HomeMy WebLinkAboutUS SURVEY 3042 LT 100 E2N2US Survey
3042
Lot 100 E2N2
#075-093-36
I-Cefty DriCling, Inc.
Well Log
IVa rerWe(I- Vrffinq andTunf S.rfec
`Anchorage, %t S(a Cu07) 345.11593
Drilling Started: 06 132w6-nmploed: 06 14 /2006
CirwBorough:
Subdivision: BLOC
L(yr
Propcny0%%wrName&Address: Edward McVeagh
Box 1113 16941 Robert Drive
Anchors
Girdwood
US Survey 3042
100
e99511
Meridian Township Range _ Section V4 of _ _r�i of Y4 of _ 'A
BOREHOLE DATA(from top of Casing))epth
Drilling method: (X ) Air rotary. ( ) Cable tool. Other _
Material: Type, Color & wetness I LI -11m I(-)
Well use: ( ) Public suPr r• I ( x ) Dhtmcstic. Other
stickup
0
2
Depth of hole: 140 - 11, Casing stickup: 2 ft
Casing type: Steel Thickness: _250 inches
Casing diameter. 6 inclws Casing depth: 140ft
overburden
2
4
Liner type: Diameter: - inches Depth: - ft
clay & gravel
4
8
Static water (from top of casing): 62.5 ft onO6 /14 r2006
Pumping level & yield: _ fel atter _ hours at _ gpm
Recovery rate: 42 gent. Method of testing: airlift
silty clay w/ rock
8
12
Development method: airlift Duration: 1 hour
silty sand w/ rock (moist)
12
21
Well intake opening type: ( X) Open end. ( ) Open hole, Other_
Scrccncd: Start: - ft, Stopped - ft
Screen type: _ Slotimcsh size: -
sand & gravel w/ little H2O
21
23
Perforatcd: Stan: - ft. Stopped: - ft
Stan: - ft. Stopped: - fI
sand & rock (dry)
23
43
Note: .............................................................. ......................................
silty clay (dry)
43
60
Grout type: _bentonite Volume -
Depth; from 9pound surface , to 20_ ft
silty clay w/ little rock (dry)
60
125
Pump intake depth: __ ft
Pump size: hp. Brand name:
clay w/ little rock (moist)
125
132
Was well disinfected upon completion! (X) Ycs. ( ) No
Method of disinfeclion:C2lCi1m.H hlorite..(.Chlorine)...
gravel w/ H2O
132
140
Driller comments/disclaimers:............................................................
........... _.................................................................... -.......
........................................................ ......... _...............................
.............................................................................................................
Well drillernamc:. JnhnnyJSay
Company namc:.... HeftyDrillingt InC..........................................
Mailing address: ... 3540.Akula........Dr.
................................................
City: Anchorage State: 6K Zip 99516
Phone number : ( 907 ) 345 _ 0593 fax:345-4700
Drillers signature:
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Section
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.muni.org/onsite
(907)343-7904
Attention: Property owner shall provide a w
DSD within 60 days of well completion.
Permit Number. SWO50183
Dalc Of lSSue: _ jun/ 1712005__
Parcel Identification Number: n75 — n93— 36
Is well located at approved permit location?( X) Yes or
)No
to the
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WATER SUPPLY PERMIT
Initial
Date Issued: Jun 17, 2005
Expiration Date: Jun 17, 2006
Permit Number: SWO50183 Parcel ID: 075-093-36
Legal Description: US SURVEY 3042 SUBDIVISION LOT 100 E2N2
Design Engineer: 0000 None Required
Owner Name: EDWARD MCVEAGH
Owner Address: P.O. BOX 111376
ANCHORAGE. AK 99511 -
Site Address: 16941 ROBERT DRIVE
Lot Size: 13860 SO. FT.
Total Bedrooms: 5 Permit Bedrooms: 5
This permit is for the construction of:
❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑✓ Private Well ❑ Water Storage
All construction must 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 engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
5. The following special provisions.
-WHEN THE WELL HAS BEEN COMPLETED AND SATISFACTORY WATER PRODUCTION HAS BEEN
DETERMINED, THE WELL DRILLER SHALL PLACE AN APPROVED SANITARY SEAL ON THE WELL HEAD AND
NO PITLESS ADAPTER OR PUMP SHALL BE INSTALLED UNTIL AN APPROVED WASTEWATER DISPOSAL
SYSTEM HAS BEEN CONSTRUCTED.
