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Home My WebLink AboutLAKE HILL ACRES #1 LTS 21 & 22 Municipality of Anchorage Community Development Department Page I of 3 On-Site Water and Wastewater Program 4700 Elmore St.. P.O. Box 196650 Anchorage, AK 99519-6650 · http://www.muni.org/onsite · (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP141316 PID Number: 051-052-20 [] New [] Upgrade James & Velva Fowler ABSORPTION FIELD ~,ddress [] Deep Trench [] Shallow Trench [] Bed [] Mound P.O. Box 670354 Chugiak, AK 99567 [] Other =hone Humber of Bedro,4oms~ Soil Rating 5GPD/SF Total depth from original grade 4 Ft LEGAL DESCRIPTION 3epth to pipe invert from original gradeGravel depth beneath pipe 3ubdivision Block Lot 3.5 Ft. .SFt Lake Hill Acres #1 22 :ill added above original grade Gravel length rownship Range Section 0-1 Ft. 13 Ft IGravelwidth 3eds: Number of Lines Distance between lines SEPARATION DISTANCES 10 Ft 3 4 Ft. 'To Septic Abso;'pg0n Lift StationHolding Sewer Total absorption area '4umber of trenches Dist. between trenches From Tank Field Tank Line 130 Ft' Ft. Well >100' >100' N/A N/A 11.6' TANK I-Iseptic I~S.T.E.P. E~] Holding rT]Other Manufacturer Capacity Surface Water >100' >100' N/A N/A Advantex/Anchorage Tank 1 500GaI i Material Number of compartments Lot Line >5' >10' N/A N/A Fiberglass Two NA Foundation >5' >10' N/A N/A LIFT STATION Manufacturer Capacity Curtain Drain None i Noted Orenco/Anchorage Tank 62.9'*Gal. Pump on level at Pump off level at H'gh water alarm at Remarks Existing Septic Tank Decommissioned in Accordance with Municipal Code. Existing Absorption 32 in. 22in 36in. Trench Abandoned in Place. Pump make and model Electrical Inspections performed by PVU26-2425-L Access Electric Tank to Installer PIPE MATERIAL House to tank D3034 drainfield D3034 G & R Excavation Draintield HDPE CO/MT D3034 Inspector A. Harala BENCH MARK (Assumed elevation) 100.0ft Inspection 1~ _ocation and descdption dates: 8/11/14 2~ 8/12/14 3r~ 8/13/14 4'" Garage Slab. Conditional Approval: Date ~¢37 ~"~J-'~' '~'¢~, ¢, Inspection Repod_1-1 Permit Number: OSP141316 Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 Page 2 of 3 PID NO.: 051-052-20 Lo~ 34 VACANT LAKE HILL ACRES NO. 1 LOTS 21 & 22 30,000 S,F. /" I / .~' I I~ I OD II/~~'~'lI L Iq T 8 8 / ~ ~ I~ Three Bedroom / / _at 36 / ® / Well _OT TH1 PLAN AS SCALE 1' = 40' A B C D S2 21.1' 20.3' PV 229' 17.9' M1 12,7 282 M2 11.3 37Z NOTE: / ~ Existing Septic Tank .~/ Decommissioned in / ~-~ Accordance with Municipal Code. Abandon Existing Absorption System in Place. t UILT Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 Elmore Road Anchorage, AK. 99519-6655 -343-7904 On-Site Wastewater Disposal System or Well Inspection Report Permit No.: OSP141316 Page 3 of 3 PID No. 051-052-20 962 Exisling Grade 107.0 Finished Grade Geote×tile Fabric Drain Field Rock ~---102.8 13' Bed Length 10 - 3/16" Holes @ 1' On Center Each Lateral 10' Bed Width 94.5 No Groundwater 8-12-14 PROFILE AS-BUILT Scale: NONE ACCESS ELECTRIC AND GENERAL TRADES PO BOX 670856 CHUGIAK AK 99567 The Advantex Treatment System suppffed by others at Lot 22, Lake Hill Acres No. ! * 24516 Grace Street in Chug[ak AK Wes wired in accordance with the Jatest electrical code. Certificat~n number, State of At( Specialty co~tractor # 39228. Owner ADMiNiSTRATOR DANIEL DELANEY 2014-032245-0 Recording Dist: 301 - Anchorage 8f1312014 02:37 PM Pages: 1 of 2 INGRESS AND EGRESS EASEMENT AND MAINTENANCE