HomeMy WebLinkAboutCHUGACH PARK ESTATES BLK 2 LT 1Chugach Park
Estates
Lot 1
Block 2
#051-471 -O5
/ PAGE i OF !
MUNICIPALITY OF ANCHORAGE /'
DEPARTMENT OF HEALTH AND HUMAN SERVICES~ ~-/~_
P O BOX 196650, 825 "L" STREET, ROOM 5~2 ----
· ' ANCHORAGE, ALASKA 99519-6650
ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT
PERMIT NUMBER:SW910304
DESIGN ENGINEER:S & S ENGINEERING
OWNER NAME:MEANS THOMAS K & PAMELA J
OWNER ADDRESS:P. O BOX 140794
ANCHORAGE, ALASKA 99514
DATE ISSUED: 9/25/91
EXPIRATION DATE: 9/25/92
PARCEL ID:05147105
LEGAL DESCRIPTION: CHUGACH PARK ESTATES BLK
T 1
2 L
LOT SIZE: 148639 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT:
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD / WELL 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 (iSAACS0).
3. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
o
RECEIVED BY:
ISSUED BY: ~
/
ENGINEER MUST VERIFY SOILS DURING INSTALLATION WITH
NEW TEST HOLE LOCATED BETWEEN ORIGINAL AND REPLACEMENT
SYSTEMS. SUBMIT LOG OF TESTHOLE WITH FINAL INSPECTION.
LOCATION OF BED MUST BE SURVEYED IN PRIOR TO EXCAVATION.
WAIVER TO CUTBANK GRANTED AT 20 FEET FOR FUTURE
REPLACEMENT BED. FILL MUST BE IN PLACE AND INSPECTED
PRIOR TO FINAL APPROVAL OF ORIGINAL SYSTEM.
~( :u/. DATE:
DATE:
Municipality of Anchorage Page / of
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: '~'"-~]~'~, PID Number:4~-~_ ~¢'~r'~ O~
Name:
~¢~E=, ~-. ~.~~...~. ~~ Wastewater System: ~ew ~ Upgrade
~:s~ I~~ ~ ~~ ABSORPTION FIELD
~ Deep Trench ~ Shallow Trench ed ~ Mound ~Other
LEGAL DESCRIPTION SoilRating: ~'~GPD/Sq, Ft. Total Depth from origina~e:
Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe
Lot: } B,ock: ~ ~U~~ ~ ~ ~ ..~.~/ Ft. ~.~ Ft.
Range: I ~ Gravel length:
Township: Section: Fill added above original grad / Ft. ~¢ ~~
Gravel width: Number of lines: I Distance between lines:
WELL: ~ New U Upgrade ~ ~ ~ Z~ ~ I ~Ft.
Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe mate~ial:~l~~
Driller: Date Drilled: Static Water Level:Ft. ~t~ ~. ~ ~te~installed:'~ ~ ~ ~
Yield: GPM I se'"': ,,. ICasing Height AbOve 8rOund:Ft. TANK
SEPARATION DISTANCES ~eptic ~ Holding ~ S.T.E.P.
To Seplic Absorption Lift Holding ~ublic/Private Manufacturer: ~ Capacity in gallons:
From Tank Field Station Tank S .... Lines ~~~~ C ~
Surface
Water I~'~ ~'~ ~ ~ -- LIFT STATION~
Lot t ~ ~
Line ~ i~/ ~ Size in gallons: Manufacture
.o .da,,on '¢' ¢ ¢.
Curtain
Drain ~ ~~ ~ ~1~ Pu~Model Electrical lnspections performed by:
Remarks: BENCH MARK
Location and Description:
Assumed Elevation:
' ENGINEE~aEAL
S & S ENGINEERING
. 170~ E~ River L~d, N°' ~ , ~~ ~
Inspections performed by: ...... =_.._~=.. Dates: lst~~~~""~;'""" .... ' "'"'""~
..,. .,.r, .,- .......
Department of Health.. Huma~ervices approval t:~,,"'-"-.
Reviewed and approved by:,/" Bat ~
72-013 (Rev. 9/91) MOA 25
Permit No. ~ I ~u~"~i Page ~ of
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
Legal Description: I~.~>c-V--"~-~ ~ ~ PID No.: ~lZ--I-~!' IO~"
72-013 A (Rev, 9/91 ) MOA 25
PERFORMED FOR:
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
1
2
3
7
8
12
~4
17
18
19
20
~..~/5~___~.~Township, Range, Section:
SLOPE
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
SITE PLAN
Depth to Water After
Monitoring? . Date:
t
s!
