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HomeMy WebLinkAboutHUISINGH LT 2Hui ingh Lot 2 #015-521-08 . ' Municipality of Anchorage Page / of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519L6650 · Telephone: 343-4744 On-Site Wastewater DiSposal System and/or Well Inspection Report ' ,. Permit Number: *-~'lt'/~)Tc:~..~7/ .. · PID Number: (O/-~-5o?/~o° Name: &~/E~ ~K~ " WasteWater System:' D New XUpgrade ~u~.: ABSORPTION FIELD ,,o,: ~ Deep Trench D Shallow Trench DBed DMound QOther , Total Depth from~r~inal grade: · LEGAL DESCRIPTION so,.,,.~: 0,~ ~.~s~.~,. Lot: ~ Block: * Subdivbion: Depth to Ripe bottom~from original grade: Ft. Gravel depth b~h pipe ,ow_~ _,o,: :,lladdedaboTor;~a~grade: Grave ength: ~ - - Ft. Ft. WELL:~BDNew U Upgrade~ Gravelwidth: ~ / NumbeTf lines'. Distancebe~eenlin~: Ft. . - Ft. Classification (Private, A,B,C): ~ Total ~ ~ased To: Tote absorption area: ~ Pipe material: / Driller; ~ Date Drilled: ~tatic Wafer Level;Ft. Inst~/~ ~r Date In~.talled'~ Yield: ff Casing Height A~ve Ground: / s,~ [ ,~m~ S,~,,:~,, ~. TAN K SEPARATION DISTANCES ~s,p,c a Holding D S.T.E.P. To Septic Absorption Lift Holding ~ubllc/Private Manufacturer: ~ Capacity In gallons: 'rom Tank Field Station Tank Sewer Lines ~~ ~ I~~ WOIV /~ /~ ~'g. % g~; Material:5~ ~ Number of Co~,ments: ' Su,aCewater /~ ~ I~ ~' I 00 ~ ~ ~ Size J0 gallons: I Manufacturer:LIFT STATION~Z_ Line )",m"': I Cu.alnDrain ~ / ~ ~ WOt )~ ~ 05 Remarks: ~/~C T~c~ ~7~ ~ ~ BENCH MARK Location and Description: J Assum~ Elevation: Inspections pedormed by: ~~~._ _-?~s: 1st :~?~'~7 ~~~-'-..,,:~' ~gle River, Alaska ~5~ ~;~' lO ' ~ ~* t ROBERT C COWAN Department of Health and Human Se~ces approval ~{ ~:.., ............. Reviewed and approved bY: ~~ C. ~ Date: II,~'~'~ ~"?~:~:":~'~.,~~, 72-013 (Rev. 9191) MOA 25 ~ #0. SW970371 ~.M~ 2 ~, 3 Plu nicip..~_ti$ y~o. ~ anchoraae DEPARTMENT OF HI:ALIbi AND HUIWAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.D. Box 196650 eAnchorage, A[ask~ 99519-66501Telephone: 343-4744 ON.SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LOT 2, HUISINGH SUBDIVISION PSD. NO. 015-521-08 EXISTING NEW TRENCH-x~ NEW 500 GA LIFT STATION NEW 1250 SEPTIC TANK 1/4" X EXST. 5 BDRM HOUSE FCO A ST~I - ST2 - C01 84.5' MT1 82._~' co21 117,.o' MT2 11~,.51 FD 8 t .S B C - 26.5' - 25.5' - 18.5' - 17.0' - 16.5' 5/'.0' - 50.0' - 98.0? - 97.~' - 49.0' - D 19.5' 21.0' 28.5' 31.0' 32.5' EXST. WELL TH INSTALLED FLOW DIVIDER ~ !i0, SW970371 P.III~ 3 I~' 3 Hunicip. o, Li~ oF Anchoraae DEPARTMENT OF HEALTHAND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 eAnchorage, A_~ask~ 99519.6650eTe~ephone: 343-4744 ON-SITE WASTEWATER DISPOSAL 5YSTEM AND/OR WELL INSPECTION REPORT LOT 2, HUISINGH SUBDIVISION P.I,D. #0. 015-521-08 ST1 ST2 /FINAL GRADEk MH 97.2' FINAL MT1 CO1 MT2 C01 = 99.0' .~...--'""~C02 = 98.5' MT1 = 91.4'./""" MT2 = 91.5' · NO WATER FOUND 81.4' B.O.H. CO1 = 95.4' C02 = 95.5' MUNIC,_.,~LITY OF ANCHORAGE BUILDING SAFETY 3500 EAST TUDOR ROAD, ANCHORAGE, ALASKA INSPECTIONS: Voi~e: (9~7) $~J. J454 Fwd: (~07) $45~235 INFORMATION.. (907) 343-8211 NAME: HEAVENLY LITES ELECT PERMH'NUMBER: 97-9082 ADDRESS: 5320 OMAI.F.Y RD DATE: 10/30/97 06:~0 AM PHONE#1:242-6847 PHONE II2: LOT.. I BLOCK: SUBDIVISION: HUISIN~H LIFT STATION ONE DRIVEWAY 2 HOUSES TH~ ONE TI~'~t~RTI-IER BACK COMMENTS #1: 02: #J: ~ is a r~ TYPE OF FA~cuicalRough ~ ~ ~~ ~ ~PECTION ~ d~e~a ~ W~~at~~n. ~ ~not~M~-~. ~ C.C.O.a~v~(~~low). ~E: .131?gPECTOR: ~'Z~,N COlem~criONS.Xtu~ stao~, oO ivor iw~OV~, rrna ~VOT~C~,. 88~Q PAGE 1 OF MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUM_AN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT NUMBER:SW970371 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:HUYETT HARVEY L OWNER ADDRESS:5320 O'MALLEY ROAD ANCHORAGE, ALASKA 99516 PARCEL ID:01552108 (UPGRADE) PERMIT DATE ISSUED:10/15/97 EXPIRATION DATE:10/15/98 LEGAL DESCRIPTION: ~,~N~H LT 2 LOT SIZE: 53232 (SQ. FT.) NUMBER OF BEDROOMS: 5 THIS PERMIT: 5 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD SYSTEM 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 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: Rick Mystrom, Mayor Munleipality of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 October 16, 1997 Robert C. Cowan, P.E. S & S Engineering 17034 Eagl~ River Loop Road Suite 204 Eagle River, Alaska 99577 Subject: Waiver Request for Lot 2 Huisingh Subdivision Waiver Request #WR9700~=~, PID #015-521-08, SW970371 Dear Mr. Cow,mm Your request for a waiver of the required 10 foot separation between an on-site wastewater disposal system and a lot line has been approved% The waived distance is 1 f~tt from the old and new absorption field to the property line. This approval applies to the existing on-site wastewater disposal system lot line separation only. Any future upgrade to the on-site wastewater disposal system will require all separations be met or another approval from this department. If there any further questions or concerns regarding this waiver, please call our office at 343-4744. Daniel J. Roth On-site Services ljw #7 Huyett MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR~ WR970064 PID~ 015-521-08 HA9 Date Received: October 7, 1997 Legal Description: Lot 2 Huisin§h Engineer: Applicant: Waiver Requested: old and new. Permit Robert C. Cowan, P~E., S & S Engineering 17034 Eagle River,Loop Road, Suite 204, Eagle River~ Alaska Harvey Huyett 99577 Lot line waiver of 1 foot from th~ absorption field Criteria: 1. Geology: Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: Special Conditions: 3. Other: Waiver is Granted: ~ Waiver is NOT Granted: List Conditions or Reasons for above: ~ f~/~£~ /~/~6~ Date: /~--/~'--- f7 By: ~ Name of Reviewer Rec ~: #03327/3832 Amount: $ 115.00 Date Paid: 10-7-97 ROBERT C. COWAN, P.E. CIVIL ENGINEERS October 6, 1997 (907) 694-2979 FAX (907) 694-1211 HEALTH AUTHORI3Y N~PROVALS SEWER&WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERtNGSTUDIES ~gND REPORTS WELL INSPECTION & FLOWTEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSAL SYSTEM DESIGN MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 2, Huisingh Subdivision Request you issue a permit to upgrade the septic system for the existing five bedroomhouseonthereferencedproperty. At-~o e. ta,,~,~7- ~ ~r A test hole was excavated and percolation test performed. The approximate location of the test hole is located on the attached site plan. The monitoring tube within the test hole has been checked and found to be dry. Attached is the proposed upgrade design. We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the installation of the proposed septic system. If you require additional information, please contact us. Sincerely, Robert C. Cowan, P.E. RCC/mg Enclosure MUNiCiPALITY Ol: ANL~HO; ENVIRONMENTAL SERVICES DIVISION OCT 07 1997 RECEIVED 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 1" =60' ~GALE / DESIGN 10' UTILITY ~.ASEMIgNT SITE-PLAN LOT LINE REQUESTED EXST. --J ~ DRIVEWAY TOTEM ROAD Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: Township, Range, Section: SLOPE SITE PLAN 10 11 12 13 14 15 16 17 18- 19- 20- WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT ~ ~) DEPTH? P Depth to Water Alter Monitoring? ~) ~y Dale: Gross Net Depth to Net Reading Da~ Time Time Water Drop ',A,3A t - - , /~ ro ~ '~ ~ ,~ ~ ~ ~1 /~_ ~ / ~ ~1: ~ ~ ~,~ ~'/~" -,/~,~ ~ ' ~ ~ ~ I~ ~o ~ ~/~. ~o""7 PERCOLATION RATE I ~ {minuteshnch) PER~C HOLE DIAMETER TEST RUN BETWEEN ~"~ / FTAND ~ / FT COMMENTS S & S ENGINEERING - //~/~// ~' PERFORMED BY: .......... ~1/'''''y/~''~- ~ / -~ CERTIFY THAT TH~ TEST ~S PERFORMED IN 17034 Eagle Klver Lffi~ K~a ~o. ~ /- - -~ v - /_~ ACCORDANCE WIT~~~ GUIDELINES IN EFFECT ON THIS DATE. DATE: ~ ~ ~-~/ 72-008 (Rev, 4/85) ROBERT C. COWAN, P.E. CIVIL ENGINEERS HEALTH AUTHORITY APPROVALS SEWER&WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE pLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ONSITE W.