Loading...
HomeMy WebLinkAboutGLACIER VIEW HEIGHTS #4 BLK 2 LT 2Onsite File Glacier View Heights #4 Block 2 Lot 2 #050-491-56 Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP201333 PID Number: 050-491-56 Dwelling: Oil Single Family (SF) 17-1 with ADU El Duplex (D) 1771 Two Single Family Project: 17-1 New RE Upgrade Name Jeff Mogg and Paula Jacobson kORPTION FIELD Site Address R Trench R Wide Trench R Bed R Mound D Trench 0 Wide Trench 22517 Eagle Glacier Loop Eagle River T Other Phone Number of Bedrooms I Rating Total d from original grade Soil 3 - w(— :: D/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from origina ade Gravel depth beneath pipe Subdivision Block —Lot GLACIER VIEW HEIGHTS #4 2 2Ft. Fill added above original grade vel length Township Range Section vel length Ft. Ft. Gravel width Beds: umber of Lines Di ce, between lines SEPARATION DISTANCES --------- Ft. st S Ft, Total absorption area Dist. tw To Septic Absorption Holding Sewer Number of trenches Dist. between riches Tank Lift Station From Field Tank Line Ft2 Ft. . Well >100' NA NA NA NA TANK E Septic E3 S.T,E.P. M1 Holding El Other Manufacturer ICapacity Surface Water >100' NA NA NA Greer 11000 Gal. Material Number of compartments Lot Line >10' NA NA NA NA plastic 2 FoundationL.!f—T STATION >10' NA NA NA Manufactu Capacity Remarks 4" insulation over tank Gal. Alarm location Electric [led by Tank to 3034 Installer JRs Septic PIPEMATERIAL Housetotank3034 drainfield — Drainfield CO/MT3034 Inspector Curtis Townsend BENCH MARK (Assumed elevation) 100 ft Inspectes:tion 1s, 5/11/21 2 nd 10/23/21 Location and description da 3rd 4th SE corner bottom of trim ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp A Conditional Approval: Date 49 1—H . . .......... . s..L..T..... 0 ...Curti.. Lo owmsenit Septic System lh� Approved No.0 11 Date I Note: this approval does not include well permit requirements. (Rev 05102118) \\\\ NTIGHBORING SEPTIC IS > 10' FROM\ pRopeRtv L|N-f- ^ x<,/ 9 --{ -./ * \R \ ".\--O -'-'/ \\\\ vf''co 15% SLOPE / 1. REMOVED EXISTING SEPTIC TANK.2. PLACED NtW 1,OOO GALLON SEPTIC TANK AND TIED INTO EXISTING ABSORPTION SYSTEM. THE TANK WAS PROVIDED WTH MINIMUM 20,, O MANWAY RISER SERVING THE FIRST COMPARTMTNT.3. ALL CONSTRUCTION WAS IN ACCORDANCE WITH ALL REQUIRIMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65. NE WE t * Y I ff2,{+,PN{{a 1OOO GAL SEPTIC TANK AND }LE CLEANOUTS. TANK IS 10, FROM FOUNDATION AI' FROM EDGE OF FIELD // EXISTING 48' (26' + x 36" x 6' EFFECTIVE DEPTH TRENCH/t C^l \ NEIGHBORING SEPTIC IS > 10' FROM PROPERTY LINE 'R?"'<14 =w ,,l-IGHBORING tL RADIUS__--\\ D5' AND ,) J.- Septic Tonk Record Drowing Prepored for JEFF MOGG AND PAULA JACOBSON 22517 Eagle Glacier Loop Eagle River, Alaska 99577 GLACIER VIEW HEIGHTS #4 BLOCK 2LOT 2 osP201 333 TKLUTNA ING/NTIR/NG, LLC 19162 I,IOUNTAIN ROAD CHUGIAK, ALASKA 99567 (e07) 406- 1 058 DATE: 1012812021 DRAWN: CLT SCALE: 1" = 40' PID: 050-491-56 SHEET 2 OF 3 MARK A B SVl I t'-8"18'-6" SV2 IJ _ /22'-7" DCO 9'-11"25'-8" _, \J] I,^ =z_z_<lLro--JLL C) Z. LIJ lr (_) >a )<7-<:-- \J Z- Lr_.1rNO>a Fl \, Ldl-*<-J LIO ---lOC) Fl - 95. +,, IN S U LATIO N OVTR TANK 1,000 G P LASTIC TAN K Septic Record Drowings Prepcred for JEFF MOGG AND PAULA JACOBSON 22517 Eagle Glacier Loop Eagle River, Alaska 99577 GLACIER VIEW HEIGHTS #4 BLOCK 2 LOT 2 osP201333 t ............... 1.,^............;n, ;: i. H. i?