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Home My WebLink AboutLEWIS & CLARK LT 104D ewis Clark #017mmO74�7A-r Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: _0SP241020 PID Number: 017-074-74 Dwelling: ME Single Family (SF) ❑ with ADU R Duplex (D) Fj Two Single Family Project: RE New M Upgrade Name THE CUSHMAN FAMILY TRUST ABSORPTION FIELD n Deep Trench 0 Wide Trench R Bed FNI Mound Site Address 8774 PATHFINDER CIRCLE, ANCHORAGE, AK El Other Phone Number of Bedrooms Soil Rating 1Total depth from original grade 907-301-9046 4 (SIZED FOR 5) *4.0 GPD/SFJ SEE DWG. Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade SEE DWG. Ft. Gravel depth beneath pipe 0.56 Ft. Subdivision Block Lot LEWIS & CLARK - 10 Fill added above original grade SEE DWG. Ft., Gravel length 51 Ft. Township Range Section Gravel width 5 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 255 Ft2 1 - Ft. Well *50'+ *50'+ *50'+ - 25+ TANK 9 Septic 9 S.T.E.P. ❑ Holding C] Other Manufacturer INFILTATOR SYSTEMS Capacity 1530/1060 Gal. Surface Water *50'+ *50'+ *50'+ - Material Number of compartments Lot Line 5'+ *5'+ 5'+ - NA PLASTIC 2/1 Foundation 10'+ 10'+ 10'+ - LIFT STATION Manufacturer Capacity Remarks *FOR AWWTS INFILTATOR SYSTEMS **1060 Gal. "FOR SECOND TANK ONLY Alarm location INDOOR Electrical installed by Installer PIPE MATERIAL House to tank D3034Tank to D3034/ drainfield D1775 RED DOG MASONARY Drainfield D3034 CO/MT D3034 Inspector GARNESS ENGINEERING BENCH MARK (Assumed elevation) 100.00 ft Inspection 1st 12J12/2024 12-/16/2024 dates: 2nd Location and description 31d 12/16/2024 0 12/17/2024 1 TOP OF FOUNDATION FLASHING NEAR FCO ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineers Stamp Conditional Approval: Date ...... .. . ..... ....... Septic Systerff/ Z f e irness., CE -795 ' Approved zDate Ants. � Note: this approval does not include well permit requirem prof ssjondN < #AECC884 (Kev ubtw ) 10PARCEL ID NUMBER:OSP2420 RECORD DRAWING 017-074-74 -- ---1----�//---------------- -- / PATHFINDER CIRCLE \ 10' T 8 E EASEMENT ,1 I .14 \ •. • • .. \ ^ooh '% / RESERVE SIT NEW IM -1530 INFILTRATOR 2\ -COMPARTMENT SEPTIC TANK - INSTALLED DOUBLE cLEANours (DBL1 6 D81-2 LS AND CLARK; TRACT 8 NEW DRAINFIELD co �-� Dz - - - LOCATION OF GEG T.M.#16 PER FINDING DURING DRAINFIELD INSTALL NEW NS -500 1GWM AEROCELE UNIT A B I C 4EW CM -1060 INFILTRATOR SINGLE COMPARTMENT STEP TANK WITH AEROCELL PUMP AND CONTROLS NOTE: PIPE LOCATIONS ARE SHOWN PER GEG SHOTS TAKEN WITH LEICA DISTO S910 LASER DISTANCE METER. SWING -TIES TO HOUSE CORNERS WERE GENERATED IN AUTOCAD. GARNESS ENGINEERING GROUP, Ltd ENGINEERING.5SALES-CONSULTING -- x 3701 EAST TUDOR ROAD SUITE 101 'ANCHORAGE. ALASKA • PHONE (907) 3375178 'WEBSITE; www.gamessengineercg.00m PREPARED FOR PHONE NUMBER: PAGE NUMBER: ROB CUSHMAN 907-301-9046 2 OF 3 PROJECTILEGAL DESCRIPTION: LEWIS AND CLARK; LOT 10 TYPE OF WORK- RECORD ORKRECORD DRAWING OF SEPTIC SYSTEM UPGRADE FCO 2.5 i NEW 4 BEDROOM %'o HOUSE 35.8 SEPTIC ST1 SYSTEM 31.4 SIZED FOR DBLI S BEDROOMS) 33.4 DBL2 27.1 NEW IM -1530 INFILTRATOR 2\ -COMPARTMENT SEPTIC TANK - INSTALLED DOUBLE cLEANours (DBL1 6 D81-2 LS AND CLARK; TRACT 8 NEW DRAINFIELD co �-� Dz - - - LOCATION OF GEG T.M.