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HomeMy WebLinkAboutSUETAWN ESTATE LT 77 (907) 343-7904 Pump Installati®n L® Well Drilling Permit Number: SW OSP Date of Issue: Parcel Identification Number: 051-511-28-000 Legal Description Property Owner Name & Address: Suetawn Est L 7 Kourosh Partow 19507 Richner Rd Chugiak, AK 99567 I Pump Installation Date: 12/1120202 I Pump Intake Depth Below Top of Well Casing: 35 I Pump Manufacturer's Name: Goulds Pump Model: 7HS05412CL I Pump Size 1i2 hp I Pitless Adapter Burial Depth: 9 feet I Pitless Adapter Manufacturer's Name: Campbell Pitless Adapter Installer: unknown Well Disinfected Upon Completion? ✓7 Yes ❑ No Method of Disinfection: Sterilene Comments: Pump Installer Name: Wheaton Water well, Inc. 1190 N. Wasilla-Fish hook Road Wasilla, AK 99654 feet Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. Development Services Department Building Safety Division e On -Site Water & Wastewater Program G 4700 Elmore Road U P.O. Box 196650 x z Mark Begich e, AK 99507 Anchorage, g s E T Y Mayor www.muni.org/onsite (907) 343-7904 Pump Installati®n L® Well Drilling Permit Number: SW OSP Date of Issue: Parcel Identification Number: 051-511-28-000 Legal Description Property Owner Name & Address: Suetawn Est L 7 Kourosh Partow 19507 Richner Rd Chugiak, AK 99567 I Pump Installation Date: 12/1120202 I Pump Intake Depth Below Top of Well Casing: 35 I Pump Manufacturer's Name: Goulds Pump Model: 7HS05412CL I Pump Size 1i2 hp I Pitless Adapter Burial Depth: 9 feet I Pitless Adapter Manufacturer's Name: Campbell Pitless Adapter Installer: unknown Well Disinfected Upon Completion? ✓7 Yes ❑ No Method of Disinfection: Sterilene Comments: Pump Installer Name: Wheaton Water well, Inc. 1190 N. Wasilla-Fish hook Road Wasilla, AK 99654 feet Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. tnev uoiuu-w) Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP201318 PID Number: 051-511-28 Dwelling: ■❑ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: X New ❑ Upgrade Name Troy Davis Homes, Inc. ABSORPTION FIELD ❑ Deep Trench X Wide Trench ❑ Bed ❑ Mound Site Address 1689 Goose Bay Road, Suite 400 Wasilla, AK 99654 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 310-2501 4 1.0 GPD/SF 6.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 5.5 Ft. Gravel depth beneath pipe 0.5 Ft. Subdivision Block Lot Sue Tawn Estate 7 Fill added above original grade 1.2/0.7 Ft. Gravel length 62/60 Ft. Township Range Section Gravel width 5.0 Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 610 Ft2 2 5.5 Ft. Well >100' >1 00' N/A N/A >25 TANK X Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Greer Capacity 1,250 Gal. Surface Water >1 >1 00' N/A N/A Material Number of compartments Lot Line >5' >10' N/A N/A NA Plastic 2 Foundation >10' >10' N/A N/A LIFT STATION Manufacturer Capacity Gal. Remarks Alarm location Electrical installed by PIPE MATERIAL House to tank F'628 drainfield Tank to D3034 Installer Alex Enterprises Drainfield D3034 Co/MTD3034 Inspector J. Mlllette BENCH MARK (Assumed elevation) 100 ft Inspection 15' 10/24/20 11/12/20 Location and description 31d 11/16/26 2�a 4'h Garage Slab. ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp +®®®OF Conditional Approval: Date .��P • ;, s ®� �p 49th =� y� 10 .. ...................... 0 ..................... . s MICHAEL E. ANDERSON .'fie Septic System ® C ®% % NO. CE -4381 : �Ar A roved pp Date 2 -0"q.%.. 1/5/21 ,,.••''��`'® A�F� ••............