No preview available
HomeMy WebLinkAboutPREUSS #3 BLK 10 LT 2 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP221263 PID Number: 050-571-50 Dwelling: 0 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New Upgrade Name John & Carol Rivera ABSORPTION FIELD ❑ Deep Trench 0 Wide Trench ❑ Bed ❑ Mound Site Address 20035 Lucas Ave. ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 1.0 GPD/SF 4 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 2.98 Ft. Gravel depth beneath pipe 1.02 Ft. Subdivision Block Lot Preuss #3 10 2 Fill added above original grade 0.32-1.11 Ft. Gravel length 80 Ft. Township Range Section Gravel width 5 Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 454 Ft z 1 Ft. Well 93.4'* 52.4'* 25+ TANK ❑ Septic ❑ S.T.E.P. ❑ Holding © Other Manufacturer Greer Capacity 1500 Gal. Surface Water 100+ 100+ Material Number of compartments Lot Line 5+ 10+ NA Plastic 1 Foundation 10+ 10+ LIFT STATION Advantex Manufacturer Capacity Remarks *Advantex system allows for 50'+ Greer 1500 Gal. **Old trench decomisioned Alarm location Downstairs sewing room Electrical installed by Power Lighting & Control Installer PIPE MATERIAL House to tank D3034 Tank to drainfield D3034 Northern Excavation Drainfield D3034 CO/MT D3034 Inspector Arcterra Consulting BENCH MARK (Assumed elevation) 100 ft Inspection 5t dates: 8/17/22 2nd 8/17/22 Location and description p 3b 8/18/22 4'h 8/18/22 Bottom of siddin ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date r�P�.��""""""'., 9 JJ* 49 Id w.tlYrtlY Y.Wtl.Y.tl tl Y.Y J+ YiY f�-9VKENNETHFUS cEj� s Septic System L//'+ Approved Date '2 b ?o 2 2*1j��`,�'� •.�.4�� Note: this approval does not include well permit requirements. �iwv voi vci 1v/ AS—BUILT SYSTEM DETAILS/SITE PLAN Permit 11SP221263 PRUESS #3 BLOCK 10 LOT 2 PID# 050-571-50 WELL A—C=41.6' A—I=63.0' I \ 4' B—C=25.3' B—I=49,5' p A ---D=42.7' A—J=48.5' I L N B—D=26,4' B—J=51.2' w- A•—E=50.6' A—K=50.4' ' �2 B—E=34.7' B—K=52.7'a A—F=51,6' A—L=92.7' F g B—F=36.6' B—L=83,9' A --G=56,5' A—M=94,8' ` m B-15=40,4' B—M=85.8' p A—H=57.4' I B—H=41,4' _tA s 0 C\\ D F G \ H \ 1500 TAN INS C❑I] SCALE: 1' = 20' o 87.8 FINAL GRADE gg,z CIL. MTM rAw: _ SEWER ROCK II 93.17 l 80, OF- AZ� Z ��•. � 4 PREPARED F❑RI JOHN & CAROL RIVERA "�. 20035 LUCAS AVE. N * _ TH * EAGLE RIVER, AK o FIELD BOOKS compo m: KE :. n E_ �4+ . BOUNDARY: N A MAWN: KSD ti 'riT STAIGNG: CHECKED: N A KMD ASBUiu: HOLT DATE rJ SSIM� DWG. FILE GRID: NWOQ ■ �_� ACRD FILE FILE N° ` 22131 SCALE: NTS RcTER T, a o x Z � m n� 9 � c�� �fl art• god, ULT I N G 6 l £� AK. 99577 _61 I \ 4' \ 1 l 40 35 L 1500 TAN INS C❑I] SCALE: 1' = 20' o 87.8 FINAL GRADE gg,z CIL. MTM rAw: _ SEWER ROCK II 93.17 l 80, OF- AZ� Z ��•. � 4 PREPARED F❑RI JOHN & CAROL RIVERA "�. 20035 LUCAS AVE. N * _ TH * EAGLE RIVER, AK o FIELD BOOKS compo m: KE :. n E_ �4+ . BOUNDARY: N A MAWN: KSD ti 'riT STAIGNG: CHECKED: N A KMD ASBUiu: HOLT DATE rJ SSIM� DWG. FILE GRID: NWOQ ■ �_� ACRD FILE FILE N° ` 22131 SCALE: NTS RcTER T, a o x Z � m n� 9 � c�� �fl art• god, ULT I N G 6 l £� AK. 99577 _61 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 Wastewater Disposal System Permit Permit Number: OSP221263 Effective Date: Work Type: Septic Upgrade Expiration Date: Tax Code Number: 05057150000 Site Legal Address: PREUSS #3 BLK 10 LT 2 G:0056 Site Mailing Address: 20035 LUCAS AVE, Eagle River Owner: RIVERA JOHN C Lot Size in Sq Ft Design Engineer: ARC TERRA CONSULTING INC Total Bedrooms: This permit is for the construction of: nt arrme11t 7/25/2022 7/25/2023 22002 Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ 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: • Locate the beginning of the field prior to installation to confirm