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Home My WebLink AboutTHE VILLAGES TIDE VIEW LT 14 Onsite File The Villages Tide View Lot 14 #020 - 091 - 59 • • Alpine Drilling & Enterprises Well Log Permit Number: NSW181421 Date of Issue: 11-27-19 Parcel Identification Number: 02009159000 Date Started: 2-27-19 Date Completed: 2-29-19 Is well located at approved permit location? x Yes ❑ No Legal Description: The Villages Tideview Lot 14 Property Owner Name& Address: George Buchanon Merit Homes Borehole Data: Depth(ft) Method of Drilling x air rotary El cable tool Soil Type,Thickness&Water Strata From To Casing type:steel stick-up 0 2 Wall Thickness:.250 inches gravelly silt 2 /9 Diameter: 6 inches Depth: 45.5 feet Liner Type: bedrock 19 266 Diameter: inches Depth: feet Casing stickup above ground: 2 feet Static water level(from ground level): 15 feet Pumping level: 260 feet after a hours pumping 2_5 gpm Recovery Rate:2_5 gpm Method of Testing:air life Well Intake Opening Type: ❑Open End x Open Hole ❑ Screened Start feet Stopped feet ❑Perforations Start feet Stopped feet Grout Type: bentonite chips&granules Volume: 5 WATER QUALITY TESTING Depth: Start 0 feet Stopped 42 feet Co11form NR3 Cou100mL Pump: Intake Depth feet Nitrates tslb mat Pump size hp Brand Name AMC 5.1 L *61urWell Disinfected Upon Completion?x Yes❑ No Method of Disinfection: chlorine tablets Comments: Well Driller: Alpine Drilling& Enterprises PD Box 110196 Anchorage AK 99511 flle,Ci 64\ie -vr 0.:DA MUNICIPALITY OF ANCHORAGE Development Services Department '`r. : Phone: 907-343-7904 On-Site Water& Wastewater Section Fax: 907-343-7997 Pump Installation Log Well Drilling Permit Number: 181421 Date of Issue: 11 _27 _18 Parcel Identification Number: 02C 09159C Legal Description Block Lot I Property Owner Name& Address: Tideview 14 George Buchanon do Merit Homes Te\e � \11-(3.3 Box 220128 Anchorage,AK 99522-0128 Pump Installation Date: 03 .02 .2019 Pump Intake Depth Below Top of Well Casing: 252 feet Pump Manufacturer's Name: Goulds Pump Model: 7HS10 Pump Size: 1 hp Pitless Adapter Burial Depth: N/A feet Pitless Adapter Manufacturer's Name: N/A Pitless Adapter Installer: N/A Well Disinfected Upon Completion? 0 Yes 0 No Method of Disinfection: chlorine tablets Comments: PLEASE SAVE FOR COSA Pump Installer Name: Company: Aarow Pump & Well Service, LLC Mailing Address: P.O. Box 110496 City: Anchorage State: AK Zip: 99511- Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation. PLAT NO. 77-208 THE VILLAGES TIDE VIEW LOT 14 52,932 S.F. N 89°57'32"E 299.78' 1 1 `o \ T. \ A f: Vc 9' N \CayceA\ / It* S S.), 119.9' \ $�\ 96.8' eG z� / t8) /per c, \ WELL 7111, C 1 wry. o N 6 to m �J w coq �? `; Av ' 0' 0 w F!o� / O �,4- N 03 OD J N i — ' ' 1 " = 50' , 50. CREEN 20i8 — ' vo `2 5 ' CREEK PER P1"` A 35 .80. • N 14°0000 E Kph Oe ct 0,0 A O ^)b A 9p, 1> o. pL Ftir}_Fo ♦` 6 0' 6 bry 3`"0• BUILDING DETAIL SCALE: 1"=20' AS - B U I L T I HEREBY CERTIFY THAT I HAVE SURVEYED THE PROPERTY DEPICTED ABOVE AND THAT NO iiiilli m, GASTALDI LAND a. ENCROACHMENTS EXIST EXCEPT AS INDICATED. 