HomeMy WebLinkAboutKENO HILLS #3 BLK 5 LT 4Onsite File
Keno Hills #3
Block 5
Lot 4
#020-171-21
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On-Site Water & Wastewater Section Fax: 907-343-7997
Pump Installation Log
Well Drilling Permit Number: _______________ Date of Issue: ____-____-____
Parcel Identification Number: ____-____-____
Legal Description Block Lot Property Owner Name & Address:
Pump Installation Date: _____-_____-_____
Pump Intake Depth Below Top of Well Casing: __________ feet
Pump Manufacturer’s Name: ___________________________ Pump
Model: _____________________________________
Pump Size: ____________hp
Pitless Adapter Burial Depth: _________ feet
Pitless Adapter Manufacturer’s Name: _________________________
Pitless Adapter Installer: ____________________________
Well Disinfected Upon Completion? XX Yes No
Method of Disinfection: _____________________________
Comments:
Pump Installer Name: __________________________________
Company: ___________________________________________
Mailing Address: ______________________________________
City: ___________________ State: __________Zip: _________
Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation.
Municipality of Anchorage
On -Site Water and Wastewater Program • (907) 343-7904 Page ( of
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: 17k) Ol pp 1 2 PID Number: &7,0 ^- 0 1 — 2l
Dwelling: &Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New &Upgrade
Name:
L Lon d
ABSORPTION FIELD
Y nn f
®.Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound
Address
I ? 0 QbSTwwh
❑ Other
Phone
Number ofBedrooms
Soil Rating /
Total depth from original grade
— l
(r Z GPD/SF
Q � (' Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
0O Ft.
Gravel depth beneath pipe
Grp Ft.
Subdiyrinion Blot'ZC
' Lot
Fill added above original grade
3,0 Ft.
Gravel length
41 Z Ft.
\�rr
Township Range Section
Gravel widthBeds:
2.0 Ft.
Number of Lines
r
Distance between lines
1 Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
Total absorption area,
Number of trenches
Dist. between trenches
From
Tank
Field
Tank
Line
,y.
5'0 C) �Ftz
1
Ft.
Well
IP(�r.'.
't��/+..
(.�/A
/q%
�pff
TANK Septic ❑ S.T.E.P. ElHolding [I Other
Manufacturer
�- ,1
hf vl 'ISG .
Capacity
/ Z S 0 Gal.
,T
Surface Water
�pJf.�-
(��f
Material
S{--�e1
Number of compartments
Lot Line
la .�
(�f7'
NA
Foundation
ZP4
Zo(
LIFT STATION
Manufacturer
Capacity
Curtain Drain
Gal.
Remarks N U V'I'Vir J G;r $
Pump on level at
Pump off level at
in.
igh water alarm at
in.
Pump make ode/
Electrical Inspections performed by
Installer
kto
PIPE MATERIAL House to tank f� aineld
-%d� \ drainfeld 3�'
JI�� �-,
[,4%MQz� �yt PI f0 el I-PIiC
Drainfield 70 3 4 CO/MT 3 0314
nspector tr(pk ASO Pr�
BENCHMARK (Assumed elevation) IO`rl,� ft
Inspection7 r VI 4 %/ Z i d�
dates: 3"
Is1
Location and descdptN C St
T r k f
Lf p
( tiJ t n5
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL
:�OFid
A t
Pg•,.... .;4s t91
Conditional Approval: DateOW
r
i 49TH +1
/1 'Po - MICHAEL N. ANDERSON •'at
') CE 94
l ��
•P�
Approved Date 6 /9 /$
�\
\Y�`
inspection Repon_u-i-tz.00c
Permit No. SWO10019 Page 2 of 2
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: KENO HILLS ADD #3 S/D, BLOCK 5, LOT 4 PID No.: 020-171-21
MARK
A
B
C01
40
39
CO2
41
40
TC01
45
44
TCO2
55
55
CO3
57
56
VALVE
58
56
C04
59
57
C05
85
87
MT
101
92 I
C06
103
94 1
b� C06 r
/P/MT ,\\
\1TH#1
1250 GALLON STEEL TANK
\ -CO5
BENCH ELEVATION, 1
BOTTOM OF SIDING
Y't e(1 Iv, S�.ttl r
Qali Pl+ `t VIA (RV
TCO1
`DIVERTER-VALVE \
i
i
i
i
i
/
/
Rc li 49
WELL
0
Municipality of Anchorage
Ment
P
WepDartinel-
VARIANCE/WAIVER
REVIEW ****
Waiver* OSVI61069 COSA#: OSC151294 Permit#: SWO10019
PID#: 020-171-21
Legal Description: Keno Hills #3. Block 5 Lot 4
Engineer: Mike N. Anderson
Applicant: Lenny Londis
Your request for a waiver of the required 5 feet horizontal separation from the septic tank to the
absorption field has been approved. The approved separation distance is 4.0 feet.
