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HomeMy WebLinkAboutAUTUMN RIDGE LT 26Autumn Ridg Lot Z6 #01§-0§4-29 Jun 13 22 08:05p Anchorage Well & Pump Ser 9072430742 p.1 MUNICIPALITY OF ANCHORAGE Development Services DepartmentC;V))� Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Pump Installation Log Well Drilling Permit Number: Parcel Identification Number: 015_05429 Date of Issue: Legal Description Block Lot Property Owner Name & Address: BALL JASON E & JENNIFER RENEE AUTUMN RIDGE 26 9211 AUTUMN RIDGE CIRCLE ANCHORAGE, AK 99507 11 Pump Installation Date: os - 27 - 2022 Pump Intake Depth Below Top of Well Casing: 210 Pump Manufacturer's Name: Pump Model: A.Y. MCDONALD 24075V3LB Pump Size: .75 hp Pitless Adapter Burial Depth: 10 Pidess Adapter Manufacturer's Name: Pitless Adapter Installer: feet feet MARTINSON Well Disinfected Upon Completion? XYes Method of Disinfection: PELLETS Comments: Pump Installer Name: Company: Mailing Address: ❑ No ANCHORAGE WELL & PUMP SERVICE 7640 KING STREET ANCHORAGE, AK 99518 907-243-0740 State: Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation. nCll[ Municipality ®f Anchorage S Ur.p.n•tment P.O. Box 196650 0 4700 Elmore Road Anchorage, Alaska 99519-6650 a (907) 343-7904 o Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program x x x x VARIANCE/WAIVER REVIEW x x x x Waiver#: OSV201003 COSA#: Permit#: PID#: 015-054-29 Legal Description: Automn Ridge L26 Engineer: Stafford Glashan Your request for a waiver of the required 50 feet horizontal separation from the absorption field to the excessive slope has been approved. The approved separation distance is 25.0 feet to the slope to the east and 36.5 feet to the slope to the north.. This waiver approval applies to the existing absorption field only. Any future upgrade to the on- site wastewater disposal system will require all separation distances be met or another approval from this department. ..................................... 0 M M X N M .... ■ .. t t ............ 0 M M M 0 0 t. t .. t.■ 1 Waiver is Granted: X Waiver is not Granted: Date: Approved : pp b Y Name of Revi er **** VARIAN C E/WAIVER REVIEW **** SHANNON 6WILSON GEOTECHNICAL AND ENVIRONMENTAL CONSULTANTS January 10, 2019 On -Site Services Engineer Municipality of Anchorage On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, Alaska 99507 RE: SLOPE SETBACK WAIVER REQUEST, 9211 AUTUMN DRIVE, PARCEL ID#015-054- 29, ANCHORAGE, ALASKA On behalf of our client, the Alaska Department of Transportation & Public Facilities (ADOT&PF), we are submitting this slope waiver request for the above parcel. As part of recent improvements on Abbott Road, a cut slope was constructed on the northern portion of the property. Figure 1 shows the existing parcel and the location of the on-site septic system and drinking water well. The septic system is located on a hill approximately 23 feet above the southern ditch on Abbott Road. The existing residence was constructed in approximately 2002 and the wastewater system consists of a traditional septic tank and deep trench infiltration system. Based on the as - built documents, the septic system includes two, 42 -foot long, 3 -foot -wide adsorption trenches oriented north to south. The distribution piping is reportedly buried four feet and a 10 -foot deep, gravel filled trench was constructed beneath the distribution piping. Based on this length, and the 5 -foot property boundary separation waiver granted, the leachfield monitoring tube identified on Figure 1 corresponds to the northern boundary of the drainfield. Three test holes were advanced to 19 feet below ground surface (bgs) by Anderson Engineering in 2000. The soil was described as 'gravel/sand with some silt) and given Unified Soil Classification System (USCS) designations for silty sand and silty gravel. Groundwater or impermeable layers were not encountered. The well log for the site describes silty gravel to a depth of 63 feet bgs where a gravelly silt was encountered. The ADOT&PF conducted a geotechnical exploration program to support the Abbott Road Rehabilitation Project. No borings were advanced adjacent to the property; however, a test -- - - - - ---- -- __ __ _ - - - - -- - -- -- _ -- - ------ _- - _ ----------------------- 5430 Fairbanks Street ■ Suite 3 ■ Anchorage, Alaska 99518-1263 ■ 907 561-2120 ■ Fax 206 695-6777 ■ www.shannonwilson.com ■ On -Site Services Engineer EIII SHANNON 6WILSON Municipality of Anchorage January 10, 2019 Page 2 of 3 pit was advanced in the ditch near the northeast corner of the subject site. This test pit encountered about 4.5 feet of silty gravel with sand overlying silt with sand and gravel. The elevation at the test pit location was not provided in the ADOT&PF report. A similar silt layer was encountered in three of the six borings advanced through the paved driving surface within 800 feet of the subject site. As part of the Abbott Road project, a 2 horizontal to 1 vertical (2:1) slope was cut into the hill to the north of the septic system. This cut reduced the horizontal separation distance to the top of the slope to just over 36 feet. The site was visited by Shannon & Wilson in October 2019 and the slope was observed to be vegetated with grass. In addition to the new cut slope, a 2:1 slope approximately 10 feet high is located 25 feet to the east of the drainfield. While the slope flattens to about 5:1 for a short distance, an average 3:1 slope extends to the east for a distance of nearly 100 feet. This slope was observed to be vegetated with grass and mature trees. No slopes steeper than 1:1 were observed within 100 feet of the disposal system. Figure 2 shows profiles developed of the existing slope (west to east) and the construction slope (south to north). A line with a slope of 4:1 (25 percent) was drawn starting from