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HomeMy WebLinkAboutFIRE LAKE BLK 1 LT 10AOnsite File dr a� Fr� qr" Kr aid..§2s 11Sp&­ .11 r\ PUI L-1 - I- i z.u()L; Municipality of Anchorage Community Development Department Page 1 of 2 On -Site Water and Wastewater Program 4700 Elmore St. - P.O. Box 196650 Anchorage, AK 99519-6650 - http://www.muni.org/onsite - (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number. OSP171296 PID Number: 051-361-08 M New Z Upgrade Name: JIM WEATHERBY ABSORPTION FIELD M Deep Trench ❑ Shallow Trench R Bed F] Mound Address 13721 MALASPINA STREET El Other Phone Number of Bedrooms Soil Rating depth from original grade 5 ITotal GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth be h pipe Subdivision Block Lot FIRE LAKE 10A Ft, Ft. Fill added above original grade I length ave Township Range Section Ft. Ft. Gravel width%�_s. _,-<. Number of Lines Distance between lines FL SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total abs ion area Number of trenches Dist. between trenches From Tank Field — Tank Line - Ft2 Ft. Well 150.8 N/A N/A N/A N/A TANK VSeptic49:@m:@*. [I Holding E) Other Manufacturer ANCHORAGE TANK Capacity I 2000G,1. Surface Water 100+ N/A N/A N/A - Material Number of compartments Lot Line 48.6 N/A N/A N/A Steel 2 NA Foundation 8.0 N/A N/A I N/A LIFT STATION Manufacturer Capacity Curtain Drain 50+ N/A N/A Gal. Remarks Pump on level at Pump off level at in. High water alarm at — in. Pump make a el Electrical Inspections performed by Installer Tank to PIPEMATERIAL House 3034 drainfleld 3034 JR's Septic Pumping Drainfield C01MT 3 Inspector PANNONE ENGINEERING BENCH MARK (Assumed elevation) 486ft InspectionLocation dates: 15' 10/19/17 2- 6/11/18 and descri tion p 3'd 4th AT HOUSE POINT A COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp Conditional Approval: 1` 142 � _�*� Qk �� -k OF At, Date 4,9 TH Steven No'n' 'o, n, el I 8149 Approved Date Iko 5 11Sp&­ .11 r\ PUI L-1 - I- i z.u()L; 10]Util. E-s'mt. 19� 10]Util. 'Esmt. APPROXIMATE LOCATION OF EXISTING DRAIN FIELDo o DRIVEWAY 5 8DR DUPLEX e INSTALLED NEW 2000 SEPTIC TANK WITH DCO AFTER 10 A 01 L CC ' DECOMMISSIONED EXISTING 2000 —SEPTIC PER MOA CODE 150.8; WELL 'p )9.89 A B TI 12.5 9.9 T2 20.6 19.0 DCO 24.3 22.7 D 0 0 Z) Z z w0 < < z M < OG./FG. 485 4.0 I __ u 2000g SEPTIC \ =4,,::�� 480.4 TANK .2 PROFILE SCALE: 1 10' Date RECORD DRAWING PAMOM MqG SVC, U -C P.O. BOX 102954 ANCHORAGE, AK 99510 6/13/18 -Pay[ d'qwa_s PHONE (907) 272-8218 FAX (907) 272-8211 Scale 49 TH 1" = 50' P.I.D. NO FIRE LAKE 131 L10A . ........ 051-361-08 !nnope DRAWN ACP JIM WEATHERBY CE 8149 PERMIT NO. 13721 MALASPINA STREET OSP171296 SITE PLAN EAGLE RIVER, AK Sheet 2 OF 2 MUNICIPALITY OF ANCHORAGE ,.rient On-Site Water& Wastewater Program \c ,F—', PO Box 196650 4700 Elmore Road ` Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 V `— http://www.muni.org/onsite 11Li p+ � r. I)cpartuncnt ANCNORpV� On-Site Wastewater Disposal System Permit Permit Number: OSP171296 Effective Date: 10/6/2017 Work Type: SepticTank Upgrade Expiration Date: 10/6/2018 Tax Code Number: 05136108000 Site Legal Address: FIRE LAKE BLK 1 LT 10A G:0453 Site Mailing Address: 13721 MALASPINA ST, APT A, Eagle River Owner: 13721 MALASPINA LLC Lot Size in Sq Ft: 39000 Design Engineer: PANNONE ENGINEERING SERVICES Total Bedrooms: 5 This permit is for the construction of: ❑ Disposal Field 0 Septic Tank ❑ Holding Tank ❑ Privy Cl 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 Received By: 'LJ. �g , 11l�1 Date: I U 6 Issued By: ief- Date: iiki6 T A. BIISHF MUNICIPALITY OF ANCHOR f F Community Development Department . `w 4,,l Phone: 907-343-79 4 Development Services Division Fax: !I77343-79 7/7 On-Site Water & Wastewater Program ") ,• �4ffr ,i; ON-SITE SEWER/WELL PERMIT APPLICATION OCT },0 4 2017 '^i Parcel I.D. 051-361-08 �c h4,/ �` /I Property owner(s) 13721 Malaspina LLC Day phone