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HomeMy WebLinkAboutNORTH WOODS BLK 5 LT 4Northwoods
Block 5
Lot 4
#051-731-04
Municipality of Anchorage Page of -3
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
Permit Number: :5W g5*007 S 7 PID Number: 05173104-
L�
Wastewater System: Aew ❑ Upgrade
Address:
- d \
ABSORPTION FIELD
Phone:
No. of Bedrooms:
❑ Deep Trench 11 Shallow Trench NKed ❑Mound ❑Other
LEGAL DESCRIPTION
Soil Rating: I
Total Depth from original grade:
j•5-S�
•3 GPD/Sq. Ft.
Lot: i�- Block, ^ / Subdivision:
" ? m S
Depth to pipe bottom from original grade:
3—``-
Gravel depth beneath pipe
/ !V
Ft.
-S Ft.
Township:
Range:
Section:
Fill added above original grade:
Gravel length:
O Ft.
.SD Ft.
WELL: pyVC❑ New ❑Upgrade
Gravel width:
30
Number of lines:
S
.Distance between lines:
L-7'
Ft.
Ft.
Classification (Private ,B,C):
Total Depth:
Cased To:
Total absorption area:
Pipe material: -STM - 30
VIA /i
Ft.
Ft.
0 SC. Ft.
'0/0'
Driller:
Date Drilled:
Static Water Level:
Installer:
Date installed:
/n
Ft.
IY�/Yl{i/i (�
z3 2/0 27
Yield:
Pump Set at:
Casing Height Above Ground:
TANK
GPM
Ft,
Ft.
SEPARATION
DISTANCES
®'Septic ❑ Holding ❑ S.T.E.P.
To
Septic
Absorption
Lift
Holding
Private
Manufacturer:
Capacity in gallons:
From
Tank
Field
Station
Tank
Sewer Lines
�%j1'1L, 7Z_"4/( ,
OD O
Well1
zSp
>23o
N /
4t_
> Z3D�
Material:
Number of Compartments:
Surfac
> (y6/
/,4—
LIFT STATION./%�
Watere
>15-o'
hl�p
r4
,�'
Lot/
ZS'
> l5
Size in gallons:
Manufacturer:
Line
Foundation
��I'
r
`�„('X
I
N /�
f
"Pump on" level at: ump off' level at:
High water alarm at:
Curtain
,L
,„ /
'
�f
_ /
/tom
O f
S
Pump M Model
Electrical Inspections performed by:
Drain
7 D
7ra
l�''i;'
ry
Remarks r/��fi. ���SF �a%r - h �.� ri
BENCH MARK
Location and Description:
4,
D✓L�/�t.r .'v. Vv(/f%.. at/ttC�/�Z //Tlr'".
v)/ -¢i S
��rr C -
Assumed Elevation: a
/v a. Ft
NS SEAL
".0 10
e°°°®°�°�
® o �
®60 ®�•
c a� o
Inspections performed by:�•���% Dates: 1s
2ndm���
Aoa ©..o®m•ooeeeoe�e
/J;khael E. /'enderson U=:vim
Department of Health Hum rvices approval�f©��e4���
Reviewed and approved by: Date:��
72-013 (Rev. 9/91) MOA 25
110
Permit No. ' s iJ Q 5-00 T7
Page 71 of S
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
Permit No.
s W 4 5 oa 57
Page 3 of 3
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
PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
PERMIT NUMBER:SW950057 DATE ISSUED: 4/26/95
DESIGN ENGINEER:ANDERSON ENGINEERING EXPIRATION DATE: 4/26/96
OWNER NAME:NORTHWOODS INC
OWNER ADDRESS:709 WEST INTERNATIONAL AIRPORT RD.
ANCHORAGE, ALASKA 99518-1123
PARCEL ID:05173104
LEGAL DESCRIPTION:
NORTH WOODS BLK 5 LT 4
LOT SIZE: 31335 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK SYSTEM
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 ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT)
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
RECEIVED BY: /'' "t,+c E ad,
ISSUED BY:
DATE: c/ Q S-
DATE : -2 6 - (,3-
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, ALASKA 99524
April 25, 1995
Municipality of Anchorage
Department of Heath & Human Services
825 "L" Street
Anchorage, AK 99502-0650
Attention: Dan Roth
RECEIVED
APR 2 51995
Municipality of Anchorage
Dept. Health & Human Services
Subject: Lot 4, Block 5, Northwoods Subdivision
Revised Septic System Site Plan
Dear Dan:
Attached is the revised site plan for Lot 4, Block 5, Northwoods
Subdivision which takes into account an adjusted water table
elevation of -8'. Readings taken within the last week indicate no
water in the monitor tubes, but the readings may change as we get
further into spring breakup.
This lot may drain more efficiently than others in Northwoods
Subdivision due to the steep slope near its midsection. Based on soil
conditions found on the lot and the adjusted water level of -8' it
appears a shallow bed system can be installed as the primary
system. The alternate system will have to be a shallow wide trench
system with insulation and mounding to maintain the 50' separation
distance from the slope. Insufficient area is available to design a
bed system for the alternate site.
Hopefully this information will lead to issuance of a septic system
permit for this lot. Please call me if you have any questions.
Sincerely,
Michael E. Anderson, P.E.
1 7,
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Lot 4, Block 5, Northwoods Subdivision
DESIGN FACTORS: SYSTEM REQUIREMENTS:
Three Bedroom Home Shallow Bed System
Pere. Rate: 42 Min./Inch 1,000 Gal. Septic Tank
Application Rate: .3 GPD/SF Min. 2' Accepting Soils
3 Bdrms. X 150 GPD / .3 GPD/SF = 1,500 SF of Absorption Area
1,500 SF / 30 LF Width = 50 LF Length
Therefore: Construct a Shallow Bed System 30' Wide X 50' Long at
the Location Shown on the Site Plan. Distribution Pipe Placed at
3.5' Below Original Ground Surface.
TYPICAL SHALLOW BED SYSTEM
(NO SCALE)
NOTE: Maintain 4' Vertical Separation From Bottom of Trench
to Groundwater Table.
Grade Area Over Trenches to Drain Away.
To !1-iovSC
/l% C.T U RA L
13 A Cl 4-r-! iA.
3ED�
1 6 ..6 0 t.1.[Orl
G►C-�crr� rAt�ltic,---�
EW
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C
-- —
"—
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o
q
.
C - a
� Fid
3 '��
A.
so
TYPICAL SHALLOW BED SYSTEM
(NO SCALE)
NOTE: Maintain 4' Vertical Separation From Bottom of Trench
to Groundwater Table.
Grade Area Over Trenches to Drain Away.
Lot 4, Block 5, Northwoods Subdivision
(Alternate Site)
DESIGN FACTORS:
Three Bedroom Home
Perc. Rate: 42 Min./Inch
Application Rate: .45 GPD/SF
Reduction Factor: .7
SYSTEM REQUIREMENTS:
Wide Trench System
1,000 Gal. Septic Tank
3' Drain Rock Beneath Pipe
3 Bdrms. X 150 GPD / .45 GPD/SF = 1,000 SF of Absorption Area
1,000 SF / 5' Wide = 200' LF X .7 (Red. Factor) = 140 LF Trench
Therefore:
Construct a Wide Trench
System With Three
Laterals
Totalling 140' in
Length. Place 3' of
Drainfield
Rock Beneath the
Lateral.
Place
Distribution Pipe at V-0"
Below
Ground
Surface.