a point at the edge of the trench, 2.5 feet above the distribution piping towards the slope. As shown in the figure, this 4:1 sloped line intersects the ground surface at distances of 138 and 76 feet from the starting point for the natural slope (eastern) and construction slope (northern), respectively. CLOSURE This report was prepared for the exclusive use of our client and their representatives in the study of this site. The findings we have presented within this report are based on the limited visual evaluation, our review of provided information, and our professional judgement. Therefore, the conclusions and recommendations presented are our professional judgment as to the characteristics of the site, and in no way guarantees that an agency or its staff will reach the same conclusions as Shannon & Wilson, Inc. 104053-001 On -Site Services Engineer MII SHANNON MLSON Municipality of Anchorage January 10, 2019 Page 3 of 3 Shannon & Wilson has prepared the information in the attached Important Information About Your Geotechnical/Environmental Report to assist you and others in understanding the use and limitations of our report. If you have any questions or comments, please contact the undersigned. Sincerely, SHANNON & WILSON AEC C 125 01 .���............ Stafford J. Glashan )O� �+ �F, . CE -10365 ��`�� D1110/20 ' ���',r 1`iF, PROFESS QAN `'\\\V100 Stafford Glashan, P.E. Senior Engineer III SJG:/msh Enc. Figure 1— Site Plan Figure 2 - Profiles Important Information about you Geotechnical/Environmental Report 104053-001 C) O m ULO O >LU o a 0)m Z z 7 ° Q J z= a ° C O W U)5 a) C J E O LO O F- Z c\ t7 U)Q Ucn z m S8£ \ rnN 00 U Q O Z N m 0 2 6 \• \ U) Ile W c_ c 4 a IN �a rn I .00* O :r O i m0in — J I N o I u1- o m �I MI = 3 N TTT II m� m rn rn Lo o �oI L, I 3 M M M O I I O C � � O � / AT rya w y I _ ;�E � O 9�1 a H a w N c o SCL a Z_ f/1 c a W � J o a o y U G in 2 ui lom C m X U Z0 a m � z LO N ^ Z a o I a i / o a a O Q� 0 E N O U' �� aQ iR� a a o N 0 ch a :> 0 o co W m w Q C;) ca J LL z o Q0 Fn z= 02 (DEm a JE `o W U cn Q L a mO w Z q O_ m Ur—Q J p ZS LU U o fl N N 67 N Q v p CO N y u cu � 111 0 N J coU a N O U L (6 0 Z O Mn 00 00 co U U a � ca E c 0 X O CL O p w Qv N n N U ro C c Mn O Cl d vi6 'n f0 a _ ya E o X a n w _1 i 1 N CL d N Q Z3 � o a H o z a) p L O z a o > O O O O � U O N O O O 00 r a co M O Q (Jaaj) Uogen813 alewixojddy (1991) Uol;ena13 a;ewlxaddy E . � N R '- Q f/I O � Q U wa J p O� d' Q ao i ABBOTT ROAD S 01 SLOPE LIMITS • O 10' CEA ESMT r - _- T - Electric Trans. Box 50' — 10' BUFFER LANDSCAPE ESMT yi _ _ s7 \ f \ I / ' � — � _" 13' ----- — — — ii .rE7Ett � � ' ' 'PROPOSED SLOPE c,, k \` r —. r MAINT. & UTILITY :i -10' T&E ESMT_ j 36'1111EASEMENT LINE o :�\ Ir i O Tree Mouse Q) u / pr 6 ' Electric Vault & Concrete Pod I, -5O • 2 Story Wood Frome House 2 6 .-- ° / Y Paved Driver/0y 9211 Autumn Ridge Drive U6 Autumn Ridge Subdivision Sanitary Sewer Stand Pipe O '4 isam<s) v \ Well Pipe I �t z i 0'06, �"}-- Desk /Q: (tJ ! ' 'SO A r t -l- r r e AA I r♦ r rN i\ r- �le hone PedestalJ i t , , 1 I , ,v, 1\ 1 ,-e ! , , , -11-- E Cable Pedestal 14' r-t \.1 / / V / t 1 L. \. L- h \ 'tip, O Electric Pedestal ` N 89'47'21 " E 318.67' ' r r\ r• " r A / `/ Y �1.� \ , ! r< ! „ 1 / , , 1 „\, ♦/ \/ L/ L/ 1 V / ,..01 \" ) v p � �\ — —: i • �• I 1 PLAT 2003-53 n 0� Z Moilbox Y 25 s -,c� OF q41I,,,r ALASKA DOT&PF .4 -7:./•$?:.• .1',� 1,�/ 41 1 1 AV(AT l ON AVENUE 0 25 50 100 T 12N R3W X _ • 9 i� ANCHORAGE AK 99502 S- M- s *•' TH '•* , PHONE: (907) 269-0700 SEC. 15 .. . SCALE IN FEET 9 LOUISE OYER %*.:.. No. LS.EER = STATE OF ALASKA DEPARTMENT OF TRANSPORTATION AND PUBLIC FACILITIES 'it,/4-6,' t,; o4P41. ' SURVEY ASBUILT FOR NONCONFORMING DETERMINATION APPLICATION ��''tt,,; �°N;;. �� Legal Description o DEPARTMENT RIGHT•OF-WAY Lot 26, AUTUMN RIDGE SUBDIVISION, SURVEYOR S CERTIFICATE Plot No. 2003-53 t Municipality of Anchorage Page 1 of 3 Development Services Department On-Site Water and Wastewater Program 4700 South Bragaw Street P.O.Box 196650 Anchorage,AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SW020081 PID Number: 015-054-29 Name: Wastewater System: New Crown Pointe Inc. Address: ABSORPTION FIELD 5400 Abbott Road Anch., AK 99507 Phone: Number of Bedrooms: Deep Trench 345-6277 Five (5) Soil Rating: Total Depth from original grade: LEGAL DESCRIPTION .45 GPD/Ft 13 Ft. Block: Lot: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe: 26 Autumn Ridge 3 Ft. 10 Ft. Township: Range: Section: Fill added above original grade: Gravel Length: 1 Ft. 84 Ft. Gravel width: Number of lines: Distance between lines: Well: New 3 Ft. 2 20 Ft. Classification(Private.A.13,C): Total Depth: Cased to: Total absorption area: Pipe Material: Private 188 Ft. 188 R. 1,680 Ft' ASTM D3034 PVC Alpine D r i l l i n_ Date 21led:9/2002 Static Water Ft. Installer: Date Installed: 1122 3J3 Sanders & Sanders 7/11-12/02 Yield: Pump Set at: Casing eight Above Ground: TANK 8 GPM Ft. 2 Ft. SEPARATION DISTANCES ®Septic 0 Holding 0 S.T.E.P. 0 Other: To Septic Absorption Lift Holding •ub(ic/Private Manufacturer: Capacity in Gallons: ' From Tank Field Station Tank Sewer Line Anchorage Tank 1,500 Material: Number of Compartments: Well >100' >100' N/A N/A >25' Steel Two (2) Surface Water >100' >100' N/A N/A LIFT STATION — NONE ON LOT Size: . Manufacturer: Lot Line >5' 5' N/A N/A Gal. Pump on'level at: 'Pump off'level at: High water alarm at: Foundation >5' >10' N/A N/A in. in. in. Pump Make&Model Electrical Inspections performed by: Curtain Drain None Noted Remarks: BENCH MARK See Lot Line Waiver. Location and Description: Door Stoop Near Foundation Cleanout. Assumed Elevation: 100.0 R. Engineer's Stamp •��0 •,',,,c 11 s �•••• ,. ••.,,, •' ♦♦1 N t : Inspections performed by: MEA Dates: 1St 7/11/02 i :• 49•.. 