L'
0
P
E
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE
(minutes/inch) PERC HOLE DIAMETER
COMMENTS
$ & S ENGINEERING [ '~_/~[~
PERFORMED
BY:
~ 7:)34 Eagle River Loop Road No. 204
STA,,.TE, Ah, I~,~I. NI(~R~GUIDELINES IN EFFECT ON THIS DATE.
ACCORDANCE
WITH
,~LL
72-008 (Rev. 4/85)
TEST RUN BETWEEN __ FT AND -- FT
CERTIFY THAT THiS TEST WAS PERFORMED iN
DATE:
HEALTH AUTHORITY
APPROVALS
SEWER & WATER
MAIN EXTENSIONS
SEWER & WATER
INSPECTION
ENGINEERING STUOIES
AND REPORTS
WELL INSPECTION
& FLOW TEST
SiTE PLANS
ROAD DESIGN
SOIL TEST
PERCOLATION
TEST
STRUCTURAL &
MECHANICAL
INSPECTIONS
ON SITE
WASTE WATER
DISPOSAL SYSTEM
DESIGN
ROBERTSHAFER, PE
ROGER SHAFER, P.E.
July 17, 1992
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ATTN: Susan Oswalt
825 L Street
P.O. Box 196650
Anchorage, Alaska 99519-6650
CIVIL ENGINEERS
,,~,/~907) 694-2979 AX 694-1211
REFERENCE: Lot I; Block 2; Chugach Park Estates
Request your approval of the d~sign change to the proposed septic
system to s~rve the referenced property.
This l~tt~r is subsequent to our submittal l~tt~r dated May 26, 1992 in
which we proposed a d~sign based on th~ ~limination of a portion of a
driveway ~as~ment on the property. However, it has come to my
attention that submittal was premature since the owner of the ~asement
has not (and apparently will not) vacate a portion of the ~as~ment.
The major item of change for this n~w d~sign involves th~ location of
the top of the bank. We propose filling th~ portions of the bank which
are less than 20 ft. from the alternate l~achfi~ld site. We b~li~v~
this w~ alleviate any potential of effluent daylighting through the
bank.
If you have any questions or require additional information for your
review, pl~as~ contact us.
Sincerely,
ROGER J. SHAFER, P.E.
RJS/gm
17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577
I"= 40'
SCALE
HEALTH AUTHORITY
APPROVALS
SEWER & WATER
MAIN EXTENSIONS
SEWER & WATER
INSPECTION
ENGINEERING STUDIES
AND REPORTS
WELL INSPECTION
& FLOW TEST
SiTE PLANS
ROAD DESIGN
SOIL TEST
PERCOLATION
TEST
STRUCTURAL &
MECHANICAL
INSPECTIONS
ON SITE
WASTE WATER
DISPOSAL SYSTEM
DESIGN
ROBERT SHAFER, P.E.
ROGER SHAFER, P.E.
May 26, 1992
CIVIL ENGINEERS
(907) 694-2979
FAX 694-1211
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
825 L Street
P.O. Box 196650
Anchorage, Alaska 99519-6650
RECEIVED
MAY 2 8 1992
D M.IJ.nicip.~,h,,.¥ of Anchorage
ept. Health & Human Services
REFERENCE: Lot I; block 2; Chugach Park Estates
Request yo~,"~., approval of the design change to the proposed septic
system to s~rve the referenced property.
As can be seen from the attached site plan the well was drilled and the
house foundation installed in a different location then shown on the
original design. To allow more room for the septic system and maintain
an 18 ft. separation to the cutback (natural change in grade more than
25%), the driveway easement for the adjacent property has be~n
decreased in size.
If you have an questions or require additional information for your
review, please contact us.
Sincerely,
ROGER J. SHAFt, P.E.
RJS/gm
17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577
I" .;, 40'
SCALE
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
PAGE 1 OF 1
ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT
PERMIT NUMBER:SW910304
DESIGN ENGINEER:S & S ENGINEERS
OWNER NAME:MEANS THOMAS K
OWNER ADDRESS:P. O. BOX 140794
ANCHORAGE, ALASKA
99514
DATE ISSUED: 9/25/91
EXPIRATION DATE: 9/25/92
PARCEL ID:05147105
LEGAL DESCRIPTION: CHUGACH PARK ESTATES BLK
T 1
2 L
LOT SIZE: 148639 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT:
3
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD / WELL 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 FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
o
U
ISSUED BY:
ENGINEER MUST VERIFY SOILS DURING INSTALLATINO WITH
NEW TEST HOLE LOCATED BETWEEN ORIGINAL AND REPLACEMENT
SYSTEMS. SUBMIT LOG OF TESTHOLE WITH FINAL INSPECTION.
LOCATION OF BED MUST BE SURVEYED IN PRIOR TO EXCAVATION.
