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LAKE HILL ACRES #3 LT 15A
Onsite File x r f $„ Z MUNICIPALITY OF ANCHORAGE "cnt S On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 n http://www.muni.org/onsite " v Departrnent On -Site Wastewater Disposal System Permit Permit Number: OSP231258 Effective Date: 8/30/2023 Work Type: SepticTank Upgrade Expiration Date: 8/29/2024 Tax Code Number: 05105126000 Site Legal Address: LAKE HILL ACRES #3 LT 15A G:1561 Site Mailing Address: 22451 MIRROR LAKE DR, DUPL B, Chugiak Owner: CHRISTIANSEN ERIK L & Lot Size in Sq Ft: 46397 Design Engineer: GARNESS ENGINEERING GROUP LTD Total Bedrooms: 6 This permit is for the construction of: ❑ Disposal Field ❑ Septic Tank Q Holding Tank ❑ Privy ❑ Private Well ❑ 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 � y; _TSS the A jb G (r Date: Issued By: Date: Municipality of Anchorage _ Department P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 o Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: OSV231044 COSA#: Permit#:OSP231258 PID#: 051-051-26 Legal Description: LAKE HILL ACRES #3 LT 15A Engineer: Garness Engineering Group Your request for a waiver of the required 3500 gallon holding has been approved. A 3000 gallon tank will be allowed. See the engineers letter. Any future upgrade to the on-site wastewater disposal system will require all code requirements be met or another approval from this department. ............................................... ■ ............................. ■ 1 Waiver is Granted: X Waiver is not Granted: Date: 8 ? Z Approved by: Name of Review .......................................................... ■ ............... ■ **** VARIAN C E/WAIVER REVIEW **** I : Development Services Department Phone. 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTICIWELL PERMIT APPLICATION Parcel I.D. 051-051-26 Property owner(s) Eri K Ckl''6�`Gn-" � C/O ARM SEPTIC SERVICES Day phone 907-688-9433 Mailing address 22451 MIRROR LAKE DRIVE, CHUGIAK, AK 99677 Site address 22451 MIRROR LAKE DRIVE, CHUGIAK, AK 99677 Legal description (Sub'd., Block & Lot) LAKE HILL ACRES #3; LOT 15A Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms 6 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) ❑ Septic Tank ❑ Upgrade [] (w/wo ADU) Holding Tank ❑ Renewal ❑ Duplex (D) E] Privy ❑ Multiple Dwellings 0 (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (signature or property owner or authorized agent) Permit/Rush Fees: 225 Waiver Fees: Date of Payment: g//SAZ3 Date of Payment: Receipt Number: H g 7R G Receipt Number: Permit No. OS P231 Z 5S Waiver No. G:\Development Services\Building SafetyMn Site Water and Wastewater\FormslClient Forms\Permit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231258, Deb Wockenfuss, 08/30/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231258, Deb Wockenfuss, 08/30/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231258, Deb Wockenfuss, 08/30/23 O H U O H U O H U O H U O H U O H U O H U O H U O H U O H U O H U O H U O H U O H U O H U O H U O H U O H U O H U O H U OH U OHU OHU OH U OHU OHU OH U OHU OHU OH U OHU OHU OH U OHU OHU LO7 1 LAKE HILL A&RES SU%D MIRROR LAKE 0' 00' M I R R O R L A K E D R I V E *RAVEL DRIVEWA< ED*E H0 1 0 ' 7 E E S M 7 ℄ E D * E O ) 3 A V E M E 1 7 S62° 1 7 ' 1 5 " W 1 4 8 . 2 0 S 2 1 ° 1 9 ' 2 5 " E 9 0 . 6 0 S6 5 ° 1 4 ' 0 1 " E 8 4 . 2 2 S2 3 ° 1 3 ' 0 0 " W 2 2 2 . 6 9 L = 2 0 4 . 0 8 R = 1 6 6 . 1 8 S 0 9 ° 0 8 ' 1 5 " E 1 1 9 . 9 3 RE7AI1 WALL S SHED S S S S S S S S W *RAVEL DRIVEWA< DO & K E G 1 0 0 ' W E L L R A DIUS 1 0 0 1 LRW 1A LDNH HLOOV AFUHV SXEGLYLVLRQ 7KLUG AGGLWLRQ ST )W 1 MLUURU LDNH DULYH SWRU\ WRRG )UDPH HRXVH LO7 1 LAKE HILL A&RES SU%D PROFESSIONAL SEAL Date:Frontier Surveys, LLC Project No: 650 W. 58th Ave. Suite E Anchorage, Alaska 99518 As-Built Survey of: www.frontiersurveys.com Frontier Surveys, LLC I, Pierre Stragier, hereby certify that this Mortgage Inspection Survey was performed by me, or under my direct supervision on Plat:Grid:Ordered By: 907.460.1686 - info@frontiersurveys.com This survey complies with the ASPLS Mortgage Location Standards. The survey represents visible improvements and conditions at the time of the survey. This document does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may reveal. It is the responsibility of the Owner to determine the existence of any easements, covenants, or restriction which do no appear on the record plat. Under no circumstances should this document be used for construction or for establishing a boundary or fence line. June 27th, 2023. Legend: Scale 1" = 40' Gas Meter Electric Meter/Outside Power Deck Septic Telephone Pole Overhead Utility Lot 15A, Lake Hill Acres Subdivision Third Addition General Notes: 1. This document is created for the purpose of a single property transaction and is subject to Federal Copyright Laws. 2. Excepting for gross negligence, the liability for this survey shall not exceed the cost of preparing this survey. 3. All measurements/setbacks are to the visual/apparent building footprint. 4. All dimensions to property lines are plus/minus 0.1ft. ARM Septic Services 23-251 06/28/2023 2014-100 1561 Water Well ConcreteG E S W -XQ 0 R E GISTEREDPROFESSIO N A L L A N D S URVEYORPierre M. Stragier No. L.S. - 9812 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP171233 Work Type: Septic Upgrade Tax Code Number: 05105126000 Site Legal Address: LAKE HILL ACRES #3 LT 15A G:1561 Site Mailing Address: 22461 MIRROR LAKE DR, Chugiak Owner: CLARK JERIMIAH J 50% & Design Engineer: ANDERSON ENGINEERING This permit is for the construction of: Effective Date Expiration Date: o t cnt Is, V J C J r' Department Lot Size in Sq Ft Total Bedrooms: 5/19/2021 5/19/2022 46397 Q Disposal Field Q Septic Tank Holding Tank Privy Private Well 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 Received By: Date: Issued By: !tet/ Date: N MUHHUPAUTY OF Community Development Department Development Services Division On -Site Water & Wastewater Program AHCIJ I ORAGE Phone: Fax: ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 051-051-26 Property owner(s) Jerimiah and Anne Clark Mailing address P.O. Box 670863 Chugiak, AK 99567 Site address 22451 Mirror Lake Drive Chugiak, AK 99567 543-7904 43-7997 ti w �163L9 �� Day phone �L5Q ° -7 ( 8 Legal description (Sub'd., Block & Lot) Lake Hill Acres #3, Lot 15A Legal description (Township, Range & Section) Lot Size 46,397 Sq. Ft. Number of Bedrooms Six (6) APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field � Initial El Single Family (SF) El (w/wo ADU) Septic Tank 0 Upgrade FxJ Duplex (D) nX Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Review Under New Code Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Sig6diture otjDroperty owner or authorized agent) Permit/Rush Fees: CJ� 6) l I Waiver Fees: o`Z S Date of Payment: '11-1 1 vi Date of Payment: 911-710 Receipt Number: 613144, Receipt Number: 00Mc' Permit No. 05f111a-�20 Waiver No. OSS n i Oto Permit App_9-1-12.doc April 24, 2018 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 Elmore Road Anchorage, AK 99519-6650 Subject: Lot 15A, Lake Hill Acres Subdivision No. 3 Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The subject lot is currently served by a holding tank which was installed in 2004. In 2014 Lots 15 and 16 of Lake Hill Acres #3 were combined to make Lot 15A and the owner increased the building on the lot to a six bedroom duplex. He is now proposing to replace the holding tank with a septic system to serve the duplex. We are therefore requesting a permit be issued for the upgrade of the septic system to accommodate the structure on the lot. The attached Site Plan and backup documentation identify the location and configuration of the existing and proposed septic systems. A new Advantex Treatment System will be placed and the holding tank will be decommissioned in accordance with Municipal Code. No conflicts