Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
MEADOW BROOK BLK 3 LT 11
Meadowbr'ook Block Lot 11 #050-192-08 Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP221373 PID Number: 05019208 Dwelling: 0 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 0 Upgrade Name WOOD SCOTT ABSORPTION FIELD ❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Site Address 18068 SANCTUARY DR ❑ Other Phone Number of Bedrooms Soil Rating depth from original grade 341-9178 4 JTotal GPDISF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot MEADOW BROOKBLK 3 LT 11 Ft. Ft. Fill added above original grade Ft. Gravel length Township Range Section Ft. Gravel width Beds: Number of Lines Ft. - Distance between lines - Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area(Number of Irenches Dist. between trenches From Tank Field Tank Line Ft' Ij Ft. Well 1001+ na na na na TANK Arta Septic ❑ S.T.E.P. ❑ Holdinp ❑ Other Manufacturer GREEK 1 Capacity 1250 Gal. Surface Water 1100'+ - na na I Material Number of compartments Lot Line 110'+ - na na NA PIStc 2 Foundation ! 10'+ _ na na LIFT STATION Manufacturer Capacity Remarks Gal. Alarm location Electrical installed by Installer PIPE MATERIAL House to tank D3034Tank to D3034 drainfielci J R's Drainfield CO141T D3034 Inspector NorthRim Eng. BENCH MARK (Assumed elevation) 100 It Inspection v 11/1/22 11/2/22 dates: 2"' Location and description 3"' 11/3/22 4 Deck ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date F 0Mr ' 4 Septic System f stapro Approved Dated 2�e Note: this approval does not include well permit requirements. /o,... ACfrVV401 1^^ Water I �I o� cy, I A I fco B I 4 BdrM I Lot 12 Lot 10 � I I I I - I I 1�, I FSS AS -BUILT MEASUREMENTS Lot 41 \ A B dcol 36.5 25 T1 37 26 T2 40 29.5 dco2 42 32 Lot 9 Lot 42 Lot 41 \ NOR THRIM _+-'E�oF��'�� MEAD❑W BR❑❑K 1�� = 40' ENGINEERING BL❑CK 3 LOT 11 RECORD steveEng.com PO Box 770724 Fogle River. Alaska 99577 f Steve Enyr.:,, = ftj,J�j, cE-825e ,.• W A S T E W LAYOUT T E R 907.694.7028 SEPTIC TANK Dt' 22 HEET:UPGRADE IS2 0f 3 rn rr,z v �o ED cn ZO Z� sx P u 1 rrl - �I�� oo N El rD -- D-) ro n M `0 �o Q oQ0 -0 h -00 O ro W n 1,D co �,D C-) m Q O MUNICIPALITY OF ANCHORAGE 1"1 C P [ S On -Site Water &Wastewater Program PO Box 196650 4700 Elmore Road g z r Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 -'r '�" http://www.muni.org/onsite v �N�koan�E tuella r t111 ell On -Site Wastewater Disposal System Permit Permit Number: OSP221373 Effective Date: 9/26/2022 Work Type: SepticTank Upgrade Expiration Date: 9/26/2023 Tax Code Number: 05019208000 Site Legal Address: MEADOW BROOK BLK 3 LT 11 G:0153 Site Mailing Address: 18068 SANCTUARY DR, Eagle River Owner: WOOD SCOTT A Lot Size in Sq Ft: 22687 Design Engineer: NORTH RIM ENGINEERING Total Bedrooms: 4 This permit is for the construction of: ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: Issued By: 9/26/22 Date: Date: Z 2 HUHMPAUTY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 05019208 Property owner(s) WOOD SCOTT Mailing address 18068 SANCTUARY DR Site address same Day phone 341-9178 Legal description (Sub'd., Block & Lot) MEADOW BROOKBLK 3 LT 11 Legal description (Township, Range & Section) Lot Size 22,687 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) 0 (w/wo AD U) Septic Tank El Upgrade ❑ X Duplex (D) El Holding Tank ❑ Renewal El Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permi Rush Fees: a�5 ate of Payment: Receipt Number: 0 3 Permit No. ®sPa a �� 3 Waiver Fees: Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc DESIGN NOTES: 1. Existing Trench Remains In Place. 2. Sewer Service Line minimum 2% slope. 3. Replace Septic Tank/Decommission Old Tank Per UPC. Connect New Tank To Existing Trench. 4. Lots Served by Public Water. 5. No Conflicts Within 200'. 6. Check Condition Of Sewer Service Line— Replace If Necessary. 7. Replace FCO If Required Or Add DCO's. SQrct L12 Sep Minicipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221373, Curtis Townsend, 09126(22 50 Gallon Tank w/DCO's ssion Old Tank NORTHRIM +�+�� OF' At MEADOW BROOK 1° 40' ENGINEERING P' sieve s 9m BLOCK 3 LOT 11 DESIGN En g. com , .... PO Box 770724 ....................... tmE"LAYOUT Eagle R/ art Alaska 99577 '.4¢ .. c"m _ W A S T E W A T E R 907.694. 7028 ' 9i2iz UPGRADE SEPTIC TANK °at9/23/22 rof 3 D O w (n � M ,z ° O ry F- Ln C+ °"3 � ca 90 v 5 D M � M ,z ° p F- Ln C+ H o 90 0 5 � D 5 rD ro 5 3 5 � i ITI n LTJ z 3- o H m A. ± 1,D td Ul r F N ED R) n ED IT W N m td F— t E-1 F --j ED c t�3 O ) m P kD ()D v M Ul -P W N !- t:J m i0 C n t_/ D to £ 0 0 t= UT m 5- rD M -Z rD P r0 N ro V,, rDroronMro��Q-o`D z n 0-o53)73 O 0-3 Z a'n X Z O 3.5 1-0 I � - O rD D to rD T, rD —1 0 —I Ln -i to 3 n (O rD o P c,+ m 3-g QO 5 O 3 < X -(DD � rD h 5 c+ n �+ n. >n 6-.v) C7 .P_+- (7 rD -rl 90 D 0 U- n � � -0 --5 0 rD � Q -o v) 3 N bd -p rr 5 _ rD O nQ-rD`hn 3 n� to O -F -0DO c DUlo PQrD n no F+ 33 rD 5 n DGl + S —1 P 3-_ bd --- P � � (� � 3 5 O c+ -3 P O l� ° c ro ?7 :5 � O rD 5 O rDI n 3Nn s:Tr<D U<-0 p NrD S Q (D,nD n Q Q n (D M rD rD 9 - go Qo 5 0 p n W X� _o n ° S O 3 -40 P < p A `< Q (D rD n 0 n M C+ ro rD ro D Q � Q v Q 9-0 z rD 5 -o to r0 c P Sj c+ 5 rD P < -~t> rD �rD X P n c+ rD h n Ln P (D m O 3 -9 r0 D 1�5 n< .._. Wnicipallty of A dn-a9e On-site Water and Wastewater REVIVED, FOR CODE COMPLJANCE 0-';&21373, Curtis Townsend, 09/26,22 p P O 5 r P 5 O c C+ -9--q :5 P rD 5 O c C+ LA 5 (D Q m P 5 O c c+ LA td r0 cF rD 5 0 ro 'o C+ n aP M � sr� o ° p F- Ln C+ o 90 0 5 -t 5 rD ro 5 5 n n S 3- Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221373, Curtis Towner, 09/26/22 TLHIM, EN INEERING SteveEng.com Meadow Brook B3 L11 SPECIFICATIONS & DESIGN GUIDELINES Wastewater System Sizing: The current septic tank has failed- the seepage trench still functions. This lot is fairly large and on public water. No adverse impacts are expected from tank replacement. Easements are present on the lot & depicted with dashed lines. The slope is indicated in the area of the septic system. No conflicts to neighbor properties. Specification Requirements: All components and work must comply with the Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and Wastewater Regulations. • New 2- compartment, 1250 gallon septic tank. Watertight couplings on inlet & outlet. • 5' minimum between the tank and trench. 