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HomeMy WebLinkAboutKASILOF HILLS BLK 2 LT 11 Onsite File Kasilof Hills Block 2 Lot 1 1 #015 - 161 - 35 Municipality of Anchorage 6102 9 T Jc V On-Site Water and Wastewater Program • (907) 343- 4 Page of 3 ON-SITE WASTEWATER INSPECTION REP ..L.a sn Permit Number: OSP191018 PID Number: 015-161-35 Dwelling: l Single Family (SF) ❑ Duplex (D) ❑ Multiple(SF and/or D) Project: ❑ New N Upgrade Name: Scott & Sharon Liska ABSORPTION FIELD Address N Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound 10921 Kasilof Blvd. Anchorage, AK 99507 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 360-2375 4 0.6 GPD/SF 11 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot 4.0 Ft. 7.0 Ft. Kasilof Hills 2 11 Fill added above original grade Gravel length Township Range Section 0.0 Ft. 73 Ft. Gravel width Beds: Number of Lines Distance between lines SEPARATION DISTANCES 3.0 Ft. Ft. To Septic j Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 1008 Ft2 1 Ft. Well >100' >100' N/A N/A >25' TANK 0 Septic 0 S.T.E.P. 0 Holding 0 Other Manufacturer Capacity Surface Water >100' >100' N/A N/A Anchorage Tank 1500 Gal. Material Number of compartments Lot Line >5' 5'** N/A N/A Steel 2 NA Foundation >10' >10' N/A N/A LIFT STATION Manufacturer Capacity Curtain Drain None Noted 1 Gal. Pump on level at Pump off level at High water alarm at Remarks Tank installed by Wilco early January, w/ inspections performed by Alaska Rim Eng. in. in. in. *20' of West end of trench is insulated. Pump make and model Electrical Inspections performed by **SEE WAIVER PIPE MATERIAL House to tank D3034 Tank to D3034 Installer drainfield Wilco Contractors Drainfield D3034 CO/MT 03034 Inspector AK Rim Eng. (Tank) / J.Millette (Trench) BENCH MARK (Assumed elevation) 100 ft Inspeectio: 151 1/12/19 2'd 3/28/19 Location and description 3rd 4th Garage Slab COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp ,Cg Conditional Approval: Date � �Q' of A; , .•• cS�lll 4 f*.. 49TH /\ • * , Benja•' • chiller #r • CE 12592 •c`�r �Jl�:.,4/12/18 ..•�v� .,===.--------7------ -kra Approved t OA— Date - I illPgzIldV‘ C— �PROFESS►ONP,� Inspection Report_9-1-12.doc KASILOF HILLS, BLOCK 2, LOT 11 Sb PERMIT # OSP191018 PID # 015-161-35 \ \ \ \ \ \ \ \ \ \ \ \ \ VACANT LOT \\ \ \ \ LOT 10 \ \ \\\ \ \ \ \ I \ \ i \ \ 1 5, ,,„ / 1 100'WELL RADIUS \ \ \ __ \ I REBUILT 73'LONG x 3'WIDE x \ \ I�. I 7'EFF.ABSORPTION TRENCH \\ \\ l N vv vv LOT 7 j 1 \ \\ \\ / l " iSH 01 \ 'o \\ / 1 TH-B MT1 LJ \\ G `, C01 \ p 2C� V2 1 NEW 1,500 GALLON \\\ \\\ LOT 6 SEPTIC TANK \t� d TH-A SV1 Z(8:1 \7N \ TH2 y TH1(6 FCO \ Cn \ \ (CORWIN 1 9) •(R&M 19781 O \2i• \\ �'^'- - ' • �^J EXISTING WELL \\'t \\ r \ LOT 11 \ \ �n\ / • co 1 o 1 \ \ I \\ I \ \ � \ \ \ ...„. - O \:\ \ .\ \ ,. \ 03\ \ \ \ \ ZQ \ 100'WELL RADII \\\ \ \\\ \ \ \ s)(\5G SEPTtC ARBA \\\ \\\ \ LOT 12 \\ \ / \ \ / \ \ \ \ \ \ \ GEitk \ [N 6INII RING \ \ , \ .��.OF`,�y\'\\-l� A B LEGEND .�.• " '�9� lI CO-CLEANOUT jc3.• ' ', T FCO 17.7 10.2 2C0-DOUBLE CLEANOUT /*; 49 TH * SV1 20.8 14.7 l -. •• •.• :•• SV2 30.8 25.8 FCO-FOUNDATION CLEANOUT ic;:-: . . / 2C0 32.3 27.5 FS FLOW SPLITTER VALVE Benja in Schiller : i 0 50 100 001 38.2 39.4 MH MANHOLE 0��<^�,� . CE 12592 / MT1 38.8 40.3 MT-MONITORING TUBE f s. Ppr16.2019 ,•• � I♦ MI = FEET CO2 86.8 63.3 'NZ.DpROFEssko �`� MT2 87.7 64.5 SV SEPTIC VENT >t\�v`"-0�. 1"=50' TH-TEST HOLE KAS I LO F HILLS B2 L11 PERMIT # OSP191018 PID # 015-161-35 OcV 0 U > > 0 LL (/) (/) CV — — 102.4 - 97.3 96.8 150C GAL 96.6 SEPTIC TANK ki �'' 90.3 01- 100.5 ORIGINAL/ FINAL GRADE 2 Ov _i 96.5 96.5 DRAINFIELD ROCK 89.5 89.5 1 73' 1 84.5 82.5 f I-<\- NO GROUNDWATER 4/1/19 _ _ 1- 1- of A�'4slll4P .1- Ori*. 491- *YY 0 T-L-- ce,ik. 0 PROFILE AS-BUILT r . Benia in Schiller •. Al GE ?r. .• E 22592 ... �./ (NO SCALE) ,l%-,rROFESS\ON^.�+� qF' 4\�11t SOILS LOG AND PERCOLATION TEST i* 49 Th * / GE ENGINEERING /,- Benja in Schiller LEGAL DESCRIPTION: KASILOF HILLS B2 LII Cn�z�o92 . �v� r/ PERFORMED FOR: SCOTT 8, SHARON LISKA ��k PROFFESS\ DATE: 1/20/19 PROJECT No.: PARCEL ID#: 015-161-35 TECHNICIAN: J. MILLETTE Professional Engineers Stamp: DEPTH TEST HOLE A (lcct) 1 —1 1' OB SLOPE SITE PLAN 3 4 5 . .•, SEE SITE PLAN 6 7 SANDY SILTY GRAVEL 8 t; - 9 . . . WAS GROUND WATER ENCOUNTERED? NO IF YES«WHAT DEPTH? - DEPTH OF WATER AFTER MONITORING: NONE 11— DATE OF MONITORING 4/1/19 12— DEPTH To 13 DATE READING GROSS TIME NET TIME WATER NET DROP (MINUTES) (MINUTES) (INCHES) (INCHES) 14 2/21 TEST HOLE PRESOAKED PRIOR TO TESTING: 15 1 16 2 3 17- 4 18 5 19 6 20 PERCOLATION RATE: (MIN/INCH) PERC. HOLE DIA. (INCHES) TEST RUN BETWEEN: FT. and FT. COMMENTS: TEST HOLE FOR WATER MONITORING AND SEPARATION TO IMPERMEABLE LAYERS ��,\\\\‘ 9f.4‘4,;"... SOILS LOG AND PERCOLATION TEST *: 49 TH /� '*!l illireGE0%,'W:1. .. ,:I j L ENGINEERING f • Benja in Schiller • LEGAL DESCRIPTION: KASI LOF HILLS B2 LII �tf 9�C�' • CE 12592 •i.ff: i PERFORMED FOR: SCOTT 8, SHARON LISKA k1t�iiOFESS1oN*� � DATE: 3/29/19 PROJECT No.: ��\\����` PARCEL ID#: 015-161-35 TECHNICIAN: J. MiL_L_ETTE Professional Engineers Stamp: DEPTH TEST HOLE B (feet) 1 1 1106 SLOPE SITE PLAN 1 2 ' ? BROWN GRAVEL MIXED -, , W/ORGANICS '' 'l 4 • . 5 •"!•• , , SEE SITE PLAN 7 '.•:: .1. . . 8 •.ti' GM (SANDY SILTY GRAVEL) s.9 ','. . . 10 WAS GROUND WATER ENCOUNTERED? NO IF YES a WHAT DEPTH? - 11 •, DEPTH OF WATER AFTER MONITORING: NONE ,'.: DATE OF MONITORING: - 12 • • • 13 DATE READING GROSS TIME NET TIME DEPTH TO WATER NET DROP (MINUTES) (MINUTES) (INCHES) (INCHES) 14 • ' ` 3/30 TEST HOLE PRESOAKED PRIOR TO TESTING: 15 1 1:40/ 1:46 6:05 0/6 6 2 1:47/ 1:53 6:09 0/6 6 16 . - 3 1:55/2:01 6:05 0/6 6 17 • 4 2:02/2:08 6:07 0/6 6 18 5 2:10/2:16 6:10 0/6 6 19 6 2:17/2:23 6:10 0/6 6 20 PERCOLATION RATE:1.02 (MIN/INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN: 3 FT. and 4 FT. COMMENTS: 3/27/0 80W MUNICIPALITY OF ANCHORAGE ,.cnr is. 