Loading...
HomeMy WebLinkAboutWOODLAND PARK LT 13EWoodland Park Lot #010-092-06 PG_E 8 vi • Municipality of Anchorage On -Site Water and Wastewater Program <r J (907) 343-7904 S A E T Y CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 010-092-06 Expiration Date. -3-)v-2/ 1. GENERAL INFORMATION Complete legal description _WOODLAND PARK LT 13 Location (site address) _2233 WEST 34TH AVENUE, ANCH AK Current Property owner(s) _TAMMY & MARK WONDZELL Mailing address _SAM Real Estate Agent 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone Day phone 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual ❑ Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer WaiverNariance request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 2 Waiver Fee $ Date of Payment Date of Payment Receipt Number d 15 3 y 7 Receipt Number COSA # O '� c 211 `7 1(o 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 MIKE N ANDERSON, P.E. Phone 727-8864 Address 4661 NATRONA AVE. Engineer's Printed Name MIKE N ANDERSON, PE Date 12/12/21 BY Original Certificate Date: 1 2 / 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 engineers work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory_ Well Flow Advisory Other COSA blue sheet 1d-W-12.doc �vr �' •e, w s 'V1 6. DSD SIGNATURE ' System #1 Approved for bedrooms. �� ^,� MICHAEL N C, -.9 469 System #2 Approved for bedrooms.�fy; .•IZf t��z( . ;°= Disapproved. Conditional approval for bedrooms, with the follow`n�,G`Igibr(/i����i S,TE AST�:V A m �0.O h AM a T BY Original Certificate Date: 1 2 / 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 engineers work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory_ Well Flow Advisory Other COSA blue sheet 1d-W-12.doc COSA Checklist Legal Description: WOODLAND PARK LT 13E Parcel ID: 010-092-06 If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled UN Total depth >40' ft Cased to >40' ft ❑■ Sanitary seal is functioning correctly r� Wires are properly protected` f` t� Casing height (above ground) iT Date of flow test for COSA 12/3/21 e Static water level at beginning of test 46 ft. Comments B. TANK DATA Age of tank(s) years Tank type/material Measured operating fluid level in septic tank Standpipes/foundation cleanout per record drawing Date of pumping D. ABSORPTION FIELD DATA AWWU SERVICE Which system tested (date installed) 9 ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective, If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet Well production at time of test 2.0+ gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes No X Coliform bacteria is Negative Nitrate mg/L 9 Nitrate less than MRL (ND) Arsenic 26.2 ug/L Q Arsenic less than MRL (ND) Collected by MNA Date of Sample 1213/21 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date Results ❑Pass For bedrooms Fluid depth prior to test in Water added gal New depth in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) If yes, enter date 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' ❑ Yes if No ft ED Yes if No ft Neighboring Tank > 100' 17/1 Yes if No ft Private Sewer/Septic Line > 25' M Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No ft Holding Tank > 100' ❑✓ Yes if No ft Neighboring Absorption Fields > 100' Water Service Line > 10' ❑ Yes Animal Containment?i 50' 0Yes if No ft ❑✓ Yes if No ft _ Community Sewer Main > 75' ❑Yes if No *50 ft Manure/Animal Excreta Storage > 100' 0 Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No ft Surface Water >' 100 _ ❑Yes if No fl Property Line > 5' ❑ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ❑ Yes if Na ft Private Wells > 100' ❑ Yes if No ft Water Main > 10' ❑Yes if No ft Community Wells > 200' ❑ Yes if No ft Water Service Line > 10' ❑ 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, ❑ Yes if No ft if absorption field is under driveway comment below Property Line > i Q ❑ Yes if No ft Wells on