Loading...
HomeMy WebLinkAboutMOUNTAIN VALLEY ESTATES BLK 2 LT 13Onsite File Mountain Valley Estates Block 2 Lot 13 #050-641-10 Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP211200 PID Number: 050-641-10 Dwelling: 0 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 0 Upgrade Name Donald Little A ORPTION FIELD ❑ D Trench ❑ Wide Trench El Bed El Mound Site Address 4627 Hiland Rd. Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 /S F Ft. LEGAL DESCRIPTION Depth to pipe invert from original de Gravel depth beneath pipe Subdivision Block Lot Mountain Valley Estates 2 13 Ft. Fill added above original grade G I length Township Range Section Ft. Ft. Gravel width Beds: Number of Lines Dist a between lines SEPARATION DISTANCES Ft. Ft. To Septic ( Absorption Lift Station Holding , Sewer Total absorption area Number of trenches Dist. between Nches From Tank Field Tank f Line Ft2 Well 1001+ I I TANK 2 Septic ❑ S.T.E.P. [:1Holding ❑ Other Manufacturer Capacity Surface Water 100'+ I I I GREER 1000 Gal. Material Number of compartments Lot Line 51+ I NA PLASTIC 2 Foundation 7,48'- I TATION Manufacturer Capacity Remarks -Waiver for Foundation to Tank of 7' requested Gal. at time of submittal. Alarm location Elects �by Installer PIPE MATERIAL House to tank D3034 Tank to drainfield D3034 ACES Drainfield CO/MT D3034 Inspector Areterra BENCH MARK (Assumed elevation) 100 ft Inspection n dates: 8/17/21 Zd 8/17/21 Location and description p 3r' 8/18/21 4111 8/19/21 Window Frame ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date t 49TH • 0 KENNETH M. uS r4„ F * �� ,. es�;��,. Septic System Approve Date q-z�-Z /711a Note: this approval does not include well permit requirements. �-ESS\�:� (P,-,, nnimrlui AS—BUILT SYSTEM DETAILS/SITE PLAN Permit OSP211200 MOUNTAIN VALLEY ESTATES BLOCK 2 LOT 13 PID# 050-641-10 i NEW 1000 ' GAL TANK .a LLI \ �1 Z o Mo X = / P t I 1 GREEN- i -J A -C=6,3' B -C=35,0' A -D=6.9' B -D=35.4' A -E=9.1' B -E=36.6' A -F=12.8' )K:IN-SITU SOIL B -F=38,9' PRISM AREA A-6=15,8' CALCULATI❑N B-6=41.1' FROM - G.B. A -H=17,1' SOWERS & G.F. SOWERS B -H=41.9' INTRODUCTORY S❑IL MECHANICS & FOUNDATIONS OF A44 "A �•A' 0 TH O o-7= PREPARED FOR: DONALD LITTLE 4627 HILAND RD. EAGLE RIVER, AK 99577 FIELD BOOKS BOUNDARY: N /A STAKINGN/A ASBUILT: JLS DM RLE: ACAD FM FILE 0 00 1000 GAL SEPTIC TANK COMPUTED: DRA15N: KS} MEa®: KMD DATE 9/20 GOD: SSW06: 'IDB N°' 21033 SITU SOIL PRISM)K ISCALE: 1' = 40' SCALES i' = 10' b fl� b a i � x n%-O-c Z � fQ ^o^ ""k'1'SULTING AK. 99577 -87'' Municipality ®f Anchorage ,�... 0111�'_t Uepartmrnt P.O. Box 196650 0 4700 Elmore Road Anchorage, Alaska 99519-6650 0 (907) 343-7904 o Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: OSV 211066 COSA OSC211525 PID#: 05064110 Legal Description: Mountain Valley Est �3 Z Engineer: Arc Terra Applicant: Little Permit#: OSP211200 101"3 Your request for a waiver of the required 10 feet horizontal separation from the Tank to the foundation has been approved. The approved separation distance is 7. This waiver approval applies to the Existing Error! Reference source not found. only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department ❑The affected adjacent property owner(s) have been given a 7 -day notice regarding this waiver. ❑ Notarized letter(s) of nonobjection have been received from the owner(s) of the affected adjacent property. Adjacent properties are not affected by this waiver. ................................................ 