WAIVER OF 18 FEET TO CUTBANK GRANTED FOR FUTURE
REPLACEMENT BED.
DATE:
DATE:
SCALE
DEED OF EASEMENT
Thomas K. Means and Darlene A. Means, Husband and
Wife, hereinafter referred to as Grantors, whose address is
3301 C~ClYL, SP #5 Anchorage, Alaska, owner of the land
· 99501
described ss:
Lot l, Block 2, Chugach Park Estate, according to
the official plat thereof, filed under Plat 72-
188, records of the Anchorage Recording District,
Third Judicial District, State of Alaska,
for good and valuable consideration, the receipt of which is
hereby acknowledged, hereby grants and conveys to FedAlaska
Federal Credit Union, a federally chartered credit union,
hereinafter "FedAlaska", whose principal place of business
is at 731 "I" Street, Anchorage, Alaska 99501, the following
easement to be used for ingress and egress to and for the
benefit of:
Lot 2, Block 2, Chugach Park Estates, according to
the official plat thereof, filed under plat number
72-188, records of the Anchorage Recording
District, Third Judicial District, Stats of
Alaska.
The easement granted is described as:
A portion of land, containing 1,575 square feet,
more or less, commencing at the easternmost corner
of Lot 1, Block 2, Chugach Park Estates, plat
number 72-188, Anchorage Recording District, Third
Judicial District, State of Alaska, which is
common with the northernmost corner of Lot 2,
Block 2, Chugach Park Estate, plat number 72-188,
Anchorage Recording District, Third Judicial
District, State of Alaska, and the THE TRUE POINT
OF BEGINNING proceed S 45"00'00" W, 40.00 feet;
thence N 04' 55 ' 29" W, 102. 90 feet; thence S
26"33'52" E, 83.00' back to the TRUE POINT OF
BEGINNING; pursuant to exhibit A attached and
incorporated herein.
This easement is for the benefit of and pertinent
to that land and any portion thereof described as:
Lot 2, Block 2, Chugach Park Estate, according to
the official plat thereof, filed under plat number
72-188, Records of the Anchorage Recording
District, Third Judicial District, State of
Alaska.
Grantors, their heirs, successors and assigns,
agree to said ingress and egress easement and its use by
FedAlaska, its biers, successors, and assigns.
Page I 542-110
1452
PAGE 0 9 2 I
FedAlaska, and its successors in interest, shall
use the rights granted above with due regard to the rights
of others in their use thereof. Grantors, and their
successors in interest, shall not obstruct the easement in
any way.
Grantors and their successors in interest
acknowledge that FedAlaska, only, but not its successors or
assigns, shall not be responsible in any way for development
and/or maintenance of the easement, or~evelo~in ~n~. ~ray b~
responsible for the costs incurred to?~ or maintain
said easement.
IN WITNESS WHEREOF, we have hereto set our hands
this 9~ day cf July, ~986.
Grantors
~mas Ki ~eans
~a~lene A. Means f '
Grantee
~ '~~ Union
Fedllas~~ederal Credit
ACKNOWLEDGMENT
STATE OF ALASKA )
) ss.
THIRD JUDICIAL DISTRICT )
THIS IS TO CERTIFY that on this 9~h day o£
July, ~986, before me personally appeared Thomas K. Means
and Darlene A. Means, known to me to be the persons
described in and who executed the foregoing instrument and
who acknowledged to me that they executed the same as their
free act and deed to the end that it may be recorded as
such.
Page 2 542-110
1452.
P~GE 0 9 2 2
18
19
2O
21
22
23
24
25
26
34
35 ii
IN wITNESS WHEREOF, I have hereunto
and my o£ficial seal this 9Eh day of July, 1
~otary Public in for A
My Commission Ex res: 5t~ 2B 1990
GMENT
STATE OF ALASKA )
)
THIRD JUDICIAL DISTRICT )
THIS IS TO C£RTIFY that on this 10~ day of July,
1986, before me personally appeared~--~
to me known end known to me to be the indent~ca~ individual
delcrl~d ia lad who executed the wL%hL~ I~d ~or~going
mentioned.
IN WITNESS WHEREOF, I have hereunto set my hand
and my official aeal thia_ loth day of July, 1986.
Notary Public in and for Alaska
My Commission Expires~
.... ".~_ !_., ·
~ · :
.. ~.~_......
