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HomeMy WebLinkAboutHEMLOCK LT 2Onsite File Hemlock Lot 2 #075-031-26 Municipality of Anchorage 0 CTVT2-019 On -Site Water and Wastewater Program • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP191402 PID Number: 075-031-26 Dwelling: W Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New ❑■ Upgrade Name: Robert & Virginia Bursiel ABSORPTION FIELD ❑ Deep Trench El Shallow Trench ❑Bed ❑Mound Address P.O. Box 484, Girdwood, AK 99587 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 441-8125 2 Existing Trench GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot Hemlock 2 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 Ft. Well *90' *86' N/A N/A >25' TANK ❑E Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Greer Capacity 1,000 Gal. Surface Water >100' >100' N/A N/A Material Number of compartments Lot Line >5' >10' N/A N/A Plastic 2 NA Foundation >10' >10' N/A N/A LIFT STATION Manufacturer Capacity Curtain Drain None Noted Gal. Remarks *See well waiver for wells on this lot Pump on level at in. Pump off level at in. High water alarm at in. & adjacent lot. Inlet & outlet of tank are sealed w/ bentonite. (Tank serial # 2920) Pump make and model Electrical Inspections performed by Tank only replaced under this permit. PIPE MATERIAL House to tank D3034 Tank to drainfield D3034 Installer Wilco Contractors Drainfield D3034 CO/MT Inspector J. Williams BENCH MARK (Assumed elevation) 100 ft Inspection 15 9/20/19 ntl Location and description 2 3rd 41h Garage slab. COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp Conditional Approval: Date ��'�P°'�F°°°'�� ffi= G9th ............... I... u u n....................... MICHAEL E. ANDERSON S r� No. CE -4381 10/3/19 �4�QPROF1 �5Ap inspection Repori_y- i - iz.00c HEMLOCK, LOT 2 PERMIT # OSP191402 PID # 075-031-26 i :t EXISTING WELL 1 t t 1 1 00'WELL RADII !j i1 1 1' LOT 1 85' WELL RADIUS 1,000 GALLON P STIC Z SEPTIC TANK W/20" M NWAY LOT 2 O NORTH CORNER OF P� TRENCH LOCATED. CO INSTALLED TO jj A y DELINEATE THE MH EXISTING WELL TRENCH LOCATION. C SV ® z-gpRMyOMg 0.MT o B FOUR SEASONS CHALETS LOT 4 EXISTING WELL \ 1 f � / f 85' WELL RADIUS 100WELL RADIUS 1 ENGINEEAtNC �\ F n MICHAEL E. ANDERSON '• No. CE -4381 f�°'•... 9125119• o•,••••� �'®.pnOFESS\�"" ` '1 50 100 lismm m 00 FEET A 2C01 24.5 15.7 MH 29.1 19.9 SV 34.4 23.8 2CO2 36.4 25.4 MT 33.8 21.4 CO 43.1 33.3 LEGEND CO - CLEANOUT 2CO- DOUBLE CLEANOUT FCO- FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT- MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE HEMLOCK, LOT 2 PERMIT# OSP1 91402 PID # 075-031-26 VV.lj PROFILE AS -BUILT (NO SCALE) 4.6 OF............ th MICHAEL E. ANDERSON No. CE -4381 9125/19 wol.fRO-FFSS 01 i Muni o aho s»cnt S cys ®f Anchorage Department P.O. Box 196650 G 4700 Elmore Road Anchorage, Alaska 99519-6650 ® (907) 343-7904 ® Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program X X X* VARIANCE/WAIVER REVIEW x x x x Waiver#: OSV191086 COSA#: PID#: 075-031-26 Legal Description: Hemlock Lt 2 Engineer: Forge engineerinq Permit#: OSP191402 Your request for a waiver of the required 100 feet horizontal separation from the absorption field and septic tank to a private well has been approved. The approved separation distance is 86 feet from the field to the well on Four Seasons Chalet Lt 4 and 90 feet from the tank to the well on the lot. This waiver approval applies to the existing absorption field and septic tank only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. Z 0 E R x t t t .... t■■■ ..... t ... t .... t. x f x ...... ■ H t. t t\.■ x .. 0 2 t .. ■■■\ a 9 x x E t .. ■ t Waiver is Granted: X Waiver is not Granted: Date: Approved by: Name of Review ■ .. x x t ..... t .... t ...... ■ 1■■ t. t t .... t t. f. t a a Z t t t .. t ... t 9 ■ .................. 1 **** VARIAN C E/WAIVER REVIEW **** October 11, 2019 MOA Development Services Department On -Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Hemlock Subdivision, Lot 2 — 507 Crow Creels Road Well to Absorption Trench Waiver Dear On -Site Services Engineer: The existing absorption trench on Lot 2, Hemlock Subdivision is located 86' from the existing well on Lot 4, Four Seasons Chalets Subdivision at its closest point. The absorption trench was originally constructed in 1978 and has been in constant operation since that time. The well on Lot 4, Four Seasons Chalet Subdivision was placed in 1972. A waiver is therefore required to allow the absorption trench on Lot 2 to remain in its constructed location less than 100' from the well. The absorption trench is constructed in soils consisting of well graded gravel to approximately 10' underlain by dense silt. The trench is down slope from the existing well with drainage to the northeast toward Crow Creek. Septic effluent that might surface from the trench would flow away from the well. The surface grade is more than 10% away from the well. Surface effluent contamination of the well is virtually impossible from the absorption trench. No log is available for the well on Lot 4 or the adjacent Lot 2A. We assume the well would be similar to Lot 2, Hemlock Subdivision which indicates a depth of 61' deep and the static water level of 20' below the surface. The log for the well further indicates a lense of blue clay and silty hardpan from 5' to 25' below the surface. This lense is typically impermeable. We are confident based on the aforementioned characteristics of the lot surface along with the well construction through clay and hardpan that the reduction in the protective radius of the well to 86' will not impact the quality of water from the water system. A water sample was recently taken from the well and indicated nitrate content of .706 milligrams per liter which would indicate the well is not influenced or contaminated by the absorption trench on Lot 2, Hemlock Subdivision. ADEC POINT ANALYSIS Bottom of Absorption Trench to Highest Water Table — 20' 2.4 Points Soil Absorption Type — Clay and Sand Equal 4.5 Points Permeability — Silt or Sandy Clay Water Table Gradient - +10% Horizontal Separation — 86' TOTAL POINTS 2.0 Points 6.0 Points 2.4 Points Almost sure to be free from any form of contamination from household sewage. Sincerely, Michael E. Anderson, P.E. 17.3 OF a 49th a: MICHAEL E. ANDERSON 4 No CE -4381 ��©FESS � October 3, 2019 MOA Development Services Department On -Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Hemlock Subdivision, Lot 2 — 507 Crow Creels Road Well to Septic Tank Waiver Dear On -Site Services Engineer: The existing septic tank on Lot 2, Hemlock Subdivision was located 85' from the existing well on the lot at its closest point. The septic tank and well were originally constructed in 1978 and were been in constant operation since that time. The septic tank was more than 35 years old and at the end of its useful life and was replaced. The new septic tank was placed close to the location of the old tank because insufficient fall was available from the house to the tank and the existing absorption trench was too close to allow 100' separation from the well. A waiver is therefore required to allow the septic tank to remain in its constructed location less than 100' from the well. The new septic tank is constructed out of high density polyethylene with an unlimited useful life and is located slightly down slope from the existing well. Septic effluent that might surface from the tank would flow away from the well. The surface grade is 0% to 5% away from the well. Surface effluent contamination of the well is virtually impossible from the septic tank. Underlying soils on the lot are silty sand with gravel based on test holes completed in the past. The log for the well on the lot indicates a depth of 61' deep and the static water level has been measured at 20' below the surface. The log further indicates a lense of blue clay and silty hardpan from 5' to 25' below the surface. This Tense is typically impermeable. We are confident based on the use of the plastic septic tank and the aforementioned characteristics of the lot surface along with the well construction through clay and hardpan that the reduction in the protective radius of the well to 90' will not impact the quality of water from the water system. A water sample was recently taken from the well and indicated results in conformance with Municipal Code. ADEC POINT ANALYSIS Bottom of Absorption Bed to Highest Water Table — 20' 2.4 Points Soil Absorption Type — Clay and Sand Equal 4.5 Points Permeability — Silt or Sandy Clay Water Table Gradient - +5% Horizontal Separation — 90' TOTAL POINTS 2.0 Points 4.5 Points 2.6 Points Almost sure to be free from any form of contamination from household sewage. Sincerely, Michael E. Anderson, P.E. 16.0 49th MICHAEL E. ANDERSON No. CE -4381 ,•' `� p •.e .10-03..... c�r� ( ®� W ^1 s��ors E 149-3p• Lot 4 FOUR SEAESONS CHALETS 0 V/ CLQ ^C• /�,1� 1ap i V� •'4 Row • • 49 T er y . Hurst ����9�c4•l •�!r! jb'9+*W� tour 0 20 40 FfSSI0NA1 USSURVEY � FEET NOTES -All dimensions shown are grid bearings and. ground distances, Record boundaries are per Plat No. 78-127. -49th Star has conducted a physical survey of the property and all details shown on this Asbuilt Survey are correct. Under no circumstances should any data hereon be used for construction or for establishment of property lines. -It is the owners responsibility to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. AS BUILT SURVEY LEGEND 49th Star Surveying LLC Lot 2, (V New Septic Tank 0 New Clean out 321 Fireoved Drive Hemlock Subdivision, CP Septic Field vent Anchorage, AK 99508 Lots 1&2 Power Pole O Well (907)891-6111 ' Z�s Tele -comm Pedestal Jeremy@49thStarSurveying.com Girdwood, AK OHF W.O. 19028 DATE: 09%23/19 Overhead Utility Line SCALE: 1"=40' " P oMUNICIPALITY OF ANCHORAGE 0enr ,,,,,,•t,,,",,,,,,,,..... • \\ On-Site Water&Wastewater Program �0,,-"t : r0, .! 196650 4700 Elmore Road PO Box ! 41 } r; Anchorage,Alaska 99519-6650.. Phone:(907)343-7904 Fax (907)343-7997 `' r• I , http://www,muni.org/onsite ;Y �• 'y: E C.S q E .-j r 4 apartment 4,...