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HomeMy WebLinkAboutDELUCIA LT 13 ~ ~.~ MUNICIPALITY OF ANCHORAGE ;/~"~l'J ~\Y-~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION I ~.~ [~ 2tI ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME . ~ ,' ~' ~PHONE ~ ~W MAI LING ADDRESS LEGAL DESCRIPTION LOCATION ;~ I ~ NO. OF BEDROOMS Well A sorp Dwelling PERMIT NO. DISTANCE TO: '~ ~ ~', ~ Manufacturer ~._. L~q, capacity in gallons Inside length Width Liquid depth ~ ~ ( .~. IF HOMEMADE: ~ ~ ~ DISTANCE TO: Well Dwelling PERMIT NO. ~ -- ~ Manufacturer ...... Material Liquid capacity in gallons ~ Well Foundation Nearest lot line PERMIT NO. ~ ~ DISTANCE TO: ~ ~ No. of lines Length of each line Total length of lines ~3nch width Distance between lines ~ l ~ inches ~ Top of tile to finish grade Material beneath tile Total effective absorption area ~ inches Length Width Depth PERMIT NO. ~ ~ Type of crib ~ib diameter Crib depth Total effective absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: ~ Class - Depth Driller Distance to lot line PERMIT NO. ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS SOIL TEST RATING REMARKS APPROV ED ~, DATE LEGAL 72-013 (Rev. 3/78) 0 8- E GED' Russell Ovster 694-2774 Soils ~t Foundations Perfomed for: Description: (feet) Legal Depth o 2 3 , 6 Name: /V//L~ Matltng Address: 'CHNICAL 8' DEVEL, '~MENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 SOIL LOG Earl Ellis Land Development Soli Characteristtc~ ].1 13 16 Ground Water Encountered: Yes~ Proposed Installation: Seepage Pit Comments: NO ~J If yes, what depth Drain Field Performed by: Date: MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D.#F--~_~.- ~_~-\~_ - ~%_ ,-~% ~"~ HAA# ~'~c:~ ~ 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Lots 12 & 13; Delucia Subdivision; ~uaiOJ /?F~ ~ Location(address or directions) Needles D~ (b) Property owner Mailing Address (c) Lending Institution Mailing Address A.H.F.C.#58689 520 East $4th Avenue Telephone'(home) Anchorage, Ak. 99503 Telephone . Business (d) Real Estate Company and Agent JACK WHITE COMPANY ATTN; Ly~da Banner (e) Address 10928 Eagle River Road Eagle River, Ak. 99577 Telephone 694-5500 Mail the HAA to the following address: (or check here P~,xif hold for pick up.) List contact person and day phone number below: S & $ ENGINEERING 17034 E=_~!e ~;~- Eagle River, Alaska 2. TYPE OF RESIDENCE Number of bedrooms Single-Family ~x 3. WATER SUPPLY Individual Well Community [] Public [] Note: If community well. s, ystem, must have wr.!tten confirmation from the State Department of Environmental ConServatibn attesting 'to th legality~and Status." 4. SEWAGE DISPOSAL On-site ~x Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legailty and status. 72-025 (Rev. 7/88) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is 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 in compliance with all Municipal and State codes, ordinance,s,, and regulations in effect on the date of this inspection. Name of Firm -t 7~3,~.. , E~jle River Loop Roa~ No. ~OA Telephone ,...a~,e River, Alaska 99577 Address Date 6. DHHS APPROVAL Approved for t/~:~uedrooms by Date / Approved .~ Disapproved Conditional , ,,~ .......... / The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 7/88) Back Page 2 of 2 Health Authority Approval (HAA) CHECKLIST - FEBRUARY 1984 343-4744 Legal Description: ,/--ot~ ~ ~ / -~.,' A. WELL DATA ~ ~ ~ ~_.~, ~L~.~-_~ ~ Well Classification ~"~,'rd~/~_ Well Log Present (Y/N) ~ Date Completed ~ ~ Yield TotaIDepth~~asedto ~O't Depth of Grouting Static Water Level / ZO Casing Height Above Ground I ..~ "'f Electrical Wiring in Conduit (Y/N) c1 Pump Set At L.2 ~ Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ! O0 'f ; On Adjoining Lots [ SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot To Nearest Edge o[ Absorption Field on Lot To Nearest Public Sewer Line /,-,)/¢, To Nearest Public Sewer Cleanout/Manhole / To Nearest Sewer Service Line on Lot 2 .