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EAGLE RIVER HEIGHTS BLK 2 LT 12
Municipality of Anchorage On -Site Water and Wastewater Program ° (907) 343-7904 Page 1 of 1 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP161355 PID Number: 050 281 29000 Dwelling: ❑■ Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New ❑■ Upgrade Name: Richard Magnuson Rev. Trust ABSORPTION FIELD ❑■ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address 10207 Wildwood St, Eagle River ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 715-8322 4 4 GPD/SF 7.82 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 2.82 Ft.5 Gravel depth beneath pipe Ft. Subdivision Block Lot Eagle River Heights 2 12 Fill added above original grade 0.15 — 0,3O Ft. Gravel length 15 Ft. Township Range Section Gravel width 2.5 Ft. Beds: Number of Lines 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 150 Fe 1 Ft. Well 101.7' 113.52' NA NA 85,2' TANK ❑ Septic X S.T.E.P. ❑ Holding ❑ Other Manufacturer Anch Tank Advantex Capacity 1500 Gal. Surface water >100' >100' NA NA Material Number of compartments Lot Line 16.51' 8' NA NA Fiberglass 2 NA Foundation 20' 33.6' NA NA LIFT STATION Manufacturer Capacity Curtain Drain NA NA NA NA No lift station. Gal. Remarks " _ 2 60 psi insulation: trench &pipe from Pump on level at in. Pump off level at in. High water alarm at in. trench to tank. Gravity flow: tank to field. Note: See OSV171001 Waiver. Pump make and model Electrical Inspections performed by Everett Taylor, 907 Elec. D3034 Tank to D3034 PIPE MATERIAL House to tank drainfield Installer Flintstone Enterprises, LLC Drainfield D3034 co/MT Inspector Mary L. Shreves BENCH MARK (Assumed elevation) 100 ft Inspeection �s 7/10/17 7/11/17 Location and description 2.d 3'd 7/12/17 4th Top of 2x4 bottom plate on concrete porch. COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL �"����,4 ®A'OF A4, Conditional Approval: DatefP.•' '•..°��I®� .v Mary 1.. hreves �y d'J'•• CE 9351 .•' � Approved ,L,�A Date 1 ao ,114 "'99iEo®o'kAl", I Inspection Keport_9-1-11.d0C MEA U G. I \ / ELECTR C RECOVERED EASEMEN 5/8" REBAR O� (TYP.) / S89'59'00"E 131.95'( 11.53(C) 10' x A FENCE\ 24.4' -- - — (TYP.) -WELL = N i GRAVEL D/W " DWELLING PO\% v 04 w 9 00 ' �2.1' � c �— \ .. , U.G. ELEC. AT. G S o ' g co i , DECK w 1 o i CO i X � 8', �o .;'. N o MT, EXISTING COs Z n i SEPT C TANK (ABA DO ED IN PLACES M9A-GODE� MT 1,500—GAL \` 3/1000 ADVANTEX B \+I 1 .3' app N a0 UTILITY 131.95'(R) 131 �- S89'59'00"EE0 '( D (TYP.) UTILITY POLE 41, w/GUY ANCHOR II � SWING TIES: A B FDN CO TO: 37.6' 26' ADV TANK MH1 51.1' 26.6' ADV TANK MI -12 60.2' 28.6' C01 ADJ TANK 59.6' 31.3' CO2 ADJ TANK 59.8' 32.8" SOUTH CO 65.1' 36' SOUTH MT 65.2' 36.4' NORTH CO 54.9' 41.6' NORTH MT 55.2' 42.2' 1'-2W SEPTIC ALASKA RIM ENGINEERING, INC. GF Aq ao0®I AS BUILT 9131 E. FRONTAGE RD. ���P:,• ze'� PALMER, ALASKA 99645 PH: (907)745-0222 : FAX: (907)746-0222 �°`'"' EMAIL: akrim®alaskarim.com WEB: www.alaskarim.com ® TH •� 4'- .... ;:'?',.. W0: 1600859 FB: 16-18 .. .. :, .. .. PAGE: 1 of 1 GRID MAP NW0053 Mary1 L'! Shreves Engineers: Planners: Surveyors — ' ®� s y SCALE: 1 — 20 FILE: 1600859 CE 9351 11 j ev� l 1957 ADDITION EAGLE RIVER HEIGHTS, BLOCK 2, LOT 12, �/ �/� PLAT No. P-588, ANCHORAGE RECORDING DISTRICT, ANCHORAGE, ALASKA. 20' BM = 100' F.G MH COVER -- 707 7BD CO POD 4" ASTM D3034, 2% SLOPE MIN •���F9OF�A� ag �• Mary Shreves mooV ��J CE 9351 v=` Jill,, OFESSv�' ��© 5' 97.91' -POD COVER TMH COVER ADVANTEX TANK —LEVEL— WATERTIGHT COUPLERS ON INLET AND OUTLET OF SEPTIC TANK SEPTIC SYSTEM PROFILE SOIL ABSORPTION SYSTEM (SEE DETAIL SH 4" ASTM D3034, 2% SLOPE MIN Conventional Single Family Residential SEPTIC SYSTEM RECORD DWG. ES RIMN EAGLE RIVER HEIGHTS B2 L12 RECORD DRAWING This record drawing represents the as—constructed condition of the improvements documented above. Based on periodic visual observation and information obtained from the installer, this data appears reasonable and represents that the project was constructed in general conformance with Not to scale SPO: 16-00859 ALASKA RIY ENGINEERING. INC ° nA 6/29/17 COMPLETED 7/12/17 DEEP TRENCH PLAN VIEW PERFORATED PVC HOLE ORIENTATION (HOLES DOWN) SECTION X -X GROUND SURFACE 97.76' (FINISHED GRADE) 97.61' (OG k RTanvFABLE CAP OVER EARTH PERMEABLE TRENCH AND HPIPE FROM COVER q -////// SURFACE GEO7EXTILE TANK TO TRENCH IY 1 -IN TRENCH DETAIL *:49TH ' Mary L'. Shreves ®i��sT'. CE 9351 ®�N�` UNDISTURBED EARTH If) 89.79' TRENCH SECTION MONITOR TUBE DETAIL NON -PERFORATED PVC ABOVE SEWER ROCK COUPLING 4' PVC PERFORATED Conventional Single Family Residential SEPTIC SYSTEM RECORD DWG. ILEQAL DESCRIPTION EAGLE RIVER HEIGHTS B2 L12 RECORD DRAWING This record drawing represents the as—constructed condition of the improvements documented above. Based on periodic visual observation and information obtained from the installer, this data appears reasonable and represents that the project was constructed in general conformance with Not to scale ALASKA RrM ENGINEERING, INC. SPO: 16-00859 MEA ELEC EASEL (SEE N LOT 4 BLOCK I 4 PLASTIC RISER (TYP IN CONCRETE, --7 4,Z,; PED (TYP. RECOVERED 5/B' RAR�L89'59'00"E R . 5'( 131.5;T;- jN -LOT 20 NFENCE24.4' (TYp,) a0 GRAVU D/w �MELLING PO\�5A . GAS U.G ELEC. O DECK cf (V `2` 00 LOT 19 EXIS NGWCT K j(AB DO ED IN PLACE PFFD-MGA—=E) O ADvu+roc 22.3' RPpN' CV* I 1 .Om� 9'00" * Z LOT 18 �a8 .53'( RP��VS 1� f V - 5cr ®Qa`a4%%%J jj OF WELL ALASKA RIM ENGINEERING, INC. Q®o'°PN�, A��SBf�a� SETBACKS 9131 E. FRONTAGE9645 O)� ��� PALM,ALA ALASKA •��y. PH: (907)745-0222 : FAX: (907)746-0222 �� EMAIL: akrim®alaskarim.com .WEB: www.alaskarim.com • �•••••••••• tl'' EPAGE: W0: 1600859 FB: 16-18 •••.� •/� •••• °^ 1 of 1 GRID MAP NW0053 ®' �' '• Ma/7 r �� snreves ®� n� ,• Y � 'x= En ineers : Planners : Surve ors g r SCALE: 1 " = 50' FILE: 1600859 �P CE 9351 N 6g��F ®j/ 1957 EAGLE RIVER �oDPI BLOCK LOT PLAT 588, ANCHORAGE RECORDIITON NG LDISTRIC T, DISTR ICT, AGE, ALASKA. S fr ';Municipality of Anchorage�* r _ P.O. Box 196650 e 4700 Elmore Road Anchorage, Alaska 99519-6650 e (907) 343-7904 e Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program Waiver#: OSV171001 COSA#: Permit#:OSP161355 PID#: 050-281-29 Legal Description: Eagle River Heiqhts Block 2 Lot 12 Engineer: Alaska RIM Engineering, Inc. Applicant: Richard Magnuson Revocable Trust Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 8.0 feet. This waiver approval applies to the existing absorption field only. Any future upgrade to the on- site wastewater disposal system will require all code requirements be met or another approval from this department. ❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of nonobjection have been received from the owner(s) of the affected adjacent property. ® Adjacent properties are not affected by this waiver. K 6 B@ 0® 0 Q® 0® M n 6.