HomeMy WebLinkAboutLAKE RIDGE TERRACE BLK 6 LT 3Lake Ridge
Terrace
Block 6
Lot 3
#051-313-25
Municipality of Anchorage
Community Development Department Page 1 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: OSP151047 PID Number: 051-313-25 ❑ New ❑� Upgrade
Name:
ABSORPTION FIELD
Larry and Ann Barr
❑ Deep Trench ❑ Shallow Trench ❑ Bed ❑✓ Mound
Address
305 Paul Sawyier Drive Frankfurt, KY 40601
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
4
2.0GPD/SF
+3.0 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
+3,5 Ft.
Gravel depth beneath pipe
.5 Ft.
Subdivision Block Lot
Lake Ridge Terrace 6 3
Fill added above original grade
6-7 Ft.
Gravel length
20 Ft.
Township Range Section
Gravel width
15Ft.
Beds: Number of Lines
3
Distance between lines
5Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Lift Station
Tank
Line
300 Ftp
I
Ft.
Well
>100'
>100'
N/A
N/A
>25'
TANK El Septic ❑ S.T.E.P. ❑ Holding ❑ other
Manufacturer
Advantex/Anchorage Tank/Orenco
Capacity
1,50OGal.
Surface Water
>100'
>100'
N/A
N/A
Material
Steel
Number of compartments
Two
Lot Line
>5'
>10'
N/A
N/A
NA
Foundation
>5'
>10'
N/A
N/A
LIFT STATION
Manufacturer
Anchorage Tank/Orenco
Capacity
500 Gal.
Curtain Drain
None
Noted
Pump on level at
Pump off level at
High water alarm at
Remarks Existing Septic Tanks and Absorption Bed
28 in.
22 in.
30 in.
Decommissioned in Accordance with Municipal Code.
Pump make and model
OSI P2005-11
Electrical Inspections performed by
Northwire Electric
PIPE MATERIAL Housetotank D3034 Tankto
drainfield D3034
Installer
JRs Pumping
Drainfeld F810 Co/MT D3034
Inspector Stuart Gilbert
BENCHMARK (Assumed elevation) 100.Oft
Inspectionsi
4/13/15 4/13/15
Location and description
dates: 2N
Lowest Concrete Step Back Deck.
3'° 4/15/16 4" 4/16/16
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL
Eq °p
®®nA*
OF • A 4g 4o
S�0o0
Conditional Approval: Date��P'
/?
89TH v, t and
. Jl. CE -4381
DOf9F.rr-�o-iL,.��o
n_r /f
®�i00®
Approveywt(=�C�—� Date ��� �'
®aae�o®o
Inspection Report_1-1-12.doc
Permit Number: OSP151047
51 60.1'45.9'
MH 1 58.7'46.9'
MH252.4'40.7'
M1 58.7'46.9'
M2 46.1'42.1'
M3 50.8'41.8'
M4 54.4'48.9'
C2 59.8'42.4'
Municipality of Anchorage
DEVEOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK. 99519-6655 — 343-7904
LAKE RIDGE TERRACE
LOT 3, BLOCK 6
31,000 S.F.
I
I
I
! LOT 2
u
J
Four Bedroom I I.
Home
LEGEND >
51 - Septic Vent
1no
_ I r
r
Z
MH - Man Hole
o
f
49thin
.�.�.....
LOT 4
I
CO - Clean Out
n;'MICHAEL E. .
ANDERSON .;
No. CE -4381
I
PLAN AS
j+'I
M1 - Monitor Tube
I
FCO - Foundation Clean Out
TH - Test Hole
WELL
��?ROFESSI��i��
SCALE 1'
= 40'
LS - Lift Station
II
SHED
8'x8'
� 10' DRAINAGE EASEMENT
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1
Page 2 of 3
PID No. 051-313-25
Existing Septic Tanks and
49thin
.�.�.....
LOT 4
I
Absorption Bed Decommissioned
Accordance with Municipal
code.
n;'MICHAEL E. .
ANDERSON .;
No. CE -4381
I
PLAN AS
BUILT
s�'•.
�a
���:ff,`•'' t -tib -i �,.. 'k �i�
♦4
i
��?ROFESSI��i��
SCALE 1'
= 40'
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1
Page 2 of 3
PID No. 051-313-25
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 Number: OSP151047
DI �pP iS �w'iP�d'
Fap &SJl d 0. 14iS
5
2.5'
101.7
N Grimed S
Ground Z
1,500 Gallon 500
Gal.
Advantex Tank Lift
4 37 Sta.
H
104.5
1/85.6'
Groundwater @ 95.6'
4/7/15
5' 5' 2.5'
Page 3 of 3
PID No. 051-313-25
Organic Layer
NOTE: 10 - 3/16" Diameter Holes per Lateral @ 1.5' Spacing.
Absorption Bed constructed with Engineered Receiving Soils (E.R.S.). All work accomplished in accordance with
Proposed AMC15.65.201 D3c.
PROFILE AS -BUILT
No Scale
am
.�/ ...L57v1
3 49th *
AEL E. ANDERSON
No. CE -4381
On -Site Wastewater Disposal System Permit
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
Permit Number: OSP151047
Tax Code Number: 05131325000
Work Type: Septic Upgrade
Permit Effective Dates: April 09, 2015 to April 08, 2016
Design Engineer: ANDERSON ENGINEERING
Subdivision: LAKE RIDGE TERRACE
Site Legal Address: LAKE RIDGE TERRACE BILK 6 LT 3 G:0653
Owner/Address: BARR LARRY J & ANN W
305 PAUL SAWYIER DR FRANKFORT KY 406012952
Site Mailing Address: 15044 TERRACE LN, Eagle River
This permit is for the construction of:
Lot Size in Sq Ft: 31000
Total Bedrooms: 4
Y Disposal Field N Septic Tank N Holding Tank N Privy N Private Well N Water Storage
All construction must 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 must notify the Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received B
Issued By:
y:J�r'r(1Date: ! /
Date: S
Municipality of Anchorage
Ment S
�p 1
v
a y
epartmenx
Development Services Division
On -Site Water and Wastewater Program
*** VARIANCE/WAIVER REVIEW ****
Waiver#: OSPIS1028 COSA#:OSC161046 Permit#:OSP161047
PID#: 051-313-25
Legal Description: Lake Ridge Terrace. Block 6. Lot 3
Engineer: Anderson Engineering
Applicant: Larry & Ann Barr
Your request for a waiver to use Engineered Receiving Soil (ERS) in accordance with proposed
code AMC 15.65.201D3c is approved with the following condition.
1. Inspections shall be performed in accordance with proposed code AMC 15.65.113B.
This waiver approval applies to the proposed drainfield only. Any future upgrade to the on-site
wastewater disposal system will require all separation distances be met or another approval from
this department.
The affected adjacent property owner(s) have been given a 7 day notice regarding this
waiver.
Notarized letter(s) of non -objection have been received from the owner(s) of the affected
adjacent property:
0 Adjacent properties are not affected by this waiver.
..:........:....................................................°._..:.......A.....1
Waiver is Granted: X Waiver is not Granted:
Dater Approved by:
ame of Reviewer
-
own ......... ................. ......a.r........ ................ ...... ....r......e
MUNICIPALITY OF ANCHORAGE
Community Development Department Phone: 907-343-7904
Development Services Division Fax: 907-343-7997
On-Site Water & Wastewater Program
ON-SITE SEWER/WELL PERMIT APPLICATION kL
Parcel LD.
