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HomeMy WebLinkAboutMOUNTAIN MANOR BLK 1 LT 2A PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW920009 DESIGN ENGINEER:S ~ S ENGINEERS OWNER NAME:BRODIGAN CHARLES J & SHARON E OWNER ADDRESS:18412 STILLWATER DR. EAGLE RIVER, AK 99577 DATE ISSUED: 1/29/92 EXPIRATION DATE: 1/29/93 PARCEL ID:05067153 LEGAL DESCRIPTION: MOUNTAIN MANOR BLK 1 LT SEC 6, T14N, R1W, SM 2A LOT SIZE: 52141 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 0 THIS PERMIT IS FOR THE CONTRUCTION OF: WELL SYSTEM 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 FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: I I i 0 25 5~°'' 75 'to0 AS-BUILT MUNICIPALITY OF ANCHORAGE 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 NAME PHONE / ~NEW MAILING ADDRESS LEGAL DESCRIPTION LOCATION NO, OF BEDROOMS Absorption area DISTANCE TO: [Well /~2~Z / ~;~! Manufacturer ~ Liq. ~,,~c,.~,n galIonsDiSTANCE TO: WelIF HOMEMADE: Inside length Dwel W dth PERMIT NO. . Liquid depth PERMIT NO. Manufacturer Material Well DISTANCE TO: Foundation ..~o Nearest lot lin,.e Total length, of lines Trench width Material beneath tile 7~_~ inches Depth No. of lines Top of tile to finish grade~ ~ Width Length Liquid capacity in gallons PER MIxT~;~O'.. Distance b~/~ lines Total effective absorption area PERMIT NO. Type of crib Crib diameter Crib depth Total effective absorption area Well Building foundation Nearest lot line DISTANCE TO: Class Depth Driller Distance to lot line PERMIT NO. DISTANCE TO: Building foundation Sewer line Septic tank Absorpt on area(s) OTHER PIPE MATERIALS,~///~O~_2-¢'~),~.- Ty, a',E ~,~' ~'z>,~' 5'5- SOIL TEST RATING REMARKS APprOVED ~?2 DATE LEGAL MOON DRILMNG SF1 BOX 668, BOGARD HD. PALMER, ALA$1(A 9g6t,q TELEPHONE 745-407] I~VOICE '~'" '~, BIk. / Sul~/.Y.~d_/~..~J~/4//q,4/,~,'~ WELL LOG Lot . DEPTH~/~./I DEPTH DEPTH n~ r?. C^SZN rORM^TmN r~ rT. c^sn~ FORMATZON XN PT. ¢^S~ ~OR~ATXON .4\ w'O~ ~o~ /\ ~o~ ~ ~ \1_ ' ~x~'J I ~ 102 202. ~5 108 203 1~ 204 ~4 106 206 ? 107 207 ~8 ~ '~08 208 9 ~ '109 209 ~ "110 210 ........ __18 118 ~ ~ 218 ~o //~-// 1~o ~/~1/i~oc ~ 220 ~21 ~.~' 121 221 _28x /~ ~ ' 123 223 _~8 ~J ~,_ ~ ,. 128 228 2~ ~~ X29 '229 ~30 '~30 230 -- .36 ~ /~ /~ ....... 136 ~ 236 -- 4T --. 147 247 ~49 ~ F~E~ 149 249 ~58 166 256 ~69~ 159 O ~ E GEO-,ECHNICAL 8' DEVEI qPMENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster Earl Ellis 694-2774 SOIL LOG r~m-z,~m Soils ~ Foundations Land Development Perfomed for: Mailing Address: /~,/2, /~,~ 7?-:, /-:;T[;z>F /J~, :~.,/~/~-. qqJ" 77 Sol] Gh~racterlstlc~ Legal Description: ~¢~ ~, Depth (fe~t) 0 2 -5 7 10 ....... 11 12 13,,,, 16 Ground Water Encountered: Yes Proposed Installation: Seepage Ptt~ No ~' If yes, what depth ~ I~:;"~,~, mm m Drain Field Co~ents: Performed by: Date: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING (~-Z~l ~ I^'~_ ~. ~ ,~.~.~ NAA# 1. GENERAL INFORMATION Complete legal description Lot 2A; Block I; Mountain Manor Subdivision; Location (site address or' directions) 18412 Stid~ater Dr~ve Property owner Mailing address Lending agency Mailing address Chuck Brodigan Day phone 18412 Stillwat~r Drive, Eagle River, Ak. 99577 Day phone Agent Carolyn Mc Fee RE/MAX OF EAGLE RIVER Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 3 ~ TYPE OF WATER SUPPLY: XX Individual well Community well Public water NOTE: Day phone 694-4200 qq~77 If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC ,attesting to the legality and status of system. 72-025 (Rev, 1/91) Front MOA #21 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 of this Health Authority Approval application 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 regulations in effect on the date of this inspection. Name of Firm Phone 5 & 5 EN~INEERIN~ Address 17034 Eagle River Loop Road NO. Eaqle River, Alaska 99577 Engineer's signature Date DHHS SIGNATURE ~' Approved for bedrooms. Disapproved. Co[~itional approval for bedrooms, with the following stipulations: Additional Comments Date ~~"'- The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The D H HS 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. 