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KIMBERLY MANOR BLK 1 LT 12
Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP241223 PID Number: 017-074-51 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name EDWARD & STEPHANIE WARNER ABSORPTION FIELD — ADVANTEX ❑ Deep Trench ❑ Wide Trench ® Bed ® Mound Site Address 7540 UPPER DE ARMOUN ROAD ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade (OG) 3 1 GPD/SF ABOVE ORIGINAL GRADE 1.5 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade (1' FROM OG + 0.5'ED) .5 Ft. Gravel depth beneath pipe 0.5 Ft. Subdivision Block Lot+1 KIMBERLY MANOR 1 12 Fill added — above / from original grade VARIES - 6.28' - 7.08 Ft. Gravel length 30 Ft. Township Range Section Gravel width 15 Ft. Beds: Number of Lines 3 Distance between lines 15 Ft. SEPARATION DISTANCES To! Septic AbsorptionHolding Lift Station Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 450 Ft' NA NA Ft. Well 50'+ 50'+ 50'+ 25'+ TANK ® Septic ® S.T.E.P. ElHolding ® Other ADVANTEX Manufacturer ORENCO / ANCH. TANK Capacity 1500 Gal. Surface water 50'+ 50'+ i 50'+ Material EPDXY STEEL Number of compartments 2 Lot Line 5'+ 5'+ 5'+ NA Foundation 101+ 10'+ 10'+ LIFT STATION — PUMP BASIN PB Manufacturer ORENCO Capacity 75+ Gal. Remarks Existing field/tank decommissioned. All biomat soils removed & new field installed. PB insulated — not the field. Alarm location Electrical installed by FIRST FLOOR LINESIDE ELECTRIC Tank to PIPE MATERIAL House to tank 3034 d of eld 3034 Installer RED DOG MASONARY a - - - Drainfeld 3034 CO/MT 3034 Inspector FWC BENCH MARK (Assumed elevation) 100 ft Inspeection 1" 11/12/2024 2nd 11/14/24 Location and description 3`d 11/15/24 41' 11/15/24 GARAGE SLAB ON-SITE WATER AND WASTEWATER SECTION APPROVAL Conditional Approval: Date A Q •� • �,�1, TH Septic Syste Approved `'� Date11/20/24. ' • Curtis Huffman �� �F�; •, CEI28991 .• 4`�/� •' ��..� . ROFE80 ote: this approval does not include well permit requirements. (Rev 05/92/18) PID:017-074-51PERMIT:OSP241223 FIRST WATER CONSULTING KIMBERLY MANOR B1, L12 MUNICIPALITY OFANCHORAGE On -Site Water & Wastewater Program PoBox 18665 4700Elmore Road Anchorage, Alaska 9n51S'66S0 Phone: (9O7)343-7So4 Fax: (8O7)343-7887 On -Site Wastewater Disposal SystemPermit Permit Number: OSP241223 Work Type: Septic Upgrade TmxCodeNummbar: 01707451000 Site Legal Address: K|K4BERLYMANOR BLK 1LT12 G:2840 Site Mailing Address: 7540UPPER OEARK4OUNRD.Anchorage Owner: WARNER ED&8TEPHAN|EJOINT Design Engineer: FIRST WATER CONSULTING This permit is for the construction of: 21 Oiapunn| Field 2 Septic Tank Holding Tank [] Privy Effective Date Expiration Date: Lot Size in Sq Ft: Total Bedrooms: 8/21/2024 8/21/2025 El Private Well 11 Water Storage All construction shall beinaccordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chepbero15.55 and 15.85and the State ufAlaska Wastewater Disposal Regulations (18A\C72) and Drinking Water Regulations (1 8AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.05.Provide notification bycalling (9U7)343-7804(24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall beeither: o. Opened and Closed nnthe same day, ur b. Covered, sealed, and heated to prevent freezing 3 )� �J n���/c� .�� � '—��^ ~ � /\ 7-/ " Received By: C- Issued By: Date: MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax- 907-343-7997 ON -SITE SEPTICIWELL PERMIT APPLICATION Parcel I.D. 017-0745-10 Property owner(s) EDWARD & STEPHANIE WARNER Day phone Mailinci address 7540 UPPER DEARMOUN ROAD, ANCHORAGE, AK 99516 Site address 7540 UPPER DEARMOUN ROAD, ANCHORAGE, AK 99516 Legal description (Sub'd., Block & Lot) KIMBERLY MANOR B1, L12 Legal description (Township, Range & Section) Lot Size 34,500 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (N all that apply) Absorption Field Fx-1 Initial M Single Family (SF) El (w/wo AD U) Septic Tank X1 Upgrade FXJ Duplex (D) 0 Holding Tank F-1 Renewal El Multiple Dwellings ❑ Prix/v F-1 and/or nN Private Well El Water Storage El THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature. of property owner or authorized agent) Permit/Rush Fees: *695 Date of Payment: Z/;�Sz ,_ q Receipt Number: C 3) 5 2?;Z Permit No. Oc-7122 9 1 Z Waiver Fees: Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com ! July 24, 2024 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC SYSTEM UPGRADE PERMIT LEGAL: KIMBERLY MANOR BLOCK 1, LOT 12 The existing septic system has been found failed and will be completely decommissioned and per the owner we request a septic permit to upgrade the existing septic system on the above referenced lot. We propose to install a mounded bed with an Advantex system to serve the existing 3-bedroom residence per the attached design. The design is based on the MOA record test hole conducted by Michael E Anderson, PE in the summer of 2003. No groundwater was observed at excavation or monitoring of this test hole. The slopes are moderate at 0-3% at the proposed upgrade location. The lot and area are served by private water with no known private wells within 50’ of the proposed septic system. Based on visual observations and review of available information, the design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241223, Curtis Townsend, 08/21/24 FIRST WATER CONSULTING KIMBERLY MANOR BLOCK 1, LOT 12 DESIGN CALCS: NO WELLS WITHIN 50' OF PROPOSED SEPTIC SYSTEM. NO SLOPES >25% WITHIN 50' OF PROPOSED FIELD. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241223, Curtis Townsend, 08/21/24 FIRST WATER CONSULTING DESIGN DETAILS: KIMBERLY MANOR BLOCK 1, LOT 12 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241223, Curtis Townsend, 08/21/24 UPPER DeARMOUN ROAD *MNNM I 1 �n nn' 1 40' ID 0 Z:7 i It UV E, I JU.UU ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: KIMBERLY MANOR SUBDIVISION FND 5/8" REBAR LOT 12 BLOCK I PLAT P-476 I ,!!!N su)?v SURVEY CERTIFICATE: 1, John L. SchullerAMP , Have conducted a OF I- A \r '4 P physical survey of this property as shown on this drawing and that the ow 10 improvements situated hereon are within the property lines and no enchroachments exist other than noted. Under no circumstance should 00, 49TH •,'� , ! �,,, any information on this drawing be used for construction of fences, ................. structures, improvements, or for establishing boundary lines. 'A o. EXCLUSION NOTES: It is the owners responsibility to determine F ...... ............... ........ -JOHN L. SCHULLER.-. 0 the existence of any casements, covenants, or restrictions which LS—11 0 10408 do not appear on the recorded subdivision plat. ew 1831 Talkeetna Street WORK ORDER NUMBER: DATE- SCALE; E-MAIL Ov V. 6 Anchorage, Alaska 99508 JULY 22, 2024 1 40' schullerokOgmail.com 7 la, Z4 DRAWN BY. CHECKED BY. MD NUMBER: Of 0�1 24-079 ession(3\ N' ® (907) 227-1455 office SW2940 JCS 24025 (907) 274-4992 fax — L 1 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Elmore St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak. us (907)343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: Anderson Engineering Legal description: Kimberly Manor, 131 L12 ❑Permit ❑C.O.S.A. ®Inspection Report The attached paperwork has been reviewed and is being returned for the following reasons: 1. M3 is shown on the site plan as a monitor tube. 2. An air gage must be in an easily accessible location inside the house. 3. Depth to pipe bottom does not match profile. 4. Total depth does not match profile. 5. Fill does not match profile. 6. Ray's Services does not sell steel tanks. 7. Fix "High water alarm set at". Name of reviewer: Deb Date: 7/7/08 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK Municipality of AnchorageM. s t''¢ Development Services Department Building Safety Division On -Site Water and Wastewater Program, 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page of www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT. Permit Number: SWO30317 PID Number: 017-074-51 Name: Edward & Stephanie warner Wastewater System:. ✓❑ New ❑Upgrade Address: 7540 Upper DeAmnoun Road Anchorage, AK 99516 ABSORPTION FIELD Phone: 349-1490 Number of Bedrooms: 4 -❑ Deep Trench O Shallow Trench D Bed ❑ Mound r/7.Other: LEGAL DESCRIPTION' Soil Rating: Total Depth from original gratle: 1 GFi 1.5 Ft. Block:/ Lot: 12 Subdivision: Depth to pipe bottom fmm ongmal grade: Gravel depth beneath pipe: Kimberly Manor +1 Ft. .5 Ft. Township: Range: Section: Fill added above anginal grace: Gravel Length: 3-5 Ft. 40 Ft. Well: Z New El Upgrade Gravel width: Number of lines: Distance between lines: z6 Ft. 1 Classification (Private, A, B. C): Total Depth: Cased to: Total absorption area: Pip. Material: Private 261 Ft 261 Ft 800 Tt ASTM D3034 PVC Dnllec Date Dolled Staticwater Level: Installer. Date Installed Alpine Drilling 6/18/04 178 Ft. Acreage Systems 9/17 to 9/19/2003 Yield, Pump Set at: Casing Height Above Ground: TANK 15 GPM 2 FL SEPARATIONDISTANCES ® Septic ❑ Holding ❑ S.T.E.P. ❑ Other: To Septic Absorption Lift Holding 3ubJIcJPrivate ManufacWrer Capacity: From Tank Field Station Tank Sewer Line Ray's Services 1,250 Gel, Material: Number of Compartments: Wall >100' >100' >100' N/A >25' Steell Two Surfacewater >100' >100' >100' NIA LIFT STATION in Manufacturer: Lot Line >5' >10' >5' N/A 550 Gal, Fat Boy -Ray's Services "Pump on' level at "Pump off' level at: High water alarm of Foundation >5' >10' >5' N/A 44 in 38 in Goulds 20EB05 Duman Dram None Noted Pump Make & Madel Goulds 20ES05 Electrical Inspections performed by: Muni. of Anchorage Remarks: Intermittent Dosing Sand Filter (IDSF) as Manufactured by BENCH MARK Location and Description. Orenco Systems and Anchorage Tank. Air Gauge Located Garage Slab Assumed Elevation: Near Manhole Currently Reading 3 PSI. 2' Coarse Sand 100.00 Ft. Beneath Absorption Bed. MEA IlLNe• Inspections performed by: Dates: 1a' 9/17/2003 jo ., gs�aa 9/19/2003 '��~� ,• ®� • •,� 2nd Development Services Department Approval*. 4918 * d '.... �•........... .... Conditional Approval Date: yy. •............. p •• MICHAEL E. ANDERSON •4All. at 6E J° E w Reviewed and approved by: Date: t%Tiet�a�'�� (Rs, 0406) Municipality of Anchorage Page 2 of 3 DEVEOPMENT SERVICES DEPARTMENT 4700 Bragaw Street Anchorage, AK. 99519-6655-343-7904 On-Site Wastewater Disposal System or Well Inspection Report Permit No. SW030317 PID No. 017-074-51 UPPER DeARMOUN ROAD 0 i S 89'54'00"E 150.00' I I well I I A B I S2 25.1' 366 .2' 52 30.6' 44.9 A.C. DRIVE MH 27.5' 46.7' HV 19742.1' M1 257' 50.5' M3 M2 O O O M2 37.2' 15.9' 93 467 32.4' _ I I N ro Four Bedroom o TH1 QA Home o w M1 ® BV o O O (0 i • MH I Z O c X_ p :2 82 iH !n 51 Z W I � Alt. Site � FENCE (APX) I in TH2 I KIMBERLY MANOR SUBDIVISION LOT 12, BLOCK 1 I 34,800 S.F. I L — — — — — — — — 1-0' — U—TIL. — —ES—MT. — — — — — — — — — • Off• �IIh1/1 S 89'54'00"E 150.00' X i.'.... 49th -.:u ♦♦ _'�`�'�..� ........ PLAN AS-BUILT -.-MICHAEL E. ANDERSON ' j Cf ♦-##'t ' NO. CE-4381 ti, � ♦♦-'••6''t� SCALE t' = 40' II/ISI E �� � ••• Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number: SW030317 Original Ground 83.9 Q 9/15/05 N H n t� `— 77.4 97.1 N 1,250 Gallon Septic Tank 91.0.