that the tank -to -field and field -to -field separations will be met. Install a cleanout so the field can be located in the future. Received B Issued By: Y= Date: Date: 3 MUNICIPALITY OF ANCHORAGE Development Services Department c Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 050-571-50 Property owner(s) John & Carol Rivera Mailing address 20035 Lucas Ave. Eagle River, AK Site address 20035 Lucas Ave. Eagle River. AK Day phone Legal description (Sub'd., Block & Lot) Preuss #3 Block 10 Lot 2 Legal description (Township, Range & Section) Lot Size 22002 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (M all that apply) Absorption Field Q Initial ❑ Single Family (SF) Q (w/wo AD U) Septic Tank Q Upgrade Q 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. Dea Duffus (Signature of property owner or authorized agent) Permit/Rush Fees: 5 % 5 Waiver Fees: Date of Payment: 113 I )_0 Date of Payment: Receipt Number: 0` _10'5G Receipt Number: Permit No. 0 S JPa22 12 6 3 Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221263, Deb Wockenfuss, 07/25/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221263, Deb Wockenfuss, 07/25/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221263, Deb Wockenfuss, 07/25/22 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 thisa'`� Day of 1 ( of 20 2�, by and between Oa n2ln� �' +lp o ; herein the "OWNER," and the Municipality of Anchorage, herein the "M[UNICIPALITY", 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 Advantex located at (legal description) Luc.cLS Preuss #3 BIk 10 Lot 2 - 20035 Lucas St, Eagle River 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) (�!4, 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. MJF— 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. 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 r"Lys✓ VWllcl dVaUIUW1CUg'GJ L11aL Luc inulltl; paaLy may 1cquvoL ica,viuo vi a,L%j repairs from the manufacturer's representative or maintenance provider. PlYa,- Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. NO& Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. 04- Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. 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. 41 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 OW N ER: By: (signature) M ✓Pry (print name) STATE OF ALASKA THIRD JUDICIAL DISTRICT The foregoin ins me t was at 20 j by j Date: 07�a�JLa a— ss. -d before me thiday of NOTARY?TIBLIC FOR ALASKA My Commission expires:0 r , 202(, MUNICIPALITY: By: (signature) (print name) State ofAlaskn NOTARY PUBLIC Vincent WoifM= My Commission Expires Jan 1, 2026 Date: ;7 2S z Z Title: (rev. 05/18/2018) Page 3 of 3 MAI LING ADDRESS~ ~'t *" "~ ~'~ ~'kl/~, ~ Li~ IF HOME~DE Inside length Width h-~ MUNICIPALITY OF ANCHORAGE '~..~ ~' DEPARTMENT OF HEALTH & ENVIRONMENTAL PROI'ECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT I~ UPGRADE We'? z , ¢ DISTANCE TO: No. of lines J / NO. OF BEDROOM~ Width Crib diameter~/4~ Building foundation DISTANCE TO: No. of cdmpartments Z Liquid depth Dwelling PERMIT NO. i Material Fou ndation~[~_ .~ ~___ Neares~ lot I~e v' Total ~;-; ~ n e.~_ Tren~w~th inches IZ~, .~ ~..~~;~te~ial¢ bene*~h¢., .~¢. ~,,tiLe ~ ~¢~¢'~ Cr~inches Depth Crib depth Total effective absorption area Building foundation Nearest lot line Driller Distance to lot line PERMIT NO. Sewer line Septic tank Absorption area(s) Liquid capacity in gallons T°ta' e ,~t'~asor~ or, area PERMit- [~O. OTHER PIPE MATERIALS SOILTEST RATI.G INSTALLERS) REMARKS iS & S Engineerin-~~, PERf'fI T NO. [,EPFtF.:hI"MENT ~ HERLT'H RNr) EN'v' I F.'r'i~.a':IENTR ., ']TE"':T T 825 '" L." STREE"f'., FtNCFfORRGE., RK, 995Ek:L 264-4720 C~ P"4 .... '_=_'; .'