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HomeMy WebLinkAboutMOUNTAIN VALE LT 2AMountain Vale Lot 2A #020-581-07 Municipality of Anchorage \\O Development Services Department Building Safety DMsion •. On -Site Water and Wastewater Program, 4700 Bragaw SL P.O. Box 106650 Anchorage. AK 99519MSO Page I of 3 www.d.andwrage.ak.us (907) 3417904 ON-SITE WASTEWATER DISPOSAL SYSTEM ANDIOR WELL INSPECTION REPORT Permit Number. SW070196 PID Number. 020-581-07 M.n. Lisa Ragland & Lee Goodman Wastewater System: ❑ New © Upgrade .. 17100 Kings Way ABSORPTION FIELD Barr P n ar araomM 3 DDWTRnm CIS r 7100N 139.d Dmo 130~ LEGAL DESCRIPTION SW RMnp T" Dom ft n ofww wp GF4Fl Fl. fl ` La 2A sip Aw Mountain Vale D*MWP aooenntiomaprV. ., Cr. os ms."" Me TowWvp Rmpr S� IFa addW �Eow onpMi psa. Well: ❑ New Cl Upgrade I Cm. I M d. l awo e.nW. Ft. R r C� IPma.. A S. CM TM DOM Cnsd b 7" 06011 on ria PM` M+ I p. R Fr X<,rm 1/��3N SEPARATION DISTANCES LIFT STATION To Fmm Sepbc Tank Absorption Field Lift Station Hokbni Tank W*4 N/A N/A N/A 83' amwwa N/A WA N/A 140'+ La Lt"' N/A N/A N/A 56' FO1^di°°" N/A WA N/A 18' cu1.n D. I N/A N/A N/A N/A R.n.kt Old septic system abandoned in olace. per i F, A+ Home Services 1 8/31/07 Ft TANK ❑ Septic 0 Hoktbq ❑ S.T.E.P. ubWPrN4t* 'w Sew Lk, Anchorage Tank MM 85' Steel Inspections performed by: Cindy Ellis Dates: 181 8/31/07 2nd 9/4/07 Development Services Department Approval Conditional Approval Date: Reviewed and approved by: rn.. owat Date: 21 9 ❑ Other. wPL� i 4000 GM rwnie. a canvw 1 100.00 n Engineees Stamp F 49TH Criicly W. Ellis +_ CE -10577 _ . LIFT STATION GM on r.« r h 'Pump air L.w K h Aw t Mad. EYa,ral Y+prtsaa pM1.nMd a BENCH MARK n. Dwrngm of well cap Inspections performed by: Cindy Ellis Dates: 181 8/31/07 2nd 9/4/07 Development Services Department Approval Conditional Approval Date: Reviewed and approved by: rn.. owat Date: 21 9 ❑ Other. wPL� i 4000 GM rwnie. a canvw 1 100.00 n Engineees Stamp F 49TH Criicly W. Ellis +_ CE -10577 _ . \ 10' TELE. ELEC. & Util EShrr. _--�------ 2DR (louse \ C \ CO \ Septic tank 8 \ Drainfield �HT1 Abandoned \ I \ in place \ HT21 T7 \ I I I I I I l I bb j i DC01 COYShea n � _ I \ AS—BUILT Mountain Vale Lot 2A A B C DC01 19.0 19.0 42.8 DCO2 20.5 18.8 44.1 HT1 21.0 20.0 44.4 HT2 28.2 26.0 47.9 HT3 35.0 32.0 52.3 DC01 COYShea n � _ I \ AS—BUILT Mountain Vale Lot 2A Record Drawing of Septic Upgrade Lisa Ragland g Parcel ID Noy 020.581-07 Permit Na SW070196 Watkins Engineering Inc. ' �o�000 QF..A.. �� �q�°o� o �? � 0 .................. r.Pp CNDY .... ..� 00: '•. CINDY 10577 �s o$ � , ..� oe................... ; Cindy W. Ellis, P.E. P.O. Box 110443 Sale 1 March 0, 20030 ft Anchorage, Alaska 99511-0443 Phone: (907) 349-1851, Fax (907) 349-1934 FINAL GRADE FCO\DC01 DCO2 HT1 84.78 HT2 HT3 80.66 80.07 4000 GALLON HOLDING TANK N.T.S. AS -BUILT Mountain Vale Lot 2A �QF.A �4 Record Drawing of Septic Upgrade ooQC� �F'A Lisa Ragland o���' .