Place 2"
of
High Intensity Direct
Burial
Insulation
Above
Distribution
Pipe.
Mound Over System
At Least
1' Above
Original
Ground.
.. _.
M
'1'YFIUAL WII)h "1'KE1Vl:rl bUIUVl
(NO SCALE)
NOTE: Maintain 4' Vertical Separation From Bottom of Trench
to Groundwater Table.
Grade Area Around Drainfield to Drain Away From the
Trench. Minimum 1' Above Original Ground.
Trench Must Be 50' From 25% Break in Grade.
cy ...
,.
�r�oc
D
c_
t
....
�
, r „
� 0
,
.. _.
i
i.. ..... ..
M
'1'YFIUAL WII)h "1'KE1Vl:rl bUIUVl
(NO SCALE)
NOTE: Maintain 4' Vertical Separation From Bottom of Trench
to Groundwater Table.
Grade Area Around Drainfield to Drain Away From the
Trench. Minimum 1' Above Original Ground.
Trench Must Be 50' From 25% Break in Grade.
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, ALASKA 99524
April 5, 1995
Municipality of Anchorage
Department of Heath & Human Services
825 "L" Street
Anchorage, AK 99502-0650
Subject: Lot 4, Block 5, Northwoods Subdivision
Septic System Design
Impacts to Adjacent Properties
Dear On Site Services Engineer:
We are hereby applying for an onsite septic system permit for Lot 4, Block 5,
Northwoods Subdivision. The location of the system and the alternate site are
shown on the attached site plan. Please note both sites are based on the same
testhole. If necessary, additional testholes will be placed and the information
forwarded to you prior to the construction of the system. The permit is needed
now, however, so the the Land Use Permit may be obtained and the foundation
work begun. In our opinion the subsurface soils in the area are uniform and will
not change substantially from the 41 minute per inch percolation rate shown.
The ground surface on the lot slopes from south to north and approaches 30 to
40% near the northern lot line. The drainfield trenches will be placed a minimum
50' upslope from any break in grade greater than 25%. In addition, the
subdivision is served by a community water system so well setbacks are not a
consideration.
1. The system, if constructed as designed, will have no adverse impact on the
wells in the area as the lot is served by a
community water system.
2. The system, if constructed
as designed,
will have no adverse impact on
existing septic systems in the
area or those
to be constructed in the future.
3. The system, if constructed
as designed,
will have no adverse impact on
reserved space, either surface
or subsurface,
on any lots located in the area.
4. The system, if constructed
as designed,
will have no adverse impact on
drainage patterns in the area. The current
draj�j� `tpq will be
maintained.
Sincerely,Mal"
4 ft ]FtC a 0( O(1"OO't1C
8F
hN�har I L
Michael E. Anderson, P.E.
"°
\J_
ti At;
IV
CT
7w
.. 25Os2T
rl
N
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0
MrA
Lot 4, Block 5, Northwoods Subdivision
DESIGN FACTORS: SYSTEM REQUIREMENTS:
Three Bedroom Home Wide Trench System
Perc. Rate: 42 Min./Inch 1,000 Gal. Septic Tank
Application Rate: .45 GPD/SF 4' Drain Rock Beneath Pipe
Reduction Factor: .5
3 Bdrms. X 150 GPD / .45 GPD/SF = 1,000 SF of Absorption Area
1,000 SF / 5' Wide = 200' LF X .5 (Red. Factor) = 100 LF Trench
Therefore:
Construct a Wide
Trench System
With Two Laterals
Each 50'
in Length. Place 4'
of Drainfield
Rock Beneath the
Lateral.
Place Distribution Pipe
at 1'-6" Below Ground Surface.
Place 2"
of High Intensity
Direct Burial
Insulation Above
Distribution
Pipe. Place 4" of Insulation
Under
Driveway.
TYPICAL WIDE TRENCH S Y SILAI
(NO SCALE)
NOTE: Maintain 4' Vertical Separation From Bottom of Trench
to Groundwater Table.
Grade Area Around Drainfield to Drain Away From the
Trench.
Trench Must Be 50' From 25% Break in Grade.
e Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: �Iir 10Wld7� _. DATE PERF
LEGAL DESCRIPTION:
�b$ ToWnship,Range, Section'
_.
COMMENTS
OH s
$10%/ *W4 6bwleb
pootioo°i�`A' JO J
A'�
poi^moo°�®�8r"; �y
VF rCgy�.�y�©gnu c+a c�a �„�r .ear
CL�jr,i rrcQ'1`7��cSv
431a 1 0o
,�., Ifvrc•l�
WAS GROUND WATER
ENCOUNTERED?
S
L
IF YES, AT WHAT O
DEPTH? P
t E
4epth to Witer Pitt Y
Ar
SITE PLAN
Brading
•Y•
Date
-E2�
Grass
Time
Net Depth t0
Time Wow
--
Net
DroP
PERGOLATION RA1L ' (minutes incn) PERG HOLE DIAMETER—
TEST RUN BE1'MYN FT AND I;2�— Fl
G j A CERTIFY THAT THIS TEST WAS PERFORMED IN
PERFORMED BY:
ACCORDANCE WITH ALL STATE ANA MUNICIPAL GUIDELINES IN EFFF.OT ONTHIS DATE. DATE: ---
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L' Street, Anchorage, Alaska 99502-0680
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: MMM ✓'� Wr'( 1N(7 DATE
LEGAL DESCRIPTION: L`) Vr I'1Mfl em* Township, Range, Section:
000.
SLOPE
V
NEAR; REAL)
n e.: 4 c�
C�
Q�
7
G n
.e
SITE PLAN
i0
I
2
Y/
3
w l
ENCOUNTERED?
11
�T
4-
S
5 5
zoM
IF YES, AT WHAT
/ p
s
ems'
_ s
P
12
6
y
�
$
°
c cL e
Depth to Water Atter
5
13
9-"
Monitoring?
Date:
.Ll .
SLOPE
V
NEAR; REAL)
n e.: 4 c�
C�
Q�
7
G n
.e
SITE PLAN
i0
WAS GROUND WATER
Y/
ENCOUNTERED?
11
a
S
IF YES, AT WHAT
/ p
DEPTH?
P
12
6
E
°
Depth to Water Atter
5
13
iJ�'
Monitoring?
Date:
I%
14-
15
4 15
16-
17— QST
18-
19
20
PERCOLATION RATE (minutes/inch) P�ERC HOLE DIAMETER
TEST RUN BETWEEN /y FT AND 1—FT
COMMENTS t *ry (iJocJ,.n •.ten i , - ,-,
PERFORMED BY: 'r I IYJAXAA4� ERTI TH�A%TJHIS JEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: —/' 91 s �
72-008 (Rev. 4/85)
y/0 <!�-�
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION AND MATERIAL SPECIFICATIONS
SUBJECT: Lot 4, Block 5, Northwoods Subdivision
GENERAL:
1. The scope of this project includes the procurement and
installation of a 1,000 gallon septic tank and the
construction of a shallow bed drainfield to serve the
proposed three bedroom home.
2. Construction shall be in accordance with the approved site
plan, design drawings, Municipal Permit with any special
provisions or conditions, and all applicable State and
Municipal Wastewater Disposal Regulations.
3. The Contractor shall be responsible for obtaining all
underground utility locates.
4. Unless specifically agreed otherwise, the property owner
shall be responsible for final grading areas subsequently
depressed from soil settling. Property owner shall also be
responsible for revegetation of affected areas unless
specifically agreed otherwise.
