HomeMy WebLinkAboutCANYON VIEW ESTATES BLK 1 LT 1
CANYON VIEW
ESTATES
BLOCK 1
LOT 1
#021-021-34
www.sullivanwaterwells.com
Pump Installation Log
Well Drilling Permit Number: OSP Date of Issue
Parcel Identification Number:
Legal Description Property Owner Name & Address
CANYON VIEW ESTATES BLK 1 LT 1 Hultquist Homes
13675 Canyon Rd.
Anchorage, AK 99516
Pump Installation Date:
6/10/26
Pump Intake Depth Below Top of Well Casing:
411 feet
Pump manufacturer’s Name:
Grundfos
Pump Model:
10SQE15-330
Pump Size:
1.5 hp
Pitless Adapter Burial Depth:
11 feet
Pitless Adapter Installer:
Pitless Manufacturer:
Unknown
Disinfected Upon Completion?
yes no
Method of Disinfection:
Chlorine 50 PPM
Comments:
Pump Installers Name:
Sullivan Water Wells
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
Merrill
Certified Drilling Log
OWNER OF LAND: Hultquist Homes
ADDRESS: 13675 Canyon Rd. Anchorage, AK 99516
LEGAL DESCRIPTION Canyon View Estates BLK 1 LT 1
DATE: 12/29/25
PERMIT NUMBER: OSP251426 DATE OF ISSUE: 12/9/25
TAX IDENTIFICATION NUMBER 02102134000
Is well located at approved permit location: Yes No
Method of Drilling: air rotary cable tool
Depth of Well: 464’
Casing Type: Steel Wall thickness .250 inches
Diameter: 6 inches, depth 188 feet
Liner type
Static Water Level: 170 feet
Recovery Rate 1 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:
Bore Hole Data
Depth
From To
0 2 Casing Stickup
2 4 Overburden
4 55 Gravel and sand
55 61 Gravel silt sand some water
61 160 Tight silty sand and gravel damp
160 169 Gravel silty sand
169 464 Bedrock hard black with quartz
seams
Drillers Name: Cole Sullivan
(Rev 05/02/)
Municipality of Anchorage
On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 1
ON-SITE
WASTEWATER INSPECTION REPORT
Permit Number: OSP251426
PID Number: 021-021-34
Dwelling: ❑■ Single Family (SF)
❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑■ New ❑ Upgrade
Name
HULTQUIST HOMES, INC.
ABSORPTION FIELD
❑ Deep Trench ❑■ Wide Trench F-1 Bed El Mound
Site Address
13675 CANYON ROAD
❑ Other
Phone
Number of Bedrooms
Soil Rating
depth from original grade
907-522-3204
4
4.0 GPD/SF
JTotal
1.0 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
0.5Ft.
Gravel depth beneath pipe
0.5 Ft.
Subdivision
Block Lot
CANYON VIEW ESTATES, B1,
LT1
Fill added above original grade
2.7 Ft.
Gravel length
35 Ft.
Township Range Section
T12N, R2W, S30, SM
Gravel width
5 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
Dist. between trenches
From
Tank
Field
Tank
Line
175 Ftz
1
N/A Ft.
Well
50'+
50'+
NA
NA
25'+
TANK ❑ Septic ❑ S.T.E.P. ❑ Holding Other
Manufacturer
ORENCO (FAP 2.0)
Capacity
1500 Gal.
Surface Water
100'+
100'+
NA
NA
Material
Number of compartments
Lot Line
5'+
10'+
NA
NA
NA
FIBERGLASS
2
Foundation
10'+
10'+
NA
NA
LIFT STATION
Manufacturer
Capacity
Remarks AWWTS
Gal.
Alarm location
Electrical installed by
PIPE MATERIAL House to tank ABs Fels Tank to D3034
drainfield
Installer
HULTQUIST HOMES, INC.
Drainfield D3034 COIMTD3034
Inspector PES
BENCH MARK (Assumed elevation) 49 ft
Inspdteeccon est 12/19/25
12/29/25
Location and description
3'd 12/30/25
2nd
4" 2/12/26
See Site Plan, GARAGE FINISH FLOOR
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
Engineer's Stamp
A�,4 1k
Conditional Approval:
Date
OF.
AWCO�
/*• STH * r
�,.. •�ev`n R. Pan•^or•e'
Septic Syste
% �% c;E 8149
�s 87/02/2026. c�
Approved
Date
ES�10h�i�
e: this approval does not include well permit requirements.
