Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
GRANITE VIEW BLK 6 LT 6
Granite View Lot 6 Block 6 #014-301-06 MUNICIPALITY OF ANCHORAGE S WATER & WASTEWATER UTILITY 3000 ARCTIC BLVD. PHONE:(907)564.2762 WASTEWATER S161143 CONNECT PERMIT DATE OF APPLICATION : 05/10/2016 SCHEDULED COMPLETION DATE: 12/31/2016 BLOCK/LOT/TRACT: BLK 6 / LT 6 / ❑X SINGLE FAMILY SUBDIVISION: GRANITE VIEW ❑ MULTI -DWELLING No. APTS M Cwt $Pf # IOU23 ❑ COMMERCIAL TAX CODE: 01430106000 GRID: SW2334 STREETADDRESS: 003003 NORTH CIR , AK OWNER: GUERRA CARLOSA& JANET R PHONE: MAILADDRESS: 3003 NORTH CIR ANCHORAGE, AK 995073954 CONTRACTOR Bradley Nelson MFB Construction Limited Partnership ASSESSMENTS ❑ Repair Existing Service ❑ Main Line Extension ❑ On Property Only ❑ City Tap ❑ Have Been Levied ❑ Hydrant Only X❑ To Be Levied ❑ Main Tap - To Property Line Only Comments: X❑ Main Tap & On Property Connect Row No. Est. - $470.00 See permit S151244 for ❑ Disconnect ackno d ment. ❑ R & R - Main Tap Only CONNECT SIZE 4 in ISSUED VWKMM INSPECTION FEE $ 103.00 ® PAID ❑ CASH PERMIT FEE $ 72.00 ® CHECK # 4635 $ 0.66 ❑ OTHER REIMBURSABLE DEPOSIT$ 0.00 INSPECTED BY NUMBER TOTAL$ 175.66 DATE -_7_7�_ REMARKS Main line frontage requirement waived due to elevation challenges in area. PERMITEE (Please Print) GUERRA CARLOSA & JANET R MAILADDRESS 3003 NORTH CIR ANCHORAGE, AK 995073954 SIGNATURE 97[0Pltl POST IN A CONSPICUOUS PLACE AT THE JOB SITE INSPECTOR COPY �� DATE SCHEDULED 12/31/2016 TIME 12:00 am INSPECTOR SUBDIVISION GRANITE VIEW BLOCK/LOT/TRACT BLK 6 / LT 6 / INDICATE NORTH I 3ao3 Exisjr, , I 1V l Sol Lei ,�nolP ]sectir. Pi�P<V ��a L. K. eF'FL9sb FSf�LASGMP++P1KivC PIPS _ � �2 Dk�P� 1•.1 '�. MWz734-ham � SIZE MAIN: a" TYPE MAIN: b/P DEPTH AT MAIN: AT AT PROP. LINE: CONNECT LOCATION: 6L�COMMENTS: LJ f SE FG H"'c 90 E v,LS T x15 Irl y"Liv er gAeAS� r �o•r,,./5 T+aP u = S "c or Hi 233Y- /oo INSEPECTED BY: DATE: M,NAT- S, 7- / (e n10 Nem + ommm" -0 J [� � o� a aZ pN pN ay NIa%+ ➢ irr)op��� � y g a y � m C�OA NA Z A A nn a~ ZyyZy N N Sn 4r' N t T A2 y m y ; A as N zA 2A nrmn r pIR v 8vzi�7^z q m m am ci M2. rim o Pis �yf arnn Hn rA„� O� v Nm Ia r�ap=N mV � A O� �a Nc Pv oC, Cad ?=x on TJ g v � � _crn•'l rn aN � nam p C m � Fon Lin f2gAm:pv z,- gmV 'f"W 2c p gQp mwrn w aakN $0qr G7 fTl �NS� � 7 '�� gv_z Sid ZI" a s ss ; AgAm wm" , M rr, $�A-y,22wj,-wa-a � vm8 =ryay ?v$19 m8� NNS F.0 ryxry7�mx >'z ��1 F§8 rrI tiAv ANY n ax SCNm -x ZO0 �� oz.Z oto ypAZZ Z�gn�ixia �� 8v Nva �h °Sz1s Orsi -5Eq . >'f C3 V_088pH - o -- s� L'c= '� myif zsn�i-� yc� ZfTI M <mmiax ES �i syn Lji A5F rgimv a�vi m si NC Qi 0 N zV9�namKi �� ❑❑o�,ma as amr� �• q �mA m vs' Vq6 Ati �� y,nm DA ANS ? CFZ9 m-0 Y� F �zcaso ilAay � m N �n m �w Aa Amt' 'r-� mi-<mz �19p U7rT1 axo�,o7r s y ry nn o�o Amy 9Z:gA � �NIn�N 8 "xi'g $vvi l 0 aM ,�8o� 5F avo ��g n��'� fx�yiyf vyiFn n Zy* .-, rvn ?xv F �rnaA �Va= ...�a m EO nr yM 2,, �_R nnv� _ vy j nv�v i v 2M 22 Sm Nm= i� xrnyn Ar�+l❑ n sag .. axe fora ~rn� my r^ �xcr =�vr i��n as m4 Gl yc �$ mcgo o c 1°� vNp �ppv c :rr r^��i� v IIm C) �xn�7CA�7pLp� Z A 2 2 OGW 1y slam 2m1 , �z yAiy 2 N y rnt �l� xp❑ duA>a oa� Smd- � a�yaNY'A� ` ; ,ialo�zpv y am n cm ->•i w nmi x-� amnFi� p Ao gi 00 aai rxiim =� 3 ZN qz� va �v nm azx 0- z S _ gz4m n a�H vvx x �� �_ _n RZ iNm ED m Aix �~ CC) g°' A wN aux `,"'� $ =m o m O `M C ST i> ... 'cc n w x sT C3 I C . I w C a P ! I avr`xt iZyz vy �asO'I`��!ppR^ -=� vi2 x1IQii S Wx S= ~F t~�ay Ay4 z❑or_ ar ox �y mC ' iA "' mrn ❑a ❑ M ❑ ril M a�o! arn i {n m � ,; _ r- a 4 a a A 9 CQC A mx~ m s _ 2 9 31 y T A m Sm 2 a O❑ O ❑ 0 IV ❑ x z s za n m? a; i a In58 F y a R, v _ -y gy atrT u^ s C Z m rn x g Q m z ❑ nEn 2 rsl m y A i m rxrl i m E x In Z In CCL ti 'a p F Y r = 00M r.,mrnm A WWW 9 �C Cp� �� ylyy0ul yy .11a,7p V ��Ln� =oopO�-�27 +2�L u1 �. pZ ❑ aa., ., ry1 f�1A00 Qo mc7 000 W Ht, L 9 I& Ke A V E ��nn C 21.7 n� y�aNIA�= CN1�AA�y�� = �f7A aLS� lN!'7NN2 i AmStIX yY' +rlr�c�fn-yAxmCm C•[u7yfn� v m �aav m PmAPOFvvv 1 II N 1 1 1 1 1 II 1 1 1 IT 9 N I N 1 1 it I I I I I D 1 1 1 R N 1 1 1 u II II I N I I N I I I N N F lip NINE Rolm 1 1 N N 1 1 1 1111 11 1 R I I N I N 1 it N 1 1 II 1 II 1 1 II I N 1 1 11 I N 1 1 1 A II N N NyA,iymar�larA+AlrsAIr{AA a,o_S�i$�xaaia���m���p000a�nC3mXJ4Yf�n7aC266fzOzimKKy9i"R CF;A ��?j��20SrnCY22Z�mv_oc�o�r'c'or"E]iacomama��n� � kyr,(y1.I s pi �x �ax't to r!r`1�nxarmo zS.�n'-°�nvrn r� yayyayy m.T �y�'ff Cyinn ~rn��(�p� O �py'rZr�m �.L-=ICAC 1 m x I R.E. G ��CmrrJ�yy 4 xC =yx ~`=�y�y.-ii yld�❑NOyCy9 OCL yyA o� i. &C �C y- 5yy� =x 5i A 2 m D 7 r T S b m 6 y y y a x f7 $ G i ? r m L 2 m y x O A l y i= L i. D a y 2e rD' srF a� �a 1 srl'� In mz aam �r� C Aa m A Ati an-4� y v my QiaxQi o =on� mom Q ma x mR'yy°�v p�7�x�i �i �io�((y-���,m A� a�a �Ox x�iC NS�� I•T.I i �z�a`.0 A�x,..0 jNJd=.