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HomeMy WebLinkAboutSHANGRI-LA ESTATES EAST BLK 3 LT 3 Onsite File Shangri - La East Block 3 Lot 3 #020 - 043 - 64 Municipality of Anchorage On-Site Water and Wastewater Program •(907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP171192 PID Number: 020-043-64 Dwelling: ❑■ Single Family (SF) ❑ Duplex(D) ❑ Multiple (SF and/or D) Project: ❑■ New ❑ Upgrade Name: Crown Pointe Inc. ABSORPTION FIELD Address ❑ Deep Trench ❑■ Shallow Trench ❑ Bed ❑ Mound PO Box 112313 Anchorage AK 99511 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade (907) 346-1506 4 3.0 GPD/SF 7.7 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot 3.7 Ft.4.0 Ft. Shangri-La Estates East 3 3 Fill added above original grade Gravel length Township Range Section 0 Ft. 25 Ft. Gravel width Beds:Number of Lines Distance between lines SEPARATION DISTANCES 5.0 Ft. Ft. To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist.between trenches From i Tank Field Tank Line 250 Ft2 1 Ft. Well >100' >100' >100 N/A >25' TANK 0 Septic I]S.T.E.P. 0 Holding 0 Other Manufacturer Capacity Surface Water >100' >100' >100 N/A Orenco/Advantex 1500 Gal. Material Number of compartments Lot Line >5' >10' i >5 N/ANA Fiberglass FAP 2 Foundation >5' >10' >5 N/A LIFT STATION Manufacturer Capacity Curtain Drain None Noted Orenco 1500 Gal. Pump on level at Pump off level at High water alarm at Remarks 42 in. 48 in. 54 in. Pump make and model Electrical Inspections performed by PF2005 MOA PIPE MATERIAL House to tank D3034Tank to D1785 Installer drainfield Sanders & Sanders Drainfield D3034 CO/MT D3034 Inspector B. Schiller BENCH MARK (Assumed elevation) 100 ft Inspeectio: 1st8/15/17 20d 8/15/17 Location and description Std 4th Garage slab COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp Conditional Approval: Date i P' •• ' .04:4# . r� -- ---— , . ... moi. /(-- • Be ' min Schiller : 5 l6 ��,.. C 2 2 Approve -7-7 Date i/— c----(c) 1'l,``''FOR1 3►'f;,`".4. '�-- �=� 7 I� Ro..ss ��. Inspection Report_9-1-12.doc SHANGRI-LA ESTATES EAST, BLOCK 3 LOT 3 PERMIT # OSP171192 PID # 020-043-64 cf N N TRACT B .1500=GAL / VACANT •' ADVANTEX TANK WI AX20 POD.. ALTERNATE SITE TH2 • r / MH CO ib . • FCO 4C2 H2�CO2 B i RI ;^/ .O !CO . slo TH'.. ..... 4-BDRM HOME > { .q•-• �, CNV _ • �`� 30 / _ . : . :. OJ �! _ WELL w--- -_- "~ -- _.,•�----_- . _. . .. GRAVEL RiVp. 25'LONG x 5'WIDE,4'EFFECTIVE i.1:7'' ; '- % DEPTH ABSORPTION TRENCH i A.C.DRIVE \ / ; Aar / N 7 LOT 4 SACK 3 VACANT A B FCO 27.9 12.0 FV 18.9 24.6 MH1 19.2 24.3 2C0 9.9 _ 45.0 C01 17.4 _ 41.7 MT1 18.3 . 52.8 CO2 30.9 66.6 - MH2 11.1 34.2 � �xx\\\ LEGEND ..i.-,-.11.9t' .106 CO-CLEANOUT /rqb��'• .9t2C0-DOUBLE CLEANOUT • •• 1 „ • *�A FCO-FOUNDATION CLEANOUT •• t FV-ADVANTEX FILTER VENT Be -min Schiller ' / MH-MANHOLE /f .• CE 12592 •,�� 0 50 100 MT-MONITORING TUBE �ijrl�c�FOPw'�.p 8 ,.• � FEET SV-SEPTIC VENT \\��"`=��� 1"=50' TH-TEST HOLE SHANGRI-LA ESTATES EAST BLOCK 3 LOT 3 PERMIT # OSP171192 PID # 020-043-64 o N o 0 I I U LL 2 2 N - /99.9 - - AX-20 POD 7 i 96.2 1 ��-96.0 1500 GAL FAP 95.35.3-7AP STEP TANK (ADVANTEX) �.. ..--90.8 0 2 99.3 ORIGINAL AND FINAL GRADE 0 1�,/ `' a 'Y �Z?Y.. .. _ Q _ i ^Far '-•;;;;;:.,.;g;•.4•;;;,..e•; .. f '°<<s 4 b.s.. �. qi'�.vi�' t( $ �L 9 95.6 '.� s tp� mo " vlt,. } r '�t� , �- 5.6 -91.6 25, 91.6-.....A." i 84.3 = NO GROUNDWATER 8/15/17 I- .--.• • 8lk1 /�•.•. Benj in Schiller j PROFILE AS-BUILT 40".... CE12592 .. �_A. (NO SCALE) 11k;F0PROFESS\ONP.'.