HomeMy WebLinkAboutT12N R3W SEC 33 LT 84BOnsite File
#018-251-18
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907)343-7904 Fax: (907) 343-7997
http://www.muni.org/onsite
On -Site Water System Permit
Permit Number: OSP211381
Work Type: Well Upgrade
Tax Code Number: 01825118000
Site Legal Address: T1 2N R3W SEC 33 LT 84B G:3034
Site Mailing Address: 2945 NUGGET LN, Anchorage
Owner: BARTEE WILLIAM D &
Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING
This permit is for the construction of:
❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy
Effective Date:
Expiration Date
Lot Size in Sq Ft
Total Bedrooms:
�t»cnt
o�
I)CI)a1*t111C11t
9/13/2021
9/13/2022
44303
Q 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
Special Provisions: To close this permit please submit:
1. Well Log
2. Pump Install Log
3. Water sample results
4. Well Decommissioning Log
Received By:
Date:
Issued By: Date
3
RUS H
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 018-251-18
Property owner(s) TOM LAKE
Mailing address 2945 NUGGET LN, ANCH AK
Site address SAME
Day phone
Legal description (Sub'd., Block & Lot) T12N R3W SEC 33 LT 84B
Legal description (Township, Range & Section)
Lot Size 44303 Sq. Ft. Number of Bedrooms 3
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field
❑
Initial ❑
Single Family (SF) ❑
(w/wo ADU)
Septic Tank
ElUpgrade
0
Duplex (D) ElHolding
Tank
ElRenewal
El
Multiple Dwellings ❑
Privy
❑
(SF and/or D)
Private Well
El
Water Storage
❑
THIS APPLICATION
INCLUDES
A 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: 7 2,� -r / 35 Waiver Fees:
Date of Payment: 61*101L Date of Payment:
Receipt Number: 00906 7 Receipt Number:
Permit No. OJ P Z 1 I3�3 I Waiver No.
GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc
September 10, 2021
Municipalities of Anchorage
Departments of Health and Human Services
P.O. Box 196650
Anchorage, Alaska 99519-6650
Fax 249-7847
Re: New well permit
Legal: T12N R3W SEC 33 LT 84B
To Whom it may concern:
This is a request for a well permit on the above referenced lot. This well replacement will not impact any of
the neighbors or encroach on any wells, septic or open water issues. The new well location will be located
per the surveyor to keep the 100’ separation between the septic tank (84B) plus the septic field on the
Shryock lot 2.
Sincerely
Michael N. Anderson, P.E.
4661 Natrona
Anch, Ak 99516
Ph 727-8864
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP211381, Deb Wockenfuss, 09/13/21
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP211381, Deb Wockenfuss, 09/13/21
Municipality of Anchorage
On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 4
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP201000 PID Number: 018-251-18
Dwelling: FEM Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ❑ Upgrade
Name
WILLIAM BARTEE & JUDITH MOSS
ABSORPTION FIELD
❑Deep Trench RE Wide Trench ❑Bed El Mound
Site Address
2945 NUGGET LANE, ANCHORAGE AK
❑ Other
Phone
of Bedrooms
Soil Rating
Total depth from original grade
[Numbe,
0.8 GPD/SF
T1: 10.3' / T2: 12.4' Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
T1: 8.1' / T2: 10.1' Ft.
Gravel depth beneath pipe
T1: 2.2'/ T2: 2.3' Ft.
Subdivision Block Lot
84B
Fill added above original grade
0 Ft.
Gravel length
T1: 29.0'/ T2: 54.0' Ft.
Township Range Section
12N 3W 33
Gravel width
5.0 Ft.
Beds: Number of Lines
Distance between lines
Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Lift Station
Holding
( Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Tank
� Line
585.7 Ft2
2
13.0 Ft.
Well
75'+
100'+
TANK 9 Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer
Greer
Capacity
1000 Gal.
Surface Water
100'+
100'+
Material
Number of compartments
Lot Line
5'+
10.0'
I
NA
HDPE
2
Foundation
10'+
I 10'+
LIFT STATION
Manufacturer
Capacity
Remarks
Gal.