5' to property lines & 10' to house. • 4' of cover or insulation is required for tank; an equivalent of 1 " insulation for F foot soil cover. Tank & solid pipe must be set on well compacted, stable soil. No large rocks for tank bedding. Plastic/fiberglass tanks require special bedding per MOA- sand or pea gravel. • 4" diameter cleanouts with airtight caps are required 1 ' to 4' from foundation wall, prior to any 90 degree bend in 4 inch line, in 2" d tank compartment, and two adjacent opposing cleanouts between the tank and the absorption field, not more than 10' from the tank positioned to provide cleanout access towards the tank and towards the absorption field. Manhole Riser required in 1st tank compartment. O All cleanouts must extend to at least ground level. • In solid pipe runs, ASTM D-3034 may be used in lieu of cast iron. • Insulation must be placed over any pipe installed under driveways or parking areas. • Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS ASTM D2661, Y Sewer Service Line is minimum 2% slope. • Septic Tank to be pumped every two years or when required. • Insulation board to be extruded direct burial polystyrene (Dow Styrofoam HI/equal) OF * 49 TH *,I �S st— Eng I+:r< CE -6256 ++.� 9/15/22 Municipality of Anchorage Page DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 ® Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Name: ~~. ~ ~t~ ~. ~~ WastewaterSystem: ~New CUpgrade Address: ~P~ ~~ ~t~, ~ f' ABSORPTION FIELD Phone: No o~rooms: ~ Deep Trench E] Shallow Trench ~ Bed ~ Mound ~ Other LEGAL DESCRIPTION Rating: ~*~ GPD/Sq. Ft~ . . Soil . Total Depth from original g~d~: Lot: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe i - WELL: ~ New ~ Upgrade Grave~ width: ~/ Number of lines: Distance~eh,,een Ctassif,cation (Privale. A.B.C): Total Depth I Cased To: Total absorption area: Pipe material~ ~ SEPARATION DISTANCES Cs~pti~ ~.~ k~o~6in~ ~ S.TX.*. From Tank F,eld Slat.on Tank S ...... Lines I~D Well ~ ~ --~ ~ ~f~ Material: Number of Compartments: Surface Foundation ~ ~/ ~ ~.1: ~_ ~ ~ "Pump on' level at: ~" " : High water alarm at: Remarks: BENCH MARK ~ ¢ <~: ~ 9~~'%%/ Location Descriplion: S & S ENGINEERING ~ -. ~ %~¢~ 17034 RaCe River L~p Read, No. 2~ ~"~¢.,.~ r¢'~ Inspections performed by: _ ~el~i~.~,Al¢~l Dates: 1st I0-'%~ ~% ~ ~ /, Department of Health 8n~ H~mpn Ser~¢s approval & '% ~ ' Reviewed and approved by: , 4 ate: ~d 72 013 (Rev 9/91) MOA 25 ; Permit No. ~-~ ~ ~ ~-~---'%'~ ~ Page ~ of Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description:~-'l f--'~%'1--'~/,-~ ~ ~ c,4~;~"~ . PID No.: 72-013 A (Rev. 9/91) MOA 25 PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW920369 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:PIPHER GERALD E & SHARI L OWNER ADDRESS:18068 SANCTUARY DR EAGLE RIVER, ALASKA 99577 DATE ISSUED:10/26/92 EXPIRATION DATE:10/26/93 PARCEL ID:05019208 LEGAL DESCRIPTION: MEADOW BROOK BLK 3 LT 11 LOT SIZE: 22687 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: ISSUED BY:~~ / October 22, 1992 ROBERTSHAFER. P E ROGERSHAFER. PE CIVIL ENGINEERS (907) 694-2979 FAX 694 1211 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER &WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOl L TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 REFERENCE: Lot 11; Block 3; Meadow Brook Subdivision Request you issue a permit to upgrade the septic system serving the referenced property. An adequacy test performed on the existing system for Health Authority Approval purposes found the system to be in a state of failure. A soil test was performed in the area of the proposed upgrade and the attached design developed. We do not anticipate any adverse effects on neighboring properties by the installation of the proposed system. If you require additional information for your review, please contact us. Sincerely, ROGER J. SHAFER, P.E. RJS/tv Attachment 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 SCALE /I / / Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG m PERCOLATION TEST LEGAL DESCRIPTION: '~"\ \ "~'"~ ~'~"~'~J Township, Range, Section: 2 3 4 5 6 8 9 10 11 12 13 14 15 16 2O COMMENTS SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED?~'~'"~ DEPTH? ~1, E 0epth t~ Water ~lter _ f~oniloring? '~3::'~'~'" y Oal~: Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE \ '[~ (minutes/tach) PERC HOLE DIAMETER TEST RUN BETWEEN ~'~ FT AND I~ FT PERFORMED BY: $ & $ EI~'IGINEERING I ~ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ~T~,¢~ ~ EFFECT ON THIS DATE DATE: , 72-008 (Rev. 4/85) MUNICIPALITY OF ANCHORAGE DL 'FMENT OF HEAl.TH AND HUMAN SER~ iS Environlnenlal Health Division i'~25"! SXeot, Anchorage, Ataska99502,'lelepi~one264 4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT ........... DIS-rANGES FROM -~i lANK FIELD - ~ -rANKS i Z SEP'rlC 14OLDING ! IIENCIt BED W. DRAIN OTHER WELL LOT LtNF FOUNDA'IION ~, % ~14- i i GRE^, R ANCHORAGE AREA BOF,. Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 ,GH INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM -- /~ PHONE '~// SEPTIC TANK: ,x / ' [~ISTANCE ~' '~ [~- ~ ---- NUMBER OF I-ROM WELL ~{~' MANUFACTURER__~~ MATERIAL ~ COMPARTMENTS INSIDE LENGTH //~ - Ir~SIDE WIDTH__ SEEPAGE 'PI-T~: NUMBER OF PITS DIAMETER __ LINING MATERIAL ,~--~¢.¢L--~ CRIB SIZE: BUILDING FOUNDATION ADDITIONAL ABSORPTION __LIQUID DEPTH .... LIQUID CAPACITY /2-_'~'-~/) GALLONS. 3 OR WIDTH DIAMETER NEAREST LOT LINE //¢ _DEPTH ~ '~I~ISTANCE FROM: WELL TOTAL_ EFFECTIVE / ABSORPTION AREA (WALL AREA) ,_~)~(~7 (], .SQ. FT. WELL: -- _CONSTRUCTION BUILDING NEAREST FOUNDATION LOT LINE __ CESSPOOL __ _, OTHER SOtJ RCES APPROVED DISAPPROVED NEAREST SEWER LINE_ _ DEPTH DISTANCE FROM: SEPTIC SEEPAGE --, TANK _ SYSTEM -- REMARKS DISTANCES: PIPE MATERIAL, LOT SLOPE: REMARKS: DIAGRAM OF SYSTEM G.A rM ]',[: CEd'J'TAC"I" F:'HONI!}i:: '7 '7 4 '7 7 3 VIER, AK t..i) F S I ZI}i::', MAX :('3 !J: ) } I::~/E K} I'.1 !J!;: L. J.!:;'Ir'.. ('':'d I::~ ~:':':' 1 OW" a r' e t h (;:.~ op ~:. ;i. (:n", s ava :i I ab 1 ,::, '1:. c) v'c~u :i. F'r d e:.u:~ :i. g n :i. n ;.; you r. ~m.:.:-~p't.. :i c s y s'!'_ (:~:, m ,, Ch o o s e 1' h e ~::) p '1'.. :J. o n t }"l a'l'., b e s t f :i. 'L s y c)LI I" ~B ;i. t ({(.) ,, ):)~::::" '1"[ :::' :::': '"d'l ..... " (F'I) ~ .. ~ ~ ~, .. :. I1",.ii .:~ :i p V ~ .,g f i')TI"I ( ='T ) ~ ' ':';~ ~" )~" ' ~ GRAVI::I,. :NG'I'H (1:::"1 . ) :1.(),, () "7 ' ;~',' :. GIRAVE:I., VOI...UI"iE: (i]U. YDS. ) 5,, l, "'~i" .~r.l.~t~ U · x-*~. I"ANI< MLJSI" HAVE Al' L, EAST 'I"WO C(:]MPARTMI~:N"I"S I c:: (..+~p/. :i ~' y t. I'~ a'l:. :: !. ]: am iamil:iar' w:i. th tt're r'(.:.:,quir'c~,rrl~.:..:,nt~i f'cir' cln-.-s:i, tc.'~ se~,~(.:::,r.s arid wi:,].ls a~:~i set fc)r"l'.h by 't..l"~e Ifiuri:iC:Ll:)a!ity of' Ancl"loi'age (M(]A) ~l"icJ tl'li.~) ~?.. :l:b~:[ ]. ]. :i.I"iEFILa]. ]. '~.I]E.;, fi~iyEi'~'..c.-:,lll :J.r'~ ~:':'~c(::C)l'(::lar'iE:0:~ ~:i.'l'..l"i al 1 MOA ;:~;,,Zl:e.J:i.l], adl~c.:.pe 'Lo a].l M(]~ and S'L ,;;cE <.:, of Alasl.::a r'~".~ClU:i, pemer'its fop 'l.:li0~ set bac:k 4. :[ L~r'ido:,r'~'Lar'lcl 'Lhat:. 'l'.his per'mil:. :i.s val:i,d tc:,p a max:i, mum d:d'iy c.'.:,r'i].ai'(].li~)liielTt'., w:i.]l r"c~<::luir't.::, al"l addJ. t.:i. orla], per'mi'L,, Il:: ¢.:~ L..IF:'I S'I"A"f']:I]N IS ',.~;'f'Al...[..l:f). ]:1',.I AI',I ARIE/'~ COVIERli::O BY MOA BI..IIL. I)IIxlG {...i..ll.l:::.;::~,'" ') "' TI.Ili:N ( 1 ) AN lii!]