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HomeMy WebLinkAboutVILLAGE PARKWAY ESTATES #1 LT 3 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: OSP241302 Work Type: Septic Initial Tax Code Number: 02029151000 Site Legal Address: VILLAGE PARKWAY ESTATES #1 LT 3 G:3637 Site Mailing Address: 19430 VILLAGES SCENIC PKWY, Anchorage Owner: PYTTE ALYSON C TRUST Design Engineer: FORGE ENGINEERING This permit is for the construction of: Effective Date: Expiration Date: Lot Size in Sq Ft Total Bedrooms: l7cpartmcnr 9/12/2024 9/12/2025 126321 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 - Ee"ceived�-* _- 1� `iSU.c' iii�- Issued By: Glia i Date: Date: ALI ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 020-291-51 Property owner(s) Alyson Pytte Trust Day phone Mailing address 6130 Romania Drive, Anchorage, AK 99516 Site address 19430 Villages Scenic Pkwy, Anchorage, AK 99516 Legal description (Sub'd., Block & Lot) Village Parkway Estates #1 Lot 3 Legal description (Township, Range & Section) Lot Size 126,321 _Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (N all that apply) Absorption Field FX� Initial FX] Single Family (SF) RX (w/wo ADU) Septic Tank RX Upgrade R Duplex ❑ (D) Holding Tank R Renewal Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: R.62— Date of Payment: 'TAA� Receipt Number: Permit No. , 0, Permit App_-'- : - I Waiver Fees: Date of Payment: Receipt Number: Waiver No. September 11, 2024 MOA Development Services, On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Village Parkway Estates #1 Lot 3 - 19430 Villages Scenic Pkwy Septic system design Dear On-Site Services Engineer: The owner of the above lot intends to build a 4-bedroom home on the property, so we are submitting this permit application for the construction of a new well and septic system. The attached site plan identifies the location of the home as well as the proposed well, septic location and alternate site. 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 fairly uniformly down toward the west at between 15 -25%. There are no slopes greater than 25% within 50 feet downslope of either the primary or alternate site, confirmed by a site visit. 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 50’ from all wells and surface water, and more than 5’ away from the septic tank. The alternate site is located more than 6’ away. 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 OSP241302, Deb Wockenfuss, 09/12/24 CO - CLEANOUT FCO - FOUNDATION CLEANOUT FD - FLOW DIVERTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE PV - PUMP VAULT LEGEND 1"=50' VILLAGE PARKWAY ESTATES #1, LOT 3 FEET 0 50 100Benjamin Schiller CE 12592REGISTEREDPROFESSIONA L E N GINEER 9/11/24 SEPTIC PLAN PV FCO 4-BDRM HOME 1 00' CEA & T E L E EASE M E N T 680 690 700 710 WELL WITH 50' RADIUS 670 660650 MT 40' LONG x 5' WIDE, 6" EFFECTIVE DEPTH ABSORPTION TRENCH. PRESSURIZED LINE MUST ENTER THE CENTER OF THE TRENCH 1500-GAL ADVANTEX TANK w/ AX20 POD TH#1 TH#2 MAINTAIN MIN 5' FROM DECK AND 10' FROM FOUNDATION ADD'L SOIL TO COVER SYSTEM W/ MAX 3:1 SLOPE. SLOPE WAS MEASURED IN THE FIELD, NO SLOPES GREATER THAN 4:1 WITHIN 50' OF THE FIELD RESERVE SITE 645 655 665 675 705695 685 DECK DECK >10' >10' MT Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241302, Deb Wockenfuss, 09/12/24 VILLAGE PARKWAY ESTATES #1, LOT 3 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 Benjamin Schiller CE 12592REGISTEREDPROFESSION A L E N GINEER 11 4" PVC W/ 20 - 18" ORIFICES EVENLY SPACED @ 2' OC DRAINFIELD ROCK 1' DESIGN FACTORS:SYSTEM REQUIREMENTS: 600 GPD PEAK FLOW PERK