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HomeMy WebLinkAboutSOUTH HILLS BLK 5 LT 1South Hills Block 5 Lot 1 #017-071-24 Alpine Drilling & Enterprises Well Log Permit Number: #SW 141066 Date of Issue: 4-8-14 Parcel Identification Number: 1 70 71 24000 Date Started: 4-9-14 Date Completed: 4-10-14 Is well located at approved permit location? x Yes ❑ No Legal Description: South Hills Blk 5 Lt 1 Property Owner Name & Address: Roger W & Gail D Augdahl 13900 Shadow Lane Anchorage, Alaska 99516 Borehole Data: Soil Type, Thickness & Water Strata Depth (ft) From To Method of Drilling x air rotary ❑ cable tool Casing type: steel Stick-up 1 1.5 Wall Thickness: 25 inches clay gravelly silt 1.5 15 15 38 Diameter: 6 inches Depth: 60.5 feet Liner Type: Diameter: inches Depth: feet silty gravel H2O 38 43 Casing stickup above ground: 1.5 feet Static water level (from ground level): 26 feet gravelly silt 43 57 bedrock 57 206 Pumping level: 200 feet after 4 hours pumping 1_5 gpm Recovery Rate: 1_5 gpm Method of Testing: air1i t H2O 81 86 Well Intake Opening Type: ❑ Open End x Open Hole ❑ Screened Start feet Stopped feet x Perforations Start 40.5 1 feet Stopped 43x1 feet Grout Type: bentonite granules Volume: 2 brs De the Start 0 feet Stopped ? feet Pump: Intake Depth feet Pump size hp Brand Name Well Disinfected Upon Completion? x Yes ❑ No Method of Disinfection: Comments: Well Driller: Alpine Drilling & Enterprises PO Box 110496 Anchorage AK 99511 V/01/2014 06:11 907-345-0202 ALPINE DRILLING PAGE 01/01 Development Services Department Building Safety Division On-Site Water dl Wastewater Program4700 Elmore RoadP,t7, *AS Box 195E+50 4 Anchorage, AK 99507 MarkBeg+oh Meyor www um.ura/onsite (907) 34$ 7904 Pump Installation Log Well Drilling Permit Number: $W 141086 Date Of ISane: 4-6-14 Parcel Identification Number: 1707124000 Legal Deseriptiea Property Owner Name & Address: Roger W & Gail D Augtlahl South Hills 81k 5 Lt 1 13900 Shadow Lane Anoxage,AK 99510 Pump Installation Date: 0117114 Pump Intake Depth Below •Top Of Well Casiug: "0 feet Pump Manufaetnrer's Name: Grund!os Pump Model: 1ME-07.240 Pump Size 3A hp Pitless Adapter Burial Depth: "A feet pitiless Adapter Manufacturer's Name: wA Pftless Adapter Installer: WA Well Disinfected Upon Completion? © Yes ❑ No Method of Disinfection: Comments: Pump Installer Name: Aarow Pump & Well Senica, LLC P,O. Box 110498 Anchwege, AK 09811-0496 Attention: The pump installer shall provide a pump installation log to the 175L1 within 30 days of pump installation. am On -Site Water System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP141066 Tax Code Number: 01707124000 Work Type: Well Upgrade Permit Effective Dates: April 08, 2014 to April 08, 2015 Design Engineer: Subdivision: SOUTH HILLS Site Legal Address: SOUTH HILLS BLK 5 LT 1 G:2940 Owner/Address: AUGDAHL ROGER W & GAIL D 13900 SHADOW LANE ANCHORAGE AK 995160000 Site Mailing Address: 13900 SHADOW LN, Anchorage This permit is for the construction of: N Disposal Field N Septic Tank N Holding Tank Lot Size in Sq Ft: 30204 Total Bedrooms: 3 N Privy Y Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received I Issued By: MUNICIPALITY OF Community Development Department Development Services Division (*D On -Site Water & Wastewater Program ON-SITE SEWERNVELL PERMIT Phone: 907-343-7904 S UftlAr APPLICATION%PR 4 2014 Parcel I.D. Property owner(s)06r..E, � (4ti 4"4 D'ff� Day phone q q -7- ?e? - Mailing address Qgoo SNA&^L,� ZAga; Site address 13706 344i7etti �.q,,jk Legal description (Sub'd., Block & Lot) 40T 1 BL.K T� _40u0+ 14a",S c<zcA.. Legal description (Township, Range & Section) Lot Size . JO Sq. Ft. Number of Bedrooms �3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Receipt Number.0 �S 5 Receipt Number: Permit No. ©SP1Ujll� Absorption Field ❑ Initial ❑ Single Family (SF) El - Septic Tank ❑ Upgrade M_ (w/wo ADU) Tank E]Renewal E]Multiple Duplex (D) ElHolding Privy ❑ Dwellings ❑ (SF and/or D) Private Well a 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 MunicipA Codq. ,,, (Signature or autnonzed Permit/Rush Fees �z Waiver Fees: Date of Payment: q - 3 - % Date of Payment: Receipt Number.0 �S 5 Receipt Number: Permit No. ©SP1Ujll� Waiver No. Permit App_9-1-12.doc ------ _ HILLSIDE WAY 91.2 �✓ 83 42' 00" W 953.20 O Lu O N 