HomeMy WebLinkAboutWOODHAVEN #3 LT 4Onsite File
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Municipality of Anchorage
On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 2
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP231115 PID Number: 015-282-49
Dwelling: ❑■ Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ❑■ Upgrade
Name
Richard Schroeder
ABSORPTION FIELD
❑ Deep Trench ❑ Wide Trench K Bed ❑ Mound
Site Address
3991 Marcelle Circle
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
4
2.0 GPD/SF
+2.0 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
+3.0 Ft.
Gravel depth beneath pipe
1.0 Ft.
Subdivision Block Lot
Woodhaven #3 4
Fill added above original grade
5.6 Ft.
Gravel length
30 Ft.
Township Range Section
Gravel width
15 Ft.
Beds: Number of Lines
3
Distance between lines
5 Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Tank
Line
450 Ft2
n/a
n/a Ft.
Well
NA
100'+
100'+
NA
25'+
TANK ❑ Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer
EXISTING
Capacity
Gal.
Surface Water
NA
100'+
100'+
NA
Material
Number of compartments
Lot Line
NA
10'+
10'+
NA
NA
Foundation
NA
10'+
10'+
NA
LIFT STATION
Manufacturer
Capacity
Remarks AUX PUMP VAULT AND DRAINFIELD
ORENCO
Gal.
INSTALL ONLY
Alarm location
TIED TO EXISTING SYSTEM
Electrical installed by
Solid Ground
PIPE MATERIAL House to tank Tank to 3034
Installer
drainfield
Pomraning Excavation, LLC.
Drainfield 3034 CO/MT3034
Inspector PES (ADDL INSPECTIONS DAILY 8/7-8/11)
BENCH MARK (Assumed elevation) 100.0 ft
Inspdection 15` 05/15/23 06/26/23
Location and description
2nd
aro 06/27/23 4th
See Site Plan, Existing Tank Lid
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
Engineer's Stamp
Conditional Approval: Date
�'��"'' •...
*: 49 TM :*
annoNe
Septic System
Approved Date Y// ?"
CE 8149
'• 230720 '
••..•,,,•••'
�
Note: this approval does not include well permit requirements.
tKev uoivtri o)
AsBuilt
8/14/2023
Feet
0 30 60
DESIGN PARAMETERS
PRIMARY/RESERVE SEPTIC SYSTEM
NO. BEDROOM: 4(600 gpd)
TANK SIZE: 1500gal ADVANTEX
FAP(E) INSTALLED AUX PUMP VAULT
PERC RATE: 39 MPI
SOIL RATING: 2.0 GPD/SF
AREA ROD: 300 SF
SYS. TYPE: BED 15'W
MIN LENGTH: 20 LF
USED:
FIELD:
3OLFx 1 5.0'Wx0.5'E. Dx+2.0'TD
TOTAL AREA: 450 SF
ERS VERTICAL CONVEYANCE
ERS -IN-SITU INTERFACE
NO BEDROOM: 4 (600GPD)
APPLICATION RATE: 2.0 GPD/SF
AREA REQ'D: 300
USED: 3OLFx 15' Wx2.0' EDx2.0'TD
TOTAL AREA: 450 SF
SWING TIE TABLE:
NOTES:
1. SWING TIES WERE PERFORMED
PER 15.65.070 E 3. THE SWING
TIES REPRESENT SLOPE DISTANCE
PERFORMED WITH A RAG TAPE FROM
READILYIDENTIFIABLE FEATURES TO
RESPECTIVE FEATURES AND ARE
NOT SURVEYED LOCATIONS.
2. APPROXIMATE SLOPE LIMITS
ARE SHOWN BASED ON DISTANCE
TAKEN WITH TAPE MEASURE TO
APPROXIMATE TOE OF SLOPE. LIMIT
OF SLOPE NOT REQUIRED TO BE
SHOWN BY 15.65 AND IS A ROUGH
LOCATION. SLOPES WERE FIELD
VERIFIED WITH THE DEPARTMENT
PRESENT BY VISUALLY VERIFYING
FROM PREVIOUSLY SET PROPERTY
CORNER STAKES.
3. NORTHERN MOUND SLOPE
ADJACENT TO PROPERTY LINE WAS
FIELD MEASURED AT A SLOPE OF
APPROXIMATELY 2.5:1 WITH THE
DEPARTMENT PRESENT. JUTE MESH
WAS INSTALLED TO STABILIZE THIS
SLOPE AND GRASS SEED WAS
PLANTED.
10' T&E ESMT
WELL (E)
I
1� 7.0
APPROXIMATE LlM
Vv i i
\ < B
EXISTING DRAIN FIELD%
ABANDONED IN PLACE - \
DISCONNECTED FROM TANK
AND PIPES TO SURFACE
REMOVED
INSTALLED DRAINFIELD N _ m
30LF x 15'W x 1.0'ED x +2.0'TD't `"
0 0
(3EA) 1.25" LATERAL PIPE WITH !le" HOLES 24" O.C.N Lo N o
WITH 2.0' SAND AND 2.0' MOA TYPE 11 \ CJ z";
M II oN �d
INSTALLED MONITOR TUBE IN EACH CORNER - - - W _
M3 \ I �o �o
PFS TH-1
A
B
AP
35.4
45.1
M 1
90.5
102.9
M2
99.6
113.5
M3
88.1
108.1
M4
1 77.4
97.1
NOTES:
1. SWING TIES WERE PERFORMED
PER 15.65.070 E 3. THE SWING
TIES REPRESENT SLOPE DISTANCE
PERFORMED WITH A RAG TAPE FROM
READILYIDENTIFIABLE FEATURES TO
RESPECTIVE FEATURES AND ARE
NOT SURVEYED LOCATIONS.
2. APPROXIMATE SLOPE LIMITS
ARE SHOWN BASED ON DISTANCE
TAKEN WITH TAPE MEASURE TO
APPROXIMATE TOE OF SLOPE. LIMIT
OF SLOPE NOT REQUIRED TO BE
SHOWN BY 15.65 AND IS A ROUGH
LOCATION. SLOPES WERE FIELD
VERIFIED WITH THE DEPARTMENT
PRESENT BY VISUALLY VERIFYING
FROM PREVIOUSLY SET PROPERTY
CORNER STAKES.
3. NORTHERN MOUND SLOPE
ADJACENT TO PROPERTY LINE WAS
FIELD MEASURED AT A SLOPE OF
APPROXIMATELY 2.5:1 WITH THE
DEPARTMENT PRESENT. JUTE MESH
WAS INSTALLED TO STABILIZE THIS
SLOPE AND GRASS SEED WAS
PLANTED.
