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HomeMy WebLinkAboutOLSON HEIGHTS BLK 1 LT 5Olson Heights Block 1 Lot 5 #018-231-06 / el Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program, 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 Page /'Of 'L www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: 006 PID Number: 61 ed — 231 —_0 b Name: j -e f t 454 r t Wastewater System: ❑ New ;qUpgrade Address. `(1401 E'l3S- 4 ABSORPTION FIELD Phone: Number of Bedrooms: Deep Trench D Shallow bench [I Betl ❑ MOuntl ❑Other' LEGAL DESCRIPTION Soil Rating: / �f Total Depth from original grade. (! v GPD/FF Ft. Block: Lot: Subdivision: // Depth to pipe bottom from original grade: Gmvel depth beneath pipe: �• 1 d`( wT D Ft. Ft. Township: Range: Section: Fill added above original grade: Z O Gravel Length: 2- Ft. Ft. Well: L-1New El Upgrade Gravel width. ZIP Number of lines: / Distance between lines: Ft. _-- Ft Classification (Private, A, B, C): Total Depth: Cased to: Total absorption area: Pipe Material: F[. 5 D�{ Ft' 1 (% 3 Driller: DateStatic Water Level: Installer: Data Installed f Ft. M(k-e . 1'I- C* O`d Yield. Pump Set at. Casing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES eptic ❑ Holding ❑ S.T.E.P. ❑ Other: To Septic Absorption Lift Holding Private Manufacturer Capacity. From Tank Field Station Tank Sewer Line A kA e l(,� 2 4qyGal. WHI !00 `'1' 102 1 L/// /` /r ty ' ` CD J MaterialT e( Number of Compartments: Surfacewawr (0011 T 10`0 f/ 1` LIFT STATION Lot Line 2D4. 1 2 S f sae Gel. Manufacturer Foundation 11 T 5 � 1� 'Pump on' level at: in. "Pump oft" level at: in. High water alarm at: in. Curtain Drainr,(4 J Pump Make 8 Ma Electrical Inspections performed by: ' Remarks. BENCH MARK elio v r A 1, z d v ry to Location and Description: rWcc 51to Assumed Elevation. /v0 Ft. Inspections performed by: 4&9t41 c, d,4 � -r'+14 Dates: 1s' P'L G o4= �0 F A����� 2nd /2 b 0� S���d y�P.•••..... Development Services Department Approval Conditional Approval Date: ......... MICHAEL N. ANDERSCN•:Q CE -9469 Reviewed and approved b pp yP Date: � Fjl .. t'}\X �@ �GfESatt V (Rev_0410O / el Permit No. SW080249 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description: OLSON HEIGHTS SUBD. BILK 1, LOT 5 PID No.: 018-231-06 MARK A B GRND. PIPE ELEV. ELEV. 14 35 103.2 99.1 FCO 01 18 49 103.2 99. 0.l — 20 50 103.8 TCO2 25 53 103.8 CO2 27 54 104 97 CO3 28 55_ 104 97 _ C04 45 85 104.5 96.5 — — — — — MT1 55 74 104.8 -------------- ------------ II II 1 1 � II I C01 I I — — ,_ I \ i 41i i I I oICO2 C1D1 ` TC01 B / II / CO TOP F SLAB jBENCH, \\ A B I \\ \ / / SCALE: "=40' \ io].z Fco cm TCOI rTcoz +oaT + c$ ........•' +a .a I coz co] coa Mn s' sz cps z �� .. 7 •♦� % r FILL ON j BLTER FQRC •u }•.... 99., R o 1.259 GALLON 1XIF_TANN 99.5 nea wR ,.,,�R.,^.n•..... • •0 •• 1�` �MICHAEL •N. ANDERSON 9 ].5 No. CE 9469• ♦♦ �� .. •............. ••, •'•,• • SERIC N SECTIO N.T.S. tSS\':.••� 9s.2 L♦f��t',�-h MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water b Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Nov 19, 2008 Expiration Date: Nov 19, 2009 Permit Number: SWO80249 Parcel ID: 018-231-06 Legal Description: OLSON HEIGHTS BLK 1 LT 5 Design Engineer: 0088 ANDERSON CONSTRUCTION & E Site Address: 004401 135TH AVE E Owner Name: TERRY STELLINGS Lot Size: 49480 SO. FT. Owner Address: 4401 E 135TH AVENUE Total Bedrooms: 3 Permit Bedrooms: 3 ANCHORAGE. AK 99516 - This permit is for the construction of: ❑-1 Disposal Field ❑,/ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ 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 engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-7904 ( 24 hours). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Date: ? e - IssuedBy: dallul /(&LIA77 Date: Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, Alaska 99507 www.muni.org/onsite (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 0( Z P? ( C) 6 Property owner(s) 1 T'P Day phone 3ti5— 33� Mailing address �}c1�1 JZJ5j h f 1VG A/Q _Zip Code '90tJlZO Site address Zip Code Legal description (Sub'd., Block & Lot) 1 Legal description (Township, Range & Section) 01 50fl t t t IC -,NTS ) i LCs Lot Size 4AZi Sq. Ft. THIS APPLICATION IS FOR (® all that apply): Absorption Field lT Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Number of Bedrooms 3 THIS APPLICATION IS AN: Initial ❑ Upgrade Renewal ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Receipt Number. I iA 0 y�f_ Receipt Number. (Rev. 11/05) Michael N. Anderson, P.E. Civil/Structural Engineering R Construction 4661 Natrona Avenue Anchorage, Alaska 99516 Phone 345-3377 Fax 345-1391 Sept. 10, 2008 Municipalities of Anchorage Departments of Ilcalth and I luman Services P.O. Dox 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 Re: Olson Heights Blk 1, Lot 5, Tax ID 018-231-06 To Whom it may concern: This is a request for a new septic permit on the above lot. The lot size is 1.1 acres, which is typical for the area. The test hole excavation revealed poorly graded sand (SP) with small layer of silt, for the entire depth of 17 feet, with no water observed after the 7 day monitoring period. The perc rate was 2 minutes per inch at —4 feet, in the sand. An application rate of 1.2 was used for the design due to the old system. The current permit is for a 3 bedroom system, this permit is for a 4 bedroom system. The additional secondary trench has been shown with lots of room for future upgrades. All of the lot has a gentle slope of about 3 to 5 percent from the north to the south, as shown on the plan. The neighboring lots will not be impacted by this new septic system due to the large neighboring lot sizes. If you have any question please call me at 345-3377 Sincerely Michael N. Anderson, P.E. •l_ DESIGN CRITERIA: MOUND OVER GRADE (THJ1) 0 4 BDRM X 150 = 600 GPD 10 ORG SOILS = 600/1.2 = 500 GPD FILTER FABRIC 4'm PIPE 500 GA/12 = 42.0 -5.0 2' OF DRAIN ROCK SP MOA DRAIN ROCK (1) TRENCH 12.0' DEEP 6.0' EFFECTIVE 2.0' WIDE 42' LONG 17 -11.0 2.0' I \ ' i /EXISTING SEPTIC (EXISTING (E ("' EXISTING SEPTIC \ SYSTEM ' _-- 1-1 — — — -------- PROPERTY LINE W/ T&E EASEMENT — — — — — — — — — — — — — — — — — - — — — — — ----------------- ------tOT-4----) r---tOrT-5------tOT-6---1 r_---tOT'7— (BLOCK 1) 1) SECONDARY (BLOCK 1) I I (BLOCK 1) I I O(BLOCK -� SYSTEM PROPOSED DRAINFIELD i �`\I ( I I I EXISTING SEPTIC EXISTIN NFIELD \ 1 ------,\�-/ SYSTEM EXISTING EPTIC TO REMAIN SYSTEM �I - . ,'' `� �� `___ ��� �` EXISTING WELL. 1L EXISTING SEPTIC TANK I i '7�-PROPOSED 1250 GALLON ` RADIUS - TYPICAL TO BE ABANDONED _ SEPTIC TANK I I ' EXISTING HOUSE WELL j 1 • WEL \ � i `.� EXISTING WELL %`'� _ E A S T 1 3 5 T H A V E N U E- -,___. 100' RADIUS) LOT 4 (BLOCK 2) LOT 5 (BLOCK 2) LOT 6 (BLOCK 2) LOT 7 (BLOCK 2) Septic Design Prepared For..