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Home My WebLink AboutRABBIT CREEK VIEW & HEIGHTS BLK 5H LT 2ARabbit Creek View Heights Block 5H Lot 2A #020-551-37 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Pae 1 of 2 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP211095 PID Number: 020-551-37 Dwelling: 9 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑■ New ❑ Upgrade Name Pg VOLOSHIN ABSORPTION FIELD Site Address 8027 BYRON DR, ANCH ❑ Deep Trench 9 Wide Trench ❑ Bed ❑ Mound Phone ❑Other �Tumber�ofBedro�oms Soil Rating Total depth from original grade 2.0 GPD/SF +1.5 LEGAL DESCRIPTION Ft. Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot } 2:0 RABBIT CREEK HEIGHTS & VIEW BLK 5H LT 2A Ft. 0.5 Ft. Township Fill added above original or Gravel length Range Section 5.0 Ft. 62 Ft ]Gravel width Beds: Number of Lines Distance between lines SEPARATION DISTANCES To Ft. Ft. Septic Absorption Holding Sewer absorption area Number of trenches Dist. between trenches From Tank Field Lift StationTank Line 0 Ft2 well *50'+ 1 50'+ 50'+ TANK 9 Septic ❑ S.T:EP. ❑ Holding Q Other Ft. Manufacturer Capacity Surface Water 50'+ 50'+ ANCH TANK/ADVANTEX 1500 Gal. Numb Number R compartments Lot Line 10'+ 10' NA FIBERGLASS 2 Foundation 1 0'+ 1 101+ LIFT STATION Manufacturer Capacity Remarks * ADVANTEX .SYSTEM ADVANTEX Gal Alarm location Electrical installed by GARAGE WALL RISING SUN Installer PIPE MATERIAL House to tank 3034 drainfield Tank to MIKE N ANDERSON, P.E. 3034 Drainfield 3034 CO/MT 3034 Inspector MIKE N ANDERSON, P.E. BENCH MARK (Assumed elevation) 106 Inspection , caft dates: �` 11/25/22 ZM 11/26/22 Lotion and description 3'" 41h TOP OF MANHOLE ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp itional Approval: Date ��.•, .;Y t?, ' A *:'4 9 LH -1y '- a 'a Septic System r ; MICHAEL N. ANDERSON Approved Date Z 2 _ �� s•. c 9 9�: ell - Note: this approval does not include well permit requirements. r 1 ...... •.�a t (� p .v 05/02/18) (', Municipality ®f Anchorage s� -- L)eparhnent P.O. Box 196650 ® 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 ® Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: OSV221082 PID#: 020-551-37 Permit#: OSP221245 Legal Description: Rabbit Creek View & Heights Block 5H Lot 2A Engineer: Michael Anderson, PE Applicant: Michael Anderson, PE Your request for a waiver of the required 4' feet vertical separation from the bottom of septic rock to the groundwater has been approved. The approved separation distance is 3.5'. This waiver approval applies to the Existing absorption field only. Any future upgrade to the on- site wastewater disposal system will require all separation distances be met or another approval from this department ❑The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of nonobjection have been received from the owner(s) of the affected adjacent property. ® Adjacent properties are not affected by this waiver. ............................................... ■ ............................. ■ 1 Waiver is Granted: X Waiver is not Granted: Date: Z 2 Z Approved by: Name of Reviewer .......... .............................................. m ................. **** VARIANCE/WAIVER REVIEW **** Dec 22, 2022 Municipalities of Anchorage Development Services Dept. On-Site Water & Wastewater Section Anchorage, Alaska 99519 Phone 343-7904 Re: WAIVER REQUEST Legal: RABBIT CREEK VIEW & HEIGHTS BLK 5H LT 2A To Whom it may concern: This is a request for a waiver for the above referenced lot. The original permit required a pump basin be installed to maintain two feet separation between ground water and the bottom of the field, but none were available. A 60 foot long 5-wide field was installed with a gravity flow system which is 3.5 feet from the measured high-water level. The ground water measurements were taken in May 2021 which is the historical high water time period. Per the MOA On-site code for vertical separation 15.65.355.H.2 the drain field pipes can’t be more than 20 long if they are not pressurized to allow for the 2-foot separation. Currently the field has 3.5-feet of vertical separation. We are requesting a waiver to 3.5 feet with a non-pressurized system. Justification for this waiver is the system is only 12 percent out of compliance with the current code section. From the septic asbuilt drawing the drain pipe from the Advantex system pod enters the field at the 16-foot mark in the 62-foot total length. Therefore, we have one 16-foot trench (meets the code) and one 46-foot trench which doesn’t. So one-third of the trench meets the code. We also have 3.5 feet of filter sand below the entire system which greatly adds to the filtering of the effluent. This system is also monitored by (Anch Tank) and will be inspected annually per the MOA guide lines, another justification for granting of this waiver. The granting of this waiver will not impact any of the surrounding neighbors with this small revision. Sincerely Michael N. Anderson, P.E. 4661 Natrona Anch, Ak 99516 Ph 727-8864 L3A B5H L4A B5H UNDEVELOPED L5A B5H UNDEVELOPED 10' UTILITY EASEMENT L6A B5H 10' UTILITY EASEMENT 10' UTILITY EASEMENT L1A B5H Certified Drilling Log OWNER OF LAND: Aleksey Voloshin ADDRESS: 8043 Byron Drive Anchorage, AK LEGAL DESCRIPTION Rabbit Creek V&H B5H L2A DATE: 8-11-21 PERMIT NUMBER: OSP211095 DATE OF ISSUE: 6-16-21 TAX IDENTIFICATION NUMBER 02055137000 Is well located at approved permit location: Yes No Method of Drilling: air rotary cable tool Depth of Well: 84’ Casing Type: Steel Wall thickness .250 inches Diameter: 6 inches, depth 80 feet Liner type Static Water Level: Flowing feet Recovery Rate 5 gpm gph Method of Testing Air Well Intake Opening Type: open end open hole Screened Start feet Stopped Perforations Start feet Stopped Grout Type: Bentonite Volume: 50 lbs Depth: from 2 feet, to 42 feet Well Disinfected Upon Completion: yes no Method of Disinfection: Chlorine 50 PPM Comments: Pulled casing back to 80’. Bore Hole Data Depth From To 0 2 Casing Stickup 2 6 Fill 6 8 Overburden 8 14 Silty Clay Sand & Gravel 14 18 Tight Silty Sand & Gravel w/ Clay 18 63 Hardpan 63 79 Tight Silty Sand & Gravel Damp 79 81 Silty Sand & Gravel Water 81 84 Bedrock Drillers Name: Cole Sullivan ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. MatSu Borough: Department of Environmental Conservation. www.sullivanwaterwells.com Pump Installation Log Well Drilling Permit Number: SW OSP211095 Date of Issue 6-16-21 Parcel Identification Number: 02055137000 Legal Description Property Owner Name & Address Rabbit Creek View & Heights Block 5H Lot 2A Aleksey Voloshin Pump Installation Date: 10/25/22 Pump Intake Depth Below Top of Well Casing: 70 feet Pump manufacturer’s Name: F&W Pump Model: 4F11P05301S Pump Size: 1/2 hp Pitless Adapter Burial Depth: 10 feet Pitless Adapter Installer: Unknown Disinfected Upon Completion? yes no Method of Disinfection: Chlorine 50 PPM Comments: Pitless Manufacturer: Unknown Pump Installers Name: Sullivan Water Wells Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. EDGE OF GRAVEL ROAD HOUSE L3A B5H L4A B5H UNDEVELOPED L5A B5H UNDEVELOPED R5 0 . 