HomeMy WebLinkAboutTIMBERLUX #3 BLK G LT 4Timberlux
Block
Lo1- 4
#018-271-58
Expired Permit
Municipality of Anchorage'
George P. Wuerch, Mayor
Btfildlng Safety Division
P.O Box 196650 · 4700 S Bragaw Street
Anchorage, Alaska 99519-6650 · (907) 343-8301
http//~xax~x ci anchorage ak us
~epartment o~
PubIic Works
6/7/2001
J DenmsGregmre
4745 Manytell Ave
Anchorage AK 99516-4122
SubJect On-S~te Water and/or Wastewater Pernut
Penmt Number SW000171
Parcel ID 018-271-58 ~
Dear J. Denms
An On-S~te Water/Wastewater Permit, number SW000171, ~ssued by this office for a single-family
system, will expire on June 15, 2001. This permtt was valid for 365 calendar days
If ttus was a well permit and the well has been drilled, a well log must be sent to th~s office for
documentation of the installation and to close the permxt
If tlus penmt was for a wastewater d~sposal system, an onglnal as-built ~nspectlon report must be sent to
this office for rewew, approval and documentatmn Th~s as-built ~nspectlon report must be s~gned by
the hcensed Professmnal Engineer who ~nspected the installatmn of the system As-built lnspectmn
reports are required to be submitted within 30 days of the completion of the system
If no system was ~nstalled under thxs permit, and you are still planning to ~nstall a well or wastewater
disposal system, a new permit must be obtained from this office A new penmt may be issued free of
charge for a second year if the apphcatmn for the renewal ~s received on or before the date of exp~ratmn
of the original permit
When applytng for a new penmt, the fees are $320 00 for a wastewater penmt and $120 00 for a well
penmt
If you have any questions, please call th~s office at 343-7904
Ja~es Cross, PE
Manager
On-S~te Water and Wastewater Program
enc Copy of permit
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On-S~te Services Program
825 L Street, Room 502
P 0 Box 196650, Anchorage, AK 9951g-6650
(907) 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued Jun 15, 2000
Exp~ratmn Date Jun 15, 2001
Permit Number: SW000171
Legal Descnpbon TIMBERLUX#3 BLK G LT 4
Design Engineer 0019 FlattopTechmcal Services
Owner Name J Dennis Grego~re
Owner Address 4745 Manytell Ave
Anchorage, AK 99516-4122
Parcel ID 018-271-58
S~te Address 004745 MANYTELL AVE
Lot S~ze 53773 SQ FT
Total Bedrooms 3 Permit Bedrooms 4
Th~s permit ~s for the construchon of
[] D~sposalF~eld [] SeptlcTank [] HoldmgTank [] Privy
[] Private Well [] Water Storage
All construction must be in accordance w~th
I The attached approved design
2 All rreqmrements specified m Anchorage Mumclpal Code Chapters 15 55 and 15 65 and the State of Alaska
Wastewater Disposal Regulabons ( 18AAC72 ) and Dnnkmg Water Regulations ( 18AAC80 )
3 The engineer must not~fy DHHS at least 2 hours prior to each inspection Provide not~flcabon by calhng
(907) 343-4744 ( 24 hours ) ( Not reqmred for a Water Supply Permit only )
4 From October 15 to Aprd 15, a subsurface soil absorption system under construction during freezing weather
must be e~ther A Open and closed on the same day
B Covered, sealed, and heated to prevent freezing
Recewed By
Issued By
Date
Date
Michael N. Anderson, P.E.
