HomeMy WebLinkAboutALLUVIAL LT 83BAlluvial
Lot 83B
#051-081-34
Lot 80
Lot 83A
S 89'53'30"E 135.00'
_ALLUVIAL STREET
I
I
I
I
I
3o.c n'
REVISED: 04 DECEMBER 2025
NOTES: GROUND LEVEL IMPROVEMENTS SHOWN ARE APPROXIMATE. DATE OF SURVEY: 05 AUGUST 2025
PLOT PLAN _ AS BUILT X SCALE 1" = 30' GRID NW 1457 Project No. J25-024 A2
re /�r P.O. Box 210005
Lang & Associates, inc. Anchorage, Alaska 99521-0005 o�
(9071 522-6476
Professional Land Surveyors surveyClangsurvey.com
I hereby certify that I have surveyed the following described property:
Lot 83B, ALLUVIAL SUED. (Plat No. 82-341)
Anchorage Recording District, Alaska, and that the Improvements situated thereon are
within the property lines and do not encroach onto the property adjacent thereto, that
no Improvements on the property lying adjacent thereto encroach on the surveyed
premises and that there are no roadways, transmission lines or other visible
easements on said property except as indicated hereon. 1�
Dated this the �K Day of gfi�M -LGI at Anchorage, Alas4
It is the responsibility of the owner to determine the existence of any easements,
covenants, or restrictions which do not appear on the recorded subdivision plat.
State of Alaska AECC963
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program, 4700 Elmore Road
P.O. Box 196650 Anchorage, AK 99507 Page of
www.ci.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: 0sP101022 PID Number: 051-081-34
Name: Sean Barnett Wastewater System: [] New [] Upgrade
Address:
21624 Sean Street Chugiak, AK 99567 ABSORPTION FIELD
Phone: 230-2264 Number of Bedrooms: Four [] DeepTrench ~ Shallow Trench [] Bed [] Mound [] Other:
Soil Rating: Total Depth from original grade:
LEGAL DESCRIPTION 1.2 GPD/Ft2 8 Ft.
Block: Lot: 83B Subdivision: Depth to pipe bottom from odginal grade: Gravel depth beneath pipe:
Alluvial 4 Ft. 4 Ft.
Township: Range: Section: Fill added above original grade: Gravel Length:
0-.5 Ft. 45 + 15 (Added) Ft.
Well: [] New [] Upgrade Gravelwidth: Numberoflines:
Distance between lines:
5 Ft. 1 - Ft.
Classification (Private, A, B, C): Total Depth: Cased to: Total absorption area: Pipe Material:
Existing Ft. Ft. 600 (Total) Fi= ASTM D3034 PVC
Ddller: Date Ddlled: Static Water Level: Installer: Date Installed:
Et, Stuart Gilbert 7/3-7/15/2010
Yield'. GPM PumpSetat: Ft. Casing Height Above Greund:pt. TANK
SEPARATION DISTANCES [] Septic [] Holding [] S.T.E.P. [] Other:
T~ To Septic Absorption Lift Holding aublic/Pdvate Manufacturer: Capacity:
From
Tank Field Station Tank Sewer Line Anchorage Tank 1,250 GaL
Material: Number of Compaffments:
we, >100' >100' N/A N/A >25' Steel Two (2)
Sur~acawater >100' >100' N/A N/A ~ / LIFT STATION
Size: Manufacturer:.
Lot Line >5' >10' N/A N/A Gal.
"Pump on" level at: "Pump off" level at: in. High water alarm at:
Foundation >5' >10' N/A N/A in. in.
Pump Make & Model Electrical Inspections performed by:
Curtain Drain None Noted
Remarks:
New 1,250 Gallon Tank Place and Existing Absorption BENCH MARK
Location and Description:
Trench Extended 15' Under this Permit. Top of Sill Plate Between Hose Bib and Gas Meter.
