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HomeMy WebLinkAboutPOTTER HIGHLANDS PH 2 BLK 4 LT 2Onsite File
POTTer
Highlands
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Municipality of Anchorage
On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 2
ON-SITE
WASTEWATER INSPECTION REPORT
Permit Number: OSP201087
PID Number: 020-281-81
Dwelling: ❑® Single Family (SF)
❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ®❑ New ❑ Upgrade
Name
John Hagmeier Homes LLC
ABSORPTION FIELD
❑ Deep Trench 9 Wide Trench El Bed El Mound
Site Address
NHN Potter Highlands Drive
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
4
6.0 GPD/SF
6.0 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
5.5 Ft.
Gravel depth beneath pipe
0.5 Ft.
Subdivision
Block Lot
Potter Highlands Ph2
4 2
Fill added above original grade
0 Ft.
Gravel length
20 Ft.
Township Range Section
Gravel width
5 Ft.
Beds: Number of Lines
n/a
Distance between lines
n/a Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Tank
Line
100 Ftz
1
n/a Ft.
Well
100'+
100'+
1001+
25'+
TANK ❑ Septic ❑ S.T.E.P. ❑ Holding ❑® Other
Manufacturer
Advantex
Capacity
1500 Gal.
Surface Water
100'+
100'+
1001+
Material
Number of compartments
Lot Line
5'+
5'+
5'+
NA
Fiberglass
2
Foundation
10'+
I 10'+
10'+
I
LIFT STATION
Manufacturer
Capacity
Remarks
orenco
250 Gal.
Alarm location
house
Electrical installed by
capstone
PIPE MATERIAL House to tank 3034 Tank to
drainiield 3034
Installer
Red Dog Masonry
Drainfield 3034 C0/MT3034
Inspector Pannone Engineering
BENCH MARK (Assumed elevation) 104.5 It
Inspeection
f'` 9/3/20
9/3/20
Location and description
ction
3`d 9/4/20
2nd
41" 10/8/20
Top of front porch near point A
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
Engineer's Stamp
Conditional Approval:
OF A�q
Date
A-,
.4
���U
Steven R."Pannone
-
Septic Syste
�.
��.•. cr- a� T e •� �
Appro
Date
�E�FZOFESSl01v�.�
��
Note: this approval does not include well permit requirements.
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PANNONE
ENG SVC LLC (C.1. 1088)
REVISIONS
P.O. BOX 1807 PALI,,ER, AK 9045
ACgS+,
PHONE (907) 745-8200 FAX (907) 745-8201
P(E..OF
- '\ /r-
t RE' 12/r/2021
POTTER HIGHLANDS PH2 134 L2 s ..
DRAWN ACP JOHN HAGMEIER HOMES LLC !'..:.0
�c, St CER87A9 none 4;
NHN: POTTER HIGHLANDS DRIVE
SITE PLAN ANCHORAGE, AK
10/30/2020
CALE
1"=50'
I.D. NO
020-281-81
-RNIT NO.
