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HomeMy WebLinkAboutREED LT 13 • N'""""`` MUNICIPALITY OF ANCHORAGE ° � `^Hent On-Site Water &Wastewater Program No: t : ,, PO Box 196650 4700 Elmore Road .i'' IAnchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 °' r t �''' L,' • . ,. http://www.muni.org/onsite , l ,; v n,' if �:. I epartmeut ;,Tft Not On-Site Wastewater Disposal System Permit Permit Number: OSP191307 Effective Date: 8/6/2019 Work Type: Septic Upgrade Expiration Date: 8/5/2020 Tax Code Number: 05110214000 Site Legal Address: REED LT 13 G:1359 Site Mailing Address: 23127 ROSEBUD ROW AVE, Chugiak Owner: LEWIS BRYAN 0 &ALICE M Lot Size in Sq Ft: 11166 Design Engineer: C & M Engineering • Total Bedrooms: 3 This permit is for the construction of: Q Disposal Field Q Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 Water Storage All construction shall 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 shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent l freezing 1 le------------- >s/ 9 Received By: � > Date: Issued By: /6 my/ Date: A// PQAfS MUNICIPALITY OF ANCHORAGE ;r Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 051 102 14 Property owner(s) Alice Lewis Day phone 830-9707 Mailing address Site address 23127 Rosebud Legal description (Sub'd.. Block & Lot) Reed Lot 13 Legal description (Township, Range & Section) Lot Size 11,166 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field x Initial U Single Family (SF) (w/wo ADU) Septic Tank ❑ Upgrade ❑ Duplex (D) ❑ Holding Tank H Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. C&M ENGINEERING (Signature of property owner or authorized agent) Permit/Rush Fees: 545 Waiver Fees: Date of Payment: ''Li'li9 Date of Payment: Receipt Number: /� O?O 6o 0 Receipt Number: Permit No. OSSPl`7 1307 Waiver No. G:\Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc C&M ENGINEERING SERVICES Ph: 907-854-5558 Municipality of Anchorage Onsite Water & Wastewater Program 4700 Elmore Rd Anchorage, Ak 99507 RE: Proposed Septic System replacement for REED LOT 13 Dear Reviewer, The above referenced property is currently served by an older, failed septic system. The owner would like to replace it with a new 3 bedroom system. We are proposing to install a new advantex septic tank and a new drain field. The old tank will be demolished per moa requirements. Our review of available documentation and field investigation show that this project will not adversely impact any nearby Wells, Wastewater disposal systems, replacement disposal sites, or drainage flowing onto and off of the subject property. The adjacent lots are relatively large and are served by public water. The documented wells on lot 14 appear to have been demolished and were likely required to be properly decommissioned prior to connection to public water. The system will be excavated to a maximum depth on the uphill side of 6’ to keep a portion of the trench in the “good” soil strata. A new testhole was excavated to verify soil and groundwater conditions and supports the soil log on file. Groundwater was not encountered in either test hole. Included with this letter is a permit application and design package, including plans, and calculations. Thank you for your time in reviewing this permit request. Please do not hesitate to contact me at 907-854- 5558 or by email cgbalzarini@gmail.com with any questions or concerns. Sincerely, Charles Balzarini, PE 7/10/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191307, Deb Wockenfuss, 08/06/19 Residence: number of bedrooms 3 br Water usage/bedroom 150 gpd/br Water Usage 450 gpd type: SHALLOW TRENCH Application Rate 4 gpd/sqft conservative required absorption area 112.5 sqft trench width (W) 5 ft minimum effective depth 1.5 ft Use excavation depth shown on plans Min Required Length: 17.55 ft MAX Excavation Depth: 6 ft Cover: 3 ft Insulation: 2" blueboard Effluent Pipe: Calc By: CGB Date: 7/30/2019 C&M ENGINEERING SERVICES 907-854-5558 Septic Design Calculations Reed Lot 13 RESIDENCE/LOT INFO DRAINFIELD Use length shown on plans 