This waiver.approval applies to the existing septic tank only. Any future upgrade to the -on-site
wastewater disposal system will require all separation distances be met or another approval from
this department.
❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this
waiver.
Notarized letter(s) of nonobjection have been received from the owner(s) of the affected
adjacent property.
®Adjacent properties are not affected by this waiver.
Waiver is Granted: X Waiver is ndt Granted:
Date: l Approved by:
ame of Revie
Y
� 1 ;"`.Sti' $ 1 '�' Y�•f� 1 ''v f��y vi" 4jPr +�
Molt,.
s
s
Certified Well
4.
For ....... _F?r41 E'�ft}eine - `r
p
Ls r
4 ' 1—auon.. i•ot 42 4lk._5, Keno Hills Subt fldd
C - Date completed.I- Ya .19.7.9 }�
41 a I, Depth of well .... .14,.5 t M
' Sire of casing.................
- i`
'Distance to water....... GL'.OUn 1 18Ve1
1. '' Distance to water while pumping .: 4 i
x i 'oF........... 6ua
....... .... gallons orhour.
+ua
q S
t � 1,•
�A' F ;,
�ypQ �2r r •'
� 1
ns.
1 Dncripuon of Fortnatil A R,, f;..,
from
:;Y to
Sand. ^111. rocks
--`''""
- 0
BCQAn till
20
,_20
40
.gravelly till_
40
68
Bed rock
68-
145
Leal water et
savelal"tlointe
In roc
but i
r
x�
r,. .•
I certify the above into&" ct
1.
F_O' urillrr.. ._.........._..__...
+ DOTTEN DRILLING CO
john's Road
A.SPENAR6'ALASKA t
., We adviseyou to attach CTi ecrtfN le to your dP.
ecd t
Ae� a axur . "Mil as r lay "or l
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MUNICIPALITY OF ANCHORAGE ZN D '7 • -Do
Department of Health and Human Services
On -Site Services Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 3434744
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Feb 08, 2001
Expiration Date: Feb 08, 2002
Permit Number: SWO10019 Parcel ID: 020-171-21
Legal Description: KIO Hll-L S #3 BLK 5 LT
Design Engineer: 0088 Anderson Construction & Eng'g Site Address: 017500 ROSEMONT DR
Owner Name: LENNY LONDIS Lot Size: 101495 SO. FT.
Owner Address: PO BOX 615 Total Bedrooms: 4 Permit Bedrooms: 4
BARROW, AK 99723-0615
This permit is for the construction of:
❑✓ Disposal Field 0 Septic Tank Holding Tank 0 Privy Private Well Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ).
