Loading...
HomeMy WebLinkAboutWARD LT 2Ward Lot 2 #011-122-81 Inspection Report_t-1-12.dbc / Municipality of Anchorage Community Development Department Page 1 of 3 On -Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP121020 PID Number: 011-122-81 0 New ❑ Upgrade Name: Dittrich Company LLC ABSORPTION FIELD ❑ Deep Trench []Shallow Trench ❑Bed E] Mound Address 2449 Brooke Drive Anchorage, AK 99517 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 632-8790 4 8 GPD/SF 12 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 4 Ft. Gravel depth beneath pipe 8 0Ft. Subdivision Block Lot Ward 2 Fill added above original grade 4-5 Ft, Gravel length 50 Ft. Township Range Section Gravel width 3Ft. Beds: Number of Lines Distance between lines I Ft. SEPARATION DISTANCES To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Lift Station Tank Line 800 Ftp One Ft. Well N/A NIA NIA N/A N/A TANK El Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Anchorage Tank Capacity I 1,250G,I. Surface Water >100' >100' N/A N/A Material Number of compartments Lot Line >5' >10' N/A N/A Steel Two NA Foundation >5' >10' N/A N/A LIFT STATION Manufacturer Capacity Curtain Drain None Noted Gal. Remarks Pump on level at In- Pump off level at in. High water alarm at in. Pump make and model Electrical Inspections performed by Installer PIPE MATERIAL House to tank D3034 Tankto D3034 drainfieltl Glacier Masonry Drainfield HDPE COJMr D3034 Inspector MEA BENCH MARK (Assumed elevation) 100.0ft Inspection 1" 5/6/12 ,� 5/7/12 Location and description dates: 3" 5/9/12 2 a Back Deck Northwest Corner. COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL 111r%%tgp 11;10 ArSA— &.A4 9o�! Conditional Approval: Date or oo,. r. ' ••'••�S'.�5� 49 •too oil -N,•----- - �. • • ..1\.������ Al 4 • Q ' •MOMp CE,43e1 U.2§.: f 1 ft I oo 1PF®��•::::i#`•�`'w �1 Approved /rC� Date `'�_?'L 'ROFESS1t1�A��� __� Inspection Report_t-1-12.dbc / Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT Permit Number: OSP121020 4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904 LEGEND S1 — Septic Vent M1 — Monitor .Tube C5 — Clean Out TH — Test Hole FCO — Foundation Clean WARD SUBDIVISII LOT 2 40,262 S.F. FENCE ' 49th FEL E. ANDERSON No. CE -4381 N 89'51'06"E 134.00' 0 M PENNY ROSE CIRCLE PLAN AS -BUILT SCALE 1' = 40' Page 2 of 3 PID No. 011-122-81 A I B 51 17.4' 45.7' S2 23.3' 48.3' C5 78.1' 70.8' C6 752 98.4' M1 1 74.2'1 72.7 Municipality of Anchorage Page 3 of 3 DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On-Site Wastewater Disposal System or Well Inspection Report Permit Number: OSP121020 PID No. 011-122-81 97.4 U (n fn UU Exislin Finished Grountl Grountl 1,250 Gallon Septic Tank 90.85 90.7 97.1 93.1 Fidms dGma Original Gratle Geotextile Fabric 89.2 Drainfeld Rock7771-- 89.2 81.2 75.1 No Groundwater 2/28/05 50' (Trench Length) :'. .......49th. ...... PROFILE AS-BUILT .� MICHAEL RSON; ~= . , NO. CEA-4381 �� No Scale "�... !,`,. `• •� On -Site Wastewater Disposal System Permit Permit Number: OSP121020 Tax Code Number: 01112281000 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Work Type: Septic Initial Permit Effective Dates: April 23, 2012 to April 23, 2013 Design Engineer: ANDERSON ENGINEERING Subdivision: WARD Site Legal Address: WARD LT 2 G:2222 Owner/Address: DITTRICH COMPANY LLC 2449 BROOKE DRIVE ANCHORAGE AK 995171252 Site Mailing Address: 7035 PENNY ROSE CIR, Anchorage Lot Size in Sq Ft: 40262 Total Bedrooms: 4 This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Receivf Issued MUNICIPALITY F ANCHORAGE Community Development Department , Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program