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HomeMy WebLinkAboutHILLSIDE PARK PUD LT 36Hillside Park Lot 36 #015-122-56 Municipality of Anchorage Development Services Department 4-0. Building Safety DivisionOnsite Water & Wastewater Program, 4700 South Bragaw St. a P.O. Box 196650 Anchorage, AK 99519.6650 www.cf.anchorage.ek.us (907) 343-7904 Page 1 of 3 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number. SW040358 PID Number. 015-122-56 Nome: MICHAEL BURNS Wastewater System: ■ New ❑ Upgrade Address: 7081 CROOKED TREE DRIVE ABSORPTION FIELD Phone: No. of Bedrooms: (907) 346-3276 4 ■ Deep Trench O Shallow Trench O Bed O Mound a LEGAL DESCRIPTION $a """¢ TOW TOW I>•Pa ham R R Block: LDC Subdivision: Depen to Pipe When, ham of 1nd BredaGomel e,nwaln Pipe: — 36 HILLSIDE PARK PUD R R Township: Runge: Section: — — — N added above anpind erode: Drerd Meeh, R R WELL: E) New [I Upgrade crom wMln: NaMer of bwe: Dletowe btwwen wwe R R CMrf"Uan Prkvt . A9.0 : Total Mptn. Tar cold eno: Pee tnolalot COMMUNITY R R $0. R OrYlw: DrYled: $toed soder L";ewlalM .. GEG. Ltd. om Y DOW 8/24/2004 R YMt $wt M 5„ Coekg NMphl MD Dfowtl: TANK R R EPARATION DISTANCES ■'Septic DNoldinq aS.T.EP. bother Septic Absorption Utt Holding btk/Prhats Mae'te`h'w` ANCHORAGE TANK capoaiv In 9a : 1250 Tank Field Station Tank sewer Lines Well100'+ rUne — — — 25'+ ud wk STEEL of � 2 Surface 100'+ — — — — LIFT STATION 5'+ — — — — sue In - - I Foundation 5'+ — — — — ury on Mwl ell of Nipr wwMw alorm at Curtain Drain NONE KNOW ► tbw. � Nwve=eere gr. Remarks: "DEEP BURIAL TANK INSTALLED. BENCH MARK teoadan WW Dwoo pum OLD SEPTIC TANK RIPPED OPEN AND FILLED BOTTOM OF SIDING ON NORTH EAST HOUSE WITH SOIL CORNER. Asanwd EMvallaa 11P0.00 R EN NEER36 0060 4 odP F'•�F• Inspections performed by: GEG, Ltd. Dates: list 8/24/2004 Inspections . Ar .......... .*ooO 2nd 3rd .ff .Y ...Go...ss:...� Development Services Department Approval �p ° 7r3 ot���'oo� Reviewed and approved by: 4%• Date:.3 - ' �b �0°dPrareeeto^°oma ��0040000 (tom. tion PERMIT NUMBER: AS -BUILT DRAWING PNUMBER: 015 SW040358 015-11 22-56 \ NOTE: SEPTIC TANK UPGRADE \ DESIGN SHOWED DRPNF D \ INCORRECTLY. PIPE LOCATIONS \ SHOWN FROM UPDATED 21.89 NEW 1250 GALLON ,, 25.84 1� H 27.36282328.01 r� r NOTE: OLD SEPTIC r r TANK WAS COMPLETELY 1 r r r \ AS -BUILT SURVEY. l r r r r r r SUMP r r r r r r r r DBL2 r r i ST2 BL1 ' r 4 B vc fta_f \ CROOKED TREE ro r NEW 1250 GALLON ,, SEPTIC TANK 1� 1 1� I r o5 r r� r NOTE: OLD SEPTIC r r TANK WAS COMPLETELY 1 r r r ABANDONED. DRIVE 8/30/2004AM, _oQ"gyp O.. .. -- "�i !Ga . -. _•'•� _ _._.._..__._. F DRAWN A.J.G. GARNESS ENGINEERING GROUP, Ltd. G� o co SCALE: CONSULTANTS 8 GENERAL CONTRACTORS 1n _ 40s — ...,,,, .•• ,•, ,. •,••,. 3701 F TMM ROAD, SURF 101 • ANCNORGGF. AK 09507 • FNnNF (00719)-0170 • FAX (007)W -37L6 PREPARED FOR: PHONE NUMBER: PAGE NUMBER: MICHAEL BURNS 465-3135 2 OF 3 eC nese.- Alp ,pJ' 5 ,• LEGAL DESCRIPTION: HILLSIDE PARK SUBDIVISION; LOT 36, `Fv 0 lip* 4 ^ pro(esslon�� pODoovoo TYPE OF WORK: AS—BUILT DRAWING OF SEPTIC TANK UPGRADE PERMTT SW04U358 AS -BUILT DRAWING PARCEL015-1 "UMBER: SW040358 015-122-56 GRADE - 95.88 ST2 TOP OF TANK AT INLET 87.44 S I I I I/ -70P OF TANK AT OUTLET - 87.44 n - - - - -ter-- U NEW DEEP BURIAL 1250 INVERT OF SUNG GALLON SEPTIC TANK INVERT OF BUNG AT AT INLET 8723 7I OUTLET - 88.98 8/24/2004 DRAWN 1fi� I:SS RI ( BY: NG GROUP, Ltd. SCALE: R.A.L. GARN CONSULTANTS 6 GENERAL CONTRACTORS 1 n C 40r 370, F TUOM OOGO SUITF 10, • GNCNOA>OF. CK OCS07 • MONF (007)357.690 • FGK (00])1K-3146 PREPARED FOR: PHONE NUMBER: PAGE NUMBER: MICHAEL BURNS 465 3135 1 OF 2 LEGAL DESCRIPTION: HILLSIDE PARK SUBDIVISION; LOT 36. TYPE OF WORK: AS -BUILT DRAWING OF SEPTIC TANK UPGRADE MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water 8 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Permit Number: SW040358 Legal Description' HILLSIDE PARK PUO LT 36 Design Engineer: 0855 Garness Engineering Group, LTD Owner Name: MICHAEL BURNS Owner Address: 7081 CROOKED TREE DR ANCHORAGE, AK 99516-6810 Date Issued: Aug 24, 2004 Expiration Date: Aug 24, 2005 Parcel ID: 015-122-56 Site Address: Lot Size: 28745 SO. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: ❑ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must 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 engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Date: Issued By: (iri �" Date: Zy o GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS August 24, 2004 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragraw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Holding Tank Upgrade for Lot 36, Hillside Park Subdivision To whom it may concern: An documented 1250 -gallon septic tank currently serves the existing 4 -bedroom house. We exposed the tank to verify the integrity, and confirmed it had holes. We are proposing that the tank be replaced, and a new 1250 -gallon tank be installed in accordance with the Municipal standards. There arc no surface waters within 100 feet of the proposed upgrade. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your P.E., M.S. NOTE. Attached is a site plan drawing, a design drawing„ and a 5 page construction specification letter which are all part of the design package for this septic system. 3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507 Ph: (907) 337-6179 • Fax: (907) 338-3246' Website: gamessengincering.com Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 01g — / LZ — /S(o Permit Number Property owner(s) MICHAEL BURNS Day phone 240-8430 Mailing address (1) 7081 CROOKED TREE DRNE • ANCHORAGE. AK. 99516 Mailing address (2) Zip Code 99516 Legal description (Lot, Block & Sub'd.) HILLSIDE PARK SUBDIVISION: LOT 36. Legal description (Section, Township & Range) N/A Lot Size THIS APPLICATION IS FOR: Acres/Sq.Ft. Number of Bedrooms 4 Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of property ewner er oulhefired agent) Permit Fees: 411i+n Date of Payment: '9-1124104 Receipt Number. 057y?,�q Waiver Fees: Date of Payment: Receipt Number. PROPERTIES ARE SERVED BY COMMUNITY WELL. LOT 34;\, HILLSIDE PARK S \ 1 1 1 1 1 I 1 ISONG LOT 35;EPTIC SYSTEM HILLSIDE PARK S/D 1 1 1 EXISTING 4 BEDROOM 1 HOUSE LOT 37; `\ 1 HILLSIDE PARK S/D 1 1 I 1 1 _ _ LOT 15; C ROOKED TREE DR-1—Vi HILLSIDE PARK S/D I 1 I 1 / 1 HILLSIDETPARK S/D / 1 1 LOT 30; LOT 14; LOT 31; 11 1 HILLSIDE PARK S/D HILLSIDE PARK S/D HILLSIDE PARK S/D 1 1 LOT 29; HILLSIDE PARK S/0 �_�c.�- 8/24/2004 ._. OF .; Ya .- -- — DRAWN R.A.L. L GARNESS ENGINEERING GROUP, td.�•: y CONSULTANTS & GENERAL CONTRACTORS 5101 F TUDOR ROAD. SURF 101 • ANrwDQAr•F AK 995D1 • 111 (0011]51-0179 • FAX (9U1151F4?4A 1 — 1009 +, PREPARED FOR PHONE NUMBER: PAGE NUMBER: MICHAEL BURNS 356-3276 1 OF 2 ff y G ess LEGAL DESCRIPTION: r���r y� 795.3 : • e HILLSIDE PARK SUBDIVISON; LOT 36,. TYPE OF WORK: 1��ie�P�OFe 331o�1` '• SITE PLAN FOR PROPOSED SEPTIC TANK UPGRADE „;;; NOTE: THE CONTRACTOR \ \ SHALL HAVE THE EAST LOT LINE FLAGGED BY A REGISTERED SURVEYOR PRIOR TO / CONSTRUCTION. \ NOTE: ALL SURROUNDING \ \ PROPERTIES ARE SERVED \ BY COMMUNITY WELL. \ \ \ \ 1 EXISnNG I ' EXISTING SEPnC DRAINFl\ELD I TANK WILL BE COMPLETELY ' ABANDONED ,,—CALLON1250 TANK s ft nNC ';�4 CROOKED TREE DRIVE DATE: 8/24/2004 Po�pF GARI`ESS ENGINEERING GROUP Ltd.DRAWN BY. T TT R.A.L. •• '� � CONSULTANTS It GENERAL CONTRACTORS SCALE: n — 4O� ,,,,,,, ,,, ,,,,,,, ,,,,,,0 3701 F. TUDM GOAD. SU1TF 101 • ANCNOGAC.F. AK 00507 • P MF (007A31fi90 • FAX (007M38-SA7 D PREPARED FOR: PHONE NUMBER: PAGE NUMBER: Q MICHAEL BURNS 465 3135 1 OF 2 OQ P •• y A, me s; Q LEGAL DESCRIPTION: Q ` % 15 e� HILLSIDE PARK SUBDIVISION; LOT 36, TYPE OF WORK: 4 e'c�cQd SITE PLAN FOR SEPTIC TANK UPGRADE ����Op0000a� 1- \ MUNICIPALITY OF ANCHORAGE 1 DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street -Anchorage, Alaska 99501 Telephone 264.4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME LS PHONE 1 ❑ NEW IY-z- 5+1 S-ID`ID UPGRADE MAILING ADDRESS W<nt 33's 1Zoo LEGAL DE CRIPTION 11%1 p� l< I'>1- LOCATION c tro�►�a rt -K- NO. OF BEDROOMS 4 ._ DISTANCE TO: Well Absorption area Dwelling PERMIT NO. 7 7 D Y ;:Z Manulacturer i%rt c-�, Material ,y.-. p No. of compartmepts Liq. capacity in gallon ! � IF HOMEMADE: Inside length Width Liquid depth 6 )e DISTANCE TO: Well Dwelling PERMIT NO. -i D 2 _ FQ- Manufacturer Material Liquid capacity in gallons DISTANCE TO: Well ZbD"f' Foundation 3p Nearest lot line 3p PERMIT NO. SS-0-fy2� WL) j LL Z No. of lines 2, Length of each line Total length of Trench wiQt� Distance between lines F W 6 inches 'VA Top to finish Material beneath Gf of tile grade s! -K � —4 8 tile 46 - Total effective bsorption area 19, p (;%%,* inches 4I ✓ Length Width av4v�% 26117c Depth PERMIT NO. W 0 rwta �1 i~ Type of crib Crib diameter evtl Crib depth Total effective absorption area W� LJ DISTANCE TO: Well Building foundation Nearest lot line J ClassDISTANCE Depth Driller Distance to lot line PERMIT NO. W W 3 T0: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS 3 Z>292q SOIL TEST RATING INSTALLER 0 NC Lf cit c -s _ L REMARKS i 'niwl•��n <c�enftK Ecd ZnS>' � NL rx1 �� For- e. z<is h^y ,t['�l "'Ie S F...t.