HomeMy WebLinkAboutSHANGRI-LA ESTATES EAST BLK 3 LT 4•
Estates Easl
r
Municipality of Anchorage
On -Site Water and Wastewater Program - (907) 343-7904 Page 1 of 3
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP181058 PID Number: 020-043-65
Dwelling: E] Single Family (SF) El Duplex (D) F71 Multiple (SF and/or D) Project: Rn New 0 Upgrade
Crown Pointe Inc
ABSORPTION FIELD
R Deep Trench Rn Shallow Trench R Bed R Mound
Address
16035 Mountain Air Dr., Anchorage, AK 99516
El Other
Phone
Number of Bedrooms
Soil Rating
depth from original grade
(907) 229-1886
14
JTotal
4.0 GPDISF
7.6 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
3.6 Ft.
Gravel depth beneath pipe
4 Ft.
Subdivision Block Lot
Shangri-La Estates East 3 4
Fill added above original grade
1.7 Ft.
Gravel length
20 Ft,
Township Range Section
Gravel width
5 Ft,
Beds: Number of Lines
Distance between li7nes
Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Tank
Line
200 Ft'
1
Ft.
Manufacturer
Orenco/Advantex FAP Tank
Capacity
1500 Gal.
Surface Water
>100'
>100'
N/A
N/A
Material
Number of compartments
Lot Line
>10'
>10'
N/A
N/A
Fiberglass
2
NA
Foundation
>10'
>10'
N/A
N/A
LIFT STATION
Manufacturer
Capacity
Curtain Drain
None
Noted
I Gal.
Remarks
Pump on level at
Pump off level at
High water alarm at
Pump make and model
Electrical Insp ctions performed by
Installer
Tank to
PIPE MATERIAL House to tank D3034 drainfield D3034
Sanders & Sanders
Drainfield D3034 CO/MT M034
Inspector J. Millette / J. Williams
BENCH MARK (Assumed elevation) 100 ft
Inspection Id 8/30/18
11t 8/29/18
Location and description
dates: 2
3 rd 41"
Bottom of siding near deck.
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL
Engineer's Stamp
Conditional
low
Approval: Date
lae
49
CE 12592
12/6/18
Approved Date U11,210
AW
inspection xopon_o 1-1z,(Joo
1080.01090.01078.01082.01084.01086.01088.01092.01094.01096.01098.0FCO100500FEET1"=50'4-BDRM HOMEEXISTING WELLCO - CLEANOUT2CO - DOUBLE CLEANOUTFCO - FOUNDATION CLEANOUTFS - FLOW SPLITTER VALVEMH - MANHOLEMT - MONITORING TUBESV - SEPTIC VENTTH - TEST HOLELEGENDCO2MTMOUNTAIN AIR DRIVE
PERMIT # OSP181058PID # 020-043-65SHANGRI-LA ESTATES EAST, BLOCK 3 LOT 4ABFCO3.7MH114.7MH225.2AB2CO36.0CO154.8MT51.8CO253.350.049.152.249.331.331.649.710
'
T
&
E
E
S
M
T
10' T & E ESMT
33' UTILITY ESMTTH#1TH#2Dec 06, 2018PLAN AS-BUILT(NO SCALE)NEW 1500-GALADVANTEX TANKW/ AX20 PODCO12COMH2MH1NEW 20' LONG x 5' WIDE x 4'EFFECTIVE ABSORPTION TRENCH50' WELL RADIUSALTERNATE SITELOT 3 100' WELL RADIUSLOT 5 100' WELL RADIUS
PROFILE AS-BUILT
(NO SCALE)
Dec 06, 2018
94.7 FINISH GRADE
20'
DRAINFIELD ROCKMT
