Loading...
HomeMy WebLinkAboutGRAVITY HILL ESTATES LT 1AGPavity Hill Lot IA #015-242-98 Remarxe I BENCH MARK Location and Description: n e- 1A_ .1 Lot ILI Inspections performed by: Dates: 1s1 i& &; " 2nd Z Development S rvices Department Approval Reviewed and approved by. Date: 10 /o OR". 12 10) ;ned Elevarcr. I ogoao90000400 nIIi19 S• •. . ••9 p0@9®oe ° O i Tobbin.5purkland o e 0-42M 000 � 0 CP r e0% '®/'t}F ���,r Municipality of Anchorage lI` Development Services Department Building Safety Division On -Site Water and Wastewater Program, 4700 S. Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page it of 4 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM ANDIOR WELL INSPECTION REPORT 0 Permit Number: a'. a0 PID Number: Ll — a1 Name Wastewater System: New El Upgrade A 1E P-11 CAddress D �� �1ip ABSORPTION FIELD Pncne Number of Bedrooms */Deep ❑Shallow Trench ❑Bed C1 Mound ❑ Ofher I LEGAL DESCRIPTION Soil Rating: 1.2 Total Depth from original grade GPD/Ft' Block Lot Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe. Fl. 'ownsn p^ Range: Section: Fill added above original grade: Gravel Length. WN W s G. L FI. Q Well: New ❑ Upgrade Gravel width: �, Ft Number of lines: Distance be,', '^?s C,assshcalion (Private, A. B. C) Total Depth: Cased to: Total absorption area: Pipe Mateririial et1✓ r��::t: Fl. (,J _7 FI. �s�(� Ft' �a%© C•;�er Dale Dr led: Static Water Level: Installer: �% j� Dale Installed r aa Li ; f L'J °, FL t Y ✓It.�`j C., a.4 J v etd Pump Set at: Casingeight Above Ground: TANK GPM J�FI. rL FI. SEPARATION DISTANCES .Septic ❑ Holding ❑ S.T.E.P. ❑ Other To Septic Absorption Lift Holding Public/PrivateManufacturer. —i, Capac,ty From Tank Field Station Tank Sewer Line / ,4e,I1, /6-0-oGa! Material: Number of Ccmcarxer!s SuraceWater NIo _- --. LIFTST TION im Size: Manufacturer Lo' Lire a'.� IV 4 15)Gal. 7 'Pump on' level at: 'Pump off" I el al: water alar^ a! Fc rdabCn :�i a in 7H m. _igh Cur,am Drain t' 1�' N I Pump Make 8 Model Elect I Inspections performed by tl O Remarxe I BENCH MARK Location and Description: n e- 1A_ .1 Lot ILI Inspections performed by: Dates: 1s1 i& &; " 2nd Z Development S rvices Department Approval Reviewed and approved by. Date: 10 /o OR". 12 10) ;ned Elevarcr. I ogoao90000400 nIIi19 S• •. . ••9 p0@9®oe ° O i Tobbin.5purkland o e 0-42M 000 � 0 CP r e0% '®/'t}F ���,r Municipality of Anchorage I�\ Development Services Department Building Safety Division On -Site Water and Wastewater Program, 4700 S. Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page of www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: _S \9/ c"J 21 00 (o PID Number: O 'ii�-- Name �E-^ CA � Wastewater System: E] New F] Upgrade L If I address ?, p ABSORPTION FIELD cr.dre Number of Bedrooms: Deep Trench ❑Shallow Trench ❑Bed ❑ Mound ❑ Cthe• Soil Rating Total Depth from original grace LEGAL DESCRIPTION 0"LI GPDrFI= 1 F . I Bleck Loc ac !� Subdivision: J /) r Z J C i S f/ / Depth to pipe bottom from original grade: Ft. Gravel depth beneath pipe. O Ft Tc­sh,p Raannge V/ section: Fill added above original grade: Fill Gravel Length. i 2 N-3 0"-1 a Fl. Well: [New ❑ Upgrade Gravel width. Number of lines: lance be-,een 1!—S Ft CGass, icanon (Private. A B. C): Total De the Cased to: Total absorption area: Pipe Material. ( � Fl. C•"ler I , � art✓ Dale Drilled: 3C ii Static Water Level: 3j Installer. e j� e - � G,^r Data Install d: L — S Fl. i� Kev L/ rl eld Pump S!�Set at: casing Height Above Ground: TANK GPM 1Jt% y L Eft Ft. Fl. SEPARATION DISTANCES I 3;&ptic ❑ Holding ❑ S.T.E.P. ❑ Other: To Septic Absorption Lift Holding Public/Private Manufacturer. Capacity Fromm Tank Field Station Tank Sewer Line A,fiK � @LH, k f 167"; 1 Lis, C7 Material: Number c' Comcar,-nerls Surface Water j�l N/ p LIFT STATION j �; Size: Manufacturer. Lc: Line J � � 0 Gal. 'Pump on' levet at: 'Pump off- le at at. High wa!er alarm a! F cundal.en._ r n. ,n r, Cuan Drain j� +-11 Pump Make & Model Electri I Inspections performed by v o Remarks S�L�N Ae- BENCH MARK Location and Description: ! A j A<SU .ed EievaFcn y� i ►J � 1 Engineers Stamp C_r 7 j Inspections performed by: 1 , 5 Dates: 1s' </� O 3 2nd 7/1 )o,nq V....., c.- Development Services Department Approval `' .1 Reviewed and approved by: Date: O S�fr c3,`'ao Gn 225 (Rt• t_n91 t s 1 i 1 #3 \,F2 �+ D 1500 GAL SEPTIC TANK I H �K B BENCH MARK A _SEDUM SF S<5% c*+ . 