�. MUNICIPALITY OF ANCHORAGE ,7,-Z 4C.4l1 DEVELOPMENT SERVICES DEPARTMENT /tee).•••• ��� '�1 4700 ELMORE ROAD ANCHORAGE, AK 99519-6650 *••49TH \ ••*rj SOILS LOG AND PERCOLATION TEST 6 •••. Ben aurin Schiller �r l 6,-. ..<,-•• CE Z2p 92 ••.�`��`�r LEGAL DESCRIPTION: SHANGRI-LA ESTATES EAST, BLOCK 3 LOT 3 Ikt4 ;.......\-- •• PERFORMED FOR: CROWN POINTE HOMES l\\X���'~� DATE: 8/5/17 PROJECT No.: Professional Engineers Scamp: PARCEL ID#: 020-043-64 TECHNICIAN: J. MILLETTE DEPTH TEST HOLE 2 (feet) I' OB SLOPE SITE PLAN 2 "'�'" ". :•;: 3 '.r"'�1°` 4 �� ;{ >. :',1: 5 _' .; .:�;.r SEE SITE PLAN i '.0,;4.\� � SILTY GRAVEL W/ SAND 8 •!i -.-1i' 10 •;'-\.?-' . WAS GROUND WATER ENCOUNTERED? NO .�'::'•' , '• IF YES @ WHAT DEPTH? 1 I j•, 'r T•^• ^ DEPTH OF WATER AFTER MONITORING: NONE a , DATE OF MONITORING: 8/15/17 12 .'.:..�': Wit .t •"2 ' '=' ' '``' DATE READING GROSS TIME NET TIME DWATER NET DROP 13 �;4., . : (MINUTES) (MINUTESH To ) (INCHES) (INCHES) 14 '::.;:;*i.,•••••'/:!" . ','. • , 7/13 TEST HOLE PRESOAKED PRIOR TO TESTING: •'''-7. ;r;: 15 "''. .. '`.::" 1 2:54/3:00 6:05 5-1/8/11-1/8 6" 16 2 3:01 /3:07 6:15 5-1/8/11-1/8 6" 3 3:08/3:14 6:16 5-1/8/11-1/8 6" • 17 4 3:15/3:21 6:14 5-1!8/11-118 6" 18 5 3:22/3:28 6:18 5-1/8/11-1/8 6" 19 6 3:29/3:35 6:17 5-1/8/11-1/8 6" 20 PERCOLATION RATE: 1.04 (MIN/INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN: 4.0 FT. and 5.0 FT. COMMENTS: Ali- me Drilling & EnterpriL ,s Well Log Permit Number: #SW171192 Date of Issue: 7-26-17 Parcel Identification Number: 02004364000 Date Started: 8-9-17 Date Completed: 8-10-17 Is well located at approved permit location? x Yes ❑ No Legal Description: Shangri-La East Block 3 Lot 3 Property Owner Name& Address: Laulima Aina Holding LLC Crown Pointe Borehole Data: Depth (ft) Method of Drilling x air rotary ❑ cable tool Soil Type,Thickness& Water Strata From To ' Casing type: steel stick-up 0 2 Wall Thickness: .250 inches gravelly silt 2 29 Diameter: 6 inches Depth: feet silty gravel 29 51 Diameter: inches Depth: feet silt 51 55 Casing stickup above ground: 2 feet gravelly silt 55 114 Static water level (from ground level, .5 silty water sand&gravel 114 116 Pumping level: 120 feet after silt 116 119 2 hours pumping 40 gpm Recovery Rate: 40 gpm water sand&gravel 119 121 Method of Testing: air lift Well Intake Opening Type: x Open End ❑ Open Hole ❑ Screened Start feet Stopped feet ❑ Perforations Start feet Stopped feet Grout Type: bentonite granules Volume: 2 bgs Depth: Start 0 feet Stopped ? feet Pump: Intake Depth feet �,�ATQUALITY'j ESTING Pump size hp Brand Name L�mL Co'itorm Well Disinfected Upon Completion? x Yes ❑ No Nitrates_�—�------- Method of Disinfection: chlorine tablets Arsenic _ ug — — Comments: Well Driller: Alpine Drilling& Enterprises PO Box 110496 Anchorage, Ak 99511 SAVE �u � . Development Services Department Building Safety Division CIA,:,� ,� A7 4 On-Site Water & Wastewater Program o,4 4700 Elmore Road $.. x P.O. Box 196650 Mark Begich Anchorage, AK 99507 a ETY Mayor www.muni.org/onsite (907)343-7904 Pump Installation Log Well Drilling Permit Number: SW 171192 Date of Issue: 7/26/17 Parcel Identification Number:02004364000 11 Legal Description Property Owner Name& Address: Block 3, Lot 3 Shangri-La East Crown Pointe P.O. Box 112313 Anchorage,AK 99511-2313 Pump Installation Date:1/6/2018 Pump Intake Depth Below Top of Well Casing:113 feet Pump Manufacturer's Name: Goulds Pump Model:10SHO7 Pump Size 3/4 hp Pitless Adapter Burial Depth: N/A feet Pitless Adapter Manufacturer's Name:N/A Pitless Adapter Installer: N/A Well Disinfected Upon Completion? 