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Home My WebLink AboutSKY RANCH ESTATES #2 BLK 2 LT 19 ,! IVIUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT MAILING ADDR ES(~ LEGAL DESCRIPTION LOCATION DISTANCE TO: Manufacturer DISTANCE TO: iF NOMEMADE: Inside length NO, OF BEDROOMS Well Dwelling PERM,T NO. 000 q O NO. of compart ents Liquid depth PERMIT NO, Well Foundation (~ DISTANCE TO; *'~- ¢~ No. of lin s th of each h of lines Top of tile to finish grade L~- ~ Material beneath tile Length Width Depth Nearestlotline -~0 PERMITNO, ~'~O O¢'~ 00 Trench width Total effective absorption area PERMIT NO. Type of crib DISTANCE TO: uilding Depth Driller Distance to lot llne DISTANCE TO: Building foundation Sewer line Septic tank OTHER PIEE MATERI LS · SOIL TEST RATING INSTAL~ REMARKS APPROVED 72-013 (Rc~Z. 3/78) DATE LEGAL PERMIT NO. ( 8El.¢.'l~l'.~l ) FIF'PLICRNT JRblES R. BENNET'F LOC'.FIT I ON SHETLFtND CIRCLE L. EGFIL i~L9 B2 SK~:R~NCN ESTSTES::' TYF'E OF SOIL 8BSORPTION SYSTEM IS: TRENCH HNCHuRP]GL., 264-4720 .:... _,, ..... LOT ~ZZE 2EIElOe ~URRE FEET MB;,.~IMt. IM NUMBER OF BEDROOMS = 4 SOIL RRTIf',IG (SQ F'f/BR)= '-258 ]'HE RE6!UIRI"-'D SIZE OF THE SOIL FIBSORPTION S'¢STEM IS: E:" E F" l H =' ~ L. E It'",l C'i 'T' F! = ::L 2 ~'~ G re-. Fi ",,-' E L D ES P T Hi ~'= ~5 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINI:ZIELD. THE DEPTH OF FI TRENCH OR PIT IS THE DISTANCE BETHEEN THE SURFACE OF THE OR. OLIND I~N[.', THE BOTTOM OF THE E~'(CR',,,'ATION (IN FEET). THERE IS NO SET HIDTH FOR TRENCHES. THE GAR'eEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETHEEN THE OUTFBLL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET:). I~E£r~:!L..II I REEl:-, '--=;EF"T' I ~) TI:~-4~::: 5 I ZE=: :.lt..;~5~Z~ PERMIT RPPI_IC¢~NT HAS THE RESPONSIBII..IT~¢ TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF RNa' HELL:S A[:,JRCENT 'FO THIS PR. OPERT'T' AND THE NUMBER OF RESIDENCES THAT 'THE HELL HILL SERVE. ....... Ti-'.IO ': ~-' ".:.~ I 1'-,I5--;PEC]'T IONS F~RF£ BACKFILLING OF BN~'r' S%"~3TEM 14ITHOUT F'INRL INSPECTION AND DEPARTMENT HILL BE SUBJECT TO PROSECUTION. F-¢. E6].#_I Z F.' E: [) ............. RPPRCIVRL B'¢ THIS MINIMUM DISTANCE BETHEEN R HELL AND RN'T' ON-SITE SEHRGE DISPOSAL S'T'STEM :[.(IEl FEET FOR B PRIVATE HELL OR ±5~1 TO 2Ea(l FEET FROM R PUBLIC HELL DEPENDIMG UPGN THE T'¢PE OF PUBLIC HEI_L. MINIMUM DISTANCE FROM R F'RIVRTE HELL TO A PRIVATE SEHER LINE IS 25 FEET F~NI) -ro R COMMUNIT~r' SEHER LINE IS 75 FEET. OTHER REQUIREMENTS MAY APPI_¥. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE FtVtqILRBLE 'TO INSURE PROF'ER INSTALLATION. PERI"'1 I -r E'~.-~-'.'F" ][ RE:5; [:~ E CE i'dE: E~.F-:' ~:-~..~ I CERTIF%" THAT :Z: I Bb'l F'RMIt. IRR WITM THE REE~UIREMENTS FOR ON-SITE SEHERS AND NEL. LS RS SET FORTH BY THE MUNICIPBLIT'T' OF ¢~NCHORRGE. 2: I HILL INSTALL THE S¥STIEM IN ACCORDANCE HITH THE CODES. 2;: I tJNDERSTRND 'THAT THE ON-SITE SEHER S'¢STEM blR~l REQUIRE IENL. RRGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. ~, ~ ~NE.[ .... ¢'~,,,~¢;.-.~= _ ~ - - ........ , ............................. ~. ¢.. 0 ........................ 17 ................ 7-[ ............................... ' .......... / ......... '~ ~ ~ .-(~ " ? , .... NCHORAGE AREA B0R Department of Environmental O. uality 3330 C Street Anchorage. Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME ~//~¢'(~ ~: LOCATION SEPTIC TANK: DISTANCE d '! ~) '~ FROM WELIZ'4~/''~/~I~ANUFACTURER~ INSIDE LENGTH INSIDE WIDTH NUMBER OF COMPARTMENTS LIQUID DEPTH LIQUID CAPACITY_/'._~,~ GALLONS. TILE DRAIN FIELD: ! TOTAL LENGTH , . Q/ LINE DISTANCE FROM WEL~,(~,~ /)~UNDATION_~____NEAREST LOT NUMBER OF U,ES ¢ DISTANCE BETWEEN LI,ES ~' TRENCH WIDTI-I~d~. TOTAL EFFECTIVE ABSORPTION AREA ~7O SQ. FT. LENGTH OF EACH UNE __ DEPTH: TOP OFTILE TO FINISH GRADE~ ~ / DEPTI-I OF FILTER WELL: ~.