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HomeMy WebLinkAboutMEADOW RIDGE ESTATES NORTH ADD BLK 4 LT 1 Municipality of Anchorage On-Site Water and Wastewater Program • (907) 343-7904 Page / of,.....T. ON-SITE WASTEWATER INSPECTION REPORT Permit Number: 05 P 17 135 7 PID Number: C) 57 531013 Dwelling: Single Family(SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New MJpgrade Name: PALL 0 I.M.g Gam' G ABSORPTION FIELD Address ❑ Deep Trench ►2'Shallow Trench ❑ Bed ❑ Mound 2 /2 S[i /14 ea clo``J /ee i r ❑ Other 1-4/— GPD/SF 3G7� Number of Bedrooms Soil Rating 5 Total depth from original grade �Phone 3 11 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot 2.. Ft. 2 Ft. 44P,2 00� / ' 4)e_ ,rJ f /'J Ado( ( Fill added above original gradeGravel length Township ot Range Section 2 Ft. Ft. Gravel width Beds:Number of Lines Distance between lines SEPARATION DISTANCES ,j Ft. Ft. To Septic AbsorptionHolding Sewer Total absorption area Number of trenches Dist.between trenches ft Station From Tank Field LiTank Line /2 / Fe / Ft. Well — _ TANK ❑Septic 0 S.T.E.P. ❑Holding plOther M�nufactu� r � Capacity r,Lrj,iN/l, rig-Am- � � / 5Q r� Gal. Surface Water f — /00 {' �(JQ /�fQ f Material Number of compartments Lot Line 01+ /it /.� f/O /-F J"fi� Z /(/�y NA LIFT STATION . Foundation •j`f i U (- ili J4- Manufacturer Capacity �} //��n/� Curtain Drain lid(A- ad(— (MA- t/n/k /�t/ 1 rf.,>,fe f7',(1 c1 /3-03 Gal. AcivP., e7A- Pump on level at Pump off level at High water alarmat Remarks cJf� (- 7s in. in. 70 in. r Pump make a d model Electrical Inspections performed by �I iii✓t .t')G S fwd�ro� 414 r /:_s----, .6C-7--Ie f L. Tank to PIPE MATERIAL House to tank 3 p�lf drainfield DJ6/y Installer 3cii J r ,t _A Drainfield O 3 i./ CO/MTb q Inspector 0 r (Z t,t,� E,` BENCH MARK (Assumed elevation) /Ga ft Inspection r Location and description �i /-��? dates: 1 12115111 p2nd / .51 i7 / /`� / �" 3'd i Z (fin 4th p /� t 0 0 r / Y Enginebrs Stamp COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL ' 41,1 .,� •Sri 11 a Date x 1 t••' Conditional Approval: - ;`- . f ' --- 1'" ---- S.::: r- • �: �>w -' -�a0FEsS� �‘ LAx T n'i Date 1/212.0 1 S i •�:V "'� Approved QsAgioje � �- Inspection Report_9-1-12.doc AS-BUILT MEASUREMENTS B A ST1 7 44 ST2 14 52 14 52 Cp50l 16 550 CO2 20 183 34 M0 CTT1 2115 0 MT2 34 Hoflestead Rc( New with 1°� Ga(lon �� COnstru-rt./ @ecOMMiss 0nOa►�Pay P aex 37 Slope On 01-'6 , (a Septic Tank Per MT 3% Slope DS2 �, UPC C01/ MT I g ST1 A I DCD 147" PCO• Drive . • 3 B 06 Neighbor Septic '''•••••.,,,...a) cs wQ J �---- - - _ A 03 37 Slope �-- Neighbor Sep-tic J 3 0 a a O Z 1„ = 50' r bRTHR/M a•�E......' �,�►e MEADOW RIDGE ESTATES ENGINEERING p..... ....tis, , NORTH ADDITION B4 L1 RECORD SteveEng. com 0 NOR LAYOUT PO Box 770724 '+� = WASTEWATER DESIGN Eagle River, Alaska 99577 +x,11 ( `C �j7�=� Date: EET: 907. 694. 7028 (GT `/ UPGRADE SEPTIC 12/29/17 r2i of 3 Foundation Cleanout30- 1 AX- 2.0 F ,lter PodR 4' Cover Ac vcxnTex Unit DCO AX2P " ",„ 7 7 ` Elevation @ 95.5' - – II'al CAP r � -U. ) Valve & Discharge Line To Old Bed I COVER r covua y% OWED m WIC—\‘__ 1500 0,511001 r-- ����� Monies ----To Absorption Trench ----- •------ .1 1 levation @ 92' - Elevation @ 91' Monitor Tube 12' 1500 GALLON 3% Slope AdvanTex /CO Elevation @ 95.5' Original Ground Elevation @ 93.5' -------.- .. , . •• • Elevation @ 91.5' Filterabric • . ' --- 4, • Effective Depth 2 Elevation @ 89.5' 5' TH Elevation @ 81.5' TH Final Water Elevation @ 83' NOR THRIM • -ut.�' '' P TRENCH END VIEW MEADOW RIDGE ESTATES j ENGINEERING ..7%,;.,,A9 SteveEng.comADVANTEX UNIT RECORD PO BOX 770724 ,,, t NORTH ADDITION B4 L1 Eagle River. Alosko 99577 . a 7 f4 ` UPGRADE SEPTIC �: •: _ s � I �2IDrawn 29 17 SE I i• - SHEa3 of 3 SE • ssox,_IPAL!r'0 0 MUNICIPALITY OF ANCHORAGE ,0`"r s„ On-Site Water&Wastewater Program �- PO Box 196650 4700 Elmore Road Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 ALLA http://www.muni.orgionsite l)& artflU•nt HO I J —1-7 gNfMOP POE On-Site Wastewater Disposal System Permit Permit Number: OSP171357 Effective Date: 11/29/2017 Work Type: Septic Upgrade Expiration Date: 11/29/2018 Tax Code Number: 05153103000 Site Legal Address: MEADOW RIDGE ESTATES NORTH ADD BLK 4 LT 1 G:1462 Site Mailing Address: 21254 MEADOW LAKE DR, Chugiak Owner: RIZZO-PELLEY MICHELLE D & Lot Size in Sq Ft: 20012 Design Engineer: NORTH RIM ENGINEERING Total Bedrooms: 3 This permit is for the construction of: 2 Disposal Field El Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: Provide current groundwater monitoring. Construction may proceed at your own risk before the 7 day monitoring is complete. Please submit stamped and signed results with the as-built inspection report. If the results require a design change, construction of the system will stop pending on-site review and approval. AMC 15.65.060.6.4 171/5/17C0 Cha ed Je h_ tlitGt/ ------ Date: /,_)//_5-7( / Received By: .c Date: /2.