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US SURVEY 3043 LT 26 PTN M/B T10N R2E SEC 18/19
Onsite File US Survey 3043 p i I'm Lot 26 P N 1; Ak�-I MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WATER SUPPLY PERMIT Initial Date Issued: Dec 05, 2002 Expiration Date: Dec 05, 2003 Parcel ID: 075-061-27, Permit Number: SW020475 V...egal Deuctiptiati US SURVEY 304313,;26';PTN MIB T10N R2E SEC 18/19 Site Address: Design Engineer 0000 None Required Lot Size: 7796 SO. FT. Owner Name: STEVE MENDONSA Total Bedrooms: 1 Permit Bedrooms: 1 Owner Address: 3021 BROOKRIDGE CIRCLE ANCHORAGE , AK 99504-4178 This permit is for the construction of: �✓ Private Well Li Water Storage n Disposal Field ❑ Septic Tank n Holding Tank U Privy All construction must be in accordance with: 1. The attached approved design. 18AAC72 ) and Drinking Water Regulations (18AAC80 ). 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations 3 The engigineerr muststnotify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: S OZ Date: /2 Oz Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South BragaW St. P.O. Box 196650 Anchorage, AK 99519-6650 uw.munlorgforosite (907)343-7904 ON-SFORA SINGTION E FAMILYDWELLING d 76-0‘l27000 1 Permit Number Wim£ Parcel I.D. .r fpit �vt� Dray ph�e�Qury63354 Property ovmer(s) STEL. (5iJa4�►SA p.O,t tt 3 6-ARIv,►obts At - Mailing address (1) Zp Code Qui S$7 Mailing address (2) ° -' o f tAT Zb T 11 S S 3°� 3 Legal description (Lot. Block & Sub'd.) ?Or to Legal description (Section. Township & Range) i. Lot Size Acres 4 Ft. Number of Bedrooms 77% THIS APPLICA'nON IS FOR: Sewer Only Sewer and Well Sewer Upgrade 0 THIS PROPERTY CONTAINS: 0 Jacuzzi H 0 Water Softening Unit Sww immmim% ng Pool � Therapy Pool made for a I certify that the above information is correct. I further certify that this application is being Single Family Dwelling and is in accordance with applicable Municipal Codes. / 0 Well Only 0 Water Storage 0 • i►'_... (Signature of propertyowner or authorized agent) Pemdt Fees: Date of Payment Receipt Number (Rev. 12/00) 0' Waiver Fees: _.,.. Date of Payment Receipt Number: K P1 T 0 7 P 4 O N Nit r }. o 0 t-st0 0 H .0 0 —**a�Jj 00 - -,. t C a° 0- s O 0') 0') (Y) C'7 ('7 �I rl - C) m O X W c cis ♦ n o LL V a_ a O 2 L) Z a LL 0 / r O 0 m � E (j) Z ``: W U (LS L a) C,6 U) c (D E >> O � a) cn 00 A N O N LO ai M C O a Q x W O O O 1 Al ` N 1 r O LO ti O a) U cu a_ O 00 T11U W U) W N O T— F- co m z I-- CL LLN 1— J M O M W D U) C 0 i;-- 2- C) .U U) (D _0 C6 a) J O 00 T- W W N z O H 00 z N H J M MO��\ \'J wW U) D U) O a) 0 M (1) U) Al W J J W 0 2 0 J J W z C 3 0 m O Q D U U) 0 0 a) ml X E O V N O N ai D a) U 4_- a) U cu C O I 4-1 o 0 ^0 to m Q- cC CL O 3 � i, •V N .V •= N (a L 0 �C L G W N cn O E ~ ~ a) ca a) r0 v L a) a 0 O 0 C N N a Rf 4 0 O cOn iQ_- •E m rL m > a Q Ln '> O 0 .N Q E o __ 0 a) U Q U) _ N 0 O cu = a) O 0 3 m Q. N z Q O c6 .Q d L CL Q E Q a) N L- 0 U V � 0 E •� 0 X Oca C L O N+' cn "- CO co N V < O ids > 0 V1 N Q U) 4—; O O Q U -0 Q O N O cl)C U v N •N F- Q o m m W U) C E o C n 0 m = Qco O L) T N Q LU O LL U U. L] X141 ` y c � U O a_ Eu) Z3 a) L CL ❑ M7. ffiEd t T 3 z O� N c T C CD O O LL � z aJ Q W = Z v Lu C7 a. T" co 00 co M Al CD 1 0) C O L C1 m ❑ LU J J ui 0 06 O J J W z a� C O CL O a c 7 U a� 0 LL *i c a) 69! E m ca LL a Q 0 Q O(aa O 0 0 U U L] C ` y O a_ Z3 a) � Q) O= Cl) O N C fn 7 IL U) U Q :3 •En Ln❑ C •� EE C ❑ E C 3 U CO OElCL �"—_, >+ F� U) Ccm Q O c a) E El a