"...?: ::
Page 3 542-110
zx~rr A
I oF
DESCRIPTION OF PROPOSED DRIVEWAY EASEMENT
Comencing at the easternmost corner of Lot 1, Block 2, Chugach Park Estates, which is commo~
with the northernmost corner of Lot 2, Block 2,.Chugach Park Estates and the TRUE POINT OF
BEGINNING proceed S 45°00'00" W, 40.00 feet; thence N 04055'29" W, 102.90 feet; thence
S 26033'52" E, 83.00' back to the TRUE POINT OF BEGINNING, containing 1,575 square feet,
more or less.
LOT SURVEY CERTIFICATION
] hereby certify that I have surveyed LOT Z , BLOCK ~--
~/~,~m,-/~/~/ /1:~.~_/<~ ~",c;~-/~-r~, PLAT NO. 7Z -/~
Anchorage Recording District, Alaska. l~nu~ntation i$ as shown. Oi~nsions are
fr~ the record plat, not necessarily as ~asured. No attest has been ~de to
locate i~rove~nts (if any). l~ls drawing is for info~tton only and the above
referenced record plat should be refered to for all di~nsions, ease~nts, and
other restrictions which ~y be in e~tstence.
~T[ ~-2~'-~..DRAwN 8¥,z:~-,
; McCLINTOCi
:LAND SURVEY COMPA
P.O. Box 671089
Chuglak, Alaska 995
Phone (907) 688-449
S~pt~mb~r 9, 1991
ROBERT SHAFER, P.E.
ROGER SHAFER, P.E.
CIVIL ENGINEERS
(907) 694-2979
FAX 694-1211
HEALTH AUTHORITY
APPROVALS
SEWER & WATER
MAIN EXTENSIONS
SEWER & WATER
INSPECTION
ENGINEERING STUDIES
AN D REPORTS
WELL INSPECTION
& FLOW TEST
SITE PLANS
ROAD DESIGN
SOt L TEST
PERCOLATION
TEST
STRUCTURAL &
MECHANICAL
INSPECTIONS
ON SITE
WASTE WATER
DISPOSAL SYSTEM
DESIGN
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
825 L Stre~
P.O. Box 196650
Anchorage, Alaska 99519-6650
REFERENCE: Lot I; Block 2; Chugach Park Estates
R~quest you issue a p~rmit to drill a well and install a s~ptic system
to s~rv~ a proposed 3 b~droom house on th~ r~fer~nc~d property.
As d~pict~d on our attached site plan th~r~ is a relatively flat
portion of th~ property with limited ar~a. From this flat portion th~
property drops off rather steeply toward the west. Du~ to th~ GW
soils, a sand filter is r~quired for th~ absorption ar~a, however,
th~r~ is not enough room on th~ property to maintain a 50 ft. s~tback
and from th~ l~achfi~ld to wh~r~ th~ steep slop~ b~gins.
Sinc~ this steeper slop~ is natural and not a man-mad~ "cutbank", w~
fe~l th~ required 50 ft. s~tback is not required in thi~ cas~.
Th~r~ is a thick organic layer with h~avy v~g~tation growth on th~
hillside. Th~ well drained gravels on th~ property will allow s~ptic
~ffluent to travel v~rtically downward as opposed to horizontally
toward the slope. Therefore, the potential for effluent surfacing
through the hillsid~ is minimal.
Due to the larg~ lot sizes in the ar~a, w~ do not foresee any adv~rs~
effects on n~igh§oring properties by th~ i~~on of ~ propos~
w~ and s~p~c s~st~.
If you have any qu~tions or require additional information for your
r~vi~w, pl~as~ contact ~s.
Sinc~rely,
ROGER J. SHAFER, P.E.
RJS/gm
17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577
PERFORMED FOR:
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L' Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
LEGAL DESCRIPTION: ~'~ '~'Z,, ~----I-~"t.~-~/~./~.~ ~ Township, Range, Section:
SLOPE
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
WAS GROUND WATER
ENCOUNTERED?
S
L
IF YES, AT WHAT O
DEPTH? p
E
Depth to Water N~I',-~ ,
Monitoring? '"'~""~"~ Dale: '~ - ~"~1
SITE PLAN
Gross Net Depth to Net
Reading Date
(~ Time Time Water Drop
--....,,
PERCOLATION RATE ~'' t
TEST RUN BETWEEN ~
__ (minutes/inch) PERC HOLE DIAMETER
__ FT AND ~ FT
COMMENTS
PERFORMED BY: ~ & $ ENGINEERING ,~~
..... · .__ J .,- r CERTIFY THAT THIS TEST WAS PERFORMED IN
ACOORDANCEWITH~,~,~~GUIDEUNESINEFFE O THISDATE. DATE:
72-008 (Rev. 4/85)
PERFORMED FOR:
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERV,
825 "L" Street, Anchorage, Alaska 99502-0650. /~,~~.~,. ; .~... ·
SOILS LOG -- PERCOLATION TEST
{~J~'..~l~-~ DATE p E R F O~R'I~'~,~
LEGAL DESCRIPTION: L,- I
2
3
4
5
6
7
8
9
~p4-1/.Township, Range, Section: --["1~_~ g PLAN
SLOPE
10
11
12
13
14
15
16
17
18
19
20
WAS GROUND WATER
ENCOUNTERED?