0 Yes ❑ No Method of Disinfection: Comments: Please save,needed for COSA Pump Installer Name: Aarow Pump&Well Service,LLC P.O.Box 110496 Anchorage,AK 99511-0496 Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. Noc,VALITY OF MUNICIPALITY OF ANCHORAGE tnr On-Site Water & Wastewater Program do ^r PO Box 196650 4700 Elmore Road Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 httpJlwww.muni.org/onsite toA I) •IwrtI) Iii 4N(HoRn(,f On-Site Water & Wastewater System Permit Permit Number: OSP171192 Effective Date: 7/26/2017 Work Type: WellSeptic Initial Expiration Date: 7/26/2018 Tax Code Number: 02004364000 Site Legal Address: SHANGRI-LA ESTATES EAST BLK 3 LT 3 G:3239 Site Mailing Address: Owner: LAULIMA AINA HOLDING LLC Lot Size in Sq Ft: 40164 Design Engineer: ANDERSON ENGINEERING Total Bedrooms: 4 This permit is for the construction of: El Disposal Field Ei Septic Tank 0 Holding Tank ❑ Privy 0 Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2, All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72)and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing k Received By: Date: 7 "02/1 J a 17 Issued By: f 'eta CO Jc z ct t' Date: I �� �D(7 MUNICIPALITY OF ANCHORAGE �r t` Community Development Department �r Phone: 907-343-7904 Development Services Division Fax: 907- -'s ; .• • On-Site Water& Wastewater Program <0 �J <) 4 ON-SITE SEWER/WELL PERMIT APPLICATION + JAL 172017 I Parcel I.D. _ 020-043-64 �s alp I Property owner(s) Crown Pointe, Inc. Day phone 229- "`c c Q 1 `)`' Mailing address P.O. Box 112313 Anchorage, AK 99511 Site address NHN Mountain Air Drive Anchorage, AK 99516 Legal description (Sub'd., Block & Lot) Shangri-La Estates East, Block 3, Lot 3 Legal description (Township, Range & Section) Lot Size 40,164 Sq. Ft. Number of Bedrooms Four (4) APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field ❑X Initial ❑X Single Family (SF) ❑x (w/wo ADU) Septic Tank ❑X Upgrade ❑ Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑x Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE /WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. � � (Signature of property owner or authorized agent) Permit/Rush Fees: t6 724 Waiver Fees: Date of Payment: -3-f i li? Date of Payment: Receipt Number: 00021C Receipt Number: Permit No. 05n17-0Waiver No. Permit App_:.: :�.:( ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) July 17, 2017 Municipality of Anchorage Development Services Department On-Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 3, Block 3, Shangri La Estates East Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Lot 3, Block 3, Shangri La Estates East Subdivision intends to construct a new four-bedroom home on the lot. We are therefore requesting a permit be issued for the construction of a new well and septic system to accommodate the home. The attached Site Plan and backup documentation identify the location and configuration of the proposed well and septic system along with the alternate site. None of the lots surrounding this lot are developed and no conflicts are found between the proposed well and septic system and those on neighboring lots. Drainage arrows developed from the ground surface contours are shown on the site plan indicating the grade and direction of flow on the lot. The drainage pattern will not be changed as a result of this project. A test hole placed on the lot during the subdivision phase indicates silty gravel with sand (GM/SM) in the zone specified for the absorption trench. The percolation rate of the soil was determined to be 20 minutes per inch. No groundwater was found during the placement of the test hole. An application rate of 3.0 gallons per day per square foot was used in the design of the absorption system. We are proposing to place a new 1 ,500-gallon Advantex Treatment Tank with gravity flow to a 25' long by 5' wide by 4' effective depth absorption trench to treat and dispose of the effluent generated in the house. The elevation of the distribution line in the absorption trench will be 4' below the surface and the total depth will be 8'. A minimum of 3' of fill or 2" of insulation and 2' of fill will be placed over the absorption trench and 4' over the septic tank. The ground surface on the lot in the area of the septic system slope to the west at a grade of about 15-20%. The new trench will be constructed parallel with the contours of the slope as much as possible in conformance with Municipal requirements. The new septic system will be constructed a minimum of 100' from all wells and any surface Lot 3, Block 3, Shangri La Estates East Subdivision July 17, 2017 Page Two water and 10' the proposed and existing water services in the area. If the system is constructed in accordance with our design the following statements apply: I. 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. s* 49TH f *�I• Attachments �... .. .MICHAEL E. ANDERSON• j 63.•;• . CE-4381 +'•1�%i�� 1'+ PLAT NO. 2011-62 SHANGRI-LA ESTATES- EAST LOT 3, BLOCK 3 40,164 S.F. TRACT B Four Bedroom Advantex VACANT N 1067' Treatment System with AX20 // 1069' Pod and Gravity Flow to Absorption Trench. S 89'57'17"E 268.73' 00 / \ • <0- o W� / \ �jij� i.'///I �-1. � 1,500 Gallon ij �/v ��/ Advantex CO Septic Tonle N -./ /:'.1' - / w2C0 MH a0 // go H1 MF �! FCO H M F Q / O/ Alternote Site ,11111 N O / co Four Bedroom Proposed wo ��Q 3o DO / Home Well ® w z O. / J J O / 25' Long x 5' Wide x I- �Q �7 / 4' Effective Depthft. D 'H• / Absorption Trench. O E o / �� // NOTE: No Development Planned or 1 �� / Ongoing on Lots Adjacent to . W ��` / Lot 3, Block 3. r N N., / -4- A.C. DRIVE / o o / / o y/ •z / • S 89'58'05E 347.38' // 1064' N / 1082' ..•�E OF oossursii�'��� LOT 4 BLOCK 3 ----_ :��...' , • VACANT — i • 49t =. ♦ CO — Cleanout ; LOT 3, BLOCK 3, SHANGRI-LA EAST SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Four Bedroom Home 5'Wide Trench System Perc. Rate: 20 Min./Inch Four Bedroom Advantex Treatment System Application Rate: 3 GPD/SF with AX-20 Pod - Gravity Flow 4' Drainfield Rock 4 Bedrooms * 150 GPD/Bedroom = 600 SF Absorption Area 600 SF/3 GPD/SF/5 SF (Width) `.5 (Red. Factor)= 20 LF Trench Length THEREFORE: Construct a 25' Long x 5' Wide x 4' Effective Depth Absorption Trench. Flow Line Elevation in Trench to be 4' Below Original Ground Surface. Total Depth to be 8' Below Existing Ground. Provide 3' Cover Over Absorption Trench and 4' Cover Over Septic Tank. Gravity Flow From Pod to Absorption Field. 3'6" eotextile Fabric 6 O 4" Perforated PVC (Holes Down) Drainfield Rock 4' 5 I I TYPICAL 5' WIDE TRENCH SECTION .._4,4.....,.,� (NO SCALE) .•,P�� • • !1A NOTE: Grade Area Over Trench to Drain Away. :4 s *0 s 49th I % I Minimum 6' Separation From Bedrock. 3 • Minimum 4' Separation From Groundwater. leisig.L L `4___ Minimum 100' Separation From Private Wells in the Area. ,,,, MICHAEL E ANDERSON i 415 Minimum 100' Separation From Surface Water or Streams. 