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Home My WebLink AboutKEMP LT 1Kemp Lot I #017-013-91 Municipality of Anchorage On-Site Water and Wastewater Program • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP181346 PID Number: 017-013-91 Dwelling: ®❑ Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New ❑ Upgrade Name: Kevin L. Lull ABSORPTION FIELD ❑ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address 12801 Patrick Rd, Anchorage, AK 99516 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 GPD/SF Ft, LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot Kemp 1 Fill added above original grade Ft. Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line Ft2 IFt. Well >100' N/A N/A NSA >25' TANK 91 Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Anchorage Tank Capacity 11250 Gal. Surface Water >100' N/A N/A NIA Material Number of compartments Lot Line >10' N/A N/A N/A Steel 2 NA Foundation >10' N/A N/A N/A LIFT STATION Manufacturer Capacity Curtain Drain None 1 Noted Gal. Remarks Tank is insulated with 2" of insulation. Pump on level at in. Pump off level at in. High water alarm at in. Pump make and model Electrical Inspections performed by PIPE MATERIAL House to tank D3034 Tank to drainfield D3034 Installer Denali Excavating Drainfield Existinq CO/MT Inspector J. Williams BENCH MARK (Assumed elevation) 100 ft Inspection151 10/10/18 10/15/18 Location and description 2nd 3`d 41h Bottom of siding at SW corner of building COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Conditional Approval: Date �,, , •!� 49 TH W� • ........... • Benjart ' chiller Approved Date �Fc •., CE 12592 /x�F� • , 4/30/19 , • ��U r ��ROFESSI4N�� inspection Repori_a- i- i z.aoc TALISMAN ROAD 10; -UTILITY EASEMENT I EXISTING WELL. I i i B i y 2-BDRM HOME i 'ANEW 1,250 GALLON A SEPTIC TANK OUTSI i 2C01 1 00'WELL RADIUS. 7 -/2CO2 SV LOT 1 ABSORPTION PIT 30'ACCESS EASEiv'IENr ,WSC Bi: 214. PG 590) A G. DRIVE _. 10 UTILITY EASE1,44ENT � ~ l d Fes" �� i ENG I N E E R I N G l • "ie C:2 •. I 49 TH Senja in Schiller CE q 4. �p•pROFESS10��4�'�. PLAN AS -BUILT (NO SCALE) PID # 017-013-91 A B 2CO1 19.2 36.8 SV160.6 78.7 S V2 61.7 83.5 2CO2 59.8 83.0 1 50 100 :_` .......Mv' ME !FEET1 LEGEND CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEAN( FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE r' t 1 I t 1 1 .et ti f' Ij i LEGEND CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEAN( FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE sang, TA Wdo a to"I KEMP LOT 1 F9 FRE -3 DO VA RM W Mo (NO SCALE) 2" INSULATION M co 49 ... ..TH .... ... ;-:......... Benja m Schiller Co 1 098 Nc,pA,,hof MUNICIPALITY OF ANCHORAGE 1,,cnr On-Site Water&Wastewater Program �,� S PO Box 196650 4700 Elmore Road _ ' Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 , http://www.muni.orgionsite j \` / I)u•partnull t On-Site Wastewater Disposal System Permit Permit Number: OSP181346 Effective Date: 9/28/2018 Work Type: SepticTank Upgrade Expiration Date: 9/28/2019 Tax Code Number: 01701391000 Site Legal Address: KEMP LT 1 G:2840 Site Mailing Address: 12801 PATRICK RD, Anchorage Owner: LULL KEVIN L Lot Size in Sq Ft: 59878 Design Engineer: FORGE ENGINEERING Total Bedrooms: 3 This permit is for the construction of: ❑ 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 freezing ..-, t_,1„:1 Received By: Date: Issued By: PQM \,9..14.0Date: q a 3 18 Community Development Department 4 Phone: 907-343-7904 Development Services Division Fax: •. 34/3,79..ort On-Site Water& Wastewater Program ittosk 71, ON-SITE SEWER/WELL PERMIT APPLICATION Q SEP 2 7 U13 a � Parcel I.D. 017-013-91 Property owner(s) Kevin L. Lull Day phone a6 8 L 9 5 Mailing address 12801 Patrick Road, Anchorage AK 99507 Site address Same Legal description (Sub'd., Block & Lot) Kemp, Lot 1 Legal description (Township, Range & Section) Lot Size 59,878 Sq. Ft. Number of Bedrooms Three (3) APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (IA all that apply) Absorption Field El Initial Single Family (SF) IX) (w/wo ADU) Septic Tank x; Upgrade I XI Duplex (D) I I Holding Tank ❑ Renewal I I Multiple Dwellings I I Privy I I (SF and/or D) Private Well n Water Storage I I 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. (Signature of property owner or authorized