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Home My WebLink AboutLAKE RIDGE TERRACE BLK 4A LT 4Lakeridge Terrace Block 4A Lot 4 #051-321-04 Municipality of Anchorage wulvis a „ On -Site Water and Wastewater Program • (907) 343-7904 Page of6 ON-SITE WASTEWATER INSPECTION REPORT AUG 2 7 '[u I.: Permit Number: OSP131419 PID Number: 051-321-04 Dwelling: ® Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New ® Upgrade Name: Eric & Karol Weatherby ABSORPTION FIELD - EXISTING ❑ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address 14631 Terrace Lane, Eagle River, AK 99577 ❑ Other Phone Number. of Bedrooms Soil Rating Total depth from original grade 3 -- GPD/SF -- Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade -- Ft Gravel depth beneath pipe -- Ft Subdivision Block Lot Lake Ridge Terrace 4A 4 Fill added above original grade -- Ft Gravel length -- Ft. Township Range Section Gravel width _- Ft. Beds: Number of Lines Distance between lines I Ft. SEPARATION DISTANCES TM__ Lift Station Total absorption area Number of trenches Dist. between trenches From __ Fel __ Ft. Well _TANK ® Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Capacityu.56 Surface Water__ ANCHORAGE TANK Gal. Material Number of compartments Lot Line_ STEEL 2 Foundation -7 LIFT STATION Manufacturer Capacity Curtain Drain NA -- NA ----------------- Gal. Remarks Existing septic tank decommissioned Pump on level at Pump off level at High water alarm at per code & new tank reconnected to existing n. id in. system. Pump make and model Electrical Inspections performed by L / I< has•%! CoiYLGT<q��#.y/ -3 a C✓ /'CGGj, Installer .IRs PIPE MATERIAL House to tank D3034 d anfield D3034 Drainfield -- CO/MT D3034 Inspector ARCTERRA BENCH MARK (Assumed elevation) 100 ft Inspection dates: 1$'11/14/13 2nd 11/14/13 Location and description 3'd 4'^ Top of landing slab COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Conditional Approval: Date AW 'z n l Approved Date c 8167&//s UdlZU12015.,. 12.87 Anchorage Tank Billed To: Terms: Duo pate: Qty Unit 1 EA 4 EA Notes! Oren Anchorage Tank 2723 Rampart 17r. Anchora0e, Alaska 99501 Phone 1-907-272-3543 Fax 1-907-277-3715 Web Site; www..anchoragetank.com 99515 Ship Vie: OR Re: Berlet ii Deseriptlon TANK, SEPTIC 1250 GAL COUPLING, SEPTIC, 5X 4 Deliver ThrUsday AM 0' 8072771715 P.0011001 INVOICE Invoice Number: 31393 Date: 1111312013 Ship Tp: Job.8ite 14631 Terrace Lane Drop front yard Eagle RfverA,K 99515 Confaat; Dave 440.4794 Purchase nrvdem Poo: Job Site Prlca $1,700.00 $6,50 Ext Price $1,700.00 $28.00 Thank you ror yof' promptAaymentl Total Invoice Balance: $0.00 Past cluebalancm su act to a service chergs of up to 14%or the maatmurn allowed by the currsrd Wate of Alaska usury Iowa, A -C=33.2' B -C=21.6' A -D=40.7' B -D=28.5' AS—BUILT TANK DETAILS/SITE PLAN Perrit:OSP131419 LAKE RIDGE TERRACE B4A L4 PID#051-321-04 / LOT 3 BLOCK 4A 130.@• � � C� = 7s•4p.5 �Slg �F 6 EA o VARIES a / y� It as 000 GAL SEPTIC s j��`�� OF AL`s 1 * 9TH N KENNETH M. DUF�i7$/ dl ` CE -7116 (� 4 04 J 1 y I,rn "vrY': SSIOIYW' 7GMRA%EL COeNEW 011ERTER��MnNG CRIB / TRENCH MS11NG S.T. 00—GAL S.T. W/ FCOs h COs.PLAWWSE MT � CO LOT 4 co BLOCK 4A N83'34'14"W 329.57' \83'35'00"W 330.38• R SCALE, NTS PREPARED FOR: ERIC & KAROL WEATHERBY 14631 TERRACE LANE EAGLE RIVER, AK 99577 FlELD BOOKS BOUNDARY: NA STAKING: NA ASSUILT: JLS DWG. FlIE: ACRD mu: FILE cOMPuTm: DRAB' BMW CHECKED: KMD DATE: 12/5/13 GRID: NW553 "N- 13-219 1 ■ Q ® WELL Z zo QD 0) Z tl� O o Q 10.7 13• m .3 O o / N 0 t 7 t0 //?•4 , /\ Z 2' CANT LOT 4 BLOCK 4A PLAYHOUSE ID , CANT GRAVEL D/W WELL \ \ \ 8g B R`(L_g0'0p' R) 10' UTILI ES i 200• (n N00"08'00"E LLI \ Of 60.00' ANCHORAGE RECORDING DISTRICT, ALASKA\ _ ASBUILT OF: LAKE RIDGE TERRACE SUBDIVISION O = FND 5/8" REBAR LOT 4 BLOCK 4A PLAT 71-293 SURVEY CERTIFICATE: I, John L. Schuller, Have conducted a physical survey of this property as shown on this drawing and that the improvements situated hereon arc within the property lines and no enchroachments exist other than noted. Under -no circumstance should any information on this drawing be used for construction of fences, structures, improvements, or for establishing boundary lines. EXCLUSION NOTES: It is the owners responsibility to determine the existence of any casements, covenants, or restrictions which do not appear on the recorded subdivision plat. DEC 3, 2013 1 1"=40' ' 13-046-2 WAM Or. amen ar MD NMeauyr. JLS I NW553 1 130214 HWY 0 N Q ~ U OQ J m TERRACE LANE low" 0 OF•.AZ std *;' c� ........ . ..:.{r. e OHN L. SCHULLER.: o s LS -10408 an �T3D SUR� w�5 SPL L ul 1831 Talkeetna Street Anchorage, Alaska 99508 (907) 227-1455 office (907) 274-4992 faa GREENHOUSE SEPTIC VENT O (tM) � I BASEMENT ENTRY DECK 44.0' E� ISTING , CANT GRAVEL D/W WELL \ \ \ 8g B R`(L_g0'0p' R) 10' UTILI ES i 200• (n N00"08'00"E LLI \ Of 60.00' ANCHORAGE RECORDING DISTRICT, ALASKA\ _ ASBUILT OF: LAKE RIDGE TERRACE SUBDIVISION O = FND 5/8" REBAR LOT 4 BLOCK 4A PLAT 71-293 SURVEY CERTIFICATE: I, John L. Schuller, Have conducted a physical survey of this property as shown on this drawing and that the improvements situated hereon arc within the property lines and no enchroachments exist other than noted. Under -no circumstance should any information on this drawing be used for construction of fences, structures, improvements, or for establishing boundary lines. EXCLUSION NOTES: It is the owners responsibility to determine the existence of any casements, covenants, or restrictions which do not appear on the recorded subdivision plat. DEC 3, 2013 1 1"=40' ' 13-046-2 WAM Or. amen ar MD NMeauyr. JLS I NW553 1 130214 HWY 0 N Q ~ U OQ J m TERRACE LANE low" 0 OF•.AZ std *;' c� ........ . ..:.