HomeMy WebLinkAboutMEADOW BROOK BLK 1 LT 1" ID4!O - �(lp% t - 3� t Municipality of Anchorage (� Development Services Department°' ,A. Building Safety Division - +• •. On -Site Water and Wastewater Program, 4700 S. Bragaw SL P.O. Box 196650 Anchorage, AK S951 M650 Page of www.Ci.anchorage.akus (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: -SLv d30 214 PID Number: O — —'S Name. G la f Wastewater System: []New Upgrade arrr ✓' Address: ABSORPTION FIELD Phone: Number of BeGooms: arOeep Trench O Shallow Trench 0 Bad ❑ Mound E3 Other. Sol Ratin¢/ Total Depth from original grade: LEGAL DESCRIPTION /r 2— GP IFe /0 Ft. Block Lot �,} fsubQnisiore i Depth to pipe boearn from original `grate: Gravel depth bereadh pipe. foal k, Township: Rause: Sectiorc Fill added above orisiial grade: Gravel Lerhsdc C9, S Ft. Ft. Gravel width Number of lines. Distance between rear: Well: ❑ New ❑ Upgrade 2.0 p,. (1 Ft. Class4cation (Private, 4,P,, Thal oepy ad to: Total absorption area: � c •� Pipe Materiak t 'CY Ft. Ft ) 7`' FP 3 v 3 Lt Onner. ate Dulled: Siaticylaterlevet lnstarter , Date Instars / Ft S tterScrr,reS s'�l9 v3 Yield. mp Set at Casirq Hei¢a Abcve Groun2 TANK 5i FL FL SEPARATION DISTANCES eptic [:)Holding S.T.E.P. ❑ Other. To Septic Absorption Lift Holding PubICIPtivat Mara'tta`e/"M From Tank Field Station Tank SewerUne AV% R/1 Gal. ,/ pu�r t / `' Atatenal: Number of Ccmpanmeru: Well MIA V. • e r H * ry � S 7�' S �.� L" Surface Yater 100'4 n,o l Ap,, r4- LIFT STATION Sce. Manutaczwec Lot Lire 'j 0 t) Wt. t}.Q ' 'pump W. levet at: 'Pump airlevel at High water alarm at: Foundation4, 95 �/ in. ` 3,t h in. N/�7 J"1 �/� Pump Make b Madel Vec-x a l Inspec9ons peff=ed by. Curtain Crain n Q ROrtdr�' BENCH MARK loeaoon and De=pucm Vrri t S�♦ Assumed E:even= lb/1.seFt - �i ,E O' FAq�s �� y~P��• '•g r • •�-y,f Inspections performed by: Mf Aee MAI pFspn Dates: a 1r` 7 N o7 TM W ...:.. 0... ..:... 2nd.... .. . Development Services Department A proval I �• MICHAEL N. ANDERSON e'• CE -9 69 : . 11�r�vF•.•�?`•��`�,� Reviero�edand approved by: �%• Date: -p ��`\\�����`1a (RN I�rd) `� 2yD Permit No. SW030)E Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Legal Description: LOT 1, BLOCK 1, MEADOW BROOK SUBDIVISION PID No.: 050-191-39 K7 S / FI -- --ZH#1 RADIUS _ AN NA 10. MEA EASEMEpa M O R 1 V E_ \ s0• EXISTING COMMUNITY WATER SERVICE EXISIT SEEP GE/ PIT ABANDONED IN -PLA NEW 500 GALLON `L STEP TANK 1 3 NEW 1,500 GALLON CO SEPTIC TANK 02 ��� / /j ALTERNATE O col ��___ �L % LEACH FIELD C01 CO2 A 4/, /ALL SURROUNDING rr� 4k- PROPERTIES SERVED BY EXISTING 5 BEDROOM HOUSE / 4� 41 COMMUNITY WATER. O � v Q / 14J i / - - - - - - - - - - - 10' UTILITY EASEMENT / ASBUILT SCALE: 1"=20' MARK A B GRND. ELEV. PIPE ELEV. Col 41.0 28.4 99.8 94.2 CO2 40.4 29.4 99.8 94.2 TCOI 40.0 29.8 99.8 TCO2 35.7 39 99.8 CO3 36.3 40.0 99.1 93.9 C04 36.8 40.8 99.1 93.9 TC03 38.3 41.5 100.2 MH 39.8 42.2 98.6 MT 46.8 75.3 105.1 CO1C0 C0 IC01 ICOt 1 X03 YM F T P•��. • ... A14 . �l 1 • s�,1f ..� 1 r,LL:4TH 9 Hoar �• .•• •• • •.••.•/ 1.500 c•uoR s00 4. 4r • MICHAEL N. ANDERSON : TMP( WT STAR srwul RM 9" �n • , CE- 46 147 147 c pnCTION WAITIe -20 N.T.S. ' AUG -28-2003 THU 11:47 AM FAX N0. To: August 2S, 2003 Mikv Anderson I'M larclrictil Cunnccliari of Lift Stallion at 18335 Knotishna Drive; 1!a gk: !aver, AhisLa 99577 (.ol 1, Muck 1 Meadow Brook, Subdivision Doix Sir, 1 assisted !lac former owner of the dwelling to install n sewage lift station. Tho ulcclaical %vas installed us per local and national codes. f a>.n a trained electrician gild have been a licensed journeyman electrician for over 20 yens. ! Sinca.rvly, Krn ltichalydson P. 01 �O�t1t(1` �tgttr5 '�' N(t kc( c ( 1\-C • '1 r rs bv*l titpuo rhos borj rt A /�k, `( (b r3'3 �- Wr/c( /Yitac1oW I�rvv(L */to Cvi' (enc Woty-ev T`J GJL-�,Udn r � [' IRI, CoVl c CYWI t, 'T1�,S YS rri 4f mctl V Irct k -e �Ur (v4 t► t J r_ W Olt, �0� 1-�e Q X(I con "L" �lO fdo PFt`7�<� 0/1 f�G �af � 1\0� •n'7(At(C4 ;VVI CS � i LA c H cc�J S k 4 r ►''' J wecS � r lw10Ckr r�( 6 'i'ht Zvi,? (tvL4(0 h (A,e, Or c, t4-- c54imt R S / h.4►VCV c�, a v c� rcC�gT ti d►r1� S ' wort/-oY ra (vti75 T1n� /`�O J'i-l�+ �ru pK '�c� (t►..�. �/' ('e0.!` � F -Ir IV's �`stl�q�ron, . ' '�e cJ� �e �( 7 ► q�v 3 Municipality of Anchorage . L. DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST .��p��• O F q �qs l l .y • : ' 137 •.f►�.rr • • ... . MICHAEL N. AND• • • • • • • 00 PERFORMED FOR: C `ad FGy I` -g r r! (r DATE PERFORMZO D '•�o� ,/n� 11 RpifSSlO�'��� LEGAL DESCRIPTION: G• I f>� Mt1N�„a orwk `r/township, Range, Section: I FC—)E `PT_H" fI ISLOPE I �;I SITE PLAN ow C, •n t r 2- 3- 4- 5- 6- 7- 8- 9- to - 11 - 12- 13- 14- 15- 16- 17- 18- i.2 2- 13•14•15•16•17•18 20• l IF YES. AT WHAT DEPTH? Zar Depth to wAff lifter It Monitoring? L t4' 0, 0 S L 0 P 0 I I I PERCOLATION RATE t 4' (minutes/inch) PERC HOLE DIAMETER PO lY Ur^ r TEST RUN BETWEEN5—1 FT AND /FT toc �Ihr eirv� PERFORMED BY: Nit ek k e I l4 A .I ev s eri 1 CERTIFY THAT/3HIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE S/ 2 S/O 72-008 (Rev. Q85) MIN 101 0 I I I PERCOLATION RATE t 4' (minutes/inch) PERC HOLE DIAMETER PO lY Ur^ r TEST RUN BETWEEN5—1 FT AND /FT toc �Ihr eirv� PERFORMED BY: Nit ek k e I l4 A .I ev s eri 1 CERTIFY THAT/3HIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE S/ 2 S/O 72-008 (Rev. Q85) � . 4 Municipality of Anchorage Dlark Begich, Mayor Building S.