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HomeMy WebLinkAboutLITTLE BEAR BLK 1 LT 13 MUNICIPALITY OF ANCHORAGE �A. i Development Services Department p p 3 Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 014-061-30 Legal description LITTLE BEAR BLK 1 LT 13 Site address 6601 BABY BEAR DR Current property owner(s) BROSH FRANK J HUNTER Expiration Date: 10/16/2024 X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: By: Original Certificate Date: 12/4/2023 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other Well to community sewer main and manhole waiver COSA Approval—June 2022 �v UPAUTY OF ANCHORAGE S Development Services Department r � p P Phone: 907-343-7904 On -Site Water & Wastewater Section �� Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 014-061-3C Complete legal description Little Bear; Block 1, Lot 13 Location (site address) 6601 Baby Bear *Anchorage, AK Current property owner(s) Frank Brosh 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS Day phone 907-223-7015 3. TYPE OF WATER SUPPLY: M Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ❑ Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank 0 Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age NSA - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: WA �l &l t 4o 1 Expedited review requested: ❑ % 4 wC � vw --tDistance: / I - /(G�n IZ o I'_� By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee T / L 6 Date of Payment COSA# Waiver Fee $ Date of Payment Waiver # COSA Applicadon_Jun© 2022 COSA Checklist Legal Description: Little Bear; Block 1, Lot 13 Parcel ID: 014-061-13 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA X Well log is filed with Onsite (or attached) Date drilled 1/10/77 Total depth 85 ft Cased to unk ft 0 Sanitary seal is functioning correctly 0 Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 10/10/23 Static water level at beginning of test 12.2 ft. Comments B. TANK DATA Measured operating fluid level in septic tank = Date of pumping ❑ Required maintenance completed, if AWWTS Comments: Public sewer D. ABSORPTION FIELD DATA Which system tested (date installed) - ❑ ALL standpipes present per record drawing Total measured depth from grade - ft (max) Measured depth to pipe invert from grade - ft (m' ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated ❑ Monitor tubes go to bottom of effec ' e. If not, state depth into effecti ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days pri r10 date of test) Gallons introduced - gallons - date Any rej venation treatment (past 12 months) - yes, enter date - Comments/Deficiencies: Public Sewer COSA Checklist June 2022 Well production at time of test 5+ gpm Water storage tank volume n/a gallons Well disinfected for coliform test? ❑ Yes Q No [2 Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L RrArsenic less than MRL (ND) Date 10/10/23 � io ll! (, / 23 C. LIFT STATION ❑ Required maintenance completed Age of lift station - years Lift station material - Comments: Public seye Adequacy test date - _,_Rtsults ❑ Pass Fluid depth prior to test - in Water added - gal New fluid depth - in Elapsed time - min Final fluid depth - in Absorption rate - gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) _ Effective depth used - in Effective depth remaining - in IZ/Z 12,j in qA 1 111-1-12,2 E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout > 100' ❑Yes if No NSA ft ❑Yes if No 30+ ft Neighboring Tank > 100' ❑■ Yes if No ft Private Sewer/Septic Line > 25' ❑■ Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No NSA ft Holding Tank > 100' [C Yes if N -o, eft Neighboring Absorption Fields > 100' Animal Containment > 50' [:]Yes i o U a ME Yes if No ft Z *10+ Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' El Yes if No ft Q Yes if ❑ N/A — Served by Community Well (not on lot) or Public Water 2 23 From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No ft Surface Water >100' _ ❑Yes if Ng--- ft Tank to Property Line > 5' Field to Property Line > 10' Water Main > 10' ❑ Yes if No ft ❑ Yes if No es if No ft Line > 10' ❑ Yes if No ft F. ENGINEER'S COMMENTS Public Sewer *See attached waiver request CF_ � Wells on Private Wells > 100' ❑ Yes if No ft Community Wells > 200' ❑ Yes if No If tank or field is under driveway comment below ft G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm Garness Engineering Group, LTD. (GEG)Phone 907-337-6179 Engineer's Printed Name Jeffrey A. Garness Date t t Z, -f J -Z3 In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including (but not limited to) soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. COSA Checklist June 2022 40 T r e f ess: C 795 z� 11 -.I ( 2 L� 1,7 G c�cpG 0 #AECC884 RF_ ��5�� 1z/7-123 qg- Municipality of Anchorage ' '��``'� S �Uelrirtment P.O. Box 196650 ® 4700 Elmore Road Anchorage, Alaska 99519-6650 ® (907) 343-7904 a Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: OSV231059 COSA#:OSC231454 Permit#: PID#: 014-061-30 Legal Description: LITTLE BEAR BILK 1 LT 13 Engineer: Garness Engineering Group Your request for a waiver of the required 75 feet horizontal separation from the public sewer trunk to the private well has been approved. The approved separation distance is 10.0 feet. In addition, the well is approved to be up to 30' from the sewer manhole. This waiver approval applies to the existing well only. This waiver may be rescinded if nitrate or bacteria readings are elevated. Waiver is Granted: X Waiver is not Granted: Date: Approved by: Name of Reviewer ............................................................ ...............� **** VARIANCE/WAIVER REVIEW **** GARNESS ENGINEERING GROUP, Ltd ENGINEERING SALES CONSULTING December 4, 2023 (Revised) Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref: Waiver Request — Well to Community Sewer Main and Manhole To whom it may concern: We are requesting waivers for existing well encroachments between the existing well and AWWU sewer main and manhole. Justifications for approving this variance is as follows: • The encroachment has existed for the life of the well (46 years). • Nitrate samples pulled by GEG on 10/10/2023 were 0.948 mg/L. • Based on an inspection by Anchorage Well & Pump Service, there were no issues found with the existing casing and/or the pitless adapter • Based on an inspection by Anchorage Water and Wastewater Utility, the encroaching mains and manholes were inspected and no issues were noted. • See the attached well log for soil information. The geological profile form 10' to 19' is gravel and sticky gray clay. In addition there is hard pan from 24' to 83'. The requested waived distances are as follows; • Well to sewer main is 10'+ • Well to sewer manhole is 30'+ Per AWWU, their statement regarding the manholes not being sealed is just that. The sewer was installed prior to the well being