HomeMy WebLinkAboutSKY RANCH ESTATES #2 BLK 2 LT 12MUNICIPALITY OF ANCHORAGE 'vent
On -Site Water & Wastewater Program �o
PO Box 196650 4700 Elmore Road e r
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http://www.muni.org/onsite u
Department
On -Site Wastewater Disposal System Permit
Permit Number: OSP231381 Effective Date: 11/17/2023
Work Type: Septic Upgrade Expiration Date: 11/16/2024
Tax Code Number: 01530236000
Site Legal Address: SKY RANCH ESTATES #2 BLK 2 LT 12 G:2737
Site Mailing Address: 11720 PINTO CIR, Anchorage
Owner: AUTREY IAN T & MEREDITH R Lot Size in Sq Ft: 20976
Design Engineer: PANNONE ENGINEERING SERVICES Total Bedrooms: 3
This permit is for the construction of:
Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ 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
R�eitr�d-By: C 5"5 uP r� —i r, P'5 5 Date:
Issued By: / Date:
MUNICIPALITY OF ANCHORAGE
Community Development Department Phone: 907-343-7904
Development Services Division Fax: 907-343-7997
On -Site Water & Wastewater Program
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 015-302-36
Property owner(s) Ian & Meredith Autrey
Mailing address 11720 Pinto Circle, Anchorage, AK 99516
Site address 11720 Pinto Circle
Day phone
Legal description (Sub'd., Block & Lot) Sky Ranch Estates #2, Block 2, Lot 12
Legal description (Township, Range & Section)
Lot Size 20,976 Sq. Ft. Number of Bedrooms 3
APPLICATION IS FOR: APPLICATION IS AN:
TYPE OF DWELLING:
(M all that apply)
Absorption Field ❑X Initial ❑
Single Family (SF) ❑X
(w/wo ADU)
Septic Tank ❑X Upgrade ❑X
(D) El
Holding Tank ❑ Renewal ElDuplex
Multiple Dwellings ❑
Privy ❑
(SF and/or D)
Private Well ❑
Water Storage ❑
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that
this is in accordance with
applicable Municipal Codes.
1�
(Signature of property owner or authorized agent)
Permit/Rush Fees: g Waiver Fees:
Date of Payment: Date of Payment:
Receipt Number: Receipt Number:
Permit No. O SP2 1 3 ( Waiver No.
Permit App_*- ::—.:c
Pannone Engineering Services LLC
Steven R. Pannone, Principal
Registered Professional Engineer
E-mail: steve@panengak.com
Mailing: P.O.Box 1807, Palmer, AK 99645
Telephone: (907) 745-8200 FAX: (907) 745-8201
19 October 2023
Municipality of Anchorage
Development Services Department
On-Site Water & Wastewater Program
4700 Elmore Road
Anchorage, Alaska
Subject: Sky Ranch Estates #2 B2 L12
Septic System Upgrade Permit Request
Septic System Design Narrative
This is a design narrative for a permit to install a septic system upgrade on the subject property. The proposed
upgrade will serve an existing three-bedroom (3) house. This lot and surrounding lots in the subdivision are served
by a community water system. Lots to the south of the subject property are served by private wells. There are
currently no wells within 100 feet of the proposed upgrade.
1. Soils:
A test hole was performed on this lot by Pannone Engineering Services, LLC on 9/15/2023. Groundwater was not
observed during the excavation of the test hole, and bedrock was not encountered. No groundwater was observed
in the test hole monitor tube after 7-days. Based on the results of the percolation test and overall soils appearance
an application rate of 0.8 gpd/SF was used for the design of a conventional wastewater treatment system in the area
of the test hole.
2. Soil Absorption System Design.
a. See Sheet 1 of the design package.
3. Surface Water:
There is no surface water within 100 feet of the proposed septic tank and drain field.
4. Topography:
See attached site plan for area topography. The area is generally flat with no substantial elevation change in the area
of the proposed drain field.
5. Drawing Markings: The Drawings are marked “For MOA Review Only”. When written notification that the
review is complete and no further comments are received from MoA On-Site Department, the note will be removed
and “For Construction” drawings will be issued.
The proposed installation will not affect the future development of this or the surrounding lots.
If you have any questions or concerns, please contact me at (907) 745-8200.