-Ifety Division P.O. Box 196650 • 4700 Bragaw Strcct Anchorage, Alaska W519.6650 • (907) 343.8301 • Pax (907) 343.800 h ltp://a���r.nnuil.org 8/28/2003 Michael N.Anderson Anderson Engineering & Construction 4640 Shoshoni Anchorage, AK 99516 Subject: Waiver Request for Meadow Brook Block 1 Lot 1 Waiver Request #WR030076 Parcel ID 4050-191-39 HA030441 Dear Michael N. Anderson: Your request for a waiver of the required 10 feet horizontal separation from the absorption field to property line has been approved. The approved separation distance is 5 feet. This waiver approval applies to the existing absorption field to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Jeffrey W. Poet Engineering Technician On -Site Water & Wastewater Program Municipality of Anchorage Development Services Department +� Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Waiver Review Worksheet WR#: 030076 PID#: 050-191.39 HAM 030441 Permit#: Date Received:8/28103 Legal Description: Meadow Brook Block 1 Lot 1 Engineer: Anderson Engineering & Construction 4640 Shoshoni Applicant: Clarke Farrer Waiver Requested: 5 toot waiver from the Absorption Field to the North Property Line Criteria: Geology Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: Waiver is Granted: Waiver is not Granted. List Conditions or Reasons for above: Date: - 2 — 3 By: �f N f Reviewer Rec#: 40832 Amount: $ 50 Date Paid:/28 8/2003 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 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Date Issued: Jul 11, 2003 Expiration Date: Jul 10, 2004 Permit Number: SW030240 Legal Description:ZMEADOW BROOK BLK :1 LT a Design Engineer: 0088 Anderson Construction & Eng'g Owner Name: Clarke & Nancy Farrer Owner Address: 18338 Kantishna Drive EAGLE RIVER, AK 99577-0244 Parcel ID: 050-191-39 Site Address: 018338 KANTISHNA DR Lot Size: 10760 SO. FT. Total Bedrooms: 5 Permit Bedrooms: 5 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. 5. The following special provisions. A percolation test must be done during excavation and submitted with the as -built inspection report. 7118103 S E Pr AA/ 6, /N 0 46 J A Af EA,040Z t? P& .5 I G Al DW TFD Tu t t /G, 2 00-7 R Tl'J� /-lF..Q l,.l-!7 GN RA 36J %'i -/L' F4-Evla 2-1,9/1 ds: THE A15X art'pTic4/ rlY r5"&I ##M p IapfA L. / FT STi`3Tt o/v iD J'd y.?- DES I&A,#, 0i Received By: Date: % %' Issued By: C I �' Date: DATE: July 11, 2003 TO: File 4E B MUNICIPALITY OF ANCHORAGE Building Safety Division T: S A E T Y MEMORANDUM FROM: Joe Goodall Engineer II, On -Site Water Wastewater Program SUBJ: Meadow Brook Block 1 Lot 1 Permit number SW030240 for the seepage pit upgrade was reviewed and approved by Jim Cross Municipality of Anchorage 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.ek.us (907) 343-7904 ON-SITE SEWERNVELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. (9 a 0 - Ej I— '3I Permit Number SW EA - _( Property owners) GA r �G f rtc r Day phone Mailing address (1) / Y'33eg L_do -� t s� eft r%r . Qde V2wer -h, gq35- _?_72 Mailing address (2) (\1'YNL Zip Code Legal description (Lot, Block & Sub'd.) V Legal description (Section, Township & Range) Lot Size 11,4T `o Number of Bedrooms _45� THIS APPLICATION 1S FOR: Sewer Only Well Only ❑ Sewer and Well Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ 1 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) Permit Fees: LWaiver Fees: Date of Payment: 7 %v Date of Payment: Receipt Number: ?7 4r'2 Z Receipt Number: (Rev. 12/00) 3 9 2 SA Michael N. Anderson, P.E. Civil/Structural Engineering 4640 Shoshoni Avenue Anchorage, Alaska 99516 Phone 345-3377 Fax 345-1391 July 16, 2003 Department of Health and Human Services P.O. Box 6650 Anchorage, Alaska 99519-6650 Re: Lot 1 Block 1 Meadow Brook To Whom it may concern: After excavating down to the top of the existing crib the elevation was found to be -16 feet. This was too deep to install the proposed new 2 bedroom system, therefore a new lift station has been designed with a new trench for all 5 bedrooms, see proposed plan. The soils were just as stated in the original design, GM, with water at -20 feet. A new trench has been proposed with 7 feet of effective gravel and length a of 44 feet. All of the neighboring lots are serviced by community water and will not be impacted by this new system or the reserve area. The property is located on a corner lot with only neighbors on the north and west with slopes being in the south west direction. If you have any question please call me at 345-3377 Sincerel .,w Michael N. Anderson, P.E. DESIGN CRITERIA: 5 BDRM X 150 = SOILS = 750/1.2 625/14 = 44' TRENCH: 14' DEEP 7' EFFECTIVE 2.0' WIDE 44' LONG WATER 750 GPD = 625 SO FT REO'D \ EXISTING SLLRA]5E ¢ PR TOrr' \ `REMAIN \ i Ell', N 2,000 GALLON STEP SEPTIC ,SANK DEMO. EXISTING- - K ANT 1 S ------ O R 1 E - TH�1`��TEST HOLE RADIUS 10' 117."i J r �•n \ 44.0' \ P ING MT J17 J�v PROPOSED SEPTIC'y �c SECO ARY SEPTIC i C.O. EXISTING HOUSE EXISTING CREEK >100' / 10' UTILITY EASEMENT / Septic Design Prepared For CLARKE & NANCY FARRER LOT 1, BLOCK 1 MEADOW BROOK SUBDIVISION Prepared By MICHAEL N. ANDERSON, P.E. 4640 SHOSHONI DRIVE (907) 345-3377 / FAX (907) 345-1391 SCALE: 1"=20' m: ALL SURROUNDING PROPERTIES SERVED 13Y COMMUNITY WATER. JULY 16, 2003 ) OVER 1BRIC .d'� OF A('�t1 ih�..,,,gs,�+'+ • '•. •,49TH / N MICHAEL N. ANDERSON :C f �, CE - 9469 •: �`�; Michael