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HomeMy WebLinkAboutSHANGRI-LA LT 21Shangri-La Lot 21 #020-043-39 Municipality of Anchorage Development Services Department Building Safely Division On-Site Water and Wastewater Program, 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 Page of www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM ANDIOR WELL INSPECTION REPORT Permit Number: swo080046 PID Number: 020-043-39 Name Willowridge Construction Wastewater System: WNew El Upgrade Address. 5532 Yukon Charlie Loop Anchorage, AK 99502 ABSORPTION FIELD Prone Number of Bedrooms 317-0051 Eight [3 Deep Trench m Shallow Trench Dead ❑ Moune El Other Sal Rating Total Depth from onginal grade LEGAL DESCRIPTION 3 GPDIFt` 1 Ft. BlpFk. Lot. 21 Smiwvon Shangn La Depth 10 pipe mdam♦Z ongmal grade. Grar+el depth bensathF pe r Ft. J Ft Townahip. Range Sectbn Fill added above original glade. Gravel Length' 2-3 Ft. 80 Ft. Well: © New ❑ Upgrade Gravel vnM Number of Inns 2 Distance between linea >10 5 Ft. rt Claaedicatam (Pnvete. A, B. C) Total Depth Cased to Total absorption area. Pipe Material. Private 306 Ft. I 44 Fl 1,200 Fe ASTM D3034 PVC Driller Date Dhlled StatkwNer Level mstilkr Data installed. Alpine Drilling 5131/08 48 Ft Red Dog Excavation 8119-25109 Yield Pump Set at CaamgHeightA veGroondF TANK 4 GPM Ft SEPARATION DISTANCES ❑ Septic ❑ Holding ❑ S.T.E.P. m Other: To Septic Absorption Lift Holding ublic/Private Mismulaidanar Capitols From Tank Field Station Tank Sewer Line Advantex/Anchorage Tank 3.500 Gal Material. Number of Compartments wet >100' >100' NIA N/A >25' Steel Two (2) sort. Water >100' >100' N/A N/A LIFT STATION she maranmunir Lot Line >5' >10' NIA N/A 500 Gal. Orenco/Anchorage TAnk 'Pomp or- kvel at 'Pump W keel rtHgh wetter alarm at. Foundabpn >5' >10' N/A N/A 28 n28 in. 32in Pump Make 6 Model Elednul InspeFit.. performed by: Cunem Chain None Noted OSI P2005-11 Muni. of Anchorage Famalks Organic Matenal Removed From Trench Area to 1' BENCH MARK Lpratnn and Deavgepn Below Surface. Coarse Sand Placed to Original Ground Garage Slab. Assorted Elesaeon Surface. 100.0 Ft Z Inspections performed by: A Harala Dates: 1M 8/20/06 �.�� pF "tilles aw •......tee q 1 21'd 8/25/09 Development Services Department Approval . (?"a 4 9 111 Conditional Approval _ _Date luaus a AHMS014: a4 �� Reviewed and approved by: Date: J 15 �� Ife PROrES5t0��� IRn lunv,l �1��������� Municipality of Anchorage Permit Number: SWO80048 DEVEOPMENT SERVICES DEPARTMENT PID No. 020-043-39 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 Page 2 of 4 On -Site Wastewater Disposal System or Well Inspection Report A B C D 51 29.2 15.0 MH1 39.3 17.3 MH2 45.1 22.0 M1 93.2 98.9 M2 111.3115.6 �I i i 49th ..... .....:....I Al MICHAEL E. ANDERSON n f No. CE -4381 RAT NO. 2002-119 SHANGRI—LA SUBDIVISION LOT 21 197,917 S.F. 19 O PLAN AS BUILT SCALE 1' = 100' Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit No.: SWO8OO48 s 121 122. 2' Insulation and Geotextile Fabric WWRAO'd ROW 114.0 No Groundwater 8/19/09 40' (Trench Length) PROFILE AS -BUILT Scale: NONE 125.5 126.3 Page 3 of 3 PID No. 020-043-39 22.4 23.1 i� 49th F A, �...........t r�Q....�...�...`.... n'; MICHAEL E. ANDERSON • �fA No. CE -4381 1 2 4 5 6 7 8 9 10 11 12 13 15 16 17 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT/ BUILDING SAFETY DIVISION ON-SITE WATER AND WASTEWATER PROGRAM 4700 BRAGAW ANCHORAGE, AK 99519 SOILS LOG - PERCOLATION TEST PROJECT #: PERFORMED FOR: Willowridpe Construction DATE PERFORMED: 8/20/2009 LEGAL DESCRIPTION: Lot 21 Shanari La Subdivision TCCT Wei G ±' 4 SLOPE SITE PLAN 71 Organic Layer - OL Silty Gravel with Sand Bedrock @ 6' WAS GROUNDWATER ENCOUNTERED9 No IF YES, WHAT DEPTHS DEPTH OF WATER AFTER MONITORING: DATE: . .L 49th ? MKHAM E AIUWNSgI No. ¢-Un •.._ S'- to . n..' S L 0 P E SEE SITE PLAN SEE SITE PLAN PERC RATE: _ MIN./INCH PERC. HOLE DIAMETER:_ TEST RUN BETWEEN FT. AND T. COMMENTS: Test Hole to Confirm Bedrock Depth. TEST PERFORMED BY: ALAN HARALA I, MICHAEL E. ANDERSON, CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES ON THIS DATE: S/26/2O11 ALPINE DRILLING & ENTERPRISES Permit Number: #SW080048 ate of issue: 5-15-08 Parcel Identification Number: 020-043-39 Date Started: 5-30-08 Date Completed: 5.31-06 Is well located at approved permit location? ® Yes ❑ No Legal Description: Shangri La Lot 21 Property Owner Name & Address Willowridge Construction Company 5532 Yukon Chadie Loop Anchorage, Alaska 99502 Borehole Data: Depth (ft) !Method of Drilling Z air rotary ❑ cable tool Soil Type, Thickness & Water Strata From To Casing type: steel Stick-up 0 1.5 Wall Thickness: .025 inches gravelly silt 1.5 3 Diameter: 6 inches Depth: 44 feet bedrock 3 306 Liner Type: Diameter: inches Depth: feet Casing stickup above ground: 1_5 feet Static water level (from ground level): 48 feet Pumping level: 300 feet after 2 hours purnping 4 gpm Recovery Rate: 4 gpm Method of Testing: air kR Well Intake Opening Type: ❑ Open End ® Open Hole ❑ Screened Start feet Stopped feet ❑ Perforations Start feet Stopped feet Grout Type: bentonite chips Volume: 5bQs Depth: Start 0 feet Stopped 44 feet Pump: Intake Depth feet WATER ' ITY TESTING ( COIIfMRI ��( e�, 1l100ML pump size hp Brand Name Well Disinfected upon Completion? ® Yes ❑ No Method of Disinfection: chlorine tablets —Af86rtIC g/L —j Comments: Well Driller: Alpine Drilling 8 Enterprises P.O. Box 110496 Anchorage, AK 99511-0496 Attention: The well driller shall p Ovide a well log to the property owner within 30 days of completion and the property owner or the well driller shall provi de a well log to the Development Services Department within 60 days of completion. Development Services Department Building Safety Division eOVE 8(// On -Site Water & Wastewater Program o 4700 Elmore Street P.O. Box 196650 LM Mark 8egich Anchorage, AK 99519-6650 Mayor w .muni.org/onsite (907)343-7904 Pump Installation Log Well Drilling Permit Number: SW080048 Date of Issue: 5115108 Parcel Identification Number: 020-043-39 Replacement Only: YES NO Legal Description Lor 11, Shangri La Pump Installation Date: 1012512009 Pump Intake Depth Below Top of Well Casing: 290 feet Pump Manufacturer's Name: Grundfos Pump Model: 15SQE15-290 Pump Size 1.5 hp Pitless Adapter Burial Depth: 10 feet Pitless Adapter Manufacturer's Name: Maas -C-6 Pitless Adapter Installer: Aarow Pump & Well Service LLC Well Disinfected Upon Completion? ® Yes ❑ No Method of Disinfection: Recirc Comments: Pump Installer Name: Property Owner Name & Address: Willow Ridge Construction Aarow Pump & Well Service LLC PO Box 110496,Anchorage, AK 99511 (907) 346- 9355 Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water d Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Renewal Permit Number: SWO90063 Legal Description: SHANGRI LA LOT 21 Design Engineer: 0014 ANDERSON ENGINEERING Owner Name: WILLOWRIDGE CONSTRUCTION COM Owner Address: 5532 YUKON CHARLIE LOOP ANCHORAGE. AK 99502 - Date Issued: May 18, 2009 Expiration Date: May 18, 2010 Parcel ID: 020-043-39 Site Address: NHN LOST HORIZON DRIVE Lot Size: 197917 SQ. FT. Total Bedrooms: 8 Permit Bedrooms: 8 This permit is for the construction of: Q Disposal Field Q 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. 5. The following special provisions. CONFIRMATION TEST HOLES FOR BEDROCK ARE TO BE MADE AT THE TIME OF CONSTRUCTION. PLEASE SUBMIT STAMPED AND SIGNED RESULTS WITH THE AS -BUILT INSPECTION REPORT. IF THE RESULTS REQUIRE A DESIGN CHANGE, CONSTRUCTION OF THE SYSTEM WILL STOP PENDING ON-SITE REVIEW AND APPROVAL. 