~.rvv,v,~.~m~--~ ~,~/~ TYPE BUILDING FOUNDATION CESSPOOl APPROVED CONSTRUCTION _ __ NEAREST LOT LINE OTHER SOURCES ____. DISAPPROVED NEAREST SEPTIC SEWER LINE TANK __, REMARKS DEPTH ....... DISTANCE FROM: SEEPAGE SYSTEM DISTANCES: INSTALLED BY: SEWER LINE DEPTH: PIPE MATERIAL: LOT SLOPE: REMARKS: Form EQ-032 DIAGRAM OF SYSTEM ,I- ANCHORAGE AREA BOF DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "CI' STREET ANCHORAGE, ALASKA 99503 PERMIT NO, SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT INSTALLATION LOCATION FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRQNMENTAL QUALITY AUTHORITY WILL 13E SUBJECT TO PROSECUTION. MINIMUM DISTANCES, REQUIREMENT~ FOUNDATION TO SEPTIC TANK DRAIN FIELD CAST [RON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEEt INTO UNDISTURBED SO[L. GRAVEL CONFORM tO BOROUGH BEGULATfONS REGARDINO iNSTALLATION. DIAGRAM OF SYE~TEM i CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE AbOVe D~$C~u~u SYSTEm iS in ACCORDANCE 3 ~..~,. ~I ~d~rs~d ~ ~ade woul~ necess~,~h~d~e~~ ~ added.. DATE 4040 "B" S'I'REE'r, ANCHORAGE, ALASKA 99503 PHONE: 907-279-2581 July 8, 1975 W.O. t~17390 Samdys Construction 8235 Jewel Lake Road Anchorage, Alaska 99510 ATTENTION: Mr. 'Bill Lieker PROJECT: Sky Ranch Subdivision #2, Lot 19, Block 2 SUBJECT: Subsurface Soils Study Gentlemen: Transmitted herein are the results of a test boring placed in the project property at the specified location and depth. The test hole was drilled by Denali Drilling, Inc., super- vision, testing and report by Alaska Testlab. The test hole was placed by means of a truck mounted B-50 Mobile drill fitted with solid flight continuous auger. The soils encountered in this study were all frost-susceptible silts and sand silt mixtures. No free water was observed during drJ. lling, however, the soil between 8.0 and 10.0 feet was wet to saturated and may indicate a small perched water table. The Greater Anchorage Area Borough has established the amount of seepage area per bedroom required for a particular seepage pit based on the unified classification of the soil. We understand this criteria to be as follows: Unified Soils Classification Seepage Area Required Square Feet/Bedroom G~-GP 85 GM 225 SW 125 SP 150 SM 250 Test lio].e 1 Lot 19, Block Depth in Feet From To 0.0 0.5' 0.5 3.5' 3.5 8.0' 8.0 10.0' 10.0 16.0' Bottom of Test Hole: Frost Line: Free Water Level: Sample Depth lA 1.5' I 4.0'-5.0' 2 8.0' 3 15.0' Elevation: 2 Existing Ground W.O. t}17390 Soil Description Peat moss and other vegetation F-4, sandy silt, ML, tan, dry, with lumps of gray silt and approximately 20% organics, soft F-2, sil__h.5~ sand, SM, gray, silt ].umps to 1/4", damp, low to medium density F-4, si]t, ML, gray, wet, some organics, trace sand, soft to stiff F-4, sandy sil~, ML, gray, damp, soft to stiff, some organics 16.0' None Observed None Observed Type of Moisture Sample Unified DRY G ML D~ZP G SM WET G ML DAMP G ML Remarks: Type of Sample, G = Grab 15.0 feet Northwest of Northwest corner of house site, approximately 90.0 feet Southwest of edge of cul-de-sac Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Parcel I.D. 015-502-43 1. GENERAL INFORMATION CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING NAA# Expiration Date: 2-17 ........ Complete legal description SKY Location (site address or directions) Current Property owner(s) MAXINE Mailing address RANCH ESTATES #2; LOT 19, BLOCK 2 117~1~ sHETLAND HEIGHTS CIRCLE * ANCHORAGE, AK 99516 FARRELL Day phone 258-2035 .1110 W. 6TH AVE. ~605 * ANCHORAGE, AK 99501 Lending agency Day phone Mailing address Real Estate Agent Mailing address ANDREA ORIBBJ[~I W/PRUDENTIAL JACK WHITE Day phone 223-5824 · 3201 C STREET SUITE 200 * ANCHORAGE, AK 99503 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well [~] Individual On-site .