#16 PER FINDING DURING DRAINFIELD INSTALL NEW NS -500 1GWM AEROCELE UNIT A B I C 4EW CM -1060 INFILTRATOR SINGLE COMPARTMENT STEP TANK WITH AEROCELL PUMP AND CONTROLS NOTE: PIPE LOCATIONS ARE SHOWN PER GEG SHOTS TAKEN WITH LEICA DISTO S910 LASER DISTANCE METER. SWING -TIES TO HOUSE CORNERS WERE GENERATED IN AUTOCAD. GARNESS ENGINEERING GROUP, Ltd ENGINEERING.5SALES-CONSULTING -- x 3701 EAST TUDOR ROAD SUITE 101 'ANCHORAGE. ALASKA • PHONE (907) 3375178 'WEBSITE; www.gamessengineercg.00m PREPARED FOR PHONE NUMBER: PAGE NUMBER: ROB CUSHMAN 907-301-9046 2 OF 3 PROJECTILEGAL DESCRIPTION: LEWIS AND CLARK; LOT 10 TYPE OF WORK- RECORD ORKRECORD DRAWING OF SEPTIC SYSTEM UPGRADE FCO 2.5 30.3 MH1 19.1 35.8 _ ST1 23.3 31.4 _ DBLI 25.6 33.4 DBL2 27.1 35.1 ST2 29.2 37.3 MH2 33.0 36.0 GWM 26.2 31.5 VP1 45.3 45.1 POD 49.6 49.8 VP2 54.8 54.9 C01 37.8 34.1 MT1 38.5 34.4 CO2 82.0 83.1 MT2 81.4 82.7 OF i 49:6A DRAWN BY: J.L.M. DATE: LICENSE 4/15/2025 #AECC884 O I�dl /1 uCr 79 3 ' mac''.`► P� ESS1c� �� PERMIT NUMBER: PARCEL ID NUMBER: TOP OF MANHOLE OSP241020 RECORD DRAWING 017-074-74 PER CONTRACTOR, (MH1) = 101.49 TOP OF TANK @ TOP OF MANHOLE 4" BY 4' WIDE QUANICS NS -500 -AC (MH2) = 100.59 INSULATION AEROCELL POD TOP OF TANK @ INLET = 96.90 CENTERED INLET = 96.90 FINAL GRADE FINAL GRADE VP1 OVER PIPE VP2 = 100.60-100.83 ST1 DBL1 DBI -2 ST2 = 100.05-100.24 MH1 Z MI -122 co Z o U 0.) ° m W o LL co m C14 PER CONTRACTOR, 2" OF Q O w o z 0 z .. INSULATION OVER TANKS TOP OF TANK @ a o m a cn 3:< co INLET = 96.61 a a a 10 10 TOP OF TANK @ INLET = 96.59 n INLET ry — OUTLET INLET INVERT OF PIPE @ ----------- _-------------- -- OUTLET = 95.72 *TIMER ENABLE - *TIMER OVERRIDE INVERT OF PIPE OPERATING INVERT OF PIPE @ MINIMUM FLOAT - 747 FLOAT - 1,094 PROPOSED PUMP TANK FLOAT SETTINGS-i'� LIQUID LEVEL OUTLET = 96.01 GALLONS GALLONS CAPACITY @ INLET = 96.32 OPERATING D & S CONCRETE TANK CM -1060 Z LIQUID LEVEL CAPACITY WHEN FLOAT VOLUME AT INLET INVERT 1278 GALLONS (747 GALLONS) WHEN FLOAT IS IS ACTIVATED. MIN. OPERATING VOLUME 1094 GALLONS �u Jm DEACTIVATED. *HIGH WATER INLET INVERT 47^ FLOAT- 1,044 OVERRIDE FLOAT 42"� s GALLONS CAPACITY HIGH WATER ALARM 40" 02 INVERT OF PIPE WHEN FLOAT TIMER ENABLE FLOAT 33" IM -1530 GALLON @ INLET = 95.97 LITTLE GIANT HIGH HEAD IS ACTIVATED. FLOAT LEVELS ARE FROM BOTTOM OF TANK. NOTE::::j U1� TWO-COMPARTMENT WE SERIES PUMP (MODEL MEASUREMENTS ARE WHERE THE FLOAT WIRE ATTACHES J= IM -1060 GALLON SINGLE -COMPARTMENT 20-WE20) IN SIM/TECH TO PIPING WITH A 3.5 INCH TETHER FROM PIPING TO d (— LU INFILTRATOR TANK PLEATED NO VAULT FILTER I FLOAT. ALL FLOATS MUST BE NARROW ANGLE FLOATS. [� t4!) 