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HomeMy WebLinkAboutMAJESTIC VALLEY ESTATES BLK 2 LT 6Majestic Valley Estates Block 2 Lot 6 #050-731-42 . Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program, 4700 S. Bragaw St. P O Box 196650 A oh n orsg%A 99519-6650 Pagel of 2 www.cl.anchorage.ak.us (907) 343.7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. SWO50327 PID Number. 050-731.42 Noma Randy and Karin Stringer Wastewater System: ❑ New ® Upgrade Addme ABSORPTION FIELD Pr"'a 45 Vallihi Circ Numear a Bwanm O D"P T� ® Sheim Tr o ea o mm d o oa LEGAL DESCRIPTION La WMeamaraernongn Vada Fa aaaw sbwa ting- Vada Well: ❑ New ❑ Upgrade C4.rnrauan (Prrvm, A B. Ck iar Dear .•..-... 2 1 2 G -PM Fd Ft TANK SEPARATION DISTANCES To —Fe— eptic Absorption LM Fran Tank Field Station Molding ubliurnvate Tank Sewer Line ®septic ❑ Holding ❑ S.T.E P. .uuar Anchorange tank/Advantex ❑Other. ro+uir 1500 cr WW 100' +100' +100' — +25 steel a° "'"�""' 3 swr wrw +100' +100' +100- — LIFT STATION La ty . +5' 3- +5 19Z or Orenco Fandrnn +5' +10' +5' �. C^ Cvlaxr Dram +�' +Sg- +50- N.mrka Ir lot line waiver granted for leach8eld •P- 0 or-• r.r r •Pwr�p ar Iavr r 37- in i �, in PU.V MMa a Mp EN Yup cb" paft , h OSI 1105 Paul Erickson BENCH MARK Nigh wnx r 6r ti 4 feet of MOA sand between bottom of new system and existing y n9 t� om Slab bby comer of garage : system. 100 Ft Inspections performed by: Chris Wood Dates: 1"-292L5- 2nd "_9/1/05 2nd 10/3!05 Development Services Department Approval Reviewed and approved by Date: of (R« wool rd CHRISTOPHER R C tQ_38j Permit No. SWO50327 Page 2 of 2 Municipality of Anchorage DEVELOPMENT SERVICES DEPARTMENT ON—SITE WATER & WASTEWATER PROGRAM 4700 SOUTH BRAGAW STREET P.O. BOX 196650, ANCHORAGE,. AK 99519-6650 On—Site Wastewater Disposal System and/or Well Inspection Report Legol Description: MAJESTIC VALLEY ESTATES LOT6 BLOCK2 SWINC TIES (UI C 1 20 0-1 150' D 1 71.8'1 48 0' .�% WELL 1V Z PAVED ORIVE 0 - CLEANOUT -WELL •'cy: - MONITOR TUBE �. 10,UTILITY EASEMENT 1 , v�LLllll CIRCLE ELEVATION MOT TO SCALE) /l SLAB BY GARAGE iJ ASSUMED ELEVATION 100' HOUSE TANK ORIGINAL GROUND LEVEL AT1 99.44 MANH LE IFT STATION FINISH GRADE 101.5 -MT \\\ 3.7' 99 2.0' TYPAR ADVANTEX 4' MOA SAND 92.9 1,500 GAL 99,0 95.2 97.8 97.8 91.4 90.7 90.7 93.9 93.9 BOTTOM OF T.H. 050-731-42 SCALE 10-5V LOT 9 (VACANT) 15X20 SEWER EASEMENT 10x11-05 ENGINEER'S SEAL ���--; rv�Vd R••. CHRISTOPHER R. W000, Ci CE -10387 ���4'!pROFESSI = 0('T. 5 J 200,5- 7-0 00570 wtio ] IT mAy COitIGE- t� 0Al OCT. 3 , zoo; DAt4L_ G�eieKSDA) i4 j1&.&oS46W EL-l'C7IGClA,C1 (ALASM LI e-LvASLF # Zo3 N(oa) lljS77hLL Co TltL E LEa Ilk (CAL SERVIC0- DAJ A S" 7/c- S,lS re VL f.% & Rhlugv SMAdtae., i/f,6 SFoi /c SVsron PiAs INSrALLFO A -r O("t/5— eALLIIFI MCLel EIULC= itl614R ALAYKt, - 896"77 , rttE Ids afLArloAl MEE rs TJ/F dill-10AMt- ELEcrRJCAL Cope' AAJQ rFIE /jlll,u�JC1 PLL` AM Milt E(CK 'OAJ Electric, Inc. 2609 A STREET '0• ANCHORAGE, ALASKA 99503 PHONE 19071 277.1431 FAX 19071 272.5115 0('T. 5 J 200,5- 7-0 00570 wtio ] IT mAy COitIGE- t� 0Al OCT. 3 , zoo; DAt4L_ G�eieKSDA) i4 j1&.&oS46W EL-l'C7IGClA,C1 (ALASM LI e-LvASLF # Zo3 N(oa) lljS77hLL Co TltL E LEa Ilk (CAL SERVIC0- DAJ A S" 7/c- S,lS re VL f.% & Rhlugv SMAdtae., i/f,6 SFoi /c SVsron PiAs INSrALLFO A -r O("t/5— eALLIIFI MCLel EIULC= itl614R ALAYKt, - 896"77 , rttE Ids afLArloAl MEE rs TJ/F dill-10AMt- ELEcrRJCAL Cope' AAJQ rFIE /jlll,u�JC1 PLL` AM Milt E(CK 'OAJ MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water d Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Aug 29, 2005 Expiration Date: Aug 29, 2006 Permit Number: SWO50327 Parcel ID: 050-73142 Legal Description: MAJESTIC VALLEY ESTATES BLK 2 LT 6 Design Engineer: 0848 Eagle River Engineering Services Site Address: 026245 VALLIHI CIR Owner Name: RANDY & KARIN STRINGER Lot Size: 54851 SO. FT. Owner Address: 26245 VALLIHI CIRCLE Total Bedrooms: 3 Permit Bedrooms: 3 EAGLE RIVER. AK 99577-9665 This permit is for the construction of: Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ 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 engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours ). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. THE UPPER SIX INCHES OF THE MOUND SYSTEM MUST CONSIST OF TOP SOIL AND THE MOUND MUST BE VEGETATED SUFFICIENTLY TO PREVENT EROSION. Received By: Issued By: /lam/ l Date:c3/29/y-5- Date: 291 dS Date: 4941 v Municipality of Anchorage • too, o � e •� y_ ` 11.O. I!ux 10(Ain() • Anchnmgc, Alaska !X97519-(Vi11 • rcicphonc (!X)7)843-&701 • fu[ (!X)71 373-82(NI i 47(X) I!mgnw Strcet e Anchomgc, Aluskn !X9507 MIM'munLorg Mayor Mark Begich Building; Safety Divlslon August 29, 2005 Christopher Woods Eagle River Engineering Services P.O. Box 773294 Eagle River, AK 99577 Subject: Waiver Request for Majestic Valley Estates Block 2 Lot 6 Waiver Request WR#: 050067 Parcel ID # 050-73142 PERMIT # SW050327 Dear Christopher Woods: Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the east property line has been approved. The approved separation distance is 0.0 feet. This waiver approval applies to the existing absorption field to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, rdaer On -Site Water & Wastewater Program Community, Security, Prospelity Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchoragc.ak.us (907)343-7904 Waiver Review Worksheet WR#: 050067 PID#: 050-73142 HA/Permit# PERMIT # SW050327 Date Received: August 29, 2005 Legal Description: Majestic Valley Estates Block 2 Lot 6 Engineer. Christopher Woods Eagle River Engineering Services P.O. Box 773294 Eagle River, AK 99577 Applicant: Randy and Karin Stringer Waiver Requested: 0 foot lot line waiver to east property line Criteria: Geology A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Waiver is Granted: X List Conditions or Reasons for above: Total: Waiver Is not Granted: Points: Date: 05 By: Joe Goodall Name of Reviewer ,......................................................................... Rec#:70 2068 Amount: $M Date Paid:t 9� I2005 Municipality of Anchorage -. Development Services Department Building Safety Division _ On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ek.us. (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 6 907 3 /W Z- Permit Number SW Property owner(s)IZiiNb�� K/iiliN 572it1ltR Day phone 09- /6/$S Mailing address (1) 26 2�I V�41 t FFL TQG1 C Mailing address (2 99577 Zip Code 9W'77 Legal description (Lot, Block & Sub'd.) ltl h i l G 1141`J 2 �• A - k _ 6 Legal description (Section, Township & Range) Lot Size 5i. KAcre aq.FL Number of Bedrooms 3 THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well ❑ ' Water Storage ❑ Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above Information Is correct. I further certify that this application Is being made for a Single Farylly Dyreliinq and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit Fees: ! Waiver Fees: Date of Payment: g 7 Date of Payment: Receipt Number: Receipt Number: (Rev. 12100) Eagle River Engineering Services Christopher R. Wood, P.E. 10421 VFW RD. Suite 201 (907) 694-5195 tel Eagle River, AK 99577 (907) 694-3297 fax August 26, 2005 Dan Roth Manager, On -Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: Majestic Valley Estates Lot 6 Block 2 Narrative & Permit Application, Lot line waiver request Dear Mr. Roth: Eagle River Engineering Services (EKES) was contracted to perform a Health Authority Approval at the above reference property. It was found that the existing leachfield was surcharged, and that presence of a water table was suspected to be the reason, and that a replacement drainfield would have to be installed. ERES did a thorough site investigation and excavated several test holes, but was unable to find any other area on the lot, or adjacent lot that would support an on-site septic system. Other areas were too saturated, had several feet of saturated peat and clay, or were too steep for proper function and permitting of a leachfield. By process of elimination, it was determined that rebuilding the existing leachfield in the same spot was the only option other than a holding tank. In order to make the new leachfield fit in the available space, it was determine that an Advantex advanced wastewater treatment system would need to be utilized. When the new Advantex septic system is installed, the old septic tank shall be pumped, removed from its existing location, destroyed, and then buried on site. Any old sewer rock that needs to be removed within 4' of the bottom of the new leachfield shall be buried on-site as well. Please see field cross-section for details. The leachfield of the existing septic system encroaches on the neighboring lot, and a new ingress/egress easement is in process for constructing the replacement leachfield. We are also requesting a lot line waiver of 0', since the new leachfield will encroach over the subject property's lot line. This system is in close proximity to a steep slope greater than 25%. Actual slope varies from 45% to 65%. The new septic system falls under the guidelines, and will be constructed In accordance with, the Engineer's Bulletin/Nlemorandum dated April 7, 2004 regarding Slope Setbacks and systems Installed prior to 1986. The original system was installed in 1980, prior to slope setback requirements. Even though the system is surcharged, there is NO evidence of this system of backing up or daylighting effluent, even on the steep slope below. No other location exists on the lot exists where a septic system can function and be protective of human health. Ever effort will be taken to maximize the distance from the replacement \2003\05-067ADVANTEXSEPTICNARRATI V E leachfield to the slope. We believe that utilizing Advantex technology will be protective of human health and the environment, and will allow this site to be utilized safely for years to come. The proposed 3 bedroom septic system will have very limited impact on adjacent properties for the following reasons: 1. The surrounding lots are large, so there is room for wells, septic systems and alternate sites. 