� �m��j ❑ $ i L] �Clz IA >C x x r� n M> �Da xrn-. Z O~7 Ax an s AZO a Oa y p vbvn pOT o� a v a1 gryr A �yv rmo x y r��r7gm Ate, qii m a a In m y r A C m` x 0? r z x x n a C Ry p A 2 A y m g ~ C x x A m o O C Q O p y C p i x y y Z AWS x 2x8 x m o ❑ g OAS T m x Z „ �❑ Am n lal r� m C c O O 2r 'l. mxA �f�1 m fir, AmCy x 7 C y� env A m ID orn vW m��y��m ~nra' Z iJ v r�x Ay a rcFn -00 o a i `rng��'rm i o5 x ? y 0 wAMD I+1 i 0 x Y m V) m Vi x m y � � �■ g rn z v M xM C M 0 M BASED UPON AWW/8 INt th:'lAETA1 ION OF THE N N N DRAWN J� N AWWVS STANDAWS AM THE SIGNEE IS NDT SIGN TURE: p d APPROVED FOR CONSTRUCTION F By A -*-.w water i W*Me w utility b Do, 2101- r MH BEYOND - SCALE Ng � OWNER: CARLOS & JANET GUERRA , SEWER SERVICE as C a' � Div sewEx EUAt : ADORE55:"q 3003 NORTH CIRCLE SHEET DESCRIPTION: `y, T:(907) 272-8218 4 SLC tW-219.97) ��sywsoPs -t ',; F:(907)277 8211 CLA usf StFIOLE w/ +s• BEHO � . r�-� - - - �• mZ 6rn N - I W 4=PCL9W 9R,a 5 - -- cAsm C o` -4--!-Iry+4 -4- - a,f 1 3 1 ! I .g. e -- _--- s$. -- 6 + I I 13 ! 1! 1! 1 1 I TT 1' -i -I-- - r .- -- N o. + Im I t - • � went PVE - l l - � � - - �', - rn 0 �� xtI-w (rano xPn7 �� 1 r 1 \ � . 0. \ ,I' . N —..Yf9.l9t [MELD rCACQ $ N S 4 O 59k 11-0.30 . w1 r.rric W ro sA W*. 9anLWI {nEW 19T4 mR N + . 0. 4' PW BACNYu Mw N N N N p N O N q BASED UPON AWW/8 INt th:'lAETA1 ION OF THE &6 8 DESION B40HEETS WTENL TITS PLAN APPROVAL DRAWN J� LS TO 94UK THAT THE PLANS WERE DESIGNED TO AWWVS STANDAWS AM THE SIGNEE IS NDT SIGN TURE: LIABLE FOR ANY ERRORS OR EWSS1ONS. 4 as APPROVED FOR CONSTRUCTION F By A -*-.w water i W*Me w utility Do, 2101- r TRUE NORTH SRP - SCALE I �• Oft on , : GAS Lid ^ i- 2 2�s i;� r _ &6 8 - r 12 DRAWN J� r I, p;...-....... _q�te,, LEGAL: GRANITE VIEW # 1 BL6 L6 SIGN TURE: - - "' ^' ti �= `- - M.ga a i' g •, 4 as ` : ., �...=.. F �• �' �a -r � cNLCKCD SRP s 19tH ^ a = f a ° 8 g� IS R a v ; 32,1 ! goag PLAN TYPE: OWNER: CARLOS & JANET GUERRA , SEWER SERVICE ; = . v g o SWIS3a PfVnar[; 'sem`. x-.,.9 ADORE55:"q 3003 NORTH CIRCLE SHEET DESCRIPTION: `y, T:(907) 272-8218 ANCHORAGE, AK 995507 ��sywsoPs -t ',; F:(907)277 8211 CLA IDGE PL seas'E ' r�-� - - - �• mZ 6rn W 4=PCL9W 9R,a 5 - -- cAsm C - a,f -- _--- s$. -- V9—SM —SVC b —q - r .- -- r 1 \ � . 0. \ $ N S LIL1 a Z PLAN SET Na. 10623 N DRAWN J� r I, p;...-....... _q�te,, annone sent$ LEGAL: GRANITE VIEW # 1 BL6 L6 SIGN TURE: - - "' ^' ti �= `- - M.ga a i' g •, ` : ., �...=.. Services, LLC �• �' �a -r � cNLCKCD SRP s 19tH ^ a = f a ° 8 g� IS R a v ; 32,1 ! goag PLAN TYPE: OWNER: CARLOS & JANET GUERRA P.O. BOX 100217 ANCHORAGE, AK 9951D SEWER SERVICE ; = . v g o SWIS3a PfVnar[; 'sem`. x-.,.9 ADORE55:"q 3003 NORTH CIRCLE SHEET DESCRIPTION: `y, T:(907) 272-8218 ANCHORAGE, AK 995507 ' DATE sn7ns ',; F:(907)277 8211 SEWER COVER SHED I a � � � 4UNE fl :12,900 SF RESIpENTI Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Mark Begich Anchorage, AK 99507 Mayor www.muni.org/onsite (907)343-7904 Pump Installation Log Well Drilling Permit Number: SW Date of Issue: Parcel Identification Number: O/y -301- O!a Legal Description Gro. -n ),�- View Be L(� 11 Pump Installation Date: 'flZ C/ Pump Intake Depth Below Top of Well Casing: 7G feet Pump Manufacturer's Name: 7'-0-P 05;acic cT Pump Model: 9-5/2— Pump S/2— I Pump Size 2 hp Pitless Adapter Burial Depth: :6 feet Pitless Adapter Manufacturer's Name: Pitless Adapter Installer: N Well Disinfected Upon Completion?yes ❑ No Method of Disinfection: Comments: Pump Installer Name: A -5 Property Owner Name & Address: (Zaa- /d s C v E7 30 a 3 G I rc., 11�0 6E BV �C O�Ln s: a z.' z 4 C 99,6-e) +S"°"+o ANCHORAGE WELL & PUMP SERV. 330 EAST 76T" AVENUE •,� ANCHORAGE, AK 99518 PHONE: 907-243-0740 AWPS.COM Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. e MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR/WELL INSPECTL~ON REPORT NAME ~ . -~. ' . A -- / --~ \IPHONE I []NEW MAILING ADDRESS q ~ _ ~ ~ ~ ~ .~ LOCATION / ~ ' NO. OF BEDROOMS DISTANCE TO: Well / Absorption area Dwelling PERMIT NO. ~ . -- I- Z Manufacturer Material No, of compartments ~ ~ Liq, capacity in gallons IF HOME.DE: inside length Width Liquid depth ~ ~ DISTANCE TO: Well Dwelling PERMIT NO. ~ Manufacturer Material Liquid capacity in gallons ' ~ Well ~ Foundation~ ~ Nearest lot line -- / PERMITNO.~ ~ ~ ~ No. of lines // Length~of each line Total length~ofolines Trench ~th~ ~ inches Distance between lines ~ ~ Top of tile to finish grade ~ / ~ ~'~Material behead//tiJ~ ,~~ ~C~ Total effective absorption ~ea -- Length Width Oepth / PERMIT NO. ~ ~ Type of crib 0rib diameter Crib depth Total effective absorption area ~ ~ell Building foundation Nearest lot line m DISTANCE TO: ~ Class Depth Driller Distance to lot line PERMIT NO. ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER ' ~OlU TEST RATING e ~'PPROVED ,F' DATE LEGAl_ ~ · E::OO:Ji: NIZIf~:TH L..[R....L[:: L.IZGI':IL t_,.G !36 G/~FI1',tITE ',,,IIIEH E!;Ut:':~ I_f.]'T T','I'"I::: ::}lri'' ::SEIIL tll[:~',OF~I~:TIIZIN f.;'r'fS'l'E:l"l I~};: .. EDB ElL, 1.. ,:: h I,.-,.~t UP1 N..JtbIL,,.. OF" Till:}: I::'.E(iUII;IED '.5IZE OF TIlE SOIL IqDd;CIIRF'TION TILE: L.[:NGTH D.T. HIZN~-..;ZOt'4 .T.% 'TILE: L[~NGI"tl (IN VE:ET) OF TIIE "FRI'~NC:I.t OF,' "HIE! DEI:':'TI.I OF' tq Tf;:~E:NC'~t OR F']:T I.C:; 'f'l. lE D];::gTFINC:[i: DETHEEN Tltf;..: 2;UI';.:Ff"IO[~: OF: TIlE GF4'.OUNI?.' fiNE> THE BOT'f'OH OF TILE".' E)'(CRVflTION (IN FEET). I"IIERE ]:~:; NO SET H:t:DTtl FOR TF.'ENOII[~'£;. TI.IE GRfI',/E:L DEP'FII :[ti::; 'FIIE M[NII"IlJM DEPTII OF ORR'eEL DE:'f'HEEN THE OI.JTi::'f:'ll_.l.. FINE::, 'l'l'l[E DOI"'FOM OF' THE E,~(CRVRTIO1'-4 (IN FEET). "r-f~ ' ~ _,,':' ,",- " ,~7 :: ~r ~ll rll~[ r)'"'['~Fr* ,F~ .... F'EF.'.HIT ,,, L].CI':INT tlR:, THE R[;~P_N;~ID].L.~I , TO II'4F:ORH '":,~ ,. L, f,,...TflL.N~ DUI('.INEi ..... : ILL. tl ION I,'4:.,I-['.....T,[ON.:, CIF FtN'~' PIEL. L21 R~;.~I'i(.,E. NT TO [III::, FF;....[ER1 F~N[) 'f'ti[:J ' ':' .' ......... f" "' .... _..E,F, v E., I4LIrlLLF.. Of':' I,Ex;,].D[;.N...E;;, 'rHF:IT TI.IE HELL HILL ':.'-':"'" TLR ANCHORAGE AREA BII' Department of Environmental Quality 3500 Tudor Road Anchorage, Alaska 99507 ~UqiM INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: INSIDE LENGTH INSIDE WIDTH _~ NUMBER OF MATERIAL _ t"~?C COMPARTMENTS. LIQUID DEPT~LIQUID CAPACITY. /G ~")O GALLONS. SEEPAGE PiT: / LENGTHO~(~,/ NUMBEROEP,TS t D,AMETER___ORW'DTH~ ..... DEPTH ~pU~: -' g'' C ~ ~ ' LINING MATERIAL ~ RIB SIZE: DIAMETER__.DEPTH DISTANCE FROM: WELL ~ BUILDING FOUNDATION NEAREST LOT LINE ~ ~0~ ~ , ~_ ABSORPTION AREA (WALL AREA) ~) ~ SQ. FT. ADDITIONAL ABSORPTION__ WELL: BUlL. DING FOUNDATION CESSPOOL ~ __, OTHER SOURCES CONSTRUCTION NEAREST LO1- LINE OEP,-. /~O. ' DISTANCE FROM: NEAREST SEPTIC ' '/ SEEPAGE ~,.,7 i SEWER LINE TANK ~'~ . SYSTEM REMARKS DISTANCES: INSTALLED BY: Z~/ ff*"~/C~ LOT SLOPE: F/EF Form PW-026 DIAGRAM OF SYSTEM GREATER ANCHORAGE AREA BOROUGH SEWAGE DISPOSAL SYSTEM . APPLICATION AND PERMIT INSTALLATION OF: SEPTIC TANK __ ~ SEEPAGe PIT __~ . . ,iD~AIN FIEL~ COMPLETION DATE ANTICIPATED ONE q t- OTHER TO BE INSTALLED BY NOTE: THIS PERMIT 15 NOT VALID ~flTHOUT ~OIL "l"~T PFRM~T V~J TI] fl_NF YFAR FINAL IN~PECTION~ 24 HOUR NOTICE I~EQUIRED. I~ACKFILLING OF ANY SYSTEM ~.¥1THOUT FINAL INSP~'.-TION ~Y THE HEALTH DEPARTMENT AUTHOIIITY WILL BE SUBJECT TO pROSECUTION. ' SEPTIC TANK SIZE TYPE-- MINIMU~ DISTANCES, I~m'QUIREMENT8 5 f~. FOUNDATION TO SEEPAGE PIt 20 SEPTIC TANK TO SEEPAGE Pit WALL . · o ~*~ST LOT WATER MAIN TO SEPTIC TANK 10 ft, DRAIN FIELD 10 ft. DRAIN f~ELO l0 ft. ft, ft. DRA,N mELD --10 SeEPAGE P,, ALSO CONSIDER AREA WELLS. SEEPAGE Pit __]~0 ~1 25 lO0 SEPTIC TANK, £1.,.. SEEPAGE PI]' DRAIN F'IELD TO RIVER. LAKE. STREAM. CAST IRON iNTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PiT FITTED WITH AfRTIGHT ~EMOVABLE Test Brown nj 1-[: (~dTJ) Was a~od a ',~or Fncountered? ?,io [f YeS~ At What Depth? 0 .0 0 i Gross 'Fime Net Time Depth to ti.,O d' Fl - CD G) CID CCY) r- r - C) CD L LI o LL C as V CL CL a 0 i U Z a 0 � ) J a a C U U) _ Q W Z ❑ 0 U a� 06 co c M E O ❑O LO N O N O co F - PIT cu C O Q X LU CD C) CDCD O i O (Y) i 4 0 a) U ti 0 LO m m Y co Q J N CO Y J m U LLIQ > U < 0 C z O C O o ch U O O � N -O J CO u ■ u Y W J W /I— V i 0 U) A (n O 0 (D V 0 O 0 Q C- CU O ca D U) U) O O rn c O a� X 0 > Q Q m cu C O =o C O O LO fn C d I.7 A "t N CDN M N 00 ai U 4— N U io C 0 M. V O O O U) Q. CL m a O 3 C� N , V N d M r :3 O L CC� G .� O cn 00 {�— 0 X aEi U L = O .0 0U) :3 ,F, U) ��N�I- C Q. a > M CD V ^ o a Q En � > > -O ._ CO .O 3 Q N E �" N ,� O '�CU U a N a) p i m a .N z Q U E , N i a -a E > c a O O L .m O d O Q QQ N CL Q 0 C (n u O >, cn �+ m d cn r +, II v/ o > }� (n in E � O Q o_ CL O ' OL a cn o Ln > y...Gi 4—LL O O Q L CY.