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CONIFER HEIGHTS BLK 2 LT 4
Conifer Heights Lot 4 Block 2 #015-093-31 MUNICIPALITY OF ANCHORAGE g DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME -T� ll__ V V I �vt1 l "f r� PHONE 6 NEW t UPGRADE MAILING ADDRESS jf 0 0 De- Be— -A 206 A �-o LEGAL DESCRIPTION C&n1r f kis t_'C>t- `i B l -c 13 LOCATION fvh�-fie r�-,-�, e NO. OF BEDROOMS Uy DISTANCE T0: Well rlo i Absorption area ,i ,S' Dwelling / 3 PERMIT NO. e Yb Yy y H Manufacturer A a s k Material No. of compartment Liq. capacity gall ns IF HOMEMADE: Inside length Width Liquid depth Y J0Z DISTANCE TO: Well Dwelling PERMIT NO. O Z 4 Manufacturer Material Liquid capacity in gallons w = DISTANCE T0: Well +/ h Foundation Nearest lot line �6 PERMIT NO C) L/y 7— `f� LU LL Z F Z W No. of lines / Length of each line _0 Total length of lines jZ7 Trench width L( -GO Inches Distance between lines ^ N Q H D Top of tile to finish grade22 T Material beneath tile �^ p inches Total effective a sor io area i (DO 1a' W C7 Length Width Depth PERMIT NO. a H W° Type of crib Crib diameter Crib depth Total effective absorption area W y DISTANCE TO: Well Building foundation Nearest lot line J J Clas Depth Driller Distance to lot line PERMIT NO, W � DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS PvL C' l SOIL TEST RATING / SO Z7'// INSTALLE� 6_K O Y Y' Cie.,,ZI ° y ! 3 - REMARKS clki Cra,'4 i's on f � "Oul be a S,'('F) .tui -(He -o P,4 4,- -t/ 0*12.— octt 8 F APPROVED �+ DATE LEGAL llJf 2�- /q8 y 'T- 1W 17,310 13, Cora / fer I+ h �- Lot�/ � jac.Ic 2 72-013 (Rev. 3/7 M -W DRILLING, Inc. P.O. Box 10-378 • 10300 Old Seward Highway (907) 349-8535 84-255 ANCHORAGE, ALASKA 99511 DRILLING LOG Well Owner DULIICT'103 .II U UD Use of Well UtAXOS C Location (address of: Township, Range, Section, if known; or distance main road Lot 4. Block 2 Conifer llelphte - Anctiorage Size of casing 6i 1 Depth of Hole 141 feet Cased to 141 feet Static water level 1-14 ft. ("abv''f6) (below) land surface. Finish of well (check one) open end ( X ) ; Screen ( ); Perforated ( ). Describe screen or perforation tbr103 Well pumping test at 1.0 gallons per TM?) (minute) for--L----hours with of drawdown from static level. Date of completion Ag..ust 23, 1984 WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness U TO 2 2 To 3 3 TO 35 :.3.5TO 55 i5 TO :' J TO 1.35 1.:35 TO 141 —TO— TO OTO —TO— TO OTO TO TO —TO— TO OTO CasiM, s tict;1.4) Fill ANCHORAGE OF Laose r,"31 $�roanl ailty mavel 1mee ravel T ra-m gilt yravl 474terbeartw. am ml NWWA Certified Contractor date No's: 814 & 971 3 — CONTRACTOR MUNICIPALITY 'OF RNCCP,.. "ROE DEPARTMENT Or HEALTH AND Efi+lViAONMENTAL F KOTEC:T I ON 825 L STREET, ANCHO"k AK 59501 0 r-4 —!S- I -r EE :ERE t4 E F W E= L t- P i x.1' M T T AM I T NO: 84044 ATE I SSUED : 06/11/84 APPLICANT: D,& S UNLIMITED ADDRESS: 7800 DEBARR #20E ANCHORAGE, AK 59504 CONTACT PHONE: 337-6753 LEGAL .DESCRI P : SUBDIVISION: CONIFER HTS. LOT: 4 BLOCK: 2 SECTION: 13 TOWNSHIP: 12N RANGE: 3W `LOT SIZE, 38852 CSCE. FT. OR ACRE MAX " BEDROOMS : 4 LISTED BELOW ARE THE;. OPTIONS AVAILABLE TO ' YOU IN -DESIGNING YOUR SEPTIC SYSTEM. CHOOSE THE OPTION THAT BEST FITS YOUR SITE. _DL EPTH TO -PIPE BOTTOM (FT.) 8.0 . GRAVgL DEPTH C FT. y 6.0 TlotaL DEPTH <FT. 14. 0 GRAVEL -W I DTH OFT. ? 2.5 GRAVEL LENGTH (FT, 50.0 3RAVEL VOLUME (CU. YDS. } 30.0 TANK SIZE (OAL9) 1,250.0 �* SOIL RATING t 5Q. FT: ,'BR) 150 THINK MUST HAVE AT LEAST TWO COMPARTMENTS I CERTIFY THAT: 1. I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE; SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE (MOA) AND THE STATE OF ALASKA. 2., I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH ALL MOA CODES AND ` REGULAT I ONS, AND IN COMPLIANCE WITH THE DESIGN CRITERIA OF THIS PERMIT. 3. I WILL ADHERE TO ALL MOA AND STATE OF ALASKA REQUIREMENTS FOR THE SET BACK DISTANCES FROM ANY EXISTING WELL., WASTEWATER DISPOSAL SYSTEM OR PUBLIC SEWERAGE.SYSTEM ON THIS OR ANY ADJACENT OR NEARBY LOT. 4. I UNDERSTAND THAT THIS PERMIT IS 'SAL -I D FOR A MAXIMUMOF 4 BEDROOMS AND* ANY ENLARGEMENT WILL REQUIRE AN ADDITIONAL PERMIT. I1=' A LIFT STATION IS -INSTALLED -IN AN AREA COVERED BY MOA BUILDING CODES THEN C1"> AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED C2> AS-BUILTS' WILL NOT BE APPROVED. WITHOUT AN ELECTR I CAL I NSPECT`I ON ` REPORTI AND (3) THE EL'ECTR I CAL WORK MUST, BE POINE BY A LICENSEE) ELECTRICIAN. S I1CiNEP, DATE APPLICANT: D & S MITER ISSUED BY DATE C� �� MUNICIPALITY OF ANCHORAGE lowar f 84 - DEPARTMENT OF =ALTH AND ENVIRONMENTAL PF 'ECTION 825'L STREET, ANCHORAGE, AK 99501 264-4720 CA V4 -- ca 30 ir to 05 EE AJ EE FZ At WELL F=5 F= R ri I _r "ERMIT NO: )ATE ISSUED: IPPLICANT: %DRESS: DONTACT RHONE _EGAL DESCRIP _OT 81ZE: IAX BEDROOMS: 840442 06/il/84 D & S UNLIMITED 7800 DEBARR #206 ANCHORAGE, AK 99504 337-6763 SUBDIVISION: SECTION: 13 38852 & SQ. FT 4 CONIFER HTS. TOWNSHIP: 12N OR ACRES) LOT: 4 BLOCK: 2 RANGE: 3W -ISTED BELOW ARE THE OPTIONS AVAILABLE TO.YOU IN DESIGNING YOUR SEPTIC SYSTEM. CHOOSE THE OPTION THAT BEST FITS YOUR SITE, - - - - - - - - - - - - - - - - - - - - - - - - --- - - - - - - - - - - -r FZ I—E N r—'" )EPTH TO PIPE BOTTOM (F7) 8. 0. 3RAVEL DEPTH <FT.) 6. 0 DOTAL DEPTH (FT.) 14.0 3RAVEL WIDTH (FT.) 2. 5 3RAVEL LENGTH (FT. 50. 0 3RAVEL VOLUME (CII. YDS.) 30.0 TANK SIZE <GALS) 1,250.0 301L RATING < SQ. FT. /BR) 150 TANK MUST HAVE AT LEAST TWO COMPARTMENTS - - - - - - - - - - - - - - I CERTIFY THAT: i. I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET. FORTH BY THE MUNICIPALITY OF ANCHORAGE (MOA) AND THE STATE OF ALASKA.' 2. 1 WILL INSTALL THE SYSTEM,IN ACCORDANCE WITH ALL MOA CODES AND REGULATIONS. - AND IN COMPLIANCE WITH THE DESIGN CRITERIA OF THIS PERMIT. 2. 1 WILL ADHERE TO ALL MOA AND STATE OF ALASKA REQUIREMENTS FOR THE SET BACK DISTANCES FROM ANY EXISTING WELL, WASTEWATER DISPOSAL SYSTEM OR PUBLIC SEWERAGE SYSTEM ON THIS OR ANY ADJACENT OR NEARBY LOT. 4. 