~' Water Sample Collected by ~ '~ ~ ~_.~'//J,.~¢'t ~ ; Date Water Sample Test Results -~_ ¢-/L~'~ ~ ,-~'~ ~--~'¢'~ £ (1 ~ Comments B. SEPTIC/HOLDING TANK DATA Date Installed ~-~/.2-7~ Size Standpipes (Y/N) t~ Depression over Tank (Y/N) No. of Compartments Air-tight Caps (Y/N) Pumping/Maintenance Contact on File (Y/N) Holding Tank High-Water Alarm (Y/N) Foundation Cleanout (Y/N) ~ 64~ Date Last Pumped (~ - 2~ -~ ~ ;,or Temporary Holding Tank Permit (Y/~) ~ /,q SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply Well l ~ 0 To Building Foundation , To Property Line /. (2 lL To Disposal Field To Water Main/Service Line i 0 ~ 72-026 (Rev. 7/88) Front To Stream, Pond, Lake or Major Drainage Course Comments ~_~'~_ ~ J~'c.. Z) ~)/tA ,~ ¢_. Q/ bL4 ~a~e C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata _~ Date Installed ~-- /~- "~ Width of Field ~,~.¢f v __~/_~ ' 1 Square Feet of Absortion Area Depression over Field (Y/N) Results of Last Adequacy Test --/6r~' Type of System Design Length of Field Depth of Field / Gravel Bed Thickness Statndpipes Present (Y/N) Date of Last Adequacy ,Test SEPARATION DISTANCE FROM ABSORPTION FIELD: ! To Water-Supply Well To Building Foundation Lot ~ / P~ To Water Main/Service Line H To Property Line To Existing or Abandoned System on ;On Adjoining Lots '~o "~ To Cutback (if present) / r~O 'au ! {o t To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Company Date ~, Niver Loop Roa~ No, 204 Alaska 9957~ MOA NO. Receipt No. c~zc~ Date of Payment Amount: $ Receipt No. Waiver Fee: $ Date of Payment 72-026 (Rev. 7/88) Back Page 2 of 2 CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. 5633 B STREET · ANCHORAGE, ALASKA 99518 · TELEPHONE (907) 562-2343 FEDERAL TAX I.D. #92-0040440 ANALYSIS REPORT BY SAMPLE for Work Order ~ 31932 Date Report Printed: FEB 13 91 @ 16:03 Client Sample ID:LOTS 12 & 13 DELUCIA S/D Client Name PWSID :UA Client Acct Collected FEB 11 91 @ 12:00 hrs. BPO ~ Received FEB 12 91 @ 14:10 hrs. Req # Pzeserved with :AS REQUIRED Ordered By S & S ENGINEERING SNSENGP PO ~ R. SHAFER Analysis Completed :FEB 13 91 Send Reports to: Labozatory Supe~yis, oL.L~:TEPHEN C. EDE 1)S & S ENGINEERING Released By :~ ~. ~ 2) = .... == === ============ ====== ======== ======== == === = == = = ==================== == ======~== = = ====== ======== = = ====== === ====== === ........... Chemlab Ref #: 910479 Lab Smpl ID: 1 Matrix: WATER Allowable Parameter Tested Result Units Method Limits NITRATE-N 1.? mR/1 EFA 353.2 10 Sample ROUTINE SAMPLE COLLECTED BY: RD.J. Remarks: 1 Tests Performed See Speclal Instructions Above UA=Unavailable ND= None Detected '* See Sample Remarks Above NA= Not Analyzed LT=Less Than, GT~Greater Than - ' MAR ~? '91 RECEIVED MAR 8 1991 Municipality of Anchorage Dept. Hea~th & Human ~rvio~ 17: 46, 9076941£51 ,_TACK WHITE/ER-" Post-ItTM branct fa~x transmittal memo 7671j # o* pagas ~ __ 'Co, ' Go, Dept, Phone ~ Fax ~ Fax ~ P.1 N ¢~PR-- ! $--9 ! THU 7 : 1 4 RE E APR 1 8 1991 MENT- M~i~ality ot Anchorage ~ASP24ENT GRANTING RIGHT OF ENCROACH ~,~it~&HumanSe~l~ Grant of an easement by Alaska Housing Finance Corporation as owner in fee simple of the following described parcels of real property: Lot 12, Delucia Subdivision, Anchorage Recording District, Third Judicial District, State of Alask% Plat % p-648 Lot 13, Delucia Subdivision, Anchorage Recording District, Third Judicial District, State of Alaska, Plat 9p-645 1. Lot 12, is an unimproved lot. Lot 13 has a residential dwelling constructed upon it. A portion of the septic system serving =he dwelling on Lot 13 encroaches on Lot 12. 