2. Immediate neighboring septic systems are all +20' distance, and no private (or community) wells within 100' of the proposed septic system. 3. Drainage will not be affected and is not a major consideration in our design. Installation of this 3 bedroom septic system and well site will not adversely affect the wells or septic systems or reserve areas on adjacent lots. If you have any questions please call our office at 694-5195. Sincerely, EAGLE RIVER ENGINEERING SERVICES e�l (/✓ C� Christopher R. Wood, P.E. Principal \2003\05-067ADVANTEXS EPTICNARRATI V E Eagle River Engineering Services Christopher R. Wood, P.E. 10421 VFW RD. Suite 201 (907) 694-5195 tel Eagle River, AK 99577 (907) 694-3297 fax August 7, 2005 Dan Roth Manager, On -Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: Majestic Valley Estates Lot 6 Block 2 Narrative & Permit Application Dear Mr. Roth: Eagle River Engineering Services (EKES) was contracted to perform a Health Authority Approval at the above reference property. It was found that the existing leachfield was surcharged, and that presence of a water table was suspected to be the reason, and that a replacement drainfield would have to be installed. ERES did a thorough site investigation and excavated several test holes, but was unable to find any other area on the lot, or adjacent lot that would support an on-site septic system. Other areas were too saturated, had several feet of saturated peat and clay, or were too steep for proper function and permitting of a leachfield. By process of elimination, it was determined that rebuilding the existing leachfield in the same spot was the only option other than a holding tank. In order to make the new leachfield fit in the available space, it was determine that an Advantex advanced wastewater treatment system would need to be utilized. This system is in close proximity to a steep slope greater than 25%. Actual slope varies from 45% to 65%. The original system was installed in 1980, prior to slope setback requirements. Even though the system is surcharged, there is NO evidence of this system of backing up or daylighting effluent, even on the steep slope below. We believe that utilizing Advantex technology will be protective of human health and the environment, and will allow this site to be utilized safely for years to come. The proposed 3 bedroom septic system will have very limited impact on adjacent properties for the following reasons: 1. The surrounding lots are large, so there is room for wells, septic systems and alternate sites. 2. Immediate neighboring septic systems are all +20' distance, and no private (or community) wells within 100' of the proposed septic system. 3. Drainage will not be affected and is not a major consideration in our design. \2003\05-067AD V ANTEXS EPTI CNARRATI VE Installation of this 3 bedroom septic system and well site will not adversely affect the wells or septic systems or reserve areas on adjacent lots. If you have any questions please call our office at 694-5195. Sincerely, EAGLE RIVO ENGINEERING SERVICES Christopher R. Wood, P.E. Principal X2003\05-067ADVANTEXSEPTICNARRATI VE LOT 7 (VACANT) 0 �c h LOT 5 / (VACANb W I V I h I 7' I N I 2 I � I ' Lor - 6 WELL %��PAVFD OPoy 1 I I I :URTIAN DRAIN LOCATION 1 H / out / / 1 / _PAGL1711 CIRC1.30.00 • i WELL/SEPTIC SITE LEGAL: MAJESTIC VALLEY ESATATES, La OWNER: RANDY AND KARIN STRINGER CONTRACTOR: UNKNOWN JOB# 05-067 1 DATE: 08/07/05 yd I LOT 8 (VACANT) 41 LOT 9 (VACANT) I ff'WK 1) EASEMENT 73X20- - - PROPOSED LEACH FIELD SEWER risco _ - EXISTING LEACH FIELD - DRNEWAY • - MONITOR TUBE o - SEWER CLEAN OUT - WELL ® - TEST HOLE 1. NEW 5X35 DRAINFIELD TO BE CONSTRUCTED 1 �ONTOP OF OL6 T)RA NFIELD PLAN LOCK2 SCALE 1 "= 60' EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 EAGLE RIVER, AK. 99577 (907) 694-5195 FAX.- (907) 694-329; z%I INSULATI APPROX EXISTIN- GROUND 3 N 1F , SURFACE 0 2% MIN 2' FILL APPROXIMATE______ r/�1N1�1 WATER TABLE 6/15 05 ixr57TArt,' REMOVE TOP �TR�k.' OF SEWER ROCK _ k AS NEEDED AND REPLACE WITH PIT RUN SAND ' 11.25' DRAINROCK i -'I 1 4' PIT RUN PFILTER SAND I 1 ----------- ABANDON IN PLACE WELL/SEPTIC SITE PLAN LEGAL: MAJESTIC VALLEY ESATATES, LOT6,BLOCK2 OWNER: RANDY AND KARIN STRINGER CONTRACTOR: UNKNOWN JOB# 05-067 1 DATE: 08/07/051 NOT TO SCALE EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 EAGLE RIVER, AK. 99577 (907) 694-5195 FAX: (907) 694-329 c�Q.. s 1k i" SYSTEM OF 4� �n '.CHRISTOPHER R. WOOD. /W CE -10387 10?a•ESSMIAN•.ee Eagle River Engineering Services Christopher R. Wood, P.E. 10421 VFW RD Suite 201 (907) 694-5195 tcl Eagle River, AK 99577-3294 (907) 694-3297 fax SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM — MOA CERTIFIED INSTALLER LEGAL: Majestie Valley Estates Lot 6 Block 2 August 7, 2005 A. GENERAL 1. The septic plan is for a 3 bedroom single family residence only. 2. The drawing and or site plan shall be apart of this specification. 3. All materials and workmanship shall meet the Anchorage Department of Health and State Department of Environmental Conservation requirements. 4. All soil tests are advisory to the design and are to be verified or modified in the field by the engineer. 5. All excavations and depths are advisory and are to be verified in the field by the contractor to meet Municipality of Anchorage, Department of Environmental Conservation requirements. 6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any adjacent multi -family wells. A licensed surveyor should locate any utility easements and exact 100' radius from the existing and neighboring on-site wells. 7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer approval. 8. Any remaining open test hole excavations shall be filled and monitor tube removed. B. ADVENTEX SYSTEM AND SEPTIC TANK 1. Septic tank shall be a fiberglass or steel 1500 -gallon tank capacity of MOA approved construction for use with Advantex system. Install as per current manufacturers recommendations for conditions in Alaska. 2. Install one AX -20 filter pod over septic tank capable of treating 450 gallons per day of waste flow. 3. Install Orenco 24" pump basin PB -2496 outside septic tank, with OSI pump model P30-05 and controls to allow 23 gallon dosing of septic leachfield. Set pump float to 13.5" above pump, timer for 1 minute dose time. Controls to be installed to MOA code by licensed electrician familiar with OSI applications. Controls to include a dedicated phone line and web based monitoring system. 4. A municipal inspection report or receipt from a licensed electrician shall be provided to the engineer verifying lift station wiring to all applicable codes. C. DRAINFIELD 1. The drainfield is to be located as shown on the site plan. 2. The total depth of the initial drainfield excavation is to be approximately 5.5' deep, relative to existing ground elevation above existing leachfield and end in top of existing drainfield. The excavation shall remove the topsoil layer, and any sewer rock withing 4' of the bottom of the new drainfield. The bottom of the excavation shall be level, plus or minus 1.5". 3. Continuous heavy mil -thickness visqueen is to be installed on the downhill edge of excavation, extending from the bottom of the excavation, up to the top of the new drainfield gravel. 4. Aporoximately four feet of Coarse Sand shall be utilized beneath the gravel layer to get 4' separation to groundwater table, and above existing sewer rock. 5. A filleen-inch layer of sewer rock is to be placed over the sand layer. The 1.0" effluent piping is to be buried within the gravel layer with 2" of gravel cover over the piping. 6. The completed drainfield gravel and piping is to be covered with typar fabric material. 7. Soil or combination of soil and extruded board insulation to a depth of Y or equivalent is to be placed over the bed. Mounded side slopes on uphill side and ends are not to exceed 3:1. 8. The septic tank and leachfield must not be closer than 100' to any existing private well, 150' to any Class "C" well, or 200 feet to any community well. \2003\05-067dminficid-lilt-Advantex spec SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM — MOA CERTIFIED INSTALLER LEGAL: Majestic Valley Estates Lot 6 Block 2 August 7, 2005 Continued: RECOMMENDED LEACIIFIELD DIMENSIONS: TOTAL DEPTII = 6' maximum GRAVEL DEPTH = 1' under effluent pipe, 2" over pipe (1.25 feet total) DRAINFIELD LENGTH = 35' DRAINFIELD WIDTH = 5' SOIL RATING= 4 GPD/fl= BEDROOM CAPACITY= 3 EFFLUENT PIPE = 1.25 from pump basin to leachfield then 1" manifold to V PVC with 1/8" holes oriented down spaced at 1.0' OC. 2 pipe runs in leachtield 2' between pipes 1.5' from sidewalls and end of trench. SEPTIC TANK = 1,500 Gal Advantex compatible tank w/ AX -20 filter pod and lift basin Twenty-four (24) hours notice required for all inspections. \2003\05-067drainfield-lift-Advantcx spec EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 Eagle River, Alaska 99577 (907) 694-5195 ERES Project No: 05-067 Calculated By: CW Date: 8/7/2005 Legal: Majestic Valley Estates Lot 6 Block 2 TEST HOLE 1 Single Family 3 Bedroom Dwelling Shallow Trench Subsurface Wastewater Disposal Field Water use at 150 gallons per bedroom = 450 gallons Percolation rate = 28 minutes per inch Wastewater application rate = 4 gallons per day per square foot Required absorption area = 113 square feet Trench width (W) = 5 feet Gravel depth (D) = 1 feet Required length = Shallow trench factor' Required absorption area / W Shallow trench factor = (W + 2) / (W + 1 +2 D) / �' S. s 1 two SSD Shallow trench factor = 0.88 t Total Excavation Depth = 1.5 feet Required length = 2T feet 35 05-067 AdvantexdrainfieldCalc 10:47 AM8/7/2005 Municipality of Anchorage Development Services Department Building Safety Division • a.r On -Site Water and Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 995196650 Y+ww.d.enchoraae.ak.us (907) 313.79N A Soils Log - Percolation Test Performed For. R�Itii)j`[ Date Performed; 6ir5l>�- Legal Description: MAILS-fff, V/VLfy gggj'S Lb 13?Township. Range, Section: -rlan) 2141 5[C . - Depth 1-IWVVI I fT(L t OV 6,ArrrC S (nM - GGh7E/ 8 Rpt►J 1 LW56 snl 15,l„ v/ r1 'ki, WAS GROUND WATER 9- ENCOUNTERED? I B 10- IFYES,ATNMATDEPTH? G•5, o Depth bWr —� / P 11- Mnit ooring? ing7 w i e 12- Dale: 2 tl0 i 13- 14- 15- 1 Tran eading Date Gross TAne Net Time Depth to Water Net Drop 1 X30 AA' v ."