HomeMy WebLinkAboutOVERLOOK ESTATES BLK 2 LT 6
Permit Number:OSP251418
Tax Code Number:06804112000
Work Type:SepticTank Upgrade
Effective Date:
Design Engineer:
Site Legal Address:OVERLOOK ESTATES BLK 2 LT 6 G:0465
Owner:JAKUBCZAK RAYMOND S &
Site Mailing Address:27531 PARAMOUNT DR, Eagle River
Lot Size in Sq Ft:76615
Total Bedrooms:4
This permit is for the construction of:
Disposal Field Septic Tank Holding Tank Privy
Non-Public
Water 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. Coodinate with On-Site staff regarding preferred method.
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
11/19/2025
11/19/2026
Expiration Date:
¨þ ¨¨¨¨
Issued To:
Issued By:
Date:
Date:
11/19/2025
11/19/2025Isatou B Njie
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 Wastewater Disposal System Permit
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP251418, Isatou Njie, 11/19/25
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP251418, Isatou Njie, 11/19/25
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP251418, Isatou Njie, 11/19/25
LEGEND
UTILITY PEDESTAL
DECK
EDGE OF ASPHALT
RECORD DATA PER PLAT #84-287
SEPTIC PIPE
WELL
1 0.9'
4
.
0
'
1 5 .6 '
2
8
.
2
'
1 6 .4 '
2
.
0
'
1 9 .4 '
2
.
0
'1 6 .4 '
2
8
.
2
'
1 5 .6 '
4
.
0
'1 0 .9 '
R E S I D E N C ECANT.
TIMBERLINE SURVEYING AND MAPPING
17035 BARONOFF AVE
EAGLE RIVER, AK 99577
907-242-5320
ryan@timberlinealaska.com
FILE NO.: 25.246
SCALE: 1" = 40 FEET
DATE: 11/11/2025
SHEET: 1 of 1
MOA GRID: SW0465
SCALE: 1" = 40 FEET(11"x17")
40'0' 80'
AS-BUILT OF:
ADDRESS: 27531 PARAMOUNT DR, EAGLE RIVER, AK
LOCATED IN: ANCHORAGE RECORDING DISTRICT
LOT 6, BLOCK 2OVERLOOK ESTATESPLAT #84-287
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Environmental Health Division
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Address
Phone(s) P'ermit N'om No of Bedrooms
Township, R~ge, 8ectio~
TANKS
~ SEPTIC [] HOLDING
Manulacturer Capacity in gallons
DISTANCES L~b ?- 0~//~/;~
SEPTIC
TANK
WELL
LOT LINE
FOUNDATION
ADSORPTION
FIELD WELL
AS-BUILT DIAGRAM (Show Iocahon of well, seplic system, property hnes. foundahon,
driveway, water bodies, etc.]
Compadments
s;T'E F_L
TYPE OF SYSTEM
~ BED [] W. DRAIN [] OTHER
TRENCH
Depth to pipe bottom from
original grade /~ I
Fill added above original grade
Gravellength
Total depth lrom original grade
iravel depth beneath pipe
FT ~J
~ravel w~dth
ET /(d~'
Total absorphon area j Distance between lines
· WELLS
/~PRIVATE
Class,flcaUon (A,B.C)
[] OTHER (Identifv)
Total Depth FT Cased to
Date Installed:
REMARKS:
FT
FT
FT
FT
FT
Municipal and State guidelines in effect on this date: ~//7 / ('~' /
Health Department Approval:,~'~ ~
certily that this inspeclion was pedormed according to all
Date: '/--.__,_~
72-013 (3/85)
F:'EI':;'.H ]: T' Ei: X F:' ]: [;,'l!!i~i DECEME!EF:~: :31 ~ 1990 ,,
ND"I' :I: I::'¥ .Ol'..IH::ii~ (IF: ]: N~:~F:'I!i!X]:T I C)N!B A,T :];4-:3-.4'7~-4, Cf!::;: :];z,[:];-4.6~i 1 ,,
E×C('~'v'AT):C)Iq I"ILJ!~F'I' BE:: OF'E:I',II~i:D P,N.'O CI....C)!i~;.',CD ON SAME
F:'RC)V:i:OE: I~.Jl:ii:l....L.. I..Ol:':) F:OR li~:XI!TI]:NE';N,EI_L. CH',!