exist between the proposed septic system and the wells on adjacent lots. Drainage arrows are shown indicating the current drainage patterns. The drainage patterns will be maintained after construction. The test hole recently placed on the lot near the proposed absorption trench indicated Silty Sand with Gravel (SW/SM) in the absorption zone. The percolation rate was determined to be 1.66 minutes per inch. Groundwater was encountered during the placement of the test holes at 7.5' below the surface and rose to 6' during the monitoring period. Surface water is also present on the lot approximately 60' from the absorption trench. We are hereby requesting waivers for the 2' vertical separation to groundwater and a 50' horizontal separation to surface water. We are proposing to place a Category III septic system with remote monitoring, and the newly adopted code allows for these separation distances. We have designed the new trench with an application rate of 6 gallons per day per square foot. We are proposing to place a new 3,000 gallon Advantex Treatment Tank with 2-AX20 Pods and a new 30' long by 5' wide absorption trench with a 0.5' effective depth. The trench will be constructed with the distribution pipe 1.5' below original ground. All organic material under the trench will be removed and replaced with MOA approved sand. Surface water is found on the lot as shown on the Site Plan. The absorption trench will be constructed a minimum of 50' from all surface water. The ground surface on the lot in the area fronting the absorption trench slopes slightly to the southwest. The trench will be placed parallel to the contours of the original existing ground as much as possible and in conformance with design criteria. A minimum of 100' will be maintained between all components of the septic system and the existing well and 50' from any surface water in the area. Sincerely, Benjamin Schiller, RE �49 �'9*I 7Be• a. in Schiller ••••• �Fc 12592FO ��h_RROFESSI��P sm fr r LOT 15A 1 EXISTING WELL } 6-BDRM DUPLEX ✓ f REMOV�EXISTING HOLDING TANK % 1 00'WELL RADII 3600 -GAL ADVANTE� TANK W/ 2x AX2PODS I � TH �� �\ \T CLEANOUT -MAY BE -- LOT T7 _ vOvt6 IF ADDITION IS BUILT MT r ALTERNATE SITE \ <0 SLOPES DOWN AT 2:1 TO m WETLANDS AND STANDING WATER 30'LF SEPTIC TRENCH WIDE;10.5 EFFECTIVE DEPTH 1 \ Itf EXISTING WELL I \ � I v 0 NOTE: \ J AMR�. NO SLOPES >25% OR SURFA E WATER WITHIN 50 OF THE PROPOSED „„EER „ SEPTIC SYSTEM. ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC SYSTEMS. LEGEND IF ANY OLD TRENCH IS FOUND DURING CONSTRUCTION OF NEW CO - CLEANOUT TRENCH THAT INTERFERES WITH THE CURRENT DESIGN, THE OLD 2CO - DOUBLE CLEANOUT TRENCH MUST BE REMOVED & BACKFILLED WITH MOA SAND OR FCO - FOUNDATION CLEANOUT EQUIVALENT. FS - FLOW SPLITTER VALVE 0 50 100 MH - MANHOLE WE FEET SLOPES > 25% MT - MONITORING TUBE SLOPES > 46% SV - SEPTIC VENT 1”=50' TH - TEST HOLE l 1 EXISTING WELL } 6-BDRM DUPLEX ✓ f REMOV�EXISTING HOLDING TANK % 1 00'WELL RADII 3600 -GAL ADVANTE� TANK W/ 2x AX2PODS I � TH �� �\ \T CLEANOUT -MAY BE -- LOT T7 _ vOvt6 IF ADDITION IS BUILT MT r ALTERNATE SITE \ <0 SLOPES DOWN AT 2:1 TO m WETLANDS AND STANDING WATER 30'LF SEPTIC TRENCH WIDE;10.5 EFFECTIVE DEPTH 1 \ Itf EXISTING WELL I \ � I v 0 NOTE: \ J AMR�. NO SLOPES >25% OR SURFA E WATER WITHIN 50 OF THE PROPOSED „„EER „ SEPTIC SYSTEM. ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC SYSTEMS. LEGEND IF ANY OLD TRENCH IS FOUND DURING CONSTRUCTION OF NEW CO - CLEANOUT TRENCH THAT INTERFERES WITH THE CURRENT DESIGN, THE OLD 2CO - DOUBLE CLEANOUT TRENCH MUST BE REMOVED & BACKFILLED WITH MOA SAND OR FCO - FOUNDATION CLEANOUT EQUIVALENT. FS - FLOW SPLITTER VALVE 0 50 100 MH - MANHOLE WE FEET SLOPES > 25% MT - MONITORING TUBE SLOPES > 46% SV - SEPTIC VENT 1”=50' TH - TEST HOLE LAKE HILL ACRES #3, LOT 15A DESIGN FACTORS: SIX BEDROOM DUPLEX PERK RATE: 1-5 MIN/IN APPLICATION RATE: 6.0 GPD/SF SYSTEM REQUIREMENTS: 5' WIDE TRENCH SYSTEM ADVANTEX TREATMENT SYSTEM 2 AX -20 FILTRATION PODS 3,000 -GAL SEPTIC TANK 150 GPD * 6 BEDROOMS = 900 GPD DESIGN FLOW 900 GPD / 6.0 GPD/SF / 5' WIDE * NO REDUCTION FACTOR = 30 LF TRENCH THEREFORE: CONSTRUCT AN ABSORPTION TRENCH 30' LONG x 5' WIDE x .5' EFFECTIVE DEPTH. FLOW LINE ELEVATION IN TRENCH TO BE 1.5' BELOW ORIGINAL GROUND SURFACE. TOTAL DEPTH TO BE 2' BELOW EXISTING GROUND. PROVIDE 2' COVER AND 2" INSULATION OVER ABSORPTION TRENCHES AND 4' COVER OVER SEPTIC TANK. REMOVE ORGANIC MATERIAL IN TRENCH AREA AND REPLACE WITH MOA APPROVED SAND. 2' TO GROUNDWATER 6' TO BEDROCK OR IMPERMEABLE LAYER ION i rvu wi ou -16 viameter rioles @ 1' O.C. 5' WIDE TRENCH SECTION (NO SCALE) NOTES: GRADE AREA OVER TRENCH TO DRAIN AWAY MIN 6' SEPARATION FROM BEDROCK MIN 4' SEPARATION FROM GROUNDWATER MIN 100' SEPARATION FROM NEARBY WELLS MIN 100' SEPARATION FROM SURFACE WATER OR STREAMS LAKE HILL ACRES #3, LOT 15A we 3000 GALLON ADVANTEX TANK EYE BOLTS EVERY 2' 2" CABLE W/ TURNBUCKLE TIGHTEN OVER TANK 10'LX2.5'Wx2.5'D I p CONCRETE BALLAST BOUYANCY CALCULATIONS: (NEGLECTING WEIGHT OF TANK) BOUYANCY FORCE ON EMPTY TANK: 3000 GAL CAPACITY x 8.35 LB/GAL = 25000 LBS WEIGHT OF CONCRETE BALLASTS: 10'x2.5'x2.5' x 150 LB/FT3 x 2 = 18,750 LBS WEIGHT OF SOIL ABOVE TANK: (6'x12' TANK) 4'x6'x12' x 145 LB/FT3 = 41,800 LBS SAFETY FACTOR: 2.4 ad SEPTIC TANK BALLAST (NO SCALE) ', •4Cq�lill F.P. .�- ' ' • Berenja n Schiller.. " . • Cpt24,205192 • ��2�� F� \lie A PROFESSIONP .� MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4.700 ELMORE ROAD ANCHORAGE, AK 99519-6650 SOILS LOG AND PERCOLATION TEST LEGAL DESCRIPTION: LAKE HILL ACRES #3, L 15A PERFORMED FOR: ANDERSON ENGINEERING DATE: 7-20-2017 PROJECT No.: PARCEL ID#: TECHNICIAN: J. MILLETTE DEPTH TEST HOLE (feet) 1 SLOPE SILTY SAND W/ GRAVEL 3 SW/SM 4 5 6 7 8 9 10 Il 12 13 14 15 16 17 18 19 20 CLAY W/ GRAVEL (PERKED UNDER 15 MIN/IN) WAS GROUNDWATER ENCOUNTERED? YES IF YES @ WHAT DEPTH? / • 5 - S DEPTH OF WATER AFTER MONITORING: b -0' O DATE OF MONITORING: 7-511 P DEPTH OF WATER AFTER MONITORING: 5-0' E DATE OF MONITORING: 5 / 1812 1 DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DEPTH To WATER (INCHES) NET DROP (INCHES) TEST HOLE PRESOAKED PRIOR TO TESTING: 7-20 1 7:04 0" 2 7:13 9 6.0" 6.0" 3 7:14 0" 4 7:24 10 6.0" 6.0" 11 7:59 0" 12 1 8:09 10 6.0" 6.0" PERCOLATION RATE: 1.66(MIN/INCH) PERC. HOLE DIA. 6" (INCHES) TEST RUN BETWEEN: 2.5 FT. and 3.0 FT. COMMENTS: Six perk tests run. Tests 3-5 are not shown, but had the same results as Test 6. MATANUSKA ELECTRIC ASSOCIATION, INC. LETTER OF NON -OBJECTION October 11, 2017 Jeremiah J. Clark and Anne E. Clark P.O. Box 670863 Chugiak, AK 99567 Re: Lot 15A, Lake Hill Acres No. 3 Subdivision (Plat 2014-100, Anchorage Recording District) Dear Jeremiah J. Clark and Anne E. Clark: MEA has no objection to the encroachment of a Septic System located in the utility easement as depicted on the attached as-built'survey drawing, subject to the following conditions: 1. The improvement will in no way restrict or limit the current or future ability of MEA to fully enjoy the benefits of the easement for any and all utility purposes that it presently enjoys under the easement. 2. MEA will be held harmless by the landowner from liability for any and all damages or injury to any person or property that may result from the existing and future use of the easement by MEA, its contractors, or assigns. 3. MEA will be held harmless by the landowner for any and all liability arising out of or relating to any use of the easement by others under a Letter of Non -Objection. 4. The landowner will be liable for any damages caused to MEA facilities by the improvement in the easement. 5. The landowner will be responsible for any special construction costs incurred by MEA due to the improvement in the easement. 6. The landowner will assure compliance with all applicable safety codes relating to the improvement in the easement. 