mr. Roberti. Hamann
Hamann Construction Co.
Box 617
Eagle River, Alaska 94577
Bear Mr. Hamann;
Enclosed is your copy of the permit and the final copy which should go to
Mr. Jones. I am sending it to you first, however, so that you can look it
over and see if it is correct and either return it to mea for correction or
forward it on to Mr. Jones if it lboks okay.
Mr. Eastaugh took leave the day after this inspection for Jones and I don't
know what the situation was only that he left a note that you were going to
write up the information for us.
Thanks a lot.
Sincerely,
Sue McKechnie
Environmental Health Aide
Enclosure.
cme
j G,-,ATER ANCHORAGE AREA BOROJ"`�H
j -+HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
VIM
391
MAILING
NAME ADDRESS �PHONE ��
LOCATION-/�_l 0'/Gly �f'� LEGAL DESCRIPTION /li/O,/
Re
SEPTIC TANK:
NUMBER OF
DISTANCE FROM WELL MATERIAL f`l COMPARTMENTS
Yid 'AKv f /' i %G �D LIQUID
LIQUID CAPACITY �!� �} GALLONS. INSIDE LENGTH �� INSIDE WIDTH DEPTH
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS OUTSIDE DIAMETER / OR WIDTH LENGTH A DEPTH__,
LINING MATERIAL s DISTANCE FROM WELL �� i BUILDING FOUNDATION Q, /
NEAREST LOT LINE O TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) -7/SQ. FT.
TILE DRAIN FIELD:
TOTAL LENGTH
DISTANCE FROM WELL FOUNDATION NEAREST LOT LINE OF LANE-S� --=
NU/P6���_S DISTANCE BETWEEN LINES TRENCH WIDTH IN. TOTAL EFFECTIVE
ABEASQ. FT. LENGTH OF EACH LINEDEILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE N. ABOVE TILE
WELL: C DISTANCE FROM s' WATER
TYPE DEPTH BUILDING FOUNDATION. Z-24;�;' SAMPLE r NEAREST
NEAREST �% SEPTIC ��. SEEPAGE / OTHER
LOT LINE ze� SEWER LINE ,TANK SYSTEM CESSPOOL , SOURCES_
DISTANCEI:
�f
I
I
DIAGRAM OF SYSTEM
DATE '4�;�-D
a-
u
/GAABjj,T113-2'U xE'ATE �iANCHORAGE AREA 'OROUGH Case No. �/ %
HEALTH DEPARTMENT
327 Eagle St. Anchorage, Alaska 99501 279-2511
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
{� � MAILING ADDRESS �Sd�, )j
PHONE NO.����
NAME OF APPLICANT, ���i�� �+ j /
R E S I D E N C E A D D R E S S It�l %i,`aI>SST.,T� eATIONOFINSTALLATION /47��
LEGAL DESCRIPTIO
APPLICATION TO INSTALL: SEPTIC TANK L, SEEPAGE PIT t�— DRAIN FIELD , OTHER
TO SERVE THE FOLLOWING FACILITY J)ev r—:-- �� LZ -e S &::-,i de/?6-le—
FINANCED THROUGH TO BE INSTALLED BY_,11-11-VZ?Z11A1/-1
PERCOLATION TEST RESULTS
THIS IS TO SERVE AS
DISTANCI
ANTICIPATED DATE OF COMPLETION
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
, PERMIT TO INSTALL A
AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED ? AxlKdaL� /7�/����
,SEPTIC TANK SIZE 1'OUd TYPEfTzE' SEEPAGE AREA TYPE
DIAGRAM OF SYSTEM
/hat
I certify I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the
above described system is in accordance with said code.
DATE APPLICANTS SIGNATURE
,h
E
OCT 29 1970
- GREATER ANCPYORAGE AREA
BOROUGH—HEALTH DEPA"MENT
'l
i
tl
j
a
E I
�-
r
ti
•
°EATER ANCHORAGE AREA BOROUGH
HEALTH DEPARTMENT CASE N
327 EAGLE -STREET
ANCHORAGES ALASKA 99501
Performed For Robert Hamamnn Date Performed 9/21/70
Legal bes,cription. Lot 0 Bloc 7 ivision Mile High Estates
This Form Redr•ts,,a: So= Log xx ercolation Test
Depth <r,;
Feet Sol'l Char•_ tev i ;ties
9
10
brown silty sand (SM)
gray sandy gravel (SW)
f
ti �I
dark gray silty sand with
scattered gravel (SM)
Was r , t0, no
Location Sketch
ME
I ONE
N No
Mal
1
N
E-1
erc7 3
E ,i ,se; ',n.� 174 1 : Seepage Pit _
_ Dra_n iie�d
DPDL ;f Inlet i)e^,th ;o Bottom Of Pit rer,c';
COMMENTS: -
127 square feel of drainage area is require per e room, et
- - -..�
_ .. crib bottom at
_R . Onth
r Test Performed By: R, E. Carlisle These recon�-,endations are comput <1 from
'' -- visual observation and based on tl,, uni-
DBtd Certified A Pied classification system. i
y: National Testing Service Inc.