•9 U� Watkins Engineering, Inc. oC • 49 TH o Parcel ID: 020-581-07 0 ` D Permit No. S V070196 0.9. Q��� •, CIN Wo SIS j OD Cindy W. Ellis, REP.O. Box 110443 0[)a, March 3, 2008ne (907) 349-1851, Fe� Alaska 99511-0443 a (907) 349-1934 G���0000..... d Not To Scale MUNICIPALITY OF ANCHORAGE Development Services Department Onsite Water 8 Wastewater Program 4700 South Bragaw Street '%1 P.O. Box 196650, Anchorage, AK 99519-6650 C (907) 343-7904 p lip ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SW070196 Legal Description: MOUNTAIN VALE LOT 2A Design Engineer: 0844 WATKINS ENGINEERING Owner Name: LISA RAGLAND Owner Address: PO BOX 112931 ANCHORAGE. AK 99511 - Date Issued: Aug 08, 2007 Expiration Date: Aug 07, 2008 Parcel ID: 020-581-07 Site Address: 17100 KINGS WAY Lot Size: 56944 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: ❑ Disposal Field ❑ Septic Tank Q Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specked 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: Date: G/(/ /C9 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 www.muni.org/onsite (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 020-581-07 Property owner(s) Jacquie Whitmore Day phone Mailing address PO Box 111858, Anchorage Zip Code 99511 Site address 17100 Kings Way, Anchorage Zip Code 99516 Legal description (Sub'd., Block & Lot) Mountain Vale Lot 2A Legal description (Township, Range & Section) Lot Size 56,944 Sq. Ft. THIS APPLICATION IS FOR IS all that apply): Absorption Field ❑ Septic Tank ❑ Holding Tank El Privy ❑ Private Well ❑ Water Storage ❑ Number of Bedrooms 3 THIS APPLICATION IS AN: Initial ❑ Upgrade Q Renewal ❑ 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. P. E (Signature of property ownO or authorized agent) PermMush Fees: Waiver Fees: Date of Payment: W31 /01, Date of Payment: Receipt Number. &3989 Receipt Number. (Rev. 11105) Watkins Engineering, Inc. RO Box 110443, Anchorage, AK 99511 (907)349-1851 cwellis®gci.net July 31, 2006 Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 RE: Mountain Vale Lot 2A Septic System Upgrade: Holding Tank To Whom It May Concern: Attached please find the application and supporting documentation to install a 4000 gallon holding tank for the referenced 3 bedroom house. The existing septic system has failed and there is no suitable location for a soil absorption system on the lot. The initial septic system was installed in 1984, consisting of a 1000 gallon steel septic tank and a 45 ft x 26 ft bed drainfield with 1 ft effective depth. On April 27, 2006, we measured 29 inches of water in the monitoring tubes, indicating that the drainfield is surcharged. It is proposed to abandon the existing septic system in place. Rabbit Creek runs through the western side of the property, and the 100 ft setback restricts the area available for a soil absorption system. On June 5, 2006, we dug 3 test holes to attempt to find a suitable site for a replacement drainfield. The locations are noted on the attached site plan, and the soil logs are attached. The first test hole encountered a layer of brown silt between the organics and the blue clay. However, this