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HomeMy WebLinkAboutCOLLIER LT 1SHEDN00° 00' 53"W 282.07'S00° 00' 53"E 282.10'N89° 53' 06"W 165.00' S89° 53' 41"E 165.00' 10' ELECTRICAL AND TELECOM. EASEMENT 10' SCREENING EASEMENT 64.0' 64.1' 26.2'114.8'LOT 3A LOT 3 LOT 228.3'36.8'2.2'11.8'38.0'26.2'68.2'25.6'13.2' 36.0' EXISTING HOUSE POWER POLE GUY WIRE DE ARMOUN ROAD 50'50'SEPTIC STAND PIPE (4)MANHOLE 1.9' 6.0'26.2' LOT 1 COLLIER SUBDIVISION AS-BUILT SEPTIC STANDPIPE WATER WELL FENCE Asphalt Concrete Overhang Wood Deck LEGEND: NOTE: THIS DRAWING SHALL NOT BE MODIFIED FOR USE AS A PLOT PLAN WITHOUT THE EXPRESSED WRITTEN CONSENT OF LCG LANTECH. DRAWN DATE: DRAWN BY: SCALE: CHECKED BY: 09/21/2020 SC ADS/AP 1" = 40' PLAT: WORK ORDER: 20081 84-55 FB/PG: 818/58 GRID: SW2939 REF: 85L107 LEGAL DESCRIPTION: ORDERED BY: DAVID CHAPUT SURVEY CERTIFICATION: LCG LANTECH, INC HAS CONDUCTED A PHYSICAL SURVEY OF THE PROPERTY AS SHOWN ON THIS DRAWING AND CERTIFIES THAT THE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES AND NO ENCROACHMENTS EXIST OTHER THAN NOTED. EXCLUSIONARY NOTE: IT IS THE OWNERS' RESPONSIBILITY TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS, RESTRICTIONS OR RIGHT-OF-WAY TAKINGS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION, FOR ESTABLISHING PROPERTY LINES, OR FOR PLOT-PLAN PURPOSES. 250 H StreetAnchorage, Alaska 99501 Survey Department Phone 562-5291 Mainline Phone 243-8985 AECC 668 PARCEL #: 017-151-17-000 ADDRESS: 7300 DE ARMOUN ROAD Onsite File Collier Lot 1 #017-151-17 ,00PALfry MUNICIPALITY OF ANCHORAGE irk ,�1>7�n� On-Site Water&Wastewater Program N° (h .a„�`; PO Box 196650 4700 Elmore Road •4 ft/ Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 �y http:!/www.muni.org/onsite 1 cpartmcnt 4'..,:;(1-;;:6 On-Site Wastewater Disposal System Permit Permit Number: OSP191347 Effective Date: 9/6/2019 Work Type: SepticTank Upgrade Expiration Date: 9/5/2020 Tax Code Number: 01715117000 Site Legal Address: COLLIER LT 1 G:2939 Site Mailing Address: 7300 DE ARMOUN RD, Anchorage Owner: CHAPUT DAVID P & CINDY W Lot Size in Sq Ft: 46544 Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING Total Bedrooms: 4 This permit is for the construction of: ❑ Disposal Field D Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 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 Special Provisions: The end of the trench is to be located prior to placing the tank. Received By: /hlAiN Date: ? (a)(� q / Issued By: Date: 0//7 J MUNICIPALITYOF ANCHORAGEIgo0 i,,,,...• O ...,,,,,. Development Services Department jl Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 017-15117 Property owner(s) DAVID CHAPUT Day phone Mailing address 7300 DE ARMOUN RD, ANCH AK Site address SAME Legal description (Sub'd., Block & Lot) COLLIER LT 1 Legal description (Township, Range & Section) 2 Lot Size 46,544 Sq. Ft. Number of Bedrooms . r APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) ill (w/wo ADU) Septic Tank 0 Upgrade 0 Duplex • ❑ Holding Tank ❑ Renewal ❑ J L 5 6 7•84/0 ❑ Privy ❑ F tip[,[1) ,i Private Well ❑ cz qw Water Storage ❑ a ' Q+9 k THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: O/ 4. ` 79 S1 't u is ance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. "MA" (Signature of property owner or authorized agent) Permit/Rush Fees: W 3100 Waiver Fees: Date of Payment: g` 7`�//y(7y� Date of Payment: Receipt Number: # /�' Receipt Number: Permit No. (ASPJ 