TH#1NO GROUNDWATER 4/06/18
89.4 COCO77.0
85.4
89.4
93.0 ORIGINAL GRADE
95.8
91.3
93.2
99.3FCOMH1 MH22CO96.7
AX-20 POD AND
MANHOLES
PERMIT # OSP181058 PID # 020-043-65
SHANGRI-LA ESTATES EAST, BLOCK 3 LOT 4
1500-GAL
FAP TANK
85.4
In, 4 !" 1 ,3 r' 2 Ell 3 22: 4@ _,0 ""- _-'; 4 t__:-:'t202`4LP-DE DIP'ILLING PAGE 01! 11,01
Alpine Drilling & Enterprises
Permit Number OSW76-11058 Date of Issue: 5-17-18 psteel ldc'utificatiou Number. o20006,4'5000
Date Star ed. :24748 Date Cuinpleted: 7-28-18 Is v, --fl located at apprrcd permit Joatiod,
c Y es r iN o
Legal Descripbon- Shan!yr;!-,L,) Es-69tes E;),st 81o(;k3 L�t 4
Property Owiter Mame & Address; Crcwn Pointe k7c;:,
PO Box 1123'13
Anch
Borehole Data,
I Drillbig g.al,
Soil Txi-pt,, 9z ';Vat�,i S ata Fr(�Tn To
CasIng type -
stick -up Wall Thickness: �iZ-L'5 ivehes
pwveh�,� sil'i 2 P, 1)*,ayneter: 6 inches Depth; 17 file¢
Sdry gravel 615
'n,-hcs Dez)th: feet
cob bl�y A"), jrnrel -m?t
co!0'11 sih
Y
S dt 1
� I,; S. 147
WATER QUALITY TESTING
Iform M
COI Nc--,q ----,----CoVI00L
Nitrates � mg/L
Arse
Casing sfickup,..j��e LoLu!id- 2 'f'�et
I
Static water Nvol (frum growid
Pumping level: 14? fel aftt,-
hours pim1ping LO gpin
10 gpru
Meth6d Gf Tesbug, aip !"ifi,
Well Intake Opening, Typ,-,
Opea"E-nd L
F� screeked Start feel Stopped fuet
[,—j Pttf;rraticms stall fect stoppl=d f
Grout Type: -Inttwlit� I
1-3.-4
Pump: Intake Depth feet
Well Disiate-led Upon Complefitya.? x 'Ycs L:) No
Method of Dhi-Mft,C'60U; Chi'OP1,W- hlblfft
ents;
Pf1 Box 110496
1PIHE DRILj- PAGE 01/0"
-3 5/23 12' 01 2 3: 9 0 5 3 .� __ _]l 2 0 2 'T t�i
MUNICIPALITY OF ANCHORAGE
Deveioptnent',Sep,,ices Department fi
Phone: qO7-343-7!)04
On -Site Water & 1= rite Sectiorl
Fax-, a07-343-7997
Pump Installation Log
Well D'illing Perrojk Number, 18 058 .11Rf&'af 5 17 18
Paecelldentificadd, n Nurnber., 02 04,1655
Desesiption Bloo, Lot---- ProperqOwner Name & Address, -
[s Estiles Inst 3 4 Po�rte
P
12.51 . 0. BOX'I
ArichoriAge.AK 99511-2,mi
PUDip lftStallmtlon J)ateM 12 - 20 18—
PUMP Intake Delpth Bcl,,rx Jfbp of %'ell Casing: - 144 feet
Pump _NIanufT4cn;n,,.rN. N.m.,Goulds
PampNfodel- 7HS07
Tact Size! 3/4
Pitles� Adapter Burial Dept?,-; n/a feet
PitJP,9'$,,',daPter ManufaiAurer"s asa t n1a
Pitless Adapter lnstMter- n/a
Well Disinfected Upon Conup)efio Yes
kv
Methed of )Disinfection: (I
5
comme"u.,
Pump Installer Name.
row Pump & Well Service, LIC
Mailbig Address, P .0
Anchorage
City.- I
Box 1110496
S'tafc. AK z1v: 99511
Attention: 71�.e pump installej- q).a' ' ' 1 P.ro'vi&'a ptinip hi";�taiiation log to 0-7,3jtc 'V?Jijj 3(1 &"j'$ (I "Inmip irsta!"atior'.
