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HomeMy WebLinkAboutSUMMIT ESTATES BLK 1 LT 3Summit Estates Block 1 Lot 3 #015-072-21 MUNICIPALITY OF ANCHORAGE %enr S On -Site Water & Wastewater Program �o PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 n http://www.muni.org/onsite v Department On -Site Wastewater Disposal System Permit Permit Number: OSP231253 Effective Date: 9/27/2023 Work Type: Septic Upgrade Expiration Date: 9/26/2024 Tax Code Number: 01507221000 Site Legal Address: SUMMIT ESTATES BLK 1 LT 3 G:2437 Site Mailing Address: 5701 E 97TH AVE, Anchorage Owner: SHOUSE CORY Lot Size in Sq Ft: 16200 Design Engineer: GARNESS ENGINEERING GROUP LTD Total Bedrooms: 4 This permit is for the construction of: Q 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 i Special Provisions: l 1. Locate the edge of the pit prior to construction and determine the separation to the well. The well waiver may need to be amended. fi2. Prior to deepening the test hole, October groundwater level to is to be monitored. The test hole is to be deepened to 18'. 3. Show the 20' CEA easement on the Record Drawing. Issued By: Date: Date: 9 Z Z Municipality of Anchorage P.O. Box 196650 0 4700 Elmore Road Anchorage, Alaska 99519-6650 0 (907) 343-7904 0 Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: OSV231042 COSA#: Permit#:OSP231253 PID#: 015-072-21 Legal Description: Summit Estates Bilk 1 Lt 3 Engineer: Garness Engineering Group The approved waivers are: 1. Proposed trench to seepage pit on the lot, 5'. 2. Proposed trench to seepage pit on Lot 4, 10'. 3. Proposed trench to property line, 5'. This waiver approval applies to the proposed field only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. ............................................... ■ ............................. ■ 1 Waiver is Granted: X Waiver is not Granted: Date:�Z% Z Approved by: B Name of Reviewe ............................. ■ ............................. ■ ................. 1 **** VARIANCE/WAIVER REVIEW **** MUMMIPALITYor A'fH0G Development Services Department Phone. 907-343-790 On -Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 015-072-21 Property owner(s) COREY SHOUSE Day phone 907-980-8085 Mailing address 5701 EAST 97TH AVENUE *ANCHORAGE, AK Site address 5701 EAST 97TH AVENUE *ANCHORAGE, AK Legal description (Sub'd., Block & Lot) SUMMIT ESTATES; BLOCK 1, LOT 3 Legal description (Township, Range & Section) Lot Size Sq. Ft Number of Bedrooms 4 APPLICATION IS FOR: (ID all that apply) APPLICATION IS AN: TYPE OF DWELLING: Absorption Field Initial ❑ Single Family (SF) Fx1 Septic Tank Upgrade X pg (w/wo ADU) Holding Tank ❑ Renewal ❑ ❑ Duplex (D) Privy El Multiple Multiple Dwellings ❑ and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: DRAINFIELD TO LOT LINE; DRAINFIELD TO DRAINFIELD (LOT 4 & LOT 3) Distance: 1'+,5'+ 1 certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: 1�5 '75- Waiver Fees: 2 2.5 Date of Payment: Receipt Number. 0 ?/2 6 G Permit No. DSP 2 -312-5 3 Date of Payment: Receipt Number: Waiver No. OS UZ?,11)g_2_ GADevelopment Services\Building Safetylon Site Water and Wastewater\FormslClient FormsWermit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231253, Deb Wockenfuss, 09/27/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231253, Deb Wockenfuss, 09/27/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231253, Deb Wockenfuss, 09/27/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231253, Deb Wockenfuss, 09/27/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231253, Deb Wockenfuss, 09/27/23 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231253, Deb Wockenfuss, 09/27/23 X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X XXXXXXX X X ℄ E 7+ A9E1UE 0  0 ' 0  0 ' L27 L27  U1SU%DI9IDED 10' U7IL ES07 3A9ED DRI9EWA< ED*E 2) 3A9E0E17 S+ED S SS S W N89° 59' 00"E 120.00 S0 0 ° 0 3 ' 0 0 " E 1 3 5 . 0 0 S89° 59' 00"W 120.00 N0 0 ° 0 3 ' 0 0 " W 1 3 5 . 0 0 LRW  %ORFN 1 SXPPLW EVWDWHV 100 ST )W  01 E WK AYHQXH  SWRU\ WRRG )UDPH +RXVH WLWK AWWDFKHG  &DU *DUDJH 1 0 0 ' WE L L RAD I US SG E 1   1     1            1 1       1  1 1   1   PROFESSIONAL SEAL Date:Frontier Surveys, LLC Project No: 650 W. 58th Ave. Suite E Anchorage, Alaska 99518 As-Built Survey of: www.frontiersurveys.com Frontier Surveys, LLC I, Pierre Stragier, hereby certify that this Mortgage Inspection Survey was performed by me, or under my direct supervision on Plat:Grid:Ordered By: 907.460.1686 - info@frontiersurveys.com This survey complies with the ASPLS Mortgage Location Standards. The survey represents visible improvements and conditions at the time of the survey. This document does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may reveal. It is the responsibility of the Owner to determine the existence of any easements, covenants, or restriction which do no appear on the record plat. Under no circumstances should this document be used for construction or for establishing a boundary or fence line. May 17th, 2023. Legend: Scale 1" = 25' Gas Meter Electric Meter/Outside Power Deck Septic Fence Lot 3, Block 1 Summit Estates General Notes: 1. This document is created for the purpose of a single property transaction and is subject to Federal Copyright Laws. 2. Excepting for gross negligence, the liability for this survey shall not exceed the cost of preparing this survey. 3. All measurements/setbacks are to the visual/apparent building footprint. 4. All dimensions to property lines are plus/minus 0.1ft. ARM Septic Services 23-175 05/18/2023 P-628 2437 Water Well Concrete G E S x W Culvert 0D\ 1 0 R E GISTEREDPROFESSIO N A L L A N D S URVEYORPierre M. Stragier No. L.S. - 9812 A 2023-026796-0 L Recording Dist: 301 - Anchorage A s 9/26/2023 03:28 PM Pages: 1 of 5 Map 1203-15A K Grid 2437 A EN23019 I III II IIII VIII I I IIII II IIII IIII II III III II IIII I III I III I I III MOA Parcel ID 015-072-21 FOR RECORDING IN THE ANCHORAGE RECORDING DISTRICT AFTER RECORDING MAIL TO: CHUGACH ELECTRIC ASSOCIATION, INC. ATTN: LAND SERVICES DEPARTMENT PO BOX 196300 ANCHORAGE, ALASKA 99519-6300 ENCROACHMENT PERMIT This Encroachment Permit ("Permit") is entered into this 22nd day of September 2023, by and between Chugach Electric Association, Inc. ("Chugach"), Grantor, who's address is P. O. Box 196300, Anchorage, Alaska 99519-6300, and Cory Shouse and Chantel Shouse, ("Permittee"), who's address is 5701 East 97th Avenue, Anchorage, Alaska 99507. WHEREAS, Chugach is the grantee or user of an easement for the construction and maintenance of electrical facilities, as follows: Described in that certain written instrument recorded on the 11th day of February 1982, at Bk.698, Pg.397 on file in the office of the Recorder, Anchorage Recording District, Third Judicial District, Seward Meridian, Alaska, (herein "Easement"). WHEREAS, Easement pertains to the following described real property: Summit Estates, Lot 3, Block 1, according to plat number P-628, Filed on the 13th day of October 1961 with the Office of the Recorder, Anchorage Recording District, Third Judicial District, Seward Meridian, Alaska, (herein "Parcel"). WHEREAS, Permittee has constructed, or proposes to construct, the following improvements on or within the real property subject to said Easement: portions of an existing 8.5' wide shed, a septic seepage pit, and a septic tank, and a proposed septic tank, proposed drainfield, and associated pipes, as shown on that certain Garness Engineering Group, Ltd. drawing titled Summit Estates, Block 1, Lot 3, Design of Septic Upgrade, Pg.2 of 2, dated 8/9/2023, on file at Chugach, within said Easement on said Parcel, (herein "Encroachment"). Encroachment Permit - Page 1 of 5 eRecorded Document WHEREAS, the Parties desire by this Permit is to authorize Permittee to construct and continue the existence of the Encroachment in its proposed and existing location, subject to the conditions and covenants set forth herein; NOW THEREFORE, in consideration of the mutual covenants, terms, and conditions set forth herein, and for other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the parties agree as follows: 1. Permit. Chugach hereby grants to Permittee, and Permittee hereby accepts, a permit to construct and maintain the Encroachment in the Easement for the Permit Period (as defined in Section 3). Permittee is not authorized to and shall not in any way expand or increase the extent to which the Encroachment occupies any of the real property encumbered by the Easement. The Parties do not intend to create a lease or other interest in real property for Permittee through this Permit, and the Parties only intend to create a permit that is revocable at will by either Chugach or Permittee as provided herein. 