RATE: 20 MIN/IN APPLICATION RATE: 3 GPD/SF 5' WIDE TRENCH SYSTEM 1500 GAL ADVANTEX TANK w/ LIFT STATION BOTTOM OF TRENCH: AT GRADE FLOW LINE ELEVATION: 0.5' ABOVE GRADE 600 GPD / 3 GPD/SF / 5' WIDE * 1 RED FACTOR [0.5 DEEP]= 40 LF TRENCH REQUIRED (40 LF SPECIFIED) 2" INSULATION 6" 9/11/24 PROVIDE ADDITIONAL FILL TO ACCOUNT FOR SETTLEMENT 5'MOA-APPROVED SAND DOWN TO RECEIVING SOILS 3:1 MAX COVER - PROVIDE JUTE MATTING, TOPSOIL AND SEED GEOTEXTILE FABRIC 2' Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241302, Deb Wockenfuss, 09/12/24 MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATERTREATIVIENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND RETAIR ACRE MINT, herein the "AGREEMENT" made and entered into as of this Day of of 201?` -4-1., by and between herein the ``OWNER," and the Municipality of Anchorage, herein the "IMUNICIPAHTY", in accordance with Anchorage Municipal Code (AMC) 15.65365. In consideration of the mutual covenants contained herein, the parties to this Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (A.WWTS), described as located at (legal description) 2. Maintenance, Repairs anti Alterations. (Owner is required to read, understand and initial each section) the term of this Agreement, the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in asatisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. Owner acknowledges that regular maintenance ofan AWWTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 0.5/18/2018) Page I of 3 Owner acknowledges that the ,Municipality may request records ofillainteriance and repairs From the manufacturer's representative or maintenance provider. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. Owner agrees that any sale or transfer of title of the property wi H not occur without a new Certificate of'On-Site Systems Approval. 4, Q Owner agrees that the A WWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing I L� guidelines for the construction, maintenance and repair of the Owners A WWTS. Owner agrees to maintain remote monitoring ol'the AwwTS as required by the AWWTS approval. 3. Term. The term of -this Agreement shall begin on the date of approval by the Municipality to operate the installed system, or upon transfer of*title, and shall continue while the AWWTS is operational or until title is transferred. 4. Nonwaiver. The failure of the Municipality at any time to enforce a provision ofthis AL,reemcnt shall in no way constitute a waiver of the provisions, nor in any way affect tile validity off -the rigeel-Ilent or arty part hereor. or Ulic right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties Linder this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court, of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of 3 OW : .N!�', 4 By: (signature) Date: rint name) STATE OF ALASKA ss. THIRD JUDICIAL DISTRICT "I'lie foregoing instrument was acknowledged before me this 44 kdavof 2024 by 4C- ------- N (T r` A RYRB--L--IC�---F--0--R-A—L VIC SANSONE Notary Public Mlv('otiiiiiissionexpires: ___Ar,,(, Z� CD2 state of Alaska St My Cam 2026 Ev m;ss;.on Expires Mar 23, 1 MUNICIPALITY: (signature.) name) Date: Title: (rev. 05/18/2018) Page 3 of 3 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: OSP221084 Work Type: Septic Initial Tax Code Number: 02029151000 Site Legal Address: VILLAGE PARKWAY ESTATES #1 LT 3 G:3637 Site Mailing Address: 19430 Villages Scenic PKWY, Anchorage Owner: BECKERLEG JOHN & KRISTINA Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING This permit is for the construction of. EI Disposal Field H Septic Tank ❑ Holding Tank ❑ Privy Effective Date: Expiration Date: menr `OF. fir. � ��� v .