HomeMy WebLinkAboutT13N R3W SEC 13 LT 9 OF 26'1, Mr, '1`1`1�11M�I, 2. 3. 4. 5. REQUEST FOR APPROVAL OF INDIVIDUAL SEWAGE AND WATER FACILII'IES (f'ill out in Triplicate) llame .of person requesting approval Richard Goeman (4108 Harrison) Name of property owner Same Legal description 165 Pla~e Street, Lot of the Sub. of the ,~E1/~, Number of bedrooms in house ..... One (1) ~ Seward Water Analysis: a. Bacterial Negative b. Detergent ' ' ' 6. Well data: Type Drilled Depth 160 ft. approx, c. Casing Size 8" Swafford Wall Distance from well to closest existing or proposed: 1. Sewer llne 2. Sept[e tank 3. Seepage Area 4. C~sspool' 100 Ftc.____ 5. Property Line Within %0 ft. of the property line 6. Other sources of ~ ' ~oss~ble contamination, i.e.~ creeks, lakes~ houses, barn~ drainage ditch~ etc. 7. Sewage disposal system. Age of system__ Septic, tank capacity in gal!~ns 1500 gallon Name of septic tank manufacturer 1. If "home made" show diagram on reverse side of this form. d. Disposal field or seepage pit size and type 1. Distance to property llne 20 ft. to house foundation 170 ft.. e. Percolation Test results f. Percolation Test performed by Use the reverse side of this form to show diagram. Diagram should include the following information: p!~operty lines~.well location, house location, septic tank location, disposal area location, location of percolation test, and direction of ground slope. 9. The information on this form is true and correct to the best of my knowledge. /s/ Richard D. Goeman Signature of Applicant ..... ~/27/67 Date Signed TO BE FILLED OUT BY HEALTtt DEPART~.~ENT PERSONNEl, The above described sanitary facilities are hereby approved, subject to the ........... ~611owing con~iions: Conditions: The above described sanitary facilities are disapproved for the following reasons: Sign~.~z ~ ~f~ie~'~:~ ~: '" ' ,. ~:' ',. Date :' Appro~yis valid for one year following the date of approval. CPJ:c~' . MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-34377904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 006-042-24 Legal description T1 3N R3W SEC 13 LOT 9 OF 26 Site address 8426 Dunlap Ct Anchorage Current property owner(s) Robert and Ronald McKinley Expiration Date: L y �- X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Original Certificate Date: 2 `� 20 Z 3 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 Services 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 work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA Approval June 2022 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. 006-042-24 Complete legal description T13N R3W Sec 13 Lot 9 of 26 Location (site address) 8426 Dunlap Ct. Anchorage, AK Current property owner(s) Robert & Ronald Mckinley Day phone 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS 3. TYPE OF WATER SUPPLY:./❑ Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ❑ Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank V Community Septic or Public Sewer 6. SEPTIC TANK: ❑ Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ 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 $ ati2o Date of Payment / 11A A /oZ 3 COSA # A3 1yd C/ � Q$ol1loC� Waiver Fee $ Date of Payment Waiver # COSA Application—June 2022 Legal Description: T13N R3W Sec 13 Lot 9 of 26 Parcel ID: 006-042-24 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA ❑ Well log is filed with Onsite (or attached) Well production at time of test 10.1 gpm Date drilled UNK _Total depth—.160" ft Water storage tank volume NA gallons Cased to . UNK ft Well disinfected for coliform test? ❑ Yes ✓❑ No ✓❑ Sanitary seal is functioning correctly Q Coliform bacteria is Negative © Wires are properly protected Nitrate 0.726 mg/L U Nitrate less than MRL (ND) Casing height (above ground) 14 in. Arsenic ug/L ® Arsenic less than MRL (ND) Date of flow test for COSA 1/10/23 Collected by Arcterra Consulting Static water level at beginning of test 28 ft. Date 12/20/22 Comments *Per MOA records. B DATA Measured operating fl dl'e ptic tank Date of pumping ~1'�`" ❑ Required maintenance completed, if AWWTS Comments: ABSORPTION FIELD DATA Which s em tested (date installed) ❑ ALL standpl resent per record drawing Total measured depth grade ft (max) Measured depth to pipe invert grade ft (min) ❑ N/A – pressurized field. ❑ Per record drawings, field is insulate . ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced __gallons date Any rejuvenation treatment (past 12 months) If yes, enter date Comments/Deficiencies: COSA Checklist June 2022 C. LIFT STATION ❑ Required maintenance completed Ae of lift station years Lift station mares sat--- Comments: Adequacy test date Results ❑ Pass Fluid depth prior to test in Water added gal New fluid depth in Elapsed time min Final fluid depth in Absorption rate gpd FIE TATUS – POST RECOVERY Effective d (per record drawings) Effective depth use in Effective depth remaining in in E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' ❑ Yes if No ft Community Sewer Manhole/Cleanout > 100' ❑ Yes if No NA ft ❑J Yes if No ft Neighboring Tank > 100' ✓❑ Yes if No ft Private Sewer/Septic Line > 25' 0 Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No NA ft Holding Tank > 100' J❑ Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' 0 Yes if No It Q Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ❑Yes if No 26+* ft © Yes if No ft ❑ N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) I3DifdiAg..l:,oundations > 10' ❑ Yes if No ft Tank to Property Line _ a" Yes if No ft Field to Property Line > 10' ❑ Yes f No_'``""ft Water Main > 10' ❑ Yes if No ft Water Service Line > 10' ❑ Yes if No ft F. ENGINEER'S COMMENTS Surface Water > 100' Wells on Adjacent Lots: Private Wells > 100' Cmmuni Weems, 200' If tank or field is under driveway *Well installed prior to 4/27/67 per MOA records. AWWU construction dated 4/1970. ❑ Yes if No ft ❑ Yes if No ft ❑ Yes if No ft 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 Arcterra Consulting Phone (907)-696-6111. Engineer's Printed Name Kenneth Duffus Date /z Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen encroachments, deficiencies or discrepancies exist. COSA Checklist June 2022 MUNICIPALITY OF ANCHORAGE WATER & WASTEWATER UTILITY 3000 ARCTIC BLVD. PHONE: (907)564-2762 BLOCK/LOT/TRACT: LT 9 OF 26/ SUBDV: T13N R3W SEC 13 TAX CODE: 00604224000 GRID: SW1241 WASTEWATER 52211rJ� CONNECT PERMIT DATE OF APPLICATION: 6/15/2022 SCHEDULED COMPLETION DATE: 12/31/2022 STREET ADDRESS: 165 PLACE ST Anchorage, AK 99504 OWNER: MCKINLEY ROBERT L 50% & MCKINLEY RONALD J 50% MAIL ADDRESS: 383 IDAHO ST #2 ANCHORAGE, AK 995040000 0 SINGLE FAMILY ❑ DUPLEX ❑ COMMERCIAL ❑ MULTI -DWELLING No. APTS 0 PHONE: CONTRACTOR: GLW Enterprises ASSESSMENTS ❑ Repair Existing Service ❑ Main Line Extension ❑ On Property Only ❑ City Tap ❑ Have Been Levied ❑ Hydrant Only ❑ To Be Levied ❑ Main Tap - To Property Line Only ❑ Cured in Place Pipe Comments: ❑ Main Tap & On Property Connect ❑ Disconnect Row No. ❑ R & R - Main Tap Only Owner Staff CONNECT SIZE 4 in ISSUED wwjjp INSPECTION FEE $112.00 ❑ PAID ❑ CASH PERMIT FEE $77.00 ❑ CHECK RCC $1.69 ❑ OTHER REIMBURSABLE DEPOSIT $0.00 INSPECTED BY SW 10.r U (nS NUMBER TOTAL $190.69 DATE KtIVIHKKJ PERMITTEE (Please Print) GLW Enterprises MAIL ADDRESS 1732 Kalgin St Anchorage, AK 99504 SIGNATURE EMAIL PHONE (907)333-6982 POST IN A CONSPICUOUS PLACE AT THE JOB SITE ••+,..`�,y INSPECTOR COPY-1�++� DATE 12/31/2022 TIME 12:00 AM INSPECTOR SCHEDULED SUBDIVISION T13N R3W SEC 13 BLOCK/LOT/TRACT LT 9 OF 26/ INDICATE ORTH +]OUS �) ZDMAG 4 ,I LA I I � _ II � rl it SIZE MAIN: TYPE MAIN: A G DEPTH AT MAIN: AT f"P. LINE: CONNECT LOCATION: o4 L COMMENTS: , (aej s�riliLe INSPECTED BY:cJ DATE: �j 2�271 X X XXXXXXXXXXXXXXXX XXX XXXX OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU ℄ DU1LA3 &OUR7 ℄ 3LA&E S7REE7OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU OHU LO7 10ROW10 ROW N90° 00' 00"W 50.00 S00° 00' 00"E 133.50N90° 00' 00"E 50.00 N00° 00' 00"E 133.5010' SA1 SEWER ES07 LO7  LO7 LO7 ED*E O) 3A9E0E17MBSHED SHEDDIR7 3AR.I1* DIR7 3AR.I1* DIR7 3AR.I1* SHED G E G E WELL HOUSE 111111  0 110 10 W 11 0111 01    1010110111 101 1100 11 O9ER 3L LRW  SHF 1 711 R0W S0  ST )W   DXQODS &RXUW 1 SWRU\ WRRG )UDPH HRXVH DXSOHx ZDHWDFKHG SLQJOH )DPLO\ HRPH  1 0 0 ' W E L L R A D IU SPROFESSIONAL SEAL Date:Frontier Surveys, LLC Project No: 650 W. 58th Ave. Suite E Anchorage, Alaska 99518 As-Built Survey of: www.frontiersurveys.com Frontier Surveys, LLC I, Pierre Stragier, hereby certify that this Mortgage Inspection Survey was performed by me, or under my direct supervision on Plat:Grid:Ordered By: 907.460.1686 - info@frontiersurveys.com This survey complies with the ASPLS Mortgage Location Standards. The survey represents visible improvements and conditions at the time of the survey. This document does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may reveal. It is the responsibility of the Owner to determine the existence of any easements, covenants, or restriction which do no appear on the record plat. Under no circumstances should this document be used for construction or for establishing a boundary or fence line. January 3rd, 2022. Legend: Scale 1" = 20' Gas Meter Electric Meter/Outside Power Deck Telephone Pole Fence Mailbox Overhead Utility Lot 9, Sec. 13, T13N, R03W S.M. General Notes: 1. This document is created for the purpose of a single property transaction and is subject to Federal Copyright Laws. 2. Excepting for gross negligence, the liability for this survey shall not exceed the cost of preparing this survey. 3. All measurements/setbacks are to the visual/apparent building footprint. 4. All dimensions to property lines are plus/minus 0.1ft. Keenan Fitzpatrick 22-653 01/04/2023 P-257B 1241 Water WellConcrete MBG E x W -DQ 0 0 R E GISTEREDPROFESSIO N A L LA NDSURVEYORPierre M. Stragier No. L.S. - 9812