5/30/08: Well location moved to the east. DMW Received Issued Date: YEA t Date: 5� Municipality of Anchorage Development Services Department Building Safety Division I _ On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, Alaska 99507 www.muni.org/onsite (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. Q-)0- Oy3' 3 7 Property owner(s)\N1 0w12iagc (fonS4-ruC+%o1,LLC Day phone -7 v'l Holding Tank Mailing address SS s. z YkKo..r C H A rz L1 r- L- w' Zip Code i 9 9TvL Site address / 7 /rte 3 t-osT Hce-Q o,r ac. Zip Code Legal description (Sub'd., Block & Lot) L=a 1 , i' 1-44-rJr'2 /-C 4 - Legal description (Township, Range & Section) Lot Size /97,917 Sq. Ft. Number of Bedrooms D THIS APPLICATION IS FOR (® all that apply): Absorption Field Septic Tank Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ THIS APPLICATION IS AN: Initial Upgrade Renewal 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. owner or authorized agent) Permit/Rush Fees: l/�i0 Waiver Fees: Date of Payment: ✓ /e % Date of Payment: Receipt Number: OI3728 Receipt Number: (Rev. 11105) 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 /WATER SUPPLY PERMIT Initial Permit Number: SWO80048 Legal Description: SHANGRI IA LOT 21 Date Issued: May 15, 2008 Expiration Date: May 15, 2009 Parcel ID: 020-043-39 Design Engineer: 0014 ANDERSON ENGINEERING Site Address: NHN LOST HORIZON DRIVE Owner Name: WILLOWRIDGE CONSTRUCTION COM Lot Size: 197917 SQ. FT. Owner Address: 5532 YUKON CHARLIE LOOP Total Bedrooms: 8 Permit Bedrooms: 8 ANCHORAGE. AK 99502 - 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. 5. The following special provisions. CONFIRMATION TEST HOLES FOR BEDROCK ARE TO BE MADE AT THE TIME OF CONSTRUCTION. PLEASE SUBMIT STAMPED AND SIGNED RESULTS WITH THE AS -BUILT INSPECTION REPORT. IF THE RESULTS REQUIRE A DESIGN CHANGE, CONSTRUCTION OF THE SYSTEM WILL STOP PENDING ON-SITE REVIEW AND APPROVAL. 530/08 64+,t( locafim mov-d to -Ae. cao . kMk/ Received By: Date: s /i - 00, \ Municipality of Anchorage 1'•T �b • -� Development Services Department Building Safety Division '• On -Site Water and Wastewater Program s 4700 Bragaw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 www.muni.org/onsfte (907) 343-7904 ON-SITE SEWERIWELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 020.043-39 Property owner(s) Willowridge Construction Company Day phone 317-0051 Mailing addreSS 5532 Yukon Charlie Loop Anchorage, AK Zip Code 99502 Site address Lost Horizon Drive Anchorage, AK Zip Code 99516 Legal description (Sub'd., Block & Lot) Lot 21, Shangri La Subdivision Legal description (Township, Range & Section) Lot Size 197.917 Sq. Ft. Number of Bedrooms Eight (6) THIS APPLICATION IS FOR (® all that apply): • THIS APPLICATION IS AN: Absorption Field i] Initial Septic Tank i] Upgrade ❑ Holding Tank ❑ Renewal ❑ Privy ❑ Private Well M. Water Storage ❑ 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. (Signature of property owner or authorized agent) Permit/Rush Fees: Waiver Fees: Date of Payment: `313/198 Date of Payment: Receipt Number. X05512- Receipt Number. (Rev. 11105) ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 1 677-7766 (FAX) February 29, 2008 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 21, Shangri La Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Lot 21, Shangri La Subdivision intends to construct an eight -bedroom home on the lot. We are therefore requesting a permit be issued for construction of a well and septic system to serve the new home. The size of the septic system and the proximity of bedrock to the ground surface limit the available area for the sewage disposal system and make it difficult to place a conventional septic system. We have therefore decided to place an Advantex Treatment System on the lot to provide the most effective treatment of the septic effluent prior to discharge into the surrounding soil strata. The location of the absorption system is shown on the attached Site Plan. Drainage pattems are also shown on the plan and will not be modified as a result of the proposed construction. The test holes placed