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HomeMy WebLinkAboutHIDDEN HILLS BLK 1 LT 34Hidden Hills lock I Lot 34 011-121 -59 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAl_ PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE ,~ 1 ~NEW D o~/ /-///t//V,4N 3,¢?-./[,:5' :"P~RADE MAILING ADDRESS z~o,,~ //2~ z ~ Z/vc/~, ,4/< LEGAL DESCRIPTION ~ ~c/ /3/ LOCATION wooD£D ~ I Wall , / D STANCE TO' ~ z / Manufacturer . ~ ~Liq. capacity in gal o~sl - i / z~ e, IIF FIOMEMADE: '~ ~ISTANCETO: Zell m~ I DISTANCE TO: l u~ INOl of lines Length ~ eaci~ lin. ~:-~ / / I ~' ~ ~ ITop o~ tile to finish grade --'~ [Length Width ~ ~ I Type of crib Crib diameter ~" ~ IClass Depth ~ / OlSTA~C[ gu~}din~ ~oundation TO ,/ Absorption area Inside lan§th OTHER Dwelling Materi¢'~r 5' £ ¢' W~ dt~ Dwelling Foundation , INearest lot Ibte Total length of lines [ Trench width 2~ I ~0 Material beneath tile Depth NO, OFBEDROOMS PERMIT NO, No, of corn artments Liquid depth PERMIT NO, Liquid capacity in gallons PERMLT [~0. . ~ ~) .~ db'~ I Distance between lines inches incbes Total effective absorption area PERMIT NO, Crib depth Total effective absorption area Building foundation Nearest lot line Driller Distance to lot line PERMIT NO, Sewer line Septic tank Absorption area(s) PIPE MATERIALS Jo3q t,~, ¥ ~,;' SOIL TE. ST RATING INSTALLER REMARKS r/,/~ ff -¢'~ I~- ?¢3 LEGAL F"ERMIT NO. F1P PI... I Ct::II'.,tT DON Hl::ll'-,llq FtH I....OCFIT i ON L..ECq:IL L34 :E:',::L H t B,[:,EIq H I L.LS 'T"r'F'E OF SOIL F:IIE~SORI::'TION :?'r".:i;]"Et"l I'S: TREI",ICH MF:I;:':;II'"IUM I",I[..II'"I[!',E".'F~:~ OF BE[:'ROOM:k.:; = ]: :.~j;O_TL RFITING ,::SIll FT,.'"E~R.':'= I_OT SIZE '_::(a9999 SQUI:::IRE F::'EET THE REQUIRED Ei;IZE OF' THE 'SOIL F:IE:SOF~:F'TION S'T'STEM IS: THE I....ENGTH D I i"IEI",IS 101'.,t I S THE LEI",IG'TH ,:: I I",1 FEE:T ::, OF THE 'TRENCH OR [:,RFI I NFI EL[::,. THE: DI:T..:PTH OF FI ]'R[-]NC,~-I OR F'IT I'.F-"; THE [:,ISTFINCE BET'I,.IEEN THE SLIRFf::IC:E OF 'T'HE GROUi'.,I[:, F:IN[:, THE E:OTTOM OF THE E',:'::CFI'v'FITiOI",I ,:: I I'.,l FEET::,. ]"HE'RE Z S i'.,tO ::SET NI[:,TH FOF?. TRENCHES. THE GRF:I'v'IZL [:,~:2:F'TH IS THE MINIMUI'I [)EPTH OF GI:i:R'v'EL. BETI,.IEEI',I THE OUTI:::I::ILI~ P IF:'E F'IND THE E',OTTCq'"I OF' THE E:'..:',CFI'v'ta'T' I ON ,:: I iq FEET ::,. F'E R t'I I "F FIF'I:::'L. I CI:::II",IT FII::IS TI'-IE R[:T. SPOI",IS I B I L t T"r' T 0 I i"~FCIRM "FH I ~:"; [:'EF'FIF.:TMEI',tT [:'L.IIR I N(]i 'r'H E INf..sTFII...LFITtOi'.,I I t'..I:i~;F'ECTIOI',,IS OF l::ll'.,l"r' I.,.IEL..LS F:tDJFtCEI'.,IT TO THIS F:'ROF:'EF~T"r' I::IND THE I",IiJME~ER OF' RES ZE:'EI",ICES THFIT THE I.,.IELL HILL ..................... "T' IL,-I~ C~ ,,::: ST'.:2 ]:, ~ rr-a ~i;;, II=:~ EZ EZ: 'T :E C} IFq :::~, FI! IF;." EE': E,;L' ~.:.: ,]Z~ ILJ :E !F;:: F...!E IE'; ....................... 8FtCKF ILL I I'.,IG OF FIt",I'T' S'T'STEi'"I J.,.I Z THOUT F Z iqt""tl... Z I",I!:]PE:CT I Ot'.,I FIN[:, FIPPRC~',,,'I:::II... E?'r' TI'"I I S DEPFtI:~'.TMEI'-,IT I.'.! t L.I.... 8E SLIE',JECT TO PROSECLtT I Ol",]. M I N I MIJM D I STFINCE E:ETI,.IEEN F:i HEL. L t::lf',l[:' fiN"r' OI",t-S I 'T'E SEt.,.Ii:::IGE [:, I SPOSI::t[... Sh.'STEM I S :L,EIEi FEET FI}F:'. I::1 PF.:IVFrT'E NELL OR ±SEI TO 20El FEE]' FROM Fl F'UE:LIR I.,JELL DEPENDING UF'ON THE T'~.'F'E. OF:' PUBL. tC WELL. MtNIMLIM [:,ISTI::tI'.,ICE FROM FI F'RIVFfT'E NELl... TO I:::i F.'RI'v'i::Fi"E SEI.,.IER L. INE I LE; 25 F'EIZT I::tl'.,t[:, TO FI CC~Mt'IUNIT"r' SEkiER LiNE 'IS 75 FEET. WELL LOGS RRE OF "t"l-.lli[ I.,.IELL. COMF'LETiON. OTHER F..'E)]:!U I REMENTS i'"JFl"r' FIPF'LV. SF'EC I F:' I C:FtT I ONe; FII"~[) L30NSTRIJ(":T I OI",I D t FIGF;~:FIMS FIRE I;:l'vq::l I LFIBt...E TO i iq:i:';Ul:;i:E F'I:~:OPEF?. I NSTFII_I._I~ITI ON. ! CEF::T I F"r' I'HFI'T :l.: I FII'I FI::.II,IIL.:I:Fffq: I.,.tI"FH THE: REL.]UII:~:IEMEN'I"S FOR ON.....SI'I"E '.E;EI.,IEP. S RI'q[:, I.,.IEL. L..':~; I::1'_":~ L::.:,[.