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Home My WebLink AboutMALLARD VIEW LT 1Mallard View Lot 1 #020-091-82 Municipality of Anchorage lak r Department of Health and Human Services Mm 825 •L" Street Iffim P.O. Box 196650 Anchorage, Alaska 99519-6650 Ride Mystrom http://www.ci.anchorage.sk.us Mayor Permit Number. #SW 0120128 Date of Issue: 5-23-02 Parcel Identscation Number: 020-091-82 Date Started: 2-10-03 Date Completed: 2-15-03 Is well located at approved permit location? ® Yes ❑ No Legal Description: Mallard View Lt 1 Property Owner Name & Address: Jim & Marsha Fergusson 16860 Old Seward Highway Anchorage. Alaska 99515 Borehole Data: Depth (ft) Method of Drilling ® air rotary ❑ cable tool Soil Type, Thickness & Water Strata From To Casing type: steel stick-up 0 2 Wall Thickness:.250 inches rill organics & silt 2 17 Diameter: 6 inches Depth: 6_4 feet day 17 27 Liner Type: gravelly silt 27 48 Diameter: inches Depth: feet Casing stickup above ground: 2 feet ; bedrock 48 407 Static water level (from ground level): 27 feet Pumping level: 407 feet after increasing water 360 407 2 hoursg um in 3 m P P _gP Recovery Rate: 3 gpm Method of Testing: airlift • Well Intake Opening Type: ❑ Open End ® Open Hole ❑ Screened Start feet Stopped feet ❑ Perforations Start feet Stopped feet Grout Type: Bentonite #8 Volume: 1 bQ Depth: Start 0 feet Stopped ? feet Pump: Intake Depth feet Pump size hp Brand Name Well Disinfected Upon Completion? ® Yes ❑ No Method of Disinfection: chlorine tablets Comments: Well Driller. Alpine Drilling & Enterprises PO Box 110496 Anchorage Alaska 99511 V MUNICIPALITY OFANCHOR4GE Development Services Department On -Site Water& Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 Permit Number: SW020128 Legal Description: MALLARD VIEW LT 1 ON-SITE WATER SUPPLY PERMIT Initial Date Issued: May 23, 2002 Expiration Date: May 23, 2003 Parcel ID: 020-091-82 Design Engineer: 0000 None Required Site Address: 016860 OLD SEWARD HWY Owner Name: JIM & MARSHA FERGUSSON Lot Size: 136546 SO. FT. Owner Address: 16860 OLD SEWARD HIGHWAY Total Bedrooms: 4 Permit Bedrooms: 4 ANCHORAGE, AK 99516-4810 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. Received By: Issued By: Date: `� �/O v Date: S 23 OZ Municipality of Anchorage • Development Services Department Building Safety Division =• Y < O On -Site Water and Wastewater Program 5 T, 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWERMELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. foo h41 Permit Number SW_O,2 0129 Property owner(s)J V M a iYi cLc4iA_ Fe' ra .(SSo n Day phone 3 q 9-0o y `7 Mailing address (1) 1 M6 (o O 018 Seu)Q rd to t.u4 - ay)cho!Lx�% Mailing address (2) Zip Code Ras) (0 y S I-() Legal description (Lot, Block & Sub'c Legal description (Section, Townshif Lot Size 31 SF I Q Acre Sq.Ft. Number of Bedrooms THIS APPLICATION IS FOR: 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!715-0-YA Date of Payment: 2. /0z Waiver Fees: Dale of Payment: Receipt Number: 02x043 Receipt Number: (Rev. 12100) x LOT 4 i I I Ls„v.as-ssi a.. c. i 0 1106.7 0 1 o cn I 0 1 CD I rn C, -I i W � i I !n M O z' I— Z M 1 rn � D N rn 1 rn z 1 1 1 PQ W i (D W 5/8" REBARR SET * FND 1.5" PLASTIC MONUMENT SET- =ENCE- —X— X — )VERHANG- NOOD DECKS- CONCRETE- 0 ASPHALT- [ EASEMENT LINE- — — — SEPTIC STANDPIPES- S� WATER WELL- ELEV (DATUM ASSUMED) ioo.o' oab0000DO4 Q O A�,�s�oOp o�Q p'..49TH....y.