..E -i"- El ,".Z; EE ~.-..~ E [4: F' EF£ [~: ~--I Z 'T ,:; 8:LE~E;E:d. ) RPF'L I CRNT LOBRT I ON LEGFIL CHR I S t.41LSON ER LRNE L2 Bi0 PRUESF'; PO BOX 4-f29 RNCH 995¢39 LOT E;IZE :Z:49-5865 23~4Z:.'.6 SQUFtRE FEET T'VPE OF SOIL FtBSORPTION S'-/STEM IS: TRENCH MRXIML.IM NUMBER OF BEDROOMS = :2-': SOIL RR'T ING THE REQUIRE[:, SIZE OF' THE SOIL RBSORPTION E;'¢STEM IS: THE LENG'FH DIMENSION IS THE LENGTH (IN FEET) OF TH.E TRENCH OR DRBINFIELD. 'THE DEPTN OF' FI TRENCH OR PIT IS THE DISTRNCE BETWEEN TH.E SURFRCE OF THE GROI..IND FIND THE BCITTOM OF TFfE EXCRVRTION (IN FEET), THERE IS NO SET NID'FH FOR TRENCHES. THE GRR',,,'EL. DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETHEEN THE OUTFRLL PIPE RND THE BOI"TOM OF THE E::.::CRVRTION (IN FEET:..'. PERMi'F RPF'L. ICRN"r I-IRS :'FIE RESPONSIBILI]"¢ TO INFORM THIS DEPRRTMENT DURING :'PIE !NSTRLLRTION INSPEC:TIONS OF RN"r' HELLS RDJRCENT TO THIS PROPERT'¢ RND ]'HE NUMBER OF RESIDENCES TFff:IT THE ~,].ELL. 1.4II..L SERVE. BRC:KFILL. ING OF RN"r' S'¢STEM WITHOUT FINRI_ INE:;PECTtON RND RF'F'ROVRL B"r' THiS DEPRRTMENT HILL. BE SUBJECT TO PROSECUTION. MINIMUM DISTRNCE BETWEEN R WELL RN[." RN'¢ ON-SITE SEHRGE [.',iSPOSRL S'.?STEM. IS 't_E~E~ FEET FOR R PRI'¢RTE NELL OF.: '1_5.E~ TO 2E~E~ F"EET FROM R PUBLIC [4ELL DEPENDING LIPON THE TYPE OF PUBLIC NELL. MINIMUM [)IS]"FINCE FROM ~ PRI',/RTE WELL TO R PRI',/RTE SEHER LINE IS 25 FEET RND TO R COMMUNIT'¢ SE:HER LINE IS 75 FEE]'. OTHER REQUIREMFNTS MR'¢ RPPLY. SPECIFIE:RTIONS RND CONSTRUCTION DIRGRRI"IS RF.'.E R',/RILRBLE TO INSURE PROPER INSTRLLRTION. I C:ER]"IF"r' THRT 1: I R.M FRMILIRR HITH 'rile RE:QUIRE:MENTS FOR ON-SITE SEHERS RND HELLS RS SET FORTH B'¢ THE MUNICIPFtLIT"r' OF RNCHORRGE. 2: I .[4ILL INSTRL, L THE S'¢STEM IN RCCORDRNCE HITH THE CODES. 3:- I UN[:'ERSTF~ FA:IT THE.-~']/'~-E;ITE SEHER S'¢STEM MR"¢ REQUIRE ENLRRGEHENT IF T'HE MORE :'. " - ................ .... .. _ ........... _ v,,,...,'_.', PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS 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 SLOPE Reading Date Gross Net Depth to Net Time Time Water Drop %! /1¢ PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND -- FT PERFORMED BY: 72-008 (6/79) F'E~:["I :[ T RF'F'L ;[ CFiN T L 3E':RT Z LEG!~,L ..:r, C:!4[;;:'~,~ 14!LSCff.,! L2 Ed..E~ F'F,.':UES:~; t..2 E :.t E~ F'F:L H:[N:i.'!"!UH DJ:.S'TF!NCE BEFI"P,~EEN R .[,.!ELL RI'.,ID Fit'.,!? OI'-,t*-S]:TE SE!,.II::IGE [:' :[ SF'OSRL S"r'S"FEH 'I_E~E~ FEET FOR F! PR:[',,,'F!TE ~,.!EI...L OR ::!..SE~ 7'0 2Ei,9 FEET FROH iR F'UBL.]:C: [,ff.T.':LL UPON THE T'¢PE OF PLtE;!_!C I.,.!ELL. HZNI'HtJH DZ:.::;TRNCiE F'ROH R I:'F.:I',,,'RTE F!ELL "!"0 R PF.::[',/'FI.,TE SEHEF: I...Ii-:~E ~S ;2'5 FEET FiND TD F:I E:O!fiHUt'-,!:r.T'¢ SEt.,.!ER LZNE ]:S 75 FEET. !.,.!ELL LOGS RRP'_" F..:E6:!U.T.i;.:ED I::II'.~D r,'tlJST BE F.:ET!...IF?.NED TO THE OF ]'FIE !,.!ELL. C'o.r'1F'L.E:TZC. d'.,!. OTHER F:E6!L!:[REHENT:E; l"lR'-r' RF:'PL?. SF'EC;.T_F'.T. CRT:[('.'~NS RI'.,!D C:ONSTF..'UC:"t"!ON R",,'RILFIE~[..E T'O :I:N'::';UF.::E I::'ROPEI:~: Z.h,!STF!LLR'r'ZON. i C:EF:T]:F',¢ TH, FIT Z: I Ch'. F:FIi"t:!:LIF!R 14ITFi THE RE:(;!U:[F..'E'."I.IEi'-.TS FOR O['.,I-.'3iTE' ':F'.I4EF?'[.i F'IF,!D I,!E ..... S_-: ,¢::IS "L:;ET F.-~F."TH E?.?' 'THE 2' 'r F!ZLL. I!'..L':.:;TFIM_ TH ........ , ..... '~'~'" ,.. THE ~. M....L. UN[. p,l'.4,~.,:, hi '[ TH CE[[:,E"S. S ~. G N E [:, ' ! S'3;L.iE [':, F!F'F'L I CFIH" . I.,.! ): L'.5Oi",l �R�7 cn 71 sr 0 u c) u > C/) M > m 7! > t— C) > Ott > > co o 0 0 o m 'Y7 �oCfl > co �D ITI Irl 1-1 "1 Irl Irl Irl 0 0 Irl ITI sr 0 u c) u > C/) M > m 7! > t— C) > Ott > > co Ul o m 'Y7 �oCfl > co �D x 0 u c) u > C/) M H m 7! > t— C) > Ott > > co Ul o m 'Y7 �oCfl > co 6- > O 0 n -n F , O * m 0 X C/) M 7! > Z C) , r- > Ott > > co Ul Parcel I.D. # MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alask~ 99519-6650 343-4744 ~ - CERTIFICATE OF HEALTH AuTHoRITY APPROVAL FOR ASINGLE FAMILY DWELLING HAA # GENERAL INFORMATION Complete legal description Preuss #3, 5ot 2 Block 10 T14N R1W Sec.8 Location (site address or directions) ?nn3~ Property owner Mailing address Lending agency Mailing address. Agent Address Jin~ny & Carol Cotton Day phone 694-0494 20035 Lucas Ave., .Eagle River, AK 99577 City Mortgage Day phone 563-0700 P.O; Box 92810, Anchorage; AK 99509-2810 -' Un/ess otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3, TYPE OF WATER SUPPLY: Individual well Carol Bennett/Fortune Day phone 562-7653 3000 A Street, Suite 101, Anchorage, AK 99503 Community well Public water NOTE: If community well s, ystem, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding ~ank 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 s~,uewwoo IBuo!~!PPV ~~.~__~__ e~n],Bu6!s sjeeu!6u~ LLS66 AA/ 'Za^TA a't-Sg.q 'f6EELL ::08 °O'c~ sseJppv ,:j61. cj-~769 euOLlcl saDT.,%zaS 5uT..zaaUT. SUA .ZaATA aT. Se:~ gu J!.4 JO eUJBN · uoRaedsu! s!q~ $o e],Bp eql uo ],oejje u! suo!lBInSeJ pub 'seouBu!pJo 'sepoa e),B]cj pUB IBd!a!unlAI lib LI~!M eOUB!IdLUo3 U! S! Lue~sXS IBsOdS!p Je~BMelSBM do/puB ,~lddns Je]eM e~!s-uo ell], 'uo!],oedeu! pub uop, BSp, se^u!/,uJ LUO~ pus seIN eSBJOLIOUV JO ,q!lBd!o!unl/N eLl~ LUOJJ peu!e~qo UORBLU]OJU! eLI], UO pesBq ],BLI], ~Jpe^ JeLlpnj I 'u!ejeLI pe],Be!pu! aJn],onJ],s jo edX~ pub suuooJpeq jo JeqLunu ell], Joj e],BnbepB pus IBUO!]ounj 'ejes s! Lua],SXS IBsods!p Je~BMe],SBM Jo/puB ~lddns Je~eM e],!s-uo ell], ~Btq SMOqS uORBO!IddB IB^oJddv ,~],pOLI],n¥ LI~IBeH S!LI~ ~O uop, BSRse^u! /~LU ].gq]./~j!Je^ I 'MOleq UMOLIS elep UOp, Bp!IB^ eq~ Jo sB pub meJeq pexNjB IBeS/~LU ~q PeB!]a@o sv I::I:I:INfiDN~ A8 NOI.LO=IdSNI .-IO .I.N::I~=IJ.Y.LS (~ MUnicipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ~-~_. /,~,~-//¢, ,,~,,~.r-j- "~--~ Parcel I.D. A. WELL DATA Well type Log present (Y/N) Total depth Sanitary seal (Y/N) Date of test Static water level Well flow Pump level If A, B, or C, attach ADEC letter. /V Date completed Cased to ~'/ Y FROM WELL LOG sEpARATION DISTANCES FROM WELL TO: Septic/holding tank on lot ~'~' '~'~'~'"~'* °~' ~'- '¢~'~'"~ Absorption field on lot Public sewer main F-ub;;~ sewer service line ADEC water system number ~'/~-.~/ Driller ~/"'~'/'~"'"'" Casing height '~" -'¢'~"~? Wires properly protected (Y/N) AT INSPECTION ,,, O g.p.m. z ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout '~'?'~ Petroleum tank WATER SAMPLE RESULTS: Coliform ! Date of sample: ,7../~ ¢/~., Nitrate - ~ '.-~ Other bacteria Collected by: x~_~''~'~ B. SEPTIC/HOLDING TANK DATA Date installed '/~°~'/ Tank size /'~,~ _¢,~-,~-- Compartments .~' Depression (Y/N) Cleanouts (Y/N) ,),/ Foundation cleanout (Y/N) High water alarm (Y/N) /v/.~ Alarm tested (Y/N) Date of pumping .'~,/~',/ ,~'",,~' ~r SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well (s) on lot ~'~' / On adjacent lots ~"?~'~ / To property line '~'~¢' / Surface water/drainage "~',//"¢ Foundation 'z"~'~ / Water main/service line Z'-/'~ / Absorption field CONTINUED ON BACK PAGE 72~26 (Rev. 3/91) Front MOA 21 Date installed Size in gallons Vent (Y/N) "Pump on" level at High water alarm level Meets MOA electrical codes (Y/N) Manufacturer Manhole/Access (Y/N) "Pump off" level at Cycles tested SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots D. ABSORPTION FIELD DATA Surface water Date installed ,//,~,~'/ Length 4,"~' ~ _Width Total absorption area Depression over field (Y/N) Result~fail) Peroxide treatment (past 12 months) SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Wellon lot /~,., / To building foundation On adjacent lots 3¢ / Surface water Curtain drain .