rn m a U v c a� ❑ NaL�i c o a) D r Y LL HOL V > M c cu❑ U) C Cl)a- rn a� a� m ❑ 0 U) L O Z7 w `oEl ElU C c m Qa m a, ❑ L m .:.i o ❑ as I > N N ? o cn V) o s❑ ❑ � L c o Q Q ElQ N ❑ Q' C •al LU J �' E N a. w 0 ❑ s VJ cn S co m A� C O W H ❑ a) w W Nm w 0 F- m cn _ LL cn Z Z L v Q O f/1 4) 4�. LL ~ a R Fw _— O O :3 cn a ow. O O > .4) F- F- cn Q Q �p CL �> N M er Lci CO L LI m w a� 0 LL *i c a) 69! E m ca LL a Q 0 Q O(aa O 0 0 U N Legal Description: US SURVEY 3043 LT 26 PTNM/B Ti ON R2E SEC 18/19 Parcel ID: 075-061-27 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA A Well log is filed with Onsite (or attached) Date drilled 1/24/03 Total depth 101 ft Cased to 100.55 ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 6/5/24 Static water level at beginning of test 68.0 ft. Comments TANK DATA operating fluid level in septic tank Date of pu>PQing ❑ Required m enance completed, if AWWTS Comments: D. ABSORPTION FIELD DA Which system tested (date installed ❑ ALL standpipes present per record dra . g Total measured depth from grade ft (m Measured depth to pipe invert from grade ft ❑ 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 gallons date Any rejuvenation treatment (past 12 months) If yes, enter date Comments/Deficiencies: COSA Checklist June 2022 Well production at time of test 5+ gpm Water storage tank volume n/a gallons Well disinfected for coliform test? ❑ Yes X No ER"C'oliform bacteria is Negative Nitrate Y mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Garness Engineering Group Date 6/5/24 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date Results ❑ Pass Fluid depth prior to test in Water added gal New fluid depth in Elapsed time min Fina id depth in Absorptio to gpd FIELD STATU POST RECOVERY Effective depth (per ord drawings) in Effective depth used in Effective depth remaining in 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' Community Sewer Manhole/Cleanout > 100' Fj Yes if No NSA ft Eyes if No ft Neighboring Tank > 100' Q Yes if No ft Private Sewer/Septic Line > 25' F-1 Yes if No *25+ ft Absorption Field on Lot > 100' ❑ Yes if No NSA ft Holding Tank > 100' FE -1 Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' Q Yes if No ft nn Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' [Eyes if No ft Q 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' ❑ Yes if No ft Surface Water > 100' es if No ft Tank to Property Line > 5' Yes if No ft Wells o . ent Lots: Field to Property Line > 10' E]Yes if No Private Wells > 100' ❑ Yes if No ft Water Main > 1�ine> es if No ft Community Wells > 200' E] Yes if No ft Water 10' ❑ Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS *Unknown separation distances from well to sewer lines on Lot 27 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 Firm Garness Engineering Group, LTD. (GEG) Phone 907-337-6179 Engineer's Printed Name Jeffrey A. Garness Date In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including (but not limited to) soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. COSA Checklist June 2022 } .. ............... y 4 arness: CE -79 3 4p�e�q LICENSEV� P�ofess;ono� #AECC884 Q no -41 jr� r .2 , `v 0 '11 -IE. PO{;TIUPI OF LOT" 26 SHONN IN 1Fi1S A2BUILT SURVEY WAS TAKEN FRO,d TI -E DESCR4'1ON IN THE TITLE HIEVORT BY� OPDEF MA 00067524 Fa - I IRS f AMERICAN II iLc, OI' ALAS --` UNDER NO CIRCUMSTANCES SHOULD AN AS -BUILT OE USED POR Ct1N5Tj1UCTiON CR FOR ESTABLISHING SCUNDARY OR FENCE LINES, THi