~,,ST EWAT ER DISPOSAL SYSTEM DESIGN ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS (907) 694-2979 FAX (907) 694-1211 REFERENCE: Lot 2, Huisingh Subdivision October 6, 1997 GENERAL: 1. The scope of this project includes the installation of a 500 gallon lift station and a two bedroom leachf~ld trench to serve the existing five bedroom residence located on the referenced property. The existing trench passes for 3 bedrooms. The existing 1500 gallon septic tank is to be checked for integrity. If of poor integrity, it is to be pumped, crashed, and abandoned completely and replaced with a new 1250 gallon septic tank. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The contractor shall be responsible for obtaining any necessary underground utility locates. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 17034 NORTH EAGLE RIVER LOOP ° SUITE 204 ° EAGLE RIVER, ALASKA 99577 Page Two Lot 2, Huisingh Subdivision October 6, 1997 Septic tanks installed with less than 4 ft. of cover shall be insulated. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed-up) before gravel (sewer rock) placement. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill o Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. Page Three Lot 2, Huisingh Subdivision October 6, 1997 Backfill over the fmal gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. MINIMUM MATERIAL SPECIFICATIONS: Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: T_vpe of Pipe Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements, which ever applies. Page Four Lot 2, Huisingh Subdivision October 6, 1997 INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required: Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre-construction meeting will take place on-site. The inspecting engineer will not coordinate; direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER U ~ MUNICIPALITY OF ANCHORAGE ~ "" ':' iS DEPARTMENT OF HEALTH & ENVIRONMENTAL PRoTEcTION ,' ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON ITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT PHONE ~NEW ~f~.~.~3Y-. ~'~aY,,~.,q :~.-S(.{.~I C~U,~RADE NAME MAILING ADDRESS LEGAL DESCRIPTION Well I Absorption area Dwelli g DISTANCE TO: I [ ~ O I B~ Material Manufacturer ~~ length ~1~ Width Dwelling Well %~-5 DISTANCE TO: I Length of each,~. No. of lines ~ Top of tile to finish grade A~ OW Material Nearest lot line =oundation ._[. ~ I Trench w~ %0 Total length of li~ inches Material beneath tile -5 ~ 0 ~ inches Depth Width neter Crib depth TotaJ effective absorption area Building foundation Nearest lot line Driller Distance to lot line Building foundation Depth DISTANCE TO: Sewer line PERMIT NO. ~[ ~:~) No, of compartments PERMIT NO. Liquid capacity in gallons PERMIT NO. Distance between lines Septic tank PERMIT NO. ~. Absorpt on area(s) OTHER SOIL TEST RATING INSTALLER REMARKS DATE LEGAL PERMIT NO. APPLICANT FRANK MOKRY SRR l?~DR OMRLLEY RD ~49 56~ LOCATION OMALLEY NEAR SPRDA CIRCLE LEGAL Ti2N R~W S22 LOT 5 LOT SIZE 5~000 SQUARE FEET ITYPE OF SOIL 88SORBTION SYSTEM IS: TRENCH I MAXIMUM NUMBER OF BEDROOMS =.j= ~UIL RATING ~=,Q FT/BR>= 85 ' ' ~'Z,~/O' .=- AASORPTION/~'q ' IS THE REWUIF. ED _I F THE :,UIL ~_TErl : ~/ ,/' THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH'OF R TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE E×CAVRTION (IN FEET>. ~HERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFRLL PIPE AND THE BOTTOM OF THE EXCAVATION <IN FEET>. RE~IJIRED~ SEF"TIBE: TF:[~k: SIZE: 150El ,]R£_LONS PERMIT APPLICANT HAS THE RE_,PON=,IBILITY TO INFORM THIS DEPARTMENT DURING 'rile INSTALLATION INSPECTIONS OF ANY WELLS 8DJAF:ENT TA THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. Tl...If_..'l ,-": Z .':,, I ~SF"EF-:T I B3P~S · ,F-'E RE~;}LI I REE) E,H~KFILLING OF ANY 5Y=,TEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE =.UBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN 8 WELL 8ND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR 8 PRIVATE NELL~ OR 150 TO 200 FEET FROM R PUBLIC NELL DEPENDING UPON THE TYPE OF PUAL. IC NELL. WELL LOGS ARE REQUIRED 8ND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DRYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION PERI.1 I T E~-~.P I RES [:.EC:ErqBER --~'~ .. I CERTIFY THAT l: I RM FAMILIAR WITH THE REt~UIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE, 2: I WILL INSTALL THE SYSTEM IN ,ACCORDANCE WITH THE CODES, ~: I UNDERSTAND THAT THE ON-SITE SENER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 5 BEDROOMS. R~RNT FRRNK MOKRY C ADDRESs WELL--SITE ...................... ~_~.d. ............................................................. DAT~STARTED ............ ~.~l~ .............. /..~ct:..._~. ................................... DAT~E,,DE,, ................... ,':...~? ............... ~..~.';../... .................................. KIND OF FORMATION: FROM .......... ~ ........... FT. TO ........ .'::7 ......... ~.....C.:./.'.~.~..~ FROM----./-.7 ........... ~.TO.../.:,a ........FT ........ ~zl ............ FROM .......................... FT. TO .......................... FT ......................................... FROM .......................... FT. TO .......................... FT ......................................... FROM ......................... FT. TO .......................... FT ............. : ........................... FROM .......................... FT. TO .......................... FT ......................................... FROM ........................ FT. TO ......................... FT ......................................... FROM .......................... FT. TO .......................... FT ......................................... FROM ......................... FT. TO .......................... FT ......................................... FROM ........................ FT. TO .......................... FT .............. , ........... i .............. FROM .......................... FT. TO .......................... FT ......................................... FROM ........................... FT. TO .......................... FT ......................................... DEFTn OF WELL ...................... ./..