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HomeMy WebLinkAboutLAKE HILL ACRES #1 LT 33Lake Hill Acres #1 Lot 33 #051-052-30 Permit Nana Municipality of Anchorage •., Development Services Department Building Safety Division On -Site Water and Wastewater Program, 4700 Bragaw SL •• P.O. Box 196650 Anchorage, AK 995195650 www.d.anchorage.ak. us (907) 343-7904 Pagel of 2 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Numbs Of Bod o LEGAL DESCRIPTION Wastewater System: ® New ❑ Upgrade ABSORPTION FIELD O o«v T a id ® Stuxow Trwxh O BM D M"aa O Odw Son naxp T.,., ..W rawaYp LAKE HILL ACRES ori« ,.w e«..m. sap. Sacharl' FI. l �.I Fa s Md a»w or"Vada F G, aLwvh. Well: New ❑Upgrade Gavel wdm 2 Ft. 40 FI wnnaa WM, 5 Oraaca ha w.0 as "G. A B. CA iota) Dom: PRIVATE Gaq b Ft. rdt"m "p Mtm 2 2.5 FI rpa Ft FI 200 Mm" tEXIISTTIG Dread Stt FIS ;ZFt ASTM 3034Da. GUARANTEED SERVICES oaa ma rw PurV Sa a Gana Hagh1 Avow Gould 5/25/2007 GIM Ft. FL TANK SEPARATION DISTANCES 7o Septic Absorption Lift Holding p septic ❑ Hotein g O S.T.E.P. ®Other. ADVANTEJC From Tank Fkld Station vWkJPMatejANC�H&RAGETAENKE Tank Sewer Line wa�lWM +100' +100' _ 15000a +2s EL H'"""a """^."• s'raoawaa +100' +100' — 2 — LIFT STATION La u» +5' +10' _ �• _ 250 0a ORENCO Fouaabn +5' +10' _ _ Perp an' M a 'Pure olr MVN a Hph was dam CurWn Draw c�^�x +•/y' }�1 44 m Moxa Mo Excmrrti�..,. a Its m TANK AND MOA CODE ORIGINAL HOLDING TANK ON LOT CAN BE UTILIZED BY VALVE BENCH MARK CONCRETE PAD AT STAIR LANDING Inspections performed by: CHARLES BALZARINI Dates: 1"5/23/2007 51222007 Development Services Department A 2nd App Conditional Approval Date: CHWSTOPHER R . MI 381 Reviewed and approved by: / ��, T (F— "%) •-- yr Date: 2---LC--c 1D0 FL Permit No. SW070067 Page 2 of 2 Municipality of Anchorage DEVELOPMENT SERVICES DEPARTMENT ON—SITE WATER & WASTEWATER PROGRAM 4700 SOUTH BRAGAW STREET P.O. BOX 196650, ANCHORAGE, AK 99519-6650 On—Site Wastewater Disposal System and/or Well Inspection Report Legal Description: LAKE HILL ACRES#1 LOT 33 LOT 29 LOT 28 SWING TES c ex HOLDINP /TANK 100' WELL DIus \ NEW 1500 CAL / I \ ANTEX SYSTEm ENCOL LFFT TEE / LOT 33 LOT 32. N to 7' i GARAGE r LL I 1( 10' UTILIT1fLASEM 0 00 / RINFIEI 5•w RAI 1 Z� --MOVE- LL -MOV E �- WELL RA IUS 70 , , �4 Rqn„ 2E.LEANOUT 197.2 - I 25' _ WELL _RAC _ -\ - MONITOR TUri BE ELEVON$_ Moi To ScALE> ORIGI TANK 95.2 ADVANTEX 4*GRA\V;EL* — t1.7' 1' FILTER SAND' ' 96.3 TH-I BOTTOM OF T.H. 051-052-30 ii, / 7/17/2007 ENGINEER'S SEAL Q0000�OpO� OF.A4. 4L?�' 4 ... . CHRISTOPHER R. NU00:. !� CE -10387 Jul is 2007 11:34RM May 31,2007 Doug Knutson Jackie Knutson 24449 Grace Street Chugiak, AK 99567 Risin6 Son Electric, Inc. 622-6777 Rising bign LLec{ric. Inc 14916 A4.9dLand Drive GagLe River. AIC 99577 (907) 622-6777 Re: lot 33 1" Addition Lake Hills Acres - Chuglak, AK 99567 Dear Mr. and Mrs. Knutson: The lift station at the above referenced property has been wired in accordance with NEC and State/Local codes. Thank you. Sincerely, t6"- +0 Kevin . Hombudde, Owner Administrator License Number 1284 Spedalty Contractor License Number 27285 cc: file MUNICIPALITY OF ANCHORAGE Development Services Department l v Onsite Water 6 Wastewater Program ` 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904Ip� I IION-SITE WASTEWATER DISPOSAL SYSTEM PERMIT 5 Upgrade Date Issued: May 17, 2007 Expiration Date: May 16, 2008 Permit Number: SW070067 Parcel ID: 051-052-30 Legal Description: LAKE HILL ACRES #1 LT 33 Design Engineer: 0848 EAGLE RIVER ENGINEERING SEI Site Address: 024439 GRACE ST Owner Name: DOUGLAS D. & JACKIE R. KNUTSON Lot Size: 23864 SO. FT. Owner Address: 24439 GRACE STREET Total Bedrooms: 4 Permit Bedrooms: 4 CHUGIAK , AK 99567 - This permit is for the construction of: Q Disposal Field ❑D Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ 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. Received By. Date: 511-710 7 Issued By./l`fc�!/– ��'L��GL�2C� Date: %%O Municipality of Anchorage Development Services Department .�I..,; Building Safety Division ` may/ On -Site Water and Wastewater Program ,„, I r. 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 ON-SITE SEPTIC/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. ()51- oSa - 30 Property owner(s) tDfLAU- N Day phone 4-0'1(. Mailing address ,] 4419 &T -A� N, L Lrt ' : Zip CodaI39�g -550 Site address ol 4 X43`1 CCK—f K_ '7T Zip Code `nSVI Legal description (Sub'd, Block & Lot) %—A-K—F b l LI - -A C.k-ES -4t I L -al "33 Legal description (Township, Section & Range) T 15 iJ Le- t W SES 3 Lot Size ..3l 9 EL Sq. Ft. THIS APPLICATION IS FOR (®alt that apply): Absorption Field Bd Septic Tank Holding Tank ❑ Privy Cl Private Well ❑ Water Storage ❑ Number of Bedrooms THIS APPLICATION IS AN: Initial Upgrade Renewal certify that the above information is correct. I further certify that this application is being made for a Single Familywelling and is accor ce with applicable Municipal Codes. of property owner or authorized agent) Permit/Rush Fees: fl Waiver Fees: Date of Payment: 5— 114 — 0 7 Date of Payment: Receipt Number: Receipt Number: (Rev. 11105) iv Eagle River Engineering Services Christopher R. Wood, P.P. 10421 VFW RD. Suite 201 (9o7) 694-5195 tel Eagle River, AK 99577 (9o7) 694-3297 fax May 17, 2007 Deborah Woekenfuss Review Engineer, On -Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: Lake hill Acres #1 Lot 33 Narrative R Upgrade Permit Application Comment Sheet Additional Info. Dear Ms. Wockenfuss, Eagle River Engineering Services (EKES) is in receipt of your comment sheet for the wastewater permit application noted above. The following additional information and clarifications are being provided to you so that you may continue your review of this permit. Comment #1: Please see revised site plan showing Muni GIS 4' contour data in addition to our slope indicators that were already provided. Please see new note regarding absence of slopes in excess of 25% within 100' of proposed system. Comment #2: Please see additional information in cross section. Comment 43: Please see attached revised spec. sheet. Comment #4: This information is not required per 15.65.060 Paragraph 11, section 1, and therefore no field percolation test was conducted in this layer. Visual rating and field evaluation of the soil gives us the impression that it would perc. at approximately 20 min. per inch. The absorption area of the designed leachfield exceeds the area requirement for soils rated up to 30 min. per inch. Comment 45: Please see new leachfield profile. Comment #6: Homeowners should have signed maintenance agreement today (5/17/07). \2003\07-022SEPTICNARRATI VECOMMENTREPLY We would be happy to provide you with any other additional information that you may need to complete your review of this permit. Please do not hesitate to contact me at our office at 694-5195. Sincerely, EAG INE RIC�RVICES 04 Christopher R. Wood, P.E. Principal \2003\07-022SEPTICNARRATI V[COMMEMREPLY Eagle River Engineering Services Christopher R. Wood, P.E. tog21 VFW RD. Suite tot (907) 694-5195 tel Eagle River, AK 99577 (907) 694-3297 fax May 14, 2007 Dan Roth Manager, On -Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: Lake Iiill Acres #1 Lot 33 Narrative & Permit Application Dear Mr. Roth: Eagle River Engineering Services (EKES) was contracted to design a 4 bedroom septic system upgrade at the above referenced property. The residence is currently utilizing a wastewater holding tank, and has been doing so since 2001 due to a failure of the original septic system that was installed in 1982. The holding