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HomeMy WebLinkAboutSILVERWOOD HILL ESTATE LT 2 Onsite File Silverwood Hill Estate Lot 2 #050 - 762 - 11 (Rev 05/02/18) Municipality of Anchorage On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP191031 PID Number: 05076211 Dwelling: ❑■ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑■ New ❑ Upgrade Name Senn Robert ABSORPTION FIELD ❑ Deep Trench 0 Wide Trench ❑ Bed ❑ Mound Site Address 19091 Silverwood Hill Drive ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 227-8709 3 5 GPD/SF 2 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 1 Ft. Gravel depth beneath pipe 1 Ft. Subdivision Block Lot Silverwood Hill Estate 2 Fill added above original grade 2.5 Ft. Gravel length 25 Ft. Township Range Section Gravel width 5 Ft. Beds: Number of Lines - Distance between lines - Ft. SEPARATION DISTANCES To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Lift Station Tank Line 120 FF 1 Ft. Well 100'+ 100'+ na na 25'+ TANK ❑ Septic ❑ S.T.E.P. ❑ Holding [@Other Manufacturer Advantex-Anchorage Tank Capacity 1500 Gal. Surface Water 100' + 100' + 100' �" na Material Fiberglass Number of compartments 2 Lot Line 5'+ 10'+ na na NA Foundation 10'+ 10'+ 10'+ na LIFT STATION Manufacturer Capacity Gal. Remarks Alarm location Electrical installed by PIPE MATERIAL House to tankTank to��G�, 303 drainfield Installer Dean C, Drainfield d_?CO/MT Inspector NorthRim Eng. BENCH MARK (Assumed elevation) 100 ft Inspection 15t 6/25/19 6/26/19 Location and description dates: nd 4th Garage Slab 3`d 6/27/19 ON-SITE WATER AND WASTEWATER SECTION APPROVAL a �Efi9iieer s S{}arnp� Conditional Approval: Date Y., Steven 1i. _rye PE 625h ' Septic System Approved Date Note: this a roval does not include well permit requirements. (Rev 05/02/18) Vtwh 11 BAX��20l��llte� �o�x Unit 3 Bdrn ! 20% Slope Well . ! 20% Slope NJ C CO3 o Driveway -u7 1/ C01/MT 5 rp < Ip P S .+ s 'oo a n n Uri o ! 1 I o 20% Slope Q* z A Q m Q Ln m P UI ro 3 + MDA Drainage Plan 20% Slope AS -BUILT MEASUREMENTS A B T1 32 73 T2 42 78 CO3 54 87 CO2 55 87 C01/MT 75 92 NORTHRIM�EOF SILVERW❑❑D HILL 1• = 1000 ENGINEERING y`P' SteveEng.corn ••*•:49m'�.....t. ESTATE LOT 2 PLAN PO Box 770724 ..a......� LAYOUT Eoye Rlw. Alaska awn WASTEWATER DESIGN Dam-� 907.694.7028 NEW SEPTIC SYSTEM 1/27/20 1C °f rn F+ o tD < xo (D rq , :3 OD Ar Ar jr m (D < Q 0 tj E3 m r,o r-9 < 0 < rrD 0W -9 0 Cp + p 0 x No 4N. 0 C+ ro F-1--1 0 7u 7u C--) Z f-'-10 0 z X D ,< m zi 11 W 70 Q < C+ < F9 7u Z 0 0 0 .... . ..... . F-9 9 ro --4 ro ro 11 F— 1,D M OD CD OD FT-1 m (D ro p n < C+ C+ P ro0 o ro rID _0F7 ro CC) I-Q OD Cil F- Cl) F-F] rrl 0 7-1 5D j tN ;Q 0 0 n Cil 0 -3 rDC+ x m WM + -9 zy- rD i 0 :3 ro 0 < rD -3 0 < ro P 3 n N, ""'� nt MUNICIPALITY OF ANCHORAGE On-Site Water&Wastewater Program N° 1 , PO Box 196650 4700 Elmore Road Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax (907)343-7997 �td r. r, httpalwww.muni.org/onsite `" ws 1 , t. i l ; E Department 4 MCti ORPC't On-Site Wastewater Disposal System Permit Permit Number: OSP191031 Effective Date: 3/12/2019 Work Type: Septic Initial Expiration Date: 3/11/2020 Tax Code Number: 05076211000 Site Legal Address: SILVERWOOD HILL ESTATE LT 2 G:0354 Site Mailing Address: 19091 SILVERWOOD HILL DR, Eagle River Owner: SENN ROBERT & KAT,ELYN Lot Size in Sq Ft: 273063 Design Engineer: NORTH RIM ENGINEERING Total Bedrooms: 3 This permit is for the construction of: Q Disposal Field IZI Septic Tank 0 Holding Tank 0 Privy ❑ Private Well El Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: -! Date: / ` Q Issued By: ,6)iA v Date: V/i/q MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: •D7-343- •97 u ��° �0 , 13 mem ON-SITE SEPTIC/WELL PERMIT