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Home My WebLink AboutKWIK LOG BLK 3 LT 13Onsite File Kwik Log Block 3 Lot 13 #013-043-30 Rick Mystrom. Mayor Municipality of Anchorage Department of Health and Human Services 825 "L" Street P.O, Box 196650 Anchorage, Alaska 99519-6650 343-4744 May 17, 1995 Frank J. Meke 835 East 73 Avenue Anchorage, Alaska 99502 Subject: Lot 13 Block 3 Kwik Log Subdivision Permit #SW940123, PID ~013-043-30 The subject permit, issued May 2, 1994 by this office for a single family well and/or on-site wastewater system, has expired as of May 2, 1995. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. If you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If a licensed Professional Engineer has inspected the installation of the on-site wastewater system, the original as-built inspection report must be sent to this office for review, approval and documentation. All inspection reports must be submitted within 30 days of construction completion. When applying for a new permit, the fees are: $320.00 for an on-site wastewater permit; $120.00 for a well permit and $440.00 for a combined on-site wastewater and well permit. If you have any questions, please call this office at 343-4744. ~erely, ~ j~mes Cross, P.E. · rogram Manager On-site Services enc: Copy of Permit PAGE 1 OF 1 NKINICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL SYSTEM PERMIT PERMIT NLrMBER:SW940'DI~7-1~ DESIGN ENGINEER:DUMMY COMPANY OWNER NAME:MEKE FRANK J OWNER AJDDRESS:835 E 73RD AVE ANCHORAGE, ALASKA 99502 DATE ISSUED: EXPIRATION DATE: PARCEL ID:01304330 LEGAL ]DESCRIPTION: KWIK LOG BLK 3 LT 13 5/o2/94 5/o2/95 LOT SIZE: 11135 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: WELL SYSTEM 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 DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 OR 343-4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS RECEIVED BY: ~~')~. DATE: / SURVEYORS. CERTIFICATE This' survey o-:..LoT~ /2.i~0 :Loc.~. B E~, k l..o~ 5o~ is made for-the'exclusive use of the present owners of the property, and also those who purchase, mortgage or guarentee the title there to within one year from the date hereof; 'and as to them I hereby certify that this survey and the above map were made in acaordance with acceptable professional standards and that the information contained hereon is, to the best of my knowledge, information and belief, a true and accurate representation thereof. Municipality of Anchorage On -Site Water and MstewaterProgram K (907) 343-7904 'CERTIFICATE OF ON-SITE SYSTEms APPROVAL Parcel I.D. 013-043-30 Expiration Date:Ney 3� ?11QC% 1. GENERAL INFORMATION Complete legal description Kwik Loa Block 3 Lot 13 Location (site address) 835 E. 73rd Ave. Current Property owner(s) Rachel Owen Day phone Mailing address Real Estate Agent 835 E. 73rtl Ave. 2. TYPE OF DWELLING: X❑ Single Family (w/wo ASU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual ❑ Individual Water Storage ❑ Holding Tank ❑ Community Class_ Well ❑ community El Public Water System [] Public Sewer 19 Waive,/Variance request for: Distance: Received by: _ e Date: COSA to be releasedto the engineer,. unless othenr i r sledby the. engineer. COSAFee C-ou1j7 Waiver Fee Date of Payment Date of Payment Receipt dumber1�f45�9ir Receipt Number COSA#. -13 Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified 1, 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 Ort -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 ARCTERRA CONSULTING,_INC, Phone 696-6111 Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. 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 intend use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. 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, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen .ert encroachments, deficiencies or discrepancies exist. ,r' OF ��- 21 L � 6. DSD SIGNATURE a xEti,aIN Ni. naev% us r System #1 Approved for bedrooms. 