Assumed Elevation:
100.0 Ft.
Inspections performed by: s. Gilbert Dates: 1st 7/3/2010
7/3/2010
~z'~V~'' .' A ,~,~
Development Services Department Approval
Conditional Approval Date: ~'~.~ ..-~.~....~.,
Reviewed and approved b Date: I
( Rev. 04/06)
Municipality of Anchorage Page 2 of 3
DEVEOPMENT SERVICES DEPARTMENT
4700 Elmore Road Anchorage, AK. 99519-6655- 343-7904
Permit Number: 0SP101022 Lof 80 PID No.: 051-081-34
S 89'53'30"E 135.00'
--CHAIN-LINK FENCE-~ _ 30,I0'
Lof 85B z
40,485 s.f.
c~
11 z
o
~jlO . .:... .
Lof
83A
."' ': '. i' 0..".'" ,.. :"
,~,,~----J~ ...:.:....' ~:., :...,
~ ~ r~' --''' ~ ..... . ..
m Four '",~e '.'.' ' Or.' .'" ...
~- ~ -- ..... ~,:....:.
Bedroom',,, .'" .~"
' Home ,,,, ; :".': i~:'-i' 0":
Si ~.a' 4~.r o~o~ .(.... ~..:-: ~....
S2 2g.5' ,18.9' .~<...-. cO. :. -... ·
C5 69.9' 84.9' ~ ' '
· .: . · . .;
C6 85.1' 97.9' '"~--~"~,, .=' '~ '.
M1 !81.7' 92.3' \
'-~,
Existing
Well
/ .
ALLUVIAL STREET
............... : ....
I ~;"."Z"':'"l"."~'~"i:"j,r~
PLAN AS BUILT
-- ~-MICHAEL £. ANI)£RSnN
~; ~n ~ No. 0£-4381
Municipality of Anchorage
DEVEOPMENT SERVICES DEPARTMENT
4700 Elmom Road Anchorage, AK. 99519-6655 - 343-7904
On-Site Wastewater Disposal System or Well Inspection Report
Permit Number: OSP101022
Page 3 of 3
PID No. 051-081-34
/-- 99.4
d' /I 1,25o Gallon I~,
/ Is°pacTank IX
94.e5-' I J ~4.5
96.8
Rnlshed Grade
Ex]sting Grade
,~_._ ........... ~ ........................ . .G.~ote.! p_ ._F_a_b n_'c. Geotextile Fabric
Drainfield Rock Dminfield Rock
90.0 ~
45' (Existing Trench Length) 15' (Additional Trench Length)1
94.0
PROFILE AS-BUILT
No Scale
Permit Number:
Tax Code Number:
Work Type:
On-Site Wastewater Disposal System Permit
OSP101022
05108134000
Septic
MUNICIPALITY OF ANCHORAGE
Development Services Department
On-Site Water & Wastewater Program
4700 EImore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
Upgrade
Permit Effective Dates: June 02, 2010 to June 02, 2011
Design Engineer: ANDERSON ENGINEERING
Subdivision: ALLUVIAL
Site LegalAddress: ALLUVIAL LT 83B G:1457
Owner/Address: BARNE'I-r SEAN D
21624 SE. AN ST CHUGIAK AK 995670000
Site Mailing Address: 21624 SEAN ST, Chugiak
°~'c rt r ,S'
I Department
Lot Size in Sq Ft: 40485
Total Bedrooms: 4
This permit Is for the construction of:
N Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage
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 wastewater code requires inspections during the installation. The engineer must notify the Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction dudng freezing weather must either:.
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received ey~~
Date:
Date:
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, Alaska 99519-6650
w~v.muni.org/onsite
(907) 343-7904
ON-SITE SEWEPJVVELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
05 £1o/oz z.
Parcel I.D. 051-081-34
Property owner(s). Sean& Lori Barnett
Mailing address 21624 Sean Street Chugiak, AK
Site address 21624 Sean Street Chugiak. AK
.Day phone 230-2264
Zip Code 995~ (, '~
.Zip Code 99516
Legal description (Sub'd., Block & Lot) Lot 83B, Alluvial Subdivision
Legal description (Township, Range & Section)
Lot Size 40,485 .Sq. Ft. Number of Bedrooms
Four (4)
THIS APPLICATION IS FOR ([] all that apply): THIS APPLICATION IS AN:
Absorption Field [] Initial []
Septic Tank [] Upgrade []
Holding Tank [] Renewal []
P~w []
Pdvate Well []
Water Storage []
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
(Signature of property owner or authorized agent)
PermitJRush Fees:
Date of Payment:
Receipt Number.
