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SKY RANCH ESTATES #2 BLK 2 LT 27
Sky P-anch Estates #2 Block 2 Lot 27 #015-302-51 Municipality of Anchorage Community Development Department NOV j Tcvte j1 ai 3 On -Site Water & Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907)343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP151293 PID Number: 015-302-51 ❑ New 0Upgrade Nome' MARY PIASKOWSKI ABSORPTION FIELD NORTH & SOUTH ■ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address; 5410 WHISPERING SPRUCE DRIVE *ANCHORAGE,AK ❑ Other Phone: No. of Bedrooms: Soil Rating: Total Depth from original grade: (907) 952-1103 4 0.8 GPD/Sq. Ft. 10 MAX & 10 MAX Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade: Gravel depth beneath pipe: SEE DWG. Ft. 7 & 7 Ft. Subdivision: Block: Lot: SKY RANCH ESTATES #2 2 27 fill added above original grade: Grovel length: SEE DWG. 35 & 35 (70 TOTAL) Ft. FI. owns Ip: orge: ec Ion: — — — Gravel width: Sachs Number of linea. Distance between linea: 2.5 & 2.5 Ft. — — Ft. SEPARATION DISTANCES Total absorption area, 980 [umber of trenches: 2 D61, between trenches: 14+ To Septic Absorption Lift Holding Public/private From Tank Field Station Tank Sewer Lines So. FL Fl Well — — — — 25'+ TANK ■ Septic ❑ S.T.E.P. ❑Holdin E) Other Manufacturer: Capacity: Surface Water 100'+ 100'+ — — ANCHORAGE TANK 1500 GoL Lot Line 5'+ 10'+ — — N/A Material: Number of comportmente: STEEL 2 LIFT STATION Foundation 5'+ 10'+ — — Curtain Drain I== NONE KNOWN Manufacture" D �y' Gal. Remarks: PER CONTRACTOR, OLD TANK WAS ' Pump on' level m: 'Pump an lev High water alarm at: DECOMMISSIONED PER UPC. pump cake h Electrical Inspections performed by: *200'+ To CLASS A WELL AND 100'+ TO PRIVATE WELLS PIPE MATERIAL *SYSTEM SIZED FOR 5 BEDROOMS House to tankTank to D3034 drainfield D3034 Installer WILCO CONTRACTORS Drainfield D3034 CO/MT D3034 Inspector GEG, Ltd. BENCH MARK (Assumed elevation) Ft. Inspection100.00 Location add Dee`nption: Dates: 1st 10/15/2015 2nd 10/15/2015 3rd 10/15/2015 4th 10/16/2015 DOOR THRESHOLD, BACK DOOR OF HOUSE ENGINEER'S SEAL Community Development Department Approval oob000 O 04 OF... Conditional approval: Date: p 49 O� p....:...1(./(A�................... :1 ��ff y A. Go essP OOP �vf ��1 CE— v�O 0 s f ca0 � �.//�(/� /,/�^ V�-�--/� Approved: Date: 1d/rore3aon°oma Inspection Report _I-1-12.doc PERMIT NUMBER: OSP151293 A I B I C FCO 40.7 24.1 14.5 ST1 42.0 24.1 17.9 ST2 45.2 27.2 27.3 DBL1 45.6 27.8 2B.2 DBI -2 46.1 28.3 29.0 FD 46.9 29.2 30.0 FS 47.6 35.5 53.2 MT1 44.0 33.0 54.2 C01 43.8 32.7 53.9 MT2 29.9 35.0 71.8 CO2 29.2 35.5 72.9 MT3 1 46.7 150.0 184.5 CO3 145.9 149.4 184.1 MT4 1 59.1 151.5 172.7 C04 1 59.5 151.2 171.7 COs 1 61.0 1 42.9 125.41 SKYRANCH ESTATES #2; BLOCK 2, LOT 21 RECORD DRAWING I \ SKYRANCH ESTATES M2: \ BLOCK 2, LOT 26 10' UTILITY EASEMENTNEW TRENCHES MT3 SNfO 03 „_, TH/1 COMMUNITY WATER I B \' o I F T2 �.; .:.. . S I DBL 1&2 T1 5 BEDROOM EXISTING CO5 DRIVEWAY.',. EXISTING FC C \ u! m Z I � I I a x EXISTING \ s � I TRENCH COMMUNITY WATE I I / _ � SKYRANCH ESTATES #2; BLOCK 2, LOT 20 L 10' UTILITY EASEMENT- 7.5' WALKWAY/10' UTILITY EASEMENT - GARNESS ENGINEERING GROUP, Ltd CIVIL & ENVIRONMENTAL ENGINEERS 3701 E NMR PWB, SURE 101 • MCHO E. N( 99W7 • PHONE (907) W7-6179 • FM (907) ]]8-3246 • WEBSRE: wwwgamw.oW,nW PREPARED FOR: PHONE NUMBER: PAGE NUMBER: MARY PIASKOWSKI 952-1103 2 OF 3 LEGAL DESCRIPTION: DRAWN BY: SKY RANCH ESTATES #2; BLOCK 2, LOT 27 L.K.B. TYPE OF WORK: DATE: . RECORD DRAWING 10/27/2015 PARCEL ID NUMBER: 015-302-51 \ N SCALE: KEY PROFESSIONALLY LOCATED BY ONE STOP SERVICES. OWNER HIRED ONE STOP SERVICES. 0-1 Ln u 71 z 'mm• v I OF >f Fr' Gar ess :_0= IE-7ri f z PROFESS ��.�� PERMIT NUMBER: OSP151293 RECORD DRAWING 015-302'"51 FINAL GRADE = 99.06-99.50 2" INSULATION PER CONTRACTOR ST1 ST2 TOP OF TANKTOP OF TANK AT INLET = 96.02 / AT OUTLET = 96.01 NESEPTIC GALLON I AT OUTLET = UNG INVERT OF BUNG INVERT OF BUNG AT INLET = 95.5795.25 NORTH SOUTH FINAL GRADE = 98.56-98.71 T.H.#1 ORIGINAL GRADE ORIGINAL GRADE AT HIGHEST POINT = 97.76 FINAL GRADE = 97.35-97.54HIGHEST POINT = 96.07 0 2 INSULATI PERS T.H.#1 III /'y ONT TOR FABRIC FILTER FABRIC INVERT OF PIPE = 94.77 INVERT OF PIPE = 93.07 7' 7.01' r BOTTOM OF TRENCH = 87.76 BOTTOM • ■ TRENCH = 86.07 RELATIVE ELEVATION D• GARNESS ENGINEERING GROUP, Ltd CIVIL& ENVIRONMENTAL ENGINEERS - 3701 E NWR ROW. SURE 101 • MCWWP M 99507 • PWK (907) 337-6179 • FM (907) 338-3346 ' WEBSITE: m Wmn*.n9in.d PREPARED FOR: PHONE NUMBER: PAGE NUMBER: MARY PIASKOWSKI 952-1103 3 OF 3 LEGAL DESCRIPTION: DRAWN BY: SKY RANCH ESTATES #2; BLOCK 2, LOT 27 L.K.B. TYPE OF WORK: DATE: �, RECORD DRAWING PROFILE VIEW 10/27/2015 -RELATIVE ELEVATION OF BOTTOM OF T.H.