10' T&E ESMT
WELL (E)
I
1� 7.0
APPROXIMATE LlM
Vv i i
\ < B
EXISTING DRAIN FIELD%
ABANDONED IN PLACE - \
DISCONNECTED FROM TANK
AND PIPES TO SURFACE
REMOVED
INSTALLED DRAINFIELD N _ m
30LF x 15'W x 1.0'ED x +2.0'TD't `"
0 0
(3EA) 1.25" LATERAL PIPE WITH !le" HOLES 24" O.C.N Lo N o
WITH 2.0' SAND AND 2.0' MOA TYPE 11 \ CJ z";
M II oN �d
INSTALLED MONITOR TUBE IN EACH CORNER - - - W _
M3 \ I �o �o
PFS TH-1
0
ITH-5
TH TEST HOLE
\ (N) NEW
9L
o�LFFO
\
(E) EXISTING
CO CLEAN OUT NO.
W
p o
\
\
FC FOUNDATION CLEANOUT
FS FLOW SPLITTER
�o
��
O
-
96
17 5
f
\
MT MONITOR TUBE NO.
Cis
v�
�
W O Lo
TYP TYPICAL
j¢�
O c W 0-)
Jo -J
EXISTING
1500g
ADVANTEX TANK W AX20 POD
U)
M
1\�VELL
NSTALLED AUXILIARY
PUMP VAULT (N)
105.5 2.0' FILTER SAND
ORIGINAL -
Z
1
Z � ^
_ 0100
�
Z
H-1
GRADE.' 102.5 n
\ AGE ESM i /
1
c�QO
=
Q
Q
_
WELL E
/ 20' DRI
�'7� E ESMT
AND SLO j
W (:D
Zoe
0
::E\
O
O O D O
z
4
SEPTIC AREA
(E)
PT
F
A
\ I
Vim\
Z =
\
z
MT MT
1" 1 A
\
B
W
30.0 3
- 4BR
z
�w
SFD
W
W
5
�
�
U
SCALE: NTS BOH
ABBREVIATIONS
0
AUX. PUMP
VAULT
(AP)
FINISHEDL ISCCV (/Y/ -.)GRADE:
K.l..25""0
ITH-5
TH TEST HOLE
\ (N) NEW
9L
o�LFFO
\
(E) EXISTING
CO CLEAN OUT NO.
W
p o
\
\
FC FOUNDATION CLEANOUT
FS FLOW SPLITTER
�o
��
O
-
96
17 5
f
\
MT MONITOR TUBE NO.
Cis
v�
�
W O Lo
TYP TYPICAL
j¢�
O c W 0-)
Jo -J
U)
M
1\�VELL
CD
>�
105.5 2.0' FILTER SAND
ORIGINAL -
Z
(E) \
Z � ^
_ 0100
�
Z
H-1
GRADE.' 102.5 n
\ AGE ESM i /
Wo-
m
c�QO
=
Q
Q
_
WELL E
/ 20' DRI
�'7� E ESMT
AND SLO j
W (:D
Zoe
0
::E\
O
O O D O
z
j 15' GAS
PT
F
Vim\
Z =
H
U)
z
MT MT
1" 1 A
AUX. PUMP
VAULT
(AP)
FINISHEDL ISCCV (/Y/ -.)GRADE:
K.l..25""0
108.1 1DRAIN-PIPETYP
MA X 1.0' DRAIN ROCK
3 37
see
NOre
3
U)
�
105.5 2.0' FILTER SAND
ORIGINAL -
Z
U
Z
H-1
GRADE.' 102.5 n
Q
()
J
Q
Q
05/23/23 (0)
lot, 20' A&A TYPE 11 104.5 ORI
vl
PT
F
2
z
W
30.0 3
z
�w
PROFILE DATE PERFORMED 4 GM/SM
5/16/23
W
W
5
�
�
U
SCALE: NTS BOH
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http://www.muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP231115
Work Type: Septic Upgrade
---Tax-Code-Number: 01528249000 - - - - ---
Site Legal Address: WOODHAVEN #3 LT 4 G:2735
Site Mailing Address: 3991 MARCELLE CIR, Anchorage
Owner: SCHROEDER RICHARD M & TRILL
Design Engineer: PANNONE ENGINEERING SERVICES
This permit is for the construction of:
Q Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy
Effective Date:
Expiration Date:
�t�,cnr S
V
DeI)artment
5/31/2023
5/30/2024
Lot Size in Sq Ft: 40021
Total Bedrooms: 4
❑ Private Well ❑ 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
Received By: S� V �is
I
Issued By:
Date:
Date:
5 / L
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. 015-282-49
"n
Property owner(s) Richard Schroeder
Mailing address 3991 Marcelle Circle
Site address 3991 Marcelle Circle
Day phone
Legal description (Sub'd., Block & Lot) Woodhaven #3, Lot 4
Legal description (Township, Range & Section)
Lot Size 40,021 Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR:
APPLICATION IS AN: TYPE OF DWELLING:
(® all that apply)
Absorption Field
❑X
Initial ❑ Single Family (SF) ❑X
(w/wo AD U)
Septic Tank
ElUpgrade
❑X
(D) ❑
Holding Tank
El
Renewal
Renewal ❑
Multiple Dwellings ❑
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
❑
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.
W�
(Signature of property owner or authorized agent)
Permit/Rush Fees: 9 S Z Waiver Fees:
Date of Payment: L% 3 Date of Payment:
Receipt Number: Receipt Number:
Permit No. /115 -
Waiver No.
Permit App_:- : :'-:c -
Pannone Engineering Services LLC
Steven R. Pannone, Principal
Registered Professional Engineer
E‐mail: steve@panengak.com
Mailing: P.O.Box 1807, Palmer, AK 99645
Telephone: (907) 745‐8200 FAX: (907) 745‐8201
24 May 2023
Municipality of Anchorage
Development Services Department
On‐Site Water & Wastewater Program
4700 Elmore Road
P. O. Box 196650
Anchorage, Alaska 99519
Subject: Woodhaven #3, Lot 4
Septic System Upgrade Permit Request
Septic System Design Narrative
This is a design narrative for a permit to install an upgrade septic system on the subject property. The proposed
upgrade will serve an existing four‐bedroom (4) house. This lot and surrounding lots are served by private wells. The
system will maintain all required separation distances.