0.. X 0 0 ........................ 1 Waiver is Granted: X Waiver is not Granted: Date: L ` 2-3 �Z I Approved by: Name of Reviewer ................................................ a M 0 M M M ...... 0 M M X E M ...... a 0 N U N N 1 **** VARIANCE/WAIVER REVIEW **** MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP211200 Work Type: SepticTank Upgrade Effective Date Expiration Date Tax Code Number: 05064110000 Site Legal Address: MOUNTAIN VALLEY ESTATES BLK 2 LT 13 G:0658 Site Mailing Address: 4627 HILAND RD, Eagle River Owner: LITTLE DONALD L & LOMA Design Engineer: ARC TERRA CONSULTING INC This permit is for the construction of: ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy �1»cnt 1)ep<irtIII ell t 6/14/2021 6/14/2022 Lot Size in Sq Ft: 46953 Total Bedrooms: 3 ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: Issued By: Date: I_ Date: 2G2 % On -Site Water & Wastewater Section ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 050-641-10 Property owner(s) Donald Little Day phone Mailing address 4627 Highland Road, Eagle River, AK 99577 Site address 4627 Highland Road, Eagle River, AK 99577 Legal description (Sub'd., Block & Lot) Mountain Valley Estates Block 2 Lot 13 Legal description (Township, Range & Section) Lot Size 46,953 Sq. Ft. Number of Bedrooms 3 Phone: 907-343-7904 Fax: 907-343-7997 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) (w/wo ADU) Septic Tank Upgrade Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. Dea Duffus (Signature of property owner or authorized agent) Permit/Rush Fees: A �2 a 15 _ _ Waiver Fees: Date of Payment: �7 20:2 f Date of Payment: Receipt Number: d O ` L1 3 CReceipt Number: Permit No. 0 -Sr- � 19 � 00 Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211200, Rebecca Carroll, 06/14/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211200, Rebecca Carroll, 06/14/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211200, Rebecca Carroll, 06/14/21 ! MUNICIPALITY OF ANCFIORAGE DEPARTMENT OF HEAl_TH & ENVIRONMENFAL PROTECTION ENVIRONMENI'AL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAl. SYSTEM AND/OR WELL INSPECTION REPORT "NAME r~ rPNONE LEGAL DESCRIPTION -LOCATIOn- ~lq* ~ ~ ~ NO. OF BEDaOOM~ Well Absorption area Dwe~ng ~ ~ ~~ Mate~ No, of ~Liq, capacity in gallons Inside length Width Liquid depth / ~ ~ IF HOMEMADE: ~ ! ~ Manufacturer --~. Material Liquid capacity in gallons O Well I Foundation , Nearest lot ~ine ~ PERMIT NO. :~ ~ ~ No. of lines Length of ea Total lengd s~ Trench width Distance betw~n lines ~ ~ Top of tile to finish grade ~. .... Material beneath tile Total effective 8~orlztion area Length Width Depth PERMIT NO. ~ ~ Type of cri Crib diameter Crib depth Total effective absorption area m ' ' Well Building foundation Nearest lot tine ~ DISTANCE O: ~ Cla~//j~ /~ ''' Depth Driller Distance to lot line ~MITNO, ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorbtion area(s) SOIL TEST RATING INSTALLER ~ ~~ ~EMARKS )13 (Rev. 3/78) F::'E R M ii; T I::tF:'PL I C F:IN"f' L 0 C F:I T I O N L.E;GRI .... DONFIL.[:' Lt'TTL.E H I GHL..RN[::' RE:' L.:I.]: E:2 MT VRLLE"r' E'.i~71" T?F'E OF :~.';OIL.. I~:IEVE.';OF;'.F'T'IOI",I S"r'S"I"EM IS: MFIX];MI...IM I'..ILIME:EEF;7. OF BE[.'.',ROOMS = ~: STAR F..'"F. 2 BOX '::.G:56 S~9!!577 LOT :E;IZE d.C:.;':":':~!:i.~: SQI.JI::IRE FEET '..'.