-i7-10 f.';‘;`" On-Site Wastewater Disposal System Permit Permit Number: OSP191402 Effective Date: 9/11/2019 Work Type: SepticTank Upgrade Expiration Date: 9/10/2020 Tax Code Number: 07503126000 Site Legal Address: HEMLOCK LT 2 G:4715 Site Mailing Address: 507 CROW CREEK RD, Girdwood Owner: BURSIEL VIRGINIA C&ROBERT F Lot Size in Sq Ft: 15975 Design Engineer: FORGE ENGINEERING Total Bedrooms: 2 This permit is for the construction of: ❑ Disposal Field ® 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 Cpecial Provisions: or to Inspection Report approval, a waiver for the septic to the neighbors well must be approved. or to Inspection Report approval,the well must have a Letter of Non-objection from the ROW department. e north corner of the dogleg is to be located in the field to ensure that the 5'tank to field separation will be ease install a monitor tube in the north corner of the existing trench when located to delineate its location. Received By: 04i4ttai rt l J/i/1- Date: q i i r P Issued By: Akifirc..---- Date: 0 (• EPLIW MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On-Site Water& Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 075-031-26 Property owner(s) Robert & Virginia Bursiel Day phone 441-8125 Mailing address P.O. Box 484 Girdwood, AK 99587 Site address 507 Crow Creek Road Girdwood, AK Legal description (Sub'd., Block & Lot) Hemlock, Lot 2 Legal description (Township, Range & Section) Lot Size 15,975 Sq. Ft. Number of Bedrooms Two APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (®all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) C (w/wo ADU) Septic Tank X Upgrade ❑x Duplex (D) [ Holding Tank ❑ Renewal ❑ Multiple Dwellings _ Privy [ (SF and/or D) Private Well ❑ Water Storage n 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. - 1, -SL, Q. a (Signature of property owner or authorized agent) Permit/Rush Fees: 025— Waiver Fees: Date of Payment: 9 1(7!19 Date of Payment: Receipt Number: C 3loc/q0 Receipt Number: Permit No. 0P19 1q62 Waiver No. Permit App_.;-:•::. c PO BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) September 11, 2019 Municipality of Anchorage Development Services Department On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Hemlock, Lot 2 – 507 Crow Creek Road Septic System Design and Permit Application Dear On-Site Services Engineer: The septic tank on the subject lot has exceeded its useful life and must be replaced before a COSA can be issued on the property. The attached site plan identifies the location of the home and the proposed and existing septic tank location. The existing well on the lot is also shown. No conflicts exist between this proposed septic tank and any other well or septic system, whether on this lot or adjacent lots. The existing absorption trench is partially within the protective well radius the lot to the south. A waiver request will be submitted with the inspection report once the exact location is known. The new septic tank will be a minimum of 100’ from all private wells and surface water and more than 10’ from the house foundation and 5’ from deck/stair supports. The trench will be located prior to construction to verify a minimum of 5’ separation from the new septic tank. 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, Michael E. Anderson, PE 9/11/19 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191402, Deb Wockenfuss, 09/11/19 2CO 10050 0 FEET 1"=50' 2-BDRM HOME DECOMMISSION EXISTING SEPTIC TANK PER MOA CODE. NOTE: NO SLOPES >25% WITHIN 50' OR SURFACE WATER WITHIN 100' OF THE PROPOSED SEPTIC SYSTEM ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC SYSTEMS. CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND HEMLOCK, LOT 2 CROW CREEK ROAD9/11/19 20' UTILITY EASEMENT1,000 GALLON SEPTIC TANK w/20" MANWAY OUTSIDE 100' RADIUS. LOCATE TRENCH TO VERIFY 5' SEPARATION FROM SEPTIC TANK. 2CO SV MH CONNECT TO EXISTING ABSORPTION TRENCH. EXISTING WELL EXISTING WELL EXISTING WELL Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP191402, Deb Wockenfuss, 09/11/19 ® r ' 1 r r Lot 1 S 8739'43'W 123.70' 1 30.00. CO Cr a rr C IL(o) t� 2 1. I� 0 o a w 0 1 w r� 0 O 32.1 r 133 01 U 2 -story CP (House ry U CP C. 1 ',try U `Dee 1 ` to 7700 a° D otic 11 $6" 149-30, Lot 4 FOUR SEAESONS CHALETS T low i �e OFA \t1 R 00 w AW T myA.Hurst • 1796 •a 119th'N Star0 za 40 US SURVEY 1 \ FEET NOTES -All dimensions shown are grid bearings and ground distances, Record boundaries are per Plat No, 78-127. -49th Star has conducted a physical survey of the property and all details shown on this Asbualt Survey are correct. Under no circumstances should any data hereon be used for construction or for establishment of property lines. -It is the owners responsibility to determine the existence of any casements, covenants, or restrictions which do not appear on the recorded subdivision plat. AS BUILT SURVEY LEGEND 49th Star Surveying 1.. Lot 2, ® clean out 321 Fireoved Drive Hemlock Subdivision, CP Septic system vent Anchorage, AK 99508 Lots 1&2, Power Pole O Well (907)891-6111 Jeremy@49th Sta rSu rvey i ng.com T� � Tele -comm Pedestal Girdwood, AK CHE W -O. 19028 DATE: 08/26/19 Overhead Utility Line SCALE: 1---40- GRE,-,fER ANCHORAGE AREA BOkdUGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: D I ST,~ ~:.~,~ :d,,::.//:~,. i FRO~ WELL /~" INSIDE LENGTH MANUFACTURER '~: ~'~ ¢' 4'/~¢ INSIDE WIDTH MATERIAL NUMBER OF ~,~ COMPARTMENTS LIQUID DEPTH LIQUID CAPACITY /¢-¢-dGALLONS. '['. LLB-DRA]4'4-Ft-E~L D: DISTANCE FROM WELL -/~:¢ '~ FOUNDATION !) NUMBER OF LINES ¢-~,, DISTANCE BETWEEN LINES ABSORPTION AREA ~3 r~"" ¢ SQ. FT. LENGTH OF EACH LINE DEPTH OF FILTER DEPTH: TOP OF TILE TO FINISH GRADE · TOTAL LENGT~I~ ,,- NEAREST LOT LINE / ~) OF LINES TRENCH WIDTH .~i IN. TOTAL EFFECTIVE MATERIAL BENEATH TILE____IN. ABOVE TILE IN. WELL: TYPE _ BUILDING FOUNDATION__ CESSPOOL APPROVED CONSTRUCTION NEAREST NEAREST LOT LINE__ SEWER LINE__ OTHER SOURCES DISAPPROVED DEPTH SEPTIC SEEPAGE TANK._ SYSTEM REMARKS DISTANCE FROM: DISTANCES: INSTALLED BY: SEWER LINE DEPTH: LOT SLOPE: REMARKS: DIAGRAM OF SYSTEM DATE :;' APPROVED /'l ?? G.A.A.B. SEWAGE GREJ ER ANCHORAGE AREA BO[ .,,UGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C' STREET ANCHORAGE, ALASKA 9950:3 TELEPHONE 274-'I 56 ! DISPOSAL SYSTEM ?-~ APPLICATION AND PERMIT NAME OF APPLICANT INSTALLATION LOCATION ~ ~ 0 t"'/~-~ ~;~ ~ 't~ /~'C DESCRIPTION ~ INSTALLATION OF: SEPTIC TANK ~: SEEPAGE Pit TYPE AND S~ZE OF FACILiTY TO BESErVED ~ ~/~ FINANCED THROUGH DRAIN FIELD SOIL TEST RESULTS . OTHER NOT. E; THIB PERMIT IS. NOT VALID WITHOUT SOIL TEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING 'OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEEPAGE Area SIZE TYPE DIAGRAM OF SYSTEM MINIMUM DISTANCES, REQUIREMENTS FOUNDAT;ON TO SEPTIC TANK FOUNDATION TO SEEPAGE P~T DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK , SEEPAGE PIT .. D[~AIN FIELD TO NEAREST LOT LINE. WELL TO SEPTIC TANK SEEPAGE Pit DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK , SEEPAGE PIT DRAIN FIELD SEPTIC TANK, , SEEPAGE Pit . DRAIN FIELD . TO RIVER, LAKE. STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH F;~EGULATIONS REGARDING INSTALLATION. I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GRE DESCRIBED SYSTEM IS IN ACCORDANCE W~TH SAiD CODE. 3UGH ORDINANCE NO. 28-68 AND THAT THE ABOVE March 7th Joe Blair, Manager Environmental Services MuniciPality of Auchorage Dear Mr. Blair: Please consider this an application for a water and sewer ermit for a new residence of my~l~ot in Gird-~ P 0 ~' wood. My lot is described as Lot 49~ ~Surve~_3~5 and consistsoof 2.48 acres. A~b~'~ ~~ ~sz~=0~' ~ present residence in purple; the proposed residence in yellow; the ex~sting and proposed sewer systems in red and the existing and proposed wells in green. The nearemt neighbor well, on lot 48, is also shown and is approximately !75 feet from the excavation for sewer installation. The creek is 375' from the septic tank site. The proposed well is 78' from the septic tank. My installations will meet standards set by the Mun- icipality of Anchorage. According to the United Soil Classification System, the log of ~urficial material encountered on excavation for installation of one con- crete ring leaching system is below: Pt- 0.0' to 0.5' organic; live moss, peat SM- 0.5' to 1.2'silty sand; mostly non-~lastic brown and gray GW- 1.2' to 10.5' gravel; well graded, sub- rounded to sub angular, max. size 16" (greywacke subrounded boulder) water seep 10.5' CL- 10.5' to 12.0' inorganic clay One concrete cri~ with lid will be installed 4½ feet above water seep. My rating is 170'sq ft of drainage based on two bedrooms and GW soil. The disturbed GW gravel will provide 284 sq ft of absorption, however, well graded gravel (undisturbed) continue~ throughout the lot. The water well proposed will be 8" cased and will probably develope sufficient production between 60 and 85 feet. Although this developement is now a second dwelling on lot 49 my plans are to subdivide off a lot containing approximately 10,000 sq feet, shown shaded grey. Your consideration on the approval of the sewer and water permit is appreciated. erely $~ i~,!:(N!P!L!h! D i?T'f:JNE:E BETHEEN ~::'~ i4ELJ.. RN[) FIN'-/ ON.-.,E;;ZTE :~;ENRGE D~;:~;F'OE;F~L ¢~;'?':~7'f'E?~ i:5 j. Eii3 FEE'F F:'O?, R F'RiVRTE HEi..L..; O~': THE !,!EL...I.. E:E~fdPL.ETiON, RVR l L.RBLE TO I i'.,P.~;UFUE F:'ROPE:[;?. i Nf~;TF!LLRTZ DRILLING, INC. Well Owner_ Bob Bursiel DRILLING LOG Location (address of: Township, Range, Section, if known; or distance mmn Lot 49 of U.S. Survey 3045, Girdwood, Alaska .Use of Well Dom. road Size of casing_ 6" Depth of Hole Static water level 20 ft. (a,Y~ Screen ( ); Perforated ( Describe screen or perforation n/a Well pumping test at 15 gallons per of drawdown from static level. Date of completion 5/18/78 61 feet Cased to 60.5 feet (below) land surface. Finish of well (check one) ). open end ( xx ); (minute) for 1 hours with 100% x~. WELL LOG Depth in feet from ground surface Give details of formations penetrated, size of material, color and hardness 0 TO 2 Casing stickup 2 TO 3 Organics 3 TO 5 5 TO. 15 15 TO 25 25 TO 43 43 TO 54 54 TO 61 TO TO_ TO. TO __TO TO. TO. Damp gravel Blue clay Silty hard pan Silty cobbles Loose gravel Sandy water grmvm] N\VWA ~rl.~ficd Contractor Ccrlfficate No's. 814 ~ 975 1 -- CUSTOMER MUNICIPALITY OF ANCHORAGE 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. 