AGREEMENT *. ?lac 14o 64-90 Lot 21, Lake Hill Acres No. 1 Thll~um~Hg bcia§~0rcl~lby * Plat: No 64-90 A~ehorage Lot 22, Lake Hill Acres No. 1 Use of Lot 21, Lake H~II Acres No. 1 in its entirety. (Grantor) (Grantor) S(a~e of Al,aslm ) )ss. TIdrd Judicial District ) I certify that I know or have satisfactory evidence that Jam~s L Fowler and Velva I Fowle~ are thc persons Sig~ed before me this 13'~ day of Augu~ 2014. Notary Publ/e in and for the Slate of Alaska My Commission Expires: 2/29/16 Mr & Mm. Fowler 2402 Mount Pleasam Road Faye~e AL 35555 [ST.~TB OF ALASKA,~,~ ] eRecorded D~cument 2of2 2014-032245-0 NAME 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 PHONE __ /, [] NEW MAILING ADDRESS C~ LEGAL DESCRIPTION LOCATION L/-/~-~/-//c- c- Manufacturer Liq. capacity in gallons I / ~ .~--~/) ,~ HOMEMADE: D STANCE TO: Well Manufacturer DISTANCE TO: Well /~.)4~) / 1 No. of lines I Lenqth of~eac~ line Top of tile to finish grade ,~ Length Type of crib DISTANCE TO: Class Width Crib diameter Well Dept Building foundation OTHER DISTANCE TO: PIPE MATERIALS SOl L TEST RATI PIG /92 I NSTA L LER R EMAR KS o~ ~ Inside length Dwelling Fou ndation~ /_~ Total length ~¢~ ~ge~ Material beneath tile Depth Width~ T'~' ~ Material Nearestlotline ~-/ Trench width .~ o inches Z- inches NO. OF BEDROOMS ~:;¢_ PERMIT NO, No. of compartments Liquid depth PERMIT NO. Liquid capacity in gallons PERMIT NO. Distance between lines,~ Z,O / Total effective absorptio, gA9 area PERMIT NO. Crib depth I Total effective absorption area Building foundation Nearest lot line Driller Distance to lot line PERMIT NO. Sewer line Sept c tank Absorpt on area(s) ~. P P R O.,V'E D'~.,,'"'/ · DATE LEGAL 825 _ Street, Anchorage, AK. ~-9501 264-4720 Permi't ~ ~ HANDWRITTEN PERMIT ,~ Applicant: ,//io ~_ Mailing Addres MUNICIPALITY OF ANCHORAGE Department,'""f Health and Environmenta~-~Protection Location: Phone Number: Legal Description: %~/ '~2~~/~~' ~/ Lot Size: Type of Soil Absorption System Is: Trench: ~ Drainfield: ~'~ ,Seepage Bed: Holding Tank: ,_~ Maximum Number of Bedrooms: ~-- Soil Rating (sq. ft/br) /~/~/~ The Required Size of the Soil Absorption System ~" / / LENGTH WIDTH 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 ~g~a~el be,tween the outfa~l~pipe and the bottom of the excavation(in feet).~,.~ /~~ * * REQUIRED SEPTIC(HOLDING) YANgtZE =-~-~B'~'~ 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 conuaunity 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 8 B * * * 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) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if tha~ 3 bedrooms/. the residenc~ is remodeled to include more /^/,.~ AppliCant f ' '~ Date: SWP/024 (1/81) [] SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ~, PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SLOPE SITE PLAN i .. WAS ROUND WATER lqO t ENCOUNTERED? O P E IF YES, AT WHAT ~EPTH? 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Gross Net Depth to Net Reading Date Time Time Water Drop ~,, ~,, ~, ,. ~t :- :~,.~,..,; E t: }.t,,~ ' :,,-,. :~ :>.::~ I ?/_ tf PERCOLATION RATE (minutes/inch) / TEST RUN BETWEEN FT AND FT.-/ 19. 20 COMMENTS PERFORMED BY: MUNICIPALITY OF ANCHORAGE Development Services Department� Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 051-052 i oR 1. GENERAL INFORMATION Expiration Date: JI-,P_y'-Z02,U Complete legal description Lake Hill Acres #1 L22 Location (site address) 24516 Grace St. Chugiak, AK 99567 Current property owner(s) Marth & David Lemaire Day phone 259-3437 Mailing address Real estate agent 24516 Grace St. Chugiak, AK 99567 Michelle Lemaire 2. TYPE OF DWELLING: x❑ Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 Day phone 259-2323 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Fx_1 Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $� Waiver Fee $ Date of Payment 2-1 2 _2 020 Date of Payment Receipt Number O8 2- gy 2 Receipt Number COSA # 0 S C 2 0 1 q,3 b 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 Eklutna Engineering, LLC. Phone 355-9820 Address 19162 Mountain Rd. Chugiak, AK 99567 Engineer's Printed Name Curtis Townsend Date 8/11/2020 6. DSD SIGNATURE System #1 Approved forL bedrooms System #2 Approved for Disapproved Conditional approval for bedrooms TH ....... t ��o 'd FC/s,F Date /I No. CE 11 OPROFESS10�t�.@ bedrooms, with the following stipulations: v� Original Certificate Date: 2`7 —Z 02—d 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 blue sheet Legal Description: Lake Hill Acres #1 L22 If more than 1 septic system on lot: COSA Checklist # 1 of 1 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 1971 Total depth 225 ft Cased to UNK ft ❑ Sanitary seal is functioning correctly 01 Wires are properly protected Casing height (above ground) 18 in. Date of flow test for COSA 7/271202C Static water level at beginning of test 181.3 ft. Comments B. TANK DATA Age of tank(s) 6 years Tank type/material Fiberglass Measured operating fluid level in septic tank 41" ❑ Standpipes/foundation cleanout per record drawing Date of pumping See Advantex report D. ABSORPTION FIELD DATA Which system tested (date installed) 8"2/ 1 4 ❑ ALL standpipes present per record drawing Total measured depth from grade 4.8 ft (max) Measured depth to pipe invert from grade 4.3 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced 195 gallons Comm ents/Deficiencies: COSA Checklist yellow sheet Parcel ID: _ Structure served by this system I 051-052-20 Well production at time of test 5.3 gpm Water storage tank volume n/a gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate <MRL mg/L ❑ Nitrate less than MRL (ND) Arsenic 1.470 ug/L ❑ Arsenic less than MRL (ND) Collected by Brandon L. Jones Date of Sample 712 712 0 2 0 C. LIFT STATION ❑ Required maintenance completed Age of lift station 6 years Lift station material F'h`gfa Comments: Adequacy test date 111121 Results Q✓ Pass For 4 bedrooms Fluid depth prior to test 0 in Water added 796.1 gal New depth 5 in Elapsed time 180 min Final fluid depth 0 in Absorption rate 796.1 gpd Any rejuvenation treatment (past 12 months) no If yes, enter date 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' 0 Yes Community Sewer Manhole/Cleanout > 100' Q Yes if No ft Q Yes if No ft Neighboring Tank > 100' El Yes if No ft Private Sewer/Septic Line > 25' F� Yes if No ft Absorption Field on Lot > 100' EZI Yes if No ft Holding Tank > 100' Q Yes if No ft Neighboring Absorption Fields > 100' F./� Yes if No ft Water Main > 10' Animal Containment > 50' R1 Yes if No ft M Yes if No ft E] Yes if No ft Water Service Line > 10' 7 Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway Community Sewer Main > 75' ❑✓ Yes if No ft M Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No ft Surface Water > 100' F Yes if No ft Property Line > 5' ❑✓ Yes if No ft Wells on Adjacent Lots: 0 Absorption Field > 5' 2 Yes if No ft Private Wells > 100' F./� Yes if No ft Water Main > 10' 0 Yes if No ft Community