y` g ° i� c Mailing address PO Box 92001 Anchorage, AK 99509 Site address 13721 Malaspina St. Legal description (Sub'd., Block & Lot) Fire Lake B1 L10A Legal description (Township, Range & Section) Lot Size 39,000 Sq. Ft. Number of Bedrooms 5 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) ❑ (w/wo ADU) Septic Tank ❑X Upgrade ❑X Duplex (D) 0 Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE I WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municip- odes. 0 1 4110 (Signature of property owner or authorized agent) Permit/Rush Fees: 4 A15 Waiver Fees: Date of Payment: !ONO- Date of Payment: Receipt Number: 05 J56 Receipt Number: Permit No. 0301-1a196' Waiver No. Permit App__-: ::_.,c; Pannone Engineering Services iic Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve@panengak,com October 3, 2017 Subject: Fire Lake Block 1 Lot 10A Tank Replace Permit Request Design Narrative This is a design narrative for a permit to install an upgrade 2,000g Septic Tank to replace an existing 2,000g Septic tank to be issued for this property. The existing tank has completely failed. It will be decommissioned per code. Currently the lot is developed. The proposed system will utilize a replacement 2,000g septic tank that will be connected to the existing drain field. The existing tank is located approximately 100'+ from the well. The proposed tank will be placed outside the existing well radius. All required separation distances will be met. 1. Upgrade Tank Design. A foundation clean out installed if needed. The tank will be located: 5'+from any property line or building foundation ab5oteitvA ���la• 10'+ from any water line 100'+ from any surface water 100'+from any private wells 200'+from any public wells The proposed installation will not affect the future development of the surrounding or existing lots. If you have any questions or concerns, please contact me at 907.272.8218. Sincerely, tank . a cleno.t, a � ***** r OFr J►1W +��p,CE ......• �rb+ Aar co I1j�' 041-?1,%� sleven R.Pannonegg :�/}/� • Steven R. Pannone, P.E. Owner/Civil Engineer Mailing: P.O. Box 100217, Anchorage. AK 99510-0217 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 i,/~ ~ DEPARTMENTOFHEALTH&ENVIRONMENTALPROTECTION  ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ~, '-~ ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME 1PHONE LEGAL DESCRIPTION ~ ~ - ' - ~aterials~ of compar~nts ~Z Manufacturer ~.~.~ No, ~ Liq. capaci~ in g.~ IF HOMEMADE: Inside length Width Liquid depth ~--pOZ~ ~facturer - Mater~al -- ~ Liquid capacity in~/. ~ .,,T.~C,~O: ~"" /~ .un.~,io.30~ ..~,.,t~ ...~,~,o.~,¢~O No of lines ~ Leng~of each li¢..,. Total I~th of Ijn~ ~~. Distance between lines ~ ~ Top 0~"~to~" grad~~' ~'Material b~e ~ ~ roches Total Length ~ Wid~- ~ ~ ~ ~ib Crib dim Crib ~ ~ ' Wel~ ~ Bui~ing fou~atim~ Near; ~ ~ DISTANCE TO: ~ Class ~ ~ ~ Depth Driller Distance to lot line PERMITNO. ~ ' ~ DISTANCE TO: Building foundation Sewer line Septic tank/~0~ Absorption a,'ea(s) /~ OTHER ~1~! NSTALLE~ ~ ~ X ~' REMARKS ~ .... r.qlr LEGAL A~E~ DATE 72-013 (Rev. 3/78) R F' F' I._ I C FI N T L El C I=1T I 0 N L. EGFIL HRRR't' FI HH_.F.E t MEN[:,E:NHRI._I._ L:[.O BSL FIRE. LHF..E ~,'~ I._I1 ['-,~ I: C:: ]:: :::'it L... ]:: '-F "'~'-" Gu F::' FI l'",l C: ~"~ [;',~':: Ffl DEF'FIRTMENT OF HEF4L. TH FINE:, EN","~RONMENTFIL PROTECT E:;~'% "'L" STREET., RNCHORFI3E' FIK. :~';~EZ SR RT E:O',:': ~.Z75 CHI_IG~RK LOT :5 1ZE ~::E:~:.:.:~ St:! ... FIRES FEET 'I"'T'PE EF:' SI]Il_ RE:SORPTION SYSTEM I:5' TRENCH MR::':: I MIJM I'.ILIHE~ER OF' BE[:,ROOMS = 5 SF~ I L RFIT I NG ,:' '=,Ii:! FT,.'"E',R.'. .... ±,=:-- THE: F.E .:..U .[ RE[:, SIZES OF THE S;I]II_. FIE:SORF'TION ~'t'L=~"EM IS: E::, E: IF::" T' II...-i .... J_ (E~ L_ E r-.I ~3 T 14 == ,3 F: FI ',.,' E I__ [:, E [::' -'F ~-t .......... THE LENGTH DIMENS;II]N IS THE LENGTH ,:.'IN' FEET;, OF THE TRENCH OR [:,F.:FIINFtEL..