[ p'pr' .<ca , .< i,a rc .>r r'i' wa d%r o..<.td -f•r�r/t wwr not 11n (k ..;i no- / . �OVtr P10.. �r'a YrYOrW-fn� ��bl Ow/Kr L ff- he /� - C �t ^ /n 6 neo it- fTF..� 01 aic .clE'o/ 7�c�rr ` i use is , tf 14t 1 APPROVED DATE LEGAL/ � 2S7P 1' l II T i11L fl,- r- Ca'1 3bl Sen / /t fv� ZL 72013 (Rev. 3178) Aon MLJN I C I_ ^AL I TY OF= ink NCF..3IIAGE Q DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION d 825 L STREET, ANCHORAGE, AK 99501 �. 264-4720 O N —SIT E S EWE R P E R M I T PERMIT N0: 07/25/ DATE ISSUEDs 07/25/855 APPLICANT: A:E.C.S., INC. ADDRESS: 1200 WEST 33 AVE, SUITE B ANCHORAGE, A); 99503 CONTACT PHONE: 561-5040 LEGAL DESCRIP: SUBDIVISION: HILLSIDE PARK LOT: 36 BLOCK: N/A SECTION: 14 TOWNSHIP: 12N RANGE: 3W LOT SIZE: 25000 (SQ.FT. OR ACRES) MAX BEDROOMS: 4 Listed below are the options available to you in designing your septic system. Choose the option that best fits your site. • TF2ENCH W _ DFiA I N DEPTH TO PIPE BOTTOM (FT.) 4.0 4.0 GRAVEL DEPTH (FT.) 7.0 3.5 TOTAL DEPTH (FT.) 11.0 7.5 GRAVEL WIDTH (FT.) 2.5 5.0 GRAVEL LENGTH .(FT.) 36.0 54.0 ' GRAVEL VOLUME (CU.YDS.) 25.0 40.0 TANK SIZE (GALS) 19250.0,** 1,250.0 ** SOIL RATING (SQ.FT./BR) 125 125 ** TANK MUST HAVE AT LEAST TWO COMPARTMENTS - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - I certify that: 1. I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage (MOA) and the State of Alaska. 2. I will install the system.in accordance with all MOA codes and regulations, and in compliance with the design criteria of this permit. 3. I will adhere to all MOA and State of Alaska requirements for the set back distances from any existing well, wastewater disposal system or public sewerage system on this or any adjacent or nearby lot. 4. I understand that this permit is valid for a maximum of 4 bedrooms and any enlargement will require an additional permit. IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN. - SIGNED �% DATE. 7 APPLICANTQ A. E. C. S., INC. ISSUED BY „� C�� DATE: _ _'- (ENGINEER'S SEAL) a v Munkipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 625 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: -J\IY1 (he-LIp% DATEPERFORMED: LEGAL DESCRIPTION: L -0t36 N1II5adG TAr�,Township, Range, Section: T/ZN 83w S?i'/S/ -to-I Pa SLOPE SITE PLAN ( EqT BOF- 0rc("CC sob'( 1 2 I 3 � . a ° 5 6 7 8- 9- 10- 11 s1011 12- 13- 14- 15 - Er FJ 2 131a 15 EN 1s Th- 1 71819 17- 18- 19 1p e�5 C' xca-tj 7 s0.,4 � �� tl5jtrcr rcrK� �•6at 11f�t�"' ,, 1; VlSun% WAS GROUNDWATER ENCOUNTERED? N o IF YES, AT WHAT DEPTH? _ Depth to Water cuter Monitoring) Date: h -tr GO — r„ 7-1 ®®��� •• M 20 PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT COMMENTS [ c PERFORMED BY: Darty d0d,,' ST S'J'D� 1 1/t' �>^CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:l2' 72 -WB (Rev. //85) Y \ ( � MUNICIPALITY OF ANCHORAGE r \ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 2644720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME i^O Sy PHONE EW O UPGRADE MAILINGADD ESS O LEGALESCRIPTION� oi f6 HiLJ . pLsr e. to,4Rk u® LOCATION Ci P.� NO. OF BEDROOMS uY DISTANCE TO: Welles Absorption area Dwelling C / G PERMIT O O EQ Manufacturer Ql� �7 Matei ��J� No. ofc partments -G—q-7 i[ ' allons IF HOMEMADE: Inside length Width Liquid depth d se JOz DISTANCE TO: Wet Dwelling PERMIT NO. X-4 Manufacturer Material Liquid capacity in gallons O w= DISTANCE TO: Well Foundation Nearest I t h it PERMIT N CO W LL D F?W No. of lines/ Length f each lino g 1 /S' Total len�qyyt p� I es. (p Trench width inches Distanrp q� en lines 7l/ H p Top of the to finish grade Material beneath ile inches Total effect," absorption area n W 0 Length Width Depth PERMIT NO. a~ W L Type of crib Crib diameter Crib depth Total effective absorption area y DISTANCE TO: Well Building foundation Nearest lot line J J Class Depth Driller Distance to lot line PERMIT NO. W 3 DISTANCE T0: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS Uc. G1 Rsr T SOIL TEST RATING 1/ INSTALLE25 n � 77 1 REMARKS OR 1 APP ED DATE LEGAL 72-013 (Rev. 3176) MLFr-a I C I . r=FFL I TY OF Ataich, : HrE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 'L' STREET, ANCHORAGE, AK. 99501 264-4720 CAr4—S I TE 'oEWEFQ F}EF? h'1 I T PERMIT NO. ( 820021 ) APPLICANT PROFESSIONAL PLANNING S PO BOX 10-762 99511 345-5622 LOCATION CROOKED TREE LEGAL LOT 36 HILLSIDE PARK SID LOT SIZE 24000 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 4 SOIL RATING (SQ FT/BR)= 125 THE REQUIRED SIZE OF THE SOIL ABSORPTION! SYSTEM IS: LtiEF~TH= O LEr-aGTH= .