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Home My WebLink AboutWYNTER PARK #1 BLK 1 LT 23Onsite File Wynter Park #1 Block 1 Lot 23 #051-491-30 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP221284 PID Number: 051-491-30 Dwelling: ® Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade Name MICHAEL ELISHA GRANT ABSORPTION FIELD ® Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 24236 HEARTHSTONE DRIVE, CHUGIAK ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 0.8 GPD/SF 10 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 3 Ft. Gravel depth beneath pipe 7 Ft. Subdivision Block Lot WYNTER PARK #1 1 23 Fill added above original grade VARIES 0.4-0.6 Ft. Gravel length 41 Ft. Township Range Section Gravel width 3 Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 574 Ft2 1 NA Ft. Well 200'+ 200'+ 25'+ TANK ® Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer GREER Capacity 1000 Gal. Surface Water 100'+ 100'+ Material Number of compartments Lot Line 51+ 10'+ NA HDPE 2 Foundation 10'+ 10'+ LIFT STATION Manufacturer Capacity Gal. Remarks SEPTIC TANK INSULATED. NEW LINE TO EXISTING CRIB. Alarm location Electrical installed by Installer JRS PIPE MATERIAL House to tank 3034. Tank to 3034 drainfield Drainfield 3034 CO/MT 3034 Inspector FWC BENCH MARK (Assumed elevation) 100 ft Inspection dates: 15` 9/12/22 2nd 9/13/22 Location and description 3`d 9/13/22 4"' 9/30/22 TOP OF MH ON-SITE WATER AND WASTEWATER SECTION APPROVAL Conditional N .491 ' ' • ' ' Approval: Date AW Q"�`.'• ' • !1Q,`� L :* ow ... . � Septic System Approvd ••.. .......... • • Curtis Huffman / ' I�rtl_2Z lc� �F '. CE 128991 . •`�r� Date / - �1cSlF�• , 10/1/22 , •�� ... lll\ pROFESSIO�� Note: this approval does not include well permit requirements. PID: 051-491-30 PERMIT OSP221284 APFR07K KEY BW WAM LM Loc i lot 24 rJasr 110.00' HEARTHSTONE DRIVE DECK 3 BRM oo RESIDENCE • -1o� ,s FM C ,OW CAAM LL HWEw&T. ODI I D w/ FD= DCO k w 00 E N DIV F "co .2. Lot 22 "EW D3034 LMM DOSIMC DEwurts9or�n oasiDm FEEitCtA35 IT. DCOj oasfwc C\J\ /' (706 YT D18L UM NLV 411x 7NKM TRE?= NZ 22 59.31 Lot 10 Lot 23 22,527 S.F. _ 51.53 1' 56 �.._ Lot 11 10' UTILITY EASEMENTS FENCE A—C=46.4' B—C=38.3' FCO BW H CO % DDCO co MT MT Co IV A—D=48.3' 99.9 / a8.4 FINAL GRADE 96.6 ae.o B—D=4Lz' ORIGINAL GRADE A—E=51.5' 961NSUL FILTER FABRIC 2• ORG/oL B — E = 4 5.3' 95.4 1.000—GALLON 5.25 95.0 95.0 A—F=60.4' HDPE TANK SEWER ROCK GM/GP B—F=55.0' A—G=66.9' aao ae.o B-6=58.8' DRY -7/20/22 do 9/12/22 A—H=95.0' TH22-1 B—H=70.8' SEPTIC SECTION 82,06 BOH A—I=95,6' SCALE, NTS B—I=71.6' WYNTER PARK #1 B1 L23 SUPPORT®SERVICES: PREPARED FOR: OF At<Q� MICHAEL ELISHA GRANT 24236 HEARTHSTONE DRIVE TH CHUGIAK, AK 99567 FIRST WATER CONSULTING DATE: 10/1/22 rtes Huffman 13030 SUES WAY _ SURVEY: KGL___ _ _ _ __ _ CE 128991 DRAWN: FWCS / /22 �+AO ANCHORAGE, AK 99516 SCALE: 1 1001 " = 50' 10/01O��'AW 907-350-9566 firstwaterAK@gmail.com AV 0 0 C5 M EAST DECK 9.2' h .- 9 .9 m 3 STORY N RESIDENCE � 11.6' 10.0'. 10.0 0 f, 6.7'(6 •Ii . 10.0'x11.0' DECK Oq O Lot 24 CV MANHOLE `- Lot 23 22 527 S F 12.3'x10.5' SHED SEP11C \ PIPES f Lot 22 WOODEN FENCE "-.. --} N 83'53'22 "yy 59.31 ' S 81-5 8' 56"W 51.53' --._._ 10' UTILITY EASEMENTS Lot 10 I Lot 11 I I NOTE: THE LOT IS SERVED BY A COMMUNITY WATER SERVICE. PLOT PLAN _ AS BUiLT _X_ SCALE 1" = 40' GRID NW 1361 Project No 22-62 fA1 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associates, inc. (907) 522-6476 Phone (907) 522-4625 Fax OF A ��0� Professional Land Surveyors kenOlongsurvey.com jonothanOlangsurvey.com � I hereby certify that I have surveyed the following described property: LOT 23, BLOCK 1, WYNTER PARK SUBDIVISION No. 1 (PLAT No. 73-149) Anchorage Recording District, Alaska, and that the improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the surveyed premises and -that -there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated this the 3'��i�N Day of`+��%�� _L`z'L of Anchorage, Alaska It is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. 