APPLICATION a FEB 1 4 2019 �6 ti Parcel I.D. 05076211 c> Senn 229-0154 01 6 8 L Property owner(s) Day phone Mailing address PO Box 772064 Eagle River Site address Silverwood Dr lgock� Legal description (Sub'd., Block & Lot) Silverwood Hill Estate Lot 2 Legal description (Township, Range & Section) Lot Size 273,063 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (E all that apply) Absorption Field 0 Initial n Single Family (SF) Ix (w/wo ADU) Septic Tank Upgrade IDuplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signacureof property own or authorized agent) Permit/Rush Fees: $5 95. 0 D Waiver Fees: Date of Payment: 2/t' ) 2.011 Date of Payment: Receipt Number: 07 C0 Z l D Receipt Number: Permit No. OS P l-11 O 3 I Waiver No. G:\Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc bRTHIM ENGINEERING SteveEng.com Steve Eng, PE, PH 907-694-7028 SteveEngPE@gmail.com Date: 2/14/19 Number of Pages: C To: MOA On-Site Services Subject: Silverwood Hill Estate Lot 2 Advantex Septic System A new 3-bedroom house is planned. Due to the shallow bedrock, a Category III Advantex is required. A new soil test is being used for design; bedrock indicated @ 5' below ground. The design calls for a new shallow trench and Advantex. The entire subdivision is on private wells and septic systems. The terrain slopes west toward. The system size is a single family at 3 bedrooms. The lots are very large in this area and most are undeveloped. Please review the wastewater system design for the future 3 bedroom home. I have included design plans & specs, design guidelines, & soil tests. If there is need for additional information or clarification please give me a call. Thanks-Ste • 1\1 ENGINEERING Silverwood Hill Estate Lot2 SPECIFICATIONS & DESIGN GUIDELINES Wastewater System Sizing: This is a planned 3-bedroom, single family home, in a developed subdivision; most lots undeveloped. The 15-20 % slope at the site will accommodate this design. A new soil test was used for design. An Orenco System AdvanTex, with 1500 gallon processing tank and 1-AX20 filter pod to be used. Separation to bedrock and groundwater is being maintained.A previous subdivision test hole in excess of 7' demonstrated no groundwater during the June time-frame. This demonstrates adequate separation to potential groundwater. The easements are located on the drawing and are not encroached upon. A Category III System drain field will allow an application rate of 5 GPD/FT2. Length = 90 FT2/5' trench, say 25'. Specification Requirements: All components and work must comply with the MOA Specifications (AMC) & State DEC , Orenco Systems Regulations • Installation by an Authorized AdvanTex Installer only; approval issued by Orenco Systems & Anchorage Tank&Welding, Inc. • 1500 gallon, two compartment AdvanTex processing tank, 1-AX20 filter, VeriComm Monitoring System &Mode la standard package per AdvanTex System Manual. • Watertight couplings on inlet&outlet. • 5' minimum between the tank and bed. 10' minimum to property lines. • 3' of cover or insulation is required for trench; an equivalent of 1" insulation for 1' soil cover. Minimum 2" insulation. • Tank& solid pipe must be set on well compacted, stable soil. • 4 inch diameter cleanouts with airtight caps are required 1' to 4' from foundation wall, prior to any 90 degree bend in 4 inch line, prior to the processing tank. • All cleanouts must extend to at least ground level • Trench to be placed level, reduced level to bedrock for advanced system. • Drain rock to be 1/2" to 2 1/2" screened. Drain rock to be distributed uniformly. • Perforated pipe to be installed level with perforations down. • Silt barrier(filter fabric) to be installed above the drain rock. • Smeared