- 91.2 -96.2-98.9 91.4 20' Page 3 of 3 PID No. 017-074-51 m m W m 3 3' Direct p Bury Ins. U x Fat Albert Pump Chamber Geotwile Fabric Over Pea Gravel —3/4" PVC Laterals (4 Each) 3/8" Pea Gravel Original Einound Air Line 18" Below Top of Sand PROFILE AS -BUILT - Scale: 1" = 10' MEMORANDUM DATE: June 29, 2008' TO:, Debbie Wockenfuss FROM: Mike Anderson, P.E. 1 SUBJECT: Lot 1.2, BlockKimberly Manor Subdivision Septic System As -Built We recently completed modifications to the septic system on the subject project as follows: 1. The Fat Albert Lift Station was uncovered to a depth of nearly 5' below the surface. An approximate depth of 3' of 2" thick direct bury insulation was placed in a 6' diameter around the lift station. The excavated area was then filled with the original ground material. The surface was then contoured and landscaped. 2. An insulated manhole cover was placed on the manhole. 3. Test Hole No. 1 was originally placed on the lot when trees brush and other hindrances to accurate measurement were noted. Once the lot was cleared the test hole was measured as accurately as possible resulting in its current location. 4. M3 is a marker of the outside edge of the bed. It is not a Monitor Tube. 5. The air gauge is installed near the manhole location. Here it provides more accuracy as it gauges the air in the location of the bed. An air gauge in the house can give faulty readings as the air line on the field side of the gauge can be plugged and the gauge will still register air flow. 6. Field notes have been reviewed and 2' of the required sand are in place. The elevations on the inspection report have been modified. 7. The parcel ID Number has been changed. 8. Total depth is correct. The organic layer was removed to 1.5' below ground and replaced with clean filter sand. 9. The exterior of the manhole has been insulated. 10. Topsoil, seeding and landscaping has taken place. We hereby request the septic system be approved as installed. MEMORANDUM DATE: November 14. 2007 TO: Reviewer FROM: Mike Anderson, P.E. SUBJECT: Lot 12, Block 2, Kimberly Manor Subdivision Septic System As -Built Prior to the construction of the septic system on the subject lot the owner decided to place an Intermittent Dosing Sand Filter (IDSF) instead of the permitted Advantex Treatment System primarily due to cost constraints. He also decided to place the system at the reserve site to minimize impact to his back yard. Both changes were discussed verbally with the City and approved. ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 (FAX) MEMORANDUM DATE: August 14, 2003 TO: Dan Roth p FROM: Mike Anderson, P.E. d�ti 1111-,_ SUBJECT: Lot 13, Block 1, Kimberly Manor Subdivision Homeowner's Agreement Attached is the homeowner's agreement for the septic system to be placed on the subject lot. The owner has determined he will not be constructing his own system based on information received from Lowell McNutt at Anchorage Tank. Edward J. Warner 1317 E. 72"d, Avenue Anchorage, Alaska 99518 Municipality of Anchorage Building Safety Onsite Water and Wastewater Section Attn: Jim Cross Dear Sir: Please consider this request to allow that I install my own wastewater system at 7540 DeArmoun Road under the supervision of Mr. Mike Anderson of Anderson Engineering. I have experience in installation of tanks. I currently am afire sprinkler contractor and we install underground tanks quite frequently for water supply to these systems. Also, from 1968 to 1982 I owned and operated a company in Portland, Oregon that performed installation of underground water, and sewer mains, as well as site preparation, including septic systems. Before graduating from high school I worked with my father for many years and his entire business consisted of installing on site septic systems including, sand filter systems, and mound systems. Please call me at my office if you have any questions. That number is 349- 1490. Sincerely Your, Ed word Warner ROM : ALPINE DRILLING Rick Mysrrom Mayor FAX NO. : 987 345 0202 Nov. 12 2007 12:47PM P1 Municipality of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 http:/Mww.ci.anCh'0raqe-ak.us Permit Number: #SW 030317 Date of Issue: 8-19-03 Parcel Identification Number: 017 -074 - bate Started: 6-18-04 Date Completed: 6-1$-04 Is well located at approved permit location? ® Yes ❑ No Legal Description: Kimber Manor Siook 1 Lot 12 Property Owner Name & Address: Ed Warner PO Box 140307 Anrhoraoe_ Alaska 99414-0307 Borehole Data: Depth (ft) Method of Drilling ® air rotary ❑ cable tool Son Type, Thicimess & Water Strata From To Casing type: steel Stick up 0 2 Wall Thickaess:.250 inches organics & silt gravelly silt sift 2 4 45 4 45 61 Diameter: 6 inches Depth: 261 feet Liner Type: Diameter; inches Depth: feet Casing stickup above ground: 2 feet gravelly cobbly silt 61 204 Static water level (from ground level): jWYeet silty sandy gravel H2O 204 208 pumping level: 261 feet after silt 208 227 2 hours pumping 15 gpm gravelly silt silty water sand & gravel 227 255 255 261 Recovery Rate: 15 gpm Method of Testing: airlift Well Intake Opening Type: ® Open End ❑ Open Hole ❑ Screened Start feet Stopped feet ❑ perforations Start feet Stopped feet Groat Type: bentonite # 8 Volume: 2 Depth; Start 0 feet Stopped ? feet Pump: Intake Depth feet pump size hp Brand Name Well Disinfected Upon Completion? ® Yes ❑ No Method of Disinfection: chlorine tablets Comments: Well Driller. Alpine Drilling & Enterprises PO Box 110496 Anchorage Alaska 99511 Attention: The well driller shall provide a well log to the property owner within 30 days of completion and the property 0 .6 M P-476 KIMBERLY MANOR SUBDIVISION LOT 12, BLOCK 1 34,800 S.F. UPPER DeARMOUN ROAD 0 r� S 89954'00"E 1 I I WELL I� I A.C. DRIVE I 41.3' o I 0 ci i to EXISTING BUILDING I 41.3' Lu O o I • SEPTIC SYSTEM o I 26.7' z IW I� I J� I I I I 10' (TIL. ESMT, — — — — — S 89054'00"E 150.00' COVERED ENTRY 166 BUILDING DETAIL SCALE: 1 "=20' GASTALDI LAND SURVEYING, LLC JEFF A. GASTALDI, R.L.S. 4726 WEST 88TH AVENUE ANCHORAGE, ALASKA 99502 PHONE 248-5454 GRID DATE 2940 3/29/2006 F.B. JOB NO. 06-02 KMS121 0 C N CONC, PAD 8.0' 0 "i N I HEREBY CERTIFY THAT I HAVE SURVEYED THE PROPERTY DEPICTED ABOVE AND THAT NO ENCROACHMENTS EXIST EXCEPT AS INDICATED. 