± O Q G') cn C O -r- U 0 o a� Z - N r •N H Q " Y WOE a� c�a cLa U Q O UE O N O = N Q F a 0 a a a 0 U r— C) m O X rW O LL V a- tea/ L.L. 0 V Z LLa O l r W L L z o co lla^) VJ L C 0 O a �o O ca U Q CL Q \N O L Q- Q - W 4— cn Cn 0 O a� c� U W -o, T- J cu a_ Q cu cu U) a) O Q 0 Q c U N rrW^ V/ U .Q IL O U Q (D U) c 7 E 0 U w Y C 0) C =o O 2 El L a) 0 N C (0 (D ^0 ^W W cn 0 U c0 a) Y � Z Z a rn W Q L6 J W_ m Z O a w cn m a a) U C ca U 0 El r N O d H m N N � > O O 0 a CL _ O Uy E - 0 O d A N U L 0 (Q U)d c CL L M m m� C aD Com•' 1 W_ U U � C W 0) W ^0 W +N+ >, N C 0 m �• j E 0) C N 0 U 0 N •n�♦ ❑ cn a a) U) a) C f0 cn c L _ (D N a� � ❑ U > CO /n N L 0- 0) /a�) uJ 0 O ❑ c0 °� W M — a) � co > U) � j CY) c0 O a ❑ Q cn OLL W N ^ I L a L ❑ ❑ a. N w LU W cny N W H LL O LL O N a. a. Z O } H N M tt N rrW^ V/ U .Q IL O U Q (D U) c 7 E 0 U w Y C 0) C =o O 2 El L a) 0 N C (0 (D ^0 ^W W cn 0 U c0 a) Y � Z Z a rn W Q L6 J W_ m Z O a w cn m a a) U C ca U 0 El r N O d H m N N � > O O 0 a CL _ O Uy E - 0 O d A N U L 0 (Q U)d c CL L M m m� C aD Com•' 1 W_ 11.8 7/30/24 N/A N/A N/A > Benjamin Schiller, P.E. (907) 522-7773 F- C: Z u F- a N Q L LU co o 3: N a L U a Of L N O F- , din z L L L O a S Ss OJ L LU 0 O i� c � in � L � L a x a; O Q O co N >� ?:o N E O a v O i N (v 0-`n U N Ol - L N > O 4U °-• 4-J ch 4J N N 4- M }, W Ln _0 L c -I N bA LE Q) N f° s O L s }' 4- O 00 Q N = _0 a1 cv O a Q m m N O m -- w Om O 4- N >, -04, > O N C: 0- O v �' O Q) O lfl u b -0L 4- N _ *k O Q O V — U N U > J U O\ N L — G� O }, 4A L v m v� Qu N O O it Q L O to a+ Q U uO co O O �O 1- c N E m `� � +- O +L t N Q) ° a Ln J u (U 76 OU O '+- N N N E an E v > .� aO 4 � cn L ° O pp =3 ++ O E O (� a w cn n O "++ _ 4— C L L L to NL J i > 4 Q N m J a..+ f0 ' E Ln L � .> f0 N Lv OL �— U cn Q t 4 - i LOT 1 LOT 2 R=120.' L=53.86 71��UTILI"EASEMENT k LOT g SHED 1 D ui V WIDE RETAINING WALL (FYP.) �F0 A TH •.� STEVEN CALLA [il1AN. LS -12034 ?4.1'� EX15TINC HOUSE r t 17.3 ,yam LOT k cT`s T`n N r N SHED ...... r j 100' RADIUS FROM EXISTING WELL CLEANOUT 1'•'•'•' '• •'• = • FROM ABANDONED SEPTIC SYSTEM R=•270.00' L=121.18' 1 u� 0 NORTH _CIRCLE (NORTH CIRCLE WAY) XVe� �j'Q�ba�oo NOTES: 1. THIS DRAWING SHALL OCGBODH IED FOR USE AS A PLOT PLAN WITHOUT THE EXPRESSED 'U'�rOfesalvttiuta��'� WRITTEN CONSENT OF ANT 2. THE HOUSE WAS CONNECTED TO THE AWWU SANITARY SEWER. THE EXISTING SEPTIC SYSTEM WAS DISCONNECTED AND ABANDONED. AT THE TIME OF THIS SURVEY, A CLEANOUT WAS FOUND IN THE PARCEL#: 014-301-06-000 GENERAL AREA OF THE ABANDONED SEPTIC SYSTEM IN THE FRONT YARD. ORDERED BY: JAYNE ALMON, VANGUARD REALTY SURVEY CERTIFICATION: LCG LANTECH, INC HAS CONDUCTED A PHYSICAL SURVEY OF THE PROPERTY AS SHOWN ON THIS DRAWING AND CERTIFIES THATTHE IMPROVEMENTS LEGAL DESCRIPTION: ADDRESS: SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO ENCROACHMENTS EXIST AS -BUILT 3003 NORTH CIR. OTHER THAN NOTED, LOT 6, BLOCK 6, EXCLUSIONARY NOTE: IT IS THE OWNERS' RESPONSIBILITY TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS, RESTRICTIONS OR RIGHT-OF-WAY TAKINGS WHICH OO NOT GRANITE VIEW SUBDIVISION APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION, FOR ESTABLISHING PROPERTY LINES, OR FOR PLOT -PLAN PURPOSES, 250 H Street ACGnchorage, Alaska 99501 Lt END - SEPTIC STANDPIPE ® "• ® rf+ellenµ ::•:::.: ►s�r.t •....::: WATER WELL -r FENCE —X—X— 'Nooil De Y� �1�•.ConrrrL• •iO Survey Department Phone 562-5291 DRAWN DATE: 8/20/2020 WORK ORDER: 20063 IncCh Mainline DRAWN BY: AP PLAT: P-033 gAcPiir<eefuAe • e„.�u,.P.eT,9, • du4JinQ, Phone 243-8985 CHECKED BY: SC GRID: SW2334 AECC668 SCALE: 1"=20' FB/PG:818/28 REF:951-94A MUNICIPALITY OF ANCHORAGE Development Services Department P p .`�. - � Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 014-301-06 Expiration Date: 1. GENERAL INFORMATION Complete legal description GRANITE VIEW BLK 6 LT 6 Location (site address) 3003 NORTH CIR, ANCH AK Current property owners) CARLOS & JANET GUERRA pay phone Mailing address SAME Real estate agent Day phone 2. TYPE OF DWELLING: El Single Family (w/wo ADU) F-1Duplexe ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well El Private Septic ❑ Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer I] Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $_ �'j to (Co� Waiver Fee $ Date of Payment �' -2` - 2 Date of Payment Receipt Number N_` -/0 Receipt Number COSA # OSC.201 H 5 r Waiver # S. 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 MIKE N ANDERSON, P.E. Phone 727-$$64 Address 4661 NATRONA AVE ANCH AK Engineer's Printed Name MIKE N ANDERSON, P.E. Date 8-24-20 6. DSD SIGNATURE 4CSystem #1 Approved for 3 bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, r *:49TH I 1JJ.....�i ::... .... • / rI 7� • MICHAEL tV. ANDERSON /� ice•, CE 946p with the following stipulations:�t�t1�..