2. Acknowledgement of Easement and. Non -Adversity. Permittee acknowledges the validity of the Easement. Permittee warrants and represents that Permittee is the owner of the fee simple interest in the land subject to the Easement and the following described real property to which the Easement is adjacent: Summit Estates, Lot 3, Block 1, according to plat number P-628, Filed on the 13th day of October 1961 with the Office of the Recorder, Anchorage Recording District, Third Judicial District, Seward Meridian, Alaska. Permittee hereby acknowledges and agrees that the Encroachment and any additions thereto, even if in violation of this permit, has not and shall not in the future give rise to any interest or estate in the real property subject to the Easement or any other real property. Without in any way limiting the foregoing, Permittee acknowledges that the Encroachment is not adverse to any interest of Chugach and its continuation is entirely with the permission of Chugach for purposes of the common law doctrine of adverse possession. 3. Permit Period. The permit period for the Encroachment shall commence on the date hereof, and subject to sooner termination as hereafter provided, shall expire on September 22, 2063. Notwithstanding the foregoing, this Permit may be terminated by Chugach at any time during the Permit Period as provided in Section 7. 4. Indemnification. Permittee shall indemnify, defend, save, and hold harmless Chugach and its officers, directors, members, partners, employees, agents, affiliates, successors, and permitted assigns against all claims made or judicial or administrative actions filed which allege that Chugach is liable to the claimant by reason of: (a) any injury to or death of any person, or damage to or loss of property, or any other thing occurring on or about any part of the Encroachment, or in any manner growing out of, resulting from or connected with the use, condition or occupancy of the Encroachment if caused by any negligent or wrongful act or omission of the Permittee or its agents, partners, contractors, IIIIIIIIIIIIIIIIIIIIIIIIIIII Encroachment Permit - Page 2 of 5 2of5 eRecorded Document 301-2023-026796-0 employees, permitted assigns, licensees, sublessees, invitees, or any other person or entity for whose conduct the Permittee is legally responsible; (b) violation by the Permittee of any contract or agreement to which the Permittee is a party in each case affecting any part of the Encroachment or the occupancy or use thereof by the Permittee; and (c) violation of or failure to observe or perform any condition, provision or obligation of or under this Permit on the Permittee's part to be observed or performed hereunder. The indemnity obligations outlined herein shall survive any cancellation, expiration, or termination, for any reason, of this Permit. 5. Modification of Utility Facilities. If the electric utility facilities located within the Easement are upgraded, added to, replaced or reconstructed, Permittee shall pay that portion of Chugach's total costs for such modification which is reasonably attributable to accommodating or preserving the Encroachment. If such payment is not made within thirty (30) days of written demand for same, Chugach may terminate this permit in accordance with Section 7(c). 6. Covenants Running with the Land. The obligations of the Permittee arising from this Permit shall be covenants running with the land which shall burden the Parcel and the Permittee's interest in the land subject to the Easement and shall benefit the Easement. 7. Termination. Chugach may terminate this permit after the giving of thirty (3 0) days written notice of such termination if (a) The Encroachment is enlarged, increased or extended within the real property affected by the Easement. (b) The Encroachment is damaged by any means to an extent of more than thirty percent (30%) of its replacement cost at the time of destruction. (c) Permittee fails to make the payment described in Section 5; or (d) The Encroachment is determined by Chugach to inhibit or prevent necessary use of the Easement for electric utility purposes in such a manner that the Encroachment can no longer be accommodated or preserved. Upon expiration or any termination of this Permit, Permittee shall promptly remove the Encroachment and restore the real property subject to the Easement to its original condition. If Permittee fails to do so within thirty (30) days after termination, Chugach may do so at Permittee's expense. 8. Notices. Any notice, demand, request, or other communication under this Permit shall be in writing and shall be addressed to the Parties at the addresses set forth below. Each party may amend its address for notices from time to time upon written notice to the other parry in accordance herewith. Communications may be delivered and shall be deemed to have been given by the delivering parry and received by the receiving party: (i) when delivered by hand; (ii) one day after deposit with a nationally recognized overnight courier or delivery service if sent priority Encroachment Permit - Page 3 of 5 3 of 5 eRecorded Document 301-2023-026796-0 overnight delivery; (iii) on the date sent by electronic mail (with confirmation of transmission) if sent during normal business hours of the recipient and if also transmitted by one of the other means permitted hereunder; or (iv) on the third day after the date mailed by certified or registered mail (in each case, return receipt requested and postage prepaid). The rejection or other refusal to accept or the inability to deliver because of a changed address of which no notice was given shall be deemed to be receipt of the communication sent. If to Chugach: Chugach Electric Association, Inc. Attn: Land Services Department P.O. Box 196300 Anchorage, AK 99519-6300 If to Permittee: 10. Governing Law. This Permit shall be governed by and construed in accordance with the laws of the State of Alaska, notwithstanding any conflicts of laws principles. 11. Waiver. No waiver, by either party, of any failure to comply with this Permit shall be deemed a waiver of any other part, or subsequent failure to so comply. 12. Entire Agreement. This Permit constitutes the entire agreement between the Parties with respect to the subject matter hereof and supersedes all other prior or contemporaneous agreements, oral or written, between the parties. No modifications, amendments, deletions, additions, or alterations of the Permit shall be effective unless in writing and signed by all of the parties hereto. 