=81.76 (T.H. DRY ON 10/15/15) 0. i�rr�y3,3rness; �= V CE -79 3 •r• _� ••• IPS ' �••� ��: N 6 N 7f Lot 26 N84a13'04"E 157.38 sh n Playhou k deck � v, CID Septic vent , , tV ���v� Retaining wal r Q`Q 11 sh j EI 7 a r w" i b 'Y 10 1p� j?1-0 J` o I Septic vents 4�� fly 140 �Sphalt .r - r —78. 3 ry D0 .... _ .:.. �0 I Septic vent Lot 27 I I I 1 I I----------------- 10' Utility Easement _N89059'33"W 170.02 ��. of • a� q f f 1a• 49th����yy *�% 00 ..... . YJ.. •.Fred Walotko: ff/ �� srf • 3255 - 5Ci� SCALE: 1"= 30' EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. FB 748 pg 20 Of th . : And imps and, adjac adjac that t visible hem Dated this BE 1 (907-248-1686) III 0 0 ZD 0 0 0 \ 6431 W 0 W U d C7 Z_ w LL CL ONE FRED WALATKA 8 ASSOCIATES Engineers and Surveyors On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP151293 Tax Code Number: 01530251000 Work Type: Septic Upgrade Permit Effective Dates: September 03, 2015 to September 02, 2016 Design Engineer: GARNESS ENGINEERING GROUP LTD Subdivision: SKY RANCH ESTATES #2 Site Legal Address: SKY RANCH ESTATES #2 BLK 2 LT 27 G:2737 Owner/Address: PIASKOWSKI MARY R REVOCABLE TRUST PIASKOWSKI MARY RUTH / TRUSTEE 5410 WHISPERING SPRUCE ANCHORAGE AK 9951623 Site Mailing Address: 5410 WHISPERING SPRUCE DR, Anchorage Lot Size in Sq Ft: 28024 Total Bedrooms: 4 This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage All construction must 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 must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received Issued By: MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Fax: 907- 343-7997 On -Site Water & Wastewater Program Mayor Dan Sullivan On -Site Sewer/Well Permit Application For A Single Family Dwelling Parcel I.D. 015-302-51 Property owner(s) MARY PIASKOWSKI Day phone (907)952-1103 Mailing address 5410 WHISPERING SPRUCE DRIVE *ANCHORAGE, AK 99516 Site address 5410 WHISPERING SPRUCE DRIVE *ANCHORAGE AK 99516 Legal description (Sub'd, Block & Lot) SKY RANCH ESTATES #2• BLOCK 2 LOT 27 Legal description (Township, Section & Range) Lot Size Sq. Ft. Number of Bedrooms 4 (OVERSIZED FOR 5) APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DEWELLING: ( PLaII that apply) Absorption Field ® Initial El Single Family (SF) Upgrade ® (w/wo ADU) Septic Tank ® Duplex (D) ❑ Holding Tank ❑ Renewal ❑ 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. GARNESS ENGINEERING GROUP Ltd. (Signature of property owner or authorized agent) a0 Permit/Rush Fees: Waiver Fees: Date of Payment: W/a 41,1/6- Date of Payment: Receipt Number: 0X141 G' Permit No. oSPIS093 Receipt Number: Waiver No. (Rev. 01/11) GARNESS ENGINEERING GROUP, Ltd CIVIL & ENVIRONMENTAL 8/26/15 (REVISED) Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref: Proposed Septic System for Sky Ranch Estates #2; Block 2, Lot 27 To whom it may concern: The existing 4 bedroom house is served by a community well and private septic system. The drainfield is in a state of failure and needs to be upgraded. We are proposing to install a new 1500 gallon septic tank and deep trench type drainfield (tank and drainfield sized for 5 bedrooms). One testhole was excavated and the drainfield is designed within the 30 foot radius. Comments regarding the design are summarized as follows: 1. SOILS: See the attached 2015 log which shows the soil classifications, groundwater monitoring, and the percolation test results. 2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications 3. SURFACE WATERS: There are no surface water concerns. 4. TOPOGRAPHY: As can be seen on the attached topography drawing, the average topography around the proposed drainfield is 5-10% east to west. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your assistance. 3701 East Tudor Road, Suite 101 *Anchorage, Alaska 99607-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com -- -ST Roc -E- 23 22 S RPETIPC SKYRANCH ESTATES #; BLOCK 2, LOT 21 COMMUNITY WATER 1 p KYRANCH ESTATE 7 LOCK 2, LOT 20 CROSS VIEW ESTATES; BLOCK 1, LOT 15 641 L .J SKYRANCH ESTATES #2; BLOCK 2, LOT 26 COMMUNITY WATER ISKYRA�ICH ESTATES #1; 00 BLOCK 5, LOT 26 I 1 \25 i I � = IVV ESTATES #2;\ , 16 BLOCK 1, 1 BLOCK i, LOT 15 � \ COMMUNTTY WATER � F -I J-) y I SKYRANCH ESTATES #2; CSEPTIC BLOCK 3, LOT 6 ARS COMMUNffY WATER \ i PppRpxlMPus ta0i i I WELL � RANCH ESTATES #1;11 K 4, LOT 1 I 1 3 / \ 2 LJ/ I CROSS VIEW ESTATES; 24 BLOCK 1, LOT 16CSEPTIC I \ R� 23 VA 11 GARNESS ENGINEERING GROUP Ltd CIVIL& ENVIRONMENTAL ENGINEERS 3701 E NOOK BOLD, EEE 101 • .WCHOPl.OE. N( 99907 • PHONE (907) 337-6119 • FM (9071 3W8 46 . NEESIIE� .w.,.,..i........:....