~.~ ............................................ STATIC rEVEL OF WATER FT....L.._~....~.. .................................................... DRAW DOWN .................................. : ....... .~ .......... ~ ............. :. ........ :: ............ FROM .......................... FT. TO .......................... FT .......................................... FROM .......................... FT. TO .......................... FT ......................................... FROM .......................... FT. TO .......................... FT ......................................... FROM .......................... FT. TO .......................... FT ......................................... FROM .......................... FT. TO ......................... FT ......................................... FROM .......................... FT. TO ......................... FT ........................................ FROM .......................... FT. TO ....................... FT ................................... FROM ......................... FT. TO ......................... FT ..................................... FROM .......................... FT. TO .......................... FT .................................. FROM .......................... FT. TO ....................... FT ................... ~ ................. FROM ....................... FT. TO ......................... FT .................................... FROM ......................... FT. TO ......................... FT .................................. C MISCL. INFORMATION: RUMBURG DRILLING 7220 E. 22N0 AVENUE ANCHORAGE. ALASKA 99504 PHONE 333~2423 Nsme Address Phone DESCRIPTION /:2.2 / Job No. STATEMENT © Q CONSULTINQ G[OLOGIST ~OX 416-M, STAR }~OUT~ A · ANCHOr?AGE. ALASKA 99507 · PHONc 344-707! SOILS ]lOG Performed rom, x2[ ~. t5 t ~q.~x D_epth (feet) Soil Descri~)tio~ --0-~,~ O-Z ~) ~5~¢~xx-~ ' ' .' ~ '; -18- 32 ~' -20- · otal Dept~.[~ ..... feet in ~b~ Was grotundwater encomatered /~ ~ What depth -- Depth to bedrock ~_O How determined k~J¢/~ oa~ ~J ~ Respectfully submitted c-~ ~_ tl~ - Gary F. Player Consulti~tg Geologist Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www. muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-521-08 GENERAL INFORMATION Complete legal description Location (site address) COSA # ~ Expiration Date: HUISINGH LOT 2 5320 O'MALLEY ROAD, ANCHORAGE, AK 99516 Current Property owner(s) FNMA Day phone Mailing address Lending agency Day phone Mailing address BOB BROCK Real Estate Agent · ~. '~.,~ .,- . lin AddreSS.. ~ Un'less otherwise requested, COSA will be held by DSD for pickup. NUMBER OF~BEBROO~S: 5 Day phone 261-7678 TYPE .OF WATER Sl~l PPLY: IndividUal~Well Individual Water Storage Community Class Public Water System Well 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 Systems 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 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 SPURKLAND ENGINEERING Address 203 w. 15TH AVE. STE.202, ANCHORAGE Engineer's Printed Name LARS SPURKLAND DSD SIGNATURE \/,// Approved for Disapproved. Conditional approval for bedrooms. Phone 279-3916 Date 11/15/2011 bedrooms, with the following stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: a,/i'":"'~ / ) ) (Rev. 11/05) Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.o, rg/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: ~utstneR ~.o~( 'L. Parcel ID: OIS A. WELL DATA Well type · D~ate completed ~lI~ Total depth I'L'[. ft. If A, B, or C provide PWSID # ~ Sanitary seal (Y/N) ~ Cased to 1~.7-. ff. Well Log (Y/N) '~ Wires properly protected (Y/N) Casing height (above groundl Y in. FROM WELL LOG Date of test ~ q 5~ [~ ~ Static water level (,'Z t ft. Well production 'LO g.p.m. AT INSPECTION qJ2~12olO 5.3 g.p.m. WATER SAMPLE RESULTS: Coliform /~e. colonies/100mL Nitrate 1,5~ mg/L :.Arsenic: B. SEPTIC/HOLDING TANK DATA · Tank Type/Material' I Tank size 1~,50 gal Number of Compa~ment~ ~ Collected by: ! Date installed (OJZ'51lql~ , Cieanouts (Y/N) ~/ Foundation cleanout (Y/N) ~ Date of pumping 0~.~ ?.Z)[O ~t Pumper' Af ~ ~¢rv~'c~ A~P~ FIELD DATA ~ ~o~ ~n~ 3;.c~ ~u~p;~ Date ins~lled m~J I~ ~il m~ng (~ ~/bd~) O,G Len~h G3 fl. Wi~h g ff. q~o~ Total depth ~'~ E. Eft. abso~tion area ~ ~ Monitoring tube Da~ of adequacy test q~Z~ ~[0 Resul~ (Pa./Fail) ~ Fluid depth in abso~tion field before test ~ in. Elapsed Time: I0ZO min. Depression overitank'~N) A~ High water alarm (Y/N) /V' Final fluid depth Any rejuvenation treatment (past 12 mo.) (YIN & type) System type D~-~ Gravel below pipe ~ Depression over field Water added J000 gal. in. Absorption rate >= JV'o,e ~u/v't If yes, give date For ~ bedrooms New depth ~;~ in. -~ g.p.d. D. LIFT STATION Date installed !o!1,~, "Pump on" level at HI' in. E. SEPARATION DISTANCES Size in gallons 500 Manhole/Access (Y/N) ~(¢~ "Pump off' level at q. [ in. High water alarm level at ~7' Cycles tested /V'~v ~l~t~ Meets alarm & circuit requirements? Y in. SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot IOO ~' On adjacent lots Absorption field on lOt Joo ~ On adjacent lots Public sewer main Sewer/septic service line Animal containment areas ,.,-CO~ -I. (/[/. O.~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: ! Ioo ~' Public sewer manhole/cleanout /V'/,~ Holding tank Manure/animal excrete storage areas Io0~ (/V. 0.~ Building foundation ,~.! ~. Property line 5 ~ Water main /VIA Water service line J0 ! f ! Absorption field 5' ~' Surface. water' .100'f ~N,O.) Water main / V~/A, Driveway. parking/vehicle storage Wells on adjacent lots [00 t' Water Service line 10' Curtain. drain 50 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line ~' I [ Building foundation I0~' Surface water ~l~O"f ( Wells on adjacent lots tOD ~f F. COMMENTS G. ENGINEER'S GERTIFIGATION I certify that I have determined through field inspections and review of Municipal records, ff~t the above systems are in conformance with MOA iCOSA guidelines in effect on this date. Engineer's Pdnted Name L.4rz5 ~0~f'kt ~, c~ % Date it1' 151 ~,O[ O Date of Payment Receipt Number (Rev. 4/10) Waiver Fee $ Date of Payment Receipt Number Municipality of Anchorage Development Services Department Building Safety DMsion On-Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www. muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING ParcelI.D. OI5- 5Zt-O~° GENERAL INFORMATION Complete legal description cos^# Expiration Date: ~'-'- ,/ ~7"-" I/' Location (site address) Curren,t Property owner(s) Fe~r~ Mailing. address Lending agency" A/~)n'~-,~l ~'~.~e A~5oc, Day phone I Day phone Mailing address Real Estate Agent [5ob ~ro(,~ Mailing Address unless otherwise requested, OOSA will be held by DSD for pickup. 2. NUMBER OFI- BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class ~ Well Public Water System Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site [] Individual Holding Tank J--]. 