agent) Permit/Rush Fees: al5- Waiver Fees: Date of Payment: q-as-q Date of Payment: Receipt Number: OOM N Receipt Number: Permit No. OSPIg kP Waiver No. Permit App_2-: :_.,c GE ENGINEERING PO BOX 240773 ANCHORAGE,AK 99524 522-7773 677-7766(FAX) September 27,2018 Municipality of Anchorage Development Services Dept-On-Site Water&Wastewater Program 4700 Elmore Rd Anchorage,AK 99507 Subject: Kemp, Lot l — 12801 Patrick Road Septic System Design and Permit Application Dear On-Site Services Engineer: The septic tank on the subject lot is leaking and must be replaced prior to the issuance of a COSA for the property. The attached site plan identifies the location of the home and the existing well and septic system. No conflicts exist between this proposed system and any other well or septic system,whether on this lot or adjacent lots. The new septic tank will be placed outside the 100' radius of the well on the lot and a minimum of 5' from all deck or stairway foundation supports and all lot lines. The existing septic tank will be decommissioned in accordance with Municipal Code. The existing well on the lot is shown. The placement of the new septic tank will not encroach into this radius or protective well radii on adjacent lots. Please refer to the attached plan sheet for the septic design. If this design is followed,there will be no adverse impacts to adjacent properties. Sincerely,14c-t-LAL � QOFALsk �*'•49 TH �\ *-:11 'y �� rr Michael E.Anderson, PE � .. , • Yt....n r F*Michael 3E81Anderson��/ �i``FD P•ROFESSION:4.4 \\\\\��„ KEMP SUBDIVISION LOT 1 S' 1 TALISMAN ROAD --1(Y-UTILITY EASEMENT / \ / N / I EXISTING WELL. \ i \ // ' PLACE FOUNDATION // I CLEAN OUT. I / ® I / 1 2-BDRM HOME / I / 1 I FCO 1 I / 0 /NEW 1,250 GALLON // /SEPTIC TANK OUTSIDE \ O/ 100'WELL RADIUS. 2CO3 (Yl - . ..'.1•,256�GALLON '. : / FSVV I SEPTIC TANK. DEC.. SI,ON•,• / 2C0 1 LMS L ' PER M.O.A.CODE. / - CONNECT TO EXISTING \ _ _ — - SERVICE LINE. \ 1 LOT 1 \\ \N EXISTING ABSORPTION N PIT. \ I 30'ACCESS EASEMENT / (M ISC BK 214,PG 590) / A.C.DRIVE / 10'UTILITY EASEMENT / / / / GE I / /illoif NGINEERING I NOTE: I _41011rlisi4, NO SLOPES>25%WITHIN 50'OR SURFACE WATER WITHIN 100'OF THE .�p� �Pr••�. �9..1. PROPOSED SEPTIC SYSTEM LEGEND �..,..• •• �* CO-CLEANOUT ., ' � - s: �� 2C0-DOUBLE CLEANOUT ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS *-7417. 1m+49th _ \ s FCO-FOUNDATION CLEANOUT • PROPERTY ARE SHOWN.NO CONFLICTS WITH WELLS OR SEPTIC i "" SYSTEMS. FS-FLOW SPLITTER VALVE ?n MICHAEL E. ANDERSON 2te,k.d= MH-MANHOLE •� .. No. CE-4381 •: � 0 50 100 MT-MONITORING TUBE �1 �F'•••.,.• 9-27-18 ,.••cti NM = = I= FEET +.�F� °ROFESS. Pia� 1"=50' SV SEPTIC VENT •�1II.s ill,- TH-TEST HOLE 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSP~ECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE FROM WELL LIQUID CAPACITY GALLONS. NUMBER OF MATERIAL ~'~'~' COMPARTMENTS ~-~'~'~ /~"~'"~"~'~"~'~' ~'~'~;~:~ LIQUID INSIDE LENGTH ~""'~I~NSIDE WIDTH ~-~--' DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS / OUTSIDE DIAMETER LINING MATERIAL ~,,~9~/~~ ~ OR WIDTH "~ 3 /,. LENGTH .~2~ / ~'~'~ , , DEPTH , BUILDING FOUNDATION NEAREST LOT LINE./~1~'/~/'~' "~'~/ TILE DRAIN FIELD: / TOTAL EFFECTIVE ABSORPTIO~I A,~,EA (WALL AREA) DISTANCE FROM WELL .~ ..... , FC~TION , NEAREST LOT LINE. NUMB DISTANC TRENCH DrEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE SQ. FT. TOTAL LENGTH OF LINES IN. TOTAL EFFECTIVE IN. ABOVE TILE WELL: LOT LINE TYPE ;,~.,,"~/~-,w..--.,~ . DEPTH ,~,~ ~ / NEAREST ,,~...~ EPTIC ///-) '"-2/'""~ SEWER LINE ~'- ,TANK DISTANCE FROM ~ WATER .BU,LD,.G EOUNOAT O", SAMPLE . NEAREST ~/,/, / SEEPAGE /~'~ / ~..'"'~-O TH ER DISTANCES: DATE DIAGRAM OF SYSTEM APPROVED HEALTH AUTHORITY GREATEI~ AN~HOHA~I~ AHI~A ~l~U~Yfl Case No.~ - ~'~ HEALTH DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 279.2511 I 0 ?3(.it~ ~'~ '~?] ?0 SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT NAME OF APPLICANT/~. ,~~ MAILING ABORESS~,''4 '~ ~7/C' PHONE NO. RESIDENCE ADDRESS /"~'~'~/~' ~ ~ ~LOCATION OF INSTALLATION /~"~ ~ ~~ LEGAL DESCRIPTION ~g~ ~E~~5 T/2~ ~ f~ APPLICATION TO INSTALL: SEPTIC TANK ~ ., SEEPAGE PIT .