1/91) Back MOA ¢Y21 Attachment Health Authority Approval HA920139 March 5, 1992 During a recent Health Authority Approval on-site inspection of the well and septic system on Lot 2A Block 1 Mountain Manor Subdivision, the well flow tests showed the combined productivity from the three existing wells to be 24 gallons per hour or 0.40 gallons per minute. The minimum well productivity required by this department to satisfy the requirements of Municipal Codes (AMC 15.55) and Health Authority Approval guidelines, in 150 gallons per day per bedroom. This equates to 0.1042 gallons per minute per bedroom or 0.31 gallons per minute for a three (3) bedroom residence. The recently determined combined productivity of 0.40 gallons per minute marginally satisfies this requirement. The financing entity and prospective buyers should be made aware of the marginal productivity of the well, and recognize the probability of an inadequate water supply during certain times of the year. There are measures which can be taken to minimize the adverse impact of the low well productivity, such as: 1. A water storage tank serving as a supplemental reserve reservoir. In view of the combined subsurface storage capacity in the casings of the three wells of approximately 1,550 gallons, surface storage may not be necessary. 2. Curtailment of non-critical water uses (washing cars, lawn and garden watering, etc.). 3. Installation of water saving devices on showers and toilets. 4. Restricted or controlled use of laundry facilities and dishwashers. 5.Self imposed water conservation practices. 6. Connect the new well into the existing water collection and storage facilities for the old well. While the subject well meets the minimum MOA requirements, the comments herein contained should be attached to the Health p~rtification and all copies thereof. ~0bert W. Robinson Civil Engineer On-site Services ljm:409 ( Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ~ '~/5._ '~...-L~ I A. WELL DATA Well type Log present ~)'N) Total depth If A, B, or C, attach ADEC letter. Date completed Sanitary seal.N) x/ Date of test Static water level Well flow Pump level Parcel I.D. ADEC water system number Driller. ~L,J~ L..~ ~ ~--,- Casedto {>,h~o '¢~ Casing height Wires properly protected~,~N) FROM WELL LOG g.p.m. AT INSPECTION MUNICIPALITY OF ANCHORAGE ENV!RONMENTAL SERVICES DIVISION SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main ~/5, Sewer service line WATER SAMPLE RESULTS: ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank 'l---~ LP~-~- Coliform ~ Nitrate Date of sample: '~----'2J~,~,~:~ ~ B. SEPTIC/HOLDING TANK DATA Date installed ~ ~ '~2~ - '7 ~ ~'1 ~'~ /~ Other bacteria Collected by: Tank size /''Z--~-O Compartments Cleanouts ((~/N) ~ High water alarm (Y/N) Date of pumping _ Foundation cieanoutq:~N) y Depression (YA~ Alarm tested (Y/N) ~'~'~ ~:::'1 t Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot /''-~-~ On adjacent lots To property line \ ~ Surface water/drainage 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) High water alarm level "Pump on" level at Manufacturer Manhole/Access (Y/N) "Pump off" level at Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed Length ~' Width Total absorption area ~'~ ~ ~ Depression over field (Y/~ ~ Results ~s?fail) 'f~''1'/~' Peroxide treatment (past 12 months) (Y/N(_~ Soil rating /L~'~ '~'/~ Gravel thickness (~' Cleanouts present~C~/N) Date of adequacy test for ~/ ~ ~ ~ L.~,~r~ If yes, give date System type Total depth bedrooms Well on lot /~ To building foundation On adjacent lots ~'~ Surface water \c~ Curtain drain hJ c~ ~-~_- SEPARATION DISTANCE FROM ABSORPTION FIELD TO: On adjacent lots / ~t?