-7/-57/ 7 Issued By: /'-''"" �A� V, U\ ClPAUUTY OF ANCHO_ : AGE • Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On-Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. Q S( " 5 3 (r O S F one 018---575Y– /v 78 Property owner(s) / /—L-� `� Day Mailing address 2/ 2 Sy f .Weadve,..' j Q r ` r _. Site address s4v.+".t_ Legal description (Sub'd., Block & Lot) `, '\,ttet kS No-t-I, Add By L1 Legal description (Township, Range & Section (r1eadow Ric')e � , Lot Size Zo/OraSq. Ft. Number of Bedrooms Y- APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (E)all that apply) Single Family (SF) Absorption Field Initial ❑ (w/wo ADU) Septic TankJ23 Upgrade Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ • THIS APPLICATION INCLUDES A VARIANCE I WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. 11E— (Signature of property owner authorized agent) Permit/Rush Fees: Jia - Waiver Fees: Date of Payment: I( –2Z-1 Date of Payment: Receipt Number: bqat Receipt Number: Permit No. D-,e11) 35-7 Waiver No. Permit App_9-1-12.doc THJM ENGINEERING SteveEng.com Steve Eng,PE,PH 907-694-7028 SteveEngPE@gmail.com Date: 11/28/17 Number of Pages: To: R. Carroll, MOA On-Site Services Subject: Meadow Ridge Estates North Addition Block 4 Lot 1 Advantex Upgrade Your Comments 11/22/17 1. Narrative changed below. 2. Drainfield depth raised to 3'. 3. Water service line indicated. 4. Gravity drainfield; DCO's added prior to field 5. Maintenance agreement to be submitted with Inspection Report/Record Drawings. 6. Location of construction test hole identified. An existing bed has failed. Due to the limited area an upgrade to a Category III Advantex is required. A previous soil test is being used for design;no bedrock indicated,but groundwater @ 8'. The design calls for a new shallow trench and dvana water sex. The old stem andsepticwill systems. The terrain e connected via diverter valve. The entire subdivision is on publicY slopes west toward Meadow Lake. The system size is a single family at 3 bedrooms. Please review the wastewater system design for the existing 3 bedroom home. I have included design plans& specs, design guidelines, & soil tests. If there is need for additional information or clarification please give me a call. Thanks-Steve \THIM ENGINEERING Meadow Ridge Estates North Addition B4 L1 SPECIFICATIONS & DESIGN GUIDELINES Wastewater System Sizing: This is an existing 3-bedroom, single family home, in a developed subdivision.The 3%slope at the site will accommodate this design.The soil test from the original septic system was used for design. An Orenco System AdvanTex,with 1500 gallon processing tank and 1-AX20 filter pod to be used. Separation to bedrock and groundwater is being maintained.The easements are located on the drawing and are not encroached upon. A Category III Systemdrain fadtorill allow� trench,an say1on rate of 15' Additional 5 GPD/FT2. Length=90 FT2/5'x 0.7 reduction test hole to be completed at construction. Specification Requirements: All components and work must comply with the MOA Specifications (AMC) & State DEC ,Orenco Systems Regulations • Installation by an Authorized AdvanTex Installer only; approval issued by Orenco Systems&Anchorage Tank&Welding, Inc. • 1500 gallon,two compartment AdvanTex processing tank, 1-AX20 filter,VeriComm Monitoring System&Mode la standard package per AdvanTex System Manual. • Watertight couplings on inlet&outlet. • 5' minimum between the tank and bed. 10' minimum to property lines. • 3' of cover or insulation is required for trench; an equivalent of 1" insulation for 1' soil cover. Minimum 2" insulation. • Tank& solid pipe must be set on well compacted, stable soil. • 4 inch diameter cleanouts with airtight caps are required 1' to 4' from foundation wall. prior to any 90 degree bend in 4 inch line,prior to the processing tank. • All cleanouts must extend to at least ground level • Trench to be placed level,minimum of 4' to groundwater,6' to bedrock. • Drain rock to be '/2" to 2 '/2" screened. Drain rock to be distributed