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Home My WebLink AboutSLEEPY HOLLOW #1 TR A1 Sleepy Hollow #1 Tract A1 #051-471-31 MUNICIPALITY OF ANCHORAGE Development Services Department Phone: 907-343-7904 On-Site Water & Wastewater Section Fax: 907-343-7997 Pump Installation Log Well Drilling Permit Number: _______________ Date of Issue: ____-____-____ Parcel Identification Number: ____-____-____ Legal Description Block Lot Property Owner Name & Address: Pump Installation Date: _____-_____-_____ Pump Intake Depth Below Top of Well Casing: __________ feet Pump Manufacturer’s Name: ___________________________ Pump Model: _____________________________________ Pump Size: ____________hp Pitless Adapter Burial Depth: _________ feet Pitless Adapter Manufacturer’s Name: _________________________ Pitless Adapter Installer: ____________________________ Well Disinfected Upon Completion? Yes No Method of Disinfection: _____________________________ Comments: Pump Installer Name: __________________________________ Company: ___________________________________________ Mailing Address: ______________________________________ City: ___________________ State: __________Zip: _________ Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation. Deveiopment Services Deparh meat Building Safety Division On -Site Water & Wastewater Program 4700 Elmore Road Matic seglch P.B. Box 196650 Anchorage, AK 99507 s A M r Y MOW � _ (W7) 343-7W Well Log , Permit Number: #SW� Date of Issue: /� areel Identification Number: . Date Started: " �? Date Completed: 2 Z 3 Is well located at approved permit location? Yes ❑ No Legal Description: Property Owner Name & Address:If 5ex /G/�i� �/cf�5��✓ Borehole Data: Depth (ft) Soil Type, Thickness & Water Strata From To Tv awl Duu, PIC Ai URU: Arsenic: ug/L Nitrates: mg), Total Coliform Bacteria: colonies/100mL Other Bacteria: coU100mL Method of Drilling E[ * rotary ❑ cable tool Calling type: J3 i3 s �c- Wall Thickness: &21�;Iriches Diameter: f� inches Depth: feet Liner Type: Diameter: inches Depth: ,feet Calling stickup above ground: 3 feet Statle water level (from ground level): meet Pumping level _^ feet after �. hours pumping gpm Recovery Rate: Z gpm Method of Testing: Well Intake Opening Type: ❑ Open End 0 Open Hole ❑ Screened Start feet Stopped feet ❑ Perforations Start feet Stopped feet rout Type: volume: Depth: Start feet _Stopped. feet Pump: Intake Depth /'-hot Pump size hp Brand Name i/, 4, 1,V Well Disinfected Upon Completion? ® Yes ❑ No Method of Disinfection: Comments: Well Driller: Attention: The well driller shall provide a well log to DSD within 30 days of completion. S (F<ev ub/uz/i T Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP231100 PID Number: 051-471-31 Dwelling: RE Single Family (SF) El with ADU R Duplex (D) R Two Single Family Project: FNI New R Upgrade Name Kim Jackson ABSORPTION FIELD E] Deep Trench gwwe re'nc`h R Bed El Mound Site Address N H N Mountain Rd El Other Phone Number of Bedrooms Soil Rating depth from original grade (907)351-7679 Three (3) 1.0 GPD/SF ITotal 6.3 / 6.3 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 5.8/5.8 Ft. Gravel depth beneath pipe 0.5/0.5 Ft. Subdivision Block Lot Sleepy Hollow #1 Tr Al Fill added above original grade 0.4/0.1 Ft. Gravel length 45 / 45 Ft. Township Range Section Gravel width 5.0 / 5.0 Ft. Beds: Number of Lines n/a Distance between lines