0 0 ' R50.0 0' 10' UTILITY EASEMENT S15° 21' 10"E 196.71 ' L=8 8 .8 4 R=7 9 0 .5 0N36° 3 3 ' 3 0 "W 8 9 . 5 1 'N3 7 ° 4 9 ' 1 3 "W 9 0 . 6 1 'N36° 3 3 ' 3 0 "W 4 9 .43 ' BYRON DRIVE R.O.W. CENTERLINE LOT 2A BLOCK 5H 21,862 SF 0.50 AC L6A B5H 10.2' NE I G H B O R ' S SE P T I C S Y S T E M EDGE OF GRAVEL ROAD 2ND F L O O R DECK 2ND FLOORENTRYLANDI N GSTAIRS SINGLE FAMILY HOUSE GRAVEL DR IVEWAY 22.2' 28.2'28.9'64.0' 55.2'41.5'N89° 11' 37"E 67.76' S89° 26' 57"W 70.09' 10' UTILITY EASEMENT RECT. SEPTIC SYSTEM LID STAIRS R50.00' HOUSE ELEC. LOCATES GAS LOCATES GAS METER ELEC. METER 32.2'40.2 ' ELEC BOX WELL CENTER MH LID VENT POWERPOLE CEA PED CEA PED COMM RISER 1 0 ' UT I L ITY EASEMENT L1A B5H SEPTIC SYSTEM PIPES ASBUILT SURVEY LOT 2A, BLOCK 5H RABBIT CREEK VIEW & HEIGHTS SUBDIVISION LOCATED IN E1/2 W1/2 & W1/2 E1/2 SEC. 1, T11N, R3W, SEWARD MERIDIAN, ALASKA EXCLUSIONS IT IS THE RESPONSIBILITY OF THE OWNER OR BUILDER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENENTS,OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR ESTABLISHING BOUNDARY OR FENCE LINES. ASBUILT CERTIFICATION I HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING PROPERTY, LOT 2A, BLOCK 5H, RABBIT CREEK VIEW & HEIGHTS SUBDIVISION, AND THAT NO ENCROACHMENTS EXIST, EXCEPT AS NOTED. Alaska Construction Surveys 907 E Dowling Rd, Suite 10 Anchorage, Alaska 99518 Office: (907) 344-5505 Fax: (907) 344-4775 Email: mcrow@akconstsurveys.com Site: Residential Address: 8043 BYRON DR, ANCHORAGE Field Survey Date: 11-19-2022 Crew: M.C. Drawn by: M.C. Scale: 1" = 40' PREPARED FOR VOLOSHIN, ALEKSEY & VITA ALASKA C CONSTRUCTION A SURVEYS S 19 Nov 2022 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Water & Wastewater System Permit Permit Number: OSP221245 Work Type: WellSeptic Renewal Effective Date: Expiration Date: Tax Code Number: 02055137000 Site Legal Address: RABBIT CREEK VIEW & HEIGHTS BLK 5H LT2A G:3340 Site Mailing Address: 8027 Byron DR, Anchorage Owner: VOLOSHIN ALEKSEY & VITA Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING This permit is for the construction of: Q Disposal Field R1 Septic Tank ❑ Holding Tank ❑ Privy ent S, �o L -1 n Department 7/7/2022 7/7/2023 Lot Size in Sq Ft: 21862 Total Bedrooms: 4 Q 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 Special Provisions: ** Pump basin after tank is required to provide pressurized system for reduced vertical separation to seasonal high groundwater. Received By: I Date: Issued By: U' ('SVA Date: r7 a 0 .Z Development Services DepartmentPhone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 020-551-37 Property owner(s) ALEKSEY & VITA VOLOSHIN Mailing address 1201 SURREY CIR APT 2, ANCH AK Site address 8027 Byron Dr Day phone Legal description (Sub'd., Block & Lot) RABBIT CREEK VIEW & HEIGHTS BLK 5H LT 2A Legal description (Township, Range & Section) Lot Size 21,862 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field Fxj Initial 0 Single Family (SF) El ADU) Septic Tank ® Upgrade El(w/wo Duplex (D) ❑ Holding Tank El Renewal Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well Pq Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: Date of Payment: Receipt Number: DD6q ?,7 Permit