5. Contractors installing wastewater disposal systems must
be certified by the Municipal Department of Health and
Human Services for system installations. Owners installing
their own systems must receive prior approval from D.H.H.S.
before beginning system installation.
SEPTIC TANK INSTALLATION
1. A septic tank is to be constructed by a certified septic tank
manufacturer. Construction shall include two 4" cleanouts
for pumping access.
2. The septic tank shall be sufficiently bedded to prevent
settling or shifting of the tank.
Lot 4, Block 5, Northwoods Subdivision
April 5, 1995
Page Two
3. All standpipes on the septic tank shall extend a minimum of
12 inches above final grade.
4. Septic tanks installed without 4' of cover shall have a
minimum of 2" of direct burial insulation.
5. A foundation cleanout shall be installed one to four feet
from the building foundation. Two cleanouts shall be
installed between the tank and the drainfield. The first
cleanout shall be located on undisturbed soil not more than
10' from the tank. The first cleanout shall be to clean
toward the drainfield. The second cleanout shall be to clean
toward the tank.
6. Final grading over the septic tank shall be such that a
positive slope exists away from the septic tank.
DRAINFIELD CONSTRUCTION:
1. The drainfield shall be constructed to the dimensions shown
on the design. The bottom of the bed shall be within 2" of
level. The bed shall not be installed on a slope greater than
10%.
2. Distribution piping
must be placed
level with
perforations
down atop a level
bed of drainfield
rock. Rock
should then
be placed over the
pipe to provide a
minimum of
2" of cover.
3. A silt barrier or geotextile fabric must be placed between
the drainfield rock and the natural soil backfill.
4. Monitor tubes must be 4" in diameter and installed at the
locations shown on the design. The portion below ground
must be perforated.
5. Contractor shall verify the septic tank and drainfield are a
minimum 100' away from any water wells in the area.
Lot 4, Block 5, Northwoods Subdivision
April 5, 1995
Page Three
6. Direct bury insulation must be placed over the distribution
system if less than 3' of backfill depth is available. Finish
grade over the trenches must be mounded to prevent
settlement or depressions.
7. Grade area surrounding the absorption trenches to drain
away.
8. A minimum 2' of accepting soil is required below the
drainfield rock. Contractor shall verify this condition prior
to placement of the rock. All pockets of unacceptable
materials must be removed and replaced.
MATERIAL SPECIFICATIONS:
1. Septic tanks must be constructed by a Municipally approved
septic tank manufacturer.
2. The following pipe materials are approved for use in septic
system installations in the Municipality of Anchorage:
Cast Iron (perforated and solid), ASTM D3034 or P.V.C.
(perforated and solid), ASTM F810 or H.D.P.E. (perforated, but
not solid) and ASTM D2662 or A.B.S. (perforated and solid).
3. Insulation shall be at least 2" thick extruded direct burial
polystyrene (Dow Chemical Co. Styrofoam HI or equal).
4. Septic tank inlets and outlets shall be fitted with
watertight couplings (Caulder, Fernco, or equal).
5. A permeable geotextile fabric (Typar, Mirafi or equal) must
be installed between the final drain rock layer and the
native soil layer.
6. All drain rock shall be .5" to 2.5" in diameter with less than
3% passing the #200 seive.
e
Lot 4, Block 5, Northwoods Subdivision
April 5, 1995
Page Four
INSPECTIONS:
A minimum of two inspections are required by Municipal
Ordinance. These inspections must be conducted under the
supervision of a professional engineer registered in the State
of Alaska. The first inspection must be conducted after the
excavation of trenches, beds or pits and before the installation
of any gravel. A septic tank may be set in place, but may not
be backfilled.
The second inspection must be conducted after the placement
of the geotextile fabric, gravel, distribution piping,
standpipes, cleanouts and insulation. No backfill should be in
place at the time of inspection.
Contractor shall provide a copy of all field survey layout and
construction notes for use in preparing the certified as -built
of the completed system.
-I w "'1 h1117 I NJVI! ONF I 1,1 l P „71 EC1-Ir)N
January 4, 1982
Dale Greiner
Lugene Lane
Eagle River, AK 99577
Permit tt 811139
Subject: L4 B5 Northwood
A permit issued by this department for a well and/or sewer
system has expired as of December 31, 1981.
Permits are issued on a calendar year basis, as stated on
the permit, by authority of Municipal Ordinance.
If you have drilled the well, a well log should be sent to
this department to document the installation date.
If an engineer inspected the installation of the on-site
sewer system, please have them send us the as-builts for our
files.
If there are any further questions, please call this office
at 264-4720.
Sincerely,
Les N. Buchholz R.
Program Manager
Sewer and Water Program
Enclosure: Copy of Permit
i
82!S „L.„ STfiF E T
v
ANCHORAGE, ALASKA 99501
s 'I
(90/) 764411 "I
k y 11
t
M Oncf All SUI /VAN,
MAYOR
-I w "'1 h1117 I NJVI! ONF I 1,1 l P „71 EC1-Ir)N
January 4, 1982
Dale Greiner
Lugene Lane
Eagle River, AK 99577
Permit tt 811139
Subject: L4 B5 Northwood
A permit issued by this department for a well and/or sewer
system has expired as of December 31, 1981.
Permits are issued on a calendar year basis, as stated on
the permit, by authority of Municipal Ordinance.
If you have drilled the well, a well log should be sent to
this department to document the installation date.
If an engineer inspected the installation of the on-site
sewer system, please have them send us the as-builts for our
files.
If there are any further questions, please call this office
at 264-4720.
Sincerely,
Les N. Buchholz R.
Program Manager
Sewer and Water Program
Enclosure: Copy of Permit
TYPE. Cif S. 011_ E=IBSCIF::PT I ON SYSTEM TEM IS : TRE'NCH
H
MAI IMUM P•dI.JMBE.E: OF BEDECir'SOIL. EsATI(',#E7 (SO f-T/E.RwW:: 23--e"'31
THE' REQUIRED SIZE OF 'T'HE SOIL. FIEISr:€F:,F.T• T ON `E,YSTI.ri IS:
W p ._ E
�...;5' hW m �'..," ....�.... V-9 :�:.:: =::::g L_ d''a5 g_:.d —'�' �'""� �:u.:: "" �r..�_ ;`:�",_.R �"� �'� ""J ° F� 0...._S_. A E;:'.. Fw= "Ir- R..,A
THE: LE:P+IGTH DIr'1EN'S-1 IP•,I IS 'THE. LEr C'ITH lIN E=E:E:T) OF 'THE TRENCH OR )RINF"IEL.D.
-C FIE DEPTH OF' FI TRENCH OR PIT IS 'THE E;:ISTANC:E: BETWEEN THE SI..RF-ACE OF "!HE.'
I..2F.:1_lUr'aD FIND THE eo-rT'E:.,im OF THE Ei:FVATC.N (.IN C=EE T':>.
'THERE IS P•40 SET' W I E:,T"E-I FOR TRENCHES.
THE C RFIVE_. DEPTH IE.". THE MINIMUM DEPTH OF I:aF::AVEL E,E:T14EEN THE. OUTF F• L.L. PIPE
F? -4D 'THE BOTTOM OF 'THE:: EXCAVATION e:IN FEET).
