HomeMy WebLinkAboutMILLER VON HOLZMAN LT 1Miller Von
Holzman
Lot 1
#051-281-95
ARCTIC PUMP & WELL INC.
Jim Sullivan
PO Box 770197
Eagle River, AK 99577
(907)688-2510
` (907)258-2510
(907) 745-2510
apw@ci.net
Pump Installation Log
Well Drilling Permit Number: SW
Parcel Identification Number:
Date of Issue:
t )CIW /1� /er V6,11 0017-M1111 4ML L -t" l
Legal Description:T15N R2W S25 Property Owner Name & Address:
Lot:30 Mitch Miller
Block: 16234 Carlisle St
Fnalr Ri�rar AK QQ577
Pump Installation Date: 9-2-14
Pump Intake Depth Below Top of Well Casing:
Pump Manufacturer's Name: Franklin
Pump Model:
Pump Size: hp
Pitless Adapter Burial Depth: feet
Pitless Adapter Manufacturer's Name:
Pitless Adapter Installer: U/K
Well Di ' meted Upon
Met of Disinfection:
Comments: Caising 40 + with no perforations
Pump Installer Name:
Arctic Pump & Well, Inc.
Arctic Pinup & Well, Inc.
Page 1 of 1
Feet
W4 Miffing Permit Nwnbore SW bate letnue
Pam Idetammoon muminnt _.,�.�..
Legal € essripifon { Property Own" Name & Address
NifgPr lton diatrnaan €tK i K" summer • smmmemmpa"VegmaLmm
Pump lastaila Wte. 9-3Zf15
Pump €ntake l)"th Below Fop of Walt i'aslng� 99 feet
Pump manufacturer's Warne: i€otdds
Pump Me":: 1OWS412CL
Pump Sim 112 hp
Pitlam Adaptec guru! Depth: SD feet
Phim Adaptat fnstaifer. UdInown
Upan CompNiicn7 0 Yes &.i no,
method of Dims CM016M SOPPINA
Caammerns. 81tk3es. kd. - 's
1 717T=174711
Inspection Report_9-1-12.doc
Municipality of Anchorage
On -Site Water and
Wastewater Program • (907) 343-7904 Page of
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP151172
PID Number: 051-281-95
Dwelling: Z Single Family (SF)
❑ Duplex (D)
❑ Multiple (SF and/or D) Project: Z New ❑ Upgrade
Name:
Mitchell & Shannon Miller
ABSORPTION FIELD
Z Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound
Address
16234 Carlisle St., Eagle River, AK 99577
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
5
1.2 GPD/SF
10.5 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
4.5 Ft.
Gravel depth beneath pipe
6.0 Ft.
Subdivision Block Lot
MILLER VON HOLZMAN
1
Fill added above original grade
Varies 0.35 — 0.65 Ft.
lGravel length
53 Ft.
Township Range Section
Gravel width
3 Ft.
I Beds: Number of Lines
--
Distance between lines
Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Lift Station
Tank
Line
636 Ftp
--
-- Ft.
Well
100+
100'+
100'+
NA
NA
TANK Z Septic R S.T.E.P. ❑ Holding ❑ Other
Manufacturer
Anchorage Tank
Capacity
1500 Gal.
Surface Water
100'+
100'+
100'+
NA
Material
Steel
Number of compartments
2
Lot Line
5'+
10'+
51+
NA
NA
Foundation
5'+
10'+
5'+
NA
LIFT STATION
Manufacturer
Capacity
Gal.
Curtain Drain
NA
*50'+
NA I
NA
Remarks *None known.
Pump on level at
in.
Pump off level at
in.
High water alarm at
in.
Pump make and model
Electrical Inspections performed by
Installer
Tank to
PIPEMATERIAL Housetotank
�drainfield
r
Sb / tytR� G
x �✓ h4
Drainfield 3034 CO/MT 3034
Inspector ARCTER
BENCH MARK (Assumed elevation) 100 ft
Inspeection
1" 7/16/15
n 7/16/15
Location and description
ction
2
3" 7/16/15
4"
Finished Floor
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL
Engin
Aw
OF V
Conditional Approval:
Date
or
f 41TU
KENNETH [. D �y /
Sa 711 1
Approved
Ci
i.