7 is wed System #2 Approved for bedrooms. �ra is o F1T Disapproved. Conditional approval for bedrooms, with the following stipulations: 1�lz �J ON-SITE By: �-C'�vc�CCs 1��7s� Original Certificate Date. �}} }} �1.2o2o 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 blue sheet 10-10.12doc CASA Checklist Legal Description: Kwik Log BIock 3 Lot 13 Parcel ID: 013-043-30 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system 1 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Well production at time of test gpm Date drilled 1994* Water storage tank volume gallons Total depth 108% ft Well disinfected for coliform test? ❑ Yes ® No Cased to 108* ft 0 Coliform bacteria is Negative ® Sanitary seal is functioning correctly Nitrate 0.758 mg1L ❑ Nitrate less than MRL (ND) ® Wires are properly protected Arsenic ug/L ® Arsenic less than MRL (ND) Casing height (above ground) 24 in. Collected by _ Areterra Consulting T Date of flow test for COSA 4118120 Date of Sample 4117120 Static water level at beginning of test 27 ft. Comments*: Information based on previous COSA. Well permitted in 1994, recipt from pump intall showed 108'total. B. TANK DATA Age of tank(s) years Tank type/material Septic/Steel Measured operating fluid level in septic tank ❑ Standpipes/foundation cleanout per record drawing Date of pumping D. ABSORPTION FIELD DATA C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Which system tested (date installed) Adequacy test date ❑ ALL standpipes present per record drawing Results ❑ Pass For bedrooms Total measured depth from grade ft (max) Fluid depth prior to test in Measured depth to pipe invert from grade ft (min) Water added gal ❑ NIA — pressurized field New depth in ❑ Monitor tubes go to bottom of effective. If not, state Elapsed time min depth into effective ❑ Code -required soil cover over field Final fluid depth in ❑ System presoaked Absorption rate gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) date of test) Gallons introduced gallons If yes, enter date Comments/Deficiencies: COSA Checklist yellow sheet 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 if No _ Community Sewer Manhole/Cleanout > 100' ❑ Yes if No NA ft [21 Yes if No _ ft Neighboring Tank > 100' ® Yes if No _ ft Private Sewer/Septic Line > 25' Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No NA ft Holding Tank > 100' ® Yes if No _ ft Neighboring Absorption Fields > 100' if No _ ft Animal Containment > 50' ® Yes if No ft ® Yes if No ft _ ft _ comment below _ Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ® 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' ❑ Yes if No _ ft Surface Water > 100' ❑ Yes if No ft Property Line > 5' ❑ Yes if No _ ft Wells on Adjacent Lots: ❑ Yes Absorption Field n 5' ❑ Yes if No _ ft Private Wells > 100' ❑ Yes if No _ ft Water Main > 10' ❑ Yes if No _ ft Community Wells > 200' ❑ Yes if No _ ft Water Service Line > 10' ❑ 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' ❑ Yes if No ft If absorption field is under driveway comment below Property Line > 10' ❑ Yes if No _ ft Wells on Adjacent Lots: Water Main > 10' ❑ Yes if No _ ft Private Wells > 100' ❑ Yes if No _ ft Water Service Line > 10' ❑ Yes if No _ ft Community Wells > 200' ❑ Yes if No _ ft Surface Water > 100' ❑ Yes if No _ ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION I 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 • • •itc Municipality of Anchorage r E On-Site Water and Wastewater Program �:,J I (907) 343-7904 5 A r r T T CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 013-043-30 Expiration Date: /0 — 161-12 1. GENERAL INFORMATION Complete legal description _KWIK LOG BLK 3 LT 13 Location (site address) _835 E 73RD AVE ANCH, AK Current Property owner(s) _WIN FAULKNER Day phone Mailing address _2825 ILLIAMNA AVE ANCH AK Real Estate Agent Day phone 578-970 2. TYPE OF,DWELLING: ® Single Family (w/wo ADU) ti ❑ Duplex a ❑ Multiple Dwellings (Single Family and/or Duplex) JUL Zulu 3. NUMBER OF BEDROOMS: 3 *77 ntiti 68L95 4. TYPE OF WATER SUPPLY: TYPE OF.WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver/Variance request for: Distance: Received by: Date: 7 7 COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ J' Waiver Fee $ Date of Payment 1'( L(OC143 Date of Payment Receipt Number Q. 1.06(42 Receipt Number COSA# CSC 1 S 133`/ 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 MIKE N ANDERSON, P.E. Phone 727-8864 Address 4661 NATRONA AVE. Engineer's Printed Name MIKE N ANDERSON, PE Date 7/12/18 °, ' °°° o..L °o Co00CC00 i°GCAQ 6. DSD SIGNATURE ?6' System #1 Approved for bedrooms. ' A...!CHAEL N. hr••D.RscN System #2 Approved for bedrooms. �' C 94 9/.