■® 9 0 H M K O 6 Q®@ 6■■@® H. 0 A® C■® O Q C H@ E@®!@ H■®® C. B®■®@ K® B® t Q M a Y 0®® 6 1 Waiver is Granted: X Waiver is not Granted: t Date: f `E! _ Approved by. Name of Reviewer ,► � j= � �a• ii 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: OSP161355 Tax Code Number: 05028129000 Work Type: Septic Upgrade Permit Effective Dates: January 04, 2017 to January 04, 2018 C111 L)rpartm(2nt /2 Z./ 17 I GtVI�` Design Engineer: ALASKA RIM ENGINEERING Subdivision: EAGLE RIVER HEIGHTS Site Legal Address: EAGLE RIVER HEIGHTS BLK 2 LT 12 G:0053 Owner/Address: MAGNUSON RICHARD I REVOCABLE TRUST MAGNUSON R I & S O/CO-TR 2997 E CARLSON RD WASILLA AK 996540000 Site Mailing Address: 10207 WILDWOOD ST, Eagle River Lot Size in Sq Ft: 10824 Total Bedrooms: 4 This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Special Provisions: A 20 foot deep test hole is to be provided prior to construction of the septic field to provide 7 -day groundwater monitoring and confirm separation to impermeable barrier. Construction may proceed at your own risk before the 7 -day water monitoring is complete. Submit stamped and signed results with the as -built inspection report. If the results require a design change, construction of the system will stop pending on-site review and approval. Co ( 5/ 3a/ 1 �1) ; �� tSe_ `u `� VAI_ C 2 (l�I3c� I�) : � � I�eaJ'i se S�s 1�n. 4-o NWZTS wl 5� ED x "j L 4 rens G� Received B By Issued By: Date: I s / 7 Date: MUNICIPALITY OF :r Community Development Department Development Services Division On -Site Water & Wastewater Program ANCHORAGE Phone: 907-343-7904 Fax: 907-343-7997 ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 050-281-29 Property owner(s) Richard Magnuson Revocable Trust Mailing address 2997 E Carlson Wasilla, AK 99654 Site address 10207 Wildwood St. Eagle River, AK Day phone 907-352-0502 Legal description (Sub'd., Block & Lot) Eagle River Heights Block 2 Lot 12 Legal description (Township, Range & Section) Lot Size 10,824 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (M all that apply) Absorption Field ❑X Initial ❑ Single Family (SF) ❑X (w/wo ADU) Septic Tank © Upgrade © Duplex (D) ❑ Holding Tank ❑ Renewal Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: n all Distance: certify that the above information is correct. I further certify that this is in accordance with (cc) Z� applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: s6 - Q Waiver Fees: 1 5� Date of Payment: Z /S /% Date of Payment: y a 01 r7 Receipt Number: p1�2d Receipt Number: Q 0 8 307 Permit No. %3 Waiver No. 0S V Jr1j 001 Permit App_ 0��j6�c/ �� C� Z ALASKA RIM ENGINEERING, INC. ENGINEERS — PLANNERS — SURVEYORS ` 9131 E. Frontage Road Palmer, Alaska 99645 Telephone (907) 745-0222 Fax (907) 746-0222 Online at: www.alaskarim.com June 29, 2017 Municipality of Anchorage, D.S.D., On -Site Water and Wastewater Department 4700 Elmore Road, Anchorage, AK, 99519 Re: Eagle River Heights Block 2 Lot 12; 10207 Wildwood Street, Eagle River, CHANGE ORDER (Septic Design Revision) AK Rim Engineering File No. 16-00859 To Whom It May Concern: This narrative addresses the revised proposed septic system renewal for an existing 4 -bedroom single-family dwelling on the above referenced lot. The revised design narrative is summarized as follows: CHANGE ORDER: Based on limited space available for a standard septic system, we are proposing the following change to the design: Original design: 8.33' ED x 60' deep trench Revised design: 1,500 -gal Advantex Treatment Tank with timed dosage and gravity outfall to 5'ED x 15' deep trench soil absorption field. Design calculations for this change: • Soil Percolation Rate: 0.6 gpd/sf (16-30 min/inch) • Category: Advantex with timed dosage = Category III system • Effluent Application Rate: 4 gal/day/sf • Absorption Field Design: 600 gpd / 4 gpd/sf = 150 sf / 5 ft ED / 2 = 15 ft length The revised septic system design details are included with this letter (see attached, Septic System Design, 3 pgs). They include the installation of the deep trench with 2.5' of soil cover and 2" insulation over the entire drainfield trench. The proposed septic system will not adversely affect the surrounding properties and does not encroach on well setbacks on the subject lot as well as surrounding lots. If you have any questions, please contact me at 907-745-0222 or at mares(kalaskarim.com. Sincerely, ALASKA RIM ENGINEERING, INC. Mary L. Shreves, P.E. Project Engineer Attachments: • Design Drawings (3) • Advantex Tank- information • Change Order Form, completed • Advanced WW Treatment System Maintenance Agreement, signed 00 Mar IU. Shreves , CE 9351 " �e ejg�llasFE®«7;�// It % mmx . . 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WILD WOOD ST. 5'EDX15' DEEP TRENCH bn N0obn 0 O X00" 6n I O �- D- I 0 <OI Z IO > I m X D 1 cn m m X U) --i 0(-) z M C) O D O D C7 0 m s6n O 22.7' X N Mr 00 0 � y c O I� m w co Ln Ul w 0 3/4' TO 15' PERFORATED 4- C INSTALL CLEANOUT ATEW SER PVC NOTE 1 BEGINNING OF PERF M 15' DEEP TRENCH PLAN VIEW INSTALL MONITOR TUBE AT END OF TRENCH INSTALL CLEANDUTEND OF ATT n PERFORATED PVC HOLE ORIENTATION (NO= DOWN) SECTION X -X 4-4NCHES INSULATION TO BE // / �/ /L ROACIMBLE PLACED OVER ALL PORMW EARTH TRENCH UNDER THE DRIVMY. 2 -INCHES OVEN ALL COYER GROUND SURFACE THE REJAW" TRENCH. SEE TRENCH DETAIL NOTE : INSULATION: WESTERN bSULFUW Ir RIGID INSULATION (OR E0.). TWO INCHES EQUIVALENT TO 2 FT SOL COVER. UNDISTURBED EARTH TRENCH SECTION MONITOR TUBE DETAIL NON -PERFORATED PVC ABOVE SEWER RCCK 4' PVC PERFORATED %oF AI I Ili II Conventional Single Family Residential LES DESCRIPTION LOT 12, BLOCK 2, EAGLE RIVER HEIGHTS �- - TH , * Io .. F�•..•.