�....... -PARED FOR: MARY PIASKOWSKI AL DESCRIPTION: SKY RANCH ESTATES E OF WORK: SITE PLAN r 3L NUMBER: PAGE NUMBER: (907)952-1103 1 OF 3 DRAWN BY: BLOCK 2, LOT 27 D.J.G. DATE: REVISED 8 15 A. Garness.ji NUMBER OF BEDROOMS: 4 (OVERSIZED FOR 5) NUMBER OF BEDROOMS: 4 (OVERSIZED FOR 5) GALLONS PER DAY (GPD): 750 GALLONS PER DAY (GPD): 750 NOTE: THE CONTRACTOR PERCOLATION RATE/S: 10.4 MIN/INCH PERCOLATION RATE/S: 10.4 MIN/INCH SHALL HAVE THE NORTH LOT PROPOSED. APPLICATION RATE: 0.8 PROPOSED APPLICATION RATE: 3.0 (CAT II) LINE FLAGGED BY A MINIMUM DRAINFIELD SQ.FT.: 938 FT' MINIMUM DRAINFIELD SQ.FT.: 250 Fl° REGISTERED LAND SURVEYOR DRAINFIELD DESIGN: I DRAINFIELD DESIGN: PRIOR TO CONSTRUCTION. MAXIMUM DEPTH OF EXCAVATION: 10 FEET WIDTH: 2.5 FEET LENGTH: 70 FEET (2 0 35 FEET) EFFECTIVE: 7 ACTUAL SQ.FT.: 1022 FT' LETTER THAT PERTAINS TO THIS DESIGN. TO OBTAIN A COPY OF THE LETTER CONTACT GEG. BY PROCEEDING FORWARD WITH THIS INSTALLATION, THE ENGINEER, WELL DRILLER, CONTRACTOR AND PROPERTY OWNER AGREE THAT THEY HAVE READ THESE SPECIFICATIONS AND AGREE TO ACCEPT THE TERMS AND MAXIMUM DEPTH OF EXCAVATION: 10 FEET WIDTH: 2.5 FEET LENGTH: 20 FEET EFFECTIVE: 7 ACTUAL SQ.FT.: 280 FT' SKYRANCH ESTATES #2; BLOCK 2, LOT 26 OWN&&; MUST BE PROFNSSIONALLI LOCAT= PRIOR TO INWALLATWN ALTERNATE SITE \ (REQUIRES ADVANCED TREATMENT -CAT II) SKYRANCH ESTATES #2; I EXISTING TRENCH M O BLOCK 2, LOT 21 INSTALL FLOW DIVERTER INSTALL' DOUBLE C/0'S 1 M 0 AFTER THE TANK' PROPOSED 1500 GALLON T SEPTIC TANK; OLD SEPTIC TANK TO BE COMMUNITY WATER UPC MMISSIONED PER V APPROXIMATE LOCATION IF EXISTING /•t�.'':"` 500 GALLON SEPTIC TANK; TO BE ®/ .•. ABANDONED PER UPC ST 4 BEDROOM HOME •�DRIVEWA I I ST1 C APPROXIMATE LOCATION (") OF EXISTING CRIB TO BE m ABANDONED IN PLACE N I ' \ 41 E INSTALL DOUBLE CLEANOUTS G N IF FCO IS NOT PRESENT MC OR ACCESSIBLE w COMMUNITY WATER SKYRANCH ESTATES _p \ #2; BLOCK 2, LOT 20 10' Utility ,E—Qsement GARNESS ENGINEERING GROUP, Ltd CIVIL & ENVIRONMENTAL ENGINEERS =I E TUDOR ROAD. SURE 101 • MIOROR . M 99507 • NNE (9077) 337-6179 • FM (907) M-32" • 11E - xrw.9onnnenymen�pxom PREPARED FOR: PHONE NBER: PAGE NUMBER: MARY PIASKOWSKI (907)9UM52-1103 2 OF 3 LEGAL DESCRIPTION: DRAWN BY: SKY RANCH ESTATES #2; BLOCK 2, LOT 27 D.J.G. TYPE OF WORK: DATE: SEPTIC SYSTEM DESIGN UPGRADE REVISED 9/2/15 A. F71 GARNESS ENGINEERING GROUP, Ltd 1 - _Nr ._,- .:..::....... CIVIL&ENV IRON MEN TALE NO INEERS;a ix-- rte,--�-_��_ "E, I, TNOORROAR. SHITE PH-ANCHOUW E.AK886W' PHONE (W3Vi 1]9'SAX (ND 3383246w.vwgamum,I¢,.Wm LEGAL DESCRIPTION: PERFORMED FOR: DEPTH If1U7ORG 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 SKY RANCH ESTATES #2: BLOCK 2, LOT 27 MARY PIAKOWSKI 816/2015 TEST HOLE #1 DEPTH TO GROUNDWATER SOIL CLASSIFICATIONS 8/6/2015 DRY GW DRY 8/13/2015 •. - 2 3:50 GP 3 ML 3 3:50 GM 6" CIL 4 4:20 GC 3 118 OIL 5 4:20 - MH 6 �zy [fSf`�`iYiY77{`Si • 3 118 27/8 EftS�7[�iCH ��/y�y��V�/i 7I/Y� • Sc DEPTH TO GROUNDWATER DATE DRY 8/6/2015 DRY 811 012 01 5 DRY 8/13/2015 6" - DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 8/10/2015 1 3:20 - 6" - 2 3:50 30 3 3 3 3:50 - 6" - 4 4:20 30 3 118 2 718 5 4:20 - 6" - 6 4:50 30 3 118 27/8 19 PERCOLATION RATE 10.4 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN 6 FT. AND 7 FT. 20 A FOUR HOUR PRESOAK WAS PERFORMED: N YES ❑ NO SOILS LOGGED BY: DAVID GARNESS PERCOLATION TEST PERFORMED BY: ERIK WIDGER COMMENTS: PERCOLATION READINGS ARE WITHIN 1/16 OF INCH. PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 2S I �� a--- --- -- a - -�--- --- - - it UNR►�VALI i Y Ur- hNL*HUrAvc Community Development Department Phone: 907-343-7904 n;.._ nn .... Septic System Owner -installer Agreement A real estate property owner (Owner) may install their own septic system. The department may issue an approval for a homeowner to perform work on a conventional (not AiivW S) on-site wastewater disposal system to serve that individual's owner -occupied, single-family or duplex home if the homeowner satisfies and agrees to the following requirements. The property owner and excavation equipment operator may perform work on no more than one owner installed project in a ?2 ,month pe,iod. As owner of (legal description) Sky Ranch Estates #2 Blk2 lot 27 5410 Whispering Spruce I agree the following items are true and accurate. My experience installing septic systems is as follows. No experience 2. The name of the excavation equipment operator is. _Jeff Piaskowski 3. There will no' be compensation fof installation services rendered. 4. 1 will be actively involved with the septic system installation at all times. 