OSP201087
MEET
2 OF 2
ptne Drilling
r
r
P F
Permit Number: 9SW201087 Date of Issue: 5-14-20 Parcel Identification Number: 02028181000
Date Started: 7-22-20 Date Completed: 7-24-•20 Is well located at approved permit location?'x Yes ❑ No
Legal Description: Potter Highlands Ph 2 Block 4 Lot 2
Property Owner Name & Address: Potter Creek Development LLC
Borehole Data: Depth (ft)
Soil Type; Thickness & Water Strata From To
Method of Drilling x air rotary El cable tool
Casing type: steel i
stick -zip 0
2
Wall Thickness:.250 inches
silty grmEel 2
graven}%silt 5
5
18
Diameter: 6 inches Depth: 64 feet
Liner Type:
Diameter: _ inches Depth: feet
silty gravel 18
51
Casing stickup above ground: 2 feet
Static water level (from ground level): 16 feet
g3 m-elly silt 51 61
bedrock 61
106
Pumping level: 100 feet after
2 hours pumping 8 gpm
Recovery Rate: 8 gpm
Method of Testing: airlift
Well Partake Opening Type:
❑ Open End ❑ Open Hole
❑ Screened Start feet Stopped feet
_
WATER 9,UALITY TESTING
x Perforations Start 61 feet Stopped 63 feet
Grout Type: bentonite Volume: 2bgs
5 Coliform -9 _ Col/100ML
De tli: Start 0 feet Stopped ? feet
Pump: Intake Depth feet
Pump size hp Brand Name
!Nitrates Z.. mg/L
Arsenic "-P—`-L
Well Disinfected Upon Completion? i Yes ❑ No
Method of Disinfection: chlorine tablets
Comments:
WeII Driller: .Alpine Drilling & Enterprises
PO Box 110496
.Anchorage .AK 99511
MUNK PALITY OF ANCHORAGE
r
Development Services Department t ? Phone. 907-34.3-7904
On -Site Water & Wastewater Section _....� Fax; 907-343-7997
Pump Installation Log
Well.Drilling Permit Number: 201087 Date of Issue: 5 _14- 2020
020 281 slaou
Parcel Identification Number: - -
Legal Description. Block Lot Property Owner Name & Address:
Block 4, Lot 2 4 2 Hagmeier Homes
Potter Highland Ph. 2 11 1
Pump Installation Date: 10 -22 -2020
Pump Intake Depth Below Top of Z'irell Casing: 90 feet
Pump Manufacturer's Name: G o u l d s
Pump Model: 7HS05
Pump Size: 1 /2 lip
Pitless Adapter Burial Depth: N/A feet
Pitless Adapter Manufacturer's Name: N/A
Pitless Adapter Installer: N/A
Well Disinfected Upon Completion? rYes ❑ No
Method of Disinfection: chlorine tablets
Comments:
PLEASE SAVE FOR COSA
Pump Installer Name:
Company: Alpine Drilling & Enterprises
Mailing Address: P.O. Bax 110496
City. Anchorage State: AK zip 995
Attention: The ptunp installer shall provide a pump installation log to On-site within 30 days of pump installation.
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
POBox 13OO5U x7OOElmore Road
*nohomgn.�|ad'a995�S'GomO Phone: �8O4 Fax: (907)
On -Site Water &Wastewater System Permit
Permit Number: O8P201887 Effective Date: 5/14/2820
Work Type: VVnUSapbc|nitiai Expiration Date: 5/14/2021
Tax Code Number: 02028181000
Site Legal Address: POTTER HIGHLANDS PH2BLK 4 L 2 G:3638
Site Mailing Address:
Owner: POTTER CREEK DEVELOPMENT LLC Lot Size inSqFt: 54348
Design Engineer: PANNONEENGINEERING SERVICES Total Bedrooms: 4
This permit is for the construction of:
Z Disposal Field Z Septic Tank [] Holding Tank 0 Privy 2 Private Well [] Water Storage
All construction shall beinaccordance 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 (1OAAC8O)
3. The wastewater code requires inspections during the installation. The angineerhoUnotif^ �the Development
Services Department per AMC 15.G6.Provide notification bycalling (AU7)343-7904(24 '
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall beeither:
o. Opened and Closed onthe same day, or
b. Covered, sealed, and heated to prevent freezing
Received By:
Issued By:
Date: Ls 4 -" /'�
Date: _51_lql�o
MUNICIPALITY OF
Community Deve opment Department
Development Services Division
On -Site Water & Wastewater Program
Phone: 907-343-7904
Fax: 907-343-7997
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 020-281-81
Property owner(s) Potter Creek Development LLC Day phone
Mailing address 561 E. 36th Avenue, Ste 200, Anchorage, AK 99503
Site address NSN Potter Highlands Circle
Legal description (Sub'd., Block & Lot) Potter Highlands Phase 2, Block 4, Lot 2
Legal description (Township, Range & Section)
Lot Size 54,348 Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field
❑X
Initial 0
Single Family (SF)
❑X
(w/wo ADU)
Septic Tank
Q
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: �aO/ Waiver Fees:
Date of Payment: ql3ol wz Date of Payment:
Receipt Number: O&Z /6 Receipt Number:
Permit No. Q5 /�/Ja%1UB?' Waiver No.