13. Assignment. This Permit and the rights of Permittee hereunder may not be assigned by Permittee without Chugach's prior written consent. CHUGACH ELECTRIC ASSOCIATION, INC. Date: 9/Zl0 /Z3 By: K"— .t Karen Keesecker Supervisor, Land Services Department Date: 2 Date: /-�O 2023 eRecorded Document PERMITTEE By; / / A house By Chantel Shouse Encroachment Permit - Page 4 of 5 4of5 301-2023-026796-0 STATE OF ALASKA ) ) Ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this day of , 2023, by Karen Keesecker, Supervisor, Land Services Department of Chugach Electric Association, Inc., an Alaska nonprofit electric cooperative corporation, on behalf of the corporation. NOTARY PUBLIC Lorraine Aldea Lehman STATE OF ALASKA My Commission Expires June 25, 2024 STATE OF ALASKA ) Ss. THIRD JUDICIAL DISTRICT ) My Commission Expires: The foregoing instrument was acknowledged before me this `day of , 2023, by Cory Shouse and Chantel Shouse. NOTARY PUBLIC LOrraifi0ldea Lehman -' STATE of ALASKA Notary Public in and for Aaska My Commission Expires June 25, 2024 My Commission Expires: S ac)�kk III II III I I IIIIIIIIIIIIIIIII Encroachment Permit - Page 5 of 5 5 of 5 eRecorded Document 301-2023-026796-0 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 . NAME PH ❑NEW ) �C rZ Get 16,4 (z - cO/N{E 3 /b II .'UPGRADE MAILING ADDRESS qq LEGAL DE CRIPTION 15,1071p? d, L3 /�cl�-- l .>_N LOCATION / 7 TZ, NO. OF BEDROOMS DISTANCE TO: Well %U 9 Absorption area C) + Dwelling �, Q PERMIT NO. � " i 6 U Y / $ q O _ W < Manufacturer Or /4,1 l7 Material 5°jLee 1 No. of compartments - 2, v' Liq. capacity in gallons IF HOMEMADE: Inside length Width Liquid depth O 1'DISTANCE TO: Well Dwelling PERMIT NO. J02 2 z F Manufacturer Material Liquid capacity in gallons O Well Foundation Nearest lot line PERMIT NO. Ulu = DISTANCE TO: u z No. of lines Length of each line Total length of lines Trench width Distance between lines F Z w inches Q x Top tile to finish Material beneath tile Total C~ of grade effective absorption area p inches Length Width Depth . » PERMIT NO. w f7 Q F Type of crib Crib diameter c Crib doth Total effective absorption area 'w° N Well Building foundation Nearest lot line DISTANCE TO: J Class Depth Driller Distance to lot line PERMIT NO. J w � DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER e tre PIPE MATERIALS pvc C r cab o SOI L TEST RATI NG IV4 2 t2 INSTALLER L/ G 6 E REMARKS b 1 N 3 511 •i nj it APPROVED DATE LEGAL j"I�N t=-3�C� Sac_iS _ i1K� a j�23 /Ye Sumnd LGf3 A,& I �� 72-013 (Rev. 3/761 � ' ������������������ ��� ������������� ' DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 025 L STREET, ANCHORAGE, AK 99501 264^4720 C) P4 I 'T'Em Q En VZ EE F1 Fn Ew FR 51 "E _T' PERMIT NO: 840716 UPGRADE DATE ISSUED: 08/23/B4 APPLICANT, TED ENGLAND ADDRESS: P O BOX 6584 ANCHORAGE, AK 99502 CONTACT PHONE: 346'1765 LEGAL DEqCRIP: SUBDIVISION: SUMMIT ESTATES LOT: 3 BLOCK: 1 SECTION: 15 TOWNSHIP: 12N RANGE: JW LOT SIZE: 17000 (SQ^FT" OR ACRES) I certify that: 1" I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage (MOA) and the State Sf Alaska" .2" I will install the system in accordance with all MOA codes and 'egulations, and in compliance with the design criteria of this permit" 3^ I will adhere to all MOA and State of Alaska requirements for the set back distances from any existing well, wastewater disposal system or public sewerage system on this or any adjacent or.nearby lot. IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS_DUILTS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE ELECTRICAL WORK/MUST BE DONE BY A LICENSEWELECTRICIAN^ \SIGNED APPLICANTv TED DATE: ISSUED BYDATE: ............ --''------------ ----------����� � � / ~ - /� . // ^�� '- //Y-7/ � //`_'"'`^'`'.`''�'`~`- o ' /` GRE' I R ANCHORAGE AREA BOVIGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM q NAME ! y� -�{A IILLIING ADDRESS A45/7= j�L �' A'Gt%t�%H`ONE=��/��"'�' � '7 / LOCATION C / 1 LEGAL DESCRIPTION -L- >- Z J r SEPTIC TANK: _ DISTANCE� n / i5 �"NUMBER OF FROM WELL MANUFACTURER �G MATERIAL is ���` COMPARTMENTS EEN� TS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH 1 LIQUID CAPACITY 'GALLONS. SEEPAGE PIT: NUMBER OF PITS --4—. DIAMETER OR WIDTH _!2_Z'7 LENGTH;Zr EPTH I,?.— LINING MATERIAL CRIB SIZE: DIAMETER—DEPTH DISTANCE FROM: WELL / l TOTAL EFFECTIVE BUILDING FOUNDATION 41//!}`�NEyAREST LOT LINE �/N . ABSORPTION AREA (WALL AREA)r SQ. FT. ADDITIONAL ABSORPTION WELL&kA b�%wl� TYPE CONSTRUCTION � CL DEPTH DISTANCE FROM: BUILDING NEAREST NEAREST SEPTICp SEEPAGE ��- FOUNDATION LOT LINE SEWER LINE TANK-SJ/"—t SYSTEM. CESSPOOL OTHER SOURCES APPROVED_ DISAPPROVED REMARKS DISTANCES:.—/'���SL An DIAGRAM OF SYSTEM INSTALLED BY: PIPE MATERIAL: LOT SLOPE: le -161 -f2 -p REMARKS: Form No. EQ -031 DATE �,/�1J �'� APPROVED v • µA P1 Li P4 I CT I F' Fl L. I "F- he 0.=.1 F= F% fA CT FA Q Fes' F==1 901 E DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTIN 2510 E. TUDOR RD., ANCHORAGE, AK. 9950+7 276-2221 1I -y- E=n =�1}1�F' 1='t 11�8I 1 PERMIT NO. C 76246 ) APPLICANT WILLIAM RHODES LOCATION EAST 89TH AVE LEGAL L- B1 SUMMIT EST TYPE OF SOIL ABSORBTION SYSTEM IS MAXIMUM NUMBER OF BEDROOMS = 4 2427 EAST 86TH AVE PIT LOT SIZE Ins � 344-2927 1.6800 SQUARE FEET SOIL RATING (SO FT/BR)= 150 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: GF-F'T'H= WL12 1_E7rAC3l_V4== 1. r IF-"-FAVAE=L_. &t=7F -1`1-i _: _S THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF EACH SIDE.IOR ASEEPAGE PIT. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE SURFACE BETWEEN THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN 'THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION CIN FEET). FQ E= f ! L J I F= E= E> cwE F' "F-' I cs T FF 1-.I1 = I .c E_ = _1 ``• e e� i=F F _- R— s -f F BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM I: 100 FEET FOR A PRI57ATE WELL OR 200 FEET FOR A PUBLIC WELL. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F° E= F O P'1 I IF % F A L_ I E> F= f3 FR ED PA E NA K F A F' F= Fes'- CA PI I '= co F..J-_-- I CERTIFY THAT 1: 1 AM FAMILIAR.. WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELL; AS SET' FORTH BY THE MUNICIPALITY OF ANCHORAGE. 1 WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 1 UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. -I SIGNED:- ! C_ ___���=--__ L_.--------�-------- APP 01 WILLIAM RHODES ISSUED BY S -- "�. GREATER ANCNOMGI ARI -A L'D 'Iff I Department of (uvnronmrnl.alality 3330 "f,' 'Arcot Anchorage, Alaska 99!j u3 SOILS LOG PHROI,ATION Th;ST Performed for/t/9. L<LiRM__ oQE� ---- ---- - O to Perform d Legal Description:_ _ 4 0c.Y_ _.�r/MM!1__F�rR?�.1. This form reports: Soils log_X_'__--� Percolation test__-- — i Depth Feet Gross Time 1- 5ANay SIr.-cy. CyRA✓Ec 2 y 'CoAR3Ta� �ooRLy GtRADaD U�GS 3 ; ------------- — 5.14TY SAND + j 4 - `'RANDOM G1'RA1/�1- 5 U SG5 - 5 M(d1 61 51,j.-ry, c4RflVr-C.Ly SA►/V I ? ' RANDoM hook To 2 �� 1 USGS-'..GM��.. `CoARgE SRA✓gLC.�/ SAND g : r-A►f Ly i.x4d-pow ` 10- 'SIL -r CoNT6.N-T i lz - ' 13 - � 14 _ )und water encountered? _/�c9 If yes; at what depth? Reading Date Gross Time Net Time Depth to Water Net, Drop —T ------------- — Percolation rate minute. •Proposed•installatnon: Seepage Pit _ -.X Drain Field Depth of inlet _S ( Depth to bottom of pit or trench -,------ "..."COMMENTS: ��_kt�_.-:5 AA" ._IS.__LQN?tcu�pg 1 ts.gs_N'LiNuous�_r3J; S9�+±NUD Performed Dyl/�""an.�t_.__. Cortific� (3t>� �(y,.-Y�7?� nate ! E(�-U40, (6/74) YG�r�i-�'�"�"' --- kd' 21 Ot�o L4 -t-A' Qs)InL cLL LQx/�, M� �L-A ru (C -1k O"Sj PL&A rnPA 0 0� aL mry\ T y�..ION GFMFPik'-.Th1CPd7 HEALTH AND EcNVIRONMLt•dTAL ," wJ F. i JDOR RD. , HNC: HOF?1 Gk. NH:. 