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HomeMy WebLinkAboutSTOLLE BLK 3 LT 4Stolle Block 3 Lot 4 #020-021-16 Municipality of Anchorage On -Site Water and Wastewater Program • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP161112 PID Number: 020-021-16 Dwelling: 0 Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New W Upgrade Name: Cash Alaska II LLC ABSORPTION FIELD ❑ Deep Trench X Shallow Trench ❑ Bed ❑ Mound Address P.O. Box 240511 Anchorage, AK 99524 ❑ other Phone Number of Bedrooms Soil Rating Total depth from original grade 569-0555 3 .8 GPD/SF 7.0 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 4.0 Ft. Gravel depth beneath pipe 3.0 Ft. Subdivision Block Lot Stolle 3 4 Fill added above original grade 0-1 Ft. Gravel length 66 Ft. Township Range Section Gravel width 5 Ft. Beds: Number of Lines Distance between lines I Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 569 Ft z One Ft. Well >100' >100' >100' >75' >25' TANK 0 Septic ❑ S.T.E.P. ElHolding ElOther Manufacturer Existing Capacity Gal, Surface Water >100' >100' NA NA Material Number of compartments Lot Line >5' 1'** NA NA NA Foundation >5' >10' NA NA LIFT STATION Manufacturer Capacity Curtain Drain None Noted Gal. Remarks Existing Septic Tank Verified Suitable Pump on level at Pump off level at High water alarm at for Continued Use. Existing Absorption in. in. in. Trench Abandoned In Place. Pump make and model Electrical Inspections performed by **See Lot Line Waiver. Installer PIPE MATERIAL House to tank D3034 Tank to drainfield D3034 Denali Excavation Drainfeld 0810 CO/MT Inspector M. Anderson BENCH MARK (Assumed elevation) 100.0 ft Inspeectio til 6/7/16 6/8/16 Location and description : 2o, 31d 4a Lower Entry Door Stoop. COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp O�'• 4�1t°e Conditional Approval: Date Aux, ° e f 49L 4 a...........;... . ........ ...... 0 • MICHAEL -�- � E. ANDERSON ; W ,0� sem• CE -4381 Approved f� I Date ��� ,',ROFE ';00• hipCu11u11 Rupurt_ 3-1-I2.dm Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT Page 2 of 3 4700 Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 Permit No.: OSP161112 On -Site Wastewater Disposal System or Well Inspection Report 1(0()�� PID N0. 020-021-16 Lot 5 NOTE Existing Absorption Trench Abandoned in Place. Existing Septic Tank Verified Suitable for Continued Use. 49th ....� ...................................... O ;MICHAELE. ANDERSON j ✓� No. cE-4381 r.� 5 STOLLE SUBDIVISION LOT 4, BLOCK 3 201,799 S.F. THREE BEDROOM HOME , A I B C1 53.4' 66.7' M1 48.8' 60.5' C2 44.6' 38.6' Existing ®Well N r_; Lot 3 'q /'UFESSIu p 1• LEGEND FCO — Foundation Clean Out CO — Clean Out PLAN AS B U I L\ MT — TH —Test Monitor Tube Hole : %'� SV — Septic Vent "-- ""— - FDV — Flow Diverter Valve SCALE 1" = 50' Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number: OSP161112 EXISTING Page 3 of 3 I�IUR.�iYZ�E�Y�id[d N Z 2 U 98.0 Finsished Grade Original Ground Geotextile Fabric az Drainfield Rock 90.5 86.0 uNo Groundwater 7-18-97 66' (Trench Length) NOTE: Trench Only Placed Under This Permit. PR❑EIUE AS -BUILT No Scale u/ 84.0 /84.0 No Groundwate 5-14-97 ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) July 29, 2016 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Lot 4, Stolle Subdivision Separation Distance Waiver Absorption Trench to Lot Line Dear On Site Services Engineer: A second absorption trench was placed on Lot 4, Stolle Subdivision in June of 2016. Little area is available on the lot due to the presence of the private well to the east, the driveway serving the house and the bluff in the back. The absorption trench was placed .5' from the northern lot line. The trench does not impact the property to the north as it is currently vacant. Sufficient area remains on that lot to construct both a primary and reserve septic site. We request a waiver be issued allowing the trench to remain .5' from the north property line. Sincerely, 111kc1t� Michael E. Anderson, P.E. 49 th _)K MICHAEL E. ANDERSON .. NO. CE --4381 Municipality of Anchorage P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 0 Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program n int S, n n � rr rr 3" L■ f Department **** VARIANCE/WAIVER REVIEW **** Waiver#: OSV161086 PID#:020-021-16 COSA#:OSC161330 Permit#:OSP161112 Legal Description: Stolle Bilk 3 Lot 4 Engineer: MEA Applicant: Cash Alaska Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is .5 feet. This waiver approval applies to the existing absorption field only. Any future upgrade to the on- site wastewater disposal system will require all separation distances be met or another approval from this department. X The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of non -objection have been received from the owner(s) of the affected adjacent property. ❑ Adjacent properties are not affected by this waiver. ............................................................................... Waiver is Granted: X Waiver is not Granted: Date: g- S -I Approved bv: � V11 j Name of Reviewer ............................................................................... On -Site Wastewater Disposal 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: OSP161112 Tax Code Number: 02002116000 Work Type: Septic Upgrade Permit Effective Dates: May 19, 2016 to May 19, 2017 Design Engineer: ANDERSON ENGINEERING Subdivision: STOLLE Site Legal Address: STOLLE BLK 3 LT 4 G:3243 Owner/Address: CASH ALASKA II LLC PO BOX 240511 ANCHORAGE AK 995240511 Site Mailing Address: 16101 HONEY BEAR CIR, Anchorage This permit is for the construction of: Y Disposal Field N Septic Tank N Holding Tank Lot Size in Sq Ft: 201799 Total Bedrooms: 3 N Privy N 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 sail 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. Receivi Issued MUNICIPALITY OF ANCHO Community Development Department Development Services Division On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Fax: MAY 1 G 2016 Parcel I.D. 020-021-16 Property owner(s) CASH ALASKA II LLC Day phone 569-0555 Mailing address P.O. Box 240511 Anchorage, AK 99524 Site address 16101 Honey Bear Circle Anchorage, AK 99516 Legal description (Sub'd., Block & Lot) Stolle, Block 3, Lot 4 Legal description (Township, Range & Section) Lot Size 201,799 Sq. Ft. Number of Bedrooms Three APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑X Initial ❑ Single Family (SF) ❑x Septic Tank ElUpgrade 0 (w/wo ADU) Duplex (D) ElHolding Tank ElRenewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Codes. DMunicipal li (Signature of property owner or authorized agent) Permit/Rush Fees: Cd 661 Date of Payment: Receipt Number: ©2-o tl CA Permit No. 0S? 1 io (11 Z Permit App_.::- :'_x, Waiver Fees: Date of Payment: Receipt Number: Waiver No. May 10, 2016 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 Elmore Road Anchorage, AK 99519-6650 Subject: Lot 4, Block 3, Stolle Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The absorption trench on the subject lot has failed and must be replaced before a COSA can be issued for the resale of the property. We are therefore requesting a permit be issued for the upgrade of the septic system to accommodate the three- bedroom home on the lot. The attached Site Plan and backup documentation identify the location and configuration of the existing and proposed septic systems. The existing septic tank will be exposed, inspected and verified suitable for continued use. Also identified on the plans are the locations of the existing well this lot. No conflicts exist between the proposed septic system and the wells on adjacent lots. Drainage arrows are shown indicating the current drainage patterns. The ground surface in the area of the proposed trench is virtually flat. The drainage patterns will be maintained after construction. The original design of the septic system for the lot was completed in 2002 and included the design and approval of the alternate site. This design includes the use of the alternate site to replace the primary alternate trench. The test holes placed on the lot during the original design indicated Silty Gravel (GM/ML) in the absorption zone of the trench. The percolation rate was determined to be between 10 minutes per inch. No groundwater was encountered during the placement of the test hole and none was noted during the monitoring period. We are using the original approved design for the new trench with an application rate of .8 gallons per day per square foot. We are proposing to use the existing 1,000 gallon septic tank and a new 66' long trench by 5' wide with a 3' effective depth. The total depth of the system will be 7' with the distribution line at 4' below the existing surface. A flow diverter valve will be placed and the existing absorption trench connected for future use. Lot 4, Block 3, Stolle May 10, 2016 Page Two The ground surface on the lot in the area of the new trench is flat. This area was previously approved during the initial design process. The trench will be placed parallel to the contours of the ground as much as possible and in conformance with design criteria. A minimum of 100' will be maintained between all components of the septic system and the proposed well and from any surface water 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 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 49th MICHAEL E. ANDERSON STOLLE SUBDIVISION LOT 4, BLOCK 3 201,799 S.F. LOT 5 UNDEVELOPED �5 5 55 WELL RADIUS LOT 8 \ \ Well Radius Must Be Located by a Registered Land Surveyor \ Prior to Construction. SCOPE OF WORK ` Verify the integrity of the THREE 1 existing septic tank for BEDROOM HOME 1 continued use. Place Flow Diverter Valve and connect 1 1 existing trench. Construct new \ � 66' long x 5' wide x 3' 1 effective depth absorption trench. ntf 66' Lang x 5' Wide x 3' Effective Depth Absorption Trench 1` LEGEND 1 FCO — Foundation Clean Out CO — Clean Out 1 MT — Monitor Tube TH — Test Hole SV — Septic Vent IFDV — Flow Diverter Valve 655a �5 � � N NOTE ® No Slopes >25% Within 50' 1 Existing of Septic System. No Well Surface Water within 100'. LOT 3 No conflicts this lot with o well r septic system on Lot 4. SITE PLAN SCALE 1" = 50' LOT 4, BLOCK 3, STOLLE SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Three Bedroom Home 5' Wide Trench System Perc. Rate: 10 Min./Inch Verify Existing 1,000 