Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
BROADVIEW BLK 3 LT 1
Broadview Block 3 Lot 1 #050-321-15 Not Eligible for COSA or LUP until non objection from row appd/issued *PLUS* Biocycle to do repairs prior to CO Municipality of Anchorage Page 1 of 3 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number. SW000463 PID Number. 050-321-15 Name: GREG BUYSMAN C/o DEBBIE LEWIS Wastewater System: ❑ New ■ Upgrade Address: 16600 CENTERFIELD DR. EAGLE RIVER, AK 99577 ABSORPTION FIELD Phone: (907) 694-4200 No. of Bedrooms: 3 O Deep Trench ■ Shallow Trench 0 Bed 0 Mound ■ Other* LEGAL DESCRIPTION Sol nwnp: 3.0 cPD/sv. rL Toa Dwlh iwm enelnal Veft **SEE REMARKS n LDC Block Subdivision: Depth to Ww beham be" "g d poet Gael dwth bmsath plrw 0.5 1 3 BROADVIEW **SEE REMARKS rt. n Township: — Range: — Section: — ry *arid abo e'gOwl peaty Geel lw,etl. 30 2.0-5.0 rL n Go el *oath: NunW Of snw: oWar"e !wwn WELL: ❑ New [IUpgrade 5 R 1 R Clo�caioa Prate. AB.D : Tool 0. Cow.a To: Total ebswpaon ares: Pipe n"lwbb R ft 150 so. rt ASTM D-3034/F-810/SCH 40 PVC arYl•n (.�� Doo DOWd: 4 Stale w" lw+l: Inrtallw: EAGLE MTN. EXC. Doo e"talrd: 11/13-15/2000 Fit. nae Pwnp SoAL Co" ll.lpht "be" Gawla: TANK an R R SEPARATION DISTANCES ■Septic* ❑Holding 0S.T.LP. To Tank Absorption Holding life � TERN UTILITIES 1500 From eld Station s Well too'+ too'+ too'+ — 25'+ FIBERGLASS " a 4 Surface 100'+ 100'+ 100'+ - - LIFT STATION Water Lot Line 5'+ 10'+ 5'+ _ _ sue in eosonc 1500 slwwlsbrer. WESTERN UTILITIES Vtq onlevel el: IMI at K0 war Bann al: Foundation 5'+ 10'+ 50+ — — 30.5" 19.5" 45" Curtain Drain NONE KNOW "wm a "oaa. MEYERS ME 40 owtnoa e•o«t� W. We br. CARCEL ELECTRIC BENCH MARK Remarks: *THIS IS A BIOCYCLE TREATMENT UNR. -EXCAVATION WAS LIMITED TO THE REMOVAL OF ALL iuo end Dwwlpuwa BOTTOM OF CONTROL PANEL BOX ON HOUSE CONTAMINATED MATERIAL TWO EXPLORATORY TEST HOLES FOR BIOCYCLE UNIT. WERE EXCAVATED IN THE AREA OF THE OLD TRENCH TO Aw~n"d oewaon: 115.72 n • arlaelmra am DETERMINE THE DEPTH OF BEDROCK. 2.2 TO 5.0 FEET OF M.OA APPROVED SAND F 4 F ((oo OP`•O FILTER ADDED BELOW SEWER DRAINROCK. '9S�O0 . � 0 Inspections performed by- AWWC, INC. Dates: 1st 11/13/2000 2nd 11/14-15/00 3rd 11/17/2000 DQ DO J fr A. Garness- Department of Health and Human Services approval 9 4�0, •., -7953 ; • `F�`vOI� Reviewed and approved by:4/W"Z EjQt Date: - 9-- 0o d\ Wilrof �7 Qslor -oto «. 91") ub* 25 PERMITNUMBER: AS -BUILT DRAWING PARCEL ID NUMBER: SWO _ SW000463 050-321-15 A B NOTE: ALL CONTAMINATED MATERIAL WAS REMOVED\ nn, I ci nn co zo FROM OLD TRENCHES AND THE AREA WAS FILLED 85.84 96.42 UppF\ ` S � I EXPLORATORY TEST HOLESTO DETERMINE BEDRK \ I � ELUVATK)NS. (SEE PROFILE) p�FZppFpi\ I � I _ le' \ cot NEW BIOCYLE UNIT A / I ��"" FOUNDATION CLEANOUT / I N PA NEW DRAINFIELD EXISTING THREE ' o I PERK BENCH BEDROOM HOUSE I I I L------------- t— 9---- ---I--- 10' UTILITY EASEMENT - I DRAW ALASKA «'ATL'R S WASTENNIATER SCALE: J.L.M. CONSULTANTS, INC. 1 = 20, 6901 DEBARR ROAD, SUTE 29' ANCHORAGE, AK 99504' M40HE (907).737-0179' FAX (90713163266 PREPARED FOR: PHONE NUMBER: PAGE NUMBER: GREG BUYSMAN c/o DEBBIE LEWIS (907) 694-4200 2 OF 3 LEGAL DESCRIPTION: BROADVIEW SUBDIVISION; LOT 1, BLOCK 3 TYPE OF WORK: AS -BUILT DRAWING OF SEPTIC SYSTEM UPGRADE A. PERMrrNUMBER: AS -BUILT DRAWING PARCEL ID NUMBER: SWO - SW000463 050-321-15 -fM GRADE Af 50UMVVE5f EW - 99.00 (AVG.) >n DARER PARIMiIER �INSU.AfION co Mf KM: MVM Af 50UMJvti51 EW - 86.50. DEPMAf NOR4EA5fEW - 61.50. 6'+ f0VEVW fISg7I.:'i!9 WVER(OF D151RIDUfION LIM - 93.50 (AVG.) fOP OF 5AW -93.00(AVGJ I 2.2 fO 5.0 FEET OF MAA APPROVED ALASKA WATER & WAS TRR'ATKR CONSULTANTS, INC. 0901 OEBARR ROM. BUT! Hf • AN[RORAGE. AK 99504 • M40W (907)337-0179' FAX (907)335-37 PREPARED FOR: PHONE NUMBER: GREG BUYSMAN c/o DEBBIE LEWIS (907) 694-4200 LEGAL DESCRIPTION: BROADVIEW SUBDIVISION; LOT 1, BLOCK 3 TYPE OF WORK: PROFILE AS -BUILT OF NEW DRAINFIELD 11/27/2C AWN BY: J.L.M. ALE, N.T.S. ;E NUMBER: 3OF3 I'M GRADE Af NORIFEASf EW - 95.95 (AVG.) vffOM OF lma (NMfMfEW) - 68.0 (AVG.) 7953: �Fa CAW mom OF ImNC}i (50U11 Mw5f EW) - 90B (AV(4.) KM: MVM Af 50UMJvti51 EW - 86.50. DEPMAf NOR4EA5fEW - 61.50. 6'+ f0VEVW fISg7I.:'i!9 WVER(OF D151RIDUfION LIM - 93.50 (AVG.) fOP OF 5AW -93.00(AVGJ I 2.2 fO 5.0 FEET OF MAA APPROVED ALASKA WATER & WAS TRR'ATKR CONSULTANTS, INC. 0901 OEBARR ROM. BUT! Hf • AN[RORAGE. AK 99504 • M40W (907)337-0179' FAX (907)335-37 PREPARED FOR: PHONE NUMBER: GREG BUYSMAN c/o DEBBIE LEWIS (907) 694-4200 LEGAL DESCRIPTION: BROADVIEW SUBDIVISION; LOT 1, BLOCK 3 TYPE OF WORK: PROFILE AS -BUILT OF NEW DRAINFIELD 11/27/2C AWN BY: J.L.M. ALE, N.T.S. ;E NUMBER: 3OF3 I'M GRADE Af NORIFEASf EW - 95.95 (AVG.) vffOM OF lma (NMfMfEW) - 68.0 (AVG.) 7953: �Fa CAW 11/20/00 NON 18:17 FAX 907 283 4794 Biocycle Alaska 2002 .............................................. FROM CARCEL ELECTRIC CARcEL FAX NO. :3464052 Pb 907.346032 Fix firth w%dTont Baker 18610 Upper StYtine drive Fs81e Raver. Al: 99377 Towbom amkfmncera: uN G ........................................... Nov. 17 2000 12:20PM P1 11.17-00 Carcel ElecGic wired tho BIO.Cyde locoed a Lot 4 Block 3 Broadview. WD in FaCIa Wver, Al.eka Thi+Bio.Cyote wu wired per the 1999 Nadmal Moetrical Cade. If you have ant quanta s ploaae eive me a call. e Cloud °° anammmgm RECEIVED DEC 04 2000 Municipality of Anchorage Oept. Health R Human Services I I I \ I I \ I ♦ I \ I I R LOT 3A�/',— I - / I \ \ I Loe XKILE &meaS/D L L ce-� !Fh LnT 1 KYLE & ERICA S/D TRACT A. V% 1 \ BROADMEW 5/D ♦\ LOT 2A. SK 2, I OPOSED SEPTIC IPGRADE. SEE PACE 2OF3 FOR DESIGN. COSTING TI BEDROOM H WACn J ��rt�7-2 ./ BROADVIF �LOT IA. 10 I HIGH HOME S/D LOT 1. BK 2. DATE: 10/13/2000 DRAWN BY: _ALASKA NVR _ATR & NVASTRNVAITL'R K.D.W. ` CONSULTANTS. INC. - - SCALE: i in c 100' 1001 DFBARR ROM. SUIT! !B • AX[XOfUGl. AB 0950E . MONE (007)357-6110 • FA)1 f907U73J24E PAGE NUMBER: � PREPARED FOR PHONE NUMBER: GREG BUYSMAN c/o DEBBIE LEWIS (907) 694-2857 1 OF 3 ylt LEGAL DESCRIPTION: yyl BROADVIEW SUBDIVISION; LOT 1. BLOCK 3. TYPE OF WORK: SITE PLAN FOR DESIGN OF SEPTIC SYSTEM UPGRADE -7953 Sent By: RE/MAX OF EAGLE RIVER, INC.; 9076960214; Jul -6-00 1:20PM; Page 14/16 C��x#ifi�e b" illt� Drug _ r . DOG Co. oba SULLIVAN WATER WELLS P.O. BOX 274• CHUOIAK, ALASKA 99567 • TCLEPHONEe8&2759 , IP6/0 uA�crs-f L.� ©r- Ra�jl/PP� OWNER OF LAND S _uN4't : n._R 1'S/2I4/J DEPTH OF WELL !d d ADDRESS :2 627 r7&U 1l -,ir 1rCd Y1.�<r9 "-%2TICLEVELOFWATER FT. I LEGAL DESCRIPTIO.° ? : f DRAW DOWN FT. DATE • Started Ended 9A_qT.rllL LIIll7 GALS. PER HR Q c KIND OF CASING e., f pQ KIND OF FORMATION: From Ft. to `2 Ft. a ZZA&CAle M From_ Ft. tom.—Ft. _From FtAo Ft. From Ft. to_ Ft. *I I X /,cn From Ft. to Ft. From Ft.to, Ft. BED�I GSE! f�LrtGA-"From Ft. to Ft From-3.0—Ft.to 52 Ft I&AM!'aim—c�r�`'�"� From Ft.to Ft From V Fi. tn. /AFL &,pQo r k ij ii-' A:f From Ft. to Ft. From..L44_FL tq_(l•,�3 ft l.1,'n r,z r l From—Ft. to Fr. Frmm Ft. tri Ft. "rAs ,�fA/»S �SCP'Prom Ft. to FC From412 Ft. to • taCFj, YMCA aZ9e4-- Jt From.. _____FL to---F'--- o__Ft-.From Free;IELFt, b -320 -Ft iza aQo ( it 6e&& From Ft. to Ft. From 330 Ft. t 2&$__Ft. eZ4 eA cA 8ZJ9&_r Ft. to Ft. �jFrroom FromJ4aiFt. to -3ZA Ft. 846W O"k ��"'from Ft M Ft. From Ft to—Ft. SC.00. I6480 From Ft. to Ft. From 372 Ft. tofliffFt��` /ae e 05 C From Ft. to Ft. From.�Ft. to NA Ft. eifa 4a. -Ac. From Ft. to Ft. From Ft, to Ft, Q','AZ rZ :C t 4.21 From Ft. to Ft. From-,jip .Ft. to tTFt. d d .: �G' A " eL- From Ft. to Ft MLSCL INFORMATION: ;o ./ 7'07'•01- �'/ 4C4S'1^`0 g DRILLERS NAMES MUNICIPALITY OFANCHORAGE Department of Health and Human Services On -Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SW000463 Legal Description: BROADVIEW BLK 3 LT 1 Design Engineer: 0041 AK Water & Wastewater Consultant Owner Name: Greg Buysman c/o Debbie Lewis Owner Address: 18610 Upper Skyline Dr. Eagle River , AK 99577 - (rto cct!c or viag ohu/tn Date Issued: Nov 01, 2000 Expiration Date: Nov 01, 2001 Parcel ID: 050-321-15 Site Address: 018610 UPPER SKYLINE DR Lot Size: 13750 SO. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of. 6Cj Disposal Field �j Septic Tank ❑ Holding Tank [] Privy El 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 DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 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: II I I toC) Date: //_/ _06 ALASKA WATER & WASTEWATER ......�.,.�....._._...r�.I CONSULTANTS, INC. October 16, 2000 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Well and Septic Design for Broadview Subdivision; Lot 1, Block 3 To whom it may concern: The existing 3 bedroom house is currently served by a private well and septic system. The existing drainfield is in a state of failure and in need of an upgrade prior to the sale of the house. One test hole was excavated on the property to find an area suitable for an onsite septic system. The proposed septic system will be designed within the 30 foot radius of the test hole. We are proposing that a Biocycle aerobic treatment unit and a five foot wide drainfield be installed. There are numerous site constraints which are as follows: • The steep topography • The presence of shallow bedrock • The presence utility easements • The location of the existing drainfield • The limited lot size Given these site constraints, we are proposing to install the Biocycle aerobic treatment plant. 1. SOILS: See the attached log which shows the soil classifications, groundwater monitoring, and the percolation test results. It is our opinion that due to the overall appearance of the soils, an application rate of 3 gallons/day/R2 should be used. 2. TRENCIi DESIGN: a. Percolation Rate: 4 minutes/inch b. Allowable Application Rate: 3 gallons/day/fit c. Number of Bedrooms: 3 d. Design Flow: 450 gallons per day e. Minimum Absorption Area: 150 0 f. Total Depth: 2 feet maximum from original grade, not the exisitng fill grade. g. Effective Depth: 0.5 feet 6901 Debarr Road, Suite 2B * Anchorage, AK 99504 Ply (9n7) 337-6179 * Fax: (907) 338-3246 * Website: akNwc.com h. Width: 5 feet i. Reduction Factor: 1 i. Minimum Length: 30 feet long j Effective absorption area = 150 ft2 3. SURFACE NYATERS: There are no surface waters within 100 feet of the proposed upgrade. 4. TOPOGRAPHY: The average topography of this property is a 15 to 20 percent running from approximately east to west; in short, there are no slope concerns. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179, or 244-9612. Thank you for your assistance. P.E., M.S. NOTE: Attached is a site plan drawing, a design drawing, one soil log, and a 7 page construction specification letter which are all part of the design package for this septic system. 6901 Debars Road, Suite 2B * Anchorage, AK 99504 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: ak% wc.com ROLOTE3A. I Tom• W N �` 1 ` •� KYLE LAT RICA S/D camle-fl 1-11-r KYLE @ ERICA S/D TRACT A. I I I I I I 1 I J IOPOSED SEPTIC UPGRADE SEE PAGE 2 OF 3 FOR DESIGN. EXISTING THREE- BEDROOM HOUSE 3A 1 KYLE @ ERG S/D �vtl • LOT 1, \ CZnNTA � ALASKA NN'XrJE4 R & IVASTLR'ATL'R CONSULTANTS, INC. 6901 DEBARK ROAD, SVITE 28 • ANCHORAGE AK 99504' PHONE 07)1]7-6179 • EAK907)733-324 PREPARED FOR PHONE NUMBER: GREG BUYSMAN c/o DEBBIE LEWIS (907) 694-2857 LEGAL DESCRIPTION: BROADVIEW SUBDIVISION; LOT 1, BLOCK 3, TYPE OF WORK: SITE PLAN FOR DESIGN OF SEPTIC SYSTEM UPGRADE DATE: ` 10/13/2000 DRAWN BY: K.D.W. SCALE: 6 1" = 100' PAGE NUMBER: 1 OF 3 HIGH HOME S/D LOT 1, BK 2 -7953 8 1 1 Ae EW SSK 2. YSTEM SEPTISYSTEM TO BET// COMPLETELY IOPOSED SEPTIC UPGRADE SEE PAGE 2 OF 3 FOR DESIGN. EXISTING THREE- BEDROOM HOUSE 3A 1 KYLE @ ERG S/D �vtl • LOT 1, \ CZnNTA � ALASKA NN'XrJE4 R & IVASTLR'ATL'R CONSULTANTS, INC. 6901 DEBARK ROAD, SVITE 28 • ANCHORAGE AK 99504' PHONE 07)1]7-6179 • EAK907)733-324 PREPARED FOR PHONE NUMBER: GREG BUYSMAN c/o DEBBIE LEWIS (907) 694-2857 LEGAL DESCRIPTION: BROADVIEW SUBDIVISION; LOT 1, BLOCK 3, TYPE OF WORK: SITE PLAN FOR DESIGN OF SEPTIC SYSTEM UPGRADE DATE: ` 10/13/2000 DRAWN BY: K.D.W. SCALE: 6 1" = 100' PAGE NUMBER: 1 OF 3 HIGH HOME S/D LOT 1, BK 2 -7953 8 NOTE: THE CONTRACTOR SHALL HAVE THE WEST PROPERTY \ \ UNE AND THE 100' WELL RADIUS TO THE NORTH/NORTHEAST OF THE PROPOSED SEPTIC SYSTEM FLACCED BY A REGISTERED LAND SURVEYOR PRIOR TO CONSTRUCTION. \ \ \ EXISTING DRAINFIELDS TO BE \ COMPLETELY ABANDONED. $ \ MATERIAL FILL WTTH SAND. ` N op 4D3, 1 � PROPOSED DRAINFIELD. \ \ \ FEET WIDE. BY 30 FEET LONG. \ SEE DESIGN PROFILE ON PACE 3 OF 3 FOR DETAILS. ^...L..y ..a.' .. ^. EXIS71NG SEPTIC TANK TO BE COMPLETELY • • \� `� CO ABANDONED GT I �`vd �TM/T o �I INSTALL DOUBLE CLEANOUTS o I PROPOSED BIOCYCIE UNR I L ------------ TO' UTILTTY EASEMENT INSTALL FOUNDATION CLEANOUT IF NOT ALREADY PRESENT ALASKA NVATER & WASTENVATRR CONSULTANTS, INC. 6901 DERARR ROAD. SUITE 28 • ANCHORAGE. AR "SOL • PHONE (907)377-6179 • FAX (007)71!-026 PREPARED FOR: PHONE NUMBER: GREG BUYSMAN c/o DEBBIE LEWIS (907) 694-4200 LECAL DESCRIPTION: BROADVIEW SUBDIVISION; LOT 1. BLOCK 3 TYPE OF WORK: DESIGN OF SEPTIC SYSTEM UPGRADE 10/13/2000 \WN BY: K.D.W. kLE: 1" —20' ;E NUMBER: 2 OF 3 EXISTING THREE BEDROOM HOUSE A.'CGI -7953 /I Mf FILL/PEAT -1•. . ' ' M.O A APPROVED + SAND FILTER a+ A. 3 FEET MIMIMUM C M.OA APPROVED SAND FILTER ALASKA NVATER & IVASTI:«TATER -- — — CONSULTANTS, INC. ...... .......,.. enm ...e w • •wuro•ee •v eou¢ • wuwF (WM%7.6170 • LR (90713]8-826 10/13/2000 DRAWN BY: K.D.W. 1" = 20' GREG BUYSMAN c/o DEBBIE LEWIS (907) 694-4200 1 3 OF 3 BROADVIEW SUBDIVISION. LOT 1. BLOCK 3 OF WORK: PROFILE VIEW OF PROPOSED DRAINFIELD EXISTING GRADE, ELEVATION VARIES FILL/PEAT 1 FOOT OF CLEAN. WASHED SEWER DRAINROCK WITH 0.5 FEET BELOW INVERT OF DRAINPIPE. 1 ORGANICS NATIVE SOILS io e'+ TO BEDROCK A. Garness; —7953 & WASTEWATER SOIL LOG - PERCOLATION TEST LEGAL DESCRIPTION: BROADVIEW S/D: LOT 1, BLOCK 3, PERFORMED FOR: GREG BUYSMAN DATE PERFORMED: 9/15/00 (feet) TEST HOLE #1 1 W Fl PEAT 7 ,«� CL LENSES 8 � " BEDROCK 9 B.O.H. 10 11 12 13 14- 15 16- 17 18 19 20 COMMENTS: PERC—HOLE DATE 1 INC. l ♦ SIT -EP -LAN I"= 100' --- DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING 2 9/18/00 1 SOIL CLASSIFlCATIONS — 6" — ME/777+ 2 3:23 10 2 3/4" 3 1/4" 3 3 3:23 — 6' GP I I ML 4 »> ORGANICS 3" 3' GM 5 CL 4 6' — 6 GC 10 OL 2 3/4- 7 tt�1 — 6' SW MH 5 10 3 1/4' 2 3/4- 9 '• �•.: SP 6' CH — 10 4:03 ' 3 1/2" 2 1/2- SM 11 OH 6 I SM/ML 4:13 10 SC 2 1/2" W/ SOME 7 ,«� CL LENSES 8 � " BEDROCK 9 B.O.H. 10 11 12 13 14- 15 16- 17 18 19 20 COMMENTS: PERC—HOLE DATE 1 INC. l ♦ SIT -EP -LAN I"= 100' --- DATE READING CLOCK TIME NET TIME (MINUTES) WATER LEVEL READING NET DROP (INCHES) 9/18/00 1 3:13 — 6" — 2 3:23 10 2 3/4" 3 1/4" 3 3:23 — 6' — 4 3:33 10 3" 3' 5 3:33 — 6' — 6 3:43 10 3 1/4* 2 3/4- 7 3:43 — 6' — 8 3:53 10 3 1/4' 2 3/4- 9 3:53 — 6' — 10 4:03 10 3 1/2" 2 1/2- 11 4:03 — 6- 12 4:13 10 3 1/2' 2 1/2" PERCOLATION RATE 4 (MIN./INCH) TEST RLIN BETWEEN 5.0 _ FT. ANQ,� FOR 4+ PERFORMED BY ALASKA WATER do WASTEWATER I, THIS WAS PERFORMED I ACCORDANCE WITH ALL DATE. DATE: /Ju o PERC. HOLE DIA. 6' (INCHES) 5 FT. CERTIFY THAT IN EFFECT ON THIS r MUNICIPALITY OF ANCHORAGE D*TMENT OF HEALTH AND HUMAN SER4kS Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name DISTANCES TO SEPTIC ABSORPTION Address Sid /9/� I FROM TANK FIELD WELL:::j /n Sd' G'N[�IN�eGN� E K /, Phone(s) - Z Permit No. � No. of Bedrooms WELL l LOT LINE i 3 y'' 15l !00 LEGAL DESCRIPTION Lot. / Block 3!?}6 Subdw n "raw FOUNDATION TYPE TYPE OF SYSTEM ❑ TRENCH ❑ BED W- W. DRAIN ❑ OTHER Township, Range, Section / AS -BUILT DIAGRAM tShow location of well, septic system, property lines, found) 0 I _ - / � Scale: /uC�t7r•1 G— — 9. X 7-- — Inspections Performed by: ' QPM , 8 r Date. r v L CSwA e R RR126X Deftly that this inspection was performed according to all Munici o I sx Health Department Approval: �/ Date: OG 44 it 72-013 (3185) SEAL ... ...... L!A ..p •b 0 A Shafer V kw. No. 1457-F ,.'�ti e TANKS LN' SEPTIC ❑ HOLDING Manulacturer Capacity in gallons G -eZ I o00 Material No. of Compartments ^LE 7— TYPE TYPE OF SYSTEM ❑ TRENCH ❑ BED W- W. DRAIN ❑ OTHER Depth to pipe bottom from Total depth from original grade original grade / astgr L, D FT l Z , s Fl Fill added above original grade Gravel depth beneath pipe _ FT /.S F1 Gravel length - r Gravel width SO -2p T FT Total absorption area Distance between lines Q SO FT /O FT Number of Imes Soil rating Pipe material Z I ISO SOFT A57A. L) 3D3�f Installer Date Installed ,7� WAr�ccn /o—L3"g!v WELLS [YFl`RIVATE ❑ OTHER fldentifvl Classitication (A,B,C) Total Depth Cased to FT FT Installer I Dale Installed 0 I _ - / � Scale: /uC�t7r•1 G— — 9. X 7-- — Inspections Performed by: ' QPM , 8 r Date. r v L CSwA e R RR126X Deftly that this inspection was performed according to all Munici o I sx Health Department Approval: �/ Date: OG 44 it 72-013 (3185) SEAL ... ...... L!A ..p •b 0 A Shafer V kw. No. 1457-F ,.'�ti e PERMIT NO: DATE ISSUED: APPLICANT: ADDRESS: CONTACT PHONE: LEGAL DESCRIP: LOT SIZE: MAX BEDROOMS: L3FO FNP4QV4C3FRFNC3E= . DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L STREET, ANCHORAGE; AK 99501 ^ 264~4720 . . / 860211 07/02/86 CHRIS WILSON/ SOUTH FORK CONST" P"O"BOX 770567 EAGLE RIVER AK 99577 694-4351 SECTION: 6* TOWNSHIP: 14N RANGE: 13750 kSR.FT. ORACRES) 3 Listed below are the options available to you in designing your septic system" Choose the option that hest fits your site, ** TANK MUST HAVE AT LEAST TWO COMPARTMENTS ---^----^~------------- I certify that: , 1" l am familiar with the requirements for on7site sewers and`wells as set forth by the Municipality of Anchorage (MOA) and the State of Alaska" 2.4 will install the system in accordance with all MOA codes and regulations and in compliance with the design criteria of this permit. 3^ I will adhere to all MOAand 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 valid for a maximum of 3 bedrooms and any enlargement will require an additional permit" ` IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS7BUILT8 WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE ` ELECTRICAL WORK MUST BE DONE,BY A LICENSED ELECTRICIAN" SIGNED ^r DATE: �-v------�-------��------------_�---- _�-~�=�~��-~~-~- APPLICANT: CHRIS NIL K CONST" ISSUED BY . DATE: W n FR CA 1 1%1 DEPTH TO PIPE BOTTOM (FT") 4"0 ' GRAVEL DEPTH (FT") TOTAL DEPTH (FT,)5. 1"5 5"5 GRAVEL WIDTH (FT") 1 0 5"0 GRAVEL LENGTH (FT3 ) ^ ' 700 ' y` [F V GRAVEL VOLUME (CU. YDS. 2610 TANK SIZE (GALS) I,O ** 1p000,0 ** SOIL RATING (SQ"FT,/BR) /150\ 150 ** TANK MUST HAVE AT LEAST TWO COMPARTMENTS ---^----^~------------- I certify that: , 1" l am familiar with the requirements for on7site sewers and`wells as set forth by the Municipality of Anchorage (MOA) and the State of Alaska" 2.4 will install the system in accordance with all MOA codes and regulations and in compliance with the design criteria of this permit. 3^ I will adhere to all MOAand 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 valid for a maximum of 3 bedrooms and any enlargement will require an additional permit" ` IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS7BUILT8 WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE ` ELECTRICAL WORK MUST BE DONE,BY A LICENSED ELECTRICIAN" SIGNED ^r DATE: �-v------�-------��------------_�---- _�-~�=�~��-~~-~- APPLICANT: CHRIS NIL K CONST" ISSUED BY . DATE: • w e +,r Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 C SOILS LOG - PERCOLATION TEST PERFORMED FOR: J V" 'll.11/d.Jc DATE PER cam^ LEGAL DESCRIPTION:L L /j ttl Township, Range, Section: DEPTH SLOPE (FEET) 07—&11 IC's 5*./e 2 0 (�L(22�Gd SAN/>t ray L�Trs.o S�r•� 3 4-- 5 - 5 6' 7 8 9- V a 0 Depth to Water 10- 1011 11 12 13- 31415161718 14- 15- 16- 17- 1 8 19 20 COMMENTS '/So 4/3r - WAS GROUND WATER .tyyN ,5 ENCOUNTERED? 1/L�5 S IF YES, AT WHAT L / O DEPTH? B p E Depth to Water After r Monitoring? 9 Date: JO •�/-�<, SITE VV Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT /l . . i A/ / I A L_ o "7e PERFORMED BN --GRJ4GLE RIVI�ooTs 'w CERTIFY THAT T/HIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINE IN EFFECT ON THIS DATE. DATE: ©/ Z 72-008 (Rev. 4/85) r • '� - • SOILS LOG MUNICIPALITY OF ANCHORAGE �\ DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ❑ PERCOLATION 825 L. Street, Anchorage, Alaska 99501 264-4720 TEST SOILS LOG — PERCOLATION TEST PERFORMED FOR:/�` --Jl / 2+ �� � IfI DATE PERFORMED: LEGAL DESCRIPTION: z— J� 6re)/. Ij �! L t�� SLOPE (FOET) Lei l:=0i�i �L 2 3 4 - — 5 6 v 9- 10 - SLOPE 10 11 I.1 r WAS GROUND WATER <ENCOUNTERED? 12 IF YES, AT WHAT DEPTH? 13 ���•s1gR{� is Date Gross Time �,�pfE.•• .l;qs,� .• Depth to Water Net Drop !S 15 * 41 "a I% 16 1L.�.. •�!