��` By: v`- 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 COSA Checklist blue sheet COSA Checklist Legal Description: GRANITE VIEW BLK 6 LT 6 If more than T septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled un Total depth 53 ft Cased to >40' ft Q Sanitary seal is functioning correctly 0 Wires are properly protected Casing height (above ground '20"+ Date of flow test for CO 'Z�\ Static water level at beginning of test ft. Comments B. TANK DATA Age of tank(s) years Tank type/material Measured operating fluid level in septic tank M Standpipes/foundation cleanout per record drawing Date of pumping D. ABSORPTION FIELD DATA AWWU SEWER SERVICE Which system tested (date installed) ❑ ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 014-301-06 Structure served by this system Well production at time of test 6+ gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes 01 N X Coliform bacteria is Negative Nitrate mg/L X Nitrate less than MRL (ND) Arsenic 12.7 ug/L O Arsenic less than MRL (ND) Collected by MNA Date of Sample 8112/20/ C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date Results ❑ Pass For bedrooms Fluid depth prior to test 0 in Water added gal New depth in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ❑ Yes if No ft Wells on Adjacent Lots: Community Sewer Manhole/Cleanout > 100' ❑ Yes if No ft Yes if No ft Neighboring Tank > 100' ❑✓ Yes if No ft Private Sewer/Septic Line > 25' r7l Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No ft Holding Tank > 100' 0 Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' F.7� Yes if No ft Q Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ✓❑ Yes if No ft 0 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. Water Main > 10' ❑ 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 Water Service Line > 10' ❑ Yes if No ft Community Wells > 200' ❑ Yes if No Surface Water > 100' ❑ Yes if No ft F. ENGINEER'S COMMENTS * NEW AWWU SEWER INSTALLED 2016? 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. COSA Checklist yellow sheet ,- A, y++ A •.. Ttip ' •'j`# r l... .............. yp �` MICHAEL N. ANDERSON O .4 `<� •, tCE94642 P �s�4�1`... ft kil ft ft Iri l O -p O r1 x o0 r O U)w a -moiAm ce c a Q�,�AIMMMEWim Cil w Qm�"� z h 00 z m rn �Oo •®oF A • r- rD- o �Qt N� cDi: �0a r P C 0 044.. z: G�o� 1 D rn 812° S7'2 Fn D ��O�e d�o D- 4 w 150 .00, Or Coco Z OO ��O•p0 qz� to k, C DN - z nr 0 o o x x m o -I -I m ON m N S Z m���c DrNn Gam, D Znm —ink . . e. n? 0 o r ; 0 0 m • :i' rn pro �• row o = >ZCZD ::;::. . . :::::::::��:::::: w 00NP.rp toCF)O m Q w Drnmn •i. 1pj... mZ 51.6'.. moo inm!D rD z C, Dm�OGI z� : 1: -� .•Do I :Z D: io N , D 0 OcDiirnto O ::::::.:.:::::::::::::::::: .O ': N 36.2'— �_ r 00 port v Zm Oy Z= . . . . . .gip .' O rn n 0m mZn-(D 77I D z 'U :': . . . . . . = mW ZmZ . . m CI N Ln n 00z�no _� o � .. 6.3' N O� o zorn�o, = o b C) oO��m �Tr O rnz D X O N n m `G m m m O D D m o--- O m 0 Z� N I O i 4.3" C.1) (� Vt r D .o r D v Z x -I .� C Z m 0 C— In { �c' W fl 2 .Z7 TJ nmdrn�Dm{m =��< mO�nO C7 II mD 13.3';. 6.0" ( II D m D D m rn � � OT=ANN 'mX< Lim= n ffl N =1yn Z W W D ID ZmzoEO0 y0�rt, m -I D m n :' n Z m z r o czz=z� z=> --4SC� r <OD ` I rr vm^' ,z Om Sn (l i < O C m - � z Q .'' .. m m 0 �r,0 mOOD Vl — C %v GM m C x mvCnO i N N ym0<.^.� �D zO cnmD - nv l ®� �oz-q mOZ m0 Z m 0 I u oOz� ��� m Dj -4 rD O O W ZD { N 2!,,m0 ��1 CL, r OOma mZ_ -n ;a 00 `\ � 00 O I a m ovoA -OvDn O m- oa o0 �m�n D m x m pTp ZA zoo D m ' —Ni Ln D O vi pGlwm — z :0 m Z zoo z�ni C o `° o SO�O-1 z>o �Cczi \ �g12 51 00 O Z�DO 0-1D —I V7 = r \ I 03 '? �c i�m zmx >-0 m D m D _ .. in• D O vii �—` 3 v Ln X :C7 -a m y LZ'1 Z OD m D -n (1 r m N w 0 �. s �m�= ��c CLf)< Ln 71' X O0 Q0 w w W ::� r�^Sm MKA Z —I Vl J to w `_ z=n ZM<, p m m NOo� D Aooz '—� —i 0- >Z m m Lf) T DEVELOPMENT SERVICES DEPARTMENT On -Site water and wastewater Section www.muni.org/onsite Arsenic Advisory Certificate of On -Site Systems Approval # OSC201457 Subdivision: Granite View, Block 6, Lot 6 907-343-7904 Fax: 343-7997 A water sample revealed an arsenic concentration of 12.7 micrograms per liter (ug/Q. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 ug/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Information on arsenic is available from the On -Site Water and Wastewater Program website (www.muni.org/onsite) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. Mailing Address P� a Bax 196650:* Anchorage, Alaska 99519 6650 *www muni org " MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner ~--~.L.. Mailing address~'~('~ ~?')._{~. ~ (~)~"~( ~ Lending agency Day phone Day phone Mailing address Agent Address Unless otherwise requested, HAA will~be~r pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: NOTE: Individual well ~-- Community well Public water If community well system, provide written confirmation from State ADEC attest- ' lng to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site ~2~ Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. Se 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. 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 . :~lT-I~'l'-J."[- 'P. ~'/~--/-4.~,~) p.~. Phone .~"?