4" ASTM 3034 max excavation depth is measured from the high side of the trench CALCULATIONS ARE FOR REFERENCE PURPOSES ONLY USE DIMENSIONS SHOWN ON PLANS CALCULATIONS ARE FOR REFERENCE PURPOSES ONLY USE DIMENSIONS SHOWN ON PLANS Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191307, Deb Wockenfuss, 08/06/19 DRIVEWAY 3 BR HOME 5.2' 8' min 8' min 10' min NEW 5'x20'x3' EFFECTIVE MAX EX DEPTH 6' MONITOR TUBE NEW FCO'S 342 341TOPOGRAPHY IS FLAT MOA CONTOURS APPROX. TH-1985 IF ENCOUNTERED, REMOVE DISTURBED MATERIAL AND FILL WITH MOA APPROVED SAND TH-2018 DEMOLISH OLD TANK PER MOA REQUIREMENTS NEW ATCO'S SHED GARAGE DECOMMISSION OLD FIELD REED LOT 13 REED LOT 14 (NO KNOWN WELLS) PROPERTY SERVED BY AWWU REED LOT 12 ROSEBUD 10' WATER EASEMENT EXACT WATER SERVICE LOCATION NOT DETERMINED SERVICE FROM ROSEBUD CONFIRMED. SEPTIC AREA SEPTIC AREA SEPTIC AREA REED LOT 2 342 342REMOVE DECK. IF REBUILT INCLUDE ACCESS FOR STANDPIPES C&M ENGINEERING SERVICES 907-854-5558 SITE PLAN LEGAL DESCRIPTION: REED LOT 13 OWNER: LEWIS DATE: 7/20/19 REV: 0 DRAWN: CB REF: SCALE: 1" = 30' CHARLES G BALZARINI CE-13854R EGISTEREDPROFESSIONALE NGINEER LEGEND CLEANOUT MONITOR TUBE NOTE: THE PROPOSED SEPTIC SYSTEM MUST BE INSTALLED GREATER THAN: 50' FROM ANY PRIVATE WELLS 200' FROM ANY PUBLIC WELLS 50' FROM ANY SURFACE WATER 5' TO ANY PROPERTY LINE OR FOUNDATION 10' TO THE HOUSE FOUNDATION 07/9/19 NOTE: ADJACENT LOTS SERVED BY PUBLIC WATER, NO WELLS WITHIN 200' OF PROPOSED SYSTEM MAX EXCAVATION DEPTH IS ALWAYS MEASURED FROM THE HIGH SIDE OF THE TRENCH Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191307, Deb Wockenfuss, 08/06/19 CHARLES G BALZARINI CE-13854R EGISTEREDPROFESSIONALE NGINEER 6/5/19 ALICE LEWIS REED LOT 13 07/15/18 NO 5/24/19 NA TOPSOIL SW/SP, SAND WITH GRAVEL AND COBBLES CHARLES BALZARINI CHARLES BALZARINI 06/05/19 BOH None SM, SILTY SAND Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191307, Deb Wockenfuss, 08/06/19 MUNICIPALITY OF ANCHORAGE ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this `; Day ofof 20Zg by and between S%� herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code (AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this Agreement agree as follows: 1. Advanced Wastewater. Treatment Svstcans. The Municipality grants permission to the Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as DV NC. located at (legal description) REED LOT 13 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) )K Throughout the term of this Agreement, the Owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the Municipality or the manufacturer's representative. The AWWTS shall be maintained in a satisfactory condition capable of performing as designed and producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. It shall be the responsibility of the Owner during the term of this Agreement to pay for all repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This includes an annual maintenance fee (typically $400 to $600). Owner agrees that only maintenance and repair personnel approved by the Municipality or the manufacturer's representative will inspect and make any necessary maintenance; repairs or pennitted alterations to the system. ,0'1�,,—Owner acknowledges that regular maintenance of an AWWTS reduces the potential failure of the system, which could include sewage backup and costly repairs or drainfield replacement. (rev. 05/18/2018) Page i of 3 Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60.030. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS. The Municipality will give at least 24-hour notice. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. Owner agrees that the AWWTS installation and maintenance requirements as provided by the AWWTS vendor/installer and approved by the Municipality are the governing uid lines for the construction, maintenance and repair of the Owner's AWWTS. 0T_ Owner agrees to maintain remote monitoring of the AWWTS as required by the AWWTS approval. 