Wells > 200' E] Yes if No ft Water Service Line > 10' 7 Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' Yes if No ft If absorption field is under driveway comment below Property Line > 10' Yes if No ft Wells on Adjacent Lots: Water Main > 10' 0 Yes if No ft Private Wells > 100' Q✓ Yes if No ft Water Service Line > 10' ❑✓ Yes if No ft Community Wells > 200' []✓ Yes if No ft Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION l certify that l 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. _ COSA Checklist yellow sheet h 8401'0' Lot 34 3 /Gat o '• , ! 16000 LOT 22 15 Q) 61 �o >\ ; ti, h�fh fOryF 0 20n ` Well 6 9hfbe tiOa \ N6� 2 0 Oy a 27 / She _ / O / LOT 21 •00 Lot 36 / MO / Chain link fence (typ) - O� 1166 0 o' �- 3001, �, Lot 20 760.00 26 /Revised 7-30-20 Corrected fence location / RECERTIFIED 7-22-20 `" s AS -BUILT NO CORNERS SET THIS DATE OF . /a� I hereby certify that I have performed a Mortgagee's inspection P�, • ;QS �� in accordance with ASPLS Standards of the following A► A , • described property:_ LOTS 21 & 22. BLOCK 1, %,— 49 th ' ® LAKE HILL ACRES SUBDIVISION, ADDITION No. 1 Anchorage Recording Precinct, Alaska, and that the /• / improvements situated thereon are within the property lines . and do not overlap or encroach on the property lying . Elizabeth L. Walatka . ,� oo adjacent thereto, that no improvements on the property lying • • �� ® adjacent thereto encroach on the premises in question and 8036 — LS j FpF • , • • gJ ® that there are no roadways, transmission lines or other ��a o ARo • ... • '��o o visible easements on said property except as indicated SCALE: 1 = 40 ! FESSIONA� ,�'® hereon. Dated at Anchorage, Alaska EASEMENTS OF RECORD, OTHER THAN 7. -t�sd this 28th day of JULY 2014. THOSE SHOWN ON THE RECORDED FB 20-3, pg 52-53 FRED WALATKA & ASSOCIATES, L.L.C. PLAT ARE NOT SHOWN HEREON. Recert 8-14-14 Engineers and Surveyors UNLESS OTHERWISE NOTED FB 14-6, pg 63-64 BE 907-248-1666 This drawing is a representation of conditions found at the time the mortgage location survey was performed. This document does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may disclose. The information contained on this drawing shall not be used to establish any fence. structure or other improvements. This drawing shall only be used for a single property transaction. Use of this drawing by the original client or by others at a later date without the consent of Elizabeth L. Walatka Is a violation of Federal Copyright law. Unless gross negligence is discovered, the liability extent of the preparer is limited to the amount of fees collected for services in preparation of this product. 08105!2020 08:20 Anchorage Tank, (FAX)907 277 3715 P.0011001 �dvanTexr` Field Maintenance Report AnchorageTank Annual Inspection 907-272-3543 --------------------------------------------------------- - ------------------ - ----- - --- ---------- Dave Lemaire Larry Betts ------------------------------------------------------------ ------------------------------------------------ 24516 Grace Street, Chugiak AK 99567 (907) 555-5555 FCFUI 2'900!4 /29f201 a Retrieve G&M Inrc., Dai(y fkn F v - I fcc;irc —Wo Tiolor sol:ini:p;t This is a COSA Inspection Plesae do ASAP Perform Field Sarriplinqfabservatioris f�7l_l (15 = NITUS, (2-6) inspect Clean -Odor: Normal Pungent Odor of SOMP!e ---------- I ------- typical rV., I s ty Eariilv 7--?Jl.nldy nor. -typical Suffirin cnbh2pe Deray 0i4y flim in FVL1 Y!!