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HomeMy WebLinkAboutGLENN VIEW ESTATES WEST PH 2 BLK 2 LT 7Glennview Estates West #2 Block 2 Lot 7 #051 - 793 - 28 Municipality of Anchorage Page 1 of 3 Department of Health and Human Services Division of Environmental Services On-Site Services Section 825 "L" Street Room 502 P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SW020024 PID Number: 051-793-28 Name: MM&M Contracting Wastewater System: New Address: P.O. Box 670495 Chugiak, AK 99567 ABSORPTION FIELD Phone: Number of Bedrooms: 688-1236 Three (3) 5' Wide Shallow Trench LEGAL DESCRIPTION Soil Rating: 1.2 GPD/Ft' Total Depth from original grade: 5 Ft. Block: Lot: Subdivision: 2 7 Glenn View Est. West Phase II Depth to pipe bottom from original grade: 2 Ft. Gravel depth beneath pipe: 3 Ft. Township: Range: Section: Fill added above original grade: 2 Ft. Gravel Length: 58 Ft. Well: AWWU Water System Gravel width: 5 Ft. Number of lines: 1 Distance belween lines: N/A Ft. Classification (Private, A, B, C): Total Depth: FI. Cased to: Ft. Total absorption area: 500 FI' Pipe Material: ASTM D3034 PVC, Driller: Date Drilled: Static Water Level: Ft. Installer: MM&M Contracting Date Installed: 4/30/02-5/1/02 Yield: GPM Purnp Set at: FI. Casing I eight Above Ground: Ft. TANK SEPARATION DISTANCES ® Septic ❑ Holding ❑ S.T.E.P. ❑ Other: To From Septic Tank Absorption Field Lift Station Holding Tank public/Private Sewer Line Manmacturer: Anchorage Tank Capacity in batons: 1,000 Well >200' >200' N/A N/A >25' Material: Steel Number of Compartments: Two (2) Surface Water >100' >100' N/A N/A LIFT STATION — NONE ON LOT Lot Line >5' 5' N/A N/A Size: Gal. Manufacturer: >5' >10' N/A N/A 'Pump on' level at: in. Pump off' level at: High water alarm at: Curtain Drain None Noted Pump Make B Model Electrical Inspections performed by' Remarks: See Lot Line Waiver for Absorption BENCH MARK Tre ncl i. Locallon and Description: Finished Floor. Assumed Elevation: 100.0 Ft. Engineer's Stamp sf Inspections performed by: Tim Kimbrough Dates: 1 4/30/02 - / 'sem % N 's Lgf',r. .... jp: • 2nd 5/1/02 K....},-".'".fffr`-'-cf."Jr'—: ..c.,-,..M:GiALL-_A�NDFPSOIP �C Department of Realth and Human Services approval 4,0 : : L- �.�:, IAO. CE-438' . 1 Reviewed and approved by: ..! - r� • Date: 3/31/02-- .i • •(Rev. ..,1,,""`..t, 10/99) `.1 {1 Municipality of Anchorage DEVELOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK 99519-6650 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number SW020024 Page 2 of 3 PID No. 051-793-28 1 1, S2 C33 LOT 7, BLOCK 2, GLENNVIEW ESTATES WEST, PHASE 2 10' Landscaping Easement 15' Utility Easement Alternate Site PLAN AS -BUILT SCALE 1" = 40' C4 J0 co 0 0 � • J • • i 49th • • 7 r • .Ai M'h.h, E. ANDERSON Crit #� .- . � NO. CE -4381 ;'.Z'I G A B 51 22.2 7.4 S2 25.4 13.7 C3 32.4 19.0 C4 91.5 68.2 M1 91.8 68.5 Page 2 of 3 PID No. 051-793-28 1 1, S2 C33 LOT 7, BLOCK 2, GLENNVIEW ESTATES WEST, PHASE 2 10' Landscaping Easement 15' Utility Easement Alternate Site PLAN AS -BUILT SCALE 1" = 40' C4 J0 co 0 0 � • J • • i 49th • • 7 r • .Ai M'h.h, E. ANDERSON Crit #� .- . � NO. CE -4381 ;'.Z'I G Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number: SW020024 PID No. 051-793-28 Page 3 of 3 FF 100.0 93.84 —8.00 U 94.2 N N M 01 U U 89.67-822 000 Galion Anch Tank 9222 89.