on this lot revealed silty gravel soils with some sand (GM). The percolation rate in the materials encountered in the area near the new system was 15 minutes per inch. No groundwater was found but bedrock was encountered at 8' below the surface. Our design provides for the bottom of the absorption trench to be as shallow as possible. We are therefore proposing to place an eight -bedroom Advantex Treatment System. The absorption trenches will be 50' long x 5' wide x 1' effective depth. The distribution line in the trench will be placed at .5' below the existing ground level. Total depth of the trench will be 1.5' below the surface. 3' of fill will be placed above the trenches and 4' over the septic tank to meet Municipal Code and prevent freezing. Insulation with 2' of fill may be placed instead of the total 3' of cover. The ground surface of the lot slopes at 20% to the northwest near the location of the primary absorption trench site. The trenches will be constructed parallel with the slope as much as possible in conformance with Municipal requirements. All components of the new septic system will be constructed a minimum of 100' from any surface water Lot 21, Shangri La Subdivision February 29, 2008 Page Two and 100' from the well proposed for this lot. No conflicts exist between the proposed well and septic system and those in the area. If the system is constructed in accordance with our design the following statements apply: The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, Michael E. Anderson, P.E. Attachments t ?. 49;- V--A--- 9;^ VC^A__ E A%-, ';SO% LOT 21, SHANGRI LA SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Eight Bedroom Home Perc. Rate: 13.5 Min./inch Application Rate: 3 GPD/SF 5' Wide Trench System 8 Bedroom Advantex Treatment System 500 Gallon Lift Station .5' Drainfield Rock 8 Bedrooms' 150 GPD/Bedroom = 1,200 SF Absorption Area 1,200 SF/3 GPD/SF/5 SF/LF'No (Red. Factor) = 80 LF Trench Length THEREFORE: Construct 2 40' Long x 5' Wide x No Effective Depth Absorption Trenches. Flow Line Elevation in Trench to be 2" Above Original Ground Surface. Total Depth to be 2.0' Below Existing Ground. Provide 3' Cover Over Absorption Trenches and 4' Cover Over Septic Tank Maintain 100' Separation From Surface Water and Subdrain Outlets. Revegetate Upper 6" Natural 3' Cover or 2" Insulation Backfill Sheeting as Necessary end T Cover to Support Fill 6" o Geotextile t Fabric 6" a 2()% Naturot S Drainfiekt Rock As (ryp. Both Trenches) 2" Insulation Req'd. (TYp. Both Trenches) As I" Perforated Remove Organics to Req'd. PVC (Holes Down) 5 Underlying GM Layer 3/16" Diameter Holes @ 7 O.C. Replace w/Filter Sand (Typ. Both Trenches) F-� 5' 10' TYPICAL 5' WIDE TRENCH SECTION (NO SCALE) �•�PxE' 9 NOTE: Grade Area Over Trench to Drain Away. : a Minimum S' Separation From Bedrock Minimum 2' Separation From Groundwater. i7Y r.....;...__ ____.__..__.., Minimum 10' Separation From Water Service Line. ��; ruuEtE uoEasa Minimum 100' Separation From Surface Water or Streams: ## �N ; No. cEJ i Minimum 100' Separation From Private Wells. �i •._ .r� d=� a:' LOT 21, SHANGRI LA SUBDIVISION - ALTERNATE SITE DESIGN FACTORS: SYSTEM REQUIREMENTS: Eight Bedroom Home 5' Wide Trench System Perc. Rate: 13.5 Min./inch 8 Bedroom Advantex Treatment System Application Rate: 3 GPD/SF 500 Gallon Lift Station .5' Drainfield Rock 8 Bedrooms' 150 GPD/Bedroom = 1,200 SF Absorption Area 1,200 SF/3 GPD/SF/5 SF/LF'No (Red. Factor) = 80 LF Trench Length THEREFORE: Construct 2 40' Long x 5' Wide x No Effective Depth Absorption Trenches. Flow Line Elevation in Trench to be 1.0' Above Original Ground Surface. Total Depth to be 2.0' Below Existing Ground. Provide 3' Cover Over Absorption Trenches and 4' Cover Over Septic Tank. Maintain 100' Separation From Surface Water and Subdrain Outlets. Revegetate Upper 6" Sheeting as Necessary Natural to