HomeMy WebLinkAboutEAGLET AERIE TR B1C
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http://www.muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP231077 Effective Date:
Work Type: SepticTank Upgrade Expiration Date:
Tax Code Number: 05060207000
Site Legal Address: EAGLET AERIE TR 131C G:0160
Site Mailing Address: 23557 SUNNY GLEN DR, Eagle River
Owner: MALLARS DAVID L & RUNAE Lot Size in Sq Ft:
Design Engineer: PANNONE ENGINEERING SERVICES Total Bedrooms:
This permit is for the construction of:
Uc+partment
4/25/2023
4/24/2024
192100
❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction shall 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 shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Te-uej fc,
Issued By: G
Date:
Date: 5/s
4
Community Development Department
Phone: 907-343-7904
Development Services Division Fax: 907-343-7997
On -Site Water & Wastewater Program
ON-SITE SEWERIWELL PERMIT APPLICATION
Parcel I.D. 05060207
Property owner(s) Dave Mallars
Mailing address 23557 Sunny Glenn ER
Site address
Legal description (Sub'd., Block & Lot) Eaglet Aerie Tr B1 C
Legal description (Township, Range & Section)
Lot Size
Day phone
Sq. Ft. Number of Bedrooms Z9
APPLICATION IS FOR:
APPLICATION IS AN: TYPE OF DWELLING:
(® all that apply)
Absorption Field ❑
Initial ❑ Single Family (SF) ❑
Septic Tank ❑x
Upgrade ❑x (w/wo ADU)
Holding Tank ❑
Renewal ElDuplex (D) ❑
Privy ❑
Multiple Dwellings ❑
(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 Municipal Codes.
SRP
(Signature of property owner or authorized agent)
Permit/Rush Fees:.? ?_ 5 Waiver Fees:
Date of Payment: 44-C4 (Z'� Date of Payment:
Receipt Number: _0�9 / 7(r Receipt Number:
Permit No. 05P2,9107_7 Waiver No.
Permit App_::- : :—'.,:c
Pannone Engineering Services LLC
Steven R. Pannone, Principal
Registered Professional Engineer
E-mail: steve@panengak.com
Mailing: P.O. Box 1807 Palmer, AK 99645
Telephone: (907) 745-8200 FAX: (907) 745-8201
24 April 2023
Municipality of Anchorage
Development Services Department
On-Site Water & Wastewater Program
4700 Elmore Road
P. O. Box 196650
Anchorage, Alaska 99519
Subject: Eaglet Aerie Tr B1C
EMERGENCY Tank Replacement Permit Request
This is a design narrative for a permit to install a 1250-gallon septic tank to replace an existing 1000-gallon septic
tank to be issued for this property. The existing tank has collapsed and needs immediate replacement. Currently the
lot is developed. The proposed replacement will be connected to the existing drain field which will be combine with
the old drain field by use of a flow splitter. We are requesting a 4 bedroom permit. This lot and the surrounding lots
are served by private wells. There are currently no wells within 100’ of this upgrade.
1. Upgrade Tank Design.
A foundation clean out installed if needed.
The tank will be located: 5’+ from any property line.
5’+ from any deck/stair support.
10’+ from building foundation.
10’+ from any water line.
100’+ from any surface water.
100’+ from any private wells.
200’+ from any public wells.
The proposed installation will not affect the future development of this or the surrounding lots.
If you have any questions or concerns, please contact me at (907) 745-8200.
Sincerely,
SRP
Steven R. Pannone, PE, F. ASCE
Owner/Civil Engineer
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231077, Deb Wockenfuss, 04/25/23
PANNONE ENG SVC, LLC (C.I. 1088) Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231077, Deb Wockenfuss, 04/25/23
PANNONE ENG SVC, LLC (C.I. 1088)SOILS LOG
INSTALL NEW 1250-GALLON SEPTIC TANK.
10 FEET
10 FEET
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231077, Deb Wockenfuss, 04/25/23
Municipality of Anchorage Page
DEPARTMENT OF HEALTH 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
Permit Number: %~cl~'O0~J~ PID Number:
Name: ~
,,Ios~'PH ~. /-.,,~,4. Wastewater System: [] New J~ Upgrade
Address:
2.~'~/d ~'o/w,~-o,~- ~-~v~- ABSORPTION FIELD
~ NO. of Bedrooms:
~(UC_.~O/~w'~'E' ,/~/~ ~/ ~ ~ Deep Trench ~ Shallow Trench ~ Bed ~ Mound ~ Other
LEGAL DESCRIPTION so,, Rating: ~.~ GPO/Sq. Ft. Total Depth from~loriginal grade:
~ ~ Subdiv~ion; Depth to pipe bottom from original grade: Gravel depth beneath pipe
Township: ~ Range: Section: Fill added above original grade: Grayel length:
I
WELL: U New ~ Upgrade Gravel width: Number of tines: Distance between lines:
~ ~ Ft. ff ~.~ Ft.
Classification (Private. A.B.C): ~ /~ Total Depth: Cased To: Total absorption area: Pipe material: ~/o
Driller: Date Drilled: Static Water Level: Installer: Date installed:
Yield: Pump Set at: Casing Height Above Ground: TAN K
~ GPM ~ Ft. /~ ' Ft.