Gallon Septic Tank Application Rate: .8 GPD/SF 3' Drainfield Rock 3 Bedrooms X 150 GPD/.8 GPD/SF (Application Rate) = 562.5 SF Absorption Area 562.5 SF/5 SF/LF-.58 (Red. Factor) = 65.25 LF Trench Length THEREFORE: Construct a 66' Long x 5' Wide x 3' Effective Depth Absorption Trench at the Location Shown. Flow Line Elevation in Trench to be 4' Below Original Ground Surface. Total Depth to be 7' Below Existing Ground. Provide 4' Cover Over Septic Tank and 3' Cover Over Absorption Trench. Maintain 100' Separation from Wells in the Area. Place Flow Diverter Valve and Tie in Existing Absorption Trench for Possible Future Use. Natural Backfill 3'6" Geotextile Fabric 6�—ed PVC (Hole Down) 3'0" 5' Drainfield Rock TYPICAL 5' WIDE TRENCH SECTION y�►•..,�, (NO SCALE) P1E.........A(,q NOTE: Grade Area Over Trench to Drain Away. = Minimum 6' Separation From Bedrock. ....n ...49th Minimum 4' Separation From Groundwater. _ Minimum 100' Separation From Wells In the Area. • ' •aa MICHAEL E.ANOERSON Minimum 100' Separation From Surface Water or Streams: QR'�%., No. mom Municipality of Anchorage tNEERS Development Services Department Sullding Safety Division , t C • a.�a On-Site Water and WastewaterPmgren , '-' ""-"""'• 4700SMMBragawSL t P.O. Boz 198650 An&wrage. AK 995146650 -A ROaEa7 G COWAN j www.d.andtara.ek.m �! �%l CE •6801 L oefr Y (907)343-7904 Solis Log - Percolation Test • ;ti: r�-1�,� Performed For. GO R J O N $' C it v 044:0— Date Perlotmed �j. �/ /D 2.. Legal Deoaiption: LOT If 01-o a re 3 57'01-4-4 Town", Pangs. Sewon: 7-rr.s7- Poe-& # 3 GM,M L fait a- PIEltt O,a,-Y WAS GROUND WATER N O ENCOUNTERED? WYES.A7WHATOEPTH1 ` DWhto WaterARw MoaftmeT weK Reading Date Groes Time Net Ane Depth to water Net trop 0 �— y YL 30 70ar.r �0 — �N 60 7 60 S" — 90 soar g^ 3 PERCCIATION RATE / V e..w.aee PERC HOLE DIAMETER j TESTRUN9ErWEEN -7 IT AND FT li COMMENTS PERFORMED BY: 4-1 O 044.! ` C. C0 W.1w 1 CERTIFY TMAT TMS TESTAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND 6fUNICIPAL GWOELINES IN EFFECT ON THIS DATE. DATE: i Municipality of Anchorage a ie DEPARTMENT OF HEALTH & HUMAN SERVICES 625 "L" Street, Anchorage. Alaska 99502-0550 SOILS LOG — PERCOLATION TEST PERFORMED FOR: %'a /t 00N $C.biv 44-A 7' DATE LEGAL DESCRIPTION: "8ak 3 5r- c.).L I Township, Range, Section: SLOPE SITE PLAN 0 '" a;* s - 'i;Fff71 •\\ 1 ORGK,.ncf PR4vrorft-y RR tnov E4 2 f'•'� $ W SiTnO WtrN Sn.T 3 4- 6- 7 5 F 8 4 r �y 9 '4 a"� q 10 •f. A. L A 12 13 14 15 1B 17 Is- 19- 20- COMMENTS 81920COMMENTS G�RAvE 1, i'y J'4"h i Con R4.,ac WASGROUND WATER 140 ENCOUNTERED? IF VES, AT WHAT DEPTH? @iblo Waa After bRY 71/1/4 et.w...ev _. 0s)e: S� Reatl)n 8 Date Gram Time Net Depth to Time Water Net Drop A �SoRrc J. xg 7 _ 1: of elf as Y t }N n 3 :os e) Y PERCOLATION RATE a-7 Inunulea/Inah) FERC HOLE DIAMETER 6 " TEST RUN BETWEEN / r/; FT AND ", 71 FT r5 It 5 ENGINEERING CERTIFY THAT THIS TEST WAS PERFORMED IN PERFORMED BY: IT 7 ACCORDANCE WITR'/1LL ERNU7RfJRnC I. GUIDELINES IN EFFECT ON THIS DATE. DATE: 7 Ar / 72.005 (Rev. 4lEM) Munlcipe8ly of Anchorage o DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMEDFOR:. G.OROOaJ SCA0 ft -el1 DATE LEGAL DESCRIPTION: "'r y SLOG 3 .5 TO LJ. t:_ township, Range, Section: DEPTH SLOPE SITE PLAN (FEET) ! �. y r 114Lf— *- ! 1 1 ? BR4A.d1 L f Y 2 q 0 3 y 4 6 �f 15 16 17 18 19 a_D.14. (+.RAJ 4cY� ,fBi..OY .S f4i' Mo04't4rf4y n4msE WAS GROUND WATER N p ENCOUNTERED? S IF YES, AT WHAT -- L DEPTH? p DAY .1 /r1197 E 8eplh to Waw Apr DRr Da MaNwing? 4, 20 PERCOLATION RATE S- 3 (minut�tind) FERC HOLE DIAMETER TEST RUN BETWEEN -7 FT AND $ FT COMMENTS &462 .'s 4e'7E4 j40..iraRgd IN Raa-4cEN7' Oto TeTT #04f- ao recr to TH4L EdsT. S & S ENGINEERING PERFORMED BY: I CERTIFY THAT IS TEST WAS PERFORMED IN 17034 op Road No. 204. 771S-7177 R vor e ACCORDANCE Wff6VrVT,jA ftNR* jt)PAL GLADElINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4185) ����mF��ss��o■ 20 PERCOLATION RATE S- 3 (minut�tind) FERC HOLE DIAMETER TEST RUN BETWEEN -7 FT AND $ FT COMMENTS &462 .'s 4e'7E4 j40..iraRgd IN Raa-4cEN7' Oto TeTT #04f- ao recr to TH4L EdsT. S & S ENGINEERING PERFORMED BY: I CERTIFY THAT IS TEST WAS PERFORMED IN 17034 op Road No. 204. 771S-7177 R vor e ACCORDANCE Wff6VrVT,jA ftNR* jt)PAL GLADElINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4185) Development Services Department Building Screty Divisicn y` On -Site Wear (& Wcste'wcter pracrcm 4700 Bragaw Street / P.O. 6ax 1966:o Mark AncharagL, AK 99719-66'•0 Maycr�,. In, "t W (9C7) .143 -790A Pump Installation Log Well DrUlin; Permit Number: SW_ Date of Issue: _ parcel Identification Number:_ Leval Description Pro erty Owner Name & Address: Stolle 63 L 4 Pump Installation Date: pump Intake Depth Below Top of Wen Casine:ay6 feet pump Manufacturer's Name: �J�qdj;4 Pump Model: /cOC3116A.W a I J8 Pump Size hp pitless Adapter Burial Depth: f/ feet pitless Adapter Manufacturer's Name: /{i�?+ Pitless Adapter Installer: /V/lf Well DisinfeMed upon Comoleconi�Yes ❑ No iYIechoA F D''': Comment Pump Installer Nae: SfZ��9/11A� m&Al A� Attention: The pump i=aller shall provide a pump installation log to the DSD within 30 days of push installation. Municipality of Anchorage • �'. • rr �wH • Ii+Fi•, Development Services Department Building Safety Division -- On-SRe Water and Wastewater Program, 4700 S. Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page I of 3 www.cl.anchorage.ak.us (907) 34}7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: _SWOQQQ5 PID Number: MO—ODI-16 N.m. of oh SG / Wastewater System: R New ❑ Upgrade ABSORPTION FIELD Plan. ^� _ 8o Nulro.r of Badrp 3 d O D.p TwKh 11<" w TranrA Dead O M w4 O Oew LEGAL DESCRIPTION a°' "'°n° g «D.pe borne "nal pM. • GP06P FI. Blob •-� La. auR6Nren: /r''�-" „ . o oapm r pp. Rohan Rom Wqg Watts " Mph R aflt pp• 3 ..`J / 1 FI. FI T~w p� Rage sworn: F'aaaaa aeov. Mgin prods + v«l&Vtt,. 66 [N� Fl. FL Well: ❑New [I Upgrade or.v«rrm' WRrr. Dwame O� "lp, Fl. I FI p yrRo.en (P".r, ti B . Tot« Dpao Ce.ad r'. Told ablomo n ✓.e'. P Ll.tanat FI. R tile?Z.56 SFIS T 0~ o«. Dulls sbhe Wa✓L.r«. M.talw: &Wr D«. h,V".d FL Yl«a S.t.l. Grua H.y aatl.. TANK cPu FI. SEPARATION DISTANCES XSeptic ❑ Holding [I S.T.E.P. Q Other. To Septic Absorption Lift Holding ubtiUPrlvate Tek/ apwty From Tank FWd Stallon Tank Sewer Line o«. WM 7 V5' Sr+ '"««« 5fCe Naro«acoro.nm«x. swfy wat" �� LIFT STATION LM for Founder, en rW at •Pump a High r.l✓ ;..—at In C,ol«n d«n oI'fe IIeiIJ• / Ma.a a Elwl.ut h,pac.ana p✓IamM Rr R.m✓Ra alf = S BENCH MARK Lorr.on and D.ampam. � r Di-Sr6r c04�bt M v gfdr574vc a, S An To -7' AEPTH, AdelriRv4a PERc //� q 4v.ppn or T I©O FL 7-4.S CA .C'A T(d sct 14'7TAof{EdSOIL S toG, ptS/4w C .,,(,ECAaLt.4 h/ 1� .•:�'2 0 t G �� /o a f� 17034 Eagle River Loop Road, No.gyp Inspections performed by: Dates:{ 1F( 6-Eag " .2nd � / �6 �... ". � ROBERT C. COWAN �l Development Services Department Approval y"gf CE•B80c .��`�wf yl Reviewed and a �-1 1 IC CLtic Es�Owate: approved b Y f 31% 1�" Dom. ^�0��"T _ (Rw 12m) t ,�t�1�irL S,arr' U PERMIT NO. SW020125 PACE 2 OF 3 Municipalityof Anchorage DEPARTMENT OF HEATH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 4, BLOCK 3, STOLLE S/D P.I.D. NO. 020-021-16 LOT 5 10' MI 1 - TLL RADIUS C TH /3 D81.1 \DBL2 ST2ST \ �NEEyy��,, FC 010 Q� ��". 1000 GALLON B G?� \ ,�. SEPTIC TANK '`y TB M `k^ O \ OO \\\+►r, DECK \\ \ TRENCH cqp! \ \MT2 CO2 ALT. SITE ATH /1 LOT 9 LOT 3 flpO\JS SCALE: V\ 40' 200"T C. COWAN C£-8801 PERMIT NO. SW0201 25 PACE 3 OF 3 Municipalit of Anchorage DEPARTMENT OF HEATH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 4, BLOCK 3, STOLLE S/D P.I.D. NO. 020-021-16 1 FINAL GRADE ST2 i 98.8' 92.5'// NEW 1000 X92.3' GALLON SEPTIC TANK CO1 MT2 CO2b1T1 CO' = 97.9' CO2 = 97.2' FINAL GRADE COI = 92.1' SR I CO2 = 92.3' MT2 = 490.1' _N'- MT1 = 89.1' E'G22 Av C� KLL(. !- Mr Ovi2v.6 . I1eGKf.L�• NO WATER FOUND b'd, I' R_0 14 N. T. S. Municipality of Anchorage INEER'S A Development Services Department i `�• Building Safety Division y�r On -Site Water and Wastewater Program 4700 South BragawSt. �A• ..�, •. _•-..�l,::...;,,,' P.O. Box 196650 Anchorage, AK 99519-6650 '/ Inl ROBERT C. COWAN Q w ww.d.anchoraoe.ak.us l� c%' CE -8801 41-; (907) 343-7904 Soils Log - Percolation Test •a _ Performed For. GO R a c S C It v Aot'L Dale Performed: Legal Description: )_o7' 11 0 Lo C K 3 5 % 0 LL£ Township, Range, Section: 7-k S' NDc fi Depth � 3 ' Date �a &MA L Depth to Water 5 X/0" L D Depth to Water After � Monitoring? Pts RC Date: 1 1 15- 16- 17- 18- 19- 20 - COMMENTS WAS GROUND WATER N0 Date ENCOUNTERED'! Net Time Depth to Water 5 IF YES, AT WHAT DEPTH? ` L D Depth to Water After P Monitoring? E Date: Site Plan Reading Date Gross Time Net Time Depth to Water Net Drop 3 O 70 Al"V ., 5 H ,�1, 30 — -1 ' — 6 J 30 nrr % %•'' 3 60— `jO 30 3 PERCOLATION RATE / V J.." Wh) PERC HOLE DIAMETER (7 ' TEST RUN BETWEEN _ 7 FT AND ��FT PERFORATED BY: /L o i pi e l� ` , Co w IN 1 i� G. Ge/2.� CERTIFY THAT THIS TEST/y�/AS PERFORATED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: G// / /O 2_ .,� . Municipality of Anchorage AW Department of Health and Human Services 825 °L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 Rick Mystrom http:/Mrww.a.anchorage.ak.us Mayor Permit Number: #SW 020125 Date of Issue: 5-22-02 Parcel Identification Number: 020-021-16 Date Started: 7-20-02 Date Completed: 7-21-02 Is well located at approved permit location? ® Yes ❑ No Legal Description: Stolle Blk31t 4 Property Owner Name & Address: Gordon Schubert PO Box 113338 A—1,A! L -in 008;11 Borehole Data: Depth (ft) Method of Drilling ® air rotary ❑ cable tool Soil Type, Thickness & Water Strata From To Casing type: steel 'stick-up 0 2 Wall Thickness: .250 inches 9, organic & silt - — - - - gravelly silt 'Bedrock - 2 — 3 - - 3 21 21 347 - - Diameter: 6 inches Depth: tM feet Liner Type: Diameter: inches Depth: feet Casing stickup above ground: 2 feet Static water level (from ground level): 127 feet Pumping level: 347 feet after 2 hours pumping 3 gpm Recovery Rate: 3 gpm Method of Testing: air Well Intake Opening Type: ❑ Open End ® Open Hole ❑ Screened Start feet Stopped feet ❑ Perforations Start feet Stopped feet Grout Type: Bentonite anular Volume: 1 bQs Depth: Start 0 feet Stopped feet Pump: Intake Depth feet Pump size hp Brand Name Well Disinfected Upon Completion? ® Yes No Method of Disinfection: chlorine tablets Comments: Well Driller: Alpine Drilling & Enterprises PO Box 110496 I Anchorage Alaska 99511 Attention: The well driller shall provide a well log to the property owner within 30 days of completion and the property - A- _ 11 -9-!11-- -1. _u-!.1- ----n I_ _ .