$T'nl{.r',lu;,',,rqdKgEKLUTNA [NG/N[TR/NG, LLC 19162 IVOUNTAIN ROAD CHUGIAK, ALASKA 99567 (e07) 606-9828 DATE: 1012812021 DRAWN: CLT SCALE: 1" = 5' PID: 050-491-56 SHEET 3 OF 3 10/17/21 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 h1tp:1/www-muni.org1onsite On -Site Wastewater Disposal System Permit Permit Number: OSP201333 Work Type: SepticTank Upgrade Tax Code Number: 05049156000 Site Legal Address: GLACIER VIEW HEIGHTS #4 BILK 2 LT 2 G:0059 Site Mailing Address: 22517 EAGLE GLACIER LOOP, Eagle River Owner: MOGG JEFFREY A & Design Engineer: EKLUTNA ENGINEERING, LLC' This permit is for the construction of: Effective Date: Expiration Date: Lot Size in Sq Ft Total Bedrooms: 8/31/2020 8/3112021 43763 ❑ Disposal Field d 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 (2417). 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: Issued By. Date: t 9A 5-- Date: 3 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 050-491-56 Property owner(s) MOGG JEFFREY & JACOBSON PAULA Day phone Mailing address 22517 Eagle Glacier Loop Eagle River AK 99577 Site address 22517 Eagle Glacier Loop Eagle River AK 99577 Legal description (Sub'd., Block & Lot) GLACIER VIEW HEIGHTS #4 Legal description (Township, Range & Section) Lot Size 43,763 Sq. Ft. Number of Bedrooms 3 BLK 2 LT 2 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) El (w/wo ADU) Septic Tank 0 Upgrade El (D) El Holding Tank F1Renewal F-1Duplex Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the abo i ormation is correct. I further certify that this is in accordance with applicable Municiploo�es. , Z-0 Z O (Signature of property owner or authorized age Permit/Rush Fees: 3 1 6<S'75(CO ID'Icl) Waiver Fees: Date of Payment: Receipt Number: 0-2-6 OD.p Permit No. © 5 P 02013 33 Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Building Safety\On Site Water and Was tewater\Forms\Client Forms\Permit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201333, Rebecca Carroll, 08/31/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201333, Rebecca Carroll, 08/31/20 Municipality of Anchorage Page { of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: "~* ~,~ I ~)L~_ ('~ PID Number: _ C'/~'~;~)'~'-¢') I '~(/'¢ Name: Address: ~~o o~m~s~l~ ~(~,~, LEGAL DESCRIPTION Lot: ~ Block: % Subdivision: Tov, nsh,p:..r-t4 section l ¢ WELL: [] Newr3 Upgrade fYield: C ass f cat on (Pr vate, A,B,C): Total Depth: Driller: Date }r ed: From Surface Water Lot Line F:oundation Curtain Drain Cased To: Ft. Ft. Static Water Level: Ft. I Pump Set at: Casing Height Above Ground: GPM Ft. Ft. SEPARATION DISTANCES Remarks: Wastewater System: /~New [] Upgrade ABSORPTION FIELD '~eepTrench [] Shallow Trench []Bed [] Mound []Other Soil Rating: O, ~ GPD/Sq. Ft Depth to pipe bottom from original grace: Fill added above original grade: Gravel da.pth~' Vd Total absorption area: ........ ii staller: Total Depth from o~r~al/g rede: Gravel depth beneath pipe (./O/ Ft. Gravel length: '~'~ /Ft. Numbe~ines: Distance between ~jnesl(~_. Pipe material: ~t"~l O Date installed: TANK ~,Septic [] Holding [] S.T.E P. ~anufacturer: ~ I Capacity in gallo~_~: Material: ,/' I Number of Compartments: LIFT STATION./_ Size in gallons: J Manufacturer:~ "PU,T~p one" I~v;I a'~'---~ff~7~' I~=~'~ High water alarm at: Pump Make~ Mode~/'1 Electrical Inspections performed by: BENCH MARK and Descr ~-'~ ~-~-l~'~k~ates: 1 Inspections performed by: _ ¢- 2nd <:~ - Department of Healt, ll~d Human"'""~vices approval Reviewed an d approved bY~~'~~~-Date: -2-/'7//?-~// 72-013 (1/91)MOA 25 Permit No. of ;~- - ~"~P~ 4:~100x=~ ~ Page ~- Municipality df Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well,inspection Report Legal Description: ~..L~_ !¢~, V~.,~. ~g[~.~..L.~.~-~.'