1 4---7,F-"F-`T' I C—. '1"" Cl P-4 Pr,T: 2: FE_ .,:a. Jn;:- l C.".0 C u R'w.� I._.- R..». Cp""_,,
F'EE=:r'1117 1=1F'F'#».:ECANT HAS THE: RESF'ClNSIE:TL.IT`r' TO INF"CIRr'1 'THIS DEFT#F:TE''1EN'T DUF:'1'#'•,#G 'THE:
I ra'w:"rAL.L.AT" I r._ N I r+1SPEC:T" I t:€r,#' OF ANY WELL -S ADJACENT TO THIS PROPERTY Y FIND THE
P•dLPMBER' CIF' RESIDENCES I DEr, CES TE"HAT" 'THE WEL.L WILL.. SERVE,
E -,'A KF IL.LIr•4Ei €::€F' FlNY�SYSTEM WITHOUT FINAL INSPECTION N FiND FIF'F'RCl+,<`AL BY THIS
DF-PAF.:TMEr•,!T !.MILL BE E;#..IBJEC �'T' TO PROSECUTION.
r'ITr•,IIML. M DISTANCE. BETWEEN A WELL, AND FtN.Y Mrd==IEtITE SEC AIDE E: yTSF'IkISAt... 'SY.' TEM 15
FEET FOR A F'CT:T' NTE WE:L»L OR 150 •TCI' 20 -lo FEET FROM A F'UBL.II� WEL.L. C::�E:F'END:Cr•.#':s
UPON THE TYPE OF F'i.»IE.L. T €:.: I.JELL_.
MINIMUM DISTANCE FROM A PRIVATE C,.#ELL. TO Fi PRIVATE SEb.1ER UNE 'IS 22,5 FEET FIND
TO FI ImClr?hiL_trdIT'-,` SEkIEF:: L.INE IS" � FEET'.
OTHER REQUIREMENTS MAY APPL._'r'. S F'EC I FI CAT I CIP•,I.`; : FIND CONSTRUCTION DIAGRAMS FIFE.
F3'':*AI'LABLE To INSL.IF::E F'IrOPE:R INSTALLFITT(.Ir•,#.
F: " E " Fc!. M T: 7- @ : w,.. n 1F " :T Ems_ E:. - CA E=." CE-=- M E?- Jam" FR ,1_ _"
T CERTIFY THAT
:1.: T Aro E=FIr'i I L.I AR kl I TH THE REQUIREMENTS FOR ON. ... SITE SEWERS AND WEE...L S AS SET'
F OR'TH BY THE MUNICIPAL I T4' OF ANCHORAGE.
2 T WILL I NSTAL_.L.. THE SYSTEM IN AC:C:CIEr:DAr,#C E WITH THE: CODES.
I IIC,IC: EF: _:l"FtrdC? TE-IFiT THE: CIP+-=:I TE SEWER:�-'R:_,'TEP'I MAY REC!LJ I RE ENL.-FIEt:I] Eh1Er•,IT IF' 'THE
RESIDENCE IS F::Er'iODEL.E D TO INCILUDE h1CIRE THAN T: BEDROOMS.
FIF'F'L_:C C:i ird GRE I r•,IEF:
ISSUED E.,Y.—
/s %14. 0
L:jEPAF':Tt'IErlT
HEAL.»T'I•-1 F#raL= 'ra',':EE:Clr r1E:::r,IFFiL_ :.C)TEC...I. r.Or.,1
825 .:L_:.
STREET, FIN,C:EIaiRAGEaF AK'.
264-4720
F-.DG� Q Gi C1 SLC.�J
F:#I:::.F'I_ I Ca=lm-"
DALE GF E* T NE: R
L.UGENE (....FINE
;_,94 3,:j.; 5
L OC AT l Clyd
r'dORTHbfI: CID
LEGAL.
L4 E5 rd€ RTNW+ nOD
LOT SIZE 22.,- ail: 0
:-;(.'!UARE.' FEET
TYPE. Cif S. 011_ E=IBSCIF::PT I ON SYSTEM TEM IS : TRE'NCH
H
MAI IMUM P•dI.JMBE.E: OF BEDECir'SOIL. EsATI(',#E7 (SO f-T/E.RwW:: 23--e"'31
THE' REQUIRED SIZE OF 'T'HE SOIL. FIEISr:€F:,F.T• T ON `E,YSTI.ri IS:
W p ._ E
�...;5' hW m �'..," ....�.... V-9 :�:.:: =::::g L_ d''a5 g_:.d —'�' �'""� �:u.:: "" �r..�_ ;`:�",_.R �"� �'� ""J ° F� 0...._S_. A E;:'.. Fw= "Ir- R..,A
THE: LE:P+IGTH DIr'1EN'S-1 IP•,I IS 'THE. LEr C'ITH lIN E=E:E:T) OF 'THE TRENCH OR )RINF"IEL.D.
-C FIE DEPTH OF' FI TRENCH OR PIT IS 'THE E;:ISTANC:E: BETWEEN THE SI..RF-ACE OF "!HE.'
I..2F.:1_lUr'aD FIND THE eo-rT'E:.,im OF THE Ei:FVATC.N (.IN C=EE T':>.
'THERE IS P•40 SET' W I E:,T"E-I FOR TRENCHES.
THE C RFIVE_. DEPTH IE.". THE MINIMUM DEPTH OF I:aF::AVEL E,E:T14EEN THE. OUTF F• L.L. PIPE
F? -4D 'THE BOTTOM OF 'THE:: EXCAVATION e:IN FEET).
1 4---7,F-"F-`T' I C—. '1"" Cl P-4 Pr,T: 2: FE_ .,:a. Jn;:- l C.".0 C u R'w.� I._.- R..». Cp""_,,
F'EE=:r'1117 1=1F'F'#».:ECANT HAS THE: RESF'ClNSIE:TL.IT`r' TO INF"CIRr'1 'THIS DEFT#F:TE''1EN'T DUF:'1'#'•,#G 'THE:
I ra'w:"rAL.L.AT" I r._ N I r+1SPEC:T" I t:€r,#' OF ANY WELL -S ADJACENT TO THIS PROPERTY Y FIND THE
P•dLPMBER' CIF' RESIDENCES I DEr, CES TE"HAT" 'THE WEL.L WILL.. SERVE,
E -,'A KF IL.LIr•4Ei €::€F' FlNY�SYSTEM WITHOUT FINAL INSPECTION N FiND FIF'F'RCl+,<`AL BY THIS
DF-PAF.:TMEr•,!T !.MILL BE E;#..IBJEC �'T' TO PROSECUTION.
r'ITr•,IIML. M DISTANCE. BETWEEN A WELL, AND FtN.Y Mrd==IEtITE SEC AIDE E: yTSF'IkISAt... 'SY.' TEM 15
FEET FOR A F'CT:T' NTE WE:L»L OR 150 •TCI' 20 -lo FEET FROM A F'UBL.II� WEL.L. C::�E:F'END:Cr•.#':s
UPON THE TYPE OF F'i.»IE.L. T €:.: I.JELL_.
MINIMUM DISTANCE FROM A PRIVATE C,.#ELL. TO Fi PRIVATE SEb.1ER UNE 'IS 22,5 FEET FIND
TO FI ImClr?hiL_trdIT'-,` SEkIEF:: L.INE IS" � FEET'.
OTHER REQUIREMENTS MAY APPL._'r'. S F'EC I FI CAT I CIP•,I.`; : FIND CONSTRUCTION DIAGRAMS FIFE.
F3'':*AI'LABLE To INSL.IF::E F'IrOPE:R INSTALLFITT(.Ir•,#.
