HomeMy WebLinkAboutMAJESTIC VALLEY ESTATES BLK 1 LT 4
Municipality of Anchorage
• Development Services Department= =_
Building Safety Division �=
On -Site Water & Wastewater Program, 4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us (907) 343-7904 Page 1 of 3
On -Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: SW030333 PID Number: 050-731-15
Name: AL & CHRIS DORDAN
Wastewater System: ❑ New ■ Upgrade
Address:
P.O. BOX 140442 * ANCHORAGE, AK * 99514
ABSORPTION FIELD
Phone: No. of Bedrooms:
(907) 696-7783 3
■ Deep Trench []Shallow Trench ❑ Bed O Mound ❑ Other
LEGAL DESCRIPTION
Sol Rating;
Total Depth from anginal grade:
Total
9.5 (MAX)
GPD /sy: Ft
Fc
Block: Lot: Subdivision:
Depth to pipe bottom from original grade:
Gravel depth beneath pipe:
1 4 MAJESTIC VALLEY ESTATES
5.0 (MAX) Ft.
4.5 Ft.
Township: Range: Section:
Fgl added above original gmdw
Gravel length:
— — —
SEE DWG. Ft.
42 Ft.
WELL:
Gravel width:
Number of linea:
Distance between linea:
New [I Up
2.5 Ft.
1
— Ft.
Closeification (Private, A,D,C): Total De
Cased To:
Total absorption area:
Pipe material: -
Ft.
Ft,
378 so. Ft.
D 3034/ F-810
Driller. Cj Date Drilled:
,'A'51
Static Wotsr Level:
Installer.
AKWWC INC.
Dote installed:
9/12/2003
FL
Yield:Pump
Set At:
Casing Height Above Ground:
TANK
GPM
�.
Ft.
SEPARATION
DISTANCES
13Septic 13 Holding ❑S.T.E.P. 13 Other
To
Septic
Absorption
Lift
Holding
Public/Private
Manufacturer. \N
Capacity In gallons:
From
Tank
Field
Station
Tank
Sewer Lines
Well
100'+
100'+
—
—
25'+
Material:
Number of compartments:
Surface Water
100'+
100'+
—
—
—
LIFT STATION
Lot Line
5'+
*1'+
—
—
—
Size in gallons:
Manufaduror.
Foundation
5'+
10'+
—
—
—
*Pump on Isvel at: mp at -High
water alarm at:
Pump Make odah
Dectricol Inspection performed by:
Curtain Drain
NO KNOW
Remarks: *WAIVER GRANTED #WR030069
BENCH MARK
Location and Description:
OUTLET BAFFLE WAS REPLACED ON THE SEPTIC TANK
BOTTOM OF SIDING ON HOUSE
Assumed Devation:
100.00
e.
ENGINEER'S SEAL
�ca"�'pgq
AKWWC,
Inspections performed by: INC. Dates: 1st 9/12/2003
..:..... ............*��Q�
2nd 9/12/2003
Q t
.........
3rd 9/12/2003
f A. Gar ess. DO
Development Servpqes Department Approval
���- -7 3
44
..
a\ o�
Reviewed and approved by: Date:—/O 3 °3
of40 f essia C. G
(Rev. 12/01) k I I I IQ
q`�QpG
�1i
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 WASTEWATER DISPOSAL SYSTEM PERMIT
Initial
Date Issued: Aug 26, 2003
Expiration Date: Aug 25, 2004
Permit Number: SW030333 Parcel ID: 050-731-15
Legal Description. NIAJESTIC:uALLEY ESTATES;BLK 1 <LT 4 ,,
Design Engineer: 0041 AK Water & Wastewater Consultant Site Address: 025805 LOUINDA CIR
Owner Name: Al & Chris Dordan
Owner Address: PO BOX 140442
ANCHORAGE, AK 99514-0442
Lot Size: 49612 SO. FT.
Total Bedrooms: 3 Permit Bedrooms: 3
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:
t
.�
Date:
Issued By: Date: 8 2u 03
8/26/2003
Municipality of Anchorage
Mark Begich, Mayor
Building Safety Division
P.O. Box 196650 • 4700 Bragaw Street
Anchorage, Alaska 99519-6650 • (907) 343-8301 • Fax (907) 343-8200
http://www.muni.org
Jeff Gamess, P.E.
Alaska Water and Wastewater Consultants, Inc
3701 E Tudor Road, Suite 101
Anchorage, Alaska 99519
Subject: Waiver Request for Majestic Valley Estates Block 1 Lot 4
Waiver Request #WR030069
Parcel ID #050-731-15
Permit # SW030333
Dear Jeff Gayness:
Your request for a waiver of the required 10 feet horizontal separation from the
absorption field to property line has been approved. The approved separation distance is
1.0 feet.