5. The name of the inspecting engineer is _Garness Engineering 6, ! agree to discuss the following items with the inspecting engineer: a. Permit design criteria and specifications. b. Inspection requirements set forth in AMC 15.65.150. c. 2 -hour minimum advance notice given to the On-site Water & Wastewater Program for all required municipal inspections. 7. l agree any changes 1 make to the items listed above will require a new approval before performing work. 8. i agree to have the project -specific On-site Wastewater Disposal System Permit available at the construction site for the duration of all related work. Owner's printed name: _Mary Pia�skowski Owners Date. 8/1212015 Septic System Owner Installer Agreemdit_Feb2015.doc MUNICIPALITY OF ANCHORAGE DEI TMENT OF HEALTH AND HUMAN SERV 'S 7f Environmental Health Division �� �l '` p Lf • 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL. INSPECTION REPORT -- DISTANCES --- FBOM TO SEPTIC TANK ABSOnPTION FIELD WELL Aadre s WELL •� •'j 3 t g — F M1one(sl peimil No. No of Bedrooms LOT LINF. Jr. _ LE :AL DESCRIPTION Lot ] Block _subdivision _ 2 1 -- FOUNDATION _ C l� — Township. Rango, Section //�� .� yy ,�//l .7 / TIpL » d `+ Pt 6 . T AS -BUILT DIAGRAM (Show location of well. driveway, water bodies, etc.I septic system. property lines, foundation , TANKS ❑ SEPTIC ❑ HOLDING Manufacturer Dapacily in gallons Material No of Compartments TYPE OF SYSTEM — — — TRENCH ❑ BED ❑ W. DRAIN ❑ OTHER Depth to pipe bottom Iro ni original grade FT Total doprtr from original grade / / FT /.– A (_', __ Fill added above ongmal grade U FT Gravel depth beneath pipe jar, +. FT ---- Gdavcl lenylh--'------- lC� ' FT Gravel width 11 FT — Total absorption area ' 80 FTI Distance between lines FT at Number or lines sot rag l Pipe I atenal SO A — InstallerDate lnslalletl lj —1— WELLS ----- -- --- ❑ PRIVATE ❑ OTHER (Identify) _ Classllicallon (A. a.C) — forst Depth cased to FT ---- FT _ Iwarilci Date Installed- -- REMARKS: — / J 0 !�-E'�L (. f_,�I/LI "L{� lh y'�j 7.a•WL(/lf LLQ !1 17b ( -*149T? �- f1 _ i �� r mulyIha1IhlsInspe.url ��f'% Seale: Inspections Performed by. ENCINEEBS SEAL. ' ' Ld• �� Fie •,r�, • c1a o •/ a �: F' e••�.. 4�'•,0% No2225—F~ !•. iuNr: aa. Asn �a @ c <<�° Dale. _. //4 �� was perinrnfell.....iling tall Date: Municipal and Sta a guidelines in effect an this date: yti� Y--+ Health Department Approval: -��_L9r___ 72-013 (3/85) �� capti<y that: 1. I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage (MOA) and the State of Alaska" �. T will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit" 3. I will adhere to all MOA and State of Alaska requirements for the set hack distances from any existing well, wastewater disposal system nr public sewerpgc system on this or any adjacent or nearby lot" 4. I understand Lhat this permit is valid for a maximum of 5 bedrooms and any enlargement will require an additional permit" I1: A L[FT STATION IS INSTALLED IN AN AREA COVERED BY MOM BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS^BUILTS NILL NOT BE APPROVED N!THDUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN" SIGNED - nATE: - APPLICANT: JOSEPH PIASKOW5KI ISSUED BY 42, mcl--R/. """-""�'^"-``~" DEPARTMEN| OF ^"^-`~^� ^ ^^` �``,-`� — HEALTH AND ENVIRONMENTAL PROTECTION ---- 825 | STREET, ANCHORAGE, AK 99501 ` 264-4720 [qERMITNO: 860142 DATE ISSUED: 05/29/86 m,'o ~~{L APPLICANT: JOSEPH P[ASKOWGKI`�� v`N"� y.r,�°^-�~'*'^S ADDRESS: 5410 WHISPERING SPRUCE ANCHORAGE, AK 99516 CONTACT PHONE: 345-4945 LEGAL DESCRIP: SUBDlVIGION: SKY RANCH ESTATES 02 LUT: 27 8LqCK: 2 SECTION: 22 TOWNSHIP: 12N RANGE: 7W LOT SIZE: 2G029 (SQ^FT. OR ACRES) MAX BEDROOMS: 5 Listed below are the options available to you in designing your septic system. Choose the option that best fits your situ. �������~���������^���������� IT ET K3 LO ED FZ IN K R. 11 DEPTH TO PIPE BOTTOM (FT.) ��l}`**� '/ 4"O 4^0 GRAVEL DEPTH (FT.) 8W0 0,5 3,5 TOTAL DEPTH (Ff.) 11^0 4.5 7"5 GRAVEL WIDTH (FT.) 2"5 �� 35"O 5"0 GRAVEL LENGTH (FT") ���1,v^**|u/ 67"0 2200 ** GRAVEL VOLUME (CU.YDS,) 10J"2 89"5 167^� TANK SIZE (GALS) 1,500.0 ** 1,500.0 ** 1,500.0 ** SOIL RATING (SQ^FT"/8R) _119 318 419 ** DEPTH TO PIPE BOTTOM < 3"5 FT" REQUIRES INSULATION ** DEPTH TO PIPE BOTTOM < 4.0 FT. MAY REQUIRE A LIFT STATION ** GRAVEL LENGTH > 75 FT. REQUIRES MULTIPLE RUNS (NOT EXCEEDING 75 FT" EACH) ** TANK MUST -----------^--------~---------^----'--'- HAVE AT LEAST TWO COMPARTMENTS capti<y that: 1. I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage (MOA) and the State of Alaska" �. T will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit" 3. I will adhere to all MOA and State of Alaska requirements for the set hack distances from any existing well, wastewater disposal system nr public sewerpgc system on this or any adjacent or nearby lot" 4. I understand Lhat this permit is valid for a maximum