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HomeMy WebLinkAboutRIDGECREST HEIGHTS LT 1Onsite File HEIGHTS 'mo" � 491 am I ?A—glb' rl *""f4w" u 10 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 Pump Installation Log Well Drilling Permit Number: _______________ Date of Issue: ____-____-____ Parcel Identification Number: ____-____-____ Legal Description Block Lot Property Owner Name & Address: Pump Installation Date: _____-_____-_____ Pump Intake Depth Below Top of Well Casing: __________ feet Pump Manufacturer’s Name: ___________________________ Pump Model: _____________________________________ Pump Size: ____________hp Pitless Adapter Burial Depth: _________ feet Pitless Adapter Manufacturer’s Name: _________________________ Pitless Adapter Installer: ____________________________ Well Disinfected Upon Completion? XX Yes No Method of Disinfection: _____________________________ Comments: Pump Installer Name: __________________________________ Company: ___________________________________________ Mailing Address: ______________________________________ City: ___________________ State: __________Zip: _________ Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation. Municipality of Anchorage P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 ® (907) 343-7904 ® Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: OSV221014 COSA#: Permit#: PID#: 015-491-04 Legal Description: T12N R3W SEC 23 S2NE4SE4NW4 PARCEL 25A Proposed Ridgecrest Lt 1 Engineer: Mike N. Anderson Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 7.0 feet. This waiver approval applies to the existing absorption field only. Any future upgrade to the on- site wastewater disposal system will require all separation distances be met or another approval from this department. ............................................... ■ ............................. ■ 1 Waiver is Granted: X Waiver is not Granted: Date: ZLe lz�av� Approved by: Name of Review **** VARIANCE/WAIVER REVIEW **** Feb. 15, 2022 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 Re: Lot line Waiver of 7.5 feet Legal: T12N R3W SEC 23 S2NE4SE4NW4 PARCEL 25A (Proposed Ridgecrest Lot 1 Subd.) To whom it may concern: This is a request Ur' a- iot line waiver on the above- referenced lot: ---The- new septic - cleanout located at the east end of the new system (lot 1) is located 7.5 feet from the east property line, not the required 10 feet. Justification for this lot line waiver is it will not impact or encroach lot 2 in any way due to the good soils and large lot size. Sincerely Michael N. Anderson, P.E. 4661 Natrona Anch, Ak 99516 Ph 727-8864 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Pae 1 of 2 ON-SITE WASTEWATER INSPECTION REPORT s Permit Number: OSP211442 PID Number: 015-491-04 Dwelling: X Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 0 Upgrade Name HOME RENEWAL COMPANY ABSORPTION FIELD Site Address 11361 MAEL ST, ANCH AK 0 Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound Phone ❑ Other �N�umber�ofBedro�oms� Soil Rating Total depth from original grade 0.45 GPD/SF 10 LEGAL DESCRIPTION Ft. Depth to pipe invert from original grade Grave! depth beneath pipe Subdivision Block Lot 11.0 T12N R3W SEC 23 S2NE4SE4NW4 PARCEL 25A Ft. 9 Ft. Township Range Fill added above original grade Gravel length g Section 31+ Ft. 92 Ft. Gravel width Beds: Number of Lines Distance between lines SEPARATION DISTANCES 2.0 jo Ft' Ft. Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches FromField Lift Station Tank Line 1665 Ftz - Ft Wel100'+ 50++ TANK © Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Capacity Surface 1001-+- GREER/ EXISTING 1000+1250 Gal. Material Number of compartments Lot Li10'+ NA PLASTIC/CONCRETE 2/1 Founda10'+ LIFT STATION Manufacturer Capacity Remarks * OLD CONCRETE TANK IS <10' Gal. OK UNDER OLD MOA CODE Alarm location Electrical installed by Installer IPIPEMATERIAL House to tank 3034Tank to 3034 MIKE N ANDERSON, P.E. drainfield Drainfield 3034 CO/MT 3034 Inspector MIKE N ANDERSON, P.E. BENCH MARK (Assumed elevation) 105 It Inspection 1n 10122/21 10/23/21 Location and descri Uon dates: 2�a P 3`d 4t^ TOP OF TANK MH ON-SITE WATER AND WASTEWATER SECTION APPROVAL En!:Line e�i's Stamp Conditional Approval:s�..`.` . `�; .4 Al Date .. r; .. :.. • •• ............ Septic Syste>/ � • MICHAEL N, ANDERSON Approve i ,, • C - 9 69 Date jt:•. Note: this approval does not include well permit requirements. C �(Vk '01-1_4 Y1- V1_ Rev 05/02/18) Permit No. OSP211442 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 343-4744 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description: T12N R3W SEC 23 S2NE4SE4NW4 PARCEL 25A PID No.: 015-491-04 - -MARK- - A \ B / c col 17 20� ®•• 021 26- 26 CO3 f7 26 - - 35 24 TC03 38 24 C04 40 22 C05 41 22 MIT 58 47 \ C06 65 — _495 _ ^. /I TH#3 \\ 100' WELL RADIUS /TH i i STING 1,250 CA ION INEW 1,000 GALLI CONCRETE TANKI PLASTIC TANK NO BAFFLE HOUSE A -MT CD7 -LO FABRC MESA ROCU 83 DRY DCT 2021 BENCH, TOP OF MH g.SBUILT SCALE: 1"=50' ®® �� OF Al OR AV 49 TH SM/GM MICHAEL N. ANDERS( No. CE 9469 �'•. 9-22-21 .A 0 / I I i I I * y a O =73 O n (D I —I � p v m _ " ❑O IO21saamo 3 N m > n (D _ D o s�R,,'�c r j rr m0 (D rD -n D O O DIAD, \ < Y¢ — 11, 3 r C) - (D 0' c ='. N �C) iv \ P zs �� '•� m 77 m D,' NZI,II IT Off' co Drn -- �` rn 0 Ip', O, n -( – _ In z O' z' N O cr W Z LF)� Et o \ C/� • �, 0 v. O D y Gl,� m 01"r� 1<� CD . O (1 f1 rt m' nn rt In (/� V •O (DX',. 3C C, C O C Nr ID (<D G (J1 tY rt r -r x. C j O '< m �' v m O; N — v n 1 ]1. (D On7 Z; m rt f -'l 1) rD rD Z' v n (D (1 ID ZC:L (� O Lvv a p moZ3 0 —S rt -0z,,N C .� ` n0 D — (D rt N (D (D -,flI Z O (D w 73 N 6tn N-O� (D C rt 0 �� N 71 O nO v O Z V' C < O (D O V) ,. * D �- ci- CL < ' O (D Ul OZ qCL p . v, n (P ��— n o m CL C ;-r O Oj 0 1 n rt O0 r� - .< \ 0- u-, L a O =73 O n (D I —I � p v m _ " ❑O IO21saamo 3 N m > n (D _ D o r j rr m0 (D rD -n (D _O O O n Z) — G 3 r C) (D 3 rt (D 0' m 0 FARPOINT I�Y- trd rllj zw r 0 tz W � ,02 ,9z saaass T 00 00 O C� 0) rn O N rlElvw ,V9'6Z2 M� �,VOJ-VO.00 N s GOOV builsix ,OS'pLl IV CDD � m I rn e V 1= m 00 m .J_ � cnQ CD �3 cD _ �0 P O O CA O '\ v � I 18.67' a co cn cn = J m -- O W., `G rri Q w 3 y LL-6ZC 3 „62,20.00 S 16@W@sD] M—O—� a IO21saamo CD MUNICIPALITY OF ANCHORAGE n�enr Onsite Water & Wastewater Program `CoQ,; id PO Box 196650 4700 Elmore Road c Mchorage, Nasky 99519-6650 Phone: 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite 4'�CMORA�t Uepartment On-Site Wastewater Disposal System Permit Permit Number: OSP211442 Effective Date: 10/15/2021 Work Type: Septic Renewal Expiration Date: 10/15/2022 Tax Code Number: 01549104000 Site Legal Address: T12N R3W SEC 23 S2NE4SE4NW4 PARCEL 25A G:2638 Site Mailing Address: 11361 MAEL ST, Anchorage Owner: HOME RENEWAL COMPANY LLC Lot Size in Sq Ft: 217800 Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING Total Bedrooms: 5 This permit is for the construction of: Q Disposal Field El 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 Special Provisions: Change Order #1: Changed to a 5 bedroom design and moved the field. Received B, Issued By: Date: / 2 Date: Z MUNICIPALITY OF ANCHORAGE R U5 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. 