drilled so AWWU did not taken any additional precautions when installing the manhole/mains because there was no encroachments at that time. In short, because of the sequence of events the manholes were not "sealed". There is also an animal containment area approximately 24' east of the existing well on Lot 12. On 11/21/23 it contained nine (9) ducks, which is under the MOA defined limit for fowl; therefore, it is our understanding that a waiver is not needed. The number of ducks was confirmed by us by counting them and the homeowner informing us. Recommendations to support the waiver are as follows; Periodic sampling for bacteria and annual sampling for Nitrate Consider installation of a RO point -of -use filter & UV disinfection at the kitchen sink for drinking water please contact us at 337-6179. Thank you for your assistance. JI.S. 3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com ,ti- Pe cc S t3 12)q/23 MH#7 ---- APPROXIMATE LOCATION OF AWWU SEWER MAINS AND ' \ MH PER AWWU DRAWING / \ �IN, \ 70, / � 1 1 / I ( RADIUS' \ ' Lot 12 WELL DECK \ HOUSE \ \ \ /\ N S ALE: mmmmow 1" = 10' EASEMENTS SHOWN i , APPX. FCO LOCAT10N mss. �� '••.� 7 ^� P..•• ..•vvbv..., 111 ARNESS ENGINEERING OUP, Ltd... .. ................ ENGINEERING,, SALES - CONSULTING-j--a-m 37M E TUDOR Rte, SUrFE 101 - ANCHORAGE, ALASKA' 1tMs`i tii%6179' x9EaS3TE vary.. cats ..{ .• ...... PREPARED FOR: FRANK BRUSH PROJECT/LEGAL DESCRIPTION: LITTLE BEAR; BLOCK 1, LOT 13 TYPE OF WORK: WAIVER REQUEST PHONE NUMBER: PAGE NUMBER: 907-223-7015 1 OF 1 DRAWN BY: PN13 DATE: 11%21%23 01 J A. Ga ess : w s 'p�p�l,J,�� LICENSE ,,� Nr��sy�,�►�+••' #AECC884 Municipality of Anchorage 325 E. 94`h Court- Anchorage, Alaska 99515-2111 - Telephone (907) 550-5900 - Fax (907) 344-7325 http://www.muni.org - http://www.awwu.biz Anchorage Water & Wastewater Utility Operations and Maintenance Division C.C.T.V. Section Condition Assessment Date: 11-2-23 WO# 513035 CCTV Inspection 6601 Baby Bear Grid SW2034 MHO18-007: This CCTV inspection was started from MH018 and headed with the flow towards MH007. This 8" DI mainline is 140.2' in length. There is two active service connections on this mainline. At 8' there is a saddle repair in good condition. No noticeable defects in this mainline. This manhole is not sealed. Grid SW2034 MHO18-CO022: This CCTV inspection was started from MH018 and headed against the flow towards C0022. This 8" DI mainline is ELI BROOKS I PACP CERTIFIED OPERATOR 31.9' in length. There are 2 active service connections on this mainline. No noticeable defects in this mainline. This manhole is not sealed. Grid SW2034 MHO18-019: This CCTV inspection was started from MHO 19 and headed with the flow towards MHO 18. This 8" DI mainline is 52.4' in length. There are 2 active service connections on this mainline. No noticeable defects in this mainline. This manhole is not sealed. Grid SW2034 M11019-020: This CCTV inspection was started from MH019 and headed against the flow towards MH020. This 8" DI mainline is 293.7' in length. There is 8 active service connections on this mainline. No noticeable defects in this mainline. This manhole is not sealed. Grid SW2034 MHO09-008: This CCTV inspection was started from MH009 and headed with the flow towards MH008. This 16" DI mainline is 215' in length. There are 2 service connections on this mainline. No defects were found in this section of main, manhole is exposed, alignment