49th ................................... o TOB LAND N SPURK NO. CE -2225 ,®< ®t bfROFE WaO SWING TIES. PRIMARY SYSTEM. PRIMARY SYSTEM 74.5 BULL RUN STANDARD DEEP TRENCHES 30 FT LONG 725 DIVERSION VALVE 10 FT DEEP 102 6 FT CTIVE ROCK 5t0 VER �G BD E AG 105.5 MONITOR BG c SECONDARY SYSTEM 116.5 MONITOR STANDARD DEEP TRENCHES 104 60 FT LONG AH 0 FT DEEP x1f N 8 FT EFFECTIVE ROCK 3 FT COVER L �K B BENCH MARK A _SEDUM SF S<5% c*+ . 49th ................................... o TOB LAND N SPURK NO. CE -2225 ,®< ®t bfROFE WaO SWING TIES. PRIMARY SYSTEM. AC 74.5 BULL RUN BC 725 DIVERSION VALVE AE 102 BE 99 AD 97 BD 86 AG 105.5 MONITOR BG 100 AF 116.5 MONITOR BG 104 SEPTIC TANK AH 58 8H 54 ;ft#l'.'L)TTJW"IWA AK 28.5 8K 55 AL 49.8 BL 75.5 AM 83.5 BM 87 MONITOR AN 49.3 8v MONITOR LJ JV /J SCALE, 1' = 50 FT. Irnnv -- — —— — — — — —- - — — — — — — — — — — — — — — — — — if R PIN TOBBEN SPURKLAND P.E. E1 2, SE1 4, SE1 4, SWl 4 SEPTIC SYSTEM AS BUILT 203 W AK. AVENUEANCHSEC 24 T12N R3W DA 7E.- SEPT. 8, 2003 (907) 7 3916 JUSTIN ANTI ERICA McCASLIN SHEET- 213 GRID. 2740 907 279-3916 � PERMIT # SW030069 PID # 016 -141 -XX 12324MCCAS20V6 6 NO SCALE rvu )(,MLC BENCH MARK: PRIMARY SYSTEM 807TOM SIDING NE COR OF BLDG ASSUMED ELEV, 100.00 TOBBEN SPURKLAND P.E. EI/2,SE1/4,SE1/4,SW114 SEPTIC SYSTEM SCHEMATIC 203 W15th Ave DATE, i SEPT, 9, 2003 Anchorage Ak 99501 SEC, 24, T12N JUSTIN AND ERICA McCASLIN SHEETS 3/4 GRIDS 2740 PERMIT # SV030069 PID # p i 5 - a qz - 0 i 12324MCCAS3P.DV9 s Monitor Clean Ou 3 c' Clean Out o Standard Trenches. z �, a 2' Wide o 30' Long � 10' Deep � O O O 6' Sewer rock 4' Cover 1500 gal Septic tank 1 Monitor Clean Out, BULL RUN DIVERSION VALVE Z 200 FLOW SPLITTER Clean Out NO SCALE rvu )(,MLC BENCH MARK: PRIMARY SYSTEM 807TOM SIDING NE COR OF BLDG ASSUMED ELEV, 100.00 TOBBEN SPURKLAND P.E. EI/2,SE1/4,SE1/4,SW114 SEPTIC SYSTEM SCHEMATIC 203 W15th Ave DATE, i SEPT, 9, 2003 Anchorage Ak 99501 SEC, 24, T12N JUSTIN AND ERICA McCASLIN SHEETS 3/4 GRIDS 2740 PERMIT # SV030069 PID # p i 5 - a qz - 0 i 12324MCCAS3P.DV9 TE ) Monitor Clean Out Clean Standard Trenches: 2' Wide 60' Long 10' Deep 8' Sewer rock 3' Cover Clean Clean Out U Monitor NO SCALE J`S�O 94� ULL RUN DIVERSION VALVE 8 100 OF �sA y �1T1 9 F� 0 a . ......... �e rvu J(.HLL SECONDARY SYSTEM BENCH MARK: BOTTOM SIDING NE COR OF BLDG ASSUMED ELEV 100,00 T❑BBEN SPURKLAND RE, EI/SE1/4,SE1/4,SW114 SEPTIC SYSTEM SCHEMATIC 203 W15th Ave SEC. 24, T12N R3 DATE, SEPT, 9, 2003 Anchorage Ak 99501 JUSTIN AND ERICA McCASLIN SHEET „q_,o,� 4/4 GRIDS 2740 PERMIT # SV030069 PID # 015-242-01 12324MCC4S3SDWG 09/11/2003 17:26 3453287 Job No.: 43-128 M W DRILLING, INC 4P.O. Box 110378* Anchorage, AK 99511 4907-345-4000 ` 907-345-3287 Fax + Project No.: N/A Permit No, SW030069 Groundwater Well As -wild & Lig 4 Well Owner. Mr. & Mrs. lvlcCaslin 4 Use of Well: Domestic 4Leg41 Descrtptiatt: Township 12N Range 3W, Sections 24, East 1/2, SE 1/4, SE 114, SW %+ Upper Huffman Road- Anchorage, Alaska Construction PAGE 02 ♦Mote Depth: 306' ♦Casing Ske: 6" t, Cased To: 34.13' ♦Material A 53 Steel ®Drill Method: Aix £_Rotary _ Welt Cotttpietion- Open end X Screen Perforated Method: 4Screen/.Perfor+atlon description. Nobe 4 Grout Nates: (1) Sack- No. 8 bentonite gmules 4 Notes: 4 Well Development: Method: Air surge Notes. *Static water level (SWL) 35' {abere) (blow) top of casing rrOC). o Wellyield test at 3 gallons per n9boute (GPM)l, ►s PeP &W for with t00% of drawdown (I)D) from static level (SWL). #mrthod. Air lift # Date of eompletlon: 30 April 2003 ®Pump lhvalk Wa11 T .no 1 hours Depth in feet from top of czsln . Details of formations penetrated, size of material color and hardness. 0_T_Q_ Candi Sticl�u► _ _3 3 TO 31.� Gravel: cobbley, clayey_ _ 31 TO , 306 Bedrock ray brei_ siltstone argil lite; Sporadic quartz lulled TO Fractures with small water seeps TQ TO _ TO TO TO -T -____-- _ TO TO .� TO TO TO TO ................ .....