17�=
r
�00C'P.L'.1r Y 0,�. MUNICIPALITY OF ANCHORAGE ,oc,,,
On-Site Water&Wastewater Program N' ' 'S
f Awe Box 196650 4700 Elmore Road ';,
tAnchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 r;
�� �'r 1 http://www.muni.org/onsite ' ' lir
rpm InIctil
,4'CNORh�'E
On-Site Water & Wastewater System Permit
Permit Number: OSP181058 Effective Date: 5/17/2018
Work Type: WellSeptic Initial Expiration Date: 5/17/2019
Tax Code Number: 02004365000
Site Legal Address: SHANGRI-LA ESTATES EAST BLK 3 LT 4 G:3239
Site Mailing Address: 16035 MOUNTAIN AIR DR, Anchorage
Owner: CROWN POINTE INC Lot Size in Sq Ft: 42839
Design Engineer: FORGE ENGINEERING Total Bedrooms: 4
This permit is for the construction of:
2 Disposal Field 2 Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 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
i /I
Received By: LA4
Date: J ` ` ;/I 7
Issued By: alori /1,,,, Date: /7g
MUNICIPALITY OF A "_ ,'$ z AGE
" -1111,.:01 I1)
I
Community Development Department 3 2018 •ne: 907-343-7904
Development Services Division s SPR -. Fax: 907-343-7997
On-Site Water & Wastewater Program '"
w
t �
ON-SITE SEWER/WELL PERM A-8" . 7 ', ' :0N
Parcel I.D. 020-043-65
Property owner(s) Crown Pointe, Inc. Day phone 229-1886
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 4
Legal description (Township, Range & Section)
Lot Size 42,839 Sq. Ft. Number of Bedrooms Four (4)
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(El all that apply)
Absorption Field ❑X Initial 0 Single Family (SF) X
(w/wo ADU)
Septic Tank ❑X Upgrade ❑ Duplex (D) n
Holding Tank ❑ Renewal ❑
Multiple Dwellings ❑
Privy ❑ (SF and/or D)
Private Well
Water Storage ❑
THIS APPLICATION INCLUDES A VARIANCE I WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
i4jt4.— Z (i.c ,\
(Signature of property owner or authorized agent)
Permit/Rush Fees: 4 i-8ti Waiver Fees:
Date of Payment: Lil au1/s Date of Payment:
Receipt Number: O Q rat D Receipt Number:
Permit No. 03101Y106-43 Waiver No.
Permit App_ ::..c
' GE
INGINtIRiNG
PO BOX 240773
ANCHORAGE,AK 99524
522-7773 677-7766(FAX)
April 23, 2018
Municipality of Anchorage
Development Services Dept-On-Site Water&Wastewater Program
4700 Elmore Rd
Anchorage,AK 99507
Subject: Shangri-La Estates East,Block 3 Lot 4—Mountain Air Drive
Septic system design and permit application
Dear On-Site Services Engineer:
The owner of the above lot intends to build a 4-bedroom home on the property, so we are
submitting this permit application for the construction of a new well and septic system. The
attached site plan identifies the location of the home as well as the proposed well, septic location
and alternate site. No conflicts exist between this proposed system and any other well or septic
system,whether on this lot or adjacent lots.
The ground surface on the lot slopes toward northwest at slopes less than 25%. It is in that flatter
area that the new septic system is located. There are no slopes greater than 25% within 50 feet
downslope of either the primary or alternate site. Ground surface contours are shown on the site
plan showing the grade and direction of flow. Stormwater drainage will not impact this septic
system.
The new trench will be constructed parallel to the slope as much as possible. It will be a
minimum of 10(1 from all wells and surface water, and more than S away from the septic tank.
The alternate site is located more than 10'away.
Please refer to the attached test hole logs and plan and profile pages for the septic design. If this
design is followed,there will be no adverse impacts to adjacent properties.