49TH y*! ET o 4Q �F LS -5202. ' gJpG AR ' aOvp AECC963 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program Po Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 hltp:l(www.muni.orglonsite On -Site Wastewater Disposal System Permit Permit Number: OSP221284 Work Type: Septic Upgrade Tax Code Dumber: 05149130000 Site Legal Address: WYNTER PARK #1 BLK 1 LT 23 G:1361 Site Mailing Address: 24236 HEARTHSTONE DR, Chugiak Owner: GRANT MICHAEL ELISHA Design Engineer: FIRST WATER CONSULTING This permit is for the construction of: Effective Date Expiration Date n,ent a O Uel�arritle�Ilt Lot Size in Sq Ft: Total Bedrooms: 8/4/2022 8/4/2023 22527 Q Disposal Field 0 Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: Issued By: 8/4/2a22 Date: Date: Q MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 051-491-30 Property owner(s) MICHAEL ELISHA GRANT Day phone Mailing address PSC 831 BOX 0051, APO AE 09902 Site address 24236 HEARTHSTONE DRIVE, CHUGIAK, AK 99567 Legal description (Sub'd., Block & Lot) WYNTER PARK #1 BLOCK 1, LOT 23 Legal description (Township, Range & Section) Lot Size 22,527 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption FieldX❑ Initial ❑ Single Family (SF) X❑ Septic Tank X❑ Upgrade X❑ (w/wo-ADU) Holding Tank ❑ Renewal ElDuplex (D) El Privy ❑ Multiple Dwellings ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: 5% 5 Waiver Fees: Date of Payment: -110-0/ 2022 Date of Payment: Receipt Number: 31 D222 Receipt Number: Permit No. ®S %',2a 1 :2 S V Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com July 20, 2022 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: NEW SEPTIC SYSTEM PERMIT LEGAL: WYNTER PARK #1 BLK 1 LT 23 The property owner has requested we obtain a new septic permit for the above referenced lot. We propose to install a deep trench and a 1000-gallon HDPE tank to serve the existing 3-bedroom residence. The design is based on the attached test hole conducted in July 2022. No ground water was observed during excavation and monitoring. The slopes are moderate at 5-10% max at the proposed upgrade location. The lot and area are served by public / class A water and the service line will be staked by a RLS prior to construction. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221284, Rebecca Carroll, 08/04/22 FIRST WATER CONSULTING DESIGN CALCS: NO WELLS WITHIN 100' OF PROPOSED SEPTIC TANK NO SLOPES >25% WITHIN 50' OF PROPOSED FIELD. WYNTER PARK #1 BLK 1 LT 23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221284, Rebecca Carroll, 08/04/22 3-BED HOUSE LOT 23 22,527 sq. ft. 10' UTILITY EASEMENT SHED LOT 22 UTILITY POLE LOT 24 CONCRETE DRIVEWAY FIRST WATER CONSULTING WYNTER PARK #1 BLK 1 LT 23 DESIGN DETAILS: Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221284, Rebecca Carroll, 08/04/22 13030 Sues Way - Anchorage, Alaska 99516 Tel. 907-350-9566 firstwaterAK@gmail.com SOILS LOG - PERCOLATION TEST LEGAL : WYNTER PARK #1 B1, L23 PERFORMED BY: FWC - I CURTIS HUFFMAN CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE & MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 7/20/2022 DEPTH FEET OG SOILS 1 2 ORG/OL 3 4 5 6 7 GM/GP 8 9 10 11 12 13 14 15 16 17 BOH 18 19 20 Reading Date Gross Time Net Time Depth to Water Net Drop 7/18/22 10 min 6 2 15/16 6 2 16/16 6 2 14/16 6 2 13/16 6 2 14/16 6 2 13/16 PERCOLATION RATE 3.6 (MIN / INCH) TEST RUN BEWTWEEN 4 & 5 FT PERC HOLE DIAMETER 6 PRE-SOAKED PRIOR TO TEST & ALL READINGS TO THE 1/16TH. GROUND WATER ENCOUNTERED: NO IF YES, AT WHAT DEPTH: DRY DEPTH TO WATER AT MONITORING: NA DATE: 7/20/22 TESTHOLE # 22-1 DATE PERFORMED: 7/13/22 SEE SITE PLAN FOR SLOPE & LOCATION COMMENTS: VERIFY GROUNDWATER MT AT TIME OF CONSTRUCTION PERFORMED FOR: PATRICK HOPE 7/20/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221284, Rebecca Carroll, 08/04/22 QGRE' ER ANCHORAGE AREA BOF Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 UGH INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME~/:/~/f~/~' (~ '' LOCATION SEPTIC TANK: DISTANCE ~ ~iQl ~ ~ FROM WELL _____ MANUFACTURER °' NUMBER OF MATERIAL /~//3'~ff-,C~t/(tJ~'S' _ COMPARTMENTS INSIDE LENGTH __ INSIDE WIDTH LIQUID DEPTH__ .LIQUID CAPACITY ~¢"¢¢? GALLONS. SEEPAGE PIT: /~:~y /~ )~¢; NUMBER OF PITS / DIAMETER OR WIDTH LENGTH DEPTH /r~l~' CRIB SIZE: DIAMETER/~/&/P"~H',~t~'_ DISTANCE FROM: TOTAL EFFECTIVE BUILDING FOUNDATION ___ ., NEAREST LOT LINE WELL ~4~' '~'~? ~ "U/' '7~"-- .