� F9 Qp� '•, Mark E. Davis 2 �a po LS -7338 p ' �jO1 �6�, \5- 4�4QQrOfessiono) �'a°� C"' 0� g tv��4 Q Pu a3\ tC Se\\tom S 90000'00" E LOT 5 RGUSON �--- foo' �U�'V- t 0 481.1 LOT 6 15 [;v4 -r LLUAL ULSUKIN I IUN: A S — BUIL_T O F": �GOVERNMENT LOTS 5 AND 6, ND & CONSTRUCTION SURVEYORS-PLANNERS-ENGINEERSS.3 T11N R3W S.M., ALASKA 0 WEST BENSON BLVD. # 103 >> >CHORAGE, ALASKA 99503 562-5291 (F)561-6626 ORDER NUMBER: DAre: scALE: EXCLUSION NOTES: It is the owners' responsibility Under no circumstances should N OV. 21, 1995 1"=100'todetermine the existence of any easements, any data heron be used for SL -9416 DRAWN BY: CHECKED BY]GRID NUMBER: cOVenant9, or restrictions which do not appear construction or for establishing DMD. t. 3336 on the recorded subdivision plat. boundary or fence lines. WF PAGE MUNICIPALITY OF ANCHOP~AGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL SYSTEM PERi, IT PERMIT NUMBER:SW940349 DESIGN ENGINEER:DUMMY COMPANY OWNER NAME:FERGUSSON J A & MARSHAL OWNER ADDRESS:16860 OLD SEWARD HWY ANCHORAGE, AK 99516 DATE ISSUED: 9/09/94 EXPIP~ATION DATE: PARCEL ID:02009101 LEGAL DESCRIPTION: TllN R3W SEC 3 LT N W2 LT 6 5 N2 & PT LOT SIZE: 315810 (SQ. FT.) NUMBER OF BEDROOMS: 5 THIS PERMIT: 5 THIS PERMIT IS FOR THE CONTRUCTION OF: WELL SYSTEM 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 DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 (24 HOURS) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AlVD CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. 1 OF 1 ll4-0 9/09/95 SPECIAL PROVISIONS: THE WELL LOG MUST BE FILED WITH THIS OFFICE WITHIN 30 DAYS AFTER COMPLETION OF THE WELL. THE WELL LOCATION MUST BE 100 FEET OR MORE FROM ANY PART OF THE SEPTIC SYSTEM. / N 90°00'00'' LOT 4 21.85' PROPOSED HOUSE LOCATION F= 154.0' Z LOT 1 1.38,107 s.f. HOUSE '~I ' DETAIL ~j ~z~.o , 17.5 EAVE O/H ORDERED BY: JIM FERGUSON with KIEWIT CONSTRUCTION Co. LOT 2 S 90'00'00" E 481.17' LOT 5 NOTES t s the owners' responsibility to determine I EXCLUSION the ex's once of on easements, covenants, or restrictions which do not oppe~Yr on the recorded subdivision plat. NO]E: It CERTIFICATION: LANTECH has conducted a survey of this property os shown on this and to the best of our knowledge and all dimensions hove been measured true PLOT PLAN OF: LEOAL DESCRIPTION: LAND & CONSTRUCTION SURVEYORS-PLANNERS-ENGINEERS 440 WEST BENSON BLVD. # 105 ANCHORAGE, ALASKA 99505 (907) 562-5291 WORK ORDER NUMBER:AUG.°Art 12, 1994 ISC^L[:i,,=iOO, ,l(fo×) 561--6626 LOT 6 .EOEND: SET FND ,/8"RB W/CAP(~) 5/8" RB O ,25' ALMON. 4~DONUMENI CONCRETE~ i'; , · 'J ELEV,(NO DATUM)- ~ LOT 1 MALLARD VIEW SUBD. (PROPOSED) LOCATION OF WELL BOROUGH ~P,~ ~ o ~ ,~ ?1o I SUBDIVISION I-0~1 BLOCK SECTION QTRS j DEPARTMENT OF NATURAL RESOURCL~; DIVISION OF WATER WATER WELL RECORD SECTION /J ~" ,.~ C~E os O!~w MERIDIAN WELL OWNER: kQCATION/SKETCI~: DEPTHS MEASURED FROM:[]casing top ~]ground surface Il WELL DEPTH: DATE OF COMPLETION Depth of hole: ft q¢ Material Type and Color From To .J DEPTI~ T_O STATIC WATER LEVEL: 2~ ft below ~top of casiGg [] ground surface METHOD OF DRILLING: [~J~air rotary [] cable tool [] other \/ USE OF WELL: ~domestic [] irrigation [] monitor [] public supply [] other CASING STICK-UP:. c.~ ft. Diam: ~ in. to ~' ft Casing type: ~)~"¢~-~ (~n in. to ,:/L.