HomeMy WebLinkAboutHANSEN SAND LAKE LT 9C3Onsite File
#012-153-35
IR
DOC CO dba
OPM
LLIVAN WATER WELLS
BILL � COLE
P.O. Box 670269, Chugiak, AK 99567 688-2759
OWNER OF LAND: Michael Swecker
ADDRESS: 3751 W. 74th Ave, Anchorage, AK 99502
Bore Hole
Data
Depth
From
To
LEGAL DESCRIPTION Hansen Sand Lake Lot 90
DATE: 9-18-20
0
2
PERMIT NUMBER: OSP201279 DATE OF ISSUE: 7-30-20
TAX IDENTIFICATION NUMBER 01215335000
Is well located at approved permit location: ®Yes [—]No
Method of Drilling: ®air rotary cable tool
Depth of Well: 205'
Casing Type: Steel Wall thickness .250 inches
Diameter: 6 inches, depth 205 feet
Liner type
Static Water Level: 88 feet
Recovery Rate 20 ® gpm Fj gph
Method of Testing Air
Well Intake Opening Type: ® open end ❑open hole
❑ Screened Start feet Stopped
❑ Perforations Start feet Stopped
Grout Type: Bentonite Volume: 50 lbs
Depth: from 2 feet, to 42 feet
Well Disinfected Upon Completion: ❑yes Ono
Method of Disinfection: Chlorine 50 PPM
Comments:
2
4
4
8
8
22
22
60
60
98
98
109
109
125
125
193
193
205
Casing Stickup
Overburden
Fill Wood & Boulders
Silty Sand w/ Gravel
Silt & Sand
Clay & Gravel
Silt & Sand w/ Gravel Water
Silt & Sand w/ Clay
Silt & Sand
Sand & Gravel
Drillers Name: Cole Sullivan
ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority.
Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation.
MatSu Borough: Department of Environmental Conservation.
® DOC CO dba
BILL8c GOLE
ULLIVAN WATER WELLS
P.O. Box 670269, Chugiak, AK 99567 688-2759
www.sullivanwaterwells.com
Pump Insallati®n Log
Well Drilling Permit Number: SW OSP201279 Date of Issue 7-30-20
Parcel Identification Number: 01215335000
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
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 Water System Permit
Permit Number: OSP201279
Work Type: Well Renewal
Tax Code Number: 01215335000
Site Legal Address: HANSEN SAND LAKE LT 9C3 G:2126
Site Mailing Address: 3751 W 74TH AVE, Anchorage
Owner: SWECKER MICHAEL E & LORI J
Design Engineer:
This permit is for the construction of:
❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy
Effective Date:
Expiration Date
Lot Size in Sq Ft
Total Bedrooms:
0 c n t
F '• .. fir.
))Dailtiii ent
7/30/2020
7/30/2021
8709
Q 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
Special Provisions:
To close out this permit, please submit the following:
1) Well log
2) Pump install log
3) Water sample results for total coliform, nitrates and arsenic.
Received By: Date:
Issued By: _ 2 Date: 713 v ? 1 �U
5
UH CSF A L TV 00 IF zk HCH 00 RA G
Ar
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
PZ,4 7- 76 - 131 ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. dra [5-3
Property owner(s) If! ll KE -
'a La—A �uJ�C �-'tZ Day phone 967 -5a9- �S�57
Mailing address 3'751 Wi 7y4 i AU -r--14
Site address 375 (
Legal description (Sub'd., Block & Lot) _ i -52/f k,/J IAk- 4r qC.3 (0:9,1616
Legal description (Township,
Lot Size S 70 Sq. F1
Range & Section)
Number of Bedrooms _
APPLICATION IS FOR: APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field ❑ Initial ❑
Single Family (SF) El
ADU)
Septic Tank 1:1 Upgrade
Upgrade ❑
Duplex (D) El
Holding Tank ElRenewal
Multiple Dwellings ❑
Privy ❑
(SF and/or D)
Private Well nX
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.
(Signature of property -owner or authorized agent)
S
Permit/Rush Fees: Waiver Fees:
Date of Payment: o' 2 U Date of Payment:
Receipt Number: 5 `'� $ (,3 Receipt Number:
Permit No. OSio 26127q Waiver No.
GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc
N, ""'y MUNICIPALITY OF ANCHORAGE oenr
7 • On-Site Water&Wastewater Program No `5; ,,
, ;; a PO Box 196650 4700 Elmore Road
4 Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 ,� r.
\ "� / http://www.muni.org/onsite
__ / 1 chartntent
'.^'CHORpVE
On-Site Water System Permit
Permit Number: OSP191145 Effective Date: 5/7/2019
Work Type: Well Initial Expiration Date: 5/6/2020
Tax Code Number: 01215335000
Site Legal Address: HANSEN SAND LAKE LT 9C3 G:2126
Site Mailing Address: 3751 W 74TH AVE, Anchorage
Owner: SWECKER MICHAEL E & LORI J Lot Size in Sq Ft: 8709
Design Engineer: Total Bedrooms: 5
This permit is for the construction of:
❑ Disposal Field 0 Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 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
Special Provisions:
To close out this permit, please submit the following:
1)Well log
2) Pump install log
3)Water sample results for total coliform, nitrates and arsenic.