tank was utilized due to the small amount of usable space on the lot due separation distances from neighboring wells and septic systems. We believe that the installation of an Advantex wastewater treatment system, or other category III systems is a viable option for this lot. A test hole and soils percolation test has yielded silty sandy gravel, GM, from 2-8 feet below the ground surface. At 8 feet below ground surface, the soil becomes very silty with some clay content. The upper layers of soil appear adequate to support a replacement 4 bedroom Category III Advanced Wastewater treatment system, and is supported by a soils percolation test in the proposed effluent -accepting soil layer. The water table stabilized and was measured at 5.1' below the ground surface after our 7 -day water monitoring period. This explains why the original drainfield failed, as the invert of the old leachfield is located 5 feet below the ground surface. It appears the original leachfield was installed in the groundwater table. We propose to keep the existing holding tank in place, in case it needs to be utilized in the future. The slope is approximately 3% towards the northeast in the vicinity of the proposed leachfield. The proposed 4 bedroom Category III septic system upgrade will have very limited impact on adjacent properties for the following reasons: 1. The new leachfield makes use of a very small space between the holding tank and original leachfield that was unusable except for with a category III system. 2. Immediate neighboring septic systems are all +20' distance, and no private (or community) wells within 100' of the proposed septic system. 3. Drainage will not be affected and is not a major consideration in our design. \2003\07-022SErncrrARRATtvt: Installation of this 4 bedroom Category III septic system, to our best available knowledge, will not adversely affect the wells or septic systems or reserve areas on adjacent lots. If you have any questions please call our office at 6945195. Sincerely, EAGLE R -R E G�INEERIN SERVICES iristopher R. Wood, P.E. Principal \2003W7-022SEPTICNARRATIVE WELL I WELL ,•� \ I 10� WELL RADIUS 100, I \ \ / I 11ECl goU6/ 1 ,r LOT 29 LOT 28 LOT 27 EXISTING HOLDIN(/TA \ ` TO BE KEPT INT/QCT 140' / AND CONECTED/ / / i�£41 / \ WITH DIVER TEI_ VALVE \ INSTALLED 1 LIFT. BASIN /VS - - - 10' U LITYI /EASEM Nr 00. R 100' WELL RAa��R1 . J "` �� ` A_DVANEW 15 EX SYSTEM / 0CAL 0 1NESf Iy,L 0 S\ I �`WkCC +200' �W pl�ytT�200 FILTER POD RAI F%41�,•I' i /SEPTIC +30' A�/ORENCO_LIFT B 51 1- 11 I E STI G DRAIN I LD I LdT 33 �� \ T E ABAND0. D / EXXIS6TINypJ SEPVTIIC TANK N \ SEE CROSS SEC 1ii1ON / 'GARAGE '( RPOSOOE OOp S SLATE LOT 32_ pC HOSE DL ` SEE PROFILE tD 101/WELL RA IUS LL I 1 y v \ WELL +200 ipnSEfnC +3 .4 S / 25' 97.2' 25' GRACEi ,/ \1. NO KNOWN URFACE WATER +100 \ \ '\/`E- -MOA 4' CONTOURS ./ \ / ® PEST HOLE — t- - EA5EMCNi NO KNOWN CURTAIN DRAINS / CH FIELD 3. -*_o SEPTICS WITHIN 30' UNLESS NOTED / o - SEWER C6E OUT_ - _ EXISTING LF 7=7AC LD 4. N ELLS WITHIN 200' UNLE$g NOTED/ + - WELL ©L DRIVEWAY 5. OFO PROPOSEDRSYSYfEM X257. WITHIN 100' WELL SEPTIC SITE PLAN-�`oF IQ LEGAL: LAKE HILL ACRES#1 LOT 33•'9S1� OWNER: DOUG KNUTSON y 0 CONTRACTOR: UNKNOWN �.*.. 9T *.� JOB 07-022 DATE:5/11/2007 SCALE 1"=40' 0.. �n •.CHRISTOPHER R. AEAGLE RIVER ENGINEERING SERVICES o� s CE -10397 10421 VFW RD. SUITE#201 '>e ' EAGLE (907) 94 RIVER, 5195 FAX. (907) 694 i O31 \ ��� 00 of Ld Ln cLLI (� (� Z O m v / zi S m -J 04 04 U) Z9 W 't N /^ OCMD w z Ln ct N NO \ �.1J � - wDll0 Q U Q N� z. 7 JV) LLJ N m W J C -4 a -Lo Lq _ I , O N O + W ^ O \ N N , r � f 0 co LL) UJ ,. Zd {Y LLIC) c—Z wZ (rj CO F-^ V nLdxz ��N0) J m< 0) (p w¢ 0000000000000 00000000000000 ' 0000000000000 �U 0 0000000000000 WCj �n q� 0000000000000 �� 0000000000000 W F0000000000000 ��� Q o000000000000 �N ao 04t 00000000000000c, r� ZZ 1-0 O000000000000 F� NW 00000000000000 NCq6� 0 vivo O 1D I� 00 01 O � Eagle River Engineering Services Christopher R. Wood, P.E. 10421 VFW RD Suite 201 (907) 694-5195 tel Eagle River, AK 99577-3294 (907) 694-3297 fax SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM — MOA CERTIFIED INSTALLER LEGAL: Lake Hill Acres NI Lot 33 May 17, 2007 A. GENERAL I. The septic plan is for a 4 bedroom single family residence only. 2. The drawing and or site plan shall be a part of this specification. 3. All materials and workmanship shall meet the Anchorage Department of Development Services and State Department of Environmental Conservation requirements. 4. All soil tests are advisory to the design and are to be verified or modified in the field by the engineer. 5. All excavations and depths are advisory and are to be verified in the field by the contractor to meet Municipality of Anchorage, Department of Environmental Conservation requirements. 6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any adjacent multi -family wells. A licensed surveyor should locate any utility easements and exact 100' radius from the existing and neighboring on-site wells. 7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer approval. 8. Any remaining open test hole excavations shall be filled and monitor tube removed. 9. It Is mandatory that a licensed land surveyor mark the location of the 100 -foot well radius, and all neighboring well radii prior to installing the septic tank and leachfield. B. ADVENTEX SYSTEM AND SEPTIC TANK 1. Septic tank shall be a fiberglass or steel 1500 -gallon tank capacity of MOA approved construction for use with Advantex system. Install as per current manufacturers recommendations for conditions in Alaska. 2. Install one AX -20 filter pod over septic tank capable of treating 600 gallons per day of waste flow. Set floats and timers per OSI Instruction. 3. Install Orenco 24" pump basin PB -2496 outside septic tank, with OSI pump model P20-05.Controls to be installed to MOA code by licensed electrician familiar with OSI applications. Controls to include a dedicated phone line and web based monitoring system. 4. A municipal inspection report or receipt from a licensed electricial contractor shall be provided to the engineer verifying lift station wiring to all applicable codes and Installation instructions. C. DRAiNF1ELD 1. The drainfield is to be located as shown on the site plan. 2. The total depth of the initial drainfield excavation is to be approximately 2' deep, relative to existing ground elevation and end in native sandy GM -type soil. The excavation shall remove only the topsoil and layer and any landscaping fill above this layer 3. A one -foot minimum layer of sand is to be installed beneath the bottom of the leachfield sewer rock. The top of the sand layer shall be level, plus or minus 1.5". 4. A nine inch (9") layer of sewer rock is to be placed over the sand layer. The 1" pressurized effluent piping is to be buried within the gravel layer with 2" of gravel cover over the piping. 5. The completed drainfield gravel and piping is to be covered with typar fabric material. 