2nd 7/12/02 • /�a •�, ; Department of Health and Human Services approval ♦‘, "' ♦ No. C_-4381 a Reviewed and approved by: Date: /Z/4/DZ- �.Gli 11��1ROFE............. SS�c 4 4 (Rev. �I••.. Municipality of Anchorage Page 2 of 3 DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On-Site Wastewater Disposal System or Well Inspection Report Permit Number: SW020081 PID No. 015-054-29 ABBOTT ROAD 0 in p6�• N 89'59'00"E 354.86' N /,O�h'S 10' CEA ESMT. (BK 72, PG 236) _; _ 10' BUFFER LANDSCAPE ESMT. y\ o' 10' T. & E. ESMT. t A B n sr Si 21.8 42.5 \j�(5, O S2 29.3 46.8 N-3 v' i ml 36.9 64.2 r� o III 1 C4 36.5 71.7 LOT 26 p, 1 C5 TH3A C7 C6 61.5 85.5 ® ' M2 61.8 80.6 Five — GRAVEL DRIVE Bedroom a Alternate Home ,Mi -a Site NA © S . ® ^.11 TH3 ,.�2 TH39 � *WELL o o ® C4 = Municipality of Anchorage Page 3 of 3 DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage,AK.99519-6655-343-7904 On-Site Wastewater Disposal System or Well Inspection Report 'ermit Number: SW020081 PID No.: 015-054-29 98.0 97.33 N Nr> > U fn Vl U U N / 1500 Gallon . " 9.,3i,.. , 31 Septic Tank 9 / 92.17 //32 92.2 v2 U f 1- U7 - - - /95.7 L'' Geotextile Fabric 92.2 7 Drainfield Rock 92.2 42' _ / . 82.2 75.7 WEST TRENCH v U f ,- In - L' /95.9 _ _ _ _ — Geotextile Fabric . _ _ 92.1 Drainfield Rock 92.1 42' _ / 82.1 EAST TE \ CH 75.7 ♦♦♦♦s....lkiaUL a PROFILE AS— BUILT ; 49th ' s •Scale: 1" = 10' • • ICHAEL E. ANDERSON ,i�a •Ufa. No. CE-4381 •••aahaI OFESSI�t•♦ •• 0:11117,1,""U�- r-.4 I ti J��1♦ ffs Municipality of Anchorage f104-4.41i: Development Services Department/On-Site Water&Wastewater Program .17) _ _-- •, 4700 South Bragaw Street Anchorage,AK 99519 SOILS LOG-PERCOLATION TEST ••<•'<.,••• „,.••'' • Performed For: Crown Pointe, Inc. Date Performed: 7/11/02 Legal Description: Lot 26. Autumn Ridge SLOPE SITE PLAN 1 OG/PT 2 3 TEST HOLE NO. 3A 4 See Site Plan 5 Gravel/Sand Some Silt 6 GM/SM 7 8 Was Groundwater 9 Encountered? No S If Yes,What Depth? L 10 Depth to Water 0 After Monitoring P 11 Date: E Golden 12 Brown 'Reading Date Gross Net Depth To Net Time Time Water Drop 13 1 11-Jul 4:08 1.75” 2 4:38 30 3" 1.25" 14 3 4:39 1.75" 4 5:09 30 2.92" 1.17 15 5 5:10 1.75" 6 5:40 30 2.92" 1.17" 16 17 18 Bottom of Hole-19' Perc. Rate: 26 Min./Inch Perc.Hole Diameter: 8" 22 Test Run Between 5 Ft.and 6 Ft. Comments: Soils Encountered are Similar to Those in Testhole 3. Test Hole Pre Soaked Prior to Testing. Performed By: Mike Anderson, I, Michael E.Anderson Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date: 7/11/02 ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 (FAX) December 13, 2002 Municipality of Anchorage Development Services Department On-Site Water and Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Lot 26, Autumn Ridge Subdivision Separation Distance Waiver Absorption Trench to Lot Line Dear On Site Services Engineer: The absorption trenches recently constructed on Lot 26, Autumn Ridge Subdivision were inadvertently placed within 5' of the south lot line. The line was not clearly marked during construction making accurate placement of the absorption trenches difficult. Sufficient area exists on the property to the south for placement of an original and replacement absorption system. In addition, soils in the area consist of silty sand and gravel and absorb water at rates considered good for absorption of septic effluent. No conflicts will exist with the well to be placed on the well to the south. All required separation distances can be met between the new trenches and all wells in the area. We therefore recommend a waiver be issued allowing the new trenches to be located 5' from the south property line. Sincerely, E Michael E. Anderson, P.E. )V 9tq • i • 1,:9• ,11 M OHAEL E. ANDERSON .•• No. CE-4381 a r 40M ALF'I hE DP.i LL.I NG FAX INC. : 90? 345 0332 Dec. 12 *2 12:21PM P: I 77----;!( Municipality of Anchorage •R . .:,ir$` ,rp.L..) Department of Health and Human Services 1 .. .,:l... p 92 5 l `a it eFt •.r — ?.O. P-ox 196650 Anchorage, A3asc&99519-6650 Rids Mystrom mt.,/lrww ci enc^cr+Aes ak.us Mayor , Z-9 Permit Number#SW Q2QM. Date of Issue: 4-29-02 Parcel Identification Number: " 4 Date Started: 9-. 7-O2 Date Completed: .4-02 s welt located at approved permit location?® Yes No _ Legal theeripdott: Autumn R. Property Owner:Naane&Addresx: Crown Pointe Inc. PO Box 112313 -- _,—...-. ,r . Anchor e. Alaska 99511 •Borehole Data: Depth(ft) Method of Drilling 0 air rotary El cable tool soil type,Thickness&Water Str From To Casing type: §?! StC! up G 2 Wall Thickness:.r'r50 inches , sift 2 5 Diameter:§inches Depth: t8$feet silty gravel 5 63 °CF Type: fret • Dia:netsr: inches Depth: gravelly silt 63 167 i Casing stickup above ground: 2 feet slit 167 178 t- -- _ -:` Static water level(from ground level): -feet very silt 176 185 Pumping leveklfffeet after: I Z 3 wafer send& gravel 185 1882 hours pumping$gpm y Recovery Rate: $gpm I I Method of Testing:gin Well Intake Opening Type: I, N Open End D Open,Hole II ❑Screened Start foet Stoppedfeet i I 0 Perforations Start feet Stopped feet . Ii Grout Typee nem•; 4 h . Volume:J bgs .I Depth: Start 0 feet Stopped feet Pump: intake Depth ._4_ feet ,, I Pump star hp Brand Name _ _ ! well DisinfectedUpom Cor$stion?E Yes 0 No ±' • • Method of Disinfection: chlorine tablets Comment : Weil Driller. Alpine Drilling d Enterprises i ,; PO Box 110496 '' Anchorage Alaska 99511 Arrentien: The well driller shall provide a well tog to the property owner. within 30 days of completion and the property .... .. .a• t •« . n ...•a. —.._a1- .a r.. rrt. .f.t. o •c . . -- _--_. . ...•-- •. rn .._.. .P ._...._ ._ ... 2001-143 AUTUMN RIDGE SUBDIVISION LOT 26 43,072 S.F. ABBOTT ROAD 0 LU 16..x,...„.5.1' y 0 07,1, N 89°59'00"E 354.86' 32.0' N ACV (0. 10' CEA ESMT. (BK 72, PG 236) • w Ft �.1 10' BUFFER LANDSCAPE ESMT. 1 2.0' c.