1 UNDERSTAND THAT THIS PERMIT IS VALID FOR A MAXIMUM OF 4 BEDROOMS AND ANY ENLARGEMENT WILL REQUIRE AN ADDITIONAL PERMIT, IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (i) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED) (2) AS-BUILTS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE ELECTRICAL WORK MUST BE. Or BY A LICENSED ELECTRICIAN. SIGNED DATE: RPPLICANT: D & S_fJMITED I SSUED DATE: •p t —0 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION •r 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SOILS LOG " PERCOLATION TEST �i PERFORMED FOR: !V % all //%�/7<�� DATE PERFORMED: ", LEGAL DESCRIPTION: t" beAv. block P H SLOPE SITE PLAN T E 2 19C grown I 3 4 5 -P 7 �� iM�� Sandy Il'raval1y SII' 8 + (S P) J iffy ieA17d/ 9- 10 10 BF d rct�in WAS GROUND WATER L 'An r� ENCOUNTERED? P O O 12 Cr t ve/ Dry E I r IF YES, AT WHAT I/ o zy rR Q,4o DEPTH? 13 0 Cobbles 14- 4 Depth to Net 15- 15 Time 16- � 17 1 .t 18 1 20 C.N. COMMENTS • i5U4,1l rty r Reading Date Gross Net Depth to Net Time Time Water Drop .t r l' J� G.Ti� PERCOLATIONRATE TESTRUN BETWE raied &Y /SD, (minutes/inch?' +# t FTPND FT pe r hoc r vnrrt PERFORMED BY: a es CERTIFIED BY: DA : 72-008 (6/79) Of/ Development Services Department Building Safety Division On -Site Water & Wastewater Program off° 4700 Elmore Road P.O. Box 196650 - Mark Begich Anchorage, AK 99507"a Mayor www muni or lag nsite (907)343-7904 Pump Installation Log Well Drilling Permit Number: SW Date of Issue: Parcel Identification Number: Legal Description Property Owner Name & Address: n 1 �t%✓ 1' i✓1Ik pt9FDr7� 14 e- � tlatol Suq$IR C11FOE 42) - a L- 1-i yJn�h oqggcl la K 91-567 Pump Installation Date: 7-0y - I5� Pump Intake Depth Below Top of Well Casing: V30 feet Pump Manufacturer's Name: (Z E 1>Up CKr-1- Pump Model: 50 G3o Cn% 8Slbt Pump Size 1>�)_hp Pitless Adapter Burial Depth: /V feet Pitless Adapter Manufacturer's Name: M05.5 Pitless Adapter Installer: Well Disinfected Upon Completion? [VYes ❑ No Method of Disinfection: G j 11 0 �L I rl 0 1) F rS Comments: Pump Installer Name: A l tl C's Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services Ort -SM Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 (907)343.4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILL/Y DWELLING Parcel I.D. # 015-093-31 HAA# 1. GENERAL INFORMATION Complete legal description CONIFER HEIGHTS SUBDIVISION; LOT 4 BLOCK 2 Location (site address or directions) 9401 SUGAR CIR ANCHORAGE AK 99516 Property owner DAVE AND DONNA DeGRUYTER Day phone (9007) 346-5399 Mailing address 9401 SUGAR STREET ANCHORAGE AK 99516 Lending agency Day phone Mailing address Agent BARRY CASSADY Day phone _(907) 244-0514 Address C/O- DYNAMIC PROPERTIES 3111 "C" STREET SUITE 100 ANCHORAGE AK 99503 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: IndMdual well xx Community well Public water NOTE: ff community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site xx Holding Tank Community on-site Public sewer NOTE: ff community wastewater system, provide written confirmation from State ADEC ing to the legality and status of system. 72-025 (Rev. 1191) FrontMOA'921 G=WW Ver-!cn Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $1000.00 at, or prior to, closing for the engineering services provided. 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is 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 inspeon, the on-site water supply and/or wastewater, disposal system is in compliance with all Muni State codes, ordinances, and regulations in effect 77 on the date of this inspection. Name of Finn Phone—(907) 337-41179 Engineer's Signature Date Zo 100 /n conducting this evaluation, AWING, inc m teal to p; e a thorough, conscientious engineering is of rile system in accordance with ADEC and M� H Guidelines & Regulations. The reported results described the performance of the system under the conditions ncountered at the time of the test, and separation distances measured to readily identfiiable features. The operational life of all wells and septic systems depend on the local soils condition, ground water levels that may fluctuate during the year, and the water 0000pO usage of the family being served by the system. These cond/tlons are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. AW WC, Inc. can therefore not provide any warranty for future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DHHS. yste pe reg �....:.... ........... .. The content of this report is for the sole benefit of the owner listed above. Any (� reliance upon or use of this report by any other person or party is not authorized,..... • • • • , • • • nor will it confer any legal right whatsoever. O fre I A. cnmgs ; 6. DHHS SIGNATURE O 4 s ., �E-7953 ••A`��� Approved for. bedrooms �Op�"P oresgu>� D0000��' Disapproved Conditional approval for bedrooms, with the following stipulations: M Note: The well for this Dronerty meets exi.stine_State and M,mirinal_Cndes. There are nitrates present. It is suggested that periodic testing be performed to insure the weils cuntiaued n ral-e— concentration is 5.97 mg/l. EPA maximum concentration is 10.0 mg/],_ More information on nitrates is available from the On-site Services program, DHHS, 343-4744.-- Date 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 independr:nt professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employeeis 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 woric. 72-025 (Rev. 1181) Bede MOA 421 computer Version b\L`.LI V LJ Municipality of Anchorage JUL; '25 2000 DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division MUNICIPALITY OF ANCHORA 825 OV Street, Rm 502 Anchorage, Alaska 98501 (907) 34SWU4 L SERVICES pn I - Health Authority Approval Checklist Legal Description: CONIFER HEIGHTS S/D• LOT 4, BLOCK 2 Parcel I.D.: 015-093-31 A. WELL DATA Well Type PRIVATE If A, B. or C, attach ADEC letter. ADEC water system number N/A Log present (YIN) N Date completed 8/23/84 Total depth 141' Cased to 141' Casing height (above ground) 12° Sanitary seal (YIN) YES Wires property protected (YM) YES FROM WELL LOG AT INSPECTION Date of test 8/23/84 7/17/2000 Static water level Well production 10 -9-P.M. WATER SAMPLE RESULTS: Coliform 7 Nitrate 9% ALA �L Other bacteria Date of sample: 7/17/2000 Collected by: A.W.W.C. B. SEPTIC/HOLDING TANK DATA Date installed 8/20/84 Tank size 1250 Number of Compartments 2 Cleanouts (Y/N) YES Foundation deanout (YIN) YES Depression (YIN) NO High water alarm (Y/N) I N/A Date of Pumping 7/17/2000 Pumper A+ HOME SERVICES `i C. ABSORPTION FIELD DATA Date installed 8/20/84 Soil rating (g.pAXI12 or ft2lbdrn) 150 System type TRENCH Length 50' Width 4'-5' Gravel thickness below pipe 7' Total depth 14' Effective absorption area 700 SQ FT Monitoring Tube present (YIN) YES Depression over field (Y/N) NO Date of adequacy test 7/17/2000 Results (Pass/Fall) PASS For 4 Bedrooms Fluid depth in absorption field before test (in.); 0" Immediately after 859 gal. water added (In.): 9" Fluid depth 0" (ins) Minutes later. 