[>. THE E:,EF'TH OF FI TRENCH OR F'IT IS THE DISTRNCE BE'H4EEN THE SURF'RCE OF TNE: GROUND FINE:, THE BOTTOM OF THE ENCR',,,'FITION ,:.'IN FEET.'.". THERE IS NO SET 1.4IDTH FOR TRENCHES. THE: GRFIVEL DEPTH IS; THE MINIMIJM DEPTH OF 6RFIVEL BETklEEN THE OUTFFIL. L. F'IPE. FIN[:, THE BOTTOM (."IF' THE ENCRVRTION ,.".IN FEET;,. FI~.-.F.flIf I::IF'F'LICFINT HFIS 'THE: RE:,FLN:,IE:ILIT'¢ TO INFORM THIS; [:,EPFIRTMENT [:,URING THE Il_Nc, OF ""~"l' '" ..... ~"' INSTFIL. L. RTII]N INSF'ECT - '- RNY I.,.IELLS; R[:,JRCENT TI:I THIS r~._ru.~.~ FIN[:' THE: H.ME:ER OF' RESIE:'ENCEL=; TI-IRT 'THE HELL. HILL :,ER,E ....................-T' I .,..!1 C! ,:". 2 ':,. I !'-,! '--.:=, F'=' E: ....... b.. -I I k--I r-.! ~=-7; i::1 F: F" F;.'.: EE g:;! ILII I F: E [: .......................... EFICKFILLING OF FtN'¢ S'¢STEM P~ITHOUT FINFIL INSPECTION RND RPF'RF/',,,'FII_ 8't' THI':.i [:,EPRF~::TMENT I.,.IILL BE SUEJEI]:T TO F'F.'L~SEC:I_ITION. MINIMUM [:,ISTRNCE BETklEEN FI WELL FINE:, RNY ON-SITE SEHRGE DIS;POSFIL S'T'STEM IS t00 FEET F'OR R PRI'v'FtTE HELL OR :tSO TO 200 FEET FROM R PUBLIC HELL. DEPENDING LIPON THE T'T'F'E OF PUBLIC NELL. MINIMUM E:,ISTFINCE FROM R PRI'¢R'rE; I.,.IEL. L. 'Ti:) Ft PRI'v'Fi-F'E SEWER LINE IS 25 FEET FINE:, TO FI COMMUNIT't' SEWER LINE IS 7~5 FEET. HELL LOGS FiRE: REi;fl..IIRED FiND MUST BE RE:TURNED "to THE E:,EPFiRTMENT HI'THIN ~:O OF THE WELL COMPLETION. OTHER I;~EIZ4UIREMENI"E; MFI'¢ FiF'PL't'. SPEi::IFICFiTIONS RNB, CONSTRLICTION E:,IRGRRMS; FIRE: W,,,'FIILRBLE TO INSURE PROPER INS-f'FiLLFiTION. I ..LF.'f IF r THRT :1..: I FIM FFIMILIRR I.,.IITH THE RE6!UIREf'IENTS FOR ON-SITE SEWERS FINE:' HELLS RE; SET FORTN B"¢ THE MUNIC I F'RL I-f"~' OF FiN]:HORFiGE. 2: I 1.4ILL Ihl=,'fHL. L THE _-,==,'fEll IN FiI]:I]:I3R[:'FiNCE 1.4ITH THE CO[:'ES. ii:: I UN[:'ERSTFiN[:' THFIT THE ON-SITE SENER S'¢"=]TEM MR'¢ RELT-!UIRE ENLRRGEMENT IF THE REES I [:'EN6~S,..~~___~ R Eb1OE:'ELE D-'-TN]~___~.~.~ I NCLLI[:~¢ ~¢ - ..,__~_MORE THFiN 5 BEE.,ROOMS. [] SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST 1 2 3 4 5 6 7 8 9 10 SLOPE 11 12 [] PERCOLATION TEST WAS GROUND WATER ,~ I~ ENCOUNTERED? O P IF YES, AT WHAT E DEPTH? DATE PERFORMED: 13 15 16 17, 18 ~ Robert A. Sha¢~ No, PLAN Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND ~ FT COMMENTS PERFORMED BY: ! ='~:~'~z=eeff~q 72-008 (6/79) /,'7,/.//// CERTIFIED WELL CONSTRUCTION LOG Wel~ owuer ~ell location]: (.ddress & leEal description) ~J~,~_ ~_~._ Static water ~.vel ~ ft. (above, ~w) [and surf.co. Dnte..~uWca~./PW/ Finish of well: (o~en-e~d, screen, perlorRte~, open-bolo, other) Descrlho intervals and size' ~A~ ~ Z Well ylel~ teste~ by (pumping, ba~lina, a~r)at_~ gal/min. for ~ hours with /~ ft. of drawdown from static level. USGS Date well completed_..~T/~,t~ .~.~c)/ /~/ .... Nearest community ~'~¢ ~/~ Location sketch or remarks DRILLER'S MATERIAL LOG Depth below land surface in feet t.2 t o Give descriptioa of strata penetrated (size of material, color, hardness of drillirlE, and water content) --to to /I/ ~to --to_ .... tO __ to__ _tO --to to ~tn to- -to,, .... to-- DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE DISTRICT OFFICE 3601 C STREET, SUITE 322 ANCHORAGE, ALASKA 99503 Mr. Robert A. Shafer, P.E. S & S Engineering 17034 Eagle River Loop, Suite 204 Eagle River, Alaska 99577 WALTER J. HICKEL, GOVERNOR R E C E IV3-8 75 APR 4 1991 April 3, 1991 Mumcipality ct Anchorage Deer. Health & Human Services Subject: Lot IOA, block 1, Fire Lake Alaska Subdivision, Class C Public Water System (PWSID Number 215192), Wastewater Disposal System and Waiver Request, ADEC Project Numbers 9121-FA-044, 9121-DA-057, and 9121-WA- 014; Review Dear Mr. Shafer: This is in response to your submittal, received in this office on March 5, 1991, in which you requested an update on the previous issued operation approvals for the existing Class C Public Water System and Wastewater Disposal System. In addition you requested