%•� T •...................... Marylu•Shreves SEPTIC SYSTEM DESIGN �j�'i�'•, CE 9351 Ili �f'ROFESSONP���` Not to scale W0: 1600859 Ausim RIYsmtNEEjum. INC R a°,F06/28/17 cowPL CD # 1 41% ALASKA RIM ENGINEERING, INC. SOIL LOG ENGINEERS—PLANNERS—SURVEYORS 9131 E.Frontage Road Palmer,Alaska 99645 A TEST I TOLE Telephone(907)745-0222 Fax(907)746-0222 Online at: wssw.alaskarim.com Project: Eagle River Hgts B2 L12 AK Rim File No, 16-00859 Date: 5/23/17 Logged By: Mary Shreves Depth (feet) Description Top soil (0-6") I Sandy gravel w/ some silt, mod dense, • • • dry, some cobbles and boulders (SP) ��.y\\\vttllll (4'-6'+/-) ��-.' E O F AC IiI •4 T 11 4 . j • �, .• MaryUL. Shreves : ,. --- - ---- '`j���F CE 9351 �-� 5 / ti-. .••. •-••#c.7 _ _..._ Ih <`.0 n, .,...- Nps • 6 Gravel wl sand and silt, dense, dry(GM) '�111111i\�\����`, (6'-20') S/V/- •7 TEST HOLE LOCATION: 8 Within 25'of proposed SAS. --1 9 1 COMMENTS: 10 i Monitoring tube installed ------------------ 11 12 —---- —-- 13 14 1 3 15 1 15.33' GW encountered 5130117 — 16 This soil log was prepared for the sole purpose of determining the feasibility of constructing an onsite wastewater disposal 17 ---- system at the location of the test hole. Soil type ratings are } based on visual observation and have not been verified with laboratory analyses. These soils have not been analyzed for 18 structural properties,structural stability,and seismic stability or for any purpose other than wastewater absorption field construction. Anyone relying on the information in this log for — 19 any use other than wastewater absorption field development I --.-.-------.--._.-................................................__........—_—. ..._ shall do so at his or her own risk. Rev 12/14 20 Bottom of Test Hole •• 6' P Features: Typical System for a 3-4 bedroom home PASSIVE aR • VeriComm control panel for remote system monitoring by us. • Monitoring & Maintenance Agreement for the life of the system • Authorized Installers and Service providers. • Pump(s) operate on 110V power, averages 3kw-hr/day. • Custom tanks for larger homes are available. • Approved by the Municipality of Anchorage. OrencQ systems Ininorpor2tiA Anchorage Tank 2723 Rampart Drive, Anchorage, AK 99501 p 907-272-3543 f 907-277-3715 AdvanTex using Steel Tank www.anchoragetank.com Rev. 1 9113 Page 4 of 4 ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT BETWEEN MUNICIPALITY OF ANCHORAGE AND Richard Magnuson Revocable Trust THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this Richard Magnuson 28 Day of June of 20 17, by and between Revocable Trust herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this Maintenance and Repair Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as Advantex WW Treatment System Tank located at (legal description). Eagle River Heights Block 2 Lot 12 2. Definitions. Alteration. Any change to the design or function of an AWWTS that includes the installation or removal of any parts, components or pieces not included in the original construction permit and design. Certificate of On -Site Systems Approval (COSA). An approval by the Municipality of existing water and wastewater disposal systems given at 1=1 the time of property sale and title transfer in accordance with Anchorage Municipal Code (hereinafter, "AMC") 15.65. These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. Ramage. Any man-made or natural change in a system that would inhibit the system from performing as designed. Maintenance and Repair. The scheduled and as needed replacement of existing parts, components and pieces of an AWWTS that were included in the original design which would allow the AWWTS to continue to perform as designed. Permit. An On -Site Wastewater Disposal Permit as required by AMC 15.65 to construct and operate an AWWTS. 3. Term. The term of this Maintenance and Repair Agreement shall begin on the date of approval by the Municipality to operate the installed system or issuance of a COSA, and shall continue while the AWWTS is in use or is operational or until the property is sold or title is transferred by the owner and a new COSA is issued to the new owner or transferee of the property. 4. Alterations, Installation and Removal of Additional Equipment. Prior to performing any alterations to an AWWTS, the owner agrees to obtain an On-site Wastewater Disposal Permit from the Municipality in accordance with AMC 15.65. 5. Maintenance and Repairs. A. Throughout the term of this Maintenance and Repair Agreement, the Owner shall maintain their AWWTS in a satisfactory condition capable of producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. The owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the municipality and the manufacturer of the AWWTS for the entire term of the AWWTS. In addition, it shall be the responsibility of the Owner during the term of this Maintenance and Repair Agreement, and any renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs. B. Owner agrees to comply with all applicable ordinance, laws, regulations, rules and orders for the AWWTS. C. Upon request by the Municipality, the owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system. When a record of maintenance is documented and maintained by the system vendor, the owner agrees to allow the Municipality access to this information. D. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60 for improper discharge. E. Owner agrees that only maintenance and repair personnel approved by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the system. F. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. G. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. H. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. I. Owner agrees to provide and maintain a telephone connection to the AWWTS as required by the AWWTS approval. 6. Nonwaiver. The failure of either party at any time to enforce a provision of this Maintenance and Repair Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Maintenance and Repair Agreement or any part hereof, or the right of such party thereafter to enforce each and every provision hereof. 