9 13q7- Waiver No. G:1Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc J August 7, 2019 Municipalities of Anchorage Departments of Health and Human Services P.O. Box 196650 Anchorage, Alaska 99519-6650 Fax 249-7847 Re: New Septic tank permit Legal: COLLIER LT 1 To Whom it may concern: This is a request for a septic tank permit on the above referenced lot. This tank replacement will not impact any of the neighbors or encroach on any wells, septic or open water issues. //y4r-- Sincerely Michael N. Anderson, P.E. 4661 Natrona Anch, Ak 99516 Ph 727-8864 I I — — _-OE ARMOUN ROAD- — _ — — — — — 1 UTILITY PROPERTY LINE—\ EASEMENTS 1 1t ■RIVEWA 1 R&R NEW 1250 GALLON PLASTIC TANK W/20" 1 RISER ItO / \ 1 TC ' • / C • EXISTING • S/�S HOUSE \• 1 // �,,r '►, pt'Ar �\ VACANT ANT y 1 r EXISTING WELL PA_ATERRh 7-1 OO'RADIUS 3.00K.0 VACANT ® 1 I POLE NO WELLS OR OPEN WATER WITHIN 100' / SHED i i SHED—):::=7 • i • ui \\\, COLLIER ,' COLLIER CLCL LOT 1 , LOT 2 0 _ m ., /' Q PROPERTY LINE -' COLLIER LOT 3 VACANT Septic Tank Replacement .�isss`Iiik%1, DAVID CHAPUT .•`7E Of. . 44. ••, P••••• • CSS 7 o. COLLIER, LOT 1 "t 49TH• %\ ♦•� Anchorage, Alaska • • • 4." • • • Michael N. Anderson, P.E. DATE: 7/24/2019 .♦j ';MICHAEL N. ANDERSON,: ♦ - •. No. 9469 a 4601 NATRONA AVE ANCHORAGE ALASKA 99516 DRAWN: DJR • (907) 345-3377/FAX: (907) 345-1391 SCALE: 1"=50' ♦♦4�I FESS,� •4 .D A RA/10iiN !l OA 0 /v 89°.5-3" 4"i /65—.-00 i 0° TELECOMbE'z-cC E6M/7"'; /8�Jc%1�=c+0/Nd ESMT�, a ...):Ra.NVt.14— t - - ' .., Or j t � ''*��-� - ID EL • �r.# ! ' , 1"5- - .1 I p:,Ire n poc • ...„„ . „C„j1/4.....," . C erold V. Rar:-d' Jr.a-�4 (7,epc .r o' NO. 4'53-S ,SJ.! J (IA9(4'OFs'L*s•o<::•'vi1.N)eat ..- . yob t 0_,56r'IL • l /J Ac 4° 100 veal.veal.•Y+ , .164 2'-to 26, Exu-T1 G New/ ,' A101.1.. &pDITIdN 61 I 00 CJ K�rvNthL \C, \O q 'y 2'a O 'On '(\i S UBMITTA („, 0,:, 2 JUL 1 9 200 64_ ,%-O ,3 �w�,L. GRETCHEN STULLEN V I ,fr, OUSE ZONE 0 APPROVED By - -i (� Date Z L°rah O All work shall be done as shown on this olot plan.Approved plans and speciflcalion° 5460;Hall not be changed,modified:.r altered .Ithout first obtaining a valid change order. 1 1 A/ 5-9` s3" n6'" iV I6�.00' j r SURVEY CERTIFICATION: I hereby certify that I have surveyed the property shown and d< scribed hereon and that the improvements situated thereon are within the property lines and n encroachments exist other than noted. PLEASE NOTE: It is the contract LEGEND: SET FOUND W'O.' ENGINEERS • PLANNERS •SURVEYORS .or's responsibility to check top 5/8"REBAR • 0 o`�L I�� of foundation in relation to HUB&TACK p NO ORN.BV /) 140 WEST BENSON BLVD. 272-9231 finish grade and building set- MONUMENT e ANCHORAGE,ALASKA 99503 562-5291 backs eas nmentsation to lot lines AL-CAP Q e CHKO.: PK NAIL X _EGAL DESCRIPTION: ) A / IRON PIPE o 6RID: 293,7 ATUM /-1. -- BL)ILI 0C ( 1=ELEVS.-ASSUMED / 'fes 1 / ) \// . f�/)�^ )�}/� SCALE, / /1Y `OJ Gam- 0 ! — F C:-� L L ! l_ F\ .l V e of 1�f J I.0 V DATE: ` )2.6 }ff MUNICIPALITY OF ANCHORAGE 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 IPHO,~N.E ~ NEW [] UPGRADE MAI LI N(~'~ESS. " LEGAL DESCRIPTION . ~ _. /, ~ 1, ~. ~ (~ _ ~ LOCATIO~ ,/ ~'/ '.' / . Y' / ' / / / NO.~B.EDROOMS / .... Well . DISTANCE TO: ~ ~ "~ I AbsorPtion area~/ Dwelling ~'1 ~"'' ( PE~5~ ,:/~NO'~¢? ~--~z" , ~ Z Manufacturer //- Material ~ = / No. of compartments ~ [Liq. ~c,~,~allons IF HOMEMADE: Inside length ~ Width ~ Liquid depth DISTANCE TO: Welt Dwelling PERMIT NO. Manufacturer Liquid capacity in gallons Foundation .