-THE INSTALLATION OF A WATER WELL SHALL MEET ALL THE ANCHORAGE MUNICIPAL CODE 15.55.
PLEASE SEETHE ATTACHED SHEET "PERMIT REQUIREMENTS FOR A DOMESTIC WATER SYSTEM". ITIS
THE BURDEN OF THE PROPERTY OWNER TO DETERMINE ANY EXISTING WASTEWATER PERMITS EFFECT
THE LOCATION OF THE WELL. IF THERE ARE ANY QUESTIONS PLEASE CALL THE MUNICIPAL ON SITE
WATER AND WASTEWATER PROGRAM AT 907-343-7904.
Received By. Date:
Issued By: I l ! 1 Date: r4117 Ar
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. —C%3" 3(o Permit Number SW
Property
phone 3y4—vg 3S
Mailing address 16 9 N I RobuA *br- v Zip Code
uS h�� 3�e42
Site address ip Code
Legal description (Lot, Block & Sub'd.) /-04- /00 C£ 2 N1 Ue
Legal description (Section, Township & Range)
Lot Size 13 9&0 .1creso
Number of Bedrooms
Sr
THIS APPLICATION IS FOR:
Sewer Only
❑
Well Only
L'7
Sewer and Well
❑
Water Storage
❑
Sewer Upgrade
❑
THIS PROPERTY CONTAINS:
Hot Tub
❑
Jacuzzi
❑
Swimming Pool
❑
Water Softening Unit
❑
Therapy Pool
❑
certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees: Waiver Fees:
Date of Payment: Date of Payment:
Receipt Number: /P�/3� Receipt Number:
(Rev. 09/04)
aAr. µnrml lozo' A0
me.c� a oa.ol 1R ,o 0
S17NOmod •\`\
M/N f
amr,mm 11
Ro
\
q
A(M YPU tle.Ot 10•
y Ne� �•�.
H 67�1
95.7 b0.
W
99
3�5. . N .;:; .
•;::�fttlT�i�r b .
M � % P924.0'.. J
Ae
W1/2 100
h
AA p
NN
�
h r�
c
a
NN
R4 r
N B�SjOpe
W
99.00, 04.
S1/2 E1/2
100 g
UNDER NO CIRCUMSTANCES SHOULD AN AS -BUILT BE USED FOR
CCNSTRUCTION OR FOR ESTASUSHING BOUNDARY OR FENCE LINES.
THE SURVEYOR TAKES RESPONSIBILITY FOR THE INITIAL TRANSACTION ONLY
AND ASSUMES FINANCIAL LIABILITY ONLY FOR THE COST OF THE SURVEY.
LISTED DISTANCES PREVAIL OVER SCALING. REPRODUCTION MAY CAUSE ERRORS IN SCALE.
LOT SAVEY SURVEY TYPE
SYMBOLS../ --' 7•'r/y/
FOMAMM AS-AlLT
a SET REBAR DRAINAGE u 'ASPHALT
" ' ':A'••
NNAL STRUCnArc AS-eULT
O FOUND REBAR 41.. WOOD SCE CONCRETE
PWT nut ... AS -MT ... LDT SX41Y ... taoOlwn'
n
® ASSUMED ELEV.-;,--p—;- METAL. FENCE ® WOOD DECK
PLOT PLANS k LOT SURVEYS
NOTE:
IT IS THE RESPONSIBILITY OF THE BUILDER OR OWNER. PRIOR TO
ONLY THOSE IMPROVEMENTS ABOVE GROUND AND VISIBLE WILL BE
CONSTRUCTION, TO VERIFY PROPOSED BUILDING GRADE RELATIVE
TO FINISHED GRADE AND UTILITY CONNECTIONS AND TO DETERMINE
SHOWN. FENCES. WELLS. SEPTIC CLEANOUTS. SIDEWALKS. DRIVEWAYS,
ETC., ARE SHOWN IN THEIR APPROKIMATE LOCATION, ONLY. SNOW
THE
WHICH 00 NNOTOF ANY APPEARR OSN THE RECORDED SUBDIVIANTS OR SIONCTIONS
PLAT.
MAY AND LOCATED.
ALL DISTANCES SOMEIMPROVEMENTS
RECORD UNOLESSNOTHER SE NOD.