,i: CEI::;,"i" ]: !::'Y 'i"HW!':
',!.. ]: ~:~n'! fa'~mi],i,::~p !,~;it.h t.h~.',~ i:~:~qL-'.:Lr'e:'l¥ie)i-.'t.s~ (or~ c:,n-'~;i'Le:, ~,:~,'~(,;:,~'~; arid
2. :I: ~:i.:l.:!.:in~;irl:.al:t. t.l'ls~ ~;;;y~;~-t.~.'..:~rn in ac:c:cmdanc:e:-~ v,~:i.'Lh all I"ICIF~ c::c~ds~s
.:::~.r"~cl il"i c::ch"np ! :i.~tru::e v~it.h the design cv it. er'. :i.;.;~ o[ 'i'..]"iJ.~
.:;.;~, :i: v~i].:l,au::lh~.:..~i~e) t.o a':t].! l't(::ir~ .;:zr'icl St.a'~t.e:.::, c)f (:~14;tusl.;:a r~[~qu:i, rs~m~z(,r"rL~;~, ic:m t.l"~;,:~ ~x.~d:. ~::,~:;~::[::
d :i. st.;~:u'tc:~::,~,~, f' r.(::*m a.n'./ ~z:n-~ i~st'. :Lng ,,~,:1. ]., wasst.~:~v~¢:*.t:.c<,r' d:i. sl::,os¢~! s'y:~;t.~:~,n'i c)r' i:)~.d:i ]. ic:
!B(.gVx~E.:q'" ~F~i.::J(..~e !i:~-')~!~i'~'..i;:~ffl Of'i t.h i ~B c)r' ~F:d"~w ~e*cJ.j a~.C:i.Z.)I'Y~'., tip Iq~alP~:)'~ ]. or.,
z!.,, I unch.zm~a'L~ar'tcl 'i'..ha?cL t. hi~is per. mit. j.~ v~a].id [cir' a~ matx:i, mum c:,f 4
/
dOTE: i
All Dimensions And Locations
Bust Be FieZd Verified Prior ~o Construction
SEWER SYSTEM LOCATION PLAN
,~CTION 1 TOWNSHIP/' RANGE
NORTH
SCALE'
A P/;EOX. / % 1oo'
DRAWN DY'
,
SUOOIVI SION
r
~ '. f, Auniclp~li~y of A. nchoca§e
E)EFJARTMENT OF HEALTH & HUMAN SERVICES
825 "L" $lr~l, Anchorage, Alaska 99502~650
SOILS LOG ~ PERCOLATION TEST
LEGAL OESCRIPTION: ~-~j~ :, IS ~ <~ V1.~'~(.-(2~4~ Township.SLOPERange. Sec,.ion:
5
6
7
8
9
10
Ef4COUNTEREO?
11
12-
14-
15
16
17
I8
SITE PLAN
IF YES. AT WHAT O
OEPTH? P
pERCOLATION PATE (m~,,,Ae~i,~,l PE.RC HOLE OIAMETER __
3'7
COMMENTS
TEST RUN 861'WEEN FT ANO
^CCORO/L~ICE WITH ALL STAi'I~- ^NO I,~IJNICIP^L ,GIJIOEUNES Cfi EFFECT ON THIS DATE. OATE: ( '~- ~ I '~(¢~
(Rev. 4'851
./
TEL£PIIONE 2'45,4071 _ - ,_,.~,
~ - - -BIk Sv'l:f,_ .. WELL,
PLEASE PAY FROM THIS INVOIO£
MUNICIPALITY OF ANCHORAGE
Department of Health & Human Services
DIVISION OF ENVIRONMENTAL SERVICES
343-4744
Parcel I.D. #
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
0~8 Of~¢.~ .-. ~ '-~ HAA# O-~-'~,~(~(..,~1
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include 10t, block, subdivision, section, township, range)
(b)
Location (address or directions)
Property owner (~ tl..~.O ~0¢~ [~'l.~.%"~u~ Telephone: (home)
_Business
Mailing Address
(c) Lending Institution
Mailing Address
Telephone
(d) Real Estate Company and Agent
Address
Telephone
(e)
Mail the HAA to the following address: (or check here~, if hold for pick up.)
List contact person and day phone number below:
2. TYPE OF RESIDENCE
Single-Family~i¢.. Number of bedrooms g
3. WATER SUPPLY
Individual Well ~ Community [] Public []
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to th legality and status.
4. SEWAGE DISPOSAL
On-site ~ Public [] Community [] Holding Tank []
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to the legailty and status.
72-025 (Rev. 7/88) Page 1 of 2
5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
As certified by my seal affixed hereto and as of the validation date shown below, Iverifythatmyinvestigationofthis
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
Address
Date
6. DHHS APPROVAL
Approved for ~ bedrooms by
Approved ~p,~ _ Disapproved
Terms of Conditional Approval
~,1,~, r~.-k Date l '7-'//O/' ~O
Conditional
The Municipality of Anchorage Department of l4ealth and Human Services(DHHS) issues Health Authority Approval
cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer
registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending
institutions in ordertosatisfycertain federal and state requirements. Employees of DHHSdonotconductinspections
or analyze data beforeacertificateisissued. The Municipality of Anchorage is not responsible for errors or omissions
in the professional engineer's work.