� N,: E03n: ill ta-th Check Control Panel Inspect/Clean. Discharge Ourrip System RecircAuiips Nnps Audible an,,! visual alarnif, 7-1 CK Dia! tore (!&lemolry nri!y) Floats Inspect/Clean Purrip System Inspect Clean Riser/Uc; ..................... i./ Splice eox .................... ,Z, Float Cords ................... Floats ................ Inspect/Service Other System Corriparients pulilp ........................ J, iwut;c� F,Iterlter, In_aeci Clear, 8iotube Pump Vali! .......... 2 RecirciAiltinq SpliltcrValve...... Comments —51Y-S�-�11-1-1—�—, Signature Biu lam Scum ------------------------------ ---------------------- ------------------------------------- PrLvious Current Previous 2rd Compart rnerjt Current PrC,,ioL-s Curient IPreaious --- - --------- i ------------------ ------------------ ----------- — ----- AevanTex Filter Date Completed corrin to 1-866-384-7404 inspect Clean -Odor: Normal Pungent LateralsJC.,;fices gionlan Konormal'xc'ss�v' ' I ' Pod eo�llonl BridgingiPonding: None!Minor Excecsi Intake vent Inspect/Clean. Discharge Ourrip System Inspect Clean Floats S p 1 i c 0 3 o.g Pump if Final corric. Jf Inspect/Service Other System Corriparients In_aeci Clear, Insaect Clean Disinfectier, Equipment /J Dispersal Laterals/06fices'!;--11 Obsorv-aft. is Addit;orlal Services Rendered 1--i CiaOrleri textile sheets? I Replaced UV items- Rcllplaced,'Uscd other iterns" Parts Used: W =lWarranty, a = qi;lcj)je (V' appropriate selection) All" E Iterr. Number Description Finil Safeb I y Inspection Vi RSV r2;.qzta!l."d EAds balled :,A 7 rvlar-ifok; reconnet:ted; !lush naives closed Vcontrol panel reactivated SUMMarylReco'Mmenciations Syslern perforwing; no further action neede,,j L-- –lank neecs punipifig .-j Cali for sen,k:e i other? Date Completed corrin to 1-866-384-7404 MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this Day of of 20 7-6 , by and between Harrison C. McKenney , herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as Advantex treatment system located at (legal description) Lake Hill Acres #1 L21 & 22 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) Lrtk Throughout the term of this Agreement, the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. rev. 0511 201 age 1 of 3 #N Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. JI -4 Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of title, and shall continue while the AWWTS is operational or until title is transferred. 4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of 3 OWNER: By: ��'%G� (signature) jLcr; Sar\ fMG 1Cenne!j (print name) Date:?-IZU /,7 0 z (3 STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) The fQregoin ins mens was ac oWLedged before me this eday of 20, by V c NOTARY PUBLIC FOR AL SKA My Commission expires: b c ct) MUNICIPALITY: (signature) (print name) f Date: Title: (rev. 05/18/2018) Page 3 of 3 Municipality of Anchorage On-Site Water and Wastewater Program (@07) 343-7004 Certificate of On-Site Systems Approval Parcel I.D. 051-052-20 Expiration Date: //-/.¢-/¥ 1. GENERAL INFORMATION Complete legal description Lake Hill Acres #1, Lot 22 Location (site address) 24516 Grace Street Chugiak, AK 99567 Current Property owner(s) James and Velva Fowler Day phone Mailing address P.O. BOX 670354 Chugiak, AK 99567 Real Estate Agent Day phone 2. TYPE OF DWELLING: [] Single Family (w/we ADU) [] Duplex [] Multiple Dwellings (Single Family and/or Duplex) 3, NUMBER OF BEDROOMS: Four AUG 1 5 2014 TYPE OF WATER SUPPLY: Individual Well [] individual Water Storage [] Community Class __ Well [] Public Water System [] TYPE OF WASTEWATER DISPQSAL: Individua Holding Tank [] Community [] Public Sewer WaiverNariance request for: Received by: '-~~ ~ ~ COSA to be released to the engineer, unless otherwise requested by the engineer COSAFee $ .2t~.