Permit App-'-'. : .-.,:c; COVID-1 9
2576 DISCOUNT APPUE
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201087, Deb Wockenfuss, 05/14/20
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201087, Deb Wockenfuss, 05/14/20
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201087, Deb Wockenfuss, 05/14/20
MUNIUPALITY OF ANCHORAGE
FY 1LL,
Development Services Department lcr Phone: 907-343-7904
On -Site Water & Wastewater Section-- Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 020-281-81
1. GENERAL INFORMATION
Expiration Date:. ' 2 r2 0 2
Complete legal description Potter Highlands Ph2 134 L2
Location (site address) NHN Potter Highlands Drive
Current property owner(s) Hagmeler Homes LLC Day phone
Mailing address 2204 Cleveland Ave Ste 201 Anchorage, AK 99517
Real estate agent
2. TYPE OF DWELLING:
0 Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 4
Day phone
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Private Well
El
Private Septic
171
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 $ 156 , d 5 A ) b -1 1 Waiver Fee $ _
Date of Payment 11 aW ao� Date of Payment
Receipt Number. r7 O G Receipt Number
COSA # 0 S C) - O � 15Waiver #
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 MoA
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
Address P.O. Box 1807 Palmer, AK 99645
Engineer's Printed Name Steven R. Pannone P.E.
6. DSD SIGNATURE
System #1 Approved for IL bedrooms
System #2 Approved for bedrooms
Disapproved
Conditional approval for
Phone (907) 745-8200
Date a 0--cJ
�Nk
T-'
• • F9
Stege r, .P Pannone W
bedrooms, with the following stip I�tv� t {(((«( ( (( OF 0
N`^^' Original Certificate Date: 2. 2 Z ©Z D
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
ON-SITE
14114.1 E
WASTEVATER z^
/
PROGRAM
N`^^' Original Certificate Date: 2. 2 Z ©Z D
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
Legal Description: Potter Highlands Ph2 B4 L2
If more than 1 septic system on tot: COSA Checklist # 1 of 1
A. WELL DATA
RM -1 Well log is filed with Onsite (or attached)
Date drilled 1121120
Total depth 106 ft
Cased to 64 ft
01 Sanitary seal is functioning correctly
®❑ Wires are properly protected
Casing height (above ground) 18"+ in.
Date of flow test for COSA new
Static water level at beginning of test 16 ft.
Comments new well
B. TANK DATA
Age of tank(s) 0 years
Tank type/material
Measured operating fluid level in septic tank n/a
© Standpipes/foundation cleanout per record drawing
Date of pumping n/a
D. ABSORPTION FIELD DATA Wide Trench
Which system tested (date installed) 9/3/20
Q ALL standpipes present per record drawing
Total measured depth from grade 6 ft (max)
Measured depth to pipe invert from grade 5.5 ft (min)
❑ N/A — pressurized field
0 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:
COSA Checklist yellow sheet
Parcel ID:
Structure served by this system 1
020-281-81
Well production at time of test 8.0 gpm
Water storage tank volume n/a gallons
Well disinfected for coliform test? Q Yes ❑ No
Q Coliform bacteria is Negative
Nitrate 2.56 mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L F11 Arsenic less than MRL (ND)
Collected by Pannone Engineering Services
Date of Sample I'J[3 L 11J1&- Joao
C. LIFT STATION
❑ Required maintenance completed
Age of lift station 0 years
Lift station material Fihe,91ass
Comments: New Orenco system
Adequacy test date n/a
Results [ Pass For 4 bedrooms
Fluid depth prior to test in
Water added gal
New depth in
Elapsed time min
Final fluid depth in
Absorption rate 600 gpd
Any rejuvenation treatment (past 12 months)
If yes, enter date
no
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'
Community Sewer Manhole/Cleanout > 100'
❑✓ Yes
7✓
Yes
if No
ft
Neighboring Tank > 100'
7
Yes
if No
ft
Absorption Field on Lot > 100'
0
Yes
if No
ft
Neighboring Absorption Fields
> 100'
Community Wells > 200' Fv Yes if No.
