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Home My WebLink AboutSKYHILLS PH 1 BLK 3 LT 6Sky Hills Ph. i Block 3 Lot 6 #011-122-28 Municipality of Anchorage Department of Health and Human Services i Building Safety Division Onsite Water and Wastewater Program, 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 9951M650 Page 1 of 3 www.cl.anchorage.ak.us (907) 3437904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. SWSW030171 PID Number. 011-122-28 Nm Wastewater System: ® New ❑ Upgrade M ABSORPTION FIELD R"rr Nutea. of Bed o ® Deep Troch O show. Trench O Bed o Moots o Other LEGAL DESCRIPTION Sod U" Tots Depth from wVwW arae Block Lot Su ck sx er Depen w V W Whwn hon o g ml article 134* N depth b~h p,pe Tuwnehp Rrge Sectm F! ticled alm,, *V Al areae Gr" LOVK Well: ❑ New ❑ Upgrade r"e Nx°h NUAwaknee Datt.n<.beb~llve Cl.eedcelm (PnvMe. A B. C) AWWU Taal Depth. Ceeed w F, ToY abwpem we. 640 Rare hlMenel FBI 013034 PVC DNler Date DOW SW"Wetw LevW hM r Co. DMS YaWIed 71912003 YWd Pulp SN M,tewp H60Above GrooM TANK GPM Ft. FI SEPARATION DISTANCES ® Septic ❑ Holding ❑ S.T.E.P. ❑ Other. To Septic Absorption Lit Holding ubhYPrtvate Mw"did1ef cal-carrom F Tank Field Station Tank SewerUne AnchTank 15000M wee 200+ 200+ 200+ 200+ 200+ Steel 2e s.t.cowMw 100+ 100+ 100+ LIFT STATION Lo Line 31.3 22.2 V SueMwelMauw cM 7.2 16.9 Pump or Wel M 'PLav ter M M NO wMw Mwm M. Fandatm 1 1 h h h Culeet Dren 1 100+ 1 100+ 1 Puro make s Model EIeGr"W hepeclm. Pe"ormed w Lomat served by AWWU. BENCH MARK Lornm era Deeoiptm Front Door Threshold Asv, n d Elim* . 100.0 FL Engineer's Stamp •••O ................. .... Inspections performed by: Pannone Eng. SVC Dates: 1"6/9/2003 49TH .....i. .................d.....� 20°0610912003 i Department of Health and Human Services a proval` ""' " """""""" F. Pannone? ♦iV��Sleven J, 0' Reviewed and approved by: Date: 7-0— /Nn (r FF 8149 �` (Rev. 1199) A..`i"'•'� •• 1401% _1Ci��• PERMIT NO, SW030171 AS -BUILT NEW PRIMA DR4INFIE Fx4' FFx3' 7 TH ❑P❑S I RE 80L, x4'I ,1 , WASTEWATER ABSORPTION SYSTEM LOT 6 BLOCK 3 SKYHILLS S/D NOTEt 1) SUBD. IS SERVED BY AWWU. THERE ARE NO WELLS WITHIN 200 FEET OF THE PROPOSED INSTALLATION. NEW SBR HOUSE NEW 15p0 PTIC TA D Cl\ Work\1-3KYHILL,IIWG 4921. A6 FC 4T p 2 % ?Cll✓ RVE FIELD) x3'W, 7'TD NOTE, 1) SUBD. IS SERVED BY AWWU. THERE 1 ARE NO WELLS WITHIN 200 FEET OF THE PROPOSED INSTALLATION. NOTE, 1) ALLWORK SHALL BE PERFORMED N ACCORDANCE WITH AMC15.65, > MATERIALS USED SHALL BE IN A CORDANCE WITH THOSE SPECIFIED IM AMC15.65, WASTEWATER DISPOSAL. 3) CONNECT POST TANK LINE TO MID- POINT OF DRAIN FIELD. TYPICAL. 4) INSTALL DRIVEWAY AT LEAST 5 FT AWAY FROM DRAINFIELD. DO NOT INSTALL DRIVEWAY OVER DRAINFIELD. 