N. Anderson, P.E. Civil/Structural Engineering 4640 Shoshoni Avenue Anchorage, Alaska 99516 Phone 345-3377 Fax 345-1391 May 26, 2003 Department of Health and Human Services P.O. Box 6650 Anchorage, Alaska 99519-6650 Re: Lot 1 Block 1 Meadow Brook Subd. To Whom it may concern: This is a request for a new permit to upgrade the exiting three bedroom septic system on above referenced lot . The current system is a good working three bedroom system but the owner wants a 5 bedroom system to match the house. The soils are excellent sandy gravel for the full depth of the hole. A test hole was drilled by Discovery Drilling last year to 24 feet, this deep hole was done to determine the water table in the area due to the creek which is located 300 feet to the east on public land. The water has been monitored for the past 6 months and doesn't rise above 20 feet. This new site plan would allow the addition of two bedroom trench plus the alternate site for 5 bedroom upgrade in the future. I have not perced the soils but the boring logs show clean sandy gravel SP. A perc test will be run during the excavation to verify the rate. All of the neighboring lots are serviced by community water and will not be impacted by this new system or the reserve area. The property is located on a corner lot with only neighbors on the north and west with slopes being in the south west direction. If you have any question please call me at 345-3377 Sincer�eMichaelN. on, P.E. DESIGN. CRITERIA: 2 BDRM X 150 = SOILS = 300/1.2 250/12, = 21' TRENCH: 16' DEEP 6' EFFECTIVE 2.0' WIDE 21' LONG EXISTING WATER S 300 GPD = 250 SQ FT REQ'D c� \ XISTR �\ PIT 0 ST. NEW 1,500 GALLON SEPTIC SANK DEMO. EXISTING-\ H TH�1`� /-TEST HOLE RADIUS 10, UTILITY EgSf�c.,r �� SEEPAGE J' 21.0' REMAIN —ice 1 r ---I - '----'f P ING i i r---- Jz---_ JC.O. jI r-- �J �y PROPOSED SEPTIC •� �lk„ SEC6NDARY SEPTIC / 1 Iw •� EXISTING CREEK >100' / / — — — — — — — — — — — — — — — — — — 10' UTILriY EASEMENT / / Q NOTE: ALL SURROUNDING PROPERTIES SERVED BY COMMUNITY WATER. IOUND OVER RADE =R FABRIC ROCK Septic Design Prepared For CLARKE & NANCY FARRER„--��• OF A(gilj LOT 1, BLOCK 1 .r1P.• •.S,ri� MEADOW BROOK SUBDIVISION `'49tH •'v 'k: b+l • K I Prepared By .• :• *...� MICHAEL N. ANDERSON, P.E.M.-7. 4640 SHOSHONI DRIVErA„ ; MICHAEL N. ANDERSON (907) 345-3377 / FAX (907) 345-1391c •. CE -9469 SCALE: 1"=20' MAY 26, 2003 t�ltl� •pOffSS1 � R • • • • • •!����"�� I.FaN , PSE OF AIS 1, Municipality of Anchorage , r +Lj�� ••.'f' �t a DEPARTMENT OF HEALTH & HUMAN SERVICES49T H •.� 825 "L" Street, Anchorage, Alaska 99502-0650 •irl' • •Yrs) SOILS LOG — PERCOLATION TEST 1 A t MICHAEL N. AND • PERFORMED FOR: G oqr �,y Jf-�* v re V- DATE PERFORIN'; Zp 00 •�o� '� LEGAL DESCRIPTION: L (1,r't�jk5-6ZoWnship, Range, Section: DECPTTH . SLOPE SITE PLAN 1 2 3 4 5 s S,n d ,1 7 C r''vC l 8 SP 0 WAS GROUND WATER 10 ENCOUNTERED? •�• S 11 IF YES, AT WHAT p DEPTH? P 12 E Depth to Water Alter e 13 Monitoring? L Bait 14 15 16 17 18 19 A ®= MM 20 -{ ' (II II PERCOLATION RATE (minutes inch) PERC HOLE DIAMETER ,-ILA 00 10000A 40 wd G TEST RUN BETWEEN FT AND FT COMMENTS n� r �- �r7 16 c o1Nr, La fLeavotiolaq, PERFORMED BY: 'e ev •► of CERTIFY THATTj,HIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE '�/ ` 5/4 72.008 (Rev. 4/85) EDGRE` R ANCHORAGE AREA BOP` 'iH , Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME✓ L_ J0675;Dh MAILING ADDRESS 3(2X /OI C-Cc0h A'1 ice PHONE LOCATION644110eIG/J1 /1/ 1�IL:�:�!li LEGAL DESCRIPTION SEPTIC TANK: DISTANCE / . MATERIAL . C ��C'' NUMBER OF FROM WELL MANUFACTURER 5CLCh SteF � COMPARTMENTS Lc. L. / S q / 6 INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY GALLONS. SEEPAGE PIT: NUMBER OF PITS DIAMETER 400 f OR WIDTH LENGTH /0, DEPTH 6' LINING MATERIAL CRIB SIZE: DIAMETER 2_DEPTHIL DISTANCE FROM: WELL TOTAL EFFECTIVE qf� BUILDING FOUNDATION �n NEAREST LOT LINE zG ABSORPTION AREA (WALL AREA) :?&o SQ. FT. ADDITIONAL ABSORPTION WELL: TYPE �o�i/1%� CONSTRUCTION BUILDING NEAREST NEAREST FOUNDATION -,LOT LINE -,SEWER LINE CESSPOOL OTHER SOURCES APPROVED DISAPPROVED REMAR DISTANCES: INSTALLED BY: PIPE MATERIAL: (6a 0 -ova LOT SLOPE: REMARKS: V C'y Form No. EQ -031 ,hV DEPTH SEPTIC TANK_ DIAGRAM OF SYSTEM DISTANCE FROM: SEEPAGE SYSTEM _ n i_ I DATE APPR n 1-<-tivc cc,(( Municipality of Anchorage 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.ek.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APP FOR A SINGLE FAMILY DWELLING ,14-2 f - V Y Vt194 r ,yl 94 i , P SA P CTT ROVAL Parcel l.D. o S v -i a l— 3 4 NAA # Expiration Date: 1. GENERAL INFORMATION .Complete legal description Le;` 1 �Ik- ( MT,dow Grout C/O_ Location -(site address or directions) Current Property owner(s) G�0. � rkAa c r.r- Day phone Mailing address t (�( 33� % r\Y\� Skm, �`(� V, YL Lending agency` Day phone Mailing address Real Estate Agent _ Day phone Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY:, TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site (� Individual Water Storage E] Individual Holding tank ' ❑ Community Class Well El Community On-site El Public Water System 9 Public Sewer 1:1 The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. 