~) fi-I~t, lo: Date of Payment ~/I ~'lJ~ Receipt Number (~ ~[c.{ ~ Date: Waiver Fee $ Date of Payment Receipt Number Waiver # Distance: 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 flies 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. Andepson, P.E. Date 8/14/14 6. DSD SIGNATURE ~ System #1 Approved for System #2 Approved for __ Disapproved Conditional approval for ........ bedrooms ~,.~'~". 6E-438'1 .,.~. ,,,~ bedrooms '.. ........ ,, bedrooms, with the following stipulationS!I~ By: E/~J~~ ~'~/./ ~¢~¢~"~Original Certificate Date: ~-/~ ¢/¢ The *~cip,~/e Development So.ices Divisio~ (DSD),ss.es Cedifi*ates of Op-S,te Systems Approval (COSA)based o~,y upon the represCntatio~ given in paragraph 5 by an independent professional civil engineer registered in the State of A~aska. The Municipality of Anchorage is not responsible fo~ errors or omissions ir the professiona~ engineer's work. ATTACHI~ENTS: COSA Checklist S~ptic System Advisory Well Flow Advisory X Nitrate Advisory Arsenic Advisory Other 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 #1, Lot 22 A. WELL DATA Well type Private Date completed 1983 Total depth UK ft. IfA, B, or C provide PWSID # Sanitary seal (Y/N) Y Cased to >40 ft. FROM WELL LOG Date of test Unknown Static water level Unknown ft. Well production Unknown g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate ND mg/L Arsenic ND ug/L Date of sample: 8/12/14 Parcel ID: 051-052-20 Well Log (Y/N) Wires propedy protected (Y/N) Casing height (above ground) AT INSPECTION 7/23/14 47.9 ft. 2.5 g.p.m. N Collected by: Anderson Engrg. Y >18 B. SEPTIC/HOLDING TANK DATA Tank Type/Material Advantex/Fiberglass Tank size 1,500 gal. Number of Compartments 2 Foundation cleanout (Y/N) Y Depression over tank (Y/N) __ Date of pumping New Const. Pumper N Date installed 8/11/14 Cleanouts (Y/N) Y High water alarm (Y/N) Y C. ABSORPTION FIELD DATA Date installed 8/12/14 Length 13 Total depth 4-5 ff. Date of adequacy test Fluid depth in absorption field before test __ in. Elapsed Time: min. Final fluid depth __ Any rejuvenation treatment (past 12 mo.) (Y/N & type) Soil rating (g.p.d./ft2 or ft2/bdrm) 5 GPD/SF ft. Width 10 ft. Eft. absorption area 130 r¢ Monitoring tube__ New Const. Results (Pass/Fail) __ Water added in. N System type Bed Gravel below pipe .5 ft. Y Depression overfield N For bedrooms gal. New depth__ in. Absorption rate >= .g,p-d- If yes, give date D. LIFT STATION No Add On Manhole - Gravity Flow to Absorption Trench. Date installed ~ - il- / ~ Size in gallons ~, Z. ~ Manhole/Access (Y/N). Y "Pump on" level at .~Z... in. "Pump off' level at ~-. ~ in. High water alarm level at .