[] · Individual w~ter Storage ['-I Individual Holding tank D community class A Well [] Community On-site r-~ Public Water System D Public Sewer D The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system, DSD also issues HAAs upon request to homeowners, Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Municipality of Anchorage Mark Begich, Mayor Btfildlng SafeW Division P.O. Box 196(350 · 4700 Bragaw Street Anchorage, Alaska 99519-6650 · (907) 343-8301' Fmc (907) 343-8200 http://www.muni.org 2/17/2004 Alaska Water & Wastewater Consultants, Inc. 3701 E. Tudor Road, Suite 101 Anchorage ,Ak.99507 Subject: Waiver Request for Sky R~ anch Estates #2 Block 2 Lot 19 Waiver Request #WRY...--,, O t4- o o o 8 Parcel ID #015-302-43 HAA 040044 Dear Engineer: Your request for a waiver of the required 10 feet horizontal separation from the absorption field to property line has been approved. The approved separation distance is 6.0 feet. This waiver approval applies to the existing absorption field to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Jeffrey W. Poet Engineering Technician On-Site Water & Wastewater Program Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www. ci.anchomge, ak.us (907) 343-7904 oH-ooo8 WR#: ° .:- PID#: pl 5-:3024:3 Dato Received: 2111104 I o o Legal Descnpbon: Sky Ranch Esates #2 Block 2 Lot 19 Englneer~ Alaska Water & Wastewater Consultants, Inc. i :3701 E. Tudor Road, Suite 101 Anchoragle Ak. 99507 Waiver Review Worksheet HA#: 040044 Permit#: Applicant! Maxine Farrel Waiver Requested: 6 feet separation distance absorption field to property line. Criteria: Geology Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: Waiver is Granted: ~ Waiver is not Granted: Mst Conditions or Reasons for above: mm~mmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmmm Rec#: 2-11-04 Amount: $175.00 Date Paid:,2-11-04 ALASIU WATER & WASTEWATER October 16, 2003 Municipality of Anchorage Development Service Department Building Safety Division On-Site Water & Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 ~ Reft Lot Line Waiver for Lot 19, Block 2 Sky Ranch Estates Subdivision//2. To whom it may concern: We request that your department issue a 6-foot lot line waiver from the south property line to the existing drainfield. Attached are the letters of non-objections from all the utility companies with rights to the 10' utility easement that parallels the south lot line. I am unaware of any adverse impacts this waiver_~ ,uld have on adjacent wells or septic systems. If you have any questions, please contact us at~}i 7-6179. Thank you for your assistance. xgeff~r~ ALjT~nes~, P i., M.S. 3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com MAR--26--~00! 84:48 PM ~6461~89 :261 ?524 P. 02 : il, , -I'/- ',< ,. ' . · ,~ ~cO~ AS-BUILT NO CORNERS 8~THIS DATE · I hem~ ~ thai I have pe~ormed a MortoaOes'a ina~ection ' ~- of ~e f~lo~ng described prope~ ~ r ~, a, .: ......... ,., ........ , ..... ~,~-z, Anchorage Recording Precinct, Alaska, and Ihat the / - ~0 ~ · impr~men~ situated ~ereon are within tho pmper~ IIn~ and .. ~ ':~ ~ ~r,d wa~c~[a ~ ~.:,~ do not ~eSap or enc~oa~ on ~e proper~ lyl~ adja~nt ~. ~... , . ~ ~ ~.' ~ereto. ~at no Improvements on pr~e~ lying advent thereto ,,, . .. ~, encroaoh on ~e pmm~es In question and that ~ere are no ~ . ~:~ ".'. e~...~ ~. -'t... ""*,,,'~' ,?s~ ~ roa~a~, tra~mleelon lines or other viable eesemenffi on · ~%~.,u~=~. ,.~, prope~ e~cept as Indicated hereon. ' %~'~ Dated at Anchorage, Alaska ~9~ME~S OF RECORD, OTHER ~AN this-- ~/6~ day of ~R~ 20 THO~E 8H~N ON ~E RECORDED FRED WA~ & ASSOCIATES m ~ ~aa:~ au~, u~,~, ~., ~ (907) 248-~8 Enalneem ~d Su~vom Feb .17. 