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Home My WebLink AboutCOLONIAL PARK BLK 3 LT 3 N2ial Park Colon* Block 3 Lot #050 am 301 we 28 Municipality of Anchorage Page _/ of Z2 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 0 Anchorage, Alaska 99519-6650 * Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: ?s- .0 ,/ 7,0 PID Number: to:5_40 - 73 0 1 C-01, a Name: Wastewater System: 0 New 0 Upgrade Address: -4 ABSORPTION FIELD Phone: No. of Bedrooms: ODeepTrench C3ShallowTrench UfBed C3Mound 00ther LEGAL DESCRIPTION Soil Rating: �_ Total Depth from original grade: ZZ 0 0, GPD/Sq. Ft Lot; Block: Subdivision: Oepth to pipe bottom from original grade: Gravel depth beneath pipe IVY=. '4 t-.? 9 Ir � / ,C7, �xr /. 3 Ft. 0, e Ft, Township: Range: I I Section: Fill added above original grade: Gravel length: ;I Ft. 41 Ft. WELL: RNew 0 Upgrade Gravel width: Number of lines: I cistance between lines: r,r�.rf,f /,5' Ft. ? 1,�' Age-( 1 41, 4- Ft. Classification (Private, A.B.C): Total Depth: ased To: I Total absorption area; Pipe material: .0 Vic. Ft. Ft. 16 SO. Ft. ?. 3r .9, , S*c A 5V Driller Date Drilled: Static Water Level: installer Date installed: Ft. Yield: Pump Set at: Casing Height Above Ground: TANK C P7M Ft. Ft. SEPARATION DISTANCES 0 Septic C3 Holding gS,T.E.P. To Septic Absorption Lift Holding Pow"nvate Manufacturer Capacity in gallons: From Tank Field Station Tank Sewer Lines /g/e> e' -J, in, /e / 0 Wel� *1.4 41 /0,.) VIA / A!r Material: F,* 6- r -r Number of Compartments: Surface Water "Zoo, LIFT STATIOIN Lot Line /0 "/a Size in gallons: 155�;,Pa Manufactu er ,6?1V exe Z 4!5, Foundation -Za 0 "Pump on" level at: *Pump off" level at: High water alarm at: Curtain /V//j Pump Make & Model Electrical Inspections performed by: Drain e. Cr mr� y _A�'/L- e AemarkS: )FIe ;2' BENCH MARK Location and Description: _FX ,,;vv rp� Y7,; 1-4 4, 70/0 e, IC Assumed Elevation: F, ENG114E SMAL OF % A 1. WON , 0,asoo 4, Ill Inspections performed by: LLv"Dates: ist 3H 2nd__L/2�3' Fl. x,,o, Department of Health and Human Services approval o, Louis X 6 CEC36 e Reviewed and approved by: OZAApZivd:�� Date: a* &V 72-013 (Ray. SMI) MOA 25 Pernilt No. -YW 19' " 70 Page �2 of Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 e Anchorage, Alaska 99519-6650 e Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report L e g a I D e s c r 1 p t i o n: j? h'l* Z' e!2/fr— P1 D No.: New Lecchbed — 2" PVC Mcnifold 1 1/4" PVC 1/8' holes 14.5* OC SWNG TIES A—C = 42' B—C = 531 A—D = 60.3' 8--D = 64.5' ELEVATIONS (NOT TO SCALE) +30' to Septic +100'to well r SW $01 � 90 ELEV - 10CLOO Public Sewer Connect 0 — TEST HOLE 0 — MONITOR TUBE 0 — SEWER CLEANOUT — WELL — EASEMENT — LEACHFIELD COONAL GROUNO Joe* LEVEL AT. - * qu Ot FIN ".d a. =..dtd� 94.9 too 80CY= CWT 0 W.3 TANK IL3 Buts \2.6 36 ILI' \It# 316 is AW aw \9z9 72-013 A (2M) MOA 25 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On -Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SW980470 Legal Description: COLONIAL PARK BLK 3 LT 3 N2 Design Engineer. 0024 Eagle River Engineering Services Owner Name: Armand Nyborg Owner Address: PO BOX 200311 Anchorage , AK 99520-0311 I I I cs c'3 CL (Y\ U-ni I - 123 -01 S Date Issued: Dec 15, 1998 Expiration Date: Dec 15, 1999 Parcel ID: 050-301-28 Site Address: 019910 SECOND ST Lot Size: 14850 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: F71 Disposal Field 2] Septic Tank Holding Tank [] Privy Private Well E] 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 DHHS at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-4744 (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 mustbeeither. A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. Blocycle Received By: Date: Issued By: Date: 12. 1:7 F'P Eagle River Engineering Services Louis Butera, P.E. P.O. Box 773294 (907) 694-5195 tel Eagle River, AK 99577-3294 (907) 694-3297 fax November 20,1998 Jim Cross, P.E. Manager, On -Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: Colonial Park N V2 Lot 3 Blk 3 Narrative & Permit Application Dear Mr. Cross: The proposed septic upgrade will have very limited impact on adjacent properties for the following reasons: - I The surrounding lots have. the wells located at opposite ends from the septics, allowing sufficient room for septic sites. 2. Immediate neighboring septic systems are all +30'distance. 3. Reserve space is adequate, due to absorption capacity and use of a BioCycle system. 4. Drainage will not be affected and is not a major consideration in our design. The proposed system for this lot is a BioCycle unit that will reduce the leachfield area and make the system feasible for a 4 bedroom upgrade. The existing leachfield will be disconnected and allowed to rejuvenate during the rest period. The adjacent lot to the East is connected to public sewer through an extended service connect to the main. Our lot is not located close enough to allow an extended service connect If you have any questions please call our office at 694-5195. Sincerely, Louis Butera, P.E. \1997\98 -081 -NAR Neighbor Septic System (BED) TH1 1 94.9 qVT 86.8 New Leachbed — 2" PVC Manifold SECOND STREET GRAVEL ROAD SURFACE 112.00 N 89*56'0" W WELL DRIVE LOT 3 HOUSE rke'5� 1. ,600 Fti 93, Q-1 "i0c cle— Tank' 40' 1 1/4- PVC 100.0 1/8" holes 14.50 OC—) Abandon existing Tank in place Requires Lot Line Waiver I I 5ystem to Pe installed at TH3 92.8, existing soil to be dug 50-7 — — — ffg 0 GTILfTy down,�,on accepting strata 56,0,, E GvIt 013.0 EASEMENT and filled with sand if needed. 5ystem to 2.00 be mounded if necessary Tie into jt4 i -n Existing Line 0 Abandon existinc Field in place 0 Public Sewer Connect 0 — TEST HOLE +30' to Septic o — MONITOR TUBE 0 SEWER CLEANOUT +100'to well WELL EASEMENT PROPOSED LEACHFIELD EXISTING LEACHFIELD SEPTIC UPGRADE SITE PLAN LEGAL: Colonial Park N 1 /2 Lot 3 Blk 3 OWNER: Nyborg CONTRACTOR: N4A ibB# 98-081 1 DATE: 11/16/981 SCALE 1 30 EACLE RIVER ENCINEERINC SERVICES AP.O. Box 773294 EACLE RIVER, AK. 99577 (907) 694-5195 FAX. (907) 694-3294 OF JJQQ0 '.