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VALLI VUE ESTATES #1 BLK 2 LT 2
Valli Vue Estates #1 Block 2 Lot 2 #015-322-10 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP201445 PID Number: 015-322-10 Dwelling: 0 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name Estate of Betty Novotney AORPTION FIELD EJ]D Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 10704 Main Tree Dr. Other Phony Number of Bedrooms Soil Rating Total depth from original grade 5 IS Ft. LEGAL DESCRIPTION Depth to pipe invert from original e Gravel depth beneath pipe Ft Subdivision Block Lot Valli Vue Estates #1 2 2 Fill added above original grade Gr I length Ft. Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Dist between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between hes From Tank Field Tank Line Ftz Well NA TANK © Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Capacity { I Surface Water 11001+ Infiltrator 1500 Gal, Material Number of compartments f { Lot Line 101+ I NA plastic 2 Foundation 10' I ATION Manufac#urer Capacity j Remarks Gal. Alarm location EleCLrn . t lied by Installer PIPE MATERIAL House to tankD3034 Tank to drainfield D3034 R&S Drainiield CO/MT D3034 Inspector Arcterra Consulting BENCH MARK (Assumed elevation) 100 ft Inspection dates: 1 10/29/20 2nd 10/29/20 Location and description 311' 10/30/20 4th South roof corner ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date.*•'" AN *. Iff S 0tA& 9tly iia ,�taueastaaus�r�tur �xz ewe t CE '71 Septic System (J (},=ail Approved G; Date 1 19 bib $ .I,��V, TO Note: this approval does not include well permit requirements.>�' it (Rev 05r02n 8) A -C=26.8' B -C=23.9' A -D=33.0' B -D=22,7' A -E=36.3' B -E=23.7' A -F=37.1' B -F=24.1' AS -BUILT SYSTEM DETAILS/SITE PLAN VALLI VUE #1 BLOCK 2 LOT 2 Permit USP201445 PID# 015-322-10 Aw OF ALS\ %*4 KENNE S/ CE Wa / \1''ESSIOTl�' y g Yi•. �� � i�'. BB x f EXISTING .;i .'•":::.:,:,:�,�.;,: •�. \ tg BUILDING FE Trso � III_ TIL- 3; I FAPPROXIMATE LOCATION •�>,.'.� - a " LTJ OF ABSORPTION AREA •��..,;,;. �: �<��;::.• I— -------...:-------------- 10' UtR Esmt Aw OF ALS\ %*4 KENNE S/ CE Wa / \1''ESSIOTl�' A ls�0 gL�JII! 82,31 SEPTIC a TANK PREPARED FOR: BETTY NOVOTNEY ESTATE 10704 MAIN TREE DR ANCHORAGE, AK FIELD BOOKS BOUNDARr. N/A STANING: N/A ASBUILM DWG. RL ' ACRD FILE: FILE — Filed COMPUTED: DRAWN' KSD CNECI@D: KMD DATE'. 11/10, GRID: SW25�1 •roe No' 20197 SCALE, NTS y g g BB x f A ls�0 gL�JII! 82,31 SEPTIC a TANK PREPARED FOR: BETTY NOVOTNEY ESTATE 10704 MAIN TREE DR ANCHORAGE, AK FIELD BOOKS BOUNDARr. N/A STANING: N/A ASBUILM DWG. RL ' ACRD FILE: FILE — Filed COMPUTED: DRAWN' KSD CNECI@D: KMD DATE'. 11/10, GRID: SW25�1 •roe No' 20197 SCALE, NTS 0 M N o I 0 6 1 in ° N LOT 3 z L I x ' OMI / 0) ODS / 2/A UTILITY / r PEDESTALS 7 o,, -.-- ,\ LONG TREE DRIVE - - N 62000'15" E 100.00' W v, V ;AT DECK 15.0' 0 co 0, LOT 2 20,181 sq. ft. t 30' SEPTIC ,S CLEANOUT 2 -STORY _ 00 9 'S SEPTIC FRAME M MANHOLE S; CVS HOUSE 25 _ SEPTIC CONCRETE LU STANDPIPES - _ DRIVEWAY 150 � cP6, 07 SHED 0 LID ti N 6 26.3' z U) ASPHALT 'V 89 °S,S''\9 \ \ 4til \ \ 30' LOT 76.S,, \\\ \ O \ \ CD I \ O CO IQ� I C:, *:'49 T" 0 15' 30' �u Sali �t r LS -14837 - i�rr�F�F'•.• .