HomeMy WebLinkAboutELMORE #1 BLK 6 LT 14MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
hftp://www.muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP251017
Work Type: SepticTank Upgrade
Tax Code Number: 01817220000
Site Legal Address: ELMORE #1 BLK 6 LT 14 G:3036
Site Mailing Address: 14335 TETON PL, Anchorage
Owner: GERHARZ PAUL J & RHONDA J R
Design Engineer: GARNESS ENGINEERING GROUP LTD
This permit is for the construction of:
Effective Date
Expiration Date:
Lot Size in Sq Ft:
Total Bedrooms:
t)rhartin�:�nP
1 /30/2025
1 /30/2026
35653
❑ Disposal Field 0 Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction shall 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 shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
4
Received By: s S ��� C� Date: /
Issued By: Date: ! 3 ° 2-C z S
ON -SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 018-172-20
Property owner(s) Paul & Rhonda Gerharz c/o Arm septic
Mailing address 14335 Teton Place, Anchorage Ak
Site address 14335 Teton Place, Anchorage Ak
Legal description Elmore #1 136 L 14
Number of Bedrooms 4
Engineering Firm Garness Engineering Group
Building Permit Number
Day phone 907-688-9433
Not Applicable X
APPLICATION IS FOR: APPLICATION IS AN:
(Z all that apply)
Absorption Field
❑ Initial ❑
Septic Tank
Upgrade
Holding Tank
❑ Renewal ❑
Privy
❑
Well
❑
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
Distance:
Permit/Rush Fees: Z Z Waiver Fees:
Date of Payment: "0 _Z 5- Date of Payment:
Permit No. 0 S P 7- 5- I 0 Waiver No.
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP251017, Curtis Townsend, 01/30/25
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP251017, Curtis Townsend, 01/30/25
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP251017, Curtis Townsend, 01/30/25
LOT 6
BLOCK 5
LOT 7
BLOCK 5
I
LOB 1
LOT
BLOCK 6
BLOCK
30
BASS
" 1MEAS. ,,,,
OF BEARINGS: 8 '
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(N -8',3 178.719) � 8.87 I=A�J. ,�'
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loeo "• •'� DRAINAGE/CREEK •.... ,,.,......,,
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i � RI AVE
ASPLS MORTGAGE LOCATION SURVEY NOTES:
NO TITLE REPORT WAS PERFORMED FOR THIS SURVEY, EASEMENTS SHOWN PER THE
RECORD PLAT. THERE MAY BE ADDITIONAL EASEMENTS NOT SHOWN HEREON. THIS
MORTGAGE LOCATION SURVEY HAS BEEN PREPARED IN ACCORDANCE WITH ASPLS
MORTGAGE LOCATION SURVEY STANDARDS. IT IS A REPRESENTATION OF THE
CONDITIONS THAT WERE FOUND AT THE TIME OF THE SURVEY. THIS SURVEY DOES
NOT CONSTITUTE A BOUNDARY SURVEY AND IS SUBJECT TO ANY INACCURACIES THAT
A SUBSEQUENT BOUNDARY SURVEY MAY DISCLOSE. THE INFORMATION CONTAINED IN
THIS DRAWING SHALL NOT BE USED TO ESTABLISH ANY FENCE, STRUCTURE, OR
OTHER IMPROVEMENTS. UNLESS GROSS NEGLIGENCE IS DISCOVERED, THE LIABILITY
EXTENT OF THE PREPARER SHALL BE LIMITED TO THE AMOUNT OF FEES COLLECTED
FOR SERVICES IN PREPARATION OF THIS PRODUCT.
