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SKYWAY PARK ESTATES BLK 4 LT 3B
5 kyway Park Estates Block 4 Lot 3B #019-141-21 Municipality of Anchorage On -Site Water and Wastewater Program • (907) 343-7904 Page � of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: JPSP / Sl 1 9 Z PID Number: V( t9 _ / y/ —'72f Dwelling: [.Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New Mpgrade Name: 31vt ABSORPTION FIELD 17 tel rll 0 El Deep Trench El Shallow Trench Bed ❑Mound Address (( '4( J El Other Phone Number of Bedrooms Soil Rating Total depth from original grade ly GPD/SF Z10 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade �/ FL Gravel depth beneath pipe �^ �� O Ft. Subdivision �nn Block Lot ��pp Fill added above original rade nor I Q Ft Gravel length Sl Ft St -C W h 1%4 ki z �'{ 36. Township Range Section Gravel widthBeds: /'�� Ft. Number of Lines -5 Distance between lines Ft SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 7 5' r Ftz �� Ft. Well /(/ / (00 A/ M / X Svr TANK El septic ❑ S.T.E.P. ❑ Holding [I Other Manufacturer Ca /fes Surface Water 100'.1 Gal. Material Number of compartments Lot Line t L 4 -NA Foundation / LIFT STATION Manufacturer Capacit zvr Curtain Drain 'L„ � t� � Gal. Remarks Pump on level at Pu level at High water alarm at � C>c� tAl.Qi llNCt/'. in. in. Pumppa ce and model Electrical Inspections performed by Installer PIPE MATERIAL House to tank_ t� Tankto �l0�' drainfeld �0?+ �xt ,�r rr__ t 1r� /` %t fi �� irJ moil or Drainfield •y 0? L4 CO/MT 3./g til' 'k Inspector All 41 it ryAtli r r BENCHMARK (Assumed elevation) /0 (,4V ft Inspection „ dates: t `ti "Cj_ Zen7% I <_ Location and description TT 3rd e l7 0 r4 SCJ COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL �+ ®F b G Conditional Approval: Date 499THH d ...1'� V...........»..� It........ . -� NilCtIAEL N. ANDERSON..', r� f'. 9 69 i j !1 r�''•• 20f/C .•' Ems.:;' Approved Date mapecaon Repon_a-1- i z.aocv Permit No. OSP151192 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description: SKYWAY PARK ESTATES BLK 4, LOT 313 PID No.: 019-411-21 30' 30' i r r I I I i BENCH AT STAIR LANDING\ MARK A B T1 20 37 T2 15 33 30' 30' i r r I I I i BENCH AT STAIR LANDING\ LJ 2T x / \ r � � I ® I I I r r / / / SA BUILT / ALE: 1"=50' i SEPTIC SECTION N.T.S. FC 49TH .MICHAEL N. ANDERS( #S No. �E 469 i / i LJ 2T x / \ r � � I ® I I I r r / / / SA BUILT / ALE: 1"=50' i SEPTIC SECTION N.T.S. FC 49TH .MICHAEL N. ANDERS( #S No. �E 469 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: OSP151192 Tax Code Number: 01914121000 Work Type: Septic Upgrade Permit Effective Dates: June 24, 2015 to June 23, 2016 Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING Subdivision: SKYWAY PARK ESTATES Site Legal Address: SKYWAY PARK ESTATES BLK 4 LT 3B G:2729 Owner/Address: MELLO CHRISTOPHER P & ELAINE M 11841 TOY DR ANCHORAGE AK 995153228 Site Mailing Address: 11841 TOY DR, Anchorage This permit is for the construction of: Y Disposal Field N Septic Tank N Holding Tank N Privy 6 -��-/S a:3D Lot Size in Sq Ft: 33047 Total Bedrooms: 4 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: MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax;5$C� &#TTAj On -Site Water& Wastewater Program ut°jM ON-SITE SEWER/WELL PERMIT APPLICATION JUN 2 3 2015 Gretchen Stuller Parcel I.D. o 9 - 14 t - Z ( Property owner(s) C�rtS M eft 0 Day phone Mailing address 1(�ry t Tt.D,4 pr Site address S & cv Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) waeL, fuv (4- F44r(`1-5 Lot Size '3 '3 OLJ Sq. Ft. Number of Bedrooms L L7 3 f,, APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (M all that apply) Absorption Field Initial ❑ Single Family (SF) (w/wo ADU) Septic Tank ❑ Upgrade Duplex (D) ❑ Holding Tank ❑ Renewal ❑ AM Privy ❑ Multiple Dw (SF a Private Well ❑ r m Q, D10 Water Storage F-1® Vj `, } THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Dist n� I certify that the above information is correct. I further certify,What this is in accordance with applicable Municipal Codes. SCI '00p. '^ of property owner or authorized Permit/Rush Fees: Date of Payment: _ Receipt Number: Permit No. d P11+0 Permit App_-'.: - c; 4c0-.-itw Waiver Fees: Date of Payment: Receipt Number: Waiver No. June 22, 2015 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 Re: New Septic system Legal: Skyway Park Estates, Blk 4, Lot 3B To Whom it may concern: This is a request for a new septic permit on the above referenced lot which has failed an adequacy test. The leach field consists of a bed system installed in the 2006 which currently has 12 inches of water in the monitoring tubes. Due to the layout of the lot it was decided to replace the current bed system with another one in the same location. High water is present in the neighbor plus existing well radius' limit the options available. The old test hole done by KND Engineering will be used for the system, nothing will be changed except the contaminated rock in the old bed will be removed. The lot is flat over the bed system and will remain the same, see the drawing. No cut banks greater than 25 percent exist within 100 feet of the bed system. This new system will not impact any of the neighboring properties due to the lot layout. Please call me if you have any questions. Sincerely , 0 Michael N. Anderson, P.E. DESIGN CRITERIA: ,4 BDRM X 150 = 600 GPD SOILS = 600/0.8= 750 GPD 750 GA/15 = 50' (1) BED 2.0' DEEP 0.5' EFFECTIVE 15' WIDE 50' LONG WI; YLL jS'E'PTI1 PROPOSED DRAINAGE FIELD WELL PROPERTY UNE ,I 1 •WELL I 1 CHRIS MELLO SKYWAY PARK ESTATES, BLOCK 4, LOT 3B Anchorage, Alaska OVER RIC E I � I I I I I I�I�I I I 20PERTY LINE IIIA (EX(l) ING WELLRADIUS � ISTING HOUSE _ II 11 --- SEPTIC II 1I I II II II 11 II II I I I I Michael N. Anderson, P.E. DATE: 6/21/2015 4601 NATRONA AVE DRAWN: DJR ANCHORAGE, ALASKA 99516 (907) 727-8864 / FAX: (907) 345-1391 SCALE: 1"=100' r 49y °;rr N. I � I SKYWAY PARK ESTATES BLOCK 3, LOT 4 I 130' 30' I I I I � 0 I r I I o r I I I ! ! I I 11 LINE .— ; — }— I 1 I I j SKYWAY PARK ESTATES BLOCK 4, LOT 3A I I 1 I I IEXISTING WELL II 100' RADIUS EXISTING 1500 GALLON STEP TANK TO REMAIN pREXISTING WELL 1qy \ 100' RADIUS PROPERTY LINE EXISTING 50'X15' BED TO BE REBUILT, ALL CONTAMINATED MATERIAL TO SKYWAY PARK ESTATES BE REPLACED. MAX DEPTH BLOCK 4, LOT 6A 2.0' TYP. I I f I 1 I 1 I I EXISTING WELL f 100' RADIUS Septic Design Prepared for CHRIS MELLO SKYWAY PARK ESTATES, BLOCK 4, LOT 3B Anchorage, Alaska Michael N. Anderson, P.E. DATE: 4601 NATRONA AVE DRAWN: ANCHORAGE, ALASKA 99516 (907) 727-8864 / FAX: (907) 345-1391 SCALE: ALL WELL RADIUS' MUST BE C® L V R L'„e STAKED BY SURVEYOR PRIOR TO EXCAVATION. 6/21/2015 DJR 1”=30' i KND ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-9736 SOILS � h,• A *, 49TH'`! 04W4,404.1 -*..... ....... W•• .:............. Performed for- Chris &x Elaine Mello �%%Date Performed: 9/5!06 Project: Skyway Park Estates Block 4, Lot 3BTFST FIOLE 9 06-2 Depth (Feet) SEE ATTACHED SITE PLAN 1- ■ ORG/OL FOR HOLE LOCATION 11- 12- ,3 14- 15- 16- 17- IS- 19- 20- SPIgp seeps ML/SM B.O.1I. INSITU MATERIAL SUITABLE AS FILTER A ce Was Ground water encountered? YES What depth? 