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 Health Authority Approval Guidelines for this application, shows that the on- site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and. from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm '4r6WIL44 rrswr to• E , Phone Address_ 14G 4o 1Aea�f,.' Engineer's Printed Name Dateif�7/'o� S. DSD SIGNATURE Approved for LF bedrooms. Disapproved.. OFA1.1 ?1p'••.....,s f MICHAEL N. ANDERSON �'•• Ct469 •��``i .00 vv� Conditional approval for bedrooms, with the following stipulations: Additional Comments Attachments: HAA Checklist Septic System Advisory Well Flow Advisory X Maintenance Agreements Supplemental Engineer's Report Other PROGRAM •2ry I x� •- 1 By: Original Certificate Date:- (Rev. 01102) r........ ............... ............. ,...,.............,.........,.................. ............ - _ _ .. _....._._........ Municipality of Anchorage • Development Services Department j Building Safety Division • On -Site Water & Wastewater Program ' " "' 4700 South Bragaw St I' P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: La, -( 8f!& 1 M•en4y%s BmA, 'S/ ParcellD: 0Sd-19(^39 A. WELL DATA Well type If A. B, or C provide PWSID # _ Well Log (Y/N) Date completed Sanitary seal (YIN)_ Wires property protected jTotal depth ft Cased to ft. Casing heig ove ground) in. FROM WELL LOG PECTION Date of test Static water level W a ft Well production g.p.m. g.p.m. WATER SAMPLE RES Coliform colonies/100 ml. Nitrate mg./L Other bacteria colonies/100 ml. is mg.1L Date of sample: Collected by: B. SEPTICIHOLDING TANK DATA Tank Type/Material -0b- f cp Date installed 7� 111)3 Tank size /So e ' gal. - Number of Compartments Z Cleanouts (YM) Foundation cleanout (Y/N) )!L Depression over tank (YIN) rl High water alarm (Y/N) Date of pumping Pumper C. ABSORPTION FIELD DATA,: Date installed Soil rating (g.p.d.e or feftrm) __L2– System type QrcbD > rrneC Length y ft:'* ' Width 'ZOO ft Gravel below pipe 3 ft. Total depth /0. S ft • Eff.absorption area j S& fe Monitoring tube Y_ Depression over field Al Date of adequacy test / Results (Pass/Fail) / For S bedrooms Fluid depth in absorption field before test G in. Water added gal. New depth in. Elapsed Time: Z-11� min. Final fluid depth z" in. Absorption rate >= �l g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) .l If yes, give date r- 0. LIFT STATION Date installed 2ZI 26 z `Pump on" level at 4t & Datum !U0 ` C w, lot at, -- E. ,E. SEPARATION DISTANCES Size in gallons 'so o Manhole/Access (Y/N) "Pump ofr level at"' tlf", High water alarm level at 9 7v( elN, iih Cycles tested 3 Meets alarm & dreutt requirements? )�r S. SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankllift station on lot M // Absorption field on lot IJ /4 . Public sewer main NIA . Sewer /septic service line On adjacent lots ( vd ! On adjacent lots 100 I (- Public sewer manhole/cleanout Holding tank fl lig! _ SEPARATION DISTANCES FROM SEPTICffl0t; NG TANK ON LOT TO: Building foundation (5-i Property line go r� Absorption field L 5 Water main s I f- - Water service line z 5 i f Surface water /of) r7 Wells on adjacent lots lb o $ f SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 5 f Building foundation '50 l f Water main S /� Water Service line 5 O r1*- Surface water i oo (4 Driveway, parkingNehide storage, /y r f Curtain drain Mill Wells on adjacent lots /00 14- F. 4 F. COMMENTS G. ENGINEER'S CERTIFICATION i y1P' • • • • • • •' •. • gs�'�+rl I certify that / have determined through field inspections and 9 *: 49T1/* ; yr review of Municipal records that the above systems are in �• • • conformance with MOA HAA guidelines in effect on this date. MICiU�� ADERWN :ft / Engineer's Printed Name Mt ear C A�.�. d rrsa, P. Igo -,r•'•• CE - ae •: �j Date ?f/Z7Av 3 '111��P�PO •O ��•• HAA Fee $ 3� S Date of Payment 51-A y O 3 Receipt Number Sa'3 2 �S (Rev. 12/01) Waiver Fee $ Date of Payment. Receipt Number v4.O lr3'2_- c�'� fly- v Iia ]t 03 FRI JU.17 FAA 6396499 VISTA REAL ESTATE ER G� � E✓srf.� %' I W ,t:� W; 1; v-, t t ' L 1 'a, ( C r -r, 0. , /i/� ` y • ti AS BUILT SrEWARP &ASSOCIATES LVZ) S: 'i_..;;".. c94-0S�4 " E ` SURVEYED THE; j 1 HERESY ., K"'IF , 1 NA. I H�JE SCALE, ��^ �- � ! FO'.LOWINV- DESC:RIBE7 PP,OPEPTY� • `G CIt A � �.3? F lE`Li/ i:.'•l t ^/, ^ �� =" � '9T/ r%:'� DATE: . AND THAT NO ENClC:A..HMnTS EXIST MEDT AS i INDICATED. IT 1:3 THE RESPONSIBILITY OF THE r -' rti i' ;r f 4 �• a MIEF TO D_1 ERK E THE EXISTEN. E OF ANY GRID: I EASEMENTS, CGV1a!IAtv'TS, OP, RESTRICTIONS; 'WHICH DO NOT AP, EAR ON' THE PECORC SJBDI- -,c a '•• -:• •:::•y.,t c VISION P�.AT. UNDER NO CIRCUKLDSTANCES SHOU FB' �,� �G, f,' ..' . '•""' t- o ( ANY DATA HEREON BE US" FOR CONSTRUCTION +� -' e OF FENCE LINES, OR FOR ESTAb_ISHING BOUND- I DRAWN `• `� ' .,r. � '='•''�`r' -' • .. P. 2 I I STATEMENT OF NON OBJECTION FOR ENCROACHMENT WiTNIN UTILITY CASEMENT Matanuska ElecmcA: sociation, Inc (MEA) has no objection with the location of 2n existing leach field within the utility easement along the north boundary lot fine of the following property; Lots 1, Block 1, Meadow Brook Subdivision, according to plat No. 72-51, I Anchorage Recording District, State of Alaska. Situated in Section 12, Township 14 North, Range 2 West, Seward Meridian. 