\ gyp' - 10' T. & E. ESMT. ;o /104.0::,8.0. aM 10.0' v o� 1.3'X 4.4' CANT li 1 .A` \\ — C"4 2.0'2 0 cll 1:)c;- .. ill LOT 26 in O, \ I cV m \ • • 0 M \ EXISTING BUILDING GRAVEL DRIVE SEPTIC SYSTEM N \ (SEE DETAIL) O • •• ^? `\ \ z 27.0. \�s0 \ •m • 27.0' m !j 32 • 2.0'X 5.3' ��d? WELL b F.P. T N a • . O. 50.0' co 0 • 19.9' N 89°52'31"E 318.68' BUILDING DETAIL SCALE: 111=20' FINAL STRUCTURE AS—BUILT AS -B U I L T I HEREBY CERTIFY THAT I HAVE SURVEYED THE PROPERTY DEPICTED ABOVE AND THAT NO GASTALDI LAND SURVEYING ENCROACHMENTS EXIST EXCEPT AS INDICATED. .�001.11•114,,OF A 1. JEFF A. GASTALDI, R.LS. IT IS THE RESPONSIBILITY OF THE OWNER TO ♦ C ..•••••.( 9 4726 WEST 88TH AVENUE DETERMINE THE EXISTENCE OF ANY EASEMENTS, 4:1P/ ••••. / :••• _� •-.:6' 1 "=40' I__/� O ANCHORAGE, ALASKA 99502 COVENANTS OR RESTRICTIONS WHICH DO NOT ! �: 49TH .v�j "T PHONE 248-5454 APPEAR ON THE RECORDED SUBDMSION PLAT. *• • * • UNDER NO CIRCUMSTANCES SHOULD ANY DATA 0 ■ GRID DATE HEREON BE USED FOR CONSTRUCTION OR FOR : •Jeffery A. Gastaldi 2437 12/12/2002 ESTABLISHING BOUNDARY OR FENCE LINES. • •3-0- •.• Ls—sosi ;• -4a' ar ANCHORAGE RECORDING DISTRICT, ALASKA •� 4"°",o.'••••••••�� a`'J�� F.B. JOB NO. •. Pofessi0na\�° �, 02-16 ARS26 NOTE : NO CORNERS SET THIS DATE. �1�fs�.� 7fir//z 1140 MUNICIPALITY OF ANCHORAGE / / Development Services Department 7( 12l Z 6 O On-Site Water& Wastewater Program 4700 South Bragaw Street P.O. Box 196650,Anchorage,AK 99519-6650 (907)343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM/WATER SUPPLY PERMIT Initial Date Issued: Apr 29, 2002 Expiration Date: Apr 29, 2003 Permit Number: SW020081 Parcel ID: 015-054-29 Legal Description: AUTUMN RIDGE LT 26 Design Engineer: 0014 Anderson Engineering Site Address: Owner Name: Crowne Pointe, Inc. Lot Size: 43072 SQ. FT. Owner Address: PO Box 112313 Total Bedrooms: 5 Permit Bedrooms: 5 Anchorage , AK 99511- This permit is for the construction of: i✓ Disposal Field [✓. Septic Tank j f Holding Tank r j Privy 1✓1 Private Well 7 Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 )and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907)343-7904 (24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: - _�` o_w-� Date: Issued By: Date: 1/2?/40 Z Municipality of Anchorage �E• e :, tri Development Services Department _ Building Safety Division =.' "` 2 On-Site Water and Wastewater Program a S'A E 4700 South Bragaw St. P.O. Box 196650 Anchorage,AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 1j/ S v S V ,� Permit Number SW Oz 008/ Property owner(s) Crown Pointe,Inc. Day phone 345-6277 Mailing address (1) P.O. Box 112313 Anchorage,AK 99511 Mailing address (2) Zip Code Legal description (Lot, Block & Sub'd.) Lot 26,Autumn Ridge Subdivision Legal description (Section, Township & Range) Lot Size 43,072 SF Acres/Sq.Ft. Number of Bedrooms Five(5) THIS APPLICATION IS FOR: Sewer Only ❑ Well Only ❑ Sewer and Well ® Water Storage ❑ Sewer Upgrade ❑ THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. Mul-441. (Signature of property owner or authorized agent) el Permit Fees: 6.56 Waiver Fees: Date of Payment: �l Z j(cZ Date of Payment: Receipt Number: 1 q7sz) 5k• Receipt Number: (Rev.12/00) ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 (FAX) April 22, 2002 Municipality of Anchorage Development Services Department On-Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 26, Autumn Ridge Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Lot 26, Autumn Ridge Subdivision intends to construct a new five- bedroom home on the lot. We are therefore requesting a permit be issued for the construction of a new well and septic system to serve the proposed home. The attached Site Plan and backup documentation identify the location and configuration of the new well and septic system and the parameters used in the design. Also identified on the plans are the location of the well on the lot and the test hole locations along with wells and septic systems located on nearby lots. Existing drainage patterns are shown and will not be altered by the development of the lot. The test holes placed near the location of the proposed absorption trench indicate clean gravel and sand with varying amounts of silt. The percolation tests completed in the material resulted in rates of 34 minutes per inch and 2 minutes per inch near the alternate site. No groundwater was found during the placement of the test holes and none was noted during the monitoring period. We are therefore proposing to place a 3' wide deep absorption trench system with 10' of gravel beneath the distribution pipe. The total depth of the trench will be 12'. The distribution pipe will be placed at 2' below the ground surface to provide sufficient drop from the septic tank to the absorption trench. Two trenches each 42' in length will be required with a Zabel Flow Splitter or equal placed to assure equal disbursement of effluent from the septic tank to each trench. The ground surface on the lot slopes as shown on the attached Site Plan with an approximate 10% slope near the proposed septic system site. The slope to the east of the new system varies from 20% to 25%. The new absorption trench will be constructed in conformance with Municipal requirements and parallel to ground contours where possible. All components of the new septic system will be constructed a minimum of 100' from the well on the lot and 10' from the service line from the well to the house. Lot 26, Autumn Ridge Subdivision April 22, 2002 Page Two If the system is constructed in accordance with our design the following statements apply: 1. The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, Michael E. Anderson, P.E. Attachments OF 44s,�i .' 49th *• �� • • •• • • MICHAEL E. ANDERSON•,u a •1��s': No. CE 4381 ,.�C)�- •♦• � • ,;OFESS�'�i�� �•aaa SERVICE HIGH SCHOOL SITE 1 • TRACT A I IL HV-304 392.46 • PLI 1_--- ___----- ----------, \ - -,--•/ I Jiiiiiit t.