015-491-04 Property owner(s) HOME RENEWAL COMPANY LLC Mailing address 1120 HUFFMAN RD STE 24-797 ANCH AK Site address 11361 MAEL STANCH AK Day phone Legal description (Sub'd., Block & Lot) T12N R3W SEC 23 S2NE4SE4NW4 PARCEL 25A Legal description (Township, Range & Section) Lot Size 217,800 Sq. Ft. Number of Bedrooms 5 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field F Initial ❑ Single Family (SF) El (w/wo AD U) Septic Tank El - Upgrade W Duplex (D) ❑ Holding Tank El Renewal ® Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ 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:-#/ Y5 " so—/ Waiver Fees: Date of Payment: Receipt Number: Date of Payment: Receipt Number: Permit No. OSP%1) L4 yZ Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc Oct. 10, 2021 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 Re: Septic Change Order Legal: T12N R3W SEC 23 S2NE4SE4NW4 PARCEL 25A To Whom it may concern: This is a request for a change order on the above referenced lot. Two test holes were excavated and found poorly graded gravels (GM/SM) for the entire depth with no water during or after the 7 day monitoring period. The existing 1250 gallon concrete tank will be cleaned and the baffles removed due to sizing requirements for the 5 bedroom. If the inlet and outlet baffles need repair they will be fixed. Then a new 1000 plastic tank will be added to the system to meet the bedroom requirement. Both perc tests were in the 40 minute per inch range which matches the older test hole data. also. A deep trench has been designed for the new leach field the same as the old field. The lot slopes to the northwest very gently at about 5 to 6 percent. This new system will not impact any of the surrounding neighbors. Sincerely i�; Michael N. Anderson, P.E. 4661 Natrona Anch, Ak 99516 Ph 727-8864 DESIGN CRITERIA: 5 BDRM X 150 = 750 GPD SOILS = 600/0.45 = 1666 SQ FT REQ'D 1666/2(8.0) = 92' (1) TRENCH 10' DEEP 9.0' EFFECTIVE 2.0' WIDE 92' LONG MOUND OVER (TH#3) ir, GRADE SEPTIC FIELD SECTION _ -E 112TH AVE- i SEPTI PTIq i / j EXISTING WELL i SEPTIq 100'RADIUS PROPERTY LINE 1 1 I 1 1 l i ` i EXISTING HOUSE — EXISTING DRAINAGE FIELD TO BE BUBBLING BROOK CIR- 1� ABANDONED 1 PROPERTY LINE IN-PLACE -ROCKRIDGE DRIVE - Septic Design Prepared for HOME RENEWAL COMPANY LLC T12N, R3W, SEC 23 S2NE4SE4SW4, PARCEL 25A Anchorage, Alaska Michael er ® • E• DATE: 10/10/2021 4601 NATRONA AVE DRAWN: DJR ANCHORAGE, ALASKA 99516 (907) 727-8864 / FAX: (907) 345-1391 SCALE: 1 "=200' FILTER FABRIC & INSULATION 4"0 PIPE SEWER ROCK OF Al; 49 -M � ;MICHAEL N. ANDERS( ' No. CE 9469 0 OR -1. OR -1.0 SM/GM SM/GM -10' -16' ( 2.0' I SEPTIC FIELD SECTION _ -E 112TH AVE- i SEPTI PTIq i / j EXISTING WELL i SEPTIq 100'RADIUS PROPERTY LINE 1 1 I 1 1 l i ` i EXISTING HOUSE — EXISTING DRAINAGE FIELD TO BE BUBBLING BROOK CIR- 1� ABANDONED 1 PROPERTY LINE IN-PLACE -ROCKRIDGE DRIVE - Septic Design Prepared