60
Date -17t`
OrFs ro API
ear's Stam
Inspection Report_9-1-12.doc
AS -BUILT SYSTEM DETAILS/SITE PLAN Permit ❑SP151172
MILLER VON HOLZMAN, LOT 1 PID# 051-281-95
RAILBELT SUBD., LOT 7C
N89055'03"W
7A"
O Co
O TEST HOLE#3 CO 0
P CO D/
N 1500 -GAL S.T.
LOT 1
41797.877 Sq. Ft.
A—C=24.0' 98,15
B—C=21.5'
A—D=31.5' y
B—D=30.5' s
A—E=68.0' o
B—E=59,0'
A—F=45.0' A —
B—F=23.5'
A—G=43.5'
B -15=21.5'9a.
38.2
o FINAL GRADE
257.85'
TWO STORY 5-13R
WOOD HOUSE
SCALE, V = 30'
o
E
EnrDx Fn C '
500 GAL T
n�v
SEPTIC 92,7 92,7 1 1
TANS \ I II SEWER ROCK
OF AL
/
1
�* 9TH *f
KENNE M. /
1 CE- W4
�Ssslo��' i
N
V
N
86,7 III
80.75 .a
53'
SCALE, NTS
PREPARED FOR:
MITCHEL & SHANNON MILLER
16280 CARLISLE ST.
EAGLE RIVER, AK 99577
907-232-6797
FIELD BOOKS COMPUTED:
BOUNDARY: NA DRAM: BMW
STAIM& NA CNENm: KMD
ASSDaT: TLN DATE: 10/30/1
DW. FlUE: GRID: NW0753
ADAD PDE: FILE ADB Nw: 15-160
On -Site Wastewater Disposal System Permit
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
Permit Number: OSP151172
Tax Code Number: 05128195000
Work Type: Septic Initial
Permit Effective Dates: June 24, 2015 to June 23, 2016
Design Engineer: ARC TERRA CONSULTING INC
Subdivision: MILLER VON HOLZMAN
Site Legal Address: MILLER VON HOLZMAN LT 1 G:0753
Owner/Address: MILLER MITCHEL R & SHANNON
16234 CARLISLE ST EAGLE RIVER AK 995779303
Site Mailing Address: 16280 CARLISLE ST, Eagle River
This permit is for the construction of:
Y Disposal Field Y Septic Tank N Holding Tank N Privy
Lot Size in Sq Ft: 41797
Total Bedrooms: 5
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.
Special Provisions: PRIOR TO FINAL APPROVAL: The original version of Soils Log "Test Pit 3"
shall be submitted.
Received
Issued By
FilZq(s fh. reservc. 5rfo evdI z -h-, bumf at5 thel") %Xay ri`-n'c.ld.
MUNICIPALITY OF ANCHORAGE
nampi
Community Development Department Phone: 907-343-7904
Development Services Division Fax: 907-343-7997
On -Site Water & Wastewater Program
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 051-281-95
Property owner(s) MITCHEL & SHANNON MILLER Day phone
Mailing address 16234 CARLISLE ST, EAGLE RIVER, AK 99577
Site address 16280 CARLISLE ST, EAGLE RIVER, AK 99577
Legal description (Sub'd., Block &Lot)
MILLER VON HOLZMAN LOT 1
Legal description (Township, Range & Section)
Lot Size 41797 Sq. Ft. Number of Bedrooms 5
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Single Family
Absorption Field
Initial
(SF)
(w/wo ADU)
Septic Tank
Upgrade ❑
Duplex (D)
❑
Holding Tank
❑
Renewal ❑
Multiple Dwellings
❑
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION
INCLUDES A VARIANCE / WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
Permit/Rush Fees:
Date of Payment: (o I t erg c -P=
Receipt Number: 63ac5k0
Permit No. " ) 5 1112
Permit App_9-1-12.doc
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
?,?CJERy
F
dye % ARC 1m
ERRA
' = CONSULTING, INC
212 E. 51" Ave, Anchorage, AK. 99503
w Office (907) 868-3791, Fax (907) 868-3793
pRSULT�Nn,S°�
June 10, 2015
Municipality of Anchorage
Development Services Department
On -Site Water & Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
Subject: New Sewer Permit — Miller Von Holzman, Lot 1
The owner has requested we proceed forward to obtain a septic permit on the
subject lot. The general slope of this lot is from north to south at a grade of
approximately 0-3% over the septic area.