__ _�""--1�Vii t7+l�r -Cat-t3fied MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM 1 WATER SUPPLY PERMIT Initial Date Issued: Apr 08, 2003 Expiration Date: Apr 07, 2004 Permit Number: SW030069 Parcel ID: 015-242-01 Legal Description: T12N R3W Sec 24 E2 SE4 SE4 SW4 Design Engineer: 0007 Tobben Spurkland, PE Site Address: NHN Upper Huffman Rd Owner Name: Justin & Eric McCaslin Lot Size: 217800 SQ. FT. Owner Address: PO Box 110983 Total Bedrooms: 5 Permit Bedrooms: 5 Anchorage , AK 99511 - This permit is for the construction of: 0 Disposal Field 0 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: Issued By: Date: _ qlro i 0 5 Date: 4S D3 Municipality of Anchorage • Development Services, Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage:ak.us (907) 343-7904 ON-SITE SEWERMELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 0 J'S — 0 1 Permit Number SW 03006 9 Property owners)' Day phone 3q Mailing address (1) ?0. Box u oct 9'� 3 Mailing address (2)Zip /.Code Legal description (Lot, Block & Sub'd.) /L SiE r y �� (Y W /V CS -so- �2 LJ Legal description (Section, Township & Range) Lot Size 2 / 7 ?OD Acres q. Ft. THIS APPLICATION IS FOR: Number of Bedrooms Sewer Only ❑ Well Only. ❑ Sewer and Well N 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. (Signature of property owner or authorized agent) Permit Fees: Waiver Fees: Date of Payment:(��� �2- Date of Payment: Receipt Number: 6 3-3`31 q Receipt Number: (Rev. 12/00) J1 .SPURKJ1eA�'J111/ P.E. 203 W 15th. Avenue, Suite 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 SEPTIC SYSTEM DESIGN E1/2,SE1/4,SE1/4,SW1/4, SEC 24 T'12N R3W JUSTIN AND ERICA McCASLIN Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street Anchorage, Alaska 99519-6650 April 3, 2003 We are submitting an application for the installation of a well and septic system for this lot. The submittal consists of three (3) drawings showing the present improvements on the lot and the adjoining properties, (sheet 1/3), the proposed improvements of the lot, of which only the well and septic system is subject to this permit application, (sheet 2/3), and a schematic of the septic system, (sheet 3/3). Soil logs and percolation tests of applicable test holes are also enclosed. The owners of the property desires to construct a 2 -bedroom residence this year and expand the house to a total of 5 bedrooms within the next 5 years. The septic system has been sized to serve the 5 -bedroom residence. Three test holes were excavated to identify the soil conditions. Test holes #1 and #3 revealed a dense sandy silt with a percolation rate of 40 minutes per inch. Test hole #2 revealed a clean sand with a percolation rate less than 1 min, per inch. Two different designs are submitted, one design for the initial system, based on test hole #2, and the reserve system based on test hole #1. Initial System No Ground Water or Impervious Layer to 16 ft. Use Standard Trench Soil Rating. From Test Hole 03/18/03 <1 min = 1.2 gal per sq.ft/day No. of Bedrooms 5 Required Area per Bedroom: 150/1.2 = 125 sq.ft. Total area required: 125 x 5 = 625 sgft Bottom Rock At 10 feet Top Rock At 4 feet Rock Depth 6 feet Minimum Trench Length 625 / 12 = 52 ft. USE 60 FT SYSTEM CONFIGURATION STANDARD TRENCH TOTAL LENGTH 60 FT TOTAL WIDTH 2 FT TOTAL DEPTH 10 FT ROCK DEPTH 6 FT COVER 4 FT SEPTIC TANK 1500 GAL E1/2/SE1/4,SE1/4,SW1/4 SEC. 24 T12N R3W Replacement trench: Percolation Rate: 40 min/inch Required Area per Bedroom: 333 sq. ft. Total Area Required: 1666 sq. ft Test Hole Depth: 16 ft Bottom Rock: loft Top Rock: 2 ft Effective Rock Depth 6 ft Cover: 3 ft Minimum Length: 1666/16= 104 ft Use: Two Trenches each 60 ft. The installation of this well and septic system will not prevent wells and septic systems from being installed on the adjacent lots. There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots. The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. 0 UNDEVELOPED S890_56'00'E 329.36' I I 1 1 \ I !7 LOT 19 1-1 1 I \ 1 \ 1 412 ti W CF •®®® • 49th LOT 2 .......................... .� TOB • PURKLAND •; ® I I No. CE -2225 • Cti ��••�' -- — — — — —— ---- IRON PW UPPER HUFFMAN ROAD 50 0 50 100 150 200 250 300 SCALE.- 1' = 100 FT. TOBBEN SPURKLAND P.E. E1 2, SE1 4, SEI 4, S�1 4 SEPTIC SYSTEM DESIGN 203 W 15TH. AVENUE SEC 24 T12N 907 279-3916 RJW DA TE. APRIL 1, 2003 (NCH. AK. 99501 JUSTIN ANIS ERICA McCASLIN SHEET- 1/3 GRID. 2740 PERMIT #SV03OXXX PID # 016 -141 -XX 12324MCCASI.DV6 I I #3 I 1500 GAL SEPTIC TANK FURURE 3 -BEDROOM ADDITION, I I 5c5% STANDARD DEEP TRENCHES 30 FT LONG 10 FT DEEP 6 FT EFFECTIVE ROCK 2 4 FT COVER REPLACEMENT TRENCHES STANDARD DEEP TRENCHES 60 FT LONG 10 FT DEEP Ort 8 FT EFFECTIVE ROCK 3 FT COVER S<5% I I I 1 I I 1 I I I I N r` 4 th®: I I o ........................:. o p 1 o ®................. . TOBB SPURKLAND NO. CE -2225 •�tiAAir V ss I I 25 0 25 50 75 100 125 50 SCALE 1' = 50 FT, PiN— — — — — — — — — — — — — — — — — — — — — — — — — — — — — IRON PIN TOBBEN SPURKLAND P.E. E1 2, SE1 4, SE1 4, SW1 4 SEPTIC SYSTEM DESIGN 203 W 15TH. AVENUE SEC 24T12N 907 279-3916 R3W DATE: APRIL 1, 2003 (NCH. AK. 99501 JUSTIN ANb ERICA WC(SLIN SHEET- 2/3 GRID: 2740 PERMIT #SV03OXXX PID # 016 -141 -XX 12324MCCAS2,DWG I Monitor CleanOu Clean Out s Cs Standard Trenches.