HomeMy WebLinkAboutSILVER CREST BLK 2 LT 20
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
hftp://www.muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP241128
Work Type: Septic Upgrade
Tax Code Number: 01506251000
Site Legal Address: SILVER CREST BLK 2 LT 20 G:2439
Site Mailing Address: 7241 STAMPS CIR, Anchorage
Owner: BINGHAM B ALLEN
Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING
This permit is for the construction of:
Effective Date:
Expiration Date:
Lot Size in Sq Ft:
Total Bedrooms:
�t1,�nt
N:
f.
Url7artn�eant
8/15/2024
8/15/2025
46770
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
4
Received By: ' � � 1'�D T_'j AtV\0 C (t--S = v Date:
sl _
Issued By: ,-- Date: J 4' Z
MUNICIPALITY OF
Development Services Department
On -Site Water & Wastewater Section
Parcel I.D. 015-062-51
2
ANCHORAGE () 5 �
ON -SITE SEPTICM/ELL PERMIT APPLICATION
Property owner(s) BINGHAM
Mailing address 7241 STAMPS CIR ANCH AK
Site address SAME
Day phone
Legal description (Sub'd., Block & Lot) SILVER CREST BLK 2 LT 20
Legal description (Township, Range & Section)
Lot Size 46770 Sq. Ft. Number of Bedrooms 4
Phone: 907-343-7904
Fax: 907-343-7997
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field
R
Initial ❑
Single Family (SF) Q
(wJwo ADU)
Septic Tank
R
Upgrade R
Duplex ❑
(D)
Holding Tank
❑
Renewal ❑
Multiple Dwellings ❑
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees: Waiver Fees: _
Date of Payment: 6,4'?_ y 47429 Date of Payment:
Receipt Number: ODiS_f7Ga D 2200 7 Receipt Number:
Permit No. CiS P I V 9 I Z- (K Waiver No.
GADevelopment Services\Building Safety\On Site Water and Wastewater\FormsUient Forms\Permit Application.doc
July 5, 2024
Municipalities of Anchorage
Development Services Dept.
On-Site Water & Wastewater Section
Anchorage, Alaska 99519
Phone 343-7904
Re: Septic permit
Legal: SILVER CREST BLK 2 LT 20
To Whom it may concern:
This is a request for a septic permit on the above referenced lot. A single test hole
was excavated and found 1 feet of organics (OG) then silty gravel (GM) mixed with
silty sands (ML/GM) to the bottom of the hole at ten feet. No water was observed
during the excavation or after the 7-day monitoring period. The perc rate was 40
minutes per inch. Due to the lot size and soils an Advantex system has been designed
for the lot. The lot slopes at 10 to 15 percent towards the northwest.
This new septic system will not impact any of the surrounding neighbors, most have
Class III advance treatment systems already.
Sincerely
Michael N. Anderson, P.E.
4661 Natrona
Anch, Ak 99516
Ph 727-8864
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241128, Curtis Townsend, 08/15/24
1"=200'
PROPERTY LINEPROPOSED
DRAINAGE FIELD
EXISTING HOUSE
EXISTING WELL
100' RADIUS
-NEWBY AVE-
SCALE:
DJRDRAWN:
DATE:
SILVER CREST, BLOCK 2, LOT 20
Anchorage, Alaska
ALLEN BINGHAM
7/3/2024
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DESIGN CRITERIA:
1.0' EFFECTIVE
4 BDRM X 150 = 600 GPD
SOILS = 600 GPD/2.0GPD/SF = 300 SF
300SF/5 = 60 LF OF TRENCH
5.0' WIDE
60' LONG
(1) TRENCH
3.0' DEEP -10
(TH#1 )
-1.0
GM/ML
ORG
FILTER FABRIC & 2" INSULATION
3,3(:
TOPSOIL & SEED
NO WATER JUNE 2024
3:1 +1.0
-3.0
TANK BUOYANCY IF REQ.
5,000 LBS CONCRETE (6YD)
5.0'
12" DRAIN ROCK
-2.0
#2&
SE
P
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I
C
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241128, Curtis Townsend, 08/15/24
M.H.
1"=50'
EXISTING
HOUSE
EXISTING WELL
100' RADIUS
DRIVEWAY
WELL
-STAMPS CIRCLE-
SILVER CREST
BLOCK 2, LOT 20
SCALE:
DJRDRAWN:
DATE:
SILVER CREST, BLOCK 2, LOT 20
Anchorage, Alaska
ALLEN BINGHAM
7/3/2024
SILVER CREST
BLOCK 2, LOT 21
SILVER CREST
BLOCK 2, LOT 19
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NEW ADVANTEX
TANK & POD W/
PUMP BASIN
MT
MT
TH#1
FOUNDATION
DRAIN AROUND
THE HOUSE
FOOTING DRAIN
SUMP, PER THE
CURRENT OWNER
EXISTING LEACH FIELD WILL BE
REMOVED AND BACKFILLED WITH
NATURAL MATERIAL
SECONDARY SYSTEM, SEE 1983
MOA FILE FOR TEST HOLE DATA,
PERC RATE OF 28 MPI.
