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Home My WebLink AboutKNIK VIEW ESTATES BLK 4 LT 1Knik View Estates Block 4 Lot ! #051-043-32 Municipality of Anchorage Development Services Department On*Site Water and Wastewater Program 4700 South Bragaw Street P.O, Box 196650 Anchorage, AK 99519-6650 www,d,anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SW020043 MM&M ContractinR P,O. Box 670495 ChuRiak, AK 99567 688-1236 Four (4) LEGAL DESCRIPTION Knik View Estates Well: Community Water System SEPARATION DISTANCES Septic Absorption Uft Tank Field Station w. >200' >200' N/A s~.w.,. >100' >100' N/A >5' >10' N/A F~,,~, >5' >3.0' N/A None Noted PID Number: 051-043-32 Wastewater System: New Page 1 of 3 ABSORPTION FIELD 5' Wide Trench 1.2 c~o~ 8.5 .. 4.5 ~,. 4 · 5 n. 52 ~,. 5 520 re ASTM D~034 PVC MM&M Contracting 3/30/02 TANK Septic LIFT STATION Tank SewerUne Anchorage Tank N/A >25' Steel N/A ~ N/A BENCH MARK Finished Floor. 1,250 Two (2) lO0.O FL Inspections performed by: Tim Kimbrough Dates: 1" 3/30/02 2"d 3/30/02 Department of Health and Human Sen/ices approval Reviewed and approved by:¢ ~ Date: ? Engineer's Stamp Municipality of Anchorage Page 2 of 3 DEVELOPMENT SERVICES DEPARTMENT · 4700 South Bragaw Street Anchorage, AK 99519-6650 - 343-7904 ~ On-Site Wastewater Disposal System or Well Inspection Report Permit Number SW020043 PID No. 051-043-32 RANKIN DRIVE TIll ~ C4 Utility Easement' Alternate Four Site Uome _® TB2 M1 A B S1 53.7 37.7 S2 60.6 45.7 C4 63.7 68.5 M1 83.6 58.7 C5 84.9 58.9 $1 Line / Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On-Site Wastewater Disposal System or Well Inspection Report Permit Number. SW020043 Legal Description: Lot 1, Block 4, Knik View Subdivision BACKFILL 86.9-'~.00.,.. 4. 0 Page 3 of 3 PID No. 051-043-32 86.91 76.0 . ~eotextile ])coln¢ield Rock BACKFILL 8~.49 86.95 $~.0o PROFILE Scole: 1" - 10' AS-BUILT NO. : 90",'68~1238 ~ul. 16 ~ 01:16PH P2 I hereby c~ t~. l,ba~e surveyed1 t~e ~oltow~$ d~ .... . .,. ~tk V~ .~ . ..... · . , ~;.,~ :~,~ ~ ~ - ':: ~ .:~~~.~ .... ..... . ':L'~-":.'~Re~eived Time'Jul,lb, 12:4 PM ~ . ~g :..:.: ' -~~dS~o.~'. :',.:,..., ',..~.;:, .: . . . . . '..,.~,:.',.....: .'-t .~o~~:., .. ,,..".;: . MUNICIPALITY OF ANCHORAGE Development Sen4ces Department On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196050, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Date Issued: Mar 27, 2002 Expiration Date: Mar 27, 2003 Permit Number: SW020043 Legal Description: KNIK VIEW ESTATES BLK 4 LT 1 Design Engineer: 0014 Anderson Engineering Owner Name: MM&M Contracting Owner Address: PO Box 670495 Chugiak, AK 99567-0495 , Parcel ID: 051-043-32 Site Address: 022738 JUDD DR Lot Size: 21787 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: [] Disposal Field [] Septic Tank [] 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. Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw St. 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. 051.043-32 Permit Number SW Pmperb/owner(s) MM&M Contractin¢l Day phone 688.1236 Mailing address (1) P.O. Box 670495 Chu.qlak, AK 99567 Mailing address (2) Zip Code Legal description (Lot, Block & Sub'd.) Lot 1, Block 4, Knik View Estates Subdivision Legal description (Section, Township & Range) 2 I, 7 '7 Acres . Lot Size Number of Bedrooms Four THIS APPLICATION IS FOR: Sewer Only Sewer and Well Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub Swimming Pool Therapy Pool Well Only Water Storage Jaouzzi Water Softening Unit 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 ageht) Number: · oc::, ': Waiver~ Fees: '~O'""~9 - ~ ~ - -,~ Date of Payment ~E) ~' ~-c~ .