5) MAINTAIN 10' SEPARATION TO ALL LOT LINES. ✓en R. Pannone: E No. CE 8149 John Hagneler s �r John Hagneier Co. • jU�/''�� 2204 Cleveland Ave, Suite 204 Anchorage, AK 99517 (907) 248-6789 P.I.D. NO- 011-122-28 NOTEt 1) SU ARE 1 THE I 5 BR 4 EW WATER ERVICE 1 INE 1 CO A B FC 30.8 12.4 TI 32.8 9.7 T2 35.9 17.8 PT 37.3 20.4 Cl 47.0 18.8 MT 40.0 43.0 C2 70.9 89.7 DESIGN- PERC RATEi I MIN/INCH SOIL RATING, 1.2 GPD/SF 125 SF/BEDROOM, 5 BEDROOM 625 SF REQUIRED, 15009 TANK DEEP TRENCH, 4' EFFECTIVE 7' TOTAL DEPTH, 80 LF 2-3' WIDE, 640SF TOTAL PANNONE ENG. SVC, LLC P. O. BOX 102954 ANCHORAGE, ALASKA 99510 272-8218 Phone & Fax AS -BUILT PERMIT NO: SW030171 AS -BUILT DETAILS P.I.D. NO, 011-122-28 WASTEWATER ABSORPTION SYSTEM LOT 6 BLOCK 3 SKYHILLS S/D NOTE, 1) ALLWORK SHALL BE PERFORMED IN ACCORDANCE WITH AMC15.65. 2) MATERIALS USED SHALL BE IN ACCORDANCE WITH THOSE SPECIFIED N Ln IN AMC15.65, WASTEWATER DISPOSAL. a, Co w 3) CONNECT POST TANK LINE TO MID- POINT OF DRAIN FIELD. TYPICAL. 1nONV313 4) INSTALL DRIVEWAY AT LEAST 5 FT Q AWAY FROM DRAINFIELD. DO NOT INSTALL a DRIVEWAY OVER DRAINFIELD. 5) MAINTAIN 10' SEPARATION TO ALL a` LOT LINES. $ N 00 OD n m Ln a, m o S S Ci\Work\I-2SKYH.DWG 4.0' a - V) AV i %....'?C'' )... + iSteven R. Pannone ��.♦ No. �CE84. ,.�2.. LnDNV3l3 NOI1VONn0! KLFAKLU r UK, PANNONE ENG. SVC., LLC John Hagneier P. 0. BOX 102954 John Hagneler Co. ANCHORAGE, ALASKA 99510 2204 Cleveland Ave, Suite 204 272_8218 PHONE & FAX Anchorage, AK 99517 (907) 248-6789 DAT 7- 4 -DA LE AS—BUILT 9 Ll Ll b u 1nOMJ313~ D W 1nDNV313 m � Ot z JW ln(INV3l3 3an1 baimoN W wig K ._61.. 1n"313 O�� Wy�jW P 0 1 J Z 6 Co p Z.'•.�iN7 Li W• A a) EJ H 1 LJ V H LLI N LQ LL CU 1nONV313 Ln 13 c c m m N Co n LnDNV3l3 NOI1VONn0! KLFAKLU r UK, PANNONE ENG. SVC., LLC John Hagneier P. 0. BOX 102954 John Hagneler Co. ANCHORAGE, ALASKA 99510 2204 Cleveland Ave, Suite 204 272_8218 PHONE & FAX Anchorage, AK 99517 (907) 248-6789 DAT 7- 4 -DA LE AS—BUILT 9 b u 1nOMJ313~ D W Y 1nDNV313 m � Ot JW ln(INV3l3 W wig 03 a` ._61.. 1n"313 O�� Wy�jW z Ca 6 Co p Z.'•.�iN7 LnDNV3l3 NOI1VONn0! KLFAKLU r UK, PANNONE ENG. SVC., LLC John Hagneier P. 0. BOX 102954 John Hagneler Co. ANCHORAGE, ALASKA 99510 2204 Cleveland Ave, Suite 204 272_8218 PHONE & FAX Anchorage, AK 99517 (907) 248-6789 DAT 7- 4 -DA LE AS—BUILT o N�N D Nmo z F a) gv o, 40 SSQ r u g A o m N z ---1 N O oo�0 vNO4OvtAm�pn m zO ZmD'( z Z fmn z I PI �ceC:rn ;ma Q� ��g� H v -i V)C7 X o�z4n"�ioo�� to N in y m�6= O c _ n 4 rz �O�'lA DO :^ kgs-�Io M -! �t 10' UTIL ESMi - - - (� S N 05.12'21 'E 108.03' - -o s � o - r ro A N p r 1 .cD Too . .,, • S9 •: o : • .. /� r •a r -! �t 10' UTIL ESMi - - - (� S N 05.12'21 'E 108.03' - -o s � o - r r= SKYHILLS DRNE v Q7 CI Co (- -• snO C: V (A O D N 00600'07"E m L=59.63' R=570.00' 24.87' L=87.88' R=770.00' 20' GAS do TRAIL ESWr. - - - - - - - - - - - - - W_ - - - O i {C) 62.8' y 4T $ N $ =Q �4 Mm N N .`I 35.4' rn rn -! �t 10' UTIL ESMi - - - (� S N 05.12'21 'E 108.03' - -o s � o - r r= V v Q7 CI Co (- -• snO V � D --<< 6.t"� MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT Renewal Date Issued: Jun 06, 2003 Expiration Date: Jun 05, 2004 Permit Number: SW030171 Parcel ID: 011-122-28 Legal Description"SKYHILLS PH 1 BLK 3 LT 6 Design Engineer. 