-~ Property line '72¢'~_ To ~xisting or abandoned system on lot Cu~ank N/A Wa.,ter mai n/service Ii ne _ ~ ~F ~'4. ) Driveway, parking/vehicle storage area E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect f this ~nspection. $ & $ ENGINEERING Signature 17,334 Eagle ~iver L~op Engineer's Name E~gle River, Alaska ~577 Date ~ ~ "~ --~ ~ HAA Fee $ Date of Payment Receipt Number Waiver Fee: $ Date of Payment Receipt Number HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOl L TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN ROBERT SHAFER, P E ROGERSHAFER, PE CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 WATER WELL DATA Lot 2A; Block I; Mountain Valley Estates WEST WELL: EAST Drilled: 1979 Static Level: 24' Depth: 405' Storage in casing: Tested September I, T~sted February 19, WELL: RECEIVED MAR 4 199 Municipality of Anchorage Dept, Health & Human Services Approximately 475 gal. (at full recovery) 1991 at 0.5 GPM 1992 at 2 GPH Drilled: 1981 Static Level: 26' Depth: 505' Storage in casing: Tested September I, T~sted February 19, SOUTH WELL: Approximately 575 gal.(at full recovery) 1991 at 1.0 GPM 1992 at 7 GPH Drilled: 1992 Static Level: 36' Depth: 385' Storage in casing: Tested February 26, NOTES: Approximately 500 gal.(at full recovery) 1992 at 15 GPH The wells are apparently seasonal. It is assumed the recent testing in February 1992 is a seasonally low ~rodu~ivity period. The total productivity from the 3 wells combined rs currently 24 GPH. 3. All 3 wells are currently plumbed into and servicing the house. There is no check valve in the water line to the west well. Water drai~ into the west well when the pump within the east well is running. Therefore, only one sample was taken for both wells since it is essentially the same water. Well flow rates were determined by a series of recovery tests taken over a minim~ of a 4 how period. 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 i,',,l ?- o ~ > '"* 3> ~,;) ,., CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 ANALYSIS RESULTS for INVOICE % 51469 Chemlab Nef.l 92.0757 SampLe # Il Matrix: WATER FAX: (907) 561-5301 Client Sample ID PWSID Collected Received Preserved with L2A El MOUNTAIN ~MOR (HOUSEJ Client Name :S & 8 ENGINEERING UA Client Acot :SNSENGP FEB 26 92 e 17:00 hrs. EPO# : FEB 27 92 ~ 12:IS hrs. Eeq~ : AS REQUIRED Ordered By :R. SHAFEN Analysis Completed : FEB 28 92 Laboratory Supe~%sgr ~%TEPHEN C. EDE Send Reports to: lis & S ENGINEERING PO# :NONE RECEIVED Parameter Results Units ~ethod Allowable Limts NITRATE-N 1.9 mR/1 EPA 353.2 10 Sample ROUTINE SABLE COLLECTED BY: R.L.S. Remarks: I Tests Perfermed ' See Special Instructions Above UA-Unavailable ND- None Detected "See Sample Remarks Above NA- Not Analyzed LT-Less Than, UT-Greater Than ~SGS Member of the SGS Group (Socidtd G~n(~rale de Surveillance) CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. TELEPHONE (907) 562-2343 5633 B Street Anchorage, Alaska 99518 Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER PRIVATE WATER SYSTEM Name 17034 Eagle River Loop Road No. 204 Mailing ^dOm_~ie ~iver, Alaska 995;77 Mo. Day SAMPLE TYPE: i .J~Routine [] Check Sample (for routine sample wtth lab ref. no. [] Special Purpose Slate Zip Code Year [] Treated Water [] Untreated Water SAMPLE No. LOCATION Time Collecled Collected By TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: CSatisfactory [] Unsatisfactory [] Sample too long in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. Date Received ~'-/.~--~/~ ~.