3. Term. The term of this Agreement shall begin on the date of approval by the ltitunicipality to operate the installed system, or upon transfer of title, and shall continue while the AWWTS is operational or until title is transferred. 4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this Agreement shall in no way constitute a waiver of the provisions, nor in any way affect the validity of the Agreement or any part hereof, or the right of the Municipality thereafter to enforce every provision hereof. 5. Amendment. This Agreement shall only be amended by authorized representatives of the Owner and Municipality. Any attempt to amend this agreement by either an unauthorized representative or unauthorized means shall be void. 6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Agreement. 7. Severability. Any provisions of this Agreement decreed invalid by a court of competent jurisdiction shalt not invalidate the remaining provisions of the Agreement. (rev. 05/18/2018) Page 2 of 3 OWNER: By: �7-�- .._ T_(signature) Date: (print name) STATE OF ALASKA ) ss. THIRD JUDICIAL DISTRICT } The foregoing ' trumentwas acknowledged before me thisZf—"day of 10 20, by ; / /ZA i TARP PUBLIC -FOR ALASKA, My Commission expires: SHAWN P. WOLKOFF Notary Public State of Alaska IMy Commission Expires Feb 5, 2023 MUNICIPALITY: By: �� _ (signature) (print name) Date: 7 / Title: (rev. 05/18/2018) Page 3 of 3 MLJNICIPALITY 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 MAILING,ADDRESS ,,_ LEGAL DESCRIPTION LOCATION IPHO.N E I ~]~W ~3- ' ' ] Well ..... DISTANCE TO: Manufacturer ~ Liq. capacity ir] gallons I 'x\-~" '. 2E DISTANCE TO: IWell NQ._eF BEDROOMS PERMIT NO. No. of compartments i aiddap* PERMIT NO. Manufacturer Liquid capacity in gallons Foundation T°t~ngthM -~°f lines aterial benea~./~__,~// Material Nearest !et I ne Trench wi c)t~.. ,_ ~, ~-- ~nches Well I'~ I DISTANCE TO: I ~'-)~'~ No, of lines Len~qt'h of each line t ?L2'+ L~ Distance between liaes kJ area Total e ~ective absorption Length Width Depth PERMIT NO, Type of crib Crib diameter Crib depth Total effective absorption area Well Building foundation Nearest lot Ih]e DISTANCE TO: Depth Driller Distance to lot line f~ I tJ f'~~- DISTANCE TO: Sewer line Building foundation Septic tank OTHER PIPE MATERIALS SOIL. TEST RATING / INSTALLER R EMAR KS APPROVED ..S/vt DATE LEGAL PERMIT NO. Absorpt on area(s)/ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 826 L, Street, Anchorage, Alaska 99601 264-4720 SOILS LOG - PERCOLATION TEST SOILS LOG PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: @ 13 14 17 20 SLOPE °( .i DATE PERFORMED: ¢SITE PLAN L J WAS GROUND WATER S ENCOUNTERED? Y~O oL P E IF YES, AT WHAT DEPTH? &f.r / Reading Date Gross Net Depth to Net Time Time Water Drop ~//aO ~a'. ~ ~. ~::~ 7~ao ,a:~m o~ q D-t~ ~:~ I0 0-~7 o. I~ PERCOLATION RATE //o c~ ,(minutes/inch) TEST RUN BETWEEN , ~'~'- FT AND ~-"~ FT CERTIFIED BY: ~ ~ DATE: DEPT. OF ENVIRONMENTAL CONSER%'AT[ON ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET~ SUITE 303 ANCHORAGE, ALASKA 99504 BILL SHEFFIELD, GOVERNOR Telephone: (907) Address: October. ~'1~ ~985 Mr.. Finus Sheldon P.O. Box 67-1087 ChtJgiak~ Alaska. 99~,~¢ SUBJECT. Lots 13 & 14, Reed Subdivision, Chu_qiak, Alaska (8621-DS-024) [)ear-Mr'. Sheldon: The [lepar. tment has r. eceived cur. r. ent water, analyses for- the s,Jbject lots and her. eby issues the Certificates to OF, er-ate for. the water, systems. Any futur, e exF, ansior, of the subje,zt project will r. equire additional aF'F'r'oval fr. om this office. Si ncer'e 1 y, Michael P. Lewis Envir. onrr, ent al Engineer. MPL/msm DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 99501 BILL SHEFFIELD, GOVERNOR 274-2533 October 9, 1985 Mr. Finus Sheldon P.O. Box 67-1087 Chugiak, Alaska 99567 SUB.]_FCT: Lots 12~ !3 & !4, Reed Subdivision, Chugiak~ Alaska (8621-DS-024 Dear Mr. Sheldon: The Department has reviewed the Engineer As-built plans for the subject project. Final approval is hereby given for the water system and the Certificate to Operate will be issued upon the submittal of current satisfactory bacteriological water samples. Any future expansion of tile subject project will require additional approval frcm this office. Sincerely, Michael P. Lewis Environmental Engineer MPL/msm cc: Alaska Environmental Control Services, Inc. MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. # CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING 5"-// 0 2.