HomeMy WebLinkAboutALPINE VILLAGE BLK 5 LT 2Alp ne Village Block 5 Lot 2 #014-132-11 January 10, 1986 TO: Permit Applicant P.O. SOX 66E0 A�•JCH(DRAGE, ALASr',A 99502-OuuO (907 ) 264-4111 T'n _,Y K,%C'ALE �. ;P DEPARTMENT OF HEALTH & HUMAN SERVICES Subject: Permit # 850480 Lot 2 Block 5 Alpine Village Subdivision A permit issued by this Department for an individual well and/or on-site sewer system has expired as of December 31, 1985. Permits are issued on a calendar year basis by authority of Municipal Ordinance. A new permit must be obtained from this Department for any well and/or on-site sewer system not installed by the expiration date. If you have drilled the well, a well log needs to be sent to this Department for documentation of the installation and to close the permit. If a private engineer inspected the installation of the on-site sewer system the original as -built inspection report(three part form) must be sent to this office for review and approval,and for documentation. If there are any further questions, please call this office at 264-4720. Sincerely, Susan E. Oswalt Program Manager On-site Services SEO/ljw enc: Copy of Permit .SL P-1 Q_J NO I C! I L._...:I `V " a" MEI F=" 94 VA Cl Vi C3 FT 64 C3 ME.` DEPARTMENT OF HEALTH AND ENVIRONMENTAL. PROTECT I Oh 825 L" STREET, ANCHORAGE., AK 99501 264-4720 - 4_3 P4 -- E30 1 Mme.` W U- L..".. L_.. M=" IEE F;: M T "T'" PERMIT NO: 850480 DATE ISSUED: oa/0005 APPLICANT: JAMES PROFFER ADDRESS: 7432 ZURICH ANCHORAGE, AK 99507 CONTACT PHONE.: 344-4797 LEGAL DESCRIP: SUBDIVISION: ALPINE VILLAGE LOT: 2 BLOCK: 5 SECTION: 24 TOWNSHIP: 12N RANGE: 3W 1....OT SIZE: 8450 (SQ.FT. OR ACMES) ]: certify that: 1. I am familiar with the requirements for on -"site sewers and wells as set. forth by't.he Municipality of Anchorage (MOA) and the State of Alaska. 2. I will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit.. 3. I will -adhere to all MOA and State.of Alaska requirements for the set bark distances from any .existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. SI GNED /__ DATE: APPLICANT: J AME F" OFFER ISSUED 1+ DATE: • �'� mss- December 31, 1979 Tames Proffer 7227 Zurich Street Anchorage, Alaska 99507 8) 2 5 "E_" STIZEET !aNCI-'ORAGE, AI_.ASKA 9� 501 , ) 264 ,f 1 I ;r- M. ,Ut �.iVAN 011".MH`.i� f /' I P'_;0 tiC"�1(7?; Permit tt 781021(Extended Permit for 1979) 'Subject : 2 i:7_oc'- 5 1•.l.pinr• `I .i l_laqe Su-,alivision A permit issued by this department for well and/or sewer system has expired. Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal ordinance. If you have drilled the well, a well log should be sent to this department to document the installation date. If an engineer has inspected the installation of the onsite sewer system, please have them send us the as-builts for our files. If there are any further questions, please contact this office at 264--4720. Sincerely," /_ttz /)'6 Les N. Buchholz,R.S. Senior Environmental Speci st LNB/ljw enc: Copy of Permit Mt—l" 11G 1 F . it— I -FV "F*` Fl r-4 (:: " k_ . ,. F=l C.3 [=— DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 "L' STREET.. ANCHORAGE, AK. 99501 264-4720 L4 E=— L_ L_ F::'[=— FZ rwl I -r PERMIT NO. ( 781021 ) APPLICANT JAMES PROFFER 7227 ZURICH ST 344 4797 LOCATION 7432 ZURICH LEGAL L2 85 ALPINE VILLAGE S/D LOT SIZE 8450 SQUARE FEET MINIMUM DISTANCE BETWEEN A WELL AND ANY ON—SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL; OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F::`&E f-rc". M I -V r=- X F=' X FZ EE � E> FEE C FEE M 0 r=— FZ =r, -1 , :l_ SDI"F:E: I CERTIFY THAT 1: 1 AM FAMILIAR WITH THE REQUIREMENTS FOR ON—SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: 1 WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. s I (3t, I SSL /.���Vzrr V3. 2 July 7, 1975 Mr. Lynn Coad GAAB — DEQ 330 C Street Anchorage, AK 99503 Subject: Lot 2, Block 5, Alpine Village Subdivision Dear Mr. Coad: Subject to the suggested conditions in your letter of July 2, 1975, we have no objection to the placement of the well 90 ft. from the seepage pit on the subject property. Yours truly, 115�0 Kyle J. erry, P E. Regional Environme al Supervisor JAY S. HAMMOND, Governor DEPT. OF ENVIRONMENTAL CONSERVATION ' SOUTHCENTRAL REGIONAL OFFICE !