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HomeMy WebLinkAboutT15N R1W SEC 18 LT 121 Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP241318 PID Number: 051-172-40 Dwelling: ■❑ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ■❑ Upgrade Name Raymond & Janet Holmsen ABSORPTION FIELD ❑Deep Trench [C Wide Trench El Bed El Mound Site Address 18760 S Birchwood Loop Rd ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 1.0 GPD/SF 4.0 / 4.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 3.5/3.5 Ft. Gravel depth beneath pipe 0.5/0.5 Ft. Subdivision Block Lot 121 Fill added above original grade 0.0/0.0 Ft. Gravel length 45/45 Ft. Township Range Section 15N 1W 18 Gravel width 5/5 Ft. Beds: Number of Lines N/A Distance between lines N/A Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 450 Ftz 2 >6 Ft. Well >1oo' >1 00' N/A N/A >25' TANK ❑ Septic R S.T.E.P. ❑ Holding ❑ Other Manufacturer Greer (Deep Burial) Capacity 1250 Gal. Surface Water > 100' >100' N/A N/A Material Plastic Number of compartments 2 Lot Line >5' >10' N/A N/A NA Foundation >10' 0' > 1 0' N/A N/A LIFT STATION Manufacturer Greer Capacity 1250 Gal. Remarks Trenches labeled west / east. Alarm location Electrical installed by Wall near backdoor Rising Sun Electric PIPE MATERIAL House to tank D3034 Tank to drainfield D3034 Installer Green General Contracting Inc. Drainfleld D3034 CO/MTD3034 Inspector M. Jakubisin & J. Opheim BENCH MARK (Assumed elevation)100 ft Inspection vt 10/15/24 10/16/24 Location and description 2�d Back door threshold 3`d 10/16/24 4"' ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date low • 49 TH *+�l Benjamin Schiller rr �'F CE 12592 c�srF . 10/22/24 . •'�C�� Septic System Approved i Date (IV�21- `� PROFESS100 No : this approval does not include well permit requirem nt (Rev 05/02/18) / Benjamin Schiller CE 12592 R E G ISTEREDPROFE S S I O N A L E N GINEER 1"=50' CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND PERMIT # OSP241318 PID # 051-172-40 T15N R1W SEC 18, LOT 121 A B MH1 82.5 MH2 86.7 MT1 96.4 AB MT2 125.8 MT3 108.3 MT4 134.2 MT5 83.8 40.8 43.2 71.5 116.5 70.9 114.8 37.8FEET 0 50 100 PLAN AS-BUILT 10/22/24 33' ROAD RESERVATION TR U D Y S T R E E T S. BIRCHWOOD LOOP ROAD 3-BDRM HOME 1250-GAL S.T.E.P. TANK WELL OUT OF VIEWPORT NEIGHBORING 100' WELL RADII (2) 45' LONG x 5' WIDE, 6" EFFECTIVE DEPTH ABSORPTION TRENCHES TH#2 MH2 TH#1 EXISTING WELL w/ 100' RADIUS 205 210 200 195 190 EXISTING TRENCH ABANDONED IN PLACE MT3MT1 MT4MT2 MT5 MH1 PROFILE AS-BUILT (NO SCALE) 95.2 90.2 95.7 101.3 FC O MH 1 PERMIT # OSP241318 PID # 051-172-40 T15N R1W SEC 18, LOT 121 1250 GAL S.T.E.P. TANK Benjamin Schiller CE 12592 R E GISTEREDPROFE S S I O N A L E N GINEER 10/25/24 MH 2 104.9 FINISH GRADE 45' DRAINFIELD ROCK MT 1 TH # 2 NO GROUNDWATER 9/17/24 98.9 101.4 89.9 98.9 101.4 104.9 ORIGINAL GRADE MT 2 MOA APPROVED SAND 100.9100.9 WEST TRENCH 104.9 FINISH GRADE 45' DRAINFIELD ROCK MT 3 TH # 2 NO GROUNDWATER 9/17/24 89.9 104.9 ORIGINAL GRADE MT 4 MOA APPROVED SAND EAST TRENCH 98.9 101.4 98.9 101.4 100.9100.9 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: OSP241318 Work Type: Septic Upgrade Tax Code Number: 05117240000 Site Legal Address: T15N R1 W SEC 18 LT 121 G:1155 Site Mailing Address: 18760 S BIRCHWOOD LOOP RD, Chugiak Owner: HOLMSEN RAYMOND H JR & JANET S Design Engineer: FORGE