�epalrn 5/9/2022 5/9/2023 Lot Size in Sq Ft: 126321 Total Bedrooms: 4 ❑ 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: S u 2 _ Date:g/z_ 7____ MUNICIPALITY z ANCHORAGE a..m Development Services Department _ Phone: 907-343-7904 On -Site Water & Wastewater Section -- Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 020-291-51 Property owner(s) BECKERLEG Day phone Mailing address 1431 OXFORD DRIVE, ANCH AK Site address VILLAGE SCENIC PARKWAY, ANCH AK Legal description (Sub'd., Block & Lot) VILLAGE PARKWAY ESTATES #1 LT 3 Legal description (Township, Range & Section) Lot Size 110517 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: (® all that apply) Upgrade Absorption Field Fx I Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ APPLICATION IS AN: Initial 0 Upgrade Renewal- F❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: TYPE OF DWELLING: Single Family (SF) . El (w/wo ADU) Duplex (D) ❑ Multiple Dwellings ❑ (SF and/or D) 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: Jt g/5 Waiver Fees: Date of Payment: `��/ �1 0 �� Date of Payment: Receipt Number:L/ Receipt Number: Permit No. 0 SP C)3 y Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc April 10, 202 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 Re: Septic Permit Legal: VILLAGE PARKWAY ESTATES #1 LT 3 To Whom it may concern: This is a request for a septic permit on the above referenced lot, the well is existing under a previous septic permit. A test hole was excavated and found 1.0 feet of organics then Silty Sand (SM) down to 3 feet then changed to bedrock in the bottom. No water was observed during excavation or after the 7-day monitoring period. The perc rate was 20 minutes. Due to bedrock an Advantex system has been designed for the lot with a pump basin. Both the house and the septic tank are on bedrock therefore the separation distance is less than 10 feet, see 50 scale site plan. A mounded system has been designed with extra fill required for the 3:1 max slope on the downhill side of the field. The slope of the lot is a max of 20 percent, see the site plan. This new system will not impact any of the surrounding neighbors due to the very large lot sizes. Sincerely Michael N. Anderson, P.E. 4661 Natrona Anch, Ak 99516 Ph 727-8864 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221084, Deb Wockenfuss, 05/09/22 SEPTIC FIELD SECTION DESIGN CRITERIA: 0.5' EFFECTIVE 4 BDRM X 150 = 600 GPD SOILS = 600/3.0 = 200 GPD 200 GA/5 = 40' 5.0' WIDE 40' LONG (1) TRENCH +1.0' DEEP (TH#1) 3.0 1.0 SP ORG 5.0' -1.0 +1.0 TOPSOIL & SEED FILTER FABRIC 6" SEWER ROCK, BOTTOM ‘3,3( GRADE 1"=200' PROPERTY LINEEXISTING WELL 100' RADIUS PROPOSED HOUSE SCALE: DJRDRAWN: DATE: VILLAGE PARKWAY ESTATES #1, LOT 3 Anchorage, Alaska BECKERLEG 4/8/2022-VILLAGES SCENIC PARKWAY-PROPOSED DRAINAGE FIELD MOA FILTER SAND 3:1 MAX S L O P E BEDROCK & INSULATION septic septic EXISTING WELL 100' RADIUS BOTTOM OF EXCAVATION MIN. 2' COVER 3RD RESERVE SITE RESERVE SITE, 5'X 40'X1' EFF, 3GPD/SF, NO SLOPES OR CUT BANKS > 25% WITHIN 50' Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221084, Deb Wockenfuss, 05/09/22 1"=50' EXISTING SEPTIC TANK MT TH#1 30' EXISTING WELL DRIV E W A Y PROPOSED HOUSE ADDITIONAL SOIL TO COVER SYSTEM W/ MAX 3:1 SLOPE VILLAGE PARKWAY ESTATES #1 LOT 3 SCALE: DJRDRAWN: DATE: VILLAGE PARKWAY ESTATES #1, LOT 3 Anchorage, Alaska BECKERLEG 4/8/2022 VILLAGE PARKWAY ESTATES #1 LOT 2 VILLAGE PARKWAY ESTATES #1 LOT 4 T11N R3W, SEC 15 NE4 PORTION 1500 GALLON ADVANTEX TANK AND POD MT MT CO M A X S L O P