7. Use of this letter by the landowner, their successors or assigns will constitute acceptance of these conditions. 8. Alteration of these conditions shall invalidate this letter. 9. This letter is not effective unless it is recorded in the Anchorage Recording District before ownership of the referenced property is changed from the above named landowner. Sincerely, Keit✓hcQuintavell is Land Services Manager STATE OF ALASKA)SS- THIS IS TO CERTIFY that on this 11 day of October, 2017 before me, the undersigned, a Notary Public in and for the State of Alaska, duly commissioned and sworn as such, personally appeared Keith Quintavell Known to me and to me known to be the individual(s) named in and who executed the foregoing instrument and acknowledged to me that he/she/they signed and sealed the same as a voluntary act and deed for the uses and purposes therein mentioned. IN WITNESS WHEREOF, I have hereunto set my hand and official seal the day and, year first above written SEAL...�•• ., Notary Public in and of Alaska My commission expires Return to: MEA, PO Box 2929, Palmer, AK 99645 Wockenfuss, Deborah M. Subject: FW: Wetlands on Lake Hill Acres #3 Ll 5A Yes, if this is the septic site, these confirm there are no wetlands. Thede -----Original Message ----- From: Ben Schiller [mailto:bena,forgecivil.com] Sent: Tuesday, June 5, 2018 2:10 PM To: Tobish, Thede G. <TobishTG cci.anchora e.ak.us> Subject: Re: Wetlands on Lake Hill Acres 43 L15A Hi Thede - Sorry, I thought I'd replied to this and just now realized my mistake, Here are some pictures I took when I drove by a week ago, from two angles. I think it's better than the aerial photography that I can find. Is this helpful? Ben On Wed, May 23, 2018 at 2:31 PM, Tobish, Thede G. <TobishTG( ,ci.anchorage.ak.us> wrote: > Ben, can you plot the septic location on an aerial photo and/or take some pictures of the septic site so I can see the vegetation and conditions. We could place those in the permit file. > Thede > -----Original Message----- > From: Ben Schiller [mailto:ben a,forgecivil.com] > Sent: Wednesday, May 23, 2018 11:58 AM > To: Tobish, Thede G. <TobishTGaci.anchoraae.ak.us> > Cc: Wockenfuss, Deborah M. <WockenfiissDM a ci. anchorage. ak.us> > Subject: Wetlands on Lake Hill Acres #3 L15A > Thede, > I'm putting together a septic permit for the above lot at 22451 Mirror Lake Drive. Deb would like confirmation that the septic system is outside the wetlands. It's fairly evident from a site visit- the system is within the U -shape of the driveway, which is all up on a mounded pad. > The MOA wetlands mapping shows the wetlands on the property, but the degree of accuracy isn't quite enough for us to prove it. What would you recommend? > Ben Schiller, PE \ Municipality of Anchorage -A, 4, • '-'11: ` Development Services Department ��... Building Safety Division On-Site Water and Wastewater Program, 4700 S. Bragaw St. P.O. Box 196650 Anchorage. AK 99519-6650 Page of www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SW040321 PID Number: 051-051-02 14 Oe Vern Craig Wastewater System: ❑ New ® Upgrade Adaass 22451 Mirror Lake Dr., Chuoiak. AK, 99567 ABSORPTION FIELD Ptaro'. Nunber d Beaoomr. 0 Deep Trench 0 ShiAM T Xh 0 Bed 0 Mara 0 Dinar NA LEGAL DESCRIPTION B°"Rr.V TNM Depth hVhOngnalar.de' GPD/FI� Fl. 81 ' Lat: &Omvrm: Do" W ppe nonan ham orpnY pane Grn depth beneath ppe: 16 Lake Hill Acres #3 Ft. Ft Ta p Ran" sedan: FA &rood ahwe ongnel pads. GravM Lovh: Ft. Ft. Well: [I New El Upgrade GrsvN wain Nwilwd Yrs Divarce net.esn Yrs Ft. I FL Ctseadcalm (Private, A B, C) Tdal Depth. Cased to rar absorptan res. Ppe Marr W. Private—Existina Ft FP D30304 & SCH40 Dnaer Date Draled: Slava Water Lewd. h Ww.. Dr. hrtrrd. pt DL Ente rises 10/06/04 Yrld'. Pune Sal r. Casae Negri Anwe Grana TANK GPM FI. Ft SEPARATION DISTANCES I] Septic ® Holding O S.T.E.P. O Other. To Septic Absorption Lift Holding PubhuPmat ww. ww. aP•ulr From Tank Field Station Tank Sewer Line Anchorage Tank 3000&1, Wal 100'+ NA NA 100'+ 25'+ Mrwrl. Steel Nunhw d Conprameds. 1 safaae W.lw NA NA NA 50'* LIFT STATION La LM NA NA NA 5'+ ao .« Gal. Fdaaalan NA NA NA 5'+ ease an la a r. amp OWr.r at Hqn-war awm at h h h Cutin onto NA NA NA NA Pwp Make& Maw Eiact.1k pectens perio by: Remwks. *Waiver #WR040052 BENCH MARK aaolun wa Dowpan. Existing system abandoned Bottom of siding Ail M EWatan 100 FL Engineer's Stamp +� OF At a• •• ,.' AW* Inspections performed by: KND Engineering. Inc.Dates: let 10/06/04 Ce••• •••� nd3176 .a2 .. ..... .• .. �: nneth M. E) i,, • Development Services Department Approval a¢% �� s :e �i o -1 Reviewed and approved by: Date: '.Z q-06 ��19F0e�• 2„I�;;H••���� ev (R12M) ��\�\\\ %04' AS -BUILT SYSTEM DETAILS/SITE PLAN Permit SW040321 LAKE HILL ACRES ADDN. #3, LOT 16 PID# 051-051-02 15 SURFACE WATER i 100' RADI�(EXIS�TnIN VACANT � �K p % LOT �6 N i I EXISTING `. DECK 3 BDRM DECK � SURFACE I HOUSE i' WATER Z g ..i APPROX. EDGE aGO `J� FCO BM OF WATER A FIAT �. a a E D C 2 1 EXISTING O \3000 GAL HOLDING 2�p= \TANK FIAT / SCALE, 1' = 30' A—C= 73.2' B—C= 67' A—D= 79.7' °� 02.9 FINAL GRADE B—D= 72.7' - - - -iiu A—E= 85.3' MAYIMY B—E= 78' d 99.0 99.0 A—F= -- 3000 GAL B—F= 6000 LBS. �. CONCRETE TANK HOLD DOWNS .10sNNE7 ..D . . � 11 L(L1bw�i ��sstox�i' 04057ASS.DWG04057 x(907)696-611 04057asb.dwg PREPARED FOR, VERN CRAIG PO BOX 671949 CHUGIAK, AK. 99567 688-2676 FIELD BOOKS tow u7m: eaww+r. _ MAMM: ST a Q _ acaua: A"e ". AN GilE DMa M GED 15 SCALEi NTS MUNI WJ ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 11 Mar 23 2006 10:52RM RI -ins Son Electric, Iric. rL?-6777 i Rising ion cc. Inc. 14916 ;;\Vadld4mand Drive Eagle River. 499577 (90 62 -677/ March 23, 2006 KND Engineering, Inc 20441 Ptarmigan Blvd. Eagle River, AK 99577-8736 FAX (907) 868-3793 Re: Lake Hill Acres #3, Lot 16 i i i I Dear Dee: hd.ln.j4qu 4 - The lift -station at the above referenced property has been wired in accordance with NEC and State/Local codes. Thank you. Sincerely, . Vokw4azA� Gita Kevin S. Hombuckle, Owner Administrator License Number 1284 Specialty Contractor License Number 27285 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water 6 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Permit Number: SW040321 Legal Description: !LAKE HILL ACRES #3 LT 16 (Dl Date Issued: Aug 06, 2004 Expiration Date: Aug 06, 2005 Parcel ID: 051-051-02 Design Engineer: 0070 KND Engineering Site Address: 022451 MIRROR LAKE DR Owner Name: VERNON CRAIG Lot Size: 33500 SQ. FT. Owner Address: 22451 MIRROR LAKE DRIVE Total Bedrooms: 3 Permit Bedrooms: 3 CHUGIAK , AK 99567-1949 This permit Is for the construction of: Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be In accordance with: 1. The attached approved design. 2. All requirements specked In Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. -THE HOLDING TANK MAY NOT BE BACKFILLED, COMPLETED OR USED UNTIL DESIGNING ENGINEER HAS INSPECTED AND APPROVED SYSTEM IN ACCORDANCE WITH ANCHORAGE MUNICIPAL CODE 15.65. A HOLDING TANK INSTALLATION MUST BE INSPECTED AFTER THE TANK HAS BEEN SET IN PLACE AND ALL PIPING AND CONTROLS HAVE BEEN INSTALLED. HOLDING TANK MUST BE EQUIPPED WITH APPROVED HIGH WATER ALARM WHICH REGISTERS BOTH VISUALLY AND AUDIBLY INSIDE THE DWELLING AND OPERATIONAL AT TIME OF INSPECTION. THE ONSITE WATER AND WASTEWATER DEPARTMENT MUST BE NOTIFIED 2 HOURS PRIOR TO ANY INSPECTION. Received By: Date: Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D 051-051-02 Permit Number SW Property owner(s) Vern Craig Mailing address (1) P_O. Rnx 671944 Chugiak, Dayphone 688-2676 AK_ 99567 MY L"t �� At QY�v� C 5�0� address (2) 22tb1 fYO✓ y- di(p Code Legal description (Lot, Block & Sub'd ) Lake Hill Acres #3, Lot 16 Legal description (Section, Township & Range) Lot Size 33500 Acres/Sq.Ft. Number of Bedrooms 3 THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Date of Payment: Receipt Number: (Rev. 12/00) Date of Payment: Receipt Number: KNID ENGINEERING, INC. 