-587.43 87.56 87.40 Geotex tile Fabric Drainfietd Rock 58.00 84.52 Il1—)%1rII f A C f' -)I 111 T C-[CUEILL /-1J—DUIL 1 Scale: 1" = 10' 91.91 87.55 ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 (FAX) May 28, 2002 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Lot 7, Block 2, Glennview Estates West Subdivision Phase II Separation Distance Waiver Absorption Trench to Lot Line Dear On Site Services Engineer: We hereby apply for a lot line waiver to allow the new absorption trench on Glennview Estates West Subdivision Phase 11 to be constructed within 5' of the existing lot line. The lot line was not clearly defined during the construction process and the new trench was inadvertently placed too close to the line. Soils encountered in the area are poorly graded sands with gravel and some silt. This material is effective in the treatment of septic effluent and migration should be contained in a fairly limited area. Sufficient area exists on the adjacent lot for a septic system and sufficient separation between the systems is possible. The subdivision is currently served by the Municipal water system and separation distances from wells in the area are not a problem. Placement of the trench within 5' of the lot line will not have an adverse impact on any septic system to be constructed on the adjacent lot in the future. We therefore recommend the lot line waiver be approved. Sincerely, 1 to m, f i�� -.�7 Michael E. Anderson, P.E. 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.ci.anchorage.ak.us (907) 343-7904 Waiver Review Worksheet WR#: WR020017 PID#: 051-793-28 HA#: HA020219 Permit#: Sh c-->" 4-0 Date Received: 05/28/02 Legal Description: Glenn View Estates Block 2 Lot 7 Engineer: Anderson Engineering Michael E. Anderson. PE Applicant: MM&M Construction Waiver Requested: 5 feet from absorption trench to lot line Criteria: Waiver is Granted: Geology Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation Total: List Conditions or Reasons for above: Waiver is not Granted: Date: 5 l 1°Z— By: me(df Reviewer Rec#: 20328 Amount: $150.00 Date Paid: 5128(2002 5/31/2002 Municipality of Anchorage George P. IJruerch. Magor Building Safety Division P.O. Box 196650 • 4700 S. Bragaw Street Anchorage, Alaska 99519-6650 • (907) 343-8301 http://www.ci.anchorage.ak.us Michael E Anderson, P.E. Anderson Engineering P.O. Box 240773 Anchorage. AK 99524 Subject: Waiver Request for Glenn View Estates Block 2 Lot 7 Waiver Request #WR020017 Parcel ID #051-793-28 Dear Mr Anderson: Your request for a waiver of the required 10 feet horizontal separation from the absorption field to property line has been approved. The approved separation distance is 5.0 feet. This waiver approval applies to the existing absorption field to property line separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concems or questions regarding this waiver, please call our office at 343-7904. Sincerely, Joe Goodall Civil Engineer On -Site Water & Wastewater Program 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 WASTEWATER DISPOSAL SYSTEM PERMIT Initial Date Issued: Feb 12, 2002 Expiration Date: Feb 12, 2003 Permit Number: SW020024 Parcel ID: 051-793-28 Legal Description: GLENN VIEW ESTATES WEST PH 2 BLK 2 LT 7 Design Engineer: 0014 Anderson Engineering Owner Name: MM&M Contracting Owner Address: P.O. Box 670495 Chugiak , AK 99567 - Site Address: 021220 PAULA SUE CIR Lot Size: 45189 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: H Disposal Field ✓[ Septic Tank ` Holding Tank Privy ri 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: -t1/2/ Date: cam`% t--)/ Date 2/12/1 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 SW e.