- 21 renches.2' Wide 30' Long � q 10' Deep 0 0 0 6' Sewer rock 4' Cover 1500 gal Septic tank ► Monitor Clean Ouj Z 200 FLOW SPLITTER Clean Out NO SCALE 49th ...p ....... . ........................ . • TOBBfN SPURKLAND 'l ° No. CE -2225 /VL! )L.MLL ASSUMED ELEV. 100.00 TOBBEN SPURKLAND P.E. EI/2,SE1/4,SE1/4,SW114 SEPTIC SYSTEM SCHEMATIC 203 W15th Ave SEC. 24, T12N R3V DATE, APRIL 1, 2003 An Ak 99501 JUSTIN AND ERICA McCASLIN SHEET 3/3 GRIDS 2740 PERMIT # SW03OXX PID # XX 12324MCCAS3,DW Municipality of Anchorage (ENGI S%A44y 00 ° Development Services Departments $ building Safety Division on -Site Water and Wastewater Program i Goo- 4700 oo-4700 South Bragaw St. p°0 a P.O. Bax 196650 Anchorage, AK 99519-6650 ® To ben 5pueklond m �� www.ci.anchoraoe.ak.us J' % (907) 343-7904 ��F9 ° F ® 0,°� Goo Soils Log - Percolation Test Performed For: r= -OCA to e- C-ASv-t t -k Date.Performed: 16 /0:5 Legal Description: t,y C I%tel S t�`l t/L1 Township, Range, Section: o y, r i -Llm P � C&M%IEiNTS WAS GROUND WATER E`lC0JN; 1 ERE0? `yam IF YES, AT WHAT DEPTH? 0 Depth to Water After p Monitoring? C E Date: 3 Lk 10> Reading Date ( Gross Time Net Time I Depth to Water I 6Depth Q81C7A N t C S 1- 2- -3-5- 3- t0 3� I 4- i 5- 6- 7 - UA . t 10- 0-11- q0 7/, I �� 11- I 1 1 12- 12-13- C0 rilz- I I') 13- �3 - 1"4 14- � 14- (r..i�clesirci) FT AND i 5- 16 �3Ci i �-r (j r- 17 17- i J- 14 � 19 20 C&M%IEiNTS WAS GROUND WATER E`lC0JN; 1 ERE0? `yam IF YES, AT WHAT DEPTH? 0 Depth to Water After p Monitoring? C E Date: 3 Lk 10> Reading Date ( Gross Time Net Time I Depth to Water I Net Drcp rI L "} L> 9-7/0 3'(u tr3l t0 3� I I i q0 7/, I �� q I! Lt I I 1 1 ' l C� C0 rilz- I I') p 3,1 �3 1 1 1"4 PERCOL'TION RATE 'OLj'N TEST RU`: BET`NEEN n (r..i�clesirci) FT AND FERC HOLE DIA`.1ETER 6 FT PERFORIMED BY: 1.5 i t. S CERTIFY THAT T SIS TEST V,1.%.S PERFORMED IN ACCORDANCE VATH ALL STATE AND j 1UNICiPAL GUIDE LINES IN EFFECT ON 1 Tr,IS DATE. DATE: 3 /1`l /03 Municipality of Anchorage (ENGINEEF{S SE�kL);: ) � C0 ° �" Development Services Department, t o Building Safety Division ®� 0000Qaosaoco°000c ® y� On -Site Water and Wastewater Program 4700 South Bragaw St. cws°° �OgO°O°0f°g� P.O. Box 196650 Anchorage, AK 99519-6650 ��r+ o Tobben Spust�6€��a�l 0 www ci.anchoraoe.ak.us e X223 o ®' (907) 343-7904 °o 00,01100 °� `�" C9 Soils Log - Percolation Test OF Performed For: iCl� ttit C.�4Si—i til Date Performed: x'40 /0 Legal Description: �z 5!~ t%�/ S �/ I Township, Range, Section: Sec '9 7r •z 12Nr P.3%X� + _. -- Depth (Feet', 1- arc( 2- 3- - 5- 6- 7- 8- 10-1 5- 6- 7- 8- 10- C C l e'l V G0-4,Ld/ Gxk/ COi\,UMEiiN T S +,`JAS GROUND WATER s IF t. YES, AT WHAT DEPTH? L Depth to Water After // p Monitoring? tt J E Date: y� �o Reading Date Gross Time Net Time j D�e�ptrtrh�to r Wa!�terF j� J, Net _Drop C%�-7 s j j j j j j PEoro—^TION RATE FERC HCLE 01A.METER +J b TEST RUiMSETNE-EN h F T AND (p FT P=RFOR?A D BY: CERTIFY THAT THIS TEST bVAj)S PERFOP�MED IN ACCORDANCE \P/ITH ALL STAT E AND 'U IICiPAL GUID=LINES IN EFFECT ON THIS DATE. DATE: V/ Z/U 3 . T q Municipality of Anchorage (ENCkIryEERstisE(�L�� Development Services Department Building Safety Division s ' t� On -Site Water and Wastewater Program j 6,1 f 4700 South Bragaw St. / Tp eoocp000<s0�aevcoa P.O. Box 196650 Anchorage, AK 99519-6650 r ' v vnvw ci.anchorage.ak.us Coa ac .. 0 0000 000000 - 0n (907) 343-7904r o c liber v^kf ?