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HomeMy WebLinkAboutBRUIN PARK BLK 5 LT 11Bruin Pork Lot 11 Block 5 #016-111-35 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP221475 PID Number: 016-111-35 Dwelling: X Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ❑■ Upgrade Name Janice Peterson/Birds of a Feather Trust ABSORPTION FIELD ❑ El Deep Trench Wide Trench El Bed Mound Site Address 11301 Polar Dr ❑ Other Phone (907) 242-5630 Number of Bedrooms 4(Four) Soil Rating 5.0 Total depth from original grade GPD/SF 3.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original 1.5 grade Ft. Gravel depth beneath pipe 1.5 Ft. Subdivision Block Lot Bruin Park 5 11 Fill added above original grade 1.3 Gravel length 25.0 Township Range Section Ft. Ft. Gravel width 5.0/5.0 © Ft. Beds: n/a Number of Lines Distance between lines n/a Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 160 Ft2 1 >14 Ft. Well >100' >100' N/A N/A >25' TANK ❑ Septic ❑ S.T.E.P. [:]Holding Fm] Other Manufacturer Orenco (Advantex) Capacity 1,500 Gal. Surface Water >100' >100' N/A N/A Material Steed _ _ Number of compartments 2 Lot Line >5' >10' _ N/A N/A NA Foundation >10' > 1 0' N/A N/A LIFT STATION Manufacturer Orenco Capacity 250 Gal. Remarks Field is insulated Alarm location Garage Electrical installed by Capstone Electric Installer PIPE MATERIAL House to tank D3034 dTank to D3034 rainfield Territory North Drainfield D3034 CO/MTD3034 Inspector B Schiller / M Jakubisin BENCH MARK (Assumed elevation) 100 ft Inspection 1m 4/21/23 4/21/23 Location and description 2�a 3'tl 4/24/23 4th Garage man -door threshold ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp 1i ' \® 0_�s Conditional Approval: Date 4WQ��` •`�t4,��,� r Septic System/ j P�. �• BenjamUr Schiller •:� 0 CE 12592 Approved /f Date `"�J; • 5/16/23 . • •�C�� �0FESSION���4 Notes this approval does not include well require permit nts. 1D. ncinn/40% �� �►�mi, Bill 11111 PERMIT # OSP221475 PID # 016-111-35 f \ \ LOT 41 LOT 9 LOT 1 / O/ ! / � ji � 15' ACCESS hASEMENT / NEIGHBORING SEPTIC AREA l LOT 10 , \ EXISTING WELL A NEW 1500 -GAL ADVANTEX \ \ V / 4NCHMAR TANK W/ AX-20'POD AND A LOT 15 y ' f%' � i \ f DISCHARGE PUMP BASIN / m Go Pv i LOT 11 / MT1 LC}"f MT TH#1 21/ NEW 25' LONG x 5' WIDEc•1.5' ABANDONED / EFFECTIVE DEPTH F1ELQ? f ® A ABSORPTION TRENCH MIN 14' SEPARATION FROM / / \ EXISTING TRENCHES ,- e j I� LOT'20 ` LOT 12 / \ J 10' UTILkT EASEMENT \\\ LOQ` 13 LOT is E NG I N E ERI NG \ /,•- / ,,. / \\ A B C *; 49 TH ;fir Benja i Schiller fP9``� •. CE 2592 i �il'T� • 5/16/23 • �•C.Cj\� \w� PRO FES 510NP� � 1 1 FCO 26.0 5.5 MH1 31.4 16.2 MH2 33.7 23.4 PB 35.8 27.6 MT1 53.0 39.6 MT2 40.3 36.6 0 50 100 iIE ME EM FEET 111=50' LEGEND CO - CLEANOUT FCO - FOUNDATION CLEAN( PB - PUMP BASIN FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE PERMIT # OSP221475 E N G I N E E R PID # 016-111-35 99.0 FINISH GRADE 97.7 ORIGINAL GRADE Ile i --INSULATION 11 DRAINFIELD ROCK 96.2 94.7 94.7 25' 83.7 GROUNDWATER 11/10/22 82.7 PROFILE AS -BUILT (NO SCALE) 49 • ' . Benja • ' Schiller • •' I �F� •. CE 12592 t��\`� PROFESSIONP�.® , 8119,01-1 co �00 , / S \ O / 75 M coO C6'70 / � o Q tri 0& �P, ��j� \ c0 Manhole a \". OO11 1P 0 04 / 6 0 / .O �, / a Wood fence (typ) / 2.0 off 6� / s " �Q �'`► Ramp / `S7 0 / 10. \ O Shed /) 00 fjf L a V s / J'.j- O \ RECERTIFIED 6-09-23 AS -BUILT NO CORNERS SET THIS DATE 1 hereby certify that I have performed a Mortgagee's inspection •. OF in accordance with ASPLS Standards of the following • •�S described property: LOT 11, BLOCK 5, • 49th •-S7 BRUIN PARK SUBDIVISION 0� Anchorage Recording Precinct, Alaska, and that the 00 • • • y • • • 4(9' • ' improvements situated thereon are within the property lines 00 and do not overly or encroach on the property lying 00-16 ... 0 0 ...:.-� . p p p Y Y g �► •. lizabeth L. 1Nalotka ; �o� ,o adjacent thereto, that no improvements on the property lying • r, adjacent thereto encroach on the premises in question and ���, • • 8036 — LS • • J�- AMthat there are no roadways, transmission lines or other SCALE' �Jr0' �Fa • • • • • •�o - visible easements on said property except as indicated • A ` � , , hereon. RoF FssIovo � g Dated at Anchors e, Alaska \�►�` th is 9th day of MAY , 2014. EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED FRED WALATKA &ASSOCIATES, L.L.C. �� PLAT ARE NOT SHOWN HEREON FB 23-2, pg 11-12 BEEngineers and Surveyors UNLESS OTHERWISE NOTED. FB 14-5, pg 3-5 907-248-1666 This drawing is a representation of conditions found at the time the mortgage location survey was performed. This document does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may disclose. The information contained on this drawing shall not be used to establish any fence. structure or other improvements. This drawing shall only be used for a single property transaction. Use of this drawing by the original client or by others at a later date without the consent of Elizabeth L. Walatka is a violation of Federal Copyright law. Unless gross negligence is discovered, the liability extent of the preparer is limited to the amount of fees collected for services in preparation of this product. 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 hftp://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP221475 Work Type: Septic Upgrade Tax Code Number: 01611135000 Site Legal Address: BRUIN PARK BLK 5 LT 11 G:2633 Site Mailing Address: 11301 POLAR DR, Anchorage Owner: BIRDS OF A FEATHER TRUST Design Engineer: FORGE ENGINEERING This permit is for the construction of: Effective Date Expiration Date: Lot Size in Sq Ft: Total Bedrooms: ent t` De pai•tnlent 11/30/2022 11/30/2023 20000 Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: 15 SuE Q p ) t2 Cz E �; Issued By: Date: Date: ll O Z�o Z Z M us MUNICIPALITY I C LITY 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. 016-111-35 Property owner(s) Janice Peterson/Birds of a Feather Trust Day phone 907-242-5630 Mailing address 11301 Polar Dr Site address 11301 Polar Dr, Anchorage, AK 99516 Legal description (Sub'd., Block & Lot) Bruin Park, Block 5 Lot 11 Legal description (Township, Range & Section) Lot Size 20,000 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (N all that apply) Absorption Field ❑X Initial ❑ Single Family (SF) ❑X (w/wo ADU) Septic Tank 19Upgrade ❑x Duplex Duplex El (D) Tank ❑ Renewal El 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. l� (Signature of property owner or authorized agent) Permit/Rush Fees: Date of Payment: Receipt Number: 055-Q6 p Permit No. oS p 02 1t-i*4s 3 _r)� Waiver Fees: kp PrbU � 0 L 3 $b Permit App_-'-:- Date of Payment: Receipt Number: Waiver No. November 21, 2022 MOA Development Services, On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Bruin Park Block 5 Lot 11 - 11301 Polar Dr Septic system design Dear On-Site Services Engineer: The owner of the above lot has a septic system that is in failure, so they are needing to build a replacement. The attached site plan identifies the location of the home and adjacent wells as the existing and proposed septic location. No conflicts exist between this proposed system and any other well or septic system, whether on this lot or adjacent lots. The ground surface on the lot slopes very moderately down from the house toward the back of the lot. There are no slopes greater than 25% within 50 feet downslope of either the primary o r alternate site. Contours are shown on the site plan showing the grade and direction of flow. Stormwater drainage will not impact this septic system. The new trench will be constructed parallel to the slope as much as possible. Wells on this and adjacent lots are shown. The new system will be a minimum of 50’ from all wells and surface water, and more than 5’ away from the septic tank. Please refer to the attached test hole log, plan and profile pages for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Benjamin Schiller, PE Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221475, Curtis Townsend, 11/30/22 , 8119,01-1 co �00 , / S \ O / 75 M coO C6'70 / � o Q tri 0& �P, ��j� \ c0 Manhole a \". OO11 1P 0 04 / 6 0 / .O �, / a Wood fence (typ) / 2.0 off 6� / s " �Q �'`► Ramp / `S7 0 / 10. \ O Shed /) 00 fjf L a V s / J'.j- O \ RECERTIFIED 6-09-23 AS -BUILT NO CORNERS SET THIS DATE 1 hereby certify that I have performed a Mortgagee's inspection •. OF in accordance with ASPLS Standards of the following • •�S described property: LOT 11, BLOCK 5, • 49th •-S7 BRUIN PARK SUBDIVISION 0� Anchorage Recording Precinct, Alaska, and that the 00 • • • y • • • 4(9' • ' improvements situated thereon are within the property lines 00 and do not overly or encroach on the property lying 00-16 ... 