••III I.1 t� • 1101 A. M.Ior 17 �••II Na. 1487-F a is- 19- 19 i 1986 SITE PLAN 113 r 'r a Reading Date Gross Time Net Time Depth to Water Net Drop i zo� / PERCOLATION RATE 1 % 4 (minutes/inch) TEST RUN BETWEEN FT AND FT COMMENTS I" 1'tJ 1 `��Q�w�'� ��YVA LL I tJL b i PERFORMED BY: CERTIFIED BV: DATE: 72-008 (6/79) r 0 A N �_ • N + Amo ��n r CA � m W d o Cud c �- W° Ff t�0 0' S °- L O N v .h : S jb P !O V Q"a It o A d -s -A b N, C C y, In mo A N �_ • N 0 N A ��n r CA I 1 !0 �_ m Q -0._ •� IN IO A U. � m W d o Cud m Loj °- O Q"a A d -s N, C C In mo C m N r 1 A4JNnPALITY OF ANCHORAGE DEPT. OF HEALTH $ ENVIRONMENTAL PROTECTION -SEf igffi RECEIVED W l4p -a I . N -o y � 3 d -4- ct „ --� 3 tit ,L SL N .N +. .aN t 'p.Sr0 rc t rc o y J _ S J _ rt C7 y� N 'p 4r .. 7 i a a ' 3 b_ -n F A4JNnPALITY OF ANCHORAGE DEPT. OF HEALTH $ ENVIRONMENTAL PROTECTION -SEf igffi RECEIVED W V I . N � W i � 3 d -4- Z --� 3 o N ,L SL N .N +. .aN t 'p.Sr0 rc t rc o y J _ N J _ S "J C7 y� y y 4r .. •v, i a a ' 3 b_ -n F A4JNnPALITY OF ANCHORAGE DEPT. OF HEALTH $ ENVIRONMENTAL PROTECTION -SEf igffi RECEIVED � W V I . N � W i � 3 d -4- Z --� 3 o N k i 3 L/ o rc t rc o T ox N � W I . N � 3 o Q d A 't LP T ox b C7 m S d a a ' 3 b_ -n a 0 Z-=Z:Fj, orl I- I �4 ,r 4v Z a t Z-=Z:Fj, orl I- I �4 ,r 4v Z-=Z:Fj, orl 0 i TO WHOM IT MAY CONCERN: We, the undersigned, do acknowledge the location of a. water well on our pronerty, Tract #1, located in the Southeast corner of Lot #3. As this well was drilled at the expense of Howard D. Buysman, with our express permission, we further grant to Howard D. Buysma.n an easement right to trench & excavate as necessary with the exnress purpose of utilizing this well as a domestic water source for a single family dwelling to be constructed in the future, linking the well to Lot 1, Blk. 3, Broadview Sub- division. We accept no responsibility for the quality or quantity of water from this well..We further grant the right to trench & excavate on easement for purpose of repair or maintenence of said well & piping & wire. Dated: Property Owners: MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION 0 31986 RECEIVED WELL OWNERS: SUBSCRIBED AND SWORN to before me this 3rd day of July 1986. Notary lic in arx? fo aska My Comni Sion expires: -'.�-� MUNICIPALITY OF ANCHORAGE 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. 050-321-15 1. GENERAL INFORMATION Complete legal description BROADVIEW BLOCK 3, LOT 1 Expiration Date: s. P% rz6 Z2 Location (site address) 18610 UPPER SKYLINE DRIVE, EAGLE RIVER AK 99577 Current property owner(s) RAYMOND E. JR. FARRELL Day phone Mailing address Real estate agent 18610 UPPER SKYLINE DRIVE, EAGLE RIVER AK 99577 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 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 ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ -6.0 Date of Payment Receipt Number � lo 19 COSA # 0.SC 22 10 Li l 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. 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 2/8/2022 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 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 & FWt'S 6. DSD SIGNATURE System #1 Approved for 3 bedrooms System #2 Approved for Disapproved Conditional approval for bedrooms Aw � q�\slll *: 49 TH ....�:* . ' • • Curtis Huffman CE 128991 `\RO8EOf bedrooms, with the following stipulati�c�s'�«(tl((<<�/��� \Sy J J By: 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: BROADVIEW, BLOCK 3, LOT 1 Parcel ID: 050-321-15 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ® Well log is filed with Onsite (or attached) Date drilled 3/1/1984 Total depth 500 ft Cased to 20 ft (CASED INTO BEDROCK) ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 22 in. Date of flow test for COSA 2/3/2022 Static water level at beginning of test 217 ft. Comments B. TANK DATA Age of tank(s) 21 years Tank type/material BIOCYCLE / FIBERGLASS Measured operating fluid level in septic tank * ® Standpipes/foundation cleanout per record drawing Date of pumping * D. ABSORPTION FIELD DATA Which system tested (date installed) 11/14/2000 ® ALL standpipes present per record drawing Total measured depth from grade *6 ft (max) Measured depth to pipe invert from grade *4.5 ft (min) ❑ N/A — pressurized field Structure served by this system Well production at time of test 0.4 gpm Water storage tank volume 2 X 300 gallons Well disinfected for coliform test? ❑ Yes ® No ® Coliform bacteria is Negative Nitrate 0.388 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) Collected by Fps Date of Sample 2/4/2022 C. LIFT STATION ® Required maintenance completed Age of lift station _ years Lift station material Comments: *SEE MAINTENANCE REPORT Adequacy test date 2/3/2022 Results � Pass For 3 bedrooms Fluid depth prior to test 0 in Water added 450 gal New depth 0_5 in ❑ Monitor tubes go to bottom of effective. If not, state Elapsed time 30 min depth into effective **0.4-1.4' OF THE 0.5'ED ®Code -required soil cover over field Final fluid depth 0 in ❑ System presoaked Absorption rate 450 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N date of test) If yes, enter date Gallons introduced gallons Comments/Deficiencies: *AT GRADE. **PER MT / CO ELEVATION SHOTS. FW'�S E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) ® Yes if No Septic Tank/Lift Station on Lot > 100' If absorption field is under driveway comment below Property Line > 10' Community Sewer Manhole/Cleanout > 100' if No ® 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' 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' N Yes if No --. - -ft.- ..- .. . Community> Wells _ 200' ®Yes -if No 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 G. ENGINEER'S CERTIFICATION l certify that / 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. ofz,064 '•,i �. 7H •:� I 0• .. ....... .. � .. .... . j :• • Curtis Huffman r��j�'c�� •. CE 128991 . cvw i C sl • . 2/11/2022• ' 0" ,s �ki pROFli Municipality of Anchorage ® Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www. c i . anchorage. ak . us (907) 343-7904 Water Well Advisory Certificate of On -Site Systems Approval (COSA) # OSC221041 During --a receipt-- oSA on-site inspection and test of the potable water supply well on Block 3, Lot 1 of Broadview subdivision, the well's productivity was determined to be .4 gallons per minute. The minimum well productivity required. by this Department. (AMC 15.55) for a 3 -bedroom residence is .3.1 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. ���CT-Oct•31. 20053 9:d9AYm roess Ensineeria Group. Ltd. Tt ,NO.0474 P.,1g,g baa 8yl a 0307 04 28571 Oct•28•00 3:49P1l; pago s/1 Qnl7 it � L n ` : y 'md 7 n:- Art�La�i iJt�t Dvt:L'ritston PFKM A.wUrd r- ['�.'Cn�'teG /r1 >3trtG3ro-y Dnaro'1 r � TOTAL ; S� Plea Se pay hV invoice. Atl taeeounl Aatt Dire tArill be ch:+rg-d lw%-, 525 Itccond bfflxg ir+arp THANK YOU S j°'`{ 5• S{'' P P e cine} A 6-vc a +..c Gf Waif 4r-> pLoN- spec D F.mts gar 6At?•25f0 Ir$, M & VMLL P.0 fkm TlO1117 of --5e-2-510 INC- ver. At:mM .� trasr• :45.2;10 fax =11.2544 1s' mA CERTafILa PUMP tNSTAI LER >? 9495 - Payment due on receipt of inwo*co unteos otter afrangemanis .rade. 'md 7 n:- Art�La�i iJt�t Dvt:L'ritston PFKM A.wUrd r- ['�.'Cn�'teG /r1 >3trtG3ro-y Dnaro'1 r � TOTAL ; S� Plea Se pay hV invoice. Atl taeeounl Aatt Dire tArill be ch:+rg-d lw%-, 525 Itccond bfflxg ir+arp THANK YOU S j°'`{ 5• S{'' P P e cine} A 6-vc a +..c Gf Waif 4r-> pLoN- spec MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into asofthis i � Day of Fea12vA,zI of 20 2 2, by and between uA R A u_w U.tslnIe.y , herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), as _ _ _ _B10 -CYCLE- SYSTEM located at (legal description) BROADVIEW BLOCK 3, LOT 1 2. Maintenance, Repairs and Alterations. (Owner is acquired to read, understand and initial each section) aL Throughout the term of this Agreement, the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. 0 t It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). tic., Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. 00L Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield. replacement. (rev. 05/18/2018) Page I of 3 0a,.L. Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. &AL Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. Owner agrees to grant the Municipality_ reasonable access to test and inspect the - AWWTS. The Municipality will give at least 24-hour notice. dAL Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. (4c- Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system; or upon transfer of title, and shall continue while the AW` I'S is operational or until title is transferred. 4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of 3 OWNER: By: /l�/(signature) ()w,{, -r kc, LAM{,( (print name) STATE OF �Iet?4eGcurl4a���., n y ) ss. 'I'TiTI?Tl T TT1T('T AT TlTCI r�Tr r ) Vll\l�l � Date: I� R�<5 T'7?— The 'zZ The fore of in trL s� r 20 by �� T/ �fwcl n wl�d d before me this �� day of Commonwealth o yrvama - o a" 'sat Matthew T. Mit-ch, notary Public NOTARY P BLIC FOR A� I Allegheny A4y commissionnenyCounty expiresApril 8,2022 My Commission expires: 2aZ Z Commission number 1223104 Member, Pennsylvania Association of Notaries MUNICIPALITY: B)' _(signature) (print name) (rev. 05/18/2018) Date:_' Title: Page 3 of 3 Lot 1 Block 3 has 13,750 Sq.ft. of Area 17% Of the Lot is covered N D 4 xet' F a v eT � � D�'!•oeacc r''r' p � 5 2A w � I WATER 4 SkYL e S66,2os`3F PROPOSED HOUSE __-60..3 10' TELECOM. & ELEC. N S89 55'407W 11 2>3 EXISTING DRIVEWAY �.sx acv[ 249.93 Seen FOR: Troy Davis Homes cn I c ppp DECI K \ D Lot 1 z NW 254 2130087 Drawn by I O DECK S66,2os`3F PROPOSED HOUSE __-60..3 10' TELECOM. & ELEC. N S89 55'407W 11 2>3 EXISTING DRIVEWAY �.sx acv[ 249.93 O moo. Block 3 BROADVIEW SUBDIVISION to verify proposed building grade relative to finish grade and utility ��� • CHARLES E. FORGES �r connections and to determine the existence of any easements, covenants.• d = �'.• or restrictions which do not appear on the recorded subdivision plat. LS -7326 n, . 05-22-13 Listed distances prevail over scaling. ,�i POPr �'••••'••OpaS+ Reproduction may cause distortion. ,tit"r; ipryal`�� Redraft 5-22-13, As -built of Well and Se tic FOR: Troy Davis Homes Date 5-15-13 Scale ill = 30' Lt FORBES & ASSOCIATES. INC Grid Plat PIAN/As-DMT Lot 1 P.O. BOX 232203 NW 254 2130087 Drawn by Field Book Anchorage. Alaska 88523 (DD7) z27-5881 CEF 242 I hereby certify that the property described hereon has been surveyed by me, or at my direction, and that the improvements situated thereon t are within the property lines and do not overlap or encroach on the ' ,• property lying adjacent thereto unless otherwise shown. That no P GRAPHIC SCALE., I Mch = JO Feel improvements on the property lying adjacent thereto encroach on the premises in question and that there are no roadways, transmission �* 49TH IS 15 70 60 lines or other easements on said property except as shown. •••�.