{r. e OHN L. SCHULLER.: o s LS -10408 an �T3D SUR� w�5 SPL L ul 1831 Talkeetna Street Anchorage, Alaska 99508 (907) 227-1455 office (907) 274-4992 faa On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP131419 Tax Code Number: 05132104000 Work Type: Septic Permit Effective Dates: November 04, 2013 to November 04, 2014 Design Engineer: ARC TERRA CONSULTING INC Subdivision: LAKE RIDGE TERRACE Site Legal Address: LAKE RIDGE TERRACE BILK 4A LT 4 G:0553 Owner/Address: WEATHERBY ERIC W & KAROL 14631 TERRACE LANE EAGLE RIVER AK 995779243 Site Mailing Address: 14631 TERRACE LN, Eagle River This permit is for the construction of: N Disposal Field Y Septic Tank N Holding Tank Lot Size in Sq Ft: 43064 Total Bedrooms: 3 N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received Issued By By: Date: Date: MUNICIPALITY OF Community Development Department Development Services Division On -Site Water & Wastewater Program ANCHORAGE Phone: 907-343-7904 Fax: 907-343-7997 ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I. D. 051-321-04 G ERIC & KAROL WEATHERBY Property owner(s) Day phone Mailing address 14631 TERRACE LANE, EAGLE RIVER, AK 99577 Site address 14631 TERRACE LANE, EAGLE RIVER, AK 99577 Legal description (Sub'd., Block & Lot) LAKE RIDGE TERRACE BLOCK 4A, LOT 4 Legal description (Township, Range & Section) Lot Size 43064 Sq. Ft. Number of Bedrooms APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) Septic Tank Upgrade ❑k (w/wo ADU) Duplex (D) ElHolding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. owner or autnonzea agent/ Permit/Rush Fees: '�00— Date of Payment: I 1 1y�13 C i Receipt Number: (�1�J`J Aja Permit No. ilJel J Permit App_9-1-12.doc Waiver Fees: Date of Payment: Receipt Number: Waiver No. o �FtCTE!?,Pq ��S ARCT1rRRA CONSULTING, INC ` 212 E. 51" Ave, Anchorage, AK. 99503 e Office (907) 868-3791, Fax (907) 868-3793 November 4, 2013 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Septic Tank Upgrade Permit — Lake Ridge Terrace Block 4A, Lot 4 The owner has requested we proceed forward to obtain a septic permit to upgrade the failed septic tank on the subject lot. The proposed upgrade will serve the existing 3 -bedroom house. 77f #_( is AV &h1&YWwVc-PC&,ys6&4c�q. The adjacent lots are served by private water as noted on the design. There is no surface water within 100' of the proposed tank. We do not expect there to be any adverse effect on adjacent lots by the development of this tank. If you have any questions, please contact me at 868-3792/FAX 868-3793. Respectfully submitted, ArcTerra Consulting, Inc. Kenneth M. uffus, P. Attachments: On -Site Sewer Application Wastewater Absorption System Details/ Site Plan 20441 PTARMIGAN BLVD • EAGLE RIVER, AK 99577-8736 • PH (907) 868-3791 • FAX (907) 868.3793 WASTEWATER DISP❑SAL SYSTEM DETAILS/SITE PLAN LAKE RIDGE TERRACE B4A L4 EASEMENTS & LOT LINES PRIOR TO CONSTRUCTION &calel J PAGE zb°'OF DESIGN DETAILS DECOMMISSION EXISTING SEPTIC TANK PER CODE INSTALL NEW 1000—GALLON SEPTIC TANK INSTALL FCO, POST TANK COs & DIVERTER — CONNECT TO EXISTING SYSTEMS NO PUBLIC WELLS WITHIN 200' OF PROPOSED SYSTEM. NO PRIVATE WELLS WITHIN 200. OF PROPOSED SYSTEM EXCEPT AS NOTED. NO SEPTIC SYSTEMS WITHIN 200' OF PROPOSED WELL EXCEPT AS NOTED. law QF AL�� 1 *. TH 04l�irx>LrII . ` S 0 ` CEEB/--711Ato 8 'a NOTES; 1. INSULATE TANK IF (4' COVER. 2, CONTRACTOR WILL ENSURE MINIMUM 2% SLOPE INTO SEPTIC TANK, 3. CONTRACTOR WILL ENSURE ALL SEPARATIONS TO ADJACENT WELLS & SEPTICS. PREPARED FOR: ERIC & KAROL WEATHERBY 14631 TERRACE LANE EAGLE RIVER, AK 99577 FIELD BOOKS BOUNDAR" NA STAwa NA ASNUkI'•. JLS DM FNE: ACRD "`E FILE COMPUTED: DRANK: BMW cHEcXm KMO DATE 11 /1 /13 Gm NW0553 Jm N.: 13-219 y oti �gCTERR'I � K 2 4 m � �a �A eR' AK 99577'�� E� WASTEWATER DISP❑SAL SYSTEM DETAILS LAKE RIDGE TERRACE B4A L4 N`4 p,s ;,4 S/S ti N 'A 0 D w 24. p' y Z X2.0' INSTALL CCID o LOT 3 BLOCK 4A �i346 S6' R) FCOs OGREENHOUSE FLAG ALL WELL RADII, EASEMENTS & LOT LINES PRIOR TO CONSTRUCTION N83°34' 41 "W 83°35'00"w Cos INSTALL NEW DIVERTER -.--EXISTING CRIB / Ti DECOMMIS I N EXISTING S. T. PLAYHOUSE INSTALL 1 00 -GAL. S.T. IN SAME L ATION W/ FCO & BLOCK 4A POST -T K COs. MAINTAIN GRAVEL 5'+ 0 FOUNDATION & D/W EX TIN SEPTIC SYSTEMS. FLAG ALL WELL RADII, EASEMENTS & LOT LINES PRIOR TO CONSTRUCTION N83°34' 41 "W 83°35'00"w Cos INSTALL NEW DIVERTER -.--EXISTING CRIB / Ti T X PLAYHOUSE N z Co LOT 4 BLOCK 4A 329.5 7' 330.38' R) Scale; 1'= 30' PAGE 2 OF 2 NOTEt DESIGN BASED ON ELECTRONIC AS -BUILT DWG BY JOHN SCHULLER PREPARED FOR: ERIC & KAROL WEATHERBY 14631 TERRACE LANE EAGLE RIVER, AK 99577 FIELD BOOKS W"AR" NA sTAo a NA Aso" JLS UNG. PDE ACAD HP: FILE COMPUTED: DRANK: BMW *a..D* KMD DATE 11/1/1 Gm: NW553 Jw Nen 13-219 oti �gCTEgR� �� g Z " 'P''SVLTING 6 fA' Ak. 99577-,15 MUNICIPALITY OF ANCHORAGE DE ATMENT OF HEALTH AND HUMAN SER ES Environmental Health Division 825 " L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NameG .� DISTANCES i C� FF't� /v J S Ct= L' TO FROM SEPTIC TANK ABSORPTION FIELD WELL Address _ l 03 L LL. WELL L yt 5il Nb l (2D /-i Phone(s) PVmv�AAF VVC'eD No. of Bedrooms S al— z5 qt> 3 LOT LINE 2c> / * _ L X1571nli- LEGAL DESCRIPTION Lot Block Subdivision t-1>4 K is IL AaC FOUNDATION 3�/ `I Township. Range. Section -BUILT DIAGRAM (Show location of well, septic system. property lines, loundation, -rlEluv'/ S G /LAS driveway, water bodies, etc.) TANKS C'�—SEPTIC �X/S�/�� ❑ HOLDING Manufacturer Capaaly m gallons Material No. of Compart r TYPE OF SYSTEM EORENCH ❑ BED ❑ W. DRAIN ❑ OTHER s" ) Depth to pipe bottom from Total depth from original grade original grade 3 FT FT f Jt D� S Y 5-7-" ' Fill added above original grade Gravel depth beneath pipe L9 — �, j FT FT eu M Gravel length Gravel width _ (� FT \ Total absorption area Distance between lines 7, 7 SQ FT /v `+ `!b t Tj to 5 YS, FT AY B� Number of lines Soil rating Pipe material ZZ SQ FT /-5i b 3,93 M -5 M n Installer Date Installed �ra3> TD WELLS 1N c p C�-PRIVATE C&57/lj6 ❑ OTHER (Identifv) Total Depth Cased to FT FT Installei Date Installed: REMARKS: -Scale: / =yV/ ENGINEER'S SEAL Inspection yerformed by: Date: atsG �� ` a r - c° �H.. e ' 77034 P Eagle River Loo Road No. 204 I g certil that this inspection was performed according to all f' %• . sT " ` r < "% Eagle River, Alaska 99577 Municipal and State guidelines in ellect on this date: 3 y4 ^ r!? t1 J Health Department Approval: Date: DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L STREET, ANCHORAGE, AK 995O1 264-4720 ��~ PERMIT NO: 870040 UPGRADE DATE ISSUED: 04/02/87 APPLICANT: ROBERT GRIFFITH / S&3 ENGINERING ADDRESS: 17034 EHGLE RIVER LOOP #204 EAGLE RIVER, AK 99577 CONTACT yHONE: 694~2979 LEGAL DESCRlP: SUBDIVISION: LAKE RIDGE TERRACE LOT: 4 BLOCK: 4A SECTION: 36 TOWNSHIP: 15N RANGE: 2W LOT SlIE: 51700 (SQ.FT" OR ACRES) I certi�y that: 1, I am {amiliar with the requiremenLs �or on�site sewers and wells as set forth by the Municipality oi Anchorage (MOA) and the State o'Alaska" 2. I will install Lhe system in accordance with all MOA codes and regulations, and in compliance with Lhe design criteria o� thispermit. 3. I -3 Z. adhei r all MOA and State oY Alaska requirements �or the set back distances f. F's any �xisting well� wastewater disposal system or public sewerage system on thilot. IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES; THEN (1> AN ELECTRICAL PERMIT AND INSPECTION MUST �E OBTAINED; (2) AS^BUILTS W1LL NOT BE ELECTRICAL INSPECTION REPORT; AND (3) THE ELECTRICALDUCTRICIAN" ~..... ..... --��------- APPLICANT: �OBERT 'ITH / S&S ENGINERING � ISSUED BY DATE: --i�=-^�`-�-��-��~*��--^-~------~----�- --�`-�-`----^-- (vim Vl � MI x y Our AM ro 3lV'JS I \ W c � U \ ,c 3lV'JS I PERFORMED FOR: I oc'FDATE PERF4tUIE LEGAL DESCRIPTION: "f 1�L�^ �`t LAXdt 2—t.DL.6 Township, Range, Section: J/61-) r—� 7�-XPVI— i SLOPE SITE PLAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS 5 WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT L O DEPTH? P E Depth to Water After Monitoring? N-LcuG Date: Reading Date Gross Time Net Time Depth to Water Net Drop ��Iff�R'S SEAL) Municipality of Anchorage /Z S DEPARTMENT OF HEALTH & HUMAN SERVICES "L" 0 825 Street, Anchorage, Alaska 99502-0650 r SOILS LOG —PERCOLATION TEST PERFORMED FOR: I oc'FDATE PERF4tUIE LEGAL DESCRIPTION: "f 1�L�^ �`t LAXdt 2—t.DL.6 Township, Range, Section: J/61-) r—� 7�-XPVI— i SLOPE SITE PLAN 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 COMMENTS 5 WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT L O DEPTH? P E Depth to Water After Monitoring? N-LcuG Date: Reading Date Gross Time Net Time Depth to Water Net Drop /Z S 7u M PERCOLATION RATE Z CR (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN L. FT AND FT ry 5 ENGINEERING PERFORMED BY:RlYer ``��,, pp Sp7�, b CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE Ai I�ICI�RL9t5tJfDELINES IN EFFECT ON THIS DATE. DATE: 5 0 �� S & S ENGINEERING 17034 E. R. LOOP #204 EAGLE RIVER, AK 99577 PHONE 4,694^2979 ******************ON~SITE SEWER PERHIT APPLICATION***************** APPLICANT: R08ERT GRIFFITH ADDRESS: 17034 E.R. Rd 4204 E.R. AK 99577 CONTACT PHONE: 694-2979 LEGAL DESCRlPTlON: LOT 4 BLK 4—A LAKE RIDGE TERRACE SEC: 36 1:KPR:2W LOT SIZE: 0 (SQ FT OR (ICRES) MAX^ NUMBER 3F BEDROOMS: 3 SOIL RATING: 225 SQ FT/BR SOIL lEST DEPTH: 14 FT NO WATER PRESENT IN TEST HOLE. ..... �.... ..... ..... ..... ..... ... .... ..... ..... ��..... ..........^. Els E12 I shl- TRENCH ...... . .......~......�^� AINFIELD EFFECTlVE DEPTH 7 COVER DEPTH 3 TOTAL DEPTH LENGTH 49 WIDTH 2^5 0 \ 0 SQ FT. 686 0 MIN. SIZE OF SEPTIC TANK IS 1000 GALLONS� ... ..... ... � ------ ------- SPECIAL CONDITIONS OR INSTRUCTIONS: MUNICIPALITY OF ANCHORAGE r 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 INSPECTION REPORT NAME i,tl - t ") Is o PHONE ❑NEW 1E MAILING ADDRESS LEGAL DESCRIPTION 17 —4 Lot i` /J 1 Lc K t- A-1 ✓_ I;G `� I'•�_I = _ �; : [_�_ LOCATION NO. OF BEDROOMS Uy DISTANCE TO: Well Absorption area Dwelling PERMIT NO. F Z aQ w 1... Manufacturer Material No. of compartments N Liq. capacity in gallons IF HOMEMADE: Inside length Width Liquid depth ❑y DISTANCE TO: Well Dwelling PERMIT NO. Z Q 2 H Manufacturer Material Liquid capacity in gallons O wI DISTANCE TO: Well �bC) Foundation 1 C) Nearest lot line - PERMIT NO. J w Z F z ww No. of lines j Length of each line — f� Total length of lines a Trench width -, inches Distance between lines cc I— p Top of tile to finish grade 4/ Material beneath tile /. inches Total effective absorption area w`- w Length Width' Depth PERMIT NO. Q F wa Type of crib Crib diameter Crib depth Total effective absorption area En DISTANCE TO: Well Building foundation Nearest lot line J Class Depth Driller Distance to lot line PERMIT NO. Lu � DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS _ SOIL TEST RATING INSTALLER hh, 1 REMARKS r i r, n T" co f;h APPROVED DATE LEGAL Permit # ,•MUNICIPALITY OF ANCHORAGE-; Department L' Health and Environmerta ?rotection� 825 Street, Anchorage, AK. 99501 , - 264-4720 # # HANDWRITTEN PERMIT # # # n G A D f V� ON-SITE SEWER PERMIT U /'" Applicant:0�3FjQ% OL S64,- Mailing Address:%Da (3L UE MCC L/yiGC T ACA 6GL leYF/t Location: EA 6-1- E /Ql J R Phone Number: a 7 /-. si!ra .2 S4 e- 3(0) 7'-/5N,RAW Legal Description: 4/671/ ,dteee YA z*Tx1v4,s rxetwC Lot Size: ZJ3 / 0 6 �/ Yoe Type of Soil Absorption System Is : U/OCs 9 A n C 76 At396ApTNON jf L,0 Trench: Drainfield: Seepage Bed: Holding Tank: Maximum Number of Bedrooms: �I ` u� Soil ating (sq t/br) 02 37 �� f ) 3-Q The Required Size of 19e Soil Abs rpti)n System Is: DEPTH -fes LENGTH /S �C GRAVEL DEPTH ft WIDTH 3� The length dimension is the length(in feet) of the trench or drainfield. The depth of a t: 76 Df the ground and the bottom o: / for trenches. The gravel da ` ztfall pipe and the bottom o; # # RE( Permit applicai installation it _ of residences t CAD CJA�J( Z_ee ; Backfilling of will be subject CSe- J _ONS it during the and the number by this department Minimum distant /'n system is 7.00 feet' for a privatew Q(J ng upon the type of public well. ll " 3�� ate sewer line is 25 feet and _ are required and must be ret -a-, r u uu zc=s aepartment withi7L 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. # # # PERMIT EXPIRES DECEMBER 31, 1 g # # 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 codes. (3) I understand that the on-site sewer system may require enlargement if the residence is remodeled to include more that 3 edrooms. Signed: Issued by: £ Appli t Date: 3 SWP/024(1/81) 7)t u - C" A. a -�� SOILS LOG MUNICIPALITY OF ANCHORAGE I' ae DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: AD A 0 -SO dam[ • �j DATE PERFORMED: -3 " /'—?