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 Dvpa r fluent 4hCHop PGE On-Site Wastewater Disposal System Permit Permit Number: OSP191018 Effective Date: 3/6/2019 Work Type: Septic Upgrade Expiration Date: 3/5/2020 Tax Code Number: 01516135000 Site Legal Address: KASILOF HILLS BLK 2 LT 11 G:2641 Site Mailing Address: 10921 KASILOF BLVD, Anchorage Owner: LISKA SCOTT C & SHARON R Lot Size in Sq Ft: 30410 Design Engineer: FORGE ENGINEERING Total Bedrooms: 4 This permit is for the construction of: ❑ Disposal Field Il Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 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 Special Provisions: The Engineer needs todo an additional test hole prior to the construction of the septic field including a percolation test. Construction may proceed at your own riskbefore the 7 day water monitoring is complete. Please submit stamped and signed results with the As-built InspectionReport. If the results require a designchange, construction of the system will stop pending On-Site review andapproval. Received By: (/ i : ,(,r �( Date: a Issued By: /G ��, Date: Municipality of Anchorage rpartmrnt P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997 http://www.muni.orq/Onsite Development Services Division On-Site Water and Wastewater Program **** VARIANCE/WAIVER REVIEW **** Waiver#: OSV191002 COSA#: Permit#: OSP191018 PID#: 015-161-35 Legal Description: Kasilof Hills BIk 2 Lt 11 Engineer: Forge engineering Applicant: Scott& Sharon Liska Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 4.0 feet. This waiver approval applies to the proposed 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. Waiver is Granted: X Waiver is not Granted: Date: 3/x//9 Approved by: /IIG/i`- 6a' Name of Revi er **** VARIANCE/WAIVER REVIEW **** MUNICIPALITY OF AN � . ®n: 9.-U 9 d ,. I A, L U Community Development Department Phone: •1 -343-7904 Development Services Division 'fid Fa '.4l7-343-7997 On-Site Water & Wastewater Program �`" ON-SITE SEWER/WELL PERMIT APPLICA • 1 Parcel I.D. 015-161-35 Property owner(s) Scott & Sharon Liska Day phone 416--2375 Mailing address 10921 Kasilof Boulevard Anchorage, AK 99507 Site address Same Legal description (Sub'd., Block & Lot) Kasilof Hills, Block 2, Lot 11 Legal description (Township, Range & Section) Lot Size 30,410 Sq. Ft. Number of Bedrooms Four (4) APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (E)all that apply) Absorption Field ❑X Initial ❑ Single Family (SF) (w/wo ADU) Septic Tank ❑X Upgrade 0 Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE /WAIVER REQUEST FOR: IL Distance: yl I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. .74.c.„.z.„.e ,-7-, ‘,),_,,g,--, (Signature of property owner or authorized agent) Permit/Rush Fees: 545 Waiver Fees: 22g Date of Payment: //3()I1q Date of Payment: 2-/2---63/1,1 Receipt Number: 05-tigQ8 Receipt Number: 0 7 S6 q J Permit No. OSP/9161$ Waiver No. CSS V I Cf 002_ Permit App_ :.....c ENGINEERINGGE PO BOX 240773 ANCHORAGE,AK 99524 522-7773 677-7766(FAX) February 23,2019 MOA Development Services Dept, On-Site Water&Wastewater Program 4700 Elmore Rd Anchorage,AK 99507 Subject: Kasilof Hills,Block 2, Lot 11 -10921 Kasilof Boulevard Septic System Design Dear On-Site Services Engineer: The septic system on the subject lot has failed. Very little area is available for a new system so we are proposing the reconstruct the existing absorption trench in its current location. We are submitting this application for the reconstruction of the system. The attached site plan identifies the location of the home as well as the existing well and septic system and the proposed system. No conflicts exist between this proposed system and any other well or septic system, whether on this lot or adjacent lots. The ground surface on the lot slopes toward the northwest at a shallow grade. Stormwater drainage will not impact this septic system.The new trench will be constructed parallel to the slope as much as possible at the same location as the existing trench which has been in place since 1989. The new trench will be 4' from the north property line and 9' from the west property line. A lot line waiver request is attached. 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' away from the septic tank. A test hole will be completed prior to construction to verify subsurface soil conditions. Groundwater will be monitored to determine the stabilized level. Please refer to the attached test hole log from the system file and the plan and profile sheets for the septic design.If this design is followed,there will be no adverse impacts to adjacent properties. Sincerely, �si i Michael E. Anderson, PE 0*. 49 THTH Eato-4---7Michael E.Anderson r+ • fkc/fl�QF.2/23/19, �F}a�'�.r'/ flit\\ �t�1�`.'. KASILOF HILLS, BLOCK 2, LOT 11 `\ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ \ S5 VACANT LOT \\\ `\ LOT 10 \\ \ \\\ / / - REMOVE ALL PIPE&CONTAMINAI\ED \ \\ // MATERIAL FROM EXISTING TRENCH \ ACKFILL EXCAVATED AREA AND DISPOSE PER MOA CODE. \\ \ / _ ROM THE WESTERMOST 8' RECONSTRUCT NEW 72'LONG x 7' \ \\_ _ / OF EXISTI4IG TRENCH WITH EFFECTIVE DEPTH ABSORPTIONS -\\ \\ / I\ MOA dAPPROVED SAND. TRENCH. / \\ \ \ \ / \ \ /\ I \ I PROPOS�iSTEST HOL : •• RK ST\ f N \\\ TO VE/R{FY SO DITIONS.\\\\ \\\ LOT 7 \\ / , ( I \ \ \ / mitenr. \\ \\\ I / / \ �_co/ \ ; \ ' MT r- •Mt / DECOMMISSION EXISTING \ \\ \ p 2�� TANK PER MOA CODE. \\m •\\ \ LOT 6 INSTALL N 1,280 \\7N \ 5. GALLON SEPTI TANK H2 TH1 \\ \ \ • (COR N 1.89) •(R&M 1978) m \\ \ •' ' *;••.�; . . rr 1111 EXISTING WELL \\2� \\ N I , i•.is .,nt4'.i4;..