°' Disapproved. Conditional approval for bedrooms, with the following stipulations: VC,/, ON-SITE WATER ANI) WASTEWATFR �. rn PROGRAM c Original Certificate Date: 7-1 "-6C 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 blue sheet 10-10.12.doc 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: KWIK LOG BLK 3 LT 13 Parcel ID:_013-043-30 A. WELL DATA Well type Private If A, B, or C provide PWSID# Well Log (Y/N)f N Date completed 1994 * Sanitary seal (YIN)Y Wires properly protected (Y/N) Y Total depth 108 ft. Cased to 108 ft. Casing height(above ground) 16"+ FROM WELL LOG AT INSPECTION Date of test 6.22-2018 Static water level ft. 60 ft. Well production g.p.m. 4.0+ g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 mL Nitrate 0.576 mg/L Arsenic: ND ug/L Date of sample: 7.2-18 Collected by: Mike Anderson B. SEPTIC/HOLDING TANK DATA Tank Type/Material Date installed Tank size gal. Number of Compartments Cleanouts (Y/N) Foundation cleanout (Y/N)_ Depression over tank (Y/N) N High water alarm (Y/N) Date of pumping Pumper C. ABSORPTION FIELD DATA—1985 SYSTEM TESTED Date installed Soil rating (SF/BEDROOM)_ System type Length ft. Width ft. Gravel below pipe ft. Total depth ft. Eff. absorption area ft2 Monitoring tube Depression over field Date of adequacy test Results (Pass/Fail) For_bedrooms Fluid depth in absorption field before test in. Water added gal. new depth in. Elapsed Time:_min. Final fluid depth _in. Absorption rate >= g.p.d. Any rejuvenation treatment(past 12 mo.) (YIN & type) If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off" level at in.High water alarm level at in. Datum Cycles tested Meets alarm &circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot NA On adjacent lots 100'+ Absorption field on lot NA On adjacent lots 100'+ Public sewer main 75'+ Public sewer manhole/cleanout 100'+ Sewer/septic service line 25'+ Holding tank 100'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation Property line Absorption field Water main Water service line Surface water Wells on adjacent lots ABSORPTION FIELD ON LOT TO: Property line Building foundation Water main Water Service line Surface water Driveway, parking/vehicle storage Curtain drain Wells on adjacent lots F. COMMENTS *well was permitted in 1994 but no well log in the file. Receipt for pump install showed 108'total. .s�""�eed"ot _� • o. �a., eta G. ENGINEER'S CERTIFICATION j y'• ow • 49TH ,M .r- �4 • �••. I certify that I have determined through field inspections and / •'•� ••••••• •. .. review of Municipal records that the above systems are in •••..... ..•.k conformance with MOA COSA guidelines in effect on this date. MICHAEL N. ANDERSON ; rte•• 7_9469,Engineer's Printed Name MIKE N. ANDERSON, PE rt • ll •'F• Date 7/12/2018 il •/fe t } COSA canary sheet_2-6-15.doc l 84681 Shed&deck encroach , Lot 3 I Lot 2 I Lot 1 N89°48'30"E / — — — ___I, x 82.50 >< X — — — 10' Utility Easement x,,12. o .�fid OWell ec G3 Shed . —I Chain link fence(typ) Ramp' I r` ' • I 4 4 / Wire fence(typ) CO -- LOT 13 --25.6 34.0 deck • 0 2 Story Frame `r } M House o r`i--Chimney] O ! ! ! O Lot 14 N 34.0 N Lot 12 CO -- 22.6;I O bO deck i I Z Z ' 1• Gravel driveway . LO . •.-- I.. ., . I l N89°48'30"E 82.50 O O CO CO E. 73rd Avenue — q — — — •�� ` AS-BUILT NO CORNERS SET THIS DATE OF 1 F.• . • . . 1 rt I hereby certify that I have performed a Mortgagee's inspection ..../.....\,::' '9S/C.., f_ of the following described property: LOT 13, BLOCK 3, % CO• 49th �\ ••-9 ' KWIK LOG SUBDIVISION 101 ?4V 1 / Anchorage Recording Precinct,Alaska,and that the improvements situated thereon are within the property lines ..Fred W a I o t k o,.g / and do not overlap or encroach on the property lying . sy r adjacent thereto,that no improvements on the property lying 4%:.„•. 3255 — S .• J- Ai, adjacent thereto encroach on the premises in question and 'PF • . h ., that there are no roadways,transmission lines or other I °pq • • • .0z•° visible easements on said property except as indicated 1 -FESSIONAL �� hereon. SCALE: 1"= 30' %X\\x•% Dated at Anchorage,Alaska EASEMENTS OF RECORD,OTHER THAN this 29th day of December ,2017. THOSE SHOWN ON THE RECORDED FRED WALATKA&ASSOCIATES,L.L.C. PLAT ARE NOT SHOWN HEREON Engineers and Surveyors UNLESS OTHERWISE NOTED. FB 18-1, pg 7 BE 907-248-1666