• . Note: this approXedoes not include well permit requirements. tnev uoiuu-w) 9:C)i:C-) -AO--1O--�O-�O� � Ocnrn cn �H)s D W cn Z� ir �zC� �'��Z-1 4A .AW W N N -i -� O C= n 1 O / O co co -P -A co CO J ! M* / ONS X _ wo:01-9)p jl oo-,Wcow co co N N co W W w w w N� W — X1 00 p p O 'J N O p �! C.0 N O -P ---j co O W cn O O N m0) P P W .t-wwcocn711 NNW O O O U 7 D 1' C7 �I 1 —I m EZE� m -n N o r / S<—i=MOOO M n m vm0D0000o --jTF 0D =c�pcnzwz O rn m r- D rn 0 m z, -I ---1 0 -I G7 m O m z C n Z W r, O rn D C Z � MM W o � Ocnrn cn �H)s D W cn Z� ir �zC� �'��Z-1 a 0Z Z N O 1 ?`ZTO> mm�mm -� 1 i =i� DL mzm -0 �cn=x n 1 O / .0 m�< -1 Zmcn_m -IS0�C> m �5 M* 0 J ! M* / ONS X _ jl U) C m z m 111 cn m� 111 SUE TAWN ESTATE, LOT 7 PERMIT # OSP201318 PID # 051-511-28 90.2 89.7 90.2 89.7 QNGINEQRINC 0� NORTH TRENCH 1-0 96.4 FINISH GRADE 95.7 ORIGINAL GRADE DRAINFIELD ROCK 90.2 MOA APPROVED FILTER SAND 89.7 "— 87.7 60' NO GROUNDWATER 8/11/20 82.7 C,'r)HTH TPf=KIrW 87.7 0 n 1 96.9 FINISH GRADE 95.7 ORIGINAL GRADE DRAINFIELD ROCK 90.2 MOA APPROVED FILTER SAND 89.7 87.7 87.7 62' PROFILE AS -BUILT (NO SCALE) �t Municipality of Anchorage P.O. Box 196650 ® 4700 Elmore Road Anchorage, Alaska 99519-6650 a (907) 343-7904 ® Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Proaram 'I Ur. p;retment x x x x VARIANCE/WAIVER REVIEW x x x x Waiver#: OSV211001 COSA#: Permit#:OSP201318 PID#: 051-511-28 Legal Description: SUETAWN ESTATE LT 7 Engineer: Forge engineering Your request for a waiver of the required 6 feet horizontal separation from absorption field to the absorption field has been approved. The approved separation distance is 5.5 feet. This waiver approval applies to the existing absorption field only. Any future upgrade to the on- site wastewater disposal system will require all separation distances be met or another approval from this department. ■ .... ■ ■ ............................. ■ ■'........ ■ ■ ............................. ■ t Waiver is Granted: X Waiver is not Granted: Date: 1A, (A Approved by: Name of Revie r **** VARIAN C E/WAIVER REVIEW **** j 33.0' I L D N K Z M I Lot 6 I Lot 8 I NOTE: 1) PLAT NOTE: ALL LOTS EXTEND TO CREEK LEGEND: (R) RECORD FROM PLAT No. 64-9 Lot 5 PLOT PLAN AS BUILT X SCALE 1" — 30__ GRID _ NW 1060__ Project No. 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associates, inc. (907) 522-6476 Phone oopppp40 (907) 522-4625 Fax oF A p�O Professional Land Surveyors kenOlangsurvey.com o !� 9 0 ionathanOlanasurvev.com O� .• . .�.�n I hereby certify that I have surveyed the following described property: LOT 7, SUETAWN ESTATE (PLAT No. 64-9) Anchorage Recording District, Alaska, and that the improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visible easements on said property except as Indicated hereon. Dated this the �P _ Day of ____- S -LLL at Anchorage, Alaska It is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. 49THW *i m ' KENkNETH. LANG o 3�2a2o •' �*� �D�cFo ..CCS 5202.• 4OnRaFfSSIONA� � 00 AECC963 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 http://www.muni.org/onsite On -Site Water & Wastewater System Permit Permit Number: OSP201318 Work Type: WellSeptic Initial Tax Code Number: 05151128000 Site Legal Address: SUETAWN ESTATE LT 7 G:1060 Site Mailing Address: 18725 JASMINE RD, Chugiak Owner: KEHOE-PARTOW DEANNA Design Engineer: FORGE ENGINEERING This permit is for the construction of: Effective Date: Expiration Date: sr S cn do' t r- n v r, V Department Lot Size in Sq Ft Total Bedrooms: 8/26/2020 8/26/2021 52272 Q Disposal Field Q Septic Tank Holding Tank Privy Q 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 Received By: Issued By: Date: Date: S 6 Zf> 4 8/26/20 n MUNICIPALITY E ANCHORAGE Community Development Department `' Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 051-511-28 Property owner(s) Troy Davis Homes, Inc. Day phone 310-2501 Mailing address 1689 Goose Bay Road, Suite 400 Wasilla, AK 99654 Site