~ ~ Datum ~'O~-I"ON~ IA~lL.Cyclestested /~Gt,,J ~-O~$T. Meets alarm & circuit requirements? in. E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot > 100' On adjacent lots > 100' >100' On adjacent lots >100' Public sewer main N/A Sewer/septic service line >25' Animal containment areas >50' SEPTIC/HOLDING TANK ON LOT TO: Public sewer manhole/cleanout N/A Holding tank N/A Manure/animal excrete storage areas > 100' Building foundation >5' Water main > 1 0' Wells on adjacent lots > 100' ABSORPTION FIELD ON LOT TO: Property line > 10' Water Service line >10' Curtain drain None Noted Property line >5' Water service line >10' Absorption field >5' Sudace water > 100' Building foundation :> 10' Water main Surface water >100' Wells on adjacent lots >100' N/A Driveway, parking/vehicle storage > 10' F. COMMENTS 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 8/14/14 COSA brown sheet_l 0-10-12.doc 8401'0' Lot 34 / / / Lot 36 I I I ;hain link fence (b/p) LOT 21 / SCALE: 1"= 40' 4- EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT ARE NOT SHOWN HEREON, FB 14-8, pg 63,84 LOT 22 / / AS-BUILT NO CORNERS SET THIS DATE [ hereby certify thai I have performed a Mortgagee's inspection of the following described property: 1, LAKE HfLLACRES SUBDIVISION, ADDITION Ng, I BE Anchorage Recording District, Alaska, and that the improvements situated thereon are within the propert~ lines and do not overlap or encroach on the properly lying adjacent thereto, that no improvements on the properly lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission lines or olher visible easements on said property except as indicated hereon. Dated at Anchorage, Alaska this ~l~'~h ,day of JUlY ,2014. FRED WALATKA & ASSOCIATES Engineers and Surveyors (907-248-1666) ' APPLIC'-]T FILLS OUT UPPER HALl ' ONLY Buyer .~ . Address , Zip Code Address Zip Code ' Really 0o. & A~nt ~ - C ~ ', .... Address Zip Code I T~pe of Resi~n~e -~Sin~le Family ~ 'Multiple Family No. of Bedroo~ ~ Other Water Supply ~ Individual A~ACH WELL LOG. A w~l Icg is required for all wells drilled since June 1975. -U' Community For wells drilled prior to that date give well d~plh (attach Icg if available). S~r Disposal '~ Public Utility When Connected to Public Utility: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSlNG CAN BE INITIATED. Time Time Time Time Date Date Date ~D.a.~. Inspector Inspector Inspector Inspector Field Notes: --/ ^ " ~' ~ . MUNICIPALITY OF ANCHORAGE ( ) APPROVED BEDROOMS *(~ONDITIONS OF APPROVAL (/} CONDITIONAL APPROVAL* Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received r~ Well to Tank Septic Tank Size EXCAVATION ROBERTA. SHAFER WORK CIVIL ENGINEER 694-2979 May 21, 1983 Mrs. Fowler Peters creek Dear Mrs. Fowler, A sewer system adequacy test was performed on the system located on the referenced property, as you requested. The septic tank was pumped and verified to have a capacity of 1000 gallons. The seepage pit was full of water and approximately 1000 gallons had to be removed. The crib was then recharged with 1000 gallons of fresh water and after a period of 24 hours all the water which had been added to the crib remained in the crib. It can be concluded from this test that the septic tank is only adequate for a ~hree bedroom residence. An additional 500 gallon septic tank Will have to be installed for it to be considered adequate for four bedrooms. The seepage pit does not appear to be functioning at all. It will be necessary to have the absorption area upgraded in order for it to be considered adequate for the four bedroom residence located on this property. ~ A soil test was performed, per your request and a permit will be obtained for the upgrading of your system. If we may be of further service, please do not hesitate to contact // s/ss cc: Municipality of Anchorage Department of Health and Environmental Protection SRB 196X EAGLE RIVER, ALASKA DATE SIGNED Redi?,rm ® SI~ND PAR?S I AND 3 WITH CARBON INTACT - 4S 469 PART 3 WILL BE RETURNED WITH REPLY