HomeMy WebLinkAboutBEAR RIDGE LT 9Bear Ridge
Lot 9
#067-621-15
Municipality of Anchorage
On -Site Water and Wastewater Program • (907) 343-7904 Page of
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP151119 PID Number: 067-621-15
Dwelling:
■
Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: •
New ❑ Upgrade
Name:
Troy Davis Homes
ABSORPTION FIELD
Address
165 E. Parks Hwy #200 Wasilla, AK 99654
El Deep Trench ■
❑ Other
Shallow Trench ❑ Bed ❑ Mound
Phone
357-9394
Number of Bedrooms
3
Soil Rating
.8 GPD/SF
Total depth from original grade
9.6 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
Gravel depth beneath pipe
Subdivision Block Lot
3.6 Ft.
6 Ft.
Bear Ridge 9
Fill added above original grade
Gravel length
Township Range Section
1-2 Ft.
47 Ft.
Gravel width
Beds: Number of Lines
Distance between lines
SEPARATION DISTANCES
3 Ft.
Ft.
To
From
Septic
Tank
Absorption
Field
Lift Station
Holding
Tank
Sewer
Line
Total absorption area
5564. Ft2
Number of trenches
1
Dist. between trenches
Ft.
Well
>100'
>100'
>100'
>75'
>25'
TANK ❑ Septic ■ S.T.E.P. • Holding ■ Other
Manufacturer
Capacity
Surface Water
>100'
>100'
>100'
NA
Anchorage Tank
1,000 Gal.
Material
Steel
Number of compartments
Two
Lot Line
>5'
>10'
>5'
NANA
Foundation
>5'
>10'
>5'
NA
LIFT STATION
Manufacturer
Capacity
Gal.
Curtain Drain
None
Noted
Remarks
Pump on level at
Pump off level at
High water alarm at
in.
in.
in.
Pump make and model
Electrical Inspections performed by
Installer
PIPE MATERIAL House to tank D3034Tank to 03034
drainfield
Northern Excavation
DrainfieldF810 CO/MTD3034
Inspector W. Roberts
BENCH MARK (Assumed elevation) 100.0 ft
Inspection1m 5/28/15 2"' 5/28/15
Location and description
3" 9/20/15 dt°
Bottom of Siding.
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL
Conditional Approval: Date
':;" s tam
�"�• OF''4$ 4 t
a!dSP,: ' S�,O
,.*; 49TH•••'*o
owt
1
Approve,. ✓
pp
vl��
i-Dd
% ' J #& Dated 2'
3-410400-
i4 or e
0 .MICHAEL E. ANDERSON :,,,..1
�'. CE -4381 �`�®
v1'-^y'•.,.-Zz-r3.•,,, ,
e�
444 /'ROFES510.°- o��
Inspection Rep6rt_9-1-12.doc
i
0
3
0 0
W
0 C
0
d C N
= O0 C
F N J N
0 00 N 0>
-
0 t Cn O2
- 3
C O V) 0 a d p
5 I -OO ui
I I I I I I
I— 0 T 000 > _
M u_i-ONU)5
I I
ti
Esz
\N
2O`pS ®>.
W
1-
0)
W
a
z
W
J
z
N
r�P••. o.-z4t.1111
•
N00`07'00"W x.00
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 Number: OSP151119
93.5
98.5 c'j
Original / Finished
Grade
93.9 1,000 Gallon
Septic Tank
3.75
Page 3 of 3
PID No. 067-621-15
Original Ground
r
Geotextile Fabric
Drainfield Rock
87.52
-744-
No Groundwater
8-28-14
87.52
47 (T nch Length)
PROFILE AS -BUILT
No Scale
O
4'1 4: 4f9tht•
•
' * $
93.5
MICHAEL E. ANDERSON
. Na CE -4381 ' 1
hli, OFE�1�Se
GO 4 -
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4700 BRAGAW STREET ANCHORAGE, AK 99519-6650
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION: BEAR RIDGE SUBDIVISION, LOT 9
PERFORMED FOR: TROY DAVIS HOMES INC.
DATE 5/28/15 PROJECT No.:
PARCEL ID#: 067-621-15 TECHNICIAN: W. ROBERTS
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
TEST HOLE 2
OB/OG
SILTY GRAVEL
WITH SAND
GM
BOH @ 16'
SLOPE
SEE SITE PIAN
WAS GROUND WATER ENCOUNTERED' NO
IF YES @ WHAT DEPTH?