•'04�' rrf'it 1��O1\\S I0\ �-���`� AS -BUILT I HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY: EASEMENTS OF RECORD, OTHER THAN THOSE SHOWN ON THE LOT 2, BLOCK 2, VALLI VUE ESTATES SUBDIVISION UNIT RECORDED SUBDIVISION PLAT (71-217)ARE NOT SHOWN HEREON. No. 1 THIS DOCUMENT DOES NOT CONSTITUTE A BOUNDARY SURVEYAND ANCHORAGE RECORDING DISTRICT, ALASKAAND THAT IS SUBJECT TO ANY INACCURACIES THATA SUBSEQUENT BOUNDARY THE VISIBLE IMPROVEMENTS SITUATED THEREON ARE SURVEY MAY DISCLOSE. WITHIN THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST EXCEPTAS INDICATED. UNDER NO CIRCUMSTANCES SHOULD ANY OF THE DATA HEREON BE USED FOR CONSTRUCTION OF FENCES, IMPROVEMENTS, OR FOR DATED THIS 6th DAY OF NOVEMBER, 2020, AT ESTABLISHING PROPERTY BOUNDARIES. ANCHORAGE, ALASKA. FIXED HEIGHT, LLC NO CORNERS SET THIS DATE I SCALE 1" = 30' Land Surveying Services 907.290.8949 WWW.FIXEDHEIGHTCOM JOB # 20220 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP201445 Work Type: SepticTank Upgrade Tax Code Number: 01532210000 Site Legal Address: VALLI VUE ESTATES #1 BLK 2 LT 2 G:2538 Site Mailing Address: 10704 MAIN TREE DR, Anchorage Owner: NOVOTNEY BETTY E DECLARATION Design Engineer: ARC TERRA CONSULTING INC This permit is for the construction of: Effective Date Expiration Date Lot Size in Sq Ft: Total Bedrooms: �1»cnt S, Department 10/20/2020 10/20/2021 20181 ❑ 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 i Special Provisions: Prior to a future COSA approval, a ROW permit and letters of non -objection are required if a portion of the absorption field is located in the Utility E=asement. 00 n [ODD y&u'\ + bop . r J3 sVw_U b --4-0 rT 6&- ko`iv� -"kv-- Q -U C� Co M-d . 'r—MC- C_ I o12 g -/2o 2_c:, Received By: Date: Issued By: _Fu" Date: to �0 U 5 MUNICIPALITY Development Services Department On -Site Water & Wastewater Section Parcel 1. D . 015-322-10 ON-SITE SEPTIC/WELL PERMIT APPLICATION Property owner(s) Betty Novotney Estate Day phone Mailing address 10704 Main Tree Dr. Anchorage, AK Site address 10704 Main Tree Dr. Anchorage, AK Legal description (Sub'd., Block & Lot) Valli Vfue #1 Block 2 Lot 2 Legal description (Township, Range & Section) Lot Size 20,181 Sq. Ft. Number of Bedrooms 5 Phone: 907-343-7904 Fax: 907-343-7997 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) IN (w/wo ADU) Septic Tank ❑x Upgrade Q (D) ❑ Holding Tank ElRenewal F-1Duplex Multiple Dwellings ❑ Privy ❑ (SF 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: 160,75 COVI�7 Waiver Fees: Date of Payment: Z24 0 Date of Payment: Receipt Number: n236ZG Receipt Number: Permit No. OSP 20/4q 6 Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201445, Rebecca Carroll, 10/20/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201445, Rebecca Carroll, 10/20/20 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program, 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page I of Z wwwcLanchorage.ak.us (907)343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM ANDIOR WELL INSPECTION REPORT Permit Number. Sw a!O l 29 PID Number. 4016--37-Z-10 Nam• 130L Nt*uaf n 4y Wastewater System: El New ®Upgrade basso lu7�y MciTn Ti.� D�i�r 9Qs/ ABSORPTION FIELD Pha» 3 3-6 - $ 9 7.r '"'"" °"'" " pilot, Tremti O Shrlow Tmncn O BW 0 Mourb o Other LEGAL DESCRIPTION Sod Rating TolaiDepnhmongimlWWa GPDfft° it. Bloch La S� 2. VR l 11 It/Lt —t .fie. 1 Dm m pWom pm bham argot Woos Deem10 Growl (lWh b ath pipe 2 a �I / F� Fl. Fl Twnan,p Rwpe sedan FA Woo above ongl a Waw Crawl Lerpm Fl. Fl. Well: N• A. El New El Upgrade Gr" o%fth. Nw d l.». DManw Demean Ines FI FI clasrf c m (Pnvre. A B. C) Tar Depm Cnao to Tar Weorpi»n Wes Pp• Malww Fl. I Ft Fig I D -.Sd 3 Y D'dw Dr•Dra1aG S»IKWrarl. v h»lal»rf� �/ 4n Dr•In°W»/ /7��6 Fl *01-eA p`0 Yw Pare Sr rc..ng H.,gie bow crab TANK GPM Ft. FI SEPARATION DISTANCES ® septic ❑ Holding ❑ S.T.E.P. ❑ Other. To Septic Absorption LB Holding lUbliciPtivale .soar From Tank Field Station Tank Sewer Line �'r'�l /l+OQ Gr w.a> Zoo 7 Lae+ wlaw Nuroar d Conpri ' Safaa.wale, > 100 > 100 — LIFT STATION ue .Uttar La LM 37 241 •+ Gal 'Pump an' I.vr at um 'Pp dr lav* r H.gn wMw "m n Founoatbn t— J � •i�j � ^ n in N Pure Mr» 4 Model EbcDical hiep•cbar» WM by C~ Dram — .. R°"" ° Or. rntirl /AfiG• //6n o /*G �lc.nk BENCH MARK Lmotbn anc Dowwo. 61212,e..1, ecSa» vnaw� i- Coo�C o a*C IL,*.. %o4RY./ ad t+t«i 12 (tNurll6a »wlgrl / yL4/F Oe4l.. G/ton 6a»/ /Gv. OFL Engineers Stamp Inspections performed by: T«/+ -{A-c Dates: 1' 617161 i W �ovaoEa� e OF AL °by 'te�•••••••. Q�+ Development Services Department Approval •• Conditional Approval Date: jW CD•9TH .; voi11 -� ... F.�......... . L: s THEODORE F. MOORE.• CE . 3589 nc Reviewed and approved by: Date: - 4a••,•9�p�., a PERMIT NO: SW060129 / \ PAGE 2 OF 2 PID NO: 015-322-10 SWING TIES: FROM: COR. "A" COR. "B" TO: FDN C.O. "C" 33' 18' S.T. C.O. "D" 29' 21' S.T. C.O. "E" 25' 26' DBL. C.O. "F" 24' 29' S.T. C.O. "G' 25.5' 31.5' 2'+ SOIL COVER fPF311twelJ INV. 1000 -GALLON 4 93.8'SEPTIC Nil PROFILE VIEW SCALE: 1" = 5' .• D. !/In/nlllir�. <IIIIIIIIIIII/. +v /IIIIIIII/II/II//III/Ih. I III/II/II//II/IIIIIIIIIII. EXISTING SEPTIC TANK •BLOCK \/—EXISTING SOIL ABSORPTION PLAN VIEW SCALE: 1" = 30' a..... ac'AL * G&� •................•.u� •.. •. THEODCRE F. MOORE j J CE -3589 `� A 4 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water d Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Jun 05, 2006 Expiration Date: Jun 05, 2007 Permit Number: SWO60129 Parcel ID: 015-322-10 Legal Description: VALLI VUE ESTATES #1 BLK 2 LT 2 Design Engineer: 0019 FLATTOP TECHNICAL SERVICES Site Address: 010704 MAIN TREE DR Owner Name: BOB NOVOTNEY Lot Size: 20181 SO. FT. Owner Address: 10704 MAIN TREE DRIVE Total Bedrooms: 5 Permit Bedrooms: 5 ANCHORAGE. AK 99516-6738 This permit is for the construction of: ❑ Disposal Field ❑/ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ 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 engineer must notify 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: 0 /s / O (o Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 ON-SITE SEPTIC/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. e::) 1,5- - 3 2 Z - /G, Property owner(s) - 3o S Nov e4 n e�;e Day phone .3 Y6 —397s— Mailing address l070 d-1 +`Tc.s n Twee D. -y A�ch y A-« Zip Code 919si,< Site address Su r^ C Zip Code Legal description (Sub'd, Block & Lot) L o f ? C / k I/c.11; V" e Eff > / Legal description (Township, Section & Range) Lot Size Pb I S1 Sq. Ft. THIS APPLICATION IS FOR (®all that apply): Absorption Field ❑ Septic Tank Ea Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Number of Bedrooms S— THIS APPLICATION IS AN: Initial ❑ Upgrade Renewal ❑ E.»t,- yenc,, 1741p1c.revnen/ c>V e'u1lcfrr.7 Sel7AC AC4nl! P f eaiP cta r/ Ti..( Kc,c e �c7 3 •+S— r Zi S certify that the above information is correct. 