� o� r? � o , c Soils Log - Percolation Test C 0 °0< Date Performed: Performed For: F— P-1 cA H (AS L— l� t Legal Description: L �r/�I 5 (/ �� Township, Range, Section: S& c �1/, ((�2 Slope Site Plan Depth Feet 00'_6-4NiC� 2- -4 3- 4- 5- 6-7 6- .i I 7 8-0T 1 0 Ln t— i �U WAS GROUND WATER C- t ENCCU`L BRED? S 10- IF YES, AT WHAT DEPTH? l L Depth to Water After P 1 1 - Monitoring? E 12- Date: 13- 3- 14 14- Reading Date Cross Time Net Time Depth to Water Net Drop I 7 -20 17- - 20- CO .114IEN T S j �d12 FERCOUJICN RATE (mi%teslmcl) FERC HOLE DIAMETER TEST RUN SE'P-NEEN FT AND FT / PERFOR,1iIED BY: . G CERTIFY THAT THIS TEST YYA.S PER FOR.AED IN ACCORDANCE Y11TH ALL STATE AND iMUNICIPAL GUIDELINES IN EFF ECT ON THIS DATE DATE: MUNICIPALITY OF ANCHORAGE EPt"S Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 015-242-98 1. GENERAL INFORMATION Expiration DatE: �7r f ` 202-0 Complete legal description Gravity HIII Estates, Lot 1A Location (site address) 8111 Upper Huffman Road Anchorage, AK Current property owner(s) Camille Ala Day phone 1-505-504-2830 Mailing address Real estate agent 8111 Upper Huffman Road, Anchorage, AK 99516 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 5 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic 0 Water Storage ❑ . Holding Tank*. ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer 1 ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ -220 Date of Payment Alta &Q �zo Receipt Number 693 &ars COSA # i.' 5if 961651 Waiver Fee $ Date of Payment Receipt Number l Waiver # i 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below; I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on=.site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm Forge Engineering Phone 907-522-7773 Address 1399 W. 34th Ave Suite 101, Anchorage AK 99503 Engineer's Printed Name Michael E. Anderson, P.E. Date 2/13/20 6. DSD SIGNATURE System #1 Approved for bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with. the following stipulations: t��w�auurr� By: Original Certificate Date: 2 2-0,>_0 The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet Legal Description: Gravity Hill Estates, Lot 1A - 8111 Upper Huffman Road If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 4/30/2003 Total depth 306 ft Cased to 34.13 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) '18 in. Date of flow test for COSA Parcel ID: 015-242-98 Structure served by this system Well production at time of test •2/7.08 gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate 1.15 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by FORGE ENGINEERING Date of Sample 1/27/20 Static water level at beginning of test 31.7 ft. Comments **12/26/19 & 2/7/20 Well Flow Test Results Before and After Frac. Attached. B. TANK DATA Age of tank(s) 16 years Tank type/material Septic/Steel Measured operating fluid level in septic tank 51 ❑ Standpipes/foundation cleanout per record drawing Date of pumping 8/7/19 - Northland Pumping D. ABSORPTION FIELD DATA Deep Trench Which system tested (date installed) 7/16/03 FOR ALL standpipes present per record drawing Total measured depth from grade 4/6.5 ft (max) Measured depth to pipe invert from grade 11/12.6ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective 7/6.1 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 2/12/20 Results ❑✓ Pass For 5 bedrooms Fluid depth prior to test 5/12 in Water added 951 gal New depth 31/35 in Elapsed time 1440 min FEWCode-requiredsoil cover over field Final fluid depth 0/15 in FOR System presoaked Absorption rate '750 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) No date of test) Gallons introduced 2000 gallons If yes, enter date Com ments/Deficiencies: Southernmost cleanout for old system is not easily located during winter conditions. All other standpipes present per record drawings. COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' Yes if No Community Sewer Manhole/Cleanout > 100' Q Yes if No ft M Yes if No ft Neighboring Tank > 100' 0 Yes if No ft Private Sewer/Septic Line > 25' M Yes if No ft Absorption Field on Lot > 100' F-/1 Yes if No ft Holding Tank > 100' 0 Yes if No ft Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' P/ Yes if No ft ❑✓ Yes if No ft if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' �✓ Yes if No ft 0✓ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' 0 Yes if No ft Surface Water > 100' 0 Yes if No ft Property Line > 5✓0 Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' 0✓ Yes if No ft Private Wells > 100' ✓0 Yes if No ft Water Main > 10'✓� Yes if No ft Community Wells > 200'✓1 Yes if No ft Water Service Line > 10' 0✓ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances.if less than required) Building Foundation > 10' 0✓ Yes if No ft If absorption field is under driveway comment below Property Line > 10' P/ Yes if No ft Wells on Adjacent Lots: Water Main > 10' ✓0 Yes if No ft Private