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HomeMy WebLinkAboutLYDALE LT 5Lydale Lot 5 #050-293-89 �Certifte� �riC�ir�g � �.og by DOC co. dG SULLIVAN WATER WELLS P.O. BOX 670272, CHUGIAK, ALASKA 99567 *TELEPHONE 688-2759 OWNER OF LAND: miLl.hr f�J ayI L' GU7it]i3.�. LEGAL DESCRIPTION: I-- Yr%-h.c < oT DATE 71 FI U b PERMIT NUMBER: 12s<6092 Date of Issuer- La -.Qb TAX IDENTIFICATION NUMBER: .%dY3- —j?:!7 Is well located at approved permit location? LLyes�O No Method of Drilling: v rotary O cable tool Depth of well: Casing Type `r h Wall Thickness inches Diameter 0 inches, depth feet Liner Type: L$ 4 4 t! c' Casing Stickup Above Ground: d • feet Static Water Level: 4 O feet Recover Rate: 10 gpm Method of Testing: '411L. Well Intake Opening Type. L'pen end 0 open hole ❑ Screened: Startfeet Stopped feet • Perforations Start �_ feel $supped feet Grout Type: 3a-?o.vi i c CVo/lume Depth: from /,t feet, to A 0 feet Well Disinfected Upon Completion? U-Yes�O No��qq Method of Disinfection: r :c •'.Je� ' ��l) h// Comments: Cr9f�.Jc, Srfc.�.J.o s cT r � 4A✓F� }r'�9�zDSPis� T I. r7—'� Ac.cr'Ri ,Sp"4 elxAJc-GCStgTi�2 Driller's Name -��. p ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority. Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. Matsu Borough: Department of Environmental Conservation. ARCTIC PUMP & WELL INC. Jim Sullivan PO Box 770197 arae Eagle River, AK 99577 (907) 688.2510 (907)258-2510 (907) 745-2510 an%V15 eci.net Pump Installation Log Well Drilling Permit Number: SW060092 Parcel Identification Number:050-293-89 Date of Issue:5-12-06 Legal Description:Lydale Property Owner Name & Address: Lot:5 Wolfe domes Block: POBX871158 Polmnr AK 006.RR Pump Installation Date: 8-3-06 Pump Intake Depth Below Top of Well Casing: 157 Feet Pump Manufacturer's Name: Pump Model:L-50 Pump Size: 1/2 Pitless Adapter Burial Depth: 10 Pitless Adapter Manufacturer's Name: Pitless Adapter Installer:U/K Dempster hp feet U/K Arctic Pump & Well, Inc. Well Disinfected Upon Completion? Yes Method of Disinfection: Chlorine Comments: Pump Installer Name: Arctic Pump & Well, Inc. Arctic Pump d Well, Inc. Page 1 of l LOT 1 I .9' LOT 2 Water Well LOT 1 I LOT 2 l S89W58'00'E 117.00' — T 20' �r Emernml :;� I � L 77-c, r — — — — 1 Story Haas . EAGLE RIVER ROAD LOT 4 ��••• NOTE: I)Bcarings and distances arc per recorded plat #80-82. 5ENTEC 1 ME 91 ME N Q TELECOM. PEDESTAL Surveying • Engineering SURVEY ' TIFI TI N: Inc he, ELECTRIC TRAWOMIER 2525 Gambell Street, Suite 200, Anchorage, Alaska 99503 cordroted a physical survey or this property as ihown © CAS LIM Tele: (907) 5633835 Fax: (907) 543-3817 ° the improvements situated O EIiCTRIC LIFTER r AS BUILT OF: LEGAL DESCRIPTION � ga the property lines and m ernosehments atict odh mm noted. WATER Lot 5 EXCLUSION NOTES: It is the owner resp°mibiliry VALVE L dale Subdivision, Alaska todeterrainethe ateteneeofmyeuements.covenmu WATER IeMW or taCictiom which do not Wppear on the recorded NOVEM m 17 m subdivision plat NOTE: Under no cimmntarees O C1FANpJi 06-4486 `g;. M,,•. G`w rahouldMy meonccumdibrthe conmuctionor �ELECPOLE _ lishirg of property tines. MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water B Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WATER SUPPLY PERMIT Initial Date Issued: May 12, 2006 Expiration Date: May 12, 2007 Permit Number: SWO60092 