-:;OIL F.:FI'I"ING ,::SQ FT,.."BfR>== iL:.¢3 /~Zl~,l,,~5. "FFIE P. EQIJ I F:E[:, E; I ZE OF::' THE SO I L RB$OF~:F:'T I ON :F.".;'.,.'STEM 1:5: THE LENGTH DIMENSION :r.s THE: L. EI'.,IGTFI < IN FEET > 13F 'I"HE: TRENCH OP. [.':,RR!NF::'IEL...[::,. "I"HE.~ E:,E:PTH OF R TRENCH (:iF;.! PIT I:E; TFIE DIIE;TflNCE E:ETklEEN THE SUF-4:FF:iCE OF' THE GROI.JI'.~D F:!NI3, THE E:O'f'TOM OF'"' THE E',:.:iCR',,,'R"f' I ON ,.': l I'.,1 FEET ::,. TI--IEFZ]E I!5 NO ."_:;ET I.,.IZE:,TH FOR TF.'rENC':HES. THE GF.~FI',,,'EL [:,EPTH .'iS THE F'IINIMUM DEPTH OF GF.:FIVEL. E:ETI4EEN THE OUTF:'t::~LL. PIPE F:INE:, THE E~OTTOM OF' THE E,'-'-.':CRVFIT l O1'.,I ,:: I N F:'EET ;:,. F'EP.M I 'T F:IF'PL. I CFINT HFIS THE F. tESF'ON':i; I E: i I_ I T"r' TO I NF'OF?M 'TH I S [.':'IEF'RP. TMENT DUF.'.' I I",tG THE 1' NSTF:tLLFI"I" I ON I NSF"ECT IONS OF: FIN"r' [,.IEL.L. 2E; F:IE:,,.TFICENT TO TH I.S PFb3F'EF.:T"r' FIND THE NUME:E:R OF RESIE:'ENCE% THRT THE NELL. 1.4ILL. SERVE. BF:ICF..'F' :1: L.L.:[ t",IG OF FII",I'T' S"r"..::;TEM I.,.I I "I"HOLr'F F I NRL I NSPEE:T I 01'-,I laND RF'F::'F~O',,,'Ft[... B'¢ TH i :.:.i; DEF::'FIF?.'I"MEN'T' 141LL BE 'E,I_IEL.'rECT TO PRO:E, ECUT I ON. M I ?.,I I f,li...lht [:, I S'T'FINCE BETI.,.IEEN FI NELl_ FINE:, FIhI'T' ON-:.3.1: TE .SEI.,.IFIGE [:, I ~;F'OSF:II_ :.--:,'¢STEM I '.-'.i; :1J~)¢3 F'EET F'OR Fl F'RI',,,'FITE NEL. L CIR.: :t.513 TO 2,..:J.;", FEET FROM FI F::'I...IBLIC I,JE'L.L I]:,EF:'EENE:,ING LIF::'ON THE 'f'"r'F'E OF PUE','L. IC: I.,.IELL .... MINIMUM I:::,ISTFINCE F'I;'.OM I::1 PF.:Z',,,'FFI'E klEI_L.. TO FI F'F?.ZVFI'T'E :.'.E, ENEP. L.].'NE I:E; 25 FEET FII",IE:, TO 1:::I CCIMMLIh! I T"r' SEI.'.IEF..' I_ I NE Z :B 75 FEET. NELL. LOGS FIF.:E F..'EQI. JIF.'.'ED F:IND MUS'T' ErE F.:ETUF.'.NED TO 'T'HE [:'EF'FffRTMEN'T' t,.IlTH~I"4 ii:E) DF:!'T'S OF:' THE I.,IEL. L. COMPL. E'TION. OTHER I~'.E!QUIF~'.EMENT':Z'; I"lR"r' FiF'PL"r'. SPECZF.T. CRTZONS FIND E:ONSTFRLIE:TZC~N 13'IIRGRI:~MS R',,,'FI I L...FIE~LE TO Z Iq~;UF;:E PROPER I N'.E;TFIL..I_FrT' I ON. I CEI:;:T]:F'T' THI::r'F :1.: I Fll'd FFIMILIF:IF;i: I.,.IITH THE REQUIREMENTS FOR OI'.,I-,SITI!i: 5;EI.,.1ERS.; FII'-,I[:, I,.I[':".I_LS F:I:F.:; SET FOFRTH EVT' T'HE: I',ILIf.,IICIF'I:::IL.I'I"'T' OF' F:ti'.,IE:HOI:Z.:F:IGEL ,~:. Z I.,.IIL..L ZN':T..;TFILL. TI-I['E ::, :: FEll II'-,I FICI]:OF.:E:,FII'.,ICI!.:: I.,.I.f. TH THE CEIE:,ES. ].i:: :[ I.Ji'.,I[)I-~:;F?.STI.":II',,tD THFIT THE: Oi'.4-SIT'F L::iEI.,.IEF.: 'E,"r'ST[:T.M MI::I'T' K'.EQI.,.tlFi:E EIqL. FIR(.:JEI"IENT IF:' THE RES I [::'ENCE 1% F.:[:JMOE:,EI_E['., TO INCLUDE MORE THF1N Z-: E',EC'F~:OI31"IL:.:,. k ~: /( ..}/;**. "/, c) ' I ...... ~!._:'...'....:'::_/_.~_ ............ z._.: ..................................... L. f' I b ...................................................... V4. 3 I ':: ':: F:'E, .,m ~ 'm r ' u icipal ty 825 "L" STREET ANCHORAGE, ALASKA 99501 (907) 264-4111 G£QRGE M, SULLIVAN, MA YOR DEPARTMENT OF REALTH AND ENVIRONMENTAL PROTECTION December 31', 1980 Donald Little Star Route 2 Box 9356 Eagle River, Alaska 99577 Permit ~ 800152 Subject: Lot 13 Block 2 Mountain Valley Estates Subdivision A perm. it issued by this department for well and/or sewer system has expired as of this date. Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal Ordinance. If you have drilled the well, a well log should be sent to this department: to document the installation date. If an engineer inspected the installation of the on-site sewer system, please have them send us the as-builts for our files. If there are any further questions, 'please call this office at 264-4720. Sincerely, // ~ Senior Environmental ~cial ist LNB/ljw enc: Copy of Permit SWP/057 PERMIT NO~ FtPPLICFINT DONFIL..D LITTLE STBR ROUTE 2 BO,'.< 92:5E 5J9577 694-Z-4]:]'. LOCR]'ION HIGHL. F~ND ROBE:, - E;. R. :'~ ,E :~> z,I~.E 4e.]95]: SQI. JFIRE FEET LEGFtL LOT ~t_. BOCK :~:M]!L ',ZSLLEM EST~ LOT TYPE OF SOIL FIBSORPTION SYSTEM IS: TRENCH MB',:<IMUM NUMBER OF BEDROOMS .--~ Z,': SOIL RFITING <SQ FT/BR)= t25 THE REQUIRED SIZE OF ]'HE SOIL RBSORPTION S'T'STEM IS: [:. E F' T t.-{ == ~ ~_ E N ~2i T H =: g 8 G R ~ %-" E L. ~-~ E F" T H ~= 5 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE 'rRENCH OR DRRINFIELD, THE DEPTH OF Fl TRENCH OR PIT IS THE DIS]'FINCE BETHEEN THE SURFFlCE OF THE GROUND FIND THE BOTTOM OF THE EXCFlVFITION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRFI',,,'EL DEPTH IS THE MINIMUM DEPTH OF GRFI'¢EL BETHFEN THE OUTFFILL PIPE,] RND THE BOTTOM OF THE E::<CFI',/FITION (IN FEET). SEPT I C PERMIT RPPLICRNT HRS THE RESPONSIBII. IT'¢ TO INFORM THIS DEPFlRTMENT DURING THE INSTFIL..LFITION INSPECTIONS OF RN'?' HELLS RDJFICENT TO THIS PROPERTY FIND THE NUMBER OF RELqIDENCES TFI8T THE WELl_ WILL SERVE. ............... T~.JO ( :~--"--~ ) INSPECT I C~P~S P]RE REL:."IJ I BSCKFIL. LING OF HNY S'T'STEM HITHOUT FINFlL, INSPECTION FIND FIPPROVFIL B'¢ THIS DEPFlRTMENT HILL BE SUBJECT TO PROSECUTION, MINIMUM DISTRNCE BETHEEN R WELL RND FlNY ON--SITE SEWFIGE DISPOSFII.,. SYSTEM IS :L00 FEET FOR Fl PRIVFtTE WELL OR :L50 TO 200 FEET FROM FI PUBLIC HELL DEPENDING UPON THE TYPE OF PUBLIC HELL MINIMUM DISTFINCE FROM Fl PRIVBTE HELL TO Fl PRIVFITE SEWER LINE IS 2.5 FEET FIND TO Ft COMMUNIT9 SEWER LINE IS 75 FEET. WELL LOGS FIRE REQUIRE[.) FIND MUST BE RETURNED TO THE DEPRRTMFNT WITHIN ]:0 DFf'r'S OF THE WEI.~L COMPLETION. OTHER REQLIIREMENTS 1'18'~ FIPPL. Y. SPECIFICFITIONS FIND CONSTRUCTION DIFIGRFII'tS FIRE FIVFIILFIBLE TO INSURE PROPER INSTFILLFtTION. P~'SRr'I ][ T EE :,':--~: P I RISS F_:,EC:Er,li~,ER _?--- :.1_.., :;L_Lg- 80 I C:ERTIF~'r~ THFlT t: I FlM FFIbiILIFIR WITH THE REQUIREMENTS FOR ON-SITE SEHERS FIND HELLS RS SET FORTH B'¢ THE MUNICIF'FILITY OF' FINCFIORFIGE. R: I HILL INSTBLL THE S'¢STEM IN RCCORDFINCE WITH THE CODES. 3: I I.JIqDERSTFIND THRT THE, ON-SITE SEWER SMSTEN MFI'¢ REQUIRE ENLFIRGEMENT IF THE RESIDENCE IS REMODELED 'FO INCL.UDE MORE THFlN 2.: BEDROOMS. SIGNED: ......................................................................... FlPPLICRNT DONFILD LITTLE ISSUED BY ............................................ DFlTE .............. a ....... V4. 0 DEPARTMENT ' HEAl_TH AND EN'¢IRONMENTRL ROTECTION 825 'L_ STREET, ANCHORAGE, AK. 264-4720 NELL Rr-JD 0 ~'4--'_:~ I TE SEL..IER I~ERhl I T F'ERMIT NO. ( ) I_EGRL. SQURRE FEET T,F'E OF SOIL RE:sORBTION SYSTEM IS: /~.~- fdRXIblUM NUfdBER OF BEDROOMS = ~ SOIL RATING THE REQUIRED SIZE OF THE SOIL RESORPTION SYSTEM IS: [)EP]'HI== ¢ LENGTH= ~ ORRVEL r,-EPTH= THE LENGTH DIf~ENSION I~ THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD. THE DEF'TH OF R TRENCH OR PIT IS THE DISTANCE BETWEEf.I THE SURFACE OF GROUND RNA THE BOTTOfd OF THE EXCRVRTION (IN FEET). THERE IS NO SET blIDTH FOR TRENCHES. THE 8RAVEl_ DEPTH IS THE MINIMUM DEPTH OF 8RAVEL BETWEEN THE OLITFFILL PIPE RND THE BOTTOM OF THE EMCRVRTION (IN FEET). REQU I E~EB, SEPT I C TR[4K :5 I ZE= PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE '.~UMBER OF RESIDENCES THAT THE I,EL.L WILL. SERVE. T~4C~ (2) I I'4SPECTIO[4S i-aRE RE QLIIRED BACKF'ILLIN~ OF ANY SYSTEM WITHOUT FINAL INSPECTION RND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETI4EEN R WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR R PRIYATE I,IELLJ OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL WELL LOGS RRE REQUIRED AND [~II..IST BE RETURNED TO THE DEPARTMENT WITHIN -~0 DAYS OF THE WELL CO['IPLETION. OTHER REQUIREMENTS MRY FIPPL~L SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE: AVRILABLE TO INSURE PROPER INSTALLATION. PERM I 'T E.~-:P I RES DECEML~ER ~--~... .1.9 80 I CER]'IF¥ THRT t: I Af'~ FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS 8S SET FOR-~H B~ THE MUNICIPALITY OF ANCHORAGE. 2: I WILL IHSTRLL THE SYSTEM IN ~E:CORDRNCE WITH THE CODES. ~: I UNDERSTAND THAT THE ON-SITE SEWER S~'STEM MRS' REC~UIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS. RPPL I C:~NT I=,I, UE.D B' V~. '~ O ~ E GEG. ECHNICAL Er DEVEL.~PMENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster Earl Ellis 694-2774 S0IL LOG Soils 6t Foundations Land Development Performed for: Legal Description: Depth (feet) Name: Z~)~.,,~,- /'/7-/-z,z: Tel. No. ~....~/'"'~? ~...._..~.~ Mailing Address: ~,i2. ~ ~,~ x ~.~J'-~, ~t~: ~,~, ~- Sol1 Characteristic~ 0 5__ 6 8~ 10 11~ ].2_ 13. 16 Ground Water Encountered: Yes Proposed Installation: Seepage Pit Comments: No yes, what depth~ Drain Field__.__._ Date: OWNER OF LAND tIrr.ifieD .+riUing ung Dy MUNICIPALITY OF ANCHORAGE DOC Co. dba DEPT. OF HEALTH & SULLIVAN NATER WELMMENTAL N',0I ECTION n 1. P.O. BOX 272, CHUGIAK, ALASKA 99567 TELEPHONE 688-2759 AUG 2 a I`. 81 J�CEIVED DEPTH OF WELL ADDRESS �I3 S STATIC LEVEL OF WATER FT. LEGAL DESCRIPTION Jg L IL �G 1.3 DRAW DOWN FT. DATE - Started Ended PERMIT NUMBER KIND OF FORMATION: From Ft. to Ft. From 9 Ft. to-3-7—Ft. I-/ d.r 6 gil lr L From Ft. to Ft. L h off. r From 37 Ft. to—l-L—Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. MISCL. INFORMATION: GALS. PER HR KIND OF CASING From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to Ft DRILLER'S NAME (Jmni-t I/ r 10,�3I • Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 5 a E T Y CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 050-641-10 _ Expiration Date: _�"2-3 1. GENERAL INFORMATION Complete legal description Mountain ValleyEstatesBlock 2 Lot 13 Location (site address) 4627 Hila_nd Rd. Eagle River, AK 99577 Current Property owner(s) Donald Little _ Day phone Mailing address 4627 Hiland_Rd. 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 M Individual Well Holding Tank ❑ Individual Water Storage ❑ Community ❑ Community Class _ Well Public Sewer ❑ Public Water System ❑ WaiverNariance request for: Foundation to Tank Distance: 7°_, Received by: _- ------ --- - _. Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 550 Date of Payment g 2 7 022 Receipt Number 0299 6 G COSA# OSCa 11 5� Waiver Fee $ oZ a 5 Date of Payment)_� Receipt Number Waiver 4 4 S V a o �o 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 696-6111 Address -20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M_DUPFUS Date�Re� Engineers 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 unseenis .