SEPARATION DISTANCES ~ ~Septic ~ Holding B S.T,E.P,
To Septic Absorption Lift Holding ~ublic/PrivateManufacturer: Capacity in gallons:
From Tank Field Station Tank Sewer Lines ~ /~
Material: Number of Compa~ments:
well' /Z~ ¢ /~7 ~ ~ ~ ~ %~¢E~
SuCkle ,~ ,~ LIFT STATION~
Water 7~ /~O ~ ~
Lot Size in gallons: Manufacturer:
Line /~ /~ ~ -- --
"Pump on" level at: ~ "Pupal at: High water alarm at:
Foundation /~ ~ ~ ~1
Curtain ~ Electrical Inspections performed by:
Drain -' ~O~F ~, ~
Remarks: BENCH MARK
Location and Description:
~ ~E~ E~D OF /~do[~AssumedElevation:
ENGINEER'S SEAL
-~K;~~ ............ 2W ~-
17834 ~le R~er Loop Road No. 204 ;¢ '~'~F ///,¢~
Inspections performed by: E~e R:vc~, ~'~"~' ~e~77 Dates: 1st ~ - ~-q~ ~L~;~,/-,,.~
Department of Heal,and H~man Services approval ¢~*;,.%,.,, CE-880]
Reviewed and approved by: Date: ~ -/¢- ¢% "'-"' ' ' '
72-013 (Rev. 9/91) MOA 25
Pern~it No. SW950058
Page 2 of 2
Municipality of Anchorage
DEPARTMENT OF HEALTH 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
05060207
Legal Description~.RACT B1C; EAGLETTE AERIE PID No.:
C0~ 86,7'-- --85.9'
86.7'-- C02 MT2
C01 95 2'c02
90:16' 90 4' "" '
83'1'--/ y i 83.1
'83.1'
ii SEWER ROCK OVER
82.6~ :.i & UNDER DISTRIBUTION: PIPES
· 74,6' NO WATER FOUND i
NEW 1000 GAB. SEPTIC
ABSORPTION BED
sco, 3.~ 38.5
CO1; 15.0 46,6
C02 2~.0 49.1
D.V. 3LO 54.7
C03 34.9 60.8
C04 147.4 144.7
C05' "I29'~2''~' "I'Z~7;~''''
C06 77.3 iOi,i
MT1 68.5 98.1
MT2 121,1 150,0
SCALE 1" = 40' i
WELL
c. COWAN
CE - 8801
72-013 ^ (1/93) *
PAGE 1 OF
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 (UPGRADE) PERMIT
PERMIT NUMBER:SW950038
DESIGN ENGINEER:S & S ENGINEERING
OWNER NAME:LABA JOSEPH P
OWNER ADDRESS:2840 COMMERCIAL DRIVE
ANCHORAGE, ALASKA 99501
DATE ISSUED: 3/30/95
EXPIRATION DATE: 3/30/96
PARCEL ID:05060207
LEGAL DESCRIPTION:
EAGLET AERIE TR B1C
LOT SIZE: 192100 (SQ. FT.)
NI/MBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK SYSTEM
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 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 A_ND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
RECEIVED BY: ~~
ISSUED BY: ~.
ROBERT C. COWAN, RE.
ROBERTA. SHAFER, RE.
CIVIL ENGINEERS
March 23, 1995
(907) 694-2979
FAX (907) 694-1211
HEALTH AUTHORITY
APPROVALS
SEWER & WATER
MAIN EXTENSIONS
SEWER&WATER
INSPECTION
ENGINEERING STUDIES
AND REPORTS
WELL INSPECTION
& FLOW TEST
SITE PLANS
ROAD DESIGN
SOILTEST
PERCOLATION
TEST
STRUCTURAL&
MECHANICAL
INSPECTIONS
ON SITE
WASTEWATER
DISPOSAL SYSTEM
DESIGN
MUNICIPALITY OF ANCHORAGE
Department of H~alth and Human S~rvic~s
P.O. Box 196650
Anchorage, AK 99519
REFERENCE: Tract BIC; Eagl~tt~ Ae~i~ Subdivision
:tt~'ce.~ bgd,toom house, on Zi~ ~g~pJrp, nced p~.ope~t~.
An adequacy t~st p~rform~d on thc ~xist~ng system for H~alth Authority
Approval purpose found th~ absorption capacity of th~ syste~ to b~
inadequate.
A t~st hol~ was excavated and a p~rcolation t~st p~rform~d. Th~
approximat~ location of th~ t~st hole is located on th~ attached sit~
plan. Th~ monitoring tub~ within th~ t~st hol~ as b~n ch~ck~d and
found to b~ dry.
Attached is th~ proposed upgrad~ d~sign.
W~ do not anticipat~ any adv~rs~ ~ff~cts on n~ighboring prop~rtie~ by
thc installation of th~ proposed s~pti¢ syst~. Th~r~ ar~ no poi~
of co~in~on w~ th~ proposed w~ ra~ w~ ~n b~ s~n on
th~ ~ach~d s~ p~n.
If you r~quir~ additional information pl~as~ contact us.
Sincerely,
ROBERT C. COWAN, P.E.
