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Home My WebLink AboutKWIK LOG BLK 3 LT 20Certificate of On -Site Systems Approval Parcel I.D. 013-043-37 Legal description Kwik Log Block 3 Lot 20 Site address 647 E 73rd Ave Anchorage, AK Current property owner(s) Stone Expiration Date: 1-21-2023 X The On-site system(s) is/are approved for 5 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: By: Original Certificate Date: This Certificate 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 Services 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 work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA Approval_June 2022 MUNICIPALITY OF ANCHORAGE 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. 013-043-37 Complete legal description KWIK LOG BLOCK 3, LOT 20 Location (site address) 647 E 73RD AVENUE, ANCHORAGE, A 99518 Current property owner(s) JASON L. STONE Day phone 2. ON-SITE SYSTEMS SIZED FOR 5 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 - 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 (r Waiver Fee $ Date of Payment %%lll2Z -7)1 Date of Payment COSA # a?6"/� 1 Sbk Waiver # COSA Application—July 2022.doc Legal Description: KWIK LOG BLOCK 3 LOT 20 Parcel ID: 013-043-37 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) Water storage tank volume NA gallons Date drilled *UNKNOWN Total depth 71+ ft Well disinfected for coliform test? ❑ Yes ® No Cased to *40+ ft ® Coliform bacteria is Negative ® Sanitary seal is functioning correctly Nitrate mg/L ® Nitrate less than MRL (ND) ® Wires are properly protected Arsenic ug/L ® Arsenic less than MRL (ND) Casing height (above ground) 24+ in. FWIrs Date of flow test for COSA 10/6/22 Collected by Static water level at beginning of test 23 ft. Date 10/6/22 Well production at time of test 3.9 gpm Comments *PER MOA DOCUMENTS IN FILE. *CIRCA LATE 1960S. PER ACCOUSTIC READINGS & AUDIBLE OBSERVATONS BOTTOM OF WELL OR PUMP APPEARS TO BE APPROXIMATELY 71' TOTAL DEPTH SEE ATTACHED SEWER SKETCH AND AWWU CONNECT CARD. B. TANK DATA — PUBLIC SEWER C. LIFT STATION Measured operating fluid level in septic tank ❑ Required maintenance completed Date of pumping Age of lift station years ❑ Required maintenance completed, if AWWTS Lift station material Comments: Comments: D. ABSORPTION FIELD DATA - PUBLIC SEWER Which system tested (date installed) ❑ ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. ❑ Monitor tubes go to bottom of effective. 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 gallons date Any rejuvenation treatment (past 12 months) If yes, enter date Comments/Deficiencies: COSA Checklist 2022 WELL ONLY.docx Adequacy test date Results ❑ Pass Fluid depth prior to test _ in Water added _gal New fluid depth _ in Elapsed time _ min Final fluid depth _ in Absorption rate gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) Effective depth used _ in Effective depth remaining in in 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' Community Sewer Manhole/Cleanout > 100' ❑ Yes if No NA ft ® 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' Animal Containment > 50' ® Yes if No ft ® Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ®Yes if No ft ® 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 Surface Water > 100' ❑ Yes if No ft Tank to Property Line > 5' ❑ Yes if No ft Wells on Adjacent Lots: Field to Property Line > 10' ❑ 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 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 10/14/22 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, Wi; . • • • • • : ;ryW�� local soil characteristics, groundwater levels that may fluctuate during the year, quality of AedtV• 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 �/� • TM •• , these various and dynamic characteristics and are outside the control of the evaluator of the �/ , , ... . , . , . , . , i. well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory j®O w %® for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & flvi s j Curtis Huffman . II" �Fc •. CE 128991 �i �cf'l�% 10/14/22 .'