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LAKE O THE HILLS BLK 3 LT 6
119,74 MIR ake 0 The , 01 s� a Municipality of Anchorage On -Site Water and Wastewater Program - (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP181356 PID Number: 015-331-27 Dwelling: limil Single Family (SF) F -I Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New FE -1 Upgrade Name: Paul & Priscilla Steer ABSORPTION FIELD **Measured effective depth less than design but still adequately sized ❑Deep Trench E Shallow Trench 0 Bed 7 Mound Address 11480 Mountain Lake Dr [] Other Phone Number of Bedrooms Soil Rating Total depth from original grade 232-9504 4 0.8 GPD/SF 1 6.7 - 6.9 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 3.2-3.4 Ft. Gravel depth beneath pipe 3.5** Ft. Subdivision Block Lot Lake 0 The Hills 3 6 Fill added above original grade 0 Ft. Gravel length 2 x 60 Ft. Township Range Section Gravel width Beds: Number of Lines Distance between lines SEPARATION DISTANCES 5 Ft. Ft. To Septic I Absorption 1 1 Sewer ; Holding Total absorption area Number of trenches Dist. between trenches Lift Station Tank Z I Tank Line From 1 Field 2 11 Ft 2 10 Ft. Well > 100, 1 >100' N/A 1111 >25' TANK ©Septic El &T.E.P E] Holding E] Other Manufacturer Anchorage Tank — Capacity 1250 Gal. Surface Water f >100' >100' i N/A i N/A Material Steel Number of compartments 2 Lot Line >10' 0* N/A N/A NA Foundation >10' >10' N/A 1 N/A LIFT STATION Manufacturer Capacity Gal. i Curtain Drain I None Noted Remarks Tank replacement only -Trench info Pump on level at in. Pump off level at in. High water alarm at in. taken from records and field measurements. Insulation placed over shallower end of tank Pump make and model Electrical Inspections performed by *Encroachment easement provided Installer PIPE MATERIAL House to tank Exist - Tank to drainfield Exist. Denali Excavating — Drainfield Existinq CO/MT D3034 Inspector J. Millette BENCH MA RK (Assumed elevation) 100 ft Inspection 11,10/12/18 Location and description I.d dates: 2 4th 3`d Bottom of back door COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp 'z-7 . kk- F k Conditional Approval: Date AM, A 49 Boniamii.R',Schiller CE 12592 10/17/18 Approved Date 10h'7/1(3 � � � N Awr PRO, I nspection Heport-9-1-12.doc // // 100500 FEET 1"=50' 4-BDRM HOME NOTE: ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC SYSTEMS. CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND PERMIT # OSP181356 PID # 015-331-27 LAKE O THE HILLS, BLOCK 3 LOT 6 A B FCO 29.9 SV1 45.4 SV2 52.4 A B 2CO 59.4 CO1 122.5 MT1 159.1 CO2 178.0 28.8 39.8 45.2 54.0 105.9 132.6 150.1 Oct 16, 2018 ROCKRIDGE DRIVE MOUNTAIN LAKE DRIVE10' T&E EASEMENTASPHALT ROADWAY EDGE OF GRAVEL DRIVEWAY 10' UTILITY EASEMENTEASEMENT FOR SEWER SYSTEM ENCROACHMENT RECORDED AT BOOK 361 PAGE 934 EXISTING 1250-GAL SEPTIC TANK REMOVED NEW 1250-GAL SEPTIC TANK W/ DOUBLE CLEANOUT SV1SV2 2CO FCO CO3 128.4 MT2 165.0 CO4 182.0 116.5 142.9 157.9 CO1 CO2 CO3 CO4 MT1 MT2 PROFILE AS-BUILT (NO SCALE) 91.8 87.6 92.3 96.5FCOSV1 SV22CO1250 GAL SEPTIC TANK 91.6 LAKE O THE HILLS, BLOCK 3 LOT 6 Oct 17, 2018 PERMIT # OSP181356 PID # 015-331-27 60' DRAINFIELD ROCKMT84.9 COCO81.4 84.8 88.3 FINAL GRADE 60' DRAINFIELD ROCKMT TH#2NO GROUNDWATER 10/14/90 85.1 COCO75.3 81.6 85.0 88.3 FINAL GRADE NORTH TRENCH SOUTH TRENCH TANK ONLY REPLACED UNDER THIS PERMIT TRENCH INFORMATION TAKEN FROM RECORDS AND FROM FIELD MEASUREMENTS EASEMENT FOR SEWER SYSTEM ENC RECORDED AT BOOK 361, PAGE 92 N 89 53' 09" E 252.04 W. OF q 4g TH u o s SHANE A. HOLT �p e LS -6914 QGa a o� �n °fessionsl Vo THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES. EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT , ARE NOT SHOWN HEREON ( UNLESS INDICATED) NOTE: FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. Lu Q of NOTE: EASEMENT IN FAVOR OF CHUGACH ELECTRIC RECORDED @ BOOK 224, PAGE 693, DATED APRIL 4, 1974 AS -BUILT SURVEY 1" = 30' NO CORNERS SET THIS DATE I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY OF THE FOLLOWING DESCRIBED PROPERTY LOT 6, BLOCK 3, LAKE 0 THE HILLS SUB. ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. DATED AT ANCHORAGE,ALASKA THIS 15 TH DAY OF OCTOBER , 2018 14049, FB 191-26,192-68 HOLT LAND SURVEYING 9309 GROVER DRIVE ANCHORAGE,AK 99507 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP181356 Work Type: SepticTank Upgrade Tax Code Number: 01533127000 Site Legal Address: LAKE O THE HILLS BLK 3 LT 6 G:2639 Site Mailing Address: 11480 MOUNTAIN LAKE DR, Anchorage Owner: STEER PAUL L & PRISCILLA Design Engineer: FORGE ENGINEERING This permit is for the construction of: Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: i„rnt Department o/-Z,/[,F 10/10/2018 10/10/2019 54552 ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: ** The existing trenches are to be documented prior to Inspection Report approval. It appears that a letter of non -objection will be needed from ROW due to the fields crossing the Utility Easement. Received By: V Date: l v l Q Issued By: �ljt% �i�� Date: ��/� 4 EPLAWS 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 Parcel I.D. 015-331-27 Property owner(s) Paul & Priscilla Steer Day phone 232-9504 Mailing address 12800 Tracy Way, Anchorage, AK 99516 Site address 11480 Mountain Lake Drive Legal description (Sub's., Block & Lot) Lake O The Hills, Block 3 Lot 6 Legal description (Township, Range & Section) Lot Size 54,552 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) 0 Septic Tank ❑X Upgrade (w/wo ADU) Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: C2 is Waiver Fees: Date of Payment: all? Date of Payment: Receipt Number: Receipt Number: Permit No. t�1c5'p���3S7o Waiver No. Permit App_-'- : ,....c October 8, 2018 MOA Development Services, On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Lake O The Hills, Block 3 Lot 6 10/8/18 Septic tank replacement Dear On-Site Services Engineer: The septic tank on the above lot is leaking and must be replaced. The existing home is a 4-bedroom. We are submitting this permit application for the placement of a new septic tank. The attached site plan identifies the location of the existing home, well and septic system, as well as the location of the new septic tank. The drainage pattern in general will not be changed by the construction. The existing tank will be pumped dry and decommissioned per code. It is a 1250-gallon tank and currently sits outside the well radius for the property and more than 100’ from neighboring lot lines. The new tank will also be placed outside the 100’ well radius. After the new tank, we will install a double-cleanout and connect into the existing absorption bed. There is a foundation cleanout already next to the foundation. Sincerely, Benjamin Schiller, PE Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP181356, Deb Wockenfuss, 10/10/18 // //10050 0 FEET 1"=50' 4-BDRM HOME NOTE: ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC SYSTEMS. CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND LAKE O THE HILLS, LOT 6 BLOCK 3 Oct 08, 2018 ROCKRIDGE DRIVE MOUNTAIN LAKE DRIVE10' T&E EASEMENTASPHALT ROADWAY EDGE OF GRAVEL DRIVEWAY 10' UTILITY EASEMENTEASEMENT FOR SEWER SYSTEM ENCROACHMENT RECORDED AT BOOK 361 PAGE 934 EXISTING 1250-GAL SEPTIC TANK DECOMMISSION PER MUNICIPAL CODE INSTALL NEW 1250-GAL SEPTIC TANK W/ DOUBLE CLEANOUT Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP181356, Deb Wockenfuss, 10/10/18 N 89 53' 09'' E 252.04. 000000pppo OF 475 �c '4 9 1H��d - SHANE A. HOLT O LS -6914 40 o/I OfessjoW 3 0 . .. . .. . ...... .. . .. . ...... .. . ..... . . ...... .. . ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... ...... .. . .. . .... 