RCC / gk
17034 NORTH EAGLE RIVER LOOP · SUITE 204 ° EAGLE RIVER, ALASKA 99577
OF ~
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'S'I'N
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
PERFORMED FOR:
LEGAL DESCRIPTION:
4
5
6
7
8
9
10
11
12
13
14-
15-
16-
17
18
19-
20-
~2-.~_ ~(~ <~',~t,~-.'¢' Township, Range, Section:
,~ ~{Z~,~... -~ ~:::~ SLOPE
WAS GROUND WATER
ENCOUNTERED?
DEPTH? r--~,~ pO
SITE PLAN
E
Depth to Water Alter
Monitoring? ~> .t~t Date:
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE '~ (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN I '/~'z~ FT AND ~'/1~- FT
COMMENTS -
S & $ ENGINEERING ~-'/~-~ '~l~',~r~ CERTIFY THAT THIS TEST WAS PERFORMED IN
PERFORMED BY: ] ~'~;4 ~al~ ~x~i: -'~p ~ ~, ~0~ ~
ACCORDANCE WITH A~e/~N~f~UIDELINES IN EFFECT ON THIS DATE. DATE:
72-008 (Rev. 4/85)
MUNICIPALITY OF ANCHORAGE
. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Environmental Health Division
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
~ame DISTANCES
~/~-~5~_~ .~~ FROM~ SEPTIC ABSORPTION WELL
Address TANK FIELD
~_~ ~ ~ ~ ~~x~ ~J~ELL
Phone(s) I Permit No. IN°' of Bedrooms
~~] ~~~ ~ LOT LINE
LEGAL DESCRIPTION
Township. Range. Section AS-BUILT DIAGRAM (Show location of well. septic system, prope~y lines, foundation.
~ ,~[~ , ~, ~X driveway water bodies, e~
~ SEPTIC ~ HOLDING
Manufacturer Capacity in gmlons
MaterTal NO. of Compa~ments
TYPE
OF
SYSTEM
~ TRENCH ~ BED ~ W. DRAIN ~ OTHER /
Depth to p,pe bottom from Total depth from original grade
original grade ~ FT ~ ~T
Fill added above original grade Gravel depth beneath pipe
Gravel length ~t FT Gravel width ~[ FT
Total absorption area Distance between lines ~ ~+
Number of lines Soil rating Pipe material
Installer
Date Installed
'
WELLS x ~ x
~ PRIVATE ~ OTHER (Identify) / 4
Classification (A,B.C)~t~,~O~ Total Depth FT~ Cased to FT .1
Installer Date installed: .
--
REMARKS:
~ale: ~ ~~~~~' '
Municipal and ile~i~m~Z7 . ///' ~//~/~0
"" "'
Health Depait~ent Approval: Date:
72-013 (3/85)
'!La~V~J.:: fTL.~.Z'L haY~/E,) at't,
{' E.)~,~ty!', t'" (.:,)! (::iL,~ :J, !'" (,:,:,)% :i. F'/!~BL.~
'i t"! :i: :;i L.II:::'(';:d:.:~C~DE:; S¥SI"IElfi i"ILJS'i' BE :[ t'q~iiVi'(..~d....LlJi!:)::) (:tEil EiH(::)WN Qlxl TI'"IIE IEIxlG :1: I"..IEi:EI:R ~ S
iOIE~!3 Z (:.~N i)P~ FED '::? / I :]!;/?() ,, IqDT :[ F:'Y I)i"'IHS E':dEF'I::)I::~:~:!: F:fi....L ii: IxlS!:::'IECT :!: (::)IxlS. T1'"I ii: S
l:::iE!::;;!fi .1: 'i ]: S I:::(;:)l::t F'l 5 :Ei:,E])i::.','E)E)I"t !iii :I: I'4E~!...JE t:::'¢d"1 ]: !....Y l::i%S :1: DEi'.NCE: [)!',11_¥ ~ (-~'.,t',!D
ii:!: X I:::' ii; ,K:iiE: S (:)N :I. 2 / ::!t; 1 / ? O ,,
· Ic~i"'!:..h By Lh,7~::' l'lLu"~:i.c::i, paJ.:i.t.y c).i:' Anc:hc:i"a'qtie (I"IE)~:~) arid t.h,x, St. at.e) c:~t'
2,, i: (4:i. i ! :Lr~s~itatl 1 '?..l"x~.) ~iy?i~t:.e~,m :i.n ac:(:::cii"claw'Ic:(.~.: ~.,~:i.'l:.h al I t"'l(::)(~ c:cx::h.'..:.:,~il and
5,, ]: ~..,J:LI]. ax::lh(:.:.:,r',:.~z, t.o ali. I~t(3(::~ and S'Lat(~.: c:~f' A:i.a~H<a r'~:.x::tu:i.r'(.?m,:.x.)rfit, s~ i'cn" 'l:.h(,>)) s~(.~rL ba(:::k
fil;(.:.::,~,d(E,i"d~u;:.'.?}:~ ~i!iy~liFl:.E.hll (::,n '(.i"i:J.~!~ (::)p al"ly ac:l.jac:er~t, ch" near'by
,.q,.,]: Lu'"~ch;¢~r'~iit, and 'It. hat. 'Ll"~:i.s~; p(~,mm:i.t. J.~ii~, val:i.d fc::,r' a rftatx:i.r'm..un c:~F 5 f::l~,:~dr'c~c, rrni~,,
a~i:i~ili(::) Lu"lcl~:~)r'~!!vLand '(',,ha't'.. 'L!"le:.) C:al::iac::J.'l:.y (;:ii' tl"~,:.:,~ !'.cxLal siy~t~¢en'~ :L!i~i. ::;j; I::)~xa::lr'cx::xns; and
(0 ~,.,.¢ n ~.:~.> r' ) F' ,':i,.q N V _.q.::;i
.I ........ ¢.. u... ,J ) ..... .......... DWT'IE ~ ........... ~...
