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HomeMy WebLinkAboutSOUTHPARK #1 BLK 2 LT 11outhpark #1 Block 2 Lot I I #020-491-25 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 14700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP201094 Work Type: SepticTank Upgrade Tax Code Number: 02049125000 Site Legal Address: SOUTHPARK #1 BLK 2 LT 11 G:3236 Site Mailing Address: 4521 SOUTHPARK BLUFF DR, Anchorage Owner: HANNEMAN MIKE E & GRACE E Design Engineer: ARC TERRA CONSULTING INC This permit is for the construction of: ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy Effective Date Expiration Date Lot Size in Sq Ft: Total Bedrooms: cam. 3wu^'•t,,, Department 5/12/2020 5/12/2021 24978 ❑ 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: Issued By: Date: Date: 4 MUNICIPALITY OF Development Services Department On -Site Water & Wastewater Section ANCHORAGE ON-SITE SEPTIC/WELL PERMIT APPLICATION Phone: 907-343-7904 Fax: 907-343-7997 Parcel I.D. 020-491-25 Property owner(s) Mike & Grace Hanneman Day phone 907-350-4024 Mailing address 4521 Southpark Bluff Dr, Anchorage 99516 Site address 4521 Southpark Bluff Dr Legal description (Sub'd., Block & Lot) Southpark #1 Blk 2 Lot 11 Legal description (Township, Range & Section) Lot Size 24'978 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) (w/wo ADU) Septic Tank © Upgrade © Duplex (D) ❑ Holding Tank ElRenewal ❑ Multiple Multiple Dwellings E-1Privy El and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. Dea Duffus (Signature of property owner or authorized agent) Permit/Rush Fees: aZaZSI /roI -'16 Date of Payment: 026 Receipt Receipt Number: 041293 Permit No. 05PA6161711 Waiver Fees: Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201094, Rebecca Carroll, 05/12/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201094, Rebecca Carroll, 05/12/20 514 '2 0 a: c 0 c 0 m 0 0 z 0 P W z z 0 LC lu ,M r l t -'O z 0 w z z z Ow N U) uj CL CL a: z x W UJ CC W z z 0 Z W 93 CC LLI > w rr z Z 0 cr. 0 U Z Lli IU w z Z 0 z 0 Ih uj _tz (.) uj cc x w CL >- w o < z T- cc w m z w �c Z tw mw F- < y 0 Cc 0 U) < m m W cc 0 w 2 0 < 01 W z z w z z* 0 z w cc w C) CD < x () IL 0 IL w a. Cl) U -U 0 w < t= z 0 a_ z z ca <3 w 2: M C) LLI w cc fn N Z Ci 0 < 0 I-- 0 o < cr m < (D CL x i i m 0- EL w z 0 z o z o w CL 0 rD lx W C >- m 11 p OMWQDXX R R z 0 0 Z z D z D W E cr- >- w t o 1 m 3: L& w >- w 0- m m CL IL 5 CL uj < 2 m 0 m m 0 D 0 (L < a_ CC w (L 0 Cz) z < 0 z z O 0 C) LIJ z z U W N m Z 0 U 0 J W Z J w _U cr W Z d X 0 tY3 7- W Y 0 W W 50Ld�06f7k B►uPP Def 46 �+J ~ ~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME MAILING ADDRESS LEGAL DESCRIPTION JAbsorption area~.,, ' Dwelling Material I nside length Dwelling Material.~ t Nearest lot line Tren~ll width I ao t~ :C DISTANCE TO: .j L~ ;~ NO, of lines Length of each line CC<[ I- J Top of tile to finish grade w~ w~.. ~ Length Width <~ :- Type of crib ~ ~ DISTANCE TO: Well .~, Class Depth ~ Building foundation Foundation Total length of lines Material beneath tile PHONE [~NEW ~q~.)~?q [] UPGRADE NO, OF BEDROOMS No, of compartments Liquid depth PERMIT NO. Liquid capacity in gallons PERMIT NO. Distance between lines inches inches Depth Crib depth Total effective absorption area BuiJdlng foundation Total effective absorption area PERMIT NO. Nearest lot line Distance to lot llne Driller PERMIT NO. Sewer line Septic tank Absorption area{s) OTHER PIPE MATERIALS SOl L TEST RATING INSTALLER DI~¢~ /~ REMARKS APPROVED DATE LEGAL 72-013 (Rev. 3/78) ~_~'~UNICIPALITY OF ANCHORAGE ~ ~,. ~ ' ,, ~Department/ ? Health and Environmenta7' ~rotection . ,~ 825 ~ Street, Anchorage, AK. ~9501 · ' 264-4720 * * * HANDWRITTEN PERMIT * * * Permit'~ ~)~/ci W~AND/0R ON-SITE SEWER PERMIT Location: Phone Number: ~V ~'~ ~ Type of Soil Absorption System Is: Trench: /NC Drainfield: Seepage Bed: Holding Tank: Maximum Number of Bedrooms: ~ ,. Soil Rating(sq.ft/br) /~p_~ The Required Size of the Soil Absorption System