0 0 ...:.-� . p p p Y Y g �► •. lizabeth L. 1Nalotka ; �o� ,o adjacent thereto, that no improvements on the property lying • r, adjacent thereto encroach on the premises in question and ���, • • 8036 — LS • • J�- AMthat there are no roadways, transmission lines or other SCALE' �Jr0' �Fa • • • • • •�o - visible easements on said property except as indicated • A ` � , , hereon. RoF FssIovo � g Dated at Anchors e, Alaska \�►�` th is 9th day of MAY , 2014. EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED FRED WALATKA &ASSOCIATES, L.L.C. �� PLAT ARE NOT SHOWN HEREON FB 23-2, pg 11-12 BEEngineers and Surveyors UNLESS OTHERWISE NOTED. FB 14-5, pg 3-5 907-248-1666 This drawing is a representation of conditions found at the time the mortgage location survey was performed. This document does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may disclose. The information contained on this drawing shall not be used to establish any fence. structure or other improvements. This drawing shall only be used for a single property transaction. Use of this drawing by the original client or by others at a later date without the consent of Elizabeth L. Walatka is a violation of Federal Copyright law. Unless gross negligence is discovered, the liability extent of the preparer is limited to the amount of fees collected for services in preparation of this product. // // // // // // // // // // // // // // // // // // // // // // // // // //Benjamin Schiller CE 12592R EGISTEREDPROFES S I O N ALENGINEER 1"=50' 25' LONG x 5' WIDE, 1.5' EFFECTIVE DEPTH ABSORPTION TRENCH MIN 14' SEPARATION FROM EXISTING TRENCH CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND MT TH#1 BRUIN PARK, BLOCK 5 LOT 11 FEET 0 50 100POLAR DRIVE275 11/16/22 10' UTILITY EASEMENT 15' ACCESS EASEMENT 280 285 275 280 280 4-BDRM H O ME 1500-GAL FAP 2.0 ADVANTEX TANK w/ AX20 POD AND DISCHARGE PUMP BASIN DECOMMISSION EXISTING SEPTIC TANK NEIGHBORING SEPTIC AREA EXISTING WELL W/ 50' RADIUS SHOWN MT 14.0 ABANDON EXISTING FIELDS Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221475, Curtis Townsend, 11/30/22 LEGAL DESCRIPTION: PERFORMED FOR: DATE: PARCEL ID#: SOILS LOG AND PERCOLATION TEST 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 DEPTH (feet) TEST HOLE 1 DATE READING START TIME NET TIME (minutes) DEPTH to WATER NET DROP PERCOLATION RATE: (MIN/INCH) (inches)(inches) DATE OF MONITORING WAS WATER ENCOUNTERED? DEPTH TO WATER AFTER MONITORING IF YES @ WHAT DEPTH? 7.7 11/1 1 2 3 GM (SILTY SANDY GRAVEL) Professional Engineers Stamp: yes Bruin Park, Block 5 Lot 11 11/01/22 016-111-35 janice peterson 3:00 0 3:30 4:02 OB 30 Benjamin Schiller CE 12592R EGISTEREDPROFES S I O N ALENGINEER11/16/22 PERC TEST LOCATION TECHNICIAN: L. Tidwell 5 7 16 14.0 - 11/10/22 COMMENTS: 6" DIAMETER TEST HOLE PRESOAKED PRIOR TO TESTING SITE PLAN USCS SOIL CLASSIFICATION WAS VISUALLY DETERMINED 030 3 15 16 030 3 14 16 5 7 16 3 15 16 3 14 16 ML (SANDY SILT) Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221475, Curtis Townsend, 11/30/22 BRUIN PARK, BLOCK 5 LOT 11 TYPICAL TRENCH SECTION (NO SCALE) NOTES: 1. GRADE AREA OVER TRENCH TO DRAIN AWAY 2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2' WITH 2" OF INSULATION 3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY Benjamin Schiller CE 12592R EGISTEREDPROFES S I O N ALENGINEER5' 1' 1'-6" 1'-6" DESIGN FACTORS:SYSTEM REQUIREMENTS: 600 GPD PEAK FLOW PERK RATE: 7.7 MIN/IN APPLICATION RATE: 5 GPD/SF 5-WIDE PRESSURIZED FIELD 1,500-GAL ADVANTEX TANK W/ AX-20 POD BOTTOM OF TRENCH: 3' BELOW GRADE FLOW LINE ELEVATION: 1.5' BELOW GRADE TOP OF TRENCH: 1.0' ABOVE GRADE 600 GPD / 5 GPD/SF / 5' WIDE * .78 RED FACTOR = 18.7 LF TRENCH REQUIRED (25 LF SPECIFIED) 1.25" PVC w/ 12 x 3 16" HOLES EVENLY SPACED @ 2' OC 11/16/22 DRAINFIELD ROCK GEOTEXTILE FABRIC INSULATION Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221475, Curtis Townsend, 11/30/22 Municipality of Anchorage Page I offs_ DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: ~4::;~'~'4:~j~ PIDNumber: ~:)l (.~ iii ~ Name: ~i~Upgrade -J,~'-'l~,~ ~ ~~ ~, ~~ ,Wastewater System: D New Address: , ~~, ABSORPTION FIELD Phone:~. ~~~ ] ~o ~.epTrench ~ Shallow Trench ~BeO ~MounO ~Other LEGAL DESCRIPTION SoilRatin,: ~-~PD/Sq. Ft. Total Dopthfromorigin~i~d~: -- Subdiv~iop: ~ _ . Depth to pipe bottom from originalgra~e~ Gravel depth beneath pipe Township: I Range: Soction: Fill added above original grade:, Gravel length: WELL: D New D Upgrade Gravel~~ ~[ Nu~lines:, Distance beyeen lines: ~;~~ Pipe material~J~ ~ i B.C): Total Depth: Ft. Cased To: Ft. Total absorption area:I ~ SQ. Ft. ~ ~~ Driller: Date Drilled: Static Water Leveh ~~7 ~. SEPARATION DISTANCES ~tic ~ ,o~ing ~ Well j~ j[~ ~ ~ ~1~ Mate~ Number o~artments: Surface Water l~ [~ -- ~ ~ LIFT STATION Lot I Li~e ~ ~/ ~. ~ ~ Size in gallons: Manufacturer: ~~ Foundation ~ ~ ~ ~' ~ "Pump on" le~off" level at: High water alarm at: CurtainDrain ~ ~,~ ~dO~ _ , Pu~Model lE,ectricallnspectionsperformedby: Location and Description:  Assumed Elevation: i~~ ~, EN~L 2nd~ ~ fl HA ER, Department of Health and Human Services approval t;~'. ' ~'~ Reviewed and approved by: _ i 72-013 (1/91) MOA 25 t PermitNo. ~'~'~t~ Page ~ of ~ Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report NO, 72-013 A (2/91) MOA 25 PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST 1 2 3 4 5 6 7 10 11 12 13 14 15 16 17 18 19 Township, Range, Section: SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? s L IF YES, AT WHAT O DEPTH? p E M 0 nit0 r in g ? .L.,-'r-.~/Date: Gross Net Depth to Net Reading Date Time Time Water Drop 2- :g ( 2- ~,,..., '-/'&. v< r 20 ~ (minutes/inch) PERC HOLE D AMETER (¢t COMMENTS PERCOLATION RATE __ TEST RUN BETWEEN __ PERFORMED BY: S & S ENGINEERING ""'"'~'~/~//~ 17034 Eagle River Loop Roa~ bio. ~0~, ~ ACCORDANCE WITH A~I~§~ARIS,,AN, I~,tt.~I~iI~I.7(~'UIDELINES IN EFFECT ON TH{S DATE. 72-008 (Rev. 4/85) CERT,FV mAT TH,S TEST WAS PERFORMED DATE: ~ "'" \ O--c:~Q"'~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PAGE 1 OF 1 PERMIT NUMBER:SW920120 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:BROADY JAMES T & MARY J OWNER ADDRESS:il301 POLAR DR ANCHORAGE, ALASKA 99503 DATE ISSUED: 6/03/92 EXPIRATION DATE: 6/03/93 PARCEL ID:01611135 LEGAL DESCRIPTION: BRUIN PARK BLK 5 LT 11 LOT SIZE: 20000 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM 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 (iSAACS0). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: ISSUED BY' ~ L~6~ ENGINEER MUST PROVIDE ADDITIONAL SOIL TEST AROUND NEW INSTALLATION. PROPERLY ABANDON OLD TRENCH AND SEPTIC TANK. HAA WILL NOT BE PROCESSED UNTIL RECEIPT OF INSPECTION REPORT. DATE: DATE' HEALTH AUTHORITY APPROVALS SEWER &WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN ROBERT SHAFER, P.E. ROGER SHAFER, P.E. CIVIL ENGINEERS May 26, 1992 (907) 694-2979 FAX 694-1211 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ATTN: Susan Oswalt 825 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 REFERENCE: RECEIVED MAY 2 8 1992 Municipality of Anchorage Dept. Health & Human Services Lot 11; Block 5; Bruin Park subdivision; Septic upgrade permit requeSt Dear Susan~ This l~tter is in r~sponse to the comments on your transmittal sheet p~rtaining to the review of the referenced property. The groundwater monitoring data collected on the test holes are as follows: THI TH2 April 15, 1992 dry dry April 22, 1992 dry 4.0' May 13, 1992 dry 4.5' May 21, 1992 dry 9' The t~st hol~s were just excavated on April 8, 1992 when there was still a heavy snow cover over the property. Shortly thereafter spring break-up commenced in full force and the snow rapidly melted. The area in the backyard of this property where the septic upgrade is proposed is a naturally depreSsed ar~a which allowed the run-off to flow toward and into the test pits. By April 22, 1992 the snow cover had melted considerably and the water level in the percolation hole for THI was full nearly to the surface while the water level in TH2 was at 4 ft. Although at first glance it appeared groundwater levels had risen dramatically, we feel these elevated levels were a reSult of run-off as opposed to elevated groundwater levels. This is evidenced by the following conditions: I. The monitoring tube in THI has r~mained dry throughout this period. Apparently the monitoring tube has been sealed and the ground sloped away adequately enough to prevent surface water infiltration. This is opposed to TH2 in which the monitoring tube was influenced by surface run-off. 2. The water level in the percolation hole for TH2 decreased in elevation during a time when groundwater levels throughout the Municipality have continued to rise. 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 Page Two Lot 11; Block 5; Bruin Park Subdivision; May 26, 1992 The ~ter levels within the existing septic system which is in close proximility to TH2 were lower in elevation than the water within the perc. hole for TH2. At this time the property is free of snow cover, pert. hole #2 is nearly dry and yet, we are near this years peak groundwater levels for the Municipality. Therefore, we feel the proposed septic upgrade as originally designed is st~ the best option for wast~wat~r disposal for the referenced property. The d~sign utilizes the less dense soils at a deeper depth and y~t maintains the required separation to groundwater as primarily evidenced by groundwater monitoring with TH2. However, at this time we propose filling the area around the proposed leachfield and directing the surface run-off away from the n~w leachfield in conformance to AMB15. 65. 060 A.~.d. If you have any questions or require additional information for your review, please contact us. Sincerely, ROGER J. SHAFER, P.E. RJS/gm ROBERT SHAFER, P.E. ROGER SHAFER, P.E. April 16, 1992 CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 HEALTH AUTHORITY APPROVALS SEWER &WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 REFERENCE: Lot 11; Block 5; Bruin Park Subdiv~ion Request you issue a Conditional Health Authority Approval and a permit to upgrade the septic system serving the referenced property. As a result of an assessment performed by Flattop Technical Services the existing system was found to be inadequate for approval. There exists a 4 bedroom house on the property. Although the original septic system was permitted and approved for a 3 bedroom house, there was a 4 bedroom approval issued on May 16, 1979 for the property. Therefore, we have not shown an alternate 4 bedroom site on the property. we do not anticipate any adverse effects on n~ighboring properties by the installation of the proposed septic system. In fact, we will be ~mproving a condition in which the existing s yst~m is only approximately 64 ft. to a n~ighboring well. If you have any questions or require more information for your review, please contact us. Sincerely, RJS / gm 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 SCALE POLAR DRIVE DECK UPGRADE Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTIO~J~ ~..~'-r- II 9 13 Township, Range, Section: SLOPE WAS GROUND WATER ~ I ENCOUNTERED? ~ ~) , S IF YES, AT WHAT O DEPTH? p 19 2O COMMENTS Deplh lo W~p,c. Alted:.,_,/ Montor nD? E SITE PLAN Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE ~ (minutes/inch) PERC HOLE DIAMETER S & S ENGINEERING PERFORMED BY; .... I I/U~4 Eagle River Loop Road No. 204 WITH~I~J~'I~iVJI~I~ii~[~rI~GUIDELINES~ IN EFFECT ON THIS DATE, ACCORDANCE 72-008 (Rev, 4/85) CERTI F Y THAT I,~k_.T,~ES~ WAS PER FOR M E D IN DATE: Municipality o! Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL O E SC R I PTI 0 N :'~/-~?~- 2 3 4 7 8 10 13 14 16 17 19 20 SLOPE Township, Range, Section: ENCOUNTERED? L ~'~ ~'~"~ IF YES, AT WHAT O I DEPTH? p Depth lo /"-.~,'/~5'['q' · Monitoring? ~7 Dote I ' SITE PLAN Gross Net Depth to Net Reading Date Time Time Water Drop -?._ ~2.~ Lc:) ~, ~1 ~ ~'/,~" ~/~" ~;~ ,, PERCOLAT,ON RATE TEST RUN BETWEEN _ (minutes/inch) PERC HOLE DIAMETER ~ FT AND ~T COMMENTS '~. ~~~~ t, PERFORMED BY: ~-~'~- ~lver/AlasKa DD377 ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE, CERTIFY THAT~THIS TEST WAS PERFORMED IN DATE: 72-008 (Rev. 4/85)  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 1P'oNE I ~kr~EW MAILING ADDRESS LEGAL DESCRIPTION ~ ~ DISTANCE TO: l O0 r ~ ~ ! O~ Liq. capa~{t~n¢l~ns IF HOME,DE: ,n~,dXel,~ Width Liquid depth Material Liquid capacitv in gallons Neares~ lot lin~ PERMIT NO~ 9 Well r Foundation ~ t Length of each ~ Total length of li~ Trench wid~ ~ inches Distance ~t~e~ines ~ Top of tile to finish grade ~ , Material beneath tile ~inches Total effect ~a~o~ on area Length J~ Width Depth PERMIT NO. ~ Type of crib Crib diameter Crib depth Total effective absorption area ~ DISTANCE TO: Well Building foundation Nearest lot line ~ Cl~ Depth Driller Distance to lot linel~_ PERM T.~NO ..... ~ Absorption area(s) ~ DISTANCE TO: Building foundation Sewer line Septic tank ( OO [ O0 OTHER so~ L TEST .AT~.~ ) , tSo ~ REMARKS ' APPROVED ~ ~ DATE LEGAL 72-013 (Rev. ~ 78) L~IELL PERMIT NO. ( ?80450 APPLICANT JAMES T. BROADY LOCATION POLAR DRIVE ~-~1_!~4 T I_~.. T PAL T T~' ,_3F A~-4C:.HC, F-':AE'iE.___ J ~ . DEPARTMENT Or HEALTH AND ENVIRONMENTAL Pc'OTEI_-:TIO~ _~2'10 LA TOUC:HE #C-2 RI'lC LEGAL LOT ii BLOCK 5 BRUIN PARK S/I:' LOT SIZE 22E10~l~ SQUARE FE~T TYPE OF SOIL RBSORBTION SYSTEM IS' TRENCH ~ g~J-qS f,18~,:',IMUM NUMBER. OF BEDROOMS = ~ SOIL RATING (SQ~BR)= 15e " ' = 12 LEt413TH= ~ GRR'-tEL DEPTH----':- ~. THE LENGTH DIHENSION I5 THE LENGTH (IN FEET..') OF THE TRENCH OR DRRINFIELD. THE DEPTH OF R TRENCH OR PIT I5 THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOH OF THE B{CRVRTION (IN FEET). THERE I5 NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH 15 THE HINIHUH DEPTH OF GRAVEL BETWEEN THE OUTFRLL PIPE AND THE BOTTOH OF THE E~',CRVRTION (IN FEET). ~::EC~.U I RED SEPT I PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. - T~Cm (~) I r-4SF"Em3TIOt4$ ARE RE~:!LIIRED 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 i00 FEET FOR A PRIVATE WELD OR i50 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. WELL LOGS 8RE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ~0 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS 8RE AVAILABLE TO INSURE PROPER INSTALLATION. F:'ERrq I T E~<P I RES DECEMBER Z<l.. ~L978 I CERTIFY THAT l: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS. VS. 2 Performed For Leaal ~escrtntton: This Form Renorts Soils Loq Yes 2204 Cleveland Anchorage, Alaska 99503 Pam Broady Oat~ Performed 10-~-77, _ Lot 11 Block 5 _Subdt¥tst0n__B~uin Park Subd~vd~(nn - Percolation Test ~eeth Feet Soil Characteristics 4-- 6 8-- 10-- 14-- 16 18-- 20-- 6" Peat - Reddish silt Slightly Silty Sand with occasional gravel Slightly Silty Sand Bottom of Test Hole Was Ground Water Encountered? No , I~ Yes, At what Denth? Readfnq Date Percolation Rate Gross Time Pttnute Net Time Depth to HZ0 Net Dron Prnnosed Inst--: Seenaae Pit Drain Field Deoth of Inlet Deot-)~"l~--i)~TTom Of Pit Or---~F~ CA~ENTS: 150 suq.u_9~~ feet drainaq~ area Test Performed Data Certified BY: Date: CTL MUNICIPALITY OF ANCHORAGE Oft � Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 01611135000 Legal description Bruin Park Block 5 Lot 11 Site address 11301 Polar Dr. Expiration Date: 9/21/2023 Current property owner(s) WALLACE JASPER & ROUGHT MICHAE X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: Original Certificate Date: 6/21/2023 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA Approval June 2022 MUNICIPALITY OF ANCHORAGE Development Services Department - r Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 