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907)696-6111/FAX (907)696-8111 July 30, 2004 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Sewer Upgrade — Lake Hill Acres 93, Lot 16 Gentlemen: The owner has requested we proceed forward to obtain a septic permit to upgrade and replace the existing septic system and tank for the subject lot. The existing septic tank will be abandoned in accordance with municipal standards. On July 2"� 2004 a site visit was conducted on the subject property. During the site visit it was noted that the ground level has subsided over the course of the past few years. As this property is located directly on the perimeter of Mirror Lake, extensive surface water has appeared. The existing septic system is in failure and well as in violation of the 100 foot setback requirement to surface water. It is our proposal that the lot be served by a 3000 gallon holding tank. The location of the holding tank is required by lot size and extensive surface water to be a maximum of 53 feet from surface water. Every effort will be made to locate the holding tank as far as physically possible from surface water. We are therefore requesting the Municipality to grant a waiver from the holding tank to surface water of 50 feet. It will be assumed that there is ground water essentially at the surface for the purpose of determining how much concrete is needed to anchor the tank properly. It is also assumed that the soil directly above the tank will be saturated with an approximate unit weight of 110 lbf/cu. Ft. It is estimated that the amount of concrete needed to anchor the holding tank properly is 6000 lbs. The lot is served by an individual well located near the. There are no public or private wells within 200' of our proposed system location except as noted. There is no surface water within 50' of the proposed system and there are no known curtain drains within 50'. We do not expect there to be any adverse effect on adjacent lots by the development of this system. If you have any questions, please contact me at 696-6111/FAX 696-8111. Subject: Lot 2, Del's Subdivision - Sewer System Upgrade August 23 1995 Page 2 of 2 Respectfully submitted, IKHD Engineering attachments: On -Site Well and Sewer Application Wastewater Absorption System Details/Site Plan Soils Log WELL & WASTEWATER DISPOSAL SYSTEM DETAILS/SITE PLA LAKE HILL ACRES ADDN. #3, LOT 16 K �Q�� OF ,AL %��11 �' FESSLOK= PREPARED FOR, VERN CRAIG PO BOX 671949 CHUGIAK, AK. 99567 688-2676 FlELD BOOKS TwuNDARr. srNwc A59ULP. DRC ilE: COMPUTED BRAWN: VBG CHEO'S" KMO DATE: 7/30/ DmD NW156 •'DB "" 04057 Scale, 1'= 100' PAGE 1 OF 3 ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-6736 NOTES, 1. MINIMUM DEPTH OF BURY FOR TANK IS 4 FEET. 2. CONTRACTOR WILL ENSURE MINIMUM 27 SLOPE INTO SEPTIC TANK. 3. CONTRACTOR WILL ENSURE ALL SEPARATIONS TO ADJACENT WELLS, SEPTICS, LOT LINES, FOUNDATIONS AND ALL OTHER SETBACKS. NO PUBLIC WELLS WITHIN ear Of 4, ABANDONED SYSTEM PIPES TO BE REMOVED AND DISCARDED BY CONTRACTOR. ►ROPOSED SYSTEM NO PRIVATE WELLS WITHIN 2W Or 5. EXISTING S.T.E.P. TANK TO BE REMOVED AND DISCARDED BY CONTRACTOR. i CSSTESEPT NT�IYSMWITHI2K 6. CONTRACTOR WILL INSTALL FCO IF NONE EXIST. PRUPVSED WELL EXCEPT AS NOTED. �Q�� OF ,AL %��11 �' FESSLOK= PREPARED FOR, VERN CRAIG PO BOX 671949 CHUGIAK, AK. 99567 688-2676 FlELD BOOKS TwuNDARr. srNwc A59ULP. DRC ilE: COMPUTED BRAWN: VBG CHEO'S" KMO DATE: 7/30/ DmD NW156 •'DB "" 04057 Scale, 1'= 100' PAGE 1 OF 3 ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-6736 1 1 KD G I FLAT WASTEWATER DISPOSAL LAKE HILL ACRES ADDN 2 SURFACE WATER Z 1,.TMOA i1 SYSTEM DETAILS #3, LOT 16 LOT EXISTING J \ 3 BDRM /per HOUSE 11 2 SURFACE WATER Z APPROX. EDGE OF WATER ° pr O a% 30' e V o � OPOSE 53, _ It I 1 iz On \\T7K 3000 NG $ ` FIAT j VACANT APPROX. EDGE �� J OF WATER , 2 SURFACE WATER z 1 1 A S`;� OF .ALS 1 ,Of / ` KENNETH 1(. D / CE -711 1 � &Ar �`U' FESSLONa' PREPARED FOR: VERN CRAIG PO BOX 671949 CHUGIAK, AK. 99567 688-2676 FIELD BOOKS MftTED: BOUNDMr. MAM; VQQ 6nuw2 *rta KMD ASE)Wt DAM 7/30 DW- ME DwD: NW156 ACAD "i0 04057.DWG " "eC 04057 Scale, 1'= 30' PAGE 2 OF 3 LL.11 LW ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 11 SEPTIC TANK ANCH❑RING DETAILS LAKE HILL ACRES ADDN. #3, LOT 16 3000 GALLON TANK DIAGRAM FREE BODY DIAGRAM OF SYSTEM ■wASSUME WATER TABLE IS AT GROUND SURFACE WATER DISPLACED, PI r 3.17'^2 IN 15' - 473 CU.FT. WEIGHT OF WATER DISPLACEDi (473 CU.FT.)(62.4 LBF/CU.FT.) _ +29,515 LBF q=+29,515 LBF (BOUYANT FORCE) WEIGHT OF TANK (3000 GAL), —3,508 LBF F(_ —3,508 LBF (WEIGHT OF TANK) WEIGHT OF SOIL ABOVE TANK, (110 LBF/CU.FT.)(6.33' :a 15' x 41= —41,778 LBF ASSUME 50% DENSITY, —41,778/2 = —20,889 LBF 5= —20,889 LBF (WEIGHT OF SOIL) NET FORCE _ (-20,889 — 3,508 + 29,515) LBF= +5,118 LBF PREPARED FOR: VERN CRAIG PO BOX 671949 CHUGIAK, AK. 99567 688-2676 FIELD BOOKS Co"rUim: sOUNDMt DRAM: sTrwc C"CCa@ Asomr. DAM 0.c ME ano: ACAO ^`E 04057.DWGI '106 "' 04057 V1 Scale: 1'= 100' PAGE 3 OF 3 ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 C ! A . Mayor 1/ark Begic/t Municipality of Anchorage b RO. 14;x l!X;(;N) \nehorngc,.\luxlut!N).i 1!1•(X:itl• Telcphane(!X)7)343- V)1• Fam(!X)7)3434Q(X) 47(X) I!ragaw Street • .lnchoruge, Alaska !XRMl7 s • . e r . wl, r""tmimrg I1till(iint; Safety Dhisloct 8/06/2004 KND Engineering 20441 Ptarmigan Blvd Eagle River, AK 99577 Subject: Waiver Request for Lake Hills Acres #3 Lot 16 Waiver Request #WR040052 Parcel ID #051-051-02 Dear Ken Duffus: Your request for a waiver of the required 100 feet horizontal separation from the holding tank to surface water has been approved. The approved separation distance is 50.0 feet. This waiver approval applies to the existing holding tank to surface water separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, o Goodall Civil Engineer On -Site Water & Wastewater Program Community, Security, Prosperity Municipality of Anchorage Development Services Department ar Building Safcty Division i On-SitcWatcr and WastcwatcrProgram ` 4700 Bragaw Strcct P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchoragc.ak.us (907)343-7904 - a• , 11.011Pf Date Received: 8106104 Waiver Review Worksheet HAM _ Permit#: Legal Description: Lake Hills Acres #3 Lot 16 Applicant Vern Crain Waiver Requested: 50' surface water to holding tank Criteria: Geology A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: Points: ............................................................................... Waiver is Granted: T— List Conditions or Reasons for above: Waiver Is not Granted: Date: r. G By: � 60oph-r- C, Name of Reviewer ............................................................................... Rec#: v&_Ua Amount: $,M Date Paid: 6/612004 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 0* 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE W E /D .J �"�,�' �X ❑ UPGRADE MAILING D ESS LEGAL DESCRIPTJON zo,7— LOCATION NO. OF BEDROOMS` Well Absorption area Dwelling PERMIT NO. V DISTANCE TO: ® � y Q wuJJC Manufacturer Material _�/ No. of compartments Liq. capacity in gallons IF HOMEMADE: Inside i2zL_ Width � Liquid depth Y JOZ DISTANCE TO: Well Dwelling PERMIT NO. O E < Manufacturer Material Liquid capacity in gallons O W oundo Nearest lot line PERMIT NO. w= DISTANCE TO: ` J LL z No. of lines Length of each Ii Total length of lines Trench width Distance between lines F Z w inches FTop finish Xp terial beneath tile Total effective absorption area of tile to grade inches W Length j Width .7 Depth PERMIT NO.E' I� Type of cr' Crib diame=E Crib depth Total effective absorption area L w Lu rn Well -Building fo ndation� y Nearest lot,`i DISTANCE TO: 0-1117 J Class Depth Driller Distance to lot line PERMIT NO. J W Idi g fouiTdau Sewer line Septic tank Absorption area(s) DISTANCE TO: OTHER W (ZPIPE MATERIALS , r V SOIL TEST RATING INSTALLER REMARKS 6jfJ lB0� )/ j L L- as i' 6 - 01 Auv- r -. '..c.... ... _>. ' , u.. No, ? a+ Al APP VE DATE LEGAL a$ 15'JjoIfl -- �" SO 196.x �.lir X07 �6 jag by DOC Co. dba SULLIVAN WATER ELLS P.O. BOX 272, CHUGIAK, ALASKA 99567 a TELEPHONE 688-2759 OWNER OF LAND U `�J <' 7tr, G rl �' =t' 7 ' DEPTH OF WELL ADDRESS ` ` 7 f /_P ! — STATIC LEVEL OF WATER FT. 49 '-iCr LEGAL DESCRIPTION—� t� F %`'j !''