~-'~"-~-- Soil rating /~¢'-~ System type. Gravel thickness ~'"~/ .Total depth Cleanouts present (Y/N) Date of adequacy test for If yes, give date __ Cutbank .,V'/4- Water main/service line Driveway, parking/vehicle storage area On adjacentlots ~"/"¢ / Propertyline To existing or abandoned system on lot bedrooms E. ENGINEER'S CERTIFICATION Signature ~ Engineer's Name Date ~//~/'i~ I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect _o,n,the.d&¢? of this inspection, HAA Fee $ Waiver Fee: $ Date of Payment Receipt Number Date of Payment -~/' - ¢/ Receipt Number ~ ¢ ~/'.;~ ('- ?~'/¢~ ) 72-026 (Rev. 3/91) Back MOA 21 NORTHERN TESTING LABORATORIES, INC. (907) 456-3110 · FAX 456-3125 3330 INOU$~RIAL AVENUE FAIRBANKS, ALASKA 69701 (907) 277-8378 · FAX 274-9648 2505 FAIRBANKS STREEt' ANCHORAGe[, ALASKA 99503 Eagte River Engtr~ering A112~57 Breus~ fi3 2/10 ~ 418 C Httrete-H Eegte River Engineerl~ Al12613 Lot g 115~ RI~ ~ ~18 C Nltrate-fl See 18 pRELIHINARY RESULTS REPORT AuguSt Units Lab~ ~ust~we l0 #ethod Parameter ~g/t 1.~ e~It o.1 u A Eagle River Engineering Services 11940 Business Blvd, Suite ~205 P.O, Box 775294 Eagle River, Ak. 99577 694-5195 Fax 694---5297 Legal: Lo'l' Type of test: U Well Flow Test [] Septic Test Only ~(Well & Septic Test [] Other: Meter Vlonitor Well Tank GPM PSI Remarks Level Time Reading (L.Lu~vel Level '¢:1'/:44I~.¢p¢__.)4Z" -70 -- ~, ~r _ ~ r-,~ ~ ,~ I~ ~,~ "~ z~ 7~ -- ~-~ -- MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 26~-4744 Application Date March 11~ 1988 GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, tow.nsh_ip, range) Lot 2; Block 10; Preuss Subdivision Location (address or directions) Luc~ Street (b) Property Owner *'~: /""' '***uu-'~r/~.u'I~- Telephone: Home Business Mailing Address (c) I'ending Institution Telephone Mailing Address (d) Real Estate Company and Agent JACK WHITE COMPANY/Lynda Banner Address 10928 Eagle River Road, Eagle River, Alaska 99577 Telephone 694-5500 (e) Mail the HAA to the followina address: or: Check here ~, if hold for pick up. List contact person and day phone number below. S & S ENGINEERING/694-2979 17034 Eagl~ River EagZ~ R~v~r, A~a~a 99577 TYPE OF RESIDENCE Single-Family ~ Number of Bedrooms o,~dered by Lynda Banner WATER SUPPLY Individual Well,~ Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite [] Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 IRev 8/861 Fronl ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verity 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 $ & _~ ~=NGINEERING Telephone 17034 Eagle River Loep Road No. 204 Address Eagle Ktver, ~.iaska Date DHHS APPROVAL Approved for ~,~'(~-~-") bedrooms by Approved .~ Disapproved Terms of Conditional Approval Conditional Date CAUTION 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. 72-025 fRev 8/86) Back Page 2 of 2 . WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) - ANC' hAUfllGI?ALYf¥ Of _~UTHORITY APPROVAL (HAA) ,,.~Ot.IMENTAL SE~ CRECKLIST - FEBRUARY 1984 ~'~ 264-4744 1 8 19BB Legal Description: Well Classification Well Log Present Total Depth '~;;'/ { Static Water Lev61 Casing Height Above Ground Electrical Wiring in Conduit Separation Distances from Well:. To Septic/H~tdjDg Tank on Lot '~2~\x,/~ If A, B, C, D.E.C. Approved (Y/N) y Date Completed ~ ~1 ~ -- ~(~;>\ Yield Cased to G1 ! Depth of Grouting "¢:~\-~ Pump Set At \'z~ Sanitary Seal on Casing Depression Around Wellhead (Y~ To Nearest Edge ofAbs, orption Field~/°n Lot To Nearest Public Sewer Line ~,:~/,~ Cleanout/Manhole ; On Adjoining Lots \ C;>~J ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot Water Sample Collected by ~'~ ~.