7 Depth to water after monitoring? ,! ,, Date? 09/12/06 is wa®�wm go - -0. . Percolation Rate <1(min/in) Perc Mole Diameter 6„ Test Run Between 4 feet and 5 feet L Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date. of Anchorage ,•. Development Services DepartmentBuilding FMunicipality Safety DivisionOnSde Water and Wastewater Program, 4700 BragawSt. P.O. Box 1%650 Anchorage, AK 995193650 Page of www.ci.anchorage.ak.us (907)343.7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SW060322 PID Number: 019.141.21 Name -- Wastewater System: ❑ New ® Upgrade Aadr.ae 11841 TOY ONE, ANCHORAGE, AK 99515 ABSORPTION FIELD Pima NMnbw d ewldbm. O Deep Troxh O Snellwe Trwrlr ® Bed 0 Mbaq 1IF LEGAL DESCRIPTION s° "a"D T" Depth rmm dngn ti e Bkrk ld S�dnagn: 4 3B 0•8 GPD/F1� D.pin wpvebdbaa+dmo.g ag, M 2 Gmw dean baroanppe SKYWAY PARK' ESTATES 2 Town.np RoVe Seaan FI. Fu •dried ww.e orprW pede 0.5 Fl Gr" Lergm 0.56-2.12 Fl. 50 FI. Well: New [I Upgrade c "W0R N.aWdae D,M„beew„w ,N CVwcaiwilParws, A S. C1 Taal Deppr C.wMm PRIVATE • EXISTING TOItl.DaarNrOrlww 15 Ft. p 3wi S FE " FI. Fe Omar Doe QYled Suac Www larw 750 Fr eulaaar D3034 Owe Ynwka Ft. LOW MICHAEL ANDERSON 10123/206 Tib ry SNa C..rp Ab Cr GPM Ft. FT TANK SEPARATION DISTANCES [3 Septic O Holding ® S.T.E.P. 0 Other. To Septic Absorption LM klm Hog PuDiwpm �w y From Tank Field Station Tank Sewer Line ANCHORAGETANK 1500Gw vVell 1004 1001+ 100'+NA 2s'+ Mww'" STEEL Nm wa e^eme 2 S,ei. Nater 100'+ 100'+ NA LIFT STATION Lot La' S'+ 2'+ NA �e ENA 1500 cw ANCHORAGE TANK • ORENCO Fpn . 5•+ 10'+ NA p a. M.w at 44 TMP a r.w w ,,n waw wean u k 42 n 48 h tM .n o en NA 'S0'+ NA Puny Make a Maga Eyanry yrpw ima pedomted aF Franklin 244504011 -112h ED'S ELECTRIC Ft mw 'None known. Lot-line/absorption field waiver Issued with BENCH MARK septic upgrade permit Old tank and field abandoned per code. G`dp Oe' Garage Slab Post tank service line and absorption bed Insulated. 100 Fl Inspections performed by: KND ENGINEERING INC. Dates: 1w 10/23/06 2nd 10123/06 Engineer's stamp 3"10124/06 = OF At lt+ Development Services Department Approval . �P,: •..S,t +� Conditional Approval Date: �.• •;9 0 O .• 1eeaNal• • ••11e e• Kenno. 1A. DuFFvt c 'e Reviewed and approved by: Date: - 3 —O C 7 4�� 9F� •�:e!? °,�.••���00 rae. owe/ pROFESSIONA+ K.D AS—BUILT SYSTEM DETAILS/SITE PLAN SKYWAY PARK ESTATES S/D LOT 3B, BLOCK 4 !� I z I� I /� 30' 1 30' 2 F- W O Z Z __q 0 O O o %U m r< TH06-02 TH06-01 0 O I 1500 CAL o • STEP ST AI 0 A -C= 73.61 M B -C=81.75 # A -D= 80.58 # B -D= 8.27 „p A-E= 866.20 $2 B-E= 82.96 = A -F=134.12 B -F=127.40 98.5 FINAL GRADE OF AZ /* 9�� 9 � n/l Kr:nntr E7 V-7118 1 1: { gb` FEsslol" N`,'-dw N 9'57'25" E (N 90'00'00" E o ,10.0• c w.s. CO a T4s P� A.C. (BY-CARA06 y D/w ) �-J wu00 OD Wm wALK 0 N89'55'45"E O'OO'OO"E - -0- — —40' - N LK15'w.0.5'D-BED GRAPHICS SCALE DEPTH O.C. 2.0' SCALE:1 "=40' Permit : SWO60322 PID#: 019-141-21 xo A D R11OOe• V% 98.18 M � $2 98.5 FINAL GRADE 964 F&M.Ar: 3P. SEWER ROCI( ' ' BED 94.3 94.; j sa.a lSCALEt NTS ELAINE MELLO 11841 TOY ROAD ANCHORAGE, AK 99515 (907)330-8236 tAS9MT;S0"tEA/k OOKS Co ~m' DRAW'km ocMM KMD, 0 Nc DAT(: 11 16 C cm 2729 06068.dwg 'DB N0" 06-068 -00 2•.40• ABBREVIATIONS BOH BOTTOM OF TESTHOLE CO a CLEANOUT MT = MONITORING TUBE ZM ENGINEERING, INC. 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907)888-3791/FAX (907)888-3793 I ECE ELECTRIC If -SC 307 272 4593 10!x/06 04:1Sp, P. COL From APPliedy1cresyatemt Fri Oct 27 16:51:45 2008 ...�_.._.. OIL: Pape 1 of 1 MUNICIPALITY OF ANCHORAGE, BUILDING SAFETY DIVISION 4700 SOUTH BRAGAW INSPECTION INFORMATION i HELP: 373-7962 INSPErTIO.N VOICE 343-6300 INSPECTION FAX(007)249-7777 www m4r1'orj!3SD.'Inspe:tions em. • NAME: Eda EteLt PERMIT#: 06-9337 COMPANY. INSPECT DATE: 10/30/2006 AM PHONE #: 272-4591 PHONE #: PHONE #: ADDRE.i: 11841 TOY DR LOT 3D BLOCK 4 SUBDIVISION: SKvWAY PARK ESTATES GRID 0: SW2729 COMMCNTS or DIRECTIONS septc !ift station /call b meet TYPE OF INSPECTION: Final Eloctrcal COMMENTS: (FOR INSPECTOR JSE ONLY) E..P"iIL LI F1 STA-rIDIJ PRINTED NAME DATE ASBUILT OF: SKYWAY PARK ESTATES SUBDIVISION LOT 3B BLK 4 PLAT 2004-191 SURVEY CERTIFICATION: I, John L. Schuller have conducted a phyaical survcy of this as shown on this drawing and Nat the improve%*n si thereon am within Ne property lines and no encroachments exist other than noted. EXCLUSION NOTES:lt is the owners responsibility to detennine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. WORK ORDER NUMDER: 00 NOV. 6, 26 K�1'�40'� n•I 06-068 ." sa 0200 s. JL5 2729 1 0603/16 UKHHDENGINEERING, INC. 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907)868-3791/FAX (907)868-3793 / LOT 4F LOT 4E 99.88' LOT 5A AtN�•.0�.�0.0�6.',a3�3,"aW. .. (,'vVV�VV V0 rr 10,�� S' UTILITY EASEMENT — 5' UTILITY EASEMENT rY�Y�X�•�Y—X�Y�Y—X�x� _ — � 1111 LOT 38 BLK 4 $ I I� U w� rg w n u � Da mm m3 TIO r �b WELL LOT 3A BLK 4 z 4 16.2•LLOT a EXISTING BLK 4A A W000 FRAM WELL �. HOUSE e'ad '^ © _ 14.9• r!Y X x w x_X it »d 10 O 1 �� O WELL C,jO 00 I �o 01 100' WELL RAOIU J o z v I G a, LT p � II ` b = sNEt I Oj • 10.Y 1. �\ OF, 4Zit \ ♦ w: o ...:.... ........... . 100.04' (i00.00'REC)• a� •a—x�X�Y�XJ _ a O •JHN L. SCHULLBRr b I1 A' O LS -10408 , M TOY DRIVE I�`°pi�•.4 'Rlocay-=� _ N 00.00'00" E \\�z��_0� O M ANCHORAGE RECORDLNG DISTRICT ASBUILT OF: SKYWAY PARK ESTATES SUBDIVISION LOT 3B BLK 4 PLAT 2004-191 SURVEY CERTIFICATION: I, John L. Schuller have conducted a phyaical survcy of this as shown on this drawing and Nat the improve%*n si thereon am within Ne property lines and no encroachments exist other than noted. EXCLUSION NOTES:lt is the owners responsibility to detennine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. WORK ORDER NUMDER: 00 NOV. 6, 26 K�1'�40'� n•I 06-068 ." sa 0200 s. JL5 2729 1 0603/16 UKHHDENGINEERING, INC. 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907)868-3791/FAX (907)868-3793 MUNICIPALITY OF ANCHORAGE Development Services Department ` 1�'r On -Site Water 6 Wastewater Program 1 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519.6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Oct 02, 2006 Expiration Date: Oct 02, 2007 Permit Number: SW060322 Parcel ID: 019-141-21 Legal Description: SKYWAY PARK ESTATES BLK 4 LT 38 Design Engineer: 0070 KND ENGINEERING Site Address: Owner Name: CHRISTOPHER 8 ELAINE MELLO Lot Size: 33047 SQ. FT. Owner Address: 11841 TOY DRIVE Total Bedrooms: 4 Permit Bedrooms: 4 ANCHORAGE. AK 99515 - This permit is for the construction of: ❑✓ Disposal Field Q Septic Tank ❑ Holding Tank ❑ PrivyPrivate Well ❑ El 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 engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: Date: D(, Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, Alaska 99519650 www.muni.org/onsite (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 019-141-21 Property owner(s)Christopher & Elaine Mello Day phone330-8236 Mailing address 11841 Toy Drive, Anchorage, AK Zip Code 99515 Site address 11841 Toy Drive, Anchorage, AK Zip Code 99515 Legal description (Sub'd., Block & Lot) SKYWAY PARK ESTATES, BLOCK 4, LOT 36 Legal description (Township, Range & Section) Lot Size33,047 Sq. Ft. THIS APPLICATION IS FOR (® all that apply): Absorption Field $460.00 Septic Tank Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage mJ Number of Bedrooms THIS APPLICATION IS AN: Initial Upgrade Renewal certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. of property owner or authorized agent) Permit/Rush Fees: $460.00 Date of Payment: Receipt Number: (83 (Rev. 11/05) Waiver Fees: 07r— Date of Payment: Receipt Number. Municipality of Anchorage ��� Development Services Department Building Division On -Site Water andd Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchoragc.ak.us (907) 343.7904 Waiver Review Worksheet WR#:060062 PID#:019-141-21 HA/Permit# SW060322 Date Received: October 2, 2006 Legal Description: Skyway Park Estates, Block 4 Lot 3B Engineer. Kenneth M. Duffus, P.E. KND Engineering, Inc 20441 Ptarmigan Blvd. Eagle River, AK 99577 Applicant: Christopher and Elaine Mello Waiver Requested: Lot Line Waiver Criteria: Geology A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: Points: .......................................................................... Waiver Is Granted: X Waiver is not Granted., List Conditions or Reasons for above: Date: 10102/06 By: Deb Wockenfuss Name of Reviewer ............................................................ gaseous ......a Rec#: 86183 Amount: $M Date Paid: 10/2/2006 0`0 Municipality of Anchorage IT {V� P0. Da 11Np:M1 • AnOwnigc. Alaskn!d 6519 -Will • 710kphonc OM 343 -SN - Fax (1)(M313 -KI N) 471N 111ntWa a Si met • Anchontge,.\lnsU !.1507 w���c.numLorg Mayor Mark Begich Iiuilding SlIfety Division October 2, 2006 Kenneth M. Duffus, P.E. KND Engineering, Inc 20441 Ptarmigan Blvd. Eagle River, AK 99577 Subject: Waiver Request for Skyway Park Estates, Block 4 Lot 3B Waiver Request WR#: 060062 Parcel ID # 019-141-21 SW060322 Dear Kenneth M. Duffus, P.E.: Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the propertyline has been approved. The approved separation distance is 2.0 feet. This waiver approval applies to the existing absorption field to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Geo Deb Wockenfus Civil Engineer On -Site Water & Wastewater Program Community, Security, Prosperity JKND ENGINEERING, INC. 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907)696-6111/FAX (907)696-8111 September 14, 2006 Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Sewer Upgrade Permit & Lot -Line Waiver Skyway Park Estates, Block 4, Lot 3B Gentlemen: The owner has requested we proceed forward to obtain a septic permit to upgrade and replace the existing septic system and tank for the subject lot. The existing septic tank and field will be abandoned in place and in accordance with municipal standards. On September 5d, 2006 two testholes were performed for the proposed system. The results of these tests are attached. The general slope of this lot is from north to south at a grade of approximately 0-3%. We have designed our system utilizing the testhole (TH06-2) we excavated for the existing 4 -bedroom house. The lot is served by an individual well. We propose to install a 15' wide by 50' long shallow bed. Water was encountered during the excavation at 7' and at 6.5' during monitoring. Due to limited area for the upgrade, a lot -line waiver of 2' to property line is requested with this septic upgrade. There are no public or private wells within 200' of our proposed system location except as noted. There is no surface water within 100' of the proposed system and there are no known curtain drains within 50'. We do not expect there to be any adverse effect on adjacent lots by the development of this system. If you have any questions, please contact me at 696-6111/FAX 696-8111. Respectfully submitted, XMID Engineering, Inc. Kenneth M. Du Attachments: On -Site Well and Sewer Application Wastewater Absorption System Details/Site Plan Soils Log/Percolation Test Owner/ Contractor Specs WELL & WASTEWATER DISPOSAL SYSTEM DETAILS/SITE PLA SKYWAY PARK ESTATES S/D LOT 3B, BLOCK 4 of WE 1—A (92-71) un � = n 30' 30' e 3 A :111 d el � aoi ab<n IP $� b s,It( E.Mt 0 120.00 • 5 Necen .M 910 mW I L�� 4 wD •1 - -- (84-43 4F (84-430) T ' 7Vt4 l iN.7.4 E X99.80 a� w• 1 - _ _ _ _ _ _ _ — I b_ N897TN• r" OMR....T MnSVM Eeet SVei 7N.ew � [I 6A (o (77-87) b S BJ.�B( A I ' r 0^ (915 n .37 N _ IO PUBLIC WELLS WITHIN 20P Q PRIPOSED SYSTEM NO PRIVATE WELLS WITHIN tar Or PROPOSED SYSTEM EXCEPT AS NOTED. NOTE: A REGISTERED LAND NO PRRUPOSED WELL EXCEPT Nei NOTE& SURVEYOR SHALL FLAG PROPERTY LINE AND WELL RADII PRIOR TO CONSTRUCTION. �-%�`%kN DIRECTION. RADE FLAT 0-37. E—NE /P(S� �F �9SL , PREPARED FOR: , ELAINE MELLO 11841 TOY L} '19* I ANCHORAGE, AK 99515 (907)330-8236 KENN UFF FIELD BOOKS CoLrUTED: /��'• CE -Ill .' �'� / eouwmr.. DR.wc _ 1 , 973/V 4 ter / STARING CHECKED-. - �FESSIONN\' ' AS9MDSCM%LER ND ENO DATE: 9/13zol TING TRE: CR k. 2729 Am TIE: 06068.dwg ''DD Nee 06-068 C\BELL k SEPTIC - PILO D7 Ly.I\Skr.l P.rk 2.L Sukd\SI«k 4\ICL 38\d•4\0D-DDD.S.Pue.Vwl■n.dw. Scale: 1'= 100' PAGE I OF 3 IE HD ENGINEERING, INC. 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 It (907)898-8111/FAX (907)898-8111 "w.KNDEngineering.com/kndenSOak.net 30) WASTEWATER DISPOSAL SYSTEM DETAILS SKYWAY PARK ESTATES S/D LOT 3B, BLOCK 4 = O CD ry C] r 00 30' 0 37 1 TH06-01 O Q I Flc' o NISUL ATION-� TH06-02 SWING -TIE CHART A -C=69.57 B -C=83.73 A -D=90.88 B -D=112.80 A -E=129.24 B -E=155.15 NOTE: A REGISTERED LAND SURVEYOR SHALL FLAG PRO LINE AND WELL RADII PRIOR CONSTRUCTION. N 9'57'25" E (N 90'00'00" E a EXISTING SEPTIC 500 GAL TANK & FIELD A. TEP ST 4" SOLID PIPE AT 1-1� 2% MAX GRADE u 0 N A.C. 7 o/W MAINTA N 16' SEPARATION FI EXISTING IELD VE v K 0-3%Floc — A - m— -x �- -N H5'-45, E — 4. (N90'00'00"E (1)50'Lxl5'WxO.5'D—BED CONSTRUCT TRENCHES MAX DEPTH O.G. -irr- p.p' MIN. OF 5' AWAY FROM CD TH LOCATION. CD R100.0' p A.I.P. = Abandoned In Ploce Ar PREPARED FOR: ELAINE MELLO 11841 TOY ROAD ANCHORAGE, AK 99515 (907)330-8236 'I KENNEF U ,r FIELD BOOKS CE- 18 �J10BQMDABI: Allf Ilk / Amuan san ER nc fEssl011t' DBC rkE: ACRD rkE: m_DO&Dkc B:\e171 ! BEPOC - Nd By L m.A3krer PArk 6l Beke\Black 4\L l DB\e•A\ CdA1 x DRAW KMD °EP`@ KMD DATE: 9113 °"tr 2729 " " : 06068 Scale: 1'= 30' PAGE 2 OF 3 liildV JSlJ ENGINEERING, INC. 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907)090-8111/FAX (907)898-8111 v.KNDEntineerins.com/kndenBfek.net 4' SOLID FROM HOUSE DESIGN CRITERIA - PRESSURIZED SYSTEM 1. 4 BEDROOMS X 150 CAL./DAY/BEDROOM=600 GPD. PAGE 3 OF 3 2• SOILS RATING 1.5 MIN./INCH= 0.8 CPD/SF(BED). 3. 300 GPD/0.4 CPD PER SF - 750 SF. 4. 750 SF/15' W - 50' L.r .►�'_�� 5. MINIMUM DESIGN SIZE - 15'(W) X 50'(L) BED 0?5' MAX. DEPTH FROM OF AZ 14 ORC. GRADE. 6-j // . • " . �s 1 6. 2" HD INSULATION REQUIRED OVER FIELD ,3' OF COVER. 7. 2" HD INSULATION REQUIRED OVER TANK ,4' COVER. '9 / 8. CONTRACTOR TO VERIFY ALL SEPERATION REQUIREMENTS ARE MET (I.E. . * I WELL RADIIEASEMENTS. PROPERTY LINES. ETC..). 9. CONTRACTOR TO VERIFY AND INSURE 2% MAX. GRADE FROM HOUSE. 10. CONTRACTOR TO PUMP TANK AND DISPOSE OF PER CODE. ncnncr n. my? �'. CE- �A, PREPARED FOR: 77�TPSS�}}�� c �L]1V11Y SNGINESRING. INC. ' 711316 L , `\�� 2a41 PV6RYIGATI BLVD. ELAINE MELLO uGU RIVER. 6t wen -8906 1 \ fib' fESSIOA, -Ar 11841 TOY ROAD rmwr-u�l r � ANCHORAGE, AK 99515 (907)330-8236 Date- 9-I3-06!DRAWING B Scslw NTS 1 06-068 S3 B:\B13L ! BEPNG - NM BY I.vl\skr.y Pick bt Suk6\81.k 4\Lot 08\6"61,06-068_3op a-Dnirn.a•t DESIGN DETAILS P.I.D. #----------_ WASTEWATER ABSORPTION SYSTEM PERMIT 11 SKYWAY PARK ESTATES S/D LOT 3B, BLOCK 4 W pp Wd Wa a 0 W FINISHED GRADE (ADD UNCLASSIFIED FILL) DVG GROINO 4 G. Qo FILTER FABRIC AND INS L GA N L00 ,E.P.NK SEWER ROCK NIIL B' 50 ' BED PRESSURIZED DISTRIBUTION SYSTEM HOLE SPACING DESIGN 4T 1. RESIDUAL HEAD = 5' 2. HOLE SIZE = 3/16' = 1.00 GAL. PER HOLE E 30 PSI KH li 3. 