//$ ABSORPTION AREA (WALL AREA) ~ '~'~- SQ. FT, ADDITIONAL ABSORPTION WELL: TYPE BUILDING NEAREST NEAREST FOUNDATION LOT LINE SEWER LINE CESSPOOL OTHER SOURCES__ APPROVED _ DISAPPROVED_ ~ REMARKS DEPTH DISTANCE FROM: SEPTIC SEEPAGE TANK SYSTEM DISTANCES: INSTALLED BY: ,~1~//~ ~" PIPE MATERIAL:('I/~'-~ ~' .~r'~:~m//2 ' LOT SLOPE: REMARKS: ~'~'/~ ? DIAGRAM OF SYSTEM DATE t APPROVED ~/ G,A,A,B, Gte3' .~R ANCHORAGE: AREA Bor 'JGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 'C" ST~:~E, ET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT PERMIT NO. SOIL TEST RESULTS ~'~"-- ~'00~'~ NOTEI THIS PERMIT IS NOT VALID WITHOUT SOIL TEST DRAIN FIELD ~)l ., DRAIN FIELD , SEEPAGE Pit ~?"Jp0I ^L~O CON~IDER Al~EA WELLS. ., DRAIN FIELD CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIiL1. 4 INCH DIAMETER CAST I~ON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE Pit FITTED With AIRTIGHT REMOVABLE CAP~. GRAVEL ]BACKFILL I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BO.ROUGH ORDINANCE NO. 28.08 AND THAT THE ABOVE DESCRIBED SYSTIEM IS lIN ACCORDANCE WITH SAID CODE.~t ~-~ ~L~;~ ~J~ ~ll~ ~ ~{ ~ ~ ~,{, DATE I ~ ~~ ~PPL~ CANT'~ ~ G ~ATU ~ E ~~~ I ~o.~ .o. ,~-0,~ - ~/ 0 Er CO. Russell Oyster 694-2774 Soils ~ Foundations EGEOTECHNICAL F~ DEVELOPMENT Box 90, Davis St,, Eagle River, Alaska 99577 694-2774 or 688-2280 Earl Ellis 688-2280 Land Development Performed for: Legal Description: £gT ~, Depth (feet) 0 ~OIL LOG Sotl Char~ctertst1~ 4 g 10 11 Ground Water Encountered: Yes__~ No ~/ If yes, what depth.__~ Proposed Installation: Seepage Pit "~- Drain Fie~d Con~ents: Perfomed by:_ ~-~ ~xj~ J ~ Date: LOOHOdT / ALASKA elqUIROFlmeFITAL cori'rROk (~11§in¢¢rin§ ~- ~nuiro~mcnM Studies $1 RU/CI S, II'lC. O(;T 2, 0 10/19/81 PEOPLES BANK & TRUST POUCH 7-007 ANCHORAGE AK 99510 SELLER - DAVID BEAN BUYER- SUBDIVISION-WINTER PARK SUB BLOCK-- LOT-23 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A PIT WITH AN AREA OF 432 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 1000 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 3 BEDROOM HOME. THE SEPTIC TANK WAS PUMPED ON 6/9/81 SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF THIS 3 BEDROOM HOUSE. 1000 IS ADEQUATE FOR 1220 ~.lcsl 251h /~u¢~u¢ "'/tnchora§¢, J~l~ska 99503 · {907) 276-1361 ([JO/i ?Gl /~ I October 9, David R. Bean 8818 Abbott Loop Road Anchorage,Alaska 99507 Subject: Lot 23 Block 1 Wynter Park Subdivision Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: (1) The standpipes to the septic tank and the leaching area need to be located and marked fo]3 our ~nspection. The septic tank needs to be pumped with a receipt submitted to this office. An adequacy test needs to be performed on the existing leaching area. This test will determine if the system is adequate according to National Standards. A lJst]ng of private firms performing the test is enclosed. This repor~ needs to be submitted to this office for our review. If theme are any further questions, please call this office at 264-4720. Sincerely, James S. Roberts Associate Environmental Specialist JSR/ljw cc: Peoples Bank and Trust % Nina Pouch 7-007 99510 ALASKA ~IqUI~Olqrn~nTAL COIqTBOL S~BUIC~S, IFIC. Mr. Les Bucholz DeparLment oF Health and 825 L. SLreet Anchorage, Ak. 9950] Dear Mr. Bucholz: This is to state that the on ].ot23~ Blk -- Winter standpipes insgalled. Oc[obe~ 20~ 1981 Environmental Protection sewer system which is locaked Park Subdivision~ has bo[h Thank you, PE 1220 LUcsl 25th Ave.ut o Anchorog¢, Alasko 99503 '~ (907] 276-1361 I,- rl- ()) 0') W o ca o H 0 Q O 2 U Z LL Q—.00 C U U) L) z03 U U Q) 06 co C Q O > 00 LO N O N ti N co 6 cu D C O M x LU O O O I O i NT Y J O a� U N d ti CD 07 rn Q Y 0) M LLI 0 Q W C") N N N U a) a ca a) Cn E vi c O Q U