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HomeMy WebLinkAboutSKY RANCH ESTATES #2 BLK 2 LT 6Sky P-anch Estates #2 Block 2 Lot 6 #015-302-30 Municipality of Anchorage Page —:Z- of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 0 Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: `�-2W!q f� '�� — PID Number: _ Name: Wastewater System: ❑ New Upgrade !( Address::j I -f a, f bIti1Gc.�`� PC'/ 'xf ABSORPTION FIELD _ A �X1(- --- --- Phone: No. of Bedrooms: — eep Trench ❑Shallow Trench ❑Bed ❑Mound ❑Other LEGAL DESCRIPTION Soil Rating: /_ 0, 60 Total Depth from original grade I �2•� l GPD/SQ. Ft. ­ --_ Lot: Block: Subdivision: it 0 6 . r Depth to pipe bottom from �original /grade: to"o�J�LiSe'_ Ft. Gravel depth beneath pipe �i r Fl. s Township: Range: Section: Fill added above original grade: Gravel length: WELL: 11 New ❑Upgrade Gravel dnpth:W ID1-41 -3,0/ Ft. Number of lines: Distance between lines: FL Classification (Private, A,�, : 1 Total Depth: Fl Cased To: Total absorption area: 11040 SQ. Ft. Pipe material: ADate �inrs Driller: Date Drilled: Static Water Level: Ft. Installer: Ov-I t l�®� led —2 --1-611 _ Yield: Pump Set at: Casing Height Above Ground: TANK Ft. Ft. SEPARATION DISTANCES �8epti ❑ H Iding L1S.T. E. P. ®- To From Septic Tank Absorption Field Lift Station Holding Tank Public/Privato Sewer Lines----LN.r�berlof Manufacturer: Capacity in gallons: AV Well OOr Material: Copartments: m I� Io0'+ LIFT STATION WateSurfacr Lot�`l Line r"I- h Size in ga to Manufacturer: Foundation / _ r �P 1� "Pump on" level at: "Pump off'lovvee'dl- High water alarm at: Curtain Drain ©� Pump Make &Model Electrical Inspections performed by: — Remarks: BENCH MARK G Pt,-fr,-f&p Location and ascription: ----��-- _% I --� i -- p ®® Assumed Elevation Q ENGINEER'S SI pL x "q OWC T1Y do )i r� °K V�, Inspections performed by: 2nd 0Ck J. MAl'E11, P.E. . �e1t rni/ a 8, 16 a u Department of Health un Ser s approvalUReviewed �dT a�4a�o®e�Im and approved by: Date: 72-013 (1/91) MOA 25 Permit No. SI ldil nZ55 Page Z of 2 - Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 a Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Legal Description: '�Ir-y ;-P4JC4+ e °rAT'6!5 t2 131,C. 2 WT (o PID No.: 01�5_�907i30 Q� CCl1 CD2 CD3 Cal NlT � A1-- I°l2[0-4-91 N aYW< _ 11 g � ���, FNQINEEp`S'SEAL r*i1�M .z �1�.rIG TANS Bp �•.. �Efl.". HAFER, P.E ,N Y • <V sv 9 vxvnv�a� IL -013 A (2/91) MOA 25 o Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LO(A — PERCOLATION TEST PERFORMED FOR:, , DATE PER LEGAL DESCRIPTION: C2-2 - �- Township, Range, SeCd On: �pAFAj" ,���p77 � ZTSLOrPE—r7 II— , 2- o. 3 4 5 6 -1 7- r 8- 9 r r" 10-/.`0 12- 13- 14- 17 2-13-14-17 18- 19 20 COMMENTS V WAS GROUND WAT ENCOUNTERED? IF YES, AT WHAT DEPTH? DepthIri Water Monitoring �,)' Munit Dale: SITE PLAN Reading Date Gross Time Net Depth to Time Water Net Drop Z_o v l S / 3f a a f 2 PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER ( TEST RUN BETWEEN `+' FT AND _ —I--_ FT PERFORMED BY: 17034 Eagle River Loop Road No. iA4 Eagle River, Alaska 99577 ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN 72-008 (Rev. 4/85) -� CERTIFY THAT THIS TEST WAS PERFORMED IN THIS DATE. DATE: / ^t - 1 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 WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW910255 DESIGN ENGINEER:S & S ENGINEERS OWNER NAME:LATHROP HARVEY W & OWNER ADDRESS:11731 WRANGLERS WAY ANCHORAGE,AK 99516 PARCEL ID:01530230 LEGAL DESCRIPTION: SKY RANCH ESTATES #2 BLK T 6 LOT SIZE: 15706 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 2 L DATE ISSUED: 8/27/91 EXPIRATION DATE: 8/27/92 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 I:i2CN�il�/�1�. ISSUED B PROVISI S: BY • DATE: C� Y • . ��? �_ �- DATE •&27 �/ k1 a W14////2 August 