.
ri , 1
Received By: i __c., f Date: S /
Issued By: i / / Date: 19
MUNICIPALITY OF ANCHORAGE
. , ,r
Development Services Department Phone: 907-343-7904
On-Site Water & Wastewater Section Fax: 907-343-7997
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D.O62- L S 3 3 5 (30°
Property owner(s) 1►C�f� L I /ok, 4:0EveR Day phone 9'67 -5;29- ,56-7
Mailing address J751 (I'ESr 7��N�¢VC / 4-11,(74/e/ die(o t die 99SOa
Site address Elf t14 ,f / ,, , /
Legal description (Sub'd., Block & Lot) 4)1- 9 C3 1/4n si71 fife thk— 42cCi Ao i
Legal description (Township, Range & Section)
Lot Size Sq. Ft. Number of Bedrooms 5
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.
(Signature of property owner or authorized agent)
Permit/Rush Fees: $22 5 b a Waiver Fees:
Date of Payment: 4,Q1 �OI9 Date of Payment: •
Receipt Number:
,p I� 1 I Receipt Number:
Permit No. Waiver No.
G:1Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc
W. 73rd AVENUE
(ROAD NOT DEVELOPED)
o
0
N 89'59'30" E 72.50'
Li.
m o
z z
0
o — 0
0 o
CA m— w
LOT 9C1 ° LOT 9C2
n1
D
(/) _
rTt
f N K N)
o m O
--t
N) N
t
/
1
'—� LOT 10 1930" E 72.50' i
20' WIDE UTILITY EASEMENT
q f
•—I LOT — — r~1clL
9C3 Ale posr
6.1 11. Z L
CJ o 12.0 °' °' 16.0 0
t O m o
O c `r
CA —II N Co (O /
/ N O/%/ EXISTING I BUILDING, D = 8.0 ,4.0 �,,...=,e':> CF A/ 0�, *
O� ��� !�0� rr, 0 LOT 9C4
���.• TH r\ •7 OO No z N N T• ::::. o
Q • 32.2 •.
l... 0 N w .•........• •• •. .... •
w
V '••An ho y P. o ., . o Q ` ..............:..... .
•
Qki(" ' . S •—9020 ••'J)4 :.:::::::D.RIVE:.:::.:.:::.:.Co.
4ata o �qo....'•.....
/)e_l, �,0` 10' W:.UTI ITY. ASEMENT 011
N 89'59'30" E 72.50' ()
CA
o - SQ-L-04?it,(1,4A, He le
0
CYli
—
NOTE: W. 74th AVENUE
1) THIS DRAWING IS NOT TO BE MODIFIED FOR USE AS A PLOT PLAN.
Legal Description: AS-BUILT Ordered By. Mike Swecker
Lots 9C1 & 9C3, Legend:
Set Fnd septic Standpipe SO •':;:Asphalt;:;:`;;';:;•j
5/8"RB W/CAP 0 5/8" RB o Water Wellco 135=mo
Hansen Sand Lake Addition Fence—X—X— ••••• "Overhan Oh
3.25" AL.MON. MONUMENT Wood Deck
Light Pole Art �i
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. NOTE: Under no circumstances should any
data hereon be used for construction or for establishing property lines.
LAND & CONSTRUCTION SURVEYORS—PLANNERS—ENGINEERS SURVEY CERTIFICATION: LANTECH has conducted a physical survey of this
440 West Benson Boulevard, Suite 200 Phone: 562-5291 thereonyas are ithin the propertyown on this ilinesand
andthat
no encroachments existother situated
Anchorage, Alaska 99503 Fax: 561-6626 than noted.
Plat: 70-131 Grid: SW2126 Dote: SEPTEMBER 4, 2007 Drawn By: TM
Work Order: 2006LH21 0 Fb/Pg: 693/70 Scale:1"=30' Checked By: APH
MUNICIPALITY OF ANCHORAGE
WATER & WASTEWATER UTILITY
3000 ARCTIC BLVD.
PHONE: (907)564-2762
BLOCK/LOT/TRACT LT 9C3
SUBDIVISION HANSEN SAND LAKE
Cr
WASTEWATER
CONNECT PERMIT
DATE OF APPLICATION
SCHEDULED COMPLETION DATE
TAX CODE 1215335 GRID SW2126 AS -BUILT
STREET ADDRESS 3751 W 74TH AVE
OWNER SWECKER MICHAEL E
MAIL ADDRESS 8419 HEATHER CIR ANCHORAGE, AK 995020000
06-3830
09/05/2006
12/31/2006
X SINGLE FAMILY
MULTI -DWELLING No. APTS_
COMMERCIAL
PHONE
CONTRACTOR 'UNKNOWN
Cu
v.
ASSESSMENTS
Repair Existing Service
X Main Line Extension
X On Property Only
City Tap
Have Been Levied
Hydrant Only
50' or Longer
To Be Levied
Main Tap - To Property Line Only
Comments:
Main Tap & On Property Connect
Row No.
Disconnect
R & R - Main Tap Only
Owner Staff
CONNECT SIZE 4 "
ISSUED w cdf
INSPECTION FEE
PERMIT FEE
$ 54.00
$ 48.00
PAID CASH
CHECK #
$ 0.00
OTHER
DEPOSIT
$ 0.00
INSPECTED BY
REIMBURSABLE
TOTAL
$ 102.00
p
LS��S ` ,
DATE /1 `/Op
NUMBER
REMARKS
BUILDING NEW HOUSE. MAY USE EXISTING ON PROPERTY SERVICE AND MOVE CLEAN OUT
PERMITTEE (Please Print) *SAME AS OWNER
MAIL ADDRESS ,
SIGNATURE / ,,A/00 7 .