01611135000 Legal description BRUIN PARK BLK 5 LT 11 Site address 11301 POLAR DR Expiration Date: June 15, 2023 Current property owner(s) BIRDS OF A FEATHER TRUST The On-site system(s) is/are approved for bedrooms X Conditional approval for 4 bedrooms, with the following stipulations: Comments or advisories: 1. Submit water results for sample taken in December 2022 2. System to be installed per OSP221475. Permit to be closed prior to full COSA approval. By: Ld — F'O(L ()& a !a 0Gtc-6-v►�vs S Original Certificate Date: 12/8/22 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA Approval June 2022 MUHMPAUTY OF AHCHORAV3 IE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 016-111-35 Complete legal description Bruin Park, Block 5 Lot 11 Location (site address) 11301 Polar Drive, Anchorage, AK 99516 Current property owner(s) Birds of a Feather Trust/Janice Peterson Day phone (907) 242-5630 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY: ❑■ Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: 0 Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel * Plastic ❑ Concrete ❑ Fiberglass Age <1 yr - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench R Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ■❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ -2W k AQ + 3N,_) Date of Payment l`a 1 S)22 C& CW6113 COSA # 05C22 J 0 Waiver Fee $ Date of Payment Waiver # COSA Application—June 2022 COSA Checklist Legal Description: Bruin Park, Block 5 Lot 11 Parcel ID: 016-111-35 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA 9 Well log is filed with Onsite (or attached) Date drilled 7/30/93 Total depth 185 ft Cased to 185 ft ❑� Sanitary seal is functioning correctly ❑■ Wires are properly protected Casing height (above ground) >18 in. Date of flow test for COSA 8/14/22 Static water level at beginning of test 84 ft. Comments B. TANK DATA Measured operating fluid level in septic tank N/A Date of pumping NEW INSTALL ❑ Required maintenance completed, if AWWTS Comments: Installed 4/24/23 D. ABSORPTION FIELD DATA Which system tested (date installed) 4/24/23 0 ALL standpipes present per record drawing Total measured depth from grade 4.3 ft (max) Measured depth to pipe invert from grade ft (min) 0 N/A — pressurized field. ❑ Per record drawings, field is insulated. ❑■ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced N/A gallons N/A date Any rejuvenation treatment (past 12 months) N/A If yes, enter date Comments/Deficie COSA Checklist June 2022 Well production at time of test 5.7 gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes 0 No ❑■ Coliform bacteria is Negative Nitrate mg/LNitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Ekl`utna Engineering Date~ 2 `��, C. LIFT STATION LTRe fired maintenance completed Age of lift station A years Lift station material Comments: Adequacy test date NEW INSTALL Results ❑ Pass Ruuid depth prior to test in ed gal New fluiNepth in Elapsed time\ed Final fluid de Absorption radFIELD STATCOVERYEffective ded dr ings) in Effective deinEffective dein E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' [_01 Yes if No Community Sewer Manhole/Cleanout > 100' 0 Yes if No ft 501 Yes if No ft Neighboring Tank > 100' ❑ Yes if No ft Private Sewer/Septic Line > 25' ❑ Yes if No ft Absorption Field on Lot > 100' [j] Yes if No ft Holding Tank > 100' C Yes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' [ifl Yes if No ft no Yes if No ft ft If tank or field is under driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' nE Yes if No ft ❑ Yes if No ft ❑ N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' [_01 Yes if No ft Surface Water > 100' 0 Yes if No ft Tank to Property Line > 5' [E Yes if No ft Wells on Adjacent Lots: Field to Property Line > 10' Q Yes if No ft Private Wells > 100' FN -1 Yes if No ft Water Main > 10' 0 Yes if No ft Community Wells > 200' Q Yes if No ft Water Service Line > 10' 0 Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS G. CERTIFICATION & 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, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firin Forge Engineering Engineer's Printed Name COSA Checklist—June 2022 Benjamin Schiller, P.E. Phone (907) 522-7773 Date 5/18/2023 AV � o49 Benjarr='Schiller .� CE 12592 P .... • P�F'Mr kkROFESSION.® Bruin Park, Block 5 Lot 11 016-111-35 5.7 7/30/93 185 185 8/14/22 Eklutna Engineering 84 8/17/22 N/A NEW INSTALLATION TO BE INSTALLED NEW INSTALL N/A N/A N/A N/A NEW INSTALL > TO BE INSTALLED Benjamin Schiller, P.E. Conditional COSA requested for later installation of system under Permit #OSP221475 (907) 522-7773 December 1, 2022 MOA Development Services, On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 12/1/22 Subject: Bruin Park B5 L11 - 11301 Polar Dr Conditional COSA request Dear On-Site Services Engineer: The owners of this property are selling their home. They had a closing date and agreement set up before they understood the difficulty of replacing their septic system. Due to the winter weather, work has been delayed. We are requesting that a conditional COSA be issued so that the sale of the home can proceed on time, with the provision that the septic system be replaced in the spring. The field is in failure, but there is no danger of contamination of adjacent properties in delaying the replacement by a few months. We have applied for a permit to replace the system (OSP221475), and have three quotes from contractors. 150% of the highest quote has been placed in escrow. This will be sufficient to guarantee that the system can be replaced. At that time, we will submit an updated survey for the property. Sincerely, Benjamin Schiller, PE ESCROW HOLDBACK AGREEMENT To: Municipality of Anchorage Agreement between: Eric R. Peterson and Janice M. Peterson (sellers) Michael Rought and Jasper Wallace (buyers) Municipality of Anchorage Property Address: 11301 Polar Drive, Anchorage, AK 99516 File No. 1865992 Amount withheld: $59,625.00 The undersigned parties authorize Stewart Title to escrow funds in the amount of $59,625.00 from the seller For the purpose of: Installation of new septic system It is the sole responsibility of the undersigned parties to provide invoices to Stewart Title for payment. Upon receipt and with Municipality approval, Stewart Title shall pay invoices for the above-mentioned work. In the event parties are requesting to be reimbursed for invoices they paid out of pocket, Stewart Title will require evidence of paid invoices before any reimbursement is paid. Once work is complete and invoices paid; any excess funds will be refunded to the seller. The undersigned parties hereby jointly and severally indemnify and hold Stewart Title harmless from and against all costs, damages, judgments, attorneys' fees, expenses or obligations of every kind and descriptions which, in good faith, it may incur or suffer in connection with this escrow holdback. Funds will not be released without full MOA approval. Dated: Sellers: Eric R. Peterson Janice M. Peterson Buyer: Michael Rought Jasper Wallace READ AND APPROVED BY: APPROVED BY: Municipality of Anchorage Stewart Title of Alaska S�_)t e o� 1 Samantha Buchite, Escrow Manager QUOTE Rock Rabbit Excavating & Construction, LLC 460 S August Circle Wasilla, AK 99654 218-851-5456 Proposal Submitted to: The Peterson Household Phone: 907-242-5630 Date: 11/29/2022 Location Address: 11301 Polar Drive Anchorage, AK 99516 Email: Proposal Number: 1505 Scope of Work • Equipment Rental • 1500 Gallon Advantex Tank • AX-20 Pod • 5x20 Pressurized Field • Rigid Insulation • Licensed Electrician for Tank Controls/Alarms *Specific tank and pod dependent on availability Total: $39,750 7400 Old Hillside Way Anchorage, AK 99516 (907) 345-1890 info@aplusak.com Estimate ESTIMATE#1009579096 DATE 12/02/2022 PO# CUSTOMER Nora Delolli (907) 441-4198 SERVICE LOCATION Nora Delolli 11301 Polar Drive Anchorage AK 99516 (907) 441-4198 DESCRIPTION To excavate and install a new 1500 gallon HDPE FAP 2.0 Advantex Tank w/ AX20 Pod and pump basin, completely decommissioning the existing tank per UPC code. To install one trench