trench sides must be raked or scarified before drain rock placement. • The finish grade must be mounded to promote drainage away from trench. • Insulation must be placed over any pipe installed under driveways or parking areas. • Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS ASTM D2661, • Sewer Service Line is minimum 2% slope • Maintenance agreement for the AdvanTex Treatment System is required for approval. • Insulation board shall be extruded direct burial polystyrene(Dow Styrofoam HI, equal *)49Pi *S ,< J$I . � M p„I �/ Iia^ tt-E236 1. unaeveLopea Cff,'?ORalloht , ogcr Unit e weu , o h 20% Slope 3 Barn m • _ (0 C, 'h 207. Slope `�\\C01/MT 20% Slope n Driveway -- N _ O 207. Slope O S ' 0- r0 O D .3 n .. n (D N i to o `n q 207. Slope Ip z P 4+ C 2 h Q n ri 9- P VI0 r010 3 ci- MOA Drainage Plan N 0 O \ 1 / DESIGN NOTES: 1. New Trench Depth At 2'. 2. 5'-Wide Shallow Trench. 3. 3' Cover Over Trench, 4' Over Tank. 4. Lots Served by Private Water Wells, \/ 5. No Conflicts Within 200'. 6. Measure Well Separation Prior To Construction. NORTHRIM 0 ' � SILVERW❑❑D HILL 1' = 100' ENGINEERING ,• PLAN SteveEng.corn * *a ESTATE LOT 2 Po Box 770724 LAYOUT E.ph RN...Ned. aria �:'••I WASTEWATER DESIGN 907.694.7028 76.71§ NEW SEPTIC SYSTEM 3/6/19 12 of 4 New 1500 Gallon AdvanTex Unit With 1 AX-20 Filter Pod -100 Well 20% Slope 3 Bdrrn rco Till C D 21, "' 20% Slope C01/MT 20% Slope �--- Driveway �--- • nate �� Trench 20% Slope NORTHRIM �•S�E�7wgk\ SILVERWDDD HILL 1" = 50' ENGINEERING Aci) .'' `may++++ SteveEng. com I ,49Iki *.'+ PLAN DETAIL g - �g ESTATE LET 2 Po Box 770724 LAYOUT ie Eagle River. Alaska 99577 '. cE- ' '- WASTEWATER DESIGN + /// :• Dote: EET: 907. 694. 7028 \ EW SEPTIC SYSTEM2/14/19 13 of 4 Foundation Cleanout 1 AX-20 Filter Pod A d v a n T e x Unit DC❑ MOWED 7 4' Cover e - ••PUF-OUT— E COVER ,.CO„P,,,, WJEDTOTAPOCA__, ,eoo GALLON i _____ i AMmTa r— au. To Absorption Trench OPT11MAJ , ii SDE srnnN _ OVER .OVER DOS ° , .._..._..._..._..._.. .._..._... , 5' TO PROVCE SHEER PROTECION- ELTDO BRIDGE TIW 11111A _ ■ i I Or, OU G Monitor Tube 12' _ g'nal r 1500 GALLON na /C1:1 Mound Cover AdvanTex 2' Cover DESIGN NOTES: 1. Depth of Trench is 2', 2. Advantex & Solid Pipe to be Placed on Compacted, 2' FilterFabric Stable Soil, Free from Boulders. :1 :: •. + Insulatio 3. Sewer Service Line is Minimum 2% Slope & 3' Cover. 4. Water-Tight Couplings. Effective Depth 1' 5. See Specification Sheet, 6. All Work To Conform to Municipality of Anchorage (AMC) _ -5% - ,. --. Requirements & Specifications. NOR THRIM ,•'� °F� ° ENGINEERING .'`��P . TRENCH END VIEW SILVERW ❑ HD HILL A 9 '* SteveEng.com f' ADVANTEX UNIT PO BOX 770724 Eagle River. Alaska 99577 4I. •. CE-42515ESTATE L ❑ T '3/6/19 NEW SEPTIC SYSTEM °ate3/6/19 grownBPSE 'scale: 1• = 5 ISH■ET:4 of 4 S❑ILS LOG - PERC❑LATI❑N TEST I\ERTI- INA Date Performed: 1/30/19 EN_9INEERING Performed For: Senn Legal Description: Silverwood Hill Estate Lot 2 DEPTH (FEET) T.H, Location: See Attached Design ...: .•' SP Sand _ :: > 2 •..j• ` Clean Sand Low Silt 5 - 6 Refusal Groundwater? No 7 - Depth -- 8 - Water Depth 9 - After Monitoring.None Date: 2/15/19 10 - # Date Gross Tine Net Tine Depth Net Drop 11 - 1 1/30 0 -- 7' -- 12 - 2 1/30 10 10 min. 12" 5" 13 - 3 1/30 12 -- 7' -- 14 - 4 1/30 22 10 nin. 12" 5' 15 - 5 1/30 25 -- 7' -- 16 - 6 1/30 35 10 min. 12" 5' 17 - 7 1/30 37 -- 7' -- 18 - 8 1/30 47 10 min. 12' 5' 19 - 9 1/30 50 -- 7' -- 20 - 10 1/30 60 10 min, 12' 5' 21 - Percolation Rate 2 min./inch Perc Hole Diameter 6" Test Run Between 1' and 2' Comments: Presoaked. Measured to nea pct 1/1FEth inch. Performed By NorthRim Fng, I CERTIFY THAT THIS TEST WAS Performed in Accordance with All State/Municipal Guidelines in Effect ON THIS DATE. DATE: 2/14/19 Ailnlk NORTHR/M *~49gi * TESTH❑LE LOG ENGINEERING T H 1 PO Box 770724 Wi •• ., Eagle River, Alaska 99577V71". 