PHONE
POST IN A CONSPICUOUS PLACE AT THE JOB SITE
AWWU INSPECTOR
Original
DATE SCHEDULED g I I I TIME 11. M4A INSPECTOR � � p, VARRE LL
SUBDIVISION HANSEN SAND LAKE BLOCKILOTITRACTLT 9C3
INDICATE NORTH
i
D
L� isE
s
SIZE MAIN:
TYPE MAIN:
DEPT AT MAIN:
AT PROP. LINE: 91
CONNECT LOCATION:I CSF E p L
COMMENTS: 1� IE -� CUT W1� A
1J S, l `dSEAL 9 C.0 .
INSPECTED BY: P�
DATE: 9
p(o
N
N
CY
afto
N
a
9
r
r wr •{ 'r r wr y4 yfi + t �r ,* 1fL J *` +T ' ; �{ } . Y z- Ft }� r { . r r r r • T r r = • s 1' S•f w r 1'r
TAX CODE No. inj 2 -15 3 - a5
st
PROPERTY
MUNICIPALITY
GRID No.
OF ANCHORAGE —SEWER UTILITY
Name Address
Plat No,-- S u b do z:s%A-,,o7 . Sr
Residential (Z Commerial El
Lot
AcctNo
:.? Block
Industrial ❑ No. of units am
CONNECT46
Main Tap On Property El Permit No,.
-I
Size _._� ,Type 4i. - / ,
Drawing No., Size Malin " Type, x • p Depth at Connect _ 17
Insulation ❑ Cleanouts Type
Connect Agent, Sm'Cc>,jn,.5-; Inspector
Comments
Date
Connect Location -411 FQ -s4- enk -P t.'YI, N.�
ASSESSMENTS
L.I.D. No. Private Dev. No. Subd. Agreement No.,--azZ1s2 L5/�o
Sewer Agreement O No. P.T.E. ❑ Roll No.,
DYE TEST
Positive El Negative ❑ N.S.A. .❑ Date
Page No. M.H. No. Billing Cycle
Tested B y
Comments
5
I
I
ti
4
do
t
0
z
Q)
q4
i , Gam' OL
y� ` }#lt i# . i'+`=mss �. r��, #+r;. + F -� -#� ^ 'r�+a :+ '.+s'e' " aF..r�"`....sy+r- s c . a t��i T ` �F•—" ..�i+7.M�
J.31 �lt1
I
It
sjuawwoo
9104uoW 10JIU03 10 u011oO01 Moys
qojqjS 413 uo��o�o� au�� a�inaaS «J11�3d0�ld NO
rTl
'x'�'�` •'. — ■� Y �. rte /i
r� � .� 77 . . ...* � �a� .1 i �. �� •} ib� . A ,!� . ..� a • ?
i F F ; f *. hf K �E Y a r i. iR .+'f iY f '� ' k 4'r� A jw '7.� w *'t %rrt `} r. �'-'t r z+l�'S is;�F JS} wR, f x}14 frY� ►itit�
TAX CODE No.
GRID No.-
MUNICIPALITY OF ANCHORAGE —SEWER UTILITY
PROPERTY:
Name Address,
Plat No. Subd.,HQ& el.s.P*yi 5e.%, &n 1
Residential D Commerial. O Industrial
CONNECT
ma-
Acct.No
�►-0�4 Lot 9 c -3 Blo
No. of units
it r
Main Tap On Property El Permit No. Size `/ TypeZ.
Drawing No. Size Main Type Depth at Connect
Insulation ❑ Cleanouts Type
Connect Agent-5-ypi i ` 4- tonC-c>,n--az+ Inspector
Comments- <:?a ' -P '` --�' / - - - -
Connect Location ��' c��� �- � �-F �. � Q
ASSESSMENTS=
L.I.D. No.—,Privat
Sewer Agreement D
e Dev. No. Subd. Ag
No. P.T. E. ❑
Date
J'Ljlv P-.-?
reemenfi No. ���,� 1,SI �r o.
Roll No.
DYE TEST:
Positive El Negative Q N.S.A. D Date
Page No. M.H. No. Billing Cycle
Tested B y
Comments
7
+ i r r >kJ64, A t., A- t � `yti6,r , r�l+ "' ^ A i' �xr 1. ti ' r.F b� fr, 14 �L s ► '� 'k �'r` r+'�+F w h � J L�'--+:7 :J i +." .iaf • r` L/L r.n�A� ' i ref a
es
Oy
jvw -,P III Leo --i- d � a
c •
p Zow-C7 4wf�� _tf+
� �tot, Slll8WUJ0o
MINT
s
0
z
J.311 t'1 133 8 1S
v aloyuow loiluoo 10 u011oOo-1 MoyS
Mace uoiJo30-1 auI-1 931na9s A183dO8d NO
o
�. ,.� , ���..r�r.,�+�r+�nrrtr* r�+`G•rr+�"'t"„�'+'i` ,..t .-;{. �..-a;�..,+�+..�. �+r�+ �t�, a r*f .� +r r-�� �A 3 i _ . x } L%L
Fi f• �fy N ` ► fr`ti r .* i 4` i4.1'1 �� ;*r ;ff S i t .0 ;T T -I ,I- jr,-A, 3��['• F "#.y* 1t F', cif * 7y4w .� 1} 'x�L• {�•, #•# i--+~ it iL 4 kms. �� { ki i4• ■ s .t } i • -7 •� f # ■ 4,^
z w
S 1 �- .�} fi # taw ■r � w i� �}"" f # { ti ! ix4r l* f.''" ff #T ;s t r• r f �fi
f.
