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Home My WebLink AboutPOTTER POINTE LT 7Pott¢ Point¢ Lot 7 #020-091-91 Municipality of Anchorage Department of Health and Human Services 825 'L' Street 'P.O. Box 196650 Anchorage. Alaska 99519-6650 Rick Mystrom http:/Nn~w,ci.anchorage ak.us Mayor Permit Number:. #SW 010115 Date of Issue: 5-15-01 Date Started: 5-20-01 Date Completed: 5-21-01 Legal Descrlptiola: Property Owner Name & Addr~s: Parcel Identification Number: 020-091-91 Is well located at approved permit location? [] Yes [] No Potter Point Lot 7 '~ Hagen Inv LLC PO Box 240186 Anchorage, Ak 99524 Borchole Data: Depth (ft) Soil Type, Thickness & Water Strata From To , sbck-up 0 2 Organics and silt 2 4 ' silt 4 11 gravelly silt 11 35 bedrock 35 207 h20 135 140 190 207 Method of Drilling [] air rotary [] cable tool Casing type: steel Wall Thickness: .025 inches Diameter: _.6 inches Depth: 40 feet Liner Type: Diameter: ~ inches Depth: Casing stickup above ground: _2 feet feet Static water level (bom ground level): 31 feet Pumping level: 207 feet after _2 hours pumping 2.5 gpm Recovery Rate: 2.5 gpm Method of Testing: air lift Well Intake Opening Type: [] Open End [] Open Hole [] Screened Start __ feet Stopped [] Perforations Start __ feet Stopped feet Grout Type: Bentonite # 8 Volume: 1 bg Depth: Start _.0 feet Stopped _+ feet Pump: Intake Depth ~ feet Pump size hp Brand Name __ Well Disinfected Upon Completion? [] Yes [] No Method of Disinfection: Clorfne Tablets Comments: Wall Drillzr: Alpine Drilling & Enterprises P 0 Box 110496 Anchorage AK 99511 Attemion: The well driller shall provide a well log to the property owner within 30 days ofcompletion and the property 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: May 15, 2001 Expiration Date: May 15, 2002 Permit Number: SW010115 Legal Description: iPO'I-rER POINTE SUBDIVISION LOT 7 . Design Engineer: 0000 None Required Owner Name: HAGEN INVESTMENT LLC Owner Address: PO BOX240186 ANCHORAGE, AK 99524- Parcel ID: 020-0gl-gl Site Address: NHN SAGE COURT Lot Size: 20000 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: [] Disposal Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage Ail 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: 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 Parcel I.D. Permit Number~ Property owner(s) //,~'~x.] ,~'~,//~._~T/r~-"~'~' ~ ~ Day phone Mailing address (1) ~ ~' ~ ~D/~ ~'~ IT address(2) ~ ~E ~O.R~ ZipCode Legal description (Lot, Block & Sub'd.) ~7 ~ ~ ~ ~ ~ Legal description (Section, Township & Range) Lot Size ~ Acres~ Number of Bedrooms ~ THIS APPLICATION IS FOR: Sewer Only Sewer and Well Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub Swimming Pool Therapy Pool Well Only Water Storage Jacuzzi Water Softening Unit I certify~.,~at_the abo~ve)infor .mation is correct. I fudher certify that this application is being made for a Slng~F~m'~y and is in accordance with applicable Municipal Codes. '(Signature of p operty ~ ' gnt) Permit Fees: Date of Payment: Receipt Number: (Rev, 17-/00) / 2 oO. o Waiver Fees: Date of Payment: Receipt Number: 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.cLanchorage.ak.us (9O7) 343-79O4 CERTIFICATE Of HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 020-091-91 t. GENERAL INFORMATION Complete legal description" Lot 7, Potter Poinl~ubdivislon Expiration Date: ~ '- '~- 0 I Location (site address or directions) Sage Circle Current Property owner(s) Hagen Investments, LLC/Haqen Homes Day phone 229-8400 Mailing address P.O. Box 240186 Anchorage, AK 99524 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: Four (4) , 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Public Water System Well TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank Community On-site Public Sewer · · The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil ..: engineer registered in the State of Alaska. Certificates of Health Authority 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 HAAs upon request to homeowners. Certificates of Health Authority Approval are -~.. valid for 90 days from the date of issue for properties served by a pdvate or Class C well and may be reissued with ~.. '. ' ...new water sample results less than 30 days old. (Ced, J.ficates 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' i'~' "' 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 Health Authority 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(aro) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Anderson Engineering Address P.O. Box 240773 Anchora.qe~ AK 99524 Engineer's PHnted Name Michael E. Anderson, P.E. DSD SIGNATURE ~ Approved for Disapproved. Conditional approval for bedrooms. Phone 522-'///3 bedrooms, with the following stipulations: Additional Comments Attachments: HAA Checklist Septic System Advisory Well Flow Advisory X Maintenance Agreements Supplemental Engineer's Report Other · . Odginal Certificate Date: Municipality of Anchorage Development Services Department Bulld~ng ~afety Division On-~lte W~te~ & Wastew'ater Program 4700 South Bragaw St. P.O. Box 196650 Ancho~ge, AK 99519-6650 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Desc~ption: Lot~,potterpoin~ubdlvtsiion Pamel ID: 020-091411 WELL DATA we~ b~e ~ ifA, B, otC provide PWSID # we~ Log ff~N) Y Date completed San~arv ~ Om) [ Wres pmpedy protected (Yin) Y Total depth 207 fl. Cased lo 40 ft. Casing height (above ground) >24 in. FROM WFU LOG AT INSPECTION Dat~ of test 5/21/2001 Static water level 3t ft. Well production 2.5 g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform 0 c~lonies/100 mL Nilrate 2 mgJI. Other bacteda 0 c~oniesil00 nd. Date of ~ample: t/30r2002 C~lec{ed by: A~w Pump and Well B. SEPTIC/HOLDING TANK DATA Tank Type/Material Munldl~lS~verl~stem Tank siz~ C~mou~ (Y~N) Foundation deanout (Y/N) C. ABSORPTION RELD DATA Date instal]ed Soil rating (g.p.d./~ ~' ~Fodrm) in. ' · Absorptlo~ cate >= g.p.d. , ~:..: .~ ' ff yes,'glve date TolM depl~ ft. ~__~ d a~m~ua~ test Flul~d~ept~ in absorp0on field before test in. 6H~e. ~ ~'eaunent (past '~2 mo.) (Y~ & type) LIFT STATION Date installed Size in gallons 'Pump on' level at in. 'Pump off" level at in. Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lilt station on lot Absorption radd on lot Public seu~r main >75. Sewer Iseptic sewice line >25' High water alarm level at Meets alarm & circuit requirements? On adjacent lots >100' On adjacent lots >100' Public sewer manhele/cleenout .100' Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Ouilding foundation Water main Wells on adjacent lots Pmpert~ line __ Water sewice line SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Absorpllon radd Surface water Water Service line Cortain drain F. COMMENTS Building foundation Water main Surface water Wefts on adjacent lots ENGINEER'S CERTIFICATION I certify that I have detemtlned Etrough field inspections and review of Municipal recon:fs that fire above systems am in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name Michael E Ande~on, P.E. Date 3/4/2002 Date of Payment ~ ~/~ -O~- Receipt Number .//.~ ~'~) ~' ~'~ Waiver Fee $ Data of Payment Receipt Number FEB-OI-O2 Q6:12~ F~3~CT&£ ENVII~ttEHTkL ,~1~___ CT&E Environmental Servlce' Inc. 9675615~01 TOOT3 P.OZ/05 F-462 ~'~t &~ R~t.# 1020528001 Client ~ame Aarow Pump · WCll Semite p ~J~ Na m~ Po~ Polntc ~nt Sampk ~ ~t 7 P~ Po;nrc ~l~ D~g Wmer Ord~ By pwsm 0 Sampln Remarks: Client ~ Printed Date/Time 02/01/2002 I?:52 Collected l~tdTime 01~30~20~2 9:~ ~Jv~ ~lme 01~2 10:20 Techukal Dir~or St~h~ ~ Ede Altowablc Prep AGilysLs Limits Date Date Init 0.200 U 0.200 ms/L EPA 30o.0 (<10) 01~1/02 JDT Coliform coI/lO01nL SMI8 9-~L~R (<1) 01/30/02 SBH