that is 25' long X 5' wide X 1.5' effective and to meet ALL engineer specifications per design dated 11/16/22. *50% deposit required prior to the start of commencement of work *Includes price of required pumping *includes surveying for septic install *Add an additional $600 to this estimate if the existing tank has to be removed and hauled to the landfill. -Will decommission the tank in place if room allows. If you have any questions or concerns, please do not hesitate to call our office at the number listed above. We are not responsible for underground utilities unless located by the Locate Call Center or settlement over disturbed areas. A 3.7% per handling fee will be charged if paying by credit card (we accept all major credit cards), and a monthly 3% finance charge will be added to all past due invoices. Tank & Drainfield Description Rate Total CUSTOMER MESSAGE * Please note that 50% is due upon acceptance to secure a scheduled slot *This estimate is based on the current design only * Any work outside of this scope will need to be reapproved by the owner prior to continuing work. *Estimate does not account for any ground water problems if they occur. If you have any questions or concerns, please do not hesitate to call our office at the number listed above. We are not responsible for underground utilities unless located by the Locate Call Center or settlement over disturbed areas. Estimate Total:$37,758.00 Quote Territory North Constructors LLC PO Box 3750 Palmer, AK 99645 622-2213 Phone 632-4492 Mobile Proposal Submitted to Phone Date Mr. & Mrs. Peterson 11/29/2022 Street/ Mail Address Mobile Proposal # 11301 Polar Dr 907-242-5630 2227 City, State, Zip Email Anchora e, AK 99516 Scope of Work Total Mob/Demob Equipment As available by supplier, Install 1500 Gallon Advantex Tank with AX -20 Pod Decommission existing tank in place per MOA code. Install 5x25 pressurized field, rigid insulation and backfilled. Wire tank controls, Alarms by Licensed Electrician $38,500.00 Assumes: Work around existing fence, install effluent line under fence without removal. Exclude: Organic Haul off, Landscaping, Topsoil, Sod Terms: 7 days Balance due, 1.5% interest charged monthly until Acceptance of proposal will constitute a binding contract and will be your bala ce is paid. notice of intent to lien if payment is not made according to contract. Signee is liable for all legal fees incurred during collection. ti mp Karets, Signature of Home Owner Co iensed by the Contractor's State License Board. Any questions concerning a contractor may be referred to the register of the board whose address is: Contractors State License Board 3601 C street, Anchorage, Alaska All work to be completed in the manner of a craftsman according to standard practices. Any alteration or deviation by owner or client, oral or written, from the above specifications will become an extra charge over and above the estimate. All estimates contingent on strikes, accidents or delays beyond our control. Our workers are fully covered by Workmen's Compensation insurance. MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this —8�$ay of� of 20,by and between J 0� i c �4' S E' 1rein the "OWNER," and the Municipality of Anchorage, kerein the "MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) 15.65365_ In consideration of the mutual covenants contained herein, the parties to this Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as Advantex System located at (legal description) Bruin Park, Block 6 Lot 11 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). Owner agrees that only maintenance and repair personnel approved by the Municipality 4� 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. 05/1812018) Page 1 of 3 Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. t Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be " assessed in accordance with AMC 14.60.030. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. 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. 0511812018) Page 2 of 3 OWNER: ` , ,, B- i p,tsv,- � gnatuxe) lt(print name) STATE OF •P,�I--- ) ss. Date: -a-a The foregoing instrument was acknowledged before me this gv'4-day of 20j23 --by K b•ecco,-4 inocs,ret earn( . S IlAo- NOTA-"PUBLIC FOR My Commission expires: REBECCAA. R400REHEAD Mgt@ 9Y PWb1 , S' of New York Chemung County No. OIN406293200 Commission Expires December 02,20—(:R6— MUNICIPALITY: 2,20 MUNICIPALITY: BY: (signature) C��'-Tl T o 1,✓ -,•s f�,n (print name)' (rev. 05/18/2018) Date: 2 -Z-0 2 Z Title: r j �-,rc— Page 3 of 3 Parcel I.D. # MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-S[ta Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 (907) 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILLY DWELLING 016-111-55 1. GENERAL INFORMATION Complete legal description BRUIN PARK: LOT 11. BLOCK 5 Location (site address or directions) 115Ol POLAR DR. Property owner Mailing address Lending agency Mailing address DOUG & SUE LEWIS C./O PARAGON PROPERTIES / / ~,/) / y~phone (907) 562-2058 Day phone Agent KRIS ABEGG W./ PARAGON PROPERTIES Address Dayphone (907) 549-1200 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 4- 3. TYPE OF WATER SUPPLY: Individual well xxx Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- lng to the legafity and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding Tank Community on-site Public sewer NOTE: XXX If community wastewater system, provide written confirmation from State ADEC ing to the legafity and status of system. 72q325 (Rev. 1/91) Front MOA ~h~21 Computer Version Note: Alaska Water and Wastewater Consultants, Inc. shall be paid t~¢;-at, or prior to, closing for the engineering services provided. 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, funcfional and adequate for the number of bedrooms and type of structure indicated herein. I further vedfy that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspeg~ion, the on-site water supply and/or wastewater dfsposal system is in compliance with all Municipal 8[¢d State codes, ordinances, and regulations in effect on the date of this inspection. / ./]k/! . Name of Firm ALASKA WAT, E~& W//A~T/V~NCE~ CONSULTANTS, INC. Phone ~(907)337-6179 ./ I// Address 6901 DEBARR RQ~AD, SU~E/¢2~ /~f~H~DRAGE, ALASKA 99504 , / Engineer's Signature ~'~ J Date // // ~ In conducting this evaluation, AVCA/C, Inc,/atl~m el~ d to provide a thorough, conscientious engineerihg analysis of the system in accordance with ADEC and MOA DHH¢ Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, ground water levels that may fluctuate during the year, and the water usage of tha family being served by the system. These conditions are outside the control of ,~, // of the system, nor do they guarantee that there are no hidden defects or encroachments. AWW¢, Inc. can therefore not provide eny warranty for future estimate of how long tho ...?~ The content of this report is for the sole benefit of the owner listed above. Any reliance upco or use of this report by any other person or party is not authorized, ~. ./~ .~. . ~ ~ ...... '(/~.~'..~/¢ffrl '- A. U-"'dCness..: bedrooms nor will it confer any legal right whatsoever. 6. DHHS SIGNATURE Approved for /"7L Disapproved Conditional approval for bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a caurtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Munidpality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA ¢Y21 Computer Version RECEIVED Legal Description: A. WELL DATA Well Type PRIVATE Log present (Y/N) Total depth 185' Sanitary seal (Y/N) Date of test Static water level Municipality of Anchorage NOV 0 6 2000 DEPARTMENT OF HEALTH & HUMAN SERVICES ,~ Environmental Services Division MUNICIPALITY OF ANCHORAGE 825 "L" Street, Rm 502 Anchorage, Alaska 995~fl~{]~II~BT-~.[~I~VICES DIVISI( Health Authority Approval Checklist BRUIN PARK: LOT 11, BLOCK 5 Parcel I.D.: 016--111--35 IfA, B, or C, attach ADEC letter. ADEC water system number YES Date completed Cased to 185' YES FROM WELL LOG 7/30/9,3 7/30/93 Casing height (above ground) Wires properly protected (Y/N). AT INSPECTION 10/12/00 87' 87' N/A 1 8~ YES Well production 10 WATER SAMPLE RE~]~TS: Coliform "~ Nitrate Date of sample: B. SEPTIC/HOLDING TANK DATA Date installed 6/18/92 Tank size 1250 GAL. Foundation cleanout (Y/N) Date of Pumping 10/11/00 C. ABSORPTION FIELD DATA Date installed 6/18/92 Length 99' Width g.p.m. 6.5 ,, _.