-#4 9 1H LOUIS A. BUTERA CE -6736 Eagle River Engineering Services Louis Butera, P.E. P.O. Box 773294 (907) 694-5195 tel Eagle River, AK 99577-3294 (907) 694-3297 fax SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM LEGAL: Colonial Park N % Lot 3 Blk 3 11/13/98 A. GENERAL 1. The well and septic plan are for a single family residence only. 2. The drawing and or site plan shall be a part of this specification. 3. All materials and workmanship shall meet the Anchorage Department of Health and State Department of Environmental Conservation requirements. 4. All soil tests are advisory to the design and are to be verified or modified in the field by the engineer. 5. All excavations and depths are advisory and are to be vcrified in the field by the contractor to meet Municipality of EC:!E0NRS requirements. 6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any adjacent multi -family wells. 7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer approval. 8. It is always recommended that a surveyor locate the nearest lot line position and the location of any easements. 9. Any remaining open test hole excavations shall be filled. B. SEPTIC TANKILTFT STATION I . Septic tank and lift station shall be BioCycle Tank, 1500 gallon. 2. Receipt from licensed electrician stating the lift station was wired to applicable codes to be supplied to Engineer. C. BED I . The bed is to be excavated to the 92.8 level as indicated on the site plan and any area of the bed not in the sandy gravel accepting soil layer shall be over excavated and brought to grade with a sand material with less than 5% fines. No equipment is to be driven over the bed area. 2. The bottom of the finished bed shall be level, plus or minus 1.5". 3. The sewer line is to replace the existing sewer line that leads to the existing leachfield. The 1 1/4" effluent lines within the bed shall be laid level within 0.1'. with 2" manifold pipe. Gravel depth below pipe is 8" minimum. 2" over pipe. Holes in pipe to be 1/8" installed holes facing down. 4. The bed gravel is to be covered with typar fabric material. 5. Soil or combination of soil and extruded board insulation to a depth of Yor equivalent is to'be placed over the leachfield. 6. The area over the bed is to be finish graded to prevent ponding of surface water runoff with maximum 3:1 sideslopes. 7. The septic tank and leachfield must not be closer than 100' to any existing private well, 150' to any Class "C" well, or 200 feet to any community well. RECOMMENDED LEACHFIELD DIMENSIONS: TOTAL DEPTH = Elev. 92.8 refer to datum GRAVEL DEPTH = 8" under pipe, 2" over pipe BED LENGTH= 40' BEDWIDTH= 15' SOIL RATING = 1.0 GPD/ft2 BEDROOM CAPACITY= 4 Hole Spacing = 14.5" on center Twenty-four (24) hours notice required for'all inspections. \1997\98-08la-spec ,- or 41.*"-%% :C4 .448" —&�e go 744 Municipality of Anchorage DEPARTMENT OF HEALTH 8, HUMAN SERVICES Louis JL Butlers �gg CE -11M e go 825 "L" Street, Anchorage, Alaska 99502-0650 111 60 , -1 SOILS LOG — PERCOLATION TEST PERFORMED FOR: '-4jwgT-t-/ —DATEPERFORMED: LEGAL DESCRIPTION: Celew-,:irl Yrr,,kA4, I.? Township, Range, Section: D IPTH I tT) 2 Date Gross Time Net Time Depth to Water 3- 0': 4- -e-w 5- 6 157-:117 )5.: qC1 )r: S -C' -1 ir-0.7-40 1 1,16 "//,4 11 5'y "lls 7 5- 8- 9- 10-- x 0//s C7 12- 13- 14- is- 16- 17 - 18 19 20 J COMMENTS -7o��-1 61n, WI*T4 'i;jhz P:.p 77eAr 42( 7jY WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? SLOPE Y, --.s Depth to Water After Monitoring? - 00- / Date: B-10 s L 0 P E SITE PLAN 'r;f Reading Date Gross Time Net Time Depth to Water Not Drop f7c - -e-w 157-:117 )5.: qC1 )r: S -C' -1 ir-0.7-40 1 1,16 "//,4 11 5'y "lls 11116 5- i4f. 2 5-2 7*1' x 0//s PERCOLATION RATE 1/2 (minutes/inch) PERC HOLE DIAMETER TEST SUN BETWEEN y FT AND -r- FT �"iolu 'liver knUil'.02ring Services PERFORMED BY: CERTIFY THAT THIS TEST WAS PERFORMED IN F271e Rivsr, AX ACCORDANCE WITH ALL STATE Op - .;%VAMTFAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-OC8 (Rev. 4i85) MunIcIpallty of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street. Anchorage. Alaska 99502-0650 SOILS LOG — PERCOLATION TEST 0:%'Iat PERFORMED FOR: Ariwgirtir lt--vebaf!!� DATEPERFORMED: 1 %./ azk -? LEGAL DESCRIPTION: Township, Range. Section: E%TH SLOPE SITE PLAN 7-11 VF�' ',(E AT 7>7 I -,, 2- 3- Date Gross Time 67P -6,1q 61,7vel 4 Net Drop 5 - ot C-.01 �Aqjlel — //-)r - Vf I 7.,v 1/ 7-//1 7 0 —32 710 8 2- "//6 -7 9 111.e ;501`701� )e -rw 10- 11 - 12- 13- 14- 15- 16- 17- 18- "I 20 COMMENTS WAS GROUND WATER ENCOUNTERED? L IF YES, AT WHAT 0 DEPTH? P flepth to Water After Monitoring? 7 catt a Reading Date Gross Time Net Time Depth to Water Net Drop f7c - ot C-.01 — — //-)r - Vf I 7.,v 1/ 7-//1 2 1-71*1y —32 710 Z 2. fZ2,4 2- "//6 -7 /7:3s— # 111.e "If / Aj:,P5- I 3r'q I-rh . -.I- "I,//,( 3- m".eX 3/1'e PERCOLATION RATE Iminutes/incri) PERC HOLE DIAMETER TEST SUN BETWEEN FT AND 50' FT Eagle Xvor Engineering Serviecs PERFORMED BY; 2 0 — I CERTIFY THAT THIS TEST WAS PERFORMED IN F3(,!e Pi'var. AK 9U17 - ACCORDANCE WITH ALL STATE Aff ELINES IN EFFECT ON THIS DATE. DATE. .2 v ,,�ML.4NI IPALGUIO 72-008jRev 4,95P Munlcfpality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "V Street, Anchorage, Alaska 99502-0650 SOILS LOG - PERCOLATION TEST PERFORMED FOR: 'e'6*f 0't-1 llviiafo.:� —DATEPERFORMED: LEGAL DESCRIPTION: CeleAfl:wl Y44Z:-kAl,� Z_? Township, Range. Section: PTW 7-//3 2-- 3- 4 - 5 6 7- * 0 '- 9 - 10 11 12 13 14 15 16 17 18 19 6/� M,457r', SLOPE WAS GROUND WATER ENCOUNTERED? IF YES. AT WHAT 0 DEPTH? 7 P E Depth to Water After Monitoring? 7 -2- Gale: SITE 17 Reading Date G!oss Time Net Time Depth to Water Not Drop 1.7; 3,0 1/4 5- 111".72 '7/v - 20 PERCOLATIONSATE (minutes, inCh) PER C HOLE DIAMETER TEST SUN BETWEEN FT AND I/ FT COMMENTS E,I;la 11,ve-'Evnevrinq PERFORMED BY. P 11 Cox ;;;es CERTIFY THAT THIS TEST WAS PERFORMED IN Ea I fli'le" K A/ ACCORDANCE WITH ALL STAEeAK. %-4 V?27P7A*L GUICELINES IN EFFECT ON THIS DATE. DATE. 7 '2 r)ce ( R ey 4, a EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 Eagle River, Alaska 99577 (907) 694-5195 ERES Project No.: 98-081 Calculated By: LB Date: 11/19/98 Legal: Colonial Park N 1/2 Lot 3 Blk 3 TEST HOLE I Single Family 4 Bedroom Dwelling BioCycle System Bed Subsurface Wastewater Disposal Field Water use at 150 gallons per bedroom = 600 gallons Percolation rate = 11.2 minutes per inch Wastewater application rate = 0.5 gallons per day per square foot Required absorption area = 600 square feet Bed width (W) = 15 feet Gravel depth (D) = I feet NOTE: Blocycle Reduction factor of 0.5 utilized Required length = Required absorption area / Bed width Required length = 600 / 15 Required length = 40 feet Total Excavation Depth = 3.0 feet Hole Spacing = 14.5 " OF 4:7 4 9 IH- ........... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . LOU[ S A. BU TER A CL - CE -6736 W FO....... W,JOROFESSO-L'�' 98-081-CAL.xis 4:37 PM 11;19198 EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 Eagle River, Alaska 99577 (907) 694-5195 BioCycle System Job #: 911-081 Legal: Colonial Park N 1/2 Lot 3 Blk 3 Date: 1/12/98 Press. Effluent Lateral: Assume Fhead at orfice 35 GPM flow rate .42 GPM per 1/8" orfice 35 /.42 =84 orfices Pipe Length 102 Spacing lengtht#of orfices 1,21 feet Spacing 14.6 inches 'OF 4Z N, TH N� . .......... . . . . . . . . . . . . . . . . . . . . . . . . . . V�*. LOUIS A. BUTERA CE -6738 Ar' 72-013 (Rev. 3/7 1W MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE ;&NEW MGC 3 _6,0. q7 r DUPGRADE MAILING ADDRESS 6204 af�Aet< I3E"P11;11y1, LEGAL DESCRIPTION z- o r 3 L oct,-..,a ) co L, N-14 e- antz up. :5;7. LOCATION NO.`0F BEDROOMS _!<lEC6Nb Well Absorption are Dwelling PERMIT NO. DISTANCE TO: /Z C) 46 ET. 0-70 7 4�� 6.15 z Manufacturer Material No. of compartments r, - P_ r- _5-145E (-, �:11 co Liq. capacity in gallons IF HOMEMADE: inside length Width Liquid depth DISTANCE TO: IN 11 =—W Dwelling I PERMIT NO. _J0Z 20 Manufacturer t.,q Material Liquid capacity in gallons Well Foundation Nearest lot line PERMIT NO. _j W DISTANCE TO: //0 F7 P7 9!9 6) -3 07 Lu U. No. lines Length of each line Total length of lines Trench width Distance between lines -3 z z of 3 - W P;z -3 4 ET az F7. 129 F7' 4amn 46 Top finish de Material beneath — otal effective area cc of tile to pr tile absorption _Z? 70 inches Z Z 0:50, ET Length Width Depth PERMIT NO. Type of crib Crib diameter Crib depth Total effective absorption area W w V) Well f Building foundation Nearest lot line DISTANCE TO:' .j .j Class P ,4.q Depth .32C) FT Driller iLLIAIC Distance to lot 11 PERMIT �10. R 4e3o7 DISTANCE TO: BullcliVq I Cyc!A��n Sewer I.Lne Septic tank J210 r Absorption area(s) I OTHER _5 WD PIPE MATERIALS PVC 45-r M3034 WE 4,Lt. SOIL TEST RATING t> 17- m A INSTALLER CADILI-AC- - C-0"SK IWA plz�� SEA 1 11 dy REMARKS ;JE:0i5-PT)4 OF f3Eb F -96M 007TOM 7-0 .,_�;(4 I r4 - - - - 11 rT, I L I V haI&MJA(, &/ZiOr 15 ;3igrr VfL E CT6h Ay 1.;ET A,*7M WnLk, WSP C. L 7y i; MVE Y T AS ?V t-4 r 3 -A Or C 5 z j J, zs� )VOT, zo 7, D DATE LEGAL APPR 717, Z�5_ 1-07 36V !Vz), R3 i CZILCA114L PA0`,-_5VBt 57 j FAM R1 72-013 (Rev. 3/7 1W I -r-,e C) F-- ic� M (-, t -i r`TR fA C-3 FEE DEPARTMENT C HEALTH AND ENVIRONMENTAL JTECTION B25 -L STREETv ANcHORAGE9 AK 9?501 264-4720 C3 P4 — S; I -r EE: E; IF LsJ FEE F -C W F -E t- I=* I=- FZ M I -F- t PERMIT NO: (350307 DATE ISSUED: 06/17/85 APPLICANT: MGC CONST: CO. ADDRESS: 6204 BLACKBERRY ANCHORAGE, AK- 99502 CONTACT PHONE: 243-8897 LOT: N2 3 BLOCK: 3 LEGAL DESCRIP: SUBDIVISION: COLONIAL PARK SECTION: 7 TOWNSHIP: 14N RANGE: 1W LOT SIZE: 14560 (SO.FT. OR ACRES) MAX PEDROOMS: 3 Listed below are the options available to you in designing your.septic system. Choose the option that best fits your site. DEPTH TO PIPE BOTTOM < 3.5 FT. REQUIRES INSULATION DEPTH TO PIPE BOTTOM <.4.0 FT, MAY REQUIRE,A LIFT STATION GRAVEL LENGTH > 75 FT. REQUIRES MULTIPLE RUNS,(NOT EXCEEDING 75 FT. EACH) TANK MUST HAVE AT LEAST TWO COMPARTMENTS - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - I certify that: 1. 1 am familiar with the requirements for on-site sewers and wells as set I forth by the Municipality of Anchorage (MOA) and the State of Alaska.. 2. 1 will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit. 3. 1 will adhere to all MOA and State of Alaska requirements for the set back distances from any exist,ing well, wastewater disposal system or public sewerage system an this or any adjacent pr nearby lot. 4. 1 understand that this permit is valid for a maximum of 3 bedrooms and, - any enlargemen�L will require an additional permit. IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS WILL NOT BE APPROVED WITHOUT ANELECTRICAL INSPECTION REPORT; AND (3) THE -ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN. SIGNED DATE: -1-7 APPLICANT: M ST. CO. ISSUED BY 4r DATE: - 7� - t - 13 E7= ID W. nr-ZA I" DEPTH TO PIPE BOTTOM (FT.) 3.0 3.0 GRAVEL DEPTH AFT.) 1.0 TOTAL DE H 4.0 GRAVEL WIDTH (FT.) 19.0 GRAVEL LENGTH (FT.) 36.0' 79.0 GRAVEL VOLUME (CU.YDS.) 0 25.4 22.0 TANK SIZE (GALS) 13,000.0 .10000.0 SOI.L RATING (SGI.FT./BR) 150 150 DEPTH TO PIPE BOTTOM < 3.5 FT. REQUIRES INSULATION DEPTH TO PIPE BOTTOM <.4.0 FT, MAY REQUIRE,A LIFT STATION GRAVEL LENGTH > 75 FT. REQUIRES MULTIPLE RUNS,(NOT EXCEEDING 75 FT. EACH) TANK MUST HAVE AT LEAST TWO COMPARTMENTS - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - I certify that: 1. 1 am familiar with the requirements for on-site sewers and wells as set I forth by the Municipality of Anchorage (MOA) and the State of Alaska.. 2. 1 will install the system in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit. 3. 1 will adhere to all MOA and State of Alaska requirements for the set back distances from any exist,ing well, wastewater disposal system or public sewerage system an this or any adjacent pr nearby lot. 4. 1 understand that this permit is valid for a maximum of 3 bedrooms and, - any enlargemen�L will require an additional permit. IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS WILL NOT BE APPROVED WITHOUT ANELECTRICAL INSPECTION REPORT; AND (3) THE -ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN. SIGNED DATE: -1-7 APPLICANT: M ST. CO. ISSUED BY 4r DATE: - 7� - t - Akunicipafity POL.,il 6-650 ANCHORAGE, ALASKA 99502-0650 of (907) 264-4111 Anchorage T0NYXN0WLf$. AIA YOR DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Permit #: 840023 January 31, 1985 TO: Permit Applicant SUBJECT: Lot 3 Block 3 Colonial Park Subdivision A permit issued by this Department for an individual well and/or on-site sewer system has expired as of December 31, 1984. Permits are issued on a calendar year basis by authority of Municipal Ordinance. A new permit must be obtained from this Department for any well and/or on-site sewer system not installed by the expiration date. If you have drilled the well, a well log needs to be sent to this Department for documentation of the installation and to close the permit. If a private engineer inspected the installation of the on-site sewer system, the original as -built inspection report and the yellow copy must be sent to this office for review and approval, and for documentation. If there are any further questions, please call this office at 264-4720. Sincerely, Keith E. Ban t, Supe visor Environmental Engineering Program KEB/ljw enc: Copy of Permit SWP/057 f -I 11 t-4 1 1--' 1 F* F-1 t- I -V 0-0 0 f:--' n Ir -4 (D F -_'F4 1:� f= - DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 625 L STREET, ANCHORAGE, AK 9950:1 264-4720 t-4 —:-7. 