~/I" FORTH B"r' 'TFtE HL.IN t F: t F'I::iL I T"r' OF FINC:HOF~'.FI(3E. 2: I !-,.tILL.. Ii",l:i3]"F:ll_l.... THE S'T'['];TEM ].'N RCCOR[:'Fff',IC:E I.,.t].'TH ]"HE' C:O[)ES. ::~:: t IJN[:'ERSTI:-]NI:) TFIFIT THE Oi",I-fi~ITE SEI.,.IIER S"r"/.-.:TEM MR'T' F.:EgKJtF~'.E: EI",tLFI[:~.tGEI"'tEI",IT IF THE: I~:E'}.;I[:,ENC:E If--:] RI:T'.'MO[;'EI....E[:' TO INC:LI...IDE: i'"IORE THFIN .~: BEI}ROOi"IS. F:IPF'L I CFth,IT [:'ON SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST [] PERCQLATION TEST PERFORMED FOR: D 0 A~ /'l ,~ //v /t/.,,4/-t LEG*, DESGR,PT,ON:4~ Z. o F ~ ¢ ~ / 7 8 9 10 11 '-------12 13 14 15- 16- 17 18 20- COMMENTS DATE PERFORMED: SITE PLAN SLOPE Gory J. Mellott CE 5444 WAS GROUND WATER ENCOUNTERED? )~/0 ~ O E IF YES, ATWHAT DEPTH7 Gross Net Depth to Net Reading Date Time Time Water Drop PF~RCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND ---- FT PERFORMED BY: _~ f~/~- y 72-008 (6/79) '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. muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 011-121-59 GENERAL INFORMATION Complete legal description Lot 34, Block 1, Hidden Hills Subdivision Location (site address) 6310 Wooded Circle Anchorage, AK 99502 Expiration Date: -/O Current Property owner(s) Robert and Elizabeth Auer Mailing address 6310 Wooded Circle Anchorage, AK 99524 Day phone 248-4267 Lending agency Mailing address Real Estate Agent Mailing Address Day phone Day phone Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: Three (3) TYPE OF WATER SUPPLY: Individual Well [] Individual Water Storage [] CommunitY Class ~ Well [] Public Water System [] TYPE OF WASTEWATER DISPOSAL: Individual On-site [] Individual Holding Tank [] Community On-site [] Public Sewer [] The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On-Site Systems 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 COSAs upon request to homeowners. Certificates of On-Site Systems 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 Olass-A or B wells ora 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 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 Anderson Engineering Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. DSD SIGNATURE TI/ Approved for ? Disapproved. Conditional approval for bedrooms. Phone 522-7773 Date 7/13/2010 4.L !,,. _~L~;" ~ '.~ bedrooms, with the following stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory X Arsenic Advisory ON-SITE WATER AND ...... ', Maintenance Agreements Supplemental Engineer's Report Other By: ~¢~~J_~ //~/ ~'~0~z- Original Certificate Date' (Rev. 11/05) Municipality of Anchorage. Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www. muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Lot 34, Block 1, Hidden Hills Subdivision A. WELL DATA Parcel ID: 011-121-59 "Well. type Private "Date comPleted 7/12/84. Total depth 184 - Date ofte~ Static water level Well production IfA, B, or C provide PWSID # Sanitary seal (Y/N)...Y ~ Cased to 183 .~. FROM VVELL LOG 7/12/84 123 10 WATER SAMPLE RESULTS: g.p.m. Well Log (Y/N) Wires properly protected (Y/N) Casing height (above ground) AT INSPECTION 4/14/lO 128.5 ft. 5.0 g.p.m. Y Y >24 in. Coliform o colonies/100mL Nitrate N/D mg/L Arsenic: 7.25 mg/I Date of sample: 4/13/lO B. SEPTIC/HOLDING TANK DATA Other bacteria o . colonies/100 mL Collected by: M. Anderson Tank Type/Material SeptJc/Stee~ Tank size 1,ooo gal. Number of Compartments Two Foundation cleanout (Y/N) ¥ Depression over tank (Y/N) N Date of pumping Arou~ the Clock Pumper 4/13/10 C. ABSORPTION FIELD DATA Date installed 5/11/84 Cleanouts (Y/N) Y High water alarm (Y/N) N Date installed 5/16/83 Soil rating (g.p.d.l~ or ~lbdrm) 100 SF/BDRM Length 25~ ft. Width 3 ft, Total depth :..12 ft, Eft; absorption area .600 ft2 Monitoring tube Date of adequacy test 4/13/10 Results (Pass/Fail) Pass Fluid depth in absorption field