075-031-26 1. GENERAL INFORMATION Complete legal description Hemlock, Lot 2 Expiration Date: -jo- lel ,,u, -i ) I , d o) c) Location (site address) 507 Crow Creek Road Girdwood, AK Current property owner(s) Robert & Virginia BUrsiel Day phone Mailing address P.O. Box 484 Girdwood, AK 99587 Real estate agent Rebecca Reichlin 2. TYPE OF DWELLING: Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 441-8125 3. NUMBER OF BEDROOMS: 2 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic 0 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 $ CJ 0. DD Waiver Fee $ Date of Payment [ 0 ! ( rJ l M11 Date of Payment Receipt Number 0 9-5 0 ZQ Receipt Number COSA # 6SCj1q1q0[q Waiver # JN �;A aot//-L 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm Forge Engineering Phone 907-522-7773 Address 1399 W. 34th Ave Suite 101, Anchorage AK 99503 Engineer's Printed Name Michael E. Anderson, P.E. Date 10715/19 6. DSD SIGNATURE SIGNATURE �f System #1 Approved for a bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the following stipulations: J r� J C� J LAS` JJ f J/ lllllll(((((((((( ON-SITE WAI ER ANE) qASZe`WATER o� PROGRAM UZ By: PACO'n, LA, let U cr\ E6 6AQ1 Original Certificate Date: 10 h 1 � -I C- V 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 Checklist blue sheet Legal Description: Hemlock, Lot 2 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 5/18/78 Total depth 61 ft Cased to 60.5 ft WE Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 25 in. Date of flow test for COSA 8/21/19 Static water level at beginning of test 51.7 ft. Comments B. TANK DATA Age of tank(s) .08 years Tank type/material Septic/Plastic Measured operating fluid level in septic tank New OR Standpipes/foundation cleanout per record drawing Date of pumping New Construction - 9/20/19 D. ABSORPTION FIELD DATA Deep Trench Parcel ID: 075-031-25 Structure served by this system Well production at time of test 7.3 gprn Water storage tank volume N/A gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate •933 mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by Forge Engineering Date of Sample 9/20/19 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Which system tested (date installed) 7/14/77 Adequacy test date 8/21/19 ❑ ALL standpipes present per record drawing Results E✓ Pass For 3 bedrooms Total measured depth from grade 6.9 ft (max) Fluid depth prior to test 8 in Measured depth to pipe invert from grade 4.8 ft (min) Water added 530 gal . ❑ N/A — pressurized field New depth 15 in ❑ Monitor tubes go to bottom of effective. If not, state 1440 Elapsed time min depth into effective 2.1 OR Code -required soil cover over field Final fluid depth 0 in ❑ System presoaked Absorption rate '450 gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) date of test) Gallons introduced *1200 gallons If yes, enter date Comments/Deficiencies: "System presoaked with 1200 gallons as this is the calculated effective volume of the trench. COSA Checklist yellow sheet None 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' 0 ** 90 Community Sewer Manhole/Cleanout > 100' F7 Yes if No ft M Yes if No ft Neighboring Tank > 100' 1771 Yes if No ft Private Sewer/Septic Line > 25' 0 Yes if No ft Absorption Field on Lot > 100' 177� Yes if No ft Holding Tank > 100' ❑✓ Yes if No ft Neighboring Absorption Fields > 100' 0✓ Yes if No ft Water Main > 10' Animal Containment > 50' P Yes if No ft Fv Yes if No ft Yes if No ft Water Service Line > 10' Q✓ Yes if No Manure/Animal Excreta Storage > 100' If septic tank is under driveway Community Sewer Main > 75' ❑✓ Yes if No ft 0 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' P/1 Yes if No ft Property Line > 5' 0 Yes if No ft Wells on Adjacent Lots: ✓I V Absorption Field > 5' 0 Yes if No ft Private Wells > 100' 0✓ Yes if No ft Water Main > 10' ft Yes if No ft Community Wells > 200' Yes if No ft Water Service Line > 10' Q✓ 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' 121 Yes if No ft If absorption field is under driveway comment below Property Line > 10' 1771 Yes if No ft Wells on Adjacent Lots: Water Main > 10' ✓I V Yes if No ft Private Wells > 100' D Yes if No **86 ft Water Service Line > 10' E Yes if No ft Community Wells > 200' Q Yes if No ft Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS *See well waivers for the well on this lot & adjacent lots. G. ENGINEER'S CERTIFICATION 1 certify that l have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. COSA Checklist yellow sheet OF 4,44 \0A 08� r; 19th - MICHAEL E. ANDERSON t4r No, CE -4381 10/16/19 C'y1slic, POST IN A CONSPICUOUS PLACE Is%. e rl t ALL WORK MUST BE INSPECTED 0 Field Inspection Request required 2 working days in advance of starting work and 2 working days in advance for final inspeciton. Call (907) 343-8206 (voice recorder) for scheduling. 0 Permit is not valid without the call-in and also must include the one -call ticket (utility locate) number. by 7 1 $120.00 Total Fees: $120.00 See reverse for requirements/remarks. I have read and understand both sides of this permit. I agree to the terms and conditions; and I certify that all work will comply with federal, state, and municipal codes and regulations and the provisions!2f- th s permit. Signature: Date: 16 — z �r —/ f MUNICIPALITY OF ANCHORAGE - RIGHT OF WAY DIVISION 4700 ELMORE ROAD TELEPHONE (907) 343-8240 FAX (907) 343-8250 RIGHT OF WAY PERMIT R192467 Type: Encrehmnt 1 1� -::i': - Status,:-: SSUO Grid: SE4715 Date Applied: 09/23/2019 "'Date Issued: 09/23/2019 Itsded-By: claudia.pinard Construction Start Date: ast Updated: 09/23/2019 >Last Pdi'ted,B_: claudia.pinard by 7 1 $120.00 Total Fees: $120.00 See reverse for requirements/remarks. I have read and understand both sides of this permit. I agree to the terms and conditions; and I certify that all work will comply with federal, state, and municipal codes and regulations and the provisions!2f- th s permit. Signature: Date: 16 — z �r —/ f Construction Requirements and Notes: 1. This permit has been issued based on the assumption that the information contained in the pals and supporting documentation is correct. Any and all omissions are the responsibility of the permitee. Any change in the scope of work requires a revised or new permit and Traffic Control Plan (TCP). 2. Contractors' acceptance of this permit constitutes acceptance of the Municipality's bonding requirements, and is contractor representation that contractor has and will comply with those requirements. Unless a specific bond is applied to this permit by written reference, the contractor's performance bond on file with Development Services, Right of Way Enforcement, shall suffice as the required bond. 3. The Permittee shall post a copy of the permit in a conspicuous location at the place to which the permit pertains before any work there is started and shall remove the permit only after the Right of Way Inspector has accepted the work as being in compliance with the permit. 4. The Municipality has the right to inspect and/or reject materials and workmanship not to Municipal standards, to stop work until corrections are made, or to require removal of the facility and to charge time, material and equipment to the Permitee to correct the facility if they fail to comply with the conditions of the permit. 5. Permitee is responsible for locating and protecting all utilities and survey markers in the work vicinity. For utility locates, call Alaska Digline at "811" or (907) 278-3121. 6. The contractor shall erect signs, barricades and detours in accordance with the U.S. Department of Transportation "Manual on Uniform Traffic Control Devices", Part VI — Traffic Controls for Street and Highway Construction, Maintenance, Utility and Emergency Operations. Failure to do so may result in fines being assessed under Title 14 for work not in conformance with a permit. 7. Changes in the approved road closures or scope of work resulting from emergency circumstances may be allowed during construction. It shall be the responsibility of the contractor to notify the Permit Office, 343-8206, and/or obtain an approved Traffic Control Plan (TCP). It shall be the contractor's responsibility to notify the following agencies: Fire Dispatch 267-4950, Police Dispatch 786-8900, Alaska State Troopers Dispatch 269-5511, People Mover 343-8253 and School Bus 742-1207 or 742-1209. 8. All construction shall be in accordance with the current edition Municipality of Anchorage Standard Specifications (MASS), applicable municipal codes and regulations and the approved drawings and special provisions of this permit. 9. As a condition of this permit all excavations will conform to the standards outlined in OSHA 29CFR, 1926 Subpart P. 10. The Right of Way shall be restored to the same, or better condition, than it was prior to the contractors' work being performed. The work shall be performed diligently and continuously, until completed to the satisfaction of the Municipal Right of Way Inspector. 11. All underground installations within a public place shall be buried at a minimum depth of forty-two inches (42") below the final surface elevation, i.e. bottom of drainage ditches, road shoulder or finished grade. 12. Permanent paving, recycled asphalt pavement (RAP), chip seal, sidewalks and curb and gutter must be replaced within 7 working days after underground work is completed. 13. Winter Condition Requirements (applicable to all Right of Way Permits). a. No trenching and or excavation is allowed within the road prism except for emergency repair of existing utility facilities or by approval of the Director of Development Services. b. Crossing of the road prism shall be by boring technology. c. No frozen material shall be placed in the excavation as fill and/or backfill. A source of non -frozen fill and/or back fill material shall be available. d. All frozen ground within the Right of Way shall be thawed prior to excavation. �enr MUNICIPALITY OF ANCHORAGE Development Services Department Right of Way Sectiony Department THIS AGREEMENT, made this 24th day of September, 2019, by and between VIRGINIA C BURSIEL & ROBERT F BURSIEL and their heirs, administrators, and assigns, hereinafter called "PERMITTEE", and the Municipality of Anchorage, a municipal corporation organized and existing under its Charter and the laws of the State of Alaska, hereinafter called the "PERMITTER". WITNESSETH: WHEREAS, PERMITTEE is the owner of the following described real property: HEMLOCK SUBDIVISION, LOT 2, according to the official records thereof, on file in the office of the District Recorder, Anchorage Recording District, Alaska, and; WHEREAS, PERMITTER owns and/or maintains the real property more particularly described as follows: The TWENTY FOOT UTILITY EASEMENT, immediately along to the east side of PERMITTEES property as shown on Plat No. 78-127, on file in the office of the District Recorder, Anchorage Recording District, Alaska, and; WHEREAS, PERMITTEE has placed a well upon the referenced real property which encroaches 7.0 feet upon the PERMITTER'S 20.0 -foot Utility Easement. NOW, THEREFORE, it is mutually agreed between the parties hereto that: 1. The PERMITTER, acting through the Director of Development Services Department, hereby grants to the PERMITTEE the privilege of allowing a well to encroach 7.0 feet upon the PERMITTER'S 20.0 foot Utility Easement, as shown on "Attachment A," included herewith. 