--c~-~-~-7-~'-7 Address ~'~ '~O_~~ Engineer's signature- ~,~t~,~7-~ DHHS SIGNATURE · /'"'" Approved for ~ Disapproved. Conditional approval for bedrooms. bedrooms, with the following .stipulations: Additional Comments 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 ahalyze data before a certificate Is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Legal Description: A. WELL DATA Health Authority Approval Checklist Well type t,t'J~I tD~{- If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) ~'~ Date completed Total depth ~ ~ / ~ Cased to z.tO I ~ Casing height (above ground) Sanitan/seal (Y/N) 'X(~'~ - Wires properly protected (y/N) FROM WELL LOG AT INSPECTION Det. I I - 'g StatiC water level I~/~ .. ~ I Well production P,[/~ g.p.m. ~ ~ g.p.m. WATER SAMPLE RESULTS: Coliform Date of sample: B. '$EPTI~TANK DATA Ntirate Other bacteria Date installed I ~ --':~--'7~- Tank size I~:x::~O ~ Number of Compartments ..L:. Cleanoute (y/N) ~/~-5 Foundationclaanout(Y/N) I'~ Deprassion(y/N) ]'.~Z-) Hlghwateralarm(Y/N) 'h'J/~ II Date of Pumping , '/~,/GO Pumper C. ABSORPTION FIELD DATA Effective absorption area '7'q7--'=~= Monitodog Tube present (Y/N) ~--~ Depression over field (y/N))-~ Date of adoquacy test Il- -~ Results(Pass/Fall). ~"P/~S~ For '~- :::~-t- .bedrooms Fluid depth in al~orptiO¢l.~flel~ before test (in.); (~ Immediately after JOT%al. water added (in.): /~ IT-.- Fluid depth ~ (Ins)Mlab'tes later: Peroxide treatment (past 12 months) (y/N) 72-026 (Rev. 3/96)* Absorption mm = I c:¢7C)-~C' g.p.d. 1, y~s, ghm date 'f'~/~ D. LIFT STATION Date installed Size in gallons Manhole/Access(Y/N) ~/r~ 'Pump on' level at' High water alarm level at' ~.~/~,*- ' 'Datum Cycles tested ~,~/~ E. SEPARATION DISTANCES --~ 'Pump off' level at* SEPARATION DISTANCES FROM WELL ON LOT TO: Septi~tank on lot ~ I Absorption field on lot qC) r Public sewer main ]'~//~ Sewer/septic service line ~ ~'~ ILift station ~/~ SEPARATION DISTANCES FROM SEPTI~ TANK ON Foundation ~1 ~11 Water main/sewice line "L'~'O r On adjacent lots On adjacent lots Public sewer manhole/cleanout LOT'FO~~ .Surface watsr/drainage 1'~/0 Wells on adjacent lots I0C~ / SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: I Property line Su cewatar Curtain drain F. ENGINEER'S CERTIFICATION Building foundation '"~/'~C~! Watermainiservicelina ,~--'~ / Driveway, parking/vehicle storage ama -~0 ! Wells on adjacent lote ~ ~(/~ C~'?/ I certify that I I'~a~term~ inspections and review of Municipal records that the above systems are in conform~~_~ on this date. Signature ~_~l~-t~/ U U ¢-'~Y""~ - - : .. Date of Payment t I' /'~(~ ' ~ 72-026 (Rev. 3/96)* Waiver I Date of Receipt Number ~'i DEPARTMENT OF/HEALTH &:HUMAN SERVICES '~:" '-" :' Divis on of Env )onmental sei-vlces '. -~: · .',~.'; .;' _".:~ :.-~ .,v- - 'On-Site serVices section .'~ .- ,~ ,pon - ?Y-~! ". . ~ox 196650 ~'AhchOrage,~Alaska' g9519-66~0 APPROVAL FOR A SINGLE FAM L WEL . ,- ~c°mPl'et~legal--" ' -- description Lot ~ ,BlO~ 6~' gra~e. Vi~ Sub~;:'v~ion Location (site address or directions) _ 3005 No~h' CZr~ '. '-- . : : MaJling"fddress '~~~k ~z ~ AK 99507. - Lending agency .... Day phone · Mailing address_ ....- ..., ...........t,lnd~v~dual well .:, - - .XXX . .... - ..... ,, -,._..-.. .... ..-~ ?NDTE:. :{f community welt sy~tem, provide ~d.o. confi~ation ft'~i;t; Ao cr 'xest ~ .,'.' tngto the legali~ and status of system; ,- . -:. ~ '~ [ '.'" -~ ~ : :' ~ .... SAL. ....... ~ .......... ' NOTE~,.....l.f~O~:~ast~w~e~e:~f~,~?Ovi~e ~i~en COnfirmatiOn from Stafe'ADEc 72-025{Rev. 1/91) Front MOAt/21 STATEMENT OF INSPECTION BY ENGINEER .... : -.- - " ,~- . .~ · - -: ,~,...::: '· . As certified bymy seai'~ffi~ed hereto and as of the validation date sh0wn below; I verify that my investigation of this Health'Authority Approval application shows that the on-site w~ter supply and/or wastewater disposal system is safe, functional and adequate for the hum ~er 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 wastewate'r'd Sposa system'is in compliance with all Municipal and Sta;te codes, ' ordinances, and regulatidns in effect on the date of this ins pection. -.. ...... - : ':": ;'-~'~":": ";'¢ $&sENGINEERING ' Phone :" :~.:OJ ~ ~ Name of Firm ,/u~,~ Eagle River L~ Road - - .: :~ .... ,':-_'. v:...:~.._ .'.::?'::: ";'-':.' .... " - .: · ' - :F'.','.,~~ ~':"~"~¢~ ~: ' ~ . .. ....... .... .... .. ., · ,.,..,..,,,-, ...... r ' ~3.'-'¢"'&:'~', "__ ~ ~ ~ ". ,'.": '.: ,, . , ,. , . . . r:.,.. ;' ' ¢' ' " ' ' ' ': ' ' ~:1 ~'~% ~ ' : "' ,'~ ~ ~ r' '''':':'¢';' ' · ' ' ? '- ; ".;'::. "' %'Condit onal approve 'for ......... "' .......,.'Bedrooms .wRh the .fo ow ng:st pu at,OhS. ~,~¢.~:.