= GF?FFk'EL C•EF}TH= tF THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR OORINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN! THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). F EnLF I F? ELti 'SEF='T I C TRt4F: S I 2"E= Z` 1CD C3F4LLCDMS PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENICES THAT THE WELL WILL SERVE. --- TUFO C 2 0 I MSF=`ECT I ONES Fl F? E F? Er!U I F ZEsE> -- BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN! A WELL AND ANY OM -SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEFENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET. OTHER, REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F>EF2Ul I T EItF" I FQES C>ECEt•7BEF? IT AL W 0 I CERTIFY THAT 1: I AM FAMILIAR, WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: 1 WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: 1 UNDERSTAND THAT THE ON-SITE SEWER. SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. ---------------------------------- SIGNED:- ---- L�1�DPP APPLICANT PROFESSIONAL PLANNING SSRS, - INC Co��udL� �pp�Gruaf LL ISSUED BY ------------------------------ DATE ----- _CIC /�-- V4. 0 n �(� ,p�uLrnj .c ll: r`s r y 1_1 r -F I Las. JJa FSa DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTIOF fzc� 825 'L' STREET, ANCHORAGE, AK. 99501 264-4720 /1 y iD F— ITE EWE=R: F•EF'rl I T (Itc2S �a PERMIT NO. { 820018 ) '� APPLICANT PROFF. PLANNING SYS. IN BOY, 10-762 245 -562 - LOCATION CROOKED TREE LEGAL LOT 36 HILLSIDE PARE: FUD LOT SIZE 25000 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCHr 9 ZO(+n L.0u4.c7' Oea MAXIMUM NUMBER OF BEDROOMS = 4 SOIL RATING CSO FT/BR)= 125 11 de1'%1 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: CNE=PTH= S L.EN0-rH= o.M: GRn%-EL CHEF=TH= 4 THE LENGTH DIMENSION IS THE LENGTH (IFJ FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION CIN FEET). THERE IS 140 SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE •, AND THE BOTTOM OF THE EXCAVATION (IFJ FEET). REGtiU I FREC+ SEPTIC TF=lrdF" 'S I GE= Cih1LLOrJ�- PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DUPING THE INSTALLATION INSPECTIONS OF ANY I -JELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. --- TL44 <-_2 ? I rod 7-F='ECT I Or -4F 7, FI FRE REG!.0 I RELY --- BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AFJD ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER. LINE IS 25 FEET AND TO A COMMUNITY SEWER LINE IS 75 FEET. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PERMIT EXP I RES C•ECEME:ER - 1� I CERTIFY THAT 1: I AM FAMILIAR, WITH THE REQUIREMENTS FOR ON-SITE SEWERS FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IFJ ACCORDANCE WITH THE CODES. 3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. SIGNED APPLICANT PP.OFF. PLANNING SYS. INC. ISSUED BY_ `-v -------------DATE- 2 _-3 _ 8 AND WELLS AS SET ENLARGEMENT IF THE V4. 0 Woom ' , ; � , t•n_lr-r s !- r t-•! �� .r -r•r !_rr= t-rr•�• _-t--rl=t .::�r_�ti. ., .• LK.' -",s rfL:14i r< fnp-r:I ro.)v s:rf tfrlllr•b-?rr/7 �"?nr: r 1 It]Jr • :�•� -► - � r�I_:: r. IiF1r:: r:4^;7rrJ tik :'_'"JJ1 T614 -4 i%20 !_,tJ •_tri= =1 !`ls-rt :- tJr•t r r Ptoo/F t 1*—m l i t ?R4Ir. :4.:111n mr, Tu;. r N ?r :'lu; r'r:-L rf- SOIL t7o_U,2F•rrurt is LOT s i � zxioo •;ou-mE rfs_r�:7'1 .._._�.._-:?I}tl.-F:.•�.r-tiac-tx's-r,•"dR�-- � �•c 1.. I!C-=r?t�(t.:n •:(x r$F r, -C •_r1IL t7S•=rv2ortoN 5r%,r,rt tS: r •,r= r-'• "(-! i '-- $ t_:'�r.,r3 rr-r - ! 3S:,t-,';•`ter_ � -- �y .�:r pm f r' [rr:an t ori t: r:< t-e-iti rm cut Ftl; rs r�r r.#= rs:-rr�:f opDRr7 trN t tt_fr. TIi< Go-: rH rJF A 1 h`-rb.1i OR P r T r5 Tt#z D t'_ rt7r11` tc rt p Jt rHE- .r -mm. tlr!G nv co r r om r j;= t7;v !v! ! ItI :-tv r?. rH::t• Ec t s flu w r !d t O rH Ft].? rFEFr'f�- :. r: r;^,a';CL cwp rl t v, rho,. rl (r mini c -4-r m 1-t-, t3?N'?�o- sn,A_t1I Tlx: tn.r r7 t /_L P tPZ! firlG fid: i�r]rrt]Ii t1;= rlf: c.i�t:Ab'iiflrJlt CtH r-}}r� t Ll=:r;C• _ , r • t" I r= Tt'rt•1F. S t A";,r-I r t^aio r W r; rl* hr_::r�+ltt_ 14 It_ (rY To u r cr..r1 TN c 5 _C���13? IT r r_ a12 t r►r; T:3E . [ rim rt]I-I1t r I ctu t rnY..c r t 1]t n u NlI .' i•js i i v no •r,7r.r!i r To r! S F?.rlr~:p r v iv iD r -r, hA A, -p r_c- rf i:l r nl-= r•01_t_ HILL w r•E 7"! 1 ti 1_.!'•iacT St_tl•J, s=rr-f r-: til =1,rt t r f'>=r• _. flit-'}G�ILI_I6H; r)P :arl'r _ter`:.mm !i(ni-M]Ur ?(rn7_ [rr:�ar rtt]`t lat7v iticT7iYrJt7_ BY Tslt•_ C<i~�r�t'rA_rrr lata Fr T4 m I tt (r -un t• t 5 r,1rb:J E:E rr > =S;ri a !•r l -_ tlrlo :vw im -; t rE •_+:Yu irs o C5•n': rpt- _'r`: rE 1 I5 tto9 Fhi-z r FnR "rt Pf? iyn rE ! k 1_I: Q2 L.:.,) TO lZOO t Ar7fy A P, Wit- I r !