is fair, and main is flowing at this time. This manhole is not sealed. Grid SW2034 MHO08-007: This CCTV inspection was started from MH008 and headed with the flow towards MH007. This 16" DI mainline is 401' in length. There is 1 service connection on this mainline. No defects were found in this section of main, manhole is exposed, alignment is fair, and main is flowing at this time. This manhole is not sealed. Grid SW2034 MHO07-096: This CCTV inspection was started from MH096 and headed with the flow towards MH008. This 16" DI mainline is 329' in length. There are 6 service connections on this mainline. No defects were found in this section of main, alignment is fair, and main is flowing at this time. This manhole is nott sealed. PAGE 25' 1 Y /0 , Utility Easement —Drainage Area Boundary----------' 30+37.59 CO 2 LJ 9.7 20+00 Existing 4015 M. H. E- I - I- 1- 5 4 . 0 'o.0 to N) 21-1.50.15 =30+00 MH I 10.03 c C).03'p.s"Z4 ��25 v z'o 10 W 125-78 L.F. AI 'L t T -TL E ,300.00 L F ,BEAR N 00 to 00 w J 26+33.68 O25+07.90 22+07.90 bo CO I MH 3 M11 2 A 'A A • A Z.I)A A/ So- 7116 :0.ldr 'A LU d gra Drainage Area oundary an �?-) TIS N Ir Ir T 12 N 431 VICINITY MAP SCALE.- I"= I Mille rl U) 1j cm AS -BUILT 165 ---------- - ------ ---- - ----------- ,dab.. .... ------- - ---------------- ---------- - - ------ - ----- ------ --- - ----------- -------------------------------- ------------ 41 Fmictimm ----- -------- .... ........ — If 160 FOR - All --------------- EA- ----- -------- 1155 - --- ----- ----- t . ............. ----------------- . . . . .................. ---------- -- -- -- TUAI- -A - .________________I ---------------- ------------------ ------------------- -------- ------------------ S/ 4- 150 - ------------ staffle-z 24 F -- ----- - - - - --- ---------- - i .-A 151--------------- W—Mv- IM-46'—ABE J — - ---- ---- ------ ------- ----- - - - - - - --------- 145 F-4-9.94 At -/Al W /A! V 44,R-2-= - - --- ---- -- - - - - -------------- -- - -- ---------------- All c--comfA&far- wj cof with -19.76 I!I 140 lye—sec �C�C--C'0'r'7'e COO. n- 7. 4- - - A - - - - - - - - - - - - - - - - - - - - ---------- - 77 ------------ -- ---------- . .. .. ..... ........ — ------ ---------------- - - -- -- --------------- ----------- ---- - - - ------------ -T --------- -- ----------- — - — - --------- -- -,E7 02;rA-= =7, Q ii -- ------------ . ........ ................ ------- . ......... ------............ -----------------------------------gji 26+00 25+00 24400 23+00 2+00 21 +00 20+00 30+00 -71+00 �0 API -111C SC/"'LE LITTLE BEAR =JELD 100!'S DA7-z E 7-N-1 =5 ELP". T3M DwN., C. '!� DESCRtPT10N LOCAT1011 LOCATION DATA DATA DESIGN r'y Ry SAAB 120 2.5" BC Mom 0.3 m;1e 17&03, BASE TELE 491" Lake Otis Porkway 24.5' po SANITARY SEWER ELEC -TAKING N E.68ttL Ave. QFILE DESIGN RA" PI'l of ---------------- LA. SAN -Z zn ir -ve -v-of, - EWER 0 U AK-[Tj E Baby Beor Ploce R 273 - -3 7 7 3 ------------S E W-;: CITY CHE -CO --N'TR ACTO R w A T ER A -k B. CHECK PE,�T 212 E- NTERNA71ONAL AIRPORT R.D. DATE j uUE 1976 G P I D 2034 G CODED EY SCALE 50, SHEET 1 of ANCHORAGE WELL & PUMP SERVICE, INC. 7640 KING STREET ANCHORAGE, AK 99518 PH. 907-243-0740 Bill To: Hunter Brosh 6601 Baby Bear Dr Anchorage, AK 99507 Invoice Invoice #: 20236181 Ship To: Hunter Brosh 6601 Baby Bear Dr Anchorage, AK 99507 SALESPERSON YOUR NO. SHIP VIA COL PPD SHIP DATE TERMS DATE PG. TYLER S RIDGWAY 37774 Net 30 11/6/2023 