for HOME RENEWAL COMPANY LLC T12N, R3W, SEC 23 S2NE4SE4SW4, PARCEL 25A Anchorage, Alaska Michael er ® • E• DATE: 10/10/2021 4601 NATRONA AVE DRAWN: DJR ANCHORAGE, ALASKA 99516 (907) 727-8864 / FAX: (907) 345-1391 SCALE: 1 "=200' FILTER FABRIC & INSULATION 4"0 PIPE SEWER ROCK OF Al; 49 -M � ;MICHAEL N. ANDERS( ' No. CE 9469 0 \EXISTING WELL LT 1 UND \ LOOT 1 —100RADIUS I LUND LOT PROPERTY LINE I r _WELL 10' MIN. TYP. FROM I �r'fH rrir rrrr C PROPERTY LINE rr rrrr rr r� 1 rr rri rr ��r r �e rr ♦ � rr r r� % ,rrl irrrrr rri 1 r —� i j rrrr ® rrrrrr{/ — G r Y r ' rrrrrr TH#2\\` C O EXISTING ,GARAGE EXISTING HOUSE ,Y r r r r r r / T12N, RM,, SE 23 S2NE4SE4SW4 / PARCE\ 25A / PROPERTY LINE T12N, R3 SEC 23 I Septic Design Prepared for HOME RENEWAL COMPANY LLC T12N, R3W, SEC 23 S2NE4SE4SW4, PARCEL 25A Anchorage, Alaska Michael N. Aner ® RE DATE: 4601 NATRONA AVE DRAWN: ANCHORAGE, ALASKA 99516 (907) 727-8864 / FAX: (907) 345-1391 SCALE: APPROX. FILL \ LIMITS FOR 3:1 \\ SLOPE \ - - 2' CONTOURS TYP 10' MIN. TYP. FROM PROPERTY LINE i 0 I / NEW 1000 GALLON PLASTIC TANK W/ 20" RISER EXISTING SEEPAGE PIT TO BE ABANDONED EXISTING 1250 GALLON CONCRETE TANK TO BE CLEANED AND BAFFLE REMOVED. INLETAND OUTLET BAFFLES TO BE CHECKED AND REPAIRED IF NECESSARY d K 2, L ,BLOCK 2, LOT to / I Aw AIF 49TH •_ 10/10/2021 O tom :MICHAEL N. ANDERSON -'t ®� No. CE 9469 DJR 10-10- 21 Municipality of Anchorage On-site Water and Wastewater IOR CODE COMPLIANCE r.. t�tv[2rwttrc i AL ecca Carroll, 10/09/20 Municipality of Anchorage ,��•,. Ir Development Services Department P '� .•• '•;Y' f� On -Site Water and Wastewater Section 49 T H 4700 Elmore St. .... .... ............. P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite .. . •'• • - • • • • • • • • ' (907) 343-7904 �i ¢sem MICHAEL N. ANDLRSCN .� r9•, CE - 9469 ••�,`' r Soils Log - Percolation Test Vit! Performed For: `-r, Date Performed: V Legal Description: Township, Range, Section: �� Z Slope Site Plan !tl IF� SE�f �w 4F P�rte� Z 5,4, Depth (Feet) 1- v d ' 2- 3- - 3 - 6- 7- 8- 9- 12- 13- 14- 15- 16- 17- 18- 19- 20- 6 -7 -9- 12- 13- 14- 15- 16- 17 -18- 19- 20 - COMMENTS COMMENTS WAS GROUND WATER ENCOUNTERED? 5 IF YES, AT WHAT DEPTH? L O Depth to Water After P Monitoring? E Date: Reading Date Gross Time Net Time Depth to Water Net Drop 6P V Cn '' 3 3 0 PERCOLATION RATEH C) (minuteslinch) PERU HUUk utAMt i trt TEST RUN BETWEEN 'a-- FT AND FT PERFORMED BY: M a A., I CERTIFY THAT THIS TEST WA PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: !pep Performed For: Legal Description: 1- 2- 3- 4- 5- 6- 7- 8- 9- 10- 11- 12- 13- 14- 15- 16- 17- 18- 19- 20 - COMMENTS 0v �5,A Soils Log - Percolation Test pt ���F�F�,af�� Tures f ti , S{�G t t,, Date Performed: 7 Township, Range, Section: Site Plan WAS GROUND WATER Date Municipality of Anchorage ENCOUNTERED?� ,� �, raEER's . �•�7F Development Services Department Water Wastewater Section �On-Site tt �49TH and IF YES, AT WHAT DEPTH? L 4700 Elmore St. P.O. Box 196650 Anchorage, AK 99519-6650 d• ......... • .. • • • ..... . Monitoring? www,muni.orct/onsite• 343-7904 E ; • • • • • ............ .. �� '.•� MICHAEL N_ ANDCRSCN (907) ."'lled � .'. CE - 9469 ' `' ,! . ,,: Performed For: Legal Description: 1- 2- 3- 4- 5- 6- 7- 8- 9- 10- 11- 12- 13- 14- 15- 16- 17- 18- 19- 20 - COMMENTS 0v �5,A Soils Log - Percolation Test pt ���F�F�,af�� Tures f ti , S{�G t t,, Date Performed: 7 Township, Range, Section: Site Plan WAS GROUND WATER Date Gross Time ENCOUNTERED?