...IECTR ]: i:;A!.... I:::'li!i:l.;',M I 't AND :1: t',ISI': I::(.T'I" :iZ O1',1 MUS'T BE OBTA I Nlii!::i}; (2) A!i!h-..):{IU I I...TS W]LI...L NE) t' BtE !~F:'F:'F;~[)Vf:i:'D I,',II'IHEJLI"I AI',I ' :: .......................... ...... n..!...t., 1'1.~1 ..,¢..... ] Ih:.l..l:.C t ',1 REF'OFi:T!I AN:F) C:) '1HE I.t , P,.I..,Al... WORK l lL.Jc~l E.~FHF..iHEN~ ~..F. HEHL1H FINE:, ENV~ONMENT~L PRO1., ..~ ~.~: ................ . F'EERI"'I:[ T NO. ,' R::,=,OI.Zt-I~ E BIJZL[',:' L.OCFIT I r'lN ....... qR~., r':~;~l IRR'¢ DR OFF KRNT 1%HNR LEGAL LJ.~. 3~ I"IEA[:,OI.4 BROOK S,.'"D " ,.,,:,~.~ ...,_ ,. ........ .-. ¢.,rE. rL.. FIT .. ~ . ......... ~1., MI Ihlb :'(Jib RB~I R' '- · IHE MZh]~'ILII',I PEF"FH '~F' R~,n,,:'~ r,,_.,..,-,;.;..;P~.Z.?N ~5TEI'I Zz,:[.,EF'I'H= I"HERE I.:";, NO SET kllE:,l"H THE I)EF'TH OF ' "' ...... FRENL. HE=,. FOR BRA I NFI EL[:,'_-';., THE £4 I[:,I"H "c. .[-, 2: FT. rF..E.N...H OR F'IT IS ']'FIE [.].=,THN...E BET~4EE[N 'f'HE GF."3UNB =LIIRFI~..E RN[.~ THE BO'f'TOt,1 OF' 'T'HE E'F:;C:AVATZCN. THE LENGTH [:,It,IEN2;ICiN ]:S THIS LENG"I"H OF' ERCH SI[:,E F'O~t R SEEPRGE PIT OR THE L. ENI3TH OF THE ""~tEN:':H, O~t B, RRINFIELD,. 'f'HE: F~E;~IIZRED -EFTZL TRNI< E, FIZ:k';FZ~LZNO OF IRNY SYSI"Ehl I,~ZTHOUT FZNRL IN%PE'CTION E'Y E,E . T'H ~ 2; [:'EF'R~TP1ENT NI LL. =,JBJEt. I TO :,;,'-c F ~ ..... EL.U [ ZEN. I"IZNZPIUM DZ2~;"I"RN;L:E FROFI PEEL.L. TO RNY SEF'T'ZC TRNK/PRCKRGE PLRNI- ~.~8 FT F']R' R ¢UE, LIu L4ELL. E;PEI:2ZFZCRT:[ON:E; RN[:, CONS'I'~LIC'rZON [)IF~6['.R[,1S RRE A',/RILRE:LE TO INSURE FROf ER ~.C:~I"]:F"~' THAT I Al"'l FRI','IZL IFtl~: 14ITH TFE' F.'E6~JIRE'[,1ENTS F'OF ~' ~,E:T F'O~:T'H BY'THE: I"IUNZC~F'R[ ]'"r'¢ nF ¢;p.]2:~_:,..,.....~ ....... - _ ~. '.d-SITE SEI4EF~S RND I,~ELLS 1.4II"H THE C:OD[~.,' // ........... 0 Russell Oyster 694-2774 Soils Et Foundations 8E Box ~, Davis St., Eagle Rivor, Alaska 99577 694-2774 or 68~-2280 $O~.L L06 PeFfo~ed fo~: Legal Description: 0 Earl Ellis 688-280 I.and Development , I~ITF, I A t",~ [NAR ¥ I hereby certify thttt [ have surveyed tilt, described property: Ltl* 7 [ /, .l :,, " '- W:- Z~ ::<' , ./:1 ' ":; .":, A ~ :lo' '.9' l{e :ordiny. t)J'e('.i~w(. Alaska, nn~l lhat will he, w[l lin tilt, Dropc 'ty li es and wil ~,ot ow'Map Duic, d id Ealde llivet', , · dny of '-.. ::- lg ' ' ttOBEIIT (' ,JOI]N~t)N MUNICIPALITY OF ANCHORAGE o Development Services Department s 4 Phone: 907-343-7904 On -Site Water & Wastewater Section Fax. 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 050-192-08 Legal description Meadow Brook Block 3 Lot 11 Site address 18068 Sanctuary Dr Current property owner(s) Scott Wood Expiration Date: / `1 , Z 3 X The On-site system(s) is/are approved for 4 bedrooms Conditional approval for Comments or advisories: bedrooms, with the following stipulations: By: " V Original Certificate Date: I/ / `7 -zo 2 2 This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA Approval_June 2022 MUNICIPALITY O_F ANCHORAGE J� koq Development Services Department ' Phone: 907-343-7904 On -Site Water & Wastewater Section ��-� Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. G 5-0 0 2-d W d Uv Complete legal description MEADOW BROOKBLK 3 LT 11 Location (site address) 18068 SANCTUARY DR Current property owner(s) WOOD SCOTT Day phone 341-9178 2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS 3. TYPE OF WATER SUPPLY: ❑ Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ■❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ❑■ Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel 0 Plastic ❑ Concrete ❑ Fiberglass Age new - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed X Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Distance: Expedited review requested: ❑ By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ 155-0 Date of Payment 11lL, I A-2 COSA # Q C-2.2 !.S 3/ vq g?qD Waiver Fee $ Date of Payment Waiver # COSA Application June 2022 COSA Checklist Legal Description: MEADOW BROOKBLK 3 LT 11 Parcel ID: OSP221373 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system _ A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Comments B. TANK DATA Measured operating fluid level in septic tank Date of pumping NA ❑ Required maintenance completed, if AWWTS Comments: * new D. ABSORPTION FIELD DATA Which system tested (date installed) 10/30/92 FE1 ALL standpipes present per record drawing Total measured depth from grade 12 ft (max) Measured depth to pipe invert from grade --5—ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) If yes, enter date Comm ents/Deficiencies: COSA Checklist June 2022 Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Date C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 9/14/22 Results 0 Pass Fluid depth prior to test 51 in Water added 600 gal New fluid depth 56 in Elapsed time 60 min Final fluid depth 51 in Absorption rate 600 gpd FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 84 in Effective depth used 51 in Effective depth remaining 33 in E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' D Yes if No ft. Community Sewer Manhole/Cleanout > 100' Surface Water> 100' Yes if No ft Tank to Property Line > 5' n Yes if No ft Neighboring Tank > 1001 E] Yes if No ft Private Sewer/Septic Line > 25' F-1 Yes it No ft Absorption Field on Lot > 100' [:1 Yes if No ft Holding Tank > 100' ❑Yes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' ❑ Yes if No ft E] Yes if No ft ft If tank or field is under driveway comment below Community Sewer Main> 75' nYes if No ft Manure/Animal Excreta Storage > 100' F-1 Yes if No ft El NIA — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' Q Yes if No ft Surface Water> 100' Yes if No ft Tank to Property Line > 5' Fol Yes if No ft Wells on Adjacent Lots: Field to Property Line > 10' On Yes if No ft Private Wells > 100' Yes if No ft Water Main > 10' 0 Yes if No ft Community Wells > 200' Yes if No ft Water Service Line > 10' Yes if No ft If tank or field is under driveway comment below F. ENGINEER'S COMMENTS G. CERTIFICATION & STATENIENT 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, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm NorthRim Engineering Phone Engineer's Printed Name Steve Eng Date COSA Checklist.lune2022 694-7028 11/1/22 Muuicipality of Auchorage Development Services Del3artment Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 995t9-6650 www.ci.anchorage.ak.us (907) 3J,3-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 050-192-08 1. GENERAL INFORMATION Complete I~gal description Lot Location (site'address or directions) 18068 Sanctuary Dr., CUrrent Propedyov;'ner(s)3im & J'ean Russo Mailing address . ,Same Lending agency .... Expiration Date: w~n~o,.,brook' $/D Eagle River, Day phone AK Day phone Mailing address Real Estate Agent Dick Brown Day phone 696-2850 Mailing Address Unless olhe~vise requested, HAA will be hem by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Public Water System Well TYPE OF WASTEWATER