~- ~ ~/~ ~tJ 0 ) Other bacteria ~-~ Collected by: A.W.W.C., INC. YES Depression (y/N) Pumper. A+ lEAST/WEST1 Soil rating (g,p.d.lff2 or flNbdrm) g.p.m. Number of Compartments 2 Cleanouts (Y/N) YES NO High water alarm (Y/N) N/A .45 Gravel thickness below pipe I'BELOW: EXISTING GRADEJ System type DEEP TRENCH 7' Total depth 13.6'-13.9' Effective absorption area 1386 SQ. FT. Monitoring Tube present (Y/N) YES Depression over field (Y/N) Date of adequacy test 10/12/2000 Results (Pass/Fail). PASS _ For 4 Fluid depth in absorption field before test (in.); Fluid depth 15/64 (ins) Minutes later: Peroxide treatment (past 12 months) (Y/N) 72-026 (Rev. 3/96)* Computer Version NO Bedrooms 6.5/54.5 Immediately after* * ?'~/~-~ gal. water added (in.):22.5/s7'25 1000 Absorption rate = 600+ NONE KNOWN If yes, give date · 1586 OALLONS TOTAL Date installed Size Manhole/Access (Y/N) ~at*_ "Pump off' level at* High wa~ ~'Datum __. ....C. yeles'~sted E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer/septic service line 10o% On adjacent lots 1 O0% 100'+ On adjacent rots 100% N/A Public sewer manhole/cleanout N/A 25'+ Lift station N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation 5'+ Property line 5'+ Water main/service line, 1 O'+ Surface water/drainage 100% SEPARA~ON DISTANCES FROM ABSORPTION FIELD ON LOT TO: Property line 1 O' Building foundation 10'+ Surface water 100'+ Curtain drain NONE KNOWN F. ENGINEER'S CERTIFI/~I~TI~'-/ I certify that I ha)~ ~t~r~i~ ~r field Inspections and review of Municipal re/~orc slt~a/Jt~le ~o~ systems are in conformance wi,h MOA HA~ gu' t~ti~/~fl~ ~n this date. Engineer's NaTE I ~ JEFFREY A. GARNESS Date I( /I O0 __ Absorption field .Wells on adjacent lots 100'+ Water main/service line Driveway, parking/vehicle storage area 10'+ Wells on adjacent lots 100% 10'+ HAA Fee $ Date of Payment ////~'~ /'~ 72-028 (Rev. 3/96)* Computer Veto[on Waiver Fee $ Date of Payment Receipt Number ,~t~ CT&E Environmental Services Inc. CT&E Ret.# Client Name Project Name/# Client Sample ID Matrix Ordered By PWSID Sample Remarks: 1006390001 AK Water & Wastewater Consultants Inc. Bruin Park L11, B5 Bruin Park L11, B5 Drinking Water Client PO# Printed Date/Time 10/17/2000 15:20 Collected Date/Time 10/12/2000 15:00 Received Date/Time 10/12/2000 15:50 Technical Director Stephen C. Ede Released Allowable Prep Paralysis parameter Results PQL Units Method Limits Date Date Init Waters Department Nitrate-N 0.500 U 0.500 mg/L EPA 300.0 10 max 10/12/00 SCL Microbiology Laboratory Total Coliform 0 col/100mL SM18 9222B 10/12/00 JDT · DEPARTMENT OF HEALTH & HUMAN SERVICES ~-t,~[!~/,, Division of Environmental Services ,. ............ ~:./-, ...... · --" On-Site Services Section ~' ........ 9-6650 Day phone Day phone commun !.:~,,~ .:. ,. ii':.NOTE~. ~' ~:i.~lfcommUnitY Wastewater sYStem~~ proVide written ~ ~' ~;~;::'~' attesting*to thelegaiityand status of system.~" 72-028 (Rem. 1/91) Front MOA ~21 5. STATEMENT OF INSPECTION BY ENGINEER . .._; ~-, i,~...:, .? As certified by my seal affixed herelo,and as of {he'validation date shown below, I veriht thai my investigatiOn 'of this, Hea!th?Auth'od~' Approval application shows that the on-site water sUpply and/or wastewater dis~ml ~ystem is ~fe; functional and adequate for the number of b~moms and Wpe of structure indi~t~ heroin. I fuRher veri~ that based on the information obtain~ from · the Mumc~pah~ of A~omge'fll~'a~.from my investigation and inspection, the on-site'water supply ano/or wastewa~r d~spo~[ s~em is in compliance with all Municipal and State codes, ..... ~'~"~ .......... "' ~ .... ~'~'"~"; ': "~" "'~ '--" " ~' · Phone.,, -,~/~Z' ... Date l ...................... Kenneth M CE 711, ....... ............ ~ .......... :_. ~ .. ....... ':; ,:;~he MunLblpal ..... . and Human Services (DHHS) ~ssues Health Authority the representations given in pa..ragra.,Ph~5,above bY an I: ~isterad in the state~f:Al~'The DHHS does this as a courtesy to purchasers of hOmeS an~J {heir lendin'g ~to ~ti~. {~rt~in f~leml and state r~luimment~. Employ~ of DHHS do not conduCt'inSPection~?'~al~z~ ~lata before a certifiCate is issued. The Municipality of Anchorage is not responsible for errors or OmiSSions in the PrOfesSional engineer's work. 72~25(Rev. 1/91) Back MOAI¢21 Legal Description: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division (907,) 825"L" Street, Room 502 · Anchorage, Alaska 99501· Health Authority Approval Checklist , A. WELL DATA Well type Log present (Y/N) Total depth Sanitary seal (Y/N) If A, B, or C, attach ADEC letter. ADEC water system number [ Cased to /~"- Casing height (above ground) Wires properly protected (Y/N) ~/ Date of test Static water level Well production FROM WELL LOG AT INSPECTION /o g.p.m. ,fi,"/ fi- WATER SAMPLE RESULTS: Coliform Date of sample: B. SEPTIC/HOLDING TANK DATA Nitrate ~.~ m,~ /I Other bacteria Collected by: _ ,,zff~J Date installed /,//~/.q.~2 Tanksize /,,2~'-~ Number of Compartments 02- Cleanouts(Y/N)./ Depression (Y/N) 4 High water alarm (Y/N) Foundation cleanout (Y/N) / . Date of Pumping 3" Pumper ~Z a-¢~_ q C. ABSORPTION FIELD DATA Date installed j,/~ / q.9-. Length ~ ~ Width Soil rating (g,p.d./ft' or ft/bdrm) , ~S'~ System type ~ Gravel thickness below pipe 7 Total depth / Effective absorption area /J' 8~ Monitoring Tube present(Y/N) / Depression over field (Y/N) ~ Date of adequacy test ~ ~'/~/f'~' Results (Pass/Fail) /9 For ,~ bedrooms Fluid depth in absorption field before test (in.); ,,2t. ~ Immediately after 700 gal. water added (in.): /~/, ?fi- Fluid depth ~ g~..~' ' (ins.) Minutes latet:~-~/zi'~;;~?%.'.kb~rption rate = 4oo~ g.p.d. Peroxide treatment (past 12 months) (Y/N) If yes, give date D. LIFT STATION "~lled Size in gallons Manhole/Access (Y~)~'""~ ~.~p on" level at* High water alarm level at* *Datum ~ Cycles tested E. SEPARATION DISTANCES "Pump off' level at* SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer/septic service line /o~ / · On adjacent lots /oo ' + /~o * 4- '. On adjacent lots /oo '-~ Public sewer manhole/cleanout /-///~ /~ '~ Lift station x~/~ /-. SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5/~, ~ t Property line /o / -/- Absorption field Water main/service line ?o t./. Surface water/drainage /aa ' ~ Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation Water mitin/service line Surface water Curtain drain Driveway, parking/vehicle storage area ~o ~ Wells on adjacent lots /o-z> ~/- Property line I F. ENGINEER'S CERTIFICATION I certify that I have determined thrufield inspections and review of Municipal records th~ ~.~ [leffems are in conformance with MOA tIAA guidelines in effect on this date . S,gnature ~~ ~LX~ Engineer's Name ~o. ~¢~ ~. ~' /~5 Date ~ff/~ .......................................................... ............................................... ~B~~x~%~ .... HAA Fee $ ~ ~ , 0 ~ Waiver Fee $ Date ofmayment ¢~/~~ Date of Payment Receipt Number Rev. 8/95 OSS: haa.wk.doc Receipt Number Rick Mystrom, Mayor Mumcipali of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 April 29, 1996 Ken Duffus, P.E. KND Engineering 20441 Ptarmigan Boulevard Eagle River, Alaska 99577 Subject: Waiver Request for Lot 11 Block 5 Bruin Park Subdivision Waiver #WR960014, PID #015-111-35, HA960142 Dear Mr. Duffus: Your request for a waiver of the 10 foot separation between and on-site wastewater disposal system and the south property line has been approved. The approved separation distance is 5 feet. This approval applies to the existing on-site wastewater disposal leachfield and property line only. Any future upgrade to the on-site wastewater disposal system will require all separations be met or another approval from this department If there are any questions,, please call our office at 343-4744. Sincerely, Daniel J. Roth Civil Engineer On-site Services