HomeMy WebLinkAboutMATHIESON LT 3AMathi'seson
Lot 3A
#051-102-63
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: OSP161288
Tax Code Number: 05110263000
Work Type: Septic Upgrade
Permit Effective Dates: September 30, 2016 to September 30, 2017
Design Engineer: PANNONE ENGINEERING SERVICES
Subdivision: MATHIESON
Site Legal Address: MATHIESON LT 3A G:1359
Owner/Address: LEWIS DEBORAH L
6500 E 16TH AVE ANCHORAGE AK 995040000
Site Mailing Address: 20757 OBERG RD, Chugiak Lot Size in Sq Ft: 42427
Total Bedrooms: 3
This permit is for the construction of:
N 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.
Received
Issued By:
;�Py6
0//'4°! /201& {a Se L9 2 a i 6
MUNICIPALITY OF ANCHORAG
Community Development Department
Development Services Division QD
On -Site Water & Wastewater Program_
Phone: 907=343-7904
Fax: 907-343-7497
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 051-102-63
BUSH
Property owner(s) Deborah Lewis
Mailing address 6500 E. 16th Avenue, Anchorage, AK 99504
Day phone
Permit/Rush Fees: 344
Site address 20757 Oberg Road
.4
Date of Payment: `� j3 iso
Date of Payment:
Legal description (Sub'd., Block & Lot) Mathieson, Lot 3A
Receipt Number:
Legal description (Township, Range & Section)
Permit No. O5P14?1 b
Waiver No.
Lot Size 42,427 Sq. Ft. Number of Bedrooms 3
APPLICATION IS FOR: APPLICATION IS AN:
TYPE OF DWELLING:
(0 all that apply)
Absorption Field ❑ Initial ❑
Single Family (SF)
(w/wo ADU)
Septic Tank Q Upgrade nX
Duplex (D)
El
Holding Tank ElRenewal ❑
Multiple Dwellings
❑
Privy ❑
(SF and/or D)
Private Well ❑
Water Storage ❑
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
Dis tance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes,
property owner or authorized agent)
A —
Permit/Rush Fees: 344
Waiver Fees:
.4
Date of Payment: `� j3 iso
Date of Payment:
Receipt Number: O9a2gE
Receipt Number:
Permit No. O5P14?1 b
Waiver No.
Permit App_" >
Pannone Engineering Services uc
Steven R. Pannone, Principal
Registered Professional Engineer
E-mail: steve@oanengak.com
September 29, 2016
Subject: Mathieson, Lot 3A
Tank Replace Permit Request
Desigp Narrating
This is a design narrative for a permit to install an upgrade 1,OOOg septic tank to be issued for this
property. The existing 1,OOOg tank is collapsing. It will be decommissioned per code and replaced.
Currently the lot is developed. The proposed system will utilize a replacement 1,OOOg septic tank that will
be connected to the existing drain field. The existing tank was installed 97' from the well and a waiver
was issued (OSP131329). The new tank will be installed 100' from the well.
1. Upgrade Tank Design.
A double clean out will be installed after the tank, and a foundation clean out installed before
The tank will be located: 5'+ from any property line or building foundation
10'+ from any water line
100'+ from any surface water
100'+ from any private well
200'+ from any public wells
The proposed installation will not affect the future development of the surrounding or existing lots. There
are no surrounding wells within 100 feet of the proposed septic location.
If you have any questions or concerns, please contact me at 907.272.8218.
Sincerely,
Steven R. Pannone, P.E.
Owner/Civil Engineer
Mailing: P.O. Box 100217, Anchorage, AK 99510-0217
Physical: 332 East Manor, Anchorage, AK 99501
Telephone: (907) 272-8218 FAX: (907) 272-8211
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
' ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 2644720
ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME
u� A • Q
P NE
Eyy
UPGRADE
MAIONGAODRESS I
LEGAL ESCRIPTION
LOCyIIOrJ O / � �
L/ lN/Well
NO. OF BEDROOMS
U Y
DISTANCE TO: /
Absorptwor'a
Dwe mg yr
PEgp 1_1 N6
�
S 2
Manufacturet�' ' �,� C
d LLsIJb
Ma e;a1A
No. of bom artments
to
Lip, ca acity in gallons
IF HOMEMADE:
Inside length
Width I
Liquid depth
d Y
J02
DISTANCE T0:
Well
Dwelling
PERMIT NO.