0 ti ti b 0 ----------------- - - - - L PROPOSED GRAVEL DRIVEWAY O \ — — — — — — — — — — — PROPOSFO SINGLE ' PANT ET FRAME HOUSE II ROOF EAVES— — ell � DECK I � I � /J( S�Pi tc_ u rf� ( r7R I oe LjEa' I � I I I _ --_____ 5.T z---- 1 10' UTILITY EASEMENT 86 53' 45" W— 3 01 NOTES: LOT 1S 30,204 SO. FEET( CITYLRECOROSI CORNERS NO. 5 REDAR ELEVATIONS BASED ON ASSUMED DATUM ( ELLIPSOID) t PROPOSED FINISHED FLOOR ` ELEVATION IS �. RABBIT 1CREEK ROAD t We,� Cb GRID 2940 THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICXNLY`( TO SHOW ANY CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES OR EASEMENTS AND IS NOT TO BELSEB FOR POSITIONING ADDITIONAL STRUCTURES OR FENCELINES. \\- V y EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT, ARE NOT SHOWW*ERE, CN.(UNLESS INDICATED) NOTE: ANY FENCELINES SHOWN ARE LOCATED APPROXIMATELY AND ARE NOT TO BE USED TO DETERMINE PR RES OR LOCATE STRUCTURES ur ANY PAVING SHOWN MAV BE APPROXIMATE DUE TO SNOW CONDITIONS. �r1 I ' l I Q-a�>� o k f 1 Af' !� OF A v�d *� 49?H* ........................... 0 SHANE A. HOLT; }0 14� LS -6914 G q J� SITE PLAN 1"=30' I HEREBY CERTIFY THAT I HAVE PERFORMED A MORTGAGEE'S INSPECTION OF THE FOLLOWING J DESCRIBED PROPERTY. LOT 1, BLOCK 5, SOUTH HILLS SUB. ANCHORAGE RECORDING DISTRICT, PLASKATHE AND THAT THE VISIBLE IMPROVEMENTS Abib N EDSIBLE HARE WITHIN THE PROPERTY LINES Ay0 NO VISIBLE ENCROACHMENTS EXIST OTy'iPR THAN NOTED. DATED AT ANCHORAyB, ALASKA THIS 17TH_ DAY OF MAV 2010. HOLTIMD EYING TEL 45-5513 11301, FB 141-5,138 Development Services Department Building Safety Division 6E B 'w On -Site Water & Wastewater Program QIP �o 4700 Elmore Road z y P.O. Box 196650 Mark eegich Anchorage, AK 99507 Mayor www.muni.org/onsite (907) 343-7904 Pump Installation Log Well DrillingPermit Number: SW > Date of Issue: / Parcel Identification Number:b`��� Legal Description Property Owner Name & Address: Pump Installation Date: Pump Intake Depth Below Top of Well Casing: Pump Manufacturer's Name:r,_J- Pump Model: . c,,,- `_;'? Pump Size '° hp Pitless Adapter Burial Depth: ✓sem+:_ feet Pitless Adapter Manufacturer's Name: :.,n e- ,.:. Pitless Adapter Installer: .,`: ,<- Well Disinfected Upon Completion?Z Yes ❑ No Method of Disinfection: Comments: Pump Installer Name: Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. STATE OF ALASKA 'DEPARTMENT OF NATURAL RESOURCES. DIVISION OF GEOLOGICAL AND GEOPHYSICAL SURVEYS WATER WELL RECORD LOCATION BOROUGH OF WELL SUBDIVISION LOT BLOCK SECTION QTRS TOWNSHIP RANGEMERIDIAN /(�//� I FI S W DIRECTIONS: WELL OWNER: ' i WELL DEPTH: ( Q g Depth of hole: t DATE OF COMPLETION: MEASURING POINT: rtop Of casing Q ground surface other: - Depth of casing:a' ?pft / � / 4/, BOREHOLE DATA: Depth STATIC WATER LEVEL: L/,Z� ft. Date)/- 7.1" 21 Material type and color From To METHOD OF DRILLING: 0 -air rotary cable tool other: .. _ .� 1 `! USE OF WELL: ®domestic Q irrigation Q monitor ❑ public supply Elother: CASING: Stick-up�f t. Diam: 4,o in 1 1,4 WELL INTAKE:' ' open end F-Iscreened ' E] perforated ubpen hole Depths of openings: to _ft _ „ SCREEN TYPE: Diam• in .[•i �i.C,.�.....,t j,u g $ Slot/Mesh S' e: Length: ft znzi4 Set Betweeand ft n GRAVEL PACK TYPE: 'Volume use2Y:::,._ Depth to top: i GROUT TYPE: Volume: Depth: .fxpm•� ft to ft DEVELOPMENT METHOD: (�(i Duration: REMARKS: jV4U\1tG\:,thNUm PUMPING LEVEL AND YIELD: pepi. Flea _ tw ft after `Z___ hrs pumping , gpm PUMP INTAKE DEPTH: ft Horsepower: - Date Pump Installed - CONTRACTOR INFORMATIION: WATER CHEMISTRY SAMPLE TAKEN? ❑ yes �no Z -� <<•-• woll Aicinfact P_d upon completion? es no r � / RegisS6red Business Name Signature of Authorized presentative //-') J, ,,/ Date PLEASE MAIL WHITE COPY OF LOG WITHIN 45 DAYS TO: DGGS PO BOX 77-2116 EAGLE RIVER, AK. 99577 PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL SYSTEM PERMIT PERMIT NUMBER:SW910158 DATE ISSUED: 6/17/91 DESIGN ENGINEER:DUMMY COMPANY EXPIRATION DATE: 6/17/92 OWNER NAME:FITZGAIRELD CHARLES V OWNER ADDRESS:P.O. BOX 112451 ANCHORAGE, ALASKA 99511 PARCEL ID:01707124 LEGAL DESCRIPTION: SOUTH HILLS BLK 5 LT 1 LOT SIZE: 30204 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: WELL 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 (18AAC80). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED B ISSUED BY: Y:, DATE: DATE: 40' �� S8304Z'E 153.Zo 1 —�— ELEJ l06= Se.,e.r Rv., Po .Sti=!