layer was not continuous across the width of the test hole; it only occurred on the north side. At the north side of the property, the slope to the west is greater than 30%. Due to the limited area available, the discontinuous nature of the soil, and the steep slope, this area is considered not appropriate for a soil absorption system. Test hole #2 encountered peat and blue clay with a 0.5 ft lense of silty gravel, with water in the organics. Test hole #3 had a lense of brown silt above the blue clay, but the water was at 3.5 ft. Neither of these test holes is considered appropriate, and no other site was identified for a soil absorption system. Therefore, a holding tank is proposed. Watkins Engineering, Inc.; July 31, 2006; Penult Application for Mountain Vale Lot 2A; page 2 am not aware of any adverse effect that this upgrade would have on any adjacent properties' water and wastewater treatment needs. Thank you for consideration of this permit application. If you have any questions or need further information, please call me at 349-1851. Yours truly, 49f2i /U& Cindy Z Ellis, P.E. President Cinerama Terrace Blk 2 Lot 16 \ Cincrama Terrace \ Blk 2 Lot 17 a2 swk..eii 89.39'lrW 38 \ JTI�10 /\ m—vvm� y Mountain Vale, Lot 1A 1 ! 1\ Mountain Terrace Estates #1 Blk 1 Lot 4 Mountain Terrace Estates 111 Blk 1 Lot 5 -------- Pane Road— ----� ---- ---------- _ Mountain Vale Lot 2A o pFq �4p Proposed Septic Upgrade - Site Plan ooP� """"' •.gS,ppp Jacquie Whitmore Watkins Engineering, Inc o��,� TH Parcel ID: 020-581-07 p a • 4.. — p....:............�...�._�...':.:'. •• C DY W. ELLIS Cindy W. Ellis, P.E. P.O. Box 110443 00 CE - 10577 July 25, 2006 Anchorage, Alaska 99511-0443 .••...•...•• Scale 1 Inch -100 ft Phone: (907) 349-1851, Fax (907) 349-1934 pppo� 00 \ Taken from Shane Holt survey, LS -6914; dated May 26, 2006 slope 30%+ \ �d 4000 gallon tank, anchored, X I— 2BR 11mw Curtain Drains Exact location ,!Tknown O \ TIINi / 10' TELE. ELEC. & Util ESMT. — "��/ Sh \ Existing y300 ga n > o \ steel septic tank - t aba oned in place. _Existing drainfield - to be .amu abandoned in place. 1 A 40� Mountain Vale Lot 2A Proposed Septic Upgrade - Site Plan Watkins Engineering, Inc. Jacquie Whitmore Parcel ID No-- 020-581-07 Cindy W. Ellis, RE July 25, 2006 Scale 1 inch = 30 ft 4 IN 7 , Wit; :"'. 49 4 Q '~rRCIN W. ELUS P.O. Box 110443 OQ•; ., ,osn Anchorage, Alaska 99511-0443 COQ.,''•••... ...... Phone: (907) 349-1851, Fax: (907) 349-1934 4��op0000�� Municipality of Anchorage Development Services Department Building Safety Division yr On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Boz 196650 Anchorage, AK 99519-650 www.cl enchoreae ek us (907) 3437904 Soils Log - Percolation Test Performed For. Legal Description: 1 Depth Jacquie Whitmore Date Performed: June 5. 2006 Mountain Vale Lot 2A Township, Range, Section: I Slope Site Plan 1 r trees) Or9AniCS 2- 3-1 - 1.5 3 ML. brown 1 u WAS GROUND NATER YES 9 O ENCOUNTERED? a IF YES. ATWIAT DEPTH? 7.0 L D Depth to Water Amer P abnmomng? 