Support Fill 3' Cover or 7' Backfill and 7 Cover 6" 1'0" 6" 16- 200/, Natural slope Varies `7' Insulation (Typ. Both Trenches) Varies I" Perforated PVC (Holes Down) 3/16" Diameter Holes @ 7 O.C. (Typ. Both Trenches) g F- 5' 10' Fabric —Drainfield Rock (Typ. Both Trenches) Remove Organics to Underlying GM Layer Replace w/Filter Sand TYPICAL 5' WIDE TRENCH SECTIO NOTE: SCALE) Grade Area Over Trench to Drain Away. Minimum 6' Separation From Bedrock. Minimum 2' Separation From Groundwater. Minimum 10' Separation From Water Service Line. Minimum 100' Separation From Surface Water or Streams. Minimum 100' Separation From Private Wells. Performed For. Legal Descriptior Depth (Feet) e6 3 o G� Q_ O 11 5- a VA 0) 6 7- _ 10- 11- 12- 13- 14- 15- 16- 17- 10- 11- 12- 13- 14- 15- 16- 17 COMMENTS COMMENTS Date Performed: 3 v O Township, Range, Section:, Site Plan WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? L Depth to Water After0 Monitoring? 4IT97 .o P Date: ur At -40 •(EN '§`r�,t��0� Municipality of Anchorage 4111, Development Services Department :J 49iti ': * BuildingSafe Division .•1 On -She Water nd Wastewater Program ... .... .•... "' 4700 South Bragaw St. P.O. Box 195650 Anchorage, AK 99519-6650 t""' .. •"' ` re°,,. ,AUCHAEL R ANDERSON., 4; > �'i•. CE w .el .anchorage .ak.usJf (907)343.7904 -4381 ��'f���•.�./iDLri�:t�a t�+f� Soils Log - Percolation Test &OFESSW 004 �41�Lsod�e Performed For. Legal Descriptior Depth (Feet) e6 3 o G� Q_ O 11 5- a VA 0) 6 7- _ 10- 11- 12- 13- 14- 15- 16- 17- 10- 11- 12- 13- 14- 15- 16- 17 COMMENTS COMMENTS Date Performed: 3 v O Township, Range, Section:, Site Plan WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? L Depth to Water After0 Monitoring? 4IT97 .o P Date: PERCOLATION RATE TEST RUN BETWEEN M;S3 r'SIL '3-r 1 4.15 1 2.38 (minuurAntlr) PERC HOLE DIAMETER FT 'AND. Q FT PERFORMED BY: CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDAN E WITH ALLSTATEALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 3 Reading Date Gross The Net Time Depth to Water Net Drop t►B . - �i� q z;tfl3 14 PERCOLATION RATE TEST RUN BETWEEN M;S3 r'SIL '3-r 1 4.15 1 2.38 (minuurAntlr) PERC HOLE DIAMETER FT 'AND. Q FT PERFORMED BY: CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDAN E WITH ALLSTATEALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 3 Municipality of Anchorage y�;� (E ssptyl Development Services Departmento 491HN Building Safety Division 0n -She Water and Wastewater Program^.. ...• .... � ' 4700 South Bragaw St. • � P.O. Box 195650 Anchorage, AK 99519-6650 www.ei.anchoraae. sk.us ,b WERSON a°�r.- CHAFL E• AND v r' • �'r,i• CE�4381 ; (907) 343-7004 +c{fes • 0� �� !�fO •...... •• •�`t+ �1Re%%vtVVI' Soils Log - Percolation Test Performed For. Date Performed: S D O'I Legal Description: Township, Range, Section:, 1-OrA 7- 1D- 11- 12- 13- 14 - 15. 16- 17- - --1s- -- 19- COMMENTS tC-5'f-4-o. ` PERFORMED BY: PERFORMEDINACCORDANCE WAS GROUND WATER ENCOUNTERED? s IF YES, AT WHAT DEPTH? L Depth WatWaterAger t/n Monitoring? (V77�r14 L D E Dale:) Y4do l v 301 TEST RUN BETWEEN Z.Q FT 'AND JJ FT %(164C a_ e . , r G . I CERTIFY THAT THIS TEST WAS i ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: Performed For. Legal D ,%zriptior V 4- 40 7- o 11• 12- 13- 14- 15- 16-' 17- 1 B- 19- 20 - PERFORMED BY: PERFORMED INP Municipality of Anchorage Development Services Department Building Safety Division On -She Water and Wastewater Program • ' 4700 South Bragaw SL P.O. Box 195650 Anchorage, AK 99519.6650 wwwel. anchoraoe. ak.us (907) 343.7904 Soils Log - Percolation Test *?'491H tkk1 .* E. ANDERSON -433 Date Performed: 1 1 I; a Township, Range, Section:, vw-K WAS GROUND WATER , r i -we I ,. ENCOUNTERED? ly•58. 3.0.0 •��' •.herr _AL1L S IF YES, AT WHAT DEPTH? /A' L Depth to Water After ,I KOi{/4iER 0 P Monhoring? E Dale: L Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE _15 fftw.