7. Amendment. A. This Maintenance and Repair Agreement shall only be amended, modified or changed by a writing, executed by authorized representatives of the parties, with the same formality that this Maintenance and Repair Agreement was executed with, and such writing shall be attached to this Maintenance and Repair Agreement as an amendment. B. For the purposes of any amendment modification or change to the terms and conditions of this agreement, the only authorized representatives of the parties are: a. Owner: Richard Magnuson Revocable Trust b. Municipality: Director, Community Development or designated authority 06/29/2017 05:32 9072358465 TOTAL OFFICE PRODUCT PAGE 02/02 C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void.. 8. Ju0s411a 'o -n: hoice of Law. Any civil action arising from this Maintenance and Repair Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of..A las.ka shall govern fbe rights and obligations of the parties under this Maintenance and Repair Agreement. 9. Severability. Any provisions of this Maintenance and Repair Agreement decreed invalid by a court of co..npetent.jurisdiction shall not invalidate the remaining provisioz►s of the Maintenance and Repair Agreement, OWNER: I r n By: ` FOA —(signature) Date: Richard Magnuson Revocable Trust (print name) STATE OF ALASKA ) Si. THIRD JUDICIAL DISTRICT ) The foregoing instrument was ack-no ledged beforc me thispVty of _ 20 9, by &ezobA) 0 k4l 1+F)0 Notary Public NOTARY PUBLIC FOR ALASKA ADAM STOVER My Commission expires: J A N :1 ,�ZOci O State Of Alaska FMV Cammhalon Expku Jan. 7, 2020 MUNICIPALITY: By: fit -uOA (signature) Date: 30 f 7 R&eCC(t l,n,r�o l (printn..aine) Title: GREA~,.R ANCHORAGE AREA BORC Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE ~ COMPARTMENTS FROM WELL ~'~'~- MANUFACTURER ERIAL INSIDE LENGTH /~/ INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY ·jjL-c''~''~ GALLONS, SEEPAGE lt~: T~ , I 5e.~'.~/~. / NUMBER OF PITS DIAMETER OR WIDTH "~ , LINING MATERIAL /}-4~-~ CRIB SIZE: DIAMETER BUILDING FOUNDATION NEAREST LOT LINE /'"~' ADDITIONAL ABSORPTION .E.GT.3/, DEPT. 2'S ~" DEPTH f! DISTANCE FROM: WELL ABSORPT,O. AREA ~WALL AREAS ~. Q.". WELL= BUILDING FOUNDATION CESSPOOL CONSTRUCTION NEAREST LOT LINE OTHER SOURCES APPROVED DISAPPROVED NEAREST SEWER LINE REMARKS DEPTH '/~"~ / DISTANCE FROM: SE~C ~'.~" SEEPAGE 'Y TANK I SYSTEM /m~ DISTANCES:. INSTALLED BY: ~'~'l"'l'~'~"~~-~'' REMARKS: DIAGP~ ~h~,~F SYSTEM DATE Form NO. EQ-O31 PERMIT NO. !APPLICANT ~ICHARD MAGNUSO~,. iLOCATION WILDWOOD LANE iLEGAL Ll2 B2 EAGLE RIVER HGTS iTYPE OF SOIL RBSORBTION SYSTEM IMAXIMUM NUMBER OF BEDROOMS = ~ HUN'rOI 25iO E. TUDOR RD.276-222i · ANCHORAGE., AK. 99507 ~,~_), ~ °'~,=x~/,~-O~O~' ON--5 ( 76166 ) BOX i006 - E.R. 688-2670 LOT SIZE iii45 SQUARE FEET TRENCH SOIL RRTINQ (SQ FT/BR)= i95 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: DEPTH= ::1-4 LENGTH= 3:0 IgiRt:lYEl DEPTH= :::LO THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM Of THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). PLANT REl~U I RED EITHER R CLASS I OR II NSF APPROVED PLANT MAY BE INSTALLED. R CONTINUOUS ~IRINTENANCE AGREEMENT IS REQUIRED. IF R MAINTENANCE AGREEMENT IS NOT KEPT CURRENT YOU HAY BE REQUIRED TO ENLARGE THE SOIL ABSORPTION SYSTEM AND/OR YOU MRY BE SUBJECT TO PROSECUTION. If A CLASS I SYSTEM IS USED THE LENGTH IS 22.0 FEET. IF R CLASS II SYSTEM IS USED THE LENGTH IS 28.0 FEET. BACKFILLING Of ANY SYSTEM WITHOUT FINAL INSPECTIOH AND APPROVAL BY THIS i DEPARTMENT WILL BE SUBJECT TO PROSECUTION. I~INIMUM DISTANCE BETWEEN R WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS ?.00 FEET FOR R PRIVATE WELL OR 2'00 FEET FOR R PUBLIC WELL. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER I NSTRLLRT I ON. 1PERM 'r T VRL I D FOR ONE %~ERR FROM I SS:ME APPLICANT RICHRP~D MRGNUSON I CERTIFY THAT l: I RM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE BODES. 3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM HAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN S BEDROOMS. PERMIT NO. MUNICIPALITY OF A~CHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 25i0 E. TUDOR RD., ANCHORAGE, AK. ~507 276-2221 ON~ITE ~E~E~ PERMIT ( 7616i ) APPLICANT LOCATION LEGAL ~ICHRRD MAGNUSON, WILDWOOD LANE Ll2 B2 EAGLE RIVER HGTS BOX i006 - E.R. LOT SIZE 688-2670 iii45 SQUARE FEET TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH MRXIMUH NUMBER OF BEDROOMS = · SOIL RATING <SQ ~1'~ ~IS: THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEMJ DEPTH= 10 LENGTH= 41 'TH= THE LENGTH DIMENSION IS THE LENGTHTHE~~yOR DRAINFIELD.oF THE THE DEPTH OF R TRENCH OR PIT IS THE SURFACE GROUND AND THE BOTTOM OF THE EXCAVATION THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMb~ DEPTHF~F~ BETWEEN THE OUTFRLL PIPE AND THE BOTTOM OF THE EXCAVATION (IN ~,~. VEL EITHER R CLASS I OR II NSF APPROVED PLANT MAY BE INSTALLED. R CONTINUOUS MAINTENANCE AGREEMENT IS REQUIRED. IF R MAINTENANCE AGREEMENT IS NOT KEPT CURRENT YOU HAY BE REQUIRED TO ENLARGE THE SOIL ABSORPTION SYSTEM AND?OR YOU MAY BE SUBJECT TO PROSECUTION. IF A CLIMBS I SYSTEM IS USED THE LENGTH IS ;3,~. 0 FEET. IF R CLASS II SYSTEM IS USED THE LENGTH IS 45. 0 FEET. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN R WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS i00 FEET FOR A PRIVATE WELL OR 200 FEET FOR R PUBLIC WELL. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS PRE AVAILABLE TO INSURE PROPER I NSTRLLRT I ON. PERM I T VAL I D FOR ONE YERR FROM I 5~UE I CERTIFY THAT i: I RM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. ' 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS. APPLICANT RICHARD MR~USON 3;~,'D O? t'OB-~. DRILLING COMPANY STATIC LEVEL OF WATER It. ~w ~o~ ~ .... ~_~ ............ :. ...... ms~ ot c~.~ _~.~D. .......... FROM FT. TO ·.""-', ~. ......... FROM ...... FT. TO . _FT. FROM ..... · 0 8 E GEOT~CHNICAL 8' DEVELO, MENT CO. Russell Oyster 694.2774 Soils ~' Foundations Performed for: Box 90. Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Earl Ellis SOIL LOG ~-228o Land Development ~,,~ ,,~ %~,~,~.~. ,o. ~- .~Ta. _ Depth (feet) Sol) Chmracterlstlc~ 2 3 7 8 9. · 10 15 16 Ground Water Encountered: Proposed Installation: Con~ents: Yes fid If yes, what depth Seepage Pit "/ Drain Fte~d / Performed by:~ Date: <7 · ..O ~ E GEOT,-,~HNICAL 8 DEVELO, MENT Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 68~-2280 Russe# Oyster 6,94.2774 Soils ~ Foundations Parlor=ed for: CO. Earl Ellis 68~-2280 SOIL LOG Land Development Legal Description: ~w~ Depth (feet) Solt ~haracterlstlc~ o 1 2 5 , 6 7 10 11 12 13 Ground Water Encountered: Yes Proposed Installation: Seepage Pit Con~nents: ~"~'-~ ~r~,z~ No ~ If yes, what depth v~ Drain Fie~d ~x' � '1 8 9 i, - • `,' 7G E_ _a • r.