..rl l rS " Y 3I16� S ri•30AA+ p 3', 9/y 5 Ic s H tt 5 f.w................���rm�wrynml YCNU HUGE UVVnETER TEST RUN BETWEEN _MSFT AND_FT COMMENTS PERFORMED BY: G 14 .� t�dV h, CERTIFY THAT THIS T ST WA PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: p FI 0 0 e 0 0 tool Ual) PBBH alweudQ lelol 0 to Li~ 0 .0r r O r Y 0 0 Rto 0 I LM 0 z auY I ! N I I i j 8o z �i ��� � ►lil �( II! I I I i, V1i i II I I I I 1 tool Ual) PBBH alweudQ lelol 0 to Li~ 0 .0r r O r Y 0 0 Rto 0 I LM 0 z s c n r 0 CD -o N_ I 0 O I � N pCC 1 O O N_ g 1 I I n m N e A xr CD toC 1 N C t � rn I I � I 3 1 � f 1 I 1 1ic g 1 1 0 1 i n 0 Cr I � 'o ea m r� 00-irw By: n a... M C W A. roe: Typical LOA LrM PmAbne 6r ResidwU u: rear. avr.s.. ... eroaJrr A&mTa' TreeenerA 6 envft MVPConWP �ul 4rJ.,J}J r rozw ow nar. � roa.++ IV: � u. r 0014 ADDM.& RIAa[ hll.: 4Vree aw: r.re •�- orenoo 9yeterne• Municipality of Anchorage Development Services Department Building Safety Division i % On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWERIWELL SUBMITTAL COMMENT SHEET To: EAGLE RNER ENG Legal description: MAJESTIC VALLEY SL 2 LT 6 ee. a -e4 � a ZD The attached paperwork has been reviewed and is being returned for the following reasons: ❑ Original signature or stamp missing on ❑ Calculation error in design. ❑ Additional soils information needed. ❑ Water monitoring results inadequate. ❑ Discrepancy in information submitted. ❑ Topographic information missing or inadequate. ❑ Incomplete; missing ❑ Incomplete; missing ❑ Additional adequacy test information needed. ❑ Water sample unacceptable. _ ❑ Measured/proposed distances/dimensions missing. ❑ Locations of all soils, percolation and water monitoring tests not shown. ❑ Proposed system too deep for soils information submitted. ❑ Well log required. ❑ Omission in narrative. ❑ Insufficient fill over tank or field._ ® Other. -NEED A NEW INGRESSIEGRESS AGREEMENT THE OLD ONE IS NULL AND VOID BASED ON SIGNED AGREEMENT PLEASE SEE ATTACHED COPY OF AGREEMENT. -NEED PROPERTY LINE WAIVER -PLEASE DESCRIBE WHAT WILL BE DONE WITH OLD TANK AND CONTAMINATED MATERIAL. NEED TO REMOVE ALL BIOMATTED CONTAMINATED MATERIAL. OR STATEMENT THAT BIOMAT AFTER EXCAVATION WILL NOT EFFECT THE NEW ABOSORBTION AREA. -NEED TO REFERENCE IN YOUR OPENING LETTER THE INSTRUCTIONS FOR CONSTRUCTING SYSTEMS IN SAME LOCATION ON ATTACHED MEMO DATED APRIL 7, 2004. Name of reviewer: JOE GOODALL Date: 8/11/2005 Please supply the necessary information and re -submit your request. DATE: April 7, 2004 MUNICIPALITY OF ANCHORAGE Building Safety Division *SA111 MEMORANDUM TO: On - Site Services Program FR2qds oss, P.E. ger, On -Site Water Wastewater Program SUBJ:' Slope setbacks from >25% In situations where slope conditions will not allow a wastewater disposal field to be located 50 feet horizontally up gradient from a change In slope to greater than 25%, as required In AMC 15.65.060.A.1.b the following requirements apply. (As allowed by AMC 15.65.030.G) 1. A point shall be determined two and one half feet above the Invert of the distribution piping of the septic field at the field's closest point to the slope greater than 25%. 2. A line shall be drawn from this point and perpendicular to the distribution piping at a down slope of 25% In the direction towards the slope greater than 25%. 3. The Intersection of this hypothetical line and the actual slope shall be a minimum of 35 feet horizontally from the point established in #1. 4. This 35 foot horizontal separation shall be the minimum allowed between a disposal field and a slope of greater than 25%. If a property has a wastewater disposal system that was constructed prior to 1986 and the absorption field encroaches a change in slope greater than 25%, an upgrade of the failed system may be approved in the same location if the following applies: 1. No other location exists on the property to construct an upgrade drain field with proper separations. 2. The engineer field verifies that no effluent ever surfaced on the slope surface. 3. The engineer maximizes the separation from the field to the slope as much as possible. AUG-29-2005(WN) 10:12 EAGLE RIVER ENGINEERING (FAX)907 694 3297 P.001/002 A 2005-060537-0 A Recording Dist: 301 -Anchorage A s 8/26/2005 9:12 AM Pages: I of 2 K 1 A 611�Ipllpl9111�11illllpl81111'�Ilppl><pIIllNllll9llplplllp�� Easement Agreement cc Whereas the septic system trench constructed to provide sewage disposal for Lot 6, Block 2, Majestic Valley Estates Subdivision extends 13 feet more or less onto Lot 9, Block 2, Majestic Valley Estates Subdivision. This document releases a previously recorded document in Book 01845, Pg. 477. Whereas the Owners of the subject parcels wish to enter into an agreement to allow the continued use of said septic system trench, the parties as follows: An casement located on Lot 9, Block 2, Majestic Valley Estates Subdivision 15 feet wide and 20 feet long, containing 300 square feet, is hereby created for septic system trench use by the Owner of Lot 6, Block 2, Majestic Valley Estates Subdivision and is more particularly described as follows: Commencing at the Northeast corner of Lot 6, Block 2, Majestic Valley Estates Subdivision; thence South 27 degrees 42' 55" West 180 feet along the easterly boundary of said Lot 6 to the Point of Beginning of the casement; thence South 62 degrees 17' 05" East 20 feet; thence South 27 degrees 42' 55" West 15 feet; thence North 62 degrees 17' 05" West 20 feet; thence North 27 degrees 42' 55" East 15 feet to the Point of Beginning of the easement. Whereas it is understood that the protection of parties is paramount, the parties agree as follows: 1. The easement shall be granted to the owner of Lot 6, Block 2, Majestic Valley Estates Subdivision and their heirs and successors. Sale or transfer of ownership by the owner (s) of either lot shall include transfer of ownership of this agreement. 2. It is expressly understood that this casement agreement shall only be valid as long as the existing septic system trench is operating in accordance with Municipality of Anchorage standards. 3. It is agreed that the Owner of Lot 6, Block 2, Majestic Valley Estates Subdivision shall hold the Owner of Lot 9. Block 2, Majestic Valley Estates Subdivision harmless from damage or penalty as follows: a. Sewage spills or overflow. b. Costs in commection with any form of violation of lav regarding septic system operation. Pagc 1 of 2 l'• J AUG-29-2006(NION) 10:12 EAGLE RIVER ENGINEERING ': (FAX)907 694 3297,: P: MOW c. Conflicts with or damage to wells, groundwater or other parts of the environment created solely by the septic system trench. d. Any cost arising out of inspection. Repair or damage of the septic system trench. This agreement has been signed and entered into this A5 day of QUA, . 2005 in the Anchorage Recording District, Third Judicial District, at Anchorage, Alaska. Owner Lot 6, Block 2, Majestic Valley Estates Eagle River, Alaska Owner Lot 9, Block 2, Majestic Valley Estates Eagle River, Alaska At Anchorage, Alaska: �G{+� Ths is to certify that on the C day o' fQu�"�, 2005, ei IA&h4 h L'Sfir �Jt Kat" ivt SfY-ytA Zt personally Oficared before mc, the undersigned, a Notary Public irl and for the State of Alaska, known to be to me to be the person (s) named in and who executed the foregoing document and hehhcy acknowledged to me that he/they were authorized to execute the foregoing document. WITNESS MY HAND AND NOTORIAL SEAL the day and year first hereinabove written. ' p(AR Y'• r NO RY PUBLIC IN AND FOR q1 aS tL cQ �. PU>3ti_ MY COMMISSION EXPIRES: 0% ` E l lar I 1 ;-p zest 2 2005-00053T-0 Ftat�lE l'. MUNICIPALITY OF ANCHORAGE ® �1 DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL- ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL, SYSTEM AND/OR WELL INSPECTION REPORT �_q'�Ct/..%'L-C,__ NAME _�,_. �._.a ._-e_______�._,-_p..,--. NEW ❑UPGRADE MAILING ADDR S9 LEGAL DESCRIPTION Z iu( LOCATION NO FBEDROOMS U DISTANCE TO: Well Absor tion area 1 (U p �� Dwelling - PERMIT NO. _ -7 Y > _ Q0.ZS a Q Manufacturer Material y No. of compartments Liq. rapacity in gallons 10 Inside length F HOMEMADE: T Width -Liquid _depth DISTANCE TO:_— _ Well Dwelling -_-- PERMIT NO. z Q 2 — (-• Manufa1lr� -5 _ — Ma—' terial---_ _ Li_ ,quidcapacity in gallons D �a DISTANCE TO: Well li(� Foundation �' Nearest lot line PERMIT �_ t- tO LL Z Z w P No. of lin5�\ V Length of each lint r �l Total length of lines, ,� Trench width Distance b tween lines Q L.. iY Top of the to finish grade i {'.�oinches ei Material beneath the Total effe five abs orp�ion area O �� dnefTES OO LU Length - Width Depth _ PERMIT NO. Q F— IL a w Type crib C dii Teter i Crib d th T til eff tive a sorption area t N DISTANCE TO: Well wilding fours ation Nearest lot lot lit r LU CI Depth Driller Distance to lot line PERMIT NO. pc,C�,�_�j '7 DISTANCE TO: Building foundatio rj Sewer line O Se tic tank p f (C} _ Absorption are�ls) IIJJ OTHER PIPE MATERIALS DI `3v��t y.. CST SOIL TEST RATING ID p fe _ INSTALLER/) II ' C� REMARKS 1 S ID 7 -- 0. 1 APPROVED DATE LEGAL = �- 77-n '}101 / / �i ,( �� a,; . ..... ICA F'-- f N" -°N F 9 FA CFE.. HEAL.1"H ANE", 7 TREF,�`Tj AN(IJIfiRWil".. Ak". R- ao -qf-) u....... f�:N �A L". NID. AFF:- i.J.'('lF'ihlT GAR' -r' F'Of-IfINY EI I>; EAGI-E P'llylER 1:.- AG U.": R -.1VE R I E i _'l A L. L 6- B Z, MAJESTIG ',*il L EY LOT .5*17E 54851 SF.UARE FEET TI-,lF,J:;. OF ':5C' "I . .... . . FFT' OP4 'S.Y, TEM 'IS: TRENCH HF-I:x;.l'HUM NLIMBER OF' l?Ef'.