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HomeMy WebLinkAboutSTIRLING LT 124B · Municipality of Anchorage Page J 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: .~ Ix'"'9 6'<::2 ~ I ~ PID Number: Name: -~cot',¢ ~ ~^¢ycf- F~/,~.er Wastewater System: ~ New. ~ Upgrade Address: /~w ~oc ~o~o~ ~e Anc~ ~t~ ABSORPTION FIELD Phone: 3~.~ ~No. of B~drooms: ~ Deep Trench B Shallow Trench ~Bed ~Mound ~Other L E G A L D E S C R I PTI O N Soil Rating:~, N.&-- Total Deptht~.from~original grade: '~ G PD/Sq. Ft. Lot: ~ ~ 8lock: Subdivision: Deplh to pipe bottom from odginal grade: Gravel depth beneath pipe Township: ] Range: I Section: Fill added above original grade: Gravel length: Number of lines: ~ Distance between lines: WELL: ~ New B Upgrade Gravel width: ~'~' Ft. ~I J ~ Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: ~- Driller: Date Drilled: SlaticWaler Level: Installer: Yield: GPM IPump Set ah FL }Casing Height AboveGround:Ft. TANK SEPARATION DISTANCES ~ Septic ~ Holding ~ S.T.E.P. To Sepllc Absorplion Lilt Holding Public/Prlvale Manufacturer: Capacity in gallons: From Tank Field Slalion Tank Sewe~ Li .... ~ Well . -- Material: XPeel N,mber o f Compartments: Surface W~te~ ,~ >Wo - LIFI STATION I Foundation . "Pump on" level at: I "Pump elf" level at:' I High water alarm at: I I Remarks: ~ll ~ ~d~ho~ ~ ~ ~ BENCH MA~K Inspections performed by: F/¢h~ ~c4 ~¢( Dates: 1st ¢/1~/¢¢ *~ :-'e ; :.?,N ¢:':.: .;, Department of Heal.and Human Services approval ~ Reviewed and approved by: ate' / ~ff' ~ ~ ....~.-~,'~%~ PEI~MIT NO: SW960218 PAGE 2 OF 2 PID NO: 01826229 67" LONG SOIL ABS. TRENCH WITH 8.0' SEWER GRAVEL 1000 GALLON SEPTIC TANK "BULL RUN" DIV. VALVE PROP. WELL SWING TIES: FROM: COR. "A" COR."B" TO: S.T.C.C. "C" 122' 152' S.T.C.C. "D" 126' 157' DBL. C.C."E" 128' 159' VALVE "F" 157' 162' TR. C.C. "G" 128' 169' TR. M.T. "H" 159' 172' TR. C.C. 'T' 198' 185' TR.C.O. "J" 161' 153' TR. M.T. "K" 175' 156' TR. C.C. "L" 226' 183' PLAN VIEW SCALE: 1" = 40' - 0" LOT 124B STIRLING S/D 64' LONG SOIL ABS. TRENCH WITH 8.0' SEWER GRAVEL 1000 GAL. SEPTIC TANK 2" RIGID 2'+ SOIL COVER INV. 98.1' INV.97.4' (BOTH TRENCHES) BOTTOM TRENCH ELEV. 89.4' BOTTOM T.H. #6 M.T. ELEV. 83.4' DRY 6/20/96~ ~,, CROSS SECTION VIEW NOT TO SCALE LOT 124B, STIRLING S/D SEPTIC SYSTEM CONSTRUCTION AS-BUILT INSPECTION REPORT FLATTOP TECHNICAL SERVICES 14530 ECHO STREET ANCHORAGE, ALASKA 99516 SCALE: AS NOTED D RAWNBY TFM OCTOBER, 1996 Munic paliD of Anchorage Department of Health and Human Services 825 "L" Street ~ick Mystrom,P.O. Box 196650 Anchorage, Alaska 99519-6650 Mayor Permit Number I~ ~I~ (7% CDate Of Issue I - & -9'7 Tax Identification NumberOl¢ -57.,~- q~c~ Date Started J ~ - 1o -~' 7 Date Completed ~___-.~_- c~ Is well located at approved permit location? ,¢~Yes E] No Legal Description Block Lot Property Owner Name & Address: Borehole Data: Depth Method Of Drilling: [] air rotary t,~ cabletool Soil Type & Thickness & Water Strata From To Casing Type: ¢~¢ ¢ ~ Wall Thickness.~¢Oinches ~aJ ~;[~ ~~ ~ ~ Diameter~inches, depth~feet Liner Type: ~ DiameteE inches, depth feet ~ 5~ ~ %~) ~ 7~ Casing Stickup Above Ground: ~ feet ~ Static Water ~vel (from ground level): ~ feet ~_%¢~*{ 5;~ ¢[¢~ ~.~¢ 7~ j~ Pumping Level:t~feeta~er J hm. pumping 7gpm ~ ( ~ ~ i Recove~ Rate: ~ ~Welllntake Opening Type: ~Open End B Open Hole ~¢ ¢/ ~' k¢,~ B Screen¢; Sta, ~ feet Stopped feet ¢ B Pedorations Sta~ ~feet Stopped feet ¢~,,. !~t I~ Depth; irom feet, to feet / , u ~ Pump Intake Depth: feet ~[8~ ~q~)~ ~ ¢/ J~3 ~0~ PumpSize. hp BrandName ¢ Well Disinfe~ed Upon Completion.'? ~ Yes B No ~. 5~ ~¢/~ ~.~ ¢¢~. ~ethodOfDisinfe~ion:_ '~ I Comments: T~L 2D~' ~'~ ~ ~ ~ Well Driller Name ~ ~ ~ .~ ~;~ EECE'VEE ~ Mailing Address IZVOJ J.k~5 ~. JUN 2 1999 ~ vicea PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW960218 DESIGN ENGINEER:FLATTOP TECHNICAL SERVICES OWNER NAME:FELGER SCOTT & ANGELA OWNER ADDRESS:14741 LOC LOMAN LANE ANCHORAGE, ALASKA 99516 DATE ISSUED: 7/26/96 EXPIRATION DATE: 7/~6/97 PARCEL ID:01826229 LEGAL DESCRIPTION: STIRLING LT 124B LOT SIZE: 49493 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / 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 (iSAAC80) . 