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
PERFORMED FOR:
DATE PERFOR
SLOPE SITE PLAN
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
2O
WAS GROUND WATER
ENCOUNTERED?
I
s
L
IF YES, AT WHAT
O
DEPTH? ~ p
E
Deplh to Water After
Monitoring? ~-~ Date: ct
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE __ (minutes/inch) PERC HOLE DIAMETER __
TEST RUN BETWEEN __ FT AND __ FT
COMMENTS /'~ ·
PERFORMED BY: 17034 Eagle River Loop Road No. 204 ~ CERTIFY THAT ]HIS TE. ST WAS
Eagle River, Alaska 99577 ~..~",/ .,~ /.~ ~, /.:,~. _
72-008 (Rev. 4/85)
PERFORMED IN
MUN,C,.AL,T¥ OF A.C.O.AGE
- DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME '~ PHONE [~NEW
MAILING ADDRESS
LEGAL DESCRIPTION
LOCATION NO. OF BEDROOMS
,
~ ~anufacturer ~~ Msteria¢ r~~ NO' of c°mpartmentsz
Liq. capacit~n gallons Inside length Width Liquid depth
/ ~ ~ 0 IF HOME.DE:
~ ~ DISTANCE TO: Well Dwelling PERM~ NO.
O Z < Manufacturer Material Liquid capacity in gallons
Nearest lot line. PERMIT~/~
Tranch ~idth
~ ~ ~ ~o. of li7, Length of~oach line, Total le~lines
-- Total effective ~bsorption area
~~ ~ ~ ~ Top of tile to finish grade ~ ¢ Material beneath tile
inches
Length Width Depth PERMIT NO.
~ ~ Type of crib Crib diameter Crib depth Total effective absorption area
~ Well Building foundation Nearest lot line
~ DISTANCE TO:
~ Class Depth Driller Distance to lot line PERMIT NO,
~ Building foundation Sewer line Septic tank Absorption area(s)
~ DISTANCE TO:
OTHER
IPEMATERIA ~ l~ ~
SOIL TEST RATING
INSTALLER ~-
REMARKS
~ . NO 1745-E ~ ~
APPR¢ ~ DATE LEGAL
72-013 t Rev. 3/78)
PERMtT' N(].
.:...:L::.:, .- t,lE':i~;"l" HOF?]"HERN
FIF::'F'L. :r. (::Fib,FI" FRRN. K :!!!;'T'E',,,'IEN~i; '":.. =.,:4
L..OE:FFt" t ON r3L..ENN C I RCL. E
[...EGF~.L TFdZlCT B-.::i.. EF!GI...L~;T i:::ilF, i:Er5 =,. [ EL]Ff'
F,EI::'FIF?TMENT' Oh HEF:ILTH FtNC' ENV!RONMENTFIL F:'I'
':"::"~,_,,_._ '" L." STRE":ET., F:tNCHORi::II]iEE., F:IK. _
;.264-' 4 '72
II..,Jl EEC... IL F~ tP,II E:::" ~,Z:u P",~ ........ S; :11:: "T'
< '?BEd. F:',8 ::,
'T'h' F'r"' _ ':" ~': ..........
_ .:. OF SOIL FIE:': '"F:'E.]"I ZN .... ~_,t EM tS TRENr:.:H
MFIXtMUH N HFE'F:' OF DEC, ROOM'.:5 ;ii: :iSOIL F~:F. iTING SQ F I. E, ..
THE RE(Z:¢JIf;.:E[:, SIZE OF THE SOIL E,.',LI*.F r I ...t',1 .::,'r=, I E.M .L=,. /'~,L ~,%
IE::~ E.:Z F" -F" It-It ....... :.::Z':: L_ II'~TZ P",,~ ~;:] 'T' 1t-"~ == '.',Ef.~ ]"~:: C':.:)~ ~:~.".'.". IF:~1%,,' EE] 1t ..... I[::, lEE If:::' l'" 11'"'"11 ......... q~.-
THE LENGTFt DIMENS;IOi",I I:3 THE LENGTH ':: tN FEET) OF THIE TRE:NCH OR DRI:::III",fI::'tEI-D.
'T'HE DEF'TFI OF R 'r'I:~'.ENCH OR F'IT I:E; THE [>ISTflNCE BETI4EEN THE SUt:;;:I::'FICE Ot::' THE
GROUN[:, F~ND 'T'HE BOTTOM OF' THE EXCI:I',,,'RTION
T'HEREE Z% NO E;ET 1.4ZE:,TI'4 FOR 'T'RENCHE'.5.