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241128, Curtis Townsend, 08/15/24
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241128, Curtis Townsend, 08/15/24
MUNICIPALITY OF ANCHORAGE
ADVANCED WASTEWATER TREATMENT SYSTEM
MAINTENANCE AND REPAIR AGREEMENT
THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and
entered into as of this _ Day of ; _�« � of 20;V , by and between
WEL) i11-� , herein the "OWNER," and the Municipality of
Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code
(AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this
Agreement agree as follows:
1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the
Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS),
described as ) j J) L)4aC k �� P 7�c-
located at (legal description)
1`6 t -,�-p ek I-- .5'1 LUFA-
2. Maintenance, Repairs and Alterations.
(Owner is required to read, understand and initial each section)
0— Throughout the term of this Agreement, the Owner shall enter into a service agreement
with an AWWTS service and maintenance provider approved by the Municipality or the
manufacturer's representative. The AWWTS shall be maintained in a satisfactory
condition capable of performing as designed and producing treated septic effluent in
accordance with the equipment's approval for operation in the Municipality.
)0-7 It shall be the responsibility of the Owner during the term of this Agreement to pay for all
repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This
includes an annual maintenance fee (typically $400 to $600).
Owner agrees that only maintenance and repair personnel approved by the Municipality
AT -
or the manufacturer's representative will inspect and make any necessary maintenance,
repairs or permitted alterations to the system.
Owner acknowledges that regular maintenance of an AWWTS reduces the potential
failure of the system, which could include sewage backup and costly repairs or drainfield
replacement.
(rev. 05/18/2018) Page 1 of 3
0 Owner acknowledges that the Municipality may request records of maintenance and
repairs from the manufacturer's representative or maintenance provider.
AOwner acknowledges that the fine for failing to maintain and repair an AWWTS may be
assessed in accordance with AMC 14.60.030.
Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS. The Municipality will give at least 24-hour notice.
Owner agrees that any sale or transfer of title of the property will not occur without a new
Certificate of On -Site Systems Approval.
Owner agrees that the AWWTS installation and maintenance requirements as provided
by the AWWTS vendor/installer and approved by the Municipality are the governing
guidelines for the construction, maintenance and repair of the Owner's AWWTS.
Owner agrees to maintain remote monitoring of the AWWTS as required by the
AWWTS approval.
3. Term. The term of this Agreement shall begin on the date of approval by the
Municipality to operate the installed system, or upon transfer of title, and shall continue
while the AWWTS is operational or until title is transferred.
4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this
Agreement shall in no way constitute a waiver of the provisions, nor in any way affect
the validity of the Agreement or any part hereof, or the right of the Municipality
thereafter to enforce every provision hereof.
5. Amendment. This Agreement shall only be amended by authorized representatives of
the Owner and Municipality. Any attempt to amend this agreement by either an
unauthorized representative or unauthorized means shall be void.
6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be
brought in the Superior Court for the Third Judicial District of the State of Alaska at
Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the
parties under this Agreement.
7. Severability. Any provisions of this Agreement decreed invalid by a court of competent
jurisdiction shall not invalidate the remaining provisions of the Agreement.
(rev. 05/18/2018) Page 2 of 3
OWNER:
By:. ?`Z (signature) Date: i z.
6L n% ! t (print name)
STATE OF ALASKA )
) ss.
THIRD JUDICIAL DISTRICT )
The foregoing instrument was acknowledged before me this 13 day of 1 a
20 Z If , by O + � 11 e ;l c"a
NOTARY PUBLIC fOR ALASKA MICHAEL YANG
My Commission expires: l t 19 Z 0 c: % Notary Public
State of Alaska
My Commission Expires Jul 18, 2027
MUNICIPALITY:
i
L
By: �j (signature)
(Print name)
Date: �� 2
1
Title: C i I' r' t - ", ,,�—
(rev. 05/18/2018) Page 3 of 3
STAMPS
CIRCLE
OF q q�;4p
'4g TH `9
r SHANE A. HOLT .'
p LS-6914 0`
Q�a a o
�ArO fessiona� boo
THE SURVEYDATA AND MEASUREMENTS HEREONAREPREPARED FOR THE
OWNER OF RECORD AS OF THE DATE OF THIS SURVEY.