-,RO('*+1T.-5 ---- 3 'SO I I RATI6113 ,.SCJ. FT.-,'BRtl=- 195 .... HE ABSORPIJOhl SY:.5TEN IS: :.J if -."5f 0-- k=., i'A 1-1 -4 -.F.h CN=A FEE I-- I THF-, L -E -NO . Ill E:'I MENSI Ok,l IS THE I P-43TH .:IN FEET) OF THE "I"RENCH OR DRAINFIF."LE). filf". OF A TR.ENGH OR, F,IT 1:"-; THE DISTAt.-ICE BET14EEN THE SURFACE OF THE APA".1 THF: W.'ITTON OF THE7 <:Ul FEFET'l. T1 IS NO SE WIDTH i.':(:'IR TRU-Ji.."HE`l. I" H E j5P:FNEl_ I -S.: THE HINIML.111 F)EP111 OF GRA'.,4`11 BETWEEN "PAE OUTFALL PIPE 1 1 11j.1 I. -I - �."I­T-A' A- THE E."r-UNFiTION 1"M FEET';'. c, Y 1:71 N" -^NK _ !,�5 1: FE -".L R. -Ea (D t*.-E.R i0 n L_ L_ J.: V` k • I I r PERHIT HAS, 'THE RE,.�:5PONSJEBILITY TiD I.NFC.IRl-1 THIS DEPARTMEhIT DURING THE I Fl L. I ATI(A.-I OF Ahl`r' WELLS ADJACENT TO THIS PROPERTY AND THE kli OF T"HA"I" THE [,,IEI,..L- I. -JILL. 1:+ERVE. ........ . . . ... 1 1 J �' I -F: T- 1 1177 A P F -..a F -Z A -Z! K.J I U.".11 OF ANI',' `5YSJ'EM WITHWJT FINAL INSPP-710N ANE) APPROVAL BY THIS 11111-1. SUBJECT TO PRO-Si:ELDLITION. F:ETWEEN A WELL ANE1 ANY ON-SITE SE14AGE f.)I�SF-`O:5AL .�WSTEJI IS F -01"n'. A PRIVATE*. WEL.L. C.)R 150 T( 200 FEET FIROPI A PUBLIG 1,4ELL DEPEk.-IDING 'FHE PrT`E OF PUL -i -'LIG HELL. ill"Li'TINI 4.1 FROM A PRI1,1ATE 14FLL TO A PRIVATE _El..,lER LINE 15 ;25 FEET ANE T .) rA f..'OH11UNIT'i-I SEWER LINE .1". 7 Ei FEET. ARE RECRYIREF.., AkID HUST RE RE'*J­fJF.,NED TO THE L)EPARTMENT WITHIN -30 DAYS 11REHENTS"; MAY APPLY. SPEC_JF­(GFlTIONS ANE.', G.ONSTRUfl*'TION DIAGRAMS: ARE". "1"0 INSURE PROPER 11.451"FiLLATTot.j. FY T11AT J.: I Fill FAMIL.T.AR, bail: TH "I"HE FOR ON. -SITE SEkIERS, ANE.', 1,49.1-5 AS SET FIFTH B"il THE MUNI(AYAl I"I"Y OF, ANCHI-IRAGE. I kl)., I ... 1- L THE :"_:Y,.:.TE H IN AGGORDANGE WITH THE GOOES. I THAT llif`,' ON-SITE :3F.I.-JER SYSTEM MAY REQUIRE ENLARGEMDff' IF." THE HE REMOE)ELED 'F0 P-4CLADE MORE ­rf-iffl.j BEDROOFIS. ..... ..... . .. ... r,.-.-...,...,..,-.-,.....-.-..-.----.,.,-.-.......---,,-.---,.-.-..,-.....,-...- ...... 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I€11 -IL C )'`r' .J:Jr= ;�tsr=3rt rt t tr1l': � _1111 I ? tu— I1•)-�TZ-' .Y_1; i _: r" f 3� I11 i=N=;J Je€fCt�r;l la : 14 I C1, 11-P-, s , rA-A-.,::'S 1'Y'113i) 3"13Y ( T .f r- , r'} l • I r _;; _i'I%32 .: `1' R -TI 1,10Y i :f71J I RJ- r F31.Fii4J's 3'it Fl E, 1`1- !"i 74f 1'7J1€:ttf_:=L, 'NCP��I.aJll 1)t r3i7ii1 It_7i.�h ,Jtr--------•---- - ____11____11 ,,.._.__�si-4�I---1111.-....__.._y�_.___._ V<i._sl' i j 0 Et E GEC. , ECHNI CAL Et DEVE_ ..PMENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Earl Ellis Russell Oyster 688-2280 694-2774 SOIL LOG Land Development Soils Et Foundations Performed for: Name: Tel. No.. Mailing Address:�_� Legal Description: 2ekt_Cfeetl Soil Characteristics 0 1 2 3� 4 5� 6 7 8 9. 10 11 12 ... 13 • •9 0 '/ 14�� 6 •••aa••n••••••u••s••s•••iu •`•N•N•••••°•••••n ••.•• Of 15 0 0-1 • Earl P. Fins : r� �O '•s NO. 1745.E J�4'i so 16 +f �9%ZZZ �� '' Ground Water Encountered: Yes No If yes, what depth Proposed Installation: Seepage Pit Drain Field,_, Comments: Performed by: _ Date'— r r r '.•... h.`. yet rV.ia KF1','. m Q .•'� P4 a oY ui UA s[ T 3 itVf �� W . 09 W - q , pw W � j" W .: ag _ 144ix fps. W 1% ir+ - t w F Py C 3 F,�Y exS gy 'yy m • • Municipality of Anchorage On-Site Water and Wastewater Program s�tl.6ilia (907) 343-7904 SA CTY CERTIFICATE OF ON—SITE SYSTEMS APPROVAL Parcel I.D. 050-731-42 Expiration Date: la-3 -l(i'g 1. GENERAL INFORMATION Complete legal description MAJESTIC VALLEY ESTATES BLOCK 2, LOT 6 Location (site address) 26245 VALLIHI CIRCLE, EAGLE RIVER,AK 99577 Current Property owner(s) SAMUEL DRESSEL&BALINDA O'NEAL Day phone Mailing address 26245 VALLIHI CIRCLE, EAGLE RIVER,AK 99577 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: 3 TYPE OF WASTEWATER DISPOSAL: 4. TYPE OF WATER SUPPLY: Individual Individual Well ® Holding Tank ❑ Individual Water Storage ❑ Community ❑ Community Class Well ❑ Public Sewer ❑ Public Water System ❑ WaiverNariance request for: Distance: Received by: -�% Date: 7/.0 COSA to be released to tF3e'engineer, unless otherwise requested by the engineer. COSA Fee $ G.P-40 Waiver Fee $ Date of Payment tp'aCJ'�� Date of Payment Receipt Number 0 Wog Receipt Number COSA# i 1agq 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 ARCTERRA CONSULTING,INC. Phone 868-3791 Address 20441 PTARMIGAN BLVD.,EAGLE RIVER,AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 6/22/2018 THIS COSA DOCUMENT CANNOT BE USED TO TRANSFER TITLE UNLESS ALL VENDORS(ENGINEERING,SURVEYING,CONTRACTORS,ETC...ASSOCIATED WITH THIS COSA ARE PAID IN FULL AT OR BEFORE CLOSING. 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. OF liz4 6. DSD SIGNATURE r*-A•p Tai '�= bedrooms. System#1 Approved for ��' , . KENNB DL41 System#2 Approved for bedrooms. 1 ��� 71 e ;. Disapproved. \ '�Fessto��11.- Conditional approval for bedrooms, with the following stipulations: G ON-SITE ) WASTEWATER z PROGRAM '14", -n/T Q'-D� By: t,wL Original Certificate Date: �- ` 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 blue sheet 10-1a12.doc • 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: MAJESTIC VALLEY ESTATES BLOCK 2, LOT 6 Parcel ID: 050-731-42 A. WELL DATA Well type PRVT If A, B, or C provide PWSID # Well Log (Y/N) Y__ Date completed 8/1980 Sanitary seal (Y/N)Y Wires properly protected (Y/N) Y Total depth 245 ft. Cased to 45 ft. Casing height (above ground) 18 in. FROM WELL LOG AT INSPECTION Date of test 8/17/1980 6.15.2018 Static water level 200 ft. 53 ft. Well production 3 g.p.m. 0.32 g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 mL Nitrate O,/5 ?mg/L Arsenic: ND _ug/L Date of sample: 6-15.2018 Collected by: ARCTERRA B. SEPTIC/HOLDING TANK DATA Tank Type/Material ADVANTEX/STEEL Date installed 10/112005 Tank size 1500 gal. Number of Compartments 3 Cleanouts (Y/N) Y Foundation cleanout(Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) Y Date of pumping rit4orAN114‘4.e040 Pumper C. ABSORPTION FIELD DATA Date installed 10/3/2005 Soil rating (g.p.d./ft2 or ft2/bdrm) 4 System type SHALLOW TRENCH Length 39 ft. Width 5 _ ft. Gravel below pipe 1.2 ft. Total depth 3.3 ft. (Measured 6/15/18) Eff. absorption area 221 ft2 Monitoring tube Y Depression over field N Date of adequacy test 10.19-16 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 600 gal. New depth 0 in. Elapsed Time: 1 min., Final fluid depth 0 in. Absorption rate >= 450 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N &type) N If yes, give date D. LIFT STATION Date installed 9/30/2005 Size in gallons 192 Manhole/Access(Y/N) Y "Pump on" level at 32 in. "Pump off' level at 22 in. High water alarm level at 36 in. Datum BOTTOM OF TANK Cycles tested 2 Meets alarm&circuit requirements? Y E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main 75'+ Public sewer manhole/cleanout 100'+ Sewer/septic service line 25'+ Holding tank 100'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 10'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ ABSORPTION FIELD ON LOT TO: Property line 0' Building foundation 10'+ Water main 10'+ Water Service line 10'+ Surface water 100'+ Driveway,parking/vehicle storage 10'+ Curtain drain 50'+(NONE KNOWN) Wells on adjacent lots 100'+ F. COMMENTS MINIMUM WATER PRODUCTION FOR 3-BR-RECOMMEND ADDING 500-GALLON WATER STORAGE. TESTED SEPTIC THROUGH LIFT STATION. G. ENGINEER'S CERTIFICATION 1 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. .. OF ALsy S t Engineer's Printed Name KENNETH M.DUFFUS , Date 6/22/2018 F *4 9 TH �* Aiphwiiiprer COSA canary sheet_2-6-15.doc ` % KENNE1 4r , ess otzaw MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT • hf r. ` 907-343-7904 On-Site Water and Wastewater Section \ j Fax: 343-7997 www.muni.org/onsite Well Water Advisory Certificate of On-Site Systems Approval # OSC181294 Subdivision: Majestic Valley Estates, Block: 2, Lot: 6 This well's productivity was determined to be .32 gallons per minute. The minimum well productivity required under (AMC 15.55) for a 3-bedroom residence is .31 gallons per minute or 150 gallons per day per bedroom. Although the subject well currently exceeds this minimum requirement, the production capacity can fluctuate. This advisory must be attached to all copies of the subject Certificate of On-Site Systems Approval. Mailing Address: P. 0. Box 196650* Anchorage,Alaska 99519-6650 *www.muni.org ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT BETWEEN MUNICIPALITY OF ANCHORAGE AND ifre4A/C j 49lv45. THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this 2 Dav of ,J-.,>Ly of 20/27 by and between f Y A/X )011/EJ herein the "OWNER,"and the Municipality of Anchorage,herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein,the parties to this Maintenance and Repair Agreement agree as follows: 1.Advanced Wastewater Treatment Systems. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS),described as Advantex AX10 located at(legal description). Majestic Valle% Est. Blk 2 Lot 6 26245 Vallihi Circle. Exile River. AK ................. .... . 2. Definitions. Alteration. Any change to the design or function of an AWWTS that includes the installation or removal of any parts, components or pieces not included in the original construction permit and design. Certificate of On-Site Systems Approval (COSA). An approval by the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with Anchorage Municipal Code (hereinafter, ``AMC") 15.65. These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. Maintenance and Repair. The scheduled and as needed replacement of existing parts, components and pieces of an AWWTS that were included in the original design which would allow the AWWTS to continue to perform as designed. Permit. An On-Site Wastewater Disposal Permit as required by AMC 15.65 to construct and operate an AWWTS. 