address 18725 Jasmine Road Chugiak, AK Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) Sue Tawn Estate, Lot 7 Lot Size 52,272 Sq. Ft. Number of Bedrooms Four (4) APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑X Initial ❑X Single Family (SF) ❑X (w/wo AD U) Septic Tank ❑X Upgrade ❑ Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings El Privy ❑ (SF and/or D) Private Well ❑X 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. (Signature of property owner or authorized agent) Permit/Rush Fees: -A01.s C©U10 Waiver Fees: Date of Payment: IS ZO Z O Date of Payment: Receipt Number: (56%%3 © Receipt Number: Permit No. 05 192-01-3)5 Waiver No. Permit App_:;- : ._.,:c PO BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) August 26, 2020 M.O.A. Development Services Department On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Subject: Sue Tawn Estates, Lot 7 – 18725 Jasmine Road Septic System Design Dear On-Site Services Engineer: The owner of the above lot intends to build a 4-bedroom home on the property. We are submitting this permit application for the construction of a septic system. A well is currently in place on the lot which will serve the new home. The attached site plan identifies the location of the home and the existing well, existing and proposed septic location and alternate site. No conflicts exist between this proposed system and any other well or septic system on this lot or adjacent lots. The ground surface on the lot slopes to the north at grades approximating 10%. There are no slopes greater than 25% within 50 feet downslope of either the primary or alternate site. Ground contours are shown on the site plan indicating the grade and direction of flow. Stormwater drainage will not impact this septic system. The new trench will be constructed parallel to the slope as much as possible. Wells on this and adjacent lots are shown. The new system will be a minimum of 100’ from all wells and surface water and more than 5’ from the septic tank. Please refer to the attached test hole logs and plan and profile sheets for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Michael E. Anderson, PE 8/26/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201318, Deb Wockenfuss, 08/26/20 x x x x 2-60' LONG x 5' WIDE x .5' EFFECTIVE DEPTH ABSORPTION TRENCHES. NOTE: NO SLOPES >25% WITHIN 50' OR SURFACE WATER WITHIN 100' OF THE PROPOSED SEPTIC SYSTEM ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC SYSTEMS. CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FD - FLOW DIVERTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGENDJASMINE ROADSUE TAWN ESTATE, LOT 7 1"=50' MT 8/26/20 10050 0 FEET LITTLE PETERS CREEK 4-BDRM HOME EXISTING WELL ALTERNATE SITE ABANDON EXISTING ABSORPTION TRENCH.MT CO COCO CO MH FCO 2CO SV TH 660 655 SV 1,250 GALLON SEPTIC TANK w/20" MANWAY. DECOMMISSION EXISTING SEPTIC TANK PER U.P.C. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201318, Deb Wockenfuss, 08/26/20 SUE TAWN ESTATE, LOT 7 DESIGN FACTORS: SYSTEM REQUIREMENTS: 600 GPD PEAK FLOW PERK RATE: <1 MIN/IN APPLICATION RATE: 1.0 GPD/SF 5' WIDE TRENCH SYSTEM 1,250-GALLON SEPTIC TANK TYPICAL TRENCH SECTION (NO SCALE) NOTES: 1. GRADE AREA OVER TRENCH TO DRAIN AWAY 2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2' WITH 2" OF INSULATION 3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY BOTTOM OF TRENCH: 4.5' BELOW GRADE FLOW LINE ELEVATION: 4.0' BELOW GRADE TOP OF TRENCH: 0.5' ABOVE GRADE 600 GPD / 1.0 GPD/SF /5' WIDE * 1.0 (RED. FACTOR) = 120 LF TRENCH REQUIRED (120 LF SPECIFIED) 8/14/20 4" PERFORATED PVC (HOLES DOWN) DRAINFIELD ROCK 5' 6" ORIGINAL GROUND 6" MOA APPROVED SAND2'-0" 3'-6" 6" Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201318, Deb Wockenfuss, 08/26/20 LEGAL DESCRIPTION: PERFORMED FOR: DATE: PARCEL ID#: SOILS LOG AND PERCOLATION TEST TECHNICIAN: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 DEPTH (feet) PROJECT No.: TEST HOLE 1 SLOPE SLOPE SITE PLAN DATE READING GROSS TIME (minutes) NET TIME (minutes) DEPTH to WATER NET DROP PERC. HOLE DIA. (INCHES)PERCOLATION RATE: (MIN/INCH) TEST RUN BETWEEN: FT. and FT. COMMENTS: (inches)(inches) SUE TAWN ESTATES, LOT 7 8/4/20 J. MILLETTE DATE OF MONITORING: WAS GROUND WATER ENCOUNTERED? DEPTH TO WATER AFTER MONITORING: IF YES @ WHAT DEPTH? - <1 6 2 3 051-511-28 TROY DAVIS HOMES, INC. 9:25 --- 1 2 3 4 5 6 6/0 9:26 9:27 9:29 9:31 12:37 1' OB Professional Engineers Stamp: 8/14/20 <1 NO NONE 8/11/20 GP POORLY GRADED GRAVEL w/LARGE COBBLES 6 6/0<1 6 6/0<1 6 6/0<1 6 6/0<1 6 6/0<1 6 Percolation test measurements completed to 1/16" increments. Sand liner required. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201318, Deb Wockenfuss, 08/26/20 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 BEDROOMS Well ¢~ ~ l Absorption area ~ Liq.~gallons IF HOME'DE: Inside length Width Liquid depth , ~ Well Dwelling PERMIT NO. ~Oz DISTANCE TO: 0 ~ ~ Manufacturer Material Liquid capacity in gallons ~ Ne.DISTANCE TO:of lines ~'~Le%g~ o~ ~ 'ne ~' Total length *~g Distance b~ lines ~¢ Trenc~ wid~, inches Totten area ~ ~ ~ Top of til~o finish grade~ Length Widtfi Depth PERMIT NO. ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: a Class Depth Driller Distance to lot line PERMIT NO. ~ DISTANCE TO: ~uilding foundation Sewer line Septic tank Absorption area(s) OTHER (Rev. 3/78) HERLTH 8ND ENVIRONMENTBL~ROTECTION ~,25 ~ STREET., RNCHCR~GE RK. 99501 ~['l--S Z TE SEWER pERr'I Z T RPFLICRNT BILL RLTER PO BOX 796 E.R. 99577 694-9~b L,]GRL L7 SUETRWN ESTRTES LOT SIZE 999999 SQLIR~FEET T~PE OF SOIL RBSORPTION SYSTEM I_.'~' TRENCH MR~IMUM NUMBER OF BEDROOMS = 4 SOIL RRTING THE REBUIRED SIZE CIF THE 50IL 8BSORPTION ~LTEM~' ~ IS: ~, DeEP'TH= ti LE[4GTH= 25 ~]RR%¢EL E>EPTH= 7 THE LENGTH DIMENSION IS THE LENGTH <IN FEET> OF THE TRENCH OR DRRINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTRNCE BETWEEN THE SURFRCE OF THE GROUND RND THE BOTTOM OF THE EXCRVRTION <IN FEET>. THERE IS NO SET WIDTH FOR TRENCHES. THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFRLL PIPE RND THE BOTTOM OF THE EXCRVRTION (IN FEET>. REC4.1J 'r RED SEPT I C TRI'-.II-.-: $ I ZE= ::L250 GRLLOI'-IS PERMIT RPPLICRNT HRS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING THE INSTRLLRTION INSPECTIONS OF RNY WELLS RDJRCENT TO THIS PROPERTY RND THE NUMBER OF RESIDENCES THRT THE WELL WILL SERVE, TWO ( ~- ) I NSPEF:T I C~-~S RRE REC41J I RED BRCKFILLING OF RNY .~t_TEM WITHOUT FINRL INSPECTION RND RPPROVRL BY THIS DEPRRTMENT WILL BE SUB..TECT TO PROSECUTION. MINIMUM DISTRNCE BETWEEN R WELL RND RNY ON-SITE SEWRGE DISPOSRL SYSTEM IS ±00 FEET FOR R PRIVRTE WELL OR 150 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTRNCE FROM R PRIVRTE WELL TO R PRIVRTE SEWER LINE IS 25 FEET RND TO R COMMUNITY SEWER LINE IS 75 FEET· OTHER REQUIREMENTS MRY RPPLY. SPECIFICRTIONS RND CONSTRUCTION DIRGRRMS ~RE RVRILRBLE TO INSURE PROPER INSTRLL8TION. F"ERr.1 I T E,~.'F" I RES DECEMBER --~--i.- :1_982 I CERTIFY THRT ±: I RM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET FORTH BY THE MUNICIPRLITY OF RNCHORRGE. 