a a
r 'WL, z
LU46- ai i I
34 * LU
+ F
LUUl a
Llj
J
.. �' ~ �-
4W -A El 0 in .,CO C:
w � 0Ev
/I LU � - `a) (1) :3 ait )
..C/) LLI D
2 C/) Z E W (n
a: 1�- Lij
z CUw (1) C-- w
_ }
UJ a z:
. .�.z 0 Z M V5
0 0" CD cis 0 M cr F-}
C;) I= 0
.-r- � .
� ..�0 2
• --. Cl)a:z- o < a w
0 w 0 .2 .0 co
F` w #
x *. } L
D ui
}Y
w Q.r. �- .� - J ,
< 2`
r w
L 0 ❑T 0
LL i
LLI
am
x 0 Cl
Mr-
uj 0
i
e.
U) *'*" �'""' a■■r
64% 69
X 4 y z
C .. -
owpm%% z LU 0 0
0 2 Z U)
LLI cc 4c
0 j
too --- Who. _ Z L J LTJ C
cr cr() cr w w w 0
w Er a: OL
—�r
LJ E <
LU " OL S... 0t
ta
.� 0... o a. z
Im = 000
`}~Lioz
Lu � y ' z
F- > -0 0 CL 0 0 w 0 L)
a: z
C a. 0,7
w U � Co
0 Lu
�LLJ 0 06
[ z LLL
v< 0 -0 OL CL (n CL U) 0 z z
() o< < 1
p °0 �— 0 0 whomuff 0
CO # . w
° ECJ CL Z F r" CLD LU cr � w'�'cm
rdw cc m (n 2 2
X Lij 0 0 z LIJi Cla:
W<o z <2 <n CL 2mm it LU LJJ j
J Z r
z z 0 %MWFFO < Z >
F- cD co x 0 z Cl) q"m
0
M=)m < C:) 2 2 C) 0 < 0 2: LU c
.. J
LU LU
•31da
0
I� auidaIV H.Ld3C1 103NNOO�NIVN lbHld3a 1�3NN0�
�) I 1 1---?
:A8 C13103dSNI
"S1N3WW0O
acs
i 65 NOUVOO-103NNOO
j� :NltlW 3dAl Ito :NI'dW 3ZIS
SlnONV313lS31OHNVW IOUINOO JO NOULV301 MONS
H313NS 3NII 331AU3S 133M3S f
� _t
r
A311V
c
loo-�b�l�i-b8 �`� ��G
:log
I r.
133HIS
HIUON
31VOICINI
F
:Naisiniaens
�-. A!'.�r fR{*a• �i i 'f„jY+Rye #+#+f�� r�I'# �f� T'+�lTt"-+' {* tii*1
i
t
A
}
CD
N
I
i f
i
".� �i
CL
{ L T
CC
t
z PLO
w`T
w
00o Fn 2 z
'f#Y p El 0 0 0 0
tof�1
I
0 f
0 LU <
i
r �!
�+ Ia.
F + Y
lb de
am
ui
b
4 :
r }V
U.
cn w 0 J.
W l
pa
+MF
{l
w
0
j C)
w
0
0
z
0
CL
a
►m
J
w
F--
Da
cc
Q
I
3: j
cm
w
LLI
COMW
z
0
QU
N
otS U
LLI
Waz
acv)
ao
CL
11
IP
E—
O
J
z
0
w
0
0
U
x
Q
p
m
4, 4V#
f ;
00 i
ii0 ❑
cn C:f..�.i �
z
ui
21 W I.... �— r w
co a) -6--a Z M
cca 0 cc Q) a) o LU
LU t %.z
.
2 c
.>
...�. Q
D cm
rt
CL co w CL
#
0 0 � � ����� # w�
#moi
C) ammew 69� 694. 60
ZOO w
OEZ
W cr 0 <
Z cro cr < w w m43
X W1
�..0
LL- LL 0
E Em
C S..
UJ
W a a�
>- aw 0
.j 043: cr 3:
Z cr CL
00 CLOCD >.w
OW Z
0
cr
00
LLJ U)
CL CL CL LM
0 <LW < 0
�m I--
06 CL Z< z 0
0�10 i
V) <2Z C; 0
0.9
()� D 0
W
N
co
2
0
w
z
z
0
U
w
CL
w
We
I
CC
w
LLI
COMW
z
0
CL
frz -
CL
Y �
w +
R
r *mss r
f
ww
p
m
4, 4V#
f ;
00 i
ii0 ❑
cn C:f..�.i �
z
ui
21 W I.... �— r w
co a) -6--a Z M
cca 0 cc Q) a) o LU
LU t %.z
.
2 c
.>
...�. Q
D cm
rt
CL co w CL
#
0 0 � � ����� # w�
#moi
C) ammew 69� 694. 60
ZOO w
OEZ
W cr 0 <
Z cro cr < w w m43
X W1
�..0
LL- LL 0
E Em
C S..