ENGINEERING This permit is for the construction of: Effective Date Expiration Date: Lot Size in Sq Ft Total Bedrooms: Alm Ucparrnacnt 10/112024 10/1/2025 Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received -By.: - Issued By:G/� �--- Date: Date: 3 ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 051-172-40 0 Raymond & Janet Holmsen Property owner(s) " Day phone Mailing address PO Box 671510, Chugiak, AK, 99567 Site address 18760 S Birchwood Loop Road, Chugiak, AK, 99567 Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) T1 5N R1 W SEC 18, Lot 121 Lot Size -108,900 _Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (0 all that apply) Absorption Field FX -1 Initial D Single Family (SF) Rx (w/wo ADU) Septic Tank M Upgrade FX] Duplex (D) r-1 Holding Tank D Renewal R Multiple Dwellings 0 Privy 0 (SF and/or D) Private Well 0 Water Storage r-1 THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: 205�'C5- Date of Payment: 2:ZZ7 0 z Receipt Number: Permit No. 05 P2- 13 1 9 Permit App_'-'- : - ; Waiver Fees: Date of Payment: Receipt Number: Waiver No. September 19, 2024 MOA Development Services, On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: T15N R1W SEC 18, Lot 121 – 18760 S Birchwood Loop Road Septic system design Dear On-Site Services Engineer: The owner of the above lot has an existing 3 -bedroom home on the property, so we are submitting this permit application for the construction of a new septic system. The attached site plan identifies the location of the home as well as the existing well and new septic location. No conflicts exist between this proposed system and any other well or septic system, whether on this lot or adjacent lots. The ground surface on the lot slopes mildly from the east to the west of the lot. The field will be located in an area uphill of the home, so the system will need a pump vault and the field will be pressurized. There are no slopes greater than 25% within 50 feet downslope of either the primary or alternate site. Contours are shown on the site plan showing the grade and direction of flow. Stormwater drainage will not impact this septic system. The new trench will be constructed parallel to the slope as much as possible. Wells on this and adjacent lots are shown. The new system will be a minimum of 100’ from all wells and surface water, and more than 5’ away from the septic tank. Please refer to the attached test hole logs, plan and profile pages for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Benjamin Schiller, PE Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241318, Deb Wockenfuss, 10/01/24 Benjamin Schiller CE 12592REGISTEREDPROFESSION A L E N GINEER 1"=50' CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND T15N R1W SEC 18, LOT 121 FEET 0 50 100 SEPTIC PLAN 9/18/24 33' ROAD RESERVATION TR U D Y S T R E E T S. BIRCHWOOD LOOP ROAD 3-BDRM HOME 1000-GAL SEPTIC TANK WELL OUT OF VIEWPORT NEIGHBORING 100' WELL RADII (2) 45' LONG x 5' WIDE, 6" EFFECTIVE DEPTH ABSORPTION TRENCHES TH#2 PV MTMT MTMT TH#1 EXISTING WELL w/ 100' RADIUS 205 210 200 195 190 EXISTING SEPTIC TANK TO BE DECOMMISSIONED PER CODE 64' LONG x 3' WIDE, 2' EFFECTIVE DEPTH ABSORPTION TRENCH TO BE ABANDONED Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241318, Deb Wockenfuss, 10/01/24 T15N R1W SEC 18, LOT 121 TYPICAL TRENCH SECTION (NO SCALE)NOTES: 