Sincerely,
SRP
Steven R. Pannone, P.E. F. ASCE
Owner/Civil Engineer
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231381, Deb Wockenfuss, 11/17/23
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231381, Deb Wockenfuss, 11/17/23
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231381, Deb Wockenfuss, 11/17/23
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231381, Deb Wockenfuss, 11/17/23
GRE*,,ER ANCHORAGE AREA BOR.,. dGH
~_? ,..~,z, Department of Environmental Quality
~'~ 3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT O~N-S~IT~E_SEWAGE DISPOSAL SyST. F..M
SFPTIC TANK:
DISTANCE ¢¢
FROM WELL~Z_ MANUFACTURER
INSIDE LENGTH__~ ] INSIDE WIDTH
~,~_ _~._ NUMBER OF
MATERIAL __ COMPARTMENTS
LIQUID DEPTH
LIQUID C APAC ITY/C)~GAI_ LON S,
TILE DRAIN FIELD: /~t¢,0
.,W~¢, I / TOTAL LENGTH /
DISTANCE FROM WELL ~/"' FOUNDATION ~ NEAREST LOT LINE ~ .OF [INES ~¢)
NUMBER OF LINES__~/~ DISTANCE BETWEEN LINES TRENCH WlDTll IN. TOTAL EFFECTIVE
ABSORPTION AREA_ ~/ SQ. FT. LENGTH OF EACN LINE ~ /
~ / DEPTH OF FILTER -- /~ ~ /~
DEPTII: TOP OF TILE TO FINISH GRADE ¢~ ~ MATERIAL. BENEATH TILE .~ ~IN, ABOVE TILE IN.
WELL: . ~/~/ '
TYPE __ :' ~-~,/ .... CONSTRUCTION
DEPTH
DISTANCE FROM;
BUILDING NEAREST
FOUNDATION____ LOT LINE
NEAREST SEPTIC SEEPAGE
SEWER LINE______, TANK____, SYSTEM
CESSPOOl
OTI-IE R SODRCES
APPROVED
DISAPPROVED
DISTANCES:
SEWER LINE DEPTH:
LOT SLOPE:
REMARKS;
REMARKS
Form LQ-032
GRE: ER ANCHORAGE AREA BOF UGH.~.~¢,.¢
PERMIT NO,
DE.ARTMENT O. ENV,RONME'"TAL QUAL,TY /
3330 "C" STREET ANCHOBAGE, ALASKA 99503 ~ (
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
_¢.J r/..~¢~ 2 ~ ,MA,,--- A.,'R-- ~-- /¢~' ~'"' n")';''-' PS°N.
f'~*U/'~ '
.,.AN... T"ROUGI' ° '' '"'TA'''' ''
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE ~ TYPE SEEPAGE AREA SI TYPE
., DRAIN FIELD
seEPAGE PIT
ALSO CONSIDER AREA WELLS.
SEEPAGE PIT
., DRAIN FIELD
CAST lEON INTO AND OUt OF SEPTIC TANK AND INTO CRIB CROSSINg GAP OF
GRAVEL ~BACKFILL
DIAGRAM OF SYSTEM
I CERTIFY THAT I Am FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDI~NO.
28-GE
AND THAT THE ABOVE
~ ~r{~~ GREATER ANCUORAGE AREA
Uel)artment of Environmental Qu ity
3330 "C" Street
Anchorage, Alaska 99503
SOILS LO(I -- PEIlOLATION TEST
This form reports: Soils log .~ZL.lg___~< ........ Percolation test
Depth
Feet
2-
lO-
11
12-
13-
Was ground water encountered? _t/~,~__ If yes, at wl~at depth? .................
Reading Date Gross l'ime Net Time Depth to Water Net Drop
;__--_7_Z-Z'--'~Z_]~ -
-~5"-x-t-(~'o = .... ~e~ ............................................
I~Z;r--~61--a-~i-o ~' -r'~ t-e. ............. ]i~i-~-~i~-e'. .....................................
Proposed ins~allat~(~-~-)'n:---S~e~'~a'-(le Pit brain Field .....................
be )th of Inlet __ '. Dept'l~--t-o"~-o~c-t-obl--o-~i)i.~ or trench ~ _~/~/ _
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-Site Services Section
P.O, Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTFIORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
ParcelI,D.# ¢)~5" 3C2E 3~' '~' HAA#
1, GENERAL INFORMATION
Complete legal description
Location (site address or directions) /I'7 ~¢' p¢^¢¢ ~rc/~'
Property owner
Lending agency
Mailing address
Agent N,~. (~o~ W~/~ ~ ~) Dayphone
Address
Unless otherwise requested, HAA will be held for pickup.
2, NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
NOTE:
Individual well
Community well ~
Public water
If community well system, provide written confirmation from State ADEC attest,
lng to the legality and status of system.
TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE:
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72°025 (Rev 1/91) Front MOA #91
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.
NameofFirm F/¢"/~-,£ ?'"~'c4,4,¢c,/' £~',.,~',~
Address /'-/.~'Z~ ~/~'c4o _¢/~ ,~,~r_4o,-~/o~
Engineer's signature ~='~ ~. ~
bedrooms.
DHHS SIGNATURE
Approved for
Disapproved.
Conditional approval for
bedrooms, with the following stipulations:
Additional Comments
By: 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 eot
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
72~325 (Rev. 1/91) Back MOA#21
ENVIROr,4MENTbj_ $J!RVICF..~ DIVISION
Municipality of Anchorage /~ ~, (~ JZ ~
DEPARTMENT OF HEALTH & HUMAN SERVICESI~ ...... :1 V~ ~;
Environmental Services Division
825 L Street. Room 502 · Anchorage, Alaska 99501 · (907) 343-4744
Legal Description:
A. WELL DATA
Well type ~'(¢.r.~
Log present (WN)
Total depth
Sanitary seal (Y/N)
Health Authority Approval Checklist
.~/~,,,,ctr ~ g/4:y ~a.~c6 ¢'¢./-#ZParcel I.D.: ol_c - :50 z - ~¢'
Date of test
Static water level
Well production
WATER SAMPLE RESULTS:
Coliform
Date of sample:
D, SEPTIC/HOLDING TANK DATA
If A, B. or C, attach ADEC letter. ADEC water system namber
Date completed
Cased to
FROM WELL LOG
g.p.m.
Nitrate
Collected Dy:
Date installed to/~ / t' ?5'- Tank size j_¢,o~,,~ Number of Compartments
Foundation cleanout (Y/N)
Date of Pumping ~//9/9 7
C. ABSORPTION FIELD DATA
Date installed IO/:~t/
Length 5'O ~ Width
Effective absorption area
Date of adequacy test <¢
Casing height (above ground)
Wires properly protectec [Y/N)
AT INSPECTION
g.p.m.
Other bacteria
r)epresst0n [Y/NI.
Pumoer
! Cleanouts [Y/N)
High water alarm (Y/N',. ,,v'. 4,
Soil rating (g.p.d,/fF or fF/bdrm) E oo ~"_ System type ~-r¢~
Gravel thickness below p~pe /o' Total depth ~_~__r
Monitoring Tube present (Y/N) Y' ~_ Deeression over field (Y/N)
Results (Pass/Fail) P,¢,-¢¢ For -~ bedrooms
Fluid depth in absorption field before test (in.); 'Ytr' Immediately after7~'5" gal. water added (in.): _ o¢~- {/~
Fluid depth ,¢/-¢/ZY (ins) Minutes later: ~¢ Absorption rate = ~ ~ g.p.d.
Peroxide treatment (past 12 months) (Y/N) Mo~¢ ~ If yes, give date ~. ~.
72-026(Rev. 3/96)* ~7 ~r/~ E~ ~ 7' N~ o~ d'~S~ ~ ~ breve4
LIFT STATION /V. ,4,.
Date installed
Manhole/Access (Y/N)
Size in gallons
"Pump on" level at*
*Datum
High water alarm level at*
Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot
Absorption field on lot
Public sewer main
Sewer/septic service line
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO:
Foundation 5' ' Property line
Water main/service line '~ to ' Surface water/drainage ~>
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line '~ 5"' Building foundation
Surface water .~. ~oo,
Curtain drain /v'¢,~c¢
On adjacent lots
On adjacent lots
Public sewer manhole/cleanout
Lift station
"Pump off" level at*
Absorption field ~' ~
Wells on adjacent lots _~, ~.oc,,
Water main/service line ;:> to '
Driveway, parking/vehicle storage area 5~o '
Wells on adjacent lots ~ zoo '
HAAFee $. 5'0'0 ~
Date of Payment z~7~/..~/~ '7
Receipt Number (5) ~'~::~ ¢// .[~¢-'~/_.,0 7 ds~-)
72-026 (Rev. 3/96)*
Waiver Fee $
Date of Payment
Receipt Number
F. ENGINEER'S CERTIFICATION
In conformance wlth MOA HAA guldelines ln effect on thls date
Engineer's Name
Date ~
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-Site Services Section
P.O. Sox 196650 Anchorage, Alaska 99619-6650
343-4744
CERTIFICATE OF HEAl_TH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
Parcel I.D.~ -C)\~Z)- ,~ ~ ~[o _ HAA#
GENERAL INFORMATION
Complete legal description
Location (site address or directions)
Property owner.