/a,., bed 2—iFh 93 a a LSxrL�Ijo 0p, r`C 38 a u 3tb n%sem >r1�-13eSfl OF A�( 19 • H �q p�. Na G.tl(s z o0 •"/ q U: Y C. REID, JR. • .N .. 17�Fi4,. raad ,4or 'f r .�� CE -2251 1 w 0i C rh, dr�I-jF \�.........�,..��� � a 13�DI 0� • A � Seybr�l� rG'to ea, c11S�ti 3 �w J, ✓ i; 3 .3tjo7E ! `0 /^ O—� FeA mE r}o�SE, .. ..._.._ 8'd•ep S J]v,s 0 _ ISE FLoo¢ r v Ileo 2 a J .s��f��e Hafer ,I ;. — •/vq sn Sy S iGi.. Jie,2. lao peat >�V, 6sd ell S../ r4= day, E�EJ 117_° S86�SSr4s"Ev .152.63 A/o dsfk.n� So,. iP sof Qoz�k.?scn e,.r LEGEND: IS Brass Cap Monumant �m'✓Z Area 2 .7/, 7;20 fl ' �t—�yr�(—r_]j�p�t` O Iron Pips a ••• '`•••• s wlr,x3ly, Robs? p surrey Hub i Tack 0*6 I hereby certify that I hwe surveyed Lot 1 , Block S 1+W HRaJte=� f�t�� Sova u,IIs 'rel •••"aaeYa*aen� Subdivision, Anchorage Recording Precinct, Alaska, G • N0 30825 ,rps and have replaced all lost comers with SIB" x.30" mbar. It is the•ee �. responsibility of the owner, prior to construction, to verify proposed �•�/eeka�PNl+'d� building location on lot, grade, and utility connections, also to NAl l�x�s determine the existence of any covenants or restrictions which do not appear on the recorded plat. Dated at Anchorage, Alaska this day of su,„ 'Ig�PLOT PLAN CONSTRUCTING ENGINEERS, INC. 9801 Buddy Warner Dr. SCALE 1" = 40' Anchorage, Alaska - 348.2000 594-098 o/ -;L — ©?1— z4 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NameDISTANCES l off—/ 5 Y f r ❑ TRENCH C9 BED ❑ W. DRAIN ❑ OTHER Depth to pipe bottom from % original gradeST Total depth from original grade ` G TO FROM SEPTIC TANK ABSORPTION FIELD WELL Addrress1 93'e9 2'leo )a /q_Ld�;-.5�aa[e 3� J9i'ic,77�1� 'f Phones) Permit No. No. of Bedrooms Ji16 e506 2 WELL h'� lw 4,0 i/rt FT LOT LINE Total absorption area Distance between li/ 13 V V SO FT LEGAL DESCRIPTION Lot / Block S..— Subdivisiog � 5o Lj l/,/�S' FOUNDATION /D'cr,oe 4s' ^i l) •-30 3f/ Installer its .4 ear -, c�u$3 -/�/.� Township, Range, Section ^�-���5, AS -BUILT DIAGRAM driveway, water bodies, (Show location of well, etc.) septic system, property lines, foundation, TANKS E ENNES®■N X SEPTIC ❑ HOLDING Manufacturer Capacity in gallons free r /Pine) Material No. of Compartments S /-era / '_. TYPE OF SYSTEM ❑ TRENCH C9 BED ❑ W. DRAIN ❑ OTHER Depth to pipe bottom from % original gradeST Total depth from original grade ` G FT /"5,- - 2+ r ` FT Fill added above original grade Gravel depth beneath pipe /'-Z 7 FT (� ..S FT Gravel length Gravel width _ FT 42 S FT Total absorption area Distance between li/ 13 V V SO FT FT Number of lines Soil rating Pipe material J 1 vL fin SO FT 4s' ^i l) •-30 3f/ Installer its .4 ear -, c�u$3 -/�/.� Date Installed. WELLS ❑ PRIVATE ❑ OTHER fldentifv) Classification (A,B,C) Total Depth - ased to FT FT Installer I Date Installed: REMARKS: ■ERNMEM®■■.■■.■. ERNMEMEME■■■■■■■ ENE FAS M W OEM l����■■NEON MEN M E ME no HER EME MEso SEE MOM■ Bonn E ENNES®■N ®EEM E ME■■■■. kev5-e f� %% J Scale: ,A7 t S Ly �� T�e/`Q dev/[r 46--p-InspectionsPerformed by: L rrlC o l it k %Heal S V fC� yy pti. �r Date: k/4�! s (✓ /D� .5'�53^/� /.S VO x Pot to/ certify that this inspection was performed according to ad '7 Municipal and State guidelines in effect on this date: _ A I Health Department Approval: 72-013 (3/85) Date: 24' "88 ENGINEER'S SEAL ` MUNICIPALITY OF ANCHnRARE Department of Health & Human Services 825 L Street, Anchorage` Alaska 97501 343~4720 ON-GITE SEWE,R & uELL PERMIT Permit Number: 880062 Date Issued: 05/26/98 Engineer Designed Dwner Name: CHAPLES V FITZGAIRELD Day Phone: Owner Address: 710() LAKE OTIS F1K1AJY 9P #30 346^2111 ANCHORAOE, AK 995o7 Parcel Id: 017-071-24 Lot Leg*l: Subdivjsion: SOUTH HILLS Lot: 1 Block- 5 Sec�ion: 25 Township: 12N Range: 3W Lot Size 2 6 (sq^ft" or acres) Max Bedrooms: This Permit: 2 Total Capacity: 2 SEPTIC TANK: Minimum total septic tank capacity: 1,O(W) gallons. Each septic tank must have at least 2 compartments" Depth to top of septic tank(s) < 4"0 feet requires insulation over tank(s)" WELL: Log must he submitted to Municipality of Anchorage Department of Health and Human Services within 3V days ol well completion. REISSUE OF 1987 PER: 11 ^v�~ �'� /��'P�" ��/���° '`z^��..'