0 z NOTE: ADDITIONAL FINAL GRADING LUS to [ �-s . i r' FINAL GRADES MT1 C01 GEG TH iCo O TOPSOIL AND HYDRO -SEEDING TO BE = 107.56-108.01 MT2 CO2 W COMPLETED IN THE SPRING/SUMMER OF 2025 �" -'�---- - L "' E ' ` (SEE NOTE) Za U) ORIGINAL GRADE @ PER CONTRACTOR, HIGHEST POINT = 104.40 W' Z 2" OF INSULATION.Z O ILL o J O o ''°o Y Z w J FILTER FABRIC U Z o c�EENOS� CL Q ¢ S�OpE! c O oW oW w J > J I— tit .. INV. OF DIST. �•�A�` �'j�I ��*+ LINE = 105.09 Gj LIMITS OF EXCAVATION. TOP OF FILTER �[ ? q *�j ALL ORGANICS REMOVED SAND = 104.53 4 = 102.07-102.40 %q ... .. ............... .:..... ; I s ............. RELATIVE ELEVATION OF GROUNDWATER ON 5/24/2024 = 98.80 d' • a A. C mess •��" o �I •. Ct-7&3 i RELATIVE ELEVATION OF BOTTOM OF TEST HOLE #16 = 88.40 LICEN&E •tiP%gSS\ �40: #AECCS&t BILL & GALE PTO 11ALLIVAR"'WATER WELLS IV Orr P.O. Box 670269, Chucgiak, AK 99567 688.2759 Well Drilling Permit Number: OSP Parcel Identification Number: Legal Description LEWIS & CLARK LT 10 Pump Installation Date: 10/16/24 www.sullivanwaterwells.com Pump Installation Log 241020 Date of Issue 3/26/24 01707474000 Pump intake Depth Below Top of Well Casing: 147 feet Pump manufacturer's Name: Flint & Walling Pump Model: Pump Size: 41`11P07301S 3/4 hp Pitless Adapter Burial Depth: 14 feet Pitless Adapter Installer: Unknown Pitless Manufacturer: Merrill Disinfected Upon Completion? ® yes Method of Disinfection: Chlorine 50 PPM Comments: Pump installers Name: Sullivan Water Wells ❑ no Property Owner Name & Address Watermark Construction 8774 Pathfinder Circle Anchorage, AK 99516 Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation. Alpine Grilling +& Enterprises Well Log Permit Number: #SW241020 Date of Issue: 3-26-24 Parcel Identifications Number: 01707474000 Date Started: 9-29-24 pate Completed: 9-25-24 Is well located at approved permit location? x Yes ❑ No Legal Description.: Lewis & Clank Lot 10 Property Owner Name & Address: Watermark Construction borehole Data; Soil Type, Thickness & Water Strata x lam, � Depth (ft) From To Method of Drilling x air rotary ❑ cable tool Casing type: steel Stick up 0 2 Wali Thickness. .250 inches Organics & silt Gravelly silt 2 4 4 55 Diameter: 6 inches Depth: 11X16 feet Liner Type: Diameter. inches Depth: feet silt 56 61 Casing stickup above ground: 2 feet Static water level (from ground level): rg2 ? feet gravelly silt 61 142 water sand & gravel 142 146 Pumping level; 145 feet after 2 hours pumping 7 gpm Recovery hate: 7 Spm Method of Testing: air fl Well Intalm Opening Type: x Open End ❑ Open Hole ❑ Screcoed Start feet Stopped feet ❑ Perforations Start feet Stopped feet Grout Type: $entonite granules Volume: 2 De th. cart 0 eet ? fillvt Pump: Intake Depth - feet Pump size _ hp Draud Name Well Disinfected Upon Completion? x Yes ❑ No Method of Disinfection: chlorine tablets Comments: Well Driller: Alpine Drilling- & Enterprises PO Box 110496 Anchorage .fiK 99511 10 � ; V5 - 4-f J'� a= O ATS3*> - p 3o a s -« ° p� �a r 3Lxsosr� a r*c =» N cr _ a aspoa�� Q rL a- a I a 0 A r7 /� =ro C70 �.'O A A p a D Now s D �s O j y 7f A Sg a °3�aY c a�a A'�� "� L1 3 -n. n G � I �° .S ill 3-` O CL 57 Ln a a p0a= C 999 0CL �3z L° -f tY .. O 00--o d O ,3+o3=a-aa3 ° 1 CL � —Z - z MO 0 3 3?