4640 Shoshom Avenue
Anchorage, Alaska 99516
Phone 345-3377
Fax 345-1391
June 7, 2000
Department of Health and Human Servmes
P O Box 6650
Anchorage, Alaska 99519-6650
Re Lot 4 Block~Timberlux Subdivision
To Whom it may concern
The above property owner has a system in fmlure A new test hole was excavated near the old
stte and had water at 10 feet after the seven day momtoring period The perc rate was 2 minutes
per inch at elevation -4 feet The sods are good silty-gravel the full depth of the test hole The
new system will be a bed with gravity flow and a section wdl be over the top of the existing
system which uall be excavated out and replaced uath natural material from on-s~te A pressure
d~stribut~on system was not chosen due to the good perc rate and the owner said the bed wdl be
larger for added hfe on the system The lot size ~s 1 25 acres with the natural slope from the
north-east corner to the south- west corner None of the surrounding properties will be effected
by this new upgrade
If you have any question please call me at 345-3377
IVh6hael Anderson, P E
RECEIVED
IUN 07 000
~ ~,--GRADE DESIGN CRITERIA. /f
4 BDRM X 150 =/600 GPD
-1'--OR~~ /FILTER FABRIC SOI~S =60~ ~oSQ ~ REQ'D
OW ~ 15o~DRAIN- ROCK TRENCH.
4.0' DEEP
0.5' EFFECTIVE
S 89'56'36" E 182 96' /
10' UTILITY EASEMENT / '~
EXISTING SYSTEM ~ ---
TO BE ABANDONED ~ ~ _ ~
~ JACENT WELL
z t ~ / 100' RADIUS
~]ING WELL
100' RADIUS
S 89 56'36" W 182 96'
- MANYTELL AVE-
SEPTIC DESIGN PREPARED FOR ~ OF AI'~,;.~
J DENNIS GREGOIRE
TIMBERLUX SUBDIVISION
PREPARED BY
MICHAEL N ANDERSON, PE
4640 SHOSHONI AVE ¢~*, CE~94~9
(907) 545-5377 / FAX (907) 345-1591 .
SCALE 1"=60' dUNE 5, 2000
EXISTING SEPTIC /
TO BE ABANDONED /
10' UTILITY EASEMENT /"" '~ %"% //
........ _/__' ......... 2,__ ____/.
EXISTING TANK
EXISTING WELL ~ ""--..
" WELL/
/ ADJACENT
,' 100' RADIUS--/
SEPTIC DESIGN PREPARED FOR ~..'~.'~-~-\~.x.
d DENNIS GREGOIRE -",,.'~-. ......
PREPARED BY ~ ...... '''''"
MICHAEL N ANDERSON, P E t ¢-; MICHAEL N ANDERSON
4640 SHOSHON~ AVE t~?~'.. C~-p~ ..~i
(907) ,345-5577 / FAX (907),.345-1391
SCALE 1"=20' JUNE 5, 2000 -~.\\~.~.~,,..~,.~..-~.
Munlmpality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street Anchorage, Alaska 99502-0650
SOILS LOG t PERCOLATION TEST
LEGALO~SCmPT~ON ~:~ ~
1
2
3
4
5
6
7
8
9
10
11
12
13-
14-
15-
16-
17-
18-
20-
WAS GROUND WATER
ENCOUNTERED?
IF YES ATWHAT
DEPTH?
_:~'. MICHAEL N ANDERSDN
~ . CE- 9~69 .
DATE PER FORMED~ ~;~~ .
Townsmp, Range. Section
SLOPE SITE PLAN
SI
Mamtormo? /' ('-') Data: .
Gro$l Nar DeDth to Net
Re~mg Date T~me Time Water Drop
PERCOLATION RATE '~ [mlnutes~mcnl PERC HOLE DIAMETER
TEST RUN BETWEEN ~'~' FTAND
PERFORMED BY ~ ~ ~ ~ ~ ~ ~ I CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE
72~8 (Rev 4~)
MUNICIPALITY OF ANCHORAGE
Hea~ and Environmental Protec on
~-- Fourth Floor West ~
825 L Street
Anchorage, Alaska 99501
279-2511, x 224, 225
INSPECTI°N REPORT ON-SITE SEWAGE DISPOSAl. SYS'i'EM
SEPTIC
DISTANCE ~} -~ ~ . NUMBER OF
FROM WELL~--- MANUFACIURER~ ..... MATFRIAL ........ COMPARTMENT'S
INSIDE LENGTH ............. INSIDE WID1H . _ LIQUID DEPTH ........... LIQUID CAPACITY~GALLONS.