21, 1991 HEALTH AUTHORITY Municipality of Anchorage APPROVALS DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street Anchorage, Alaska 99501 ROBERT SHAFER, P.E. ROGER SHAFER, P.E. CIVIL ENGINEERS (907) 694-2979 FAX 6941211 SEWER& WATER REFERENCE: Lot 6; Block 2; Skyranch Estates #2 MAIN EXTENSIONS Request you issue a permit to upgrade the septic system serving the referenced property. SEWERR INSPECTIONCTION An adequacy test was performed on the existing system on July 16, INS 1991. The absorption capacity of the system was found to be less than adequate. A soil test was performed on August 13, 1991. However, due to the ENGINEERING STUDIES or permeability of the soils, a second test hole will need to be AND REPORTS po P Y performed prior to construction to verify the soil conditions. Attached is our proposed design. If you have any questions or require WELL INSPECTION additional information for your review, please contact us. & FLOW TEST Sincerely, SITE PLANS ROGER SI FER RJS/ss ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURALS MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSALSYSTEM DESIGN 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 rG (5 GINEERSSA�:)' $q Municipality o4 Anchorage 1 DEPARTMENT OF HEALTH & HUMAN SERVICES f 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST ;)•At'' ` °` "' PERFORMED FOR: --DATE PERFORMED':'_ \'1 LEGAL DESCRIPTION: LIP 24- r Net Drop 1 - . z Z'" ` ZZ- o r1 la"y N 5 3- has g" 2 4- 1, 5 In lo`. o L a 7 — it 9 10 11 12 13 c q /'- 14 15 r � ` r 16 17 / 18 c 19 RE COMMENTS Township, Range, Section: I SLOPE WAS GROUND WAT ENCOUNTERED? S IF YES, AT WHAT L DEPTH? O P E geplh to Water Aller Monitoring? _ Date: SI I E PLAN Reading Date � T,Time �� Gross Net Time \ E? Depth to Water Net Drop 1 _ Z'" ` ZZ- o r1 la"y N 5 if has g" 2 In lo`. o L a G z �M PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER _ TEST RUN BETWEEN _ � FT AND I FT $ R S ENGINEERING PERFORMED BY: I - ERTIFY THAT THIS TEST WAS PERFORMED IN Eagle River Loop Road No. 294 ACCORDANCE WITH V1Algi67'FIZ@If)ANsi'81tldIQPWGUIDELI NES IN EFFECT N PHIS DATE. DATE: T7 72-008 (Rev. 4/85) GRb,.C*R ANCHORAGE AREA BOR .1GH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 1' INSPECT -ION REPORT ON-SITE SEWAGE DISPOSAL_ SYSTEM _ NAME _F ©�>�_�'e-����-- MAILING ADDRESS-��•�r___�'�n(I---- PHONEg9Z-'1��/ LV Fk7-'S�..Q/w. �.{%1CA"c,..,- LEGAL DESCRIPTION t�.11 -�---13 i"C LOCATION _- - �-- SEPTIC TANK: I DISTANCE NUMBER OF FROM WELL(3CTN� ANUFACTURER. ._ MATERIAL - ---- __-COMPARTMENTS INSIDE LENGTH__- INSIDE WIDTH_ LIQUID DEPTH LIQUID CAPACITY (5)'i'�GALLONS. TILE DRAIN FIELD: C TOTAL LENGTH � -( DISTANCE FROM WELL 0YWPY. -FOUNDATION r -_NEAREST LOT LINE_ _ -OF LINES NUMBER OF LINES--.- DISTANCE BETWEEN LINES TRENCH WIDTFI-3� IN. TOTAL EFFECTIVE ABSORPTION AREA SQ. FT. LENGTH OF EACH LINE -_ I DEPTH OF FILTEIR DEPTH: TOP OF TILE TO FINISH GRADE MATERIAL BENEATH TILE WELL - TYPE CONSTRUCTION BUILDING NEAREST FOUNDATION LOT LINE CESSPOOL -. OTHER SOURCES APPROVED- _- -DISAPPROVED DISTANCES: INSTALLED BY: 1 SEWER LINE DEPTH: (� - PIPE MATERIAL: LOT SLOPE: REMARKS: Form EQ -032 NEAREST SEWER LINE REMARKS fl$ ABOVE TILE -----IN. DISTANCE FROM: SEPTIC SEEPAGE TANK . SYSTEM_ DIAGRAM OF SYSTEM q 342v' Cc�L-o�- n1 DATE L I (0 7t APPROVED G.A.A.B. /,rte GRE, :R ANCHORAGE AREA BO. JGH DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT No. I ILII\\ 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT NAME OF APPLICAN�� � " MAILING ADDRESS LGA �- "y - -PHONE INSTALLATION LOCATION [�/ r �� >/-/[✓��"=-�L LEGAL DESCRIPTION INSTALLATION OF: SEPTIC TANK L� SEEPAGE PIT �•/�...��.