>.)c-, Property owner(s) MM&M Contracting Day phone 688-1236 Mailing address (1) P.O. Box 670495 Chugiak, AK 99567 Mailing address (2) Zip Code Legal description (Lot, Block & Sub'd.) Lot 7, Block 2, Glennview Estates West Subdivision Phase 2 Legal description (Section, Township & Range) Lot Size lir; /S `t Acres/�;q.F Number of Bedrooms Thee (3) THIS APPLICATION IS FOR: Sewer Only ® Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade in THIS PROPERTY CONTAINS: Hot Tub Swimming Pool Therapy Pool ❑ Jacuzzi n I Water Softening Unit ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) �r rt Permit Fees: :`> L Waiver Fees: Date of Payment: :21( /70 `, Date of Payment: Receipt Number: / ;CC? `'%r Receipt Number: (Rev. 12/00) , t .14 I an13§7 162.0a 15' Telt k _str Rer j .30•39 164. 177.7 151 Talc & Vet Eamt 131.98 venue:re:4 88_15 4.5 • . , : .• • , - , • ln 0 0. ....... ..... . . , .. .4,1k .. .............. .. • ... ••• ................ •* -r:4 ... .......... 7 THIS PROJECT— 'Q• \ Leap Esmt eio & 'l;c Esml 1S1,192_65 ••••1129-:::::•;f1L11 P:a •V,z.f.• •-• f • ' '..'''..-:,••-..k-'•'.1..N897A0V9',:f.-40-30-.0'20)01'.7.02)(P--30,:rii-T,2,"7. /-•;-•:'; 63-64 AREA MAP SCALE 1" = 100' 7 ! LOT 7, BLOCK 2, GLENNVIEW ESTATES WEST SUBDIVISION, PHASE 2 z 0 co �dSP Gfijf to i � P,f R ci a 10' Landscaping Easement 15' Utility Easement 1,000 Gallon Septic Tank SITE PLAN SCALE 1" = 40' Alternate Site ®,J TH1 / 45' Long X 5' Wide / X 3' Effective Depth Absorption Trench TH2 .• LOT 7, BLOCK 2, GLENNVIEW ESTATES WEST SUBDIVISION, PHASE 2 DESIGN FACTORS: Three Bedroom Home Pere. Rate: 4.6 Min./Inch Application Rate: 1.2 GPDISF SYSTEM REQUIREMENTS: 5' Wide Trench System 1,000 Gallon Septic Tank 3' Drainfield Rock 3 Bedrooms X 150 GPD / 1.2 GPD/SF = 375 SF of Absorption Area 375 SF/5 LF (Width)*.58 (Red. Factor) = 43.5 LF Trench Length Therefore: Construct a 45' Long X 5' Wide X 3' Effective Depth Absorption Trench. Flowline Elevation in Trench to be 2' Below Original Ground Surface. Total Depth to be 5' Below Existing Ground. Mound Over Trench to Provide a Minimum of 3' of Cover or Provide 2" of Direct Bury Insulation and 2' of Cover. 1'6" 6" 3'0" Geotextile Fabric 5'0" 4" Perforated PVC Drainfield Rock •1 • • TYPICAL WIDE TRENCH SECTION jr;a / / „ Ems, (NO SCALE) NOTE: Grade Area Over Trench to Drain Away. Minimum 6' Separation From Bedrock. Minimum 4' Separation From Groundwater. Minimum 10' Separation From Water Service Line. ... 4. ♦♦♦h......�4+ 8 10 12 13 14 15 16 17 18 MUNICIPALITY OF ANCHORAGE BUILDING SAFETY DIVISION ON-SITE WATER AND WASTEWATER PROGRAM 4700 SOUTH BRAGAW STREET, ANCHORAGE, AK 99519 SOILS LOG - PERCOLATION TEST PROJECT #: M0204 PERFORMED FOR: PAUL MYERS / MM&M CONSTRUCTION LEGAL DESCRIPTION' COMMENT' LOT 7, BLOCK 2 GLENN VIEW WEST SUBD. DATE PERFORMED' 2-05-02 TEST HOLE # 1 OG - RED - BROWNISH SILTY SANDS W/ GRAVELS POORLY GRADED SANDS WITH GRAVELS & LITTLE FINES - SP WAS GROUNDWATER ENCOUNTERED? IF YES, WHAT DEPTH SLOPE 0% NO DEPTH OF WATER NONE AFTER MONITORING. DRY SILTY - GRAVELY DATE' 2/12/02 SANDS - MEDIUM DESITY / SM -GM 4444 • 4 44 4,'.'