S 2 H
Manufacturer
Material
Liquid capacity in gallons
O
W=
DISTANCE TO:
Well
��/
Foundation /
n
Nearest Iq� liA a
Off/-f-.'4�.�
PEHM
H 2 W
No. of line
Length %rip line
P o
Total len f fines
Trencl.Tth
J �C inches
Distance .en lines
H
O
Top of the to finish grade
Material beneath the !
inches
Totalphon area
W
V
Length
Width
Depth
PERMIT NO.
<t-
W�
Type of crib
Crib diameter
Crib depth
Total eflecbva absorption area
DISTANCE TO:
Well
Building foundation
Nearest lot line
J
J
Class
Depth
Driller
Distance to lot line
PERMIT NO.
W
DISTANCE TO:
Building foundation
Sewer line
Septic tank
Absorption area(s)
OTHER
PIPE MA RIALS
SOIL TEST RATING
INSTALLER /
,q'1'CS
REMARK
,5iA7V
'
7d) -
DATE LEGAL
K"
V;P43 (Rev. 3/)8) - /
r•11-1 r -a I r_: I P r _ I -r fl F= F=1 r-4 C= H 1_1 y I j E - 51-19
•.,_ DEPARTMENT OF HEALTH AND ENVIROWENTAL PROTECTION Ilii
• 125 'L' STREET. ANCHORAGE, AK. 93_01 9.zt)
264-4r72fl
11rJ— ITE Er-JEF PFEE F<:M I T
RER.t1IT rJO. C 790204 )#
-�.2i
APPLICANT MADELYNN PIATHLESON BOX 511 E. R. 68^ 235:
LOCATION GLENN/OBERG RD.
LEGAL L 3A MATHKISON SLB LOT SIZE 40030 SOURRE FEET
TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH
rtA}:IP1UM NUMBER OF BEDROOMS 3 SOIL EATING (SC! FT/BR)= 125
THE FEOUIPED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
C•CF='TH— 7.- LEr4 Ci -F"= 4 s:3F=:F-9%.- EL C•E PTH=
THE LENGTH DIMENSION IS THE LENGTH CIN FEET) OF THE TRENCH OP. DRAINFIELD.
THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE E}.CAVATION CIN FEET).
THERE IS 110 SET WIDTH FOP. TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE EXCAVATION CIN FEET).
*E EPT I C TFir-JK S~ I E-- 4_� � GF iLLC►I1�5
PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFOF,•r•1 THIS DEPARTMENT DURING THE
INS-TALLATION IN'=PECTIONS OF ANY WELLS ADJACENT TO THIS PP.OPERTY AND THE
NUt•1EER OF RESIDENCES THAT THE WELL WILL SERVE.
--- -y-WID t_ � 7 I rAS F=,EI:--T I Or -J=• HF?E F= 1_I I F='ELN ---
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETNEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR A PRIVATF•`LJELL: OF:
1_.0 TO 200 FEET FROM Ei PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
PEFs:r1 I Z' E: :P I F2E- C•EC Er•1E:EF= =71s 1' : '_-+
I CERTIFY THAT
1: I AM FAMILIAR WITH THE REQUIREMENTS FOP. ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IPJ ACCORDANCE WITH THE CODES
I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REtU1P.E ENLARGEMENT IF THE
RESIDENCE IS V-10DELED TO INCLUDE r10RE THAN 3 BEDROOMS.
S I GNED : '---------
APPL -; "JT MADELYNN MATHLESON
ISSUE .�. - -- - --- ----- - �------DATEv -lb�f7 --- V-
2
- 0 Ft
E GEOT�CHNI CAL Et DEVELOPMENT CO.
what -'depth d aril L. Oyster
n t_
•
dOX 90, Davis St., Eagle River, Alaska 99577
Installation: Seepages Pit
Drain'Field
694.2774 of 6M-2280
RusseAOyster --.
._..... _. - .•: ..... :.. EedElfis' .
634-2774
SOIL- LOG -- .-- ___.. _ emz?80
Soils Er Foundations
'Land Development
Performed for: Name: r;.:; I va 1iTel No.
6
Mailing Address: r' o. ivl ail =:1+1R Riv+ Ai,r:%�= 9v977
Legal Description: -1 Ve♦'4t95C^ .i+IlYil`ri9i nn
'�O
Depth (feet)
Soil Characteristics
1
silt t.c ,r] ;.it.77
a roots ara organics. „_ j 27
ft.�Er
by:
Date_: 6y"l 25.