~ Time Received L2/¢ Analytical Method: Membrane Filter No. of colonies/100 mL Lab Ref. No. Result* I F-Y3 I FTq I F-Tq A~t A.D.E.C. , READ INSTRUCTIONS BEFORE Membrane Filter: Direct Count Verification: LSB BGB Fecal Coliform Confirmation BACTERIOLOGICAL WATER ANALYSIS RECORD O Coliform/100 mi COLLECTING SAMPLE Final Membrane FIIterr~sults ReportedBy /.,~'b 0'/(~ Date __ / TNTC = Too Numerous To Count i PART nNE [IF/wu-' '-:~ OB = Other Bacteria Coliform/100 mi CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 ANALYSIS RESULTS for INVOICE # 51469 Chemlab Ref.t 92.0757 Sample t 9 Matrix: WATER FAX: (907) 561-5301 Client Sample ID : L2A BI MOUNTAIN ~NOR S/D SOUTH W~LL PWSID : UA Collected : FEB 26 92 ~ 17:00 hzs. RecelYed : FEB 27 92 Pzeserved with : AS REQUIRED Analysis Completed : FEB 28 92 Laboratory Supervisor : ST[~HEN C. EDE Pales,ed By : ~/~~_~ Client Name :S & S ENGINEERING Client Acct :$HSENOP BPOt : Req! : Ordered By :R. SHAFER Send Reports to: lis & S ENOINEERING POt :NONE RECEIVED Parameter Results Units Method Allowable Limte NITRATE-N 2.1 W/1 EPA 353.2 10 Sample ROUTINE SAIdPLE COLLECTED BY: RAY. 1 Teets Performed ' See Special Inetructlona Above UA-Unavailable ND- None Detected "See Sample Remrke Above NA- Hot Analyzed LT-Less T~mn, gT-Greater Than Member of the SCS Group (Soci0te G~n(~rale de Surveillance) CHEMICAL &'GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. TELEPHONE (907) 562-2343 5633 B Street Anchorage, Alaska 99518 Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER PRIVATE WATER SYSTEM Namo Phone No. Mailing Address C~y State Zip Code Mo, Day Year SAMPLE TYPE: ~- Routine [] Check Sample (for routine sample with lab ref. no. [] Special Purpose [] Treated Water [] Untreated Water SAMPLE No. LOCATION 4l Time Collected Collected By TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: '~ Satisfactory [] Unsatisfactory [] Sample too long in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. Time Received 1212 Analytical Method: Membrane Filter * No. of colonies/100 mi. Lab Ref. No. Result* I 1 BACTERIOLOGICAL WATER ANALYSIS RECORD READINSTRUCTIONS BEFORE Membrane Filler: Direct Count Verification: LSB Fecal Coliform Confirmation BGB Coliform/100 mi Final Membrane Filter Results TNTC = Too Numerous To Count OB = Other Bacteria Date Coliform/100 mi 7% A DIVISION OF COMME~RCIAL TESTING & ENGINEERING . TELEPHONE (907) 562-2343 5633 B Street Anchorage, Alaska 99518 Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER PRIVATE WATER SYSTEM Name $ & S ENGINEERING Eagle River, Alasl~a 99577 Phone No. C~y Mo. Day SAMPLE TYPE: ~ Routine [] Check Sample (for routine sample with lab ref. no. [] Special Purpose SAMPLE No. LOCATION Slale Zip Code Year [] Treated Water [] Untreated Water Time Collected TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: atisfactory [] Unsatisfactory [] Sample too long in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. Date Received ~/'~ ~-----~ /c'~/ Time Received 1 ~-',~ (~ Analytical Method: Membrane Filter "No. of colonies/lO0 mi. Lab Ref. No. Result* Analyst Collected By BACTERIOLOGICAL WATER ANALYSIS RECORD READ INSTRUCTIONS BEFORE COLLECTING SAMPLE Membrane Filter: Direct Count Verification: LSB Fecal Coliform Confirmation Final Membrane Filter Results Reported By ~_~-,,~'~r~,, TNTC = Too Numerous To Count BGB Date Time: Coliform/100 mi Coliform/100 mi OB = Other Bacteria MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Dateg~¢~'~'-''~ 1. GENERAL INFORMATION (a) Legal Descripti.o,n (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicant Nam6~¢ ~-'Telephone: Home (c) Applicant is (check one): Lending Institution (d) Lending Institution ~__~--~-- Telephone Address ........................... (e) Real Estate Company and Agent ........ Address ~eleph~ne (f~h..~ HAA to the following address: / TYPE OF RESIDENCE Single-Family ~ Multi-Family [] Number of Bedrooms Other WATER SUPPLY Individual Well~, Community [] Public [] Note: If community welt system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite,,~] Public [] 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. 