1. Soils:
A test hole was performed on this lot by Pannone Engineering Services, LLC on 5/11/2023. Groundwater was
observed at a depth of three feet (3.0’) during the excavation of the test hole, and bedrock was not encountered.
Groundwater was observed near surface level in the test hole monitor tube after 7‐days. Based on the results of the
percolation test and overall soils appearance an application rate of 2.0 gpd/SF was used for the design of a Cat III
wastewater treatment system in the area of the test hole.
2. Soil Absorption System Design.
a. See Sheet 1 of the design package.
3. Surface Water:
There is no surface water within 100 feet of the proposed septic tank and drain field.
4. Topography:
See attached site plan for area topography. There are no steep slopes in the area of the upgrade.
5. Drawing Markings: The Drawings are marked “For MOA Review Only”. When written notification that the
review is complete and no further comments are received from MoA On‐Site Department, the note will be removed
and “For Construction” drawings will be issued.
The proposed installation will not affect the future development of this or the surrounding lots.
If you have any questions or concerns, please contact me at (907) 745‐8200.
Sincerely,
Steven R. Pannone, P.E. F. ASCE
Owner/Civil Engineer
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231115, Curtis Townsend, 05/31/23
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231115, Curtis Townsend, 05/31/23
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231115, Curtis Townsend, 05/31/23
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231115, Curtis Townsend, 05/31/23
Municipality of Anchorage
On -Site Water and Wastewater Program • (907) 343-7904 Page 1 of 2
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP171250 PID Number: 015-282-49
Dwelling: X Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑■ New ❑ Upgrade
Name:
Spinell Homes
ABSORPTION FIELD
E]Deep Trench E] Shallow Trench ❑■ Bed E] Mound
Address
3991 Marcelle Circle
❑ Other
Phone
Number of Bedrooms
Soil Rating
depth from original grade
4
JTotal
2.0 GPD/SF
5.0 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
4.5 Ft.
Gravel depth beneath pipe
0.5 Ft.
Subdivision Block Lot
Woodhaven #3 4
Fill added above original grade
0 Ft.
Gravel length
30.0 Ft.
Township Range Section
Gravel width
15.0 Ft.
Beds: Number of Lines
3
Distance between lines
5 Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Tank
Line
z
450 Ft
N/A
N/A Ft.
Well
181.0
181.9
N/A
N/A
173
TANK ❑ Septic X S.T.E.P. ❑ Holding N Other
Manufacturer
Anch Tank/ Orenco/ Advantex
Capacity
11500 Gal.
Surface Water
100+
100+
N/A
N/A
Material
Fiberglass
Number of compartments
2
Lot Line
44.7
10.0
N/A
N/A
NA
Foundation
11.2
29.6
N/A
N/A
LIFT STATION
Manufacturer
Capacity
Curtain Drain
50+
50+
N/A
N/A
Orenco
500 Gal.
Remarks
Pump on level at
Timed in.
Pump off level at
in.
High water alarm at
45 in.
Pump make and model
P2005
Electrical Inspections performed by
Muni of Anch
PIPE MATERIAL House to tank 3034 Tank
drainfield 3034
Installer
Pomraining Construction
Drainfield 3034 CO/MT 3034
Inspector PES
BENCH MARK (Assumed elevation) 100 ft
Inspecttiones: 15` 11/17/17 11/17/17
Location and description
2nd
3m 6/7/18 4'h
Bottom of Trim
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL
Engineer's Stamp
Conditional Approval: Dater
QF: ACgsl�
49TM �••* I
• Steven R. Pannone
%
41 Ae - CE 8149
cif. N r
Approved-I�`\����,�g, �yr g� Date 7 3 1
11 Z PROF C—
Inspection Report_9-1-12.doc
-DESIGN PARAMETERS -
PRIMARY/RESERVE SEPTIC SYSTEM
NO. BEDROOM: 4 (600 gpd) TH—
TANK SIZE: 1500g ADVANTEX ACT
W/ AX20 POD
PERC RATE: 48 MPI
SOIL RATING: 2 GPD/SF
AREA ROD: 300 SF
SYS. TYPE: BED 15'W
MIN LENGTH: 20.0 LF
USED:
30 LFx15'WxO.5' E.D., 5.0' TD '
TOTAL AREA: 450 SF 10.0 ��
: yy
0
nV
II OG./FG.
a
LOCATION) w I
INSTALLED DRAINFIELD 4
30LF x 15'W x 0.5'ED x 5.0'TD SEPTIC AREA (E)
i o
v11 INSTALLED 1500g ADVANTEX TANK z
DCO WITH AX20 POD
INSTALLED FOUNDATION CLEAN OUT
INSTALLED DOUBLE.CLEAN OUT
O T1 AFTER TANK
T2 A I
4BR
HOUSE
181.0 /
M M �M
1 81 .7
/� M M
i� \ \�
O \
IWELL (E) /--
• \/ 20' DRAINAGE ESMT
/ SLOPE, ESM
ES
WELL 15' GAS AND
0 w
A
B
FC
10.7
21.50
T1
17.3
23.8
T2
26.6
31.3
DCO
28.5
35.1
M 1
39.6
38.7
C2
57.9
39.30
C3
53.9
33.50
C1
61.3
43.60
M2
62.4
1 45.10
0
nV
II OG./FG.
a
LOCATION) w I
INSTALLED DRAINFIELD 4
30LF x 15'W x 0.5'ED x 5.0'TD SEPTIC AREA (E)
i o
v11 INSTALLED 1500g ADVANTEX TANK z
DCO WITH AX20 POD
INSTALLED FOUNDATION CLEAN OUT
INSTALLED DOUBLE.CLEAN OUT
O T1 AFTER TANK
T2 A I
4BR
HOUSE
181.0 /
M M �M
1 81 .7
/� M M
i� \ \�
O \
IWELL (E) /--
• \/ 20' DRAINAGE ESMT
/ SLOPE, ESM
ES
WELL 15' GAS AND
0 w
w
m
j 7
O p
w O
FILTER FABRIC
w Q
m W FO
0o z
DRAIN ROCK 6" ABOVE PIPE INV
U
U o
4" 0 DRAIN PIPE
AX20
OG. FG.
2" RI
POD
101.0
.
Ir
0.5' SEWER ROCK
15009 ADVANTEX
TANK
PROFILE
SCALE:NTS
w
7 �
K 0
O 4
z w
o
� U
TEST HOLE 2
OB/OG
1
65
0
SM
-2 9 2. 0
(5/15/13)
(5/15/14)
15
16 _84.5
DATE PERFORMED: (DRY 11/17/17)
3/12/13
NOTES: PANNONE ENG SVC, LLC �'—oF q����1 D�2�20,s
RECORD DRAWING �'..