2. The PERMITTEE agrees forever to indemnify, defend, save and hold harmless, the Municipality, its officers and employees, from any and all lawsuits, claims or actions brought to any person for or on account of damage to property or injury, disease, illness or death of persons, including all costs and expenses incident thereto, arising wholly or in part from or in connection with the existence of, alterations, maintenance, repair, renewal, reconstruction, operation, use or removal of the encroaching well, as placed upon the PERMITTER'S 20.0 foot Utility Easement. 3. The PERMITTEE shall not assign or transfer any of the rights granted herein to another individual or company without first notifying and securing the approval of the Director of Development Services Department. 4. This Agreement and Permit grants PERMITTEE no interest in PERMITTER'S real property whatsoever, except only the encroachment rights described herein. 5. The PERMITTER reserves the right to revoke this permit upon twenty (20) days written notice to the PERMITTEE. The PERMITTEE agrees upon such notice of revocation, to move said encroachment(s) from the 20.0 foot Utility Easement in which it is placed. Should the PERMITTEE refuse or fail to comply with said written notice, the PERMITTER may, without further notice to the PERMITTEE, remove or cause to be removed the encroachment(s), and the PERMITTEE hereby agrees to reimburse the PERMITTER for all costs incidental to the removal thereof. In addition to the mutual promises heretofore made, the PERMITTEE has paid the PERMITTER a one-time permit application fee of $120.00. The PERMITTER hereby waives the annual fee of $315.00. IN WITNESS WHEREOF, the parties hereto have hereunto set their hands and seal the day and year first hereinabove written. GRANTOR: MUNICIPALITY OF ANCHORAGE kVirginia C Bursiel, Owner Tac . Frost, Jr. Ri&4it of Way Supervisor 1.i1 C e p.4S Robert F Bursiel, Owner STATE OF ALASKA } ) ss. THIRD JUDICIAL DISTRICT ) THIS IS TO CERTIFY that on this 24th day of September, 2019, before me, the undersigned, a Notary Public in and for the State of Alaska, duly commissioned and sworn as such, personally appeared Jack L. Frost, Jr., known to me to be the Right of Way Supervisor for the Municipality of Anchorage, Alaska, who executed the foregoing instrument, and he acknowledged to me that he executed said instrument as the free and voluntary act and deed of said corporation for the uses and purposes therein mentioned, and that he was authorized to execute said instrument. WITNESS my hand and official seal on the day and year first above written. �Q�; .•••• • .•L�/�0 NOTARY PUBLIWia,dforAlaska My Commission E: 1--Z2•-23 r •• : �G :NOTARY :P U'BLIC;�� Notary Public CUTTER T. RAGUSA STATE OF ALASKA ) State of Alaska ) ss. My Commission Expires 3/28/2022 THIRD JUDICIAL DISTRICT ) THIS IS TO CERTIFY that on this -�-01 day of 0 cf0 6-e r , 2019,.before me, the undersigned, a Notary Public in and for the State of Alaska, duly commissioned and sworn as such, personally appeared heri Pow 1 0 ursl e ( known to me to be the individual(s) named herein who executed the foregoing instrument, and (s)she acknowledged that (s) she did so freely and voluntarily for the used and purposes therein mentioned, and on oath stated that (s)she was authorized to execute said instrument. WITNESS my hand and official seal on the day and year first above written. TARY PUBLIC in an or Alaska My Commission Expires: STATE OF ALASKA ) ss. THIRD JUDICIAL DISTRICT THIS IS TO CERTIFY that on this 24th day of September, 2019, before me, the undersigned, a Notary Public in and for the State of Alaska, duly commissioned and sworn as such, personally appeared Jack L. Frost, Jr., known to me to be the Right of Way Supervisor for the Municipality of Anchorage, Alaska, who executed the foregoing instrument, and he acknowledged to me that he executed said instrument as the free and voluntary act and deed of said corporation for the uses and purposes therein mentioned, and that he was authorized to execute said instrument. WITNESS my hand and official seal on -the day and year first above written. ��� •;tri NOTARY U IC in and fors a jV = My CommiW6 Expires: * PU LIQ , Of A�PS�P�\\ STATE OF AbASKA I j' P o tjA-- ) ) ss �I THIS IS TO CERTIFY that on thi�r&day of _ c- b�jt-- , 2419, before me, the undersigned, a Notary PubU in and for the State o A my commissioned and sworn as such, personally appeared ,fie c5 e�7` '7-2" -AL S t . known to me to be the individual(s) named herein who executed the foregoing instrument, and (s)she acknowledged that (s) she did so freely and voluntarily for the used and pumoses therein mentioned, and on oath stated that (s)she was authorized to execute said instrument. WITNESS my hand and official seal on the s NOTARY PUBLIC STATE of ARIZONA Pima County WILLIAM MARTIN My Commission Expires septernber 01..2021 and year first above written. Y PUBLIC in and for Aiaslw emission Expires: —!21 . 1, S ?7_70 7_0 6"E Lot 4 FOUR SEAESONS CHALETS 4{�OF. °A�ac��nent A-% I 0 20 40 US SURVEY NOTES FEET -All dimensions shown are grid bearings and ground distances, Record boundaries are per Plat No. 78-127. -49th Star has conducted a physical survey of the property and all details shown on this Asbuilt Survey are correct. Under no circumstances should any data hereon be used for construction or for establishment of property lines. -It is the owners responsibility to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. AS BUILT SURVEY LEGEND 49th Star Surveying LLC Lot 2, clean Out 321 Fireoved Drive Hemlock Subdivision, CP Septic System vent Anchorage, AK 99508 Lots 1812 Power Pole Q well (907)891-6111 ' © 'tele -comm Pedestal Jeremy949thStarSurveying.com Girdwood, AK OHE W.O. 19028 DATE_ 08/26/19 Overhead Utility Line SCAT M 1^=40' 2019-038387-0 A Recording Dist: 301 - Anchorage S 10/14/2019 12:15 PM Pages: 1 of 3 RECORD IN ANCHORAGE RECORDING DISTRICT RETURN TO: Cavaliere Law Firm, LLC P.O. Box 80288 Fairbanks, AK 99708 Tel: (907) 374-0516 THIS COVER SHEET HAS BEEN ADDED TO THIS DOCUMENT TO PROVIDE SPACE FOR RECORDING DATA AND TO COMPLY WITH MARGIN REQUIREMENTS SET FORTH IN 11 AAC 06.040 OF TITLE 11 OF THE ALASKA ADMINISTRATIVE CODE. THIS COVER SHEET APPEARS AS THE FIRST PAGE OF, THE DOCUMENT IN THE OFFICIAL RECORD. DO NOT DETACH eRecorded Document O 0 U E �+ U LT. d 3 01 W0000 o W 0o cO M a X� >� >m°��a Ua :X SE°' IN THE SUPERIOR COURT FOR THE STATE OF ALASKA THIRD JUDICIAL DISTRICT In the Matter of the Estate ) of ) VIRGINIA CANDLIN BURSIEL, } } Deceased. } Case No. 3AN-18- v PR/E LETTERS TESTAMENTARY The will of Virginia Candlin Bursiel having been admitted to probate, Robert Paul Bursiel is appointed personal representative of the estate. e' Date f7�1—Regist ar/S. eri_or" ourt Judge ACCEPTANCE I, Robert Paul Bursiel, accept the duties�and'promise to perform the duties as required by law of the office of personal representative of the estate of Virginia Candlin Bursiel. I acknowledge my duty as personal representative to: (a) take possession and control of decedent's property as required by AS 13.16.380, determine the liabilities of the estate, and complete an inventory as required by AS 13.16.365; (b) provide notice to heirs and devisees as required by AS 13.16.360; (c) provide notice to creditors as required by law, publish notice when required, and review and either accept or reject claims as required by AS 13.16.455-.515, except as provided by AS 13.16.690; (d) advise the court in writing of my address and telephone number as required by Probate Rule 8; (e) file returns for state estate taxes, if required by AS 43.31.121, and AS 43.31.250; M co NM co (f) pay homestead, exempt property and family o N eRecorded Document v ry+ U s o c " rn o b89 y, .mr rr1 rsa 00 ¢. j rn N Jc `L000 ¢m �0,'0 D v Uprr x �� allowances as required by AS 13.12.401-.405, costs of administration and other claims as required by AS 13.16.470, and distribute the assets of the estate; and (g) close the estate as soon as appropriate as required by AS 13.16.620-.670. No bond is required to be filed. Date Robert Paul Bursiel P.O. Box 60789 Fairbanks, Alaska 99706 (907) 388-3163 VERIFICATION I, Robert Paul Bursiel, being first duly sworn, upon oath, depose and state as follows: I am the person named above; I have read the foregoing document and understand the contents thereof; I have executed it freely and voluntarily for the uses and purposes set forth therein; and, I verify that the same is true of my own knowledge and belief. Robert Paul Bursiel SUBSCRIBED AND SWORN to, before me, on this day, March 31, 2018. Notary /Public in and for Alaska My Commission Expires: 11/28/19 I NOTARY PUBLIC ;• = 40 OFI cerfify that this is a true and correct copy of the original on file in my office. ATTEST: Clerk of tie Trja! Courts at Anchorage Letters Testamentary t Deputy Gate J In the Matter of the Estate of Virginia Candlin Burs?ei Case No. 3AN-18 , PR/E Page 2 eRecorded Document 011638 �AN! A t, t P.O. Box 196ciso Anchorage. Alaska 99519.6650 Telephone: (907) 343-7900 Fax: (90) 34:3-7527 http :{f -w.mvni,arg iv fark'Hqgycht A=kyor RECORD ON NONCONFORMING DETERMINATION RESULTING FROM ADOPTION OF AMC 21.09 (Provided at no cost per AMC 21.09.020.D) GRID: SW 4715 [PROPERTY IDENTIFICATION NUMBER: 075-031-26 LEGAL DESCRIPTION: Hemlock, Lot 2 SITE ADDRESS: NI -INT Crow Creek Road NEW ZONING DISTRICT: CG6 OLD ZONING DISTRICT FROM "GIRDWOOD ARE PLAN" MAP 11: Commercial/Residential DOCUMENTED NONCONFORMITIES (ATTACH ADDITIONAL SHEETS IF NECESSARY: - As -built dated 1/29/79 shows that carport encroaches approximately 6' into required 10' southern side yard and approximately 9' into 18' required front yard. - As -built shows violation of 10' separation requirement between principal structure and accessory structure. Carport appears to be approx 5' from steps leading to principal structure. DATE NONCONFORMITIES ESTABLISHED: 2/7/06 REVIEWER: Mike Billmaier ATTACH CAMA RECORDS, AS -BUILT SURVEY OR OTHER DOCUMENTATION AS APPROPRIATE '�RCEL, ('7c �— nal - j7 o LEFERENCE C1RID: / RD ON NOINCONFOIR'-NIUNG D:-,:TERAIJ-I-,-,�-A.T---,0N RE 01 0 F AN; I C _?.i)9 (ProAded at no c0s, per,AAW 21.0%0 MD) 7 P-\',,)PERTFY SFE ADDRE-- E,N OLD Z()NING; EHSTRN7F FRCAI—GTR-DW0I0D AREA PIATTAIAP 11: DOC D NON!"CON-FOURTIES (ATT.X(AI,j)r)ITI(.