F: " E " Fc!. M T: 7- @ : w,.. n 1F " :T Ems_ E:. - CA E=." CE-=- M E?- Jam" FR ,1_ _"
T CERTIFY THAT
:1.: T Aro E=FIr'i I L.I AR kl I TH THE REQUIREMENTS FOR ON. ... SITE SEWERS AND WEE...L S AS SET'
F OR'TH BY THE MUNICIPAL I T4' OF ANCHORAGE.
2 T WILL I NSTAL_.L.. THE SYSTEM IN AC:C:CIEr:DAr,#C E WITH THE: CODES.
I IIC,IC: EF: _:l"FtrdC? TE-IFiT THE: CIP+-=:I TE SEWER:�-'R:_,'TEP'I MAY REC!LJ I RE ENL.-FIEt:I] Eh1Er•,IT IF' 'THE
RESIDENCE IS F::Er'iODEL.E D TO INCILUDE h1CIRE THAN T: BEDROOMS.
FIF'F'L_:C C:i ird GRE I r•,IEF:
ISSUED E.,Y.—
/s %14. 0
l
•
PERFORMED FOR:
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG — PERCOLATION TEST
❑ SOILS LOG
PERCOLATION
TEST
DATE PERFORM EDZ�<:�e--r-V
LEGAL DESCRIPTION: / ' V b r /'% t'v o-�-q jo `
SLOPE SITE PLAN
DEPTH
�FF�ET) 67
-%TC/ 57/ Z- 7;X S 9 /x40
2
1
3
y�W
4
5
1-0 all 7
/w j �
8 - dZ-3
10-
11 WAS GROUND WATER *j J 0 S
ENCOUNTERED? OL
p P
12 - IF YES, AT WHAT E
/ DEPTH?
13
14-
41516
Date
Gross
Time
Net
Time
15-
Net
Drop
�n
16-
►r
; S o
I � t�
/� �� ti
17
17
18
RR•R
IRC AP<aw n
�-
Rr
�•
19
Roiart A. Sh„
p
„ " •t':
20-
COMMENTS
0
COMMENTS
PERFORMED BY
72-008 (6/79).
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
►r
; S o
I � t�
/� �� ti
3 � tr
17
PERCOLATION RATE (minutes/inch)
TEST RUN BETWEEN FT AND FT
ks ' 7'u CERTIFIED
DATE: W ue-7- 1.
Municipality of Anchorage
-� Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 051-731-041 HAA # 0500,IC74
Expiration Date:
1. GENERAL INFORMATIOjq
Complete legal description' A or':' -- s LI 6 S
L,'pcation (site address or directions) ,2252 I /1/or}on Gou rl , pefeft Creek
Current Property owners) d ��- =- Ferre l�rez Day phone 688-6010
M-iiling address
Lending agency • L.
Mailing address
ANV3M1I&;�
Day phone
Real Estate Agent G'ndV W'1Lr Dayphone a.4(q-Ig3o
Mailing Address 65 Cen4efr 17 orlue Egyle 1Zt,Iee Ay- 49577
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
❑
Individual On-site
❑
Individual Water Storage
❑
Individual Holding tank
•❑
Community Class Well
❑
Community On-site
0
Public Water System
®
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are
valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with
new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.)
Certificates are valid for one year for properties served by Class A or B wells or a public water system. The
Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. 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 Health Authority 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 Eagle River Engineering Services
10421 VPN Rd., Suite 201 Phone, 6 9y- 5195
Address Eagle River, AK 99577
Engineer's Printed Name�/,_ _ "O ef- Q. Wm Date _ 6/;Z?/c6-
5.
/29/06
5. DSD SIGNATURE t GiRfSTOPHERR
CEIP7
✓ Approved for _3 bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
Attachments:
HAA Checklist X
Septic System Advisory
Well Flow Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
By: - n�A �+ Original Certificate Date: % — / 3 - o. -
(Rev 01102)
Municipality of Anchorage a•
• Development Services Department �" y
Building Safety Division _44 s • � <<
On -Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description:VarA1 i J< Ly0 65 Parcel 10:0!F/-731 -01f
A. WELL DATA
Well type jpj1i 6.
Date completed _
Total depth ft.
Date of test
Static water level
Well production
If A, B, or C provide PWSID #
Sanitary seal (YIN)
Cased to ft.
FROM WELL LOG
WATER SAMPLE -RESULTS:
colonies/100 ml.
Arsenic: _ mg./I.
B.EPT IHOLDING TANK DATA
Nitrate mg -A.
Well Log (Y/N)
Wires properly prdtected_ 414f)
Casing heigh
j4et5—ove ground) in.
ft.
Other bacteria colonies/100 ml.
Date of sample: _ Collected by:
Tank Type/Material SeO±,'C.Afee I Date installed 6I� 3 �4zs
Tank size /. 000 gal. Number of Compartments Cleanouts (9N) YCS
Foundation cleanout &N)'Y(e.3 Depression over tank (Y& no- High water alarm (Yo h C
Date of pumping � Jo$ Pumper S_. vo#*4c � Oi-n;0;&ef5
C. ABSORPTION FIELD DATA
Date installed 6/91�4is . Soil rating EEHDor ft2/bdrm).3 System type Qed
Length 50 ft. Width 30 ft. Gravel below pipe 0. S ft.
Total depth 9 S YR' EH. absorption area jf fLW Monitoring tube .)6C.I_ Depression over field 12& -
Date of adequacy test 4 O Results(ss ail) amass For 3 bedrooms
Fluid depth in absorption field before test Y in. Water added WO gal. New depth b in.
Elapsed Time:ffla min. Final fluid depth 'I 5in. Absorption rate >= q SrQ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y& type) n6n a AMj5k .tIf yes, give date.✓/A _
D. LIFT STATION
Date installed
"Pump on" level at _in.
E. SEPARATION DISTANCES
Size in gallons Manhole/Access
tn. High water alarm level at in.
Cycles tested Meets alarm 8 circuit requirements?
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot
Absorption field on lot
Public sewer main
line
On adjacent to
i
n adjacent lots
Public sewer manholelcleanout
Holding tank
SEPARATION DISTANCES FROM SEPTIC/11118lIPIM6 TANK ON LOT TO:
Building foundation +5 Property line 45' Absorption field +S
Water main +10, Water service line + 10' Surface water +100,
Wells on adjacent lots 'x100'
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line +10' Building foundation +I U Water main -4r l0'
Water Service line +IU' Surface water +100' Driveway, parking/vehicle storage 7'
Curtain drain +SU' Wells on adjacent lots +1006
F. COMMENTS
G. ENGINEER'S CERTIFICATION
/ certify that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA HAA guidelines in effect on this date.
Engineer's Printed Name
Date 9/0S
HAA Fee $ q J0
Date of Payment Ulm I°i
Receipt Number 7onv- Air
(Rev. 12101)
Waiver Fee $
Date of Payment
Receipt Number
LOT 3
SEPTIC CLEANOLRS
15' LMUTY EASEMENT -N
N
U
8
RW -7Y CREEIYBE r
rz
NORTON COURT
PACT A
5.0' X 10.0' BALCONY
PLOT PLAN _ AS BUILT X SCALE -IL—"40* 40' GRID NW1459 Project No. 05-133
Lang & Associates, inc. 11500 Daryl Avenue, Anchorage, Alaska 99515-3049
(907) 522-6476 Phone �cop�Op�
Registered Land Surveyors (907) 522-4625 Fax eGo OF A �k
kglongis0alasko.nef / Jclangle0ciasko.net �,``'•,•••••••••�•9s4�n'
1 hereby certify that I have surveyed the following described properly: `pY
LOT 4, BLOCK 5, NORTHWOODS SUBDIVISION (PLAT No. 79-195) 0 �:' 4 9� Q
Anchorage Recording District. Alaska, and that a Improvements situated thereon are ............0
within the property party Iines and do not encroach onto the property adjacent thereto, the
�••
no Improvement* on the property lying adjacent thereto encroach on the surveyed � �=�,.
promises and that then are no roadways, transmission nnes or other visible Q.. ' '• ,•
easement* on sold property except as Indicated hereon. QOa KENNETH .