-FE - r.l �r]lr rt.: P!F' IY MJF IC I•zI-L- tlLr roil ,si Otsrnor.,: F,iai A pRrvrir} lo -it. TO A PPLYATE >3rtR LINE t*:;:l FE>rr Snp T9 comi,RR! t rY St•k:Tt L U A: N ?5 FEU. r. nri r, ref r.IJt3.r_rk;rtf Itly fiP LY. VE t?'dti[Ltrs F rn [rf +.0 r VXr F- ViSrO-I.ArtON (='r.f<:r•! t 7' t :•:�• I r�E=•_. L••t�r�4_r•]t_sc= rte: v:'L. Z:3:•_e•=t I r:fP:r(> ? MIT !. r Po� FNl9tl,[IiF mm F132 ON-:IfE .}w.rp.5 tido RKLL: sig _fir u�rH r:v rw I•AJrfiCIP;7LtlY �a• Ntr; r)f:;rr� Z. i ttrl!_ Itr5T:lJ_ r:r HIM Tl*. t-mv:s. 111;tC�J<:iHil!� r�'lT Tf#-: 11N-�tI =J FF. S'r`:T2ii RRY ykr_rilJt':s_JIT IF II" r} F:E:iCf-Fb'.x. r•. f Zyxg1 Err TO , Irhy-i rv= tPY< rH:llf 4 <vhY.xertS - -- ------ :�."•`�_ t ..i1�re-: ,'•i.ti, l.`d r ral 5'r•5. IhX� ---?------ ------------vtrr _ - "� -- va ID MUNICIPALITY OF ANCHORAGE �, ."� �❑ PERCOLATION • \a DEPART OF HEALTH AND ENVIRONMENTAL ECTION TEST b[a L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERFORMED FOR: STF— VE N C2 LD V r-_ Q DATE PERFORMED: 1 - 210-tg2 LEGAL DESCRIPTION: �LC�T 3% U I LL_S IDE 'PA2 K ? Q D r-_-. SLOPE SLOPE SITE PLAN 1 (FEET)I ,C,ILr 2 - CZ..ti 3 `�'• L�l�t GO i>� kc" �6 i 6 ' 7 0`4 9 10 �o 11 G .a 12 Hol; 13 14 U-1 16 Y:•• •T9 17 * 49� 18 .... . ,UNE 25 197E ¢ �. 19 f 11 ;cs ..... • • • 20 `/�►� �� E� COMM PERFORMED WAS GROUND WATER . wt . ENCOUNTERED? �V IF YES, AT WHAT DEPTH? ■■r•.E_N_■_■■ Date Gross Time ■■.■-m" Depth to Water Net Drop ■■U ■■I ■■IM■■■■■■'. ■■■■■■N ■IVA■■■■■■I. ■M■■■■■■■ R ■"■■■■■■■" ■W■■■■■■■■ Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND FT CERTIFIED DATE: Ir 26.82 77-008 (4/79) �St 6�l �1 \ks w i Municipality of Anchorage • Development Services Department ppb Building Safety Division ... \� Onsite Water & Wastewater Program y 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519.6650 www.ci.anchorage.ek.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-122-56 HAA# / JrJf �rtfl 1. GENERAL INFORMATION Expiration Date: Complete legal description HILSIDE PARK SUBDIVISION: LOT 36. Location (site address or directions) 7081 CROOKED TREE DRIVE--• 'ANCHORAGE." -AK: 99516 Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address MICHAEL BURNS Dayphone (907) 346-3276 7081 CROOKED TREE DRIVE • ANCHORAGE. AK. 99516 Day phone SHARI BOYD w/ PRUDENTIAL JACK WHiTE Day phone 563-5500 3201 'C' STREET SUiTE 200 • ANCHORAGE, AK. 99503 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well ❑ Individual Water Storage ❑ Community Class -A• Well Public Water System ❑ TYPE OF WASTEWATER DISPOSAL: Individual On-site 0 Individual Holding tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineers work. 4. 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 Health Authority Approval Guidelines for this application, shows that the onsite water supply and/or wastewater disposal system Is(are) safe, functional and adequate for the number of bedrooms and typo of structure Indicated herein. I further verify that based on the Information obtained from the Municipality of Anchorage (les and from my investigation and Inspection, the onsite 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. Name of Finn GARNESS ENGINEERING CROUP, Ltd. Phone Address •3701 E. TUDOR ROAD, SUITE 101 0 ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, Ltd. attempted to provide a thorough, conscientious engineering analysis of the system 6r accordance with ADEC and MOA DSD Guidelines Q Regulations. The reported results described the performance of the system under the conditions encountered at the time of Me test, and separation distances measured to readily Identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwaterlevels 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 the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, Ltd. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report Is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any otherperson orparty Is not authorized, nor will It confer any legal right whatsoever. 5. DSD SIGNATURE V/Approved for q— bedrooms. Disapproved. 