- / /?L HAA # ,/~/'d' 0¢~ ¢.,-5~.~-''~ 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include 10t, block, subdivision, section, township, range) Lot 131 Reed Subdivision Location (address or directions) (b) Property owner Mailing Address (c) Lending Institution Mailing Address H.U.D.#025746 605 (¢~4t 4.tk Avenus. Telephone:(home) ...... ~, ,.,, .s~,~ 99501 ,~ ....... ~o ~, ........ Telephone Business (d) Real Estate Company and Agent ASSOCIATED BROKER.~ ATTN: Sandy Address. 6,¢0 (¢o.st 36Zh Auo.~uo.; Sub.fo. ¢1; A,o~r~go~ Al~ 99503 Telephone (e) Mail the HAA to the following address: (or check here D~if hold for pick up.) List contact person and day phone number below: ~, ~'. ~. FNGtNEE~ NG ,:~ I~i,ver Leop Roa~l Ne. ~te ~y~_rz A_las_ka 2. TYPE OF RESIDENCE b,/ Single-Family~ Number of bedrooms ~ 3. WATER SUPPLY Individual Well~t( ' Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site~ ~/ Public[] Community[] Holding Tank[] Note: if community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-O25 (Rev. 7/88) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of thevalidation date shown below, I verify that myJnvestigation'ofthis Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe,' functional end 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. 5 & $ ENGINEERING 17034 Eagle River Loop Road No. 204 Eagle Fdver~ ~577 Telephone Name of Firm Address Date Approved for ~ bedroo Date Approved Disapproved Conditional Terms of Conditional Approval e,,)';'Tla Ii [el ~ The Municipality of Anchorage Department of Health and Human Services(DHHS) issues Health AuthorityApproval cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DH HS do not conduct inspections or analyze data before a certificate is issued. The MunicipalityofAnchorageis not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev, 7/88) 8ack Page 2 of 2  MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) ~.~ cI~^Li~_~IE,C~Id$~ FEBRUARY 1984 Legal Description: ~ Well Log Present (Y//N)~// Total Depth~_C.¢O '~ased to Static Water Level /I ~ A. WE,-L DATA · l;;tV t!, g Well Classification 1~)¢' Date Completed ~.~ -/ I '"" /d/,q Depth of Grouting // Pump Set At Casing Height Above Ground / (:~ Electrical Wiring in Conduit (Y/N) Y' SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot / 3 To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line /k)/~ To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results If A, B, C, D.E.C. Approved (Y/N) ~ .¢- Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ~ ..d On Adjoining Lots / / .~ Z / ; On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole Comments B. SEPTIC/HOLDING TANK DATA Date Installed Ln-,/'~- ~ 4 , (~cL3~¢~/ 2 ~ S~ze / No. of Compartments Standpipes (Y/N) _Air-tight Caps (Y/N) )// Foundation Cleanout (Y/N) Depression over Tank (Y/N) ~'U Date Last Pumped / Pumping/Maintenance Contact on File (Y/N) ~'.)/~ ;for Holding Tank High-Water Alarm (Y/N) __~1___ Temporary Holding Tank Permit (Y/N) /~//~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply Well To Property Line To Water Main/Service Line / / To Stream, Pond, Lake or Major Drainage Course / ~0 ~ · 72-026 (Rev. 7/88) Front Page 1 of 2 Soils Rating in Absorption Strata / h-~ ~ -~/L~,c-~ Type of System Design[ Date Installed L~- / ~ - CC~.~ Length of Field Width of Field .~.-.~, 3-- / Depth of Field ..-~ Gravel Bed Thickness z/ / .~. Square Feet of Absortion Area ~.%~ '¢ Statndpipes Present (Y/N) ~'/ Depression over Field (Y/N) I'd Date of Last Adequacy Test Results of Last Adequacy Test ~:~¢ff~/-~ '7~ c~% ~' c~- SEPARATION DISTANCE FROM ABSORPTION FIELD: ? To Water-Supply Well / .~, 2. ~ To Property Line To Building Foundation / © ,.