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HomeMy WebLinkAboutSUNNY VALLEY LT 23Sunny Valley Lot 23 #050-354-07 ~ 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 LEGAL DESCRIPTION ~ ~ Manufact~ ~ ~ / ia of ~partments L~l,o.s IF HOMEMADE: I.sJd. le.gth Width Liquid depth O ~ ~ Manufacturer Material Liquid capacity in gal]OhS ~ Well Foundation Nearest lot line PERMIT NO. . . Class ~ 'T De~th/~ / ~.~ Distance to lot line PERMIT "O. ~ ~ DISTANCE TO: Building foundation / Sewer line Septic tank Absorption area(s) OTHER - REMARKS CHUGIAK, ALASKA 688-3199 PA '11 DRILLING CON' WE SERVE ALL ALASKA POST OFFICE BOX 42 - CHUGIAK, ALASKA 99567 OWNER OF LAND ...r i1Q a5.. &...Sherryll..Coo p.:....: ............... ADDRESS ..S. T...'G%...?. ._: ....::f x.£ �: =s....lal S:n?..................... WELL - SITE .....L2? Sunny Valley Sub. ER .................................................................................. DATE - STARTED ........................... :7an....2 4......19.8......................... DATE- ENDED ................................. aT. ^....3..r....1.9.8.4......................... KIND OF FORMATION: Redrill KODIAK, ALASKA 486-4826 DEPTH OF WELL....................175ft. ................................................................... STATIC LEVEL OF WATER FT. ....... 1.15.... i} .,,1;.��c,,,cs.' .,..,.,.,.. DRAW DOWN FT........X-.00............e.....st...., ....................................................... GALS. PER HR..... 48.O...G., P..y?........es.t........................................... KIND OF CASING .................. Zft. of 5'° Sch;=40 .„...,,,,,, FROM..... 0 .............. FT. TO ....... .............FT...Oy. FT.. rbt,rden ............... FROM..... 2C4..........FT.TO.....��s:...........FT...Sil'. ........ ................... .��......... FT. TO ......15:9........ FT...Suf?d...Silc...&..Gravel FROM ....................... FT. TO ........................ FT.............:............. ................................ Plugged Back 17Z FROM ......1 .............. FT. TO ......2.1.:........ Sand & Silt FROM ....................... FT. ..Su, fc tea.ter FROM .... -2-41 .......... FT. TO ........................ FT................................. FROM ..... 1........... FT. TO ....... ?.......... FT...= ard...Pa? ........... FROM ....................... FT. TO ........................ FT................................. FROM ...... 3.5........... FT. TO .......7.5.......... FT:................................ FT...Si.l:t ... &... Gravel FROM ....................... FT. TO ........................ FT................................. FROM ......L '............ FT. TO ......95.......... FT. J.a ders........... FROM .................:..... FT. TO .......................: FT................................. FROM ..... .2-5........... FT. TO ...... x110........ FT..?;.dat...cIal:..j........ FROM ....................... FT. TO ........................ FT................................. FROM .....1) FT. TO .......1 0 :. FT...5. ., & TPi ater ....... . FROM ....................... FT. TO ........................ FT................................. FROM ......1.Q?......... FT. TO .......25........ FT.. Wamen..&..utavel FROM ....................... FT. TO ........................ FT................................. FROM ..... .��......... FT. TO ......15:9........ FT...Suf?d...Silc...&..Gravel FROM ....................... FT. TO ........................ FT.............:............. ................................ FROM..:................. 5c FT: TO.; ..................... 172 FT.................................... Sand & Silt FROM ....................... FT. TO ........................ FT................................. FROM ......17' 2......... FT. TO ......?:'?:S........ FROM ....................... FT. TO ....................... FT.................................. FROM ...... 7 ;........ FT. TO ..:..:2.04....... FT...cand ... &.... i3 .. FROM ....................... FT. TO ........................ FT:................................ MISCL. INFORMATION: Hang pump 20' off bottom- I6 ° gravel pack in bottom of well. No Karranty or no v.arranties implied. = }� pl„ ; . wel-J r-erirate(f 1721 ft. to 175 ft. Fer_.-rcti.�,. yrc:uvei .:•a -iced fCrYC.--....�t. DRILLERS NAME ............ ......:::.............................................................................................. MUNICIPALITY OF ANCHORAGE . Department[ f Health and EnvironmentaL~rotection · 825 ~ Street, Anchorage, AK. ~501 264-4720 ~.