S
L
IF YES, AT WHAT O
DEPTH? p
E
Depth te Water Nter
I Gross Net Depth to Net
Reading Date Time Time Water Drop
_
/
PERCOLATION RATE
__ (m~nutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN __ FT AND ~. FT
COMMENTS '" ~ -~ ............... ~
~] ] IAtV I I I I l/
PERFORMED BY: C~'~, . .~,~~ , ~/ / ~~ ~ CERTIFY THAT THIS TEST WAS PERFORMED IN
72-O08 (Rev. 4/85)
SCALE
JUN-15-92 MON 7:38 DEH SUPPLY FT RICHARDSON FAX NO, 9078837158 P, 02
rtifi h rilling
b.v
ooc co,
SULLIVAN WATER WELLS
P.O. BOX 6T0272, 0H'JGIAK, ALASKA 99567 · TELEPHONE
PERMIT NUMBER
ST-~TIC LEVEL OF WATER Fl',
DRAW DOWN FT.
~^~.~ER.R_ ~
KIND OF FOI~IATION:
~r~ 0 ~t. to.~.~F~ c,~r,~o ~ 5'7, cc,~ t9 From.~i~Z.F~. ~o.~=F. ~*,~ ~*~
From..~.~Ft.
From .Ft. to
Fmm~__.Ft, to~Ft-~. I t (,~/ / From _
Ftom__~0.--=Ft. to ,0_~ Ft._
From 10'5 Ft,
From~t-
FmmJ._~--Ft,
From~Ft,
Front ~_~.~Ft.
MISCL. INFORMATION:
to~ Ft.
to__ Ft.
to__Ft.
tO_ _.Ft.
_ Ft. to~Ft.
-Ft. to...-=-~=Ft.
---Ft. to____Ft. .
Ft- to~Ft ....
Ft.
JUN 1 5 1992
Mu~ ~c;pal, [.y ct Anchorage
Dept. Health & Human Services
DRILLER'S NAME /'-?'~-"/"/'~~
of
Anchorage
P.O., X196650
ANCHORAGE, ALASKA 99519-6650
(907) 264-4111
TONY KNOWLES,
MAYOR
DEPARTMENT OF HEALTH & HUMAN SERVICES
January 9, 1987
Tom Means
% S & S Engineering
SRB 196X
Eagle River, Alaska 99577
Subject: Lot 1 Block 2 Chugach Rark Estates Subdivision
On-site Sewer & Well Permit 9860233
A permit issued by this Department for an individual well
and/or on-site sewer system has expired as of December 31,
1986.
Permits are issued on a calendar year basis by authority
of Municipal Ordinance. A new permit must be obtained from
this Department for any well and/or on-site sewer system not
installed by the expiration date.
If you have drilled the well, a well log needs to be sent to
this Department for documentation of the installation and to
close the permit.
If a private engineer inspected the installation of the on-site
sewer system the original as-built inspection report (three part
form) must be sent to this office for review and approval, and
for documentation.
If there are any further questions, please call this office
at 264-4744.
R.W. Robinson
Program Manager
On-site Services
RWR/ljw
enc: copy of permit
,..41:: r" ~-d:',. 'lEt',t1 JiF HEAL'T'H AND EN~.I:f._,NI'.EI,I,~.d_ F"ROTEC]'I"ION
8~-75 t S'TF;;EET ANE~HOF:RAGE AK 9'::75q~ 1
~;::' A zl-.-..-/-I. 7'.':' (',
:::::::::::::::::::::ENG I NEI:'::RtED DES I Glq
~]'7 / 1 z. /,::> z
f'OM MEANS
C/O SR B :1.96X
E:AGL. E R ]: VER :, Al'::'.
I....EGAI_ ::::::::::::::::::::::::::: SUBDIVISION.~ CHUGACH F:'ARK EST. LilT: 1 BLOCK=
SECTION: 15 "f'OWNSHIF': ],.N RANGE: 1W
I...0T S ]: ,:!E ~ ::}. 4A (SQ. I="T. OR ACRES)
c: e r' 'L i f y t h a'L:
].. :i: am familiar' with the r. equii-.emer':'t.s fop on-site sewers and wells as set
f'c,r.!:.h by 'Lhe Muni(:ipali{y of Anchorage (MOA) and the State of Alaska.