~:¢~,;¢ .. Comments Approval Certificates ba~ed only upon the 'representations given n paragraph 5 above by an indePendent~ profess ona eng neer reg Stered n the State of Alaska. The DHHS does th s as a cou rtesy t0'Pd~Cha"ers of' and their lending institutions in Order to satisfy certain federal and state requ r~nents: 'Employees of DHHS d° n~t condu~t,inspeCtions or ana yze ,data before a certificate s SSued 3'he Municipa!ity of AnChorage is 'not · responsible for e~-rors'0~ ~missi°n$ ir~'th'~ Pr6fes~ionai ~ngineer'~ W°rl~'::;''7, ;: ";" 72-025(Rev, I/91) Back MOA~I , . ~ ,, , ; :; ::..: Municipality of Anchorage Department of Health and Human Services HEAl. TH AUTHORITY APPROVAL CHECKLIST ~///~ 3~,'~/Parcel I,D. LegalDescription://2'T~,. /¢/~./4~ f~/?/q/~J/7~ ~ A. Well Data Well type Log present (Y/~ If A, B, or C, attach ADEC letter. ADEC water s/stem number Date completed ~N/~, ,~,~/?F_ [I/~2 Driller ~/u,E, Total depth %~ '+- Cased to ~'0 '¢- Casing height Sanitary seal ~',1) /~.~ Wires properly protected~CC/N) FROM WELL LOG AT INSPECTION // Date of test Static water level / f Well flow [ ( g.p.m. -~o5/ g.p.m. Pump level1 t. ~.~ SEPARATION DISTANCES FROM WELL TO: / Septic,q=u~,~mg tank on, lot Absorption field on lot Public sewer main Sewer service line WATER SAMPLE RESULTS: Coliform / Nitrate Date of sample: ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank 0 ¢JoM- .L'~~. Other bacteria. Collected by: iii. SEPTIC/~TANK DATA Date installed II/~O/~Z Cleanouts (/~) ~Z Foundation cieanout (Y/6~ High water alarm (Y/~ kJ{/~ Date of pumping /o/~//¢ '[ Tank size /d(/O ~,~¢_. Compartments / /U¢ Depression (Y/~ Alarm tested (Y/t~,O /1'//~ Pumper ~,~%//~.' I !/ SEPARATION DISTANCES FROM SEPTICfl.'I~Itii~ING TANK TO: Well(s) on lot _, . '~¢~{;::X~ ~ On adjacent lots To property line I0 * Su dace water/drainage Absorption field /OO~ Foundation ¢~ Water main/service line 72.026(3~3)'Fron~ '-~- ~:¢~- (~' ~?'~,4.4,~- OF CONTINUED ON BACK PAGE C, LIFT STATION ,.~/~ Date installed Size in gallons Vent (Y/N) High water alarm level Meets MOA electrical codes (Y/N) "Pump on" level at Manufacturer Manhole/Access (Y/N) "Pump off" Level at .Cycles tested SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date install,ed//I/~/¢Z ~ // ~/1~ /7~ Length 2~1 / ~0 Width T.9.~absorption area¢-~2 ~;F/ /;-O Date of adequacy test //~fl Water level in absorption field before test Peroxide treatment (past 12 months) (Y/I~ Soil rating (GPD/Ft2) ~$s¢l/¢/~//,2o~¢.~Systemtype~,c~6ffr/-/~E~,~//, Z< Gravelthickness /~( /,~ Totaldepth /~' / ///// Cleanout present (~¢/N) ,,~ Depression over field (Y/N_.) Results (p.ass/fail) P/}5 ,.~ for ¢,?.- Bedrooms ~¢ '~ / ~.'- 0'-- After test ~' / ~0'f X~o~ If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot To building foundation On adjacent lots Surface water Curtain drain ~c~ o~ On adjacent lots .-¢¢.,1' f 3')' Property line To existing or abandoned system on lot Cutbank /u/~4 Water main/service line Driveway, parking/vehicle storage area ~ ,-~ ~ ,~r~;-~'-~-~,f-.',~:~ ,,~A-~d~--/,---- E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HA,~ guidelines in effect on the date of this thspecb'on. Signature Engineer's Name Date HAA Fee $ ~~0 ~ r-/D Date of Payment Receipt Number .-...'?:, :. (.:. .; .. -.. Waiver Fee $ Date of Payme~ Receipt Numar '~0 7 Rick Mysrron Mayor Mtmicipality of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 March 8, 1995 Mr. Robert W. Cowan S & S Engineering 17034 Eagle River Loop Road, Suite 204 Eagle River, AK 99577 Subject: Waiver Request for: Lot 6, Block 6, Granite View Subdivision Waiver Approval: if WR950008 Dear Mr. Cowan: Your request for waiver(s) of the required 100 foot horizontal separation of a septic system to a private well has been approved. The approved separation distance(s) are: Well to crib on Lot 6 Block 6 Well on Lot 1 Block 5 to crib on Lot 6 Block 6 Well on Lot 1 Block 7 to trench on Lot 6 Block 6 90 feet 81 feet 97 feet This waiver approval applies to the existing septic system to well separations only. Any future upgrades will require all separation distances be met or another approval be obtained from this department. Sincerely, . Civil Engineer On-Site Services kb WR~ ]Date Received: Legal Description: Engineer: MUNICIPALITY OF ANCHORAGm Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR950008 PID# 014-301-06 HA# HA950050 Permit # 2-22-95 Lot 6 Block 6 Granite View Subdivision S & S Engineering 17034 North Eagle River Loop, Suite 204 Eagle River, AK 99577 Applicant: Tom Tomlinson Waiver Requested: Well to crib on Lot 6 - 90 feet Well on Lot 1 Blk 5 to crib on Lot 6 Blk 6 - 81 feet Well on Lot 1 Blk 7 to trench on Lot 6 Blk 6 - 97 feet 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: Date: 3 --~--~--- By: ~/~/t/ /~r~/ Name of Reviewer