ANY USE OF THIS DRAWING BY THIRD PARTIES IS PROHIBITED UNLESS
WRITTEN PERMISSION IS PRO VIDEO.
THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY
CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; AND IS
NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES.
EASEMENTS OF RECORD OR OTHER RIGHTS OF WAY, OR ANY ENTITY NOT ON THE RECORD PLAT
ARE NOT SHOWN HEREON, UNLESS NOTED.
NOTE. FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE
PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS.
ANY PAVING SHOWN HEREON MAYBE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE.
ONLY VISIBLE IMPROVEMENTS ARE SHOWN HEREON
AS BUIL T SURVEY fry = 30
NO CORNERS SET THIS DATE
I HEREBY CERTIFY THA T I HA VE PERFORMED A SURVEY
OF THE FOLLOWING DESCRIBED PROPERTY
LOT20 BLOCK2 SILVERCRESTSUB.
A NCHORA GE RECORDING DISTRICT, ALASKA, AND THAT THE
VISIBLE IMPROVEMENTS SITUA TED THEREON ARE WITHIN
THEPROPERTYLINESANDNO VISIBLEENCROACHMENTS
EXIST OTHER THAN NOTED.
DATED ATANCHORAGE,ALASKA THIS 22ND DAYOF
MA Y 2024
HOL T LAND SURVEYING
9309 GROVER DRIVE
ANCHORAGE,,AK 99507
16056 236-75 PP3-s5z5
I�
(~ MUNICIPALITY 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
NAME "' PHONE I []NEW
MAILING ADDRESS
LEGAL DESCRIPTION
. .o.
PER~IT NO.
Well Absorption area D;;il~ /
O
/,~
Material No. of compartments
~<1- Z Manufacturer ~'X I%~
~ ~ Liq. capacity in gallons Inside length Width Liquid dept~
/ ~.~-O IF HOMEMADE: ~- _
Well Dwelling PERMIT NO, *~
~ DISTANCE TO: '~
O Z ~ Manufacturer _ Material Liquid capacity in gallons
Well :oundation__~¢1 Nearest lot line J~ t PERMIT NO,~.O¢~/~~. ~,~
DISTANCE TO:
~Z~ ~ ~ NO. of lines I Length of eac~e,~, Total length of ~ines~.~; Trench w d~l~ , ~ Distance between Ijnes/~
~ ~ Top of tile to finish grade ~ t Material beneath.., tile ~ I i~e~ Total effective~ '~abs°rB~°n
Length "' Width Depth PERMIT NO.
~ Type of crib ~ Crib diameter Crib depth Total effective absorption area
~ Well Building foundation Nearest lot line
~ DISTANCE TO: ~
~ Class , Depth Driller Distance to lot line PERMIT NO.
~ DISTANCE TO: Building foundation_~ Sawer line . ~ Septic tank .f~ ~ Absorption area(s).~_ ~ ~ I.
OTHER
~IPE MATERIALS
SOIL TEST RATING ~J
~NSTALLER ~_
REMARKS
· t-~'/:,(J c l,~ /'1 o ii .¢ 7' 8 4. "O'z_ Li, I ' fi- /
APpRO~E~ ~
,L '~(~,l./(V ~ W'~ ~>'-~K',,::':~:'' ~ ~;/~ 1. k ' .... ;' /.,~-.~:/:'-':
72-013 (Rev. 3/78)
I....C)T :: 2'.C
,r:d-~dqGE: :: :]!;N
[)E:F:"TI'I 'I"C) I::' ]: F'Ei: X:~,EFI"TC)N(I:::T.)
£:~B'.(~VEi:I.... DIEF:'TH (F:T,,
'f'CIT(~I... )::)IEI:::'TH (I:::T,,)
GI:W~VEd~.. ~,J:[)':)Tr.l (F:"I",,
E.)F~:(:~VIEI.. I.,15:N0:YFH (I:::"1",,)
,5}R:~VI!F.I_.. VC)I....LJFIIE: (CLJ ,, Y!:)S ,, )
']"~]1,.I1.~:: S :1: ZE (G(.~[...S)
!![Z:) ]: I_. FdqT ]: N('..] (Si;!,, F:'T,, /!.31::;:)
ALASKA
. ,dlRO[IlTI [1TAL COI"ITROL
~n~Jneerin¢I $ ~nuironmcnl~J $1udics
OCTOBER 11 1~84
LEE OOHNSON
SRA BOX 61-D
ANCHORAGE AK 99507
SELLER - LEE 00HNSON BUYER -
SUBDZVZSZON - SZLVER CREST BLOCK - 2
ADEQUACY TEST FOR SEWER SYSTEM
LOT - 20
THE TYPE OF ABSORPTZON SYSTEM ZS A TRENCH WZTH AN UNKNOWN AREA.