~ ~e::~f'~l~'")'¢;~L-~2~i f4~ ; Date ~ -- \"~ -- ~--~ Water Sa%~ Test Results ~ ~'-~--'~-~ ~ ~ ,~~ ~ ~ Comments ~ ~ ~ ¢~ ~,~ ~ *¢~ ~~ B. SEPTIC/HOLDING TANK DATA Date Installed "~ ~"2~2~ ~P\ Size ~, ~ No. of Compartments Standpipes~N) '~f Air-tight Caps (~h'4) ~" Foundation Cleanoutd~) Depression over Tank (Y/~ ~ Date Last Pumped Pumping/Maintenance Contract on File (Y/N),ff5/ 'for Holding Tank High-Water Alarm (Y/N) h~ Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/I-Ce~4¢,,9 ,Tank: To Water-Supply Well To Property Line To Water Main/Service Line Course \ To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Page 1 of 2 72~026 fR~v 8/861 Fronl C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed '~ ~ ~ ~ Width of Field "~-c:~ Square Feet of Absorption Area Depression over Field ~ Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot ~¢'~--FCZ--~ Type of System Design Length of Field Depth of Field Gravel Bed Thickness ~;~ -cf=, Standpipes Present Date of Last Adequacy Test To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Property Line \ ~ [Jr'- To Existin~ or Abandoned System on ; On Adjoining Lots TO Cutbanlk (if present) r~-~//~ To Driveway, Parking Area, or Vehicle Storage Area Comments Da~alled Size in Gallons~'~ "Pump On" Level at ~ High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) ~uring Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Sign§d& $ F. NG;NF,.F.~,|~;C Date -~ Compileit/4 Eagle River Loop R~d No, 2~OA No. Eagle RNer, A~s~ ~ Receipt No. ~ ~ _ Date of Payment Amount: $ Page 2 of 2 72-026 (Rev 8/86~ Back Client Sample ID:L2, PlO PRUESS PWSID :UA Collected ~h%R 13 88 @ hrs. Received MAR 14 88 8 14:00 hrs. P~esexved with :NONE CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. FEDERAL TAX ID # 92-0040440 ANALYSIS REPORT BY SAMPLE £oz Wo~k Ozde~ # 5602 Date Repo~t Printed: ~AR 16 88 @ 12:05 Client Name : S Q S ENGINEERING Client Acer : SNSENGP P.O.# NONE RZC'D Raq # Ordezed By : R. SHAPER Analysis Completed :}~R 14 88 Send Reports to: Laboratozy Supervieor :STEPHEN C. EDE 1)S & S ENGINEERING Released By : ~ ~. ~ 2) Special Instxuct: Chemlab Ref #: 9362 Lab Smpl ID: 1 Matrix: Watez Allowable Paramete~ Tested Result/Unit8 Method Limit~ .............................................................. ..................................... EPA 353.2 10 NITRATE-N 0.59 Sample ROUTINE SAMPLE Remarks: SAMPLE COLLECTED BY R.P. I Test~ Pezformed ' See Special Instructions Above UA:Unavailable ND: None Detected "See Sample Remarks Above NA- Not Analyzed LT-Less Than, GT=Gzeatez Than MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-472O Application Date GENERAL INFORMATION (a) Legai.O~n (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicant Name ~(' ¢¥{~)¢¢x'[1¢.._ '"*:'~1' ~?ZC-G~(~)~'~ Te ephqne.:., 13pme Business Owner/builder ' Buyer [] Other [] (explain); (c) Applicant is (check one): Lending Institution [], , , ,~ ; & ~a~,) ....... .... ,'" .... Telephone (d) Lending Institution ,,.,~---v (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family"'~ Multi-Family [] Number of Bedrooms ~ Other WATER SUPPLY Individual Well'[2C----Community [] Public [] Note: If corn munity well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsile'~ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (11/84) Page 1 of 2 '5. ENGINEERING FIRM PROVIDIN~''~INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/o[ 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 J~~ ~ ~oc.-t~¢~'¢_-.~ Telephone "~ Date ~ - Engineer's Seal DHEP APPROVAL Approved for' ..../z./., ,..,~.