() RECORD DATA PER. PLAT #P-63 5
—._._._.—EDOE OF GRAVEL
EDGE OF ASPHALT
E OVERHEAD UTILITIES
pp
-c- POWER POLE
@ UTILITY PEDESTAL
(�)
WELL
8
SEPTIC PIPE
SEPTIC TANK LID
DECKr
CONCRETE
1 60'
(Ilffxl7ll)
EOT 14, BEOCK 6
EEMOR-E SUBDIVISIOW
ADDRESS:All:)Dl**4. NO,- I PEAT #P-63 5A
ANCHORAGE,
` ANCHORAGE
TIMBERLINE SURVEYING AND ' ' •
17035 BARONOFF AVEFILE NO.: 25.014
~ MUNICIPALITY OF ANCHORAGE
DI RTMENT 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
..,.o DISTANCES
^oo,e.~ TANK FIELD WELL
~ -~'/l ~ LOT LINE ~0 ~7
FOUNDATION I g ~ I
TANKS N
~ SEPTIC ~ HOLDING
~1
TYPE OF SYSTEM
~TRENCH ~ BED ~ W. DRAIN ~ OTHER
~6 + ~.~ ~ 3~ SOFT ~ FT
I '-" '
~ PRIVATE ~ O~HER (Idenfilv~
REMARKS: ~ ~11 ~ ~ ~ ~ I~~1~
~ ,'~,1~ ~ ~'~ ~+7' ,"~ '~'"~ ':'~
- .:.: ~.~ ~. ~:~A~... ~-~i 'P~,. · _.
Dale ' ~ ~ ~ ** '- ,~ ~ ,
3/~/~ * ,.. ~ ..........................
I ~~ ~ ~ .~fy that mis i.~e~ion *, pedNmed ,=rding ~ ,11 ~.% THEODOAE F. mOORE.:
Municipal Ind State guidelifl~ tn efte~ on ~is date: ~/~ /~ ~.'[~ qx~x *. %.. CE- 3539 .' .' ..~ J~ '
. *~ ~%- · ...... .
72-O13 (3/85)
MUlq ]: C I F'AL I -]-~/ OI= ANCI-1OI-TAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L STREET, ANCHORAGE., AK 99501
264-4720
O[q--S I -1-E SEI,:JER ::~ WI-iLL F~EIRM I -I-
PERMIT NO:
DATE ISSUED:
860044
02/12/~]6
AF'I':'L I CAN 1:
ADDRESS:
CO~ TAC'I PHONE:
LEGA~ DESCR IP:
~LOT SIZE:
MAX BEDROOMS:
PRIME PROF'ERTY INVES
8400 HARTZELL RD
ANCNORAGE~ AK 99505
549-5641
SUBDIVISION: ELMORE
SECTION: 34 TOWNSNIP:
(SQ.FT. OR ACRES)
LOT: 14 BLOCK: 6
12N RANGE: 5W
Listed below are the options available to you io designing your septic
'syste)m. Choo~ the option that best ~its your site.
.DEP;II [0 PIPE BOTTOIt (FT.)
GRAVEL DEPTH (F'¥.)
]'O[AL DEPTH (FT.)
GRAVEL WIDTH (FT.)
GRAVEL LENG1-H (FT.)
'GRAVEL VGLUME (CU.YDS.)
I'ANK SIZE (GALS)
SOIL RATING (SQ.FT. /BR)
~0~! BED W. D4~I N
4.0
4.~
5 17.0
54.0
21.5
} ** 1,000.0 **
· 125 125
** TAI'~K MUST HAVE AT LEAST TWO COMPARTMENTS
I certi(y that:
1. I am ~amiliar with the requirements ~or on-site sewers and wells as set
~orth by the Municipality o~ Anchorage (MOA) and the State o~ Alaska.
2. I will install the system in accordance with all MOA codes and regulations,
and in compliance with the design criteria o~ this permit.
3. I will adhere to all MOA and State o~ Alaska requirements for the set back
distances ~rom any existing well, wastewater disposal system or public
sewerage system on this or any adjacent or nearby lot.
4. I understand that this permit is valid ~or a maximum o~ 3 bedrooms and
any enlargement will require an additional permit.
IF A L. IFT STA]ION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES,
]HEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS
WILL NOT BE APPROVED WITHOLIT AN ELECTRICAL INSPECTION REPORT; AND (5) THE
ELECTRICAL WOR~US~ BE DONE3Y A I~ICENSED ELECTRICIAN.