907694.7028 � ' GE❑TECHNICAL Date: �: 2/14/19 2 of 2 MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT,herein the"AGREEMENT" made and entered into as of this 5 Day of F-e-b of 20/7 , by and between Robert & Katelyn Senn ,herein the"OWNER,"and the Municipality of Anchorage,herein the"MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein,the parties to this Agreement agree as follows: 1. Advanced Wastewater Treatment Svgteins. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System(AWWTS), described as Adv.antex Category Ill, located at(legal description) Silverwood Will Estate. Lot 2, Eagle River 2. Maintenance,Repairs and Alterations. Owner is required to read, understand and initial each section) Throughout the term of this Agreement, the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the I manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. ,11)4i js It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s),maintenance, adjustment(s),replacement costs, and inspection costs. This includes an annual maintenance fee(typically $400 to$600). VOwner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance, repairs or permitted alterations to the system. Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system,which could include sewage backup and costly repairs or draifleld replacement. (ravr (15/1/2/1(11 R1 PAHA 1 of 1 14V-S Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. ,40 Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be hh .. ., assessed in accordance with AMC 14.60.030. U Owner agrees to grant the Municipality reasonable access to test and inspect the 4_97, AWWTS. The Municipality will give at least 24-hour notice. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On-Site Systems Approval. Owner agrees that the AWWTS installation and maintenance requirements as provided \A by the AWWTS vendor/installer and approved by the Municipality are the governing guidelines for the construction,maintenance and repair of the Owner's AWWTS. ioi Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the Municipality to operate the installed system,or upon transfer-of title,and shall continue while the AWWTS is operational or until title is transferred. 4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof,or the right of the Municipality thereafter to enforce every provision hereof. 5. Arnegdment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the SuperiorCourt for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Seyerability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Agreement. (rvv f c/1 Rm1 sn Parra 7.of 1 O ' • ,//♦ (signature) Date: K ate l Senn (print name) STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was acknowledged before me this Q5 day of ' • ‘.. 201q , by TEENAH FLOYD Notary Public I TARY ' :LIC FOR ASKA Stale of Alaska My Commission expires: Nov 3Q. ) My Commission Ekpires.Nov X0.2021 MUNICIPALITY: By: tel (signature) Date: 3//24? /4h Woci g5 (print name) Title: (MPir (lc i112/7n1 RI Para i nf.1 ♦llitlOwee. Ni ♦ Ltgol Deserlprton. Job No.: 01-194 9 7 Permit No.: swoloms 'Project No.: NIA CP� M -W Drilling, Inc. ♦P.O.Box 110378#Anchorage.AK 995U$ •907-345.4000 • 907-345-3287 Fox* Groundwater Well As-Bitilt A Low Neil & Penny (Rucando. Manhew) # Asa of lVick Construction ♦11uleDeptb: 367' • Caving Size: 6- ♦Cased re. 39.65' ♦31aterki. A:3 Stml ♦Drill Method: AlrR06y — Perf. ♦ Iretl Cutnpledon. Open errd X Screen Perfuraled _ stulrod: 0Scree,s/Perfamd6n desalpdon: None • Groat Nola': 10" holt drilled to 39AY.6- easing run to 39-65' and armulus trcmic grouted with ne: cement L) surface. ♦ A'r11 Dcveleptrsentt Meed: Ait surge holler. ♦ Smile vara lerel (S -WI) 100' (a*~') (bdow) top of casbrg 1700- • wsll yield tat or 2-3 gallons per trdnuls (CPAlV for 1 'Paan srtth I OWP of drawdo ax (DD) from stark furl (SOI). ♦111ethad: Airlift • Dale of eormpledua: 14 Novcmbcr 2001 ♦PAnrp lnstalk Well 1.00 Dcpt9 in reet from 10 ofeaslae. Deulk of rormatlons penetrated, size of material eotor snd hardusv. 