DISPOSAL: Individual On-site [] Individual Holding tank [] Community On-site Public Sewer [] The Mur~icipalily of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given In paragraph 5 by an Independent prolesslonal civil engineer registered In Ihe State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except be[ween spouses) for propedies sewed by a single family on-site wastewater disposal and/or water supply system. DSD also Issues HAAs upon request to homeowners. Certificates of Health Aulhority Approval are valid for 90 days [rom Ihe date of Issue for propedies served by a private or Class C well and may be reissued with new waler sample results less than 30 days old. (Cedi~icates may be reissued for a period of up to one year with valid water samples.) Certificates ere valid for one year for properties served by Class A or B wells or a public water system. The Municipality o! Anchorage Is not responsible for errors or omissions tn the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER ' As certified by my seal al'fixed hereto and as et. the valldalion daie shown below, I verify that my Investlgalion, based on procedures outlined In the Health Au~horih/Appmva~ Guidelines for this application, shows that Ihs on-site water supply and/or wastewa[er disposal syslem Is(are) safe, functional and adeqoele for the number of bedrooms and type of stmclure Indicated hereln. I fuHher verify Ihs{ based on the Information obtained from the Municipality of Anchorage files and from my investigation end Inspection, the on-site water supply and/or wastewater disposal system Is(ere) In compliance wilh all applicable Municipal and State codes, ordinances, and regulations In el'fect at Ihe time of installation. Name of Firm S & S Engineering Address 17034 N. EaRle River Looo RD., Engineer's Printed Name Robert C. Cowan 5. DSD SIGNATURE /.'/" Approved for Disapproved, Z-[bedrooms. Conditional approval for Phone694-2979 Ea~le River, AK 99577 Date ~-,,~_'....7.... ,,.-."t~ b~drooms, with Ihe following slipulations: Additional Comments Attachments: HAA Checklist Septic Sys{em Advisory Well Flow Advisory X Maintenance Agreements Supplemer~tal Engineer's Report Olher By: Original Cediticate Date: Municipality of Anchorage Development Services Department Building Safety Division On.Site Water & Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage, ak.us (907) 343-7904 O HEALTH AUTHORITY APPROVAL CHECKLIST Well type If A, B, or C Date completed Y/N) Total depth, ft. ft. Date of test Static water level It. Well production g.p.m. Well Log {Y/N) Coliform __ :olonies/100 mi. Nitrate mg./I. Arsenic: mg./L Date of sample:, B. SEPTICJHOL.DING TANK DATA Tank Type/Material ~°rlC~ / Tank =~e I ~ gal Numar of ~n~ ~ F~nda~n ~eano~ ~/N) ~ ~pm~n ~r ~nk ~) ~ Date of pumping q/i'~oZ Pu~ ~ ~ C. ABSO~ON ~E~ DATA*~ ,' .~ Wires properly protected ~/~ Otherfi:mct~fia. colo~le~/'lO0 mi. Date installed ~/~ Cleanouts {Y/N) ~/ High water alarm (Y/N) ~/ Date ,..ta,,. Total de~h Fluid de~ in a~omfion field ~m t~t'~ ~. ~r adde~al. E~ps~ Ti~: ~min. Final flu~ dep~ ~in. ~fion m~ >= ~y rejuvenation ~ea~ (p~ 12 ~.) System tyl:e "7'~'~'~C.--,,J CT. r-4 Gravel below pipe '~ ft. Depression over field, ~J For ~ bedrooms New depth.~2~.in. ~ g.p.d. If yes, give date ~ O. UFT ~rATION Date installed 'Pump on' level et/ in. / Datum / E. SEPARATION DISTANCES Size in gaflons 'Pump off' level at Manhole/_,~'e_ _ss (Y/N) in. High water alarm level at in. Meets alarm & cimult requirements? SEPARATION DISTANCES FROM WELL,,~tff. OT TO:. Septic tank/lift stet]on on lot / On adjacent lots Absorption field on lot / On adjacent lots / Public eewer main ~ Public sewer manhole/cle~ut Sewer/septic service line ~ Holding tank / SEPARATION DISTANCES FROM SEPTIC/H~,4~[IG TANK ON LOT TO: Building foundation ~ ~4- Property line 5 '"/'" Absorption field Water main I 0 i · f' Water service line / O ' ~' Surface water Walls on adjacent lots ~/ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Pmpertyline /'~5) ~-i- Bulldingfoundat]on [ (~ f.4- Watermain If") Water Service line ~1~+- . Surface water 14~N~ 14" Drlveway. paddngNehldestorage C ,n dre,n aWe,son edJ ..t lots Fo COMMENTS' G. ENGINEER'S CERTIFICATION ,,, ¢,_~' -.../'~ '.,*....~ ~,- review of Municipal records mat the above systems are in conformance with MOA HAA guidelines in effect on this date. p,...g~d~l~lll;~EEl~ ~z,~_~----~ Engineer's Printed Name ~JJ~f...4, T C. COW.,,,.-' HAA Fee $ ~ '~ 5'". "° Waiver Fee $ Date of Payment fl / I :~/e ';~~,f Date of Payment Receipt Number O ~ Y',Y' '7 ~ ~ Receipt Number (Rev. 12~01) ".'~-,',';,.,':-'~ .,', .' .... --;(-" .-."", ',.-.. ,.'.'.. ,vv' ..... ,~ .. . ' .... ..,,. .. . . ~0 ,.ST. ~...,., .... . ..... :,.,,,,... · ...:.. -: ..' .: "' " T:.UA, R : D ~ !~ :' ,'." ' , · :...'. .. ' ,~ , ' ' [z:~.l~ r ; .. % ..- : .,. , 11 · '· . I \.,~\ '. .... ~ .'. : · -,~ // .... . ,.-.t-__--- ; :.. ,,, . .. .... ;. q '""" ' ' ' // · · , I ..~ \~'%. . ~. ..%,, , '1' .. . // / ... "'"'% ~ · ,,, ~ .,,:__~.¢.~ I ", :,., -. ,..- / / ,..... I . · ..- .,-.. ·/ ..,. ... ,,,// .,.. ,~ ...'...· . ..:'~," ,..,.. ,17'"'/ · U ' ' ~.~.'~'~" ". ""'"' ' : MUNICIPALITY OF ANCHORAGE DEFARTMENT 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 APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION Complete legal description Lot 11; Block 3~ M~adow Broo~ Subdivision Location (site address or directions) 18068 Sanctuary Dr~v¢ Property owner Mailing address Lending agency Mailing address Pipher, G~rald & Sherrie 18068 Sanctuarq Drive, Day phone Eagle Rive% A~ska 99577 Day phone Agent P¢~ Ostdieh TARGET, !NC. REALTO? 17034 Eagle Rive~ Loop Road '~ Address P. 0, Br~ 774~27 Eagl~ River, Alask,a, 99577 Unless otherwise requested, HAA wih be held for pickup. NUMBER OF BEDROOMS: 4_. TYPE OF WATER SUPPLY: Individual well Community well Public water ×X Day phone 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 XX NOTE: 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 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 wastewater disposal system is safe, functional and adequate for the number of bedrooms and typeofstructureindicated herein. I furtherverifythatbasedontheinformationobtained 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 Address Engineer's signature 6. DHHS SIGNATURE 17034 Eagle River Loop Road No. 2{34 Phone Approved for bedrooms. Disapproved. Conditional approval for ~T///.. //'/ ,) bedrooms, with the following stipulations: :;,,,, / /¢/ , ._,. ,: C Additional Comments 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 reg istered in the State of Alaska. The DHHS does th is as a courtesy to purchasers of homes and their lendin9 institutions in order to satisfy certain federa[ and state requirements. Employees of DHHS do not conduct ins:.: :::OHS or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible ior 