� Municipality of Anchor OCT 19 2027 r `_ -:t. I_ On-Site Water and Wastewater Prograii(907) 343-7904 �a ,�, 5 a E•Y . t{ h� <, 5 Certificate of On-Site Systems Approval-`5 s 1, g Parcel I.D. 050-281-29 Expiration Date: 1 ra 1 V 1. GENERAL INFORMATION: Complete legal description Eagle River Heights; Block 2, Lot 12 Location (site address) - 10207 Wildwood Street*Eagle River,AK Current Property owner(s) Jimmy Magnuson Day phone 355-6960 Mailing address Real Estate Agent Katie Likkel Day s e -9512 2. TYPE OF DWELLING: 11- Z Single Family (w/wo ADU) Iuso- / ,, El Duplex El Multiple Dwellings (Single Family and/or Duplex) I 0;2,3 17 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well El Community ❑ Public Water System ❑ Public Sewer El WaiverNariance request for: Distance: Received by: ` -- - Date: COSA to be released to the engineer,unless otherwise rec es d by he engineer. k► La123i) I It, I tln(. 1a 1 b4c0-1/6 COSA Fee $ 9ca n Waiver Fee $ Date of Payment to Ii a 111- Date of Payment Receipt Number 6309•5 Receipt Number COSA# 05Gt�'I 1 ' 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: Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101-Anchorage,Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: 10 11 g /1: In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system o OF A /, in accordance with the guidelines and regulations established by the Municipality of Anchorage and ,cvC.•••..... `��11 industry practices. The reported results describe the condition of the system/s on the date/s of the 0,z ' / ...• evaluation, Separation distances were measured to readily identifiable features. Hidden defects or 0� ; v encroachments may exist that were not identified during the evaluation. The operational life of all wells \ 4` T � * and septic systems depend upon a variety of variables, including but not limited to, soil conditions, V 1 groundwater levels (that may fluctuate during the year), quality of construction (materials and Q workmanship),and the water usage of the family utilizing the system/s. These conditions can vary,and _ ... ;�,-�, ,—t Q are outside the control of GEG. Satisfactory test results do not guarantee future performance of the ff •y Gorr ss; system/s; therefore, GEG makes no warranty(express or implied) regarding the future performance of V1CE 7 Q� the well or septic system. GEG makes no representation whether an alternative well or septic system vh`!9's cmO can be installed on the property in the event either of the current systems fail to perform adequately in Ql� e f b /,�• •f ,rA the future. The conteptof this_report is for the sole benefit of the person/party that retained GEG to %OPa Pr a\ ofzss�o�a� perform the evaluation. Iidfice upon the information provided in this report by any other person or OpO\P.p• party (including subs9g(te t.prop2fty purchasers) is not authorized, nor will it confer any legal right whatsoever <� #AECC884 6. DSD SIGNATURE I` System #1 Approved for bedrooms ���`ky�K�,f,�ri t l 1 System #2 Approved for bedrooms .�`PLr"�� GF ,y<r Disapproved a :11-# QN-SITE �mConditional approval for bedrooms, with the followstiAi>C AND WASTEWATER o��, Nt<OGRAM41e- M!-SER .. By: � �--� Original Certificate Date: 1 (9 2q 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. • 7. ATTACHMENTS: COSA Checklist _ Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet_?0-10-12.cloc If more than 1 septic system is on the lot: COSA Checklist # of Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: Eagle River Heights; Block 2, Lot 12 Parcel ID: 050-281-29 A. WELL DATA Well type Private If A, B, or C provide PWSID# ,N/A Well Log (Y/N) Yes Date completed 6/25/1975 Sanitary seal (YIN) Yes Wires properly protected (YIN) Yes Total depth 105.5 ft. Cased to UNK ft. Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 6/24/1975 10/10/2017 Static water level 65 ft. 60.8 ft. Well production 40 g,p.m. 7.5+ g.p.m. WATER SAMPLE RESULTS: Coliform U colonies/100 ml. Nitrate'�' \ mg./L. Collected by: GEG. Ltd. Arsenic: g./L. Date of sample: 10/10/2017 B. SEPTIC/HOLDING TANK DATA Tank Type/Material Advantex/S_T.E.P./Fiberglass Date installed 7/10-12/2017 Tank size 1500 gal. Number of Compartments 2 Cleanouts (Y/N) Yes Foundation cleanout (Y/N) Yes Depression over tank (Y/N) No High water alarm (Y/N)Yes (at Panel) Date of pumping New Pumper — C. ABSORPTION FIELD DATA *Below Existing Grade Date installed 7/10-12/2017 Soil ratingp.d,/f or ft'/bdrm) 4 System type Deep Trench Length 15 ft. Width 2.5 ft. Gravel below pipe 5 ft. Total depth *8 ft. Eff. absorption area 150 ft` Monitoring tube Yes Depression over field No Date of adequacy test New Results (Pass/Fail) Pass 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 > 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) None Known If yes, give date — D. LIFT STATION Date installed Size in gallons Manhole/Access (YIN) "Pump on" level at in. "Pump off" level at 'a wa er alarm level at _in. I- •• Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ On adjacent lots *100'+ (W/ Caveat) Absorption field on lot 100'+ On adjacent lots *100'+ (W/ Caveat) Public sewer main 75 + Public sewer manhole/cleanout 100'+ Sewer/septic service line 25'+ Holding tank 75'+ Animal containment areas _ 50'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5+ Water main - 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots *100'+ (W/ Caveat) SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line **8'+ Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain None Known Wells on adjacent lots *100'+ (W/ Caveat) F. COMMENTS *Could not confirm well/septic on lot to north (Eagle River Heights; Block 2, Lot 11), backyard fenced in and standpipes were not visible. **WR#OSV1 71 001 44��OppO G. ENGINEER'S CERTIFICATION �= OF,!q �4%, oP ' S 00 I certify that I have determined through field inspections and i ');' ' 9 TH rr • 400 review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this VA / -- date. i(I v �Q--.