2004 3:41PM CHUG ' POWERI~tG $d, llYdY$ P. 2 May 17, 2001 Alaska Water & Wastewater 6901 DeBar Road, Suite 2-B Anchorage, Alaska 99504 Attention: Meghan Subject: Letter 6fNon-o~ecfion for Existing Septic Syslem Lot 19; Block 2, Sky Ranch Estates Subdivision #2 '. Grid 2737, 1203-22D, OB01017 Dear Meghan: Chugach does not object to the septic drain field cncroachmeat into the utility easement on the south side of your property, Lot 19, Block 2, Sky Ranch Estates Subdivision #2, as shown on the attached as-built by Fred Walatka, dated March 21, 2001. It is Chugach'$ undcrstandingthat the septic veto is at thc edge ofthe easement and the septic drain field ends at that vent. All work within thc casement are must be in compliance with the enclosed copy of Chugach's Electrical Facility Clearance Requirements. Also enclosed for your use and information is the JLocate Call Center card, and Chugaeh's IYhat/s an Easement? handout. This non-objection is given v4thou~ prejudicc to Chugach's fall enjoyment of any aad all fights it may have in and to such easement. Sincerely, Jim K. Topolski Managcr, Land Services Enclosures cc: Maxine Coppe, 11740 Shetland Heights, Anchorage, Alaska 99515 Chu.qoch Beclric/.~sack~lion, inc. 560; t.'.i4::c;~o:o D:;~,c,, P.O. ~.',~x ~.9~$00, A.~,':.h.~m:.j,L .t,!o¢..,: ¢05'..06200 · i907; '.'0.~ [007'1 .'~62 0027 · t. SOOi 4/8.14c24 November 3, 2003 ACSm Alaska Communications Systems Jeffery A. Garness Alaska Water & Wastewater 3701 E. Tudor Road, Suite 101 Anchorage, Alaska 99507 ACS has no objection to the encroachment of that portion of the septic drain field into a platted easement located on Lot 19, Block 2, Sky Ranch Estates Subdivision, Unit No. 2, as depicted on the as-built drawing submitted. Acceptance and use o~ th~s letter of non-objection by yourself, your heirs, your assigns, or your successors, will constitute agreement to the following stipulations: ACS will be held harmless, now and forever, for any damages or injury to any person or property as a result of this encroachment. o Any ACS facility damaged or destroyed as a result of this encroachment will be repaired at no cost to ACS. Any costs incurred by ACS for special construction necessitated by this encroachment will be borne by the property owner. Ail applicable safety code regulations will be observed and maintained. This letter of non-objection will in no way preclude ACS from full use and enjoyment of its rights within any portion of its right-of-way. ', Foreman ' Outs/de Plant Engineerin~ ACCEPTANCE: DATE: AC&p # 428 :: G$\le\L .. \Enginee r\Correspo\Nonobj ec\skyRanch_L19 600 Telephone Avenue Anchorn.qe, Aln.~l~n oo:n: -n,,. 10/24/2003 ENSTAR Natural Gas Company ~[DIV]SION (~F SE..MCO E.NERGY. nglneerlng uepartment 401 E. International Airport Road P. O. Box 190288 Anchorage, Alaska 99519-0288 (907) 264-3743 FAX (907) 562-0053 Alaska Water & Wastewater Consultants P,e: 3701 E Tudor P,oad, suite 101 Grid: Anchorage, Alaska 99507 Letter of Non-objection A2737 To whom it may concern: ENSTAP, Natural Gas Company has no objection to a septic vent and related improvements encroachment into the 10 feet utility easement situated along the south property boundary of located on Lot 9, Block 2, Sky P,anch Estates, Unit No. 2 Subdivision. Acceptance and use of this letter of non-objection by yourself, your heirs, your assigns, or your successors, will constitute agreement to the following stipulations: ENSTAP, will be held harmless, now and forever for any damages or injury to any person or property as a result of this encroachment. Any ENSTAP, facility damaged or destroyed, as a result of this encroachment will be repaired at no cost to ENSTAR. Any costs incurred by ENSTAP, for special construction necessitated by this encroachment will be borne by the property owner. All applicable safety code regulations will be observed and