(Rev. 11/05)
Waiver Fees:
Date of Payment:
Receipt Number:.
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 522-6779 (FAX)
May 12, 2010
Municipality of Anchorage
Development Services Department
On-Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject:
Lot 83B, Alluvial Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The septic tank on Lot 83B, Alluvial Subdivision is failing and must be replaced. We
are proposing to replace the tank with a new 1,250-cjallon steel septic tank to serve the
four-bedroom home on the lot. The existing absorption trench will also be extended 15'
to comply with design requirements for a four bedroom home. We are therefore
requesting a permit be issued for the construction of a new septic tank and trench
extension. The attached Site Plan and backup documentation identify the location and
configuration of the existing septic system and the location of the new tank and trench
extension. Also identified on the plans is the existing well on the lot. The new tank will
be placed more than 100' from the well on this lot and those in the area. The existing
tank on the lot will be properly disposed on the property. The drainage patterns will be
maintained after construction.
The ground surface on the lot is basically fiat in the area of the new tank and in all other
areas. The new septic tank will be constructed near the location of the existing tank
and as parallel with the slope of the land as possible in conformance with Municipal
requirements.
If the tank is constructed in accordance with our design the following statements apply:
The tank, if constructed as designed, will have no adverse impact on the wells in
the area or those to be constructed in the future.
The tank, if constructed as designed, will have no adverse impact on existing
septic systems in the area or those to be constructed in the future.
Lot 83B, Alluvial
May 12, 2010
Page 2 of 2
The tank, if constructed as designed, will have no adverse impact on reserve
space, either surface or subsurface, on any lots located in the area.
The tank, if constructed as designed, will have no adverse impact on drainage
patterns in the area. The current drainage pattern will be maintained.
Sincerely,
Michael E. Anderson, P.E.
Attachments
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 (FAX)
MEMORANDUM
DATE:
June 2, 2010
TO:
Jay Crewdson, P.E.
FROM:
Mike Anderson, P.E.
SUBJECT:
Lot 83B, Alluvial Subdivision
Septic System Permit
We have revised the septic system upgrade to include an extension to the existing
absorption trench to meet design requirements for a four bedroom home. The
existing trench will be extended a total of 15' at the north end of the existing trench.
In addition, the owner of the property will contact the Municipal Tax Department to
request the number of bedrooms shown in the assessment of the property be
modified to four. Please modify the permit application to include the trench
extension and the four bedroom home.
Lot 8~A
S 89'53'30"E 135.00'
--CHAIN-UNK FENCE
Z
Lot 85B
40,485 s.f.
~CO
///
Four ~
Bedroom ~
Home
LEGEND
SV - Septic Vent
CO Cleon Out
MT - Monitor Tube
TH - Test Hole
Existing
Well
Lawn Area
N 89'52'58"W 155,01'
ALLUVIAL STREET
SITE PLAN
SCALE 1" = 40'
LOT 83B, ALLUVIAL SUBDIVISION
DESIGN FACTORS:
Four Bedroom Home
Perc. Rate: 1 to 5 Min./Inch
Application Rate: 1.2 OPD/SF
Existing Trench: Satisfactory forThree Bedrooms
SYSTEM REQUIREMENTS:
5' V~de Trench
1,250 OaIIon Septic Tank
4' Drainfield Rock
1 Bedroom X 150 GPD/1.2 GPD/SF (Application Rate) = 125 SF Absorption Area
125 SF/5 SFILF*.5 (Red. Factor) = 12.5 LF Trench Length
THEREFORE: Construct a 15' Long x 5' Wide x 4' Effective Depth Absorption Trench at the End of
Shown. the Existing Absorption Trench. Flow Line Elevation in Trench to be 4' Below Odginal
Ground Surface. Total Depth to be 8' Below Existing Ground. Provide 4' Cover Over Septic Tank
and 3' of Cover Over Absorption Trench, Maintain 100' Separation from Wells in the Area.