0062 Pannone Engineering Services Site Address: 008255 SKYHILLS DR Owner Name: John Hagmeier Co. Lot Size: 40478 SO. FT. Owner Address: 2204 Cleveland Dr. Suite 204 Total Bedrooms: 5 Permit Bedrooms: 5 Anchorage , AK 99517 - This permit is for the construction of. ❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either. A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: I Date: Z�Xa Cl r Date: Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.enchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 011.122.28 Permit Number SWO30/ %/ Property owners) John Hagmeler Homes, LLC Day phone 248.6789 Mailing address (1) 2204 Cleveland Ave.. Anchorage, AK 99517 Mailing address (2) Zip Code Legal description (Lot, Block & Sub'd.) Lot 6 Bk 3 Sky Hills Phase Legal description (Section, Township & Range) Lot Size 40478 Acres/Sq.Ft. THIS APPLICATION IS FOR: Number of Bedrooms 5 Sewer Only ® Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ 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. (Signature of property owner or authorized agent) Permit Fees: Date of Payment: Waiver Fees: Date of Payment: Receipt Number: jJ�o� ^] I Receipt Number: (Rev. 12/00) RENEW (o -6 -03 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water 8 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Date Issued: Jun 06, 2002 Expiration Date: Jun 06, 2003 Permit Number: SW020149 Parcel ID: 011-122-28 Legal Description: SKYHILLS PH 1 BLK 3 LT 6 Design Engineer: 0062 Pannone Engineering Services Site Address: 008255 SKYHILLS DR Owner Name: John Hagmeier Co. Lot Size: 40478 SO. FT. Owner Address: 2204 Cleveland Dr. Suite 204 Total Bedrooms: 5 Permit Bedrooms: 5 Anchorage , AK 99517 - This permit is for the construction of: Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: Date: 2 -- Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. DII — 12-P—a<� Permit Number SW Property owner(s) John Hagmeier Co Day phone 248.6789 Mailing address (1) 2204 Cleveland Drive, Suite 204 Mailing address (2) Anchorage, AK Zip Code 99517 Legal description (Lot, Block & Sub'd.) Legal description (Section, Township & Range) Lot Size 40.478 Acres/Sq.Ft. THIS APPLICATION IS FOR: Number of Bedrooms 5 Sewer Only ® Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ 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. (Signature of property owner or authorized agent) c Permit Fees:1 C �//� 23 Waiver Fees: tD Date of Payment: 0 Z Date of Payment. Receipt Number: 0?1D!9 3 I il' Receipt Number: (Rev. 12100) Pannone Engineering Services, LLC P.O. [lox 102954 Consulting Engineers Anchorage, Alaska, 99510 (907) 272-8218.227-3522 (907)272-8218 Fax June 2, 2002 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program 4700 S. Bragaw Street P. O. Box 196650 Anchorage, Ahaska 99519 Subject: Lot 6, Block 3 Sky Hills S/D, Septic System Permit Gentlemen: My firm was contacted to design and install a new septic system for the