1 further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: N 60 —`C Waiver Fees: Date of Payment: <i 1 S / Oe,"* Receipt Number. gyttl� (Rev. 11105) Date of Payment: Receipt Number: ;TOP TEGHN�CAL:SERVICES - --- - -- CML & ENVIRONMENTAL ENGINEERING • ENERGY CONSERVATION 6 ANALYSIS TED MOORE, P.E. 14530 ECHO CANYON ROAD PH./FAX: (907)345-1355 ANCHORAGE, AK 99516 E -Mail: tgmoore@gci.net June 4, 2006 M.O.A. DSD P.O. Box 19-6650 Anchorage, AK 99519 Dear Sirs: The purpose of this letter is to provide the required design narrative in support of our application for a permit to replace a collapsing septic tank on Lot 2, Block 2, Valli Vue Estates, Addn. #1, located at 10704 Main Tree Drive. A site plan and specifications are enclosed for your review. The replacement tank will be installed at the location shown on the site plan. The topography of the lot slopes downward toward the west The proposed project will have no significant impact on present or future water supply and wastewater disposal systems serving adjacent properties, nor will it have any significant impact on reserved space -surface and subsurface, or on drainage. Please give me a call at 345-1355 if you have any questions on this submittal. Sincerely, Ted Moore, P.E. LOT 1, BLOCK 3 VALLI VUE EST #1 \ \ i i REPLACE EXISTING \ — _ 1000 -GAL. SEPTIC TANK \PG w. NEW 1000 -GAL S.T. \� N 5-BDRM \ HOUSE DRIVE -1 ` RUT \ O �_> DBLCO. HOUSE r \ ` 1 RETAIN \ 1 FxISTING SOR-0AL SEPTIC TANK AREACRETAIN EXISTING SOIL \ L __ _ _ .. ABSORPTKIN TRENCH. _ �T Z BLOCK 2--- \ 1 m � 1 VALLIVUE SEPTIC AREA 1 1 1 1 1 1 1 HOUSE LOT 3,BLOCK 2 ; VALLI VUE EST #2 LOT 1, BLOCK 2 VALLI VUE EST #1 1 1 1 1 1 1 1 1 1 1 1 ------------------- ----------------------------------- NOTE: ALL LOTS IN THIS SUBDIVISION ARE SERVED BY A CLASS "A" COMMUNITY WATER SYSTEM E..:4�,e Ar r * ' 49 m T' 0,05n, ......................... THEOOOREF.MOORE i CE -3589 A ,� e. :... AdF 11\�RafEss%o f� (Flattop 7echnicalSemicea 14530 Echo Canyon Ro9Anchorage,,XX99516 Thou (90) 34S -135S Lot 2, Block 2, Valli Vue Estates, Unit #1 10704 blain Tree Drive Septic Tank Replacement Specifications 1.0 General: 1.1 The scope of the project consists of removing a collapsing 1000 -gallon septic tank and replacing it with a new 1000 -gallon septic tank 1.2 Construction shall be as depicted on the approved site plan. Minor deviations from these drawings may be allowed or required by the engineer conducting the inspections. All construction procedures and material specifications shall conform to Municipal and State requirements. All separation distances shall be in conformance with Municipal requirements, unless specifically waived. 1.3 The contractor shall be responsible to obtain any necessary utility locates, and to work around any buried utilities. 1.4 Unless agreed otherwise, the contractor shall be responsible for any tree clearing and grubbing necessary to complete the project. 1.5 The contractor shall provide adequate cover material and rough grading over all system components to ensure that proper drainage is achieved after settlement and that there are no residual depressions. Insofar as possible the contractor shall minimize damage to trees and existing lawn areas. 1.6 Unless specifically agreed otherwise, the homeowner shall be responsible for finish grading after the soil is compacted, as well as placement of topsoil and reseeding all areas disturbed by the construction. 2.0 Septic Tank 2.1 The existing septic tank must be properly abandoned by thoroughly pumping, removing the top and backfilling with soil, or burial elsewhere on site. 2.2 The new 1000 -gallon, 2 compartment septic tank shall be Municipally approved and shall be set level on undisturbed soil. Each compartment shall be equipped with a watertight manhole cover and a 4" cleanout. Care shall be taken to achieve the required S foot minimum separation from the building foundation. 