HomeMy WebLinkAboutT14N R2W SEC 12 LT 1 OF 11TI4N R2W
12
Lot I
of
11
050- 273
-09
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
http://www.muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP261060
Work Type: SepticTank Upgrade
Tax Code Number: 05027309000
Site Legal Address: T14N R2W SEC 12 LT 1 OF 11 G:0052
Site Mailing Address: 17122 FOOTHILL AVE, Eagle River
Owner: DEBUSK KEITH K
Design Engineer: FORGE ENGINEERING
This permit is for the construction of:
❑ Disposal Field Z Septic Tank ❑ Holding Tank ❑ Privy
Effective Date
Expiration Date:
Lot Size in Sq Ft:
Total Bedrooms:
4/23/2026
4/23/2027
27225
Non -Public
❑ Water 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. Coodinate with On -Site staff regarding preferred method.
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
Special Provisions: Waiver OSV101247 was previously issued for a 79' separation from the subject property's
well to the septic tank on property. This waiver is hereby renewed and granted a separation distance of 81.5'
from the proposed tank to the existing water well.
Issued To: FORGE ENGINEERING
Date: 4/23/2026
Issued By: Curtis Townsend Date: 4/23/2026
3
MUNICIPALITY OF ANCHORAGE 1+
C�
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section
ON -SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 050-273-09
Property owner(s) Keith Debusk Day phone (907)242-9097
Mailing address 17122 Foothill Ave, Eagle River, AK 99577
Site address Same
Legal description
T14N R2W SEC 12, Lot 1
Number of Bedrooms 3
Engineering Firm Forge Engineering
Building Permit Number
Not Applicable 0
APPLICATION IS FOR:
APPLICATION IS AN:
(N all that apply)
Disposal Field
❑ Initial ❑
Septic Tank
R. Upgrade 0
Holding Tank
❑ Renewal ❑
Privy
❑
Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
Septic tank to well separation
Permit/Rush Fees: Z 2 �_ Waiver Fees:
Date of Payment:
Permit No. G S (' Z L f 0 6
Date of Payment:
Waiver No.
Distance: 81.5'
May 2025
April 23, 2026
MOA Development Services, On-Site Water & Wastewater Program
4700 Elmore Rd
Anchorage, AK 99507
Subject: T14N R2W SEC 12, Lot 1 – 17122 Foothill Ave
Septic system design
Dear On-Site Services Engineer:
The owner of the above lot owns a 3-bedroom home on the property. The existing septic tank has
collapsed and is in need of immediate replacement, so we are submitting this permit application
for the installation of a new septic tank. The attached site plan identifies the location of the home
as well as the proposed tank location.
The proposed tank location is 81.5 feet from the existing well, while the current tank is located 79
feet from the well and was previously granted a waiver. This system has been in place for nearly
50 years with no adverse impacts. The location of the existing buildings in relation to the piping
to the drainfield does not allow the tank to be placed outside the well radius. Also, the most recent
water sample, taken in 2010, showed nitrate levels of 0.126 mg/L with no coliform detected, well
within acceptable limits. It is for these reasons we request a waiver for the proposed tank.
Wells on this and adjacent lots are shown. The new system will be a minimum of 100’ from surface
water, and more than 5’ away from the existing drainfields. Please refer to the attached plan page
for the septic design. If this design is followed, there will be no adverse impacts to adjacent
properties.
Sincerely,
Benjamin Schiller, PE
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP261060, Curtis Townsend, 04/23/26
Benjamin Schiller
CE 12592REGISTEREDPROFESSION A L E N GINEER
1"=50'
CO - CLEANOUT
2CO - DOUBLE CLEANOUT
FCO - FOUNDATION CLEANOUT
FS - FLOW SPLITTER VALVE
MH - MANHOLE
MT - MONITORING TUBE
SV - SEPTIC VENT
TH - TEST HOLE
LEGEND
T14N R2W SEC 12, LOT 1
FEET
0 50 100
SEPTIC PLAN
4/22/26
2CO
REMOVE EXISTING SEPTIC TANK
EXISTING DRAINFIELDS TO
REMAIN IN SERVICE
(EXISTING WAIVER TO
NEIGHBORING WELL)
NEW 1000-GAL
SEPTIC TANK.