3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By:
Issued By:
Date: 2 o
Date: 2,8-01
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.enchorage.ak.us
(907) 343-7904
ON-SITE SEWERIWELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 020 — /7/-2/--- Permit Number SWQ/00/ 9
Property owners) I-rin 0 4 � o d , z, LAfI Aar 1 Day phone :7 C f 5"33
Mailing address (1
C,
Mailing address (2) PV 80u L l s 891
Row Ak
Zip Code
Zfrl 4,
Legal description (Lot, Block & Sub'd.) L /
t; �
/77723
le, z'No
/-/i
# 3
Legal description (Section, Township & Range)
Lot Size 4=S:47- 'f Acrel.F Number of Bedrooms
Jo1'� 49S
THIS APPLICATION IS FOR:
Sewer Only Well Only ❑
Sewer and Well ❑ Water Storage ❑
Sewer Upgrade A
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.
(Signature of property owner or authorized agent)
Permit Fees: 3 Z o , oo Waiver Fees:
Date of Payment: 2.&A / Date of Payment:
Receipt Number: Oy 2-7 Receipt Number:
(Rev. 12/00)
Michael N. Anderson, P.E.
Civil/Structural Engineering
4640 Shoshoni Avenue
Anchorage, Alaska 99516
Phone 345-3377
Fax 345-1391
February 5, 2001
Department of Health and Human Services
P.O. Box 6650
Anchorage, Alaska 99519-6650
Re: Lot 4 Block 5 Keno Hill Sbd. Addition #3
To Whom it may concern:
This is a request for a permit to upgrade the existing three bedroom system to a four bedroom
system because the owner would like to build an addition to the existing house. The soils are silty
gravel the full 15' depth and no water found. The perc was 3 minutes per inch which was very.
similar to the original perc. The new trench will be installed perpendicular to the slope per the
plans. The slopes are less than 25 percent near the septic area with a flat spot for the new trench
as shown on the plan. A new 1250 gallon tank will be add to the new trench due to its age and
size. Also a diverter valve will be installed to the old trench for future use.
This new system will not affect the future development of the neighboring properties due the large
lots and locations of the wells and septic systems. The general drainage is to the west.
If you have any question please call me at 345-3377
M
Anderson, P.E.
MOUND OVER
IGN CRITERIA'
o GRADE
4 BDRM X 150 = 600 PD '1 OR o i-'FILT R FABRIC
SOILS = 600/1.2 = 500 FT EO'� 1 "
500/12 = 42'
TRENCH: °° o O
DEEP
6 EFFECTIVE
2.
SNC' DRAIN ROCK
I i
� I
7
A,
o I
RAGE
O�
EXISTING WELL 0
100' RADIUS
O�
a
1 �
ROSEMONT Drive4
SEPTIC DESIGN PREPARED FOR
LENNY AND KATHRYN LANDIS
LOT 4, BLOCK 5
KENO HILLS SUBDIVISION, ADDN NO. 3
PREPARED BY
MICHAEL N. ANDERSON, P.E.
14250 N. GOLDENVIEW DRIVE
(907) 345-3377 / FAX (907) 345-1391
SCALE: 1"=200' FEBRUARY 2, 2001
O F • l i
r y~P.•• A••�sf�-ili
•9 r
-*4
r�
MICHAEL N. ANDCRSON� •
r . •moi
• �
257.
20% 0
-��
--'
-------
FLAT
MONITORING TUBE
��—EXISTING TRENCH 257
i
i C.O.,, • -+�
EXISTING PIPING �
i
I �
207.
ONERTER VALVE -�
NEW 1,250 GALLON
TH,I 1 SEPTIC TANK
FLAT
i
EXISTING HOUSE
i
100'
SEPTIC DESIGN PREPARED FOR
LENNY AND KATHRYN LANDIS
LOT 4, BLOCK 5
KENO HILLS SUBDIVISION, ADDN NO. 3
PREPARED BY
MICHAEL N. ANDERSON, P.E.
14250 N. GOLDENVIEW DRIVE
(907) 345-3377 / FAX (907) 345-1391
SCALE: 1 "=40'
FEBRUARY 2, 2001
0
WELL
----------------
r y• .• •. S,f.�l+l
49TH =, k
TO • MICHAEL N. ANDERSONCE
s . Z
Municipality of Anchorage/�t : 9 T 11 "�' ' v
DEPARTMENT OF HEALTH & HUMAN SERVICES .. ..y1, /.