This waiver approval applies to the existing absorption field to property line separation
only. Any future upgrade to the on-site wastewater disposal system will require all
separation distances be met or another approval from this department.
If there are any further concerns or questions regarding this waiver, please call our office
at 343-7904.
Sincerely,
rtnginleer
On -Site Water & Wastewater Program
Municipality of Anchorage
¢AG£ BGS
Development Services Department s <a
Building Safety Division:
On -Site Water and Wastewater Program
4700 Bragaw Street s " £'
P.O. Box 196650 Anchorage, AK 99519-6650
www ci.anchorage:ak.us
(907) 343-7904
Waiver Review Worksheet
WR#: 030069 PID#: 050-731-15 HA#: - Permit#:
Date Received: 8/12103
Legal Description: Majestic Valley Estates Block 1 Lot 4
Engineer: Alaska Water & Wastewater
3701 E. Tudor Road Suite 101
Applicant: Ai & Chris Aordaro
Waiver Requested: 1 Foot Lot Line Waiver to the West Lot Line
Criteria: Geology Points:
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
Total:
■.■.r.■■r■■r�■�■■cis■■■rar■■rrrr.■■■■■-�■■■■■:�.■■■■■■r:■■■■■r■ a ■rr.■r■■rra■■rr■■r:■s■■
Waiver is Granted: Waiver is not Granted:
List Conditions or Reasons for above:
Date: �ji4 v By: l
Name of Reviewer
■ra+r a rr;�■rr■■':.r■■■■■�.■■■•■4�■■■■■■'■■■■�;r:■■■■■�r■■rr'Y.■■■■r■-■.•■■■r■.:�■■■■:■.r r.■:•■■■
Rec#: 39998 Amount: $150.00 Date Paid: 8/12/2003
Municipality of Anchorage
• ''� Development Services Department
Building Safety Division
On -Site Water & 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. t Permit Number
Property owner(s) AL & CHRIS DORDAN Day phone 696-7783
Mailing address (1) P.O. BOX 140442 * ANCHORAGE. AK
Mailing address (2) Zip Code 99514
Legal description (Lot, Block & Sub'd.) LOT 4. BLOCK 1: MAJESTIC VALLEY, ESTATES _SUBDIVISION
Legal description (Section, Township & Range) N/A
Lot Size t(J,7i Acres/Sq.Ft.
THIS APPLICATION IS FOR:
Number of Bedrooms 3
Sewer Only ❑ Well Only ❑
Sewer and Well ❑ Water Storage ❑
Sewer Upgrade 0
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.
ALASKA WATER & WASTEWATER CONSULTANTS INC.
Permit Fees: �00 a
Date of Payment: 2S -11-03
Receipt Number: J1 1 Cl O
Waiver Fees: a®`
Date of Payment:
Receipt Number: 1
ALASKA. NATER & WASTEWATER
9. M& CONSULTANTS, INC.
August 8, 2003
Municipality of Anchorage
Development Service Department
Building Safety Division
On -Site Water & Wastewater Program
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Proposed Septic Upgrade for Lot 4, Block 1; Majestic Valley Estates Subdivision
To whom it may concern:
The existing 3 bedroom house is served by a private well and septic system. The septic system
consists of a 1000 gallon concrete septic tank and a trench type drainfield. The drainfield is
surcharged and needs to be upgraded. A test hole was excavated south of the drainfield. The new
drainfield will be designed around the 30 foot radius of this test hole. We are proposing that the
inlet/outlet baffles on the existing septic tank be exposed and the integrity verified. If the
integrity is poor, than we will install new inlet/outlet baffles. We are also proposing that a trench
type drainfield be installed. Comments regarding the design are summarized as follows:
1. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring,
and the percolation test results. It is our opinion that an application rate of 1.2 gallons/day/fe
should be used.
2. TRENCH DESIGN:
a.
Percolation Rate: <1 minutes/inch
b.
Proposed Application Rate: 1.2 gallons/day/ft2
c.
Number of Bedrooms: 3
d.
Design Flow: 450 gallons per day
e.
Minimum Absorption Area: 375 ftZ
f.
Total Depth: 9.5 feet (max.)
g.
Effective Depth: 4.5
h.
Width: 2.5 feet
i.
Reduction Factor: N/A
j.
Minimum Length: 42 feet long
k
Effective absorption area = 378 ft2
3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic
system.
3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com
4. TOPOGRAPHY: The area for the proposed drainfields is a 5t percent slope running
approximately north to south. The area below the drainfield is a 20-25 percent slope. In short,
there are no slope concerns.
5. LOT LINE WAIVER: We request a 1 foot lot line waiver to the west lot line. We are
unaware of any adverse impacts with the granting of this waiver.