~_ 3 / Well / DISTANCE TO: J O ~ No. of lines ,~ Length'~f each lirje .,../ Top of tile to finish grade ~- -7 / Length Width Type of crib Crib diameter Well DISTANCE TO: Depth Building foundation Total len~t~o~i Fes Material beneath tile Depth tMaterial Nearest lot line~? _)~ /' PERMIT NO_ Trench wi(~h'~(-~ ~-'~ ~ ~'3 ~ I Distance bet.~n lines ;~.~ -~ inches Tot~ ef_fective~bsorption area "~/ Z inches ~, (2 ~:~' ~. ' "/'~" PERMIT NO, Crib depth Total effective absorption area Building foundation Nearest lot line Class Driller Distance to lot line PERMIT NO. Sewer line Septic tank Absorption area(s) DISTANCE TO: OTHER PIPE MATERIALS soil TEST RATING .~ ., INSTALLER ' "' ,, ~--~ 72-013 (Rev. 3/78) DATE LEGAL T E:,EF'~F.:TMENT -' HEFILTH FIND ENVIRO[-,iHENTFIL ':'OTECTION :;:2.:5 "L STF.'EET., FI[',ICHOF.'.FtGE., RI':::. 9. ~ -_. -_'~ ::L 2~4-4720 "._:. E ~-.-" E F"- F' E F-: ~-"1 T C_ml'-.l--'_:.-~ I TE PERI"IIT NO. ,:: L::30:-::39 RF'F'LIC:RNT LOCRTION LEGRL ..TUD"r' FI COLLIER SR BOX 740--"-: RNCHORRGE 995±6 N3:,.-"5., E'1.,.-"2., NE1,--"4., NEi,.."4., SEi,-."4 T±2NF.:~H S;::-'6 LAT SIZE 999999 SL--.!URF.:E FEET TYPE OF SOIL RE:SORF'TION S"¢STEH IS: TRENCH f"tR~..':I['ll_lf'l NLIHBER AF E:E[:,F.:OE~MS = 3: S A I L F.:R T I N G "S I.:.! F T,--" E:F.: ;, = 445 THE REQUIRED SIZE OF THE SOIL RBSORF'TION,S"r'STEhl IS: [:' E i' T i = "'1 ~:_--~ b i I"~.t ~] T i = i ]: 4 ~] F-: R ".'" E b [:' i F' T i = THE LENGTH DIMENSIO['4 IS THE LENGTH ':;IN FEET;:' OF THE TRENCH OF.: [:'RRINFIELD. THE DEPTH OF R TF.:ENCH OF.: PIT IS THE [."ISTRNCE E:ETHEEN TFIE SLIRFRCE OF THE GROUND RND THE BOTTOM OF THE EXCRVRTION (IN FEET;'. THERE IS [40 SET HI[:'TH FOR TF.:ENCHES. THE GRRVEL DEPTH IS THE I"IINIHUH DEPTH OF GRRVEL BETWEEN THE OUTFRLL PIPE RN[:' THE BOTTOi'f OF THE EXCFt'v'RTION ':: IN FEET>. ~--."El;.,bi T F:EE:. 2~EF'T i ,-: TF-~I'-.I~-::." -.=% l" ZE= t~-Z.'~E'~ E'~ m..~ RE b b--Ul"-.l'_--~ PERMIT FtPPLICFINT HR$ THE F.:ESF'ONSIE:ILIT'¢ TO INFORI'I THIS E:,EPFIF.:THENT E:,LIRING THE iNSTFILLFtTION TNSPECTTONS OF RN'T' HELLS FtDJFICENT TO THIS PROPERTY FINE:, THE NUI'IBER OF RESIDENCES THFIT THE HELL HILL SERVE. T' i-.-I C, .:.' 2 ::. ~ l"-4 ~.. F" e ,-: T I m-i I"-.m s R F: e F: Em;! Id I F." E Ii:. BFICKFTLLTNG OF RN'¢ S'¢STEH HITHOUT FINRL INSPECTION FINE:, RPPROVRL BY THIS E:,EF'FtRTHENT HILL BE SUBJECT TO PF.:OSECUTION. hlINtMUM [:,ISTRNC:E BETWEEN Fi HELL RN[:, RN'.r' ON-SITE SEHFIGE DISPOSFIL S'-?STEM IS :LAO FEET FOR Fi F'RI',/FITE HELL OF-: 150 TO 200 FEET FROH R PUBLIC: HELL DEPENDING UPON THE T'.r'F'E OF PUBLIC WELL. HiNIHUi,1 [:,!STRNC:E FROH R PRIVRTE HELL TO R PRi'v'RTE SEWER LINE IS 25 FEET RND TO R COMMUNIT"r' SEHER LINE IS 75 FEET. OTHER REQU I F.'.EMENTS MFi"r' RPF'L'T'. SPEC I F I CRT I OHS RN[:' CONSTRUCT I ON [:'I RGRRHS RRE Wv'FIILFIE:LE TO INSURE PROPER INSTRLLRTION. F'EF-:I-'I I T E::":;F' I F:E$ [:,ECEI'IE:EF: 2-:1_, 19:--:---:: i C:ERTIFY THRT ±: I Rt'"i FRi"IiLiFtR WITH THE REQUIREMENTS 'FOF.: ON-SITE SEWERS FINE:' HELLS FIS SET FORTH B'T' THE MUNIE:IF'RLIT"r' OF RNCHOF.'.RGE 2' I HILL INSTRLL THE S"r'STEH IN FICF:EIF.:[:,RNI__:E WITH THE Iz:O[:'ES. _3'.':: I UN[:'ERST8h4D THRT THE ON-SITE SEHEF.: S"r'STEH hlR"r' REQUIRE ENLRRGEhlENT IF THE RESI[.,ENCE IS REHODELE[:' TO INE:LLIC, E HOF.:E THRN -".. 8E[.'ROOHS. SiGNE[:' _ -~--. [::'r FI -:-LLIE.' Z S'_-qLIE E:, E:¥_ " ' [:,RTE__ V4. 