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Home My WebLink AboutTONY SCHAFF LT 4AOnsite File Tony Schaff Lot 4A (Lot 98-4) #075-093-48 Development Services Department _ Phone: 907-343-7904 On -Site Water & Wastewater Section --- Fax: 907-343-7997 Certificate of On -Site Systems Approval I Parcel I.D. 075-093-48 Expiration Date: 1. GENERAL INFORMATION Complete legal description Tony Schaff Lot 4A Location (site address) 145 Agostino Mine Current property owner(s) Mailing address Real estate agent Rd, Girdwood, AK 99587 Thompson, Marlene R Day phone _ PO Box 27, Girdwood, AK 99587 Alisa Parrent 2. TYPE OF DWELLING: ❑® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone (907)250-3154 3. NUMBER OF BEDROOMS: I 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ❑Q Private Septic ❑ Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer 114 Waiver request for: W� +D jp r%Vc,,� Sewer Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ L!`]/ g Waiver Fee $ 3 d Date of Payment 2 Date of Payment 10/'a7/0,021 Receipt Number a b y �0 Receipt Number 0 35 9 '7b COSA# 0 SCS I I (o 3'7 Waiver# 0S14 110855 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 Forge Engineering Phone (907) 522-7773 Address 1399 W. 34th Ave Suite 101, Anchorage, AK 99503 Engineer's Printed Name Benjamin Schiller, P.E. 6. DSD/SIGNATURE System #1 Approved for System #2 Approved for Disapproved Conditional approval for bedrooms bedrooms Date 10/25/21 TH • � . ,. Benjarrir chiller ��F�lJ'% • . , 10/25/5 %21 , , . •��,�� bedrooms, with the following stipulations: os "oP�-OF ri/_ .p J3 ON- ITF WATER AND r" By: C�UU Original Certificate Date: 10 The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA Checklist blue sheet COSA Checklist yellow sheet COSA Checklist Legal Description: Parcel ID: If more than 1 septic system on lot: COSA Checklist # of Structure served by this system A. WELL DATA Well log is filed with Onsite (or attached) Date drilled Total depth ft Cased to ft Sanitary seal is functioning correctly Wires are properly protected Casing height (above ground) in. Date of flow test for COSA Static water level at beginning of test ft. Well production at time of test gpm Water storage tank volume gallons Well disinfected for coliform test?Yes No Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by Date of Sample Comments __________________________________________________________________________________ B. TANK DATA Age of tank(s) years Tank type/material Measured operating fluid level in septic tank Standpipes/foundation cleanout per record drawing Date of pumping C. LIFT STATION Required maintenance completed Age of lift station years Lift station material Comments: D. ABSORPTION FIELD DATA ______________________ Which system tested (date installed) ALL standpipes present per record drawing Total measured depth from grade ft (max) Measured depth to pipe invert from grade ft (min) N/A – pressurized field Monitor tubes go to bottom of effective. If not, state depth into effective Code-required soil cover over field System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Adequacy test date Results Pass For bedrooms Fluid depth prior to test in Water added gal New depth in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) If yes, enter date Comments/Deficiencies: Tony Schaff L4A 075-093-48 10.8+ Unknown Unknown ■ Unknown ■ ■ ■ ■ ■ 18+ Forge Engineering 10/12/21 76 10/6/21 COSA Checklist yellow sheet 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 ft Neighboring Tank > 100’Yes if No ft Absorption Field on Lot > 100’Yes if No ft Neighboring Absorption Fields > 100’ Yes if No ft Community Sewer Main > 75’Yes if No ft Community Sewer Manhole/Cleanout > 100’ Yes if No ft Private Sewer/Septic Line > 25’Yes if No ft Holding Tank > 100’Yes if No ft Animal Containment > 50’Yes if No ft Manure/Animal Excreta Storage > 100’ Yes if No ft From Septic/Holding Tank on Lot to:(Please enter distances if less than required) Building Foundations > 10’Yes if No ft Property Line > 5’Yes if No ft Absorption Field > 5’Yes if No ft Water Main > 10’Yes if No ft Water Service Line > 10’Yes if No ft Surface Water > 100’Yes if No ft Wells on Adjacent Lots: Private Wells > 100’Yes if No ft Community Wells > 200’Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to:(Please enter distances if less than required) Building Foundation > 10’Yes if No ft Property Line > 10’Yes if No ft Water Main > 10’Yes if No ft Water Service Line > 10’Yes if No ft Surface Water > 100’Yes if No ft If absorption field is under driveway comment below Wells on Adjacent Lots: Private Wells > 100’Yes if No ft Community Wells > 200’Yes if No ft F. ENGINEER’S COMMENTS 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. 10/25/21 N/A ✔ ✔ *12 N/A ✔ ✔ ✔✔ *See attached waiver request ✔ I MM1,17,110 iW limi, lam 11 M101", '410 L _§� , i`__ q - MM P.O. Box 196650 a 4700 Elmore Road Anchorage, Alaska 99519-6650 0 (907) 343-7904 o Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Department On -Site Water and Wastewater Section Waiver#: OSV211085 COSA#:OSC211637 Permit#: PID#: 075-093-48 Legal Description: Tont/ Schaff Lot 4A Engineer: Forge Engineering Applicant: Marlene Thompson ��cnr S I�eparxment Your request for a waiver of the required 25 feet horizontal separation from the sewer service line to the private well has been approved. The approved separation distance is 12.0 feet. See engineer's waiver request for justifications. This waiver approval applies to the existing above -ground sewer service line only. Any future upgrade to the private sewer line will require all separation distances be met or another approval from this department. ■vvavmmmvmmevvammmmvvmvvvvmmmmmmavvvvmvmmvvvvmmvmmmmamvvammmvmmvavmmvmmvmvammm� Waiver is Granted: X Waiver is not Granted: Date: Approved by: Name of Reviewer mvmammmvavammvmmvvavvmmmammvvvmmmammmavmmmmvmvvevevmammmvavvvvmmmmmvvavvmmmavv� October 26, 2021 MOA Development Services, On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 10/26/21 Subject: Tony Schaff Lot 4A – 145 Agostino Mine Road Dear On-Site Services Engineer: The property at 145 Agostino Mine Road has a well that was drilled on an unknown date, and a sewer service that was installed in 1987. Based on sewer connect cards provided by AWWU, the service was installed with a future home in mind. The service was constructed and dimensioned from the existing ‘cabin’, with the note ‘House not constructed at this time’. The service is more than 25’ away from the well. However, it seems that the proposed house was never built, and the cabin was connected to the service with an above-ground connection. This connection is comprised of standard sewer pipe, as would be in a crawlspace, boxed in with wooden framing and plywood protection. As the underground portion of the sewer service meets separation from the well, the only portion of concern is the piping above grade. While it is non-standard, it does not constitute a significant danger of contamination. Currently, the well does not show any bacterial contamination or nitrates. Future homeowners can expose the pipe