Natural
Backfill
Geotextile
-- Fabdc
4" Perforated
PVC (HoPes Down)
Drainfield Rock
TYPICAL 5' WIDE TRENCH SECTION,,,?~,,,,,,
(NO SCALE> o._~.'~..~...~,
NOTE: Grade Area Over Trench to D~n A~y . ~ __ ~ ~ ~ ~
Minimum 6, Separation F~m Bedeck. E.:2.~......;.....~.~....~...~
Minimum 4 Separation From G~un~ter. ~[~.~ ~
Minimum 100 Separation From Wells in ~e Ama. ~. -~'~";~;~'"'~
Minimum100 Sepa~tionFromSudacaWaterorS~eams..~.~ .o. c~, ~
Lot 80
Lot 83A
S 8g'53'30'E 135.00'
Lot 83B
40,485 s.f.
Z
$EFnc
50.6'
1,41
I
,
WELL
PLOT PLAN
N 89'52'58'W 135.01'
/
ALLU IA.J.. JSTREETI
AS BUILT X $CA~ 1' ,- 30' GRID NW 1457 Project No, 10-079
Long & Associates, inc.
(907)
522-6476
Registered Land Surveyors (oo7)
522-4525
kglangleOalaeka.net / JclangleOataeka.net
11500 Doryl Avenue, Anchorage; Alaska 99515-3049
Phone
Fax
I hereby certify that I have eurreyed the following described properly:.
Lot B3B. ALLUVIAL SUBO. (Plat No. 82-341)
Anchorage Recordlng District. Alaska. and that the Improvements eltuated thereon are
within the properly lines and do not encroach onto the properly adjacent thereto, that
no Improvemenf~ on the property lying adJaoent thereto encroach on the surveyed
preml~es and that there are no roadways, tranemleelon lines or other visible
eaeemenf~ on eald praperty except ae Indicated haman.
Dated thle the 'Z,'~'d' Day of ~¥ , .~, at Anchorage. Alaska
It la the msponslblllty of the owner to dete~nlne the existence of any easemenf~,
covenants, or restrlcflons whlch do not appear on the recorded eubdlvlslon plat.
,~~,/,, ~ MUNICIPALITY OF ANCHORAGE
?~'--'~.~, ~, DEPARTMENT OF HEALTH & ENVIRONMENTAL. PROTECTION
ENVIRONMENTAl. ENGINEERING DIVISION
i 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME lPHONE ! J~NEW
MAILING ADDRESS
LEGAL DESCRIPTION
~ ' ~ ~ NO, O~ BEDROOMS
J Well ~ ~sorption area / Dwelling ~ PERMIT NO,
~ Manufacturer ~ ~~ Material~~ No. of compartments~
~ ~ Liq. ca~tr¢~allons IF HOME.DE: Inside length Width Liquid depth
~ ~ Well Dwelling PERMIT NO.
j~Z DISTANCE TO:
O ~ ~ Manufacturer Material Liquid capacity in gallons
O Well Foundation ~ PERMIT NO.
~ OISTANOETO: ff ~'0 '~ ~ Nearestl°tline ~8~ ~ZdO 07
ND. Of lines / Length of each ,in~'~ Total length ofl,~ ' ~ 0 inches Distance eenlines
~ ~ ~ Top of tile to finish grade f Material beneath tile
~ ~ ~'~ inches Total effec~ve ~bsorption~ ~'~area
Length Width Depth PERMIT NO.
~ ~ Type of crib Crib diameter Crib depth Total effective absorption area
~ Well Building foundation Nearest lot line
¢ DISTANCE TO:
~ Class Depth Driller Distance to lot line PERMIT NO.
~ Building foundation Sewer line Septic tank Absorption area(s)
~ DISTANCE TO:
OTHER
PIPE MATERIALS
INST~LER ~, ~
REMARKS' ,/ ~ ' g ~ ~ t ~i~O f
! _¢: s o' ( 'rO s Tt7 2 a', '"
L
APPROVED DATE LEGAL
72-013 (Rev. 3/78)
L..E' .-_'~ R L.
iF-r'
]"~-!.F~ I t:-i'..F:iTLI F,~h'IF-'i'.J'::;T-hI'.j T'"-; THF: I:-',~.Jf?",L-! (.[.i'.,! I::E-~E"['.", F~L:' THE 'T'¢,F-'.~.,:'-.J Cl,l:;~'
Ti--!F' ....... I'"F'"C:'TL~:.~ . r=. CIF R TRF:'NCH iq~'_.. P!T~ Z:5 'T'NF-' ...... ,..F',*'::TF~h,iF:E'z ........ E'E'T'i,.!.E'E'N T~4~', ....... ::.-~:UF:F¢,C:E:
FkF-.'OL!i",E:, P, Nr.:, THE: ~:''TT,-,*,I nF .,.....ff., ,::
........... ~ ......... THE E',:.:h"_':R?F-!T'r ~' .' 'tN
THEF:E 1_':.--., NO :E;£T F. iZDTH FOR TF:ENCHE'.'5.