`-� DRAIN FIELD OTHER TYPE AND SIZE OF FACILITY TO BE SERVED FINANCED THROUGH -- _ TOO BE INSTALLED ,�JI��I-�<7 SOIL TEST RESULTS — c��r�ST'EI THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION SY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE �� TYPEpiG�/U6f-f SEEPAGE AREA SIZE _ /c%l�aG'v'Lc�(�•r'�+ MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT Za l , DRAIN FIELD - SEPTIC TANK TO SEEPAGE PIT WALL /,9 11 SEPTIC TANK L/ SEEPAGE PIT ` 0 , _. DRAIN FIELD TO NEAREST LOT LINE. ) J WELL TO SEPTIC TANK _ SEEPAGE PIT DRAIN FIELD _ _. ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK _7z 'oQ / SEEPAGE PIT DRAIN FIELD - . SEPTIC TANK SEEPAGE PIT __Z�. DRAIN FIELD TO RIVER, LAKE STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL 13ACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. G.A.A.B. OR LICENSED DESIGNER I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF DESCRIBED SYSTEM 15 IN ACCORDANCE WITH SAID CODE. DATE -/ />�APPLICANT'S SIGNATURE FORM NO. EO -016 TYPE DIAGRAM OF SYSTEM V'��rOIL �3 Z(' iLSlf�✓''JGsr I �/ Y G,� 1.._ 74 I �iQ I - -, 41 f AREA BOROU 28.66 AND THAT 'fHE ABOVE 0 Performed for Legal llescripdon:_ f,�] This form reports: Soils GRGATLR ANCHORAU ARL.A IMMUGII Department of Lnvironmental Quality 3330 "C" Street Anchorage, Alaska 991,()3 SOILS LOG PI:Ii0I,A'r10N '1'1'5'1' Depth 7 aZ_ Feet 2- 3 - S, L �-y S4- tid tlA, 4 - aA-AJdI S11 -f 6- �M-mL 6- S,ope e. Date Performed C/ _43/4,5 on test 13 - l__L Was ground water encountered? � 12If yes, at what depth? w`� Date Gross Time Net Time Depth to Water Net Drop Reading .k-1 Ale. 13 - l__L Was ground water encountered? � 12If yes, at what depth? w`� Percolation rate 11/2-Q_ I1111ULez., Proposed lnstalla lar: Seepage Pit Drain Field Depth of Inlet __• Depth to bottom of pit or trent' COMMENTS: -- - - -- -- Performedp1-yYlo.c. —_. Certified By. Date Gross Time Net Time Depth to Water Net Drop Reading Percolation rate 11/2-Q_ I1111ULez., Proposed lnstalla lar: Seepage Pit Drain Field Depth of Inlet __• Depth to bottom of pit or trent' COMMENTS: -- - - -- -- Performedp1-yYlo.c. —_. Certified By. 0 �,� IV (99 5:9' 3-� W 205.40.- /d/ 0,5.40 .- /D ' WAG K WAY PROPOSM DWELIANG LOCA.TION., I N It is tbo contractor's 'rosponsibilil# Q3 tiaic y Top of Foundation in relationship W Fb*b i Grade. '.fop of Foundation its indicato4Iq otlo wirso of block above Finish Grades �q OF A4 tlp f . ,N� .o °. eid �•. 17p I I p•e o/gya°ygy/p/ a //{/� a(�/9e�°(o/,rs •u ° "e.. A.m - �+• L Fred- Walatka ' h4 N 3255 8 pHpFfSSIONAI apt � I �., 5. I hereby certify that I have surveyed the following) described property,. _tri% 6 f3°L a u/r /V.9, z ---- Anchorage Recording Precinct, Alaska, and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on prop- erty lying adjacent thereto encroach on the premisesin question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon, Dated at Anchorage, Alaska this—2 J Y'.day of _ ✓U/1�E _ __ . 18_ FRED WALATKA & ASSOCIATES Engineers and Surveyors, OC}it}i LwA, r^�wi+E, <Ic l<Kv . ✓k eva A, i � •••...-i fff F tl-eo s. F�_ (6 i at' a7 sh,r i r-ror o• o r -.ns+ a1S<it:.iO n •cepei_�' SPA0- Dry n =ie -a `rr,tn r>';<1+0M Ot Pit ....�.,. Test Performe=d I4y Data Certified Ley Date L %f..d.._�� �._....�� : .�S.:f ttt UA '!I 31 ��.A .', .... TRFE7 CHK `p qpi HORF:-. WMA 9950] Pe r fmmed (,,, LeRalV.i<; ✓� ,.- T(? Ner' )'9Ef} .. /q ,. 4 7 1 + } f T i ....... .y� V c-�i.i.,?.4=SS' ,..« .,...,,.,..Mid.,, .,.........,,,....,a. ...............�..- t F. Y'c. >l 7 h i on } C 11. . �. OC}it}i LwA, r^�wi+E, <Ic l<Kv . ✓k eva A, i � •••...-i fff F tl-eo s. F�_ (6 i at' a7 sh,r i r-ror o• o r -.ns+ a1S<it:.iO n •cepei_�' SPA0- Dry n =ie -a `rr,tn r>';<1+0M Ot Pit ....�.,. Test Performe=d I4y Data Certified Ley Date L %f..d.._�� �._....�� : .