~) PERC HOLE DIAMETER TEST RUN BETWEEN —Fir 'AND 3.45r FT CERTIFY THAT THIS TEST WAS WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: i -we I ,. ly•58. 3.0.0 •��' •.herr / r3+jo lF✓ v P, iil '1•cly PERCOLATION RATE _15 fftw.~) PERC HOLE DIAMETER TEST RUN BETWEEN —Fir 'AND 3.45r FT CERTIFY THAT THIS TEST WAS WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ANDERSON ENGINEERING P.O- BOX 240773 ANCHORAGE, AK 99524 May 12, 2008 Mr. Krzysztof W. Balaban 16244 Seville Park Circle Anchorage, AK 99516 Attention: Mr. Josh Sundstrom Willowridge Construction Subject: Lot 21, Shangri-La Subdivision Septic Tank Placement Dear Mr. Balaban: The design of your new home and the characteristics of the lot require the septic tank to be placed approximately 150' from the nearest access point for maintenance. Septic tank pump trucks have the capacity to pump the tank from that distance, but may charge an additional fee for the service. In addition, the Municipal ordinance governing septic system states "The point of access for the pump truck must be no more than 100 feet from the septic tank" The City will waive this requirement provided you acknowledge your understanding the location of the septic tank does not meet current Municipal code. Please indicate your understanding of the information contained above and your willingness to proceed with the location of the septic tank in its current designed location by signing below. Sincerely, Michael E. Anderson, P.E. ACCEPTED: A?�7 —� Krzysztof W. Balaban ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT MEMORANDUM OF UNDERSTANDING BETWEEN MUNICIPALITY OF ANCHORA E AND_WYSLTOF RA/ A13AN THIS MEMORANDUM OF UNDERSTANDING made and entered into as of this L Day of MwIL of2049e, by and between &NUeNtE & c.A3AN herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this Memorandum of Understanumg agree as follows: 1. ADVANCED WASTEWATER TREATMENT SYSTEMS. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as IAD VAU -7,v�, located at J f1wwr, -LA Lor a -i Anchorage, Alaska. ts 2. Definitions. A. Alteration. Any change to the design or function of an AW WTS that Includes the installation or removal of any parts, components or pieces not included in the original construction permit and design. Prior to performing any alterations to an AW WTS the owner must obtain a Wastewater Disposal System Construction Permit from the Municipality pursuant to Anchorage Municipal Code (hereinafter, "AMC") 15.65. B. Certificate of On -Site Systems Approval. An approval by the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with AMC 15.65. These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. C. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. D. Maintenance and Repair. The scheduled and as needed replacement of existing parts, components and pieces of an AWWTS that were included in the original design which would allow the AWWTS to continue to perform as designed. E. Permit (Construction) An On -Site Wastewater Disposal System Construction Permit as defined by AMC 15.65. F. Permit (Operating) An Advanced Wastewater Treatment System Operating Permit. An annual permit, issued by the Municipality, that allows the Owner to operate an AWWTS, upon meeting all the requirements of this agreement, the conditions of Operating Permit, the requirements of the On -Site Wastewater System Construction Permit and all relevant provisions of AMC 15.65 3. Fee. Owner shall pay to Municipality an annual fee of Zeyzd ($700), .00), payable on or before the issuance of the operating permit and annually th reafter. The annual fee is due on or before the anniversary date of the approval by the Municipality of installed system. 