We are unaware of any adverse impacts this installation would have on adjacent wells or septic
systems. If you have any questions, please contact us at 337-6179. Thank you for your
M.S.
NOTE: .4 site plan drawing, a design drawing, a soil log, and a 7 page construction specification
letter which are all part of the design package for this septic system.
3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com
I \ / \
I
/ !
E \`\ MAJESTIC VALLEY ESTATES I
100' WELL RADIUS
\\ LOT 2, BLOCK 4
I \ t I
I \ \ 0
/MAJESTIC VALLEY ESTATES
I MAJESTIC VALLEY ESTATES ` �\ // LOT 3, BLOCK 4
LOT 5, BLOCK \
.100' WELL RADIUS 1
\ `\
�i TH#1
I
i
I � _
DENALY S/D;
LOT 4, BLOCK 1j `\
I
i \
I \ ,
i
____
I
\
DENALY SUBDIVISION;
LOT 10, BLOCK 1,
DENALY S/U; \
LOT 11, BLOCK 1,
EXISTING SEPTIC
\_ SYSTEM
` LOUINDA CIRCLE
PROPOSED SEPTIC UPGRADE
DESIGN PAGE 2 OF 2)
ALASKA WATER & WASTEWATER
CONSULTANT&INC.
701 F. TUDOR ROAD. SIIITF IOI • Amr HORAGF. AK 005n7 • PWnKIP (On7)3i7-A170 . FAY f0n7MiA_iI/.A
MAJESTIC VALLEY S/D;
LOT 1, BLOCK 4,
DATE:
8/8/2003
DRAWN BY-
C.J.G.
SCALE:
1 " = 100,
PREPARED FOR PHONE NUMBER: PAGE NUMBER:
AL & CHRIS DORDAN (907) 696-7783 1 1 OF 2
MAJESTIC VALLEY ESTATES SUBDIVISION; LOT 4, BLOCK 1
OF WORK:
SITE PLAN FOR PROPOSED SEPTIC SYSTEM UPGRADE
EXISTING
3 BEDROOM
HOUSE
�\
\\
\
MAJESTIC VALLEY ESTATES
LOT 3, BLOCK 1 \\
y^:
100' WELL RADIUS I
` LOUINDA CIRCLE
PROPOSED SEPTIC UPGRADE
DESIGN PAGE 2 OF 2)
ALASKA WATER & WASTEWATER
CONSULTANT&INC.
701 F. TUDOR ROAD. SIIITF IOI • Amr HORAGF. AK 005n7 • PWnKIP (On7)3i7-A170 . FAY f0n7MiA_iI/.A
MAJESTIC VALLEY S/D;
LOT 1, BLOCK 4,
DATE:
8/8/2003
DRAWN BY-
C.J.G.
SCALE:
1 " = 100,
PREPARED FOR PHONE NUMBER: PAGE NUMBER:
AL & CHRIS DORDAN (907) 696-7783 1 1 OF 2
MAJESTIC VALLEY ESTATES SUBDIVISION; LOT 4, BLOCK 1
OF WORK:
SITE PLAN FOR PROPOSED SEPTIC SYSTEM UPGRADE
1r
EXISTING DRAINFIELD TO BE
USED AS A RESERVE SITE
FLOW
INSTALL DOUBLE
CLEANOUTS
EXISTING 1000 GALLON
CONCRETE SEPTIC TANK TO
BE EXCAVATED OUT AND _
\ THE INTEGRITY VERIFIED,
NG y� \\ \ EXISTIC�O�ATION \
PROPOSED DRAINFIELD.
EXCAVATE A TRENCH THAT IS F \
9.5 FEET DEEP MAXIMUM BY �, \
2.5 FEET WIDE BY 42 FEET \
LONG. ADD 4.5 FEET OF CLEAN, I •:''.
WASHED SEWER DRAINROCK. ' •''
xA'' yk4,
Uj
t
3
' o
NOTE: THE CONTRACTOR SHALL \
HAVE THE WEST LOT LINE FLAGGED *" "• ''
PRIOR TO CONSTRUCTION.
w K.
_. 8/8/2003
04 OF o�4
A
DRAWN BY:
AJ.,ASKA. WATER & WASTEWATER
C.J.G.
!
SCALE:
CONSULTANTS, INC.1
" = 40'
�............ . .... ........
3701 E. TUDOR ROAD, SUITE 101 " ANCHORAGE, AK 99507 " PHONE (907)337-6179 - FAX (907)338-3246
PREPARED FOR: PHONE NUMBER:
PAGE NUMBER:
AL & CHRIS DORDAN 696-7783
2 OF 2
..... a A. ness.