that the Department waive the minimum 150 foot separation distance between the existing Class C Public Water System Source Well and the Septic Tank to 145 feet. I have reviewed the submitted information, the office's file on this facility, and discussed the reported nitrate levels with departmental staff and have the following comments: Based on the information submitted to this office and this office's files, it appears that the Class C Public Water System located on Lot 10A, Block 1, Fire Lake Alaska Subdivision is in compliance with the provisions of 18 AAC 80, State Drinking Water Regulations. Based on the results of the adequacy test (existing wastewater disposal system passed), submitted under your stamp as a Professional Engineer, it appears that the existing wastewater disposal system is adequate to handle the volume of wastewater from a five bedroom duplex. Thus, in accordance with the provisions of 18 AAC 72, Wastewater Disposal Regulations, the wastewater disposal system serving the facility on Lot 10A, Block 1, Fire Lake Alaska Subdivision is approved for operation. The enclosed signed "Approval of On-Site Residential Water and Sewer Systems" is the Department's approval for the existing wastewater disposal system. In your March 5, 1991 submittal, a separation distance waiver was requested for the 145 feet between the on-lot Class C Public Water System Source Well and the on-lot Septic Tank. As a result of my review of the information submitted, the Department has found the information provided to be satisfactory for allowing the requested waiver, in accordance with 18 AAC 72.035 and 18 AAC 80.020 (e) of the State Wastewater Disposal and Drinking Water Regulations, respectively. The separation distance between the existing on-lot Class C Public Water System Source Well and the existing on-lot Septic Tank has been waived from 150 feet to 145 feet. This waiver will remain valid as long as semi-annual analytical results for nitrate (as nitrogen) and Total Coliform Bacteria are submitted to this Department. I recommend that water samples be collected during May and October of each year. In addition, once nitrate levels start to remain over 8 mg/I for more than two consecutive samples, engineering plans will need to be submitted to this office for installation of a nitrate removal package onto this public water system. Due to the monitoring requirements of the waiver, the following Public Water System Identification (PWSlD) Number is assigned to this public water system, 215192. Please inform your clients that the PWSlD Number assigned to their public water system will need to be on all analytical data submitted to this Department so that the waiver will remain valid. Thank you for your cooperation with this Department. If you have any questions, please do not hesitate to contact me. Sincerely, Keven K. Kleweno Environmental Engineer Enclosure: As Stated cc: John Smith, DHHS, w/o Enc. APPLI(' NT FILLS OUT UPPER HAl ONLY Property Owne~. ...~,~ ~,,~?/ /)~. ',~ /~/~'J'/~;/'~/~ ~.,~()/~.~,.~. Phone MalllngAddress/.~/~~ ~--/~ //P~//IZ/~/F./?//~///T/ Address Zip Code Lending Institution /~--~./~ Phone Address Zip Code Phone Realty Co, & Agent /'W~/S Address ...~...~' , Zip Code Legal Description ,,~ ~'~ 2'- Type of Residence L~ Single Family E~/~ultlple Family No. of Bedrooms [] Other Water Supply ~ndivldual ATTACH WELL LOG. A w~l log is required for all wells drilled since June 1975. L~ Community For wells drilled prior to that date, give well depth (attach log if available). ~ Public Utility Sewer/Disposal I~lndlvidual Year Individual Installed: ~] Public Utility When Connected to Public Utility: C] Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time \ Date Date Date Date Inspector Inspector Inspector Inspec~r Field Notes: MUNICIPALITY OF ANCHORAGE ,//,), ~ DEPT. OF HEALTH ENVIRONM2NI'AL PROTECTION , :~,/~ MAR 8 19C?. RECEIVED ( ) APPROVED BEDROOMS *CONDITIONS OF APPROVAL ( ~DISAPPROVED Soils Rating ~ Date ~wer Installed Well To Absorption Area Well Log Received /~,~.. ~, / % ¢ t Well ~o Tank / ~ 72.023 (3182) _March 14, 1983 Jerry D. and Ramona Groves SR 43 ~alaspina ~agle River, All 99577 Subject: Lot 10A Block 1 Fire Lake ~qubdivision Apt)reval for the individual sewer and %?ater facilities cannot be granted until the following items have been completed: O~° The top of the %.