Dated this the of Jog Zbo Q
LS 5202
Day�, of Anchorage, Alaska Poly
It 1s the responsibility of the owner to determine the existence of any easements, �40"O
FftwoNAL
covenants, or restrictions which do not appear an the recorded subdivision plat.
Alunicipahty of Anchorage
3 Y
\ �'• ++ L'O. Itis 1%4iill•,lnchuml;c,.\I;Iska99751949:ill•471N114rnl;.nc tivral
Illliec: (!M17):13a-1i:N11 • 15m: 0N171 :408-t:Y1N1 Llge//x���c.numi.m7(
Mayor Mark Begich De-velopmcnt Seniecs Department
July 13, 2005
Pierre and Andrea Perez
22521 Norton Cour
Chugiak, AK 99567
RE: Encroachment: Chain Link Fence and Septic Inspection Pipes
Block 5, Lot 4, Northwoods Subdivision, Grid NW 1459
Dear Mr. and Mrs Perez:
men[
i
yr
6
Department
The Right -of -Way Division has reviewed a request for a letter of nonobjection to existing septic
inspection pipes and a 4' chain link fence, which encroaches from I' to 7', respectively, into the 15' Utility
Easement on the south property line. On the as -built survey dated July I, 2005, submitted with the
request, the petitioner has shown the encroachments.
This letter of nonobjection is issued with stipulations, and by using it the petitioner is agreeing to the
following:
1. Municipality of Anchorage (MOA) will be held harmless, now and forever, for any damages or
injury to any person as a result of the encroachments.
2. All applicable codes and regulations will be observed and maintained within the easement.
3.. This letter of nonobjection will in no way preclude MOA from full use and enjoyment of its rights
within any porion of the easement.
4. Additional and extraordinary costs incurred during any future required construction, repair or
reconstruction of MOA improvements to accommodate any or all of the encroachments shall be paid
by the property owner.
5. Obtain letters of nonobjection from the following utilities:
®Anchorage Water & Wastewater Utility ❑Alaska Communications Systems
❑Chugach Electric Association, Inc. ®Matanuska Telephone Association
®Matanuska Electric Association, Inc. 0Enstar Natural Gas Company
❑Municipal Light and Power ®GCI Cable of Alaska
❑Eyecom (Girdwood cable TV)
All letters of nonobjection should be retained in your permanent files. Should you have any questions,
please call me at 343-8033.
Sincerely, ( Concur,
Jack L. Frost, Jr.
Right of Way Supervisor
Properly Owner(
Community, Security, Prosperity
LOT 3
SEPTIC CLEANOUTS
15' UTILITY EASEMENT I
RAA/7r GREENBELT
N 90'00'00'E 126.50'
LOT 4
31,335 s.f.
TRACT A
CHAINUNK FENCE—N,,. x _I 5.0' % 10.0' BALCONY
x'Irl
CANT
2.0' X13.1' CAN.
0.00.
OGi4
76.28.
XY
24.39j - S Ts G
N 90.0O'00'W S.
N EOJcfCoAcrr r'!� � i
NORTON COURT
STkN1'i'r?� 'I
PLOT PLAN AS BUILT X SCALE 1' - 40' GRID NW1459 Pr0Ject No. 05-133
Lan &Associates, inc. 11500 Daryl Avenue, Anchorage, Alaska
9 (907) 522-6476 Phone
Registered Land Surveyors (907) 522-4625 rax
kglangla0alasko.net / Jclangl000laeko.net op�
1 hereby certify that I have surveyed the following described property:
LOT 4, BLOCK 5, NORTHWOODS SUBDIVISION (PLAT No. 79-195)
Anchorage Recording DWcf. Alaska, and that the Improvements situated thereon are 9.
within the properly lines and do not encroach onto the property adjacent thereto, that
no Improvements on the property lying adjacent thereto encroach on the surveyed
Promises and that then are no roadways, transmission lines or other visible
easementson said property except as Indicated hereon. O0
Dated this the 1oo'o Day of �• Sbr.6• at Anchorage, Alaska �e
N Is the responsibility of the owner to determine the existence of any easements,
covenants, or restrictions which do not appear on the recorded subdMsion Plat.
99515-3049
49m.,�a`............
Ti.i.Y•• •q.
KENNETH L
LS -5202
l 7F SSKINA-.
Jul 06 2005 4:38PM
July 1, 2005
EHSTRR Eneineerin6
Eagle River Engineering Services
Ms. Sarah Martin
10421 VFW Rd. Suite 201
Eagle River, Alaska 99577
Re: Letter of Non -Objection
Grid: NW 1459
To whom it may concern:
Sn7-562-0053
XNSTAR Nmurat Cal C,,pa•y
A DIVISION OF SEMCO ENEROy
Engiac�6 Depuftnm
401 E. (nsemaamalAhyost Road
F. O. Dox 190266
Anebora6e,Alasks 99519-02U
(907)334.7743
FAX (907) 562-0053
ENSTAR Natural Gas Company has no objection to a septic encroachment into the utility
easement situated on the South Fifteen Feet (15 ft) of Lot 4, Block 5, North Woods Subdivision,
Plat 79-195, located within the Section 4, Township 15 North, Range 1 West,Seward Meridian,
Records of the Anchorage Recording District, Third Judicial District, State of Alaska.
Acceptance and use of this letter of non -objection by yourself, your heirs, your assigns, oryour
successors, will constitute agreement to the following stipulations:
• ENSTAR will be held harmless, now and forever for any damages or injury to any person or
property as a result of this encroachment.
• Any ENSTAR facility damaged or destroyed, as a result of this cacroachmeat will be repaired at
no cost to ENSTAR
• Any costs incurred by ENSTAR for special coasmctioa necessitated by this encroachment will be
borne by the property owner.
• All applicable safety code regulations will be observed and maintained.
•
This Letter of non -objection will in no way preclude ENSTAR from full use and enjoyment of its
rights within any portion of its righto6w2y.
Sincerely,
dz�-104�
Andrew Fraiser
Right -of -Way Assistant
ENSTAR Natural Gas Company
cc: File
P.2
MTA,OSP ENG
my I T?,
9::O� CALL ON
907 761 2646
YOUR COMPANY
NON -OBJECTION TO EASEMENT
By this document Matanuska Telephone Association. Inc.
encroachment of a Septic System within the platted 151,yti
Subdivision, flat No. 79-195, Anchorage Recording.VliAet;
07/06 '05 14:26 NO.914 01/01
,TtMl3ies that it has no objection to the
isement upon Lot 4, Block 5, Northwoods
Judicial District, State of Alaska.
.;r! L
####tt►!!flRtlR►►f#flf►►►R#Rte,i�#�#R###!##!#R!#;t►►#;########!;!!!R###R##t#;;t##fR#;i!!#!