Wells > 100' Yes if No ft Water Service Line > 10' 0✓ Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100'✓0 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION 1 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. COSA Checklist yellow sheet T 14 °MICHAEL E. ANDERSON'" � No. CE-4381AV 2/13/20 'W 4W �� 1,4'OR�'��s��� t40' DATE: 12/26/19 Address: Legal Description: MOA Parcel ID: Num. of bedrooms: [Single Family Forcie Engineerinci PO Box 240773, Alaska 99524 Phone: 907-522-7773 fax: 907-677-7766 8111 Upper Huffman Gravity Hill Est L1A ❑ Multi -Family ❑ Commercial Type of Test: [�] Well Flow Only ❑ Septic Adequacy Only ❑ Both Well static level: 31.7 ft. Casing above ground: 32 inches Is wire in conduit? Yes ❑ No ❑ N/A Is there a sanitary cap on well? Yes No N/A INSPECTOR: L.Tidwell GALLONS FOR TEST: 750 gals. (150 GAL/BEDROOM) Time Flow Rate (g pm) Vol. (gal) Cum. Vol. (gal) Well Static Level (ft) Tank Liquid Level (inch) MT#1 Liquid Level (inch) MT#2 Liquid Level (inch) MT#3 Liquid Level (inch) MT#4 Liquid Level (inch) Meter Reading Comments 12:58 ` 31.7 Trench 1 Does septic tank require pumping? ❑ Yes ❑ 34818.7 1:08 4.29 42.9 42.9 56.81 Yes ❑ No ❑ N/A 34861.6 1:18 2.0 19.7 62.6 82.43 ❑ N/A Are there 'septic vents? 34881.3 1:28 2.0 19.8 82.4 96.2 34901.1 1:48 1.1 22.2 104.6 105.9 Grade to bottom of mon tube 34923.3 2:08 1.1 22.1 126.7 118.9 Reviewed By: 34945.4 2:28 0.5 10.3 137 122.2 34955.7 2:48 0.7 14 151 131.2 34969.7 3:08 0.5 10.1 161.1 133.9 34979.8 3:28 0.5 10.1 171.2 141.9 34989.9 3:38 0.3 3 174.2 143.5 34992.9 3:48 0.2 2.7 176.9 144.9 34995.6 3:58 0.2 2.7 179.6 146.1 34998.1 4:11 0.2 3.1 182.7 146.2 35001.2 U Gals/Min Flow Rate: Measurements Trench 1 Does septic tank require pumping? ❑ Yes ❑ No ❑ N/A Grade to bottom of cleanout Is there a depression over tank or field? Yes ❑ No ❑ N/A Grade to bottom of mon tube EFF: Is there a foundation cleanout? ❑ Yes ❑ No ❑ N/A Are there 'septic vents? Yes ❑ No ❑ N/A Trench 2 Grade to bottom of cleanout Test Results: Grade to bottom of mon tube EFF: Reviewed By: Date: ��GHOgh,C� WATERWELL - TEST PUMP REPORT l m Conducted by Anchorage Well & Pump Service 330 E 76th Avenue, Anchorage AK 99598-2840 p sERs� Ph: (907) 243-0740 Fax: (907) 243-0742 OWNER INFORMATION Owner: Address: Well Location: PUMP INFORMATION Intake Depth: Static Water Level: Max Drawdown: Air Line Depth: Average Discharge: CAMILE ALA 8111 UPPER HUFFMAN ANCHORAGE PUMP ON Time: 2:50PM Date: 2/6/2020 PUMP OFF Time: 12:36 Date: 2/7/2020 WELL INFORMATION Total Depth: Depth of Casing: Static Water Level: Casing Size: Screen Diameter: Screen Slot: Screened From: Screened To: GPS: Remarks: Monis Elapsed Time Water Level Flowmeter Flow GPM Notes Feet Meters ReadingUsage 2:50 PM 2/6/2020 1183986 START 6:36 AM 2/7/2020 1189203 4 CK 4 10:26 AM 2/7/2020 1189820 _ CK 11:25 AM 7 -Feb 1190283 CK 11:38 AM 7 -Feb 1190403 PUMP DRY PUMP OFF STA TEST 11:46 AM 7 -Feb 1190405 START PUMP 12:03 PM 7 -Feb 1190579 PUMr OFF 176 GAL. 7.04 GPM 12:11 PM 7 -Feb 1190579 PUM ON 12:36 PM 7 -Feb 1190756 PU OFF 177 GAL. 7.08 GPM. AT TIME OF TEST MB WELL #5 PAGE 1 Parcel I.D. 015-242-98 Municipality of Anchorage On-Site Water and Wastewater Program (907) 343-7904 Certificate of On-Site Systems Approval GRAVITY HILI-~LO~T l'J~ Expiration Date: ,Gretchen Stulfe,~' 1. GENERAL INFORMATION Complete legal description Location (site address) 8111 UPPER HUFFMAN RD ANCHORAGE AK Current Property owner(s) ERICA MCCASLIN Day phone Mailing address Real Estate Agent Day phone 2. TYPE OF DWELLING: [] Single Family (w/wo ADU) [] Duplex [] Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 5 4. TYPE OF WATER SUPPLY: Individual Well [] Individual Water Storage [] Community Class __ Well [] Public_Water System [] TYPE OF WASTEWATER DISPOSAL: Individual [] Holding Tank [] Community [] Public S. ewer [] WaiverNariance request for: NONE .Distance: Received by: Date:, 7.1~'] ) ~ COSA to be released to the engineer, unless othe~vise requested by the engineer. · COSA Fee $. Date of Payment Receipt Number COSA # Waiver Fee $ Date of Payment Receipt Number Waiver # $. 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 SPURKLAND ENGINEERING Address 203 W. 15TH AVE.,STE.202A, ANCHORAGE, AK 99501 Engineer's Printed Name LARS SPURKLAND ~ bedrooms 6. DSD SIGNATURE System #1 Approved for .