1 3 Term. The term of this Maintenance and Repair Agreement shall begin on the date of approval by the Municipality to operate the installed system or issuance of a COSA,and shall continue while the AWWTS is in use or is operational or until the property is sold or title is transferred by the owner and a new COSA is issued to the new owner or transferee of the property. 4 Alterations, Installation and Removal of Additional Equipment. Prior to performing any alterations to an AWWTS,the owner agrees to obtain an On-site Wastewater Disposal Permit from the Municipality in accordance with AMC 15.65. 5. Maintenance and Repairs. A. Throughout the term of this Maintenance and Repair Agreement, the Owner shall maintain their AWWTS in a satisfactory condition capable of producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. The owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the municipality and the manufacturer of the AWWTS for the entire term of the AWWTS. In addition,it shall be the responsibility of the Owner during the term of this Maintenance and Repair Agreement, and any renewals thereof,at the owner's sole expense,to pay for any and all: (1) repair(s), (2)maintenance, (3)adjustment(s), (4) replacement costs,and (5) inspection costs. B. Owner agrees to comply with all applicable ordinance,laws, regulations,rules and orders for the AWWTS. C. Upon request by the Municipality,the owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system.When a record of maintenance is documented and maintained by the system vendor, the owner agrees to allow the Municipality access to this information. D. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60 for improper discharge. E. Owner agrees that only maintenance and repair personnel approved by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the system. F. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. G Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On-Site Systems Approval. 2 H. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction,maintenance and repair of the Owner's AWWTS. I. Owner agrees to provide and maintain a telephone connection to the AWWTS as required by the AWWTS approval. 6. Nonwaiver. The failure of either party at any time to enforce a provision of this Maintenance and Repair Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Maintenance and Repair Agreement or any part hereof, or the right of such party thereafter to enforce each and every provision hereof. 7. Amendment. A. This Maintenance and Repair Agreement shall only be amended, modified or changed by a writing,executed by authorized representatives of the parties,with the same formality that this Maintenance and Repair Agreement was executed with,and such writing shall be attached to this Maintenance and Repair Agreement as an amendment. B. For the purposes of any amendment modification or change to the terms and conditions of this agreement,the only authorized representatives of the parties are: a. Owner: 14Z. ...0. .Jo4/6.5 b. Municipality: Director, Community Development or designated authority C. Any attempt to amend,modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. 8. Jurisdiction: Choice of Law. Any civil action arising from this Maintenance and Repair Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Maintenance and Repair Agreement. 3 • 9. Severability. Any provisions of this Maintenance and Repair Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Maintenance and Repair Agreement. OWNER: By: _,,,_ ______C7 (signature) . .. _. 2G t2. ,i071/e,...5-(print name) STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT) Daze: / c' ,c (Dl Y The foregoing instrument was acknowledged before me this? day of!:72•2..<_..t?..._ , 2O1 , by —74 a &) 1' :. 7 • C))1: 12-t/ZDI 1 4 �,;,_ _s i _ ,1":2) • Zai 2./24.1NOTARY PUBLIC FOR ALASKA My Commission expires: /'- . --a, / .0„„,,.O�Ftttt"'"t444 t• _40. MUNICIPALITY: ` NOTARY �� II expires m� scion ^ !+'a y (signature) = A • E V LIC __... . (print name) ;9ikF �• � ,,.M ��PS Date: Title: 4 Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 A ;P0 i E v'Ali 3 t 2015 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL=mac; Stier Parcel I.D. 050-731-42 Expiration Date: 7 /S 1. GENERAL INFORMATION Complete legal description Majestic Valley Estates Block 2 Lot 6 Location (site address) 26245 VALLIHI Circle Eagle River, AK Current Property owner(s) Spindler Day phone 694-4994 Mailing address same Real Estate Agent Maureen Huston. Partners Real Estate Day phone 694-4994 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class C Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ COSA to be released to the engineer, unless COSA Fee $ 501 (o / Date of Payment �1! / C5 Receipt Number 67-6 ULD COSA# 6505-11114 requested by the engineer. Date of Payment Receipt 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 NorthRim Engineering Phone 694-7028 Address PO Box 770724, Eagle River Engineer's Printed Name Steve Eng_ Date 6. DSD SIGNATURE System #1 Approved for Z bedrooms. System #2 Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the following sl IN seev¢ w a;, o gas By: Original Certificate Date: � The Municipality of An orage Devlopment 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 Septic System Advisory Well Flow Advisory COSA blue sheet 9-1-12 doe X Nitrate Advisory Arsenic Advisory Other B. SEPTIC/HOLDING TANK DATA Tank Type/Material AD V!{ &7_614 S iE61- Date installed. Tank size 1500 gal.. Number of Compartments 3 Cleanouts (YIN) Foundation cleanout (Y/N) ,_�4 Depression over tank (YIN) / High water alarm (Y/N) Date of pumping 'A114 Pumper C. ABSORPTION FIELD DATA shallow Date installed LO S Soil rating (g.p.d./e or ftz/bdrm) 1 System type ?"r. A . Length . 31� ft. Width 5 ft. Gravel below pipe 412 ft. Total depth ft. Bff. absorption area Monitoring tube Depression over field Date of adequacyaest Z fS Results (Pass/Fail) _^ For 3 bedrooms Fluid depth in absorptionfiield before test o in. Water addedE(2 gal. New depths in. Elapsed Time: 3 p min. Final fluid depth 0 in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N &type) 1VQ If yes, give date 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: AW_T4i:I'1 /C y l LE)/ .6.S"i BZL4 Parcel ID: o.SO-73/, e�/Z A. WELL DATA Well type P If A, B; or C provide PWSID # Well Log (Y/N) Date completed Sanitary seal (Y/N) Wires properly protected (Y/N) Total_depth,2Y ft. Cased to AZ Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test. &d (.$' Static water level Z a O ft. J l ft. Well production 3 g.p.m: f, g.p.m: WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate mg/L Arsenic Mb ug/L Date of sample: Z 2G f5 Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material AD V!{ &7_614 S iE61- Date installed. Tank size 1500 gal.. Number of Compartments 3 Cleanouts (YIN) Foundation cleanout (Y/N) ,_�4 Depression over tank (YIN) / High water alarm (Y/N) Date of pumping 'A114 Pumper C. ABSORPTION FIELD DATA shallow Date installed LO S Soil rating (g.p.d./e or ftz/bdrm) 1 System type ?"r. A . Length . 31� ft. Width 5 ft. Gravel below pipe 412 ft. Total depth ft. Bff. absorption area Monitoring tube Depression over field Date of adequacyaest Z fS Results (Pass/Fail) _^ For 3 bedrooms Fluid depth in absorptionfiield before test o in. Water addedE(2 gal. New depths in. Elapsed Time: 3 p min. Final fluid depth 0 in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N &type) 1VQ If yes, give date D. LIFT STATION Date installed 30 OS Size in gallons %Z Manhole/Access (Y/N) "Pump on" level at 3Z in. "Pump off' level at Z in. High water alarm level at 3 C in. Datum . n ffan Cycles tested Meets alarm & circuit requirements? Y E. SEPARATION DISTANCES WELL ON LOTTO: Septic tank/lift station on lot / 640 ` Absorption field on lot /Uo "f Public sewer main A A i Sewer /septic service line Animal containment areas 5,0 On adjacent lots la t On adjacent lots Public sewer manhole/cleanout /l(A Holding tank lOa lr� Manure/animal excrete storage areas ABd If SEPTIC/HOLDING TANK ON LOT TO: r Building foundation 5 r Property line Absorption field $� 4' Water main AIS— Water service line /0 `tom Surface water Wells on adjacent lots 1,06 rt ABSORPTION FIELD ON LOT TO: l Property line Building foundation 10 �'' Water main Water Service line 1.,D// 7Surface water M6 �� Driveway, parking/vehicle storage Z -O It - Curtain drain pw' Wells on adjacent lots )a F. COMMENTS G. ENGINEER'S CERTIFICATION OF Ate •as,� •; s,° � ! certify that l have determined through field inspections and�j ad review of Municipal records that the above systems are in 0ga % conformance with MOA COSA guidelines in effect on this date. , •. Engineer's Printed Name SifAX �o - Sieves W. Eng r�" g Date A m��5 fBg� s 3/g3,ra 'o� COSA yellow sheet_2-6-15.doc - - ', I ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT BETWEEN MUNICIPALITY OF ANCHORAGE AND �V l I5� THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this Day of A i2r of 20�, by and between herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this Maintenance and Repair Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as GCjVA.1 located at (legal description). Lor- G z Ias;e-S+,'c VL Ile,, Esl,Je- 2. Definitions. Alteration. Any change to the design or function of an AW WTS that includes the installation or removal of any parts, components or pieces not included in the original construction permit and design. Certificate of On -Site Systems Approval (COSA). An approval by the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with Anchorage Municipal Code (hereinafter, "AMC') 15.65. These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. Maintenance and Repair. The scheduled and as needed replacement of existing parts, components and pieces of an AWWTS that were included in the original design which would allow the AWWTS to continue to perform as designed. Permit. An On -Site Wastewater Disposal Permit as required by AMC 15.65 to construct and operate an AWWTS. 