Alarm location
Electrical installed by
PIPE MATERIAL House to tank 3034 Tank to 3034
Installer
drainfield
NORTHERN EXCAVATION
Drainfield 3034 CO/MT 3034
Inspector Pannone Engineering
BENCH MARK (Assumed elevation) 217 ft
Inspdection vt 20200824 20200825
Location and description
2�d
3`° 20200826 41
HOUSE TRIM
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
Engineer's Stamp
Conditional Approval: Date
pp
�. OF AC �.kk
.'����
Steven �. I'7nncr•
Septic System
Approved I 1/u
' . vE 81 9
Date
_S&
Note:
Note: this approval does not include well permit requirements.
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NOTES: PANNONE ENG SVC fLLC (C.1. 1088)
RECORD DRAWING P.O. BOX 1807 PALLIER, AK 99645
PHONE (907) 745-8200 FAX (907) 745-8201
SITE: 2945 NUGGET LANE
DRAWN JRL WILLIAM BARTEE & JUDITH MOSS
SITE PLAN PO BOX 112947
ANCHORAGE, AK 99511
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RECORD DRAWING P.O. BOX 1807 PALLIER, AK 99645
PHONE (907) 745-8200 FAX (907) 745-8201
SITE: 2945 NUGGET LANE
DRAWN JRL WILLIAM BARTEE & JUDITH MOSS
SITE PLAN PO BOX 112947
ANCHORAGE, AK 99511
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SITE: 2945 NUGGET LANE
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Po Box 112947
ANCHORAGE, AK 99511
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PANNONE ENG SVC, LLC (C.1. 1088)
P.O. BOX 102954 ANCHORAGE, AX 99510
ONE (907)272
PH -8218 FAX (907) 272-8211
Tl 2N R3W S33 L84B
SITE: 2945 NUGGET LANE
WILLIAM BARTEE & JUDITH MOSS
PO BOX 112947
ANCHORAGE, AK 99511
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PANNONE ENG SVC, LLC (C.1. 1088)
P.O. BOX 102954 ANCHORAGE, AX 99510
ONE (907)272
PH -8218 FAX (907) 272-8211
Tl 2N R3W S33 L84B
SITE: 2945 NUGGET LANE
WILLIAM BARTEE & JUDITH MOSS
PO BOX 112947
ANCHORAGE, AK 99511
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20201111
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OSP201000
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MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http://www.muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP201000
Work Type: Septic Upgrade
Tax Code Number: 01825118000
Site Legal Address: T12N R3W SEC 33 LT 84B G:3034
Site Mailing Address: 2945 NUGGET LN, Anchorage
Owner: BARTEE WILLIAM D &
Design Engineer: PANNONE ENGINEERING SERVICES
This permit is for the construction of:
Effective Date:
Expiration Date
Lot Size in Sq Ft
Total Bedrooms:
81261zezv 60(-(
y»ent Is,
rX
v
Department
1/10/2020
1/9/2021
44303
Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ 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
QVC add i -KS+
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Received By: R Date:
8�� b/zv Lc
Issued By: Date:
Municipality- of Anchorage
P.O. Box 196650 • 4700 Elmore Road
Anchorage, Alaska 99519-6650 a (907) 343-7904 o Fax (907) 343-7997
http://www.muni.org/Onsite
Development Services Department
On -Site Water and Wastewater Section
wcttt
Dcpartnlcut
* * * * VARIANCE/WAIVER REVIEW * * * *
Waiver#: OSV201000 COSA#: Permit#:OSP201000
PID#: 018-251-18
Legal Description: T12N RM Section 33 Lot 84B
Engineer: Pannone Engineering Services
Applicant: William Bartee & Judith Moss
Your request for a waiver of the required 100 feet horizontal separation from the septic tank to
the private well on this lot has been approved. The approved separation distance is 70.0 feet. See
engineer's waiver request for justifications.
This waiver approval applies to the proposed 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.