6.4 E Date: 6-17-06 PERCOLATION RATE (nw ft&ticn) PERO HOLE DIAMETER TESTRUNBETWEEN FT AND FT COMMENTS No percolation test. South side of test hole did not have brown ML - just peat and blue clay. PERFORMEDBY: CindyW.Ellis I uluu 'vZW2 CERTIFY THAT THISST/yyy�yyyAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDE ES IN EFFECT ON THIS DATE. DATE: ' r'� 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 99519-6850 www.ci anchorene 0 us (907) 3437904 Soils Log - Percolation Test Performed For. Jacquie Whitmore Date Performed: June 5, 2006 Legal Description: Mountain Vale Lot 2A Township, Range, Section: Slope Site Plan Depth pry tliGs - /, o 2' mL $roWr1 3 3.5 Sha mL� Gt117 - 9- 10- WAS GROUND WATER ENCOUNTERED? YES e 9 S IF YES, AT KHAT DEPTH? 3.5 L o OOH Depth to Water After P 11- Monnodng? 3.6 E 12- Date: 6-12-06 1 1 1 COMMENTS No percolation test. PERCOLATION RATE (mm"Oxh) PERO HOLE DIAMETER TEST RUN BETWEEN FT AND FT PERFORMED BY: Cindy W. Ellis I J PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL r rfW CERTIFY THAT THIS TEST WAS IN EFFECT ON THIS DATE. DATE: &-17.6(0 Performed For. Legal Description: Depth Municipality of Anchorage ��P(ENGINEER' Std Development Services Department; 49TH BuildingSafety Division Onsite Watererand Wastewater Program iA ^•-- 4700 South Bragaw SL , P.O. Box 196650 Anchorage, AK 99519-WSO cis CI d W. www.cl anchorage sk us C :, y Ellis (907)3437904 CE-tosn Soils Log - Percolation Test ss;xintc Jacquie Whitmore Date Performed: June 5, 2006 Mountain Vale Lot 2A Township, Range, Section: Slope Site Plan TH 1.1 I Organics ML 10- 11- 12- 13- 14- 15- 16- 17 - 3 sntL/!aP 61 tic'61" 5.0 COMMENTS No percolation test. WAS GROUND WATER YES ENCOUNTERED? 6 IF YES, ATwiAT DEPTH? 3.0 L 0p Depth to water Aft" Monhodng? 0.8 E Date: 6-12-06 PERCOLATION RATE (mina..M1cn) PERC HOLE DIAMETER TESTRUNBETINEEN FT AND FT PERFORMED BY: Cindy W. Ellis I V .2 CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDEL ES IN EFFECT ON THIS DATE. DATE: -&-17-06 MUNICIPALITY OF ANCHORAGE ® DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264.4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME FTHONE ❑ NEW Xl XXXRYaX-X Joe Longly - Applicant 277-6682 X]UPGRADE MAILINGADDRESS V PO :Sox 4-1909 Anchorage Alaska 99509 LEGAL DESCRIPTION Lot 2A tett. Vale Subd.; Sec 1 T11 N R31;1 LOCATION Clark Rd. & Paine Rd. NO. OF BEDROOMS Two a;<- U DISTANCE TO: Well 100+ ft. Absorption area 21 ft. Dwelling 10 ft. PERMIT NO, e P' _Y I- Z W< Manufacturer Greer Material Steel No. of compartments Two, rn Liq. ca gallons gallons fill fill IF HOMEMADE: Inside length _------ Width _ Liquid depth D Y DISTANCE TO: Well Dwelling — PERMIT NO. = z H Manufacturer ---------------- Material ------ Liquid capacity in gallons -----------. a w T DISTANCE TO: Well 1 00.6 Foundation 31 Nearest lot line _l• PERMIT N - .-� 1,C'� "' J w z No. of lines Length of each line 09 Total length of lines Taomr. width Distance between lines ti z w 5 18 2 6 f t inches ¢ Imo. Top of tile to finish grade 3-l• f -t. Material beneath tile Total effective absorption area 0 1 ft. ,ravel 1 ft.sanrdhes 1140 - Length Width Depth PERMIT NO. � _____--- ------ ---------- ---- ----------- Q l- -Type 0.