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Home My WebLink AboutMURRAY BLK E LT 20 • • c v •° Municipality of Anchorage On-Site Water and Wastewater Program ' (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 014-043-28 Expiration Date: / Q- 7-17 1. GENERAL INFORMATION Complete legal description MURRAY BLK E, LOT 20 Location (site address) 6446 HOMER DR,ANCHORAGE AK Current Property owner(s) C&D ENTERPRISES Day phone Mailing address _SAME Real Estate Agent Day phone 2. TYPE OF DWELLING: A A h t ® Single Family (w/wo ADU) ill Duplex 1 )-111.1 ❑ Multiple Dwellings (Single Family and/or Duplex) I 0..2 A.VY) 3. NUMBER OF BEDROOMS: NONE 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual ❑ Individual Water Storage Holding Tank ❑ Community Class Well Community ❑ Public Water System ❑ Public Sewer Waiver/Variance request for: pa Distance: Received by: `174X Date: ? 7 R COSA to be released to the engineer, unless otherwise requested by the engineer. ARM 4a = CA-f( 6o COSA Fee $ Cj 31� t Waiver Fee $ Date of Payment 11 t 11 Cl O?SL'Date of Payment Receipt Number .\2A,C19 Receipt Number COSA# ()sC f 1 2V v 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. Narne of Firm MIKE N ANDERSON, P.E. Phone 727-8864 Address 4661 NATRONA AVE. Engineer's Printed Name MIKE N ANDERSON, PE Date 717/17 RST-� ',‘,t, 'L 410.3., '` , .•9 c o f.J n • 7 '. ,Cly 1 ••• • ,1 �V •" a '. 9 0 9 4 i 0000. Y • ••r¢ 6. DSD IGNATURE ,• fl9 • •40e•.e.e,99 • � •'i:^' • MICHAEL N. ANDERSON •:- r'S System #1 Approved for0 bedrooms. � ,tti,',, • ,0, System #2 Approved for bedrooms. t s, 7� .k4 r„ •r-S'SV3- Disapproved. �� . ,=��: Conditional approval for bedrooms, with the following stipulations: pi's" U r q/uwh0 -=.-"' -- ON-SITE rn WATER AND _- 1idASTENVATFR c ' PROGRAM U ,. _,-" ,______---,--- I-- 0 By: ` L'`'�-/( .a S Original Certificate Date: 7-7-1 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. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 10.10.12.Coc 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: Mt'RRAY 13LK E, LOT 20 Parcel ID: 014-043-28 A. WELL DATA Well type Private If A. B. or C provide PWSID # Well Log (Y/N) N Date completed 1987?? Sanitary seal (YIN)Y Wires properly protected (YIN) Y Total depth 91.5 ft Cased to 91.5 ft. Casing height (above ground) 24"+ FROM WELL LOG AT INSPECTION Date of test 6/2812017 Static water level ft. 16 ft. Well production g.p.m. 5+ g p m WATER SAMPLE RESULTS: Coliform NEG colonies/100 mL Nitrate ND mg/L Arsenic: ND ug/L Date of sample: 612812017 Collected by: Mike Anderson B. SEPTIC/HOLDING TANK DATA Tank Type/Material AWWU Date installed Tank size _ gal. Number of Compartments Cleanouts (Y/N) Foundation cleanout (YIN) Depression over tank (Y/N) N High water alarm (Y/N) Date of pumping Pumper C. ABSORPTION FIELD DATA— Date installed Soil rating (sf/bedroom) System type Length ft. Width ft. Gravel below pipe ft. Total depth _ft. Eff. absorption area ft2 Monitoring tube_ Depression over field 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) If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (YIN) "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 WELL ON LOT TO: Septic tank/lift station on lot On adjacent lots 1001+ Absorption field on lot On adjacent lots 100'+ Public sewer main 100'+ Public sewer manhole/cleanout 1001+ Sewer/septic service line 50'+ Holding tank 100'+ Animal containment areas 1001+ Manure/animal excrete storage areas 100'+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation Property line _ Absorption field Water main Water service line Surface water Wells on adjacent lots ABSORPTION FIELD ON LOT TO: Property line Building foundation _ Water main Water Service line Surface water Driveway, parking/vehicle storage Curtain drain Wells on adjacent lots F. COMMENTS G. ENGINEER'S CERTIFICATIONOF A/4 likk / certify that l have determined through field inspections and r h~P�•• j�for Ir review of Municipal records that the above systems are in "* l:'49TH * conformance with MOA COSA guidelines in effect on this date. 1 :741V7\ Engineer's Printed Name MIKE N. ANDERSON. PF, 11 ,r,:, • MICHAEL N. ANDERSON .r4r, et Date 7/7/2017 ,• C -9169 • ,`�`� � �,)4•741. jam. • . ,.� � ;``�p E- -%' COSA canary sheet_2-6-15.doc 907 Water Well Services 9 0.7 e,. "37 R wt. T P.O Box 210249 , i AK 99521 (907)230-1868 RESIDENTIAL&COMMERCIAL WATER ANO WELL SERVICES johnnie.netherton1702@gmail.com 24MR EMERGENCY SERVICES AVAILABLE FREE ESTIMATES 70nNsfhswon P O Bot 21020 AKAArogt AX 21 907-230-786 INVOICE BILL TO INVOICE# 1399 RE:Max DATE 06/28/2017 3350 Midtown Place DUE DATE 07/28/2017 Anchorage,Ak 99503 TERMS Net 30 Wellcamera 1 No cracks.breaks or perferations, Total depth 91.5 ft from top of casiSWL 16ft casing stick up 24"+.pitless 10ft from top casing. Well cap and conduit 1 Nit Well cap seal was cracked and rubber ring was rotten,conduit was not up to code or attached to well cap.All replaced and up to code. • 8459M Lot 20 Lot 4 11 N89°53'45"E 150.00 30 — — i }-- -- I T 197_ 48.0 i� � . O Well I I I m 2 Story Wood Lot 5 w Frame Building 0 I 2.0 OH • • o w °' Lot 20 _ o 3 Q `r' L uc) w I g g . Fs F. - I Asphalt; ids 4 48.0 — co I I ' Co r f o I l a N89°53'45"E 150.00 ! o o O o I I z = I o o ( Lot 6 '1) I I Lot 19 - oLc) —8.5 1 I Sh29e.0 d I N89°534.5"E 150.00 Lot 7 I 30 Lot 18 ��OF � ' Revised:6-29-17 . �Q'�F'• • • �;96�/ AS BUILT • 49 t •9 / I hereby certify that I have surveyed the following described ow*: •' property: LOTS 19&20,BLOCK E,MURRAY SUBD. •�,..•. Anchorage Recording District,Alaska,and that the �c . • Brett A. Wilmot .,. s improvements situated thereon are within the property lines and ,/ •• 112392- IS .••J�4, A do not overlap or encroach on the property lying adjacent ! aw �4'e'o, • . • . • • "• . thereto,that no improvements on property lying adjacent thereto •spa° encroach on the premises in question and that there are no I OFEss1ONAI �..." roadways,transmission lines or other visible easements on X\\A.N:44' said property except as indicated hereon. SCALE: 1 30' Dated at Anchorage,Alaska EASEMENTS OF RECORD,OTHER THAN This 20th , day of JUNE 2017. THOSE SHOWN ON THE RECORDED FB 17-4, PG 45 FRED WALATKA&ASSOCIATES PLAT ARE NOT SHOWN HEREON. BE (907-248-1666) Engineers and Surveyors