Prepared by
SURVEY CERIMCATION .�,�,�,.r♦»,�,,
of �•,��
Robert E. Johns, Jr. & Assoc.
PLDT%"" e�iow
I Wee, -ery r 1 Aw IAPA+r -.•Pl •
treew e�YlW-lrl842
GJ• •• •• •�.
Professional Land Surveyors
C t
ANCHORAGE. ALASKA 99501
r.r rrrrr.r
'-' r» r �'e �'.r• r. r {f ;' t ��
Rea Lot S.F.
Rec. %at rue Na
49th"
1'-40'
1885
USS 3042
FOUNDATION As-euaT �.....d . .... ...... ......
l er.l L Y� I. Y.rl rte!/ r I 0 /
0.
Date SUM
9-28-97
Drawn DK
REJ
CDft by. -
Y M W
�; , ..., .....�
rlr.rr.r r�ir ,T
•JOHN
Date Drawn: 10-1-97
�Q 4912
W.O.
97-92
:ROBERT•
;
r»..— ,��
-...r:�.r...r
" 4121— e =�
.•'•�a'•
nNAL STRI=CTURE AS-BULT. �# sA '•..,,
Legal Osaalptlon:
•,
""•..`.'"�».`� we 1�^ e� ••................ 06 ;.��
er r r rrrN.
�44,1;aIlk
r.r.r
Nt/2 E1/2 LOT 100 USS 3042
����
P I IC
�SAREA ,
101
I S
,r--- �y NO
f �
100 O �
7 �O
(J
SEPTIC
AREA
B
I
\ I�O
` OT
\ AII
LEGEND 0AD
06/17/2005 14:03 5625427 A" PAGE 02
:' Re�o[ding p1sL30'1.AnchoJage ,'
V.
• _ '.. ;�r � � k'�iIIII�1I1M11111I111U�I�YNA��11I��`�IUYI�IIII�II�l9� r r
dinc�onseWaie[ffi'A'u�swruc.Vllfi!Y'.•�•.:Xj ^��c`�•'Qm•�i'yi ��?t�'; _
..;;,::.:..• .. Anceor�taaxv9so)'.:` E;✓='. _
.:chore : e VlratZ.
'
:: Ei?En>jLn WER EiivYCE cormiEribi+F A.GREEMNT_
IT
P.
Lo
"tlif
::':TiilS/CGREEMENT behveendva^t§ h(cNea�7h �OyQne end �ncfiaJ�9N+aferS
Vi�aslewatcr.Ut61tYWY�WUjls701, puroosaofp{oviilin�sanrta}Y .+emcatoloflDQE
5,rivey3042 in'. 1- 1tt;710�1, RAE, 3 M y Tlaska (Property`s P3°nertr7a.•
. .'wi{lvrian areacet7lfkatr�. AWtN the R
:.:. Ta V bY. pg IeJory ComrNssbr of Waska, (RC�,),A ,.. .
dIVkIE'FtEAu�rlVyYll`opera}es'ti(deCreS,.iv7es.andr¢9(itaLonshppro'VedDyUaRCA +�.•':.'.
�Prpnxl]Sid(edknU:/(flfVyl}NfastewalBrTanftwhJrlr(romtime:totimafssub]edtodfangeand
rAlflt RFJiSy prod V. i05chf6d butsrde ;he 4ecdd�d area bf ori existhTg sani�ry
...... yeewertnaln. lfl onderitig aannargsev efYeavficatrnovada r•
4rekY 7anQ c
:.`- WFfEREAs;rowrlei_aeeJres hre" PtopeYCy 13 David #3 61
;l lough ilri`extendeijseroce eonmFp pri horn the P(operty io enc A WU rciafrt tazated in
:�. ... .ariod,er(Jenefitedarea;�nd , '
.....:.... .....:::.