1. GRADE AREA OVER TRENCH TO DRAIN AWAY 2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2' WITH 2" OF INSULATION 3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY 4. IF NECESSARY, THIS TRENCH CAN BE LOWERED UP TO 1' 6" DEEPER INTO THE RECEIVING SOILS, WITH BOTTOM OF TRENCH ADJUSTED TO 5' 6" BELOW GRADE Benjamin Schiller CE 12592REGISTEREDPROFESSION A L E N GINEER DRAINFIELD ROCK 6" 3' 6" DESIGN FACTORS:SYSTEM REQUIREMENTS: 450 GPD PEAK FLOW PERK RATE: 0.3 MIN/IN APPLICATION RATE: 1 GPD/SF 5' WIDE TRENCH SYSTEM 1000-GAL SEPTIC TANK BOTTOM OF TRENCH: 4' BELOW GRADE FLOW LINE ELEVATION: 3' 6" BELOW GRADE 450 GPD / 1 GPD/SF / 5' WIDE * 1.00 RED FACTOR [6" DEEP] = 90 LF TRENCH REQUIRED (90 LF SPECIFIED) GEOTEXTILE FABRIC 6" 9/17/24 PROVIDE ADDITIONAL FILL TO ACCOUNT FOR SETTLEMENT 5' 2' 2' MOA APPROVED FILTER SAND 1.25" PVC WITH 15x 1 8" HOLES AT 3' o.c. FOR EACH TRENCH Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241318, Deb Wockenfuss, 10/01/24 LEGAL DESCRIPTION: PERFORMED FOR: DATE: PARCEL ID#: SOILS LOG AND PERCOLATION TEST 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 DEPTH (feet) TEST HOLE 1 DATE READING START TIME NET TIME (minutes) DEPTH to WATER NET DROP PERCOLATION RATE: (MIN/INCH) (inches)(inches) DATE OF MONITORING WAS WATER ENCOUNTERED? DEPTH TO WATER AFTER MONITORING IF YES @ WHAT DEPTH? ---- 9/10 1 GM (SILTY GRAVEL) Professional Engineers Stamp: YES T15N R1W SEC 18, LOT 121 9/10/2024 051-172-40 KEIRA DREHER --- --- 1' OB --- Benjamin Schiller CE 12592REGISTEREDPROFESSION A L E N GINEER TECHNICIAN: M. JAKUBISIN --- 5.5' N/A N/A COMMENTS: SITE PLAN --- USCS SOIL CLASSIFICATION WAS VISUALLY DETERMINED 9/17/24 CLAY PERCOLATION TEST NOT ATTEMPTED DUE TO THE SURFACE WATER SATURATING THE SOILS AND THE HIGH GROUNDWATER. TEST HOLE INCLUDED FOR SOIL PROFILE ONLY Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241318, Deb Wockenfuss, 10/01/24 LEGAL DESCRIPTION: PERFORMED FOR: DATE: PARCEL ID#: SOILS LOG AND PERCOLATION TEST 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 DEPTH (feet) TEST HOLE 2 DATE READING START TIME NET TIME (minutes) DEPTH to WATER NET DROP PERCOLATION RATE: (MIN/INCH) (inches)(inches) DATE OF MONITORING WAS WATER ENCOUNTERED? DEPTH TO WATER AFTER MONITORING IF YES @ WHAT DEPTH? 17.8 9/10 1 2 3 GP (POORLY GRADED GRAVEL) Professional Engineers Stamp: 13' T15N R1W SEC 18, LOT 121 9/10/2024 051-172-40 KEIRA DREHER 4:00 1 0 16 4:30 5:00 1' OB 30 Benjamin Schiller CE 12592REGISTEREDPROFESSION A L E N GINEER PERC TEST 1 LOCATION TECHNICIAN: INSPECTOR 3 4 16 YES 10.5' 9/17/24 COMMENTS: 2 4 16 USCS SOIL CLASSIFICATION WAS VISUALLY DETERMINED 9/17/24 1 0 1630 3 4 16 2 4 16 1 0 1630 3 4 16 2 4 16 GM (SILTY GRAVEL) PERC TEST 2 LOCATION GC (CLAYEY GRAVEL) DATE READING START TIME NET TIME (minutes) DEPTH to WATER NET DROP PERCOLATION RATE: (MIN/INCH) (inches)(inches) 0.3 9/10 1 2 3 5:16 1 0 16 5:17 5:19 1:13 7 0 16 6 0 16 1 0 161:36 1 0 161:11 7 0 16 6 0 16 7 0 16 6 0 16 4 5:21 1 0 162:03 7 0 16 6 0 16 5 5:24 1 0 162:02 7 0 16 6 0 16 6 5:26 1 0 162:00 7 0 16 6 0 16 PERCOLATION TEST 1 PERCOLATION TEST 2 SEE SITE PLAN FOR TEST HOLE LOCATION Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241318, Deb Wockenfuss, 10/01/24 80.2 M 1 STORY , N RESIDENCE N 80.2' a. CONCRETE WALKWAY GRAVEL . HOUSE DETAIL Scale: 1 " = 30' I I I � I I p I I Lot 1068 v I I _ — — EAST 330' 1 1.0' x 15.4' HOUSE STALL 8.2' x 16.2' WITH LEAN–TO GREENHOUSE 00 ASEPTIC PIPES Lot 121 / 44,030 s.f. (MOA) r I v z I \ 92.7' o /�.