72-025 (I 1~84) Page 1 of 2 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 Heaith Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, funchonal 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 andor wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Telephone Date p~-~, ~9~.7-,~79 _ DHEP APPROVAL Approved for Z~:Z~ bedrooms by Approved _t/'~ .... Disapproved Terms of Conditional Approval Conditional CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations 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 requirements. Employees of DHEP do not conduct inspectior~s 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. Pane 2 of 2 WELL DATA MUNICIPALITY OF ANCHORAGE (MOA) , HEALTH AUTHORITY APPROVAL (HAA) ,~ CHECKLIST- FEBRUARY 1984 pku' o~ tlLALU; ~ 264-4720 i~N,,i~C:NIV~Nu~,L ~C~.~ 'ON Legal Description: ,J- c~1"' Z. 'i u ;l:~?~-_,l~ :,:~" ~ RECEIVED Well Classification S~,¢', If A, B, C, D.E.C. Approved (Y/N) Well Log Present~)N) Date Complete~/'~-'-~ To:tal Depth (2.-3 ~ J~'~ )Cased to 1F~C--~'~Depth of Grouting Static Water Level ('"2~.~ ~ .') ( ~c;:>' \ Pump Set At C;sing Height Above'round ( ~¢" ~ (~' ~) Sanitary Seal on Casing~N) Electrical Wiring in Conduit(~)'N) Depression Around Wellhead S~paration Distances from Well: To Septic/~ ;o',¢/,ng Tank on Lot ~ ~ ~-¥ ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot t ~c~ ~ ~ ; On Adjoining Lots TO Nearest Public Sewer Line¢,D To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected by ~ ~--.-,..,~', r"-~c..c~l~.~,z,~ ; Date Water Sample Test Results ~ <"~~ Comments "~'~ ~ ~ ~J~5, E~ ~, SEPTIC,': ~L::.':: TANK DATA Date Installed ~"~ - rl ~ Size I~',~0 No. of Compartments Standpipes (~) Air-tight Caps~;)N) Foundation Cleanout(~N) Depression over Tank (Y(~ PUmping/Maintenance Contract on File (Y/N) HOlding Tank High-Water Alarm (Y/N) Separation Distances from Septie~.~e~-~ Tank: To Water, Supply Well To Property Line C ~ ~.-~- To Water M-affl/Service Course Date Last Pumped (z~ -7-.'~ /'~/,~ ;for " Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~'"~ ~ I - '7 Width of Field , ~ ~=~/~ Type of System Design Length of Field ~ Depth of Field '~ ' Gravel Bed Thickness ~7,~.- Standpipes Present ~N) Date of Last Adequacy Test ~ -';~) ~ ~'~--'- Square Feet of Absorption Area Depression over Field (Y~) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot To Water ~ri~r/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area To Property Line /~.~ To Existing or Abandoned System on ; On Adjoining Lots '~:~ / To Cutbank (if present) /,Z. Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Levet at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access.(Y/N) : , "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request Signed ~'-~ ~ ~..,.,,~,~,,-~.~,,,,~ Date Con~ ~?~ J~* ~. MOA No / Receipt No.' ,3~-~ Date of Payment ~ Amount: $ ~a~e 2 of 2 ' DA'['~: RECEIVED i " INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR, NSPECTOR INSPECTOR ~.~ f ~ ~[ MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPT~ OF HEALTH & DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECtH)~RONMENTAL PF;©TECTION 1~ 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL SANITATION DIVISION Telephon. 264-4720 R~CE[~ REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILI DIRECTIONS; Complete all parts on page 1; Incomplete requests will not be processed, Please allow ten (10) days for processing. PROPER~ RES(DENT (If d~ffe~ent from abo ~- PHONE 2. BUYER .~ MAILING ADDRESS ~ PHONE 3. LENDING ~S~ITUTION / _ , MAI LING A~RESS /~ ~ / / LEGAL ~ESCRIPTIO 6. TYPE OF RESIDENCE [~SiNG LE FAMILY [] MULTIPLE FAMILY NUMBER OF~BEDROOMS [] One [] Four [] Two [] Five [] Three [] Six [] Other WATER SUPPLY [~' INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY 8. SEWAGE DISPOSAL SYSTEM ~3-" INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY * ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) ~;I_/~ F~YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF BEDROOMS [] ONE [] THREE [] FIVE [] TWO [] FOUR [] SiX [] OTHER 2. WATER SUPPLY [] INDIVIDUAL [] COMMUNITY [] PUBLIC UTILITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM []INDIVIDUAL/ON -SITE [~ PUBLIC UTILITY Connection Verified []Septic Tank or []Holding Tank Size: !