No. OS P)) 9 � y5 Waiver Fees: Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc July 1, 2022 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 Re: Septic & Well Permit Legal: RABBIT CREEK VIEW & HEIGHTS BLK 5H LT 2A (Renewal) To Whom it may concern: This is a request for a septic and well permit on the above referenced lot. Two test holes was excavated and found 2 feet of organics then Silty Gravel (GM) down to 6 feet then changed to silty sands (ML) in the bottom. Water was observed at 3 feet but raised to 2 feet after the 7-day monitoring period. The perc rate was 42 minutes per inch. Due to the lot size and soils an Advantex system has been designed for the lot. The lot slopes at 10 to 12 percent towards the northeast. No open water or cut banks existing with 100 feet of the proposed site. NOTHING HAS CHANGED FOR TIS PERIMT. This new well or septic system will not impact any of the surrounding neighbors. Sincerely Michael N. Anderson, P.E. 4661 Natrona Anch, Ak 99516 Ph 727-8864 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221245, Rebecca Carroll, 07/07/22 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Water & Wastewater System Permit Permit Number: OSP211095 Work Type: WellSeptic Initial Effective Date Expiration Date: Tax Code Number: 02055137000 Site Legal Address: RABBIT CREEK VIEW & HEIGHTS BLK 5H LT 2A G:3340 Site Mailing Address: 8027 Byron DR, Anchorage Owner: VOLOSHIN ALEKSEY & VITA Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING This permit is for the construction of: Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy lrcntR S, Department 6/16/2021 6/16/2022 Lot Size in Sq Ft: 21862 Total Bedrooms: 4 Q 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 Special Provisions: ** Pump basin after tank is required to provide pressurized system for reduced vertical separation to seasonal high groundwater. I Received By: Date: Issued By:L ('i�_c'� Date: a0�2 t ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 020-551-37 Phone: 907-343-7904 Fax: 907-343-7997 Property owner(s) ALEKSEY & VITA VOLOSHIN Day phone Mailing address 1201 SURREY CIR APT 2, ANCH AK Site address M gC 5r] bj ROQ t 'kl V E�AN04 Legal description (Sub'd., Block & Lot) RABBIT CREEK VIEW & HEIGHTS BLK 5H LT 2A Legal description (Township, Range & Section) Lot Size 21,862 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field Fx� Initial ❑ Single Family (SF) El ADU) Septic Tank IX-1Upgrade El(w/wo Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: $820 Waiver Fees: Date of Payment: 11 5 1 aOa1 Date of Payment: Receipt Number: 0 0 5 55 r Receipt Number: Permit No. OSP211095 Waiver No. G:\Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc May 1, 2021 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 Re: Septic & Well Permit Legal: RABBIT CREEK VIEW & HEIGHTS BLK 5H LT 2A To Whom it may concern: This is a request for a septic and well permit on the above referenced lot. Two test holes was excavated and found 2 feet of organics then Silty Gravel (GM) down to 6 feet then changed to silty sands (ML) in the bottom. Water was observed at 3 feet but raised to 2 feet after the 7-day monitoring period. The perc rate was 42 minutes per inch. Due to the lot size and soils an Advantex system has been designed for the lot. The lot slopes at 10 to 12 percent towards the northeast. No open water or cut banks existing with 100 feet of the proposed site. This new well