P.O. BOX 100217 ANCHORAGE, AK 99510 r 'S. .. , i
r'"P' f Scale
PHONE (907) 272-8218 FAX (907) 272-8211 i* 49 TM *�l ,"=50'
' .... P.I.D. NO
DRAWN BY: ACP WOODHAVEN #3, LOT 4 . ... / 015-282-49
SPINELL HOMES, INC. fj Steven Pannone �
%, CE 8149 PERMIT NO.
�\��
MARCELLE CIRCLE � � •. OSP171250
PLAN ANCHORAGE, AK ,l>1��F��7pSS10NP��+ Sheet
2OF2
Certified Drilling log
P DOC CO dba
J UB, LLIVAN
4WATER WELLS
P.O. Box 670269, Chugiak, AK 99567 688-2759
OWNER OF LAND: Spinell Homes
ADDRESS:
Bore Hole
Data
Depth
From
To
LEGAL DESCRIPTION Woodhaven #3 Lot 4
DATE: 9-29-17
0
2
PERMIT NUMBER: OSP171250 DATE OF ISSUE: 9-5-17
TAX IDENTIFICATION NUMBER 01528249000
Is well located at approved permit location: ®Yes ❑No
Method of Drilling: ®air rotary ❑cable tool
Depth of Well: 105'
Casing Type: Steel Wall thickness .250 inches
Diameter: 6 inches, depth 104 feet
Liner type
Static Water Level: 64 feet
Recovery Rate 8 ® gpm ❑ gph
Method of Testing Air
Well Intake Opening Type: ® open end ❑open hole
❑ Screened Start feet Stopped
❑ Perforations Start feet Stopped
Grout Type: Bentonite Volume: 50 lbs
Depth: from 2 feet, to 42 feet
Well Disinfected Upon Completion: ®yes ❑ no
Method of Disinfection: Chlorine 50 PPM
Comments:
2
4
4
17
17
25
25
81
81
85
85
101
101
105
Casing Stickup
Overburden
Silty Sand & Gravel
Silty Sand & Gravel Wet
Tight Silt Sand & Gravel w/ Clay
Tight Silt Sand & Gravel 4 GPM
Silty Sand & Gravel w/ Clay
Sand & Gravel
Drillers Name: Cole Sullivan
ATTENTION: It is the responsibility of the property owner to submit a copy of the well log to the proper authority.
Municipality of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation.
Matsu Borough: Department of Environmental Conservation.
Well Drilling Permit Number: OVV 0SP271250 Date ofIssue 9-5-17
Parcel Identification Number: 01528249000
Legal Description
Woodhaven #3 Lot 4
Pump Installation Date: 4-4-18
Pump Intake Depth Below Top ufWell Casing: 90
Pump manufacturer's Name: F&VV
Pump Model: 4F07P05301S
Pump Size: 1/2
MdessAdapter Burial Depth: 10
PidessAdapter Installer: Pomranin0Eucaxetion
Disinfected Upon Completion? M yes Fl no
Method ofDisinfection: Chlorine S8PP&0
U Comments: Pit|essW1anufacturen Martinson
U
Pump Installers Name: Sullivan Water Wells
Property Owner Name &Address
SpineUHomes
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
�'`"'L'"rr MUNICIPALITY OF ANCHORAGE
On-Site Water&Wastewater Program
Aik, PO Box 196650 4700 Elmore Road �
Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 r.
http:l/www.muni.orglonsite
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On-Site Water & Wastewater System Permit
Permit Number: OSP171250 Effective Date: 9/5/2017
Work Type: WellSeptic Initial Expiration Date: 9/5/2018
Tax Code Number: 01528249000
Site Legal Address: WOODHAVEN #3 LT 4 G:2735
Site Mailing Address: 3991 MARCELLE CIR, Anchorage
Owner: SPINELL HOMES INC Lot Size in Sq Ft: 40021
Design Engineer: PANNONE ENGINEERING SERVICES Total Bedrooms: 4
This permit is for the construction of:
❑ Disposal Field 0 Septic Tank ❑ Holding Tank ❑ Privy El 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
Received B : ' 410v,...'” L 17
Y ,� � �� _Q Date: � 6
Issued By: o Jffr Date: J/5/7
MUNICIPALITY OF ANCHORAGE
- i
Community Development Department . Phon:, 907-343-74 e ,
Development Services Division -� F:x. sillia97 1
On-Site Water& Wastewater Program
AUG L 4 2011
ON-SITE SEWER/WELL PERMIT APPLICATION
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Parcel I.D. 015-282-49 it 0/ 6 8
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Property owner(s) Spinell Homes Inc Day phone
Mailing address 1900 W Northern Lights Blvd #200, Anchorage, AK 99517
Site address NSN Marcelle Circle
Legal description (Sub'd., Block & Lot) Woodhaven #3, Lot 4
Legal description (Township, Range & Section)
Lot Size 40,021 Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(®all that apply)
Absorption Field ❑X Initial ❑X Single Family (SF) ❑X
(w/wo ADU)
Septic Tank ❑X Upgrade ❑ Duplex (D) ❑
Holding Tank ❑ Renewal ❑
Multiple Dwellings ❑
Privy ❑ (SF and/or D)
Private Well ❑X
Water Storage ❑
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: /'�4 ? Waiver Fees:
Date of Payment: 8/24 f '" Date of Payment:
Receipt Number: �} Qarad4 Receipt Number:
Permit No. 0sp«/ash Waiver No.
Permit App_ ::.,c
Pannone Engineering Services tic
Steven R. Pannone, Principal
Registered Professional Engineer
E-mail:stevePpanengak.com
September 5, 2017
Subject: Woodhaven #3, Lot 4
Well and Septic System Permit Request
Design Narrative
This is a design narrative for a permit to install a well and septic system to be issued for this property. The
proposed system will serve a proposed four (4) bedroom house. Currently the lot is undeveloped. The
system will utilize a new 1500g advantex tank with an AX20 pod and a drain field. This lot and the
surrounding lots are served by private wells. There are no wells within 100' of the proposed septic
system.