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M::.::.: SINOW AINID/011.1 ::1::01[:::: I 00,100411 NO I E' EAS EMENI IN FAVOR OF UUG AUlI BEMMC RE00RDED [300K 224, PAGE 693, DMED AP[Ihl 4, 1974 AS -BUILT SURVEY 111 =30' NO CORNERS SET THIS DATE I 111-1 IIF 0ER'"F'1IF")( 'I IdAVE 1")IERIGRMED A SLPRVEY 011 'I 11B 11E D 11P 1-1, 0 11P 11E 11 F T' ��H ��E F0 OW"IN(.3 DES,01.11 LOT 6, BLOCK 3, LAKE 0 THE HILLS SUB. AMCF-IGRAGE RECGRD'ING D ",I S'"I"' ��R �I C"I" X1 ASKA, -tEFUEGM Af�E V I Si' 1B I., ��E Sl"I"'LIA'"FED "Fll1111 "I", I-1 ��E RRGRER'"I"'Y [.'EMES AND MO VIS'D�3�1 ��E IIF X115][" 0-1_11-1 IER -11-111-1 JI NG-FIIF I"). DA'"I"' IlE IID A'"I"' AM 1-1 IIRAG IlE AIILASKA -FI-fIS IIDAY 01"' 2018 14049, FB 191-26 HOLT LAND SURVEYING 9309 GROVER DRIVE ANCHORAGE,AIK 99507 345-5513 Tom Fink, Mayor Department of Health and Human Services 825 "L" Street P.O, Box 196650 Anchorage, Alaska 99519-6650 343-4744 February 20, 1992 Paul L./Pricella Steer 11481 Mountain Lake Drive Anchorage, Alaska 99516 Subject: Lot 6 Block 3 Lake O' the Hills Subdivision Permit ~SW910020, PID ~015-331-27 The subject permit, issued February 14, 1991 by this office for a single family well and/or on-site wastewater system, has expired as of February 14, 1992. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. If you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If a licensed Professional Engineer has inspected the installation of the on-site wastewater system, the original as-built inspection report must be sent to this office for review, approval and documentation. All inspection reports must be submitted within 30 days of construction completion. When applying for a new permit, the fees are: $90.00 for an on-site wastewater permit; $50.00 for a well permit; $140.00 for a combined on-site wastewater and well permit. After March 14, 1992 the fees will be increased to $200.00 for an on-site wastewater permit; $75.00 for a well permit $275.00 for a combined on-site wastewater and well permit. If you have any questions, please call this office at 343-4744. Program Manager On-site Services enc: Copy of Permit PAGE 1 OF MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES PoD, BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE tJASTEt,.IATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:S(,1910020 DESIGN ENGINEER:ROBERT KNIEFEL, P.E. Ot,INER NAME~STEER PAUL L & PRICELLA OUNER ADDRESS:l!481 MOUNTAIN LAKE DR ANCHORAGE. ALASKA 99516 BATE ISSUED: 2/14/91 EXPIRATION DATE: 2/14,/92 PARCEL ID:01533127 LEGAL DESCRIPTION:'iLAKE 0 THE HILLS BLK 3LT: LOT SIZE: 54552 (SQ, FTo) NUMBER OF BEDROOMS: 5 THIS PERMIT: 5 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD ./SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE THE ATTACHED APPROVED DESIGN, ALL. REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15,55 AND 15,65 AND THE STATE OF ALASKA UASTEUATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING UATER REGULATIONS (18AACSO), THE FOLLOWING SPECIAL PROVISIONS° SPECIAL PROVISIONS~ ENGINEER MUST VERIFY INTEGRITY OF EXISTING SEPTIC, OR REPLACE ~,]ITH NE~ 1~500 GALL~.~]N~'~ , RECEIVED BY: .... ~~:22~'~2'"~ ................. BATE: _ ..... ;ISSUED BY Tom Fink, Mayor Municipality Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 January 8, 1991 Paul Steer 11481 Mountain Lake Anchorage, Alaska 99516 Subject: Lot 6 Block 3 Lake O'the Hills Subdivision Permit #900339, PID #015-331-27 The subject permit, issued by this office for a single family well and/or on-site wastewater system has expired as of December 31, 1990o A new permit must be obtained from this office for a well and/or on-site wastewater system not installed by the expiration date. If you have drilled the well, a well log needs to be sent to this office for documentation of the installation and to close the permit. If a private engineer inspected the installation of the on-site wastewater system, the original as-built inspection report (three-part form) must be sent to this office for ~review, approval and documentation. All inspection reports must be submitted within 30 days of construction completion. When applying for a new permit, the fees are: $90.00 for an on-site wastewater permit; $50.00 for a well permit; $140.00 for a combined on-site wastewater and well permit° If you have any questions, please call this office at 343-4744. JW/ljm:200 enc: Copy of Permit "Kids Are Our Future" U.;:i!