~.S'7~ If Tank is homemad{ give dimensions: TYPE OF TANK PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER DATE INSTALLED INSTALLER TOTAL ABSORPTION AREA MATERIAL 4, DISTANCES Septic/Holding Tank WELL TO: Absorption Area to nearest Lot Line SOILS RATING MANUFACTURER Absorption Area ISewer Line JNearest Lot Line 5. COMMENTS DATE [~'~APPROV E D FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVEDIBY ~ 72-010 {Rev. 6/79) C C ; MUNICIPAL TY OF ANCHORAG I *~ " ? MENTAL PROTECTIOF~V RONh,,~NTAL ~'F, ~'u [~CTIO~ ~--,~ DEPARTMENT OF HEALTH & ENVIRON '~ 826 L Street - Anchorage, Alaska 99501 ~[~1 ~// ENVIRONMENTAL ENGINEERING DIVISION ~ To ephone 264-4720 R ' · ECEi ED HEGUE~T FOH APPHOVAL OF INDIVIDUAL WATERAND ~EWEH FACILITIE~ D RECT ONE: Comp ere all parts on page 1. Incomplete reque~ will notbe processed. Please allow ten (10) days for processing. 1 PROPER+YOWNER ' ~ Y~d' ' ' ' PHONE PROPERTY RESIDENT (If different from E ' ' PHON above) ' ~ R , , ~ r , PHONE 2. BUYE MAILING ADDRESS 3. 'LENDING INSTITUTION ~ , ' ~ ' ' I PHONE MAIL~G ADDRES8 4, REaLTOR/AGENT I PHONE MAILING ADDRESS 5. 'LE~L DESCRIPTION __ ' /,~' ~ · . ' ~ ~ . ' STR"Z' "r.o. / [ ~, [] Two [] Five I 'i ' [] MULT PLE'FAMILY ~ Three I'"'1 Six I ? WA+ER SUPPLY , n ~ ~E~ INDIVIDUAL*' * 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 UTI LITY depth (at,tach Icg if available.) , 8. SEWAGE DISPOSAL SYSTEM ~ **If individual/on-site, give installation date /~/);~Y /~2~ INDIVIDUAL/ON-SITE** If system is over two (2) years old an adequacy test is require(J [] PUBLIC UTILITY bv this Department, NOTE: THE INS I~ECTION' FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. ?:~-o~d{3/78) THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX 2. WATER SUPPLY PERMIT NUMBER [] INDIVI DUAL DEPTH OF WELL [] COMMUNITY 'DATE DRILLED [] PUBLIC UTILITY Connection Verified ,. LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified . INSTALLER E~Septic Tank or E~Holding Tank Size: / ~)~)~3 If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIA[~ Absorption Area to nearest Lot Line 5. COMMENTS [~L-~'~P ROV ED FOR '~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY (Title) // LEGAL DESCRIPTION (Rev, 3/78) Glo FROM D. Adams I00000 TRIP SUBJECT Inspection Fee Refund DATE 4/17/79 IklI:gllAOl~ On May 2, 1978 Duncan McLeod purchased seven sewer and well permits. When the systems should have been inspected the Municipality was on strike. Lot 7 Block 2 Broadwater Heights # 780249 Lot 3 Block 1 Mountain Manor # 780252 Lot 2 Block 1 Mountain Manor and # 780246 Lot 10 Block 3 Mountain Manor # 780247 were inspected by a private engineer. The fees for the above legal descriptions should be refunded. $120.00 @ $30.00 ea. ke~-l@-Bleek-2-Meun~a+n-Mane~---~.)~ed-By-Mu~+e+pa~+~Y N/A Lot 7 Block 3 Timberline - expired Ri..~J~t 4 Block 1 Mountain Manor - inspected by Municipality 5 Block 1 Mountain Manor - inspected by Municipality McLeod Construction P.O. Box 795 Eagle River, Ak 99577 Redi~/ormI 4S 471 Poly Pak {50 sefs) 4P471 SIGNED DETACH AND FILE FOR FOLLOW~UP DATE MUNICIPALITY OF ANCHORAGE ECONOMIC DEVELOPMENT AND PLANNING P.O. Box 196650 Anchorage, Alaska 99519-6650 PRELIMINARY PLAT APPLICATION OFFICE USE ~.~.~ REC'D BY: VERIFY OWN: Please till in the Information requested below. Print one leffer or number per block. Do not write in the shaded blocks, 1. Vacation Code 2. Tax Identification No. 3. NEW abbreviated legal description (T12N R2W SEC 2 LOT 45 OR SHORT SUB BLK 3 LOTS 34). I"I01uINITIA ZN .A ,0 R S MB BI L SA 4. iXlI?I#{I abbreviated legal description ('r12N R2W SEC 2 LOT 45 OR SHORT SUB BLK 3 LOTS 34) full legal on back bags. I.IolulNITIA I N "A NO R ISJUIBI IBI~.I ILIZ IIIII / II IIIII 5. Petitioner's Name (Last - First) 6. Petitioner's Representative IclHIAIRILIES BROD ~GIAINI I I I I I~I~ILILI~IAI" I"~CL I,TOCK Il'l Itl IIII IIIIIIII III ~c~into~k L,d Assoc.. ~n~. Addreea 18412 