HomeMy WebLinkAboutZODIAK MANOR ALASKA BLK 7 LT 18Onsite File
Zodiak Manor Alaska
Block 7
Lot 18
#015-042-29
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section--- Fax: 907-343-7997
Parcel I.D. 015-042-29
Certificate of On -Site Systems Approval
Expiration Date
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1. GENERAL INFORMATION
Complete legal description Zodiac Manor Alaska, Block 7, Lot 18
Location (site address) 4731 Mars Dr., Anchorage, AK 99507
Current property owner(s) Glazier Family Trust Day phone
Mailing address same
Real estate agent Stephanie Olendorff Day phone 907-229-6099
2. TYPE OF DWELLING:
El Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 5
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Private Well
El
Private Septic
❑
Water Storage
❑
Holding Tank
❑
Community Well
❑
Community
❑
Public Water System
❑
Public Sewer
El
Waiver request for: Distance:
Received by: Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ as 0 ! a!&
Date of Payment &I glgU 28
Receipt Number dry ci-7eak'
COSA # 4 SG-Ad1 ?V15'
Waiver Fee $
Date of Payment
Receipt Number
Waiver #
COVID-19
257q' 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 Crewdson Engineering LLC Phone 907-280-9493
Address PO Box 671389, Chugiak, AK 99567
Engineer's Printed Name .lames CrewdSOn Date 6-2-2020
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6. DSD SIGNATURE _ / ••'a
System #1 Approved for S bedrooms / ... .. r
/ ames A. Crewdson ;
System #2 Approved for bedrooms %
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Disapproved `'y.a?��• P�'"�
Conditional approval for bedrooms, with the following stipulahkirk ~T
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Original Certificate Date: 7— 202o
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
Septic -System Advisory.
Well Flow Advisory
COSA Checklist blue sheet
Nitrate Advisory
Arsenic Advisory
Other
Legal Description: Zodiac Manor Alaska, Block 7, Lot 18
If more than 1 septic system on lot: COSA Checklist # of
A. WELL DATA
❑ Well log is filed with Onsite (or attached)
Date drilled 7-17-78
Total depth 170 ft
Cased to unk* ft
❑ Sanitary seal is functioning correctly
❑ Wires are properly protected
Casing height (above ground) 12+ in.
Date of flow test for COSA 5-29-20
Parcel ID: 015-042-29
Structure served by this system
Well production at time of test 3+ glom
Water storage tank volume 0 gallons
Well disinfected for coliform test? ❑ Yes ❑ No
® Coliform bacteria is Negative
Nitrate 1.53 mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L ® Arsenic less than MRL (ND)
Collected by Crewdson Engineering LLC
Date of Sample 5-29-20
Static water level at beginning of test 130 ft.
Comments Is not noted on well log, but granular soils to bottom of hole indicate likely to be 170'
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
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
❑ 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
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
Final fluid depth in
Absorption rate 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)
F. ENGINEER'S COMMENTS
G. ENGINEER'S CERTIFICATION!
l certify that t 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
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Community Sewer Manhole/Cleanout > 100'
❑ Yes
if No
ft 7 Yes
if No ft
-Nea _
❑ Yes
if No
ft Private Sewer/Septic Line > 25'7 Yes
if No ft
Absefpien-Field eA et 1148
[:] Yes
if No
ft Holding Tank > 100' 0✓ Yes
if No ft
Rle+ghbeFing Abserptaee�s _-1-w
Animal Containment > 50' 171 Yes
if No ft
❑ Yes
if No
ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75'
❑� Yes
if No
ft ❑✓ Yes
if No ft
e�•-E-�t-�: ¢r�-lease-����ista!asc-�-+f-12ss-tFiaa-rega�+;�}
Building Foundations > 10'
Yes
if No
ft Surface Water > 100' F] 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'
Q 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
F_r�n.n�S®F�?%i{3.�-
: poi i .a•
Building Foundation > 10'
El 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
if No ft
Water Service Line > 10'
❑ Yes
if No
ft Community Wells > 200' ❑ Yes
if No . ft
Surface Water > 100'
❑ Yes
if No
ft
F. ENGINEER'S COMMENTS
G. ENGINEER'S CERTIFICATION!
l certify that t 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
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Frontier Surveys, LLC Project No: 20-183
Date: 6/2/2020
Ordered By: Stephanie Olendorff Plat: 65-92 Grid: 2336
}
LOT 19
,Ey Electric Meter/Outside Power
y Gas Meter ® Deck
Water -Well
\8
i
ro, Telephone Pole — Overhead Utility
Fence LT, Tel. Pedestal
Mailbox EL Elec. Pedestal
General Notes: 0 15 30 60
1. This document is created for the purpose of a single property transaction and is subject to Federal Copyright Laws.
2. Excepting for gross negligence, the liability for this survey shall not exceed the cost of preparing this survey.
3. All measurements/setbacks are to the visuallapparent building footprint. Scale in Feet
4. All dimensions to property lines are plus/minus 0.1ft.
PROFESSIONAL SEAL
This survey complies with the ASPLS Mortgage Location Standards. The survey represents visible improvements and
conditions at the time of the survey. This document does not constitute a boundary survey and is subject to any
inaccuracies that a subsequent boundary survey may reveal. It is the responsibility of the Owner to determine the
existence of any easements, covenants, or restriction which do no appear on the record plat. Under no circumstances
should this document be used for construction or for establishing a boundary or fence line.
AS -Built Survey of:
Lot 18, Block 7 Zodiak Manor Alaska Subdivision
I, Pierre Stragier, hereby certify that this Mortgage Inspection Survey was performed by me, or
under my direct supervision on June 2nd, 2020.
Frontier Surveys, LLC FRONTIER
650 W. 58th Ave. Suite E Anchorage, Alaska 99518 &"�5z
907.460.1686 - info@frontiersurveys.com
www.frontiersurveys.com
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