~ , DRAIN FIELD , OTHER TO SERVETHE FOLLOWING FACILITY ~~ ~~ BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT ., THIS IS TO SERVE AS ~ .AS OESCRIBEB BELOW, ., SEPTIC TANK SIZE · PERMIT TO INSTALL A ,,4:~¢/,¢,'~ ~,v SIZE OF UNIT TO BE SERVED TYPE~ SEEPAGE AREA ~:~7~' TYPE DIAGRAM OF SYSTEM DISTANCES: I certify that l am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the above described system is m accordance with said code. GREATER ANCHORAGT; AREA BOROUGH CASE # HEALTH D}ii,AkT?.1EN T '- 827 EAGLE f;TREET ANCHORAGE · ALASKA Depth ' Loe~tion Sketch Soil Ch Was Ground Water Encountered?__~. If Yes, At Reading Date Gross ?ime Nez Time Depth To H?O Net Drop Field ~ ~~t prooo~ed tn~tal~Seepage ~'t / O~,ain _ - -,~ - Depth To Bottom Depth Of Inlet 2~_=- COMMENT,>. .:_' .... ~ ' ' ---'--= - November 17, 1970 l~r. Hent-/ Schroe~ter Anchorage, Alaska 99502 ~ ~/~, s~ i/a, ~ ~/~, ' Dear ~r. Schroedor: S~nce the inspection of the subje~ se~er syst~, engineerin~ plans have been submit~eg and approved on Greet septic t~ks. Enclosed please find y~r copy of the inspection repor~ livini approval tot ~e se~er syste~. Sincerely, C.$. McKechnie Environmental Health Aide November $, 1970 Route A. ~ox aSOF An~ho~e, Alaeks 99502 SUBJEC?~ The Greet eeptAo tank beAn~ used byyouon the eub~eet lot has not received the approval of om~ Depatqment.~To~ th~s reasoa, the ~reer tank must be re- moved and r~plaeedb¥ a Borough approved tank as eoen aa sprang break-up makes di~g~ng p~aetieal. Thank you very much i~or your Sincerely, John R. Lee, £.S. Sanitar,ian /omo 6R-RALS MUNICIPALITY OF ANCHORAGE • ire Development Services Department *". Phone: 907-343-7904 On-Site Water & Wastewater Section -� Fax: 907-343-7997 Certificate of On-Site Systems Approval Parcel I.D. 017-013-91 Expiration Date: E-( 0-47 1. GENERAL INFORMATION Complete legal description Kemp Lot 1 Location (site address) 12801 Patrick Road Current property owner(s) Kevin Lull Day phone Mailing address 12801 Patrick Rd, Anchorage, AK 99516 Real estate agent Day phone 2. TYPE OF DWELLING: Single Family (w/wo ADU) n Duplex Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well Private Septic U Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer Waiver request for Distance: Received by: Date: COSA to be released to the engineer,unless otherwise requested by the engineer. COSA Fee $ 5-67) Waiver Fee $ Date of Payment 671 1/19 Date of Payment Receipt Number (1S 1ioq n Receipt Number COSA# 6509/39 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 Forge Engineering Phone 907-522-7773 Address 1399 W. 34th Ave Suite 203, Anchorage AK 99503 Engineer's Printed Name Benjamin Schiller, P.E. Date 4/30/19 411 k Aliv/V��0). ��— :7 fj 6. DSD SIGNATURE / •• "'• 2 X-- System #1 Approved for .3 bedrooms t •. Benja 7 chiller : j CE System #2 Approved for bedrooms � �dl• 4 30192• •••• l IF''Fo •pROFESS10N^ti.� Disapproved Conditional approval for bedrooms, with the following stipulations: or A&Afi( do(!�'% ON-SITE �Q WATER AND WASTEWATER 0_,PROGRAM SCJ//rOfJ <<c' J)1;, T St}R`1\ r Er y: �- ( `� Original Certificate Date: (C r I The Municipality of Anchorage 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 Other COSA Checki st blue sheet • COSA Checklist Legal Description: Kemp Lot 1 Parcel ID: 017-013-91 If more than 1 septic system on lot: COSA Checklist# of Structure served by this system A. WELL DATA El Well log is filed with Onsite (or attached) Well production at time of test 5.4 gpm Date drilled *1970 Water storage tank volume 450 gallons Total depth *330 ft Well disinfected for coliform test? ❑ Yes 0 No Cased to *17 ft ❑� Coliform bacteria is Negative ❑■ Sanitary seal is functioning correctly Nitrate .541 mg/L ❑ Nitrate less than MRL (ND) ❑■ Wires are properly protected Arsenic ug/L Arsenic less than MRL (ND) Casing height (above ground) 18 in. Collected by Forge Engineering Date of flow test for COSA 8/31/18 Date of Sample 4/19/19 Static water level at beginning of test 19.7 ft. Comments *Well info taken from original inspection report. Casing depth taken from new pump install log. B. TANK DATA C. LIFT STATION Age of tank(s) <1 years ❑ Required maintenance completed Tank type/material Septic/Steel Age of lift station years Measured operating fluid level in septic tank N/A Lift station material ❑� Standpipes/foundation cleanout per record drawing Comments: N/A Date of pumping New Tank D. ABSORPTION FIELD DATA Seepage Pit Which