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Home My WebLink AboutEAGLE CREST #2 BLK J LT 2BEagl Crest Block Lot 2B #050-295-97 APR 16 '93 11:47 I~:/t~ OF £AGL£ RIVR, A & L DRILLING COMPANY BOX 97, EAGLE RIVER, AL/~KA OWNER OF LAND ADDRES~ STATIC LEVEL OF WATER FT. Ended / FL ~ ". F , 'Fifo Ft. FL , Fr~m FI to__Ft. , , Ft. ' F~m ' Fh ~ Ft. , ' Fc , From FC t~F~ FL From FI t~t ..... FL · F~ FL ~ . FL FI From FLto,,, ' FL t : FL From , Ft. From q ff From f ~ o r~om ./",~ rt.t, . From. 1151 'FL to From~Fr. to. FL to From~Ft. to From~-~_Ft. ~ From Ft, to From~Ft.'to Fro*m Ft. to From Ft. to From~Ft. to Fr~Ft. t~ . IIUSCL. IN~OPJ, iATION: MUlti I C I I,;i¢:~L I I'Y I_]i= DEPARTMENT ~' HEALTH AND ENVIRONMENTAL .(OTECTION 825 L STREET,264-4720 ANCHORAGE, AK 99501 ON--SITE WELL PERMIT PERMIT NO: DATE ISSUED: 860555 09/08/86 APPLICANT: ADDRESS: CONTACT F'HONE: BILL SULLIVAN P.O. BOX 670272 CHUGIAK, AK 99567 688-2759 LEGAL DESCRIP: LOT SIZE: SUBDIVISION: EAGLE CREST 2NDADD. LOT: 2B SECTION: 7 TOWNSHIP: lqN RANGE: 10540 (SQ.FT. OR ACRES) BLOCK: certify that: 1. I am familiar with the requirements for 2. 5. on-site sewers and wells as set forth by the Municipality of Anchorage (MOA) and the State of Alaska. I will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit. I will adhere to all MOA and State of Alaska requirements Cot the set back distances from any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. SIGNED DATE: APPLICANT: B~% ~LLI VAN , ISSUED BY ~-~/¢-~'7' '~-'~ DATE, MUNICIPALITY OF ANCHORAGE Development Services Department Phone: (907)343-7904 On -Site Water & Wastewater Section Fax: (907)343-7997 Parcel ID 050 -293-97 Certificate of On -Site Systems Approval OSC251135 Expiration Date: 4/14/2026 Legal description EAGLE CREST #2 BLK J LT 2B Site address 18646 CITATION RD Current property owner(s) PARKER JILLIAN X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or conditions: By-' ;/ �-''�� --- — Original Certificate Date: 4/28/2025 This' ertificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject fystem(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Service Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's submittal. ATTACHMENTS: COSA Checklist x Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other lr�!' !"110111 1 - Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 05029397000 Complete legal description Eagle Crest #2 B -J 1_213 Location (site address) 18646 Citation Rd., Eagle River, AK 99577 Current property owner(s) Jillian Parker Day phone 907-691-8083 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS 3. TYPE OF WATER SUPPLY: � Private Well serving #_1 dwelling units 7 Other Non-public well as regulated by MOA 7 Water Storage F1 Community Well or Public 4. TYPE OF WASTEWATER DISPOSAL: ❑ Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank Ff Community Septic or Public Sewer 5. SEPTIC TANK: F71 Steel ❑ Plastic ❑ Concrete M Fiberglass Age - See advisory if steel or fiberglass older than 20 years 6. ABSORPTION FIELD: F-1 AWWTS ❑ Bed Fj Deep Trench 7 Wide Trench 0 Seepage Pit Waiver request for: Expedited review requested: 7 Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $_ Uzo Waiver Fee $ Date of Payment 4 tlL 12,5 Date of Payment COSA # ot>czs � k SS Waiver # COSA Application_Ap2025.doc Legal Description COSA Checklist Eagle Crest #2 B -J 1_213 Parcel ID: 05029397000 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system 1 A. WELL DATA ❑1 Well log is filed with Onsite (or attached) Date drilled 10/5/76 Total depth 166 ft Cased to 40+ ft Q Sanitary seal is functioning correctly ❑Q Wires are properly protected Casing height (above ground) 16 in. Date of flow test for COSA 4/14/25 Static water level at beginning of test 123.7 ft Comments B. TANK DATA Aced fluid level in septic tank Date of pumpin ❑ Required maintenance co d, if AWWTS