cn O O O o -Q o O t U o E O O O Q Q m a) co CU N o CL En (D cn C O O c a� H U X E O u ON M I 0 o`` 0^ 0 :3 / 'a ^ CL 3O W y a O E -� O 0 CD U _ O Op C U) N v :3 a CL N 0 0 (n > o CD Z5 Q Q 0 cn Ln> N o .o 3-0Q y E N ,� O U Cl) T N O N co m = O 3 �, ,N z a U v Qi E L r = cn •C > C O_ 'a O R 0 m Lo o Q Q EN Q 'a N Q o a) C!! O L N E V ' d X cCL co M 0 m = o cn +, > ++ CO N O E 'a_ C O Q O a Q 0 > 0 a- U N (n O ° c_n N > O O O O U o L a C +� C = U 0) ca w O � �a �a Er- Z W CO O O -�e m U o R oE = U a O vii CL (n Q Q Q O O) CY) CY) c'7 M d' d' c� co O O 0') CY) O X W O LL 0 nZ Q 0 �2 V z LL yy_ I J Q^ 0 N N E u) V � L z � 3 U) U //�� ^x VJ L N Q O' > (n ❑o IA T - w (1) U (0 'H LAI U) U N O U O J O C O L C - >1 M w Q J J A N N0 I.f.. ❑ W m M w 0 W N On U) W V/ V! w m z O 9. N C m C N N C N N N ❑ O a) co El J a a U) W 2Q LL LU a F- ai U cn � C C O O N >N 2� >, N C � C E E O O U U O U C ca O > m a c a) ❑ _ U M O U) � O ca in � •L m 0.. O N U J > co m m i>.M ❑ ❑ I.f.. W a W F- 2) LL LU a F- Iq O O U) U O U a. N U) C O E O U Y C (0 H O M El U cn cT 2) N LL U C O U El U U) ca d a) a� U) LZ r U H a W U) s: 2 ca N U C co N 1w L Q U) N ❑ C N Ef} E N >' c� L'L d L 4-- 0 O N > N > RS a c0 l`�N^Il 1 ❑ U COSA Checklist.docx COSA Checklist Legal Description: WYNTER PARK #1 BLOCK 1 LOT 23 Parcel ID: 051-491-30 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____ A. WELL DATA - PUBLIC &/OR CLASS “A” WATER Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Well production at time of test gpm Water storage tank volume NA gallons Well disinfected for coliform test? Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date Comments __________________________________________________________________________________ B. TANK DATA Measured operating fluid level in septic tank 48” Date of pumping 8/27/24 Required maintenance completed, if AWWTS Comments: C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA Which system tested (date installed) 9/30/22 ALL standpipes present per record drawing Total measured depth from grade 10.6 ft (max) Measured depth to pipe invert from grade 3.4 ft (min) N/A – pressurized field. Per record drawings, field is insulated. Monitor tubes (MT) go to bottom of effective (ED). If not, state depth into effective Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced 2000 gallons 8/27/24 date Any rejuvenation treatment (past 12 months) N If yes, enter date Adequacy test date 8/28/24 Results Pass Fluid depth prior to test 0 in Water added 475 gal New fluid depth 9 in Elapsed time 1440 min Final fluid depth 0 in Absorption rate 450 gpd FIELD STATUS – POST RECOVERY Effective depth (per record drawings) 84 in (MOA 7’ ED) Effective depth used 0 in (Final Fluid Depth) Effective depth remaining 84 in Comments/Deficiencies: Approximate total measured depths from existing grade. ED per elevation measured shots & appears approximate. COSA Checklist.docx E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) - NA Septic Tank/Lift Station on Lot > 100’ Yes if No ft Neighboring Tank > 100’ Yes if No ft Absorption Field on Lot > 100’ Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’ Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’ Yes if No ft Holding Tank > 100’ Yes if No ft Animal Containment > 50’ Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft N/A – Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10’ Yes if No ft Tank to Property Line > 5’ Yes if No ft Field to Property Line > 10’ Yes if No ft Water Main > 10’ Yes if No ft Water Service Line > 10’ Yes if No ft Surface Water > 100’ Yes if No ft Wells on Adjacent Lots: Private Wells > 100’ Yes if No ft Community Wells > 200’ Yes if No ft If tank or field is under driveway comment below F. ENGINEER’S COMMENTS G. CERTIFICATION & 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, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Engineer’s Printed Name CURTIS HUFFMAN, PE Date 9/4/2024 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & 9/4/24 MUNICIPALITY OF ANCHORAGE o. Development Services Department { �` Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I. D. 051-491-30 1. GENERAL INFORMATION Expiration Date: . —' Z - 2 O Z3 Complete legal description W VNTER PARK #1 BLOCK 1, LOT 23 Location (site address) 24236 HEARTHSTONE DRIVE, CHUGIAK, AK 99567 Current property owner(s) MICHAEL ELISHA GRANT Day phone Mailing address PSC 831 BOX 0051, APO, AE 09902 Real estate agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ❑ Private Septic Water Storage ❑ Holding Tank ❑ Community Well - "A" ® Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee $ -� S-0 + a o d Waiver Fee $ Date of Payment 7/2 j ��g Date of Payment Receipt Number O11 .�2 L(2 Receipt Number COSA # C 2 3 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY, ANCHORAGE, AK 99516 Engineer's Printed Name CURTIS HUFFMAN, PE Date 7120122 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the system and maintenance. The operational life of all well and septic systems are subject to ..�~'4\�ll� these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, any estimate of how long a system will function satisfactory ��Q; • . ; f' for current or future occupants or guarantee that no unseen encroachments, deficiencies or g.' •:� (1 discrepancies exist can be given by First Water Consulting &FWCS *' 9 TH •'* �� .. ...... 6. DSD SIGNATURE •Curtis• u ..... • H ffman System #1 Approved for bedrooms �� F��'•• CE 128991 . ��`�W �� rF�•..?/20/22.•� System #2 Approved for bedrooms�� ESS0 � Disapproved Conditional approval for bedrooms, with the following stipulations: By: lrw 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 Legal Description: WYNTER PARK #1 BLOCK 1 LOT 23 Parcel ID: 051-491-30 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA - CLASS A WELL "DAWN WATER" ❑ Well log is filed with Onsite (or attached) Date drilled Total depth _ft Cased to _ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) — in. Date of flow test for COSA Static water level at beginning of test _ft. Comments B. TANK DATA Age of tank(s) NA - NEW years Tank type/material SEPTIC / HDPE Measured operating fluid level in septic tank NA ® Standpipes/foundation cleanout per record drawing Date of pumping NEW TANK D. ABSORPTION FIELD DATA Structure served by this system Well production at time of test _gpm Water storage tank volume_ gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate _mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by_ Date of Sample C. LIFT STATION ❑ Required maintenance completed Age of lift station _ years Lift station material Comments: Which system tested (date installed) NEW FIELD Adequacy test date NEW SEPTIC SYSTEM ® ALL standpipes present per record drawing Results ❑ Pass For _bedrooms Total measured depth from grade 10.6 ft (max) Fluid depth prior to test in Measured depth to pipe invert from grade 3.4 ft (min) Water added _ gal ❑ N/A – pressurized field New depth _ in ® Monitor tubes go to bottom of effective. If not, state Elapsed time min depth into effective ®Code -required soil cover over field Final fluid depth in ® System presoaked Absorption rate clod (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) date of test) If yes, enter date Gallons introduced gallons Comments/Deficiencies:. MT/CO AT GRADE W/ 7' EFFECTIVE DEPTH. F E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ® Yes if No ft Wells on Adjacent Lots: Community Sewer Manhole/Cleanout > 100' ❑ Yes if No ft ❑ Yes if No ft Neighboring Tank > 100' ❑ Yes if No ft Private Sewer/Septic Line > 25' ❑ Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No ft Holding Tank > 100' ❑ Yes if No ft Neighboring Absorption Fields > 100' Surface Water > 100' ® Yes Animal Containment > 50' ❑ Yes if No ft ❑ Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ❑Yes _ if No ft ❑Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Surface Water >' 100 _ ®Yes if No ft Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ® Yes if No ft Private Wells >' 100 _ ®Yes if No ft Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No ft Water Service Line > 10' ® Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ® Yes if No ft If absorption field is under driveway comment below Property Line > 10' ® Yes if No _ ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells > 100' ® Yes if No ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS NEW SEPTIC SYSTEM INSTALLED PER MOA PERMIT. G. ENGINEER'S CERTIFICATION I certify that l 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. ANW AW V.1-11 vw.. / Curtis Huffman 1� ��l�c<`�•. CE 128991 T G��F • 10/1/22.