before test 13 Elapsed Timer: 840 min, Final fluid depth 0 Any rejuvenation treatment (past 12 mo.) (Y/N & type) System type ..Deep Trench Gravel below pipe 6 Y Depression over field ... N For 3 bedrooms in, Water added 820 gal. New depth in. Absorption rate >= 450 N If yes, give date 33.5 in. g.p.d. LIFT STATION Date installed "Pump on' level at Datum in. E. SEPARATION DISTANCES Size in gallons "Pump off" level at . Cycles tested in. Absorption field on lot Public sewer main Sewer/septic service line Animal containment areas SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot >1o0' >1O0' N/A >25' Property line >1o' Water Service line >1o' Curtain drain None Noted Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? >100' On adjacent lots >1oo' On adjacent lots >1oo' Public sewer manhole/cleanout Holding tank N/A N/A >50' ' Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Property line >5' AbsOrption field >5' Water main N/A Water service line >10' Surface water >100' Wells on adjacent lots >100' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation >10' Surface water >100' Wells on adjacent lots >100' F. COMMENTS: Water main >10' Driveway, parking/vehicle storage >25' Septic Tank Encroaches into 10' Utility Easement. See Letter of Non Objection; in. G. ENGINEER'S CERTIFICATION . review of Municipal m~s that the above systems am in Engineer's Pnnted Name Michael E. Andemon, P.E. Date 7/14~OlO ~ COSA Fee $ q ~ Waiver Date of Payment Receipt Number (Rev. 11105) Date of Payment Receipt Number SGS Reft# I I 01554001 Client Name Anderson Engineering Printed Date/Time 04/19/2010 13:46 Pro.iect Name/# Hidden Hills L34,BI Collected Date/Time 04/13/2010 15:30 Client Sample ID Hidden Hills L34,BI Received Date/Time 04/13/2010 15:30 Matrix Drinking Water Technical Director Stel~hen C. Ede Sample Remarks: Allowable Prep Analysis Pararneter Results LOQ Units Method Container ID Limits Date Date Init Metals by ICP/MS Arsenic 7.25 5.00 ug/L EP200.8 C (<10) 04/14/10 04/15/10 SCL Waters Department Total Nitrate/Nitrite-N 0.100 U 0.100 mgFL SM20 4500NO3-F B (<10) 04/16/10 AYC Microbiology Laboratory Colony Count 0 col/100mL SM20 9222B A (<200) 04/13/10 DLC Total Coliform 0 col/100mL SM20 9222B A (<1) 04/13/10 DLC Fecal Colii~orm 0 col/100mL SM20 9222B A (<1) 04/13/10 DLC Letter of Non-Objection Instructions To properly process your request we need certain information to evaluate your application. Please provide the following documentation or annotate the documents with the additional information: 1. One copy of the application with all the information filled out. 2. One copy of the most recent property as-built survey or plot plan. 3. Show location of the encroachment (fence, wall, building, shed, etc.) on the site plan or as-built survey. 4. Show the dimensions from the object to the property line and how far it projects into the easement. Also show the height above ground measuring from ground surface to bottom edge of structure. 5. After notification that we are approving your request, contact each utility company that services your area. Provide them a copy of your plans/as-builts so they may prepare a letter of non-objection to your encroachment(s). You are required to obtain the letters from the utility companies even though you may not think they have facilities on your property. Each company evaluates their own past, present and future requirements for your area. Do not obtain letters of non-objection until you receive notification from the Right of Way Division that your application for the Letter of Non-objection has been approved. 