0 _~MUNIClPALITY OF ANCHORAGE e~/~DEPT. OF H£ALTH ~', ~F.~IRONMENTAL PROTECTION MUNICIPALITY OF ANCHORAGE ,'~~ AgG ~ ~ABTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ,~,~~,~,l ~ 825 L. Street, Anchorage, Alaska 99501 264-4720 RECEIVEDSOILS LOG - PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 SLOPE L o~ ~-~ SILT I~L SOILS LOG PERCOLATION TEST DATE PERFORMED: SITE PLAN ]¥/rr 10 11 12 13 WAS GROUND WATER ~ J ENCOUNTERED? J~J ~ IF YES, AT WHAT DEPTH? S 14 15 16 1 1 1 2O Reading Date Gross Net Depth to Net Time Time Water Drop /! /;Lo 15o PERCOLATION RATE TEST RUN BETWEEN (/~nutes/inch) COMMENTS PERFORMED BY: CERTIFIED BY: 72-008 (6/79) ARCTIC ENGINEERS, INC. August 19, 1983 AEI# 83-013-20 Judy Collier Lamb Drive Anchorage, Alaska LEGAL: OWI~ER: HOUSE TYPE: WATER: SEPTIC SYSTEM: TEST DATE: PROCEDURE: N.'[ 3/5 of E 1/2, NE 1/4, NE 1/4, SE 1/4 Sec. 26 T12N R3W SM Judy Collier 3-Bedroom, 1-Story, Single Family On-Site Well From on-site determination - no MOA records Tank: ~ga~ Absorption System: Log Crib Absorption System: Unknown Approval ~ Date: August 17, 1983 Water from a garden hose was metered into the crib at a rate of 4.25 gallon per minute. Liquid rise in the crib was measured every 10 minutes. When 85 gallons had been added, the crib became full. At that time, addition of water was halted and absorption monitoring was carried out. The calculated rate of rise in the crib was 168 gallons per foot. Judy Collier Adequacy Test 83-013-20 --2-- PROCEDURE: (cont'd) RESULTS: Absorption monitoring was carried out for 73 minutes after ~i_ll~inq the c~i~. The resultant plot of absorption vs. time, with the extrapolated daily absorption capacity, is included. The plot of absorption vs. time yielded a daily absorption capacity of~22 gallons ~er day. The required absorption capacity for a 3-bedroom house is 450 gallons per day. The soil ab~sorption system fails to meet M.u/n_icipality of Anchorage requirements. ARCTIC ENGINEERS, INC. August 19, 1983 Judy Collier Lamb Drive Anchorage, Alaska AEI# 80-013-20 INVOICE% 13083 ADEQUACY TEST THE FOLLOWING AMOUNT IS BILLED FOR THE SERVICES RENDERED: Engineering Services $235.00 Pumping 60.00 $295.00 TOTAL BILLED TO DATE: $295.00 THIS INVOICE AND SUPPORTING DOCUMENTATION APPROVED FOR SUBMITTAL TO CLIENT. PLEASE REFERENCE OUR INVOICE NUMBER ON YOUR REMITTANCE. MUNICIPALITY OF ANCHORAGE ~i~ DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 017-151-17',, HAA# ~ ~ ~5~% GENERAL INFORMATION Complete legal description Lot 1, Collier Subdivision Location (site address or directions) 7300 DeArmoun Road, Anchorage, Ak Property owner Mailing address Lending agency Mailing address Agent Address Yvonne Jelley Day phone 562-1320 7300DeArmoun Road, Anchorage, AK 99516 Residential Mortgage/Jean Brunner Day phone 222-8889 1400 West Benson,2nd floor, Anchorage, AK 99503 Day phone 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Unless otherwise requested, HAA will be held for pickup. 3 NOTE: XXX Individual well Community well Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: NOTE: Individual on-site Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 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 in. vestigation of this Health Authority Approval application 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 s & s ENGINEERING 170.34 Eagle River Loop Road No. 204 Address ~,~i~ ,~;v~_r. Alaska Engineer's signature -- '?~., ,~-~- Phone Gc~-~ ?