~ Receipt Number: March 5, 2002 Municipality of Anchorage Development Services Department On-Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 1, Block 4, Knik View Estates Subdivision Septic System Design and .P, ermit Application Impacts to Adjacent Properties Dear Onsite Services Engineer:. .The owner of Lot 1, Block 4, Knik View Estates Subdivision intends to construct a new four-bedroom home on the lot. We are therefore requesting a permit be issued for the construction of a new septic system to serve the proposed home. The attached Site Plan and backup documentation Identify the location and configuration of the new septic system and the parameters used in the design. Also identified on the plans are the location of the water service line on the lot and the test hole locations along with the septic systems located on nearby lots. Existing drainage patterns are shown and will not be altered by the development of the lot. Two test holes were placed near the location of the proposed absorption trench. These test holes indicate clean well-graded gravel with varying amounts of sand near the location of the new absorption trench. Percolation tests in the material resulted in rates of less than 1 minute per inch. No groundwater was found during the placement of the test holes and none was noted during the monitoring period. We are therefore proposing to place a 5' wide shallow absorption trench system with 4' of gravel beneath the distribution pipe. The total depth of the trench will be 7.5'. The distribution pipe will be placed at 3.5' below the ground surface to provide sufficient drop from the septic tank to the absorption trench. The total length of the new absorption trench will be 50'. The ground surface on the lot slopes as shown on the attached Site P.!an with very, little to no slope near the proposed septic system site. The new absorption trench w~ll be 'constructed on a fairly flat surface in conformance with Municipal requirements and parallel to ground contours where possible. All components of the new septic system will be constructed a minimum of 10' from the water service on the lot. If the system Is constructed In accordance with our design the following statements apply: 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. The subdivision is currently served by a community water system. Lot .1, Bl(~ck 4, Knlk View Estates Subdivision ·. 'March 5, 2002 Page Two 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, Michael E. Anderson, P.E. Attachments 170.00 85-11~ THIS PROJECT 17932 · '~ VACANT .o_~ ~ " .,:'. WCS1 179.26 / / I / I I I / I I I / / JUDD Circle mo.oo .5~.~. R^NKIN ., 27 \ \ \ I I 3 / / 2/ /9 /8 /3 $75.~O 50.00 205.00 w£$' /7 · AREA SYSTEM PLAN .. SCALE 1" = 100' No. C[-4381 .l RANKIN DRIVE 0% - 1% Alternate Site 0% 1% TH1 TH2 Utility Easement ~--~,- 1% 10' I ~ Four ., ~--~ ~ Bedroom Home 1,250 Gallon Septic Tank 50' Long X 5' ~ Wide X 4' Eff. ~-_Depth_Absorption Trench ~ Water Serv:[ce //~ _~ / / SITE PLAN ' SCALE 1" = 30' LOT 1, BLOCK 4, KNIK VIEW ESTATES SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Four Bedroom Home Perm Rate: <1 Min./Inch Application Rate: 1.2 GPDISF 5' Wide Trench System .250 Gallon Septic Tank 4' Dralnfleld Rock 4 Bedrooms X 150 GPD 11.2 GPD/SF = 500 SF of Absorption Area 500 SFI5 LF (Width)*.5 (Red. Factor) = 50 LF Trench Length Therefore: Construct a 50' Long X 5' Wide X 4' Effective Depth Absorption Trench. Flowline Elevation In Trench to be 3' Below Original Ground Surface. Total Depth to be 7' Below Existing Ground. Mound Over Trench to Provide a Minimum of 3' of Cover or Provide 2" of Direct Bury Insulation and 2' of Cover. ,,//,,,%///~.~//~ Natural Backf ~ ( 3 ' Minimum' ~ 3 ' ,, Geotextile Fabric · '/ 4" PVC 4 ' % (Roles Down) ~ Dratnfteld ~ / ~ . t~ock ..- .'-": :, ' · .' . ~PICAL WIDE TRENCH SECTION': ' NOTE.. .~ Grade Area Over Trench to Drain Away ....... [ ~.. ~,.... ~, ~-~. .: ' .?.