HomeMy WebLinkAboutTHOMAS L BOYLE BLK 1 LT 15B•,
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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 System Permit
Permit Number: OSP231199
Work Type: Well Initial
Tax Code Number: 01528329000
Site Legal Address: THOMAS L BOYLE BILK 1 LT 15B G:2734
Site Mailing Address: 11643 GANDER ST, Anchorage
Owner: KAUSHAGEN DANIEL ANTON
Design Engineer:
This permit is for the construction of:
Effective Date:
Expiration Date:
»>e,nt (
O. v
A 10
Department
Lot Size in Sq Ft:
Total Bedrooms:
7/20/2023
7/19/2024
49500
❑ Disposal Field ❑ 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
j_
Special Provisions:
To close this permit please submit:
1. Well Log
2. Pump Install Log
! 3. Water sample results
4. Well Decommissioning Log
- i
R-eceiveW.. Y: I (A e O2 In e K- Date:
Issued By: Date:
Z Z
2
MUNICIPALITY OF ANCHORAGE
N1 xz�
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
ON-SITE SEPTICMELL PERMIT APPLICATION
Parcel I.D. vfs�a"�?_ya 0oD
Property owner(s) t) Day hon
Mailing address �` �? Z
Site address // V N i
Legal description (Sub'd., Block & Lot) 1 �� L _ 7 G
Legal description (Township, Range & Section)
Lot Size Sq. Ft. Number of Bedrooms
APPLICATION IS FOR:
(Z all that apply)
Absorption. Field ❑
Septic Tank ❑
Holding Tank ❑
Privy
❑
Private Well
3
Water Storage
❑
APPLICATION 1S AN: TYPE OF DWELLING:
Initial Single Family (SF)
(w/wo ADU)
Upgrade ❑ Duplex (p) ❑
Renewal ❑
Multiple Dwellings ❑
(SF and/or D)
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
app4able Municipal Codes.
(Signature of property owner or
rized agent)
Permit/Rush Fees: 02.25 Waiver Fees: _
Date of Payment: %7.K1Z T2 Date of Payment:
Receipt Number: Receipt Number:
Permit No. 0S P Z 3 / ( Waiver No.
GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc
DESIGN CALLS:
3 BDRM X 150 GPD = 450 GPD
Municipality of Anchorage
450 GPD/3 GPD/SF. = 150 SF SAS
150 SF / 5'W = 30'L TRENCH
REVIEWED FOR CODE COW
FINAL GRADE
3:1 OR LESS
USE 1 TRENCH — 30' (L) X 5' (W)
X 0.5'(ED)
TOPSOIL AND VEGATATE
TOTAL DEPTH IS BELOW EXISTING
GRADE: —0.5'
EXBLODISTNG GRADE
EXCAVATE 41+ & ADD TYPEII & MOA
SAND PER:
MT
USED REDUCED S❑ILS APPLICATI❑N
RATE,
FROM L.s
INSTALL THE PRIMARY & RESERVE
FIELDS.
BOTrof ED AT
-00.. 5' FROM
EXISTING GRADE MAX
30 LF 1.25" PVC W/ 3/16TH HOLES @ 1' EXCAVATE 4-5' ORG/OL—SM
LAYERS TO SW LAYER
SPACING (TYP). 30 HOLES PER LATERAL. & ADD 2'+ TYPEII ERS SOILS
TOTAL DEPTH OF sme ARE1
SAND WILL DEPEND A
ON GROUNDWATER
MONITORING RESULTS.
� OYif10R6WM1Di9 \
Lor 13A
Tli}1 A-11
AMO1�® fAkY
\ STAB R • SD' DL SIFFIl STIC
RAAl4 fl®t A .I TAKK 4111 AF1D
coanucma rwo�co�c _ rm � u'r ..a..
Lot 16A
NO VISUAL SEPTIC
SYSTEM & APPEARS
TO BE DECOMMISSIONED.