276-2221 A getF.:t__B Fa'EFY47"C, tdCi.1 16095 APPLICANT DAHL C:OF"DOk"UTION 2427 EAST 06TH FIVE 340-.927 LOCATION 89TH OFT= BIRCH LEGAL La $1 SUMMIT ESTATES SIZE 16800: t;El_9P�RF FEET MINIMUM DISTANCE BETWEEN A WELL AND ANY ON—SITE SEWAGE DISPOSAL SYSTEM Is loo FEET FOR A PRIVATE WELL OR 200 FEET FOR A PUBLIC WELL.. WELL. LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 0 DAYS OF THE WELL COMPLETION. SPECIP=ICHT'IONS"OND CONSTRUCTION DIAGRAMS ARE FitAIL.i°TE:LE TO XhSJRE F`Oi:iF'k::R' INSTALLATION. I CERTIFY THAI' 1: I AN FAMILIAR WITH THE: REQUIREMENTS 1"OR ON—SITE SEWERS AND WELLS AS SE:i' FORTH BY THE MUNICIPALITY OF ANCHORAGE;' WILL INSTALL. THE SYSTEM IN ACQOF.'DANCL?. WITH THE CODES. f fEF'1-'LI NT C+AHL. CORPORATION ISSUED BY .... 4...: s c, W M t� r b� N V l SON WELL ®RILLIr 1a 1305 W. 45TH STREET ANCHORAGE,. ALASKA 99503 PHONE 272-9343 DRILLING LOG Well Owner to � Use of Well Location (address of: Township, Range, Section, ^if known; or distance main Size of casing Depth of Hole eet Cased tofeet Static water leveLO._G? b_tt. (above) (:below) land surface. Finish of well (check one) open end Screen ( ); Perforated ( ). Describe screen or perforation Well pumping test at IS per (hour) inute for hours with ft. of drawdown from static level. Date of completion J Utz WELL LOG Depth in feet from ground surface —TO �1 d _TO 43 TO LL -C— _44 TOSS S81 f TO(0 �,- 10, Give details of formations npenetrated, size of material, color and hardness `. L'a, Qce),— J G P Lw� �� G p ►y. — TO - - Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 015-072-21 COSA# �$ c7133 Expiration Date: 1. GENERAL INFORMATION Complete legal description SUMMIT ESTATES LOT 3. BLOCK 1 Location (site address) 5701 EAST 97TH. ANCHORAGE. AK 99516 Current Property owner(s) I V)LM I 1 VST -V--YIcS Day phone Mailing address PbTXX 2151- Yalio_ryk. 02 enaw=1 - 25n Lending agency Day phone Mailing address Real Estate Agent BOB BR�KK Day phone 261-7678 Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual On-site Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ . Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verity that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ArcTerra Engineering & Surveying, Inc. Phone 868-3792 Address 20441 PTARMIGAN BLVD.. EAGLE RIVER, AK 99577 Engineer's Printed Name KENNETH M. DUFFUS Date 05/07/2008 Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year and the water usage of the family being served by the system. The operational life of all well and septic systems are subject to these various and dynamic characteristics and are outside the control of the evaluator of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will function satisfactory for current or future occupants or can ArcTerra guarantee that no unseen encroachments, deficiencies or discrepancies exist. 5. DSD SIGNATURE _(C Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory 7T ����Nl•SEVtw�� Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Date: (Rev IIMS r ` Municipality of Anchorage ,. •. ' • Development Services Department` _ Building Safety Division _ On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: SUNIMfr ESTATES LOT 3. BLOCK 1 Parcel ID: 015-072-21 A. WELL DATA Well type PRIVATE If A, B, or C provide PWSID # _ Well Log (YIN) Y Date completed 5/25/1976 Sanitary seal (Y/N)Y Wires properly protected (YIN) Y Total depth _fi3ft. Cased to eft. FROM WELL LOG Date of test 5/25/1976 Static water level 28.5 ft. Well production 15 9— p.m-WATER SAMPLE RESULTS: Casing height (above ground) min. AT INSPECTION 1/22/2008 43 ft. 8.4 g.p.m. Coliform colonies/100mL Nitrate 9.06 mg/L Other bacteria -Q colonies/100 mL Arsenic: _NIZmg/I Date of sample: 4/18/2008 Collected by:11efty Drilling B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 8/23/1984 Tank size 1500 gal. Number of Compartments 2 Cleanouts (YIN) _X Foundation cleanout (YIN) Y Depression over tank (YIN) hL High water alarm (YIN) N—Date of pumping 1/22/08 Pumper 14cDonalds C. ABSORPTION FIELD DATA Date installed 6/11/1976 Soil rating (g.p.d./ftz or fe/bdrm) DA System type Crib Length _aft. Width 2 ft. Gravel below pipe _111. Total depth 9 ft. (12.5' measured) Eff. absorption area No fl? Monitoring tube Y ' Depression over field tL Date of adequacy test 4/30/08 Results (Pass/Fail) sass For gbedrooms Fluid depth in absorption field before test Q in. Water added -eq- gal New depth 38.4 in. Elapsed Time: 1080 min. Final fluid depth Q in. Absorption rate >= Mg.p.d. Any rejuvenation treatment (past 12 mo.) Y (YIN & type) Septic Clear/Acid if yes, give date 3/31/08 D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) 'Pump on" level at—in. 'Pump off" level at—in. High water alarm level at—in. Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ Absorption field on lot ' 97' Public sewer main 75'+ Sewer /septic service line 251+ Animal containment areas 50'+ On adjacent lots • 80'+ On adjacent lots 80'+ Public sewer manhole/cleanout 100'+ Holding tank 100'+ Manure/animal excrete storage areas 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5+ Absorption field 5'+ Water main 301+ Water service line 101+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 101+ Building foundation 10'+ Water main 10'+ Water Service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+ Curtain drain 50'+(None Known) Wells on adjacent lots 1001+ F. COMMENTS G. ENGINEER'S CERTIFICATION „�E OF A -'I% 1 certify that I have determined through field inspections and • • ••••.� review of Municipal records that the above systems are in V�a 'M :9 conformance with MOA COSA guidelines in effect on this '•_ „ •••••"_• date.En ineer's Printed Name KENNETH M. DUFFUSe,dI �; 9 If u•J,ti, .1" ./ v. r Date 05/07/2008 �� OpD NpV COSA Fee $430.CO Date of Payment 5 DS Receipt Number 1 b 4Q ja (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number Municipality of Anchorage ,.. Development Services Department Building Safety Division ` On -Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 Nitrate Advisory Certificate of On -Site Systems Approval # 080133 A Certificate of On -Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block 1, Lot 3 of Summit Estates subdivision. This inspection revealed a nitrate concentration of 9.06 milligrams per liter (mg/L) was reported for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Please see the attached "Nitrate Fact Sheet" for important information regarding nitrate. This advisory must be attached to all copies of the subject Certificate of On - Site Systems Approval. Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ct.anchorage.ek.us (907)343-7904 ON-SITE SEWERIWELL SUBMITTAL COMMENT SHEET To: Ken duffus Legal description: Summit Estates Block 1 Lot 3 ❑Permit ®C.O.S.A. ❑Inspection Report The attached paperwork has been reviewed and is being returned for the following reasons: 1. Camera well to insure there is unperforated casing for a minimum of 40 feet Name of reviewer: Jeff Date: May 15, 2008 /I `OFl Aa,row re.1,, c� G(.a.. rt.«s.� ` u 5Y1 G s 6 c 740 /.<- ok.• W eL i t%a Y/ S y ra rL�(-Gt , % Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK 'D ��� Municipality of Anchorage :7r 1:(1. lk,x L"�, ) • Anclmnigc, Alaska .r�.11.)'(�;R) - 37(X) Elmore INN �� OPim ('.M)7) 3%34it0I - rax: (N)7) 313dt21M1 lulp://r�uu'.nnmi.nrq Mayor Nark /icy/ich Dcvclopmcnt Ser %ices Department July 14,2008 Kenneth M. Duffus, P.E. KND Engineering, Inc 20441 Ptarmigan Blvd. Eagle River, AK 99577 Subject: Waiver Request for Summit Estates, Block 1 Lot 3 Waiver Request WRk: 86-167 Parcel ID 4 015-072-21 IIA080133 Dear Kenneth M. Duffus, P.E.: Rell x04 Sr^ �e r �. Department Your request for a waiver of the required 100 feet horizontal separation from the septic tank to the private well has been approved. The approved separation distance is 85.0 feet. This waiver approval applies to the existing septic tank to private well separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, �V W Deb Wockcnfu s Civil Engineer On -Site Water & Wastewater Program Community, Security, Prosperity Municipality of Anchorage Development Services Department • Building Safoy Division On -Site Water and Wastewater Program 4700 Bmgaw Street P.O. Box 196650 Anchorage, AK 99519.6650 www.ci.anchorage.ak.us (907) 343-7914 Waiver Review Workshect WR#:86-167 PID#:015-072-21 HA1Permit# IIAO80133 Date Received: July 14, 2008 Legal Description: Summit Estates, Block 1 Lot 3 Engineer: Kenneth Al. Duffus, P.E. KND Engineering, Inc 20.341 Ptarmigan Blvd. Eagle River, AK 99577 Applicant: MLMI Trust Series Waiver Requested: An ammendment to the 1986 waiver to include 85' from the well to the tank on lot 4. Criteria: Geology Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: C .................................. ......essas...................... ...... Waiver is Granted: X List Conditions or Reasons for above: Waiver is not Granted: Date:147/ 108 By: Deb Wockenfuss Name of Reviewer ......................................................................... Rec#: Amount: $ Dale Paid: 7114/2008 Summit Estates, 61 L3 Parcel ID: 015-072-21 Waiver for 85 feet from tank on Lot 4 to well on Lot 3 Issued July 14, 2008 General 1. From the water sample, total coliform was 0, and total nitrates was 9.06 mg/L. A camera was used to check for perforations. Wetness was found in the casing so a liner and pressure grout was installed to 55' 2. Any overflowing sewage would move away from the well head. ADEC Criteria Points Water Table Depth of water bearing zone in well 46 feet Assumed bottom of field 8 feet 38 feet 1'(8/10) + 4 4.8 Soil Sorption Soil descriptions from well log of Lot 3 Permeability Soil descriptions from well log of Lot 3 DEC PTS Depth From Depth To Thickness Calc. Pts Sand, Clay and Gravel 1.5 8 40 32 1.26 Clay 6 40 43 3 0.47 Hardpan 6 43 46 3 0.47 0 0.00 0 0.00 0 0.00 38 2.21 2.2 Permeability Soil descriptions from well log of Lot 3 Water Table Gradient - Waler table slopes away form the water source 6.3 Assume +26.7% slope Horizontal Separation 85 feet between septic tank and well x=10/25+2.0 2.4 Total Points 17.6 As per ADEC waiver guidelines, with a point value of 17.6, almost sure to be free from any form of contamination from household sewage. DEC PTS Depth From Depth To Thickness Calc. Pts Sand, Clay and Gravel 2 8 40 32 1.68 Clay 0 40 43 3 0.00 Hardpan 2 43 46 3 0.16 0 0.00 0 0.00 0 0.00 0 0.00 38 1.84 1.8 Water Table Gradient - Waler table slopes away form the water source 6.3 Assume +26.7% slope Horizontal Separation 85 feet between septic tank and well x=10/25+2.0 2.4 Total Points 17.6 As per ADEC waiver guidelines, with a point value of 17.6, almost sure to be free from any form of contamination from household sewage. Revision of Waiver WR86-167 HA080133 Summit E BI L5 90' Water Table Gradient Calculation Summit Estates, Block I Lot 3 180' 7/14/08 Summit Estates, n i L4 94' Adjusted D' 1 G N7 e A wk f. A r d 3 3 4 a S a W Tf "J I� r • J `w jljJ/ ---- -- --- --— --- ---- I 5 4 oQf 6 1 dofS I' 0 SCOMCR7, O SMICf TACNK ¢ TYe11 TYell 6 5 I N I I I >Th, Z UNDEVELOPED r I i 49th � r 0 BEN.SPURKL... •'•� No. cc -2225 tits e5 0 25 50 75 100 125 150 SCALE: 1' = 50 FT. F I I IUHbQN 5PUNKLANU Y.L.I I SUMMIT KS'IATU, BK I LOY' 5 I I SEPTIC SYSTEM LAYOUT 203. AK. AVENUE 5601 E97TH. AVE. DATE: SEK. 8, 1000 (907) 279-J916 (NCH. 99MMRCARET NOVELLI SHEET: 1/3 CRID. 2437 PERMIT N PTD k 015-072-23 SUI•f0I052D1✓6 N+cHOnAac, Atrsr,A"502 r DRSlllkO 1.00 %T.. r i • " TM 0+tti M E(Wtt1 �.. -1 Loettim' (addmaa ef: ?o.rohIN Ran^ SacUms• l( kwwn.- or dtatanct mala rood '• q i`1, ' •��++L .' tll}c 1 Stasi t iia t at! l •n. i �• ♦ r�... t 3iu of aftA;s dt rrt. at noityZOQ Cyd ft--2A—fftt statk go aw itVOL-3-1--ft (C.TPRA : (bekw) land tur(am FUlah of trtU (dwA am) Sped end ( •%• % i' i'wfOr=tad ( )• "t 'i .,. . il•i, ,. DOWTRW Pavan a ntriart��� a4 N/ttlDoe>pFnt tat 't pit (Yam (mhiuk) to 1 hnvra ttt, 1007 w � ; •at tMrtrc'a�trs fswn statLe It+.L +i ! i � • t • r : r WAS of trj��n,=,irts� l d Qct=1973 • vML too CIA Depth 1n 1r7t b"m •r S ' gtrrd sabtri � •• . ' � O M tSttalSa o< fotmatkxa perxtratcd, dnt o! ma tertat, ednr • • � : •' v� '`t,0°r}�t•rn��S __ •• �4tlttr nr,<,�� :'�: t •:[�• �TO hd sAy_.'Y'0r • �� a si�'rn •e6 ..Uj_TO M „QQ_•m I G+O . YO ;� • , �•; , »__� .. l ,. •, k, r, 1`'n1ti'1 Ct•:!:!:n1 f'•.•traNrr .. • l ��� v'a CIA T22 yr►ytl r, 1`'n1ti'1 Ct•:!:!:n1 f'•.•traNrr .. • l ��� v'a e �rV CIERRA �r ENGINEERING AND SURVEYING, INC. May 7, 2008 Dan Roth, Program Manager Municipality of Anchorage Development Services Department On -Site Water & Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 RE: SUMMIT ESTATES, BLOCK 1, LOT 3 — WELL/SEPTIC WAIVER Dear Dan, Per previous discussion with you, please modify the existing waiver (WR86-167) to include the septic system of the adjacent Lot 4 of the referenced property. Only one standpipe on Lot 4 could be found. This standpipe is within a dog kennel and owners have not been home with various attempts to ascertain if this is a field or tank cleanout. Based on MOA records it appears that this is a septic tank cleanout. See attached WR86- 167 drawing with our notes in red with COSA documents. In any event, this encroaching system was inadvertently missed with the fore mentioned waiver and we have roughly verified the separation distance between the septic standpipe to the well to be approximately 85'. If you have any questions or require additional information, please contact me at 868-3792 / FAX 868-3793. Respectfully, An'XeTn Engineerigg,& Surveying, Inc. Kenneth M. Duff <P.E. Attachments: As Noted L C3 'o lgfjb 1;11,✓W2 D44vj.Ji --200.0GvsA 3W.tAvric.V.c . SJsevnG� PFT p k (36DR&Orr •DR►vE wnY ifavtE V '� • c.o r 3 EAS 7- .......... .......... d v ................? ...... : THEODORE F. MOORE j .` .• �f. •, CE - 3589. -% ,Lo e �O%rl'*._••..... eek`°r PRup6R� a1ti�r i JSY/O 6i9 L . t EIT�t TANhr 1h f ' LOT Z L 3, B 1, .Sl.<Nty IT, EST D.4 r� ; • J i / zf'/ ,v� DRAWN I3Y: TFry ' SCS R<LM 1081364001 Client Name HeftyDrllling Project Nama/Il 3701 97th Ave Client S■mpleID 570197th Ave Well Mauls Drinking Water PWSID 0 Sample Remarks; All DatesRlmes aro Alaska Standard Thee Printed Data/Llme 04/302008 925 Colketd DataRlma 04/18/2008 11:30 Received DatdLhae 04/182008 12:10 TKhmlcsl Direetar Stephen C. Ede Allowable Prep Analysis Puonercr pxsults PQL Unks Memel Osm twm Umiu Dom Day iNt Metals by XCp/NO Arsmie ND 5.00 ug/L E1,200.8 C (<I0) 0424108 0428/08 1.138 Water• Dspartmomnt Teal NitreteJNitrite.N 9.06 0.100 HLarobiology Laboratory Colony Count 0 Total Coliform 0 Face] Coliform 0 mg/L SW0450ONO3-F 8 (d0) col/100mL SM20 922213 A (0001 coV100mL SWO92228 A &I) cuVl00mL SM2092228 A Nil 0421)08 LCP 04/18/08 SDP 04/1LIDS SDP 04/18/08 SDP �°C�ti'" •MRA .ser VAJW "'a'•'S 89'59000" W 120.00' ------- 04 w. "mm___—_ ?0' "L ESUT. SHED •CON C •..� W'36,6' .a '• ,yg d � W v 24.0' 15.d O a EksnN0 `T• a . • No=rn 4 ' .. q y,J.6'� ,Y 29.5' 2 CA' R c . •MIL -- S 89'59100". W 120.00'--_---- O E. ,97t4 AVE. =(89th) statv[T CE1T11nCADp1 6 *1�• ell Prepared by ' PLOT PLAR •• Rob@fit E. Johns, Jr. & Assoc. "'".:.; a+ ~ ~ e"• •"1700 .'•4 ••�. "" •j� Professional Land Surveyors A.r rw,r�.NMMYM w+. •a"r w r ,�.r r •...1 bee Iry !•' I, . ' ORIMK OR. ANa1ORA .AUSKA SM4 9 �• Seola, R,q. Lot S.F. Rer, fld FE• Na FRIMOA7ION At-BIALT � .• •/ V=301. •a,., a NI•.. .. a.w ww ww I ^�wr•+~ir • .•• ...` Date SuN ya.Il ON" •Y CMeMa s I. ee w"'u.~.� �•• CBERT a' • ' 12 w w r .. �...+rw ew w." S, ? ♦ M 4 - i : Oete Oman: Old; .1�23�0a :.Ra37 W.0. .90a FINAL aDtuc7uRE AS-NIT : •ti ,= Lpd VenApticM L •ewaNP...+ •awl way a.ar /^ '••... 6aA �� �'"�. ,.,,•• ���i� ��r..Nond `� ••• Lot 3, Block .1 ' «.� w...: '"" "' 4�ti�••+• .. .. . SLatmit Estates Lor suA YT yV1Ey�T 13 rwmDA•DI, a-sk&T SY1AQ013 b EEIAL tD41CRRC Af-•IB.T • SET RERM �+-r�..�.