n/a Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches 2 Dist. between trenches From Tank Field Tank Line 450 Ft2 Ft. Well >100' >100' N/A N/A >25 TANK 91 Septic E] S.T.E.P. 0 Holding Fl Other Manufacturer Greer Capacity 1,000 Gal. Surface Water >100' >100' N/A N/A Material Plastic Number of compartments 2 Lot Line >5' >10' N/A N/A NA Foundation >1 0' >10' N/A N/A LTP$-Q1_ATION Manufacturer Capacity Remarks Gal. n-.. Alarm location Electri fled by PIPE MATERIAL House to tank D3034d Tankto D3034 rainfield Installer JR's Septic Pumping and Excavation Drainfield D3034 CO/MT D3034 Inspector M, Jakubisin BENCH MARK (Assumed elevation) 100 ft Inspectes:tion 15` 5/23/23 5/24/23 Location and description da 2 �d Fop of Foundation @ NE Corner 3(d 4"' ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date PD 101' CO AV 49 X Benjarhifi�chiller Septic SysteAm Approved Date Onts. 0 6-, - CE 12592 819/23 �k�, PROFESVP�. N this approval does not include well permit requirern (F<ev ub/uz/i T CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND PERMIT # OSP231100 PID # 051-471-31 A B FCO 26.1 2CO 31.2 MH 32.5 A B SV 35.0 2CO 36.3 FS 40.6 CO1 55.1 49.1 47.7 48.5 50.3 51.2 63.7 43.9 1"=50' 3-BDRM HOME FCO SLEEPY HOLLOW #1, TRACT A1 FEET 0 50 100 Benjamin Schiller CE 12592 R E GISTEREDPROFE S S I O N A L E N G INEER M O U N T A I N R O A D 8/21/23 1,060 GALLON INFILTRATOR TANK (2) 45' LONG x 5' WIDE x 0.5' EFFECTIVE DEPTH ABSORPTION TRENCHES TH#1 520 PLAN AS-BUILT 530 540 2CO1 FS CO1 MT1 CO3 MT3 CO2MT2 CO4 MT4 MT1 56.346.0 CO2 23.779.4 MT2 20.877.6 CO3 60.855.0 MT3 62.157.4 CO4 33.884.4 MT4 31.883.3 2CO2 EXISTING WELL ALTERNATE SITE PROFILE AS-BUILT (NO SCALE) 94.7 90.5 95.3 99.6 FC O MH SV 1060 GAL INFILTRATOR TANK 99.7 FINISH GRADEMT 1 TH # 2 NO GROUNDWATER 5/4/23 93.5 CO 1 CO 2 83.3 93.5 99.3 ORIGINAL GRADE MT 2 2C O 2 94.6 Benjamin Schiller CE 12592 R E GISTEREDPROFE S S I O N A L E N GINEER 8/21/23 PERMIT # OSP231100 PID # 051-471-31 SLEEPY HOLLOW #1, TRACT A1 99.4 FINISH GRADE 45' DRAINFIELD ROCK MT 2 TH # 2 NO GROUNDWATER 5/4/23 93.0 93.5 CO 2 CO 4 83.3 93.0 93.5 99.3 ORIGINAL GRADE MT 4 NORTHWEST TRENCH SOUTHEAST TRENCH 2C O 1 91.0 MOA APPROVED SAND 45' DRAINFIELD ROCK 93.093.0 91.0 MOA APPROVED SAND 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 Water & Wastewater System Permit Permit Number: OSP231100 Work Type: WellSeptic Initial Tax Code Number: 05147131000 Site Legal Address: SLEEPY HOLLOW #1 TR Al GA 160 Site Mailing Address: Owner: JACKSON KIM & ERIC Design Engineer: FORGE ENGINEERING This permit is for the construction of: Effective Date Expiration Date: Lot Size in Sq Ft: Total Bedrooms: U Department 5/15/2023 5/14/2024 361022 Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy Q 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: I ( -D r (` C. Issued By: Date: Date: 3 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. 051-471-31 Property owner(s) Kim Jackson Mailing address PO Box 671387, Chugiak, AK 99567 Site address NHN Mountain Rd Day phone 907-351-7679 Legal description (Sub'd., Block & Lot) Sleepy Hollow #1, Tract Al Legal description (Township, Range & Section) Lot Size 361,022 Sq. Ft. Number of Bedrooms 3 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 1ZUpgrade ❑ ❑ (D) Holding Tank ❑ Renewal ElDuplex 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: 52.0 Waiver Fees: Date of Payment: /iT2.:�2! Date of Payment: Receipt Number: 07s/ V,17 