0 __._ TO 2 Casiniz stickup_ Silt: brown, oobbleys loose 2 TO 8 8 'W- 20 Bedmek: brown -black, weathered silt -stone argillite _ 20 TO 74 As above: blue -black, some quartz fissure filling 74 TO 320 As above: blue -blacks small water_seaaps in sporadic fractures —_ As above- blue, sofa 320 TO 343 343 TO 367 As above: blue -black, quartz fracture filling with water sea s .T_.0 — _._..... - - - - ....... _.. ----.._... ...... ...-TO __... _..... ... TO .......- —---.........—---��'s.�r........._ _ .. - ..._ ......TO TO •' TO ' TO �;jtirWA Ccrtiitesi C^n racier TO Certirtcato xo's. 814 & 073 mil MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WATER SUPPLY PERMIT Initial Date Issued: Sep 20, 2001 Expiration Date: Sep 20, 2002 Permit Number: SW010385 i: Legal DescriPtion: T14N R1W SEC 6 SE4NW4 & w2sW4NE4 = Design Engineer: 0000 None Required Owner Name: Neil & Penny Nichols .... Owner Address: 19336 Timberline Dr Eagle River, AK 99577- This permit is for the construction of: Disposal Field [~] Septic Tank [~ Holding Tank Parcel ID: 050-762-03 Site Address: Lot Size: 2613600 SQ. FT. Total Bedrooms: 0 Permit Bedrooms: 0 Privy Private Well I--J Water Storage. 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 ( 18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for'a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. [; 5.: The following special provisions, r ;i WHEN THE WELL HAS BEEN cOI~PLETEDAND SATISFACTORY WATER'pRODUcTION 'IS DETERMINED,' . ..... ~ '''THE WELL'SHALL HAVE AN APPROVED SANITARY SEAL PUT ON IT'AND NO PITLESS ADAPTER OR PUMP ' ::' SHALL BE INSTALLED UNTIL AN APPROVED WASTEWATER DISPOSAL SYSTEM HAS BEEN CONSTRUCTED. Received By: Date: Municipality of Anchorage Development Services Dep. artment 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 SEWEPJWELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLI'NG Permit Number Prdperty owner(s) Mailing address (1) Mailing address (2). · / Legal description (Lot, Block & Sub'd.) Legal description (Section, Township & Range) Lot Size ~/Ct- Acres/Sq. Ft... Day phone Zip Code' Number of Bedrooms_ THIS APPLICATION IS FOR: Sewer Only El Sewer and Well El Sewer Upgrade F'] Well Only Water Storage THIS PROPERTY CONTAINS: Hot Tub Swimming Pool '~ Therapy Pool El Jacuzzi [] El Water Softening Unit [] I certify that the a/bo~e information is correct. I further certify that this application is being made for a Single Fam~fing(_4' ~/.¢ ,,~,, ~cordance.,~.~_/.c_..C,..j[~_/with applicable Municipal Codes. (Signature of ~operty o~'~ or authorized agent) Permit Fees: Waiver Fees: Date of Payment: Receipt Number: (Rev. 12/00) Date of Payment: '~'~Receipt Number: Fax Cover Sheet To: Shirley or Lynn, fax number 907-343-7997 From: Nell Nichols, fax number 907-696-0707 pages enclosed: One Transmission time: 1030 ADT, July 12, 2001 Subject: exploratory drilling permit for drinking water well on T14N R1W Sec. 6 SE4 NW4 & W2 SW4 NE4. This parcel is currently undeveloped, there are no septic systems on this property, nor do any lie within 800 - 900 feet of intended drilling sites. Property Onwer: Drilling contractor: Neil Nichols 19336 Timberine Dr. Eagle River, AK 99577 Wayne Westberg at MWM Drilling 345-4000. Please process this application. Thank you, Neil Nichols 