.....k •4 • y S L 0 P E SITE PLAN READING DATE GROSS TIME NET TIME DEPTH OF WATER NET DROP Start 2/5/02 14:30 12" 1 15:00 30 6.125" Recharge 15:00 12" 2 15:30 30 6 0" Recharge 15:30 12" 3 16:00 30 6.0" PERC RATE: 5.0 MIN./INCH PERC. HOLE DIAMETER' TEST RUN BETWEEN 4.5 FT. AND 5.5 FT NO IMPERMEABLES ENCOUNTERED / HOLE PRESOAKED PRIOR TO TEST TEST PERFORMED BY: T.L. KIMBROUGH I MICHAEL E. ANDERSON, CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES ON THIS DATE: 10 12 13 1/4 15 16 17 18 MUNICIPALITY OF ANCHORAGE BUILDING SAFETY DIVISION ON-SITE WATER AND WASTEWATER PROGRAM 4700 SOUTH BRAGAW STREET, ANCHORAGE, AK 99519 SOILS LOG - PERCOLATION TEST PROJECT #' M0204 PERFORMED FOR: PAUL MYERS / MM&M CONSTRUCTION LEGAL DESCRIPTION" LOT 7, BLOCK 2 GLENN VIEW WEST SUBD. DATE PERFORMED' 2-05-02 TEST HOLE # 2 O6 - RED - BROWNISH SILTY SANDS W/ GRAVELS POORLY GRADED SANDS WITH GRAVELS & LITTLE FINES - SP WAS GROUNDWATER ENCOUNTERED? SLOPE 0% NO IF YES, WHAT DEPTHP DEPTH OF WATER AFTER MONITORING. DRY SILTY - GRAVELY DATE' SANDS - MEDIUM DESITY / SM -GM BOH C• •• NONE 2/12/02 S L 0 P E SITE PLAN 2% READING DATE GROSS TIME NET TIME DEPTH OF WATER NET DROP Start 2/5/02 14:20 12" 1 14:50 30 65" Recharge 14:50 12" 2 15:20 30 6.5 " Recharge 15:20 12" 3 15:50 30 6.5" 7 PERC RATE' 4.6 MIN./INCH PERC. HOLE DIAMETER: 6" TEST RUN BETWEEN 3.5 FT. AND 4.5 FT. COMMENTS' NO IMPERMEABLES ENCOUNTERED / HOLE PRESOAKED PRIOR TO TEST TEST PERFORMED BY: T.L. KIMBROUGH I, MICHAEL E. ANDERSON CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES ON THIS DATE: 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.muntorg/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 051- - COSA# O 8007- 1. --1. GENERAL INFORMATION Expiration Date: J / ! " 0 9 Complete legal description rrtra rim VLL&J ffs at-cs fr 257' F9Z Z Location (site address) at,1-.O /'cu-i.(ia .$k -c Gime__ B:Z Current Property owner(s) %i t -t- Day phone R'3o- Opp 1 Mailing address O. fxx IPS ItpQ r C.k ae°I'156"3- Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System n 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 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. g a River Engineering Services Name of Firm 10421 VFW Rd , Shite 201 Address Eagle River, AK 99577 Engineer's Printed Name C[iris'Phe-r t2- vtlo0c( 5. DSD SIGNATURE Approved for 3 bedrooms. Disapproved. Conditional approval for By: Phone Coc/q_ Si°7S Date f2/ r)o7 A. Q NRfSiQPNER R. WQ s''' ........ CE:f0387 ssi bedrooms, with the following stipulations: ON-SITE •fin WATER AND : rn WASTEWATER : PROGRAM Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other (Rev. 11/05) Original Certificate Date: 5--/4 — 0 8 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & 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 CHECKLIST Legal Description: 61]2vn 11.40 &ISL //M+ t#0 13x2 L g-- Parcel ID: 061- 7`73-8' A. WELL DATA Well typeWith/ie- If A, B, or C provide PWSID # Well Log (Y/N) Date completed Sanitary seal (Y/N) Wires properly protectedly/N)— Casing height(ab6ve ground) in. Total depth ft. Cased to ft. FROM WELL LOG AT INSPECTION Date of test Static water level �_ 1 ft. Well production g.p.m. g.p.m. WATER SAMPLE R S: Coliform colonies/100 mL Nitrate mg/L Other bacteria colonies/100 mL rsenic: mg/I Date of sample: Collected by: B. SEPTIC/HAL-Me TANK DATA Tank Type/Material cAnyhont./ani-/ $f -cam Date installed 47 30/0-d- Tank size 1y 000 gal. Number of Compartments cL Cleanouts ®N) ILA_ Foundation cleanout &N) Depression over tank (VS) kb High water alarm (AD inlet. Date of pumping ( I f05/o7 Pumper TR is Tut-wnei 5 C. ABSORPTION FIELD DATA J Date installed 5/ 1 /0)-.. Soil rating g...d./ft orft2/bdrm) L.2 System type (A)Se dreun-i+-P-ed Length 5S? ft. Width 5 ft. Gravel below pipe 3 ft. Total depth 9 ft.441; Eff. absorption area 50aft2 Monitoring tube Depression over field fin Date of adequacy test 101 f0i Results (Pass/Fele) Piss For 2 bedrooms Fluid depth in absorption field before test ?. I in. Water added 595 gal. New depth 32 in. Elapsed Time:lyL{Omin. Final fluid depth 2.1 