337-6179 Conditional approval for bedrooms, with the flowing stipulations: Attachments: HAA Checklist (/ Septic System Advisory Well Flow Advisory Manitenance Agreements Supplemental Engineers Reort Other ON-SITE _ •: • VYNIGt�n'•" • WASTEVATER �PRIIGf'�-' - By: n j A Original Certificate Date: (Rw. 17)01) Municipality of Anchorage • Development Services Department Building Safety Division On-SBe Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www,d.anchorage.ek.us (907) 343.7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: HILLSIDE PARK SUBDIVISION: LOT 36, Parcel ID: 015-122-56 A. , WELL DATA Wen type 9 Date completed Date of test Static water level Well production COMMUNITY WELL If A, B, or C provide PWSID#1� 2461 Sanitary Cased to ft. FROM WELL LOG ft. g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 ml. B. SEPTIC/HOLDING TANK DATA Nitrate Well Log protected (Y/N) Casing height (above ground) in. AT INSPECTION ft. g.p.m. Date of sample: Collected by: Tank TypelMaterial STEEL Date Installed 8/24/2004 Tank size 1250 gal, Number of Compartments 2 Cleanouts (Y/N) `ES Foundation cleanout (YM) YES Depression over tank (Y/N) NO High water alarm (YM) N/A ml. Date of pumping NEW Pumper C. ABSORPTION FIELD DATA Date Installed 2/10/1982 Soil rating (g.p.d./WW41!ErnD 125 System type TRENCH Length 63 ft, Width UNK ft. Gravel below pipe 4 ft. Total depth *8.83 ft. Elf. absorption area 500 ft' Monitoring tube *YES Depression over field NO Date of adequacy test 8/12/2004 Results (Pass/Fall) PASS For 4 bedrooms Fluid depth in absorption field before test 0 in. Water added 1034gal. New depth eisimsin. Elapsed Time: 4 min. Final fluid depth 2 In. Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN K yes, give date *MONITORING TUBE EXTENDS 26 INCHES TOO DEEP. D. LIFT STATION Date Installed Size in gallons "Pump on" level at _in. E. SEPARATION DISTANCES High water alarm level at in. Cycles tested Meets alarm & circuit requirements? SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tanklltft station on lot Absorption field on lot Public sewer main service line COMMUNITY WELL On adjacent lots Public sewer manhole/cleanout Holding tank SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 200'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Water main 100+ Water service line 10'+ Surface water 100'+ Driveway, parkingiveNcle storage 5'+ Curtain drain NONE KNOWN Wells on adjacent lots 200'+ F. COMMENTS G. ENGINEER'S CERTIFICATIONG _ I certify that I have determined through field inspections and review of Munidpa/ records that the above systems are in """' " ' "' .. """' conformance with MOA HAA guidelines in effect on this date. A. mesa: Engineer's Printed Name JEFFREY A. GARNESS Date 8�d�/y� �a�• �~ HAA Fee $ W y„! Waiver Fee $ _ Date of Payment Date of Payment Receipt Number } y O Receipt Number. (nev.1001) ; J 08/27/04 FRI 17:54 FAX 9077827518 SRARI BOYD'S OFFICE t LOT 35 �6 O - �o �E r/,b/ Ej\C, 1. V .SCpriC of Lot 30' , Block Hi//side fork P. U.D. J-/Z)�/ Anchorage Recordln� Precinct, Alaska L107-37 X002 RECERTIFIED LOT SURVEY CERTIFICATION LEGEND / I herebyterlify than l nave surveyed the propertyehDvn and described JZ c Brass capped morumentrecoveri hereon,and that the enprovemems shuated thereon are within the prop, O :Iron pipe and/or rebar recovered erty Ines and do rot overlop or encroach on odjacem prOperty and that no a - 2s21ub B tock reccvared Irtlprhemems on adjacent properly overlap or en6wchon the prermses • x 5M"x Wrebar Sat This StlrVey in TxsncA and that there are nor rcodways, ul'Ili:y lits or caher visible eosemems 0n said property except as indicated hereon. ILT 7• R L 60" ; Ml 192 P ••••"wVp •i FESUNAL V1 Scale/ /! Aj-� Date Prepared by: 1:1R. L. BUTTD// �(,/ o5 _03 85 Req%srae0 LonO Suneydr (9071279-6700 5/9 W. EignrAAve. dncAordge,.d/dske9950/ Rei. F B No Property of: 2539 .34-50 M%/`hr7.o/ R/ o MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 36 Hillside Park Subdivision (T12N R3W Section 14) Location (address or directions) 7081 Crooked Tree (b) Applicant Name RAndall Hintz Telephone: Home 346-2558 Business Applicant Address 7081 Crooked Tree (c) Applicant is (check one): Lending Institutional ; Owner/builder ❑ ; Buyer ❑ ; Other ❑ (explain); (d) Lending Institution Address Telephone (e) Real Estate Company and Agent Peter Jarrett, Heritage Homes Address 207 E. Northern Lights Boulevard Telephone 276-1333 (f) Mail the HAA to the following address: 4. 2. TYPE OF RESIDENCE Single -Family Qi x Multi -Family ❑ Other Number of Bedrooms four(4) 3. WATER SUPPLY Individual Well ❑ Community ©x Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite lix Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 m,84t b. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. l 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address Date Telephone Engineer's Seat All conditions of the Conditional Approval dated March 12, 1985 have been met, as per the engineer's letter dated May 10, 1985. This property now meets with MOA requirements and standards and is fully approved. 