UJ
W a a�
>- aw 0
.j 043: cr 3:
Z cr CL
00 CLOCD >.w
OW Z
0
cr
00
LLJ U)
CL CL CL LM
0 <LW < 0
�m I--
06 CL Z< z 0
0�10 i
V) <2Z C; 0
0.9
()� D 0
W
N
co
2
0
w
z
z
0
U
w
CL
..
LU
ct
0
w
CC
w
COMW
CL
frz -
..
LU
ct
0
{ • L r '��=i —- * �a�_�,�i rY�4 ti*zz.,LwJ.t'�.*y f4 F + .� — ![ N_ T �' �' • 'w s
A8 (]�103dSNI
2�—:SiN3WtNOO
-st �-o --- _-I N011t/OO�l i:D3NNOO
� aui-i odoad lb' Hid3G L33NNOO� /�` NIVVI 1'd Hid3G 103NNOO -NIb'W 3dA-.l- �- :NIbW 3ZIS
A311V
sin0NV310lS310HNVW 10HIN03 =10 NOUV301 MOHS
H013NS 3NII 301AH3S H3M3S
�- er.-'D L :log 1 ->13018
- -� �h- - t)
7
n
133HJLS
i
HiHON
31VOICINI
cn
m
m
z`
m
n
0
m
0
Z...Z /�54/
*NO ISIA 148f1S
GRr"~XTER ANCHORAGE AREA BOROU'~";H
HEALTH DEPARTMENT
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
'N? 839
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION
SEPTIC TANK:
DISTANCE EROM WELL £
LIQUID CAPACITY /~/~/._?C~3 GALLONS.
MAILING
ADDRESS .'3 7.~J ~/ ?J~ ~;'L
PHONE
MATERIAL _c~ ~'.~;/ /~.,~/'~ ~,?/~:~t,/~(,~ 7'??COMPARTMENTsNUMBER OF j
_~ LIQUID
INSIDE LENGTH '~ INSIDE WIDTH DEPTH
SEEPAGE SYSTEM:
NUMBER OF PITS /
LINING MATERIAl
NEAREST LOT LINE.
SEEPAGE PIT:
OUTSIDE DiAM~ OR WIDTH ,, LENGTH ,/ , DEPTH
D CE FROM WELL , G FOUNDATION
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) SQ. FT.
TILE DRAIN FIELD:
y ~-~ TOTAL LENGTH
DISTANCE FROM WELL '~ , FOUN~D'A% . NEAREST LOT LINE , OF LINES
NUMBER OF LINES DISTANCE BETWEEN LIN~S -- ___TRENCH WIDTH ~li~. TOTAL EFFECTIVE
ABSORPTION AREA SQ. FT. LENGTH OF~ CH LIN
DISTANCE FROM WATER
WELL: TYPE ,"z;-'J J/,? ~}~ I'(~ DEPTH ~' , BUILDING FOUNDATION. "- SAMPLE_ --- ., NEAREST
NEAREST __ SEPTIC SEEPAGE OTHER
LOT LINE .... , SEWER LINE . TANK ~"- , SYSTEM '~- , CESSPOOL. ~ ., SOURCES
DISTANCES:
DIAGRAM OF SYSTEM
- ; :: ! ._ ~., : ~
GrEa,ER ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAL OUALITY
3500 TUDOR ROAD POUCH 6-650
ANCHORAGE, ALASKA 99E02
TELEPHONE 279-86S6
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
PERMIT NO..
INSTALLATION Of SEPT C TANK SEEPAGE P T ~ DRAIN FIELD , OTHER ,
FINANCED THROUGH ~// ~' [/ TO BE iNSTAlLED bY
COMPLETION DATE ANTICIPATED
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION,
SEPT,OTANKS'ZE" area S,ZE
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK '~'!
FOUNDATION TO SEEPAGE Pit ~'~ ~° . DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT Wall / ~'*- /
· SEEPAGE PIT ., DRAIN FIELD
SEPTIC TANK
TO NEAREST LOT LINe.
WELL TO SEPTIC TANK
DRAIN P[ELD
WATER MAIN TO SEPTIC TANK .
DRAIN FIELD //~ z
SEPTIC TANK,
. SEEPAGE PIT
ALSO CONSIDER AREA WELLS.
.. SEEPAGE PIT
SEEPAGE PIt /f~-~/~'~ j
. ., DRAIN FIELD
TO RIVER, LAKE, STREAM.
DIAGRAM OF SYSTEM
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGH~.~EGULATIONS REgarding iNSTALLATION.
· ' HEALTH AUTHORITY
, OR
[/ LICENSED DESIGNER
, CERT,FY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER aNCHORAGE AREA ~OROUGH ORD,NANCE NO. 28-68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE·
'~'~'¢' / APPLICANTS SIGNATURE .
G~-'TER ANCHURAGE AREA
BOROUG~,~,
3500 TUDOR ROAD
ANCHORAGE, ALASKA 99502
CASE #
Performed For Betti Baker
Legal Description: Lot Block
This Form Reports Soils Log ×
Lot 9 - C3
Date Performed 1D/?l/71
S u b d i v i s i o n Hanson Sand Lak6
eP-~-F?O 1 a t i o n Test
Depth
Feet
Soil Characteristics
Brown clayey silt (ML)
Was Ground Water Encountered?
Gray silty fine to medium sand (SM)
no
If Yes, At What Depth?
Reading Date . Gross Time I Net Time Depth to H20 Net Drop
!
~e~colation R'ate Minute
Proposed Insta]'lation: Seepage Pit x Drain Field
Depth Of Inlet
COMMENTS:
Depth To Bottom Of Pit Or Trench
250-square feet of drainage area is required per bedroom with the cr. ib set at
depth of from 2.5 to 8.5'.
lest Performed By R. E. Carlisle ' Data Cert'ified By:National Testing Svs. Inc.
Date:
.
# OIZ 153=, ,5? 00o
GAAB HD~
G,~'C~TER ANCHORAGE AREA BOR¢'~-~'",H
HEALTH DEPARTMENT
327 EA~LE ST. ANCHORAGE, ALASKA 99501 2/9-251
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
MA,L,NG 37. / 74
ADDRESS _
PHONE
SEPTIC TANK:
D,STANCE FROM WEL'
LIQUID CAPACITY ',.~
~/~)- )t~":-~ ~ GALLONS.
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS
LINING MATERIAL
NEARESI LOT LINE
1- ¢1-c
OUTSIDE DIAMETER
MATERIAL ~/~(~/'J'~'~ L'~ /~J ''~ NUMBER OF
COMPARTMENTS
/v, c',
INSIDE LENGTH. INSIDE WIDTH
LIQUID
DEPTH
C X5/~ 774/~i
OR W[DIH ~
DISTANCE FROM WELL ~'-- /,Z. /
E-13-7 /
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
, LENGTH . DEPTH
BUILDING FOUNDATION
TILE DRAIN FIELD:
DISTANCE FROM WELl FOUNDATION , NEAREST LOT LINE
NUMBER OF LINES DISTANCE BETWEEN LINES TRENCH WIDTH
ABSORPTION AREA SQ. FT. LENGTH OF EACH LINE
TOTAL LENGTH
OF LINES.
IN. TOTAL EFFECTIVE
DEPTH: TOP OF TILE TO FINISH GRADE
DEPTH OF FILTER MATERIAL BENEATH TIL~'
IN. ABOVE TILE]__
WELL:
TYPE ,J,Jt~zlC~b ~-,,],~'. DEPTH
LOI LINE ~ 7/ NEAREST
SEWER LINE
~7~"~ DISTANCE FROM ///_~// / WATER
, BUILDING FOUNDATION. SAMPLE
SEPTIC ~'/' ., £ SEEPAGE ~',~'~/~,~/~, CESSPOOL
TANK, ~')~'/N , SYSTEM
NEAREST
OTHER
SOURCES
DISTANCES:
A-:p~ f'zi
!
/
-~ ~=~:3r
L~a"T ~ g
DIAGRAM OF SYSTEM
. ,~.~ -..
GREATEI _tNCHORAGE AREA . )ROUGH CaseNo.--
HEALTH DEPARTMENT
327 Eagle St. Anchorage, Alaska 99501 279-2511
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
RESIDENCE ADDRESS LOCATION OF INSTALLATION
LEGAL DESCRIPTION L~'~ ~ C ~
~ ~/~ "
APPLICATION TO INSTALL: SEPTIC TANK ~ ,SEEPAGE PIT ~ ~I~RAIN FIELD , OTHER
FINANCED THROUGH ~e k-~ TO BE INSTALLED BY
PERCOLATION TEST RESULTS ~ ANTICIPATED DATE OF COMPLETION
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
THIS IS TO SERVE AS
/~, Z~)L),C"~'~/ ,PERMITTO INSTALLA
/
AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED
· SEPTIC TANK SIZE
DISTANCES:
Health Authority
51',o ~,~ ~J
TYPE ~,//')~/d'~SEEPAGE AREA .TYPE
DIAGRAM OF SYSTEM
that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the
above described/////~//~~system is in accojAance~ with said code.
.... ADDI If'ahlTq ql~hlATIIR
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: (907)343-7904
On -Site Water & Wastewater Section Fax: (907)343-7997
Parcel ID 012 -153-35
Certificate of On -Site Systems Approval
OSC251265
Expiration Date: 6/16/2026
Legal description HANSEN SAND LAKE LT 9C3
Site address 3751 W 74TH AVE
Current property owner(s) SWECKER MICHAEL E & LORI JANE
X The On-site system(s) is/are approved for 5 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or conditions:
By;
Original Certificate Date: 7/14/2025
Thrg C tificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
sys m(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage,
D velopment Service Department (DSD) issues COSAs based upon representations provided by an
independent professional engineer. The Municipality of Anchorage is not responsible for errors or
omissions in the professional engineer's submittal.
ATTACHMENTS:
COSA Checklist X Well Flow Advisory
Absorption Field Advisory Nitrate Advisory
Tank Age Advisory Arsenic Advisory 28.5
Other
1. GENERAL INFORMATION JUL 03 2M
Parcel I. D. 012-153-35
Complete legal description Hansen Sand Lake, Lot 9C3
Location (site address) 3751 W 74th Ave
Current property owner(s)
Michael & Lori Swecker
2. ON-SITE SYSTEMS SIZED FOR BEDROOMS
Day phone
3. TYPE OF WATER SUPPLY: � Private Well serving k-1— dwelling units
(907)529-6559
El Other Non-public well as regulated by MOA F-1 Water Storage
❑ Community Well or Public
4. TYPE OF WASTEWATER DISPOSAL: ❑ Private Septic F-1 Private Septic serving 2 dwelling units
D Holding Tank rm-1 Community Septic or Public Sewer
K: R Steel ❑ Plastic ❑ Concrete Fj Fiberglass
Age See advisory
ass older than 20 years
6. ABSORPTION FIELD: F-1 AWWTS; Fj Bed M Deep Wide Trench El seepage Pit
Waiver request for: Distance:
Expedited review requested: ❑
By applying for this entitlement, this property is subject to inspection by municipal On-site staff
to verify the accuracy of the information provided.
COSA Fee $ P'�?p Waiver Fee $
Date of Payment
COSA # 015 C
Date of Payment
Waiver #
COSA Application—Apr2025.doc
COSA Checklist
Legal Description: Hansen Sand Lake, Lot 9C3
Parcel ID: 012-153-35
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system 1
A. WELL DATA
❑■ Well log is filed with Onsite (or attached)
Date drilled 9/18/20 Total depth 205 ft
Cased to 205 ft
❑■ Sanitary seal is functioning correctly
❑■ Wires are properly protected
Casing height (above ground) 24 in.
Date of flow test for COSA 6/16/25
Static water level at beginning of test 60 ft.
Comments
TANK DATA
Meas d operating fluid level in septic tank
Date of pu i g
❑ Required mai
Comments:
ce completed, if AWWTS
D. DISPOSAL FIELD DATA
Which system tested (date installed)
❑ ALL standpipes present per record drawin
Total measured depth from grade ft (max)
Measured depth to pipe invert from grade ft (min)
❑ N/A — pressurized field.
❑ Per record drawings, field is insulated.
❑ Monitor tubes go to bottom of effective.
If not, state depth into effective
❑ Presoaked required if
(Required if house vacant or field not used for more
than 30 days prior to date of test)
Gallons introduced gallons date
Any rejuvenation treatment (past 12 months)
If yes, enter date
Comments/Deficiencies:
COSA Checklist_May2025.docx
Well production at time of test 4.5 gpm
Water storage tank volume N/A gallons
Well disinfected for coliform test? ❑ Yes ❑■ No
❑■ Coliform bacteria is Negative
Nitrate mg/L ❑■ Nitrate less than MRL (ND)
Arsenic 28.5 ug/L ❑ Arsenic less than MRL (ND)
Collected by Forge Engineering
Date 6/16/25
C. LIFT STATION
❑ Required maintenance completed
Age of lift station years
Lift station material
Comments:
Adequacy test date
Results ❑ Pass
Fluid depth prior to test in
Water added gal
New fluid depth in
Ela ed time min
Final flui epth in
Absorption rat gpd
FIELD STATUS — P T RECOVERY
Effective depth (per reco drawings)
Effective depth used in
Effective depth remaining in
in
E. SEPARATION DISTANCES
From Well on Lot to: (Please enter distances if less than required)
Septic Tank/Lift Station on Lot > 100'
0 Yes if No ft
Neighboring Tank > 100' 0 Yes if No ft
Disposal Field on Lot > 100' ❑■ Yes if No ft
Neighboring Disposal Fields > 100'
R Yes if No ft
Sewer Line/Main > 100' R Yes if No ft
Sewer Manhole/Cleanout > 100'
❑� Yes if No
Sewer Service/Septic Line > 25'[E Yes if No
Holding Tank > 100' Yes if No
Animal Containment > 50' Yes if No
Manure/Animal Excreta Storage > 100'
❑■ Yes if No
❑ N/A — Served by Community Well (not on lot) or Public Water
tic/Holding Tank and Disposal Field(s) on Lot to: (Please enter distances if less than required)
Tank to Foundation >
❑ Yes
if No
ft
Surface Water > 100'
❑ Yes if No
Field to Foundation > 10'
❑ Yes
if
ft
Wells on Adjacent Lots:
Tank to Property Line > 5'
❑ Yes
if No
ft
> 100'
❑ Yes if No
Field to Property Line > 10'
❑ Yes
if No
ft
Community Wells >
❑ Yes if No
Water Main/Service Line > 10'
❑ Yes
if No
ft
If tank or field is under driveway comment be o
F. ENGINEER'S COMMENTS
ft
ft
ft
ft
ft
ft
ft
ft
G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based
on procedures outlined in the Certificate of On -Site Systems Approval Guidelines, indicates that the on-site water
supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation, unless noted otherwise.
Name ofFirm Forge Engineering
Engineer's Printed Name Benjamin Schiller, PE
COSA Checklist_May2025.docx
Phone 907-522-7773
Date 7/2/25
�' OF A�'`�l
*:49TM •*
/JJ .. ... ........
Ir '.. Benja • ' . chiller
�� �F��•. CE 12592 .•��`��
I'l>t` PROFESS14O
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT 1 'ad ` 907-343-7904
On -Site water and wastewater Section Fax: 343-7997
www.muni.org/onsite \ -
Arsenic Advisory
Certificate of On -Site Systems Approval # OSC251265
Subdivision: Hansen Sand Lake, Block: , Lot: 9C3
A water sample revealed an arsenic concentration of 28.5 micrograms per liter
(ug/L). The Environmental Protection Agency (EPA) has established a maximum
contaminant level (MCL) of 10.0 ug/L for public drinking water systems. While
private wells are not subject to this regulation, EPA standards are based on existing
health information and can therefore be used to gauge the relative quality of water
from private wells. Information on arsenic is available from the On -Site Water and
Wastewater Program website (www.muni.org/onsite) or at 343-7904.