in. Absorption rate >= t4 SO g.p.d. Any rejuvenation treatment (past 12 mo.) (Ytype) il%n If yes, give date nig D. LIFT STATION Date installed — - -Size in gallons ref Manhole/Acce "Pump on" level at in. "Pump o - . ' O in. High water alarm level at in. Datum-- Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main Sewer /septic service line D n -5I containment areas On adjacent lots On adjacent lots P c eanout Holding tank Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/I-IOLDING TANK ON LOT TO: Building foundation -r S � Property line t5 Absorption field Water main t10O ' Water service line ta5 ' Surface water *100 Wells on adjacent lots fi /0O SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 5 Building foundation aO Water main 1-/0O Water Service line t dJ ' Surface water -1-100' Curtain drain OW z {2vlawvi Wells on adjacent lots 1100 F. COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name C %iri 5-fvlatazi- /iQood Date 12/1907 Driveway, parking/vehicle storage 34, COSA Fee $ Date of Payment Receipt Number (Rev. 11/05) 5/7-4g in7322t) Waiver Fee $ 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:0. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 C, Midi 671.3 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. t%S 7%3 — 2- 4 HAA # 056(-) Expiration Date: 3 " 3 - 0 6 1. GENERAL INFORMATION Complete legal description 41.64110 1-60•1 GSI. (AMS, rAZ. 13 a, L. 7 - Location (site address or directions) 1J 21 Z2t) PA 141. -As S yt Ga LL Current Property owner(s)fa/(c. 4 ,4bk. .tl'iu4 nmgsti Day phone 614- 2077 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address Po Box 670064-f CH-w&TAK 4-41 ?°15 Day phone 042g !tvito LEy/24 wtrAtDayphone 217-5714 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System 3 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 4 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 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 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(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm e'4AUr d2iJ &Y&. /U4.-Alee2.;WA SUM . Phone 614'- S 1,5— Address 95" Address /0921 1)FeJ kb Sot£rr 201 £t4zs QT1mS 99S-77 Engineer's Printed Name GiQTSToPM6)t 12- b.1oocd> Date 0/45 5. DSD SIGNATURE ✓ Approved for 3 bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations-. By: Additional Comments ``` tsiYf OF/mac% • ``• ON-SITE • • c�'0= WATER AND ; m : WASTEWATER : PROGRAM 0 AN • �-'m)11!0 '1. Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other (Rev. 01/02) Original Certificate Date: 3 - 3 Or Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: �ir!ENNVJ6)4 T. tJESf 4'Z 132 L 7- Parcel ID: q5j -7'7.3-2-4 A. WELL DATA Well type PACE- G If A, B, or C provide PWSID # Date completed Sanitary seal (Y/N) Wires properly prote Y/N) Total depth ft. Cased to ft. Casing h-'- (above ground) in. �n�4T INSPECTION Well Log (Y/N) FROM WELL LOG Date of test Static water level ft. Well production " g.p.m. g.p.m. WATER SAMPLE ' : I LIS: Coliform colonies/100 ml. Nitrate mg./I. Other bacteria colonies/100 ml. rsenic: mg./I. Date of sample: _ Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material 4avc4. TAMC/ S'FCEL Date installed '//30/02 Tank size !,ao'O gal. Number of Compartments Z Cleanouts9N) Y15 Foundation cleanout elN) YES Depression over tank (Y(1 QO High water alarm (YL Ai-DAJ 4 Date of pumping 5/2//vii Pumper 3 p'S C. ABSORPTION FIELD DATA Date installed S/I lo2- Soil rating (g.p.d./ft2 eh ftz/LJirn) /. Z System type WJJOE DR4 NE1Zl- Length .S Qi ft. Width S ft. Gravel