��h.•.., to It is the responsibility of the owner or builder, p y prior to construction, �' �.fs�r���J O moo. Block 3 BROADVIEW SUBDIVISION to verify proposed building grade relative to finish grade and utility ��� • CHARLES E. FORGES �r connections and to determine the existence of any easements, covenants.• d = �'.• or restrictions which do not appear on the recorded subdivision plat. LS -7326 n, . 05-22-13 Listed distances prevail over scaling. ,�i POPr �'••••'••OpaS+ Reproduction may cause distortion. ,tit"r; ipryal`�� POST IN A CONSPICUOUS PLACE ALL WORK MUST BE INSPECTED Field inspection Request required 2 working days in advance of starting work and 2 working days in advance for final inspeciton. Cali (907) 343-8206 (voice recorder) for scheduling. Permit is not valid without the call-in and also must include the one -call ticket (utility locate) number. MUNICIPALITY OF ANCHORAGE - RIGHT OF WAY DIVISION 4700 ELMORE ROAD Till r -M -I MF t911171343-8240 EMAIL: moarowrequests@muni.org • i k"will 1l ,y ill C fi' I v r_ I N.paI-ttilaitt R'151734_ Type: Encrchmnt Status: Issued Grid: NW0254 Date Applied: 06/16/2015 Date Issued: 06/16/2015 Issued By: PWLMM Construction Start Date: Last Updated: 02/14/2022 Last Updated By: PWLMM Permittee: FARRELL RAYMOND E JR Work Order: Utility: Contact Person: Rick Farrell, 907-726-5047. Primary Inspector: Address/Loc: 18610 UPPER SKYLINE DR, Eagle River - @ Mountain Ash Drive Legal Description: BROADVIEW BLK 3 LT 1 G:0254 Original Work Description: Encroachment of 1" copper water service line from 0' to 25' Into Upper Skyline Drive Right of Way for a length of 110' to a well located on Lot 3A, Rouse Subdivision, at a depth of approximately 1 V.This permit was created from an application in 2015, which cannot be located. The encroachment of the water service has ben in place for years prior to 2015 and the current owners occupancy. The water service crosses the dead end of the existing right of way and no letters of non -objection are being required of the owners who have been there since the house was rebuilt on the existing foundation in 2014. The permit is being issued in 2020 as the Land Use Permit was closed this year which allows this action to proceed. hange Orders Su CO Date CO # New Work Description 02/14/2022 81517341000 THIS IS NOTA COMPLETED, ISSUED, ENCROACHMENT PERMIT UNTIL THE SECOND ENCROACHMENT PERMIT DOCUMENT, CONTAINING THE LANGUAGE INDEMNIFYING THE MUNICIPALITY OF ANCHORAGE, IS SIGNED AND FULLY EXECUTED BY BOTH THE PROPERTY OWNER AND THE MUNICIPALITY OF ANCHORAGE. THE FOLLOWING `USE" IS DOCUMENTED AS EXISTING: Encroachment of 1" copper water service One from 0' to 25' into Upper Skyline Drive Right of Way for a length of I IV to a well located on Lot 3A, Rouse Subdivision, at a depth of approximately 1U.This penult was created from an application in 2015, which cannot be located. The encroachment of the water service has ben in place for years prior to 2015 and the current owner's occupancy. The water service crosses the dead end of the existing right of way and no letters of non-objecdon are being required of the owners who have been there since the house was rebuilt on the existing foundation In 2014.The peril Is being issued In 2020 as the Land Use Permit was dosed this year which allows this action to proceed. No additlonai fees due this change order. Summarized Financial Transactions See reverse for requirements/remarks. I have read and understand both sides of this permit I agree to the terms and conditions; and 1 certify that all work will comply with federal, state, and municipal odes and regulations and the provisions of this permit. olSignature: .-�.-/ L ��2�.%' Date: POST IN A CONSPICUOUS PLACE ALL WORK MUST BE INSPECTED Field Inspection Request required 2 working days in advance of starting work and 2 working days in advance for final inspeciton. Call (907) 343-8206 (voice recorder) for scheduling. Permit is not valid without the call-in and also must include the one -call ticket (utility locate) number. MUNICIPALITY OF ANCHORAGE - RIGHT OF WAY DIVISION 1) ( l?fI i' t'1T7 E'tl f. 4700 ELMORE ROAD TELEPHONE (907) 343-8240 FAX (907) 343-8250 RIGHT OF WAY PERI 111T 8151734 - Type: Encrchmnt Status: Issued Grid: NW0254 Date Applied: 06/16/2015 Date Issued: 06/16/2015 Issued By: PWDEW Construction Start Date: Last Updated: 05/28/2020 Last Updated By: PWLMM Permittee: FARRELL RAYMOND E JR Work Order: Utility: Contact Person: Michael Anderson, 522-7773 Primary Inspector: Address/Loc: 18610 UPPER SKYLINE DR, Eagle River - @ Mountain Ash Drive Legal Description: BROADVIEW BLK 3 LT 1 G:0254 Original Work Description: Encroachment of 1" copper water service line from 0' to 25' into Upper Skyline Drive Right of Way for a length of 110' to a well located on Lot 3A, Rouse Subdivision, at a depth of approximately 10'.This permit was created from an application in 2015, which cannot be located. The encroachment of the water service has ben in place for years prior to 2015 and the current owners occupancy. The water service crosses the dead end of the existing right of way and no letters of non -objection are being required of the owners who have been there since the house was rebuilt on the existing foundation in 2014. Since the application was not located and the ROW Permitting System indicates fees were paid, it is presumed no fees are due. The permit is being issued in 2020 as the Land Use Permit was closed this year which allows this action to proceed. Summarized Financial Transactions Fee Description Quantijy Amount Permit 1 $115.00 Total Fees: $115.00 'z--& See reverse for requirements/remarks. I have read and understand both sides of this permit. I agree to the terms and conditions; and I certify that all work will comply with federal, state, and municipal codes and regulations and the provisions of this pe Signature: (�` Date: Z_ V �"Z MUNICIPALITY _ OF_ANCHORAGE Community Development Department Right of Way Section Department THIS AGREEMENT, made this 14th day of February, 2022, by and between Raymond E. Farrell, Jr. and their heirs, administrators, and assigns, hereinafter called "PERMITTEE", and the Municipality of Anchorage, a municipal corporation organized and existing under its Charter and the laws of the State of Alaska, hereinafter called the "PERMITTER". WITNESSETH: WHEREAS, PERMITTEE is the owner of the following described real property: BROADVIEW, BLOCK 3, LOT 1, according to the official records thereof, on file in the office of the District Recorder, Anchorage Recording District, Alaska, and; WHEREAS, PERMITTER owns and/or maintains the real property more particularly described as follows: The 60 FOOT RIGHT OF WAY OF UPPER SKYLINE DRIVE, immediately to the north of PERMITTEES property as shown on Plat No. 70-0008, on file in the office of the District Recorder, Anchorage Recording District, Alaska, and; WHEREAS, PERMITTEE has a 1" copper water service line upon the referenced real property which encroaches from 0 to 25 feet upon the PERMITTER'S Upper Skyline Drive Right of Way for a length of 110 feet. NOW, THEREFORE, it is mutually agreed between the parties hereto that: 1. The PERMITTER, acting through the Director of Community Development Department, hereby grants to the PERMITTEE the privilege of allowing a water service line to encroach from 0 to 25 feet upon the PERMITTER'S Upper Skyline Drive Right of Way for a length of 110 feet, as shown on "Attachment A," included herewith. 2. The PERMITTEE agrees forever to indemnify, defend, save and hold harmless, the Municipality, its officers and employees, from any and all lawsuits, claims or actions brought to any person for or on account of damage to property or injury, disease, illness or death of persons, including all costs and expenses incident thereto, arising wholly or in part from or in connection with the existence of, Ecklund, Timothy J From: Frost, Jack L. Sent: Monday, February 14, 2022 10:50 AM To: McGee, Lynn M.; Snelson, John W.; Pinard, Claudia F.; Sauerbrey, Jon L.; Wockenfuss, Deborah M.; Carroll, Rebecca M.; Ecklund, Timothy J Cc: Littlefield, Mark H.; Winsor, Anthony L. Subject: Change Order to ROW Permit R151734; 18610 Upper Skyline Drive, Eagle River, AK The purpose of this e-mail is to document that currently, there is not a completed, executed Right of Way Encroachment Permit for water line encroachment in the municipal right of way, at the above identified property. Right of Way Permit R151734 was issued for the installation of a water line in the Upper Skyline Drive right of way to document the existence of the water line. The water line is an encroachment that was illegally installed without benefit of permit (approximately 1985). R151734 was created to document the water line's existence. An encroachment permit is required for it to legally remain. The encroachment permit process has not been completed and therefore there is no legal encroachment permit. The Encroachment Permit consists of two related permits/documents. The first document is a Right of Way "use" permit, titled "Encroachment" to allow the "use"; in this case installation of a water line, to legally occur. The second part of the Encroachment Permit contains language approved by the Municipal Attorney's office, indemnifying the Municipality of Anchorage from harm, claims, etc. Both portions of the Encroachment Permit must be completed and signed by the applicant, and the Municipality of Anchorage, for the encroachment to, legally remain. The property owner at 18610 Upper Skyline Drive has repeatedly refused to sign the indemnification document. The water line was installed .prior to the property owner purchasing the property (approximately 1985). However, once we identified the encroachment was present, we are responsible to ensure the Municipality is protected. The property owner is selling the house. In the process they will need a Certificate of Onsite Systems Approval (COSA) from the On -Site Water and Wastewater section. A requirement for that is to have a legal source of water. The first part of the Right of Way permit has been signed and can be easily misunderstood as being an encroachment permit since "ENCROACHMENT" is the title of