� Depth to Water Net Drop s IF YES, AT WHAT DEPTH? L Depth to Water After P Monitoring? Jf E Date: Z Reading Date Gross Time Net Time Depth to Water Net Drop Jf 6�% ti i!J PERCOLATION RATE (n inutes/inch) PERC HOLE DIAMETER ,r j TEST RUN BETWEEN FT AND 49 FT PERFORMED BY: �L7 I CERTIFY THAT THIS TEST WA PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE_ DATE: JtJ 2 Performed For: Leg/all Description: iD Depth oar q r 2- Municipality of Anchorage Development Services Department On -Site Water and Wastewater Section 4700 Elmore St. P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.orq/onsite (907)343-7904 Soils Log - Percolation Test 49jj�j '. 1 �••ee.••a.• eeeeae e. r• e•�4: r.•seee ...•. eee.e •r b -'a MICHAEL N. ANDERSON f'. CE - 9 69 Date Performed: L�- /V (L- , Z Z ?�_ Township, Range, Section: Slope Site Pian 8 - WAS GROUND WATER AL V 9- ENCOUNTERED? S 10- IF YES, AT WHAT DEPTH? L Depth to Water Atter o 11- Monitoring? a177- P12- Date: / 13- 14- 15- 17- 18- 19- 20- V PERCOLATION RATE AY-1)� (minutesfinch) PERC HOLE DIAMETER i t �n TEST RUN BETWEEN FT AND / j FT COMMENTS '`1`� t 1r ra r rt ��s � a `// &.11 -----t---- PERFORMED BY: Lj" 'I CERTIFY THAT THIS TEST WA PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: j 2 t / Lot 1 \ WELL ROTFCI/VF I RAD/°S m \ �0.2'xi 6.3' STORAGE 8'x20' CONNE% - - GRAVEL - O_ 8.3'x12.1' G o r SHED 32 2 a 9.5'x16.8' SAWMILL Unsubdivided m HOUSE DETAIL Scale: 1" = 30' \N )E HOUSe -CHAIN-LINK / FENCE ' .GRAVE S 89'58'1° Lot 2 I 1"E 660.23' 1 PIPES NOTE: BOUNDARY IS COMPUTED FROM THE BLM TOWNSHIP SURVEY PLAT. I Lot 3 c 3 7' o — 0 — _ _ — _ 0 N I W N � I I 0 N WELL ROTFCI/VF I RAD/°S m \ �0.2'xi 6.3' STORAGE 8'x20' CONNE% - - GRAVEL - O_ 8.3'x12.1' G o r SHED 32 2 a 9.5'x16.8' SAWMILL Unsubdivided m HOUSE DETAIL Scale: 1" = 30' \N )E HOUSe -CHAIN-LINK / FENCE ' .GRAVE S 89'58'1° Lot 2 I 1"E 660.23' 1 PIPES NOTE: BOUNDARY IS COMPUTED FROM THE BLM TOWNSHIP SURVEY PLAT. I Lot 3 c 3 7' o — 0 — _ _ — _ 0 N N � m 0 m w N 14 o) C7 Si, NEI, S EJ, N W1, SECTION 23, T12N, R3W, SEWARD MERIDIAN, ALASKA 5.0 Acres Lot 1 A Lot 1 B 2 a FL C EL U i O T N t N 0 OJ Qa :✓ �( O 0) 0 J CL �9m�0 m QLL m yat Q N Q we m T O m v m Q�:E and O �„C m O am 00 ° o a m pl O C% N m G m m c c I M3oam= m w a m o c c =m°mm rnNm��Er ~�0CC� m 6Ntmm-o `I w v v U I 0 0 9 0 o fi=ocorn°;� m mc�o ° o o. I v m wo \a v x mo m m Z 0 0 > L\C1 0,:E O O W OI C� a OIn C OrL r v my^v I a.\o ma c+m I w w m L m c m z a LIE c o U m me > O m m >.NOw0a0C.m .0 m��L_ENEv m a3ca°m o 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 hftp://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP201400 Effective Date: Work Type: Septic Upgrade Expiration Date Tax Code Number: 01549104000 Site Legal Address: T12N R3W SEC 23 S2NE4SE4NW4 PARCEL 25A G:2638 Site Mailing Address: 11361 MAEL ST, Anchorage Owner: FALL DONALD G & ANN Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING This permit is for the construction of: Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy Ment S Department 10/9/2020 10/9/2021 Lot Size in Sq Ft: 217800 Total Bedrooms: 4 ❑ 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: An additional percolation t Is require rior to construction of the drainfield, in the location shown on the site plan, to verify co' o tent soils the wh a length of the field. If results require a design change, construction shall stop ending r iew and approval of a order. Please submit results with the inspection report (or chan order, I uired). o� �2\ kc� �j � peyle� . �el C2 Received By: Date: 9 Issued By: eZyec Date: 01/29!2013 00:31 907243074::' HWPS, 1NC. PAGE y----.