ENSURE 10' FROM
FOUNDATION
EXISTING WELL (TYP)
NEIGHBORING SEPTIC
(EXISTING WAIVER TO
NEIGHBORING WELL)
81.5
NO RECORDS. CONFIRM LOCATION OF
EXISTING WELL IS 100' FROM PROPOSED
TANK DURING INSTALL
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP261060, Curtis Townsend, 04/23/26
A
0
4�d
GREA,-ER ANCHORAGE AREA BOk,..dGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOS. AL SYSTEM
SEPTIC TANK:
DISTANCE
FROM WELL,.~?
INSIDE LENGTH
MANUFACTURER
INSIDE WIDTH
MATERIAL
NUMBER OF
COMPARTMENTS
LIQUID DEPTH
LIQUID CAPACITY / ~ GALLONS.
LINING MATERIALC/~/~//I~': CRIB SIZE:
.UlLDING FOUNDATION '~/,
DIAMETER DEPTH DrSTANCE FROM: WELL
NEAREST LOT LiNE /0 TOTAL EFFECTIVE
ABSORPTION AREA (WALL AREA) ~' SQ. FT.
ADDITIONAL ABSORPTION
WELL:
TYPE CONSTRUCTION
BUILDING NEAREST
FOUNDATION LOT LINE
CESSPOOL OTHER SOURCES
APPROVED DISAPPROVED
NEAREST
SEWER LINE
REMARKS
DEPTH DISTANCE FROM:
SEPTIC SEEPAGE
TANK SYSTEM
DISTANCES:
DIAGRAM OF SYSTEM
LOT SLOPE:
REMARKS:
PERMIT NO.
DEPARTMENT ' HERLTH AIN[:, ENVIRONMENTRL ROTEI]:TION
825 '"L" STREET, ANCHORRGE, RK. 9;~501.
~PPLIC:FINT
L. OCR]"ION
L. EG~L
LESTER SMITH.
FOOTHILL [:,R
L.i OF Lil SEC ±2 T:t4N
E:O'X 83 E. R.
LOT SIZE
694-23:69
]:4225 SQI.JRRE FEET
'¥"¢PE OF SOIL flBSORBTION SVSTEM IS: TRENCH
NUMBER OF' BEDROOMS = ~:
SOIL RRTING (SQ FT/BR)= i50
THE REQUIRED SIZE OF THE SOIL RBSORPTION S'¢STEM IS:
THE LENG]'H DIMENSION IS THE L. ENGTH (IN FEET) OF 7'PIE TRENCH OR DRRINFtELD.
THE DEPTH OF R TRENCH OR PIT IS THE DISTRNCE BETWEEN THE SURFRCE OF THE
GROUND RND THE BOTTOM OF THE Ek.',CR'v'RTION (IN FEET).
]"HERE IS NO SET WIDTH FOR TRENCHES.
THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRR',,,'EL BETWEEN THE OUTFRLL PIPE
FIND THE BOTTOM OF THE E'XCRVRTION (IN FEET).
6'RE:KFILLING OF RN9 SVSTEM WITHOUT FINRL INSPECTION RND RPPRO'v'RL BY THIS
DEPRRTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMIJM L I=1'MNLE BETblEEN A WELL FIND AN"r' ON-SITE SEb. IRGE DISP]SflL z,r.z, TEM IS
:L00 FEET FOR R PRIVRTE WELL OR 200 FEET FOR A PUBLIE: WELL.
SPEC]:FICRTIONS RIND CONSTRUCTION DIRGRRt'IS ARE RVFtIL.RBLE TO INSURE PROPER
INSTALLATION.
t
±:
FOR]'H B"r' THE MUNICIPRLIT"r" OF RNCHORRGE.
2: I WILL INSTRLL THE S"r'STEM IN FICCORDRNCE WITH THE CODES.
2;: t UNDERSTRND THRT THE ON-SITE SEWEF:: S"r'STEM MR? REt.]UIRE
RES I[:,ENCE~EMODELE[:, TO I NCLU[:'E MORE THFtN ]: E:E[?ROOMS.
RPPL I CRNT LESTER SMITH
i _,_,UE.[ ............. DflTE .........
