HomeMy WebLinkAboutT12N R3W SEC 15 LT 47T12N R3W
Sec. 15
Lot 47
#015-052-15
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No. 3514.5
1lUAVEYOR'S CERTIFICATION
1 HLNESY CERTIFY THAT I HAVE SURVEYED
PPOPERTY DESCRIBED ON THIS PLAT AND
/J o° 0.5 IV,/ /is. oz I
LEGEND YS ( Soy
R'hAr 4'.,,04 CNsy-rec D<d�
FOUNDATION
--�.—
DRAINAGE ARROWS �t
7-4i r //f'�✓%�f JurvtY bu^1 6At<� ow �L MvuJ !w
NOTESI fIAA.lRd./T.�A� were f; d Ar•�b..�✓ (N.,..,...,A)
1. IT SMALL EE THE RESPONSISILITY OF THE IIUILOEE ON OWNER TO VtWIFT tHAI
WILDING LOCATION SHOWN MEETS ALL SUBDIVISION COVENANTS AIID TONINS
ORDINANCES. - - -
t. IT IN THE IIE@PONSISILITY OF THE SUIL610 TO VERIFY ALL ELEVATION@ WITH
.RESPECT TO ALL UTILITIES, a DRAINAGE.
@. THIS PLAT REPRESENTS THE PARCEL OF PROPERTY OESCRIAED SELOW TAKEN
FROM THE RECORDED PLAT DESCRIBING THAT FARM. INSTRUMENT@ RECORDED
PRIOR TO OR A/TER THE FILING.OF -THE REOOROED PLAT'ANE NOT SHOWN ON
(HIS PLAT.'_....
4. THE INFORMATION Off THIS PLAT 10 FOR THR
F LENDING INItITUTION
SPECIFICALLY TO Mill ANY CONFLICTS SETW� MOS'y (TING STRUCTURES ANO
PLATTED LOT LINES ON EASEMENT* , THE PLAT IE NOT TO SE USED FOR
POSITIONING ADDITIONAL STRUCTURES OR PENCE*.
011W
Gf #TER ANCHORAGE AREA F 'OUGH
Department of Environmental Quality
3500 Tudor Road
Anchorage, Alaska 99507
^T INSPECTION REPORT OSI—SITE SEWAGE DISPOSAL SYSTEM
NAMET'�L:-�� ` � � .(1 -i -L - MAILING ADDRESS Lo-, q5u PHONE
LOCATION ?��,;py� .� JJ``��. (}rJ (.-�_ LEGAL DESCRIPTION
A.
�jt--.._—�--_ _
SEPTIC TANK
DISTANCE(( NUMBER OF
FROM WELL ���'— MANU FACTU PER `_>�`S(e, MATERCOMPARTMENTS
/52L'
INSIDE LENGTH _— INSIDE WIDTH. —LIQUID DEPTH --LIQUID CAPACITY_ GALLONS.
SEEPAGE PIT:
/ r
NUMBER OF PITS __L_. DIAMETER -___OR WIDTHa , LENGTI-i`� //, DEPTH
LINING MATERIAL ''(-� CRIB SIZE: DIAMETERSTDEPTH_ DISTANCE FROM: WELL
I, TOTAL EFFECTIVE
BUILDING FOUNDATION! O f-, NEAREST LOT LINE .?6) ABSORPTION AREA (WALL AREA) SO. FT.
ADDITIONAL ABSORPTION
WELL
TYPE OSL-I aiL PLc&Lce CONSTRUCTION- '<UJ, DEPTH_ DISTANCE FROM:
BUILDING i NEAREST NEAREST SEPTIC - SEEPAGE
FOUNDATION. ��> �C �"','7 LOT LINE_�L� -- SEWER LINE -2.0 { TANK Jf_2_SYSTEM.
CESSPOOL A)N' Z21,"`OTHER SOURCES
i
APPROVED_ L_DISAPPROVED
DISTANCES:
INSTALLED BY: _OLILC.EL�>K �`-
PIPE MATERIAL: J "Y' —
LOT SLOPE
REMARKS:
'
>1s j
REMA
DIAGRAM OF SYSTEM
d '
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ya VNJA
J
LVLat
'g 3[)i L�nK 5 13ielJZ cY"n�5 .
y
DATE C�. �- i%Z — APPROVED 2lis•.