� L�. LEGAL DESCRIPTION: O T r Gel LA P— Za AG tw lxe- fc?C ,3 S36 7-•5- /t 4-21y • DESLOP SITE PLAN PTH ITM 1 !I �E dct S l ��QC N 1 O' n Chaf� 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 C6,�� COMMENTS PERFORMED BY: i' WAS GROUND WATER A)® S ENCOUNTERED? L O P E IF YES, AT WHAT DEPTH? hI ir! 0 /ian^ > /P Reading Date Gross Time Net Time Depth te-E?F Water Net Pf Drop P /O f ae o Z !/S`U •oS lF�e // 1ro 0 17 /fl Z -O C/ Z- 0,06 O7 /0 b O SS /Z Zo /O o, v)- 0 • 0j - IL z0 / Z 70 C� D • 5Y' C2 /ZjO PFRRC�LATION RATE i9t2 (minutes/inch) 1- T//E-S�T�r77R99UN BETWEEN 7 FT AND � FT awl sf+C'-rT-S • ! �1� � !� CERTIFIED BY: DATE: j-I� a-"�--012/ GREV R ANCHORAGE AREA BORE'`"GH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON—SITE SEWAGE DISPOSAL SYSTEM NAME PhPIXV AACKI? MAILING ADDRESS 9)0 �CxI�15^ 4MV4t; /`` k PHONE LOCATION LEGAL DESCRIPTION Ivi y el Ale 74 rm&e SEPTIC TANK: DISTANCE �� FROM WELL INSIDE LENGTH SEEPAGE PIT: MANUFACTURER Gyeea C NUMBER OF MATERIAL J-eL —COMPARTMENTS—f INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY /OHO GALLONS. s NUMBER OF PITS __L_. DIAMETER 7L OR WIDTH f LENGTH lv, DEPTH 6 ` r LINING MATERIAL � CRIB SIZE: DIAMETER e DEPTH !� DISTANCE FROM: WELL 1q51�r// ! TOTAL EFFECTIVE BUILDING FOUNDATION*_, NEAREST LOT LINE_r . ABSORPTION AREA (WALL AREA) V°?z SQ. FT. ADDITIONAL ABSORPTION WELL: TYPE wk/``CONSTRUCTION �r^ 6w� DEPTH BUILDING ` UI NEAREST NEAREST SEPTIC FOUNDATION r ! LOT LINE SEWER LINE TANK CESSPOOL APPROVED DISTANCES: , OTHER SOURCES DISAPPROVED REMARKS DIAGRAM OF SYSTEM vi INSTALLED BY: c PIPE MATERIAL: cow eL+^ 6(wr �' y LOT SLOPE: REMARKS: DISTANCE FROM: SEEPAGE SYSTEM �7 7 DATE 9 t I ''J APPROVE/� G.A.A.B. y}t'v J � I /eoes NAME OF APPLICANT INSTALLATION LOCATION a i \ GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 PERMIT NO. SEWAGE DISPOSAL SYSTEM ® APPLICATION AND PERMIT LEGAL DESCRIPTION ✓ 4- INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACILITY TO BE SERVED — FINANCED THROUGH SOIL TEST RESULTS COMPLETION DATE ANTICIPATED MAILING ADDRESS C ' c e / vae SEEPAGE PIT I 7t�r N FIELD OTHER TO BE BY NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE v '44�TYPE! MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL Z SEPTIC TANK SEEPAGE PIT 0DRAIN FIELD TO NEAREST LOT LINE. - -. �f///� WELL TO SEPTIC TANK r SEEPAGE PIT—/ " s —. DRAIN FIELD _ ALSO CONSIDER AREA WELLS. E AREA SIZE WATER MAIN TO SEPTIC TANK SEEPAGE PIT DRAIN FIELD SEPTIC TANK, , SEEPAGE PIT / DRAIN FIELD TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL (BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. i G.A.A.B. OR LICENSED DESIGNER TYPE DIAGRAM OF SYSTEM I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GRED ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. L� APPLICANT'S SIGNATURE `/J GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" Street ANCHORAGE, ALASKA 99503 'F CA ct ► @ ,`, v•av�- Case # Performed For wo ( rk/. %Y%td-le•/ Dated Performed E''�_� Legal Description: Lo Block lxl-g Subdivision /a & A2,c1& p _7e -7e-2 This Form Reports Soils Log Percolation Test - Soil Test Must Be Logged To 4' Below Proposed Seepage System - Depth Feet Soil Characteristics I- 2- 3- 4- 5- 6- 7- 8- 9- 10- 11 — 12- 13- 14— /,5-0 -- 2- 3- 4-5-6- 7- 8- 9- 10- 11- 12- 13- 14— /,5-0 Was Ground Water Encountered? Ho If Yes, At What Depth? Reading Date Gross Time Net Time Depth to H2O Net Drop Percolation Rate Minute Proposed Installation: Seepage Pit Drain Field Depth of Inlet Depth to Bottom of Pit or Trench COMMENTS: Test Performed BY �,c_ Date Certified BY: Date TAUS* I • E •id1_'7 Municipality of Anchorage 5 67 o rPPG On-Site Water and Wastewater Program "4140' ��_ . <, ,cel o (907) 343-7904 Nva -' ` �S•f F E T Y v7 i U7J Certificate of On-Site Systems Appr N z I 3a o � Parcel I.D. 051-321-04 Expiration Date:e L 9 9 7 - �b 08, a01° 1. GENERAL INFORMATION: Complete legal description LAKERIDGE TERRACE; BLOCK 4A, LOT 4 Location (site address) 14631 Terrace Lane*Eagle River 99577 Current Property owner(s) Eric Wetherby Day phone 632-2902 Mailing address Real Estate Agent Day phone 2. TYPE OF DWELLING: vc,0 8970 ,1 Single Family (w/wo ADU) a ❑ Duplex z a. NOV 0 7 •(.1113 ❑ Multiple Dwellings (Single Family and/or Duplex) L y` V 3. NUMBER OF BEDROOMS: 4 .>�� a 69L95 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: Received by: Date://4/�4 COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ S2f 4 -t` 3 (5.((O Waiver Fee $ Date of Payment lit/o 7((B l ttillq Date of Payment Receipt Number O 2 Q O 7) 1 QL1tICR67 Receipt Number COSA# OSCAB(S$`l Waiver# c 5. k`STA IYIENef C N 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: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179 • Address: 3701 East Tudor Road, Suite 101-Anchorage,Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: I,I i "7 1t `a oQo00p�‘ In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system ,,0OF A , 0' in accordance with the guidelines and regulations established by the Municipality of Anchorage and g,��..