Sincerely, "�e��►���, d
OFA ed
All* • 49TH 03• .• 0
Michael E. Anderson, P.E. �•••• •••• •••• ••• •• • ,�
Attachments , :MICHAEL E. ANDERSON OC
•
I,%••• CE-4381 :4.4,44-1 OF
0111
o�►�V:.o�o•
SHAN ❑ RI - LA ESTATES , BLOCK 3 , LET 4
,
PID NO. 020-043-65 §§ COD /
NO. OSP18105�
I! 11
/ Septicc Sites/ 1 Proosed 1
/ 1 Well® I
I I
/ �ti 11 '' \ If
—,
\ LOT 3 __
/
Z �\
'�P / \ • . . , • /( -\-
- -
�O ``moi/ �0 ' well Ac��` / \ ��
L �,_' _,,
// ►1� /Jt. site �TH2 --- �.
�, / 5 �O'' AV, rr 20 Long x 5• Wide � r_� �__
/ O �i5 i ' :;�' x 4' Effective Depth1.
///'ep otcl A� II r1, ; r ��� Absorption Trench. N
•
/ / r' a✓11 SWC f 9�/ Proposed I - �� Four. Betlr•
oom } w w
f W811 Four 8 Broom ' Advontex Tr ment�� a-17=" �� � - w
/ ,8h� 0 Ho a System with AX20 F
per • • (`\ Pod.
1 �
/ —..----,2--- _____ -... ..// 4 401 ._ .. . .:..:,... __--I
W4.411p- . :-./.: .....: '. '-......H. .• 1
/
1196• --✓ 1
1
._,.�.s��►li1s�OF A/.1 •O O
4,4
NOTE: Septic Sites
a )'••••••• • J- .O NO SLOPES >25% WITHIN 50' OR SURFACE WATER WITHIN 100' OF THE LEGEND:
_ • 49th i ' * 0 LEGEND:
PROPOSED SEPTIC SYSTEM CO — Cleanout
• #41. j� E._.
. 10/ SV — Septic Vent
t�cw�.c.t c�V�ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS PROPERTY ARE TH — Test Hole
OMICHAEL E. ANDERSON LL��� 4 SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC SYSTEMS. MT — Monitor Tube
•1-' No. CE-4381 'ti`, SITE PLAN FCO — Foundation Clean Out
t ,�, .• MH — Man Hole
v. �� 1'�uttSS1e i, SCALE 1' = 50' CONTOUR INTERVAL 5'
SHANGRI-LA ESTATES EAST, BLOCK 3 LOT 4
DESIGN FACTORS: SYSTEM REQUIREMENTS:
600 GPD PEAK FLOW 5' WIDE SHALLOW TRENCH SYSTEM
PERK RATE: 2.1 MIN/IN 1,500-GAL ADVANTEX TREATMENT TANK
APPLICATION RATE: 6 GPD/SF
600 GPD/6 GPD/SF/ 5'WIDE '.5 RED. FACTOR = 10 LF TRENCH REQUIRED (20 LF SPECIFIED)
BOTTOM OF TRENCH: 8' BELOW GRADE
FLOW LINE ELEVATION: 4' BELOW GRADE
TOP OF TRENCH: 0'ABOVE GRADE
r 6"
— —III—III—III—III—III— _
I I 1=1 11=1 11=1 11=1 I I�I I
1=1 11=1_I 1=1 11=1 I I-III-I
11=1 I I-I 11=1 11=1 I I�I f
1=1 11=1 11=1 I I-III-III-I
3'-6" III-III-III-III-I I I-1 I I
1=1 11=1 11=1 11-I 11-I 11-I
I I I-1 11=1 11-I 11-I I I-I I I
1=III=1 I 1=III-111-1 I I—I
111=111=111=111=111=III
I-1 I I-1 I I-1 11=1 I I-1 11=1
6" :;.:::: : : :,
71,
'='==�'='='=•'='=�=•'='='='-='='• 4" PERFORATED PVC (HOLES DOWN)
DRAINFIELD ROCK
'.:.:.;.;.:.:.:.:.:.:.:.:.:.:._
7110C11:•...;.•:::::.:.:.:::
.;.1:11.;11:0:*:.:.:.:.:::::.:.:..