'r'NP qF.'-F¢,'~! r:,r-:'PT,Li: T:5 'THF ~.'IN'[h' t'4 E:,EP-FH n~:' ('3p¢,','~: FF.-"I-,I~F:,.i THE
F!h,ir) "FL-~:' B(?rTOh! C!F: TNE EL,F'.¢a, ,qT TEIN ,:: .T.N .... T).
Z H':_:;TF! ....... F,T 'J: OH I ,NSF'E'7:T T. !'.'!HS ('_' F FfN"r' !.,.IF:Z[ .L.E FE:,..:r~E:ENT 'FO TH ;r t..:.: PRCiPFZEFI-V F~!'.4_F:, T'WE
?.LF!E:E'~: OF .~:EJ::z';[DENC:EE; THP, T T'HE NELL i,.iILL EEF:'v'E
FEET FOF:.: !:i F'F:!'v'FITF._' lr,r!ELL (]? :.1.. ?$ ,.Z~ TC! 2;i:JE~ FEET
'T'.'.4E T ~,,-' ... F.'I!F.;! HELL.
...... ?. ~_ f"!F.' . ....... :[ C
hit ~4 T hll li',i...,., -, _. , .... , [;, T ~"Ffi~l'.~(.'.:E.,. ',:'~;, - I',~,..,, ¢:~., F'F?.;['v:FtTE !'.JELL "Fi_-! ~ .......... !::'i-? 1' ',.,h:.q'T'E
, '~'1 ~ ~' '~*
.... L,'J'~_,r'~.~. ;'? SEI4EF: !_~t",EE ZS '::'~;, ._. FEET
'F: I~ i u::'~ ~ !"':('IMF'! F."T T ("1,~.,i
L.Fi.'E:LE -F'O I NSLIRE: F%-:E~F'EF.': _T !",!STF!LL.FFF :[
,-:-~,4,, I ..'-:IF-'.'. :[ 'THE '! .... '"" ~" ' ...... * ...., .I .......................
J_ 'L' Rf"l F'F.t'..T. ...... !.,! TH F.:E!;!LI REHENT'.'5 FOF;: C!N--E;ZTE .::.~.~..b.F..::, H!',L., i F.u i ::;' ,.::,,::' ,:::r.: .....
FORTH E'.'.--' "['HE: HL
............... , t'.:, -, 1 .-.-, ! ~ H .E:.']
:~" Z "~ r'~''~-'~''-~m 'T'N~:!q" T..~.~':-' (]h~i.~...':.:.['T'l::' Ei:~!,!~.~'E: -,¢,'"Tr"-,~ ~"~""F',,,Tprz' ::?..~i F:i~'FW::'h'~':'h'T' ii:' 'r'~--~~::'
.... ,.. m~..,~.~...-. ~ mr-,h...,
fir-:.l::, T -'
T ,z',--'~ ll.C'l.'.':, F--.: ~,~
?CHNI CAL 8- DEVEL ~MENT '"
~O.