/7--'- !, :i. ::/ , .? / -[2 -- X- i, SEPTIC SYSTEM DESIGN SCALE PREPARED BY: ~'~':~'~ ~ = ~f Kniefel Engineering MOA CE 90-030 I fo., 16, -- ~o o WASTEWATER SYSTEM UPGRADE FOR LOT 6, BLOCK 3, LAKE 0' THE HILLS Ail materials, construction methods, and inspections to meet MOA regulations and requirements. Contractor is responsible for providing and notifying MOA (343-4744) and engineer of need for inspections. System Design = $ bedrooms at 188 sf/bedroom = 940 sf. 2 @ 6Q if of $~Wide Trench with 4 foot gravel = 940 sf/4' d~Pth x .5 (rf)= 118 if. 120 feet of trench provided. Ail portions of system upgrade will be at least 10 feet from an~~ ..... property line. The old tank is to be excavated at the time of construction and replaced if major deterioration is noted. Replace with 1,500 gal. two compartment tank. of additional fi'elds at a later date. Ail adjacent lot~ to be checked for well separation distances prior to final construction. Any discrepancies from those noted should be immediately reported ~o the engineer. Narrative Description -- The lot slopes gentl/y to the west on a grade not exceeding four percent. The lot to the north slopes down to this lot near the north property line. The lot in the area of the new field is sparsly covered with alder and some spruce trees. The system upgrade will have little probable effeet on. the adjacent walls, wastewater systems,.area drainage and will still allow.the plaeement MOA CE 90-030 /o -lc, J Municipality o! Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: AI~ ~"~A ~Z"f~ ~y ~ t'~ ~ Township, Range, Section: ~'~..% TIZ, s~oPE S,T. PLAN 10 ~'11 ~ ~'~ ~'~" WAS GROUND WATER ENCOUNTERED.;' $O~E Acc,v,. s 11 ~ t~ ~t~ IF YES, AT WHAT ~ 0 DEPTH? p Beplh to Water ~er 13 ~nilarin~2 ~ 14 15 16 17 18 Gross Net Depth to Net Reading Date Time Time Water Drop &,, /, .,t-.,to z:~t.. /c, .r'f'../,~- :i/~~, 19 20 PERCOLATION RATE t ~_~__~ (minutes/inch) PERC HOLE DIAMETER -- TEST RUN BETWEEN ~ FT AND -.~ FT ,:3 ..,.,/,,,.., -- COMMENTS PERFORMED BY: l~/k~ j ~ I ~ ~ ~ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: o4. o! Township, Range, Section: ~..'~, ""~lZ~,.~ SITE PLAN sLOPE Il°- 10- 14 WAS GROUND WATER ENCOUNTERED? S L IF YES, AT WHAT '"' O DEPTH? p E Depth to Waler After Monitoring? ~q~l~ Dale: 16 17 18 19 20 Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE ~ (minutes/inch) PERC HOLE DIAMETER __ TEST RUN BETWEEN ( ,~'~' F T AND 2. ,~' F T COMMENTS PERFORMED BY: ~'~' ~ II ~¢'~''~'~ t ~"% ~,~,¢ I ~'"~,~ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev, 4/85) SEPTIC SYSTEM UPGRADE - OWNER LOCATION PAUL & BONNIE STEERS LAKE O' THE HILLS 11481 MOUNTAIN LAKE DR LOT 6 BLOCK 3. ANCHORAGE ALASKA ~516 NWl/4 S2~ T18N R3W SM AK INVOICE # ~O0~I&13B ANCHORAGE AK ACREAGE SYSTEMS, INC., ~ii! furnish ail materials and preform ali labor necessary to complete the following system. Ali work to be constructed to engineers specifications and under the approval of the Municipality of Anchorage. ACREAGE SYSTEMS, INC., will provide the following work for the installation of SEPTIC SYSTEM UPGRADE ACREAGE SYSTEMS, INC., WILL INSTALL A 1,500 GALLON SEPTIC TANK FOR A 5 BEDROOM SYSTEM. EXCAVATE SEPTIC FIELD AS PER MUNI PERMIT. CONNECT NEW SYSTEM TO PRESENT HOUSE SYSTEM. ABANDON OLD SEPTIC SYSTEM AS REQUIRED BY D.H.H.S. BID INCLUDES ALL MATERIALS, LABOR AND EQUIPMENT. LAND CONTOUR CHANGES WILL OCCURE. Inspection by D.H.H.S. approved engineer. Ali work shall be installed as required in Department of Health and Human Services (DHHS) permit ~0 (must be filled in and accepted to validate). The above location is engineered-for a perk of 150 and no water or rock. Owner will provide Acreage Systems, Inc , IF NEEDED, property lineii--~ staking with easements, variances, setbacks, utility locations, we setback, proposed building staking, engineering, surveying, pumping and~ permits. The job will be finished to coarse grade and some topography changes may occur. Finish landscaping is not in this bid. Ail the above work is to be completed