— of crib - - - - - - - Crib diameter -------- Crib depth -------- Total effective absorption area ------ N DISTANCE TO: Well ^--_---__ Building foundation -------- Nearest lot line ----------,-,----,. -- J ClasJ)rlV'ate Depth 63 ft. Drille Voss Distanyoo lot line PERMIT N0, 800660 LLI DISTANCE TO: Buildingf pdanon o'�U -{• Sewer_�i I\��1� Septic apVVIS, cmb+ AbsorptioA ea(s) 1 OTHER PIPE MATERIALS 3034 /1 O SOIL TEST RATING 250 SIS'/BDRM 6/1 1 /84 INSTALLER Owners resident, Joe Longley REMARKS Owner wishes to a.dd one bedroom. rz e "C_ .rr I n l 14P 1 Aw 7-2 N*' e roaaea waaaa.e.e d C-'• T+n D. Bartur .wf k .., , 't.- v CE aWON aq•a.atoo �O aJ�/h M A0�'ES814. '� NOH.2-3lgz I'1LNa� �r)JiAN3 -10 r <Ioi mN aLDV'l(H_)V ;o ,U APPROVED DATE LEGAL I& 0`� /2-Uls (Hev. J/ /8) 1 c_V) DEPARTMENT OF HEALTH AND ENVIRONMENTAL. OMENTAL_ PROTECTION 825 L STREET. . ANCHORAGE: AK 99501 21'54-4720 ID IF -4 -- ° = I —F El = F—E a. •a iE FR LF=° F_= F,? t-1 17 PERMIT 1-40: 8-40507 UPGRADE AN AREA DATE ISSUED: 05,/26/84 INSPECTION MUST BE OBTAINED. (._') AS—BUILT=; APDL I CANT : ,.TGE LONGLY INSPECTION REPORT; AND '3) THE ELECTRICAL 4'�Li IRK 4' UST ADDRESS: 941 E. DI=WLING RE:': #101 ANCHORAGE: Ab'•. _ 950': CONTACT PHONE: —7:45-5826. LEGAL DESC:RIP: SUBDIVISION: MOUNTAIN MALE LOT: 2A SECTION: .1_ TOWNSHIP: 1:11.1 RANGE: 314 LOT SIZE: 569,44 .'.SQ. FT. OR ACRES) ) BLOCK: Ne -'A CERTIFY THAT: 1. I AM FAMILIAR WITH THE REQUIREMENTS FOR ON—SITE SEWERS AND WEL.L_S AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE (NOA) AND THE STATE OF ALASKA. u., i k[ILL INSTALL THE SYSTEM IN ACCORDANCE WITH ALL NOA CODES AND REGULATIONS: AND IN COMPLIANCE WITH THE DESIGN CRITERIA OF THIS PERMIT.' _.. .I WILL. ADHERE 'TCI ALL_ MOA AND STATE OF ALASKA REQUIREMENTS FOR THE SET BACK E:, I STAhICES FROM ANY EXISTING WELL: WASTEWATER DISPOSAL SYSTEM OR PUBLIC SEWERAGE SYSTEM ON THIS OF! ANY ADJACENT OF: NEARBY LOT. IF A LIFT STATION I:;:. INS.-TALLEE> IN AN AREA COVERED BY r'ICIA BUILDING CODES: THEN :::1.? AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED. (._') AS—BUILT=; WILL NOT BE APPROVES:' WITHOUT AN ELECTRICAL INSPECTION REPORT; AND '3) THE ELECTRICAL 4'�Li IRK 4' UST BE DONE E:Y ` L. i � ' Pd -,ECS ELECTRICIAN. S I GNEDDATE : --- __ --_ APPLICANT: _OE ONGL'r' ISSUED BY DATE: : _ �/ o2 --Ay x SOILS LOG MUNICIPALITY OF ANCHORAGE • +.e`> DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 2644720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: TO I�lAnq ly n DA/TE PERFORMED: CCS LEGAL DESCRIPTION: �� I L/—I I I f(/�.IJyL'Lo, t4— 6//. V Jf- `�,�,I.EJd((Jjs erx— I gPTN11 SLOPE SITE PLAN �. I„ 8" J-w�� 2- 3-- 3 — 4 / 5 6 7 n' 9 / 10 12 13 41516 14-- 15- 16 17 18 19- 20 COMMENTS gym— 5ro Ue-1, �� � + 7 � `x.71 .