--/ ft WELL INTAKE O~NING TYPE: [] open end [] screened [] perforated ?ox, open hole Depths of openings: to ft SCREEN TYPE: Diam: m Slot/Mesh Size: Length: GRAVEL PACK TYPE: Volume used: Depth to to GROUT TYPE: Depth: from ft LEVEL AND ~;~E~LD: ,~ ft after hr~ pumpiog PUMP INTAKE DEPTH: ft Horsepower: WELL DISINFECTED UPON COMPLETION? [] YES gpm [] NO CONTRACTOR INFORMATION: · ,nc ~gnal~e ol Authorized I~espre~'live REMARKS: PLEASE MAIL WHITE COPY OF LOG TO: DNR/DIVISION OF WATER PO BOX 772116 EAGLE RIVER AK 99577 2116 PERFORMED FOR: ~diib"~ Te~Iinldal l~iSivlces 14530 Echo Street .Anchorage, g. laskc~ 99518 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG m PERCOLATION TEST . LEGAL DESCRIPTION: N Y~.~ NJ/v~ Y~-, 5Ia/~ ~ Y~,~" ~/~Township, Range, Section: ¸ PT GFt siLTY GRAVEl.. ~'~r~ $OHE RooTS 3- GP/GM FR~cT uR~b ROCK TE&T ~OAE ~oo~ LIK~ 7- 8- B~ HANb. 9- 10- 11 13- 14- 15- 16- 17 18 SLOPE I I WAS GROUND WATER ENCOUNTERED? S L !F YES, AT WHAT O DEPTH;) Oeplh to Water ADer Moniloring? 30, 'T'IzN, R2~.,'.. SITE PLAN Reading Date Gross Net Depth tO Net Time Time Water Drop PERCOLATION RATE TEST RUN BETWEEN COMMEN~s , __ (minutes/inch) PERC HOLE DIAMETER __ FT AND PT CCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. 72-008 (Rev; 4/85) CERTIFY THAT THIS TEST WAS PERFORMED IN DATE; "7 / 1~'/~ f PERFORMED FOR: ~6ftb~ Tebhn~c'a! S~v~ce.~ 14530 Echo Street ~Z/dhorage, ~laskc~ 99516 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG'-- PERCOLATION TEST - LEGAL DESCRIPTION: N ~j N~A/Y~, 5[4/~, ~' Y~,.~' ~/qTownship, Range, Section: SeC 3o, 'r'l~. N, R2 Iv'. 1 2~ 3~ 4- 6- 7 8 9 10 11 12 13 15 17- 18- 19- 20- PT SITE PLAN 5~ N~3"~ 31LTY No COBB LES COMMENTS LOOSE DISTliSt T TO So~ ~ b GRAVEL Bock SLOPE I II1 1 I !_;Il I I WAS GROUND WATER ENCOUNTERED7 IF YES, AT WHAT bEPTH?~ 8epth to Wafer Aller r. Monitoring? Reading Date Gross Net 'Depth to Ne~ Time Time ('~lN~) Water Drop 3;~ 2o Y~ HaO ~:38:zo 27 -- 3;~ 2~ PERCOLATION RATE ~' I (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN 3,~' FT AND ,. ,~.0 FT ACCORDANCE WITH ALL ST~rE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. 72-008 (Rev. 4/85) CERTIFY THAT THIS TEST WAS PERFORMED OATE: . ?/h~ /PI MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section - Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 020-091-82 1. GENERAL INFORMATION Expiration Date: 12" Z 7r Z% Complete legal description Mallard View Sub, Lot 1 Location (site address) 16860 Old Seward Hwy, Anchorage, AK 99516 Current property owner(s) Jim & Marsha Fergusson Day phone (907)348-0047 Mailing address Real estate agent 16860 Old Seward Hwy, Anchorage, AK 99516 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 5 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Private Septic ❑ Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer 7 Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 2 00 1 Date of Payment Receipt Number 0 1 d y (o D COSA#_ OSGZI 1-732-1 Waiver Fee $ Date of Payment Receipt Number 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 Forge Engineering Phone (907) 522-7773 Address 1399 W. 34th Ave Suite 101, Anchorage, AK 99503 Engineer's Printed Name Benjamin Schiller, P.E. Date 8/25/21 PD s .49 TM / 6. DSD SIGNATURE 5 .. ......r......... System #1 Approved for bedrooms / Benjam�n-Schiller System #2 Approved for bedrooms �i�• 8/25/292..