E 2 0 % TANK MIN. 5' FROM DECK & FOUNDATION, SOILS ARE BEDROCK PUMP BASIN IF REQUIRED, MIN. 5' TO FIELD SLOPE WAS MEASURED IN THE FIELD, NO SLOPE AROUND THE FIELD MORE THAN 4:1 NO SLOPES GREATER THAN 4:1 WITHIN 50' OF THE FIELD FOR RESERVE SITE SEE 100 SCALE DWGS APPROX. SHOULDER OF SLOPE OVER 25% EXISTING WELL EXISTING WELL TH#2 TH#1 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221084, Deb Wockenfuss, 05/09/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221084, Deb Wockenfuss, 05/09/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221084, Deb Wockenfuss, 05/09/22 Rick Mystrom. Mayor Mtmicipality of Anchorage Department of Health and Human Services 625 "L" Street P,O. Box 196650 Anchorage. Alaska 99519-6650 http://www.ci.anchorage.ak.u$ July 8, 1999 Donald Mark Williams PO BOX 244271 Anchorage, AK 995244271 Subject: VILLAGE PARKWAY ESTATES #1 LT 3 Permit # SW980153 PID # 020-291-51 The subject permit, issued 6/5/98 by this office for a single family well and/or on-site wastewater system, has expired as of 6/5/99. If you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If a licensed Professional Engineer has inspected the installation of the on-site wastewater system, the original as-built inspection report must be sent to this office for review, approval and documentation. All inspection reports must be submitted within 30 days of construction completion. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. When applying for a new permit, the fees are: $320.00 for an on-site wastewater permit and $120.00 for a well permit. If you have any questions, please call this office at 343-4744. Sincerely, Program Manager On-site Services enc: Copy of Permit PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PEP. MIT PER/~IT NUMBER:SW980153 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:WILLIAMS DONALD MARK OWNER ADDRESS:P.O. BOX 244271 ANCHORAGE, ALASKA 99524 DATE ISSUED: 6/05/98 EXPIRATION DATE: 6/05/99 PARCEL ID:02029151 LEGAL DESCRIPTION: VILLAGE PARKWAY ESTATES $1 LT LOT SIZE: 126321 (SQ. FT.) ~ER OF BEDROOMS: 4 THIS PERi, IT: 4 THIS PEP/~IT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 5o THE ATTACHED ~PPROVED DESIGN. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18DJ1C72) AND DRINKING WATER REGULATIONS (18AAC80). THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT) FROM OCTOBER 15 TO APRIL 1S A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED ~%U) CLOSED ON THE Si5/~E DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: ~/~ ,~"~ ROBERT C. COWAN, P,E. CIVIL ENGINEERS May22,1998 (907) 694-2979 FAX (907) 694-1211 SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECT[ON & FLOWTEST SITE PLANS SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS DESIGN MLrNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 32, Tract A, Village Parkway Estates Request you issue a permit to install a septic system and drill a well to serve the proposed four bedroom house on the referenced property. One test hole was excavated and a percolation test performed. The approximate location of the test hole is located on the attached site plan. At the time of excavation 8/5/95, no water was encountered in the test hole. After seven days ground water monitoring the monitoring tube was checked and the hole was found to be dry. Ground water was checked again on 5/4/98 and was found to be at 12 feet. We do not anticipate any adverse effects on neighboring wells, septic systems,~ or drainage patterns by the installation of the proposed septic system There are no points of contamination within the proposed well