~ell casing should be sealed so that it is water tight. Ex~os~(] electrical wires to the well head are in violation of the Municipality of Anchorage codes and must be encased in conduit. o The water analysis report needs to be submitted to this office from the Chem Lab, 5633 B Street, for our revie%~. Please notifv this Department for a reinspection when the noted discrepancies have been corrected. If there are any further questions,.please call this office at 264-4720. Sincerely, JR157/p/E1 Jim Roberts Associate Environmental ~ DATE RECEIVED ",~ INSPECTION APPOINTMENTS TIME ' ' I NaPEOTOR I NaPEO~O~ MUNICIPALITY OF AHCHORAGE OF HEALTH &  DEPARTMEHT OF HEALTH · EHVlROHMEHTAL PROTEC~ O~E~ P~OTE~IO~ 825 L Street - Anchorege, Alaska 99501 ' AUB g 6 198t ENVIRONMENTAL SANITATION DIVISION REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES OIRECTION8: Complete all parts on page 1. Incomplete reques~ will not be p~oceued, Please allow ten (10) days for processing. 1, 'PROPERTY OWNER J_ PHONE Har~ A. ~d ~deltne M. Mackey ~88-281~ MAik~NG ADDS[SS St. Rt. Box ~ 8385~ Pioneer 8g., PBO~TY ~SID~T Hf different from a~ov*) PHO~ 2. BUYER PHONE ~roves, Jer~ ~d Remona 69~4519 ~A}~NG ADDreSS ~aska Mutual Savin~s~ 27~-255~ M~ILI~G (I will pick up ) 4. REALTOR/AGENT I PHONE Tar~ RealtyJ 277-0551 J02~ W. 25gh Ave. ~oho~age, ~. 99505 5. LEGAL DESCRIPTION Bk. ~,Lot IOA Ftrelake ~ubdiviston STR E ET LOCATION Mendenhall 6. TYPE OF RESIDENCE I--] SINGLE FAMILY MULTIPLE FAMILY NUMBER OF~BEDROOMS [] One [] Four [] Two ~l Five [] Three [] Six [] Other 7. WATER SUPPLY INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY * ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach Icg if available.) 8. SEWAGE DISPOSAL SYSTEM [~ INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY 19R1 YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY NUMBER OF BEDROOMS [] ONE [] THREE [] FIVE [] OTHER [] TWO [] FOUR [] SIX PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 1. TYPE OF RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY 2. WATER SUPPLY [] INDIVIDUAL [] COMMUNITY [] PUBLIC UTILITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM r--IINDIVIDUAL/ON -SITE []PUBLIC UTILITY Connection Verified []Septic Tank or []Holding Tank Size: /~ If Tank is homemade give dimensions: TYPE OF TANK TOTAL ABSORPTION AREA 4. DISTANCES WELL TO: PERMIT NUMBER DATE INSTALLED INSTALLER SOILS RATING MANUFACTURER MATERIAL Septic/Holdingj/~'=1~ Tank IAbsorption Area lSewer Line [I~earest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS DATE [] APPROVED FOR ,_~ BEDROOMS ~ CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED 72-010 (Rev, 6/79) �1 MUMCIPALITY OF ANCHORAGE Development Services Department �� ti� Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 051-361-08 1. GENERAL INFORMATION Expiration Date: II -q- 2/ Complete legal description Fire Lake Block 1 Lot 10A Location (site address) 13721 Malaspina Street Current property owner(s) Jim Weatherby Day phone Mailing address Real estate agent Day phone 2. TYPE OF DWELLING: R9 Single Family (w/wo ADU) ❑ Duplex Multiple Dwellings (Single Family and/or Duplex) r 3. NUMBER OF BEDROOMS: 5 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well El Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ Waiver Fee $ Date of Payment 7/1 Sl?