•
;WO:.:di:::.:.:.:.,
lklk
♦ e`+` A�
TYPICAL 5' WIDE TRENCH (r)?:• o
•' s�Pe
SECTION j: 49 T
NOTES: (NO SCALE) A lr :..• 0
1. GRADE AREA OVER TRENCH TO DRAIN AWAY r �:MICHAEL E. ANDERSON.:,�
2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2' ® s'•• CE-4381 : `"�
WITH 2" OF INSULATION �` ff�•'y �'L' �-,I f•'•��
3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER 41 ; E s`� ft
THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY
MUNICIPALITY OF ANCHORAGE ���p�E,Y ���♦
DEVELOPMENT SERVICES DEPARTMENT ���
it; 49th_ �N : .II
4700 ELMORE ROAD ANCHORAGE, AK 99519-6650 •,,,,,Xr�• ;,,
SOILS LOG AND PERCOLATION TEST p‘,MIt71AEL E. ANDERSON {{iii;
VNo. CE-4381 ...:,_:1 ,4,
LEGAL DESCRIPTION: SHANGRI-LA ESTATES EAST B3 L4 �.♦ �� y u ."�•�,
PERFORMED FOR: CROWN POINTE � itie
DATE: 3/27/18 PROJECT No.: Professional Engineers Stamp:
PARCEL ID#: 020-043-65 TECHNICIAN: J. MILLETTE
DEPTH TEST HOLE 1
(feet)
1' OB SLOPE SITE PLAN
4c.:).-.0:.-4:.,......,.. :
5 '--:i`:.;!!�;,;' SEE SITE PLAN
:. ;:.'
7 ;,:.;..,;.....;::"1.:',.,....? SILTY SANDY GRAVEL
I 0 •?~•' ,Z'• ' WAS GROUND WATER ENCOUNTERED? NO
•`•"-▪'" IF YES @ WHAT DEPTH? -
'•i- '••'c DEPTH OF WATER AFTER MONITORING: NONE
11 !::i.1-:.;.•::.
=:...-�.+ DATE OF MONITORING: 4/06/18
, 12 _``• ` _.
-".~ DEPTH TO
::k.';',.' GROSS TIME NET TIME NET DROP
• DATE READING (MINUTES) (MINUTES) WATER (INCHES)
13— %� ; ; (INCHES)
--.;':.,.--,...--e,....
14 `;7: :: ::;,` 4/06 TEST HOLE PRESOAKED PRIOR TO TESTING:
15 'y:.:; 1 12:02 4 a
2 12:32 30 6 78-
16 • ----▪----
3
8 18
17 3 12:33 44
4 13:03 30 5711 2
18 5 13:04 4 a
19 6 13:34 30 54 11
20
PERCOLATION RATE: 20 (MIN/INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN: 4 FT. and 4.5 FT.
Pei Mgt]/ /CagM.cMe,it" Uric 1-0 -the- X6 "-
COMMENTS:
OF 4,'
MUNICIPALITY OF ANCHORAGE ,1-...........F ♦♦
DEVELOPMENT SERVICES DEPARTMENT
4.7C)`'• • . .• ♦♦
4700 ELMORE ROAD ANCHORAGE, AK 99519-6650
i 49th i *♦♦o
pit_ezei ceTi.".4.7
SOILS LOG AND PERCOLATION TEST i'c =.MICHAEL E. ANDERSON;�j
•:.,,,-... No. cE-4381 1,, ;
LEGAL DESCRIPTION: SHANGRI-LA ESTATES EAST B3 L4 ♦♦4, 0,_•-•-•. �� ♦/
PERFORMED FOR: CROWN POINTE h,��aa�rl►s �♦
DATE: 3/27/18 PROJECT No.: Professional Engineers Stamp.
PARCEL ID#: 020-043-65 TECHNICIAN: J. MILLETTE
DEPTH TEST HOLE 2
(feet)
1 1.5' OB SLOPE SITE PLAN
5:•...
`;ii;...