���� 4♦•♦ TERRY STELLINGS . P �i OLSON HEIGHTS, BLOCK 1, LOT 5 : �� ' Anchorage, Alaska; 49TM .........::..... "" Prepared By MICHAEL N. ANDERSON, P.E. . k 4640 SIIOSIIONI DRIVE (907) 345-3377 / FAX (907) 345-1391 j . �'E OERSON = : N �i.. r;/, E/9,4/69 a5?: •... SCALE: 1"=100' OCTOBER 31, 2008 4����i �551�•'. �1 i I I I I I I I I I I I ------------STs------------- r- GREEN HOUSE 1 GO I MT T 1 I ' I � � `CO i Ii EXISTING GRAINFIELD TO BE RETAINED EXISTING SEPTIC TANK TO BE ABANDONED, J#� I `#J I ' I I I I I , I �• I � � n : EXISTING EXISTING 4 BEDROOM HOUSE i i i n DOUBLE CO i � PROPOSED 1.250 GALLON SEPTIC TANK : DOUBLE CO Septic Design Prepared For TERRY STELLINGS OLSON HEIGHTS, BLOCK 1, LOT 5 Anchorage, Alaska Prepared By MICHAEL N. ANDERSON, P.E. 4640 SHOSIIONI DRIVE (907) 345-3377 / FAX (907) 345-1391 SCALE: 1"=30' OCTOBER 31, 2008 —LOT -6— — — — —� PROPERTY LINE WELL .�.,• �.4 {s 49 R �.y.........[� .... . ,T\ °. MICHAEL N. ANDERSON: µ �n'•._ No. CE 9469 wL�R•s Municipality of Anchorage S .,. Ilf Development Services Department y: y BuldingSafetYDivision *• 49TN ,fit �� y� On -Site Water and Wastewater Program .. :. y.. a ..... a ... 4700 South Bragaw SL J� P.O. Box 796650 Anchorage. AK 99519-6650 ....... r www cianchorace.ak.us -jO • MICHAEL N.ANOLRSON ; 2' oo (907) s� • a / 9 Soils L'o'g - Percolation Test ,I it. '�'�"''kN Performed For. T -C i! S g�t�'^/c �+ __ Date Per'ornM:� +d Legal Description: L r -ib ��<+n 7'`ir� R F S Township, Range. Section: Site Plan 2- 3- 4- 5- 6- 7- 8- 9- 10- 11- 12- 14- 15- 16- 17• 19- rJ�SA.,,c S sr,V%j C7ee10c� s WAS GROUND WATER D ENCOUNTERED? S IF YES, AT WHAT DEPTH LC Depth to Water After __II p 6rl lontioring? ,*, E Date: 9 4 O Readng Dale Gross Time Net Tlme Depth Id Water Net Drop oif P, rfcvL 9ti. v* Lf H 4 S ,. Ye L PERCOLATION RATE 71 1r 11,, fit PERC HOLE DIAMETER TEST RUNBc i NEEM JY FT AND r FT COMMENTS Ise-if 4 0e !r t A t CERTIFY THAT THIS TEST WAS PERFORMED BY: %C Aga e•�VA — Y bloV PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 2.64-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/013 WELL INSPECTION REPORT NAME MAILING ADDRESS , N -A �0 PHONE 1VEW P_ UPGRADE LEGAL DESCRIPTION L LOCATION _ Well Absorption rea Dwelling FDISTANCE TO: fj r L F- z r Material Lu to N in gallons Inside length Width � IF HOMEMADE: NO. OF BEDROO S PERMIT NO. No. of compartments Liquid depth ®C7Z DISTANCE TO: Well Dwelling PERMIT NO. Z T 2F 4 Manufacturer Material Liquid capacity in gallons 0 w= DISTANCE TO: Well _�(�� ( Foundation f "1 Nearest lot line PERMIT NO. Lu ¢. Z N z cc No. of lines Length of each line Total len th of lines .� . Trench width (© inches Distance between lines cch p Top of tile to finish gradef 'y 4'« S Material beneath the inches Total effective absorption area ,S ")S IL C7 Length Width v Depth PERMIT NO. 4 r cL— Lu a Type of crib Crib diameter Crib depth Total effective absorption area y DISTANCE TO: Well Building foundation Nearest lot line J J Class Depth Driller Distance to lot line PERMIT NO. W DISTANCE T0: Building foundation Sewer line Septic tank Absorption area(s) OTHER LEGAL PIPE MATERIALS F ,� SOIL TEST RATING INSTALLER 0 REMARKS 4_1 b Z LLL I APPROVED DATE ��� r ;3L) DEPARTMENT OF HEALTH AND ENVIRONMENTAL. PROTECTION 825 ' L ' STREET, ANCHORAGE, AK. 99501 WEER—L- -, 264--4720 W EES IT.. R_- 1=4r.-40 � P-,1-4• x -F E PERMIT NO. { 790314 ) 11cf APPLICANT ED HERZOG 242.8 EAST ;BOTH AVE 277 7 A 166 LOCATION 135TH AVE LEGAL L5 H:2, 01 -SEN HTS: LCAT SIZE 50000 SQUARE FEET TYPE OF SOIL ABSORE:T I ON SYSTEM I S : TRENCH MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING CSG FT/BR) •= 125 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: UC E— F:'eT'G`-'J=- --1;2 I_IE_:'P-403`rM =- -4 m3A1;,�'iFO FE I— V::)[FEE F:�" VHS a THE LENGTH DIMENSION I S THE LENGTH (,'IN FEET) OF THE TRENCH OR DRA I NF I ELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE:: BETWEEN THE SURFACE OF THE GROUND AND THE OOTTOM OF THE EXCAVATION <IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE; GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL. PIPE AND THE BOTTOM OF THE EXCAVATION CIN FEET). F?.' IEE 0:A i.J X ER Ems-' r:'m :R� E= F =" `N"' TC or,:: -" n"�= `: X :2! V" - -- :'L 0-9 i CA IL- L_ "_ V A:E-�- PERMIT APDL I CANT HAS THE: RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE;: INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE; WELL. WILL SERVE. < F, R OACKF I LL I NG OF ANY SYSTEM Ed I THOUT FINAL INSPE:.'C:TION AND APPROVAL BY THIS DEPARTMENT NILE.. BE: SUBJECT 'TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE=; DISPOSAL SYSTEM IS. 100 FEET FOR A PRIVATE WELL., OR :1"50 TO 200 FEET FROM A PUBLIC: WELL. DEPENDING UPON THE 'TYPE OF PUBLIC WELL. NE:LL LOGS ARE; REQUIRED AND MUST BE RETURNED TO THE: DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARF. AVAILABLE TO INSURE PROPER INSTALLATION. F-°E�'"Ems„M X -IF EEXF� TC F-'4.* E L --a C-.EEmFrF E;., ­.tl S I CERTIFY THAT 9.: I AM FAMILIAR WITH THE REQUIREMENTS FOR (IN -SITE SEWERS AND WEE._LS AS SEAT FORTH BY THE MUNICIPALITY OF ANC:HORACiE.. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES, <': I UNDERSTAND THAT THE;. ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE: RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. SIGNED: --m-a __r � C"�QLl. '_����. APPLICANT ESD V :. F ISSUED BY Lam' SOILS LOG /- MUNICIPALITY OF ANCHORAGE / DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION El PERCOLATION TEST Pouch 6650, Anchorage, Alaska 99502 276.2221 -- /SOILS LOG - PERCOLATION TEST 7 PERFORMED FOR: `� DATE PERFORMED: LEGAL DESCRIPTION: SLOPE SITE PLAN DEPTH ( (FEET) 2 / 1I — - i /l 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS 5ctir)C-ly C- ,/ c J7U WAS GROUND WATER J `� 6 _ _ 1 1 ENCOUNTERED? O E r� IF YES, AT WHAT DEPTH? Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE TEST RUN BETWEEN 4, PERFORMED BY:`--- O.:5174' .574' CERTIFIED BY: 72-008 (7/76) (minutes/inch) FT AND FT ) f1 Uaoys DATE: (G� I UNICIPAI_ITY OF ANCHORAGE ® POUCI )0 • ANCHORAGE, AK 99502. • PHONE 2L J0 FINANCE. DEPARTMENT CASH RECEIPT No. 035463 RECEIVED / % f� FROM..—� _I.zl�,--€<�..-.td-.SS_._ �d�t-...—.--- DATE ADDRESS— AMOUNT�/ I ,�.; .t-rl�'di,_ r7 : _f.J '( .;i.;t ./€ �.["i., $^ -491 REMARKS E;(-.RIPTIQu prg/CC-. Acct/Obj -- Task Option Cost Center, tc r,WA/WO -77 B - Amount - r --.-L- Ji U- Colfecting Orgn. No 40-007 (Rev. 8;76) DISTRI BUT I ON: White - Treasury; Yellow — Customer; Pink -- Book; Goldenrod — Department Mf ■ M -W DRILLING, Inc. P. O. Box 4-1224'• 1310C International Airport Road (907) 274-4611 ANCHORAGE, ALASKA 99509 DRILLING LAG Well Owner j", Use of Well Location (address of: Township, Range, Section, if known; or distance main road r �,i. _).iCSC:� ri1SFJ-il 7.e1-, 11 f�.^-. '•1°; c:.� L�RCLiB2' ,,— Size of casing Depth of Hole Static water level ft. :666746) Screen ( ); Perforated Describe screen or perforation Well pumping test at gallons, per. of drawdown from static level. 1,1 Date of completion ?U/' Feet Cased to A 7 feet land surface. Finish of well (check one) open end (minute) for hours with 1:�10' ft. WELL LOG Depth in feet from ground surface Give 44iils of formations penetrated, size of material, color and hardness TO 1 ` Cas ai ckun -in TO Ciayey gavel: TO a`> CLI. "_e,Ables: Qravelly. 1Z _ TO 0 Clayey eobLles: r1vclly TO ': WetravaZly clan - TO l '.