..t' •
Please be advised that MTA through the issuance of this document does not forfeit any of its rights to the use
of the area cited. In the exercise of these rights MTA will, if needed, upgrade, maintain, repair, and/or replace
buried or aerial telecommunications facilities within the casement. Any repairs that may be required to the
encroachment as a result of utility construction will be borne by the property owner of record. This document
does not authorize the placement of any additional encroachments within the easement area. Property owners
are required to obtain utility locates before doing any kind of work in the utility easements and will be liable
for any damages caused by their construction work in the easements.
This document is in no way, an agreement to vacate any portion of the utility easement and should not be
interpreted as such,
Issued for Matanuska Telephone Association, Inc. this 6th day of July, 2005, by,
w _
Real Estate & Properties Supervisor
16th day of July, 2005, before me the undersigned, a Not Public in arid for
the State of Alaska, duly commissioned and sworn. as such, personally appeared Bonnie Bailey known to me
and to me known to be the individual named in and who executed the foregoing instrument and acknowledged
to me that he signed and sealed the same as a voluntary act and deed for the uses and purposes therein
mentioned.
IN WITNESS WHEREOF, I have hereunto set my hand and official seal the day and year first above writtett'`�
aaA,tpafN�! Yggyy, .... � '. �>.'•.R.,ryr
-aQaw ara•�-�•`2a�'4 I / / Aw / ��,/ � •• �:,• +VL1�/
Notary ubl in an for
'- r'fz- __..._ My commission expires:
•' �� f'.....ra A _.rte:
Matarru$ka Telepbone Association, Inc ".01
>;:F'Box335A ' ,gar.
,atts s
IL
AIt-- '
��jii,►�44 �t.`:�t,-;w� t�«.\�}a�f�t!-l�iiy1y\4a'sa7'4!� rsa�.
t,ti�7ii14±li ti�r!\iS11'is^•;•!i%•
Matanuska Telephone Association, Inc.
Jul Ob 05 01:20p
July 8, 2005
Eagle River Engineering Services
Home Owners Representatives
10421 VFW Rd.
Eagle River, Alaska 99567
Dear Eagle River Engineering Services,
P.1
Subject to your agreement to indemnify the company as set forth below, GCI Cable Inc.
of Alaska has no objection to the septic system cleanouts encroaching 6' into the15'
utility easement on the South property line of Lot 4, and Block 5, Northwoods
Subdivision. Known as (22521 Traverse Way Eagle River, Alaska 99567), in city grid I/
NW1459.
This letter ofnon-objection in no way precludes GCI Cable from full use and enjoyment
of any rights it may have within any portion of the utility easement and or the right-of-
way, including unlimited access for servicing its facilities. Also any additional and
extraordinary costs incurred during any future required construction, repair or
reconstruction of GCI's facilities to accommodate any or all of the encroachments shall
be paid by the property owner.
By signing below, you agree to indemnify and hold GCI Cable harmless, now and
forever, for any damage, costs, expense (including reasonable attorney's fees), liabilities
and injury to any person or property occurring as a result of the encroachment.
Please indicate your acceptance by signing and returning 's letter to self a he
address below.
Sincerely,
,%`� Acceptance
Rob Iiansen
OSP Design
7
Date
5151 Fairbanks Street • Anchorage, Alaska 99503 9 907 / 868-5600
7-082005 4:26PM FROM
ENCROACHMENT NON -OBJECTION AND AGRFEMENT
THIS AGREEMENT, made and entered into this _J=day of Jk
2005, by and between MATANUSKA ELECTRIC ASSOCIATION, INC., an Atatdkan
non-profit member owned electric cooperative, whose post office address Is Box 2929,
Palmer, Alaska, 99545, hereinafter called'First Parry', and ANDREA L. PEREZ b_
PIERRE A. PEREZ whose address Is 22521 Norton Court, Chuniak, Alaska_
99567 hereinafter caned •Second Party', WITNESSETH THAT:
A septic system encroachment located in the 15' platted utility easement within
Lot 4, Block 5, NORTH WOODS SUBDIVISION, according to Plat No. 79-195
T15 N.R 1w SE
DISTRICT, Third Judicial
RECORDING
NOW, THEREFORE. for and in consideration of their mutual agreements and
other good and valuable consideration, the receipt of which is hereby acknowledged,
First Parry, for Itself. Its successors and assigns, waives its objections to Second Party's
encroachment on the said easement for the purpose mentioned, subject to the
following conditions:
1. Second Party will hold First Party harmless from liability for any injury
or damage to any person or property which may result from such encroachment
2. This nonobjection Is granted with the full understanding and
agreement by all parties having an Interest In the above property that this
encroachment will in no way restrict or limit the current or future ability of MFA to fully
enjoy the benefits of the easement for any and all utility purposes that it presently
enjoys under the easement. This non -objection Is further conditioned by the stipulation
that MEA will be held harmless from liability for any and all damages to the
encroachment that may result from the existing and future use of said easement by
MEA, its contractors, successors, agents, licensees, or assigns.
3. Any facilities or property of First Party which are damaged or destroyed
as a result of such encroachment will be repaired or replaced. The cost of repair or
replacement will be paid entirely by Second Party.
4. Second Party will comply with all applicable safety codes and
regulations.
6. Any expenses which First Parry may incur In the relocation or
modification of its facilities to accommodate the said encroachment will be paid entirely
by Second Party.
By its execution of this Agreement, Second Party agrees, for itself, Its
successors and assigns, that is encroachment upon the named easement as
hereinabove mentioned will be subject to the foregoing conditions.
P. 2
7-08=2005 4:26PM FROM
Encroachment Non -Objection and Agreement
Page 2
IN WITNESS WHEREOF, the parties have caused this Agreement to be
executed by their duly authorized representatives and agents as of the day and year
first above mentioned.
-I MATANUSKA ELECTRIC ASSOCIATION. Wt.
8Y�-��..��(First Party)
—A l,-) J
General Manager his Representative
STATE OF ALASKA
:SS
THIRD JUDICIAL DISTRICT
The fore oing cement was acknowledged before me this 7 . , day of
�LuN .20�by,�y?t�-rC._�,
�� EL A.
t Notary Public for the State o a a
My commission expires: 3
SECOND PARTY
Pierre A. Perez
STATE OF ALASKA
SS.
THIRD JUDICIAL DISTRICT
�
The foregoing agreement was acknowledged before me this day of
JL4 Z03ar—.bY�1t�tLn C f:�✓L Q p(yrL'IaRE"L,
RETURI
t �--'—
Notary PublIE for the State qJ Alaska
My commission expires:
2929, PALMER. ALASKA 99645
ii
P. 3
MUNICIPALITY OF ANCHORAGE
• DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services Ak
On -Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
Parcel I.D. # 051 _7S1 _04 HAA # UVQ\S-(!�()Q'SD
1. GENERAL INFORMATION
Complete legal description Lot 4; dock 5 Northwoods
Location (site address or directions) 22521 Norton Court
Property owner non P. carri P Ste hens Day phone _688-1555
Mailing address 29921 Nnrtnn C niirt 0hrl q i a_ k AK 9Q t; 67 -
Lending agency Day phone
Mailing
Agent _
Address
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: ThrE 1
3. TYPE OF WATER SUPPLY:
Individual well
Community well xxx
Public water
Day phone
NOTE: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site xxx
Holding tank
Community on-site
Public sewer
NOTE: If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025(Rev.1/91) Front MOAD21
A
14
By:
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 of this Health Authority Approval application 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 inspection.