~ Date DHHS SIGNATURE Approved for T' H RE £ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHH$) issues Health Authority Approval Certificates 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, 1/91) Back MOA t¢21 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services DivisionJUL 0 lB 1999 825 L Street, Room 502- Anchorage, Alaska 99501 · (90~7U~i3C~[i~,TcZ~F4ANCi.iOp, AGE ~.NVIRONMENTAL SERVICES DIVISION Health Authority Approval Checklist Legal Description: ~'?/- _/ ° OO/-Z-/(--~'~ ~,/,~ Parcel I.D.: © [ ~ - ~ ~)- ) - I 7 / A. WELL DATA Well type t/g;~/V.47~J~/~/_.J~lf A, B, or C, attach ADEC letter. ADEC water system number Log present (Y~ ,",,/0 / Total depth 2 20 Date completed~ 4 J~ ~' ~ 'j) Cased to ~:frO ( ~-'~ ' Casing height (above ground) Sanitary seat(~/N) ')/~-..~ Wires properly protected ~N) yC--~ Date of test Static water level Well production FROM WELL LOG g.p.m. AT INSPECTION WATER SAMPLE RESULTS: Coliform O Date of sample: B. SEPTIC/HOLDING TANK DATA Nitrate ! ..O~ Date installed ' f Foundation cleanout (Y/N) Date of pu~nPing Date installed Length / 3 Width Effective absorption area I 01~ Tank size Depression (Y/N) Pumper Collected by: Other bacteria ~ ~ & b I'NI~INEERINI3 17034 Eagle River Loop Road No. 204 Eagle River, Alaska 99577 Fluid depth ~ ~' 3 '/,~" (ins) Minutes later: ~ O Peroxide treatment (past 12 months) (Y/N) /V~''~ 72-026 (Rev. 3/96)* Absorption rate = ~ 5-0 g.p.d. yes, give date /~///~r If / Soil rating (g.p.d./fF o System type /~_~-Z--~ C/'~ Gravel thickness below pipe (-,. / Total depth Monitoring Tube present t~N) ,~ ~ Depression over field (Y~ Results P~Fail) /e.__~_~_~-__~J For --~ bedrooms Fluid depth in absorption field before test (in.); 3 /~' U," , ~ ? Immediately after? ~-,,[. gal. water added (in.): Number of Compartments Z Cleanouts (Y/N) / /Utt~ High water alarm (Y/N) LIFT STATION Date installed /'~ /~ Size in gallons _.~-~ Manhole/Access ~ (Y/N) "Pump on "Pump off" level at* High water alarm level at* ~~'~~*Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot ! O 0 1'4' Absorption field on lot Public sewer main Sewer/septic service line ~ ~- '~/ On adjacent lots // On adjacent lots Public sewer manhole/cleanout Lift station /~/'~ / SEPARATION DISTANCES FROM SEPTIC/HOLDINGTANK ON LOTTO: Foundation '~ / O / Property line /(~ -/ Absorption field;" ~z~- Water main/service line ~-~-('~ Surface water/drainage /~/~- Wells on adjacent lots /oo '+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line /(~ ~-/- Water main/service line Building foundation /0 Surface water / ~')~ / "~' Driveway, parking/vehicle storage area ~--~"~.~/~v'O E~... / Curtain drain /~/~/~/~ /~--/~/~/'~/ Wells on adjacent lots /~ ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal records ~_e(~oy~'~ms are it~ conformance with MOA I-I/A~.,uideii, es in effect on this date. Signature ~//'~~ ~ . Engineer's Name ~ 0'~*'()- ~' (0 ~ Date '~ / ~ / ~ ~ HAAFee $ ~.~/~. /o Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # d-~,\-~- \~\- \-~ GENERAL INFORMATION Complete legal description Lot 1 Co1] ier Subdivision Location (site address or directions) 7300 DeArmoun Rd. Anchorage, Alaska Property owner Judy Collier Mailing address 7~[3{3 D~Armc)un Rd_ Anchorage~ Lending agency k.~A'T J~ ~/Z~ ~ ~ ~ /~f~.~ Mailing address I~ ~. ~~ [~ Agent ~ ~ ~ 1%~ ~ ~, Address I~ ~. ~~ Unless othe~ise requested, HAA will ~e he~d for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: NOTE: Day phone 3 4 5-1 3 1 9 Alaska Day phone Day phone c'~'~-'''~- ~.