> Clay: grauel.ly TO ' Red eZaw, , azandv, gravely, sf,p r, _ rM 7-19 Watcg -s and and gravel' TO TO 3 —CONTRACTOR 5. LEGAL DESCRIPTION DATE RE IVED INSPECTION APPOINTMENTS TIME TIME TIME G L E FAMILY ❑ Two ❑ Five ❑ MULT L'E FAMILY ❑ Three ❑ Six 7. WATERR�IN Y -- -- -- DATE * ATTACH WELL LOG. A well log is required for all wells drilled DATE DATE ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOS SYSTEM s -�--� INSPECTOh 1 /_YEAR ON-SITE SYSTEM WAS INSTALLED. INSPECTOR INSPECTOR NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. — WITI�TY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPT.. OF HEALTH & DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECftWONMENTAL-PROTECTION 825 L Street - Anchorage, Alaska 99501 - o OCT 12 1979 ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 R� j ` REQUEST F013 APPROVAL OF INDIVIDUAL WATER AND SEWER FARC L � DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER - - PHONE - MAILING ADDRES PROPERTY RESIDENT (If different from above) f PHONE 2. BUYER - - PHONE MAI LING ADDRESS 3. LENDING INSTITUTION _ yl OPHONE MAILING ADDRESS --- 4. REALTOR/AGENT PHONE MAILING ADDRESS - - - - - - 5. LEGAL DESCRIPTION STREET LOCATION C 6. TYPE OF RESIDENCE NUMBER OF�BEDROOM r - G L E FAMILY ❑ One C� Four ❑ Other__ ❑ Two ❑ Five ❑ MULT L'E FAMILY ❑ Three ❑ Six 7. WATERR�IN Y -- -- -- ❑ INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975, For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOS SYSTEM s -�--� INDIVIDUAL/ON-SITE** /_YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER ❑SepticTan or ❑ Holding Tank n nIf Tank is homemade Size: J give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS lt�' APPROVED FOR �_ BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE 7�-?c Parcel I.D. 018-231-06 �f �v Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Expiration Date: V —.2 1' C �^ Complete legal description Olson Heights, Block 1, Lot 5 Location (site address) 4401 East 135th Avenue Anchorage, AK 99516 Current Property owner(s) Terry and Maureen Stallings Day phone Mailing address Real Estate Agent 4401 East 135th Avenue Anchroage, AK 99516 Day phone 2. TYPE OF DWELLING: x❑ Single Family (w/wo ADU) ❑ Duplex rr, F-1:_> Multiple Dwellings (Single Family and/or Duplex) COSA Fee $ G 2v j Waiver Fee $ Date of Payment�� (1 Date of Payment Receipt Number h ��Gi �l �n Receipt Number COSA# ��� I ��Waiver# AUC 1 2 2014,. 3. NUMBER OF BEDROOMS: Four 4. TYPE OF WATER SUPPLY: TYPE OF, WAS TE WATER; DISPOSAL: Individual Well 0 Individual i ` Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public ?Nater System ❑ Piub1 is.S_eew ❑ WaiverNariance request for: Distance: Received by: C- 2 Date: COSA to be release to the engineer, unless otherwise requested by the engineer. COSA Fee $ G 2v j Waiver Fee $ Date of Payment�� (1 Date of Payment Receipt Number h ��Gi �l �n Receipt Number COSA# ��� I ��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. Name of Firm Anderson Engineering Address P.O. Box 240773 Anchorage, AK 99524 Engineers Printed Name Michael E. Anderson, P.E. 6. DSD SIGNATURE — z System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for Phone 522-7773 , Pate bedrooms, with the following stipulations: By: / z 4 Original Certificate Date: The un, ali chorage 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 forerrors 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 bluesheet r'- L c If more than 1 septic system is on the lot: COSA Checklist # of _ Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: Olsen Heights, Block 1, Lot 5 Parcel ID: 018-231-06 A. WELL DATA Well type Private If A, B, or C provide PWSID # Date completed 9/7/78 Sanitary seal (Y/N) Y Total depth 178 ft. Cased to 178 ft. FROM WELL LOG Date of test 9/7/78 Static water level 40 ft. Well