(Rev 05/02/)
Lot 1
Lot 2
C
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TH-2 (PES 2019)
NO
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VACANT LOT
TH-1(PES-2025)
4BR
SFD (N)
WELL (N)
P
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2
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1
6
-
0
1
3
1
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3
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TH-1 (PES 2019)
NO WELLS OR SEPTICS W/IN 100'
PA
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W
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ABSORPTION
FIELD (N).1500gal ADVANTEX FAP (N)
20
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CAT III (NIC)
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50' WELL RAD.
100' WELL RAD.
82.0'
92.0'
91.8'
24.2'
81.4'76.8'
69.2'
57.9'
47.8'
44.8'
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NEW SEPTIC
DESIGN PARAMETERS
PRIMARY/RESERVE SEPTIC SYSTEM
NO. BEDROOM: 4(600 gpd)
TANK SIZE: 1500gal ADVANTEX FAP
W/AX-20
DESIGN PERC RATE: 16-30 MPI
SOIL RATING: 4.0 GPD/SF
AREA RQD: 150 SF
SYS. TYPE: WIDE TRENCH 0.5' E.D.
MIN LENGTH: 30.0 LF
USE:
35LF x 5.0'W x 0.5' E.D., 1.0' T.D.
TOTAL AREA: 175
WATER LINE / WELL
RADIUS
ESMT/SETBACK
STREAM/DRAINAGE
WAY CENTERLINE
FLOW PATH
RECORD DRAWING
THIS RECORD DRAWING REPRESENTS THE AS-BUILT CONDITION OF THE PROPERTY IMPROVEMENTS DESCRIBED ABOVE.
THE DRAWING AND ANY OTHER SUBSEQUENT ATTACHED OR INCLUDED INFORMATION IS BASED ON PERIODIC VISUAL OBSERVATION
BY A REPRESENTATIVE OF PES ALONG WITH NOTES, PHOTOS, AND OTHER INFORMATION PROVIDED BY THE INSTALLER OF THE SYSTEM.
THE INFORMATION PROVIDED IN THE RECORD DRAWING APPEARS REASONABLE AND REPRESENTS THAT THE PROJECT WAS DESIGNED AND CONSTRUCTED IN GENERAL
CONFORMANCE OF 18 AAC 72, THE ADEC ONSITE WASTEWATER SYSTEM INSTALLATION MANUAL, AND AMC 15.65 WHERE APPLICABLE. PES SHALL NOT BE HELD LIABLE FOR
SYSTEM DEFICIENCIES WHICH FALL OUTSIDE THE SCOPE OF THE REQUIRED VISUAL OBSERVATIONS OR SUBSEQUENT OBSERVATIONS IF REQUESTED BY THE INSTALLER. SEPTIC
SYSTEM INSTALLERS ARE TRAINED AND APPROVED BY THE MUNICIPALITY OF ANCHORAGE AND OR ADEC AS APPLICABLE. INSTALLERS ARE RESPONSIBLE FOR CONSTRUCTING
THE SEPTIC SYSTEM AS DESIGNED AND ENSURING THEIR WORK CONFORMS TO THE CODES AND POLICIES STATED ABOVE.
ABBREVIATIONS
ADVTX ADVANTEX SYSTEM
BM BENCHMARK
CO CLEAN OUT NO.
(E)EXISTING
ESMNT EASEMENT
FC FOUNDATION CLEANOUT
FND FOUNDATION
MT MONITOR TUBE NO.
MH MANHOLE NO.
(N)NEW
NIC NOT IN CONTRACT
PL PROPERTY LINE
RES FLD RESERVE FIELD
TH TEST HOLE
SHEET NOTES:
1.WELL LOCATION HEREON IS PER RECORD MEASUREMENT
AND DIFFERS FROM LOCATION SHOWN ON PERMITTED
DRAWINGS.
12
8
11
10
9
BOH
6
7
5
3
4
2
TH-1 (2025)
OR
1
OG: 41.6
13
PROFILE
SCALE: NTS
MOA SAND TO LEVEL AS NEEDED
BM
GARAGE FF:
49.00
1500g
ADVANTEX
FAP
FC
CO3 CO1
OG/FG: 47.3
MT1 MT2 CO2
FG: 44.7
0.5' DRAIN ROCK
4" DRAIN PIPE
FILTER FABRIC
BOTTOM OF
FIELD: 40.6
INV:41.1
BOTTOM OF
FIELD: 40.6
INV:41.1
INV:43.9
TOT: 44.8
SM/GM
SM/ML
MH1 ADVTX
FG: 45.0
*NO
WATER
OBSERVED
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1 SCALE: N.T.S.