��``�` Disapproved i��F�PROFESSIONP� Conditional approval for bedrooms, with the following stipulations: llll(l((fr�r P F�i�� VVAS ,.. R,AN p m J�o PRoGhA R o= By: Original Certificate Date: 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: Mallard View Sub, Lot 1 Parcel ID: 020-091-82 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 0.52 gpm Date drilled Unknown* Water storage tank volume gallons Total depth 139** ft Well disinfected for coliform test? ❑ Yes ❑ No Cased to Unknown" ft ❑Coliform bacteria is Negative ®❑ Sanitary seal is functioning correctly Nitrate mg/L 01 Nitrate less than MRL (ND) no Wires are properly protected Arsenic ug/L ❑ Arsenic less than MRL (ND) Casing height (above ground) 24 in. Collected by Forge Engineering Date of flow test for COSA 8/17/21 Date of Sample $/9/21 Static water level at beginning of test 47 ft. Comments * No Well Log ** During testing well ran dry —139' DATA Age of tan years Tank type/material Measured operating fluid level i tic ❑ Standpipes/foundation cleanout per Date of pumping tank drawing SORPTION FIELD DATA Which sys sted (date installed) ❑ ALL standpipes p t per record drawing Total measured depth from gra ft (max) Measured depth to pipe invert from gra ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet T STATION ❑ Require intenance completed Age of lift station ears Lift station material Comments: Adequacy test date Results EJ Pass For bedrooms Fluid depth prior to test in Water added gal New depth in lapsed time min Final epth in Absorption rate gpd Any rejuvenation treatmen st 12 months) If yes, enter date 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' F✓ Yes Community Sewer Manhole/Cleanout > 100' ft [✓ Yes if No ft M Yes if No ft Neighboring Tank > 100' Yes if No ft Private Sewer/Septic Line > 25'✓Q Yes if No ft Absorption Field on Lot > 100' ❑✓ Yes if No ft Holding Tank > 100' ❑✓ Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' Yes if No ft n✓ Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' [✓ Yes if No ft Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' Q✓ Yes if No ft Surface Water > 100' Yes if No ft Property Line > 5' ✓V Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ED Yes if No ft Private Wells > 100' 0✓ Yes if No ft Water Main > 10' Yes if No ft Community Wells > 200'✓❑ Yes if No ft Water Service Line > 10' Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' E✓ Yes if No ft If absorption field is under driveway comment below Property Line > 10' F✓ Yes if No ft Wells on Adjacent Lots: Water Main > 10' Yes if No ft Private Wells > 100' 0✓ Yes if No ft Water Service Line > 10' 0✓ Yes if No ft Community Wells > 200' ❑✓ Yes if No ft Surface Water > 100' ✓V Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that l have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. COSA Checklist yellow sheet OF A 50 *�0 • ' Benjam' &hiller 9 FFG' •. CE 12592�� 8/25/21 PROFESSOO September 23, 2021 PO BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) FORGECIVII.COM MOA Development Services, On -Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Mallard View Sub, Lot 1-16860 Old Seward Hwy Irrigation well Dear On -Site Services Engineer: The subject property has a second well which is not being used for drinking and is only used for irrigation purposes. The well is connected to power and fixtures are in place for collection points. A water sample was taken and the sample results are attached. As far as we can tell, this well is in compliance with MOA code. Sincerely, Benjamin Schiller, PE Municipality of Anchorage Development Services Department s"= Building Safety Division F F 7 Y On-Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Water Well Advisory Certificate of On -Site Systems Approval (COSA) # OSC211521 During a recent COSA on-site inspection and test of the potable water