radius that can be seen on the attached site plan. If you require additional information, please contact us. Sincerely, Robert C. Cowan, P.E. RCC/mg Enclosure 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 _1'_' = 60' SITE PLAN DESIGN //I ~~ ~// / ~ ~~ ~ m _~Nn ~ELLUELLS WITHIN Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: DATE PERF( Township, Range, Section: 3 4 5 6- 7- 8 9 10 11 12 13 14 15 16- 17- 18- 19 20 SLOPE SITE PLAN A ,¢ WAS GROUND WATER Monitoring? Reading Date Time /Ot.s'7 //:uo //~'~ Net Time Depth to Net Water Drop ~ U¥" '1~" ~ 'z~" PERCOLATION RATE ~ {minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN ~)~ FT AND O~ . FT J~flV~ C ~ YST{~~~O/[ ~CERTiFYTHAXTHISTESTWASPERFORMEDIN PERFORMED BY: S & S ENGINEERING m 17~4 ~gle River L~ Road No. 2~ ~/13'- ACCORDANCE WI~~AL GUtDELINES IN EFFECT ON THiS DATE. DATE: 72~08 (Rev. 4/~) NoTE:App]icahon -nus[befllled o~completely SINGLE FAMILY DWELLING Prol~erty Owner Name T(TVXr(,I~,CQ- i/~A-(-L~'-t~- ~]~(~'~ ' Mailing Address ~' O, ~O~ ~C/~¢)1 .~, ~(C_ ...... ~arcel Id;~tJfic~t~n Numbe; '~ ' Day Phone ..~-~_~-// ¢/ Zip Code Lot Size /'~ [,) Z ~ f Acre,~ Inspections will be conducted by: R E C E i V E D Number of Bedrooms Approved Engineering Firm~*~*~ Municipali~ (permit fee included) AP~9 Does your house contain any of the following: Hot Tub, Swimming Pool, Therapy Pool, 5ecu~i, ~ MUNICIPALIIY OF ANCHO~GE or Water SoEener Unit Jf yes, which one? ~u~n~ This application is for: Sewer Only Sewer and Well Sewer Upgrade Well Only ~ Water Storage. I ce~i~ that the above info~ation is correct. I fu~her ce~i~ that~ application is being made for a Single Family Dwelling and in accordance with applicable Municipal Codes. // , . ~ Prope~ Owner~ell Driller 72-012 (Rev, Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Services Division Telephone: 343-4744 ON-SITE SERVICES FEE DOCUMENTATION Date Paid: ~// Name of Payer: (Name on Check) Mailing Address: (Off of check) Legal Description(s): Permit Number: OS--'03579 Type of Payment: (Indicate Amount Paid) !ealth Authority: Excavator Permit: Sewer & Well Permit: Engineer Permit: Well Permit: Sewer Permit: Copy Request: 72q)34 (Rev. 10/87) Pumper Permit: Well Driller Permit: Tank Manufacturer: (Waste Treatment) DISTRIBUTION: WAIVERS: Lot Line: Well to Tank; Well to Field Field to Surface Water Tank to Surface Water WHITE--MASTER FILE CANARY--PROGRAM FILE STATE OF ALASKA DEPARTMENT OF NATURAL RESOURCES DIVISION OF MINING & WATER MGMT WATER WELL RECORD SECTION QTRS SECTIOI J TOWNSHIPr_]NF_~s RANGE~]Ew MERIDIAN LOCATION/SKETCH: WELL OWNER: DEPTHS MEASURED FROM:~]casing top Rground surface BOREHOLE DATA: Material Type and Color Depth From To WELL DEPTH:,~ ~.:; ~, ft D/~T~E OF COMPLETION Depth of hole;,~,. ~' ~' Depth of casing' ~.(~) ft ~-~7' i/f ! ~'/ DEPTH TO STATIC WATER LEVEL: /'~ ~-~f ~' f~ below ~{~] top of casing [] ground surface Date: .;,~-,~, //~t '/ O M~HOD OF DRILLING; ~ air rota~ ~ cable tool ~ other USE OF WELL:~,.~] domestic [] irrigation [] monitor [] public supply [] other CASING STICK-.U.p.: Casing type: .2~'~;?'. ft. Diam: ~' in, t~ ft ~' in, to_.'-'-~ Oft WELL INTAKE OPENING TYPE: [] open end [] screened [] perforated ~'~] open hope Depths of openings: to ft SCREEN TYPE: .Diam: in. Slot/Mesh Size: Length: ft GRAVEL PACK TYPE: Volume used: Depth to top: GROUT TYPE: ,~_.~z~z.-~lume: Depth: from ft to DEVELOPMENT METHOd: ¢~.,.~;'~.. Duration: ~'-) ~., ,~Z/4~.,.~ ft PUMPING LEVEL AND YIELD: ft after ~2~-,. hrs pumping ~. ? _ _ gpm PUMP INTAKE DEPTH: ft Horsepower: __ WELL DISINFECTED UPON COMPLETION?