��Aw COSA Checklist 2022 WELL ONLY.docx -,�o -� MIN mi 19— 1. -13 1. - lu — Ia. 10 Im 1 10 IN I -I I - 010, -.10\ -I -,-- lo: Id: lai 16 15 alri o C6 LU gjj u z z ui Z z !uj l- ENLU In 19— 1. -13 1. - lu — Ia. 10 Im 1 10 IN I -I I - 010, -.10\ -I -,-- lo: Id: lai 16 15 alri o 73 � 0 V 0) 1 0305 (I 0 ROUGH VERY APPROXIMATE SKETCH S89a48'30'!W 82.50 ,.. Ia ilTILITY EASEMENT , ONE STORY WOOD FRAME DUPLEX N �BFEI'z,- 6' CHAIN LINK- FCO INK-FCO PER o i2. OH` AWWU a DOCS N • F 94_? f - f11s Vi U IL _. ; ♦ - - * •+ittr+FdSi{9 bkffB&i 5 MANN : `:► 1SF'I:�AL •:A4 :C4 - N LINK c +w - "` .'ARIi{;`. ,, ., PER VISUAL SITE VISIT SWING TIES 01 S89448'30"W 82.50 IJA A.K ° e • • • fto ROUGH VERY APPROXIMATE SKETCH a ,q ,u o � si a aomm�{ IV, s3� 4u U Pi r'., pp ..� A•, c b sy�4ov p etl+� u u 2313' CRi'1`. i� Ft fj a v ae m 0 1= maTx�'J.mQ M A � Q.•"ra P4� eA ROUGH VERY APPROXIMATE SKETCH a ,q ,u o � si a aomm�{ IV, s3� 4u U Pi r'., pp ..� A•, c b sy�4ov p etl+� u u 2313' CRi'1`. i� Ft fj a v ae m 0 1= maTx�'J.mQ M A � Q.•"ra P4� October 9. 1968 My. Peter K. gaplund c/o Hughes, Thorness ~ ~owe Anchorage, ^la,ks 99501 SUBJECT~ Well Reserve Easement Lot 20, Block 3, Kwik Log Subd. Dear Mr. Asptund: We understand that you hesitate to grant the subject easement ~o the ¢~nera of the Kwik Log Subdivision as you feel the easement will detract from your property val~s. This let'kev is to explain the necessity of the easement and to ~ie you to assist the owner of the system and this office in our efforts to bving the water supply into compliance with applic~)le codes. The ^laske Administrative Code setahltshes protective radii around all semi.-puhltc and public water supply systems. It ts against the law to install various portions of sewerage systems within these radii. The well involved is a Class As Semi-public and the protectiv, radii a~e as follcws~ (2) (~) 0-~0 feet ~ No source of potential contamination ~0-80 feet - Only cast iron sewer pipe with leaded and caulked Joints 80-120 feet - Enclosed portions of sewage disposal facilities, f. e., septic tanks, A/C pipe, eta. beyond 120 feet - Seepage pits, drain fields, and other seepage systems may he installed. I~egard.less of the existence or the nonexistence of the required easement, it is illegal to violate the protective radii established in the code. The easement is merely a method of assuring that the well is not encroached upon without requiring continued surveillance by the Department. Mr. Peter, K. Asp:Lund Page 2 October 9~ 1968 We are su.~e that you OaR appreotate this need if you ~onsids~ that mm%y of these small subdivisions' wells stay in use for 20 year~ or more. Re~o~dlnZ of the easement p~ov~das a pmrmanent reoord a~d an effective method of preventing enomoach~mnt. As the situation stands today~ we a~ unable to approve the watem system for service to additional hom~s; consequently~ if you to develop your p~operty, water fmom the ~iat~g system would not be available. Again, wa urge you to provide the necessary easenmnts at this so that this matter can be permanently dispat~hed. Sincerely, DAVID R. L. DUNCAN, M. D. Medical Director BY: SanitarASn RRS / E~,~o ! i'"-1 S ow to whom d~te, and r-~-] ueliver u ~. / / L_.J ~ddress whore delivered L-J to addressee / : o RECEI PT Rece~ed~e nmnbered article d~scribed below. kSIGN^TURE OR NAME OF ADDRESSEE (Must always b#.~ll~d ~n) [$S~E'S AGENT, IF ANY RECEIPT FOR CFRTIJ:iED CITY, STATE, AND ZIP CODE EXTRA SERVICES FOR ADDITIONAL FEES Heturil Receipt Deliver to deDvered deDvered ~ 50~ fee [~ 10¢ fee [] 35¢ fee POSTMARK OR DATE / ~/~t:/~ E A S E M E N T ~g~ 1 of 3 This agmeement, made and entemed into this ~ ........ )day of .,by and between ' or Anchomage~ Alaska, party of the first part, which expression shall include his, her, o~ thei~ heirs, executors, administPato~s~ agents~ om a~¢~p~m whem~ the context so Pequi~es )~ of Anchorage, Alaska, party of the see~d part, which expression includes his, her, or their heirs, executors: administrators~ oP agents where the context so mequiPes om admits, witnesseth: Whereas, the party of the first part o~rns and has title to that Peal estate and real property located near Anchorage, Alaska, desemibed as follows And whereas, the party of 'the second par~ owns and has title to a parcel of p~operty which adjoins the foregoing and described as desires to grant a per~tual easement for the purpose of ( ~>~.~' ~ ,'~ [ located at ( ~ F ( o ~ ,~,c,~ ~-('~ ~(~ ill ~ ' ~.'~u V ,"':') 5o [,~,~;, and the easement shall be within the madius of ( I> t> ) feet fmom the well site. Now, themefome~ it is hereby agreed as follows: The party of ~he second part does hePeby gmant, assi~, ~d set ovep to the party of the first part a pe~tual ease~nt fop Page 2 of 3 the purpose of installing and operating a community water system, said well shall be located at ( ~\~ ~i~'l~ ~ ~ i~.