�S.:f ttt Parcel I.D. 015-302-30 4£ Municipality of Anchorage X On -Site Water and Wastewater Program (907) 343-7904 s n , p` Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Expiration Date: a Z_ / 6 - Complete legal description Sky Ranch Est. #2, Block 2, Lot 6 Location (site address) 11731 Wranglers Way Current Property owner(s) Curtis Wilson Day phone Mailing address Real Estate Agent 11731 Wranglers 2. TYPE OF DWELLING: Q Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual FI Individual Water Storage ❑ Holding Tank ❑ Community Class 'A' Well 0 Community ❑ Public Water System ❑ Public Sewer ❑ Waiver/Variance request for: Distance: Received COSA to be released to the engineer, unless otherwise requested by the engineer. Date: l % COSA Fee $ L qQ — Waiver Fee $ Date of Payment 1611113 Date of Payment Receipt Number 0&-02%�_ Receipt Number COSA# LISC13/5aq Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218 Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone 6. DSD SIGNATURE j System #1 Approved for 'T T bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for Date 8/9/13 bedrooms, with the following stipulations: By: azz�Original Certificate Date: % 0 — I / " / 3 Theunici li of chorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet � '., c If more than f septic system is on the lot: COSA Checklist # of Structure served by this system I Certificate of On -Site Systems Approval Checklist Legal Description: Sky Ranch Est. #2, Block 2, Lot 6 A. WELL DATA Well type Class 'A' Date completed _ Total depth ft. Date of test Static water level Well production If A, B, or C provide PWSID # 212916 Sanitary seal (Y/N) Cased to ft. FROM WELL LOG WATER SAMPLE RESULTS: ft. Coliform colonies/100 mL Nitrate mg/L Arsenic ug/L Date of sample: B. SEPTICIHOLDING TANK DATA Tank Type/Material Septic/Steel Tank size 1,250 gal. Number of Compartments Foundation cleanout (YIN) Y Date of pumping 5/12/13 Parcel ID: 015-302-30 Well Log (Y/N) Wires properly protected (Y/N) Casing height (above ground) in. AT INSPECTION ft. 9 - p.m - Collected by: Date installed 11/10/75 Cleanouts (Y/N) Y Depression over tank (YIN) N High water alarm (Y/N) N _ Pumper Northland Pumping Service C. ABSORPTION FIELD DATA Date installed 9/7/91 Soil rating (g.p.d./ft2 or ft2/bdrm) 0.6 GPD/SF System type Deep Trench Length 65 ft. Width 3 ft. Gravel below pipe 8 ft. Total depth 12 ft. Eff. absorption area 1,040 ft2 Monitoring tube Y Depression over field N Date of adequacy test 8/7/13 Results (Pass/Fail) Pass For 4 bedrooms Fluid depth in absorption field before test 0 in. Water added 610 gal. New depth 18 in. Elapsed Time: 280 min. Final fluid depth 0 in. Absorption rate , 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) No If yes, give date D. LIFT STATION Date installed "Pump on" level at Datum _ Size in gallons in. "Pump off' level at in. Cycles tested E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main Sewer /septic service line Animal containment areas SEPTIC/HOLDING TANK ON LOT TO: Manhole/Access (Y/N) _ High water alarm level at Meets alarm & circuit requirements? On adjacent lots On adjacent lots Public sewer manhole/cleanout Holding tank Manure/animal excrete storage areas Building foundation 5+ Property line 5+ Water main 10+ Water service line 10+ Wells on adjacent lots 200+ ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water Service line 10+ Surface water 100+ Curtain drain 50+ Wells on adjacent lots 200+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Steven R. Pannone Date 8/9/13 COSA brown sheet 10-10-12.doc Absorption Feld 5+ Surface water 100+ Water main 10+ Driveway, parking/vehicle storage 10+ Iri1 ..csa aRaxc auapl } . acv. (AalwnT ,l Toxwc oxmecr It e 'r,TaHT amawa soeAOl I a:c an0wc 5l1e.1tlt AAA aa°wc 218.oc �: I 1 WRANGLERS WAY / T--- 5 rw cc li Lu7 I \ 1 I 45.0' N ob a