~-J YES [] NC CONTRACTOR INFORMATION: REMARKS: ( ~ ~'~ 4.,--~.~ /b.~'~z~/ ~eg~(ered, Business Name / ~ ..... . -- . ~. ~ .._ ,~ c~ PLEASE MAIL WHITE COPY OF LOG TO: ..... b~gnature of Authorized Res~resentative ____ 3601 C St, Suits 800 ANCHORAGE AK 99503-5935 Phons '(907)269-8639, Fax (907)562-1384. r� o Municipality of Anchorage Y ` On -Site Water and Wastewater Program (907) 343-7904 s ` Certificate of On -Site Systems Approval Parcel I.D. 020-291-51 Expiration Date: l l q-2— f 1. GENERAL INFORMATION: Complete legal description VILLAGE PARKWAY ESTATES #1; LOT 3 Location (site address) Current Property owner(s) Mark Williams Day phone 350-0889 Mailing address Real Estate Agent 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: VACANT LOT 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well © Individual ❑ Individual Water Storage ❑ Holding Tank ❑ 'nom Community ClassWell_f ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver/Variance request for: Distance: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee $ GO Waiver Fee $ _ Date of Payment %� `�� 1 Date of Payment Receipt Number OST 761 G Receipt Number COSA OSG2 l x{35 Waiver # In 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: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101- Anchorage, Albska 99507 [2, Engineer's Printed Name: Jeffrey A. Garness Date: ��- f 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,7 U groundwater levels (that may fluctuate during the year), quality of construction (materials and / t: �v 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 ' • • • • • • .. . • • • • •G the well or septic system. GEG makes no representation whether an alternative well or septic system �v �, je f/1 eeyy A. Gar _ss: can be installed on the property in the event either of the current systems fail to perform adequately in Qn9.[� CE_ zp `•I �!` ` / 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 �J party (including subsequent property purchasers) is not authorized, nor will it confer any legal right Yess%0 whatsoever. `� Q 6. DSD SIGNATURE System #1 Approved for _---_�bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, JON_R-!CC88�, g WATER AND z^ C3 WAST1,_V',!ATER o pROGF,AM J�G 11�1 with the following stipulai!�d�nj T SER )�)� By: tn._ Original Certificate Date: r) r `' The Municipality of Anchorage Development Servic Division (SD) 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 Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other 0.1 } all Legal Description: VILLAGE PARKWAY ESTATES #1; LOT 3 Parcel ID: 020-291-51 H f more than 1 septic system on lot:: COSA Checklist # of Structure served by this system lam? A. WELL DATA n O Well log is filed with Onsite (or attached) Well production at time of test 0.9 gpm x _ 3 Date drilled 6/11/9II •� Water storage tank volume N/A gallons > Total depth 285 ft C Well disinfected for coliform test? ❑ Yes No Cased to 20 ft ``v❑ Coliform bacteria is Negative Jl Sanitary seal is functioning correctly Nitrate mg/L NKNitrate less than iV1RL (ND) 01 ❑ `Wires are properly protected ArsenicS-S 3 ug/L ❑ Arsenic less than MRL (ND) Casing height (above ground) 18+ in. Collected by GEG, LTD. Date of flow test for COSA 7/14/21 Date of Sample 7/14121 Static water level at beginning of test 111.2 ft Comments WELL HAS BEEN CHLORINATED AND THE TOP HAS BEEN WELDED SHUT. WELL MUST BE CHLORINATED AGAIN ONCE HOME IS BUILT D. TANK DATA Ace of tank(s) years Tann 'type/material i}ileasured operating fluid level in septic tank ❑ Standpipes/foundation cleanout per record drawing Date of pumping D. ABSORPTION FIELD DATA Which system