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: t'~-p,-~:::P~.D ~R~Z' ., Parcel I.D. A. WELL DATA Well type fl't~F~ ~ If A, B, or C, attach ADEC letter. ADEC water system/n~ber Log present (Y/N) ......... Date completed ./Driller Total depth ....... Cased to Ca~g height_ Sanitary seal (Y/N) ...... Wires properly pr,~cted (Y/N) __ _ FROM WELL LOG / AT INSPECTION Date of test Static water level Well flow - SEPARATION DISTANCES FROM WELL Septic/holding tank on lot / ; O~ja~ lots Absorption field on lot ~ ; On adjacent lots / Public sewer main ~ Public sewer manhole/cleanout / Sewer service line / / WATER SAMPLE RESULt/S/ ~::':°:,:amPle: / Petroleum tank Nitrate. Other bacteria Collected by: B. SEPTIC/HOLDING TANK DATA Date installed Cleanout~N) High water alarm (Y~ Date of pumping Tank size )~ Compartments Foundation cleanout(~N) k -t//' Depression (Y~ Alarm tested (Y/N) b-.t/-~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot h-~/1A'' On adjacent lots To property line_ ~-M~ I Absorption field Surface water/drainage /~ -If Foundation Water main/service line 72-026 (Rev. 7/91) Fronl CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) High water alarm level Manufacturer ccess (Y/N) "Pump on" level. J.art' "Pump off" leve~ at Meets MOA electrical codes .(.Y-~) SEPARATION DISTA/~E FROM LIFT STATION TO: Well on lot On adjacent lots Cycles tested Surface water D. ABSORPTION FIELD DATA Date installed I O - ;~ O-E~/7.--~ ' Length ~ Width Total absorption area Depression over field (YL-¢~ Results (pass/fail) Peroxide treatment (past 12 months) (V//~)) Soil rating ~'~ ~i~O/~T'C-System type Gravel thickness -~ / Total depth Cleanouts present~_N)"~ Date of adequacy test f~ for SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot ~ / ¢/%'. On adjacent lots '~' ~'~ If yes, give date Property line bedrooms To building foundation ~.(-Ct To existing or abandoned system on lot On adjacent lots ;::2_2,0 t _~_ Cutbank h-~(21J, ~ Water main/service line Surface water / ~ ~ -~ Driveway, parking/vehicle storage area Curtain drain h.~-h3..¢_¢~ !~--~,J ~v~,.~t~/ . E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature Engineer's Name Date 5 & $ ENGINEERING 17034 ~a~le River Loop Roar.~ Ne. 204 Engle [~iye~, AiasEa 9~25;~7 HAA Fee $ Date of Payment Receipt Number 72-026 (Rev 3/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number GENERAL CONTRACTOR Excavation · Custom Homes INVOICE from DEAN CONSTRUCTION & DEVELOPMENT BILL TO: FIRM: NAME: ADDRESS: CITY: STATE: LEGAL LOT: BLOCK: Target Realty Pete Ostdiek Eagle River Alaska 99577 DESCRIPTION 18068 Sanctuary 1! SUBDIVISION: Meadow DATE of BILLING 10-30-92 DESCRIPTION of WORK PERFORMED: I~stal 1 septic system upgrade per engineers des±gn. Per Ouc, te $1,980.00 Ins'~all seo:,nd clean-out ,:,n ~eptic tank. 50.00 T,:,t a 1 $2,03 ' . 00 .AMOUNT DUE $2,030.00 HC 85 BOX 9352, EAGLE RIVER, ALASKA 99577 33 W~OH IT NAY CONCgt~N. A~Eer breakup and before June ]0~ 1993~ I will bring equipment back to this site to fiji holes and level to a final grade. This was impossible to do during winter inst~ll~ition ~[/the new septic bed. The cost for this is included in ~j~~ the abov i Rdbert z Dean November ] 7, 1992 HC85, BOX 9352 · EAGLE RIVER, ALASKA 99577 · TELEPHONE (907) 694-9117 MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF I:NVlRONMENTAL SERVICES 343-4744 Parcel I.D. # CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING C" '-z;"'.--I ~ :~-- ?~_y,'7~ NAA # 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 11; Block 3; M~adowbroo~ Subdivision Location (address or directions) 1 8068 SancZ~ary (b) Property owner Mailing Address (c) Lending Institution Mailing Address Standard F&d~ral Sv~s B~. Telephone: (home) of Maryland Telephone Business (d) Real Estate Company and Agent Tomblins o n Address MARSTON REAL ESTATE ATTN: Shirl~ Telephone (e) Mail the HAA to the following address: (or check hereX~, if hold for pick up.) List contact person and day phone number below: $ & S ENGINEERING 17034 Eagle River L~op P, oad No, 204 Hagle River,.Alaska 99577 2. TYPE OF RESIDENCE Single-Family (~X Number of bedrooms 3. WATER SUPPLY Individual Well [] Community [] Public E~,~ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-siteX~ 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. 72-025 (Rev. 7/88) Page 1 of 2 ~ j.o ~ etSed 'MJOA~ s,Jeeu!bue leUO!SSa~oJd eq~ u! 8UO!S$!LUO JO SJOJJe JOj elq!suodsaJ lou s! ebeJoqou¥ 1o Xl!led!o!unlA[ aqJ. 'penss! s! e~eo!j!~JeO e eJo~eq elep aZXleUe Jo suo!loedsu] lonpuoo lou op 9HHG jo saa,~oldUJ3 'slueguaJ!nbeJ eleis pue ]eJepej u!elJeo X~s!ies ol JepJo u! suo!lni!isu! ~u!pual J!eql pue seuJoq ~o sJaseqoJnd ol ,~selJnoo e se s!q~ seop 8HHG aqj. 'e;tSelV ~o alei8 aqi u! paJels!~aJ Je@u!bua leuo!ssaloJd ~uepuedepu! ue Xq eAoqe ~ qdeJl~eJed u! UeA!b suop, elues@JdaJ aqi uodn Xluo peseq peleo!j!Jao leAoJddV X1]Joqlnv qlleeH senss! (SHHQ) seO!AJe$ uegunH pue q~leeH ~o ~uaLu~JedeC] abeJoqouv ~o X~!led!o!un~ aqj. leUO!l!puoo leAoJddv 18UO!l!puoO ~o suJJe± pe^oJdde$!Q /N<~ paAoJddv ,~q sguooJpeq ~ Jo~ pe^o~ddv ']¥AOI4dd~ SHHQ '9 euoqdelal ~0~ 'oN peon{ doo-~ AO^!~ ejBe~l t~£0ZL eleC] ssaJppv uJ,q-t ~o aLUeN 'uoRoadsu! s!qljo elep aq~, uo ~oej~e u! suoileln6eJ pue 'seoueu!pJo 'sepoo e),elS pue led!o!unF,~ lie q),!~ eoUe!ldLuoo u! s! LUelS/,S leSOds!p JeleAe),se/~ Jo/pue/qddns ~ele~ e~,!s-uo eq~ 'uoRoedsuj pue uo!~e6Rse^u! XLU LUOJ~ pue selJ~ e6eJoqouv Jo /,l!led!o!unR aql LUOJJ peu!e~qo UO!leLUJO~U! eql uo paseq ~eLl~ ~!Je^ JeqlJn~ I 'u!eJeq pe~eo!pu! eJnlonJls jo ed/q pue suuooJpeq jo JaqLunu eq~ Jo~ e~enbepe pue leUO!lOUnj 'ejes s! LUelS/,S leSOds!p Jele/~e~se/~ Jo/pue ,~lddns Je~e~ e~,!s-uo eql ~eq~ s~oqs le^oJdd¥ ,~poqlnv q}leeH s!ql jo uoRe6!lse^u!/,LU leq), XJ!Je^ I '~oleq u/~oqs elep uo!3epJle^ eq~ jo se pue o3aJaq pex!j~e leas XLU Xq peit!),Jeo SM NOI.L¥1NblO=INI (3N~¢ ~'J2Ca 'H01:1'¢~$ ~1'11=1 '$.LS~J. '$NOI.LO~dSNI 9Nl(31^Ol=ld WI:il.-I IDNII:It~NIeN~ '9 Well Classification MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) CHECKLIST- FEBRUARY 1984 343-4744 Legal Description: ~----¢¢T- If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) · Date Completed Yield Total Depth Cased to Depth of Grouting Static Water Level Pump Set At Casing Height Above Ground Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot -"~¢:~ ~ To Nearest Edge of Absorption Field on Lot '"'~,~c~f ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected by ; Date Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA Date Installed ~_/~Lc Size Standpipes ~¢?N) Depression over Tank Air-tight Caps (r.~/N) Pumping/Maintenance Contact on File (Y/N) Holding Tank High-Water Alarm (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply Well '2..--¢=~c:~ I~ To Building Foundation To Property Line \,=~,l .~ To Disposal Field To Water Main/Service Line \ ~ t ,y To Stream, Pond, Lake or Major Drainage Course \ ~.