• .... ..,./ .,..„:„..-: -----_______=-----_=-_-_-_--.....- :-...-___- - ..,..< -- ---7::----:----- .....— .-:,-----7- -.,.....-7-i- .' - I- -- 7 - •C---- C ..--",-- --, ___ _=..........:;_ .— -•=___„....._________ m..-....?-- -.........s._ ...7-----,.-- -- — s . --„, ,----<A QB0 TT '1:Z•C_ A---1611 .40,),,,,'--7-..----, <its 3\ , \ \ \ 387.2\ \ '.,.., 1 '3 \ ;• ./ ' ' ' 1 / DEDICATE TO R.S.W.\ 66 /(824 sq.ft.,'" / A / ., / ./ i / / *.7. • - •- ---/- ____-*•-39.92 _\_____. ___T_ , c. . , _.4.:1,4.. ....._::_. .iii .111111r..."-- ...r.Z.......... ....___.._..... ........_.-..7:-..--77zz-.17.-"--- C'n• r- ..--- .:.-....: -_-4,„........p,-- ;z----77 '-' - --:• '' 'Y''''''4..r•rs -..:471------:------------47-7----1*---- — -------- -------------=-----:::j\%-----------) i ) 1 6 Id Ca ESN.CIIK 72.PG 2.3&) 1 -- ---. 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I ,,, f i 1., .. ."1 dP ' / / / \ ' I , ' i / i i 111 K Les) / 40— az- + \ \\ 41711 %\41 cu j II.! 1 ',,j • 79 )pi) II 1 I .___ .11 , \ __...`•\ \ iki-zo PANDCIN (.1,1it''', , - ----2 -- ___.,71011.„-- i C.- -422/ ,e, q 1 i i • I _..• r 1 1---,,-.... N-\A,0V\ iP\RiRIVuEllI,Dikyr 20\ \,_1 ;Or*R/P/ i \ /t ',I 11intni ,I .I ! ! i I II ‘• ..---•,) 1 \ • i i _, (f,-. A \ 11 1-..• ' \ ' i 1 \ I i --t-—---k. 011 i 4*,,SIMS1114 IN I I I \\ •'' '• •V ‘. 1 \ r \•-- I 1 1 t-s‘ - .'\\ ". ii , \ g 1•••- 2t.../.44 4 i I ; \ \• • '',.. .--7' ' \\lull* ' 2.••••• ...:4- 57, ! i I ! \ ,:s., . ""--.:\ i. 1 'It `-'s ***-• .• I I i I eit."--......,--/-/ \ v -, •.. 4,- • \ 1 i 1 9 1.111 arv•l \*•.; ) 1 ' --..., /.,/ i siks.• -,...... A\ I AoS,-+ ., \ .• • 1,, • : 49th \ ' ‘:\ 'A .\\,... •-:4.-.`t-/ ‘ , .ow : sql, tiimplseditAlZal ; . a i I: ,,._.1 1 1 A• . ....-- ---.., ., /) , 40125 ft 1 1 - ,, ,(i, / 4_417- 14.1• Xi MICHAEL E. ANDER;ON it'd ! i 1 fl /4•5 ig . I AREA SYSTEM PLANS , it 41,-... . , il 10-,:r,.... NO. CE-4381 . '.)' 4)(tO....•.............„\i/ / , ..,.....„„ _ „ .. , / ./.,L), ,,... ... . i , --''"-:---------77-:-."---r--, •ft .,..• •••• • .,Aim", / -1- . .. ----.... .`".•‘:.M\14-1.„t..cg. AUTUMN RIDGE SUBDIVISION LOT 26 43,072 S.F. ABBOTT ROAD b in 400 , [ 377' )N 89°59'00"E 354.86' .1 tifr, 10' CEA ESMT. (BK 72, PG 236) r ii -� 10' BU}-PLR LANDSCAPE ESMT. 1-10' T. & E. ESMT. D �j� • \ 2-42 ' Long X 3 ' Wide X 10' T \ Effective Depth Absorption Trenches M M \ x412' faiiOHG4 p N � O'—� \\ 'Five ''�cFpq�p°sFo C� Proposed droom �N �q \ Well "''tR. • •mel LOT 26 N \ \ =: LOT 26, AUTUMN RIDGE SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Five Bedroom Home Deep Trench System Perc. Rate: 34 Min./lnch 1,500 Gallon Septic Tank Avg.Application Rate: .45 GPD/SF 10' Drain Field Rock 5 Bedrooms X 150 GPD/.45 GPD/SF = 1666.7 SF of Absorption Area 1,666.7 SF/20 SF/LF= 83.3 LF Trench Length Therefore: Construct Two Absorption Trenches Each 42' in Length by 3' Wide With 10' of Drainfield Rock Beneath the Distribution Laterals. Distribution Laterals to Be Placed 2' Below Existing Ground. Total Depth of Trenches to Be 12'from Existing Surface. Place a Flow Divider Valve to Assure Even Effluent Flow to Each Trench. Mound Over Trenches or Provide 2"of Insulation to Provide Frost Penetration Protection. / Natural - - . 5' ' Backfill ��—'r` Geotextile - - x - Fabric . 5' :.•3?. O ey 4" Perforated y-tnr:'• PVC (Slots Down) ... •,.� • 10' Drainfiela Rock • :•r! .... •�: a -• f - 3-' f TYPICAL DEEP (NO TRENCH SECTION CALE) +GAP-.E,T...g4q ,�• • NOTE: Grade Area Over Trench to Drain Away. i I 49th •• *• Minimum 6' Separation From Bedrock. i • Minimum 10' From Lot Line. Minimum 4' Separation From Groundwater. • ;MICHAEL E. ANDERSON•; Minimum 100'Separation From Wells in the Area. �i�/�'.,•. No. CE-4381 •••.��� Minimum 10' Separation From Water Service Line. ••� ...•..,•••••••••,,,..••���� ,f,,,�ESS\ • arc-)/ *s. • / . * • s49t I Municipality of Anchorage iO.y�;MICHAEL E. ANDERSitt44024.‘cal, ON to- • Department of Health &Human Services • ♦0 ; it 825 L Street,Anchorage,AK 99502-0650 �• /% No. CE-4381•••�• . II SOILS LOG-PERCOLATION TEST •••4;; ; s �•••� Performed For: Bob Klein Date Performed: 11/30/99 • I Legal Description: Lot 26.Autumn Ridge Subdivision SLOPE SITE PLAN . . ilti II 1 OG/PT 2 3 TESTHOLE NO kb1 �' -,,'' • • - 1 1,, 1 26 iiillIlhil ! if!Ili 4 1 ` i/./ , Ni43.151 sq.ft iii'�..�1',r/ i,,,I z-III 5 Gravel/Sand ;• '\.�'t `eta.?, de �' s iiili ' ' r`�r?,I/./rl�4 Some Silt '- � ' ' ll 6 GM/SM . III - 7 8 U 9 . Was Groundwater Encountered? No S If Yes,What Depth? • L 10 Depth to Water 0 III . _ After Monitoring None P 11 Date: 1/22/00 E II 12 Golden Reading Date Gross Net Depth To Net Brown Time Time ' Water Drop 13 . - 1 4-Dec . 11:02 4.125" 2 11:32 • 30 5" .875" 14 3 11:33 4.125" 4 12:03 30 5" .875" III 15 5 12:04 4.125" 6 12:34 . 30 5" • .875" U :: • , II 18 19 Bottom of Perc. Rate: 34 Min./Inch Perc. Hole Diameter: 6" IHole Test Run Between 5 Ft. and6 Ft. Comments: Percolation Cavity Presoaked Prior to Testing. - 11 Performed By: Alan Harala. I,Michael E.Anderson Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date: 1/20/00 I • arm of A/ 9 It~ ' ( '•i'4- # r' .'9 • Municipality of Anchorage .°a0 Department of Health &Human Services 2escv ,; 825 L Street,Anchorage,AK 99502-0650 . V C - ,Y 31 •�.a; I SOILS LOG-PERCOLATION TEST ` •'• •toe ,� "' Performed For: Bob Klein Date Performed: %% 1>1100D0 • • I Legal Description: Lot 26.Autumn Ridge Subdivision SLOPE SITE PLAN II 1 OG/PT - _ .-, 2 '.s�\ I3 TESTHOLE NO,3 S ' _- iiirc.! - _ - - -j 1 III 4 5 Gravel/Sand I i� 4/ - a3.�s� �.n i!!'`, i; : 1 ,�i. Some Silt / / . f4S52i / \ 3 .li' ';f{;'tl if��J, 111 6 i, �_, a♦t. -<1714132/71-/i f 1 �/i! ate'�i :;;i?• ! GM/SM > `; i,�,' J ,: t /moi j i,%;i . -}:i i- ; 8 . I .. Was Groundwater 9 . Encountered? No S If Yes,What Depth? L . I 10 - Depth to Water 0 After Monitoring None P ... 