4. Term. The term of this Memorandum of Understanding shall be for the life of the AWWTS. Ka The tern begins on the date of approval by the Municipality of the installed system and shall continue while the AWWTS system is in use or operational or until the property is sold or title is transferred by owner and a new certificate of On -Site approval is issued to the new owner or transferee of the property. 5. Alterations, installation and Removal of Additional Equipment. Owner agrees not to make any alterations, removal of parts or additions to the AWWTS without a Constriction Permit from the Municipality. 6. Maintenance and Repairs. A. Throughout the term of this Memorandum of Understanding, the Owner shall maintain AWWTS in good repair. In addition, it shall be the responsibility of the Owner during the term of this Memorandum of Understanding, and any extensions or renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs. Further, Owner agrees to comply will all applicable ordinance, laws, regulations, rules and orders for the AWWTS. B. Owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system pursuant to the terms and conditions contained in the Owner's AWWTS Operating Permit. This schedule shall be submitted to the Municipality annually upon the renewal of the permit. The schedule of maintenance and repair contained in the Owner's AWWTS Operating Permit is: 'Bi— O11n u C. Owner acknowledges that the fine schedule for failing to maintain and repair an AWWTS are codified in AMC 14.60. r3 D. Owner agrees that only maintenance, repair personnel certified by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the system. E. Owner agrees to grant the Municipality reasonable access to test and inspect the AW WTS upon 24 hours written notice. F. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. G. Owner agrees that the relevant provisions of the standard specification guidebook for AW WTS is the governing professional guidelines for the construction, maintenance and repair of the Owner's AW WTS. 7. Nonwaiver. The failure of either parry at any time to enforce a provision of this Memorandum of Understanding shall in ❑o wcy constitute a waiver of the provisions, nor in any way effect the validity of the Memorandum of Understanding or any part hereof, or the right of such parry thereafter to enforce each and every provision hereof. 8. Amendment. A. This Memorandum of Understanding shall only be amended, modified or changed by a writing, executed by authorized representatives of the parties, with the same formality of this Memorandum of Understanding was executed and such writing shall be attached to this Memorandum of Understanding as an amendment. B. For the purposes of any amendment modification or change to the terms and conditions of this contract, the only authorized representatives of the parties are: Owner: ZPZV20 i?i1A.A41tl Anchorage: Purchasing Officer C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. 9. Jurisdiction: Choice of Law. Any civil action arising from this Memorandum of Understanding shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govem the rights and obligations of the parties under this Memorandum of Understanding. 10. Severability. Any provisions of tnis Memorandum of Understanding decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Memorandum of Understanding. Date: f%P,C,/L /,-'Hl00 STATE OF ALASKA TFIIRD JUDICIAL DISTRICT MUwlr,IPAI TTY• By: Title: Date: ) ss. The foregoing instrument was acowledged before me this /S day of 20�, by �2(tiLtQA r 'n�A tom, �E�N Ir NOTARY PUBLIC FOR ALASKA off` E l. My Commission expires: 0 r i PUBLIC 24. J'6•. o f— Parcel I.D. VSW CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program ` 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni.org/onsite (907)343-7904 020-043-39 FOR A SINGLE FAMILY DWELLING 1. GENERAL INFORMATION Complete legal description Shangri La Subdivision, Lot 21 Location (site address) Lost Horizon Drive Anchorage, AK 99516 COSA# o5C lIll l3 Expiration Date: Current Property owner(s) Willowridge Construction