2. Alaska Housing Finance Corporation, as owner of Lot 12 and grantor, hereby grants to the owner of Lot 13, grantee, an easement fcr encroachment of Lot 13's septic system on to Lot 12. This right of encroachment is limited to that portion of the system now encroaching on Lot 12 and only to the exten= of the encroachment as it exists on the date of this grant. No further encroachments may be placed on Lot 12 nor shall the above described encroachment be expanded without the express written consent of grantor. 3. Grantee shall have the right to repair the encroaching septic system, and reasonable righ=s of access to Lo= 12 for such purposes, so long as the repaired system does not expand the encroachment. In the event grantee replaces the septic system or drainage field, such replacements shall be located solely on Lot 13. In the event grantee removes any or all of the encroachment, the easement shall terminate as to that portion of the encroachment sO ramoved. 4. Grantee, hereby indemnifies and holds harmless grantor from any and all claim~, demands, lawsuits, settlements, damages, costs and expenses, including attorney's fee~, suffered or incurred by grantor as a result of any personal inju~, death or property damage arising out of the encroachment. 5. This easement shall terminate one year after the date on which public sewer service becomes available to Lot 13, but shall terminate on the date Lot 13 is connected to public sewer service if such date is earlier. 6. The costs of maintaining, repairing, replacing or removing the encroachment shall be borne solely by grantee. 7. The right of encroachment provided for herein shall run with the land and be binding upon and inure to the benefit of the owners of Lots 12 and 13, their respective heirs, devl.~e~, successors a~d assigns, DATED this %~'. day of ALASKA HOUSING FINANCF. CORPORATION Grantor - Lot 12 Grantor - Lot 13 Property Disposition officer Page 1 Of 2 pages APR-- 18--9 I THU ? : 15 [02 Ih2 180 ACKNOWLEDGMENT STATZ OF ALASKA ) THIRD JUDICIAL COURT ) THIS IS TO CERTIFY that on this I~day of ~ , 1991 personally appeared before me Nola Cedergreen,-~nown to me to be the person described on an~ who executed the within grant of easement and acknowledged that she signed the same as her free and voluntary act and deed for the uses and purposes therein mentioned. GIVEN UND£R MY HAND and official seal the day and year last above written. ~ Public in '~nd for_Ala My Commission exDire~: ~-~&5%-- After recording return to; AH¥C Antn: Gil Lulay AHFC #58659 /,i I S T R; C T Tran~A~a~km REQUESTED BY. Title APR il '9i i4:07 ATTY GENERAL ANCH. 907-276-36g? P04/5 EASEMENT ~OR USE AND MAINTENANCE OF W~'LL Grant ~{ an easement made by Corporation as owner- in fee simple of parcels of real property: Alaska Housing Finance the ~ollowing described Lot 12, Detucia Subdivision, Anchorage Recording District, Third Judicial District, State of Alaska Lot 13, Delucia Subdivision, Anchorage Recording District, Third Judicial District~ State o~ Alaska 1. Lot 12 is an unimproved lot. Lot 15 Mas a residential dwelling constructed upon it. The wat~rwell serving l. ot i5 is located on Lot 12. This grant of easement is intended to define th~ rights and obligations of ~he ~wners ~f Lo~s 12 and IU with respect to the use and maintenance o~ the waterweli. 2. AHFC, as owner of Lot 1~ and grantor, grants to the owner of Lot 12, as grantee, a permanent and pe~petuaI easement to opera~e, maintain, repair and supply electricity t~ the well and to draw as much water as grantee may reasonably need for residential purposes. The easement shall allow grantee to pass to and {rom grmntor's land for said purposes and to perform all o~her acts necessary to take and use water ~rom the well. Grantor a~rees that it will keep the well and rights o~ access granted hGr, e~n unencumbered so as t~ allow grantee free use and access to the well during the tmr-~ o~ this easement. 