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Home My WebLink AboutSUNSET HILLS BLK A LT 4Onsite File unset Hills 4 "771 RUs/f MUNICIPALITY 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. 018-202-05 Expiration Date: 1. GENERAL INFORMATION Complete legal description SUNSET HILLS BLK A LT 4 Location (site address) 14200 SUNVIEW DR, ANCH, AK Current property owner(s) GENE STRID Day phone Mailing address 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: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well R Private Septic ❑ 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 $ X481 33L Waiver Fee $ Date of Payment '515-12020 Date of Payment Receipt Number 005-111 Receipt Number COSA # 0 5 26 ( I.23 Waiver # COVID-19 25% DISCOUNT APPLIED 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm MIKE N ANDERSON, P.E. Phone 727-8864 Address 4661 NATRONA AVE ANCH AK Engineer's Printed Name MIKE N ANDERSON, P.E. Date 5-1-20 6. DSD SIGNATURE System #1 Approved for 3 System #2 Approved for _ Disapproved Conditional approval for Q°K W*: 49TIJ L _ e% �e. e. • °i1� • • o e s• o o 0. 0 o . s a rip bedrooms........ d 7�;� h11CF1AE(Y N. ANDERSON ."% ;4 bedrooms d °a°. CE 9 69 oFessio«��\�`°�° _ bedrooms, with the following stipulation Original Ori Certificate Date: Y g' 2.-x%2 0 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 COSA Checklist Legal Description: .5 V hzGt- H11 f S L k A L fjf L( Parcel ID: 018-202-05 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled UK Total depth 40'+ ft Cased to 40'+ ft 0 Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 16 in. Date of flow test for COSA 4/17/20 Structure served by this system Well production at time of test 5+ gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes 0 No ❑E Coliform bacteria is Negative Nitrate mg/LNitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by MNA Date of Sample 3/17/20 Static water level at beginning of test 86.4 ft. Comments PUMPED WELL DOWN TO ELEVATION 91.4 AT 5 GPM. B. TANK DATA Age of tank(s) years Tank type/material Measured operating fluid level in septic tank ❑ Standpipes/foundation cleanout per record drawing Date of pumping D. ABSORPTION FIELD DATA AWWU SERVICE Which system tested (date installed) - ❑ ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date Results ❑Pass For bedrooms Fluid depth prior to test in Water added gal New depth in Elapsed time min ❑ Code -required soil cover over field Final fluid depth in ❑ System presoaked Absorption rate gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) date of test) If yes, enter date Gallons introduced gallons Comm ents/Deficiencies: AWWU SEWER LINE RUNS OUT THE BACKOF THE HOUSE OVER 40' AWAY THROUGH THE HOUSE DIMENSION COSA Checklist yellow sheet 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' ❑ Yes if No Community Sewer Manhole/Cleanout > 100' n Yes if No ft ❑✓ Yes if No ft Neighboring Tank > 100' ❑✓ Yes if No ft Private Sewer/Septic Line > 25' ED Yes if No ft Absorption Field on Lot > 100' C] Yes if No ft Holding Tank > 100' ❑✓ Yes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' ❑ Yes if No ft P/1 Yes if No ft ft If septic tank is under driveway comment below Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' 0 Yes if No ft Q Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No ft Surface Water > 100' ❑ Yes if No ft Property Line > 5' ❑ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ❑ Yes if No ft Private Wells > 100' [:]Yes if No ft Water Main > 10' ❑ Yes if No ft Community Wells > 200' ❑ Yes if No ft Water Service Line > 10' ❑ 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 driveway comment below Property Line > 10' ❑ Yes if No ft Wells on Adjacent Lots: Water Main > 10' ❑ Yes if No ft Private Wells > 100' ❑ Yes Water Service Line > 10' ❑ Yes if No ft Community Wells > 200' ❑ Yes Surface Water > 100' ❑ Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION I certify that I 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 if No ft if No ft �A ��•° MICHAEL N. ANDCZ56Nee' ;� CE 469 1 d y j �(tr PLOT PLAN ___ AS BUILT _X_ SCALE _1" _= 30N GRID — SW 3033Project No. 19_71 V1 ___ 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Long & Associates, in c. (907) 522-6476 Phone (907) 522-4625 FaxOF A Fav©�OOp��4 Professional Land Surveyors ken0langsurvey.com o OQ P-9s,4p4 jonathan0langsurvey.com I hereby certify that I have surveyed the following described property: LOT 4, BLOCK A, SUNSET HILLS SUBDIVISION (PLAT No. P-228) Anchorage Recording District, Alaska, and that the improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated this the _?` _ Day of `� Z�s�in��?t�ik N_,�at Anchorage, Alaska It is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. 49TH ............. ...... ........... ' M KENNETH .LAN cr d44�Fo S-5202. �J�G 44RcR.pF�SSIONAL 1ANQ� AECC963