4 SURVEY I NG. LLC IT IS THE RESPONSIBILITY OF THE OWNER TO •P, C,.........OFQ4•I. JEFF A. GASTALDI, R.L.S. DETERMINE THE EXISTENCE OF ANY EASEMENTS. •• '`; •.'t" 2000 E. DOWLING RD.. SUITE 8 COVENANTS OR RESTRICTIONS WHICH DO NOT � *; 49TH • ANCHORAGE. ALASKA 99507 APPEAR ON THE RECORDED SUBDMSION PLAT. ,g • PHONE 248-5454 UNDER NO CIRCUMSTANCES SHOULD ANY DATA f • : ••• '� HEREON BE USED FOR CONSTRUCTION OR FOR • Jeffery A. Goslaldi GRID DATE ES-6091 ESTABLISHING BOUNDARY OR FENCE LINES. va s-0,-... 5/24/2019 •' • SW3336 5/24/2019 . 6c, '••....•••�•�d`' .• ANCHORAGE RECORDING DISTRICT, ALASKA I '0IPsslonol\-° 4 F.B. JOB NO. NOTE : NO CORNERS SET THIS DATE •w4 111 IWO' VTV14 Permit No. OSP181421 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description: THE VILLAGES TIDE VIEW LT 14 PID No.: 020-091-59 / N -- / \ 1 i / 1 S/\ \\ 1 1 / 1 1 / 1 ' AWWU CO1 I ® / I \ v � NEW WELLN r 1 I DRIVEWAY I "If.- \ / \ / \ / \ / ,//'//:/" N / / /------' N 1 / / N / /\ \ / / / ----- ___-- Ili i i 1 1 1 SCALE: 1"=50' \ \ '.�ioximilivIII • . �..• q<q!.. MJ GGTH * ° ,0�MICHAEL N. ANDERSON' # - •.... No. 94 9 • -� „(,Pnt,r. MUNICIPALITY OF ANCHORAGE ,,,,c»r On-Site Water&Wastewater Program N': PO Box 196650 4700 Elmore Road Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax.(907)343-7997 „ http://www.muni.org/onsite ' + `` ' i Li I)cpit rtmutt t On-Site Water System Permit Permit Number: OSP181421 Effective Date: 11/27/2018 Work Type: Well Initial Expiration Date: 11/27/2019 Tax Code Number: 02009159000 Site Legal Address: THE VILLAGES TIDE VIEW LT 14 G:3336 Site Mailing Address: 4545 VIRGO AVE, Anchorage Owner: BUCHANAN GEORGE K Lot Size in Sq Ft: 52932 Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING Total Bedrooms: 4 This permit is for the construction of: ❑ Disposal Field 0 Septic Tank 0 Holding Tank 0 Privy E Private Well 0 Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing 4.' Received By: Date: 1) kr? (11 Issued By: &J/q/ I i Date: I//Z7 r' P MUNICIPALITY OF ANCHORAGE ,,,,*,, Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 020-091-59 Property owner(s) MERIT HOMES Day phone Mailing address Site address Legal description (Sub'd., Block & Lot) THE VILLAGES TIDE VIEW LT 14 Legal description (Township, Range & Section) Lot Size 52,932 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Initial ❑ Single Family (SF) D Absorption Field [11 Initial ADU) Septic Tank ❑ Upgrade ❑e 3 4 .. Duplex (D) Li Holding Tank Ci Renewal KQ ope/ultiple swellings ❑ Privy CI /lig `y' t�v��`JcjJ{� (3 _ d/or D) N Private Well 0 Q • Water Storage CI ��/8 ; Q-6 a THIS APPLICATION INCLUDES A WAIVER REQUEST ' ' = y X10\ Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. MAAt (Signature of property owner or authorized agent) Permit/Rush Fees: at 344-00 Waiver Fees: Date of Payment: 1112-1118 Date of Payment: Receipt Number. a , Receipt Number: Permit No. OSP 18 1 42.1 Waiver No. G:1Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc • • Nov. 20, 2018 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage,Alaska 99519-6650 Fax 249-7847 Re: New well Permit Legal: THE VILLAGES TIDE VIEW LT 14 To Whom it may concern: This is a request for a new well permit on the above referenced lot. The entire subdivision is serviced by a community sewer and private wells. The permit will not impact any of the surrounding neighbors due to this design. Please call me if you have any questions. Sincerely I""" M Michael N. Anderson,l/ P.E. 4661 Natrona Anch, Ak 99516 Ph 727-8864 1 ______ \\\ \\ A fN//// VACANT LOT---\\ \k, N PROPOSED HOUSE PROPERTY LINE/ 1 /PROPOSED WELL / I� 100'RADIUS \1 LOTS SERVICED BY ------\ AWWU SEWER -- \ CREEK � 1 _______— ---,,,,. , , is 411_\ Y , \. \d, \ ` A Design Prepared for _��1F 1iii.. MERIT HOMES l.•.P�. O" 44-:, . THE VILLAGES TIDE VIEW, LOT 14 i'7' 49TH f1 '• '' -j/ Anc : i44 : horage, Alaska MichaelP.E. ��':MICHAEL N. ANDERSON= v! • l N. Anderson, PDATE: 11/15/2018 No. 69 ::' 4601 NATRONA AVE DRAWN: DJR .V.j '•/% •'�,�•••G�`' . ANCHORAGE,ALASKA 99516 • (907) 727-8864/FAX: (907) 345-1391 SCALE: 1"=200' *444. �, `'..44 T11N R3W SEC 3 1 N2SE4NW4SW4 PROPERTY LINE 11 10'UTILITY EASEMENT------ { • \ / \\ \ i i// \'S \\ o \ / ` o \ / \ , / PROPOSED \\ \ \ HOUSE \ \ / 1I \ J�' WELL ... ... 1 ey .. . ® I P MIN. DISTANCE :P I 0O i BETWEEN AWWU • i S� /L SEWER LINE AND I /�f WELL IS 25' '//' APPROX.AWWU / 0 / / w I- \ SEWER LINE , / / i / w � i/ \ \/ / / \ / / I \ / .... / \ PROPOSED WELL ' / _ k 1 / 100'RADIUS / 1 \ � � / t ]� i �1 – / / -- -- -- -- SENPNG�EPSEM�N� C'F /r — ' — — \ I \ \ K MP�N ' \ 50 GRED �VT ! \ \ \ ' =�KM NZENP�G�/ ' I \ \\ \ \ \ / \\ \\ \\ / \i THE VILLAGES TIDE VIEW THE VILLAGES TIDE VIEW \ --- --- LOT 17 i LOT 13 \ \ i \ / \--\ —\— — — r \ \ \ I _\ \ V — - - Design Prepared for ...-. SOF / "4* MERIT HOMES 4,..,„<c›:................. s .i THE VILLAGES TIDE VIEW, LOT 14 . 49TH Anchorage, Alaska • ' • • `y/L • P.E. � •! Michael N. Anderson, (- DATE 11/15/2018 ...t1%.MICHAEL N. ANDERSONNo. C 94,94.•,.>: 4601 NATRONA AVE DRAWN: DJR ��. .".4,17V-1.4-.. ,,i, 7)// ANCHORAGE, ALASKA 99516 • (907) 727-8864/FAX: (907) 345-1391 SCALE: 1"=50' 14,11 ;. •• re)11 -S-0 e)- _ MUNICIPALITY OF ANCHORAGE r? r Airs -To�� WASTE � . CONNECT PERMIT 02 -9771 ,414 ,4Aso, WATER &WASTEWATER UTILITY DATE OF APPLICATION 09/16/2002 3000 ARCTIC BLVD. SCHEDULED COMPLETION DATE 12/31/2002 PHONE: (907)564-2762 BLOCK/LOTITRACT LT 14 ).--1 SINGLE FAMILY SUBDIVISION THE VILLAGES TIDE VIEW j MULTI DWELLING No.APTS 11 COMMERCIAL TAX CODE 2009159 GRID SW3336 AS-BUILT STREET ADDRESS 4545 VIRGO AVE OWNER BUCHANAN GEORGE K PHONE MAIL ADDRESS 7503 PINE CUP DRIVE HUMBLE, TX 773460000 I CONTRACTOR C&N ASSESSMENTS Repair Existing Service X Main Line Extension On Property Only City Tap Have Been Levied Hydrant Only 50'or Longer To Be Levied Main Tap-To Property Line Only Comments: X Main Tap&On Property Connect Row No. rOC -- Disconnect ( C{o R&R-Main Tap Only Owner ___-Steff CONNECT SIZE 4 " ISSUED jgladman INSPECTION FEE $ 64.00 71-•PAID CASH PERMIT FEE $ 38.00 CHECK# $ 0.00 �DTHER C e----- DEPOSIT $ 0.00 INSPECTED'-BY j !