�� .u' I CERTIFY THAT: 1. I am 4amiliar with the requirements �or on-site sewers and wejls as set forth by the Municipality of Anchorage (MOA) and the State of Alaska" 2. I will install the system in accordance with all MOA codes and regulationsv and in compliance with the design criteria of this permit. 3" I will adhere to all MOA and State o[ Alaska requirements �or the set hack distances from any existing well, was+ewater disposal system or public sewerage system on this or any adjacent. or nearby lot. 4, I understand that this permit is valid for a maximum of 2 bedrooms^ I also that the capacity oH the total system is 2 bedrooms anct any enlargement will require an additional permit" Signed: L DAT�: ---7'----~~---~ (Owner> CHARLES V FITZGAIRELD Issued By: DATE: unic;ipanty ®1 January 12, 1988 P.O. BO. 196650 ANCHORAGE, ALASKA 99519-6650 (907)343-4200 WlXiCpWP tEX Tom Fink, MAYOR DEPARTMENT OF HEALTH & HUMAN SERVICES Charles V. Fitzgerald 7100 Lake Otis Parkway #30 Anchorage, Alaska 99507 Subject: Lot ,Z BLock 5 South H'ubdiv ion Permit #870218, Tax 1 017-071-24 A permit issued by this Department for an individual well and/or on-site sewer system has expired as of December 31, 1987. Permits are issued on a calendar year basis by authority of Municipal Ordinance. A new permit must be obtained from this Department for any well and/or on-site sewer system not installed by the expiration date. If you have drilled the well, a well log needs to be sent to this Department for documentation of the installation and to close the permit. If a private engineer inspected the installation of the on-site sewer system, the original as -built inspection report (three-part form) must be sent to this office for review and approval, and for documentation. Effective January 1, 1988, a new fee schedule is in effect. When re -applying for a new permit, the new fees are; $90.00 for an on-site sewer permit; $50.00 for a well permit; $140.00 for a combined sewer and well permit. If there are any further questions, please call this office at 343-4744. Sinc y, 01 Robert W. Robinson Program Manager On-site Services RWR/ljw enc: Copy of Permit � |1UNIC L I (Y (/F ApsC NR4GV ^ Deyartmer,t of Heali� & Huma� Services 82L L Stree! Anc|vorane, A, asks 995Q1 343-4W0 ON-SiTE SE;1 [V & WE! L PERPIIT Pe,mit |�umber� 8702|8 DaLe [ssued: �8/�8/S7 J�ner Name: CKARLES L FITZ ELD Owoer Ad�ress: 710� LAKE DTl5 PKWY SP �3o /�N�HDRARE, A� 99�O7 Day Phnne: 34956G6 Parcel [d: 0l7 -071 -Of, Lot Lega1: Subdivision: MUTH HALLS SUM. Lot: 1 Block: � SecLion: 25 Township: 12N Pawn" 3W LoL Size 29336 'sq.1 L. or acres) Max Bedrooms: This PerMij: 2 lotal Capacity: 2 AWA SYSlIA�: Listed below are Me opKions available to you in designing your sew�r sysiemChoose the nPtian that best fits your site, T R E N C K H E Q W. D R A 1 N Depth io 6' pe bottom (ft): 4.0 4.0 Grave1 pop: h Gt): 9.0 05 35 ToKal Depth (f I): 1y,0 Grave! Widih (vt): 2.5 u Gravel Lengnh Al > 0 ** Qrave1 Vjiowe (cubic yds): 36.3 32.7 57,8 3o�1 1 atng ;sed (sq 1 t/brm: M. 290 362 ** Gravel engt|, > 50 fei reqjires su1tip}e soils tesis. ** 6ravel lnngAh > M Ceet reauires muKiplv runs (not exceeding in it eacV. ., i .. r:: �..:. i Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: (,VOY �O 1�ic C a DATE PERFORMED: 6 � �� , 6b LEGAL DESCRIPTION: (\ ���-J L7v� J L.b�*wnship, Range, Section: T17 0 C --"3w SCC—, Z5 -1 SLOPE SITE PLAN/^•f �.16t0 R!1_ 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS /?S -r. /;,,-c (JC c6- ,t ct441. WAS GROUND WATER Al �(� ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Water Age Monitoring? a ■■■■NINER■■ ■■■N11IMM■� �KynRM0 PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER CO (E' TEST RUN BETWEEN � FT AND � b FT PERFORMED BY: I l Ly 711 ter 1 . _.LI ttl�Y—�`L`ERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES I FFECT O THIS DATE. DATE: 72-008 (Rev. 4/85) _ ��� /C�. V1 �KynRM0 PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER CO (E' TEST RUN BETWEEN � FT AND � b FT PERFORMED BY: I l Ly 711 ter 1 . _.LI ttl�Y—�`L`ERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES I FFECT O THIS DATE. DATE: 72-008 (Rev. 4/85) _ ��� /C�. V1 ALASKA F1,11RO(1m MAL COnTROL SERI "..CS, InC. Engincerinq 6 Enuironmemal Studies PERCOLATION TEST DATA SHEET CLIENT ClIaAe2; //z,er->/s DATE %1 -:?,-2 ADDRESS �/0a /oh C?t�s 51—, -LQ 20 ZI P CODE o f 5- 6 7 LEGAL LOCATION Sc TOTAL DEPTH OF HOLE 1a `f ft. 7-4 is be %oz Jve.' l'-& G✓!