Mayor- Dan Sullivan ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 011-122-81 Property owner(s): The Dittrich Company Day phone: 632-8790 Mailing address: P.O. Box 90411 Anchorage, AK 99509 Site address: Penny Rose Circle Anchorage, AK Legal description (Sub'd., Block & Lot): Ward Subdivision, Lot 2 Legal description (Township, Range & Section) Lot Size: 40,262 Sq. Ft. Number of Bedrooms: Four (4) THIS APPLICATION IS FOR: THIS APPLICATION IS AN: (® all that apply) Absorption Field X Initial X Septic Tank X Upgrade ❑ Holding Tank ❑ Renewal ❑ Privy ❑ Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: 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. or authorized agent) Permit/Rush Fees: Jr - (0 Date of Payment: Receipt Number: a lloa_ Permit No. Waiver Fees: Date of Payment: Receipt Number: Waiver No. C:\Users\BenSAppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\DF3WQFBP\Permit Application Lot 2.docC:\Users\Ben\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\DF3WQFBP\Permit Application Lot 2.doc ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766(FAX) February 20, 2012 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 2, Ward Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer The owner of Lot 2, Ward Subdivision intends to construct a new four-bedroom home on the lot. We are therefore requesting a permit be issued for the construction of a new septic system to accommodate the home. The subdivision is served by the AWWU water system. The attached Site Plan and backup documentation identify the location and configuration of the proposed septic system along with the alternate site. No existing wells or septic systems are closer than 100' from the proposed septic system. Drainage arrows are shown on the site plan showing the grade and direction of flow on the lot. The drainage pattern will not be changed as a result of this project. The test holes placed on the tract in the area of the absorption trench and alternate site indicated clean sand (SM/SP/SW) material with some silt. The percolation rate of the soil was determined to be from 6 to 15 minute per inch. No groundwater was found during the placement of the test holes and none was noted during the monitoring .period. An application rate of .8 gallons per day per square foot was used in the design of the absorption system. We are proposing to place a new 1,250 -gallon septic tank and a 47' long by 3' wide by 8' effective depth absorption trench to treat and dispose of the effluent generated in the house. The elevation of the distribution line in the absorption trench will be 3.5' below the surface and the total depth will be 11.5'. A minimum of 3' of fill or 2" of insulation and 2' of fill will be placed over the absorption trench and 4' over the septic tank. The ground surface on the lot in the area of the absorption trench is nearly flat with a slight bias to the north at a grade of 5%. The new trench will be constructed parallel with the slope as much as possible in conformance with Municipal requirements. The new septic system will be constructed a minimum of 1 00'from all wells and any surface Lot 2, Ward Subdivision February 20, 2012 Page Two water and 10' from the proposed and existing water services in the area. If the system is constructed in accordance with our design the following statements apply: 1. The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, njami� . Schiller, P.E. Attachments we��---•alb � •�F OF A( st P,.