;7,, ]: wi].i :install the system in accopdance wi{h all MOA codes and r. egu].ations,
.amd J.n compl:i, ance with the design cr'itenia of' this permit.
5. ]' w:ll adher'e to a].l MOA and State of Alaska neqt.tir, ements f'or the set bac:k
d.i. star':ces fr'om any existing we:l. 1, wastewateP disposal system of public
sewer'ai]e system <:~r'~ this of arty adjacent or' nearby ].ot.
NST'AL.I....ED IN AN AREA C[)VERE:D BY MOA BUILDING CODES,
) PERMIT AND :I:NSPECT'ION MLST BE OBTAINED; (~;~) AU-"-':.UIt....I,::~
._.I_.E.L,,RICAI- INSPECTION RE'.PORT~ AND (3) THE
'ITH[]LI'T' AN F ..... r-. .
~ONIE' BY A L..ICENSED EI_ECTR:fC!AN,
l
S 8, S E .NGINEERING
Si~B 196X
EAGLE RIVER, AK 99577
CL,,,vlPUTATION SHEET
SU~EC~: /_. / E Z
DATE: JUL II 1986
SHEET OF
BY
CKD
De/, ?/¢
/
5z
/.%¢o
Zy '/¢,.'/.0.,¢ x
PERFORMED FOR:
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
LEGAL DESCRIPTION:
5
6
7
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~.4N~L/~I~ ~,~l/..T°wnship, Range, Section: '~"t~ E~ PLAN
WAS GROUND WATER . t
ENCOUNTERED7 N I:~
s
L
IF YES, AT WHAT O
DEPTH? p
E
Depth lo Water Alter
Monitoring? ~ ~/. ,~,-'~J,,' Date: ~'~"~
SLOPE
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE J~/~ (minutes/inch} PERC HOLE DIAMETER __
TEST RUN BETWEEN __ FT AND __ FT
COMMENTS -- .................. ~
PERFORMED ~Y: ~: ~ ~"~ ' '~ '~ AY ~ ~ ~ ~ ~ CERTIFY THA~ THI~ TEST WAS PERFORMED IN
ACCORD~NC~ WITH ALL STATE AN~ MUNICIPAL GUIDELIN~I~ECT ON THIS DATE. DAT~;
72-008 (Rev. 4/85)
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
Parcel I.D. #
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
051-471-05 HAA#
1. GENERAL INFORMATION
Complete'legal description
Lot 1; Block 2; Chugach Park Estates
Location (site address or directions)
Property owner
Mailing address
Tom Means
P.O. box 772394
19550 Ch]~ga~h p~ Drive
Chuqiak~ AK
Day phone 694-7942
Eagle River, AK 99577
Lending agency
Mailin. g address
Day phone
Agent
Address
Sharon Minsch/Remax Eaqle River
Day phone 694-4200
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS: 3
TYPE OF WATER SUPPLY:
Individual well · xx
Community well
Public water
NOTE:
If community well system, provide Written confirmation from State ADEC attest-
lng to the legality and status of system
4. TYPE OFWASTEWATER DISPOSAL:
x×
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE: If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025(Rev, I/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~
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 investigation and inspection, the on-site water
supply and/or wastewater disposal/t~a~l~ ~ai/a~e~'°~pliance with all Municipal and State codes,
ordinances, and regu at om/ - t
NameofFirm 690~I ,:~rr Ad~ Sulte~ Phone
Address ~
¢
Enginee¢s signature .
Alaska W~ter, &
Wastewater Consultant. s, Inc.
Shall be PAID $ /'/~)O - at,
or prior to, closing for the
Engineering ~er~ices Provided.
6. DHHS SIGNATURE
×_
Approved for
Disapproved.
bedrooms.
Conditional approval for
bedrooms, with th-e following stipulations:
Additional Comments .
The Municipality of Anchorage Department of Health and Human Services (DHHS) 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.
RECEIVED
Municipality of Anchorage FEB 0 4 2000
DEPARTMENT OF HEALTH & HUMAN SERV~:~FAL,W OF,,NC~
Environmental Services Division (907) 3~EN~'ALsERvlcE
825 "L" Street, Rm 502 Anchorage, Alaska 99501
Health Authority APproval Checklist
Legal Description: CHUGACH PARK ESTATES; LOT 1, BLocK 2 Parcel I.D,:
A. WELL DATA
051-471-05
Well Type PRIVATE
Log present (Y/N) YES Date COmpleted
Total depth. 400' Cased to 400'
Sanitary seal (Y/N)
IfA, B, or C, attach ADEC letter. ADEC water system number
4/91
Casing height (above ground)
YES Wires properly protected (Y/N)
18 "+
YES
FROM WELL LOG
Date of test 4/91
Static water level 110'
Well production 0.6
AT INSPECTION
1/25/2000
WATER SAMPLE RESULTS:
Coliform. 0
Date of sample: 1/25/2000
B. SEPTIC/HOLDING TANK DATA
Nitrate
98'
g.p.m. 1.0+ g.p.m.