0 i This non -objection is granted with the full understanding and agreement by all parties having an interest in the above property that this leach field encroachment will in no way restrict or limit the current or future ability of MEA to fully enjoy the benefits of the easement for any and all utility put poses that it presently enjoys under the easement This non -abjection is further conditioned by the stipulation that MEA wait be held harmless from liability for any and all damages to the encroachment that may result from the existing and future use of said easement by MEA, its contractors, successors, agents, licensees, or assigns. MV STATE OF ALASKA ) )S THIRD JUDICIAL DISTRICT ) The foregoing agreement w 20 n 3 . by �w TP.pp••pp{ilO.p(Ll1•ItW rY W,1 ,Ir Matanuska Electric Association, Ina General Mdriager or his Represent five Date i YO 0 In o L'•Q,s-e 0" -4.,� AS -BUILT I hereby certify that I have surveyed the following described property- LOT t 3LOCJc1 i nEA0pu�1 g,, iop}� 5"2 NE /y 5=C^11714N Anchorage Recording Precinct, Alaska, and that the improvements situated thereon are within the propert,Y fines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on pro - arty lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission :rocs or other visible easements on said property except as indicated hereon. . Dated at Fagle River, Alaska this 6 day of— JIIL`( 13-713— ROBERT C. JOHAISo N SCALL: Registered Land Surveyor No. 880 -LS I"= 20' Box 450, Eagle River, Alaska Phone 694-2543 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 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 4 SC-- 1 9 1— 3 9 HAA # 0- C\9 ()L�IC, 1. GENERAL INFORMATION Complete legal description LdT t acne V, I MaA-Dow 00 V, 5lD Location (site address or directions) IS 33 R ISA N < cc. l4iu A Q79Lid c,? Property owner M 6692ct to wA 0K6!�v?_ Day phone 2ql — 39'13 Mailing address I `�3 IcANT`Sfl,v i '�j2wt� �?p.�X ��o2Uu r cvp• 995�5z Lending agency Day phone Mailing address Agent A t &-N C—� Day phone 7— Address Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water 3 k NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site — Public sewer NOTE: 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 M21 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm' Q?O( Nb P_/J'; . Svc Phone 2F2-- 'B`Zt-R Address P_n•Qd� 9cDsv-cf Engineer's signature Date 6. DHHS SIGNATURE Approved for 3 bedrooms. Disapproved. Conditional approval for Additional Comments M /r/ VV 2 VA Steven R. Pannone #kti CE•8149 r bedrooms, with the following stipulations: Date 0_06-011/'-7 06 �/' The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates 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 DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA k21 Municipality of Anchorage C*D DEPARTMENT OF HEALTH & HUMAN SERVICE E C E I V S D Environmental Services Division 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-474 199Y Municipality of Anchorage Health Authority Approval Checklist [)Opt. Health & Human Services Legal Description: L ! IB ( ytgrzoo[ s/ Parcel I.D.: n,'S_OP- 191 3! ' A. WELL DATA Well type A w W cJ If A, B, or C, attach ADEC letter. ADEC water system number Log present(Y/N) Total depth Sanitary seal (Y/N) Date of test Static water level Well production WATER SAMPLE RESULTS: Date completed Cased to FROM WELL LOG Coliform Nitrate 2! me Casing height (above ground) Wires properly protected (Y/N) Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA AT INSPECTION Other bacteria Date installed �?/21 1343 Tank size /C700 Number of Compartments rZ Cleanouts (Y/N)_�r_ Foundation cleanout (Y/N) � Depression (Y/N) 4) High water alarm (Y/N) Date of Pumping '?I241gV _Pumper -'2`S C. ABSORPTION FIELD DATA Date installed 0-2(/72 Soil rating (g.p.d./ft2 rff2/bdr 125 System type C 2 (IS Length 8 Width /Z Gravel thickness below pipe 6 Total depth /a 9F P -r Effective absorption area 36'o Monitoring Tube present (Y/N) v Depression over field (Y/N) ..J Date of adequacy test 41'Z a 14 7- Results (Pass/Fail)'TASS For _3 bedrooms Fluid depth in absorption field before test (in.); 1,S4 Immediately after ��gal. water added (in.): l cJ a Fluid depth ec5" (ins) Minutes later: z a m( -j Absorption rate = G -C" zls o p g.p.d. Peroxide treatment (past 12 months) (Y/N) ✓V v If yes, give date 72-026 (Rev. 3/96) D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm E. SEPARATION DISTANCES `Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main service line Size in gallons at' "Pump off" level at` On adjacent lots adjacent lots Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation I I i Property line Z t3 '-F Absorption field Water main/service line 2 c), Surface water/drainage 10c Wells on adjacent lots -Zc>O SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Z o r Building foundation 2 0 t Water main/service line Surface water /0y Driveway, parking/vehicle storage are Curtain drain / C;t Wells on adjacent lots Z F. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal record in conformance with MOA HAA guidelines in effect on this date. } Signature Engineer's Name STS\/t_�J 2adaNNg per' Date 2 f 30/4 X41 •ti h h ►. HAA Fee $ CY 1 Date of Payment Receipt Number %z�.