051-313-25
Property owner(s) Larry & Ann Barr
Mailing address 305 Paul Sawyier Drive Frankfort, KY 40601
Site address 15044 Terrace Lane Eagle River, AK 99557
Day phone
Legal description (Sub'd., Block & Lot) Lake Ridge Terrace, Block 6, Lot 3
Legal description (Township, Range & Section)
Lot Size 31,000 Sq. Ft. Number of Bedrooms Four
APPLICATION IS FOR: APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field ❑X Initial ❑
Single Family (SF) ❑X
(w/wo ADU)
Septic Tank ❑ Upgrade ❑X
Duplex (D) ❑
Holding Tank ❑ Renewal ❑
Multiple Dwellings ❑
Privy ❑
(SF and/or D)
Private Well ❑
Water Storage ❑
THIS APPLICATION INCLUDES A VARIANCE /WAIVER REQUEST FOR:
C R S Dis tance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
CE Q'J'
(Signature of property owner or authorized agent)
Permit/Rush Fees: i5w. 60
Date of Payment: a
Receipt Number: 0117(t
Permit No. 65Pit 5
Permit App_> :- ::...:c.
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No. W! ,>L.)CKO44�
W i
CO -0 oscv;7105s
-Y�* Or z
rand nDwr EJQS.
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 FAX
April 7, 2015
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 3, Block 6, Lake Ridge Terrace Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer
The existing absorption bed system on Lot 3, Block 6, Lake Ridge Terrace Subdivision
encroaches into the utility easement and possibly onto the neighboring property. The
adjacent property owners are unwilling to allow a permanent easement on their property
for the absorption bed. We are therefore requesting a permit be issued for the
relocation of the absorption bed to a new location on the lot. The attached Site Plan
and backup documentation identify the location and configuration of the proposed
absorption bed along with the existing system. No existing wells are closer than 100'
from the proposed absorption bed. Drainage arrows are shown on the site plan
showing the grade and direction of flow on the lot. The drainage pattern will not be
changed as a result of this project.
The new absorption bed will be constructed with Engineered Receiving Soils (E.R.S.) in
accordance with proposed AMC 15.65.201.D3c and an Advantex Treatment System
with an AX -20 Filter Pod. The bed will be elevated to 3' above ground with clean
coarse sand. A total of 4' of sand will be required to replace the 1' of organic material
at the existing ground level. The existing bed has been in service since 1981 and has
functioned well to the current day. The water from the bed has been flowing to the
water table and out of the area. We expect the new bed to act in the same manner.
We are proposing to construct a new 20' long by 15' wide by .5' effective depth
absorption bed to treat and dispose of the effluent generated in the house. The
elevation of the distribution line in the absorption bed will be a minimum of 3' above the
surface. The existing organic material will be removed and replaced with coarse sand.
A minimum of 3' of fill or 2" of insulation and 2' of fill will be placed over the absorption
bed. A lift station vault will be placed to transport the effluent to the new absorption
Lot 3, Block 6, Lake Ridge Terrace Subdivision
April 7, 2015
Page Two
bed.
The ground surface on the lot in the area of the absorption bed is flat. The new bed will
be constructed parallel with the contours of the slope as much as possible in
conformance with Municipal requirements. The new septic system will be constructed a
minimum of 100' from all wells and any surface water and 10' from the proposed and
existing water services in the area.
If the system is constructed in accordance with our design the following statements
apply:
The system, if constructed as designed, will have no adverse impact on the wells
in the area or those to be constructed in the future.
2. The system, if constructed as designed, will have no adverse impact on existing
septic systems in the area or those to be constructed in the future.
3. The system, if constructed as designed, will have no adverse impact on reserve
space, either surface or subsurface, on any lots located in the area.
4. The system, if constructed as designed, will have no adverse impact on drainage
patterns in the area. The current drainage pattern will be maintained.
Sincerely,
Michael E. Anderson, P.E.
Attachments
ANDERSON ENGINEERING
P.O.. BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 (FAX)
April 9, 2015
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 3, Block 6, Lake Ridge Terrace Subdivision
New Absorption Bed Constructed with Engineered Receiving Soils
Dear Onsite Services Engineer:
The subsurface soil characteristics on the subject lot will not allow for the design or
construction of an absorption system that meets all of the requirements of current
Municipal Code. We are therefore requesting the use of Engineered Receiving Soils
(E.R.S.) in accordance with proposed AMC 15.65.201.D3c. The existing absorption
bed on the lot has been in use since 1981 and is still functioning as designed.
Unfortunately it was constructed with groundwater found at 1' below the surface. We
are proposing a similar design, but with an Advantex Treatment System and E.R.S. in
conformance with proposed Municipal Code. We hereby request your approval of the
waiver allowing the use of E.R.S.
Sincerely,
Michael E. Anderson. P.E.
MICHAEL E. ANDERSON
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LOT 3, BLOCK 6, LAKE RIDGE TERRACE SUBDIVISION
DESIGN FACTORS:
Four Bedroom Home
Perc. Rate: 40 Min./Inch
Application Rate: 2 GPD/SF
4 Bedrooms X 150 GPD/BDRM = 600 GPD
600 GPD/2 GPD/SF/15 LF (Width) = 20 LF Bed Length
SYSTEM REQUIREMENTS:
Raised Bed System
Advantex Treatment Sytem
Add On Lift Station
Pressure Distribution System
3.0' Coarse Sand
THEREFORE: Construct a 20' Long x 15' Wide Raised Absorption Bed as Shown Below.
Remove Existing Organic Material and Replace with Coarse Sand. Level Bed Area with
Coarse Sand. Place Distribution Piping at 3.0 Above Original Ground Surface. Provide 2" of Insulation
and 2' of Cover Over Bed or 3' of Cover. Place Topsoil and Seed on Outer 6" of Mound.
r3
Topsoil and tate
Outer 6" of MoundMound
to Prevent Erosion
3'
Min
Remove Organics and In Situ 1 0
Material to 1' Below Grade. Min
Topsoil and Revegetate
Outer 6" of Mound
to Prevent Erosion
2" Insulation & 2' Cover (Min.)
2.5' 5.0' 5.0' 2.5'
3
—]1
1" PVC
10 - 3/16" Diameter
Holes per Lateral
NOTE: The Absorption Mound will be Constructed with Engineered Receiving Soils (E.R.S.).
A Pre Construction Meeting and Inspections are Required in Accordance with Proposed AMC
15.65.113B.
TYPICAL RAISED BED SECTION • �.F��aF••o,♦♦♦
NO SCALE • Q ••
( •
) •
NOTE: Grade Area Surrounding Bed to Drain Away. • �" '�
Minimum 6' Separation From Bedrock. 49th
;`
Minimum 4' Separation From Groundwater. ]} yj
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Minimum 150' Separation From Wells in the Area. •A :Mchl �r`r. ......
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;
Minimum 10' Separation From Water Service Line. 0 ias E. Anderson
!n% No. CE -4381
O O O
Drainfield Rock
2' (Min.) of Coarse Sand (See Specification)
J (Min.) Type IIA Classified Fill
2.5' 5.0' 5.0' 2.5'
3
—]1
1" PVC
10 - 3/16" Diameter
Holes per Lateral
NOTE: The Absorption Mound will be Constructed with Engineered Receiving Soils (E.R.S.).
A Pre Construction Meeting and Inspections are Required in Accordance with Proposed AMC
15.65.113B.
