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Home My WebLink AboutMINDYER MANORS BLK 2 LT 6Mindyer Manors Block 2 Lot 6 #020-091-73 Municipality of Anchorage On -Site Water and Wastewater Program ✓,��;�• --� (907) 343-7904 Certificate of On -Site Systems Approva Parcel I . D.020-09 1-73 1. GENERAL INFORMATION: Expiration Date: 2 — 02 q " %0 Z/ - Cornplete legal description MINDYER MANORS; BLOCK 2, LOT 6 Location (site address) 4600 VIRGO AVENUE'ANCHORAGE, AK Current Property owner(s) Mailing address Real Estate Agent Day phone JEFFREY PAISLEY Day phone 907-250-0333 2. TYPE OF DWELLING: Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual ❑ Individual Water Storage ❑ Holding Tank ❑ Community Class_Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑X Waiver/Variance request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 21U COU10 Date of Payment 1 I 1 I,aogC) Receipt Number V 0 � 1 G Waiver Fee $ Date of Payment Receipt Number COSA T 05 G 2016 q 9 Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of 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(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm: Garness Engineering Group Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101- Anchorage. Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: t i�I %? In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and �• �•�,., industry practices. The reported results describe the condition of the systemis on the datels of the Separation distances to identifiable features. Hidden defects or ,y r_ OF /111 evaluation. were measured readily encroachments may exist that were not identified during the evaluation. The operational life of all wells��\_. and septic systems depend upon a variety of variables, including but not limited to, soil conditions, I groundwater levels (that may fluctuate during the year), quality of construction (materials and �' • workmanshi p), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of( �' ..... •`. . .. C;`_ the %yell or septc system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in v r _ , l UQ, `9. the future. The content of this report is for the sole benefit of the person/party that retained GEG to t� �'fe ��1 perform the evaluation. Reliance upon the information provided in this report by any other person or = Pr part (including subsequent property purchasers)is not authorized, nor will it confer an legal right ' •` es jO whatsoever. #AECC884 6. DTD,SIGNATURE 3 System #1 Approved for bedrooms System #2 Approved for Disapproved Conditional approval for bedrooms bedroorns, OF (thy 6, with the followit ptalbjtaSi,TE t� P� D Wps R 1L� J IJ�J 11� Original Certificate Date: 'v2'"( —� 1 The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist _ Nitrate Advisory Septic Systern Advisory Arsenic Advisory Well Flow Advisory Other Legal Description: MINDYER MAN ORS; BLOCK 2, LOT G If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA I !''Well log is filed with Onsite (or attached) Date drilled ts�z�rrx= Total depth 245 ft Cased to ft J Sanitary seal is functioning correctly A Wires are properly protected Casing height (above ground) 18+ in. Dat:: of flov,� test for COSA u7!30t20 Static water level at beginning of test 14.4 ft. Comrnents 1-1 AWWU SEWER B. TANK DATA Age of tanks) years Tank type/material Measured operating flt.,` , vel in septic tank Standpipe undation cleanout per record drawing roping D. ABSORPTION FIELD DATA VVhich systenn tested (date installed) ALL standpipes present per record drawing Total measured depth from grade ft (max) rtAeasured depth to pipe invert from grade ft (min) ❑ N/A – pressurized field i_,i Monitor tubes