--~ System ~r2 Approved for __ Disapproved Conditional approval for Phone 279-3916 Date 11/21/14 bedrooms, with the following stip~ The Municipality of An~rage Development Services Division (DSD) issues Certificates of On-Site Systems Approval(COSA) based only of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist Septic System Advisory Well. Flow Advisory X Nitrate Advisory Arsen. c Adv sory Other If more than t septic system is on the lot: COSA Checklist # 1 of 1 Structure served by this system 1 Certificate of On-Site Systems Approval Checklist GRAVITY HILLS LOT 1 Legal Description: A. WELL DATA Well type PRIVATE IfA, B, or C provide PWSID # --- 4/31/03 Y Date completed Sanitary seal (Y/N)_ 34* Total depth 306 ff. Cased to ft. FROM WELL LOG Date of test 4/03 35 Static water level ff. 3 Well production g.p.m. WATER SAMPLE RESULTS: NEG 1.89 Coliform __colonies/100 mL Nitrate mg/L 11/12/14 ND Arsenic ug/L Date of sample: Pamel ID: 015-242-98 Well Log (Y/N) Y Wires properly protected (Y/N) Y Casing height (above ground) 36 AT INSPECTION 11/12/14 38 ft. 1.1 g.p.m. in. Collected by: ANSON MOXNESS N B. SEPTIC/HOLDING TANK DATA Tank Type/Material STEEL/SEPTIC 1500 Tank size __ gal. Foundation cleanout (Y/N) Y Date of pumping 11/10/14 Date installed 7/16t03 Number of Compartments 2 Cleanouts (Y/N) Y N Depression over tank (Y/N) __ High water alarm (Y/N) Pumper A+ HOME SERVICES 7/16/03 Date installed Length 30/30 = 60 11/12 Total depth __ ff. C. ABSORPTION FIELD DATA Soil rating (g.p.d./t~ or ff2/bdrm) 1.2 2 ft. Width ff. Eft. absorption area 720 ~ Monitoring tube __ 12/3/14 PASS Date of adequacy test Results (Pass/Fail) Fluid depth in absorption field before test 22~38 in. Water added 1000 315 24~37 Elapsed Time: min. Final fluid depth Any rejuvenation treatment (past 12 mo.) (YIN & type) TRENCH System type Gravel below pipe 6.0 ft. Y N Depression over field __ For 5 bedrooms gal. New depth 35157 in. in. Absorption rate >= 750 g.p.d. If yes, give date --- D. LIFT STATION Date installed -- ''Pump on" level at -- Datum - Size in gallons __ in. "Pump of~' level at Cycles tested Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit ~equirements? SEPARATION DISTANCES WELL ON LOT TO: 100'+ Septic tank/lift station on lot Absorption field on lot 100'+ Public sewer main NA 25'+ Sewer/septic service line Animal containment areas 50'+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ NA Water main 100'+ Wells on adjacent lots ABSORPTION FIELD ON LOT TO: 10'+ Property line Water Service line 10'+ 50'+ (N.O.)** Curtain drain 100'+ On adjacent lots On adjacent lots 100'+ Public sewer manhole/cleanout NA NA Holding tank Manure/animal excrete storage areas 100'+ Property line 5'+ Water service line 10'+ Absorption field 5'+ Surface watar 100'+ 10'+ Building foundation Surface water 100'+(N.O.)** Wells on adjacent lots 100'+ Water main NA Driveway, parking/vehicle storage 10'+ F. COMMENTS *INTO BEDROCK ** N.O.- NONE OBSERVED 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 Pdnted Name t_ARS SPURKLAND 11/21/14 Date COSA bmwnsheeL1~1~12.doc I 10I T ~ E EASEMENT [ 10' T * E EASEW~NT ~ 50' 0 ~U~O~ V~W OI~CL~ ~ LOT 2 LOT ~ LOT 2 / / ~' ~ MUNICIPALITY OF ANCHORAGE Development Services Department Right of Way Division Department ENCROACHMENT PERMIT 20100231 THIS AGREEMENT, made this 14th day of April, 2010, by and between Justin and Erica McCaslin and their heirs, administrators, and assigns, hereinafter called "PERMITTEE", and the Municipality of Anchorage, a municipal corporation organized and existing under its Charter and the laws of the State of Alaska, hereinafter called the "PERMITTEW'. WITNESSETH: WHEREAS, PERMITTEE is the owner of the following described real property: GRAVITY HILL ESTATES SUBD1VION, LOT 1, according to the official records thereof, on file in the office of the District Recorder, Anchorage Recording District, Alaska, and; WHEREAS, PERIMITTER owns and/or maintains the real property more particularly described as follows: The FIFTEEN FOOT RIGHT OF WAY DEDICATION FOR INGRESS, EGRESS, AND UTILITY PURPOSES, PER DEED, BOOK 143, PAGE 73, immediately to the west side of PERMITTEES property as shown on Plat No. 2006-166, on file in the office of the District Recorder, Anchorage Recording District, Alaska, and; WHEREAS, PERMITTEE has placed a well upon the referenced real property which encroaches 5.0 feet upon the PERMITTER'S 15' Right of Way and Utility Easement. NOW, THEREFORE, it is mutually agreed between the parties hereto that: 1. The PERMITTER, acting through the Director of Development Services, hereby grants to the PERMITTEE the privilege of allowing the well to encroach 5.0 feet upon the PERMITTER'S 15' Right of Way and Utility Easement, as shown on "Attachment A," included herewith. 