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 Systems 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 homeownem. 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 propedies served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the.professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown beloW, I verify that my. investigation, 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 Engineer's Printed Name DSD SIGNATURE ~ Approved for 3 bedrooms. Phone 2~'/- 3?/C, Date l/~(Z;Wo Disapproved, Conditional approval for ,e t, bedrooms, with the following stipulations: By: Attachments:· COSA Checklist Septic System Advisory Well .Flow Advisory Nitrate Advisory X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other (Rev. 11/05) Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519-6650 www. muni.org/onsite (907) 343-7904 Legal Description: A. WELL DATA CERTIFliCATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST ~4~5i~J~ Lo~ ~ Parcel ID: Well type, Pt'i~ R~C Date completed ~_~."~ Total depth J7.7_ ff. IfA, B, or C provide PWSID # --" Sanitary seal (Y/N) ¥ Dis- 5z1- 09 Cased to ~ 22. ft. Well Log (Y/N) ~/ Wires properly protected (Y/N) Casing height (above ground) FROM WELL LOG AT INSPECTION Date of test /~1~,~3I' Jl']r;~ ~/I Z~i/ZOlO I t Static water level 67.. ft. (oZ' ft. Well production /~0 g.p.m. ,,cf~ g.p.m. WATER SAMPLE RESULTS: Y Coliform N"(.~. colonies/100 mL Nitrate /~O mg/L Collected by: L~,~'.~ ,-~w.~-I~J: Date installed J0[~3] Cleanouts (Y/N) High water alarm (Y/N) /V' System type Arsenic: A/D ug/L date of sample: ~li~lZolO B. SEPTIC/HOLDING TANK DATA Tank Type/Material A~cl~n~. T~[/ I Tank .s~ze l~r"JO" g,a!,. Number of Compartments '~- Four~da~ion deanout (Y/N), ¥ Depression over tank (Y/N) , /V' Date of pumping oc~ge~. ' Zoto Pumper ~-t ~, C. :ABSORPTION FIELD*DATA ' :.. '.' ' ~l.~-'~ (, ~'t3-9 , Date installed lo!Z~]l'N~, 'Soil rating (~~or ff2/bd~m) 0.(~ Lehgth · (,.~ fi: Width .~ ff. Total depth' ~',~*' ft. Eft. absorption area 50¥ ft2 Monitoring tube .. Date of adequacy test ~j!~l[/..oto Results (Pass/Fail) ~',~$.~ Fluid depth in absorption field before test 'Zo in. Water added 'ice0 gal. Elapsed Time: toZo min. Final fluid depth. ~7.. in. Any rejuvenation treatment (past 12 mo.) (Y/N & type) Gravel below pipe ~ ft. Depression over field ~V' Absorption rate >= ~(now~ If yes, give date .in. For .~ bedrooms. Newdepth ~ in. '~O g.p.d. D. LIFT STATION Date installed jo!zs]l,~,r~ Size in gallons 5oo "Pump on" level at ~/! in. "Pump off" level at ~1~ in. Datum ~,'" T~,~ Cycles tested /v'tw ~)um[p '[,,~tx t~ o~.¥. ~o E. SEPARATION DISTANCES Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? in. Absorption field on lot Public sewer main Sewer/septic service line Animal containment areas SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot ~oo ~ 7. S~· So ~, N.O On adjacent lots lO0~} t On adjacent lots !oo Public sewer manhole/cleanout Holding tank Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation S '-F Property line $ ~ Water main /V/A Water service line 10 ' t- Wells on adjacent lots [00 I- Absorption field Surface water [00'+ G= SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line e 1t Building foundation {0'~- Water Service line [0'~ Surface water /00 ~{' (~.0,'~ Curtain drain .~0'~ (/V',O,) Wells on adjacent lots [00 COMMENTS ENGINEER'S CERTIFICATION Water main /V/A Driveway, parking/vehicle storage 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 COSA Fee $ /'"// Date of Payment Receipt Number 0 t~O ~:~',~) (Rev. 4/10) Waiver Fee $ Date of Payment Receipt Number CUSTOMER · 7501 E. 140th Avenue Ancho.rage, Alaska 99516 345-].890 Spurkland Eagineemg INVOICE # 39011 Block Lot DATE DESCRIPTION AMOUNT ..~ ...... ~ -.,:.. :.:~'"~.. '; .,,..~:'-, .. ,., :',:~,i:," ":':"~!;r":Z~'"" 07/07 1500..gallons, 3 st~ioes (ldus 500 ea!!_~ ]it~'j 3'~S' B-o$~.~' .. ~.!:, ....... :',,:,' ..... ', /65 '~'~ Gallons ~ Septic X Leach Ama Hilding Tank 8ta pipes Time ['~ PROBLEM AREA ~ CALL FOR MORE INFORMATION ~I NEEDS TO BE DONE AGAIN IN 6 MONTH8 [] Good Shape [] 81udge Buildup on Bottom [] Floater on top [] Jim cap missing or E] Cut standpipe to 1' above ground [-'1 Needs Septictfine needs replacing Page: 1 https:llfast.firstam.net/smsfast/imaging_WB/pub/pages/preview.html?isSingle=l &Reposit... 10/7/2010 Municipality of Anchorage · Development Services Department Building Safety Division On-Site Water & Wastewater Program . ~,, .4700 South Bragaw SL .... P.O. Box 196650 Anchorage, AK 99519-6650 .... : ' www.d.anchorage.ak~[~s '. · (9O7) 343-7~04 CERTIFICATE Of HEALTH AUTHORITY APPROVAL FOR A SINGLE'FAHILY DWELEING Parcel i.D. el ~'~-521-08 ¶. GENERAL INFORMATION Expiration Date: '7- ~.. ~ -' O ! Complete legal descdpflon LOT 2; HUISINGH SUBDIVISION LocatJon(sitaaddressordirectJons) 5320 O'MALLEY ROAD * ANCHORAGE, AK Current Property owner(s) Mailing address L~nding agehcy Mailing address Real Estate Agent Malling address CHU Y. LEE Dayphone 346-2448 5302 OMALLEY ROAD * ANCHORAGE, AK 99516 Day phone MARK LI'FrLE w,/ ASSIST 2 SELL Day phone 8001 PIONEER DRIVE * ANCHORAOE~ AK 99504 338-2482 Unless othenyise requested, HAA will be held by DSD for p/ckup. 2. NUMBEROF BEDROOMS: 5 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-sita Individual Holding tank Community On-site Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given In paragraph 5 by an Independent professional civil engineer registered In the State of Alaska. Certificates of Health Authority Approval are required for the I~ansfer of t~tle (except between spouses) for properties served by a single famiIy on-site wastewater disposal and/or water supply system. DSD also Issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of Issue for properties served by a pdvate or Class C well and may be reissued with new water sample resulLs less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties sen'ed 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. Note:Alaska Water and Wastewater Consultantso Inc. shall be pald $1050.OO at, or prlor I to closing for the engineering satlt, ces provfded. - ~ I 4. STATEMENT OF INSPECTION BY ENGINEER As sartJfied by my seal affixed hereto and as of tho validation date shown below, I verity that my Investigation, based on procedures outlined In the Health Authority Approval Guidelines for this application, shows that the on-site water supp~/ and/or wastewater disposal system is(are) safe, functional and adequate for tho number of bedrooms and type of structure indicated herein. I further vadty that based on the information obtained from the Municipality of,anchorage §los and from my Investigation and Inspection, the on-site water supply and/or wastewater disposal system Is(are) In compliance ~th ail applicable Municipal and State codes, ordinances, and regulations in effect at the h'me of Installation. Name of Fin~ ALASKA WATER &: WASTEWATER CONSULTANTS. INC. Address 6901 DEBARR ROAD. SUITE 2B * ANCHORAGE, AK 99504- Engineer's Printed Name JEFFREY A. CARNESS, P.E. Phone 337-6179 Engineer's Comments: In condu~'ng ~hts evaluation, AWW~, Inc. attempted to prevfde a through, conscfantious engineering analysis of the system In accordance ~th ADEC and MOA DSD Guidelines & Regulafions. The reported results described the podormance of the system under the condi#ons enceuntared at the t~rne of the test, and seporaffon distances measured to readi~ Ideatifiable features. The operational rife of all walls and septic systems depend on the Iocal soils c~dition, groundwater levers that may Iluc~uate during the year, and the water usage of the farnl¥ being sen/ed by the system. These conditions are ¢~J~stde the control of the e~aluatot of the system. ,.