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: DATE: DATE: C~ & EN~ON~NT~ ENG~EER~G * ENERGY CONSERVA~ON & ~YS~ TI~ODORE F. MOORE, P.E. 14530 ECHO ST. PH: (907) 345-13~5 ~uly 10, 1~ ~CHORAGE, ~KA 99516 M.O.A. DHHS P.O. Box 19-6650 Anchorage, AK 99519 Dear Sirs: The purpose of this letter is to provide the required design nmTative in support of our application for a permit to construct wastewater disposal facilities on Lot 124B, Stifling S/D, located off Twilight Lane. Soils logs, perc test results, a site plan, design di'awings and specifications are enclosed for your review. The proposed system will be constructed in the vicinity of test hole # 6. As can be seen from the soil log, the native material between 4' and 16' below ground level is a sandy silt with a measured perc rote of 60 minutes per inch. The overlying material between 2' and 4' below ground level is a silty sandy gravel with a perc rate of 3 minutes per inch. Ignoring the higher perc rate of the shallow soils and using the soil application rate of 0.45 gpd/sq, ft. specified in the wastewater ordinance for soils with a perc rate of 60 minutes per inch, this proposed 3 bedi-oom residence requires a total absorption area of (3 x 150)/0.45 = 1000 square feet. The proposed 63 foot long trench design with 8 feet of sewer gravel has a total absorption area of 1008 square feet. The topography of the lot in the area of the proposed construction is almost level. If finances allow, the owners, who operate a trucking business, plan to install the replacement trench at the same time as the original; if so they will install a diversion valve allowing periodic switching between the two trenches. The proposed project will have no significant impact on present or future water supply and wastewater disposal systems serving adjacent properties, nor will it have any significant impact on reserved space- surface and subsurface, or on drainage. Please give me a call at 345-1355 if you have any questions on this submittal. Sincerely, Ted Moore, P.E. F. Nq/IRONMENTAL SERVICES Ol¥1~lON ,JUL RECEIV. ED HSE ', ~ ', ' ~'~ LOT 101 , ~~POWER '~ ', ~ WELL POLE ', , ~ ,, LOT ~.._.~i " ,, 102 ' ', ,' T.H. ".. . DOUBLE C.C. ', .' PROPOSED ~ ~. DIVERTER VALVE , .' 1000GAL. O Z ~ "'. ..~.OSED 63' LONG ~ .'" ~P~? TANK . ~-'--- ~ ...... - ~ ~ - SOIL ARS TRENCH - ~-' . · PROPOSED- , ~.- ...... "', O~5 3 BDRT''. ~3. ~ ~,TH 8 GVL. BELOW PIPE ." ', HOUSE ~ '~-~ ~" ~ ~ ' ~ SITE FOR SAME CONFIGURATION ~ , T.H.~2 ~ ~ REPLACEMENT TRENCH , '~ (OPTIONAL TO CONSTRUCT ~ ' PROP. ~ AT SAME TIME AS ORIGINAL) LOT ~ , WELL / ~nn' ~ W 123 / ', ~ LOT 124B < z STIRLING S/D z ~ ~, T.H. ~1 / ~0 '. , . - LOT 124A '- ~ .' STiRLING S/D '" - ' (VACAN~ ~,?.~ ~:~ ~WILIQHT LANE /.5r:-::~ :,Q~'~ ~ ::¢; . LOT 124B STIRLING S/D ~ , "~ ~ WELL AND SEPTIC SYSTEM ~ '"~ ~' ~'.-.~ ~.:~ ~ ~'~ SITE PLAN ~"~ ~°~'*~'~"*'*°~"'x* FLA~OP~C~IC~SERVICES 1 INCH=50 FEET ~,~,*~c*~*~ **~'~'~ 14530 ECHO S~T DRAWN BYTFM ANCHO~GE, ~ASKA 99516 MAY, 1996 ~.~e~ ~'~" ~ "~ , ~;" :~ NOTE: THIS IS NOT A SURVEYED P~T. ~ ,~ Z'~ :~;:...,~ ,,.~- ALL LOCATIONS SHOWN ARE APPROXIMATE. o.o.~,,'t' MO~.TOR TUBE ~' ..//J~ / PERF PIPE~-' ~ CONSTRUCT 63' LONG DOUBLE '1 // 'l / ' _ I ~SOIL A,BSORPTION TRENCH c.c. ~ // I ~ "~}," WITH 8 SEWER GRAVEL I/w-~L-v-~ .......... i~_ ---i- ..................................... , INSTALL NEW 1000 GALLON OPTIONAL INSTALLATION OF SEPTIC TANK SIMILAR REPLACEMENT TRENCH PLAN VIEW SCALE: 1" = 10' - 0" CLEANOUT MONITOR TUBE __ MOUND BACKFILL 12" IIGINAL GROUND ' RIGID INSULATION 4" DIA.ASTM F-810 PERF PIPE 1/2" SEWER GRAVEL BOTTOM OFTRENCH SECTION "A - A" SCALE: 1" = 5' - 0" LOT 124B STIRLING S/D PROPOSED SEPTIC SYSTEM PLAN AND CROSS-SECTION FLATTOP TECHNICAL SERVICES 14530 ECHO STREET ANCHORAGE, AK, 99516 SCALE: AS SHOWN DRAWN BY: TFM JULY, 1996 Flattop Technical Serv~es 14530 Echo Street, Anchorage, AK99516 Phone (907) 345-1355 Lot 124B, Stirling S/D intersection of Twilight Lane and Loc Loman Wastewater disposal system installation Specifications 1.0 General: 1.1 The scope of the project consists of a 1000 gallon septic tank followed by 63 lineal feet of soil absorption french containing 8 feet of sewer gravel below the horizontal distribution pipe. 1.2 Construction shall be as depicted on the approved site plan and design drawings. Minor deviations from these drawings may be allowed or required by the engineer conducting the inspections. All construction procedures and material specifications shall conform with Municipal and State requirements. All separation distances shall be in conformance with Municipal requirements, unless specifically waived. 1.3 The installer shall be responsible to obtain any necessm~y utility locates, and to work around any buffed utilities. 