� REIMBURSABLE TOTAL $ 102.00 / 1-i-- NUMBER DATE /' / REMARKS PERMITTEE(Please Print) 'SA-AS CONTRACTOR PHONE '- ----., MAIL ADDRESS ,�---- / , SIGNATURE -..p.. j?? vc.,r /j�-`.'ti„�" g--- _" POST IN A CONSPICUOUS PLACE AT THE JOB SITE AWWU INSPECTOR Original DATE SCHEDULED TIME INSPECTOR SUBDIVISION THE VILLAGES TIDE VIEW BLOCKJLOTITRACT LT 14 INDICATE NORTH SIZE MAIN: {A" ATYPE MAIN: , DEPT AT MAIN: I AT PROP. LINE: � '� CONNECT LOCATION: .5 � y') �� COMMENTS: /IV j,57.,� 0 OZ INSPECTED BY: DATE:9, 19 �,2 PERMIT # 02-9771 LOT 14 VILLAGE TIDE VIEW 9/19/02 co /' • 8' DEEP AT PROPERTY • az*, s's w*e • 45 BEND VIRGO AVE 't1,....,,,I.,.., ".• , :i ...:. ... - , ..... -,, -. .1.-...:,.*- -7. . 7 • i-- . . ., .„, • - - - ...,,i- ttti. 7.: lipc----1744, , , , ,. N4,.., , / .• ,, Ar .: . , .1, ,., 44' '," ft 4 I.,... ,4 • .,. '1..,4. '• ''', p otk, •AR\'••, IP i. '' „it. *•• ..1- .' 4 '. c '4fly •1 ' ''' 4r1:41.2 '''.• • ' A'' , A .4- 1..,p; ,,,:i",f• ' ,_%, . s.1 ..._ . • .... ., .. . -- x,-,4 ••„--0- , s', .--. .,W1,.=R 4 ' ...' 4: "" • N. 1.. 4, ,„.„ ,, 4,,,, ,„ . . ,. ,. A... •„t • • ...`51 .v."1:i••„. A ' * ,,....,,i,i;, \ * AL rf 1 111A, . ,4 4 ' .., ,:,•''; ''''''' 'A ,'' *1/4.4 qc.I ''' 'A t* *.. (‘' " . l''.4/ '''' ,..) • 1." ; '. 4.; '''ir :,.......4.;-(.1,. -4.• 4 ,S'4 ..,..(,, ,.:,. ,/ , .'• .v., V IY. ''.7` ,; - 0,2A 1'1 Iii, 1.1 4.71, ,'',..i*, •-$4.,',I ,r .tre'',A:',7: ' ' 'A",:t#hA,-,OA N '4i>''el; ANN'' s ‘,.r,,A";', , •r/ '•4 - i'4:144'‘5,t1,4 t — tiqc :" ro; ., 4 , .- '.1 t:'• •:A 44.,4_,....c,Lis lkiti4 AS 'J,, ' -; 1,, t.4.•,-\e''''VS,4.• 'e.,A. •••,'A*4••'A'',J. Z .0"'f,iiii...4 '',r• Alf 4. 1114.• *O. *'Arifot,,,,,, -c.- ,... P. - •• -' t <-41 4., l'<,,Csei. .'• ' # '', x<'. qt,..., • > iy ':ir - ' IF.4.-'..., ,<.` .-.:M 1: 4 ' ° - - '-,'••• • '1/4(5,32tZ'Ver.." ° %,44.' y, ',z.3.!.' / / 1,4./ - -, '...0,..',, i,..... i;:.. - 7'-,,,p,,, t . , ' 70. „• r:4,,,,-; , V. N:47-,,e; 'A-144t: ,.-4,' ,',,. "", ' / .4.y,' . ^ ' „ ',4''',• .,. ' hp,i„,,'"k. "i:i4jety,Vitt,,,,,%2 11:441i- ';,)"..'I'. i r ' '.'41/ • , . ., ;.. : .i.. ,011,0 ' ;',":4.'*e..'4;114:ls•4..' .tr 1/2", y'4":'44'a,t,'PAT'AS.V.A4 t,st ,,,,, li:,c*• 4 /*' .,../ , ... ... . le *'t, . , ./ .- '''' ..• ,'. v..... 4. "' t. 14 14'; A^.'' 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''' -, „, ,,,, . ,... .., ,,. .., ...... , ,....„....,„_..... .. . ...,....., . ... .. .., ..... . ..„ . ,., . . . , . ., ....„,../ ... _ .. .,.. ..,,_.,., , . ., .. , .. .....„..... .... . , „.. ,, . ....... „ .... .. , , ,, ,, ,..... .,......„......_ . .. ,...„,, , . .......... . ......., . ,. ,..._........ ...._ ,_,. ,. ., . .• .. ... . i 'e r ........___ • imp...pm,jai - -77111111t • ,.....--......,--,..., ,--......—...--- ,....--........--...., ,...„---.......