EXISTING o NOUS= FOa C.O.s 45.C' °'9• 7." Cyt s C.O.s x 3 -- —— 10' U'IL ESMT N890 55 33,vi 225.800' RESPONSIBILITY NO CIRCUMSTANCES SHOULD AN AS-BU:LT. BE USED FCR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FCE UNES THE SURVEYOR TAKES RESPONSIBTY FOR THE INITIAL TRANSACTION ONLY AND ASSUMES FINANCIAL LIABIUTY ONLY FOR THE COENST OF THE SURVEY LISTED DISTANCES PREVAIL OVER SCALING. REPRODUCTION MAY CAUSE ERRORS IN SCALE Lar SURLEY SURVEY TYPE ❑FOIINOARON AS -BUILT SYMBOLS F-- ... L J nNAL STRUCTURE AS-BWLT SET REBARZM °DRAINAGE j'''''L ''�' AmyA - ;pp]11 PLOT PLAN ... AS -BUILT ... LOT SURVEY . , , OCR= 0 FOUND REBAR �r�. WOOD FENCE 1. La': r...1 CONCRE'L -2 AS -BUILT ... NO BI T Cl REMAnCATON AS B 0 C `RS T ASSUMED -:EV v j OJ4 Ae METAL FENCE . PLOT PLANS & !07 SURVEYS ® waLlD DEC., f101 E. : ITN THE RESPONSIBILITY OF THE BUILDER OR 14 R. PRIOR -0 On LY ?-:CSE rMPROVEMENTS ABOVE GROUND AND VISIBLE R`.' 9E CONSTRUCTION, TO VERIFY PROPOSED BUILDING GRAOc RELq-I'/E SnO WN FENCES, WELLS, SEPTIC CLEANOUTS, SIDEWALKS, ORI VEWAYS, TO FINISHED GRADE AND UTIUTY CONNECTIONS P.ND i0 Dc'ERA!ME - ARE Sn C.S, !N THEIR APPROXIMATE . SIDEWALKS ONLY. SNCL= THE EXISTENCE OF ANY EASEMENTS, COVENANTS OR V, iCTIONS MAY PREVENT SOME ;MPRCVEMENTS FROM BEING SEEN ANO LCCA i C WHICH CE NOT APPEAR ON THE RECORDED SLED: vI S:ON PLAT.I ALL. D157ANCES ARE RECORD UNLESS OTHERPMSE NOI ;; SURVEY CERTIFICATION ..' illi,, Prepared by - 'Omy„„„..•�E CF 4�'((�11+�0 Robert E. Jo"ns, Jr. & Assc +fo16�'��a0.°11°"`0n°tli0t1 .+/��'• ••.�r� i Profe SSIOJTol Land Surveyors M1.nW v wWIYW tll M tlM bt °vM. w Memorex Pm mebaw O.eWm / �J:• �j� wer.e°. mA s°m.A y °T.xn.w° eM ym / ••'..) , '7008,4,k Drive. I,xcun° e°e ee eunvL _� {i �� ANCHORAGE. AALASKA 99504 FOUNDATION OUNDATIONtrAASr-., BnUsIaLTy e„ory wee I =...... r BCC ReAU Fl, N; ,•..•"'C�^ ov. e+aLlaiaa me,'.E1° .. Do:e Sxveycdl Drawn o _._... _ �.E ..,8 rT Y REJ 'Chocked °Aa'�mw me ro mm°°n•.«b wl ° ROBER- E .i .9I I C.7/271 l .�i 1\ � �• 0tl1s�"` A � � \ •Date Drown: Gr7a: FINAL STRUCTURE AS -BUILT ��$� 4 ,—C ; e 09l30A3 2737 fW.9. i '-Iry G? Rm�'1 E yhy i., M•°T M1111 ftt I f • I nu.. °slum.° m Arau A.:.r a sx •� ° ea "••........ .. � . 6`r0� . Leysl �escrlFLm. ._—... otessioncl t'+++ Lot BLOCK u..wm..w atmnecm d +wm ...s1 +���\\*\aa`' SKY RANCH ESTATES #2 n MUNICIPALITY ANCHORAGE j, '-• DEPARTMENT OF HEALTH &HUMAN SERVICES 44144"I'lDivision of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel LD. If �t — .via C HAA tt - iA Wi \ C i1C_n1 1. GENERAL INFORMATION Complete legal description Lot 6; Bloch 2; Shy Ranch Eetata *2 Location (site address or directions) 11731 WkangZerh Way Property owner Harvey Lathrop Day phone Mailing address 11731 Glrangter3 Way, Ancho�cage, AZasha 99516 Lending agency Day phone _ Mailing address_ Agent K4,i6 Kurtz Address 5201 JACK WHITE COMPANY C Street Suite 100 Aneho Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 4- 3. TYPE OF WATER SUPPLY: Individual well Community well Public water Day phone 563-5500 AZaaha 99503 NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site XX 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 (Rm 1/91) F,onl MOA P21 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 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. II Name of Firm S & S ENGINEERING Phone 17034 Eagle River Loop Road No. 204 Address Eagle River. Alaska 99577 Engineer's signature 6. DHHS SIGNATURE Approved for Disapproved. Conditional approval for Additional Comments :a bedrooms. 1I1TIr Date d?"/d'<�/ C✓_��'Rr �b: yam' R^, ,i ��� �jJ.S •FER, P.E. •.� �iIf.'