•,. •:. J \ \ / '\ / r o / \LOT 11 / � r \ \\\ \ \\/ r O \.11 \ /7\ \ -... — — — — --- --- ‘ <L. \ \\\ \ \\ Q \ \ \ \ \ EXISTING SEpT1G AREA 12 / ' - - `\1� \\1 \ \ LOT \ \� \ \\ N \ \ / \ \ \ GE \ /No. / \ \ \\ \\ 1' ENG N INING� YOTE: \ , \ _,„pai .til• NO SLOPES>25%WITHIN 50'OR SURFACE WATER WITHIN 100'OF THE LEGEND ��••4-�F.NOF,. Cq b. PROPOSED SEPTIC SYSTEM < •,••• ., .. CO-CLEANOUT a?C-') � 1 ': .. 2C0-DOUBLE CLEANOUT . •' ••: ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS s ° 49th i� • FCO-FOUNDATION CLEANOUT %• f i PROPERTY ARE SHOWN.NO CONFLICTS WITH WELLS OR SEPTIC r FS-FLOW SPLITTER VALVE .... «......�.w t• •• SYSTEMS. 41 MICHAEL E. ANDERSON•, ; MH-MANHOLE •i� �. NO. CE-4381 r° � 0 50 100 MT-MONITORING TUBE ♦ F •. 2/23/19 .•••'fid'.• im NE N. mi FEET 40. SV-SEPTIC VENT ♦•444,0„5;;�441. 1" .50' TH-TEST HOLE KASILOF HILLS BLOCK 2 LOT 11 DESIGN FACTORS: SYSTEM REQUIREMENTS: 600 GPD PEAK FLOW 7' DEEP TRENCH SYSTEM PERK RATE: 15 - 30 MIN/IN 1250-GAL SEPTIC TANK APPLICATION RATE: 0.6 GPD/SF 600 GPD / 0.6 GPD/SF/3' WIDE/7DEEP/2 SIDES = 71.4 LF TRENCH REQUIRED (72 LF SPECIFIED) BOTTOM OF TRENCH: 10' BELOW GRADE FLOW LINE ELEVATION: 3' BELOW GRADE TOP OF TRENCH: 0.5'ABOVE GRADE 6" X11— — ——_—'10k= : =ifif= = =TEE —I I 2.5' = C = � L--JL...11-11= = 1.. 6" : : :_: : ., ii:i:= "'• 4" PERFORATED PVC (HOLES DOWN) :I;•:•::::::::::::;.;.;:;:_::.. -::• ::::::::.,:.:::•:.::::::.:::.. DRAINFIELD ROCK :.:.:::.:.:.:.:::::.:.:.:.:.:. :.:::::;:::.:.:::::::.::•:::•. :::::.:.:::::::::.:;:::::.:.:. 7' •:.: : : : :_: ::::: :_: : : :. :;• :;:;:::::;:::;:::::::::::.:. ''.*:;•-=•;• O. REMOVE ALL CONTAMINATED -: ::' MATERIAL FROM EXISTING . ABSORPTION TRENCH AND • •-:::-:-::::`::. —•- DISPOSE IN ACCORDANCE ::.::::::::::::::::::::::::::. WITH MOA CODE. ::::::::::.0cdi::::::::::::::. :::;:;:.:;:;:;:;:.:;:::::::;:. :;• :;:;:.:::.:;:;:;:.:.:::::::. REMOVE ALL CONTAMINATED MATERIAL FROM EXISTING ABSORPTION TRENCH AND DISPOSE IN ACCORDANCE ./_ WITH MOA CODE. REPLACE � • r±�ll 1 lJ WITH MOA APPROVED SAND. 4 3' 1 ENGINEERING' '. 7111%it TYPICAL TRENCH SECTION '�,P••••"'••"'••••~• •.• NOTES: (NO SCALE) • 49th �` '�'�••• 1. GRADE AREA OVER TRENCH TO DRAIN AWAY • ! 2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2' •�nl.•MICHAEL E. ANDERSON • •• No. CE-4381 •_kJ 3. CHECK .,-..,...vWITH 2" OF .N AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER ••t�fF�`'• 2/04/19+''�``�4: THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY ����� SSS 44•x• rbc, Ix go (yE <<l: _: u .e.ktW E N G I N E E R I N G PO BOX 240773 ANCHORAGE,AK 99524 522-7773 677-7766(FAX) February 23,2019 Municipality of Anchorage Development Services Department On-Site Water and Wastewater Program P.O. Box 196650 Anchorage,AK 99519-6650 Subject: Kasilof Hills,Block 2,Lot 11 - 10921 Kasilof Boulevard Separation Distance Waiver Absorption Trench to Lot Line Dear On Site Services Engineer: Very little area is available on the subject lot to upgrade the septic system. We are proposing to reconstruct the existing absorption trench at its current location. The western end of the trench is only 4' from the northern property line. The majority of the trench is more than 10' from the property line. Soil conditions at this location are composed of gravel with silt with percolation rates under 20 minute per inch. Very little migration of effluent is anticipated. The adjacent lot is currently vacant with more than sufficient room to allow for placement of a well and septic system which will not be affected by the location of the proposed trench. We therefore request a waiver be issued allowing the trench to be 4' from the lot line at its closest point. Sincerely, B Michael E. Anderson, P.E. .•'�E OF A4,14.• 11 %* 49th rC • -j .. •A MICHAEL E. ANDERSON? ; •C No. CE-4381 �= '\ \ \ 1 `\ \\\\ \\ \ \ \ LOT 10 .,,, ,---\ _.•0` �\ N BLOCK 2 /� \'o. �\ f 5/8" REBAR o W 2pp 51'<RgyGl \\; \\ LOT 7 \\/ (TYP) S�Zppp / cn \. ' �� \ / Inz,' \y Z1Tn` © O / 15.2. \' o ` 4" PLASTIC c o\ r RISER (TYP.) � f DECK OVERBUILDING `\� po\ LOT 6 l o © I GARAGE WELL y \ �\ ,—o / �Sr. = 1 I v3 0 /= o `fin ASPHALT mg \ 'o\ 3p �' DRIVE 1%= L Q T o0. `\ \\ ; x 0 %/a6.� ` 30,410 S.F. p \\ \\ /� DECK , \ th (rn,) N DWELLING \ U.G.T&E \ / 0 2a� 36.E / N \ \ / \ / NAT GAS I \.3p.\CANT N 0 ) A W 841_, .4 _., 7:6 1 2 Op~ \rE7 \\\\\ N1pp LEGEND: \(C)=CALCULATED DATA g; 16 (M)=MEASURED DATA \ \ O N LOT 12 ohu OVERHEADR)=RECORD DATA UTl LTIES LAT \ \ ER C/? o--. I.,Z U.G.=UNDERGROUND ` \ r/ T&E=TELECOMMUNICATION & \ \ 'c ELECTRIC \ z \ NAT.=NATURAL \ PED=PEDESTAL \ \ FND.=FOUNDATION \ (TYP.)=TYPICAL \ \ \ \ \ > 1* = 50' I ° NOTES: 1. EXCEPTING FOR GROSS NEGUGENCE, THE LIABILITY FOR THIS SURVEY SHALL NOT EXCEED THE COST OF PREPARING THIS SURVEY. 2. THIS SURVEY REPRESENTS VISIBLE IMPROVEMENTS Sc CONDITIONS ON THE DATE OF SURVEY. 3. THIS DOCUMENT DOES NOT CONSTITUTE A BOUNDARY SURVEY & IS SUBJECT TO ANY INACCURACIES THAT A SUBSEQUENT BOUNDARY SURVEY MAY DISCLOSE. 4. THIS SURVEY PERFORMED FOR SCOTT USKA, R SHOULD ONLY BE USED FOR A SINGLE PROPERTY TRANSACTION. I EXCLUSION NOTE: 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. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE LINES. �������1f11 aJF FARMER SURVEYING ��unt q�'I bits AS—BUILT 9131 E. FRONTAGE RD. •4P^`. °° �`�'F,��j PALMER,PH (907)745-022259645 `►'� °°°°°9 "°'l' P' " � bob®farmersurveying.com farmersurveying.com .*/ ° 49TH i\ ear ~ WO: 1800769 .............._...............°.i FB: 18-10 •• • LLC. PAGE: 1 of 1 , e...0.-,....----e 8. Planners: Surveyors SCALE: 1 " = 50' FILE: 1800769AS Robert J. Farmer .�o :: -0,°.. 10615—S c.