1#6%,: No._CE-4381 :7_`": MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT/ON-SITE WATER AND WASTEWATER PROGRAM 4700 ELMORE ROAD, ANCHORAGE, AK 99519-6650 SOILS LOG - PERCOLATION TEST PROJECT #: PERFORMED FOR: Crown Pointe Homes DATE PERFORMED: 7/13/17 LEGAL DESCRIPTION: Lot 3. Block 3. Shangri La Estates East TEST HOLE # 1 SLOPE SITE PLAN OG/OL I 2 - 6 ___.o .• e See Site Plan L+ -.' :: Silty Gravel a • with Sand ' GM/SM 5 " • 6 7 - •p 8 - •. .!, a WAS GROUNDWATER 9 - ` ENCOUNTERED? No S - ' . L IO • • IF YES, WHAT DEPTH? 0 DEPTH OF WATER P II — AFTER MONITORING: None E DATE: 7/22/2017 12- '-. •• • • 13 '• .,.4" ����� r,'�+� READING DATE GROSS NET DEPTH To NET 4Fr,`P�.,..• "' N. TIME TIME WATER DROP IL - •rPC9 �1 1 7/13 5:48 0.00" 1 BOH ; 49th � •': fit 2 6:18 30 1.50" 1.50" 15- i SE4-7 3 6:19 0.00" ••A, MICHAEL E.ANDERSON = 4 6:49 30 1.50" 1.50" _ 16 -,:r..'•• �� 5 6:50 0.00" #• N0. CE-4311 ��a �j��o'' .:L'..:Z P����~ 6 7:20 30 1.50" 1.50" 18 PERC RATE: 20 MIN./INCH PERC. HOLE DIAMETER: 6" TEST RUN BETWEEN 3.5 FT. AND 4.5 FT. COMMENTS: Test Hole Pre Soaked Prior To Percolation Test. TEST PERFORMED BY: MEA I, MICHAEL E. ANDERSON, CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES ON THIS DATE: 7/20/17 ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT BETWEEN MUNICIPALITY/ OF ANCHORAGE AND C� (AA- THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this /c7 Day of )/7 of 20 £ by and between ( '..& � , herein the"OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein,the parties to this Maintenance and Repair Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS),described as Advantex Treatment System located at(legal description). Lot 3, Block 3, Shangri La Estates East Subdivision 2. Definitions. Alteration. Any change to the design or function of an AWWTS that includes the installation or removal of any parts,components or pieces not included in the original construction permit and design. Certificate of On-Site Systems Approval(COSA). An approval by the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with Anchorage Municipal Code (hereinafter,"AMC") 15.65. These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. Maintenance and Repair. The scheduled and as needed replacement of existing parts, components and pieces of an AWWTS that were included in the original design which would allow the AWWTS to continue to perform as designed. Permit.An On-Site Wastewater Disposal Permit as required by AMC 15.65 to construct and operate an AWWTS. 3. Term. The term of this Maintenance and Repair Agreement shall begin on the date of approval by the Municipality to operate the installed system or issuance of a COSA,and shall continue while the AWWTS is in use or is operational or until the property is sold or title is transferred by the owner and a new COSA is issued to the new owner or transferee of the property. 4. Alterations, Installation and Removal of Additional EQuiument. Prior to performing any alterations to an AWWTS,the owner agrees to obtain an On-site Wastewater Disposal Permit from the Municipality in accordance with AMC 15.65. 