��,d PROFES51lA�'�..; MUNICIPALITY OF ANCHORAGE A Development Services Department � Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 051 491 30 1. GENERAL INFORMATION Expiration Date: Complete legal description WYNTER PARK #1 BLOCK 1 LOT 23 Location (site address) 24236 HEARTHSTONE Current property owner(s) MILLER/ DEARINGER Mailing address Day phone Real estate agent Day phone 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ❑ Private Septic ❑ Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System F Public Sewer. ❑ Waiver request for: N O N E Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 51-5-6 Date of Payment 'V/089 Receipt Number ODa SOL/0 / COSA # /36 u 113?Y Waiver Fee $ Date of Payment Receipt Number 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 C&M ENGINEERING Phone 8545558 Address 20182 TULWAR Engineer's Printed Name CHARLES BALZARINI Date 8/13/2019 of A/, i*� `'•'49 TH r TH•* I 6. DSD SIGNATURE r _4_System #1 Approved for bedrooms �r�• HARLES G BALZA '1141j System #2 Approved for bedrooms +��... CE -13854 ��r/ Disapproved lhiF�PROFESSI�NP�� Conditional approval for bedrooms, with the following stipulations: ILSMIaaLaarra�s� 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 engineers work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet COSA Checklist Legal Description: WYNTER PARK #1 BLOCK 1 LOT 23 If more than 1 septic system on lot: COSA Checklist # 1 of 1 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Comments PUBLIC WATER B. TANK DATA Age of tank(s) 44 years Tank type/material FIBER 0 Standpipes/foundation cleanout per record drawing Date of pumping D. ABSORPTION FIELD DATA PIT Which system tested (date installed) 8/75 0 ALL standpipes present per record drawing Total measured depth from grade 10 ft (max) Measured depth to pipe invert from grade NA ft (min) ❑N N/A — pressurized field E Monitor tubes go to bottom of drainfield. If not, state depth into effective Parcel ID: 051 491 30 Structure served by this system Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes F No ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by _ Date of Sample C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date. 8/7/19 Results ® Pass For 3 bedrooms Fluid depth prior to test 24 in Water added 450 gal New depth 38 in Elapsed time 1440 min ❑ Code -required soil cover over field Final fluid depth 22 in ❑ System presoaked Absorption rate 450 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) NO date of test) N/A Gallons introduced NA gallons If yes, enter date Comments/Deficiencies: COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ® Yes if No Community Sewer Manhole/Cleanout > 100' Yes if No ft ® Yes if No ft Neighboring Tank > 100' ®Yes if No ft Private Sewer/Septic Line > 25 E] Yes if No ft Absorption Field on Lot > 100' ®Yes if No ft Holding Tank > 100' QYes if No ft Neighboring Absorption Fields > 100' Q Yes if No ft Water Main > 10' Animal Containment > 50' ® Yes if No ft ® Yes if No ft if No Ft Water Service Line > 10' ® Yes if No ft Manure/Animal Excreta Storage > 100' ®Yes Community Sewer Main > 75' 0 Yes if No ft `t❑ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Surface Water > 100' ® Yes if No ft Property Line > 5' ®Yes if No ft Driveway/Parking > 0' ®Yes if No, comment Absorption Field > 5' ®Yes if No ft Wells on Adjacent Lots: Private Wells > 100' Q Yes if No ft Water Main > 10' ® Yes if No ft Private Wells > 100' ®Yes if No Ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ®Yes if No ft From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' Q