1. Soils. One test hole was performed in the vicinity of this system by Michael E Anderson in January
2013, and groundwater was monitored for at least seven days. Ground water was not observed to a
depth of 9.0' below the surface in the test hole monitor tube in May of 2013. Bedrock was not
encountered in the test hole to 16.5'. Based on the results of the percolation tests and overall soils
appearance; an application rate of 2.0 gallons/day/square was used for a Cat III wastewater system in
the area of the test hole.
2. Soil Absorption System Design.
a. See Sheet 1 of the design package.
3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and drain field.
The proposed drain field upgrade will maintain at least 100 feet from all surface water and drainage
ditches.
4. Topography: The existing topography on the lot generally slopes from east to west, with a slope
of approximately 5% in the area of the drain field. There are no steep slopes within 50' of the proposed
drain field. The proposed drain field will maintain 50' separation all steep slopes.
S. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification that
the review is complete and that there are no further comments is received from MoA On-Site
Department, the note will be removed and "Issued for Construction" drawings will be issued.
The proposed installation will not affect the future development of this or the surrounding lots.
Mailing: P.O. Box 100217, Anchorage, AK 99510-0217
Physical: 332 East Manor, Anchorage, AK 99501
Telephone: (907) 272-8218 FAX: (907) 272-8211
p . - . - . - - . - . - . ,
_ N.)
R .° PRIMARY / RESERVE DRAINFIELD (P) \ I �'
3OLF x 15'W x 0.5'ED x 3.0'TD I
R
8 INSTALL MONITOR TUBE AT EACH CORNER ` , SEPTIC AREA (E) 1
-TH I. I 1
CLEAN OUT (P) 4 ! �y
AT THE END OF EACH LINEN \
TH-5 \
N0100
4 T i
9 N1500g ADVANTEX TANK (P)
WITH AX20 POD
INSTALL FOUNDATION CLEAN OUT
l:. INSTALL DOUBLE CLEAN OUT \�
4BR AFTER TANK
N I HOUSE \� it
\ . (P)
\ N‘\ M M-�Mz
M\ N 1,1`
Nil
l'\\\ N
•
\'' \ *An
•\ p� \ WELL (E) ,„----1%_______________Z--
.•
�
\ •` /fix, 20' DRAINAGE ESMT /
SLOPE ESMT
•` 15' GAS AND
• ••` \ /
DESIGN PARAMETERS _'`r'•' •• WELL P 3
PRIMARY/RESERVE SEPTIC SYSTEMz i
N0. BEDROOM: 4 (600 gpd)
TANK SIZE: 1500g ADVANTEX -1N
: , le,.,,,i''
`"W/ AX20 POD W ` V '
PERC RATE: 48 MPI \ W 1 °
SOIL RATING: 2 GPD/SF ABBREVIATIONS
AREA RQD: 300 SF \?. LEGEND TH TEST HOLE
MIN ENGTTYPE: BED 10 LF W WATER LINE/ `(P) PROPOSEDMIN LENGTH: 20.0 LF � 1L ,\ WELL RADIUS J (E) EXISTINGFUSE: vs1 , 000 CLEAN OUT NO.
30 LFx15'Wx0.5' E.D., 5.0' TDNEW SEPTIC MT MONITOR TUBE NO.
TOTAL AREA: 450 SF TYP TYPICAL �'
NOTES: PANNONE ENG SVC, LLC �`of At Al 9�5�20,7
FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 'c�.......qS l0
PHONE (907) 272-8218 FAX (907) 272-8211
...47,S,‘"-•c ' 4i.•19tt Scale
5*. .• /` • I/ 1"=50'
11 111111,•,� , P.I.D. NO
WOODHAVEN #3, LOT 4 "�� �• 015-282-49
SPINELL HOMES, INC. r S'teven 'F�. nnorae PERMIT NO.
��c, CE 8149 .,�e-/� OSP171250
MARCELLE CIRCLE It s . •• i
PLAN ANCHORAGE, AK tk ./'fp •D ONp�� -' Sheet
,Ak-\\-%--%'- OF 2
SPECIAL PROVISIONS TO SPECIFICATIONS
1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF
ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF
ON—SITE WASTEWATER DISPOSAL SYSTEMS AND AND IN ACCORDANCE WITH AMC 15.65 AND 15.55.
2. SCOPE OF WORK; INSTALL NEW ADVANTEX AND SOIL ABSORPTION SYSTEM INSTALL WELL.
3. GROUNDWATER WAS NOT ENCOUNTERED TO A DEPTH OF 9 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL
TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 9 FEET BELOW
EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY.
4, THE CONTRACTOR (BOTH WELL AND SEPTIC SYSTEM CONTRACTORS) SHALL HAVE ANY WELL LOCATION AND SEPTIC
LOCATION STAKED AND ANY LOT LINE AND WELL RADIUS SHOWN ON THE PLAN WITHIN 30 FEET OF THE PROPOSED
SYSTEM STAKED BY A REGISTERED LAND SURVEYOR BEFORE STARTING THE WORK.
5. THE CONTRACTOR IS RESPONSIBLE FOR ALL R.O.W. AND OTHER REQUIRED PERMITS, OTHER THAN THE ATTACHED.
6. THE CONTRACTOR SHALL CALL FOR LOCATING OF ALL BURIED UTILITIES.
7. THE CONTRACTOR SHALL PROVIDE 24 HOUR NOTICE TO THE ENGINEER PRIOR TO START OF WORK. ALL SURVEYING AND
LOCATES SHALL BE IN PLACE PRIOR TO NOTIFYING THE ENGINEER.
8. THE CONTRACTOR SHALL NOTIFY THE ENGINEER OF ANY DISCREPANCY BETWEEN THE APPROVED DRAWINGS AND SITE
CONDITIONS/LIMITATIONS POTENTIALLY CAUSING THE NEED TO MODIFY THE DESIGN.
9. AT THE COMPLETION OF THE WORK, THE CONTRACTOR SHALL SUBMIT RED—LINE AS—BUILT DRAWINGS TO THE ENGINEER.
THE RED—LINES SHALL INCLUDE PIPE LENGTHS, ORIGINAL GROUND ELEVATIONS, PIPE ELEVATIONS, AND TANK
ELEVATIONS.
10. THE CONTRACTOR SHALL PROVIDE PHOTOGRAPHS OF THE SYSTEM INSTALLATION TO INCLUDE BOTTOM OF EXCAVATION,
TOP OF PIPE WITH CLEAN—OUTS AND MONITOR TUBES INSTALLED, INSTALLED TANK AND FINAL GRADING.