THE GRFIVEL. [:,EF'TH ZS; THE MZI",IZMUM DEPTH OF GRFIVEL 8ETNEEI"4 THE OLITFFfl....L. PIF:'E
FIND THE E:OTTOM OF THE E::-:iCRVRTZON
"":' ;',' "' . 2.- ..... r. .....
F EF..fII 1 RF'PL. I CFINT HFE'.7, THE F.'E '.",PUl"&:, 1 .:, ,l. L.~ I I .r TO I NF:'OF::M TH I S'; [:,EF::'RF;..:TMIENT [,_ F' t H ::ii THIE
iNSTFILL. F:fTIOI'.,I .I:I'.,ISF'E3T]:ZIq'!~ OF:' Fiht'-¢ t.,.E]_LS F:I[:,JFICENT TO THIS:, F'ROPERT"r' FIND ]"HE
NUi"IBEF~:: OF' RES!E:,E]'-~.(3E'"ii; 'T'HFC!" "f'HE NELL. I,.I!L.I_ '.:E;E!:;~t',,,'E:.
E:FK]:KF:ILLII",IG OF FtN"r' .:: r= tel1 I.,.IITHOUT FINFIL INSPECTION F:I?',I[:' ::lt'l'~ .... I THiS
[:'EI::'I:::tF;:]?MEN]" t.,.t:[LL BE .:,UE,..E..I TO PRO'$ECI...TT";N
MINIMUM [:'ISTRNCE BETWEEN FI NELL FIN[.'." Ffi",l"r' ON-:L:!;ITE SEI.,.IFtCiilE [."ISPO:.::i;F~I-Sh"STEM
±~30 FEET FOR R PF.:IVRTE t.4ELL..~ OR
:1.50 TO 20(!) FEET FROM F:t PUBLIC I.,.IEL. L [:,EPENE:'ING UPON THE 'T'"r'PE'i OF F'UE;L. IC I.,.IIELL.
NELL.. L. OE~':":; RRE REQUIF'?,ED RND MUST BE RETUI:;?.NE[> TO THE DIEF::'FIRTMENT N ITHi'N ]i:O [:'Fih"S
(:IF' THE F.IIEL. I_ COMF'LETION.
OTHER REQU:[F~:EMENTS MR'¢ RPP[.."r'. SPEC I F:'I CRT I
R"/FI 1' LFIli::LE T'O Z IqSt...IRE PROPER It",I:iSTRLL. f:I]" t [)hi.
F" E:}Z F.:;:: tP'~ ::E T' E: ;,="=: F" ][ IF;;L" E~Z ."%; [:" EE C: EE!.'. IP'll lEE: IEE: IF;;: :Z:]~: :i ..... i. :Di~ ";;::=" :.:.'E:
t C:EF.:T I F'"r' THFFF
'.'L.: I FIH F'FIMIL. IRR I4ITH THE REQUIREMENTS FOR ON-'SI'T'E SEf-,.IE:.RS FINE:' I.,.IELLS FIS SE'T'
F:'OF..'TH B"r' THE MUN I E.': l PRL I T"r' OF RI",IE:HORf:fGE.
2.: I t4ILL IN'.:i!;TFII_L THE :iS'¢STEM IN RCCOR[:'F!I'qCE NITH THE CODES.
3:: 1' L'IN[':,IER'::];TFtN[.':' THFIT THE ON-:E;ITE SEI.,.IER ':T,"r'STEM MR"r' REQLI!F:E ENLI:::IRGEMEh!T IF' THE:
RES I [:'ENCE I i-.'; TO INCLUDE i"IORE THFIN ::~: E:EE:,ROOMS.
F'RRNK S TEVEI'.,I:i5
F'E F.':M I T N 0,
DEF'laRTMENT C HERLTH RND ENVIRONMENTRL ~ <OTECTION
8~5 '"L" STREET., laNCHORRGE, RK. 50501
~64-47~0
i,...tE[_L F"EF: f'l I T
,:: 8~544 )
~IF F _ t CRNT
LOCRT ! ON
LEGFtL
FRRNK :, I E, EN_
GI_ENN C I F ..L,E
TRRC:T Ed. ERGLET RIF.:ES S,'"D
P. 0. E,J~'=,
LOT =,I ..' E
FEET
MINIMUM DISTRNCE BETNEEN R NELL. RND RNY ON-SITE SEI.4FIGE DISPOSRL SYSTEM IS
:.1.88 FEET FOR F! PRI',,,'laTE NELL OF.! :L50 TO 200 FEET FROM F"I PUBLIC NELL DEPENDING
UF'ON THE TYPE OF' PUBLIC WELL
MINIMIJM DISTRNCE FROM ta PRIVRTE NELL TO la PRIVRTE SEP.IER LINE IS 25 FEET RND
TO R COMMUNITY SENER LINE IS 7.5 FEET.
WELL LOGS laRE REC!UIRED RND MUST BE RETURNED TO THE DEPlaRTMENT NITHIN ]:0 Dla"?S
OF THE WELL COMPLETION,
OTHER REQUIREMENTS f'lla"r' RPPL'¢. SPECIFICRTIONS RND CONSTRUCTION DIRGRlaM'-:', laRE
RVRILRBLE TO INSURE PROPER INSTRLLRTION.