11 Date: 1/22/00 E II 12 Golden . Reading Date Gross Net Depth To Net Brown Time Time Water Drop • 13 1 4-Dec ._10:58 3.25" I2 11:28 30 4.5" 1.253 11:29 3.25" 4 11:59 30 4.25" 1" I 15 , 5 6 12:01 3.25" 12:31 30 4.125". - .875" 16 III 17 II 18 19 Bottom of Perc. Rate: 34 Min./Inch Perc. Hole Diameter: 6" III . Hole Test Run Between 4 Ft.and 5 Ft. Comments: Percolation Cavity Presoaked Prior to Testing. 4 Performed By: A. Harala. I,Michael E.Anderson Certify That This Test Was Performed • In Accordance With All State and Municipal Guidelines In Effect On This Date: 1/20/00 I .40..1beo®^,q4 I. tA ' • III ..., ..,.....* . .fir '\ 1 •1 .�r ,A f. P - 111 • Municipality of Anchorage '""J•L ' o'er ''. :..ct a>::Easc:a Department of Health Human Services ,',`•. 4 am 825 L Street,Anchorage, AK 99502-0650 �� �'•.,• ••.•• :rte ISOILS LOG-PERCOLATION TEST °? ctSS1��a•®�y• Performed For: Bob Klein Date Performed: 1217/99 il I Legal Description: Lot 26.Autumn Ridge Subdivision . SLOPE SITE PLAN i• 1 PT/OL =I -�—� ——-�z 2 • II 3 ,.' - _ _ TESTHOLE NO.39 --`�— ''� t ` U' 4 L1 ��'!� 04 ?j:�\; 26 --t it t �' 2,! I. 1 ) r //j %43.151 Sq ft. 7 (%j.�/i' 5,/f4<3.422 '4 3.2 ''l i + ..,..L.:,,‘ t � ✓% � ��_� • 3 tiff' �. r7:!%(;:/! SM/GM 15 '' , .tea:, �f ; T� li. . .r`:' = 111 6 7 1111 8 • Was Groundwater I9 Encountered? No S _ If Yes,What Depth? L 10 Depth to Water 0 U After Monitoring None P 11 Date: 1/22/00 E I 12 SM Reading Date Gross Net Depth To Net Time Time Water Drop 13 1 8-Dec 12:15 4.38" III 2 12:25 10 9.38" 5" 14 3 12:26 4.38" 4 12:36 10 9.38" 5" 4 15 5 12:37 4.38" 6 12:47 10 9.38" 5" 16 1111 17 ill 18 19 Bottom of. Perc. Rate: 2 Min./Inch Perc. Hole Diameter: 6" IHole Test Run Between 5 Ft.and 6 Ft. Comments: Percolation Cavity Presoaked Prior to Testing. INPerformed By: A. Harala. I,Michael E.Anderson Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date: 1/20/00 11 . MUNICIPALITY OF ANCHORAGE Development Services Department"' Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 015 054 29 1. GENERAL INFORMATION Complete legal description Autumn Ridge Lot 26 Location (site address) 9211 Autumn Ridge Current property owner(s) AKDOT Mailing address Expiration Date: 657 — I2_?z Day phone Real estate agent Day phone 2. TYPE OF DWELLING: 0 Single Family (w/ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 5 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: N O N E q Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ Date of Payment Receipt Number 0��j C? COSA # Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm C&M ENGINEERING Phone 8545558 Address 20182 TULWAR Engineer's Printed Name CHARLES BALZARINI Date 3/9/21 49 TH 6. DSD SIGNATURE j • • / -%�i:: 7 1 I System #1 Approved for bedrooms CHARLES G BALZARII1I System #2 Approved for bedrooms ��F��s.•. CE -13854 _0 Disapproved �l TF�FOP • ' ' ' ' NP��� 1l ROFES510 -�. Conditional approval for bedrooms, with the following stipulations: fi KJ Ld1�. S o� c Inl C e � o� a r�� � I C ✓' k�.e4' `��l��IpALITV (rr��ii �qTF siTF m '^- �, r VICES By: �LsOriginal Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet COSA Checklist Legal Description: AUTUMN RIDGE LOT 26 Parcel ID: 015 054 29 If more than 1 septic system on lot: COSA Checklist # 1 of 1 Structure served by this system 1 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 9/2002 Total depth 188 ft Cased to 188 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) +18 in. Date of flow test for COSA 3/4/21 Static water level at beginning of test 162 ft. Comments B. TANK DATA Age of tank(s) 19 years Tank type/material SEPTIC STEEL Measured operating fluid level in septic tank 50 ❑ Standpipes/foundation cleanout per record drawing Date of pumping SEE COMMENT D. ABSORPTION FIELD DATA TRENCH Well production at time of test +5.5 gpm Water storage tank volume - gallons Well disinfected for coliform test? ❑ Yes FOR Nc ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by C.BALZARINI Date of Sample 3/3/21 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Which system tested (date installed) 2002 Adequacy test date 3/4/21 ❑ ALL standpipes present per record drawing Results ED Pass For 5 bedrooms Total measured depth from grade 14 ft (max) Fluid depth prior to test 33 in Measured depth to pipe invert from grade 4 ft (min) Water added 750 gal FOR N/A — pressurized field 38 New depth in OR Monitor tubes go to bottom of effective. If not, state Elapsed time <1440 min depth into effective ❑ Code -required soil cover over field Final fluid depth 14 in ❑ System presoaked Absorption rate 750 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) NA date of test) Gallons introduced 2000 gallons If yes, enter date y NA Comments/Deficiencies: water level in field elevated due to pre-soak. All.septic standpipes verified located as installed. COSA Checklist yellow sheet 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' 0 Yes if No Community Sewer Manhole/Cleanout > 100' ❑✓ Yes if No ft M Yes if No ft Neighboring Tank > 100' 0 Yes if No ft Private Sewer/Septic Line > 25' ❑✓ Yes if No ft Absorption Field on Lot > 100' 0 Yes if No ft Holding Tank > 100' 0 Yes if No ft Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' ❑✓ Yes if No ft 7 Yes if No ft if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' El Yes if No ft Q Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' Q Yes if No ft Surface Water > 100' ❑✓ Yes if No ft Property Line > 5 0 Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ❑✓ Yes if No ft Private Wells > 100'✓❑ Yes if No ft Water Main > 10'✓❑ Yes if No ft Community Wells > 200' ❑✓ Yes if No ft Water Service Line > 10' ❑✓ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' 121 Yes if No ft If absorption field is under driveway comment below Property Line > 10' ❑ Yes if No 5 ft Wells on Adjacent Lots: Water Main > 10'✓❑ Yes if No ft Private Wells > 100' Yes if No ft Water Service Line > 10' ❑✓ Yes if No ft Community Wells > 200' ❑✓ Yes if No ft Surface Water > 100' ✓0 Yes if No ft F. ENGINEER'S COMMENTS HOME WAS VACANT FOR AN EXTENDED PERIOD, TANK WAS NOT IN NEED OF PUMPING AT TIME OF INSPECTION. SLOPE AND PROPERTY LINE WAIVERS ON FILE. G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. COSA Checklist yellow sheet OF AL: 4 :'4,9 TH '• ... .. �10, CHARLES G BALZARINI CE-13854Awe Ail • �� �' /�. �� pROFE5S14NP .. 