Name of Firm Andprsnn Engineerin^ Phone 522-7773
Address
Engineer's signature
DHHS SIGNATURE THD
C
Approved for L[ ~ E bedrooms.
Disapproved.
Conditional approval for
Additional Comments
Date 6/7/99
bedrooms, with the following stipulations:
Date �� q
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in orderto satisfy certain federal and state requirements. Employees of DHHS 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.
72-025 (Ret. 1/91) Beck MOA 021
Municipality of Anchorage JUN 0 7 I
00* DEPARTMENT OF HEALTH & HUMAN SERVICES ,riUNiGPALITYOFA
Environmental Services Division ENVIRONMENTAL SER I
N
825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744.
Health Authority Approval Checklist
Legal Description: Lot 4, Block 5, Northwoods Parcel I.D.: 051-731-04
A. WELL DATA - Community Water System
Well type
Log present (Y/N)
Total depth
Sanitary seal (Y/N)
Date of test
Static water level
Well production
If A, B, or C, attach ADEC letter. ADEC water system number
Date completed
Cased to
FROM WELL LOG
g.p.m.
Casing height (above ground)
Wires properly protected (Y/N)
AT INSPECTION
WATER SAMPLE RESULTS: - Community Water System
Coliform
Date of sample:
B. SEPTIC/HOLDING TANK DATA
Nitrate
Collected by:
Other bacteria
g.p.m.
Date installed 6/91195 Tank size 1 , 0 0 0 Number of Compartments 9. Cleanouts (Y/N)_Y
Foundation cleanout (Y/N) v Depression (Y/N) N High water alarm (Y/N)
Date of Pumping A/1R/9A Pumper San;tary n„mrarc
C. ABSORPTION FIELD DATA
Date installed 6 / 27 / 9 5 Soil rating (g.p.d./ft2 or ftz/bdrm) -3 System type nPd
Length 50' Width 30' Gravel thickness below pipe 5' Total depth 3 , 5' - 4 .5'
Effective absorption area 1 , 500 SF Monitoring Tube present (Y/N) Y Depression over field (Y/N) N
Date of adequacy test 9 / 16 / q R Results (Pass/Fail) Pass For 3 bedrooms
Fluid depth in absorption field before test (in.); 0 Immediately after a R opal. water added (in.): 1 "
Fluid depth 0 (ins) Minutes later: 10 Absorption rate = > 450 g.p.d.
Peroxide treatment (past 12 months) (Y/N) N If yes, give date
72-026 (Rev. 3/96)*
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MUNICIPALITY OF ANCHORAGE
• DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On -Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
Parcel I.D. # D5 i 7 3 i Lt HAA #
1. GENERAL INFORMATION
Complete legal description tvr 4FLO L" �^ �° 12s1k iso 065
r
Location (site address or directions)
Property owner m M(� r r - k. �� • -� Day phone
n � n�
Mailing address �'� �� L '��'"� C 41' �' o c�
Lending agency Day phone
Mailing address
Agent
Address
Day phone
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: I ltk-c=
3. TYPE OF WATER SUPPLY:
Individual well
Community well XX X
Public water
NOTE: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site XXIX
Holding tank
Community on-site
Public sewer
NOTE: If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev. 1/91) Front MOA #21
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 of this Health Authority Approval application 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 inspection.
Name of Firm ANDi:-:RS'0rj EJG/J IZ f tj6 Phone ELLL `f5 S1
Address —P
Engineer's signature
6. DHHS SIGNATURE
By:
2-40773
"— Approved for '--dIA-L bedrooms.
Disapproved.
Conditional approval for
Additional Comments
a11TIC
n_4 6if- g9 s z'q-
Date 7/z i Q
bedrooms, with the following stipulations:
Date '7/2 )-lo--
The
l1
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS 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.
72425 (Rev.1/91) Back MOA #21
I
Municipality of Anchorage
Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: i- 1' 4 L?>Wgl.j�: A)PA I}WONS Parcel I.D.
A. Well Data
45'1731©4
Well type l.44SS If A, B, or C, attach ADEC letter. ADEC water system number
Log present (Y/N) Date completed Driller
Total depth
Sanitary seal (Y/N)
Date of test
Static water level
Well flow
Pump levell
Cased to
FROM WELL LOG
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot
Absorption field on lot
Public sewer main
Casing height
Wires properly protected (Y/N)
AT INSPECTION
; On adjacent lots
; On adjacent lots
Public sewer manhole/cleanout
g.p.m.
Sewer service line—Petroleum tank
WATER SAMPLE RESULTS: &N,A SUiT� (JAT- M' Sy% i1-L�l✓�
Coliform
Date of sample:
B. SEPTIC/TANK DATA
Nitrate
Collected by:
Other bacteria
Date installed � f Z3/ 95 Tank size f ODb At-+' � Compartments
m
Cleanouts (Y/N) y Foundation cleanout (Y/N) ( Depression (Y/N)
High water alarm (Y/N) -AJ G Alarm tested (Y/N) q A
Date of pumping iV C'VJ C w >"nW cx'1O ") Pumper #41A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
t
Well(s) on lot /J D On adjacent lots Zb D Foundation
To property line 72:9 Absorption field i1 Water main/service line
Surface water/drainage ;W D
6/
'> 10 1
72.026(3/93)'Front CONTINUED ON BACK PAGE
C
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Date installed � f Z3/ 95 Tank size f ODb At-+' � Compartments
m
Cleanouts (Y/N) y Foundation cleanout (Y/N) ( Depression (Y/N)
High water alarm (Y/N) -AJ G Alarm tested (Y/N) q A
Date of pumping iV C'VJ C w >"nW cx'1O ") Pumper #41A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
t
Well(s) on lot /J D On adjacent lots Zb D Foundation
To property line 72:9 Absorption field i1 Water main/service line
Surface water/drainage ;W D
6/
'> 10 1
72.026(3/93)'Front CONTINUED ON BACK PAGE
C. LIFT STATION
Date; installed
Size in gallons
Vent(Y/N)
High water alarm level
Meets MOA electrical codes
SEPARATION J, Ff
nn lot
D. ABSORPTION FIELD DATA
"Pump on" level at
LIFT STATION TO:
On adjacent lots
Manufacturer
Manhole/Access
tested
off" Level at
Surface water
Date installed � Z L,%/ 9S Soil rating (GPD/Ft2) 0 3 System type g
f r � r �
Length S%, Width 30 Gravel thickness • S Total depth 3,51 -M
Total absorption area M3 00 F , z Cleanout present (Y/N) Y Depression over field (Y/N) e�!
Date of adequacy test ^JLVJ at -J 5'7. Results (pass/fail) f ASS for T � Bedrooms
Water level in absorption field before test O
Peroxide treatment (past 12 months) (Y/N)
AV
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot Al o Aj c
To building foundation
On adjacent lots 1 S D
Surface water >/o D
_On adjacent lots
�I
To -existing or abandoned system on lot
Cutbank A D A) G: Water main/service line
test O
If yes, give date MA
i
Property line
Driveway, parking/vehicle storage area
Curtain drain > S'6 i
E. ENGINEER'S CERTIFICATION
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on 1bq, date of this inspection.
Q�
Signature
Engineer's Name 1A cq4c-L E / N oL-�2Spti 0
Date1Zp
/
I / Q� 4
�—r
J r
HAA Fee d2) Waiver Fee $
Date of Payment/n (7 _� J_ g�� Date of Payment
Receipt Number `G %�0Ch X� Receipt Number.
72-026 (3/93)" Back