PRODUCTION CAN VARY SEASONALLY.
FUTURE PERFORMANCE IS NOT GUARANTEED
0.614 mg/L Other bacteda 0
Collected by: A.W.W.C., INC.
Date installed 8/14/92
Foundation cleanout (Y/N).
Date of Pumping 1/22/2000
C. ABSORPTION FIELD DATA
Date installed 8/14/92
Length *56' Width
Tank size
1000
YES Depression (Y/N) NO
Pumper JR'S PUMPING
Number of Compartments 2 Cleanouts (Y/N).
High water alarm (Y/N) N/A
*TRIANGULAR BED. SEE NSPECTION REPORT
Soil rating (g.p.d./fl2 or fl2/bdrm) 0.7 System [ype. BED
*23' Gravel thickness below pipe 0.5' Total depth 4.6'
Effective absorption araa 643 SQ.FT. Monitoring Tube present (Y/N) YES Depression over field (Y/N)
Date of adequacy test_ 1/25/2000 Results (Pass/Fail) PASS For. 3
Fluid depth in absorption field before test (in.); _0" ('DRY) immediately after
Fluid depth. 0" (ins) Minutes later:
Peroxide treatment (past 12 months) (Y/N)
72-026 (Rev. 3/96}* Computer Vemlon
YES
NO
Bedrooms
510 gal. water added (in.).O__' ('DRY)
0 Absorption rate = 450+
NONE KNOWN If yes, give date_.
D. LIFT STATION
Date installed
Manhole/Access (Y/N)
High water~
~[es~ted
. Size in..g~~
~~ _"Pump off' level at*_
*Datum. -
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot
Absorption field on lot.
Public sewer main
Sewer/septic service line
1OO'+
100'+
N/A
25'+
On adjacent lots 100'+
100'+
.On adjacent lots
_ Public sewer manhole/cleanout N/A
Lift station N/A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Foundation 5'+ . Property line_ 5'+
Water main/service line_ 10% Surface water/drainage 100'+
SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO:
property line_ 10'+ . Building foundation 10'+
Surface water_
· Absorption field.
Wells on adjacent lots.
100'+
_Water main/service line
. Driveway, parking/vehicle storage area_
Curtain drain
NONE KNOWN
F. ENGINEER'S CERTIF '~
I certify that I ~ d~ ti
of Municipal /'eco~d,~ ~l
with MOA ~A g~j~j _
Signature ] ~/I~'
Engineer's Na~e/
field inspections and review
systems are in conformance
on this date,
JEFFREY A. GARNESS
5'+
100'+
10'+
10'+
,Wells on adjacent lots_ 10~./~+
HAA Fee $ ~ D-''b '"~'~
Date of Payment ~'/Z//zr~
Receipt Number
72-026 (Rev. 3196)* Computer Version
Waiver Fee $
Date of Payment
Receipt Number
Sent By: RE/MAX OF EAGLE RIVER~ INC,;
9076960214~ Feb-2-O0 4:48PM; Page 2/2
FOLLOWING DESCRIBED PROPERTY~ :'r.ol: [, ~." =.60'
INDICATED, IT .18. THE R~SlBILI~- OF-~ 6111gZ
E~EM~ ~OV~A~Si OR"~!~DNS' : ~1160
WHI~ ~ NOT ~ ~ THE' RE~D~ ~1'
~Y.~TA H~BE US~. FOR CON~U~ION~' 29-26
ARY LINES, ' ' '
ALASKA WATER & WASTEWATER
coNSULTANTS. INC.
NUMBER OF BEDROOM:' _~'~ GALLONS PER DAY NEEDED:
~ *SEE H.A.A. SITE VISIT CHECKLIST* ~ST:
1. Casing Height (Ab~ove Ground)i,.~_~,, c9"
2. Sanitary Seal: <~__~E~O (if NO,, d,e,,scribe in Comments)
Wires in Conduit: (~-.~/~ (if' NO ,,,d. esc~be i,n C.o. mments? .
3. Water Samples Needed: ~ NO~(i_f. ,,.Y~S,,, dd:~nt;7~:
4.
Depression around Well: YES /~__.99g~ ~.~, , u
5.