DEPTH OF WATER AFTER MONITORING: NONE
DATE OF MONITORING. 6/5/2015
0
P
E
...E OF r O
•
;
■ 49th GV ''[S�,�,.�)
EatA4
(4 M7 CHA�E'L E. ANDERSONL��,
tC f NO. CE -4381
��.h min3„.i.
Professional Engineers Stamp:
SITE PLAN
SEE SITE PLAN
SEE SITE PLAN
DATE
READING
GROSS TIME
(MINUTES)
NET TIME
(MINUTES)
DEPTH To
WATER
(INCHES)
NET DROP
(INCHES)
5/28/15
TEST HOLE PRESOAKED PRIOR TO TESTING:
I
2:14
1.25"
2
2:44
30
4.00"
2.75"
3
2:45
1.13"
4
3:15
30
3.88"
2.75"
5
3:16
1.50"
6
3:46
30
3.25"
2.75"
PERCOLATION RATE: 10.9(MIN/INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN: 4.5 FT. and 5.5 FT.
COMMENTS' TEST HOLE PRESOAKED PRIOR TO TEST.
TEST PERFORMED BY ANDERSON ENGINEERING. I, MICHAEL E. ANDERSON CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE: 9/22/15
Ca._
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4700 BRAGAW STREET ANCHORAGE, AK 99519-6650
DEPTH
(feet)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION: BEAR RIDGE SUBDIVISION, LOT 9
PERFORMED FOR: TROY DAVIS HOMES INC.
DATE: 10/7/2 015 PROJECT No •
PARCEL ID#: 067-621-15 TECHNICIAN: MEA
TEST HOLE 3
OB/OG
SILTY GRAVEL
WITH SAND
GM
BOH @ 3'
WAS GROUND WATER ENCOUNTERED'
IF YES @ WHAT DEPTH?
DEPTH OF WATER AFTER MONITORING: NONE
DATE OF MONITORING- 6/5/2015
SLOPE
SEE SITE PLAN
Na
Professional Engineers Stamp:
SITE PLAN
SEE SITE PLAN
SEE SITE PLAN
DATE
READING
GROSS TIME
(MINUTES)
NET TIME
(MINUTES)
DEPTH To
WATER
(INCHES)
NET DROP
(INCHES)
10/7/15
TEST HOLE PRESOAKED PRIOR TO TESTING:
I
2:22
0.50"
2
2:52
30
3.50"
3.00"
3
2:53
0.38"
4
3:23
30
3.38"
3.00"
5
3:24
0.50"
6
3:54
30
3.50"
3.00"
PERCOLATION RATE: 10 (MIN/INCH) PERC. HOLE DIA: 6 (INCHES)
TEST RUN BETWEEN: 2.5 FT. and 3.5 FT.
COMMENTS• TEST HOLE PRESOAKED PRIOR TO TEST. TEST HOLE TO VERIFY SOILS FOR ALTERNATE SITE.
SOILS IDENTICAL TO TEST HOLE NO. 2.
TEST PERFORMED BY ANDERSON ENGINEERING. I, MICHAEL E. ANDERSON CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE: 10/8/2015
Certified DrillingLi_g
DOC COON;
IBM ULLIVhN WATER WELLS
P.O. Box 670269, Chuglak, AK 99587 888-2758
OWNER OF LAND: Sarah & David Bellville
ADDRESS: 8070 Pioneer Rd Unit A, Anchorage, Ai{ 99504
LEGAL DESCRIPTION Bear Ridge Lot 9
DATE: 5.30-15
PERMIT NUMBER: OSP1S1119 DATE OF ISSUE:
TAX IDENTIFICATION NUMBER 06762115000
Is well located at approved permit location: yes N0
air rotary ❑cable tool
5-12-15:
Method of Drilling: a
Depth of Well; 285'
Casing Type: Steel
Diameter:
Liner type
6
Wall thickness ,250
inches, depth 285
inches
feet
Static Water Level: Flowing
Recovery Rate 12 gpm
Method of Testing Air El Well Intake Opening Type: I�„y open end
❑ Screened Start feet
❑ Perforations Start Met
Grout Type: Bentonite
Depth: from 2 feet,
Well Disinfected Upon Completion:
Method of Disinfection: Chlorine
feet
gph
open hole
Stopped
Stopped
Volume: 50 Ibs
to 42
yes LJ no
0 PPM
Comments:
Bore Hole Data
Depth
From To
0
2
2
4
4
20
48
20
48
171
171
185
185
279
279
285
Casing Sticku
Overburden
Sand and Gravel
Hardpan
Tight Silt and Gravel
Silty Sand and Gravel with Clay
Tight Silty Gravel with Clay
Sand and Gravel
Drillers Name: Cole Sullivan
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.