< 0 I SEE HOUSE DETAIL 123.7' O WELL O I J V rJ� \ Q 33' ROAD RESERVATION WEST 330' BIRCHWOOD LOOP ROAD -------- -----------! T I I I I 0 0 0 w Ui 0 M C4 CA O Lot 1 Lot 122 NOTES: A BOUNDARY RETRACEMENT WAS NOT PERFORMED AS PART OF THIS SURVEY. THE ADJACENT HOME ON LOT 122 IS NEAR THE PROPERTY LINE AND IMPROVEMENTS ON LOT 122 MAY ENCORACH ONTO LOT 121. PLOT PLAN ___ AS BUILT _X_ SCALE _1_== 60' GRID NW 1155 Project No J24 -1181A1 P.O. Box 210005 Lang & Associates, inc. Anchorage, Alaska 99521-0005 Boz (907) 522-6476 Professional Land Surveyors jonathan0longsurvey.com o� O F qp kenOlangsurvey.com r-- - I hereby certify that I have surveyed the following described property: GOVERNMENT LOT 121, SECTION 18, T15N, R3W, SEWARD MERIDIAN, ALASKA Anchorage Recording District, Alaska, and that this Mortgage Location Survey is a representation of the conditions that were found on the date the survey was performed. This survey does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may disclose. The information contained hereon shall not be used to establish any fence, structure, or other improvements. Dated this the __OIDay of J __---, ZZ–at Anchorage, Alaska It is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. .... .... .. ... .,%� �'JONAT C. LANG o� Q4'�Fo '(_S-9944. 404�O ESSIONA0p6o D�000v�� State of Alaska AECC963 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 Absorption re U~ Manufacturor~~ t -- ~ato~ ~o ~mpartments -- h~ Liq' c7~3' gall°ns IF HOMEMADE: Inside length Width Liquid depth Well Dwelling PERMIT NO. O ~ ~ Manufacturer ..... Materia) Liquid capacity in gallons ~ DISTANCE TO: Wel, ~ / Foundation~ Nearestlot.Z~r ~ No, of~nes I Longt'~ Totalle~hof~os~ -- Tronchw~ inches* Distanceb~nes ~ ~ -~~h grad~' - ~ Material beneath tile Total effectiCe absorption area ¢ Length Widt}~ Depth ~y inches PERMiT%~~ ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area ~ Well Building foundation Nearest lot tine ~ DISTANCE TO: ~ Class Depth Driller Distance to lot line PERMIT NO, m Building foundation Sewer line Septic tank Absorption area{s) ~ DISTANCE TO: SOIL TEST RATING DATE LEGAL 72-013 ( PERMIT NCI. EF'FIRTMEN'T' L HEFILTH FIN[) EN'v'IRONMENTFIL .... uTEC:]"ION 825 "L. '264-4.720 ,.'. 8:t. 06:1..7 ) E:O:,4 594 E. R. LOT SIZE ~ PFL] ..FIN r LOC:FIT I ON LE:GFIL FIL I...FIR$C]N,.."RIJST I C H .tie ..... O. EOUTH E, IFd_Htt..~UC L ' ")' '"' = " M ....... EL...[.,=, T'¢PE OF =,UIL PIE,_, ... [~.[ T ~[ Jihl .: T:IEH IS: DRRINF"IEL[:' NUMBER OF BEE:,ROOHS = ]: .SZIIL RFITING ,[S~ F'F,.¢E:R)= :I. EO :,I,¢..E. OF:' THE SOIL RE'qFIRP't'ICIN :,~:,TEM ''-' T'HE REE!UIRE[:' '-' ~ ' - - - '-'""" 'T'HE L..Et4GTH [)IHEN~SION I:, THE LENGTH ,'IN FEET) CIF' THE TF, EN...FI IF.' DRRINFIEI._D. TFIE; DEPTH OF R TRENCH OR. PIT Z!=~?HE L".):[STFINCE BETI4~i',t ~ SURFFICE OF T'HE GROUND RND TF'IE BOTTC~M OF 'T'FIE E,~,L. FI~,,'RTZON (ZN F~ ~ ~ THE GRFI,,,'E.. [:,EPTH ;[5 THE i"IINIHUM DEF'TH OF GRRVE-~br4'-THE OUTFFIt. L FIFE RND THE BCITTCIM ElF THE EXCFI'¢FITIOt.~ (IN FEET). F'ERMIT RFFLI_.HhI"r FL-I=, THE RE:-]PZI'..!%I.F.-~ILIT'¢ TO INFI]RM THI% [.EFFI[.TMENI DItRIN(~ TFIE ..... : :- ,:':,= . " ':" IFlI-., F'ROPERT¥ FIND ]"HE ].N.::,T~ L. Lftl ION IN...,I EC. TIJN-, OF FIN"r' I.,.IEL. L.S FIDJFII]:ENT 'TO '" c NUMBER OF RESIDENCES THFIT THE I.,.IEL..L.I.,.IILL _EFt. E. MINIMUM DISTFINCE BE"f'I.,.IEEN FI NELL FIND FIN',¢ ON-:5ITE SENRGE DISPOSFIL S'¢STEM IS :'L0~3 FEET FOR R PRIVFITE NELL OR :1..50 'TO 20C1 FEET FROi'd FI PUBL. IC NELL DEPEt.,I[:,ING UPON THE T'¢PE OF PUBLIC NEL. L. HINIMUrfl [:,ISTRNCE FROM FI PRI'v'RTE NELL. TO FI PRIVFII"E SENER I...INE IS 25 FEE:T FIND TO FI C:OMMUN~T'¢ SENER LINE ~E; 75 FEET. OTFIER REE.!UTREMENI"S MR"¢ FIPPL'¢. SPECIFICFITIONS RND C:ONSTRUCTION DIFIGRFIM'-"'::; FIRE FIVFiZ[..FIE¢._E TO INSURE: PROPE:R :[NSTRLLRTION. I CERTIF'¢ q'HFIT :1..: I FIM FRMILIRR NITH THE; REL=.!UIREMENTS FOIl'. ON-SITE SENERS FIND NELLS RS SET FORTH B'¢ THE HUNIC':IPRLIT¥ OF FIt.,ICHORFIGE. 2: I NIL. L INSTFILL THE SYSTEM IN FICCORDFINCE NITH THE CODES. ]:: I LINDERSTFIND THFIT THE ON-SITE SENER SYSTEM f,lFi'¢ REE!UIRE ENLFIRGEMENT IF;' THE RESIDENCE IS; F,!EMO[:,ELI~[:, T.r2¢~ INCLU[:,E MORE THFI!_4, ', I ~ dqE [' Russell Oyster 694-2774 Performed for: Legal Description: ~'~'- ) & E ENC~,NEERING & DEVELO, Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 MENT CO. Earl Ellis SOIL LOG ~- / 688-2280 Mailing Address: ~--~,~--.z~ ~ ~.~X ~'5~'~., ~6,./,,d~ ~ ?~ Depth (feet) 80# Characteristics 7__ 8 9__ 11__ , ~', PLOT PLAN 12__ 13 14 ~'~-~~"~ ~'~'"' 15 16__ Ground Water Encountered: Yes ~ No Proposed Installation: Seepage Pit.__ PERC. TEST If yes, what depth O ~1- E GEOTECHNICAL ~ DEVELOPMENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 6~-2280 Russell Oyster Earl Ellis 694-2774 688-2280 Soils ~ Foundations Land Development $OZL LOG DePth (feet) Sot1 Characteristics 1 3 12 Ground Water Encountered: Yes ~ No Proposed Installation: Seepage Pit Con~nents: Z ~c Z.)~-~-~/?,~/zo/t/ Perfomed by: If yes, whet depth Drain Fte~d /W/Lc Date'>-:///~ /? 7 .~'(). MUNICIPALITY OF ANCHORAGE Development Services Department / Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 051-172-40-000 Leaal description T15N R1 W SEC 18 LT 121 Expiration Date: 8/12/2025 Site address 18760 S BIRCHWOOD LOOP RD Chugiak AK 99567 Current property owner(s) HOLMSEN RAYMOND H JR & JANET S X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: 0 Original Certificate Date: 11/6/2024 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA Approval June 2022 MUNICIPALITY OF Development Services Department On -Site Water & Wastewater Section ANCHORAGE Phone: 907-343-7904 Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 051-172-40 Complete legal description T15N R1 W Section 18 Lot 121 Location (site address) 18760 S Birchwood Loop Rd, Chugiak, AK 99567 Current property owner(s) Raymond & Janet HOlmsen Day phone 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS 3. TYPE OF WATER SUPPLY: ■❑ Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ❑■ Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel 0 Plastic ❑ Concrete ❑ Fiberglass Age NEW - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench ■❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ Z �� C, Waiver Fee $ Date of Payment A- C, �z9 Date of Payment COSA # S C� Z c� / y Waiver # COSA Application_ June 2022 T15N R1W Section 18 Lot 121 051-172-40 4.4 8/12/24 N/A N/A N/A NEW Benjamin Schiller, P.E. (907) 522-7773 n 1 STORY , N RESIDENCE N 80.2' a. CONCRETE WALKWAY GRAVEL HOUSE DETAIL Scale: 