in a substantial and workman- ilke manner according to the standard practices for the sum of: $ ~8~5.00 Payment is to be made in the full amounts by owner to Acreage Systems, Inc. Payment schedule is one-half down with the return of this contract and final payment one day after engineers final inspection. This proposal is void if not sighed within thirty days. By ACREAGE SYSTEMS, INC. DATE: 90/10/24 OWNER ACCEPTANCE & WARNING As my agent, ACREAGE SYSTEMS, INC., is hereby authorized to furnish ail materials, labor, inspections and permits required to complete the work in the above proposal the terms thereof. I/we hereby acknowledge the right of Acreage Systems, Inc. to claim a lien to secure payment for the cost of labor, materials, equipment furnished for the repair or Owner s sigi]a~UFe GR~i ~ER ANCHORAGE AREA Be' UGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LOCATION MAILING ADDRESS ~4Z ~),9,~-. $ 7 ~ J~ PHONE 5 LEGA'DESCR,PT,ON SEPTIC TANK: DISTANCE /t~ FROM WELL INSIDE LENGTH MANUFACTURER INSIDE WIDTH MATERIAL _F/~4; / NUMBER OF COMPARTMENTS LIQUID DEPTH_ LIQUID CAPACITY JT-~O GALLONS. SEEPAGE PIT: NUMBER OF PITS / DIAMETER__OR WIDTHT~, LENGTH-~ ,~ DEPTH · LINING MATERIAL. CRIB SIZE:-- D]AMETER__DEPTH DISTANCE FROM: WELL /) L. TOTAL EFFECTIVE BUILDING FOUNDATION ~-~::~ NEAREST LOT LINE ~.~ ABSORPTION AREA (WALL AREA) ?~(~ SQ. FT. WELL: TYPE /a~,, ~ 7~< CONSTRUCT,O, DEPTH D,STANCE FROM: BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION __ LOT LINE SEWER LINE TANK__ SYSTEM CESSPOOL APPROVED OTHER SOURCES DISAPPROVED DiSTANCES:/~¢ ~- /OD' ~C ~ DIAGRAM OF SYSTEM PIPE MATERIAL: /?~ LOT SLOPE: REMARKS: Form No. EQ-031 DATE NAME OF APPLICANT INSTALLATION LOCATION GrEATEr ANCHORAGE AREA BorouGh DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-456! PERMIT NO.. SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT PHONE LEGAL DESCRIPTION INSTALLATION OF: SEPTIC TANK FINANCED THROUGH COMPLETION DATE ANTICIPATED SEEPAGE PiT ~ . DRAIN FIELD ~ OTHER NOT~ ~HI~ PERMIT IS NOT VAEID WITHOUT FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. DIAGRAM OF SYSTEM MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK ~ FOUNDATION TO SEEFAGE PiT SEPTIC TANK TO SEEPAge PiT Wall -- /~ '~ DRAIN FIELD SEPTIC TANK _,SEEPAGE PIT , DRAIN FIELD TO NEAREST LOT LINE. DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAiN TO SEPTIC TANK , SEEPAGE PIT DRAIN FIELD . EXCAVATION 5 FEET INTO UNDISTURBED SOIL. TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PiT FITTED WITH AIRTIGHT REMOVABLE GAPS. GRAVEL SACKFILL CONFORM TO B~LATIONS REGARDING INSTALLATION. OR I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREAT~ ANCHORAGE AREA BOROUGH ORDINANCE NO. 2S-68 AND THAT THE ABOVE DATEDEBCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE.~_~__~.~..~, APPLICANT'S SIGNATURE k~_ ..,FER ANCHORAGE AREA BOROUGH Depa~%ment of Environmental Quality 3330 "C" Street Anci~orage, Alaska 99503 Performed for ~ /~.~/~. Date performed Legal Oescrip~Q~. __~J~/~.J~~ /~.~ /p/~_ ]' ~ this form reports: Soils log_~z. , Perc61ation test Depth Feet 9- lO- ll - 13-. 14 - Was ground water encountered? "Reading If yes, at what depth? Date Percolation rate Gross Time Net Time Depth to H20 n'linute~ · ~ .... ' r~ Drain Field Proposed lns..~lac~on; S~apage '"'" ' .... Dep~.n of ..hie,. . Depth co oo~ton, o~ pit or ~rencn . Certificate of On -Site Systems Approval Parcell.D. 015-331-27 imKMAZI11:40-41401• 0 ' Complete legal description Location (site address) Expiration Date:—dan 0�01� Current property owner(s) Priscilla & Paul Steer Day phone _ Mailing address 12800 Tracy Way, Anchorage, AK 99516 Real estate agent 2. TYPE OF DWELLING: Fx-1 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 4, 3. NUMBER OF BEDROOMS: Day phone 907-232-9504 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well El Private Septic � Water Storage ❑ Holding Tank 0 Community Well D Community 0 Public Water System 0 Public Sewer 0 Waiver request for: Distance: Received by:_ Date: idil by COSA to be