CERTIFV THR]'
I RM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET'
ENLFtI~'.GEI'dEI'.,IT IF TIdE
0 Et E GEM __CHNI CAL Et DE.VIEL�.. ,-'MENT CO.
Box 90, Davis St., Eaale River, Alaska 99577
694-2774 or 688-2280
Russell Ovster Earl Ellis
694-2774 SOIL LOG 68f3-2280
Soils Et Foundations Land Development
Performed for: Name: Tel. No.'�"
Mal l i rya Addresses'
Leaal pescriotion:
Depth feet Soil mCharacteristics
I
3
5
6
7
12
13 _ ,. _ j
14
ti L1-� ,,. A
F'k
15 `3 -
> kxo k>
t� : ,��j ,,�_ v,(l
�,:� a �►.��;� r� r� '1
,I, 1
�\ 4✓\�j1.��"V� �> �/� 'ice
AT_6
�/
L�
"/
Water Encountered:
Yes
No If yes,
what depth
s
Proposed Installation: Seepage Pit
Drain Field
r`
Comments: - ��j�,a��
_'_7 �;�
_ ��, k'.��v 3' r;
V
Performed byY: _,� v'r�' �a �,. ��� Date:
lhOunicipality of Anchorage Fir
• Development Services Department
Building Safety Division .:
k I
On -Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907)343-7904
CERTIFICATE OF ON -SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
votr'tAnce- 05 V 1�12�t7
Parcel I.D. 05027309 COSA#
1. GENERAL INFORMATION Expiration Date: I
Complete legal description T14N R2W SEC12 LOT 1 OF 11
Location -(site address) 117122__FOOTHILL * EAGLE RIVER AK * 99577
Current Property owner(s) MICHELLE SCHILLING Day phone
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
17122 FOOTHILL * EAGLE RIVER AK * 99577
Day phone
VICTORIA BRINK Wj KELLER WILLIAMS Day phone
696-4410
351-9434
101 W BENSON BLVD. SUITE 503 *ANCHORAGE. AK 99503
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
Individual On -site
0
Individual Water Storage
❑
Individual Holding tank
❑
Community Class Well
❑
Community On -site
❑
Public Water System
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer
of title (except between spouses) for properties served by a single-family on -site wastewater disposal and/or
water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems
Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may
be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As cerlified by my seal affixed hereto and as of the validation date shown below, t 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 t,~e 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 GARNESS ENGINEERING GROUP, Ltd.
Phone 337-6179
Address .5701 E. TUDOR ROAD, SUITE.101 * ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Date
Engineer's Comments:
In conducting this evaluation, GEG, LtD. attempted to provide a thorough,
conscientious engineerin~j'bnMySis.of the system in accbrdance with ADEC and MOA ~
DSD Guidelines & Regulations. The reported results described 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 soils condition, groundwater 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 the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any legal right whatsoever.
DSD SIGNATURE
~Approved for -~
Disapproved.
Conditional approval for
bedrooms.
bedrooms, with the following stipulations:
Attachments: COSA Checklist
Septic System Advisory
Well Flow Advisory
(Rev.
Arsenic Advisow
Maintenance Agreements
Supplemental Engineer's Report
Other
Original Certificate Date:
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
CERTIFICATE OF 0N-S1-¢ 7: S APPROVAL
Legal Description:
WELL DATA
Well type PRIVATE
Date completed
Total depth i20
T14N, R2W, SEC 12, LOT 1 OF 11
6/18/86
ff.
IfA, B, or C provide PWSID# N/A
SanitarY seal (Y/N) YES
Cased to
FROM WELL LOG
Date of test 6/18/86
Static water level 80
Well production 10
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 mi.
Arsenic: ND ug./L.
120 ft.
g.p.m.
Nitrate 0.126 mg./L.
Date of sample: 10/5/2010
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC/STEEL
Tank size 1000 gal, Number of Compartments
Foundation cleanout (Y/N) YES
Date of pumping I 0 J /5 ]! o
CHECKLIST
Parcel ID: 05027309
Well Log (Y/N)
Wires properly protected (Y/N)
Casing height (above ground)
AT INSPECTION
10/6/2010 ·
69 .ft.
5.03 g.p.m.
YES
YES
12+ in.
Other bacteria 0 colonies/100 mi.
Collected by: GE(;; Ltd.
Date installed **'7/12/77
2 Cleanouts (Y/N) YES
Depression over tank (Y/N) NO High water alarm (Y/N) N/A
Pumper JR'S PUMPING
ABSORPTION FIELD DATA
Date installed **'7/:12/77
Length 20+30=50 .ft.
Total depth*17/17.8 ft. Eft. absorption area 800 ft2 Monitoring tube YES
Date of adequacy test: *'10/6/2010 Results (Pass/Fail) PASS
ISOUTH/NORTH TRENCHI
I'BELOW EXISTING GRADE TO Bo'FrOM OF WHAT ARE ASSUMED TO BE SUMPS I
Soil rating (g.p.d./ft2o~, 150 System type DUAL DEEP TRENCHES
Width 3. ft. Gravel below pipe 8 ft.