••'•.. • :/S10O industry practices. The reported results describe the condition of the system/s on the date/s of the G v evaluation. Separation distances were measured to readily identifiable features. Hidden defects or /0 I ' r �: A • T encroachments may exist that were not identified during the evaluation. The operational life of all wells ,� * • �*OD and septic systems depend upon a variety of variables, including but not limited to, soil conditions, •"•"' "' ' A groundwater levels (that may fluctuate during the year), quality of construction (materials and / VA workmanship),and the water usage of the family utilizing the system's. These conditions can vary,and �'.... Q are outside the control of GEG. Satisfactory test results do not guarantee future performance of the / J:f r •rness. system/s; therefore, GEG makes no warranty(express or implied) regarding the future performance of • 1/O CE 7° 3 ' SOD the well or septic system. GEG makes no representation whether an alternative well or septic system Q j• /•. 7 ; •,cel can be installed on the property in the event either of the current systems fail to perform adequately in 4 wed 4.`1.1.j( o', the future. The content of this report is for the sole benefit of the person/party that retained GEG to V pro{ession oQ perform the evaluation. Reliance upon the information provided in this report by any other person or \kOOOoo� party (including subsequent property purchasers) is not authorized, nor will it confer any le righty ,, whatsoever. \\�, Ci ,2t YG. #AECC884 ON_S\1E v 6. DSD SIGNATURE AN '/ -TER p Z. i System #1 Approved for 7 bedrooms M WA-TOP" o ASCE A System #2 Approved for bedrooms �c2 9g0GR M a Disapproved ,0,. SER0�C� � Conditional approval for bedrooms, with the following stipulations: By: laibt(1,()A ( JVri' Original Certificate Date: Nov V O E) Q018 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 er 9ineer.'s work. 4'• • r 7. ATTACHMENTS: , '. COSA ChecklistNitrate%Atlrisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 10-10-12.doc 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: LAKERIDGE TERRACE; BLOCK 4A, LOT 4 Parcel ID: 051-321-04 A. WELL DATA *PER GEG INSPECTION Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) NO Date completed 1973(?) Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES Total depth *1989+ ft. Cased to UNK ft. Casing height(above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 10/17/18 • Static water level ft. 137.2 ft. • P^ Well production g.p.m. 2.8+ g.p.m. WATER SAMPLE RESULTS: Coliform NEG colonies/100 ml. Nitrate ND mg./L. Collected by: GEG, Ltd. Arsenic: <5.0 ug./L. Date of sample: 10/17/18 B. SEPTIC/HOLDING TANK DATA *DOUBLE CLEAN-OUTS BEFORE TANK Tank Type/Material SEPTIC/STEEL Date installed 11/14/13 Tank size 1250 gal. Number of Compartments 2 Cleanouts(Y/N) YES Foundation cleanout(Y/N) *NO Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping 1/1518 Pumper JR'S PUMPING C. ABSORPTION FIELD DATA 'BELOW EXISTING GRADE AT MONITORING TUBE IN CENTER OF 1987 TRENCH Date installed 1973/1984/1987 Soil rating (g.p.d./ft2o ft2/bdr )150/225&237 System type CRIB/DEEP TRENCHES Length 51 ft. Width 2 ft. Gravel below pipe 7.0 ft. 714+ 672= 2 Total depth *8 ft. Eff. absorption area 1386 ft Monitoring tube YES Depression over field NO Date of adequacy test 10/17/18 Results (Pass/Fail) PASS For 4 bedrooms Fluid depth in absorption field before test 0 in. Water added 649 gal. New depth **4 in. Elapsed Time: 45 min. Final fluid depth 0 in. Absorption rate>= 600+ g.p.d. Any rejuvenation treatment(past 12 mo.) (Y/N &type) NO If yes, give date - -INFORMATION ON 1973 LOG CRIB AND 1984 TRENCH ARE IN THE MOA RECORDS -TESTED 1987 TRENCH ONLY *CONDITION OF 1984 TRENCH IS UNKNOWN -CRIB DRY ON 11/5/18 -THE STRUCTRAL INTEGRITY OF 1973 LOG CRIB IS UNKNOWN -FLOW SPLITTER PROVIDES EVEN DISTIBUTION THROUGH BOTH DRAINFIELDS -MONITORING TUBE IN CENTER OF 1987 TRENCH ONLY EXTENDS 50 INCHES BELOW INVERT **AFTER INTRODUCING THE FIRST 201 GALLONS THERE WAS 2"ON LIQUID IN THE MONITORING TUBE D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump off level at .• wa er alarm level at in. - _ Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main 75'+ Public sewer manhole/cleanout 100'+ Sewer/septic service line 25'+ Holding tank 100'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation `5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS 'MET CODE AT TIME OF INSTALLATION A ,�♦^♦ G. ENGINEER'S CERTIFICATION 4,4::?,.‘..••' ''I••.:' ,�♦1♦' 1 /certify that I have determined through field inspections and : .• 4t •�� •. �• • review of Municipal records that the above systems are in • i conformance with MOA COSA guidelines in effect on this / • ,,� date. �, f�,�A. Game-. Engineer's Printed Name JEFFREY A.GARNESS •♦•♦-P1'• —795 c•••:..4.): Date 11 /7/143 40 PROFESS�� LICENSE ♦•It\a"�e� #AECC884 (Rev. 10/12/12) Municipality of Anchorage -� Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. DiTr_ 7 —0 1. GENERAL INFORMATION HAA#� �isZDDoZ-O Expiration Date: - S" Complete legal description Lot 4• Block 4A: LakeridQg Terrare s/n Location (site address or directions) 14631 Terrace Lane Paul F, River AK 94577 Current Property owner(s) Robert & Donna Griffiths Dayphone 696-4676 Community Class Well ❑ Mailing address P.O. Box 771733 Eagle River, AK 99577 Lending agency Mailing address Real Estate Agent Mailing Address Day phone Kings Realitor/ Bonnie King Dayphone 689-2276 Lakehill Dr ChuRiak, AK 99567 Unless otherwise requested, HAA will he held by DSD lorpickup. ��Z,� I �1S /o -L- 2. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well El Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Individual On-site 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 transfer of title (except between spouses) for properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of 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 s & 5 ENGINEERING Phone G 07 y " 7 C1 Address Eagle River Alaska 99577 Engineer's Printed Name R 0 Q't'e T C- co &"j'# Date A 3 A z OF nceear r- ccwr fl 5. DSD SIGNATURE CE -880.1 �. ; Approved for bedrooms. f�1t'< �' - .