Adjacent Lots: Water Main > 10' ❑ Yes if No ft Private Wells >' 100 _ ❑ Yes if No ft Water Service Line > 10' ❑ Yes if No ft Community Wells > 200' ❑ Yes if No ft Surface Water > 100' ❑ Yes if No ft F. ENGINEER'S COMMENTS *HOME BUiLT IN 1949, REQUIRED SEPARATION 501 G. ENGINEER'S CERTIFICATION l certify that / 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 •.f� .; l�A�'�•f a . . f EWG v� • f . • . o Y (. r'? + MICHAEL N. ANDERSCN �F61 www.muni.org/onsite Arsenic Advisory Certificate of On -Site Systems Approval # OSC211716 Subdivision: Woodland Park, Lot 13E A water sample revealed an arsenic concentration of 26.2 micrograms per liter (ug/Q. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 ug/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. information on arsenic is available from the On -Site Water and Wastewater Program website (www.muni.org/onsite) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. Mailing Address P O Box 196650 *Anchorage, Alaska 99519 6650 * www murii org TAX CODE No.ail-o22-�� GRID No. MUNICIPALITY OF ANCHORAGE — SEWER UTILITY PROPERTY Name Plat No. Subd. Address f i�� g� �lE Ac10 � Al Lot—J Block Residential ❑ Commerial ❑ Industrial ❑ No. of units CONNECT: Main Tap ❑ On Property ❑ Permit No. Size Type Drawing No. Size Main Type Depth at Connect Insulation ❑ Cleanouts Type Connect Agent Inspector Date Comments Connect Location ASSESSMENTS: L.I.D. No. Private Dev. No. Subd. Agreement ❑ No. Sewer Agreement ❑ No. RTE. ❑ Roll No. DYE TEST= Positive ❑ Negative ❑ N.S.A. ❑ Date Page No. M.H. No. Billing Cycle Tested By Comments z 0 m .a N o} 00 O N1 m [C � aY wQ CD C?� u _} _Z z O o uo :O w ~ F O Z to zO 0 Z LU u O w 0 LU a- m U ol$ § ` Z } o z = M O1},'1 R�i F o a. O_ O x (9 J Fw Z m - xO D F— o Q a ru w z p O U w w w w--- z LL. w 0 < 0 V g O O � u - . • 1 Z Z p Z a Iq _L N F❑ u r, C� o t j 0 0 ° O W W Z 0 w Q U a m * uj mO N z Z N z F ZZ�� z❑ Z Ln o (9 2 +� p p� w u N p N N d N N u a m ¢rl N Z C] LU N a ' w a . 0 z z NZ o Pa o J It F O w z w z a O Zs F u O19 -1 w i i 4. at3ots z z o w ¢ z NOS F l O w 2 w w a w O r V w� Z O m O U 1- V 0.. O a U pi 5 Z u o} n wQ u oo C w u w Z } o z oz 2 F O Fw ru O Z' 0 w--- g z u a j O z Z O u a ' . O w w w O w F z N W O j U. Z - m U w u Z z w O 1 z a rj F o Z F w w F wO V d z L O V } t a U hl F 0 w w O l7 u m Jl N N m a F a � o o °o > rp Q N z ¢ a O N Q O t9 a< w z z z V w } NWi3 i> C �w z Z wm w m w w 0 < O a a w w t Z - W $ J Y ¢ w a' ¢ O f 4. V V z Z w Z w w U __ Z a q. i C 5 F Z} } >' N J w N F tt [C 7 F an u O a R m, U D u u u, U w l -t..20 R, a ce J 5 L7� f o.00 ( N q L u O -S S b M.0CC90°'� i HCl '�R hor v a m e s,H v H i o '.. R v �S •' u p m r� m yU » o n a a o a O J 9.7 N o �_tv Gbo C) Ao"la9°'� uGm 18.0 re 4 °off e Ln a O ti "' { [i j °'. u� o � -• a b s em ° a { v'oo -oaf 13 d«vaau Lf) m` o uu av I-�IpF ;°v ou.a. 1po mp so>$4" 0.4 $3 c oo ( U) a o p �A III w d u v 4 20.6 �T, A F. •J ski b c a `' p rCx— up��p mo LIJ Ia.n z,. +w a ff a.. a: m C a 4 � a i ay. O an GARAGE 20.4-- -& ar N00.03'30"r 5, ~0 2(9 10 ! a 0c j oo y.x� O O o as cv C� togo I ®e {v ( as It tip .d EDas upi &. C Co CJ l! N c0 CI M of cv 7m A cc Mark Begich Mayor Development Services Deportment Building Safety Division On-Site Water & Wastewater Program 4700 Elmore Road P.O, Box 1966§0 Anchorage, AK 99507 {9o7) 343-7904 Pump Installation Log Well Drilling Permit Number: SW Parcel Identification Number: ~lC~'tPc[~.'O~ Date of Issue: Legal Description Pump Installation Date: ~/~/~ Property Owner Name & Address: Pump Intake Depth Below Top of Well Casing: (~ feet Pump Manufacturer's Name: A 'Y' Pump Modeh '~'~/ Pump Size ~hp Pitless Adapter Burial Depth: Pitless Adapter Manufacturer's Name: Pitless Adapter Installer: Well Disinfected Upon Completion? YESes [~ No Method of Disinfection: Co m men t.%.