Coliform
N e4 .
Col/1 OOmL
Nitrates
o • 9' a
mg/1.
Arsenic
N D
ug/U
Bore Hole Data
Depth
From To
0
2
2
4
4
20
48
20
48
171
171
185
185
279
279
285
Casing Sticku
Overburden
Sand and Gravel
Hardpan
Tight Silt and Gravel
Silty Sand and Gravel with Clay
Tight Silty Gravel with Clay
Sand and Gravel
Drillers Name: Cole Sullivan
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.
SOLif,itN WATER WELLS
P.O. Box 670269, Chugiak, AK 99567 688-2759
www.sullivanwaterwells.com
Pump Installation Log
Well Drilling Permit Number: SW O5P151119
Date of Issue 5-12-15
Parcel Identification Number: 06762115000
Legal Description
Bear Ridge Lot 9
Property Owner Name & Address
David & Sarah Bellville
8070 Pioneer Dr. Unit A, Anchorage, AK 99504
Pump Installation Date: 6-18-15
Pump Intake Depth Below Top of Well Casing: 250'
Pump manufacturer's Name: Goulds
Pump Model: 75B07412CL
Pump Size: 3/4 hp
Pitless Adapter Burial Depth: 10' feet
Pitless Adapter Installer: Northern Excavating
Disinfected Upon Completion? I yes ❑ no
feet
Method of Disinfection: Chlorine 50 PPM
Comments: Pitless Manufacturer: Martinson
Pump Installers Name: Cole & Terry—Sullivan Water Wells
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
On -Site Water & Wastewater System Permit
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
Permit Number: OSP151119
Tax Code Number: 06762115000
Work Type: WellSeptic Initial
Permit Effective Dates: May 12, 2015
to May 11, 2016
Design Engineer: ANDERSON ENGINEERING
Subdivision: BEAR RIDGE
Site Legal Address: BEAR RIDGE LT 9 G:0804
Owner/Address:
BELLVILLE DAVID P & SARAH M
8070 PIONEER DR UNIT A ANCHORAGE AK 995040000
Site Mailing Address: 3322 BEAR RIDGE CIR, Eagle River
Lot Size in Sq Ft: 40946
Total Bedrooms: 3
This permit is for the construction of:
Y Disposal Field Y Septic Tank N Holding Tank N Privy Y Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the -Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By: j /V Date:
Issued By: �'f V t! Date: S"
CUBM!TTAI
MAY 11 2015
MUNICIPALITY OF ANCF9CYRiNer
N'
JCommunity Development Department
Development Services Division
On -Site Water & Wastewater Program
Phone: 907-343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 067-621-15
Property owner(s) David & Sarah Bellville Day phone
Mailing address 8070 Pioneer Drive Unit A Anchorage, AK 99504
Site address 3322 Bear Ridge Circle Eagle River, AK 99577
Legal description (Sub'd., Block & Lot) Bear Ridge, Lot 9
Legal description (Township, Range & Section)
Lot Size 40,496 Sq. Ft. Number of Bedrooms Three
APPLICATION IS FOR: APPLICATION IS AN:
(® all that apply)
Absorption Field
Septic Tank
Holding Tank
Privy
Private Well
Water Storage
Initial
Upgrade
Renewal
0
TYPE OF DWELLING:
Single Family (SF)
(w/wo ADU)
Duplex (D)
Multiple Dwellings
(SF and/or D)
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
Distance:
0
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees: 41 a51-1•'JQ
Date of Payment:
Receipt Number: 001-0atli
Permit No. Os P161119
5/11/15
Permit App_9-1-12.doc
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 (FAX)
May 10, 2015
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 9, Bear Ridge Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The owner of Lot 9, Bear Ridge Subdivision intends to construct a new three-bedroom
home on the lot. We are therefore requesting a permit be issued for the construction of
a new well and septic system to accommodate the home. The attached Site Plan and
backup documentation identify the location and configuration of the proposed well and
septic system along with the alternate site. Also identified on the plans are the existing
wells and septic systems on surrounding lots. No conflicts exist between the proposed
septic system and well or septic systems and wells on adjacent lots. Drainage arrows
and surface contours are shown on the site plan showing the grade and direction of
flow on the lot. The drainage pattern will not be changed as a result of this project.