We have designed the 5 -bedroom system utilizing the testhole that was
performed in the fall of 2014, which results are attached. Groundwater was not
noted at time of construction or during monitoring. An existing well is located
on the eastern portion of the subject lot as shown. We propose to install a 53'
deep trench.
Adjacent properties are served by community and private water. There is no
surface water within 100' of the proposed system and there are no known curtain
drains within 50'. We do not expect there to be any adverse effect on adjacent lots
by the development of this system. If you have any questions, please contact me
at 868-3791 / FAX 868-3793.
Respectfully submitted,
ArcTerra Consulting, Inc.
Kenneth M. Duffus, P. .
Attachments: On -Site Sewer Application
Wastewater Absorption System Details/ Site Plan
Soils Logs/ Percolation Tests
20441 PTARMIGAN BLVD • EAGLE RIVER, AK 99577-8736 • PH (907) 868-3791 • FAX (907) 868-3793
WELL & WASTEWATER DISP❑SAL SYSTEM DETAILS/SITE PLA
OF *4 1
/ 4 /
CE -711
'•wE99Iot�6\'
PREPARED FOR;
MITCHEL & SHANNON MILLER
16280 CARLISLE ST.
EAGLE RIVER, AK 99577
907-232-6797
FIELD BOOKS
cawum-
MILLER VON HOLZMAN, LOT 1
WAKRA NA
Q1� KMD
ASOMM
N89'55'03"W + LOT 7C 6
D*a "�
'�°` NW0753
""FILE
'10B ""' 15-160
30'
X
z z
wsr Prr p
1500-cN ST.
x Z
O
gyp,
r''r V
N DVRY FIELD 5'
t+q
10. PI 17.W
••
V
m
LOT 1
a 7.W
x
�' YF1L
H
2&W WELL
y
PRD1EC'ME ROM
I71
(n
�
Ut
x
N 8'38'27"ES86'31'58"E
50
o w
tsyy f
N9
X ^
FLAG PROPERTY LINES
WELL RADII
& EASEMENTS
PRIOR TO CONSTRUCTION
Scatel 1'= 50'
DESIGN DETAILS PAGE 1 OF 2
5 BDRM X 150 GPD = 750 GPD
750 GPD/1.2 GPD PER SQ. FT. (1.2 MIN/IN.)= 625 SQ. FT
(625 / 2 x (6' GRAVEL) = 53 FT. TRENCH
NO SLOPES >15%
USE 1 TRENCH - 53' (L) X 2' (W) X 6' (ED)
WITHIN 100' OF
Total depth of system Is 10.5' max from original grade.
PROPOSED SEPTIC
Total depth of gravel below distribution pipe Is 6' .
NOTES;
1° Pm MED YCr a �M e00'
1. INSTALL NEW 1500 GAL. SEPTIC TANK & INSULATE TANK IF <4' CO\
IE WE= snrwN zor DP
2. INSULATE TRENCHES WITH 2' HD BURIAL FOAM IF < 3' OF FILL.
PRS Srn.�s xmF
NO SEMIC SME VM
MIN. 2' FILL WITH INSULATION, )3' COVER NO INSUL REQ.
PROPOSEDWEu Ez ASNU a
3. CONTRACTOR WILL ENSURE MINIMUM 2% SLOPE INTO SEPTIC TANK.
4. CONTRACTOR WILL ENSURE ALL SEPARATIONS TO ADJACENT
WELLS, SEPTICS EASEMENTS, PROPERTY LINES. ETC...