---.._... Michael Reisher Permit Office Supervisor Anchorage Water& Wastewater Utility Direct: 907-786-5645 Michael.Reisher(aawwu.biz 2 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WATER SUPPLY PERMIT Initial Permit Number: SW020322 Legal Description: THE VILLAGES TIDE VIEW LT 14 Design Engineer: 0014 Anderson Engineering Owner Name: George Buchanan Owner Address: PO Box 111675 Anchorage , AK 99511-0000 Date Issued: Sep 03, 2002 Expiration Date: Sep 03, 2003 Parcel ID: 020-091-59 Site Address: 004545 VIRGO AVE Lot Size: 52932 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: C Disposal Field E Septic Tank Lj Holding Tank ❑ Privy Private Well Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: > Gi Date: 3 �� Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water and Wastewater Program r' 4700 South Bragaw St. s A " Y P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 6,9-0 - bQ f 'S`1 Permit Number SWO?_037.4 Property owner(s)_George Buchanan Day phone 441.6955 Mailing address (1) P.O. Boz 111675 Anchorage AK 99511 Mailing address (2) Zip Code Legal description (Lot, Block & Sub'd.) Lot 14, The Villages Tide View Subdivision Legal description (Section, Township & Range) Lot Size qZa Acre Acre q.Ft THIS APPLICATION IS FOR: Number of Bedrooms Four (4) Sewer Only ❑ Well Only Sewer and Well ❑ Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit Fees: Jet /To Waiver Fees: Date of Payment: ? -" 0 2. Date of Payment: Receipt Number: 94717 !�d Receipt Number: (Rev. 12/00) August 27, 2002 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 14, The Villages Tide View Subdivision Well Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer The owner of Lot 14, The Villages Tide View Subdivision intends to construct a four- bedroom home on the property. We are therefore requesting a permit be issued for the construction of a new well to serve the home. The subdivision is currently served by the Municipal sewer system and the home will be connected to this system. The attached Site Plan and backup documentation identify the location and configuration of the new well and the setbacks required to the sewer system. If the well is constructed in accordance with our design the following statements apply: 1. The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, &J� Michael E. Anderson, P.E. Attachments MUNICIPALITY OF ANCHORAGE Department.~ Health and Environmenta~..~rotection 825 '-'~ ~ Street, Anchorage, AK. ', ;501 ' 264-4?20 # * * HANDWRITTEN PERMIT Permit f~l~ SEWER PERMIT ?~'~-~'~,.~AII~'02 ON-SITE Location: Phone Numb~er:~--~/'~ Legal Description: ~/~ Y~ ~ ~JJ-- Lot Size: Type of Soil Absorption System Is: Trench: Drainfield: _ Seepage Bed~ ~ Holding Tank: Maximum Number of Bedrooms: , %~ Soil Rating(sq.ft/br) /~ DEPTH The Required Size of the Soil Absorption System Is:' ',~ LENGTH /C'/k~k~..GRAVEL DEPTH ~"/' WIDTH 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). "' REQUIRED SEPTIC(HOLDING) TANS SIZE : ~O GALLONS # # Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. # ~ * TWO(2). INSPECTIONS ARE REQUIRED * * * Backfilling of any system without final inspection.and approval by this departmen will be subject to prosecution. Minimum distande between a well and any on-site sewage disposal system is 100 fee for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet.' Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. ' ' * PERMIT EXPIRES DECEMBER 31, 1 9 8 3 ' - ' I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if the~residence is remodeled to include more~~¢that 3_~e~rooms/~ Signed: ____.~'~J~.,.,./ Issued by: Applicant Date: -7--/ "rntheeventthatallftstatlonlslnstalledsn ~ electrical permit and Inspection must bo SWP/024 (1/81) ' obtained. As-builts cannot be approved un- til the electrical inspection Is received In this office. The electrical work must be per- formed by a licensed electrician." ,*.-~,'~Y' ~' '7125 Old Sewerd Hwy. Anchorage, Alasl~ 99502 ~'.-~.':~ .-. , ~49-6561 SOILS LOG - PERCOLATION TEST · ~ SOILS LOG .... ' ' PERCOLATION TEST 5 L Ob.° ' ~ . ~-'~ ~L/~ '~- "' --~ ..... ~ f-~ I1 ~ ReadmnU O,3te - ~et Depth IO Net ~- ~, ~.........;~e~: 20- · MUNICIPALITY O_ F ANCHORAGE Development Services Department \ .. _. j Phone: 907-343-7904 • On-Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On-Site Systems Approval Parcel I.D. 020-091-59 Expiration Date: 9) 6 1 1q 1. GENERAL INFORMATION Complete legal des ri tion THE VILLAGES TIDE VIEW LT 14 4/5 1VIRGO AVENUE, ANCH AK Location (site address) Current property owner(s) MERIT HOMES Day phone Mailing address SAME Real estate agent Day phone 2. TYPE OF DWELLING: N i 3 4 5 0 :, 0 Single Family (w/wo ADU) c . ' . ❑ Duplexr ' ❑ Multiple Dwellings (Single Family and/or Duplex) Z -• .' 3. NUMBER OF BEDROOMS: 4 o fy 6' 0 4. TYPE OF WATER SUPPLY: TYPE OF ` • `TEWA1i DISPOSAL: Private Well 0 Private Septic I 1 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer IX Waiver request for: Distance: Received by: 1/1" 1'`ert - 11(9 , Date: 6#//9 COSA to be released the engineer,unless otherwise requested by the engineer. COSA Fee $ 550 -r 33o e, Waiver Fee $ Date of Payment 6731/19 �1511l Date of Payment 23811110 Receipt Number # X0933Receipt Number COSA# .0 C19/W 6 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. I acknowledge that On-Site staff may visit the site to verify the information submitted. Name of Firm MIKE N ANDERSON, P.E. Phone 727-8864 Address 4661 NATRONA AVE ANCH AK Engineer's Printed Name MIKE N ANDERSON, P.E. Date 5-29-1�w‘-‘q Pd fir: 49TH '4 P 6. DSD SIGNATURE / / `i �/ System #1 Approved for L � bedrooms �, ,;MICHAEL N. ANDERSON ;� System #2 Approved for bedrooms �i,!rf.. CE �% p � • �\ Disapproved �`\ r8OiISSId,I�,'= `‘\•oo'b:4- Conditional approval for bedrooms, with the following stipulations: ` " LTYr0��.