= Date of Payment Receipt Number d 3 2 6, Receipt Number COSA # 6SC 2 1 13 g Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER . As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may Fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed above. Reliance on this report by another person is at their own risk. Pannone Engineering Services LLC highly recommends buyers hire their own engineer to evaluate this report. Name of Firm Pannone Engineering Services Address P.O. Box 1807 Palmer, AK 99645 Engineer's Printed Name Steven R. Pannone P.E. 6. DSD SIGNATURE System #1 Approved for System #2 Approved for Disapproved Conditional approval for bedrooms bedrooms Phone (907) 745-8200 Date bedrooms, with the following stipulations: 113 WAST`=VVATER z J� PROGRAM J Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet Legal Description: Fire Lake Block 1 Lot 10A If more than 1 septic system on lot: COSA Checklist # 1 of 1 A. WELL DATA H Well log is filed with Onsite (or attached) Date drilled Total depth 111 ft Cased to 111 ft FR Sanitary seal is functioning correctly Q Wires are properly protected Casing height (above ground) 16 in. Date of flow test for COSA °"'"Qf Static water level at beginning of test 99.1 ft. Comments B. TANK DATA Age of tank(s) 4 years Tank type/material 5 "" Measured operating fluid level in septic tank 3 ❑® Standpipes/foundation cleanout per record drawing Date of pumping 7 D. ABSORPTION FIELD DATA Deep Trench Which system tested (date installed) °'"J"i", Q ALL standpipes present per record drawing Total measured depth from grade 10 ft (max) Measured depth to pipe invert from grade 3-4 ft (min) ❑ N/A — pressurized field © Monitor tubes go to bottom of effective. If not, state depth into effective © Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 051-361-08 Structure served by this system 1 Well production at time of test 3.51 gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes F/1 Nc FEE Coliform bacteria is Negative Nitrate 3.62 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L FE -1 Arsenic less than MRL (ND) Collected by PES Date of Sample °'''"`U. C. LIFT STATION ❑ Required maintenance completed Age of lift station N/A years Lift station material N/A Comments: Adequacy test date Results ❑✓ Pass For 5 bedrooms Fluid depth prior to test 0 in Water added 750 gal New depth 16 in Elapsed time 200 min Final fluid depth -0 in Absorption rate 750+ gpd Any rejuvenation treatment (past 12 months) If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' Fv1 Yes if No Community Sewer Manhole/Cleanout > 100' Q Yes if No ft jV Yes if No Neighboring Tank > 100' Yes if No ft Private Sewer/Septic Line > 25' [Q Yes if No Absorption Field on Lot > 100' Yes if No ft Holding Tank > 100' 0 Yes if No Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' ❑✓ Yes if No Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' [D Yes if No ft � Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' F1 Yes if No ft Surface Water > 100' ft ft ft ft ft Q Yes if No ft Property Line > 5' Fv1 Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' El Yes if No ft Private Wells > 100' 0 Yes if No Water Main > 10' 0 Yes if No ft Community Wells > 200' 0 Yes if No Water Service Line > 10' Z Yes if No ft if septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' El Yes if No ft If absorption field is under driveway comment below Property Line > 10' Z Yes if No ft Wells on Adjacent Lots: Water Main > 10' [j Yes if No ft Private Wells > 100' jQ Yes if No Water Service Line > 10' Q Yes if No ft Community Wells > 200' Yes if No Surface Water> 100' Q Yes if No ft F. ENGINEER'S COMMENTS �v,a testy (e2S�c (iea�Gcsza�G'�'�� G. ENGINEER'S CERTIFICATION 1 certify that i have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. 