The test hole placed on the lot in the area of the absorption trench and alternate site
indicate silty gravel (GM) with sand in the zone specified for the absorption trench. The
percolation rate of the soil was determined to be 10 minutes per inch. No groundwater
was found during the placement of the test hole and none developed during the
monitoring period. An application rate of .8 gallons per day per square foot was used in
the design of the absorption system. We are proposing to place a new 1,000 -gallon
septic tank and a 47' long by 3' wide by 6' effective depth absorption trench to treat
and dispose of the effluent generated in the house. The elevation of the distribution
line in the absorption trench will be 3' below the surface and the total depth will be 9'. A
minimum of 3' of fill or 2" of insulation and 2' of fill will be placed over the absorption
trench and 4' over the septic tank.
The ground surface on the lot in the area of the septic system slopes to the southwest.
The new trench will be constructed parallel with the contours of the slope as much as
possible in conformance with Municipal requirements. The new septic system will be
Lot 9, Bear Ridge
May 10, 2015
Page Two
constructed a minimum of 100' from all wells and any surface water and 10' the
proposed and existing water services in the area.
If the system is constructed in accordance with our design the following statements
apply:
1. 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 Tots 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
•
•
0
N -----CO-
N
I 0 c
J y 6
Q
> H O O c
Ill L O 6 0 N O
Z .+ c � 3a.)>0
O lei coo 0 a p
j 0 M I-0 V)M
OF Z I 1 1 1 ILIJ l 1
O w E- IL0HU t00
O mN fn1
>I
z
Q
J
LLJ
F -
v
11
7 F
z
I
HAEL
N00.07'00"W 50.00
LOT 9, BEAR RIDGE SUBDIVISION
DESIGN FACTORS:
Three Bedroom Home
Perc. Rate: 10 Min./Inch
Application Rate: .8 GPD/SF
3 Bedrooms X 150 GPD/.8 GPD/SF (Application Rate) = 562.5 SF Absorption Area
562.5 SF/12 SF/LF = 46.875 LF Trench Length
THEREFORE: Construct a 47' Long x 3' Wide x 6' Effective Depth Absorption Trench at the Location
Shown on the Site Plan. Flow Line Depth to be 3' Below Existing Ground. Total Depth of Trench to
be 9' Below Existing Ground. Provide Minimum 4' Cover Over Septic Tank and 3' Cover Over
Absorption Trench. Maintain 100' Separation From All Wells in the Area.
SYSTEM REQUIREMENTS:
Deep Trench System
1,000 Gallon Septic Tank
6' Drainfield Rock
2'6"
6'0"
Natural
Backfill
Geotextile
Fabric
4" Perforated
3'
PVC (Holes Down)
TYPICAL DEEP TRENCH
(NO SCALE)
NOTE: Grade Area Over Trench to Drain Away.
Minimum 6' Separation From Bedrock.
Minimum 4' Separation From Grouridwa
Minimum 100' Separation From Wells in
Minimum 100' Separation From Surface
Drainfield Rock
SECTION ....��-•444��
PI :.
•49th TF 4 - L
ter. }}yy
the Area. •jjMICHAEL E. ANDERSON g:
Water or Streams. ♦ . No. CE-4381 kir,
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
4.700 BRAGAW STREET ANCHORAGE, AK 99519-6650
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION: BEAR RIDGE SUBDIVISION, LOT 9
PERFORMED FOR: TROY DAVIS HOMES. INC.
DATE: 4/18/15
PARCEL ID#: 067-621-15
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
OB/OG
PROJECT No
TECHNICIAN• W. WHALEY
TEST HOLE 1
SILTY GRAVEL
WITH SAND
GM
BOH @ 15'
SLOPE
SEE SITE PLAN
WAS GROUND WATER ENCOUNTERED? NO
IF YES @ WH
DEPTH OF WATER AFTER MO1
DATE OF MO
114
49th
Cts,
0 MICHAEL E. ANDERSON
••t ' No. CE -4381 ?