��, 72-026 (Rev. 3/96)' Waiver Fee $ Date of Payment Receipt Number 5S I a 5 � CIO tioveys'�ms are Pannone rr,• 8149 Steven R. Pannone, P.F. P.O. Box 142025 Consulting Engineer Anchorage, Alaska 99514 (907)272-8218 SEPTIC SYSTEM ADEQUACY TEST Legal: Lot 1 Block l M Location: I �) .k�N- stdns✓L Owner: MA2ciA wdZlu Residence: v . K -9:p o1E uN , e R, A V Septic System: Tank Size: / vb o gallons. Absorption System Type: C�943 (from Municipal records) Absorption System Size: 3 (n Absorption Area: ! eYal 6 zf- Installation Date: R / s Soil Rating: 12 .S Date of Pumping: Date of Test: alaala� Test Procedure: System was inspected and meassured. Tank was found with Feet of cover. Liquid depth was measured to bet— Inches. The drain field was found to have 1-2- Feet of cover and a total depth of t e5T . There was /F' Inches of liquid measured in the field's monitor tube. Water was added to the system at a constant rate of a.3 G.PM. The water levels in the tank and drain - field monitor tube were monitored. A total of 16-5 Gallons of water was added. During the test the level rose co Inches in the field. No rise was noted in the tank. The infiltration rate was monitored for 2o Minutes. During this period, a total of Gallons were absorbed. By extending the observed infiltration rate, a total absorbption rate 14b5,aGallons per day was arrived at. TESTS RESULTS: This system meets1dftNWmP0=M the code requirements of the Municipality of Anchorage. The operational life of all septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. We can therefore not give any estimate of how long the system will continue to meet the operational requirements of the Municipality and State. off: •- -.e.9. 49T" Steven R. Pannone: iii CE 8149 1B414 ® MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date 1. GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot: 1 Block 1 Meadowbrook Subdivision Location (address or directions) (b) Property Owner Marcia Walker Telephone: Home Business Mailing Address (c) EE Lending Institution Mailing Address Real Estate Company and Agent Aririrocc Talonhnno Telephone (e) Mail the HAA to the following address: or: Check here E, if hold for pick up. List contact person and day phone number below. 2. TYPE OF RESIDENCE Single -Family Mxx Number of Bedrooms three(3) 3. WATER SUPPLY Individual Well E Community Lxx Public E Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL OnsiffOxxPublic E Community E Holding Tank E Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 tRev 6/661 Front 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION a As certified by my seal affixed hereto and as of the validation date shown below, I verify that 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. Name of Firm Address Date Telephone Engineer's Seal The necessary information for finall approval of the subject property has been obtained. The subject property now meets MOA standards. The water monitoring/upgrade is not required. DHHS APPROVAL Approved for three (3) bedrooms b i e November Approved xxxxxx Disapproved Conditional Terms of Conditional Approval CAUTION 13, 1986 The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval certificates 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 DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. I . Page 2 of 2 72-025 raev BIBB) Back STATEMENT - /`/%r/- c 1111,elr ,V/, -s -1 0, % s Zc) 7"/ 41 �t� l�%ECfG��✓ C%Coo �c �t �' c� PLEASC ETURN THIS STUB WITH YOUR %j, TANCE. YOUR CAHCLLLEU CHECK IS YOUR RECEIPT. DATE DESCRIPTION CHARGES CREDITS BALANCE is�Glir��z /� S 1 PAY LAST AMOUNT IN BAIL' Ne'P rnl l l",ki _ MUNICIPALITY Or ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date October 13, 1986 _ 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) T.cit 1 Rl nnk__7 Meadow Brook Subdivision T1 4N 2W sec . 12 Location (address or directions) (b) Applicant Name Marcia Walker Telephone: Home 694-9388 Business 271-5812 Applicant Address P.O. Box 244 Eagle River, Alaska 99577 (c) Applicant is (check one): Lending Institution ® ; Owner/builder M ; Buyer O ; Other ® (explain); (d) Lending Institution GMAC Mortgage Telephone 562-2181 Address 701. E. Tudor Suite 107 Anchorage, Alaska 99503 (e) Real Estate Company and Agent Address N/A _ Telephone (f) Mail the HAA to the following address: a 2. TYPE OF RESIDENCE Single -Family ID Mult!_F m ly ® Other Number of Bedrooms 3. WATER SUPPLY Individual Well fel Community Pub is f Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite ® Public 0 Community El Holding Tank 0 Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (1 liB4) 5. ENGINEERING FIRM PROVIDINu INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that 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. *ori final septic systeminspection report not available. N approvaldeterminate on Iunicpal approval of this report. ame of Firm Telephone Address EAGLE RIVER ENGINEERING SERVICE, EAGLE RIVER, Al( 99577 Date 6if 779294--- — 694.5195 ao Ovo° 'c ��_. •ii V r Ehg neer's Seal C, r. Louft 'e °.:one [vv° .