Comments: D. ABSORPTION FIELD DATA hich system tested (date installed) ❑ L standpipes present per record drawing Total me sureddepth from grade ft (max) Measured de, th to pipe invert from grade ft (min) ❑ N/A — or \urized field. F-1Per record dry ings, field is insulated. El Monitor tubes go to ttom of effective. If not, state depth into ative ❑ Presoaked required if (Required if house vacant or fiel of used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) If yes, enter date Well production at time of test 8.7 gpm Water storage tank volume n/a gallons Well disinfected for coliform test? ❑ Yes M No 9 Coliform bacteria is Negative Nitrate 4.75 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L R Arsenic less than MRL (ND) Collected by Brandon's On -Site Services LLC. Date 4/14/25 C. LIFT STATION red maintenance completed Age of lift station years Lift station material Comments: Adequacy test date Results F-1Pass Fluid epth prior to test in Water ad d gal New fluid dep 11 in Elapsed time min Final fluid depth in Absorption rate gp FIELD STATUS — POST REC VERY Effective depth (per record drawin s) Effective depth used in Effective depth remaining in Comments/Deficiencies: This property is served by Community Septic or Public Sewer COSA Checklist June 2022 in E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' ❑ Yes if No Community Sewer Manhole/Cleanout > 100' Fil Yes if No ft ❑Q Yes if No ft Neighboring Tank > 100' g Yes if No ft Private Sewer/Septic Line > 25' Q Yes if No ft Absorption Field on Lot > 100' ra-1 Yes if No ft Holding Tank > 100' Yes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' RE Yes if No ft ❑i Yes if No ft ft If tank or field is under driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' 0 Yes if No ft 0 Yes if No ft ❑ N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No ft Surface Water > 100' ❑ Yes if No ft Tank to Property Line > 5' ❑ Yes if No ft Wells on Adjacent Lots: Field to Property Line > 10' ❑ Yes if No ft Private Wells > 100' ❑ Yes if No ft Water Main > 10' ❑ Yes if No ft Community Wells > 200' ❑ Yes if No ft Water Service Line > 10' ❑ Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS G. CERTIFICATION & 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, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm Walden Const. Cons. & Eng., LLC. Phone 907-354-6661 Engineer's Printed Name Robert L. Walden Date 4/21/2025 f' Jx" %`i i's`Ui "...-f'_. C✓'�. G -^`rte ` t s,J%'' 4/21/25, COSA Checklist June 2022 Municipality of Anchorage Development Services DeDartment Building Safety Division On-Site Water and Waslewaler Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 995t9-6650 www,ct.anchorage.ak.us (907) 343-7g04 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 1. ..GENERAL INFORMATION Expiration Date: "~ - · ~Aailing addres?." .~E= Len(~i~g'~(~, Day phone It,la[ling address Real Estate Agent Mailing Address Day phone NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class~ Well Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-sile Individual Holding tank Community On-site Public Sewer The Municipality o~' Anchorage Developmenl Services Department (DSD) Issues Certificates of Health Authorily Approval (HAA) based only upon the representations given In paragraph 5 by an independent professional civil engineer reglslered in the Slate o1' Alaska. Certificales o[ Health Authority Approval are required [or the lransfer of lille (except belween spouses) for properties served by a single family on-sile wastewaler disposal and/or water m~pply system. DSD also Issues HAAs upon request 1o homeowners. Cedificates of Health Authority Approval are valid for 90 days from the date of issue [or properlies served by a private or Class C we!l and may be reissued wilh ~]ew water sample results less lhan 30 days old. (Ced[fica[es may be reissued