of 5 bedrooms and any enlargement will require an additional permit" I1: A L[FT STATION IS INSTALLED IN AN AREA COVERED BY MOM BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS^BUILTS NILL NOT BE APPROVED N!THDUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN" SIGNED - nATE: - APPLICANT: JOSEPH PIASKOW5KI ISSUED BY 42, mcl--R/. Cj C2 0 (tl C1 I A LOT 15 T3 L- r1 C K 2 I__Pl 26 \ \ BLOCK 2 �� \ PAf DOCK OT -) �v�� I LANE BLOCK 2 COIJNI-Ci EXIS?ING C'AIBI I-- —_ -- — J TANK + % I TEST CRIB \/ I NgLc. PROPOSEF 500 GA;_ aSEP/TIC TANK I I I I 25 0 100 200 300 SCALE V 50' SEPT,IC SYSTEM LIPCRADE LOT 27, BI 0�-K 2 SI<1'RA�JC ! ESTATE: _ICI I PIASKEIWSKI T033L,N N�URKLAN11 P,E, 203 W - i H. AV- f IJE ANCHOP( -]f_, AK. 99�DCI JAY 20, 1986 -- -- �\ F41,S`Ump���� LOT 2%r 2 t BLOCK u 500 GAL TANK I 1000 TANK CD (X��� V EXIST CONCRETE: CRIB I 64" SUMP i 20 0 40 00 120 GRAPHIC SCALE 1 40' SEPTIC SYSTEM AS BUILT LOT 27, FLOCK 2 SKYRANCH ESTATE .JOE PIASKOWSKI MAY 30, 1986 T OBDEN SPURKLAND RE, 203 WEST 15TH, AVENUE ANCHORAGE, ALASKA, 99501 IA SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TERCOLATION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: G%,� "PH T Ii�Sbvl>� `'�� p `,__cam—DATES PERFORMED: �Rr�r 'l'•'i 1,P% _ LEGAL DESCRIPTION: Lor p -%r A_Y�l_ S 4-1 rr'orNt}4 as Ara, w � , T 1, 2P11 rn te/ SLOPE SITE PLAN M L 51 Lo 1°' 2 3 r 4-` 4N6y SILT - 5 - IL T- 5- wjI-G la��wlMoj 6- ML 7 - ' " clGOb{4 .6 au -_ r C,16Y,% V-4'( 8 9 � 10- 16 17• 18 P' -rd ij4Tf-l� -,�• 19 19,•, 20 COMMENTS r_ 25, 1971 .'�•,r,:� Asa 49L4 WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? S L __O E Reading Date Gross Time Net Time Depth to Water Net Drop // 2 0 l o 7/� 6�i6 5c, 10 �r// �0�4, i / `t i S L __O E Reading Date Gross Time Net Time Depth to Water Net Drop // 2 0 l o 7/� 6�i6 5c, 10 �r// �0�4, PERCOLATION RATE_— 'Z—(minutes/inch) L...� _ EST RUN BETWEEN FT AND -1 FT PERFORMED BY: — ' � CERTIFIED BY:_ �r'i � DATE_ 72-008 (6/79) .N SOILS LOG MUNICIPALITY OF ANCHORAGE • '', DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TESTOLArION ; /' 825 L. Street, Anchorage, Alaska 99501 264-4720 ' SOILS LOG -- PERCOLATION TEST' PERFORMED FOR:, -p1 0.1" 64S DATE PERFORMED: 6117/1' E+ _ LEGAL DESCRIPTION:_l%0T A:7AAK Q- S KyA6N(-W X- 0- ' , ��c AL2, �"J,`�f`/�__!� —7 " SLOPE —SITE PLAN 1_ SIL_i z - int L 3- 4 5 6 7 s 9 10 11 12 13 14 15 16 17 G) 1� 4 19 SIL r-/ C� 1V�tw lal�l C00129C s►c.ry s�-N� uU � rar• s7� yaks L— i. 0 2225-E JUf E 2S, I971 WAS GROUND WATER I O S ENCOUNTERED? L O P E IF YES, AT WHAT DEPT Ii? Reading Date Gross Time Net Time Depth to Water Net Drop 20 PERCOLATION RATE _ 20"0 V(. YA 1,.. (minutes/inch) /^ _TEST RUN BETWEEN I's_ FT AND �d' `� F�Tt-- `1 L COMMENTS- _SSI L. L,O F°'d ft NO --P'! 7p 0r— 1 rzwf cki- PERFORMED BY: p . r CERTIFIED BY: �/ a DATE: 72-008 (6/79) vSOILS LOG MUNICIPALITY OF ANCHORAGE r • 1 DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ❑ TESTOLATION /� 825 L. Street, Anchorage, Alaska 99501 264-4720 _ SOILS LOG -- PERCOLATION TEST PERFORMED FOR: 19 J.{p� 1 I O, S "A.I{ _DATE PERFORMED:_ LEGAL DESCRIPTION: LOT -7 CK -al %I112AU i14cxwsT—A F� 9Cat2,, 7-);Z M. 31t�/ SLOPE SITE PLAN E T F E ) _ 2 3- 4 5 - • • o OAcN V 6 • s n 8' • o • -- 9 . • • u 10- rl 11 12 13 14- 17 2225.E •�:?-t 18gf�?'. `Cs � WAS GROUND WATERS ENCOUNTERED? L O P IF YES, AT WHAT E _ DEPTH? Reading Date Gross Time Net Time Depth to Water Net Drop 20 PERCOLATION RATE ✓ (t !;'cv' minutes/inch) TESL- RUN BETWEEN __tLe- FT AND A'a FT �q �/ COMME=NTS I La Ip�7 �r SO u r4 �� fJ P �'.y _w�-14-- _ PERFORMED BY: O -'s CERTIFIED BY: 4' DATE:_ 72-008 (6/79) JL3, SOILS LOG MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION i:. TEST 825 L. Street, Anchorage, Alaska 99501 2644720 SOILS LOG -- PERCOLATION TEST PE=RFORMED FOR: �©C.elp G.S 6;../J -St 18 1 DATE PERFORMED: LEGAL DESCRIPTION:_ 1-.0 _ 5K Q &4)1 (241`v.I'f � ��� '� C "`/ / /� r. tom• �_ � I-F*Pt -1-I NII( I - —� SLOPE SIS TE PLAN 1- 2- 6 , 7 8- 9- 10 Y ' S11-71- FP' OZ.EU Mw S#NNI>►L I H 4 11 - --- 13- 14-- 15 - 4- 15- 16. 17OFe /1( ,.+x;1..1_ ee� o- eeee+ 19'Mr .n'. J 2225+E 20 °(+ ,t'. IVE 2S, 1971 +' 'fin • i, COMM PERFORMED BY: 72-008 (6/79) WAS GROUND WATER „ 1� S ENCOUNTERED? L O E IF YES, AT WHAT _ DEPTFI7 Reading Date Gross Time Net Time Depth to Water Net Drop ;.v 3c� ! 07 ��/t, s�/k—, �O /0 PERCOLATION RATE ;/-?