+ „4 ZONE TESTED i�9. % ft TO /F ft TH 0 ,?1S1& ' TEST HOLE DIAMETER Z f READING M CLOCK TIME NET TIME DEPTH TO DATUM NET DROP RATE (min/in) 7 �7 n' 15'17 lc� (�40�i S� f 7 zg �z3� 31-Z 3U 0 �7 3E 1302 3'3'z ac7 0 b7s vn r362.. FINAL PERCOLATION RATE 1102, (min/in) .Qq0 SQUARE FOOT/BEDROOM PERFORMED BY /,12,.i MOA STB' -024 1200 West 33rd Auenue Sm :• P• An6oroge, Alaska 99503 • (907) 2761361 .. pry C. Rva, A CE•2251 ; Pmfesstona� N � Ur o 3 +I ao O ° I 17 POS Ev FZAm6 40JSE , S: F�ooa E v tlr° Z �— E 8G0 SS' 4S" E sL 3 LEGEND: Brain Cap Monument 0 Iron pipe e 5/6" x 30" Fisher O Survey Hub & Tack I hereby certify that I havesurveyed Lot 1 , Block S , So;, \ 14)M Subdivision, Anchorage Recording Precinct, Alaska, and have replaced all lost corners with 5/8" x 30" rebar. It is the responsibility of the owner, prior to construction, to verify proposed building location on lot, grade, and utility connections, also to determine the existence of any covenants or restrictions which do not appear on the recorded plat. Dated at Anchorage, Alaska this I�{N day ofS-UU, CONSTRUCTING ENGINEERS, INC. 9601 Buddy Werner Dr. Anchorage, Alaska 346.2000 694.9098 ELEv 106 ELEv It ( ° PLOT PLAN SCALE 1" = 40' El.Ev tco° S83o 4 4Z E 153. Zo / 6LE V 106— Sewr tz ti bed e—y"- tr erK�- nc`ulc6/e 41 RS%r'' tj Iq'4 N,. ..d` 3sx>«fi4D 6 xl�'-adSA fd OF A4q �� •i a"g �� ,/ •• •• iii►►► ' Coe * ;Z lb . 9sa a a. Ne lolls zoo u•••s•• Iuu•••N•• •/ .SC'Yrr{ FP.J ei-ve 'OOOie - IEE YC. REID, JR. -. .63-a �j • CE-22.1Na : 1-f•T41j `1.... dILV VJ �3Sa�l :pa li 0% YA A O r F¢AwE }Jsr,. vJ✓.Sl� �'rr7t'an o ISk j:Loo4 V. Elle c�ra,n �o sfce�o. Z o W 0 .:5✓r {ear ,J+a¢r / �Ofl �eaf J.Vr &'I dreg Yle �//ovN E+-E� I17-° S86�SS'4S'rEw ,ISZ.C-,3 �. ue,Syfk„,} So,.,��wf ;Qoz�6zse.«e.�-C �tEJ qF+` L,t6 rn %mo' LEGEND: J 49 arm GP Monumerrt c T Area IL ,Ji, 7aD A O Iron Pipe•• • 516" x 30" Hebert*.•• • S M Survey Hub 6 Took jj�' 1 hereby certify that I have surveyed lot 1 ,Block S 1 ' e f�N66e•• So l► lar"Ils •�S►eiestate*J0estIt* Subdivision, Anchorage Recording Precinct, Alaska, G e 3082 No.4 jrps and have replaced all lost comers with 6(8" x-30" rebar. It is the ��faee > responsibility of the owner, prior to construction, to verify proposed building location on lot, grade, and utility connections, also to fa"'�: (ID determine the existence of any covenants or restrictions which do not appear on the recorded plat. Dated at Anchorage, Alaska this day of sl.,` ,19�_. PLOT PLAN CONSTRUCTING ENGINEERS, INC. 66011 Buddy warner Or. SCALE 1" Anchorage, Alaska " 3{6.2000 664•6088 ALASKA HUIROWnTAL COnTROL ONUS, InC. Cnqinecrinq 6 Cnuironmental Studies I ni t fI X 1 1 :I V W C, 11, ,0 1 M E, , 110U 6 o q3 cl C. 1200 West 33rd Auenue. Suite 6 * Anchorage, Alaska 99503 o (907) 561-5040 IWi3 1110 °OI — jr m C m O N I- � a o r I 1 M a m h /, h3 026 y \• Q a �� • o M !b Z W � ° 8469£-�- �n. BH Me02iile00N .� I !� O � 1� 60'zyb M�IOF�IIo00 N R H r m O 1o00N S ro l9H bl'09£ M 0211 _ „—_. .—�-- -' v b eun MOQb'M�� 1 N •' 4 �i 0 41 61 09 OS 29'OG£ I c1 I a v f _. .y. —7r�-- � 4 In I J m IM _N II � ozobl ' BB blt £6'8££ I Ir I M ILO N M I� N � II m - L__ � . I i Im TE ! r"1 � r 0 I- � tJ m oo'eu I Ym OE-Lz£ N M AO Parcel I.D91 707124 Municipality of Anc On -Site Water and Wastewater (907) 343-7904 Certificate of On -Site Systems Approval 1. GENERAL INFORMATION fir Expiration Date: Complete legal description Lot 1, Block 5, South Hills Location (site address) 13900 Shadow Lane Current Property owner(s) Roger & Gail Augdahl Day phone 947-9826 Mailing address 13900 Shadow Lane, Anchorage, AK 99516 Real Estate Agent Diane L Stefan 2. TYPE OF DWELLING: El Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Day phone 229-2250 cc 7C:11 halo 1i 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Q Individual 0 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Received by: ,n' Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ " Sq (. foo Date of Paymentg06 5 - Receipt Number COSA # oSGI� l� Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm DHI Consulting Engineers, LLC Address 800 E Dimond Blvd. Ste. 3-640, Anchorage, AK 99515 Engineer's Printed Name Dee High 6. DSD SIG ATURE System #1 Approved for —3— bedrooms System #2 Approved for Disapproved Conditional approval for bedrooms Phone 344-1385 Date 9/11/15 bedrooms, with the following stipulations: TH NIS I?JH.0' CE07 •••'S *� Pmfess�XOO I\\S'•6:0, By: Original Certificate Date:�'2a— The 41 mciW& Anc ge Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheaf f :, c If more than 1 septic system is on the lot: COSA Checklist # of _ Structure served by this system Certificate of On -Site Systems Approval Checklist A. WELL DATA Well type Private If A, B, or C provide PWSID # Datecompleted 11/21/91 Sanitary seal (Y/N) Y Total depth 408 ft. Date of test Static water level Well production Cased to —5ft FROM WELL LOG 11/21/91 48 ft. 0.5 9 - p.m - WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate 0.53 mg/L Arsenic <5.0 ug/L Date of sample: _9/10/15 B. SEPTICIHOLDING TANK DATA Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) 3.5' in. AT INSPECTION 9/10/15 47 ft. 5.0 g.p.m. Collected by: Dustin High Tank Type/Material Steel Date installed 1988 Tank size 1000_ gal. Number of Compartments _2_ Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping 7/30/15 Pumper A+ Home Services, Inc. C. ABSORPTION FIELD DATA Date installed 7/88 Soil rating (g.p.d./ftz orft /bdrm) 290 System type Bed Length 52 ft. Width 25 ft. Gravel below pipe 0.5 ft. Total depth 5.7 ft. Eff. absorption area J MQ_f? Monitoring tube _Y Depression over field N Date of adequacy test A/10/15 Results (Pass/Fail) Pass For 3— bedrooms Fluid depth in absorption field before test 0.25 in. Water added 461 gal. New depth 2.5 in. Elapsed Time: 1440 ,min. Final fluid depth X 95_ in. Absorption rate >= 461 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) No If yes, give date D. LIFT STATION Date installed "Pump on" level Datum Size in gallons in. "Pump off' level at E. SEPARATION DISTANCES Cycles tested WELL ON LOT TO: Septic tank/lift station on lot 100'+ Absorption field on lot 100'+ Public sewer main N/A Sewer /septic service line QA1 Animal containment areas _ 100'+ SEPTIC/HOLDING TANK ON LOT TO: (YIN) High water alarm Meets alarm & On adjacent lots 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout N/A Holding tank N/A Manurelanimal excrete storage areas 100'+ Building foundation 12' Property line 50'+/_ Absorption field 46 Water main N/A Water service line N/A Surface water _ 100'+ Wells on adjacent lots _100'+ ABSORPTION FIELD ON LOT TO: Property line 23'+/- Building foundation 43' Water main N/A Water Service line N/A Surface water 100'+ Driveway, parking/vehicle storage 4' Curtain drain N/A Wells on adjacent lots 100'+ F. COMMENTS Running test on well #1 (east:} G. ENGINEER'S CERTIFICATION I certify that / have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Date COSA canary sheet 2-6-15.doc r1l HILLSIDE DRIVE 153.20' 83' 42' 00,,E ..... .................. .... ... 30' C.O.S .......................... ............ CI... ...... ............ ..................... W 2 ... ........ It ..... 35.6' Ill: z ........ b 26.7' Uj m 333 0) 4a. Lu 0 1 CDo C'JEXISTING HOUSE C:) 60.0 1 b C) U) 0 co 0 WELL WELL ------------------ 101 UTIL ESMT N86' 534-5'W 152.65' UNDER NO CIRCUMSTANCES SHOULD AN AS -BUILT BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE LINES. THE SURVEYOR TAKES RESPONSIBIUTY FOR THE INITIAL TRANSACTION ONLY AND ASSUMES FINANCIAL LIABILITY ONLY FOR THE COST OF THE SURVEY. LISTED DISTANCES PREVAIL OVER SCALING. REPRODUCTION MAY CAUSE ERRORS IN SCALE. TYPE SYMBOLS HSURVEY �'-T= As -BUILT •SET REBAR DRAINAGE ASPHALT ❑ MNAI. STRUCTURE AS -MILT ❑ -BUILT TOPOGRAPHY 0 FOUND REBAR e 9 e WOOD FENCE CONCRETE PLOT PLAN ... AS ASSUMED ELEV. )( IE )( METAL FENCE WOOD DECK AS -MILT ... NO ;�TLfi':.TIFXA*TIow AS -BUILT ... NO 00111,1131S SET PLOT PLANS & LOT SURVEYS NOTE: IT IS THE RESPONSIBILITY OF THE BUILDER OR OWNER, PRIOR TO ONLY THOSE IMPROVEMENTS ABOVE GROUND AND VISIBLE WILL BE CONSTRUCTION, TO VERIFY PROPOSED BUILDING GRADE RELATIVE SHOWN, FENCES, WELLS, SEPTIC CLEANOUTS, SIDEWALKS, DRIVEWAYS, TO FINISHED GRADE AND UTILITY CONNECTIONS AND TO DETERMINE ETC., ARE SHOWN IN THEIR APPROXIMATE LOCATION, ONLY. SNOW THE EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS MAY PREVENT SOME IMPROVEMENTS FROM BEING SEEN AND LOCATED. WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. ALL DISTANCES ARE RECORD UNLESS OTHERWISE_ NOTED. SURVEY CERTIFICATION *.0*"* OF 14, Prepared by Robert E. Johns, Jr. & Assoc. PLOT PLAN 4 g�,: m y wen, Mot I � phydcoily werwd W' � . .................. � Oil # Professional Land Surveyors w., AF AW41' 1700 Brink Drim ANCHORAGE, ALASKA 99504 =qmdoblftlw� el� h. w• ma wmm F A *A0 AN 49th Scale: 40' Rea. Lot S.F. Rec. Plot File No. FOUNDATION AS -BUILT &.. hwel,y.." Matt �ft �y of V,o Al ...................... 