5. Maintenance and Repairs. A. Throughout the term of this Maintenance and Repair Agreement,the Owner shall maintain their AWWTS in a satisfactory condition capable of producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. The owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the municipality and the manufacturer of the AWWTS for the entire term of the AWWTS. In addition, it shall be the responsibility of the Owner during the term of this Maintenance and Repair Agreement, and any renewals thereof, at the owner's sole expense,to pay for any and all: (1)repair(s), (2)maintenance,(3)adjustment(s),(4)replacement costs, and (5) inspection costs. B. Owner agrees to comply with all applicable ordinance, laws, regulations, rules and orders for the AWWTS. C. Upon request by the Municipality,the owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system. When a record of maintenance is documented and maintained by the system vendor,the owner agrees to allow the Municipality access to this information. D. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60 for improper discharge. E. Owner agrees that only maintenance and repair personnel approved by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the system. F. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. G. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On-Site Systems Approval. H. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction, maintenance and repair of the Owner's A W W TS. I. Owner agrees to provide and maintain a telephone connection to the AWWTS as required by the AWWTS approval. 6. Nonwaiver. The failure of either party at any time to enforce a provision of this Maintenance and Repair Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Maintenance and Repair Agreement or any part hereof, or the right of such party thereafter to enforce each and every provision hereof. 7. Amendment. A. This Maintenance and Repair Agreement shall only be amended, modified or changed by a writing, executed by authorized representatives of the parties,with the same formality that this Maintenance and Repair Agreement was executed with, and such writing shall be attached to this Maintenance and Repair Agreement as an amendment. B. For the purposes of any amendment modification or change to the terms and conditions of this agreement,the only authorized representatives of the parties are: i a. Owner: </ D.'.do L b. Municipality: Director, Community Development or designated authority C. Any attempt to amend,modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. 8. Jurisdiction: Choice of Law. Any civil action arising from this Maintenance and Repair Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Maintenance and Repair Agreement. 9. Severability. Any provisions of this Maintenance and Repair Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Maintenance and Repair Agreement. OWNER: By: (signature) Date: doii7 ‘g4,,L (print name) STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) The f regoin i ment ackno le ged before me this da t 20/ /, by 5 �, u 'i'7 . .. ✓ • ,L / :..?:•;11CitARY'' • • ARY PUBLI FOR ALASKA �� My Commission expires: 2/c 4. / PUB r MUNICIPALITY: Y: �►`.AN By: te. 031,J (signature) Date: 11)1-41 "1 (k(&3eCCJA C - -- \ (print name) Title: J .0.1 '8 o 77 • • ` 4 6. t Municipality of An s - , r 3 <0 On-Site Water and Wastewat:.i: o•ra (907) 343-7904 .! •�•. 4-Q-O r .•LI l a ' SA l e Ty // • Certificate of On-Site System 4„r4• ;i.. Parcel I.D. 020-043-64 Expiration Date: ,krl 10, 02 C7 f 1. GENERAL INFORMATION Complete legal description Shangri-La Estates East B3 L3 Location (site address) 15985 Mountain Air Dr Current Property owner(s) Crown Pointe Inc. Day phone (907) 748-5579 Mailing address PO Box 112313 Anchorage AK 99511 Real Estate Agent Day phone 2. TYPE OF DWELLING: El Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well El Individual 0 Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Distance: Received byNaU ti, — 71&/,(7_.