uniformly. • Perforated pipe to be installed level with perforations down. • Silt barrier(filter fabric)to be installed above the drain rock. • Smeared trench sides must be raked or scarified before drain rock placement. • The finish grade must be mounded to promote drainage away from trench. • Insulation must be placed over any pipe installed under driveways or parking areas. • Approved pipe materials include cast iron,PVC ASTM D3034,PVC ASTM F789, ABS ASTM D2661, • Sewer Service Line is minimum 2% slope • Maintenance agreement for the AdvanTex Treatment System is required for approval. • Insulation board shall be extruded direct burial polystyrene(Dow Styrofoam HI or equal) OF /NCt; • ( Al4 �t)� ••:'fit • 't� /!,2///.7 � :� DESIGN NOTES: 1. New Trench Depth At 4'. CO-IF i 2. 5'-Wide Shallow Trench, 3. 2' Cover Over Trench + Insulation. 4. Lots Served by Public Water System. 5. No Conflicts Within 200'. 6. TH From 1983 Soils, Additional TH @ Construction. 7, Check Condition Of Sewer Service Line- Replace If Necessary. 8. Connect Old Bed Via Valve Tng. Lute lIo—Bed. Ai✓Cr%£f2 ✓i44-v'6 9. Confirm Water Service Location Prior To Construction. Nom ,es teaa Rd Ne t 1S �ih 1 °XC4ll _ Cons trU�1. ..., IS°n°Dla e�r"pnTeX 3% Slope /On Sep Lica TQ nk P a� 3% Slope t. C❑1 ®! er UPC _ � r � DC'/I. 15 %Driv- ea TH 10 Neighbor a Sep c �� J Ira a37. Slope - q a - Neighbor a Sep-tic -i 3 O a a NORTHRIM :4s'orZ%.:s,. MEADOW RIDGE ESTATES 1 soENGINEERING =;P... '..t.. St SteveEng. com %*:4sm *'' PLAN g NORTH ADDITION B4 L1 PO Box 770724 k=. . -. - E g,: LAYOUT Eagle River, Alaska 99577 . WASTEWATER DESIGN 907. 694. 7028 UPGRADE SEPTIC Dat 2/15/17 2EEof 3 CO Foundation Cleanout 1 AX-20 Filter Pod x. 4' Cover A CI V Q n T e X Unit DCO ~TY MULCTEDROM—1 r.rwJ _ — — :4: p i F:: 1 Valve & Discharge Line To Old Be: r w-cur COVER CURD TO UM III.w.wemoNrAwawAwAwimi ,soo oAuw .I.NMI �' j = i —.—To Absorption Trench ei8'e•ORT1PRTO PR ( 0OTo , MDSE E%CAVATEJM A i Monitor Tube 12' 1500 GALLON /CO 3% Slope AdvanTex Original Ground DESIGN NOTES: 1. Depth of Trench is 4'. 2' Cover 2. Advantex & Solid Pipe to be Placed on Compacted, Filterabric • : + 2' Insulation Stable Soil, Free from Boulders. 1•4' 3. Sewer Service Line is Minimum 27. Slope & 3' Cover. 4. Water-Tight Couplings. Effective Depth 2 5. See Specification Sheet. 6. All Work To Conform to Municipality of Anchorage (AMC) -..--5, Requirements & Specifications. NORTHRIM Act. .°F ' , TRENCH END VIEW MEADOW RIDGE ESTATES ENGINEERING ,ii;i•• i .. SteveEng.com • :: : ADVANTEX UNIT Po BOX »0 24 4 NORTH ADDITI❑N B4 L1 ' Eagle River, Alosko 99577 �S cs pAg 441 tz11s� 'r7= UPGRADE SEPTIC Dat'12/15/17 'Draw" BY: SE rel.: 1' = 5 of 3 I 3 SE SOILS LOG - PERCOLATION TEST 1\ICRTI- INA Date Performed: 12/12/17 ENGINEERING Performed For: Lee Legal Description: Meadow Ridge Est North Add Block 4 Lot 1 DEPTH (FEET) T.H. Location: See Attached Test it.. Organic 1 - Boring Location Map 2 - ::0 •. 4' SM Silty Sand 3 - 4 _ 0 5 - .:: ,• . d, .. 6 _ Gravel Groundwater? No 7 - Q: ,; ": Depth 8 - : .. 8 Water Depth _ p: After Monitoring. 10.5' Date: 12/15/17 10 - # Date Gross Time Net Time Depth Net Drop , 11 - 1 12/14 0 -- 6'::.�.. 12 - 2 12/14 10 10 min. 5" 1N 13 - 3 12/14 20 -- 6' 14 - 4 12/14 30 10 min. 5" 1" 15 - 5 12/14 30 -- 6 -- N 6 12/14 40 10 min. 5" 1" 16 - 6N -- 17 - 7 12/14 40 -- 18 - 8 12/14 50 10 min. 5' 1'19 - 9 12/14 50 -- 6' _- 20 - 10 12/14 60 10 min. 5' 1' 21 - Percolation Rate 10 min/in Perc Hole Diameter 6" Test Run Between 3' & 4' Comments: CERTIFY THAT THIS TEST WAS Performed By NorthRirn Fng. Ie Performed in Accordant ith All State/Municipal Guidelines in Effect ON THIS DATE. DATE: /0757(7 "4 9 TH2 •\1- °F• Meadow Rid Est N NORTHRIM *4;%,„ ADD BLOCK 4 LOT 1 ENGINEERING • �. e Po Box 770724 . ,1.,.o,. . Eagle Rlver: ',4.7028 99577 I <z7-4r ' TEST H O L E LOG : r9069GEOTECHICAL 12/15/17 ~IUNICtPALI tW ©}? ANCHORAGE DEi ABTBBNT OF HEALTH & EBVtBONIVtEBTAL PB0~ECTt0B ONSI~BSEWAGxDISPOSALSYSTEMABD/ORWELI tNSPE(TiO RE. PORE MAtIIN( ADDi/ES8 i.OCAI iON iitSTANC tO; IF: HOMe'MADE: L I)I /ANCI '1 NO OF BE }ttO(}MS ~ d(9 t t~ Ix ~t e~gt[ (tib lept/ Near st tot PERMIT Distarm( to ottin( P!liM I Ab~;orpdo PIPE MATIi~IAtS iii} RAIiN( IN if ALI Eft ~; M Ail < ermit Legal DeSCriptiOn E~v ir on~ent a Health and AK~ 99501 825 ~ street~ Anohorage~ ~ e e ~ELL AHD/0R oN~S~I~ SPSER ) Ma~i~ng Address PhOne Name}er: Type of soil pGhsorptien System Is: Holding Tank~ Trench: Drainfield Seepage Bed~ .......... -'~ So I Rating(Sq~ft/br} Maximum Number of Bedrooms ....... ., ~sorSt on sYst~n Is~ ~ GRAVEL D~P¥ ~? .... / d aintlield~ The D~PIH LENGTH and The length dimeRSiort is the length[in ~eet) ef the krench or depth of a trench or eib is the diseance between the surface of the ground , feet} There is no set width for treRches~ the bottom e~[ -the excavation{iR depth of gravel between the out~all pipe and The gravel depth is the minimum e the bottom of the e~cavation[in * * REQUiReD SEPiIC(HOLD[NG} lANK SIZE = this departmen~ during the responsibility to Anform and the number Permit applicant has the instalJahiOn inspections of any wells adjacent te this property of residences that the well ~il] ~erve. ~ * * TWO(~} iNSpEcTIONS AR~ R~GUIR~D * * e * and aPPr°va~ by th~S depart:~aen Backf lling of any svshem w~thout final inspec,~l~on w 1i be subject to prosecuhier~ sy rem i.s 100 fee depending upon the t}fPe N~nimum distance between a well and any on-Site sewage dAspesa .~. ce from a private well %e a for a private well or ~50 te 200 feet ~rom a pubAiC well mrivate sewer lkne Minimum d~, tan ~.~ line 5s 75 ileeh~ e well comP],eh;~on~ a co~'0ani~.~Y ~e of . %n 30 days ef ~ph diagrams are 25 feet an he ~ e arhment with and must !~ ....... en~cs may applf- F , . . e available ho insure proper installat~en~ * * * p~RNI[ EXP~R~.S DECENB~R 51~ t 9 S 3 s. that requirements for on-'site sewers and wells iE cur ~.:h ?f if ~ ef Anchorage ~ (1} iii am fa~tiliar w hh the set :ertl by the HuRmcLpa~'~tl with codes~ enlargement I will ~nstall t s!/s~:em iR accerdaRc ire oRe. site sewer system may and i ne?i: 5 g ~mod~led to include Issued by: Date~ swp/osa(1/s~} 825 L St~ee~ A~-~ff~o~age Aas~a 99 6t 26z~ 4720 SO~LS LOG P~RCO~ A f~ON 'iTS~ t0 I6 · ? 18 19 ' ESi' FUN BEqWi/:t:N F Municipality of Anchorage <<.• / ' °f On-Site Water and Wastewater Program V •, t"� (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 051-531-03 Expiration Date: LCA-t'l c?, c?0 aO 1. GENERAL INFORMATION Complete legal description Meadow Ridge Estates North Add Block 4 Lot 1 Location (site address) 21254 Meadow Lake Drive Current Property owner(s) Pelley Charles L Day phone 884-3073 Mailing address Same Real Estate Agent O'Banion Day phone 844-3073 I 2. TYPE OF DWELLING: V..' , t;\Single Family (w/wo ADU) ti V (1][11z ��C `• � :. i•D� Duplex rz Multiple Dwellings (Single Family and/or Duplex) /-.'-/ OF BEDROOMS: 3 �� 3. NUMBER 1 � 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well n Individual Individual Water Storage ❑ Holding Tank 1 1 Community Class C Well n Community n Public Water System ® Public Sewer 1 -�_z, Date: ____7 /1_____ Y i Reced b y •- COSA to be released to the engineer,unless otherwise requested by the engineer. aZ COSA Fee $ 1 / /42 .A- '- (-1 . - Date: Date of Payment jd f A9 11-' Date of Payment Receipt Number 0.92 -5--3b Receipt Number COSA# 05('J' x.5-9 Waiver# 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm NorthRim Engineering Phone 694-7028 Address PO Box 770724,Eagle River Engineer's Printed Name Steve Eng Date 12/27/2017 6. DSD SIGNATURE System #1 Approved "" y for bedrooms. • System #2 Approved for bedrooms. t`G� ^: �' Disapproved. ‘;i: 2/Z J_..: troa Conditional a `''��<<•..•• pproval for bedrooms, with the following stipulations: ‘T( itttt eP�- yo.. - ��i; WAT WASTEWAR oz PROGRAM ONSITETF oo�-NT SER\A6ci By: VOL_JUQ.A. C_(Ltuka kwt Ec-6. r1c1 Original Certificate Date: 1/2/13 The Municipality of Anchorage Devlopment Services Division(DSD)Issues Certificates of On-Site Systems Approval(COSA)based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska.The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet_9-1-12.doc If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system Certificate of On. Site Systems Approval Checklist Legal Description:/14eat �Ow EstA//tickii8y LI Parcel ID: O5( S3f Q3 A. WELL DATA PUBLIC w47" Well type If A, B, or C provide PWSID# Well Log (Y/N) Date completed Sanitary seal (Y/N) Wires properly protected (Y/N) Total depth ft. Cased to ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test Static water level ft. ft. Well production g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate mg/L Arsenic ug/L Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material .5Eirr/C-/41,LUzti\PTEl<1-C7L Date installed/2450 7 Tank size/.SOO gal. Number of Compartments a Cleanouts (Y/N) y Foundation cleanout(Y/N) y Depression over tank(Y/N) Al High water alarm (YIN) yDate of pumping /1/Ek) Pumper C. ABSORPTION FIELD DATA S'A.4/l//// 0c, Date installed /zfis//7 Soil rating (g I d_/ft2 or ft2/bdrm) -5 . System type Tiesr‘t Length , /7ft. Width S ft. Gravel below pipe 0- ft. Total depth 3- ft. Eff. absorption area /ft2 Monitoring tube y Depression over field 4/ Date of adequacy test ^/f(A) Results (Pass/Fail) P For ? bedrooms Fluid depth in absorption field before test in. Water added gal. New depth in. Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d. Any rejuvenation treatment(past 12 mo.) (Y/N &type) If yes, give date D. LIFT STATION -- Date installed /2-i/417 Size in gallons /506' Manhole/Access (Y/N) "Pump on" level at 75 in. "Pump off'level at 77 in. High water alarm level at ' 70 in. Datum 0 f ser- Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: PUBLIC (,fir%FR Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/cleanout • Sewer/septic service line Holding tank Animal containment areas Manure/animal excrete storage areas SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'f Property line /0 Absorption field 5-t Water main / d 't Water service line /Q 't Surface water /Q ¢ Wells on adjacent lots l4Q �(- ABSORPTION FIELD ON LOT TO: Property line / 1. -- Building foundation Q ��/ ater main /0 /f- 6' r Water Service line /0 /-1" Surface water /Q.O �f Driveway, parking/vehicle storage /�cl f Curtain drain 0Aik— Wells on adjacent lots /0 a F. COMMENTS G. ENGINEER'S CERTIFICATION 0°` •4 L. '% I certify that I have determined through field inspections and ,.^ 4Avi „� review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name /2 I •} Date /272�/ • '\<<;;•••• 255 0\''or PROFEoso,. COSA yellow sheet 2-6-15.doc I N o HOMESTEA D ROAD _ _ — — — — R=270.00' _ _____ _____ S 75,26 SEPTIC PIPES 0 cv 48"E 148 Allik g MANHOLE 45' / < -,14-/ SEPTIC PIPES -P v o y �� l N 132 TREATMENT POD �r m ri '0op / 9• v. D a Tract C a lmim ., .: Lv Lot ti°' • .0'x6.0' DECK® 20,012 s.f. p�' °?, 3.0' PROW psi s� \ CANT Q of�'pf ^� / p 10.5'x 15.3' BALCONY ABOVE ?4• �0 0' ,� / 8.5'x14.0' DECK BELOW ryas W 1� 2.0'x 4.4' o / N 75, CANT o / / 5 / 26'48'W 216.14 of 2.0' CANT / Lot2 3-`_ p II / NOTE: LOT IS SERVED BY A COMMUNITY WATER SYSTEM PLOT PLAN AS BUILT X SCALE 1" = 40' GRID NW 1462 Pro act No. 17-488 R1 _ 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 07 522-6476 Phone . 00Opp Lang & Associates , inc .i c 907} 522-4625 Fax opoF AL��� Professional Land Surveyors kenolangsurvey.com Dv,`�•... ;••. A6A JonathanOlangsurvey.com ‘3/\Z-7- /\Z7 i ' . ,-Q I hereby certify that I have surveyed the following described roe O BLOCK 4, MEADOW RIDGE ESTATES SUBDIVISION NORTH ADDITIONTd (PLAT P A on are 33) 0*: H LOT 1, D Anchorage Recording District, Alaska, and that the improvements s that / ' lines and do not encroach onto the property adjacent thereto, within the property surveyed �p C. LANG 0 0 no improvements on the property lying adjacent thereto encroach on the �nn". Q premises and that there are no roadways, transmission lines or other visible VQO��+, Lir Mk_ Z4,'.1-except as indicated hereon. c� ' easements on said property P �O �P .'"-:'.7.9.9..4.1 .'.,c ,'LgJ1 E+ �C - 74-±7, at Anchorage, Alaska %Q4 ORp S510NAL� ' Dated this the 2--(;471 Day of �>� —' ��OOOoo�� 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. AECC963 ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT BETWEEN MUNICIPALITY OF ANCHORAGE AND C.14 a t s-ro'NSt, rel q+Jo ►`1 EL i s5A A. A. MI u.420 THIS MAINTENANCE AND REPAIR AGREEMENT made and-ennt isroped into of this Cttiaat' Day of 1 3i Aty of 2018 ,by and between P1 .ass& A.wl. M:t,-.aa° herein the"OWNER,"and the Municipality of Anchorage,herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein,the parties to this Maintenance and Repair Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as A44PJTE. located at(legal description). M t<ka v3 R 7 p2.-r 601-H t %L L. 1. 2 Definitions. Alteration. Any change to the design or function of an AWWTS that includes the installation or removal of any parts,components or pieces not included in the original construction permit and design. Certificate of On-Site Systems Approval (COSA). An approval by the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with Anchorage Municipal Code(hereinafter,"AMC") 15.65. These approvals certify that 1. the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. Maintenance and Repair. The scheduled and as needed replacement of existing parts,components and pieces of an AWWTS that were included in the original design which would allow the AWWTS to continue to perform as designed. Permit. An On-Site Wastewater Disposal Permit as required by AMC 15.65 to construct and operate an AWWTS. 