and visually inspect and repair the pipe in the case of leakage. We request that a waiver be issued for the non-standard sewer line separation to the well, which is 12’ away where it enters the building. Sincerely, Benjamin Schiller, P.E. 100' RADIUS Benjamin Schiller CE 12592R E GISTEREDPROFES S I O N A LENGINEER1"=20' TONY SCHAFF SUB, LOT 4 A B CO 7.0 A B 12.0 FEET 0 20 40 NOTE: SEWER SERVICE ABOVE GROUND IS PROTECTED BY A WOODEN-FRAMED PLYWOOD BOX Oct 26, 2021 25' RADIUS CO SEWER MAIN APPROX LOCATION SEWER SERVICE PER AWWU CONNECT CARD30.0 ABOVE-GROUND SEWER CONNECTION SEWER AND WELL LOCATIONS r, MUNICIPALITY OF ANCHORAGE - WATER & WASTEWATER UTILITY 3000 ARCTIC BOULEVARD PHONE 786-5557 NNNECT �_ DATE OF APPLICATION 10 —24 —86 SCHEDULED COMPLETION DATE 1286 X SINGLE FAMILY -:4 ❑ MULTI -DWELLING , LOT/TRACT BLOCK SUBDIVISION f/ ,4,/ / No. APTS ❑ COMMERCIAL ❑ INDUSTRIAL TAX CODE 07.5-09 �— yz/�_ GRID_ �� DRAWING No,Snnj '[}`ajjk y LID 63 BUILDING ADDRESS s3-- 1�71� r j'� -.+Y ter' OWNER -- fr :z� �- -� >1PHONE MAIL ADDRESS r`i, f'; ,c ° ?. , �., '` > fey —7, CONTRACTOR:_ lr carie ASSESSMENTS (License & Bond required) ❑ ON PROPERTY ONLY J(y�qINN T%—TO WOPERTY LINE ONLY (lviOA or tate RO Permit Required) ❑ MIP l T/�P & 9N PI�OPE%TY CONNECT ('v'u or tale OW ermit equired) ❑ R -O -W NO. CONNECTION SIZE INSPECTION 1 Y ❑ Main extension agreement ❑ Subdivision agreement ❑ Extended connect agreement ❑ Pending iii) 6.0-3 CHARGE$ S/C PERMIT FEE $ 1 ❑ PAID PERMIT FEE $ REIMBURSIBLE NUMBER DEPOSIT $ REMARKS: =D BY: Dare ❑ CASH ❑ CK# INSPECTED BY: TOTAL $ I DATE: V10 rr 9884-7751-3524 PERMITTEE (Please Print) Rick King of gSXH f 'LONE MAIL ADDRESS I HAVE READ THE CONDITIONS AND REGULATIONS ON THE REVERSE SIDE OF THIS PERMIT AND AGREE TO COMPLY WITH THEM. PERMITTEE SIGNATURE POST IN A► CONSPICUOUS PLACE AT° THE J SITE 80 -Ml (Rev 11!85) IMMA11I •a�n.�wn-:-.... VN F®R I z 0 M (n A 10Z U) 0 z w -j U_ W w0 Y- = (D z W Z W0 OC F- > z cc 0 W (.) U) Li- cr. 0 WO :i -,z w0 C.) 0 0 :r C/) OdBU N01103dSNI 83M3S 0 0- 0- w Ow z z 0 CL w O uj z z Ow m 0 1 F— C) w z z 0 V, Zf- Id L :z ZU, cc z mt-vw w C) uj C-) C,: Cl) Ei 0 z z OdBU N01103dSNI 83M3S 0 0- 0- w Ow z z 0 CL w O uj z z Ow m 0 1 F— C) w z z 0 V, Zf- Id L o z w C) 2 Cl) 0 z MUNICIPALITY OF ANCHORAGE WATER & WASTEWATER UTILITY 3000 ARCTIC BOULEVARD PHONE 786-5557 LOT/TRACT- . SUBDIVISION 7'8 C.t —1Li • DATE OF APPLICATION f7— SCHEDULED COMPLETION DATE 1�rS'INGLE FAMILY ❑ MULTI -DWELLING No. APTS D COMMERCIAL BLOCK TAX CODE ��,°'; t ;' GRID STREET ADDRESS A .. ,� {AS l-BUILT No. nt ,-J OWNER —PHONE— `7 HONE `' J MAIL ADDRESS a , -f �t•�w { 1I'�.5_' f CONTRACTOR: ON PROPERTY ONLY ❑ MAIN TAP --TO PROPERTY LINE ONLY (MOA or State ROW Permit Required) ❑ MAIN -TAP & ON PROPERTY CONNECT (MOA or State ROW Permit Required) ❑ R -O -W NO. ❑ Main extension agreement ❑ Improvement District ❑ Extend connect agreement O Pending CONNECTION SIZE !1 CHARGE $ INSPECTION FEE $ I PERMIT FEE $ REIMBURSIBLE NUMBER REMARKS: PERMITTEE (Please Print) MAIL ADDRESS ID O CASH INSPECTED BY: DEPOSIT $ gn TOTAL $ �. DATEtj" �-XZ PHONE I HAVE READ THE CONDITIONS AND REGULATIONS ON THE REVERSE SIDE OF THIS PERMIT AND AGREE TO COMPLY WITH THEM. — PERMITTEE SIGNATURE ST IN A CONSPICUOUS PL T T E JOB SITE 8"21 (Rev. 11/86) h 0 U O co W �o\ LLL a CL Q � a- a w o h � , U o z i z z LU OUB U LLJ w0 W Z 2 A� O CCW > zho_ d cc 0w P I � U O v U- C/ u. C/o w O w V wo z O U c.t CA,6„v _ Stub arc - z U) h / LJ U U � O Cl) — U ccZ U z (� O 2 w J� w zzz w 2 N O O l8Od38 N01103dI 83M3S la UJ Q I p m C) W f -- w d U) •z