♦rT
Professional Engineers Stamp:
SITE PLAN
SEE SITE PLAN
T DEPTH"
ITORING: NONE 0
SEE SITE PLAN
,IITORING. 5/10/2015 P
E
DATE
READING
GROSS TIME
(MINUTES)
NET TIME
(MINUTES)
DEPTH To
WATER
( INCHES)
NET DROP
(INCHES)
4/18/15
TEST HOLE PRESOAKED PRIOR TO TESTING:
I
1:31
0.75"
2
2:01
30
3.75"
3.00"
3
2:02
0.63"
4
2:32
30
3.6Y
3.00"
5
2:33
0.63"
6
3:03
30
3.63"
3.00"
PERCOLATION RATE: 10 (MIN/INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN: 4.0 FT. and 5.0 FT.
COMMENTS' TEST HOLE PRESOAKED PRIOR TO TEST.
TEST PERFORMED BY ANDERSON ENGINEERING. 1, MICHAEL E. ANDERSON CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE: 5/10/2015
rs
Municipality of Anchorage
On -Site Water and Wastewater Program
(907) 343-7904
Certificate of On -Site Systems Approval
Parcel I.D. 067-621-15 Expiration Date:
1. GENERAL INFORMATION
r/g*
Complete legal description Bear Ridge, Lot 9
Location (site address) 3322 Bear Ridge Circle Eagle River, AK 99577
Current Property owner(s) Troy Davis Homes, Inc. Day phone 357-9394
165 E. Parks Highway, No. 200 Wasilla, AK 99654
Mailing address
Real Estate Agent Day phone
2. TYPE OF DWELLING:
Q Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS:
Three
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well E Individual Q
Individual Water Storage ❑ Holding Tank ❑
Community Class Well ❑ Community ❑
Public Water System - ❑ Public Sewer ❑
WaiverNariance request for: Distance:
Received by: Date: Af--f /!
COSA to be relea d to the engineer, unless otherwise requested by the engineer.
COSA Fee $ (0q 8° Waiver Fee $
Date of Payment 9/21-1/K c 0 Date of Payment
Receipt Number 065714G Receipt Number
COSA # 05C16 l5K( 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
Engineer's Printed Name Michael E. Anderson, P.E.
6. DSD SIGNATURE
System #1 Approved for
System #2 Approved for
Disapproved
Conditional approval for
By:
bedrooms
bedrooms
Phone 522-7773
Date 9/2211Sve.t ®®aw®
a �F OF AL tag
p. S'
� -•'° 49 l � _ .7%‘,0 AS
roc •q°° i
,OBY•e lOq S9Y 99aq° q
ate,• fuVCHAEI -ANDERSON
®�'rff'•,9 ZZ-/ S •� °mac,
bedrooms, with the following stipulations:
Original Certificate Date
Th > unicipality 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
Septic System Advisory
Well Flow Advisory
COSA blue sheetr -
Nitrate Advisory
Arsenic Advisory
Other
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: Bx10 r R1 cLG / Lo -t- q
A. WELL DATA
Well type A r i V If A, B, or C provide PWSID # Well Log (Y/N) y
Date completed 5/12/15 Sanitary seal (Y/N) Y Wires properly protected (YIN) y
Total depth AS5 ft. Cased to a85 ft. Casing height (above ground) > l8 in.
FROM WELL LOG AT INSPECTION
Date of test 5- !Z• 16
Static water level 1I0 ft. ft.
Well production 12-- g.p.m. g.p.m.
Parcel ID: 0(07— 1//2-1
WATER SAMPLE RESULTS: (,
Coliform V colonies/100 mL Nitrate - fi() 2,/mg/L p �%
Arsenic MD ug/L Date of sample: Q')0IP5 Collected by: Wean Gn(slyl-e-eriri
B. SEPTIC/HOLDING TANK DATA C r- r ttt G �j J J
Tank Type/Material ���(�f (�e1 Date installed v . Z -O . /5
Tank size 1 V 60 gal. Number of Compartments a Cleanouts (Y/N) y . 1
Foundation cleanout (YIN) y Depression over tank (Y/N) N High water alarm (Y/N) r 'v
Date of pumping !Nevi enn Pumper
C. ABSORPTION FIELD DATA pp�
Date installed Soil rating (g.p.d./ft2 or ft2/bdrm) . O &PD/ SF System type�2f) Qk(ch
Length 14. ft. Width 3 ft. Gravel below pipe IP ft.