~allsfacto,7 test results do not guarentse future performance of the system, nor do they guarantee that there are no hidden defects or enotcechmenta. AWWC, Inc. can therefore not provide any warranty or fuIure estimate of hmv long tho sJ,~tam wfli continue to moot the operatlonal requirements of the ADEC or MOA DSD. The content of this repo~t Is for the sole benefit of the owner listed above, ivey reliance upon or use of this report by any other person or party is not authcvfzed, not v, til it confer any legal dght wha~,onver. 5. DSD SIGNATURE I,-'''''~ Approved for Disapproved. _~' bedrooms. Conditional approval for Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Manitenance Agreements Supplemental Engineer's Reort Other Original Certificate Date: Municipality of Anchorage Development Services Department 8u~ng s~;,,~y oMam O~,-Slte Water & Wastewater Program 4700 South 8ragaw SL P.O. 8ox 196850 Anchorage, AK 99519-6650 A. W~LL DATA Well ~fp~ PRIVA1[ Date completed Total depth 122 HEALTH AUTHORITY APPROVAL CHECKLIST HUISINGH SUBDMSION; LOT 2 Parcel ID: 015-521-08 flA. B, or C provide PWSlD~ N/A 8/78 Sanitary seal (Y/N) YES IL Casedto 122' It. FROM WELL LOG Date of Mst 8/78 8teflo water level 62' IL g.p.m. Well produclion WATER SAMPLE RESULTS: 16 Coliform 0 colonies/lO0 mi. Nllrate 0.5 regal.. Date of ~ample: 3/27/01 Collected I~. SEFTIC/HOLDING TANK DATA Tank Type/Matadal STEEL 1250 Tank$1ze +500 gal. Number of Compertmante 2 Foundation deanout (Y/N) YES Dapresslon over tank (Y/N) NO Date of pumping .1/27/01 Pumper we, log (Y/N) Daslng height (above ground) AT INSPECTION 3/27/01 60' IL Y 12"+ In. 7.63 g.p.m. AWWC, INC. Dateinstalled 10/25/97 aeanouta (Y/N) H~hwateralarm(Y/N). YES NORTHLAND PUMPING ~ I**TESTEO 1997 TRENCH ONLYI ~ . ¢. ABSORPTION fiELD DATA 8/24/78 ~ 85/ Data Installed ~ o,,,~.s/~7 8oll rating {~.pzl~/bdn~ o.s 8y~em t~e TRENCH ~;/' - '-'"--'~ =-~'~-3' ~ s f..o:/ _ Total t,'~tlc ~'- IL Eft. ,13sorp~on ~t' Monitoring tube YES Dapresslon aver,eld NO Date of adequacy tast *.3/27/01 Resulls(Pass/Fall) PASS For 5 bedrooms m~/~rr2 Flulddepl~Inabso~lleldbefomtest 36/36 In. Wateradded 595 gal. Newdeplh 47/47.5 In. Elapsed Time: 144 min. Final auld depth ~In. Ab~n rate >~ 750+ g.p.d. Any reJmmrmtion lmalmant (past 12 mo.) (Y/N & type) NONE KNOWN If ye~, glv~ da~ -- -~7,~+/- otci ~q~t~m D. UFT STATION Date Installed 10/2,5/97 'Pump on' level et 41 In. Datum Bo'FroM OF TANK E. SEPARATION DISTANCES SEPARATION DISTANCES FROM W;;~ ON LOT TO: Size In gallons 500 'Pump off" level et 4.1 In. Cycles tested 5 Septic tank/lift station on lot, 100'+ Abeerption field on lot 100'+ Publio sewer main N/A Sewer/eepflc eewlce line 25% IVtanhole/~ (Y/N) '~S High water alarm level et 47 Meets ala~n & circuit requlmmenta? On adjacent lots, lO0'+ On adjacent lots. 100'+ Public eewer manhole/cleanout Holding tank N/A N/A SEPARATION OISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Water main N/A Water eewlce line 10'+ Welisoneo'Jacentlots 100'+ I~/I'. SEPARATION DISTANCE FROM ABSORPTION RELD ON LOT TO: Property line .1 '+ Water sewlce line 10'+ Curtain drain NONE KNOWN F. COMMENTS Absoq~on field 5'+ $u~ace wste£ 100'+ Bulidlng foundation 10'+ Water main N/A YES G. ENGINEER'S CERTIFICATION Sun'ace water 1 oo'+ Driveway, peddng/vehlcle storage ~ ~- rmu co WelisonadJacentlnts.~oo'+ Pw. [*WR 97006¢I I certify that I have detem~lned through field inspections end review of Municipal records that the above systems are In conformance with MOA HAA guidelines In effect on this date. Date JEFFREY A. GARNESS HAA Fee $ Date of Puymont Receipt Number {Rev. Waiver Fee $ Date of Payment Receipt Number, MUNICIPALITY 0F ANCHORAGE.. :' DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION Lot 2; Corn plete legal description HAA# ~c~ ~ Huisingh Location (site address or directions) 5320 O'Malley Anchorage, AK 'ProPerty owne. r Harvey Huyett Mailing address 5320 O'Malley Lending agency Mailing address Anchorage, Dayphone AK 99516 Day phone 346-1704 Agent Address Greg Broderick/ Vista Real Estate Day phone 273-7299 Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 5 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 ××× Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confi~:mation from State ADEC attesting to the legality and status of system. 72-025 [Rev. 1/91) Front MOA#21 o STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto andas of the validation date shown below, I verify that my 'investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm S & S ENGINEERING 17034 Eagle River Loop ~oad No. -~, Add ress Eagle RIver~ Alaska 99577 Engineer's signature ~,~J 4 . ~r~ Phone Date /O/l:l-q/q7 DHHS SIGNATURE V Approved for ~ ~- Disapproved. Conditional approval for bedrooms. ©.¢ETA_ bedrooms, with the following stipulations: Additional Comments By: ~¢~v///,4,t,~- C "/~,,~0¢~ Date. The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA ~21 Legal Description: MUNICIPALITY OF ANCH~c . Municipality of Anchorage ENVIRONMENTAL SERVI~N DEPARTMENT_ OF HEALTH. & HUMAN~ SERVICES OCT 2 ~nvironmen~al services uivision 825 L Street, Room 502- Anchorage, Alaska 99501. (907) 343-~7L~t., E I V E D Health Authority Approval Checklist ParcelI.D.: 0IS'- 3' ~-/ - O ~' A. WELL DATA Well type ~/~ )v4~ ~ If A, B, or C, attach ADEC letter. ADEC water system number Log present Total depth Cased to Sanitary seal {~/N) ¥ e~ J' Wires properly protected(~/N) FROM WELL LOG AT INSPECTION Date of test Y / '~ ~' &~ / ~ / '~' ? ! *' Static water level ~ ~' 6 ~ Well production ~O g.p.m. ! o + WATER SAMPLE RESULTS: Coliform E) Nitrate Date of sample: fo / 3 ~ t ~l "/ B, SEPTIC/HOLDING TANK DATA Date installed /0/~. 3/~ 7 Tank size j ~ ~O Collected by: Other bacteria O S & $ ENGINEERING ~70~-~ ~'~;~ ~4ver Loop ~<oa(I No. 204 Eagle River, Alaska 99577 Number of Compartments ~ Cleanouts~) Y~_.r Foundation cleanout (~)N) ¥ ~ -~ Depression (Y~ '~ o Date of Pumping ,/v/& -/v~ ~/ Pumper High water alarm (Y(~) C. ABSORPTION FIEL~D DA~A ' ~/3~,/~ ¢~-- Date installed /o/~-~//q 7 S,oilrating (g.p.d./ft~orfF/bdrm) ~. ~ Systemtype Length · G ~ ~ Width ~ Gravel thickness below pipe ~ ' Total depth 7 ' Eff~ofiw absorption am8 ~o ~ ~onitorino Tub~ pm~nt ~/N) v~ D~pm~ion owr fi~ld (Y~ ~ o Dat~ o~ ad~quaoy t~t q [ 3 I ~ ? ~sults (Pass/Fail) ~ ~s.