::fnlKtREA5 A�(FAaSthaeapaotY;toixtrrdaanlaiysewer c�tatHePr6pe^1
tivongn antix7endaGsenila.connod+en w 8 sewerhG,rn Ydnsweted 6pearKayy •DgnenC ..
r':Oth�rpropeities`and:.... .: .-: .a..:
W, -HE Rbk- 'AWVfiJlia9:par4i3tthjWsanciMA e4end:aanitayeeve erviE25r0, Af
NOYJ-THEREFORE.1g i o),f§46dtlonpfthq$over,i3ritkarnfaewQhorCIA, a 1p;n rld
.. '1f .Tho Oivnei.i+*M-excavetd ton�evc( End tonneil the Pro'pe`rty Idcaled:south of ,
IFQbst4sdMna i20ada DprOxui7atelY t 50 feeEVuasl of fhe kiterse G[AgosGnb.MindRoad : , :;•
•andtproat Road¢htfwobd Aft;.to'th6 AGVVlflt"sonitary�ewEr MalR tocatdd wrtFiln Ayait7,o '
r'. : :v::':r•
MN-itdad, app{o *Tia" 2.64 feet east Qf the�Ploperty,at.O4vner'5l%ple�osb and`expense5c,
• • . bec6edih6e;iWh AwN{fl-atandards,.ttie engineered plans presented Ia�AWUVU$.and'subteel to
eormecllonperiTitting'ptid(nspection-byAW4VU:':. .. �. _:' .... .- . ..
::• .....
2 Qvmer shall obtalna9 necesgary approvats,Jpgreements arab ptxmbLSfnr'
::.-: easerrJe�ts,.Dulld,n construetbnartdiptiRycaniiecGonjier(riils_3rxtp5yalfleeS '::•.,''
r :=::: ttioltoart)(CtnshLctkn,
:... $ bwitersf]a115UtYTlit•a design &swing'tflhepniposadsdrvicecomacnon
'.lime bf VonnecI":pertnit, bdr(w L, ch vvltl lticlode put iii bbtTmakd o,,Vje doYlz6nfat aii(r !.• .', .
:.Wrocal.toehWndithgSe onneEl'an extension AndgppuGerranras Yfaanoutsrp(pestzd
!xiepth andmaterah, a a�{tappllwUe; pun�pntt starwndesfgtrantt c2pacttfes
shal'te7mbtmC•AWVVU for any Cost encumbered byAVVVYV and.fncfd¢,k.
fo' 6wne�s Constn,ctoTr ind lnstallatiWr nl-. uta ootihettiiorrand :sernce extertsian
Reiit-bUrserneni shad betdlna dvtiV h6i 30 doys afteY th" dete`ot Gomsetfavofttie'Properfy;d
- . ...''3tfe 3inifa "'cdviertn-W.
CS/17/2005 14:03 5625427 AWWU
PAGE 03
;yr;1W4
' • ' ' S _Upon xbmplatbn of corts$uctloti �txl Fomedfon to Jhe sanit@ry 3exver tnatiw.
••b;Aneri4855umeall66ONk¢.aamggetausmDythe>a:denifettservich'coltneet>a'n,'tto Jho
•..
ex sewer. sewer. sin to'pie Pfo =and'wilt ihssume-sll resprxrstiiFty.rai trumte[wnce,apd
:Zeparro� UM Soto cg yonmew-zon`from,%e eWsGn9.sewerms rt tb the edperiy O-INoinUiide; tulTibl`
'be Wiled to :the fdlgvNng^flushttigrol the tete e, }Oddin�:btfie ser3lee, fro?t, G�9g
"'> leanouts, apct eYosiwi w'sfahi3ge mused !N dearulf, tegV[ed by sevragrx cvertlovr aiidfor _.
.
E Jhedesigh tidoonstrticCon ofbte axlundedeormocdonsE alb cordormlaAvvWU
n
DeMn fibrsge Stay darcj Stiectiticat tinA' jlrUL$S)
esVi and ConstrWichfILx9ces, Municip3lAyof
especuvely eitd Jhe IiatlfpanPtturibing R'AdE The itxtended aani�(�fOewefS. tee fomFctipn
- ' .
'
udei i Jilt s'tatfarrwittr-a fses•.,rirLied Servmbe Mna of least2,. haiiameter, iW satuterys'evrer*
'
fat•Suues st alf be sep"ratsd tram a tywatq xery t� bf Water)Wix by b*-eutah4e<of,9U,fe.t pr
.. :;Inp[O QrorizbntaHyltxtd,').9 4lPtoraj{verttCattY):_and•ahall be inst?eEWd.hilaccdrdanFerydth `'-.:
�:'.