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. ANCHORAGE RECORDING DISTRICT, ALASKA NOTE: NO CORNERS SET THIS DATE w FENCE (API() 1 11=40' OF 4:4911-1 ♦ 0 lo ..... ...... .............. ! Y A. G°st°Idi o AN ..^•, •r• LS -6091 •' tJm� 4W map ••........• �6°♦♦ •�efOj`ession°I L°��� t"Q, C' 011Munieipali4Tof Anchorage P.O. Box 196650 • Anchorage, Alaska 990196650 • 4700 )✓]more Road Office. (907),43.8'M • Fax(907) 343-8200 http://mn.mmii.org h1ay07- Mark Begich Developniexat Senices LDel:)artsnent November 8, 2007 Edward Warner 7540 Upper De Armoun Road Anchorage, AK 99516 Subject: NOTICE OF VIOLATION Kimberly Manor Block 1 Lot 12 On -Site Water & Wastewater Permit (SW030317) Certified Mail #:70042510000198887163 Dear Edward Warner: All Department The final inspection report for your wastewater system has not been received by the On - Site Water and Wastewater Program office. This letter will serve as a Notice of Violation that there is an unapproved water and/or wastewater system at this location. Anchorage Municipal Code requires: Within 30 working days from the date of the final inspection of an on-site wastewater disposal system, an inspection report, shall be submitted to the department by the owner or his agent. The report must bear the seal of an engineer and be on a form and to standards prescribed by the department. No person may cause or permit any wastewater to be discharged or disposed of except into an on-site wastewater disposal system conforming to state and municipal standards. In order to avoid future enforcement actions, which may include fines, please contact your engineer to resolve this violation. An inspection report for the subject wastewater system must be received by this office within two weeks of the date on this letter. Thank you for your cooperation in this matter. Please call the On -Site Water and Wastewater Program at 343-7904 if you have any questions. Sincerely, lt Deb Wockenfus Civil Engineer On -Site Water & Wastewater Program Community, Security, Prosperity Page: 1 Document Name: untitled PARCEL: 017-074-51-000 CARD: 01 OF 01 RESIDENTIAL SINGLE FAMILY STATUS: RENUMBERED TO/FROM: 017-073-29-000-15 1 --------- GRW: PUBR WARNER EDWARD J & STEPHANIE KIMBERLY MANOR BLK 1 LT 12 7540 UPPER DE ARMOUN RD 0 ANCHORAGE AK 99516 3801 SITE 7540 UPPER DE ARMOUN RD LOT SIZE: 34,500 ---DATE CHANGED--- ----DEED CHANGED ---- ZONE : R6 OWNER :08/15/03 STATEID: 200310074878 TAX DIST: 012 ADDRESS: 02/23/05 DATE: 07/28/03 GRID : SW2940 HRA # : 00-0000 PLAT: 00-0000 NOTES : RENUMBERED FROM 01707329000 PLAT P -476 ----------------------------------ASSESSMENT HISTORY -------------------------- --- LAND-- --BUILDING- ---TOTAL--- -COMM COUNCIL - APPRAISED VAL 2005: 67,300 265,500 332,800 HILLSIDE EAST APPRAISED VAL 2006: 72,900 301,500 374,400 -EXEMPTION--- APPRAISED VAL 2007: 100,700 338,000 438,700 -----TYPE----- EXEMPT VALUE 2007: 0 0 0 STATE CREDIT 2007: RESID CREDIT 2007: TAXABLE VALUE 2007: /J Date: 11/8/2007 Time: 03:11:46 PM 0 0 438,700 Munieiliality of Anehorage �� � P.O. Box 19665 n 0 • clioiage, :Uasha 99,519 6650 - Teleplioue (907) 343-8301 • Pax (907) 343-8200 4700 Braga m St,cd • Anchorage, Alaska 99507 {v"l v.➢lttn].OT6 Hayor Marle Begich Building Safety Division 10/7/2004 Ed Warner P.O. Box 140307 Anchorage, AK 99414-0307 Subject: Expired On -Site Water and/or Wastewater Permit. Permit Number: SW030317 Legal Description: Kimberly Manor Block 1 Lot 12 Dear Mr. Warner: An On -Site Water/Wastewater Permit, number SW030317 issued by this office for a single-family system, expired on August 18, 2004. The permit was valid for 365 calendar days. If this was a well permit and the well has been drilled, a well log must be sent to this office for documentation of the installation and to close the permit. If this permit was for a wastewater disposal system, an original as -built inspection report must be sent to this office for review, approval and documentation. This as -built inspection report must be signed by the licensed Professional Engineer who inspected the installation of the system. As -built inspection reports are required to be submitted within 30 days of the completion of the system. If no system was installed under this permit, and you are still planning to install a well or wastewater disposal system, a new permit must be obtained from this office. When applying for a new permit, the fees are: $460.00 for a wastewater permit and $175.00 for a well permit. If you have any questions, please call this office at 343-7904. Sincerely, Daniel J. Roth Manager On -Site Water and Wastewater Program Enc: Copy of permit Community, Security, Prosperity MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 q I--I)U2�1 � 0�.) cA1,Q,1C;-)-(C),� ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT Initial Permit Number: SW030317 Date Issued: Aug 19, 2003 Expiration Date: Aug 18, 2004 Parcel ID: 017-07451 Legal Description: KIMBERLY MANOR SUBDIVISION BLOCK 1 LOT 12 Design Engineer: 0014 Anderson Engineering Owner Name: ED WARNER Owner Address: PO BOX 140307 ANCHORAGE, A 99414-0307 Site Address: NHN UPPER DEARMOUN ROAD Lot Size: 35200 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: ❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy All construction must be in accordance with: 1. The attached approved design. ❑✓ Private Well ❑ Water Storage 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. � I 7 Received By: Issued By: Date:,.