~ ',' Minimum 6' Secretion From B~roc~ ."-' :~ ~' '~J'. /: , ~':'~.~::" C ~" ~ : Minimum 4' Separation From Groundwater.:" ~ ,:..,. ~;, ~: ~" :-".'-~ ..<'.'.-~,:~[ ,.'Minimum 10' Secretion From Water Se~tc~ Liner:. ~ '~;' i: T: ~:*~ ~,~. ~:~ . · .--)'~ ~.~.,,~, .: . ,. ', .- ' ,,r" · + ~ . ' · ,:,-' ',.,J~'.,~'. ~,' /.~ PROJECT #: PERFORMED FOR: Municipality of Anchorage Development Services Department/On-Site Water and Wastewater Program 4700 South Bragaw Street, Anchorage, AK 99516-6650 - - SOILS LOG - PERCOLATION TEST. HM~.M I'ON~TRUCTION / PAUl HYER~, DATE PERFORMED: LEGAL DESCRIPTION: I OT 1 BLOCK ~, KNIK V1FW SUBD 10--1 II --I I 12 I TEST HOLE # 1 OG / BROWNISH SILTY-SANDY-GRAVELS SLIGHT DENSITY / WELl. GRADED SANDY GRAVELS - GW SLOPE 0% WAS GROUNDWATER ENCOUNTERED~ NO S L IF YES, WHAT DEPTH? O P DEPTH OF WATER J~JoJl. e AFTER MONITORING: E DATE: 2/28/02 SITE PLAN 1"=100' 0% ~5 16-- 17~ MEDIUM DENSITY / SILTY-SANDY- READING GRAVELS Start 1 .,.. Recharge ~"~ 49th ~ ~ ~' $ Recharge PERC R~TE: - 1 TEST R~ BETWEEN DATE ' GROSS NET DEPTH OF NET T~ME TIME WATER DROP 2116102 1/.:00 12" 1/.:02 2 12" 1/.:03 12" 1~,:05 2 12" 1/.:06 12" 1/.:08 2 12" MIN./INCH PERC. HOLE DIAMETER: 6" 3.~ FT. AND /..5 FT. COMMENTS: NO IMPERMEABLES ENCOUNTERED / HOLE PRESOAKED PRIOR TO TEST TEST PERFORMED BY: T.L. K~MB~'OUGH I, M,CHAEL E. ANDERSON, CERTIFY THAT TH~S TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GU:DELINES ON THIS DATE: Municipality of Anchorage Development Services DepadmentJOn-Site Water and Wastewater Program 4700 South Bragaw Street, Anchorage. AK 99516-6650 .......... SOILS LOG - PERCOLATION TEST_____._- PROJECT'#: t~o?o'7 .... ' PERFORMED FOR: HH&H C0N~TRUCT~gN / PAUl HYERS DATE PERFORMED: LEGAL DESCRIPTION: LOT 1 BLOCK/. KN[K VIEW SUBD I I I 12 TEST HOLE # 2 OG / BROWNISH SILTY-SANDY-GRAVELS SLIGHT DENSITY / WELL GRADED SANDY GRAVELS - GW SLOPE WAS GROUNDWATER ENCOUNTERED') NO 0% IF YES, WHAT DEPTH',~ DEPTH OF WATER ~lol'te AFTER MONITCRING: DATE: 2/28102 S L 0 P E SITE PLAN 1"=100' 0% 15 17-- 18 HEDIUH DENSITY / SILTY-SANDY- READING DATE GRAVELS Start 2/16/02 1 GROSS NET DEPTH OF NET TIME TIME WATER DROP 1/*:25 12' 1/.:26 1 12" 1/.:27 12" 1/.:28 1 12" 1/.:29 12" 1/.:30 1 12' MIN./INCH PERC. HOLE DIAMETER: 6' 35 FT. AND .../..S FT. COMMENTS: NO IMPERHEABLES ENCOUNTERED / HOLE PRESOAKED PRIOR TO TEST TEST PERFORMED BY: T.L. KIMSROUGH I, MqCHAFI E. ANDERSON, CERTIFy THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES ON TH:S DATE: ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 1, BLOCK 4, KNIK VIEW ESTATES SUBDIVISION GENERAL: The scope of this project includes the procurement and placement of a new 1,250 gallon septic tank at the location shown on the Site Plan. Work also includes the construction of a new 50' long X 5' wide X 4' effective depth absorption trench at the location also shown on the Site Plan. The distribution line in the trench will be placed at 3.5' below the existing ground surt'ace. Total depth of the trench will be 7.5' below the existin, g ground surface. The new absorption trench must be placed a minimum of 10' from the water service on the lot. Construction shall be in accordance with the approved site plan, design drawings, Municipal Permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. The Contractor shall be responsible for obtaining all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. Contractors installing wastewater disposal systems must be certified by the Municipal Department of Health and Human Services for system installations. Owners installing their own systems must receive pdor approval from D.H.H.S. before beginning system installation. SEPTIC TANK INSTALLATION 1. A new 1,2,5.0-gallon septic tank must be procured from an approved source and installed at the location shown. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 3. Th.e... septic tank shall be sufficiently bedded to prevent settling or shlfbng of the tank. 4. All standpipes on the septic tank shall extend a minimum of 12 inches above finalgrade. . - 5. Tanks In'stalled without 4' of cover shall have a minimum .of 2" of direct burial insulation. 6. A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts are required between the tank and Lot 1, Block 4, Knik View Estates Subdivision · IVlarch 5, 2002 Page 2 of 3 7. Final grading over the tank shall be such that a positive slope exists away from the septic tank. DRAINFIELD CONSTRUCTION: 1. The drainfield shall be constructed to the dimensions shown on the design. The bottom of the trench shall be within 2" of level. 2. Distribution piping must be placed level with perforations down atop a level bed of drainfield rock. Rock should then be placed over the pipe to provide a minimum of 2" of cover. 3. A silt barrier or geotextile fabric must be placed between the drainfield rock and the natural soil backfill. 4. Monitor tubes must be 4" in diameter and installed at the locations shown on the design. The portion below ground must be perforated. Contractor shall vedfy the septic tank and drainfield are a minimum 100' away from any pdvate water wells in the area, 150' from a Class "C" Well or 200' from any community well. Direct bury insulation must be placed over the distribution system if less than 3' of backfill depth is available. Finish grade over the trench must be mounded to prevent settlement or depressions. 7. Grade area surrounding the absorption trench to drain away. A minimum 2' of accepting soil is required below the drainfield rock for a 5' wide trench. Contractor shall redly this condition prior to placement of the reck. All pockets of unacceptable materials must be removed and replaced. MATERIAL SPECIFICATIONS: 1. Septic tanks must be constructed by a municipally approved septic tank manufacturer. 2. The following pipe materials are appreved for use in septic system installations in the Municipality of Anchorage: Cast Iren (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated, but not sol!d)'and ASTM D2662 or A.B.S. (perforated and solid). Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Co. Styrofoam HI or equal). ' '. ' ' Septic tank inlets and outlets shall be fitted with watertight couPlings (Caulder, Femco, or equal). .:...,' ~." ' · .. Lot 1, Block 4, Knik View Estates Subdivision -- .~ ~i~arch 5, 2002 Page 3 of 3 5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed between the final drain rock layer and the native soil layer. 6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the #200 sieve. INSPECTIONS: Municipal Ordinance requires a minimum of two inspections. These inspections must be conducted under the supervision of a professional engineer registered in the State of Alaska. The first inspection must be conducted after the excavation of trenches, beds or pits and before the installation of any gravel. A septic tank may be set in place, but may not be bacldilled. The second inspection must be conducted after the placement of the geotextile fabdc, gravel, distribution piping, standpipes, cleanouts and insulation. No backfill should be in place at the time of inspection. Contractor shall provide a copy of all field survey layout and construction notes for use in preparing the certified as-built of the completed system. Parcel I.D. 51.043-32 2. NUMBER OF BEDROOMS: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Ancho, age, AK 9951~6650 www.ci.anchorage.ak..us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Expiration Date: GENERAL INFORMATION Complete legal description Location (site address or directions) Judd Drive at Rankin Drive Current