1.4 The installer shall provide adequate cover material and rough grading over all system components to ensure that proper drainage is achieved after settlement and that there are no residual depressions. Insofar as possible the contractor shall minimize damage to trees and existing lawn areas. 1.5 The homeowner shall be responsible for finish grading after the soil is compacted, as well as placement of topsoil and reseeding areas disturbed by the construction. 2.0 Septic Tank: 2.1 The new 1000 gallon, 2 compartment septic tank shall be Municipally approved and shall be set level on undisturbed soil. Each compartment shall be equipped with a wate~ght manhole cover and a 4" cleanout. If the tank is buried less than 4 feet, it shall be insulated with 2 inches of approved burial type, rigid insulation. 2.2 All pipe connections to the tank shall be equipped with waterproof mechanical couplings. The waste line from the residence to the septic tank shall have a minimum slope of 1/4'" per foot, and the waste line between the tank and the soil absorption system shall have a minimum slope of 1/8" per foot. A cleanout shall be installed within 5 feet of the building foundation, and a double cleanout shall be installed within 5 feet downstream of the septic tank. 2.3 If the replacement trench is to be constructed at the same time as the original, a "Bull Run" diversion valve shall be installed to allow periodic switching between the two trenches. 3.0 Soil absorption system: 3.1 The soil absorption system shall be constructed by excavating a 63 foot long, 10 foot deep trench in the approximate location shown on the site plan. 3.2 The bottom of the excavation shall be level. Any compacted or smeared surfaces shall be raked to allow proper infiltration. 3.3 A total of 8.5 feet of approved sewer gravel shall be placed in the bottom of the excavation with the perforated distribution pipes laid level such that the pipe inverts are no less than 8.0 feet above the bottom of the sewer gravel. Sewer gravel shall be 0.5" - 2.5" screened gravel, with less than 3% passing the #200 sieve. 3.4 Monitor tubes and cleanout pipes shall be of 4" diameter and installed in the locations shown on the design drawings. The portion of the monitor tube extending thi'ough the sewer gravel shall be perforated. 3.5 Approved filter fabric shall be placed over the entire top sm'face of the sewer gravel. A nfinimum of 2 feet of soil cover is to be placed over the filter fabric. If the soil cover thickness is less than 3 feet, two inches of rigid, burial type insulation is to be placed over the enth'e top surface of the gravel, in addition to the filter fabric. 3.6 The top sm'face of the cover material shall be raised a minimum of 12 inches higher than the surrounding terrain to allow for subsequent settlement, and shall be graded to smooth contours. Fill slopes shall be no steeper than 3:1. 3.7 The homeowner shall be responsible for an'anging to have the site finish graded after the backf'fll material has stabilized, and for placement of adequate topsoil and seed to promote rapid revegetation of areas disturbed by the construction. 4.0 Inspections: 4.1 A minimum of 4 engineering inspections will be required during the course of the project: (1) initial stakeout with the installer to establish the location of the system and to discuss the plans, specifications and construction procedures, (2) after the native material has been excavated to expose the inf'fltrative surface to ensure that it is level and at the right elevation, and conforms with the soil test infoixnation, (3) after the sewer gravel is in place and the distribution pipes have been laid and connected up to the septic tank, but prior to placement of insulation or filter fabric, and (4) after rough backfill and grading is complete. The septic tank requires one inspection after it is set level and the piping connected, but prior to backfill. This inspection may be incorporated with any of the above inspections. 4.2 The installer shall coordinate the timing of the inspections with the engineer sufficiently far in advance to ensure the availability of the engineer. TEST HOLE # 6 LEGAL DESCRIPTION: DATE PERFORMED: PERFORMED FOR: DEPTH (feet) 1 FLATTOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 SOILS LOG -- PERCOLATION TEST Lot 124 B, Stifling S/D March 22, 1996 Scott and Angola Felger Pt. SM Reddish sandy loam GP/GM Somewhat sifty, sturdy gravel Similar to T.H. #3 MI, Gray sandy silt SLOPE SITE PLAN '.H. #2 F.H. #1 ~_ B.H. (3/22/96) ML Gray sandy silt B.H, (6/12/96) Depth to Groundwater Date 'qo groundwater to 11,5' 3/22/96 ~Ionitor tube dry to 11.5' 4/29/96 5th groundwater to 16' 6/12/96 Monitor tube dry to 16' 6/20/96 Clock Net ]~me Percometer Net Drop Date Reading Time (minutes) Reading (inches) 3~25 12" Presoak Start 3:06 8 1/8 #1 3:36 30 8 5/8 1/2 Add water 3:37 7 3/4 #2 4:07 30 8 1/4 1/2 #3 4:37 30 8 3/4 1/2 PERCOLATION RATE 60 (minutes/inch) PERC HOLE DIAMETER 5 TEST RUN BETWEEN 4,5 FT AND FT COMMENTS: The original depth of this test hole was 11.5' on 3/22/96, however the test hole was deepened to 16 feet on 6/12/96. Base infiltration rate on 0.45 gpd/sq, ft. for 60 min/inch soils. Top of sewer gravel will penetrate into more permeable GP/GM stratum. PERFORMED BY FLATTOP TECHNICAL SERVICES. I ~"".~.~ "~'~.~,.e~'~... CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: '7/~ [ 90~' TEST HOLE LEGAL DESCRIPTION: DATE PERFORMED: PERFORMED FOR: DEPTH (feet) FLA'FrOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 SOILS LOG -- PERCOLATION TEST Lot 124 B, Stirlin§ S/D March 21. 1996 Scott and Angela Felger Pt. SM reddish gravelly loam ML Gray gravelly sandy silt Boulders above 5.5' Hard digging - many cobbles Pockets of silty sand SLOPE SITE pLAN #7  '.H, #2 F.H. #1 COMMENTS: SM Silty sand B.H. Depth to Groundwater Date No groundwater 3/21/96 M,T. dry 4/29/96 Clock Net Time Percometer Net Drop Date Reading Time (minutes) Reading (inches) 3/21 12" presoak 12:50 P,M. 27 7/16 1:00 10 26 7/8 9/16 1:22 22 26 1/4 5/8 1:52 30 25 3/4 1/2 5:06 194 22 1/4 3 1/2 PERCOLATION RATE 60 (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN 6.0 FT AND 6.5 FT 6,I PERFORMED BY FLATrOPTEOHNICALSERVICES. I ~'"~__'~.~.~. CERTIFYTHATTHISTESTWASPERFORMEDIN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 7 TEST HOLE # 3 LEGAL DESCRIPTION: DATE PERFORMED: PERFORMED FOR: DEPTH (feet) 1- FLATTOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 SOILS LOG -- PERCOLATION TEST Lot 124 B, Stifling S/D March 22, 1996 Scott and Angela Felger Pt. SM Reddish sandy Ioam GP/GM Somewhat silty sandy gravel ML Gray gravelly sandy silt Si,nilar to T.H. 81 Easier digging SLOPE COMMENTS: Depth to Groundwater Date No groundwater 3/22/96 Monitor tube dry 4/29/96 Clock Net Time Percometer Net Drop Date Reading Time (minutes) Reading (inches) 3/22 12" Presoak 27 1/2 Add water and start 11:12:37 23 3/8 gl 11:17:37 5 21 15/16 1 7/16 Add water 11:18 23 7/16 82 11:23 5 22 1 7/16 Add water 11:23:15 23 3/8 83 11:28:15 5 21 15/16 1 7/16 Add water 11:28:30 23 11/16 #4 11:33:30 5 22 3/16 I 1/2 PERCOLATION RATE 3 (minutes/inch) PERC HOLE DIAMETER 8 TEST RUN BETWEEN 3,5 FT AND 4.0 FT Perc test coilducted in zone that was somewhat siltier than typical of the stratum. PERFORMED BY FLATrOPTECHNICALSERVICES. I .~',.~,~.,~, CERTIFYTHATTHISTESTWASPERFORMEDIN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES iN EFFECT ON THIS DATE. DATE: Rick Mystrom, Mayor Mmficipali T of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 http://www.ci.anchorage.ak.us 343-4744 December 22, 1998 Scott & Angela Felger 14716 Loc Loman Lane Anchorage, Alaska 99516 4083 Subject: Lot 124B Stirling Subdivision Permit #SW970415, PID #018-262-29 The subject permit, issued December 22, 1997 by this office for a single family well and/or on-site wastewater system, has expired as of December 22, 1998. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. If you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If a licensed Professional Engineer has inspected the installation of the on-site wastewater system, the original as-built inspection report must be sent to this office for review, approval and documentation. All inspection reports must be submitted within 30 days of construction completion. When applying for a new permit, the fees are: $320.00 for an on-site wastewater permit; $120.00 for a well permit and $440.00 for a combined on-site wastewater and well permit. If yo~_have any questions, please call this office at 343-4744. S in~/ly, ~/ ~ames Cross, P.E. ~rogram Manager On-site Services enc: Copy of Permit PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL SYSTEM PERMIT PERMIT NUMBER:SW970415 DESIGN ENGINEER:FLATTOP TECHNICAL SERVICES OWNER NAME:FELGER SCOTT & ANGELA OWNER ADDRESS:14716 LOCH LOMOND LANE ANCHORAGE, AK 99516 DATE ISSUED:12/22/97 EXPIRATION DATE:12/22/98 PARCEL ID:01826229 LEGAL DESCRIPTION: STIRLING LT 124B LOT SIZE: 49493 