• • r1 p ea�FESSOO+ y bedrooms, with the following stipulations: 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 DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7M25(Rsv.1/91) Beck MOAR21 ITY OF MWNICIP NTAL ""'ICES DIVISION AGE Municipality of Anchorage ENvI Department of Health & Human Services I 1991 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: JoL Parcel I.D. RECEIVED A. WELL DATA Well type A— Log present(Y/N)_ Total depth Sanitary seal (Y/N) Date of test Static water level Well flow Pump level If A, B, or C, attach ADEC letter. ADEC water system number �JIA— Date completed to FROM WELL LOG SEPARATION DISTANCES FROM WELL TO: Driller Casing height Wires properly protected (Y/N) AT INSPECTION r Septic/holding tank on lot 2� ; On adjacent lots Absorption field on lot I�C,1+ ; On adjacent lots _ Public sewer main Sewer service line WATER SAMPLE RESULTS: Coliform Date of sample: B. SEPTIC/HOLDING TANK DATA Nitrate Public sewer manhole/cleanout Petroleum tank Collected by: Other bacteria Date installed Tank size t2e�-0 Compartments 2 Cleanouts (VN) _ Fqu dation cleanout¢P/N) � Depression (YM High water alarm (Y/N) n/ Alarm tested (Y/N) r—����� Date of pum� ping (� �� Pumper �� 6 `/ f y!w� SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: �(( 1/ l Well(s) on lot /�Q/IOn adjacent lots %D '� Foundation To property line kc�;, Absorption field Water main/service line—� r Surface water/drainage '(7J _/_ 72-026 (Rev. 7/91) Frani CONTINUED ON BACK PAGE C. LIFT STATION Date i talled Size in gal s Vent (Y/N) High water alarm level "Pump on" level at Meets MOA electrical codes (Y/N) Manufacturer Manhole/Access (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot D. ABSORPTION FIELD DATA On adjacent lots "Pump off' level at Cycles tested Surface water _ Date installed Soil rating System type Length Width "J Gravel thickness Total depth 12— Total Z'Total absorption area n Cleanouts present (WN) Depression over field (Y/9 Date of adequacy test ry A Results (pass/fail) u for zt Peroxide treatment (past 12 months) If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 4�f?,Ae- On adjacent lots %� /4— Property line i To building foundation o T110 existing or abandoned system on lot On adjacent lots ��I Cutbank ISI Ot—� Water main/service line Surface water 1 �,7tfi Driveway, parking/vehicle storage area = Curtain drain\ _ `S .p/(�,ly E. ENGINEER'S CERTIFICATION ��� / - E t< �N�Ct �' "I `�G�� 41-n w I certify that 1 have checked, verified, or conformed to all MOA and HAA guidelines in efts g °� S & S ENGINEERING j° Signature 17(134 Fagl River "p Rnart No 204 00 i449TH Eagle River, Alaska 99577 Engineer's Name Date /u HAA Fee $ / / O Waiver Fee: R Date of Payment Receipt Number 72-026 Rev. 3/91)Back MOA 21 Date of Payment Receipt Number 0 .• i bedrooms J this inspection. DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE DISTRICT OFFICE 3601 C STREET, SUITE 322 ANCHORAGE, ALASKA 99503 FOR: S & S Engineering August 27, 1991 PWSID 212916 WALTER J. NICKEL, GOVERNOR 563-6775 My review of the records on file in this office reveals that the Sky Ranch Estates #2 Class A Public Water System, is in compliance with the provisions of 18 AAC 80.2.00, State of Alaska Drinking Water Regulations. Sincerely, -CvPh. ���•2tc,t� Keven K. Kleweno Lead Engineer ---�-- --- -- DA B EC E I V ED---- 1(7(o( Lti V a INSPECTION APPOINTMENTS 6, TYPE OP RESIDENCE- — TIME __ - i'IME TIME DATE � DATI? DATE - n� 9, INSPECTOR �— INSPECTOR INSPECTOR�1)4\ A. \ANCHORAGE - ---DEPY..UF -i - - ---- MUNICIPALITY OF ANCHORAGE - DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION I tALIFi NVIRONMENTAL I .cwECTION - - - • 825 L Street • Anchorage, Alaska 89501 - i hL�r� i 7 1981 depth (attach log if available.) ENVIRONMENTAL SANITATION DIVISION Telephone_ 264.4720 - -- [Ler IND] VIDUAL/ON-SITE** /9 YEAR ON-SITE SYSTEM WAS INSTALLED, RECEIVED - REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. - - 1. PROPEiRTY OWNER II - MAILING ADDRESS_S/f J1 - I� v't '- - 162 G /�,�U 4 ?