G.A.A.B.
GRE PE=R ANCHORAGE AREA BC DUGH
DEPARTMENT OF ENVIRONMENTAL QUAL.1'Y PERMIT NO.
3500 TUDOR ROAD POUCH 6.660
ANCHORAGE. ALASKA 98502
TELEPHONE 279.66B6
SEWAGE DISPOSAL. SYSTEM m APPLICATION AND PERMIT
NAME OF APPLICANT
` "" _
INSTALLATION LOCATION __—�—_) /_, ':. ..
LEGAL DESCRIPTION 'T) 2' /✓ R3 L" c
INSTALLATION OF: SEPTIC TANK ._ n SEEPAGE:: PPI -T -J, '_ ////Djjpii,7rAIN FIELD r OTHER
TYPE AND SIZE OF FACILITY TO BE SERVED `.dL��"L}��r �- "yL�L
FINANCED THROUGH _.�:_____.���—_ TO BE INSTALLED BY
SOIL TEST -RESULTS ��91• -- NOTE, THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
COMPLETION DATE ANTICIPATED
FINAL INSPECTION, 24 HOUR
NOTICE REQUIRED. BACKPILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION MY THE
HEALTH DEPARTMENT AUTHORITY WILL ME SUBJECT Y'O PROSECUTION.
SEPTIC TANK SIZE .... "'.�_
TYPE SEEPAGE AREA SIZI[
l` / ��—
TYPE
MINIMUM DISTANCES, RMQUIRMMMNTS
,
FOUNDATION TO SEPTIC TANK _ 7 --- --.
i
FOUNDATION TO SEEPAGE PIT _, �1 DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT WALL
SEPTIC TANK _�.�.._..._. SEEPAGE PIT DRAIN PIEL13
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK - d'" "-- SEEPAGE PIT_e,
DRAIN FIELD ___ _, ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK SEEPAGE PIT �.
DRAIN FIELD
SEP`T'IC TANK, !� �I_�_, SEEPAGE PIT DRAIN FIELD
TO RIVER, LAKE. STREAM,
CAST IRON INTO AND OUT OF SEPTIC TAN/( AND INTO CRIS CROSSING GAP OF
EXCAVATION 0 FEET INTO U��I�TUABRq BOIL,
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC: TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REhIOVABLB CAPS.
GRAVEL BACKPILL,
CONFORM TO BOROUPH-,RIEOULATIONB REGARDING INSTALLATION
HEALTH AUTHORITY
OR
LICENSED DE91GNE11
DIAGRAM OF SYSTEM
'C"
T AT 1 AM FAMILIAR WITH TWE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE
DEB CFI Eb BY EM I!1 IN ACCORDANCE WITH SAID CODE.
DAT�'yAPP4.ICANT'S SIGNATURE
34 3 z Pd It
UBMITTA
• -� Muni patYlty24KZXac orage V
On-Site W 11�s�gy�IWProgram
907) 343-7904
5A FIY
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel l.D.015-052-15
1. GENERAL INFORMATION
Complete legal description T12N, R3NV, Sec 15, Lot 47
Expiration Date: )2-3-1,5-
Location (site address) 9340 Carlson St, Anchorage AI{ 99507
Current Property owner(s) David Vought Day phone
Mailing address 9340 Carlson St, Anchorage AK 99507
Real Estate Agent Day phone
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3, NUMBER OF BEDROOMS: 5
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
®
Individual
Individual Water Storage
❑
Holding Tank
❑
Community Class Well
❑
Community
❑
Public Water System
❑
Public Sewer
❑
Waiver/Variance request for: Distance:
Received by: `Aw 0`e Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee
Date of Payment b $([
Receipt Number iRlB,113
COSA #i
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.
Name of Firm Mike N. Anderson, P.E. Phone 727-8864
Address 4661 Natrona Ave. Anch. AK 99516
Engineer's Printed Name Mike N. Anderson
6. DSD SIGNATURE
System #1 Approved for
System #2 Approved for
Disapproved.
Conditional approval for
M
PE Date 08/27/15
,b�mawdp�
OF A.