0003
LEGAL DESCRIPTION:
. E 7953 ,•'
MAJESTIC VALLEY ESTATES SUBDIVISION; LOT 4, BLOCK 1,
uV�edp ..'essiov\O\,o—>�p
TYPE OF WORK:
DESIGN OF PROPOSED SEPTIC SYSTEM UPGRADE
09 O4
wilm
AEASKA WATER & WASTEWATER H �Sy��9p
CONSULTANTS, INCANCHORAGE, AV- 99507 * PHONE- (907)337-6170. tr ,t DO
ta w°. ........ ... ..............
E 7UDOR ROAD, SUITE 101
•SOIL LOG — PERCOLATION TEST 0
LEGAL DESCRIPTION: MAJESTIC VALLEY ESTATES; LOT 4, BLOCK 1; QO ' .J f e A. rness., QQ
—7953 � o`Q
PERFORMED FOR: CHRIS DORDAN DATE: 7/31/2003 pOm ,kp
DEPTH ���� ORGANICS �0 a °&
(feet) — TEST HOLE ��D000q�`��
FILL SOIL CLASSIFICATIONS i
,.o GW ORG
3 ORGANICS """GP ML'
GM CL /
GC OL
4 SW MH
�••• SP CH
5 SIM OH �y
$r, SC TH#1 114
SC
6 w\ `
�A ,t y
9
SITE PLAN -'
GP—GM�x.
TO
1"=100'
'
10—
S
P—SM
DATE READING CLOCK NET TIME WATER LEVEL NET DROP
11 ; TIME (MINUTES) READING (INCHES)
12 fir: POpE�
13 R=v" S el
�R P
14
15
16 B.O.H. G NO
17
5
18
19 PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 6.0 FT. AND 7.0 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES N NO
SOILS LOGGED BY: JODY MAUS PERCOLATION TEST PERFORMED BY: NICK HEITSTUMEN
COMMENTS: THE NATURAL SANDY INSITU SOILS WILL ACT AS A SAND FILTER
PERFORMED BY AKWWC, INC. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WA ERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: II D
DEPTH TO
GROUNDWATER
DATE
DRY
7/31/2003
DRY
8/7/2003
ti GREA. C'R ANCHORAGE AREA BM. -J'GH
,EM,
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
�/I,N/SPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME 1 105- (7f11I,e'Le' S MAILING ADDRESS PC �.�0� 3G� L�f%'�C- `Y� PHONE 4'f' -�» t
LOCATION efC �Agx �/� �/r �o�iU LEGAL DESCRIPTION /- - �7 I�CC&� e%p��5r 12�
SEPTIC TANK:
DISTANCEr NUMBER OF
FROM WELL /z 3 MANUFACTURER 1141';4 /PV MATERIAL (7em er- —COMPARTMENTS—'
INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY -4-0-0-e-2 GALLONS.
T �',VC %F•
SEEPAGE PtT:
NUMBER OF PITS DIAMETER OR WIDTH_, LENGTH_, DEPTH
LINING MATERIAL ���� CRIB SIZE: DIAMETER_DEPTH DISTANCE FROM: WELL /53'
r TOTAL EFFECTIVE a
BUILDING FOUNDATION z 7, NEAREST LOT LINE ABSORPTION AREA (WALL AREA) �0 SQ. FT.
ADDITIONAL ABSORPTION N
WELL:
TYPE De'-1�1c'17
CONSTRUCTION .�
�r%'�t%�V
,,ii
DEPTH //0 DISTANCE FROM:
BUILDINGNEAREST
NEAREST
SEPTIC SEEPAGE i
TANK
FOUNDATION
LOT LINE
SEWER LINE
, SYSTEM
CESSPOOL
OTHER SOURCES
APPROVED
DISAPPROVED
REMARKS
DISTANCES: DIAGRAM OF SYSTEM
INSTALLED BY:Fhf 9CC���Lrfjn% r
" y9• 3 �,rl ,VIG• � (�� ��
PIPE MATERIAL: 441_ CI s TCo��
f'ceF five
LOT SLOPE: tit
REMARKS: %G rS T V / PR�J�� GC kr/.7ee P/PGI
/75 Z71 1
DATE %5 APPROVED
G.A.A.B.
Form No. E0-031
GRE, ER ANCHORAGE AREA BOi. )UGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
,/ 3330 "C~/~TREET ANCHORAGE, ALASKA 99503
jr/~ TELEPHONE 274-456 !
II
SI:WAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
INSTALLATION LOCATION
INSTALLATION OF: SEPTIC TANK - SEEPAGE PIT
~T
E~ THI~ PERMIT IS NOT VALID WITHOUT ~OIL
COMPLETION DATE ANTICIPATED
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WiLL be SUBJECT TO PROSECUTION.
MINIMUM DISTANCES, REQUIREMENTS DIAGRAM OF SYSTEM
/
FOUNDATION TO SEPTIC TANK
FOUNDATION TO ~EEPAGg PIT ., DRAIN F~
SEPTIC TANK TO SEEPAGE Pit WALL
TO NEAREST LOT LINg.