La ICB
SEPTIC AFU
lot I'm I Lot 13A
100' ¢u TU049�
try +
THOMAS L BOYLE BLOCK 1, LOT 15B SUPPORT®SERVICES:
PREPARED FOR:
DANIEL KAUSHAGEN TRUST... - (�G
11641 GANDER STREET
ANCHORAGE, AK 99516 ;.
DATE: 6/14/2023
_. SURVEY: KGL
DRAWN: FWCS
SCALE: 1" = 60'
PAGE: 1 OF 2
Municipality of Anchorage
Onsite Water and Wastewater
REVIEWED FOR CODE COW
JA
301 X 5' W MOUNDED TRENCH
cm
TOPSOIL AND VEGATATE
SUMMER 2023
MT
MT
,3:1 SLOPE TYP
2'+ COVER ABOVE
TOP OF SEWER ROCK
INSULATION& FABRIC
6' OF SEWER ROCK
MAINTAIN —0.5
G AT HIGHEST
Ann a'+ MOA SAND Tn
POINT.
30 LF 1.25" PVC W/ 3/16TH HOLES @ 1' EXCAVATE 4-5' ORG/OL—SM
LAYERS TO SW LAYER
SPACING (TYP). 30 HOLES PER LATERAL. & ADD 2'+ TYPEII ERS SOILS
TOTAL DEPTH OF sme ARE1
SAND WILL DEPEND A
ON GROUNDWATER
MONITORING RESULTS.
� OYif10R6WM1Di9 \
Lor 13A
Tli}1 A-11
AMO1�® fAkY
\ STAB R • SD' DL SIFFIl STIC
RAAl4 fl®t A .I TAKK 4111 AF1D
coanucma rwo�co�c _ rm � u'r ..a..
Lot 16A
NO VISUAL SEPTIC
SYSTEM & APPEARS
TO BE DECOMMISSIONED.
La ICB
SEPTIC AFU
lot I'm I Lot 13A
100' ¢u TU049�
try +
THOMAS L BOYLE BLOCK 1, LOT 15B SUPPORT®SERVICES:
PREPARED FOR:
DANIEL KAUSHAGEN TRUST... - (�G
11641 GANDER STREET
ANCHORAGE, AK 99516 ;.
DATE: 6/14/2023
_. SURVEY: KGL
DRAWN: FWCS
SCALE: 1" = 60'
PAGE: 1 OF 2
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: OSP241208
Work Type: Septic Renewal
Tax Code Number: 01528329000
Site Legal Address: THOMAS L BOYLE BLK 1 LT 15B G:2734
Site Mailing Address: 11641 GANDER ST, Anchorage
Owner: KAUSHAGEN DANIEL ANTON
Design Engineer: FIRST WATER CONSULTING
This permit is for the construction of:
Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy
Effective Date:
Expiration Date:
Lot Size in Sq Ft:
Total Bedrooms
l)chartmettt
7/16/2024
7/16/2025
49500
❑ 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. Open ed-and-elo d on the same day, or
b.r vered, sealed, a_n'akeated to pryent-freezing____
Special Provisions:
• Prior to IR approval, an easement is to be recorded to protect the required cover of the bed.
-R+ved-ay: _3/� 554.ke 4 _VC) WC Date:
Issued By: Date:
3
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 015-283-29
Property owner(s) DANIEL KAUSHAGEN & REVOCABLE.... Day phone
Mailing address 11600 WAGNER STREET ANCHORAGE, AK 99516
Site address 11641 GANDER STREET ANCHORAGE, AK
Legal description (Sub'd., Block & Lot) THOMAS L BOYLE BLOCK 1 LOT 15B
Legal description (Township, Range & Section)
Lot Size 49,500 Sq. Ft. Number of Bedrooms 3
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(N all that apply)
Absorption Field
Initial ER
Single Family (SF)
(w/wo, AD U)
Septic Tank
EJ Upgrade
Duplex
❑
(D)
Holding Tank
0
Renewal 0
Multiple Dwellings
El
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Signatu.rp,:of property owner or authorized agent)
Permit/Rush Fees: I232
Date of Payment:
Receipt Number:
Permit No. o5yo2'Jt20o
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
GAIDevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc
First Water
C 0 N S U! T I N C
13030 Sues Way, Anchorage, AK 99516
907-350-9566 / FirstWaterAK@gmail.com
July 16, 2024
Municipalities of Anchorage
On -Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
RE: SEPTIC SYSTEM UPGRADE PERMIT — ADVANTEX TRENCH
LEGAL: THOMAS L BOYLE BLOCK 1, LOT 15B
The property owner has requested we renew the septic permit OSP231158 for the above
referenced lot. This permit has just expired within the last 3 weeks and request issuance --
attached is the expedited renewal fee. Nothing has changed on the lot or adjacent lots that would
affect the design as permitted. The lot and area are served by private water. The design will not
impact any of the neighboring properties. Please contact us if you have any questions.