- A. - T\_._. _rTr__1.t. In ri-_.__' __'.t en .1 ---- -r---'- II !" Jlayor .llurk Begich Municipality of P.O. N).% 1!Xiin(I • ,\nchorngc, .Vuskn !Y.Li1!)dXinll • Telephone (!X)7) 343 -KU)[ • Fax (!X)7) &43-!t'_(X) 47(X) Ihagaw Slrccl •.\nchomge,,%1nskn!X1.907 """'"enLorg I31111(ling Safety Dhislon 8/10/2005 S&S Engineering 17034 Eagle River Loop Road, 4204 Eagle River, Alaska 99577 Subject: Waiver Request for Stolle Subdivision, Block 3, Lot 4 Waiver Request #WR050061 Parcel ID 4020-021-16 Permit # SW020125 Dear Mr. Cowan: Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 8.0 feet. This waiver approval applies to the existing absorption field to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Julie Makela, P.E. Civil Engineer On -Site Water & Wastewater Program Community, Security, Prosperity Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchoragc.ak.us (907)343-7904 Waiver Review Worksheet WR#: WR050061 PID#: 020-021-16 HAM _ Permit#: SW020125 Date Received: 8/4105 Legal Description: Stolle Subdivision, Block 3. Lot 4 Engineer. S&S Engineering 17034 Eagle River Loot) Road. #204 Eagle River, Alaska 99577 Applicant: Gordon Schubert Waiver Requested: 8 feet from absort)tion field to lot line Criteria: Geology A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: Points: ............................................................................... Waiver is Granted: _I Waiver Is not Granted: List Conditions or Reasons for above: Date: i�('T _ By. , ame of Reviewer .............................................................................. Rec#: 71934 Amount: $175.00 Date Paid:45 S& July 25, 2005 ROBERT C. COWAN, P.E. ROBERTA. SHAFER PE. CML ENGINEERS (907) 6942979 FAX(907)694.1211 NEALTNAUTNIORITY APPROVALS MUNICIPALITY OF ANCHORAGE Development Services Department P.O. Box 196650 SEWERE(fE SCIONS Anchorage, AK 99519-6650 REFERENCE: Lot 4; Block 3; Stolle SEWERA WATER I SPECTICN Request you grant a waiver on the referenced property for the horizontal separation distance between the leachfield and the north property line at 8 feet. ENGINEERWGSTUOIES AND REPORTS We do not anticipate any adverse effect on the well or the adjacent property. If you require additional information, please contact us. WELLINSPECTION S PLOW TEST l Sincerely,? SITE PIANS J;/ Robert C. Cowan, P.E. RCC/ts ROAD DESIGN SOILTEST PERMIT FEE: PAYMENT DATE:'31140 "- RECEIPT #: 'li 34 PERCOLATION - - TEST STRUCTURAL S AECKAN CAL. ON SITE WASTEWATER DISPOSALSTSTEM DESIGN 17034 NORTH EAGLE RNER LOOP • Sun 204 • EAGLE RIVER, AUkSKA 99577 SM PEAETTRAVIIRORIITY APPROVALS 11G Date: _S/31/03 nOBERT C. COWAN, PE. nOBERTA. SHAFER P.E. CML ENGINEERS (907)694-2979 FAX(907)694.1211 Municipality of Anchorage SEWERAWATER DEPARTMENT OF HEALTH AND HUMAN SERVICES MNN EXTENSIONS 825 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 SEWER 6 WATER INSPECTION ' REFERENCE: SOT cI 13 "GK 3 s; a LLE- S/o ENXiHEERRlo S11AIE4 ANDREPORTS The septic inspections for te referenced property were performed on /O z. and 6 a i . Prlor to submitting the On-site Wastewater Disposal System and/or Well Inspection Report we are waiting for the o .be - wEUINSPECTION SPLOWTEST r . completed. DISiFA- cH.4 .c a cx&&..(o IA., 61j102_ If we may be of further service please contact us. SITEPLANS Sincerely, 2clz� POW DESIGN Robert C. Cowan, P.E. SOILTEST PERCOLATION TEST STMJCnXM a MECNHMCAL INSPECTIONS ONSITE WASTEWATER ORSPOSALSYSTEY DESIGN! 17094 NORTH EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER, ALASKA 99577 _Z. ✓ ZP MUNICIPALITY OF ANCHORAGE Z� Development Services Department On -Site Water& Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 2 AO -10 Z �/ S pE<Tioiv (907) 343-7904 'C// g : ODP, .., ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT Renewal Date Issued: May 22, 2002 Expiration Date: May 22, 2003 Permit Number: SW020125 Legal Description: STOLLE BLK 3 LT 4 Design Engineer: 0003 S & S Engineering Owner Name: Gordon Schubert Owner Address: PO Box 113338 Anchorage , AK- -OON aqt::nc -:�o Parcel ID: 020-021-16 Site Address: Lot Size: 201799 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 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. 61*102 E N& iuF s1? PR oPoSEs re �FOFS�G,v s rs rE�y Oat re '9 lopR�oc �IT-io ti TF_ S r @ 7/ r/ -4 T 7 rG r6 L p ry! 3 r � Fi��<Ti► 6 S, s ' L o vC. Received By: Issued By: Date: 5—x.