-!?,570 -7 - PROPERTY RESIDENT (If different from above) - — ---�—moo—� PHONE — 2,.BUYER - - - - - P ONE - MAILING ADDRESS - - 3. LENDING rSTITUTI—ON -- ^-- PHONE MAILING ADDRESS - 4. REALTOR/AGENT o PHONE^� MAILINGADDRESS - - - - 5. LEGAL DESCRIPTION <i ✓- l ��_ L� ,�__ STREET LOCATION - /N s - 1(7(o( Lti V a h5 6, TYPE OP RESIDENCE- - - NUMBER OF BEDROOMS - - ❑ one El EJOther SINGLE FAMILY 1:1Two ' ClFive C1MULTIPLE FAMILY E!J�Three ❑ Six - ----_ 7. WATER SUPPLY. - ----- --— EJINDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled Com- COMMUNITY - since June 1975. For wells drilled prior to that date, give well ElPUBLIC UTILITY depth (attach log if available.) S. SEWAGE DISPOSAL SYSTEM [Ler IND] VIDUAL/ON-SITE** /9 YEAR ON-SITE SYSTEM WAS INSTALLED, [J_ PUBLIC UTILITY NSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. NOTE: THE: I 72-010 (Rev. 6U0) W 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY - 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ TWO ❑ THREE ❑ FIVE ❑ OTHER ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON-SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATEINSTALLED INSTALLER ❑Septic Tank or ❑ Holding Tank Size: - J Q If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL T0: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 6. COMMENTS CQ�APPROVEDFOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE / BY CyI/ 72-010 (Rev. 6/79) _z o; -� e � 14ATERIALSTF5TINro • QUALITY CONTROL _..f' SOILS EN3INEER114G 2204 Cleveland Ave. 710 Third Ave. PO. Box 10-1126 P.O. Box 2540 Anchorage, AK. 99511 Fai rbonks, AK. 99707 277-0231 4 52 -12 67 • 4 56- 5155 S 'TIC SYSTEM ADEQUACY REPORT JOB NO. DATE OF REPORT DATE OF TEST 81-1614 I LEGAL DESCRIPTION LOT -6--, BLOCK 2 __, -Sky Ranch Esta_teS _ SUBDIVISION OR __—_-. --SECTION , T -_N, R --_W, S.M. , ALASKA PERFORMED FOR: John Mulholland SRA Box 1621G Anchorage, Alaska 99507_ PHONE NO. _345-3044 REQUESTED BY: PHONE N0.._._ TYPE OF SYSTEM. ;�7 `SEPTIC TANK - SIZE _1,5-00-- GALLONS 11 CRIB OR SEEPAGE PIT XE] LEACH FIELD NUMBER OF BEDROOMS SEPTIC TANK WAS PUMPED In YES 0 NO ABSORPTION RATE: AVERAGE 24 HOURS -__480. -GALLONS. SURGE RATE -__.120_ -GALLONS IN .. 12_--- MINUTES. NOTES B OBSERVATIONS: Init 360 120 TEST PERFORMED BY: day -1 -. --- ---day 2 - -day-3 - 68-3/4 -68--3/4 - ---- --68-3/4--- 68" ---- -- -- 67-3/4-- 67-3/A_ 7-3/4-67-3/4- - --- -- REPORT PREPARED BY: -. _ __ APPROVED BY:_._- MUNICIPALITY OF ANCHORAC= DEPARTM, r OF HEALTH AND ENVIRONMEi ,L PROTECTION 825 L Street, Anchoraaa. Alaska 99501 264-4720 Date Received: December 38-, 1977 41: Time J ;.' )I #2: Time _--_ #3: Time _ Date 1j(-)- ){ l I i —&p Date _—__ Date _— Insp �� Insp Insp — REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES 1.. Lending institution Request: Jack White Company, Jon C. Dawson Mailing Address: 3201 C Street 99503 _ Phone: 277-1553 —_ 2. Property Owner: John G./Linda B. Seekings _ Phone: 264-4254 Mailing Address: Star Route A Box 1623B 99507 3. Legal Description: Lot 6 Block 2 Sky Ranch Estates Subdivision #2 4: Single Family Residence: (x) Multiple Family Residence: ( ) 5 Number of Bedrooms: Three Number of Bedrooms: Well System: Tndividual Well ( ) Conuuunity/Public System (x) Permit If Construction Depth of Well Well Log on File ( ) —_ Bacterial Analysis Sewage Disposal System: On-site System (x) Permit It Installed 1976 Public Utility ( ) Installer r(c cu xcr l-1 ,. Septic Tank Size �)�.��.