I ..EF.TIF~ THlaT
~_, SET
:~-: t laM FlaMILIlaR 14ITH ]'HE REQUIREMENTS FOR UN-_,ITE ~,EI.,IER_ laN[:, NELL. S '"';
FORTH B'¢ TH~I_INICIPlaLITY OF RNCHORlaGE.
2: I I~~FILL--' ~"TNE .S~STEM IN RC:CORDRNC:E NITH TFIE .]:ODES.
~ RPPLICRNT FRRNK STEVENS
Box 1~50 ' Anchorage, Alaska. 9951~650 -
72-025 (Rw. 1/91) Front MOA~21
g-to'the legality and StatUS Of system.
INSPECTION
and/or Wastewater ~
and type of structure indicated herein~: I ~urther~e[iht t~ based on t~e i nformat on ob~ined from
the Municip~ll~ of Ancho?~e ~iles}~ from'mY i~ve~t~tion and insp~ion, the on-site water
8u~pl~ and/or wa~w~t~r ~l~po~lsy~t~mi~ In ~ompli~n~ with all Munm~pal and $~t~ ~od~,
ordinances, ~nd ~ul~tion~in ~on
Municipality of Anchorage ,~
Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
A, Well Data
Well type
Log present (~)
Total depth
Sanitary seal
If A, B, or C, attach ADEC letter. ADEC water system number
Date COmpleted Lo~\ ~. ~ ~ Driller
Cased to '~ ~ ¥ Casing height
Wires properly protected {~N) ,.~
FROM WELL LOG AT INSPECTION
Date of test C, ~ L~.~6 \ ~.~ 7.-~
Static water level ~ ~ ~ \/~.~k ~' ~
Well flow ~O ~. g.p.m. ~ ,~ ~ · g.p.m.
Pump level1 ~ O¢¢ ~o~
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot t "/~1 ~
Absorption field on lot ~ L~q ~
Public sewer main ~ JA
Sewer service line 'Z--~' ~A-
; On adjacent lots
; On adjacent lots
Public sewer manhole/cleanout
Petroleum tank
WATER SAMPLE RESULTS:
Coliform (-)
Date of sample:
Nitrate
Collected by:
Other bacteria
B. SEPTIC/HOLDING TANK DATA
Date installed /'-/~ I c) _5~'"'~ Tank size /'~ Compartments
Cleanouts([~l) ~/ Foundation cleanout~/N) y' Depression (Y~J~j~
High water alarm ('R~ ~ Alarm tested (Y/N)
Date of pumping ,/~J.//~ -" j'-./~ ~,,,~ Pumper ~J'//~
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot / ~ ~ / On adjacent lots / c) ~ I ~ Foundation / z'r/ /
To property line / o ~ '/' Absorption field ! ~ 1 ~ Water main/service line ~o ~ ~
Surface water/drainage /,~ {g
72-026 (3/93)* Front
C. LIFT STATION
Date installed Manufacturer
Size in gallons Manhole/Access (Y/N)
Vent (Y/N) "Pump on" level at "P~t
High water alarm level
Meets MOA electrical codes (Y/N)
Welron lot On adjacent lots Surface water
D. ABSORPTION FIELD DATA
Date installed ~ ~ ~'O .~c~ ~--
Length 7~'~ /
Total absorption area
Date of adequacy test
Water level in absorption field before test
Peroxide treatment (past 12 months) (Y,~
Soil rating (GPD/Ft2)
Width ?.~'- Gravel thickness
I/~-5" f~
Cleanout present([~N) '7/
,J/,~ --/J~;,,--J Results (paso/fail)
L~, 5/ System type · ~
O,~- j Total depth
Depression over field (Y~D
~ tor ~ Bedr~ms
A~er test
If yes, g~e date
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot / ~ "~
To building foundation
On adjacent lots
Sudace water
Curtain drain
On adjacent lots /o ~ ~ ~' Property line
L.~ C'- ' To existing or abandoned system on lot
Cutbank 'J//,~ Water main/service line
Driveway, parking/vehicle storage area
E. ENGINEER'S CERTIFICATION
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in e~h~e, date of this inspection.
uate ~1( t I ~ ~,~ ~;~ ~. , .~',~.
HAA Fee $ ~ DC) , ~ Waiver Fee $
Date of Payment /-/--/.Z - ~ ~ Date of Payment
Receipt Number ~'~' ~7 ?~?,~ Receipt Number
72-026 (3/g3)' Back
MUNICIPAEITY OF ANCHORAGE
Department of Health & Human Services
DIVISION OF ENVIRONMENTAL SERVICES
343-4744
Parcel I.D. #
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description ( nclUde 10t, block, subdivision, section, township, range)
Tract BI~ Eaglette Aerie Subdivision
Location (address or directions)
(b) Property owner
Mailing Address
(c) Lending Institution
Mailing Address
Frank Stevens
P.0.Box 771612
Telephone:(home) 694-3701
Eagle River, Alaska 99577
Business
Telephone
(d)
RealEstate Company and Agent Re/Max of Ea~le River ATTN: Don McKenzie
Address 16600 Centerfield Drive S~ite 201 Ea~le River, Ak.99577,.