'Depression over field NO
For 3 bedrooms
Fluid depth in absorption field before test 10 in.
Elapsed Time.: 225 min. Final fluid depth 10
Any rejuvenation treatment (past 12 mo.) (YIN & type) **SOUTH TRENCH TESTED.
Water added 655 gal. New depth 1 6 in.
in. Absorption rate >= 450+ g.p.d.
NONE KNOWN If yes, give date -
PRESOAKED WITH 2210 GALLON OF WATER ON. 10 0.
D. LIFT STATION
Date installed
"Pump on" level at
Datum ~
E.
in.
Size in gallons Manhole/Access (Y__~_) ~
"Pump off" leveL.aL-------inT-'"-- High water alarm level at
Cycles tested Meets alarm & circuit requirements?
SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
'79'+
Septic tank/lift station on lot
Absorption field on lot 100'+
Public sewer main N/A
Sewer/septic service line 25'+
Animal containment areas 50'+
,in.
On adjacent lots *96'+
On adjacent lots '79'+
Public sewer manhole/cleanout
Holding tank N/A
Manure/animal excrete storage areas
N/A
100'+
Water service line
Curtain drain NONE
COMMENTS
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+
Water main N/A Water service line 10'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'.+
10'+
KNOWN
*SEE ATTACHED
Absorption field 5'+
Surface water. 100'+
NORTH TRENCH/SOUTH TRENCH
Building foundation **UNKNOWN Water main N/A
Surface water 100'+ Driveway, parking/vehicle storage
Wells on adjacent lots. '93'+
1'+
WAIVER REQUEST. **RELATION OF SOUTH TRENCH TO GARAGE SLAB UNKNOWN.
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 MOA ,COSA guidelines in effect on this
date.
Engineer's Printed Name JEFFREY A. GARNESS
Date
COSA Fees
Date of Payment
Receipt Number
(Rev. 11/05)
Waiver Fee $
Date of Payment
Receipt Number
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS :,,~:::~ :~;', ,, ~
October 22, 2010
Municipality of Anchorage
Development Service Department
On-Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650,
Anchorage, Ak 99519-6650
(907) 343-7904
Ref: Multiple Waiver Requests for T14N, R2W, Sec 12, Lot 1 of 11,
To whom it may concern:
Properties Well to Properties Septic Tank:
The existing 3 bedroom house is served by a private well and septic system. During our site investigation
work to obtain a COSA, we discovered that the well on the subject proPerty is only 79 feet away from the
existing 1000 gallon septic tank on the subject property. We request you grant an-8-1-~ot separation
distance waiver from the well on the referenced property to the septic tank. The following items are
justification for the waiver:
· The well and septic system are on opposite sides of the house. If effluent were to surface, it would be
unable to travel towards the well head.
· The existing encroachment has existed for over 24 years.
· Attached is the well log for the referenced property. The well depth is 120 feet. The soil appears to be
variations of clay, gravel, & sand.
· The lawn is neatly groomed, so if the tank were to overflow, the effluent would be obvious and the
problem would be addressed immediately.
· We are only asking for a 21% variance.
· Recent water samples results indicated no bacteria present and nitrate levels to be 0.126 mg./L. In short,
the water quality is within MOA, state, and EPA requirements.
Properties Well to Adjacent ProperW (Stuart Lot 1) Absorption Field & Septic Tank:
The existing 3 bedroom house is served by a private well and septic system. During our site investigation
work to obtain a COSA, we discovered that the well on the subject property is only 79 feet away from the
absorption field & 96 feet away from the septic tank located on the adjacent property (Stuart Lot 1). We
request you grant a 79 foot & 96 foot separation distance waivers from the well on the referenced
property to the absorption field & septic tank on the adjacent lot. The following items are justification for
the waiver:
· The existing encroachments have existed for over 24 years.
· Attached is the well log for the referenced property. The well depth is 120 feet. The soil appears to be
variations of clay, gravel, & sand.
· The lawn is neatly groomed, so if the tank and/or drainfield were to overflow, the effluent would be
3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507-1259
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com
obvious and the problem would be addressed immediately.
.We are only asking for a 21% variance & a 4% variance..
*Recent water samples results indicated no bacteria present and nitrate levels to be 0.126 mg./L. In short,
the water quality has not been adversely impaired by this encroachment.