0 �­v Date Sur%,eyed: 08/28/15 Drawn la Y' REJ Checked b JMK m MY 10 � that a M. ....... ........ F 0 •ROBE olooendon. d W.Uon h. a.NOW J JR.* 0 Date Brown: 08/31/15 Grid 2940 15-358 FINAL SZTRETU�REBUILT Legal DeImription: �Woy ." mot I Lot 1 BLOCK 5 Sell SOUTH HILLS - o meat s, MUNICIPALITY OF ANCHORAGE Community Development Department c Right of Way Section Department ENCROACHMENT PERMIT R141603 THIS AGREEMENT, made this 5s` day of June, 2014, by and between ROGER and GAIL AUGDAHL and their heirs, administrators, and assigns, hereinafter called "PERMITTEE", and the Municipality of Anchorage, a municipal corporation organized and existing under its Charter and the laws of the State of Alaska, hereinafter called the "PERMITTER". WITNESSETH: WHEREAS, PERMITTEE is the owner of the following described real property: SOUTH HILLS, BLOCK 5, LOT 1, according to the official records thereof, on file in the office of the District Recorder, Anchorage Recording District, Alaska, and; WHEREAS, PERMITTER owns and/or maintains the real property more particularly described as follows: The 100 FOOT RIGHT OF WAY OF SHADOW LANE, immediately to the east of PERMITTEES property as shown on Plat No. P-636, on file in the office of the District Recorder, Anchorage Recording District, Alaska, and; WHEREAS, PERMITTEE has placed a well upon the referenced real property which encroaches approximately 3 feet upon the PERMITTER' S Shadow Lane Right of Way. NOW, THEREFORE, it is mutually agreed between the parties hereto that: 1. The PERMITTER, acting through the Director of Community Development Department, hereby grants to the PERMITTEE the privilege of allowing a well to encroach approximately 3 feet upon the PERMITTER'S Shadow Lane Right of Way, as shown on "Attachment A," included herewith. 2. The PERMITTEE agrees forever to indemnify, defend, save and hold harmless, the Municipality, its officers and employees, from any and all lawsuits, claims or actions brought to any person for or on account of damage to property or injury, disease, illness or death of persons, including all costs and expenses ineident-thereto,-arising- wholiyar-in--part-frsr7or-in—connection-witlrthe------ existence of, alterations, maintenance, repair, renewal, reconstruction, operation, use or removal of the encroaching well, as placed upon the PERMITTER' S Shadow Lane Right of Way. 3. The PERMITTEE shall not assign or transfer any of the rights granted herein to another individual or company without first notifying and securing the approval of the Director of Community Development Department. 4. This Agreement and Permit grants PERMITTEE no interest in PERMITTER'S real property whatsoever, except only the encroachment rights described herein. 5. The PERMITTER reserves the right to revoke this permit upon twenty (20) days written notice to the PERMITTEE. The PERMITTEE agrees upon such notice of revocation, to move said encroachment(s) from the Shadow Lane Right of Way in which it is placed. Should the PERMITTEE refuse or fail to comply with said written notice, the PERMITTER may, without further notice to the PERMITTEE, remove or cause to be removed the encroachment(s), and the PERMITTEE hereby agrees to reimburse the PERMITTER for all costs incidental to the removal thereof hi addition to the mutual promises heretofore made, the PERMITTEE has paid the PERMITTER a one-time permit application fee of $115.00. The PERMITTER hereby waives the annual fee of $300.00. IN WITNESS WHEREOF, the parties hereto have hereunto set their hands and seal the day and year first hereinabove written. GRANTOR MUNICIPALITY OF ANCHORAGE ack L. Frost, Jr. Right of Way Supervisor STATE OF ALASKA ) ss. THIRD JUDICIAL DISTRICT ) THIS IS TO CERTIFY that on this t�day of aLLruz- 2014, before me, the undersigned, a Notary Public in and for the State of Alas a, duly commissioned and sworn as such, personally appeared Jack L. Frost, Jr., known to me to be the Right of Way Supervisor for the Municipality of Anchorage, Alaska, who executed the foregoing instrument, and he acknowledged to me that he executed said instrument as the free and voluntary act and deed of said corporation for the uses and purposes therein mentioned, and that he was authorized to execute said instrument. WITNESS my hand and official seal on the day and year first above written. .