• 4 .4 ; • 4 9 H -H 0 ...........e 9� ,Benjin 1 Schiller; 1&% CE -12592 C I -----------cn I I 1 I I a 1 I I � I I I I u.M Wei 2c-1 I I YI N IDl .E 4n1 I I I I m I o Lot 9 o c. I I I L t. 10' Utility Esmt — I - T- O U) T I =� 1 `I 1 IO I L I Mw r� y 10 cn Q/ IC 1 1Z7 I I I 1 I� I �I YI Hanks Subdivision .a J i VACANT o IPENNY - — - - - — ROSE S89'51'10"W 329.76' o CIRCLE 10 249.69' " 1* --------------- - k I• I �15' Gas Esmt I I i � I I -----------cn I I 1 I vi e a o I _0 W WO O rn �, C N IDl .E 4n1 I I I Do m I o Lot 9 o I I I Lot 4 10' Utility Esmt — L------133.99'---- T- O ---- - Drainage s\ \ e Esmt \ \- o O Lot 7 \\ o w 42,134 \ W � N sq.ft. `;\\ + m VACANT sem\\\ 10' T&E Esmt --134.00'---- ------- 223.06 ------ Ratcliffie Subdivision 1 3 2 AREA PLAN SCALE 1° = 100' I I I S0' 1 1 1 VACANT 1 1 U) -----------cn I a I 2c-: I U E Q _ H83'S1'C6'E 118.x' IDl .E 4n1 I I I I I I Ise I_ e. Lot 4 �4Wi N.I. 1 I I O U) T V) I -O Vn IO VACANT 1., s r� y cn Q/ Lot 6, I\ 45,681 0, sq.ft. b I� N 1N Ip Izt .` 49th /�V• E. ANDERSON F241' 244' N 89'51'06"E 134.00' 10' Utility Easement --------------------- �J 7 kf TH4 �o( e S(e 47' long x 3' Dept ec de x Efftive Depth TH3 Absorption Trench c0 MT k kj CO cc 2i v C C r i i246.5 - z .n mi in avi rv x x Home SLAB 5' / Jx N / x O V N � (/ N I H A.C. DRIVE N RQ'S1'1n"F 1za n' 249.4' o - - 17 PENNY ROSE CIRCLE SITE PLAN SCALE 1" = 40' WARD SUBDIVISION LOT 2 40,262 S.F. LEGEND SV — Septic Vent MT — Monitor Tube CO — Clean Out TH — Test Hole FCO — Foundation Clean Out z4z.3 �0. ....�....gGq!��i a GJp'` Q 49th �...} � 1 -9 -'.MICHAEL E. ANDERSON i •1 : No. CE -4367 I Al LOT 2, WARD SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Four Bedroom Home Deep Trench System Perc. Rate: 6-15 Min./Inch 1,250 Gallon Septic Tank Application Rate: .8 GPD/SF B' Drainfield Rock 4 Bedrooms X 150 GPD/.8 GPD/SF (Application Rate) = 750 SF Absorption Area 750 SF/16 SF/LF = 46.88 LF Trench Length THEREFORE: Construct a 47' Long x 3' Wide x 8' Effective Depth Aborption Trench at the Location Shown. Flow Line Elevation in Trench to be 3.5' Below Original Ground Surface. Total Depth to be 11.5' Below Existing Ground. Provide 3' of Cover Over Trench and 4' Over Tank or Provide 2" of Insulation and 2' of Cover. Maintain 10' Separation From Water Services in the Area. Natural Backfill 3'0" Geotextile Fabric 6'. 4" Perforated PVC (Holes Down) 1.3104 3' Drainfield Rock TYPICAL DEEP TRENCH SECTION (NO SCALE) NOTE: Grade Area Over Trench to Drain Away. Minimum 6' Separation From Bedrock. Minimum 4' Separation From Groundwater. Minimum 100' Separation From Private Wells in the Area. Minimum 100' Separation From Surface Water or Streams. Minimum 10' Separation From Water Service Line. MUNICIPALITY OF ANCHORAGE mLOpt9ENT SERVICES DEPARTME$7MUIL9ING SAFETY DmSjON -SITE WATER "ANN WASTEWATER PROGRAM 4740 SAVJTH $RAGAYB APaCHoRAGE, AK 99519 PROJECT #: SOILS LOG -PERCOLATION TEST PERFORMED FOR, DATE PERFORMED, �Clb/45 LEGAL DESCiiipTIOIV: teF 2 Jot t+sPers Sobdlroi�ian TEST HOLE # 3 SLOPS SITE PLAN t� 1 A 3z 6 i Qs ' See Site Plan LAI y J 9"�tl Sm n, Olive r yv Sand with Sit WAS GH ATcR Y ENCOUNTERED? &16 O IF YES, WHAT DEM? Sea Site Plan DEPTH DF'WATER p a ; .:AFTER MONITORING: E DATE: 2/28/2405 .5 . e44 It READING DATE G NET DEPTH To NET L TIME :TIME WATER ORz7F Start ` 2/18 1424 6.51 apsrls L 1 14:5& 3D 9.32' 35 Rem rge 105:226{ 6t9.p32' 5i56 10 '~ R •0 I�llfa Stv FERC RATE: , M#N./INCr PERC. HOLE DIAMETER.—.— TEST RLW SETWEEN 4 -fl FT.S..— FT, CDmt: n Test Nate pre Soaked Prior to Percolai ''REST PERF IEA By,, 1, � -AND CERTIFY THAT Tms TEST WAS PES D lu ALiSA%CE ..