5. Grantee shall bear. all costs associated with the operation, maintenance and repair of the well and waterlines. 4. Grantee hereby indemnifies and holds harmless grantor from any and all claim~, demands~ lawsuits, settlements, damages, costs and expenses, including attorney's fees, suffered or incurred by grantor as a re~oit o~ any personal injury, death or property damage arisingin connection with the waterweil or waterlines. APR 11 '91 14:07 ATTY GEHERAL AHCH. 90?-2?6-369? 5. This easement shall run with the land and be binding upon and inure to the benefit of the owner's of Lots i2 and 15 and their- respective heir. s, devisees, successor~ and assigns. DATED this day of ALASKA HOUSING FINANCE CORPORATION Grantor- Lot 12 Or. antee- Lot 15 By; Nola Cedergreen pr~operty Disposition O~icer ACKNOWLEDGMENT STATE OF ALASKA ) ) ss. THIRD JUDICIAL COURT ) THIS iS TO C~RTIFY that on this day o~ .. ~, 1~91 personally appear, ed Oe.~ore me Nola Ceder~r'een, known to m~ to be the person described in and who e;4ecuted the within grant and voluntary act and deed for the uses and guppo.ses thep~n mentioned. GIVEN UNDER ~Y HAND and official seal the day and year last above written. Notary Public in and for Alaska My commission expires~ APPLICANT FILLS OUT UPPER HAL,- ONLY Property Owner Buyer , Address Zip Code Phone ,/;..;., :?' .,', 'l '? 'i Lending Institution Address .~ ..,: . / ~. ~/,/ ~_ /~ ,..;~:~ Zip Code Realty Co. & Agent Address Zip Code Phone Phone Legal Description Street Locatio~ Type of Residence [~' Single Family F~ Multiple Family No. of Bedrooms : Other Water Supply ,t~ Individual .... ~'~, !i~,:.~ // ~] Community - ~ Public Utility Sewer Disposal ~-~ Individual ~: Public Utility : Holding Tank ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if availa~'ie~'--''~ Year Individual Installed: When Connected to Public Utility: NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time ~ Time Time Date Date Date Date ~:~/ Inspector Inspector inspector Inspector Field Notes: ~ ~ .~. ~ ,~ -'~ % . APPROVED BEDROOMS DISAPPROVED 'CONDITIONS OF APPROVAL Soils Rating Date Sewer installed Well To Absorption Area j_ Well to Tank L ''~ O Well Log Received 72-023 (3f82) ADEOUACY TEST WAI'E R AfAr} SEWER !NSPEC 1 ION WEt [. INSPECT!ON'S AiND FLOW TEST SllE PL/,Nb ROAD DESIGN SOIL T[$T ON SiTE WASTE WATER D}SPOSAL SYSTEM DESIGN EXCAVATION WORK. ROBERTA. SHAFER December 19, 1983 CIVIL ENGINEER 694-2979 Arlene Mau!din P.O. Box 772203 Eagle River, Alaska 99577 Reference: Lot 12 & 131 DeLucia Subdivision A sewer system adequacy test was performed on the system located on the referenced property, as you requested. The septic tank was pumped and verified to have a capacity of 1000 gallons, r£he absorption trench was tested by a continuous flow of water over a period of 48 hours with- out any adverse effect on the system. It can be concluded from this test that the waste water disposal system serving the three bedroom residence located on this property is currently functioning adequate 5- However~ the system cannot be guaranteed against subsequent failure. A well inspection was also informed and it was noted that the well casing needed to be equipped with ~n adequate sanitary seal and the well wires placed into conduit. This work was performed and the well casing no%; meets all Municipal code requirements. 'flow test was also performed on this well, per your request and it was termined that the well has a static water level of approximately 90 et. After draw do%~n of the water to ap?roximgtely26 ~ the recovery te of this well appears to be approximately ~O gallons per hour. 'r6'~ be of furthe~ service pi. ease do not hesitate to contact us. If we , Sincerel'y, , ~:',.~./"/ ./ ...' %/?/, /.~ (/" , //'...' · / ~/"' ~AS/ss / ' / cc: k~n]czpalitv of Anchorage Dcpart. m~}nt of Health and Environmental ]~rotection SRB 190X EAGLE RIVEH. A, A.,KA 9q!i7'!