referenced lot. We conducted a field investigation to locate existing wells and septic system before designing the proposed system. Two test holes were excavated in August of 1998 for the system design, which is on file with your department. No ground water was encountered. No bedrock was encountered in the test hole. The lot is 40,478 sq ft in size. Lot 6 slopes to the south at a rate of approximately 1-3 percent in the proposed septic area. The proposed installation will be located on the southwestern portion of the lot on a relatively flat area. The proposed location is greater than 200 feet away from any wells. This lot is served by AWWU water service. The proposed system will be greater than 10 feet from the water service lines. The proposed installation will not affect the future development of the surrounding or existing lots. See the attached design. Please contact me at 272-8218 or 227-3522 if you have any questions about the proposed installation. Sincerely, t Steven R. 1'a one, P.L. Attachments: CANVnRK0.1711 FRSb-3SKY1111.I SIX11.1x1R PERMIT NO- SV02 DESIGN I >I Of , AI N J =I iPROS Li R❑POgED PI DRAII 80LFp 4'EF 15.5 iTHS .C�•°P '0= 49L+ P.I.D. NOt WASTEWATER ABSORPTION SYSTEM LOT 6 BLOCK 3 SKYHILLS S/D NOTE, 1) SUBD. IS SERVED BY AWWU. THERE ARE NO WELLS WITHIN 200 FEET OF THE PROPOSED INSTALLATION. PROPOSED SERVICE LINE 2%-/ ISED I° PTIC T IMARY ROPOSED BR HOUSE 4 NOTEi 1) SUBD. ARE NO THE PROI 5 BR 87 L2'/. 2 .2 3 ,6 1 3 RVE FIELD) x3'W, 7'TD NOTE, 1) SUBD. IS SERVED BY AWWU. THERE 1 ARE NO WELLS WITHIN 200 FEET OF THE PROPOSED INSTALLATION. NOTE, 1) ALLWORK SHALL BE PERFORMFU- IN ACCORDANCE WITH AMC15.65.i 2) MATERIALS USED SHALL BE ON J 'G ACCORDANCE WITH THOSE SPECIFIED IN AMC15.65, WASTEWATER DISPOSAL. 3) CONNECT POST TANK LINE TO MID- POINT OF DRAIN FIELD. TYPICAL. 4) INSTALL DRIVEWAY AT LEAST 5 FT �AWAY FROM DRAINFIELD. DO NOT IN �� '## DRIVEWAY OVER DRAINFIELD. / 5) MAINTAIN 10' SEPARATION TO ALL t -•-i LOT LINES. R. Ponnone= ji John Hagneler John Hagneler Co. ?, •'�� 2204 Cleveland Ave, Sulte 204 •• ••' �� Anchorage, AK 99517 (907) 249-6789 DESIGN- \ PERC RATE,1 MIN/INCH SOIL RATING, 1.2 GPD/SF 125 SF/BEDROOM, 5 BEDROOM 625 SF REQUIRED, 1500g TANK DEEP TRENCH, 4' EFFECTIVE 7' TOTAL DEPTH, 60 LF 2-3' WIDE, 640SF TOTAL PANNONE ENG. SVC, LLC P. 0. BOX 102954 ANCHORAGE, ALASKA 99510 272-8218 Phone & Fax DESIGN PERMIT NO- SW02 DESIGN DETAILS P.I.D. NOt WASTEWATER ABSORPTION SYSTEM LOT 6 BLOCK 3 SKYHILLS S/D NOTE, 1) ALLWORK SHALL BE PERFORMED IN ACCORDANCE WITH AMC15.65. 2) MATERIALS USED SHALL BE IN ACCORDANCE WITH THOSE SPECIFIED IN AMC15.65, WASTEWATER DISPOSAL. 3) CONNECT POST TANK LINE TO MID- POINT OF DRAIN FIELD. TYPICAL. 4) INSTALL DRIVEWAY AT LEAST 5 FT AWAY FROM DRAINFIELD. DO NOT INSTALL DRIVEWAY OVER DRAINFIELD. 