the permit. Both portions of the permit must be executed. For clarification we are issuing a change order with the following language: THIS IS NOT A COMPLETED, ISSUED, ENCROACHMENT PERMIT UNTIL THE SECOND ENCROACHMENT PERMIT DOCUMENT, CONTAINING THE LANGUAGE INDEMNIFYING THE MUNICIPALITY OF ANCHORAGE, IS SIGNED AND FULLY EXECUTED BY BOTH THE PROPERTY OWNER AND THE MUNICIPALITY OF ANCHORAGE. THE FOLLOWING "USE" IS DOCUMENTED AS EXISTING: Encroachment of 1" copper water service line from 0' to 25' into Upper Skyline Drive Right of Way for a length of 110' to a well located on Lot 3A, Rouse Subdivision, at a depth of approximately 10'.This permit was created from an application in 2015, which cannot be located. The encroachment of the water service has ben in place for years prior to 2015 and the current owner's occupancy. The water service crosses the dead end of the existing right of way and no letters of non -objection are being required of the owners who have been there since the house was rebuilt on the existing foundation in 2014. The permit is being issued in 2020 as the Land Use Permit was closed this year which allows this action to proceed. If there are any questions regarding this situation please contact me at your convenience. Regards, "Ke Jack L. Frost Chief, Code Enforcement & Acting Director Municipality of Anchorage Development Services Department PO Box 196650, Anchorage AK 99516-6650 : 907.343.8033 907.727.7632 c 2 • Municipality of Anchorage On -Site Water and Wastewater Program (907)343-7904 => *+ Certificate of On -Site Systems Approval 050-321-15 Parcel I.D. Expiration Date: Al 1. GENERAL INFORMATION Complete legal description Broadview, Block 3, Lot 1 Location (site address) 18610 Upper Skyline Drive River, AK 99577 Current Property owner(s) Troy Davis Homes Day phone Mailing address 165 E. Parks Highway, Suite 200 Wasilla, AK 99645 Real Estate Agent 2. TYPE OF DWELLING: [-xl Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System WaiverNariance request Three Day phone TYPE OF WASTEWATER DISPOSAL: 21 Individual I] ❑ Holding Tank ❑ ❑ Community ❑ ❑ Public Sewer ❑ Received by: COSA to be relea ie, lcrfhe engineer, unless otherwise requested by the engineer. COSA Fee $��' Date of Payment % / Receipt Number COSA# < c6 Date: - 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 Anderson Enginee Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. 6. DSD/SIGNATURE System #1 Approved for 1? bedrooms System #2 Approved for _ bedrooms Disapproved Conditional approval for bedrooms Phone 522-7773 x» ate -- " MIC`HAkL r K _ with the following stipulations: By: >/: (:�i„� �,�.- 'e tae+ Original Certificate Date: G/ / The Municipality of Anq orage 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 t li c 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: Broadview, Block 3, Lot 1 Parcel ID: 050-321-15 A. WELL DATA Well type Private If A, B, or C provide PWSID # Well Log (YIN) Y Date completed 3/1/84 Sanitary seal (YIN) Y Wires properly protected (YIN) Y Total depth 500 ft. Cased to 20'3 ft. Casing height (above ground) >12 in. FROM WELL LOG AT INSPECTION Date of test 3/1/84 5/16/13 Static water level 9 ft. 2 ft. Well production .42 9-P,m, .35 P.P.M. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate .131 mg/L Arsenic N/D ug/L Date of sample: 6/4/13 Collected by: Sullivan Water Wells B. SEPTICIHOLDING TANK DATA TankType/Material Biocycle/Fiberglass Tank size 1,500 gal. Number of Compartments 4 Foundation cleanout (YIN) Y Depression over tank (YIN) N Date of pumping 5/27/09** Pumper JR's Pumping C. ABSORPTION FIELD DATA Date installed 11/13/2000 Cleanouts(Y/N) Y High water alarm (YIN) Y Date installed 11/14/00 Soil rating (g.p.d./ft2 or ft2/bdrm) 3.0 (3HU16l- System type ° vvioe i rencn Length 30 ft. Width 5 ft. Gravel below pipe .5 ft. Total depth 3'2-6 ft. Eff. absorption area 250 ft2 Monitoring tube Y Depression over field N Date of adequacy test 6/4/13 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 550 gal. New depth 1 in. Elapsed Time: 5 min. Final fluid depth 0 in. Absorption rate >= 450 g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) If yes, give date D. LIFT STATION Date installed 1/14/00 Size in gallons 1,500 "Pump on" level at 30.5 in. "Pump off' level at 19.5 in. Datum Bottom of Panel Cycles tested 0** E. SEPARATION DISTANCES Manhole/Access (YIN) Y High water alarm level at 45 Meets alarm & circuit requirements? Septic tank/lift station on lot > 100' On adjacent lots > 100' Absorption Feld on lot >100 On adjacent lots >100 Public sewer main N/A Public sewer manhole/cleanout _ >25' N/A N/A ■A Sewer /septic service line Holding tank Animal containment areas >50' Manure/animal excrete storage areas >100' SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5 Property line >5 Water main >10 Water service line >10 Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO: Property line >10 Building foundation > Water Service line >10' Surface water >100' Curtain drain None Noted Wells on adjacent lots >100' Absorption field >51 Surface water > 100' Water main N/A Driveway, parking/vehiclestorage >10' in. F. COMMENTS **No Structure On Site Since System Last Tested on 6/4/09. Well Flow and Water Testing Completed by Sullivan Water Wells. Absorption Trench Pre Soaked. G. ENGINEER'S CERTIFICATION I certify that t 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 Michael E. Anderson, P.E. Date 1/8/2013 COSA brown sheet_10-10-12.doc t QCs A `9 s 49?H qq .....•..•..........— -. ..y MKHAEt E. APIDER_ A E � ® `s•• CE 4381 �BISS O:'�� Municipality of Anchorage s Development Services Department Building Safety Division 5 E On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Water Well Advisory Certificate of On -Site Systems Approval (COSA) # 131258 During a recent COSA on-site inspection and test of the potable water supply well on Block 3, Lot 1 of Broadview subdivision, the well's productivity was determined to be .35 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3 -bedroom residence is .31 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. Page 1 of 1 Wockenfuss, Deborah M. From: McGee, Lynn M. Sent: Thursday, January 09, 2014 11:07 AM To: Wockenfuss, Deborah M. Cc: Poet, Jeff W., 'Mike Anderson'; Wyatt, Daune E. Subject: COSA for Broadview Lot 1, Block 3. Deb: We are aware that a COSA is pending for the above lot and there is a sense of urgency for the transfer of ownership. After consulting with Jack Frost, we are unconditionally going to approve the encroachment of the private water service line and accompanying electric power in the undeveloped portion of Upper Skyline Drive. The encroachment permit will cover the ROW from Rouse Lot 3A to the above lot via the Upper Skyline Drive right of way. The paperwork to do so will take longer than the time frame to execute the sale so I am requesting this pre - approval will suffice till we finish the process which will be done within 5 working days. Mike Anderson/Troy Davis Homes: We need to issue the ROW Encroachment Permit to the permanent property owners, not the builder, as the contractor has no long term interest in the property. When that information is provided on the Encroachment Permit Application, we will process the paperwork and prepare the documents for the permanent owner's signatures. Thanks, Lynn M. McGee Senior Plan Reviewer Right of Way Section mcgeelm@muni.org 343-8226 343-8250 (fax) 1/9/2014 Phone MUNICIPALITY OF ANCHORAGE • Community Development Department • On -Site Water & Wastewater Program P: 907-343-7904 • F: 907-343-7997 • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org Intermittent Dosing Sand Filter Maintenance Log Street Address U e t J k i n ice' hr - Legal Desc. � n,V 4 \Sk PID Septic Tank: -Sludge level1�it��C inches Absorption Field: -Pumping: required es no -Pumping completedey s no -Liquid level inches -Flushing valves per approved designey s no -All flushing valves opened, distribution lines flushed, and flushing valves closedey s no Lift station: -Pump basket cleanedey s no •Biotube effluent filter cleanedey s no -Timer float setting inches -High level float setting 35 inches -Reference point -Pump on seconds -Pump off minutes -Cumulative lifetime cycles -Cumulative run time hours -Operation satisfactoryey s no Air System: -Air pump filter cleaned es no -Air pressure psi -Date of latest install or rebuild e3 &\o -Air system operation satisfactory not satisfactory Alarm System: -Dedicated electrical circuit es no -Audible and visual alarm inside dwelling es no -Float setting ' a inches -Alarm system operation satisfacto not satisfacto Comments: Maintenance Provider: Technician /Lc�"s y`�'/ Company 4-ks ���vll',P +�w�� Signature_ IDSF Maintenance Log_040313.doc Date of maintenance Date Jun 12 13 01:45p Sullivan Water Wells 907 688 2759 p.2 Q131LL Ok COLE .... VV V� -ULL{VAN WATER WELLS P.O. Box 670269, Chugiak, AK 99567 688-2759 TO: PHONE OATS OF ORDER ORDER TAKEN BY CUSTOMER'S ORDER NO. (j DAYWORK (j CONTRACT (j EXTRA JOB NAMEINUMBER JOS LOCATION L3 93 TERMS: JOB PHONE 5T I/G DATE QTY. DESCRIPTION OF WORK PRICE AMOUNT L Lila: �� } \ � l 'A ti rim 515 -� J5 L4y5 1� 5 31-1 J NO �(A Lh r c `nf? - t7 Work ordered Signature I hereby ackn,,letlge the satisfactory completion of the above described Work. DATE COMPLETED 5 �_ I/ _ 1 ' C Municipality of Anchorage .. Development Services Department Building Safety Division > On -Site Water and Wastewater Program .. ... 4700 Bragaw Street P.O. Box 196650 G • Anchorage, AK 99519-6650 (907)343-7904 -r7 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 050-122-2s COSA#17 qQ LjE7 Expiration Date: C1 - 5? - 0 q 1. GENERAL INFORMATION Complete legal description Broadview Subdivision Block i Lot i- -- Location (site address) 2862o Upper Skyline Drive Eagle River. AK ggsn Current Property owner(s) Terri & Robert Ireland Day phone Mailing address Lending agency Mailing address Real Estate Agent Mailing Address -A5 B S George Mason Drive Alexandria VA 2202 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: -3- 3. 