�4'_: I HEREBY CERTIFY THAT A MORTGAGE INSPECTION WAS PERFORMED 1 ,,,ROF>ssla . ,p* ��`' KASILOF: UNDER MHILLS SUBDMSION,Y DIRECTION ON HBLOCK 2, LOT E FOLLOWING D11 DESCRIBED PROPERTY: 111t1t"-.1�%%%�-2818 SURVEYED PLAT No. ON 96,HEA20th0OFG ANCHORAGE RECORDING, 0118TRlCT, ALASKA. @2018 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 _ ALA AdOres!; ANcH ~(~,TRENCH [] BED [] W. DRAIN E] OTHER ongmal grade ';;~ 1 FI C~ -'- F1 G[avel depth beneath p~pe FT WELL LOT LINE FOUNDATION DISTANCES SEPTIC TANK ABSORPTION FIELD WELL AS-BUILT DIAGRAIVi ~$how tocat~ol ol well, sep,lc system ploperly hnes, Ioundabon. WELLS L ~ PRIVATE.~._',,%~?///' [] OTHER {Identify) ;'~¢'-"' ~'~ ~"' ' ~---- -- q~D,tal E~epth Fl' Cased to REMARKS: FT Scale: I~'T.<~ Inspections Performed by. I ~'~ (""' '~ 't~ f~.~-~']~' t~ N ) I (2. f-- LC (~ cedily Ihat Illis inspeclJon was parlormed according to all ~uniopal and S,ate guidel,nas in ellac, on 'his date: Health DepartfllorltApproval: ~~,J~.4~ Tom Fink, Mayor / unicipality of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box '196650 Anchorage, Alaska 99519-6650 343-4744 August 1, 1989 Bruce Corwin, P.E. Corwin & Associates 1000 East Dimond Boulevard Suite 205 Anchorage, Alaska 99515 Subject: Waiver Request for Lot 11 Block 2 Kasilof Hills S/D Waiver Request ~WR890040, Permit ~890144 PID #015-161-35 Dear Mr. Corwin: Your request for waiver of the required 10 foot separation between a septic system and a lot line has been approved. waived distance is 6 feet. The This approval applies to the existing septic system lot line separation only. Any future upgrade to the septic system will require all separations be met or another approval from this department. Sincerely, Susan Oswalt On-site Services SO/lw: ~7 MUNICIPALF[¥ Vt- ENVIRONMENTAt SERVICES DIVISION ~COVE: ' 'o~ LOT ti ~LK ~. KP,51L_O F: H I L. __ ~ ~T~S'z ~ou~ ~ SEWER. SYSTEM 'LOCATION PLAN a "" "~ " ] ]~ T~ ACCURACY OF L~ATION OF EXISTIR6 // ~ .~ ~"'~: ................. ?~*~*~;~:~:~;~:~:~:~`~::~::~::~:~:~:.`~:~.?...~;~;~:~ NOT BY SURVEYINe TECHNIQUES. ~;;~*~',~:.~,;,~,, ~;~ .... ~' *' '" ......... '* ~ '~! ' '* ' :' .......................................~ '""'"'" 't"'"'i'i ' ' ................................................. DIMENSIONS INOICATED HAVE BEEN ~EER'S SEAL) Municipality of DEPARTMENT OF HEALTH & HU 825 "L" Street, Anchorage, Alas~,a SOILS LOG -- PERCOL, PERFORMED FOR:Al AS KA. (JS'A. 2 4 7 g 10 12 17- 1§ 2O HILL~ nge, Section: T/Z..k.L ~.- ~ (...) /PE SITE PLAN Townsh WAS GROUND WATER ENCOUNTERED? COMMENTS ~-'"/1~ _~-~,. / IF YES, AT WHAT DEPTH? ]~Xt/ Reading Date Gross Net Depth to Net Time Time Water Drop ~ / ?//,./~ 4:0(2 /o,.,,,'~ -.F' ,/o' ~Z " ¥'/o '~ . F' ,6~" ~'4 " 't-:~o " , F" . OF' ~ ,~'~ " 4:40 " , T' .0~' PERCOLATION RATE / 7, 7/ (minu~es/inchl PERC HOLE DIAMETER TEST RUN BETWEEN Z~ FT AND 72-008 (Rev. 4185) (~ { / WAS PERFORMED IN MUNICIPALITY OF ANCHORAGE _~0.~~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 LStreet - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPFCTtON REPORT LEGAL DESCRIPTION DISTANCE TO: I~/el] I ~ O LOCATION Manufacturer Liq, caf DISTANCE TO: Manufacturer Absorption area ._~ IF HOMEMADE: We~l DISTANCE TO: No, of linss (~ ~. Length of each line(¢ Top of tile to finish grade Length Type of crib / DISTAN~ TO: Width L(; , Foundation Total length of lin~)(~ Material beneath tile Depth Crib diameter Crib depth Well Building foundation Depth Driller Building foundation DISTANCE TO: OTHER PIPE MATERIALS _ ' SOIL TEST RATING INSTALLER R EMAR KS Sewer line Wiclth Material Nearest lot line Trench widtl~;)(_z~ inches '~ .~ches NO. OFB~ROOMS No. of cornpart, g~ents Liquid deptl~,~/~ PERMIT NO. Liquid capacity in gallons .ERM,T NO. q ~0 (~ ~g Distance between Jines Total effective abgorption orea ~E~MIT NO. · Total effective absorption( -~(~area Nearest lot line Distance to lot line Septic tank ~-- Absorption area APPROVED DATE LEGAL THE I...EN[.:i'f'H E:, :[ I"llZl'.,l'.i!~; 11: Eflq I f~; THE: L. IEI'.,IGTH ,:: I l',t FEET ::, ElF' "I~,HE TF'.Iiii:NCH Eft;i: [::,1:~:1::1 ]: i'.,ll:::' :[ El_l:::,. THE: DEF'TI.I Ol:z I:::1 "I"I:;iiEr.,IE:H OR F':I:T I!!; THE E:,:I:!FI'FiI'.,ICE: E~ETI.qlE!!!i]'.,f 'I"HIC :::;I..II:~:FI:':IE:E OI::r 'TI.IE GI:;iICII.JI'.,I[) FII'.,ID THfi: DOTTOH OF' THE: THEF~'.E ]:E'; NO ~li:.'"l' I.,.I:[I:::,TH F'[.)I~: 'l"HIi!: Gf~'.FI',,,'EL. [::,IEF'TI.I ]: ::~; THE H I i'.,I I P1UH I::,EF'TH OF' GF;iff:/',,,'Ei:L. I!i~E'TH[i:IEI'.,I THE OLFI"i::'F:IL..!.. F:' :[ I:::'I!!: FIN[) 'TIJE: E',C)T'[OH OF THE E:XCf::I',,,'F'IT ]: Ed'.,I ,:: ]: I.,I F'Efi~:T ::,. I::'~:f;i'.I,'l :[ '1" I:::IF'F'L. I IZ:f:ll'.,l"l" I-II::l'.ii~ '=I'HE Iqflg:':'.];F'Ol',,l:~i; I El :[ I.. I T'T' TO ]: I",II:::'EIi';;:H TI'I :[ ~i; I'::'EF:'F:If;iI"I'HEIq/' [)1...1[:;i: :1: !",lCii "l'Flli: J:NFi;TI:zlLI_f::IT:[Eff',I :I:r.,Eii;F'ECTION~; OF' IZ:th,l'.r' I.,.IE!L.L.]i.!; I:::IC,.J'F:ICEI'.,IT 'TO TH]:'5 l:.:'l:;il[)f::'l:ii:FilT'?' I:::d'.,!D 'TH[!i: r.,IUHE',[:::I:~: iDF Fi:fi[~i!;]:DI!!:I.,tCE6 THI:::IT THfE t.,.IEI...I.~ HILJ~_ '..).;t:i::l:;~',,,'l!~:. Eiq:IC:I':::F' :1: I..L. I I",IG OF F:II",I"~' !~:'¢~.:.';'I'EM I.,.! :1: 'THOIJT r:: I NFIL ]: i",lti!i;F'lii!:E:T :[ O1'.,I I:::IND I:::ff::'l:::'l;;:Cl'v'F:lL. E!:"¢ TH ! [::'[i!I::'IqF;;:"I~I"'I[EI",I"f' kl ILI_. Iii!:[!:: :51J[.:)..]'IEC'T TO f::'I:~:Ofi!;[Ec:LrT' I Oi'.,I. 1'4 :[ 1'.41 I"ILIH [::, ]: ~STF:II'.4CE: E:[~:"I"I.,.IEIEN f::l l,.ll:!i:l....I... F:II'.,ID F:IN"r' O1"4-"~!; I "Fl:~: ::t.6ui) I:::Ei:[ET F'I::)f;i: I:::1 F'R:[',,ff:ITE~: HEI...L..~ :'L.'SE~ 'I"C~ ;2(E,;i) F'E:ET F:I'4:OM FI F'LI[31...IC kl[~:l...[.. [::,[EI:::'[EI'.,I[)]:I'.,II3 UI:::'I:]II'.,I THE: 'F"r'F'IZ O1:::' I:::'U[!!',L.I(::: I.,.II!:L.t.. Iql!ii:L.I... L.E~G:ii!; I:::IF;:[E [;~li~:~j:!Ll:l'.l;i:[~:[:, FIN[::' HI...I:i!;T OF "I'I"IE I,.IEI..L O"[H[!i:Fi: t'~:lii!:QU ]: l;;'.[!i:Hli:!:l",lT!