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska ~501 264~720
SOILS LOG -- PERCOLATION TEST
[] SOILS LOG
I-I PERCOLATION
TEST
PERFORMED FOR:
LEGAL DESCRIPTION:
1
3
4
5
6
7-
8-
9-
10-
11
12
13
DATE .ER~ORMED:
SLOPE SITE PLAN
WAS GROUND WATER SL
ENCOUNTERED? ~' O
P
IF YES, AT WHAT E
DEPTH? ~ *° Ou
15-
18- ** T~;OOO;E r. MOORE
CE - 3589
19
Gross Net Depth to Net
Reading Date Time Time Water Drop
. '...- ~..'P~RCO LATION RAT [minutes/inch)
./~"~'ff ~ TEST RUN BETWEEN FTAND ,FT
~,f~ ,~ q.o ~ ~et~ q~,,d~,-~. Foe 3 ~,' ~e tz'~z~'
724)08 (6/79)
...I
Flattop Tech/~fch!
,'-', ' 14530 Echo Street
'Anchorage,-Alaska --g9516'
f
WATER WELL RECORD
STATE OF ALASKA
DEPARTMENT OF NATURAL RESOURES
Division of Gsologicol p, Geophysicol Surveys
Drilling Permit No.
A.D.L. No,
ARch. Elmore 14 6 --of--of--of-- s~
Ic--c~. [OISTANGE AN0 DIRECTION FROM ROAD INTERSECTIONS L OWNER OF WELL= James Alllason
Add,.,: 8400 Hartzell Rd.
ARch., Ak. 99507
Feet Below 4. WELt DEPTH: (fineS) 5. DATE OF COMPLETION
E. WELL LOG Sorfoce 146 .". 5 - I 86
Till: grey ~d h~d. 0 78 s. ~c~u,. ,oo, ~,o,e.y
[lluvium: ~rey co[or~ medium 78 87 ~..~ ~.,,.~
hardness. ~.us[: ~ oo..,,s:
Till: grey end h~rd. 87 ~1 ~ ,.,.,,o.
Alluvium: grey and hard~ and 91 98 ~ ve,,w,,,
water saturated, e. CASING: O T~reodld ~ Welded
Silt ~ud g~nd: brown co[or; 98 9~ 4~.. 6 ~.. ,~ 146 ,,. ~.~,~ w,~,h, 17 ,~,./,,.
with water; 2 ~pm. 4~. ~.. ,~ .. D.,~ 5.cv. ,,.
Ti~: ~re~ a~d har~, 99 105 $. FINISH OF WELL: ope~
Alluvium: brown color~ hard~ 105 127 ~.,:
and water saturated. S~o,/M*,h S',,:
Alluvium: ~rey colo~ medium 127 145 s., ~,t..,. ft. a.~ f,.
Sand: brown color, with water: 145 1~6 ,O. SVAV,C WA~, [ZV~U~ 76 ,,. 5 /1 ~6
8 gpm. ~ov. o, ~e,,o.
Moflrlel: ~ Neat Clme.t ~Othe~: ~t~r~
Foss Drilling AA 758
~..,~I~ra Anch., Ak. 99501
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
GENERAL INFORMATION
(a)
Legal Description (include lot. block, subdivision, section, township, range)
Location (address or directions)
· -r%.~ F/~ c~
Oqq
(b) Applicant Name J- ~'-('
Applicant Address
(c) Applicant is (check one): Lending Institution I-I; Owner/builder
(d) Lending Institution ~q,A~ ' Telephone
Address
(e) Real Estate Company and Agent
Address ~y~C,~ ~r~zell
Telephone 3y~-
(f) Mail the HAA to the following address:
TYPE OF RESIDENCE
Single-Family I~ Multi-Family []
Number of Bedrooms ~
Other
3. WATER SUPPLY
Individual Well F~ Community [] Public []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status. \~ ~ ~ i ~ ~,
4. SEWAGE DISPOSAL
Onsitel~ Public[] Community[] Holding Tank [] ~ ~
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page 1 of 2 ?2-02,5 (11,84)
ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION ·
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 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 furlher 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 (:'~'~/~ 'T'~'(./~,,',;¢~(
Address I ~/,,C3~
Telephone .~ ~"- 13,~.5-
Approved edrooms gY
Terms of Conditional Approval
-'CAUTION
The Muncipality of Anchorage Department of Health ~nd Environmental Protection (DHEP) issues Health Authority
Approval certificates based ~>lely upon the representations given in paragraph 5 above by an independent professional
engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or
analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the
professional engineer's work.