[- C' Date: 8 F/0.? Municipality of Anchorage • -.t Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 0/ 7 — 074 Permit Number SW U3U3/] Property owner(s) Ed warner Day phone 441-1467 Mailing address (1) P.O. Box 140607 Anchorage, AK 99414 Mailing address (2) Zip Code Legal description (Lot, Block & Sub'd.) Lot 12, 61ock 1, Kimberly Manor Subdivision Legal description (Section, Township & Range) Lot Size 3Z,1_ 00 Acre q.Ft. Number of Bedrooms Four (4) THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well M Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Date of Payment: Date of Payment: Receipt Number: 73-44 44 Receipt Number: (Rev. 12A0) ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 (FAX) August 3, 2003 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 12, Block 1, Kimberly Manor Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Lot 12, Block 1, Kimberly Manor Subdivision intends to construct a new four-bedroom home on the lot. We are therefore requesting a permit be issued for the construction of a new well and septic system to serve the home. The attached Site Plan and backup documentation identify the location and configuration of the new well, septic system and alternate site and the parameters used in the design. Also identified on the plans are the location of the surface drainage, test holes and the wells and septic systems on the surrounding lots. Drainage arrows and spot elevations are shown indicating the current drainage patterns. The drainage patterns will be maintained after construction. The test holes placed on this lot revealed silty gravel with some sand. The percolation rate in the upper layers ranged from 3 minutes to 5 minutes per inch. Layers below 2' were tighter with more silt and percolated at a rate of 45 to 60 minutes per inch. Materials below 6' became virtually impervious. No groundwater was noted in either test hole and none was noted during the monitoring period. We are proposing to place a 1,500 -gallon Advantex Treatment System with an add on lift station on the lot. Effluent will be pumped to a 40' long x 20' long absorption bed with 2' of coarse sand to replace removed organics and elevate the bed 1' above existing ground. Insulation will be required along with 2' of fill to prevent frost penetration and freezing. Some grading will be required to insure surface drainage is away from the new septic system. The ground surface on the lot slopes as shown on the site plan from north to south at Lot 12, Block 1, Kimberly Manor August 3, 2003 Page Two varying shallow slopes. The surface drops approximately 3' at the midpoint and then again flows toward the southwest corner of the lot. The absorption bed will be constructed parallel with the slope as much as possible in conformance with Municipal requirements. All components of the new septic system will be constructed a minimum of 1 00'from any surface water and 1 00'from the well on this and adjacent lots. If the system is constructed in accordance with our design the following statements apply: 1. The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, -P Ear Michael E. Anderson, P.E. Attachments �P 49th •°� MICHAEL E. ANDER; NO. CE -4381 Upper De Armoun Road 150.00 150.00 1 ';�Q.O'o!: 150.00 aro .se6 o 16 13 m! N n c5 N Ci VACANT LOT o m! H Omo Home "E 179 67 N 14 0 " ,a 7Blosoo 0 1m0o 11 m m as m.r,easnantsrnam o re ® wiP LMS13Y�n ^2p O J , H2 15 3 K�Mg�R Y 110 00 N80 Zy'00"E 101Uti1 Esmt 0 3 o M N CJ 1 N 2 s� 0 0 N Ab ,171 70.00 150. 0 Cox Drive °9s B oa'a °. t. TH®. >� aeo o� m,e A44CIIAEL E. ANDERSON _`,� to AREA PLAN �� sf, `E �$'It SCALE 1" = 80' ���®��� Up er De Armoun Road 150.00 '•r 0 Proposed Well I 12 MI o Bedroo N M� Home M 1 500 Gallon N 10' Advantex Treatment Systerrj TH 1 with Lift Station ® 40' r--------- 13'--------� Alternate Site ------____- ZO I- ® Iw 3\o TH 2 W 1= 3✓',/ Grade Area to Drain Away From Bed Area 10' Utility Easement ���•"� "ffff SITE PLAN = 4..th . •'�` ;.....:..... gt,....�.....® SCALE 1" = 50' .�y.. :• MICHAEL E. ANDERSON �, j�.•r, No. CE4381 •��2�� ••f''f %FESSV�i•••• LOT, BLOCK 1, KIMBERLY MANOR SUBDIVISION f''`•" AdvanTex" Treatment System ;'n; AX20 - Mode la a„msr 40x94Pod uFr NOTE: THE BOARD INSULATIOprr E INSTALLED OVER THE SEPTIC BEYOND CH ALL SIDES EXCE THE ADVANTEC FILTER. THIS FOR HEAT TO ESCAPE FROM RISE TO THE FILTER .ABO S' JIY CAP— FO1+L GRADE— CttP.21 a• Aes Pwm-ctn (SYP.2: a' AM COUPLJHC OL.UEO TO TANK (TYP.2) MMw TO PROPOSED DRAJNFIELD INLET i OPTIONAL- SUDESUMN i.j ":I; OF a• PIPE WDi TH5 CONNEMION TO P8» DE i j - �'3 BE�ROOM�I�i I S"CERPtxJv+oTo _I FIBERGLASS ,TANK .! DMOCE EXCAVAT)ON I!; SYSTEM SECTION NOT TO SCALE NOTE: SYSTEM MUST BE PLACED IN STRICT CONFORMANCE WITH MANUFACTURER'S RECOMMENDATIONS. '• 4Qth_ •. MICHAEL [. ANDERSON NO CE -4381 • LOT 12, BLOCK 1, KIMBERLY MANOR SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS Four Bedroom House 4 Bedroom Advantex Treatment System Perc. Rate: 48-60 Min./Inch 1,500 Gallon Combination Tank Application Rate: 1 GPD/SF 2' Coarse Sand Bed 4 Bedrooms X 150 GPD/1 GPD/SF (Application Rate) = 600 SF Absorption Area 600SF/20= 30 LF Bed Length THEREFORE: Construct an oversized bed 40' Long x 20' Wide x 1' Effective Depth Absorption Bed. Flow Line Elevation in Bed to be 1.5' Above Original Ground Surface. Total Depth to be 1' Below Existing Ground. Maintain 100' Separation From Wells in the Area. Place 2' of Direct Bury Insulation and 2' of Fill Over Absorption Bed or Provide Minimum 3' of Cover to Prevent Freezing. Place 4' of Cover Over Septic Tank. 4 A 2 � F 2" Insulation Cover 1.25" ( Schedule PVC I/ 4ZGeotextile Fabric Drainfeld Rock , 7-7-7-77-1'72=71 Lz 1 0 0 0 A;©vecl'•C'oa�sg.3and' See-5.icJficatio < ... pr GrogLn� Remove Organics to Underlying Soil 2.5' 5' 5' 5' 2.5' 20' TYPICAL ADVANTEX BED SECTION (NO SCALE) NOTE: Grade Area Over Trench to Drain Away. Minimum 6' Separation From Bedrock. 