DJR/ljm: Waiver/Broady MUNICIPALITY OF ANCHORAGE ' ' Department of Health and Human Services ' on-site Services Section Waiver Review Worksheet WR~ ~k~t~/"'Y'5\~ PID~ 0,1.6r1~1~3~ HA# HA960142 Permit Date Received: Apri% 15, 1996 Legal Description: LOt ll~ Block, , ,5, Bruin, , Park, , Engineer: Ken Duffus, P.E,, KND Engineering · 20441 Ptarmigan Boulevard, Eagle River, ALaska 99577 Applicant: Jim Broady. Waiver Re uested: hot line waiver of 5 feet from the property line Criteria: 1. ' · ' ' · Geology. Points. A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. 'Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Waiver is List Conditions or Reasons for above: SEf fmA ~U/~£~4WD &F~T£;~ m~ ~t~s rt~: ;~,~'~. , ..... . ....... Date: B · Name of Reviewer Rec 9: ~D ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-87:36 (907)6966111/FAX (907)696-8111 April 12, 1996 Municipality of Anchorage Dept. of Health & Human Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 REF.: Lot 11, Block 5, Bruin Park Lot line waiver Gentlemen: While researching the munidpal records in preparation for conducting adequacy/well flow tests on the subject property, I found a discrepancy in the distance between the end of the trenches and the lot line. The original as-built, submitted by S & S Engineering in 1992, shows a distance of 10 feet. At the same time, the Health Authority worksheet shows only 2 feet. We found no record that the Municipality required a lot line waiver at that time. In addition, S & S was unable to explain the discrepancy. An updated survey was obtained which shows the distance from the deanout to the lot line to be 6.4 feet. We estimate that the actual end of the trench is approximately 1.5 feet closer to the lot line. Therefore, we are requesting a lot line waiver allowing the system to be 5 feet from property line. This waiver will not negatively impact surrounding properties. The well to the east on Lot 20 is slightly over 100 feet away, so there is no potential for development in the well radius area. Should an upgrade be installed on Lot 12, it would be a minimum of 15 feet from the lot line; since the trench contains 7 feet of gravel, this separation is more than adequate. Should you have any questions, please contact me at 696-6111 / FAX 696-8111. Respectfully submitted, Kenneth M. Duf ,~P.E. Ap~-O3-g6 10:04A No~. '~n At~ Management 1907[ ~5680 P.01 STATE OF ALASKA DEPARTMENT OF NATURAL RESOURCES DIVISION OF WATER WATER WE~L RECORD LOCATION OF WELL · OROUGfl ~4/BDJ~qSION LOT BLOCK SECTION GTI~ LOCAT~~: ~ O~: D~HS M~SUR~ FR~:Oci,~op ~gr~ ~e ~ D~H: DATE OF CO~N Doth of ~e: / ~ ft BO~LE DATA: ~lh Depth _Mattel Ty~ ~ ~Hr Fr~ To ' ' ~PO~W ~ I~ 0 ~ O~ TO ~ATC WATER L~EL: M~MOD OF DRI~G: USE OF ~ ~TAKE 8CRE~ ~: _ Oiam:  G~V~ PACK TYPE: OR~T TYP~ V~u~: DW~O~ M~O0: _~ u ~ 0 ~MP ~AKE D~TH: _ fl ~er: ~ DI~FECTED UPON C~pLa~I 0 YE~' CONTRACTOR INFORMATION: REMARKS: RegiuJ~ed Busir~er, a t~me~ ~ ' ' r-- g (~.hod'ze~l flesprese-ntative- = ~ PLEASE MAIL WHITE COPY OF LOG TO: DNPJDIVISION OF WATER PO BOX 772116 EAGLE RIVER AK 99577.2! 16 b MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.# ["~[f~- ~\\--~,-~ HAA# ~6~c%Q~;:)-~(~ GENERAL INFORMATION Complete legal description ~ II ~ ~ ~,---~l~-~~~'~m' Location (site address or directions) Property owner Mailing address Lending agency Mailing address Agent Address Day phone '"~-'~'~" '2..1 ~--~"~'~ Day phone Day phone Unless otherwise requeSted, HAA will be held for pickup. NUMBER OF BEDROOMS: '¢¢ TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA#21 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms 'and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address Engineer's signature $ & $ ENGINEERING 17034 Eagle River Leap Road No. 2.04 Eagle River, Alaska 99577 Phone Date q "\ ~- ~ ?-''' DHHS SIGNATURE ~ Approved for ~" bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments Date 7- 2 ~'- ~2, The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional enginee¢s work. 72-025 (Rev, 1/91) Back MOA Municipality of Anchorage ~CL Department of Health & Human Services E IV E D , A. WELL DATA Well type-~-~.X/~ If A, B, or C, attach ADEC letter. Log present) ~ Total depth ~'"~c'~ / Sanitary seal(~N) y Human Servicea ADEC water system number ~ Date completed I/~ Driller.~J~¥-~ ~----~"I-~T~----~ Cased to {---1~ / Casing height [ "~" Wires properly protecte~N) y FROM WELL LOG AT INSPECTION Date of test Static water level ~ / ff~ ! Well flow Pump level SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field .on lot Public sewer main ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Sewer service line Petroleum tank WATER SAMPLE RESULTS: Coliform ~ Date of sample: '~-'~" ~"~' B. SEPTIC/HOLDING TANK DATA Date installed ~/ t~/q ~ Tank size Nitrate Other bacteria ,~' Collected by:~~'-~"~ ~"~!,_3 tf'~t~ L..--- Compartments Cleanouts(~'N) "~: Foundation cleanou~/N) / Depression(Y~) High water alarm (/~ I1~/.~ Alarm tested (Y/N) NJ/~ Date of pumping h,J~,.~ '"T~r~ I~ .~ Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot I~ _"~1 On adjacent lots .1__~-~~ Topropertyline ..~.~, I Absorption field I'll ' Foundation Water main/service line Surface water/drainage 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date in~t~ll~d / Size,in gallons, , Vent. (Y/N) · ~ ,', High water alarm level Meets MOA electrical code~N) SEPARATION DI/$,7~'NCE FROM LIFT STATION TO: Well on lot/ On adjacent lots D. ABSORPTION FIELD DATA ~.,~hole/Access (Y/N) __ "Pump on" level.aY' "Pump off" level at '/'"'"'/ Cycles tested Su rfaoe water Date installed Length 1~;~ ! Total absorption area Depression over field (Y~ Results (pass/fail) Peroxide treatment (past 12 months) (Y/N) Width Soil rating 4~:~,~ ~'~'f"~-System type'-J~,~'"~ Gravel thickness '~' / Total depth Clean outs p resented}N) Date of adequacy test /'..-J/-~, I for -cdC bedrooms If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot [ I '~' / To building foundation On adjacent lots On adjacent lots [ ~'d¢- / Property line ~' / To existing or abandoned system on lot Cutbank ~ ~ I~ Water main/service line ~ ~/..p.- Surface water Curtain drain [~::>~ I -'~ Driveway, parking/vehicle storage area E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. '"' Si~nat_m 17034 Eagle River L~p Road No. 204 Eagle River, Alaska Yy.~Y/ ncneer's.ame Date ~-'~'~ HAA Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING GENERAL INFORMATION Complete legal description Lot 11; Block Si Bruin Park S~bdivisionl Location (site address or directions) 11501 Polar Drivz .,~ Property owner Mailing address Lending agency Mailing address Agent Address Jam~s T. Broady Day phone 349-2753 200 W~t $4th St. #1160 Anchorage, Alaska 99503 N~ional Bank of Alaska Day phone Day phone Unless otherwise requested, HAA will be held for pick~up. 4 NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Y,X Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA#21 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater is in compliance with all Municipal and State codes, ordinances, and regulation the date of this inspection. Name of Firm Address ~ 204 Engineer's signature ~ECO~EN~ APPROVAL ON THE THE SEPTIC SYSTE/~ IS UPGR^~)E~) FOR A 4 BEDROOM ~APA~ITY. ~ ..... Phone Date 6. DHHS SIGNATURE Approved for Disapproved, Conditional approval ms, with the following stipulations: Additional Comments By: Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph' 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA #21 Legal Description: Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Parcel I.D. A. WELL DATA Well type/'~'~ Log present (~N) "~ Total depth Sanitary seald,5~) If A, B, or C, attach ADEC letter. Date completed Cased to \"7 ADEC water system number '-"- ~ {''7 '~[ Driller Casing height \ ?'