■........................■aa....a■■.■aaa.a...a.■■a.....aa..aa....a0aa..a.aaa.aA
Waiver is Granted: X Waiver is not Granted:
Date: ///0 oC01C Approved b ��l
pp : Y
Name of Reviewer
................................ a . . .. ■-■ ■ .................. ■ ■ a ......... a . a a a ... 1
**** VARIAN C E/WAIVER REVIEW ****
MUMCIPALITY OF
Community Development Department
Development Services Division
On -Site Water & Wastewater Program
EIP /M
L. j 11 4-1 5�
Phone: 907-343-7904
Fax: 907-343-7997
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 018-251-18
Property owner(s) WILLIAM BARTEE & JUDITH MOSS
Mailing address PO BOX 112947, ANCHORAGE AK 99511
Site address 2945 NUGGET LANE, ANCHORAGE AK
Day phone
Legal description (Sub'd., Block & Lot)
Legal description (Township, Range & Section) T1 2N R3W S33 L84B
Lot Size 44,303 Sq. Ft. Number of Bedrooms 3
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field
x❑
Initial ❑
Single Family (SF) x❑
(w/wo ADU)
Septic Tank
®
Upgrade RXDuplex
(D) ElHolding
Tank
❑
Renewal ❑
Multiple Dwellings ❑
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
WELL TO SEPTIC TANK SEPARATION Distance: 70'
1 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: _26 / Waiver Fees:
Date of Payment: UA/24 24 Date of Payment: l 3 f'
Receipt Number: owlet Receipt Number: d a q115 6)
Permit No. 65P,2616,00 Waiver No. 0V2N O06
Permit App_:-:• : .,:c:
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201000, Rebecca Carroll, 01/10/20
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201000, Rebecca Carroll, 01/10/20
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201000, Rebecca Carroll, 01/10/20
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201000, Rebecca Carroll, 01/10/20
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MUMCI AUTY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section �` �" Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 018-251-18
1. GENERAL INFORMATION
Expiration Date: 10 23 ` 21
Complete legal description T1 2N R3W Sec33 L84B
Location (site address) 2945 Nugget Lane
Current property owner(s)
Mailing address
Real estate agent
William Bartee / Judith Moss
2. TYPE OF DWELLING:
Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
Day phone
Day phone
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Private Well
0
Private Septic
El
Water Storage
❑
Holding Tank
❑
Community Well
❑
Community
❑
Public Water System
❑
Public Sewer
❑
Waiver request for: Distance:
Received by: Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ �/ Waiver Fee $ _
Date of Payment 020.2 % Date of Payment
Receipt Number 00730C=7 30C=7 Receipt Number
COSA # 0.5 G 2 t l g /y 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.
In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with McA
COSA guidelines and regulations. The reported results describe the performance of the system under the conditions encountered at the time
of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on
the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not
guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore we cannot
provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole
benefit of the owner listed above. Reliance on this report by another person is at their own risk. Pannone Engineering Services LLC highly
recommends buyers hire their own engineer to evaluate this report.
Name of Firm Pannone Engineering Services Phone (907) 745-8200
Address P.O. Box 1807 Palmer, AK 99645
Engineer's Printed Name Steven R. Pannone P.E.
Date
1. vUG c'V� --e V-
O,VM
FATER
PROGRAM
B Original Certificate Date:
Z
�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 Checklist blue sheet
6. DSD SIGNATURE
• . • • • • . • • •
System #1 Approved for
bedrooms Steven -R. Porinone'
S stem #2 Approved for
Y pp
bedrooms Fc . C= 0149
\\`
,siF •-
Disapprovedp�,3���®�
Conditional approval for
bedrooms, with the following stipulations:
1. vUG c'V� --e V-
O,VM
FATER
PROGRAM
B Original Certificate Date:
Z
�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 Checklist blue sheet
z
Legal Description: T12N R3W Sec33 L84B
If more than 1 septic system on lot: COSA Checklist # 1 of 1
A. WELL DATA
❑ Well log is filed with Onsite (or attached)
Date drilled unk
Total depth unk ft
Cased to unk ft
R Sanitary seal is functioning correctly
® Wires are properly protected
Casing height (above ground) 12+ in.
Date of flow test for COSA 7/6/21
Static water level at beginning of test 57.2' ft.