7,t COSA Checklist yellow sheet OF 7,74 H 9�f teven R, Pat none ft ft ft ft ft ft ft ft 30' 0 O L6 O 0 O O Z 2.9' i_(1T I2A S89'59'30"E 200.00' IC' UTILITY EASEMENT T BL OCIt 1 LOT 10A I iZ W LL o _ ( d o 8'x16SHED j 2:4' o) A.C. DRIVEWAY GREENHOUSE I L' SR S O C:o.. / / 100.4'O I o 20.9 /S V (OrI - 44.1' 2'x8.8' CANTILEVER DECK ---,, �-2 STORY WOOD I 1' FRAMED HOUSE I c 49TH { Clark E. Kinney o`' � '•, 11760�� • . ,����yy�7r 1 • • ©ems Oressil-a o DECK x Ln N89 59'30"W 200.00' MENDENHALL STREET EXCLUSION NOTES: IT IS THE OWNER'S RESPONSIBILITY TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. NQTES; 1. RODNEY P. KINNEY ASSOCIATES, INC. HAS CONDUCTED A PHYSICAL SURVEY OF THIS PROPERTY AS SHOWN ON THIS DRAWING AND THAT THE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO ENCROACHMENTS EXIST OTHER THAN NOTED. 2. NO CORNERS SET THIS SURVEY. SURVEKOR'S CERTIFICATE: I HEREBY CERTIFY THAT I AM PROPERLY LOT 8A ESA_ L/////// BUILDING — — — — — OVERHANG - FENCE 010 CLEANOUT OSP SEPTIC RISER `- WATER WELL REGISTERED AND LICENSED TO PRACTICE LAND GRAPHIC SCALE SURVEYING IN THE STATE OF ALASKA, THIS 40 0 20 40 REPRESENTS A SURVEY MADE BY ME OR UNDER MY DIRECT SUPERVISION, THAT THE MONUMENTS SHOWN HEREON ACTUALLY EXIST AS DESCRIBED, AND THAT ALL DIMENSIONS AND OTHER DETAILS ARE CORRECT. ( IN FEET ) 1 inch = 40 ft. LOT 1 O BLOCK 1 AS—BUILT Rodney P. Kin ew60CIONS, k FIRE LAKE SUBDIVISION (PLAT 67-3) consulting Englnoers a Surveyors ANCHORAGE RECORDING DISTRICT 7/21/21 1 FIGURE 1 POST IN A CONSPICUOUS PLACE ALL WORK MUST BE INSPECTED :vns ,rte Field Inspection Request required 2 working days in advance of starting work and 2 working days In advance for final inspeciton. Call (907) 343-8206 (voice recorder) for scheduling. r' Permit is not valid without the call -In and also must Include the one -call ticket (utility locate) - r number. MUNICIPALITY OF ANCHORAGE - RIGHT nF wav rntnsrnni De I'art I I I U I It 4700 ELMORE ROAD TELEPHONE (907) 343-8240 EMAIL: moarowrequests@muni.org RIGHT OF WAY PERMIT R211891 Type: Encrchmnt Status: issued Grid: NW0453 Date Applied: 07/28/2021 Date Issued: 07/28/2021 Issued By: claudia.pinard Construction Start Date: Last Updated: 07/28/2021 Last Updated By: _claudia.pinard Permittee: 13721 MALASPINA LLC Work Order: Utility: Contact Person: Steve Pannone (907) 745-8200 Primary Inspector: Jon Sauerbrey Address/Loc: 13721 MALASPINA ST, APT A, Eagle River - @ Mendenhall Street. Legal Description: FIRE LAKE BLK 1 LT 10A G:0453 Original Work Description: Septic field encroaches 2.9 feet into the Malaspina Street Right of Way. SujMpyAized Financial Transactions Fee Description ua ti Amours Permit 1 S120.00 Total Fees: $12D.00 Soo reverse for requirements/remarks. I have read and understand both sides of this permit I agree to the terms and conditions; and I certify that all work will comply with federal, state, and municipal codes and regulations and the provisions of this permit. Signature: � Date:` MUNICIPALITY OF ANCHORAGE Development Services Department Right of Way Section Department THIS AGREEMENT, made this 29th day of July, 2021, by and between 13721 MALASPINA LLC and their heirs, administrators, and assigns, hereinafter called "PERMITTEE", and the Municipality of Anchorage, a municipal corporation organized and existing under its Charter and the laws of the State of Alaska, hereinafter called the "PERMITTER". WITNESSETH: WHEREAS, PERMITTEE is the owner of the following described real property: FIRE LANE, BLOCK 1, LOT 10A, according to the official records thereof, on file in the office of the District Recorder, Anchorage Recording District, Alaska, and; WHEREAS, PERMITTER owns and/or maintains the real property more particularly described as follows: The SIXTY FOOT RIGHT OF WAY OF MALASPINA STREET, immediately to the north side of PERMITTEES property as shown on Plat No. 67-03, on file in the office of the District Recorder, Anchorage Recording District, Alaska, and; WHEREAS, PERMITTEE has placed a septic field upon the referenced real property which encroaches 2.9 feet upon the PERMITTER'S Malaspina Street Right of Way. NOW, THEREFORE, it is mutually agreed between the parties hereto that: 1. The PERMITTER, acting through the Director of Development Services Department, hereby grants to the PERMITTEE the privilege of allowing septic field to encroach 2.9 feet upon the PERMITTER'S 60.0 -foot Right of Way, as shown on "Attachment A," included herewith. 