-,',NAL SPIEETS 1F NEC'ESSARY! ma Land Use; Enlorcc-Ment Officer Municipality of Anch0ra0e DATE N-ONCONIFFOR.MITTES EST. Li `J -1 & J/ J3430411380 REXIEVIET, =,/' / /Z x === &0-01111,.— ATTACH AS—BUILT !T sTHE7 DOCT A,S -i!LT PIHOTOGPIAPHS OTHER: 2019-038863-0 A Recording Dist: 301 - Anchorage s 10/16/2019 01:23 PM Pages: I of 4 A IN III III 1008-08D Grid 4715 EN 19036 075-031-26-000 ENCROACHMENT PERMIT This permit is between Chugach Electric Association, Inc., an Alaska non-profit electric cooperative, (herein "Chugach"), whose address is P. O. Box 196300, Anchorage, Alaska 99519 and Robert Paul Bursiel, Personal Representative of the Estate of Virginia C. Bursiel (herein "Permittee"), whose address is P.O. Box 60789, Fairbanks, Alaska 99706. 1. Easement. Chugach is the grantee or user of an easement for the construction and maintenance of electrical facilities, as follows: Described in that certain written instrument recorded on the 19`h day of May 1955, in Volume 118, Page 98, on file in the office of the District Recorder, Anchorage Recording District, Third Judicial District, Seward Meridian, Alaska, Dedicated by the plat of the subdivision known as Hemlock Subdivision, according to Plat Number 78-127, recorded on the 41h day ofAugust 1978, on file in the office ofthe District Recorder, Anchorage Recording District, Third Judicial District, Seward Meridian, Alaska, (herein `Easement") which pertains to the following described real property: The Easterly Twenty Feet (F,'ly 20') of Lot Two (2), Hemlock Subdivision, according to Plat Number 78-127, recorded on the 4th day of August 1978, on file in the office of the District Recorder, Anchorage Recording District, Third Judicial District, Seward Meridian, Alaska. Permittee acknowledges the validity of the Easement. Permittee warrants and represents that Permittee is the owner of the fee simple interest in the land subject to the Easement and the following described real property to which the Easement is adjacent: Lot Two (2), Hemlock Subdivision, according to Plat Number 78-127, recorded on the 4`h day of August 1978, on file in the office of the District Recorder, Anchorage Recording District, Third Judicial District, Seward Meridian, Alaska, Encroachment Permit - Page 1 of 4 (herein G°Parcel"). eRecorded Document 2. Encroachment. Permittee has constructed or purchased the following improvements on or within the real property subject to said Easement: A carport that encroaches approximately Seven Feet (7') into the easement for a distance of approximately Eighteen Feet (18'); Three Feet (3') wide deck stairs that encroach approximately Ten Feet (10') into the easement that connect the second story deck to the carport; a well located near the northeast end of the lot that encroaches approximately Seven Feet (7') into the easterly side of said Easement for a distance of approximately One Foot (P); a rock retaining wall approximately Two Feet (2') wide along the north side of the driveway that encroaches through the entire casement, (herein "Li ncroachment"). 3. Permit. Chugach hereby authorizes Permittee to continue the existence of the Encroachment in its existing location subject to the covenants set forth in this permit. 4. Indemnification. Permittee shall indemnify and hold Chugach harmless from any claims for personal injury, property damage or other loss arising in any way from the continuation of the Encroachment. S. No Expansion.or Increase. Permittee shall not in any way expand or increase the extent to which the Encroachment occupies any of the real property encumbered by the Easement without the prior written consent of Chugach. Chugach has no obligation to provide such consent. 6. No Interest in Real Fstate Acquired. Permittee hereby acknowledges that the Encroachment and any additions thereto, even if in violation of this permit, has not and shall not in the future give rise to any interest or estate in the real property subject to the Easement or any other real property. Without in any way limiting the foregoing, Permittee acknowledges that the Encroachment is not adverse to any interest of Chugach and its continuation is entirely with the permission of Chugach for purposes ofthe common law doctrine ofadverse possession. This permit creates no interest in the real property subject to the easement. 7. Modification of Utility Facilities. If the electric utility facilities located within the Easement are upgraded, added to, replaced or reconstructed, Permittee shall pay that portion of Chugach's total costs for such modification which is reasonably attributable to accommodating or preserving the Encroachment. If such payment isnot made within thirty (30) days of written demand for same, Chugach may terminate this permit in accordance with paragraph 9, below 8. Covenants Running with the Land The obligations ofthe Permittee arising from this permit shall be covenants running with the land which shall burden the Parcel and the Permittee's interest in the land subject to the Easement and shall benefit the Easement. Encroachment Permit - Page 2 of 4 eRecorded Document ll)11111110111111111((1111 2014 2019-038863-0 9. Termination. Chugach may terminate this permit after the giving of thirty (30) days written notice of such termination if- a. f a. The Encroachment is enlarged, increased or extended within the real property affected by the Easement. b. The Encroachment is damaged by any means to an extent of more than thirty percent (30%) of its replacement cost at the time of destruction. C. Permittee fails to make the payment described in paragraph 7, above. 0. Term. This permit shall, if not sooner terminated by Chugach, expire forty (40) years from the date hereof. 11. Entire Agreement. This written permit constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all other prior or contemporaneous agreements, oral or written, between the parties. No modifications, amendments, deletions, additions or alterations of the permit shall be effective unless in writing and signed by all of the parties hereto. CHUGACH ELECTRIC ASSOCIATION, INC. t By: Shelly Schmitt, for Manager Distribution Engineering Date: % %% ( ( o eRecorded Document PERMITTE R Bert Paul Burstel, Personal Representative of the Estate of Virginia C. Bursiel, letters Testamentary filed at Serial No. 2019-038387-0, Anchorage Recording District, Alaska Date:_ / �l Encroachment Permit - Page 3 of 4 IIIIIIillll IIIIIIIIIIIIIII 3 of 4 2019-038863-0 STATE OF _��"^s A— ) ) ss: The foregoing instrument was 2019, by Robert Paul Bursiel Persona NOTARY PUBLIC STATE OF ARIZONA Pima County WILLIAM MARTIN My Cammisston Expires September 01, 2021 STATE OF ALASKA ) ) ss: THIRD JUDICIAL DISTRICT ) before me this � day of 0j"r (2._, Public in and for the State of N D.— imission expires: 4, .l.?.a 7 The foregoing instrument was acknowledged before me this day of C/C ib r 2019, by Scl Senior Manager, Distribution Engineeringff Chugach Electric Association, Inc., an Alaska corporation, on behalf of the corporation. STATE OF ALASKA NOTARY PUBLIC Stephen L. Howe �`.iy c'�xnrnisslon Expires AFTER RECORDING RETURN TO: Chugach Electric Association, Inc. P.O. Boz 196300 Anchorage, Alaska 99519-6300 eRecorded Document Notary Public in and for the State of Alaska— " My commission expires: 4422-0 Encroachment Permit - Page 4 of 4 III II�IIII IIII IIIIIIII � I III 4 of 4 2019-038863-0 DocuSign Envelope ID: 328774FD-23C7-4DE2-A4A5-510552969AD2 Last<a �:�::.,r��,��.�,�,,., t". September 27, 2019 Robert & Virginia Bursiel 507 Crow Creek Rd Girdwood, Alaska 99587 Alaska Communications has no objections to the existing well encroaching into the 20' Utility Easement located along the eastern boundary of lot 2, Hemlock Subdivision, otherwise known as 507 Crow Creek Rd Girdwood, Alaska as depicted on the drawings provided by Forge Engineering. Alaska Communications currently utilizes this easement and has no objections to the encroachment. Alaska Communications hereby issues this letter with stipulations to allow the encroachments of the above mentioned into the easement. Acceptance, (your signature below), and use of this letter of non -objection by yourself, your heirs, your assigns, or your successors, will constitute agreement to the following stipulations: 1. Alaska Communications will be held harmless, now and forever, for any damages or injury to any person or property as a result of this encroachment. 2. Any Alaska Communications facility damaged or destroyed as a result of this encroachment will be repaired at no cost to Alaska Communications. 3. Any costs incurred by Alaska Communications for special construction necessitated by this encroachment will be bome by the property owner. 4. All applicable safety code regulations will be observed and maintained. 5. This letter of non -objection will in no way preclude Alaska Communications from full use and enjoyment of its rights within any portion of this easement 6. Alaska Communications is under no obligation to restore any structure damaged as a result of Alaska Communications full use and enjoyment of its rights within any portion of easements or right-of-ways. Please sign both copies, retain one copy for your use and return the other to Alaska Communications. SiNerel , n Austin Ki Network Engineer, Outside Plant Alaska Communications Outside Plant Engineering, MS#14 600 Telephone Ave. Anchorage, AK 99503 ACCEPTANCE SIGNATURE: DATE: C10/2DocuSigned by: E /2019 TZ 11 F06E599485314BC... ' Grid SE4715 GWC DocuS'ign Envelope ID: 328774FD-23C7-4DE2-A4A5-510552969AD2 September 27, 2019 Robert & Virginia Bursiel 507 Crow Creek Road Girdwood, AIC 99587 Dear Robert & Virginia Bursiel, Subject to your agreement to indemnify the company as set forth below, GCI Communication Corp has no objection to the existing well located within the utility easement at the northeast end of Lot 2 Hemlock Subdivision also known as 507 Crow Creels Road, city grid 4715, GCI WO#19-0001-50. This letter of non -objection in no way precludes GCI Communication Corp from full use and enjoyment of any rights it may have within any portion of the utility easement and or the right-of-way, including unlimited access for servicing its facilities. Also any additional and extraordinary costs incurred during any future required construction, repair or reconstruction of GCI's facilities to accommodate any or all of the encroachments shall be paid by the property owner. By signing below, you agree to indemnify and hold GCI Communication Corp harmless, now and forever, for any damage, costs, expense (including reasonable attorney's fees), liabilities and injury to any person or property occurring as a result of the encroachment. Please indicate your acceptance by signing and returning this letter to me at the address below. DocuSigned by: Sincerely, .. 