``%'`° DRAW DOWN FT. _ DATE • Started " ' `' Ended' `' GALS. PER HP. — PERMIT NUMBER - KIND OF CASING KIND OF FORMATION: ' From Ft. to__ 1, Ft. From Ft. to Ft. From ` Ft. to_Li i Ft. f f'. ,j From Ft. to Ft. r From .j i, Ft. to_LFt. /'/ 0r- From Ft. to -Ft.— i From ' � /! Ft, to •-s �� Ft. I % K -mss.- t. / +'r-rlj rnc'q� , ZFrcom Ft. to Ft _ From Ft. to Ft. OU dtf' 'IFrom Ft. to Ft --- Frorn Ft. to _13 `~Ft. 2 r..j �< 15 4 u rti From Ft. to Ft. From_ Ft. to Ft. ___; �? u z �' Fran __ Ft. to Ft. From,, =Ft. to Ft. `/ / i+ ~' ;%' 4-!4.:='f1 ° From Ft. to Ft. From Ft. to Ft, s From_ Ft. to Ft. From Ft. to Ft. + •� `� From Ft. to Ft. j From Ft. to Ft. From Ft. to—Ft. From Ft. to Ft. From Ft. tom—Ft. -- From--Ft. to Ft. From_ Ft. to Ft. -- From Ft. to Ft. From. Ft. to Ft. - From Ft. to_ Ft. Fran Ft. to Ft. _ From Ft. to Ft. From Ft. to _Ft. From Ft. to Ft. Fran Ft. to Ft -- MISCL. INFORMATION: MUNICIPALITY OF ANCHORAGE, i Department �E Health and Environmenta?rotection 825 L Street, Anchorage, AK. y9501 264-4720 _ _,._. Permit # # # # HANDWRITTEN PERMIT * * * ( ? WELL AND/OR ON-SITE SEWER PERMIT C Applicant: re/ "Co /-/ 2�C Mailing Address Location: !'h 1'el;&/2 45;-4x Phone Number: Com% �Z le5;� 7 Legal Description: G 6 �� �� ``�//�ot Size: Type of Soil Absorption System Is: Trench: Drainf ield : Se ge Bed : "-1i�lai ng�Tank Maximum Number of Bedrooms: 1_4�7 Soil Rating(sq.ft/br) DEPTH The Required Side of the Soil Absorption LENGTH GRAVEL DEPTH System Is: DTH The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE _ ��� GALLONS # # Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. * # * TWO(2) INSPECTIONS ARE REQUIRED # # Backfilling of any system without final inspection.and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 u 3 # # # I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) Iwill stall the sys m in accordance with codes. (3) I unders a that h on-site sewer system may require enlargement if the�res' e i odeled to include more that 3 bedrooms. (� Si ned:C71 Issued by: U,-)��L•� ��_ g licant Date: SWP/024(1/81) / r/!2v'U/�1J MUNICIPALITY OF ANCHORAGE • ae DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTI 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS PERFORMED BY: / SOILS LOG ❑ PERCOLATION TEST �� ✓ C.,!r ---l- DATE PERFORMED: `-� a � 33 Z- %4 arq ��wg 3ua y� r aEare �.:3:xn?sr �' e '�69e6,C R�0` r'�`aLty ra ssu" r�_ WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? SLOPE f f/-�O SITE PLAN Reading Date Gross Time - Net Time Depth to - Water Net Drop l 4{, PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT Aft FT DATE#/�� January 4, 1978 Michele Delaney Post office Box 15 Chugiak, Alaska 99567 Subject: Lot 16 Lake Hill Acres Subdivision #3 Permit #77806 A permit issued by this department for well and/or sewer system has expired. Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal ordinance. If you have drilled the well, a well log should be sent to this department to document the installation date. If there are any further questions, please contact this office at 264-4720. Sincerely, Health and Environmental Protection Sewer and Water Section /~ ���� �������4������9 . DEPHRTMF.N| yHEHLTH HND ENVINUNMENTHL CTION HNCHURHGE/ HK. 99��1 � ^ ^ 279--2511 HPPL1CHN| LE DELHNEY P. O. BOX 15 CHUGIHK 99567 061 I. UK1Yl-M 1 LQT 1.6 LAKE HILL HCRES HDD ] LOT S�ZE 14]55 SQUHRE FEET MIN1MUM DlSlMNCE 8ETWEEN H WELL HN[,.,, fiNY CIN--SIlSEWHGE DISPQSHL SYSTEM IS 10M FEE[ FUk M P�lVHTE WELL OR 200 FEET FUR H PUBLIC, WELL WELL LUGS HRE HEQUIRED HND MUST BE RETURNED TO THE DEPHR[MENT WlTHlN ]0 DHyS 11.11- THE WELL CUMPLETION. OTHER Fll�| U1HEMENlS MHY HPPLV. SPECIFlCHT1QNS AND CONSTRUCTlON DlHGRHMS HRE MV1-1lL1181 E lD INSURE PROPER INSTHLLHTIUN. .0, 11- 1 �fi-, - k=- [Il. � ���� l C�K|1FY [HHl 1� I HM FHMILIHK WlTH THE REQUIREMEHTS FUR UN�SITE SEWERS AND WELLS HS SET FUHlH BY lHE MUNICIPHLITY OF HNCHORHGE. 2� l WlLL lNSTHLL THE SYSl�EM IN HCCORDHNCE WITH THE CUDES. HPPLlCHNl MICHELE V] 0 .Rarch 27, 1979 Vs. Michelle DelWICAY P.O. Sox 15 chugiak, Ak 99567 Subject, Improper Disposal of Sewage Lot 16, Lakehill Acres 43 ilecently this department recfttdcla.a complaint regarding an: illegal suer disposal system located at the subject pr©verty. Investigation of tate c o t -)lair d revealed the discharging of :cava (untreated) sewage into an opened. excavation (pit) located approxinately sixty (60) feet from the lake. Further, there were also, an earth privies located within cighty (00) fee=t of the same lake. Both conditions are in violation of Flu_nicipal code of Ardinance 15.65.020 (Prohibited r7asteviatc:- Disc;harcje and Practices) and 15.65.100 (Earth Privies). Pleas.: be advisers that occupancy of the subject property i' prohibited until the violations noted has been corrected. �{?$ ♦r� €�rrmitfrom this department is requi.r'ed prior to any se -we construction. I f t,here are ;any further questions f phase contact this office at 264-4720. 5incerelyr John Kenne&y Principal 00de Enforcement officer JK/da : l,1 cc: Larry Se:lson Petra Real Estates & Investments 2710 Fairbanks, Anchorage, Ak- MUWC�PAUTY OF Development Services Department On -Site Water & Wastewater Section Parcel I.D. 051-051-26 Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Complete legal description LAKE HILL ACRES #3 LOT 15A Phone: 907-343-7904 Fax: 907-343-7997 Expiration Date: 1l-20 `2- 4 Location (site address) 22451 MIRROR LAKE DRIVE, CHUGIAK, AK 99567 Current property owner(s) JERIMIAH & ANNE CLARK Day phone Mailing address Real estate agent PO BOX 670863. CHUGIAK. AK 99567 2. TYPE OF DWELLING: ❑ Single Family (w/wo ADU) ® Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 6 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ® Private Septic ❑ Water Storage ❑ Holding Tank Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee $ 550 Waiver Fee $ Date of Payment V�AZ[ Date of Payment T' Receipt Number Receipt Number COSA # 0-`�CZ 1 I t_1 G 0 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY, ANCHORAGE, AK 99516 Engineer's Printed Name CURTIS HUFFMAN, PE Date 8/12/2021 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject toq/ these various and dynamic characteristics and are outside the control of the evaluator of the •� • well and septic system. Therefore, any estimate of how long a system will function satisfactory g�Q:. • • -1•,9 �`� for current or future occupants or guarantee that no unseen encroachments, deficiencies or f discrepancies exist can be given by First Water Consulting & FLIN - / * • H .. • ..