--'~z_~_~j, I Individual well }( Community well Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site .,,~' Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. NOTE: 72-025 (Rev 1t91~ F,nn, ~ "9~ 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 of this Health Authority Approval application 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 inves.t~ation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with al! .Municipal and State codes, . ordinances, and regulations in effect on the date of this inspection. Name of Firm , Phone DH/ C~kltin~ En~ineers/~ 800 R_ Di~'ond~B ~d. -Suite ~-5~nch°raqe Address , Engineer's signature ~r~_,~.~_ ~,~~'~~..-: Date ~///',,F/Y~"~ "6. DHHS SIGNATURE Approved for Disapproved. Conditional approval for Alask~'"~ ~9951 $ bedrooms. ~bedrooms, with the [ollowing'-Stipulations: ~The Municipality of Anchorage Department of Health and Human ServiC~'~ (DHHS) issues Health A~thority Approval Certificates 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 !~n~titu~.tions in order to satisfy certain federal and state requ[r~ments. 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. ,..~ '. .~ . ,~ Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825"L" Street, Room 502 · Anchorage, Alaska 99501· (907) 343-4744 Health Authority Approval Checklist Legal Description: A. WELL DATA Well type Log present (Y/N) iD0 Total depth Sanitary. seal (Y/N) t C. KB I [-'~.C% ¢,,. ~(,3 ~?:=' f') Parcel I.D.' If A, B, or C, attach ADEC letter. ADEC water system number Date completed to GO' ~M ~ ¢,~,,~j,~ r'~ Casing height (above ground) Wires properly protected (Y/N) t'T~-% FROM WELL LOG AT INSPECTION Date of test Static water level Well production g.p.m. WATER SAMPLE RESULTS: Coliform O Nitrate K2),<{ '~ Other bacteria Date of sample:<2]- 1<~- q=/.~ Collected by: B. SEPTIC/HOLDING TANK DATA Date installed to,3 -~(h ~ Tank size I ~ Number of Compartments & Cleanouts (Y/N) Foundation cleanout (Y/N) .~,:_.5~ Depression (Y/N) bOq.-3 High water alarm (Y/N) Date ofPumpingC~-C~-~'~ ~ Pumper ~-'2x%.b-l'q3- ABSORPTION FIELD DATA Date installed jq~.,,,~_,,,~.~C..~ Soilrating (g.p.d./ft2 orft2podrm)dq~% Systemtype Tt~/~.~-/q Length J:~:~ (~ Width ~ ~ Gravel thickness below pipeCO'% Total depth Effective absorption area [ G, ~ Monitoring Tube present(Y/N) yG,~ Depression over field (Y/N) Date of adequacy test ~ - )-<:'t ~ Results (Pass/Fail) /O~ %ex For ~ bedrooms Fluid depth in absorption field before test (in.); Fluid depth Q)'~ Minutes later: Peroxide treatment (past 12 months) (Y/N) Immediately after O" gal. water added (in.): (in.) Absorption rate = c-/%6, g.p.d. If yes, give date /U//4 LIFt STATI~ Date installed Manhole/Access (Y/N) High water alarm level at* Cycles tested Size in gallons evel at* *Dat~ "Pump off' level at* E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot J ~~t(]~]5 Absorption field on lot i G%"r Public sewer main ~/t/~ Sewer/septic service line ~(~)'t(~ · On adjacent lots I I (,~ J't~(~) · On adjacent lots j/(--)' ~'-(~ P. blic sewer manhole/cleanout IX9 station ¢ 1/4 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation Water main/service line ~'~ Surface water/drainage SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation ~'<}- 'Q) Water main/service line ~ [/-\ Surface water [,._) [~ Driveway, parking/vehicle storage area {('-~ t 3(~) Curtain drain b,) //~ Wells on adjacent lots IlO '-~-Q) F.ENGINEER'S CERTIYICATION I certify~elermined thru fie/Id inspections and review of ms are in c°nf°~i with ~OA H~?linx~ffect °n this date' Signature .