••••'`� Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By: (2L (cJ. ,p Original Certificate Date: (Rev. 121D0( Municipality of Anchorage .•• Development Services Department Budding Safety Division :. • r, On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Lagai Description: jol" �R f" �� r"(9" rParcel IU: S/' S-21 ' �" A. WELL DATA Well type 2(vfE-(Tl— Date com,,plleted Total depth iy ft. If A, B, or C provide PWSID # Sanitary seal (Y/N) — Cased to -+—!ft. FROMWEL�OG Date of test Static water level Well production g-p•m- WATER SAMPLE RESULTS: Well Log (YIN) nl Wires properly protected (YIN) Casing height (above ground) t in. AT INSPECTIO 01 I 3 ft. 9-p M. Coliform COI.es/1 ml. Nitrate 0eZmmg.A.. ,rOithe�r bacteria 40 colonies/100 ml. Date of sample: 0 Z Z/ Collected by: SYS ( of Eat- I B. SEPTICIHOLDING TANK DATA Tank Type/Mayt�erri��al G S•2'e� Date Installed T Tank size Log) gat. Number of Compartments %__ Cleanouts (Y/N) Foundation cieanout (YIN) Depression over tank (Y/N) N High water alarm (Y/N) i Date of pumping Pumper -T-7- S C. ABSORPTION FIELD DATA Date installed Solt rating (g.p.d.At= or fP/bdrm) System type 2r #3`• I'CH Length Width S ft. Gravel below pipe r Total depth [0412,11. Eff. absorption areakj?t-ft Monitoring tube Depression over field rsL Date of adequacy test � 0 ( Results (Pass/Fail) As S For bedrooms Fluid depth In absorption field before test in. Water added gal. N,e{w, ,depth in. Elapsed Time: min. Final fluid depth in //Absorption rale >= �f `� b g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) (.i l If yes, give date D. LIFT STATION Date installed `Pump on" level at Datum E. SEPARATION DISTANCES Size in gallons "Pump off* level at _ in. Cycles tested Manhole/Access (YM) High water alarm level at Meets alar & circult requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: f Septic tan ion on lot / 60 1 '� On adjacent lots bo Absorption field on lot 1 06 1 f On adjacent lots / O O f"F Public sewer main iV A Public sewer manhole/deanout �Pr S�/septic service line S Holding tank N iF SEPARATION DISTANCES FROM SEPTIC/HOkMWG TANK ON LOT TO: Building foundation -f Property line '�' Absorption field r 1 Water main 14 & Water service line Q f Surface water b O f- -Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line t O 1� Building foundation 10 't' Water main /#10( t T Water Service line / f Surface water O Driveway, parking/vehide storage Curtain drain J Wells on adjacent lots—L92!--4— F. COMMENTS 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 HAA guidelines in effect on this date...", w COWAN 2 Engineer's Printed Name �pg!<2T �• cQ:ggpl Date _ / HAA Fee $ 3 7 S. J Date of Payment i Ia 31 OX Receipt Number t.H 8 H H �'�• (Rev. 12/00) Waiver Fee $ Date of Payment Receipt Number In. !i e2ec' TNwj4. .ttA�o PI I.A I Appeo To TN./ D•ZAWI/6 It • ASDiTILY C.nf•f •'r _� I hereby vi slily that 1 hnve sur%ryed ihr• InHess iao: descrilwd property:, LoT y,� ,Ioc!_d 1�,i air, r� • •r. f.?,•C..T! %Ti! c.C_S_✓. l�rl _Jl F•y. .:/ . •F, •.• Anchorage Itemrdi ""Precinct, Alaska. mid that the Imprortments situated therran are niihm the pluperty lines and do'nol overlap or encroach on the property lying adjacent therein, that no improven,enl, on prop- - erly lyingadjacent thereto encivoch on the prcmisrs In question and that there are no roadeayr• trsn•Inktic"I lines or other visible easements on said properly except as Indicated hereon. tinted at t3Fle IUver, Atlssska this day af_l='eS.,-Rei �_. _..____ If1.:.•. timm'r G JOII`:SU\- SCALE: Ileplstered Lnnd Sureryor No Ten.L4 I'v ,}p' Box 456. t mIc llivel, Alaska Phnne v9l�_•518 MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARIMIENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date (a) Legal Dellsccriptio�n (include lot, blockr' subdivision, (section, township, range) T [ /SAC CI — "L/1�'i L,>& P,d. e Trt`? .Sba�n Location (address or directions) (b) Applicants Name Telephone `�-7I -� Applicants Address (c) Applicant is (check one) Lending Institution Owner/builder Buyer F___1 ; Other F-�:j (explain); (d) Lending Institution Tele hone Address (e) Real Estate Co. & Agent Address Telephone 2. TVpe of Residence Single -Family 5�!r Multi -Family Other (describe) Number of Eedrocas 3. Water Supply Individual Well rzf Community Public Note: If ccmmnity well system, must have written confirmation ficm the State Department of Environmental Conservation attesting to the legality and status. Is the well adequate for the number of bedrocm specified in this HA4 ON) 4. Sewage Disposal Onsite 5�f Public Community Holding Tank Is the wastewater disposal system adequate for the number of bedrooms ON) Q�'C_ C�\z ova [Page 1 of 21 2-15-84 5. Engineering Firm Providing Inspections, Tests, Data and Information I certify that I have checked, verified, or conformed to all MOA HAA Guidelines in effect on the date of this inspection. Signed Date :S K. 8 _ Name of Firm-- AI Q Telephone Address Signed by Date //)Z'Y-z (ENGINEER SEAL) 6.DHEP Approval Approved for -3 s bedrocros Approved Disapproved Terms of Conditional Approval 0 Conditional Date X7A The Municipality of Anchorage Department of Health and Environmental Protection does not guarantee the continued satisfactory performance of the water supply and/or the wastewater disposal system. This approval indicates that, as of the validation data shown above, Used cn the data and information furnished by an engineer registered in the State of Alaska, the water supply and wastewater disposal system is safe and func- tional for the number of bedrooms and type of structure indicated. (DHEP SEAL) ?. Mail the HAA to the following address: RB2/d5/s [Page 2 of 21 2-15-84 MUNICIPALITY OF ANCHORAGE (MOA) MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & HEALTH AUTHORITY APPROVAL (HAA) ENVIRONMENTAL PROTECTION CHECKLIST - FEBRUARY 1984 MAR 2 3 10P A. WLL DATA RECEIVED Well Classification If A, B. Or C. D.E.C. Approved(Y/N) I -A Well Log Present (Y)o Date Completed Yield" G Total Depth Uc�rs.