or septic system will not impact any of the surrounding neighbors. Sincerely Michael N. Anderson, P.E. 4661 Natrona Anch, Ak 99516 Ph 727-8864 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211095, Rebecca Carroll, 06/16/21 1"=200' PROPERTY LINE PROPOSED SEPTIC PROPOSED HOUSE-CARL STREET--BYRON DRIVE- SCALE: DJRDRAWN: DATE: RABBIT CREEK VIEW & HEIGHTS, BLOCK 5H, LOT 2A Anchorage, Alaska ALEKSEY & VITA VOLOSHIN 5/5/2021 5/1/2021 -VIOLA CIR- - M A R V I N C I R - -BYRO N D R I V E - DESIGN CRITERIA: 0.5' EFFECTIVE 4 BDRM X 150 = 600 GPD SOILS = 600/2 = 300 GPD 300 GA/5 = 60' 5.0' WIDE 60' LONG (1) MOUND +2.0' DEEP 6 (TH#1 & 2) 2.0 GM ORG 5.0' +1.5 +2.0 MOUND OVER FILTER FABRIC & SEWER ROCK & 3,3( TOPSOIL & SEED WATER @ 2.0' MAY 2020 2" INSULATION 3:1 +4.0 -2.0 FILTER SAND ML REMOVE ALL ORGANICS BELOW FOR TANK BUOYANCY 4,000 LBS CONCRETE (1YD) THE ENTIRE MOUND Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211095, Rebecca Carroll, 06/16/21 1"=50' PROPERTY LINE PROPOSED HOUSE D R I V E W A Y PROPOSED ABSORPTION FIELD -BYRON DR- BLK 5H LOT 5A SCALE: DJRDRAWN: DATE: RABBIT CREEK VIEW & HEIGHTS, BLOCK 5H, LOT 2A Anchorage, Alaska ALEKSEY & VITA VOLOSHIN 5/5/2021 5/1/2021 NEW 1500 GALLON TANK W/ ADVANTEX POD. WELL WELL SEPTIC MT MT CO CO PROPOSED WELL NO WELL OR SEPTIC ON FILE OR FOUND VACANT VACANT VACANT VACANT SEPTIC BLK 5H LOT 6A BLK 5H LOT 4A BLK 5H LOT 1A -CARL ST-10' UTILITY EASEMENT 1' FOOT CONTOURS SLOPEEXTENT OF MOUND WITH 3:1 SLOPE FOOTING DRAINS > 10' AWAY FROM THE LEACH FIELD AND 25' FROM ANY PERFORATED DRAIN AND WELL PUMP BASIN Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211095, Rebecca Carroll, 06/16/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211095, Rebecca Carroll, 06/16/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211095, Rebecca Carroll, 06/16/21 MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this Day of M A V of 20 Z I , by and between hk '-, t- L. c , herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as `f X z & A t`) v / 1 E C. LI located at (legal description) 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) Throughout the term of this Agreement, the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). ! ; Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. lr ILL Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Page 1 of 3 V Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. ' Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. AL_`;f� Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. V Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. fLL Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue while the AWWTS is operational or until title is transferred. 4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of 3 OWNER: By: '(signature) �- F �-- �, F- y (print name) STATE OF ALASKA. ) ) ss. THIRD JUDICIAL DISTRICT ) Date: � — // -- Z c z l The foregoing, instrument was acknowledged before me this 11 day of 2011, by t/�(�� •fr Cn"�W NOTARY PUBLIC FOR ALA.SI{.A My Commission expires: MUNICIPALITY: By: Ati� / . 1 �'U['t� (signature) J?e 6 WC, ai- rd � (print name) Date: 6,11 6 2 D. Title: (rev. 05/18/2018) Page 3 of 3 October 3p 1077 i 0) 7619 Gale Lai-,ison Star Route 1? Boo 4 3 8A 7\,lwhoraq,c_g Alaska 99507 `u"tYi} (y C: .t z)G2.t':it1J.t xxpirc`3.'t,ion I)C!ctr' �-ir. �,�GiI�£rCJlla A i7f:WvIit isb"UO( axy� tz�a <i,e for W IAL anFt/ax on—site t4s t,al .l rt,.lca:a on .s}t ? )31-oc:k 5 lta-bbit C:rc�ok k�� bciiViSiol t� �.. ]Y%[" =r) tblF: :l 3,,',UC? C ado =C c f'C}:a C}[L[' � .