Loading...
HomeMy WebLinkAboutCAMPBELL HEIGHTS BLK 1 LT 1BCampbell 'D Heights Block 1 Lot 1 B #014-071-23 O m y0.y 00.y 0 0y.y oyy oyy 0 �0.yy0y 0y.y I 1 j W 00 iV i r� iN i i f j t 00 v W iW I V Ir IV ; N i00 U 00 m Z %. v m A a mrm/ vrm a oZ j= Gf r C Z 'I A 0 crd r Q j tOq r i I j i � y i N 00 m Z %. v m A a mrm/ vrm a oZ j= Gf r C Z 'I A 0 r r N H Iir tL_ I Tyr' r-IF[CH�IT:RGE DEPARTMENT. HEALTH AND ENVIRONMENTAL. IOTECTION 825 'L' STREET, ANCHORAGE, AK. 99501 254-4720 L�IELL_ F�ERM I T I PERMIT FJO. C 820545 ) APPLICANT GAILAN E JOHNSON 5710 RUTH ST ANCHORAGE 99507 349-2307 LOCATION 'LEGAL L181 CAMPBELL HTS LOT SIZE 999999 SQUARE FEET i MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE I -JELL OR 150 TO 200 FEET FROM A PUBLIC I -JELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER: LINE IS 25 FEET AND TO A COMMUNITY SEWER, LINE IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS OF THE WELL COMPLETION. OTHER, REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER, INSTALLATION. FJERt•7 I T E: lFP I RE'S C--ECa:ME3ER =::I- : 1 n%^_•^ I CERTIFY THAT 1: I AM FAMILIAR WITH THE REQUIREMENTS FOR: ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. SIGNED: ---------------------------- APPLICANT GAILAN E JOHNSON a� ISSIIEG EY_-----____- 7T- /; Yle V4. 0 !•iiT • � LTJ • N w r r= n r ?-•r' f ir•t�:=f t�:�i=:f�:�t_ t � fiu rl9tr:1 i o- -Le-o m ;7rh? c?l ' Iffll N i f17- P?�? rEr f I rJM ! 204-4: 2N t= {=s. -fit r r �ao,SyS :3:".�l.I��rir rttll..iari a .r�x�it��1N +. ,xa3 r I s?.`I LC117_ ii PL n;t tat "N t»n Plir11 t:r >t:tl�Jo•fA3s 33 r$i 's49 -2--;)3Z? 3- 9'3'3?'1? S�]IJAFr c J 3 a• � T MitiflAJii OI r:?rk'� ofn•t A t+ f>l_1. MD IiYr PE tSp'i R- TnrGi 115e ttc3 .^•_f ��?� N PRIYNIb 4b11_ �J£ 1-1 TQ '"??1 r FFim is PI_t:l1C I>_tP_IK�'�7t0ItT+3: f 1`1iNIWli (ASI- l %c FP(! A FF[Yrilt tC_LI_ TO A F?.IY:3r_ DE! -P -F f`cr.r 1410 J r. 7.; ± ;- + n75 ",%% Rz ,Aj I r,�-- 0 tV In t•A;. r rj: rx IUi L ry arc- oarF'Af: rtt* +•1 r W I rt1 I N 39 U►iY: rjr rte_ Pl?EL+ ow -pt fiilli elf <rtJtJ[r+ rA tlra i1Ar' 1ir"?l Y. 5:'£�: i�I� tiftiJlK IV* 4i4`fiar>•?lk:riall 0[Fp=vr3 —V:S .J rr.imiKuc re Ihmm .`,,c!cFvp ilr�friU�+r[�)li c t•1 I T Gz: F> T_ F."fE:O Cwt �,�f 1.1Le i s:L: �•�:?.� ►r -p r cli r.4n r + I rut Fr11iIL[fi: III IM r'rI` Oti-;t re ;J-wa•z5 Iit10 i•zj2; ri: r :-i�1}i t; r]-� I•AJ±II�:i`'.�_IrY :i= r3t>•x1�r.� I IdIU- Itr;ri/?%�-! ft' :e rVt Iti Iti.i0y;;Cr.—VKZ HIM rRE Com:. -- rlrr�t I�::aT1r 9[6,•Nl 8 fixflfi ?Tl 15_ab i• HY-- - ----------- CAT& ---- ,-=-t _- ^s t� ILI sTiBDIVitION: f STREET o I a W O" Z O I v 'W m � INDICATE • NORTH LU L r h I f , Ce_ 210 Qo rL SEWER SERVICE LINE SKETCH SHOW LOCATION OF CONTROL MANHOLES/CLEANOUTS ALLEY i ' . I • M SIZE MAIN: TYPE MAIN CONFECT DEPTH AT MAIN ------CONNECT DEPTH AT Prop. Line . 7 j CONNECT LOCATION: , i COMMENTS: A/Ci /fid h I. ,INSPECTED BY: SP�/Pk �/ DATE: , Municipality of Ai On -Site Water and Wastewa (907) 343-7904 CERTIFICATE OF ON-SITE Parcell.D. 014-071-23 1. GENERAL INFORMATION 61 6 9 i OAR ,R ograrnOCT 08 X15 r S APPRO 01686 Expiration Date: u Complete legal description CAMPBELL HEIGHTS BLOCK 1, LOT 1B Location (site address) 6710 ELMORE ROAD ANCHORAGE, AK Current Property owner(s) JAMES & DANIELLE COOMBS Day phone Mailing address Real Estate Agent 1314 5TH AVENUE NORTH GREAT FALLS MT 59401 2. TYPE OF DWELLING: ® Single Family (w/wo ADIJ) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual ❑ Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer WaiverNariance request for: Distance: Receive dd bd! Date:(— COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 5a,L Date of Payment l C)14 k Receipt Number aW5-()D COSA# ©GJ061659 Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal at e eto 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 ARCTERRA CONSULTING, INC. Phone 868-3791 Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 10/08/2015 Engineers Comments: This investigation was completed in compliance with ADEC and MOA regulations. 