B~;× 90, Daviso,.~" Eagle Rive, Alaska 99577
694 '~- ~ '
~ ?~. or 688 2280
, ~sseft Oyste~ E/~r/
694 2774 SOIL LOG 68~ 228o
Soils ~ Foui~dations Land Development
Performed for:
Legal
Depth
Mailing Address:
Description' '
.... ,
(f__eet) Soil
Tel. No,
Characteristics
Ground Water Encountered: Yes c No
Proposed Installation: Seepage Pit
Comments:
If yes,
Drain Field
/
what depth__~
Performed by:__
APP~ OV E D
DATE
LEGAL
'1
l
8-EGE
Russell Oyste
694-2774
So;Is ~ Foundat;ons
TECH, NI CAL 8- DEV"LOPMENT
Box ~.~0, DaJis St., Eagle River, Alaska 99577
694-27?4 or 688-2280
SOIL LOG
Earl Ellis
68~-2286
Land D evel .op.ment
Performed for: Name: ~, ,L~ ~x¥~'7-/~ ~:J¢--,7-/~- /~" Tel. No. Mailing Address:
Legal Des~ .'tption: ~..o ;~- ~-~> .~,~ _...~5/_7c'~..-~-]. ~2~/~5-/,/, l~/Vv'; -~-~,,'~/,
D e ~ h___[_f, e_e_e .t_)_
S_9_11 CharacteristicE
13
Ground Xater Encountered: Yes- ~ No If yes, what depth //
Proposed Installation: Seepage Pit Drain Field
~ '~ .. 4~_2~:,4,~,~ X,,~ t,',,"~f~# :,.'.z'~£ /'M:~','~:,::z>~
Co~ents: 1~: ~ ~z,':?c:~c .....
Perfomed by:~ ~.~~/~..~ __" .~ 6
by
DOC Co. dba
SULLIVAN WATER WELLS
P.o. BOX 670272, CHUGIAK, ALASKA 99567 · TELEPHONE 688-2759
OWNER OF LAND ,..~'~'~.~
ADDRESS =?.J (o~(~
LEGAL DESCRIPTION
PERMIT NUMBER_.~TJ~X~ Da .~ of Issue__ __
TAX INDENTIFICATION NUMBER
Is well located at approved permit location?
[]~'r~rota ry
Method of Drilling: ~ I1
Depth of well: ~ _~' ~
I[],,~s I~ No
cable tool
BORE HOLE DATA
DEPTH ]
Casing Type ~Wall Thicknesso~ ,~ inches t i/
~5- ~ feet
Diameter ~ tl inches, depth
Liner Type: ~O,,~t ~'
Casing Stickup Above Ground: ~ ~
Static Water Level (from ground level): ~ ~
Pumping level: feet after hrs. pumping
Recover Rate: Z~ gpm
Method of Testing: /~. j .J~
feet
feet
gpm
RECEIVED
[~r~'en End ~1 Open Hole
feet Stopped feet
feet Stopped feet
Volume '~C)~ /- _/~ ~'
feet, to '-- feet
feet
.hp Brand Name
Well Intake Opening Type:
~ Screened; Start
~ Perforations Start
Grout Type: .~.',,~ ~'(~,",J¢I'
Depth: from ...~',3~ ~.~_.~
Pump Intake Depth:
Pump Size
Well Disinfected Upon C~il~on? 1O~s ~1 No
Method of Disinfection: .T-'~F_/~' 7",.~' .,~'o ]P~°~I/J
Comments: d. ~O A.~ ~J.~.
ivlu,,ic~paiity oi A-~;horage
Dept. Health & Human Sen,'ice8
ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality
of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. MatSu Borough:
Department of Environmental Conservation.
Driller's Name .27~~
Rick Mystrom,
Mayor
Municipality of Anchorage
Department of Health and Human Services
825 "L" Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
http://www.ci.anchorage.ak.us
343-4744
July 2, 1998
Sean D & Lori A Barnett
21624 Alluvial Street
Chugiak, Alaska 99567 5233
Subject: Lot 83B A~-lOzvi-al Subdivision
Permit #SW970168, PID #051-081-34
The subject permit, issued July 2, 1997 by this office for a
single family well and/or on-site wastewater system, has
expired as of July 2, 1998.
A new permit must be obtained from this office for a well
and/or on-site wastewater system NOT installed by the
expiration date.
If you have drilled the well, a well log must be sent to
this office for documentation of the installation and to
close the permit.
If a licensed Professional Engineer has inspected the
installation of the on-site wastewater system, the original
as-built inspection report must be sent to this office for
review, approval and documentation. Ail inspection reports
must be submitted within 30 days of construction completion.
When applying for a new permit, the fees are: $320.00 for an
on-site wastewater permit; $120.00 for a well permit and
$440.00 for a combined on-site wastewater and well permit.