system tested (date installed) 10/22/1970 Adequacy test date 8/31/18 ❑� ALL standpipes present per record drawing Results E Pass For 3 bedrooms Total measured depth from grade 12.5 ft (max) Fluid depth prior to test 69 in Measured depth to pipe invert from grade N/A ft(min) Water added 577 gal ❑ N/A— pressurized field New depth 77 in ❑ Monitor tubes go to bottom of effective. If not, state 240 depth into effective N/A Elapsed time min ❑■ Code-required soil cover over field Final fluid depth 75 in Absorption rate >450 gpd ❑ System presoaked (Required if vacant for greater than 30 days prior to Any rejuvenation treatment(past 12 months) None date of test) Gallons introduced N/A gallons If yes, enter date Comments/Deficiencies: Exact effective depth could not be accurately measured.Lateral drain pipe is not present in seepage systems. COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot> 100' Community Sewer Manhole/Cleanout> 100' 0 Yes if No ft El Yes if No ft Neighboring Tank > 100' El Yes if No ft Private Sewer/Septic Line >25' El Yes if No ft Absorption Field on Lot> 100' 0 Yes if No ft Holding Tank > 100' El Yes if No ft Neighboring Absorption Fields> 100' Animal Containment> 50' 1 Yes if No ft D Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ElYes if No ft ❑✓ Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations> 10' 0 Yes if No ft Surface Water> 100' El Yes if No ft Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' CI Yes if No ft Private Wells > 100' 0 Yes if No ft Water Main > 10' 0 Yes if No ft Community Wells> 200' ElYes if No ft Water Service Line > 10' 0 Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' 0 Yes if No ft If absorption field is under driveway comment below Property Line> 10' 0 Yes if No ft Wells on Adjacent Lots: Water Main > 10' El Yes if No ft Private Wells > 100' El Yes if No ft Water Service Line> 10' DI Yes if No ft Community Wells> 200' 0 Yes if No ft Surface Water> 100' 0 Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION � OF Akoakki � I certify that I have determined through field inspections and review �)P. of Municipal records that the above systems are in conformance with ,*g'• •M N.1.--..•:v *9 MOA COSA guidelines in effect on this date. % /\ • •• * �0 r• Benja• chiller �Fc r •.. CE 12592 ....`4,E fi 4.9: 4/30/19 ,.t, Ag COSA Checklist yellow sheet �1�1 pRQFESS��14i PLAT NO. 73-3 KEMP SUBDIVISION LOT 1 59,878 S.F. TALISMAN ROAD 0 N 89°26'45"E 179.81' • 10' UTIL. ESMT. isits it t0 42.2' ' o• �a. C9 30.7' fkyS>j^ ofck s6o• 6Ur4OrNC rc °��°w ci rn t m o+ N O O Q m � O q In 3 C ORr_, 30' 8 62 a < Q o 0 • 0 z SEPTIC SYSTEu • 1 "=30' 30'ACCESS EASEMENT (MISC BK 214, PG 590) A.C. DRIVE 10' UTIL. ESMT. • N 89°24'47"E 199.88' • AS -BU I L T I HEREBY CERTIFY THAT I HAVE SURVEYED THE GASTALDI LAND PROPERTY DEPICTED ABOVE AND THAT NO ,n�)11•41 SURVEYING, LLC ENCROACHMENTS EXIST EXCEPT AS INDICATED. ** •OF.,41414.. IT IS THE RESPONSIBILITY OF THE OWNER TO • JEFF A. GASTALDI, R.L.S. DETERMINE THE EXISTENCE OF ANY EASEMENTS, P''•• s1�• 2000 E. DOw ING RD., SUITE 8 COVENANTS OR RESTRICTIONS WHICH DO NOT *•; 49TH •••.: *• ANCHORAGE, ALASKA 99507 APPEAR ON THE RECORDED SUBOMSION PLAT. � q. PHONE 248-5454 UNDER NO CIRCUMSTANCES SHOULD ANY DATA 0ro. ++jj a . de ay a devote, GRID DATE HEREON BE USED FOR CONSTRUCTION OR FOR ,; .��. 91 .. et ESTABLISHING BOUNDARY OR FENCE LINES. ♦ ......... 6°;4411P F.B. JOB NO. ANCHORAGE RECORDING DISTRICT, ALASKA •k �`s`�+::.• NOTE: NO CORNERS SET THIS DATE 06-05 L1KEMP Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON'SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 017-015-91 1. GENERAL INFORMATION Expiration Date: / ~ -..