THE SYSTEM ZS CAPABLE OF ACCEPTZNG 550 GALLONS OF WATER PER DAY,
THE SURGE CAPACZTY OF THE SYSTEN ZS 242 GALLONS,
BASED UPON THE 'rEST DATA THE SYSTEM ZS NOT ACCEPTABLE FOR A
HOfi'E OF 5 BtZ. DROOICiS.
SEP?'ZC TANK ADEQUACY
THE EXZSTZNG 5EPTZC TANK VOLUIvE OF 1250 GALLONS ZS ZNADE~2UATE BY
250 GALLONS FOR THZS HOUSE OF 5 BEDR00t4S,
1200 UJesl 33rJ Aucnu¢, $uii¢ B. Anchor,fie, Alasb 99503.,(907) 56F5040
PERFORMED FOR:
LEGAL DESCRIPTION:
2
3
4
6
7
9
10
12
14
16 ~'
17
18
19
20-
COMMENTS
PERFORMED BY:
72-008 (6/79)
SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L, Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
[] PERCOLATION
TEST
SLOPE v' SITE PLAN
ENCOUNTERED? O
P
E
IF YES, AT WHAT
DEPTH?
Gross Net Depth to Net
Reading Date Time Time Water Drop
~t.~O 11-/5- :~ : .~ ~ ~ , ~ ~
~ ~0 ~,' ~q ~ ,d~
~ ~,'1~ /O ,Jd ,~
PERCOLATION RATE
z-,' ,'~.
TEST m.m~.~ 3, ~ ... ~,~ ~~ ...... ',:;B~, -.
MUNICIPALll'Y OF ANCRORAGE
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
l~HONE
-'~PG RAD E
MAI LING i~ DR ESS
LEGAL,~OESCRIPTION
LOCATION
DISTANCE TO:
Manufacturer
Well I Absorption area
Dwelling
Widt ~
Liq.
DISTANCE TO:
Inside length
Ne. OF BEDROOMS
Liquid dept~
IF HOMEMADE:
Wall Dwelling PERMIT NO.
Manufacturer Material Liquid capacity in gallons
F gu n da t i~,~ / Nearest bli~,e..~
Tota"e,~,ffms Trench ~,~
~-~' ~:2) inches
Material beneath tile /~8 inches
Depth
PERM'T ~dOr; ~ I
Total e,~.~c.~.~.~9~, tion area
PERMIT NO,
Crib depth Total effective absorption area
Building foundation Nearest lot line
Driller Distance to lot line
Septic tank
DISTANCE TO:Well [ ~ 0 t ~
No. of ,nesI ,eng.~lT, ne
Top of tile to finish, grade
Length Width
Type of crib Crib diameter
Well
DISTANCE TO:
Class Depth
Building foundation
DISTANCE TO:
Sewer tine
OTHER
PIPE MATERIALS ,%.
SOIL TEST RATING
REMARKS ,
APPRO~
DATE .{A~LEGAL
72-013 (Re~.. 3/78)
iPERMIT NO,
Absorption area(s)
PERMIT NO. ( 80008il. )
APPLICANT JAK C:OI"ISTRUCT I ON
LOCATION UPPER ABBOTT ROAD
I--"l U N ]: C :Ir; F' F~'tI~, F¢ ~'~-=~ u_~ ES
DEPARTMENT OF HEALTH FIND ENVIRONi','IENTAL~ PROTECTTON
,5125 ," L" STREE'1% RNCHORRGE., Ak.::.
.'.264-472L3
SE~,.IEIF4: b~ PtGRFIIIt.-]:,EZ PEE:I'4 I T
BO::',', 25t± CHILKRT COURT 99577
694-]::18i
LEGAL
LOT 20 BLOE, K :,:. SIL'¢EROREST S,/'D J
TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH
LOT SIZE
46'770 St.]LIARE FEE]'
MAXIMUM NUMBER OF BEDROOMS
SOIl_ RR'¥ING (SL]! FT.-"BR)= ±75
]'HE RE6!UIRED SIZE OF THE SOIL RBSORP],'ION S'¢STEM I'~]:
[:, El F"'-IF H== ]:'" L. E l"-.l E.~i -r H = ;--_~2 I..S F.: R %." E L_ [:,EP ]' t-.~ = 4.
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCFI OR DRAINFIEL[:..