production WATER SAMPLE RESULTS 0 Well Log (Y/N) Y Wires properly protected (YIN) Y Casing height (above ground) >18 in. AT INSPECTION 8/18/14 41.6 ft 6.2 9-P M. Coliform 0 colonies/100 mL Nitrate 4.01 mg/L Arsenic ND ug/L Date of sample: 8/6/14 Collected by: Anderson Engrg. B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Tank size 1,250 gal. Number of Compartments 2 Foundation cleanout (Y/N) _ Date of pumping 8/22/14 Y Date installed 12/6/08 Cleanouts(Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) Pumper Around the Clock Pumping N C. ABSORPTION FIELD DATA Date installed 12/6/08 Soil rating (g.p.d./fie or ft2/bdrm) 1.2 GPD/SF System type Deep Length 42 ft. Width 2 ft. Gravel below pipe 6 ft. Total depth 8-9 ft. Eff. absorption area 504 ft2 Monitoring tube Y Depression over field N Date of adequacy test $/18114 Results (Pass/Fail) Pass For 4 bedrooms Fluid depth in absorption field before test 45 in. Water added -61 9 gal. New depth 54 in. Elapsed Time: 1,440 min. Final fluid depth 45 in. Absorption rate >= 600 g p d Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed _ "Pump on" level at Datum No Add On Manhole - Gravity Flow to Absorption Trench. Ii E. SEPARATION DISTANCES WELL ON LOT TO: Size in gallons "Pump off' level at in. Cycles tested Manhole/Access (YIN) High water alarm level at in. Meets alarm & circuit requirements? Septic tank/lift station on lot On adjacent lots 100' Absorption field on lot > 100 On adjacent lots > 100' Public sewer main N/A Public sewer manhole/cleanout N/A Sewer /septic service line >25' Holding tank N/A Animal containment areas >50 Manure/animal excrete storage areas _> 100' SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5 Property line >5 Water main >10 Waterseiviceline. >10 Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO: Property line —>1 00 ____ Building foundation >10' Water Service line >10' Surface water >100' Curtain drain None Noted Wells on adjacent lots _> 100' F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that l 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. Engineer's Printed Name Michael E. Anderson, P.E. Date 8/22/14 COSA brown sheet 10-10-12.doc Absorption field >5 Surface water >100' Water main N/A Driveway, parking/vehicle storage > 10' `%%,'4, s i r % eP��:®F •q ea: 41.t E AXIM60N: W p s 4381 1 ■ ■ 8402E McCabe West Subd, Lot 3 McCabe Subd. Lot 5 Lot 3 N890SW11"F 1R';nn Lot 4 C N89053'00"E 165.00 Q 0 co m SCALE: V= 30' EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON. E, 135th Avenue OF q�Asipp ,0* : 49th s' # 00 .00 '.Fred Walatka. per B` % • 3255-S • .,g7 1p ��SSIONAL. � PR 161. nn 7'2-W Lot 6 i AS -BUILT NO CORNERS SET THIS DATE 1 hereby certify that I have performed a Mortgagee's inspection of the following described property: LOT 5 BLOCK 1 _QLSON HEIGHTS SUBDIVISION Anchorage Recording District, Alaska, and that the Improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska this 25th day of August ,2014. FRED WALATKA & ASSOCIATES Engineers and Surveyors MEMORANDUM DATE: August 29, 2014 TO: Jeff Poet n FROM: Mike Anderson, P,E. Z -IL SUBJECT: Olsen Heights, Block 1, Lot 5 Conditional Certificate of On Site System Approval The Inspection report for the septic system on this property indicates it has a 1,250 gallon septic tank and a 42' long x 6' effective depth absorption trench for a total effective area of 502 square feet. The soil is rated at 1.2 square feet per bedroom. The total area required for four bedrooms is therefore 500 square feet. This septic system exceeds the requirements for a four bedroom home.