11. THE CONTRACTOR PROVIDED DATA (UPON WHICH THIS RECORD DRAWING IS BASED) APPEARS TO REPRESENT THE
PROJECT AS CONSTRUCTED. THIS DATA IN CONJUNCTION WITH THE PERIODIC FIELD OBSERVATIONS BY THE ENGINEER
(OR HIS DESIGNEE) AS REQUIRED BY AMC 15.65 DOES NOT GUARANTEE THAT THERE ARE NO HIDDEN DEFECTS BY THE
CONTRACTOR.
12. THE CONTRACTOR SHALL SIGN THE FOLLOWING:
I CERTIFY THAT ALL WORK WAS PERFORMED IN ACCORDANCE WITH THE APPEND PERMIT, AND ANY AND ALL CHANGE
ORDERS, AND THAT THE AS—BUILT REDLINES ARE TRUE AND ACCURATE REPRESENTATION OF THE PROJECT AS
CONSTRUCTED,
CONTRACTOR:
BY; . TITLE:
DATE:
NOTES: • PDate
ANNONE ENG SVC, LLC � at. 9/5/2017
FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 ."� ''' 'Q
PHONE (907) 272-8218 FAX (907) 272-8211 j*�P ;1`sy�+�0 Scale
•,11110 IIr P.I.D. NO
WOODHAVEN #3, LOT 4 .-41111‘. .. 82-49
SPINELL HOMES, INC. �'teven -. 'P: no e 5 PERMIT NO.
�c�. CE 8149 OSP171250
MARCELLE CIRCLE I s "
DESIGN DETAILS ANCHORAGE, AK Sheet
"k 0+ 2OF2
MUNICIPALITY OF ANCHORAGE 40,s imaikkOF �
DEVELOPMENT SERVICES DEPARTMENT e�.P��... •.. ++1�
4700 BRAGAW STREET ANCHORAGE, AK 99519-6650 : .49th *...\ '���%
SOILS LOG - PERCOLATION TEST -y ...Eez
40,;MICHAEL E. ANDERSON j
LEGAL DESCRIPTION: WOODHAVEN SUBDIVISION No. 3 ��**l• No. CE--381 ;a1
PERFORMED FOR: SPINEL HOMES +44 GI
SS .••�
DATE: 1/11/13 PROJECT No.: laaa`th
PARCEL ID#: TECHNICIAN: A. 1-JARALA 1'rnfesciunAl f:nKmrars Stamp:
DEPTH TEST HOLE No. 5
(feet)
SLOPE SITE PLAN
1 '�f
2 .
3 •
• SILTY SAND
4 — WITH VARYING SILT SEE SITE PLAN it
5 — l
6 ,M
7
8
WAS GROUND WATER ENCOUNTERED?FRED"
IFYES(ir;WHAT DEPTH? c
DEPTH TO WATER AF'IL•R MONITORING: 9.
1 ODATE OF MONITORING: 5/15/13
5/15/I4. 9'
11
•
GROSS TIME NET TIME DEPTH TO NET DROP
12 DATE READING (MINUTES) (MINUTES) WATER (INCHES)
13 1/17 TEST HOLE PRESOAKED PRIOR TO TESTING:
14 I 1:15 1.373
15 — 2 1:45 30 2,00"
3 1:46 1.50"
16
BOH @ 16.5 4 2:16 30 2.125" .b25
1 7- - 5 2:17 1.25"
18 t� 2:47 30 1.875" ,>25"
19
PERCOLATION RATE: 48 (MIN/INCH) PERC. HOLE DIA. S" (INCHES)
TEST RUN BETWEEN: 4 FT. and 5 FT.
COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST.
TEST PERFORMED BY ANDERSON ENGINEERING. I, MICHAEL E. ANDERSON CERTIFY TIIAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE: 3/12/13
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. 015-282-49-000
Expiration Date: 10/28/2023
Legal description WOODHAVEN #3 LT 4
Site address 3991 MARCELLE CIR Anchorage AK 99516
Current property owner(s) SCHROEDER RICHARD M & TRILL
X The On-site system(s) is/are approved for 4 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or advisories:
Original Certificate Date: 7/28/2023
This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
system(s) is/are in substantial compliance with municipal code. The Municipality of
Anchorage, Development Services Department (DSD) issues COSAs based upon
representations provided by an independent professional engineer. The Municipality of
Anchorage is not responsible for errors or omissions in the professional engineer's work.
ATTACHMENTS:
COSA Checklist X Well Flow Advisory
Absorption Field Advisory Nitrate Advisory
Tank Age Advisory Arsenic Advisory
Other
COSA Approval_June 2022
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 Application
1. GENERAL INFORMATION
Parcel I.D. 015-2 82-49
Complete legal description Woodhaven #3 Lot 4
Location (site address) 3991 Marcelle Circle
Current property owner(s) Richard Schroeder
2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS
Day phone
3. TYPE OF WATER SUPPLY: n Private Well ❑ Private Well serving 2 dwelling units
❑ Private Well serving 3+ dwelling units ❑ Community Well or Public
❑ Water Storage
4. TYPE OF WASTEWATER DISPOSAL: IM Private Septic ❑ Private Septic serving 2 dwelling units
❑ Holding Tank ❑ Community Septic or Public Sewer
5. SEPTIC TANK: ❑ Steel ❑ Plastic ❑ Concrete FE -1 Fiberglass
Age 5 yrs - See advisory if steel older than 20 years
6. ABSORPTION FIELD: ❑ AWWTS 0 Bed ❑ Deep Trench ❑ Wide Trench ❑ Seepage Pit
Waiver request for:
Expedited review requested:
Distance:
By applying for this entitlement, this property is subject to inspection by municipal On-site staff
to verify the accuracy of the information provided.
Date of Payment
COSA# b50-2-3/Z&'g
Date of Payment
Waiver #
COSA App: ation June 2022
COSA Checklist_June 2022
COSA Checklist
Legal Description: Parcel ID:
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____
A. WELL DATA
Well log is filed with Onsite (or attached)
Date drilled Total depth ft
Cased to ft
Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) in.
Date of flow test for COSA
Static water level at beginning of test ft.
Well production at time of test gpm
Water storage tank volume gallons
Well disinfected for coliform test? Yes No
Coliform bacteria is Negative
Nitrate mg/L Nitrate less than MRL (ND)
Arsenic ug/L Arsenic less than MRL (ND)
Collected by
Date
Comments __________________________________________________________________________________
B. TANK DATA
Measured operating fluid level in septic tank
Date of pumping
Required maintenance completed, if AWWTS
Comments:
C. LIFT STATION
Required maintenance completed
Age of lift station years
Lift station material
Comments:
D. ABSORPTION FIELD DATA
Which system tested (date installed)
ALL standpipes present per record drawing
Total measured depth from grade ft (max)
Measured depth to pipe invert from grade ft (min)
N/A – pressurized field.
Per record drawings, field is insulated.
Monitor tubes go to bottom of effective.
If not, state depth into effective
Presoaked required if
(Required if house vacant or field not used for more
than 30 days prior to date of test)
Gallons introduced gallons date
Any rejuvenation treatment (past 12 months)
If yes, enter date
Adequacy test date
Results Pass
Fluid depth prior to test in
Water added gal
New fluid depth in
Elapsed time min
Final fluid depth in
Absorption rate gpd
FIELD STATUS – POST RECOVERY
Effective depth (per record drawings) in
Effective depth used in
Effective depth remaining in
Comments/Deficiencies:
COSA Checklist_June 2022
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well on lot)
Septic Tank/Lift Station on Lot > 100’
Yes if No ft
Neighboring Tank > 100’ Yes if No ft
Absorption Field on Lot > 100’ Yes if No ft
Neighboring Absorption Fields > 100’
Yes if No ft
Community Sewer Main > 75’ Yes if No ft
Community Sewer Manhole/Cleanout > 100’
Yes if No ft
Private Sewer/Septic Line > 25’ Yes if No ft
Holding Tank > 100’ Yes if No ft
Animal Containment > 50’ Yes if No ft
Manure/Animal Excreta Storage > 100’
Yes if No ft
N/A – Served by Community Well (not on lot) or Public Water
From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required)
Building Foundations > 10’ Yes if No ft
Tank to Property Line > 5’ Yes if No ft
Field to Property Line > 10’ Yes if No ft
Water Main > 10’ Yes if No ft
Water Service Line > 10’ Yes if No ft
Surface Water > 100’ Yes if No ft
Wells on Adjacent Lots:
Private Wells > 100’ Yes if No ft
Community Wells > 200’ Yes if No ft
If tank or field is under driveway comment below
F.ENGINEER’S COMMENTS
G.CERTIFICATION & 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, indicates that the on-site water
supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation, unless noted otherwise.
Name of Firm Phone
Engineer’s Printed Name Date
To: Page: 1 of 1 2023-05-05 23:01:31 GMT 19073086608 From: Wes Anderson
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Repernediuvead other osss?
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MUNICIPALITY OF ANCHORAGE
ADVANCED WASTEWATER TREATMENT SYSTEM
MAINTENANCE AND REPAIR AGREEMENT
THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and
ered into as of this <99 Day of �� t of 20o 3, by and between
n �, herein the "OWNER," and the Municipality of
� I a 1, y
Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code
(AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this
Agreement agree as follows:
1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the
Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS),
described as Advantex
located at (legal description)
Woodhaven #3 L4
2. Maintenance, Repairs and Alterations.
(Owner is required to read, understand and initial each section)
Throughout the term of this Agreement, the Owner shall enter into a service agreement
with an AWWTS service and maintenance provider approved by the Municipality or the
manufacturer's representative. The AWWTS shall be maintained in a satisfactory
condition capable of performing as designed and producing treated septic effluent in
�/accordance with the equipment's approval for operation in the Municipality.
V " it shall be the responsibility of the Owner during the term of this Agreement to pay for all
repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This
includes an annual maintenance fee (typically $400 to $600).
U Owner agrees that only maintenance and repair personnel approved by the Municipality
or the manufacturer's representative will inspect and make any necessary maintenance,
repairs or permitted alterations to the system.
Owner acknowledges that regular maintenance of an AWWTS reduces the potential
failure of the system, which could include sewage backup and costly repairs or drainfield
replacement.
(rev. 05/18/2018) Pagel of 3
Owner acknowledges that the Municipality may request records of maintenance and
repairs from the manufacturer's representative or maintenance provider.
Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be
assessed in accordance with AMC 14.60.030.
+� Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS. The Municipality will give at least 24-hour notice.
Owner agrees that any sale or transfer of title of the property will not occur without a new
Certificate of On -Site Systems Approval.
IL
Owner agrees that the AWWTS installation and maintenance requirements as provided
by the AWWTS vendor/installer and approved by the Municipality are the governing
guidelines for the construction, maintenance and repair of the Owner's AWWTS.
Owner agrees to maintain remote monitoring of the AWWTS as required by the
AWWTS approval.
3. Term. The term of this Agreement shall begin on the date of approval by the
Municipality to operate the installed system, or upon transfer of title, and shall continue
while the AWWTS is operational or until title is transferred.
4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this
Agreement shall in no way constitute a waiver of the provisions, nor in any way affect
the validity of the Agreement or any part hereof, or the right of the Municipality
thereafter to enforce every provision hereof.
5. Amendment. This Agreement shall only be amended by authorized representatives of
the Owner and Municipality. Any attempt to amend this agreement by either an
unauthorized representative or unauthorized means shall be void.
6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be
brought in the Superior Court for the Third Judicial District of the State of Alaska at
Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the
parties under this Agreement.
7. Severability. Any provisions of this Agreement decreed invalid by a court of competent
jurisdiction shall not invalidate the remaining provisions of the Agreement.
(rev. 05/18/2018) Page 2 of 3
ature) Date:
STATE OF ALASKA )
) ss.
THIRD JUDICIAL DISTRICT )
name)
The foregoing instrument was acknowledged before me this ay day of 301 ,
203 , by ova•
NOTARY PUBLIC FOR ALASKA CHRISTIAN KOST
My Commission expires: Notary Public
State of Alaska
My Commission Expires Dec 21, 2025
MUNICIPALITY:
(signature) Date:
(print name) Title:
(rev. 05/18/2018) Page 3 of 3
9j07•'t.c_" Munici alit of Anchors e ,; );c .,On-Site Water and Wastewater Program (11.8
�,V'„ . %Z�1g a
(907) 343-7904 a 1p11 /7
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Certificate of On-Site Systems Approval ii ,,"
Parcel I.D. 015-282-49 Expiration Date: O C* 51 a 0 1 8
1. GENERAL INFORMATION
Complete legal description WOODHAVEN #3 LOT 4
Location (site address) 3991 MARCELLE CIRCLE
Current Property owner(s) SPINELL HOMES, INC Day phone
Mailing address 1900 W. NORTHERN LIGHT BLVD, #200 ANCHORAGE, AK 99517
Real Estate Agent Day phone
2. TYPE OF DWELLING:
0 Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 4
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well 0 Individual 0
Individual Water Storage ❑ Holding Tank ❑
Community Class Well ❑ Community ❑•
Public Water System ❑ Public Sewer ❑
WaiverNariance request for: Distance:
. AiIli' /18
Received by: :,.� ,\1 I % Date: 1 IL(
COSA to be released to the engineer,unless otherwise requeste he engineer.