•:* 6. DSD SIGNATURE Curtis Huffman / System #1 Approved for bedrooms ����F9�s•• CE 128991 �i Fop pRO— ONP��� �. System #2 Approved for bedrooms k\�\\\`SSO Disapproved Conditional approval for bedrooms, with the following stipulations: �llllry r% -f l. ON-SITE IAIA i,AND M RO%AM o By: li►- Original Certificate Date: The Municipality of Anchorage Development 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 Checklist Legal Description:, LAKE HILL ACRES #3 LOT 15A Parcel ID: 051-051-26 If more than 1 septic system on lot: COSA Checklist # _of _ Structure served by this system A. WELL DATA ® Well log is filed with Onsite (or attached) Date drilled 8/20/1983 Total depth 140 ft Cased to 140 ft ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 24 in. Date of flow test for COSA 8/6/2021 Static water level at beginning of test 22 ft. Comments B. TANK DATA Age of tank(s) 17 years Tank type/material HOLDING TANK / STEEL Measured operating fluid level in septic tank *4" ® Standpipes/foundation cleanout per record drawing Date of pumping 8/5/2021 D. ABSORPTION FIELD DATA Well production at time of test 4 gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ® Nc ® Coliform bacteria is Negative Nitrate mg/L ® Nitrate less than MRL (ND) Arsenic 6.21 ug/L ❑ Arsenic less than MRL (ND) Collected by_ FW Date of Sample 8/6/21 C. LIFT STATION ❑ Required maintenance completed Age of lift station _ years Lift station material Comments: Which system tested (date installed) Adequacy test date ❑ ALL standpipes`` -present per record drawing Results n Pass For bedrooms Total measured depth from'grad..e _ft (max) Fluid depth prior to test in Measured depth to pipe invert from grade -ft (min) Water added gal ❑ N/A — pressurized field New depth _ in ❑ Monitor tubes go to bottom of effective. If not, state sed time min depth into effective Elapsed - lap ❑ Code -required soil cover over field Finail 'fl-uidd-,depth in ❑ System presoaked Absorption rate ``gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment -(past 12 months) date of test) Gallons introduced gallons If yes, enter date Comments/Deficiencies:. F'ls OWNER HAS DECIDED NOT TO PURSUE SEPTIC UPGRADE UNDER OSP171233. E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ® Yes if No ft Community Sewer Manhole/Cleanout > 100' ® Yes if No ft ® Yes if No Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No Neighboring Absorption Fields > 100' Animal Containment > 50' ® Yes if No ® Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ® Yes if No ft ® Yes if No ft ft ft ft ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Surface Water > 100' ❑ Yes if No *50+ ft Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No _ Water Main > 10' ® Yes if No ft. Community Wells > 200' ® Yes if No _ Water Service Line > 10' ® Yes if No ft If septic tank is under driveway comment below F r om_Absorption Field on Lot to: (Please enter distances if less than required Building Foundation = 1.0 ® Yes if No ft If absorption field is under driveway comment below Property Line > 10' ®Yes No _ ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No wft ------,Private ,.__Private Wells > 100' ® Yes if No _ ft Water Service Line > 10' ® Yes if No ft Community Vve!ts_> 200' ® Yes if No Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS *MOA WAIVER ISSUED. G. ENGINEER'S CERTIFICATION 1 certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. AW .. .. ....... .. .... ....t...:. '. Curtis Huffman �� �'F'•, CE 128991 S/16/2021.. •4P OPROFiSSO ft ft Parcel I.D. 051-051-02 1 Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 Certificate of On -Site Systems Approval RC, �Z'ss 0(f- Expiration Date: / I - 9 - `4 GENERAL INFORMATION Complete legal description Lake Hill Acres #3, Lot 16 Location (site address) 22451 Mirror Lake Drive, Chugiak, AK 99567 Current Property owner(s) Federal Home Loan Mortgage Day phone _ Mailing address 5000 Plano Parkway, Carrollton, TX 75010 Real Estate Agent 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: Five Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual ❑ Individual Water Storage ❑ Holding Tank 1XI Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Received by: Date COSA to be releasert to the engineer, unless otherwise requested by the engineer. COSA Fee Date of Payment Receipt Number COSA # E s c / 3/ L/,9 3 Waiver Fee $ Date of Payment Receipt Number 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 Anderson Engineering Phone 522-7773 Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. 6. DSD SIGNATURE System #1 Approved for _�_ bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms Date 8/8/14 e P,. I » : MCeq:44E. ANDERSON ��� sf • CE - 4381 sr ,e,ie SSS ��`� with the following stipulations: By: cr_Original Certificate Date: The Munici44£gment Services Division (DSD) issues Certificates of Cn-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 r 1., c If more than 1 septic system is on the lot: COSA Checklist # of _ Structure served by this syste_m Certificate of On -Site Systems Approval Checklist Legal Description: Lake Hill Acres #3, Lot 16 A. WELL DATA Well type Private If A, B, or C provide PWSID # _ Date completed 8/20/83 Sanitary seal (YIN) Y Total depth 140 ft. Cased to 140 ft FROM WELL LOG Date of test 8/20/83 Static water level 80 ft. Well production 5 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate • 174 mg/L Arsenic N/D ug/L Date of sample: 7/29/14 B. SEPTIC/HOLDING TANK DATA Parcel ID: 051-051-02 Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) 36 in. AT INSPECTION 9/10/13 30.1 ft 4.2 g.p.m. Collected by: And. Engrg. Tank Type/Material Holding/Steel Date installed 10/6/04 Tank size 3,000 gal. Number of Compartments 1 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) Y Date of pumping Pumper Does Not Currently Require Pumping C. ABSORPTION FIELD DATA Date installed Soil rating (g.p.d./ftZ or ft2/bdrm) System type Length ft. Width ft. Gravel below pipe ft. Total depth ft. Eff. absorption area ftZ Monitoring tube _ Depression over field _ Date of adequacy test Results (Pass/Fail) 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 "Pump on" level at Datum in. Size in gallons _ "Pump off' level at Cycles tested Manhole/Access (Y/N) _ in. High water alarm level at Meets alarm & circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot N/A On adjacent lots > 100' Absorption field on lot N/A On adjacent lots >100' Public sewer main N/A Public sewer manhole/cleanout N/A Sewer /septic service line >25' Holding tank >75' Animal containment areas >50' Manure/animal excrete storage areas >100' SEPTIC/HOLDING TANK ON LOT TO: Building foundation >51 Property line >5, Water main > Water service line > 0 Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO: Property line N/A Building foundation N/A Water Service line N/A Surface water N/A Curtain drain N/A Wells on adjacent lots N/A F. COMMENTS "Waiver Issued. G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Michael E. Anderson, P.E. Date 8/8/2014 COSA brown sheet_10-1412.doc Absorption Feld >51 Surface water 50'** Water main N/A Driveway, parking/vehicle storage N/A Parcel I.D. 051-051-02 GC �L Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 Certificate of On -Site Systems Approval 1. GENERAL INFORMATION Expiration Date: - `2 Complete legal description Lake Hill Acres #3, Lot 16 Location (site address) 22451 Mirror Lake Drive, Chugiak, AK 99567 Current Property owner(s) Federal Home Loan Mortgage Day phone _ Mailing address 5000 Plano Parkway, Carrollton, TX 75010 Real Estate Agent Day phone 2. TYPE OF DWELLING: El Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: Three 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual ❑ Individual Water Storage ❑ Holding Tank F-1 Community Class Well ❑ Community ❑ P�hlic .Nater c,.�+e1.n n Publi_ rV 1 $crier r-, U WaiverNariance request Received bi' ✓ ^ S %' i .; Date <; engin_ COSA to be rele�ae'd to ii4e eer, unless otherwise requested by the engineer. COSA Fee $ yqb — II Date of Payment 1 12J r� Receipt Number 01311 COSA# osC.�3�yi;3 Waiver Fee $ Date of Payment Receipt Number Waiver # 6. 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. 