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Day phone Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding Tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered In the State of Alaska. Certificates of On -Site Systrms 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 COSAs upon request to homeowners. Certificates of On -Site Systems 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. (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 verity 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 bedroorgs and type of structure indicated herein. I further verify that based on the Information obtained from the MunjMdlity of Anchorage files and from my Investigation'and rspection, the on-site water supply and/or waktyl?a Ir disposal system is(are) in compliance with all applidIabl rnicipai and State codes, ordinances, `d a tions in effect at the time of installation. >,. , Jt Name of Firm'Pannone Engineering Services LLC•! Phone 242-8218 Address P.O. Box 102qS4, Anchorage, AK qgSio Engineer's Printed Name Steven R. Pannone, P.E. Date &' tdorf 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. The 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 lire of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system These conditions are outside the control of the evaluator of this system All systems eventually fail an satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. PPS can therefore not provide any warranty for future performance nor give any estimate of how long the system will continue to meet the operational requirements of the htOA DSD. 71ic 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. 5. DSD SIGNATURE -7 Approved for 7 bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Pte_, •� Q ••. ON-SITE w Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: , o Original Certificate Date: �r - k - 0-1 Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Broadview Subdivision Block a Lot a Parcel ID: oso-ata-as A. WELL DATA Well type P If A, B, or C provide PWSID # _ Well Log (WN) Y Date completed -4/1/1984 Sanitary seat (YIN)Y Wires properly protected (YIN) Y Total depth iSoo ft. Cased to zo' • ft. Casing height (above ground) aa. in. FROM WELL LOG AT INSPECTION Date of test g6& 1126/2009 Static water levelg ft. 247 ft. Well production 0.42 9 P•m• 0.12 9.p -m. WATER SAMPLE RESULTS: Coliform 'o.00 colonies/100 mL Nitrate o.00 mg/L Otther bacteria 0.00 colonies/100 mL L P Arsenic: 00mg/i Date of sample: SLa o9 Collected by: Michael Wehr 64 B. SEPTIC/HOLDING TANK DATA Tank TypelMaterial Western Utilities Fiberglass Tank size': igoo gal. Number of Compartments & Foundation cleanout (Y/N) Y Depression over tank (Y/N) N Date Installed 2alaa2000 Cleanouts (YIN) Y High water alarm (YIN) Yes Date of pumping Stn/2oog Pumper ms's Pumping C. ABSORPTION FIELD DATA LI�ZP '310 Date Installed ulaa12000 Soil rating p.d./ft2 ft rm �.- System type Shallow Trench 045 L(ZP Length ,3o ft. Width s ft. Gravel below pipe A4!!!�E ft. Total depth; 2.6.o ft. Eff. absorption area }5o fe Monitoring tube Y Depression over field N Date of adequacy test 02612004 Results (PasslFail) Pass For 3 bedrooms Fluid depth in absorption field before test o.00 in. Water added4So+ gal. New deptho.co in. Elapsed Time: o.00 min. Final fluid depth o.00 in. Absorption rate >= &So+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) N If yes, give date D. LIFT STATION Date installed 2/14/2000 Size in gallons xcoo Manhole/Access (Y/N) Y `Pump on' level at 3qS in. "Pump ofr level at &g,5 in. High water alarm level at bS in. Datum Bott of Control Panel Box Cycles tested 2 Meets alarm & circuit requirements? Y E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Zoo+ Absorption field on lot ioo+ Public sewer main NIA Sewer /septic service line 2c+ On adjacent lots ioo+ On adjacent lots ioo+ Public sewer manhole/cleanout NIA Holding tank _loo+ Animal containment areas ioo+ Manure/animal excrete storage areas 200+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation ao+ Property line 20+ Absorption field_ ao+ Water main NIA Water service line _25+ Surface water soo+ Wells on adjacent lots zoo+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 20+ Building foundation 20+ Water main NIA Water Service line 2c+ Surface water _soo+ Driveway, parking/vehicle storage 2c+ Curtain drain None Known Wells on adjacent lots soo+ F. COMMENTS Se 'c 51a+1 4154 tn5pe fed joy 6;4cyc4 G. NGIN ER'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 COSA guidelines In effect on this date. Engineer's Printed Name Steven R. Pannone./P.E. Date COSA Fee $BYO f d 9 U511 itak Waiver Fee $ Date of Payment n6 r0 / Receipt Number o 715, ,6 (Rev. 11105) Date of Payment Receipt Number _ , S%Sleven R "' _ Ponroner Ji No. CE r•41:_D 8149 a FT��M',rt •t ted• Municipality of Anchorage • .� Development Services Department "s4; Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 Nater Well Advisory Certificate of On -Site Systems Approval (COSA) # 090157 During a recent COSA on-site inspection and test of the potable water supply well on Block 3, Lot 1 of Broadview subdivision, the well's productivity was determined to be 0.31 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 3 -bedroom residence is 0.31 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. ASBUILT SEWARD & I HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALA FOLLOWING DESCRIBED PROPERTY: ,sve THAT NO ENCROAEHMENTS�EXIST EXCEPT AS DATE= �Z� AND INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY GRID, ZSy EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD X39 ANY DATA HEREON BE USED FOR CONSTRUCTION OF FENCE LINES, OR FOR ESTABLISHING BOUND- DRAW�'f ARY LINES. 7_t ov.n. jo M.h S+r..d p D 1���•. LS -6918 w'Vfy Td Wd4T:40 0002 SS '3;)G BB6D 469 L06 : 'ON >W-4 XHWi38 N 3)10088 : WO8.A Oct•28. 2005 12:22PN Garness Engineering Group, Ltd•„��rtiti;��jy �Io�Ot60,..,P• I 6 3 WA vMIR N T eil and waren Line) ''bb THIS AGREEMENT. mode thisaybyand betweenWilliam C.Farberand Lisa L. Farber, husband and wife, 16560 ouse Cirelc, Eagle ver, Alaska 99377, ("Grantoel, and Oregoty J. Buystran, a single man,16600 bowney Ave.. d 121, paramount, CA 90723, ("Grantee"), 1. RECITAIS_ This agreement is made with reference to and Incorporates the following (sets and ob)ectivcs: (a) Grantor and Grantee each own property as hereinafter described, Grsntce has been wing a well and water line located on Oranter's property for a number of years. (b) The parties desire to formalize the well and water line easement prior to Grantee scllin` his property so that the easement will be recordad prior to such sale. (c) It is the iotaAlon of the parties to create an easement to perpduity nmeing with the land. 2. fQNS DERATIM This Easement is trade in tonsidoration of Ten Dollars (510.00) and other valuable eomidetation, including the twos and provisions hereof, the receipt and sufficiency of which are hereby mutually acknowledged. 3. EROPERrvDESCRiPTIONS M1 S .� (a) Grrsator's Berdned-PNoarm a£L, LOT 3A, ROUSB SUBDIVISION, according to the official Plat thereof, Mcd under PlatNo.90L9,rccordsoftheAnelwro cording!) ict.Third Judicial District, State of AWI:L (b) Grantee's BeaeQlted Prelle�ty: LOT O E (1), LOCK THREE (3). BROADVIEWSUSDIYISION,according touh official lattlureof,fileauoder FlatNo.70•g,records ofthe AnchorageRecordin 'stria ThirdludicjaIDjat.icr, stateofAlasks. I / A. 3SASIP41 f. orherrelatedrnpro(av)emRennlcsrlotlon. This iteaummtfor inexisingMawWff 1sd locatedlndwSourheastcomarofGrantoesBfOadrys Bensfitcd Property ("Easement-). (b)s5ne8riii I (Grantor requests I%and at Grantee or Its succcs5or'j cost, the Easement9irein ganted shall be converted into an adequate and specific easement by amending this Easement deeloration by attaching a map of Grantor's property prepared by a registered Alassa land surveyor mW specifically loatidgthe Easement features on Grantor's Property, If Grantee or hs socsessor fail orrefirse to cooperate and pay for making the euement speeitie,then this easement shall terminate for all purposes. (e)ran . Grantor hereby grants, bargains, sells, conveys, Imnsfen and delivers to Gramm Ill' successors, transferees and assigns, the Easement above described, which Easement b located on, overend across the Grantors Burdened Property for the benefit of Grantee's Ecaefltted Property. (d) Pa rnose. This Easement is forthe purpose ofma'wsining the existing Easement features located :11�81r�; ., .. , ni�.r .-.1I Qwc1.Kw L'?JIITIC =y11NA:MJ4 Thal Oct -28. 2005 12:22PhP, Garness Ensineerins Group, Ltd 'rtU1•GUy79,jo.0460_.j. 2 WATER WELY. PA_S 9M E N'E (Weilaed WaieLtnc) TIUSACA/,FMLNT.madeNk_ _dayn(_ _ X2000,by&MbctwccnWiiikmC.Fabataal Lba I.. h'NW. husband and wife, IASW Rouse Churg Fagle Riva. AIAAkm "S77, (' Gmntoe). and rrogorr J. 13uysmatl, a single man, '166M Doteoey Ave. 012I, limaxwal, Cr1907!3, CCraelca"). 1. AMMAI-'4. 7htt ofirm um Is made With ref mn" to and inawporetat the falk1wing facts IN o"itts: !a) Onmaum and Ortnim each ovnt property m paeelnaflur 4eaaibcd. Gimlet has been wing a waa and water lige lusted nn pantor's pfWCrty for a aurid a aryaan. (b) 1U portlaa desire to fond;= the wall and caster lirw oaecroettt Prior to Oram. f.ltlng his Property so dwt the usancm will M twonkd prkvr to Such sale. (c) It Is Nm intention of the Father W emaa In eason"t In perpetuity tuimIna with the land. _, rQN5%Q&AATION. TWs L'asaa m (s wA4e In cer,44mtkon of Tet Dollars (f1v.0o) and ether valuable cwuideratiun, InahrUag the bores 1nJ ymviabro leant the rvWpt and saf"ickncy of whkh sax hera6y "ANDY 3. nOr JMDESCRIMtON4. +y •�� (a) fa'tgatalAs Hardenedt4anattw D�` ; /, IPI 3A. ROUSF. SUDDIV 1SION, according to die ofliclal Plat Ihereor, riled under Plat No. 9A .89 ,rwwds orthe Amhomp ftecnrdlnr Dutrict,Thlyd Melal District. Stale orAlavka. (b) Cramsj2y teae.ldted Pronctert I.eT OUR (I), at= THREE (31 DROADV IEW SUDD1VISIOW. Dccwding to tale dacial plat tbereaf, rtba undcr MuNe.70 t.sec+wJrofdtcAodtorageRacwdbpDiatrkt,lyird)uAidalDiatriol Sure of Aloka. 1. 1 MAffi T. ►�J (A) This is a cugaonl for alk cxIm6g waw well. Usbimlla Weanling sd any other related Iats<o.craenes belied it die Snutheae erxtter offrrstdWs ettrdrnol Property M the board of rlroamds ricnerma Property (" guorme). (b)SWI IfGrMlWJayuesn1%WAItGnnbcotietueetssa'se0A1 8aSWT1dA)9ftingMIW shall be convened into an adoquata and "Mc e■ emeni by antendiag We Eaeemem dealuetion by attoch)ng a reap Of Grantor's property prePsfed by a seSistered Alaska land survgw and specifically bating dw gacaacai features on urnrwwl propartyMcwtvaw (a aaoaenor fail otrtrau to cooperate and pay fur making the comment spxific, diem this emem.nt A-11 terminate for all purposes. (c) Ceaot Mentor hereby Fttm. bwphL% Ulla. eunven vmrcrs gad dvnvets tv Can«• hs• Sinn"ors, rranAmet etd acaims, the Easement above derelbed which Easement 4 balled Uri. Over gad aervss the Grantors nurdaned Property for the bonefit urflrtlaae'a sumer cad Property.. (d) 1'u rnww 7WI ITaaanent Is Wr de Pwpoac ufwainw)ninr the extdiagraa,man falutea rotated <s\?WaaaiTm\aAM wt. -t. A Paq* —1 n �.. ntYIMI��n✓•n� rYYLL/n �.7n 1r�C Tx'v'we•xm lJ ev•vr e•M9�OJ�IM Oct•28. 