(��, �� •�- Tony D. BurPor CF 5130 c �A,o�j•ip��4"\�',� k�O11�DUENRDDWATER IF YES, AT WHAT DEPTH? ■ /y-0 L 0 P E Reading Date Gross Time Net 'Fime Depth to Water Net Drop (�,, 90 —II 1za��c� Asn PERCOLATION RATE �� (minutes/inch) TEST RUN BETWEEN FT AND L FT 4k PERFORMED BY: CERTIFIEDBY: DATE: 72-008 (6/79) r3, S9 C LXX r3, S9 C r3, S9 u =MellD 0 S0°24`jT'E1-297.18'(AA�11I�� �—SOUT297.01' IR 10 i A I33' 11 148. i - -- 148.50'-- SOUTH �Z X 0 / 00 co g o �I 144o' o M U o / Jry r -n � �� 0 n Oo 0 0 W ,o 146x' A; 3 (ID NN .� n mmm wZ U N co N_ m 0 o G v W A �N W --4 �. V D ' N 00 --. 0 1480' Z O {Z� =-ir A m -nLn - g� m w w °° °° n O V m O V G A3 A0 C< ,no C n -- 148.50'-- SOUTH �Z X 0 / 00 co g o �I 144o' W 0 M U O NO\ r -n � �� 0 n Oo 0 0 W ,o 146x' A; 3 (ID n mmm wZ O _ _ 11 mi V) N { m m M AZ T mn 4° m W W O\ ZZA rn co OD m --. 0 1480' Z mnnmQ> =-ir A m - g� I I Zm I10'UTILITVEASEMENT i-- 148.51'--i -V� 297. 01' Clark w "-woad W 0 M m W NO\ 6-4 -n cc 1O O A; Mm m (ID n M wZ 00 S 2A -n D_ m / 1 ZW 1 O V1 o 1 -11 rM DD �o 0,2 C� O� N NO V 0 Im N zz 0• n A M 4 m M v rn 0 m A m Z D� f1�d0 aaa ° w ° z 10 0 N co M m � -n m op m Mm m n M m, 00 S p -n D_ M DGCnm 0 m --. M° Z mnnmQ> (0 Zm -V� -i z00"c`^ G G Di A0 C< ,no C Z W=-I-<�-- m -n m D Z Z M m n p m D x M M m n z Z w r- D (A p Z D� rn N O 2 Z w D •, \� Z Z D m C �+ D D m n D D O< m m m n 0 f1�d0 aaa ° w ° z 10 0 N co 7 ^ ' G -W - (i-FN'.:.«�'_s/)'r!;.Slr.l. I; t� c", 1r> f r,;o, c .6 J r C. ]tt i+ 7.o �)oc 4z' C�r�„ / l-Inro! Pn.l CI<i,]. /!]Jf, i h /:..' 7nnv f C.F. 51 'O ' 6 ?„J MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HF,AUrH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH 10THORITY APPROVAL CERTIFICATE 1. General Information Application Date 9/29/8/11_ (a) Legal Description (include lot, block, subdivision, section, township, range) Tot 2l?, 1,1U. Vale Su.l:�d_. f'1 '1 Fr I'R ';j 3',r 1 Location (address or: directions) In.tcrloectio 1 of Clark Rd.. ex Paine Rd. (b) Applicants Nana _Porman. Grant felephoy)o 277-6682 Applicants Address P. 0. i3ox ;• 4.--1909Anchorage Al.. 99509 (c.) Applicant is (check one) Lending Institution Owner/builder XX. Buyer ; Other (explain) ; (d) Lending Institution'':/1�a— Address (e) ictal Estate Co. & Agent Address Telephone 2. Tvpp,- of lesidence Single -Family Number of. Bedrooms 3. Water Su 1 Multi. --Family Other (describe) 1.01,11o•- .rztc:nt to vd.d on.e a.ddi Li_onal µiystem designed for Hir.ee bodroorfir,. Individual Woll [TTI Community F-1 Public Notes If crxmunity wall system, must have written confirmation from the State EX-,partment, of Environmental Conservation attesting to the legality and stratus. Is the well adequate for the number of tedrooms specified in this HAA (,YM) yw___m_ 4. Sevra e Dis oral Onsite rXX: Public Cornrnunity _ry Holding Tank 1 Is the wastewater disposal. system adequate for the number of badr=ri (Y/N) [Page 1 of 21 2--1.5•-84: 5. Enuineerirg Firm Providing 'Cn �ix�civians, lbsts, Data and Information I certify that I have checked, verified, or conformed to all MA HAA Guidelines in effect: on the date of tl}is inspection. Signed Da to �2 #1, / Name of Firm Mrter and A.r:,;ocj,ate s 11blo