� Oli 1 encroachments, deficiencies or discrepancies exist. ""Ilr L• , 1 _� ter --- 6. DSD SIGNATURE System #1 Approved for 3 bedrooms. System #2 Approved for bedrooms. Disapproved. KENNIETH V. Ul / Air Conditional approval for bedrooms, with the following stipulations: `gJ--- ON-SITE �= - G) 'n, T D - rn WAST_. ,ATE Jm PROGRAM o �O By: Original Certificate Date:__q__-2_z___4 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 engineers work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory _-_ Arsenic Advisory Well Flow Advisory _ Other COSA blue sheet -1 0-10-1 2-doc: Legal Description: Mountain Valley Estates Block 2 Lot 13 Parcel ID: 050-641-10 If more than 9 septic system on lot: COSA Checklist # of A. WELL DATA Well log is filed with Onsite (or attached) Date drilled 6/15/81 Total depth 41 ft Cased to 41 ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 21 in. Date of flow test for COSA 5/17/21 Static water level at beginning of test 26 ft. Comments B. TANK DATA Age of tank(s) New years Tank type/material Septic/Plastic Measured operating fluid level in septic tank New Standpipes/foundation cleanout per record drawing Date of pumping New tank installed 8/17/21 D. ABSORPTION FIELD DATA Which system tested (date installed) 712/81 ALL standpipes present per record drawing Total measured depth from grade 9 ft (max) Measured depth to pipe invert from grade 4 x ft (min) ❑ N/A — pressurized field Monitor tubes go to bottom of effective. If not, state depth into effective Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet Structure served by this system Well production at time of test 1.9 gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes No Coliform bacteria is Negative Nitrate 2.27 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Arcterra Consulting Date of Sample 5/17/21 IFT STATION ❑ Requl ainti Age of lift station Lift station material Comments: nce completed ears Adequacy test date 5/17/21. Results ❑✓ Pass For 3 bedrooms Fluid depth prior to test 0 in Water added 550 gal New depth 24 in Elapsed time 40 min Final fluid depth 0 in Absorption rate 450+ gpd Any rejuvenation treatment (past 12 months) If yes, enter date 7/2/81 IR states material beneath the tile is 108" all the other information supports 5' effective E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' Yes if No Community Sewer Manhole/Cleanout > 100' ® Yes if No ft [0 Yes if No ft Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25'21 Yes if No ft Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No ft Neighboring Absorption Fields > 100' Surface Water > 100' ® Yes Animal Containment > 50' ® Yes if No ft ® Yes if No ft *Waiver requested for foundation to tank of 7'. ** Field verified 5' separation on 8/17/21. Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ® Yes if No ft ® Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No 7.48* ft Surface Water > 100' ® Yes if No ft Property Line > 5' ® Yes if No ** ft Wells on Adjacent Lots: Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No. Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No. Water Service Line > 10' ® Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' Yes if No ft if absorption field is under driveway comment below Property Line > 10' ® Yes if No ft Wells on Adjacent Lots: Water Main > 10' Yes if No ft Private Wells > 100' ® Yes if No Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS *Waiver requested for foundation to tank of 7'. ** Field verified 5' separation on 8/17/21. G. ENGINEER'S CERTIFICATION 1 certify that / 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_ COSA Checklist yellow sheet ft ft ft III o �, cTE Y,,, VrA AK. YtSTi..y]��' AugLiest 25, 2021 ARcTruzizA CONSULTING, INC 20441 Ptanni-an Bid, Eagle River, AK 99577 Office (907) 696-6111, Fax (907) 868-3793 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Separation Waiver Renewal — Mountain Valley Estates Block 2 Lot 13 We have replaced the septic tank on the subject lot on 8/17/21. There is no existing waiver for the distance between the building foundation and the tank. The leachfield is in working order and due to limited space the tank was removed and the new tank was placed in a location that best removed it from foundation (site verified 7.48') and field (site verified 5.01'). The existing tank location is the most removed from the foundation while still maintaining 5 feet from the existing trench. We do not expect there to be any adverse effects by the placement of this tank in the existing location. If you have any questions, please contact me at 696-6111 /FAX 868-3793. Respectfully submitted, ArcT'erra Consulting, Inc. Y4__ Kenuleth M*Dis, Attachments: SGS Laborary report 20441 PTARMIGAN BLVD ► EAGLE RIVER, AK 99577-8736 • PH (907) 868-3791 • FAX (907) 868-3793 f I30' 30' i� 0 cc O O 1! jl DECK © LOT 13 BLK 2 { o '- z Q J = t � O t\ O CD o fl J � GREEN— HOUSE oil ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: MOUNTAIN VALLEY ESTATES LOT 13 BLOCK PLAT 73-152 SURVEY CERTIFICATE: I, John L. Schuller, Have conducted a physical survey of this property as shown on this drawing and that the improvements situated hereon are within the property lines and no enchroachments exist other than noted. Under no circumstance should any information on this drawing be used for construction of fences, structures, improvements, or for establishing boundary I ines. EXCLUSION NOTES: It is the owners responsibility to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. WORK ORDER NUMB I scam E—MAIL• AUG 23, 2021 1"=40' schuller®aknet 21 —060-'Z DRAMM BY: CHECKED BY GRID NUMBER: BGO1K/Pme JLS SW0658 210266 181'aa 12.0' 8.0' 0 16EN L-,:,Ejj: 6 4 SEPTIC VEN T (typ) f MH 65 30.0' c4 0 o_ rri O U) 1.0' c rrn z GRAVEL D/W WELL 213 5a O = FND 5/8" REBAR F ..4,Z 1 � • 49TH ....../..... I f •.d,QHN L. SCHULLER. 0 sel !: LS -10408 fessiono\ —' ALp LAND IS" x 141�41 0 1831 Talkeetna Street Anchorage, Alaska 99508 (907) 227-1455 office (907) 274-4992 fax MUNICIPALITY OF ANCHOP~,GE DIVISION OF ENVIRONMENTAL HEAL%H DEPAR~I~ENT OF H~LALTH AND ENVIRCINMENTAL P.qOI'ECTION (a) Legal Description (include lot, block, subdivision, -~.ction,. ...... to, reship, range) Location £~dd~ess or directions,) Applicants Ad.ess (c) Applicant is (check o~) ~nding Institution ~; (d) Lending Institution Te lc.phone Address Address Te le phone 2. i[_yRe_._ o_~f i~siden~e S i ngle-F~mily~.-- Number of i~edroc~rs 3. Water Multi-Family Other (descm, i~. ) Individual Well ~- Con~nunity [~I Fublic IlI Note: If ccmn~nity ~11 system, must ha~ ~itten confir~tion ~:cm ~e State ~p~nt of ~virorm~ntal Con~rvation attesting to t~m legality ~d status. is ~e ~11 ade~ate for the numar of ~drc~ s~cified in this ~ ~2N) Is the wastewater dis~sal system adequate for ~e n,~r of ~edroc~ ~j~]) [Page 1 of 2] 2-15-84 5. En.