4t/6/4.4 Municipality of Anchorage • • s� Development Services Department Building Safety Division On-Site Water and Wastewater Program �'� T 4700 Bragaw Street P.O. Box 196650 Anchorage,AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-054-29 COSA# OG o I f 1--/- Expiration Expiration Date: 7 - ,S - 0 G 1. GENERAL INFORMATION Complete legal description Lot 26 ; Autumn Ridge Subdivision Location (site address) 9211 Autumn Ridge Cir. Anchorage , AK Current Propertyowner(s) Colleen & Steven Mukavitz Day phone 265-6176 Mailing address Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 5 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ 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. Name of Firm S & S Engineering Phone 694-2979 Address 17034 N. Eagle River Loop Ste . 204 Eagle River , AK 99577// Engineer's Printed Name n 415 A-r C. I�aw4r Date 7/3,h c ©F i, 111 sA ' ` ..• . �("1,.k\ 0) 5. DSD SIGNATURE R, COWAN! <f, i ROBERT C. COWAN r•L.A l/ Approved for bedrooms. # 0r`,. CE-8II01 Disapproved. Conditional approval for bedrooms, with the following stipulations: t„t((((((((wo,i 04, sit.*. ••'� C:; Z.; ON-SITE `•g WATER AND . R'_ • WASTEWATER PROGRAM • '• .•cp• •.....• Attachments: COSA Checklist X Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineer's Report Nitrate Advisory Other By: (� Original Certificate Date: 11 5—- 0 (Rev.11105) • • Municipality of Anchorage .GE •;Ic"'° Development Services Department = ` ° Building Safety Division ` Bin E. " On-Site Water&Wastewater Program SA E T. 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: ''? 426; //4.7-1-0✓11IV *-.11:E4-E- /6 Parcel ID: 01 - 0 SI- A. WELL DATA l Well type ---7t (i 1 If A, B, or C provide PWSID# Well L (Y ) / " ,- Date completed (05/0 Z Sanitary seal4N) YE-15 Wires properly protecte (Y/N) "(F'3 Total depth 1 S8'ft. Cased to /n Ift. Casing height (above ground) I8 I4-in. FROM WELLLOG AT INSPECTION Date of test VP)/02- . .-.42-c!5/6'2-x/6 0 Static water level 1 2.3 ' ft. I VC4 ft. Well production &U g.p.m. c g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate N'/_() mg/L Other bacteria e. colonies/100 mL Arsenic: tib) mg/I Date of sample: 3I i 7/0 c. Collected by: J4 5 F.-A:4e i Jo crepix, B. SEPTIC/HOLDING TANK DATA Tank Type/Material `�'6PfIC../ C L Date installed 7/t( -i zip Z Tank size (C'O gal. Number of Compartments =Z. Cleanout I) l -`jt" 5 Foundation cleanout (Y1N) `J 5 Depression over tank (Y1 ) ti) High water alarm (Y® &30 Date of pumping 1 Pumper • - c,5 C. ABSORPTION FIELD DATA Date installed 7/i)-IZ-/n-L Soil ratinggii/ft2or ft2/bdrm) e+ q 6 System type b I'TI ILC Length 841 ft. Width ft. Gravel below pipe /C I ft. Total depth PI,ft. Eff. absorption area I(- ( ft2 Monitorin tube `IV Depression over field NO Date of adequacy test 1"9--9)a, Resul as /F il) For bedrooms • Fluid depth in absorption field before test J .� in. Water added 771 gal. New depth 2e yin. ` Elapsed Time: 11,1, min. Final fluid depth ). in. Absorption rate >= `711( t- g.p.d. Any rejuvenation treatment (past 12 mo.) (1&type) perC If yes, give date D. LIFT STATION k)14 Date installed Size in gallons Manhole/Access (YIN) _________- "Pump on" level at in. "Pump off' level at in_,_____- -�{ig water alarm level at in. Datum ------Cycles tested Meets alarm& circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: t Septic tank/lift station on lot /0 �" On adjacent lots IOC 4 r r Absorption field on lot /Dd -f- On adjacent lots rCil") -1- Public sewer main 1\3)-1.- Public sewer manhole/cleanout Nt-1- Sewer/septic service line 9.. 1-1- Holding tank ,r�,6'1 % t Animal containment areas cD 'F Manure/animal excrete storage areas I Od -i- SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: f Building foundation �� Property line i Absorption field 5 '� Water main tafil Water service line Surface water (� t 4 I Wells on adjacent lots )DO 4 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: i I Property line 10 -� Building foundation /0 + Water main NIA Water Service line )a i- Surface water )OO r-- Driveway, parking/vehicle storage j0 f Curtain drain 1 4.. ' "^IV Wells on adjacent lots 1�O-f- F. f- F. COMMENTS G. ENGINEER'S CERTIFICATION 'c,S' ,.•'-' •, d �' rIk4. ° t" 4 I certify that I have determined through field inspections and ! . ti review of Municipal records that the above systems are in °' conformance with MOA COSA guidelines in effect on this date. y 4,-y. ...............,,d 7, ',a ROB%RTC COWAN e Engineer's Printed Name 6�/4 �% ��' �- 1 C,',%'' CE-8801 •. `�:',�,% 3 34 / o( �ttt<- ;•. ....••';��= Date , • . . w 1Z�Z ,'. +mow COSA Fee $ -/3, Waiver Fee $ /75 Date of Payment 4/710 Date of Payment "17/00 Receipt Number 033 Z(p '` Receipt Number D J7 ?(p (Rev. 11/05) 2001-143 AUTUMN RIDGE SUBDIVISION • LOT 26 3 43,072 S.F. D A) 1 IU r I rU in ABBOTT ROAD en St� F— I . 1_4� V I-. p��• N 89'59'00"E 354.86' AU/ W N bry�40* 10' CEA ESMT. (BK 72, PG 238) - 9 Fn Cr.' _ 10' BUFFER LANDSCAPE ESWT. 4 `` I ff 3 c.1 yy ;10 T. St E. ESMT. M In ' ''� ,.R... C�1 15r `t - N Ivy I C?'t,.