� fvi1Y :fYi tixf=. cvrx you :1Cj 17;,ia Y to i11tjI1i tllc= caJ.? and/ort>n- �.t:r asE.vsc�Y' Bys m:ip a nnvy pormit. is roc -lirod. Tile o:rigilIc t€�st rilaa,y lac las,,;' to ol)tairi a c:u:rront permit. :Ci' t1w well has been Fxr:illc!it, <j wel.i Jog should be Sent to tixtcs c epart- ient to c10c:ml nt this inn -l'- l latiol" dulte- :t'f: Fjf Lr 1Y l4Tt' a�1v, ,_ uF r .i.r)n4 r c, rd nci the €3i�QWf matters,�.7�E£3 �F' 264— trit7 Y1F3'� IICE;�ta e: to CF ULflEJi:. t:t1�s3 Oi f�.E L iT1Xl1eCta:�#.E��.y at 4720. Les N1. '3U011101 -9i, P' ciallit ar ian .i ill',/7-.i it �� DEPHRTMEN� HEHLTH HND ENVIRONMENTHL r�OTECTION ur 2516 ETUDOR RICHORHGE/ HK99507 276�..... ..... ... 1 --if- EE �� PERMIT NO ( 76819 ) ]44�]055 HPPLICHNT GHLE LHMSON SRH BOX 4]8A LOCHTIUN E��JE0I|�/E ST LOT SIZE ]1445 SQUHRE FEET LEGHL L2 B5 RHBBIT CREEK VIEW TYPE OF SOIL HBSORBTION SYSTEM IS� TRENCH MHXIMUM NUMBER F B OEDROOMS c ] SOIL RHTING (SQ FT/BR)� 125 THE REQUIRED SIZE OF THE SOIL HBSORPTION SYSTEM IS� �� THE LENGTH DIMENSION I5 THE LENGTH (IN F�ET) OF THE TRENCH OR DRHINFIELD THE DEPTH OF H TRENCH OR PIT IS THE DISTHNCE BETWEEN THE SURFHCE OF TH� GROUND HND THE BOTTOM OF THE EXCHVHTION (IN FEET) THERE IS NO SET WIDTH FOR TRENCHESTH OF GRHyEL BETWEEN THE OUTFHLL PIpE THE GRHVEL DEPTH IS THE MINIMUM DEP HND THE BOTTOM OF THE EXCHVATIOW (IN FEET) �� A�� _�� BY THIS BHCKFILLING OF HNY SYSTEM WITHOUT FINHL INSPECTION HND HPPROVHL DEPHRTMENT WILL �E SUBJECT TO PROSECOT1ON MINIMUM DISTHNCE BETWEEN H WELL HND HNY ON~SITE SEWHGE DISPOSHL SYSTEM IS 100 FEET FOR H PRIVHTE WELL OR 200 FEET FOR H PUBLIC WELL INSURE pROpER SPECIFICHTIONS HND CONSTRUCTION DIHGRHMS ARE. HVHILHBLE T� INSTHLLRTIO� � �� F7 F.... �� I CERTIFYHTHHTHR WITH THE REQUIREMENT5 FOR ON-SITE SEWERS HND WELLS HS SET 1 I M� � n�� F�RTH By THE MUNICIPHLITY OF HNCHORHGE-NCE WITH THE CODES 2� I WILL INSTRLL THE SYSTEM IN HCCORDHSySTEM MHy REQUIRE ENLHRGEMENT IF THE ] I UNDERSTAND THHT THE ON~SITE SEWEP R SIDENCE IS REMODELED TO INCLUDE MORE THHN ] BEDROOMS SIGNED� �~~~ 6PPLICHNT `GHLE LHMSON DHTEY �~~~-�~^�-~~`' lSSUED B^��_.�~ r _- RIF ie W ji � V J I S co FI k� N VW .: 6l W / / w V TJ __ co f A q A r U P v Of ? ' Hi M r e RIF ji � V I S FI k� N Of ? ' Hi M r e Sdq'fa , �.•x e s.y I y vII � Y � 0 " V) C � l) 4 `? �.•x e s.y I y vII � 0 " I 0 V, i u )d MUNICIPALITY OF ANCHORAGE 0,,N <r�tE � Development Services Department r'' Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Parcel I.D. 020-551-37 Certificate of On -Site Systems Approval Expiration Date: *?-3/ 2 Z0 Z Z Legal description RABBIT CREEK VIEW & HEIGHTS BLK 5H LT 2A Site address 8027 Byron Dr Anchorage AK Current property owner(s) Voloshin X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: By. Original Certificate Date: 12/23/2022 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field AdvisoryNitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA Approvmjune 2022 P'�' us pr MUNICIPALITY OF ANCHORAGE I =`i Development Services Department Phone: 907-343-7904 �- ~ -' On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 020-551-37 Complete legal description RABBIT CREEK VIEW & HEIGHTS BLK 5H LT 2A Location (site address) $027 BYRON DR ANCH AK Current property owner(s) VOLOSHIN 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS Day phone 3. TYPE OF WATER SUPPLY: X Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ❑■ Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel ❑ Plastic ❑ Concrete ❑■ Fiberglass Age 2022 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑i AWWTS ❑ Bed ❑ Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: 0 Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ 12-6, w Date of Payment / 9�1Lojaq_ COSA# 05(2215 70 #- 01(a2,(,3 Waiver Fee $ Date of Payment Waiver # COSA Application—June 2022 COSA Checklist Legal Description: RABBIT CREEK VIEW & HEIGHTS BLK 5H LT 2A Parcel ID: 020-551-37 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system _ A. WELL DATA 0 Well log is filed with Onsite (or attached) Date drilled 8/11/21 Total depth 84 ft Cased to 80 ft Q Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 24 in. Date of flow test for COSA NEW Static water level at beginning of test ft. Comments *ARTESIAN WELL B. TANK DATA Measured operating fluid level in septic tank Date of pumping NEW N Required maintenance completed, if AWWTS Comments: *NEW ADVANTEX SYSTEM D. ABSORPTION FIELD DATA Which system tested (date installed) 11/15/22 0 ALL standpipes present per record drawing Total measured depth from grade 3.5 ft (max) Measured depth to pipe invert from grade 3.0 ft (min) ❑ N/A —pressurized field. ❑ Per record drawings, field is insulated. ❑� Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) If yes, enter date Comments/Deficiencies: COSA Checklist June 2022 Well production at time of test 5 gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes No 9 Coliform bacteria is Negative Nitrate 0.831 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L X Arsenic less than MRL (ND) Collected by MNA Date 11/9/22 C. LIFT STATION X Required maintenance completed Age of lift station 2022 years Lift station material FIBERGLASS Comments: NEW SYSTEM Adequacy test date NEW Results Q Pass Fluid depth prior to test _ in Water added _ gal New fluid depth _ in Elapsed time _ min Final fluid depth _ in Absorption rate _ gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) _ in Effective depth used _ in Effective depth remaining _ in E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' *50 Community Sewer Manhole/Cleanout > 100' D Yes if No _ ft Fi Yes if No _ ft Neighboring Tank > 100' Fa Yes if No ft Absorption Field on Lot > 100' 2 Yes if No *50 ft Private Sewer/Septic Line > 25' Q Yes if No _ ft Holding Tank > 100' Yes if No _ ft Neighboring Absorption Fields > 100' Animal Containment > 50' Q Yes if No _ ft Dn Yes if No _ ft Manure/Animal Excreta Storage �> 100' Community Sewer Main > 75' ❑e Yes if No _ ft I �J Yes if No _ ft D N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Fleld(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' DE Yes if No _ ft Surface Water > 100' FE Yes if No _ ft Tank to Property Line > 5' Field to Property Line > 10' Water Main > 10' Water Service Line > 10' Di Yes if No _ ft Do Yes if No _ ft RE Yes ifNo_ft 2 Yes if No _ ft F. ENGINEER'S COMMENTS " ADVANTEX CAT 1 SYSTEM Wells on Adjacent Lots: Private Wells > 100' Community Wells > 200' ❑� Yes if No _ ft 0 Yes if No _ ft If tank or field is under driveway comment below G. CERTIFICATION & 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, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm Engineer's Printed Name COSA Checklist June 2022 Phone 727-8864 Date �0.�g�. GF• !� a��t� •• ?' OW ....... ............ MICHAEL N. ANDERSCN O+ CE 94 ,r