5) MAINTAIN 10' SEPARATION TO ALL LOT LINES. m a a u C c s L O K i C C:\Work\1-2SKYH.DWG OF {` 49n! ren R. Panni No. CE 8149 John Hagneler John Hagneler Co. 2204 Cleveland Ave, Suite 204 Anchorage, AK 99517 (907) 248-6789 Ou 3anl WINCH lrCW3l3 LrO W3l3 LrCW3M IMNY313 1nOW3M NOurawcj Li W U P Z W �Z o CL _j W. W O R m bi F—/ LL a n PANNONE ENG. SVC., LLC P. O. BOX 102954 ANCHORAGE, ALASKA 99510 272-8218 PHONE & FAX DESIGN Mue1 Anchorage. OF HEA DEPARTMENT OF HEALTH d HUMAN SE4VtCE5 $25 V Street Anenera6e. Alaska 99502.0650 SOILS LOG — PERCOLATION TEST Iw0INEBRI BEAU PERFORMED FOR; L R Construction DATI PERFORME2: LIGAL DESCRrPTION:. L? &t BLE 3,, Skr Nil Subdivision TS is WAS GROUNC WATER N ENCOUNTEREO? S IP YES. AT WNAT 1 L OEFTN? �'e P sear a waw uw '.11:c, •! • Menimrhpl ��•O PEPCOLATION RA•E �m.nNw+gMr FERC NOTE DU4ETCR TEST RUN ASTWEEN + FT AND r. PT COMMENTS — Pere cavity was presoaked PERFCAMED B•. CEATIFY TMA? TMS TEST WAS REPFCAMEO IN C a9 r •Ira OII ACCOROANCE W.y",%LL STATE Ahi MUNICIPAL GUICELINES IA EFF4CT ON TWIS CAT!. CAM ZOO•d wallso ZOl80/20 , •,,,,,,,_.;,j�?LE'�ZL.28 4047a sqftnr�-- 71. WAS GROUNC WATER N ENCOUNTEREO? S IP YES. AT WNAT 1 L OEFTN? �'e P sear a waw uw '.11:c, •! • Menimrhpl ��•O PEPCOLATION RA•E �m.nNw+gMr FERC NOTE DU4ETCR TEST RUN ASTWEEN + FT AND r. PT COMMENTS — Pere cavity was presoaked PERFCAMED B•. CEATIFY TMA? TMS TEST WAS REPFCAMEO IN C a9 r •Ira OII ACCOROANCE W.y",%LL STATE Ahi MUNICIPAL GUICELINES IA EFF4CT ON TWIS CAT!. CAM ZOO•d wallso ZOl80/20 , •,,,,,,,_.;,j�?LE'�ZL.28 0-72- gz/S MuO ip fify ofEAT & HUMAN DEPARTMENT OF FiFJtLTM d HUMAN SERVICES 825 -L- Street, Anchorage, Alefka 995020830 SOILS LOG — PERCOLATION TEST A (INCiNElR3fEAL) I /7 1N - P111tCRM10 FOR: L H Construction DAT9►1R110HMe0: 8--11-98 LEGAL CCSCRIFTION: LT G, 8LS I 4- 7- 12 712 13 14 15 is I �ttig 17 -I t9 -i 19 Bills Subdivision WAS GROUND WATER ENCOUNTERED? IF VES. AT WHAT DEPTH? At l f C • r c _ F 1 Etelrle Wm Mn 0 a"T.wfa Mwt�nPg7 Ont 27 ��PERCOLATIONFATE �•� IME WWKC ) r_AC KOLL DIAMETER TEST PUN eETWEEri � FT ANO -;4 FT COMMENTS- Pere cavity Was Oresoiked .�■■■N NRad Rud{nE Cut Gro" TimmsWear I O.oen h eye O.eO IN • I :yy. .ot. 7 .478 ICJ yli; 17A%. r C` r o I 1 At l f C • r c _ F 1 Etelrle Wm Mn 0 a"T.wfa Mwt�nPg7 Ont 27 ��PERCOLATIONFATE �•� IME WWKC ) r_AC KOLL DIAMETER TEST PUN eETWEEri � FT ANO -;4 FT COMMENTS- Pere cavity Was Oresoiked .�■■■N NRad Rud{nE Cut Gro" TimmsWear Nat O.oen h eye O.eO • I :yy. .ot. 7 4 yli; 17A%. r C` r o :a %57 PERFORMED BT'S—+' - I O de II 9pe O ZATIFY THAT THIS TEST WAS PERFORMED IN ACCOACANCe WITH ALL STATE ANO MUNICIPAL GUIDELINES IN cfFECT ON This LATE CAT! 902-d tG1180 20/E0/£0 . ..,,.. a ,..