30 GALS (PUMP DELIVERY)/1.00 GALS./HOLE - 30 HOLES 4. 135 LF LATERAL/30 HOLES = 4.5' SPACING PER HOLE 5. ALL HOLES SHALL HAVE CAPS INSTALLED PER MANUFACTURES SPECS. 2.5'(typ) CAP ENDS OF PIPE(TYP) M.T.T. 2.5'(typ) I \c 41 LF 1 1/4' PV W/3/16' HOLES @ 5.47' SPACIN (TYP) 1 1/4' PVC FROM TANK TO FIELD Lo 1 1/4' PVC FOR MANIFOLD ; U'1 M.T. O 1 1500 GAL 0' S.T.E.P. O OQ C.O. C.O. C.O. urt stetb 4' SOLID FROM HOUSE DESIGN CRITERIA - PRESSURIZED SYSTEM 1. 4 BEDROOMS X 150 CAL./DAY/BEDROOM=600 GPD. PAGE 3 OF 3 2• SOILS RATING 1.5 MIN./INCH= 0.8 CPD/SF(BED). 3. 300 GPD/0.4 CPD PER SF - 750 SF. 4. 750 SF/15' W - 50' L.r .►�'_�� 5. MINIMUM DESIGN SIZE - 15'(W) X 50'(L) BED 0?5' MAX. DEPTH FROM OF AZ 14 ORC. GRADE. 6-j // . • " . �s 1 6. 2" HD INSULATION REQUIRED OVER FIELD ,3' OF COVER. 7. 2" HD INSULATION REQUIRED OVER TANK ,4' COVER. '9 / 8. CONTRACTOR TO VERIFY ALL SEPERATION REQUIREMENTS ARE MET (I.E. . * I WELL RADIIEASEMENTS. PROPERTY LINES. ETC..). 9. CONTRACTOR TO VERIFY AND INSURE 2% MAX. GRADE FROM HOUSE. 10. CONTRACTOR TO PUMP TANK AND DISPOSE OF PER CODE. ncnncr n. my? �'. CE- �A, PREPARED FOR: 77�TPSS�}}�� c �L]1V11Y SNGINESRING. INC. ' 711316 L , `\�� 2a41 PV6RYIGATI BLVD. ELAINE MELLO uGU RIVER. 6t wen -8906 1 \ fib' fESSIOA, -Ar 11841 TOY ROAD rmwr-u�l r � ANCHORAGE, AK 99515 (907)330-8236 Date- 9-I3-06!DRAWING B Scslw NTS 1 06-068 S3 B:\B13L ! BEPNG - NM BY I.vl\skr.y Pick bt Suk6\81.k 4\Lot 08\6"61,06-068_3op a-Dnirn.a•t KIND ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 SOILS PERCOLATION TEST Performed for. Chris & Elaine Mello Date Performed: 9/5/06 Project: Skyway Park Estates Block 4, Lot 3B TEST HOLE # 06.2 Depth ORG/oL SEE ATTACHED SITE PLAN FOR HOLE LOCATION SP/gp seeps ML/SM B.O.H. 19- ,. INSITU MATERIAL 20- SUITABLE AS FILTER Was Groundwater encountered? YES What depth? 7' Depth to water after monitoring? 6,,5'.Date? 09/12/06 Reading Date Gross Time Net Time Depth to Water Net Drop 1 9/5/06 1:00 V - 2 1:02 2 min dry 6- 3 1:03 6" - 4 1:05 2 min dry 6" 5 1:06 6" - 6 1:08 2 min dry 6- 7 8 9 10 11 12 • I Water Added Percolation Rate < 1(min/in) Perc Hole Diameter 6„ Test Run Between 4 feet and 5 feet 1, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date. KNDD ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER. AK 99577-8: SOILS PERCOLATION TEST Performed for: Chris & Elaine Mello Date Performed: 9/5/06 Project: Skyway Park Estates Block 4, Lot 3B TEST HOLE n 06-1 Depth (Feet) ORG/OL-w/ mix fill SEE ATTACHED SITE PLAN FOR HOLE LOCATION 11- 12- 13- 14- 15- 16- 17- 18- 19- INSITU MATERIAL 20- SUITABLE AS FILTER Was Groundwater encountered? YES What depth? 8' Depth to water after monitoring? 7S' Date? 09/12/06 Percolation Rate < 1 (min/ in) Perc Hole Diameter 6„ Test Run Between 4 feet and r feet L Kenneth N1. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date. a� t t s�■s ae�a�a as Percolation Rate < 1 (min/ in) Perc Hole Diameter 6„ Test Run Between 4 feet and r feet L Kenneth N1. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in effect on this date. ILK D ENGINEERING, INC. 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 696-6111/ FAX (907) 696-8111 ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES AND MATERIAL SPECIFICATIONS LEGAL DESCRIPTION: Skyway Park Estates, Block 4, Lot 3B GENERAL: 1. The scope of this project includes the installation of a septic tank and/or drainfield to serve a single family residence on the referenced property as delineated on the attached Municipality of Anchorage (MOA) permit and site plan. 2. Construction shall be in accordance with the approved site plan and design drawings; MOA permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. KND Engineering Inc (KND) assumes no responsibility of the accuracy of the as -built survey provided by the owner or owner's representative. 4. The owner or contractor is responsible to notify the engineer of any discrepancies noted on the design plans or drawings prior to commencing work. These discrepancies could be, but not limited to, possible encroachments, surface water, varying soils, unplatted easements, types or use of dwellings on or adjacent to property, nearby public wells, etc. 5. The contractor shall be responsible for locating any necessary underground utilities, easements, property lines and surface water. The owner and/or contractor shall ensure, if deemed appropriate, that a registered land surveyor prior to construction flags all setbacks. 6. The contractor shall be responsible for verifying all pertinent separation distances and component layout. 7. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. On all leachfield mound systems, the property owner shall be responsible for ensuring a satisfactory vegetation growth over the mounded area. 8. The MOA Development Services Department On -Site Water & Wastewater Program must certify contractors installing wastewater disposal systems. Owners installing their own systems must also receive prior approval from said MOA Department. SEPTIC TANK / HOLDING TANK / LIFT STATION INSTALLATION: 1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 2. The septic tank shall be sufficiently bedded with proper material and compacting to prevent damaging, settling or shifting of the tank. 3. All standpipes on the septic tank shall extend a minimum of 12 inches above the final grade. 4. Septic tanks installed with less than 4 foot of cover shall be insulated. The contractor will ensure that the fill over the tank does not exceed the burial depth rating. 5. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 feet from the tank. The second cleanout, in line, shall be to clean toward the septic tank. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic Page 1 of 3 Reference: Skyway Park Estates, Block 4, Lot 3B Date: 09/14/06 Page: 2 of 3 7. All H.D.P.E. tanks shall have a vertical length of 4 -inch perforated drainpipe besides the tank extending to the bottom of the tank to above grade to monitor ground water. 8. All tanks shall be anchored when there is not enough adequate soil cover to resist buoyancy forces in high -groundwater areas. 9. All holding tanks and lift stations shall have an audible and visual alarm inside the residence. 10. All lift stations shall be wired in compliance with the Uniform Electrical Code and all MOA guidelines. 11. The contractor shall remove the old tank, or abandon it in compliance with the Uniform Plumbing Code. The contractor is solely responsible for the abandonment procedure. ABSORPTION TRENCII/DRAINFIELD INSTALLATION: 1. Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavaction become smeared, they must be raked or scratched (roughed -up) before gravel (sewer rock) placement. 2. Once the sewer rock is installed, the distribution pipe is installed level with the perforations facing downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. 3. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. 4. Monitoring tubes shall be four- (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. 5. Backfill over the final gravel layer must not be less than twenty-four inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. 6. All advanced technology waste water disposal systems (Advantex, Biocycle, Intermittent Dosing Sand Filter, etc...) shall be constructed, installed, maintained and monitored per manufacturer's specifications and MOA requirements. MINIMUM MATERIAL SPECIFICATIONS: 1. A MOA approved septic tank manufacturer must construct any septic tank proposed for installation. 