3. Term. The term of this Maintenance and Repair Agreement shall begin on the date of approval by the Municipality to operate the installed system or issuance of a COSA, and shall continue while the AWWTS is in use or is operational or until the property is sold or title is transferred by the owner and a new COSA is issued to the new owner or transferee of the property. 4. Alterations, Installation and Removal of Additional Equipment. Prior to performing any alterations to an AWWTS,the owner agrees to obtain an On-site Wastewater Disposal Permit from the Municipality in accordance with AMC 15.65. 5. Maintenance and Repairs. A. Throughout the term of this Maintenance and Repair Agreement, the Owner shall maintain their AWWTS in a satisfactory condition capable of producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. The owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the municipality and the manufacturer of the AWWTS for the entire term of the AWWTS. In addition, it shall be the responsibility of the Owner during the term of this Maintenance and Repair Agreement, and any 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. B. Owner agrees to comply with all applicable ordinance, laws, regulations, rules and orders for the AWWTS. C. Upon request by the Municipality,the owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system. When a record of maintenance is documented and maintained by the system vendor,the owner agrees to allow the Municipality access to this information. D. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60 for improper discharge. E. Owner agrees that only maintenance and repair personnel approved by the Municipality will inspect and make any necessary maintenance,repairs or permitted alterations to the system. F. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. G. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On-Site Systems Approval. H. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. I. Owner agrees to provide and maintain a telephone connection to the AWWTS as required by the AWWTS approval. 6. Nonwaiver. The failure of either party at any time to enforce a provision of this Maintenance and Repair Agreement shall in no way constitute a waiver of the provisions,nor in any way affect the validity of the Maintenance and Repair Agreement or any part hereof,or the right of such party thereafter to enforce each and every provision hereof. 7. Amendment. A. This Maintenance and Repair Agreement shall only be amended, modified or changed by a writing, executed by authorized representatives of the parties, with the same formality that this Maintenance and Repair Agreement was executed with,and such writing shall be attached to this Maintenance and Repair Agreement as an amendment. B. For the purposes of any amendment modification or change to the terms and conditions of this agreement,the only authorized representatives of the parties are: ,,�/� a. Owner:CNft:s 1°PtIE4 I q. 0"1 a!_•5S • tit `i LA.44•t4 b. Municipality: Director, Community Development or designated authority C. Any attempt to amend, modify,or change this contract by either an unauthorized representative or unauthorized means shall be void. 8 Jurisdiction: Choice of Law. Any civil action arising from this Maintenance and Repair 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 Maintenance and Repair Agreement. 9. Severability. Any provisions of this Maintenance and Repair Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Maintenance and Repair Agree m Jen t., a /VW count kulo , OWNER: ' '•, u1 ` a 1 t boLt- By: (signature) Date: 1 � . Pa ame) STATE OF ALASKA ) )ss. THIRD JUDICIAL DISTRICT ) The foregoin t, instrument xs ac owledged before a this day of Lag, 20 IS,,by " _1 _JP' I.i+ . I1 ler IVicto t N ' 'YPUB FORA My Commission pires: ]�� STATE OF ALASKA ,•. NOTARY PUBLIC .",i4 •\kA•ry. y C. Nugent My Commission Expires:July 19,2018 MUNICIPALITY: By: (signature) Date: (print name) Title: File Number: 57229 SPACE ABOVE IS USED FOR RECORDERS Filed for Record at the request of USE ONLY Alyeska Title Guaranty Agency After recording return to: Christopher M. Millard 21254 Meadow Lake Drive Chugiak,AK 99567 POWER OF ATTORNEY (Special Alaska) KNOW ALL MEN BY THESE PRESENTS: That Christopher