~ ~ as located ~] that certain amended plat approved by the Greater Anchorage Platting Board and filed for record, such easement shall be within the radius of ( /~? u )feet from the well site. The party of the second part shall fully use and enjoy the ~for~a{d premises, except as to the rights herein granted. i This agreement is subject to the following provisions: 1. Second Party shall: a) Restrict the use of that portion of ( ~- ¢~-( ? ~3 ) which falls within the ( ~]O )foot radius of the well from all sources of contamination~ and that portion of said tract which falls within the ( ~(~ )foot radius shall have no sewer, septic tank~ or disposal fields, except that sewer lines of cast iron pipe with leaded and caulked joints shall be permitted, and that portion which falls within the ( ~3 ~) )foot radius shall have no seepage pits, and that portion which falls within the ( / ~ ~ )foot radius shall have no cesspools, as regulated by the Greater Anchorage Area Borough Health Depamtment. To have and to hold the said easement~ right~ and might of way unto the party of the first part, successors, or assigns for a period of perpetuity and under the conditions, restrictions and considerations as set forth above. It is expressly unders~:ood and agr~eed that this easement is a covenant running with the land. IN WITNESS WHEREOF, the parties hereto have caused this agreement to be executed under seal as of the day and year first above written. STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) This is to certify that on the ( ) day of ( ) before me, the undersigned Notary Public in and for the State of Alaska, duly commissioned and sworn~ personally appeared ( ) known to me and to me known to be the individuals named in and who executed the foregoing instrument~ and acknowledged to me, each for himself and not for the other, that they signed and sealed the same as their voluntary act and deed for the uses and purposes therein set forth. IN WITNESS WHEREOF, I have hereto set my hand and official seal the day and year first above written. Notary Publ[~ in and :for Alaska b~y commission expires: JOHN C. HUGHES DAVID H, %HORSNESS ROBERT C, LOWE R]CHARD O. GANTZ ROBERT C, ERWIN JAMES M. POWELL HUGHES. THORSNESS. LOWE, GANTZ & CLARK ATTORNEYS AT LAW 807 G STREET ANCHORAGE, ALASKA 9950~ October ll, 1968 Mr. Rolf R. Strickland, R.S. Sanitarian Greater Anchorage Area Borough Health Department 327 Eagle Street P. O. Box 968 Anchorage, Alaska 99501 TELEPHONE 272-5477 RE: ASPLUND Property Lot 20, Block 3, Kwik Log Subdivision Our File No. 6845 Dear Mr. Strickland: You realize, of course, that Peter K. Asplund is now deceased and that the only person who can act for the estate is the Exe- cutrix, Genevieve L. Nichols, of 5401 41st Street S.W., Seattle, Washington. Under these circumstances, you can understand that the Executrix who holds the property as a quasi officer of the Court is, or may be, reluctant to bind the property for a period beyond the course of her administration. The three-page document which you have prepared purports to have the Executrix enter into an agreement with Kwik Log Subdivision, Inc., restricting the use of the property in question according to certain formula or a pattern based upon -40-, --80-, -120-, and -150- feet radius provisions. The mere fact that I suggest that the Executrix would be somewhat reluctant to execute this document, under the circumstances, does not mean that she will not execute the document, provided that she understands fully what it means. Mr. Rolf R. Strickland, R.S. October 11, 1968 Page Two. If you could prepare a plat of the area in question and could demonstrate to us in a graphic manner where the various radii would fall upon the property known as Lot 20 of Block 3, it would at least be more understandable, and the limitations on the property would be graphically illustrated and made a part of the agreement. If you will please prepare such a graphic illustration, I will submit the document in question to the Executrix for her deter- mination. If you have any questions, please advise. Very truly yours, HUGHES ~ THORSNESS, LOWE~ GANTZ Hughe _~ JCH:f cc: Genevieve L. Nichols 5401 41st St., S.W. Seattle, Washington