2: I WILL INSTRLL THE SYSTEM IN RC:CORDRNCE WITH THE CODES. ~: I UNDERSTRND THRT THE ON-SITE SEWER SYSTEM MRY REBUIRE ENLRRGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THRN 4 BEDROOMS. ' RPPLICRNT BI~n RLTER ~~, O & E EN~NEERING & DEVELOCMENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster 694-2774 Performed for: Name: Mailing Address: Legal Description: Depth (feel) Earl Ellis SOIL LOG 688-2280 ,/~ ~-~- ,~ ~'~-~-/'~ __ . Tel. No. ~'T ~/~ Soil Characteristics 0 2__ 3__ 4__ 6__ 7__ 8__ 9__ PLOT PLAN 12__ 13__ 14__ 15 16__ Ground Water Encountered: Yes Proposed Installation: Seepage Pit Comments: ,,.] No ~ If yes, what depth Drain Field PERC. TEST Performed by: 0 &' E EL_~INEERING ~' DEVELO~M4ENT CO. Russell Oyster 694-2774 Civil Engineering Soils 8- Foundations Box 90, Davi~ St., Eagle River, Alaska 99577 694 2774 or 333 5240 Earl Ellis 333-5240 Surveying Land Development PERMIT NO. RPPLICRNT BILL RLTER BOX ?96 E.R. 99577 LOCRTION LEGRL L? SUE TRWN LOT SIZE 694-9t~0 999999 SQURRE FEET MINIMUM DISTRNCE BETWEEN R WELL RND RNY ON-SITE SEWRGE DISPOSRL SYSTEM IS ±00 FEET FOR R PRIVRTE WELL OR 150 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DIS]RNCE FROM R PRIVRTE WELL TO R PRIVRTE SEWER LINE IS 25 FEET RND TO R COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS RRE REQUIRED RND MUST BE RETURNED TO THE DEPRRTMENT WITHIN ~0 DRYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MRY RPPLY. SPECIFICRTIONS RND CONSTRUCTION DIRGRBMS RRE RVRILRBLE TO INSURE PROPER INSTRLLRTION. PER~'~ I T E,~'~ F' I RES DECEMBER I CERTIFY THRT t: I RM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET FORTH BV THE MUNICIPRLITY OF RNCHORRGE. 2: I WILL INSTRLL THE SYSTEM IN RCCORDRNCE WITH THE CODES. RFFLtCRNT BILL RLTER C/ / ~ ~ ..... .... V4. 0 DOC Co. dba P.O, BOX 272 CHUGIAK ALASKA 99567 o TELEPHONE688.2759 OWNER OF LAND _,/,~/ff& LEGAL DESCRI~ION DATE- Started _ ~'// PERMIT NUMBER DEPTH OF WELL ~ STATIC LEVEL OF WATER FT. .~)'.2 __ DRAW DOWN FT. GALS. PER HR ~'~ ,,.,d ~j KIND OF CASING (..[. -h~ , ' KIND OF FORMATION: From /~ Ft. to_ '~'~' Ft. __ ~-: c~,. ,*. o d,4 c ~,~:- *' ~-' From From~Ft. to Ft._ 'f<a ff ~ From.~ From ': Ft to ~',,? Ft. /72~4~;~fl, , -' ~ - -,, ~ . _ , . ~,~,~. ¢~A From From ~J From~ Ft. to ~Ft. From~Ft. to_ Ft. ~./ ,'~. ~ /~ _ / From~Ft. to~_Ft~ From Ft. to _Ft._ From Ft. to __Ft. From Ft. to Ft From Ft. to_ Ft From Ft. to Ft From Ft. to Ft. From Ft. to _Ft. From_ Ft. to Ft. From From From From From From __ From __ Frmn __ From __ Ft. to_ Ft. ta__ Ft. to___ Ft. to Ft. to Ft. to.__ Ft. to __ Ft. to~ Ft. to Ft. to Ft. to Ft. to Ft. to _Ft. t~ Ft. to __Ft. to Et. to_ Ft Ft. _Ft. Ft _Ft. _Ft. Ft. _ Ft. Ft _Ft. Ft. Ft_ MISCL. INFORMATION: DRILLER'S NAME APPLI(~IT FILLS OUT UPPER HAI%~::ONLY Property Owfler , ~.?'~j Z ~ ~ ~ Z ~ ~ , ~ Phone Realty Co. ~' A~n~ ~ / ' Phone Address Zip Code Legal Desoript[on / Type of Resi~nce Single Family ~Uultiple Family No. of Bedroo~ ~ Olher Water Supply ~ I.dividual ~ ~ ~ [~C~' A~ACH WELL LOG. A w~l log is required for all wells drilled since June 1975. ~ Community ~ ~ ~ For wells drilled prior to that date, give well depth (attach log if available). ~ Public Utility Sewer Oisposal ~ Public Utility ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSlNG CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspector Inspector Inspector ¢ 0 C'i' 2 0 1982 ,~ __ ~!,~ w~, to Tank Sept,c T,~k Si~e I ~ MUNICIPALITY OF ANCHORAGE Development Services Department Phone: (907)343-7904 On -Site Water & Wastewater Section Fax: (907)343-7997 Parcel ID 051 -511-28 Certificate of On -Site Systems Approval OSC251029 Expiration Date: 1/21/2026 Legal description SUETAWN ESTATE LT 7 Site address 18725 JASMINE RD Current property owner(s) BECERRIL COURTNEY L& X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for Comments or conditions: No comments bedrooms, with the following stipulations: By:/�, Original Certificate Date: 2/4/2025 This Ce ificate 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 Service 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 submittal. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other MUNICIPALITY OF ANCHORAGE D4;�� Development Services Department 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. 051 Complete legal description SUETAWN ESTATE LOT 7 Location (site address) 18725 JASMINE ROAD EAGLE RIVER, ALASKA 99577 Current property owner(s) COURTNEY & RICHARD BECERRIL Day phone 2. ON-SITE SYSTEMS SIZED FOR 4 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 4 - 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 $ Waiver Fee $ Date of Payment Z Z 02 Date of Payment COSA # 05('_2_5/009 Waiver # COSA Application.doc COSA Checklist.docx COSA Checklist Legal Description: SUETAWN ESTATE LOT 7 Parcel ID: 051-511-28 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA Well log is filed with Onsite (or attached) Date drilled August 1982 Total depth 49’ 10” ft Cased to 50 ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 36 in. Date of flow test for COSA 1/24/25 Static water level at beginning of test 23 ft. Well production at time of test 3+ gpm Water storage tank volume *300+ gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate 0.921 mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date 1/21/25 Comments *300+ gallon storage tank in crawlspace. B. TANK DATA Measured operating fluid level in septic tank 57” Date of pumping 1/22/25 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) 11/16/20 ALL standpipes present per record drawing Total measured depth from existing grade 8.8 ft (max) Measured depth to pipe invert from grade 5.3 ft (min) N/A – pressurized field. Per record drawings, field is insulated. 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 1/23/2025 date Any rejuvenation treatment (past 12 months) N If yes, enter date Adequacy test date 1/24/25 Results Pass Fluid depth prior to test 0 in Water added 600 gal New fluid depth 1 in Elapsed time 30 min Final fluid depth 0 in Absorption rate 600 gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) 6 in (MOA 0.5’ ED) Effective depth used 0 in (Final Fluid Depth) Effective depth (ED) remaining 6 in Comments/Deficiencies: Approximate total measured depths from existing grade. ED per elevation measured shots, visual observations, MOA records & appears approximate. 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) 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 2/3/2025 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 & 02/03/25 MUNICIPALITY OF ANCHORAGE Development Services Department �;W' �.. Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval 051-511-28 p q- 1. Parcel I.D. Ex iration Date: GENERAL INFORMATION Complete legal description Sue Tawn Estates, Lot 7 Location (site address) 18725 Jasmine Road Chugiak, AK Current property owner(s) Kourosh Partow Day phone (907) 310-2501 Mailing address Real estate agent 19507 Richner Road Chugiak, AK 99567 2. TYPE OF DWELLING: ❑■ Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Private Septic Q Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 75 Date of Payment 02 f Receipt Number nI q 2_1) COSA # OSC211019 Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this, application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm Forge Engineering Phone (907) 522-7773 Address 1399 W. 34th Ave Suite 101, Anchorage, AK 99503 Engineer's Printed Name Michael E. Anderson, P.E. Date 1/15/21 z 831 IA-1Sb'M BOriginal Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet .�®�� q� ®ago ................... a' 49th 6. DSD SIGNATURE +It. .0IT 3 C 0................................................_... ®d7�MhilCHAEL System #1 Approved for bedrooms E. ANDERSON 8 System #2 Approved for % No. CE -4381 �•' ' bedrooms e sT=.. ,.