4 ''_ +?•
5 r'.`.;��:�f
':; ' SEE SITE PLAN
6 —'*:.'•.`-4;.4;..:,.,:)
7 lr, :•' '. SILTY SANDY GRAVEL
10 ';,' '` WAS GROUND WATER ENCOUNTERED? NO
`�: ��:'! IF YES @ WHAT DEPTH? -
11 y.-' `i.' DEPTH OF WATER AFTER MONITORING: NONE
;v'-: .; f:'; DATE OF MONITORING: 4/06/18
4-,:.1:;A:.:.::-7:.
+ z;
, 12
=�`~''':•='.',`," GROSS TIME NET TIME DEPTH TO NET DROP
` DATE READING WATER
13 : ?:�'-, ::.
fi.. (MNUTES) (MINUTES) (INCHES) (INCHES)
14 :':45:..3 4/06 TEST HOLE PRESOAKED PRIOR TO TESTING:
15 '.:!":: ;r 3" 1 10:39/10:49 10 5 a / 10 4 a
=` '` 2 10:54/11:04 10 5a / 9a 42
3 11:06/11:16 10 5a / 9s 4a
17
4 11:17/11:27 10 5a / 9Z4a
18 5 11:28/11:38 10 5a / 9a 48
19 6 11:39/11:49 10 5a / 9a 48
20
PERCOLATION RATE: 2.4 (MIN/INCH) PERC.HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN: 4.5 FT. and 5 FT.
Per 11144 - /"IeawGMe,rts weveAD 711e I4 r'
COMMENTS:
ADVANCED WASTEWATER TREATMENT SYSTEM
MAINTENANCE AND REPAIR AGREEMENT
BETWEEN MUNICIPALITY OF ANCHORAGE
AND CROWN POINTE HOMES
THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this
16TH Day of MAY of 20 18, by and between CROWN POINTE HOMES
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 WASTE WATER TREATMENT SYSTEM
located at(legal description).
SHANGRI-LA ESTATES EAST BLOCK 3 LOT 4
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 Equipment. 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 AWWTS.
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:
a. Owner: CROWN POINTE HOMES
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:
Date: 5-- (7 16
By: (signature)
Chi-6o.- CA bk' (print name)
STATE OF ALASKA )
) ss.
THIRD JUDICIAL DISTRICT )
The foregoin t instrument was acknowledged before me this /7 day of-Inez)
20j' , by _• ' � �h
o
�\\011111111//j��
•.. t As. 'U , 0
NOTAR ciBLIC FOR ALASKA �00
My Commission expi � /O/ at) /9 = I•NOTARY;
*\ PUBLIC 1*
/�44OF A1)" \
MUNICIPALITY:
By: A�� R/ �,..,-/ (signature) Date: ,577/5
Deb a10okca ruyy (print name) Title:
Certificate of On -Site Systems Approval
Parcel I.D. 020-043-65
1. GENERAL INFORMATION
Expiration Date: mo_;, C' I oft � C)1 t
Complete legal description Shangri-La Estates East Block 3 Lot 4
Location (site address) 16035 Mountain Air Dr, Anchorage, AK 99516
Current property owner(s)
Mailing address
Real estate agent
2. TYPE OF DWELLING:
Crown Pointe, Inc
Day phone
PO Box 112313 Anchorage, AK 99511
El Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF-BEDV.00ITS: i
Day phone
229-1886
4. TYPE OF WATER SUPPLY:
1 1-6�
TYPE OF WASTEWATER DISPOSAL:
Private Well
El
Private Septic
(]
Water Storage
❑
Holding Tank
❑
Community Well
❑
Community
❑
Public Water System
❑
Public Sewer
❑
Waiver request for: Distance:
�J I„
Received by: 1 7,w {/ _ /37' Date: Z 11 /
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $
1 1-6�
Date of Payment
Pj 7- /V
Receipt Number
D'aMoa
COSA #
do c 18 1&36
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 Forge Engineering Phone 907-522-7773
Address PO Box 240773, Anchorage, AK 99524
Engineer's Printed Name Benjamin Schiller, PE Date 12/06/18
6. DSD SIGNATURE
System #1 Approved for
System #2 Approved for
Disapproved
Conditional approval for
qbedrooms
bedrooms
r
OF: A�`��l�l
.g.. y
*:49TM •*
b;ja.. Schiller • • • .