&PITH ALL. STATE AND i LWICIPAL GUIDELINES. ON.Tms LATE: 2/28/2005. MMICIPALITY OF ANC GE DEVELOPMENT SERVICES DEFARTMFNT%BUlLDIrjG SAFETY DIVISION ON-SITE MATER Atop WASTEWATER PRCGRA.M 4704 SOUT; BRAGAW ANCHORAGE'99519 PROJaC SOILS LOG - PERCOLATION TEST PE1C7RMED FOR, DATE PEEP ED. _ 2Ff6P�5 LEGAL DESCRIPTIOM 1prt nns o s 5 IVI Ion TESTHVp Sf Lr � SLOPE IT PLAN F1 C ee S See Site Ran r r. - Sand with Silt ntl�; ,, { .. WAS GROUNDWATER � '� KCtSUMfERs�. - NO S IF YM WHAT DEPT*d? Sea Si7a Pints E: i1EPYtf €F WATER I I •• .� Nene AFTER YSo[+ItT{}idlR%;: E ` DAM MV2885" OF �mnRErilllN6 [SOT[ i CRUS$ AiEY i?EEPIH To NIIL , i TIME - TIME WATERTF¢R..... Il "�' "�.a �� �`'4 �� Start 2t7? i &3:78 5.38'. °. ti4th r 7 73<2Q 10 7.87` Rechnr r a 73;23 5.38" 7�:�� � J}� 3 y��+`�� f1,47 • sol$ 76 FERC RATE: MIrr.PleaCw PERC. HOLE DIAMETESt 'TEST RIX4 SETW!!FN A& R'!-. ANU S -G T, UU� 22 L�+rM ��t�ws t �d� ��I� T�� �v'��I,f�.� li{iiI•. �'� £��I,i���l€i�:.i�iJ. -. TEST PERP -. Dr. M 3, bnM&!.A_MMKM CERTIFY THAT TiffS TEST WAS FEWOFNED I'N AOWMANCE tWIT4 ALL STATE AND FSUNICIPA(. GUIDELINES gra TIAs DATE:. 2/28/2005 pe pv:-) „, ;e. ®;`f ' Municipality of Anchorage On-Site Water and Wastewater Program R (907)343-7904 5 A 1 t't'r Certificate of On-Site Systems Approval Parcel I.D. 011-122-81 Expiration Date: 10/24// 1. GENERAL INFORMATION Complete legal description Ward L2 Location (site address) 7035 Penny Rose Circle Current Property owner(s) Danielle Ryman Day phone Mailing address 7035 Penny Rose Circle , Anchorage, AK 99502 Real Estate Agent Day phone 2. TYPE OF DWELLING: Q Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community El Public Water System Public Sewer ❑ WaiverNariance request for: Distance: r � - Received by: Date: 8/7//e COSA to be released to the er,unless otherwise requested by the engineer. COSA Fee $ 52 Waiver Fee $ Date of Payment t( 15i!A Date of Payment Receipt Number (5 -11AC'') Receipt Number COSA# AC IA 19 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. In conducting an adequacy test,I attempt to provide a thorough,conscientious engineering analysis of the system in accordance with MoA COSA guidelines and regulations.The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition,ground water levels that may fluctuate during the year,and the water usage of the family being served by the system.These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system,nor do they guarantee that there are no hidden defects or encroachments.Therefore we cannot provide any warranty for future performance, nor can we estimate remaining life of the system.The content of this report is for the sole benefit of the owner listed above. Name of Firm Pannone Engineering Services LLC Phone (907) 745-8200 Address P.O. Box 1807 Palmer, AK 99645 Engineer's Printed Name Steven R Pannone Date /f &_ ilk 6. DSD SIGNATURE �#10' • X System #1 Approved for Lt bedrooms i'••Steven• •. annone• )09 CE-8149 System #2 Approved for bedrooms Disapproved l\ PR4FESS1ctkl'\'+ Conditional approval for bedrooms, with the following stipulations: ON-SITE e" WATERAND WASTEWATER o PROGRAM c 4,, r4• By: ija)v-7,1:71-z—z,„_-- Original Certificate Date: fl/7�S The Municipality of AnchDevelopment 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 blue sheet` - If more than 1 septic system is on the lot: COSA Checklist# 1 of 1 Structure served by this system 1 Certificate of On-Site Systems Approval Checklist Legal Description: Ward L2 Parcel ID:011-122-81 A. WELL DATA Well type n/a If A, B, or C provide PWSID# Well Log(YIN) Date completed Sanitary seal (Y/N) Wires properly protected (Y/N) Total depth ft. Cased to ft. Casing height(above ground) in. FROM WELL LOG AT INSPECTION Date of test N/A N/A Static water level ft. ft. Well production