�'/° Z Date: Z 2 k Municipality of Anchorage o 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 SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 00Z- I — /& Permit Number SW OZO/ 2'S Property owner(s) (?"C7 j�/��>l�r, �G/1 U/J (3/;7� Day phone _ 3 <%Z/ 6' Mailing address (1)_ 0� /-OX %l 3 b ����-»� � W �I rll Mailing address (2) Zip Code Legal description (Lot, Block & Sub'd.) Legal description (Section, Township & Range) Lot Size got -7q 9 Acresq.Ft. THIS APPLICATION IS FOR: Number of Bedrooms 3 Sewer Only ❑ Well Only ❑ Sewer and Well Water Storage ❑ Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit Fees: Ss (7 Waiver Fees: Date of Payment: S-- / 6 - O 2— Date of Payment: Receipt Number: f q g 3 Receipt Number: (Rev. 12100) Municipahty of Anchorage y Department of Heath and Human Services ��, 825 "L" Street ��� Rick Mystrom, P.O. Box 196650 Anchorage, Alaska 99519-6650 Mayor http://www.ci.anchorage.ak.us 343-4744 August 18, 1998 Gordon B Schubert PO Box 113338 Anchorage, Alaska 99511 3338 Subject: Lot 4 Block 3 Stolle Subdivision Permit #SW970261, PID #020-021-16 The subject permit, issued August 15, 1997 by this office for a single family well and/or on-site wastewater system, has expired as of August 15, 1998. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. If you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If a licensed Professional Engineer has inspected the installation of the on-site wastewater system, the original as -built inspection report must be sent to this office for review, approval and documentation. All inspection reports must be submitted within 30 days of construction complet'_on. When applying for a new permit, the fees are: $320.00 for an on-site wastewater permit; $120.00 for a well permit and $440.00 for a combined on-site wastewater and well permit. If you have any questions, please call this office at 343-4744. .Sinderely, /Jm esCgram Manager On-site Services enc: Copy of Permit cc: S & S Engineering MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW970261 DESIGN ENGINEERS & S ENGINEERING OWNER NAME:SCHUBERT GORDON B OWNER ADDRESS:120 WEST 14TH AVE. ANCHORAGE, AK 99502 PARCEL ID:02002116 LEGAL DESCRIPTION: STOLLE BLK 3 LT 4 LOT SIZE: 201799 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 IHIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 1 DATE ISSUED: 8/15/97 EXPIRATION DATE: 8/15/98 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 DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY:�--� DATE: !' Q ISSUED BY: / DATE: S �5 9 �S & S� ROBERT C.COWAN, RE. ROBERTA. SHAFER, P.E. EnGlneexlnG ma CIVIL ENGINEERS AA (907)694-2979 July 29, 1997 FAX(907)694-1211 MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION HEALTHAUTAPPROVALS HORITY MUNICIPALITY OF ANCHORAGE JUL 3 p 1997 Department of Health and Human Services P.O. Box 196650 RECEIVED EC c I v E SEWER&WATEfl Anchorage, AK. 99519 L. ANNEXTENSIONS REFERENCE: Lot 4, Block 3, S To c,L: Subdivision SEWER&WATER INSPECTION Request you issue a permit to install a septic system to serve the proposed three bedroom house on the referenced property. Test holes were excavated and percolation tests performed. The approximate location of ENGINE TUDIES AND REPORTSORIS P the test holes are located on the attached site plan. The monitoring tubes within the test holes have been checked and found to be dry. WELOWTESCTION This roe has enough area for a future septic upgrade which can be seen on the BFLOW TEST property rtY � P pgT attached site plan. We do not anticipate any adverse effects on neighboring wells, septic systems or drainage SITE PLANS patterns by the installation of the proposed septic system. If you require additional information, please contact us. ROAD DESIGN Sincerely, SOILTEST ? V�_ " 4, Robert C. Cowan, P.E. RCC/mg PERCOLATION TEST Enclosure STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 1" = 60' SITE -PLAN DESIGN SCALE c oy� � r Ai7� E0H > O times � H y7 RI N W W0 y ? W d > D Ham' W fTl D 0 O 0 z r Z �y Zp m"O moo. Om0 xi ILII Ln t�d 'o a n��YYTr� i O - - --"A" -3 P3UBDRM p o ry roo �pApS F HOUSE o FO d w Fjy 0 qY o X 0 n C) o �x m o 0 WO Din 10LM z -I m w ow0 z0O Nzy H S_ a x cCc m a -i avmiKm zm V ZO m zDnm y"N N .ice Y G1 n v m z z% I .n D 2 AZ-T�r<y3 H _c t ' r vim ZKmz V c z y 0o v N C Z Ce v. �i00 Zf 4cn C rc� Z>x = �C) m ••DO A A_v0 mo N> oDz i Ao yy 0 3 ODy ZZ O H Z8 ol ZN H P w oamo h vO�Z� • •�v��`iy OmD�� O-jo p =m Zq t, mm m v' p m xrpa ori 0 ozop '.' F i^ �3 1M�a ' el $ PROPERTY LINE APPROX. 170' oo 4C yam t v z y FfA E d Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: Go 2nO,J S 1 DATE PERF( LEGAL DESCRIPTION: LD '1 5>_K 3 S Tp LjL JE. Township, Range, Section: SLOPE SITE PLAN DEPTH (FEET) 7 L 1 34 ©2FA�r�5 h 2 3- 4- 4 r 5 Q v 6 GM/ML 7 8- 9 9 a 10 11 \3�t 12 13 14--- 15 4 15 16 17 18 19 20 COMMENTS if re/Lr 7-O (;-RAv h�Y� SAND y S ! L T WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT •— L O DEPTH? p DAY ,3I q7 Depth to Water After- / Monitoring? b"y Date: Reading Date Gross Net Time Time Depth to Net Water Drop Q�.-Ui9 l�L PERCOLATION RATE S-1 3 (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN -7 FT AND 0 FT /yio.•.tr"I iA tN Ra4-h c6t✓% Op.p TIFy htd c_>r BAST 3 O NG% .G�1✓� PERFORMED BY: S & S ENGINEERII CERTIFY THAT THIS TEST WAS PERFORMED IN 17034 Eagle River Loop Road No. 204 '7/ /5-/q 7 ACCORDANCE Wij4Cd-Rrir1 TA WR.aVM97PAL GUIDELINES IN EFFECT ON THIS DATE, DATE: 72-008 (Rev. 4/85) Municipality of Anchorage e DEPARTMENT OF HEALTH & HUMAN SERVICES t 625 ••L•• Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: V-0 /t n0 N S 061,13/'''0 -r DATE PERFORMED:, ROBERT C. COWAN [E-8801 LEGAL DESCRIPTION: LJ] H -OLk 3 5rC. -L E - Township, Range, Section: PERTH ^� SLOPE SITE PLAN (FEET') 1 OR6,6rIc5 P44..vlooS� y N 2 3 Gross Time Net Depth to Time Water Net Drop ra s -/o2 97 4 ` r�r1s 5 .H B C 6 ` 4R': ! M/ 7 TAY (T'ML 8 a t 9 a •, r. 10 •4. o: D� 5 11 - •a 12 13- 14- 15- 16- 17- 18- 19- 20- COMMENTS 314151617181920 COMMENTS CA14Vj,1,Ly S4"4y 7-/c5 FFaL6 +V / Ca.