3. Term. The term of this Maintenance and Repair Agreement shall begin on the date of approval by the Municipality to operate the installed system or issuance of a COSA, and shall continue while the AWWTS is in use or is operational or until the property is sold or title is transferred by the owner and a new COSA is issued to the new owner or transferee of the property. 4. Alterations. Installation and Removal of Additional Eauiament. Prior to performing any alterations to an AWWTS, the owner agrees to obtain an On-site Wastewater Disposal Permit from the Municipality in accordance with AMC 15.65. 5. Maintenance and Reuairs. A. Throughout the term of this Maintenance and Repair Agreement, the Owner shall maintain their AWWTS in a satisfactory condition capable of producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. The owner shall enter into a service agreement with an AWWTS service and maintenance provider al2roved by the municipality and the manufacturer of the AWWTS for the entire term of the AWWTS. In addition, it shall be the responsibility of the Owner during the term of this Maintenance and Repair Agreement, and any renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs. B. Owner agrees to comply with all applicable ordinance, laws, regulations, rules and orders for the AWWTS. C. Upon request by the Municipality, the owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system. When a record of maintenance is documented and maintained by the system vendor, the owner agrees to allow the Municipality access to this information. D. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60 for improper discharge. E. Owner agrees that only maintenance and repair personnel approved by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the system. F. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. G. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. H. Owner agrees that the AW WTS installation and maintenance requirements as provided by the AW WTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AW WTS. I. Owner agrees to provide and maintain a telephone connection to the AW WTS as required -by the AWWTS approval. 6. Nonwaiver. The failure of either party at any time to enforce a provision of this Maintenance and Repair Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Maintenance and Repair Agreement or any part hereof, or the right of such party thereafter to enforce each and every provision hereof. 7. Amendment. A. This Maintenance and Repair Agreement shall only be amended, modified or changed by a writing, executed by authorized representatives of the parties, with the same formality that this Maintenance and Repair Agreement was executed with, and such writing shall be attached to this Maintenance and Repair Agreement as an amendment. B. For the purposes of any amendment modification or change to the terms and conditions of this agreement, the only authorized representatives of the parties are: V41k� a. Owner: b. Municipality: Director, Community Development or designated authority C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. 8. Jurisdiction: Choice of Law. Any civil action arising from this Maintenance and Repair Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Maintenance and Repair Agreement. 9. Severability. Any provisions of this Maintenance and Repair Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Maintenance and Repair Agreement. OWNER: By: SS (signature) Date: t 3 5 ya c¢--4 (print name) STATE OF ALASKA THIRD JUDICIAL DISTRICT The foregoing instrument was 20/,5 , by Roag P. Chan, My Coiplmission expires: ss. ed before me this/�ay of MUNICIPALITY: By: Lam✓ (signature) ))e (A'61"cn �:Uss (print name) Date: Title: C 1 PUBLIC Zia cdas �OA-y Municipality of Anchorage -• Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us 343- ge.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. t45V 73/ Lf Z_ HAA # /i(+ o 5'0 5_3 y Expiration Date: z lot - 1. GENERAL INFORMATION Complete legal description 1jA:j 3i7 G t1hU'6:/ E57. L 6 137 - Location 'ZLocation (site address or directions) 2 6 2 y 5 Vh L6l d C iRLL Current Property owner(s)RdND`/ v1 11C RT) STR.EM 4612 Day phone Mailing address Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: / Individual Well L� Individual On-site ul 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 Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority 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 HAAs upon request to homeowners. Certificates of Health Authority 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 sample results. (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 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 Health Authority 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 6,Vle 2TJa7t 6NC- SUGS. Phone G 9y-5/`lr Address _IDYZ( VFW (pot. Suit' 2u 1 Engineer's Printed Name 611iWSR &,a P. t.Jooh 5. DSD SIGNATURE P" Approved for 3 bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory By: (Rw 0107) Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: /p �_z %uS Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: m 4T657'_PG u -Li kY L- 5T_ L 6 gZ Parcellb: Agri 7 � / 42 A. WELL DATA Well type Eq%/hIE If A, B. or C provide PWSID # Date completed �� II $0 Sanitary seal (9/N)L_5* Total depth 2Nr ft. Cased to 115'- ft. FROM WELL LOG Date of test eb117 / qo Static water level 2v0 ft. Well production 3 g.p.m. WATER SAMPLE RESULTS: Coliform --!9-Colonies/100 ml. Arsenic: mg./I. B. SEPTIC/HOLDING TANK DATA Nitrate<D• 1 mg./I. Date of sample: 6 tS d5 /0/vFlo 6 - Well Log (5N) _ VC -:_5 Wires properly protected (9N) G5 Casing height (above ground)+I_in. AT INSPECTION G/z3/o s' 5 3 ft. C?. y g.p.m. Other bacteria __A�L colonies/100 ml. Collected by: C liRl S Ct%oob Tank Type/Material +t tf 7AWL..J57"6'E"L Date installed /d /01 /v Tank size 12gal. Number of Compartments 3 �,eanouts (Y/N) i/b3 Foundation cleanout &N) *75 Depression over tank (Y10#0 High water alarm (9N) Ye. 3; Date of pumping Al /+ Ar&IJ Pumper C. ABSORPTION FIELD DATA Date installed 03 Soil rating (g.p.d./ft2 or fl-/bdrm) 4 System type 4bt)*A;rD( bJ2*;V6e1_ rj Length 3 q ft. Width s ft. Gravel below pipe /• 2 ft. Total depth ft. Eff. absorption area 22 ft2 Monitoring tube Y&> Depression over field VQ Date of adequacy test N ,I/EtJry,am Results (PassiFety 194 -5 s For bedrooms Fluid depth in absorption field before lest -�_ in. Water added gal. New depth! in. Elapsed Time: _Cmin. Final fluid depth min. Absorption rate >= y 5S0 g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) N tl If yes, give date M/$ - r D. LIFT STATION Dateinstalled 1/30/0r Size in gallons j 0%Z ManholelAccess&N) ilkS 'Pump on' level at 12 -in. 'Pump off level at in. High water alarm level at 3,6 in. Datum 00MAJ Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAift station on lot t /ori / Absorption field on lot -t- too I Public sewer main f / Sewer /septic service line t 2 S / Meets alarm a circuit requirements? X� On adjacent lots /j;,0 / On adjacent lots f'!0 r r Public sewer manhole/cleanout *too Holding tank 1-/4010 r SEPARATION DISTANCES FROM SEPTIC/ OTANK ON LOT TO: Building foundation f i / Property line fiS Absorption field—t S Water main 2SN r Water service line f /D r Surface water Wells on adjacent lots + /00 r SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: I / Property line 3 Building foundation 't /0 Water main 't' Zs - Water SWater Service line 1-0 Surface water f-/00 Driveway. parking/vehicle storage Y' 2 - Curtain drain 1 SD r Wells on adjacent lots fi/vD r F. COMMENTS 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 HAA guidelines in effect on this date. Engineer's Printed Name G1423 -S tnlbd> Date 1011/ 105 HAA Fee $ y,�C)oU 4 t6 l'l5 • cO w Date of Payment ID/II/ n C� Receipt Number '7 �,�n1 j JAM (Rev. 12101) Fee $ Date of Payment Receipt Number M Il: Legend. • #4 reborn recorved. Lot 5 OF BHN L. SCHULLER: I.S-10400 • r� Jt =; Wel Asphalt Driveway Ip' Ul`ED CO_ M iJO,pp (rec _ o - Vall ih • � R- � S7739 Z5'f Lot 6 Deck *n Pile .'.".se2. L gy . S'pllf ' Deck Deck on on 2e;'; Pae Pas Elect. Stub Out C Tank Access • C.O. GI lk w E.I. ons. a 2006_060531-0 ASBUILT OF: MAJESTIC VALLEY ESTATES SUED. LOT 6 BLK 2 PLAT 77-27 SURVEY CERTIFICATION: SMITH SCHULLER CO, has eonducted aDhysimprovements of this as shown on this drawing and Wat the si thereon are within the property lines and no encroachments exist other than noted. EXCLUSION NOTES:It is the owners responsibilitytodetermine the existence of any Casements,restrictions covenants, or restricons which do not appear on the recorded subdivision plat. Ocl O6, 2005 1 1-.50' 05-375 « sn acs.* s as* rrw RNS Jt.5 OWAW \ i LAND SURVEYING * MAPPING * PLANNING 2331 SCARBOROUGH DRIVE, ANCHORAGE ALASKA 99504 TELTAX.# (907) 337-6046 Lot 5 MUNICIPALITY OF ANCHORAGE Department of Health & Human Services ' DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D. # Q.5-0 - w -412- HAA # ,�/�'h(-D6 %5 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) _ n - G (b) Property owner �/-�f r Telephone : (home) —p� Bus1ness 2�& - Mailing Address (c) Lending Institution A�� / Telephone Mailing Address (d) Real Estate Company and Agent Address Telephone (e) Mail the HAA to the following address: (or check here (11"'if hold for pick up.) List contact person and day phone number below: 2. TYPE OF RESIDEN Single -Family Number of bedrooms 3. WATER SUPPL;'_<ommunity Individual Well ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. h. SEWAGE DISP AL On-site Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-025 (Rev. 7/88) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is 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 in compliance with all Municipal and State codes, ordinances, and r:�U� ations in effect on the date of this inspection. Name of Firm &:Z �i, • !