TYPICAL RAISED BED SECTION • �.F��aF••o,♦♦♦
NO SCALE • Q ••
( •
) •
NOTE: Grade Area Surrounding Bed to Drain Away. • �" '�
Minimum 6' Separation From Bedrock. 49th
;`
Minimum 4' Separation From Groundwater. ]} yj
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Minimum 150' Separation From Wells in the Area. •A :Mchl �r`r. ......
t.t
;
Minimum 10' Separation From Water Service Line. 0 ias E. Anderson
!n% No. CE -4381
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4700 BRAGAW STREET ANCHORAGE, AK 99519-6650
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION: LOT 3, BLOCK 6, LAKE RIDGE TERRACE SUB.
PERFORMED FOR: LARRY BARR
DATE: 3/21/2015 PROJECT No.:
PARCEL ID#: TECHNICIAN: LARRY BETTS
DEPTH TEST HOLE 1
(feet)
1
2
3
4
5
6
7
8
9
1Q
11
1
Xlwel l
d
al
° SILT W/SAND
SOME GRAVEL
ML
e
BOH @ 12'
SLOPE
WAS GROUND WATER ENCOUNTERED? YES
e 49th
E. ANDERSON
SI IF: PLAN
SEE SITE PLAN 8
2
IF YES rs. WHAT DEPTH?
DEPTH OF WATER AFTER MONITORING: 2' 2%
DATE OF MONITORING: 4/7/15 P
E
DATE
READING
GROSS TIME
(MINUTES)
NET TIME
(MINUTES)
DEPTH TO
WATER
(INCHES)
NET DROP
(INCHES)
TEST HOLE PRESOAKED PRIOR TO TESTING:
3/21
1
2:22
1.75"
2
2:52
30
2.50"
0.75"
3
2:53
1.63"
4
3:23
30
2.38"
0.75"
5
3:24
1.75"
6
3:54
30
2,50"
0.75"
PERCOLATION RATE: 40 (MIN/INCH) PERC. HOLE DIA. 6" (INCHES)
TEST RUN BETWEEN: 1.0 FT. and 2.0 FT.
COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST.
TEST PERFORMED BY ANDERSON ENGINEERING. I, MICHAEL E. ANDERSON CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE: 4/5/2015
MUNICIPALITY OF ANCHORAGE �'
SOILS LOG
DEPT. OF HEALTH &
ENVIAQIlIMENTAL P?OTECTION MUNICIPALITY OF ANCHORAGE
• !'Y r7 q ppEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION
U tj` 2 ! 39(dl TEST
825 L. Street, Anchorage, Alaska 99501 264-4720
/v SOILS LOG - PERCOLATION TEST
PERFORMED FOR: h 1'%y ji'mft} CC i �/C Lldna J DATE PERFORMED: 2;11t2�'l
LEGAL DESCRIPTION: 13
DEPTH dw� r C SLOPE SITE PLAN
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16.
17-
18-
19-
20-
PERFORMED
7-
18•19-
20-
PERFORMED BY:
�o_nnc rc rnm
s, i -A7 saw a
S
WASGROUND WATER s- L
ENCOUNTERED?
O
P
IF YES, AT WHAT}� E
DEPTH? a .
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
/
54YP-14
0
D
1,67
Z
/e
/0
6.1'
0,02
c
30
/®
/ 60
PERCOLATION RATE �V� lminutes/inch)
TEST RUN BETWEEN FT AND 0'3� FT r
1?3cf Xf 1ic. /6r+z7� l ` Ot✓
CERTIFIED
DocuSign Envelope ID: 05883B4E-B1a4A919-ABB0A1AF791D7502
MUNICIPALITY OF ANCHORAGE
o
Community Development Department Right of Way Section
Development Services Division Phone: 907-343-8240
Fax: 907-343-8250
Mayor Dan Sulllvan
February 4, 2015
Larry J & Ann W Barr
305 Paul Sawyier Drive
Frankfort, KY 40601-2952
RE: Encroachment. Raised Absorption Bed in Utility Easement
Lake Ridge Terrace Subdivision, Block 6, Lot 3, Grid NW0653, 15044 Terrace lane, Engle River, Alaska
The Right of Way Section has reviewed a request for a letter of non -objection to an existing 17' x 30' raised absorption
bed, which encroaches 8' x 30' into the 10 foot Utility Easement. On the Site Plan dated 2/3/15, submitted with the
request, the petitioner has shown the absorption bed.
This letter of non -objection is issued with stipulations, and by using it the petitioner is agreeing to the following
I. Municipality of Anchorage (MOA) will be held harmless, now and forever, for any damages or injury to any
person as a result of the encroachments.
2. All applicable codes and regulations will be observed and maintained within the casement.
3. This letter of non -objection will in no way preclude MOA from full use and enjoyment of its rights within any
portion of the easement.
4. Additional and extraordinary costs incurred during any future required construction, repair or reconstruction of
MOA improvements to accommodate any or all of the encroachments shall be paid by the property owner.
5. Maintain letters of non -objection from the following utilities:
N
Anchorage Water & Wastewater Utility
❑
Alaska Communications Systems
❑
Chugach Electric Association, Inc.
®
Matanuska Telephone Association
®
Matanuska Electric Association, Inc.
®
Enstar Natural Gas Company
❑
Municipal Light & Power
®
GCI Cable of Alaska
❑
Eyecom (Girdwood Cable TV)
❑
No letters required
All letters of non -objection should be retained in your permanent files. If you have any questions, please call Daune
Wyatt, Right of Way Plan Reviewer at 343-8240.
Sincere y, u3ipneE by:
/*y—Jack L. Frost, Jr.
Right of Way Supervisor �La, °tuft ° br/.
QKA& 17AW
Mailing Address: P.O. Box 196650 - Anchorage, Alaska 99519.6650 - http:l/www.muili.org
LOT 2
S 89.40'00•E 200.00'
❑ LOT 3
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31,000 S.F.
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ENCROACHMENT
AREA
X 30'DECK
A
ABSORPTION BED
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TWO-STORY
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29 ,
10' DRAINAGE EASEMENT
N 89.40'00'W 200.00'
PSE.. �.. qCq ���
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LOT 4
49th
0............................................R
P, ; MICHAEL E. ANDERSON
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NO. CE -4381
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SCALE V = 40'
MUNICIPALITY OF ANCHORAGE
® DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME
PH gN
V
NEW
MAILING ADDRESS
LEGAL DESCRIPTION
LOCATION
NO. OF BEDROOMS
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Inside length
Width
Liquid depth
0�=
DIS ANCETO:
Well
Dwelling
PERMIT NO.
Z
Z F
Manufacturer
Material
Liquid capacity in gallons
❑
Well
Foundation
Nearest lot line
PERMIT NO.
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DISTANCE T0:
- LL y
No. of lines
Length e ch
Total length of lines
Trench width
Distance between lines
H Z w
inches
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Top of tile to finish grade
Material beneath tile
Total effective absorption area
❑
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Width
Depth (
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pi el
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Crib diameter
Crib de`_
Total effective absorption area
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Well - ,,,�-
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Nearest lot line �� f
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Class
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Distance to lot line
PERMIT NO.
Lu
DISTANCE TO:
Building foundation
Sewer line
Septic tank
Absorption area(s)
OTHER
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PIPE MATERIALS
SOIL TEST RA NG01.
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REMARKS ? `
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APPRO D x:.ati -_ y4';b TE LEGAL ._. _ .