10/2 2019 Date alk us Kofoid Manager Outside Plant Design & Data Management GCI Communication Corp 5151 Fairbanks St. Anchorage, AIC 99503 907-868-6168 Office 907-868-8580 Fax ® Anchorage Water & Wastewater Utility Engineering Division Mayor Board Chair Ethan Berkowitz Aaron D. Dotson September 30, 2019 Robert F. & Virginia C. Bursiel P.O. Box 484 Girdwood, AK 99587 Re: HEMLOCK LT 2, Grid (SE4715) Request for Letter of Non -objection to Encroachment (Tax ID# 075-031-26) The Anchorage Water and Wastewater Utility received a request from your Representative Forge Engineering on September 27, 2019 in regards to an existing well encroaching within the Utility Easement along the east property line of HEMLOCK LT 2. AWWU is currently not using this Utility Easement and has no objection to the encroachment. AWWU hereby issues this letter with stipulations to allow the encroachment of the existing well within the easement, property owner(s) agrees to the following: 1. AWWU will be held harmless, now and forever, for any damages or injury to any person as a result of the encroachment; 2. The property owner(s) shall call for utility locates before excavation in the easement; 3. All applicable codes and regulations will be observed and maintained within the easement; 4. This letter will in no way preclude AWWU from full use and enjoyment of its rights within any portion of the easement; 5. The property owner(s) shall pay any additional and/or extraordinary costs incurred to accommodate the encroachment during any future required construction or reconstruction of AWWU facilities; 6. AWWU's non -objection does not imply other approvals that may be required for this encroachment; and, 7. AWWU does not provide a position for any other parcel or utility impacted by the encroachment. Should you have any questions, please call the AWWU Planning Section at 564-2739. FPaul ely, H tcher Engineering Technician III Anchorage Water & Wastewater Utility 0 Clearly 3000 Arctic Boulevard • Anchorage, Alaska 99503 Phone 907-564-2774 • Fax 907-562-0824 • w-.vw.avAvubiz IN THE SUPERIOR COURT FOR THE STATE OF ALASKA THIRD JUDICIAL DISTRICT In the Matter of the Estate ) of } VIRGINIA CANDLIN BURSIEL, } } Deceased. } Case No. 3AN-18- •'v PR/E } LETTERS TESTAMENTARY The will of Virginia Candlin Bursiel having been admitted to probate, Robert Paul Bursiel is appointed personal representative of the tate. :. Date "—Regist ar/S eriox" ourt '� Judge �,. ACCEPTANCE O '- -C*E I, Robert Paul Bursiel, accept the duties and promise NO to perform the duties as required by law of the office of n personal representative of the estate of Virginia Candlin Bursiel. I acknowledge my duty as personal representative to: (a) take possession and control of decedent's property as required by AS 13.16.380, determine the liabilities of the estate, and complete an inventory as required by AS 13.16.365; (b) provide notice to heirs and devisees as required by AS 13.16.360; av (c) provide notice to creditors as required by law, publish notice when required, and review and either accept c or reject claims as required by AS 13.16.455-.515, except as provided by AS 13.16.690; o 3 � C' B:1P (d) advise the court in writing of my address and „ o telephone number as required by Probate Rule 8; W O Q N ax `� (e) file returns for state estate taxes, if required Q m o by AS 43.31.121, and AS 43.31.250; Ua U. E H c (f) Pa Yhomestead, exempt property and family U a Q rn�°�` CN cz _W00� jr�N x ccs 00 .a 0 U O 00 > Q �Ur.. ELMZ. allowances as required by AS 13.12.401-.405, costs of administration and other claims as required by AS 13.16.470, and distribute the assets of the estate; and (g) close the estate as soon as appropriate as required by AS 13.16.620-.670. No bond is required to be filed. 3 Date Robert Paul Bursiel P.O. Box 60789 Fairbanks, Alaska 99706 (907) 388-3163 VERIFICATION I, Robert Paul Bursiel, being first duly sworn, upon oath, depose and state as follows: I am the person named above; I have read the foregoing document and understand the contents thereof; I have executed it freely and voluntarily for the uses and purposes set forth therein; and, I verify that the same is true of my own knowledge and belief. Robert Paul Bursiel SUBSCRIBED AND SWORN to, before me, on this day, March 31, 2018. Notary/Public in and for Alaska My Commission Expires: 11/28/19 1. NOTARY PUBLIC `` ` OFAti- �`°� polls mlo, I certify that this is a true and correct copy of the original on file in my office. ATTEST Clerk of tie r+'al Courts atAnchora e BAA 1A ) X1 )nnAN LJ, �i Letters Testamentary ! veputy Oa1e In the Matter of the Estate of Virginia Candlin Bursiel Case No. 3AN-18- j�aPP./E Page 2 ent / MUNICIPALITY OF ANCHORAGE Development Services Department Right of Way Section , Ucparhucnt ENCROACHMENT PERMIT R192467 THIS AGREEMENT, made this 24th day of September, 2019, by and between VIRGINIA C BURSIEL & ROBERT F BURSIEL and their heirs, administrators, and assigns, hereinafter called "PERMITTEE", and the Municipality of Anchorage, a municipal corporation organized and existing under its Charter and the laws of the State of Alaska, hereinafter called the "PERMITTER". WITNESSETH: WHEREAS, PERMITTEE is the owner of the following described real property: HEMLOCK SUBDIVISION, LOT 2, according to the official records thereof, on file in the office of the District Recorder, Anchorage Recording District, Alaska, and; WHEREAS, PERMITTER owns and/or maintains the real property more particularly described as follows: The TWENTY FOOT UTILITY EASEMENT, immediately along to the east side of PERMITTEES property as shown on Plat No. 78-127, on file in the office of the District Recorder, Anchorage Recording District, Alaska, and; WHEREAS, PERMITTEE has placed a well upon the referenced real property which encroaches 7.0 feet upon the PERMITTER'S 20.0 -foot Utility Easement. NOW, THEREFORE, it is mutually agreed between the parties hereto that: 1. The PERMITTER, acting through the Director of Development Services Department, hereby grants to the PERMITTEE the privilege of allowing a well to encroach 7.0 feet upon the PERMITTER'S 20.0 foot Utility Easement, as shown on "Attachment A," included herewith. 2. The PERMITTEE agrees forever to indemnify, defend, save and hold harmless, the Municipality, its officers and employees, from any and all lawsuits, claims or actions brought to any person for or on account of damage to property or injury, disease, illness or death of persons, including all costs and expenses incident thereto, arising wholly or in part from or in connection with the existence of, alterations, maintenance, repair, renewal, reconstruction, operation, use or removal of the encroaching well, as placed upon the PERMITTER'S 20.0 foot Utility Easement. 3. The PERMITTEE shall not assign or transfer any of the rights granted herein to another individual or company without first notifying and securing the approval of the Director of Development Services Department. 4. This Agreement and Permit grants PERMITTEE no interest in PERMITTERS real property whatsoever, except only the encroachment rights described herein. 5. The PERMITTER reserves the right to revoke this permit upon twenty (20) days written notice to the PERMITTEE. The PERMITTEE agrees upon such notice of revocation, to move said encroachment(s) from the 20.0 foot Utility Easement in which it is placed. Should the PERMITTEE refuse or fail to comply with said written notice, the PERMITTER may, without further notice to the PERMITTEE, remove or cause to be removed the encroachment(s), and the PERMITTEE hereby agrees to reimburse the PERMITTER for all costs incidental to the removal thereof. In addition to the mutual promises heretofore made, the PERMITTEE has paid the PERMITTERa one-time permit application fee of $120.00. The PERMITTER hereby waives the annual fee of 5315.00. IN WITNESS WHEREOF, the parties hereto have hereunto set their hands and seal the day and year first hereinabove written. GRANTEE: ..�p i'•Yt � dU.! �V.1r_.T- Virginia C E Robert F Bursiel, Owner GRANTOR: MUNICIPALITY OF ANCHORAGE t Frost, Jr. of Way Supervisor i STATE OF ALASKA } ss. THIRD JUDICIAL DISTRICT ) THIS IS TO CERTIFY that on this 24th day of September, 2019, before me, the undersigned, a Notary Public in and for the State of Alaska, duly commissioned and sworn as such, personally appeared Jack L. Frost, Jr., known to me to be the Right of Way Supervisor for the Municipality of Anchorage, Alaska, who executed the foregoing instrument, and he acknowledged to me that he executed said instrument as the free and voluntary act and deed of said corporation for the uses and purposes therein mentioned, and that he was authorized to execute said instrument. WITNESS my hand and official seal on -the day and year first above written. /j� G:• K4U,y/ iii �., _ 1 ' C e �--�- ;� •.F� NOTARY �U IC in and f�rr laska rlC�2 :NOT, = RY My Commi Expires'/ * ' PUBL OFAY \\N� ///illlllll\\\ STATE OF ALASKA A?:�nJA ) ) ss. C. L"& THIS IS TO CERTIFY that on thiL ►day of Go. rX._ , 2019, before me, the undersigned, a Notary Pub ' in and for the State o ,�,, duly commissioned and sworn as such, personally appeared r-7` h ..LS r s ;1e t .known to me to be the individual(s) named herein who executed the foregoing instrument, and (s)she acknowledged that (s) she did so freely and voluntarily for the used and purp�ses therein mentioned, and on oath stated that (s)she was authorized to execute said instrument. WITNESS my hand and official seal on the q* and year first above written. NOTARY PUSUC STATE OF ARIZONA 0 Pima County WILLIAM MARTIN tJty Commission Expires September Ot. 2021 