for a period of up lo one year with valid water samples.) Certificates are valid for one year for propedies 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 pro[essional engineer's work. 4. STATEMENT oF INSPECTION BY ENGinEER As certified by my seal affixed hereto and as cJ the valldatton da{e shown below, I verity Ihat my tnvesllgalion, based on procedures outlined In the Health Authod['/Approval Guidelines for this applicalion, shows that the on-site waler supply and/or wastewater disposal system Is(are) safe, funclional and adequate for the number of bedrooms and type of structure Indicated herein. I Jurther verify Iha~ based on the Information obtained from Ihe Municipality of Anchorage files and from my Investigafion end Inspection, Ihe on-site water supply end/or waslewaler dtsposal system Is(are) In compliance With all applicable Municipal end Slate codes, ordinances, · and regulations In effect at Ihe time oflnstallafion. Name of Firm ,~'~ ~ ~-'~/(.//,v/~A-,~-J.-.,/~-- Engineer's Pnnted Name 5. DSD SIGNATURE . ~ Approved for 3 Disapproved. Conditional approval [or bedrooms. Phone bedrooms, with Ihe following stipulations: Additional Comments Altachments: HAA Checklist Septic System Advisory Well Flow Advisory X Maintenance Agreements Supplemental Engineer's Report Other Original Cedificale Date: ~ - ..Q. ~ - C3:2__ Municipality of Anchorage Development Services Department Building Safety Division ~,~° On-Site Water & Wastowater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage. AK 99519-6650 ~1~.~ www.ci.anchorage.ak.us _ (goT) 4 .',,go4 - HEALTH AUTHORITY APPROVAL CHECKLIST LegalDesoription:/_~PT '~-~ : ~14._,~': ~-~7'" ParcellO: 0~'-0, , / A. WELL DATA Well type '~/~-~ V~,,~'~ Oate completed ~/~'~, Sanitary seal (Y/N) Y Total depth I (~ ~, ft. Cased to 4~'~. FROM WELL LOG AT INSPECTION Static water level t '~ '~ ' ft. I ~-~'-.-"~' Wall production Well Log {Y/N) Y~_ W~es properly protected (Y/N) '7" Casing height (above ground) { ?-.-'lt- In. fi* g.p.m. WATER SAMPLE RESULTS: Coliform (~ colonies/100 mi. Date of sample: B. SEPTIC/HOLDING TANK DATA Tank Type/Material Tank siZe gal. Nitrate ~, I{~ rng./1. Other bacteria .~.~_ colonies/1 O0 mi. Collected by: ~fl ~ 4~/~--~//'~''''-'~- /'"~'~'- . Foundation cieanout (Y/N) (Y/N) Date installed Cleanouts (y/N) High water alarm (Y/N) Date of pumping. C. ABSORPTION FIELD DATA Date installed Length Total depth ft. Date of adequac Fluid ~efore test (g.p.dJft~ or ~/bdrm) W~th ft. ft2 Monitoring tube Results (Pass/Fail) in. Water added System type Gravel below pipe Depression over field gal. ft* For bedrooms New depth in. Elapsed Final fluid depth in. (past 12 mo.) (Y/N & typ~) Absorption rate >= If yes, give date g.p.d. D. LIFT STATION Date insteJled /'J,/~ Size in gallons 'pump on" #)vel at .._.~ln. 'Pump off" level at Manhote/Access (Y/N) in. High water alarm level at in. Meets alamt & C~lt requirements? Fo SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tenldlift station on lot Absorption field on lit ,/~//~ On adjacont lots /'"///~ On adjacent lots Public sewer main /~:~'/'/- Public sewer manhole/cleanout /{~Q /~- Sewer/septic service line. ~ ~" ~ ~ H¢flding tank ....... SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: ~)(. I ,'~ ~.~ C.- ~ C--..f._~ Building foundation / Properly line / Absorption field Water main / Water sewice line/ Surface water / Wells on adjacent ii/ . / SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Water Sewice line Surface water / Driveway, parking/vehicle storage Curtain drain Wells on adjacent lots/ 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 confo~nance with MOA HAA guidelines in effect on this date. Engineer's Printed Name ,~6~ r- ~'. Date .¥/& ~-/0 "z. Date of Payment Receipt Number (Rev. 12/00) Waiver Fee $ Date of Payment Receipt Number I I,~11 IU I .']1 ll. llf~l. I HEREBY CERTIFY .THAT I HAVE SURVEYED THE SCAL~; FOLLOWIN(; DESCRIBED PROPERTY, /,,~-,.,.