3: -r E- -@I,- C-: W E- r--: !i- 1-4 FE L_ L_ F=' E: F:;-:.' Pl I -T- PERMIT NO: 640023 DATE ISSUED: 02/29/84 APPLICANT: GARY GREENFIELD ADDRESS: S&S ENGINEERING EAGLE RIVER, AK . 99577 CONTACT PHONE: 1594-2979 LEGAL DESCRIP: SUBDIVISION: COLONIAL PARK' LOT: 3 BLOCK: 3 SECTION: 7 TOWNSHIP: 14N RANGE: 11-1 LOT SIZE: (SQ. FT. OR ACRES) MAX BEDROOMS: 21 LISTED BELOW ARE THE OPTIONS AVAILABLE TO YOU IN DESIGNING YOUR SEPTIC SYSTEM. CHOOSE THE OPTION THAT BEST FITS YOUR SITE. - - - - - - - - - - - - - - - - - - - - - E. FE C� - - - - - - - - - - - - - - - - - - - DEPTH TO PIPE BOTTOM (FT.) 3. 1.7i :44* GRAVEL DEPTH (FT. ) 0.5 TOTAL DEPTH (FT.) 3.5 GRAVEL WIDTH <FT. ) 19. cl GRWEL LENGTH <FT. 2 6. cl GRA,)EL VOLUME (CU. YDS. 2 5. 3.' TANK" -SIZE (GALS) I., Cl 0 0. 0 SOIL RATING (SQ. FT. /BR) 150 DEPTH TO PIPE BOTTOM < 3. 5 FT. REQUIRES INSULATION DEPTH TO PIPE BOTTOM < 4. 0 FT.- MAY REQUIRE A LIFT STATION TANK, MUST HAVE AT LEAST TI -40 COMPARTMENTS - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - I CERTIFY THAT: L I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITt SEWERS AND I -JELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE (MOA) AND THE STATE OF ALASKA. 2. 1 I -JILL INSTALL THE SYSTEM IN ACCORI)ANCE.WITH ALL MPA CODES AND REGULATIONSi AND IN COMPLIANCE 14ITH THE DESIGN CRITERIA OF THIS PERMIT. 1 WILL ADHERE TO ALL NOR AND STATE OF ALASK'A REQUIREMENTS FOP, THE SET BACK" DISTANCES FROM ANY EeXISTING WELL, WASTEWATER DISPOSAL SYSTEM OR PUBLIC SEWERAGE SYSTEM ON THIS OR ANY ADJACENT OR. NEARBY LOT. 4. 1 UNDERSTAND THAT THIS PERMIT IS VALID FOR A MAXIMUM OF 2 BEDROOMS AND ANY ENLARGEMENT I -JILL REQUIRE AN ADDITIONAL PERMIT. IF A LIFT STATION IS INSTALLED IN AN AREA COVEPED BY r-lOFi BUILDING, CODES� THEN (1) AN ELECT�,;�AL PERMIT AND INSPECTION MUST BE OBTAINED;. (2) AS-BUILTS WILL NOT BE APP _WHOUT AN ELECTRICAL INSPECTION REPORT; AND (2) THE ELECTRICAL WC!K HL IXX ,,4�9NE,'BY A LICENSED ELECTRICIAN. SIGNED DATE: - ---------- ------- -2 ---------- APPLICANTqi- �'Y ;.ENFIELD ISSUED BY DATE: ---------- --- yl ------- PERFORMED F LEGAL DESCR MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SOILS LOG 0 PERCOLATION TEST (io� (�l ?jt!2;2 6�-eeltl 7�4eXCYI _DATE PERFORMED: f -S— 0 C( 0 N: '0 r ,o7a /) / C S'I'Z 7- 5-,.91VO C,121�vell —0 1 t r 3 — �z .Z -x:6--e �z 10- J�o AA 40 -P 410110 1 WAS GROUND WATER S 11 ENCOUNTERED? L -- U 12- IF YES, AT WHAT P 13- DEPTH? 14- 15— OF Al, 16- 4. 17— % nN 18— R,� b 1,rt A. Shale 19- tjo. 1457-E 20— COMMENTS NE Reading .0 'Z Gross Time �4 Depth to Water Net Drop 5- 6— Z- 7- 6- 8 .Z -x:6--e �z 10- J�o AA 40 -P 410110 1 WAS GROUND WATER S 11 ENCOUNTERED? L -- U 12- IF YES, AT WHAT P 13- DEPTH? 14- 15— OF Al, 16- 4. 17— % nN 18— R,� b 1,rt A. Shale 19- tjo. 1457-E 20— COMMENTS NE Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE —(minutes/inch) �9'� RVN BETVqEN FT Arq6 FT a, Pee A-uo� PERFORMED BY: CERTIFIE� ��DATE: ? C- 72-008 (6/79) .'0- (1001� DuRbiN DRIdiNq CC Mile 1.2, Lucas Road P.O. Box 871348 Wasilla, Alaska 99687 (907) 32SOM5 376-VIEII Name: Best Buy Builders, Inc. Address: P.O. Box 772033 City: Eagle River, AK Phone: 694-52 Job Lot 3� Blk 3, Colonial Park Location. Crew— R.Durbin/S.Zachariasen Date: Doc. 17-20, 1985 _ Notes: Well cased to 320 ft. includin 2 ft. stick-up Static water level: 290 ft. f surface GPM: 8 Recommended pump setting: 315 Depth Well Log 0-18 Broilm sand and gravel 18-66 Gray clay and gravel 66-189 Brown sand and gravel 189- 08 Bro;,,m sand 208-d6o Brov.m clay and sand 260-�20 Brovm sand and gravel 32 rom f t. 25 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program S A r 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.orglonsite (907) 343-79D4 CERTIFICATE OF ON-SITE SYSTEMs APPROVAL FOR A SINGLE FAmiLy DWELLING Parcel I.D. 0 50 — 301 Z4P COSA # br�NIP_C� Expiration Date: I I — 1— 0 :7 GENERAL INFORMATION Complete legal description C-010nt4t Elrk R./oc le- 3 Aa/z Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class _ Well Public Water System — Z/ -- Dayphone S5'2—;F45VZ Day phone Day phone TYPE OF WASTEWATER DISPOSAL: f9 Individual On-site JB� Individual Holding Tank El Community On-site El Public Sewer 1:1 The Municipality of Anchorage Development Services Department [DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given In paragraph 4 by an independent professional civil engineer registered In the State of Alaska. Certificates of On -Site Systems 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 COSAs upon request to homeowners. Certificates of On -Site Systems 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. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties 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 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. Nameof Address Firmix Phone< W- 7,02 Engineer's Printed Name Date 7 /67 OF ............. : S. DSD SIGNATURE Steven W. Eng PE 6256 Approved for --!q--bedrooms. 4 :,- . cl Disapproved. kelp -.— It. Conditional approval for — bedrooms, with the following stpulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By. Original Certificate Date: g — I — n 7 (nev. 1 IJ05) Municipality of Anchorage Development Services Department Building Safety Division 4700 Bragaw, Street On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onshe (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEms APPROVAL CHECKLIST Legal Description.424!s/aAco.1 Pezrk, 9/,,,, k ?i A( �7 10A—F Parcel I D: 0.rQ — 3 0 (1 -;Z 1? A. WELL DATA Well type Jp— Date completed 4zd141"X Total depth.320—ft. Date of test Static water level Well production If A, B, or C provide PWSID # _ Sanitary seal (YIN) Cased to IM—ft. FROM WELL LOG dc' WATER SAMPLE RESULTS: Well Log (Y/N) 7\� Wires properly protected (Y/N) Casing height (above ground) ZQ in. AT INSPECTION jV 7 -ft. 9 -P.M. e -r . 