Telephone 694-4200
(e)
Mail the HAA to the following address: (or check hereY~, if hold for pick up.)
List contact person and day phone number below:
S & S ENGINEERING
17034 Eaale glarer L~n I~,=~,,,,i M~ ~n~
~gle River, Alaska 995~
2. TYPE OF RESIDENCE
Single-FamilyJ~ Number of bedrooms
3. WATER SUPPLY
Individual Well ~X Community [] Public []
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to th legality and status.
4. SEWAGE DISPOSAL
On-site~ Public [] Community [] Holding Tank []
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to the legality 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 th is
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, ordinances, and regulations in effect on the date of this inspection.
Name of Firm
17034 Eagle River Loop Road No. 204
Address
Date
Telephone
$. DHHS APPROVAL
Approved for -;3 bedrooms by
Approved ~/,.~ Disapproved
Terms o¢ Conditional Approval
Conditional
Date
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
NIUNICIPALrfY OF A~
DEPT. OF HEALI~,~JI~_'~".,.I
ENVIRONMENTAL PR~
SEP 2 0,1990
RECEIVED
MUNICIPALITY OF ANCHORAGE (MOA)
Health Authority Approval (HAA)
CHECKLIST - FEBRUARY 1984
343-4744
Legal Description:
A. WELL DATA
Well Classification ~l~¢~h
Well Log Present (~N) X,/ Date Completed
Total Depth ~¢r~ Cased to ,¢¢~,~-t- Depth of Grouting
Static Water Level
Casing Height Above Ground ~,7---
Electrical Wiring in Conduit t~N)
SEPARATION DISTANCES FROM WELL:
To Septic/Holding Tank on Lot
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line
If A, B, C, D.E.C. Approved (Y/N) I~/~
Yield ~ ~ ~t~'~'vN
Pump Set At t ~.
Sanitary Seal on Casing (~N) V J
Depression Around Wellhead (Y~[~) ~ "~
; On Adjoining Lots ~3~-'
\ c) o ~.t.- ; On Adjoining Lots
To Nearest Public Sewer Cleanout/Manhole
To Nearest Sewer Service Line on Lot ~.~-
Water Sam pie Collected by --~ ~', ~ ~__..4N~G.I
Water Sample Test Results ~.~.~,,,N-C~'-c:~/2.~ --
Comments
B. SEPTIC/I-I~Ce~I~NB TANK DATA
Date Installed ~'-~'~'"]~' Size
Standpipes )N)
Depression over Tank (Y~g~
Pumping/Maintenance Contact on File (Y/N)
Holding Tank High-Water Alarm (Y/N) t'4J/
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK:
To Water-Supply Well
To Property Line \C
To Water Main/Service Line
\'7~'~$'-''° No of Compartments 'Z.--
Air-tight Caps~)'N) W -- Foundation Cleanout~)N)
Date Last Pure ped
--
; for
Temporary Holding Tank Permit [Y/N)
I -¥- To Building Foundation
To Disposal Field
To Stream, Pond, Lake or Major Drainage Course
Comments
72-026 ,Rev. 7/88) Front Page 1 of 2
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed °i -- ~c'1 --c~ ~
Width of Field ~'~
Square Feet of Absortion Area ~_~
Depression over Field (Y/~
Results of Last Adequacy Test
MUNICIPALITY OF ANCFIORAG~
ENVIRONMENTAL SERVICES
Type of System Design
Length of Field ~:~)~ .:';~!'? 20 1990
Depth of Field ~ ~--~/~-'
' Iv D
Gravel Bed Thickness ~¢ o~
Statndpipes Present ~)
Date of Last Adequacy Test
SEPARATION DISTANCE FROM ABSORPTION FIELD:
TO Water-SupPly Well Lc:>~~'~-
To Building Foundation ' ~,c~~
Lot
To Water Main/SerVice Line
To Stream, Pond, Lake, or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments
To Property Line ¥O t, ~
To Existing or Abandoned System on
; On Adjoining Lots ~'c>~''~'''
To Cutback (if present) I',J//~.
D. LIFT STATION
Date Installed Dimensions
Size in~ Manhole/Access (Y/N) ~
"Pump On" Level at -"'"'""'""~ "Pump Off"~
High Water Alarm Level at ~_ .~'""'~Vent (Y/N)
Tested for ~ ~~ Pumping Cycles during Adequacy Test.
Meets MOA Electrical Codes ~ ~
Comments ~ ' ~
**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 ~ o c =~,,-_,~,~cD,~c
~nmn~nv 17034 Eagle Ri~er Loop Road No. 204
Eagle Rive~ Ala~ 99577
Date ~/y~ ~~~"~, ~'~e, I
I
/
/
Receipt No. D~ Receipt No.