~; _I~=,L.V__ ~-~"~-PID No.: N 72-013 A (2/91) MOA25 PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW910099 DESIGN ENGINEER:S & S ENGINEERS OWNER NAME:MOGG JEFFREY A & PAULA M OWNER ADDRESS:HC 80 BOX 5136 OBERG ROAD CHUGIAK, ALASKA 99567 DATE ISSUED: 5/14/91 EXPIRATION DATE: 5/14/92 PARCEL ID:05049156 LEGAL DESCRIPTION: GLACIER VIEW HEIGHTS #4 BLK 2 LT 2 LOT SIZE: 43763 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: ISSUED BY: ~'~,~J ~LC DATE: -~ ~/ May 6, 1991 ROBERTSHAFER, P.E. ROGERSHAFER CIVIL ENGINEEFiS (907) 694-2979 FAX 694-1211 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERrNG STUDIES ANDREPORTS WELLINSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN Mu~icip~Zity of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 REFERENCE: Lot 2; Block 2; Glacier View Heights Subdivision; PERMIT REQUEST NARRATIVE: We have proposed the installation of a I000 ga~on septic tank and mo trenches with a spill over. The septic system is to be located 100 ft. away from an existing well on the property. The trenches are to travel across a slope of abou~ 10% which exists on the property. There is a neighboring septic system located approximately 30 ft. from the proposed septic. However, there should be no influence on one by the other. The lots in this area are relatively large. We foresee no impact on neighboring properties by the installation of the proposed septic system. /¢0B~T A. SHAFER, P.E. ~/~m 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 SCALE SCALE Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLA'rlON TEST 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16-- 17 18 19 20 Township, Range, Section~-'\ SLOPE WAS GROUND WATER ENCOUNTERED? IF YES, ATWHAT DEPTH? Depth to Wate,.~A~. ~ ~onilorD3D? "v t'--~ ,ate: SITE PLAN Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE __\ c;, (minutes/tach) PERC HOLE DIAMETER ~ 'I-EST RUN BETWEEN ~ . ~AND "7 FT COMMENTS ~//~-/ : :. hF~:;,;;'L~i~.~N~-, ~' / PERFORMED BY ~.~':i~q (~'i:~e?, ~L,l~,5[~q ~?~;7~Z ~~ ' ~~~ I ~~~ _ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES I~T ON THiS DATE. DATE: 72 008 (Rev. 4t85) ~ Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLAIlON 7'EST PERFORMED FOR: LEGAL DESCRIPTION: L'Z.-. ~:~ ~ 7 L...~V~.C..~Township, Range, Section: 10 11 12, 13 14 15 16 17 18 19¸ WAS GROUND WATER ENCOUNTERED? Date YES, AT WHAT D,~PTH? Water AII~ ? Reading Gross ] Net I Depth tO Net Drop PERCOLATION RATE _~'"~ (minutes/inch} PERC HOLE DIAMETER ~0 k TEST.U. ~ETW~EN G'"- ~ AND b ~T 'E~gle River, Aias~a 9~5~'l ~ ~ ~~ .... T~ E~ WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELiN~FECT ON THiS DA] E DA]E ~;/*~ 72-008 (Rev. 4/85) / by DOC Co, 6ha SULLIVAN' WATER WELLS ~,O, BOX 272, CHUGIAK, ALASKA 99567 · TELEPHONE 688-2759 · OWNER OF LAND .... ADDRESS ;'. "LEGAL DESCRIPTION - DATE.Sta.ed q~/~L~ Ended ~" PE~ITNUMBER DEPTH OF WELl, _ ,//~/C~? /'' ~/ // STATIC LEVEL OF WATER FT. --/7 c?), ~/~Z~(RAW DOWN FT. GALS. PER HR C~' / O C- KIND OF CASING 4¢ -~ ~: /O From ~ Ft. From ~ _Ft. From.__ Ft. From ,,~,"' Ft. Fr°m ,,Y~ Ft. From .~C"7 FI. From J,/,(' Ft. · From I ~J _Ft. From__Ft. From Ft. KIND OF FORMATION: From Ft, to Ft. From Ft. to Ft, ,: From Ft. to Ft, From____Ft. to Ft, ~,~' From, _Ft. to Ft._ i':: 'From____Ft. to.__.Ft._ i' From ..... Ft. to Ft. From__Ft. to Ft. From Ft. to__ Ft. From· Ft. to Ft From Ft. to__Ft From Ft. to FI From Ft. to Ft From Ft. to Ft From Ft. to__Ft From Ft. to____Ft From__.Ft, to_____Ft From Ft. to Ft From__ Ft. to Ft From Ft. to Ft From _Ft. to Ft __ From___.Ft. to__Ft. From__.Ft. to__Ft. From FI. to Ft :~ MISCL. INFORMATION: DRILLER'S NAME MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION Complete legal description Lo¢: 2~ B£ock 2i GZacier Viz~/~ He.Zqhts -feLl Location (site address or directions) EagZe Glacier Loop Property owner Mailing address Lending agency Mailing address J¢.