~ t Jr Comments '~'¢-~5 ¢-b¢-~-¢-~'¢'~;:'c:~.,-- ~O'~'\¢ ~,~---~(-'"t , No. of Compartments '2-- Foundation Cleanout ~Y:/N) /4te Last Pumped ; for Temporary Holding Tank Permit 72-026 (Rev. 7/88) Fronl Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~'/'~ i,¢ Width of Field \ ~ ~,4.~ Type of System Design '~'~-~; Length of Field Depth of Field Gravel Bed Thickness -~¢-/'~''~ Statndpipes Present Date of Last Adequacy Test Square Feet of Absortion Area Depression over Field (Y/~ Results of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well .?..¢~.L ~ To Property Line ~ ''~' Y To Building Foundation, Lot r4/A To Existing or Abandoned System on ; On Adjoining Lots % To Cutback (if present) To Water Main/Service Line ~ ¢, 4- To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments ~ .~'--15q"~ t-.l:~.~ ~ LIFT STAT,O. Date In~ed f ' Dimensions Size in Gall-0'n~. Manhole/Access (Y/N) "Pump On" Level at-7'~'"'"~ "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 **Check Permitted Bedroom Rating Against HAA Request** I certify that l have checked, verified, or conformed to all MOA and HAA guidelines i~..~ ~t~ inspection. .%f~Luy ~,~ ;:%~. ':, Company '17034 ~agleAiaskaRiver Loop~¢Sz~Road No. 204 Eagle River, Date ~' / / MOA No, ~ ~D --- ¢¢~ ~~ /,~ ReceiptNo. ~ /7~7 q/'~(~¢'/~ ) ReceiptNo. Date of Payment ~/~ ~'~E_) " Waiver Fee: $ Amount:$ '/ 7~2~ (~ ~ Date of Payment 72-026 (Rev. 7/88) 8ack Page 2 of 2 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 GENERALINFORMATION (a) Legal Description (include lot, block, subdivision, sec?on, townsh~, range) /_.// /3 ,:3 /o,-co Location (address or directions) Name _~ ' Telephone: Home Business (b) Applicant Applicant Address~A¢~ ~. ~ ¢~ .7 (c) Applicant is (check one): Lending Institution ~;Owner/builder~;Buyer ~; Oth¢(explain);~/~ Y (d) Lending Institution Address (e) Real Estate Company and Agent Address Telephone -r i ~)i~.on~e (f) '. he HAA to the following address: TYPE OF RESIDENCE Single-Family~ Multi-F~D Number of Bedrooms Other WATER SUPPLY \? Individual Well [] Community [] Public/~ Note: I! community well system, must have written confirmation from the State Department ol 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. 72-025 (t 1/84) Page 1 of 2 ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Ftealth Authority Approval shows that the on-site water supply 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 Address Date S & S E~gineering Eaqle ~.lver. Ain,En Telephone Approved for /~.~'~r~, bedro(o~ns by Approved ,~'~ __ Disapproved Conditional Terms of Conditional Approval CAUTION 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 72-025 (11/84) MUNICIPALITY OF ANCHORAGE ~ DEPARTM~,,,," OF HEAL'rH AND ENVIRONMENTAL PR,,., , ECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, sec,,ion, townsbjch range) Z../_/ .'? (b) (c) Location (address or directions) Applicant Name __C'~////"'~?~.~ Telephone: Home Business (check one): Lending Institution [];Owner/builder [];Buyer []; Othe.f'~(explain);~/~"~..4¢L/./~ Applicant is // - (d) Lending Institution Address (e) Real Estate Company and Agent _ Address Telephone T¢¢~hone (f) ~t'~.~'~the HAA to the following address: TYPE OF RESIDENCE Single-Family//~ Multi- Fa?J,y Number of Bedrooms. Other WATER SUPPLY Individual Well [] Community E~] Pu blic./~,,. / - Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE.DISPOSAL .,./- ©nsite.~ 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 (1u84) ENGINEERING FIRM PROVI[ ~NSPECTIONS, TESTS, FII. E SEARCH,, .~ AND INFORMATION As cedified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedroorns 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 Telephone Address 5 Date Approved ~,~ Disapproved ~'~ Conditional Terms of Conditional Approval CAUTION 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 72-025 ( 11/84) Home Savings & Loan Association September 8, 1986 Municipality of Anchorage Department of Health and Human Services 825 L Street Anchorage, AK 99501 RE: Lll B3 Meadow Brook Enclosed is the Health Approval letter I called you about today. Thank you for your prompt assistance with this matter. Sincerely, Janelle Nelsen 1001 E. Benson Blvd. P.O. Box 7008 Anchorage, Alaska 99510-7008 (907) 276-1451 MUNICIPALITY OF ANCHORAGE HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 WELL DATA Well Classification "~ ~A['-~L-I~ ~UNICIPALITY OF ANCHORAGE DEPT. OF HEALTH ENVIRONMENTAL PROTECflON 264-4720 APR r/~ 1§86 Legal DescriptJo~n:.,, If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) Total Depth Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot ~.x_)~ I ~ To Nearest Public Sewer Line Cleanout/Man hole Water Sample Collected by Water Sample Test Results Date Completed Yield Depth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date Comments Date Installed Standpipes ~)/,,N) Depression over Tanl-¢~) SEPTIC/HOLDING TANK DATA ~,- Size I'~-~-~'~-'- No. of Compartments Air-tight Caps (~l'4¢ Foundation Cleanout,(~i Pumping/Maintenance Contract on File (Y/N) .../ Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well ~-~ ! '~' To Property Line ~ f 7-- To Water Ma~n .......... ~ne ~' Course Date Last Pumped z'/-Z'~-~ ~' ; for Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72~026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ,Width of Field ~ t Square Feet of AbsorPtion Area Depression over Field Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation Lot To Water Main/Service Line Type of System Design Length of Field Depth of Field Gravel Bed Thickness Standpipes Present f~/4~ Date of Last Adequacy Test To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments ,~, '/ To Property Line [ ~ ~ F- To Existing or Abandoned System on ; On Adjoining Lots ,.~.-,~ t ~ TO Cutbank (if present) D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Date MOA No, ~'.!,~ ~E.,~.D .~ Signed 5 & ,5 Compai~B Ea~l~ ~iver Alaska Receipt No. Date of Payment Amount: $ Page 2 of 2 72-026 (! 