g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform N/A colonies/100 mL Nitrate mg/L Arsenic ug/L Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic / Steel Date installed 5/6/12 Tank size 1250 gal. Number of Compartments 2 Cleanouts(Y/N) Y Foundation cleanout(Y/N) Y Depression over tank(Y/N) N High water alarm(Y/N) N/A Date of pumping 10/29/18 Pumper A+ Home Services C. ABSORPTION FIELD DATA Date installed 5/6/12 Soil rating (g.p.d./ft2 or ft2/bdrm) 0.8 System type Deep Length 50 ft. Width 3 ft. Gravel below pipe 8 ft. t6.2 'per P6 800 Y N Total depthS. ft. Eff. absorption area ft2 Monitoring tube Depression over field Date of adequacy test 10/26/18 Results(Pass/Fail) Pass For 4 bedrooms Fluid depth in absorption field before test 79* in. Water added 600 gal. New depth 86 in. Elapsed Time: 1440 min. Final fluid depth 79 in. Absorption rate >= 600 g p d Anyrejuvenation treatment None Known (past 12 mo.)(Y/N &type) If yes, give date D. LIFT STATION Date installed N/A Size in gallons Manhole/Access(YIN) "Pump on" level at in. "Pump off'level at in. High water alarm level at in. Datum Cycles tested Meets alarm&circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: Septic tank/lift station on lot N/A On adjacent lots Absorption field on lot On adjacent lots Public sewer main Public sewer manhole/cleanout Sewer/septic service line Holding tank Animal containment areas Manure/animal excrete storage areas SEPTIC/HOLDING TANK ON LOT TO: Building foundation + Property line 10 + Absorption field 101+ Water main 25'+ Water service line 25'+ Surface water 100'+ Wells on adjacent lots 100 + ABSORPTION FIELD ON LOT TO: Property line + Building foundation 10+ Water main 10 + Water Service line 25'+ Surface water 1 00�+ Driveway, parking/vehicle storage 101+ Curtain drain 50'+ Wells on adjacent lots 100 + F. COMMENTS As-Built on file *System 83% used G. ENGINEER'S CERTIFICATION 4•.�`0F. ��t' I certify that I have determined through field inspections and ''�p'�P' �4, •. � .7 review of Municipal records that the above systems are in ;• • i /r •• tf� ;lir: conformance with MOA COSA guidelines in effect on this date. 47 .1.140W Engineers Printed Name Steven Pannone 9� ��`0119,-.. •••Seven •..Pannone. 11/2/18 0 CE-8149 Date vii49 • ,te r t, `\\t—�"' COSA canary sheet_2-6-15.doc Parcel I.D. 011-122-81 1. GENERAL INFORMATION Complete legal description Lot 2, Ward Subdivision Location (site address) COSA # 6SC Q I'A Xo Expiration Date: 5-- Cts - Z 1 7035 Penny Rose Circle Anchorage, AK 99502 Current Property owner(s) The Dittrich company Mailing address Lending agency Mailing address Real Estate Agent Mailing Address P.O. Box 90411 Anchorage, AK 99509 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: Four (4) 3. TYPE OF WATER SUPPLY: Individual Well Municipality of Anchorage Individual Water Storage Development Services Department Community Class Well Building Safety Division Public Water System On -Site Water and Wastewater Program 1 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 ^ www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 011-122-81 1. GENERAL INFORMATION Complete legal description Lot 2, Ward Subdivision Location (site address) COSA # 6SC Q I'A Xo Expiration Date: 5-- Cts - Z 1 7035 Penny Rose Circle Anchorage, AK 99502 Current Property owner(s) The Dittrich company Mailing address Lending agency Mailing address Real Estate Agent Mailing Address P.O. Box 90411 Anchorage, AK 99509 Unless otherwise requested, COSA 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 Well ❑ Public Water System ❑✓ Day phone 632-8732 Day phone Day phone 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-sife 