: petrnft requ iernerks Tli�Owner shag by rRspo tsibb poi rejnu and Dost of cepa rtq my p t Cr
tit er utttitj, lrtij eriCotfitdred _!din-_ged:dwrMg tlic if 4Ne4ori Rf thB extert�!FA anular .
setapf-s>I to GQ!Lctedmm
;.
" . UPOL mm5>'actory c9vTvO%, urh eiagnded ¢�n?t3tY s of sernc§
;cgltaecpon pWWil agrees to7urr ish.serutary sower "Mce_to tnt Properiyat sdch rales turd
°:.•
��, �grtder such. tarx>fione''as grB•set forth Gnttim thoi4W WU �arNf eS a�ypfWgC by thcRGA or Itg.-
�u«cessaf5 :��rriT arJtnowledges Vw{ Rarlff rales and t:o`htlmbghx'aie,a,UbJed 1a ,change.
'Flowever be.tonsfrued d *e A VAp
s ins nbM- esfi'sshaR.t' 4 Agreeittent *, carbnire sdrvlce
!'' '
• mi Owner-in tt a averltthat .oWnertir. �resr}nnyogttii R . ormit3dio ot1h $. Agraema t ' :
..
8 Qvfier ahpd p[osvfda. AWV1U wih a Tetprd .draw g ,plan IcoMO t:on Af
:..)tons tniction WWx shaft indtdk. bVkM be )irrnted toy the-.ftmieJ ektsndad ConnecUbjI,loeatton
.:- t ,.•
'She record drawmn� trust Cnv ifiangas In atptajriE or etevstipmis dmeristonrrtrr re7alanship to
distance from the ptattad road oentedin or pkopertyl:rrdTorrary,angk ysifh(s pr bandsdf pfp0
wu*) thQ fight•ofgray ttra {¢Coro drawhrg ;h501,q'haznhaand verGtaip Hf
laaiadlbt>
. recorQ
.: 'CrawlrK).stwutd the ro»!}puiahtxt thane for CuturC-lxxldnp xcofmrodabons, , .
.•..;
,¢�:...,�4rn0'eV_enFimlC�'Tieretiosii•adEi!%ttaf�cGPhaltlCtts.li�ofhe[p"'roperlies�nfo:sucR•'.%.''
.'.:..•...,,..
•-�•'• � ..70.- 'an:na-even€tier`t[(>wA,ec.rditami.DtJUisngs�uilh'�erfianerit><auridations•Cobe-btiilt'
•,-
- ..
.
.�.:, .
'a'ierihet;.kttndeds€raca"riui,necfia'n:.. ..
• • • . • j 1 :i3wner agreesto �rold liarirdess.:kiiterrnify arimf�detend ai his mcpense;;AYUY+(IY
• • ,
•DPufAe.ltui)1cipal�tyoP,Arictfagyfrom'aryl)atiillp?orfesptltrat'h1rtylor:nnyfo34ort1aMa'ge
,
'•�%rhij tpay-arise out:pfOwner'3pixfo{rnancrand,'taLstaUion•ot arty,ieRtis pad cgnrJitlons of .'
-'.
. ads AgreOment:. ... .. .. `
.
n004 062974
06/17/2005 14.03 5625427 PAGE 04
_ter
: .:ECS :2003. 10�• .. .. ,t
:lot7�J0'{E2�IQ2),,US.S�i'�ey304E.'•..•`
.. iPi�tlSorA . '.. ... ' • ... ,
' ',' i4. :Ownet.sllail pay a sewerinrnk 8ssessment A[g:tate;of So `a4t4s frzfereneeTlD '.. .
Ca?�Zi f1a[.t1(itareYdllt'Ct Qrope[ty tintf�raletod',5pedA Assessritcnt.Ct arges LPod cd+utr4!ulMf ,
• sQthe eztenCed;eervi_ce.Corinectf«C •... .; ...:- .
15 OWnec agr"d..8nd 61tvenspt4th3ttt 117Arw aB s pewee' m Is ponstrueted
fomeft�arsC7[)�whk►iiienerds�tw.ErmaertyOvmer+.ytcesdiya.simte•thevbrganonloea7r
�dx levy-uPorimnnectton u+ar�es �that-are'Uien a15ar� otthe. AINWt.I Tantf as fifett �d . • .
• • • .. 16 "�At suth'�nc'as a sanJtarK.;sgpvrit jnaTn js';6orts'Yn,�•jvld"dr,ba,seta�,'gig '' _ ..