Y PUBLIC in and for emission Expires: —cZ Cal S 7j70 I49 -30 Lot 4 FOUR SEAESONS CHALETS 0 _ 20 40 US SURVEY FEET NOTES -All dimensions shown are grid bearings and ground distances, Record boundaries are per Plat No. 78-127. -49th Star has conducted a physical survey of the property and all details shown on this Asbuilt Survey are correct. Under no circumstances should any data hereon be used for construction or for establishment of property lines. -it is the owners responsibility to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. AS BUILT SURVEY LEGEND - 49th Star Surveying LLC Lot 2, ® Clean Out 321 Fireoved Drive Hemlock Subdivision, CP septic System vent Anchorage, AK 99508 Lots 1&2 Power Pole O Well (907)891-6111 s © Tele -comm Pedestal Jeremy@49thStarSurveying.com Girdwood, AK OHE W.O. 19028 DATE: 08/26)19 Overhead Utility Line SCALE: 1'=40' 2019-038387-0 A Recording Dist: 301 - Anchorage s 10/14/2019 12:15 PM Pages: 1 of 3 RECORD IN ANCHORAGE RECORDING DISTRICT RETURN TO: Cavaliere Law Firm, LLC P.O. Box 80288 Fairbanks, AK 99708 Tel: (907) 374-0516 THIS COVER SHEET HAS BEEN ADDED TO THIS DOCUMENT TO PROVIDE SPACE FOR RECORDING DATA AND TO COMPLY WITH MARGIN REQUIREMENTS SET FORTH IN 11 AAC 06.040 OF TITLE 11 OF THE ALASKA ADMINISTRATIVE CODE. THIS COVER SHEET APPEARS AS THE FIRST PAGE OF, THE DOCUMENT IN THE OFFICIAL RECORD. DO NOT DETACH eRecorded Document eRecorded Document IN THE SUPERIOR COURT FOR THE STATE OF ALASKA THIRD JUDICIAL DISTRICT In the Matter of the Estate of VIRGINIA CANDLIN BURSIEL, Deceased. Case No. 3A—N-18-p-R—/E LETTERS TESTAMENTARY The will of Virginia Candlin Bursiel having been admitted to probate, Robert Paul Bursiel is appointed personal representative of the tate. r Date -Regi_I s tr str ar/S. erjpr ourt udge Judge ACCEPTANCE C) I, Robert Paul Bursiel, accept the dutie's'and'promise o to perform the duties as required by law of the office of co personal representative of the estate of Virginia Candlin Bursiel. I acknowledge my duty as personal representative to: (a) take possession and control of decedent's property as required by AS 13.16.380, determine the liabilities of the estate, and complete an inventory as required by AS 13.16-365; (b) provide notice to heirs and devisees as required by AS 13.16.360; (c) provide notice to creditors as required by law, publish notice when required, and review and either accept or reject claims as required by AS 13.16.455-.515, except as provided by AS 13.16.690; R 32 '60, (d) advise the court in writing of my address and 00 o co telephone number as required by Probate Rule 8; C* 4 I- 00 - , >,00 - M t- (e) file returns for state estate taxes, if required - o 0 00 m° ca by AS 43.31.121, and AS 43.31.250; > 14 C) :9 9 a; 67.49 4 . - (f) pay homestead, exempt property and family eRecorded Document w allowances as required by AS 13.12.401-.405, costs of administration and other claims as required by AS 13.16.470, and distribute the assets of the estate; and ig) close the estate as soon as appropriate as required by AS 13.16.620-.670. No bond is required to be filed. Date Robert Paul Bursiel P.O. Box 60789 Fairbanks, Alaska 99706 (907) 388-3163 VERIFICATION I, Robert Paul Bursiel, being first duly sworn, upon oath, depose and state as follows: I am the person named above; I have read the foregoing document and understand the contents thereof; I have executed it freely and voluntarily for the uses and purposes set forth therein; and, I verify that the same is true of my own knowledge and belief. Robert Paul Bursiel SUBSCRIBED AND SWORN to, before me, on this day, March 31, 2018. �% Of s NOTARY PUBLIC •,��OFAti °, ` Notary /Public in and for Alaska. My Commission Expires: 11/28/!9 I certify that this is a true and correct Cotay of the original on file in my office. ATTEST: Clerkjof t ie Frig[ COUrts atAnchnrnn� Letters Testamenta-ry t u 17atc In the Matter of the Estate of Virgiria Candlin 5ursie: Case No. 3AN-18-j(,a PR/E Page 2 eRecorded Document o co M 0 00 CO o C6 O N 38863-0 A Recording Dist: 301 - Anchorage iiiHuuu1 i6/2 iM0 ri9 mi01ii2 iaPou�Pages: 1iuiioiuipii 1008-08D Grid 4715 EN 19036 075-031-26-000 ENCROACHMENT PERMIT This permit is between Chugach Electric Association, Inc., an Alaska non-profit electric cooperative, (herein "Chugach"), whose address is P. O. Box 196300, Anchorage, Alaska 99519 and Robert Paul Bursiel, Personal Representative of the Estate of Virginia C. Bursiel (herein "Permittee"), whose address is P.O. Box 60789, Fairbanks, Alaska 99706. 1. Easement. Chugach is the grantee or user of an easement for the construction and maintenance of electrical facilities, as follows: Described in that certain written instrument recorded on the I9`h day of May 1955, in Volume 118, Page 98, on file in the office of the District Recorder, Anchorage Recording District, Third Judicial District, Seward Meridian, Alaska, Dedicated by the plat of the subdivision known as Hemlock Subdivision, according to Plat Number 78-127, recorded on the 41h day of August 1978, on file in the office of the District Recorder, Anchorage Recording District, Third Judicial District, Seward Meridian, Alaska, (herein "Easement") which pertains to the following described real property: The Easterly Twenty Feet (F.'ly 20') of Lot Two (2), Hemlock Subdivision, according to Plat Number 78-127, recorded on the 4" day of August 1978, on file in the office of the District Recorder, Anchorage Recording District, Third Judicial District, Seward Meridian, Alaska. Permittee acknowledges the validity of the Easement. Permittee warrants and represents that Permittee is the owner of the fee simple interest in the land subject to the Easement and the following described real property to which the Easement is adjacent: l.ot Two (2), Hemlock Subdivision, according to Plat Number 78-127, recorded on the 4`h day of August 1978, on file in the office of the District Recorder, Anchorage Recording District, Third Judicial District, Seward Meridian, Alaska, Encroachment Permit - Page 1 of 4 (herein "Parcel"). eRecorded Document 2. Encroachment. Permittee has constructed or purchased the following improvements on or within the real property subject to said Easement: A carport that encroaches approximately Seven Feet (7') into the easement for a distance of approximately Eighteen Feet (18'); Three Feet (3') wide deck stairs that encroach approximately Ten Feet (10') into the easement that connect the second story deck to the carport; a well located near the northeast end of the lot that encroaches approximately Seven Feet (7') into the easterly side of said Easement for a distance of approximately One Foot (1'); a rock retaining wall approximately Two Feet (2') wide along the north side of the driveway that encroaches through the entire casement, (herein "Encroachment"). 3. Permit. Chugach hereby authorizes Permittee to continue the existence of the Encroachment in its existing location subject to the covenants set forth in this permit. 4. Indemnification. Permittee shall indemnify and hold Chugach harmless from any claims for personal injury, property damage or other loss arising in any way from the continuation of the Encroachment. 5. No EXpansion.or Increase. Permittee shall not in any way expand or increase the extent to which the Encroachment occupies any of the real property encumbered by the Easement without the prior written consent of Chugach. Chugach has no obligation to provide such consent. 6. No Interest in Real Fstate Agquired. Permittee hereby acknowledges that the Encroachment and any additions thereto, even if in violation of this permit, has not and shall not in the future give rise to any interest or estate in the real property subject to the Easement or any other real property. Without in any way limiting the foregoing, Permittee acknowledges that the Encroachment is not adverse to any interest of Chugach and its continuation is entirely with the permission of Chugach for purposes ofthe common law doctrine ofadverse possession. This permit creates no interest in the real property subject to the easement. 7. Modification of Utility Facilities. If the electric utility facilities located within the Easement are upgraded, added to, replaced or reconstructed, Permittee shall pay that portion of Chugach's total costs for such modification which is reasonably attributable to accommodating or preserving the Encroachment. If such payment is not made within thirty (30) days of written demand for same, Chugach may terminate this permit in accordance with paragraph 9, below 8. Covenants RUnnini? with the Land. The obligations ofthe Permittee arising from this permit shall be covenants running with the land which shall burden the Parcel and the Permittee's interest in the land subject to the Easement and shall benefit the Easement. Encroachment Permit - Page 2 of 4 eRecorded Document 2of4 2019-038863-0 9. Termination. Chugach may terminate this permit after the giving of thirty (30) days written notice of such termination if: a. The Encroachment is enlarged, increased or extended within the real property affected by the Easement. b. The Encroachment is damaged by any means to an extent of more than thirty percent (30%) of its replacement cost at the time of destruction. C. Permittee fails to make the payment described in paragraph 7, above. 10. Term. This permit shall, if not sooner terminated by Chugach, expire forty (40) years from the date hereof. 