�l. JT /cRC WAS GROUND WATER Q ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth to Water Ager b A Y nate. 74 3L9-7 S' It ' Reading Date Gross Time Net Depth to Time Water Net Drop P icsu/;-K s -/o2 97 3 TAY v PERCOLATION RATE `l • 7 (mmutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN / /A FT AND a- ,/--L FT E GINEERING PERFORMED BY: EE17034 ragle nn,, pp ee,,•yer eeeet4,n� qqpp � CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITA'1*1 SjVAefH Tt'F7Q1G ??A4 1- GUIDELINES IN EFFECT ON THIS DATE. DATE: 7 /7 J' / '1`7 72-008 (Rev. 4/85) Parcel I.D. 020-021-16 Municipality of Anco On -Site Water and Wastewater Phiog n "' (907) 343-7904 a JUL 2 9 2016 g T f E T Y I: L(5p Certificate of On -Site Systems 1. GENERAL INFORMATION Expiration Date: ) f / b Complete legal description Stolle, Block 3, Lot 4 Location (site address) 16101 Honey Bear Circle Anchorage, AK 99516 Current Property owner(s) Mailing address Real Estate Agent 2. TYPE OF DWELLING: Cash Alaska 11 LLC Day phone P.O. Box 240511 Anchorage, AK 99524 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System WaiverNariance request for:, Three Day phone, 569-0555 TYPE OF WASTEWATER DISPOSAL: El Individual FX] ❑ Holding Tank ❑ ❑ Community ❑ ❑ Public Sewer ❑ Received by: Qjt �i�A fI _ Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 42 k9. fo Waiver Fee $ Date of Payment � � 7i/(7 Date of Payment Receipt Number Receipt Number COSA# UTC-l(/31�0 Waiver * �/6A0 30Q 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 Phone 522-7773 Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. 6. DSD SIGNATURE System #1 Approved for —3— bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the Date 7/29/2016 r By: Original Certificate Date: E_7�C�! The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory . Arsenic Advisory Well Flow Advisory Other COSAbluesheet r - :: c 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: Stolle, Block 3, Lot 4 A. WELL DATA Well type Private If A, B, or C provide PWSID # Date completed 7/21/02 Sanitary seal (YIN) Y Total depth 347 ft. Cased to 27 ft. FROM WELL LOG Date of test 7/21/02 Static water level 127 ft. Well production 3 g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 mL Nitrate ND mg/L Arsenic ND ug/L Date of sample: 6/17/16 B. SEPTICIHOLDING TANK DATA Parcel ID: 020-021-16 Well Log (YIN) Y Wires properly protected (Y/N) Y Casing height (above ground) >18 in. AT INSPECTION 9/4/2015 129 ft. 2.9 g:p.m. Collected by: And. Engineering TankType/Material Septic/Steel Date installed 6/1/02 Tank size 1,000 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (YIN) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping 7/29/16 Pumper Around the Clock C. ABSORPTION FIELD DATA a Date installed 6/7/16 Soil rating (g.p.d./ftZ or ftZ/bdrm) .8 GPD/SF System type 5' Wide Length 66 ft. Width 5 ft. Gravel below pipe 3 ft. 85 Total depth 8- EE ft. Eff. absorption area 569 fe Monitoring tube Y Depression over field N Date of adequacy test New -Const Results (Pass/Fail) For 3 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.) (Y/N & type) If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at in. "Pump ofF' level at in. High water alarm level at Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES WELL ON LOTTO: Septic tank/lift station on lot >100' Absorption field on lot >100' Public sewer main >75' Sewer /septic service line >25' >50' On adjacent lots On adjacent lots >100' >100' Public sewer manhole/cleanout >100' Holding tank >75' Animal containment areas Manure/animal excrete storage areas >i nn' SEPTIC/HOLDING TANK ON LOT TO Building foundation >51 Property line >5 Absorption field >51 Water main >10' Water service line >10' Surface water >100' Wells on adjacent lots >100' ABSORPTION FIELD ON LOT TO: > 10' Property line Building foundation Water Service line >10' Surface water >100' Curtain drain Nolle Noted Wells on adjacent lots >100' F. COMMENTS Water main >10' Driveway, parking/vehicle storage >10' in. G. ENGINEER'S CERTIFICATION I certify that 1 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 7/29/2016 COSA brown sheet 10-10-12.doc %D MICHAEL E. ANDERSON s•2 CE -4381 ;` w AV a3aWasnSNn PLOT PLAN AS BUILT x SCALE = 1uu GRID --Mw oz4.5 Pi 11500 Daryl Avenue, Anc Lang & Associates, inc. (907) 522-6476 Phone (907) 522-4625 Fax Professional Land Surveyors kenolangsurvey.com I hereby certify that I have surveyed the following described property: LOT 4, BLOCK 3, STOLLE SUBDIVISION (PLAT 81-42) Anchorage Recording District, Alaska, and that the improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto, that no Improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated this the lb's Day of Lu —, IOU- , at Anchorage, Alaska N Is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. No. _ e. Alaska 49TH 4L ... .... KENN �S% 2 ,.