9 -P.M. Coliform __Q_colonies/100 mL Nitrate /. VZ mg/L Arsenic: lot ug/L date of sample: CIZZ16 7 B. SEPTICIHOLDING TANK DATA Other bacteria d colonies,1100 mL Collected by: Albe-AZAW IS, J Tank Type/Material '9to0YCL'r1X-'"1._r_r Date installed Tank size gal. - Number of Compartments Cleanouts (YIN) Foundation cleanout (Y/N) Depression over tank (Y/N) IV High water alarm (Y/N) Date of pumping -SACIO 7 Pumper EiaC:,�fo_ dArka I C. ABSORPTION FIELD DATA Date installed.,,V11 9 Soilrating (g.p.d./ft2or41!'h,'RR)t!2, /L __.T _ System type 4646 Length !�z ft. Width ft. Gravel below pipe ft. Total depth -6 ft. Eff. absorption area&S fe Monitoring tube --;)/— Depression over field At Date of adequacy test <LaLo7 Results (Pass/Fail) P141V For_�/ bedrooms Fluid depth in absorption field before test 0 in. Water adcledj��gai. New depth / in. Elapsed Time: 110— min. Final fluid depth 0 in. Absorption rate >= 4�O g. p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) LAIAL - If yes, give date D. LIFT STATION Date installed 411 0-f 'Pump ono level atZY in. DaturnsgAt± %,Q I E. SEPARATION DISTANCES Size in gallons 15aC 'Pump off" level at!!�S in. Cycles tested 5 SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot. AV / " Absorption field on lot 1160., Public sewer main Sewer /septic service line Animal containment areas - /046- 'f' Manhole/Access (ON) �Z High water alarm level at �23` in. Meets alarm & circuit requirements? On adjacent lots /a a On adjacent lots /00 "Y' Public sewer manholelcleanout Holding tank — la d- ", Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: f le) / Building foundation 144 o- Property line Absorption field Water main 14TO Water service line Surface water Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line Id /* Building foundation Water main Water Service line 2!F!� Surface water. /ad Driveway. parking/vehicle storage Curtain drain adA Wells on adjacent lots "41 �- F. COMMENTS tir gqf� -%% M:;,%v .......... 44%11 G. ENGINEER'S CERTIFICATION "6 V 4 I certify that I have delennined through field inspections and go review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Soevia W. Eng N. 4 Engineers Printed Name Pf 6256 ��,,o Date ZZ/1/67 . ........ COSA Fee Date of Payment 0116, Receipt Number 55 (Rev, 11/05) Waiver Fee $ Date of Payment Receipt Number I 'o o -Ie,- 40 ASBUILT-NO CORNERS SET THIS DATE. SEWARD I HEREBY CERTIFY -THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY: AND THAT NO ENCR646rMENTS EXI I�WEXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OF FENCE LINES, OR FOR ESTABLISHING BOUND- ARY LINES. SCALE: 0 A� DATE: GRID: Oveno MeA 3.�.,d FB- ots 1�. LS - 18 Ar FRAWN: BioCycle Alaska Qtr Maintenance Report POB 202691 04 Anchorage, AK 99520 2k Qtr 2007 563-1646 office/398-6574 cell Email: biocyclealaska@alaska.net 02 2nd Street b River, AK 99577 MAINTENANCE DESCRIPTION COMMENTS PRIMARY CHAMB ER SCUM LEVEL 415) HIGH AERATION CHAMBER & AERATION SYSTEM BLOWER SIZE 0 120 LIMIN AERATION PRESSURE e9t811GII LOW NOISE LEVEL (2g HIGH GENERAL CONDITION V(ffJ POOR PIPING SYSTEM: AIR LEAKS 0 LEAKS AIR DIFrUSER/AIR SUPPLY POOR % MIXED LIQUOR CONDITION ODOR 0 YES CLARIFICATION CHAMBER SLUDGE ACCUM IN I IOPPER HIGH CLARITY OF EFFLUENT nMR -AIR CLOUDY DISCHARGE CHAMBER DISCHARGE PUMP OPERATING NO ALARMS CHECKED AND OPERATING AIR/POWER Y S NO HIGHWATER (YrS NO Maintenance 2007 was performed today BY- DATE: C MrAA- MA 07.11e:00T 1�:38 FAX 317 552 3TA3 351 INTEL SQUAD � 00! ADVANCED WASTEWATERIW, ^TinENT SYSTEIM MAINTENANCE AND REPAIR AGREENTNT r*jj.rvjORANDV51 OFUNDERSTANDING BUNYUN MUNICIPAJ Xr; OF A-'qCrl3'rb'XE A1N0:V7,-ti,S f — THIS NAMMORANDW I OF LIMERSTANDING made arid entered into as of this (if 21) —e,7b.y and b.-tvc.-r: J.rre.bi the"OWNER," and the Municipali--y of Anchor -M, herein th:- IncorsideriLtionoft2einuttialcovcrFlntscolita4,eehemiti.lhc 'IT Al)'.rANCED%VA.STENVATERI'REAT,kUWrSYI% MS MLnkipalitY permission ui own�.r to udll;= wtlopertte an Advanced V.7x;t,:wx.cr Treatment SysL.,-n (AWV731, dt:SC`.'A -.- M. Anclicragc,Alaska. 2. 1441.16010M. A. Alter,ition. Any change to the dcsigr, or ;wtction of fai AWWTS that Tnclucles the limallation or removal Q! any patis, ccur.r.onems or riMCS rict iwhidcd hi thc or0r.3' constrvrOrin perni2, and t 3c�;-n. Prici tr, performing any atterations To an AWWT!; the owt rr must obtain a Wastewater Disposal Sys(em Conatructlon Permit fioni. th.n.Municipality r-j;quant to Anchorage Municip:!l Code (licreinafica,"AM.C") 15.65. B. Certificate of On Fite System$ Approv P L Arapprovalbytlie Mia-tic[paliq of exiiiine. waxr and %N astewzier disios3l f ysterns giN en at elic cril-c! of Froperty sale and title tr=sfcr in accordance with AMC 15.65. 07 3V200T 12:39 FAI W SU -!153 381 BrEL SQUAD 121003 These approvals certify that th6 systcjrz are adequate Im L4c 1101TICS that L�� support aad in., :�tt.e wd�.- t',;t were in place at the time of sYstem constructiln. Darrine, Any towi-Inade or natural change in a system that would inhib:t th-- syst�m i1rorn rvirforming as designed. D. N1nInt.-nau:%* nod Rep -Mr. Tb� sri.oduled and as needed replacement of exisliny c in u e in ro),poc:mts and pieces olen A%%r%'-TS that m er cl d d t�eoriginal de�ign%%hizh wot;"Uc.IITvth,-A%VW,'Stocont:r,ato terforrin 55 de;igned. E. Perwit , .Couht-fuclion) Aii0n-Site�'Vastev�,aterr)ispos--IS.t-iicin as defined by AMC 15.65. F. Permit (Operating) Ar. Advanced Waswwair.rTreatrnert System Opera.in.-Permit. AnaLnuall perrnit, issued by dx Municipally, that allows the awner to op-c-te ai AW%VTS, upon meefin.- al! the ron treincras of this agr�,-ernenr, the condition3 of Ope:aling Permit, *-',e Ycquircrnents of the On -Site Wastcwa,er Syveri ConstirucLion Pen -sit and' all relevant provisions of AMC 15.65 FS�L. Owner shall pay tt),MunicipalitY an Onnual fee of IVIA (3_`7�nn% payable on or before the issuance OfLhc operating permit and annually thereaftcr. The annual fee is due 4;n .)r the annive:szry date of the approval by th, I�Iunicipility oi insudled systein. 