WELL TO SEPTIC TANK /~ SEEPAGE Pit
DRAIN FIELD ALSO CONSIDER AREA WgLLS,
WATER MAIN TO SEPTIC TANK , SEEPAGE PIT
DRAIN FIELD.
TO RIVER, LAKE, STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITN AIRTIGHT REMOVABLE CAPS. ~<~ /
CONFORM TO BOROUGH I:~GU~ATIONS REGARDING INSTALLATION,
rn
-� LOG OF DRP4�.I NG by A & L DRI LU' G COMPANY
OWNER OF LAND .... 5..~1y1�/A�LI��S.. ............. _......... DEPTH OF WELL.......1 ..[................► P .:.......
ADDRESS........................................................... _.................................... .. STATIC LEVEL OF WATER FT....6.
.
L/ t / �/�J'ES/i C /
WELLSITE.,C.Q.�...7p•--5�.................................................................... DRAW DOWN FT. ..... h�...................................................
DATE -STARTED ....... fJ...1..2.Q1T..S..................................... _............... GALS. PER HR. ..... J.;Z.........................._...................
DATE—ENDED ........V1 ..179 ...................................................... KIND OF CASING ..... v.. ...................................
KIND OF FORMATION:
FROM ........ 4. .......... FT. TO..... ........... FT....,SFC^GISFR'W✓r�...............FT. TO ........................ FT...............................
FROM...pL.i.............FT. TO ... .... ri..C....... FT...//l.^J.il.vQ� FROM ........................ FT. TO ........................ FT...............................
FROM......
IIcc........FT. TO.... 7.k ........FT.........f h R. / FROM........................FT. TO ........................ FT,
FROM........I..Q..........FT. TO.....Q...�.._....... FT .......... � .- �4' FROM`...........�..........FT. TO........................FT.
FROM... �...............FT. TO .... f.�.g.......... .,1
.FT.. ...........
:.�s.�'' FROM.............. ..... _... FT. TO ........................ FT,
r
FROM........................FT. TO ........................ FT..............
FROM........................FT. TO ........................ FT .............. :
FROM........................FT. TO ........................ FT...............................
FROM........................FT. TO ........................ FT ...............................
FROM........................FT. TO ........................ FT............................... FROM ........................ FT. TO ........................ FT ........................ _.....
MISCL. INFORMATION:
ri(P 41glS.
DRILLER'S NAME /✓/f•
..........................................
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. #
CERTIFICATE OF HEALTH AUTHORITY
APPBOVAL FOR A SINGLE FAMILY DWELLING
1. GENERAL INFORMATION
Complete legal description
Lot 4: Block ]: Majestic Valley Estates SubdivisiQn
Location (site address or directions) 1770 gaqle River Road, gaqle River, Alaska
Property owner
Mailing address
Lending agency
Mailing address
Agent
Address
Kevin Dougherty Day phone 276-1640 wk
694-5084 hm
1770 Eagle River Road, Eagle River, Alaska 99577
NORTHLAND MORTGAGE Day phone
Eagle River, Alaska - ATTENTION: Trish
Day phone
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS: 3 'k/
TYPE OF WATER SUPPLY:
Individual well xxx
Community well
Public water
NOTE:
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE:
xxx
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev. 1/91) Front MOA ¢21
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewaterdisposal 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
$ & $ ENGiNEERiNG
Address 17034 Eagle River Loop Road No. 2(~2J
Eagle River, Alaska 9957'/
Engineer's signature
Phone
Date
DHHS SIGNATURE
./~ Approved for "~
Disapproved.
Conditional approval for
bedrooms.
bedrooms, with the following stipulations:
Additional Comments
By:
1 -4, J I[,J
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.
72-025 (Rev, 1/91) Back MOA ~21
Municipality of Anchorage
Department of Health & Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: I-¢zcd'4~¢ '~:;~-~¢-- I
A. WELL DATA
Well typ~~ If A, B, or C, attach ADEC letter.
Date completed
Log present~'N)
Total depth
Sanitary seal4~Zi~4)
Date of test
Static water level
Well flow
Pump level
Cased to
FROM WELL LOG
Parcel I.D.
ADEC water system number
~ ~'~ ~7~:~ Driller
!
Casing height
Wires properly protected~ZN)
AT INSPECTION
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot
Absorption field on lot
Public sewer main
Sewer service line
g.p.m.