Page 2 of 2
72-025 (11/64)
~,,.'~ MUNICIPALITY OF ANCHORAGE (MOA)
~,"~ HEALTH AUTHORITY APPROVAL (HA, A)
~.~1 ,~..~ ~E~KLIST- FEBRUARY 19~
'~ · ~ ,+:'Y~ L~al D~cription: ~C'~ I~,
Well Classification ~ ~ ~< If A, B, C, D.~C. Approv~ (Y/N)
Well Log Pre~nt (Y/N) ~ Date Complel~ ~/I / g~ Yield
Total Depth f ~' Cased to ! Y~'
Static Water Level "7~
Casing Height Above Ground I ~;"
Electrical Wiring in Conduit (Y/N) Y'
Separation Distances from Well:
To Septic/Holding Tank on Lot f O'1 ~
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line
Cleanout/Manhole
lOB ~
Depth of Grouting ~V~/t}.
Pump Set At ~n ~'
Sanitary Seal on Casing (Y/N)
Depression Around Wellhead (Y/N)
; On Adjoining Lots
; On Adjoining Lots
Water Sample Collected by
Water Sample Test Results
~, A, To Nearest Public Sewer
~lr A, To Nearest Sewer Service Line on Lot
'3'-~ ~ :Date ,~/' E Z
Comments
B. SEPTIC/HOLDING TANK DATA
Date Installed ~/~-~/'~' Size I~"C~
Standpipes (Y/N) ~ Air-tight Caps (Y/N)
Depression over Tank (Y/N)
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/Holding Tank:
To Water-Supply Well
To Property Line
To Water Main/Service Line
Course ~ ~r_J'O ~
No. of Compartments ~,
Foundation Cleanout (Y/N) ~
Date Last Pumped /q~/~. (' rl--~-,
; for ~,l, ~.
Temporary Holding Tank Permit (Y/N)
N. ,,9..
To Building Foundation I
To Disposal Field
To Stream, Pond, Lake. or Major Drainage
Comments
Page I of 2
72-026{11/84)
C. ABSORPTION FIELD DATA
Soils Raling in Absorption Strata I Z,,5" ~ ~/~ c~'r~, Type of System Design
Date Installed ,~ /~-' $/ ~" Length of Field ~' ¥'
Width of Field / -/~ Depth of Field ~/, 7,5" °
Square Feet of Absorption Area
Depression over Field (Y/N)
Results of Last Adequacy Test
Gravel Bed Thickness 0,%c~
.~' 7~' Standpipes Present (Y/N) 'r"
N Date of Last Adequacy Test .
Separation Distance from Absorption Field:
To Water-Supply Well
To Building Foundation
Lot , /~l, ~.
To Water Main/Service Line
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments
To Property Line ~
To Existing or Abandoned System on
; On Adjoining Lots ~> ;~O '
TO Cutbank (if present) N,
~m lO0 '
D. LIFT STATION N,/~*
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
.Pumping Cycles during Adequacy Test. Meets MOA
Comments
** Check Permitted Bedroom Rating Against HAA Request **.,
I certify that I have checked, verified, or conformed to all MO,~ and HAA guidelines in effect on the date of th=s ~nspechon.
Signed ~ ~,, ~ Date ~'/~'/~'
Company F~/~ ~c~[~ MOANo. ~-~
ReceiptNo. ~ % ~ ~ ~ ~ ~
Date of Payment ~l ~/~ L
Amount: $ ~ ' ~ Engin~r's Seal
Page 2 of 2