If you have any questions, please call this office at 343-4744.
i~~s, pi~grS amCr~anag e~ g.~
On-site Services
enc: Copy of Permit
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 WELL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW970168
DESIGN ENGINEER:
OWNER NAiqE:BARNETT SEAN D & LORI A
OWNER ADDRESS:21624 SEAN ST
CHUGIAK, AK. 99567
DATE ISSUED: 7/02/97
EXPIRATION DATE: 7/02/98
PARCEL ID:05108134
LEGAL DESCRIPTION:
ALLUVIAL LT 83B
LOT SIZE: 40485 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT:
THIS PERMIT IS FOR THE CONSTRUCTION OF:
WELL 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 ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT)
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
RECEIVED BY:
ISSUED BY:
DATE:
APPLIC IT FILLS OUT UPPER HAl. NLY
owner
Phone
Pro~,.',rty
BuyerMailing Address ,~ ~" J ~i~-~ ~ '~' ~.~ /~,
Address ':"~' ~ (/'~ l~k~ ~. Zip CoOs
Phone
Lending Insti.tution ~
,!
Realty Co. & Agent -" Phone
Address L/~ O [~,.[ t .-~.. Zip~CoOe
Legal Description [--O Jr %'~ b %
Type of~esidence
L.~.,,~ingle Family
LI Multiple Family No. of Bedrooms
[] Other
Water Supply
~/~ndividual .~')../' ATTACH WELL LOG. A we~l log is required for all wells drilled since June 1975.
~' Community ;;' ' ' For wells drilled prior to that date, give well depth (attach Iog'if available).
[] Public Utility
Sewer Disposal
~dividual Year Individual Installed:
I~ Public Lltility When Connected to Public Utility:
[] 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 Inspector ~
~ · "Municipali~ 0f Anch0rag~"
,: "Dept. of Health
( ~ APPROVED BEDROOMS~ *CONDITIONS OF APPRO~[hu"mental
( )
( ) CONDITIONAL APPROVAL*
Well to Tank Septic T~k Size
72-023 (3182)
MUNICIPALITY OF ANCHORAGE '*
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL HEALTH CASE REVIEW WORK SHEET
~ PLATTING BOARD [] PLANNING & ZONING
CASE NUMBER
S-6095
DATE RECEIVED
January
27 , 1982
COMMENT TQ PLANNING BY
February 19, 1982
NAME
T15N R1W Section 5 replat of Lot 83
into Lot 83A, 83B
FOR MEETING OF CASE O~-
,,./'
P[~UB .UQWATER NOT AVAILABLE TO PETITION AR EA
~PUBLIC SEWER NOT AVAILABLE TO PETITION AREA
71-014 (Rev. 2/78)
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: (907)343-7904
On -Site Water & Wastewater Section Fax: (907)343-7997
Certificate of On -Site Systems Approval
OSC251379
Parcel ID 051 -081-34
Legal description ALLUVIAL LT 83B
Expiration Date: 5/13/2026
Site address 21624 SEAN ST
Current property owner(s) BARNETT SEAN D
X The On-site system(s) is/are approved for 4 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or conditions:
By: Original Certificate Date: 9/9/2025
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 Service 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 submittal.
ATTACHMENTS:
COSA Checklist X Well Flow Advisory
Absorption Field Advisory Nitrate Advisory
Tank Age Advisory Arsenic Advisory
Other
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 051-081-34
Complete legal description Alluvial Lot 83B
Location (site address) 21624 Sean Street
Current property owner(s) Sean & Lori Barnett
2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS
Day phone (907)306-1882
3. TYPE OF WATER SUPPLY: X Private Well serving # 1 dwelling units
r_1 Other Non-public well as regulated by MOA Fl Water Storage
R Community Well or Public
4. TYPE OF WASTEWATER DISPOSAL: Fol Private Septic F Private Septic serving 2 dwelling units
El Holding Tank R Community Septic or Public Sewer
5. SEPTIC TANK: 100 Steel n Plastic n Concrete n Fiberglass
Age 15 - See advisory if steel or fiberglass older than 20 years
6. ABSORPTION FIELD: E] AWWTS R Bed RN Deep Trench R Wide Trench R Seepage Pit
Waiver request for:
Expedited review requested: r-1
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 $ �So
Date of Payment
COSA#
Waiver Fee $
Date of Payment
Waiver #
COSA Application_Apr2025.doc
COSA Checklist
Legal Description: Alluvial Lot 83B
Parcel ID: 051-081-34
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system _
A. WELL DATA
R Well log is filed with Onsite (or attached)
Date drilled 7/7/97 Total depth 65.5 ft
Cased to 65.5 ft
R Sanitary seal is functioning correctly
R Wires are properly protected
Casing height (above ground) 28 in.