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COSA Fee $ (1061 Waiver Fee $
Date of Payment 6- 21-1r Date of Payment
Receipt Number c 32(0 6 Receipt Number
COSA# 05C `D tn✓ 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.
In conducting an adequacy test,I attempt to provide a thorough,conscientious engineering analysis of the system in accordance with MoA COSA
guidelines and regulations.The reported results describe 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 soil
condition,ground water 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 system. All systems eventually fail and satisfactory test results do not guarantee future
performance of the system,nor do they guarantee that there are no hidden defects or encroachments.Therefore we cannot provide any warranty
for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed
above.
Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218
Address P.O. Box 100217, Anchorage Ak. 99510
Engineer's Printed Name Steven R Pannone Date 6/20/2018
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6. DSD SIGNATURE 1
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System #1 Approved for 1 bedrooms 6'':S1everi •.'Pannone
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System#2 Approved for bedrooms •.• •� r
Disapproved 1 ��OFESS����' '•
Conditional approval for bedrooms, with the following stipulations:
OF AA,
ON-SITE
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WATER AND
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WASTEWATFR
<0 PPROGRAM .
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By: 1tCfi Original Certificate Date: JkAtj 5 018
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 blue sheet ..
If more than 1 septic system is on the lot:
COSA Checklist# 1 of 1
Structure served by this system 1
Certificate of On-Site Systems Approval Checklist
Legal Description: WOODHAVEN #3 LOT 4 Parcel ID: 015-282-49
A. WELL DATA
Well type PRIVATE If A, B, or C provide PWSID# Well Log (YIN) Y
Date completed 9/27/17 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y
Total depth 105 ft. Cased to 104 ft Casing height(above ground) 24 in.
FROM WELL LOG AT INSPECTION
Date of test 9/27/17 NEW
Static water level 64 ft. ft.
Well production 8.0 g.p.m. g.p-m.
WATER SAMPLE RESULTS:
Coliform Neg colonies/100 mL Nitrate 3.94 mg/L
Arsenic ND ug/L Date of sample: 6/19/18 Collected by: PES
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material ADVANTEX/ FIBERGLASS Date installed 11/17/17
Tank size 1500 gal. Number of Compartments 2 Cleanouts (Y/N) Y
Foundation cleanout(Y/N) Y Depression over tank(Y/N) N High water alarm (Y/N) Y
Date of pumping NEW Pumper N/A
C. ABSORPTION FIELD DATA
Date installed 11/17/17 Soil rating (g.p.d./ft2 or ft2/bdrm) 2.0GPD System type BED
Length 30 ft. Width 15 ft. Gravel below pipe 0.5 ft.
Total depth 5.0 ft. Eff. absorption area 450 ft2 Monitoring tube Y Depression over field N
Date of adequacy test NEW Results (Pass/Fail) For 4 bedrooms
Fluid depth in absorption field before test in. Water added gal. New depth in.
Elapsed Time: min. Final fluid depth in. Absorption rate >= g.p.d.
N
Any rejuvenation treatment(past 12 mo.) (Y/N &type) If yes, give date
D. LIFT STATION
Date installed 11/17/17 Size in gallons 500 Manhole/Access (Y/N) Y
"Pump on" level at timed in. "Pump off' level at in. High water alarm level at 45 in.
Datum Bottom Cycles tested Meets alarm&circuit requirements? Y
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot 100+ On adjacent lots 100+
Absorption field on lot 100+ On adjacent lots 100+
Public sewer main 75+ Public sewer manhole/cleanout 100+
Sewer/septic service line 25+ Holding tank 100+
Animal containment areas 50+ Manure/animal excrete storage areas 100+
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 10+ Property line 5+ Absorption field 5+
Water main 10+ Water service line 10+ Surface water 100+
Wells on adjacent lots 100+
ABSORPTION FIELD ON LOT TO:
Property line 10 Building foundation 10+ Water main 10+
Water Service line 10+ Surface water 100+ Driveway, parking/vehicle storage 10+
Curtain drain 50+ Wells on adjacent lots 100+
F. COMMENTS
G. ENGINEER'S CERTIFICATION .,�"~~`�`\�
I certify that I have determined through field inspections and ,r P
review of Municipal records that the above systems are in 0*; TH �\ •.*¶4
conformance with MOA COSA guidelines in effect on this date. 0••• 4.41°'V /
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Engineer's Printed Name Steven Pannone ` :SS ever .'Pannone • j
Date 6/28/2018 6 :-.. CE-8149 %
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COSA canary sheet_2-6-15.doc
PLAT NO. 2016-76
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AS-BU I L T I HEREBY CERTIFY THAT I HAVE SURVEYED THE
PROPERTY DEPICTED ABOVE AND THAT NO •S/1111/
GASTALDI LAND ENCROACHMENTS EXIST EXCEPT AS INDICATED. �4. OF q� 11
SURVEYING, LLC 1 .........
RIS THE RESPONSIBILITY OF THE OWNER TO ♦ p.•• QS•�
JEFF A GJISTALDI.RA-S• • '`• 4
DETERMINE THE EXISTENCE OF ANY EASEMENTS,
2000 E.DOWUNG RD..SUITE 8 COVENANTS OR RESTRICTIONS WHICH DO NOT 49m ••�..:9;.0
ANCHORAGE,ALASKA 99507 APPEAR ON THE RECORDED SUBDIVISION PLAT. 0
PHONE 248-5454 UNDER NO CIRCUMSTANCES SHOULD ANY DATA S.�ler,A.Gasldi ■
GRID GATE HEREON BE USED FOR CONSTRUCTION OR FOR ". LS-6091 :' zr..
SW2735 1/9/2018 ESTABUSHING BOUNDARY OR FENCE UNES. •'',• •.V91�N..•0 sr,•
ANCHORAGE RECORDING DISTRICT,ALASKA •/ `Oressand°p',4
F.B. JOB NO. /111111$�
17-04 WHS4 NOTE: NO CORNERS SET THIS DATE