2.3 A double cleanout shall be installed in the discharge line between the new tank and the other 1983 500 -gallon tank, which has been inspected and appears to still be in okay condition. 3.0 Inspections: 3.1 A total of 3 engineering inspections will be required during the course of the project: (1) initial discussion with the contractor to finalize the location of the tank and construction procedures, (2) after the tank is set level and piping connected but prior to backfill, and (3) after rough backfill and grading is complete. 3.2 The installer shall coordinate the timing of the inspections with the engineer sufficiently far in advance to ensure the availability of the engineer. 72-013 IRev. 3/78) ' MUNICIPALITY OF ANCHORAGE / DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99507 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME ` j PHONE ❑ NEW Uovia�ea �6. �I'bWY� -1'wl- 12./o�5 UPGRADE MAILING ADDRESS aRA Sox a(o - �t LEGAL DESCRIPTION Loo Z 31 k 2 VAII'I �ue LOCATION —Crep NO. OF BEDROOMS Lone Maiv) Trete U DISTANCE TO: Well (' Or7lmUhl Absorption area Its Dwelling I Zo NO. PERMIT NO�.1 11 11 Wri i ,e -K Y WH Manufacturer Y0. e Material �C2 1 No. of compartments i w Liq. capacity in gallons IF HOMEMADE: Inside length Width Liquid depth — s�0 o�z DISTANCE TO: Well Dwelling PERMIT NO. = z F Manufacturer Material Liquid capacity in gallons O DISTANCE TO: Well Camm(An'14 Foundation I 15 Nearest lot line f Z� PERMIT N W r1 A4 ei�t w= A J E z No. of lines Length of each line Total length of lines Trench width Distance between Ijyes Fzw Z 4/pr–to,-50 /00' &C) inches _& Q F Top of rile to finish grade Material beneath tile i2- Total effective absorption ajj.ea 926i"l Z inches Length Width Depth PERMIT NO. w Q6 F Type of crib Crib diameter Crib depth Total effective absorption area w ° Lu w Well Building foundation Nearest lot line DISTANCE TO: J Class Depth Driller Distance to lot line PERMIT NO. J w Building foundation Sewer line Septic tank Absorption area(s) DISTANCE TO: OTHER PIPE MATERIALS `, ^^ 7 V 4 SOI L TEST RATI NG 15D 9"e' INSTALLER �ob�ln E xutva-l;n EX 83 - 6Nq REMARKS o R, 5' f ILI I--- 30 ob ice APPROVED DATE LEGAL Ilton -tv 1- i*a-65 L 2 31k Z Valk Wje� r -a+ 72-013 IRev. 3/78) ..MUNICIPALITY OF ANCHORAGE Department ''F Health and Environmenta% protection 825 `�, Street, Anchorage, AK. >9501 264-4720 # # # Permit # HANDWRITTEN PERMIT # # # �J`Ca� ON-SITE SEWER PERMIT - Applicant; ��a � � , C< 'o-1 Mailing Address: 7s 9 �yy Location:t*� Phone Number: :3Z/�-fes!//>� Legal Description: 6 %9,(LJle 'dot Size: fes/ Type of Soil Absorption System Is: Trench: f/Drainfield: Seepage Bed: Holding Tank: F�— Maximum Number of Bedrooms: Soil Rating(sq.ft/br) The Required Size of the Soil Absorption System Is: % DEPTH U LENGTH % . GRAVEL DEPTH WIDTH 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 SJZE = 0- () 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 department' 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 31, 1 9 3 3 I certify that: (1) I am 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 isremodeled to include more th�ar-)3 bedrooms. Signela:Awy Gi Issued by:�`l� i L2L0- Applicant Date: SWP/024 (1/81) S UU GFS �ri)S �f3J11 6S lam' �/015Oq U-ecF GRE' ER ANCHORAGE AREA BOP`IUGH Department of Environmental Quality II I 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITESEWAGEDISPOSAL SYSTEM NAME [r MAILING ADDRESS .he '�-ZOV 7 II)) 'JPHONE3�f��•F`/�g�gq LOCATION LEGAL DESCRIPTION Z_Z�/ZyG �� v%ue SEPTIC TANK: DISTANCE/'N��� .f-�' NUMBER OF / FROM WELL MANUFACTURER MATERIAL5/ COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY 000 GALLONS. SEEPAGE PIT: NUMBER OF PITS DIAMETER OR WIDTH —3/, LENGTH, DEPTH 1/1--21 LINING MATERIALCOh(rWe CRIB SIZE: DIAMETER DEPTH & DISTANCE FROM: WELL J TOTAL EFFECTIVE BUILDING FOUNDATION/ _ , NEAREST LOT LINE . ABSORPTION AREA (WALL AREA) SQ. FT. ADDITIONAL ABSORPTION WELL TYPE CONSTRUCTION BUILDING NEAREST FOUNDATION LOT LINE CESSPOOL OTHER SOURCES_ APPROVED DISAPPROVED NEAREST SEWER LINE , REMA DEPTH DISTANCE FROM: SEPTIC SEEPAGE TANK SYSTEM DISTANCES:' 1 - 2 q,4C - 2,1'IP" DIAGRAM OF SYSTEM zI INSTALLED BY: ✓Oh _ 3 Ad PIPE MATERIAL: E2'lf riQS�/ l5� / '�A LOT SLOPE: X C REMARKS: Form No. EQ -031 GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 �XWxo nK`,+J SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT ZIA NAME OF APPLICANT v - rl'"'/V MAILING ADDRESSRO-� / PHONE54Z:�'9 INSTALLATION LOCATION LEGAL DESCRIPTION INSTALLATION OF: SEPTIC TANK 2/ SEEPAGE PIT DRAIN FIELD �, OTHER TYPE AND SIZE OF FACILITY TO BE SERVED��'�' FINANCED THROUGH TO BE INSTALLED BY SOIL TEST RESULTS /S� NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE ( try V TYPE MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT DRAIN FIELD E / SEPTIC TANK TO SEEPAGE PIT WALL I I SEPTIC TANK J . SEEPAGE PIT ' , DRAIN FIELD �U TO NEAREST LOT LINE. WELL TO SEPTIC TANK �00 DRAIN FIELD WATER MAIN TO SEPTIC TANK DRAIN FIELD ALSO CONSIDER AREA WELLS. _SEEPAGE PIT /d / SEPTIC TANK, �`O SEEPAGE PIT ___L DRAIN FIELD TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. G.A.A.B. OR LICENSED DESIGNER SIS / DIAGRAM OF SYSTEM 1 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREEA777 BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE — / / r �-3 APPLICANT'S SIGNATURE FORM NO. EQ -016 November 21, 1973 First National Bank of Anchorage P. 0. Box 720 Anchorage, Alaska 99510 Re: Lot 7., block 2, lalli Vue Subdivision Attention: Ann Olson Dear Miss Olson: It is not economically f^asiblo for public sewer to serve the subject lot at this time. An approved community wator system presently serves the entire subdivision. Sincerely, Susan L. DickersoH, Sanitarian SED/ko " J; I - i ")c, Municipality of Anchorage -= ♦ � On -Site Water and Wastewater Program a REM - i. (907) 343-7904 CERTIFICATE OF ON -'SITE SYSTEMS APPROVAL Parcel I.D. 015-322-10 Expiration Date: Se, } , 1. GENERAL INFORMATION Complete legal description Valli Vue Estates #1 Block 2 Lot 2 Location (site address) 10704 Main Tree Dr. Anchorage, AK Current Property owner(s) Estate of Betty Novotney Day phone Mailing address 10704 Main Tree Dr. Anchorage, AK Real Estate Agent Day phone 2. TYPE OF.DWELLING: ® Single Famfly (w/wo ADU) ❑ Duplex. ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: Individual Well ❑ Individual Water Storage ❑ Community Class A Well Public Water System ❑ WaiverNariance request for: 5 TYPE OF WASTEWATER DISPOSAL: Individual Holding Tank ❑ Community ❑ Public Sewer ❑ Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ Ld 12, SU CQ V I Q Waiver. Fee $ Date of Payment 11 112 I Zv z o Date of Payment Receipt Number O y 6 y 5 G. Receipt Number ,-COSA# 05C201621 Waiver# Distance: 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 ARCTERRA CONSULTING INC. Phone 696-611 Address 20442 PTARMIGAN BLVD., EAGLE RIVER AK 99577 Engineer's Printed Name KENNETH M. DUFFUS // Date /1 /d-40 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen�..