hone 563 716 11 5331 Tudor Top C .r. ele Address _ 1_ _ _ Signed key.4.. Date 9/29/8 (ENGINEER SEAL) 6. DRUP Approval Approved forl;, badrocw--; Apps, ovec�/ Disappr*o�d <- Terfris of Conditional Approval. — BY Conditional 1411..v •ep&9i� .etl. ctibn6 jj EE 'i en>s wti: i,, o`lublu�o u��oli Tony 1). Nirkr CL•bNO The Municipality of. Anchorage Department of Health and Envi.r-cnrmntal. Protection da -,s not guarantee tlx; continued satisfactory perf:oinTunc e of tiro water supply and/or the wastewater: disposal system. This approval indicates that, as of_ the validation date shown alxo\x-, based on the clata and information furnished by an engin-3er registered in the State of. Alaska, the vrater supply and wast:ewator disposa.1 system is, safe and fun(-•° t ional for the numbor of bedroo. wn and type of structure indicated. (DHEP SPAT.) 7. Mail the HAA to the following address: iio rn<)n (;ra.n. KB2/d5/s (Page 2 of 21 1...15•-84 MUNICIPALITY OF ANCHORAGE (MOA) 0 1 A 1 I. -Y-14 HEALTH AUTHORITY APPROVAL (HAA) Mi CHECKLIST - FEBRUARY 1984 NOI1J31Odd 1V1NT/iNOMAN3 Legal Description: )8 WAVII-1 d0 'ICCI A. WELL DATA Lot 2A, Mountain-Val���!"AMI'vt1t)IMIN Well Classification Private If A, B, or C. D.E.C. Approved(Y/N) y Well Log Present (Y/N) Y Date Completed 6/25/80 Yield 20GpM Total Depth 63 ft. Cased to 63 ft. Static Water Level 19 ft. Punp Set At Depth of Grouting na 62 ft. Casing Height Above Ground 5 ft. Sanitary Seal on Casing (Y/N) Y Electrical Wiring in Conduit (Y/N) Y Depression Around Wellhead (YM) N Separation Distances from'Kbll: To Septic/Holding Tank on Lot 100+ ft. On Adjoining Lots 100- ft. To Nearest Edge of Absorption Field on Lot 100+ f tp On Adjoining Lots 100-I- ft. To Nearest Public Sewer Line N/A. To Nearest Public Sewer Cleanout/Manhole N/A To Nearest Sewer Service Line on Lot N/A Water Sample Collected By T. Barter Date 9/26/84 Water Sample Test Results Satisfactory Comments B. SEPTIC/HOLDING TANK DATA Date Installed 9/25/84 Size 1000 gal No. of Compartments Two (2) Standpipes (Y/N) Y Air -tight Caps (Y/N) Y Foundation Cleanout (Y/N) Y Depression over Tank (Y/N) Jv Date Last Pumped Upgrade - new tank Pumping/Maintenance Contract on File (Y/N) T?/A ; for N/A Holding Tank High -Water Alarm (Y/N) N/A Temporary Holding Tank Permit (Y/N) Y Separation Distances from Septic/Holding Tank: To Water -Supply Wall 100+ ft. To Building Foundation 10 ft. To Property Line 10.1• ft. To Disposal Field 21 ft. To Water Main/Service Line N/A To Stream, Pond, Lake, or Major Drainage Course 100 +f t . Comments [Page 1 of 21 2-15-84 g C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 250 ST/BDRP4 Type of System Design Engr, Bed Date Installed 9/25/84 Length of Field 45 ft. Width of Field 26 ft. Depth of Field 2 ft. Gravel Bed Thickness 1 ft. Square Feet of Absorption Area 1140 Standpipes Present (Y/N) Y Depression over Field (Y/N) N Date of Last Adequacy Test 9/25/84 upgrade Results of Last Adequacy Test Upgrade- neer Separation Distance from Absorption Field: To Water -Supply Wall 100+ ft. To Property Line 10+ ft. To Building Foundation 10+ ft. To Existing or Abandoned System on Lotholging tank remove;dOn Adjoining Lots 100+ ft. To Water Main/Service Line N/A To Cutbank(if resent) W/A To Strew/Pond/Lake/or Major Drainage Course 100.1• ft. To Driveway, Parking Area, or Vehicle Storage Area Comments Holding tank near _road removed, adjacen_� to dwelling. 