/,C Telephone 52 01-13 ZZ Address Date 6. DHHS APPROVAL Approved for J bedrooms by Approved Disapproved Terms of Conditional Approval ngineer's Seal �V1XXI Date Z4 At Conditional CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 7788) Back Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MOA) • Health Authority Approval (HAA) CZHECKLIST - FEBRUARY 1984 es Dv(SioN 343-4744 Legal Description: Lo—, E, 17& MA 5 Tl( (Ifi l E- - ST)4TC- A. -A. WELL DATA �i < Well Classification (la rL If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) Y_ Date Completed k1c, I/ % CfC) Yield 0,. 5- 6 P&I Total Depth z4.) ' Cased to 4S"' Depth of Grouting U, Static Water Level 4 � ' Pump Set At vim. •� Casing Height Above Ground /�'' Sanitary Seal on Casing (Y/N) _' Electrical Wiring in Conduit (Y/N) y J Depression Around Wellhead (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot 100' ; On Adjoining Lots /CiC t To Nearest Edge of Absorption Field on Lot 110 ' ; On Adjoining Lots o_-"100' To Nearest Public Sewer Line �J,Zd To Nearest Public Sewer Cleanout/Manhole 1\1 11q To Nearest Sewer Service Line on Lot 9d ` Water Sample Collected by JrPi >/ Date Water Sample Test Results _ lA-11SFi4c:Tu / a CommentsVied B. SEPTIC/HOLDING TANK DATA Date Installed /966' Size /)OG No. of Compartments Standpipes (Y/N) y Air -tight Caps (Y/N) _ Foundation Cleanout (Y/N) Depression over Tank (Y/N) Date Last Pumped Pumping/Maintenance Contact on File (Y/N) for k.111 Holding Tank High -Water Alarm (Y/N) WA_ Temporary Holding Tank Permit (Y/N) f 1 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water -Supply Well IC)U To Building Foundation To Property Line ')0 ' To Disposal Field To Water Main/Service Line 'U To Stream, Pond, Lake or Major Drainage Course KI A Comments 72-026 (Rev. 7/66) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata NSs�; -rl Type of System Design Date Installed `1/K0 Length of Field `? ' Width of Field 56 Depth of Field Gravel Bed Thickness -7U Square Feet of Absortion Area X Statndpipes Present (Y/N) y Depression over Field (Y/N) +� Date of Last Adequacy Test /�/ x,/�� Results of Last Adequacy Test i 0Cl SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well j DS To Property Line ? -� e. t��m e --,t ff To Building /Foundation �7 To Existing or Abandoned System on Lot u1A ; On Adjoining Lots ' 100 ' J To Water Main/Service Line 5 To Cutback (if present) MA4 To Stream, Pond, Lake, or Major Drainage Course ,4/,Z/q To Driveway, Parking Area, or VehicleC) / Storage Area 1 i Comments *,& E�cX e / / ' [Z, S -f- I�r�pe✓ Li nC D. LIFT STATION Date Installed ' Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments "Check Permit d Bedroom I certify that? h�checked inspection. / Signed Company Dimensions Manhole/Access (Y/N) ,.Pump Off' Level at Vent (Y/N) Pumping Cycles during Adequacy Test. ng Against HAA Request" i ted, or conformed to all MOA r Date IL/.t(ZkT / MOA No. Ci ZeS Receipt No. i� �� �� 0 L/ 147 Receipt No. %'k = � Date of Payment � ..f -I ` -�q 9 0 o Waiver Fee: $ Amount: $ _i aDate of Payment 72-026 (Rev. 7/88) Back Page 2 of 2 i the date of this Engineer's Seal oO �a �. '4 � n & associates,inc. Consulting Engineers 1000 E. Dimond Blvd. • Suite 205 • Anchorage, Alaska 99515 • (907) 522-1311 December 28. 1988 Mr. Gary Pogany P.O. Box 323 Eagle River, Alaska 99577-7605 SUBJECT: EASEMENT AGREEMENT BETWEEN LOT 6 AND LOT 9, BLOCK 2, MAJESTIC VALLEY ESTATES SUBDIVISION, EAGLE RIVER, ALASKA Dear Mr. Pogany: Enclosed is an easement agreement as we discussed by telephone on this date. Please review as soon as possible and let us know if you have any questions or need any other information. We believe that this agreement is both fair and reasonable, especially since we note that you actually installed the sewer system on Lot 6, Block 2, Majestic Valley Estates in 1980. Very ruly Yogars, CORW / & AS C3L`ATES , INC. ruce J.Corwin, P.E. PresiP t Encl 's re FNMA; maj estat MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION 'JAN 19 1989 11E C1:1VErD BK01848PG477 EASEMENT AGREEMENT Whereas the septic system trench constructed to provide sewage disposal for Lot 6, Block 2, Majestic Valley Estates Subdivision extends 13 feet more of less onto Lot 9, Block 2, Majestic Valley Estates Subdivision and, Whereas the Owners of the subject parcels wish to enter into an agreement to allow the continued use of said septic system trench, the parties agree as follows: An easement located on Lot 9, Block 2, Majestic Valley Estates Subdivision 15 feet wide and 20 feet long, containing 300 square feet, is hereby created for septic system trench use by the Owner of Lot 6, Block 2, Majestic Valley Estates Subdivision and is more particularly described as follows: Commencing at the Northeast corner of Lot 6, Block 7., Majestic Valley Estates Subdivision; thence South 270 42' 55" West 180 feet along the easterly boundary of said Lot 6 to the Point of Beginning of the easement; thence South 62° 17' 05" East 20 feet; thence South 270 42' 55" West 15 feet; thence North 620 17' 05" West 20 feet; thence North 27° 42' 55" East 15 feet to the Point of the Beginning of the easement. Whereas it is understood•that the protection of parties is paramount, the parties agree as follows: 1. The easement shall be granted to the owner of Lot 6, Block 2, Majestic Valley Estates Subdivision and their heirs and successors. Sale or transfer of ownership by the owner(s) of either lot shall include transfer of ownership of this agreement. 2. It is expressly understood that this easement agreement shall only by valid as long as the existing septic system trench is operating in accordance with Municipality of Anchorage standards. Should the system cease to operate, this easement agreement shall immediately become null and void and any new system or expansion shall be constructed solely within Lot 6, Block 2, Majestic Valley Estates Subdivision. 3. It is agreed that the Owner of Lot 6, Block 2, Majestic Valley Estates Subdivision shall hold the Owner of Lot 9, Block 2, Majestic Valley Estates Subdivision harmless from damage or penalty as follows: a. Sewage spills or overflow. b. Costs in connection with any form of violation of law regarding septic system operation. Page 1 of 2 Y BKO18N8Pc478 „yv c. Conflicts with or damage to wells, groundwater or other parts of the environment created solely by the septic system trench. d. Any cost arising out of inspection, repair or damage of the septic system trench. This agreement has been signed and entered into this�6;day of mac'. , , 1989 in the. Anchorage Recording District, Third JU cial D ri 1:, at/�'n6h rage, Alaska. COLLIS D. B• R EN J 1�'✓ Assam-sk e President - r Federal National Mo tgage Association Owner Lot 6, t3lock, Owner Lot 9, Block 2, _ Majestic Valley Estates Majestic Valley Estates Eagle River, Alaska Eagle River, Alaska AT ANCHORAGE, ALASKA: This nis to certify that on the 1�1d day of Tonua��_, 1989, IIQh� C 1�0�'7 v r Wi�fnr-d trJ C'.iu7rles , personally appeared.before me, the undersigned, a Notary Public in and for the State of Alaska, known to be to me to be the, person(s) named in and who executed the foregoing document and }re/they acknowledged to me that -lie/they were authorized to execute the foregoing document. WITNESS MY HAND AND NOTORIAL SEAL the clay and year first hereinabove written. 0 NOTARY PUBLICSAND FOR AoLASRA Wy mond for the scam of Alaska MY Commission Exoires February 26, 1769 MY COMMISSION EXPIRES: STATE OF ALASKA ) `C' \'• `.. THIRD JUDICIAL DISTRICT ) :; THIS IS TO CERTIFY that on this 19th day of Januafp':198;,.'kfe,fQ,r me, a Notary Public in and for the State of Alaska, pei;5trnJy,ag ear®dI'll„ COLLIS D. BEARDEN, known to me to be the ASSISTANT`LICCyPR1JI� 17. of the FEDERAL NATIONAL MORTGAGE ASSOCIATION, and that', e:,,ex� c'uted, the within instrument on behalf of the Corporation thereih na &d and acknowledged to me that such.borporation executed the within' instrument pursuant to its by-laws. IN WITNESS my hand and official seal thi 9th day of J nuary, 1989. NOT PURLIC IN ND FOR THE STATE OF ALASKA My o unission Expires:�p—/8-q/\1[117�� MUNICIPALITY OF ANCHORAGE Page 2 of 2 ?fl(,i0 n DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION J A N 01989 1110EIVED --- 004205 1000 F. Plw.�+�--1 blrYl. AHCHO";�r,c: REC - %kvcLwro.a(e/ AV, R9 515 JAN 19 1 36 PH'89 f : ADDRESS InC'i. 1 i0'v 9 'V /30 Com_ OFA'jk 0"a"a p°° 40199 9 p�p pppp0pup ppuap0 °n°p°p; °4 4W 6 m ° William S. SmHh ! o v* J No. 107.5 a a�av ®�AOPES°SIONVJ �QA.Q.E1,cia4�L`�"aR`v LEGEND ® Prlmory monument recovered ® lrm Alpe and/or rebor recovered O d/B':r 30" rabor set this survey PREPARED FOR+ FIVW/i C 0. ORIVN BY.- /clf,� WAO, N0,7/z P� F6. NO, Zg� GRID TNO. / of/ CHCKD BY• AS -5611L r I horoby cortify that an accurate survey of Ilia following described property- Lo„cSC_ac E z_ A'//C6r S -7 was made on l21IZff and that /ho improvemonts situated Maroon ore within the property /ries and do not overlap or encroach on the proporly tying odjacont thereto, that no improvements on property tying adjocont thereto encroach on the premises In question and that There are ao roadways, Transmisslon 1/nes cr other visible easements on sold properly arcept as indicated horeon. Doted at Anchorage, Alaska, Ihic2day, of �� i G�f��x • � 1/JIiGl�”' L.S. No. ;r/o7S PREPARED BY CORWIN 8 ASSOCIA 7 ES 1000 E. DIMOND BLVD, SUITC 205 ANCHORAGE, ALASKA 99515 (907) 522-1311 I December 21, 198 Mr. Gary Pogany P.O. Box 323 Eagle River, Alaska 99577-7605 SUBJECT: SEWER SYSTEM LOT 61 BLOCK 2, MAJESTIC VALLEY ESTATES SUBDIVISION, EAGLE RIVER, ALASKA Dear Mr. Pogany: Upon completion of an as -built survey for the above referenced property, it was discovered that the sewer system extends approximately 13 ft. onto your property (Lot 9, Block 2, Majestic Valley Estates). We are writing this letter to .request an easement agreement which would allow this system to .remain as constructed. We have enclosed a copy of the as -built so that you can see where the easement would be located. Please review the enclosed information as soon as possible and contact us at 522-1311 to discuss the details. We look forward -to resolving this issue in the next couple of weeks. Very Truly Yours, CORWIN & ASSOCIATES; INC. Bruce J. Corwin, P.E. President enclosure BJC/bbb/pogany/bruce HEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FEDERAL TAX ID # 92-0040440 ANALYSIS REPORT BY SAMPLE for Work Order # 10944 Date Report Printed: DEC 21 88 @ 10:44 Client Sample ID:L6, B2, MAJESTIC VALLEY PWSID :UA Collected DEC 16 88 @ 08:00 his. Received DEC 16 88 @ 11:30 his. Preserved with :NONE Analysis Completed :DEC 20 88 Laboratory Supervisor :STEPHEN C. EDE Released By Special Instruct: Chemlab Ref #: 3746 Lab Smpl ID: 1 Parameter Tested ------------------------------ HITRATE-N Sample ROUTINE SAMPLE. Remarks: SAMPLE COLLECTED BY J. KRESS Matrix: WATER Result/Units ----------------------- ND(0.10) mq/1 Client Name CORWIN & ASSOC Client Acct CORWINP P.O.