6. Soil or combination of soil and extruded board insulation to a depth of Y or equivalent is to be placed over the bcd. Mounded side slopes on uphill side and ends are not to exceed 3:1. \2003W7.022-Advantex spec SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM—MOA CERTIFIED INSTALLER LEGAL: Lake Hill Acres ill Lot 33 May 17, 2007 Continued: 7. The septic tank and lcachricld must not be closer than 100' to any existing private well, 150' to any Class "C" well, or 200 feet to any community well. 8. The existing sewage holding tank is to be kept in place, and a valve inside the lift basin shall installed to direct and isolate the flow to the holding tank in the future, if desired. RECOMMENDED LEACHFIELD DIMENSIONS TOTAL DEPTH= 2' maximum GRAVEL DEPTH = 0.5" under effluent pipe, 2" over pipe (0.75 feet total) SAND DEPTH= 1' minimum DRAINFIELD LENGTH = 40' DRAINFIELD WIDTH = 5' SOIL RATING= 5 GPD1W BEDROOM CAPACITY = 4 EFFLUENT PIPE = 1.25" HDPE from pump basin to leach6eld then 1" manifold to I" PVC with 1/8" holes oriented down spaced at 1.5' OC. 2 pipe runs in lcachricld 2.5' between pipes 1.25' from sidcwalls and end of trench. SEPTIC TANK = 1,500 Gal Advantcx compatible tank w/ AX -20 filter pod and lift basin Twenty-four (24) hours notice required for all inspections \2003\07-022-Advantcx spec EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 Eagle River, Alaska 99577 (907) 694-5195 ERES Project No.: 07-022 Calculated By: CW Date: 5/11/2007 Legal: Lake Hill Acres #1 Lot 33 Single Family 4 Bedroom Dwelling Advantex System TEST HOLE 1 Shallow Trench Subsurface Wastewater Disposal Field Water use at 150 gallons per bedroom = Percolation rate = Wastewater application rate = Required absorption area = Trench width (W) _ Gravel depth (D) _ 600 gallons 10 minutes per Inch 5 gallons per day per square foot 120 square feet 5 feet 0.5 feet Required length = Shallow trench factor • Required absorption area / W Shallow trench factor = (W + 2) / (W + 1 +2 D) Shallow trench factor= 1.00 Total Excavation Depth = 1.0 feet 79 0-01(rM- dr 5 OW6Q Required length = X feet Z,n t r so b,., -v-, pF fi w LIC) f MfM R WOOD CE -M 07-022 AdvantexdrainfieldCalc 1:41 PM5/1 M007 EAGLE RIVER ENGINEERING SUITE10421 VFW RD, EAGLE RIVER, AK. 99577 (907) 694-5195 FAX: (907) 694-3297 SOILS LOG - PERCOLATION TEST TOP HER R. WOOD. CE -10387 PERFORMED FOR: DOUG KNUTSON DATE PERFORMED 4/24/2007 `\\�==`t•� NET DROP(IN) LEGAL DESCRIPTION: LAKE HILL ACRES #1 LOT 33 TOWNSHIP RANGE SECTION T15N. R1W. SEC.3 2' 1 2 11 12 13 14 15 18 17 18 19 21 TEST HOLE5 _ LOPE oevnl If (� FILL CRAY—BROWN GM SANDY GRAVEL. LOW SILT •. GRAY—BROWN GM SILTY SANDY GRAVEL o GRAY GM GRAVEL WITH SOME CLAY WAS GROUND WATER ENCOUNTERED? YES SITE PLAN(NOT TO SCALE LOT 33 PERC TEST RESULTS READING DATE GROSS TIME NET TIME DEPTH TO WATER NET DROP(IN) 1 04/26/2004 1:00 0:00 2' 11 0 2 04/26/2004 1:30 0:30 3' 2 1/16 3 1/16 3 04126/2004 1:31 0:00 2' 11 0 4 04/26/2004 2:01 0:30 3' 2 3 5 04/26/2004 2:02 0:00 2' 11 0 6 04/26/2004 2:32 0:30 3' 115/16 215116 * PERC HOLE WAS PRE-SOAKED PRIOR TO TEST PERCOLATION RATE- 10 (MIN/INCH) PERC HOLE DIAMETER-$' SOILS 0 D 8 HER WOOD PERCOLATION TEST BY: CHRISTOPHER WOOD I - CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: $ yj /� tl Q mm m MEN MOEN MI 11 0 ME NEI Ill E MENI om�mmom ise; Uai) Pe•H aiweuAa mol T 10 a s r U 5F i U L° c U i CL L ~ung 4 i s E u p s 80 ¢ z N C F h N Ea w Lm A r 0 d o z • N N ECL rC Cr0 Oo .a O OJ C G �NO)mG N mi Q oo r N K N} $0� c 2F 3E3g z V R cz 2 Municipality of Anchorage ' Development Services Department Building Safety Division `• ' ' - On -Site Water and Wastewater Program, 4700 S. Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 Page of www.cLanchorage ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: :Swololoq PID Number. OS/—QS';? —30 Na" 1�6wtqJ4 + c,1 `Q K 0n Wastewater System: ❑ New ❑ Upgrade 6rSt tf• 6604,6 ABSORPTION FIELD Mniba, of qv* a 13 DN" Tech 13 Shel" T,wch 13 Eel O Mavtl O Olbar LEGAL DESCRIPTION W RNrq Taltl Oepa+can agnN pads P Ft Bock La Subd.laiorc , / Daptb le ppa Doran nem agntl pod Ora,NdwthbanaNh Pn": Lo �� FI. it To mtl.p Rangesed,ow FA added abae a" o N 6.0%thl Lrt I I FI. rade Well: ❑ New ❑ Upgrade _h Ft. Mnba aa.. o"INK.ab»« wt clssvreNwnj1PMNs, A P. C� Taal Deplk Caaadw Tatl poe"Na P" Mallow EYa 71iF P 1 FI. F, FIS pilar DNI D"Md Slabc WNNL"MIaIIK WrLd0 EX. DNa a"IaaW O o/o FL r,.la P N wPitAber.G,and TANK PM FI. FL SEPARATION DISTANCES ❑ Seprlc XfHolding ❑ S.T.E.P. ❑ Other. To Septic Absorption LIR Holding PubBrJPrivat MN`^ w // c nilly From Tank Station Tank Sewer Line v %dr i 500 GN. won 100 4- /F�iielld (j0 + —^ 45 J S T ^ MNNw �G'a / Nun w a Co Or maaa' sate. wNN 104 1001„` dpa.,,, LIFT STATION La L+" 36' S' 13 ` ' ^ 51 � � 41 % 'Punp on. b N. 'P +N N N,pO wN« tlam al fandtlm Y In it poly N E"clncal k wl ctw pert by cw"D'" KL h� —• BENCH MARK LWt",I Nb MwTbm. 807yot" of S8dan • �• to Maa,rd Nron Olnf' QO Ft Ellptrl`lZj�^p A....V r�P�G•OF C J +• 1 SRSINGINNERING Inspections performed by:17034 Eagle River Loop Rud, No�F, $•• 1Q -d' e"w C. COWAN N� Development Services Department Approval n i ROBERT y �"� •, CE -6801 Reviewed and approved by: Date: q'1/- 0 1 ttt p� ••w... "r �� ti`i�11t3�*T (R— IZW) �� PERMIT N0. SW010109 PACE 2 OF 3 Municipalit of Anchorage DEPARTMENT OF HEATH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 33, LAKE HILL ACRES #1 P.I.D. NO. 051-052-30 L� I 1 I I I I II LOT 28 II I o, , �P T 10' UTILITY EASEMENT ----------------_,L. NEW 2500 GALLONCO. ----T-------- HOLDING TANK •' DV (DIVERTER VALVE) CO ' pyo I' E%ISTING _--�-- i 1250 GALLON 0 �\ SEPTIC TANK♦_ t., T ti GARAGE i s I 4BfOT/C NOBS fOM 1, - 40" .n 1 ROBERT C. COWAN CE•8801 /�•r 1It F'•C.... _.� PERMIT NO. SWO10 109 PACE 3 OF 3 Municipalityof Anchorage DEPARTMENT OF HEATH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 33, LAKE HILL ACRES f1 P.I.D. NO. 051-052-30 FINAL GRADE 91.6' 97.6' C 0 1 � CO2 NEW 2500 GALLON HOLDING TANK N. T. S. A 8 DV 24.5 36.0 C011 53.5 52.5 CO2 58.0 56.0 CO3 1 49.5 50.0 t l MUNICIPALITY OF ANCHORAGE Development Services Department Onsite Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519.6650 (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: May 10, 2001 Expiration Date: May 10, 2002 Permit Number: SWO10109 Parcel ID: 051-052-30 Legal Description: LAKE HILL ACRES #1 LT 33 Design Engineer: 0003 S & S Engineering Site Address: 024439 GRACE ST Owner Name: DOUGLAS D. & JACKIE R. KNUTSON Lot Size: 23864 SQ. FT. Owner Address: 24439 GRACE STREET Total Bedrooms: 4 Permit Bedrooms: 4 CHUGIAK . AK 99567 - This permit is for the construction of: ❑ Disposal Field ❑ Septic Tank ❑✓ Holding Tank ❑ Privy ❑ Private Well ❑ 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. Received By: Issued By: Date: W®rm -- --- I I - N I Parcel I.D. 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 PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING O S' 1— 0 S' a— 3 o Permit Number SW O/O/ D 9 D4^1(6-VtS D. s TRcktt: R. Propertyowner(s) JOt�G �Nt_!1-SOS Day phoneZ(o�--I�ZZ Mailing address (1) Z�{�4'q ��IZ4 S� 4Z 14- G la,tc l� 8956 -SS42 SITE bleiliRg address (2) 24439 GRff t:E Sik1:6 T Zip Code Legal description (Lot, Block & Sub'd.) L 6 Legal description (Section, Township & Range) Lot Size Acre q.F 2-386¢ THIS APPLICATION IS FOR: re_< #/ Number of Bedrooms T Sewer Only ❑ Well Only Sewer and Well ❑ Water Storage Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi Swimming Pool ❑ Water Softening Unit Therapy Pool ❑ certify that the above information is correct. I further certify that this application Single Family Dwelling and is in accordance withapplicableMunicipal Codes. S ENGINEERING 1 / I'✓W' [ ^ f'�-- 7034 Eagle River Loop Road No. 204 Eagle River, Alaska 99577 ha (Signature of property owner or authorized agent) Permit Fees: 3 a-0. Waiver Fees: Date of Pavment: y /3 0/ 01 Date of Payment: Receipt Number: D0 3 -;L iV S' Receipt Number: (Rev. 12100) a n is being made for a S& IEKM ALIT NORI APPROVALS SEWERBWATER MAN E%TENSION.R SEWER 6 WATER INSPECTION ENONEERNGSTUOIES ANDREPORTS WMNSPECTICN S FLOW TEST SITE PLANS ROADDESIGN SOILTEST