OF *4 1
/ 4 /
CE -711
'•wE99Iot�6\'
PREPARED FOR;
MITCHEL & SHANNON MILLER
16280 CARLISLE ST.
EAGLE RIVER, AK 99577
907-232-6797
FIELD BOOKS
cawum-
WAKRA NA
Q1� KMD
ASOMM
DATE 6/10/15
D*a "�
'�°` NW0753
""FILE
'10B ""' 15-160
n/v'VLTTINO .
�' AK. 99577'
WASTEWATER DISP❑SAL SYSTEM DETAILS
MILLER VON IRLZMAN, LET 1
N89°55'03"W
LOT 7C
Flq
x
x
x
TEST PIT #3
[7
RESERVE=
n
INSTALL NEW
1500 -GAL S.T.
CkC
C0
MT
7m-1
NEW\PRIMARY FIELD
MILOT 1
MJ0
25.0' t- -j
L4
o
17.0
N �
� of 7.5'
0
0
100' WELL 125.5'
PROTECTIVE RADIUS
11
°38'27_"E
A " / V O4 1 I L\
FLAG PROPERTY LINES
WELL RADII & EASEMENTS
PRI❑R TO CONSTRUCTI❑N
PREPARED FOR,
MITCHEL 4 SHANNON MILLER
16280 CARLISLE ST.
EAGLE RIVER, AK 99577
907-232-6797
FIELD BOOKS cauvmm:
aax�ornr. A wu,Nx:
BMW
Slmlft NA CHEdQR KMD
�7.. DAM 6/10/15
owc. Fly: mm. NW0753
A0"0
`FILE " N°.. 15-160
Scale: 1'= 30'
PAGE 2 OF 2
r,-<vspyTI "C .
�°R AI( 88577-'
'
r2l.
p�N3.70�
�v
25.0' t- -j
L4
o
17.0
N �
� of 7.5'
0
0
100' WELL 125.5'
PROTECTIVE RADIUS
11
°38'27_"E
A " / V O4 1 I L\
FLAG PROPERTY LINES
WELL RADII & EASEMENTS
PRI❑R TO CONSTRUCTI❑N
PREPARED FOR,
MITCHEL 4 SHANNON MILLER
16280 CARLISLE ST.
EAGLE RIVER, AK 99577
907-232-6797
FIELD BOOKS cauvmm:
aax�ornr. A wu,Nx:
BMW
Slmlft NA CHEdQR KMD
�7.. DAM 6/10/15
owc. Fly: mm. NW0753
A0"0
`FILE " N°.. 15-160
Scale: 1'= 30'
PAGE 2 OF 2
r,-<vspyTI "C .
�°R AI( 88577-'
Municipality of Anchorage
Development Services Department
Building Safety Division
Y .fit OD-Slfe Water and Wastewater Program
4700 Elmore Read
P.O. Box 196850 Anchorage, AK 99507
xmmu&RMOrage ak.us
(907) 343-7904
Solis Log - Percolation Test
Performed For: Mitch and Shannon Miller Date Performed: Oct 6, 2014
Legaloesionprion: T15N R2W Sec 25 LT30 Township, Range, Section; T15N R2W Sep 25 LT30
TEST PIT 3
Depth
(Feet)
SM Brcwn, organ:::, s4ty SAND
Sof IIrcx,i, sixty SAM}
GM -SM 4geikw shy, sandy CRAVEA.
CRAVELwith g3" cnbUles
NOTE NIT WAS WAS GROUND WATER
INS'l-Al KED 10 16_L, F 3. ENCOUNTERED? NO
—I — —
to- PERC TEST CONDUCTED IF YES, AT WHAT DEPTH? n1a L
AT !i FT BGS, Depth to Water After — 0 T
11 Monitoring? NONEI DRY P
— E
12- Date. 10/14114
M
1
Reading
Deft
Gross Time Net 'Firne,
Depth to Water
I Net Drop
18:10
---11
62.5 in.
2
18:15 5
66.0 in.