; On adjacent lots
; On adjacent lots
Public sewer manhole/cleanout
Petroleum tank
WATER SAMPLE RESULTS:
Coliform ~ Nitrate
Date of sample: ~ "~'~ g-'
I,I
Collected by:
Other bacteria
B. SEPTIC/HOLDING TANK DATA
Date installed
Cleanouts~N)
High water alarm (Y/N)
Date of pumping
[~'¢ Tank size / ,-~¢-~ ¢,¢~t,. '¢'o~¢d¢;~ Compartments OIL'.
Foundation cleanout ZORN) ~ Depression (Y/j~
Alarm tested (Y/N)
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot
To property line
Surface water/drainage
On adjacent lots / L'°t~1'~ Foundation
_Absorption field ~/'~ Water main/service line
72-026 (Rev. 7/91) Front
t-/~.~ ~-~. ,¢~ t,-¢:; I~,---o~-0~'~-'¢-''-rc~, CONTINUED ON BACK PAGE
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 electrical codes (Y/N)
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot On adjacent lots
Surface water
D. ABSORPTION FIELD DATA
Date installe~d ~ A-¢~¢-c¢,
Length ~,c,..q~ ~4..1;', Width
Total absorption area
Depression over field (Y/~
Results c(.~/fail)
Peroxide treatment (past 12 months) (Y/(~
Soil rating
Gravel thickness
System type
Total depth
Cleanouts present (~'N) "-/
Date of adequacy test "~O- ~.
for '~ bedrooms
¢-~,4¢. If yes, give date "--'- -
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot /
To building foundation
On adjacent lots
Surface water
Curtain drain f-,-~¢-~ ~"-~¢~
E. ENGINEER'S CERTIFICATION
On adjacent lots \ c~¢ .~ Property line
/ ~-~ To existin~ or abandoned system on lot
Cutbank ~4//~ Water main/service line
Driveway, parking/vehicle storage area
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
S & S ENGINEERING
17034 Eagle River Loop Roa~ No. ')04
Signature ~agle ~tive., Alaska ~I~577
Engineer's Name
HAA Fee $ ,/
Date of Payment
Receipt Number
,/
72-026 (Rev. 3/91) Bac~ MOA 2'1
Waiver Fee: $
Date of Payment
Receipt Number
¢...O & C,' / fCC ~ IE_ . ,~s.~u~,~
Anehor~g~ ~e~rdln~ P. reemt~, ~l~sk~, and ffml t~e
lmprovmnents,~dl~mb;,8 .Ihereon m'u wRhi~ the
~ne8 ~n~l do,~ot ove~'~p ,or ~ne~'o~e]~ on lhe~
~'ing adjacent thereto, ~lmt po lmp~uve~en~'s
erly lying a~jac~mt ~h~kefa 6n~oach on 'the :~reml~ea
flu~tio~ and that' th~ o~a ~0 roadxva~s, ~ransmi'3~mt
Jmes q~ oth~ vls!ble, e~em~n~s m],~Aid.~ropm'tF except
Da'ted at Eugle ~tvei','~aska.
SCALE: Re~stere. d Lapd Surveyo~ No, 880-LS
1"= ~t ~ Box: 45O/ Eagle River, Alaska.'
Phon~" 694-.2543
Time
Date
Time
Date
Inspector Inspector
Comments
Date
Conditional Approval
Date Sewer Installed
Soils Rating
Permit No.
Well To Absorption Area
Well to Tank
Septic Tank Size
Holding Tank Size
Well Log Received
APPLICANT FILLS OUT LOWER HALF ONLY
Property Owner FT/7~x ~,-,,--' ~._- rr,~ .~- '---~'- / ~ / /'z ' ,'-~ "- ' - , ~ u'~,,q..~,,,¢~./ .... Phone
MalllngAddress-.~?~//~ 7' ~ '-"-'//"'// /'~./ZJ_~'T' -~ ~'~'/Y' ,/')/"'/~' /~/~-:~/~,~/r,, ¢~..~'¢-.~ ~-?0/-°O'~'~'''~'
Buyer /~1'"/~ V*/'/¢'- f~ b ~" ~/-/' {~f~'~i- ~'
Address
Lendtng Institution £E6P /,---,'-¢ ! ¢¢,-~-,'~,~-- ,of----,, ¢,'-' ,r--, .'~ ~,'~¢,' ,~:.'--9 Phone
Realty Co. & Agent /~" ~ ;~' / ~' ¢'"~ /~' ¢~'"'¢ ~
LegalDescrlptlon¢--''/ ~! ,*'~/~'"'-fl / ,"" /,~-' ,./ ' ~'/fc ~.~/¢~-fz-/' /-..b,.;
Street Location /4.~' //,-¢/ ,~O(.///4.M~,,~- /'~/~.,/'~ ~",~ /~..,~ ¢/_ /.? /'~/f...-/~.--~
Phone
Typej?f Residence
L-J Single Family
[] Multiple Family No, of Bedrooms
E~ Other
Wate~,Supply [] Individual
[3 Community
[] Public Utility
Sew~e Disposal T'] Individual
E] Public Utility
[] Holding Tank
ATTACH WELL L.OG, A well log is required for alt wells drilled since June
1975. For wells drilled prior to tlmt date, give well depth (attach log if
available,) /_.~~
Year Individual Installed:
When Connected to Public Utility:
NOTE: THE INSPECTION FFE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
~ 0
,~0
STANLEY BRUST & ASSOCIATES
Engineers - Planners - Surveyors
Project No. f"~"~7
Adequacy Test Log
Legal Description
No of Bedrooms
Date Time Level Readinss Remarks
tank
- .