~. ~ -// Complete legal description KEMP LOT 1 Location (site address) 12801 PATRICK ROAD *ANCHORAGE, AK Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing. ad.al, tess DUNCAN BOSLEY Day phone 12801 PATRICK ROAD *ANCHORAGE, AK 763-444-1320 Day phone BILL BABYLON W/ PRUDENTIAL Day phone 3801 CENTERPOINT DRIVE *ANCHORAGE, AK 99503 351-4762 Unless otherwise '/~quested, COSA will be held by DSD for pickup. NUMBER OF 'BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well · Individual On-site · Individual Water Storage [] Individual Holding tank [] Community Class Well [] Community On-site [] Public Water System [] Public Sewer [] The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On-Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. STATEMENT OF' iNSPECTiON BY ENGINEER As cei'tified by my seal affb:ed hereto and as of the vafidation date shown be/ow, I verify that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guideiines for this application, sho~ 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 inform,,ation obtained from the Municipafity of Anchorage files and from .my investigafien 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 GARNESS ENGINEERING GROUP, Ltd. Address 5701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY AG GARNESS, P.E. Phone 357-6179 Date 9/~ ~ /II Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysi~ of the system in accordance with ADEC and MOA DOD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. DSD SIGNATURE ~"" Approved for 2 bedrooms. Disapproved. Conditional approval for · Pr, uuRAM - bedrooms, with the following stipulations: ~ /,',,,'7~NT SF___\t~'.,'.?" COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory (Rev. 11/05) Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report U'EP~eF Original Certificate Date: ~r_ ~. ~)..__ / / Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: WELL DATA Well type PRIVATE Date completed PRE Total depth *94+ ft. KEMP LOT 1 Parcel ID: 017-015-91 *PER GE(; FIELD MEASUREMENTS **WELL INSPECTED BY AWPS (SEE A'FFACHED MEMO). If A, B, or C provide PWSID# N/A Well Log (Y/N) 1970 Sanitary seal (Y/N) YES *'17 TO Cased to BEDROCK ft. YES Wires properly protected (Y/N) YES Casing height (above ground) 12+ in. FROM WELL LOG AT INSPECTION Date of test NO WELL LOG 9/9/11 Static water level / ft. 27 Well production / g.p.m. 5.55 g.p.m. Co WATER SAMPLE RESULTS: Coliform O colonies/100 mi. Arsenic: ~ O,?"~ ug./L. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Tank size 1000 gal. Number of Compartments 2 Foundation cleanout (Y/N) *NO Date of pumping 9/6/11 ABSORPTION FIELD DATA Date installed 10/1970 Length 22 ft. Total depth * 12.16 ft. Date of adequacy test Fluid depth in absorption field before test 83 in. Elapsed Time: 244- min. Final fluid depth 87 Any rejuvenation treatment (past 12 mo.) (YIN & type) Nitrate0, i')¢mg./L. Collected by: GEG, Ltd. Date of sample: 9/9/1 1 *2"CLEANOUT LOCATED BY STEVE PANNONE. P.E. INSIDE HOUSE ON WEST WALL, PER 10/11/06 COSA. Depression over tank (Y/N) NO Pumper I'BELOW EXISTING GRADEI Soil rating (g.p.d./ft2or~ 225 Width 2.5 ft. Eft. absorption area 810 ft2 Monitoring tube YES 9/9/11 Results (Pass/Fail) PASS Water added 600 gal. Date installed 10/1970 Cleanouts (Y/N) YES High water alarm (Y/N) N/A A+ HOME SERVICES System type SEEPAGE PIT Gravel below pipe 9 ft. Depression over field NO For 5 bedrooms New depth 94.5 in. __ in. AbsorPtion rate >= 450+ g.p.d. NONE KNOWN If yes, give date - D. LIFT STATION Date installed "Pump on" level at__ E= in. Size in gallons Manhole/Access ~ .__ "Pump off" leve~ High water alarm level at Cycles tested. Meets alarm & circuit requirements? SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: *50'+ Septic tank/lift station on lot Absorption field on lot 100'+ Public sewer main N/A Sewer/septic service line 25% Animal containment areas 50' + in. On adjacent lots. 100'+ On adjacent lots 100'+ Public sewer manhole/cleanout Holding tank N/A Manure/animal excrete storage areas N,/A 100'+ F= SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main N/A Water service line 10'+ Surface water 100'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Water service line 10'+ Curtain drain NONE COMMENTS *ACCEPTABLE PER 1970 Building foundation. 10'+ Water main N/A Surface water 100'+ Driveway, parking/vehicle storage KNOWN Wells on adjacent lots 100'+ CODES. WELL WAS EXISTING IN 1970 PER INSPECTION REPORT. 