696-0707, neilanichols~CS.com EXPLORATORY WELL PERMIT APPLICATION: TI4N R1W Sec. 6 SE4 NW4 &W2 SW4 NE4 c) NE4 NW4 40 ac. Zoned PLI currently undeveloped land access DRILLING SITE 3 NW4 NE4 40 ac. Zoned PLI currently undeveloped land SE4 NW4 &W2 SW4 NE4 DRILLING SITE 2 -"'~-'~/-' --I I 60 ac. Zoned R-8 Survey monument: Center of Sec. 6 McGimsey Tract DRILLING SITE 1 'i3mber Ridge Subdivision Eagle's Nest Subdivision Drive 330 -- LOT 2 1 Parcel I.D. 05076211 Certificate of On -Site Systems Approval Expiration Date: -5--- 10 - 2 OLD 1. GENERAL INFORMATION Complete legal description Silverwood Hill Estate LT 2 Location (site address) 19091 Silverwood Hill Drive Current property owner(s) Senn Day phone 227-8709 Mailing address Real estate agent owner Day phone --------- — 77 2. TYPE OF DWELLING: V rb Fx_1 Single Family (w/wo ADU)Duplex J A N 2, OF > -I F-1 Multiple Dwellings (Single Family and/or Duplex)Aj CU 3. NUMBER OF BEDROOMS: 3 /Z 01 6 8 L 9 C;1 A 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well E Private Septic Z Water Storage 1771 Holding Tank D Community Well 0 Community E71 Public Water System 0 Public Sewer El Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $_ -7S - oo Date of Payment OI L4 -b(2- Receipt Number 0TV) St COSA# 0SC,201032 Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm NorthRim Eng. Phone 694-7028 Address PO Box 770724, Eagle River Engineer's Printed Name Steve Eng 6. DSD SIGNATURE System #1 Approved for —3 bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the following stipulations: "J" 11)�t)11 Original Certificate Date: ^ to—W& The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet Legal Description: Silverwood Hill Estate LT 2 If more than 1 septic system on lot: COSA Checklist # A. WELL DATA'' ❑ Well log is filed with Onsite (or attached) Date drilled 11/14/01 Total depth 367 ft Cased to 39.65 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 24 in. Date of flow test for COSA 1/9/20 Static water level at beginning of test 86 ft. Comments B. TANK DATA Age of tank(s) new years Tank type/material Fiberglass WN1 Measured operating fluid level in septic tank new ❑ Standpipes/foundation cleanout per record drawing Date of pumping new D. ABSORPTION FIELD DATA New - -!cl Which system tested (date installed) New ❑ ALL standpipes present per record drawing Total measured depth from grade 4.5 ft (max) Measured depth to pipe invert from grade 3.5 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. 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 of Parcel ID: 05076211 Structure served by this system Well production at time of test 3 gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes IN No OR Coliform bacteria is Negative Nitrate 1.73 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L OR Arsenic less than MRL (ND) Collected by NRimEng Date of Sample 1/9/20 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date New Results Q Pass For 3 bedrooms Fluid depth prior to test 0 in Water added gal New depth - in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) no 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' Q Yes Community Sewer Manhole/Cleanout > 100' Q Yes if No ft Q Yes if No ft Neighboring Tank > 100' M Yes if No ft Private Sewer/Septic Line > 25' M Yes if No ft Absorption Field on Lot > 100' M Yes if No ft Holding Tank > 100' P/I Yes if No ft Neighboring Absorption Fields > 100' Yes if No ft Water Main > 10'✓❑ Animal Containment > 50' Q_Yes if No ft M Yes if No ft Yes if No ft Water Service Line > 10' Q Yes if No Manure/Animal Excreta Storage > 100' —Q If septic tank is under driveway Community Sewer Main > 75' Q 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' Q Yes if No