1080 Absorption rate 600+ GPD Peropde treatment (past 12 months) (YIN) NONE KNOWN If yes, give date 72-026 (mev.3MOr Computer Vel8lon D. LIFT STATION Date installed Manhole/Access(Y/N) High water alarm E. SEPARATION DISTANCES *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: at' "Pump off' level at` Septiolholding tank on lot 100'+ On adjacent lots 100'+ 5'± , Absorption field on lot 100'+ On adjacent lots 100'+ Wells on adjacent lots? Public sewer main Sewer/septic service Public sewer manhole/cleanout N/A —_ Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation 5'+ Property line 5'+ Absorption field 5'± , Water main/service line 10'+ Surface water/dralnege 100'+ Wells on adjacent lots? 00'+ SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO: Property Ilne 10'+ Building foundation 10'+ Water main/aervioe Ilne_? 0'+ Surface water WL Curtain drain NON F. ENGINEER'S I certify that 1 of Municipal p with MOA HA Driveway, parldng/vehiole storage area—10__+--_ inspections and review 9ms are In conformance Is date. Engineer's Name V V JEFFREY A. GARNESS Date 7 60 HAA Fee Date of Payment Receipt Number 4 6 l / 72-026 (Rev. 3106)' Computer VemWn d'3l a Wells on adjacent Waiver Fee Data of Payment Recelpt Number 07-20-00 16:54 FROM -CTE ENVIRONMENTAL ATLCTU Environmental Services Inc. 5615301 T-675 P.03/05 F-227 CT&E Ref.# 1003875002 Client P4# Clivat Name Ali Water & Wastewater Consultams Inc. Printed Date/Time 07/20/2000 1$:01 Project Name/# N/A Collected Datellime 07/17/2000 16 00 Client Sample ID Conifer Hts Lot 4, B2 Received Aatu/Time 07/172000 16:45 Matrix Drinking Water Technical Director Sttvphheeuu C. Ede Ordered By PLASIA v Released By / Sample Remarks: Allowable Prcp Analysis Paramcrcr Resu1L, PQL iJmis Mcibud Linins Daae Date Ink Waters Deparmant Nitrate -N 5.97 0.500 mg/L EPA 300.0 10 max 07/17/00 SCL Microbiology Laborato 'Poral Coliform 0 couiOOmL SM189222B 07/17/00 KAP MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES MEM Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I. D. # D 15 - 6'2_3 - 3 / 1. GENERAL INFORMATION Complete legal description �a �% 131oc HAA # 4A g50511 / 7_5 Location (site address or directions) 9,110 r,:-� Property owner l ` l� Day phone 3V6 — 1511_ - Mailing address Lending agency Day phone Mailing address Agent �'2r� ���fL�� . �P /��ax Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site_ Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 S. 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Knl�g;noorinn Phone 20441 Ptarmigan Blvd. Address ,,:..__ . Engineer's signature 6. DHHS SIGNATURE �L Approved for bedrooms. Disapproved. Conditional approval for Additional Comments By: 4UTIC Date �a .'11 of et t., bedrooms, with the following stipulations: Date 102 9 0 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. 72-025 (Rev.1/91) Beck MOA #21 MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES_ Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # D / S'" © 9 3 - 3/ E/wf�NM if), °FA NCNU VSERV rc� Q -*t 0 g 1995 RECE, VED 11 � HAA# 1. GENERAL INFORMATION Complete legal description Location (site address or directions) �icc�ArG, ,Tle- Property owner �� ¢ ��-%� H �h��r! Day phone Mailing address 24v/ AKd40r�& Lending agency Day phone Mailing address Agent i—a-r°% .a°!,c/�z�t/L�'�X Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: ~ 3. TYPE OF WATER SUPPLY: Individual well X Community well ` )' Public water ,� � NOTE: If community well system, provide written confirmation from State ADEC attest- ttesting ingto the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA 821 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Phone Address Engineer's signature Date OF q 4 4' s �'�� • • • ,•S,j IGo ll T. 0 • •. 0 so a to •. • **!!*Osage* •o**@ a :••• Kenneth M. Duff �o a CE 7116 •: Z� 11116 'OROFESSO 6. DHHS SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: t� v, By:. .1 Date 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. 72-025 (R•v.1/91) Beck MOA •21 MUNICIPALITY OF ANCHORAGE • '� DEPARTMENT OF HEALTH & HUMAN SERVICES. Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 0 e �S- 1. GENERAL INFORMATION I)_1. HAA # I Complete legal description L �- ��� .2— Location Location (site address or directions) .> 11 •r , � �� ' i i T Property owner �� �� ��+ ��✓�-�1 Day phone Mailing address 1 4ol Su.> Lending agency Day phone Mailing address Agent ��ro� .1�ou fit /L/�X Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual well X Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site K Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025(Rev.1/91) Front MOAN21 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 of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm 1C�11J , Phone Address a � ��i ar.�. ��n V Engineer's signature��y -'az. � f�,�.L Date 17;,14 F t y JC.S )YRtItA.IU p,...wO,M1n •O QOte / � i%- -'; O FE S SV"j ' ' 6. DHHS SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments By: Date 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 order to 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. 72-025 (Rev. 1/91) Back MOA 021 MUNICIPALITY OF ANCHORAGE M E M O R A N D U M SEPTIC SYSTEM ADVISORY HEALTH AUTHORITY APPROVAL NO. 4A 7RSII Prior to a recent adequacy test on the septic system for this lot, 'WS inches of standing water was observed in the absorption field. This indicates that approximately $6 % of the absorption area is inundated. Although this system passed the adequacy test, the remaining life expectancy may be limited. This advisory must be attached to all copies of the subject Health Authority Approval. Municipality of Anchorage FNP, Nc/o zltyoF DEPARTMENT 0 HEALTH & HUMAN SERVICES�,,.7 NTA`SFR�� Fsyo Environmental Services Division I of 825"L" Street, Room 502 • Anchorage, Alaska 99501 • (907) 3A„3-4744 '8 X99 46 �c�, S Health Authority Approval Checklist �� Legal Description: Zo /- 4 &,k a Con, *4, ebR S Parcel I. D.: A. WELL DATA Well type TvLd, If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) U Date completed Total depth ``� r Cased to l Casing height (above ground) Sanitary seal (Y/N)y Wires properly protected (Y/N) FROM WELL LOG Date of test Static water level / a Well production /V WATER SAMPLE RESULTS: Coliform AT INSPECTION /O - 30- 9s ,/.7-3. g.p.m. `/. 99 g.p.m. Nitrate Z/ 7( Other bacteria Date of sample: lD � /,9� Collected by: /CND "h o e cll-1 B. SEPTIC/HOLDING TANK DATA Date installed 9- k -.Z - 8 1;4 Tank size / a. So Number of Compartments -�-- Cleanouts (Y/N)_-Y-- Foundation cleanout (Y/N) Depression (Y/N) N High water alarm (Y/N) ^44 Date of Pumping / m - 3 - 95 Pumper A o o -J4 `&,z W R&nr� �Kq C. ABSORPTION FIELD DATA Date installed 8 a a - T 54 Soil rating (g.p.d./ft` or ft2/bdrm) /Sb �f''System type 0'e -se %i^.ncGt Length 5 y/ Width 4-C' Gravel thickness below pipe 7 ' Total depth /& 3 /1434,E Effective absorption area 64PO -FiF Monitoring Tube present(Y/N)-Y-- Depression over field (Y/N) /Y Date of adequacy test 10 30- GIS Results (Pass/Fail) %lei sS For 74 bedrooms Fluid depth in absorption field before test (in.), , a2. S Immediately after to 76 gal._ water added (in.): 75 " Fluid depth *7 S (ins.) Minutes later: rn r Absorption rate = Do g.p.d. Peroxide treatment (past 12 months) (Y/N) Af If yes, give date D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level E. SEPARATION DISTANCES Size in " P mvZ-h" level at* "Pump off' level at* *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot / 67,9 ! ; On adjacent lots Absorption field on lot /D CEJ /t ; On adjacent lots /00/71- ,/ iq eq DO/71- !oo /f Public sewer main A/4 Public sewer manhole/cleanout 4J11 Sewer /septic service line S / t Lift station A/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation /-q/ Property line / y / � Absorption field .z 3- 5 Water main/service line /t Surface water/drainage �tWells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation -1 S t Water main/service line / D Surface water / O / f Driveway, parking/vehicle storage area _ d-© 1 4 - Curtain drain /,48 />,- Wells on adjacent lots / am !f Property line SOlt F. ENGINEER'S CERTIFICATION I certify that 1 have determined thru field inspections and review ofNlunicipal records �ie��ovAks Alfre in conformance with MOA HAA guidelines in effect on this date. �,�Q� •.••"'��•''••.s sL d •' °•s ryv V# Signature 0 : 49� • 000.6• loos••*•$ n i •. • 20 Engineer's Name _ /r�r �.� eiyi /fir. c� u s � il�se� Seal� ••: •.oB • Kenne M. DuE{4's �//yam �I® J,••, CE 7116 •: Date 7 �J0 4-- 4`1VV117A5- as 00 ------------------------------ HAA Fee $ �. t 0 Waiver Fee $ _ Date of Payment �� Date of Payment Receipt Number �� Receipt Number Rev. 8/95 OSS: haa.wk.doc NOV 07 '95 04:29PM NTL ANCHORAGE P.1 NORTHERN TESTING LABORATORIES, INC. 116 3330 INDUSTRIAL AVENUE FAIRBANKS, ALASKA 88701 (907) 458.2118, FAX456.3126 �I 2606 FAIRBANKS STREET ANCHORAGE, ALASKA 88803 {9071277-8378 • FAX 2749645 DRINKING WATER ANALYSIS REPORT FOR TOTAL COLIFORM BACTERIA KND Engineering Public Water System I.D.# 20441 Ptarmigan Blvd. Eagle River, AK 99577-3736 Date Received: 10/31/95 Time Received: 11:00 Date Analyzed: 11/01/95 Time Analyzed: 09:00 Date Reported: 11/03/95 Time Reported: 12:10 Next Sample Due: Phone No. Purchase Order No. Collected by: SO Sample Type: Routine Untreated Method of Analysis: Membrane Filtration Comments: Comments: S - Satisfactory U - Unsatisfactory POS - Positive Test Result ND - None Detected TNTC - Too Numerous To Count (>200 Colonies) CG - Confluent Growth HSM = Heavy Sediment Masking, Results May Not Be Reliable SA - Sample Age >30 Hours But <48 Hours, Results May Not Be Reliable Old - Sample Age >48 Hours, Too Old For Analysis R - Resample Required NT - No Test * # Colonies/100 ml ** # Colonies/ml Sample Sample Total* Fecal* Other* HPC** Location Date Time Lab# Coliform Coliform Bacteria Result Comments ......................................... --------- ---- ..................... ........... 1 9401 Sugar Cir. 1.4/2 10/30/95 09:33 AB9211 0 NO 0 NT S Conifer Hts /4,4 VW Qu- C-,kt-'d t 4,axio- � C-+� Jule a fer En i onmental Analyst NORTHERN TESTING LABORATORIES, INC. 3330 INDUSTRIAL AVENUE FAIRBANKS, ALASKA 99701 (907) 456-3116 • FAX 456-3125 2505 FAIRBANKS STREET ANCHORAGE, ALASKA 99503 (907) 277-8378 • FAX 274-9645 KND Engineering 20441 Ptarmigan Blvd. Eagle River Ak 99577 Attn: Ken or Dee Our Lab #: A141630 Location/Project: 9401 Sugar Circle Your Sample ID: Lt 4 Blck 2 Conifer Hts. Sample Matrix: Water Comments: Report Date: 11/08/95 Date Arrived: 10/31/95 Date Sampled: 10/30/95 Time Sampled: 0933 Collected By: * Definitions * ND = Non Detected H = Above Regulatory Max. E = Estimated Value M = Matrix Interference D = Lost to Dilution MDL = Method Detection Limit Lab Date Date Number Method Parameter Units Result * MDL Prepared Analyzed ------------------------------------------------------------------------------------------------ A141630 EPA 353.3 Nitrate -N mg/L 4.76 0.50 11/01/95 r Reported By: Anthony J. Lange Chemistry Supervisor �,. `AUNICIRAL;T`! OF :UNCI ,CgAGE ,_� SEFAR T MENT OF :-fE.iL'-i 2, i~U�MAN SERVICE Division or Environmental Services �"�"' t'i, _ On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-1744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING q Parcel I.D. # 4n\/. -J's J -i HAA # Q A9 1. GENERAL INFORMATION Complete legal description Location{ ff'e add 'ress;Drdirections) -7U 7�y jw�3N•, _ ,�t},l :� +iG, yf'1 J(�/ /l/'/ �L �C. ����� Pro 4-rty'owner`` Day phone k - 1�. Maill'cldres�' r 5 + n Lendi` nc"��>r• i., ey Day phone Mailing a f Cif'%D. Agent Diy phone 1507 Address Unless otherwise requested, HAA will be held for pickup. ` 2. NUMBER OF BEDROOMS: V 3. TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site �S Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA x21 F! ='1C:'17=. A- c ~^ �/ . C 'ereic nC '--SIT zne';aiicauon Oelo`V. ierlf`/ . . '8rtlfie� / m, :eal .:iil::e ,� uai..:iiC4vn � , investigation .T :his "eaith uincnty Apprcvai application snows ,hat :he an -.site ',Vater succ;,/ and/ or wastawater disposal system is safe.:unctionai and adeeuate for the numcer of tedrecros and type of structure indicated herein, i furtherverify that based on the information obtainec from the iiunicipality of ,Ancnorage files and from my investigation and inspection, :he on-site 'water supply and/or'Naste'Nater disposal system is in compliance With all Municipal and State codes. ordinances, and regulations in effect on the date of this inspection. Name c Firm /"� �'�� :i(, (�r�e-7( Phone Address Engineer's signature 6. DHHS SIGNATURE Approved for Disapproved. 0 Conditional approval for Additional Comments bedrooms. (Ka e(9)r bedrooms, with the following stipulations: Date 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 order to 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. 72.025 (Rev. 1/91) Bacx MOA #21 Municipality of Anchorage Department of Health & Human Services (}!,�,ar'I HEALTH AUTHORITY APPROVAL CHECKLIST r� Legal Description: % Parcel I.D. A. WELL DATA P'9 Well typ If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) �t?S Date completed 9-(28 Driller `�- r Total depth �`1� Cased to N/ Casing height Sanitary seal (Y/N) Wires properly protected (Y/N) WATER SAMPLE RESULTS: �5_ %Z37 % 16 Coliform f Nitrate _� [( Other bacteria &SFoctcrd Date of sample: �3� 9 Collected by: �ob M� �� f B. SEPTIC/HOLDING TANK DATA Date installecj '�'J�r' `7 Tank size / Q- Compartments Cleanouts/N) a Foundation cleanout (Y/N) Depression (Y/N) High water alarm -(Y/N), Alarm tested (Y/N) 104 Date of pi.(mping (R �Of Pumper ��� - 4, SEPARATION DISTANCES PR(�'I'VI` SEPTIC/HOLDING TANK TO: on lot Well s ' � D. � f () On adjacent lots Foundation To property line '� Absorption field } Water main/service line Surface water/drainage A)M 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE FROM WELL LOG AT INSPECTION Date of test Jam'_ ��f o� 10 10 _ g Static water level 1A M Im 5Z Well flow g.p.m. �+ g.p.m. ` .� 0 Pump level igam j%AL,)AA ll -n C C SEPARATION DISTANCES FROM WELL TO: Se tic/holdin tank on lot Septic/holding g ���� f ; On adjacent lots IDD q- Z Absorption field on lot ; On adjacent lots /op 4 - Public sewer main Public sewer manhole/cleanout Av/A Sewer service line ,L Petroleum tank aux WATER SAMPLE RESULTS: �5_ %Z37 % 16 Coliform f Nitrate _� [( Other bacteria &SFoctcrd Date of sample: �3� 9 Collected by: �ob M� �� f B. SEPTIC/HOLDING TANK DATA Date installecj '�'J�r' `7 Tank size / Q- Compartments Cleanouts/N) a Foundation cleanout (Y/N) Depression (Y/N) High water alarm -(Y/N), Alarm tested (Y/N) 104 Date of pi.(mping (R �Of Pumper ��� - 4, SEPARATION DISTANCES PR(�'I'VI` SEPTIC/HOLDING TANK TO: on lot Well s ' � D. � f () On adjacent lots Foundation To property line '� Absorption field } Water main/service line Surface water/drainage A)M 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. �_F' STATION Baia instadpc Size In gallons Vent (Y/N.) High water alarm level Manufacturer Manhole/Access (Y/N) "Pump on" level at "Pump off" level at Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot D. ABSORPTION FIELD DATA On adjacent lots Cycles tested Surface water Date installed —��D-- t�Soil rating 15D P/ gR System type Length Width Gravel thickness f Total depth >�� Total absorption area /j Cleanouts present (Y/N) e5 Depression over field (Y/N) No Date of adequacy test`yid'� Results (pass/fail) for ''7 bedrooms Peroxide treatment (past 12 months) (Y/N) 0/h If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot JOO !f On adjacent lots ZOO "t Property line %0 To building foundation /0 f To existing or abandoned system on lot /U/A On adjacent lots 130 t Cutbank N/AWater main/service line /0 Surface water JVD/.t Driveway, parking/vehicle storage area Curtain drain NZ E. ENGINEER'S CERTIFICATION 1 certify that 1 have checked, verified, or conformed to all MOA and HAA guidelines in eff='tQpV jjjte of this inspection. OF '�� h, R Co Signature %SOON * �, Engineer's Name kohlv Date - ui C(1, ` 9,�3 y � ', Noword C. Nobw No. 3063' HAA Fee $ / 719 ' CJD Date of Payment —7- Z.;t Receipt Number 72-426 (Rev. 3/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number CHE3111CAL & GEOLOGICAL LABOKAY"ORY v, �wsowwro�. 5633 S STREET Client Sample ID : L4 B2 CONIPEP, HTS. PWSID UA Collected 12/31/92 1 13:30 his. Received : 12/31/92 ! 14:50 his. Preserved with Analysis Completed 01/04/93 Laboratory Supervisor STEPHEN C, EDE Released By :� A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. ANCHORAGE. ALASKA 99518 TELEPHONE (907) 582.2343 FAX: (907) 581-5301 ANALISIS RESULTS for INVOICE 1 61982 Chemlab Aef.1 92.7034 Sample 1 1 Matrix: WATER Client Name :ACUMETRiX CORPORATION Client Aect :ACMIETC BPO# PO# :NONL RECEIVED Req# Ordered By :TERRY Send Reports to: 1)ACUMETRIX CORPORATION 2) •........................ ........................... .--...................... ................... .»........... ................... .... Parameter Results Units Method Allowable Limits NITRATE -N ..- 4,23 mg/l EPA 3$3.2/300.0 10 Sample ROUTINE SAMPLE COLLECTED 9I: UA. NO TAC FOR THIS SAMPLE. Remarks: ................................................................................. ...........................................6.460.. 1 Iestr Performed See Special instructions Above UA -Unavailable ND- Hone Detected See Semple Remarks Above NA- Not Analyzed LT -Lest Than, GT -Greater Than w 9Poftomm 16.Z=Member of the SGS GrouA (Societe Generale cie Surveillance) S�' g•d �" � .9 4t{ wx «�� �r n, yiy„, n tY4 • -� d'1 t4'IX rt v �t rn*+ a �jw—rfrsw� , !.! Ue1u a Ei • t 4 '�+ +•i !, > _ ! i tt r ' f i s [? r 9 �` -4 j, rhn�F MUNICIPALITY OF ANCHORAGE'.""" 47i,.t • DEPARTMENT OF HEALTH & HUMAN SERVICES J„ k y� Z"' .. -. -. ... . .. user �ar�ar� R" Division of Environmental On-Site Services Section :i kE ,_ t.a PfY..-e W • �at,+,kr�ks°xA 1,rt x n y g vw ext P O. Box 196650 Anchorage, Alaska' 99519-6656:...` r i k ;'w" , .� 343-4744. a. Pt+ 'r a at sr ;1,sk 5 i3r f _-bri .+: e !ar{`•k��._. K�Ss i_ i✓ t z ! T k' .it a i.k:.i a`i�'f €- CERTIFICATE OF HEALTH AUTHORITY `,:> , Y �;' APPROVAL FOR A SINGLE FAMILY DWELLING r g �y Parcel I.D. # 1 S'_ (>�1= �S 1 HAA # 1. GENERAL INFORMATION Compete legal description Lot 4; Block 2 Conifer Heights Subdivision Location (site address or directions) 9401 Sugar Circle, Anchorage, Alaska Property ownerPrudential Relocation Mailing address Lending agency Day phone Day phone Mailing address Agent Bonnie Mehner/JACK WHITE COMPANY Day phone 563-5500 Address 3201 C Street, Anchorage, Alaska 99503 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 4 V 3.- TYPE OF WATER SUPPLY:------ - - Individual well xxx Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. j 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site xxx Holding tank Community on-site Public sewer = NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA N21 S. 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 of this Health Authority Approval application shows that the on-site water supply ' and/or wastewater disposal system is 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm ' Phone S & S ENGINEERING Address 17034 Eagle River Loop Road No. 20d Eagle River, Alaska 99577 d 2� — 9 Engineer's signature Date Arco•. qTw ;•�� 4a / 1� iH ER, P 6. •; �t v ?p994460066 PROFESSO 4- 6. DHHS SIGNATURE Approved for bedrooms. I Disapproved. Conditional approval for bedrooms, with the following stipulations: i rhe Municipality' of Anchorage Department of Health and Human services (DHHS) issues Health Authority 4pprovalert)ficates based only ,upon the representations given -in paragraph 5 above by an independent professional engineer regis#erect in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes ind theirending institutions in orderto satisfy certain federal and state requirements Employees of DHHS do not :onductmspections or analyze data before'a certificate is issued. The Murncipaiity of Anchorage is not responsible for errors or omissions in the professional engineer's work y , w > 4 S_ d r• h 3J a4 1 o- K e:('i s k w S : a+ .a A J' AEax � 2.025 (Am7A11) B♦Ck t INOA 021 ' %' Xi1+ a fYt�S ✓_ +s s a. ",�-, rs dk N +111. Additional Comments >. Date f, -30' B LA. rhe Municipality' of Anchorage Department of Health and Human services (DHHS) issues Health Authority 4pprovalert)ficates based only ,upon the representations given -in paragraph 5 above by an independent professional engineer regis#erect in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes ind theirending institutions in orderto satisfy certain federal and state requirements Employees of DHHS do not :onductmspections or analyze data before'a certificate is issued. The Murncipaiity of Anchorage is not responsible for errors or omissions in the professional engineer's work y , w > 4 S_ d r• h 3J a4 1 o- K e:('i s k w S : a+ .a A J' AEax � 2.025 (Am7A11) B♦Ck t INOA 021 ' %' Xi1+ a fYt�S ✓_ +s s a. ",�-, rs dk N +111. Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: - : Cowl kr 92,r, AIS Parcel I.D. A. WELL DATA Well type��"""`"i If A, B, or C, attach ADEC letter. ADEC water system number [�l� t - Log present (Y/N) T Date completed Ja Z�1^%L— Driller Total depth 1411 Cased to / 4 1 Casing height 12- t Sanitary seal (Y/N) (-+ Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION Date of testZ �_ Q� o _ S - 47 PUNIGPALITY OF ANCHORAGE: � t -ONMENTAL SERVICES DIVISION Static water levelX7-4 OCT 2 7 1991 Well flow J :n g.p.m. '7 • g.p.m. Pump level U< UK RECEIVED SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot / OD �t ; On adjacent lots 100 Absorption field on lot i ()to t ; On adjacent lots 1 DD t Public sewer main A IIA Public sewer manhole/cleanout AJ Sewer service line Z -(- Petroleum tank —; mot') ISNOT rJ WATER SAMPLE. RESULTS: Coliform ,�,rn jrSf+�-ffl�u Nitrate 14 C�4 Other bacteria Date of sample: ACL -�1 Collected by: k 5 Ew1GiNtol '! (r I pje B. SEPTIC/HOLDING TANK DATA Date installed f; - Z D - E541 Tank size / Z _,G-0 Git Compartments 2 Cleanouts (Y/N) T Foundation cleanout (Y/N) Depression (Y/N) h-) High water alarm (Y/N) �JA Alarm tested (Y/N) J*J11J' Date of pumping 101 g - I I Pumper A-,' Fi' [)me-- SEPARATION )me SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot h f On adjacent lots 100 t Foundation / To property line LQ 1 Absorption field z Water main/service line 2 .5 fi Surface water/drainage 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION \ Date installed Size in gallons Vent(Y/N) High water alarm level "Pu?Rp on" level at Meets MOA electrical codes (Y/N) Manufacturer Manhole/Access (Y/N) SEPARATION DISTANCE FROM LIFT STATI TO: Well on lot On adjacent to D. ABSORPTION FIELD DATA "Pump off" level at Cycles tested Surface water _ Date installed OL' Zo gSoil rating _,/ 424'%System type 9Z�A rQe�c�n Length �Q —Width I, 2j "- o (oo Gravel thickness r Total depth TotalL absorption area __ X00 Cleanouts present (Y/N) u Depression over field (Y/N) Date of adequacy test J o " l 8- c1 Results (pass/fail) IP A s t, for �4 bedrooms Peroxide treatment (past 12 months) (Y/N) X)1A If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot IDD �+ On adjacent lots t7O �t r 1 � Property line- I o t To building foundation / 0 �'F To existing or abandoned system on lot N lA i On adjacent lots 3 O f Cutbank AJ LN Water main/service line /0 't Surface water 100 t Driveway, parking/vehicle storage area (n r4 Curtain drain tJ1 � E. ENGINEER'S CERTIFICATION 1 certify that 1 have checked, verified, or conformed to all MOA and HAA guidelines in effect on k eof this inspection. S 0ALq Amp •••r• seg. Signature S & S ENGINEERING /��?� '•� 17034 Eagle River Loop Road No. 204 A0 *: 49TH Engineer's Nam6agls River, Alaska 99577 .... . q �• •srs•.• • `sysss • Date � - ROGERSH FER, P.E. : C� Ij •. 0811 fROFESSONP.�.'o~ HAA Fee $ , YT Date of Payment tl-a /- Receipt Number 72-026 (Rev. 3/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 S STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX, (907) 561-5301 ANALISIS REPORT EI SAMPLE for RUSHorderi 39388 Date Report Printed: OCT 18 91 4 14:41 Client Sample ID:L4 E2 CONIFER HEIGHTS 3/D PWSID :UA Collected OCT 17 910 13:20 hre. Received OCT 17 914 14:00 hrs. Preserved with :AS REQUIRED Client Name :S & S ENGINEERING Client Acct :SNSENGP BPO 1 PO # NONE RECEIVED Req # Ordered By :R.D.J. Analysis Completed :OCT 18 91 Send Reports to; Laboratory Super ie r :STE N C. EDE 1)S & S ENGINEERING Released By : G�fG , �--- 2) •■e•w...........w.s.....wrr.......r..........w.................s.....•.r........................................*........r..r....... Chamlab Ref IM: 915570 Lab Smpl ID: 1 Matrix: WATER Allowable Parameter Tested Result Units Method Limits --------------------------------------------------------------------------------------------------------------- NITRATE-N 3.3 mg/l EPA 353.2 10 Sample ROUTINE SAMPLE COLLECTED BI: R.D.J. Remarks: &Osseo ...... ............ am .......................... 0.. o..........rrs..waw....u.w.....rw rsww.....r...ww.. r 1 Tests Performed See Special Instructions Above UA -Unavailable ND- None Detected " See Sample Remarks Above NA- Not Analyzed LT -Lege Then, GT -Greater Than re, EMB Member of the SGS Group (Soc*6 GAnArale de Surveillance) -,n i L -in nnnnnnnr.nnnnnr.nnnnnn nnnnnnnnn nnnr.r.nnnnr.n nr i T n T n.• T r' r" T MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVALgg OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date FE'B /61, /98 8 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) L D T 5/ BLo c/-- Z S13 7-/ 2 A1 ,2 3 u/ Location (address or directions) 1 9V01 506,92 o elvE (b) Applicant Name, e5leg;vs iv ui0o0 Telephone: Home Business Applicant Address 'lozl 4A -QS (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder Z; Buyer ❑ ;Other ❑ (explain); (d) Lending Institution 61&40 /l7oe.7-4-1c L'�2�o�.¢r�m� Telephone /a/ Address 701 E TU r_> ort m d (e) Real Estate Company and Agent FD2T[I.VE P.L�oPEeTiEs o�Lo2E5 �occlrrlA�tJ Address 3000 A Telephone 5-6 Z - 74, -G3 (f) Mail the HAA to the following address: CALL. -sL)a r. -D 3119-0D/� 2. TYPE OF RESIDENCE Single -Family 0 Multi -Family ❑ Other Number of Bedrooms `'f 3. WATER SUPPLY Individual Well % Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite " Public El Community 13 Holding Tank 1:1 Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (ivaa) 5. ENGINEERING FIRM PROVIDING 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 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firma/ tN141�IAJ Telephone Address 1057 GJ' Date shl, /6 8 S ''e aury `."y' Cb 0 �}.�<�'� �. Engineer's Seal s♦ eJ q9 pIly. o�ry`�pyna'egoV. c.7eaoae»,fin �+.a oeoo , Michgei E. Anderson •�A '•'�tt� 9�o osoeemoeeee��� Yia� pRgFESS10�P�„°► 6. DHEP APPROVAL � A�/ ,fit ��� Approved fbr a�� bedrooms by Date f ��FJi�t4i� /Q w Approved � Disapproved Conditional Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations 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 (11/84) ANJ0MGE MUNICIPALITY OF ANCHORAGE (MOA) MUN1�pENTp SERVICES 01,1,1510N HEALTH AUTHORITY APPROVAL (HAA) IEWVi ONM CHECKLIST FEBRUARY 1984 17 1958264-4720 Legal Description: Gor Al BLoGK Z RE 'EtVED eaw�F �E��Mr� A. WELL DATA Well Classification OIV,ATE If A, B, C, D.E.C. Approved (Y/N) &,_14 Well Log Present (Y/N) Date Completed 19' Z3Yield - * GPM Total DepthNOA/i. /y� Cased to ✓y/ Depth of Grouting l Static Water Level IZ61 8. Pump Set At wmr "i-AW"..v" Casing Height Above Ground zG„ Sanitary Seal on Casing (Y/N) ,Y Electrical Wiring in Conduit (Y/N) y Depression Around Wellhead (Y/N) .tt Separation Distances from Well: To Septic/Holding Tank on Lot �y�� ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot Zot ; On Adjoining Lots To Nearest Public Sewer Line My/" To Nearest Public Sewer Cleanout/Manhole iLd3 To Nearest Sewer Service Line on Lot Water Sample Collected by A1Cr492_0A1 ; Date Z-13-89 Water Sample Test Results SATISI` r'lc ro 2 Comments IMEJL 45.40ep0.4r.E: B. SEPTIC/HOLDING TANK DATA Date Installed 8'ZZ-y Size ZZ So No. of Compartments Z Standpipes (Y/N) ✓ Air -tight Caps (Y/N) V Foundation Cleanout (Y/N)y Depression over Tank (Y/N) x1 Date Last Pumped Z-9-88 Pumping/Maintenance Contract on File (Y/N) Y ; for Holding Tank High -Water Alarm (Y/N) N�l Temporary Holding Tank Permit (Y/N)&"�� Separation Distances from Septic/Holding Tank: To Water -Supply Well �'�� To Building Foundation To Property Line To Disposal Field Z To Water Main/Service Line 35� To Stream, Pond, Lake, or Major Drainage Course _ ,VowE NOl'fD ✓N A/E'�A Comments z5E�errc rAA41e- i,S Apfi'po 4TH. Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 'ISO Type of System Design ZeAF-WC14/ Date Installed 8- Zo B It/ Length of Field sa Width of Field '18��D Depth of Field Gravel Bed Thickness Bf Square Feet of Absorption Area 7O0 Standpipes present (Y/N) Depression over Field (Y/N) 1S Date of Last Adequacy Test Z -/3-88 Results of Last Adequacy Test X2461WCA Separation Distance from Absorption Field: To Water -Supply Well / ZO' To Property Line .g2� To Building Foundation 3�� To Existing or Abandoned System on Lot �VOM5 6A/ LoT ; On Adjoining Lots To Water Main/Service Line SG To Cutbank (if present) I&PNE. pizc %gm 7 - To Stream/Pond/Lake/or Major Drainage Course 146NE iN 14 CEA To Driveway, Parking Area, or Vehicle Storage Area ZO Comments ASSO-PTiotir deElEiD Is 4,0"VfrF— D. LIFT STATION NI Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) — Comments Dimensions Manhole/Access (Y/N) _ "Pump Off' Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA ** 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 -L E (.G'+A&A-1- Date 2'X �g 8 Company ©vAPAA �NGfZ MOA No. Receipt No. �� Ci .4. -�V.®� Date of Payment°°••'�,� �I Amount: $ l /'' m .491—H* Engineer's Seal /•.&e•N..od•ua................. S Page 2 of 2 72-026 (11/84) CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562.2343 FEDERAL TAX ID # 92-0040440 Client Sample ID:WELL WATER PWSID :UA Collected FEB 13 88 8 10:00 Received FEB 13 88 B 14:30 Preserved with :NONE ANALYSIS REPORT BY SAMPLE for Work Order # 5189 Date Report Printed: FEB 16 88 9 10:24 Client Name : MCFADDEN, WAYNE Cl lent Acct : MCFAWC hrs. P.O.# NONE REC'D hrs. Req # Ordered By Analysis Completed :FEB 15 88 Laboratory Supervisor :STEPHEN C. EDE Re 1 eased By : q C. *6c/ special Instruct: Chemlab Ref #: 9103 Lab Sapl ID: i Matrix: Water Send Reports to: 1)MCFADDEN, WAYNE 2) Allowable Parameter Tested Result/Units Method Limits --------------------------------------------------------------------------------------------------------------- NITRATE-N 2.5 mg/i EPA 353.2 10 MUNICIPALITY OF ANCMORAOE ENVIRONMENTAL SERVICES 1)ry1S10N 71988 RECEIVED Sample ROUTINE SAMPLE Remarks: 1 Tests Performed a See Special Instructions Above UWnavallabie ND= None Detected as See Sample Remarks Above NA= Not Analyzed LT --Less Than, GT -Greater Than MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date (a) Legal Description (include lot, bl Location (address or directions) (b) Applicants Name subdivision, section, township, range),/ Telephone Home Businesd �� Applicants Address (c) Applicant is (check one) Lending Institution ; Owner/builder ; Buyer F::1 ; Other E:�:j (explain);�I / (d) Lending Institution /�, %�/� T�.� / Telephone Address (e) Real Estate Co. & Agent Address Telephone (f) Mail the HAA to the following address: v, Guuu So 90el TeirTcl('06> 2. ape of Residence Single -Family- Multi -Family F—[ Number of Bedrooms 3. Water Supply - Other (describe) Individual WellIEZ17t Community Public Note: If community well 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. [Page 1 of 21 5. Engineering Firm Providing 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 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 in compliance with all Municipal and State codes, ordinances, and regula- tions in effect on the date of this inspection. Name of Firm Telephone !- i Address 7Z Zd / Date Z/5-/05- 6. DHEP Approval Approved for "A11N)bedrooms -N- 11� llz vt� zAF, ..' fry �.•� xt p •°••y f�• vO Car Me y 4 � • 353 Date Approved i-�_ f Disapproved Conditionals Terms of Conditional Approval 4 Tl -.'s sG�wtc� �."-`�`-• �oa�..... '4 a.. -i- +4e 4. - tr' rn e- n f o,. ppr,o.�w 1 . �ZN• g o��p ra � 4.(� i S cQa.: f 2. ! � &5r. 8 CAUTION THE 11[JNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH 'AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS 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 REQUIRE- MENTS. 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. (DHEP SM RR4/ej/D1S (Page 2 of 2] 7-19-E4 MUNICIPALITY OF ANCHORAGE (MOA) I- figs HEALTH AUTHORITY APPROVAL (HAA) RECEIVED CHECKLIST - FEBRUARY 1984 A. WELL DATA Legal Description:_.rrcrl�s�n Well Classification s141sig ,x:�4,yI4Y If A, B, c>r C, D.E.C. Approved(Y/N) Well Log Present NN) Date Completed4G Zs, /�1�/ Yield �a , Total Depth /// Cased to /%/��-T Depth of Grouting Static Water Level 1Z</ Pump Set At Casing Height Above Ground Sanitary Seal on Casing Electrical Wiring in Conduit 1) Depression Around WallheadudgL Separation Distances frau Well: To Septic/Holding Tank on Lot On Adjoining Lots /tf:� Zt 1�F7 To Nearest Edge of Absorption Field on Lot/ele On Adjoining Lots/� f �G To Nearest Public Sewer Line To Nearest Public Sewer Cleancut/Manhole �V To crest Sewer Service Line on Lot Z Water Sample, Collected ByDate Water Sample Test Results Ccmrents B. SEPTIC/HOLDING TANK DATA Date Installed AUGC. Zd, SQ' Size No. of Compartments � Standpipesd&) Air -tight Caps Foundation Cleanout N) Depression over Tank (Y Date Last Pumped e4 /11 Pumping/Maintenance Contract on File ME) for �- Holding Tank High Water Alarm (Y/N) Temporary Holding.Tank Permit (Y ) Separation Distances from Septic/Holding Tank: To Water -Supply Will To Building Foundation 13 To Property Line 50 4' F61? f- To Disposal Field 71 + Rzr To Water Main/Service Line To Stream, Pond, Lake, cr Major Drainage Course; Comments _ '�Jc�aivCC� [Page l of 21 'y� 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in-Absorption Strata SDF�B Type of System Design 1 Date Installed.' ,/,l sos 20 Length of Field 5'; � Width of Field�`/,� — go , ee Depth of Field Gravel Bed Thickness �s Square Feet of Absorption Area S Standpipes Present Y ) Depression over Field to of Last Adequacy 'hest _ Results of Lash Adequacy Test. ._.. Separation Distance Fran Absorption ield; 104— To D4-To Water Supply Tnie 11 IZ � F To Property Line To Building F ndation -39 % To Existing or Abandoned system cn Lot ; -On Ad' ining Lots To Water Main/Service Line ¢ To Cutbank(if esent) To Stream/Pond/Lake/cr Major ainage Course To Driveway, Parking Area, cap Vehicle Stcrage Area 16/ 4- Cam nts -CamBnts D. LIFT STATION Date Installed Dimensions Size in Gallons Manhole/Access (YIN) "Pump On" Level at "Pump Off" Level at High Water Alarm Level at Vent (Y/N) Tested for Pumping Cycles during Adequacy Zest. Meets MSA Electrical Codes(YM) Comments ** ' Check Permitted Bedroan Rating Against HAA Request ** I certify that I have checked, verified, cr conformed to all MOA HAA Gu=zes in effect on the date of this inspection. Signed Date Co Ccmpany MOA No. � ... • .....:..;. e s...! ....:. KBl /d5/s Car s. May ,�� s� ,• 6353 •; j 9 •'•. 00*000 .••a �C.�e `�i [Page 2 of 21 t4��pROFESSIO� 2-15-84 Location: BESSE, EPPS & POTTS 2220 EAST 88 AVENUE ANCHORAGE, AK 99507 (907) 349-6451 WATER WELL TEST Date: 2 Subdivision:- � S Lot: A Block: Client's Name: //-// Address: Tester:,2��,r�d�t/ Initial Reading cn Meter: /3 ZyU NOTES: Production Rate: ---;>',5 GPM 24 -Hour Capacity — Gallons NOW wz M10 �� Et� t01 tee! • NOTES: Production Rate: ---;>',5 GPM 24 -Hour Capacity — Gallons A,- /o30.ao' 1,4 FA or,4 S T o OF A44 11, sw 01 �• •••• •• •wr iw w.N�wf • f� w^ . Andrew F. Patt , • 3514-S411 SURVEYOR`S CERTIFICATIONS I HEREBY CERTIFY THAT I HAVE SURVEYED THE PROPERTY DESCRIBED ON THIS PLAT AND THE IMPROVEMENTS SITUATED THEREON ARE LOCATED AS SHOWN ON THIS PLAT. �� y DATED THIS DAY OF 1920 ._ e LEGEND ' O LOT CORNERS lVpl`' FOUNDATION 4-(o /a f – R- 7 sei,IcXs �— DRAINAGE ARROWS !/.Sed• NOTES: I. IT SHALL BE THE RESPONSIBILITY OF THE BUILDER OR OWNER TO VERIFY THAT BUILDING LOCATION SHOWN MEETS ALL SUBDIVISION COVENANTS AND ZONING ORDINANCES. 2. IT IS THE RESPONSIBILITY OF THE BUILDER TO VERIFY ALL ELEVATIONS WITH RESPECT TO ALL UTILITIES. H. THIS PILAT P.GPRELiNT3 THE ?A^Cis 0,PROPERTY ZESCRIBED l'ZLuW TAKEN FROM THE RECORDED PLAT DESCRIBING THAT PARCEL. INSTRUMENTS RECORDED PRIOR TO OR AFTER THE FILING OF THE RECORDED PLAT ARE NOT SHOWN ON THIS PLAT. 4. THE INFORMATION ON THIS PLAT IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES OR EASEMENTS , THE PLAT IS NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES OR FENCES.