MUNICIPALITY OF ANCHORAGE-,
Department 7 Health and Environmenta ?rotection
825 L Street, Anchorage, AK. 'v9501
264-4720
HANDWRITTEN PERMIT # # #
WELL DOOR ON-SITE SEWER PERMIT
Applicant.Mailing
rtD�/vi Mailing Address :
Location: �4',`y 6, ),,Phone Number:
Legal Description: L'T'. `S /tel&(�
Size:
Type of Soil Absorption System Is:
Trench: Drainfield: _ Seepage Bed: Holding Tank:
Maximum Number of Bedrooms: Soil Rating(sq.ft/br) 81,5;
The Required Size of the Soil Absorption System Is:
DEPTH LENGTH /7 r . GRAVEL DEPTH (!:L /I WIDTH 36
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).
r 10 O
# # 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 3 1
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
the residence is remodeled to include more 7:2tbedrooms.
Signed:l Issued by:
Applica Z�l-t _
Date :
SWP/024(1/81)
4
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MUNICIPALITY OF ANCHORAGE - SOILS LOG
DEPT. OF HEALTH &
ENVIROMMENTAL RIOTECTION MUNICIPALITY OF ANCHORAGE
ae 7 '��II pEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION
UG 2 TEST
825 L. Street, Anchorage, Alaska 99501 264-4720
* CE I V E D SOILS LOG - PERCOLATION TEST
PERFORMED FOR: h a l -x) r-P—F �-F ��t �Ci t'�'-� DATE PERFORMED:
r
LEGAL DESCRIPTION: L 2 /—e
7 SLOPE SITE PLAN
DEPTH c" 2-, C
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
COMMENTS
PERFORMED BY: h,/CLA
70 -An. 1.19.1
WAS GROUND WATER S
ENCOUNTERED? '� S' L
O
P
IF YES, AT WHAT E
DEPTH?
I
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
d1,67
0,0z
3
z0
0,Q�
PERCOLATION RATE " / r2 (minutes/inch)
O
j TEST RUN BETWEEN FT AND �'FT Q��
A-) C�^
A- .
CERTIFIED BY:
DATE: oG Fid
GREATER ANCHORAGE AREA BORCOff—I�ATER ANCHORAGE AREA BORO"�H p
Depart<?:ent
of Environmental Qualit}'1Ifi
: 3500 TuQor Road -- Pouch 6.6 1V *T? 9O
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
MAILING -?3-i
NAME 1LA')r_'PTtCCZ 2C(i.CiikAfi1 ADDRESS 162C? 601111Q1_(1(__112'ec' .4 PHONE IV75
LOCATION- 'p P-1 O)Er LEGAL DESCRIPTION /Q)l 3E �- SCP ' �i(ffjH / liYilrt z USG.
SEPTIC TANK:
NUMBER OF
DISTANCE FROM WELL 613,1 IN- /'¢ MATERIAL 04 X1 ? -COMPARTMENTS
LIQUID
LIQUID CAPACITY /AC -n GALLONS. INSIDE LENGTH INSIDE WIDTH DEPTH
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITSOUTSIDE DIAMETER OR WIDTH jO / f � / LENGTH fK / DEPTH G /
LINING MATERIAL C!0)Cr%c=i0 DISTANCE FROM WELL 0Cr9�2- d [BUILDING FOUNDATION
NEAREST LOT LINE TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) / SQ. FT.
TILE DRAIN FIELD:
TOTAL LENGTH
DISTANCE FROM WELL FOUNDATION- NEAREST LOT LINE , OF LINES
NUMBER OF LINES DISTANCE BET�61EENNEI ES TRENCH WIDTH IN. TOTAL EFFECTIVE
ABSORPTION AREA
FT. LENGTH OF EACH LIN
DEPTH: TOP OFINTO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE
WELL:DISTANCE FROM WATER
P
TYPE rot- DEPTH BUILDING FOUNDATION. SAMPLE , NEAREST
NEAREST SEPTIC SEEPAGE OTHER ilC
LOT LINE , SEWER LINE , TANK SYSTEM , CESSPOOL 1061Lik/U0c=2 z
SOURCES
DIAGRAM OF SYSTEM
DISTANCES:
CICL CasT• r 2n,a
SL7iC T`c5i 2,504'
fir kj rcv�-n
tfN - 44 nk - (t
.3 I'J?cI.KC:Il� 1�c:llS.F�
lei h� EJ(i4�,
I tom-' Rq'kyl by
AALLHC,L, A&VXT'
DATE MatLt 26 1572 APPROVED LPILILAJ- /_7Ct j�7c2,t.ir'V
GREH rER ANCHORAGE AREA BOISOUGH
• DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO
" 3500 TUDOR ROAD POUCH 6-650
ANCHORAGE, ALASKA 99502
TELEPHONE 279-8686
SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT fiF
NAME OF APPLICANT Cow N*'CL 944' L' MAILING ADDRESS "�
INSTALLATION LOCATION
LEGAL DESCRIPTION
INSTALLATION OF: SEPTIC TANK P,
,
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH
SOIL TEST RESULTS
COMPLETION DATE A
2178
PHONE Jam• -
PIT DRAIN FIELD OTHER
a, n Ji`I i
TO BE INSTALLED
NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE _ TYPE
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
SEEPAGE AREA SIZE
r
FOUNDATION TO SEEPAGE PIT P DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT WALL /•'"
SEPTIC TANK. SEEPAGE PIT19L), DRAIN FIELD
TO NEAREST LOT LINE. 6--Z)
�
WELL TO SEPTIC TANK { SEEPAGE PIT
p r
DRAIN FIELD ALSO CONSIDER AREA WELLS.
r f
WATER MAIN TO SEPTI��AMK SEEPAGE PIT
DRAIN FIELD //J�
SEPTIC TANK, SEEPAGE PIT --L-=—, DRAIN FIELD.
TO RIVER, LAKE, STREAM.
CAST IRON INTO AND OUT_OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGE ULATIONS REGARDING INSTALLATION.
HEALTH AUTHORITY
OR
LICENSED DESIGNER
TYPE
DIAGRAM OF SYSTEM
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DESCRIBE STEM IS INACCORDANCE WITH SAID CODE.
DATE ��% •' APPLICANT'S SIGNATURE
CPG.a B vi
• Municipality of Anchorage
V
On -Site Water and Wastewater Program
(907) 343-7904 5 a E T Y
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 051-313-25
1. GENERAL INFORMATION
Expiration Date
Complete legal description Lake Ridge Terrace Block 6 Lot 3 _
Location (site address) 15044 Terrace Lane, Eagle River,._AK
Current Property owner(s) Kristen Coyne Day phone
Mailing address
Real Estate Agent
PO Box 711308 Eagle River, AK,_99577
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
Day phone
3. NUMBER OF BEDROOMS:
4
TYPE OF WASTEWATER DISPOSAL:
4. TYPE OF WATER SUPPLY:
Individual
Individual Well
0
Holding Tank
❑
Individual Water Storage
❑
Community
❑
Community Class _ Well
❑
Public Sewer
❑
Public Water System
❑
WaiverNariance request for:
Distance:
Received by: ______ Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ ,550 - Waiver Fee $
Date of Payment y Z 7 2 2 Date of Payment
Receipt Number 0 �I J 3 j G Receipt Number
COSA # __. 0,5-C-2-11 a ()' 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 ARCTERRA CONSULTING, INC. Phone 696-6111
Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577
f
Engineer's Printed Name KENNETH_M. DUFFUS _ ,. Date.
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,
ArcTerra can not give any estimate of how long a
system will function satisfactory for current or future
occupants or can ArcTerra guarantee that no unseen .�. ,� OF -%
�
encroachments, deficiencies or discrepancies exist
6. DSD SIGNATURE
* /19 z,Ii71
_.-P`\ KENNETH M. D FFA
System #2 Approved for bedrooms.
717.a41'J�`
Disapproved.�-
Conditional approval for bedrooms, with the following stipulations:
By: _ 1i m _F,-A/uriOriginal Certificate Date:_5/7 ____
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 blue sheet 10-10-12.doc
COSA Checklist
Legal Description: Lake Ridge Terrace Block 6 Lot 3 Parcel ID:
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 1972*
Total depth 125* ft
Cased to 88* ft
® Sanitary seal is functioning correctly
i Wires are properly protected
Casing height (above ground) 24 in.
Date of flow test for COSA 4/15/21
Static water level at beginning of test 111 ft
Comments *Information from 11/10/16 COSA
B. TANK DATA
Age of tank(s) 5 years
Tank type/material Septic/Steel
Measured operating fluid level in septic tank
❑■ Standpipes/foundation cleanout per record drawing
Date of pumping *Advantex
D. ABSORPTION FIELD DATA
Which system tested (date installed) 4/16/16
® ALL standpipes present per record drawing
Total measured depth from grade 7 ft (max)
Measured depth to pipe invert from grade 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 2000 gallons
Comments/Deficiencies:
COSA Checklist yellow sheet
(K 1-11 I -I C
Well production at time of test 4.0 gpm
Water storage tank volume gallons
Well disinfected for coliform test? E Yes ❑ No
® Coliform bacteria is Negative
Nitrate 3.22 mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L 0 Arsenic less than MRL (ND)
Collected by Arcterra Consulting
Date of Sample 4/15/21
C. LIFT STATION
Required maintenance completed
Age of lift station 5 years
Lift station material Steel
Comments: Advantex
Adequacy test date 4/15/21
Results V Pass For 4 bedrooms
Fluid depth prior to test 0 in
Water added 622 gal
New depth 3 in
Elapsed time 105 min
Final fluid depth 0 in
Absorption rate 600+ gpd
Any rejuvenation treatment (past 12 months)
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'
® Yes if No ft Wells on Adjacent Lots:
Water Main > 10'
Community Sewer Manhole/Cleanout > 100'
0 Yes
if No
ft
21 Yes
if No
Neighboring Tank > 100' ® Yes
if No
ft
Private Sewer/Septic Line > 25' R] 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
0 Yes
if No
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10' ® Yes if No ft Surface Water > 100'
Property Line > 5' ® Yes if No ft Wells on Adjacent Lots:
Absorption Field > 5' ® Yes if No ft Private Wells > 100'
ft
ft
ft
ft
ft
® Yes if No ft
Yes if No ft
Water Main > 10' 0 Yes if No ft Community Wells > 200' a Yes if No ft
Water Service Line > 10' ® 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' R] 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'
® Yes if No ft Private Wells > 100' 0 Yes if No
Water Service Line > 10'
® Yes if No ft Community Wells > 200' 0 Yes if No
Surface Water > 100'
® Yes if No ft
F. ENGINEER'S COMMENTS
G. ENGINEER'S CERTIFICATION
l 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.
COSA Checklist yellow sheet
ft
Ig
05/05/2021 15:55 8686770 APLUS PAGE 01
ads Room ■ moon■■ mama 411602
ateI� ■ ■ ■ ■■■ ■ ■ ■ ■ ■a ■■■■ 0
■
on ■■■ ■■■ ■ ■■■ ■ ■
�ar,tl7e;>c® Field Maintenance Report
Annual Insp action
I'mwivO w/fnvlrogx
Kris Coyne
acro emrlpM
15044 Terrace Lar Eagle River AK 99577
rix 8,e ID~� ID R
AX -136604 County OSP151047
Retrieve C&M Info
Dally flow
Reche ratio_
Timor settings:
Perform Field Sarnpl. Ig/Observations
NTU (15 x NTUe) pF (6-g) DO (2-6)
JD•7 7 7
Odor of Samplo
Typical 1r-' Musfy ❑ Earthy ❑ Moldy
Non -typical Sulfide ❑Cabbage ❑Decay
Oily film In Zu 0 ga �o
Foam In tank ❑ os 7No
Check Control Panel
Recirc Amps DIECherge AmpE
Audible and visual alamn K
Dial f►otrte gelemmry, only) Yes
Wr
Inspe cyCle�an P m S N
pem
Inspect Cloan
Riser/Lia ............. .......
Splice Box............
Float Cords .......... . ..::
Floats ................
Pump ................ .
Siotube Flker......... ..... .: rYi
Blotubet Pump Vault
RecimUlating Splitter Val. ..... , .
Comments
Signature
If ■ ■ ■ Id.
If ■■ ■
■■■ ■ If
AnchorageTank
907-272-3543
Inspect/Clean AdvanTex Filter
Om uror
Insrpye�ct
Odor,�Nomnal ❑Pungent LateralalOrifices K
6lomrreet
Larry Betts
k] Normal ❑ Excasalve Pod Bottom
I
7
C --Met Ph...
Np-/1
480-294-8536
POdi
420970
WU MAULM
osro of Lent lnopnntlon
Inspeot
RTU130167
01/05/2021
Measure Sludge/Scum
f
Pump
Float cords '
Sludge
scum
tat Compartment
Current PreYIDUE
%X
Cumpm Pmvious
2nd Compartment
Curmm Previous
Current Pmvious
Inspect/Clean AdvanTex Filter
Insrpye�ct
Odor,�Nomnal ❑Pungent LateralalOrifices K
6lomrreet
Clean
k] Normal ❑ Excasalve Pod Bottom
I
7
Bridging/ponding: NonelMlnor ❑ Excessive Intake Vent
Np-/1
Inspect/Clean Discharge Pump System
Inspect
RlsprlLld Floats
Inspeot
Clean
Splice Box
127'
f
Pump
Float cords '
Inspect/Samloe Other System Components
Inspoct Clean
Disinfection Equipment Dispersal Laterals/Orifice&tF
Inspect
Claan
Observations
Additional Services Rendered
❑ Clowned textile sheet,? ❑ Replaced UV items?
❑ Replacod/Used other Soma?
Parts Used: W - Warranty, B 1 Billable (✓ approprlate soiection)
W S Item Number n -...-e....--
rmarisafety Inspection
RSV reinstalled kis bolted on
Manifold reconnected; flush valvas closed Acomrel Parisi reactivated
Summary/Recommendations
❑ System performing; no further action needed ❑ Tank nods pumping
❑ Call for service ❑ OtheR
® Date
Fax completed form to 1-866-584-7404
THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and
entered into as of this t Day of Px',4=�- of 20 , by and between
i
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:
I. Advanced Wastewater Treatment Systems. The Municipality grants permission to the
Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS),
described as Advantex AX
located at (legal description)
Lake Ridge Terrace Block 6 Lot 3, 15044 Terrace bane, Eagle River
2. Maintenance, Repairs and Alterations.
(Owner is required to read, understand and initial each section)
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).
,�t- 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. 05/18/2018) Page i of 3
i�
} Owner acknowledges that the Municipality may request records of maintenance and
repairs from the manufacturer's representative or maintenance provider.
;y Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be
assessed in accordance with AMC 14.60.030.
n_ Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS. The Municipality will give at least 24-hour notice.
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
..,...{signature) Date:
(print name)
STATE OF ALASKA
THIRD JUDICIAL DISTRICT
The foregoing instrument was acknowledged before me this day of
, 'i, 11 -
202L, ruby
Irit
STATE OF ALASKA
NOTARY PUBLIC
LIC
V -X "J, Lint r- A QKA NOTARY PUB
FOR A
My Commission expires: Andrea M. NeIson
-My Commission Exores May 9, 2M4
MUNICIPALITY,
By: ldlLeel�l d.7,W& (signature)
- IG'4e(ra (print name)
Date:
Titte:
{rev. 05/18,12018) Page 3 of 3
LOT 2
Ld
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ca
D
tr
V
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r7 D
m
TERRACE LAME
a
n
N00'20'00"E 150.00'
NOO'20'00"E 150.00'
ANCHORAGE RECORDING DISTRICT, ALASKA
ASBUILT OF:
LAKE RIDGE TERRACE SUBD
LOT 3 BLOCK b PLAT P-549
SURVEY CERTIFICATE: 1, John L. Schuller, Have conducted a
physical survey of this property as shown on this drawing and that the
improvements situated hereon are within the property lines and no
enchroachments exist other than noted. Under no circumstance should
any information on this drawing be used for construction of fences,
structures, improvements, or for establishing boundary lines.
EXCLUSION NOTES: It is the owners responsibility to determine
the existence of any easements, covenants, or restrictions which
do not appear on the recorded subdivision plat.
WORK ORDER NUMBER; DATE scus: [—WAX;
APR 3, 2021 1"=30'
21 —02a MAA Sr.OEQ p orad Huuem Roar ua::
JLS NW0653 210133
PAVEMENT APPROXIMATE
DUE TO DEEP SNOW AND ICE CONDITIONS
�.� F All
40,
low
49TH
� 1
..
F OHN L. SCHULLER -
+�� LS -10408 -1,0
c
LAND
LOT 4
1831 Talkeetna Street
Anchorage, Alaska 99508
(907) 227-1455 office
(907) 274-4992 fax
• Municipality of Anc
On -Site Water and Wastewater
(907)343-7904
Parcel I.D. 051-313-25
Certificate of On -Site Systems Ap
1. GENERAL INFORMATION
Complete legal description
Location (site address)
Expiration Date: 02. — i — 0 /
Lake Ridge Terrace, Block 6, Lot 3
15044 Terrace Lane Eagle River, AK 99577
Current Property owner(s) Larry & Ann Barr Day phone
Mailing address
Real Estate Agent
305 Paul Sawyier Drive Frankfort, KY 40601
2. TYPE OF DWELLING:
Fx] Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
Day phone
Weiver/Variance request for: Distance:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ 429.(0'0 ' Waiver Fee $
Date of Payment k/1 if LO Date of Payment
Receipt Number R7 7 Receipt Number
COSH# N0iI015`42 Waiver#
Four
3. NUMBER OF BEDROOMS:
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
Fx]
Individual
0
Individual Water Storage
❑
Holding Tank
❑
Community Class Well
❑
Community
❑
Public Water System
❑
Public Sewer
❑
Weiver/Variance request for: Distance:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ 429.(0'0 ' Waiver Fee $
Date of Payment k/1 if LO Date of Payment
Receipt Number R7 7 Receipt Number
COSH# N0iI015`42 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 S(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.
Phone 522-7773
Date 11/10/2016
@�UFl�dl'3r
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6. DSD SIGNATURE j° . ' .. s..>, .. a.'...
0 7,11
System #1 Approved for bedrooms °' "+ r""""`
® ��MIERAEC" F_ ANDERSON
System #2 Approved for bedrooms �D�� 5% tCE i 4381;
Disapproved
da8hjj!A oa��@�®
Conditional approval for bedrooms, with the following stipulations:
i
By: 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.
ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA blue sheet!'- c
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 Ridge Terrace, Block 6, Lot 3
A. WELL DATA
Well type Private
Date completed 1972
Total depth 125 ft.
Date bf test
Static water level
Well production
If A, B, or C provide PWSID #
Sanitary seal (Y/N) Y
Cased to 88 ft.
FROM WELL LOG
Unknown
Unknown ft
Unknown gpm
WATER SAMPLE RESULTS
fl 3 S s
Coliform 0colonies/100 mL Nitrate mg/L
Arsenic Pug/L Date of sample: 10/21/16
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic/Steel/Advantex .
Tank size 1,500 gal. Number of Compartments 2
Foundation cleanout (Y/N) .Y Depression over tank (Y/N) N
Date of pumping New COnSt. - Pumper
Parcel ID: 051-313-25
Well Log (Y/N) N
Wires properly protected (Y/N) Y
***
Casing height (above ground) 4 in.
AT INSPECTION
11/5/2016
108.4 ft.
4.1
g.p.m.
Collected by: Anderson Engrg.
Date' installed _
Cleanouts(Y/N)
4/13/15
Y
High water alarm (Y/N) N
C. ABSORPTION FIELD DATA
Date installed 4/13/15 Soil rating (g.p.d./ft2 or ft2/bdrm) 2.0 GPD/SF
Length 20 ft. Width 15 ft.
Total depth +7 ft. Eff.-absorption area 300 ft2 Monitoring tube.
Date of adequacy test New Const, Results (Pass/Fail)
Fluid depth in absorption field before test in.
System type Mound
Gravel below pipe •5 ft.
Y Depression over field N
For bedrooms
Water added gal. New depth in.
Elapsed Time: min. Final fluid depth in.
Any rejuvenation treatment (past 12 mo.) (Y/N & type)
Absorption rate >= g.p.d.
N If yes, give date
D. LIFT STATION
Date installed 4/13/15
"Pump on" level at 2b in.
Datum Bottom of Tank
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot
Absorption field on lot
Public sewer main
Size in gallons 500
"Pump off" level at 22 in.
Cycles tested New Const.
>100'
>100'
>75'
Sewer /septic service line >25'
Animal containment areas >50'
SEPTIC/HOLDING TANK ON LOT TO
Manhole/Access (Y/N) _
High water alarm level at
Y
30 in.
Meets alarm & circuit requirements? Y
On adjacent lots
On adjacent lots
>100'
>100'
Public sewer manhole/cleanout >100'
Holding tank >75'
Manure/animal excrete storage areas >100'
>5' >5' >5'
Building foundation Property line Absorption field
'
Water main > 10' Water service line- >10' Surface water >
Wells on adjacent lots >100'
ABSORPTION FIELD ON LOT TO:
Property line >10, Building foundation >10'
Water Service line >10' Surface water >100'
Curtain drain None Noted Wells on adjacent lots >100'
Water main N/A
Driveway, parking/vehicle storage >
10,
F. COMMENTS
***Well is located in a watertight manhole with a drain to the exterior.
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 11/10/2016
COSA brown sheet 10-10-12.doc
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MICHAEL E. ANDERSON �
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MUNICIPALITY OF ANCHORAGE
DIVISION OF ENVIRONMENTAL HEALTH
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE
1. General Information Application Date U '2
(a) legal scrition (i clu lot,/block, subdivision, section, township, range)
Location (address or directions)
(b) Applicants Name_ ea 41
Applicants Address
(c) Applicant is (check one) Lending Institution owner/builder
Buyer Other � (explain);
(d) Lending Institution /S7'z r��I �( Gl6l !/( Iplephcne
Address Iz-?bwG c, 7L
(e) Peal Estate Co. & Agent
Address
Telephone
2. Zoe of Residence
Single -Family yralti-Fannrnly Other (describe
Number of Bedrooms
3. Water Suml,
/0
Individual Wall � Community Public
Notes If ca unity well system, must have written confirmation from the State
Departwe nt of Environmental Conservation attesting to the legality and status.
Is the well adequate for the number of bedroom specified in this HAA (Y )
4. Sewage Disposal
Onsite Public Community F--�j Holding Tank
Is the wastewater disposal system adequate for the number of bedreans (Y :)
(Page 1 of 21
2-15-84
N
5. Enqir,�erirq Firm Providing inspections, 'Tests, Data and Information
I oertify that --I h ve checked, verified, or conformed to all MOA HAA Guidelines in
effect on the dat 'oji.tlaia/inspection.
Date !/�`� —6
Name 6f,'Yirm Telephone
Address,f;ISv�i►�'f
OF .4 � �t
pa �qtt c� "(..
_..: �7„� 111U�i7y ��Ni{:i t..y5
Signed by 1.Vri €.)'� c;^, .� s OW J° , A
IZ-
Da
(ENGINEER SEAL)
6.DHEP Approval
Approved for 3 tedroam
By w_,�.„� cs�u� c CL Date 7/ i� S�
Approved � Disapproved Conditional.
Teyms of Conditional Approval–
The Municipality of Anchorage Department of Health and EnvironTmntal Protection does
not guarantee the continued satisfactory performance of the water supply and/or the
wastewater disposal system. This approval indicates that, as of the validation, cote
shown above, based on the data and information furnished by an engir•.eer registered in
the State of Alaska, the water supply and wastewater disposal system is safe and func-
tional for the rumber of bedrooms and type of structure, indicated.
(DHEP SEAL)
7. Mail the HAA o the ..pllowing address:
KB2/d5/s
(Page 2 of 21
2-.15-84
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
A. WELL DATA
MUNICIPALITY OF ANCHOMOE
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
APR 1 `/ 1984
RECEIVED
Well Classification If A, B. or C. D.E.C. Approved(Y/N)r" 114
Well Log Present (4- Date Completed &f � YieldxC�e f
Total Depth Com- 46 -'Cased to 6,( 4c Depth of Grouting
Static Water Level OZ- �7 ` Pump Set At " C -1 -
Casing Height Above Grounds i` Sanitary Seal on Casing (Y
G.
Electrical Wiring in Conduit (Y/,> kts<<j l��i*c2 Depression Around k4ellhead ( )
Separation Distances from Well:
To Septic/ u l4- -7ank on Lot t67-1
/ On Adjoining Lots
To Nearest Edge of Absorption Field on Lot; On Adjoining Lots �l//L7C�
To Nearest_ Public Sewer Lire ``-/ !" /4 To Nearest Public Sewer
Cleanout/Manhole /i ` P4 To Nearest Sewer Service Line on Lot - ef6O
Water Sample Collected By ✓ ` /f % Date
Water Sample Test Results -5-,4/77
Comments& -fie// //-) S//)r /�2
'O vies' Z J !-
`%IM
B. SEPTIC ANK DATA fG`
Z c�,
l�
Date Instal
Standpis (Y it -tight
Depression over Tank ( ) Date
Pumping/Maintenance Contract on File
Holding Tank High -Water Alarm
Uh
f�)
No. of Carp;Z ents
®
Foundation Cleanout ( )
Pumped 5—CR- ` l9 `TZ s
;for ex A
temporary Holding Tank Permit (ym/ lid
Separation Distances from Septic a
To Water -Supply Well / qo
To Property Line To
To Water Main/Service Lire /e'po To
Course
Comments
C
/14
Building Foundation 2,
Disposal Field 43
701/
Stream, Pond, Lake, cr Major Drainage
(Page 1 of 21 2®1.5-84
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata _; /� Type of System Design��/C)C7%C��
`,, � Length of Field / Len C
Date Installed �`/,� �Z��- g
Width of Field Z Depth of Field 6
Gravel Bed Thickness `r
Square Feet of Absorption ea Standpipes Present
Depression over Field (,v4)) Date of Last Adequacy
Results of Last Adequacy Test 7-1.
Separation Distance from Absorption Field: �' ' :�_S
To Water -Supply Wbll /0 o , To Property Line /Q
To Building Foundation 6o To Existing or Abandoned System on
Lot On Adjoining Lots
To Wntec Service Line 10D / To Cutbank(if resent) X)
To Stream/Pond/Lake/or Major Drainage Course XX
To Driveway, Parking Area, or Vehicle Storage Area
D. LIFT STATION
Date Installed�Dimensions
Size in Gallons %�/ Manhole/Acces (Y
"Pump On" Level at / � L r "Pump Off" Leve at_ / o /
High Water Alarm Level at 1U0 A) G Vent
Tested for �� _ Pumping Cycles during Adequacy Test. Meets MOA
Electrical
Comments /_)L-7/aJ lxalvll_�7 I SLG/2Ff� r�(if LG a� ` ��/-:-
/ee J
*� Check Permitted Bedroom Rating Against HAA Request
I certify th I v checked, verified, or conforxred to all MOA HAA Guidelines in effect
on the dat of t ction.
OF
Signed / Dater
°'A Be_f9h
"8�lC�iNfn MOA No.
Compa a -'; >�
4ALASKA
fia {t
KB1/d5/s
A...lRa r
[Page 2 of 21
2-15-84
APPLIi...-,NT FILLS OUT UPPER HAL ONLY
1/t7`
JI/ -JS/' cf' /
" -7 / ,.:7,?af
G% //I��l�
Phone
rPropertyowner
- fir,
Zip Code C/
,//41,nc
as 7 F
Buyer w )_� �% 71
( ) CONDITIONAL APPROVAL'
Address
Zip Code
Lending Institution
Phone
��/`��
Address
Zip Code
Realty Co. R Agent
Phone
r
Address
Zip Code
Legal Description
C✓ K�
street Location
Type/of Residence
ASingle Familyt
i
edrooms
Multiple Family No. of Bedrooms-
0
❑ Other
Water Supply
Individual
ATTACH WELL LOG. A well log is required for all wells drilled since June 1975.
log if
❑ Community
For wells drilled prior to that date, give well depth (attach available).
- ❑ Public Utility
Sewer Disposal
%Individual
Year Individual Installed:
Z Public Utility
When Connected to Public Utility:
❑ Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE' PROCESSING CAN BE INITIATED.
jInspector
Time
Time Time - -
CC'' Date /�
Date D 1DInspector Inssppector Inspector
(Dc_�/� LL)
Field Notes: v'r� SAW Q��J -oZr'r -�i3 .
v � MUNIC4RALITY OF ANCHORAGE
�- ior„ �C�-^//'����C}}it{�e.��/J1� f, ! N RO\�J�LiVTAL PROTECTION
, V Acl iJ:d
C(V E
v1�(
) APPROVED BEDROOMS
i
g8 N�
'CON IT S OF APPROVAL vvKK 7
1
(DISAPPROVED
( ) CONDITIONAL APPROVAL'
DATE
/ t
/,o7
/,o
,
,
Soils Rating Date Sewer Insfale.0, ;1.� Well To Absorption Area ` /e' JG Well Log Received
Z�jG7 C Q X Well to Tank ��� (�Af(JEv Septic Tank Size /AOo $^� c�
- -''ATE
z
RECEIVED
INSPECTION APPOINTi,'IENTS
-- --
TIME TIME
I
TIME - -
DA{E 1 DAi-E DATE
n Z 1
nl�._ aC
---------- ----+INSPECTOR
INSPECTOR
INSPEC OR
�\� L, ELI One 17 Four D Other__
L0
-��
5y) �, ^ Two 0 Five
MUNICIPALITY CFTORAGE
MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH &
i - DEPARTMENT OF REALTH & ENVIRONMENTAL
PROTECTION ENVIRONMENTAL KOTECTION
r
�\ 825 L Street - Anchorage, Alaska 95501
45r"V W )
ENVIRONMENTAL SANITATION
DIVISION
Telephone 264-4720
LD PUBLIC UTILITY
depth (attach log if available.)