TILE DRAIN FIELD:
~lD ( TOTAL LENGI'H
DISTANCE FROM WELl .... FOUNDATION___~>~_' _ .NEAREST LOT LINE .... OF LINE "~"-~
~ of Lines .......... DISTANCE BETWEEN LINES ........ TRENCI4 WIDT~IN.
TOTAL.
EFFECTIVE
ABSORPTION AREA ................... SQ. FT. LENGTH OF EACIt t INE
[)EPTtl OF FILTER ~ ~ I ~ /
DEPTH: TOP OF TILE TO FINISH GRADE ..... MATERIAL BENEA'IH TIL. E~~ _I~ABOVE TILE ~_~
SEEPAGE PIT:
Log Crib Rings.__
BUILDING FODNDATION ....
DIAMETER _ OR WIDTH ..... EENG ! H_--, DEPTH
Crib Size: DIAMETER_ __DEPTH .... DISTANCE FROM: WELL
TOTAL EFFECTIVE
NEAREST LO[ LINE .... ABSORPTION AREA (WALL AREA)
_sq. FT.
Well J
Class: Depth:
Well Distance To: Lot Line __
Bldg: Sewer Line: ____
Pipe Materials:
~ of Sedr?omsk
Ins%aller. ~ __
Remarks:
1
F'ERM I'f' NO.
14FFI J_.fl-,ll
LOC:FiT ): ON
I....IE EiFIL
TFIE LENGTH DIMIENS;I:ON IS THE I_IENG'I'I-I ,:: II",l F'EET > OF: THE TF?.ENCH OR DRF:IINF']:I:E!..[:'.
THE [:,EPTH OF FI TREN[::H OR I::'IT IS THE [)ISTFINCE IBETHEE]",I THE SLIRP-FIC:E OI'v 'THE
GFi:OUN[:' F:IND TI.'II~E BOTTOM OF THIE L::;,-,iCI::I',,,'FITION (IN FEE:T).
THE: 'TF?.EI'4C:H I-,.I I [)TH FOR [:,F..'F~]; NF' I EL.I)!.:; I F; _.3.': FEET.
TI-fiE GF?R'v'EI_. [:,EF'TH I'.E; THE; HINIMI..IH DE:PTH
R[q[> THE BOTTOH OF THE: EXCI:::I',,,'FCf' ): [)N ,::
E~I::ICIEF: I I..L I NG OF:' I::11",l"¢ :S"r'STIEM H I THOLJT F I I",IRL I t'.,ISF'E:C:T I ON FIND RF'I::'RO'v'FII,., E:? TH 1%
I:::,EF>F:~[.~'.TI','IE:I'4T 1.4II..L. E:E: :i.7;I...IIEL]'ECT TCI I::'I;?OS;IECLI'F:[ON.
f'!IN]:MLIH [:,I'E;'FF:INCE: EHi:_':TH~F_'[I",I FI I,.IL::LI.. l::ff4[:, I::~iq"r' ON-S';ITE SE].4FIGIE DISPIZr_'SFIL S;'z"_:5'FiEM
:LEIO F'E:]ET F'I:]R FI F'F'.I'v'F:ITE: HL-'.:LL O1:~: :;:::CIC1 F'E.:E:T FOF'. F! F:'LIE~L!C HELl ....
HELL. LOGS; FII:~'.E F:'.E(;!LIIF:IEI:::, F:INI:> MUS;T DF: FdE'TIJI:~'.hlEE:, TO THE: [:,EF'F:IF,:TMENT H!TFI:[N :]!:O DFt'¢S;
OF -I-14E 14EL.L C:OMF'L.ETIOI",I.