•.J r A. Carless: Engineer's Printed Name JEFFREY A. GARNESS °O 9 '•. —7953 r opo Date (Oh f3//-7 �644Ba' iQ i�.3 (', �� p�ofeseiono ��oove. .a #AECC884 (Rev. 11/05) 8465D Lot 11 Lot 20 33 :a9°59100"E 131.95 to 1, g Q . 021 a a N. W — __ ..__ w�Wood fen W 24.0 o x lY )Gravel driveway r N ai f0 1 in I• • N o •— u7 0C\I - t- - - - - ---. Y;2.0 E = x oto o w 2.0 0 Lot 12 _ i+`� N ^l L1J p o �5 c� ��, o o Lot 19 __I o e�\G,e� CD deck x o } I O oo t- O Z 00 "'� 2.0 01+,4 Z ��° 22.0 x �eQ } Greenhouse Cain link fenc Ch o --ar 33 f A I S89°59'00"E 131.95 Lot 13 I Lot 18 • OF A 1 1 i AS-BUILT NO CORNERS SET THIS DATE mier,`:Z....• • �'1.6\ 1, I hereby certify that I have performed a Mortgagee's inspection r C�• 49th �5- •-9 0 of the following described property: LOT 12, BLOCK 2, of> ': /\ •. EAGLE RIVER HEIGHTS 00 • ,,C v •• Anchorage Recording District,Alaska,and that the improvements situated thereon are within the property lines �, .Fred Wal o tkU :,� w and do not overlap or encroach on the property lying j, sr�•• 3255 - S •• ,,, adjacent thereto,that no improvements on the property lying PF • . `' �. adjacent thereto encroach on the premises in question and SCALE: 1"= 30' t.,o jO.., • • . • • .,Pa= that there are no roadways,transmission lines or other ♦+ visible easements on said property except as indicated X\\% hereon. Dated at Anchorage,Alaska EASEMENTS OF RECORD, OTHER THAN this 11th day of October ,2017. THOSE SHOWN ON THE RECORDED FRED WALATKA&ASSOCIATES,L.L.C. PLAT ARE NOT SHOWN HEREON Engineers and Surveyors UNLESS OTHERWISE NOTED. FB 17-7, pg 55 BE 907-248-1666 ..... .. .- ....-.._....... ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT BETWEEN MUNICIPALITY OF ANCHORAGE AND r\ t_ \ Y . THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this C Day of ( ..Y C of 20 , by and between� S1� A-k' , herein the"OWNER,"and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this Maintenance and Repair Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as ("\OSAJa6U . ‘-lAiaC1 located at(legal description). 1 rV-ko \� _J�� . V6 _*•&_) 2. Definitions. Alteration. Any change to the design or function of an AWWTS that includes the installation or removal of any parts,components or pieces not included in the original construction permit and design. Certificate of On-Site Systems Approval (COSA). An approval by the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with Anchorage Municipal Code (hereinafter,"AMC") 15.65. These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. Maintenance and Repair. The scheduled and as needed replacement of existing parts, components and pieces of an AWWTS that were included in the original design which would allow the AWWTS to continue to perform as designed. Permit. An On-Site Wastewater Disposal Permit as required by AMC 15.65 to construct and operate an AWWTS. 3. Term. The term of this Maintenance and Repair Agreement shall begin on the date of approval by the Municipality to operate the installed system or issuance of a COSA, and shall continue while the AWWTS is in use or is operational or until the property is sold or title is transferred by the owner and a new COSA is issued to the new owner or transferee of the property. 4. Alterations, Installation and Removal of Additional Equipment. Prior to performing any alterations to an AWWTS,the owner agrees to obtain an On-site Wastewater Disposal Permit from the Municipality in accordance with AMC 15.65. 5. Maintenance and Repairs. A. Throughout the term of this Maintenance and Repair Agreement, the Owner shall maintain their AWWTS in a satisfactory condition capable of producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. The owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the municipality and the manufacturer of the AWWTS for the entire term of the AWWTS. In addition, it shall be the responsibility of the Owner during the term of this Maintenance and Repair Agreement, and any renewals thereof, at the owner's sole expense, to pay for any and all: (1)repair(s), (2)maintenance, (3) adjustment(s), (4) replacement costs, and (5)inspection costs. B. Owner agrees to comply with all applicable ordinance, laws, regulations,rules and orders for the AWWTS. C. Upon request by the Municipality, the owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system. When a record of maintenance is documented and maintained by the system vendor, the owner agrees to allow the Municipality access to this information. D. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60 for improper discharge. E. Owner agrees that only maintenance and repair personnel approved by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the system. F. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. G. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On-Site Systems Approval. H. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's AWWTS. 6. Nonwaiver. The failure of either party at any time to enforce a provision of this Maintenance and Repair Agreement shall in no way constitute a waiver of the provisions,nor in any way affect the validity of the Maintenance and Repair Agreement or any part hereof,or the right of such party thereafter to enforce each and every provision hereof. 7. Amendment. A. This Maintenance and Repair Agreement shall only be amended,modified or changed by a writing, executed by authorized representatives of the parties, with the same formality that this Maintenance and Repair Agreement was executed with, and such writing shall be attached to this Maintenance and Repair Agreement as an amendment. B. For the purposes of any amendment modification or change to the terms and conditions of this agreement,the only authorized representatives of the parties are: a. Owner: to\,)1 b. Municipality: Director,Community Development or designated authority C. Any attempt to amend,modify,or change this contract by either an unauthorized representative or unauthorized means shall be void. S. Jurisdiction: Choice of Law. Any civil action arising from this Maintenance and Repair Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Maintenance and Repair Agreement. 