Properties Absorption Field to Adjacent Properties Well (T14N R2W Sec 12 Lot 4):
The existing 3 bedroom house is served by a private well and septic syStem. During our site investigation
work to obtain a COSA, we discovered that the well on the subject property is only 93 foot away from the
absorption field on the adjacent property (T14N, R2W, Sec 12, Lot 4). We request you grant a 93 foot
separation distance waiver from the well on the referenced property to the absorption field on the adjacent
lot. The following items are justification for the waiver:
*The well and septic system are on opposite sides of the driveway. If effluent were to surface, it wou
very obvious to the homeowners and they would be able to address the problem immediately.
.The existing encroachment has existed for over 24 years.
*We were unable to locate any other well logs except for the one for our referenced lot (T14N, R2W
12, lot 1 of 11) which is attached to this waiver request. The well depth is 120 feet. The soil appears
variations of clay, gravel, & sand.
'.The lawn is neatly groomed, so if effluent were to overflow, the effluent would be obvious an,
problem would be addresSed immediately.
*We are only asking for a 7% variance.
*Recent water samples results indicated no bacteria present and nitrate levels to be 1.48 mg./L. In
the water quality has not been adversely impaired by this encroachment.
We are unaware qf any adverse impacts this would have on adjacent wells or septic systems fro~
granting of these x~aivers. If you have any questions, please contact us at 337-6179. Thank you for
assistance.
i
x~f~f ~ ~.~G'~,l~essi P.E., M.S.
mre~/t7 ~
ld be
, Sec
to be
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3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507-1259
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com
- F o o~-h-TL~--A v e n u e
I
~ / T14N R2W SEC 12
I
~T 1 ~TUART LOT J
,
~ SCALE: ~GLE RIVER RO~
MICHELLE SCHILLING 276-4665 I 1 or 1 ~¢'..~e~freyA. G~,'
WAIVER REQUEST 10/19/2010
(Rev. 01/05)
,1 Municipality of Anchorage
P.O. Box 196650 • 4700 Elmore Road
%f Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997
httP://www.muni.org/Onsite
Development Services Department
On -Site Water and Wastewater Program
**** VARIANCE/WAIVER REVIEW ****
W R#: 05 V 101247
P I D#: 050-273-09
HAM OSC101265 Permit#:
Legal Description: T14N R2W Sec12 Lot 1 of 11
Engineer: GEG
Applicant: David Schilling
Your request for multiple waivers regarding the subject property's well and septic system has
been approved. The waivers are approved as detailed below.
1. 79 foot separation distance from the subject property's well to subject property's septic
tank.
2. 79 foot separation distance from the subject property's well to the drainfield on Stuart Lot
1.
3. 96 foot separation distance from the subject property's well to the septic tank on Stuart
Lot 1.
4. 93 foot separation distance from the subject property's drainfield to the well on T14N
R2W See.12 Lot 4 of 11.
This waiver approval applies to the specific separation distances as detailed above. Any future
upgrade to the on -site wastewater disposal system will require all separation distances be met or
another approval from this department.
.................. 0 0 E a a 0 0 a 0 0 0 0 ...... 0 0 0 N a M 0 0 0 2 00 0. 0 ... 0 ... E\ 0 E a a 0 M .. 0 0 0 2 0 0 0 0 0■.
Waiver is Granted: X Waiver is not Granted:
Date: 10/28/10 Approved by -
Name of Reviewer
.................... 0 0 0 0 E x ......... 4 0 0 M a 0 0 0 M .■ ............ \ ... \ 0 a N 0 E 0 t 2 a 0 N a■.
Rec#: 090976 Amount: 1050 Date Paid: 10/22/10
**** VARIANCE[WAIVER REVIEW ****
JjkJelln e c.)
01
-Z3
: if ,
Tn';
ko
T,
..... .. ......
AS -BUILT
I hereby certify that I , have surveyed the following described
property. !"'i
17.
Anchorage Recording Pre6mct, Alaska, and that the improve-
ments; situated thereon are within the property lines and do not
overlap or &-ncrQach on the property lying adjacent thereto, that
no Impmvements on lying adjacent thereto enerbach
on the PMP" ying
in question and that there are no roadways,
transmission or other visible easements on said property
except as indicated hereon.
Dated at Ea -le River, Alaska
rG -
this l . Iay of
ROBIERT C. JOITNSON
Registered Land Surveyor or No- 880-LS
'Box 77-0456, Eagle River, Alaska 99577
Phone (907) 694-2543
ARCTIC PUMP & WELL INC.