,. :Prdofti pre..Qwner . f¢eS, t4 nnad $Ae:, e:cferi :Ce C ms Y) cdrmecU4n ` !o
•connect to .:the newiJ(`-ConsWcted.sewaf me,nrat ONmees xxperse.:and'(o:r�teese _llfe
Muniupartty.ot Aneh4!aBe fSorD anf cdi9slpq[ jrol��c ager swv(�e
Ng did
{: '• ;3"'eC Se±gicR tonnSctionf r . •.
.. 1xt'':*rhsWrril9�Y�dlGortis„snd�oyecrar,ts'rbilfa5ied pt'tgisi,}lgrselnenf,afiaR,'Oe° ..
bf tduLg upon�ti subsequet+t �ar0es herehrit r Gwfude §Il iraria(erspf lt�e_ProCeny.'whet�er or
:..
`not for eorOderattdnr3r,dacopyof lttis�cyeemsnt3TraR6e fdedwdtt 0iiAitharage p,stricY
°'; .•• •': Recorder's,Cjffice :3sgYYesti�`netaido..s},ap:lzo0 �dTa9e A�as+m 99sG1'..
..T1is'claus8s"11.cofof�i3inad �liefdirti';ahaB �CoNs�ituty;the.,entire;Xgfe�nient;'6ery'ieen;tha' i7wii6tYzn¢ .•.
• AtjTED 8to "e :NsaTw: els-
•
•}lE4UESTm;eYs ;Edv1afd,,.S:1rtcVq�gh _ .' .. .' .. -•
h jY of ;.ER .OwNbki ,:- Edward'.S;H3dlteaghi ; : ::.<`:.. ;'! '=;:' : :;:•
MAIUtdGAI)dR$SS� PAt&111370.
.. ; ..: :. AntliAfa9e” Alaslsti:S9511�7378.... y ..:.'.• .
.'Su6divisl6rr Lot. . • Yax fdor l tiraGbn NQ..
3.1`t2.vt.. SE12, .. .:..•OFs=0,9336: ... ,
APPROVED BY: ONNEIZ .:
A1P KPRE.MO P,E.` •'iED ,RO(S."MCVEASN ` '
06/17/2005 14:03 5625427 PAGE
urmo�ezt�tl Us s��rsoni
STATE OF ALASK/t. �:' • • .. „ .
'THIS;t9'fA � RfIFY tha£oil; lh�s day of ::' J 3QQ4 beJa� me 1
• '.;'tF1e 0ndersigried, a'Nofaiy �ubkChr.00awr the sSlaid orN�slcadui wrNtnas�toned:�d sextn •: ' ' •`
- .: •• eg'st1cA; Aerso'n81fY-mppgBrcd,E4Wi4R0� !3 I�1CVrEAGH kridwn b hte:M pe thelri4R'AOOai ..... ....
Tarried tlerelrt it ho exenitea
em.
fa?9 9 �5liumenS and f a asktw vteCgetf that Aie dfd s6
'beery m5d j vntarllY pgai artg.puryosgs uter�itl (lleri4oned �nl$op�5thstated teat h=
is'e1y Mo!.r a;e .'!O.. id yutr, NT
WITNESS iiry l>ariQ and 0f9cfa[_sekbit, Jt a Eay AhQ year ,cate3GSl:a6pve`
• Wtiftert ; • :
NOTA&YPU9ucfnand 1orPJaska
• '� .; '. • �': •• ,MY?�tirrii3is£ion.Eigvres., 4-r�=]�.. , :s.' .
mss: .. '•,kw:..: '•C: :' .:'{'�
kJil
.. .. .."fNIRCt:�U61Gt4L'DtS`ZFtIy'T' ,:1 • .. ...
... TKS t57v tMT1FY h> it,bO1hfsr5- Aaay r i 'A?ch 2664;hetbr�
:,me the imdefJ ned s7otary ppf>bcta and for tFie. Stale ot.Alasga OeIYcommtss(orierl .nd
'•.:x4v..no'isnrn�tnr'sr,nad�adtSAaYecl ��Mr:'rV'�'i"amo%'P:t=__.�krirni'A tame b:liti •-
' , • i�1tlTNl;SS:itiyhand'aiad oMcia[ seafon the¢ay and�`6a�'fu'sEeDoire wiittdl. .� .
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