PERCOLATION TEST STRUCTURAL WOIANICAL INSPECTIONS ONSITE WASTEWATER p6POMSYSTEM DESIGN ROBERT C. COWAN, P.E. CMLENGINEERS (907)694.2979 FAX(907)694.1211 April 12, 2001 MUNICIPALITY OF ANCHORAGE DevtL.oF���r sEn.0 N,s � P.O. Box 196650 Anchorage, Alaska 99519 REFERENCE: Lot 33, Lake Hills Acres SID This letter is a request to issue a permit to upgrade the existing system with installation of a holding tank that will serve the four bedroom residence on the referenced property above. We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the installation of the proposed septic system. Attached is a site plan which depicts the locations of the existing septic system and proposed holding tank. If you require additional information, please contact us. Sincerely, Robert C. Cowan, P. E. RCC I by Enclosure 17034 NORTH EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER, ALASKA 99577 LOT 33, LAKE IIILLS ACRES S D •• _ 7wwN B+: _•tCAtu Bv: �s•L: 5 LET: f•v��{ ` ••'. B.J.J. R.C.C. 4-17-01 1 OF 1 & DESIG /C�zIT A. CONTRA TOR S REO RED\TO +_nglnrrring / OBTAIN uT LOCOA s 4 BDRM = 25100 AL N HOLDING TANK PRIOR To NY xcA loN\ 1 ^...%Lr SOILS = 8 GPD SQ FT. WORK. Rpp1U$ i PAT RCEERT C. COWAN f� I p0• WEIL i'C I /l+`p: CE -8301 A I I 17034 EAGLE RIVER LOOP ROAD I I LOT 28 1 EAGLE RIVER. ALASKA 99577 I I LOT 2/I PHONE/ (907)694-2979 1L*.�y?•'� FAX/ (907)694-1211 \ I I Jy j CONTRACTOR IS RESPONSIBLE �� I OR L OF ALL SURROUNDING W ADII Z 75' WELL RADII SHOWN F W Q SEPARATION TO PROPOSED \\ \ O� a 2500 GALLON SEPTIC TANK _ LOT 25 N 10' UTILITY EASEMENT_ PROPOSED EXIStNG-STSTE �5 TIC 2500 GALLON ^ , * O �F,\.� U TAN 1G TO REMAIN 1 CC HOLDING TANK )S, i FOR FUTURE USE _ _ VS � WELL I EXISTING 1250GALLON 0 RA IDI SEPTIC TANK\CO f+� T °0 S BULL RUNIf DIVERTER VALVE N f \ \ GARAGE 4 BfOROG c0Ld i 32°SGS HOUsfOM LOT `� �� LOT 24 10p' WELL RADIUS I °°• �° \ LOT 23 \I ALL PORTIONS OF TA,VK I WITH LESS THAN 40 OF I rassw. m WO t COVER REQUIRE INSULATION. [�•� MUNICIPALITY OF ANCHORAGE ® DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION I� ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264.4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE ❑ NEW UPGRADE MAI LIN6 ADDRESS 4a Cha j LEGAL DESCRIPTION /--:33 a' Ago r e j .4-y LOCATION// NO. OF BEDROOMS a 4 Wel��� `� Absorpt' n r Dwel�' / PERMIT NO./ / Uy DISTANCE TO: �� w za F Manufactur r M �_ No. of com rtment ur Liq. ap city i lions IF HOMEMADE: Inside length Width Liquid depth 0 ]STANCE TO: Well Dwelling PERMIT NO. - z = z < Manufac Material Liquid capacity i s i DISTANCE TO: Foundation Nearest lot line _VFM T NO. LU LL Z No. of lines Length of each lin - Tota] length of lines Trench wid Distance between lines inches ¢ Fes- Top of tile to finish grade Maters eath the Total effective absorption area p inches Length Width Depth PERMIT NO. w < F Type of crib Crib diameter Crib depth Total effe absorption area wa wWell N DISTANCE TO: Building foundation Nearest lot line J Class Depth Driller Distance to lot line PERMIT NO. J W DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) y OTHER //� "- PIPE MATERIALS 4l 1, SOIL TEST RATIN9 M} I Q INSTALL n` � '4 �e V L ea �1lG REMARKS n � J -11 �G(w J� // 1�l f c 6 S rAG. S< a •eeq p P 4001 �,A//'�' ' rC e O eV e e GTI tea.. g s �,OA/tlt�a—W 3.,Di�/'�•ii"i:`.�[.I-2gT/ a �-u ° i s •r• es .0 °e P �i ea 4$7- e'•„a`. -- iii A el eek' L�9' APPROVED DATE AL hr) / 1 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 NAMEP [:1NEW UPGRADE C MAI LING ADDRESS �2 LEGAL DESCRIPTION 0/ XGj �C M �� �? /� 3 /��/ '114 c�, LOCATION NO. OF BEDROOMS% U DISTANCE TO-7] DISTANCE TO: WW Absorption afea� Dwelling] / PERMIT NO. Y F Z WGlw� Manufact _ i I No. of ccartments ti Liq. cep ity„� &lions L,�L�l IF HOMEMADE: Inside length Width Liquid depth O Y JAZ DISTANCE TO: Well Dwelling PERMIT NO. = z FManufacturer Material Liquid capacity in gallons O Well f / Wei y1(,9'7" Foun "on C Neares of ne� PE.Fj QlT .^f w= DISTANCE TO: -� J LLz No, of lines j Length acb l jfa Total len �Ii iZ/ -F�-- Trench Distance v ep does /� Z w ( J .y inches F - cc To oftheA to finish gr 1 V/ a ial b nR thrleer inchesCJ Total off iye ab�so rption area CJ Length Width Depth PERMIT NO. w -11­- Type of crib Cri dame r yi Crib depth Total effective absorption area w w rn DISTANCE TO: Well Building foundation Nearest lot line Clast-- XIS- Dep h /c- Driller Distance to lot line PERMIT NO. w � DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER fi U� U PIPE MATERIALS /H SOILTESTRATING f INSTALLER �G /✓ �S 1>J�G'��1� 6-L= REMARKS •o0•s s g - /1' !/ L. • e alt, '• s • - -tir:; X L//� •I • F i.06 No. 7457•' VNN APPRE j DATE LEGAL TYPE OF SOIL HBSOR' TION SYSTEM 10 TRENCH MHXIMUM SQIL RHTIN(,'-,, 250 THE REQUIRED SIZE OF THE SOIL HBSORPTI8H SYSTEM IS: � �FEE ��— T- I -A 75 pit KF� �E L— ����9A� � TH� LENGTH DIVIENSION 11, THE (IN FEET) OF THF. TRENCH OR DRHINFIELD THE DEPTH OF F"i TRENCH 8R PIT IS THE DISTHNCE BETWEEN THE SURFACE OF THE GROUND HND THE BOTTOM OF THE EXCHVHTIOP-i (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES- THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE QUTFHLL PIPE AND THE BOTTOM OF THE EXCH9HTION (IN FEET). Ali FOE F" -F- 1 P0 -V Fit VA PC 10 3: 12' EH ������'D P.-A� PERMIT APPLICANT HHS THE RESPONSIERILITY TO INFORM THIS DEPHRTMENT DURIENG THE INSTHLLHTION INSPECTIQNS OF HNY WELLS HDJHCENT TO THIS PROPERTY HND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. il - gmA CH �::--P �POO ����-'IF :1 ��ES'. 102 IEEE- P, 1, __� BHCKFILLING OF ANY SYSTEM WITHOUT FINHL INSPGCTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION MINIMUM DISTHNCE BETWEEN H WELL HND HNY ON—SITE SEWHQE DISPOSHL SYSTEM IS 100 FEET FOR H PRIVATE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UP8N THE TYPE OF PUBLIC WELL MINIMUM DISTHNCE FROM H PRIVHTE WELL TO H PRIYHTE SEWER LINE IS 25 FEET HND TO H COMMUNITY SEWER LINE H; 75 FEET. OTHER RE�UIREMENTS MHY �PPLY� SPECIFICHTIONS HND CON�T�UCTION DIHGRHMS ARE AVAILABLE TO INSURE PROPER INSTHLLHTION �I", I Fos MET KIM ESE Q U 1-1 M W 1;? :1. Kilo :A 1.0"! [ CERTIFY THHT 1:I HM FHMILIHR WITH THE REQUIREMENTS FOR ON.SITE SEWERS HND WELLS HS SET FORTH BY THE MCNICIPHLITY OF � ' DEPHRTMEIFF HEHLTH HND ENVIRONMENTHL WITA THE CODES. �OTECTION / ^ / 825 'L/ ' STREET, 9501 264~4720 . ~~N X~I- U to, ESE WI Ev! lot IF, T-,�� PERMIT NO. ( 820]07 ) Fit PLICHNT RAYMOND TORRES R. BX EHGLE RIVER 000000� LOCHTION GRHCE ST LEGHL L ]:] B J. HILL HCRES LOT SIZE 22000 SQUHRE FEET TYPE OF SOIL HBSOR' TION SYSTEM 10 TRENCH MHXIMUM SQIL RHTIN(,'-,, 250 THE REQUIRED SIZE OF THE SOIL HBSORPTI8H SYSTEM IS: � �FEE ��— T- I -A 75 pit KF� �E L— ����9A� � TH� LENGTH DIVIENSION 11, THE (IN FEET) OF THF. TRENCH OR DRHINFIELD THE DEPTH OF F"i TRENCH 8R PIT IS THE DISTHNCE BETWEEN THE SURFACE OF THE GROUND HND THE BOTTOM OF THE EXCHVHTIOP-i (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES- THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE QUTFHLL PIPE AND THE BOTTOM OF THE EXCH9HTION (IN FEET). Ali FOE F" -F- 1 P0 -V Fit VA PC 10 3: 12' EH ������'D P.-A� PERMIT APPLICANT HHS THE RESPONSIERILITY TO INFORM THIS DEPHRTMENT DURIENG THE INSTHLLHTION INSPECTIQNS OF HNY WELLS HDJHCENT TO THIS PROPERTY HND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. il - gmA CH �::--P �POO ����-'IF :1 ��ES'. 