3 ;'d -
Savri_v Gray._ .ath cobbles to 12 inches.
Clan a-.! _10.3e:" 1CG
sq. ft:%o%
6
t
7
8 �_:.; -
3riv�1]y :.irl, very clown ani wail grade -i.
at
9 r
4 p
,•
10
ll: -
15
!6
q
.. / ..'
}
x.
airyly C.:i el with acbbles to 12 inrhe...
'-all rrcunt. of- silts.
1iZ
Q At
iotLom of pit.
of
.......................
Ground Water Encountered: Yes No
tc If yes,
what -'depth d aril L. Oyster
Proposed
Installation: Seepages Pit
Drain'Field
rt�r,A�oPROFESS��y�.�'�"?
CC.^snents:
T1,' `
t K'foat'in �� a-a.a. +.:1 s;din '6f'taliN_ �
6
Performed
by:
Date_: 6y"l 25.
r-
a,J-
gwtJ
Municipality of Anchorage°
On -Site Water and Wastewater Program <
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 051-102-63 Expiration Date:
1. GENERAL INFORMATION
Complete legal description MATHIESON LOT 3A
Location (site address) 20757 OBERG ROAD, CHUG IAK, AK 99567
Current Property owner(s) RICHARD & NORMA MATHIESON Day phone
Mailing address 1914 LAKE SHORE BLVD., JACKSONVILLE, FL 32210
Real Estate Agent Day phone
2. TYPE OF DWELLING:
[)j Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 1
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
[]
Individual
[X]
Individual Water Storage
❑
Holding Tank
❑
Community Class Well
❑
Community
❑
Public Water System
❑
Public Sewer
❑
Received by: + Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ {�j0 Waiver Fee $
Date of Payment OtI o h a C Date of Payment
Receipt Number tSa 5 Receipt Number
COSH# C&C 1�1�i30 Waiver# iiSi�J1&91
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 AHC; I LHRH CONSULTING; INC
The operational life of all well and septic systems are subject to these various;
septic system. Therefore, ArcTerra can not give any estimate of how long a sl
guarantee that no unseen encroachments, deficiencies or discrepancies exist.
6. DSD SIGNATURE
__L System #1 Approved for. bedrooms
System #2 Approved for, bedrooms.
Disapproved.
Phone 868-3791
Date 9n✓12
hA regnlatioos. The asaaamentof thecandmouof the well and septic
' due tosubsurface comtitiow thA mavnnt hr i.l.m IA A.::.: 1-
Conditional approval for bedrooms, with the following
M,
13' Original Certificate Date: p —
Th Munid a"y n.horage 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 3e_ Other
COSA blue sheet 9-i-12.dee
Municipality of Anchorage
Development Services Department
Building Safety Division <
On -Site Water and 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: MATHIESON LOT 3A Parcel ID: 051-102-63
A. WELL DATA
Well type PRIVATE If A, B, or C provide PWSID #
Date completed unk Sanitary seal (YM) Y
Total depth unk ft. Cased to *40+ ft.
FROM WELL LOG
Date of test —
Static water level ft.
Well production
Well Log (YM) N
Wires properly protected (YIN) Y
Casing height (above ground) 18 in.
AT INSPECTION
8/29/12
155 ft.
WATER SAMPLE RESULTS:
Coliform NEG colonies/100mL Nitrate 1.57 mg/L
Arsenic: ND mg/I Date of sample: 8/31/12 Collected by: ArcTerra
B. SEPTICIHOLDING TANK DATA
Tank Type/Material Septic/Fiberglass Date installed 61979 Tank size 1000 gal.
Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (YM) *Y Depression over tank (Y/N) N
High water alarm (YM) N Date of pumping Pumper Jk
C. ABSORPTION. FIELD DATA
Date installed 616/79 Soil rating (g.p.d./ft2 or ftz/bdrm) 125 System type Deep Trench
Length 25 ft. Width 3 ft. Gravel below pipe 8 ft. Total depth 11.7 ft. (Measured 8/29112)
Eff. absorption area 375 fl? Monitoring tube Y
Date of adequacy test 8/29/12
Depression over field N
Results (Pass/Fail) Pass For 1 bedrooms
Fluid depth in absorption field before test 56.4 in. Water added 600 gal. New depth 87.6 in.