4. Terra. The term of this Memorandum of Understandinz shall be rer the life of die A W %kT-q - 07?3112007 12LI-0 FAI 31T 532 315) 381 IN-rEL SWAD em Me jyIurtjk;jrAjity of the installed sysixni and "O.'I-1 ji. 1hf PMP.rty is ,�ai! ic�%tin:t6 wwle the AWW'I S SYsUINI i_ ri te a i3�ucd t,; sold or title is transferred L,� uv.wi oi,� & nW certificate Of 0 -Si approv th,r -?,* ow -net or trinsfere- of the prqerry. 5. Alterat _n2irguipmen-1. Onncragfccs not to true any alteraticiiis. removal orp3rts or additions to the AWWrS without 3 Construction P--rmit itom the Municipality. 6. Ma:intellnnce R�nsi Z A. Throughout the term of thill Memomridurn of Cndcrstancling, die OU-ner shaU maintain ANV%VTS In good repair. In eddkion, it shall be the responsibility of the owner during the term of this Memorandum of UndListanding, and any cxtcrisions.or renewals thereof, at the ownet*sscle eLpenso, to ray for any and all: (1) repair(s). (2) mninteriance. (3) ac�justment(s). (4) replacement costs, and (5) ins�ecticin costs. Further, Owner agrees to comply will all applicable ordinvince, lawi. regiflations, rules and orders rot the AWNWrS. B. Owner agrees to provide tl,e'jNv.'jaiejpality a written scliedule of routine maimenaace and repairs which have been performed on the system pursuant to the terms &nd conditions rontaintd in the Owner's AWWTS Operiting Pennit. This schedule Shall be submitted to the Municipality artnuallY upon the renewal of the permit. The --chedule of maintenance and repair contained in the Owner's A%%%ITS Op. -rating Permit is: � --- 4 C. Owner acknowledges that the Mw scliedule for failing to ma intaii, and repair an ANMTS are codified in ANIC 14-60. ± '3 kL .53 381 I.SrEl. SQUID 7 2007 �2:40 FAI 3-17_n: 37 D. ()wnef agrees tl�.at only maintenance. repair persormel certified by the ,,,,tunic ipality will inspwt and rnaVe any neCC35ttry maintenance, repeirs or permitlixi a1wrations to the SYSICM. C.. OAMer agrek;3 10 6T3n'tbC Municipality reasonabl, access to test and inspW the AWWTS upon 24 hours writtm no:ice. r. Owner agrems lhzt any sxl-- or trinsfe.- of titic of the property will, not occur without a new Cerulfira-c of On-Ske Systems ApproN M. G. O%kncra�,tetsth3LIJ!Crt-ityantpttivi3ions of the standard specification guidebook f)r AWWTS is the ativcr.ling professicird guidelints for the c jnsrru.1�011, maintenance and repilir oFthe Owner's AWNVTS. 7. Noringive . ThTfa:ltueofcith�pa.�rlaten),tiincloenfaircaprovigionoftlils Niern-,randum of Understandi!i,-4 sb.-J! it- ro way const�tute a waiver ist the provisions, net in any way effftt tll,-' vr;;Jicv of the Mcmicrand irn of Uneurstanding or any p3rt hircof, or the rielit of sudi pail) thcreaftcr to Worce Zach an! ever) pi ovhIt3n hereof. a. Amadmi"I. A. This VIcrnorandurn of UnI.rstsf�&O shpill only bc amen -led, modified or danged by a vTitjng,,e%ccjted by audiari=1 rc�rcscntatives of the puties, with the same formcUly of this Memorandum of Understandin-. was c-.N,-,,.utcd ard sL:,( h -ATY41E. sh:tll be attached io this Nirworandurn ofUnderst.�riding u� an aracudinrit. D. For the parpo�cs of [my ImMI(Imcrit modification or change to the terms and conciltions of this contract, the oit!y authorized representa Lives of the parties ere: Zoos ViM/2007 12:41 FAX 31T .4;Z—V33 381 INTEL SQUAD Owner'. —2E� ra ct Anchorage: Em-1-1—slag- Lsr, C. Any attemrt ,-I Fun-ld rin 4:"Y, ot th:-� rv-'?r2-t L"' citlwr an =aUthorized r--presentati-,c or ussauihoelzeJ ro.cans shall be vold- 9. jur1Mi0lo_n-_Cb(,lcc 0 lnA- Any act*;;n ansing frorn this Memorandum of _J_ Un&rstanding shall be bro.sg1T. its j,,-:jkt 711*id Judicia! District of the laws cf the Stu' shall, gvvenn the rights and oniigatiolss O� Che PLA!" ... uidcr this Mcroorandurn of Understanding. 10. 5eySr 0 gilil-1. Any provisiuns ofNs hletnorpndury', of Understinding decreed izvalid by a cotir. of compcterstjarisdiction !hall not invalidate. the remaining provisions or the Memozuid-mn of Undc'sm'ding. IfTIVICIPAUTY: BY: 4*_iqt�z By: Title: Date: Date: STATE OF ALASKA J'jjIRD JUDICIAL DISTRICT The foregoing insinLnent was acknowlcdg�d before me this day of 7. 0 ul . 1'y Cr]`ARY��ffdCF RALASKA My Commission expires: NOTARY 1 e1v\ppBL1CJ* , -I— uo6e 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.cl.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. PS*O *301 — ;29 1. GENERAL INFORMATION, Complete legal description Location (site address or directior A IT' HAA # 04&503 Expiration Date: /2 o!j . A&A I 02 1 S6, Aej*!�Lr, AA'-' '1156-7 Current Prop owner(s) Mailing address 1474710 Lending ag'dhcy Mailing address Day phone Day phone _ Real Estate Agent 76�" 6__Z��_ Day phone 6!7 1/ — ,5e s"?.) Mailing Address &?f_4 1,e_iV4q_ Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 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. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties 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. TYPE OF WASTEWATER DISPOSAL: Individual On-site 24: Individual Holding tank 0 El Community On-site 0 El Public Sewer El The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 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. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties 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 the 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 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 effe o stpllation. IWAM ihnngineering Services Name of Firm 10421 VFW Rd., Suite 201 Phone �Oe) it - Address Engineer's Printed Name C"1,rTVPWC;9 e- - 4VAe D 5. DSD SIGNATURE Approved for — bedrooms. Disapproved. Conditional approval for 4— bedrooms, With the fo Date q- 111-0�L Al; Ili iiiii .51:1:111 �::' :F15FI::11 1: i F:11;i i new property owner shall sign the attached maintenance jed. Additional Comments Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory B (Rm 01102) ON-Sl�.E" S7E\ NATER 99WENT0,F"' Maintenance Agreements Supplemental Engineer's Report Other original Certificate Date: fy I tzz /0�j D. LIFTSTATION Dateinstalled Sizeingallons _L!9� �Ip Manhole/Access ON) qo�_� "Pump on" level at ;5' in. "Pump off' level atqg-!