11. Entire Agreement ' reement. This written permit constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all other prior or contemporaneous agreements, oral or written, between the parties. No modifications, amendments, deletions, additions or alterations of the permit shall be effective unless in writing and signed by all of the parties hereto. CHUGACH ELECTRIC ASSOCIATION, INC. t By: Shelly Schmitt, for Manager Distribution Engineering Date: eRecorded Document PERMITTE { R bert Paul Burstel, Personal Representative of the Estate of Virginia C. Bursiel, Tetters Testamentary filed at Serial No. 2019-038387-0, Anchorage Recording District, Alaska Date: (,—") Encroachment Permit - Page 3 of 4 3 of 4 2019-038863-0 ASTATE OF A— ) ss: The foregoing instrument was 2019, by Robert Paul Bursiel, Persons NOTARY PUBLIC STATE OF ARIZONA y Pima County WILLIAM MARTIN fviy Camml;Sion Expires September 01, 2021 STATE OF ALASKA ) ) ss: THIRD JUDICIAUDISTRICT } u before me this day of Public in and for the State of N pr nmission expires The foregoing instrument was acknowledged before me thisp— lk day of CJf % 2419, by ��Ilf-- I 1 (1— SeniorManager, Distribution Engineering df Chugach Electric Association, Inc., an Alaska corporation, on behalf of the corporation. FSTA—TFOP—ALASKA OTARY PUBLIC `�tophen L. Howe L'.fy ('.,anrnisslon Ewes AFTER RECORDING RETURN TO: Chugach Electric Association, Inc. P.O. Boz 196300 Anchorage, Alaska 99519-6300 eRecorded Document Notary Public in and for the State of Alaska�� My commission expires: —+Z\ zZo Encroachment Permit - Page 4 of 4 11111111111111111111111 4of4 2019-038863-0 DocuSign Envelope ID: 328774FD-23C7-4DE2-A4A5-510552969AD2 September 27, 2019 Robert & Virginia Bursiel 507 Crow Creek Rd Girdwood, Alaska 99587 Alaska Communications has no objections to the existing well encroaching into the 20' Utility Easement located along the eastern boundary of lot 2, Hemlock Subdivision, otherwise known as 507 Crow Creek Rd Girdwood, Alaska as depicted on the drawings provided by Forge Engineering. Alaska Communications currently utilizes this easement and has no objections to the encroachment. Alaska Communications hereby issues this letter with stipulations to allow the encroachments of the above mentioned into the easement. Acceptance, (your signature below), and use of this letter of non -objection by yourself, your heirs, your assigns, or your successors, will constitute agreement to the following stipulations: 1. Alaska Communications will be held harmless, now and forever, for any damages or injury to any person or property as a result of this encroachment. 2. Any Alaska Communications facility damaged or destroyed as a result of this encroachment will be repaired at no cost to Alaska Communications. 3. Any costs incurred by Alaska Communications for special construction necessitated by this encroachment will be borne by the property owner. 4_ All applicable safety code regulations will be observed and maintained. 5. This letter of non -objection will in no way preclude Alaska Communications from full use and enjoyment of its rights within any portion of this easement 6. Alaska Communications is under no obligation to restore any structure damaged as a result of Alaska Communications full use and enjoyment of its rights within any portion of easements or right-of-ways. Please sign both copies, retain one copy for your use and return the other to Alaska Communications. Sierel , Austin s Ki , Network Engineer, Outside Plant Alaska Communications Outside Plant Engineering, MS#14 600 Telephone Ave. Anchorage, AK 99503 ACCEPTANCE SIGNATURE: DATE: CDocuSigned by: 10/2/2019 FOIBE5994B5314BC... Grid SE4715 GWC DocuSign Envelope ID: 328774FD-23C7-4DE2-A4A5-510552969AD2 September 27, 2019 Robert & Virginia Bursiel 507 Crow Creek Road Girdwood, AK 99587 Dear Robert & Virginia Bursiel, Subject to your agreement to indemnify the company as set forth below, GCI Communication Corp has no objection to the existing well located within the utility easement at the northeast end of Lot 2 Hemlock Subdivision also known as 507 Crow Creek Road, city grid 4715, GCI WO#19-0001-50. This letter of non -objection in no way precludes GCI Communication Corp from full use and enjoyment of any rights it may have within any portion of the utility easement and or the right-of-way, including unlimited access for servicing its facilities. Also any additional and extraordinary costs incurred during any future required construction, repair or reconstruction of GCI's facilities to accommodate any or all of the encroachments shall be paid by the property owner. By signing below, you agree to indemnify and hold GCI Communication Corp harmless, now and forever, for any damage, costs, expense (including reasonable attorney's fees), liabilities and injury to any person or property occurring as a result of the encroachment. Please indicate your acceptance by signing and returning this letter to me at the address below. DocuSignad by: Sincerely, �.. 10/2 2019 Date arkus Kofoid Manager Outside Plant Design & Data Management GCI Communication Corp 5151 Fairbanks St. Anchorage, AK 99503 907-868-6168 Office 907-868-8580 Fax Anchorage Water & Wastewater Utility Engineering Division Mayor Ethan Berkowitz September 30, 2019 Robert F. & Virginia C. Bursiel P.O. Box 484 Girdwood, AK 99587 Re: HEMLOCK LT 2, Grid (SE4715) Request for Letter of Non -objection to Encroachment (Tax ID# 075-031-26) �a Board Chair Aaron D. Dotson The Anchorage Water and Wastewater Utility received a request from your Representative Forge Engineering on September 27, 2019 in regards to an existing well encroaching within the Utility Easement along the east property line of HEMLOCK LT 2. AWWU is currently not using this Utility Easement and has no objection to the encroachment. AWWU hereby issues this letter with stipulations to allow the encroachment of the existing well within the easement, property owner(s) agrees to the following: 1. AWWU will be held harmless, now and forever, for any damages or injury to any person as a result of the encroachment; 2. The property owner(s) shall call for utility locates before excavation in the easement; 3. All applicable codes and regulations will be observed and maintained within the easement; 4. This letter will in no way preclude AWWU from full use and enjoyment of its rights within any portion of the easement; 5. The property owner(s) shall pay any additional and/or extraordinary costs incurred to accommodate the encroachment during any future required construction or reconstruction of AWWU facilities; 6. AWWU's non -objection does not imply other approvals that may be required for this encroachment; and, 7. AWWU does not provide a position for any other parcel or utility impacted by the encroachment. Should you have any questions, please call the AWWU Planning Section at 564-2739. eerely, Paul H tcher Engineering Technician III Anchorage Water & Wastewater Utility O Clearly 3000 Arctic Boulevard • Anchorage, Alaska 99503 `✓ Phone 907-5642774 • Fax 907-562-0824 - www.avnvubiz IN THE SUPERIOR COURT FOR THE STATE OF ALASKA THIRD JUDICIAL DISTRICT In the Matter of the Estate ) of ) VIRGINIA CANDLIN BURSIEL, ) Deceased. j Case No. 3AN-18- v PK -/—E ) LETTERS TESTAMENTARY The will of Virginia Candlin Bursiel having been admitted to probate, Robert Paul Bursiel is appointed personal representative of the state. Date"—'Registrar/S- erior, ourt Judge ACCEPTANCE C:) I, Robert Paul Bursiel, accept the duties.and-promise to o perform the duties as required by law of the office of Cz personal representative of the estate of Virginia Candlin Bursiel. I acknowledge my duty as personal representative to: (a) take possession and control of decedent's property as required by AS 13.16.380, determine the liabilities of the estate, and complete an inventory as required by AS 13.16.365; (b) provide notice to heirs and devisees as required by AS 13.16.360; av (c) provide notice to creditors as required by law, publish notice when required, aS and review and either accept or reject claims as required by AS 13.16.455-.515, except provided by AS 13.16.690; as o Qh 0" (d) advise the court in writing of my address and -z oo H 4) o 0? 00 0 400 telephone number as required by Probate Rule 8; a w�QitS�N >.. Q 00 (e) file returns for state estate taxes, if required by AS 43.31.121, and AS 43.31.250; Q0'v4' .. Mid' Z w S E-. w ( f ) pay homestead, exempt property and family U E o c% o E 3 a,a a00H p 00 J4 t° °O Qmrot 00 L ( v x U C� Lz.. E E-- r allowances as required by AS 13.12.401-.405, costs of administration and other claims as required by AS 13.16.470, and distribute the assets of the estate; and (g) close the estate as soon as appropriate as required by AS 13.16.620-.670. No bond is required to be filed. Dat Robert Pau 1 Bursiel P.O. Box 60789 Fairbanks, Alaska 99706 (907) 388-3163 VERIFICATION I, Robert Paul Bursiel, being first duly sworn, upon oath, depose and state as follows: I am the person named above; I have read the foregoing document and understand the contents thereof; I have executed it freely and voluntarily for the uses and purposes set forth therein; and, I verify that the same is true of my own knowledge and belief. Robert Paul Bursiel SUBSCRIBED AND SWORN to, before me, on this day, March 31, 2018. ,.tis. eAk114-- NOTARY :_ PUBLIC ,` OF„A�,,, 111 IL A 4 Notary/Pubiic in and for Alaska My Commission Expires: 11/28/19 I certify that this is a true and correct copy of the original on file in my office. ATTEST Cler of.t ie �rjal Courts atAnchoraop Letters Testamentary I t7eputy-.... J In the Matter or the Estate of Virginia Candlin Bursiel Case No. 3AN-18-%aPR/E Page 2 /VlUNIcIPALITY OF MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & t DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIOI~NVIRONMENTAL PROTECTION ' 825 L Street - Anchorage, Alaska 99501 ENWRONMENTALENG~NEER*.GD~WS~ON JAN 2, 1979 Telephone 264-4720 A...OVA DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER f~'})~ [ PHONE m,L,NG^DDRESS 484 PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE MAILING ADDRESS 3, LENDING INSTITUTION PHONE 4. REALTOR/AGENT I PHONE I MAI LING ADDRESS 5. LEGAL DESCRIPTION 6. TYPE OF RESIDENCE NUMBER OF BEDROOMS D One D Four ~ ~ Two ~ Five SINGLE FAMILY ~ MULTIPLE FAMILY ~ Three ~ Six Other 7. WATER SUPPLY /~ INDIVIDUAL~ COMMUNITY [~ PUBLIC UTILITY *ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) SEWAGE DISPOSAL SYSTEM [] INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY **If individual/on-site, give installation date If system is over two (2) years old an adequacy test is required by this Department, NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS ['IME TIME TIME DATE DATE DATE I NSPECTO R INSPECTOR INSPECTOR DIRECTIONS: ' 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [~]-- '"~i NG LE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2, WATER SUPPLY ~}-'/"i'~IDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [~]41~TDIVl DUAL/ON -SITE DATE iNSTALLED []PUBLIC UTILITY Connection Verified. INSTALLER ~Septic Tan~or ~Holding Tank Size: ]~)~ If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4, DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line I WELL TO: Absorption Area to nearest Lot Line ~ APPROVED FOR BEDROOMS ~ CONDITIONAL APPROVAL (letter must accompany certificate) ~-~DISAPPROVED DATE BY (Title) LEGAL DESO~I~TIO~ 72-010 (Rev, 3/78)