2005 12:22PM Garness Ensineerins Group, Ltd. ._._....._No•0d60•r,,,P• 3 OK037I,OP00480 on Grantor's Property in perpetulty runnhtg with the land. S. MAINTENANCE in comideration of the grant of Easement, the parties agree to the following maintenance and repair provisions: (a) -Ci" All costs of upkeep and maintenance for the easemont and Improvements placed therein shall be the sole tetpons)bility and obligation of Grantee. MIDaIntres, Grantee is speelficallyawarc that Onntor an expensive French drain system running essentially parallel to the wall line. in the come of any repairs or maintenance of the well and warcr lines Grantee, Its successors, transferees, assigns and designers shall indemnity and hold Grantor and the Crantor's Burdened Property harmless from, and shall be responsible for and promptly pay for, any damage done to Grantor's Property. Failure of Grantee, its succeswrr, trttnsfeross,auigns and designers to promptlypay for any Pith damage afternotke thereo Morin Grantor, shall truck Granter to terminate this EasemevhL (c) Notice. Grantee shall give Grantor prior twice of the nature of repairs or malntenance and what and by whom the work will be done before Crsntee or its contractors or agents go upon Grantors Property. t car �►r ul e u (a) Pgrrietes This Is an Moment In perpetuity and as $uch shall be a covenant running with the Grantor's Property for ft benefitorGnanices Property,butshali terminate at such time as Qrantce's Property no longer utilizes the water well featured In the Eassement. (b) trivate ibis is not a public easement, but is only for the private and exchuivo use and benera of Grantor's Property, turd Orantee's successors, transfer•.es, assigns or designees. Granto►shall be entitled to use of said easement area in any roamer which does not disturb or Interfere with the Grantee's use. (c) Other Vses. This Easement shall be used by tie benefitted property only for the purposes herein specifically donned, and for no other purpose. (d) R 1 PebtR : k nle All usages mast comply with any and all starutcs, ordinances, reguluions and rules or any applicable covenants, conditions and restrictions orany duly constituted public authorhy currently in force or hereafter enacted which effect or pertain to the Easement granted. The costs of such compliance shut) be boons by Grantee, Its successor, transferees and atsigns. (e � .Grantee area to indcmtnily, defend and hold Orantorharmless from any and all claims of any n re w ich may arise ::fee or by virtue of this grant ondlor Onntee's use of the Easement area. (I)PI talme Grantormakesnomprcsents6onsastothe quantity, qualliyorpotawityorthewell water, nor as the p Ica) condition or location of the well and water lines, nor as to compliance with any govemmerxal egulati relating thcreto.. 7. iNf,7iriea trshbi ding upon and banes to the benefit of the pardeshercto,their heim, successors, trap crc and Assigns, the b and benefiucd properties described herein. 1N W £0 , the have sct the day and year hereinabove tint written. GRANTO t�.4p�— W' Cr F Lisi i_ Farber (signatures Contieoed on Next Page) n n• , ..rYnY"N•n, rM'Y Vt.CO L'?„1T,C TlrVla,O•NMJJ =-=T Pprai_07_Vln Oct -28. 2005 12:23PM. Garness Ensineerine Group. Ltd. C..%.r ,ijo-0460P.O.P. 4 . �• ©K03148PGb401 GRANTEE; GREGORY J.BUYSMAN ACCEPTED AND APPROVED AB LIENHOLDER OF GRANTORS' AFOREM5NTIONED REAL PROPERTY BY VIRTUE OF THOSE RECORDED DEEDS OF TRUST IN BOOK 2612 AT PAGE 689 AND BOOK 2808 AT PAGE 302 AND BOOK 3681 AT PAGE 439. ALASKA FERE REDITUNION BY: STATE OF ALASKA ) ) as: JUDICIAL DISTRICT) This Is to certify that on the ,L_ day of Undersigned Notary Pubic. personally appear �ril�_ LIE before me the .n rvwRa uo^ reeenu weoa Umon, known to me and to melnown to be the Person named In and who executed the Above and f=going and he acknowledged to me that he signed the same freely and vokrntarlty for the Uses and purposes thomin man Toned. WITNESS my hand and of&!al seal 1& u Nolmy Pubic N end asks My Comrrkslon expkes: _may Eos M ^.�- I.,.-,.-.x•,-,rc.n, ooc.+.co M-.WITic =wnva:woJJ =:=T Oct•28. 2005 12:23PM Garness Ensineerins Group. Ltd. ..••_No•0460•,,.,P. 5 0903740PG04Bj L�4RnNTeE: BREGORir�r"3i SMAN ACCEPTED AND APPROV9D AS LIENHOLDER OF GRANTORS' AFOREMENTIONED REAL PROPERTY BY VIRTUE OF THOSE RECORDED DEEDS OF TRUST IN BOOK 2512 AT PAGE 689 AND BOOK 2ao9 AT pAGE 302 AND BOOK 3881 AT PAGE 430, ALASICA USA FEDERAL CREDIT UNION eY: ALASKA sr. T11al 4 to eror H1bG upon s day 0 undersigned Nott pon ri Notary s, y appesppnl aria m me known to be ax poison n N and wl o exeeukd W dgad to me qml he signed he -aa bccl and wk�nyrC thenen nwon o WITNESS rrly hand ane QnlGar teal I Page —3- 7090, beforo foregnby and ho ea and purposes Q.C'd Q�J=t 01 acr_ .GQ W1 J11TIC 71-W'DW!W0JJ =:=T CP1cv-Qi-IM Oct•28. 2005 12:23PM. Garness Ensineerins Group. Ltd. — ....-lo•0460....P. 6 UK037118PG048a ST'ATEOFCALIrORNiA ✓COUNTY OF THIS IS TO CERTIFY that as r ' %y of6 e C- 2DO0.6eforr nit the undomitp ed Nutay Pubric, PCFWMIIy appcomd C xiewK Y J. IIUYSMAN- lose a&=&w d to me known to be dw pcnon named 'in and who executed the ■bova wd fornalnR and he acknowledged lame Ihat he shoed die fame Auly and vokmivfliy for tha 1tsai and "as" orcin r%Mj0nad. W ITNFCS my hond tvtd aficW teal �I IWI'Atlt �IaIAnOdee CaN/ W Caltrlt ta�aa Jet xUo01 STATE OF ALASYA THIRDIUDICIALDISTRIcr ;It Ne Ptlblie wCnlirunllr -. My tonaolaeian "PIMS:t7 JP J � THIS IS TO CERTIFY that on the_ dry of . 2000• before uw the nndoraiantd Notaty pUhlie• PUsanalty *PPcartd WILLIAM C FARDtR waJ s.1SA L. FARBER, known to arm and to me known w ba the penny named In a" whn exrsytad the above and anogoini end he acknowledged to me that Iw sillow alas Vane frtcly and rolttnavily 111017 the taxa! Ind Purposes therein nrentianed. WITNESS aty hand and official teal, Notary ►vb— l�ml rur'A1ukt My eammksinn expires:_. C:%z"exbM%N%TCR WCLC 7 Paae -4- n^- rr_Yur rr•nl Cat a UMMI1TIC 7`YYl]x]CWOJJ =!7T CVVL1 -4 -V)n Oct•28. 2005 12:23PM Garness Ensineerins Group, Ltd. No -0460 P. 7 'UK 037 It aPG0484 STATE OF CALIFORNIA ) ss COUNTY OF ) M41SISTOCERTIFY that onthe day of�_,2000,beforemethe undersigtxdNDlary Public, personallyappeared C RECORY L BUYSMAN,known tome and tome known to be the person named In and who executed the above and foregoing and he acknowledged to me that he signed tic same fkely and voluntarily for the uses and pwposes therein mentioned. WITNESS my kand and official seal. NO2ery public In and for California My commission expires: STATE OF ALASKA ) is THIRD JUDICIAL DISTRICT ) THIS IS TO CERTIFY that on theleday of CE 2000, before me the undersigned Noby Public. personalty appeared WILLIAM C. FARBER and LISA L FARBER, known to me and to me known to be the person named in and who executed the above and foregoing and he Acknowledged to the that he Signed the same freely and voluntarily for the uses And purposes therein mentioned. WITNESS my hAnd and officlal sql. �Z Notary Public In and for Alaska i_ NOTARY My commission eapires:_bblm� L PI1$X,jO' J October 11, 2004 002988 2i101JA-4 AH 931 RECORDING DISTRICT REOUESTEO By rrMAktPACRMI M., • . ,•.max.,.-•.-,nc.n, oo o v IVITtc 7v-nva-w0JJ 77:=T CVC0-0:)-l1n Oct•28. 2005 12:23PM Garness Engineerins Group, Ltd. No -0460 P. 8 L Med Sfafei Of Mork 57ako/Naakt v -- 7M5IS TO GERTIfYtwl" hwwy *4"".4ua and cared cm aft,, aww*rlaaaatwZr as l00wSb end lMaGmy afika. jt4rA "Twrs WH£p£OF. 1 have no-mrb Ot "'Y pend and We a.kW rM cgdm noel at Arrlmlaa . At ego °Y OcafdOt as +r.w Nv'r M u O.O•J maw M' II171G J 81110:WOJJ =!' lC X2 -cm -l -n n BIOCYCLE ALASKA June 6, 2009 Steve Pannone, P.E. Pannone Engineering Services 11301 Olive Lane Anchorage, AK 99515 n Aerated lF avtewater Treatment Systemv Re: BioCycle system at Broadview Subdivision Lot 1, Block 3 Eagle River, AK 18610 Upper Skyline Drive, Eagle River, AK 99577 Dear Steve: We were recently contacted by Alaska Water & Wastewater Consultants, Inc. of Anchorage to request an inspection of the BioCycle wastewater treatment system serving the referenced property. AWWC is the engineering firm of record for this installation. On May 28, 2009 we contracted with JR Pumping Services to pump the BioCycle system per MOA requirements. The MOA requires any advanced system that has been in service more than 2 years be pumped in the event of the sale of that property. Mr. Larry Betts, BioCycle services technician, coordinated the pumping and was present to instruct JR's Pumping on the procedure. As you are aware this residence was completely destroyed by fire in 2008. Mr. Betts, using a portable generator, checked the proper operation of all mechanical equipment in the BioCycle system. He determined that the 80 liter/minute air blower, the Meyers 0.4HP, discharge pump and all pump floats were working properly. When the residence is replaced, as is the intention of the new owner, BioCycle Alaska, Inc. will install a new control panel and new wiring to the BioCycle, fill the system with clean water and test all equipment and alarms. Please let us know if you need additional information regarding the BioCycle system serving this property. Regards BioCycle Alaska, Inc. Gus Andress, P.E. 4971 Thompson Drive 399-0331 cell }lamer, AK 99603-7434 226-2476 oMce Email: blocyclealaskaas alaska.net NJ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES M Division of Environmental Services _ On -Site Services Section P.O. Bax 196650 Anchorage, Alaska 99519-6650 (907) 343A744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILLY DWELLING Parcel I.D. # 050-321-15 HAA # IligCCU t rr tl (, 1. GENERAL INFORMATION .r . ... . . . r2 X : . I= r: :k . .•. QERRIF LEWI.S.1• RFMAX :MAOF I : Lending agency Mailing address Day phone Agent OFRRIF LEWIS w/ REMAX OF EAGLE RIVER Day phone (007) 694-6400 Address 16800 PFNTFRFIFI n nRIVF EACLF RIVFR AK 44577 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 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. 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 ing to the legality and status of system. 