Date:
�f $
• '� Municipality of Anchorage
On-Site Water and Wastewater Program a
(907)343-7904 Dery
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcell.D. 050-201-28
1. GENERAL INFORMATION
Complete legal description _MILE HI #1 BLOCK 7, LOT 10
Expiration Date: /a - 3 O / S�
Location (site address) 22230 UPPER CANYON DRIVE EAGLE RIVER AK 99577
Current Property owner(s) RICHARD & TERRY DAVIS Day phone
Mailing address
Real Estate Agent
35467 KALIFORNSKY BEACH ROAD KENAI AK 99611
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
Day phone
3. NUMBER OF BEDROOMS:
2
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
❑
WaiverNariance request for: Distance:
COSA to be released to the
unless otherwise requested by the engineer.
COSA Fee $ 4,25D 1e'
Date of Payment 9mg �✓-3 2p
Receipt Number 3 5ai7 Q
COSA#
Date:
Waiver Fee $
Date of Payment
Receipt Number
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 ARCTERRA CONSULTING, INC. Phone 868-3791
Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577
Engineer's Printed Name KENNETH M. DUFFUS Date 9/23/13
Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition
of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface
conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate
during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are
subject to these various and dynamic characteristics and are outside the control of the
evaluator of the well and septic system. Therefore,
ArcTerra can not give any estimate of how long a
system will function satisfactory for current or future ��, <�%A
occupants or can ArcTerra guarantee that no unseen
encroachments, deficiencies or discrepancies exist.
6. DSD SIGNATURE ► '
m6 xE:n ,; u/eeu: M
+� System #1 Approved for bedrooms. "'a/
System #2 Approved for bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
)F
VVXT ,R AND
'IS IN
By: Original Certificate Date.
Mint
Th un a,y horage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only
upon the rep%sentations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality
of Anchorage is not responsible for errors or omissions in the professional engineer's work.
ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSAbluesheel 10-10-12doc
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: MILE HI #1 BLOCK 7, LOT 10 Parcel ID: 050.201-28
A. WELL DATA
Well type PRVT If A, B, or C provide PWSID #
Date completed 911992 Sanitary seal (YIN) Y
Total depth 240 ft. Cased to 20 ft. (Into Bedrock)
FROM WELL LOG
Date of test 911992
Static water level 55 ft.
Well production 0.5 g.p.m.
WATER SAMPLE RESULTS:
Coliform NF-&- colonies/100 mL Nitrate O q5 mg/L
Arsenic: No ug/L Date of sample: 91412013
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC I STEEL
Tank size 1000 gal. Number of Compartments 2
Foundation cleanout (YIN) Y Depression over tank (YIN) N
Date of pumping NA -New Tank Pumper
C. ABSORPTION FIELD DATA
Date installed 911 812 01 3 Soil rating (g.p.d./ftz or ftZ/bdrm) 1.2
Length 21 ft. Width 2 ft.
Total depth 11 ft. (Measured 9/19/13) Eff. absorption area 252 ft2-
Date of adequacy test NA- NEW FIELD Results (Pass/Fail) _
Well Log (YIN) Y
Wires properly protected (YIN) Y
Casing height (above ground) 24+ in.
AT INSPECTION
8123113
83 ft.
0.44 9-P M.
Collected by: ARCTERRA
Date installed 9118113
Cleanouts (YIN) Y
High water alarm (Y/N) N
System type DEEP TRENCH
Gravel below pipe 6 ft.
Monitoring tube Y Depression over field N
Fluid depth in absorption field before test _ in. Water added_ gal.
Elapsed Time: _ min. Final fluid depth in. Absorption rate >=
For 2 bedrooms
New depth in.
Any rejuvenation treatment (past 12 mo.) (YIN & type) N If yes, give date
---
D. LIFT STATION
Date installed
"Pump on" level at _ in.
Datum
Size in gallons
Pump off' level at _ in.
Cycles tested
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot 100'+
Absorption field on lot 100'+
Public sewer main 75'+
Sewer /septic service line 25'+
Animal containment areas 50'+
SEPTIC/HOLDING TANK ON LOT TO:
Manhole/Access (Y/N)
High water alarm level at
Meets alarm & circuit requirements?
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/cleanout 100'+
Holding tank 100'+
Manure/animal excrete storage areas 100'+
Building foundation 5'+ Property line 51+ Absorption field 5'+
Water main 10'+ Water service line 10'+ Surface water 100'+
Wells on adjacent lots 1004
ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 104 Water main 104
Water Service line 101+ Surface water. 1004 Driveway, parking/vehicle storage 3'+
Curtain drain 50'+tNONEKNOWNI Wells on adjacent lots 1004
F. COMMENTS
G. ENGINEER'S CERTIFICATION
i certify that i have determined through field inspections and review of
determined through field inspections and review of Municipal records that
inspections and review of Municipal records that the above systems are in
Municipal records that the above systems are in conformance withMOA
above systems are in conformance with MOA COSA guidelines in effect on
conformance with MOA COSA guidelines in effect on this date.