Sincerely,
O�A6 L""_
Curtis Huffman, P.E.
F I W d (Li -i,
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: OSP231158
Work Type: Septic Initial
Tax Code Number: 01528329000
Site Legal Address: THOMAS L BOYLE BLK 1 LT 15B G:2734
Site Mailing Address: 11643 GANDER ST, Anchorage
Owner: KAUSHAGEN DANIEL ANTON
Design Engineer: FIRST WATER CONSULTING
This permit is for the construction of:
Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy
.nj r
f
- l�ehartrncnt-
Effective Date: 6/26/2023
Expiration Date: 6/25/2024
Lot Size in Sq Ft: 49500
Total Bedrooms: 3
❑ 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: 1 5 " (-U I (� Date:
'
Issued By: Lam_, Date: V*Z 3
MUNICIPALITY OF ANCHORAGE
Development Services Department_ Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 015-283-29
Property owner(s) DANIEL KAUSHAGEN & REVOCABLE.... Day phone
Mailing address 11600 WAGNER STREET ANCHORAGE, AK 99516
Site address 11641 GANDER STREET. ANCHORAGE, AK
Legal description (Sub'd., Block & Lot) THOMAS L BOYLE BLOCK 1 LOT 15B
Legal description (Township, Range & Section)
Lot Size 49,500 Sq. Ft. Number of Bedrooms
I
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(N all that apply)
Absorption Field
®
Initial ®
Single Family (SF)
Septic Tank
j(
Upgrade❑
(w/wo AD U)
Duplex (D) ❑
Holding Tank
❑
Renewal ❑
Multiple Dwellings ❑
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Si ghature:of_property owner or authorized agent)
Permit/Rush Fees: 595 Waiver Fees:
Date of Payment: 6�5�23 Date of Payment:
Receipt Number: ?dSIG - — Receipt Number:
Permit No. 05%023 l /-95 Waiver No.
GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc
13030 Sues Way, Anchorage, AK 99516
907-350-9566 / firstwaterAK@gmail.com
!
!!
June 15, 2023
Municipalities of Anchorage
On-Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
RE: SEPTIC SYSTEM UPGRADE PERMIT – ADVANTEX TRENCH
LEGAL: THOMAS L BOYLE BLOCK 1, LOT 15B
The property owner has requested we obtain a permit to install a new septic system of the above
referenced lot. There was no evidence of any existing septic field on the lot, but per MOA
records there may have been one along the eastern portion of the lot and not in proximity to the
proposed septic system. We propose to install one Advantex trench mounded system to serve the
proposed 3-bedroom residence. The design is based on the attached and recent test hole
conducted in the spring of 2023, which shows groundwater at 6 at excavation and at 4 at
monitoring.
The slopes are moderate at 3-8% at the proposed upgrade location. The lot and area are served
by private water. The Advantex system will be staked to verify that the system will be 50+ to
any private wells or surface water. The design will not impact any of the neighboring properties.
Please contact us if you have any questions.
Sincerely,
Curtis Huffman, P.E.
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231158, Curtis Townsend, 06/26/23
FIRST WATER CONSULTING
THOMAS L BOYLE BLOCK 1, LOT 15B
DESIGN CALCS:
NO WELLS WITHIN
50' OF PROPOSED
SEPTIC SYSTEM.