�,1 ae: p �lS7ilIC c4"?,-/ Division 4 - e Mork Sag,ch Purr P Installation Lag Well Drilling Permit Number: SW� Date of Issue: Parcel Identification Number: I Legal Description 1 - Property One Iawe & Ad4 A/ R3W Pump Installation Date: Pump intake Degtlt 13e1�w Top of Well Pomp Manufacturer's Name: ee/d� Pump t%ladeh x%��° vl e le Pump Size.i1 hp Pitless Adapter Burial Depth: /4' feet Pities Adapter Manufacturer's Mame; pklees :?t:nu dal~ 1Wt;)'3er: e19isint y d uu Coz p;et.cn �; ; H i yl^jt'az;d odJ��n G � 4 Comments: ; Pump Installer Name. feet Morago Pump & Well Service 330 East 78th Avenuo Andhofags, Naske 99513 Phone: 907-243-0740 Fax: 907-243-0742 s Attention: The pu.np instahi - shall provide a pATip installation log to the DO within 1U days e_ pump installation. August 16, 1966 Mr, Donald Fall 2006 83rd Avenue Anchorage, Alaska 99509 011 SUBJECT: S-Iwage Disposal System Ins;pecioa for Existing Vlore, Parcel 25A, Section 236 T12N, R3W, SM Dear Mr. Fall: The Greater Anchorage Area Borough Health Department inspected and approved the installation of a 1,250 gallon septic tank in ecniunctl.on with adequate seepage area to serve the existing threaabedroom home at the subject location. Sincerely, DAVID R. L DUHCAH, M. D. Medical Director M MR R. Strclan, Sanitarian RRS/srr P .�1...� — SEWAGE DISPOSAL SYSTEM - APPLICATION � PERMIT Name of Applicant_ C!/�/ %- L� Mailing Address Ph, # ����✓� S jock TL I l�(rE 12 D. oF� l. Residence Address s L cation of Installation— Description Z.. /,/Z/V/�GU i Application to Install: Septic tank)C , Seepage pit , Drain field__ , Other 11 To Serve the Following Facility__ .rDiLe�pM /uSE Financed Through /Voaye To be Installed by �OCfle6 ZuekvA77N6- Percolation Test Results sVoN F Anticipated Date of Completion 01468 r-/CLb /NSR BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT This is to serve as DISTANCES: L3 9 9.010N �P�frL y"tL/V� permit to install a described below. Size of unit to be served 2,�Dtic tank size Type Seepage Area Type 1�Q(L Cc�MFNr izHpI&S 1 0 tW/ LA'/L(rsE GQA'✓�/L Sep+IL +CLN C tj ST21C —LAND neait.n Authority I certifythat I am familiar with the requirements of Greater Anchorage Area Borough 3rdinance No. 28-68 and that the above described system is in accordance with said code, P MUNICIPALITY OF ANCHORAGE Development Services Department ` On -Site Water &Wastewater Section -� Phone: 907-343-7904 Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 015-491-04 1. GENERAL INFORMATION Expiration Date: q—(, ,2 p ZZ Complete legal description T12N R3W SEC 23 S2NE4SE4NW4 PARCEL 25A (Lott) Location (site address) 11361 MAEL ST, ANCH AK Current property owner(s) HOME RENEWAL COMPANY LLC Day phone Mailing address 1120 HUFFMAN RD STE 24-797, ANCH AK 99515 Real estate agent 2. TYPE OF DWELLING: Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 5 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well [] Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date.