Total depth 1 i ft. Eff. absorption area 556+ tt2 Monitoring tube 7 Depression over field ki
Date of adequacy test _14PJA) Cnl t4fQ llesults (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 >=
Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, giva date
g.p.d.
ooptt-o -of laays umoiq VS00
9 FOZ/OZ/L a}ea
'3•d 'uosiapuy '3 JOeyagAJ eweN pe}uud s,JeGulSu3
•euep situ uo page ur sewlaprn6 VS00 VOW gu/M ooueWJOJUon
uu ode sweus fs anoge ow win spioocu ledplunpy Jo moped
pun suogoadsw pay 115no qu pewwrouap emu 1 mil fppea l
NOIIV014111130 S.1133NION3 'O
0 < e6eio}seplyan/6ulped'6eManuU
V/N ulewas}eM
00 4< -a}eM eoellns
plug uogdiosgy
,9<
.001<
SIN3WWO3 'd
OO (< s}ol }ueoefpe uo suom pa}ON euoN Lipp wimp
.001< 1G}eM aoepns 0 ix awl animas n}eM
,01<
uol}epunoj6ulpung ,0i.< augAuedoJd
:01101 NO 01314 NOIldUOSOV
OO (< sup! }ueoefpa uo sum
0 4< awl ao!MJas Jae 0 J.< uiew JeleM
Gull Rpedad 9< uol}epunol 6ulpung
:01101 NO )INV! ONI01OH/o11d3S
same e6eao}s a eioxe lewluafeJnuefy
Nue} 6wploH
.001<
.9L<
}noueelo/aloquew JOMOS ogled
s}ou }ueoefpe up
s}ol }ueoefpe up
.001<
.001<
Esfuaws.nnbei flnono 9 uuele span
,9<
'ul 18 lana) WJele Ja}eM y61H 'u1
(N/A) sseooy/auoyueyy
.09<
,9Z<
OMB }uawule}uoo lewluy
Gull GOIAIGs nudes/JOMOS
ulew JOMOS wind
,006<
.001<
.001<
}ol uo plug uondiosgy
}quo uoue}s UII/Hue} nudes
:01101 NO 113M
S30NVISI0 NOIIVHVd3S '3
poise) sap p wn}ea
18 lana) ,Jun dwnd„ •ul 18 Wel „UO dwnd„
suoue6 ul 0zls pane}sul a}ea
NOIIVIS 1411 '0
LOT 9
40,920 SQ.FT. OF AREA
10
BEAR RIDGE
_
CIRCLE
to o
00 9
i/A°°°0ti
to
7
4
N
N N
w
a"
Ory
8
GRAPHIC SCALE: I Inch = 50 Feet
25 0 25 50 100
FOR: TROY DAVIS HOMES
FORBES& ASSOCIATES, INC.
F.O. BOX 232293
Anchorage, Alaska 90523
(007) 227-5881
Date
09-17-15
Seale
1" = 50'
Grid
SE 804
As—built Survey
2150159
Legal Description
Lt9
Block
Drawn by
eef
Field Book
246
BEAR RIDGE
SUBDIVISION
I hereby certify that the property described hereon has been surveyed
by me, or at my direction, and that the improvements situated thereon
are within the property lines and do not overlap or encroach on the
property lying adjacent thereto unless otherwise shown. That no
improvements on the property lying adjacent thereto encroach on the
premises in question and that there are no roadways, transmission
lines or other easements on said property except as shown.
It is the responsibility of the owner or builder, prior to construction,
to verify proposed building grade relative to finish grade and utility
connections and to determine the existence of any easements, covenants,
or restrictions which do not appear on the recorded subdivision plat.
\ Listed distances prevail over scaling.
\ Reproduction may cause distortion.
%%%%lift
49TH
1
I1
".,..0
:i '. CHARLES E. " . FORKS : of
iffir
;riy. ", LS -7326 j'.:
a'•, 091815 ae A
f'�:er
essieoe1gi14'
'► 111%~
1