1 " = 30' r0 I j Lot 1068 Lot 1 o I I EAST 330' 11.0' x 15.4'-/8.2 x 16.2' HOUSE STALL GREENHOUSE WITH LEAN-TO o6 M \ SEPTIC PIPES SEPTIC MANHOLE O I v z0 I / 92.7' 0 \ O SEE HOUSE DETAIL 0 0123.7' w (/) w Lot 122 L4 WELL r*i I w 3 \ � N �V M Q� QO \ 4 0030 s.fl (MOA) 33' ROAD RESERVATION WEST 330' I S. BIRCHWOOD LOOP ROAD PLOT PLAN AS BUILT _X- SCALE 1" = 60' GRID _ NW_ 1155 Project No. _— J24 -188A2 P.O. Box 210005 Lang & Associates, inc. Anchorage, Alaska 99521-0005 2,9 Professional Land Surveyors j9G7) 522-6876 y cam F A o00 onathanOlan surve o kenOlangsurvey.com I hereby certify that I have surveyed the following described property: 0� P O� GOVERNMENT LOT 121, SECTION 18, T15N, R3W, SEWARD MERIDIAN, ALASKA 0 * : —pQ Anchorage Recording District, Alaska, and that this Mortgage Location Survey Is a""" ""' "" t7 representation of the conditions that were found on the date the survey was performed. Q This survey does not constitute a boundary survey and is subject to any inaccuracies �""... jo HAN C.C...-LANG :.�.0 that a subsequent boundary survey may disclose. The information contained hereon shall Q o not be used to establish any fence, structure, or other improvements.��r�, ' C70 _Z404-, �4�AFo' ..LS -9944.• ' SZ Dated this the _� Day of C70 �4-, at Anchorage, Alaska Q AR ' • • • • a000 400 �FfSSIONA� �a It is the responsibility of the owner to determine the existence of any easements, �Opppoo4 covenants, or restrictions which do not appear on the recorded subdivision plat. State of Alaska AECC963 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENWRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL~i~. OF ON-SITE SEWER AND WATER FACILITY 264-4726 Application Date AP~Tf, 1'~: 19~7 (d) (e) GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) ~zfp~ lP1~ ~r15N~ R1W: Rr~nt~inn 18 Location (address or directions) ~ilP 1 ~ R~T]'I~' RTR~T4W~OI~ Tf)OP RF~AD (b) Applicant Name ~v~n~cn wnr~n~,¢ Telephone: Home ~RR-::)6~? Business Applicant Address SR D3× 2343, Ch~dGTJ~. AL~SI(A 99567 (c) Applicant is (check one): Lending Institution []; Owner/builder:~; Buyer []; Other [] (explain); net Lending Institution F_T_W:q_m N_A~T©TM _~At,~4 QP ANF~N Telephone Ag/4-Pl (3_~ Adaress P.O. ROX 770548: ,~AGLE P,Z'v'ER~ AL,ASK& 99577 Rea Estate Company an(3 Agent Address Telephone Mail the HAA to the following address: N/A n/a n/a PTCXUP BY EAGLE RIVER ENGINEERZNG SERVICE TYPE O F RESIDENCE Sing e-Family [~ Multi-Family [] Number of Bedrooms 3 Other WATER SUPPLY Individual Well:{~ Commumty[] Public [] Note: f community we~ system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite~ Public [] Community [] ' Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (11/84) Page 1 of 2 ENGINEERING FIRM PROVIDIN~ INSPECTIONS, TESTS, FILE SEARCH, DAtA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that mY investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is sate, 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 weter supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm EAGLE RIVER ENGIN~RING SERVICES Telephone 694-6196 Address P.O. BOX 77~294 : ~AP, T,~ RT~/F'~R; AT,A,~T~A 99577 Date AP~TT, 13, 1987 DHEPAPPROVAL '- Approved ,o, ~'/'~ "~ C.~..'~eO re o m s bY ~"~~'~ ''~ ' Approved ,c.