~I---~----_M~L.~ /~ ., ~. Engineer's Name ~7~ e_ LtF~//~ '~. ~o" d:i'.,j* Date ~/o70 / ~7 )' ~d'*:~ HAA Fee $ Date of Payment c~/~//~~'~'~ Receipt Number / ~ ~ 7 (//~d//~'~:,) Rev. 8/95 OSS: haa.wk.doc D/q / Waiver Fee $ Date of Payment Receipt Number i INVOICE SEWER AND DRAIN ",~ ~-~ '7,¢e¢.~(~.,~ CLEANING SERVICE P.O. BOX 112688 I Job Address PHONE 345-2513 ANCHORAGE, ALASKA 99511-2688 DATE TERMS-- 30 DAYS ROTe-ROOTER SERVICE CALL HRS. @ STEAM THAWING HRS. @ TRIP CHARGE HRS. @ OVERTIME CHARGE HRS. @ ADDITIONAL LABOR CHARGE HRS. @ cDSrOMER ORDER # /fPUMPING SERVICE/~.5~ (GAL.) HRS. / @ HYDRO-JET SERVICE HRS. @ TV CAMERA INSPECTION HRS. @ · ~"MATERIALS ~ · P :p PLEASE PAY FROM THIS INVOICE TOTAL TOTAL FOOTAGE CLEANED OR THAWED BLADES USED. LINE CLEANED [] JOB NOT GUARANTEED FOR FOLLOWING REASON WORK ACCEPTED BY ~/(~- [~y Collier Well Recovery Calculations 10/2/95 W.O. 95226 Initial Time ad (ft) at (rain) Av (gal) Av/at (gal/min) 3:09 0.9 4 1.3 0.3 3:13 2.1 5 3.1 0.6 3:18 0.4 2 0.6 0.3 3:20 2.1 2 3.1 1.5 3:22 2.7 2 4.0 2.0 3:24 1.0 1 1.5 1.5 3:25 1.2 1 1.7 1.7 3:26 0.9 1 1.3 1.3 TOTAL 11.3 18 16.6 - Notes: 1.Average recovery rate 0.9 gpm. 2.Well had large storage tank, so was able to supply 4.5 gpm for absorption test. 3.Based on test conducted 9-7-95. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date ~ ~'//~?-" ~ GENERAL iNFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) o o oE (b) Applicant Name ~[/~)T ~.O(~LIEIZ-- Telephone: Home Applicant Address Business (C) Applicant is (check one): Lending Institution I-I · Owner/builder,~; Buyer [] ' Other [] (explain); (d) Lending Institution Telephone Address (e) (f) Real Estate Company and Agent Address Telephone Mail th~-IAA to the following address: TYPE OF RESIDENCE Single-Family'[' Multi-Family [] Number of Bedrooms ~ Other WATER SUPPLY Individual Well ~ Community Public Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. 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 I of 2 o ENGINEERING FIRM PROVIDING ..,ISPECTIONS, TESTS, FILE SEARCH, DA'I As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation Authority Approval shows that the on-site water supply and/or wastewater disposal system is sate, functional for the number of bedrooms and type of structure indicated herein. I further verify that based on the inform~t~on from the Municipality of Anchorage files and from my investigation and inspection, the on-site water wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations the date of this inspection. Name o! Firm ~'~--V,J i~ Engineer's Seal DHEP APPROVAL y~ Approved for ~ bedrooms b Approved .~ Disapproved Conditional Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations 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 requirements. 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. Page 2 of 2 72-o25 (11,84) MUNICIPALITYDEPT. oFOFHEALTH ^ ~PI~tlCIPALITY OF ANCHORAGE (MOA/ ENVIRONMENTAL PROTEc~tr~LTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 ' ~? 