# NONE REC D Req # Ordered By : J KRESS Send Reports to: 1)CORWIN & ASSOC 2) Allowable Method Limits -------------------------------- EPA 353.2 10 .....,,...........................,...........................................---.........................-.---- 1 Tests Performed See Special Instructions Above UA -Unavailable ND- None Detected See Sample Remarks Above NA- Not Analyzed LT -Lase Than, GT -Greater Than + ' MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1...Ceneral Information (a) Legal Description (include Application Date 11'&Q7 -9:z block, subdivision, section? township, range) ✓'01_ Fs 1X4-%5 6abdfyistyN Location (address or directions) t, /� L (b) Applicants Name (4(le r'� ..vd Telephone - Home Business Applicants Address of / l 176%. eC-i?C ,t 4) 9, 46:L F-1F11/G7e /a/K 9ff:77 (c) Applicant is (check one) Lending Institution ' er builder ; Buyer ; Other [::Z (explain); (d) Lending Institution Hla.,s/�Q /''%u.%u� I .5'r�vf'►�9s 1 ?N�i Telephone Q74/ 3-56// Ad ,as © t Grp ✓ /f AI GAt 0 (e) Real Estate Co. & Agent Ly Address Telephone (f) Mail the HAA to the following address: lS tJ (cam V 6.1AfeV 2. Type of Residence Single -Family F>4 Multi -Family = Number of Bedrooms 3. Water Supply Individual Well W Community = Other (describe) Public = Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. G. Sewage Disposal Onsite Public E::j Community Holding Tank Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the Legality and status. (Page 1 of 21 5. En&ineering Firm Providing Inspections, Tests, File Search, Data and Information As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on --site water supply and/or wastewater disposal system is 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 in compliance with all Municipal and State codes, ordinances, and regula- tions in effect on the date of this inspection. Name of Firm _ Telephone Address 19Gx Date 6. DHEP Approval Approved for �=2 bedrooms By Ir • .• .u. .�.. ... .5� fT Robert A. Shafer 1457•E AV to l� Approved Disapproved r! Conditional -� Terms of Conditional Approval CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK. (DHEP SEAL) RR4/ej/D18 [Page 2 of 2] 7-19-84 A. WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 MLUNUPALITY OI' ANCI'z:2,' DEP(. OF I ILALi� I F.NVIROi,iMINIAL h,;_i., DEG :10 1984 nF - -q- T ,r V .J Legal Description: LO' ack Well Classificatio /(./�J'� If A, B, or C, D.E.C. Approved(Y/N) Well Log Present (Y Date Canpleted A/0 c/ d2i) Yield`` _ �d,1111 Total Depth Cased t 2— 4e��� Depth of Grouting Static Water Level Ile !/o �� ripyi t At (� Casing Height Above Ground / cr Sanitary Seal on Casing(6t Y Electrical Wiring in Conduit (Y Depression Around Kbllhead Separation Distances from 6Ve To Septic/� Tank on Lot /�C) ( On Adjoining Lots To Nearest Edge of Absorption Field on Lot �� ( On Adjoining Lots To Nearest Public Sewer Lie A) j} To Nearest Public Sewer � Cleancut/Mad-ioie_6�zza To Nearest Sewer Service Line on Lot Water Sample Collected B'* B;°JGtWEiIN ; Date /2_ Water Sample Test Resiaj�, I IV ER, LAmwr i� G I,5 Comaents B. SEP'T'IC/HOLDING TANK DATA � f% � No. of C Date Installed LLD Size canpartments Standpipe (Y/Id) Air -tight Caps (7!/iQ) Foundation Cleanout (Y/N) Depression over Tank (' Date Last Pumped ZZ �z�J"3� Pumping/Maintenance Contract on File (Y for Holding Tank High -Water Alarm (Y ),' Temporary Holding Tank Permit ('Yjfii) Separation Distances from Septics Tank: To Water -Supply `� pp y Well ��L�• To Building Foundation To Property Line To Disposal Field c`J To Water Service Line To Stream, Pond, Lake, cr Major Drainage Course D /`-j y Comments vje- Receipt #(„ (D Date Paid: �-- Amount: (Page 1 of 21 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata � Type of System DJsign Date.Installed Length of Field Width of Field 3 Depth of Field Gravel Bed Thickness 72- r� Square Feet of Absorption Area 5_ed_� Standpipes Present Depression over Field (Y Date of Last Adequacy Test 12- ,e`7ZL.�, Results of Last Adequacy 'lest._ Separation Distance from Absorption Field: To Water -Supply 6 11 Z/C:'' r To Property Line To Building Foundation 2 J " To Existing or Abandoned System on Lot N O ",_rF ; On Adjoining Lots /U 0 To Water /Service Line 74 To Cutbank(if present) N U ^JF To Stream/Pond/Lake/or Major Drainage Course /_) a /tom' To Driveway, Parking Area, or Vehicle Storage Area Convents /U-0 )..J-]2 D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Di nens ions 5.ole/Access (YIN) f" Level at Vent (Y/N) Tested for Pumping Cyples during Adequacy Test. Meets MOA Electrical Codes(YM) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conforned to all MOA HAA Gu on the date of this inspection. [--- = Signed a & V C6GI[dEl«SiN Date Co an M�, t•)i i�VBR, ALASKA �g57r �Y MOA No. KB1/d5/s [Page 2 of 21 Qes in effect Rob9d A. 2-15-84 m - INSPECTION APPOINTMENTS DATE RECEIVED - -L � -- --- -------- TIME --- — ---- — — -- - — — TIME � TIME ---- -- DATE - - -- - — ------ DATE / - — --- —D ATf- INSPECTOR � INSPECTOR INSPEC"fOR ❑ One [A Four E:1 Other -- UAI1EIRAE'I:r AN - -PP A6t— ❑ T"wo LA Five C_1 MULTIPLE FAMILY roll Three F_7 Six MUNICIPALITY OF ANCHORAGEDEPT. OF HEALTH & ENVIRONMENTAL PROTECTION DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION 625 L Stroct - Anchorago, Alaska 99501 AUG 12, '1981 ❑ ENVIRONMENTAL SANITATION DIVISION Siticc June 1975. For wells drilled prior to that date, give well Telephone 2644720 R E C I V S D REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all pans on page 1. Incomplote requests will not be procussod. Please allow ten (10) clays for processing. 1. PROPER Y OWNER C ❑ PHONE MAILING ADDRESS NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. PHOPER-TY RESIDENT (If different from above) PHONE 2. RUYC:� PHONE MAILING ADDRESS 3. L DING INSTITUTION PHONE MAILING ADDRESS 4, REALTOR'AG E, T -��--Z� 1__ PHONE MAI L I N 37 DR(�(`-SS 0 5. LEGAL ----,_'-------��.�--.�- ------- —. S"I"R E1 ACIONTI�--\ice- K 10 G. T' OFE IDEt NUMBER OF,BI-DROOMS ❑ One [A Four E:1 Other 1=/ � SINGLE FAMILY ❑ T"wo LA Five C_1 MULTIPLE FAMILY roll Three F_7 Six 7. WATER SUP [- INDIVIDUAL` ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY Siticc June 1975. For wells drilled prior to that date, give well PUBLIC UTILITY depth (attach log if availahle.) 0. SEWAGE DISPOSAL SYSTEM i'GY INDIVIDUAL/ON-SITE"1 ._JYEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (11 a, 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER of BEDROOMS L] ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ SINGLE FAMILY O MULTIPLE FAMILY C] TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY PERMIT NUMBER INDIVIDUAL DEPTH OF WELL ❑ COMMUNITY ---_----------------- DATE D13ILLED ❑ PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER ❑INDIVIDUAL/ON -SITE DATE INSTALLED _ --- ❑PUBLIC UTILITY Connection Verified - INSTALLER ❑Septic Tank or ❑1 Holding Tank Size:% � 00 If Tank is homemade SOILS RA'nNG give dimensions: ---------------- TYPEOFTANK — _ ._—---------------------- MANUFACTURER /+ TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Scptic/Holding TankAbsorption Area Sewrr Line Nearest Lot Line WELL T0: Absorption Area to nearest Lot Line 5. COMMENTS APPROVED FOR _ BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) DISAPPROVED DATE 6 sat 72-010 (Rev. 6/70) I 5. LEGAL DESCRIPTION DATE: RECEIVED INSPECTION APPOINT N TIME TIME V fr-11 TIME A Ct 0 DATE DATZ DATE: / L�SINGLE FAMILY -meq- ()- INSPECTOR INS ECTOrR (� INSPECTOR E!t--] NDIVI DUAL* * i ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIMIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 1Otqn, YEAR ON-SITE SYSTEM WAS INSTALLED. 0*79�� 5�.� � ENVIRONMENTAL SANITATION DIVISION Telephone 264.4720 ll�� EE (( vv REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWEF� A�TLIAET DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PERTY OWNER P7E PHONE MAI ING ADDRESS PROPERTY RESIDENT (If different from above) - PHONE 2. BUYER - PHONE MAILING ADDRESS 3. LENDINGINSTITUTION (' PHONE n / �/ :2 MAILING ADDRESS /J f% -r /� 4. REALTOR/AGENT PHONE MAILING ADDRESS 5. LEGAL DESCRIPTION STREET LOCATION li I- _12X/ 6. PE OF RESIDENCE 6. NUMBER OF,BEDROOMS El One E] Four ❑ Other L�SINGLE FAMILY _ ❑ Two ❑ Five ❑ MULTIPLE FAMILY Z;1 --Three ❑ Six 7. WATER SUPPLY E!t--] NDIVI DUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) B. SEWAGE DISPOSAL SYSTEM L�i- 1NDIVIDUAL/ON-SITE** 1Otqn, YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) ��i o n _ _� eT'_"y�`p(.1d -- `� /�t.VS_C.�/l/y_1 C_�'i ck „ /] ./Yqp�✓ � �v.6t' �i.a .t&�t m1� j .IL�CO M 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ TWO ❑ THREE ❑ FIVE ❑ OTHER ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY�io't- Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER ❑Septic Tank or ❑Holding Tank Size: 1000 If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL ,{ 4. DISTANCES WELL T0: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS E5 ---APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE 1 } BY C, M 72-010 (Rev. 6/79)