~ & Paula Moqg HC80 Box 5136 Ob~.rg Road~ Day phone Ch¢~ciak; A,~. 995~7 Day phone 753-3549 Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 3 TYPE OF WATER SUPPLY: X× Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: XX If community wastewater system, provide written confirmation from Stat~ ADt:'C attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA ,~21 STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, [ verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I furtherverifythatbased on the information obtained from the Municipality of Anchorage flies 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 __ Address Engineer's signature DHHS SIGNATURE ?/~ Approved for --~ Disapproved. Conditional approval for S & S ENGINEERING 17034 Eagle Ri.vet Loop Road Eagle River. Alaska Phone__ Date bedrooms. bedrooms, with the following stipulations: Additional Comments By: Date 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~)25 (Rev, 1/91) Back MOA ~'21 Municipality of Anchorage /~ Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ~¢_~,Z.~_~!nr-k'/2- ~ ~'/AC..,'e¢ t.),g,,~ ~-A, Parcel I.D. Log present (Y/N) ~ Total depth /~l~ ~ A. WELL DATA Well type ~j'~o~, ~, .~.~;lu, If A, B, or C, attach ADEC letter. Date completed Cased to ~ 0 ~- Sanitary seal (Y/N) _ b~ FROM WELL LOG Date of test x../ Static water level Pump level L) ADEC water system number ,z~ - ~4 Driller ~.~o/)1'¢!~) Casing height Wires properly protected (Y/N) g.p.m. AT INSPECTION _ ~/~UNICIPALITY OF ANCHORAGE q- ~0 k~I~ONMENTAL SERVICES DIVISION OCT b 1991 g.p.m. RECEIVED SEPARATION DISTANCES FROM WELL TO: f Septic/holding tank on lot ! Z O Absorption field on lot [ ~;~ ~ Public sewer main Public sewer service line _ ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE REStJLTS: Coliform ,~..~, .-~'~.~.-~c,'?o¢~ Nitrate '~¢~.~'-<',~'~'~¢'~1 ~'~'~ Date of sample: ~ - 2 ~ - ¢ I Collected by: B. SEPTIC/HOLDING TANK DATA Date installed ~. - / ~ ~ I Cleanouts (Y/N) High water alarm (Y/N) Date of pumping t~)/(A ... Other bacteria Tank size ! t~OO ~Pt ( Compartments Foundation cleanout (Y/N) ~ Depression (Y/N) f"-) / ~ , Alarm ~__/O ~ L.,~ ~ tested(Y/N) ~/¢~r SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK 'I'O: Welt(s) on lot To property line Foundation Water main/service line_ Surface water/drainage Absorption field oo 72-026 (Rev. 3/91) Fronl MOA 21 CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) "Pu'~'r'r'~on" level at High water alarm level ~ % ~ Meets MOA electrical codes (Y/N) ~. SEPARATION DISTANCE FROM LIFT STATIO~TO: Well on lot On adjacent Io"~. Manufacturer Manhole/Access (Y/N) "Pump off" level at Cycles tested Surface water D. ABSORPTION FIELD DATA Date installed ~'- /- ~ I Soil rating (~). ~ Length ~ ~ ' Width ~:~ ~ Gravel thickness Total absorption area .=,.~-?', ~ ~ Depression over field (Y/N) Results (pass/fail) /~/Y~ Peroxide treatment (past 12 months) (Y/N) ~.~/_~. System type _~',~z,~ .~.~c..~ I Total depth [ O Cleanouts present (Y/N) 01 Date of adequacy test for bedrooms If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Wellonlot / (.OO "J- To building foundation On adjacent lots Surface water I Curtain drain On adjacent lots I ¢. ¢ 'f" Property line , / 0 To existing or abandoned system on tot ~, Cutbank ~O 3" _Water main/service line Driveway, parking/vehicle storage area ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in e~e~t~¢g the.elate of this inspection. S &S ENGINEERING Signature 17034 Eagle River Loop Roa~l No. 204 Engineer's NameEagle River, Alaska ¢~527 HAA Fee $ / Date of Payment Receipt Number · ~L~ROFESS~U,-~ Waiver Fee: $ Date of Payment Receipt Number