825'L" Street. Anchorage. Alaska 99502-0650 X,�r%�" ` ......:...�
. .
.....
SOILS LOG - PERCOLATION TEST �d �� �MICH CF- A` pfRSCN: r
• / r �aN r S DATE PERFORMED, �4 is
PERFORMED FOR: t^ I%►j
LEGAL DESCRIPTION: L L'1 f3'3 /,e
c- O I,, ���i TOWrlShlp. Range. Section:
DEPTH
S/d SLOPE SITE PLAN
(FEET) I p(Y�gt1leS I I I I i _
1
2-
3-
4 34
5-
6-
7-
8-
9-
10-
11
Q.
13
14
15-
16
17
18
19
20
:OMMENTS
Owr
WAS GROUND WATER /p
ENCOUNTERED? I�/
IF YES. AT WHAT
DEPTH?
Depth to wabr Aver
Men , m? N o n Oetc ? It7l
i
L
E
Reeding Dan Grou i Net
Time Time
Depth to
Water
Net
Drop
3 O �„
`iOhPJ
/0 M/N
3.Si.
re 1
/Onr/n
77.7
/Ow ir.
3/ --ire"
PERCOLATION RATE Zt J (minutevinch) PERC HOLE DIAMETER /I
11 TES/T/ R�1\ N BETWEEN y FT AND
t S FT r I I
e PLt� S (y� igrtl t o r n -t h t� SI` ....�,., 'ti< a r -t� P r,►, L
PERFORMED BY: (r��Q QJ � rbc I CERTIFY TT THIS TEST WAS PERFORMED IN
���L/
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE —4/
UL(
Rev. a,851
• Municipality of Anchorage
On -Site Water and Wastewater Program
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS
Parcel I.D. 020-171-21
1. GENERAL INFORMATION
RUSH!
JUN 18
Expiration Date: Ct`J
Complete legal description KENO HILLS ADD #3 BLOCK 5, LOT 4
Location (site address) 17500 ROSEMONT DR. ANCHORAGE, AK 99516
Current Property owner(s). LENNY LONDIS Day phone
Mailing address 17500 ROSEMONT DR, ANCHORAGE, AK 99516
Real Estate Agent Day phone
2. TYPE OF DWELLING:
Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS:
4. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage.
Community Class Well
Public Water System
gm
TYPE OF WASTEWATER DISPOSAL:
®
Individual
❑
Holding Tank
❑
❑
Community
❑
Public Sewer
❑
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ / `72� 4A Ipt Waiver Fee $ 215 k 129
Date of Payment/' 7Date of Payment
Receipt Number 1 M079 s Receipt Number 1 S�q IZy
COSA# O8d15 agy Waiver# 05UI6/06�1
c,'# 960
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 ANDERSON CONSTRUCTION & ENGINEERING Phone 345-3377
Address 4661 Natrona Ave. Anch. Ak 99516
Engineer's Printed Name 'MICHAEL N. ANDERSON, PE Date 06/15/15
6. DSD SIGNATURE
_ System #1 Approved for bedrooms.
System #2 Approved for
Disapproved.
Conditional approval for
bedrooms.
OF Al -kj
MICHAEL µ Ah.DEPSON
C 9869 `d
bedrooms, with the following stipulations:
1�Uttttufu„
ON-SITE
By: z Original Certificate Date:
The Municipality of Anchors Development Services Division (DSD) issues certificates of On -Site Systems Approval (COSA) based Only
upon the representation 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 blue sheet_10.1P12.doc
If more than 1 septic system is on the lot:
COSA Checklist # _of _
Structure served by this system _
Certificate of On -Site Systems Approval Checklist
Legal Description: KENO HILLS ADD #3 BLOCK 5 LOT 4 Parcel ID: 020-171-21
A. WELL DATA
Well type Private If A, B, or C provide PWSID # zl�_ Well Log (YIN),> 1
Date completed ILL% c azI Sanitary seal (Y/N) Y
Total depth iNz:Z-ft. Cased to kLft.