1 '~ ~5' 264-4720 Legal Description: ~'~ ZG -'TlZhi .RECEIVED WELL DATA C Well Classification F~' V~ ,, A, B, C, D.E.C. Approved (Y/N, Well Log Present (Y/N) ~ Date ~ompl~ted U~ ~0~ Yield Total Depth Z~O' Cased to ~~ Depth of Grouting ~ Static Water Level j ~ I Pump Set At Casing Height Above Ground Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) ~ Depression Around Wellhead (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot /0/ I · On Adjoining Lots To Nearest Edge of Absorption Field on Lot /¢0 / ' On Adjoining Lots To Nearest Public Sewer Line ..~/~ To Nearest Public Sewer Cleanout/Manhole ~/~ To Nearest Sewer Service Line on Lot Water Sample Collected by ~ · Date Water Sample Test Results Comments ~ TH~ ~'~/~ ~ ~~ /~ ~ T C~~ B. SEPTIC/HOLDING TANK DATA Date Installed Standpipes (Y/N) 'Y Air-tight Caps (Y/N) Depression over Tank (Y/N) ~ Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) /~v///¢ Size /000 No. of Compartments Z. y Foundation Cleanout (Y/N) Date Last Pumped ~ T' 'for /~'~/~/) Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well /~// To Property Line To Water Main/Service Line ~.//~ Course To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Comments Page I of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well / / ~ To Building Foundation Lot /~O '~' To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments /t~'~' V/~(/'~'(.. ~ ~/~'p/~2 Type of System Design Length of Field { ~"~' Depth of Field /O t Gravel Bed Thickness ~, I Standpipes Present (Y/N) ~//. Date of Last Adequacy Test To Property Line To Existing or Abandoned System on · On Adjoining Lots To Cutbank (if present) D. LIFT STATION Instal ed'7'~'"'--~ Size in ~ "Pump On" Dimensions Manhole/Access (Y/N) "Pum at __ Vent (Y/N) High Water Alarm Level Tested for Electrical Codes (Y/I Commel during Adequacy Test. Meets MOA ** Check Per I certify tha Signed Company Receipt No. Date of Payment Amount: $ Page 2 of 2 72-026 (11/841 Rating Against HAA orconform, toall MOAa iAAguidelinesineffectonthedateofthisinspection. NO. 5'~--~5''-~'¢'/''~ ~ ~ ~.,,~./ ~:~ -~-~ ~g~neer's bea~ FIELD PUMPING TEST DATA SHEET LOCATIO~I OF WELL (LeQal Description):~cz~ WELL DEPTH: ~0 FT. CASING: FT SCREE?I: DATE DRILLING CO.qPLETED: DRILLER: STATIC !.lATER LEVEL {Top of Casing): /S~. co FT I Elaps6~ Time Sincel Clock Pumping Started/ I Depth to Drawdown/ Pumping Remarks Time Stopped~ Min.I ,Water, ft. Recovery Rate, GPM I 2_ 4r~ 0 /~'¢ (swl) 0 0 ) Start i ~Do 3 5 ~z¢ 4o ~ 6o (t ho.r) Sd-~ 180 (3 nours)l 7¢m3. ~0 ~ ..... ~/% 210 ~ 240 (4 hours)' . RECOVERY 5 ,. lo 15  30 I , 35 50 ' 6n (1 hour) ,, WJ ~ mm' IZQ (Z hours)i APPLI,' ',NT FILLS OUT UPPER HA '" ONLY Buyer Address A////'~ Zip Code Lending Institution /~,~ ~-- W/~ ~"',t ~/,~://~ L.,,~'/~j~//, Phone Realty Co. & Agent Type of Residence ~.~Single Family Multiple Family No. of Bedrooms ~ Other Water Supply AIIACH WELL LOG. A ~lndividual . ~. For wells drilled prior to that date, give well depth {attach log i~ aYailable). ~ ~ommunity Sewer Disposal Year Individual Installed: .J~ Individual [] Public Utility When Connected to Public Utility: [] Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time(..~( Date Inspector Date Inspector Date Inspector Time , ~ Date I / ~ Insp/ or~ [ Field Notes: MUNICIPALITY OF ANCHORAGE ,~') APPROVED BEDROOMS I t' J~'~ (,~) DISAPPROVED ) CONDITIONAL APPROVAL* BY: . 1[~. ~ ~[,,,~~...,..~ . '~x, ~.L-~>~-- DEPT. OF H~ALTH & """~' ,t' ~ / ' ' , ~ - , ENViRONMeNTAL PROTECTION ..RECEIVED *CONDITIONS OF APPROVAL Soils Rating 72-023 (3182) Date Sewer Installed Well To Absorption Area Well to Tank Well Log Received Septic Tank Size