9. Severability. Any provisions of this Maintenance and Repair Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Maintenance and Repair Agreement. OWNER: By: _.:( signature) Date: /0 ' ID- J,'1h 4 i nic4091 Ar (print name) STATE OF ALASKA ) ss. THIRD JUDICIAL DISTRICT ) The forego' g instrument was acknowledged before me this I r day of °dab( Y 20 ,by ,1n k" t A YYIG pe . 1 ,117 COURTNEY HEIN NOTARY PUBLIC FOR ALASKA 1 Notary Public `�[mak State of Alaska \�` L My Commission expires: , ^, My Commission Expires Apr 10,2021 MUNICIPALITY: / r `� 6f (signature) Date: 1c9 (print name) Title: 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 Parcel I.D. tt CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION ~......~ Complete legal description ~ Locat~rec~i0ns) /~)~-- ~ ~r. Ma~g.~d .~..[.. ,~.,. ~. . Maid ng~o,~r.e.~,.]~ :.~t'.' ,.,' Agent ~*i~'~*;~~°~) Day phone Address Unless othe~ise requested, HAA will be held for pickup. 2, NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: if community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. m 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. ¢ 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 .__.~ ,~, h /~. ^'-* "~-~'J · ~' ~' Phone Address ~q[ ~ ~U~', ~~ ~ ~---~ ~~' ~ Date Enginee~ssignature ~ -~ ~ / -//- Dis~'pproved. Conditional approval for 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 errors or omissions in the professional engineer's work. Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Log present (Y/N) Total depth Sanitary seal (Y/N) LegalDescription: /----o'~ I~.. 3/~C~C-/c- Z. PamelI.D. A. Well Data Well type ,~2~,uuc~ -/-~/c,~ If A, B, or C, attach ADEC letter. ADEC water system number Date completed {0!~q' 1%~' Driller .~u Cased to ~ C)(J~ Casing height JUL" FROM WELL LOG Date of test Static water level Well flow Pump level1 SEPARATION DISTANCES FROM WELL TO: SepticJl~tank on lot ? ~ "~ Absorption field on lot I Public sewer main Sewer service line ~_c., ~J,- "~ Wires properly protected (Y/N) C/,~..~ AT INSPECTION ; On adjacent lots /~' ; On adjacent lots /~' Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform 1~(~,~; V'~ N[trata ~.~ vY~/,~ Date of sample: ~1 '~..I ~"~-~ Collected by: Other bacteria B. SEP3'ICJH.. QLEIING,,T,~N K p~?.A_ ;,;.~,~.-.... . ..,..¥~..;~...,.,~..:... Date installed,~'.~ (.~,_".I ~. ""~b,'-.. Tank s~ze I 7_.. ~ Compartments Cleanou, t~.('~/~/N~'~e *'1_,~----~<,?, FouBdation ¢leanout (y/N) ~'~'-~ Depression (Y/N) High w[~e'r ~larm'(y/N) ~" ~ ~' ~!'~/'~ Alarm tested (Y/N) Date.. p , p' g ,, . '..,. ~..~, '-'o" . .,, ~, . ?,. tt SEPARATION DISTANCEs FROM SEPTIC/HOLDING TANK TO: Well(s) on I~t; :'"' f. !.~'."~-'-'~ / On adjacent lots I oo' 4- Foundation / Z- To property line I ~'4- Absorption field ~ o~ Water main/service line Surface water/drainage ~ul ~ CONTINUED ON BACK PAGE 72-02S (3/93)' From C. LIFT STATION Date Installed Size in gallons Vent (Y/N) High water alarm level 'Pump on' level at Manufacturer Manhole/Access (Y/N) 'Pump off' Level at .Cycles tested Meets MOA alectfical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots .Surface water D. ABSORPTION FIELD DATA Date Insta,,ed (.~,!~. ~ ! "'~.~ Length ~,c, ~ Width Total absorptio~ area [oc:,c~ ~c) Cleanout present (Y/N) Date of adequacy test .%/t ! ~"~ Water level In absorption field before test Peroxide treatment (past 12 months) (Y/N) ~ c, Soil rating (GPD/FF) I C)~ Gravel thickness Results (pass/fail) System lype -~ ~' ~/Total depth 1 ~ ~ Depression over field (Y/N) /..J o for .'~ Bedrooms After test ~'-~'~ ~ If yes, give date I'J//k SEPARATION DISTANCE FROM ABSORPTION FIELD TO' Well on lot I L~r~ To building foundation On adjacent lots Surface water Curtain drain I'J On adjacent lots I c)o' + Property line To existing or abandoned system on lot Cutbank I"11 ,~ Water main/service line Driveway, paddng/vehicle storage ama ~-~ E. ENGINEER'S CERTIFICATION I ce~'~ that I have checked, vedfied, ~r confocmed to all MOA and I-~AA guide~~"~! Signatur. p ~ Engineer's Name ~ t'~-~w~"'~ ~'/,N~,_~'-~ Date ~-,1'~ /%"~ '~'~,,~ _CE- 8147 H~ Fee $ /~D,~D Wa~er F~ $ Date of Pa~ant ~-/D -~ ~ Date of Pa~ent R~lpt Num~r ~¢ ~ 7Z~7) Re~ipt ,um~r /2-02S (3,'93)' Back MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date //! - ~---~' GENERAL INFORMATION (a) Legal Description (include lot, block, subdi,_vision, section, township, range) Location (address or directions) (b) Appl cant Name ~_/~./4/1~.~ J~l'~',~u~,'Telephone: Home ~"~ ~-,/- ~/~z/ Business Applicant Address /O~_o~- J,,J~_o~/~,,,"> /~./,./,=- (c) Applicant is (check one): Lending Institution J~"; ~/builder []; Buyer []; Other I-I (explain); (d) (e) Lending Institution / ~1~/~-~oM~-~. /~.6~,.3P-- Address ?0 "~--.'~ 7t~ Real Estate Company and Agent Address Telephone &~,.y'- ~ 03 Telephone (f) Mail the HAA to the following address: S & S ENGINEERING SRB 196X EAGLE RIVER, AK 99577 TYPE OF RESIDENCE Single-Family [~Multi-Family I"1 Number of Bedrooms ~ Other WATER SUPPLY Individual Well J~Community r"l Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWA~J.SPOSAL Onsite~ Public[] Community[] Holding Tank[] Note: If corn munity well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11,84) 5..ENGINEERING FiRM PROVIDIN~ INSPECTIONS, TESTS, FILE SEARCH, Da I'A AND INFORMATION As certified by my seal al'fixed hereto and as of the validation date shown below, I verify that my investigation of thi~ HeaLth- Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I 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 ~['EI~N(~ Telephone Address SR ~ Date EAGLE RIVER: AIC DHEP APPROVAL Approved for ../~i,,,er.. ~'~> bedrooms by ApproVed ~ Disapproved Conditional Terms of Conditional Approval Date CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain lederal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72~25 {11/84) MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST o FEBRUARY 1984 JYII,~ICIPALITY OF ANCHORAGe: DEPT. OF HEAt'tH & J~IVI~TAI. PROTECTION Legal Description: ' WELL DATA Well Classification Well Log Present ~VN) Total Depth / ~ Static Water Level 7. ~'~". If A, B, C, D.E.C. Approved (Y/N) Date Completed Yield Cased to Casing Height Above Ground Electrical Wiring in Conduit ~N) Separation Distances from Well: To Septic/Holding Tank on Lot ~' ' To Nearest Edge of Absorption Field on Lot ./~ Depth of Grouting Pump Set At Sanitary Seal on Casing {~) Depression Around Wellhead (Y/~;) ; On Adjoining Lots ·' ~ ' '~ ; On Adjoining Lots ,,'~.,2 /'~' To Nearest Public Sewer Line /"~'~ To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot ~. s' ~' Water Sample Collected by Water Sample Test Results Comments ~,~-~'~' ~/,=~_b, 7'~5,-~c~-,c'o~'*-~.