~.,~_ Approved bedrooms by ~ /~' '~'~/~Date Disapproved - Conditional Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (11/84) MUNICIPALITY OF ANCHORAGE (MOA} HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 264-4720 Legal Description: WELL DATA Well Classification ~C-~ Well Log Present (Y/N) '"/ Total Depth _ ~ I Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Man hole Water Sample Collected by If A, B, C, D.E.C. Approved (Y/N) -- Date Completed '~ -Iq - E~ ~ Yield ~ I Depth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots Id'~ ; On Adjoining Lots td'b+ To Nearest Public Sewer To Nearest Sewer Service Line on Lot -- ; Date z~'- {~ Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA Date Installed ~7- ~-St Size Standpipes (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from ~ept~c/Holding Tank: To Water-Supply Well To Property Line To Water Main/Service LJne l ¢r'E~ No. of Compartments "I Air-tight Caps (Y/N) "/ Foundation Cleanout (Y/N) Date Last Pumped Z~- -- ; for "- Temporary Holding Tank Permit (Y/N) To Building Foundation G' ~- To Disposal Field IQ+- To Stream, Pond, Lake, or Major Drainage Course Comments Page I of 2 72-026(1U84) ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~ - -3 - P~ I Width of Field ~:~0 '~ Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well l ~ To Building Foundation ~,.~ Lot ~ t~ ,~,¢'/l~,a¢~/k Type of System Design Length of Field Depth of Field Gravel Bed Thickness ,~ -Pr--+ Standpipes Present (Y/N) ~" Date of Last Adequacy Test ~'- [4 -~G To Water Main/Service Line -- To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments To Property Line To Existing or Abandoned System on ; On Adjoining Lots " To Cutbank (if present) D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have chCL~ed,L¢ ,verified' or conformed to all MOA and HAA guidelines in effect on the (late of this inspection. Signed dl/'P.~ ~ Date Company ~ ,'~ ~s~¢--'¢"~-'~~ MOANo Receipt No. '~7 ~-' ') 0 Date of Payment ~']~ J ~ ~ ~:~ ~ Amount: $ (¢ ~ ~-\-~'' Engineer's Seal Page 2 of 2 72-026 (11/84} E~...?EPT. Of: HEALTH & ~vtRO~MENTAL i~ROTECTJON RECEIVED Prl~ess ~.~bdivisioi~ At your verbal request, I've prepared aJ~ appiicatior~ ~r ~ horizot~tai separation waiver ~etween the privale well e~d septic system s.b,ject property. My request is based on ~ site visit to perform all ~deq~acy test, ma~er quality resuHs, and review of the lot survey, and vJeli log. I might add ~hat it seems in~ppr~¢~ require tile oluner ~o a~piy for e waiver on 8 Io~ approved July 5, 19~I (permit ~810654). It is a flagr~n~ ac~ on the pad of the After r~vie~ing tim materials mentio~ied above, it is my opinion tb~t Mr. Gary Rdai~- 5170 Luca.~ Eagle River, Alaska 99577 Ref: Lot 2, Block 10 Preuss Subdivision Pear Mr. Adair MUNICfPALIT¥ OF ANCHORAQT. DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION 1986 RECEIVED At yollr request, I performed an Adequacy Test on the existing septic system for the three bedroom residence at the above referenced location. According to the Greater Anchorage Area Borough's Inspection report for installation of On-Site Sewage Disposal Systems at this location (July 3, 1981), your system consists of a 1000 gallon steet tank and 46 lineal feet of trench. Upon arriving at the property on April 14, 1986; i observed the septic system and recorded the static water level of the tank. The septic system was in normal use before and during the test. The sump at the south end of the trench was monitored for the test. No water was present at any time during the test. This indicates that all the water was absorbed prior to reaching this end of the trench. Water was introduced to the system at 6 gallons per minute. I futher certify that the well sustained a yield of 6 gpm for a period of time in excess of two and one-half hours without showing any signs of stress. On the date tested, this septic system met the sewer and water requirements for a three bedroom residence. Sincerely, Tony !