6. Please provide Right of Way Division one copy of each letter of non-objection from the utility companies. Mail or deliver to Development Services/Right of Way, 4700 Elmore Road, Anchorage, AK 99507 or Fax to 343-8250. If you have questions, please call us at 343-8240. Checklist for Utility Companies [~ Anchorage Water & Wastewater Utility [] 3000 Arctic Boulevard Anchorage, AK 99507 Contact: Planning Phone: 564-2739 Fax: 562-0824 [] Chugach Electric Association, Inc [~ 5601 Electron Drive Anchorage, AK 99519 Contact: Karen Talbert Phone: 762-4781 Fax: 762-4852 [] Matanuska Electric Association, Inc. ~ P.O. Box 2929 Palmer, AK 99645 Contact: Keith Phone: 745-3231 Fax: 761-9322 [~ Alaska Communications Systems [] 1216 E. Dimond Boulevard (Physical Address) 600 Telephone Ave., Mail Stop 14 (Mailing) Anchorage, AK 99515 Contact: Outside Plant Engineering, Foreman Phone: 564-1820 Fax: 561-8356 Email: acs.ospecentral~acsalaska.com [] Letters of Non-Objection Municipal Light & Power 1200 East 1~t Avenue Anchorage, AK 99501 Contact: KLm Watsjold Phone 263-5262 Fax: 263-5804 Enstar Natural Gas Company P.O. Box 190288 Anchorage, AK 99519 Contact: Tom Arminski Phone: 334-7743 Fax 334-7798 GCI 5151 Fairbanks Street Anchorage, AK 99503 Contact: Outside Plant Design Fax: 868-8580 Matangs~,a Telephone Association P.O. Box 3550. Palmer, AK 99645-3550 Contact: Bonnie Bailey Phone: 1-800-746-9510 Fax: 761-2646 TelAlaska, Inc./dba Eyecom (Girdwood cable TV) 201 East 56th Avenue Anchorage, AK 99518 Contact: Cliff Burris Phone: 563-2003 Fax:550-1630 Rev. 575/2010 (Please see reverse for detailed instructions) MUNICIPALITY OF ANCHORAGE Development Services Department Right of Way Division Phone: (907) 343-8240 Fax: (907) 343-8250 ~epartment APPLICATION FOR LETTER OF NON-OBJECTION TO ENCROACHMENT (PLEASE PRINT) Building/Land Use Permit #: ROW Permit #: OwnerName: /'~l~m-t~ 4- ~'ct~At~t=-tl4 Mailing Address: b$iP &JooJ)c*o ~,ze(.~' City/ST fiauee,t, oa..~6e'7 t~.-g.... Zip Physical Address: ~'~¥~ ~" CiW/ST Zip Phone (home/office/mobile): 7_. ~/~ - ~,tZ t,.~ Subdivision: ~ I } O ~O 14 t ct_$ Block: Describe encroachment: '~-'P Tt ~ -'F'~.., t~. t-O A 5 Facsimile: Lot: .~¢ Grid: Type of drawings furnished: As-built survey Submitted by: ,a4 t c. MPrt.--r- ~- Please Print Site Plan )~ Other Phone Number Email Application must include $115.00 non-refundable application fee and a copy of the as-built/site showing and dimensioning the existing and/or proposed encroachment(s). It is the applicant's responsitibility (upon notification) to obtain letters of non-objection from utility companies and provide documentation to Right of Way Division. Upon final review and there being no objections, a formal letter of non-objection will be provided to the applicant for permittee's permanent records. Letter of non-objection is void without permittee's acceptance and signature on file with Development Services, Right of Way Division. Costs associated with any removal and/or repair associated with the encroachment are borne by the Perrnittee. Initial: Date Received: By: Approved/denied by Zoning Plan Review: Comments: APPLICATION FEE Transaction # Check No.: Cash: [] CC: [] By: Date: Amt: Right of Way Plan Review: By: Date: Comments: Approved / Denied / Resubmit Action Required: Jack L. Frost, Jr., Right of Way Supervisor Date Notified: [] AWWU I--ICEA []MEA [-]ENSTAR [-1TELALASKA I--IML&P l--lACS ["']GCI []MTA Rev. 5/5/2010 (Please see reverse for detailed instructions) MUNICIPALITY OF ANCHORAGE Planning & Development Services Dept. Development Services Division Mayor Dan Sullivan July 16, 2010 Phone: 907-343-8301 Fax: 907-343-8200 Robert and Elizabeth Auer 6310 Wooded Circle Anchorage, AK 99502 Encroachment: Septic Tank in Utility Easement Hidden Hills, Block 1, Lot 34, Grid 2222, 6310 Wooded Circle The Right of Way Division has reviewed a request for a letter of non-objection to an existing septic tank which encroaches approximately 2-3 feet, for a distance of approximately 8.0 feet, into the 1 O-foot Utility Easement running east to west on the southern property line. On the Site Plan, submitted with the request, the petitioner has shown the septic tank. This letter of non-objection is issued with stipulations, and by using it the petitioner is agreeing to the following: 1. Municipality of Anchorage (MOA) will be held harmless, now and forever, for any damages or injury to any person as.a result of the encroachments. 