49th Minimum 4' Separation From Groundwater. i Minimum 10' Separation From Water Service Line. MICHAEL E. neoeasoI Minimum 100' Separation From Surface Water or Streams. ��c :, No. CE4381 I 2 3 4 5 6 vie 17 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT/ON-SITE WATER AND WASTEWATER PROGRAM 4700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-6650 SOILS LOG - PERCOLATION TEST PROJECT #: PERFORMED FOR: Ed Warner DATE PERFORMED: 7/9/2003 LEGAL DESCRIPTION: Lot 12 Block 1, Kimberly Manor TEST HOLE # 1 SLOPE SITE PLAN I I PT/0G Silty Sand Some Gravel SM Impermeable Silt ML WAS GROUNDWATER ENCOUNTERED? IF YES, WHAT DEPTH? DEPTH OF WATER AFTER MONITORING: 1&._ DATE: 4Y. 49th W* MICHAEL E. ANDERSON No. CE -1301 BOH - 16' p� None 7/14/2003 L 0 P E Upper De Armoun Road N TH10 TH2 0 - READING DATE GROSS TIME NET TIME DEPTH OF WATER NET DROP Start 7/9 4:4S 6.75" 1 515 30 6.125" .625" Recharge 5:16 6.5" 2 5:46 30 6" 5" Recharge 5:47 6.75" 3 6:17 30 625" S.. PERC RATE: 60 MIN./INCH PERC. HOLE DIAMETER: 6" TEST RUN BETWEEN 2.5 FT. AND 3.5 FT. COMMENTS: Test Hale Pre Soaked Prior to Test. Material From 6' Down Impervious. TEST PERFORMED BY: MEA I, MICHAEL E. ANDERSON, CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES ON THIS DATE: 7/14/2003 1 2 5 4 5 6 1 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT/ON-SITE WATER AND WASTEWATER PROGRAM 4700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-6650 SOILS LOG -PERCOLATION TEST PROJECT #: PERFORMED FOR: Ed Warner DATE PERFORMED: 7/9/2003 LEGAL DESCRIPTION: Lot 12, Block 1, Kimberly Manor TEST HOLE # 2 SLOPE SITE PLAN PT/0G II Silty Sand Some Gravel SM Impermeable Silt ML WAS GROUNDWATER ENCOUNTERED? No S NET TIME L IF YES, WHAT DEPTH? 0 DEPTH OF WATER None P AFTER MONITORING: E .._ DATE: 7/14/2003 541 .c7.; - �S 49th .•;; MICHAEL E -ANDERSON No. CE -4301 Z90 E 5510N:, BOH - 16' Upper De Armoun Road N TH10 TH2 0 - READING DATE GROSS TIME NET TIME DEPTH OF WATER NET DROP Start 7/9 5:11 7.125" 1 541 30 6.5" .625" Recharge 5:42 7.25" 2 6:12 30 6-625" .625" Recharge 1 6:13 1 7.125" 3 6:43 30 6 5" .625" PERC RATE: 48 MIN./INCH PERC. HOLE DIAMETER: 6" TEST RUN BETWEEN 2.0 FT. AND 3.0 FT. COMMENTS: Test Hale Pre Soaked Prior to Test. Material From 6' Down Impervious. TEST PERFORMED BY: MEA I, MICHAEL E. ANDERSON, CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES ON THIS DATE: 7/14/2003 PRESSURE DISTRIBUTION CALCULATION Elevation at Highest Discharge Point -- - Pressure -at Highest -Discharge -Point Liquid Level in Tank (Elevation) Diameter of Holes in Distribution Line Diameter of Distribution Line Hole Spacing in Distribution Line Length of Transport Line Diameter of Transport Line Q = 12.4h h-= 12.4(.1875)(.1875) 5 _ .9748 GPM/Orifice _ .9748 * 32 = 31.2 GPM TDH = (111-100) + .0192(31.2)(31.2) + = 11 + 18.7 + = 31' .000995(15) (31.2)I 5 1.3 106' 5' -Head -- 100' .1875" (3/16") 1.25" 1.5' 15' 1. 5" Therefore 32 Orifices, 8 in Each Lateral @ 4.375' Spacing With 31' Total Dynamic Head. Orifice Diameter 3/16" Pw �aMtCHAU E. Ai.�!`CR507d ����•�$ P o CE-A38i F k�ORENCO SYSTggS:NC �J _j 2826 COLONIAL ROAD ROSEBURG, OR 97470 (503)673-0165 ADVANCED WASTEWATER TREATMENT SYSTEM T}'I_AINTENAINCE AND REPAIR AGREEMEN T MEMORANDUM OF UNDERST:ANDEN G BETWEEN MUNICIPALITY OF ANCHORAGE AND �¢7WCAr[Q S, �Qr11u� _—_-- rills MEMORANDUM VN U1V l)L'C>tHN;JUNV ai2u cftl+'_e!2 lijw GS vi ILaS day of Cl y-_ 20_Q`' by and between .�,pL—u—M herein the "OWNER," and the Municipality of Anchorage, herein the "MJNICIPALIT`r'." In consideration of the mutual covenants contained herein, file parties to this Memorandum of Understanding agree as follows: 1. ADVANCED WASTEWATER TREATMENT S` STEMS. Muzr cipalitI grants permission to Owner to utilize and operate an Advanced Wastewater "..treatment Sys'! -'i"..1 q (AWWTS), described asfcc� ® _ located at _t�c kal tnna� Anchorage, Alaska. 2. Definitions. A. Alteration. Any change to the design or fanction of" an AWWTS that includes the installation or removal of any parts, components or pieces not included in the original construction permit and design. Prior to performing any alterations to an AWWTS the owner must obtain a Wastewater Disposal System Construction Perinit from the Municipality pursuant to Anchorage Municipal Code (hereinafter, "AMC") 15.65 B. Certificate of On -Site Systems Approval. An approval by the Municinality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with AMC Page I of 5 15.65. These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. C. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. D. Maintenance and Repair. The scheduled and as needed replacement of existing parts, components and pieces of an A"AM i S that were included in the original design which would allow the AVTWTS to continue to perform as designed. E. Permit (Construction). An On -Site Wastewater Disposal System Construction Permit as defined by AMC 15.65. F. Permit (Operating). An Advanced Wastewater Treatment System Operating Permit. An annuai permit, issued by the Municipality, that allows the Owner to operate an AWWTS, upon meeting all requirements of this agreement, the conditions of the Operating Permit, the requirements. of the On -Site ITvastewater System Construction Permit and all relevant provisions of AN1C 15.65. 3. Fee. Owner shall pay to Municipality an annuai fee of _ &Q __ (S,Z.00), payable on or before the issuance of the operating permit and annually thereafter. The annual fee is due on or before the anniversary date of the approval by the Municipality of installed system. Pace 2 of 5 erm. The term of this Memora� of`Undeistanding -hall be for the life of the AWWTS. The term begins on the date of approval by the Municipality of the installed system and shall continue while the AWWTS system is in use or operational or until the property is -sold ortitic-istransferred-by owner and- a new certificate of on site approval is -issued to the new owner or transferee of the property. S. Alterations, Installation and Removal of Additional Equipment. Owner agrees not to make any alterations, removal of parts or additions to the A WWTS without a Construction Permit from the Municipality. 6. Maintenance and Repairs. A. Throughout the term of this Memorandum of Understanding, the Owner shall maintain AWWTS in good repair. in addition, it shall be the responsibility of the Owner during' the term of this Memorandum of Understanding, and any extensions or renewals thereof, at'the owner's sole expense, to pay for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs. Further, owner agrees to comply with all applicable ordinances, laws, regulations, rules and orders for the AWWTS. B. Owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system pursuant to the terms and conditions contained in the Owner's AWWTS Operating Permit. This schedule shall be submitted to the Municipality annually upon the renewal of the permit. The schedule of maintenance and repair contained in the Owner's AWWTS Operating Permit is: Page 3 of 5 C. Owner acknowledges that the fine schedule for failing to maintain and repair an AWWTS are codified in AMC 14.60. D. Owner agrees that only maintenance, repair personnel certified by the Municipality will inspect and make any necessary maintenance, repairs _ or permitted alterations to the systems. E. Owner agrees to grant the Municipality reasonable access to 'test and inspect the AWWTS upon 24 hours written notice. F. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. G. Owner agrees that the relevant provisions of the standard specification guidebook for AWWTS is the governing professional guidelines for the construction, maintenance and repair of the Owner's AWWTS. 7. Nonwaiver. The failure of either party at any time to enforce a provision of this Memorandum, of Understanding shall in no way constitute a waiver of the provisions, nor in any way affect the validity of this Memorandum of Understanding or any part hereof, or the right of such party thereafter to enforce each and every provision hereof. 8. Amendment. A. This Memorandum of Understanding shall only be amended, .modified or changed by a writing, executed by authorized representatives of the parties, with the same formality as this Memorandum of Understanding was executed and such writing shall be attached to this Memorandum of Understanding as an amendment. Page 4 of 5 B. For the purposes of any amendment modification or change to the terms and conditions of this contract, the only authorized representatives of the parties are: Owner: Z�t/ie✓2:^'( -.1 • \t4/6t rn � �— Anchorage: Purchasing Officer C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. 9. Jurisdiction: Choice of Law. Any civil action arising from this Memorandum of Understanding shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Memorandum of Understanding. 10. Severability. Any provisions of this Memorandum of Understanding decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Memorandum of Understanding. OWNER: MUNICIPALITY: Title: G d tr 6-/kF_I=R Date: (% C 3 Date: O STATE OF ALASKA } ) ss. THIRD JUDICIAL DISTRICT } The foregoing instrument was acknowledged before me this 1 day of AJ6,s7 2003, by c_p_ ,N the of (2e4,10 on behalf of Municipality of Anchorage. STATE OF ALASKA G %If1c` NOTARY PUBLIC NOTAV PUBLIC FOR AL.-`dK.A Army A. W11inghoM P2 -MI Mlrco"Oft neo"J*a► Page 5 of 5 --- My COI--M-- S$lori exgfres _� vL7 G� ooy Ric6ardWSSIGNMENTVAAACode Addendum AMC 15.65 [N00-0257]\Memomnudm at Undemtandine Version VI.doc s W r Paze 6 of 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 Parcel 1. D. 017-074-51-000 Legal description KIMBERLY MANOR BLK 1 LT 12 Expiration Date: Site address 7540 UPPER DE ARMOUN RD Anchorage AK 99516 11/1/2025 Current property owner(s) WARNER ED & STEPHANIE JOINTREVOCABLE TRUST X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: a Original Certificate Date: 11/21/2024 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. 