10'+ G. ENGINEER'S CERTIFICATION I certify that I 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 JEFFREY A. GARNESS Date ~/ l~ /Ii COSA Fee $ Date of Payment Receipt Number (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number SGS Reft# 1114367001 Client Name Garness Engineering Group, Ltd Printed Date/Time 09/15/2011 16:15 Project Name/# Kemp Lot 1 Collected Date/Time 09/09/2011 13:49 Client Sample ID Kemp Lot I Received Date/Time 09/09/2011 15:10 Matrix Drinking Water Technical Director Stel~hen C. Ede Sample Remarks: Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Metals by ICP/MS Arsenic 10.7 * 5.00 ug/L EP200.8 C (<10) 09/13/11 09/15/11 NRB Waters Department Total Nitrate/Nitrite-N 0.194 0.100 mg/L SM20 4500NO3-F B (<10) 09/12/11 AYC Microbiology Laboratory E. Coli Negative I 100mk SM20 9223B A 09/09/11 CR Total Coliform Nezative I 100mL SM20 9223B A 09/09/11 CR Municipality of Anchorage Community Development Department Development Services Division On-Site Water and Wastewater Program 4700 Elmore Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 Arsenic Advisory Certificate of On-Site Systems Approval # 111349 A Certificate of On-Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Block , Lot 1 of Kemp Subdivision. This inspection revealed an arsenic concentration of 10.7 micrograms per liter (ug/L) for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of 10.0 ug/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Information on arsenic is available from the On-Site Water and Wastewater Program website (www.muni.org/onsite) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On- Site Systems Approval. ARCTIC PUMP & WELL INC. PO Box 770197 Eagle River, AK 99577 (907) 688-2510 (907) 258-2510 (907) 745-2510 apw~2,;~ci.net Pump Installation Log Well Drilling Permit Number: SW Date of Issue: Parcel Identification Number: Legal Description:Kemp Lot: 1 Block: Property Owner Name & Address: Duncan Bosley 20171 Eidelweiss St Nw C'~rl~r bANI ~qfll 1 Pump Installation Date: 9/15/2011 Pump Intake Depth Below Top of Well Casing: Feet Pump Manufacturer's Name: Dempster Pump Model: Pump Size: hp Pitless Adapter Burial Depth:3 feet Pitless Adapter Manufacturer's Name: Martinson Pitless Adapter Installer: U/K Well Disinfected Upon Completion? Yes Method of Disinfection: Chlorine Comments: Well casing set into bedrock at 17' no water intrusion above 40' Pump Installer Name: Arctic Pump & Well, Inc. ~4rctic Pump & Well, Inc. Page 1 of/ Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Bragaw Street Anchorage, AK 99519-6650 www. muni.org/onsite (907) 343-79O4 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 1. GENERAL INFORMATION Complete legal description Lot 1 Kemp S/D Location (site address) 12801 Patrick Road, Anchoraqe, AK 99516 COSA# 0 Expiration Date: I ~ ~',~ Io'~- Current Property owner(s) Mary Woodward Mailing address P.O. Box 111906, Anchoraqe, AK 9951 Lending agency Day phone Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well [] Individual Water Storage [] Community Class Well [] Public Water System [] TYPE OF WASTEWATER DISPOSAL: Individual On-site [] Individual Holding Tank [] Community On-site [] Public Sewer [] The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On-Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On-Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with vaIid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for eh'ors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I vedfy 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(am) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Pannone Enqineerinq Se~ces, LLC Phone 272-8218 Address P.O. Box 102954, Anchoraqe, AK99510 Engineer's Printed Name .G. Scott Crowther, P,E. Date /4, Engineers Comments: In conducting an ad~u~--'j tost, I sncmpt to provide a thorough, conscientious engineering analysis of thc system in accorda~ee with MOA DSD Guidelines & Regulations. The reportcd results describe thc pert'orma~ce of thc system under thc conditions encountered at thc time ortho test, and separation distances measured to readily idcntifiable features, Thc operational life of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during thc year, and thc water usage of thc family be?g' sen, cd by thc system. These cond~bons' ' arc outside' thc control ortho cvaluator of this system. All. s/stems cventuall¥:~.~nd satis factopj lest results do not guarantee futuro performance of thc system, nor do they guarantee that them arc no.~n encroachments. PES can therefore not provide any warranty for future pe~l'ormanee nor glvc any estimate ofh~ continue to meet the operational reqmrements of the MOA DSD. The content ofth:s report is for thc sole be~,'~.