Properly owner(s) MM&M Contractinq, Inc. Mailing address P.O. Box 670495 Chuniak. AK 99567 Lending agency Mailing address Real Estate Agent Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. Four 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class _A Well Public Water System Lot 1. Block 4. Knik View Estates Subdivision Day phone 688-1236 Day phone Day phone TYPE OF WASTEWATER DISPOSAL: [] Individual On-site [] Individual Holding tank [] Community On-site [] Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for proper[les served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of tne validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastev;ater 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 Anchorag~ 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 lime of installation. Name of Firm Anderson Enaineefinq Phone 522-T/73 Address P.O, Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. DSD SIGNATURE t// Approved for Disapproved. bedrooms. Date 7122./2002 ...~:..- Or A/-i',. ~^'. CE-,~23t .' .:~ Conditional approval for bedrooms, with the following stipulations: Additional Comments " _ ~. ON-~II '- . C~ ~3. WATER AND . ~ : WASTEWAI'ER : Attachments: HAA Checklist Septic System Advisory Well Flow Advisory By: (Rev. 12~00) X Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 43'00 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-~650 www.ci.ancberage.ak.us (~07) 343-7e04 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: LotLBIock4, KNkVlawEstates A. WELL DATA WeU type A_ Date completed __ Total depth ft. ff A, B. or C pmvida FWVSID # FROM WELL LOG g.p.m. Nitrate mg./I. C~lacted by: Date of test Static water level Well production WATER SAMPLE RESULTS: Date of sample: · Bo SEPTIC/HOLDING TANK DATA Tank Type/Matadel 8el~./Steel Tank size 1~50 gal, Foundation deanout (Y/N) Y Date of pumping C. ABSORIrrION FIELD DATA Number of Compartments Depression over tank (Y/N) Pumper New Cons=ucflon Parcel ID: 051-043-32 wel~ Log (Y/N) Wires properly protected (Y/N) Casing height (above ground) AT INSPECTION g.p.m, Date installed 3rLq)~2002 Soil rating (g.p,d./ff~ or ~rodrm) t.2 6PD/~F Length 62 Total depth ~ fl. Date of adequacy test P Date installed 3/30/2002 Cteanouts (Y/N) Y High water elarm (Y/N) N colonlas/lO0 mi. System type 5' Wide Shallow Trench lt. Width 5 fl. Gravel below pipe 4 ft. Eft, absorption area 520 .~ Monitoring tube Y Dapre$_ _$1on over field .N_ Results (Pass/Fell) Fluid depth in absorption field before test in. Water added gal. Elapsed Time: min. Final fluid depth in. Absorption rate >= Any rejuvenation lmatment (past 12 mo.) (Y/N & type) N Eyes, give date New depth in. g.p.d. D. LIFT STATION Date installed 'Pump on" level at Datum E. Size in gallons Manhole/Access (Y/N) in. 'Pump off' level at __ in. High water alarm level at in. Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot N/A Absorption field on lot N/A Public sewer main N/A Sewer/septic service line On adjacent lots N/A On adjacent lots N/A Public sewer manhele/cleanout N/A Holding tank N/A SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Building foundation >5' Property line >5' Water main N/A Water sewice line >t0' Wells on adjacent lots >200' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line >t0' Building foundation >10' Water Service line >10' Cudain drain None N0ted F. COMMENTS Lo{ is sermd by AWWU water systsm, G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspectk)ns and re~4ew of Municipal mcorde that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name Michael E. Anderson, P.E. Date ~ HAAFee S "-~-7'~-. -- Receipt Number C~- ~)~ ~ (~. 12/0o) Sudace water >10~ Wells on adjacent lots >200' Absorption field >5' Surface wat~ >100' Water main >10' Driveway. pa~ing/vehicle storage >25'