Yes if No ft Driveway/Parking > 0' 0 Yes if No, comment Property Line > 10' ® Yes if No ft Wells on Adjacent Lots: Water Main > 10' 0 Yes if No ft Private Wells > 100' Q Yes if No ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' EJ Yes if No ft Surface Water > 100' Q Yes if No ft F. ENGINEER'S COMMENTS LINE BETWEEN CRIB AND TANK TO BE REPLACED DUE TO AGE OF SYSTEM OWNER MAY WISH TO PREEMPTIVELY REBUILD THE CRIB (permit required) G. ENGINEER'S CERTIFICATION P't� OF Akqsk� l certify that 1 have determined through field inspections and review ® of Municipal records that the above systems are in conformance with W*:* MOA COSA guidelines in effect on this date. 8/15/2019 i'1• • • • • .. • • • •lam<;,.`,,�� Z,_-.�.. . jj rkARLES G BALZARINI CE -13854 COSA Checklist yellow sheet Parcel I.D. 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 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Expiration Date: GENERAL INFORMATION Complete legal description W/,vf3~'e Location (site address or directions) Current Property owner(s) Mailing address $~0( I[hth? C;rcle Lending agency h/e lis F~r~O Mailing address ,4 ,., ~-, ~-~ ~_ ~ Day phone 5"( ,2 - ~ ,~23 /~nchot-a3e.] /He 'l'~5og Day phone 25'7 Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well [--I Individual Water Storage [] Community Class /~ , Well [] Public Water System --.'¢-,::~ ~ TYPE OF WASTEWATER DISPOSAL: Individual On-site [] Individual Holding tank [--I Community On-site [] Public Sewer [] The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HA,&) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of .AJaska, Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. 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 may be reissued for a period of up to one year with valid water samples.) 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. 4. 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, .i ~b~sed on procedures outlined in the Health Authority 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 bedroorDs and type of structure indicated herein. I further verify that based on the information obtained from the Mummp.a[~ty. of Anchorage files and from my ,nvest~gabon and inspectmn, the on-site water supply and/or wa~tewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, a~r~d r~gulations in effect at the time of installation. Address fo. ~,ez 7732'~'/ Eo(,t~ ~;~er, /~g ~$77 Engineer's Printed Name /~0o}$ B~f¢r¢ Phone Date DSD SIGNATURE Approved for Disapproved. Conditional approval for bedrooms, with tt~e following stipulations: Additional Comments Attachments: HAA Checklist Septic System Advisory Well Flow Advisory (Rev. 12~0~) X Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchomga, AK 99519-6650 www.ci.anchorage.ak.us (SO7) 343-7~04 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: W'y~Ter A. WELl. DATA ~/0 We~t~ If A, B, o~ C provide PWSID # Date complet~ Sanitary seal (Y/N) Total depth ~t. Cased to ft. WELL LOG Date of test Static water level ~ fi. Well produCtion ~,~g.p.m. WATER SAMPLE RESULTS: DC~altiefO~fmsample: colonias/100 mi. Parcel to: 05'1- ~ l- 30 Well Log (Y/N) Wires propedy protected (Y/N) Casing height (above ground) AT INSPECTION in. g.p.m. Other baCteria colonies/lO0 mi. B.' SEPTIC/HOLDING TANK DATA Tank TypeJMatel~al Tank size Foundation cteanout (Y/N) ~Y Depression ave~ tank (Y/N) ~'0 Date instaliad 3'/13'/75' Cleanouts (Y/N) )/e High water alarm (Y/N) Date of pumping ~"- 'Zi~ -o ~._ Pumper ,~'~'Y p~.,..~y..,'-~- c. ABSORPTION FIELD DATA Date installed ~'//~'/?,Y' Soil rating (g.p.d./fl~ or ~/bdrm) L,Z~I, Length J ~' / ft. W~th I ~'' ft. Total depthS. 