- Date: ;D//U//f COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ (g gl)'T '11 = III b� Waiver Fee $ Date of Payment H-5-1? Date of Payment Receipt Number 6351 t Receipt Number COSA# 05GI$ i l 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 Forge Engineering Phone (907) 522-7773 Address PO Box 240773 Anchorage, AK 99524 Engineer's Printed Name Benjamin Schiller, PE Date 4/2/18 —4?) * *;:t7 TM 6. DSD IGNATURE • .. •• ' ke I � l "S stem #1 Approved for / bedrooms Bena fSchiller System #2 Approved for bedrooms r#�As. c1131t: E sae •.4,4k; Disapproved Ir FEST.W Conditional approval for bedrooms, with the following stipulations: = QN.SITE WATER AND r" 0 WASTEWATER oz PROGRAM O,o 'Yr SER\I\k'F'S By: ao&A aLs /et. 7'm �c�.Icv,u1 Original Certificate Date: Qcj l0 QD11Y ) 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 r c 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: Shangri-La Estates East B3 L3 Parcel ID: 020-043-64 A. WELL DATA Well type Private If A, B, or C provide PWSID# Well Log (Y/N) Y Date completed 8/10/17 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 121 ft. Cased to 121 ft. Casing height (above ground) 24 in. FROM WELL LOG AT INSPECTION Date of test 8/10/17 New Static water level 56 ft. ft. Well production 40 g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform Neg colonies/100 mL Nitrate •309 mg/L Arsenic ND ug/L Date of sample: 9/14/18 Collected by: Forge Eng. B. SEPTIC/HOLDING TANK DATA Tank Type/Material Advantex/Fiberglass (FAP) Date installed 8/15/17 Tank size 1500gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout(Y/N) Y Depression over tank(Y/N) N High water alarm (Y/N) Y Date of pumping Pumper New Construction C. ABSORPTION FIELD DATA Date installed 8/15/1$ Soil rating (g.p.d./ft2 or ft2/bdrm) 3.0 GPD/SF System type 5-Wide Length 25 ft. Width 5.0 ft. Gravel below pipe 4.0 ft. Total depth 7.7 ft. Eff. absorption area 250 ft2 Monitoring tube Y Depression over field N Date of adequacy test New Const 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 8/1 5/1 7 Size in gallons 1500 Manhole/Access (Y/N) Y "Pump on" level at 42 in. "Pump off' level at 48 in. High water alarm level at 54 in. Datum Bottom Cycles tested 2 Meets alarm&circuit requirements? Y E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot >100On adjacent lots >100 Absorption field on lot >100On adjacent lots >100 Public sewer main >75' Public sewer manhole/cleanout >100 Sewer/septic service line >25' Holding tank >75' Animal containment areas >50' Manure/animal excrete storage areas >100' SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5 Property line >5 Absorption field >5 Water main >10' Water service line >10' Surface water >100' Wells on adjacent lots >100 ABSORPTION FIELD ON LOT TO: Property line > Building foundation >10 Water main >10 Water Service line > Surface water >100 Driveway, parking/vehicle storage >10' Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS G. ENGINEER'S CERTIFICATION \ %�P :4$9411 I certify that I have determined through field inspections and jre*� TiH .. .* Toreview of Municipal records that the above systems are inilip conformance with MOA COSA guidelines in effect on this date. % ��--, Engineer's Printed Name Benjamin Schiller, P.E. I�enjami'� -chiller •:� j Date 9/25/18 +,�1�'``;..E 1 �2 ��.