� in. High water alarm level at .29-15' in. Datum 'ToP or- Rok�!,Kej-Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROMVELL ON LOT 'TO: Septic tank/lift station on lot On adjacent lots too Absorption field on lot On adjacent lots Public sewer main -7 P u blic se we r rn a nho 1 a cl e a n o u t Sewer /septic service line — :7 -Holding tank SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT, TO: Building foundation Property line 5-7 Absorption field Water main /00 Water service line /00-1, Surface water 0,f) Wells on adjacent lots 100 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10 Building foundat io n 5 5 wat a r rn a in /0 0 Water Service line 05 Surface water 100 1- Driveway, parking/vehicle storage Curtain drain n" kn0j&2 Wells on adjacent lots 100 F. COMMENTS kE.... .... G. ENGINEER'S CERTIFICATION I certify that I have determined throu�h field inspections and .... ..... 11 I I - review of Municipal records t ha t th e above,systems are in conformance with MOA HAA guidelines in effect on this date. CHMSTOPHER 000 'CU Engineer's Printed Name 6"Jarl�9p le- t0216P ........... Date HAA Fee $ *30 Waiver Fee $ Date of Payment rn nt Date of Pay e -------- Receipt Number Receipt Number (Rev: 12/01� IN 89-56'00- W 112.00 WELL 291 1.0 DING �k Ri� 2 -STY FRAME HOUSE IE FENCE LOT 3 SIOCYCLE 79.8. OTANK 1 COVER 1W 1 10' UTILITY EASEMENT 69_tI5'00 E b UlAfN-UNK FENCE 1 �12. 0 0 x S, ................. ........................... LOUIS A. BUTERA LS -9338 9 .0, %�,'Ofesslonol F4� Ln a E_� LEGEND: WOOD DECKS ASPHALT DRIVEWAY SEPTIC STANDPIPES 0 PVC PIPE WATER WELL EAGLE RIVER 'CALE: DATE. BY, SHEET: ENGINEERING SERVICES ASBUILT SURVEY 1'=30' 9/15/03 8JR 1 z0f P-0. Box 773294 10421 WIN Drive DESCRIPTION:N 1/2, LOT 3, BLK 3 p Eagle River, Alaska 99577 COLONIAL PARK SUB. ERES Project Number: 03-043 e "D (907) 6.94-51.95 rAX (907) 694-3297 CADD FilejeNDme: 093-043ABil M s I hereby certify that I have surveyed the following described property- N 1/2. LOT . 3. BLOCK 3 COLONIAL PARK SUBDIMSION Anchor ge Re�ordng Precinct, Alaska, and that no encroachments exist except as Indicated. It is ,he �es onsIbilli y of the owner a determine the elxistence of any easements, covenants. or restriction IS which do not appea on the recorded subdivision plot. Under no circumstances should any data hereon be ij..,I f— - "S"Otion of fence lines, or for establishing boundary lines - e*�t'l Municipality of Anchorage 10 Development Services Department -TV'N. Building Safety Division OnZte Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 UERTIFICATE OF HEALTH AUTHORITY APPROVAL. FOR A SINGLE FmLY DWELLING Parcel I.D. 0510) 301- 7_!� HAA# Expiration Date: 1. GENERAL INFORMATION Complete legal description Location (site address or directions) 9 9 1 sr(wl�> 5- L10C_ 1111JER, 79�'b7 A Cu t r : refit Property ow I ner(s) ARMB&jh M%h101ZG Dayphone AIIA- Mailing'address 112. NEPTYA-4e elrUt_�rj 01IMpAib _ECAC"L, 32171-12DI Lending agency Mailing address Real Estate Agent Mailing Address Day phone L4t4k+ 11AA1_r1_R)�_Q/RC-i1MX Dayphone OY-qzoo U��RF14-Lb t>z' STr' 7-01 j _L:'AjKLCRT-y6RjAt'�9677 Untess otherwise requested, HAA will be held by DSD forpickup. 4. 2. - NUMBER OF BE'DROOMS: 3."- TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site Er Individual Water Storage 0 Individual Holding tank El Community Class Well El Community On-site El Public'Wate'r System El Publ,,c Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 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 andfor 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. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties 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 sea[ affixed hereto and as of the 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 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. Nomc of Firm Eag1eRiverEngj!!eerbV-Services F;Fone ' '�,qq;_ Slq!57– U — Address _7 Xox 773294, Eagle River, AK 99577-3294 Engi.neer'sPrinted Name. Date q 5. DSD SIGNATURE ClczlS-rCP4Wi5' WOW Approved for bedrooms. CE:10117 Disapproved'.* ...... ......... Condi*tional approval for 4 bedrooms, Wth the following stipulgr,@W�_4yo IM At the time of title transfer, the new property owner shall sign the attached maintenance agreement which shall be returned to this office before an unconditional approval is issued. Additional Comments Attachments: HAAChecklist' Septic System Advisory Wellflow Advisory X Maintenance Agreements Supplemental Engineers Report Other o,. Original Certificate Pate: ?;�7 e��PK - (R". 0IM2) nN-qITF WATERAND WA TEWAT6R PROGRAM Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program S A T Y 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: COLOIJ17AL PAJZK_ L-07 '? RLK 7 ! tJ'1-7- Parcel I D: C)SO -3 01 - ZS A. WELL DATA Well type RDAF67 If A, B, or C provide PWSID # Date completed al - _Y__ �.!gws Sanitary sea[ (Y/N) Total depth 3210—ft. Cased to __J2.0 ft. FROM WELL LOG Date of test _bc& 2011114657 Static water level ZW ft. Well production 9 -P.M. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mi. Nitrate Q,3Amg.A. Arsenic: mg.A. Date of sample: JA2/675 B. SEPTICIHOLDING TANK DATA Tank Type/Material SZr;C FIRF9�1A-S5 UoCYCLC Well Log (Y/N) Y Wires properly protected (YIN) Casing height (above ground) - ZU in. AT INSPECTION c _Z17Z I c�3 9 -P.M. Other bacteria 0 colonies/100 mi. Collected by: LpL4 8 UTEI�A Date installed -1 /Jq IC79 Tanksize /5'c�p gal. Number of Compartments CleanoutserN)- HATC14 Foundation cleanout (Y/N) Depression over tank (Y/N) Al High water alarm (Y/N) Date of pumping 4.17 Z.&:5 —Pumper_-�'iUs C. ABSORPTION FIELD DATA Date installed IL?��J Soil rating (g.p.d ./ft2 or ft2lbdrm) 12:!�Dr4&z system type T3rvCXLC W Length ft. Width ft. Gravel below pipe 0-0a ft. Total depth tt. Eff. absorption area _(IL.�_ft2 monitoring tube j__ Depression over field _N_ Date of adequacy test _5 Li Results (Pass/Fail) PAS5 For -4-- bedrooms Fluid depth in absorption field before test _0 in. Water added 2,10981. New depth_0 in. Elapsed Time: 0 min. Final fluid depth In. Absorptionrate 600-+ �_g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) AJ — If yes, give date D. LIFT STATION Date installed i P, VIM "Pumpon"levelat ?