Elapsed Time: 1380 min. Final fluid depth 58.8 in. Absorption rate >= 150+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (YM & type) N If yes, give date --
D. LIFTSTATION
Date installed Size in gallons Manhole/Access (Y/N)
"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
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 96'+/- On adjacent lots 100'+
Absorption field on lot 100'+ On adjacent lots 100'+
Public sewer main 75'+ Public sewer manhole/cleanout 100'+
Sewer/septic service line 251+ Holding tank 1001+
Animal containment areas 5n'+ Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 51+ Property line 51+ Absorption field 51+
Water main 101+ Water service line 10'+ Surface water 100'+
Wells on adjacent lots loo'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 30'+ Water main
Water Service line 101+ Surface water 100'+ Driveway, parking/vehicle storage 101+
Curtain drain 50'+ (None Known) Wells on adjacent lots 1001+
F. 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 {fi
conformance with MOA COSA guidelines in effect on this date.
Engineer's Printed Name KENNETH M. DUEFUS ?1i
Date 9/7/12
COSA Fee $490.00 Waiver Fee $
Date of Payment Date of Payment
Receipt Number Receipt Number
(Rev. 11105)
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www. ci. anchorage. ak. us
(907)343-7904
Water Well Advisory
Certificate of On -Site Systems Approval (COSA) # 121430
During a recent COSA on-site inspection and test of the potable water
supply well on Block , Lot 3A of Mathieson subdivision, the well's
productivity was determined to be 0.83 gallons per minute. The minimum
well productivity required by this Department (AMC 15.55) for a 0.1 -
bedroom residence is 1 gallons per minute. Although the subject well
currently exceeds this minimum requirement, all parties concerned are
advised that the production capacity of the well may fluctuate. Restriction
of non-critical water uses such as washing cars and watering lawns and
gardens may be required.
This advisory must be attached to all copies of the subject Certificate of On -
Site Systems Approval.
—x
OBERG
} WELL
0
U
Q
N�53, 00
9-7•2g (r) 97
ROADD-�+
JEHOVAHIREH STREET
I
ANCHORAGE RECORDING DISTRICT, ALASKA
AS -BUILT OF:
MATHIESON SUBDIVISION
LOT 3A PLAT 78-50
SURVEY CERTIFICATE: I, John L. Schuller, Have conducted a
physical survey of this property as shown on this drawing and that the
improvements situated hereon are within the property lines and no
enchroachments exist other than noted. Under no circumstance should
any information on this drawing be used for construction of fences,
structures, improvements, or for establishing boundary lines.
EXCLUSION NOTES: It is the owners responsibility to determine
the existence of any easements, covenants, or restrictions which
do not appear on the recorded subdivision plat.
12-022
16. 2012
JLS I NW1359 I 1201
R -50l
,2hnb 09 � lR
�S � g
(H) = HELD
(C) = CALCULATED
(M) =MEASURED
OO = FND RED.AR
= END ALUMINUM MONUMENT
���� OF......
.4 'S01
49TH
......... .. ..
OHN L. �.N
�SCHULLERr o : LS -10408
z
\- fessiono\
o PDL NDRp�.f'
Tn �
1831 Talkeetna Street
Anchorage, Alaska 99508
(907) 227-1455 office
(907) 274-4992 fax
N00°0215311E 139.47'(M)
N00°00'00"E 140.00'(R)
10' UTILITY EASEMENT
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ROADD-�+
JEHOVAHIREH STREET
I
ANCHORAGE RECORDING DISTRICT, ALASKA
AS -BUILT OF:
MATHIESON SUBDIVISION
LOT 3A PLAT 78-50
SURVEY CERTIFICATE: I, John L. Schuller, Have conducted a
physical survey of this property as shown on this drawing and that the
improvements situated hereon are within the property lines and no
enchroachments exist other than noted. Under no circumstance should
any information on this drawing be used for construction of fences,
structures, improvements, or for establishing boundary lines.
EXCLUSION NOTES: It is the owners responsibility to determine
the existence of any easements, covenants, or restrictions which
do not appear on the recorded subdivision plat.
12-022
16. 2012
JLS I NW1359 I 1201
R -50l
,2hnb 09 � lR
�S � g
(H) = HELD
(C) = CALCULATED
(M) =MEASURED
OO = FND RED.AR
= END ALUMINUM MONUMENT
���� OF......
.4 'S01
49TH
......... .. ..
OHN L. �.N
�SCHULLERr o : LS -10408
z
\- fessiono\
o PDL NDRp�.f'
Tn �
1831 Talkeetna Street
Anchorage, Alaska 99508
(907) 227-1455 office
(907) 274-4992 fax
ARCTIC PUMP & WELL INC.
Jun Sullivan
_ PO Box 770197
nm wn srsi ) Eagle River, AK 99577
sons a e'iarKi (907) 688-2510
(907) 258-2510
(907) 745-2510
atw-7i:eci llo
Pump Installation Log
Well Drilling Permit Number: SW
Parcel Identification Number:
Date of Issue:
Arctic Pump & Well, Inc.
Page 1 of I
Legal Description:Mathieson
Lot:3A
Property Owner Name & Address:
Richard Mathieson
Block:
20757 Oberg Rd
�'hn oiak AK 90577
Pump Installation Date: 09-15-12
Pump Intake Depth Below Top of Well Casing: Feet
Pump Manufacturer's Name: Dempster
Pump Model:
Pump Size: hp
Pitless Adapter Burial Depth: feet
Pitless Adapter Manufacturer's Name:
Pitless Adapter Installer: U/K
Well Disinfected Upon Completion? Yes
Method of Disinfection: Chlorine
Comments: Casing 40'+ with no perforations
Pump Installer Name:
Arctic Pump & Well, Inc,
Arctic Pump & Well, Inc.
Page 1 of I
c>+oRgG
ANCHORAGE WELL & PUMP SERVICE, INC.
330 E. 76TH AVENUE
��---
ANCHORAGE, ALASKA 99518
PHONE (907) 243-0740
FAX (907) 243-0742
FEDERAL I.D. 92-0153194
No
GREAT LANG REALITY -KATHY GEP,ACI
11411 OLD GLENN HVOY
EAGLE RIVER, AK 99577
invoice* 20121554
Awp Via:
GREAT LAND REALITY
NANCY STAHLY
20757 CIBERG RD
PETERS CREEK
Irfvoicz
�RCTERRR re
s`o ARC 1m
lrHRAa Y €
? CONSULTING, INC
z 212 E. 51" Ave, Anchorage, AK. 99503
m,�� Office (907) 868-3791, Fax (907) 868-3793
September 7, 2012
Jeff Poet, On -Site Engineering Technician
Municipality of Anchorage
Development Services Department
On -Site Water & Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
RE: MATHIESON LOT 3A – WELL - SEPTIC TANK WAIVER
Dear Jeff,
Per your request, we are submitting a waiver request for the separation distance between
the septic tank to the well located on the referenced lot. Per the John Schuller, LS as -
built survey dated August 16, 2012—the septic tank first compartment cleanout was
measured at 97'+/- to the subject property's well. Additionally, the 1979 Municipality of
Anchorage (MOA) inspection report record documents show that the MOA approved the
lesser separation distance.
This well is located up gradient from the septic field. The well and septic are located on
opposite sides of the house and have been in operation for over 30 years. Water quality
results are acceptable. We are therefore requesting that a waiver to 95' feet between the
referenced well and septic tank be granted at this time.
We respectfully request that the waiver and the Certificate of On -Site Systems Approval
be granted. If you have any questions or require additional information, please contact
me at 868-3791 / FAX 868-3793.
Respectfully,
Arc Terra Consulting, Inc.
Il/
Kenneth M. Duffus, P.E.
Municipality of Anchorage
P.O. Box 196650 • 4700 Elmore Road
Anchorage, Alaska 99519-6650 • (907)343-7904 • Fax (907) 343-7997
http://Www.muni.org/Onsite
Development Services Division
On -Site Water and Wastewater Program
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**** VARIANCE/WAIVER REVIEW ****
Waiver#: OSP121329
PID#:051-102-63
COSA#:OSC121430 Permit#:
Legal Description: Mathieson, Lot 3A
Engineer: ArcTerra
Applicant: Richard & Norma Mathieson
Your request for a waiver of the required 100 feet horizontal separation from the septic tank to
the private well has been approved. The approved separation distance is 95.0 feet.
This waiver approval applies to the existing septic tank only. Any future upgrade to the on-site
wastewater disposal system will require all separation distances be met or another approval from
this department.
❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this
waiver.
❑ Notarized letter(s) of non -objection have been received from the owner(s) of the affected
adjacent property.
® Adjacent properties are not affected by this waiver.
.................................................................... 0..........
Waiver is Granted: X Waiver is not Granted:
Date: CIL5 / aZ Approved by:
Name of Reviewer
..................... ................
.........................................
Rec#: N/A Amount: Waived Date Paid: N/A
**** VARIANCE/WAIVER REVIEW ****