COSA guidelines in effect on this date.
on this date.
Engineer's Printed Name KENNETH M. DUFFUS
Date 9123 113
COSA brown sheet 10-10-12.doc
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Municipality of Anchorage s ,
e,
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
Water Well Advisory
Certificate of On -Site Systems Approval (COSA) 4 131495
During a recent COSA on-site inspection and test of the potable water
supply well on Block 7, Lot 10 of Mile High 41 subdivision, the well's
productivity was determined to be 0.44 gallons per minute. The minimum
well productivity required by this Department (AMC 15.55) for a 2 -bedroom
residence is 0.2 gallons per minute. Although the subject well currently
exceeds this minimum requirement, all parties concerned are advised that the
production capacity of the well may fluctuate. Restriction of non-critical
water uses such as washing cars and watering lawns and gardens may be
required.
This advisory must be attached to all copies of the subject Certificate of On -
Site Systems Approval.
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UNDER NO CIRCUMSTANCES SHOULD AN AS -BUILT BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE ONES.
.THE SURVEYOR TAKES RESPONSIBILITY FOR THE INITIAL TRANSACTION ONLY
AND ASSUMES FINANCIAL LIABILITY ONLY FOR THE COST OF THE SURVEY.
LISTED DISTANCES PREVAIL OVER SCALING. REPRODUCTION MAY CAUSE ERRORS IN SCALE,
LF,T SURVHY SURVEY TYPE
SYMBOLS
' rGUNDA11011 AS -BUILT
• SET REBAR � � DRAINAGE D ASPHALT
[I nNAL STRUCTURE AS -BUILT
[. HOT PLAN AS -BUILT LOT SUR'•EY TOPG[ltARRr
In
G FOUND REBAR g_g._e. WOOD FENCEI ° ".� CONCRETE
... ... ...
DO a ASSUMED ELEV. -k( I( K METAL FENCE ®
.._':_BUILT . . No CORNERS SET 2 KCERTRCATM AS- ILT NO CORNERS 9T
WOOD DECK
l' P.,_ i PLANS & LOT SURVEYS
NOTE:
{ IT -:i THE RESPONSIBILITY OF THE BUILDER OR OWNER, PRIOR TO
ONLY THOSE IMPROVEMENTS ABOVE GROUND AND VISIBLE WILL BE
Ci;,STRUCTION, TO VERIFY PROPOSED BUILDING GRADE RELATIVE
SHOWN. FENCES, WELLS, SEPTIC CLEANOUTS. SIDEWALKS, DRIVEWAYS.
TC-IwSHEO GRADE AND UTILITY CONNECTIONS AND TO DETERMINE
ETC., ARE SHOWN IN THEIR APPROXIMATE LOCATION, ONLY. SNOW
T}-_'. EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS
MAY PREVENT SOME IMPROVEMENTS FROM BEING SEEN AND LOCATED.
Ws- .H DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT.
ALL DISTANCES ARE RECORD UNLESS OTHERWISE NOTED.
SU"'jEY CERTIFICATION
.�.,�`�*�I
•.•�E OF fq�
Prepared by
Robert E. Johns, Jr. & Assoc.
PLG"LAN
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ANCHORAGE, ALASKA 99504
Scale: ill
= 601
Rec. Lot S.F.
Rec. Plat File No.
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Date Surve d:
" 09/23/13
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Date
09/23/13
NW058
13-493
FINAL STRUCTURE AS -BUILT
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Legal Description:
Lot 10 BLOCK 7
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MILE HI #1
Page 1 of 1
Poet, Jeff W.
From: Brent Western [bmw.kndeng@ak.net]
Sent: Friday, September 27, 2013 8:06 PM
To: Poet, Jeff W.
Subject: Re: Crystal Repo rtViewer[ 1 ]. doc
Jeff,
Per our conversation today --the surveyor did not show the driveway correctly. He didn't adjust his
driveway from his previous as -built before the septic was installed. The inspection report septic as -built
is correct -- the field is NOT in the driveway and has barricade around the end to prevent parking /
driving over it.
Thanks,
Brent M. Western
ArcTerra Consulting, Inc.
907-440-4601 Cell
907-868-3792 Office
907-868-3793 Fax
"Quality is never an accident; it is always the result of high
intention, sincere effort, intelligent direction and skillful
execution. It is the wise choice of many alternatives."
--William A Foster
On Sep 27, 2013, at 4:01 PM, Poet, Jeff W. wrote:
<CrystalReportV fewer[ I ].doe>
9/30/2013