go to bottom of effective. If not, state depth into effective j Godeaequired sail cover over field iJ System presoaked (Required if vacant for ater than 30 days prior to elate of test) Gallor " , roduced gallons C lents/Deficiencies: COSA Checklist yellow sheet Parcel ID: 020-091-73 Structure served by this system Well production at time of test 3.2+ gpm Water storage tank volume NSA 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'diRL (ND) Collected by GEG, LTD. Date of Sample ""0'2° C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date Results ❑Pass For edroorns Fluid depth prior t in Water a gat kSw depth in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic; Tank/Lift Station on Lot > 100' NSA Community Sewer Manhole/Cleanout > 100' F-1Yes if No ft ❑ Yes if No ft Neighboring Tank > 100' ❑ Yes if No ft Private Sewer/Septic Line > 25' ❑✓ Yes if No it Absorption Field on Lot > 100' ❑ Yes if No NSA ft Holding Tank > 100' ❑Q Yes if No ft Neighboring Absorption Fields > 100'Animal es Containment > 50' ❑/ Yes if No ft 0 Yes if No ft ❑ Yes if No ft If septic tank is under driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' El Yes if No ft ✓❑ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Funding Foundations > 10' ❑ Yes if No ft Surface Water > 100' it No Noo� Property Line > 5' ❑ Yes if No ft ---'�` Wells on ots: Absorption Field > 5' ❑ Yes if No Private Wells > 100' Private Wells > 100' ❑ Yes if No Water Main'_ 10' es if No ft Community Wells > 200' ❑ Yes if No zrvice Line > 10' ❑ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required Buildina Foundation > 10' ❑ Yes if No ft If absorption fieldis under 'ay comment below Property Line > 10' ❑ Yes if No ft Weld-r�tllac�ts: I 2ter Main > 10' ❑ Yes if No Private Wells > 100' ❑ Yes if No Water Service Line > 10' es if N ft Community Wells > 200' ❑ Yes if No Surfa d er > 100' ❑ Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION 1 certify haat l have determined through field inspections and review of 1111unicil?airecorcis that the above systems are in conformance with y_ h,70A COSA guiclehnes in effect on this dale. �CE- ; 95- ,, r � Cr15A rhe.�klisr yelfotA; sheet Pr r VAECCflIIa ft ft 1 M -W Drillinq, Inc. t i L�+v� i l(61'� ot`V It � *P.O. Uox'110:'`8. Anchorage, AK 99511• •°�7-:45-M :' • 907-3''r-"7.87 Fax• - .. JG - 02 -154 Permit No. vW020185 — CPau,rtlu'clE. �: f..c^t tri/t d Ire ♦ is i. !r vnee. 14. L. Pa'sle, Tn •. _ 1Ae of Well: Dom^stie DNo';. 2;': t. Ymra ;e, AY 'r:onstru�•'im •%C ;a/u 240' ♦CoslrgSize. 6" t•C.'.see To. 32' .,1..11Alethod. Airiletary - ♦Alatenah A 53 S.e. Pe:; t;;'clt Catnptetion. open end X Screen Perforated _ Method. ♦Sereen/Perforation description: None ♦CroutNotes: (1) Sack- No. 9 benton ite granules ♦ Notes: Annulus grouted to 40'. ♦ H ell Development Method: Air surge Notes: ♦Static water level (SWL) flowing (above) (below) top of casing (IOC). ♦ N ell yleld test at 4 gallons per minute (CPM)/gallons per hour (CPN) for 1 hours with 100% of drawdown (DD) from static level (SWL). ♦Method: Airlift ♦ Date ofcompletion: 28 August 2002 ♦Pump Install., — veli Log Depth In feet from top of casing. Details of formations penetrated, size of material, color and hardness. 0 TO 3 Casing stickup 3 TO 15 Clayey gravel: traces of sand 15 TO 245 Fractured bedrock TO TO TO TO TO TO TO TO TO TO TO TO TO TO liWWA'Certl>ried Contractor TO C afi...