� v••J Ji 6. DHEP APPROVAL; Approved for /edrooms by Date Approved —, Disapprover Conditional`s— Terms of Conditional Approval Install a groundwater monitoring tube adjacent to the absorption area and monitor for seven(7) days. If after monitoring, encorachment of water into the leaching area is observed, upgrade of the system will be required. Funds to be escrowed to assure work is completed no later than November 29, 1986. An CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or ornissions in the professional engineer's work. Page 2 of 2 72-025 (11/84) DEPT. OF HEALTH & MUNICIPALITY OF ANCHORAGE (MO.,, ENVIRONMENTAL PROTECTION HEALTH AUTHORITY APPROVAL (HAA) OCT 17" CHECKLIST - FEBRUARY 1084 264-4720 �- `+J " Legal Description_` �, / ey�� A. WELL DATA Well Classification /" 6h If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) _ Date Completed Yield Total Depth Cased to Depth of Grouting Static Water Level _ Pump Set At Casing Height Above Ground — Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (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 Cleanout/Manhole Water Sample Collected by Water Sample Test Results _ Comments B. SEPTIC/HOLDING TANK DATA On Adjoining Lots — ; On Adjoining Lots — To Nearest Public Sewer To Nearest Sewer Service Line on Lot Date ne Date Installed i3 Size No. of Compartments Standpipes (Y/N) Air -tight Caps (Y/N) y Foundation Cleanout (Y/N) /0 Depression over Tank (Y/N) 10 Date Last Pumped Pumping/Maintenance Contract on File (Y/N) ��ti ; for -- Holding Tank High -Water Alarm (Y/N) /� Temporary Holding Tank Permit (Y/N) 1✓�� — Separation Distances from Septic/Holding Tank: i To Water -Supply Well BGG To Building Foundation i To Property Line To Disposal Field`' To Water Main/Service Line _ 020 — To Stream, Pond, Lake, or Major Drainage Course Comments Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed P``e �57� Width of Field ` " Aj, ^, , , U ,/Lr Type of System Design �" (- Length of Fieldi✓Lr �Gw� Depth of Field D. LIFT STATION l /q Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) — "Pump Off' Level at Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed L Date Company �/ ST —oLG3— '�®r' � ,��d#��'u• p Y � �/ i. MOA No. ��(� �.•.,•y '�t., df2' 7 Receipt No. ???�2� 'r- �'' ;' Q`4.}�+qtr• '. -t•: M ����iT X� �e �" 149TM Date of Payment 1 Amount: $ 4 .y, 07) a Lt�lfl/ 3 rid *cannot verify system dimentsions or location above �d `� e Louis A. Rutera water table. No records on file. Approved by MOA in 1979. d�\°°a CE'.6736 Page 2 of 2 72-026 (11/84) Gravel Bed Thickness Square Feet of Absorption Area Zf�q mown Standpipes Present (Y/N) / Depression over Field (Y/N) Date of Last Adequacy Test 71�c Results of Last Adequacy Test /7 c Z�1,c AA- 114 Ile Separation Distance from Absorption Field: To Water -Supply Well To Property Line %r To Building Foundation To Existing or Abandoned System on Lot /1J/ ; On Adjoining Lots '?`fid To Water Main/Service Line jr To Cutbank (if present) I>r� To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area e'st_ Comments D. LIFT STATION l /q Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) — "Pump Off' Level at Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed L Date Company �/ ST —oLG3— '�®r' � ,��d#��'u• p Y � �/ i. MOA No. ��(� �.•.,•y '�t., df2' 7 Receipt No. ???�2� 'r- �'' ;' Q`4.}�+qtr• '. -t•: M ����iT X� �e �" 149TM Date of Payment 1 Amount: $ 4 .y, 07) a Lt�lfl/ 3 rid *cannot verify system dimentsions or location above �d `� e Louis A. Rutera water table. No records on file. Approved by MOA in 1979. d�\°°a CE'.6736 Page 2 of 2 72-026 (11/84) Tim. Time � ie Date Date Date Inspector Inspector Inspector Comments (�( Conditional Approval . Date Sewer Installed m Permit No. Septic Tank Size / © <?7 Holding Tank Size Soils Rating Well To Absorption Area Well Log Received Well to Tank APPLICANT FILLS OUT LOWER HALF ONLY Property Owner r"Ivv Phone -) J Mailing Address Buyer Address J,n.j��.,✓G/%I G:SG1r�( /`'.^/,>-"C /t�rr✓1 J.. J%��� 'f1"GI l/ ✓ j ./, Lending Institution J'L /.i,� - ! t%'< ,f Phone Address Realty Co & Agent J ,//; / ��iJr� jyJl !/ ( (1GJl// J/( Phone i Address �. l (j (:, f l ,.. \ , [., , J_J� /V v `/.% Legal Description.,/'-, ; Street Location (. J�! Ir Type off Residence Single Family l ❑ Multiple Family No. of Bedrooms ❑ Other _ Water Supply ❑ Individual ATTACH WELL LOG. A well log is required for all wells drilled since June F*community 1975. For drilled to that date, depth log If wells prior give well (attach Public Utility available.) Sewag� Uisposal [� Individual Year Individual Installed: _ ❑ Public Utility When Connected to Public Utility: -- Ll Holding Tank NOTE: THE INSPECTION PEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN RE INITIATED. MUNICIPALITY OF ANCHORAGE O DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection: CMRO VA xxxx FHA CONV 2. Property Owner: Mailing Address:_ 3. Name of Buyer: SLOVER, Floyd N. & Rowena J. River 3220 Kantishna Drive Eagle Day Phone: 694 2461 MOORE, Larry L. & Cindy L. c/o Ramada Inn Mailing Address: 598 W. Northern Lights Blvd Day Phone:279 9112 4. Name of Lending Institution: AMFAC MORTGAGE CORPORATION Mailing Address: 401 E. Northern Lights #212 Phone: 277 8588 5. Name of Realtor or Agent:. Bill Hannan Mailing Address: Phone: 344 0332 6. Legal Description: Lot 1, Bl k 1, Meadowbrook Subd. Location: 3220 Kantishna Drive Eagle River, Alaska 7. Type of Facility to be Inspected: 8. Water Supply Type of Supply septic systerp Public Utility If Individual, number of dwellings presently served If Individual, depth of well 9. Sewage Disposal System Type of System: Public Utility If Individual, date of installation 72-003(3/76) No. Bdrms, -3- Individual Individual (on-site) xxxx f xc/wnLION %"!,P c uVJ - Ac,lNa i. - SRR ID X rn ._L IW?E <, AK 9os7/ DATyi � / ... PHONE., . NAME: ADDRESS.-'�------- J � LiCSC PtIPTION AMOUNT TO "PAL BALANCE ULIE 30 DAYS FROM DATE 01- BILLING. 