TOTAL DEPTH OF
SAND WILL DEPEND
ON GROUNDWATER
MONITORING RESULTS.
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231158, Curtis Townsend, 06/26/23
FIRST WATER CONSULTING
NO SLOPES >25% WITHIN 50'
OF PROPOSED FIELD.
DESIGN DETAILS:
THOMAS L BOYLE BLOCK 1, LOT 15B
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231158, Curtis Townsend, 06/26/23
% GRAVEL 0.7 USCS SP-SM
% SAND 88.7 USACOE FC N/A
% SILT/CLAY 10.6 % PASS. 0.02 mm N/A
% MOIST. CONTENT 12.6 % PASS. 0.002 mm N/A
N/A
N/A
N/A
SIEVE SIEVE TOTAL %SPECIFICATION
SIZE (mm)SIZE (U.S.)PASSING (% PASSING)
152.40 6"
76.20 3"100
38.10 1.5"100
19.00 3/4"99
12.70 1/2"99
9.50 3/8"99
4.75 #4 99
2.00 #10 99
0.85 #20 98
0.43 #40 95
0.25 #60 73
0.15 #100 35
0.075 #200 10.6
ELAPSED DIAMETER
TIME (MIN) (mm)
0
1
2
5
8
15
30
60
250
1440
SOUNDNESS OF AGG.
(ASTM C88)
DEGRADATION
(ATM T-313)
LA ABRASION
(ASTM C131/C535)
SP. GRAV. COARSE AGG.
(ASTM C127)
11301 Olive Lane ∙ Anchorage, Alaska 99515 ∙ Phone: 907-344-5934 ∙ Fax: 907-344-5993 ∙ www.nge-tft.com
N/A
N/A
The testing services reported herein have been performed to recognized industry standards, unless otherwise noted. No other warranty is made. Should engineering
interpretation or opinion be required, NGE-TFT will provide upon written request.
N/A
HYDROMETER RESULT
N/A
SIEVE ANALYSIS RESULT
2023 Material Testing
6697-23
Tranquility Grab @ 5'
23-S-2
Poorly-graded sand w/ silt
6/12/2023
Payton Triplett
Andrew Fortt
TOTAL %
PASSING
UNKNOWN
UNKNOWN
First Water Consulting ServicesPROJECT CLIENT:
PROJECT NAME:
PROJECT NO.:
SAMPLE DESC.:
NGE-TFT ID #:
CLASSIFICATION:
DATE RECEIVED:
TESTED BY:
REVIEWED BY:
UNIFORMITY COEFFICIENT (Cu)
COEFFICIENT OF GRADATION (Cc)
ASTM D1557 (uncorrected)
ASTM D4718 (corrected)
OPTIMUM MOIST. CONTENT. (corrected)
115
120
125
130
135
140
145
0 2 4 6 8 10 12 14 16
DR
Y
D
E
N
S
I
T
Y
(
p
c
f
)
MOISTURE CONTENT (%)
MOISTURE-DENSITY RELATIONSHIP ASTM D1557
SILT or CLAYCOBBLES
GRAVEL
Coarse Fine
SAND
Coarse Medium Fine
0
10
20
30
40
50
60
70
80
90
100
0.0010.010.1110100
FI
N
E
R
B
Y
M
A
S
S
(
%
)
GRAIN SIZE (mm)
PARTICLE SIZE ANALYSIS ASTM D6913 / C136 / D422
#200#40#101.5 1/2363/4 #4 #20 #60 #1003/8
U.S. SIEVE OPENING IN INCHES U.S. SIEVE NUMBERS HYDROMETER
13030 Sues Way - Anchorage, Alaska 99516
Tel. 907-350-9566 firstwaterAK@gmail.com
SOILS LOG - PERCOLATION TEST
LEGAL DESCRIPTION: THOMAS L BOYLE B1 L15B
PERFORMED BY: FWCS / FWC - I CURTIS HUFFMAN CERTIFY THAT THIS TEST WAS
PERFORMED IN ACCORDANCE WITH ALL STATE & MUNICIPAL GUIDELINES IN EFFECT
ON THIS DATE. DATE: 6/15/2023
DEPTH
FEET OG
SOILS
1
ORG/OL
2
3
4
SM/ML
5
6
7
8
SW (SIEVE)
9
10
11
BOH
12
13
USE LOWER
SW LAYER
14
AS RECIEVING
15
16
17
18
19
20
Reading Date Gross
Time
Net
Time
Depth to
Water
Net
Drop
6/9/23 30 min 6 9/16
30 min 6 10/16
30 min 6 9/16
PERCOLATION RATE 54 (MIN / INCH)
TEST RUN BEWTWEEN 2 & 3 FT
PERC HOLE DIAMETER 6
PRE-SOAKED PRIOR TO TEST & ALL READINGS TO
THE 1/16TH.