~/2_ A Pump Installer Name: A 0~)/05 Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. KtiSfi • •11V- Municipality of Anchorage o"� E• r31' On-Site Water and Wastewater Program ;,,A1 (907) 343-7904 $A r E T CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Parcel I.D. 010-092-06 Expiration Date: I t — 2-1 — 1-0 1. GENERAL INFORMATION Complete legal description WOODLAND PARK LT 13E 22_ 33 w 3y Location (site address) _ , EAGLE RIVER AK Current Property owner(s) _CHERYL ROURICK Day phone Mailing address _22607 NORTHWOODS DR CHUGIAK, AK 99567 Real Estate Agent Day phone h56789 2. TYPE OF DWELLING: �o ® Single Family (w/wo ADU) ' ;Nov Q� 111 ❑ Duplex AUG ; ❑ Multiple Dwellings (Single Family and/or Dupl-• , 1 2018 a 3. NUMBER OF BEDROOMS: 3 ' o e` L9S1 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual ❑ Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer Waiver/Variance request for: Distance: Received by: Date: 24//7 COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ 41 • co Waiver Fee $ Date of Payment . -1 Ii 2 Date of Payment Receipt Number Receipt Number COSA# OSC(2(42-1 Waiver# �:�..4- 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 MIKE N ANDERSON,Y.E. Phone 727-8864 Address 4661 NATRONA AVE. Engineer's Printed Name MIKE N ANDERSON, PE Date 8/21/18 ei jc.• OF ,/ `' 49'''4— a ar 'f Cd n o It 9 f.'-1 C.�i.,} -•oa- j!,0 0 0°x 0 0 0 o a p O°°L a 0 a Coos a,a ° a .//I/a... n a a a nae a o 0 0 6. DSD SIGNATURE e� =.,,"a �,;rcr,. r +ti�:zscN ' ., a Ce 9:.159 .. ,1. System #1 Approved for 3 bedrooms. 4 ,p -. at 1 �; :.,C c �•• ,as-1 System #2 Approved for bedrooms. �k'�•;RO ESS1G ''' Disapproved. Conditional approval for bedrooms, with the following stipulations: ��kU `r_ iOff. 0/\/_80. T c JwArERFy IN'ISTSANu r n pRAT -). pGr-, ' 1 1..,,`Ilr`re' By: _ Gw. -.40 ' Original Certificate Date: Tz i r1 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 �C Well Flow Advisory Other COSA blue sheet 10-10.12.doc • 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: WOODLAND PARK LT 13E Parcel ID: 010-092-06 A. WELL DATA Well type Private If A, B, or C provide PWSID# Well Log (YIN) N Date completed UN Sanitary seal (Y/N)Y Wires properly protected (IN) Y Total depth >40' ft. Cased to 40'+ ft. Casing height (above ground)f "+ FROM WELL LOG . AT INSPECTION Date of test UN 4-19-2018 Static water level UN ft. 46 ft. Well production UK g.p.m. 2.0+ g.p.m. WATER SAMPLE RESULTS: 6 4,4 Coliform NEG colonies/100 mL Nitrate p mg/L Arsenic: UK ug/L Date of sample: / Collected by: Mike Anderson g• 71 B. SEPTIC/HOLDING TANK DATA Tank Type/Material Date installed Tank size gal. Number of Compartments Cleanouts (YIN) Foundation cleanout (Y/N) Depression over tank (YIN) _ High water alarm (Y/N) Date of pumping Pumper C. ABSORPTION FIELD DATA— Date installed Soil rating (SF/BEDROOM) System type Length _ft. Width _ ft. Gravel below pipe ft. Total depth ft. Eff. absorption area ft2 Monitoring tube_ Depression over field_ Date of adequacy test Results (Pass/Fail) For_bedrooms Fluid depth in absorption field before test in. Water added gal. new depth in. Elapsed Time: min. Final fluid depth_in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (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 in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot NA On adjacent lots 100'+ Absorption field on lot NA On adjacent lots 100'+ Public sewer main * 50'+ Public sewer manhole/cleanout 100'+ et U c .or S Sewer/septic service line 4111* c4 �. � Holding tank 100'+ Animal containment areas 50'+ Manure/animal excrete storage areas 100'+ SEPTIC/HOLDING TANK ON LOT TO: Building foundation Property line Absorption field Water main Water service line Surface water Wells on adjacent lots ABSORPTION FIELD ON LOT TO: Property line Building foundation , Water main Water Service line Surface water Driveway, parking/vehicle storage Curtain drain Wells on adjacent lots F. COMMENTS r k q 51 HOME WAS BUILT IN 1949, REQUIRED 50' SEPARATION BETWEEN WELL AND SEWER MAIN OR MANHOLES. WELL IS LOCATED IN THE BASEMENT -;..,�� OF ALeNt G. ENGINEER'S CERTIFICATION .