THE DEPTH OF' A TRENCH OR PIT IS ].'HE DI'.2;TAI'.~CE BE'f'&4EEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE EXCRVR]'ION (IN FEET).
THERE IS NO SET NIDTFI FOR TRENCHES.
TFIE C~RR',,.'EL DEPTH IS ],'HE r.IINIMUM DEPTH OF GRAVEL BETI,.IEEN THE OUTFRLL PIPE
FIND 'THE E:O'rTOM OF THE EXCAVATION (IN FEET).
t.-4:EE;!IU I RE-Z[) :SFZP']" I C: TRi'-,i~-:: '~:='1 I ZE== ::1.,2-..':5 ~-i~ GRL_L_C~I~,I:~;
PERMIT APPLICANT HAS 'THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE
INSTALLATION INSPECTIONS OF AN'¢ HELLS ADJACENT TO THIS PROPERTY AND THE
NUMBER OF RESIDENCES THAT ].'HE WELL WILL SERVE.
BACKFILLING OF AN"r' SYSTEM NITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT I-'.IILL BE SUBJECT TO PROSECUTION.
MINIMUM DI~';TANCE BETWEEN ~ NELl_ AND ANV ON-SI]"E SE['.IRGE DISPOSAL S;'¢STEM IS
100 FEET FOR A PRIVATE NELL OR ::L50 TO 2¢30 FEET FROM A PUBI_IC NELL DEPENDING
IJPON THE TYPE OF PUBLIC I,.IELL
MINIMUM DISTANCE FROM A PRIVATE WELL TO R PRIVATE SEWER LINE IS 25 FEET AND
TO R COMMUNITY SEWER LINE IS 75 FEET.
OTHER RE~]:!IJIREMENTS MRS" RPPL°¢. SPEC:IFICRTIOIqS I=IND CONSTRUCTION DIAGRAMS ARE
FI',/AILRBLE TO INSURE PROPER INS'TALI, ATI ON.
P EF...'.~'-I I ']~ EZ,~-;F' I E:[::-].S [:,EZIZ:E]t"IE:EF.: 3::~_.,
I CERTIFY THAT
1: I AFl FAMILIAR NITH THE REQUIREMENTS FOR ON-SITE SEWERS AND 14ELLS AS SET
FORTH B'¢ THE MUNICIPF~LIT¥ OF ANCHORAGE.
2: I WILL INSTALL. THE S'¢STEM IN ACCORDANCE P]ITH THE CODES.
]:: I UNDERSTAND THAT THE ON-SITE SEWER S'¢STEI'd MA'¢ REt.]UIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS.
S I GNED: ..........................................................
RF'PL ICANT JAK CONSTRUC].' I ON
825 eL STREET, RNCHORFIQE, FIK. ~ 1
264-4720
i.41='LL. R~4D ON--SITE SEb4ER
ANCHORAGE
NUN i~ I PI¢::::IL I t~l~
DEPFIRTMENT C ~EFiLTh FIND EN~ZIRONMENTFIL ~ ~'OTECTION
PERMIT NO. "" ~ 6 /~
LOCRTION
TVPE Of SOIL RBsORBTION SYSTEM I~i ~;t;O~/L-~"
MRXIMUbl NUMBER OF BEDROOMS = / SOIL RRTING
THE REQUIRED SIZE Of THE SOIL FIBSORPTION S~STEM IS:
DEPth= { LENGTh= ~¢' gR~VEL DEPTH= V ~
THE DEPTH OF FI TRENCH OR PIT IS THE DISTFINCE BETWEEN THE SURFACE OF THE
GROUND FIN~ THE BOTTOM OF THE EXC~VFITION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRFIVEL BETWEEN THE OLITFFILL PIPE
RND THE BOTTOM OF THE EXCRVRTION (IN FEET).
REQUIRED SEPTIC TANK SIZE= ~O. GALIO~4S
PERMIT RPPLICFINT HRS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING THE
INSTFILLFITION INSPECTIONS OF FINV WELLS FIDJFICENT TO THIS PROPERT~¢ FIND THE
NUMBER OF RESIDENCES THFIT THE WELL WILL SERVE.
T~O < 2 > INSPECT I i~I~4S ,~,RE REQLI I
BBCI<FILLINi3 OF RN~ S'¢STEM WITHOUT FINFIL INSPECTION FIND FtPPROVFIL B~' THIS
DEPFtRTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTRNCE BETWEEN FI WELL FIND FIN¥ ON-SITE SEWFtOE DISPOSFIL SYSTEM IS
~00 FEET FOR FI PRIVFITE WELL~ OR
150 TO 200 FEET FROM FI PUBLIC WELL DEPENDING UPON THE T'~PE Of PUBLIC WELl.
WELL LOGS FiRE REQUIRED FIND MUST BE RETURNED TO THE DEPFIRTMENT WITHIN ~0 DFIYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MRY RPPL~¢. SPECIFICSTIONS FIND CONSTRUCTION DIFIGRRM$ ARE
FIVFIILSBLE TO INSURE PROPER INSTFILLFITION.
PER~I I T E>:P I RES DECEMBER ~l- --! .~'?:~
I CERTIF*¢ THRT
:~: I FIM FRMILIFIR WITH THE REQUIREMENTS FOR ON-SITE SEWERS FIND WELL~ RS SET
FORTH BV THE MUNICIPRLIT¥ OF RNCHORRGE.
2: I WILL INSTSLL THE SYSTEM IN ~CCORDRNCE WITH THE CODES.
~: I IJNDERSTRND THST THE ON-~ITE S~WER S~'STEM MR~ REQUIRE ENLRR6EMENT IF THE
RESIDENCE IS REMO~ TO INULU~E~ORE THRN ~ BEDROOMS.
SIGNED~~- ~ '"' ~- ...........
I~SUEO B¢__M_~ ......................... ~n __- ~_~. _~e_~. %¢ ,-/ ~ ~¢ V~. 2
MUNICIPALITY 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
LOCATION NO, OF BE~OOMS
.
Well Absorption area Dwelling
~ ~ ~ ~ Manufacturer0 ~. Matefi~ No. of compart,~
~ ~ Liq. capacity in gallons IF HOMEMADE: Inside lengt~ Width.. . Liquid
Well Dwelling PERMIT NO,
~ DISTANCE TO:
~ ~ ~ Manufacturer Material I_iquid capacitv in
~ DISTANCE TO: Well ~O O '~ F;u:a;t~ O '~ Nearestl°~i~V
Length of~ach line Trench Distance between lines '
~ ~ No. of line~ Total length of lines
~ ~ Z ,,~ / width
~m Top of tile to finisb grade~ q5 ~ ~ Materialben~(~htile ~'W inches ~9t~leffecti' T-'- '~onarea
Length Width Depth PERMIT NO,
~ ~ Type of crib Crib diameter Crib depth Total effective absorption area
~ Well Building foundation Nearest lot line
~ DISTANCE TO:
CI~ DBpth Drille~ "~ Distance to lot line PERMIT NO,
Septic tank Absorption areals)
~ Building foundation Sewer line /~ ~
~ DISTANCE TO: /~ '~ /DQ) ~ ~,,
OTHER
PIPE ~ATE~IALS
INSTALLERs5 ~/'
I
REMARKS O' ~ .,
- C
-APBROVED //' DATE LEGAL
72-013 IRev. 3/78)
I':!VI':! :!: !..H :,1. ~::. i'0 T i",!:!i!;l_ll;i:l::: I:::'I:,i:(')Pi:!!:Fi: T I",1:!!;'t"1:::1[ .I. f::l'l' ]: FIE!
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
Pouch 6-650, Anchorage, Alaska 99§02 276-2221'
SOILS LOG- PERCOLATION TEST
PERFORMED FOR:
LEGAL DESCRIPTION:
1
4
5
6
7
8
9
I0
11
12
13
14
15
16
17
18
19
2O
SOILS LOG
PERCOLATION
TEST
DATE PEREORMED: 7~' ? ?~' 7~7
5'/
COMMENTS Z> d ./i..~5 /' r., ~" d:
SLOPE SITE PLAN
L.J
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Gross Net Depth to Net
Reading Date Time Time Water Drop
/ 1~.2/ ~r.'~o?"l
PERCOLATION RATE /' '~ ,,~/A/ (minutes/inch)
TEST RUN BETWEEN ~ ,,, FT AND FT
t~ ~' L- h ~: L~'-,~'~ .7" h/:/'?~
DATE: ?"' z?'--??
72-008 (7/76)
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
GENERAL INFORMATION
(a)
Legal Description (include lot, block, subdivision, section, township, range)
Location (address or directions)
7,z-,l/
,, .~, . . <
(b) Applicant Name,4~¢'~£;- ~*'/½,'v/~¢?'q'' Telephone: Home ~/-:'~" O¢ :~ Z~- Business
(c) Applica. nt is (check one): EeBding Institution []; Owner/builder~; Buyer [2; Other [] (axplain);
(d) Lendihg Institutio'n:" ':;' Telephone
Address
(e) Real Estate Company and Agent
Address
Telephone
(f) Mail the FtAA to the following address:
2. TYPE OF RESIDENCE
Single-Family~[4J~ Multi-Farmer [] Other
Number of Bedrooms 7-
WATER SUPPLY
Individual Well~ Community[] 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 [] 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.
Page 1 of 2 72-025 (11/84)
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
Date ,
DHEP APPROVAL~
Approved for F~2z~'___ bedrooms b ...,~..,~,~_o~~,, Date
Approved ~ Disapproved Conditional
Terms of Conditional Approval
CAUTION
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 ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST- FEBRUARY 1984
Legal Description:
WELL DATA
Well Classification '?" "-~---_/~-"/~//']~'- _ ~ If A, B, C, D.E.C. Approved (Y/N) ,A,/,//'/
Well Log Presen¢;~N) Date Completed /g2%~-~ ~''/~¢ Yield Q~.'~ ¢~
Total Depth / 7~
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
Depth of Grouting /-')//~
Pump Set At ~/~/'~
Sanitary Seal on Casing (Y~)
Depression Around Wellhead (Y/~
; On Adjoining Lots
To Nearest Edge of Absorption Field on Lot _ /¢"~ I ; On Adjoining Lots
To Nearest Public Sewer Line .~/,/~ To Nearest Public Sewer
Cleanout/Manhole _ /,,//.~J¢ To Nearest Sewer Service Line on Lot
Water Sample Collected by . //~¢'~:~ /¢, ~/~'~/~:~:~/' ; Date .
Water Sample Test Results
Comments ~ ~Jc_.3Z/., ,,~f-r¢',~/ ~'~7~ /"Z"/",¢'~ ,
/
SEPTIC/HOLDING TANK DATA
Date Installed ¢"¢~
Standpipes~N)
Depression over Tank (Y~-)
To Water Ma n/Service Line
Course
Comments
Size
Air~tight Caps~'~N)
Pumping/Maintenance Contract on File (Y/N)
HoLding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/Holding Tank:
To Water-Supply Welt /'¢~;' /
To Property Line
No. of Compartments ~
Foundation Cleanou~rN)
Date Last Pumped /~z-/~ ~-(~
/U'//~ ;for ~//~*
Temporary Holding Tank Permit (Y/N)
To Building Foundation
To Disposal Field .
To Stream, Pond, Lake, or Major Drainage
Page 1 of 2
72-026(11/84)
ABSORPTION FIELD DATA
Date Installod~"~/~/~,~//))~'- ~-';'~ ~ //-;~-*~ Length of Field
Width of Field ~ -~ / ~
Square Feet of Absorption Area
Depression over Field (Yi/~)~
Results of Last Adequacy Test
Separation Distance from Absorption Field:
/
To Water-Supply Well /~)
To Building Foundation
Lot ~ ~T~/~ffb'$
To Water Main/Service Line
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments
Depth of Field ~ 7'
F'
Standpipes Present'N)
Date of Last Adequacy Test
/
To Property Line
¢~?'" / To Existing or Abandoned System on
/0 / ,/¢r/'/~"'; On Adjoining Lots ~2
/g/,'~ To Cutbank (if present)
-I,¢ ¢
LIFT STATION //
Si;ee inn ~ allo n~alled s -~ ~"'--'"~"-.~ __ M a n hD io I~;~;ic°ens~ (Y/N)
"Pump On" Level at ~p 'Off" Level at
High Water Alarm Level at ~)
Tested for ~ ~ P~pi~ Cy~ Adequacy Test. Meets MOA
Electrical Codes (Y/N) ~.
Comments ~~
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I h~v/c~ck~d,,/~ erified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signed J~"[~,/ ~¢~'~'~ Date
Receipt No. ?~"") ~ ~ /
Date of Payment I - ~
Amount: $ (.,.,2 '~
Page 2 of 2
72-026 (11/84)
ALASKA ENVIRON~"FNTAL
CONTROL SERVIC, , INC.
].200 West 33rd Avenue, Suite B
ANCHORAGE, ALASKA 99503
(907) 561-5040
SHEET NO OF
CHECKED BY OATE
SCALE J ~"~
J
ALASKA erlUIROnlT1EnTAL CONTROL SeRUICE$, Inc.
~n§JneerJn§ $ ~m, ironmcnt~l
LEE JOHNSON
P.O. BOX 10-2782
ANCHORAGE ALASKA
99510
SELLER-LEE JOHNSON
LEE JOHNSON
P.O. BOX 10-2782
ANCHORAGE ALASKA
99510
01/31/86
60043
LEGAL:SILVER CREST BLOCK 2 LOT 20
FLOW TEST ON WELL
WELL FLOW DATE-i/29/86
A FLOW TEST WAS PERFORMED ON THE WELL. 549 GALLONS OF WATER WAS
PUMPED AT A RATE OF 4.6 GPM OVER A DURATION OF 2 HOURS.