�. ZCSL£LZLOG • •_•— . --. _ . CERTIFICATE OF HEALTH AUTHORITY APPROVAL a f , FOR A SINGLE FAMILY DWELLING Parcel I.D. 011-122-28 HAA #_„ 3 O Z3 �. Expiration Date:�l- 1. GENERAL INFORMATION Complete legal description _Lot 6 Block 3 Skvhilis Phase 1 Location (site address or directions) 8255 Skyhllls Drive, Anchorage. AK Current Property owner(s) John Hagmeler Homes, LLC Day phone 248-6789 Mailing address 2204 Cleveland Ave.. Anchorage, AK 99503 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DHHS for pickup. NAA picked up by: 2. NUMBER OF BEDROOMS: 5 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System C j� y ® Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Hea!th Authority Approval are required for the transfer of title (except between spouses) on properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to home owners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. (Rev. 11189) Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 �? 117111 www.ci.enchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL a f , FOR A SINGLE FAMILY DWELLING Parcel I.D. 011-122-28 HAA #_„ 3 O Z3 �. Expiration Date:�l- 1. GENERAL INFORMATION Complete legal description _Lot 6 Block 3 Skvhilis Phase 1 Location (site address or directions) 8255 Skyhllls Drive, Anchorage. AK Current Property owner(s) John Hagmeler Homes, LLC Day phone 248-6789 Mailing address 2204 Cleveland Ave.. Anchorage, AK 99503 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DHHS for pickup. NAA picked up by: 2. NUMBER OF BEDROOMS: 5 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System C j� y ® Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Hea!th Authority Approval are required for the transfer of title (except between spouses) on properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to home owners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. (Rev. 11189) 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 Health Authority Approval Guidelines for 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 applicable Municipal and State codes, ordinances, and regulations in effect at the time of Installation. Name of Finn Pannone Encl. Svc. Phone 272-8218 Address P.O. Box 102954 Anch. AK 99510 Engineer's Printed Name Steven R. Pannone, P.E. Date Engineers Comments: In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DSD Guidelines & Regulations. 71c 4 reported results describe the performance of the system under the conditions encountered at the time of ( the test, and separation distances measured to readily identifiable features. The operational life of all fluctuate M i wells and septic systems depend on the local soil condition, ground water levels that may {t during the year, and the water usage of the family being served by the system. These conditions arc outside the control of the evaluator of this system All systems eventually fail and satisfactory lest results 0 do not guarantee future performance of the system, nor do they guarantee that there are no hidden defect /. for future any or encroachments. PES can therefore not provide any warranty performance nor give 0 # 0 estimate of how long the system will continue to meet the operational requirements of the ADCC or MOA DSD. 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 authorised nor will it confer any legal right whatsoever. 6. DSD SIGNATURE y Approved for .