2. The following pipe materials are MOA approved for use in septic system installations: Type of Pipe Perforate 52H Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). 5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. If deemed necessary, a sieve analysis should be performed. 7. When sand is being used as a filter material, its gradation specification must conform to current MOA or DEC requirements. Reference: Skyway Park Estates, Block 4, Lot 3B Date: 09/14/06 Page: 3 of 3 INSPECTIONS: Typically there will be three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: 1. The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. 2. The second inspection must be conducted after the placement of the sewer rock, distribution lines, standpipes, and cleanouts, but before the placement of the silt barrier, insulation, or any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required, especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. The inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre -construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractor's activities. The owner shall contract with the contractor to perform the work outlined in these specifications and attached plans and in accordance with the attached MOA permit. All materials, components, and construction practices shall comply with the MOA's and the State of Alaska's latest ordinances, regulations, or policies regarding wells and septic systems. The failure of the inspecting engineer to notice a material or construction non-compliance does not relieve the contractor of his/her responsibility to correct such deficiency. There will be no contractual arrangement existing between the contractor and KND Engineering, Inc. KND shall be the owner's representative and will inspect the work as stated above to document the contractor's activities. Final acceptance of the contractor's work rests with the owner and the MOA. KND shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. KND's inspecting engineer will not be responsible for the construction means, methods, and techniques, sequence, procedures or the safety precautions incident to this project. BY PROCEEDING FORWARD WITH THE INSTALLATION OF THE WATER AND/OR WASTEWATER SYSTEM (S), THE PROPERTY OWNER, CONTRACTOR, AND WELL DRILLER ACKNOWLEDGES HAVING READ AND ACCEPTED THESE SPECIFICATIONS. 1#' Municipality of Anchorage Development Services Department • �.r Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: KNO Engineering Legal description: Skyway Park Estates, Block 4 Lot 38 The attached paperwork has been reviewed and is being returned for the following reasons: ❑ Original signature or stamp missing on ❑ Calculation error in design. ❑ Additional soils information needed. _ ❑ Water monitoring results inadequate. _ ❑ Discrepancy in information submitted. ❑ Topographic information missing or inadequate. ❑ Incomplete; missing ❑ Incomplete; missing _ ❑ Additional adequacy test information needed. _ ❑ Water sample unacceptable. _ ❑ Measured/proposed distances/dimensions missing. ❑ Locations of all soils, percolation and water monitoring tests not shown. ❑ Proposed system too deep for soils information submitted. ❑ Well log required. _ ❑ Omission in narrative. _ ❑ insufficient fill over tank or field._ ® Otherll. Ground water monitoring done the month before or after Name of reviewer: Deb Wockenfuss Date:/� 20/06 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK MUNICIPALITY OF ANCHORAGE Hea .h and Environmental Protea on Fourth Floor West 825 L Street Anchorage, Alaska 99501 279--2511, x 224, 225 INSPECTION REPORT ORI -SITE SEWAGE* 0151"O.SAL SYSTEM _ NAME..-__'A-t`� _—`-2---- MAILING ADDRESS ,_�C�_= 15----- PHONE LOCATION _--_..-- LEGAL DF..SC RIPTION- L i'_ 4l SEPTIC TANK: DISTANCE I r NUMBER OF FROM WLLL_IQS�_ MANUFACTURER_ -,G Rnv-_r_—MAI'FRIAL INSIDE LENGTH—_. .——...— INSIDE WIDTH__.-_ LIQUID DEPTH —__ LIQUID CAPACITY �'�GALLONS. TILE DRAIN FIELD:�k I r c�-Q ( TOTAL LENGTH 57 i DISTANCE_ FROM WF-LL[ 0o+_FOUNDATION.___��__ NEAREST LO"F LINE - --_OF LINE _ —_ # of Lines -_--J.__.— DISFANCE BETWEEN LINES __0_( N._...—TRENCII WIDTI-I 3 ' IN. TOTAL_ EFFECTIVE AGSORPT.; F) i i�RLA _ — `�_ SQ. 1-1. LENGTH OF L/'1CI-I LINE L DEPTH OF FILTER DEPTH: TOP OF I ILL '10 FINISH GRADE _�__`J —MATERIAL. BENF_ATII "DILE____`. V__.IN. ABOVE TILE __3IN, SEEPAGE PIT: DIAMEFER --OR WIDTH Log Crib Rings Crib Size: DIAMCIER BUILDING FUUNDA-I ION_—, NL"ARESI- LOT LINE Well i^ \\ 2 Class: -t��C_ Depth: Well Distance To: Lot Line;,xol Bldg: I q1 _ Sewer Line: joo7v— Pipe Materials:C.. $ of Bedrooms: Installer: NeL�-Irv, cLx-�� Remarks : , LENGTH._—, DEPTH UEPTH...__DISTANCE FROM: WELL____.__. TOTAL EFFECTIVE AGSORPTION AREA (WALL AREA) _SQ. FT. I 4 .tpC5fLY GRE.. I"ER ANCHORAGC': AREA 30.(OUGH wear 4 R DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO _ _ 3330 "C" STREET ANCHORAGE, ALASKA 99503 VJIVi�W �) E TELEPHONE 274-4561 seee•„e. SEWAGE DISPOSAL SYSTEM -- APPLICATIC1"{NANf) PER T` NAME OF APPLICANT / / 0 / PRONE ��MAILING ADDRESS ( V "' � ^i ;' _ INSTALLATION LOCATION -- LEGAL. DESCRIPTION INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACILITY TO BE SERVED SEEPAGE PIT DRAIN FIELD �— OTHER FINANCED THROUGH -- TO BE INSTALLED BY SOIL TEST RESULTS NOTE, THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED S L/-L^✓'Z� N eJ -��� 50 N FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF EN///jjjV IRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO P/R/O�SECUTI`ON.. SEEPAGE AREA SIZE `✓ Q TYPE SEPTIC TANK SIZE /�5-0 —TYPE MINIMUM DISTANCES, REQUIREMENTS DIAGRAM OF SYSTEM FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT SEPTIC TANK TO SEEPAGE PIT WALI SEPTIC TANK . SEEPAGE PIT TO NEAREST LOT LINE. WELL TO SEPTIC TANK DRAIN FIELD WATER MAIN TO SEPTIC TANK DRAIN FIELD DRAIN FIELD DRAIN FIELD SEEPAGE PIT ALSO CONSIDER AREA WELLS. SEEPAGE PIT 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 13ACKPILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. / G.A.A.B. on LICENSED DESIGNER 1 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GR DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE �� _ APPLICANT'S SIGNATURE EQ -01 6(3-75) 1_-'1_-_' -'-I-_-' --- '._. AREA BORGUGH ORDINANCE NO. 28.68 AND THAT 'rHE ABOVE V A li 1 k: 1 .1. F Y 11 If :I f !11 BY, ll-IFHUI:,] I C 1, FI -11 T OF 67�ro ri I 1'ed .3 Curti 6 'fO (G/7.1) 4, -0 Dep;rtment of licalth olid Ltiv fronmental Protection, I; AncIlOrfillo, Alaska 90507 2 7 I'MO-CS6r, Jurfurf,K.,d lol. I.S i,o(; plMOIATION TI; TO j . This ............. I 011: 36...O.L"K Otfl. Perfum f4rin ru or io.j So I. lt�'S_t Peri:blatiolf,(,O�F! V De p th Feet 2 3 4 1, e. 7 10 12 `7' 13 Wa S gromw wter cncoijntel�ud? /V61. Ir V"S, at %Y110L . jt?i,tfl? 4 ............ I(co d n o ...... .. . DO Lu - ---------- Gross T i alu "It Time to Ivnivi Ile t. orop .. .............. ........... .. . ... ......... ............. ------ ------- .... iv�C*0`1:11'1 ........ ....... o' ...... . -A 11 to. -llropo� no v, 0 L I oil:. p I t 0 COI!llrllTS: let Drahi Held Om 0 1) t or trencil 67�ro ri I 1'ed .3 Curti 6 'fO (G/7.1) 4, -0 v+' ga' ENKINS WELL DRILLING P.O. oex 3-142 Eco ANCHORAGE, AK 99501 PHONE 344-3792 DRILLERS WELL LOG J1 ;7 CUSTOMER _ M . llobart Froarjor 1360 i... 72tiQ Ave, Aliohox�zgo, 99502 LOCATION Iz)'%, 3b, Block 40 Skyway k'aeg (off IQe.t2 Road) — SIZE 6"_ DEPTH _58` - CASING DEPTH 5 GROUTING DEPTH ??A YIELD 840_Un — STATIC WATER LEVEL 35. HOW TESTED Air PUMP INSTALLED _11A __— TYPE — ^� FORMATIONS ENCOUNTERED AND APPROPRIATE DEPTHS _ TO 3 _ 'POP 204.1, WAY 4 bin dirt 3 TO 20 «play 11/6maVo2 20 TO 1,6 _ Sravo2 (2-3' rott_k at 23-26') ~------ 16-- TO _1a l0000u�,7 ciIDa]�._S)1'�i& r1n� u,_ J-1— TO TOTO cmcomi'tored about 6265 foot. TO TO -- TO -- TO - — TO _— TO 1-010(3-75) MUNICIPALITY OF ANCHOfIAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 4 q lel (.21 Certificate of On -Site Systems Approval Parcel I.D. -0- -07 Expiration Date: 5i c w ao 1. GENERAL INFORMATION Complete legal description SKYWAY PARK ESTATES BLK 41 LT 313 Location (site address) 11841 TOY DR, ANCH, AK Current property owner(s) SHANNON HARRIS Day phone Mailing address Real estate agent Day phone 2. TYPE OF DWELLING: El Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic 7 Water Storage ❑ Holding Tank1,, ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewerj ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ J`� / `-ac �a JWaiver Fee $ Date of Payment Jllot(J aU Date of Payment Receipt Number (1615 72J Receipt Number COSA # 0501:961,W Waiver #' COVID-19 257o DISCOUNT APPLIED STATEMENT OF INSPECTION BY ENGINEER As certified by my sea[ 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 4 Address 4661 NATRONA AVE ANCH AK Engineer's Printed Name MIKE N ANDERSON, P.E. Date 4-25-20 V. 6. DSD SIGNATURE° System #1 Approved for 4 bedrooms J ;Fp • MICIiAti.` N. ANDERSC,' System #2 Approved for bedrooms ¢ �� 9 9 Disapproved Conditional approval for bedrooms, with the following stipulations: �r ON-SITE 1 r m r /-IA „ /� PROD AM o By: Oa.7�_nzu Original Certificate Date: I 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. `z 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet Legal Description: SKYWAY PARK ESTATES BLK 4 LT 313 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 2/18/77 Total depth 65 ft Cased to 65'+ ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 18°+ in. Date of flow test for COSA 4/9120 Static water level at beginning of test 34 ft. Comments B. TANK DATA Age of tank(s) 2006 years Tank type/material Step7STEEL Measured operating fluid level in septic tank *32 ❑ Standpipes/foundation cleanout per record drawing Date of pumping 4/4/20 D. ABSORPTION FIELD DATA Which system tested (date installed) 6/27/15 ❑ ALL standpipes present per record drawing 3,©t - rnt4A Total measured depth from grade -M ft (max) Measured depth to pipe invert from grade 2.5 ft (min) [:1 N/A - pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective Parcel 1D: 019-141-21 Structure served by this system Well production at time of test 5+ gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate 3.28 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by MNA Date of Sample 419120 C. LIFT STATION ❑ Required maintenance completed Age of lift station 14 years Lift station material steel Comments: * pump level set correctly Adequacy test date 4/9/20 Results F, -']Pass For 4 bedrooms Fluid depth prior to test *1 in Water added 600+ gal New depth 2.0 in Elapsed time 1440 min ❑ Code -required soil cover over field Final fluid depth 1 in ❑ System presoaked Absorption rate 600+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) date of fest) Gallons introduced 0 gallons If yes, enter date Comments/Deficiencies: *south 2 MT pipes dry, north pipes had 1" prior to test. North MT pipes near manifold pipe COSA Checklist yellow sheet 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 Community Sewer Manhole/Cleanout > 100' Q✓ Yes if No ft ✓❑ Yes if No ft Neighboring Tank > 100' Q Yes if No ft Private Sewer/Septic Line > 25' 7 Yes if No ft Absorption Field on Lot > 100' E] Yes if No ft Holding Tank > 100' ❑✓ Yes if No ft Neighboring Absorption Fields > 100' ❑✓ Yes if No Water Main > 10' Animal Containment > 50' 7 Yes if No ft 0 Yes if No ft Yes if No _ Water Service Line > 10' Q Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway Community Sewer Main > 75' 7 Yes if No ft ❑✓ 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' Q Yes if No_ Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: ft 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' Q 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' Q✓ Yes if No ft If absorption field is under driveway comment below Property Line > 10' ❑ Yes if No 2* ft Wells on Adjacent Lots: Water Main > 10' 171 Yes if No ft Private Wells > 100' Q Yes if No Water Service Line > 10' Q Yes if No ft Community Wells > 200' Q Yes if No Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS * see MOA Waiver in the file. G. ENGINEER'S CERTIFICATION l certify that l 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 O e A I h; e � �•' � .•ems ��� � ,• 49T Y '' °•'; a e. e s• o e o• o e. e o 0 0�• a o �iS moo• MICMAEt: N. ANDERSON: u�•• CE -9 69 • �® ��r��••�f5�2v s ��aFs�csr,til<t�� .� ad �4 ft ft ft ft ft Owner Phone Septic Tank: Legal Desc. Lift Station/Pump Vault lwt Street Address Jo \/ 0 r W1 D -Sludge level inches -pumping: required Lift station: -Pump basket cleaned (a no -Effluent fi -Control floats cleaned (yeV no -Proper f1c. -Operation satisfactory es no Alarm System: -Dedicated electrical alarm circuit (Y., -Alarm system operation satisfactof Manhole Riser -Ground water intrusion at riser ::t] -Ground water intrusion around rb:6'. nd pipe -Manhole lid: Functional 1 yes. no -Audible"' notsafi's "factory ng completed yes no inas confir'm"""6d.-_/`vel no ual alarm inside -:dwelling e no -Weep hole functional e no Properly SecuredCLes) n Other -All manufacturer, required i'n'"sp d .......ectid' maint6h.."Pce completed es no Comments: ................................................................................................................................... I ............................ Maintenance Provider: Technician Company L Q- �-v k c Qs - Signature Date of maintenance �_ Date. • Municipality of Anchorage r" On -Site Water and Wastewater Program (907)343-7904 S . EST r CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel l.D.019-141-21 1. GENERAL INFORMATION Expiration Date: 1 - '3 0 - ) g Complete legal description SKY PARK ESTATES S/D BLOCK 4, LOT 3B Location (site address) 11841 TOY DR. ANCHORAGE, AK Current Property owner(s) CHRIS MELLO . Day phone Mailing address SAME Real Estate Agent Day phone 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) t4Duplex19 46' Multiple Dwellings (Single Family and/or Duplex)�3. l, NUMBER OF BEDROOMS: 4 B 9 7 E 2 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 ❑ Waiver/Variance request for: Distance: Received by: `lam i r Date: G/ COSA to be released to the engineer, unless otherwise requested by the engineer. l 60 COSA Fee $ 2 k,n JshO = 0 Waiver Fee $ Date of Payment Receipt Number I b q q `C l COSA# 65C15132v q Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm M= N ANDERSON, P.E. Phone 727-8864 Address 4661 NATRONA AVE. Engineer's Printed Name MIKE N ANDERSON, PE Date 06/29/15 6. DSD SIGNATURE 1� System #1 Approved for bedrooms. System #2 Approved for bedrooms. Disapproved. OF Al 49TH RRl66c { 9 MICHAEL N. ANDERSON ;`-^,` r^ �i, • CE - 9 69 lZa� ®�r7 gyp By: Original Certificate Date: ( - 30 `115-- TheunicipalH of nch a 