THE DRAWDOWN WAS 13.6 ' WITH A RECOVERY TIME OF 30 MINUTES
AND THE STATIC WATER LEVEL WAS 76 FEET.
THE WELL IS ADEQUATE FOR THIS 4 BEDROOM HOME.
1200 LUesl 33rd J~ue,ue, Suite ~°Anchoro§e, J~loske 99503°(907) 561-5040
- D,~,TE RECEIVED
INSPECTION APPOINTMENTS
TIME TIME ~, 1/ TIME
INSPECTOR
I NSPECTO R INSPECTOR
MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION DEPT. OF I'-",N;{ &
825 L Street - Anchorage, Alaska 99501 ENVIRONME,,JL',L ~, .,i ~CTION
ENVIRONMENTAL SANITATION DIVISION / PR 1 1980
Telephone 264-4720
DIRECTIONS: Complete all parts on page 1, Incomplete requests will not be processed. Please allow ten (10) days for processing.
MAILING ADDRESS
PROPERTY RESIDENT (If different from above) PHONE
2. ~UYER ..... PHONE
MAILING ADDRESS
3, LENDIN~ INSTITUTION - PHONE
tCw
PHONE
LEGAL DESCRIPTION
STREET LOCATION
r ,'v le_
6. TYPE OF RESIDENCE /
~- SINGLE FAMILY
[] MULTIPLE FAMILY
NUMBER OF,BEDROOMS
[~] One [] Four
[] Two [] Five
[~ Three [] Six
[] Other
7. WATER S}.IPPLY
~ INDIVIDUAL*
[] COMMUNITY
[] PUBLIC UTILITY
* ATTACH WELL LOG. A well log is required for all wells drilled
since June !975. For wells drilled prior to that date, give well
depth (attach log if available.)
8, SEWAGE DISPOSAL SYSTEM
.[~ INDIVIDUAL/ONJSITE**
[] PUBLIC UTILITY
YEAR ON-SITE SYSTEM WAS INSTALLED.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
THIS SIDE FOR OFFICIAL USE ONLY .
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] S~NGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2, WATER SUPPLY
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTILITY
Connection Verified LOG RECEIVED
3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[] INDIVIDUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY
Connection Verified
INSTALLER
[]Septic Tank or [] Holding Tank
Size: . If Tank is homemade SOILS RATING
give dimensions'. .[ '~'~-~'~
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCES Septic/Holding Tank IAbsorption Area Sewer Line Nearest Lot Line
I
WELL TO:
Absorption Area to nearest Lot Line
5. COMMENTS
PPROVED FOB E OOMS
[] CONDITIONAL APPROVAL (letter must ac/cqmpany certificate)
~_,,~ISAPPROV E D ,~, /
72-010 (Rev, 6/79)
STAMPS
CIRCLE
OF q q�;4p
'4g TH `9
r SHANE A. HOLT .'
p LS-6914 0`
Q�a a o
�ArO fessiona� boo
THE SURVEYDATA AND MEASUREMENTS HEREONAREPREPARED FOR THE
OWNER OF RECORD AS OF THE DATE OF THIS SURVEY.
ANY USE OF THIS DRAWING BY THIRD PARTIES IS PROHIBITED UNLESS
WRITTEN PERMISSION IS PRO VIDEO.
THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY
CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; AND IS
NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES.
EASEMENTS OF RECORD OR OTHER RIGHTS OF WAY, OR ANY ENTITY NOT ON THE RECORD PLAT
ARE NOT SHOWN HEREON, UNLESS NOTED.
NOTE. FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE
PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS.
ANY PAVING SHOWN HEREON MAYBE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE.
ONLY VISIBLE IMPROVEMENTS ARE SHOWN HEREON
AS BUIL T SURVEY fry = 30
NO CORNERS SET THIS DATE
I HEREBY CERTIFY THA T I HA VE PERFORMED A SURVEY
OF THE FOLLOWING DESCRIBED PROPERTY
LOT20 BLOCK2 SILVERCRESTSUB.
A NCHORA GE RECORDING DISTRICT, ALASKA, AND THAT THE
VISIBLE IMPROVEMENTS SITUA TED THEREON ARE WITHIN
THEPROPERTYLINESANDNO VISIBLEENCROACHMENTS
EXIST OTHER THAN NOTED.
DATED ATANCHORAGE,ALASKA THIS 22ND DAYOF
MA Y 2024
HOL T LAND SURVEYING
9309 GROVER DRIVE
ANCHORAGE,,AK 99507
16056 236-75 PP3-s5z5
I