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 SIGNATURE _Approved for bedrooms. Disapproved. Phone 522-7773 Conditional approval for bedrooms, with the following stipulations: Attachments COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: oC ,e_ f Original Certificate Date: L - (Rev. 11M) Municipality of Anchorage �• '� Development Services Department Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99507 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Lot 2, ward subdivision Parcel ID: 011-122-81 A. WELL DATA Well type Awwu If A, B, or C provide PWSID # _ Well Log (YIN) Date completed _ Sanitary seal (YIN) _ Wires properly protected (YIN) Total depth ft. Cased to ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION 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/L Other bacteria colonies/100 mL Arsenic: _ ug/I Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Date installed 5/5/2012 Tank size 1,250 gal. Number of Compartments TWO Cleanouts (YIN) Y Foundation cleanout (YIN) Y Depression over tank (YIN) N High water alarm (YIN) N Date of pumping New Construction Pumper C. ABSORPTION FIELD DATA Date installed 5/6-9112 Soil rating (g.p.d./ft2 or ftZ/bdrm).8 GPD/SF System type Deep Trench Length 50 ft. Width 3 ft. Gravel below pipe 8 ft. Total depth 15 ft. Eff. absorption area 800 ft' Monitoring tube Y Depression over field N Date of adequacy test New const. 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.PA. Any rejuvenation treatment (past 12 mo.) (YIN & type) N If yes, give date D. LIFT STATION Date installed "Pump on" level at _ in. Size in gallons "Pump off" level at _ in. Datum Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on lot Public sewer main Manhole/Access (YIN) _ High water alarm level at Meets alarm & circuit requirements? On adjacent lots On adjacent lots Public sewer manhole/cleanout Sewer /septic service line Holding tank Animal containment areas Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Property line >5' Absorption field >5' Water main N/A Water service line >10' Surface water >100' Wells on adjacent lots >100' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line >10' Building foundation >10' Water main >19 Water Service line >10' Surface water >100' Driveway, parking/vehicle storage >25' Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS: Property is Served by AWWU Water System. 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. Engineer's Printed Name Michael E. Anderson, P.E. Date 9/13/2012 COSA Fee $ is 5 + Date of Payment O t 11111 Receipt Number b*q0%% (Rev. 11105) ©L c t 311 (a-( _ a * ••• 491H Waiver Fee $ _ Date of Payment Receipt Number rQ9 6-AND6t50fy0 �v PROFESSt0Np X, 1 `40' FENCE (APX) PLAT NO. 2006-13 WARD SUBDIVISION LOT 2 40,262 S.F. N 89°51'06"E 134.00' 10' T. & E. ESMT. ---------------------- I I x I � � t a O O r7 r N � SEPTIC SYSTEM _ M O O � Z f • 43.9' 10.7 EXISTING BUILDING CONC. WALK 1 CONC. WALK A.C. DRIVE ro /* CONC. N 89'51'10"E 134.00' O r7 PENNY ROSE CIRCLE AS -BUILT GASTALDI LAND SURVEYING, LLC JEFF A. GASTALDI, R.L.S. 2000 E. DOWLING RD., SUITE 8 ANCHORAGE, ALASKA 9950 PHONE 248-5454 GRID DATE 2222 9/6/2012 F. B. JOB NO. 12-04 WARD2 I HEREBY CERTIFY THAT I HAVE SURVEYED THE PROPERTY DEPICTED ABOVE AND THAT NO ENCROACHMENTS EXIST EXCEPT AS INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE LINES. ANCHORAGE RECORDING DISTRICT, ALASKA NOTE: NO CORNERS SET THIS DATE. t •.�' OF ALAS'* ■AV C0 * 49 TH••••�, ■........................ r....................... ..■ 0 , : Jeffery A. Gastaidio` ■ W 0- •. LS -6091 J Y���� • ��'O'�••... •.. "•�aS.I p