M. Millard of 21254 Meadow Lake Dr., Chugiak, AK 99567, has made, constituted and appointed, and by these presents does hereby make constitute and appoint, Melissa A. Murdock Millard of 21254 Meadow Lake Dr, Chugiak, AK 99567, his true and lawful attorney for him and in his name, place and stead, and for his use and benefit regarding the following described real property: Lot 1, Block 4, Meadow Ridge Estates Subdivision, North Addition, according to the official plat thereof filed under Plat No. 74-133, in the records of the Anchorage Recording District, Third Judicial District, State of Alaska. GIVING and GRANTING unto his said attorney full power and authority to do and perform all and every act and thing whatsoever requisite and necessary to be done in and about the premises, as fully to all intent and purposes as he might or could do if personally present, including but not limited to contract, agree for, purchase, receive and convey lands, tenement, hereditament, convey, mortgage, hypothecate, bargain, sell or sign any document for, remise, and release. Also for him and in his name, and as his act and deed, to sign, seal, execute, deliver and acknowledge such deeds, leases and assignment of leases, covenants, agreements, mortgages, hypothecations, bills, bonds, notes, receipts, evidence of debt, releases and satisfactions of mortgage, judgment and other debts, and such other instruments in writing, of whatsoever kind or nature, as may be necessary or proper in the premises hereby ratifying and confirming all that his said attorney Melissa A. Murdock Millard shall lawfully do or cause to be done by virtue of these presents. This Power of Attorney shall expire and terminate on June 01, 2018. Dated this(2L' fday of D t/A OtAt- , 2O(i" Christopher M. Millard State of Alaska ) Third Judicial District) ss. On this 2-64 4^- day of D.QCQ,AAbe V , , before me, the undersigned, a Notary Public in and for Said State, personally appeared Christopher M. Millard, personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity(ies), and that by his signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. Witness' y h d and official seal. STATE OF ALASKA i•v NOTARY PUBLIC OP Mk _ �- Kat Arnold Notary Pub:c in and for theSt9t of Alaska My Commission Expires:August 4,2020 � My Commission Expires: L MUNICI?ALIIY OF ^NOHORAGE g~at~ment ol Health & H~ma~ DIV]S~ON OF ~NV~ON~ENTAL 3424744 CERTIFICATE OF INSPECTION [OR HEALTH AUTHORITY APPROVAL OF ON SITE SEWER At.aD WATER FACH~ITY FOR SINGLE FAMILY DWELLING Parcel LD. # ...... ~p t.x ........ HAA # .....: ,EZ~&dJ~2') 1 GENERAL INFORMATION (.Must be compIeted prior to submittal) (a) Legal Description (include I0t, block, subdivision, section, Location (address or directions) (b) (e) (d) (e) Properly owner I:~q..[Z <~\N~ [~,{~ Telephone: (home) Address ~Y Telephone 1 Mail the HAA to the ~o lowing address: (or check here~ if hold tar pick 2, TYPE OF RESIDENCE Number of bedrooms 3 WATER SUPPLY individual Well E] Public [] Note: It community well system, must have written confirmation from the State Department of Enviror}mental Conservation a~testing to th Jegality and status. 4, SEWAGE DISPOSAL Public [3 Community L3 Holding Tank [] Note: If cornmunity well system, must have written confirmation from the State Department of Environmental Conservation attesting to the Iegailty and status. A cert~fied by my eaIaffixedheretoandasofthevalidadondateshown below~verifythatmy~nvest~gationofthis Health Authority Approvat shows that the on*site water supply and/or wastewater disposad system is safe, functional and adequate for the number of bedrooms and type of structure ~nd~cated herein, ~ further vedfythat bssed ca the k*ffotmation obtained from the Municipality of Anchorage flies and from my ~nvest~gation and inspection, the on~s~te water supply and/or wastewater dasposaI system ~s in compliance with ail Municipal and State codes, ordinances, and regulations m effect on the date of this ~nspection Name of Firm ~}:;%E~ A~S~jL7~, ......... Telephone ..... ~&~ Date Engineer's Seal ~HH8 APPROVAL Approved tn~ -- ~;¢ Approved lerms et Conditionai Appfov;~¢ bedrooms by Hi~ ~I?