��q.,....:. 9�
•�..
X. ..................
V0 MICHAEL,NANDERSON ;Tom' dA
bedrooms. e�jtt9f�9a
_ bedrooms. 1a,`"�`�t„►
bedrooms, with the following stipulations:
Original Certificate
The'MuniWaliV( ge 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
Septic System Advisory
Well Flow Advisory
COSA blue sheet 10-10-12.doc
Nitrate Advisory
Arsenic Advisory
Other
If more than 1 septic system is on the lot:
COSA Checklist # _of _
Structure served by this system _
Certificate of On -Site Systems Approval Checklist
Legal Description: T12N, R3W. See 15, Lot 47 Parcel ID: 015-052-15
A. WELL DATA
Well type Private If A, B, or C provide PWSID # _ Well Log (Y/N) N
Date completed Pre -1972 Sanitary seal (YIN) Y Wires properly protected (Y/N) Y
Total depth 196 ft. Cased to 196 ft. Casing height (above ground) 18 in.
FROM WELL LOG AT INSPECTION
Date of test 812812015 -see well flow- John Netherton
Static water level ft. 126 ft.
Well production g.p.m. 4+ g.p.m.
WATER SAMPLE RESULTS:
Coliform
NEG
colonies/100 mL Nitrate 2.12
mg/L
Arsenic:
6.82
ug/L Date of sample:
7/2812015
Collected by: Mike Anderson
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC I STEEL Date installed 1011911972
Tank size 1500 gal. Number of Compartments 2 Cleanouts (Y/N) Y
Foundation cleanout (YIN) Y Depression over tank (Y/N) N High water alarm (Y/N) NIA
'Date of pumping -812812015 Pumper AROUND THE CLOCK
C. ABFtORP,TION FIELfY'DATA -1985 SYSTEM TESTED
[Sate n§talled9 110 911972 Soil rating (g.p.d./ftp or ft2/bdrm) 225 sflbdrm System type LOG CRIB
Length 34 f# Width 30 ft. Gravel below pipe 9.0 ft.
Total depth 43.2 It Eff. absorption area 1125 ft2 Monitoring tube Y Depression over field N
DAf ..of adequacy test 612212914 Results (Pass/Fail) PASS For 5 bedrooms
Fluid.depth'ih'absorptioO field before test 61 in. Water added 800+ gal. New depth 66.5 in.
Elapsed Time:' ' 1200 min. Final fluid depth 59 in. Absorption rate >= 800+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) UNKNOWN If yes, give date
D. LIFT STATION
Date installed Size in gallons Manhole/Access (YIN)
"Pump on" level at in. "Pump off' level at in.High water alarm level at— in.
Datum
E. SEPARATION DISTANCES
WELL ON LOT TO:
Cycles tested Meets alarm & circuit requirements?
Septic tank/lift station on lot 80'+ PRE 1973 *"
Absorption field on lot 1001+
Public sewer main 754
Sewer /septic service line 251+
Animal containment areas 1001+
SEPTIC/HOLDING TANK ON LOT TO:
On adjacent lots 1004
On adjacent lots 1001+
Public sewer manhole/cleanout 100'+
Holding tank 100'+'
Manure/animal excrete storage areas 1001+
Building foundation 5'+ Property line 54 Absorption field 51+
Water main 104 Water service line 10'+ Surface water 100'+
Wells on adjacent lots 1001+
ABSORPTION FIELD ON LOT TO:
Property line 101+ Building foundation 10'+ Water main 101+
Water Service line 101+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain 50'+(NonaKnown) Wells on adjacent lots 100'+
F. COMMENTS
"* Septic installed Aor to 1973 when 100' radius was required. 15cA hl
GNlti FOPh�+ �HS%n'Yn i$'^Srfl%O �ai�,
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MPA COSA guidelines in effect on this date.
Engineer's Printed Name Mike N ANDERSON, PE
Date 0812812015
COSA canary sheet_2-6-15.doc
OF AlsJi
o. .....