below pipe .3 ft. Total de th fi ft. Eff. absorption area SOO ftZ Monitoring tube YiS Depression over field kir, 75%1.5' MeasMRm'A Date of adequacy test 2 25/0I— Results (Pass/€94) Pk $5 For 3 bedrooms Fluid depth in absorption field before test 32 in. Water added'f37ga1. New depth 37 in. Elapsed Time:/911omin. Final fluid depth 32- in. Absorption rate >= (-) 50 g.p.d. Any rejuvenation treatment (past 12 mo.) COQ& type) MO If yes, give date k///} D. LIFT STATION Date installed Size in gallons Manhole/Access Y/ "Pump on" level at in. "Pump ' levelyi„-! in. High water alarm level at in. ti 1 Datum � Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO Septic tank/lift station on lot 'f Absorption field on lot Public sewer main Sewer /septie- ervice line 51V On adjacent lots Public sewer manhole/cleanout Holding tank SEPARATION DISTANCES FROM SEPTIC/litt1MS TANK ON LOT TO: Building foundation + 5 r Property line tS r Absorption field 7 Water main 4 ! 00Water service line T 25 Wells on adjacent lots '1' 100 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 5 Building foundation 20 Water main t 100 r Surface water 1— /uO r Water Service line f 2 5 Surface water *100 Driveway, parking/vehicle storage 3 r Curtain drain AK9NC KNOWN Wells on adjacent lots 1"' tc 7 +so' F. COMMENTS pkR Fitt. ME4StAR` M6x1T5 .1.4) s ysm To 136 pPRMAs dowiEofrJMER kbbe» mo2E scPia re. Fr, 4-4- - SI5TE" . $P&++RS "TO $C. NC/t2 FHLtn Bk; run271o4.1.21)4 - G. ENGINEER'S CERTIFICATION I certify that t have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name Gnus/' PHgit R. t„ lIoo3D Date 370!()C illia 43> ; ba^Pctk 1 ic1 .4Niarc4f&b. ... R..... .4 CHRISTOPHER R W000 : CE:10387 HAA Fee $ 436 'O? Waiver Fee $ Date of Payment 3/, /05 -Date of Payment Receipt Number 61r -/o274" Receipt Number (Rev. 12/01) 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.ci.anchorage.ak.us (907) 343-7904 Septic System Advisory Health Authority Approval # 050078 During a recent adequacy test on the septic system for Block 2, Lot 7 of Glenn View Est. #2 subdivision, 32 inches of standing water was observed in the absorption field. This indicates that approximately 89% of the absorption area is inundated. Although this system passed the adequacy test, the remaining life expectancy may be limited. This advisory must be attached to all copies of the subject Health Authority Approval. th'rec el! LAN ccc OA 1.‘ r is- 4 E E n.'t • FrCi-1,r te:.• • • / „ vort.r. , A. .. s . ); s. A •.) / i'n, AS -BUILT v .4)5SE c, R. pf nah:reerthyy.certifythatlihavesuir surveyed following• described L0 r7aLc .;.• c 4. If- / t‘i, R ‘A'' • • Anchorage Recording Precinct, Alaska, -and that the improve- - ments situated thereon are within the property lines and do not overlap or encroach on the property lying adjacent thereto, that no improvements on property lying adjacent thereto encroach on the premises in question and that there.are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated at Elle River, Alaska this. a 1 day of 200.2” • SCALE: .R013ERT C. JOHNSON Registered Land Surveyor No. 880 -LS 1" 5--c, Box 77-0456, Eagle River, Alaska 99577 - Phone (907) 694-2543 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 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 051-793-28 1. GENERAL INFORMATION HAA #�.a( Expiration Date: ) /)-rlcs Complete legal description Lot 7, Block 2, Glennview Estates West Subdivision Phase 11 Location (site address or directions) Paula Sue Circle Current Property owner(s) MM&M Construction Day phone 688-1236 