en
I �FGr�% CE 12592 • AN
12/6/18
r5pipPROFESS1�Na���'�,r
bedrooms, with the following stipulations:
ON-SITE
PROGRAM
By: 4 Original Certificate Date: I a 12I'ms
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
Ifmore than 1 septic system is on the lot:
' ^ COSAChecklist #of___
Structure served bythis system
Shangri-La �� �������|Dr� � Lot /1 0�O-0��-A�
Legal Description: ^u«^u~« East Block " �~` `- Parcel |�� ~^-" "�'= "~
/\. WELL DATA
Well type Private |fA. B. or provide PVVS|D # WellWellLog (\/N) \/
/1'" �
Date completed ''^7/�A=Sanitary seal (Y7N) \/ Wires properly protected (YYN)Y
147 147 ��
To�a|depth�� Caned1nft. Casing height (above ground) in.
FROM WELL LOG AT INSPECTION
Date of test 7/28/18
Static water level '" v��
ft.
VVeUproducU1Don '~ g -p -m-
VVATERSAKJPLERESULTS:
R7
Coliform N��O co|onies/100 mL Nitrate i
mg/L
Arsenic K][l 11/19/18
ft.
Em
Collected by- FOR"8 Engineering
TonkType/Mateho| AdvaOteX FAP /Fiberglass Date installed 8/30/18
Tank size _1500 gai Number ofCompartments 2 C|eanouha(Y7N) Y
Foundation cleanout (Y7N)\/ Depression over tank (YYN) N .'._ High water alarm MYYN) ._
Date of pumping Pumper New Construction
Date installed R/KlMR Soil rating (o.p.d *2 or*2 /bdnm) 4 GPD/SF System type 5 - Wide
�
O � z1
Length 20 ft. ��h� ft. ��v�bo���pe_,____�
Total depth ^,�__9.3ft. Eff.ubsorph200 on�areo Monitoring tube \/ Depression over field N
Date ofadequacy test New Construction Reau|ta(Paaa/Fei|)For bedrooms
Fluid depth inabsorption field before test in. Water added_ gal. New depth_____in.
Elapsed Time: min. Final fluid depth in, Absorption rate >= g.pA.
Any rejuvenation treatment (past 12mo.)(YYN&type) |fyes, give date_________
D. LIFT STATION
Date installed
"Pump on" level ai
Datum
_ Size in gm|kma__
in. ^Pumpoff'|eva| at
— Cycles tested
__ Monho|eAAnoaas(Y7N)______
in. High water alarm |ava| et_____
— Meets alarm & circuit requirements?
E. SEPARATION DISTANCES
WELL ONLOT TO:
1MD
Septic tank8ift�>1OO' >`
station ~~ OnacUao�n(|ota '~~
10O
Absorption field >' >1OO'
o|d on lot '~~ Dnadjacen�|o�n '~~
'
Public sewer main >75' Public :^1OO
cs*�ermenho|a/ manhole/cleanout '~~
'�
Sewer /septic oem>^-5' ���RO
service line Holding tank / vu
'
Animal containment areas >50' Manure/animaluManure/animal exonaha donagmareas>100'
SEPTIC/HOLDING TANK ONLOT TO:
Building foundation >1 0/
on '° Property line >5.
Water>1 O'
mon ~ Water service line >10'
Wells nnadjacent lots >1OU'
ABSORPTION FIELD ONLOT TO:
' 0
Property �°1
y|ine >1 0, Building foundation >10'
Water Service line >10' Sud>1O0'
�uewabar '~~
None Noted >100'Cu�aindroin '` ~ VVeUsnnadjaoen�|o�o_�_���_
F. COMMENTS
G. ENGINEER'S CERTIFICATION
/ certify that /have determined through field inspections and
review of Municipal opoonfu that the above systems are /n
conformance with MOA COSA guidelines in effect on this date.