`P.•' I certify that I have determined through field inspections and o • * . 49TH /' • * review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. /. / MICHAEL N. ANDERSON : P� Engineer's Printed Name MIKE N. ANDERSON,PEr��•. CE 94 9 Date 812112018 , '1)(0 ' 7 a' E*�'.;' COSA canary sheet_2-6-15.doc MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT • .7e 907-343-7904 On-Site Water and Wastewater Section ' Fax: 343-7997 www.muni.org/onsite Arsenic Advisory Certificate of On-Site Systems Approval # 0SC181421 Subdivision: Woodland Park, Lot: 13E A water sample revealed an arsenic concentration of 25.8 micrograms per liter (ug/L). The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 ug/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. information on arsenic is available from the On-Site Water and Wastewater Program website (www.muni.org/onsite) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On-Site Systems Approval. Mailing Address: P.O. Box 196650* Anchorage,Alaska 99519-6650 *www.muni.org 4 GRAPHIC SCALE: 1 Inch = 20 Feet F c==1 1 t 10 0 10 20 40 • Q . v BFB A W . 20 _ • - S89°55'54"W 142. 38 ••,_. . . • . • . • . - • • • • • • • - . - . . • . - 43.7 • z I 39.0 Z O WELL • 0 ON ONE STORY CD d WOOD FRAME O CA HOUSE CJ-1 O24.0 v , O rj 11.7 En w CJ1 > o , GI • o > , O 14. 0 15.0 • N m . co co 2 0 0.6- l 11.7 S89°56'30"E 142.27 N N) O p W. 34TH AVE \ UE The original plat recorded In 1947 shows this property Date Scale Legal Description to be fifty foot by one hundred forty feet. A more recent 2-14-2018 1' = 20' survey adjacent to this parcel was recorded in 2004, and .411:41101116,vik Lot 13E the recorded dimensions as shown hereon. OF, ��\, Grid Heavy snow cover at the time of this survey may r SW 1628 AS—BUILT have covered minor items at ground level. `� WOODLAND PARK i<S ••••• SUBDIVISION These structures were constructed in 1949, and may Drawn byField Book `� BFB ASB2018 PLAT I P-81 not have to comply with current Municipal building * TH ��. setback requirements. / 4.9 �L�-.� - ' • * I hereby certify that the property described hereon has been surveyed •• :". .- BOBBY F. B URNETT by me, or at my direction, and that the improvements situated thereon /1 BOBBY F. BURNETT , / are within the property lines and do not overlap or encroach on the LS-548f Al 2941 Carriage Drive property lying adjacent thereto unless otherwise shown. That no :d"-/y`/ • Anchorage, Alaska 99507 improvements on the property lying adjacent thereto encroach on the Nc, (907) 350-5541 premises in question and that there are no roadways, transmission ` ssioNAL lines or other easements on said property except as shown. ‘vt‘..`4 907 Water Well Services O7 WA FE R �t P.O Box 870475 / � r.0 L Wasilla,AK 99687 (907)230-1868 RESIDENTIAL&COMMERCIAL WATER AND WELL SERVICES johnnie.netherton1702@gmail.com 24HR EMERGENCY SERVICES AVAILABLE FREE ESTIMATES John Netherton P.0 Box 210249 Anchorage,AK 995 21 907-230-7866 INVOICE BILL TO INVOICE# 1613 Mike Anderson(Anderson Engineering) DATE 08/29/2018 4661 Natrona Dr DUE DATE 08/29/2018 Anchorage,AK 99516 TERMS Due on receipt ACTIVITY QTY RATE AMC).,f Well casing extension 1 1,375.00 1,375.00 Casing extended 24"+above grade BALANCE DUE $1 ,375.00 90'7 16LI'z'k•ml- - WELL RESIDENTIAL&COMMERCIAL WATER AND WELL SERVICES 24HR EMERGENCY SERVICES AVAILABLE FREE ESTIMATES 907-230-T$6$ In regards to property 2233 west 34th Ave Anchorage Alaska 99517. The components will need to be removed down hole and will be reinstalled after extension has been completed.The pressure tank will be temporarily removed and reinstalled as well. Total cost will be $1375.00 and will be completed by end of day 8/29/2018 If you have any question please call or text at 907-230-1868. Thanks John and Katie Netherton