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 CDSAbluesheet 10-10-12.doc If more than 1 septic system is on the lot: COSA Checklist # Structure served by this system _ Certificate of On -Site Systems Approval Checklist Legal Description: SKY PARK ESTATES S/D BLOCK 4. LOT 3B Parcel ID: 019-141-21 A. WELL DATA Well type Private Date completed 211811977 Total depth 65 ft. Date of test Static water level Well production If A, B, or C provide PWS ID # _ Well Log (YIN) Sanitary seal (YIN) Y Cased to 65 ft. FROM WELL LOG 211811977 35 ft. 10 g.p.m. WATER SAMPLE RESULTS: Wires properly protected (YIN) Y Casing height (above ground) 18 AT INSPECTION 612212015 U Coliform NEG colonies/100 mL Nitrate ND mg/L Arsenic: 7.65 ug/L Date of sample: 4/2912015 Collected by: Mike Anderson B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC I STEEL Date installed 1012312006 Tank size 1500 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (YIN) Y Depression over tank (YIN) N High water alarm (Y/N) Y Date of pumping 6127115 Pumper Around the Clock C. ABSORPTION FIELD DATA — 1985 SYSTEM TESTED Date installed 61 72 12015 Soil rating (g.p.d./ft2 or fe/bdrm) 0.8 System type BED Length 51 ft. , Width 15 ft. Gravel below pipe 0.5 ft. Total depth 2_0 ft. Eff. absorption area 750+ ft2 Monitoring tube Y Depression over field N Date of adequacy test NEW Results (Pass/Fail) NEW For 4 bedrooms Fluid depth in absorption field before test NEW in. Water added NEW gal. New depth NEW in. Elapsed Time: NEW min. Final fluid depth NEW in. Absorption rate >= NEW. g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) UNKNOWN If yes, give date D. LIFT STATION Date installed 1012312006 Size in gallons 1500 Manhole/Access (YIN) Y "Pump on" level at 44 in. "Pump off' level at 42 in. High water alarm level at 48 in. Datum BOTTOM OF TANK Cycles tested 3 Meets alarm & circuit requirements? Y E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot 1004 Absorption field on lot 1001+ Public sewer main 75'+ Sewer /septic service line 501+ Animal containment areas 1001+ SEPTIC/HOLDING TANK ON LOT TO: On adjacent lots 1004 On adjacent lots 100'+ Public sewer manhole/cleanout 1004 Holding tank NA Manure/animal excrete storage areas 1001+ Building foundation 54 Property line 54 Absorption field 5'+ Water main 1001+ Water service line 101+ Surface water 1001+ Wells on adjacent lots 1004 ABSORPTION FIELD ON LOT TO: Property line 2'+ WAIVER Building foundation 101+ Water main 10'+ Water Service line 104 Surface water 1001+ Driveway, parking/vehicle storage 21+ Curtain drain 50'+(NoneKnownl Wells on adjacent lots 1004 F. COMMENTS EXISTING BED WAS REPLACED AND INSULATION ADDED ON THE NORTH HALF OF THE BED ONLY G. ENGINEER'S CERTIFICATION I certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name MIKE N. ANDERSON, PE Date 0612912015 COSA canary sheet_2-&15.doc Of • •. q 1 A� l :1p:•.••• s 0 '*9TH • w ...... O • MICHAEL 5 N. ANDERSON ; R LOT 4E LOT 4F N00'066''33"W 99.88' LOT 5A O"OttuW-- 1-M0OLRE 5' UTILITY EASEMENT _ _ 5 UTILITY EASEMENT _ FX—%—X—'—`—X—x_X_-_ F X j j LOT 3B BLK 4 I o �0 U C) W 04 W I � �- z0� Z< v m O O m M m V I O M6 20.3' X M WELL v g V ® a J 20Z Ira WI LOT 3A 16.2' 0.01 w &' LOT 6A EXISTNG - R �1 WOOD FRAME ]] a x5, n D HOUSE a.01 14.9• 25.3' h m %—% d Y, X—X y ; W 220• W a0 Co I W In 0 N O O n0 Ij0 Q, O O O A.C. I z Z Z D/W u o • a 7 (16 i • SHE 1Q1 • SEPTIC VENT (tYp) [k 100.04' 100.00'REC X—X—X,X--_X — 0 M _TOY DRIVE _ N 00'00'00" E 0 M ANCHORAGE RECORDING DISTRICT, ALASKA ASBUILT OF: I = FND ALUMINUM MONUMENT SKYWAY PARK ESTATES SUBDIVISION O = FND 5/8" REBAR LOT 3B BLOCK 4 PLAT 2004-191 SURVEY CERTIFICATE: I, John L. Schuller, Have conducted a0 F A r �` '�Q+�D LpAW rL [T physical survey of this property as shown on this drawing and that the .0 • • • ..... • L, <Q�,, �.�ti0 S '�,�f improvements sih=d hereon are within the property lines and no enchroachments exist other than noted. Under no circumstance should /� Gj�• ,4 any information on this drawing be used for construction of fences, rK y structures, improvements, or for establishing boundary lines. �. *...... ., ... . ..... * �'�.' Q' % t" J ..'.. v r EXCLUSION NOTES: It is the owners responsibility to detennine F'p ' :' ""' • • Y •� the existence of any easements, Covenants, or restrictions which % 0. - OHN L. SCHULLER.- / do not appear on the recorded subdivision plat. ,, m LS -10408 ami/ :• .,,,•,•, „ WORN ORDER NUMBER: DART scwe r-Nra, '1 r^P & �� 1831 Talkeetna Street JUNE 28, 2015 1"=40' 1`ap �' Z "` �. oZ, 5A Anchorage, Alaska 99508 15-026 °• ar ° a ora R soak qac\ro%essionel ss (907) 227-1455 office JLS 2729 150211 \\\\���� (907) 274-4992 fax '• � Munici alit �of�Anchorage..•„�,.: ..,: '.;; � • Developrii nk' ervices Department s1BuiidingSafety Div isionr:,•. ,•,:r.. ,•. •` �0 Site Water and Wastewater Progrm a ..: r.v •,. ... J: t . • :: :: x1.::4700 South Bragaw SL., ' • • P.O. Box 196650 ;Anchorage; AK',99519-6650 wwvid.onchor2ge.ak.us • , : • •• (907) �, •. CERTIFICATEOF-HEALTH .AUTHORIiYAPPROVAL "•' ”' FOR A,SINGLE FAMILY DWELLiNG:i t''- .: ! •• %"�:lit ,t!: . .: �;. .•. .. . 019• loll—Z .. --.-- .. _ ;, •_;.1_:'r...:•. :.-•.._._._�.. .... Parcell.D:} '.r.� •: ,. .._' :'IiAAIf j�n•�3'8. Expiration Date:. /n ` / 0 !i l 7. GENERALINFORMATiON ; Complete legaldesaiption • L`a:i• '3y S>�y tuA �! 1�AOk^SI ..:,• . , ., •._, :.. •� TORI � l7 �\V1=: Location (site'address or direciions) 'l t IS {•1 Current Property owners) ' 'GPc P O L-' O►2 Day phone Maiiingaddress; ,.• Lending agency Day phone' •. .L .. .. .. •• .. ..'.�� ... Mailing address 'lRealEslate'Agent .Mailing•Address.. .. .._...• — ..: _.._: -.. .'.. �.•..—�f{! .' unles's othenvise.requested, HAA wfn be held by DSD lor&kup. OF .2. NUMBER BEDROOMS:'. 3. TYPE .OF,WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well individual On-site individual Water Storage ❑ InHolding tank 0 Community Class Well ❑ Community On-site ❑ Public Water System ❑ 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 en Independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of tide (except between spouses) for properties served by a single family on-site wastewater disposal andfor water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval ere valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with neer water sample results less than 30 days old. (Certiricates may be reissued for a period of up to one year with vatid water samples.) Certificates ere valid for one year for properties served by Class A or B wells or a public vizier system. The Municipality of Anchorage is not responsible for errors or omissions In the professional engineer's work. Q. STATEMENT OF INSPECTION 13Y ENGINEER {u et rtIfied by my seal affixed hereto and as of the validationovadlate Guide nes for this application, I verifyat t my o , shows that the based on procedures outlined In the Health AuthorttY APP on-site water supply and/or wastewater disposal system ls(are) safe, functional and adequate for the number of investigation and Inspection, the on-site water supply endlor bedrooms and type of structure indicated herein. I further verify that based on the Information obtained from e Municipality of Anchorage files and from my tis Wastewater disposal system Ware) In compliance with all OPPhcable Municipal and State codes, ordinances, and regulations In effect at the lime of installation. Phone o27 y �• Name of Firm 16 • ' " " ' " - Address el ^u� o o u, u e • Date 2�+I Engineer's Printed Name ,• pct, ~•� f GINEER'S (TAMP csra. ,•:w 5. DSD SIGNATURE � i "i. •. ••: •'',,, .: • 2. ••. •• bedrooms. Approved ' ` '•""'' '�' y _ proved for Disapproved. Conditional approval for bedrooms, with the following stipulations: «rrn r 44 � Additional Comments Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory �— (R". IM :: ND • "" WAS • _ n Maintenance Agreements �— Supplemental Engineer's Report Other r _ Original Certificate Date: 2:d - O� Municipality of Anchorage ••• • Development Services Department Bullding Safety Division :.... On -Site Water & Wastewater Program 4700 South Dreg" St. P.O. Box 19M Anchorage, AK 9951"M www.d.