__~ineerin_9_q Firm Pr_ov~i~ctions, 1%sts, E~ta ~nd Information I. cgrtify that I have' e,hecked, verified, o~ oonfom~d to all MDA F. AA ~i~li~s ~ effect on the date O~ ~{:n;k-~ ~¢ion. ~ /_ N~ of Fi~ ' Eblepho~ Address Signed by Date ( F~NGINEER SEAL) 6. DHEP Aj~?roval Api~{'oved fox -~ bedrooms Te~ms of Conditional Approval Conditional The Municipality of Ancho~'age Department of ~k~,alt:h and Enviro~a~ntal P~otection not .guarantee the continued satisfacto~-y pe~fo~manc~ of t:l~ wateF, supply and/c~ wast~,water disposal system. 'l~is approval indicates that, as of the, validation shc~, above, based on t]~ data and information fut-nished t%; an engineer registere the State of Alaska, the wateF, supply and wastewater disposal system is safe and tional fo~ the. numbez, of P~drcor~ and type of structL~e indicated. ( g{EP SEAL) 7..~ail the HAA to the fol].cwing address: KB2/d5/s [Pa~e 2 of 2] 2-15~84 ae MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) C?~CKLIST ' FEBRUARY 1984 NOI/D]ZO~d 1VZN~WNO~IANa '~ HZIVBH ~O '.[dBa ~OV~OHDNV ~O AillVdlDINnW Well Classification :', ~, Well Log i P~esent ~N) Total Depth ~/ / Cased to Static Water Level // / Casing He ight Above Ground Electu~ical Wiring in Conduit~'?~;N) Sepamation Distances from Well: If A, B, or C, D.E.C. Approved(Y/N) ~ Date C~leted ~//c)--//~/ ': ~ield ~3'-(~/~F~7'7;- C~/ / ~p~h of/G~outin~ Sanit~y ~al on Casing ~) ~ession ~nd ~l~ead (Y~ Pump Set At To Septic/HcE%~2~ Tank on Lot //7~-~ TO Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleancut/Manhole A~/~ To Nearest Sewe~ Service Line on Lot Water Sample Collected By : ~': ~_ z~ ~_~ ; Date ! / . water sample Test ~sults ~-~/~.7E./~l~,~-c~v~?,-~;) ca~,ents ~114/'~ /7'/~'/~/dm~./ (/..t',:-,'- ._ ,, ; On Adjoining Lots /?~-~5~ / ; On Adjoining Lots To Nearest Publia Sewer Be $.EPTIC/MO~I~G TANK DATA Date Installed 7/~/~ / Size Standpipes ~N) Ai~-tight Cap~/N) Pumping/Maintenance Contract on File (Y/~) /v/~ ; for Holding Tank High-Water Alarm (Y/N) ~- Temporary Holding Tank Permit !.Y/N.).. Separation Distances from Septic7~i~3-Tank: To Water-Supply Well _ /.. C~ ,~-- ' To Building Foundation '~C-~) / To Property Line _ /~/) /'~-' To Disposal Field ~-- / To Water Main/F~rvice Lin~ Course No. of Compart~m~nts ~._-- Foundation Cleanout (Y _~2 ~.~ To Stream, Pond, Lake, or Major Drainage Comments [Page 1 of 2] 2-15-84 CJ ABSORPTION FIELD DATA Soils Rating in Absorption Stnata Date Installed Width of Field Type of System D~sign Length of Field ~ c~ / Depth of Field ? / Gravel Bed Thickness ~L~ ~/ Standpipes Pnesent ~) Depression over Field (Y~.~ Date of Last Adequacy Test Results of Last Adequacy Test ,~'-~- Separation Distance from Absorption Field: To te -Su ly To Line TO Building..~undation ~Z / To Existing or Abandoned System on Lot A//~. ; On A~joining Lots To Water Main/Service Line /%//~ To Cutbank(if, present) To St~eam/Pond/Lake/c~ Major Drainage Course To Driveway, Pa~king Area, o~ Vehicle Storage Area _~--~-~ Co~(~ents D. LIFT STATION Date Installed Size in Gallons "P~.~0 On" Level at High Water Alarm Level at Tested fo= Electrical Codes ('Y/N) Comn~nts Dimensions Manhole/Access (Y/N) /f" Level at Vent (Y/N) Pumping~ ing Adequacy Test. Msets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that jL-~ave checked, verified, or conformed to all MOA on the date Qf~ th~s Signed ~.~///~../././' Date Company ~%~.~//. ~ ~, ~"%~%~N~,~?%N~%, MOA NO/. KB1/dS/s I~~'~- [Page 2 of 2] 2-15-84