tested (date installed) ❑ ALL standpipes present per record drawing Total measured depth from grade ft (ma Measured depth to pipe invert from grade ❑ N/A — pressurized field (min) ❑ ivlonitor tubes go to bottom of ' ective. If not, state depth into effective ❑ Code -required soil�cerover field El System preso ed (Required if v�a ant for greater than 30 days prior to date of tes . ,J,Kns introduced gallons ments/Deficiencies: COSA Checklist yellow sheet C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: 'Adequacy test date Results [ Pass For bedrooms Fluid depth prior to test in Water added gal New depth in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) If yes, enter date 4 E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ❑ Yes if No ft N/A Community Sewer IVlanhole/Cleanout > 100' Property Line > 10' ❑ Yes if No ft ❑✓ Yes if No ft Neighboring Tank > 100' ❑✓ Yes if No ft Private Sewer/Septic Line > 25' Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No NSA ft Holding Tank > 100' ❑✓ Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' ❑✓ Yes if No ft � Yes if No f t , Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ❑✓ Yes if No ft 0 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No ft Surface Water > 100' ❑ Yes if No >--ff Property Line > 10' es if No ft Wells on Adjacent Lots: Property Line > 5' ❑ Yes if No ft Wells on Adjacent Lots: Private Wells > 100' ❑ Yes if No ft Absorption Field '_ 5' Water Main > 10' ❑ Yes if No ft ❑ Yes if No ft Private Wells > 100' Community We >� Yes if No ft ❑ Yes if No ft Water Service Line > 10' ❑ Yes if No ft If septLc-tank' is under driveway comment below From Absorption Field on Lot to: (Please enter distances- ni ess than required) Builcling Foundation > 10' ❑ Yes if ft If absorption field is under driveway comment below Property Line > 10' es if No ft Wells on Adjacent Lots: Water Main > 10' ❑ Yes if No ft Private Wells > 100' ❑ Yes if No ft Water Sery ine > 10' ❑ Yes if No ft Community Wells > 200' ❑ Yes if No ft rtace Water > 100' ❑Yes if No ft F. ENGINEER'S COMMENTS VACANT LOT G. ENGINEER'S CERTIFICATION 1 certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with y MOA COSA guidelines in effect on this date. .:... . '� ............ . COSA Checklist yellow sheet A- —"G ,,._.�...-` .:.. . J f rest A. Prness. 9, CE 7 t,3 L��apro FesstonQoo #AECC884 it Scenic Parkway Q3 Villages Edge .. of ASPhalt S 04'34'04" E C1 50.8 C) 4 rr) Co ui O Co F N 16 P — — to O� Co m LO � Ir -- to M r -- NO 0 in Co U) C: _0 lu a) u 3: cc 0 -2 Z > 0 W -0 oz U° C a> V -0 T, Gj Gj cc cc 2 0- 0 LuC CC 0 _ Q, U°_c � C L C ,c 3: C -Cc:: lzv Q N 16 P — — to O� Co m LO � Ir -- to M r -- NO 0 in Co U) C: _0 lu a) u 3: cc 0 -2 Z > 0 W -0 oz U° C a> V -0 2 Gj Gj cc cc 2 0- 0 LuC CC 0 _ Q, U°_c � C L C ,c 3: C -Cc:: lzv o C) OU 0 0 n 0 -, -oc co IU >0 0 "j, — <vC 0 C 0. Q) 0 Q D Sl 0 0- vOi C Qj C) CIj un < < < oC) -j f c 0 Z M Q z Caj u a C z U LD Q) -C — L u (,\j L) Lu >. 0 2 :DX t - (2' Z, C) L (D U a) U x < > < < Lj) 7 0 < .0 N C) U > W QV" 4� C) C) Ct) Cn U U- Cz WCt CD u OC 2: C', W < — > 0 00tz, 0 z CO > cr 0 �- -J C- � � 30: Municipality o Anchorage ft. Development Services Department :X Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 Water Well Advisory Certificate of On -Site Systems Approval (COSA) # OSC211435 During a recent COSA on-site inspection and test of the potable water supply well on. Lot 3 of Village Parkway Estates #1 subdivision, the well's productivity was determined to be .9 gallons per minute. Restriction of non- critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval.