HomeMy WebLinkAboutGLACIER VIEW HEIGHTS BLK D LT 16Glacier' View
Height
lock b
Lot 16
050- 501
-01
On-Site Water & Wastewater System Permit
MUNICIPALITY OF ANCHORAGE
Development Services Department
On-Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
Permit Number: OSPl11324
Tax Code Number: 05050101000
Work Type: WellSeptic Initial
Permit Effective Dates: November 10, 2011 to November 09, 2012
Design Engineer: PANNONE ENGINEERING SERVICE
Subdivision: GLACIER VIEW HEIGHTS
Site Legal Address: GLACIER VIEW HEIGHTS BLK D LT 16 G:0159
Owner/Address: NICHOLS PENNY ELAINE
9140 WALLACE ST EAGLE RIVER AK 995779551
Site Mailing Address: 9140 WALLACE ST, Eagle River
Lot Size in Sq Ft: 28002
Total Bedrooms: 4
This permit is for the construction of:
Y Disposal Field Y SepticTank N Holding Tank N Privy Y Private Well N Water Storage
All construction must be in accordance with: 1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater
Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80).
3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received B '~7 /
Issued By:
I UNICIPALITY
OF ANCHORAGE
Community Development Department
Development Services Division
On-Site Water & Wastewater Program
Mayor Dan Sullivan
Phone: 907-343-7904
Fax: 907-343-7997
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. d)~'O-- ~.!-- ¢1
Property owner(s) '~_.¢~.~ ,¢101¢0Z. Day phone
Mailing address ~!/.¢0 u),4/.z.~¢.~" E,T'~e'~-"7)~",¢.~-z¢_7 ~l,/¢'t'~- ;/¢-l(' ~7~
Site address ~/~0 ~~e' ~
Legal description (Sub'd., Block & Lot) ~E~ d~ ~T¢ ~ ~
Legal description (Township, Range & Section)
Lot Size ~~ Sq. Ft. Number of Bedrooms ~
THIS APPLICATION IS FOR: THIS APPLICATION IS AN:
([~ all that apply)
Absorption Field ~ Initial [~
Septic Tank 1~ Upgrade []
Holding Tank [] Renewal []
Privy []
Private Well ~
Water Storage []
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
I certify that the above information is correct. I further certify that this application is being made
for a Single Family Dwelling and is in accordance with applicable Municipal Codes.
(Si~t,'=ra"t~r~C'f'Cf~(~r~ owner or authorized agent)
Permit/Rush Fees:
Date of Payment:
Receipt Number:
Permit No.
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
G:\Building\On Site\Forms\Client Forms\Permit App_010411 .doc (Rev. 1/11)
Pannone Engineering Services LLC
Steven R. Pannone, Principal
Registered Professional Engineer
E-maih steve~panengak.com
November 3,2011
Municipality of Anchorage
Development Services Department
On-Site Water & Wastewater Program
4700 S. Bragaw Street
P. O. Box 196650
Anchorage, Alaska 99519
Subject:
Glacier View Heights, Block D, Lot 16
Septic System Permit Upgrade Request
Ladies and Gentlemen:
I am writing to request a permit to construct a new septic system and well be issued for this property. The
proposed system will serve a proposed four-bedroom house. Currently the lot is undeveloped. A new drain
field will be installed in west-central portion of the lot and will be sized to handle a four-bedroom waste
stream. The reserve area will be parallel and just north of the proposed field. The surrounding developed
lots are served by private wells. The private wells are located over 100 feet from the proposed soil
absorption system.
1. Soils. One test hole was excavated by Pannone Engineering Service in September of2011. See the
soil log attached. Ground water was monitored for seven days. No ground water was monitored to a depth
of seventeen feet (17') below ground level after the monitoring period. Bedrock was not encountered in the
test hole. It is my opinion, based on the results of the percolation tests and overall soils appearance; an
application rate of 1.2 gallons/day/square feet should be used, using a conventional wastewater treatment
system and 6 gallons/day/square feet for a category III system (reserve).
e
Soil Absorption System Design.
a. See Sheet 2 of the design package
3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and the
existing drain field. The proposed drain field upgrade will maintain at least 100 feet from all surface water
and drainage ditches.
4. Topography: The average topography in the area immediately surrounding the proposed septic
system is approximately 5 percent. The edge of the field is located approximately twenty feet (20') from the
edge of a steep bank having a 100 percent slope. Before construction of the septic system begins the owner
will remove material from uphill of the area of construction and place it below to create a level area for
Mailing: P,O, Box 500217, Anchorages AK 99510-02t7
Physical: 6:,t. 5 East 82nd Ave, Cuite B6, Anchorage~ AK 99503
Telephone: (907) 272-8218 FAX: (907) 272-82:Z1
Page 2 of 2
construction and to create a 25% infiltration line that will not daylight sooner than 50 feet. It is not likely
the effluent will infiltrate at a 25% slope since the drain field will be installed in sand and gravel with a
percolation rate of 1-5 mpi.
5. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification
that the review is complete and that there are no further comments is received from MoA On-Site
Department, the note will be removed and "Issued for Construction" drawings will be issued.
The proposed installation will not affect the future development of the surrounding or existing lots. There
are no wells within 100 feet of the proposed septic location.
If you have any questions or concerns, please contact me at 272-8218.
Sincerely,
Steven R. Pannone, P.E.
Owner/Civil Engineer
Attachments:
MaiL~g: P,O~ Box 100217, Anchorage, AK 99510-,0217
Physicak 615 East 82r,~ Ave, Suite B6, Anchorage, Al< 99503
Telephone: (907) 272-822~8 FAX; (907) 272-821~'£
~~~, / /:¥/I /-- 12509 SEPTICTANK (P)
~~ 5'] / ,,,// / W/DOUBLE CLEAN OUT
~~ ~F%;.,,~ PRIMARY DRAIN FIE? (P)
FOR CONSTRUCTION P.O. ,"OX 100217 A"CHO"AOE, A~ 99,510 ~ ~"~,, 11/9/11
9140 WALLACE STREET '¢~ ~%;¢f 0SPl11324'
PLAN EAGLE RIVER, AK 99577 J~~(¥~(~ Sheet
SPECIAL PROVISIONS TO SPECIFICATIONS
1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALI'P( OF
ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF
ON-SITE WASTEWATER DISPOSAL SYSTEMS.
2. ALL WORK SHALL BE IN ACCORDANCE WITH THE A%I'ACHED SPECIFICATIONS.
,3. SCOPE OF WORK: INSTALL NEW 1250g SEPTIC TANK AND SOIL ABSORPTION SYSTEM.
4. NO GROUNDWATER WAS OBSERVED AS EVIDENCED BY THE SOIL TEST HOLE. tF AN APPARENT WATER TABLE IS
OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 17 FEET BELOW EXISTING GRADE NOTIFY THE ENGINEER
I M MEDIATELY.
~//-FI LTER FABRIC
TH- 1
SM '\ ~/ .............. ~'.~i!.~.!~i.i~~'
~ 3.0 ~
-2.0~-,~ ~_L :...~ ..2~ 0.5
~; -~ ~%GRAVEL BEDDING
; 8.0 ~ ~4" ¢ DRAIN PIPE
I
~.0
/
-17 NO gr~undwoter
SECTION
monitored
0 0 ~0 0
z
/
1250 g SEPTIC , ,, :. :,.:.,...~,, :..,.~...
P R 0 F I L E .E~P T...OH S~
DESIGN PARAMETERS
PRIMARY SEPTIC SYSTEM
NO. BEDROOM: 4 (600 gpd) ABBREVIATIONS LEGEND
TANK SIZE: 1250g CU COPPER ~ W- WATER LINE/
PERC RATE = 1-5 MPI DIP DUCTILE IRON PIPE WELL RADIUS
SOIL RATING: 1.2 GPD/SF TH TEST HOLE
AREA RQD: 500 SF FC FOUNDATION CLEAN OUT
~ SS ~ NEW SEPTIC
SYS. ~PE: DEEP TRENCH 8.0' E.D. T~ TANK CLEAN OUT NO.
MIN LENGTH: 51.25 LF C¢ CLEAN OUT NO. LIMIT OF EXCAVATION
USE: M~ MONITOR TUBE NO.
R.I. RIGID INSU~TION
55 LF X 5' WIDE, 8' E.D.,
11' TD DCO DOUBLE CLEAN OUT
TOTAL AR~: 560 SF DV DIVERTER VALVE
FS FLOW SPLICER
~~. D a t e
~.0U[ (~07) 272-8218 [~X (~07) 272-a211
~.I.D.
~0-501-0~
GLACIER VIEW HEIGHTS, BLOCK D, LOT
PENNY NICHOLS eve~E~1%n
PERMIT
NO.
9140 WALLACE STREET ,~.. .~ 0SPl11524
DETAILS EAGLE RIVER, AK 99577 ~o~sgo~:c~ '- ...... '~¢2~ Sheet
TEST HOLE1 SOILS LOG - PERCOLATION TEST
SLOPE ~i~ ~, \ ~ "~ ,, / ~, ~, ',
~ ~,~,ous~-/, ~,, ~ ....... :~ ....... ::~': i"',,
I ~ SM SIL~ SAND ........................................
5
"x '/'L S',:., ' '... x / ::.,::, ~ .... -.. "'
~~-'~ ............ ' ' '"~:"}' ' """~'~ z '~:':' ..... O ....
6~
....... ~ ~ ~ ...... '-~ .' "..~ '",.
"~ S~LW/SANDY ~ "', ~'---~/~....~ ....... / Z. ......... /,.'%'' .... .................
12 ~
WAS GROUND WATER SLOPE
14 ~ ENCOUNTERED? N
~5 ~ IF YES, AT WHAT TH
~6 ~ DEPTH? -0-' X
17 ~ -- DEPTH TO WATER A~ER
BOH MONITORING? -DRY-
18 ~ DATE: 9/21/11
19 CLOCK J WATER
R~DING DATE '
TIME NET TIME LEVEL NET DROP
R~DING
DATE PERFORMED: 9/14/11 1 9/14/11 2:07 --- 6.00 ---
2 2:17 10 MIN 1.00 5.00
3 12:32 -- 6.00 --
4 12:42 10 MIN 1.75 4.25
5 12:42 -- 6.00
6 12:52 10 MIN 1.80 4.20
PERO~TION ~TE 2.4 (min/inch) PERC HOLE DIAMETER 6 inches
TEST RUN BE~EEN 3 ~ AND 4 FT
COMMgNTS: Test hole excavated by A~AS~ DIVBRS. P~ec hole was preso~ed.
·est ~a fo~ o~e hour. ~ast 3 readings reposed
?B~ORMBD BY: Steres R. P~o~e, P.~. I CBRTI~Y T~AT ~IS TgST WAS PSR~ORMED IN ACCORDANCB
....... .~ A~ ~e
PHONE (~0~) 2~2-a2~ [~x (~07) 272-a2~ ~....~m ~
~.I.D.
GLACIER VIEW HEIGHTS, BLOCK D, LOT 16 ~'050-501-01
91&0 WALLACE STREET~~{~.. ..~ os~324
SOI~S ~OG EAGLE ~IV[~, AK 9~77 ~'~ ....... ~'.
~o~ss~ s~
READING DATE CLOCK WATER
TIME NET TIME LEVEL NET DROP
READING
1 9/14/11 2:07 --- 6.00 ---
2 2:17 10 MIN 1.00 5.00
3 12:32 -- 6.00 --
4 12:42 10 MIN 1.75 4.25
5 12:42 -- 6.00 --
6 12:52 10 MIN 1.80 4.20
TOPSOIL
4:1 INRLTP~TION -- ~.~..~ "'""2~ .
~'" T~I'
NOTES: P~O~ ~O ~C, L~ ~---~'~..,..
~o~ OON~o~.ON ~.0. ,OX ~00~ ~NCHO~, ~ ~0 ~? ....... ~~,-- ~ ~a, ~,~
PHONE (907) 272-8218 FAX (907) 272-8211 ~*"~ ~ '~*'6 1"=2o'
P.I.D. NO
PENNY NICHOLS '~~"~ PERMIT NO.
9140 WALLACE STREET ~1~' ~ osP1~1324
.~?~.. .. '_.~
SITE SECTION EAGLE RIVER, AK 99577 ~OESgbA~"~ ....... ~-~ Sheet
-~~
ADVANTEX SYSTEM DESIGN (.RESERVE FIELD)
ADVANTEX
24" PASSIVE
4" JIM CAP AX20 POD\-- INSULATED AUXILIARY AIR
~., ~ ~ RISER, PUMP ~ VENT
SLIDE SECTION "'~1 !
OF 6" PIPE ~ /
OVER THIS CONNECTION ,'--'~u|
TO PROVIDE
J
SHEER PROTECTION- i4'-
EXTEND TO
BRIDGE EXCAVATION
/-FILTER FABRIC
TH-1
RESERVE SEPTIC SYSTEM -2.o--
NO. BEDROOM: 4 (600 gpd)
TANK SI~E: ~ 500~ S.I.E.~. G~AVE~ BIDDING
PERC RATE = 1-5 MPI
SOIL RATING: 6 GPD/SF GM
AREA RQD: 100 SF 1.5
SYS. ~PE: WIDE TRENCH 1.5' E.D.
RF: 0.78 5.0 GRAVEL
MIN LENGTH: 15.6 LF 6.0
I
usE: SECTION
No groundwater
20 LF X 5' WIDE, 1.5' E.D., 11' TD monitored
TOTAL AREA: 128 SF
NOTES: P~O~ ~O ~C, L~ ~ __,?~ Dete
~ 9~. ~C~ ~, 11/9/11
FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510
PHONE
ScQle
~ ~..'~ ~ ~ '.~ 1"=20'
GLACIER VIEW HEIGHTS, BLOCK D, LOT 16
PENNY ~'OHO~ ~e~ER~lttnt~e~PERMIT NO.
9140 WALLACE STREET '~f~... .-~%~' OSPl11324
SITE SECTION EAGLE RIVER, AK 99577 l~?e~n~Fs¢~¢~ Sheet
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
Date Received January 3, 1977
Time of Inspection lO:O0 a.m.
Date of Inspection
REQUEST FOR APPROVAL OF JKennedy
INDIVIDUAL SEWER & WATER FACILITIES
FOR
1-4-77 Tuesday
1. Approval requested by:
Mailing Address: Post Office Box 819 ,Palmer
2. Property Owner: Steven W. Murto
Mailing Address: Star Route Box 196A, 99577
Farmers Home Loan Administration
Phone: 745-4771
Phone: 694-9026
Legal Description:Lot 16 Block D Glacier View Heights
Location:
5. Type of facility to be inspected Single Family
6. Well Data:
A. Type Individual
C. Construction
7. Sewage Disposal System: On-site system
A. Installed B. Installer
C. Septic Tank: 1. Size
D. Seepage Pit: 1. Absorption Area
E. Disposal Field: Total length of lines
8. Distances:
A.Well to: Septic tank
Nearest lot line
B.Foundation to septic tank
C.Absorption area to nearest lot line
No. of bedrooms 2
B. Depth
D. Bacterial Analysis
2. Manufacturer
2. Material
, Sewer Lines
, Absorption area
, Other contamination
, Absorption area
EQ-034 (1/74) Page 1 of two pages
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
2510 East Tudor Road, Anchorage, Alaska 99504 276-2221
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES
1. Type of Inspection: CMRO. .VA FHA
2. Property Owner: ,~ '7'~' v~'/~ 'W, M u, r~7o
CONV.
Mailing Address: $ /,t I~o/. ~/c¢~-t DayPhone: ~'d-~
3. Name of Buyer:
Mailing Address:
4. Name of Lending Institution:
Mailing Address:
5. Name of Realtor or Agent:
Mailing Address:
(~ ~A ¢-~E/¢~ '~/IzF ~
6. Legal Description:
Day Phone:
Phone:
Phone:_
7. Type of Facility to be Inspected:
8. Water Supply
Type of Supply:
--~"~ .,~..2' No. Bdrms.
Public Utility. Individual
If Individual, number of dwellings presently served
If Individual, depth of well
Sewage Disposal System
Type of System: Public Utility
If Individual, date of installation
Individual (on-site)
72-003(3/76)
Page 2 of two pages - Re , for Approval of Individual Ir & Water Facilities
Legal Description Lot 16 Block D Glacier View Heights
Comments t~33~\ t '~-%~ ~._~ ~ ~t~L~ ~ ~3%~)-~'~.
Approved Disapprove ~.~ ate ?~-~7
Approval ~Valid for one year from date signed }
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
certify that the information contained in this request for approval to be a true and
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED
Date
EQ-034 (]/74)
january 13, 1!377
r~:q%~ast for approval of individ~at a~'wer a-~%d water
for the ~ject properhy ca~), .~ot b~a approved
the pro~t~rty fails to meet the spe~i~icg~tons
of thi~ department.
a.t 279~'251i~ e~te~SiOn 224 Or cOm~ i~¥tO our o:~fi(:e~ at
•
Municipality of Anchorage
On-Site Water and Wastewater Program
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 050-501-01 Expiration Date:IO�2��
1. GENERAL INFORMATION
Complete legal description _GLACIER VIEW HEIGHTS BLK D LT 16
Location (site address) _9410 WALLACE DR, EAGLE RIVER AK
Current Property owner(s) JOHN FARMER Day phone
Mailing address _SAME
Real Estate Agent Day phone
2. TYPE OF DWELLING:
Z Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: • 4
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well ® Individual
Individual Water Storage ❑ Holding Tank ❑
Community Class A Well ❑ Community ❑
Public Water System ❑ Public Sewer ❑
WaiverNariance request for: Distance:
Received by: //41.11\ Date: 77 `'�fie/
1
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ .52(e, Waiver Fee $
Date of Payment 524 Date of Payment
Receipt Number C !O OS- Receipt Number
COSA# OSC18Gg--/ Waiver#
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 MIKE N ANDERSON,P.E. Phone 727-8864
Address 4661 NATRONA AVE.
Engineer's Printed Name MIKE N ANDERSON, PE Date 7/18/18
•
6. DSD SIGNATURE
System #1 Approved for '1 bedrooms.
System #2 Approved for bedrooms.
Disapproved. : ?E Ai
Conditional approval for bedrooms, with the fol*ring sti S`Taions�"y
A. Ott- t rc`
WNTER AN°
Ll WASTEWATER c
PRQGRF,M
: c
}n"c-it IT c c O\I"C`.
� 7-2-4—e
By: 1�`^-fes' ( Original Certificate Date:
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only
upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The
Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA blue sheet 10-10-12.doc
If more than 1 septic system is on the lot:
COSA Checklist# of
Structure served by this system _
Certificate of On-Site Systems Approval Checklist
Legal Description: GLACIER VIEW HEIGHTS BLK D LT 16 Parcel ID: 050-501-01
A. WELL DATA
Well type PRIVATE If A, B, or C provide PWSID# Well Log (Y/N) Y
Date completed_5/29/12 Sanitary seal (YIN)Y Wires properly protected (Y/N) Y
Total depth 240 ft. Cased to 124 ft. Casing height(above ground) 18"+
FROM WELL LOG AT INSPECTION
Date of test 5-29-12 7.3.18
Static water level 65 ft. 66 ft.
Well production 6.0 g.p.m. 5+ g.p.m.
WATER SAMPLE RESULTS:
Coliform ND colonies/1 00 mL Nitrate ND mg/L
Arsenic: 5.07 ug/L Date of sample: 6-27-18 Collected by: MNA
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material STEEL Date installed MENi3 10- 13
Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) Y
Foundation cleanout (Y/N)Y Depression over tank (Y/N) N High water alarm (Y/N) N
Date of pumping 6-27-18 Pumper ALASKA QUALITY PUMPING
C. ABSORPTION FIELD DATA-SYSTEM WAS PRE-SOAKED PRIOR TO TESTING.
Date installedLlO-9-I3Soil rating (GPD/SF) 1.2 System type CRIB
Length 18 ft. Width 18 ft. Gravel below pipe 7.0 ft.
Total depth 11' ft. Eff. absorption area 504 ft2 Monitoring tube Y Depression over field N
Date of adequacy test 6-27-2018 Results (Pass/Fail) PASS For 4 bedrooms
Fluid depth in absorption field before test 0 in. Water added 800+gal. new depth 12 in.
Elapsed Time: 1440 min. Final fluid depth 0 in. Absorption rate >=_800_g.p.d.
Any rejuvenation treatment(past 12 mo.) (Y/N &type) N If yes. give date
•
D. LIFT STATION
Date installed Size in gallons Manhole/Access (Y/N)
"Pump on" level at in. "Pump off' level at in. High water alarm level at in.
Datum Cycles tested Meets alarm &circuit requirements?
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot 100'+ On adjacent lots 100'+
Absorption field on lot 100'+ On adjacent lots 100'+
Public sewer main 75'+ Public sewer manhole/cleanout 100'+
Sewer/septic service line 25'+ Holding tank 100'+
Animal containment areas 100'+ Manure/animal excrete storage areas 100'+
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'
Water main 10'+ Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10 Water main 10'+
Water Service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain 50'+(None Known) Wells on adjacent lots 100'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
1 certify that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this date.
Engineer's Printed Name MIKE N. ANDERSON,PE
Date 711812018
COSA canary sheet_2-6-15.doc