-,~-t:~ ~ NO ~MENTS ~IST ~C~ ~ ~, ~;7., ~ .~' ~.- ~ ~ D~RMINE THE ~ISTEN~ OF ANY W~ ~ ~ ~E~ ~ ~ R~ ~1- ": ~X .................... ~...,,~ ~.,{ ~ ' VISI~ P~T. U~ NO CIRCUMSTANCES S~ F~ f~-.. t5-~{8 ...'~e ~Y DATA H~ BE U9~ ~R ~NS~U~ION ~ FEtE LIN~, OR ~R E~LISHINO ~ND- D~WN ARY LINES. ASBUILT-NO CORNERS SET THIS DATE. Parcel I.D. # . ~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O, Box 196650 Anchorage, Alaska 99519-6650 343-4744 ~UNICIPALI1~ OF ANCHORAGe CERTIFICATE OF HEALTH AUTHORITY ENVIRO 'NM~NTAL S~VICI-'S DIVISION APPROVAL FOR A SINGLE FAMILY DWELLING 050 293 97 ~o~ ',' HAA# ~'~ ~'~-.~ ,~ ECEIVED IAY 2 8 1998 1. GENERALINFORMATION Complete legal description Lot 2Bt Block J: ~ale Crest Location (site address or directions) Property owner Mailing address 18646 Citation Eagle River, AK P~h P~q~on Day phone 6q~-o~o4 '18646 Citation Eagle River, AK 99577 Lending agency city Mortoaqe/ Jeannie Mee Mailing address Day phone 696-0701 Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY:; Individual well Community well Public water NOTE: XXX If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OFWASTEWATER DISPOSAL: NOTE: Individual on-site Holding tank Community on-site Public sewer xxx If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and es of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date Of this inspection. $ & $ ENGINEERING Name of Firm ;~'G~-~ ~.~ R;,,~, L.,~v ~'. ..... ~., ..~ Phone G ¢~ ~/~ .~. 9 '7 ~' Address Eagle River, Alaska 99577 Engineer's signature .. '?~./~.' ~ Date DHHS SIGNATURE ~ Approved for . t"'"-'~ C) Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not' conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errom or omissions in the professional engineer's work. IaAY 2 8 998 Municipality of Anchorage .._.^.._. ~ - 1~' OF ANM'~w,~ DEPARTMENT OF HEALTH & HUMAN SE~_~ .......... ,,.,~I~T~ Environmental Sewlces DMsion ~ 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Legal Description: Health Authority Approval Checklist ooo A. WELL DATA Well type Log present(~) Total depth If A, B, or C, attach ADEC letter. ADEC water, syetem number Date completed Cased to I ~' ~' Casing height (above ground) Wires pmper~ protected ~) Date of test Static water level Well production FROM WELL LOG g.p.m. AT INSPECTION z.+ I 'l ~. 2.. g.p.m. WATER SAMPLE RESULTS: Cctffomt (~ Nitrate Date of sample: Collected by: B. ~O TANK, DATA Date instal~ Number of Compartments ~ Cleanoute (Y/N)__ F~~.. ~. _____~__ High water alarm (Y/N) Date of Pu~pi~g' ' :"' ' "' Pumper C. ABSO~I:~10N FIELD DATA-':' ~..... Length~ ~"~'dtYr~ Gravel thickness below pipe Total depth Effective absorpfion area Mo~M'~ad.~Tupe present (Y/N) Depression over field (Y/N) Date of adequacy test Results (P~~ _ For Fluid depth in absorption field before test (in.); Immedtate~ gal. water added (in.): Fluid depth (ins) Minutes later:. Absorption rote =~-.~ g.p.d. Peroxide treatment (past 12 months) (Y/N) If yes, give date ~ 72-02e (Rev. 3/96)* ~ bedrooms D. UFT~ Date installed ' -"'-,,.~ Size in gallons Manhole/Access (Y/N) ~ High water alarm level at* *Datum ~ Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELLON LOT TO: Septic/holding tank on lot Absorpfion field on lot Public sewer main ..~ "Pump off" level at* I cerSfy that I have determined thru field inspections and mvfew of Municipal record~~.rns are HAA Fee $ '~'~-~ ' '"'" Date of Payment ~ RecaiptNumber~9~'7,9..'~/~.~74~'C 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number Water main/service line .SuSa .se water/drainage SEPARATI~ORPTION FIELD ON LOTTO: " Property line ,; ~ BulFd~aa~.~~ Water main/sewice line F. ENGINEER'S CERTIFICATION ~ '~' Litt stat,Ion '~ DING TANK ON LOTTO: Absorption field, On adjacent lots On adjacent lots Public sewer manhole/cleanout