\ t15)1._, \\ •V. , r LOT 25 N b t0 � ME ri ExIsnHG U) • Z GRAVEL p NE (xc ocraU e srstat >. aa e �SD \ �. . Tip i MO MILL Il.tly, - so.0 N 89.52'31"E 318.68' BUILDING DETAIL SCALE: 1''-20' The Ioc2lIon of Ore structure(c) FINAL STRUCTURE AS-BUILT as shown on Ihls record dteytIng AS—B U I L T I HEREBY CERTIFY THAT I HAVE SURVEYED THE (as-bultt'o0mplleevih Tole 21.AMC. PROPERLY DEPICTED ABOVE AND THAT NO •,lt,a By; 'V fERt2 GASTAL.DI LAND SURVEYING ENCROACHMENTS EST EXCEPT AS INDICATED. �� OF f� Dale: I , 112� JEFF A GASTALDI, R.LS. RIS THE RESPC+NSIBILITY OF THE CANER TO :�p k. ,.....JitIN• . 4726 WEST 88TH AVENUE DETERMINE THE EXISTENCE OF ANY EASEMENTS, i1I=d ► ANCHORAGE,ALASKA 99502 COVENANTS OR RESTRICTIONS WHICH DO NOT ir (")::49-1H 9•j . —40 APPEAR ON THE RECORDED SUBDMS1ON PLAT. •''�t yt PHONE 248-5454 UNDER NO CIRCUMSTANCES SHOULD ANY DATA .4111 GRID DATE HEREON BE USED FOR CONSTRUCTION OR FOR I: *. 'ye A .t t tD ESTABLISHING BOUNDARY OR FENCE UN ES 237 12/12/2002 .'P'•. �r•..•'9 � Cal CB, J06 H0. ANCHORAGE RECORDING DISTRICT, ALASKA •�.'%ur�„an.�% , I � 02_16 ARS�6 NOTE: NO CORNERS SET THIS DATE. �f.NMI-� Cn CD NJ IV A t9 R1 MO- Municipality of Anchorage • Development Services Department o17 ,� 4 Building Safety Division On-Site Water and Wastewater Program °A TY 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-054-29 HAA# y/F CZ QCe .Z c Expiration Date: 3' l(lip? 1. GENERAL INFORMATION Complete legal description Lot 26. Autumn Ridge Subdivision Location (site address or directions) Ziemlak Circle Current Property owner(s) Crown Pointe. Inc. Day phone 727-8167 Mailing address 5400 Abbott Road Anchorage.AK 99507 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: Five(5) 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality 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 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 less than 30 days old. (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 effect at the time of installation. Name'of Firm Anderson Engineering Phone 522-7773 Address P.O. Box 240773 Anchorage,AK 99524 Engineer's Printed Name Michael E.Anderson. P.E. Date 12/13/2002 , i • 5. DSD SIGNATURE �� • Approved for bedrooms. •��• t *. Disapproved. Conditional approval for bedrooms, with the following stipulations: • • • UN-S/1 • cr; : WATER AND • NAS T ENA; ' • Additional Comments ppf)GR,^M ` • T �y� • Attachments: ► HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other By: f Original Certificate Date: /ZA. /o?.. (Rev.12/00) • • Municipality of Anchorage tG o •; �_� Development Services Department �z Building Safety Division S• E T V On-Site Water&Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lot 26,Autumn Ridge Parcel ID: 015-054-29 A. WELL DATA Well type Private If A, B, or C provide PWSID# Well Log (YIN)Y Date completed 412912002 Sanitary seal (YIN)Y Wires properly protected (Y/N)Y Total depth 188 ft. Cased to 188 ft. Casing height(above ground) >24 in. FROM WELL LOG AT INSPECTION Date of test 4/29/2002 Static water level 123 ft. ft. Well production 8 g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate .26 mg./I. Other bacteria 5 colonies/100 ml. Date of sample: 12/1212002 Collected by: MEA B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 7/11/2002 Tank size 1,500 gal. Number of Compartments 2 Cleanouts(Y/N)Y Foundation cleanout(Y/N)Y Depression over tank(Y/N) N High water alarm(Y/N) N Date of pumping _ Pumper New Construction C. ABSORPTION FIELD DATA Date installed 7/12/2002 Soil rating (g.p.d./ft2 or ft2/bdrm).45 GPDISF System type Deep Trench Length 84 ft. Width 3 ft. Gravel below pipe 10 ft. Total depth 14 ft. Eff. absorption area 1680 ft2 Monitoring tube Y Depression over field N Date of adequacy test Results(Pass/Fail) For bedrooms Fluid depth in absorption field before test in. Water added gal. New depth in. Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d. Any rejuvenation treatment(past 12 mo.) (Y/N &type) N If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on"level at in. "Pump off'level at in. High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot >100' On adjacent lots >100' Absorption field on lot >100' On adjacent lots >100' Public sewer main NIA Public sewer manhole/cleanout NIA Sewer/septic service line >25' Holding tank NIA SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Property line >5' Absorption field >5' Water main NIA Water service line >10' Surface water >100' Wells on adjacent lots >100' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 5' Building foundation >10' Water main >10' Water Service line >10' Surface water >100' Driveway, parking/vehicle storage >25' Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS See Lot Line Waiver. G. ENGINEER'S CERTIFICATION •• �E OF .44I♦♦ 41 • ♦i I certify that I have determined through field inspections and 5 : .,;♦♦ review of Municipal records that the above systems are in ... ° •• conformance with MOA HAA guidelines in effect on this date. i.,..,••.. 7• • • ' MIC.H_L L. A\;;E 3S3 - Engineer's Printed Name Michael E.Anderson,P.E. ♦ �s:,•• No. CE-4381 .• '�� Date 12/13/2002 ♦♦♦4;; ; Wit••• HAA Fee $ Waiver Fee$ Date of Payment Date of Payment Receipt Number Receipt Number (Rev. 12/00) Anchorage • • i Age Municipality of Anchorage Ittaxi All-America City S �.r Building Safety Division 'III' George P. Wuerch, Mayor 2002 12/16/2002 Engineer Company Name &Address Subject: Waiver Request for 5' Lot line waiver Waiver Request#WR020094 Parcel ID #015-054-29 Dear Mr Anderson: Your request for a waiver of the required 10 feet horizontal separation from the absorption field to property line has been approved. The approved separation distance is 5.0 feet. This waiver approval applies to the existing absorption field to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, • /.odall ngineer On-S' e Water& Wastewater Program P.O. Box 196650 •Anchorage,Alaska 99519-6650 •Telephone: (907)343-8301 • Fax: (907)343-8200 4700 South Bragaw Street • Anchorage,Alaska 99507 http://www.cLanchorage.ak.us