1/84) MUNICIPALITY OF ANCHORAGE DEPARTE'tENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTN AUTHORITY APPROVAl.. OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 11 Block 3 Meadow Brook Subdivision L. ocation (address or directions) Applicant Name Chris Telephone: Home Business 694-4200 Applicant Address (b) (c) Applicant is (check one): Lending Institution I]; Owner/builder []; Buyer []; Other ~']~X(explain); realtor (d) Lending Institution Telephone Address (e) Real Estate Company and Agent Re/Max of Eagle River Address Telephone Mail the HAA to the following address: (f) TYPE OF RESIDENCE Single-Family I~ Multi-Family [] Number of Bedrooms Four (4)___ Other WATER SUPPLY Individual Well [] Cornmunity [] Public-xidex 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 ~x Public [] Community [] Nolding 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) ENGINEERING FIRM PROVIDING ,,4SPECTIONS, TESTS, FILE SEARCH, DA'~,, AND INFORMATION 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 shows that the on-site water supply 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 _____ Telephone Address Date Engineer's Seal DHEP APPROVAL Approved for four(4) Approved xxxxx Disapproved Conditional Terms of Conditional Approval '/~ats--'July 18, 1986 CAUTION 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 72-025 (11/84) ROBERTA. SHAFER HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECRANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN July 6, 1986 Municipality of Anchorage Depar~,ent of Health and Human Services 825 L Street Anchorage, Alaska 99501 ATTENTION: Susan Oswalt CIVIL ENGINEER 694-2979 MUNICIPALITy OF ANCHORAoE DEPT. OF HEALTH & F-NVIRONMENTAL PROTECTION JUL r, 198:, .RECEIVED REFERENCE: Lot 11; Block 3; Meadow Brook Subdivision Attached is an on~site wastewater disposal system inspection report upgrading an existing system from three bedrooms to four bedrooms serving the residence located on the referenced property. In March 1986 you issued a Health Authority Approval for this property and at that time an adequacy test had determined that the system was adequate for four bedlams. However, since the absorption area had originally been designed for three bedrooms a conditional approval was given pending the upgrading of the system~! A permit was issued for the upgrading in April, 1986 and the work was accomplished prior to publication of recently approved Municipal Ordinance. Request you now issue the final HAA. If we may~b~ of further service, please contact us. SRB 196X EAGLE RIVER, ALASKA 99577 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 GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Lot ll Block 3 Meadow Brook Subdivision Location (address or directions) (b) Applicant Name Chris Telephone: Home Business 694-4200 Applicant Address (c) Applicant is (check one): Lending Institution []; Owner/builder []; Buyer []; Other [~X(explain); realtor (d) Lending Institution Telephone Address (e) Real Estate Company and Agent Address Re/Max of Eagle River Telephone (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family B.N Multi-Family [] Number' of Bedrooms £our (4) Other WATER SUPPLY Individual Well [] Community [] Public'Ix Note: If community well system, must have written confirmation from the State Department ol Environmental Conse[vation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite []xx 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 (~1/84) EI'~IGINEERING FIRM PROVIDING ~NSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As cedified by my seal affixed hereto and as of tile validation date shown below, I verify that my investigation of this Health Authority Approval shows that tile on-site water supply and/or wastewater disposal system is safe, functional and adequate for' tile 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 Telephone Address Date Engineer's Seal Approved for ~ ~¢,,'~ bedrooms , Approved Disapproved Conditional XXXXXXXXXXXXXXXXXXXXXXXXXXXXX Terms of Conditional Approval ~)bj;_a~in a~oe12mit to upgrade the existing_ leachfield to be adequate for a four(4) bedrrom residence. Funds to be escrowed to assure work is comp].eted no later than June 30, 1986. CAUTION The Muncipality of Anchorage Department of Ftealth 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 72-025 (11/84) s & s ~.r~i~,ri~ C..,vlI~TATION SHEET SRB 196x SUBJECT: DATE: SHEE¥ BY_ CKD _ OF MUNICiP~,i TECTIoN RECEIVED SUBJECT: DATE: SHEET BY CKD OF ,<, OF ANCHORAG,7. HEALTH & PROTECTION 1986 RECEIVED Home Savings & Loan Association April 1, 1986 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND EVIROMENTAL PROTECTION DIVISION OF ENVIROMENTAL HEALTH 825 L. STREET ANCHORAGE, ALASKA 99501 AttN: JOHN KENNEDY Dear Mr. Kennedy, Enclosed you will find a health approval for L/11. B/3. MEADOW BROOK SUB. Per our conversation you stated if I sent this approval back that you would give me an approval that does not have the condition about the permit, since the seller has picked one up from your office. If it would be easier for you to just line out and initial the change, I could still use th'is Thank you for your help ±n this matter and if you have any questions please give me a call at 276-1451. I need the approval back as soon as possible. Sincerely. Bei y Loan Closer 1000 E. Dimond Blvd., Suite 103 Anchorage, Alaska 99515 (907) 272-1451 MUNICIPALITY OF ANCHORAGE DEPAR3'~NT OF HEALTH AND ENVIRONMENTAL ~-r~OTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPRO~'AL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date GENERAL INFORMATION (a) Legal Description (include lot, block, subSivision, section, township, range) Lot 11 Block 3 Meadow Brook Subdivision Location (address or directions) Applicant Name Chris -Tetel~h~Sh~e: Hor0e.' Business 694-4200 Applicant Address (b) (c) Applicant is (check one): Lending Institution []; Owner/builder []; Buyer []; Other E]:X(explain); realtor (d) Lending Institution Telephone Address (e) Roal Estate Company and Agent Address Re/Max of Eagle River Telephone (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family [~ Multi-Family [] Number of Bedrooms four (4) Other WATER SUPPLY Individual Well [] Community [] Public:4~]× 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 E~xx 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) ENGINEERING FIRM PROVIDIN ,SPECTIONS, TESTS, FILE SEARCH, DA' ,ND INFORMATION As certified by my seal affixed hereto and as of tile validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply 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 Telephone Address Date Engineer's Seal~'''~''~-' r Approved_ Disapproved Conditional XXXXXXXXXXXXXXXXXXXXXXXXXXXXX Terms of Conditional.Approval ~ ~ ..... '~:._' '~,_~upgrade the existing leachfield to be adequate for a four(4) bedrrom residence. Fund's to be escrowed to assure work is completed no later than June 30, 1986~ CAUTION 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 Jn 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 professional engineer's work. Page 2 of 2 72-025 (11/84) NiunicipahcYo Anchorage P.O. B,. 