FROM WELL LOG
Date of test %4A < <
k'LVatG
tiro►#
Static water level ft.
Well production ifl g,p,m,
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 mL Nitrate _rW mg/L
Wires properly protected (Y/N) Y
Casing height (above ground) 16 in.
AT INSPECTION
611 612 01 5
m Q 'f- g.p.m.
Arsenic: ND ug/L Date of sample: 05/2012015 Collected by: Mike Anderson
B. SEPTICIHOLDING TANK DATA
Tank Type/Material SEPTICISTEEL Date installed 7/1412001
Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N)
Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (YIN)
Date of pumping 2D Pumper�(YWj }1,C 4gef{
C. ABSORPTION FIELD DATA—
Date installed 711412001 Soil rating (g.p.d./fe or W/bdrm) 1.2 System type DEEP TRENCH
Length 42 ft.' Width 2 ft S Gravel below pipe 6 ft.
Total depth 10 ft. • Eff. absorption area 500�ftt2Monitoring tube Y Depression over field N
Date of adyquacy,test 0512012015 Results (Pass/Fail) PASS For 4 bedrooms
Fluid depth in absorption field before test 36 in. Water added 620 gal. New depth 44 in.
Elapsed Time: 1440. min. Final fluid depth 33 in. Absorption rate >= 600+ g,p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date
D. LIFT STATION
Date installed
"Pump on" level at
Datum
Size in gallons _
in. "Pump off' level at
Cycles tested _
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot i00'+
Absorption field on lot 100'+
Public sewer main 75'+
Sewer /septic service line 25'+
Manhole/Access (YIN)
in.High water alarm level at _ in.
Meets alarm & circuit requirements?
On adjacent lots 1001+
On adjacent lots 1001+
Public sewer manhole/cleanout 100'+
Holding tank 4001+
Animal containment areas 50'+ Manure/animal excrete storage areas 1001+
SEPTIC/HOLDING TANK ON LOT TO:
I
Building foundation 201+ Property line 701+ Absorption field_ ZZor�
Water main 40 ID 4- Water service line 501+ Surface water 100'+
at-- ItL cW,
Wells on adjacent lots 1001+
ABSORPTION FIELD ON LOT TO:
Property line 10'+ . Building foundation 204 Water main O, 10 14
Water Service line 504 Surface water 1004 Driveway, parking/vehicle storage 504
Curtain drain (None Known) Wells on adjacent lots 1001+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that l 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.
Engineer's Printed Name.MICHAEL N. ANDERSON, PE
Date 0611612015
COSA canary sheet 2-6-15.doc
OF 4,1
It* a
• . ..............
P MICHAEL N. ANDERSON ;
f, CE 9 9
•., fI '0i
N 89 59'09"W371.87
0� 0
OQ m SHANE A. HOLT
Q4 4�OLS-6914 O p.
Q`O /asslonal Laos
00400��0
THE INFORMATION HEREON 15 FOR THE USE Of LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY
CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; AND IS
NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES.
EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT, ARE NOT 514OWN
HEREON (UNLESS INDICATED)
NOTE: FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO OETERMNE
PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS.
ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW AND/MR ICE.
I., =4P
'I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY
OF THE FOLLOWING DESCRIBED PROPERTY
LOT 4/ BLOCK 5, KENO HILLS NO. 3 ( PLAT 73-200)
ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE
VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN
THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS
EXIST OTHER THAN NOTED.
DATED AT ANCHORAGE,ALASKA THIS 8 TH_ DAY OF
_APRIL , 2015.
12887, F8 165-16
HOLT LAND SURVEYING
600 HIGHVIEW DRIVE
ANCHORA6EAK 99515
345-5513