supply well on Lot 1 of Mallard View subdivision, the well's productivity was determined to be .52 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 5 -bedroom residence is .51 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. WATER & WASTEWATER UTILITY 401 W. INT'L AIRPORT RD. PHONE: 564-2762 CONNECT PERMIT SCHEDULED COMPLETION DATE (SINGLE FAMILY F", MULTI -DWELLING No. APTS- 1-2 COMMERCIAL LOT/TRAct, BLOCK SUBDIVISION % TAX CODE GRID- AS -BUILT No. STREET ADDRESS OWNER MAIL ADDRESS PHONE CONTRACTOR: ASSESSMENTS J REPAIR EXISTING SERVICE Ll ON PROPERTY ONLY i To be levied upon connection MAIN TAP- TO PROPERTY LINE ONLY J Main extension agreement U Improvement District J MAIN TAP & ON PROPERTY CONNECT C! Extend connect agreement U Pending 'j RJ Paid -O-W NO. CONNECTION SIZE INSPECTION PERMIT - CHARGE $ FEE FEE PERMIT ISSUED BY: 0 PAID 11 CASH 'D CK#- REIMBURSIBLE INSPECTED BY: NUMBER DEPOSIT $ &, TOTAL $ DATE: Z REMARKS: PERMITTEE (Please Print) PHONE MAIL ADDRESS_,___. ....... IHAVE READ THE CONDITIONS AND REGULATIONS ON THE REVERSE SIDE OF THIS PERMIT AND AGREE TO COMPLY WITH THEM. PERMITTEE SIGNATURE POST IN A CONSPICUOUS PLACE AT THE J 916 -ITE 31-122 (Rev. 11189) d-Y " A74)'d t7 \ : : | � }&}\ |� cjx 5/E' REBARR SET (j) END C I., PLASTIC MONUMENT SET -Q ENCE- —X-- X — )VERHANO- 4OOD DECKS- YONCREF- ('�'t^•t ASPHALT- ..."�-.'-„,-�•.-- EASEMENT UNE - SEPTIC STANDPIPES -Q WATER HELL- glia LOT 4 I °6 1 I ,p I I \ i a I I N t 06.7 O i ........ ...... LT1 I 0 1 0 I I M i n =-I I -----' - 0,1 'i1 IzTt i % 5.3' t.0 11 rn D i w 25.4 D v HOUSE ; m DETAIL o 4.7' Z o „ 18.0'4: w i t0 N I 111 11, f P I o w I I 1 � 01.. I I I I i q�S'EH•A� � �OOt �r`s1Z'C'C1uK �10 S 90.00'00” E 481.17' _ LOT 5 RGUSON LOT 6 -15 ul III LttiAL Utat;rar I IUN: I AS—BUILT O F. GOVERNMENT LOTS 5 AND 6, LAND & CONSTRUCTION SURVEYORS—PLANNERS—ENGINEERS S.3 T11 N, R3W, S.M., ALASKA 440 WEST BENSON BLVD. # 103 r ANCHORAGE, ALASKA 99503 562-5291 (F)561-6626 WORK ORDER WMSER: oAM ;scut: EXCLUSION NOTES: It 1s the o—a,. responsiblity Undar no ci...—tonces should NOV. 21, 1995 1"=100' to determine the axisfence of y easements, any data h— be used for 94 -SL -9416 a n sr. a¢am "1 r cwo tiusuc covenants, or restrictions which not appear construction or for ectoblishing DMD. t. 3336 on the recorded subdivision Plot. boundary or fence ilnes. Legend Y, Electric Meter E] Concrete /T� Tel. Pedestal 17. Mailbox A LEA Elec. Pedestal �+ Fence ($; Sewer C.O. ® Deck W Water Well General Notes Excepting for gross negligence, the liability for this survey shall not exceed the cost of preparing this survey. Dimensions to property lines are plus/minus 0.1ft. This document is created by Frontier Surveys for the purpose of an as -built survey for Mary Cox, only. This document is based on Plat No. 96-20, Anchorage Recording District. UNSUBDIVIDED Disclaimer 1. This survey complies with the ASPLS Mortgage Location Standards. The survey represents visible improvements and conditions at the time of the survey. This document does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may reveal. It is the responsibility of the Owner to determine the existence of any easements, covenants, or restriction which do no appear on the record plat. Under no circumstances should this document be used for construction or for establishing a boundary or fence line. 0 25 50 100 Scale in Feet O F q Zq1111,,,, 4pterjrm.st • . • gier • .. • •�iio_ ''N. LS -9812 ,• • .>�� 'f 8/17/2021 J`V