1?wl n_ D. LIFT STATION Date Installed Size in Gallons --- "Pump On" Level at 10+ ft. owner has y Vin., t to .remove tank r Dimensions Manhole/Access (Y/N)------------- "Pump Off" Level at ------------- High Water_ Alarm Level at-------------- Vent (Y/N)------------- Tested for ------------ - - Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes(Y/N)--------------- --- Coim-ents Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conforTred to all MOA HAA Guidelines in effect on the date of this inspection. AV Date O �/ '� •,.•M.....*w" . Signed ti — � t%* �? .•' Company �' MOA No. i *,r',4�ts S'�I, KB1/d5/s [Page 2 of 21 2-15-84 Time APPLIC IT FILLS OUT UPPER HAL' JNLY Time Property Owner. . . hone Date f Date Date Inspector Mail:hg Address i t . - (. , .� :>X / '� �^ -;-. I ., / i : /.. Zip Code % '/ �' ;! � -1 1. - !•f < P Inspector Buyer Field Notes: \' c, i.: Address ,ir.-,;' , _> ;�'.�.c, c-/ <_. >:. , •� �./ i`!-, . r-: ,- Zip Code f 7��,�ra,>-..J .�:. (%iM/ � LendingInstitution -i r;�/;- -'" Phone (-ova b T ' Address t `�!7/:` s Zip Code /',�:(:-/ N o ij Realty Co. & Agent f1 j.., �,.;�• . ,..,,,�� fF _.- i, r ,/ Phone 'CONDITIONS OF APPROVAL �^ R F - C f�^ j E j� I<, W Addresss <-.:� /, 1. r:•`�`.% r -fir,,, -f? %. r -r .-,, Zip Code DATE i;.. Legal Description _ f � e -/ VAf" �'.'L,K(dVf,! Street Location',?<_/ Date Sewer Installed 1-�-� --,S /•:.rt i_>..-_ t` !�:. r. c'ir.< r.-✓ Well To Absorption Area Type of Residence V ['Single Family Septic a Size d O Multiple Family No. of Bedrooms— I('> ❑ Other Water Supply Individual ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. '❑ Community For wells drilled prior to that date, give well depth (attach log if available). ❑ Public Utility Sewer Disposal ❑ Individual Year Individual Installed: ❑ Public Utility When Connected to Public Utility: ,q,ieZr� Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CANBE.INITIATED. Time Time Time i e Date Date Date Date Inspector Inspector Inspector Inspector Field Notes: \' c, (%iM/ � 44t"C IPAI IT°/ APICIIORA PEPT ! i�- I Qe � lG l (-ova b T ' lJvl r r IYIAL r r,e �IQN ff 04 W�. Gw�v-. �" �e N o ij ( ) APPROVED BEDROOMS (`-) DISAPPROVED 'CONDITIONS OF APPROVAL �^ R F - C f�^ j E j� I<, W ( ) CONDITIONAL APPROVAL' X17 DATE BY: -- Soils Rating Date Sewer Installed Well To Absorption Area ell Log Received V Well to Tank Septic a Size d O 2023 (3182) vs 1iovlftl-ln �3n 'Ir, -t l)1: -f I. r a V-A I I i(A. vi tl1vl I i.A I ld wo i, c,,i JA z i^.411 L C i 11111.:1-.{. 'C I I C.,Cl j 1) lj+--I V1? bO C' 11 k "CU- ()I- -tl'intl 011 A n hol J j. 11(l) L: -..l Al- tn''rC ;ACQ -Ajj C.tll via'; OJJJ.cjl2 Cory oqr-t ifl rl In (jo j--