MICHAEL PL .4Nocoen:, •d
Rore
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AFM euna msAac
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30,
42
47
I
N90° 00'00'W 280.23'
WELL
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EXISTING
STRUCTURE S, F
52.7 b O r„ ._
4 m e
LILLESTON STREET
- — -- - ------------------------------
I
UNDER NO CIRCUMSTANCES SHOULD AN AS -BUILT BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE LINES.
THE SURVEYOR TAKES RESPONSIBILITY FOR THE INITIAL TRANSACTION ONLY
AND ASSUMES FINANCIAL UABIUTY ONLY FOR THE COST OF THE SURVEY.
LISTED DISTANCES PREVAIL OVER SCALING. REPRODUCTION MAY CAUSE ERRORS IN SCALE.
Lar suROEY SURVEY TYPE
SYMBOLS
FOJNOA71ON AS-B1tlLT
• SET REBARO ASPHALT
;w DRAINAGE
FI.AL LIAE As-BxLTrm
[ISTRVC7
ElLOT SNQUIURVEY TOPDGMAPNY
O FOUND REBAR 1-e- g WOOD FENCE '.�CONCRETE
PLOTPTA.... AS -BALI ... ...
®ASSUMED ELEV. j( If X METAL FENCE ® WOOD DECK
T... NO i... NO O=*3RS SET
PLOT PLANS & LOT SURVEYS
NOTE:
IT IS THE RESPONSIBILITY OF THE BUILDER OR OWNER. PRIOR TO
ONLY THOSE IMPROVEMENTS ABOVE GROUND AND VISIBLE WILL BE
CONSTRUCTION, TO VERIFY PROPOSED BUILDING GRADE RELATIVE
SHOWN. FENCES, WELLS, SEPTIC CLEANOUTS, SIDEWALKS, DRIVEWAYS,
TO FINISHED GRADE AND UTILITY CONNECTIONS AND TO DETERMINE
ETC.. ARE SHOWN IN THEIR APPROXIMATE LOCATION, ONLY. SNOW
THE EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS
MAY PREVENT SOME IMPROVEMENTS FROM BEING SEEN AND LOCATED.
WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT.
ALL DISTANCES ARE RECORD UNLESS OTHERWISE NOTED.
SURVEY CERTnCATION•rrrrK
•••�,
����
Prepared by
Robert E. Johns, Jr. &Assoc.
PLOT PIAN
.,.,..W,..I--Na+wbr.wa
M M bw, w1 YsIM I,e•N M M•! I
sip* „q�
♦ �P,.• ••.�j
Professional Land Surveyors
M1aw MyM a tlMOYI,M M tl Aw lel wn,w.
,� : ••
1700 Brink Drlve.
ANCHORAGES ALASKA 995d4
luw.el1e'.: dame w..rw .m"_
�`
Scale: 1v = 50'
Rec. Lot S.F.
Rec. Plat File No.
j �••
FOIJNDA710H AS -BUILT
•
Date Surve d:
'` 10/20/14
Drawn b .
'REJ
Checked byA A
K
4 MWl E YwE Y.. I,n4I waH eitl I
tlA»
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Date Drawn: 10!20/14
Gria: 2436
wG 14-507
FINAL STRUCRIK AS -BUILT
Aa.eT a AMM e., I,wOy Y,tl I
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Legal Description;
I, rey
....•^� �a �1
Lot 47
.mewa m er w a tiM a w
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,����i������.�•••••
T12N R3W SEC 15
907 Water Well Services
6630 E 8TH AVE
ANCHORAGE, AK 99504
(907)230-1868
johnnie.nethertonl702@gmall.com
INVOICE
BILL TO
Mike Anderson (Anderson
Engineering)
Natrona Dr
x
Services
Well flow test yielding 6 + g.p.m . Water level stabilized at 152' at
open discharge of 6 g.p.m
Services
well camera inspection and following results: total depth 192, S.W.L
151, cased to 120'+, pitless at 10' saw no breaks cracks or
perforations. pitless was sealed.
Services
Well casing extension (welded) and wire extension with conduit. Used
existing well cap as seals were still intact and in good condition
Services
water proof heatshrinks
All work above is for property located at 9340 Carlson Rd Anchorage
Alaska
INVOICE# 1115
DATE 09/01/2015
DUE DATE 09/01/2015
TERMS Due on receipt