2. The PERMITTEE agrees forever to indemnify, defend, save and hold harmless, the Municipality, its officers and employees, from any and all lawsuits, claims or actions brought to any person for or on account of damage to property or injury, disease, illness or death of persons, including all costs and expenses incident thereto, arising wholly or in part from or in connection with the existence of, alterations, maintenance, repair, renewal, reconstruction, operation, use or removal of the encroaching septic field, as placed upon the PERMITTER'S 60.0 - foot Right of Way. 3. The PERMITTEE shall not assign or transfer any of the rights granted herein to another individual or company without first notifying and securing the approval of the Director of Development Services Department. 4. This Agreement and Permit grants PERMITTEE no interest in PERMITTER'S real property whatsoever, except only the encroachment rights described herein. 5. The PERMITTER reserves the right to revoke this permit upon twenty (20) days written notice to the PERMITTEE. The PERMITTEE agrees upon such notice of revocation, to move said encroachment(s) from the 60.0 -foot Right of Way in which it is placed. Should the PERMITTEE refuse or fail to comply with said written notice, the PERMITTER may, without further notice to the PERMITTEE, remove or cause to be removed the encroachment(s), and the PERMITTEE hereby agrees to reimburse the PERMITTER for all costs incidental to the removal thereof. In addition to the mutual promises heretofore made, the PERMIYFEE has paid the PERMFI TER a one-time permit application fee of $120.00. The PERMITTER hereby waives the annual fee of $315.00. IN WITNESS WHEREOF, the parties hereto have hereunto set their hands and seal the day and year First hereinabove written. GRANTEE: GRANTOR: MUNICIPALITY OF ANCHORAGE '4C=k --L L James L. Weatherby% k L. Frost, Jr. Owner / fight of Way Supervisor Workflow: OSC211396 - Level 1 Review - 7/14/2021 12:27:57 PM �d1 of 1 O 100% ® v i Find I Next Plan Review - Review Comments Report Project Name: OSC211396 Workflow Started: 7/14/2021 12:27:51 PM Report Generated: 08/04/2021 07:06 AM REVIEW COMMENTS REF # CYCLE REVIEWED BY TYPE FILENAME DISCUSSION 1 1 Onsite Well and Changemark Fire Lake Bt L10A - chk.pdf Responsed by: Customer Service - 7/22/2 Septic Changemark note#02 revised Tim Ecklund This home per tax records is a duplex. Please check the appropriate box on 7/21/21 10:12 AM the application 2 1 Onsite Well and Changemark Fire Lake B1 L10A - chk.pdf Responsed by: Customer Service - 7/22/2 Septic Changemark note #03 new as -built attached. As a result of the . Tim Ecklund The survey doesn't match the record drawing. Shouldn't there be a survey, we have already submitted a ROV 7/21/21 10:12 AM standpipe at the end of the trench? Please address encroachment application to the ROW de That licatio ' ch or, 3 1 Onsite Well and Changemark Fire Lake B1 L10A - chk.pdf Responsed by Customer Service - 7/22/2 Septic Changemark note #01 The existing and previously approved det Tim Ecklund Please address/ justify drain field under driveway on the checklist under located under the driveway has never fro: 7/21/21 10:12 AM separations adequate structural support to prevent d, vehicle traffic. 4 2 Onsite Well and Changemark Fire Lake Bt L10A - ab.pdf Responsed by: Customer Service - 8/3/21 Septic Chanaemark note 401 approved ROW attached Tim Ecklund It appears per the survey provided dated 7-22-21 that the absorption field 7/23/217:06 AM might encroach into the road. Please get a determination from ROW U c'FZLA