~; I'161"r' F:lF:'l::'L"r'. FI'v'I:::I!L.I::I[!i[L.[!!:-I"O :l:[',l:ii:;I..ll:(:[i~ I::'[;i:OF'I~!:I:;?. :[ C: [E I:;;: ' I" :[ F'"r' THI:::IT ::1..: ]: F:IM f::'l::lf'l:[L. I I::ll:;~: I.,.IITH THE F'I:)I:;i'.'T'H E',"? THE I"ll..II",IICII:::'F:II_IT"r' ELF" 2:: ]: F.!ILI.. IN~];'T'I:::IL.L THE': :F!;'T':STI:~:':r't :]i:: ]: I...ll'.4[::,[!if;i:S'l"l::ll'.,ll:::, THFIT 'I"I'"IE: ON-.-.:!i!;I'Tl:i:: :5[:':l.,.IEI;i: ~.:,"r'?f'IEH i"lFl"r' I'~:ffEQ[.IIF::[~' I:EHI_.I::ff;;:GI:i:I'"IEI",I'T :I:F: 'TI'lIE F'.E::ii;II:::'lZi",lC::li!: 1:5 I:;~'.[!:HO[:'Iii!:L.L::I)TO f::I[::'F'L.]: CF:IHT F:IE h: July 19, 1978 R&H No. 851131 Hr. Rex Brown 8240 Pioneer Pkwy. Anchorage, Alaska 99504 Subject: Soil Investigation for Sanitary Sewer System, Lot 11, Block 2, Kasilof Hills Subdivision, Anchorage, Alaska Dear Mr. Brown: At your request of July 12, 1978, we conducted a subsurface soils investi- gation at the proposed location of the sanitary sewer system on the subject lot. The investigation complied with those procedures required by the Muni- cipality of Anchorage Department of Health and Environmental Protection. This investigation, which was accomplished on July 12, 1978, consisted of a test hole drilled to a depth of 16 feet below the existing ground surface. The test hole was sited according to your instructions and its location is shown in attached Drawing A-01. Drilling was accomplished with a rotary drill rig using continuous flight solid-stem auger with an outside diameter of 6 inches. A sample was taken at the depths shown on the soils log in Drawing A-0]. The sample will be held in storage at our lab for approxi- mately six months. In addition, all material brought to the surface by the augers was continuously monitored by an experienced engineering geologist. The topography at the drilling site is generally horizontal. At the time of the investigation the site had original vegetation consisting of long grasses and spruce. The top of the test hole was located at original ground surface. The soils encountered in the bore hole are shown in the test hole log in Drawing A-01. This log displays specific conditions encountered at the test location. However, subsurface conditions may vary in other parts of the lot without any apparent surficial evidence of the change. Groundwater and bedrock were not encountered. At the time the hole was drilled seasonal frost was not present and permafrost was not encountered. A percolation test was performed within the bore hole at the depth shown in the attached Table 1. All depths were measured from the top of the hole. The data in Table 1 show average infiltration from the depths indicated to the bottom of the hole. The measured percolation rate was 6.25 minutes per inch. June 19, 1978 Mr. Rex Brown Page -2- We appreciated this opportunity to be of service to you. Please contact us if you have any questions concerning this letter or if we can be of addi- tional service. Very truly yours, R&M CONSULTANTS, INC. Lynne Kosikowski Staff Geologist JMB:LK/kah Jim McCaslin Bro~, Ph.D. Project Manager ~ BORING NUMBER i Date Completed: 7-17~-78 SOIL DESCRIPTION ORGANIC MATERIAL Dark Brown, Soft, Slightly Moist ....... 1~5' GRAVEL with some silt (GM) Numerous Cobbles Brown, Very Dense, Slightly Moist 4.5' GRAVEL W/SOME SAND (GP) Brown, Dense, Dry 7.0' LOCATION SKETCH No Scale T.H.~' 60'-- LOT 11 SANDY GRAVEL W/TRACE TO SOME SILT (GM) Brown, Very Dense, Dry to Slightly Moist Numerous Cobbles 16'T.D. REFUSAL ON BOULDER NO WATER T~2~LE ENCOUNTERED CONSULTANTS, INC.] SOILS LOG NOTE: DISTANCES SHOWN ARE APPROXIMATE AND HAVE NOT 8EEN MEASURED 8Y SURVEYING METHODS, EXPLANATION ~'~ -.. ORGANIC MATERIAl i~: L/ltle Visible Ice 0:10' Vx~----'---' ,'i~:~ ~ A.B. L--'ICE DESCRIPTION · ". ,.~SAMpIE NUMBER ~Ss 72,5Z1% ,85.gpcf . '~ ~ATF~ CONTENT ~O. ~ATE~ TABL~ ~L~RO~ STRATA CHA~G~ BEDROCK TYPICAL SOILS LO~ SAMPLER TYPE SYMBOLS ORGANIC ~'-~ SILT ~ BEDROCK ~ SAND ~ IC~ MASSIVe' LOT 11, BLOCK 2 KASILOF HILLS SUBDIVISION ANCHORAGE, ALASKA TIME 3:50 3:51 3:52 3:53 3:54 3:55 3:56 3:57' 3:58 3:59 4:00 4:05 4:10 4:15 4:20 4:30 4:40 4:50 TABLE I PERCOLATION TEST Rex Brown R & M NO. 851131 ELAPSED TIME 0 1 2 3 4 5 6 7 8 9 10 15 20 25 3O 4O 50 6O FEET 3~8 3.9 3.85 3.85 3.9 3.9 3.95 3.95 4.0 4.0 4.05 4.10 4.2 4.25 4.3 4.4 4.5 4.6 DROP IN INCHES 0 0 0.6 0 0.6 0 0.6 0 0.6 0 0.6 0.6 1.2 0,6 0.6 1.2 1.2 1.2 9.6 Inches Total Drop 6.25 Minutes Per Inch SlX INCH WATER VVE!__L DRILLED AND CASED OUT TO THE DEPTH OF___~50 ;-'6.e~, DRILLED AT THE RATE OF_ PROPERTY OWNER __ LOCATION OF VVELL SIT]E~F.~,~,, PER FOOT. ~o 99504 WELL LOG: 1._'. _- y. DATE : ' "-- *':': ~ "" - "~".-'~:':-' ;-'0"" ':-" ': ' '-' ' .k'A'5-.i~<'-.. ,: .... · ........... ...... -'- ~ ..... -; ..... ,., ' ': ' ' ....... ::%;,';,.:t~d:,;;~,-,. ..:,, ,. , . COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLE--TION OF SAID DRILLING VCRITE CHECK F'AYABLE TO RAMF,ART DR1LL1NG WORKS FOR THE SUM OF THANK ,YOU YERTM MUCH. BERNIE C:LAUS OF RAMPART.DRILLING WORKs ePCIM/S MUNICIPALITY OF ANCHORAGE • E:7 i Development Services Department ' Phone: 907-343-7904 On-Site Water & Wastewater Section �� Fax: 907-343-7997 Certificate of On-Site Systems Approval �Q 7 Parcel I.D. 015-161-35 Expiration Date: iO l 7 1. GENERAL INFORMATION Complete legal description Kasilof Hills Block 2 Lot 11 Location (site address) 10921 Kasilof Blvd Current property owner(s) Freya & Jesse Janssen Day phone Mailing address 10921 Kasilof Blvd, Anchorage, AK 99507 Real estate agent Jesse Campbell Day phone 885-9057 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well n Private Septic Water Storage ._, Holding Tank ❑ Community Well Community n Public Water System U Public Sewer U Waiver request for: Distance: Received by: Date: COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ b50 Waiver Fee $ Date of Payment 5/I //4! Date of Payment Receipt Number ( 1b Receipt Number COSA# 3�r Al!3Waiver# 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 Benjamin Schiller, P.E. Date 4/30/19 OF Agk•t10 Oa i* 497 %� *rl4 6. DSD SIGNATURE '•, System #1 Approved for LI bedrooms / Benja chiller : / • ,• CE 12592 Lev System #2 Approved for bedrooms filtF9Fpp... .. ION*`.