1 QTY. ITEM NO. DESCRIPTION PRICE UNIT DISC % EXTENDED TX. 1 Service Call CAMERA WELL TO CHECK 1 PITILESS DEPTH AND CONDITION AND CHECK CASING INTEGRITY TO 40' 1 Field Service 11/02/23 - Check system. $258.00 $258.00 Locate well head and remove well seal. Camera down hole to pitless adapter and 40'+ down casing to verify integrity. Pitless depth is 10' from top of casing. Pitless adapter integrity appears to be in acceptable condition. Interior casing was in good condition with acceptable levels of corrosion buildup. Reinstall well seal. 0.5 ST5-Tyler Service Tech 0.5 ST9-Service Tech Service Tech Helper - Tallon 1 CAMERA WELL CAMERA $400.00 $400.00 Sale Amt.: $658.00 We appreciate your business. Thank you! Freight: $0.00 Sales Tax: $0.00 Total Amt.: $658.00 Paid Today: $0.00 Balance Due: $658.00 I 8508D Carriage Estates Subd *ABY s • ° ' DRIVI NX xx 0 OF &Aos—lizabeth L. I�atka ,' .0 s # • - Ls , •Com.. + a . , • ' tan +► AS -BUILT NO CORNERS SET THIS DATE I hereby certify that I have performed a Mortgagee's inspection in accordance with ASKS Standards of the following described property: LOT 13 BLOCK 1 LITTLE BEAR SUBDIVISION Anchomge Recording Precinct, Alaska, and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska this 2nd day of October , 2023. EASEMENTS of R OTHER THAN THOSE SHOWN ON THE RE FRED WALATKA $ ASSOCIATES, L.L.C. PLAT ARE NOT SHOWN HEREON Engineers and Surveyors UNLESS OTHER NOTED, FB 23-4, pg 2 BE �-2�8 l This drawing is a representation of conditions found at the time the mortgage location survey was perfunned. This document does not constitute a boundary survey and is subiect to any Inaccuracies that a subsequent boundary survey may disclose. The Information contained on this drawing shall not be used to establish any fence. structure or other improvements. This drawing shall only be used for esingle ction, Use of this by the original client or by at a later date the consent of Elizabeth L. Walatka is a of Federal Copyright taw- Unless grossrw ce is ft liability extent of the preparer is limited to the amount of fees collected for services In preparation of the product Ifigendiscovered. Lot 9 ! Lot 1©A Lot 11 N89058'57"E 42.93 �- ., i 15' Utility Easement l Q) ! \ G Chain link fence (typ) 1 Lot 13 c� M I \\ Lot 1 � I Vsell \ Lot 12 ( Lot 11 ! shed \ \ ! 24.0 ®! 13.3 \ ® c N 1 Story Frame Z �+ Nouse \ O C1 ! 13.3 , 25 AX ! o \ \ 24.0 CL EAST 86.40 *ABY s • ° ' DRIVI NX xx 0 OF &Aos—lizabeth L. I�atka ,' .0 s # • - Ls , •Com.. + a . , • ' tan +► AS -BUILT NO CORNERS SET THIS DATE I hereby certify that I have performed a Mortgagee's inspection in accordance with ASKS Standards of the following described property: LOT 13 BLOCK 1 LITTLE BEAR SUBDIVISION Anchomge Recording Precinct, Alaska, and that the improvements situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska this 2nd day of October , 2023. EASEMENTS of R OTHER THAN THOSE SHOWN ON THE RE FRED WALATKA $ ASSOCIATES, L.L.C. PLAT ARE NOT SHOWN HEREON Engineers and Surveyors UNLESS OTHER NOTED, FB 23-4, pg 2 BE �-2�8 l This drawing is a representation of conditions found at the time the mortgage location survey was perfunned. This document does not constitute a boundary survey and is subiect to any Inaccuracies that a subsequent boundary survey may disclose. The Information contained on this drawing shall not be used to establish any fence. structure or other improvements. This drawing shall only be used for esingle ction, Use of this by the original client or by at a later date the consent of Elizabeth L. Walatka is a of Federal Copyright taw- Unless grossrw ce is ft liability extent of the preparer is limited to the amount of fees collected for services In preparation of the product Ifigendiscovered. ,, [:,EF'RF;.:TMENT ' I'*IE[;:tL.'I.f'H R['.