~c owner Any reliance upon or use oflhis report by any other person or part7 Is not euthori?~.d nor will it confer any~$,l,l ~'~h t whatso~$~'.7' Approved[or bedrooms. Disapproved. . 1~ ~,_\ o. scott Cond,t,onal approval for bedrooms, with the following st'~~~.~ ,_ · .... ...' Attachments: COSA Checklist Septic System Advisory Well Flow Advisor7 Nitrate Advisory X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Date: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onaite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Lot t Kemp ParcellD: O1'~- OI3-~1 A. WELL DATA Well type _P. If A, B, or C provide PWSID # Date completed u/~l~d Sanitary _=e-_! (Y/N) ! Total depth 330 ft. Cased to 4~ ft. FROM WELL LOG Well Log (Y/N) N p opeW prot (Y/N) Casing height (above ground) ~:~e in;, AT INSPECTION Static water level J ft. ! ~ ft. Well production ~ g.p.m. ~,:) g.p.m WATER SAMPLE RESULTS: Coliform '-O '" colonies/100 mL ' Nitrate ,A,/T~ mg/L Other bacteria.-- O ~colonies/100 mL Arsenic: /~.~1' mga Date of sample: ~/Z~o /= Collected by: ~ I?-13 B. SEPTIC/HOLDING TANK DATA Tank Type/Material Gr~'Avnrov~J Steel Date installed t0/ZJ/'lg70 Tank size t000 gal. Number of Compartments 1_ Cleanouts (Y/N) Y FoundaBor~ cleano,.ut~.~.Y~/N.)__.____~"_=...,Deprassicn over.,k (Y/N)N High~a~r alarm (y/N)N/A Date of pumping ~/'~ Pumper C. ABSORPTION FIELD DATA Date installed t9123/t970 Soil rating (g.p.d./fl2 or ft3/bdrm) 225 System type Length ~ ft. Width Z;) ft Gravel below pipe ~1 ff. Totel depth tla3 ff. Eft. abeorpflon area I~11) ~ Monitoring tube Y DeDressidn over field N Date of adequacy test ~)/2006 Results (Pass/Fail) PIqt For_3 bedrooms Fluid depth in absoq3flon field before test 64 in. Water added ~'J0 gal. New depth69 in. Elapsed Time: t260 min. Final fluid depth 65 in. Absorption rate >= ~ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N9 If yes, give date D. UFT STATION Date installed V~/'[ ~:~ Size in gallons ~ (Y/N) "Pump on' level at ~.~1 at in. High water alarm level at Datum ./...,-'~ Cycles tested Meets alarm & circuit rsquiremerds? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Se~c ten~,t station on lot ~1' Absorption field on lot 11~) Public sewer main Sewer Iseptic eewice line ~ Animal containment areas On adjacent lots 11~)+ On adjacent lots Public sewer manhole/cieanout Holding lank Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation t~+ Pmpen'y line 1~ Water main ~ Water sewice line 25+ Wells on adjacent lots 11)0+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: absomtion fle~ Surface water Property line Water Service line Curtain drain F, COMMENTS Building foundation Sun'ace water Wells on adjacent lots Water main ~ Driveway, panVJngNehid® st~age t1~. G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspec~ons and review of Municipal tecon~ that the above systems are in conformance with MOA C08A guidelines in effect on this date. Engineer's Printecl Name G. Scott Cn:,~ef, p.~, Date cos Fee $4f I (~. 1~) Waiver Fee $ Date of Payment Receipt Number Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 w~wv.muni.org/onsite (907) 343-7904 Arsenic Advisory, Certificate of On-Site Systems Approval # 060519 A Certificate of On-Site Systems Approval inspection and test of potable water was recently conducted on the well water supply on Lot I of Kemp Subdivision. This inspection revealed an arsenic concentration of 16.9 micrograms per liter (ug/L) for the property's well water sample. The Environmental Protection Agency (EPA) has established a maximum contaminant level (MCL) of I0.0 ug/L for public drinking water systems. While private wells are not subject to this regulation, EPA standards are based on existing health information and can therefore be used to gauge the relative quality of water from private wells. Information on arsenic is available from the On-Site Water and Wastewater Program website (www.muni.org/onsite) or at 343-7904. This advisory must be attached to all copies of the subject Certificate of On- Site Systems Approval. SGS Ref.# 1065782001 Client Name Pannone Eng. Srv. Project Name/# Lot l Kemp Client Sample ID Lot I Kemp Matrix Drinking Water All Date~/Tlmes are Alaska Standard Time Printed Date/Time 10/12/2006 12:36 Collected Dateffime 09/25/2006 16:00 Received Datefrime 09/26/2006 11:45 Technical Director Stephen C. £de Sample Remarks: Metals b~ ICP/MS A~ic 16.9 * $.00 ug/L EP200.