~;pE:CIF'I[::FI'FICd'.,I'E:; F:ff4[:, C:ON'.'5"FF?.I...ICTZON DIR[~fl~:l::lld:i5 FIRE R',,,'FI]:LFIE~I._[E TEl IN'ZCJt:?.E: F:'F?.OPEI:N:
I NL?TF:ILLFIT I
I C:ERTIF'"P 'f'HI::FI'
::L: I F:ff"l FRI"'III_!FII:~: H ITH THE IRE6:!IJIF~'.EP'IEt",~'I'~'; F'Cff':: OI",I'-:!5ITE: SIEI.4ERLS F:IN[::' I.,IEL.LS; Fff.5 SET
F:OI:C'I'H E:"r' -I"H[:S HIJIq I C: I F'FII- I T'¢ OF' FINE:F~OF?.F'IC4E.
;;::: I I,.IIL.L ]:NE;-FFtLL THE:: S"r'S;TE:P'I IN FIC:C:OI:~:DFINCE 14]:TH THE CODE'-:::.
~:: .[ LJN[::,IEI-:4:'.F:TFf:IND THFIT THE OI",I-S:I'f'E '_"St.EI-qE':I:~: :E:'¢STFZH MFI"r' I~'.EE!LI:i:I;?.E; IEI",ILFIRGE]'11ENT iF' THtE
FitESI[:'['ZHIZ:E: ]::5 I4'.[.E.f"I,:::,[::,[:_'L..E[::' TIZ,#NCI..L'E:'I'Z I'"lE'f;~% "['HF, I".' 4 IE:IE[:,RC, C,I"I:E;.
s ~,:,~.~:_:z:,: :.--.--~~.-' -.c:--~-~'~ .....................................................
F:ff:'F'L I CI~NT [:,l:ZNl'.4'r~¢:] I F'.E
..::,::;, ,:1-, ,::,~, ~~ ....................... ~:f:m~: ................................. ~----.4..s-'- ¢..7.... .............
CONSULTING GEOLOGIST
.SOILS LOG
~egal Description
Soil Descriotion
-16-
-18-
-20-
· otal Depth I ~-' feet in ~
Was groundwater encountered ~? Wha~ dep~ ~__?
Denth ~o bedrock / o . How de~ermined ~ ~~?
Respectffully submi'bted ~
Gary F. Player
Consulting Geologist
Well Owner
Location
DRILLING,
DRILLING LOG
Use of WeJJ,:
(address of: Township, Range, Section, if known; or distance ma~'ff'£gad ,
Size of easing n,' _Depth of Hole ].09 feet Cased to J.03.7[ feet
Static water level 6[) ft. (~BS~) (below) land surface. Finish of well (cheek one) open end (
Screen ( ); Perforated ( ).
Describe screen or perforation
Well pumping test at il () gallons per of drawdown from static level.
'./?:?/77
Date of completion
(minute) for hours with . (,-)/
WELL LOG
Depth in feet from
ground surface Give details of formations penetrated, size of material, color and hardness
(' -', "~ 'i s t itfi:.:u.p
.TO ' ~ o . ~ ~r,
.TO_
'1. r)
.TO
TO.
TO
TO '/! /
/(i
);
~ft.
TO
TO
TO
TO
TO
TO
_TO
_TO
J 0.,
~l:~.].tty cobbles (Bou]de:c 49')
Sandy gravel
Silty
S~tz~dv ~, ravel
NWWA Certified Contraotm-
Certificate No's. 814 &
2--STATE
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
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
1. GENERAL INFORMATION
Complete legal description Lo'r 4 . ~LtC' ~ 'TItlE, LuX '¢'.~-~
Location (site address or directions) HTur5 rl^N¥'T£LL ,~VE , ANCO, /}~. c/~5'/~,
Property owner
Mailing address
Lending agency
Mailing address
Agent NoNE
Address
~)~NN~S ~REGoJR£ Dayphone 3~5'-IGoW
Se~,'r'~6 ~'10RT GA6£ Day phone
- CgFJN6NcE Day phone
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS: 3
TYPE OF WATER SUPPLY:
Individual well v/
Community well
Public water
NOTE:
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE:
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025(Rev. 1/91) Front MOA~2t
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 of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I further verify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm FLAT'TOP "F,¢-CI~ SvC~;
Address I
Engineer's signature
6. DHHS SIGNATURE
Phone ~' 13~'~'-
-,... 4,9'-'!¢.-
Approvod for ~,~) bodrooms.