Is: // LENGTH ~_~S GRAVEL DEPTH ~' WIDTH DEPTH The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). · * REQUIRED SEPTIC(HOLDING) TANK SIZE = /~,~--~'© GALLONS * * Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. · * * TWO(2) INSPECTIONS ARE REQUIRED Backfilling of any system without final inspection and approval by this ~epartment will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending.upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. · * * PERMIT EXPIRES DECEMBER 3L 1 9 $ 3 * * * I certify that: (!) I ara familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if the residence is remodeled to include more that~ bedrooms. Applicant C/ SWP/024(1/81) ~ Oepac~nt O~ H~aZth and ~v~o~t~ ~c0tection 825 L Strut, ~cho~age, AK. 99~0~ . 264-4720 ~ermit ~ - -~ W~AND/O~ ON-SITE SEWER PERMIT Phone N~er: c,Y . T~e of ~O~ ~so~ptfOn ~ystem ~a~ N~er of B~room~: . ~t[ Rakin~(sq. ft/br) WIDTH <=<>>_:r.: Th~ i~ngth d~en~io~ is the leugth(~ fee~) of the treooh or drain~Le[d~ ~ depth of a ~r~nch o~ pit is ~he distance between the s~r~ace of the the bottom of ~he ~xcavat~o~(in f~t)- "~ REQUIRED S~PTIC(HO~I~) TANK S[Z~ ~- /'~ffO GALLON~. ~e~it applicant has the respon~ibilit% to i~fox~ this departme~ installation insp~tl~ns of any wells adJac~t- to ~is proper~an4 ~ e e ~(2) INSPECTIONS ARE REQUIRED · ~ - ", ~ok[Llling of any system without f~aZ inspection and approve% by will be ~ubj~t to pros~ution~ Nini~ d[fltanee between a ~all ~d any o~-~[te sewage dis~sal.~ystom for a privat~ we~% or 150 to 200 feet from a.p,lb[~o wel~ ~'~?~2.~ public wellU~'' M~ntm~ dist~0e from a.prxvate well to a ~d mus~ be retur~ to th[~ de~rt~e~t w[~in 30 days of the well availahl~ to ins~e ~roper installation. ~ cereify that: (l) ~ ~ f~iliar ,~ith the r~iro~n~s for on-site sewer~ and met forth by the M~iGipality of ~chorag~. (2) ~ Will install the syst~ ~ a~oo~ance with codes. (3) ~ u~de~t~nd that the o~-stte ?ewe~ system may rgqu~e ~--{..~emodel~ to include.re tha~ ~room~. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST .J~ SOILS LOG [] PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: DATE PERFORMED; 2 3 4 5 6 7 8 9 10 11 12 13 15 17 18 20- SLOPE SITE PLAN /// / / / was GROUND WATER ~. ENCOUNTE.ED? E IF YES, AT WHAT DEPTH? Gross Net D~pth .to Net Reading Date Time Time Water Drop ~ERCOLATION RATE , (minutes/inch) TEST RUN BETWEEN COMMENTS PERFORMED BY; 'L ~¢ rc~. CERTIFI ED BY: FT AND FT DATE: 72-008 (6/79) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION [] TEsTPERCOLATION 825 L, Street, Anchorage, Alaska 99501 264°4720 SOILS LOG -- PERCOLATION TEST 2 3 4 5 G 7 8 9 10 11 12 13 14 15 16 17 18 19 20- DATE PERFORMED: ~,vdL y r~ J SLOPE SITE PLAN WAS GROUND WATER S ENCOUNTERED? ,)[Jo L O P E IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND __ ET COMMENTS PERFORMED BY: .~ ~. [,q'~ CERTIFIED BY: DATE: 72-008 (6/79) APPLI( ..... ~IT FILLS OUT UPPER HA('~hONLY Address Single Fsmily ~ Mulliple Fsmily NO. ~ Holding Tank NOTE: THE INSPECTION FEE MUST A~COMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspector Inspector Inspector Field Notes: DEPT. OF H~^LTFI & ENVIRONMENTAL PROTECTION AU8 i !983 RECEIVED (~') APPROVED BEDROOMS OF APPROVAL ( ) DISAPPROVEO CONDI~:IO L PPROVAL* DATE BY: Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received Well to Tank Septic Te, qk Size $u • Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 Certificate of On -Site Systems Approval Parcel I.D. 020-491-25 Expiration Date: 7- 9 . 1. GENERAL INFORMATION Complete legal description Southpark #1, Block 2, Lot 11 Location (site address) 4521 Southpark Bluff Drive Current Property owner(s) Mark & Kathleen Fitzgerald Mailing address 4521 Southpark Bluff Drive Real Estate Agent 2. TYPE OF DWELLING: Il Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF 4. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public vJater System WaiverRrarlance request.for: Received by: we -• F it COSA to be released to th9/endineer, unless otl COSA Fee $ 410 Date of Payment ed 13)13 Receipt Number 6VI1 t_i G COSA # 0,:Dck 3 I u 1 0 Day phone Day phone TYPE OF WASTEWATER DISPOSAL: ❑ Individual 0 ❑ Holding Tank ❑ ❑ Community ❑ F,71 Publle Sewer ❑ Date: requested by the engineer. Waiver Fee $ _ Date of Payment Receipt Number Waiver # i 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 Pannone Engineering Services LLC Address P.O. Box 100217, Anchorage Ak. 99510 Engineer's Printed Name Steven R Pannone 6. DSD SIGNATURE System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for Phone (907) 272-8218 Date 7/11/13 bedrooms, with the following stipulations: By: Original Certificate Date: "- The:. unici ali` $ Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet; - c If more than 1 septic system is on the lot: COSA Checklist # 1 of 1 Structure served by this system 1 Certificate of On -Site Systems Approval Checklist Legal Description: Southpark #1, Block 2, Lot 11 Parcel ID: 020-491-25 A. WELL DATA Well type AWWU If A, B, or C provide PWSID # Well Log (Y/N) Date completed Sanitary seal (Y/N) Total depth ft. Cased to ft. FROM WELL LOG Date of test Static water level ft. Well production g.p.m, WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate mg/L Arsenic ug/L Date of sample: B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Tank size 1,250 gal. Number of Compartments 2 Wires properly protected (YIN) Casing height (above ground) in. AT INSPECTION ft. g.p.m. Collected by: Date installed 7/1/83" Cleanouts (YIN) Y Foundation cleanout (Y/N) Y Depression over tank (Y/NL) IN High water alarm (Y//N�), N Date of pumping % P-0 12 Pumper 0 t 40m& SSt/U 1 L t; S � ■1 (�_ C. ABSORPTION FIELD DATA Date installed 7/1/83" Soil rating (g.p.d./ft2 or ft2/bdrm) 125 SF/BR System type Deep Trench Length 36 ft. Width 2.5 ft. Gravel below pipe 7 ft. Total depth 12.3 ft. Eff. absorption area 504 ft2 Monitoring tube Y Depression over field N Date of adequacy test 7/9/13 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 0 in. Water added 637 gal. New depth 0 in. Elapsed Time: 110 min. Final fluid depth 0 in. Absorption rate , 600+ 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 at in. Datum Size in gallons "Pump off" level at in. Cycles tested E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 100+ Absorption field on lot 100+ Public sewer main 75+ Sewer /septic service line 25+ Animal containment areas 100+ SEPTIC/HOLDING TANK ON LOT TO: Manhole/Access (Y/N) High water alarm level at Meets alar & circuit requirements? On adjacent lots 100+ On adjacent lots 100+ Public sewer manhole/cleanout 100+ Holding tank 100+ Manure/animal excrete storage areas 100+ Building foundation 5+ Property line 5+ Water main 10+ Water service line 10+ Wells on adjacent lots 100+ ABSORPTION FIELD ON LOT TO: Property line 10+ Building foundation 10+ Water main 10+ Water Service line 10+ Surface water 100+ Driveway, parking/vehicle storage 110+ Curtain drain 50+ Wells on adiacent lots 100+ Absorption field 5+ Surface water 100+ F. COMMENTS * No clear date of installation 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 Steven R. Pannone Date 7/11/13 COSA brown sheet 10-10-12.doc in. LC SCALE : 1" = 30' LUI a 0' 15' 30' 60' K oar E I hereby certify that an accurate survey of the following described property: PSE OF LOT SOUTHIPARK SUBDIVISION ADDITION NO. 1 (81-338) 11, BLOCK 2 49TH— * ♦ was made on August 6. 2013 and that the improvements ,...... ....w situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no Lee improvements on the property lying adjacent thereto encroach on Knrabetnikoff. A the premises in question and that there are no roadways, No, 3143-S e transmission lines or other visible easements on said property except '........... + as indicated hereon. Easements other than those shown on the ok»: lk1k wee record plat may not appear on this drawing. Anchorage Alaska, this 7th day of August 2013_ K oar E