Water Service Line > 10'
0
Yes
if No
ft
Community Sewer Main > 75'
F/�
Yes
if No
ft
Community Sewer Manhole/Cleanout > 100'
❑✓ Yes
if No ft
Private Sewer/Septic Line > 25' F71 Yes
if No ft
Holding Tank > 100' ❑✓ Yes
if No ft
Animal Containment? 50' 0 Yes
if No ft
Manure/Animal Excreta Storage > 100'
0 Yes if No ft
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10' P/l Yes if No ft Surface Water > 100'
[Z] Yes if No ft
Property Line > 5'
0
Yes
if No
ft
Wells on Adjacent Lots:
Absorption Field > 5'
❑✓
Yes
if No
ft
Private Wells > 100' ✓Q Yes if No
Water Main > 10'
Yes
if No
ft
Community Wells > 200' Fv Yes if No.
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'
E✓
Yes
if No
ft
If absorption field is under driveway comment below
Property Line > 10'
F71
Yes
if No
ft
Wells on Adjacent Lots:
Water Main > 10'
Yes
if No
ft
Private Wells > 100' Yes if No
Water Service Line > 10'
Yes
if No
ft
Community Wells > 200' Q Yes if No
Surface Water > 100'
F71
Yes
if No
ft
F. ENGINEER'S COMMENTS
G. ENGINEER'S CERTIFICATION OF AL
I certify that I have determined through field inspections and review .7
of Municipal records that the above systems are in conformance withH
MOA COSAguidelines in effect on this date.
Steven IPanno,a.
; r
CE S i 9
Az'
COSA Checklist yellow sheet
ft
ft
ft
ft
MUNICIPALITY OF ANCHORAGE
ADVANCED WASTEWA` ER TREATMENT SYSTEM
���; Al<NTE ANCE AND REPAIR AGREE ENT
THIS .MAINTENA.\TCL AND REPAIR AGREEMENT, herein the "AGREEMENT" made and
entered into as of this 14 `-i'_ Day of Nov ember or20 2 0 , by and between
Kristin R. S c h o e t z _, herein the "OWNER," and the Municipality of
Anchorage, herein the "MUNI CIPALITY", 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 Municipalitygrants permission to the
Omer to utilize and operate an Advanced Wastewater Treatment System (AWWTS),
described as Advantex 1500
located at (legal description)
Potter Hi_a,hlands Subdivsion, Phase 2 Lot 2, Block 4
2. 'Maintenance. Repairs and Alterations.
(Owner is required to read, understand and initial each section)
;rt Throughout the terns 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 duiung 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 S400 to $600).
" Owner agrees that only n-iaintcnance 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
' Owner acknowled-es that the Municipality may request records of maintenance and
repairs 1101"n the Imnufacturer's represen'tative or maintenance provider.
-;�1Pv Owner acknowledges that the fine for failing to irlaintain and repair an AWWTS may be
assessed in accordance with. AMC 14.60.030.
.Y,Ar` Owner agrees to grant the Municipality reasonable access to test and inspect the
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 AWWTS vendor/installer and approved by the Municipality are the governing
uuidehnes for the construction, maintenance and repair of the Owner's AWWTS.
Owner- agrees to maintain remote monitoring of the AWWTS as required by the
AWWV'S approval.
3. Terin. 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. Ston waiver. 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. 05118/20 1 8) Page's of 3
OWNER:
By:
c
Kristin R_ Schoetz (printname)
STATE OF ALASKA }
ss.
THIRD JUDICIAL DISTRICT }
Date: Nov 14, 2020
The foregoing instrument eras acknowledged before me this i 4 chday of November
2020 , by i��i , chael W. Scnoetz --
NOTARY PUBLIC FOR 9 A.SKA
My Commission expires: Feb. 2 8, 2 0 2 2
MUNICIPALITY:
B : (signature)
STATE OF ALASKA
NOTARY PUBLIC
Michael VV. Schoetz %
MAI Commission EVires Feb 28, 2022
Bate: J ?,-2_-7_t9
(print. name) Title:
(rev. 05/18/2018) Page 3 of 3
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