11 INTGRFSP PER MONTH ON ACCOUNTS OVER 30 DAYS. 4q A EXCAVATION Century 21; Metropolitan ATTENTION: Bob Swires P.O. Box 677 Eagle River, Alaska 99577 WORK November 29, 1981 ROBERT A. SHAFER CIVIL ENGINEER 694-2979 W..UNIC! PALITY OF ANCHORAGF UFPT. CF i'. °1T. i & �r✓i�oNrd.Fur "TEcrloN I:) F. r- s Dear Mr. Swires, It, 4' Reference: Lot 1; BiOcK i; Meadowbrook Subdivision; Larry Moore Property A sewer system adequacy test was performed on the system located on the referenced property, as you requested. The septic tank was pumped and verified to have a capacity of 1.000 gallons. The seepage pit was charged with 900 gallons of water and after a period of 24 hours, 469 gallons had percolated out of the crib. It can be concluded from this test that the waste water disposal system serving the three bedroom residence located on this property is currently functioning adequately. However, the system cannot be guaranteed against subsequent failures. If we may be of further assistance, please do not hesitate to call. Si EF IE cc: Security Pacific Mortgage Compafty Municipality of Anchorage Department of Health and Environmental Protection SRB 196X EAGLE RIVER, ALASKA MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPT. G;' : ;`,L, , c, DEPARTMENT OF HEALTH &ENVIRONMENTAL PROTECYIIVIRON:d,C„T; .: CT ION 825 L Street - Anchorage, Alaska 99501 e ENVIRONMENTAL ENGINEERING DIVISION FEB 2 0 '..I;` Telephone 264.4720 R � � YE1 A Lj REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER T DI RECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. - 1. P OPERTY OWNER PHONE MAILING ADDRE�S� ❑� �T o EJ Five ROPERTJJY/R�T'(if//{{ddrfff er abo el ` 4X Ln, PHONE 7. WATER SUPPLY 2. BUYER y/ ffJ7 / PHONE MAILING ADDR S --� 3. ENDING INSTITUTION PHONE moi/ / J L'�. (©(rtf %�"lf� �r/`l��' -- MAILING ADDRESS 4. REALTOR/AGENT PHONE /--L' r1 xlle /y /P A) MAIy�ING ADDRESS c �2L,4 //,Z) —:> f ,.7 �1” 5. LEG L DESCRIPTIO STR ET LOCATIO A/1q� ,,�o ✓� D _ 6. TYPE OF RESI ENCS NUMBER OF BEDROOMS ED One ED Four El Other SINGLE FAMILY ❑� �T o EJ Five E] MULTIPLE FAMILY L� Three ❑ Six 7. WATER SUPPLY ❑ JNDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled � COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM ew2/ 11' L>�INDIVIDUAL/ON-SITE** **If individual/on-site, give installation date_ If system is over two (2) years old an adequacy test is required ❑ PUBLIC UTILI-rY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) THIS SIDE FOR OFFICIAL USE ONLY INSPECTION APPOINTMENTS DATE RECEIVED TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER ❑Septic Tank or ❑ Holding Tank Size: If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS APPROVED FOR 73 BEDROOMS --CONDITIONAL APPROVAL (letter m t ccompany certificate) ❑ DISAPPROVED ' DATE i—�}l 1 J BY (Tit PC LEGAL DESCRIPTION CV 1U Mov. J//al S & S ENGINEERING SRB 196X Eagle Fiver, Alaska 99577 694-2979 AtTAC Mortgage Company 705 W. 6th Avenue Anchorage, Alaska January 31, 1979 Reference: Property of "ors. Slover, Kantishna Road and Eagle River Loop Road, Lot 1, Block 1, Meadow Brook Subdivision. An adequacy test of the sewage system on the referenced property could not be preformed at this time due to the uncertainty of the location of the seepage pit. It is recommended that the test be delayed until frost conditions allows excavation to locate the pit and install a stand pipe. It is estimated at this time that the maximum cost to be attributed to the upgrading of the system if required will be: Lump Sum $1800.00. On completion of the adequacy test of the existing system and/or soil test the exact nature of the upgrading, if required can be determined. I am confident that the cost will not exceed the above figure and may be considerably less. rely, e� Robert A. S fer/ P.E. cc:2 0 Colonial Realty 4460 Business Park Boulevard Anchorage, Alaska 99503 Mrs. Rowena Slover 3220 I:antishna Eagle River, Alaska 99577 S, ENGINEERING P..7CIIANICAL ENGINEER MECHANICAL ENGINEERS PIVIL ENGI*TEER DAVID SLENIGUM CIVIL ENGINEERS ROBERT A. SHAFER 694-9055 SRB 196X Eagle River, Alaska 99577 694-2979 May 15, 1979 MUNICIPALITY CI` r+NCHORAG� DEFT. C vrTION AMFAC Mortgage Company 705 W. 6th Avenue Anchorage, Alaska 99501 • k�KEN L0 Reference my letter of January 31, 1979. As requested by Mrs. Slover, an adequacy test was performed on the sewage system located on Lot 1, Block 1, Meadow Brook Subdivision. This test was performed on May 13 and 14; however, prior to performing the test, the seepage pit had to be located and a standpipe extended to above the ground: The septic tank was also pumped and verified to have a capacity `of 1,000 gallons. 'The seepage pit was charged with approximately 650 gallons of water and after a 24 hour period the water level recorded indicated that approxi- mately 1,$69 gallons of water had been removed from the pit. It can be concluded and seepage pit are the property from the above survey and test that the septic, tank adequate for the three bedroom residence located on R "ERl CF: Mrs. Slover Municipality of Anchorage, Dept of Health & Environmental.Protection W S - AJ, j I.AV i Floyd Slover C%TI Lot 1 Block 1 Meadowbrook Sub. 3220 Kantishna Drive raFle River, Ak. -_ Upgrade sewer system I IPL F I) - Amf ac Mortgage Co. 705 West 6t�i`Ave. Anchorap-e, Ak. Uc wV F, Using existing septic tank; adding ItOf of drain trench, 51 of rock. rice based on soil test of 125 per bedroom. Any alteration or deviation from the above specifications -involving extra cost of material -or labor will become an extra charge over the sum mentioned in this quotation. Total price; $'2000.00 5