Receipt Number: Permit No. 0-`�? P 2.3 I I dD Waiver No. Permit App_::- : ,'-..:c May 15, 2023 MOA Development Services, On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Sleepy Hollow #1 Tract A1 – NHN Mountain Rd Septic system design Dear On-Site Services Engineer: The owner of the above lot intends to build a 3 -bedroom home on the property, so we are submitting this permit application for the construction of a new well and septic system. The attached site plan identifies the location of the home as well as the proposed well, septic location and alternate site. No conflicts exist between this proposed system and any other well or septic system, whether on this lot or adjacent lots. The ground surface on the lot slopes mildly toward the north at between a 5-10% slope. There are no slopes greater than 25% within 50 feet downslope of either the primary or alternate site. Contours are shown on the site plan showing the grade and direction of flow. Stormwater drainage will not impact this septic system. The new trench will be constructed parallel to the slope as much as possible. Wells on this and adjacent lots are shown. The new system will be a minimum of 100’ from all wells and surface water, and more than 5’ away from the septic tank. The alternate site is located more than 6’ away. Please refer to the attached test hole log, plan and profile pages for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Benjamin Schiller, PE Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231100, Curtis Townsend, 05/15/23 CO - CLEANOUT 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FD - FLOW DIVERTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE LEGEND 1"=50' 3-BDRM HOME FCO SLEEPY HOLLOW #1, TRACT A1 FEET 0 50 100Benjamin Schiller CE 12592REGISTEREDPROFESSION A L E N GINEER M O U N T A I N R O A D 5/8/23 1,060 GALLON INFILTRATOR TANK (2) 45' LONG x 5' WIDE x 0.5' EFFECTIVE DEPTH ABSORPTION TRENCH TH#1 520 ALTERNATE SITE SEPTIC PLAN PROPOSED WELL LOCATION 530 540 2CO FSV COMT COMT COMT COMT Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231100, Curtis Townsend, 05/15/23 SLEEPY HOLLOW #1, TRACT A1 TYPICAL TRENCH SECTION (NO SCALE) NOTES: 1. GRADE AREA OVER TRENCH TO DRAIN AWAY 2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2' WITH 2" OF INSULATION 3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY Benjamin Schiller CE 12592REGISTEREDPROFESSION A L E N GINEER 4" PERFORATED PVC (HOLES DOWN) DRAINFIELD ROCK 5' 6" 3' DESIGN FACTORS:SYSTEM REQUIREMENTS: 450 GPD PEAK FLOW PERK RATE: <1 MIN/IN APPLICATION RATE: 1.0 GPD/SF 5'-WIDE TRENCH SYSTEM 1060-GAL INFILTRATOR SEPTIC TANK BOTTOM OF TRENCH: 6' BELOW GRADE (CAN BE LOWERED TO MAXIMUM OF 10' BELOW GRADE) FLOW LINE ELEVATION: 3.5' BELOW GRADE 450 GPD / 1.0 GPD/SF (/ 5' WIDE * 1 RED FACTOR [0.5 DEEP])= 90 LF TRENCH REQUIRED (90 LF SPECIFIED) GEOTEXTILE FABRIC 5/8/23 6" 6" MOA-APPROVED FILTER SAND 2' ADDITIONAL SOIL ADDED FOR SETTLEMENT Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231100, Curtis Townsend, 05/15/23 LEGAL DESCRIPTION: PERFORMED FOR: DATE: PARCEL ID#: SOILS LOG AND PERCOLATION TEST 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 DEPTH (feet) TEST HOLE 1 DATE READING START TIME NET TIME (minutes) DEPTH to WATER NET DROP PERCOLATION RATE: (MIN/INCH) (inches)(inches) DATE OF MONITORING WAS WATER ENCOUNTERED? DEPTH TO WATER AFTER MONITORING IF YES @ WHAT DEPTH? 