STILLWATER Addre~ 11940 Business Blvd., Suite 205 city EAGLE RI'VER state ALASKA city EAGLE RIVER State ALASKA Phone#.694-4150 Zip 99577 Pho,e# 694-4499 Zip 99577 7. Petition Area 8. Proposed 9. Existing Acreage Number Number Lota Lots 10. GridNumber 11. Zone I I I~1.1119 7 Illl ~ F~IIIIIIIINIwlI~IsI41 IIIll 12. FeeS 13. Community Council Ea§le River B. I hereby certify that (I am) (I have been authorized to act for) the owner of the properly described above and that I desire to subdivide it in conformance with Chapter 21 of the Anchorage Municipal Code of Ordinances. I understand that payment of the basic subdivision fee ia nonrefundable and is to cover the costa associated with processing this application, that it does not auure approval of the subdivision, I also understand that additional fees may be assessed if the Municipality's costa to process this application exceed the basic fee. I further understand that assigned hearing dates are tentative and may have to be postponed by Planning Staff, Platting Board, Planning Commission, or the Assembly due to administrative reasons, Date: 9-23-91 Signature *Agents must provide written proof or authorization. ( ATTATC H E D ) C. Please check or fill in the following: 1. Comprehensive Plan -- Land Use Classification X Residential Commercial Parks/Open Space Transportation Related 2. Comprehensive Plan -- Land Use Intensity Special Study 3, Environmental Factors (if any): a, Wetland 1, Developable 2. Conservation 3. Preservation Marginal Land Commercial/Industrial Public Lands/Institutions Dwelling Units per Acre Alpine/Slope Affected b. Avalanche c. Floodplain 3-9 d. Seismic Zone (Harding/Lawson) D, Please indicate below if any of these events have occurred in the last three years on the property, Rezoning Case Number Subdivision Case Number Conditional Use Case Number Zoning Variance Case Number Enforcement Action For Building/Land Use Permit For Army Corp of Engineers Permit E, Legal description for advertising. Lot 2, Block I Mountain Manor Subdivision Alpine/Slope Affected Industrial Special Study Anchorage Recording District, Alaska Checklist X 30 Copies of Plat Reduced Copy of Plat (8~/~-x] 1) C~rtificate to Plat '~ Fee Topo Map 3 Copies Soils Report 4 Copies'; X Aerial Photo X Housing Stock Map X Zoning Map X Water: X Sewer: X As-Built Waiver Private Wells Private Septic Community Well Community Sys. X Representation Authorization Letter Public Utility Public Utility VACATION OF RIGHT-OF-WAY OR OFFICE USE ~..~ EASEMENT APPLICATION Municipality of Anchorlge ~c'o a¥~ . DEPARTMENT OF COMMUNITY PLANNING VERIFY OWN P.O. BOX 6650 Anchorage, Alaska 99502-0650 A. Please fill in the information requested below. Print one letter or number per block. Do not write in the shaded blocks. 0. Case Number (IF KNOWN) 1, Vacation Code 2.Abbreviated Description of Vacation (EAST 200 FEET SOME STREET) Isl~lc ,-I~1,1~1 ~s,~- I~Iz.IB~ ~?/ 2-/ / Existing abbreviated legal description (T12N R2W SEC 2 LOT 45 OR SHORT SUB BLK 3 LOT 34). I I II I 1,1/I I I I I I II I/,I11, [I 4. Petitioner's Name (Last- First) I clHI^I"I ~Elsl IBI"I0101~IGI^I"I I I I I II I II!1I I1:11 I 5. Petitioner's Representative I I Ill MCCiint0ck [and Associates, Inc. Address 18412 Stillwater City Eagle River State Al{t$ka Phone No. 694-4150 Bill Me__ 99577 Address 11940 Business Blvd. ~ Suite 205 City Eaqle River State Alaska 99577 Phone No. 694-4499 Bill Me Petition Area Acreage 7. Proposed Number 8. Existing Number 9, Traffic Analysis Zone 10. Grid Number 12. Fee/$ 100.00 11. Zone 13. Community Council Eagle River I hereby certify that (I am) (I have been authorized to act for) the owner of the property described above and that I desire to vacate it in conformance with Chapter 21 of the Anchorage Municipal Code of Ordinances. I understand that payment of the basic vacation fee is nonrefundable and is to cover the costs associated with processing this application, that ~t