released 4 the engineer, unless otherwise requested by the engineer. I C OSA e (4 4LUAC) 4- CCkr&+A0yk Fee $ Waiver Fe $ late of Payment 1011011-6 Receipt Number 3 (0 COSA # 1 S-1-19 Date of Payment 5-�Qasb IT Receipt Number 1611's 11,81, - Waiver # (3 )c (7 tq 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 Forge Engineering Phone 907-522-7773 Address 1399 W. 34th Ave Suite 101, Anchorage AK 99503 Engineer's Printed Name Benjamin Schiller, P.E. Date 10/15/18 0, A/ 'k 49 "1 6. DSD SIGNATURE C- .............. System #1 Approved for bedrooms . . System #2 Approved for bedrooms CE 12592 Disapproved kPROF Conditional approval for bedrooms, with the following stipulations: Pro V) Je ono 12a o )e >< -krs o -C n o n - o c 4j c) n +0 �ee_p 7 i'1e <�rctui � 'f U _N\0 (0 ON-s]TE I AND Vc Z n03 WASTFZ, rn P WATER 0 7 ROGRAM By: Original Certificate Date: C)C� 1 aoll's 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 engineers work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet Legal Description: Lake 0 the Hills 133 L6 F. J§VJTJaXX# MA[fil Well type Private If A, B, or C provide PWSID # Date completed Unknown Sanitary seal (YIN) Y Total depth ft. Date of test Static water level Well production Cased to ft. FROM WELL LOG Unknown WATER SAMPLE RESULTS: ft. If more than I septic system is on the lot: COSA Checklist # of Structure served by this system Parcel ID: 015-331-27 Well Log (Y/N)N Wires properly protected (YIN) Y Casing height (above ground) 36 in, AT INSPECTION 9/26/18 73 ft. 9 -p -m- 3.43 9.p -m - Coliform Neg colonies/100 mL Nitrate 0.99 mg/L Arsenic ND ug/L Date of sample: 9/18/18 Collected by: Forge Engineering B. SEPTIC/HOLDING TANK DATA Tank Type/Materia[Septic / Steel Tank size 1250 gal. Number of Compartments Foundation cleanout (YIN) Y Date of pumping C. ABSORPTION FIELD DATA Date installed 10/12/2018 Cleanouts (YIN) Y Depression over tank (YIN) N -High water alarm (YIN) N Pumper New construction Date installed C. 1991 Soil rating (g.p.d ./ft2 or ft2 /bdrm) 188 SF/BDRM System type Wide Length2 x 60 ft. Width 5 ft. Gravel below pipe _3.5** ft. Total depth 6.9/6.7 ft. Eff. absorption areal 11 l.ft2 Monitoring tube Y Depression over field Date of adequacy test 9/27/18 Results (Pass/Fail) Pass For bedrooms Fluid depth in absorption field before test 0/11.5 in. -Water added 4002* gal. New depth 12.5/33 in. Elapsed Time: 4320 min. Final fluid depth 0/3 in. Absorption rate >=600 9 -p -d, Any rejuvenation treatment (past 12 mo.) (YIN & type) NO If yes, give date *SIGNIFICANT ADDITIONAL WATER WAS INTRODUCED DUE TO CIRCUMSTANCES RELATED TO TESTING OF TANK. D. LIFT STATION Date inabsUed___ "Pump on" level at Datum __ Size in ge|kma in. "Pump off' level atin. _ Cycles tested E SEPARATION DISTANCES WELL ONLOT TO: Monhm|e/Aooeea(YYN) High water alarm level at in. Meets alarm & circuit requirements? _� / OO SeodohankUUtatad>1 00' station On �t �r1'"` ' OD / 0O Absorption field �^1 e|don|ot >1 00' Ona�acent|��^1 s '"~ ' / Public aevvermain >75'' "7�Public savverman hole/cleanout >100' ~"10O /�9 >100,Gevver/aopd>^- c service line `~ Holding tank / `�`� ' K8 Aninne|containment areas >50'~"�Danure/animo|excnebaotonageanaas >100, SEPTIC/HOLDING TANK ONLOT TO: / O Building foundation �^1 on '^' Property line >5. ' O Water main �^1'~ Water service line >10' Wells/ �||� on adjacent lots �"1UO " Absorption field Surface water >5. >1 00' -------' *Encroachment easement provided ABSORPTION FIELD ONLOT TO: * �/ Property D y|ine Building foundation �"1O/_'__,^____ / VVaharService line �p1O/ 8u�aoevvater >100''"°1O0 NDD�NOf{�� >100'Curtain drain None Noted ^ " Wells on adjacent |ota_.