017-074-51 Complete legal description KIMBERLY MANOR BLOCK 1, LOT 12 Location (site address) 7540 UPPER DEARMOUN ROAD, ANCHORAGE, AK 99516 Current property owner(s) ED & STEPHANIE WARNER TRUST... Day phone 2. ON-SITE SYSTEMS SIZED FOR 3 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 (EPDXY STEEL) Age NEW - 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 $ yI-1 Date of Payment I i5— Z 0?, u- , COSA # S c,,7 -L/ I 13 Waiver Fee $ Date of Payment Waiver # COSA Application.doc COSA Checklist.docx COSA Checklist Legal Description: KIMBERLY MANOR BLOCK 1 LOT 12 Parcel ID: 017-074-51 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) Date drilled 6/18/04 Total depth 261 ft Cased to 261 ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 20 in. Date of flow test for COSA 7/15/24 Static water level at beginning of test 147 ft. Well production at time of test 5 gpm Water storage tank volume NONE gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate 3.54 mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date 11/01/24 Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank NA Date of pumping NA – NEW TANK Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station NEW years Lift station material PLASTIC Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) NEW SYSTEM ALL standpipes present per record drawing Total measured depth from existing grade 6.08 ft (max) Measured depth to pipe invert from grade ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes (MT) go to bottom of effective. (ED) 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) N If yes, enter date Adequacy test date NEW SYSTEM 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) 6 in (MOA 0.5’ ED) Effective depth used 0 in Effective depth (ED) remaining 6 in Comments/Deficiencies: Approximate total measured depths from existing grade. COSA Checklist.docx 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’ Yes if No *50+ ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No *50+ ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ 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 Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No *5+ ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No *50+ ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No *50+ ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS *MAY MEET CONVENTIONAL SEPARATIONS, BUT SYSTEM MEETS CATII/III SEPARATION DISTANCE REQUIREMENTS. 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 11/20/2024 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, local soil characteristics, groundwater levels that may fluctuate during the year, quality of 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 these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & 11/20/24 MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this 15 Day of Nove m be( of 20ja+, by and between fiylle Nrr-k , herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this Agreement agree as follows: I. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AW WTS), described as AN ADVANTEX SYSTEM located at (legal description) KIMBERLY MANOR B1, L12 2. Maintenance. Reoairs and Alterations. (Owner is required to read, understand and initial each section) Throughout the term of this Agreement, the Owner shall enter into a service agreement with an AW WTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AW WTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). t"R Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. Owner acknowledges that regular maintenance of an AW WTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Page 1 of 3 Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. Owner acknowledges that the fine for failing to maintain and repair an AW WTS may be assessed in accordance with AMC 14.60.030. Owner agrees to grant the Municipality reasonable access to test and inspect the AW WTS. The Municipality will give at least 24-hour notice. CAL Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On-Site Systems Approval. 9a Owner agrees that the AW WTS installation and maintenance requirements as provided by the AW WTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AW WTS. JP Owner agrees to maintain remote monitoring of the AW WTS as required by the AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue while the AW WTS is operational or until title is transferred. 4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of 3 OWNER: Bti L- t (signature) Date: �l r� (print name) STATE OF ALASKA ) ss. THIRD JUDICIAL DISTRICT ) The f4egoing*g instrument was acknowledged before me this day of b114�NLW NOTARY PUBLIC NOTARY I FOR ALASKA WILLIAM J LOGAN My Commission expires: JI -111 202-7 STATE OF ALASKA My Commission Expires December 11, 2027 signature) Date: 01G� hint name) Title: (rev. 05/18/2018) Page 3 of 3 0 ro UPPER DeARMOUN ROAD oRa°r-%d'nn"P- 1 r;n nn' JUU %ilt UU C I JU.UU ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: KIMBERLY MANOR SUBDIVISION LOT 12 BLOCK 1 PLAT P-476 SURVEY CERTIFICATE: I, John L. Schuller, Have conducted a physical survey of this property as shown on this drawing and that the improvements situated hereon are within the property lines and no enchroachments exist other than noted. Under no circumstance shouli any information on this drawing be used for construction of fences, structures, improvements, or for establishing boundary lines. EXCLUSION NOTES: It is the owners responsibility to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. WORK ORDER NUMBER: DATE: SCALE: E—MAIL NOV 20, 2024 1 "=40' schullerakOgmailxom 24-079-2 DRAYM BY. CHECKED BY GRID NUMBER: BOOK AGE: JLS SW2940 240340 OO = FND 5/8" REBAR 1 " = 40' OF LAND N 61 / 49TH R.......... ...... ......! U� VA % FA �'�- r .� ... .:.. ...................:..i . C *JOHN L. SCHULLER.• 0 / = .' 'sr LS -10408 0�/ lk 0,1 . , • , . �J / 1831 Talkeetna Street W. .:� . d Anchorage, Alaska 99508 �� o fe oN �..�► (907) 227-1455 office ��` sslo`(907) 274-4992 fax ���