RECEIVED
REQUEST FOR APPROVAL OF INDIVIDUAL WATER
AND SEWER FACILITIES
D!RV:CTIONS, Complete ail parts on page ?. Incompiete requests will not be processed. Please allow ten (10) days for processing.
I __
PHONE
MAILINGADDRESS trs� Jr�
NOTE: THE INSPECTION FEF_ MUST
__--_.—_—._--..)—_—
----
PR CPER T'Y R(_S!D`NT (I' d:fierent Rom above)
PHONE
2, BUYER �f_
PHONE
NiaiLiNG ADD FSS
------- ---
PHONE
- --- — --
— -- —
MAILING ADDHFSS—
.a
PHONE
. MA'IIKG ADDRESS
_ r
.1)
5. 1176 _ DFSCRIPTiOhJ
TREEr I_OCATION ---- ---------------'—
S
r6:_"ryPE
-- --
OF E RESIDEiJC—��_�_����NUMi3Eft
OF,BEDROOMS`� -
SINGLE FAMILY
�\� L, ELI One 17 Four D Other__
L0
5y) �, ^ Two 0 Five
L 1 MULTIPLE FAMILY
� ����
l�u��Q L.-; Three E:1 Six
__
7. NJATER S16PPLY
INDIVIDUAL'
* ATTACH WELL L.OG. A well Ing is required for all wells drilled
O COMMUNITY
since June 1975. For wells drilled prior to that date, give well
LD PUBLIC UTILITY
depth (attach log if available.)
8. SEWG
AE D!SPOSAL-9YSTE.M-
X INDIVIDUAI_ION-SITE°"
t I i YEAR ON-SITE SYSTEM WAS INSTALLED.
M PUBLIC. UTI I_ITY
NOTE: THE INSPECTION FEF_ MUST
ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
77-01n (hev 6/75) _ -e
MIS SIDLE FOH OFFICIAL USE ONLY
1. TYPE. Of: FIESIDENCE NUMBER OF BEDROOMS
I: J SINGLE FAMILY C..J ONE a -rHRE[ ❑ FIVE I-] OTHER
C1 MULTIPLE MAIL.Y (.i TWO F] FOUR O SIX
Pr_IZMI'f NUMf3E:N
2. WA -1 FR SUPPLY
I 1 INDIVIDUAL I)EP'fR OF WE it.
C1 COMMUNIT`r -- - ---- --- ---- ---- ---
DATL DRILL ED
1 .1 PUBLIC: UTILITY
Connection Ven fied-_------ _ LOG RE:CGIVED
'. SE:WAGL' DISPOSAL_ SYSTEM PE_RniIT NUMBER
r -I INDIVIDUAL./CiN-SITIDAI-:.-._N—STAL------------------ ----------
unll_Iii �nl.l_tD
L..JPUmIC UTIL-I1Y
..
Cannectlon Vended --------
INF- - ---- - - ----- - - ---- — ------ -
I-._1Sep1ic Tank or i _Nolding l onk
.circ. 11 I'ank k homemade SOILS I-
f e P F
f"(PF 0 F TANK I'll AN0FAC-I'IJRER
TUTFU ABSORPI ION .AR EA MATERIAL.
4. DIS L r `_ 11c,lnir./r.;.a ink Idnk nber rl. IiUn F rt.- Sr we. �inr, ' ,.r.. r
ilhsor ption Area to nvarrat I-ot Line - - - --
5. COMMENTS
ILI/%APPROVED FOR BEDROOMS
L_' CONDITIONAL. APPROVAL. (letter must accompany certiricate)
C I DISAPPROVLD
DnTe v
72 010 (nnv. 6/ /0)
ALASKA cnUIROWnTAL C011TROL HUM, Inc.
Engineering & EEnuironmental Studies
MUNICIPALITY OF ANCHORAGE
DEPT. OF 11 ALid &
ENVIRONMENTAL P„G(ECTION
0 19 81
8/18/81 RECEIVED
LORRAINE MINOR
P.O. BOX 677 EAGLE RIVER
ANCHORAGE AK 99577
SELLER - EASTHAM
SUBDIVISION -LAKE RIDGE TERRACE BLACK -6 IAT -3
ADEQUACY TEST FOR SEWER SYSTEM
THE TYPE OF ABSORPTION SYSTEM IS A PIT WITH AN AREA OF 864 SQFT.
THE SYSTEM IS CAPABLE OF ACCEPTING 1 GALLONS OF WATER PER DAY.
BASED UPON THE TEST DATA THE SYSTEM IS NOT ACCEPTABLE FOR A
HOME OF 4 BEDROOMS.
THE SEPTIC TANK WAS PUMPED ON 2/28/81 .
SEPTIC TANK ADEQUACY
THE EXISTING SEPTIC TANK VOLUME OF 1000 GALLONS IS INADEQUATE BY 250 GALLONS
FOR THIS HOUSE OF 4 BEDROOMS.
loop/C. Roil. Jr. s
1%0 No. 4251•E ' C
�� A�OfESSIb���
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3500 Tudor Road, Anchorage, Alaska 99507 2798686
Date Received 1/25/74
Time of Inspection 2.00_pm
Date of Inspection 1/28/74
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & MATER FACILITIES
FOR
VA
1. Approval Requested By: Alaska National Bank
Address:
Pouch
7010 Anchorage
Phone: 277_Ujj-
2. Property
Owner:
Lawrence R
Eastham
Phone: 688-24gg
3. Legal Description: Lot 3 61ock 6- Lake Ridagp T rrare
a. Location: Hill Crest Dant' and Blue Spruce Lane
5. Type of Facility to be Inspected:--S-inn1P
Number of Bedrooms: Four (4
6. well Data: Nothing on file
A. Type
B. Depth
C. Construction D. Bacterial Analysis cat;-fartpr;y
7. Sewage Disoosal Svstem:
A. Installed 1972 B. Installer Wallace
C. Septic Tank: 1. Size LQQO_gals 2. Manufacturer Wallace
D. Seepage Pit: I. Size 2. Material .on_r,tp. Rings
E. Disposal Fie1.d: Total Length of Lines
8. Distances:
A. Well To: Septic Tank_' Absorption Area 100 , Sewer Lines
Nearest Lot Line Other Contamination
B. Foundation to Septic Tank `;. Absorption Area 901
C. Absorption Area to Nearest Lot Line
X-
n ReglnEt for Approval of ��'vidual Sewer & Water Faciliti(��
Page Two
Q. Comments:
Annrov Disapproved Date
Apnrova] Valid for One Year From Data Signed
Greater Anchor. age Area -Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM.
I Certify that the infnrmation contained in this request for approval to he a true
and accurate representation of the su-t)iect sewer and .eater facilities located at:
Si-.1nod Date