�. (minutes/inch) TEST RUN BETWEEN FT AND / /Z" FT CERTIFIED BY: DA Gk - -,R ANCHORAGE AREA 6 `%H Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM ��-- - �.,��/— [c vz NAME •-'U `��f7// �i /t `°f-p(Pi1SKl MAILING ADDRESS �' -'�� � r t/-/�'�' PHONE - LOCATION / -'['ll (;p_s 6(h4 O:(' /- /::'[/F LEGAL DESCRIPTION_ SEPTIC TANK: - DISTANCE / NUMBER OF FROM WELL 24.111-YI MANUFACTURER``'�"�^/°''O . MATERIAL � /�n/[`/,'('�' _COMPARTMENTS I INSIDE LENGTH--- INSIDE WIDTH LIQUID DEPTH_ _LIQUID CAPACITY // (' /' _GALLONS. Ai'c/) 77-:51- SEEPAGE PIT: NUMBER OF PITS DIAMETER OR WIDTH LENGTH LENGTH _�-/, DEPTH LINING MATERIAL4 - (//;?,"CRIB SIZE: DIAMETER --DEPTH Q / DISTANCE FROM: WELL 06rym / TOTAL. EFFECTIVE BUILDING FOUNDATION— NEAREST LOT LINE '-[ ABSORPTION AREA (WALL AREA) _9 SQ. FT. ADDITIONAL ABSORPTION _ WELL.: TYPE (lel Ml')"1 . CONSTRUCTION BUILDING NEAREST FOUNDATION _. LOT LINE CESSPOOL OTHER SOURCES NEAREST SEWER LINE APPROVED DISAPPROVED REMA DISTANCES: INSTALLED BY: PIPE MATERIAL: LOT SLOPE: REMARKS: !'�.•Ort77n/�i i„/ /�G'2/jet: E.S-S 0..� in/r-c(, Orr Tr. t:' � ♦71i1n/rM1/= Form No. EQ -037 DEPTH SEPTIC TANK. DIAGRAM OF SYSTEM DISTANCE FROM: SEEPAGE SYSTEM _. i� r 1� I , DATE APPROVED !f-` G. A. A. B. GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT NAME OF APPLICANT bZ QA�C.if-Y♦\\J�..-p,�lllMAILING ADDRESS - 3v1'I'I_ INSTALLATION LOCATION LEGAL DESCRIPTION �� ` '�+--��� +- '�!"1W f✓ `� '- INSTALLATION OF: SEPTIC TANK Qe)o SEEPAGE PIT f DRAIN FIELD PERMIT NO PHONE OTHER TYPE AND SIZE OF FACILITY TO BE SERVED�- FINANCED THROUGH 7l TO BE INSTALLED BY- S/f/�/Zi SOIL TEST RESULTS I� L� U G NOTE. T1 PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED 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 / SEEPPAAGE AREA /SIZE TYPE MINIMUM DISTANCES. REQUIREMENTS /�.S�=y%�L� �Y �j��"` I -t,�(/�/ DIAGRAM OF SYSTEM 1 FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT �` DRAIN FIELD _ SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK � SEEPAGE PIT �GRAIN FIELD TO NEAREST LOT LINE. fh WELL TO SEPTIC TANK V O SEEPAGE PIT DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK SEEPAGE PIT - V , DRAIN FIELD //,, SEPTIC TANK, _�y Ur , SEEPAGE PIT C/ 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 BACKFILL CONFORM TO BOROUGH REGULATIONS REG ING INSTALLATION. G.A.A.B. Of? LICENSED DESIGNER I CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. X ,L! DATE _ --L-P`��C(�� � �--�! APPLICANT'S SIGNATURE FORM NO. EQ -616 MUHMPAUTYOF HCHOPRAGE �11*a Development Services Department �� �= Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Parcel I.D. 015-302-51 Certificate of On -Site Systems Approval Expiration Date: 1 `� Legal description SKY RANCH ESTATES #2 BLK 2 LT 27 Site address 5410 WHISPERING SPRUCE DR Anchorage AK Current property owner(s) SHAHNAZARIAN X The On -site system(s) is/are approved for 5 bedrooms Conditional approval for Comments or advisories: bedrooms, with the following stipulations: By Original Certificate Date: 11 /14/2023 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services 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 work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA ApprovaLJune 2022 MUNICIPALITY OF ANCHORAGE m Development Services Department t Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 015-302-51 Complete legal description SKY RANCH ESTATES #2 BLOCK 2, LOT 27 Location (site address) 5410 WHISPERING SPRUCE DRIVE, ANCHORAGE, AK 99516 Current property owner(s) DAVID & YASSAMIN SHAHNAZARIAN Day phone 2. ON -SITE SYSTEMS SIZED FOR 5 BEDROOMS 3. TYPE OF WATER SUPPLY: ❑ Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ® Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ® Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ® Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age 8 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ® Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: 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 $ �S l� Waiver Fee $ Date of Payment Date of Payment COSA # 05C 2 M 3 9 Waiver # COSA Application.doc COSA Checklist.docx COSA Checklist Legal Description: SKY RANCH ESTATES #2 BLOCK 2, LOT 27 Parcel ID: 015-302-51 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA - PUBLIC &/OR CLASS “A” WATER Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Well production at time of test gpm Water storage tank volume NA gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank 51” Date of pumping 10/09/2023 Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 10/16/2015 ALL standpipes present per record drawing Total measured depth from grade 11.2 ft (max) Measured depth to pipe invert from grade 4.4 ft (min) N/A – pressurized field. Per record drawings, field is insulated. (S trench) Monitor tubes (MT) go to bottom of effective (ED). 