. ��f�[l'��Ol'[l��C>�'||(�[ ��7�
Engineer's Printed NameBenjamin 1 ' Schiller, '''' ' / �-
Date 12/06/1A
Absorption field >51
Surface water >1D0'
Water�~10'
��in ' ~
Driveway, parking/vehicle storage
>1D'
in.
MIT
JNICIPALITY OF ANCHORAGE
F.iii-AWN11 -1 11
THIS MAINTENANCE AND REPAIR AGREEMENT, herein the *'AGREEMENT" made and
entered into as of this i b Day of December
of 20 18 , by and between
herein the "OWNER," and the Municipality of
Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code
(AMC) 15.65365. 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 (AWINITS),
described as Advantex System
located at (legal description)
Shangri-La Estates East, Block 3 Lot 4
(Owner is required to read, understand and initial each section)
r Throughout the term of this Agreement. the Owner shall enter into a service agreement
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
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.
�x Owner acknowledges that regular maintenance of an AWWTS reduces thep otential
failure of the system, which could include sewage backup and costly repairs or drainfield
replacement.
(rev. 05/18/2018) Page I of 3
Owner acknowledges that the Municipality may request records of maintenance and
repairs from the manufacturer's representative or maintenance provider.
4 41-1
1,9 Owner acknowledges that the fine for failing to maintain and repair an ANTS may be
-4 Z:I
assessed in accordance with AMC 14.60.030.
t
Owner agrees to grant the Municipality reasonable access to test and inspect the �
-LK�-
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.
Owner agrees that the AWWTS installation and maintenance requirements as provided
by the AVV-WTS 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
ZD
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: ,1.�0�_ C - 2<i1 (signature) Date: )off I 'O) J
�1 L Z��'�-71-+_.,-,) (print name)
STATE OF ALASKA )
ss.
THIRD JUDICIAL DISTRICT )
The foregoing instrument was acknowledged before me this I0 day of
209, by �QJ C) � 19
STATE OF ALASKA*
NOTAR h�UBLIC OR ALAS NOTARY PUBLIC
My Commission expires: 2 2 Taleashia Payton
My Commission Expires: February 13, 2021
MUNICIPALITY:
By: - JI -e-1010-01- C
IAF - C C g (print name)
Date: 2/12 /�0 j
Title:
(rev. 05/18/2018) Page 3 of 3
SHANGRI-LA
PLAT NO. 2011 -62
ESTATES - EAST
LOT 4, BLOCK 3
42,839 S.F.
S 89058'05"E 347.38'
SUBDIVISION
0
0
N
W
N
O
0
O
O
1 "-401
ISCROFMFNT
)
6� T:Y•� 3t�1•��►•Lil>�•I�y
AS -BU I L T
I HEREBY CERTIFY THAT I HAVE SURVEYED THE
PROPERTY DEPICTED ABOVE AND THAT NO
GASTALDI LAND
ENCROACHMENTS EXIST EXCEPT AS INDICATED.
SURVEYING, LLC
IT IS THE RESPONSIBILITY OF THE OWNER TO
JEFF A. GASTALDI, R.L.S.
DETERMINE THE EXISTENCE OF ANY EASEMENTS,
2000 E. DOWLING RD., SUITE 8
COVENANTS OR RESTRICTIONS WHICH DO NOT
ANCHORAGE, ALASKA 99507
APPEAR ON THE RECORDED SUBDIVISION PLAT.
PHONE 248-5454
UNDER NO CIRCUMSTANCES SHOULD ANY DATA
HEREON BE USED FOR CONSTRUCTION OR FOR
GRID
DATE
SW3239
11/9/2018
ESTABLISHING BOUNDARY OR FENCE LINES.
ANCHORAGE RECORDING DISTRICT, ALASKA
F.B.
JOB N0.
NOTE: NO CORNERS SET THIS DATE
18-03
SLE43
OF 1♦
49TH
�. ....�..y.............. ..�
o : Jeffery A. Gostoldi o
. •. LS -6091 ��AIF
s� •.� 11/9/2018lorof'
••S
'4140as** **•
BUILDING DETAIL
SCALE: 1"=20'