102 IEEE- P, 1, __� BHCKFILLING OF ANY SYSTEM WITHOUT FINHL INSPGCTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION MINIMUM DISTHNCE BETWEEN H WELL HND HNY ON—SITE SEWHQE DISPOSHL SYSTEM IS 100 FEET FOR H PRIVATE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UP8N THE TYPE OF PUBLIC WELL MINIMUM DISTHNCE FROM H PRIVHTE WELL TO H PRIYHTE SEWER LINE IS 25 FEET HND TO H COMMUNITY SEWER LINE H; 75 FEET. OTHER RE�UIREMENTS MHY �PPLY� SPECIFICHTIONS HND CON�T�UCTION DIHGRHMS ARE AVAILABLE TO INSURE PROPER INSTHLLHTION �I", I Fos MET KIM ESE Q U 1-1 M W 1;? :1. Kilo :A 1.0"! [ CERTIFY THHT 1:I HM FHMILIHR WITH THE REQUIREMENTS FOR ON.SITE SEWERS HND WELLS HS SET FORTH BY THE MCNICIPHLITY OF HNCHORHGE Ah I WILL THE SYSTEM IN HCCORDHNCE WITA THE CODES. ]� I UNDERST T TE �E�ER SYSTEM MAY REQUIRE ENLHRGEMENT IF THE SIGNED � PPLICHNT RHYUK11 �- lD TQRRES p V4.0 ❑ SOILS LOG MUNICIPALITY OF ANCHORAGE • +� DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: M C'/ C DATE PERFORMED: LEGAL DESCRIPTION: /Z— 3 3i1 V C // Ac EP H SLOPE SITE PLAN 1 2 G 3- 4 5 } 6- 7 ;I tt0 9- 10- 11 0 11 12 13 4 14 15 16 c7, f�� / t 1 f 17 18 19 �9F0 y "ROFESS100\- 20-4 COMMEN WAS GROUND WATERS ENCOUNTERED? /f/f/ L O P IF YES, AT WHAT E -p DEPTH? Reading Date Gross Time Net Time Depth to Water Net Drop 17 18 19 �9F0 y "ROFESS100\- 20-4 COMMEN WAS GROUND WATERS ENCOUNTERED? /f/f/ L O P IF YES, AT WHAT E -p DEPTH? Reading Date Gross Time Net Time Depth to Water Net Drop l f S�iu 6!,3 --- 'i ate 2,`10 /0 Al, lu 6 PERCOLATION RATE TEST RUN BETWEEN f; � ::Ivy F:t�k"ilecli PERFORMED BY: et [/.A. C+2"'4 CERTIFIED B (minutes/inch) LFT AND = FT an ft �L�o r /k 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 NAME Bp p �J / / � -(fYvl PL_�� (U. ❑ NEW UPGRADE MAILINGADDRESS\,J / LEGAL ESCRIPTIO 14 �s LOCA^�TJ�,pL�� NO. OF BEDROOMS / f Well Absorption area Dwelling PERMIT NO. Uy DIST CE TO: I- Q LU Manufactures Material - No. of compartments y Liq. capacity in gallons �5_S V IF HOMEMADE: Inside length Width Liquid depth z DISTANCE TO: Well Dwelling PERMIT NO. 2 z FManufacturer Material Liquid capacity in gallons Well > fy� ( / Foundatiow !�. Nearest lot line 6 { PE 1I A10.00. Lu = DISTANCE TO: J LL z No. of lines 2�- Len th of e h line ( K Total length of lines Trench widwh Distance n Vines A Z w �— l� �% //, '50 inches N CC Top Ae finish � benea tie of Total effective absorption area f. of to yra e �_� erial ` `r- ❑ 2�(� inches Length Width lieptn PERMIT NO. w C7 Q H Type of crib Crib m er/L Crib depth Total effective absorption area a a. w y Well Building foundation Nearest lot line DISTANCE TO: Depth Driller Distance to lot line PERMIT NO. _jClass J �y { ! ,ms �I..- Lu Building foundation Sewer line Septic tank Absorption area(s) DISTANCE TO: Ilel OTHER PIPE MATERIALS vj SOILTESTRATIN /> e 2 INSTALLER .$-r�,�`zo, WA- REMARKS ��<f 6009 tJfp V� q7q, yy� t' y 9 Robert A Zh, 'c No. 1487 A 9OFESSIONP, - -W x A PP/Fj0VE % LEE /J j `G-A7L /�7DATE ��� ��� ��������� �-� �"�- - -�w­ - ������' � THE LENGTH DIMENSION IS THE LE��GTH <IN FEET) OF THE TRENCH OR DRHINFIELD T�E DEPTH OF H TRENCH OF� PIT IS THE DISTF���E BETNEEN THE SURFHCE OF THE ' 'DEPHRTMENT HEHLTH HND EMYIRONMENTHL THE GRHVEL DEPTH IS THE MINIMU1*- 1 DEPTH OF GRHVEL BETWEEN THE OUTFHLL PIPE HMD THE BOTTOM OF THE EXCHVHTIGN (IN FEET) .�OTECTION ��������� ����� ����� ���� 825 STREET, HNCHORH8E, HK995G1 DURIMG THE 26�~4720 H�D THE PE�MIT NO ( 820009 ) - . ff YI ... ��� ����� �~~� HPPLICHNT FINIS SHELTON BOX 560 688�I26] LOCHTIO� PETERS CREEK IS 100 FEET FOR H PRIYHTE WELL SR 158 TO 200 FEET FROM H PUBLIC WELL DEPENDING LEGHL LOT ]] LA KEHILIT- M�NTMUM DISTHNCE FRQM H PRIYHTE �ELL TO H PRIV�TE SEWER LI�E IS LOT SIZE 40000 SQUHRE FEET TYPE OF �OIL HBSORPTION SYSTEM IS� TRE�CH OTHER REQUIREMENTS MHY HPPLYSPE�IFICHTIONS HND CONSTRUCTION DIHGRHMS MHXIMUM NUMBER OF BEDROOMS� 4 SOIL RHTING (SQ FT/BR)� 250 THE REQUIRED SIZE OF THE SOIL HBSORPTIQN SYSTEM IS� ��� ��� ��������� �-� �"�- - -�w­ - ������' � THE LENGTH DIMENSION IS THE LE��GTH <IN FEET) OF THE TRENCH OR DRHINFIELD T�E DEPTH OF H TRENCH OF� PIT IS THE DISTF���E BETNEEN THE SURFHCE OF THE GROUND HND TH� B(}TTOM OF TL EXCHVHTION (IN THERE IS NO SET WIDTH FOR TRENCHES THE GRHVEL DEPTH IS THE MINIMU1*- 1 DEPTH OF GRHVEL BETWEEN THE OUTFHLL PIPE HMD THE BOTTOM OF THE EXCHVHTIGN (IN FEET) ��������� ����� ����� ���� �������� PERMIT HPPLICHNT H�S THE RESPONSIBILITY TO INFORM THIS DEP�RTMENT DURIMG THE INSTHLLHTION INSPECTIONS OF HNY WELLS HDJHCEMT TO THIS PROPERTY H�D THE NUMBER OF RESIDENCES THHT THE WEL� WILL SERVE - . ff YI ... ��� ����� �~~� BHCKFILLING OF HNY SYSTEM WITHOUT FINHL INSPECTIOM HND HPPROYHL BY THIS DEPHRTMENT WILL BE SUBJECT TO PROSECUTION MINIMUM DISTHNCE BET|�EEN H WELL HND HNY ON~5ITE SEWHGE DISPOSRL SYSTEM IS 100 FEET FOR H PRIYHTE WELL SR 158 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL M�NTMUM DISTHNCE FRQM H PRIYHTE �ELL TO H PRIV�TE SEWER LI�E IS 25 FEET HND TO H COMMUNITY SEWER LINE IS 75 FEET OTHER REQUIREMENTS MHY HPPLYSPE�IFICHTIONS HND CONSTRUCTION DIHGRHMS HRE HVHILHBLE TO INSURE PROPER INST"LLHTIONL I CERTIFY T�HT 1� I HM FH�ILIHR WITH THE REQUIREMENTS FOR ON~SITE SEWERS HND WELLS HS SET F0RTH BY THE MUNICIPHLITY OF HNCHORHGE 2� I NILL INSTHLL THE SYSTEE WITH THE CODES ]� I UNDERSTHND THHT THE ON�SITE SEWER SYSTEM MHY REQUIRE ENLHRGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THHN 4 BEDR0]M�� SIG�ED�~� ... _.... ..... ~~��~ RPPLIC�N�r FINIS SHELTON 21 � 2~. ��' 4-00 Ao V40 J ❑ SOILS LOG MUNICIPALITY OF ANCHORAGE • +.e DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION/Q` PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: ✓ % � G J she e 1 k DATE PERFORMED: L 0 3,gkJ LEGAL DESCRIPTION: 1-33 /, �-e - `-e /' IJ` DEPTH G 1 ��> 2 3 C' 5 e 6 10- 0 Date Gross Time 11 11 Depth to Water Net Drop 12 13 e, ° ; o j 3� ti�i 1'j OF 4f 15 xv 6 16- �o `� r, 3 �, it 17 17 18 Robert A. Sh r 4d N'•• No. 1457- 19 A �<�pgOFESS10NAt•LF,��J /o r, l v 3 rL �r I rr 20 COMMENTS / L t6XII%/�tl� PERFORMED BY: 79-nnR ranoi �C WAS GROUND WATER S ENCOUNTERED? L 0, P IF YES, AT WHAT E DEPTH? Reading Date Gross Time Net Time Depth to Water Net Drop ell Z e, ° ; o j 3� ti�i 1'j 10 P �o `� r, 3 �, it f A WJ /o r, l v 3 rL �r I rr l,l PERCOLATION RATE :3 D (minutes/inch) TEST RUN BETWEEN v FT AND 6 FT CERTIFIED DATE: 2i l%ylez U ICIPAUTY F 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. 051-052-30 1. GENERAL INFORMATION Complete legal description LAKE HILL ACRES #1 LOT 33 Expiration Date: 1-1-2-2 Location (site address) 24449 GRACE STREET, CHUGIAK, AK 99567 Current property owner(s) TERESA & TROY VEST Day phone Mailing address Real estate agent PO BOX 9000. BROWNSVILLE. TX 78520 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ® Private Septic Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee $ 5 5 0 Waiver Fee $ Date of Payment 9 Date of Payment Receipt Number 9 002 1 a Receipt Number COSA # 03C-0,1 15 51 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 FIRST WATER CONSULTING Phone 907-350-9566 Address 13030 SUES WAY, ANCHORAGE, AK 99516 Engineer's Printed Name CURTIS HUFFMAN, PE Date 9/17/2021 Comments: This investigation was completed in compliance with MOA guidelines, regulations, and best industry practices / methods. The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The flow and absorption rates may change due to subsurface conditions that may not be observed from the surface, changes in land use, local soil characteristics, groundwater levels that may fluctuate during the year, quality of construction (workmanship & materials), the water usage of the family being served by the �`\\\\\\ system and maintenance. The operational life of all well and septic systems are subject to `-' these various and dynamic characteristics and are outside the control of the evaluator of the �'•�(i .!q well and septic system. Therefore, any estimate of how long a system will function satisfactory ��Q:. •Z�i .. for current or future occupants or guarantee that no unseen encroachments, deficiencies or g•' discrepancies exist can be given by First Water Consulting & FWC..S . ' .6. DSD SIGNATURE ^ • ' • Curtis Huffman � System #1 Approved for bedrooms �� c�s � •, CE 128991 System #2 Approved for bedrooms ili �PROFESSOX Disapproved Conditional approval for bedrooms, with the following stipulations: 1:3 ON- `� IATA SITE �y wA`'S-T AND m r FROG � o J o AM Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other Legal Description: LAKE HILL ACRES #1 LOT 33 Parcel ID: 051-052-30 If more than 1 septic system on lot: COSA Checklist # _of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled PRE 1975 Total depth 235 ft Cased to UNKNOWN ft ® Sanitary seal is functioning correctly ® Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 9/15/2021 Static water level at beginning of test 185 ft. Well production at time of test 4.7 gpm Comments B. TANK DATA Age of tank(s) 14 years Tank type/material ADVANTEX / STEEL Measured operating fluid level in septic tank ® Standpipes/foundation cleanout per record drawing Date of pumping * D. ABSORPTION FIELD DATA Which system tested (date installed) 5/25/2007 ® ALL standpipes present per record drawing Total measured depth from grade 2_9 ft (max) Measured depth to pipe invert from grade _ft (min) ® N/A — pressurized field ® Monitor tubes go to bottom of effective. If not, state depth into effective ® Code -required soil cover over field W/ INSULATION ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: Structure served by this system _ Water storage tank volume NA gallons Well disinfected for coliform test? ❑ Yes ® No ® Coliform bacteria is Negative Nitrate 0.764 mg/L E]Nitrate less than MRL (ND) Arsenic ug/L ® Arsenic less than MRL (ND) Collected by FW't;->- Date of Sample 9115/2021,, - C. LIFT STATION ® Required maintenance completed Age of lift station 14 years Lift station material STEEL Comments: *SEE MAINTENANCE REPORT Adequacy test date 9/15/2021 Results Z Pass For 4 bedrooms Fluid depth prior to test 0 in Water added 600 gal New depth 2 in Elapsed time <15 min Final fluid depth 0 in Absorption rate 600 gpd Any rejuvenation treatment (past 12 months) N If yes, enter date FWCS 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 ® Yes if No Neighboring Tank > 100' ® Yes if No ft Private Sewer/Septic Line > 25' ® Yes if No Absorption Field on Lot > 100' ® Yes if No ft Holding Tank > 100' ® Yes if No Neighboring Absorption Fields > 100' Water Service Line > 10' ® Yes Animal Containment > 50' ® Yes if No ® Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ®Yes if No ft ® Yes if No From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ® Yes if No ft Surface Water > 100' ® Yes if No Property Line > 5' ® Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No Water Main > 10' - - - .® Yes if No ft Community Wells > 200' Yes if No Water Service Line > 10' ® 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) ft ft ft ft ft ft ft ft Building Foundation > 10' Yes if No ft If absorption field is under driveway comment below Property Line > 10' ® Yes if No _ ft Wells on Adjacent Lots: Water Main > 10' ® Yes if No ft Private Wells > 100' ❑ .Yes if No *50+ ft Water Service Line > 10' ® Yes if No ft Community Wells > 200' ® Yes if No Surface Water > 100' ® Yes if No ft F. ENGINEER'S COMMENTS *THIS IS A CAT III SYSTEM & MEETS THOSE SETBACK / SEPARATION CODE REQUIREMENTS. G. ENGINEER'S CERTIFICATION l certify that l 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. tlow ,�� Jos PIC_. • .,� �+ : 4g TH .. .... .......... Curtis Huffman I 101, .,% i CE 128991 4' • 9120/2] . •'ti�v� t�1, *PROHS*S N� .,v MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS AINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this *-)I of S ,' y, �-O V4 `11 of 20 , by and between �,- le +, ���`�y����` C,5,IQ 7ctUZa5 , herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code (AMQ 15.65.365. In consideration of the mutual covenants contained herein, the parties to this Agrees dent agree as follows: 1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), escribed as AN ADVANTEX SYSTEM ocated at (legal description) LAKE HILL ACRES #1 LOT 33 2. 6aintenance, Repairs and Alterations. (0 1 ner is required to read, understand and initial each section) 'E,hroughout the term of this Agreement, the Owner shall enter into a service agreement vith an AWWTS service and maintenance provider approved by the Municipality or the anufacturer'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. � I 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). . ;Owner 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 �ailure of the system, which could include sewage backup and costly repairs or drainfield (rev. 0/18/2018) Pagel of 3 I t� Owner acknowledges that the Municipality may request records of maintenance and tepairs from the manufacturer's representative or maintenance provider. ��( ( wner acknowledges that the fine for failing to maintain and repair an AWWTS may be ssessed in accordance with AMC 14.60.030. w~ner agrees to grant the Municipality reasonable access to test and inspect the �WWTS. The Municipality will give at least 24-hour notice. �t- ( owner agrees that any sale or transfer of title of the property will not occur without a new i-ertificate of On -Site Systems Approval. �L Dwner agrees that the AWWTS installation and maintenance requirements as provided 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. �1 (1-1Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. erm. The term of this Agreement shall begin on the date of approval b the 5 b pp Y Municipality to operate the installed system, or upon transfer of title, and shall continue jvhile 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 Ix-reement shall in no way constitute a waiver of the provisions, nor in any way affect I validity of the Agreement or any part hereof or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of f ie Owner and Municipality. Any attempt to amend this agreement by either an lie representative or unauthorized means shall be void. 6. Uurisdiction. Choice of Law. Any civil action arising from this Agreement shall be I brought in the Superior Court for the Third Judicial District of the State of Alaska at nchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent N jurisdiction shall not invalidate the remaining provisions of the Agreement. (rev. 01/18/2018) Page 2 of 3 By: (signature) Date: « 11 name) STATE OF ALASKA ) ss. THIRD JUDICIAL DISTRICT ) The for-goi'ngg instrument was acknowledged before me this c2l day of 5eC-hAk \- , 20 II , Uy t� , shri n �— SABRA L. GILLILAND Notary Public NOTARY PUBLIC FOR ALASKA State of Alaska —� f -a flame My Commission Expires Jan > >, zoz3 y Commission expires: _(signature) Date: �� d _(print name) Title: (rev. 05/118/2018) Page 3 of 3 U`J/ 2.1 / 2b21 U1:11 8b8b 11 b AHLUS HAaL N2 0911712OZI 09:58 A 100r;gge Tank (FW107 277 3715 P,0011001 0aw now 401 528 ONNEEMN 0 OEM EMvahl �axo Field Maintenance Report Annual in;rpection AnchorageTank 907-272-3543 Plnfuirty oi+7l;Ofl1•r�ChlnQ i opmunel ........._._.._ Troy Vest Larry Betts 87rn arxirase c:rnrxt H hunn 24449 Crate E Beet, Chugiak AK 99567 (907) 250-1560 AX 91to IU h courtly tO a pod r Frau i/UL N Dots U1 Luafi Inapnetion AX -112427 SVV070067 1209492 RTU'110 f 27 09/03/202tt Retrieve O&M In'D OZriy Rocha. mlto Timor : ctCsn$Ix: This is a C0,1 A Inspection. Please fax to ,Anch Tank for Brant Perform Field Sri mpling/Observations NTU (15 z N7U9) pH (a -S) 00(2-6) 7 ------------ _..