3.6 in
18:16
61,0 In
4
18:21 5
65.0 In.
4.0 in
5
18;22 —
62.0
18:27 5
66.25
4.25 In,
rCMwV HVNiIAIL 1.Z (Mintneaflacti) FERC HOLE VLAMETER 6 in,
TEST RON BETWEEN 5 FT AND 6 FT
COMMENTS Test hole presoaked prior to test.
PERFORMED BY: Mitch Miller, PE I Mitchel R. Miller CERTIFY THAT THIS TEST WAS
PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE, DATE: OCT. 16,2014
IIIq115' 1:1W
Municipality of Anchorage
On -Site Water and Wastewater Program
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcell.D. 051-281-95
1. GENERAL INFORMATION
Complete legal description MILLER VON HOLZMAN LOT 1
Expiration Date: 26 l
Location (site address) 16280 CARLISLE ST., EAGLE RIVER AK 99577
Current Property owner(s) MITCHELL & SHANNON MILLER Day phone
Mailing address
Real Estate Agent
16234 CARLISLE ST., EAGLE RIVER, AK 99577
Day phone
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 5
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well
®
Individual
Individual Water Storage
❑
Holding Tank
❑
Community Class _ Well
❑
Community
❑
Public Water System
❑
Public Sewer
❑
Waiver/Variance request for: Distance:
COSA Fee $ ��} ��/= �s</, Waiver Fee $
Date of Payment l(� y�l J� Date of Payment
Receipt Number 09 5(0
COSA#
Receipt Number
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.
Name of Firm ARCTERRA CONSULTING, INC. Phone 868-3791
Address 20441 PTARMIGAN BLVD., EAGLE RIVER, AK 99577
Engineer's Printed Name KENNETH M. DUFFUS Date 10/30/15
Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations. 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 inland- use, local soil characteristics, groundwater levels that may fluctuate
during the year and the water usage of the family being served by the system. 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 well and septic system. Therefore,
ArcTerra can not give any estimate of how long a
system will function satisfactory for current or future
occupants or can ArcTerra guarantee that no unseen G OF AL\ \
encroachments, deficiencies or discrepancies exist.
4gmlt
6. DSDSIGNATURE
system *1 Approv, for 1 bedrooms.
System #2 ApplB'bd for
Disapproved.
Conditional approval for
bedrooms.
bedrooms, with the
9 sKENNhEbFE5�510I
OH�I
rjillf
�
OF MCQ'',rr,
By: _� C_ Original Certificate Date: 111&11-5
The Municipality o Anchorage elopment 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 professionalengineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA b1w sheet 10-1d-12Am
yid �jER PND
By: _� C_ Original Certificate Date: 111&11-5
The Municipality o Anchorage elopment 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 professionalengineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA b1w sheet 10-1d-12Am
If more than 1 septic system is on the lot:
COSA Checklist # _of _
Structure served by this system
Certificate of On -Site Systems Approval Checklist
Legal Description: MILLER VON HOLZMAN LOT 1 Parcel ID: 051-281.95
A. WELL DATA
Well type PRVT If A, B, or C provide PWSID #
Date completed 1962 circa Sanitary seal (Y/N) Y
Total depth unknown ft. Cased to 40+ ft. (assumed)
Date of test
Static water level
Well production
FROM WELL LOG
ft.
WATER SAMPLE RESULTS:
Well Log (Y/N) N
Wires properly protected (Y/N) Y
Casing height (above ground) 24+ in.
AT INSPECTION
/O JOl/J4 a1,4
-ltlr 32 ft.
.-04M. S.! g.p.m.
Coliform NEG colonies/100 mL Nitrate 1.53 mg/L
Arsenic: ND ug/L Date of sample: 10123 8 10/27 2015 Collected by: ARCTERRA
B. SEPTICIHOLDING TANK DATA
Tank Type/Material SEPTIC / STEEL
Tank size 1500 gal, Number of Compartments 2
Foundation cleanout (Y/N) Y Depression over tank (Y/N) N
Date of pumping NA- NEW TANK Pumper
C. ABSORPTION FIELD DATA
Date installed 711612015
Cleanout's (Y/N) Y
High water alarm (Y/N) N
Date installed 7/1612015 Soil rating (g.p.d.W or fe/bdrm) 1.2 System type DEEP TRENCH
Length 53 ft. Width 3 ft. Gravel below pipe 6 ft.