6. DHEP APPROVAL Approved for four(4) bedrooms by; --f ate May 14, 1985 Approved xxx Disapprov68 Conditional f Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 I �G JG°3G3dQaD9 PMLPALiry oR20AN 3 W. AOE 203 GE AL j 279799501 CONSULTING ENGINEER ncvr Oi I Icon � 8 ENVIRONMENTAL PROTECnM MAY 10 "5 RECEIVED MUNICIPALITY OF ANCHORAGE MAY 10, 1985 DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Re: Conditional Health Authority Approval, Lot 36, Hillside Park Madame; On March 3, 1985 a conditional approval was given for subject lot. The conditions for the approval have been met. The standpipes to the tank have been straigtened, and the tank pumped. Please furnish this office with an unconditioned approval. Yours Spurkland P.N. '• MUNICIPALITY OF ANCHORAGE ' DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIROIZ ENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE 1. General Information Application Date a/84.5 (a) Legal Description (include lot, block, subdivision, section, township, Location (address or directions) 7e81 C_2oatCtzi> -riZeE syb-z�s8' (b) Applicants Name ��a«�Q.,Bl.,�, Telephone - Home Business Applicants Address -709-1 QOa V t D 7 a E= E (c) Applicant is (check one) Lending Institution 1/K I ; Owner/builder ; Buyer [:] ; Other [� (explain); (d) Lending Institution Telephone Address (e) Real Estate Co. & Agent Address A07 C • No P_rK efZ L[ 6 0-S Telephone a.7 to — 13 S -) (f) Mail the HAA to the following address: pn1) -G, I, PI, 2. Type of Residence Single -Family' Multi -Family Number of Bedrooms 1 3. Water Supply Individual Well M Community M Other (describe) Public Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. Sewage Disposal Onsite 1 *41 1 Public Community Q Holding Tank Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1 of 21 . 5. Engineering Firm Providing Inspections, Tests, File Search, Data and Information As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is 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 oa-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regula- tions in effect on the date of this inspection. Name of Date 343 ($ 5 6. DHEP Approval 0 (ENGINEER SEAL) Approved for bedrooms By Approved Disapproved _ Terms of Conditional -n i iLfl— ter- b Telephone A79 -3q 11_� .................. /n• a. 2225-E �'• LUNE 2S, 071 Conditional £'SCrCt.'•CdRami CAUTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE- MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK. (DHEP SEAL) RR4/ej/D18 [Page 2 of 21 7-19-84 A. WELL DATA 5 MUNICIPALITY OF ANCHORAGE (MOA) AUTHORITY APPROVAL (HAA) - FEBRUARY 1984 Legal Description: Well Classification r -J ASS A If A, B, or C, Well Log Present (Y/N) Date Ccnpleted Total Depth Cased to Static Water Level Pump Set At fAUNIuarurr c= U � h85 D.E.C. Approved(Y/N) yE S Yield Depth of Grouting Casing Height Above Ground Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot �L130 �' ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot OU0 +I-- on Adjoining Lots To Nearest Public Sewer Line Clearcut/Manhole Water Sample Collected By Water Sample Test Results COME nts B. SEPTIC/HOLDING TANK DATA To Nearest Public Sewer To Nearest Sewer Service Line on Lot Date Date Installed _r2-le.M Size )ASO No, of Crnpartmerts Tvyo Standpipes (Y/N) y Air -tight Caps (Y/N) y Foundation Cleanout (Y/N) Y Depression over Tank (Y/N) P4 Date Last Pumped Se.. e•. "-r-AF4 Pumping/Mainterance Contract on File (Y/N) I✓/A ; for N/A Holding Tank High -Water Alarm (Y/N) MIA Temporary Holding Tank Permit (Y/N) N/A Separation Distances from Septic/Holding Tark: To Water -Supply Wall .Leo To Building Foundation i To Property Line 1b+ To Disposal Field I* To Water Main/Service Line /O To Stream, Pond, Lake, or Major Drainage Receipt M 49 Date Paid: _g - -6 � Amount: [l en Q'- [Page 1 of 21 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 125 Type of System Design TR C N eN Date Installed R. • IV • az Length of Field G3 4 --- Width of Field 3d + ✓ Depth of Field a Gravel Bed Thickness y� `- Square Feet of Absorption Area Sep ✓ Standpipes Present (Y/.1) Depression over Field (Y/N) Q Date off Last Adequacy 'lest Results of Inst Adequacy Test fig,-�:.SA cyo r.� Separation Distance from Absorp—tion. Field: To water -Supply Hall ab0 + To Property Line /D + To Buildirg Foundation sz® To Existing or Abandoned System or. Lot AID N E t On Adjoining Lots 30 4 - To Water Main/Service Lire /O'. ' To Cutbank(if present) NOME To Stream/Pond/Lake/or Major Drainage Cause NONL To Driveway, Parking Area, or Vehicle Storage Area 6o Ccmnents D. LIFT STATION NONE Date Installed Dimensions Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes(YN) Comments Manhole/Access (Y/N) "Pump Off" Level at Vent (YN) Pumping Cycles doing Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or ccnforried to all MOA HAA Guidelines ir effect on the date of this irspection. Signed Date S 79/�s Ccnpary `�� MOA No.