2. All applicable codes and regulations will be observed and maintained within the easement. 3. This letter of non-objection will in no way preclude MOA from full use and enjoyment of its rights within any portion of the easement. 4. Additional and extraordinary costs incurred during any future required construction, repair or reconstruction of MOA improvements to accommodate any or all of the encroachments shall be paid by the property owner. 5. Maintain letters of non-objection from the following utilities: [] Anchorage Water & Wastewater Utility [] Chugach Electric Association, Inc. [] Matanuska Electric Association, Inc. [] Municipal Light & Power [] Eyecom (Girdwood Cable TV) [] Alaska Communications Systems [] Matanuska Telephone Association [] Enstar Natural Gas Company [] GCI Cable of Alaska [] No letters required All letters of non-objection should be retained in your permanent files. If you have any questions, please call me at 343-8240. Sincerely, Jack L. Frost, Jr. Right of Way Supervisor Concur G:lDevelopmott ServiceslROW~Von-objection letterslHidden Hills, Blk 1, Lot 34, Auer. doc WOODED CIRCLE 0 0 0 0 HIDDEN HILLS SUBDIVISION LOT 34, BLOCK 1 1 1,~13 S,F. Single Family Home Area of Encroachment --~ 1,000 Gallon \ Septic Tank O' UtilityEosem 6310 Wooded Circle PID NO. 011-121-59 · GRID ,NO. 2222 SITE PLAN SCALE 1" = 20' MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES ~--I ~')~ - D ~/ CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 AUGUST 5, 1988 Application Date GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (al Legal Description (include lot, block, subdivision, section, township, range) LOT % 'R]'~]CK ~ HIDDEN HTT,T,S ,qUIg1')TVT.qTON Location (address or directions) ' 03~0 't,rXliDgD_n'r~rrbE (b) Property Owner FAN'NTE FLAE Telephone: Home Mailing Address 320]. "C" STRE'R,T SUITE #505 Business 561-0828 ANCHORAGE 99503 (c) Lending Institution FANNIE MAE Telephone Mailing Address_ (d) Real Estate Company and Agent FANNIE MAE Address Telephone (e) Mail the HAA to the followina address: or: Check here~ if hold for pick up. List contact person and day phone number below. BRUCE PAq'm~.RSON 274-76] TYPE OF RESIDENCE Single-Family ~ Number of Bedrooms WATER SUPPLY Individual Well;l~ Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsit~ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page I of 2 72~025 trey 8/861 Front leUO!SSa]oJd aqi u! SUO!SS!LUO JO SJOJJ8 JOJ alq!suodsaJ ~ou s! abeJoqou¥ jo/%iled!o!un~ aql 'panss! s! eieo!jliJao e eJoj@q e]ep eZXleUe Jo suo!~oadsu! ~onpuoo iou op SHHQ jo saa~old~u3 's~ueLua~!nbaJ aiels pue leJapaj u!elJaa X]s!~es ol ~epJo u! suo!~nNsu! bu!pual J!aq~ puc seuuoq jo sJaseqoJnd ol Xsapnoo e se s!ql seop SHHC] aql 'e)tSel¥ jo e~e~S eql u! peJe]s!baJ JaaU!bUa leuo!ssaloJd ]uepuadapu! ue ,~q a^oqe c~ qdeJbeJed u! ua^ih suo!~e~uesaJdaJ aq~ uodn 4(lUO paseq sa~eo!jCJao le^oJddv X~!Joq~nv qHeaH sanss! (SHHQ) sao!^~as UeLUnH pue qlleaH jo ~ua~upedaQ @6eJoqouv jo /q!led!o!un!AI aql NOI.LNVC) ~H& OO& 2SO~O OO& QM~ ~86I ' 8~ XqfU] NOIJ.¥iN~IO:INI aNY ¥±¥a 'HO~lYaS :191:1 'SIS:Il 'SNOIZO:~dSNI DNIQIAOI:Id IAI~II:I DNI~I:I3NI{DN3 'g MUNICIPALITY OF ANCHORAGE (MOA) HFAL~'J~rAUTHORITY APPROVAL (HAA) · p,,¢.C ~I'IST- FEBRUARY 1984 ~ 0¥ ~, F,¥9" %~;%q \"'" 264-4744 '~¢.O~ ~ Legal Description: l,~ ~ R~f{ ] ~:~ ,~_ ~ w H~D~ ~I~S S~DIVISION Well Classification ~ If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) Total Depth 183' Static Water Level ] 23* Casing Height Above Ground o!