��' 1l FES IONCl" COSA brown sheet 10-10-12.doc PLAT NO. 2011-82 SHANGRI—LA ESTATES—EAST LOT 64 3�1 BLOCK 3 4 .F. S 86•57'17"E 268.73' as.o• f �, �" // Milliki.r • A4-441111 e"3I I n �4 A4a / sync$31VJ I I 4n dv 4%/ Q•/SC I I p' C' �y O� / B��NC I I 4 a ^a, ® c I g I h. b o to 4) ? / -,, I I I ki I b J�� 3p,o4/cs, // I 14 z ` I Ib ef �, / GRAVEL DRIVEI b g4. 1 "=40' I I rt-, to W ~•' b 40' K v / I I ,Nr r�� U / I I t / I I O S e9•5e'05'E 347.36' Z BUILDING D ETAI L SCALE: 1".•20' AS—BUILT I HEREBY CERTIFY THAT I HAVE SURVEYED THE PROPERTY DEPICTED ABOVE AND THAT NO GASTALDI LAND ENCROACHMENTS EXIST EXCEPT AS INDICATED. ���OF e* 4.4SURVEYING, LLC IT IS THE RESPONSIBIUTY OF THE OWNER TO ��k, QC JEFF A.GASTALDI, R.LS. DETERMINE THE EXISTENCE OF ANY EASEMENTS, • ,V' qS'I 2000 OOWUNG RD.,SUITE 8 COVENANTS OR RESTRICTIONS WHICH DO NOT • �• 17: �j 7...,„„ E. ANCHORAGE,ALASKA 99507 APPS ON THE RECORDED SUBDIVISION PLAT. 49IL1 •••�% PHONE 248-5454 UNDER NO CIRCUMSTANCES SHOULD ANY DATA GRID DATE HEREON BE USED FOR CONSTRUCTION OR FOR ..Z..Jeffery a 91iota �}i ESTABUSHING BOUNDARY OR FENCE UNES. .r,. �-9o91 .. • SW3239 1/4/2018 s ••.1 /8 I F.B. JOB N0. ANCHORAGE RECORDING DISTRICT,ALASKA •. �ory,onal�O'��• NOTE: NO CORNERS SET THIS DATE wJ18a„s`' 17-04 SLE33 , MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT,herein the"AGREEMENT" made and entered into as of this 26 Day of September of 20 18 ,by and between t` r fI7L4) ,herein the"OWNER,"and the Municipality of Anchorage,herein the"MUNICIPALITY",in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein,the parties to this Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System(AWWTS), described as Advantex System located at(legal description) Shangri-La Estates East, Block 3 Lot 3 2. Maintenance,Repairs and Alterations. (Owner is required to read, understand and initial each section) Throughout the term of this Agreement,the Owner shall enter into a service agreement It_ with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in 4 accordance with the equipment's approval for operation in the Municipality. It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s),maintenance,adjustment(s),replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to$600). Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system,which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Page 1 of 3 4\--- Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. Vitt Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. Owner agrees to grant the Municipality reasonable access to test and inspect the L 4 AWWTS. The Municipality will give at least 24-hour notice. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On-Site Systems Approval. •--4' Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction,maintenance and repair of the Owner's AWWTS. ,* Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system,or upon transfer of title, and shall continue while the AWWTS is operational or until title is transferred. 4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions,nor in any way affect the validity of the Agreement or any part hereof,or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of 3 OWNER: By; 4- '(. (signature) Date: \ Q--7-(1 Ot 1 I (print name) STATE OF ALASKA ) )ss. THIRD JUDICIAL DISTRICT ) The foregoing fpregoing,instrutpetaitswas acknowledged before me this day of ©C , 204_6,by It r\(, NOTARUBLICTOR ALASKA Q'�Q:.•••••••..;•kt My Commission expires: /O '2(6' 2 ( ���• • ko MUNICIPALITY: 0///11111Nt� By: a(f. C? J67 (signature) Date: i 0/1 0/201 Reije c cR aro If (print name) Title: (rev. 05/18/2018) Page 3 of 3