~ Date Disapproved Conditional The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated based oniy upon the representations given in paragraph 5 above by an independent professional eneineer registered in the State of Alaska 'lhe DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements, Employees oi DHHS do not conduct inspections or analyze data before a certificate is issue& The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's worx Legal Descdptiom A WELL DATA WeIIClassi caton Y,: / IfA B,O, DEC Approved{Y/N) / WeI~ Log SFesent (Y/N) [)a~e Oomple~ed Yield ~om~ Depth Qssed to )ep~ of Stadc Wae~ Leve~ Pump Se~ A~ O sing Height Above G~ound Sanitary Seal oe Qasing (Y/N) Elec~dca~Wffh~g{~ ConduJ (Y/N) DepFesslonA~(undWeHhead(Y/N) SEPARAIlON DISTANQESFROMW LL3 To Sep ~c/f oldmg lank on Le~ ; On Adjolnhag Lots XoN{,~= ~,~ Edge of Abso~p~lon F~eld on Lot ~L~2 2 ~OnAd~o~nh~gLo~s Te Nea~es~ PubI~ s Sewer Lk'~e ~o Neams~ Public Sewe~ Oleanout/ManhoJe Jo Nearest Sewe~ Servace Lne on Lot Water Sample Co Iected bx { Date Wa~er Sample lest Results / SEPTaC/HOLD~N~ TANK DATA instdled ,% e Nc,. f ComparImer~t ;}tandpipe (Y/N) Y Ajr-Hght C ps <Y/N1 ;;{~/ Foundaton Cieanout (Y/N) ~/' Depreas on over 'Tank {Y/N) $---. Date Last Pumped Fumpng/Mainter~n(eContac onF1 (Y/N) - , '~, z ; for Tank High Wate~ Alarm (Y/N) ,~&~ ~ Fernpo~ary T~nk Permit / Itolding (Y/N) SE~ARA~IONDiStANCESFROMSEP IC/HOLDING~iANK: ) Water Supply Waif To Building Foundation t r(¥)erty Lira 4~; Io Dispo aI Field Waier Ma n/c~erwce Line Pond, L ke or Major Drainage Course C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed '/ / Width of Field ~ ~ ' Square Feet of Absortion Area '~[.-~'¢? Depression over Field (Y/N) Results of Last Adequacy Test ~AT-'/.~ ~---',~'Fu£ Y SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well ~C~.'; ' + To Building Foundation JO' Lot k~/~ To Water Main/Service Line zCr,5~ ¢ ~'~To Stream, Pond, Lake, or Major Drainage Course ~"~L~ To Driveway, Parking Area, or Vehicle Storage Area Type of System Design Length of Field Depth of Field Gravel Bed Thickness Statndpipes Present (Y/N) Date of Last Adequacy Test To Property Line ~" /--~'~/'~// To Existing or Abandoned System on ; On Adjoining Lots >' ~ To Cutback (if present) Comments D. ',,T S T,O. //A Date Inst~d Size in "Pump On" Lev~ High Water Alarm L'e,v, el at Tested for Cod~ Meets MOA Electrical ) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. **Check Perr~..ed Bedroom~ng Against HAA Request** I certify tha~' I/~'¢v/e ,ch ckc'hl,,Cerified, or conformed to all MOA and H inspection.//////// ///. Date //~ /~ / MOA No. ~ 2 (~ Receipt No. Date of Payment Amount: $ S'2? 72-026 (Rev 7/88) Back Receipt No. Waiver Fee: $ Date of Payment Page 2 of 2 effect on the date of this '~ u, ~n'ine'~r's Seal PLAT 5,(( 7 v JO.On / ? qOv} iber !6~ 19,. } P ~IX) 21143I V( la F C {f 644720 ApNI ~ ii;~(ciec oi();l ~d~ sli to [] Ow~e/t i(er?~ BJy [~ ;Othe [1 (explait}; ; 1984 Lega £t A~ B~ C~ C~ D~E~C~ oved( [~te leted Y~e Id ~pth of G~outinq~ Statim Water {e~a ~ [an~ ~t At ....... Casing [~ight D~ Gr~nd . Electrical Wiring in ~n~it (Y/N) ~uaration Distan~s fr~ ~lh To ~a~st Ed(~ of ~ls~ption Field on Lot~///Il ; C~ Adjoining I.mts /d~9 To Near, est ~blic ~r Line To ~a~est ~blic ~Pa~r Ctean~q/t~&ole Tn ~est r ~rvi~ Li~e on ~t Watte~ Sa~tple Collected By ......................... ~ ~te Wat~3;~' Sat~[e Test ~SUltS [~ste Installed ~ _~/©L~ ~ Standpi~s Air-tight Caps ) Foundation Cleanout ) F~[~ession o~r Tar~ ~ P~ing/~intensn~a Cen~act ~ Fire EOF Holding Tank High-Water Ala~8 ~ary ~].dir4~ Tank ~rmit Sept-aLien Distan{~$ ~ [~pti .Tank: Tn ~o~x~rt¥ H.~ 4~{}~ ~ To DisF©sal Field /Pa~ 1 of 2l ReceiDt ~ Date Paid: TLmount~ 2-15-84 ABSORPTION FIELD DATA Soils Rating in Abso~pti.on Strata 'Width of Field ' ' ( ~' Square Feet of Absczption A=ea Dep=ession over Field ~'~ Results of Last Adequacy Test /JZ) 7Z - Type of System Design Length of Field 3~ Depth of Field ~/ ,, ~<---0 ~ StandPipes ~e~nt ~) ~ of ~st A~a~ ~st ~F~ Separation Distance f~(m~ A~sc~tion To Water-Supply W~ll To Suildin~ Foun~tion Lot ~ 0 ~ TO Ware= ~in/~=vi~ Line /~ -/' To ~t~(if ~e~nt) TO Stre~ond~ke/~ TO ~i~way, P~ki~ ~ea, Field: To Property Line ~c-'Tz To Existing c~' Abandoned System cn D. LIFT STATION Date Installed Size in Gallons "!~a,~ O~" Level at High Water Alarm Level at Tested for Electrical Codes(Y/N) Dimensions Ma Pumping ole/Access :l~Ve. Level at nt (Y/N) lng Adequacy Test. Meets MOA Co~ents ** Check Permitted Bedrocm Rating Against HAA Request ** certify that I have checked, verified, c~ confof,~ed to all MOA HAA Guidelines in effect on the date of this inspection. ~ & ~ EN~INEERIN~ Signed SRB 19~X KB1/d5/s [Page 2 of 2] 2-15-84 Wat}r Syst~x~ 'is 'in (~pI-!a~c ~' St te [}n ~k~n! } 9/} i 6X A(/ Al Aj~KA 99577