--""- Disapproveo Conditional Terms of Conditional Approva CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the repi:esentations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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. Page 2 of 2 72-025 (i 1/84) A. WELL DATA ~I~IClPAUTY OF ANCHORAGE HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 264-4720 1y~Na~N~l~ Legal Description: Lot 121, T15N, R1W, Section 18 Well Classification pRIVATE If A. B. C, D.E.C. Approved (Y/N) N/A Some ~ata Well Log Present (Y/N) N attachedDate Completed BEFORE OCT. lq67 Yield ~.~ GPM/te~ted 4/8/87 Total Depth165'reported0ased to l~O'reporteGeDth of Grouting n/a Static Water Level 32'h~1 nw t~p nf aa~qn[ Casing Height Above Ground 14" Electrical Wiring in Conduit [Y/N) Y Separation Distances from Well: To Septic/Holding Tank on Lot '97' To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer L~ne n/a Cleanout/Manhole n/a Water Sample Collected by ~,NP, TNEER Water Sample Test Results AAq~TSPAP,qT)RY Comments WWFt, LT, T~,~q~AT,]'~I') PR~ 1~ Pump Set At Approx 11Q' f'~cm ~.~fmae Sanitary Seal on Casing (Y/N) Y Depresmon Around Wellhead (Y/NI N : On Adjoining Lots +1 OD' 11~ ' : On ADjoining Lots +100 ' To Nearest Public Sewer To Nearest Sewer Serwce Line on Lot ~] ~ ; Date APRTT, ~ 1Q87 B. SEPTIC/HOLDING TANK DATA Date InstalledpmP Oct 197~,Size 1 Standpipes (Y/N) Y Air-t ght Caps (Y/N) Depression over Tank (Y/N) N Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) n/A Separation Distances from Septic/Holding Tank TO Water-Supply Well 97' To Property Line To Water Main/Serwce Line 75' No. of Compartments lm~nr~wn Y Foundation Cleanout [Y/N) Y Date Last Pumped ,0, PRT~, 1~, 19~7 n/a : for ....... Temporary Holding Tank Permit (Y/N) n/a To Building Foundation qS' To Disposal Field 6' To Strean' Pond. LaKe. or Major Drainage Course Comments Page 1 of 2 72-026(11/84) C, ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed 19~1 Width of Field '3~ ~ 50 Square Feet of Absorption Area Depression over Field (Y/N) Type of System Design TRENCH Length of Field 64' Depth of Field 6' Gravel Bed Thickness 2 ' Standpipes Present (Y/N) ¥ Date of Last Adequacy Test APRTL 10: 1987 Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well ~_1~' To Building Foundation ~4 ' Lot 10 ' To Water Main/Service Line 98' To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area To Property Line 10' To Existing or Abandoned System on ; On Adjoining Lots +'~0' To Cutbank (if present) +10' D. LIFT STATION N/A Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test, Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed..--~-?'~ -- Date APRIL 10, 1987 CompanyEAGfg RIVER ]~NGIN~RZN¢vlOA No. ST-265 Receipt No. '~ Date of Payment Amount: $ neer's Seal Page 2 of 2 72~026 (11/84) Eagle River Engine0dng Services P. 0. Box 773294 Eagle Riveq AK 99577 694-5165 FROM THE Dr"~( OF.' Raymon~J:t.. Hohnsen WELL ~DATA: Drilled well Lo~ation: in yard Distance to: Building sewer or other drainage pipe - hO' Septic tank- 50' Cesspool - 100' Material: Building sewer - Wood, Transite Diameter of well: 6" Depth of Well: 165.! Well Casing Materi~l: Steel DiAmeter - 6" Depth - 150' Length of drop pipe: lO0I Water Depth from bottom: 1~7' Pump lo~ation: In well To EAGLE RIVER ENGINEERING SERVICES ~,..;. P. O. Box 773294 EAGLE RIVER, ALASKA 99577 Phone 694-5195 LETTER ~ete ~/~'/~ /_~ ~-/~/ Subject [] Please reply [] No reply necessary SIGNED ~ ~