~ For 3 b~drooms Fluid d~pIh in absorption field b~Iom ~ (in.); t ' ~" Immediately a~er3~ ~al. wa~r added (in.): ~ ~ ~" Fluid depth ';)' '~" (ins) Minutes later: ~.~ d Absorption rate = ~' $~0 ~ g.p.d. Peroxide treatment (past 12 months) (Y/N) ~ ~'/-- ~,,~v,/ If yes, give date 72-026 (Rev. 3/96)* D, LIFT STATION Date installed / D Man hole/Access {~)/N). High water alarm level at* Cycles tested E, SEPARATION DISTANCES Size in gallons "Pump on" level at* ~L ~' *Datum "Pump off" level at* ) ~' Absorption field o~ lot Public sewer main SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot J o O t ~_ I0o ~ Property line Surface water Curtain drain On adjacent lots On adjacent lots Public sewer manhole/cleanout Sewer/septic service line '~ ~' ''/- Lift station ,/o o ~'~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation ~' t.f_ , Property line 5' Water main/service line /o '-/- .Surface water/drainage I o SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: ~' C ~r(q?ooSW) Building foundation la leo Absorption fiel(~. ~" Wells on acljacent lots I o o ~.-~ Water main/service line Driveway, parking/vehicle storage area Wells on adjacent lots / ~ o r..~ lo F, ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal records t~ in conformance wi. th MOA ~AA g~lidelines in effect on this date. Signature ~~ ~ Engineer's Name j~ ~,&~,-c~- ~'-. ~'~d ~,x~f,~ Date ' / 7 8re HAA Fee $ ~/~)' ~ Date of Payment / 0/~/~'''~ Receipt Number _ 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number .~. 2 ~ MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 1. General Information Application Date (a) Legal_.Descriptio~n (include lot, block, subdivision, section, tpwnship, range) Location (address or directions) (b) Applicants Name ~-.,~.A~:;~M~, Y I-IOY~'/'7" (c) (d) Telephone - Home Business Applicants Address ~,~ Appliqant~s (check one) Le~i~ Institution ~ ; ~er/builder~; Buyer~ ; O=her~(explaln); Address (e) (~) Real Estate Co. & Agent Address Telephone Mail the HAA to the following address: 2. Type of Residence Single-Family.~. Number of Bedrooms 3. Water Supply Individual Well~-~ Multi-Family ~-~ Other (describe) Community~--~ Public~--~ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. Sewage Disposal Onsite ~ Public ~-~ CommUnit~ I~/ Holding Tank ~ Note: If community well system, must have writ~en confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1 of 2] J En~ineerin$ Firm Providt~ Inspectlons~ Tests~ File Search~ Data and Information As certified by my seal &(~ixed hereto and as of the validation date shown below, I verify that my investigation of th~s Health Authority Approval shows that the on-site water supply amd/or wasti~mter disposal system is safe, functional and adequate for the number of bedrooms a~ type of structure indicated herein. I further verify that, based on the informatio~ obtained from the Municipality of Anchorage-files and from my investigation and inspec=~on, the on-site water supply and/or wastewater disposal system is in compliance ~h all Municipal and State codes, ordinances, and regula- tions in effect on the ~ of this inspection. Name of Firm / g. ~'/~,C~_~ U Address ate ~NGINEER SEAL) Approved for ~ --,rooms ~ - _; ~ ' ' Approved / D~..pproved ~ ~ Te~s of Conditional Approval CAUTION THE MUNICIPALITY OF ANCJ~0RAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES ~T~ALTH AUT~ORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAP~ 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTION~! IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT ~LESPONSIBLE FOR ERRORS OR OMISSIONS IN THE PROFg~'~I]IONAL ENGINEER'S WORK. RR4/eJ/D18 [Page 2 of 2] (DHEP SEAL) ,~ I(llll /'", · ~, ~ .... t}// 7-19-84 ~'~ /~1 MUNICIPALITY OF ANCHORAC2 DEPT, OF HEALTII IiNVIRONMENTAL ~i~C rFCTION ' M~zczP~Z~ OF ~C~O~ ~o~) ~ ~o~ ~ov~ (~) fEB 2 8 1985 - R EC 5 V D A. ~ ~TA Well Classification ~e~ - If A, B, ~ C, D.E.C. App~oved(Y~) Well ~ ~esent (Y~) ~N~Ik~ Date ~leted ~ [~/Yield Total ~p~ I a ~ /' Card to I ~ ~/~pth~f G~outing~ Static Wate~ ~1 &~ ~ ~ ~t At ~.~ / Casing ~ight ~ Ground I ~" /~ Sanit~y ~al on Casing (Y~) Elec~ieat Wi~ing in ~nduit (Y~) ~ / ~p~ession ~ound ~l~ead (Y~) Sep~ation Distance f~ ~11: To ~ptic~olding Ta~ on ~t I~ ~ ; ~ ~joining Lots To ~a~est Edge of ~so~ption Field on ~t I~ ; ~ Adjoining ~ts To Newest Public ~ Line ~ To ~est ~blic Clean~t~a~ole ~ ~ To ~est ~ ~rvi~ Li~ on ~t Wate~ S~le Collected By ~ ~ / ; ~te .~-~- ~/~ ~ Wate~ S~le Test ~sults ~L,L~L~ ~ ~ ' SEPTIC/HOLDING TANK DATA Standpipes (Y/N) 0 tq~.~ir-tight Caps (¥/%1) '~~undation Cleanout Depression over Tank (Y/N) ~ ~--~ate Last Pumped ~'/~/O~ / Pumping/Maintenance Contract on File (Y/N) I~ ; for Holding Tank High-Water Alarm (Y/N) I~'/~ Temporary Holding Tank Permit (Y/N) Separation Distances f~om Septic/Holding Tank: To Water-Supply Well I '.'2,0 To Property Line To Water Main/Service Line I 0 '~ cour~ NONE To Building Foundation I ~ To Disposal Field ~ To Stream, Pond, Lake, c~ Major D~ainage Comments ~ ~/h Receipt × Amount: [Page I of 2] 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Width of Field ~&/' / Type of System Design T~L~NcH Length of Field /~ i ~ Depth of Field 7 '/ Square Feet of Absorption A~ea Depression over Field (Y/N) ~- Date 'of Last. Adequacy Test Results of Last Adequacy Test ~.~,..~. ~ SeDa~ation Distance from Absorption Field.. To Water-Supply Well Jg ~ To P~operty Line ,/O To Building Foundation ~ ~ I To Existing or Abandoned System on Lot. ~ (; v;~-- ; On Adjoining Lots ~ ~ ~ To Water Main/Service Line ~g) ~ To Cutbank(if present) .~N~ To Stream/Pond/Lake/c~ Major Drainage Cocmse ~ ~ N ~- To D~iveway, Parking A~ea, o~ Vehicle Storage A~ea ~ ~' Gravel Bed Thickness j~ ' / /' Standpipes P~esent (Y/N) ~g; ~ Comments De ST TZO Date Installed Size in Gallons "Pump On" Level at High Wate~ Alarm Level at Tested for Electrical Codes(Y/N) Co~nts Dimensions Manhole/Access (Y/N) "Pump Off"'Level at Vent (Y/N) Pumping Cycles du~ing Adequacy Test. M~ets MOA Che~k Permitted Bedrocm Rating Against HAA Request certify that I have checked, verified, c~ conformed to all MOA HAA Guidelines in effect on the date of this inspection Signed ~ Company ~ KBl~dS/s [Page 2 of 2] MOA No. ~J'~'-O I{ 2-15-84 03 W. 15th AVE "C" SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE: (907) 279-3916 MR.HARVEY HUYETT 5320 O'MALLEY ROAD ANCHORAGE, ALASKA 99516 FEBRUARY 27, 1985 SEPTIC SYSTEM ADEQUACY TEST LEGAL: LOCATION: OWNER: RESIDENCE: WATER SYSTEM: SEPTIC SYSTEM: DATE OF PUMPING: DATE OF TEST: TEST PROCEDURE: TEST RESULT: Lot 2, Huisingh 5320 O'Malley Road Harvey Huyett Single Family, Five Bedrooms On Site Private Well FROM MUNICIPAL RECORDS: TANK: Greer Steel, 1500 gal. Two Comp. ABSORPTION SYSTEM: ABSORPTION AREA: SOIL RATING: INSTALLATION DATE: February 26, 1985/ February 27, 1985/ Trench 450 sq.ft. 85 August 24, 1978 Trench was charged with water at a steady rate of 6.25 gallons per minute. The liquid levels in both tank and trench was monitored. Liquid level in tank did not change during test. Liquid level in trench rose from 21.5 inches to 36. When checked after 24 hours liquid level was down to 21 inches.