� '! 3 A o s OA a X I I a �.s3 �p 73o AV ria • � 1 =Av <CAc= C A A a 3° DO ^, v 9-6- vQ,001 OL 0 0 0 no 4 p C so f+ 3 0v a a p s g=. Ccno G7 'g Nom. n.z Q !3pC ID N J po > 5a3°`'>o Lt a v3 a 0cdi o° osao a cc • C1 3 J N > r 0 O Q A p 7C' D Z d f7 U3 z En m ctt E - c rn I � x 0 A a C z *t r0 a Z � C7 Z a) C d Ln m u n z s 0 m IN 0 O N 2 Coh' r KA Q cD d MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program S{. PO Box 196650 4700 Elmore Road i. Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite "f L)epartinc:t�t On -Site Water & Wastewater System Permit Permit Number: OSP241020 Effective Date: 3/26/2024 Work Type: WellSeptic Initial Expiration Date: 3/26/2025 Tax Code Number: 01707474000 Site Legal Address: LEWIS & CLARK LT 10 G:2941 Site Mailing Address: 8774 PATHFINDER CIR, Anchorage Owner: CUSHMAN FAMILY TRUST THE Lot Size in Sq Ft: 108113 Design Engineer: GARNESS ENGINEERING GROUP LTD Total Bedrooms: 5 This permit is for the construction of: Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy 2 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 Issued By: Date: Date: 6 Z= (-I Development Services Department On -Site Water & Wastewater Section ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel 1. D. 017-074-74 Phone: 907-343-7904 Fax: 907-343-7997 Property owner(s) ROB CUSHMAN Day phone 907-301-9046 Mailina address NHN PATHFINDER CIRCLE *ANCHORAGE, AK Site address NHN PATHFINDER CIRCLE *ANCHORAGE, AK Legal description (Sub'd., Block & Lot) LEWIS AND CLARK; LOT 10 Legal description (Township, Range & Section) Lot Size Sq. Ft. Number of Bedrooms 4 (5 SEPTIC) APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field � Initial El Single Family (SF) (w/wo AD U) Septic Tank El Upgrade ❑ Duplex (D) ❑ Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well 0 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. (Signature of property owner or authorized agent) Permit/Rush Fees: Waiver Fees: Date of Payment: 2 2 2 `% Date of Payment: Receipt Number: Receipt Number: Permit No. 0 S P `� O Z O Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241020, Deb Wockenfuss, 03/26/24 THE DEPICTION OF ALL STRUCTURES SHOWN ON ADJACENT PROPERTIES ARE APPROXIMATE IN REGARD TO CONFIGURATION/LOCATION AND MAY BE BASED SOLELY ON PUBLICLY AVAILABLE MOA GIS RECORDS. THE LOCATION OF ALL WELLS AND SEPTIC SYSTEMS SHOWN ARE APPROXIMATE AND MAY BE BASED SOLELY ON INFORMATION OBTAINED FROM PUBLICLY AVAILABLE MOA ONLINE RECORDS AND/OR AS -BUILT SURVEYS �. I LEWIS AND CLARK; LOT 2 VACANT LEWIS AND CLARK; LOT 117 VACANT ,J PREVIOUSLY PROPOSED WELL LOCATION f LEWIS AND CLARK; TRACT B VACANT WETLANDS PER TRIAD ENGINEERING GRADING PLAN IN SUBDIVISION FILE OF MOA RECORDS - NOT IDENTIFIED AS A WETLAND