Jim Sullivan, CPI
Ham'— �,- PO Box 770197
arnrn rsr�s mrrrf
sufs s RAW Eagle River, AK 99577
(907) 688-2510
(907)258-2510
apwrgdnet
Pump Installation Log
Well Drilling Permit Number: SW
Parcel Identification Number:
Date of Issue:
Legal Description: T 14N R2W S12
Property Owner Name & Address:
Lot:I of 11
Michelle Schilling
Block:
10023 Chandalar St
Fav1P Ri-vpr AK 94577
Pump Installation Date: 10/14/2010
Pump Intake Depth Below Top of Well Casing: Feet
Pump Manufacturer's Name: Pump Model:
Pump Size: hp
Pitless Adapter Burial Depth: feet
Pitless Adapter Manufacturer's Name:
Pitless Adapter Installer: Arctic Pump & Well, Inc.
Well Disinfected Upon Completion? Yes
Method of Disinfection: Chlorine
Comments:
Well permanently decommissioned by procedure15.55.060L.c.
Pump Installer Name:
Arctic Pump & Well, Inc.
Arctic Pump & Well, Inc.
Page 1 of 1
// .- GREATER ANCHORAGE AREA BOROUGH
'3330 "C" Street., Anchorage, Alaska 99503 274-4561
~ / j~ ~~ Date Received June 21, 1976
u .....
-J~ '. Time of Inspection 2:30 p.m.
~ Date of Inspection ?-Z-?6 ~e~Ze
REQUEST FOR APPROVAL OF Thursday
INDIVIDUAL SEWER & WATER FACILITIES
FOR
1. Approval requested by:
3,
4.
.5.
'6.
Mailing Address:
Property Owner:
Mailing Address:
Area Inc. % Myrna Johnston
Post Office Box 249, Ea~e River Phone: 694-9555
Lester L. Smith Phone: 694-2369
Post Office Box 83
Legal Description: T14N R2W Section 12 Lot 1 of 11
Location:
Type of facility to be inspected Single Family
Well Data: Individual
A. Type
C. Construction
Sewage Disposal System:
A. Installed B. Installer
C. Septic Tank: 1. Size 2. Manufacturer
D. Seepage Pit: 1. Absorption Area 2. Material
E. Disposal Field: Total length of lines
~eet Myrna at the Area Realty Ea~le River office.
No. of bedrooms
, Absorption area
Distances:
A. Well to: Septic tank
Nearest lot line
B. Foundation to septic tank
.C. Absorption area to nearest lotline
B. Depth
D. Bacterial Analysis
, Other contamination
, Absorption area
, Sewer Lines
EQ-034 (1/74) Page 1 of two pages
1
2.
333p
Department of Envi ronme~.tal qual i t~UNIClPALITY
'C" St.~ Anchorage Alaska 99503 27aDq)~(~HEA~TH&
~ ENViRONmeNTAL PROTECTION;
REOUEST FOR APP2OVAL OF
]~I~FJ~L×~WATER' FACILITIES
Type of Ins'pectio.~:
JUN 3 1 1976
VA FHA CONV
Propewty Owner: ~$~
~.0. ~o× 83
Mailing Address: ~agle ~lver, ~ 99577
3. Name of Buyer: ~/~
NailipQ Address:
~. 2ame of Lending Institution: ~/A
Da.y Phone
694-2369
e
Day Phone
-,
Mailing Address:
Name of Realtor or Agent:
Phone
,Myrna Johnston, Area, Inc. Realtors
'Mailing Address:
P.O. Box 249
Eagle River, AK
Legal Description:' - T14N
Location: Approximately
Phone 694-9555
99577
R2W Sec 12 Lot 1 of 11
1 mile E.R. Rd. turn"l.eft one street
short of .Genora St. whit~ w/qreen trim
Type of Facility to be inspect'ed:
~later Supplyi, .(only)
Type '~f S~pply: PuSli'c
-2nd house on riqht. -'. ,.'
.- N01 Bd~msl
Individual x ' ....... '
Utility
dWelli'ngS, pre'sexily se~ed 1 '
If' Individual','number of
If Individual, depth of well
Sewage Disposal'System
Type,of S~stem: Public Utility
'~ndividual (on-site)
_.If..Ind~v'idual, date of installation
Rea~to~ will have key
page 2 of two pages - Re~-~t for Approval of Individual .?-Aer & Water Facilities
'Legal Description
T14N R2W Section 12 Lot 1 of tl
Comments:
Approved
Disapproved Date ~l~,~i
Approval~Valid for one year from date signed
Greater Anchorage Ar~a Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
I certify that the information contained in this request for approval to be a true and
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED
Date
EQ-034 (1/74)