~-------'-- This system meets the Municipal requirements for a five bedroom house as of this date. The operational life of all septic systems depends on the local soil conditions, ground- water levels that may fluctuate during the year, and the water usage of the family being sereved by the system. These conditions are outside the control of the evaluator of this septic system. We can therefore not give any estimate of how long the system will continue to meet the operational requirements of the Municipality and State.' ~'CONSULTING ENGINEER C"~03 V9 15th AVE "C" SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE: (907) 279-3916 MR. HARVEY HUYETT 5320 O'MALLEY ROAD ANCHORAGE, ALASKA 99516 FEBRUARY 27, 1985 RESIDENTIAL WELL INSPECTION LEGAL: LOCATION: OWNER: TYPE OF WELL: Private WELL LOG AVAILABLE: Yes INSTALLATION REQUIREMENTS MET: WELL YIELD FROM WELL LOG: 30 gpm. PUMP YIELD: 6.25 gpm. DATE OF INSPECTION: 2.26.1985 Lot 2, Huisingh 5320 O'Malley Road Harvey Huyett Yes TEST PROCEDURE: Wellpump was run for two hours. During this time 750 gallons were drawn from the well without loss of pressure or discoloration or silting of the water. TEST FOR COLIFORMS: The test for coliforms was negative. TEST RESULT: The Municipal requirement for well flow is 150 gallons of water per bedroom per 24 hours.This well surpasses this requirement. The assessment of the condition of this well applies only to the conditions as of this date. The flow rate of the well may change due to subsurface conditions that may not be observed from the surface, and changes in land use and other factors that may impact the conditions of the aquifer feeding the well. ~ , . . DAT~: RECEIVED NsPEcT ON APPOINTMENTS ' DATE DATE DATE ' ~JUlql~lrALI I ¥ OF ANCHORAGE MUNICIPALITY OF ANCHORA'GE DEPT. OF I':EALTH & DEPARTMENT OF HEALTH & ENV'iRONMENTAL PROTECTIO~NVIRONMENTAL !';~OTECTION i!, 825 L Street - Anchorage, Alaska 99501 ":' FEB 201980 ENVIRONMENTAL SANITATION DIVISION Te e..o.e 26,-"2o REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1, Incomplete requests will not be processed. Please allow ten (10) days for processing. . 1. PROPERTY OWNER j PHONE I MAILING ADDRESS PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE MAILING ADDRESS 3. LENDING INSTITUTION J PHONE I MAILING ADDRESS 4. REALTOR/AGENT /~/ ~-~'~O~ g- { j PRONE' MAILING ADDRESS 5. LEGAL DESCRIPTION STR RET LOC'ATIOIq- 6. TYPE OF RESIDENCE ' ~NGLE FAMILY [] MULTIPLE FAMILY NUMBER OF~BEDROOMS [] - One [] Four [] Two [] Five .~' Three [] Six Other 7. WATER SUPPLY [] INDIVIDUAL* [] COMMUNITY [] PUBLIC UTI LITY * ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM [] NDIVIDUAL/ON-SITE** [] PUBLIC UTILITY YEAR ON-SITE SYSTEI~ WAS INSTALLED, NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED, 72-010 (Rev. 6/79)7~1'~'/.~_ ~ THIS SIDE FOR.OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ,, NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL ' DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3, SEWAGE DISPOSAL SY~$TEM PERMIT NUMBER E~INDIVIDUAL/ON -SITE DATE INSTALLED F'~ PUBLIC UTILITY Connection Verified 'INSTALLER []Septic Tank or [] Holding Tank Size: If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AR EA MATERIAL Absorption Area to nearest Lot Line 5, COMMENTS I~APPROVED FOR ,,'<~ BEDROOMS [] CONDITIONAL API~ROVAL (letter must accom/g~Wl~certificate) [] DISAPPROVED ' / / .... ~'¢h'CY~ 9 LEGEND CERTIFICATE OF OWNERSHIP ~ DEDICATION ~r Al~a M~I Savings ~ ~o ZONING PUBLIC UTILITIES No publl~ ~ter $upp~t or Sewage disposal is currently available to lots I~ 2 Huisingh ~ubdivi$ion. .NOTES Vehicular ac~ fo O 'Malley Road ehallb~ /?~i?~d fo one ~0' curb ~ut centered on ~e property IIn~ COmmOn to Lots I ~ ~. PLAT OF LOT I ~ LOT 2 HUISINGH SUBDIVISION A SUBDN'ISION OFWl/2 LOT 5, SEC. 22, TI2N, R$14t' LOCATED WlTHIN NE II~, S~ 22, TI2N, RSW, S.M,~AL~SKA COMPRISING 2,~9 AC~ES MON~ OB LESS I~IEMI ~ ASSOCIATES LAND SURVEYORS IlL EIGHTH AVE.~209 ANCHORAG~ ALASKA 2/24/77 I Scold: f0= 100' S-4347 Hui ingh L°t 2 #015-521-08 Municipality of Anchorage Development Services Department Building Safety Division MEMORANDUM DATE: TO: FROM: SUBJECT: 09/06/01 Jetty T. Weaver, Jr., Platting Officer, CPD  es Cross, PE, Program Manager, On-Site Water & Wastewater Comments on Cases due September 7, 2001 The On-Site Water & Wastewater Program has reviewed the following cases and has these comments: 2001 - 174 An administrative site plan review for a 4 bedroom Bed & Breakfast. No objections. RETURN COMMENTS TO: DEPARTMENT OF PLANNING Zonlng and Platting Division P.O. Box 196650 Anchorage, Alaska 99519-6650 Phone 343-4215 Case No. 2001-174 A request for ~,10 · An Administrative Site Plan Review for a 4 bedroom Bed & Breakfast In the R-6 District (Suburban Residential) per AMC 21.40.080.C.9; Huialngh Subdivision, Lot 2. Located at 5320 O'Malley Road.' CURRENT ZONE: R-6 Suburban residential dist~ct COMMENTS AND MEETING SCHEDULE: Hearing Date: Agency Comments Due: Council Comments Due: Friday, October 05, 2001 ~.F~day; September 07, 2001 Tuesday, September 25, 2001 DISTRIBUTION: STANDARD DISTRIBUTION Huffman O'Malley Community Council Municipality of,anchorage ?lannhg Depattmeat, Zoning Sect/on PO Box 196650 Anchorage AK 99519-6650  Municipality of Anchorage Department of Community Planning and Development P.O. Box 196650 Anchorage, Alaska 99519-6650 SITE PLAN REVIEW This application for a site plan review is for the Iollowing: FINAL 1. ~ NEW 2. ~ AMENDMENT REQUIRED BY I.A.O. 2. P. LI. ZONE A. Please fill In the information requested beloW. Print one letter or number per block. OFFICE USE verify °w~: ~' Poster and Affidavit: 1. Case Number ( If known) 2. Petitioning for IZIolol~l-IIl~l~ I I 3. Abbrevf~_!ed legal description (T12N R2W SEC 2 LOT45 OR SHORT SUB BLK 310T 34). Full legal on back page. I~1o1~1 I~ I.I~I,I~I;IM~I.I 1.1.1~ I I I I I I I I I I II 4. Petitioner's N~ame (Last - First) 5. Site Acidress Iolclol~l~l~l.I Iml;Icl~t~l~lllllllllll la-~lol Iol~l~l~l~t,~l Address: ~ City: ~~_~State: ~__ZiP:'~" ~ A.M. Phone: .%--'~'~'-~-~/,/' P.M. Phona: '~~_~Fax 6. Petitioner's Representative* ^ddrass: City:. State: Zip: A.M. Phone: P.M. Phone: III Fax II P, ECEIVED .~UG 2 R ~001 ~lJNICIPALITY OF ANCHORAGE ~ITY PLANNING & DEVELOPMENT 7. Currant Zoning: I~1~1 I I I1 10. Hearing Date Ioll l~lololq YYMMDD 8. Petition Area Acreage 11. Principal Tax Number bi ~lsq ~t~t Iolsl 9. Grid number ~1~ I I 12. No. Tax Parcels · 14. Community Council B. I hereby certify that (I am) (I have been authorized to act for) the owner of the property described above and that I deslre site plan review approval In conformance with Chapter 21 of the Anchorage Municipal Cod~ of Ordinances. I understand that payment of the site plan review fee is nonrefundable and is to cover the costs assoclateCI with processing this appllca- tion, that It does not assure approval of the site plan. I also understand that additional fees may b, e assessed ff the Municipality's costS to process this application exceed the basic fee. I further understand that assigned dates are tentative and may have to be postponed by Planning Staff or Planning Commission due to administrative reasons. Date: Signatura~ * Agents must provide written proof or authorization. 