+.. @. SIA t. 972 y.. MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water 8 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ONSITE WATER SUPPLY PERMIT Initial Permit Number: SW020185 Legal Description: MINDYER MANORS BLK 2 LT 6 Date Issued: Jun 20, 2002 Expiration Date: Jun 20, 2003 Parcel ID: 020-091-73 Design Engineer: 0000 None Required Site Address: 004600 VIRGO AVE Owner Name: H.L. Paisley Trust Lot Size: 46269 SO. FT. Owner Address: PO Box 190081 Total Bedrooms: 0 Permit Bedrooms: 0 Anchorage . AK 99519 - This permit Is for the construction of., ❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy Q Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. g120/02 So" W Received Issued By:B. pt? ope,2 Tr of-A/6ER %✓wr9itar 40 `4("L FS i'1 rtOV/a(, it xrP'R t.c-F_Lc. 537- funTl'F,p oPf(fii�tiir}6E L.frD P44we LAwgo. Date: 71 t7 2 Date: 6/120/02 I Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWERMELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcell.D. 020 091 73 000 02 •�0 T?; , Permit Number SW020/85' Propertyowner(s) x.L Paisley Trust Dayphone 276-2233 Mailing address (1) PO Box 190081 Anchorage Ak. 99519 Mailing address (2) Zip Code Legal description (Lot, Block& Sub'd.) Lot 6 Bkl 2 Mind Yer Manors S/D MOA Legal description (Section, Township & Range) Grid 3336 Lot Size 46,269 sgft. Acres/Sq.Ft. Number of Bedrooms Nothidg built yet THIS APPLICATION IS FOR: Sewer Only ❑ Well Only El Sewer and Well ❑ Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. property ownerXauthorized agent) Permit Fees: Date of Payment: Receipt Number: (Rev. 12/00) 6//7111 ? Waiver Fees: Date of Payment: Receipt Number: • L w ` ,N Lot 6 Blk 2 Mind Yer Manors S/D MOA ID#020 09173 000 02 PROPOSED STRUCTURE and WELL LOCATION.. �. NOTE: There are no Neighboring wells �9 within A 50' radius. Lot 5 (closest neighbor) is servicei by public sewer. to \ / ••'1 ,� i / / VVVVV/ `1 ' • rJ� �!- a ,. { ✓ s� % % 1 �J V, T U ' • PROPOSED STRUCTURE! I OAS '•�/ REQUEST FOR DISTANCE CHANGE FOR ON SITE WATER WELL RE: Lot 6 Blk 2 Mind Yer Manors S/D Existing Well Permit Approved / dated 6/20/02 REQUESTED LOCATION CHANGE: New well placement location to be 55' (feet) from permitted location REASON: The parcel was "witched" and a much better flow area was discovered 55' behind the original location. As the well has not been drilled, and at the costs to drill, I would like to drill in an area "deemed" more "plausible" in obtaining water! The added 55' increases the distance to the sewer line. Please let me know any requirements. Kim Paisley 276-2233. Lot 6 Blk 2 Mind Yer Manors S/D MOA ID#020 09173 000 02 Q f - PROPOSED STRUCTURE and WELL LOCATION.. i NOTE: There are no Neighboring wells cwithin ASO' radius. Lot 5 (closest neighbor) is service(' 1, by public sewer. . te rat G �! � '�, ` ,•� ,�/Cf, � PROPOSED STRUCTURE «. r . \tel{`\/�, \•[v},• , . r -� y - '',� a Lot The V Tide Subdi NOTES 1. Bearings ani 2. Sufficient bo...,—r -- ..a,we>La,,,,,,, We buujeu parcei on the grouna. Not all controlling evidence is shown hereon. "`AS s Farpoont Land Services, LLC s SURVEYING, MAPPING, LAND PLANNING, GIS mro 1 13 1 E. 76th Ave., Suite 10 1 Anchorage, Alaska 995 15 rarpolntAK.com • (907) 522-7770 • survey@farpomtak.com ASBUILT SURVEY OF: TSURVEYY CERTIFICATION: FARPOINT has conducted a physical Lot 6, Mindyer Manors Subdivision, of the subject property, the improvements situated Anchorage, Alaska n are within the property lines as shown. (Plat # 78-294) SION NOTESItistheowners responsibilityt0determine istence of any easements, covenants, or restrictions which NORKORDERNo DATE: SCALE: appear on the Plat used for this Survey. NOTE: Under no FEB. 29,2016 7 "= 60'stances should any data hereon be used forconstruction 16007 DRAWN: CHECKED: GRID No: FB BOtheestablishlnMJH TFH '"MRM, 17Rgofpropertylines. / I/ LEGEND Monument Septic Vent Power pole Existing Fence 'ARED FOR: Paisley AK99516