0.08 4/27/23 1 2 3 4 5 GM (SILTY SANDY GRAVEL) Professional Engineers Stamp: no SLEEPY HOLLOW #1 TR A1 4/27/23 051-471-31 Kim and eric jackson 11:44 0 11:45 11:46 11:48 11:49 1' OB 00:28 Benjamin Schiller CE 12592REGISTEREDPROFESSION A L E N GINEER 5/5/23 PERC TEST LOCATION TECHNICIAN: l.tidwell 6 n/a dry 5/4/23 COMMENTS: 6" DIAMETER TEST HOLE PRESOAKED PRIOR TO TESTING SITE PLAN 6 USCS SOIL CLASSIFICATION WAS VISUALLY DETERMINED 00:28 00:30 00:33 00:32 0 6 6 0 6 6 0 6 6 0 6 6 1 6* * WATER RAN OUT BEFORE 6TH TEST COULD BE RUN, DUE TO FAST ABSORPTION AND WASTE TRYING TO FILL THE PERK HOLE TO 6" Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231100, Curtis Townsend, 05/15/23 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 OSC251291 Parcel ID 051 -471-31 Expiration Date Legal description SLEEPY HOLLOW #1 TR Al Site address 19365 MOUNTAIN RD Current property owner(s) JACKSON KIM & ERIC X The On-site system(s) is/are approved for 3 bedrooms By: 6/27/2026 Conditional approval for bedrooms, with the following stipulations: Comments or conditions: Original Certificate Date 8/14/2025 This Ce ' icate of On -Site Systems Approval (COSA) is intended to demonstrate the subject syste (s) is/are in substantial compliance with municipal code. The Municipality of Anchorage, De lopment Service Department (DSD) issues COSAs based upon representations provided by an in ependent professional engineer. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's submittal. ATTACHMENTS: COSA Checklist X Well Flow Advisory Absorption Field Advisory Nitrate Advisory Tank Age Advisory Arsenic Advisory Other MUNICIPALITY 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. 051-471-31 Complete legal description Sleepy Hollow #1, Tract Al Location (site address) 19365 Mountain Rd, Chugiak, AK 99567 Current property owner(s) Kim & Eric Jackson 2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS Day phone 907-351-7679 3. TYPE OF WATER SUPPLY: 0 Private Well serving # 1 dwelling units ❑ Other Non-public well as regulated by MOA ❑ Water Storage ❑ Community Well or Public 4. TYPE OF WASTEWATER DISPOSAL: 0 Private Septic ❑ Private Septic serving 2 dwelling units ❑ Holding Tank ❑ Community Septic or Public Sewer 5. SEPTIC TANK: ❑ Steel FW Plastic ❑ Concrete ❑ Fiberglass Age 2 - See advisory if steel or fiberglass older than 20 years 6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench 0 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. COSA Fee $ 5SO Date of Payment 711712-5 COSA# JSC2s12_ii Waiver Fee $ Date of Payment Waiver # COSA Appiication_Apr2025.doc COSA Checklist Legal Description: Sleepy Hollow #1, Tract Al Parcel ID: 051-471-31 If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system 1 A. WELL DATA ❑■ Well log is filed with Onsite (or attached) Date drilled 5/29/23 Total depth 501 ft Cased to 50 ft ❑■ Sanitary seal is functioning correctly ❑■ Wires are properly protected Casing height (above ground) 36 in. Date of flow test for COSA 5/29/23 Static water level at beginning of test 25 ft. Comments Home was only recently completed B. TANK DATA Measured operating fluid level in septic tank New Date o pu ❑ Required maintenance completed, if AWWTS Comments: Home was only recently completed D. DISPOSAL FIELD DATA Which system tested (date installed) 5/24/23 FE -1 ALL standpipes present per record drawing Total measured depth from grade 6.7/6.4 ft (max) Measured depth to pipe invert