STANLEY BRUST & ASSOCIATES
Engineer,s' - Pb~ntters -,~'t~rvt,j,or.~'
1317 Easl 741h Av('nuc
Anchorage, Alaska 99507
{907) 349-6577
~ - PTI C SYS'¥E M
ADEQUACY REPORT
LEGAL DESCRIPTION '
__ SLJBDIV!SION
OR ......... $EC710~4 ~ T _ _ N , R .... W, S.M. , ALASKA
-I'YPE OF SYSTEM '
fiUh,',BER OF B£DkOOMS .........
SEP11C TAi',~K WAS PL~I,;PED E3 YES
E~/ $EFTIC 'lANK - SIZE
0 CRIB OR SEEPAGE PI'T
E~ LEACH FIELD
rm,/xNN 0
/? _ GAL LON5
lES1 PERFOR~4FD BYi
~,-¢'~.'?"_ H~ ~3R'f t ~,Li A:,i.r' RY'
/-Z
To
Address
City
1
' I
_.........—
j
j I
j
I
i
i I
STATEMENT
8K 882
May 25, 1982
Harold C. and Betty !i. Burt
c/o Stenie Riady
411 East 36th Ave.
Anchorage, AK 99503
Subject: Lot 4 Block 1 Majestic Valley Estates
Approval for the individual sewer and water facilities cannot
be granted until the following items have been completed:
C��The water analysis report needs to be submitted to this
office from,the Chem Lab, 5633 B Street, for our review.
f' The septic tank pumped with a receipt submitted to this
department.
An adequacy test needs to be performed on the existing
leaching area. This test will determine if the system is
adequate according to National Standards. A listing of
private firms performing the test is enclosed. This report
needs to be submitted to this office for our review.
Please notify this Department for a reinspection when the
noted discrepancies have been corrected. If there are any
further questions, please call this office at 264-4720.
Sincerely,
W
Robert C. Pratt
Associate Environmental Specialist
Enclosure
RP114/p/EH
(jj~T~ GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
Date ReCeived Janaury 18, 1977
'rime of Inspection
Date of Inspection
REQUEST FOR APPROVAl. OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
Conv.
1. Approval requested by:
Mailing Address:
2. Property Owner:
Mailing Address:
Spokane Mortgage Company
% Shirley
3201 C Street, Suite 250 Phone: 277-0543
John P. Nix, Jr. Phone:
Alyeska Office, Glenallen, Alaska.
3. Legal Description: Lot 4 Block 1 Majestic Valley Estates
4. Location:
See attached map
5. Type of facility to be inspected
6. Well Data:
A. Type Individual
C. Construction
7. Sewage Disposal System:
A. Installed 1976
C. Septic Tank: 1. Size
D. Seepage Pit:
E. Disposal Field:
8. Distances:
A. Well to: Septic tank
Nearest lot line
B. Foundation to septic tank
Single Family
No. of bedrooms 3
B. Depth 110'
D. Bacterial Analysis
On-site syStem
B. Installer
$
2. Manufacturer
1. Absorption Area
Total length of lines
, Absorption area
, Other contamination
2. Material
, Sewer Lines ,
, Absorption area
C. Absorption area to nearest lot line
EQ-034 (1/74) Page 1 of two pages
Page 2 of two pages - Req.~st for Approval of Individual S ar & Water Facilities
Legal Description Lot 4 Block 1 Majestic Valley Estates
Comments
Approved~~
.~.~.~ ~ Disapproved
Date
Approval ~Valid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
certify that the information contained in 'this request for approval to be a true and
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED Date
EQ-034 (1/74)
ITy OF ANCHOR
MUNICIPALITY OF ANCHORAGE
~NVIRoNME_ HEALTH & Age
DEPARTMENT OF ENVIRONMENTAL QUALITY NTAL PROTECTION
:825"L" St. Anchorage. Alaska 99501 (-4th Fl) 279-2511 J/!N 1 8 1977
REQUEST FOR APPROVAL OF RECE ',
INDIVIDUAL SEWER and WATER FACILITIES .! zf~)
1. Type of Inspection: CMRO VA
2. Property Owner: Mr. & Mrs. John P. Ni~, Jr.
Mailing Address: Aleyska Office, ~lenallen , Alaska
3. Name of Buyer: Harold C. Burr, Jr. & Betty Morgan Burr
FHA CONV XX
Day Phone unknown
leave message
Mailing Address: 6631 E. llth, Anchorage, Alaska 99504Day Phone 277-3575
Name of Lending Institution: Spokane Mortgage Co.