~. Barter, P.E. This report is an application for horizontal sep~ratioil ~aiver af 96.-'fee~ b~)eea ~l~e i000 gallan, ~wo compartment, s~eel septic ~aak aad the private well of the sub,iect propsrt~. Norma~ con~ructiaa Northern Test ~ab ~eport ? Ton!.~ ~. Oarter un c panty Anchorage 496650 ANCHORAGE, ALASKA 99519-6650 (907) 264-4111 TONY KNOWLES, MA YOR DEPARTMENT OF HEALTH & HUMAN SERVICES April 24, 1986 Tony Barter, P.E. Barter and Associates 10461 Hampton Drive Anchorage, Alaska 99516 Subject: Lot 2 Block 10 Preuss Subdivision Waiver Request, WR86-049 Dear Mr. Barter: Your request for a waiver of the minimum horizontal separation distance requirement between the well and the septic tank on the subject lot has been granted. The 100 foo~ separation requirement has been waived to 96 feet. This waiver is valid for the existing three bedroom single family dwelling only. Sincerely, Stephen S. Morris Civil Engineer On-site Services SSM/ljw I...=~, i [~,~E RECEIVED INSPECTION APPOINTMENTS Tt,~Vi E TIME TIME DATE DATE DATE MUN C PAL TY OF ANCHORAGE DEPT. DEPARTMENT OF HEALTH & ENVIRONMENTAL P~OTECT ON  825 L Street- Anchorage, Alaska 99501 ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROP E RT~_~..0WN E ~.) / . PHONE MAI LI N..G.~DDR ESS PROPERTY RESIDENT (if different from above)~t./:~' 2. BUYER -'P PHONE MAILING ADDRESS 3, LENDING INSTITUTION PHONE MAILING ADDRESS I PHONE 4. REALIOR/AGENI MAILING ADDRESS LEGAL DESCmPT,O Z' A STREETLOCATION X~,c ~ S 6. TYPE OF RESIDENCE NUMBER OF~BEDROOMS ; [] One [] Four INGLE FAMILY [] Two [] Five [] MULTIPLE FAMILY ('~;]~ Three Six 7. WATER S~JPPLY INDIVIDUAL* '[~] GOMMUNITY [] PUBLIC UTI LITY [] Other * ATTACH WELL LOG. Awell log is required for all wells drilled since June 1975. For wells drilled~rior to that date, give well depth (attach log if available.) j,~£,l~q,~t~ ~)-I ~j)}~_j.~ 8. SEWAGE DISPOSAL SYSTEM ~ iNDiViDUAL/ON.SiTE** YEAR ON-SITE SYSTEM WAS INSTALLED, [] PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF BEDROOMS [] ONE E~ THREE E~] FIVE [] OTHER [] TWO [] FOUR [] SIX PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 2. WATER SUPPLY [] INDIVIDUAL [] COMMUNITY [] PUBLIC UTILITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM []INDIVIDUAL/ON -SITE EZ]PUBLIC UTILITY Connection Verified []Septic Tank or [~] Holding Tank Size: If Tank is homemade give dimensions: PERMIT NUMBER DATEINSTALLED INSTALLER SOILS RATING TYPEOFTANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS [~P~" APPROVED FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) E] DISAPPROVED DATE BY 72-010 (Rev. 6/79) LUCAS A VENUE oOF A � _o 49 0 0�oi°NSHANE A. HOLT � 000 Q� LS -6914 �ofessiona\ V11 ��DOOoo�� THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES. EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT , ARE NOT SHOWN HEREON ( UNLESS INDICATED) NOTE: FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. THE SURVEY DATA AND MEASUREMENTS HEREON ARE PREPARED FOR THE OWNER OF RECORD AS OF THE DATE OF THIS SURVEY. ANY USE OF THIS DRAWING BY THIRD PARTIES IS PROHIBITED UNLESS WRITTEN PERMISSION IS PROVIDED. AS-BU/L T SURVEY 1" =20' NO CORNERS SET THIS DATE I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY L 0T 2 3LOCK 10 PREUSS N0. 3 SUB. ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE VIS/BL E IMPRO VEMENTS S1 TUA TED THEREON ARE WI THIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. DATED A T ANCHORAGE,ALASKA THIS 24TH DA Y OF AUGUST ,2022 15489 F3224-4 226-70 HOL T LAND SURVEYING 9309 GRO VER DRIVE ANCHORAGE,AK 99507 223 8615 3750GCI NET