HomeMy WebLinkAboutDORA #2 LT 220
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LOT SIZE
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20E~Z~O SQURRE FEET
MINIMUM [.',IS]"RNCE BETHEEN R H. ELL BND RN"r' ON-SITE SEHRGE DISPOSRL SYSTEM IS
::I..E.'~C~ FEET FOR R PR I',/RTE 1.4ELL OR :¢.5C~ TO 2~":~:3 FEET FROM FI PUBLIC I.,.IELL [)EPENDING
UPON THE T"r'F'E OF PUBLIC HELL..
MINIMUM DISTRNC:E FROM R PRt',,,'R]'E HELL TO R PR I ',,,'RTE SEI.4ER LINE IL=.; 25 FEET RND
TO R COMMLINIT'¢ E.';Eb. IER LINE IS 75 FEET.
t.,.tELL L. OGS FIRE RE6~UIRED RND MUST BE RETURNED 't"0 THE DEPRRTMENT HI'T'HIN
OF THE 1.4EI_L C:OMPLETION
(]]"HER RE(;!UIREMENTS MFI'¢ RPF'L'¢. SPECIFICR'TIONS RN[:, CONSTRUCTION [:,IFIGRFIMS RRE
R'¢RILRP.,LE 'TO INSURE PROPER INSTRLLRTION.
F:>EF.:f-1 I T EE :-"-=." P I F-.".Ef5 [:,EC:Er"IE:EE.' ]::t..,,
I CERTIF"r' 'THRT
i: I RM FFIMILIRR NITH THE REQUIREMENTS FOR ON-SITE SEHERS RND HELLS RS SET
-' ' ' ~ -I ' "' I .....
F'OF;..'TH B"r' "['HE MUNIL. IFRLIT~' LF RN.,HUR~-~.
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FIPPL. I(~T T. S]"ENRRT C:ONz;T.
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MUNICIPALITY OF ANCHORAGE
ci ,
Development Services Department 1 Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval c�
Parcel I.D. 014-251-39 Expiration Date: U 2 3
Legal description DORA #2 LT 22
Site address 8501 ROSALIND ST
Current property owner(s) RICHARD 2016 FAMILY TRUST
dk s 8r� z° z3
X The On-site system(s) is/are approved for bedrooms
Conditional approval for
Comments or advisories:
By:
bedrooms, with the following stipulations:
Original Certificate Date: 5/1/2023
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 Advisory Nitrate Advisory
Tank Age Advisory Arsenic Advisory X
Other
COSA Approval—June 2022
MUHMPAUTY (OF ANCHORAGE
Development Services Department `"
P P 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. 014-251-39
Complete legal description Dora #2 Lot 22
Location (site address) 8501 Rosalind Street, Anchorage, AK 99507
Current property owner(s) Kevin Richard Family Trust Day phone (907) 441-7325
2. ON-SITE SYSTEMS SIZED FOR? B DROOMSCA S/ S/ 20-3
3. TYPE OF WATER SUPPLY: 9 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 ❑i Community Septic or Public Sewer
5. SEPTIC TANK: Br�ie=iE Prsuc E Ronatae E tr�biaiglass
Age N/A - See advisory if steel older than 20 years
i. ABSORPTION FIELD: El Deep T-I-ench E] Wide Trench P Seepage Pit -
Waiver request for:
Expedited review requested: ❑
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 $ 2BO
Date of Payment
COSA # OSS' 22 1 I 1
Waiver Fee $
Date of Payment
Waiver #
COSA Application—June 2022
Arsenic Advisory
Certificate of On -Site Systems Approval # OSC231116
Subdivision: Dora #2, Block: , Lot: 22
A water sample revealed an arsenic concentration of 28.3 micrograms per liter
(ug/L). The Environmental Protection Agency (EPA) has established a maximum
contaminant level (MCL) of 10.0 ug/L for public drinking water systems. While
private wells are not subject to this regulation, EPA standards are based on existing
health information and can therefore be used to gauge the relative quality of water
from private wells. Information on arsenic is available from the On -Site Water and
Wastewater Program website (www.muni.org/onsite) or at 343-7904.
This advisory must be attached to all copies of the subject Certificate of On -Site
Systems Approval.
Marling Address P O Box 196650 * gnchorage, Alaska 99519 6650 *www mum org
Dora #2 Lot 22 014-251-39
5.1+
4/30/81 106
106
18+ 28.3
4/5/23 Forge Engineering
35.2 4/5/23
>
Property is served by AWWU sewer.