-<in. Datum 5t2-: coworyo-5 E. SEPARATION DISTANCES Sizeingallons 15�� 87cclaManhole/Access(Y/N) ' x "Pump oft"Ievel at �f �Iin. High water alarm level at 22-5- in. Cycles tested :56Z: (omougolt'> Meets alarm & circuit requirements? Y SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 1y6 Absorption field on lot 00 Public sewer main --7 j57 Sewer /septic service line On adjacent lots oc> On adjacent lots / Do Public sewer manhole/cleanout I 00*r Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation Property line Absorption field Water main IW Water service line Surface water I V0 Wells on adjacent lots _ I I �,Ot SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10 - Building foundation 6S Water main IuO + Water Service line Z5 4� Surface water - I Lc> Driveway, parking/vehicle storage !721-� Curtain drain AtetiC JcAinwoj Wells on adjacent lots /06t F. COMMENTS G. ENGINEER'S CERTIFICATION / certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed NameeHRI—a�-fte?, R.V)(.) Date /Z-9 101 HAA Fee $ Waiver Fee $ Date of Payment Date of Payment 06 Receipt Number Receipt Number. (Rev. 12101) CHIMTOPHR k WOOD .. CHOT 11 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date 2- 1., GENERAL INFORMATION (a) Legal Description (include lot. block, subdivision, section, township, range) & 0-r 3 RLOCIK 3 C'0t_0_"11qL rAlzm Location (address or directions) ::5:PC0Nb (b) Applicant Name agagT_ jqUy AuiLpen5- Telephone: Home A41A Business e— 94 - 5�--7Z Applicant Address 90, 13OX 7 -7 Z j233 FArLr alyr-a 7 57 Z (c) Applicant is (check one): Lending Institution 13 ; Owner/builderx-, Buyer E3 ; Other 0 (explain); (d) Lending Institution 6VoE!5Z__L4&M M0k6_-AA3'9 Telephone 621 71972 JXN PRM661L Address --- /Z eXb e,4F_A1tV &?A�Y, 5fj17-,C (e) Real Estate Company and Agent Address Telephone (f) Mail the HAA to the following address: 2. TYPE OF RESIDENCE Single-Familyx Multi-Familyll Other Numberof Bedrooms - '3 3. WATER SUPPLY IndividualWel Community Public Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite�( - Public Community Holding Tank Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11,84) 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by myseal affixed hereto and as of thevalidation date shown below, I verifythat my Investigation of this Health Authority Approval shows that the on-site watersupply and/or wastewater disposal system Is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the Information obtained from the Municipality of Anchorage files and from my Investigation and Inspection. the on-site water supply and/or wastewater disposal system Is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this Inspection. Name of Firm r–Or4UJI" 4t AS$a4— ZNC- Telephone _5�6 1 6 1671 Addre Date too to co j o No. 8 Ile P11 0 a 6.' DHEPAPPROVAL Approved for bedrooms by e�� Date Approved Disa>14ved U Coxional — Terms of Conditional Approval a101W, i zap eo CAUTION , Engineer's Seal The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given In paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate Is Issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 rfr(IZ3 MUNICIPALITY OF ANCHORAGE P DEPT. OF HEALTH & MUNICIPALITY OF ANCHORAGE (MOA) EWIRONMENTAL PROTECTIOIJ HEALTH AUTHORITY APPROVAL (HAA) 0 CHECKLIST - FEBRUARY 1984 264-4720 ' lkW V E D Legal Description: 407-3 A A. WELL DATA Well Classification _PRiy,97_'F. If A. B, C, D.E.C. Approved (Y/N) AJ Well Log Present (Y/N) YES Date Completed 12- Yield is appi Total Depth '420 Fr- Cased to 3 ?='D PV Depth of Grouting A4�k Static Water Level 2 20 F 7'9 Pump Set At 'OF _4Z-41 = 70 Casing Height Above Ground _-3 Sanitary Seal on Casing (Y/N) Y_FeZS Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N) ZVO Separation Distances from Well: To Septic/4,�Tank on Lot 120 On Adjoining Lots 12100 C70 dr=V To Nearest Edge of Absorption Field on Lot On Adjoining Lots E 77 To Nearest Public Sewer Line - To Nearest Public Sewer Cleanout/Manho e To Nearest Sewer Service Line on Lot AZ49 Water Sample Collected by Date -P Water Sample Test Results A&9 ThS PEA C MOAR Comments B. SEPTIC/0181:01NEI TANK DATA Date Installed 7 4 2 2 - 400size Z4000 0*44L, No. of Compartments Z Standpipes (Y/N) YES Air -tight Caps (Y/N) Y85 Foundation Cleanout (Y/N) YES Depression over Tank (Y/N) 140 Date Last Pumped Al/A Pumping/Maintenance Contract on File (Y/N) for AJ AIA J. Holding Tank High -Water Alarm (Y/N) .1 — Temporary Holding Tank Permit (Y/N) _602 Separation Distances from Septic/Holding Tank: To Water -Supply Well 12 0 F-7: To Building Foundation .4 & Al To Property Line I'L /0 97% To Disposal Field 9'50� F T To Water Main/Service Line WA To Stream, Pond. Lake, or Major Drainage Course —W-& Comments AJOOVP-- Page 1 of 2 72-02601/84) D. LIFT STATION &o -r ossp) C. ABSORPTION FIELD DATA Dimensions Soils Rating in Absorption Strata ISO 44�A FT, Zwnd Type of System Design Dateinstalled 74Z7.0 Length of Field Z Width of Field /8 FT, Depth of Field 6' E 7, Tested for Gravel Bed Thickness 4rdp IAICf4als Square Feet of Absorption Area Standpipes Present (Y/N) YE.- S Depression. over Field (Y/N) 1410 Date of Last Adequacy Test A44A Res ults of Last Adequacy Test I certify th*catche Separation Distance from Absorption Field: To Water -Supply Well To Property Line 17 FT. To Building Foundation To Existing or Abandoned System on Lot On Adjoining Lots To Water Main/Service Line To Cutbank (if present) ov To Stream/Pond/Lake/or Major Drainage Course IF To Driveway, Parking Area, or Vehicle Storage Area *10 F 7. Comments NO"Je D. LIFT STATION &o -r ossp) Date Installed Dimensions Size in Gallons Manhole/Access (Y/N) "Pump On" Level at "Pump Off" Level at High Water Alarm Level at Vent(Y/N) Tested for Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments we Check I er tted Bed oom Rating Against HAA Request we P I certify th*catche verified, orconformed toall MOAand HAA guidelines in effect on thedateof thisinspection. Signed Date Company MOA No. Receipt No. OF 41, tI, Date of Payment t., - Amount; S L C5,m- Engineer's Seal J S J. Comin Page 2 of 2 o. CE -5283 1'(�' 410 6, �. 0, *'- %'VAV P we*. \ � t',Z, � 72-026 (11,84)