` bedrooms. Disapproved. Rk ............. 49rr, zt ,en R. Ponnone; z?• No CE 8143 AbZxE55\C}�� Conditional approval for bedrooms, with the following stipulations: ,,,tttttfrr�rrrrr,, v. Additional Comments nN-SITE. S WATER AN ..rn CTC�TFR :: �•. PROGRAM ••�� moi, ln�� •nf�G .� Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other By: 0, Original Certificate Date: % — 17- 03 Expiration Date: Reissue Date:, (Rev 1159) Municipality,of Anchorage Development Services Department =' Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ek.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST , Legal Description: _Lot 6 Block 3 Skvhllis Phase 1 Parcel I.D.: 011.122.28 A. WELL DATA Well type City Water If A. B, or C provide PWSID # _ Well Log Date completed _ Sanitary seat _ Wires properly protected _ Total depth ft Cased to ft Casing height (above ground) in. FROM WELL LOG f� A PECTION Date of test 0 (I r Static water level ft ft Well production g.p.m 9 -p.m WATER SAMPLE RESULTS: Coliform col es/100 ml Nitrate mg/l Other bacteria colonies/100 ml Date of sample' Collected by. B. SEPTIC/HOLDING TANK DATA Tank Type/Material Greer Steel Date installed 7/912003 Tank size 1500 gal Number of Compartments 2 Cleanouts 2 Foundation cleanout Y Depression over tank N High water alarm N/A Date of pumping Pumper C. ABSORPTION FIELD DATA Date installed 7/9/2003 Soil rating (9.p.d./ft2 or ft2/bdrm)1_2 System type _Deep Trench Length 10 It Width 3 It Gravel below pipe 4 ft Total depth Z It Effective absorption area4We Monitoring tube y Depression over field1N Date of adequacy test AJJ;,W Results (Pass/Fail) Pass For bedrooms Fluid depth in absorption field before lest 0 in Water added0 gal. New depth0 in. Elapsed Time: 0 min Final fluid depth 0 in Absorption rate >= 750+ g,p,d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) ,d1�_ If yes, give date (Rev. 11199) D. LIFT STATION Date Installed ingallons 'Pump on' level at ump off" lev Datum Cycles tested .E. SEPARATION DISTANCES SEPARATION Septic tank/lift station on lot Absorption field on lot Public sewer main FROM WELL ON LOT TO: On lots adjacent lots Manhole/Access In High water alarm level at _ In Meets alar & circuit requirements? sewer manhole/cleanout Sewer /septic service I' � Holding SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 10' Property line 80+ Absorption field 5' Water main 25'+ Water service line 15' Surface water 100+ Drainage 100+ Wells on adjacent lots 1001+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 17' Building foundation 17' Water main 25'+ Water Service tine 17' Surface water 100+ Driveway, parking/vehicle storage 20'+ Curtain drain AI.A Wells on adjacent lots 100'+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name Steven R. Pannone P.E. Date_ 77//Z(/0,3 HAA Fee Date of Payment �� Receipt Number (Rev. 11/99) i.....r. 0.......1 ..... ♦ f� sSleven •�R................ Par.^one;• i �1�%♦ , f.F. R 49 44 Fee $ Date of Payment Receipt Number