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 2000 gallons 10/09/23 date Any rejuvenation treatment (past 12 months) N If yes, enter date Adequacy test date 10/10/23 Results Pass (N / S Trenches) Fluid depth prior to test 29” / 5 in Water added 1200 gal New fluid depth 44” / 17 in Elapsed time 1440 min Final fluid depth 28” / 2 in Absorption rate 750 gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) 84 in (MOA 7’ ED) Effective depth used 28” / 2 in (Final Fluid Depth) Effective depth remaining 56” / 82 in Comments/Deficiencies: Approximate total measured depths from existing grade. ED per elevation measured shots & appears approximate. Per MOA docs, the southern trench is insulated. COSA Checklist.docx E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) - NA Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS 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 of Firm FIRST WATER CONSULTING Phone 907-350-9566 Engineer’s Printed Name CURTIS HUFFMAN, PE Date 10/20/23 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & 10/20/23 I .M Lot 21 10, uTILITY EASMENT' Lot 26 15' WALKWAY 3�04 W 157.3W S $4 { t CHAIN LINK II FENCE SEPTIC PIPES 1 1 1 PLAY HOUSE ' 1 �y rvi M Z 0 U) a n � C 1 Lot 27 o 0 I j 28,025 s.f. o I m WOOD SHED _ y � CIO LT'� — — < I CHAIN LINK FENCE — R=.^lWOOD FENCE � M - - I S 89'59'33" E 170.02' I CHICKEN COOP J I" 9 WOOD FENCE �` Os r O 2 STORY ESIDENCE WITH r, WALKOUT BASEMEN ,,�-.ABPHALr: SEPTIC PIPES PECK DECK Z Lot 26 PLOT PLAN AS BUILT X SCALE 1" = 40' GRID SW 2737 Project No. 23-552A1 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associates, inc. (907) 522-6476 Phone �`�` kenOlangsurvey.com a� LAhX Professional Land Surveyors jonathanOlangsurvey.com ~, QF A ryanOlongsurvey.com '�� qc �{ I hereby certify that I have surveyed the following described properly: fig.'• LOT 27, BLOCK 2, SKY RANCH ESTATES #2 SUBDIVISION (PLAT 71-290) R *. 49 '.* �� Anchorage Recording District, Alaska, and that the improvements situated thereon are R • • • • • • • • • • • • • • within the properly lines and do not encroach onto the property adjacent thereto, that J . no Improvements on the property lying adjacent thereto encroach on the surveyed • • • • premises and that there are no roadways, transmission lines or other visible KEN ETH G. LAIN ,Yq easements on said properly except as indicated hereon. Dated this the Day of f�ir��l�ra�.=1-�L c `' at Anchorage, Alaska�FDp� 4f�•'�p5�.+: ,�•�' It Is the responsibility of the owner to determine the existence of any easements, �l1 `ROFESSIONA��Pt\\t11�4 covenants, or restrictions which do not appear on the recorded subdivision plat. State of Alaska AECC963 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date 1 I u lro 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) .�p_£*gA0 1,�/NlSPk-121 SP(i.U(_ (� (b) Applicant Name \,_.T "_GOsspi Telephone: Home ���" 4 1�'�? Business Applicant Address` ✓ W) (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder K; Buyer ❑ ; Other ❑ (explain); (d) Lending Institution Address (e) Real Estate Company and Agent Address -- Telephone (f) Mail the HAA to the following address: 2. TYPE OF RESIDENCE Single -Family X Multi -Family ❑ Other Number of Bedrooms 6 3. WATER SUPPLY Telephone Individual Well ❑ Communilyx 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 ElCommunity ❑ Holding Tank ElNote: 11 comrnunity well system, must have written confirmation from the Slate Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 7z-025 n1!84t 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION 0 As certified by my seal affixed hereto and as of the validation dale 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 dale of this inspection. f� ,/% -7� Name of Firm o bb t ti +>� U K y �•a^^.s" � �^ Telephone d Address Date (s.) DHEP APPROVAL Approved for Approved ON NJ. 2225-E. 'r JUNE 25, 1971 NAL _f:LLVR� bedrooms _X__ Disapproved Conditional Terms of Conditional Approval 4 CAUTION Engineer's Seal 61 The Muncipality 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 a 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) MUNICIPALITY OF ANCI•IORAG@ DEPT, OF HEALTPI & MUNICIPALITY OF ANCHORAGE (MOA) ENVIRONMENTAL PROTECTION HEALTH AUTHORITY APPROVAL (HAA) u rl 0 "1 1986 CHECKLIST- FEBRUARY 1984 284.4720 Legal Description: _ A. WELL DATA Well Classification C4ASS /� If A, E3, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) Date Completed Total Depth — Static Water Level Cased to 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 Collectedby Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA Depth of Grouting - Pump Set At Yield Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) On Adjoining Lots - On Adjoining Lots - To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date Date Installed 117Y,14.810.. Size /4960 1.25700 No. of Compartments — it,+ .L Standpipes (Y/N) Z— Air -tight Caps (Y/N) —_Y___ Foundation Cleanout (Y/N) )0'* Depression over Tank (Y/N) _ / Date Last Pumped Pumping/Maintenance Contract on File (Y/N) �/- ; for Holding Tank High -Water Alarm (Y/N) _JV/A Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water -Supply Well - + To Building Foundation To Property Line _ 1P To Disposal Field _--rO To Water Main/Service Line 1 () To Stream, Pond, Lake, or Major Drainage Course (1F u f1{ Comments Page 1 of 2 72-026(11/811) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 's 0. Type of System Design T2AENc4 Date Installed et4p b Length of Field lo 3 Width of Field =✓f� Depth of Field I Gravel Bed Thickness b,5 Square Feet of Absorption Area �✓�� Standpipes Present (Y/N) 7r U(/ D ,1 • •,,,,'�t Depression over Field (Y/N) N Date of Last Adequacy Test WA 1: � E V Results of Last Adequacy Test Separation Distance from Absorption Field: To Water -Supply Well > 0.0-0 To Property Line To Building Foundation "1 V To Existing or Abandoned System on Lot 10 ; On Adjoining Lots 730 To Water Main/Service Line 10 To Cutbank (if present) N O %J E To Stream/Pond/Lake/or Major Drainage Course NONC To Driveway, Parking Area, or Vehicle Storage Area Comments — D. LIFT STATION Date Installed _ Size in Gallons NoNe "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at ** Check Permitted Bedroom Rating Against HAA Request ** Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA I certify that I have checked, verifie or conformed to all OAand HAA guidelines in effect on the date of this inspection. Signed Date Company MOA No. Receipt No. a -e(A % ( Date of Payment _% a Amount: $ Page 2 of 2 72-026 (11184) OF JAI , tri TH at222.5_L NE 25, 1971 Engineer's Seal DEPT. OF ENVIRONMEIVTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 99501 DATE: May 15,1986__ PWS I.D.# 211813 To Whom it May Concern: RILL SHEFFIELD, GOVERNOR Telephone: (907) Address: 274-2533 According to records on file in this office the SKY RANCH I _ Water Regulations Water System is in compliance with the State Drinking Sincerely, /v�- j /' . Michael P. Lewis Environmental Engineer DEFT. OF (ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 99501 DATE: May 15, 1986 PWS I.D.#_ 212916 To Whom it May Concern: BILL SHEFFIELD, GOVERNOR Telephone: (907) Address: 274-2533 According to records on file in this office the _ SKY RANCH II Water Regulations Water System is in compliance with the State Drinking Sincerely, Michael P. Lewis Environmental Engineer N� GREATER ANCHORAGE AREA BOROUGH p• a �. Department of Environmental Quality �"`+n1, „�,,,,�� 3330 "C" Street, Anchorage, Alaska 99503 274-4561 .Qr ec-%1• vj� Kr Date Received 0%x%1 � • b Time of Inspection f J� /0 c�,v Date of Inspection 4-,- REQUEST FOR APPROVAL -OF. ?/"AD)VIDUAL SEWER & WATER FACILITIES FOR 1. Approval requested by Mailing Address: 2. Property Ovlrir�'% Mailing Add'h;essr 3. Legal Description 4. Location: C1 5 E. "Phone:(, '�- Type of facility to be inspected ,.>ii� « No Well Data: A. Type —:4 — 1 B. Depth C. Construction of bedrooms��l 1�sf E- D. Bacterial Analysis 7. Sewage Disposal System: scu- r��o rn A. Installed _ B. In11.ler _ C. Septic Tank: 1. Size D. Seepage Pit: 1. Absorption Area _ E. Disposal Field: Total length of lines 8. Distances: 2. Manufacturer 2. Material 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 - Requr for Approval of Individual Seg & Water Facilities Legal Description Comments '6/ Approved 'D fL�� Disapproved Date Approval,Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water Facilities and these facilities are operating satisfactorily. SIGNED __ Date _ EQ -034 (1/74) 1. 2. 3. 4. 5. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF ENVIRONMENTAL. QUALITY 3330 "C" Street, Anchorage, Alaska 99503 — 274-4561 REQUEST FOR APPROVAL.. OF INDIVIDUAL SEWER and WATER FACILITIES Type of Inspection: CMRO ^�.,''„„^^VA FFIA CONV Property Owner: \ 1��_1r_ y) — Mailing Address: O �[ t=te— �te— _ Day Phone -7r7��j,� SII. Tx�F�rnaitOnal,Jslc l 3 lei 3�)R3 Name of Buyer:._____ )il � `�•' LLi• Mailing Address: �IQZ7 rjLkhj—® Day Phone q�1, Name of Lending Institution: _ !9 -a ��tJIS��,q��.—�r�1°rc, Mailing Address: ' p• �' -2-090 J Phone-<=1�'��:_5; I 1 '� Name of Realtor or Agent: — Mailing Address: _— — Phone _ 6. Legal Description:—�-1.,L�2 Location:__}Y.� + ��— h I ` ` c�:P-- — 7. Type of Facility to be inspected: No. Bdrms. 8, Water Supply Type of Supply: Public: Utility _ Individual If Individual, number of dwellings presently served YYIm�n If Individual, depth of well ----- 9. Sewage Disposal System Type of System: Public Utility _ Individual (on-site) x If Individual, date of installation --_ EC1-037 (1/74)