� E VV), ;•j%OTAR'-. AUBLjo #0 STATE STATE OF ALASKA THIRD JUDICIAL DISTRICT a_ r A NOTARY PUBLIC in arilas a My Commission Expires: ss. H THIS IS TO CERTIFY that on this �k_ day of :S LK-t\�R_ 2014, before me, the undersigned, a Notary Public in and for the State of Alaska, duly commissioned and sworn as such, personally appeared Roger W. Augdahl, known to me to be the individual named herein who executed the foregoing instrument, and he acknowledged that he did so freely and voluntarily for the used and purposes therein mentioned, and on oath stated that he was authorized to execute said instrument. WITNESS my hand and official seal on the day and year first above written. f�� rw NOTARY PUBLIC in and for Alaska �,,yyNE wrq My Commission Expires: Q -1 t —7 • pOTAlZy •.. STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) THIS IS TO CERTIFY that on this 4k*�' day of k0i l lS k- 2014, before me, the undersigned, a Notary Public in and for the State of Alaska, duly commissioned and sworn as such, personally appeared Gail D. Augdahl, known to me to be the individual named herein who executed the foregoing instrument, and she acknowledged that she did so freely and voluntarily for the used and purposes therein mentioned, and on oath stated that she was authorized to execute said instrument. WITNESS my hand and official seal on the day and year first above written. NOTARY PUBLIC in and for Ala*a My Commission Expires: C11-111 -1 �L8 1OFA NB_ao" '4y `--- _. PROPOSED 6A4VfL OAIV FW AY yf r t O I PROPOSED SINSLE - FAMILY FRAME NOUS£ N 86 53' NOTES: LOT IS 30,101 $0. FEETI CITY AECORO51 CORIIER< N__ 5 REBAR £L£L'AT!ONS °95fD ON FSSUMEO DATUM i ELLIPSOID) PROPOSED FINISMEO FLOOR ELEYATIDH IS RABBIT CREEK ROAD IN 156 Ph 0 ITA74% aLi�-+ t)atc% Atf work sha I be one assh wn an this plot plan. Approved plans and specification shall not be changed, modifjad or altered without first obtaining a valid change order. I Z 'o � l O I ;> 4 I'4 Da 1.4 o c�QFq�q�4 oo�P. s OQI rn�} O eGi: 491-H ............... ........... ..:... SHANE A. HOLT; O no_ SITEPIAN 1"= 30' I HEREBY CERTIFY THAT I HAVE PERFORMED A MORTGAGEE'S INSPECTION OF THE FOLLOWING DESCRISEDPROPERTY, LOT 1, BLOCK 5, SOUTH HILLS SUB. GRIO IROS ANCHORAGE RECORDING DISTRICT ALASKA ANO THAT THEINFORMATIONHERE.EONIS FOR THE USE DF LENDMGINSTIMIONb SPECIFICALLY TO BROW ANY CONFLICTS BETWEEIa LMTN NTHE S'ELTHE PROPERTIMENES AND NTE.O VISIBL.EOIJ ARE STRUCTURES OR LIN PATTED LOT LINES OR EASEMENTS AND IS NOT TO BE US ED FOR POSITIONING ADDITIONAL ENCROACHMENTS EXIST OTHER THAN NOTED. STRUCTURES OR FENCELINES. EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE RECORDED PLAT. ARE NOT SHOWN HEREON.NNIESS INDICATED) DAY OF_MAYHORAGE ALASKA THIS _t]TH_ 010_ OR LOCATE FENCELINES SHOWN ARE LOCATED APPROXIMATELY AND ARE NOT TO BE USED TO DETERMINE PROPERTY LINES TEL355HOLT 313URV 01, FS 1115139 OR LOCATE STRUCTURES. ANY PAVING SHOWN MAY BE APPROXIMATE DUE TO SNOW CONDITIONS. 11 A -t mm+ All POST IN A CONSPICUOUS PLACE ALL WORK MUST BE INSPECTED Field Inspection Request required 2 working days in advance of starting work and 2 working days in advance for final inspection. Call (907) 343-8206 (voice recorder) for scheduling. Permit is not valid without the call-in and also must include the one -call ticket (utility locate) number. MUNICIPALITY OF ANCHORAGE RIGHT OF WAY DIVISION RIGHT OF W, Type: Construction Work ROGER W & GAIL D SOUTH HILLS BLK 5 L E ent permit Last I. Last R141603 6!5/2014 See reverse for requirements/remarks. I have read and unders d bothaydes of this permit. I agree to the terms and conditions; and I certify that all work will comply with federal, >94, and u icip3,Lfodes and regulations and the provisions of this permit. Signature: �� VW Date: J I 1.7