company Day phone 317-0051 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address 5532 Yukon Charlie Loop Anchorage, AK 99502 Unless otherwise requested, COSA will be held by DSD for pickup. Day phone Day phone 2. NUMBER OF BEDROOMS: Eight (6) 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems 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 COSAs upon request to homeowners. Certificates of On -Site Systems 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 sample results. (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 engineer's 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 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 thatpased on the information obtained from the Municipality of Anchorage files and from my investigation and insoe`ctionthe 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 Engineer's Printed Name Michael E. Anderson, P.E. 5. DSD SIGNATURE _4Z Approved for 1— bedrooms. Disapproved. Phone 522-7773 Date 5/25/2011 Ata 6 AMOMCM CE*4381 Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Nitrate Advisory / Other By: l�e/i� G �(f 0 Original Certificate Date: r_ (Rev 11n5) Municipality of Anchorage Development Services Department Building Safety Division': On -Site Water & Wastewater Program 4700 Elmore Road P O Box 196650 Anchorage, AK 99507 wwwmuni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Shangn La Subdivision, Lot 21 Parcel ID: 020-043-39 A. WELL DATA Well type Private If A, B, or C provide PWSID # Date completed 5/31/08 Sanitary seal (YIN) Y Total depth 306 ft Cased to 44 ft FROM WELL LOG Date of test 5/31/08 Static water level 48 ft. Well Log (YIN) Y Wires properly protected (YIN) Y Casing height (above ground) >18 in. AT INSPECTION 5/26/2011 48 ft. Well production 4 gpm. 4.5 Q. p. M. WATER SAMPLE RESULTS. Coliform 0 colonies/100 mL Nitrate 3.31 mg/L Other bacteria colonies/100 mL Arsenic. N/D ug/I Date of sample: 5/17111 Collected by A. Haraia B. SEPTIC/HOLDING TANK DATA Tank Type/Material Advante. Treatment System Date installed 1/9-10/04 Tank size 3.500 gal Number of Compartments 2 Cleanouts (YIN) Foundation cleanout (YIN) Y Depression over tank (YIN) N High water alarm (YIN) Date of pumping New Construction Pumper N/A C. ABSORPTION FIELD DATA Date installed 8119-25111 Soil rating (g p.d./ftZ or ftz/bdrm) 3 GPDISF System type 5' Wide Trench Length 80 ft. Width 5 ft Gravel below pipe 2 ft Total depth 1 ft. Eff. absorption area 1.200 ft' Monitoring tube Y Depression over field N Date of adequacy test New Const. 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) N If yes, give date Y D. LIFT STATION Date installed 4/19/2011 Size in gallons 500 "Pump on" level at 28 in. Pump off' level at 28 in. Datum Bottom of Tank Cycles tested New Construction Manhole/Access (Y/N) Y High water alarm level at 32 in. Meets alarm & circuit requirements? Y E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot >100' On adjacent lots >100' Absorption field on lot >100' On adjacent lots >1GO' Public sewer main N/A Public sewer manhole/cleanout N/A Sewer /septic service line >25' Holding tank N/A Animal containment areas >50' Manuretanimal excrete storage areas >100' SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Property line >5' Absorption field >5' Water main N/A Water service line >10' Surface water >100' Wells on adjacent lots >100' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line >10' Building foundation >10' Water main N/A Water Service line >10' Surfacewater >100' Driveway, parking/vehicle storage 5' Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS: 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. Engineer's Printed Name Michael E. Anderson, P.E. Date 5/25/2011 COSA Fee $ Date of Payment Receipt Number (/ 7,2:3 Q n (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number 49m *� CE�4381 tsar.: .. , r.,.��c,- ,'1f# FE5$� *A4'w