GROUND WATER ENCOUNTERED: YES
IF YES, AT WHAT DEPTH: 6
DEPTH TO WATER AT MONITORING: 4
DATE: 6/14/23
TESTHOLE # 23-1 DATE PERFORMED: 6/6/23
SEE SITE PLAN FOR SLOPE & LOCATION
COMMENTS:
SIEVE ANALYIS AT 5 PERCOLATION TEST
PERFOMRED AT 4 WITH RAPID ABSORPTION
OF <1 MIN PER INCH IN THE SANDY SOILS.
ADDITIONAL PERC TEST PERFOMRED PER BELOW.
VERIFY GROUNDWATER MT
AT TIME OF CONSTRUCTION
PERFORMED FOR: DANIEL KAUSHAGEN
6/15/23
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231158, Curtis Townsend, 06/26/23
N
M
M
N
0
u
l
30.0'
Lot 15A
Lot 14A
_... ELEVATION '= D9.0
Lot 16A
Lot 16B
Lot 13A
PLOT PLAN _X AS BUILT __ SCALE —!!—= 30'— GRID _ SW 2734__ Project No.
11500 Daryl Avenue, Anchorage, Alaska 99515-3049
Lang & Associates, inc. (907) 522-6476 Phone
kenOlangsurvey.com
LEGEND s�� \\�
NOTES: Professional Land Surveyors jonothanoiangsurvey.com OF. Agk,9 ,
1 LOT COVERAGE = 13.2% frovisOlangsurvey.com r is
104.8 EXISTING ELEVATION ) AWNP
103.0 PROPOSED ELEVATION 2) SEE ENGINEER'S PLANS FOR I hereby certify that I have surveyed the following described property: �.' 9 ,,
WELL & SEPTIC LOCATIONS. LOT 15B, BLOCK 1, BOYLE SUBDIVISION (PLAT No. P -244B) �*; 49TH •,*
SURFACE DRAINAGE Anchorage Recording District, Alaska, and that the improvements situated thereon are ••••••• • • 0,
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 KENNETH G. LANG e.10
easements on said property except as indicated hereon.,+ c 0.5 02 . ,-%
� AN Q
0 10 25 50 100 Dated this the __��?___ Day of _ �bhuar _LJ23 at Anchorage, Alaska 23.�DSJ�
F
---- l ROfESSIONAI���
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. State of Alaska AECC963
SCALE: 1"=30'
MUNICIPALITY OF ANCHORAGE
ADVANCED WASTEWATER TREATMENT SYSTEM-'
MAINTENANCE AND REPAIR AGREEMENT
11-11S MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and
e Bred into �s of this Da of J—
of of2U,73 , by and between
herein the "OWNER," and the Municipality of
Anchorage, herein the "MU ICIPALITY", 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
al description)
I MUiviHZ) LbUYLL t3LUCK 1, LOT 15
n�anrr��
to
(signature) Date:
(print name)
STATE OF ALASKA
THIRD JUDICIAL DISTRICT ) ss.
The foregoing instrument was acknowledged before me this day of
209 j by � uW"A I J�
_MMA
NOTARY PUBLIC FO AL
My Commission expires: �.�j NOT,, , m
WNIC ALITY:
By: (signature) Date: 2 2
(print name) Title: (/L C '`f C�, (--IS ��