- COSA ate:COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ oZ &V Waiver Fee $ Date of Payment /ZA-_5r"/ Date of Payment Receipt Number OZ 02-'2 Receipt Number COSA # 0 5 C 21 ( 7 3 Waiver # S. 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_$$64 Address 4661 NATRONA AVE ANCH AK Engineer's Printed Name MIKE N ANDERSON, P.E. Date 12/21/21 6. DSD SIGNATURE System #1 Approved for 5 System #2 Approved for Disapproved Conditional approval for • . (, _....,. bedrooms ........., rnlc:;�:ei bedrooms F cc bedrooms, with the following stipulatiAl�� ; �__-"'_ ­ TY OFgrr�rii WATER STf=v'ATER z; J J � JJ0 C15 ���JJi�yTSERVI� S B k- Original Certificate Date: 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: T12N R3W SEC 23 S2NE4SE4NW4 PARCEL 25A Parcel ID: 015-491-04 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled UN Total depth 168 ft Cased to >40'+ ft FOR Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 12 in. Date of flow test for COSA 1113012' Static water level at beginning of test 78 ft. Comments 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 * existing concrete tank & new plastic D. ABSORPTION FIELD DATA new 5 bedroom Which system tested (date installed) 10122121 IN ALL standpipes present per record drawing Total measured depth from grade 13 ft (max) Measured depth to pipe invert from grade 4—ft (min) ❑ N/A – pressurized field On Monitor tubes go to bottom of effective. If not, state depth into effective NO Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced 0 gallons Comments/Deficiencies; COSA Checklist yellow sheet Well production at time of test 3+ gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by MNA Date of Sample 11/30121 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date NEW Results F Pass For 5 bedrooms Fluid depth prior to test in Water added gal New depth in Elapsed time min Final fluid depth in Absorption rate and 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' ❑ Yes if No Community Sewer Manhole/Cleanout > 100' Q Yes if No ft Q Yes if No ft Neighboring Tank > 100' Q Yes if No ft Private Sewer/Septic Line > 25' 0 Yes if No ft Absorption Field on Lot > 100' Yes if No ft Holding Tank > 100' Q Yes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' Q Yes if No ft El Yes if No ft ft If septic tank is under driveway comment below Community Sewer Main > 75' Q Yes if No ft Manure/Animal Excreta Storage > 100' ✓[� 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' Q Yes if No ft Property Line > 5' (Z] Yes if No ft Wells on Adjacent Lots: Wells on Adjacent Lots: Absorption Field > 5' Q Yes if No ft Private Wells > 100' Q Yes if No ft Water Main->� TO' -✓Q Yes if No ft Community Wells > 200' LJ Yes if No ft Water Service Line > 10' Q 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' Q✓ Yes if No ft If absorption field is under driveway comment below Property Line > 10'✓Q Yes if No ft Wells on Adjacent Lots: Water Main > 10' 0 Yes if No ft Private Wells > 100' Ul Yes if No ft Water Service Line > 10' Q Yes if No ft Community Wells > 200' Q Yes if No ft Surface Water > 100' Q Yes if No ft F. ENGINEER'S COMMENTS * old concrete tank is <1Q' from the foundation G. ENGINEER'S CERTIFICATION I certify that / have determined through held 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 �N``�8�, wes. ive+r�:r��•••A•�u '.1 �• �% MICHAEL N. ANDERSG.14 f J••.. • C 9 69 •._ �l � pr i Z.�rC,z-.�• 1. 2. 3. 4. 