� „ Cased to ONIYq�,�)ty Depth of Grouting�� Static Water Level \1N`l-�c,��s4v1 Pump Set At Casing Height Above Ground � ' `/'+_ Sanitary Seal on Casing C Electrical Wiring in Conduit 4fii) Depression Around Wellhead (Y Separation Distances from Well: To Septic/Holding Tank on Lot \1� / On Adjoining Lots } 160 r_ To Nearest Edge of Absorption Field/on Lot On Adjoining Lots To Nearest Public Sewer Line To Nearest Public Sewer Cleancut/4anhole -To Nearest Sewer Service Line on Lot Water Sample Cod By ; Date /� llecte Water Sample Test Resultsr�-r��zac Cam nts A' Ai1t c �oC= i(�t C� -��a� � i�.� �t�•r Ota-s�-n , \ mac t B SEPTIC/HOLDING TANK DATA Date Installed -71 Size J= C;E;A X_ No. of Canpartments 1. Standpipes ON) Air -tight Caps Foundation Cleanout (Y Depression over Tank (YJ0 Date Last Pumped '5y e Pumping/Maintenance Contract on File (Y ) for Holding Tank High-water Alarm (Y/N) Temporary Holding Tank Permit (YM) h1 Separation Distances fran Septic/Holding Tank: To Water -Supply Fbll ��, / To Building Foundation /Nito To Property Line To Disposal Field. C civ�nE�cs� T 1Catef �rrVserviee'Line As To Stream, Pond, Lake, cr Major -Drainage 11 G� ( S S Lvvey avllw.pl- bb0.,ie bTa wO ossa: a..Wp�,F: N'n c fy ,5� (Page 1 0 f 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata �rm Type of System Design Date Installed 17� Length of Field Width of Field _ \ Depth of Field (� Gravel Bed Thickness Square Feet of Absorption Area F-' ' Standpipes Present QY'j) Depression over Field (YD Date of Last Adequacy TestResults of Last Adequacy 'lest L\�- , � �� i� ap� - U�a�-t�� Separation Distance from Absorption Field: To Water -Supply Well �� ` To Property Line f To Building Foundation To Existing or Abandoned System on 'Lot ; On Adjoining Lots '-- Vo() To Water Main/Service Line To Cutbank(if present) \� To Stream/Pond/take/or Major Drainage Course N hjl�, To Driveway, Parking Area, or Vehicle Storage Area � Comments D. LIFT STATION Date Installed Size in Gallons "Rump On" Level at High Water Alarm Level at Tested for Electrical Codes(Y/N) Camments Dimensions Manhole/Access "Pump Off" Level at Vent (YM) Pumping Cycles during Adequacy Test. Meets MDA ** Check Permitted Bedroan Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA HAA Guidelines in effect on the" date of this inspection. •s Of Signe dUZ r �`/onla Date e'�r°"��/� C �'' MOA �an No. `�� C�4 �49°�_ _A y /1 \' �� KB1/d5/s '[Page 2 of 21 2-15-84 0 kZ A.,/' February 27, 1984 ilk ADEQUACY TEST WATER AND SEWER INSPECTION WELL INSPECTIONS AND FLOW TEST SITE PLANS ROAD DESIGN SOILTEST ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN EXCAVATION WORK Municipality of_ Anchorage Department of Health and Environmental Protection 825 L Street Anchorage, Alaska 99501 ROBERT A.SHAFER CIVILENGINEER 694-2979 REFERENCE: Lot 4; Block 4A; Lake Ridge Terrace Subdivision Request a Health Authority Approval be provided for the residence located on the referenced property. The following documents are provided for your information: A. Application for Health Authority Approval Certificate. B. Health Authority Approval Checklist dated February 1984. C. A drinking water analysis report for total coliform bacteria. The septic system serving the residence located on this property failed an adequacy test. It is recommended that a soil test be performed to determine the requirements for an upgrade of this system. At the time the adequacy test was performed the water in the crib was visible within the clean-out above the elevation at the top of the crib. The septic tank was pumped and verified to have a capacity of 1000 gallons. The crib had to be pumped and approximately 1600 gallons of water was removed. Approximately 1000 gallons of water was then added back to the crib and after a period of 24 hours the water level in the crib was higher than measured the previous day. It is suspected that the water level in this crib is being influenced by the water table in the surrounding area. It may be that the upgrading of this system will require a lift station and a Geepage bed or even a mound system. Approximately three days after the completion of the adequacy test the water level inthe seepage pit was again monitored and found to be at the same/level. f C' p j �'GC Cve `.F9 Gtiv�C2C- �/I G� e !O ll ^ ��..nev CArl ❑ 0111=0 Al ACVA GoC;77 1 page two Municipality of Anchorage A well production test was performed on the well located on the referenced property and was determined that the minimum sustained yield of the well exceeded 0.104 gallons per minute per bedroom. However, subsequent reduction in flow or failure of this well cannot be guaranteed. If we may be of further service, please do not hesitate to contact March 2, 1984 Pour .1 6-650 ANCHORAGE, ALASKA 99502-0650 (907)264-4111 TONY KNOWLES. MAYOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Robert Olson 552 Etolion Circle Eagle River, Alaska 99577 Subject: Lot 4 Block 4A Lake Ridge Terrace Subdivision Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: (1) A soils test needs to be done and performed by a registered engineer. ✓ (2) Obtain a permit to upgrade the existing on-site sewer system from this Department prior to any construction. / (3) Upgrade the existing on-site sewer system to meet Municipal ✓ Standards. If there are any further questions, please call this office at 264-4720. Sincerely, John Kennedy Engineering Tech II JK/ljw cc: Robert Shafer S & S Engineering Star Route Box 196-X Eagle River, Alaska ,99577 ALASKA 61 01ROWnTAL COnTROL SCRUINS, InC. Engineerinq & 6nuironmental Studies MARCH 23 1984 BOB PAGETT 603 W TUDOR ROAD ANCHORAGE AK 99502 SELLER — GALLERY OF HOMES BUYER — SUBDIVISION — LAKE RIDGE TERRACE BLOCK — 4A LOT — 4 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A CRIB WITH AN AREA OF 432 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 320 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 609 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 2 BEDROOM HOME. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME OF 1000 IS ADEQUATE FOR THIS 2 BEDROOM HOUSE. Of A * 493H_19 ►foy C. Reid, Jr. No. 2251-9 _. "••. *owes .- ;°ROFESSIOjP` ,nAA iii... "-A Q„-- R . Ak,6 aarinQ.(071 SRLgn/IA MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HWICIPAUTv OF ANCHORAGE DEPT. OF HEALTH & CHECKLIST - FEBRUARY 1984 ENVIP.ONMENTAL PROTECTIOR A. WELL DATA0 P !1. Lot 4 Block 4A L�k��dgeTerrace ,Subdivision Well Classification 1L If A, B. or C, D.E.C. gflch( / v L Well Log Present (Y/N) Date Completed " k, Yield Total Depth Z ga Ca ed t (� Depth of Grouting-__„ u AW Static water Level LC p Set At Gf �2o I.� -- J Casing Height Above Groun Sanitary Seal on Casing ((q Electrical Wiring in Conduit &)91(% � Depression Around Wellhead (rM) Separation Distances from Well: To Septic/Holding Tank on Lot /20 rt On Adjoining Lots �� To Nearest Edge of Absorption Field on -Lot Z ; On Adjoining Lots �dC� To Nearest Public Sewer Line Al 1 7 To Nearest Public Sewer �f Cleanout/Manhole AIZ 4 fTo Nearest Sewer Service Lire on Lot /00 Water Sample Collected By L el- ,L Date 2 Water Sample Test Results Cawents B. SEPTIC/HOLDING TANK DATA Date Installed Size e706) a;- No. of Compartments Standpipes (Y/N) ns_ Air -tight Caps (YIN) Yef Foundation Cleanout (YIN) /11�/O' Depression over Tank (YIN) VO Date Last P d 2- Pumping/Maintenance- Pumping/Mainteranee Contract on rile (YEN) O ; for Holding Tank High -Water Alarm (Y/N) Temporary Separation Distances from Septic/lielthiig� To Water -Supply Wall To Building To Property Lire GO To Disposal Holding Tank Permit (Y/N)/ A Foundation Za Field ZZ 14 - To = To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course Al ® hl IF ComientS .1-.^J /So /J A/1 % 721vi EA) Fed- Pq M.14 Inc a7C��19S,vc� [Page 1 of 21 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorptio Strata /� -Type of System Design Gi 2 12 Date Installed 3 Length of Field p�8 Width of Field _ r(g Depth of Field G v avel Bed Thickness Square Feet of Absorption Area ' Z Standpipes Present (Y-/4) P S Depression over Field (Y/N) AJO Date of Last Adequacy Test e Results of Last Adequacy est ,,e col z Separation Distance from Absorption Field: To Water -Supply Wall To Property Lire - To Building Foundation ( To Existing or Abandoned System cn Lot �� On Adjoining Lots To Water Main/Service Line To Cutbank(if present) To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area �b r � Comments We ? _ ar�¢,BOJA AJ �-� ;?S!K'4 AJ D. LIFT STATION Date Installed / Dimensions Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes(Y Comments Manhole/Access (YM) "Pump Off" Level at Vent (YM) Pumping Cycles during Adequacy Ti)st. Np-ets MOA ** Check Permitted Bedrocm Rating Against HAA Request ** I certify that have checked, verified, or, conformed to all MOA HAA Guidelines in effect on the dates o£ ins ion. Signe Date X41 F Co�C mpa ',..5 �rl &PPl.K 4/. MOA No. � `. •. KB1/d5/s [Page 2 of 21 . r 2-15-85 #1: Time 9: �,NICIPALITY OF ANCHORAGE'— v' ~ DEPARTMEi. uF HEALTH AND. ENVIRONMENT ROTECTION 825 L Street, AnchoraaP, Alaska 99501 264-4720 `-ate Received: October 19. 1977 a.m. #2: Timepyy� #3: Time Date 10-�h- Insp Wi sday Date Mm Date InsP Insp r' REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES 1. Lending Institution Request: Alaska National Bank of the North Mailing Address: 3301 C Street, Calais II Phone: 278-4581 2. Property Owner: Jurij Pikas Mailing Address: 1702 Blue Spruce Lane 99577 Phone: Disconnected 3. Legal Description: Lot 4 Block 4A Lake Ridge Terrace Subdivision 4: Single Family Residence: (x) Number of Bedrooms: Multiple Family Residence: ( ) Number of Bedrooms: Two 5. Well System: Individual Well (x) Community/Public System ( ) Permit # Construction Depth of Well 280' Well Log on File ( ) Bacterial Analysis 6. Sewage Disposal System: On-site �System (x) Public Utility ( ) Permit # Installed _kms` Installer j� wV1^/ Al L_Q- .key-, Septic Tank Size C) 00 Manufacturer G tiZes� T� Absorption Area LXX Soils Rate Material 7. Distances: Well to Septic Tank to Absorption Area to Sewer Line to Nearest Lot Line Nearest Lot line Absorption Area M CIAICIPALITY OF ANCHORAGE �,D %� �• Department of Health and Environmental Protection 825 L Street, Anchorage, Alaska 99501 279-2511, ext. 224, 225 --aequest for Approval of Individual Sewer and Water Facilities 1. Property Owner: Z"_TU R I� / Mailing Address: 17jo,'Z_ j�s�c�.�r? __�-4I _ ��._Phone: `011Q_6Vsi��CJ_kY 2. Name of Buyer: _ ti'NieZ Mailing Address: 1-711 it -o a..' k Phone: 110 3. Lending Institution: �� VG2 Lr/YKx CR1AI , 33v� G S� 02�� Phone: a7t6��.d�� Mailing Address: — 4. Realtor/Agent: �xC(cl��✓ Mailing Address: `��9--'''�. Phone: 5. Legal Descripticn: -LD _q�_L4 46",o Street Location: ASi— \ Wf-J. � 0i U- '_ 6. Single Familv P.esiclence: dumber of Bedrooms: _ _ �_k_^ Multiple Family Residence: ( ) Number of Bedrooms: Water Supply: *Indivi.dual Well ) Pu};lic/Community System ( ) If Individual. ?d^il, -,.,,ell depth (% If Community System, nar.,e oL sy—;te!n 8. Sewage Disposal System: On-site Systerl (x) Public System ( ) If On-site System, '-"ate of insta.11atLor: *"VOTE: A well log is required on AT,L wells drilled since 6/75. Ga 3/77 page -Two Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 4 Block 4A Lake Ridge Terrace Subdivision Affadavit Attached: ( ) Letter Attached: ( ) Approved: VL� Date: / Disapproved: Departm ni orksheet 0 . T2® 5AMAAAL (AM -CUP, Date: ti z,t OAf �Qi mak, U