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 inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. 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, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen OF AZ\ encroachments, deficiencies or discrepancies exist./-:+�j-4 ll 6. DSD SIGNATURE _1.o� System #1 Approved for bedrooms. System #2 Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the .n KE:SRh'1'y M' ➢ 'Y ' 1 9 7t1a tit'ti /r /0"9 zoo, \���� =- vvf{t tH AND r --r .... Original Certificate Date: ,/44// of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 10-10-12.dm 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: CAMPBELL HEIGHTS BLOCK 1, LOT 1B Parcel ID: 014.071.23 A. WELL DATA Well type PRVT If A, B, or C provide PWSID # Date completed 12121/1982 Sanitary seal (Y/N) Y Total depth 87 ft. Cased to 87 ft. FROM WELL LOG Date of test 12.21.1982 Static water level NA ft. Well production 14 g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 mL Nitrate 0.531 mg/L Arsenic: ND ug/L Date of sample: 9.18.2015 B. SEPTIC/HOLDING TANK DATA — PUBLIC SEWER Tank Type/Material Tank size _ gal. Number of Compartments Foundation cleanout (Y/N) Depression over tank (Y/N) Date of pumping Pumper C. ABSORPTION FIELD DATA Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) 24+ in. AT INSPECTION 9.18.2015 ft. Collected by: ARCTERRA Date installed _ Cleanouts (Y/N) High water alarm (Y/N) Date installed _ Soil rating (g.p.d./f? or ftZ/bdrm) _ System type Length ft. Width ft. Gravel below pipe ft. Total depth ft. Eff. absorption area ftz Monitoring tube Depression over field Date of adequacy test Results (Pass/Fall) For bedrooms Fluid depth in absorption field before test _ in. Water added gal. New depth_ in. Elapsed Time: —min. Final fluid depth in. Absorption rate r_ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date D. LIFT STATION Date installed "Pump on" level at _ in. Datum E. SEPARATION DISTANCES WELL ON LOT TO: Septic tankilift station on lot NA Absorption field on lot NA Public sewer main *20'+ Size in gallons "Pump off"level at _ in. Cycles tested Sewer /septic service line *10' +i - Animal containment areas SEPTIC/HOLDING TANK ON LOT TO: PUBLIC SEWER Building foundation Water main Property line _ Water service line Wells on adjacent lots ABSORPTION FIELD ON LOT TO: PUBLIC SEWER Property line Building foundation _ Water Service line Surface water Curtain drain Wells on adjacent lots F. COMMENTS Manhole/Access (Y/N) _ High water alarm level at Meets alarm & circuit requirements? On adjacent lots NA On adjacent lots NA Public sewer manhole/cleanout *100' Holding tank NA Manure/animal excrete storage areas 100'+ Absorption field Surface water Water main Driveway, parking/vehicle storage *Per MOA & AWWU records -- well meets separation distance requirements at time of construction -see attached AWWU docs G. ENGINEER'S CERTIFICATION I certify that i have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name KENNETH M. DUFFUS 10 Date 10 -2015, COSA canary sheet 2-6-15.doc . AW OF F A f QO uV 6 $ �tov� R in. Ed o rima eu�cw¢'cmAIX `` J �A mTeAas it enxcrw xteaal 00 k 1A r F I 5890 56' 17"W 126.19' WELL*, I 21:01 EXISTING � �` N }y,s CD Uj L HOUSES II �a Z i NSHED� l 