Date of Payment ~'~ ' ~O Waiver Fee: $
Amount: $ /:~ Date of Payment
72-026 (Rev. 7/88) Back Page 2 of 2
1. General Information
(a) Legal Description (include lot, block, subdivision, section,
Location (address or directions)
(b) Applicants ~ame ~ ~>/40r~ ~elephone - ~ome
MUNICIPALITY OF ANCHORAGE
DIVISION OF ENVIRONMENTAL NE~ALTH
DEPARTMEN~ OF HEALTH AND ENVIRONMENTAL PROTECTION
APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE
Application Date ~J~/~
to.p, range)
Bus ines s
~-~ ; Owner/builder~;
Telephone
Applicants Address
(c) Applicant_is (check o_~ne) Lending Institution
Buyer ~--~ ; OtherI I (explaim);
(d) Lending Insti~ution
Address
(e) Real Estate Co. & Agent
Address
Telephone
(f) Mail the H~ to the following address:
e
Type of Residence
Single-Family~''
Number of Bedrooms
Multi-Family~--~
Other (describe)
Water Suppll'
Note: If community well system, must have written confirmation from the State
Department of Envirornnental Conservation attesting to the legality and status.
Sewage Disposal
Onsite ~ Public ~-~ · Community ~-~ Holding Tank ~-~
Note: If community well system, must have written confirmation from the State
Department of Environmental Conservation attesting to the legality and status.
[Page 1 of 2]
e
En$ineerin$ 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, ordinances, and regula-
tions in effect on the date of this inspection.
Name of Firm
$
Address
Date
(ENGINEER SEAL)
DHEP Approval
Approved for ,_'~
Approvedc~'
bedrooms
Disapproved
Terms of Conditional Approval
CAUTION
THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
(DHEP) ISSUES MEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT-
ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED
IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND
THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE-
MENTS. EMPLOYEES OF DHEP 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.
(DHEP SEAL)
RR4/ej/D18
[Page 2 of 2]
7 -19-84
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH A~THORITY APPROVAL (FAA)
CHECKLIST - FEBRUARY 1984
ae
Be
Well Classification .~' F
Well Log P~esen~/N)
Total Depth /~z/ .. Cased to
Stati. c.'Water ~evel 5- '"/v~'. Pun~ Set At
Casi.n~ Be igh~ Ab~ve Ground 3 ~ /!
Elec~t~ical .Wi~ing ~,'in .Conduit ~/N)
Separation Dis%ahc~s f~c~ Well:
Sanitary Seal on Casing ~/N)
Depression A~ound Wellhead ~
To Septic/Holding Tank on' LOt /~ /
. ; On Adjoining Lots
Tc~iN~.a~est Edge.,.'of,'AbSorption Field ~n Lot. ~/~._ ., On Ad3olnlng Lots
To Nea~e'st~ 'Pflblic s~er Linde A///~ To Nearest Public Sewe~
Cle~'~anhole /~/~ To Nearest Sewe~ Service Line on Lot
Water Sample Collected By~'%~'~//Z~&~7 ; Date 7//~/~
Water Sample Test Results ~/~-7-/~/~"F~
SEPTICX~i~]~ TANK DATA
Date Installed ~-/~-//?~ Size / ~-~-~ No. of Cc~,~a~tments
Standpipes~) Ai~-tight bps~) Foundation Cleanout
Depression ove~ Tank (¥~ Date Last >~d or'~'//[~/~'~
Pumping/Maintenanc~ Contract on File ~Y/N) ; f
Holding Tank High-Wate~ Alarm (Y/N),~//~ Temporaz~; Holding Tank Per-mit (Y/N)
Separation Distances f~cm Septic/Holding Tank:
To Water-Supply W~ll /~ /
,~ To Building Foundation ///
To P~opert¥ Line ~/~Z-, To Disposal Field
To Water Main/Se~vige Line /~//~ W~ Pond~ Lake, c~ Major D~ainage
Cor~ents
[Page 1 of 2] 2-15-84
ABSORPTION FIELD DATA
Soils Rating in Absorption ,Strata
Date Installed
Width of Field
Square Feet of Absc~ption A~ea
Depression over Field (Y~
Results of Last Adequacy Test
oe system
Length of Field
~p~ of Field ~/'/
Grail ~d ~ick~ss
~ ~ Stan~ims ~esent~)
~ of ~st A~a~ ~st ~
Separation Distance f~cm Absorption Field: /
f
;
To Wate=-Supply W~ll
To Building Foundation
Lot /~
To Water Main/Service Line
To~ond/Lake/c~ Major Drainage Course
To Driveway, ParkingArea, c~Vehicle Stc~age A~ea
Co~f~nts
To P~operty nine ~--7'~?--
To Existing o~ Abandoned System cn
To Cutbank(if ~esent). /t//~
'zVZ '
D. LIFT STATION
Date Installed
Size in Gallons
"Ptu~ 0~" Level at
High Water AlarmLevel at
Tested for
Electn~ical Codes(Y/N)
Cc~ments
Dimensions
Manhole/Access (Y/N)
Off" Level at
Vent (Y/N)
es du~ing Adequacy Test.
M~ets ~DA
**
** Check Permitted Bed~ocm Rating Against HAA Request
MOA Guidelines in effect
I certify tha~ve~ ch~ecked, verified, c= confc~T~ed to all HAA .
'--- .. _~r- ~ , , I /
KB1/d5/s l~I'~ ~BK~'~'~?' "° ""~
[Page 2 of 2]
2-15-84