� (" "� p1AINAOf i-:�_'J ASPHALT O ADTRM ...A VIXT... of wal`aT... Ta••Ia1rn,T 0... FOUND REBM ••--��w WOOD /GtC[ `.:i'••.. OONCRrm 00 ASSUMED ELEV. '• AL FI.71CC PLOT PLANS a LOT 511RVEY5 NOS ITR THE REWONSIBIUTY OF THE BUILDER OR OWNER. PRIOR TO CONSTRUCTION TO VERIFY PROPOSED 6UILOING GRADE RELATIVE ONLY THOSE IMPROVEMENTS ABOVE GROUND AND LRSIBLE TVIL.L B[ TO FINISHED OIEADE AND UTILITY CONNECTIONS AND TO DETERMINE SWaWw. F6NOE& WttLS. SEPTIC C_RANWM S,DEYVALK DIRVCwAY7. [TC.. ARE SHOWN IN THEIR APPRO%IMATE LOCATION. THE VaTIENCE C: ANT EASEMENT$, COVENANTS OR RESTRICTIONS ONLY. SNOW MAY PREVENT SOME IMPROVEMENTS FROM OEINC SEEN IGH OT AP►EA ON TNC RECORDED TURbOVIZION PLAY. A AND LOOATEv. UNDER NO CIRCUMSTANCES SHOULD AN AS-BURT BE USED FOR CONSTRUCTION OR M ESTABLISKNO SOUIIVARY OR FENLT' MCS. R THE SURVEYOR TAKES MONSIVILMY FOR TME BMTIAL TRANSACTION ONLY AND ASSUMES FINANCIAL LIABILITY ONLY FOR TME COST Or 711E SURVEY, USTED DISTANCES PREVAIL OVER SCALING RCMtODUC:ION. MAY CAUSE ERRORS IN SCALL ARROW PUMP & WEU SERVICE, LLC P.O. Box 110496 Anchorage, AK 99511 Office: (907) 346-9355 • Fax (907) 333-8976 Eagle River: (907) 622-9335 TO:e683793 P,1 OWDOCEE, N° 08069 r/�S/ [� CUSTOMER JOB SITE h4w;c `ps-$o� �,� r S7bI LI_)/n'� G., '1L/_7,' Thank You SIGNATURE (I Hereby Acknowledge the Satisfactory Completion of the Above Described Work and agree that K above work Is not paid for In 90 days I agree to allow Aarow Pump a Well Service, L.L.C. the right to remove unpaid for equipment and Charge for labor already performed a labor to remove unpaid for aqulpm ni.) TERMS: ACCOUNTS PAYABLE AT 10TH OF MONTH FOLLOWING PURCHASE. SERVICE CHARGE AT RATE OF 1.5% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS. - Po �' — — - �- in -� MVOICED TE WEtLO awl / CML TE�Puup DEPT" eDM rave QUANT11Y DESCRIPTION PRICE AMOUNT Pe 60 re L I . ;- /� S a /'Q[ r/'S /O J //7ie55GJ arr a c iyt5 Pllk-02,914e,Fri 're o v«70 LABOR HOURS RATE AMOUNT TOTAL MATERIAL TOTAL LABOR WORK ORDERED BY DATE COMP, I TOTAL LABOR PAY THIS AMOUNT S1� Thank You SIGNATURE (I Hereby Acknowledge the Satisfactory Completion of the Above Described Work and agree that K above work Is not paid for In 90 days I agree to allow Aarow Pump a Well Service, L.L.C. the right to remove unpaid for equipment and Charge for labor already performed a labor to remove unpaid for aqulpm ni.) TERMS: ACCOUNTS PAYABLE AT 10TH OF MONTH FOLLOWING PURCHASE. SERVICE CHARGE AT RATE OF 1.5% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS. MAY -29-2008 10:418 FROM: ARROW PUMP & WER SERVICE, LLC P.O. Box 110496 Anchorage, AK 99511 Once: (907) 346.9355 • Fax (907) 333-8976 Eagle River. (907) 622.9335 //�� CUSTOMER 22 Q r Vlom It Roperl r . r1%% U Broc e '2,f)) C, 5fir SLI `fir /00 An IS AOra lfgr `l7503 L r1/ j - --)/- -7,�e- v 1-'7Xn *-,% 70:2617532 P.1 omw 06fa NQ 08021 JOB SITE r .5 70 J t= 9 2L12V �Z04,311 04 3,/��ac% r Sgjw;t�:� X _{w)C-a6k77 JDa61-2ii7(% — r .� e w�}ce *e S wEu. oEPTM sm aaonrNrEo ruwr oa.nr eAUtSPERSON OUANTIT`/ DESCRIPTION PRICE AMOUNT wcityr arowkdG -Fa r hour'5 AIV5.Int / P ' 1^6 Jr' K d Lc ;ir r LABOR HOURS RATE AMOUNT TOTAL MATERIAL TOTALLABOR WORK ORDERED BY DATE COMP. TOTAL LABOR PAY THIS AMOUNT Thank You SIGNATURE it Hereby ACknowtedge the Satisfactory Completion of the Above Described Work and agree that If above work is not PLd for In 90 days I agree to allow Aerow Pump A Wal SeMcs; L.L.C. the dgM to remove imps d for equipment and charge for labor already performed a labor to remove unpaid for equipment) TERMS: ACCOUNTS PAYABLE AT IOTH OF MONTH FOLLOWING PURCH 88'eflCs�ilV ED SERVICE CHARGE AT RATE OF 1.5% PER MONTH WILL BE CHARGED ON OVERDO MAY 2 9 2008 BY: - MAY -19-2008 01:54P FROM: 70:3437997 P.1 AAROW PUMP & WEU SERVICE, LLC P.O. Box 110496 Anchorage, AK 99511 Office: (907) 348-9355 • Fax (907) 333-8978 Eagle River: (907) 622-9335 I CUSOMER,Tjj L Ck-jQVAmAki A tit9rig ge, ke S'F�03 Lail u A6 /- 603, J MODICE N° 08000 r JOB SITE 1 5-70 / 97ZVve WE wIXLDEPTH 6WL CHLORINATED PUMP DEPTH ERSON . w' %/A QUANTITY DESCRIPTION PRICE AMOUNT LA a P r d �t LABOR HOURS RATE AMOUNT TOTAL MATERIAL TOTAL LABOR WORK ORDERED 87 DATE COMP. TOTAL LABOR PAY THIS AMOUNT Thank You SIGNATURE (1 Hereby Acknowledge the Satisfactory Completion of the Above Described Work and agree that If above work Is not paid lot In 90 days I agree to allow AarOW Pump & Well Service. L.L.C. the right to remove unpaid for equipment and charge for labor already performed & labor 10 remove unpaid for equipment.) TERMS: ACCOUNTS PAYABLE AT 10TH OF MONTH FOLLOWING PURCHASE. SERVICE CHARGE AT RATE OF 1.5% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL' ;q(p —� OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date I I / zS /.5 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) p ¢ 3 Qtoe IT. 1 Summit �=�e kt Location (address or directions) S701' E 97 t (b) Applicant Name A H FC Telephone: Home Z_7e' 55'99 Business fh Applicant Address 235 E A✓ (c) Applicant is (check one): Lending Institution ❑ ; Owner/bu'der 19; Buyer ❑ ; Other ❑ (explain); rn 6z ¢'lrrf- Mai / f3a o1/3ne6 Telephone 2 7� - 6304 (d) Lending Institution Address Gw6 tai y A.'e AACAanw 9960/ (e) Real Estate Company and Agent For4z(ne — N1eI a Sud7t 7d+u�+at Address '3000 ,1 Sf o 41C'10 aVe 9`i503 _ Telephone 56 2 7d -s3 (f) Mail the HAA to the following address: t/Ffotd dor piclr -cr�� L\' 2. TYPE OF RESIDENCE Single -Family ® Multi -Family ❑ Other Number of Bedrooms H /t 1 ' I ! \ 3. WATER SUPPLY Individual Well IR 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. 72-025 (11184) 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 verifythat 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 regulations in effect on the date of this inspection. * Name ofFirm FlarNoe Tec Anrcae_' Telephone 35'S -1T4 -S Address IN53a r<'che S� 66ncyorac�r ftp 9%SI( Date It / 2,$-/8b� See lei' Wgil S�ey�e cif S'cParafwn c�ufane[ warmer /l�u/Pvi - �: f OF A AV ®p • ,4 a+ ......................... ®A ............... Engineer's Seal Q THEODORE F. MOORE CI V '.•e CE - 3539 ' ,•' w 6. DHEP APPROVAL l i Ai Date / F , ` I Approved for � bedrooms by Approved L 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 72-025 (11/04) 10� P CC.JNIl\tgyCIPALITY OF ANCHORAGE (MOA) �`\ty F \E QR',-, ALTH AUTHORITY APPROVAL (HAA) JN\PQ�QS: 0� CHECKLIST - FEBRUARY 1984 1 264-4720 �r\J\RD Legal Description: 1-0113, 8(ock• I . •. ���� C .yam i � Er %. �eJ A. WELL DATA �� V Well Classification P/ rvo`Fe If A, B, C, D.E.C. Approved (Y/N) N•�• Well Log Present (Y/N) �' Date Completed ! ZS'! 7K Yield 1.5* Total Depth "u Cased to 6.3' Depth of Grouting M.A. Static Water Level HM' Pump Set At > SO' Casing Height Above Ground Is Electrical Wiring in Conduit (Y/N) Y' Separation Distances from Well: To Septic/Holding Tank on Lot _ Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) On Adjoining. Lots 7 too' To Nearest Edge of Absorption Field on Lot R7' '!- ; On Adjoining Lots 7 too ' To Nearest Public Sewer Line N. A. To Nearest Public Sewer Cleanout/Manhole N• A. To Nearest Sewer Service Line on Lot N. A. Water Sample Collected by Tr ry ; Date It / Zo t q6 Water Sample Test Results Sci�el �at{o�i /to CO"Ar'" a" ,Ae.- 1,ac%2na Comments * Waiver #7,e d JWr Wed - S12V7C ./i/ Separz+/ion B. SEPTIC/HOLDING TANK DATA Date Installed 9/ Z3 / B y Size ICOO x` l No. of Compartments Standpipes (Y/N) Y Air -tight Caps (Y/N) Depression over Tank (Y/N) N Pumping/Maintenance Contract on File (Y/N) FA. r. Holding Tank High -Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water -Supply Well log, To Property Line To Water Main/Service Line Course roo Comments Page 1 of 2 72-026(11184) t' Foundation Cleanout (Y/N) Y Date Last Pumped It/2y for Temporary Holding Tank Permit (Y/N) & To Building Foundation 17. To Disposal Field 26, % sayep e lir, _ To Stream, Pond, Lake, or Major Drainage C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata !SO D ' /(d -C Type of System Design SQVare -Ait Date Installed o"/ It / 7 o Length of Field 219' (pe,- eei t Width of Field - % (Rel- —yu'!f� Depth of Field 9 Gravel Bed Thickness Un trnaW6 Square Feet of Absorption Area tW firer Standpipes Present (Y/N) Y Depression over Field (Y/N) N Date of Last Adequacy Test 0/ 2 1 /66 Results of Last Adequacy Test Ad elFuaFe der H bedroony Separation Distance from Absorption Field: 103' 4 c.o To Water -Supply Well 9 7 peri To Property Line 9 _ipl' uf-bu1%< Zo' �rvm C.O. To Building Foundation - f6 cram c. o, To Existing or Abandoned System on Lot At, H• ; On Adjoining Lots 9 30 To Water Main/Service Line N. A. To Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course foo To Driveway, Parking Area, or Vehicle Storage Area H 2 Comments Y wa,yee neso/¢o,� ZrVr iwg —s01ya e reParoA<,.e D. LIFT STATION p. A . Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at ** Check Permitted Bedroom Rating Against HAA Request ** Vent (Y/N) Pumping Cycles during Adequacy Test, Meets MOA I certifythat I''have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed ? `� Date B/ e,5-196- Company e,5-/bCCompany FW* TSH. Svct, MOA No. Receipt No. /00/ DOO/ ®®ccI®c1'AQ Date of Payment —�_ � ��i •• r° Amount: $ ��—� ��©4 •' Engineer's Seal e..Y.®�� 9 Ol�f,9TFI......... s /•�•.............e ,M•owe •'y a e/•....t�t!. • Page 2 of 2 `j °• THEODORE F. MOORE ; d i�•. aCE - 3589 Q �sJl '.. e •� f'' �Q4 lM���e•°e..••' V��� 72-026(11/84) tan - rWesslonl� ®�> Abu—. iO OEALTgkO��'� 'NtAE PROTECTION =212-1.11 :1 VED CAM & ENVIRONMENTAL ENGINEERING • ENERGY CONSERVATION & ANALYSIS THEODORE F. MOORE, P.E. November 25, 1986 14530 ECHO ST. PH: (907) 345-1355 ANCHORAGE, ALASKA 99516 M.O.A. Dept. of Health and Human Services P.O. Box 6-650 Anchorage, AK 99501 RE: Separation distance waiver - L 3, B 1, Summit Estates Dear Sirs: By means of this letter I am requesting a waiver down from 100 feet to 97 feet for the separation distance between the well and the closest part of the soil absorption system on the subject lot. Relevant backup information from your files, as well as a drawing showing the system layout on the lot are enclosed. The soil absorption system was installed on 6/11/76 and consists of a seepage pit having dimensions of 28' X 9' X 28' X 6' and a total effective wall area of 600 sq. ft. per the approved inspection report. On that document the inspector reported a distance of 97 feet between the closest part of the pit and the well. The soils log indicates that no groundwater had been encountered down to 13 feet. On 11/21 thru 11/25/86 I conducted an adequacy test of the water and wastewater disposal systems. The house had been unoccupied for some time prior to the test. The seepage pit accepted a surge loading of over 1500 gallons and, when full, did absorb at an adequate rate for the permitted 4 -bedroom residence. I measured the seepage pit cleanout to be 103 feet from the well. According to the driller's log, the well was completed on 5/25/76 and has a total depth of 63 feet, a static water level 28.5 feet below land surface and a yield of 15 gpm. On the date of my test, the static water level was at 44 feet below ground surface, and steady pumping at 3.6 gpm caused a maximum drawdown to 50 feet below ground surface. A water sample taken that day showed no evidence of contamination by coliform or other bacteria. The topography of the lot is generally flat, with a slight slope towards the northwest which, in the event of seepage pit failure, would tend to carry effluent further away from the well. The well log shows a mixture of sand, clay and gravel to 40 feet. This is underlain by 3 feet of clay and 3 feet of hardpan which separates it from the waterbearing strata. These strata should protect the aquifer from contamination coming from above. �.J In consideration of the foregoing factors, is is my opinion that that the requested waiver can be granted without creating a public health hazard. Please give me a call if you have any questions. cc. Judie Thomas, Fortune Properties Sincerely, Ted Moore, P.E. ®CID �Q • ®® .................... ° THEW ORE F. MOORS. °. CE - 3589 L� SEPVAGC'' H 6EDliuU�w DRlvE WAY NuvsE M •� t/ "LD y 1-07— 3 (� - too "�-went, rrtai�� rr AINe:f — 120 EAST yi Lo r 2 ( ucecacn0 ® �� or- A<� o� 0�.�'.''•............ 4 L 3, 3 1� Su MM IT EST �..7.'.'/................... d • • .....c� ® THEODORE F. MOORE . ED �: k... CE - 35897S' @Qal'rfG �''• .... •' ��hm' ik less 1, - D.4r5 ;.. II/as 6� 0114 DRAWN f3Y: TF/7 ., I m a z ISAACS PUMPING SERVICE (Norm Tibbetts Owner) 6218 Quinhagak Street ANCHORAGE, ALASKA 99507 Phone 5633300 `7hank`You PAOWCIEC9�Irc. GrIXm, N.as 011)1. Mp�� ty P.O'96X 196650 ����g���n ANCHORAGE, ALASKA 99519-6650 ®f (907) 264-4111 g� Anchorage TONY KNOWLES, MAYOR DEPARTMENT OF HEALTH & HUMAN SERVICES December 3, 1986 Theodore F. Moore, P.E. Flattop Technical Services 14530 Echo Street Anchorage. Alaska 99516 Subject: Lot 3 Block 1 Summit Estates Subdivision Waiver Request WR86-167 Dear Mr. Moore: Your request for waiver of distance from the seepage pit to the well on the subject lot has been approved. The waiver is for the required 100 foot separation to be waived to 97 feet. This waiver is good only for the existing four bedroom seepage pit and any future upgrade will require another approval from D.H.H.S. Sincerely, Daniel J. Roth Civil Engineer On -Site Services g�Sep X9l�sanir W N % d S ' (�' L. Time Time Time Time . APPLI( ` NT FILLS OUT UPPER HAI, ,,ONLY Date Properly Owner /Va .-�7Ti. Phone � - r. /� ' p Mailing Address 00r �� G. l- /1) y0�/T -C- �,l Zip Code ' %` -;.-15 Buyer Insp ori Inspector Address '�� d Zip Code Lending Institution -'fl���'S f��iJK _��'�r"%i(f iG); rc'NA/1/ Phone Address �/�. /rA (-C C Zip Code j/,..o:i - Realty Co. & Agent JUL 2 21983 ,. Phone RECEIVED XI APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED GI-) CONDI ZONA Address /) Code Legal Description L. O % S �- �O �' (;Zip J /j 1W ✓r'/ / 7' /7 Street Location ZD/ Type of Residence Soils Rating Date Sewer Installed Single Family Well to TanK Septic Tank Size ❑ Multiple Family No. of Bedrooms- ❑ Other Water Supply - ATTACH WELL LOG. A well ll log is required for all wells drilled log since June 1975. if , o Community /�; tt� r F For wells drilled prior to that date, give well depth (attach available). El Public Utility 5 Sewer Disposal Individual C O� (7% �) - Year Individual Installed: ❑ `Public Utility N ° I a When Connected to Public Utility: ❑ Holding Tank 111\ NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. W N % d S ' (�' L. Time Time Time Time . Date Date Date_ 1 (( ate% �'� ll��l.� Date 7- S, 7 Inspector Inspector Insp ori Inspector Field Notes: MUNICIPALITY OF ANCHORAGE / DEPT. OF HEALTH ENVIRONMENTAL PROTECTION wJ �j JUL 2 21983 RECEIVED XI APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED GI-) CONDI ZONA OVAL' DATE /7 Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received Well to TanK Septic Tank Size )2013131821 y_. \i _ DATE RECEIVED INSPECTION APPOINTMENTS ESTATES TIME TIME I E DATE DATE / DATE ❑ One A .Four ❑ Other i..` INSPECTOR INSPECTOR INSPECTO MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE OF HEALTH & ENVIRONMENTAL PROTECTION DEPT. OF HEALTH & DEPARTMENT 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL PROTECTION • ENVIRONMENTAL SANITATION DIVISION APR 2 J 1981 Telephone 264-4720 pp �(('' CC \' REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEW&-F°A�I�IYI DIRECTIONS: Complete all parts a page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. / /7/YEAR ON-SITE SYSTEM WAS INSTALLED. PHONE 1. PROPERTYOWNER MR. & MRS. MIKE MCCOMAS 349-39I7 MAILING ADDRESS - SRA BOX 75M ANCHORAGE, ALASKA 99507 NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. PROPERTY RESIDENT (If different from above) PHONE 349-3917 97TH & BIRCH ROAD PHONE 2. BUYER MR. & MRS. TED ENGLAND 344-3737 MAILING ADDRESS SRA 75 C ANCHORAGE ALASKA 99507 PHONE 3. LENDING INSTITUTION FIRST NATIONAL BANK OF ANCHORAGE 36TH & C MAILING ADDRESS 36TH & C STREETS PHONE 4. REALTOR/AGENT 1144-7514 OWNER MAIL NG DRESS L42� East 86th Street Anchoragp, Alaska 99507 5. LEGAL DESCRIPTION LOT 3, BLOCK I SUMMITT ESTATES STREET LOCATION 97TH & BIRCH 6. TYPE OF RESIDENCE NUMBER OBEDROOMS ❑ One A .Four ❑ Other [NX SINGLE FAMILY ❑ Two MW Five- " ❑ MULTIPLE FAMILY ❑ Three ❑ Six 7. WATER SUPPLY INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled - ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM / /7/YEAR ON-SITE SYSTEM WAS INSTALLED. INDIVIDUAL/ON-SITE** ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-070 (Rev. 6/79) 72-010 (Rev. 6/791 THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLEFAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ TWO ❑ FOUR ❑ FIVE ❑ OTHER ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED — LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON-SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATEINSTALLED �P INSTALLER SOILS RATING ❑Septic Tank or ❑ Holding Tank Size: L) U? If Tank is homemade give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL �) 4. DISTANCES WELL T0: Septic/Holding Tank Absorption Area 6e er Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS 1` M APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter mu accompany certificate) [[Y DISAPPROVED VC DATE BY ys- 72-010 (Rev. 6/791 ALASKA RUIROW11TAL COnTROL Engineering & 6nuironmental Studies 1ST NATIONAL BOX 4-2090 ANCHORAGE BANK/MCCOMAS AK 99509 SELLER — MIKE MCCOMAS ScRUICcs, Inc. MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & ENVIRONMENTAL P CHCTG7N f� l,M' A 5 1981 RECEIVE -0 MAY 12 1981 SUBDIVISION—SUMMIT ESTATES BLOCK -1 LOT -3 THE TYPE OF ABSORPTION SYSTEM IS A PIT WITH AN AREA OF 600 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 600 GALLONS OF WATER PER DAY. BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A 4 BEDROOM HOME. THE SEPTIC TANK WAS PUMPED ON 5-12-81 . �e®FaA&®9� I Dy C. 9efo1, W. 2251.1 1220 West 251h Auenue • Anchorage, Alaska 99503 • (907) 276-1361 hum �J s`h fl „„�i -:ET 82b � � OPi; (:E, ^•.Lt\.,I�49E75:11 (9(17) 264-a1 11 S AA tW f) i P 1 f "NT"F if Ci' ENV ['3' _:aTPt f _C-_ `F.::TIC)M April 28, 1981 m i.ke Mc Comas Star_ Route A Box 75M Anchorage, Alaska 99507 Suhject: Lot 3 Block 1 Summit Estates Subdivision Approval .for (he individual sewer and water facilities cannot be granted until the following .items have been completed: (1) The water analysis report needs to be delivered to this office from the Chem Lab, 5633 B Street, for our r-eview. (2) The septic tank ,:pumped with a receipt submitted to this office. (3) An adequacy test needs to be performed on the existing leaching area. This test will determine if the system is adequate according to National Standards. A listing of private firms performing the test is enclosed. This report needs to be submitted to this office for our review. If there are any further questions, please call this o`_fice at 264-4720. Sincerely, Robert C. Pratt. R.S. Associate Specialist RCP/ljw cc: First National Hank of Anchorage Post Office Box 4-2090 99509 -MUNICIPALITY OF ANCHORAGE DEPARTME' `OF HEALTH AND ENViRONMEN PROTECTION 825 's Street, Anchorage, Alasa 99501 279-2511, ext. 224 or 225 #1: Time Date In sp Date Received: May 11, 1977 #2: Time #3: Time Date Date Insp _ Insp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES�p/ Llu� lJec�t���. 1. Lending Institution Request: First National Bank of Anchorage Mailing Address: Post Office Box 4-2090 99509 Phone: 274-1521 2. Property Owner: Clifford/Debbie Me Comas Mailing Address: Star Route A Box 75M 99507 3. Legal Description: Phone: 349-3917 Lot 3 Block 1 Summit Estates Subdivision 4: Single Family Residence: (x) Number of Bedrooms: 5 _.j Multiple Family Residence: ( ) Number of Bedroom -5— L 5. Well System: Individual Well (x) Community/Public System ( ) Permit # Construction Depth of Well Well Log on File ( ) Bacterial Analysis 6. Sewage Disposal System: On-site System (x) Public Utility ( ) Permit # Installed Installer Septic Tank Size X71 Manufacturer Absorption Absorption Area Soils Rate .5 Q i Material _ 7. Distances: Well to Septic Tank to Absorption Area / to Sewer Line Nearest Lot line Absorption Area to Nearest Lot Line ..Page Two Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 3 Block 1 Summit Estates Subdivision Comments: The subject property was permitted and designed for a four (4) bedroom residence only and con not be approved for a five (5) bedroom as requested. Affadavit Attached: ( ) Letter Attached: ( ) Approved: Date: Disapproved: Ijj J_ Date: May 23, 1977 Department Worksheet: 1. 2. 3. 0 5. A MUNICIPALITY OF ANCHORAGE ® DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L Street, Anchorage, Alaska 99501 279-2511, ext. 224, 225 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES MUNICIPALITY OF AN -111 DEPT. OF I-iEAL;..-, ENVIRON.'."-iiAL PROi.L.r.41V t3k -RE C.I�--IVED Type of Inspection: VA FHA__ CONV__ XX Drnnerty nlAinar• Clifford & Debbie McComas Mailing Address: Star Route, ABox 75M,Anch. AK Day Phone Name of Buyer: Clifford & Debbie McComas Mailing Address: Star Route A,Box 75M,Anch.AK Day Phone Name of Lending Institution: First National Bank of Anchorage Mailing Address: P.O.Box 4-2090 Anch. AK 99509 Phone:_ Name of Realtor or Agent: none Mailing Address:_— Phone:_ Legal Description: Lot 3, Block 1. Summit Estates Location 5701 East 97th, Anchorage, Alaska. 7. Type of Facility to be Inspected: SFD 8. Water Supply Type of Supply: Public Utility If Individual, number of dwellings presently served If Individual, depth of well 9. Sewage DisposaLSystem Type of System: Public Utility If Individual, date of installation 349 3917 349 3917 274 1521 No. Bdrms. 5 bedrooms Individual ndividual (on-site) XX 5/9/77 We would appreciate the earliest attention your office as loan is pending. Thank you. If the form an be pickup up w4 274 1521X39. Thank you Una M. Bennett Lohn Processo 72-003(3/76) could give the aBOVE n.ready, please call June 24, 1176 sl COW 0rMo 2027 Mat 66th AVOMM wwrales, IlMU 995052 subjeatt Wall Lori Legal 0000riptions tot 3 a look I Summit zatAtes .4 pear Girt our reeds How that th ea opaw nt 3AA0 not rooe ve V011 log on No =doct Property* Municipal ordinance requiroo well logo to be submittal within thirty tai days after drilling is Conploted. The Well cannot'ba €colder & for SYMMI by thiO Wart - pent until the wall log is received, Would you PIOROO $and o4 h4nd OAS ry A «COPY of tho well sawor and later Section, so we M d0c"-Ut Aur filOs ;Aad 01030 04t y0ar vermlt. xf `you AMO any quoatt�an ,. or o have not *0 yep, drilled your well: pleasa call un_ t 276-222:1, oxt=sion 263 or 2814 inn er4.:l`_7e Paula* Nander s n WN 'Page``mwo Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: Lot 3 Block 1 Summit Estates Subdivision Comments: Affadavit Attached: '(;) Letter Attached: ( ) Approved: Date: Disapprove Date: Department Worksheet: ria . ro _ Municipality of Ak,�rageogTE May 26, 1977 .._ SENT — Environmental Health Dept. �TO Lot 3, Block 1 SUBJECT - —.�.. >...._ a Summit Estates FOLD HERE RETURN RETURN TO ioned When the SOUTH CENTER BRANCH ® THE FIRST NRTIONRL BONK OF RNGHORRGE P. O. BOX 4-2090 ANCHORAGE, ALASKA 99509 ATTENTION OF: t was made an error of (5). We have at DATE �n � � � �n,�, •;ter ;I