(/r�,S Manufacturer_['no�� —__ Absorption Area hey;' _ Soils Rate ;)'I'i _` Material _ 7. Distances: Well to Septic. Tank. ^--_ to Absorption Area to Sewer Line Nearest Lot line Absorption Area to Nearest Lot Line Page Two Department of Iiealth and Environmental Protection Request for Approval of ]Individual Sewer and Water Facilities I,egal Description: Lot 6 Block 2 Sky Ranch Estates.Subdivi.5ion #2 Comments: Affadavit Attached: (') Letter Attached: ( ) Approved: Date: Disapproved: Date: Department Worksheet: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF ENVIRONMENTAL QUALITY ;825"L" St. Anchorage, Alaska 94501 (4th. F1) "279-2511 INDIVIDUAL SEWER and WATER FACILITIES vv 1 1. Type of Inspection: CMRO VA FHA CONY X 2. Property Owner: D hr. S!��C j q �q Mailing Address: 9 S'07 '&�N VAC 1613 -T:L 9D Phone 6 - l 3. Name of Buyer: Mailing Address: 4. Name of Lending Institution: Day Phone Mailing Address: / Phone / I 5. Name of Realtor or Agent: --T /q�0� I�1S a1 ��- + i '� Co Mailing Address: a6) ,` 17 t�� V�tl'Lv�99 � Phone �c SS 6. Legal Description: �. u 7 �� `� �-t% ��� 1`► I�,(� P1C fly T'�i75� Location: S&® OFF 13%TZCIH TZ0A b 12E—r-WF_EA/ /?4d�y hIvb 1AuF M15�nJ C i 1 1 W Ie.fi*NCsLEP'S W W-/) 2, s �yr- r�cr St►�u,� FBdr 7. Type of Facility to be inspected: � ( No. Bdrms. _ 8. Water Supply C, o,AA" u/✓ITY Type of Supply: Public Utility vii. -ELL individual If Individual, number of dwellings presently served _ If Individual, depth of well 9. Sewage Disposal System Type of System: Public UtilityIndividual (on-site) )�/ If Individual, date of installation I � 1 r L`tPl - CNVIrc01�:,- EQ-037 (1/74) ... c.... i yq R�(NO[A6[ APFA •F� 0 �$ S GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received October 21, 1976 Time of Inspection --L(;'6(0 Date of Inspection /L]- 32 REQUEST FOR APPROVAL OFT/ - INDIVIDUAL SEWER & WATER FACILITIES FOR Conv. 1. Approval requested by: Alaska mutual Savings Bank Mailing Address: Post Office Box 1120 Phone: 274•-3561 2. Property Owner: George Hood Phone: 274-5014 Mailing Address: 3. Legal Description: Lot 6 Block 7. Sky Ranch Estate 4. Location: NHN Wranglers 5. Type of facility to be inspected Single Family No. of bedrooms 3 6. Well Data: A. Type ` Community B. Depth C. Construction D. Bacterial Analysis 7. Sewage Disposal System: On -sate system A. Installed __Z B. Installer C. Septic Tank: 1. Size /. �(7_ 2. Manufacturer D. Seepage Pit: 1. Absorption Area 2. Material E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank �^ , Absorption area Sewer Lines Nearest lot line Other contamination B. Foundation to septic tank _, Absorption area C. Absorption area to nearest lot line EQ -034 (1/74) Page 1 of two pages Page 2 of two pages Re !st for Approval of Individual ;er & Water Facilities Legal Description Lot 6 Block 2 Sky Ranch Estates Comments Approved - r J\Adt. Disapproved _ Date Approval Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM 1 certlty that the intormation containea in this request Tor approval to De a Lrue anu accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. NONIN EQ -034 (1/74) Date MUNICIPALITY OF ANCHORAGE • �e DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO _VA FHA CONV % 9 9 a 19 .� 7 I W Property Owner:_ Georpe Z Hood Mailing Name of Buyer: John G. Seekings Day Phone: +-514 Mailing Address: NHN Wranglers Day Phone: 265-4254 — Name 65–+4— Name of Lending institution: —Alaska Mutual Savings Bank Mailing Address: P. 0. Box 1120 .Phone: 214-3561 Name of Realtor or Agent: Pat Stephan Mailing Address: 101 E. International Air. Rd. Phone: 272-1541 Legal Description:. Lot 6 Blk. Blk. 2 Ekyranch Estates Location:— NHN Wranglers Type of Facility to be Inspected:.—Single Family No. Bdrms._3 Bd. Water Supply Type of Supply: Public Utility—X--Individual If Individual, number of dwellings presently served — If Individual, depth of well Sewage Disposal System Type of System: Public Utility If Individual, date of installation. 72-003(3/76) Individual (on-site)_—X-