•'yJ�G p �o a� SIONA-L Municipality of Anchorage • Development Services Department Building Safety Division Onsite Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 t7qeLaDoo CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 0204121-16 COSA # D "lo -'�9l Expiration Date: i /0 S 1. GENERAL INFORMATION Complete legal description Lot 4, Block 3, Stolle subdivision Location (site address) 16101 Honey Bear Circle Anchorage, AK99516 Current Property owner(S) Gordon B. and Yelena Sdwbert Mailing address 16101 Honey Bear Circle Anchorage, AK 99516 Day phone 666.1661 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: Th1Be RI 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site r❑ 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 Onsite 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 Onsite 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 pubfic 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 seat 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 flies and from my investigation and inspection, the on-sfte 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 Phone 522-7773 Address P.O. Box 240773 Anchorage, AK 99524 Engineers Printed Name Michael E. Anderson, P.E. 6. DSD SIGNATURE t� Approved for 3 bedrooms. Disapproved. Date 9262007 Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineers Report Other _ By Original Certificate Date: (R. 1105) I Municipality of Anchorage ., • Development Services Department `•: Building Safely Division On -SRO Water 6 Wastewater Program • • • „ 4700 Bragaw Street P.O. Box 198650 Anchorage, AK 89519.8650 www.munLa g/onsft (807) 343-7904 CERTIFICATE OF ON—SITE SYSTEMS APPROVAL CHECKLIST 4 3 Legal Description: I.ar 1, eb& /, sbae & tarvWm Parcel ID: 020421-1e A. WELL DATA Well type PMaM N A; B, or C provide PWSID a _ Wes Log (YAC Y Data completed 7)21)02 Sanitary seal (YIM Y Wires properly protected (YIN) Y Total depth 347 R Cased to 27 fl. Casing height (above ground) >24 in. FROM WELL LOG AT INSPECTION Date of feet 7=2002 =5=07 Static water level 127 �, 110.1 It. Well production 3 g.p.m. 1.75 g.p.m. WATER SAMPLE RESULTS: Coliform a coloniesM00 mL Nitrate -Z, mglL Other bacteria 0 colonies/100 mL Arsenic: _ mgA Data of sample: e29Rf7 Collected by: F. I aDoux B. SEPTICIHOLDING TANK DATA Tank Type/Material 39PWSW Date installed enrmo2 Tank size !Am gal. Number of Compartments Two Cleanouts (YM) Y Foundation cleanout (YAD Y Depression over tank (YAC N High water alarm (YIN) N Date of pumping warm" Pumper ore stamm.rc. PunW4g C. ABSORPTION FIELD DATA Daae installed GMAM SW rating (g.p.dAe or felbdrm) •e G IOW System type s wide Tnvo Length ee fL Width 5 2 Gravel below pipe 3 ft. Total depth s fL EfL absorption areaSee >!z Monitoring tube Y Depression war field N Date of adequacy test 9)2srmo7 Results (Pass/Fall) Pao For 3 bedrooms Fluid depth in absorption field before test 13.5 in. Water addedt 75D gal. New depth 24.75 in. llapsed Tkne: 1.140 min. Final fluid depth 1s.5 in. Absorption rate >= 450 g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN 6 type) If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (YIN) 'Pump on' level at _ in. 'Pump or level at _ in. High water alarm level at in. Datum Cycles testes Meeh alarm & droA ropuiemenb9 E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAift station on lot >107 On adjacent lob >iw Absorption field on lot >iw Public sewer main _ WA Sewer /septic service fico On adjacent lots >1W Public sewer manhoWdeanout Holding lank WA Animal containment area NOM Manurelanunal excrete storage areas NOW SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Building foundation >5' Property Ane>5_ Absorption field >5 Water main WA Water servkx line >10' Surface water >1W Wells on adjacent lets >207 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line a" Building foundation >11r Water main >11Y Water Service line >117 Surface water >107 Driveway, paddrgIvehide ssaage 125' Curtain drain NO" NOW Web on adjacent kts >2' F. COMMENTS: " L t Line Waiver Issued ener2005 AImft Absarpem Trench m bee Fmm wopeny tine. O. ENGINEER'S CERTIFICATION I Ger* that 1 have determhred through field inspectIons and review of Munidpal records Mat the above systems am in con fumance wAh MOA COSA guldalines m effect on this date. Engineer's Printed Name Michael E. Anderson, P.E. Date ttr 5=07 COSA Fee i7 Waiver Fee $ _ Date of Payment V29/07 Date of Payment Receipt Number 0767-67/ Receipt Number, (Rev. 1IMM a L waaasen SGS Environmental Services Inc 200 W. Potter Drive Anchorage, AK 99518 Tel: (907) 562-2343 Fax (907) 561-5301 SGS Ref. M 1074945 All datesNmes are Alaska Standard Time Client Name: Anderson Engineering Printed Date/rrne: 10/03x07 14:44 Project Name: Stolle SD, L4, B3 Collected Date/Time: 09/19/07 14:10 Client Sample ID: Stolle SD, L4.83 Received Date/time: 09/19107 14:35 Mabbc Drinking Water Technical Director. ephen Edy PWSID Relea y: Sample Remarks: Allowable Prep Analysis Parameter Results POL Units Method Limits Data Date Init Bacteria 0.00 92228 09/19/07 09/19/07 sdp Nitrate 0.17 0.10 mg1L EPA 300.0 10.00 10/02107 10/02/07 ids SEP -28-2007 11:32 'm M CI N H S&S ENGINEERING \ `"� .+ ``\fie, 6r•O N 907 694 1211 r� o •—ra ww.• `� wS �a,a � wu'•^^'K a \ 06 ��S•I `a•• ^^ �N K``''p`ao. s•,.n. L O X37.64 ~Lor.rs .0 N z Z M P.