__,=^,_ Water main >1O' Driveway, parking/vehicle storage >1O' F COMMENTS *^C|8@OOUfSappear tOhave settled slightly ODeast side and retain liquid even when trench is empty. Monitoring tubes may have some debris at the bottom, reducing depth. G. ENGINEER'S CERTIFICATION / certify that /have determined through field inspections and review of Municipal records that the above syatn/nu are /n conformance with MOA COSAguidelines ineffect onthis date. _Benjamin c� ��'|| ���� ����//|n63[ / Engine��sPhnh�dNam� ` �- 10/15/18 COSA brown sheet -1 0-10-1 2.doc PO BOX 240773 ANCHORAGE, AK 99524 522-7773 • GE 677-7766 (FAX) ENGINEERING FORGECIVIL.COM October 17, 2018 OF&ilkll • MOA Development Services, On-Site Water& Wastewater Program j*'49 TH *fir/ 4700 Elmore Rd ;+ • ''' Anchorage, AK 99507 r/ • Be..rle ,� .hiller ' I+�Fc••. •CE 12592 .•(<•A,' Subject: Lake 0 The Hills, Block 3 Lot 6 T, srF9 .•)o�)��)$. ���� Conditional COSA request ik\4:krE to Dear On-Site Services Engineer: The owners of this property are selling their home. Their septic system crosses a utility easement and encroaches onto the neighboring property. The system had been designed and permitted at one point, but the permit had expired without record drawings on file. The owners had obtained an easement for the encroachment onto the neighboring property, but there is no record of a permit for the utility easement. This issue came up in the last two weeks of the sale of the home. We have applied for the permit from the ROW department, but we know that it will take time to contact the various utility companies and obtain the appropriate letters of non-objection. This situation has existed for several decades without incident,and we do not anticipate any problems from the utility companies for this encroachment. We request a conditional COSA so that the owners can meet the closing deadline while we pursue the needed letters. Sincerely, Benjamin Schiller. PE Municipality of Anchorage MUNICIPALITY O F ANCHORAGE Community Development Department Right of Way Section 4700 Elmore Road - Anchorage,AK 99507 APPLICATION FOR RIGHT OF WAY PERMIT Phone 907-343-8240 Fax 343-8250 MOAROWrequests@muni.org PRIMARY SITE Street# 11480 Street Name Mountain Lake Drive Parcel# 015-331-27 Nearest Cross Street Rockridge Drive Plat 72-0236 Grid SW2639 Subdivision Name Lake 0 The Hills Block 3 Lot 6 Tract APPLICANT AND CONTACT Permittee Forge Engineering 0 Contractor ❑ Utility ❑ Owner Mailing Address 1399 W. 34th Ave Suite 101 City Anchorage State AK Zip 99503 PROJECT DETAILS Type of Permit ❑ General ❑ Rental ❑ Driveway 0 Utility ❑ StMntc ❑ MOA* ❑■ Encroachment/Non-Objection *MOA Project Name Project# Work Order# Utility Acct# Activity Date: From To Description: Septic trenches run through the utility easement onto neighboring property. Site plan showing encroachment and easement for neighboring property are attached. ROAD CLOSURE DETAILS Use Supplement Worksheet for addt'l closures Road Name ❑ Full ❑ Partial I None ❑ Sidewalk Only Adjacent to TCP Attached? ❑Yes ❑ No ❑On its Way Closure Dates: From To Hours of Closure From To A full road closure or a partial road closure on a classified arterial or collector street requires an approved Traffic Control Plan(TCP) signed by MOA Traffic Department. Consult the OS&HP to determine road classification. RIGHT OF WAY DETAILS Check all that apply. Use Supplemental Worksheet for additional rights of way. Location Type Surface Material Road Prism Pavement Age Construction Method Curb& Gutter ❑ MOA Right of Way ❑ Gravel/Dirt (see reverse) [] lorLessYr ❑Trench Open 0 None I Utility Easement(s) ❑Asphalt ❑ Inside ❑ 1to2Years ❑ Boring/TrenchlessTech ❑Type 1 ❑ Drainage Easement ❑ RAP/Chip ❑ Outside ❑2to3Years ❑ Existing Conduit ❑Type 2 ❑ Public Use Easement ❑ Concrete ❑ N/A ❑ 3YearsPlus ❑Aerial 0 Type 3 ❑ BLM Easement I Grassy Area ❑ N/A- No Cut Req'd ❑ Closure Only ❑Type 4 ❑ Pedestrian/Bike Trail ❑ Undeveloped ❑ Maintenance Only ❑ ❑ Sidewalk ❑ N/A ❑Alley Lineal Feet Parallel to Right of Way I certify I am the owner/authorized representative for the project described in this Right of Way Permit application and that all work will comply with federal,state and municipal codes, regulations, relevant design criteria and conditions of the permit. 