Mailing address P.O. Box 670495 Chugiak, AK 99567 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: 3. TYPE OF WATER SUPPLY: Individual Well individual Water Storage Community Class Well Public Water System Three (3) TYPE OF WASTEWATER DISPOSAL: Individual On-site individual Holding tank Community On-site Public Sewer u 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 private or Class C well and may be reissued with new water sample results less than 30 days old. (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 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(are) 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 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P,E. 5. DSD,NATURE Approved for J bedrooms. Disapproved. Conditional approval for Phone 522-7773 bedrooms, with the following stipulations: Additional Comments r re t..._•`;':,,\:*(). ON-SITE WATtRAND WASTEW a ° PROGP MATER e Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other Rxr (Rev. 12/00) �o ^^�^�' Cern{ca'c Municipality of Anchorage Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.cLanchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lot 7, Block 2, Glenn View Estates West Phase 11 Parcel ID: 051-793-28 A. WELL DATA Well type AWWU If A, B, or C provide PWSID 11 Well Log (Y/N) Date completed Sanitary seal (Y/N) Wires properly protected (Y/N) Total depth ft. Cased to ft. Casing height (above ground) FROM WELL LOG AT INSPECTION in. Date of test Static water level ft. ft. Well production g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 ml. Nitrate mg.A. Other bacteria colonies/100 ml. Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material SepticlSteel Date installed 413012002 Tank size 1,000 gal. Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (YIN) Y Depression over tank (Y/N) N High water alarm (Y/N) N Date of pumping Pumper C. ABSORPTION FIELD DATA Date installed 51112002 Soil rating (g.p.d.fft2 or ft2/bdrm) 1.2 GPD/SF System type 5' Wide Shallow Trench Length 58 ft. Width 5 ft. Gravel below pipe 3 ft. Total depth 7 ft. Eff. absorption area 580 ft2 Monitoring tube Y Depression over field N Date of adequacy test Results (Pass/Fail) For bedrooms Fluid depth in absorption field before test in. Water added gal. New depth_ in. Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed Size in gallons "Pump on" level at in. "Pump ofr level at in. Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot On adjacent lots Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer /septic service line Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Manhole/Access (Y/N) High water alarm level at in. Meets alarm & circuit requirements? Building foundation >5' Property line >5' Water main NIA Water service line >10' Absorption field >5' Surface water >100' Wells on adjacent lots >100' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 5' Building foundation >10' Water Service line >10' Surface water >100' Curtain drain None Noted Wells on adjacent lots >200' F. COMMENTS See Lot Line Waiver for Absorption Trench. Water main >10' Driveway, parkinglvehicle storage >10' 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 HAA guidelines in effect on this date. Engineer's Printed Name Michael E. Anderson, P.E. Date 5/28/2002 �` 6F q(_ �'`6 , arar'A 1 * 4Q TH : S.:: . 1 0 i P CE: 81 •'-S-";-' #&' if ••'. AFD . •.•••'• •SC©• �1O,tloeEsL®'�,� HAA Fee $ 375 . SC) Waiver Fee $ / 50 • EYE Date of Payment 5/2I/0 Date of Payment C724 a Dw j Receipt Number (Rev. 17100) Receipt Number 2O5L9--