Parcel ID: 050-293-89 Legal Description: LYDALE LOT 5 Design Engineer: 0000 None Required Site Address: 18739 EAGLE RIVER ROAD Owner Name: WOLFE HOMES Lot Size: 15210 SO. FT. Owner Address: PO BOX 871158 Total Bedrooms: 3 Permit Bedrooms: 3 PALMER. AK 99688 - 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 specked 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. Issued By. Date: Date: .S,/2-06 Municipality of Anchorage -•\ Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 www.muni.org/onsite (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 4 r-1 5 (1-3 Q 12 9 Property owner(s) I OQ 1 _f �e &ACS Day phone i i S - -S 9 6 / Mailing address PO Sri // S 8 PLi 1 Ptd e to Zip Code Site address i7 9 �� d[in _Zip Code 9 9(2 b 2 Legal description (Sub'd., Block & Lot) Lo -F Legal description (Township, Range & Section) Lot Size 5 I Ib Sq. Ft. THIS APPLICATION IS FOR (® all that apply): Absorption Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well Water Storage ❑ Number of Bedrooms 3 THIS APPLICATION IS AN: Initial ❑ Upgrade ❑ Renewal ❑ 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. (Signature of property ownew�uthorized agent) Permit/Rush Fees: Pis— / Waiver Fees: Date of Payment 5—NIOlp Date of Payment: Receipt Number. Vo? Fg Receipt Number. (Rev. 11105) i i LOT 1 LOT 2 89'58'00" W .AGLE RIVER ROAD i LOT 3 — r...a.000,40 ..—..u.....� ; MMIC , •. J. HORNE; 8 i NTo. �♦�9F� /LS5y318 Tl�i'. �.1 �,'NC NOTE: 1) Bearings and distances arc as per plat#80-82 \ 1III• p ROFESS IOak1- 2 Elcv. Asumcd s E w ER as q I *. S If NTE C LEGEND © CABLE N p TELECOM. PEDESTAL ® ELECTRIC TRANSFORMER Surveying• Engineering SURVEY CERIIFICA-1IUN:SL•NTLCInc. has 2525 Gambell Street, Suite 200, Anchorage, Alaska 99503 conducted a physical survey of this property as shown M WATER VALVE Tele: (907) 5633835 Fax: (907) 563.3817 on this drawing and that the improvements situated thereon arc within the property lines and no WATER HYDRANT PLOT PLAN: LEGAL DESCRIPTION encroachments exist other than noted. Q SEPTIC VENT EXCLUSION NOTES: It is the owners responsibility LOT 5, LYDALE SUBDIVISION to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. NOTE: Under no circumstances "�a01"""` � ,x seni*� net 06,278 ,,,•••, ,,20D6 ,,,•<„ .m,.,,.. should any data hereon be used for the construction or SPU MFE NIA w- for the establishing of property lines. G W J V 3 CD O J 0 Fi S'c..L_ W '•� Is4fl••4.l.0 W Jcr• �=w W V LL G O e Z iUDd3U N01103dSNI HAM I m O Z 4 W J V s to V W H J W O Y S N Z w a .! J LU O v ¢ ¢Im W O N Ci C' W W O 'S m W C N F Q V O J C3 0 N x a W O F W 2 1` O C L2 L. �IL a W a ri P.1 f11 0 1 Q CD j Z J F W z N Z VJ 60.1 G� 84 • Municipality of Anchorage °T On -Site Water and Wastewater Program (907) 343-7904 Certificate of On -Site Systems Approval Parcel I.D. 050-293-89 Expiration Date: 2-3-17 1. GENERAL INFORMATION Complete legal description Lydale, Lot 5 Location (site address) 18739 Eagle River Road Eagle River, AK 99577 Current Property owner(s) Kimberly Kincaid Day phone Mailing address 18739 Eagle River Road Eagle River, AK 99577 Real Estate Agent Shannon Parberry 2. TYPE OF DWELLING: (] Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System WaiverNariance request for. Three Day phone 232-0227 TYPE OF WASTEWATER DISPOSAL: Received by: I Zj 2y 1,(A)1 �/,/il i COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ CIQU O Date of Payment ��0� LO Receipt Number COSA# 05CIM62c) Date: 1113 Waiver Fee $ Date of Payment Receipt Number Waiver # Individual � ! C] ElHolding Tank ElElCommunity ❑° L j Public Sewer ® U Received by: I Zj 2y 1,(A)1 �/,/il i COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ CIQU O Date of Payment ��0� LO Receipt Number COSA# 05CIM62c) Date: 1113 Waiver Fee $ Date of Payment Receipt Number Waiver # 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. Name of Firm Anderson Engineering Address P.O. Box 240773 Anchorage, AK 99524 Engineers Printed Name Michael E. Anderson, P.E. 6. DSD SIGNATURE System #1 Approved for 3� bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for Phone 522-7773 Date 10/31/2016 bedrooms, with the followin By: I I A Original Certificate Date: a 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 ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet r'- ! . If more than 1 septic system is on the lot: COSA Checklist # of Structure served by this system • "Certificate of On -Site Systems Approval Checklist Legal Description: Lydale, Lot 5 A. WELL DATA Well type Private If A. B, or C provide PWSID # Date completed 7-8-06.'- Sanitary seal (YIN) Y Total depth 169 -ft - Cased1to —MI(PE) FROM WELL LOG Date of test – 7-8-06 -- Static "water level 140 ft. Well production 10 g.p-m- WATER SAMPLE RESULTS: Coliform:' 0 ' colonies/100 mL Nitrate 3.10 mg/L Arsenic ND ug/L Date of sample: 10/18/16 B. SEPTIC/HOLDING TANK DATA - Tank Type/Material Tank size gal. Number of Compartments Foundation cleanout (YIN) _ Date of pumping Parcel ID: 050-293-89 Well Log (YIN) Y' Wires properly protected (YIN) Y Casing height (above ground) >18 in. AT INSPECTION - 10-5-16 , 145.8 4:1 9 -p.m - Collected by: And. Engineeringl' Date installed Cleanouts (YIN) Depression over tank (YIN) _ High water alarm (YIN) Pumper C. ABSORPTION FIELD DATA I Date installed Soil rating (g.p.d./11:2 or ft /bdrm) System type Length ft. Width ft. Gravel below pipe ft. Total depth: ft- Eff. absorption area _ft • Monitoring tube Depression over field Date of adequacy test , Results (Pass/Fail) For bedrooms Fluid depth in absorption field before test in. Water -added , gal.. New depth• in. Elapsed Time: min.Final fluid depth in. Absorption -rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) If, yes, give date D. LIFT STATION Date installed "Pump on" level at in Datum E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main >75' Size in gallons _ "Pump off" level at Cycles tested _ Sewer /septic service line >25' Animal containment areas >50' SEPTIC/HOLDING TANK ON LOT TO: Building foundation Water main Property line Water service line Wells on adjacent lots ABSORPTION FIELD ON LOT TO: Property line Building foundation Water Service line Surface water Curtain drain Wells on adjacent lots Manhole/Access (Y/N) _ in. High water alarm level at T1 Meets alarm & circuit requirements? On adjacent lots >1 00' On adjacent lots >100' Public sewer manhole/cleanout >100' Holding tank >75' Manure/animal excrete storage areas >100' F. COMMENTS Property is Served by AWWU Sewer System. G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineers Printed Name Michael E. Anderson, P.E. 10/31/2016 COSA brown sheet_70.10-12.doc Absorption field Surface water Water main Driveway, parking/vehicle storage 9