Benjamin Schiller, P.E.4/11/23
N/A
N/A
N/A N/A
N/A
(907) 522-7773
)r 46
PROPEIO.�Y:
GRID No., 2-3
MUNICIPALITY OF ANCHORAGE —SEWER UTILITY
Name Addresses
Plat No. Subd-
Residential
Commerial ED Industrial ❑
YoSA�A.vtJ ST AcctNo �� - 00/9-
M�ft%
MNW Lot Block
No. of units f
CON NECT: �
Main Tap On Property ❑ Permit No. 3 ;2---- Size Type
Drawing No. Size Main Type Depth at Connect
Insulation O Cleanouts t 11 Tyj)e r24
Connect Agent
Comments suis
C 4- Az 29
Connect Location
I ASSESSMENTS:
Inspector L'.4�e
.e
� 4-s l�clve T _ 1 /V
Lv I.D.
No.
Private Dev. No.
subd. Agreement ❑ No.
Sewer
Agreement
El No.
P.T.E. ❑ Roll No.
DYE TEST
Positive ❑ Negative ❑ N.S.A. El Date
Page No. I M.H. No. Billing Cycle
Tested B y
Comments
T.
4E- Date
0
-- ;2 ? -.-- a
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. ~' ..... ' .... DATE RECE VED
. -; ';~ * INSPECTION APPOINTMENTS
-TIME ~ r r ' TIME ' TIME
DATE DATE DATE ' "
INSPECTOR INSPECTOR I NSPEOTOfl ... '
~u~IL. IPALITY OF. ANCHORAGE
~ Telephone 264 4720 '
' ' RECEI.¥ED
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
.BI RECTIONS: Complete all parts
1. PROPERTY OWNER
-MAI LING ADDR ESS _ -- ......
~Y~?,~ a~, /I, ~,~ C,//
PROPERTY RESIDENT (If different from above) PHONE
2, BUYER 7 ' . PHONE
MAILING A'DDRESS
3. LENDING INSTITUTIO~I . . ~ ·, ' ' ' ' ' I PHON.E~.
4: R~;AL'rOR/AGENT .,~ ' ' ' ' I PHONE'
MA L G - ESS'
//" . ' ,
STREET LOCA~TION~/ -
6. TYPE OF RESIDENCE
~ SINGLE FAMILY
[] MULTIPLE FAMILY
'~. WATE[I~UPPLY
INDIVIDUAL*
[] COMMUNITY
[] PUBLIC UTI LITY
8. SEWAGE DISPOSAL SYSTEM
INDIVIDUAL/ON-SITE
PUBLIC UTILITY
' ~UMBEt~ Ot~BEDROOk/IS
I'-I_ One [] Four [] Other
Two [] Five
~ Three [] Six
* ATTACH WELL LOG. A well tog is requ red for al wells drilled
since June 1975. For wells drilled prior to tha~d~te, give well
depth (attach l,o.g f _ava lable.) · ~ ,~L_/~ , ·
YEAR ON-SITE SYSTEM WAS INSTALLED.
I
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010 (Rev. 6/79) ~//~.~
1. TYPE OF RESIDENCE
[] SINGLE FAMILY
I--I MULTIPLE FAMILY
2. WATER SUPPLY
[] INDIVIDUAL
[] COMMUNITY
[] PUBLIC UTILITY
Connection Verified
3. SEWAGE DISPOSAL SYSTEM
[] INDIVIDUAL/ON -SITE
[]PUBLIC UTILITY
Connection Verified
[]Septic Tank or []Holding Tank
Size:. If Tank is homemade
give dimensio ns:
TYPE OF TANK
TOTAL ABSORPTION AREA
4. DISTANCES
WELL TO:
THIS SIDE FOR OFFICIAL USE ONLY
NUMBER OF BEDROOMS
[] ONE [] THREE [] FIVE
[] TWO [] FOUR [] SiX
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
PERMIT NUMBER
DATE INSTALLED
INSTALLER
SOILS RATING
MANUFACTURER
MATERIAL
Septic/Holding Tank [Absorption Area ISewer Line
[] OTHER
Nearest Lot Line
Absorption Area to nea rest Lot Line
5. COMMENTS
DATE
[~' APPROVED FOR ~ BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED
72-010 [Rev. 6/79)