&5S7_-01/ KEl/d5/s [Page 2 of 21 OF At �l 00 .. 2225-E r n•. NE 25, 1971 2-15-84 BILL SHEFFIELD, GOVERNOR DEPT. OF ENVIRONMENTAL CONSERVATION Telephone: (907) Addnu: ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 274-2533 ANCHORAGE, ALASKA 99501 DATE: .318185 PWS I.D./ aJ a s16i To Whom it May Concern: According to records on file in this office the Water System is in compliance with the State Drinking Water Regulations Sincerely, 3 W. 15th AVE "C" SUITE 203 Von n LS� � Pada �� Polio �20A CHORAGE.ALASKA99501 CONSULTING ENGINEER TELEPHONE: (907) 279-3916 PETER JARRETT HERITAGE HOMES 207 E NORTHERN LIGHTD BLVD. ANCHORAGE, ALASKA 99503 S E P T I C S Y S T E M MARCH 8, 1985 A D E Q U A C Y T E S T LEGAL: LOT 36 HILLSIDE PARK LOCATION: 7081 CROOKED TREE OWNER: RANDALL HEINTZ RESIDENCE: FOUR BEDROOM, SINGLE FAMILY WATER SYSTEM: CLASS A, COMMUNITY SYSTEM SEPTIC SYSTEM: FROM MUNICIPAL RECORDS: TANK: GREER STEEL, 1250 GAL. TWO COMP. ABSORPTION SYSTEM: TRENCH ABSORPTION AREA: 500 SQ.FT. SOIL RATING: 125 INSTALLATION DATE: OCTOBER 1982 DATE OF PUMPING: CLEAN OUT TO TANK HAS MOVED AND ACCESS TO TANK PREVENTED. TANK NOT PUMPED DATE OF TEST: MARCH 7, 1985 TEST PROCEDURE: WATER WAS ADDED TO THE DRAINFIELD AT A STEADY RATE OF 8 G.P.M. WATER DEPTH IN TRENCH WAS MONITORED. AFTER ADDING 610 GALLONS THE WATER DEPTH HAD NOT CHANGED FROM THE ORIGINAL DEPTH OF 10 INCHES. TEST RESULT: THIS SYSTM ACCEPTED WATER AT A RATE OF 8 GALLONS PER MINUTE. IT SURPASSES THE MUNICIPAL REQUIUREMENTS. 1� Of�\��� a; The operational life of all septic �pl�,.••• systems depends on the local soil conditions, y; y+r groundwater levels that may fluctuate during *:,4 gT�t••••%*r the year, and the water usage of the family %•• ••• ••••••••a being sereved by the system. These conditions o� ••• •2225•E •.'e-% outside the controlf the of unot rgive this septicsystem cantherefore JUNE 25. 1371 _,;�: any estimate of how long the system will �� °!s • ,.•;iJ��� continue to meet the operational requirements iZlb�C� of the Municipality and State. 1 10 DA'Y RECEIVED .. .... - INSPECTION APPOINTMENTS v (j TIME TIME TIME . DATE DATE DA SINGLE FAMILY INSPECTOR _.. INSPECTOR .__ ...._.._-..., .. INSPECTOR ..._-.... __ .. ..... ❑ Three ❑ Six 7. WATER SUPPLY ❑ INDIVIDUAL' MUNICIPALITY OF ANCHORAGE C& COMMUNITY 1I. -G a Pls% NL \ DEPARTMENT OF HEALTH& ENVIRONMENTAL PROTECTION ❑ PUBLIC UTILITY 1 825 L Street • Anchorage, Alaska 89501 8. SEWAGE DISPOSAL SYSTEM ENVIRONMENTAL SANITATION DIVISION VU INDIVIDUAL/ON-SITE" Telephone 264-4720 ❑ PUBLICUTILITY REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing _.,v.. 1 PROPERTYOWNER _/ .... 1 ,.,; PHONE ,•• ., ,. ,. 39 MAI LING A DRESS . 0. Bele ` %O '7!e 2414e,4. Ak. 99 s// PROPERTY RESIDENT fit different from above) - PHONE 2. BUYTR Mr H N MAILING ADDRESS , 3. LENDING INSTITUTION PHONE MAILING AD HESS 4. REALTOR/AGENT /' %rrlN (1%�(fS 41 1 rO PHONE at r t)oar r MAILINGADDRESS I 3 a O/ -'[r '• 5�., ��� iiorz �k 99003 �_ . I S. LEGAL DESCRIPTION 3G Ari�i v . - 10-1/b STREET LOCATION - ION roe k�.l , TPe• Dv;✓e 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS , SINGLE FAMILY ❑ One UK Four ❑ Other ❑ Two ' ❑ Five ❑ MULTIPLE FAMILY ❑ Three ❑ Six 7. WATER SUPPLY ❑ INDIVIDUAL' a ATTACH WELL LOG. A well log is required for all wells drilled C& COMMUNITY 1I. -G a Pls% NL " since June 1975. For wells drilled prior to that date, give well .. ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM VU INDIVIDUAL/ON-SITE" q Z YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLICUTILITY /V�ad !°o.csfvK�{tok NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PHUCESSING CAN BE INITIATED. n-vtv ltsev. a�el e��� V ^�L cv*�� / $T Jo.�"'. _ C 1. Q• 140 i sa -Tom- July 21, 1982 Professional Planning Systems, Inc. F.O. Box 10-762 Anchorage, AIC 99511 Subjectz Lot 36 hillside Park FUD Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: The second standpipe to the septic tank has been knocked over and will need to be installed. 4 -S3Z O L- me L'! - Please notify this Department for a reinspection when the noted discrepancies have been corrected. If there are any further questions, please call this office at 264-4720. RP173/p/Eti Sincer y, L Y/" Robert C. Pratt Associate Environmental Specialist