Amount: $ 920.00 Rec #: 00678 (608) Date Paid: 02/09/95 57.8 .57.4 2.7 2.2 HEALTH AUTHORI~r' APPROVALS SEWER&WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOWTEST SITE PLANS ROAD DESIGN SOIL TEST PERCO[~,TION TEST STRUCTURAL & MECHANICAL INSPECfIONS ONSITE WASTEWATER DISPOSAL SYSTEM DESIGN E. NVI~,OhlMEN'[ AL SERVICES February Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 ROBERTC. COWAN, RE. ROBERTA. SHAFER, RE. CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 REFERENCE: Lot 6 Block 6 Granite View Subdivision Request you issue a Health Authority Approval on the referenced property and grant a waiver for the horizontal separation distance between the following: 1. Well and the crib serving this property at 90 ft. 2. Well serving Lot 1 Blk 5 and the crib on the referenced property at 81 ft. 3o Well serving Lot 1 Blk 7 and the trench on the referenced property at 97 ft. The mitigating factors involved which support the issuance of the waivers are as follows: 1. Reference to the site plan/topo, surface effluent would not flow toward the wells. 2. The road drainage would also prevent surface effluent from reaching the wells across the street. 3. The house is located between the well and septic on the referenced property. 4. Nitrate sample taken from the well located on the referenced property indicated "none detected". In our opinion, the separation distance requirement prescribed by 18AAC.021 is not necessary in this case. If we may be of further service please contact us. Sincerely, 17034 NORTH EAGLE RIVER LOOP o SUITE204 o EAGLE RIVER, ALASKA 99577 ~o o~ <~ F-O "x OJ 0--1 NYqd 311S ,Og = ,,!, MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION '¥. 825 L Street - Anchorage, Alaska 99501 tENVIRONMENTAL ENGINEERING DIVISION ' ' Telephone 264-4720 . REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES'; DIRECTIONS: Complete all parts on page t, Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. ~OPERTY O~NER ' I PHONE MAILING ADDRESS PROPERTY RESIDENT {If different from above) PHONE 2, BUYER . ~ PHONE 3. LENDING INSTITUTION ~ [ PHONE MAILING ADDRESS 4. REALTOR/AGeNT [ PHONE 5. LEGAL DESCRIPTION STREET LOCATION 6. TYPE OF RESIDENCE ~ SINGLE FAMILY ~ MULTIPLE FAMILY 7, WATER SUPPLY INDIVIDUAL~ COMMUNITY PUBLIC UTILITY 8. SEWAGE DISPOSAL SYSTEM ~ INDIVI DUAL/ON-SITE*~ [] PUBLIC UTILITY NUMBER OF BEDROOMS -' [] One [] Four [] Other [] Two [] Five [] Three [] Six *ATTACH WFLL LOG. A well Icg is re(:uired for all wells drilled since June 1975, For wells drilled prior to that date, give well depth (attach Icg if available,} . **if individual/on-site, give installation date / ~' ? ~z~ ? If system is over two (2) years old an adequacy test's required by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DAT DATE DATE ' INS INSPECTOR INSPECTOR 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [~'i NG LE FAMILY [] ONE [] THREE [] FIVE E~ OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WA_~SU PP LY jl~ INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED E~ PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [~NDIVIDUAL/ON -SITE DATE INSTALLED E~PUBLIC UTILITY Connection Verified INSTALLER E~eptic Tank or []Holding Tank Size: /(~OO If Tank is homemade SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERI~L 4, DISTANCES Septic/Holding Tank Absorp~tion Area Sewer Line Nearest Lot Line WELLTO: Absorption Area to nearest Lot Line ~"/APPROV ED FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY (Title) / / LEGAL DESCRIPTION 72-010 IRev. 3/78) !011 ~agt T~r:Jor ROad S~ti'[-~¢ 190 995(F7 GREATER ANCHORAGE AR£A BOROUGH Department of Environmental Quality 3500 Tudor Road, A.chorage, Alaska 99507 Date of Inspection REQUEST FOR APPROVAL' OF INDIVIDUAl, SEWER & WATER F^CILITIES FOR Address; 5. Type of Facility to be Inspected: Number of Bedrooms:__ ~ ~ · A. Type__ (j) // c. ConstrucUon_,©:f 7. Sewage Disposal System: C. D. Distances: A. Well To: Installed/~'7~1- B. I nstaller~?.~ Septic Tank: 1. Size /000 2. Manufacturer t7 W · '6 · Seepage Pit: 1. Size ~)-/~2 2. Material ~(~)~O~tt,~, Disposal Fteld~ To~al Length of Lines ....... ~ ....... ,' Septic Tank ~ , Absorption Area. , Sewer Lines ; Nearest Lot Line ~04~/~) Other Contamination Foundation to Septic Tank ,~ / "~ Absorption Area . Absorption Area to Nearest Lot Line_____~(~ ~.~' ~eque.~t for Approval of ,4divtdual Sewer & Wate~ Faeilttius '~ge Two 9. Comments: Aporove~ -~L ~ Date -Disapproved~ I\ ApproVal Valid for One Year From Date Si~ned Greater Anchoragh/Area Borough, Department of ~nviro~menta] Qua].tty D~AGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the sub.iect sewer and water facilities located at: Signed Dage