�; Aft.-Mb�'%, encroachments, deficiencies or discrepancies exist. �F' 4 TH '� 4 6. DSD SIGNATURE System #1 Approved for 5 bedrooms. NETH "6 D1 " 4` U", System #2 Approved for bedrooms- Disapproved. ®.+►'�` Conditional approval for bedrooms, with the following stipulations: �```Q'\1Y OFrr�r ON-sgac i ��-WATER AW) rn By: Original Certificate Date: 1 1 a Oa The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska, The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet-10-10-12.doc Legal Description: COSA Checklist Valli Vue Estates #1 Block 2 Lot 2 If more than 7 septic system on lot: COSA Checklist # _of 7. LL DATA ❑ Well log d with Onsite (or attached) Date drilled Total depth ft Cased to ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Comments B. TANK DATA Age of tank(s)10/29/20 years Tank type/materialSeptic/Plastic Measured operating fluid level in septic tank NEW ® Standpipes/foundation cleanout per record drawing Date of pumping NEW 10/29/20 D. ABSORPTION FIELD DATA Which system tested (date installed) 7/19/83 ® ALL standpipes present per record drawing Total measured depth from grade 11.3 ft (max) Measured depth to pipe invert from grade 8.4 ft (min) ❑ N/A — pressurized field ® Monitor tubes go to bottom of effective. If not, state depth into effective Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Com ments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 015-322-10 Structure served by this system Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes _ No ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) AN.ug/t ❑ Arsenic less than MRL (ND) Collected Date of Sample STATION ❑ Requ art, Age of lift station - Lift station material Comments: completed Adequacy test date 9/21/20 Results ❑✓ Pass For 5 bedrooms Fluid depth prior to test 19 in Water added 750 gal New depth 21 in Elapsed time 15 min Final fluid depth 19 in Absorption rate 750+ gpd Any rejuvenation treatment (past 12 months) _ If yes, enter date E. SEPARATION DISTANCES ® Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' Private Well on Lot to: (Please enter distances if less than required or if community well) Private Wells > 100' 0 Yes if No ft Water Main > 10' Septic Tank/Li on Lot > 100' if No _ ft Community Sewer Manhole/Cleanout > 100' Water Service Line > 10' Yes if No _ ft ❑ Yes if No _ it Neighboring Tank > 100' ❑ Yes i It Private Sewer/Septic Line > 25' ❑ Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No _ ft Tank > 100' ❑ Yes if No _ ft Neighboring Absorption Fields > 100' Animal Contain 0' ❑ Yes if No ft El Yes ifNo_ft _ Manure/Animal Excreta Storage > Community Sewer Main > 75' ❑ Yes if No _ ft ❑ Yes I ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No _ ft Surface Water > 100' 0 Yes if No _ ft Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ® Yes if No It Private Wells > 100' 0 Yes if No ft Water Main > 10' 0 Yes if No _ ft Community Wells > 200' 0 Yes if No _ ft Water Service Line > 10' 0 Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' 0 Yes if No _ It If absorption field is under driveway comment below Property Line > 10' 0 Yes if No _ It Wells on Adjacent Lots: Water Main > 10' ® Yes if No _ ft Private Wells > 100' 0 Yes if No ft Water Service Line > 10' 0 Yes if No _ ft Community Wells > 200' 0 Yes if No _ ft Surface Water > 100' ® Yes if No _ ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION I certify that 1 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. COSA Checklist yellow sheet MUNICIPALITY OF ANCHORAGE TENT OF HEALTH & HUMAN SERVICES ision of Environmental Services k OF Parcel l.D: #-,t—' � � 5 :3a a -10 GENERAL INFORMATION s ...,`. Complete legal description Lot' 2, Bk6 sr,>y ; _�t g'J.PF� v41 g5D0 Ci Ci ADEC est By:, 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 orderto 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. 