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: LO1 25121BV-S 4VSTATE 1LFarrelIo: A. WELL DATA � If A, S. or C ProvN/e- Provide PWSID 0 � Web Log (YM) Well type A Date completed .qI d . Sany seal (YIN) Win property protected (YM) Total depth —n• Cased to CaskV height (above ground) yfn. FROM WELL LOG AT INSPECTION Date of fast static water save! Well production WATER SAMPLE RESULTS: • f.olyoitn colordesllooml. Nitrate 3"21n+gJt• Ottrorbacteria colonies/100 ml. • Des of sample: (01411v ( Collected by'. S B. SEpnC/HOLDINGTANK DATA Tank TypslMateriet �'F_ S 1 L Date installed Tank size � ge. Number of Compartments L Clam (Y ) _—f-�— Depression over tank High water (YIN) ' Foundation cleanout (YRJ) � Depr (Y/N) Date of pumping G/.� Pumpor C. ABSORPTION FIELD DATA Date Installed 5%5oJV Soa rating (9.P.dJfe Or ft°lbdnn) I bO System type c 3 11— ^1L Width ft. Gravel below Pipe Length `tt Total depth A ft. Eff. absorption area Y,5Lfe Montoring tube'_�/- Depression over field t Date of adequacy lest Results (Posa/Fail) For � bedrooms q .r:: O Fluld depth in absorptionu bblo a tea r;� ?kt.3 y Water added i=` =ae1. '10o New depC'__ _• 5 tion rete >= �T fl g•P•d- Elapsed TimePa min. Final fluid depth In. Absorp Any rejuvenation trreatment (Past 12 mo) (YIN E type). N Ryes. give date D. UFT STATION Date Installed Size in gallons pump on' level at _In. -Pump oft' Datum E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAtR station on lot t o o Absorption field on lot 120 + Public sewer main N�� Sewer /septic service Une---ZM2— (YIN) High water alarm level at In. Meets alarm b dretA requirements? On adjacent lots > �5 On adjacent Wes 7 1,5' O Mae sewer manhowdeanout fq& Holding tank N/A SEPARATION DISTANCES FROM SEPTICIHOLDINO TANK ON LOT TO: too P�rtI+UAe 3 LAbsorption SOW 100 Budding foundation �=-- In Water mein NIA, Water service Mm Z.5y Surface water N Web on adjacent lots -Z_ %4!aav'"+ r'"t 1"b SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: c l I Water main Driveway. pie storage l i Property line .,l' 2 water Service Une Nlo curtain drain - F. COMMENTS Guiding foundation .1= surface water N 1,0 Wens on adjacent bis > 11 D 1 , O. ENGINEER'S CERTIFICATION Inspectloru end fJ r.....' F•...a1. •r . I certify that I have determined through held r+1... ). review o/Mun/c4w records that the above sYsfemt are /a conformance with MOA HAA guideArm In effect on fhb data. .,,,aaftd " r %,6140P .� " :� 223 '. ."N ;,r Engineers Printed Name t a b (' No Q� �1,?;:;�........«•'�-��'.: Date HAA Fee $ C 0 r Waiver Fee $ Date of Payment & I_I At, Receipt Number (Rev. 12100) Date of Payment Receipt Number IVIUnicipaality ®f Anchorage December 27, 1985 P.O.9OX 6650 ANC110MCF. ALASKA 99502 -MSD (907)264.4111 TONY M(NOWLES. MAron DEPARTMENT OF HEALTH &HUMAN 69"'C" Nark Holum Alaska Soil Testing and Engineering 6100 A Street Anchorage# Alaska 99502 Subject: skywanrk Estates Subdivision Waiver Request 060 Dcar Hr. Holum: This Department has reviewed your request for a waiver of the Cinimum subjecthorizontal pr separation Thu required 100 foot minimumulrod between a well daeparationtic nk for to tho the subject property. well on the at lot has been waived to 79 feet for tontan tank on the subject lot and waived to leat-for.the septic tank on -the the adjeceat Shia waiver is valid for a three bedroom dwelling only. Sincerely. 4 . Tl o.� Stephen S. Norrie civil Engineer On-aite Services SSM/ljw l DEPART[ 825 MUNICIPALITY OF ANCHORAr" T OF HEALTH AND ENVIRONME AL PROTECTION L Street, Anchoraoa. Alaska 99501 264-4720 Date Received: January ll, 1978 (fl: Time �); 2,� ��1)1 _ 42: Time #3: Time _ Date _L '4(�� Date Date Insp__ Insp TInsp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES 1. Lending Institution Request: Alaska Pacific Bank Mailing Address: Post Office Box 420 99510 Phone: 276-3110 2. Property Owner: Robert/Carol Prosser _^__ Phone: 344-•9223 Mailing Address: 11821 Toy Drive 3. Legal Description: Lot 3B Block 4 Skyway hark Estates Subdivision 4: Single Family Residence: (x)) Number of Bedrooms: Four Multiple Family Residence: ( ) Number of Bedrooms: 5. Well System: Individual Well (x,) Community/Public System ( ) Permit # Construction M. - Depth of Well Well Log on File ( ) Bacterial Analysis 6. Sewage Disposal System: On-site System (x) Permit If Installed 1977 Public Utility ( ) Installer , o Septic Tank Size Jy_`QLC)L, x�j� Manufacturer. 1�fg'r� Absorption AreaiL3 q�, _ Soils Rate 1Material 7. Distances: Wel]. to Septic Tan], _j_C�� to Absorption Area to Sewer :Line Nearest Lot .line —_,Absorption Area to Nearest Lot Line Page Two Department of 'Health and Environmental Protection Request for Approval of Individual. Sewer and Water Facilities Legal Description: Lot 3B Block 4 Skyway Park Estates Subdivision Comments: Affadavit Attached: ( Letter Attached: { Approved: ��[` Date: Disapproved: Date: Department Worksheet: eee-osa O zce,: odo 1 11bW 101010NUUM UO! ON 11.61 `dV - mq (op!, $. 003)—03OIAOUd 39VUTAOO 3ONVUUSNI ON 008£ w10� Sd """""""""""""""-"' (P 1 ) All3Al l30 1V10315 9 p05 """ "" "" """' "" """"-"""" AlNO 33S53tl00V 01 113A1 110 ° 059 """""" ,1100 001 a 01 A,an!10p ql!M 5301Atl3S - JSf " pa3an118p alm1m le� pu Pue elep 'n.mlln of seaOgS 'Z 1,1130311 - 099 """""" A100 00asappe 01 A.—,1 "1161 I MPSI ....,...... panAllap a19p Pue 1e0UA1 of SIAug5 '1 Ntl013U 53:11 1VN011100V 1101 MO U35 101011,10 0NV'-I1VAS "0'd C'I 0 'ON ONV 133111S C.i ) 31Vq NO _. OL AUS (a elsod .r snld) -)OF Ilt/IM j 210,1,ldl IAN . N I C I PALi TY OF AN,_-:14iRAGE Department of Health and Environmental Protection 825 L Street, Anchor.agk,, Alas',a 99501 279-2511, ext. 224, 225 Request for Approval of Individual Sewer and Dater Facilities 1. Property Owner: Robert & Carol Prosser Mailing Address: 11821 Toy Drive Phone: 344 9223 _ 2. Name of Buyer: Robert & Carol Prosser Mailing Address: 11821 Toy Drive Prone: 344 9223 3. Lending Institution: Alaska Pacific Bank _ Mailing Address: _^ P.O. Box 420 Anchorage, AK _ Phone: 276 3110 4. Realtor/Agent: _, None Mailing Address: - Phone: 5. Legal Description: _ L3 -B, Block 4, Skyway Park Estates Street Location: NHN Toy Drive 6. Single Family Residence: (X) Number of Bedrooms: Multiple Family Residence: ( ) Number of Bedrooms: 7. Water Supply: .*Individual Well VX) Public/Community System If Individual Well, well depth ? (Drilled in March/77) If Community System, name of system ,,_.,8 _ _ Sewage Disposal System: On-site System .(X>) -Public System ( ) If On-site System, date of installation: (Summer '77) ? LiUNgCPAUIY OF ANI_. CEP7. CF 0 ALi:' *NOTE: A well log is required on ALL wells drilled since 3/77