-.lj g1( Ol y_SiT �o WT '- WAS? RAND m .c531 -i- _% pKOEwATFR S0 GRAM o l..,J, E 11��\ By: i�.Lie o Onitj Original Certificate Date: 6 6 1 9 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 X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet COSA Checklist Legal Description: THE VILLAGES TIDE VIEW LT 14 Parcel ID: 020-091-59 If more than 1 septic system on lot: COSA Checklist# of Structure served by this system A. WELL DATA ❑■ Well log is filed with Onsite(or attached) Well production at time of test 2.5+ gpm Date drilled 2-29-19 Water storage tank volume 0 gallons Total depth 266 ft Well disinfected for coliform test? 0 Yes ❑� No Cased to 45.5 ft ® Coliform bacteria is Negative 0 Sanitary seal is functioning correctly Nitrate mg/L IN Nitrate less than MRL (ND) ❑■ Wires are properly protected Arsenic 5, 1 2 ug/L 0 Arsenic less than MRL (ND) Casing height(above ground) 24+ in. Collected by MNA Date of flow test for COSA NEW Date of Sample 5/30/11 Static water level at beginning of test 15 ft. Comments B. TANK DATA C. LIFT STATION Age of tank(s) years 0 Required maintenance completed Tank type/material Age of lift station years Measured operating fluid level in septic tank Lift station material ❑ Standpipes/foundation cleanout per record drawing Comments: Date of pumping D. ABSORPTION FIELD DATA AWWU SEWER Which system tested (date installed) Adequacy test date ❑ ALL standpipes present per record drawing Results ['Pass For bedrooms Total measured depth from grade ft(max) Fluid depth prior to test in Measured depth to pipe invert from grade ft(min) Water added gal 0 N/A—pressurized field New depth in 0 Monitor tubes go to bottom of effective. If not, state Elapsed time min depth into effective ❑ Code-required soil cover over field Final fluid depth in 0 System presoaked Absorption rate gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months) date of test) If yes, enter date Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout > 100' ❑Yes if No 1.4 ft M Yes if No ft Neighboring Tank > 100' ❑✓ Yes if No ft Private Sewer/Septic Line> 25' ❑✓ Yes if No ft Absorption Field on Lot> 100' r]Yes if No t41(‘ ft Holding Tank > 100' ❑✓ Yes if No ft Neighboring Absorption Fields> 100' Animal Containment> 50' E Yes if No ft ❑✓ Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' E Yes if No ft LI Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations> 10' El Yes if No ft Surface Water> 100' CI Yes if No ft Property Line > 5' ❑ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ❑ 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' Cl Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ❑ Yes if No ft If absorption field is under driveway comment below Property Line > 10' El Yes if No ft Wells on Adjacent Lots: Water Main > 10' ❑ Yes if No ft Private Wells > 100' El Yes if No ft Water Service Line > 10' ❑ Yes if No ft Community Wells >200' ❑ Yes if No ft Surface Water> 100' El Yes if No ft F. ENGINEER'S COMMENTS "'��v G. ENGINEER'S CERTIFICATION 0 I certify that I have determined through field inspections and review ,''fie;•'• .•.t., 1 of Municipal records that the above systems are in conformance with y 'Arr. MOA COSA guidelines in effect on this date. �*.'• �� •. • . '.....e... i� O.• MICHAEL N. ANDERSCN . c•• CE 94 9 ••�°�i El P . • COSA Checklist yellow sheet 1%4Fp P ((f.•,. .`)..;,' �Lo�NAE-S‘Sl4_,n_