Mailing address
Lending agency
Mailing address.
Agent
Address
Day phone
Day phone
Day phone
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS: '-~'~
I'YPE OF WATER SUPPLY:
NOTE:
individual well
Community well ~
Public water
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAl.:
NOTE:
Individual on-site
Holding tank
Community on-site
Public sewer
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-o25(Rev. 1/91) Front MOAII21
STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I further verify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm ~/~ ~'/~ ,~A-~'~,~ Phone
Eno ineer's sig natu re ~-~,~'~[~ u Date
DHHS SIGNATURE
[,/ Approved for ~
Disapproved.
Conditional approval for
bedrooms.
bedrooms, with the following stipulations:
Additional Comments
By: / , . . _ 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 p.rofessional engineer's work.
(Rev, 1/91) Back MOA ~Y21
Municipality of Anchorage
Department of Health and Human Services
H£ALTH AUTHORITY APPROVAL. CHFCKL. IST
Legal Description: Lo-fL-/~
A. Well Data
Well type
Log present (Y/N)
Total depth
Sanitary seal (Y/N)
(~B, or C, attach ADEC letter. ADEC water system number
Date completed Driller
Cased to Casing height
Wires properly protected (Y/N)
FROM WI-'LL LOG
Date of test
Static water level
Well flow
Pump level1
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on Ici ~u/¢/
Absorption field on lot
Public sewer main
g.p.m,
AT INSPECTION
g,p.m.
; On adjacent lots
; On adjacent lots
Public sewer manhole/cleanout
Sewer service line
Petroleum tank
WATER SAMPLE RESULTS:
Coliform Nitrate
Other bacteria
Date of sample:
Collected by:
B. SEPTIC/HOLDING TANK DATA
Date installed I0/,,,~//~,~'"
Cleanouts (Y/N) Y
High water alarm (Y/N)
Date of pumping ~-/-~".~
Tank size /O o O Compadments
Foundation cleanout (Y/N) /,,,/ Depression (Y/N)
Alarm tested (Y/N)
Pumper
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot m ~/¢ On adjacent lots
To properly line ~'o ~ Absorption field
Surface water/drainage /-(-/:)'
Foundation (~
Water main/service line
72-026 (3/93)* Front CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed
Size in gallons
Vent (Y/N)
High water alarm level
"Pump on" level at
Manufacturer
Manhole/Access (Y/N).
"Pump off" Level at
Cycles tested
Meets MOA electrical codes (Y/N)
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot ,,~/'/~' On adjacent lots
D. ABSORPTION FIELD DATA
Date installed / 0/~
Length ,~O ~-'¢' Width
Total absorption area
Date of adequacy test
Water level in absorption field before test
Peroxide treatment (past 12 months) (Y/N) ,AC/
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot
To building foundation
On adjacent lots /Ob
Surface water
Curtain drain
E. ENGINEER'S CERTIFICATION
Surface water
Soil rating (GPD/Ft2) ~ System type
,,~'t4~ Gravel thickness /O ~ Total depth /~ .~../L-
Cleanout present (Y/N) ',/ Depression over field (Y/N)
Results (pass/fail) ,~)A-~ .& for
O ~ After test O
If yes, give date /~4-
On adjacent lots ~¢ Property line
To existing or abandoned system on lot
Cutbank /,-/A- Water main/service line ,.'~
Driveway, parking/vehicle storage area /
Bedrooms
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signatu re~"~~~.
Date <::~/3/'~ ,-'.'.'.~
Date of Payment
Receipt Number
72-026 (3/93)* Back
Waiver Fee $
Date of Payment
Receipt Number
lC)'
.p
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