This advisory must be attached to all copies of the subject Certificate of On -Site
Systems Approval.
GRAPHIC SCALE
1 15 30
1"=30'
LOT 10
WEST
En
O
O
M
O
0
O
O
ii
ARW _
�,�Q'•
* • �`i T I
2
O
O
m
O
O
O
Z
73 RD AVENUE
(ROAD NOT DEVELOPED)
O
m
N890 59' 30"E 72.50'
� i
250 H Street
Anchorage, Alaska 99501
N
Survey Department
Z
Phone 562-5291
r'
Mainline
LU
Phone 8985
O
N
AECC 66688
N
Q
w
WERE FOUND AT THE TIME THIS SURVEY WAS
AVENUE
PERFORMED. THIS AS -BUILT DOES NOT
CONSTITUTE A BOUNDARY SURVEY AND IS
SUBJECT TO ANY INACCURACIES THAT A
J
LOT 9C1
o
LOT 9C2
DRAWING SHOULD NOT BE USED IN SUPPORT OF
O
ANY NEW CONSTRUCTION.
b
THIS AS -BUILT ONLY SHOWS EASEMENTS THAT
cn
O
WERE ON THE ORIGINAL PLAT. IT IS THE PROPERTY
OWNER'S RESPONSIBILITY TO DETERMINE IF
0
O
THERE ARE OTHER EASEMENTS, COVENANTS,
RESTRICTIONS, OR RIGHT OF WAY TAKINGS OF
O
RECORD NOT SHOWN ON THE ORIGINAL PLAT.
LEGEND:
UTILITY PEDESTAL
Z
CLEAN OUT
p
o
N890 59' 30"E 72.50'
F, Concrete
--
o
i 20' UTILITY EASEMENT
DRAWN DATE:
6/17/2025
WORK ORDER: 25033
LOT 9C4
AP
PLAT: 70-131
CHECKED BY:
GMG
z
12.0' 16.0'
1 " = 30'
FB/PG: 827/19 REF: 06LH210
2
w
N M
N
QUj
J
- 8.0' EXISTING 14.0'
=-_ HOUSE
O
11.3'
0
0>
m o
Fn
O
N
0
N ....
O
32.2'
O
z
�......... .............
NOTE:
.. �,
rn
1)
THIS MORTGAGE LOCATION SURVEY (AS -BUILT)
°O
WAS PREPARED FOR MICHAEL SWECKER. IT
LOT 90
SHOULD ONLY BE USED FOR A SINGLE PROPERTY
`__......
TRANSACTION. RE -USE OF THIS DRAWING BY THE
...................
ORIGINAL CLIENT OR BY OTHERS FOR ADDITIONAL
USES LATER WITHOUT THE EXPRESS WRITTEN
.1.0'' .UuflLITY.EAS. MENT
CONSENT OF LCG LANTECH, INC. IS A VIOLATION
2)
--0F FEDERAL COPYRIGHT LAW.
THE LIABILITY EXTENT OF LCG LANTECH, INC.
N890 59'30"E 72.50'
� o
m
En
WEST 74TH
AS -BUILT
ORDERED BY: MICHAEL SWECKER PARCEL #: 012-153-35-000
LEGAL DESCRIPTION: ADDRESS: 3751 W. 74TH AVE
LOT 9C1 & 90
HANSEN SAND LAKE ADDITION
250 H Street
Anchorage, Alaska 99501
CG
Survey Department
Phone 562-5291
��� Inc
Mainline
3)
Phone 8985
a"gec&,wh P� �ue��nd�
AECC 66688
SHALL BE LIMITED TO THE AMOUNT OF FEES
COLLECTED FOR SERVICES IN PREPARATION FOR
THIS PRODUCT, UNLESS GROSS NEGLIGENCE IS
DISCOVERED.
3)
THIS MORTGAGE LOCATION SURVEY (AS -BUILT) IS
A REPRESENTATION OF THE CONDITIONS THAT
WERE FOUND AT THE TIME THIS SURVEY WAS
AVENUE
PERFORMED. THIS AS -BUILT DOES NOT
CONSTITUTE A BOUNDARY SURVEY AND IS
SUBJECT TO ANY INACCURACIES THAT A
SUBSEQUENT BOUNDARY SURVEY MAY DISCLOSE.
4)
THE INFORMATION CONTAINED ON THIS
DRAWING SHOULD NOT BE USED IN SUPPORT OF
ANY NEW CONSTRUCTION.
5)
THIS AS -BUILT ONLY SHOWS EASEMENTS THAT
WERE ON THE ORIGINAL PLAT. IT IS THE PROPERTY
OWNER'S RESPONSIBILITY TO DETERMINE IF
THERE ARE OTHER EASEMENTS, COVENANTS,
RESTRICTIONS, OR RIGHT OF WAY TAKINGS OF
RECORD NOT SHOWN ON THE ORIGINAL PLAT.
LEGEND:
UTILITY PEDESTAL
.......Asphalt
CLEAN OUT
p
WATER WELL
® ood Deck
F, Concrete
FENCE X
DRAWN DATE:
6/17/2025
WORK ORDER: 25033
DRAWN BY:
AP
PLAT: 70-131
CHECKED BY:
GMG
GRID: SW2126
SCALE:
1 " = 30'
FB/PG: 827/19 REF: 06LH210