~r !' Electrical Wiring in Conduit (Y/N) Y~plastic) Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line N/A Cleanout/Manhole Water Sample Collected by Water Sample Test Results Y __ Date Completed 7/12/R/4- * Yield Cased to ]_8_3W Depth of Grouting Pump Set At 178*- Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) //© Y ; On Adjoining Lots /~'/~,/2~-& ; On Adjoining Lots //'/.~/O~,-~% To Nearest Public Sewer_ ) To Nearest Sewer Service Line on Lot ;Date 7/28/88 Comments B. SEPTIC/HOLDING TANK DATA =,/'1 '1/84* Size --1250' No. of Compartments 2* Air-tight Caps (Y/N) y Foundation Cleanout (Y/N) Date Last Pumped N ;for Temporary Holding Tank Permit (Y/N) To Building Foundation rj~.P._~. ¢(.~ To Disposal Field ~:))~0)~ ¢; To Stream, Pond, Lake, or Major Drainage Date Installed Standpipes (Y/N) ¥ Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well To Property Line ~¢/'/~ T~ Water Main/Service Line N/A Co u rse I~o~E--WtTh~4uu fee L Comments--Septic lot line. in uti!ity~asgmeq%t and too close to * INDICATES ]ArEORMATION FROM DEPARIMENT OF HEALTH FILE, NOT POSSIBLE TO VERIFY, Page 1 of 2 72-026 (Rev 8'861 Front ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed 5/16/~3w Width of Field .30" Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test 100w Type of System Design 'I'RE~CI-I Length of Field 25w Depthof Field ]2'* ~( 9' to bott~rn ~f sta_ndpipe ) Gravel Bed Thickness ~ 300w Standpipes Present (Y/N) Y (ONE) N Date of Last Adequacy Test 7/28/88 1245 gallons pumped in @ 2.7 ~pm (7.75 hours) with no rise in float 9 feet below level. Separation Distance from Absorption Field: ~roun~ To Water-Supply Well To Building Foundation Lot NO_~,TE VISIBLE To Water Main/Service Line N/a To Stream/Pond/Lake/or Major Drainage Course Pas sed. To Property Line OV ~'_V /O To Existing or Abandoned System on ; On Adjoining Lots ~2_ 'Z. SO ~' ¥o Cutbank (if present)DF~.P $~A_.f',I.D PIT 200 ft IA_ST N/A To Driveway, Parking Area, or Vehicle Storage Area other ¢m¢t nC' hn~_~se Comments * INDICATES INFORMATION FROM DEPARTMENT OF HEALTH FILE, NOT POSSIBLE TO VERIFY. LIFT STATION N/A Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted. Bed eom Rating Aga' st HAA Request** See Cerumen% on se %ic ~ank~ _ I certify~i~a~Ffl~i~v,Cchec/-cg~, '~fied, ¢/onformed to all MOA and HAA guidelines in effect on the dat~is¢~p~o~ ComCny EEIS / ' / MOANo. CE88-285 ¢ ~~ Date of Payment F -x~-P~ ~ ,l lich%,~ ~2~ , Page 2 of 2 72 026 fRev 8'861 Back Tom Fink, Mayor / unicipality Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 August 29, 1988 Richard C. Button Engineering Evaluation and Investigation Services 200 West 34th, Box 267 Anchorage, Alaska 99503 Subject: Waiver Request for Lot 34 Block 1 Hidden Hills Subdivision Waiver Request ~WR88-049, #HAAS8-0324 Dear Mr, Button: Your request for waiver of the required 10 foot separation between a septic system and a lot line has been approved. waived distance is 8 feet. The This approval applies to the existing septic system lot line separation only. Any future upgrade to the septic system will require all separations be met or another approval from this department. Sincerely, Daniel J. Roth Civil Engineer On-site Serivces DJR/ljw#7 Non Objection To A Uaiver of Lot Line Set for The Septic Tank on Lot 34, Block 1, Hidden Hills We the owners of Lots 36 and 37, Block 1, Hidden Hills Subdivision do not object to the granting of a waiver permitting the existing septic tank of Lot 34, Block 1, Hidden Hills to remain partially within the required 10' property line setback, Approximately 2 feet of one corner of the t-ank falls within the required setback, If in the future the tank need to be replaced, we request that the septic tank be moved to a distance that is at least 10 feet from the lot line. NAME: ............ NAME: DATE: Z~ M, Dotson ..... MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION AUG 9 5 1988 RFCFIVED Document No. 8105PC3.TXT/PC-9 ANALYSIS REPORT BY SAMPLE for Work Order ~ 8206 Date Report Printed: AUG 2 88 @ 11:56 Client Sample ID:L3d, B1, HIDDEN HILLS PWSID :UA Collected JUL 28 88 @ 22:00 hfs. Recei¥od 3UL 29 88 @ 11:30 hrs. Preserved with :4 DEG. C Analysis Completed :JUL 29 88 Client Name : EElS CONSULTING ENGINEERS Client Acct : EEISCOTB P.O~ NONE REC~D geq ~ Ordered By : B. PATTERSON Send Reports to: t)EEIS CONSULTING ENGINEERS Special Instruct: Chemlab gef ~: 1999 Lab Smpl ID: 1 Matrix: Water Allowable Parameter Tested Result/Units Method Limits NITRATE-N ND(O.iO) ms/1 EPA 353,2 10 Sample ROUTINE SABLE. Remarks: SAMPLE COLLECTED BY B.P. 1 Tests Performed See Special Instructions Above UA=Unavailable ND= None Detected "See Sample Remarks Above NA: Not Analyzed LT:Less Than, GT:Greater Than Wooded Circle Well Fence ~ (Under ConstructionI 21.2 Fnd. Rebar Fnd . Rebar N Clean Out , Septic' Tank. 10' Utility ~ ~ ~ '-~--~ ..[ / Easement I hereby certify that I have surveyed the property described on this plat and the improvements situated thereon are located as shown on this plat, LEGEND o Lot Corners Foundation Fence NOTES 1, It shall be the responsibility o~ the builder or owner to verify that building location shown meets all subdivision covenants and zoning ordinances, 2, It is the responsibility of the builder to verify all elevations with respect to all utilities & drainage, 3, This plat represents the parcel of property described below taken From the recorded plat describing [hat parcel, instruments recorded prior to or after the Filing of the recorded plat are not shown on this plat. 4. The Information on this plat Is For the use of lending institutions specifically to show any conflicts between existing structures and platted lot lines or easements, the plat Is not to be used ~or positioning additional structures.or Fences, ASBUILT Lot 34 Blk 1 Hidden Hills Subd. ENGINEERING EVALUATION & INVESTIGATION SERVICE 200 West 34th, Box 267 Anchorage, Alaska 99503 (907) 274-7611 ~ 8105 IDate August 3, 1988 Project I MUNICIPALITY OF ANO{ORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPAiTfMENT OF HF2kLTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HFJ~LTH AU'I~ORITY APPROV~fL CERTIFICATE 1. General Information Application Date (a} Legal Description (include lot, block, subdivision, secticn, township, range) Location (address or directions) (b) Applicants N~ .... D ~>,~ [~~~ ~lepho~ ~' 2-'/129 Applicants Ad~es~_ //_:~~P. Z A (c) Applicant is (che~ o~) ~ndi~w Institution (d) ~nding Institution /~L~/~'~ C: "'z%i~~q .Tempi Address (e) Real Estate Co. & Agent Address Telephone 2. T~._. of l~sidence Single-Family Numbe:e of []edrooms Fk]lti-Family ~-~[ Other (desc~i~) 3. Wate~ Sui?p_ly- Individual ~.%~ 11 Note: If ~nity %~11 system, must have va~itten confirmation fresh tJ~e State Departn~nt of Environmental Conservation attesting to tN~ legality and status. Is the %~11 adequate for the number of becb:ocn%s sF~cified in this IL%A (Y/N) 4. Sewa_.qe Dis_pos__al_ Onsite ~ Public IL-: Cor~nunity :: Holding Tar~ Is the wastewater disposal system adequate for the ~umber of tedrcoms (Y/N) [Page. 1 of 2] 5. Eng_i. ne, erincl Firm t>roviding__In_q~soe~ctions_, 1%___zsts___i,_[~_ta and Information Addre ss~ _ ._ Signed by ____~'/q, ~__.~l z/t/Lz g L d~____ Date ~ -' / (';, -' ~" ~/ I c~.r'tify that I have checked, verified, o~: conformed to all ,MOA HAA Guidelir~s in effect on the date of this inspection. Date .~.,~ L~'~ Telephone ,) ( ENGINEER SEkL) 6. DHEP Approval Approved for -~L~ beduooms ,:. ~ Disapproved Terms of (bnditional Approval Date The Municipality of Anchorage DepartJ~ent of Health and Env].ron~ental P~,otect:[on dces not ~arant~ the continued satisfactory ~rformance of t~m~ water, supply and/or the wastewater dis~sal system. This approval indicates that, as of the validation d~te sh~,m a~, ~d on t~ ~nta and info~n~tion furnished bt ~ engineer registered the State of ~aska, the water supply and wastewater dis~sal system is safe and tional for ~%e pim~r of hedr~ ~d ty~ of structure indicatedo (DHEP SEAi,) 7. Mail the HAA to the fol.l.c~ving address: KB2/dS/s [Page 2 of 2] ae MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 Well Classification S//~6'. Well Log Present ..