72-026 (Am- 1/91) BKk' MOA #21 r ® Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: n -T ISL / V41LZ 4/ Parcel I.D. (ils -3x2-10 Well Data Wel e Log preset Total depth Sanitary seal (Y/N) Date of test Static water level Well flow Pump levels NiT IfA B, or C, attach ADEC letter. ADEC water system number Date completed Driller Cased to Casing height WELL LOG SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line WATER SAM .TS: properly protected (Y/N) AT INSPECTION M. + ;Onacent lots On a=cent tk Public sewer manhole/i Petroleum tank of sample: Collected by: 6x5 Other bacteria rol S \B. SEPTIC/TANK" ATA Date installed a6 q e Tank size 1600AL 5o0 6a- Compartments f / Cleanouts&N) YDS Foundation cleanout (YA) 7F-S_Depression (Y/N No High water alarm (Y/90 01A Alarm tested (Y/N)) /JIA- Date of pumping 11//q q# Pumper TS/ ACS SEPARATION DISTANCES FROM SEPTIC/F14WI)IN&TANK TO: Well(s) on lot N/PrOn adjacent lots a, Do V- Foundation S To property line to Absorption field 5 fi Water main/service line Jo ,+ Surface water/drainage 106 72-026(3W)•F=t ..CONTINUED ON BACK PAGE j o z Z n 9 P. y' D r m T z S U1 y oC in G Other bacteria rol S \B. SEPTIC/TANK" ATA Date installed a6 q e Tank size 1600AL 5o0 6a- Compartments f / Cleanouts&N) YDS Foundation cleanout (YA) 7F-S_Depression (Y/N No High water alarm (Y/90 01A Alarm tested (Y/N)) /JIA- Date of pumping 11//q q# Pumper TS/ ACS SEPARATION DISTANCES FROM SEPTIC/F14WI)IN&TANK TO: Well(s) on lot N/PrOn adjacent lots a, Do V- Foundation S To property line to Absorption field 5 fi Water main/service line Jo ,+ Surface water/drainage 106 72-026(3W)•F=t ..CONTINUED ON BACK PAGE T STATION l�jl Date installed (/ ft Size in gallons Vent (Y/N) "Pump High water alarm level Meets MOA electrical codes (Y/N) _ SEPARATION DIST D. ABSORPTION FIELD DATA LIFT STATION TO: On adjacent tots (Y/N) "Pump ofy" Levbl at Surface water Date installed x'19 I �d3 Soil rating (GPD/Ft) 15o �%/i System type Wt\ol Length IOo Width �D'i Gravel thickness �ai Total depth /D Total absorption area Cleanout present'/ ) YJFS Depression over field (YAP No Date of adequacy test 3 `� �� Results ( as ifail) �SS for T Bedrooms Water level in absorption field before test172y After test G Peroxide treatment (past 12 months) (Yo 6kr b(Nr If yes, give date "IA SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot /J//+- On adjacent lots oZod { Property line To building foundation 10 To existing or abandoned system on lot (/vi• On adjacent lots Cutbank NIA Water main/service line /o Surface water too 4 - Curtain drain NONE E. ENGINEER'S CERTIFICATION 1 certify that/ have checked, verified, or conformed to S & S ENGINEERING Signature 17=d F.-F.Ini Engineer's Nam9agle River, Alaska Date 3 //S- A HAA Fee $ � . Date of Payment /a Receipt Number _- l'�29� 72-020 (3193)' Back parking/vehicle storage area !v and HAA guidelines in effect on the deo( this inspection. Waiver Fee $ Date of Payment Receipt Number