~[-" EN'¢ l Fi' ]Nh' E~.I]'F!L '-';:ClTEt]:T :.f. *-" 25:!E~ E. FU[:'OR Rt}.., RNCHOF-'.IhGE., RI':::. 2;'....-SEf;TM 27E-222:t II.,-~E.'L.L. F E. IF,.._~ '~ 3E ,- e,_".:1.4 ) PERHIT NO., ,' ""' FIPPI_!CFINT ED RINNER 8Z.'::LO !...1E;LL:E;LE'T' COUFI':T LOCRTION BFtB'¢ 8ERR PLFICE LEGRL L-t.~.: E;:i. LITTLE BEFIR '-:',,.'"[:' LOT .'~.;IZE E41Z.~C'! '5'31JFtFI:E: FEET i',lll'.41'MUi"l E, ISTFINL-:E BETWEEN R NELL RND FIN'¢ ON---cl, t'TE SENFIGE 2L00 FEET FRR FI PRZVRTE !-4ELL OR 208 FEET F JR R FUE, LI_. NELL. NELL LO6q FIRE REQUZRED RNE:' MJ=,T BE: RETURNEE:, TO THE DEPRRTHENT 1.4ITHZN OF THE NEL. L COi"IPLETION. _ . [.iHL4RRI'I.~ RF.'.E FIVRI'LRBLE TO 'rNSUF.'.E FF.._FEF.. SF'ECIFICRTIONS FINE) F:ONL--iTt~'UCTION ', ...... '- - l NSTFILLFIT l ON. F E.F_rl ..-t[T' '-.-'RE I [) F-EiP.._ C,i"4E %-"EiRF.t I UEI~.ilFr THFIT :i.: I Ri',1 FRMILtFtR NITH THE REQUIREMEIqT='-q FOR ON-SITE _-,ELJER= FIN[:, NELLE; F'IL--, SET FORTH E:~' THE I',IUN I C I PFIL I T~" OF RNC:HORRGE. 2.':: I [,)ILl.. INSTRLL THE _,-r_ EM IN I':ICC:CJRE:,FIIqCE WITH THE CODES. IFFLI..MNT ED RINNER I :~E;LIE;E:' E: ,r _ -:::. ....... _~"_ . ~_~d~ .... ~ n~ ..................... ~ ' MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ~NCHORAGE  DEPARTMENT OF HEALTH & ENV RONMENTAL PROTECTION DEPT. O~F ~I,~SALTi! 825 L Street ~ Anchorage, Alaska 99501 FNV RONMENT,~L F:;.<)i':~L/Um ENVIRONMENTAL ENGINEERING DIVISION FEB 1_ 1979 Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEW& ~FLI'iVIL~ D DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed, Please allow ten (10) days for processing. 1, PROPERTY OWNER ] PHONE Employee Transfer Corp(Peck) MAILING ADDRESS PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE Teutsch 337-5251 MAILING ADDRESS 3961 Briant Ridge Place 3. LENDING INSTITUTION J PHONE NATIONAL BANK OF ALASKA % Larry CampbellI 276-1132 MAI LING ADDRESS Pouch 7-025 99510 4. REALTOR/AGENT J PHONE Dale Hopkins % Dynamic Realty, Inc.J 279-7611 MAILING ADDRESS 501 West Northern Lights Boulevard 99503 5. LEGAL DESCRIPTION Lot 13 Block 1 Little Bear Subdivision STREET LOCATION 6601 Baby Bear 6. TYPE OF RESIDENCE ×[~'~ SINGLE FAMILY [] MULTIPLE FAMILY NUMBER OF BEDROOMS [] One [] Four [] Two [] Five ~:X Three [] Six [] Other 7. WATER SUPPLY (~× INDIVIDUAL* [] COMMUNITY [] PUBLIC UTILITY 8. SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON-SITE** X~ PUBLIC UTILITY *ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior '~th~at date, give well depth (attach log if available.) **If individual/on-site, give installation date If system is over two (2) years old an adequacy test is required 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 DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE I NSP ECTOR I NSPECTO R INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER []INDIVIDUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER []Septic Tank or []Holding Tank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL. ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line I WELL TO: Absorption Area to nearest Lot Line 5. COMMENTS [~APPROVEDFOR ,__~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY (Title) LEGAL. DESCRIPTION . 72-010 (Rev. 3/78) ~-(.. ~.i',_~-,1 ........... "--~UNICIPALITY OF ANCHORAGE "'.' '-' ~~ -"1 ::.I)e~5~tment'. Of Health and Environment'at Protection".',.?'-:.'-;'' .~,-'~.~ :..:)'-" ~~j} I ; I :' I 279-2511, ext. 224, 225 I l -~ ~quest for Approval of Indzvzdual Sewer and Water Faczl~tzes e Mailing Address: Name of Buyer: Mailing Address: Phone: Phone: Lend in g Institution: ~~ ~ ~ F ~/~ ~-~ ~ ~: ~7'/'''''; ~ ~) Mailing Address: ~f ~ ~ ~ ~ ~, ~_ Phone: ~)~-//~ ~ . Realtor/Agent: ~ Mailing Address: ~~ '6. Legal Description: Street Location: Single Family Residence: Multiple Family Residence: Number of Bedrooms' ( ) Number of Bedrooms: Water Supply: *Individual Well ~ Public/Community System If Individual Well, well depth ~ C~IO If Community System, name of system ( ) 8. Sewage Disposal System: on-site System ( ) Public System If On-site System, date of installation: *NOTE: A well log is required on ALL wells drilled since 6/75. 3/77. ~-~MUNICIPALIT¥ OF ANCHORAGE~-~ ~ :' ~' ~- '~'.' - ' : , D --. '~ .... .': ':: <' .' :~EPAR:T:ME~F, 0,- .FI~AE~H AND ENVIRONMENTAL P,,OTECiION , , , , - 825'- L sureet, Anchorage, Alaska 99001 ~ Date Received: March 21, 1977 1:30 p.m. 2nd InspoctSon: TSmo Date 3-22-77 Tues Date Inspector DiXson Inspector REQUEST FOR APPROVAL OF INDIVIDUAL SEWER .AND WATER FACILITIES Lending Institution Request: Mailing Address: Alaska National Bank of the North Pouch 7-010 Calais ii Donal Dahl Phone: 2. Property Owner: Phone: Mailing Address; Star Route A Bok 79 3. Legal Description: 277-5511 344-5720 Lot 13 Block 1 Little Bear ~/O 4. Single Family Residence: (x~ Number of Bedrooms: 3 Multiple Family Residence: ( ) Number of Bedrooms: Permit %76314 5. Well Data: Type Individual /~ _ Depth 85 ' Construction--~~~/~~/,./ Bacterial Analysis 6. Sewage Disposal System: On-site system ( ) Public Utility Permit % ~ ~ ~7 Installed ' Installer Septic Tank Size Manufacturer Absorption Area Soils Rate Material Well Log Filed Distances: Well to Septic Tank to Sewer Lines Nearest Lot Line Absorption Area to Nearest Lot Line to ~bsorption Area Page ~T~,~_~ · i' · ,?, .' · ~ ~ o ~",~ ~' .... ...~' ,' ~ Department of Health and Environmental Protection~ ~ i ~ i Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 13 Block 1 Little Bear Subdivision Comments: Affadavit Attached: Approved: Disapproved: ( ) Letter Attached: ( ) Date: Date: Department Worksheet: MUNICIPALITY OF ;,iNCHORAGE MUNICIPALITY OF ANCHORAGE DEPT. Oi: ,~'. ;.I.J;, ~'. DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTEC3~i'~VI~~'°NMENI''\L ?<o'r= CT Oh 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 ,~./i>,P P, 1_ 19/7 REQUEST FOR APPROVAL OF S WER and WATER FAC,',T,ES R CEIV D 1. Type of Inspection: CMRO 2. Property Owner: ! Mailing Address: 3. Name of Buyer: VA / Mailing Address: FHA CONV. D~y Phone: ~'~Z~/_.~"' 7 -~ O Day Phone: ,5. Name of Realtor or Agent: E~ Mailing Address: 6. Legal Description: 7. Type of Facility to be Inspected: ~ ~/,,~ ,/,~ Z--"~'""r-~'¢~'"' /t, No. Bdrms. 8. Water Supply Type of Supply: Public Utility If Individual, number of dwellings presently served If Individual, depth of well Individual Sewage Disposal System Type of System: Public Utility /"'~'~ Individual (on-site) If Individual, date of installation 72-003(3/76)