~ * * * HANDWRITTEN PERMIT * * * Permit ~ ~, , WELL AND/OR ON-SITE SEWER PERMIT App:licant: ~ O~-7-A~-~ ~M~,~, Mailing Address:~/~ Location: ~Cf B ~-"~' ~O~ Legal Description: ~o7- 23 ~vW Type of Soil Absorption System Is: Trench: Drainfield: Maximum Number of Bedrooms: ,~ Phone Number: ~ ~ ~L~ Lot Size: Seepage Bed: ~-~/--~Holding Tank: Soil Rating(sq.ft/br) ///~/--~ T~he~ Required ~Size off, the Soil ~so.,rption Sys~t_em Is: DEPTH LENGTH GRAVEL DEPTH W I DTH The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE = /~)~) GALLONS * * Perr~it applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. * * * TWO(2) INSPECTIONS ARE REQUIRED * * * 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 is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimura distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 8 3 * * * I certify that: (1) Z am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. may require~enla, r~ement if (3) I under st and that the on-site s ewer system t~~' '--~~ the residenct~s reydeled to inslude more Date: ~,, A SWP/024 (1/81) EXCAVATION ROBERT A. SHAFER WORK CIVIL ENGINEER 694-2979 Specifications for elevated bed alternative waste water treatment system. I..General A. All excavations and depths are advisory and are to be verified or modified in the field by an engineer. Ail materials and workmanship shall meet the requirements Of Anchorage Department of Health and Environmental Protection permit. II. Lift Station A. The stock material for the lift station shall be either galvanized steel (ASTM A-4444-76) or aluminum culvert, capable of burial to 10 feet. The 24 inch pipe for the lift station shall have a welded water tight bottom of the same thickness and composite as the culvert. C. The top cap shall be rain tight and fastened with screws. D. Ail electrical fittings and connections in the lift station shall meet the requirements for a water tight service. E. The sump pump shall be capable of delivering approximately 10 GpM at a head of 20 feet. F. The .sump pump shall be suspended not less than 6 inches off the ~ bottom of the lift station with a chain or nylon line. III..Seepage Bed A. The gravel for the bed shall be screened to sizes of ½ inch to 2~ inches. The berm around the permeable material, feet horozontal. seepage bed shall be constructed of im~ and on a slope of 1 foot vertical per 2.5 C. The bottom elevation of the bed shall be plus or minus 2 inches. D. The insulation required shall be dow extruded blue st'~r~ofoam :', insulation board of the 2 inch thickness, or equal. SRB 196X EAGLE RIVER~ ALASKA EXCAVATION ROBERT A. SHAFER CIVIL ENGINEER 694-2979 I~L 4~/ L ~ /~ SRB 196X EAGLE RIVER, ALASKA EXCAVATION ROBERTA. SHAFER WORK CIVIL ENGINEER 694-2979 SRB 196X EAGLE RIVER, ALASKA EXCAVATION ROBERT A. SHAFER WORK CIVIL ENGINEER 694-2979 SRB 196X EAGLE RIVER,ALASKA EXCAVATI ON ROBERT A. SHAFER WORK CIVIL ENGINEER 694-2979 LIFT STATION GROUND VARIABLE CHAIN_ .OR NYL©N RO 2" TO 4 C0I. TO' ..<, , BED SI LlC£ CAULKING .../.'---METAL _CAP '~-'--SC R EW.'5 4 BOX CONDUIT LAMP ~P.--POWE R CORD VAR1ABLE, '~ FtEAT LAMP FOR DRAIN HOLE~ 2~/ PVC PIPE SUMP PUMF I ,4, -~' METAL PLATE- WINTER USE, SRB 196X EAGLE RIVER, ALASKA LARM CORD -$1LLCQNE CAULKING PVC PIPE FROM' SEPTIC TANK ILLET WELD ALL AROUND MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street. Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST ~ SOILS LOG [] PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9- 10- 11 13. 14- 15- 16- 17- 18- 19- 20- SLOPE ,/ OATE PERFORMED: SITE PLAN N ENCOUNTERED? Gro~ Net Depth to Net Reading D ~e Time Water Drop / / PERCOLATION RATE ~/~ (minutes/inch) .~L~B ETWEE.~.~.N FT AND -- FT • Municipality of Anchorage _ I_ On-Site Water&Wastewater Program - q'I'' "'''�� (907)343-7904 5 6 7 8 9 7 n.�11I�Ill/ CERTIFICATE OF ON—SITE SYSTEMS A - OVAL Q:? a d i Parcel I.D. 050-354-07 Expiration D't-s. es' mod ' ` 1. GENERAL INFORMATION Complete legal description SUNNY VALLEY; LOT 23 Location (site address) 9340 WEST LAKE DRIVE*EAGLE RIVER,AK Current Property owner(s) JAMES E.CAUDILL Day phone 907-297-9216 Mailing address 9340 WEST LAKE DRIVE'EAGLE RIVER,AK Real Estate Agent LINDSEY BERGERON Day phone 907-622-5000 2. TYPE OF DWELLING: ▪ Single Family(w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well U Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well 0 Community On-site 0 Public Water System ❑ Public Sewer 0 WaiverNariance request for. N/A Distance: - Received by: `— Date: F/0/7 COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee$ 5Zh Waiver Fee$ Date of Payment S'Ict Date of Payment Receipt Number ONg0 `-'� Receipt Number COSA# C.1 5`/g• 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 GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179 Address 3701 E.TUDOR ROAD, SUITE 101 "ANCHORAGE,AK, 99507 J Engineer's Printed Name JEFFREY A. GARNESS,P.E. Date gl f i a Engineer's Comments: in conducting this evaluation,GEG provided an engineering evaluation of the well androrseptic system in accordance with the +�**Atv\II 4 1 guidelines and regulations established by the Municipality of Anchorage and industry practices.The reported results describe the .44. ♦4�� OF (14,6/1;;;„ condition of the systems on the date's of the evaluation.Separation distances were measured to madly identifiable features. � Hidden defects or encroachments may exist that were not identified during the evaaluation.The operational life of all wells and septic systems depend on a variety of variables including,but not limited to,soil conditions,groundwater levels(that may fluctuate during • 1 v* • the year),quality of construction(materials and workmanship),and the wale'usage of the family utilizing the system/S.These * *j' I. ';* •f• 0 conditions can vary,and are outside the control of GEG.Satisfactory test results do not guarantee future performance of the r,,,,,., ,.. ,. r„,.". 0 systeMs;therefore,GEG makes no warranty(express or implied)regardng the future performance of the weD or septic system. 0 J • GEG makes no representation whether analernativewell orseptic system can beinstalled onthe property krthe event either ofthe 0 v,,l�„ „ 4 / current systems fail,The content of this report is for the sole benefit oldie perso'party who retained GEG.Reliance upon the • • r- A. Garet ss information provided in this report by any other person or party,includ'ng but not limted to subsequent property purchasers,is not ♦ G� J I 7 l�r authorized.in shod,GEG disavows any legal duty to anyone other than the person/party who paid for this report. .• rJ E-T954 95 i .•' ei BiL,P<c4 6. DSD SIGNATURE LICENS • E 14 ESS .4. System#1 Approved for -3 bedrooms. System#2 Approved for bedrooms. Disapproved. ' , Conditional approval for bedrooms,with the following stipulation` ON-SITE WATER G R AND ..ft... n WASTE1IVATLR Z •:‘ IU•ro,GORAlVl e. n By: - ` Original Certificate Dater I O—( 7 The Municipality or Anchorage Develop,emt Services Division(DSD)issues Certificates of On-Site Systems Approval(COSA)based only upon the represenatations 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. ATTCHMENTS: COSA Checklist Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other (Rev.10/12112) 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 SUNNY VALLEY. LOT 23 Parcel ID: 050-354-07 A. WELL DATA **SEE NOTE IN WELL LOG: WELL WAS"PLUGGED BACK TO 174" Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES Date completed 1!311984 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES Total depth 176 ft. Cased to '"241 ft Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test 1/31/1984 7/31/2017 Static water level 61 (7) ft. 16 ft. Well production 8.0 g.p.m. 1 1+ g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate ND mg./L. Collected by. GEG. Ltd. Arsenic: <5.0 ug IL Date of sample: 7/31/2017 34 YEAR OLD STEEL SEPTIC TANK IS B. SEPTIC/HOLDING TANK DATA APPROACHING THE END OF IT'S USEFUL LIFE Tank Type/Material SEPTIC/STEEL Date installed 10/30/1983 Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) YES Foundation cleanout (YIN)(YIN) 1A,L Depression over tank (Y/N) NO High water alarm (YIN) N/A JR'S PUMPING 7/6/2017 Date of pumpingPumper C. ABSORPTION FIELD DATA I'BELOw EXISTING GRADE I '+ADECiDEDESIGNIGN CR TERRIAOFOR DRAINFIENL D SIZINGETS Date installed 10/30/1983 Soil rating (g.p.d.Ift`or t�`/bdr3"125 System type BED Length 25 ft. Width 18 ft. Gravel below pipe 0.5 ft. Total depth 4.1+ ft. Eff. absorption area "450 ft2 Monitoring tube YES Depression over field NO Date of adequacy test 7/31/2017 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 0 in. Water added 484 gal. New depth 0 in. Elapsed Time: 0 min. Final fluid depth 0 in Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes. give date - MT EXTENTS 12 5"BELOW THE INVERT OF ADJACENT CLEANOUT D. LIFT STATION Date installed Size in gallons Manhole/Access (YIN) "Pump on"level at in. "Pump off' level at .. wa er alarm level at in. •- _ •• Cycles tested Meets alarm &circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot *91 On adjacent lots 100'+ Absorption field on lot- 100'+ On adjacent lots 1004 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'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water *95' Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line "0' Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water `70' Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS 'WAIVER ON FILE WITH MOA; ROAD DITCH WAS DRY DURING OUR INSPECTION ON 7/31/2017 ••WR#070052 G. ENGINEER'S CERTIFICATION •4P•`P,.•••••••• ' .1 I certify that I have determined through field inspections and 1. ••;:•••• 49 • • r review of Municipal records that the above systems are in N •, conformance with MOA COSA guidelines in effect on this •• . • •• ••••;• •y date. ♦cm'•1•e•fr/e A Game s; LL,■ s Engineers GI Printed Name JEFFREY A. GARNESS •�j >.*. $ B •••; C.i Date / 1 f .4.,PROFESS\ .••• LICENSE litlisswr *AECC884 (Rev.10/12/12) \ ',..... --� li \ \ , \ \ Lot 21 \ \ sSho\ \ 0a / i / 10' UTILITY EASEMENTS \\ \ / // Lot 24 0 0l., 0 o h b 0 Z 10.1 'x 10.2' SHED BALCONY Lot 23 WELL— 4,e1:r'*° ._ 1.999 Acres o , fy o• 34.. co �� 1,° $ Lot 226 GRAVEL •. 0 •: DRIVEWAY ` 0 0 cn pp SEPTIC PIPES ...:.-L o N 90'00'00"W 304.00' 0 iiil — — — — — — WEST LAKE DRIVE PLOT PLAN AS BUILT x SCALE 1" = 60' GRID SW 0057 Project No. 17-246/A1 1150064 DarylAvenue. Phone nu Anchorage, Alaska 99515-3049 _ang & Associates , inc . (907) (907) 522-4625 Fax a�0 A ` 'N Professional Land Surveyors kenolangsurvey.com ! , . ,q it jonothanOlangsurvey.com K ' S d1� hereby certify that I have surveyed the following described property: Qoo, q . ;d\ �OY LOT 23, SUNNY VALLEY SUBDIVISION (PLAT P-631) $ *' 49Th i '..--57*, Va nchorage Recording District, Alaska, and that the improvements situated thereon are ti i 'Rhin the property lines and do not encroach onto the property adjacent thereto, that V , ( V o Improvements on the property lying adjacent thereto encroach on the surveyed (� ` 1 . Q KENNETH G. LAID 1 . remises and that there are no roadways, transmission lines or other visible ¢c' ,• . 00 asements on said property except as indicated hereon. Ifpc�i,, 1•!1:O - I ated this the Day of , at Anchorage, Alaska Q p o� O�p'PO ssioNA- ' Is the responsibility of the owner to determine the existence of any easements, 0ft04�Qa "✓ 0 Municipality of Anchorage -� Development Services Department x. Building Safety Division • +• ' On -Site Water 8 Wastewater Program 4700 Bragaw Street ` P.O. Box 196650 Anchorage. AK 99519-6650 650 www.m) 343-7/onsite ✓✓// till y5to' (907)343-7904 y J CERTIFICATE OF ON-SITE SYSAPPROVAL FOR A SINGLE FAMILY DWELLING f Parcel I.D. 0'610— 39101 COSH# ►—I (�70 3��� 0 00 1. GENERAL INFORMATION Expiration Date: Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent . Mailing address SUNNY VALLEY LOT 23 ' 9340 WEST LAKE DRIVE • EAGLE RIVER AK 99577 TOM AND SHERRY COOK Day phone 694-6840 PO BOX 772368 • EAGLE RIVER AK 99577 Day phone MARIANNE HAMILTON w/DYNAMIC Day phone 317-5756 3111 'C° STREET • ANCHORAGE AK 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site ❑ Individual Water Storage ❑ Individual Holding tank ❑ Community Class Weil ❑ 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 samples. (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 engineers work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified byp? 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 A plbvXGuidelines for this application, sltows that the on-site water supply and/or wastewater disposal system is (are) saa, li[ * bona/ and adequate Vor the number of bedrooms and type of structure indicated herein. I further verify the based on fhb e" information obtained from the Municipality of Anchorage riles and from my investigation and ftispectiexl, 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 GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179 Address 3701 E. TUDOR ROAD, SURE 101 • ANCHORAGE, AK 99507 Engineers Printed Name JEFFREY A. GARNESS, P.E. Engineers Comments: In conducting this evaluation, GEG, VD. attempted to provide a thorough, conscientious engineering analysis of the system In accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the lest, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory last results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report Is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party Is not authorized, nor will It confer any legal right whatsoever. 5. DSD SIGNATURE V/ Approved for _ 3 bedrooms. Disapproved. Conditional approval for bedrooms, with the flowing Date 10/7-/0;7 F \QP���Y �821bns: �'•.'Py ON-SITE : c `?d4T€RAND WASTEWATER Attachments: / COSA Checklist t/ Arsenic Advisory Septic System Advisory Maintenance Agreements Well Flow Advisory Supplemental Engineers Reort Nitrate Advisory Other By: Original Certificate Date: )0 11 T 1111 (rew.1IMS) Municipality of Anchorage Development Services Department =� Building Safety Division On -Site Water & Wastewater Program ' • " 4700 Bragaw Street P.O. Box 108850 Anchorage, AK 995111.8650 www.muni.org/onsite (907)343.7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: SUNNY VALLEY, LOT 23 Parcel A. WELL DATA Well" PWAX If A, B, or C provide PWSID# N A Data completed 1/31/1984 Sanitary seal (YIN) YES Total depth 241 ft, Cased to 176+ ft. FROM WELL LOG Date of test 1/31/1984 Static water level 115 ft. Well production 8 9 -P.M. WATER SAMPLE RESULTS: Coliform a colonies/100 ml. Nitrate N/A mg./L. Well Log (YIN) YES Wires properly Protected (YIN) YES Casing height (above ground) 18 in. AT INSPECTION 9/27/2007 39 ft. . 1.03 g.p.m. Other bacteria 0 colonies/100 ml. Arsenic: 0.76 ug./L. Date of sample: 9/17/2007 Collected by: GEG Ltd. B. SEPTIC/NOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date installed 10/30/1983 Tank size 1000 gal. Number of Compartments 2 Cleanouts (YIN) YES Foundation cleanout (YIN) YES Depression over tank (YIN) NO High water alarm (YIN) N/A Date of pumping 9/19/2007 Pumper JRS THERE IS INSULATION OVER C. ABSORPTION FIELD DATA PRELOW EXISMG TANK AND DRAINFIELD Date installed 10/30/1953 Solt rating .p.d. r ft'/bdrm) 125 System type BED Length 25 ft. Width 18 ft. Gravel below pipe 0.5 ft. Total depth !3.67 ft. Eff. absorption area 450 ft' Monitoring tube YES Depression over field NO Date of adequacy test 9/27/2007 Results (Pass/Fall) PASS For 3 bedrooms Fluid depth In absorption field before test DRY in. Water added 450 gal. New depth DRY in. Elapsed Time: 0 min. Final fluid depth DRY in. Absorption rate >= 450+ g,p.d. Any rejuvenation treatment (past 12 mo.) (YIN 8 type) NONE KNOWN If yes, give date — D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N "Pump on" level at _in. "Pump off I High water alarm level at in. Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot *91'+ On adjacent lots 100'+ Absorption field on lot 100'+ On adjacent lots 100'+ Public sewer main N/A Sewer /septic service line 25'+ Animal containment areas 50'+ Public sewer manhole/cleanout N/A Holding tank N/A 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 N/A Water service line 10'+ Surface water *95,4 - Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line *0' Building foundation 100+ Water main N/A Water service line 10'+ Surface water *70- Driveway, parking/vehicle storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS *SEE ATTACHED WAIVER REQUESTS. G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this j . .. ........... date. .... Go ess,- Engineer's Printed Name JEFFREY A. GARNESS ' , CE— Date Lo -.;L �•.,dPA�.��a COSA Fae 730 f %dui k - Date of Payment /d Receipt Number. 5� (Rev. 41M) Waiver Fee $ Date of Payment �� 3 Receipt Number SEP -28-2007 FRI 09:58 AM DYNAMIC PROPERTIES FAX NO. 9072617446 0 SURVEY CERTIFICATION PLOT PLAN F I.I•�... rY. rw. .r Ml w��r1Y�M�M..•rl.. n `------- ;fyo� P. 02/02 4\ Robert E. 11 IC 60' Prepared by Johns, Jr. & Assoc. ionol_Lond Surveyors Lot Ne. FOUNDA1104 AS -BUILT L .�.. +... •....r �.•. r 1 V t _ fl qul. �y e: Dlown er GI�b[W by. rrr w r Ir .r r� lti .......... : T JOHNS. •• n. Oa• Dro•nl GfM: R.O. �:. _ '. W.�ww.~...•1'�� /I u �1�l 4121-5 - - 213 MAL SIRDCTURE AS -BUILT L+t. ,. A•i1..Rr la1 ; ,•`� r •.• ; •' �� • 1, •/,O ••............... L•Sal D..ulFllln: LW M. MIN. r MMI W r W. na :�� Lot 23 H� F•••bnd L' IED ��eeeRwwww�w Sunny Valley Subf'ivision ❑ LOT SH SURVEY TYPE SYMBOLS �'•� ❑ FO•OATW AS -BUTT • SET REBAR• =ORANAOE ASPHALT C3 RIML slRuellAlc ?T FOUND REBAR ��. MOOD FTNCE I--�3 CONCRETE C) PLOT RIIN ... ' CORN .OT YRtKY ... TC•OM.VNY AS-"T..L �o� (I 00 9) ASSUMCD OLEV. - " .. METAL FENCE PLOT PLANS & LOT SURVEYS Nom: IT IS THE RESPONSIBILITY OF THE BUILDER OR OWNER. PRIOR TO ONLY THOS[ IMPROVCMCNTS ABOVE *ROUND AND VISIBLE WILL BE CONSTRUCTION, TO VERIFY PROPOSED DUILDINO GRADE RELATIVE SHOWN. FENCES„ WELLS SEPTIC CLEANOUTS. SIOCWALXS. DRIVEWAYS. TO FINISHED CRADE AND UTILITY CONNECTIONS AND TO DETERMINE ETC.. ANE SHOWN IN THEIR APPROXIMATE LOCATION. ONLY. SNOW THE EXISTENCE OF ANY EASEMENTS. COVENANTS OR RESTRICTIONS MAY PREVENT SOME IMPROVEMENTS FROM BEINC SEEN AND LOCATED. WHICH DO NOT APPEAR ON THE REQOROED ,,ORPLAT. AI.L P1R OROJUSTANCES SHOULD AN AS-BULT BE USW FOR CONSTRUCTION OR FOR ESTABLISHNC BOUNDARY OR FENCE LINES. UNDER NO INC SURVEYOR TAXCS RESPONSIBILITY FOR THE INITIAL TRANSACTION ONLY AND ASSUMES FINANCIAL UABILITY ONLY rOR THE COST OF THC WRVLT. LISTED w-TAWCCS PRCVAL OVER SCALING. REPRODUCTION MAY CAUSC ERRORS N SCAIF Mayor Mark Begich Muldeipality of Anehorage I.0. Ik,x 1!N CA0 • ltnellomgc, Al:lska!KAil9d'iGi0 • Tcicphnnc (9)7) 3t3!CN11 • Taz (907) 33.4f " 47(10 I1m), m Slrccl • Anchorage, Alaska 99507 %mwtnun!.org October 3, 2007 Iluilding Safety Division Jeffrey Garness, P.E. Garness Engineering Group 3701 E. Tudor Road, Suite 101 Anchorage, AK 99507 Subject: Waiver Request for Sunny Valley Waiver Request WR#: 070052 Parcel ID # 050-354-07 IIA070315 Dear Jeffrey Garness, P.E.: 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 91.0 feet. Also your request for a waiver of the required 100 feet horizontal separation from the septic tank to the surface water has been approved. The approved separation distance is 70.0 feet. And a 0 foot horizontal separation from absorption field to south lot line is approved. 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, 1 J od,II Ci Engineer On -Site Water & Wastewater Program Community, Security, Prosperity GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS 3 GENERAL CONTRACTORS October 3, 2007 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 Attn: Joe Goodall Ref: Sunny Valley, Lot 23. Waiver of Separation Distance Between Surface Water and the Drainfield on Property. Mr. Goodall: On October 3, the MOA performed a mandatory site visit to the subject property to evaluate a waiver that was requested by our office. During the MOA site visit, several concerns were identified. They are summarized as follows: There was a slight depression around the well head. GEG staff member Kyle Maus returned to the site today and corrected the situation. Attached is a photograph of the well head. The dminfield is less than 50 feet uphill from a slope that is over 50%. Slope conditions such as this are not addressed on the COSA questionnaire, nor have they been addressed historically in the HAA/COSA process. The septic system was installed in 1983. During our site visits we never noticed effluent daylighting from the cutbank/slope. In short, there is no reason to believe the proximity of the drainfield to the 25%+ grade slope is going to be problematic in the future. The mounded bed does not have 3:1 slopes that are vegetated. During our evaluation of the system (when a new MT and CO were installed) it became apparent that a portion of the drainfield only had about 6-12 inches of soil cover over it. Even though this issue is not a item that must be addressed on the COSA questionnaire, we told our client that fill would need to be placed over the insulated bed so as to provide a minimum of 2 feet of soil cover. This work was done; however, the impacted area was not topsoiled/seeded. During our evaluation it was noted that the drainfield was completely dry (after 24 years in service). Based upon the 125 soil rating, it is reasonable that the drainfield effluent moves downward rather rapidly into the insitu soil, with very little lateral migration. Given the fact that the septic system has operated as long as it has with no daylighting, it 3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507-1259 Ph: (907) 337-6179 • Fax: (907) 338-3246' Website: www.gamessenginecring.com is reasonable to believe that there will be no adverse impact associated with leaving the recently imported fill un -vegetated. Surface water was identified in the road ditch approximately 70 feet away from the drainfield and 95 feet away from the septic tank. Attached is a drawing which shows the approximate location of the water on 10/3/07. GEG employee Kyle Maus has made a number of site visits to this property. During his site visits the subject ditch was dry. It is our assertion that the water in the road ditch is intermittent and probably the result of recent rains. To be conservative, we are requesting that your department grant a waiver of 70 feet between the drainfield and the surface water and 95 feet between the septic tank and the surface water. Justification for the waivers are summarized as follows: o The surface water appears to be intermittent and it is debatable whether a waiver is even required. o The drainfield and septic tank are located in a visible location and if it were to overflow or daylight sewage it would not go unnoticed. There is only a cleanout and monitoring tube in the southeast comer of the bed. Overflowing effluent from the tank or drainfield would have to flow down the east side of the driveway until it reaches the road ditch, and then westward in the road ditch until it reaches the surface water. If either were to overflow, the path of migration to the surface water would be over 100 feet. o The septic system was installed in 1983. To the best of our knowledge, this encroachment has existed for 24 years with no adverse impact. please contact us at 337-6179. Thank you for your assistance. R.S. 3701 E. Tudor Road Suite 101 • Anchorage, AK 99507-1259 Ph: (907) 337-6179 • Fax: (907) 338-3246 " Website: www.gamessengincering.com / / i / 1 I 100' WELL RADIUS I � I 1 1 EXISTING J BEDROOM HOUSE \ WEST LAKE DRIVE O O GARNESS ENGINEERING GROUP, Ltd. --•- •-••--=-• CONSULTANTS 3 GENERAL CONTRACTO.......... 3MI G TI000 OMD. lf01C 101. ANCHOWL Mt WW1. ,110.[ 007)3 1-0111 • FM (W)1.IXM 10 PREPARED FOR: PHONE NUMBER: PAGE NUMBER: TOM AND SHERRY COOK 694-6840 2 OF 2 ns, tr LEGAL DESCRIPTION: SUNNY VALLEY, LOT 23 TWE OF WORK: AS—BUILT (R.. 01105) K.D.M. VUXri ••IQ 10/3/2007 1 I 1 I I I / I / r ••p A.-G4ness.: SUNNY VALLEY S/D. LOT 20 [SEPTIC SUNNY VALLEY S/D. ARE�D LOT 21A :PTI \ 0' WELL RADIUS>�t\ / SUNNY VALLEY S/D. \ / LAT 218 \ \ 100' I SUNNY VALLEY S/D. iii2� LOT 27 / / / SUNNY VALLEY LOT 22A 100' WELL RADIUS r 1 SUNNY VALLEY S/D. \ LOT 228 —_------- WES!-LAKEn&&E—_ C�0? SUNNY VALLEY S/D. LOT 28 SUNNY VALLEY S/D. LOT 29 GARNLSS ENGINEERING GROUP, Ltd. 49 •-..., .•- »-.•- •.•.-• CONSULTANTS& GENERAL CONTRACTORS •• ••• . ......• ......••• f0� [ 1Up011 fOb, fort 10� • . AK WJO> • A.Y( - 1" • IY w . f[ .. w.. PREPARED FOR: PHONE NUMBER: PACE NUMBER: ••• •• ......•• ......; ••• TOM AND SHERRY COOK 694-6840 1 OF 2 Q o f y G ness; LEGAL DESCRIPTION: DRAWN BY: QO J �� CE -79 ,53 •• `FG SUNNY VALLEY, LOT 23 K.D.M. 00_,^\p ' Tp. 17/IO'� �Ao TYPE OF WORK: UATE: `QQO4Op�oOoo� SITE PLAN 10/3/2007 (Rw. OIMS) SUNNY VALLEY S/D. \ \ / LOT 24 3EXISTING BEDROOM / HOUSE 100' WELL RADIUS I C� \ / INTERMITTENT SURFACE I WATER IN ROAD DITCH �--' _ I SUNNY VALLEY S/D. iii2� LOT 27 / / / SUNNY VALLEY LOT 22A 100' WELL RADIUS r 1 SUNNY VALLEY S/D. \ LOT 228 —_------- WES!-LAKEn&&E—_ C�0? SUNNY VALLEY S/D. LOT 28 SUNNY VALLEY S/D. LOT 29 GARNLSS ENGINEERING GROUP, Ltd. 49 •-..., .•- »-.•- •.•.-• CONSULTANTS& GENERAL CONTRACTORS •• ••• . ......• ......••• f0� [ 1Up011 fOb, fort 10� • . AK WJO> • A.Y( - 1" • IY w . f[ .. w.. PREPARED FOR: PHONE NUMBER: PACE NUMBER: ••• •• ......•• ......; ••• TOM AND SHERRY COOK 694-6840 1 OF 2 Q o f y G ness; LEGAL DESCRIPTION: DRAWN BY: QO J �� CE -79 ,53 •• `FG SUNNY VALLEY, LOT 23 K.D.M. 00_,^\p ' Tp. 17/IO'� �Ao TYPE OF WORK: UATE: `QQO4Op�oOoo� SITE PLAN 10/3/2007 (Rw. OIMS) %- ?1 &I 'Plo I�: t� , W 0 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.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: GARNESS ENGINEERING Legal description: SUNNY VALLEY LOT 23 ❑Permit ®C.O.SJL ❑Inspection Report The attached paperwork has been reviewed and is being returned for the following reasons: 1. SURFACE WATER? 2. DRAINAGE AROUND WELLHEAD 3. NEED ENGINEERING STATEMENT OF SLOPE GREATER THAN 25% NEAR ABSOPRTION FIELD. 4. INFORMATION OF RECENT DIRTWORK ON ABSORPTION FIELD. TOP SOIL AND SEEDING Name of reviewer: JEFF Date: October 3, 2007 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK State of Alaska: Separation Distance Waiver Guidelines for S.C.R.O. (State of Alaska Memorandum to District Orrice Engineers dated January 3,1985) Waiver Request for: Sunny Valley Parcel I D#: 050-354-07 Waiver Request Number WR#: 070052 Waiver Requested: 91 foot horizontal separation from well on -lot to septic tank. Engineer: Jeffrey Gamess, P.E. IIA070385 Septic Tank Data The septic tank was installed in 1983. The the bottom of the septic tank is approximately 10 feet deep. The septic tank is located down gradient from the well on -lot. The engineer indicates that if there was any overflowing wastewater the topography is in such a way the wastewater would not flow toward the well. Well Data The well was installed in 1984. The well has encroached the existing septic tank for more than than 20 years and water sample results are with -in municipal standards. The static water level was measured at 39 feet during Garness inspection. The soil strata show a gravel layer, hard pan, and silt. Municipality of Anchorage Development Services Department � building Safcry Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage. AK 99519.6650 www.ci.anchoragc.ak.us (907)343-7904 Waiver Review Worksheet WR#:070052 PID#:050-354-07 HAIPermit# 1IA070385 Date Received: October 3, 2007 Legal Description: Sunny Valley Engineer. Jeffrey Garness, P.E. Garness Engineering Group 3701 E. Tudor Road, Suite 101 Anchorage, AK 99507 Applicant: Tom Cook Waiver Requested: 91 foot horizontal separation from well on -lot to septic tank. Criteria: Geology A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Points: 3.83 3.59 2.17 4.50 2.64 Total: L 16.732 .............................................•.........................•.. Waiver is Granted: X Waiver is not Granted: List Conditions or Reasons for above: Date: 1013/07 By: Joe Goodall Name of Reviewer Red#: 78243 Amount: S2LO Date Paid:101312007 State of Alaska: Separation Distance Waiver Guidelines for S.C.R.O. (State of Alaska Memorandum to District Office Engineers dated January 1,1985) Waiver Request for: Sunny Valley ParcelID#: 050-354-07 Waiver Request Number WR#: 070052 Waiver Requested: 91 foot horizontal separation from well on -tot to septic tank. Engineer: Jeffrey Gamess, P.E. IIA070385 Water Table Points un Depth of well: 39 3.83 Depth of septic system: 10 29 Distance from the bottom of the system to the highest water table In feet Point Value 0 0 8 1 17 2 24 3 30 4 40 5 85 6 100 7 290 8 1000 9 I Point Value 0 10 ' Straight line Interpolation Is permitted between any two values Soil Sorbtion Points ., 3.59 Soil Type I Point Value 0 10 29) 0 + f 15 29, 6 + 4 ( 29 3.5 + (I 0 0 29 Clean Gravel Fractured Rock 1 l Course Clean Sand 1.5+ 0 0+ 0 0+ 0 0+ 0 0 Sand w/ Small Amt of Clay 2.5 29) f 29, [ 29 ) f —j9—) Silt 3.5 Clay and Sand Equal 4.5 0 + 3.1 + 0.5 + 0 Clay 6 0 + 0 + 0 + 0 'Use the predominant soil type but values can be averaged for a mixture Permeability Soil Type Point Value Clay(will channel) 0 Silt and Sandy Clay 2 Clayey Sand 3 Fine Sand 1.5 Sandy Gravel 1 Fractured Rock 0.9 Course Sand (30 grit) 0.4 Clean Gravel 0 [29)1 + 29)3 +[2 )1 +[29)1 Points an 2.17 +[29)2 +[ 9)1 +29) 1 +[ 29) 1 0.34 + 1.55 + 0.28 + 0.00 0.00 + 0.00 + 0.00 + 0.00 *Use the predominant soil type but values can be averaged for a mixture Gradient Points «n 4.5 4.50 %Slope Points Value Separation -60% 0 30% 0.3 25 20% 0.7 slopes toward well -10% 1.2 100 •5% 2 5 0% 2.93- flat 5% 4.5 10% 6 slopes away from well 60% 7 *If the gradient Is unknown, assume the worst case Horizontal Points «n 9 t 2.64 Horizontal Point Separation Value In Feet 0 0 25 0.7 50 1 75 2 100 3 150 5 200 6 300 7 *Linear Interpolation between two point value Is acceptable. Horizontally means straight line distance to the well not the contaminate travel distance to water table which may be greater. Conclusion: Grant Waiver Total Points: 16.732 GARNESS ENGINEERING GROUP, Ltd. - I I- -- -- - CONSULTANTS & GENERAL CONTRACTORS a, + �-y-,= October 1, 2007 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Sunny Valley, Lot 23. Waiver of Separation Distance between the Well on Property and the Septic Tank on Property. The existing three (3) bedroom house is served by a private well and septic system. The septic system was installed on October of 1983 and the well was drilled in January of 1984. Per the as -built survey (prepared by Robert E. Johns, Jr. and Associates) the separation distance appeared to be less than 100 feet. We shot the separation distance with a Topcon total station and determined the separation distance between the well and the first tank clean-out to be 93.49 feet. Attached is a site plan. Based upon the graphical drawing, it appears that the septic tank is as close as 91 feet from the well; therefore, we are requesting a separation distance waiver of 91 feet. Justification for the waiver is summarized as follows: • The encroachment has existed for approximately 23 years and recent water samples indicated nitrate levels as non-detectable and no bacteria to be present. • Attached is a well log for the subject property. The well is 176 feet deep. The first 75 feet of the well is drilled though a geological profile of gravel, hardpan, and silt. • Attached are well logs for a number of adjacent properties. The wells range from 118 feet deep to 140 feet deep. All of the wells are below thick protective layers of clay, sand, gravel, hardpan, and/or silt. • The well head extends at least 18 inches above grade, has a sanitary seal, and has appropriate drainage around it. • Attached is a topography drawing of the area. The topography is such that overflowing wastewater from the septic tank would not Bow towards the well. • There is a house between the septic tank and the well, so it would be impossible for overflowing wastewater to reach the well unnoticed. Based upon the aforementioned facts, it appears that there is minimal risk associated iwith granting the requested 91 feet waiver between the is ell and the septic tank. According to the as -built survey and our field measurements, the drainfield is approximately 2 -0 feet from the property line that parallels Sunny Valley, Lot 22B. There are no septic systems with 100 feet of our client's drainficld. In short, there are no concerns associated with this encroachment. We are requesting that your department Issue a (Moot walver from the drainfield on the subject property and the closest property line. please contact us at 337-6179. Thank you for your assistance. 3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507-1259 Ph: (907) 337-6179' Fax: (907) 338-3246 • Website: www.gamessenginecring.com SUNNY VALLEY S/D, \ \ \ LOT 20 SUNNY VALLEY S/D, LOT 24 \ `3EPnC SUNNY VALLEY S/D. ARE�D LOT 21A \ \ \ SUNNY VALLEY \ OT 21 B SUNNY VALLEY S/D, LOT 27 \ / \\ �\\ 1%IN EAC\ S/D, SUNNY VALLEY S/ \ / EXISTING \\ / 3 BEDROOM / HOUSE 100WELL RADIUS \ / 100'eW� ELL RAOIUST 22A 100' WELL RADIUS 1 SUNNY VALLEY S/D, LOT 229 - L--- WESI-LAKE—DRIVF--- C►�� SUNNY VALLEY S/D, LOT 28 GARNGSS ENGINEERING GROUP, Ltd. ^-- _—•--�- CONSULTANTS 6 GENERAL CONTRACTORS LT N,Lw run: PHONE NUMBER: PAGE NUMBER TOM AND SHERRY COOK 694-6840 1 OF 2 LL DESCRIPTION: DRAwN SUNNY VALLEY, LOT 23 TYPE OF WORK: SITE PLAN K.D.M C�el?l SUNNY VALLEY S/D, LOT 29 ••.rte 100' SET BACK FROM SURFACE WATER 1 I EXISTING I I i S HOUSE OM I I ,., r---� WEST LAKE DRIVE \ 1 o�OF Op GARNL•'SS ENGINEERING GROUP, Ltd. pp: 4 .7 ^•'-� •�'--­ CONSULTANTS R GENERAL CONTRACTORS . p ....:. .. . ..... ... ...:... JMI C 11I00II NI of I lel • NCNo,,, . M Ml01 ,,,W (BOW -41" • FNI 007}3X,,,4 • eDLI[ �.yenr.yYy,.yymn PREPARED FOR: PHONE NUMBER: PACE NUMBER: ... . .. .......... ....... TOM AND SHERRY COOK 694-6840 2 OF 2 O"l '•. f r y . Gar ss.: LEGAL DESCRIPTION: DRAWN BY: O0. SUNNY VALLEY, LOT 23 K.D.M. I' TYPE OF WORK: DATE: 40 40fe..100°o AS-BUILT 9/28/2007 �0p04000� ~ - APPLICi.~IT FILLS OUT UPPER HAL~.,~ONLY Phone Lending Institution Address Zip Code Realty CO. & Agent Phone Address Zip Code Street Location · Type of Residence 8~ Single Family Water Supply .~, Individual ATTACH WELL LOG. A well log is required for all wells drilled since Juqe 1975. (~ Community For wells drilled prior to that date, give well depth (attach log if available). [] Public Utility PuPlic Utility When Connected to Public URlity: NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time~ 0',(~~---~ (~' ~ Date ~. ~_~U( ~' ,nsp~tor Insp~tor Inspirer Insp~to~ Field Notes: ~pPROVg~:DROOMS} *CONDITIONS OF APPROVAL Soils Rating Date ~wer Installed Well TO Absorp~ea / ~ u I Well Log Received 'l ~