maintained. This letter of non-objection will in no way preclude ENSTAP, from full use and enjoyment of its rights within any portion of its right-of-way. Sincerel~ ~ \ cc: File MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. # CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SiTE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING '1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include 10t, block, subdivision, section, township, range) Location (address or directions) (b) Property owner p'c-~4,'2' ¢4~','/ //¢~ // Mailing Address /} ~ ~ ~ e~/4~ ~ /'~ /d (c) Lehding Institution Mailing Address Telephone: (home) ,~P'5'-315'.¢ Business Telephone (d) Real Estate Company and'Agent Address Telephone (e) Mail the HAA to the following address: (or check here~, if hold for pick up.) List contact person and day phone number below: 2. TYPE OF RESIDENCE Single-Famiiy,~ Number of bedrooms ~-~ 3. WATER SUPPLY Individual Well [] Community~f Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site~ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (Rev. 7/88) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval 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 ~o~.~./~/J d- /~ ?L/_¢ Telephone ._~..c,~, ~ ~/ Address ~ ~. ~/~ / ~, ~ ~7 6. DHHS APPROVAL Approved for ,_~ bedrooms by Approved c/~'~_ Disapproved Terms of Conditional Approval Conditional The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated 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. 72-025 (Rev. 7/88) Back Page 2 of 2 Well Log Present (Y/N) Total Depth Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) SEPARATION DISTANCES FROM WELL.: o~~ MUNICIPALITY OF ANCHORAGE (MOA) ~ ¢,_~- L~-~I,"-'~ Health Authority Approval (HAA) /~.,~[X,. ,¢ .~ ~ 343-4744 ~ Well blassificati~%~ ~o ~ ~ ~, / y ~ ~ If A, B, C, D.E.C. Approved (Y/N) ~ Date Completed Yield / Depth of Grouting ~ Pump Set At ~ Sanitary S~-~ (Y/N) Depres~Around Wellhead (Y/N) To Septic/Holding Tank on Lot ~ ; On Adjoining Lots To Nearest Edge of Absorption Field on Lo~ ; On Adjoining Lots To Nearest Public Sewer Line ~ To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service~ on Lot Water Sample Collect~ ; Date Water Sample ~ults Gommonts B. SEPTIC/HOLDING TANK DATA Date Installed 7/7-5' ~. Size ¢ lOc, o?4/', No. of Compartments ~ / Standpipes (Y/N) '/V Air-tight Caps (Y/N) Depression over Tank (Y/N) _ //'Y/ Pumping/Maintenance Contact on File (Y/N) Holding Tank High-Wa. ter Alarm (Y/N) SEPARATION DISTANCE~S FROM SEPTIC/HOLDING TANK: To Water-Supply Well To Property Line ~ .;~ ~z/=7' To Water Main/Service Line ~ To Stream, Pond, Lake or Major Drainage Course Comments Foundation Cleanout (Y/N) Date Last Pumped __~/'~/~ ;for >//4 Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field ~ 72-026 (Rev. 7/88) F¢ont Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absortion Area Depression over Field (Y/N) Results of Last Adequacy Test Type of System Design ¢' '7-~'~''~(~ Length of Field '~ (~¢ 7 ' Depth of Field ~- ¢¢// Gravel Bed Thickness ;f' ¢'0 // Statndpipes Present (Y/N) Date of Last Adequacy Test ,/0//~'/~o~ SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well To Building Foundation ~ :.2. E) ¢- ' Lot To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course ,"~///~ To Driveway, Parking Area, or Vehicle Storage Area Comments )f~ ~,,~ D//I/~' To Property Line '"¢- ,.~0 ' To Existing or Abandoned System on ; On Adjoining Lots /~<¢~ '/~ To Cutback (if present) /"Y'~//~ D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. **Check Permitted Bedroom Rating Against HAA Request** I certify that l have che/o/ked,/~e/r.i-fied, f or conformed to all MOA and HAA g~iS'eline_~s~r~'-'~{~e~b~.~e date of this ReceiptNo. ¢7 ReceiptNo Date of Payment ,~' / ~¢/~ Waiver Fee: $ Amount: $ ~.~¢,¢ ~ Date of Payment 72-026 (Rev 7/88) 8ack Page 2 of 2 (907) 349-6451 LOCATION: Subdivision: Lot: Block: Date: .. ~//~/~'~ ?? Initial Reading on Meter: DRAW GAI~LONS GALLONS FIF, r.n Mf~ER DOWN TIME GPM ~1 VOLUME ~OTAL MONITOR LEVEL READING _.. ~,:,z/ ~'r~ ?,~ 7~_ /$'Z- " " ?'~ ~<~7, /~.'~ / 7,2_ 72_ 2/ ti .... ~;?. ,~? -- ~ '~/ - ~ , 12;¥ 5 NOTES: P:cduczion Rate: /~1//~ GPM 24-Hour Cap~city Gallcns HOME Anchorage, Alaska 99516 SERVICES, 15900 Francesca Drive Alaska 99516 or 341-2444 345-1890 CUSTOMER Block Lo't DATE DESCRIPTION AMOUNT ~-' :-}' F ,.,~:, J~--'_s ~:- . 1.2' / ~ ' ' //.' :~-c: , ~--:.~ .... TOTAL .... ~ -~ ~EMA~KS. :~//~ .//'Y tjv~;'-~-7* ~g~>~ /~..~/~l z //,..r' ,~7J)]-.; ~2 ?, ./~ ~Gallons Y/Septic ~Oe~pool Holdin~ Tank '~- Standpipes ~ ~'~ //',-.~((A~Ti me ~ P~OBLEM A~EA--CALL FO~ MORE INFO~ATIO~ ~ NEEDS TO BE DONE AGAIN IN 6 MO~TH~ ~ Good Shape ~7~iud~e buildup on bottom ~"Floater on top ~ dim cap missin~ or ~ Out standpipe to ~' above ~r~und ~ Needs 8eptlctrine needs replacin~ --PLEASE PAY FROM THIS INVOICE-- ANCHORAGE, ALASKA 99503 STEVE COWPER, GOVERNOR 563-67?5 DATE: Octobec 17, 1988 PWSID: 212916 To Whom It May Concern: According to the records ESTATES II Water System is Drinking Water Regulations. on ¢ile in this o¢¢ice, the SKY RANCH in compliance with the State o¢ Alaska Please note that departmental records indicate that the public water system ~as installed prior to the 1978 implementation o¢ the Alaska Drinking Water Plan Review regulations, No as-built plans have been reviewed or approved by the department, nor are any necessary, Since the system has submitted acceptable water samples on a regular basis and received a satisCactory sanitary survey evaluation by the department, the system is acceptable under the standards in e¢¢ect at the time o¢ installation. An o¢¢icial "Certi¢icate to Operate" may be issued upon receiving a complete set of as-built plans, Any expansion o¢ the water system aCter 1978 will require plan revie~ and the issuance o¢ a "Certi¢icate o¢ Operation" permit, VEC:pkk Sincerely, ¢// / FV!rv~ n~Eo~ rn ia iai'' F i 01 d ~¢icer MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PRO'rECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR NEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date ~,,~/'-~//~ ¢ GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (add,ess or directions) (b) Applicant Name/'~,/,e~,,J~_Z/~.)~ F Telephone: Home ~_~" "~ ~'";S- Business _,~'~"~_-~ ' Applicant Address /~.L~,~w E-- (c) Applicant is (check one): Lending Institution []; Owner/builder~; Buyer []; Other [] (explain); (d) Lendi ng I nstit utio n ,~/1,~L~,? Address [ A~_(~2 / (e) Real Estate Company and Agent Address Telephone (1) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family]~] Multi-Family [] Number of Bedrooms -'~ Olher WATER SUPPLY Individual Well [] Community Jf~ Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite [] Public [] Coremunity [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 7~-025 m,841 ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DAT~, AND INFORMATION 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 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 iaformation obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wasteweter disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection, Date Engineer's Seal Approved for _.~/~',,.,"--' bedrooms byy~ Approved ~ Disapproved Terms of Conditional Approval Conditional Date CAUTION The Muncipelity of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before e certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (11/84) WELL DATA MUNICIPALITY OF ANCHORAGE [MOLl HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: ~o7- /(~ ~¢-.)~ .~- (..-)~J,-r ~' ,.~/<'~/ ~,q~e~ ~.-=;-r,~'~-~-.-~--, Well Classification Well Log Present (Y/N) Total Depth Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole _ Water Sample Collected .b.yj'_ Water Co m.m~.~/'-- If A, B, C. D.E.C, Approved (Y/N) Date Completed Yield DePth of Grouting Pum~SetAt __ Sanitary Seal on~ing (Y/N) Deoressio~A~round Wellhead Y/N) On Adjoining Lots : On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on LOt Date B. SEPTIC/HOLDING TANK DATA Date Installed Standpipes (Y/N) ,.~ __ Air-tight Caps (Y/N) Depression over Tank (Y/N) ,A/' Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well To Property Line /420¢ ~" To Water Main/Service Line 27--%-'¢ /'-r' Course /V'/,~ Comments Size foo_~r., No. of Compartments ~ Foundation Cleanout (Y/N) Date Last Purr pea /'J/q for /,/~ Temporary Holding Tank Permit [Y/N) To Building Foundation ,.~,- ~r- To Disposal Field _ To Stream Pond LaKe, or Major Drainage Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 7 '7'-,~' Date Installed '~ / ,. Width of Field , ~:-~ // Square Feet of Absorption Area ~'~"~(.~ ~%~- Depression over Field (Y/N) A ,,) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot ,4/./',4 To Water Main/Service Line /c~¢- ~-~- To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Type of System Design ' 7,~e-,~ Length of Field ¢'~'7 Depth of Field ~ Gravel Bed Thickness (,~.,~3 u Standpipes Present (Y/N) Date of Last Adequacy Test~-~ To Property Line ,,2~.;, To Existing or Abandoned System on ; On Adjoining Lots /Oo~- To Cutbank (if present) ~o+ ~r Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certily that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Date Company MOA No. Receipt No. Date of Payment Amount: $ Engineer's Seal Page 2 of 2 , ,, IRLI. SHEFFIELD, GOVERNOR ]DEPT. O~ ENV~[RONMENT,~L CONSERV,~T]~ON Telephone; (907) Address: ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 99501 274-~533 DATE: May 7, 1986 PWS I .0./~ 212916 To Whom it May Concern: According to records on file in this office the SUBDIVISION Water Regulations SKYRANCH ESTATES II Water System is in compliance with the State Drinking Sincerely, Michael P. Lewis Environmental Engineer A+Homo 15900 Fram Anchorage, ~ 345-1890 t A+ HOME SERVICES~ 15900 FRANCESCA DRIVE ANCHORAGE. AK 99516 (907) 3~,5-1890 L / DATE DESCRIPTION CHARGES CREDITS ' BALANCE PREVIOUS BALANCE f; BALANCE DUE ~ If th/s statement does no t agree w/th your records p/ease not/fy us at once. S TA TEMEN 7' ,dNICIPALITY OF ANCHORAGE //~r~[~.,~ 825 L Street, Anchorage, Alaska 9950]. ~'~ ~quest for Approval of Individual Sewer and Water Facilities 1. Property Owner: Crose, Tom & Sharon Mailing Address: SRA Box 1625-M, Anch. Ak. Phone: 344-7573 Name of Buyer: Mailing Address: Bennett, James R. & Carole D. C/O Fire Prevention Systems 6361 Neilson Wayt Anch. Ak. Phone: 682-6316 Lending Institution: Peoples Bank & Trust Co. Mailing Address: Pouch 7-007~ Anch. Ak. 99510 Phol2e: 279-7511 Realtor/Agent: N/A Mailing Address: N/A Phone: N/A Legal Description: Street Location: Lot 19, Blk. 2, Sky Ranch Estates Subdivision #2 NHN Shetland Helghts Circle Single Family Residence: (X) Number of Bedrooms: Multiple Family Residence: ( ) Number of Bedrooms: Water Supply: *Individual Well ( ) If Individual Well, well depth If Community System, name of system ~]J~3J~/Co~unity System (X Sewage Disposal System: *~n-site System If On-site System, date of installation: X) Public System ( ) unknown *NOTE: 3/77 A well log is required on ALL wells drilled since 6/75. ** If on-site sewer system is over two(2) years old, an adequacy ~est is required by this department. A fee of $25.00 must accompany each reque~N~6~.~O~oe~ing~" ~'"~"~" can be initiated· ~NVIRONM~N~LPRo~cllON~ ENVIRONMENTAL ENGINEERING DIVISION Telephone 264-4720 ^..ROVA. o. WATER MUNICIPALITY OF ANCHORAGE MUNICmA1 rY OF DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIO(~p~ ~)~ CTION DIRECTIONS: Complete all parts on pago 1. Incomplete requests will not be processed, Please allow ten (10) days for processing, 1. PROPERTY OWNER PHONE MAILING ADDRESS ~ROPERT¥ RESIDENT (If different from above) PHONE PH(~NE ' V1AI LING ADDRESS 3. LENOING INSTITUTION ,~,,.//~-/,," ,,~'~,~' ~y MAILING ADDRESS 4. RE/~TOR/AGENT, PHONE PHONE MAI G ADDRESS STREET LOCATION 6. TYPE OF REEIDENCE ,~ SINGLE FAMILY [] MULTIPLE FAMILY 7. WATER SUPPLY [] INDIVIDUAL* COMMUNITY PUBLIC UTILITY E. SEWAGE DISPOSAl. SYSTEM N DIVIDUAL,~ON-SITE** [] PUBLIC UTILITY r NUMBER dF BEDROOMS [] One ~] Four [] Two [] Five [] Three [] Si>; [] Other_ ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.} f individual/on-site, give installation date ~/¢J>~ If system is over two {2} veers old an adequacy test is required Dy this Department, NOTE: THE INSPECTION FEE ~/IUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TiME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connectior~ Verified LOG RECErVED 3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [~]INDIVIDUAL/ON -SITE DATE INSTALLED [~]PU BLIC UTILITY Connection Verified INSTALLER E~Septic Tank or []Holding Tank Size: f~-~b If Tank is homemade BOIL8 RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL // 4, DISTANCESwELL TO: Septic/HoldinaTank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS FOR 4~ BEDROOMS E~'"'~APP R O V E D [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY (Title) //2 LEGAL DESCRIPTION 72-010 (Rev. 3/78) MUNI¢ PALITY OF ANCHORAGE DEPARTMENT OF: HEALTH & ENVIRONMENTAL PROTECTION ' ~ ] ENVIRONMENTAL ENGINEERING DIVISION Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SFWER FACILITI ES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed, Please allow ten (10) days for processing. 1, PROPERTY OWNER PHONE 344-7573 Tom/Sharon Crose ~AILING ADDRESS Star Route A Box 1625-M 99507 PROPERTY RESIDENT f different from above) PHONE PHONE 682-6316 _ 2. BUYER James R/Carole. D Bennett % Fire Prevention Systems PHONE 2'79-7511 MAILINGADDRESS 6361 Neilson Way Anchorage, 3. t. ENDINGINSTITUTION Peoples Ba~k and Trust 99510 PFiONE MAILING ADDRESS Pouch 7-00'7 4, REALTOR/AD ENT MAILING ADDRESS 5. LEGAL DESCRIPTION Lot 19 Block 2 Sky Ranch Estates Subdivision ~2 STREET LOCATION NHN Shetland Heights Circle 6. I'YPEOF RESIDENCE NUMBER OF BEDROOMS ~[~1 SINGLE FAM LY [] MULTIPLE FAMILY 7, WATER SUPPLY [] INDIVIDUAL* :X[~ COMMUNITY [] PUBLIC UTILITM 8, SEWAGE DISPOSAL SYSTEM NDIVIDUAL'ON-S[TE** [] ~UBLIC UTILITY [] One [] Four [] Other [] Two [] Five ~ Three [] Six ATTACH WELL LOG. A well log s required for all wells drilled since June 1975. For wells drilled prior to tt' ~t (late, give well dapth (attach log if available.) f individual/on-site, g've installation date If system is over [wo (2) years old an adequacy test is renulreo by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED, 72-010(3/78) THIS SIDE FOR OFFICIAL USE ONL · DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE DIRECTIONS; 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE I~--'~H R E E [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2, WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTi LITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER ~IVIDUAL/ON -SITE DATE INSTALLED Connection Verified INSTALLER E]3~eptic Tank or [] Holding Tank ~ Size: / ~30 If Tank is homemade SOILSRATING give dimensions: ~, ..~t3 TYPE OF TANK~t,~ MAN UF~j~, TOTAL ABSORPTION~,.~O AREA M AT E R I A'L~z-~'J/C-~ 4, DISTANCES Septic/HoldingTank ~bsorption Area Line WELL TO: Sewer Line Nearest Lot Absorption Area to nearest Lot Line [] APPROVED FOR BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [~ISAPPROVED 72-010 (Rev. 3/78)