SURVEYOR TAKES RESPON5ISILITY FOUR THE INITIAL TRANSACTION ONLY AND ASSUMES FINANCIAL [.]ABILITY ONLY FOR THE COT OF THE SURVF.' LISTci) DISTANCE5 PREVAIL OVER SCALING. REPRODUCTION MAY CAUSE RRORS IN SCALE. LOT SUIII&Y SURVEY TYPE SYMBOLS tCu IDA11 ri A8-61JILtE' ao ° ASI]HP SET RF:%:.r DRAINAGE ft;tAt. SMUCTURE AS—su;LT - FOUND RESAR Vi' OD FENCE PLOT PLAtr AS-•BI)ILT LOT SURVEY ... TOi OGRAPhY AS�UMIG17 L +. v _ _....,> n r, .L� I (oa Qs) C. ". r --k METAL FENCE !7` 1 WODU PLOT PLANS & LOT SURVEYS Lilt; I::: A a Col1ER � ETC,, ARE SHOWN RN THEIR APPROXIMATE LOCATION, MAY PREVENT SOME IMPROVEMENTS FROM BEING SEEN AND LOCA j WHICH DO NOT APPEAR ON THE RECORDCD SUBDIVISION PLAT. ! ,_rt.rr I T*� I Prepared by SURVEY CERTIFICAWN ��®� of .a•r , 'iLDalc 'TonoI. I Mgr E AC��4, ,��-�p ,. .'�� �•' + Professional Land Surveyors tho la &. o and da wzi heram, a+Aa 4•at I , c. f : ad a eataa6and 4 ar the wt a rner.. Q no -41 jr� r .2 , `v 0 '11 -IE. PO{;TIUPI OF LOT" 26 SHONN IN 1Fi1S A2BUILT SURVEY WAS TAKEN FRO,d TI -E DESCR4'1ON IN THE TITLE HIEVORT BY� OPDEF MA 00067524 Fa - I IRS f AMERICAN II iLc, OI' ALAS --` UNDER NO CIRCUMSTANCES SHOULD AN AS -BUILT OE USED POR Ct1N5Tj1UCTiON CR FOR ESTABLISHING SCUNDARY OR FENCE LINES, THi SURVEYOR TAKES RESPON5ISILITY FOUR THE INITIAL TRANSACTION ONLY AND ASSUMES FINANCIAL [.]ABILITY ONLY FOR THE COT OF THE SURVF.' LISTci) DISTANCE5 PREVAIL OVER SCALING. REPRODUCTION MAY CAUSE RRORS IN SCALE. LOT SUIII&Y SURVEY TYPE SYMBOLS tCu IDA11 ri A8-61JILtE' ao ° ASI]HP SET RF:%:.r DRAINAGE ft;tAt. SMUCTURE AS—su;LT - FOUND RESAR Vi' OD FENCE PLOT PLAtr AS-•BI)ILT LOT SURVEY ... TOi OGRAPhY AS�UMIG17 L +. v _ _....,> n r, .L� I (oa Qs) C. ". r --k METAL FENCE !7` 1 WODU PLOT PLANS & LOT SURVEYS Lilt; I::: IJ iT ISTHE RESPONSIBILITY OF THE BUILDER OR OWNER, PRIGR TO CGNSTRUCTION, TO VERIFY PROPOSED BUILDING GRADE RELATIVE I OeILY THOSF. f-MPRGV_A{ENTS ABOVti GROUND AND VISIBLE WILL SHOWN. FENCES, ,ELLS, SEPTIC CL[ANOU'TS, SIDEWALKS, DRIVEW ONLY. S: i TO FINISHED GRADE AND UTILITY CONNECTIONS AND TO DETERMINE: THE EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS ETC,, ARE SHOWN RN THEIR APPROXIMATE LOCATION, MAY PREVENT SOME IMPROVEMENTS FROM BEING SEEN AND LOCA j WHICH DO NOT APPEAR ON THE RECORDCD SUBDIVISION PLAT. ALL. DISTANCES ARE RECORD UNLESS OTHERNASE: NOl Prepared by SURVEY CERTIFICAWN ��®� of Robert 1. Jahns, Jr. 8c Assc !PLOT PLM 1; h,,eay "0, that 1 heap PI`~ dy z+�++t� E AC��4, ,��-�p ,. .'�� �•' + Professional Land Surveyors tho la &. o and da wzi heram, a+Aa 4•at I , c. f : ad a eataa6and 4 ar the wt a rner.. ''Sr �j y y� 1 1 700 Brink Drive. r ALASKA 99504 ANCHORAGE, ca a.'s-.7 an tha'Icn aid to tho baa: of my ..�er}C'-e Bad eb:lNaa, as dttt.na;ata ha.e local s, v;o-'d lrjd =d ,ur - r `r' ; __ �'t , _ yy Rec. Lot S.F. Rea Plat File ,ter �1t�p�-'" } 60' jJu 1DATIC*I As BUILT .:<.sc M Jc1tn* r. harasy ac-tlry aL 1 I ^. ynad m ,Aa -6u9! wrv4yaR ra. y r.•,:i raR s � t �x . - �% ! ncee Surveyed: 10/31/16 Drown by. S� now I:.:e.l:atiM U ��a tat a.'.d that CIl kha�� I ::.: ata:ar.. ata :n:xmoum m :ho•.a oa tNa Baa as ercraea,ayAia Blot .alaas-i }�' . .............:...� .. • ;�• a• .,ase ssse,s •i. r •9 m R06ERT E. JOHNS. JR. C": �� I Dd[a Drawn, .a 1 '{ t©:11 Grid: ! ¢ 3 3 W.O. 16-4 KaYn a l C(4tAa 4 9+• � 1 .? 1 _ SI ' tV IRNA'-- STRUCTURE AS -BUILT that 'sf+• t°yam ,�ti_ ��a _ey.,i Ge xrlpticn Yh I ., PSCa-t E ;Baa. .. by rrtfry ^ I' 7�!"1F'�'Y•lCittl nC 1 n 1 7P,