6. DSD SIGNATURE I System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved Phone 522-7773 Date 9/17/2013 Conditional approval for bedrooms, with the following stipulations: By: �� Original Certificate Date: __ -q —.23-13 The unicipality'4chorage Development 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 cosawueshet r 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: Lake Hill Acres #3, Lot 16 A. WELL DATA Well type Private If A, B, or C provide PWSID # Date completed 8/20/83 Sanitary seal (Y/N) Y Total depth 140 ft. Cased to 140 ft. FROM WELL LOG Date of test 8/20/83 Static water level 80 ft. Well production 5 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate N/D mg/L Arsenic N/D ug/L Date of sample: 8/29/13 B. SEPTICIHOLDING TANK DATA Parcel ID: 051-051-02 Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) 36 in. AT INSPECTION 9/10/13 30.1 ft 4.2 g.p.m. Collected by: And. Engrg. Tank Type/Material Holding/Steel Date installed 10/6/04 Tank size 3,000 gal. Number of Compartments Cleanouts (Y/N) Y Foundation cleanout (YIN) Y Depression over tank (Y/N) N High water alarm (Y/N) Y Date of pumping Pumper Does Not Currently Require Pumping C. ABSORPTION FIELD DATA Date installed Soil rating (g.p.d./ftz or ftZ/bdrm) System type Length ft. Width ft. Gravel below pipe ft. Total depth ft. Eff. absorption area ft' Monitoring tube_ Depression over field _ Date of adequacy test Results (Pass/Fail) 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 "Pump on" level at in. Datum E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot _ Absorption field on lot Public sewer main Sewer /septic service line Size in gallons "Pump off"Ievel at Cycles tested N/A N/A N/A >25' >50' Manhole/Access(Y/N) in. High water alarm level at in. Meets alarm & circuit requirements? On adjacent lots > 100' On adjacent lots >100' Public sewer manhole/cleanout >75' N/A Holding tank Animal containment areas Manure/animal excrete storage areas >100' SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Property line >5 Water main >10 Water service line >10' Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO: Property line N/A Building foundation N/A Water Service line N/A Surface water N/A Curtain drain N/'4 Wells on adjacent lots N/A Absorption field >5 Surface water 50'** Water main N/A Driveway, parking/vehiclestorage N/A F. COMMENTS Well is Encased in Wooden Utilidor. Service Line Exits Well Head. Well and Water Line Must be Insulated and Heat Traced to Prevent Freezing. ** Waiver Issued. G. ENGINEER'S CERTIFICATION 1 certify that / have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Michael E. Anderson, P.E. Date 9114/2013 COSA brown sheet 10-10-12.doc V01- MICHM 8 ANDERSON �� m •,� CE - 4381 °\? 414 40FESSO�' 'Grfvr— !J£rr4o Municipality of Anchorage Development Services Department Building Safety Division i 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. 051-051-02 COSA# Qpo"W — Expiration Date: t7--2-7 -O6 1. GENERAL INFORMATION Complete legal description Lake Hill Acres #3, Lot 16 Current Property owner(s) Vern Craig Day phone 688-2676 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address Day phone Kathy Ciernri Day phone 694-9125, E Unless otherwise requested, COSA will be held by DSD for pickup. F#:I11'ul=L .Z�]�-3491:1671614F3i 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System The Municipality of Anchorage Development Services Department (DSD) issues Certificates of Onsite 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 Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. TYPE OF WASTEWATER DISPOSAL: ® Individual On-site ❑ ❑ Individual Holding Tank 19 ❑ Community On-site ❑ ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of Onsite 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 Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my Investigation, based on procedures outlined in the 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 , KND FNr.INFFRING,• - 696-S11111 0 Engineer's Printed Name KFNNE1H M DIIFFll4 Date 6/2-VOG Engineer's Comments: This investigation was completed In compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, KND can not give any estimate of how long a OF q �1 system will function satisfactory for current or future '%4, _'68" it occupants or can KND guarantee that no unseen �. y �'•••'f" encroachments, deficiencies or discrepancies exist. * iwn.., 5. DSD SIGNATURE ✓ Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory JQP"- .... • -yy0 • ON -SIT •• WATER AND : X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Date: Municipality of Anchorage t Development Services Department ° Building Safety Division On -Site Water & Wastewater Program " 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 995196650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description, Lake Hill Acres #3. Lot 16 ParcellD: 051-051-02 A. WELL DATA Well type PRIVATE If A. B, or C provide PWSID # Date completed 8/20/1983 Sanitary seal (Y/N)Y Total depth 140 ft. Cased to 140 ft. FROM WELL LOG Date of test 8/20/1983 Static water level go ft. Well production 5 g.p.m. WATER SAMPLE RESULTS: - Well Log (Y/N) Y Wires property protected (Y/N) Y Casing height (above ground) 36 in. AT INSPECTION 6/21/06 24 ft. 6 9 - p.m - Coliform _Q-_oolonies/100mL Nitrate ND_mg/L Other bacteria _0 colonies/100 ml. Arsenic: -W mg/I Date of sample: 06/12/06 Collected by: KND Engineering, Inc B. SEPTICIHOLDING TANK DATA Tank Type/Material Holding Steel Date installed 10/06/04 Tank size 3000 gal. Number of Compartments.1 Cleanouts (Y/N) Y Foundation cleanout (YIN) Y Depression over tank (Y/N) N High water alarm (WN) Y Date of pumping 6/8/06 Pumper ,I$# C. ABSORPTION FIELD DATA Date installed Soil rating (g.p.d./It= or fe/bdrm) _System type Length R. Width _ft. Gravel below pipe --ft. Total depth ___ft. Eff. absorption area _ftr Monitoring tube _Depression over field _ Date of adequacy test Results (Pass/Fail) _For bedrooms Fluid depth in absorption field before test in. Water added___gal. New deptt_in. Elapsed Time:___nin. Final fluid depth—in. Absorption rate >=. Any rejuvenation treatment (past 12 mo.) (YM & type) If yes, give date----- ... D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) 'Pump on" level at_in. 'Pump off" level at—in. High water alarm level at in. Datum Cycles tested Meets alarm 8 circuit requirements? Y E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot +GG4- /W Absorption field on lot lte'+r A/.4 Public sewer main 75'+ Sewer /septic service line 25'+ On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout 100'+ Holding tank 100'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 51+ Property line 5 ' + Absorption field 5 ' + Water main 10'+ Water service line 10'+ Surface water 5 0' (# W R 0400 5 2 ) Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line NA Building foundation NA Water main NA Water Service line NA Surface water NA Driveway. parkirp/vewde storage NA_ Curtain drain NA Wells on adjacent lots NA_ F. COMMENTS W&1FTZTT'la1 u . . 1 i . .. r; G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and iy–J/ r9v review of Municipal records that the above systems are in 0Ns� conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name KENNETH M. DUFFUSf�9.�+.CIZz664. Date 6/23/06 �`NI ROFESSIM-1�; COSA Fee $430.00 Date of Payment (/(2,3 . Lo (o Receipt Number $2I (J / Waiver Fee $ Date of Payment Receipt Number APPROXIMATE EDGE SURFACE WATER MIRROR LAKE DRIVEWAY ENCROACHES N WELL b sJ OeOs�lV LOT 15DOC a?t9• e. ONE STOR WOOD -F ME V• o :,.�• DEC LOT 16 32,789 s.f. SEPTIC CLEANOUTS I PILINGS \ b e6 rb1"G9 -_L1+."—\ APPROXIMATE _ LOT 17 \EDGE OF SURFACE WATE 10' UTILITY EASEMENT NOTE: LOT DOES NOT CLOSE MATHEMATICALLY PLOT PLAN AS BUILT X SCALED=40' GRID NW1561 Project No. 04-167�iY.-l1'� Lan & Associates Inc. 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 907) 522-6476 Phone 9 e Registered Land Surveyors 907) 522-4625 Fax www.longeurveyors.com / InfoOlangsurveyon.com .. 