26.01 z r m J _ SHED i10' UTfL ESMT. W 126.10` N894 57'30"E 3;11 1G UNDER NO CIRCUMSTANCES SHOULD AN AS-,UUIkT BE USED FOR CONSTRUCTION OR FOR ESTA"HING BOUNDARY OR FENCE LINES, THE SURVEYOR TAKES RESPONSIDUATY FOR THE INITIAL TRANSACTION ONLY AND ASSUMES FINANCIAL LIABILITY ONLY FOR THE COST OF THE SURVEY. LISTED DISTANCES PREVAIL OVER SCALING. REPRODUCTION MAY CAUSE ERRORS RN SCALE, LOT-SMVEY SURVEY TYPE SYMBOLS _ FOUNIIATiON AS -BUILT ° SET RESAR DRAINAGE ASPHALT Q MAL STRUCTURE As 10` 0 FOUND REBAR 4-0-4 .... FENCE CONCRETE .. . , . L8i-SURVEY ... Tp^OtlMFNY ❑ PLOT AN AS'ILi PL .,WOAD ASSUMED REV -p--j(—)(- METAL FENCE iL.s-+,LlJ WOOD DECK T U N S SET RE6RIIRCA T PLOT PLANS & LOT SURVEYS NOTE: IT IS THE RESPONSIBILITY OF THE BUILDER OR OMNER, PRIOR TO ONLY THOSE IMPROVEMENTS ABOVE GROUND AND VISIBLE VALL BE CONSTRUCTION, TO VERIFY PROPOSED OUILDING GRADE RELATIVE SHOWN. FENCES. WELLS, SEPTIC CLEANOUTS, SIDEWALKS, DRIVEWAYS, TO FINISHED GRADE AND UTILITY CONNECTIONS AND TO DETERMINE ETC_ ARE SHOWN IN THEIR APPROXIMATE LOCATION, ONLY. SNOW THE EXISTENCE OF ANY EASEMENTS, COVENANTS:. OR RESTRICTIONS MAY PREVENT SOME IMPROVEMENTS FROM BEING SEEN AND LOCATED. Wf*CH OO NOT APPEAR ON TME RECORDED SUBDIVISION PLAT. ALL DISTANCES ARE RECORD UNLESS OTHERWISE NOTED. SURVEY CERTIF4CATION as+aa>A�r '` OF q h, "�°,,,... Prepared :bar Robert E. Johns, Jr, & Assoc. PLAN PLOT 1h..h anxf erirrmw MW�r«.wsw tlu Ia #w+r .q "r eq as uwr i i "��` °► jay _ Professional Land Surveyors 1700 Brfr& Drive. raw bur��aenmWbdmar alit �.+ ns ,aem ," w oEin ana b ew Mw a mr J ANCHORAGE, ALASKA 0004 aa0w am`^r+raeru mxinram mw wn {O < VSAT &i !� Aw .r Scale: 1" ;0 30' Rec. tet S.F. Rea. Ptat rat Na. F"DATION AS -BUILT i ` Y -. y �J SUrveytid: Dram bK ONeakad b t RObrel c ,kNw: x. Areeer afelltr+Nit I ie .x.. ; ..s Data 1U106/15 F�EJ 6 A I�/ lYli\ wd r"C1O°`""`"n uw wm�z �°? ROBERT E. JOHf+(B JR °o..o ✓r Data Oram: 10/07115 Grid 2035 W.D 15-409 0, s, % '4 41 21—ST`AAAF1 Legal Desa¢rflaTt.. RNAL STRDGTURP AS -BUILT r., rwaxy c«aM!Ara r . + fm* L aw.x c a�rre y°.?° cx�{.'ri .. rf+�a+'�. ,,tT C� ��++��// ,I Li>tiB B1v�V1� 1 s'1enUaw ir.rr`ne.a7P ;» ;� �a�•lw� af..... Ni ', r -L* CAMPBELL HEIGHTS Time ....:APPLIr'�NT FILLS OUT UPPER W7 ONLY Property Owner 47 r� .� c:0 SO Phone 5�i a 2 Mallfg Address Zip Code r ,i Buyer P Date Dare Address ZIP Code Lending Institution / �'? eS/�� ! ns•�.'•�,,, Phone Address Inspector Zip Code ' Realty Co. & Agent Phone Address Code Field Notes:H Y`) Lepel Description�w%z; D /Zip Street Location 249[ DFnT C, I,� Type of Residence ' 9filingle Famlly Multiple Family No. Bedrooms i,cG 2 21932 ❑ Other of RECEIVED Water Supply 'CONDITIONS OF APPROVAL [a7 Individual Cid 1�V ATTACH WELL LOG. A well log Is required for all wells drilled since June 1975. 'LJ Community�� % 6 For wells drilled prior to that date, give well depth (attach log if available). ❑ Public Utility Sewer Disposal Soils Rating ❑ Individual Well To Absorptlon Area Year Individual Installed: �CSAZ Public Utility Septic Tank Size When Connected to Public Utility: ❑ Holding Tank Well to Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time 1 u Date Date Dare Date 0 Inspector Inspector Inspector Inspector 1 Pccu,, A Field Notes:H Y`) �,1UNICIPALITT OF ANCHOR!+ rT.� F DFnT C, I,� n e.� EMR 7l V._t ")L,, :.O.r.,_TION i,cG 2 21932 RECEIVED (,. ;) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( I DISAPPROVED [4'1 -;CONDITIONAL APPROVAL* �/� / ► 1"�V..�.�� U.�.jt� Vj,. �I/''r % 6 DATE Soils Rating Date Sewer Installed Well To Absorptlon Area Well Log Received Septic Tank Size Well to Tank non uer