10/17/18 907-310-9090 ben@forgecivil.com Signature Date Phone Email Benjamin Schiller, PE Printed Re\ January 2014 (PLEASE PRINT DOUBLE SIDED/FRONT TO BACK) Page I of 2 Notification of Commencement of Work At least two working days before the work is commenced or resumed,the permittee shall call in to activate permit(p.343-8206)and provide a valid one-call ticket(utility locate) number.The Right of Way permit is not valid without the required two working day notification and the valid one-call ticket number. Failure to comply with these requirements shall result in immediate forfeiture of the pre- paid right-of-way permit inspection fees. Roadway Prism Roadway prism means the top surface to one foot outside of the limits of the traveled way, shoulder, curbs and gutter, attached sidewalk, and the supporting subsurface structure,the limits of which are defined by a surface sloping down and away from one foot outside both sides of the surface at a ratio of one-foot vertical to one and one-half-foot horizontal. Utility companies performing work strictly outside the prism and which does not require an approved municipal Traffic Control Plan may perform such work under their annual Blanket Permit. Applications for Driveway Access Refer to MOA Driveway Standards for driveway regulations;for a copy,visit http://www.muni.org/departments/works/traffic/pages/default.aspx ROW Permit Application requires a site plan approved and stamped by the MOA Traffic Section. Right of Way Fees • Trench/Open Excavation Inside Road Prism$340 • Inspection rates are$130/hr weekdays 7:30 a.m.to • Trench/Open Excavation Outside Road Prism$225 4:30 p.m. Saturday inspection rates are$197/hr with a 2 hr • Trench/Open Excavation in public easements$130 minimum. Sunday or holiday inspection rates are$281/hr • Partial Road Closure(or a sidewalk closure) $280 with a 2 hr minimum. • Full Road Closure$395 • Residential Driveway Permits with no curb cuts are$260. • Pavement Break/Cut is a minimum of$130 and varies Additional fees apply for curb cuts. depending on the age of pavement. Please reference Title 24 for complete fee structure and fee calculations. Rental Fee Calculation Provide a drawing showing the location and square footage in the right of way is required and must accompany your application. A current Certificate of Liability with$300,000 minimum General Liability must accompany permit application, and must have the MOA ROW as a Certificate Holder. Rental Fees are calculated at.70/sf/month Developed or.45/sf/month Undeveloped. The minimum basic rental fee is$130. 'L x 'W= sf x /ft= $ /mo. =30days = $ /day x days=$ Encroachment Permits and Letters of Non Objection An application for an Encroachment Permit or Letter of Non Objection to an encroachment in a Utility Easement, Drainage Easement, ROW Road Reserve, or Public Use Easement must be accompanied by a current as built or plot plan showing the following information: Accurate description of structure, materials, dimensions, distance structure encroaches upon and along the easement, distance from grade to top of structure, etc. Photos are strongly recommended. Please note letters of non-objection from utilities will be required from the property owner during the review process(see supplemental checklist for instructions and contact information). A$115 non- refundable fee is collected at time of application and does not guarantee approval of encroachment. Supplemental Worksheets When work is on more than one right of way, your application requires the Supplement Worksheet(s)for each additional right of way. If you are applying for an Encroachment Permit or Letter of Non-Objection, information and further instructions are on the Supplemental Worksheet for Encroachments. Right of Way Office Hours Office hours are Monday through Friday, 7:30 a.m.to 4:30 p.m. Please submit applications no later than 4:00 p.m. FOR USE BY THE RIGHT OF WAY PERMIT OFFICE Permit Fee Date Received By Pavement Break Fee Date Processed By Closure Fee Date Notified By Pre-Paid Inspection Fee Encr/NOL Application Fee Assigned ROW Permit# Tota Re\ J:un rtn 2011 (PLEASE PRINT DOUBLE SIDED/FRONT TO BACK) Page 2 or 2