5. GREATER ANCHORAGE AREA BOROUGH f Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received Time of Inspection I/�/)O rn Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR Approval requested by: /3 1 . Mailing Address: �ly /� I -Z0 V. Phone: �Z7 P/ Property Owner: G�=�j / 2�� Phone: Mailing Address: � � a 3 — .9 -50,1 Legal Description: ZACom. ,�3, Location: A P /�Ud FI G' Type of facility to be inspected 6. Well Data: A. Type �B. Depth No. of bedrooms C. Construction D. Bacterial Analysis 7. Sewage Disposal System: -/-7 - A. Installed B. Installer C. Septic Tank: 1. Size / 2,5--0 2. Manufacturer D. Seepage Pit: 1. Absorption Area 7_ 2. Material Pic/ztT E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank / % , Absorption area � c!5-0 Sewer Lines Nearest lot line , Other contamination B. Foundation to septic tank / 5-e , Absorption area / 7 C. Absorption area to nearest lot line EQ -034 (1/74) Page 1 of two pages U GREATER ANCHORAGE ARLI BOROUGH Department of Environmental Quality 3330 "C" St., Anchorage, Alaska 99503 - 274-4561 RECEiVBD' REQUEST FOR APPROVAL OF SPK G b 1974 INDIVIDUAL SEWER & WATER FACILITIES r" AGDEPTEOF ENV RONMENTAL QUAL11YH 1. Type of Inspection: CMRO VA x FHA CONV 2. Property Owner: Donald G. Fall Anchorage Mailing Address: Box 23 SRA 99507 _Day Phone 344-3368 3. Name of Buyer: Donald G. Fall Re -Finance 99507 Mailing Address: Box 23 SRA Anchorage Day Phone 344-3368 1 4. Name of Lending Institution: First National Bank of Anchorage Mailing Address: P.O. Box 720 Anchorage 89510 Phone 279-4481 5. Name of Realtor or Agent: None Mailing Address:Phone 6. Legal Description: T12N R3W Sec 23 Parcel 25A Location: 7 F, E1 Type of Facility to be inspected: Water Supply Type of Supply: Public Utility M Individual x If Individual, number of dwellings presently served If Individual, depth of well Sewage Disposal System 1 3 Type.of System: Public Utility Individual (on-site) x If Individual, date of installation GREATER ANCHORAGE ARI_!, BOROUGH Departmet of Environmental Quality ntb 3330 C St., Anchorage, Alaska 99503 - 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES 1. Type of Inspection: CMRO VA x FHA _ CONV _ 2. Property Owner: Donald G. Fall Anchorage Mailing Address: Box 23 SRA 99507 Day Phone 344-3368 3. Name of Buyer: Donald G. Fall Re -Finance 99507 Mailing Address: Box 23 SRA Anchorage Da Phone 344-3368 4. Name of Lending Institution: First National Bank of Anchorage Mailing Address: P.O. Box 720 Anchorage 99510 Phone 279-4481 5. Name of Realtor or Agent: None _ Mailing Address: Phone 6. Legal Description: T12N R3W Sec 23 Parcel 25A Location: II Type of Facility to be inspected: Water Supply Type of Supply: Public Utility No. Bdrms. 3 Individual x If Individual, number of dwellings presently served If Individual, depth of well 9. Sewage Disposal System 1 Type.of System: Public Utility Individual (on-site) x If Individual, date of installation Page% of two pages Request for Approval of Individual S—ier & Water Facilities + Legal Description o rc e Z9- 5 0— 2-3 / 1241 2Dh/ Comments Approved Disapproved Date Approval Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in tnis request Tor appruvai uu uu a W.0 w„w accurate representation of the subject sewer and water facilities and these facilities are operati:r'ig s a t i s f a torily �, A SIGNED �/ Date 7 EQ -034 (1/74) e- r��k