(Y/N) Total Depth / ~3 Cased to Static Water Level ~ ./ Casing Height Above Ground / Elect=ical Wiring in Conduit (Y/N) Separation Distances f~n Well: To Septic/Holding Tank on Lot / To Nearest Edge of Absorption Field on Lot // To Nearest Public Sewer Line If A, B, o~ C, DoE.Co Approved(Y/N) Date Co~?leted 7"~/~ ~ ~'~/ Yield__/~ ~__~_/~/¥ / ~/3 Depth of G~outing ~ ~t At /~ Sanit~y ~al on Casing (Y~) /. ~ession ~ound ~l~ead/Y~) ~ Cleancut/Manhole /~, ~ To Nearest Sewer Service Line on Lot Wate~ Sample Collected By ~/~.~ ~ /V~-¢~;7; Date /- Z ~-.~/ Cc~nts ; On Adjoining Lots // ; On Adjoining Lots To Nearest Public Sewer SEPTIC/HOLDING TANK DATA Date Installed ~-/~- ~ Size / 2 I ~ Standpipes (Y/N) ~ Air-tight caps (Y/N) No. of Compartments ~. Foundation Cleanout ~/N)____~__ Depression ove~ Tank (Y/N) /%/ Date Last Pumped' ~'~ Pumping/Maintenance Contract on File (Y/N) ; for Holding Tank High-Water Alarm (Y/N) Temporary ~lding Tank Permit ~Y/N) Separation Distances f~om Septic/Holding Tank: To Water-SupplyWell / To Property Line / ~ To Water Main/Service Line Course To Building Foundation 2 F To Disposal Field ~' To Stream, Pond, Lake, o~ Major D~aiDage Con~nts [Page 1 of 2] 2-15-84 ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~'~/~ ' ~ Width of Field ~ ¢ ~' + Square Feet of Absorption A~ea Depression over Field (Y/N) /~! d Y.? .-¢-? Type of System Design Length of Field ~_.¢ Depth of Field / 2 / Gravel Bed Thickness ~C ? ~ 7 Standpipes P~esent (Y/N) Date of Last Adequacy Test /CA Results of Last Adequacy Test /CA Separation Distance from Absorption Field: To Water-Supply Well // ~ To P~operty Line ~f~ / To Building Foundation ~. ¢¢- / To Existing or Abandoned System cn Lot /~ ~ ; On Adjoining Lots 3 ~ / q~ To Wate~ Main/Service Line /¢/% To Cutbank(if present) /I//~ To Stream/Pond/Lake/o~ Major D~ainage Course /~/% To D~iveway, Parking A~ea, o~ Vehicle Sto~age A~ea ~f/?-/~ Con~ents D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes(Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles du~ing Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request I certify that I have checked, verified, o~ conformed to all:MOA=HAA,_Guidelir~s i~Df~ect on the date of this inspection. ¢' ~.' OF ~; -%% 12 2-15-84 APPLIC ',,IT FILLS OUT UPPER HA[. ONLY Properly Owner /.. ' ,J / ;;j) ~ / '- Phoee Mailing Address , .~ ." ' ' ? ~ ~. /, .,' ' .z,, Zip Code ,? ~,.~ ;' ... '~/ ./'' //,~,. ~ Buyer Address Zip Code Lending Institution /? ,' -' .- :? n = ~' : "" ~" "'~ // Phone Address /: 1/ ~'~' x~"- /'7/. .: x: . ' ~'' '. ZipCode ;?' ; Phone Realty Co. & Agent Address Legal Description Zip Code Street Locatic~ ~ ~ .c; : /.... x\. .: //.~.. Type of Residence {Z~' Single Family t~ Multiple Family No. of Bedrooms [] Other Water Supply ~' Individual ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. [] Community For wells drilled prior to that date, give well depth (attach log if available), [] Public Utility Year Individual Installed: When Connected to Public Utility: Sewer Disposal E~ Individual [] Public Utility [] Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 'rime Time Time Time Date Date Date Inspector Field Notes: Inspector ) APPROVED BEDROOMS ( ~"'D~APPROVED (DAT~ C O N <~10~K.~A ~-""A ~1~ i~-"'V~ ' Inspector Date _ Insp6~ MuNICIPAU'fY OF ANCHORAGE DEPT, OF !-',%,'.,LTH & ~NVJRONMENTAL ?Rof~CIION 'CONDITIONS OF APPROVAL Soils Rating Date Sewer Installed 72.023 (3182) Well To Absorption Area Well to Tank ?~ ~ /10 Well Iog Received Septic Tank Size