72-025 (Rev. 1/91) Front MOA 921 Computer Version Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $3,483.75 af, or prior to, closing for the engineering services provided. 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my Investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure Indicated herein. l further verify that based on the Information obtained from the Municipality of Anchorage files and from my Investigation and inspection, the on-site water supply and/or wastewater disposal system Is In compliance with all MunicipaAand State codes, ordinances, and regulations in effect on the date of this inspection. , ,$V1 Name of Finn Phone (907) 337-6179 Engineer's Signature t Date IZ-b /cc In conducting this evaluation, AIMOVC, Ina t m d de a thorough, conscientious engineering analysis of the system In accordance with ADEC and M HH uidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily Identifiable lectures. The operations! life of all wells and septic system - on the local soils condition, ground water levels that may fluctuate during the year, and the usage of the family being served by the system. These conditions are outside the control c 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. AININC, 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. 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. 6. DHHS SIGNATURE Approved for -bedrooms Disapproved Conditional approval for Additional Comments 0 bedrooms, with the following stipulations: Date / 2 - A`- O o 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 #21 Computer Version RECEIVED Municipality of Anchorage DEPARTMENT OF HEALTH iii HUMAN SERVICES DEC p 4 Environmental Services Division 825 -v Street, Rm 502 Anchorage, Alaska 99501 (907) 34314744 MUNICIPALITY OF ENVIRONMENTAL SERVICES DIVIM Health Authority Approval Checklist LegalDoWpyom BROADVIEW SUBDIVSION: LOT 1. BLOCK 3. Parcell.D.: 050-321-15 A. WELL DATA NOTE: WELL IS ON LOT3A, ROUSE S/D. Welt Type PRNATE H A. 8, or C, attach ADEC letter. ADEC water system number N/A Log present (YIN) YES Date completed 3/1984 Total depth 500' Cased to 20'-4"(To BEDROCK) Casing height (above ground) 18' Sanitary seal (YIN) YES Wires property p (YM) YES Data of test Static water level Well production WATER SAMPLE FROM WELL LOG 3/1984 0.42 g.p.m. 0.^751 AT INSPECTION 8/7/2000 <25' 0.50 g.p.m. Date of sample: 11/28/2000 Collected by: A.W.W.C.. INC. S. SEPTICIHOLDING TANK DATA 'THIS A BIOCYCLE TREAMENT UNIT "INSIDE CRAWLSPACE Date installed 11/13-15/00 Tank size • 1500 Number of Compartments 4 Cleanout (Y/N) YES Foundation cleanout (Y/N) "TES Depression (YIN) NO High water alarm (Y/N) YES Date of Pumping NEW Pumper - C. ABSORPTION FIELD DATA *FROM FINAL GRADE Date installed 11/13-15/00 Soll rating (g.p.dJfl2 0l drtn 3.0 System type TRENCH Length 30' Width 5' Gravel thickness below pipe 0.5' Total depth •3'-6' ERecSve absorption area 150 SQ.FT. Mont" Tube present (YM)�Y S Depression over field (YIN) NO Data of adequacy test NEW Results (Pass/Fail) – For 3 Bedrooms Fluid depth in absorption Reid before test On.); Fluid depth – (Ins) Minutes later. Peroodde treatment (past 12 months) (Y/N) 72-M IRM. 5Wr CWWA8r V.man Immediately atter – gal. water added pn.): — Absorption rate = B yes, give date – D. LIFT STATION ' *THIS IS A BIOCYCLE TREATMENT UNIT Date Installed 11/13-15/2000 Size in gallons • 1500 Manhole/Access (Y/N) YES 'Pump on' level eY 30.5" •Pump oft' level at' High water alarm level at' 45" —*Datum BOTTOM OF TANK Cycles tested NEW E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Sepddholding tank on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main N/A Public sewer manhole/deanout N/A Sewer/septic service line 25'+ LHt station 100'+ SEPARATION DISTANCES FROM SEPTIVHOLDING TANK ON LOT TO: Foundation 5'+ Property One 5'+ Absorption field 5'+ Water maintservice line 10'+ Surface water/dralnege 100'+ Wells on adjacent lots 10o,+ SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO: Property line 106+ Building foundation 106+ Water maiNservice line 10'+ Surface water 100'+ Driveway, parking/vehicle storage area 50'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. ENGINEER'S I certify that / d field lnspecYons and review of Muhl lost s t systems are /n conformance with MOA g d on Uds date. Signature Engineer's Ned// JEFFREY A. GARNESS Date Z -6Z -6/ I On d':10 HAA Fee Date of Payment Z 0 d Receipt Number O u 7 O ( Zq nose (nw. wear CMPAW VOrdDn Waiver Fee Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION Environmental Health Division CASE REVIEW WORKSHEET CASE NUMBER: Z-85-74 DATE RECEIVED: July 1, 1985 COMMENTS DUE BY: July 22, 1985 SUBDIVISION OR PROJECT TITLE: Lot 1 Block 3 Broadview Subdivision ( ) PUBLIC WATER AVAILABLE ( ) PUBLIC SEWER AVAILABLE ( ) COMMUNITY WATER AVAILABLE COMMENTS: 'If- 5�"t�-�,'(�i'Z' f ►ro Sem 'C' s Sty----� t!��'- 'o .1. TLc 71, -,.e-- tin ccLS�- k,.-_ 71-014 (Rev. 5/83) THE MUNICIPALITY OF ANCHORAGE ZONING BOARD OF EXAMINERS AND APPEALS APPLICATION FOR VARIANCE Building Permit: U'� <3003 Applicant: �40wA 9-1;? RYSMA4 Address: Z50-7 1U'&b #-VVIA TZJ Phone Number: z�t-1`-o�t61 Legal Description of Property Involved: Lot 1 Block 3 Subdivision b V0-0 V %a4,00 So ljr- Present utur Use of Property St�►sl e. F�,�1ti i�es� �e•.cra DU — -_7 D F S/ZE' _7 c,:24 SITE PLAN REQUIRED. This is a request for a variance from Section 02 /. 6 -0 q0 C �� Z L3 _Eof the Land Use Regulations Ordinance /-=- (- Tax Assessing No.: 050 a2-1 15"*' DO NOT WRITE IN THIS SPACE .� 3/- 6-61.c2' Date Received: r Receipt No.: k �P-/'9C elk �� /0 Z.B.E.A. Case No.: zf- r`f Hearing Date: --�s- SPOSITION Approved Denied Conditions: Date of Appeal: Hearing Date: Approved Denied Conditions: Letter Sent: Permit Issued: —7 (See Minutes) (See Minutes) A. The existing situation: cmx�� 64 li 4rlayk<Dlw� Oio't' wtdg, ai We** erQ) 'a,,P bas .4" QV04-ele s bpe, o91 10%. - C-kOP. o t 'IP-Ul I's Qv- rock ,3c� r► i r? S Q s (R -G rfxa ,%ev+ b V IMw5 1 . B. Granting of this petition would permit: 14 S1 -V40-- Cay')14 �Pe 44TY4 lryV ��% SVS ►"�t�n ,i. as �o y?�a�lfr•l lour �5ezgt,p� py-wftj ^+kc se ++c � bW grime., af�rA INN ase •fro km Coy.SjrvucAq-& 6n A#*- p6 A -t(, . 0; 10+ LV Nem be nick iS o C- u sC s u v - a e Sep yS V V"o i r.S . BEFORE A VARIANCE MAY BE GRANTED, THE APPLICANT MUST PROVE THAT EACH OF THE FOLLOWING SIX CONDITIONS HAVE BEEN FULFILLED. ANSWER EACH OF THE CONDITIONS IN DETAIL, USING ADDITIONAL SHEETS IF NECESSARY. The undersigned alleges that: 1. Special conditions exist which are peculiar to this land, struct re of building involvgd and are not applica le to other land/structures in the same district. These special conditions are: i On\4 S i 1"S 5 v 4 4-k sk -a �� t, <Aj S AA-., c.ow\ a. cin 6.a. ) v.$4a 1 a -,,044--t. r 'r .lam. 44\1 Sm S W.*, LW cL ll.. 34z ltd -Ik s 1.04 W ZS G.re.-,t.ke4x S V �C�t 1�� S l or. 1 h j9'10� .�•�2'�s ^ak d4r^-6 r ►,, I (over) 84-046 (5/84) Front 2. Strict interpretation of the provisions of the Zoning Ordinance would deprive the applicant oft he rightsq ly enjoyed by other properties in the same district under the terms of the Ordinance. These rights are: - he righ woo W"(e-6) w.JN4 m -,,P R-5 Se,4 asks wav�Cl �xrolt� i �' Sept -i c, s 3. The listed special conditions and circumstances do not result from the action of the applicant and su h condi- tions and circumstances do not merely constitute a pec�uniary (monetary) hardship or inconvenience in that: ,( 4. Granting of the variance will be in harmony with the objectives of the Zoning O dinance an neighborhood or otherwise detrimental to public welfare for the following reasons: �t3�� IC 'E'� I s dr`4�tar� d C s� 1� W D �,� �'�►� � �� 2 _. l 5. Gran ing of the lies in that: I It; permit a use that is injurous to the tted in the dittrict in which the ►� Su C- \Zyra0 -�c� Vr2-lour¢. a 6. The variance granted ithe minimum varia ce that will mpke possi le a reaso ble use of the land building or structure in that: moo"�� s [�'} W, i� -z\ l ow V'W,. V i2- CQ ar- 0442Iv \s e. a4IVx0%iy r u I Z� Applicant further alleges that: (Use additional sheets if necessary for additional information.) 1 ,') st C7 RU f- 770-310 ap&,L.a IR -k U G 1� Address (O 23 I? 0500 Signaww6lfland Owner :2,-07 9 W a 0 *V,C "RA (S19 A!^ Address l� 9 � 3 84-046 (5/84) Back '2- 7 7— 0 2 b to LLG>. NO: c(ifiss (".-v Mcin-jmtnt Iron ripe 5/a' x 3o" P;AUar ;imeev Hub & Tark tr-rehy rt.,(o"y That f ;lave surveyed (-ol h3ve rev,1.4cad -AI 'ost with 5/-k" reba. It o, or;(.),, to L;.)n3-`.!UM','rl, V) vel-;jy i '), i iCt, J o 0 utl!:.,yi;.-jnnecl— s, ak iU e,.,jie.ar on thDl,l,!dl a! knchorj,.i-,, thi,;c. - 0 N 53 18 U CF! k; LN 4 iF. 113, IN C. .3 C 1.:,.jW 11 p r C, 1. l0q, 5-/ MoA/ 4"C�L O SEK/.5 T� i W/NN (UNS'UB D/ V / DE DD h 0 :.-i0'UTici7y �A �EME'.vTs O A./ 84 E,4�ST P a IN ¢ CURVE OgT-A v 7i Ap a3o.Gb� O a T= 37. m 31.8/ \ py- N 3Z, ZB7Sf air R BG OC/S© .250. oc-, 7F. S 7.58' 3334Y 3 70. B/' io'e,,riciry 4/005 -7 EgSEMENT � ` \_ EX /S r '� FToslD ANO DEO/GqT/GN /MOL/EO oR /N rE//Dev Y 7W15 Z I 7-[/RA1AR0G//S/O A-4SA6AfAr 75 3 � O � lt4 o° h �Q ~ � � 5 /� 8/35• F. D � V \ N A SB9�¢Q' o •eF �9 �S, 9B�s•F o C h 250.// h 0 :.-i0'UTici7y �A �EME'.vTs O A./ 84 E,4�ST P a IN ¢ CURVE OgT-A v 7i Ap a3o.Gb� O a T= 37. m 31.8/ \ py- N 3Z, ZB7Sf air R BG OC/S© .250. oc-, 7F. S 7.58' 3334Y 3 70. B/' io'e,,riciry 4/005 -7 EgSEMENT � ` \_ EX /S r '� FToslD ANO DEO/GqT/GN /MOL/EO oR /N rE//Dev Y 7W15 Z V \ 45�i4os.F. 2 h 0 :.-i0'UTici7y �A �EME'.vTs O A./ 84 E,4�ST P a IN ¢ CURVE OgT-A v 7i Ap a3o.Gb� O a T= 37. m 31.8/ \ py- N 3Z, ZB7Sf air R BG OC/S© .250. oc-, 7F. S 7.58' 3334Y 3 70. B/' io'e,,riciry 4/005 -7 EgSEMENT � ` \_ EX /S r '� FToslD ANO DEO/GqT/GN /MOL/EO oR /N rE//Dev Y 7W15 2507 Blueberry Rd, Anchorage. Alaska 99503 May 31. 1985 TO WHOM IT MAY CONCERN: I, Howard D. Buvsman. do herebv authorize Rod A. Grill of RODNIC. INC. to act as an agent for me in the matter of the variance of Lot 1. Block 3 of the Broadview Subdivision. to be heard on Julv 25. 1985. 2507 Blueberry Rd. Anchorage. Alaska 99503 May 31. 1985 TO 'WHOM IT MAY CONCERN: I. Howard D. Buvsman. do herebv authorize Charles A. Landers. Surveyor, to act as an a--ent for me in the matter of the variance of Lot 1. Block 3 of the Broadview Subdivision, to be heard on July 25. 1985. �Nly Pa.Ss+BLs LcrA-OoN FbC "E-pTv— SYS.-T� l Ma`I A QEr> s-'s-mvv\ DUG TO 4 (,.A G'zOUh)O wAT&el K6-1 TO l?f}OToGR#1?4:s LCCA,-noQ -.P. imeecrX00