Comments Well flow by Sullivan's Water Wells
B. TANK DATA
Age of tank(s) new years
Tank type/material
Measured operating fluid level in septic tank NEW
❑® Standpipes/foundation cleanout per record drawing
Date of pumping NEW SYSTEM
D. ABSORPTION FIELD DATA Wide Trech
Which system tested (date installed) 08'2412020
0-1 ALL standpipes present per record dr win
Total measured depth from grade 10.3 f (M X)
,t
Measured depth to pipe invert from grade 8.1 deft (min)
F-1 N/A — pressurized field
FE -11 Monitor tubes go to bottom of effective. If not, state
depth into effective
I Code -required soil cover over field
❑ System presoaked
(Required if vacant for greater than 30 days prior to
date of test)
Gallons introduced gallons
Comments/Deficiencies: W = *?e
COSA Checklist yellow sheet
Parcel ID:
Structure served by this system 1
018-251-18
Well production at time of test 1 gpm
Water storage tank volume na gallons
Well disinfected for coliform test? ❑ Yes ❑✓ No
Coliform bacteria is Negative
Nitrate mg/L FE -1 Nitrate less than MRL (ND)
Arsenic ug/L H Arsenic less than MRL (ND)
Collected by Sullivan's
Date of Sample 7/6/21
C. LIFT STATION
❑ Required maintenance completed
Age of lift station _ years
Lift station material
Comments:
Adequacy test date new
Results ❑✓ Pass For 3 bedrooms
Fluid depth prior to test in
Water added gal
New depth in
Elapsed time min
Final fluid depth in
Absorption rate 450 gpd
Any rejuvenation treatment (past 12 months)
If yes, enter date
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well)
Septic Tank/Lift Station on Lot
> 100'�^
10
Community Sewer Manhole/Cleano _
100'
Yes
if No o ft
Yes
if No ft
Neighboring Tank > 100'
2 -<es
if No 0 ft
Private Sewer/Septic Line > 25' 2es
if No ft
Absorption Field on Lot > 100'
�es
if No ft
Holding Tank > 100'
o Yes
if No ft
Neighboring Absorption Fields
> 100,
Yes
Animal Containment > 50'
�rYes
if No ft
if No ft
Community Sewer Main > 75'
[Yes
if
Manure/Animal Excreta Storage > 1
Yes
No ft
if No ft
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10'
LJ Yes
if No ft
Surface Water > 100'
(es
if No ft
Property Line > 5'
�es
if No ft
Wells on Adjacent Lots:
Absorption Field > 5'
Qs/Yes
if No ft
Private Wells > 100'
E�Yes
if No ft
Water Main > 10'
[Yes
if No ft
Community Wells > 200'
(Yes
if No ft
Water Service Line > 10'
EJ/yes
if No ft
If septic tank is under driveway comment
below
From Absorption Field on Lot to: (Please enter distances if
less than required)
Building Foundation > 10'
Yes
if No ft
If absorption field is under drive11 way comment
below
Property Line > 10'
2Yes
if No ft
Wells on Adjacent Lots:
Water Main > 10'
Efyes
if No ft
Private Wells > 100'
E�-<e s
if No ft
Water Service Line > 10'
(Yes
if No ft
Community Wells > 200'
[]-Y'es
if No ft
Surface Water > 100'
D Yes
if No ft
F. ENGINEER'S COMMENTS
G. ENGINEER'S CERTIFICATION
l certify that 1 have determined through field inspections and review
of Municipal records that the above systems are in conformance with
MOA COSA guidelines in effect on this date.
COSA Checklist yellow sheet
teven R "Pannone
1 CE 8149 .
�?nrtSSly
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Ref # 1 Changemark note #01 Well Tim 7/23/21 1:02 PM Cycle 1
and Ecklund
Septic
T12N R3W S33 �
L84B - chk.pnf �c1
It appears this well maybe located in the crawl space.
Markup Since not all crawl spaces stay dry and some are prone
toflood/liIiliiiiiIIIIIIIIing, what asure �inlplac�eRes�n�r Service - 7/26/21 1 i:12 AMWatd over the weekend to alert residents if water is in