6. Does Well need Four Hour Flow Test (FHA): YES /(~
WELL PRODUCTION: I,O ~ GPM ( o~o I GALLONS IN ~ MINUTES)
Comments: 6 : ~
Signature:
Date:
6901 Debarr Road, Suite 2-B * Anchorage, Alaska 99504 * Ph: (907) 337-6179 * Fax: (907) 338-3246 * awws~alaska.net
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
Parcel I.D. #
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
GENERAL INFORMATION
Complete legal description
Lot I; Block 2~ Chu.qach Park Estates
Location (site address or directions)
Property owner
Mailing address
Tom M~ans Day phone
P.O.Box 140794 Anchorage, Alaska 99514
Lending agency
Mailing address
Day phone
Agent
Address
Day phone
Unless otherwise requested, HAA will be held for pickup.
5
NUMBER OF BEDROOMS:
TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
NOTE: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
XX
NOTE: 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
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 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
Address
ENGINEERING
7034 Eagle River Loop Road
Ea~le River. Alaska 99577
Phone
Engineer's signature
DHHS SIGNATURE
____~. Approved for
Disapproved.
Conditional approval for
Date
bedrooms.
bedrooms, with the following stipulations:
By:
'Additional Comments
...-~
The Municipality of Anchorage Department of Health and Human Services (DHHS) 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 #21
Municipality of Anchorage
Department of Health & Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: [.~c~'? ~ '~t~.~ ?-.-
A, WELL DATA
Well type "~'\~'~ If A. B, or C. attach ADEC letter.
Log present (~N) V
Total depth z~ C:~ ~
Sanitary seal:JEt, N) ~"!
ADEC water system number
Date completed '~'/~. ~ Driller~L--L--\
Cased to ! ~ ~ Casing height \~-~
Wires properly protected(~)
FROM V~ELL LOG
Date of te~t
Static water level
Well flow
Pump level
AT INSPECTION
SEPARATION DISTANCES FROM WELL TO:
I
Septic/holding tank on lot \
Absorption field on lot
Public sewer main
RECEIVED
; On adjacent lots ~ ~ I Pr-
; On adjacent lots \
Public sewer manhole/cleanout /~/,~r
Petroleum tank I'~
Sewer service line
WATER SAMPLE RESULTS:
Coliform ~ Nitrate
Date of sample: ¢:~ ,-'~_~ .-- ~'I.,,-
B. SEPTIC/HOLDING TANK DATA
Date installed ~'" ~ z3r~'Z''~ Tank size
Cleanouts~)
High water alarm (Y/N)
Date of pumping
~;~.,~.~ m..~/,~ Other bacteria
Collected by:
Foundation cleanout~)~l) y Depression (Y~
Alarm tested (Y/N)
I"-,J~ Pumper "----'"
17034 Eagle River Loop Road No. 204
Ea,3~e Rive~'. Alaska 99577
Compartments ~
SEPARATION DISTANCESFROM SEPTIC/HOLDING TANK TO:
Well(s) on lot I ~ On adjacent lots
To property line ~ C:> '~ Absorption field
Surface water/drainage
Foundation
Water main/service line ~, c::,
72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed
Manufacturer
Size in gallons
Manhole/Access (Y/N)
Vent (Y/N)
"Pump on" level at
"Pump off" level at
High water alarm level
Cycles tested
Meets MOA electrical codes (Y/N)
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot
On adjacent lots
Surface water
D. ABSORPTION FIELD DATA
Date installed ~ ~ ~ z3¢-~t'7'"' Soil rating
'Length ~-~
Width ~'~Gravel thickness
Total absorption area /~;~'~
Depression over field (Y/j~> ,
Peroxide tteatmen~ (past 12 months) (Y/~)
Total depth
Cleanouts present({35~) "-/
Date of adequacy test
for
If yes, give date
bedrooms
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
!
Well on lot
To building foundation
On adjacent lots ..~.~ t Jr-
On adjacent lots ! ~:=c~ ''~ Propertyline
To existing or abandoned system on lot
Cutbank ~ ~ ~ Water main/service line
Surface water
Curtain drain
\
I
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 effect on
$ & $ ENGINEERING
17034 Eagle River Loop Read Ne.
Signature =~~:~ o: .... ^~.o~.
Engineer's Name
Date
HAA Fee $ /
Date of Payment
Receipt Number ~ ~...//'/ /~-'~)
72-026 (Rev. 3/91) Back MOA 21
Waiver Fee: ,$
Date of Payment
Receipt Number
on_.tJ;ke~C~, ~ of this inspection.
.,;?;;:.:..o..,(..
S & S ENGINEERING
17034 Eagle River Loop Road
Eagle River, Alaska 99577
Flow is not Guaranteed
Subsequent Variations
Can Occur.