Disapprovod.
Conditional approval for
Date tl~). ~ /~'~.~
bedrooms, with the following stipulations:
Additional Comments
Date
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 D HHS 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 errors or omissions in the ~rofessional engineer's work.
· 72~25 (Rev. 1/91) Back MOA#21
(~ Municipality of Anchorage
Department of Health & Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: /.or 4, B~-~ G~ T~t-I~Lox Parcel I.D.
A, WELL DATA
Well type F'RIVATE
Log present (Y/N) ~
Total depth / 0~1 ~
Sanitary seal (Y/N)
If A, B, or C, attach ADEC letter.
Date completed
Cased to I 0 ~
FROM WELL LOG
Date of test
Static water level
Well flow
Pump level
SEPARATION DISTANCES FROM WELL TO:
f
Septic/holding tank on lot )3.0
Absorption field on lot I
Public sewer main
Sewer service line I I,.~
ADEC water system number
~l~"1/~'1 Driller M.W.
Casing height j~..
Wires properly protected (Y/N) ~
g.p.m.
; On adjacent lots ~/oo /
; On adjacent lots '>/oo '
Public sewer manhole/cleanout ~/oo /
Petroleum tank NoNE Ol&5£.~'£b
WATER SAMPLE RESULTS:
Coliform
Date of sample:
Nitrate ,~ o.t~f.,~- Otherbacteria ,~o,~t v'c./co,"~,ff'
Collected by: ~'~,~ T3'O? "F£¢fl, 5~'¢ 5'
S. SEPTIC/HOLDING TANK DATA
I J
Date installed ~f1~$/77
Cleanouts (Y/N)
High water alarm (Y/N)
Date of pumping
Tank size 12-~0 Compartments
Foundation cleanout (Y/N) Y Depression (y/N)
~ .,~- Alarm tested (Y/N) N
,5'"/ t ~ / ~ Pumper _'~.~ ~
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot 12~
To property line No ¢
Surface water/drainage
On adjacent lots ~'100' Foundation 5
Absorption field .Water main/service line
72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed
Manufacturer
Size in gallons
Vent (Y/N)
High water alarm level
"Pump on" level at
Manhole/Access (Y/N)
"Pump off" level at
Cycles tested
Meets MOA electrical codes (Y/N)
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot
On adjacent lots
Surface water
D. ABSORPTION FIELD DATA
Date installed
Length SS' Width
Total absorption area
Soil rating ~ ~ F'rz/SD~4
~¢?G//avel thickness 2.$ '
System type
Depression over field (Y/N) ~
Results (pass/fail) ~'¢zj~'
Peroxide treatment (past 12 months) (Y/N)
NeNE
Total depth
Cleanouts present (Y/N) ~'
Date of adequacy test .~/~ ~¢/~.
for -~
If yes, give date N,'/I.
bedrooms
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot J '~o
To building foundation
On adjacent lots
Surface water
f
Curtain drain NONE-. of~S£RV,~b
E. ENGINEER'S CERTIFICATION
On adjacent lots ~ IOo Propertyline
To existing or abandoned system on lot N.~ ·
Cutbank N,/~. Water main/service line ~ 2~ ~
Driveway, parking/vehicle storage area ~ '
date of this inspection.
I certify that I have checked, verified, or conformed to all MOA and HAA guidelin,
HAA Fee $
Date of Payment
Receipt Number
72-026 (Rev. 3/91 ) Back MOA 21
Waiver Fee: $
Date of Payment
Receipt Number