~'~' Wires properly protected ~TN) Date of test Static water level Well flow Pump level FROM WELL LOG / g.p.m. AT INSPECTION Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line SEPARATION DISTANCES FROM WELL TO: ; On adjacent lots ; On adjacent lots Public sewer manhole/clean, cut Petroleum tank WATER SAMPLE RESULTS: Coliform ~ Nitrate Date of sample: Collected by: Other bacteria 'B. SEPTIC/HOLDING TANK DATA Date installed Cleanouts L'~) High water alarm (Y/N) Date of pumping Compartments Foundation cleanout(~N) T Depression (Y/,_N~ ~ Alarm tested (Y/N) ------ Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot ~ I,+~ On adjacent lots To property line [ ~:::,t.~ Absorption field Surface water/drainage 72-026 (Rev. 7/91) Front Foundation ~ Water main/service line NTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) High water alarm level "Pump on" level at Manufacturer Manhole/Access (Y/N) "Pump off" level at Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed ~ ~ ~ '~"~:~ I Length ~'(:::~ Width "~ Total absorption area '"7c~E> ~ Depression over field (~'/,J~> I'~ Results (pass,~[~~ ~/'~ L~ Peroxide treatment (past 12 months) (Y/~ Soil rating I..~ Gravel thickness Cleanouts present<:~/N) Date of adequacy test for If yes, give date System type ~---~1~ Total depth Y bedrooms Well on lot ~ ~ To building foundation On adjacent lots ,~c:> Surface water SEPARATION DISTANCE FROM ABSORPTION FIELD TO: On adjacent lots ~ ~! Property line To existing or abandoned system on lot Cutbank /~ ~'~-.~ Water main/service line ~ ~:~c:>l '~ Driveway, parking/vehicle storage area Curtain drain ~",]~ ~/~--'t,~.~-3 ~~1,,-~/~1 ~-~/2. ~-~/p}"/~,/A-/.~ E. ENGINEER'S CERTIFICATION ~~ ~~ ~~ I/~ I ceflify that I have checked, verified, or conformed tO all MOA and HAA guidelines in effect on the date of this inspectio~ HAA Fee $ Date of Payment Receipt Number Signature 17034 Eagle River Loop Road Eagle River, Alaska 995~ Engineer's Name Waiver Fee: $ Date of Payment Receipt Number 72-026 (Rev. 3/91) Back MOA 21 TI~ODORE F. MOORE, FH: (90'/) 34S.1{$S 14530 ECHO ANCHORAOE, AI.~N KA qg{~,~ llames mud Ma.-y Bromdy 200 W, 34th Avenue Auchorase, AR: 99503 Dear Mr, and Mrs. Broady: Bilk 5, Brain Park S~, Cop~ of ~van~ back~ d~u~n. ~e enolos~, Ac~r~x8 ~ ~e ~'s 1o{, ~e weU ~ eom~le~ ~ Janu~ of 1979 ~d has a to~ dep~ of 173 f~t ~d a yield of 5.2 ~ ~ ~ dam of o~ ~mt ~e smu~ wat~ level stood ~ ~ f~ ~low ~, mp of ~ eamg'. ~g a to'~l of 181 galions of wat,~ ~om ~e. weU ~t ~e averag, pump ou~ut of 5.3 gpm. . . caus~ ~e ~r ~sid~ ~e e~in~ ~o ~ ~wn do~n to ~e level p~ pu~p mt~ atJY0, f~h~ w~c~' fl~ ~e wa~ ~d ~ pump w~e ~ off. We then monitor~ me acm~ geld of ~e we~ Is 1.57~m when ~ wa~ lev~2~ ~v;n dom ~o ~eld ~ m~ ~ ad~u~ for Mu~mp~ ap~'ov~ et apfivat~ we~ TO ~t ~0 ~A ~tu~ ~ ~ofl~ 220 g~0tx$ 0f us,~bk a~ve~ound storage woulo a ~s~r prop ~d ass~ia~ con,uts. A~ w~ ~ns~tt~ wi~ o~ IeU~ ~Ce~. 4/1~ ~e test resets from ~,e wa~ samples coB~ on M~"~ 2"~ w~r--* ~aeto~', showhg 0 ¢°l~onn of.~her ~ae~3 ~e[,l~.~., ~, should ~$o po~t out ~a~ ~ ~a~,~ ~e ~Uu sysmm ~ aemnma ~ have to ~ ~en m ~ sine tim flae new syae~ d~s not encroach on · ~m~ from ~, webs on ~ lot, ~ the. ,oufia~s, of yours, ~d ~t ~'-~'~ y-our well. ~, pr~t ~filing system app~s m ~ with~ 64 f~t of ~, well on Mt ~0. I m enclos~g ~ ~voi~ for the ~l~c~ of A~ ~a~ quoed o~ offend b~linS. Please f~l ff~ ~ g~ve me a ~ u you nave aY quemons on m~ report. Sincerely, Ted Moore, P.E. 14530 ECHO lames ~nd Mary Broady 100W, 34th Avenu& ~1160 Anchorage, AK 99503 . P~e.r ~o. ut requ~t 0n March 31 1 inspected the waetewa.te, r dispo$~.l system s~rving your residence off Lot .! 1, Bloc.k ~.; Bru~ .Park S/D, Iota.ted at 11301 Polar D,n?e. lregm,~ to inform you that it will not t~ ul compliance with Molll¢lpid requirement, ': Accordhlg to.th~ ~.~uilt inil~tton repo,.on file at th~ Municipal Health Department (copy ~nclosed), the w~tewate, I' cliepo$~ I. ysterll w~$ installe.~ m eeptem~' of 1978 and consists of a 1250 ~sllnn septi'o t~k .f, oll?.w~ by ,~9 llneal' feet of soil absorp.~on' ' trench containing' ' 6 feet .... of s~v~ gavel'-"-b~neathr'-""thc ho~n~l di~bution p,~, The normal fl'uid depth in a vroncrlv func~ionine seoti¢ tank is aon?n~ a.~tnout, to~ p~pe, ^*. the tmle,ot my inspe, cuon I rt~.~ured a fluid d~pth of 109 roches in th~, scp~ ranx cmm0ut pi .1~, and 75 ~o. hes m the cle0.noat ~ioe at the b~innina of'the U'~nch wkieh down only ~ the top of the horizon~ dis~rton pipe,' 2~h~ monitor~t-ube a'i the end of th~ trenc'"h°[~ ov 105 inches of fluid m ~t, w~rh ~ ~op of t.h~ flu.!d t~mg just t~low ground l~el. In fa~t, most of the had ~n melt~ from ~ ~r~ over the ~nc.h. and the ground surface appe~ed quite d~p. Th ..e~. observations all. point.to the the wastewater disposal system, t~lng surch-.arged, an.d. thus not ~.ligtble for a ~ .~. r~, ¢at~ until tt ha beau up~d~, You should veri~y that there :s no leaking plumbing flxrun, m,~c~e me house, bemuse such a leak could also cauSe the system to become surcharged, ~e The following is a bretkdown of th~ steps ~td estima.t~ costs n~ssary to proce~ with an up..er, do of soil absorpuon sys~m: " B~l~oe for:soils .~sts $300- $400 ' S~°ils an~lys~s (2 visual soils tests, l~rc,t~sts, $rou. n. dwat~r monitoring) $410 Systzm design (~tt~ plan, con. smlcrio, n plans., specsficattons, narrative) $450 " .Only ,o. nc~ the d?..ign' 'xs complete and appr~v, ed wi.Il it be possibly to get bids to determine the actual Construction ,cost which cmt range fr!m $,~000 .$.10,000 or more, You shOuld also figure on $450 for Construction mspectio.n~ and preparation o.f as-bmlt..drawings, Please ~ve me a call if you h~ve questions, or if you w~$h me to proceed w~th the softs testing and design work. Sincerely, Ted Moore, P.E, F' R-- T LIE I[ I I $ 7 F L ~'l'T T ~3F T EO HI-4 I t-; ~,~L ~ ~drm~ 39qOq FIC'ISSIN L, IO~H J~: I I ~00'39~d DN I ~Jd~ -~ ~ PHON 'MAILING ADDRESS INGLE FAMILY Four- EE] Other_' Two- ate, give v~ell - DATE 3TOR DIRECTIONS: THIS SIDE FOR OFFICIAL USE ONLY INSPECTION APPOINTMENTS TIME DAT~E INSPECTOR DATE DATE I N~Pi~CTOR 1. TYPE OF RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY 2. WATER SUPPLY INDIVIDUAL [] COMMUNITY [] PUBLIC UTILITY · Connection .Verified ~,, NUMBER OF BEDROOMS [] ONE [] [] TWO [] THREE [] FIVE FOUR [] SiX ~ERMIT NUMBER [] O~HER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM [] I NDIVI DUAL/ON -SITE F-IPU BLI(~' UTI LITY Connection Verified []Septic Tank or [] Holding Tank Size: j~o3..~)_ If Tank is homemade give 'dimensions: TYPE OF TANK TOTAL ABSORPTION AREA WELL TO: )tion Area to nearest Lot Line 5, COMMENTS' PERMIT NUMBER DATE INSTALLED SOILS RA,TING _ . MATERIAL Araa ISewer Line DATE ~APPROVED FOR , ~ BEDROOMS . [] CONDITIONAL APPRbVAL (letter'must accompany certificate) [] DISAPPROVED LEGAL DESCRIPTION IBY (Title)~ ~ 72-010 (Rev. 3/78) ~ay 9, 1979 James T./Pamela Broady Star Route A Box 1797 Anchorage, Alaska 99507 Subject: Lot 11 Block 5 Bruin Park Subdivision Approval for your individual sewer and water facilities will not be granted until the following items have been completed: (1) A well log is submitted to this department. (2) The top of the well casing is sealed with a sanitary seal so that it is water tight. (3) The depression or pit arced the well casing should be filled with impervious type soil so that it slopes away from the well casing. (4) ~e water analysis report be delivered to this office from Chem Lab, 5633 B Street, for our review. Notify this department for a re-inspection when descrepancies have been corrected. If there are any further questions, please contact this office at 264-4720. Sincerely, Robert C. Pratt, RSS. Associate Specialist RCP/lJw Alaska U.S.A. Federal Credit Union 777 Juneau Street 99501 ' ~OX 140 q SIM.A, ALASKA 99687 "'PHONE .376-.,5277 '~ AUDIT -,, -'5 I KENA! SUPPLY CO. -'lj~l BOX499 BOX 6185 J~NAI, ALASKA 99611 · ANCHOR~,GE, AK. 99502 J J~PHONE 283-7521 PHONE 279-9495 . .. ,,o':~,.-v. ... .... ..-.....: '~rfln~GC ~A[ 99509': ORDERED B ~CK ORDERED C -%C~NCELLED .T - ~R~NSFERREO 10 ~NOTHEH CH~RC, E SHEET METAL SUPPLIES 108833 WHEN INC.= ACCOUNTS PAYABLE $ J~.AUDITED JOB. NO. APPROVED ~/~ DATE. '~'~/,' C! / ~/ ' ) " ,,,ed by ) ' ~:~ ' ~ ~,t~lDl~%J[ M'LI,~'T NOel' E~E-I~IETLJ r~NED WITHOUT Og~ COI'~ISI;-NT. ~ MONTH SERVICE CHARGE ON PAST DUE ACCOUNTS., KENAI COPY JAMES T. BROADY or PAMELA M. BROADY ~,-!': k, 1.052 32]0 Latouche C-2 276-657! .", . PAY)lO tHE