~' To Existing or. Abandoned System on Lot ¢v//~ ; On Adjoining Lots To Water Main/Service Line /F~ 'k ~- To Cutback (if present) To Stream, Pond, Lake, or Major Drainage Course / Of P To Driveway, Parking Area, or Vehicle Storage Area ~:~O/ 'Y Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) -"'""'"'"--~_...........~...~ Pumping Cycles during Adequacy Test. **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Company Date S & S ENGINEERING 17034 Eagle River Loop Road No. 204 MOA No. Receipt No. ,~ Date of Payment Amount: $ Receipt No. Waiver Fee: $ Date of Payment 72-026 (Rev. 7/88) Back Page 2 of 2 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date H88-0081A GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 13 Reed Subdivision Location (address or directions) Property Owner H,U,D. Telephone: Home Business Mailing Address (b) (c) (d) Lending Institution Mailing Address Telephone Real Estate Company and Agent Eric Dyrud % Associated Brokers Address 640 West 36th Avenue, Suite 1 Anchorage, Alaska lelephone 563-3333 99503 (e) Mailthe HAAtothefollowina address:or:Checkhere~:,~fholdforpickup. Listcontactpersonand day phonenumberbelow. S & S Engineering 17034 Eagle River Loop Road, Suite 204 Eagle River, Alaska 99577 694-2979 TYPE OF RESIDENCE Single-Family F-~x Number of Bedrooms three(3) WATER SUPPLY Individual Well I~:× Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite ~[](x~Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 fRev 8/861 Front Page 1 of 2 5.ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is 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 ay§tern is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. NameofFirm S & S Engineering Telephone 694-2979 Address 17034 Eagle Rlver Loop Road, Suite 204, Anchorage, Alaska 99577 Date Engineer's Seal This department has received written confirmation from the engineer regarding the Conditional Approval of March 2, 1988. The corrections have been accomplished and an inspection has been completed by the engineer. The subject property meets with Muncipal standards is now approved. DHHS APPROVAL Approved for three (3) bedrooms by Approved XXXXXXXXXXXXX Disapproved Terms of Conditional Approval Conditional April 29, 1988 CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements, Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 fRev 8/86) Back MUNICIPALITY OF ANCHORAGE 44 3~-,~ 4~'06,n DEPARTMENT OF HEALTH & HUMAN SERVICES ~,.//~,.., ~I"/C'~'; ~.~G'E S '~ '-'4,'/. DIVISION OF ENVIRONMENTAL SERVICE - .~ - ~/Ox, CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL,~ ~/~O~, 'v Application Date Eebruary ].5, '1988 -. GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) ' (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 13; Reed Subdivision Location (address or directions) (b) Property Owner HUD Telephone: Home Business Mailing Address (c) (d) Lending Institution Mailing Address Telephone Real Estate Company and Agent ASSOCIATED BROKERS/Eric Dyrud Address 640 West 36th, Suite 1, Anchoraqe, Alaska 99503 Telephone 563-3333 (e) MailtheHAAtothefollowinaaddress:or:Checkhere[], ifholdforpickup, Listcontactpersonand day phonenumberbelow. S & S ENGINEERING/694-2979 17034 Eagle River Loop Road, Suite 204 Eagle River, Alaska 99577 ordered by Eric Dyrud TYPE OF RESIDENCE Single-Family ~ Number of Bedrooms WATER SUPPLY Individual Well:~j~ Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite [] Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 trey 8/861 Fronl Page 1 of 2 ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein, ~ 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 in compliance with all Municipal and State codes, ordinances, and regulations in effect on the' date of this inspection. Name of Firm ~ & ~ =;.'C'-,";~'~.[;.~G Telephone Address 17034 Eagle RA, er Loop R<hld ~g., ~ Eagle River~ Alaska 9~577 Date ' ~'P~ ~-- ~ Approved for ?~,..~,~,~,-'2bedrooms by .... Date ~ ,-Dis~pprovod Conditional CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 fRev 8/861 Back WELL DATA M ............ IVI. U,I~!rw, I.P..