72-025 (Rev. 7/88) Back Page 2 of 2
A. WELL DATA
Well Classification /'~ [~'b~ '
MUNICIPALITY OF ANCHORAGE (MOA) ~
Health Authority Approval (HAA)
CHECKLIST - FEBRUARY 1984
343-4744
Legal Description: ~.0~" ~, ~/--~1~. 'Z.-
Well Log Present (Y/N) Y Date Completed
Total Depth ~-"'¢¢0 Cased to ~
· Depth of Grouting
Static Water Level ~ ~'! Pump Set At
&'
Casing Height Above Ground ~ Sanitary Seal on Casing (Y/N)
Electrical Wiring in Conduit (Y/N) Yl~ Depression Around Wellhead (Y/N)
If A, B, C, D.E,C. Approved (Y/N) ,~/4 ~,
Yield ~ ~"ff~¢~ dI~''0~'~0)
SEPARATION DISTANCES FROM WELL:
To Septic/Holding Tank on Lot
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line '
To Nearest Sewer Service Line on Lot
Water Sample Collected by I(-~J
Water Sample Test Results ~/~"
Comments ~.J~.~ ~-.~ & ~
; On Adjoining Lots '~
~-- ~[ O ; On Adjoining Lots
To Nearest Public Sewer Cleanout/Manhole J~J/,~
B. SEPTIC/HOLDING TANK DATA
Date Installed [ / ~ 0 Size
Standpipes (Y/N) 7
Depression over Tank (Y/N)
Pumping/Maintenance Contact on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
[, ,~0 No. of Compartments
Air-tight Caps (Y/N) Y~5 Foundation Cleanout (Y/N)
/,~ 0 Date Last Pumped ~
~O ;for IJ IA
Temporary Holding Tank Permit (Y/N)
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK:
To Water-Supply Well ~ C~O
To Property Line ,~0
To Water Main/Service Line ~'~.-~
To Stream, Pond, Lake or Major Drainage Course
To Building Foundation
To Disposal Field
Comments
72-026 (Rev. 7/88) Front Page 1 of 2
C. ABSORPTION FIELD DATA
Soils Rating in Absorptijcn ,~Stre/ta
Date Installed t 11 ~
Width of Field (8
To Water-Supply Well
To Building Foundation
Lot "~'
Square Feet of Absortion Area
Depression over Field (Y/N)
Results of Last Adequacy Test
SEPARATION DISTANCE FROM ABSORPTION FIELD:
To Water Main/Service Line
To Stream, Pond, Lake, or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments
Type of System Design
Length of Field
Depth of Field
Gravel Bed Thickness O. ~'
Statndpipes Present (Y/N)
Date of Last Adequacy Test
To Property Line IO
To Existing or Abandoned System on
' On Adjoining Lots "&,O O
To Cutback (if present) ~J //~
IA
(0
'~D..LIFT STATION
Date I r~s(alled -_
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Meets MOA Electrical Codes (Y~).~_-~-
Comments - ~ -
Dimensions
Manhole/Access (Y/N)
"Pump Off~SL-ev6'l '~t
. .... ~ ....... Vent (Y/N)
· Pumping Cycles during Adequacy Test.
**Check Permitted Bedroom Rating Against HAA Request**
I certify that I have checked, verifie~or conformed to all MOA and HAA guidelines i.neff(Cot:or~.the date of this
inspection. ,~ ~/~ ~ ?/
MOANo. E6: ~-'~[O ¢~0 ¢' ~ ...... ':' ' "'
f./ , . ......
Receipt No. c--~ c~ ,~ '~/ ('~/"-~ O~ ~-- .) Receipt No.
Date of Payment ,'/O- ~ ~ ~ '0 Waiver Fee: $
Amount: $ / .~ ~ O) ~ Date of Payment
72-026 (Rev, 7/88) Back Page 2 of 2
KE KNIEFEL ENGINEERING
8441 Miles Ct., Anchorage AK. 99504
(907) 337-1121 · Fax (907) 338-1874
Date of Tt~eting: December 3, 1990
Legal Description: Lot 6, Block 2, Overlook Subdivision
Street Address:
Number of Be. drooms; 4
Well Flow Test: Depth of Well: 250~ Static Water Level 65~
Average Flo~ RaBe: > 4 gpm
Results of Water Quality Analysis: ~otal Coliform -'~ 0 colonies
Nitcate--N ---- <0.1 mg/l (10 mg/l allo~abl8)
ResulBs of Septic System Adequacy:
Ne~/a System, Checked and found standpipes, and (sleanoute.
,E.$.Ca,g,,$...E.~,B,~l),&.;%,.,,,Q?,,_,,&.b,aL..-.~,QS ...... The sep'bio system was f]sM and not
Beeted for ad~qua(sy, oi]].y to insure the stqndpipes and CO were in
the proper position.
The sys I';em was tested in accordance with HOA policy and
~egulations in focca at the time of this test.
!: