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Home My WebLink AboutGLACIAL LT 6 Rick Mystrom. Mayor Municipality 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 July 8, 1999 Kirk Hoessle & Dennis Weber PO BOX 389 Girdwood, AK 995870389 Subject: GLACIAL LT 6 Permit Ct SW980245 PID Ct 075-091-16 The subject permit, issued 7/17/98 by this office for a single family well and/or on-site wastewater system, is due to expire as of 7/17/99. 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. Ifa 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. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. HoWever a new permit can be issued free of charge for a second year if the application for the renewal is received on or before the date of expiration of the original permit for which a fee was paid. When applying for a new permit after the original permit has expired or for more than a second year, the fees are: $320.00 for an on-site wastewater permit and $120.00 for a well permit. If you have any questions, please call this office at 343-4744. Program Manager On-site Services enc: Copy of Permit PAGE 1 OF MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH ~ ~ SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 PERMIT NLrMBER:SW980245 DESIGN ENGINEER: OWNER Nin/V/E:HOESSLE KIRK OWNER ADDRESS:BOX 389 GIRDWOOD ALASKA 99587 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL SYSTEM PEP_MIT DATE ISSUED: 7/17/98 EXPIRATION DATE: 7/17/99 PARCEL ID:07509116 LEGAL DESCRIPTION: GLACIAL LT 6 LOT SIZE: 7524 (SQ. FT.) NIIMBER OF BEDROOMS: 3 THIS PERMIT: 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 D/qD 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) 3LND 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 U1TDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED 15/%rD CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: DATE: DATE: I I I I / / / / W~-TER & WASTEV~.~;TER UTILITY 3000 ARCTIC BLVD. PHONE: (907)564-2762 BLOCK/LOT/TRACT LT 6 SUBDIVISION GLACIAL TAX CODE 7509116 GRID STREET ADDRESS GLACIER DR GR4813 AS-BUILT WASTEWATER CONNECT PERMIT 98- 1690 DATE OF APPLICATION SCHEDULED COMPLETION DATE 07/15/98 12/31/98 [] SINGLE FAMILY [] MULTI-DWELLING No. APTS [] COMMERCIAL OWNER HOESSLE KIRK MAIL ADDRESS PO BOX 389 GIRDWOOD, AK 99587 PHONE CONTRACTOR [] Repair Existing Service [] On Property Only [] Hydrant Only [] Main Tap - To Property Line Only [] Main Tap & On Properly Connect ] Disconnect [] R & R- Main Tap Only CONNECT SIZE 4" [] City Tap ] 50' or Longer REIMBURSABLE NUMBER Row No. INSPECTION FEE $ 104.00 PERMIT FEE $ 35.00 $ 0.00 DEPOSIT $ 0,00 TOTAL $ 139.00 ASSESSMENTS [] Main Line Extension [] Have Been Levied [] To Be Levied Comments: / IOwner IStaff !! I ISSUED sparr ~PAID [] CASH [] OTHER INSPECTED BY DATE / / REMARKS PERMITTEE (Please Print) MAIL ADDRESS PHONE SIGNATURE POST IN A CONSPICUOUS PLACE AT THE JOB SITE CUSTOMER COPY Original WATER WELL RECORD STATE OF ALAS'KA DEPARTMENT OF NATURAL RESOURES Division of Geological 8~ Geophysical Surveys LOCATION OF WELL (Please complete either Ia, lb or lc.) A.D.L. NO. I~., Borough Subdivision ~ ~ ~[ '/4q l rs. ' [ I W~ C~ Section No. TownshiPN~ Range E~ Meridian C(~( ~ I- ° f-'°f-°f -- ~DISTANCE AND DIRECTION FROM ROAD iNTERSECTiONS Street Address end Area of Well Location WELL LOG Feet Surface Top Bottom 0 Malarial Type JUt_ 22 199 9_ Municlpahty o--tAncnorage Oept Hca!th & Humnn .qervices 4. WELL,,D~PTH: (final) 5. DATE OF COMPLET O~ · 6. []Coble to.oI %~Rotary []Driven Dug DAuger ~Jeff*~ ~Bored ~ Other: 7. USE:~Oomelflc ~ Public Supply ~ Induslry ~ ]rrigollon ~ Recharge ~ Commerical ~ Test Well ~ Other: 8. CASING: ~ Threaded Type: Diameter: Set belween ft, and fl. Backfilling Gravel pock . 'O. STAT'CWATE. LEVEL, Z/--S-- ,,. Above or [] Below land surface Dote Equipment used: PUMPING LEVEL below lend surface and YIELD ~ft. offer__hrs, pumping, g.p.m. ft. ~3fler hrs. pumping g.p.m. 12.GROUTING Well Grouted: '~Yes [] No Moterlol: [] Neat Cemenl [] Other: IS, PUMP: (if available) HP Length of Drop Pipe ft. capocHy g.p.m. 16. WATER WELL ~[~[~A~RTIFICATION: 3540 AKUL~ DPiJV~ 15. Water Temperature 14. REMARKS: ° []r []c Dole: WHiTE-State DBGS, PiNK-DrillsG CANARY-Cuslomer PLAT STATUS: FINAL GREA:I'ER ANCHORAGE D EPARTMEN~,,, ~ 6REATER ANCHORA6E AREA BOROU6~I~R°uca'H~AL~H-- BOX 4.00 ANCHORAGE, ALASKA DATE: January 12, 1966 Charles Harvard -Ff~-- Department Traffic Department Spenard District C~ty of Anchorage Telephone Utility Alaska Department of Highways Assistant Superintendent of Mails Anchorage Natural Gas Corporation Chugach Electric Association, Inc. Matanuska Electric Association Matanuska Telephone Association City of Anchorage Public Works Dept. City of Anchorage Municipal Light and Power Dept. Borough Tax Assessor Mayor of Girdwood RE: Subdivision: Lot 67 of U. S. Survey 3045, to be .designated Glacial Subdivision Gentlemen: Petition has been received by the Greater Anchorage'Area Borough Planning and Zoning Commission for the proposed Subdivision of subject property. Attached is a copy of the proposed plat. Will you please submit your comments in writing, specifying any easements or other requirements that your department or system may need. If we do not hear from you by Feb~uary'l, 1966 assume that you do not wish to submit any comments. Our next scheduled meeting after above date will be we will February' 9, 1966 Very truly yours, C. J. Hoschou~'~/~ Planning Assistant !(H: rd NOTE: If yOu have no further use for attached plat, please return with your comments. 7/16/65' / 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 Parcel I.D. 075 091 16 1. GENERAL INFORMATION Complete legal description Glacial Lot 6 Location (site address) 127 Ravenwood Current property owner(s) Dennis Weber Mailing address Real estate agent 2. TYPE OF DWELLING: 0 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Expiration Date: f 0_ 2 q_ 0 Day phone Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Q Private Septic ❑ Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ID Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ Date of Payment //9 Receipt Number COSA # a 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. Name of Firm C&M ENGINEERING Phone 8545558 Address 20182 TULWAR Engineer's Printed Name CHARLES BALZARINI Date 7/18/2019 Aw meg.• � •.9 � j*:49TM •.� 6. DSD SIGNATURE .. "' " • "' System #1 Approved for bedrooms / .. ""' "' CHARLES G BALZARINI System #2 Approved for bedrooms �� F� •.. CE -13854 .• , A Disapproved iFOPiF�s�,� ' P��`��'r pp ilk\\�4� Conditional approval for bedrooms, with the following stipulations: ��177))1?)llll�l By: Original Certificate Date: The Municipality of Anchorage Lelopment 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 COSA Checklist blue sheet W `SITE 1,AIASTEIN.AT€R m:z =, .o .� ��177))1?)llll�l By: Original Certificate Date: The Municipality of Anchorage Lelopment 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 COSA Checklist blue sheet Legal Description: GLACIAL LOT 6 If more than 1 septic system on lot: COSA Checklist # 1 A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 7/2/98 Total depth 80 ft Cased to +47 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) +12 in. Date of flow test for COSA 7/2/19 Parcel ID: Of 1 Structure served by this system 1 Well production at time of test +4.8 gpm Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate 0.580 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by C&M ENGINEERING Date of Sample 7/2/19 Static water level at beginning of test 45 ft. Comments ESTABLISHED WELL FLOW LIMITED BY TESTING METHODS, WELL PRODUCTION IS LIKELY MUCH HIGHER. WELL LOG INDICATES 20 GPM B. TANK DATA Age of tank(s) years Tank type/material ❑ 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 drainfield. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet 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 Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ❑ Yes if No Community Sewer Manhole/Cleanout > 100' Yes if No ft y/❑ Yes if No ft Neighboring Tank > 100' ❑Yes if No ft Private Sewer/Septic Line > 25' F,71 Yes if No ft Absorption Field on Lot > 100' ❑Yes if No ft Holding Tank > 100' ❑Yes if No ft Neighboring Absorption Fields > 100' if No ft Animal Containment > 50' ❑✓ Yes if No ft ❑✓ Yes if No ft ft Community Wells > 200' ❑ Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' F✓ Yes if No ft ✓❑Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No ft Surface Water > 100' F_� Yes if No ft Property Line > 5' ❑Yes if No ft Driveway/Parking > 0' ❑Yes if No, comment Absorption Field > 5' ❑Yes if No ft Wells on Adjacent Lots: ❑ Yes if No ft Water Main > 10' ❑ Yes if No ft Private Wells > 100' ❑ Yes if No ft Water Service Line > 10' ❑ Yes if No ft Community Wells > 200' ❑ Yes if No ft From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' ❑ Yes if No ft Driveway/Parking > 0' ❑Yes if No, comment Property Line > 10' ❑ Yes if No ft Wells on Adjacent Lots: Water Main > 10' ❑ Yes if No ft Private Wells > 100' ❑ Yes if No ft Water Service Line > 10' ❑ Yes if No ft Community Wells > 200' ❑ Yes if No ft Surface Water > 100' ❑ Yes if No ft F. ENGINEER'S COMMENTS PROPERTY SERVED BY PUBLIC SEWER, NO SEPTIC. G. ENGINEER'S CERTIFICATION 1 certify that 1 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 date. 7/18/19 COSA Checklist yellow sheet of A/- .... ...... /-.�••� . �jj CHARLES G BALZARlUI . r� �'��•. CE -13854 .•��`��'•® ,W ''PROFESS10NP, NI Frontier Surveys, LLC Project No: 19-273 Ordered By: Dennis Weber Scale 1" = 20' / n � A Y Electric Meter/Outside Power iy Gas Meter ® Deck S; Sewer C/O `W; Water Well rQ Telephone Pole � Tel. Ped. o Fence 4.E, Elec. Ped. Mailbox—Ow— OverheadUtility Date: 07/22/2019 Plat: 66-28 1 Grid: N/A General Notes: 0 10 20 40 i, This document is created for the purpose of a single property transaction and is subject to Federal Copyright Laws. 2. Excepting for gross negligence, the liability for this survey shall not exceed the cost of preparing this survey. SCOIe In Feet 3. Al:measurements/setbacks are to the visual/apparent building footprint. 4. All dimensions to property lines are plus/minus o.tft. OF glgs!Il/ 09TH i ... .... .... .. ; � •' • • •Frederic W. nor • • • • ,� i NO. I.S:9946 X '�!C`rj. ••, 7/22/2019 & lftt t ttt0\\\\ ONA- PROFESSIONAL SEAL This survey complies with the ASPLS Mortgage Location Standards. The survey represents visible improvements and conditions at the time of the survey. This document does not constitute a boundary survey and is subject to any inaccuracies that a subsequent boundary survey may reveal. It is the responsibility of the Owner to determine the existence of any easements, covenants, or restriction which do no appear on the record plat. Under no circumstances should this document be used for construction or for establishing a boundary or fence line. AS -Built Survey of: Lot 6, Glacial Subdivision I, Frederic Wagner, hereby certify that this Mortgage Inspection Survey was performed by me, or under my direct supervision on July 17th, 2019. Frontier Surveys, LLC FROM j' R 650 W. 58th Ave. Suite E Anchorage, Alaska 99518 .5112 V@ 907.460.1686-info@frontiersurveys.com www.frontiersurveys.com