$ C (<10) 09/28'06 10/11/06 TIC Wa~ers Department Nitrate-N ND 0.100 mg/L EPA 353.2 B (<10) 09/26/06 ALR lq~ crobiolo~ Imborator~ TotalColiform 0 col/lOOmL SM209222B A (<1) 09/26/06 TLF Environmental Consulting and Design SEPTIC SYSTEM ADEQUACY TEST LEGAL: LOCATION: OWNER: RESIDENCE: WELL: SEPTIC SYSTEM: Lot I Kemp S/D 12891 Patrick Road Mar~ Woodward-Eddy Single Family,Three Bedrooms On Site Single Family FROM MUlqlCIPAL RECORDS: 3 Bedroom System TANK: ABSORPTION SYSTEM: ABSORPTION AREA: SOIL RATING: INSTALLATION DATE: WAIVERS GRANTED: Steel Tank, One Compartment. Crib gl0 Sq. Ft. Unknown 10/23/I 970 None Required DATE OF LAST PUMPING: issac's Pumping DATE OF TEST: June 20t~ , 2006 TEST PROCEDURE: The septic tank was located and measured. After lank clean outs and a trench monitor were located. The ~'ench monitor was 12.5 feet deep and contained 64 inches ofliquld. Four handred seventy gallons of clean water was added to the system while the liquid levels in the tank and the trench were monitored. The water level rose 5 inches in the trench monitor and remained constant in the tank. After 21 hours the liquid level in the trench had dropped 4 inches, indicating that the system is capable of absorbing over 600 gallons per day. TEST RESULT: This system meets the code requirements of the ttealth and Social Services Department of the Municipality of Anchorage. NOTE: The operational life of all septic systems depends on the local soil conditions, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this septic system. We can therefore not give any estimate of how long this system will function satisfactorily for current or furore occupants. All septic systems ultimately fail. Some systems last 15-20 yearn, others fall after less than five years. 203 West 15t~ Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (907) 276-6013, SpurklandEng~gci.net Environmental Consulting and Design RESIDENTIAL WELL INSPECTION LEGAL: OWNER: LOCATION: Lot 1 Kemp S/D Mary Woodward-Eddy 12801 Patrick Road TYPE OF WELL: WELL LOG AVAILABLE: INSTALLATION REQUIREMENTS MET: WAIVERS GIL~NTED: WELL YIELD FROM WELL LOG: WELL YIELD FROM TEST: Private, Single Family No NO None Unknown 6.3 Gallons per Minute DATE OF INSPECTION: 6/30/06 TEST PROCEDURE: The well was pumped at a constant rate. At pumping rate of 6.3 gallons per minute a total of 470 gallons was pumped. TEST FOR E.COLI AND TOTAL NITROGEN: Well was tested for E.Coli, total nitrogen, and Arsenic on June 26~, 2006. RESULTS: E.Coll. 0 Other Bacteria 0 Total Nitrate-N 1.44 mg/I Arsenic 14.1 ug/I. Max. allowable Total Nitrate-N 10 mg/I. 10 Colonies of Bacteria Allowed ND- None Detected TEST RESULTS: Municipal code does not allow well pits. The well head must be upgraded to conform with current code. Aarrow Pump & Well has been contacted to perform the required work. An arsenic content of 14.1 ug/l was determined. This is above the current EPA limit (5 ug/1). When a COSA approval is issued an arsenic advisory will accompany it. Tills WELL WII,L PRODUCE MORE TIIAN 3 GALLONS PER bllNIrrE FOR MORE TtIAN FOUR tlOIJRS The Municipal requirement for well flow is 150 gallons of water per bedroom per day. This well exceeds this requirement. The assessment of the condition of the well applies only to the conditions as of the day tested. The flow rate may change due to subsurface conditions that may not be observed from the surface, and changes in the land use and other factors that may impact the aquifer feeding the well. 203 West 15tb Avenue Suite 203, Anchorage, AK 99501, Phone: {907) 279-3916 Fax: (907) 276-6013, SpurklandEng~gci.net 73-3 KEMP SUBDIVISION LOT 1 59,878 S.F. m TALISMAN ROAD ~.¢.00' N 8g'26'45"E 179.81' 30' 1"=30' 42..2' 30.7' ~0" ACCESS EASEMENT (MISC BK 214. PG 590) A.C. DRIVE 10' U'nL. ESUT. N 89'24'47"E 199.88' A S- B U I L T , .~ cmn' MT, ..v~ su.v~_~ ~CRO~HW~ ~1~ ~C~ ~ INDI~. SURVEYING, LLC ff ISSUE R~NSIBI~ OF ~E OWN~ TO 4726 ~ 88~ A~uE C~ OR R~I~NS ~H ~ ~T ~CHO~G~ ~ 99502 ~P~ ON ~E RECORD~ SUBDMSION P~T, PHONE 2~-5454 UNDER NO CI~UM~C~ SHOU~ ~ DATA CEID DA~ H~EON BE ~ ~R ~N~;~U~N OR ~R 28~ 5/15/2006 ~USHING ~UN~ OR ~E UN~, ~CHO~GE RECORDING DI~I~, ~ RD. JOB NO, 06-05 L1K~P N~ NO ~RN~S S~ ~IS ~