___,------ Odor of of sample Typical ,lusty t;arlhy D Moldy Nan.typir•.ul ) WHidc `CalJtragc F�nr..rtny oily film to l! r -1 Y"s A Nc Fd*rta at lank 0 Yes j/J NO Check Control P incl FReciirC Mtp?; Olschalge tu>1pa Audible and visue alarms 10K / Mini riiA (ri.•teme:t ;q only) I�Yoa /I leo InspectlCleAn Pt rags System f� Inspect Clean Riser)I it] . _ ... , ... , l Splice Bar ...... .............. Float Cords .... .............. !T Klnnt2......... ............. Dump ......... dnWW, , _ vioftlbe Pump Val Et ............ ' Reoirta3ating Spll :er valva,_commonts Me0Sum S1ucige1Scurrt fiIudge $cugt UA Oompartnlotlt current PrrJvig41-R... _ Current -- Previous- ) , 2nd Gompdr'Iment Current P?CVi0Qkt Currant Prevloun In,g ACYCInAn Adv:tAT{sx Filter In*noct Glean Odor F/11jormal 0 Pungent LatemInlorifir.- � �'T 8iprnat_ Normal 0 Excaaaivc: Pool gnttonl Bridging/Ponding: /Nonclr4inar ❑ Excessive intakoV&c is Inspect/Clean Discharge Pump System Inspect lmpr..c;t Clean Riz§ar/Lid Floats Splico Bort Purnp Float cords Inr.pe&JSeriric[a 0tlnar Sy -.tarn Oompooents Inspect Clean [r)-lPmct Clsnn 00irlfaCtion Equipment Dispesel Leterals/Orifioa ' ttdidif;yvnal Services F4prrderao El Cleaned textile streets? (- Replaccw UV itcrhs7 RoplacLcl/Hoed other iterna? parts U98d: vJ = Warratity, B i- Billable (V appropriaCc srloation} VIf 13 Item Number D*4crfption Fin&Safety Inspection 7 RSV ra;wtaliod blanlfold n c;onmeted; flush Valve& Owed Surf rnalyfRecommendations System performing; no farthoe action nceded i� Gall for iiervic.& Llds :Jolted on Xcontrol pertel r{ tct6vttted ( hank naive* pumpbtg Qlt;er7 _„��„_•_ Date • • •.�� ... —.. S3X �ris11 pleted form to 1r866 -3a4-741$34 EAST 190.35 EAST 9720 i i GRACE STREET o�0000pp� 0 o�OFAk"%% c 1H �0 o,` N SHANE A. HOLT Q� LS -6914 �Q"Ifessiona\ Lao DOpood� INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY LICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; AND IS TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES. MENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT , ARE NOT SHOWN ON ( UNLESS INDICATED) : FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE ERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. s -BUILT SURVEY 1" =20' )RNERS SET THIS DATE HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY THE FOLLOWING DESCRIBED PROPERTY 0T33, LA KE HILLACRESFIRS TADD'N. JCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE [SIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN iE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST OTHER THAN NOTED. DATED AT ANCHORAGE,ALASKA THIS 215T DAY OF SEPTEMBER 2021 15228, FB 217-32 FIOLT LAND SURVEYING 93o9 GROVER DRIVE ANCHORAGE,AK 99507 345-5513 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519.6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. oL;l —ns5a- 30 1. GENERAL INFORMATION COSA# ObAtel Expiration Date: 111,2 D — V % Complete legal description L/1 Ke, 4-, H ArmeS Location (site address) 'Z Li LIACI Gin ce- 22T Current Property owner(s)�DLAI �.D Kn.-j- ,nrL Day phone Mailing address Lending agency Mailing address Real Estate Agent Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. Day phone Day phone 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual On-site Individual Water Storage ❑ Individual Holding Tank ❑ Community Class Well ❑ 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 sample results. (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 engineer's work. 4. 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 e.11.b7. S. Phone G 9el- Address /o4!a 1 vGr✓ ice. S47rc. zd t 6X 41c 92527 Engineer's Printed Name _GNPTc,7o0 &2 R. Oocxb Date 5. DSD SIGNATURE Approved for Lbedrooms. Disapproved. Conditional approval for bedrooms, with the followi Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: L Original Certificate Date: &I (Rw. 11105) Municipality of Anchorage • Development Services Department E Budding Safety Division ---.Ori Sits Watei & WesteWater Program = :. 7 4700 Bragaw Street 'r P.O. Box 196650 Anchorage, AK 99519-6650 r www.muni.orglonsite (907) 3434904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: La.ke� 17 i I I ACreS -'*I Le♦ V� Parcel lD:0X_/-O3 a-30 A. WELL DATA Well typeT6Y&+e If A, B, or C provide PWSID # _ Well Log (Y(fb hi 0 Date completed,;ne 1975 Sanitary seal &l N) O Wires properly protected 6?N) 6_7 Total depth �_ft. Cased to }. 4 O ft. Casing height (above ground) �in. FROM WELL LOG AT INSPECTION Date of test (,Lin_knaifl H/1212-007 Static water level 1 a knoij Y1 ft. Is r� ft. Well production. lin k13Cx_')n g.p.m. +6.25 g.p.m. WATER SAMPLE RESULTS: Coliform _j2L-colonies1100 mL Nitrate Qom8 mg/L Other bacteria __0_ odonies/100 mL Arsenic: -0- mg/1 Date of sample:66WO-7 Collected by. C �: r 1 ri t B. SEPTICIHOLDING TANK DATA TankTypelMaterial RA)ZixnTQXdS+ee,I Date installed 5/2 S/2.007 Tank size Ll= get. Number of Compartments _ cieanouts ON) Y E5 Foundation cleanout ®N) YE.& Depression over tank (Y® hQ High water alarm (Ye Imo_ Date of pumping Al i -i Cn 2h3j h)rPumper N/A C. ABSORPTION FIELDDATA Date insia0eda,,m,&C07Soi1 rating (g.p.d.e or KIM.... S System type 5)0 jj IOL -1 _TnErr V1 Length 40 ft. Width 5 ft. Gravel below pipe % ft. Total depth -3- ft. Eff. absorption area loafe Monitoring tube YE,513epression over field's Date of adequacy test sults �Fell)1�A SS For /' bedrooms Fluid depth in absorption field before test _ in. Water added gal. New depth in. Elapsed Time: -0- min. Final fluid depth -0- in. Absorption rate >= 600 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y9& type) N 0 If yes, give date N/A D. UFT STATION Date installed 5/2grt£3` ]these in gallon-- �f'i, ManhelelAccess ON) _ 'YES "Pump on' level at tj'_ in. -Pump of r level at `1Q in. High water alarm level at HC in. DatumJeJJJ4Yn (L E6(&b n Cycles tested Qv _i C. eraArIJMNests alarm s circuit requirements? 'YES E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAfft station on lot i' 1OD' Absorption field on lot + 10C' Public sewer main + l Oct Sewer /septic service line +2 Sr Animal containment areas + 1001 On adjacent lots + 1 QCY On adjacent lots 100' Public sewer manhole/deanout +1001, Holding tank + 7br Manure/animal excrete storage areas -+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation ;r I 0 Property line + 61 Absorption field } Sr Water main +101 Water service line + 101, Surface water Wells on adjacent lots + 100f SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line + 1 Or Building foundation ; {Or Water main +10' Water Service line + 1©r Surface water F + 1©Qr Driveway, parking/vehicle storage Curtain drain + 1,i Or Wells on adjacent lots +1010 r F. COMMENTS * rAna well but C.Gn not be ver; 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 date. Engineer's Printed Name C-6- iaik=� le_r R. i nod Date COSA Fee $qT__�o Waiver Fee $ _ Date of Payment - Date of Payment Receipt Number p Receipt Number, (Rev. 11105) s, it, ;(./I d i • r I r ll ._ �h •,- r y AS -BUILT I hereby certify that.I have surveyed the, following described prcperty_LoT-33 1 Anchorage itecording Precinct, Alaska, and Ahat the improvements situated thereon are within the -property lines and do not overlap 'or encroach on tho properly lying adjacent thereto, that no improvements on prop- erty lying adjacent thereto enerpach on the premises in gueshon'and that there are no roadways. transmission lines or other visible -easements on said property except as indicated hereon. . Doted atm gle River. Alaska thio: 6, :^ ' .day of _C; a & ROBERT C. JOHNSON SCALE: ', Registered Land Surveyor 1' Box 453 Eagle Biver, Alaska Phone 64-2543 is MUNICIPALITY OF ANCHORAGE • Department of Health & Human Services 4 0 DIVISION OF ENVIRONMENTAL SERVICES] 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D. # 0,5_/ O 5 2 3 d HAA # � `g - )q 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 33i Lake if,C,P.PA AChu #1 Location (address or directions) (b) Property owner A_ H_ F_ ('_ # 34349 Telephone: (home) Business Mailing Address (TaitizPA) 54n F-, _36th Ai9ohnne7ap. A�aAbn. (c) Lending Institution Non.thtand Montaaae Telephone Mailing ••• Bu-siness Btyd. r 18 Eaqte r , •ra ra 99577 (d) Real Estate Company and Agent JACK WHYTE COMPANY I VNDA BANNER Address 109PRears Riyetr :aaa Eaqtp Riveit A&Aka 99577 Telephone 694- (e) 92 (e) Mail the HAA to the following address: (or check here k if hold for pick up.) List contact person and day phone number below: S & SENGINEERING 17034 Eagle River Loop Road No. 204 Eagle River, Alaska 9957; 2. TYPE OF RESIDENCE Single -Family IX 3. WATER SUPPLY Individual Well%] Number of bedrooms 4 Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site f$ Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (Rev. 7/88) Page 1 of 2 Z }o Z abed HOEB (8B/[ ABU) SZO-ZZ -�aorn s,aaauibuo leuolssa}oad agl ul suolssiwo ao saoaaa aol alglsuodsaa lou si ebeaogouy }o Al!ledlolunW aq1 •panssi si oleo!}lliao e aao}aq Map azAleue ao suoiloadsui lonpuoo lou op SHHO }o sae (oldw3 •sluawaalnbai alels pue leaapa} uieliao Apiles of aapio ui suopnlllsui bulpual aiagl pue sawog }o saasegoand of Asalmoo e se slgl Baop SHHCI aql 'ei{seIy }o alelS aql ul paaalslbaa aaouibua leuolssa}oid luapuadopui uu Aq anoge g gdea5eaed ul uanlb suoileluesaadai aql uodn hluo paseq paleoilpoo lenoaddy Allaoglny gllu@H sonssi (SHHCD 6801AJGS uewnH pue gllu9H }o luawlaedaa obeaogouy }o AllledlolunW aq1 Momnyal lena.ddy leucippuo0 to swial leuoll!Puo0 panoaddesip x panoaddy _ algia � Aq swooapaq ao} panoaddy "IVAO)JddV SHHQ '9 amu.'+ .. � 4, 14n , n „v@ tc _ Li966 W201Y'aenl�l ®Ide _ 170r 'ON peoa door aenitl 91513 17 SSaa P Pt/ 6 2, auogdolal JNIb33NI0N3 S T S wild }o aweN uolloadsul slgl }o alep agl uo loalle ui suollelnbai pue 'saoueulpao 'sapoo alelS pue ledlolunW Ile gllM eouelldwoo ul sl walsAs lesodslp aalernalseM ao/pue (lddns aalum ells-uo aql 'uopoadsul PUB uollebllsanu! Aw woe} pue sal!} ebeaogouy }o AllledlolunA eql woe} paulelgo uollewao}ul eql uo paseq leg! (}lean aaglan} I -ulaaaq paleolpul ainlonils }o adAl pue swooapaq }o aagwnu aql ao} alenbepe pue leuolloun} 'apes sl wals (s 1esodslp aalemalseM ao/pue /lddns aalern ails-uo aql leg1 smogs lenoaddy Allaoglny glleaH slgl }o uollebllsanui AW leg! A}lean ! 'molaq unnogs alep uolleP!len aql }o se pue olaaaq pail}}e leas (w Aq poilpoo sy NOI.LVWli0dNl (INV VIVO `H3dtl3S 3l1d `S1S31 `SN01103dSNl JNIOIAOad VYHI3 JNIH33NION3 'S MUNICIPALITY OF ANCHORAGE • ENVIRONMENTAL SERVICES DIVISION MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) SEP 14 1588 CHECKLIST - FEBRUARY 1984 264-4744 Legal Descri ion: L<7 -r C E I V E L.►h Iii l A. WELL DATA Well Classification 1 jJ �\ t (�J /b'Ie If A, B, C, D.E.C. Approved (Y/N) Well Log Present(Y QIP— Date Completed Yield Total Depth 0V-- Cased to G(o� i Depth of Grouting Static Water Level I e)o r Pump Set At Casing Height Above Ground �2U -r Sanitary Seal on Casing Electrical Wiring in Conduit CVN) Depression Around Wellhead Y( 1 Separation Distances from Well To Septic/ felding Tank on Lot Ar ; On Adjoining Lots I To Nearest Edge of Absorption Field on of ) `t ; On Adjoining Lots To Nearest Public Sewer Line To Nearest Public Sewer _ I Cleanout/Manhole P To Nearest Sewer Service Line on Lot Z� Water Sample Collected by ljS�ItJ� ; `Date 0 Water Sample jest Results � Stf/x��� ' % Comments B. SEPTIC/MOt H -NG TANK DATA Date Installed �� `2�'��Size � � No. of Compartments Z Standpipest9N) —y Air -tight Caps(C'?"N) Y,__--- Foundation Cleanout6 J) Depression over Tank (Y&9Date Last Pumped 4-A, s Pumping/Maintenance Contract on File (Y/N); for Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) Separation Distances from SeptictHviding Tank: I To Water -Supply Well k �� 1+ To Building Foundation Z� To Property Line- 1 C> ('� To Disposal Field r f To Water Main/Service Line `� To Stream, Pond, Lake, or Major Drainage Course 4- Comments ��S (fr57' ft.OL PJM�11�6� JI0�1L�� 1�Dt'1�i OF �"� VV>' Py r-r-'►o\iSAP r-1 1:-:5 l-4>�S Page 1 of 2 72-026 (Rev. 8/861 Front C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 2�✓��� Type of System Design Date Installed 0 &f;A� I -ZA - bS— Length of Field ' 'aq' r f Width of Field 2',5- Depth of Field Gravel Bed Thickness �o Square Feet of Absorption Area " c>_,�78"P Standpipes Present l 1) Depression over„Field (YO Date of Last Adequacy Test - -72 C1 8g Results of Last Adequacy Test Separation Distance from Absorption Field: 1 To Water -Supply Well ��O I� To Property Line I To Building Foundation To Existing or Abandoned System on Lot �1 I t7 On Adjoining Lots �� '- To Water Main/Service Line i , To Cutbank (if present) rZ 'A To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area �� 1 Comments 1-21�71 lCi �i S— l"l —82 13i� D. LIFT STATION I v 1 Date Installed Size in Ga_ "Pump On” Level at High Water Alarm Level at — Tested for Electrical Codes (Y/N) Comments 1 Dimensions Manhole/Access (Y/N) "Pump Off' Level at ** Check Permitted Bedroom Rating Against HAA Request ** Vent(Y/N) ing Cycles during Adequacy Test. Meets MOA I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Date 9//2�B . i7 CompAIP34 Eagle River Loop Road No. ',1A No. Eagle River, Alaska 99577 r Receipt No. t9� 0 S ' 2� Z Date of Payment D Amount: $ ( _7D DD Page 2 of 2 72-026 fRev 686) Back AA -0,A-4 Time Time e bate Date Date Inspector Inspector Inspector Comments Cojti IIApproval � Gs- Date Sewer Installed Permit No. Septic Tank Size Holding Tank Size ti Soils Rating Well To Absorption Area Well Log Received rq R� Well to Tank APPLICANT FILLS OUT LOWER HALF ONLY Property Ownerj _ ` 5 �:� Phone Mailing Address: / -XZ Buyer Address Lending Institution f` '"'r'"" Phone �7�-GSGS Address Realty Co. & Agent _, (fJ ,' ice. s / % Phone Address 1`y,•., ,(� ;/'ii{!/G'� ::.f-�`/3S� Legal Description r = /moi . - .` / 1 4/.' 77777-777775- Street Location/,,/'A/ rl�-Ar1%/ Type of Residence © Single Family ❑ Multiple Family No. of Bedrooms ❑ Other Wet upply Individual ATTACH WELL LOG. A well log is required for all wells drilled since June ❑ Community 1975. For wells jri4,> 5, prior to that date, give well depth (attach log if ❑ Public Utility available. Sewage Disposal C] Individual Year Individual Installed: ❑ Public Utility When Connected to Public Utility: t% ❑ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. N G 610+wv AS-BIrILT I hereby certify .that I have surveyed ,the following described liToperEy ! N / t U' 4 Anchorage Recording Precinct, Alaska, and that -the improvements situated thereon are, within the property lines and do not overlap or'enc.oach on the property lying adjacent thereto, that no 11 iprovernents on prop- erty lying adjacent thereto encroach on tiie premises in question and that there are no rondwuys, transinission lines or other visible easements on said property except as indicated hereon. Dated at Eagle. River, Alaska tlrls.--(_ qday of�-:S=L t.f R.OBEIVP C. JOHNSON SCALD: Registered Land Surveyor NO. 820-I,S 1" I Box 456, Eagle River, Alaska Phone 694-2543