196650 ANCHORAGE1 ALASKA 99519-6650 (907) 264-4111 TONY KNOWLES, MA Y Of] DEPARTMENT OF HEALTH & HUMAN SERVICES June 23, 1986 Allen Buher P.O. Box 774773 Eagle River, Alaska 99577 Subject: Lot 11 BLock 3 Meadowbrook Subdivision On-site Sewer Permit (Upgrade) #860103 - Issued April 28, 1986 On Hay 20, 1986, The Anchorage Assembly approved a new ordinance regulating on-site wastewater disposal systems (septic systDms). All septic systems constructed after tile effective date of this ordinance are subject to the provisions of this ordinauce. Our records show that you curreqtly hold a permit for the inst. allation of 'a septic system. We,strongly urge tha~ you contact this off, i¢,e prior to constructing your system. Any changes in t]~e code that could impact tile construhtion rsquire~nents of your septi¢ system will be identified and brought to you~ attentfon. [~lease contact the Environmental Services Division at 264-4720. Thank you for your cooperation. Sincerely, / Susan E. Oswalt Program Manager On-site Services SEO/SSH/ljw DEPARTME 825 ~1: Time ])ate MUNICIPALI'FY OF ANCHORAGE OF HEALTH AND ENVIRONMEN' ~ L Street, Anchora~a, AlasKa 264-4720 PROTECTIO~o~PLp~ 99501 - ~ 'l~ex Date Received: March 10, 1978 %2: Time ~3: Time Date Date Insp O~,z~J Insp Insp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES 1. :Lending Institution Request: Alaska Pacific Bank % Valerie A. Thayer_ Mailing Address: Post Office Box 420 99510 Phone: 276-3110 2. Property Owner: Mike Cerelli Phone: Mailing Address: % Linda Switzer 349-4476 __~,~ [ .,~ .I ~ ~ ~L ^ I 3. Legal Description: Lot 11 Block 3 Meadow Brook Subdivisiof~,_ 4: Single Family Residence: (x) Multiple Family Residence: ( ) Number of Bedrooms: Two Number of Bedrooms: Well System: Permit ~ Construction Individual Well ( ) Community/Public System'S) Depth of Well Well [Log on File ( ) Bacterial Analysis Sewage Disposal System: On-site System ( ) Public Utility ( ) (h~L~4 I~. Permit # Installed ~c~-l{~. Installer ~e-~,~ Septic Tank Size %~b o~e~J_[mx% , Manufacturer Absorption Area ~&~' Soils Rate ~0. Material Distances: Well to Septic Tank to Sewer Line Nearest Lot line to Nearest Lot Line to Absorption Area Absorption Area Page Two Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 11 Block 3 Meadow Brook Subdivision Comments: Affadavit Attached: ( Approved:. ~ ~3~J~ ~ Disapproved: Letter Attached: ) Date: Department Worksheet: llVJ&l 'IVNOIJ, VNU~I!NI UOJ ION ]IVG UO (oSe~sod mhd JNICiPALiTY OF ANCHORAGE ~_~ Department of Health and Environmental Protect[on (( 825 L Street, Anci]orage, Ala..<a 99501 279-2511, ext. 224, 225 -~ -x{equest for Approval of Individual Sewer and Water Fac£].ities 1. Property Owner: Mike Cerelli Mailing Address: .Phone: Name of Buyer: GLENN P. & SUSAN L. THRASHER Mailing Address: 4938 E. 43, Apt. 2B Phone: Lending Institution: ALASKA PACIFIC BANK /\/~3~J~~--~ Mailing Address: P.O. Box 420, ANC 99510 Phone: 276-3110 Realtor/Agent: Mailing Address: Linda Switzer/Marston 34~9 4476 ~ Sa(6i-~ ~ ?~' ----%~a~m Eiiio-f/Executive 27'6 7777 Phone: Legal Description: Street Location: Lot 11, B3, Meadowbrook S/D 3030 Sanct~raTy Dri~-cj~l~--River AK 99577 Single Family Residence: ( ) Number of Bedrooms: 2 Multiple Family Residence: ( ) Number of Bedrooms: Water Supply: *Individual Well ( ) If Individual Well, well depth If Community System, name of system Public/Community System ( Sewage Disposal System: On-site System ( ) Public System If On-site System, date of installation: *NOTE: A well log is required on ALL wells drilled since 6/75. Please contact Sam Elliot of Executive to set up appointment time. If you cannot reach him please call Linda Switzer. DEPr OF '.~ AGE t~NVIRONMENTAL PROTECTION 3/77attachment $25.00 check for inspection fee. 'dA8 8- 1978 GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received~o~,..~e~ Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR 1. Approval requested by: Mailing Address: 2. Property Owner: Mailing Address: Cony. Coast Mortgage % Judy 4450 Business Park Bl~d. Erick Johnson Post Office Box 1109 99577 Phone: 274-9594 Phone: 694-2794 3. Legal Description: Lot 11 Block 3 Meadow Brook Subdivision 4. Location: Sanctuary Drive Type of facility to be inspected Single Family Well Data: A. Type Public C. Construction Sewage Disposal System: A. Installed C. Septic Tank: D. Seepage Pit: E. Disposal Field: Distances: A. Well to: Septic tank Nearest lot line B. Foundation to septic tank No. of bedr~ms ~ B. Depth D. Bacterial Analysis On-site system ~r~ z~ ~. 1976 B. Installer _~q~D~, l. Size ;,.~]) . 2. Manufacturer 1. Absorption Area .~q/~If%.~q~ ~ Total length of lines 2. Material , Absorption area , Other contamination , Absorption area , Sewer Lines C. Absorption area to nearest lot line EQ-034 (1/74) Page 1 of two pages Page 2 of two pages - Req ~t for Approval of Individual S ,r & Water Facilities Legal Description Lot iL1 Block 3 Meadow Brook 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) Please Call Jo Davis -- ~" 'n ready ( this is a rush - thi.~ DEQ -- Closing held- MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTE(~IDtNIPALITY OF ANCfIORA~E 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 DEPT, OF ftEALTH & ENVIRONMENTAL PROTI:.CTIQNJ REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES CMRO VA FHA Erick Johnson --,~Associate Investment Inc. P. O. Box 1109 Eagle River 1. Type of Inspection: 2. Property Owner: Mailing Address: 'as ordered before the move of JAN 2 ? Day Phone: 694-2794 3. Name of Buyer: Day Phone: Attention: Judy Phone: Mary Utter - Executive Realty Inc. Phone: Mailing Address: 4. Name of Lending Institution:_. Coast Mortgage Mailing Address: Anchorage Business Park 5. Name of Realtor or Agent: Mailing Address: 2810 C Street 276-7777 6. Legal Description: Lot 11 Block 3, Meadowbrook Subdividison Eagle River Location: Eagle River Sanctuary Drive) 7. Type of Facility to be Inspected: 8. Water Supply Type of Supply: Public Utility XXXX If Individual, number of dwellings presently served If Individual, depth of well 9. Sewage Disposal System Type of System: Public Utility If Individual, date of installation NEIV' HOME 1976 SFR No. Bdrms 2 Individual Individual (on-site) 72-003(3/76) HOUSE DETAIL Scale: 1"=30' DRIVEWAY DVEWAY N 'w 2 O .:. R Sf �c OEgOUg£ 133 Lot 12 w. 10.7x10.2' SHED 6.1'x4.4' WALL Lot 11 22,687 S.F. SEPTIC PIPES I Lot 10 10' UTILITY EASEMENTS �t�m 10 UTILITY \s�. \ Lot 9 EASEMENTS 4,S"ji 7 ST 52.2• \Ion l/ ry W/ OA�!GyTSIOfNGf Lot 38 9 fj e$M�.ry CHAIN-LINK FENCE 5z, w 2.0'x5.2' J[ ? CANT Lot 42 6.0'x23.3' DECK NOTE: THIS LOT IS SERVED BY A COMMUNITY WATER SYSTEM. Lot 41 PLOT PLAN ___ AS BUILT _x_ SCALE _11 __ 50' GRID _ NW 0153__ project No. ____ 22=ZZ ZA_1____ 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associates, in c , (907) 522-6476 Phone 0000�Op� (907) 522-4625 Fax Professional Land Surveyors kenolongsurvey.com o ,. OF A9 jonothanOlongsurvey.com �� .• .,s QO_ I hereby certify that I have surveyed the following described property: LOT 11, BLOCK 3, MEADOW BROOK SUBDIVISION (PLAT No. 75-57) Anchorage Recording District, Alaska, and that the improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visible easements on said properly except as indicated hereon. Dated this the _w{t� Day ofl�_+��ZJ���.>+lr��' ___, _x"•12--, at Anchorage, Alaska It is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. .� 49TH •.�* . KENNETH ..LANG •o L -5202.••' S°o �4��OFfSSIONAU �yvo AECC963