ft Surface Water > 100' Yes if No ft Property Line > 5'✓Q Yes Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' Q Yes if No ft Private Wells > 100'✓0 Yes if No ft Water Main > 10'✓❑ ft Yes if No ft Community Wells > 200'✓❑ Yes if No ft Water Service Line > 10' Q Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' 0 Yes if No ft If absorption field is under driveway comment below Property Line > 10' 0✓ 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' Q Yes if No ft Community Wells > 200' Yes if No ft Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS y G. ENGINEER'S CERTIFICATION I certify that l have determined through field inspections and review of Municipal records that the above systems are in conformance with ._ MOA COSAg uidelines in effect on this date. PEER'S COSA Checklist yellow sheet BLM Lot 3 _ — — — — — — N 89'59'53"E 329.98' p, J WELL Lot 3 / Lot 1B 199.2' c -0 n i N o 1 SEPTIC FIFE-o{}� 52.4' I TREAD -ENT PODS M.LIHOLES p� SEPTIC P:PES lliw i iii I 20' T&E EASEMENT CENTERED ON EDGE i. OF ACCESS EASEMENT— Lot 2 \ , III 273,063 S.F. � I 1 Lot 2 I I60' PRIVATE ACCESS EASEMENT I I ...I. iii T30' NATURAL GAS EASEMENT THIS HALF (� OF ACCESS EASEMENT i I Lot 1 C as Lot 1 DA \\� \ \ 'o /// ob \ \\ V 4\ Lot 1 D8 i I HOUSE DETAIL Sccle: 1" = 30' PLOT PLAN --- AS BUILT X_ SCALE _7_= 100_ GRID _ NW 0354__ Project No. —_ 19-21985 11500 Daryl Avenue, Anchorage, Lang & Associates, I n c.. (907) 522-6476 Phone Alaska 99515-3049 (907) 522-4625 Fox Professional Land Surveyors ken0langsurvay.com c�p0p0p o 0F o .,...._ �S�4Q jonathon®longsurvey.com 1 hereby certify that I have the following described dam' surveyed property: LOT 2, STVERWOOD HILL 4.oTH ESTATE SUBDIVISION (PLAT No. 2002-6) Anchorage Recording District, Alaska, and that the Improvements situated thereon aro o°O "' 'G (t within the property lines and do not encroach onto the property adjacent thereto, that no Im rovements on the property lying adjacent thereto encroach on the_surva ed P P P Y Y 9 I Y there `••• •• G fes. '. KENNE G L4VG/ Pand that are no roadways, transm(sslon lines or other vfsibje easements on said property except as indicated hereon. vp �`' ll»" (�°f •. 1 ('LZ �20'ta .•Q t1Q F•PFo'•..LS-5202.'' 24: Dated this the :n ____ Day of=ec+==;vu —, Zo2o_, of Anchorage, Alaska gJOO ,o "•••••' o v aQ�Ra�SSIONAC 1 �Nc It Is the responsibility of the owner to determine the existence of any easements, 004OONA— covenants, or restrictions which do not appear on the recorded subdivision plat. AECC963 ARCTIC PUMP & WELL INC. Jim Sullivan PO Box 770197 Bade River, AK 9977 Cdlfl[II WAttB SYffiYS, SAtts a staeta (907) 688-2510 r (907) 243-2282 -rump Installation • Well Drilling Permit Number: SWO10385 Parcel Identification Number: 05076211 Date Of Issue: 9/20/2001 Legal Description Silverwood Hill Estate Property Owner Name Address: Robert/Katelyn Senn Lot: 2 Block: AK Pump Installaion Date: Pump Intake Depth Below Top of Well Casing: Pump Manufacturer's Name Pump Model: Pump Size: Pitless Adapter Burial Depth: Pitless Adapter Manufacturer's Name Pitless Adapter Installer: Well Disinfected Upon Completion? Method of Disinfection: Comments: Pump Installer Name: Arctic Pump & Well, Inc. Tuesdnv, January 28, 2020 9/3/2019 306 Franklin 5Y 10FRD07P4-2W230 455 tdh 6 Feet S-50 u/k Yes Chlorine OWNER: By: (signature) Date: l Z� H2O I (print name) STATE OF ALASKA ) ss. THIRD JUDICIAL DISTRICT ) \ The foregoing instrument was.ac�kX1 %'owledged before me this -day of 0.`(1 20_0b by Cl' LOYD NOTARY P LIC FOR A ASKA TEE Notary Public n� �`Fkiy Notary Public My Commission expires: �Oy , �u State of Alaska mission Expires Nov 30, 2021 MUNICIPALITY: % (signature) Date: (print name) Title: Page 3 of 3