ON MOA WETLANDS MAPPING (ATTACHED) f m ANDLOT3 VACANT t� \ 4` Well L.ocot t O�\ fEVISED WELL LOCATION 50' 7` GENERAL Lt / OF 50' WELL �- HOME WAS MOVED SOUTH; LOCATION SHOWN PER .DWG FILE PROVIDED BY SURVYOR AND CONFIRMED WITH BUILDER 1 LEWIS AND CLARK; LOT 11 VACANT ENGINEERING SALES CONSULTING � 3701 EAST TUDOR ROAD SUITE 101 'ANCHORAGE. ALASKA' PHONE (907) 337.6179' WEBSITE: wwm.gamessengineering.com PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ROB CUSHMAN 907-301-9046 1 OF 1 PROJECT/LEGAL DESCRIPTION: DRAWN BY: LEWIS AND CLARK; LOT 10 D.J.G. TYPE OF WORK: DATE: SEPTIC SYSTEM DRAINFIELD DESIGN - REVISED WELL LOCATION 6/13/2024 ' LEWIS AND CLARK; LOT 9 VACANT -AWWfS DESIGN IN MOA RECORDS - PER GEG SITE VISIT, HOME APPEARS TO BE UNDER CONSTRUCTION LEWIS AND CLARK; LOT 7 VACANT N S ALE: 1"=100' OF ,. P ......... ' w ? r AV *\ dC1TH �o o .. Jef ey A. mess 3w W } -J, i CE -7953 �� AV AV LICENSE ��'k lk #AECC884 �� Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241020, Deb Wockenfuss, 03/26/24 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241020, Deb Wockenfuss, 03/26/24 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241020, Deb Wockenfuss, 03/26/24 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241020, Deb Wockenfuss, 03/26/24 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241020, Deb Wockenfuss, 03/26/24 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241020, Deb Wockenfuss, 03/26/24 THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and entered into as of this Day of of 20 2..11 , by and between , herein the "OWNER," and the Municipality of 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 UC4 n located at (legal description) le -{FIs cf 16,P- C1�� 2. Maintenance, Repairs and Alterations. (Owner is required to read, understand and initial each section) 61— 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. Ct, 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). 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. C�- 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) Page 1 of 3 CG- Owner acknowledges that the Municipality may request records of maintenance and repairs from the manufacturer's representative or maintenance provider. 66- 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. CL Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. C — 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. C.C. 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. lolonwaiver. 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 haw. 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 OWNER: BY C�� CZ 61,4 r— (signature) Date: j Z printname) STATE OF ALASKA. ) ) ss. THIRD JUDICIAL DISTRICT ) The foregoiU-S trument was acknowledged before me this a2 day of OWL14 2014, by L I¢ CUN PUBUG NOTARY PUBLIC F R ALASKA IM] NOTARY MyCommissinexpir s: lzjof� ?o2r+ MUNICIPALITY: By: (signature) (print name) (rev. 05/18/2018) Date: 3 Z Title: Page 3 of 3