from grade 6.2/5.9 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 NSA gallons N/A date Any rejuvenation treatment (past 12 months) N/A If yes, enter date Well production at time of test 2 gpm Water storage tank volume N/A 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 Forge Engineering Date 6/27/25 C. L=TATION❑ R Age of lift station Lift station material Comments: nce completed equacy test _--d ate sults ❑ Pass Fluid de th prior to test in Water adde gal New fluid depth in Elapsed time min Final fluid depth Absorption rate gpd FIELD STATUS — POST RECO Effective depth (per record drawin Effective depth used in Effective depth remaining in Comments/Deficiencies: Trenches listed NW / SE System has not been in use, the construction of the home is just now being completed COSA Checklist_May2025.docx in E. SEPARATION DISTANCES From Well on Lot to: (Please enter distances if less than required) Septic Tank/Lift Station on Lot > 100' 0 Yes if No ft Neighboring Tank > 100' 0 Yes if No ft Disposal Field on Lot > 100' ❑■ Yes if No ft Neighboring Disposal Fields > 100' R Yes if No ft Sewer Line/Main > 100' R Yes if No ft Sewer Manhole/Cleanout > 100' ❑� Yes if No Sewer Service/Septic Line > 25'[E Yes if No Holding Tank > 100' Yes if No Animal Containment > 50' Yes if No Manure/Animal Excreta Storage > 100' ❑■ Yes if No ❑ N/A — Served by Community Well (not on lot) or Public Water From Septic/Holding Tank and Disposal Field(s) on Lot to: (Please enter distances if less than required) Tank to Foundation > 10' 0 Yes if No ft Surface Water > 100' 9 Yes if No Field to Foundation > 10' ❑■ Yes if No Tank to Property Line > 5' R Yes if No Field to Property Line > 10' ❑� Yes if No Water Main/Service Line > 10' ❑E Yes if No F. ENGINEER'S COMMENTS ft Wells on Adjacent Lots: ft Wells > 100' ❑� Yes if No _ ft Community Wells > 200' ❑� Yes if No _ ft If tank or field is under driveway comment below ft ft ft ft ft ft ft ft 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 ofFirm Forge Engineering Engineer's Printed Name Benjamin Schiller, P.E. COSA Checklist_May2025.docx Phone (907) 522-7773 Date 7/15/25 kl11 �* •49 TH .. .. .. ... ........ J� '. • Benja. ' . chiller �% • CE 12592 •.�� I,l`F�pROFESSI4N�t-� � 10' UTILITY EASEMENT N 00'00'55"E 31.28' cRq yeC / N �qv •,o 0 20 50 100 200 \ \ Tract 1 \ \ Lot 2 S 89'56'38"E 705.41' \ \ 412. HOUSE DETAIL Scale: 1 "=30' MANHOLE - L=57.56' R=820.00' NN 0 °r. L=31.45' R=230.00' 130.19' \ 163.22 \ O \ Lot 3 IC PIPES 0 Tract Al �� \ 8.29 Acres \ \ \ s \ BLUFF\ \ �� CONTROL LINE \ �\ ty \ \PETERS CREEK \ 1 - \ Lot 4 O; \ O \ S 13'00'00"E 496.53' \ 157.87' 1 30.00' N 89'59'40°W 654.40' � / I / � I Y Lot 5 Lot 1 I I 1) rI I PLOT PLAN _� AS BUILT X SCALE_1»=100_ GRID _ NW 1160Project No. 22-736 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associates, inc. (907) 522-6476 Phone (907) 522-4625 Fax F Professional Land Surveyors kenAlangsurvey.com ,q jonathanAlangsurvey.cam ��P sh0 I hereby certify that I have surveyed the following described property: TRACT Al, SLEEPY HOLLOW SUBDIVISION No. 1 (PLAT No. 88-104) Anchorage Recording District, Alaska, and that the improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. Dated this the Day of ___' ____, __- at Anchorage, Alaska It is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. 49TH • �, • •KENNET G. NG [ (e Fp •'•.LS 202.•' gJp p '•-.....••' Ngo �OnROFfsslo�A�- �� AECC963