~:ITY OF ANCHORAGE (MOA) ENVIRONMENTAL PRO~LIST ' FEBRUARY 1984 264-4744 MAR t 1988 RECEIVED Cased to f ~dP Well Classification Well Log Present ~.'~N) Total Depth / ~ ~' Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (~/N) Separation Distances from Well: Legal Description: If A, B, C, D.E.C. Approved (Y/N) Date Completed /~:,:--- /~'- '~ Yield 7 Depth of Grouting Pump Set At l~?~---, Sanitary Seal on Casing (~N) Depression Around Wellhead To Septic/PlokC4~g. Tank on Lot / '¢2 ~ ; On Adjoining Lots ¢ Field on L t. To Nearest Edge of Absorption LC ; To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole /'J To Nearest Sewer Service Line Water Sample Collected by ~-~/--2~ Water Sample Test Results Comments ~ "¢¢¢ ~ B. SEPTIC/~ TANK DATA Date installed Standpipes~C;'N) _ ~' _ Air-tight Caps (~N) Depression over Tank (Y(~;) /d Pumping/Maintenance Contract on File (Y/N) ~Z~--//,~_/ Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well / ~'~ ~ To Property Line To Water Main/Service Line Course No. of Compartments ~ ~ Foundation Cleanout t~N) /~/ j.~/ DateLast Pumped ~'7~.o ~ ~8 ; for /,.3//4, Temporary Holding Tank Permit (Y/N) To Building Foundation / To Disposal Fiel¢l, To Stream, Pond, Lake, or Major Drainage Page 1 of 2 72 026 IRev 8861 Front C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~::~ Width of Field Square Feet of Absorption Area Depression over Field (Y/~j) Results of Last Adequacy Test Separation Distance from Absorption Field: Type of System Design Length of Field ~ '7 Depth of Field Gravel Bed Thickness Standpipes Present ~N) Date of Last Adequacy Test To Water-Supply Well To BuildingLot Foundation r4j,~/ To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments I To Property Line To Existing ~r Abandoned System on ; On Adjoining Lots To Cutbank (if present) /"~//~-/ '7..-o/± "Pump On" Level at ~ High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all M CA and HAA guidelines in effect on the date of this inspection. Signed ~ ,3, S ENGINEERING Date C 17034 Eagle R~er Loop Read Ne. ompany E. agie I<iver~ Aiaska ~95.~f*~~'~0'~'~4°' Receipt No, Amount: $ / 5~- Page 2 of 2 72 026 IRev 8~861 Back MUNICIPALITY OF ANCHORAGE DIVISION 0F ENVIRONY~NTAL ~iEALTtI DEPARTMENT OF ~TH ~D Eh~IRON~NTAL PROTECTION APPLICATION FOR I~TH AUTHORITY ~PROV~ CERTIFICATE General info.etlon Application Date (a) Legal Description (include ,lot, .~1oc1% subdivision~ se9tion, township~ range) Location ,~address or directions) Telephone- I{ome Business (l)) Applicants Name ~?,~,~t~ Applicants Address (c) Applicant is (check oae) Le-ading Institution (d) Lending Institution Telephone Address (a) Real Estate Coo & Agent Address Telephone (f) ~,iai_ the ttAA to the following address: 2o ~y__?~ of Residence Single-Family~_~[~ Nuraber of Bedrooms biul ti-F amily ~_-~.~ Other (describe) Water S u.p_~p 1~ Note: If community well system, must have written confirmation from the State Department of Envirorm~ental Conservation attesting to the legality and status~ Sewage Disposal Note: If community wall system~ must have ~,r~itten CO~Lfirmation from the State Department of Environmental Conservation attesting to the legality and status. [Page 1 of 2] 5o Engineering Firm Providing Inspections~_ Tests~ File Search, Data and Information As certified by my seal affixed hereto and as of the validation date shown below~ verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is 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 bkmicipa].ity of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with ~1 Municipal and State codes~ ordinances~ and regula~ tions in effect on the date of this inspection~ Con iona2. Approved L--"-' Dis oved Te~,ns of Conditional Approval. CADTION THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEAJ, TH AND ENVIR0~N~LENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY APPROVAL, CERTIFICATES BASED SOLELY UPON THE REPRESE~¥%- ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGIb~ER _REGISTERED IN THE STATE OF ALASKA~ Ti{E DHEP DOES THIS AS A COURTESY %0 PURC~L4SERS OF HOMES AND THEIR IY~NDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN [~'EDERAL AND STATE REQUIRE-" MENTSo ~dPLOYEED OF DHEP DO NOT CON-DUCT INSPECTIONS OR ANALYZE DATA BEFORE A CERTIFICATE tS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NO~ RESPONSIBLE FOR ERRORS OR OMISSIONS IN THE pROFESSIONAL ENGINEER'S WORK° (DHEP SEAL) tll4lej/Pl8 [Page 2 of 2] 7-19-84 ~ C ~ HEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, ,INC. TELEPHONE (907) 562-2343 ANCHORAGE INDUSTRIAL CE-N-~ER 5633 B Street Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER WATER SYSTEM: ~cs (*) See h on back I,D, NO, Water System Name ff Phone No. Mailing Address CiW State Zip Code Mo. Day Year SAMPLE TYPE: ~IF1 Routine Check Sample (for routine sample with lab ref. no. [] Special Purpose Treated Water Untreated Water SAMPLE NO. :' LOCATION 3 I 4 I 5 Time Collected Collected TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: ,[~ Satisfactory [] Unsatisfactory [] Sample too long in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. Date Received Time Received Analytical Method: [] Fermentation Tube [] Membrane Filter Lab Ref. No. Result* Analyst I CT-] I ~ I lq-] I r-Tq 08.1220 (b) Rev. 1983 BACTERIOLOGICAL WATER ANALYSIS RECORD READ INSTRUCTIONS BEFORE Membrane Filter:. Direct Count Verification: LTB Final Membrane Filter Results Reported By BGB. Date Time: Coilform/100ml Coilformll00ml COLLECTING SAMPLE TNTC = Too Numerous To Count 'JIJICI~ALITY OF AHCHOItAGE D~PT, OF HEAl.TH & MUNICIPALITY OF: ANCHORAGE (MO~)tVIP.,C)Nk4[ ',ITAL PROTECTION HEALTH AUTHORITY APPROVAL (HAA) . CHECKLIST- FEBRUARY 1984 ~' '" ']' 'i 'J985i 264-4720 WELL DATA Well Classification Well Log Present (~N) Total Depth / ~o Cased to Static Water Level //,ZO; Casing Height Above Ground Electrical Wiring in Conduit (~N) If A, B, C, D.E.C. Approved (Y/N) Date Completed ~-~ '-/~ -~'~ Yield Depth of Grouting Pump Set AtW~/ / Sanitary Seal on Casing (~N) Depression Around Wellhead (YN~ Separation Distances from Well: .. To Septic/Holding Tank on Lot /~""¢ "' "' ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot ~ /~57- '"; On Adjoining Lots To Nearest Public Sewer Line ___ 'Fo Nearest Public Sewer Cleanout/Manhole ,u//?¢' ~" To Nearest Sewer Service Line on Lot Water Sample Collected by ,/¢Z'~J5 /¢. ,¢J//z~ ; Date Water Sample Test Results .¢'//"/~/~:;)¢'d~/'~/¢' Comments ~'z~*~/L~ /'~/7/~'d~'/L='~ ~/-',27: /¢//~,4,/ /~' ¢/v/,E~Z-.L- ,L.~',,)uT*~,*/ ~/' B. SEPTIC/HOLDING TANK DATA ~'" '¢/~'-~'/Size ./'¢~¢~ ~/~' No. of Compartments Foundation Cleano~ut (~/IN) Date Last Pumped /~///~ :for ,~// Temporary Holding Tank Permit (Y/N) Date Installed Standpipes ~q) Air-tight Caps,) Depression over Tank (Y~_~ Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) _ /.//~/~ Separation Distances from Septic/Holding Tank: /.~, / ~_... To Water-Supply Well To Property Line To Water Main/Service Line Course J I.-~ To Building Foundation To Disposal Field (-~ / To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72-026(11/84) ABSORPTION FIELD DATA Soils Rating in Absorption Strata / ',,7 Date Installed ('¢ '~/'~ Width of Field ,,Z,, .'>"' Square Feet of Absorption Area Depression over Field (Y(~)~ Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well /~.~Z~ / To Building Foundation Lot To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Type of System Design Length of Field Depth of Field '~ Gravel Bed Thickness Standpipes Present (~}N) Date of Last Adequacy Test To Property Line To Existing or Abandoned System on ; On Adjoining Lots -2-'~?' (~' To Cutbank (if present) Comments D. LIFT STATION "'~DateJ.n_,~..~nstalled Size in Gallon~'~'-~.~._.~ "Pump On" Level at '~-~-- High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) ~'~"1~0..~ Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify t h at I h.~.~/e.~ed.,, v~rified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed ~"'~/':-'~( ' /~'~'""-- Date Company ,//L~(~ y MOA No. Page 2 of 2 72-026 (11/84) EA.'-SI!iMI!IN'i'S FOR WLLL AND WATER LINES · ,. ;.' '.-. d/b/a Finis Construction The Gl. enter, I. ln~.