Date of flow test for COSA 8/14/25
Static water level at beginning of test 12 ft.
Comments
B. TANK DATA
Measured operating fluid level in septic tank 48
Date of pumping 5/13/25
171 eq i Hanc�comp�leted, �AWWTS
Comments:
D. DISPOSAL FIELD DATA
Which system tested (date installed) 12/31/89*
FE11 ALL standpipes present per record drawing
Total measured depth from grade 7.25 ft (max)
Measured depth to pipe invert from grade 3.25 ft (min)
❑ N/A — pressurized field.
❑ Per record drawings, field is insulated.
A Monitor tubes go to bottom of effective.
If not, state depth into effective
P'r
Req ' if h
esoaked requd if,
(ouseirevacant or field not used for more
than 30 days r to date of test)
Gallons introduced gallons date
Any rejuvenation treatment (past onths)
If yes, enter date
Well production at time of test 5.9 gpm
Water storage tank volume N/A gallons
Well disinfected for coliform test? ❑ Yes O No
R Coliform bacteria is Negative
Nitrate 4.34 mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L Arsenic less than MRL (ND)
Collected by Forge Engineering
Date 8/14/25
FT STATION
❑ Require inti
Age of lift station .
Lift station material
Comments:
completed
Adequacy test date 8/14/25
Results ` Pass
Fluid depth prior to test 0 in
Water added 772 gal
New fluid depth 0 in
Elapsed time 1440 min
Final fluid depth 0 in
Absorption rate '600 gpd
FIELD STATUS — POST RECOVERY
Effective depth (per record drawings) 48
Effective depth used 0 in
Effective depth remaining 48 in
Comments/Deficiencies: *Field upgraded 7/3/2010, 15' added
COSA Checklist_May2025.docx
in
E. SEPARATION DISTANCES
From Well on Lot to: (Please enter distances if less than required)
Septic Tank/Lift Station on Lot > 100'
Yes
Sewer Manhole/Cleanout > 100'
ft
n Yes
if No
ft
n Yes
if No ft
Neighboring Tank > 100' 2 Yes
if No
ft
Sewer Service/Septic Line > 25'[E Yes
if No ft
Disposal Field on Lot > 100' no Yes
if No
ft
Holding Tank > 100' R Yes
if No ft
Neighboring Disposal Fields > 100'
Field to Property Line > 10'
Animal Containment > 50' 2 Yes
if No ft
Yes
if No
ft
Water Main/Service Line > 10'
n
Yes
if No
ft
Manure/Animal Excreta Storage > 100'
Sewer Line/Main > 100' Q Yes
if No
ft
n Yes
if No ft
❑ N/A — Served by Community Well (not on lot) or Public Water
From Septic/Holding Tank and Disposal Field(s) on Lot to: (Please enter distances if less than required)
Tank to Foundation > 10'
Yes
if No
ft
Surface Water > 100'
n Yes if No ft
Field to Foundation > 10'
Q
Yes
if No
ft
Wells on Adjacent Lots:
Tank to Property Line > 5'
0
Yes
if No
ft
Wells > 100'
R Yes if No ft
Field to Property Line > 10'
Yes
if No
ft
Community Wells > 200'
Yes if No ft
Water Main/Service Line > 10'
n
Yes
if No
ft
If tank or field is under driveway comment below
F. ENGINEER'S COMMENTS
G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based
on procedures outlined in the Certificate of On -Site Systems Approval Guidelines, indicates that the on-site water
supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation, unless noted otherwise.
Name of Firm Forge Engineering
Engineer's Printed Name Benjamin Schiller, P.E.
COSA Checklist May2025.docx
Phone (907) 522-7773
Date 8/15/25
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Benjarrih-Schiller .'
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