Total depth 10.5 ft. Eff. absorption area 636 ft {Monitoring tube Y Depression over field N
Date of adequacy test NA- NEW FIELD 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 >=
Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date
D. LIFT STATION
Date installed
"Pump on" level at _ in.
Datum
Size in gallons
"Pump off" level at —in.
Cycles tested
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot 100'+
Absorption field on lot 100'+
Public sewer main 75'+
Sewer /septic service line 25'+
Animal containrrtenf areas 501+
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 54 Property line 51+
Manhole/Access (Y/N)
High water alarm level at
Meets alarm & circuit requirements?
On adjacent lots
On adjacent lots
Public sewer manhole/cleanout 1004
Holding tank
Manure/animal excrete storage areas 100'+
Absorption field 54
Water main 10'+ Water service line 101+ Surface water J004
Wells on adjacent lots 1001+
ABSORPTION FIELD ON LOT TO:
Property line 101+ Building foundation 104 Water main 104
Water Service line 101+ Surface water. 1001+ Driveway, parking/vehicle storage 104
Curtain drain 50'+ (NON€ KN0WNI Wells on adjacent lots 1004
F. COMMENTS
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 KENNETH M. DUFFUS
Date
COSA canary sheet_2-5-15.doc
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f tKSN
us t
p v 7,
"�Mt7S5I0'`iPti
in.
LEGEND:
MEASURED DATA 12.5'
RECORD DATA N 90'00`00" W
RECOVERED REDAR O
REGOVEP.ED ALUMINUM MONUMENT la
RALBELT SUBD., LOT 7C
w•
LOT 1
41797.877 Sq.Ft.
12� �9qq+E
NOTES,
5/PS v / /
/ N 24.2'K
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MUM VON HOLZMAN SUBD., LOT 2
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PROTECTIVE RADIUS '
L 30'
ASP�L� DR1V6
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116.954
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1. ALL BEARINGS, DISTANCES AND AREAS SHOWN ARE RECORD, UNLESS NOTED OTHERWISE,
2. THIS SURVEY IS PREPARED IN ACCORDANCE WITH THE ASPLS MORTGAGE SURVEY STANDARDS.,
EXCLUSION NOTE,
IT 15 THE RE5PON5151LITY OF THE OWNER TO DETERMINE THE EXI5TENGE OF ANY EA5EMENT5,
GOVENANT5, OR RE5TRIGTION5 WHICH DO NOT APPEAR ON THE RECORDED 5UDDIV15ION PLAT. UNDER
NO 6IRCUM5TANGE5 SHOULD ANY DATA HEREON DE U5ED FOR CONSTRUCTION OR FOR E5TA5L15HING
5OUNDARY OR FENCE LINE5.
AS -BUILT SURVEY CERTIFICATE
I HERESY CERTIFY THAT I, OR SOMEONE UNDER MY DIRECT 5UPERV1510N, HAVE PERFORMED AN
A5-DUILT 5URVEY ON THE FOLLOWING DE5GRIDED PROPERTY'
LOT 1, MILLER VON HOLZMAN SUBDIVISION
AND THAT NO ENCROACHMENTS EXIST EXCEPT AS INDICATED. RVASIONNr I
,v--- -,�4 ��" ' LOT 1, V�lld®
�� MILLER VON HOLZMAN SUBDIVISION
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2015-25
No.9106-5 •;'J�: REr mNo DaTrocT ANGHORA�7E NW 753 f - 40' MGN/TAN TLN
I�Fp •.. S +
�44To, F• "•... •++ PREPARED FOR: 5UMNER COMPANY
PO E50X 672992, WA5ILLA 99687 AS—BUILT SURVEY