1 hereby certify that 1 have surveyed the following described property: j-iJ0 LOT 16, LAKE HILLS ACRES SUBDIVISION ADDN i3 (PLAT No. 64-89) pUj: 491 y Anchorage Recording District, Alaska, and that the Improvements sifualed thereon an within the property lines and do not encroach onto the property adjacent thereto, that no Improvements on the property lying adjacent thereto encroach on the surveyed promises and that then an no roodways, transmission lines or other visible easements ; on sold property except as Indicated hereon. KENNETH G. LANG LS -5 02 Dated this the 0P' Day of JJu�+� e , "�o�• at Anchorage, Alaska �v b••. N 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. MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENt OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information (a) Legal Des rip ion (include lot, ���j �/y 1_3 Application Date g-1 7-_S / subdivision, section, township, range) oC� .11. Lc:- 4G�' 1' -- Location (address or directions)/ lei/ i�� 0 2 0 (ef Af (b) Applicants Name 11�Zlj ['eRI Telephone – Home Business Applicants Address ,j _9 %(.)fr–C %Le 6k /%/� �£?iCG•1 (c) Applicant is (check one) Lending Institution ; owner/builder 1:2r; Buyer E:l ; Other E::j (explain); (d) Lending Institution Telephone Address (e) Real Estate Co. & Agent Address Telephone (f) Mail the HAA to the following address: 2. Type of Residence Single–Family Number of Bedrooms 3. Water Supply Individual Well Multi–Family Community = Other (describe Public Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. Sewage Disposal Onsite Public Community Holding Tank El Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1 of 2] 3.- 35 7f- (b) f 5. Engineering Firm Providing Inspections, Tests, File Search, Data and Information As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that, based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regula- tions in effect on the date of this inspection. Name of Firm A. & Address x�a� ZcTf f Date_ (ENGINEER 6. DHEP Approval Approved for bedrooms By Approved: Disapproved Terms of Conditional Approval CN:ijY��[�I`1 Conditional Telephone OF •Al dam `T i p 466 to Shabnr � �u 8� p• 57-P THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK. (DHEP SEAL) RR4/ej/D18 PROTECTION REPRESENT - REGISTERED HOMES AND REQUIRE - BEFORE A FOR ERRORS [Page 2 of 21 7-19-84 MUNICIPALITY OF ANCHORAGE (MOA) ^� �q HEALTH AUTHORITY APPROVAL (HAA) ®I A J CHECKLIST - FEBRUARY 1984 A. WELL DATA N0110310U 1V1N3MMIAN3 18 HDV3H 30 U34 BE)V210HaNV d0 AiIlVdIaINnyl Well Classification < If A, B, or C. D.E.C. proved(Y/N) � Well Log Present �(Y�N) Date Completed 7_�OIA3 Yield Total Depth %y& L2 � Cased to Depth of Grouting '-- Static Water Level CPQ / Pump Set At Ue Casing Height Above Ground 367 " Sanitary Seal on Casing Y ) Electrical Wiring in Conduit 6N) Depression Around Fbllhead (Y; I�Q Separation Distances from Well: / To Septic/Holding Tank on Lot on Adjoining Lots //PC To Nearest Edge of Absorption Field o Lot /L7 / On Adjoining Lots lel To Nearest Public Sewer Line To Nearest Public Sewer Cleancut/Manhole__I To Nearest Sewer Service Line on Lot 0 At Water Sample Collected By�S-�� ; Date 61 Water Sample Test Results ,} -71 S /=--xy c S Comments B. SEPTIC/—W �TANK DATA Date Installed 1-10-e3 Size _/(n9d No. of Compartments —Z - Standpipes N) Air -tight Caps/( Foundation Cleanout (Y, Depression over Tank (YAQ Date Last Pumped Pumping/Maintenance Contract on File (y(YM) for Holding Tank High -Water Alarm (YIN) t111A Temporary Holding Tank Permit (Y/N)#Vs4 Separation Distances from Septic/ffol4it- -Tank: To Water -Supply Wales To Building Foundation 3S To Property Line �f To Disposal Field fy To Water Main/Service Line /4 To Stream, Pond, Lake or Major Drainage Course Comments -0 SvC(0 Of (Page 1 of 21 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata %l0O"//� Type of System Design A07001V,6 Date Installed j / b 3 Length of Field 32- / Width Z - Width of Field / 2 Depth of Field MOO^//)/ Gravel Bed Thickness fZ Square Feet of Absorption Area �6 Standpipes Present 6I) Depression over Field (YAO Date of Last Adaquacy Test Results of Last Adequacy Test Separation Distance from Absorption Field: To Water -Supply Pb ll /0s- To Property Line Z15 1'4 To Building Fo "dation X53 To Existing or Abandoned System on Lot N On joining Lots 3 b 14 To Water Main/Service Line 1-41114 To Cutbank(if present) ^� /4 To Stream/ and /or Major Drainage Course ,/9 /'—� i To E?riveway, Parking Area, or Vehicle Storage Area `-D Comments D. LIFT STATION Date Installed /0-83 Dirrensions(o Size in Gallons e;6 Manhole/Access) "Pump On" Level at O j � 39 "Pump Off" Level at High Water Alarm Level at 410 to Vent (-12E Z�7 Tested for /VC / Pumping Cycles during Adequacy Test. Meets MOA Electrical Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to on the, date of this inspection. Signed a :' 'FIn,4tfJty�;�i O Date /v 'tr.r RIVER, ALASKA '" 57:7 Company _, PH, 4394•.2070 MOA o. KBl/d5/s [Page 2 of 21 all MOA HAA Guidelines in effect OF A. Shob�r •; w 1497-2 \. pRnrccc�O��p � 2-15-84 6 SUAAU E UF A SHEFFIELD, GOVERNOR DEPT. OF ENVIRONMENTAL CONSERVATION SOUTHCENTRAL REGIONAL OFFICE 437 "E" STREET, SUITE 200 ANCHORAGE, ALASKA 99501 August 14, 1984 274-2533 Robert Shafer, P. E. S & S Engineering SRB 196X Eagle River, Alaska 99577 SUBJECT: Waiver Horizontal Separation between Well and Septic Tank, Lot 16, Lake Hill Acres, Addition # 3. Dear Mr. Shafer: The Department has reviewed the subject waiver request and hereby waives the horizontal separation between the private well and septic tank to 88 feet for a three bedroom home. Sincerely, s�� ruce E. Erickson District Engineer BEE/dd M I R R O R v � m ti IT J L A N E LnTe�_ Gs/ iIME1��/.f a �Y ��a9'/ry 1 zlN 19 H J a S )o° R.2I2a Wa,21 ARR90.22 180• ry0.0 - - 1 TAX. NOTES - 1. BEARINGS ARE BASED ON A LOCAL GRID SYSTEM USING THE B.L. M. BEARING ALdNG THE NORTH SIDE Of SECTION 2 AS CONTROL. 2, LOT ON R9 ARE 3/e°PIPE. 3. ALL LOTS EXTEND TO ACTUAL SHORE LINE AS SHOWN. 4. The 101 Utility Easement is granted an extra 51 clashing privilege. DT100p891 64-89 R FC Q J 15 �V I.l E )0' g0 on 2T. a BZ 9G 1 • WW �� I6�111T 9 ESD CYE � t NuyHcrJi � ��! e'JV 3 0 r;„°sn�o "'0 oP m N M I R R O R v � m ti IT J L A N E LnTe�_ Gs/ iIME1��/.f a �Y ��a9'/ry 1 zlN 19 H J a S )o° R.2I2a Wa,21 ARR90.22 180• ry0.0 - - 1 TAX. NOTES - 1. BEARINGS ARE BASED ON A LOCAL GRID SYSTEM USING THE B.L. M. BEARING ALdNG THE NORTH SIDE Of SECTION 2 AS CONTROL. 2, LOT ON R9 ARE 3/e°PIPE. 3. ALL LOTS EXTEND TO ACTUAL SHORE LINE AS SHOWN. 4. The 101 Utility Easement is granted an extra 51 clashing privilege. DT100p891 64-89 R FC S T R E E T RESTRICTIONS ON THIRD ADDITION LAKE BILL ACRES SUBDIVISION The following restrictions shall apply to all lots of this eub- dlvision, to -wit, 1. No quonset huts nor war Surplus buildings may be put on the lots. 2. Troller houses must be over forty feet in length and must be all d.m. 3. No lot may be used as a car wrecking lot or yard, storage of Surplus or junk. 4. No occupant may keep more than too dogs, and no kemuels nor Stables can be maintained. 5. No liquor nor intoxicating beverages may be sold from any lot of the subdivision. 6. Purchasers agree not to subdivide Buy lot for a period of five years. 7. If any of these restrictions are violated, the title will revert to the original owner. Reese Tatsm, Oscar THIRD ADDITION LAKE HILL ACRES SUBDIVISION A DEVELOPMENT BY REESE TATRO LOCATED IN THE NW 1/4 OF SEC.2 a HE 1/4 OF SEC. 3, T 15A R I W SM ALASIIA, SEPTEMBER, 1964 SCALEI I"=100' SURVEYED AND DRAWN BY ROBERT C. JOHNSON IOU.”' g0 on 2T. • WW 3 e'JV 3 0 oP m N 22 zz 1� n ° o c T V 12T.90 -- IIY.yO —._ — _ N 92° OS 50'E Street to be continwd/ S T R E E T RESTRICTIONS ON THIRD ADDITION LAKE BILL ACRES SUBDIVISION The following restrictions shall apply to all lots of this eub- dlvision, to -wit, 1. No quonset huts nor war Surplus buildings may be put on the lots. 2. Troller houses must be over forty feet in length and must be all d.m. 3. No lot may be used as a car wrecking lot or yard, storage of Surplus or junk. 4. No occupant may keep more than too dogs, and no kemuels nor Stables can be maintained. 5. No liquor nor intoxicating beverages may be sold from any lot of the subdivision. 6. Purchasers agree not to subdivide Buy lot for a period of five years. 7. If any of these restrictions are violated, the title will revert to the original owner. Reese Tatsm, Oscar THIRD ADDITION LAKE HILL ACRES SUBDIVISION A DEVELOPMENT BY REESE TATRO LOCATED IN THE NW 1/4 OF SEC.2 a HE 1/4 OF SEC. 3, T 15A R I W SM ALASIIA, SEPTEMBER, 1964 SCALEI I"=100' SURVEYED AND DRAWN BY ROBERT C. JOHNSON