�� Disapproved \ Conditional approval for bedrooms, with the following stipulations: ���\Y(OF( 4.1 C(ir GHQ ° x ON-SITE c WATER AND 17-1 WASTEWATER z1 PROGRAM \� 1)))))11)10' By: Original Certificate Date: S Tl 7 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 COSA Checklist Legal Description: Kasliof Hills Block 2 Lot 11 Parcel ID: 015-161-35 If more than 1 septic system on lot: COSA Checklist# of Structure served by this system A. WELL DATA ❑■ Well log is filed with Onsite (or attached) Well production at time of test 1.1 gpm Date drilled 9/15/78 Water storage tank volume gallons Total depth 350 ft Well disinfected for coliform test? ❑ Yes ❑■ No Cased to 40+ ft Coliform bacteria is Negative EI Sanitary seal is functioning correctlyNitrate 0.913 mg/L El Nitrate less than MRL (ND) Wires are properly protected Arsenic ug/L 0 Arsenic less than MRL (ND) Casing height(above ground) 32 in. Collected by Farmer's Surveying Date of flow test for COSA 12/21/18 Date of Sample 12/20/18 Static water level at beginning of test 53 ft. Comments B. TANK DATA C. LIFT STATION Age of tank(s) <1 years ❑ Required maintenance completed Tank type/material Septic/Steel Age of lift station years Measured operating fluid level in septic tank Lift station material th Standpipes/foundation cleanout per record drawing Comments: N/A Date of pumping New construction D. ABSORPTION FIELD DATA Deep Trench Which system tested (date installed) 1/12/19 Adequacy test date New Construction 0 ALL standpipes present per record drawing Results ®Pass For if bedrooms Total measured depth from grade 11 ft(max) Fluid depth prior to test in Measured depth to pipe invert from grade 4 ft(min) Water added gal ❑ N/A—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' Community Sewer Manhole/Cleanout> 100' 0 Yes if No ft Q Yes if No ft Neighboring Tank > 100' El Yes if No ft Private Sewer/Septic Line > 25' 0 Yes if No ft Absorption Field on Lot > 100' 0 Yes if No ft Holding Tank > 100' 0 Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' 0 Yes if No ft 0 Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' 0 Yes if No ft n Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ElYes if No ft Surface Water> 100' ❑✓ Yes if No ft Property Line > 5' El Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' 0 Yes if No ft Private Wells > 100' ✓❑ Yes if No ft Water Main > 10' El Yes if No ft Community Wells > 200' 0 Yes if No ft Water Service Line > 10' 0 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' 0 Yes if No ft If absorption field is under driveway comment below Property Line > 10' ❑ Yes if No 5* ft Wells on Adjacent Lots: Water Main > 10' 0 Yes if No ft Private Wells > 100' EJ Yes if No ft Water Service Line > 10' 0 Yes if No ft Community Wells > 200' 0 Yes if No ft Surface Water> 100' 0 Yes if No ft F. ENGINEER'S COMMENTS Waiver OSV191002 for separation to lot line G. ENGINEER'S CERTIFICATION �1���X‘\, OF A4.glll I certify that I have determined through field inspections and review , II...•' • l of Municipal records that the above systems are in conformance with /O •• .„ ` *-.117% MOA COSA guidelines in effect on this date. %*;.4 T! /\ • *1� • /r • Benja. chiller j r1 lac•.• CE 12592 •��/ �JJ 4/30/19 •••CSA / COSA Checklist yellow sheet ,ilia PROFESSO rs-4�' \ \1 \ \ \ 1 1 \ \ \ \ \ \ \ LOT 10 c\ BLOCK 2 �� '/ \o \ \\� 1 S�+�Ra� \ �\ LOT 7 \/ 5/8" REBAR •00,00"`N 200 / \SN; \r 0\mac �\ \ I E 116.2' ; �� \ 0 (:r 4" PLASTIC f \I^ O f )RISER (TYP.) o® BUILDING Z� o\ ` 111 x I GARAGE OVER \ o,\ LOT 6 n WELL \ \ I ;-� %` �/= o i' o1 I ASPHALT �� \ oo\ n DRIVE �w �N_ \ i^ I 3�+ .: �at o._ LOT a \ 7\\ tit a • ./ ►/� 30 410 S.F. 0 \ \ � 0.. �/a6.7' W 1�,�� ' O \ Ul R ( ) DWELLING` \\ U.G.T&E \\ // 36.4' 1/ \ / 0 a \ NAT GAS \-.) \CANTN �\ 73 r 203.0)<R�c>` ` _._.! ' \\ \\ �Z '<v <\\rg° _ • N (C)=CALCULATED DATA \\\ \ \\ ND: \\ Com, t (M)=MEASURED DATA \ohu OV RHED=RECORD AUTILIITIES TA PER LAT \ M Z U.G.=UNDERGROUND \ \ �-N T&E=TELECOMMUNICATION & \\ \ '' -6 N ELECTRIC \ Co 46 NAT.=NATURAL Z N \ PED=PEDESTAL \ \ -'. \ \ FND.=FOUNDATION \ \ (TYP.)=TYPICAL \ 1 1 \ \ \ 1" = 50' \ \ NOTES: 1. EXCEPTING FOR GROSS NEGLIGENCE, THE LIABILITY FOR THIS SURVEY SHALL NOT EXCEED THE COST OF PREPARING THIS SURVEY. 2. THIS SURVEY REPRESENTS VISIBLE IMPROVEMENTS Sc CONDITIONS ON THE DATE OF SURVEY. 3. THIS DOCUMENT DOES NOT CONSTITUTE A BOUNDARY SURVEY & IS SUBJECT TO ANY INACCURACIES THAT A SUBSEQUENT BOUNDARY SURVEY MAY DISCLOSE. 4. THIS SURVEY PERFORMED FOR SCOTT & SHARON LISKA, IT SHOULD ONLY BE USED FOR A SINGLE PROPERTY TRANSACTION. EXCLUSION NOTE: 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. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE LINES. tgo• 't �I�ll, AS-BUILT AB FARMER SURVEYING 9131 E. FRONTAGE RD. -S c....°°•........... iij PALMER, ALASKA 99645 •4: 4�P°° ' °**.j>r I�, PH: (907)745-0222 bob®farmersurveying.com www.farmersurveying.com i * 49TH /\ °°;* i 1hk ° WO: 18-00769 70. Li/CI PAGE: 1 of 1 FB: 19-01 �� -_---- 4. Robert J. Farmer :oNO Surveyors:Planners SCALE: 1 " = 50' FILE: 1800769AS /���'If'•° 10615—S •"��S I HEREBY CERTIFY THAT A MORTGAGE INSPECTION WAS PERFORMED L' ,,A, pb°FfSSI.NAL\'A�```� KASILOFUNDER MHILLS SUBDIVISION,Y DIRECTION ON HBLOCK 2,FOLLOWINGE LOTD11 DESCRIBED PROPERTY: lI��tl«„"����� PLAT No. 66-96, PALMER RECORDING DISTRICT, PALMER, ALASKA y J� t7 SURVEYED ON THE 17TH OF APRIL, 2019. ©2019 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH &HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage. Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING HAA# ~ ~c~ -q~ 0 bt, ~ 1, GENERAL INFORMATION Complete legal description ~,~.,1 I,I ~ ~..?~,~ .f~., Location (site address or directions) Property owner Mailing address Lending agency Mailing address. Day phone Agent Ad dress Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well NOTE: Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: NOTE: Individual on-site Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev, 1/91) Front MOA ~21 ':~JOM $,JBBU!bU~ lBuo!sseJoJd eqJ u! SUO!$S!LUO JO SJOJJe JOJ elq!suodseJ ~ou s! 86BJoqou¥ jo X~Jled!o!un!AI eq/ 'penss! s! @leo!J!:Ueo e eJojeq m, ep eZ/~leUe JO suo!loedsu] lonpuoo ~ou op SHHQ jo see/,olduJ:q 's~ueuueJ!nbeJ e~e~s pub leJepej ulel~eo/gs!~es o~ Jep~o u! suogn~p, su! 6u!puel J!eLl~ pub seLuoq Jo sJeseqoJnd oh/ts@iJnoo e se s!q~ seop SHH(] eq/'e~tselV jo @leis eq~ u! peJe~s!beJ JeeujDue leUO!SsejoJd ~uepuedepu! ue Xq e^oqe 9 qdeJbeJed u! ua^ih suo!ielueseJde~ eq), uodn XlUO p@seq sm, eo!j!lJeo le^oJddv ,~1poq~nv q),leeH s@nss! (SHHQ) seo!AJes ueuJnH pub q),leeH jo ~ueLuMedeQ ebeJoqouv jo X~!led!o!un~ eqj_ sjueuJuJoo leUO!l!pp¥ :suo!~elndRs bUlMO OJ eq~ q:~!M 'sguooJpeq Jo~ IeAOJdde leUO!I!puo0 'guJooJpeq ~ 'pe^oJddes!G JoJ. peAoJddv ~ 31:InJ.V'NglS SHHQ 'sepoo elm, cj pub Ied!oiunlN lie q~,!M eOUB!IdLUoO U! S! UJm, SXS lesOds!p J@:~BM@:~,SBM Jo/puB Xlddns ]e~BM e~!s-uo eq~ 'uop, oedsu! pUB uop, eB!~seAu! ~LU LUOJ~ pub seliJ e6eJoqouv jo Xl!led!o!unlAI eq], uJoJj peu!e~,qo UOp, BUUJOJU! eq~, uo peseq ~,e q), Xjpe^ Jeq~Jnj I 'u!eJeq pe~eoipu! eJ nlonJ~,s jo ed~, pUB suaoo]peq Jo JeqLunu eq~, Joj elBnbepe pub leUOp, ounj 'BiBs s! uJm, sXs lesods!p JejeMm, SBM Jo/puB ,~lddns Je~eM e~!s-uo eql leq~ SMOqS uop, eo!lddB le^oJddv X~,poq),nv qjleeH s!q), ~o UOp, B6!lseAu! ~LU ],eql ,~j!Je^ I 'MOleq UMOqS elep UO!~Bp!IB^ eq~ Jo se pub o~eJ@q pex!j~e IBeS XuJ Xq peit!~Jeo sV "9 bl~l:lNlONi] AB NOIJ. O:IdSNI :10 /N:IIN~iJ.VJ.S 'S Legal Description: A, Well Data Well type Log present (Y/N) Total depth Sanitary seal (Y/N) Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Date of test Static water level Well flow Pump level1 ~' ~,~ ; !~,',Parcel I.D. if A, B, or C, attach ADEC letter. ADEC water system number Date completed ' /??:,:/'/¢'~ Driller ~¢ ;~ Casing height Wires properly protected (Y/N) Cased to FROM WELL LOG ct~ 0 AT INSPECTION g.p.m, g,p.m. SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot / I L--~ Absorption field on lot Public sewer main Sewer service line ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform Date of sample: B. SEPTIC/HOLDING TANK DATA Date installed / ;¢<-) /,~ '( Nitrate ~-~ ,'7 7 Other bacteria l- ~ ~ :S Collected by: '~7 ~ Tank size Compartments Cleanouts(Y/N) ? Foundation cleanout (Y/N) _ High water alarm (Y/N) Date of pumping '-[.~.~., ~st%/ed Depression (Y/N) (Y/N) ]"///~ ~,'b Alarm Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot i i~ To property line ~, ,J~ Surface water/drainage On adjacent lots Absorption field Foundation Water main/service line 72-026 (3/93)* Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) "Pump on" level at High water alarm level Meets MOA electrical codes (Y/N) Manufacturer Manhole/Access (Y/N) "Pump off" Level at Cycles tested SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Length 'Tf:~~ Total absorption area Date of adequacy test Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) Width Soil rating (GPD/Ft2) ¢~./?-OL System type '/~/'¢.~ ,2 il Gravel thickness '~ Total depth JO ~ Cleanout present (Y/N) fh/'7~'~ Depression over field (Y/N) ~k.( Results (pass/fail) for . -~'~ Bedrooms I ~;,'~ After test c.~ -'~ If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot I 0 To building foundation On adjacent lots '~ ~ Surface water N i ~ Curtain drain ~'q ( (~' On adjacent lots '~ I C','(~ Property line ¢~ To existing or abandoned system on lot Cutbank ~'~ ~ ~,t. ~ Water main/service line Driveway, parking/vehicle storage area E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to afl MOA and HAA gu/defines in effe¢ on th~ .d,a~te of this inspection. Signature Engineer's Name Date HA,& Fee $ Date of Payment Receipt Number 72-026 (3/93)* Back Waiver Fee $ Date of Payment Receipt Number ANCHORAGE, ALASKA 99502-5904 (907) L79-.. 716 Mur~icipai ity o-F Anchor agc~: Division o~ ~--r~.vironmerH:ai Health O,apartment of Health and Social Services E]20 I Street Anchorages Alaskm 99501 Subii~:,c.t: HAA ~:or Lc)i: i1., Block 2 Kasi)oz~ Hills Au~ust .3c) ~ ] 993 Ge~t i emen; q-he (,~e!). was (:esi:ed lin August 2~ 1993. At Lhe b~:~gin~J ng o.F th[a test the water sur~:ace was .Fouled at 44 feet belew top o-F At ,=~ pomping rate of 6.5 gallons per minute the ~;ol].ow~n~ read-- ings were 'k~),ken. TIME bJtYTER METER SONAR I: 33 182 ~, 230 44- 1: 4Ei ..3:J-lO :[ 12 2: 0:~ 460 205 2: 40 306 2: 50 298 3: 00 290 3: 10 282 3: 20 ~ ~ ~ 3: J;O 264 3: 40 257 Stop Water ~: 30am .];0 J}u~-il'~r~ one boor oxF recover',/ th~, ~1] recovered 49 .Fec~,~ or 7..~,.5 ga)Ions ( 1.'2 cjpm) 'Thins recowary rate prevailed ~of some, Izimm as evidenced by the full recovery over nicjhJ:. ]l~e residence was occupied durin(] '[his l:~t-:iod: ~iith unl-::llOVJn qu,vd]hi'Lies o-f: wat[z~r MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. # 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include 10t, block, subdivision, section, township, range) CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING · %, ,--' L'~- /Lo~- ~--,~ NAA# ~-~c~ { .,~\ Location (address or directions) !o¢/z i ,F..AS ! LOF (b) Property owner .Al /'~,~ Mailing Address P(~ (c) Lending Institution Mailing Address (d) A i,J.m H A K. Telephone: (home) ANc_~ A K Telephone ~ Busi ness "7¢O'4X, -- ~- 75-~ Real Estate Company and Agent Add ress ~/~ 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~'~ Number of bedrooms 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 legality and status. 