SEPTIC SYSTEM PROFILE
Permit Number:OSP251426
Tax Code Number:02102134000
Work Type:WellSeptic Initial
Effective Date:
Design Engineer:
Site Legal Address:CANYON VIEW ESTATES BLK 1 LT 1 G:3042
Owner:HULTQUIST HOMES INC
Site Mailing Address:13675 CANYON RD, Anchorage
Lot Size in Sq Ft:56107
Total Bedrooms:4
This permit is for the construction of:
Disposal Field Septic Tank Holding Tank Privy
Non-Public
Water 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. Coodinate with On-Site staff regarding preferred method.
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
12/9/2025
12/9/2026
PANNONE ENGINEERING SERVICES
Expiration Date:
þ þ ¨¨þ ¨
Issued To:
Issued By:
Date:
Date:
12/9/2025
12/9/2025
PANNONE ENGINEERING SERVICES
Isatou B Njie
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
MUNICIPALITY OF ANCHORAGE
A
Development Services Department
Phone: 907-343-7904
On -Site Water & Wastewater Section
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 021-021-34
Property owner(s) Hultquist Homes, Inc. Day phone.
Mailing address 12570 Old Seward Highway Anchorage, AK 99515
Site address NHN Canyon Road
Legal description CANYON View Estates Block 1 Lot 1
Number of Bedrooms 4
Engineering Firm Pannone Engineering Services, LLC.
Building Permit Number A2 S- 5 7(17 Not Applicable r_1
APPLICATION IS FOR: APPLICATION IS AN:
(Z all that apply)
Disposal Field
M Initial F -I
Septic Tank
El Upgrade ❑
Holding Tank
❑ Renewal ❑
Privy
❑
Well
Water Storage
❑
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
Permit/Rush Fees: too
Date of Payment: 1117W21
Permit No. 05PAIZIZ�
May 2025
Waiver Fees:
Date of Payment:
Waiver No.
Distance:
Pannone Engineering Services LLC
Steven R. Pannone, Principal
Registered Professional Engineer
E-mail: steve@panengak.com
26 November, 2025
Mailing: P.O.Box 1807, Palmer, AK 99645
Telephone: (907) 745-8200 FAX: (907) 745-8201
Municipality of Anchorage
Development Services Department
On-Site Water & Wastewater Program
4700 Elmore Road
Anchorage, Alaska
Subject: Canyon View Estates Block 1 Lot 1
NHN Canyon Road
Well & Septic System Permit Request
This is a design narrative for a permit to install an initial well and septic system on the subject property. The
installation will serve a proposed four (4) bedroom house. This lot and surrounding lots are served by private wells.
Currently there are no wells within 100ft of the proposed installation.
1. Soils: A test hole was performed on this lot by Pannone Engineering Services, LLC –in 2019 during the initial
subdivision’s development, as well as an additional test hole conducted in 2025. Approximate locations are shown
on the attached site plan. Groundwater was not observed during the excavation of TH-1 (PES 2025) to a depth of
12.5’ below ground surface (BGS), and bedrock was not encountered. Groundwater was not observed in the test
hole monitor tube after 7-days to a depth of 12.5’ BGS. Based on the results of the percolation test conducted in
2025 and overall soils appearance; an application rate of 4.0 gpd/SF was used for the design of an advanced
wastewater treatment system in the area of the newly conducted test hole.
2. Soil Absorption System Design: See 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.
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, please contact me at (907) 745-8200.
Sincerely,
SRP
Steven R. Pannone, P.E. F. ASCE
Owner | Principal Engineer
26 November 2025
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP251426, Isatou Njie, 12/09/25
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP251426, Isatou Njie, 12/09/25
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP251426, Isatou Njie, 12/09/25
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP251426, Isatou Njie, 12/09/25
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP251426, Isatou Njie, 12/09/25
12/9/2025
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: (907)343-7904
On -Site Water &Wastewater Section Fax: (907)343-7997
Parcel ID 021 -021-34
Certificate of On -Site Systems Approval
OSC261234
Expiration Date:
Legal description CANYON VIEW ESTATES BLK 1 LT 1
Site address 13675 CANYON RD
Current property owner(s) HULTQUIST HOMES INC
X The On-site system(s) is/are approved for 4 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or conditions:
i
By: - Original Certificate Date:
7/16/2026
This/
certificate—of On -Site Systems Approval (COSA) is intended to demonstrate the subject
sy4tem(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage,
Development Service 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 submittal.
ATTACHMENTS:
COSA Checklist X Well Flow Advisory
Absorption Field Advisory Nitrate Advisory
Tank Age Advisory Arsenic Advisory
Other
MUNICIPALITY OF
Development Services Department
On -Site Water & Wastewater Section --
ANCHORAGE
Phone: 907-343-7904
Fax: 907-343-7997
Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 021-021-34
Complete legal description Canyon View B1 L1
Location (site address) 13675 Canyon Rd
Current property owner(s) Hultguist Homes
2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS
Day phone
3. TYPE OF WATER SUPPLY: ❑■ 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: ❑■ Private Septic ❑ Private Septic serving 2 dwelling units
❑ Holding Tank ❑ Community Septic or Public Sewer
5. SEPTIC TANK: ❑ Steel ❑ Plastic ❑ Concrete ■❑ Fiberglass
Age new - See advisory if steel or fiberglass older than 20 years
6. ABSORPTION FIELD: ❑■ AWWTS ❑ 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.
COSA Fee $D Waiver Fee $
Date of Payment L a Date of Payment
COSA # (i S GoZ �' ( 2 3Waiver #
COSA Application_Apr2025.doc
COSA Checklist_May2025.docx
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. DISPOSAL 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:
E. SEPARATION DISTANCES
From Well on Lot to: (Please enter distances if less than required)
Septic Tank/Lift Station on Lot > 100’
Yes if No ft
Neighboring Tank > 100’ Yes if No ft
Disposal Field on Lot > 100’Yes if No ft
Neighboring Disposal Fields > 100’
Yes if No ft
Sewer Line/Main > 100’ Yes if No ft
Sewer Manhole/Cleanout > 100’
Yes if No ft
Sewer Service/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 Disposal Field(s) on Lot to: (Please enter distances if less than required)
Tank to Foundation > 10’ Yes if No ft
Field to Foundation > 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/Service Line > 10’ Yes if No ft
Surface Water > 100’ Yes if No ft
Wells on Adjacent Lots:
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
Phone Name of Firm
Engineer’s Printed Name
COSA Checklist_May2025.docx
Date
MUNICIPALITY OF ANCHORAGE
ADVANCED WASTEWATER TREATMENT SYSTEM
MAINTENANCE AND REPAIR AGREEMENT
THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and
entered into as of this lry14'bay of :9 l.K — of 20. Z (.,by and between
CMA0 CaiAe. fn + DOY'c (kjherein 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 AdvanteX
located at (legal description)
Canyon View Estates Lot 1 Block 1
2. Maintenance Repairs and Alterations.
(Owner is required to read, understand and initial each section)
bL C 'C,' 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.
VL CG 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).
by C C 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.
OL� CG 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
PC -L4— 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.
p < < G Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS. The Municipality will give at least 24-hour notice.
C� Owner agrees that any sale or transfer of title of the property will not occur without a new
Certificate of On -Site Systems Approval.
p�- CG 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 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.
s
(rev. 05/18/2018) Page 2 of 3
OWNER:
By: (signature) Date: 6 Z�
l 0.Y�n CaO e061 ��-t (P�t name)
STATE OF ALASKA )
ss.
THIRD JUDICIAL DISTRICT )
The foregoing instrument was acknowledged before me this li�"day of Jv tXA ,
202-11, byCw✓t� o Cr�.t.r�t 4i -D. QV90ng CkSjVv.(G
NOTARY PUB 1C FOR ASKA .STATE OF ALASKA
NOTARY PUBLIC
My Commission expires: _,6 (?,21,d?ib Ashlee LaVigne
(signature) Date:
;print name) Title:
(rev. 05/18/2018) Page 3 of 3
Lot 1, Block 1,
Canyon View Estates Subdivision
Asbuilt
Land Surveying
Land Development Consultants
Subdivision Specialists
Construction Surveying
AEC# 173042
S4
Group
610 E 5th Avenue
Anchorage, Alaska 99501
(907) 306-8104
mail@S4AK.com
0 50'
GRAPHIC SCALE
0 30'
GRAPHIC SCALE
1" = 30'
5/25/2026