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: 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 ALAS[<A WASTEWATER DISPOSAL REGULATIONS {18AAC72) AND DRINKING WATER REGULATIONS {18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS RECEIVED BY: issuance: DATE: , -?EI~MIT NO: SW960218 PAGE 2 OF 2 PID NO: 01826229 "A" ~L_ 67" LONG SOIL ADS. TRENCH SWING TIES: WITH 8.0' SEWER GRAVEL / FROM: COR."A" COR. "B" 1000 GALLON / TO: SEPTICTANK ~ / S.T.C.C. "C" 122' 152' TR. C.C. "G" 128' 169' TR. M.T. "H" 159' 172' P "L" STIRLING S/D R 100' 64' LONG SOIL ADS. TRENCH WITH 8.0' SEWER GRAVEL PLAN VIEW SCALE: 1" = 40'-_,,~0" RIGID 2'+ SOIL COVER ~ ~V 1000 GAL ~~~,~ SEPTIC INV. ~¢ · , TANK 98.1' INV.97.4' ~;~ (BOTH -- ~: TRENCHES) TRENCH ELEV. 89.4' BOSOM T.H. ~6 M.T. LOT 124B, STIRLIN6 ELEV. 83.4' DRY 6/20/96 ~ SEPTIC SYSTEM CONSTRUCTION AS-BUILT INSPECTION REPORT CROSS SECTION VIEW ~=o~c~[c~ s~c~s ~ SCALE: AS NOTED NOT TO SCALE ~4¢~c~os~T J D~YTFM ..c~o~e~, ~.s~ HSE ,.;/ ~ "~ ,~ LOT 101 POWER ', ', POLE ~, LOT ,,' 102 ' .~ ', T.H. ,' .. . DOUBLE C.C. .' ,' ' './ ' ' , #3 T.H. OPT ONAL "BULL RUN" .' i ."PROPOSED #4 /'"~. DIVERTER VALVE ..." " ' ', ..' 1000 GAL. O / \ ,' ', /," ___S_E_P~_IC_ _TANK '--7-- , OSED 63' LONG .,.% - -- _. - ? ~'"-~.. .. SOIL ABS TREN H , ._..._ ...... ~:! O ;~H. p~.. C~,TH 8, GVL. BELOW pipE . - , HOUSE '. '-:'...- ~,~ - ~ , ~..- T.H. /, ~" ~' ~., 0#7 , , ~ ',~ D ' ', SITE FOR SAME CONFIGURATION ~ ' ~ ~ \ REPLACEMENT TRENCH ii i T.H. #2 , ~ (OPTIONAL TO CONSTRUCT , ~ ' PROP. ~ AT SAME TIME AS ORIGINAL) , LOT I , WELL / ~1 ' LU ,~ R lOO' LOT 1248 ' z 123 ~ ', ~ ' ' , STIRLING S/D ,' z ,, I O ; ~ ', ' T.H. #1 ' ', O · I~ - LOT 124A '. ~ .. STIRLING S/D 1 '" ' ' (VACANT) ' ~..-~ *'~,~ 'r.~ ,~.%"[Wl LI G H T LANE ~%.~ ...,,~ .'"~- ~- -~, . LOT 1248 STIRLING S/D .,.;;?~ ,o' . ~*~.,~.,~: ~.- WELL AND SEPTIC SYSTEM ~,?'~ -° ~:~:;~ ' ~--,~ SITE PLAN ~ , IItEODO;;~ F, .'-~OO~¢ 2 ~ 14530 ECHO STREET DRAWN BY TFM ANCHORAGE, ALASKA 99516 MAY, 1996 ~t,, y~*.~"'~**o*,'% tf.q,~.~,~.' NOTE: THIS IS NOT A SURVEYED PLAT. ~a~¢-;~;-~:~' ~'~' ALL LOCATIONS SHOWN ARE APPROXIMATE. �_It � a Development Services Department �7 Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 018-262-29 Legal description Stirling Lot 124B Site address 3771 Twilight Lane Anchorage Ak Current property owner(s) Jeffrey Kempff Expiration Date: 11-30-22 X The On-site system(s) is/are approved for 3 bedrooms Conditional approval for bedrooms, with the following stipulations: Comments or advisories: By: Original Certificate Date: ^ �� This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, Development Services Department (DSD) issues COSAs based upon representations provided by an independent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other COSA ApprovaIjune 2022 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Application 1. GENERAL INFORMATION Parcel I.D. 018-262-29 Complete legal description STIRLING LOT 124B Location (site address) 3771 TWILIGHT LANE, ANCHORAGE, AK 99516 Current property owner(s) JEFFREY KEMPFF & SHANNON MUSE Day phone 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS 3. TYPE OF WATER SUPPLY: ® Private Well ❑ Private Well serving 2 dwelling units ❑ Private Well serving 3+ dwelling units ❑ Community Well or Public ❑ Water Storage 4. TYPE OF WASTEWATER DISPOSAL: ® Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ® Steel ❑ Plastic ❑ Concrete ❑ Fiberglass Age 26 - See advisory if steel older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ® Deep Trench ❑ Wide Trench ❑ Seepage Pit Waiver request for: Expedited review requested: ❑ Distance: By applying for this entitlement, this property is subject to inspection by municipal On-site staff to verify the accuracy of the information provided. COSA Fee $ 55 0 Waiver Fee $ Date of Payment 5�6�2"Z Date of Payment COSA # os C 27_ I ci I Q Waiver # COSA Application—July 2022 copy.doc Legal Description: STIRLING LOT 124A & 124B Parcel ID: 018-262-29 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system A. WELL DATA ® Well log is filed with Onsite (or attached) Date drilled 1/10/1998 Total depth 204 ft Cased to 204 ft ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 8/10/22 Static water level at beginning of test 58 ft. Well production at time of test 4+ gpm Comments B. TANK DATA Measured operating fluid level in septic tank 49" Date of pumping 8/10/22 ❑ Required maintenance completed, if AWWTS Comments: 26 YR OLD TANK — SEE MOA ADVISORY. D. ABSORPTION FIELD DATA Which system tested (date installed) 9/19/96 N ® ALL standpipes present per record drawing Total measured depth from grade 10 ft (max) Measured depth to pipe invert from grade 3_5 ft (min) ❑ N/A — pressurized field. ❑ Per record drawings, field is insulated. ❑ Monitor tubes go to bottom of effective. If not, state depth into effective 8' IR — MEAS. 7.51ED ❑ Presoaked required if (Required if house vacant or field not used for more than 30 days prior to date of test) Gallons introduced gallons date Any rejuvenation treatment (past 12 months) N If yes, enter date Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ® No ® Coliform bacteria is Negative Nitrate 0.233 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) Collected byME Date 8/10/2022 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 8/10/22 Results M Pass Fluid depth prior to test 67 in Water added 500 gal New fluid depth 75 in Elapsed time 1020 min Final fluid depth 64 in Absorption rate 450 god FIELD STATUS — POST RECOVERY Effective depth (per record drawings) 96 in Effective depth used 91 in Effective depth remaining 64 in Comments/Deficiencies: MT/CO AT GRADE. TESTED CURRENT N TRENCH. SYSTEM OPERATING IN THE TOP WS EFFECTIVE DEPTH. S TRENCH HAD 41" OF FLUID & ABSORPED 350 GAL INJECTED. SYSTEM INSULATED PER IR COSA Checklist—July 2022 copy.docx E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well on lot) Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout > 100' ® Yes if No ft ® Yes if No ft Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' Z Yes if No ft Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' ® Yes if No ft ® Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ®Yes if No ft _ ®Yes if No ft ❑ N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No *9 ft Surface Water >100' _ ®Yes if No ft Tank to Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: Field to Property Line > 10' ® Yes if No ft Private Wells >' 100 _ ®Yes if No ft Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No ft Water Service Line > 10' ® Yes if No ft F. ENGINEER'S COMMENTS If tank or field is under driveway comment below *MOA WAIVER OSV181011 S FIELD & FOUNDATION & NOTES FIELD IN DRIVEWAY. G. CERTIFICATION & 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, indicates that the on-site water supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation, unless noted otherwise. Name of Firm FIRST WATER CONSULTING Phone 907-350-9566 Engineer's Printed Name CURTIS HUFFMAN, PE Date 8123122 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic .`1 \`\k applies only to the conditions as of the day tested. The flow and absorption rates may change i due to subsurface conditions that may not be observed from the surface, changes in land use, '���i• . • • • • • . • .:�,�� i local soil characteristics, groundwater levels that may fluctuate during the year, quality of rI�Q"•' construction (workmanship & materials), the water usage of the family being served by the A �j,• •� ��� system and maintenance. The operational life of all well and septic systems are subject to *� TM •�* these various and dynamic characteristics and are outside the control of the evaluator of the , • , , , , , , , • , , , , • , • , , well and septic system. Therefore, any or NO estimate of how long a system will function satisfactory for current or future occupants or guarantee that no unseen encroachments, deficiencies or discrepancies exist can be given by First Water Consulting & • • • • • • • ' fW[.5 � Curtis Huffman FFG' •. CE 128991 �dI • . • 8/23/22 • ��� COSA Checklist—July 2022 copy.docx www.muni.org/onsite Septic Tank Advisory Certificate of On -Site Systems Approval #OSC 221410 Subdivision: Stirling Lot 124B Starting at 20 years of age the MOA issues Advisory's for steel septic tanks The septic tank for this COSA / property is 26 years old. A leaking septic tank may be a source of contamination to the aquifer. Typical replacement costs range from $10,000 to $15,000 This advisory must be attached to all copies of the subject Certificate of On -Site Systems Approval. This is an example of a 16 -year-old septic tank in failure and should be replaced. Mailing Address P O Box 196650 *Anchorage, Alaska 99519 6650 *www muni orgy`. . vs , ,- , -:: ti,.---Nt . • Munici '�ta MAR 2 8 2018 ...i 8 4,, -tic._ On-Site Water and Wastewater am 1! I 1 :3OA1 " nit"'i (907) 343-7904 c, VIE T Y II0I 6 B L0 Certificate of On-Site Systems Approval Parcel I.D. 018-262-29 (o --3C) - 12Expiration Date: 1. GENERAL INFORMATION Complete legal description Stirling Lot 124A &124B Location (site address) 3771 Twilight Ln. Current Property owner(s) Scott & Angela Felger Day phone (907) 229-3568 Mailing address 261 Oertli Ln. Hamilton, MT 59840 Real Estate Agent Day phone 2. TYPE OF DWELLING: O Single Family (w/wo ADU) El Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 . 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well 0 Individual 0 • Individual Water Storage ❑ Holding Tank Cl Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: 177: �J Fu'4'Lfidvx--r:tY\- Distance: Received by: 12/40-11,C4.JAfi)/X- Date: 3/9%a COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ 5Z( t -- y6o✓ �y I bo Waiver Fee $ Date of Payment , I - lig Date of Payment Receipt Number 05(n51 , Receipt Number COSA# OSC.T 1 I 1 0 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. Name of Firm Forge Engineering Phone (907) 522-7773 Address PO Box 240773, Anchorage, AK 99524 Engineer's Printed Name Benjamin Schiller, PE Date 3/23/18 Al • • '•*�j 6. DSD SIGNATURE / ' " System#1 Approved for 3 bedrooms � ( " r / Bella j n Schiller :. System #2 Approved for bedrooms �� ;.• C"12592 � Disapproved kea� !` Conditional approval for bedrooms, with the following stipulations: P -c\( OF Alm/yo ON-SITE CO' WATER AND WASTEWATER o PRO( RAM 4A17.—p\l\(cc; • By: Fc0CL4,11 Ori inal Certificate Date: 3 —3Ly ins g 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 engineery4egjstes d in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. t� 3 ,•� J�' ,� •• t.Y 'tet•• 7. ATTACHMENTS: •,,' COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory. ':. Well Flow Advisory Other ;'�; r ' COSA blue sheet E c If more than 1 septic system is on the lot: COSA Checklist# of Structure served by this system Certificate of On-Site Systems Approval Checklist Legal Description: Stirling Lot 124A &124B Parcel ID: 018-262-29 A. WELL DATA Well type Private If A, B, or C provide PWSID# Well Log (Y/N) Y Date completed 1/10/98 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y Total depth 204 ft. Cased to 204 ft. Casing height (above ground) 24 in. FROM WELL LOG AT INSPECTION Date of test 1/10/98 3/23/18 Static water level 58 ft. 54 ft. Well production 7 g.p.m. 2.6 g.p.m. WATER SAMPLE RESULTS: Coliform Neg colonies/100 mL Nitrate 0.176 mg/L Arsenic ND ug/L Date of sample: 3/13/18 Collected by: Forge Eng B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 9/18/96 Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping 11/15/17 Pumper Around The Clock Pumping C. ABSORPTION FIELD DATA Date installed 9/1 9/96 Soil rating (g.p.d./ft2 or ft2/bdrm) 0.45 GPD/SF System type Deep Trench Length 67/64 ft. Width 3.0 ft. Gravel below pipe 8.0 ft. Total depth 11 8 12 ft. Eff. absorption area 1072/1024 ft2 Monitoring tube Y Depression over field N Date of adequacy test 3/23/18 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 38/35 in. Water added 471/502 42/42 p P gal. New depth in. Elapsed Time: 1440/240 min. Final fluid depth 30/35 in. Absorption rate >= 450/450 g p d N Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date 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 WELL ON LOT TO: Septic tank/lift station on lot >100' On adjacent lots >100' Absorption field on lot >100' On adjacent lots >100' Public sewer main >75' Public sewer manhole/cleanout >100' Sewer/septic service line >25' Holding tank >75' Animal containment areas >50' Manure/animal excrete storage areas >100' SEPTIC/HOLDING TANK ON LOT TO: 10' >5' >5' Building foundation Property line Absorption field Water main >1 0' Water service line >1 0' Surface water >100' Wells on adjacent lots >100' ABSORPTION FIELD1 OO'N LOT TO: rr ; ' Property line > Building foundation >�Q Water main >10' >10' > Water Service line Surface water >1�� Driveway, parking/vehicle storage Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS *Both septics presoaked with 2000 gal. each and tested separately. G. ENGINEER'S CERTIFICATION ,."�- I certify that I have determined through field inspections and ���;•' ��+�AAle � review of Municipal records that the above systems are in %A *.•49 pi_• '••* , conformance with MOA COSA guidelines in effect on this date. .,.. Engineer's Printed Name Benjamin Schiller, PE •.. Date 3/23/18 6 c, seri in Schiller S i 4,�''•. CE 12592 ..wkii s41‘.�F cI COSA brown sheet 10-10-12.doc • ,L y678 a 70 '' RUSH A X GF • ENGINEERINGQI 6 8 � p� , PO BOX 240773 ANCHORAGE,AK 99524 522-7773 677-7766(FAX) March 29, 2018 Municipality of Anchorage Development Services Dept- On-Site Water& Wastewater Program 4700 Elmore Rd Anchorage,AK 99507 Subject: Stirling L124A& 124B—3771 Twilight Septic trench evaluation Dear On-Site Services Engineer: The owner of the above lot has an approved septic system consisting of two full trenches connected with a bull-run valve,allowing for switching back and forth. During construction of the home,the foundation was build 9' away from the second trench, and the driveway was placed over it. All the pipes for this trench were covered with metal caps that allow access to the pipes while supporting them for vehicular traffic. As-built documentation is clear that the trench is insulated, and field measurement show that it has more than 2' of additional cover. As the system has been in place for over 20 years, and there is no evidence of settling or cracking of pavement, it is clear that the rock and pipes are under sufficient fill so as to structurally support the driveway. We are asking for a waiver for the 9' separation to the foundation.There is sufficient distance that if there were problems with the trench, it could be excavated with precautions so as to protect the home,and there is no evidence that the foundation has been stressed at all by the proximity to the trench. In addition to all of this,there are no indications of any problems with the septic system in the past 22 years of service. It is evident that this system will continue to function in compliance with regulation as it was built. Sincerely, � ill Benjamin Schiller, PE %° P • ^O` = ui �1 �� �••• Benjachiller j .�S �` 1 d + F CE 12592 • / a. �tG/4: . . 3/27/18.• ,� �,( illi oFEssi00-... 3118' -- p,fnr it Municipality of Anchorage I>•partnit nt P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax(907) 343-7997 http://www.muni.orq/Onsite Development Services Department On-Site Water and Wastewater Section **** VARIANCE/WAIVER REVIEW *** Waiver#: OSV181011 COSA#: OSC181110 Permit#: PID#: 018-262-29 Legal Description: Stirling Lot 124A& 124B Engineer: Forge Engineering Applicant: Scott&Angela Felger Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the foundation has been approved. The approved separation distance is 9.0 feet. In addition, the location of the drainfield under the driveway is approved. See engineer's waiver request letter for justifications. This waiver approval applies to the existing absorption 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. Waiver is Granted: X Waiver is not Granted: Date: 34o/18 Approved by: f.)4 Name of Reviewer **** VARIANCE/WAIVER REVIEW **** Lot 102 Lot 101 . . N ,` _ O S 89'58'43"E 299.47' tri 1.5' CANT z I 10.0' SEPTIC PIPESco o COVERED o DECK_ q_ n -F.111040 W ,, 175.3' 4 62.7' m / 68.3' • . \ Lot 124B Cji iv COVDECDK t • 49,493 s.f. / 2 STORY RESIDENCE— • '''•• • •. 8'x35' CONEX r" w/ FULL BSMT. • ci ••• • • • SEPTIC PIPE 0 Lot (123 WELL •' C7 A N 89'58'43"W 299.57' z �oI OM�F 0 ` O/ / 3' R.O.W. & UTILITY EASEMENT O \ 7p "P -7 • C W mss, ' ��: : Lot 124A 4 ''' ----10' 40,319 s.f. r*i Z UTILITY EASEMENT -'.,:i'in :.: . F m .i.j‘l \ -------.- / �gq}- a, - • . cn W . . N 3' R.O.W. & UTILITY EASEMENT --I — — 30.0' N 90'00'00"W 299.65' I cil TWILIGHT LANE PLOT PLAN AS BUILT X SCALE 1" = 60' GRID SW 3035 Project No. 18-082/A1 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associates , inc . (907) 522-6476 Phone Q000000� (907) 522-4625 Fax oo OFA / \�'N Professional Land Surveyors kenOlangsurvey.com . '''''z:. c . jonathanOlangsurvey.com DoP s QO I hereby certify that I have surveyed the following described property: QOM• 1" ...-r-1„ LOTS 124A & 124B, STIRLING SUBDIVISION (PLAT No. 84-486) 0* 49TH . * 0 Anchorage Recording District, Alaska, and that the improvements situated thereon are 0 VA within the property lines and do not encroach onto the property adjacent thereto, that D no improvements on the property lying adjacent thereto encroach on the surveyed /o `i?'��KEN N0. premises and that there are no roadways, transmission lines or other visible mac, '. + o vivqtg easements on said property except as indicated hereon. Q 4p ,p•'•.Ls-5202.•'' gJv� Dated this the ,, Day of ?,A•62c , 201 , at Anchorage, Alaska OQ A ao 0 OR°�SSIONA'- o It is the responsibility of the owner to determine the existence of any easements, DOOoo�oa covenants, or restrictions which do not appear on the recorded subdivision plat. AECC963