HomeMy WebLinkAboutPARKER LT 9, 10
MUNICIPALITY OF ANCHORAGE
f"� !
Development.Ili
Services Department p Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 008-031-65
1. GENERAL INFORMATION
Complete legal description Parker LT 9, 10
Location (site address) 4225 Parker PI
Current property owner(s)
Mailing address
Real estate agent
Expiration Date: b — ! (z'71 ^ z
FEDERAL NATIONAL MORTGAGE ASS.
E•
2. TYPE OF DWELLING:
❑ Single Family (w/wo ADU)
0 Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
Day phone 261-7603
Day phone 261-7603
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Private Well
Private Septic
❑
Water Storage
❑
Holding Tank
❑
Community Well
❑
Community
❑
Public Water System
❑
Public Sewer
0
Waiver request for: Distance:
Received by: Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ $280 11
Date of Payment J7 ZD 2
Receipt Number. Ll % 2 g b
COSA # OSC211107
Waiver Fee $
Date of Payment
Receipt Number
Waiver #
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, 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. I acknowledge that On -Site staff may visit the site to verify the information submitted.
Name of Firm NorthRim Eng. Phone 694-7028
Address PO Box 770724, Eagle River
Engineer's Printed Name Steve Eng Date 3/4/20
++P�� OFAr
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6. DSD SIGNATURE f' f
System #1 Approved for bedrooms f♦ tee; �^9t� t Qki
♦� CE-62ss'Y
System 92 Approved for bedrooms j;/ 4 -12'
214W
Disapproved
Conditional approval for bedrooms, with the following stipulations:
lllllll(((((frr(�
ON-SITE
',!A TP D
OGA AM41
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Original Certificate Date: 3— `67 ZI
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the
representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is
not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
Legal Description:
Parker LT 9, 10
If more than 1 septic system on lot: COSA Checklist # of
A. WELL DATA
❑ Well log is filed with Onsite (or attached)
Date drilled 1957
Total depth 90 ft
Cased to 40+ ft
❑ Sanitary seal is functioning correctly
FOR Wires are properly protected
Casing height (above ground) 12+ in.
Date of flow test for COSA 3/4/21
Parcel ID: 008-031-65
Structure served by this system
Well production at time of test 8+ gpm
Water storage tank volume 0 gallons
Well disinfected for coliform test? ❑ Yes ❑ N
❑ Coliform bacteria is Negative
Nitrate mg/L ❑ Nitrate less than MRL (ND)
Arsenic 6.35 ug/L ❑ Arsenic less than MRL (ND)
Collected by NRim Eng
Date of Sample 3/4/21
Static water level at beginning of test 11.9 ft.
Comments 43' of casing viewed with camera by Jim Sullivan
B. TANK DATA
Age of tank(s) years
Tank type/material
Measured operating fluid level in septic tank
❑ Standpipes/foundation cleanout per record drawing
Date of pumping
D. ABSORPTION FIELD DATA
Which system tested (date installed)
❑ ALL standpipes present per record drawing
Total measured depth from grade ft (max)
Measured depth to pipe invert from grade ft (min)
❑ N/A — pressurized field
❑ Monitor tubes go to bottom of effective. If not, state
depth into effective
C. LIFT STATION
❑ Required maintenance completed
Age of lift station years
Lift station material
Comments:
Adequacy test date
Results ❑ Pass For bedrooms
Fluid depth prior to test in
Water added gal
New depth in
Elapsed time min
❑ Code -required soil cover over field Final fluid depth in
❑ System presoaked Absorption rate gpd
(Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months)
date of test)
Gallons introduced gallons If yes, enter date
Comments/Deficiencies:
COSA Checklist yellow sheet
E. SEPARATION DISTANCES
From Private Well onLot to: (Please enter distances aless than required or if community well
Septic Ta nk,'LiftStation cmLot > 100'
Yes
if No__h
Community Sewer Manhole/Cleanout >1NI
��Yem
ifNo___ft
Property Line >5'
r7l Yes
kNo5O It
Neighboring Tank >1OU' P�You
dNnh
Private Wells >100' [lYes UNoh
Private Sewer/Septic Line >25'Yeo
ifNo10+ h
Absorption Field onLot>1O0' R, Yeo
i[NnM
Private Wells >1O0'
Holding Tank >1O0' Yes
ifNoh
Neighboring Absorption Fields >10U
iyNoft
Animal Containment >5O' Yeo
^~
if �
�lYes
if No
h
----
Community Sewer Main >75' FlYes
if No 5{)
It
Manure/Animal Excreta Storage >1OO'
2 Yes
if No It
From Tank onLot to: (Please enter distances if less than required)
Building Foundations >10�
Yes
if No__h
If absorption field is under driveway comment below
Surface Water>100,
'0Yes KNoh
Property Line >5'
Yes
UNoU
El Yes
Wells onAdjacent Lots:
Private Wells >100' [lYes UNoh
Absorption Field >5/
C3 Yes
KNoM
Community Wells >2U0' FlYes ifNoh
Private Wells >1O0'
171 Yes ifNo#
Water Main >1O'
F7Yes
iyNoft
Community Wells >2OO'
[71 Yes ifNnM
Water Service Line > 10'
nYno
ifNoft
|yseptic tank iyunder driveway comment below
From Absorption Field mmLot to: (Please enter distances if less than required)
Building Foundation >10'
[J Yes
ifNoh
If absorption field is under driveway comment below
Property Line >10'
E]Yes
ifNo__h
Wells on Adjacent Lots:
Water Main >1O'
El Yes
i[Noft
Private Wells >100' [lYes UNoh
Water Service Line >10'
FlYes
i(NoM
Community Wells >2U0' FlYes ifNoh
Surface Water >YOO`
El Yes
ifNoft
F. ENGINEER'S COMMENTS
1957 well under old separation requirements
G. ENGINEER'S CERTIFICATION
/ certify that / have determined through field inspections and review
xVMunicipal records that the above systems are inconformance with
MOA CO8Aguidelines ineffect onthis date.
i
15.0' Lot 8
! CHAIN—LINK FENCE
I i WEST 133.50' / ( F
N
8.1'x12.1' SHED— / (I
Lot 11
I 10' SANITARY SEWER EASEMENT
I I I
NOTES:
1) THERE ARE NO BEARINGS ON THE ORIGINAL PLAT. THE BEARINGS SHOWN HEREON ARE ASSUMED.
2) THE DRIVEWAY IS APPROXIMATE DUE TO SNOW & ICE COVER.
MORTGAGE SURVEY _X_ SCALE _ 1"_= 30 GRID SW 1734 Project No.21-116LR1
11500 Daryl Avenue, Anchorage, Alaska 99515-3049
Lang & Associates inc. (907) 522-6476 Phone
(907) 522-4625 Fax
Professional Land Surveyors ken®Iangsurvey.com X=1
Q1 0 A
F
........
jonathan®longsurvey.com d'` .• ' '9s Q
I hereby certify that I have surveyed the following described property:
LOTS 9 & 10, PARKER SUBDIVISION (PLAT No. P-310)
Anchorage Recording District, Alaska, and that this Mortgage Location Survey is a
representation of the conditions that were found on the date the survey was performed.
This survey does not constitute a boundary survey and is subject to any inaccuracies
that a subsequent boundary survey may disclose. The information contained hereon shall
not be used to establish any fence, structure, or other improvements.
Dated this the ��Day ofR�✓��'L�------_—,`Li__, at Anchorage, Alaska
It is the responsibility of the owner to determine the existence of any easements,
covenants, or restrictions which do not appear on the recorded subdivision plat.
49!H*
KENNETH G. LA o<r
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•'•.LS -5202.•'• 5 0
AR Ngo
�FfSSIONAL �a
AECC963
EAST 133.50' j
10.2'
24.2'
C)
.
o•. GRAVEL
N
0
Q - ' DRIVEWAY
�'
W
Lo
8.2'x8.3' SHED
V
47.2'
26.3'
Lot 9
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6,675 S.F.
N G'�O�`'
N
24.2'
10.1'
(�
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O
WELL
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Ce
Z
( II
W
26.3'
to
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Lot 10
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I
Io 6,675 S.F.
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����GF,
F
0
( 01
WOODEN FENCE
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0
`n 57.6'
NF,`'�� ro
6.0'
I
I` —
- CHAIN—LINK
FENCE W
2s.�'
33.6
I /
I i WEST 133.50' / ( F
N
8.1'x12.1' SHED— / (I
Lot 11
I 10' SANITARY SEWER EASEMENT
I I I
NOTES:
1) THERE ARE NO BEARINGS ON THE ORIGINAL PLAT. THE BEARINGS SHOWN HEREON ARE ASSUMED.
2) THE DRIVEWAY IS APPROXIMATE DUE TO SNOW & ICE COVER.
MORTGAGE SURVEY _X_ SCALE _ 1"_= 30 GRID SW 1734 Project No.21-116LR1
11500 Daryl Avenue, Anchorage, Alaska 99515-3049
Lang & Associates inc. (907) 522-6476 Phone
(907) 522-4625 Fax
Professional Land Surveyors ken®Iangsurvey.com X=1
Q1 0 A
F
........
jonathan®longsurvey.com d'` .• ' '9s Q
I hereby certify that I have surveyed the following described property:
LOTS 9 & 10, PARKER SUBDIVISION (PLAT No. P-310)
Anchorage Recording District, Alaska, and that this Mortgage Location Survey is a
representation of the conditions that were found on the date the survey was performed.
This survey does not constitute a boundary survey and is subject to any inaccuracies
that a subsequent boundary survey may disclose. The information contained hereon shall
not be used to establish any fence, structure, or other improvements.
Dated this the ��Day ofR�✓��'L�------_—,`Li__, at Anchorage, Alaska
It is the responsibility of the owner to determine the existence of any easements,
covenants, or restrictions which do not appear on the recorded subdivision plat.
49!H*
KENNETH G. LA o<r
�0�����••.3Cc��2t ••J��G
•'•.LS -5202.•'• 5 0
AR Ngo
�FfSSIONAL �a
AECC963
1. Approval requested by:
Mailing Address:
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "c" Street, Anchorage, Alaska 99503 274-4561
Date Received December 23, 1975
Time of Inspection
Date of Inspectionc~)~
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
FHA
Alaska National Bank of the North % Kathy Albrecht
Pouch 7-010, Anchorage 99510
2. Property Owner: Gerald C. Strachan
Mailing Address:
Box 298, Nome, Alaska
3. Legal Description: Lot l0 Parker Subdivision
4. Location:
4225 Parker Place, Anchorage
5. Type of facility to be inspected
'6,
Well Data: Individual
A. Type
C. Construction /~////~'~
7. Sewage Disposal System: On-site system
A. Installed
Phone:
Phone:
C. Septic Tank: 1. Size
277-5511 x 31
Single Family No. of bedrooms 3
B. Depth
D. Bacterial Analysis
B. Installer
2. Manufacturer
2. Material
D. Seepage Pit: 1.. Absorption Area
E. Disposal Field: Total length of lines
8. Distances:
A. Well to: Septic tank
Nearest lot line
B. Foundation to septic tank
, Absorption area
Other contamination
, Absorption area
., Sewer Lines
C. Absorption area to nearest lot line
EQ-034 (1/74) Page 1 of two pages
Page 2 of two pages - Req 't for Approval of Individual S ~r & Water Facilities
.~egal' '
Description Lot 10 Parker Subdivision
Comments
Approved
Disapproved . Date
Approvals, Valid for one year from date signed
Greater Anchorage Ar~a Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
I certify that the information contained in this request for approval to be a true and
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED Date
EQ-034 (1/74)
274-4561
Alaska ~auional ~! the i~o~th
Pouch 7-010
Subjec~ Lot i0 Barker Sub~ivision
connected b~ June !5~ 1976.
~.~e water ~upply i? via an individual well, Th~?onstruction is
not -~ ~ - ~ ~
If yo~ have any
135 ~
LNB/lJh
~C~ ~rald $~roc'h~
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWAGE AND WATER FACILITIES
(Fill out in Triplicate)
2.
3.
4.
5.
Name of property owner
Legal description
Number-of bedrooms in house
Water Analysis:
b. Detergent
Well data:
a. Type,
c. Casing Size_
Distance from well to closest existing or
1. Sewer line
2, Septic tank
3. Seepage Area
Cesspool'
5. Property
6. Other sources of possible contamination, i.e., creeks, lakes,
houses, barn, drainage ditch, etc.
Age of system .... /[> ~..~ .
Septic tank capacity in gallons ~-0,O, . , .
Name of septic tank manufactum~r,
1. If "home made" show diagram on reverse side of this form.
Sewage disposal system,
a0
b.
C.
d.' Disposal field or seepage pit size and type
1. Distance to property line
to house foundation~ l~p!; , .
e, Percolatlon~Test ~esults , ·
f. Percolation Test performed by
Use the reverse side of this form to show diagram, Diagram should include
~he following information: p~operty lines~.well location~ house location,
~6ptic tank location, disposal area location~ location of percolation test~
an~ direction of ground slope.
The l~fo~rmtion on this form is true and correct to the best of my knowledge.
7,:;/.. , ,, : />-..(: :
S,ignature of Applicant / ' ' ' ~a~e Signed
TO BE FILLED OUT BY HEALTH DEPARTMENT PERSONNEL
~i above described sanitary facilities are hereby approved, subject to th.e.
.......... ~llowing cond~ons~ -
Conditions:
The above described sanitary facilities are disapproved for the following
reasons:
' SignatUre 6f ~?~%¢.ra}i~i ~"~'."",.'.': i~. Date ~"," ~'~:~, :'~.;.3.
Approval is valid for one.' year following the date of approval.
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