Mailing Address: 320l "C" St., Suite 250~ Anch., Ak 995~0ne 277-0543 Shirley
Name of Realtor or Agent: ghenn~lm Raal ty: M~l~CcJ~O~r
Mailing Address: 236 E. 5th Avenue, Anch., Ak 99501 Phone 279-3511
Please contact real estate agent, as owner's are out of town; agent has key.
Legal Description: Lo~ A: glne. k 1: MA.TRgTTC VALLEY F. gTAT~,g gURT)TVTgTO]5~. N 1/2: ,gE 1/~,
S 23, T 14 N, R 1 W, SM, Alaska
Location:_wil~ 6; ~gl~ R~v~r Pr1; npprnw 7 mflnm .ql~, nF ~nglm Rivnr C, iry C~nl:~.r
See attached pl~.~p
7. Type of Facility to be inspected.: Home
8. Water Supply
Type of Supply: Public Utility
If Individual, number of dwellings presently served
If Individual, depth of well ll0feet
9. Sewage Disposal System
Type of System: Public Utility
If Individual, date of installation
NHN Louinda Circle~ _
Eagle River, Ak 99577
No. Bdrms. 3
Individual Well
1
Individual (on-site)
Approx~ Spring
SEPTIC
EQ-037 (1/74)
GREATER ANCHORAGE AREA BOROUGH '~ ~/~ /-~ '>~
Department of Environmental Quality ~/:.~
3330 "C" Street, Anchorage, Alaska 99503 274-4561
Date Received ~
Time of Inspection/~:,~]-
Date of Inspection
FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
Approval requested by: ~~ ~ ~
Mailing Address: ~ ~hl J-J~¢
Property Owner: ~x~
Mailing Address: Q~ ~ ~ ~ ~/,/o ~X ¢~ ~¢
Legal Description: ~ ~/ ~ / ~~c ~
Type of facility to be inspected J~O No. of bedrooms
Phone:
Phone:
6. Well Data:
A. Type /~
C. Construction
7. Sewage Disposal System:
A. Installed
C. Septic Tank: 1. Size
B. Depth ~/~D
D. Bacterial Analysis
B. Installer /~
~/~00 2. Manufacturer
D. Seepage Pit: 1. Absorption Area 2. Material
E. Disposal Field: Total length of lines. ~/~1~/~/ ~'/~/?~'/~
Distances:
A. Well to: Septic tank /~ ~ , Absorption area
Nearest lot line , Other contamination
B. Foundation to septic tank
Sewer Lines
Absorption area
C. Absorption area to nearest lot line
EQ-034 (1/74) Page 1 of two pages
Page 2 of two pages - Re .st for Approval of Individual ,
Legal Description
,er & Water Facilities
Comments
Approved _~ ' Disapproved
Approval.Valid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
certify that the information contained in this request for approval to be a true and
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED
Date
EQ-034 (1/74)
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF ENVIRONMI:NTAL QUAL~ITY
3330 "C" Street, Anchorage, Alaska 99503 - 274-4561
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES
1. Type of Inspection:
2. Property Owner;
Mailing Address:
3. Name of Buyer:
CMRO
Gary PoeanS
VA FHA CONV X
PO Box 323, Eagle River, Ak.
John P. Nix and Judith K. Nix
Day Phone 688-2390
Mailing Address: 2435 Lee St. Anchorage, Alaska
4. Name of Lending Institution: NATIONAL BANK OF ALASKA
Mailing Address: P. 0. Box 3-3859. Anchnragm. Ak.
Attn: Deborah Helgeson
5. Name of Realtor. or Agent: n/a
Mailing Address:
Day Phone
Phone 279-2506 est.
Phone _ n/a
Legal Description:
Location:
Lot 4~ BLock 1~ Majestic Valley EStates
off of Eaqle River Road on Louinda Circle
Type of Facility to be inspected:
Water Supply
Type of Supply: Public Utility
If Individual, number of dwellings presently served
If Individual, depth of welt
Sewage Disposal System
Type of System:
single family residence . No. Bdrms.
110'
Public Utility
Individual XX
Individual (on-site)
If Individual, date of installation new construction
Please contact Deborah Helgeson at NBA 279-2506 ext. 19 if there are problems
in contacting the seller for the inspection. Also please forward the final
inspection to the above noted address.
[~Q-037 {1/74) ~ C~ ,~