-~*~ or-~ (/-~_1-~G, Pc~.-~,,~,,z.~, B. SEPTIC/HOLDING TANK DATA Date Installed Standpipes (~)'N) Air-tight Caps {~)N) Depression over Tank (Y,~ Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: TO Water-Supply Well ~. ~" · Size ~ ;> c,c) No. of Compartments Foundation Cleanout (~/N) Date Last Pumped ; for - Temporary Holding Tank Permit (Y/N) To Properly Line To Water Main/service Line Course ""///A To Building Foundation To Disposal Field ~ o To Stream, Pond, Lake, or Major Drainage Comments Page I of 2 72-026(11/84) ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed (~ ' Z. ~ Width of Field .~" Square Feet of Absorption Area Depression over Field (Y/~i~) Results of Last Adequacy Test .~_ .,'-., Separation Distance from Absorption Field: To Water-Supply Well /'~,:~ To Building Foundation ~. ~/~-~' Lot To Water Main/Service Line (c) / -/- Type of System Design Length of Field Depth of Field t~' Gravel Bed Thickness ,/p' Standpipes Present ~tN) Date of Last Adequacy Test To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments To Property Line To Existing or Abandoned System on ; On Adjoining Lots TO Cutbank (if present) /~'//'/~ "'[,4 D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments °* Check Permitted Bedroom Rating Against HAA Request ** I certify thai I_ha.ve checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. 5 &5 I~NGINEERING ///~ ~//~.~ Signed .~ ~ ~^.,,_ Date///.~ C°mpanYE~GJ-E ~J'~, AJ~ ~;)1# MOA No. Date of Payment Amount: $ ~ ~", Page 2 of 2 ]V unicipality o¥ Anchorage P.O. BOX 6650 ANCHORAGE, ALASKA 99502-0650 (907) 264-4111 TONY KNOWLES. MA YOR DEPARTMENT OF HEALTH & HUMAN SERVICES December 2, 1986 Robert A. Shafer, P.E. S&S Engineering SRB 196-X Eagle River, Alaska 99577 Subject: Lot 12 Block 2 Eagle River Heights Subdivision Waiver Request WR86-166 Dear Mr. Shafer: Your request for a waiver of the 100 foot separation required between the septic tank and well on the subject property has been granted. This distance has been waived to 95 feet. This waiver is valid for the existing three bedroom single family dwelling only. Sincerely, Stephen S. Morris civil Engineer On-site Services ROBERTA.$HAFER CIVIL ENGINEER 694-2979 November 28, 1986 MUNICIPALITY OF ANCHORAGE CEPT. CF HEALTH & ENVIRONMENTAl PROTECTION HEALTH AUTHORIT~ APPROVALS SIEWER & WATER MAIN EXTENSIONS SEWER & WAt'ER INSPECTION ENGINEERING STUDIES AND REPORTS SITE PLANS ROAD DESIGN SOIL TEST DEC ]. 1986 Municipality of Anchorage Department of Health and Human Services 825 L Street Anchorage, Alaska 99501 RECEIVED Ai~?2~TION: Steve Morris REFERENCE: Lot 12; Block 2; Eagle River Heights Subdivision Request you approve the attached Health Authority Approval and issue a waiver to the horizontal separation distance between the private well and the septic tank located on this property. The original permit issued by the Municipality on May 11, 1976 contained a waiver to 80 feet and was dated June 23, 1976. The on-site inspection report dated June 28, 1976 shows a horizontal separation distance between the well and the septic tank of 95 feet. Distance measured in the field between the well and the cleanout on the septic tank is 97 feet. In accordance with a risk analysis performed by us it appears that the well is almost sure to be free from any form of contamination from household sewage. Therefore it is our opinion that the horizontal separation distance prescribed by 18AAC72.021 is not required in this case. In addition to those documents required for an HAA you will find a copy of our risk analysis work sheet and a plot plan showing the general location of the well and the on-site wastewater disposal system. If we may/~ of further service, please contact US. . SRB 196X EAGLE RIVER, ALASKA 99577 L. oT 17_. ~ & S ENGINEERING SR8 196X · EAGJ. E RIVER, AK 99577 C~MF:~'ATION SHEET DATE: SHEET OF BY CKD "-~REAT£R ANCHORAGE AREA BOROUGH Department of. Environmental Quallty 3330 "C" Street, Anch.ora?.~ Alaska 99503 274-4561 ~J _~ ~ ~ ,~T Date Received May 19, 1976 ~]~.Q'~'~f ' Time of Inspection 10:30 a.m. ~~ REQUEST FOR APPROVAL OF . Bob Neale ~ } INDIVIDUAL SEWER & WATER FACILITIES co °j 1. Approval requested by: First National Bank of Anchorage Mailing Address: 201 West 36th Avenue Phone: 2. Property Owner: Richard & Nina Magnuson Phone: e 4. 5. 6. Mailing Address: Legal Description: % Jack Linton 277-5681 688-2670 Box 1006, Eagle River Lot 12 Block 2 Eagle River Heights Subdivision Location: Meet her at the Eagle River office, she will take you £~v.. th=e= Type of facility to be inspected . Single Family No. of bedrooms 3 Well Data: Well - individual A. Type C. Construction B. Depth D. Bacterial Analysis 7. Sewage Disposal System: A. Installed B. Installer C. Septic Tank: 1. Size D. Seepage Pit: 1. Absorption Area E. Disposal Field: Total length of lines 2. Manufacturer 2. Material Distances: A. Well to: Septic tank Nearest lot line , Absorption area , Other contamination , Sewer Lines B. Foundation to septic tank , Absorption area C. Absorption area to nearest lot line EQ-034 (1/74) Page 1 of two pages MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ~ ~/,UNtCIP,~LITY OF AI,~CHOP. AOE D[?I'. OF I~.~/'.L1;'I ,"; [N?I2ONM[N'I,% ~LC Tr. CTION 1. 9 1976 1. Type of Inspection: 2510 East Tudor Road, Anchorage. Alaska 99504 276-2221 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES CMRO VA_ FHA Mailing Address~ ~ /oo~ ..~ ~:~, ~r~ Day Phone: ?,E.C E I.VE D.. CONY '~ 3. Name of Buyer: _ Mailing Address: Name of Lending Institution: Mailing Address: ~J'-~¢~ Day Phone: A-~-. ~',,,-L.,~A. Phone: 5. Name of Realtor or Agent: Mailing Address: 6. Legal Description: '/'v'~'' '-~ IZ, "'~J~,~-L''J/ Z Location: /1, ~0 ~ ~, ~L :j~ 7. Type of Facility to be C4° ~ lC.. 8. Water Supply Type of Supply: Public Utility If Individual, number of dwellin~ pr~ently If Individual, depth of ~11 [~ Phone: No. Bdrms, '~ 9. Sewage Disposal System Type of System: Public Utility Individual (on-site), If Individual, date of installation 72-003(3/'/6)