/ SOUTHCENTRAL REGIONAL OFFICE MACKAY BLDG. 338 DENALI STREET ANCHORAGE 99501 July 7, 1975 Mr. Lynn Coad GAAB — DEQ 330 C Street Anchorage, AK 99503 Subject: Lot 2, Block 5, Alpine Village Subdivision Dear Mr. Coad: Subject to the suggested conditions in your letter of July 2, 1975, we have no objection to the placement of the well 90 ft. from the seepage pit on the subject property. Yours truly, 115�0 Kyle J. erry, P E. Regional Environme al Supervisor 1-11d7'rl I6-0 IA., -e- /l July 26 1975 8Bard 2 N Anc3mra"s Alaska 9999 erect: Lot 3,, Block 5 Alpine Village Subdivision fter it. Niggard: Affording to our records the wells in the area of the subject lot run fhe 1041 deep to 1351 deep. The ally well existing on the subject let is it* close to the serer on lot one and its am old serer systaa. This well would need to be plumed with an iwparvious ssterial such as cement. If YOU have any quail ns* please call V4 -Ml extension 133. Sincerely. Lynn Coad Sanitarian II LC/ab FROM INTER -OFFICE MEMORANDUM GREATER ANCHORAGE AREA BOROUGH DEPARTMENT: lX/ SUBJECT:.. INITIATED BY: DATE OF MEMO:�1'%/-,. DATE ANSWER TO: DEPARTMENT: REQUESTED: REQUESTED: RECEIVER: MESSAGE: REQUESTED ACTION SCHEDULE ®s' SIGNATURE MUNICIPALITY OF Development Services Department On -Site Water & Wastewater Section Parcel 1. D. 014-132-11 ANCHORAGE Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Phone: 907-343-7904 Fax: 907-343-7997 Expiration Date: -7 - Z —202-0 Complete legal description ALPINE VILLAGE BLK 5 LT 2 Location (site address) 7416 ZURICH ST, ANCHORAGE AK Current property owner(s) Mailing address Real estate agent DAVID MOLLETTI Day phone SAME 2. TYPE OF DWELLING: El Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic ❑ Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer 0 Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ qt/2 Date of Payment !l / 9 1;2%.2D Receipt Number / �®�in COSA# Cq6il3,� Waiver Fee $ Date of Payment Receipt Number 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm MIKE N ANDERSON, P.E. Phone 727-8864 Address 4661 NATRONA AVE ANCH AK Engineer's Printed Name MIKE N ANDERSON, P.E. Date 3-25-20 X, ,� Original Certificate Date: I-(- Z _z ©Zo 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 0r 4 6. DSD SIGNATURE p. ° ; .,.,,.. °:....:�.... , . 0 ° 3 System #1 Approved for bedrooms • ...: ; . ............ System #2 Approved for V MICHAEL N. ANDERSON bedrooms ¢ `�,'•• CE 94 9 Disapproved i, (.�- • • 2 70. •'�`� , Conditional approval for bedrooms, with the following stipulatio��d0d���� 3-CeC90Jc.c?,-- lisle -fin Sec,,rP✓ SP6�110 Cr --'- IA 0 X, ,� Original Certificate Date: I-(- Z _z ©Zo 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: ALPINE VILLAGE BLK 5 LT 2 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled UN Total depth ft Cased to ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 30"+ in. Date of flow test for COSA 3/20120 Static water level at beginning of test 51 ft. Comments B. TANK DATA Age of tank(s) years Tank type/material Measured operating fluid level in septic tank ❑ Standpipes/foundation cleanout per record drawing Date of pumping D. ABSORPTION FIELD DATA AWWU SEWER SERVICE Which system tested (date installed) ❑ ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade 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: 014-132-11 Structure served by this system Well production at time of test 2.6+ qpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by MNA Date of Sample 3/20120 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date Results ❑Pass For bedrooms Fluid depth prior to test in Water added gal New depth in Elapsed time min Final fluid depth in Absorption rate 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' ❑ Yes if No Community Sewer Manhole/Cleanout > 100' ❑ Yes if No ft ❑✓ Yes if No ft Neighboring Tank > 100' Z Yes if No ft Private Sewer/Septic Line > 25'[D Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No ft Holding Tank > 100' Q Yes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' ❑✓ Yes if No ft Z Yes if No ft ft If septic tank is under driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' 0 Yes if No ft Q Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No ft Surface Water > 100' ❑ Yes if No ft Property Line > 5' ❑ Yes if No ft Wells on Adjacent Lots: ❑ Yes Absorption Field > 5' ❑ Yes if No ft Private Wells > 100' ❑ Yes if No ft Water Main > 10' ❑ Yes if No ft Community Wells > 200' ❑ Yes if No ft Water Service Line > 10' ❑ 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' ❑ Yes if No ft If absorption field is under driveway comment below Property Line > 10' ❑ Yes if No ft . Wells on Adjacent Lots: Water Main > 10' ❑ Yes if No ft Private Wells > 100' ❑ Yes if No ft Water Service Line > 10' ❑ Yes if No ft Community Wells > 200' ❑ Yes if No ft Surface Water> 100' ❑ Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION I certify that / have determined through field inspections and review .vM v ° ° ° °41 �` ;� ° ° ° ` er�-�q of Municipal records that the above systems are in conformance with MOA COSA in t�; •°;. °o°� =�k guidelines effect on this date. s MICHAEL N. ANDERSON f CE79 69 ° el. COSA Checklist yellow sheet '' ° • • ° ° , F�� �' r?jjrcSC 1���m G& $y • Municipality of Anchorage On -Site Water and Wastewater ProgramSUB < (907) 343-7904 s A ; 7 r JAN 2 8 Parcel 1. D. 014-132-11 Certificate of On -Site Systems Approval Expiration Date: - V 1. GENERAL INFORMATION / ',-J Complete legal description Alpine Village, Block 5, Lot 2 Location (site address) 7416 Zurich St. Current Property owner(s) James Stephen Laughlin Day phone Mailing address 6438 Sw Rose St. Culver, OR 97734 Real Estate Agent I Day phone 2. TYPE OF DWELLING: El Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well I] Individual ❑ Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer . Q Waiver/Variance request for: Distance: Received I: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 61;k( Waiver Fee $ //Date of Payment � 9f//q Date of Payment Receipt Number 032-ict 6 Receipt Number COSA# O5C-IgIol� 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. Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone Date 1/13/2014 6. DSD SIGNATURE __/System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the following stipulations: BY E / ( / 2 Original Certificate Date: The M icipeli'f Aro rage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representa ions 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 blue sheet £ b c If more than 1 septic system is on the lot: COSA Checklist # _L_of 1 Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: Alpine Village, Block 5, Lot 2 A. WELL DATA Well type Private If A, B, or C provide PWS ID # Date completed Sanitary seal (Y/N) Y Total depth ft. Cased to ft. FROM WELL LOG Date of test Static water level Well production WATER SAMPLE RESULTS: ft. Parcel ID: 014-132-11 Well Log (Y/N) N Wires properly protected (Y/N) Y Casing height (above ground) 18+ in. AT INSPECTION 1/10/2014 52 g.p.m. 3.0+ Coliform colonies/100 mL Nitrate LJ 1 mg/L Arsenic 7--7 I ug/L Date of sample: (v /)L-0 N B. SEPTIC/HOLDING TANK DATA Tank Type/Material Tank size gal. Number of Compartments_ Foundation cleanout (Y/N) _ Depression over tank (Y/N) Date of pumping C. ABSORPTION FIELD DATA Pumper Date installed Soil rating (g.p.d./ft2 or ftz/bdrm) Length ft. Width Collected by: PtjS Date installed ft. Cleanouts (Y/N) High water alarm (Y/N) System type ft. Gravel below pipe ft. Total depth ft. Eff. absorption area ftz Monitoring tube _ Depression over field _ Date of adequacy test Results (Pass/Fail) For _ bedrooms Fluid depth in absorption field before test in. Water added gal. New depth in. Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p,d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed Size in gallons _ "Pump on" level at in. "Pump off' level at Datum Cycles tested _ E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main 75+ Sewer /septic service line 25+ Animal containment areas 100+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation Water main Wells on adjacent lots ABSORPTION FIELD ON LOT TO: Property line Water Service line Curtain drain F. COMMENTS G. ENGINEER'S CERTIFICATION Property line _ Water service line Building foundation _ Surface water Wells on adjacent lots Manhole/Access (Y/N) _ in. High water alarm level at Meets alarm & circuit requirements? On adjacent lots 100+ On adjacent lots 100+ Public sewer manholelcleanout 100+ Holding tank 100+ Manure/animal excrete storage areas 100+ I 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. Engineer's Printed Name Steven R. Pannone Date 1/1312014 COSA brown sheet -1 0-10-1 2.doc Absorption fie Surface water Water main Driveway, parking/vehicle storage in. v -4M � 0 GO -',n m>ME n m"'z r z0E m � 0 _° 0 N x0 O m;D _;u0 X00 oAi ?oM M -4 Z 0 T W D QO vy' a 0 Zry� 'W W r0. r- cyl O CO NXII o E wom g� 01 00, Er O 1� '8-=Vw s'i � w rJ3 ,f�w. O CD M J+•' � ' Si t � • •dam M �O '3'3v��aw o°.1mAy.3nnav3� gm QO vy' 1 r0. 1 E wom g� 01 2 Er O 1� '8-=Vw s'i a� M n o _ p �O '3'3v��aw G•a'� A ay xa'aEr m� 5.3 ix n7 -c1 a5n m 10 cD w� iD�s 0 2 m�iu 6oaa�"m N an 9' m 4 w� �0 PL Me w s N 3 n r O y N00007'00"W 65.00 10' Utility Easement ---- — — — — — — — QJ(D 3 r-----, I I I I 10.3 I ( 10.0 I I � I o I I � { I �n I < I 3 �@v fD in N d I( 10.0 I 11.1- 1 { I I 0 I m I I I I I I v I I I I � N00007'00"W 65.00 ZURICH STREET 8392E W O O O OD co N M