does not assure approval of the vacation. I also understand that additional fees may be assessed if the Municipality's costs to process this application exceed the basic fee. I further understand that assigned hearing dates are tentative and may have to be postponed by Planning Staff, Platting Board, Planning Commission, orthe Assembly due to administrative reasons. Date: 9-23-91 Signature *Agents must provide written proof or authorization. MCCLINTOCK LAND ASSOCIATES, INC. I 1940 8U~NI:I~ BLVD., St/ITl: 20S, EAGLE RIV£R, ^LASKA September 23, 1991 Municipality of Anchorage Economic Development and Planning P.O. Box 196650 Anchorage, Alaska 99519-6650 Re: Proposed Plat of Lot 2A, Block 1, Mountain Manor Subdivision and the Vacation of a Portion of a 33' Section Line Easement VACATION REQUEST AND JUSTIFICATION Ladies & Gentlemen: We are submitting a preliminary plat for the above referenced vacation (and subsequent replat). All that is being sought is the vacation of the 33 foot section line easement within the lot. The lot boundaries are not being al{ered. Please review the documents submitted herewith including the preliminary plat, zoning map, topographical map, housing stock map, and aerial photo. The primary reason for our vacation request is that the home located on the lot encroaches into the easement approximately 7 feet. Ail of the surrounding property has been subdivided in accordance with the particular zoning regulations for R-6 and R-7. All of the lots in the area have approved legal and physical access which does not utilize the section line easement. In fact, the section line easement is not constructable to Municipal road standards. According to the Municipal Topographic Map, the section line easement has an average grade of 13.25% within proposed Lot 2A and the steepest 200 feet within the lot has a grade of 23%. Other existing easements, including a 10 foot utility easement, and a 20 drainage easement, adequately provide for other needs. These easements will remain unchanged. In summary, the 33 foot section line easement is not used, is not needed, and is unusable for access. We request that it be vacated. Sincerely, Bill McClintock Registered Land Surveyor Encl. Phone: (907) 694-4499 ~ Fax: (907] 694-3297 ~ AK Toll Free: 1-800-478-4499 ~ C. Please check or fill in the following: 1. Comprehensive Plan -- Land Use Classification X Residential Commercial Parks/Open Space Transportation Related 2. Comprehensive Plan -- Land Use Intensity Special Study 3. Environmental Factors (if any): a. Wetland 1. Developable 2. Conservation 3. Preservation Marginal Land Commercial/Industrial Public Lands/Institutions Dwelling Units per Acre Alpine/Slope Affected b. Avalanche c. Floodplain 3-9 d. Seismic Zone (Harding/Lawson) __ Please indicate below if any of these events have occurred in the last three years on the property, Subdivision Conditional Use Zoning Variance Rezoning Case Number Case Number Case Number Case Number Enforcement Action For Building/Land Use Permit For Alpine/Slope Affected Industrial Special Study Legal description for advertising. Lot 2, Block I Mountain Manor Subdivision Anchorage Recording District, Alaska Checklist Sewer: 20-019 Back [4/85} (See Prel. Plat Application) 30 Copies of Plat Reduced Copy of Plat (81/2 x 11) Certificate to Plat Fee Topo Map 3 Copies Soils Report 4 Copies Aerial Photo Housing Stock Map Zoning Map Water: Private Wells Private Septic Waiver Community Well Community Sys, Public Utility Public Utility ,.5 S89°OTOO"E 208.21(NR)N TOPOGRAPHY 9g PROPOSED LOT 2A, BLOCK 1, MOUNTAIN MANOR SUBDIVISION Scale: 1 Inch = 100 Feet Contour Interval = 4 Feet September 3, 1991 Base Map from Municipality of Anchorage Grid Maps NW253 & NW254 Contours from enlarged Municipality of Anchorage Aerial Photographic Map Prepared By: McCtintock Land Associates, ]nc. - 11940 Business Blvd., Suite 205, Eagle River, Alaska 99577 - Phone (907) 694-4499