~ Sheldon, Company, whose mai].illg address is P.O. BOX 67-1087, Chugiak, Alaska 9956';, for valuable consideration the receipt of which ~ hereby acknowledged, bein~ ~he owner 'o~ cor~a~n adjacon~ real properties hereinafter referred to as Parcels A, B, and C, t~itua[ed in Reed Subdivision, Peters Creek, Alaska, more particularlLy described as follows. ! ..~ . ~. Reed Subdivision, .I. ARCEL A. Lot ]!'our teen (14) , ~'~7S'''''?~; ..... the official plat thereof, filed under a~,coi, dlng to Plat No. P--390, records of the Anchorage Recording · ' -' d- Third Judicial District, State of Alaska; and ~ ,.,. Reed Subdivision, ~. ARChL B. Lot ~.'hi~teen (13) , Plat ~o. ~?....~90, ~eco~ds o~ the R~cho~nge District, Third Judicial District, State of Alaska; and ~ '" C LoL t~we].ve (1.2) ~ Reed 8ubdivi~ion~ 1. ARCLL · ' f ~led unde~ aceo~dx.~ to the offioial p~at ~he~eo~ PlaL No, p-.390~ ~eeo~ds o~ ~he Anchorage Reeord~n~ ~ hereby ~rants ~rom said PareeZ ~ Lo Said Parcels B and S~,~ Lhe use and ma~nLenanee of ~wo wells and two waLe~lines an q~asement for those existing wells and water lines as more ~articularly shown on the as-built survey attached hereto as ExhJ. bJ.t "A". Said Easement shall be 10 feet in width, comi~encing at a point 30 feet West of the Southeast property corner of Parcel A, with the southern property boundary of Parcel A as the Easement's southerly boundary, and shall extend to the common lot line between Parcels A and B. Purther, the Grantor hereby grants, from Parcel' B, a 10 foot easement for the existing water line to Parcel C. Said easement is to be located along the South 10 feet of Parcel B. These easements are :for the maintenance and use of two water wells and water lines presently situated on the above- described easements, more particularly shown on the as-built drawing atta~,~ed hereto as Exhibit A, and by this reference made a part hereof. The easement hereby created and granted shall be binding upon and inure to the benefit of parties hereto, their heirs, legal representatives, successors and assigns, and shall exist and run with the land. During the existance of the herein-granted easement, the owners of Parcel A and B shall not utilize the easement areas mn any manner which will prevent the owners of Parcels B and/or C from having full, free, exclusive and uninterrupted use the ~two respective water wells to which the respective water lines from each lot are connected, including maintenance purposes of the said well and water line. Nothing herein contained shall be construed to imply any warranty by the owner(s) of Parcel A as to the quantity or quality of water to be obtained from said wells, liability for any damages caused by non-delivery of water, no~ liabi].ity in any way for upkeep and maintenance of the wells serving ]?arce'J,s B and C,; nor shall the owner(s) of Parcel A in any way be responsible for the upkeep of the wells or waterlines and, further., the owner(s) of Parcel A shall not be liable fo]: any damages or injury to persons or property occurr.in.q within the easement. area. · '/ ~ ~/ -~ 19B5, at Chugiak, day of. /'"' ,'/>' ~ ~ Alaska° I?inis Construction Co]~pany STATE OF ALASKA ) ) S~. THIRD JUD.ICIAL DISTRICT ) ' ";'Y that on the ~. the THIS IS ~:O CER~.II... day of 1985, before me, a notary public in ? ' Alaska, du].y commissioned and sworn as such, personally to be [:he individual namc,~ 'appeared [IN~S SHELDI~IN~ known Co me herein, who acknowledged to me thg, t he executed the ..... , ..... ~,, Fn, the uses and purpo~es instrument freely anc~ vu.,.~. ~, ............. .~ .... mentioned therein, and that the same was his act. ~N WITNESS WHEREOP ! have ,hereun~;° set emy hand and d ear ]ast' above wEiLtA~--iIi4.'?,; ,official seal on ' ' ' -' ~ ~' ""'"':'" the day an y ,,e ,.,., ......... ,e ,~-:,' ' '~. ~; %'~7,/3'~,,''':' ,4,~,;2~ I ,'' ',',',? ,,,, ,.,... /.,.: ...... .... ',.: , ~,,. - " "~ %;/~'P,;~ 1200 West 33rd Avenu ultu l~ ANCHORAGE, ALASKA .~9503 (907) 561-5040 ALASKA ENVIRON~IENTAL CONTROL SERVI~ ;, INC. 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907) 561-5040 SHEET NO __ OF CHECKED BY DATE