20-039 (Rev. 2,,9e)' Page 1 C. Please,_check or fill In the following: 1.~Comprehensive Plan - Land use Classification · V Residential ~ Marginal Land ~ Commemial __ Commemial/lnd~Jstrial Parks/Open Space ~ Public Lands/institutions ~Transportation Related 2. Comprehensive Plan - Land use Intensity ~ Dwelling Units per acre Special Study 3. Environmental Factors (if any): a. Wetland 1. Development 2. Conservation 3. Preservation Alpine/Slope Affected Industrial Special Study Alpine/Slope Affected b. Avalanche c. Floodplain , d. Seismic Zone (Harding/Larson) D. Please Indicate below if any of these events have occurred In the last three years on the property. Rezoning Case Number Subdivision Case Number Conditional Use Case Number Zoning Variance Case Number Site Plan Review Case Number Enforcement Action For Building/Land Use Permit For g~[~-,,,~-,~. -'~ <3 I-. ¢3~_~ / E. At least 25* copies of the following muat be submltted with the application (sea AMC 21.15.030). 1. Site plans (drawn to scale) depicting: a. Building Footprints d. Lighting & Signage b. Parking Space Layout e. Drainage/Grading ., c. Traffic & Pedestrian Circulation f. Schematic or detailed Landscape Plan ~ 2. Building Plans (drawn to scale) if required: a. Root Plans *(if public hearing required) b. Elevations (all sides) or (13 coples If non public hearing) c. Exterior Colors and Textures (material list) F. The following must also be provided: - : ' 1. Vicinity map depicting proposal in ralationship to sun'oundings. 2. Narrative description of the following: '~ ' a. Statement of Planning Objectives/Description of Operation . b. Development Schedule with Phases and Dates c. Intent of Final Ownership d. Total Occupancy 3. General site plan review standards ehould be addressed and any applicable public faciiity sit~ review stan- dards or P. LI. requirements muat be addressed (cea AMC 21.,50.200) · 4. Optional (may be required by Planning Commission or staff). ' a. Holding Capacity of Land Analysis d. Economic Impact Report b. Soils Reports e. Air Quality Impact Report c. Traffic Impact Report f. Noise Impact Report G. The full legal description for legal advertisement (use separate sheet if necessary). STANDARDS FOR SITE PLAN REVIEW ' The petitioner should address the following general standards as part of the narrative. In addition, many site plan reviews have specific requirements from zoning special limitations or adopted plans which must be add ressed. (See AM C 21.50.200) The authority hearing a site plan review application may approve the application only if It finds that the site plan: Will not have a permanent negative Impact on the Items listed below, substantially greater than that anticipated from permitted development: 1. pedestrian and vehicular traffic clmulation and safety; 2. the demand for and availability of public services and facilities; / 3. noise,M/) Lz,b1'air' water or other forms~./. \ t,.3 0°f/~vimnmental-- (~ [---3~ f,~ E'p°lluti°n; 4. the maintenance of compatible and efficient development patterns and land use Intensities. 20-030 (Rev. 2~e)' Page 3 N OF E~VIRO~M£'~rTAt' HF~LTN '' DW~IO , ' ~OGRA~ / ' ' ' ' DRIN~NG ~VATKR AND W~E~ATER . T~lepho.t: (907) 269-751~ . ' 55S CORDOVA STREET Fnx: (goT) 26~7650 A~O~G~. AL~ ~9~1 'Inly 3, 2001 Dc~r Mt. Gat~-.~: . iver r ueSt ~nd L-sforma6oo on ~e ~ C public ~r syst~ ~et~d ~.~ omc. on ,- ..... " ' ~e borne ~ a five b~om home wkh ~ ~ four ot ~cs~ b~drooms m a B~ ~nd Wssta~cr R ~ar ~hat ~ wml~ disposal systen~ have b~en d~si~ in icco~C~ wi~h S ~, ~ Ragulfiflans ai~ Guidance. ~ha approval flora ~ Mun~iplli~ ~ cu~ent (4-1~2~1) ~ Walvers or Separation Distunce Wai~a~ to I~= ~lsdng oc-sit~ wm~at=r d~po~ sys~ on Lot 2. ~lsingh afld Lol 1 Go~h ~m rc~icwe~ ~ dls~ca mbc waIwd Is f~m ~e I ~0 t~ dis~ce down la 120 f~ ~a ~1~ ~crh walve~ w~ fcund valid ~ c~ be g~ed. ~us ~e following w~iv~ ~ g~nt~d: ~e sepa~ion dls~nce b~on ~e Omi C ~blk water s)'g~ sou~ ~t!l and ~¢ I. septic ~n~ on Io~ 2, ~u~ingh Subd~vislon is walve~ from 150 fi¢t I~ 120 riel 2. ~e ~oa ~Bt~ce bern'eeo ~e Cl~s C ~ubllc water ~s~ sou~e'~ell ~ Lot Huis~gh Su~dlvblon m~ ~e existln~ soll abso~icn sys:em on ~ 1, Gmh Su~lv~i0n pabli~ W~ler ~) stem · - ~ove ~iv~ e~n~d and a'complem CI~'C public water ~stem teg~l~:~ f~. ~1 W~ thc ...... watersy~m ~ now npp~V~. A ~ of Pa~ I of ~e completed ~i~6on to~ co.mimt~ ~e . - . . commend ~at you monitor for ~I m~ to~ b~edn ~d hi.tm (~ ~is a~rova~ does not imply ~a ~ng oraddi~onal au~hor~ions, nor obl~ate ~y state' fcde~ or I~:1 ~gul~o~' body to gr~nt mqu~e8 ~orizatlons. Municipality of Anchorage Building Safety Division PubllcWozks RESIDENTIAL COMMENTS Reviewed by: HELLMAN, BECKY A. Phone: 343-8237 Fax: 343-8200 Lot: 2 Block: Project: Permit #: 01--0541 Date: 5/16/01 Subdivision: HUISINGH Contact: OWNER GENERAL CONTRACTOR PERMITEE OWNER CONTACT PERSON ARCHITECT/DESIGNER Lh-~ CHU Y& SON C & OWNER MIKE O'CONNER MIKE O'CONNOR IvlIKE O'CONNER OWNER Phone: Fax: (907) 562-331 (907) 562-331 (907) 562-331 (907) 562-331 Plan Review Comments: I. Please provkle smoke detectors on all levels in every sleeping ~om and adjacent hallways. I)etectors sIa~ll bo from commercial power, wL-ed in serle~ with battery backup. Update plans to allow for verification. CAll0 316. Inspector to verify 2. Please clsHfy exit egress window sill heights ar* not more than 44' above finish floor ~cl rr,;n;mum net clear opening height ls 22' and mlnlrmlm net cleat opening width is 20% CA]K) 310.2 and '110.2.1. Inspector to verify 3. Please be aware that all studs in bathroom plumbing walls are required to bo a re;fl;mum of 6 ~ches Ilom;nsd · width unless otherwlso approved. Reference: CABO 23.85.602.5 Impector to verify MAY l 6 2001 BECKY HELLMAN Pago 1 of I ts t~e ;,spons. tb111t:y o~ the ov~er to existence of a~ e~s~, covenant, o~ ~. respon~l~ll~ fo~ ~he lnl.~til ~ransl~on ~lY. . s,ow~ ~r.c ~C~a[O ~r, ~[ .or ,~,~ ., ~.NCHORAG l l I l I l I : ALASKA DEPARTMENT OF COMMUNITYAND ECONOMIC DEVELOPMENT P.O. BOX 110806,~IUNEAU,*A.,K,...,,.. 99811-0806 ALASKA BUSINESS.LICENSE 'l'hls Is to certify that the licensee named below holds an Alaska Business License covering the period January 1 through December 31 ol the license year(s), or Iracb~on thereof. This license must be posted in a conspicuous place at the IocatJo?. It is not b'ansferable or assignable. LICENSE YE:ARS(S) E~Firm 12/31101 business in the state without having coa~olied with the other requiremenls of the laws o! the State of Alaska or of lhe Un~ted States. COMMISSIONER OF COMMUNII~ AND ECONOMIC DEVELOPMENT