• �: ®®4a®®4 Disapproved 1/15/21 .• PROFCSS\C 11W ®11'0aa®a®®' Conditional approval for bedrooms, with the following stipulations: WH4nnu, z 831 IA-1Sb'M BOriginal Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet Legal Description: Sue Tawn Estates, Lot 7 If more than 1 septic system on lot: COSA Checklist # A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled August 1982 Total depth 50 ft Cased to 50 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) '18 in. Date of flow test for COSA 1/5/21 Parcel ID: 051-511-28 of Structure served by this system Well production at time of test 2.5* gpm Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes ❑ N ❑ Coliform bacteria is Negative Nitrate 0.028 mg/L ❑ Nitrate less than MRL (ND) Arsenic 0.31 ug/L ❑ Arsenic less than MRL (ND) Collected by Wheaton Water Wells Date of Sample 12/14/20 Static water level at beginning of test 23 ft. Comments *Well testing completed by Wheaton Water Wells B. TANK DATA Age of tank(s) <1 years Tank type/material Septic/Plastic Measured operating fluid level in septic tank New ❑ Standpipes/foundation cleanout per record drawing Date of pumping Tank placed 10/24/20. D. ABSORPTION FIELD DATA 5' Wide Shallow Trenches Which system tested (date installed) 11/16/20 IN ALL standpipes present per record drawing Total measured depth from grade 7.2/6.7 ft (max) Measured depth to pipe invert from grade 6.76.2 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Septic System is gravity flow. Adequacy test date New Construction Results [] Pass For bedrooms Fluid depth prior to test in Water added gal New depth in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) If yes, enter date Absorption Trenches constructed 11/16/20. E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ❑✓ Yes Community Sewer Manhole/Cleanout > 100' Q Yes if No ft Q Yes if No ft Neighboring Tank > 100' F/� Yes if No ft Private Sewer/Septic Line > 25' 0 Yes if No ft Absorption Field on Lot > 100' F/� Yes if No ft Holding Tank > 100' Fv� Yes if No ft Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' R Yes if No ft 0 Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' F/1 Yes if No ft 0 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' F✓ Yes if No ft Surface Water > 100' ®✓ Yes if No ft Property Line > 5' ❑✓ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' [✓ Yes if No ft Private Wells > 100' 0✓ Yes if No _ Water Main > 10' ✓V Yes if No ft Community Wells > 200' Q✓ Yes if No _ Water Service Line > 10' M✓ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' Q✓ Yes if No ft If absorption field is under driveway comment below Property Line > 10' 0 Yes if No ft Wells on Adjacent Lots: Water Main > 10' F.71 Yes if No ft Private Wells > 100' U Yes if No Water Service Line > 10' 0 Yes if No ft Community Wells > 200' U Yes if No Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. COSA Checklist yellow sheet ��E�OF 49th - 1 ........ .....14 ....... .92.,...........,..... i o MICHAEL E. ANDERSON No. CE -4381 1/21/20 ft �I ft ft << a=o o_w m N 00'05'W 150.00' 0 ri n JASMINE ROAD M q �o t 0 q+ m m w ««ten t rmn C m fl 0 0« O a I n 0, o o s 0 `a `c'�o `o a m o:cc �I mo u ao o c o I m vq E«`m—°qm s omgo ++ C m � C 'n n ° 02 waavo�x 9 O m m O t i � 3 « oaw°nOm -da---ON n «y+T'g.o -I =� I at Lv�izo.Eco no « o > ® q e�LtEEm +c m 4 3 c M. o " 00 N 00'05'W 150.00' 0 ri n JASMINE ROAD M q �o t 0 q+ m m o m a o En ««ten t rmn C m fl 0 0« O a I n 0, o o s 0 `a `c'�o `o I o m o:cc �I mo u ao o c o I m vq E«`m—°qm s omgo ++ C m � C 'n n ° 02 waavo�x 9 O m m O t i � 3 « oaw°nOm -da---ON n «y+T'g.o -I =� I at Lv�izo.Eco no « o > ® q e�LtEEm +c m 4 3 c M. o " 00