72-025 (Rev, 7/88) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified bymysealaffixed hereto and as of the validation date shown below, IverJfythat my investigation of this 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. NameofFirm(~'~E~L~/ll\i ¢ /~,.~5C'<- Telephone Address /~?~c~ J~ D ~ ~l[~kl D ~2~ Date ~ 8. DHHS APPROVAL Approved for ,,.¢'- bedrooms by Approved g(,,_ Disapproved Terms of Conditional Approval Conditional The Municipality of Anchorage Department of Health 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 order to satisfy certain federal and state requirements. Employees of DHHSdonotconductinspections or analyze data before a certificate is issued. TheMunicipalityofAnchorageisnot responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 7/88) Back Page 2 of 2 MUNICIPALITY OF ANCHORAGE (MOA) Health Authorily Approval (HAA) CHECKLIST- FEBRUARY 1984 343-4744 Legal Description: Lo If A, B, C, D.E.C. Approved (Y/N) __ Well Log Present (Y/N) 7 Date Completed 5/,~ Total Depth -- (. Cased to~-3' Depth of Grouting 1-},~ Static Water Level __27_~' Pump Set At Yield Casing Height Above Ground ~ ?'z ' Electrical Wiring in Conduit (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line ~i //~ To Nearest Sewer Service Line on Lot Water Sample Collected by ,Y--. L;,~ Water Sample Test Results .~,'~ Comments ? ~:~v_o~/ -~_~ Sanitary Seal on Casing (Y/N) ~ Depression Around Wellhead (Y/N) ~ ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole ;Date SEPTIC/HOLDING TANK DATA Date Installed [~ 7~ _~Size // Standpipes(Y/N) y _Air-tight Caps(Y/N) Depression over Tank (Y/N) ~ Pumping/Maintenance Contact on File (Y/N) ~L! Holding Tank High-Water Alarm (Y/N) /kl SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply Well ] I~ ~ To Building Foundation No. of Compartments Foundation Cleanout (Y,¢~4~) Date Last Pu m ped _~//~.5-/~¢¢( ;for ~.J Temporary Holding Tank Permit (Y/N) To Property Line ~Z. ' % To Water Main/Service Line ;:" -¢© ' To Stream, Pond, Lake or Major Drainage Course To Disposal Field ."5- ' '+' 72-026 (Rev. 7/88) Fronl Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ,-~, , Width of Field '-~ 6,0" Square Feet of Absortion Area Depression over Field (Y/N) Results of Last Adequacy Test Type of System Design Length of Field -/E; ' Depth of Field /O ~ Gravel Bed Thickness -7 ~ Statndpipes Present (Y/N) Date of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well I ~/.z~' ~ To Building Foundation Lot l '~ ' To Water Main/Service Line ;~ .¢O ~ To Stream, Pond, Lake, or Major Drainage Course It,.J To Driveway, Parking Area, or Vehicle Storage Area Comments' ' (*/~6¢ I ~ ~, J~ .~o To Property Line To Existing or Abandoned System on ; On Adjoining Lots .~' ~'~O ' To Cutback (if present) D. LIFT STATION Date Installed ~ Size in Gallons "Pump On" Level at~ High Water Alarm Level a~N Tested for es (Y/~ Meets MOA Electrical Cod Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked verified or.conformed to alI MOA and HAA guidelines in effect on the date of this inspectionE _/¢' ~.~ ~_////' ~ Company ~. (2/L. ~.~, / ~' Date ~- ¢> ,* ( ~ MOA No. ' ¢-- Receipt No ¢:~/¢j2 Date of PaYment F ~--~-(:~/' ' Amount: $ /~::)~- 72-026 (Rev 7/88} Back Receipt No. Waiver Fee: $ Date of Payment Page 2 of 2 -r '' MUNICIPALITY OF ANCHORAGE ' , ~,~z~ ccl'lO~ ~ ~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ~EST FO~ ~PP~OVAk OF I~DIVIDHAk ~ATfiB A~D SE~R F~ClLITIES IIRECTIONB~ Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. t. PROPERTY OWNER PHONE ~'~- 9 9~9 MAILING ADDRESS PROPERTY RESIDENT ill different from abovel 2. BUYER PHONE PHONE MAILING ADDRESS 3'.' LENDING INSTITUTION MAILING ADDRESS" PHONE 4, REALTOR/AGENT PHONE' MAILING ADDRESS 5, LEGAL DESCRIPTION STREET LOCATION /t/N/I./ 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS ~ One [~]~our [] Other ~' SINGLE FAMILY ~ Two ~1- r-ivl; [] MULTIPLE FAMILY [] Three [] Six ~ 7. WATER SUPPLY INDIVIDU~,L' COMMUNITY PUBLIC UTILITY * ATTACH WELL LOG, A well log is required for all wells drilled since June 1975, For wells drilled prior to that date, give wel depth (attach log if available,) 8, S~WAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE** PUBLIC UTILITY **If individual/on-site, give installation date ~7~ '~ If system is over two [2) years old an adequacy test is required by this Department NOTE: THE INSPECTION FEI-: MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED, THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPEOTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS ~ SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY B~~ TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY []~* I NDIVI DUAL DEPTH OF WELL [] COMMUNITY "~ ~'~) I DATE DRILLED Connection Verified LOG RECEIVED 3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER E~;all~DIVI DUAL/ON -SITE DATE INSTALLED ~'~" []PUBLIC UTILITY ~ Q Connection Verified INSTALLER [~%eptic Tank or E] Holding Tank Size:~(-', If Tank is homemade SOILS RATING TYPE OF TANK MANUFACTURER/ TOTAL ABSORPTION AREA MATERIAL~ 4. DISTANCESwELL TO: Septic/Holding t'ank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS ~PPROVED FOR ,...~¢/ BEDROOMS [] CONDITIONAL APPROVAL {letter must accomp~ certificate) DATE i BY (Ti t1.¢)/~ / LEGA~ D ESC'RIPTION 72-010 (Rev. 3/78)