2. The PERMITTEE agrees forever to indemnify, defend, save and hold harmless, the Muhicipality, its officers and employees, from any and all lawsuits, claims or actions brought to any person for or on account of damage to property or injury, disease, illness or death of persons, including all costs and expenses incident thereto, arising wholly or in part from or in connection with the existence of, alterations, maintenance, repair, renewal, reconstruction, operation, use or re~noval of the encroaching well, as placed upon the PERMITTER'S 15' Right of Way and Utility Easement. 3. The PERMITTEE shall not assign or transfer any of the rights granted herein to another individual or company without first notifying and securing the approval of the Director of Development Services. This Agreement and Permit grants PERMITTEE no interest in PERMITTER'S real property whatsoever, except only the encroachment rights described herein. The PERMITTER reserves the right to revoke this permit upon twenty (20) days written notice to the PERMITTEE. The PERMITTEE agrees upon such notice of revocation, to move said encroachment(s) from the 15' Right of Way and Utility Easement in which it is placed. Should the PERMITTEE refuse or fail to comply with said written notice, the PERMITTER may, without further notice to the PERMITTEE, remove or cause to be removed the encroachment(s), and the PERMITTEE hereby agrees to reimburse the PERMITTER for ail costs incidental to the removal thereof. In addition to the mutual promises heretofore made, the PERMITTEE has paid the PERMITTER a one-time permit application fee of $115.00. The PERMITTER hereby waives the annual fee of $300.00. 1N WITNESS WHEREOF, the parties hereto have hereunto set their hands and seal the day and year first hereinabove written. GRANTEE: GRANTOR: MUNICIPALITY OF ANCHORAGE fi Jack L. Frost, J~. Right of Way Supervisor STATE OF ALASKA ) THIRD JUDICIAL DISTRICT ) THIS IS TO CERTIFY that on this/~day of April, 2010, before me, the undersigned, a Notary Public in and for the State of Alaska, duly connnissioned and sworn as such, personally appeared Jack L. Frost, Jr., known to me to the Right of Way Supervisor for the Municipality of Anchorage, Alaska, who executed the foregoing instrument, and he acknowledged to me that he executed said instrument as the free and voluntary act and deed of said corporation for the uses and purposes therein mentioned, and that he was authorized to execute said instrument. WITNE,~lla3tthtaad and official seal on the day and year first above written. -~ '.~, ~-" ,~.~' ~ My Co~ission Expires: STATE OF ALASKA ) ) SS. THIRD JUDICIAL DISTRICT ) THIS IS TO CERTIFY that on this ~f.~- day of .~,~..~; J ,2010, before me, the undersigned, a Notary Public in and for the State of Alaska, duly commissioned and sworn as such, personally appeared Eric,~ ~nel--Jtd~t~r. McCa~li., known to me to be the individual(s) named herein who executed the foregcJl~'~}~ru~ent, and (s)he acknowledged that (s)he did so freely and voluntarily for the used and purposes therein mentioned, and on oath stated that (s)he was authorized to execute said instrument. WITNESS my hand and official seal on the day and year first above written. NOTARY PUBLIC in and for Alaska My Cormnission Expires: ~,~, ~ d -~-/:/'t ~. G,qDevelopmcnt SereicesiROt~4Encroachment Permil$1Gravity Hill Estates, Lot l, McCaslin,doc Page $ of~ b~ STATE OF ALASKA ) THIRD JUDICIAL DISTRICT ) THIS IS TO CERTIFY that on thi~} day of .~' '~/.~ [, t_ ,2010, before me, the undersigned, a Notary Public in and for the State of Alakka, duly commissioned and swom as such, personally appeared Justin McCaslin, known to me to be the individual(s) named herein who executed the foregoing instrument, and (s)he acknowledged that (s)he did so freely and voluntarily for the used and purposes therein mentioned, and on oath stated that (s)he was authorized to execute said instrument. WITNESS my hand and official seal on the day and year first above written.