7,~' ft. Eft. absorption ama q. 3 ~ ~ Monitoring tube Date of adequacy test ~Jl~-15'/O 3. Results (Pass/Fail) Fluid depth in absorption field before test ,~'~' in. Wator added3'~0 gal. Elapsed Time: la~ min. Final fluid depth 6"/oJ~n. Absorption rate >= Any rejuvenation treatment (past 12 mo.) (Y/N & type) System type /e;f [./(~,~ C ri ~) G Pe~tk · ravel below pipe {~ ft. Depression over field/V'O For .,~ bedrooms New depth.7_,~_ in. l¥ $-,.3 g.p.d. If yes, give date ~ D. BFTS'rATION /V/R Date ~ Size in gaJlons "Pump on" level af"~ in. "Pump off" level at __ Datum '"'"~yctes tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main Sewer/septic ser¥ice line Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? On adjacent lots On adjacent lots Public sewer manhole/cleanout Holding tank SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Building foundation ~ ~.l Water main ~ ~. 5' ' Wells on adjacent lois '~100 ~ Property line 'f I 0 ' Water service line t- 2. $ / Absorption field Surface water SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line + I0 / Building foundation + 25~ Water main ~-2.~'/ Water Service line ~ 2 5' / Sun'ace water -/. {00 ' Driveway. parking/vehicle storage + ,~ 5' / Curtain drain I~'/R Wells on adjacent lots '1' I00 / F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field i~spection~ 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 .Z 0/4i 5 ~a ]~re. DateD, Payment [02- Receipt Number t~-~"~ ~ ~f/ IRev. 12/00} Waiver Fee $ Date of Payment Receipt Number BASIS OF BEARING 225.00 (R) 225.04 (M) LOT 24 OFAC °Cti, 4 9 TH '•.7, .......... ...y.......s.............. -r. . . . . . . . . . . . . . . . . - ..... LOUIS A. BUTERA LS -9338 aQs y�4 p'Ofessionoi LEGEND: SET FOUND 5/8" REBAR 0 i 2.00" AL.MON. HUB AND TACK ❑ FENCE W00D DECKS GRAVEL DRIVEWAY SEPTIC STANDPIPES C WATER WELL -0- EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 10421 VFW Drive Eagle River, Alaska 99577 (907) 694-5195 FAX. (907) 694-3297 ASBUIL T SURVEY OWNER: MCBRATNLY DESCRIPTION: WYNTER PARC LOT 23, BLOCK 1 N89'59'59" E 24.99' COMPUTED ANGLE do DISTANCE (DIFFERS FROM PLAT) 5' LE: (DATE: BY: SH "c:.: t"=30' 18/15/02 K41S 1 f i EKES Project Number: 02-030 CADD -ile Name: 02-030AB I hereby certify that I have surveyed the following described property. WYNTER PARK, LOT 23, BLOCK t Anchorage Recording Precinct, Alaska, and that no encroachments exist except as indicated. It is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. Under no circumstances should any datc hereon be used for construction of fence lines, or for establishing boundary lines. ~---~' ,- DATE RECEIVE[) INSPECTION APPOINTMENTS TIME - 'rIME .~17~ TIM,_-' INSPECTOR INSPECTOR INSPECTO~ MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEFT. OF NEALTH ~/~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTEC'rI~RONMENTAL PRo'rECTION 825 L Street - Anchorage. Alaska 99501 ) ENVIRONMENTAL SANITATION DIVISION OCT '7 1981 Telephone 264-4720 DIRECTIONS: Complete all parts o]~ page 1, Incomplete requests will not be processed, Please allow ten (10) days for processing, ~OPERTY RESIDENT (If different from above) PHONE ~AILINQ ADDRESS MAILING ADDRESS ,_ . · MAI LIN6'ADDRES8 ~'. ~.EGAL DES~RIPTION~ ~ __ ~,-~Z.~ ~ -- STREET LOCATION / / -- , B, TYPEOF~NRES ENCE NUM~ OF,BEDROOM8 GEE FAMILY- ~*~//~ ~ ~ One ~ :our ~ Two ~ Five ~ MULTIPLE FAMILY ~ Three ~ Six Other 7, WATER SUPPLY [] INDIVI DUAL* * ATTACH WELL LOG. A well log is reauired for all wells drilled ~ COMMUNITY since June 1975. For wells drilled prior to that date, give well [] PUBLIC UTI LITY depth (attach log if available,I ~ SEWAGE DISPOSAL SYSTEM ~" INDIVIDUAL/ON-SITE** / ~ ~ ~ YEAR ON-SITE SYSTEM WAS NSTALI. ED, [] PUBLIC UTI LITY NOTE: THE INSPECTION FEE MIJST ACCOMPANY EACH REQUE'ST BEFORE PROCESSING CAN BE INITIATED, THIS SIDE FOR OFFICIAL USE ONLY , . 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY ,~'ON E [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL ~ DEPTH OF WELL ~' COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER ,~'INDIVI DUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY ~-~:~-/ //~ ~ ~ Connection Verified iNSTALLER [~..S~ptic Tank or []Holding Tank ~-~ ' ' Size: /ZJ~J/) If Tank is homemade SOILS RATING / give dimensions: TYPE OF TANK _ ~,~ , MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 5. COMMENTS ~L~ APPROVED FOR BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY ' ) ~ 72 010 (Rev. 6/79)