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Home My WebLink AboutMOUNTAIN VALLEY ESTATES BLK 4 LT 1Mountain Vail y Est. Block 4 Lot ! #050-651-02 On-Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 EImore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP161160 Tax Code Number: 05065102000 Work Type: Septic Initial Permit Effective Dates: July 0% 2016 to July 01, 2017 Design Engineer: GARNESS ENGINEERING GROUP LTD Subdivision: MOUNTAIN VALLEY ESTATES Site Legal Address: MOUNTAIN VALLEY ESTATES BLK 4 LT 1 G:0758 Owner/Address: GARNET PAUL J & MILLER GARRIE W.B. '/8737 STONE HILL DR EAGLE RIVER AK 995770000 Site Mailing Address: Lot Size in Sq Ft: 64999 Total Bedrooms: 4 [){. This permit is for the construction of: Y Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by carling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B, Covered, sealed, and heated to prevent freezing. Received By: ~'~ Date: -~7/ ~,/ I/¢ Municipality of Anchorage P.O. Box 196650 e 4700 Elmore Road Anchoraqe, Alaska 99519-6650 ® (907) 343-7904 ® Fax (907) 343-7997 http:llwww.muni.orqlOnsite Development Services Division On-Site Water and Wastewater Program **** VARIANCE/WAIVER REVIEW **** WaiverS: OSV161067 COSA#: Permit#: OSP161160 PID#: 050-651-02 Legal Description: Mountain Valley Estates B4 LI Engineer: Garness En.qineerin.q Group Applicant: Paul Garnett Your request for a waiver of the required 50 feet horizontal separation from the absorption field' to the excessive slope has been approved. The approved separation distance is 30.0 feet. This waiver approval applies to the proposed absorption field only. Any futm'e upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. [] The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. [] Notarized letter(s) of nonobjection have been received from the owner(s) of the affected adjacent property. [] Adjacent properties are not affected by this waiver. Waiver is Granted: X Waiver is not Granted: Date: Approved by: ..~'_. __ Name of R&v~-=~e'F - **** VARIANCE/WAIVER REVIEW **** Community Development Department ~ Phone~~ Development Services Fax: 907- 343-7997 On-Site Water & Wastewater Program Mayor Dan Sullivan On-Site Sewer/Well Permit Application ForA Single Family Dwelling Parcel I.D. 050-65-102 Property owner(s) PAUL GARNET Day phone 955-9222 Mailing address Site address NHN MICHAEL DRIVE *EAGLE RIVER, AK 99577 Legal description (Sub'd, Block & Lot) MOUNTAIN VALLEY ESTATES; BLOCK ¢, LOT 1 Legal description (Township, Section & Range) Lot Size Sq. Ft. Number of Bedrooms 4- APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DEWELLING: ( [~_11 that apply) Initial [] Single Family (SF) [] Absorption Field [] (w/wo ADU) Septic Tank [] Upgrade [] Renewal [] Duplex (D) [] Holding Tank [] Multiple Dwellings [] Privy [] (SF and/or D) Private Well ~' Water Storage [] THIS APPLICATION INCLUDES A VARIANCE/WAIVER REQUEST FOR: DRAINFIELD TO SLOPES >25% Distance: 50 FEET I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/Rush Fees: ¢~,~ Date of Payment: Receipt Number: Permit NO. Waiver Fees: Date of Payment: Receipt .umber: Waiver No. (Rev. 01/11) ., . Quanic. s GARNESS ENGINEERING GROUP, Ltd CIVIL & ENVIRONMENTAL ENGINEERS June 30,2016 Municipality of Anchorage Development Service Department On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref: Proposed Septic System for Mountain Valley Estates; Block 4, Lot 1 To whom it may concern: The existing lot is vacant. On 9/25/2015 two testholes were excavated on the subject property. On 10/1/2015 a percolation test was attempted but could not be performed due to runoff into the perk bench. On 3/29/2016 percolation tests were attempted again but were unsuccessful due to runoff into the perk bench. The homeowner removed several feet of material near the testhole locations minimizing runoff into the benches. On 5/5/2016 two percolation test were attempted, one near T.H.#1 and the other near T.H.#2. The attempted percolation test on T.H.#2 was again unsuccessful due to runoff into the perk bench, however, a percolation test was successfully performed on T.H.#1. We are proposing to install a CAT II system consisting of a Quanics 650 Aerocell pod, a 1500 gallon STEP tank and a 5 wide trench type drainfield. Two test holes were excavated on the property and the drainfield is designed within the 30 foot radius of test hole #1. Comments regarding the design are summarized as follows: 4. SOILS: See the attached 2015 logs which show the soil classifications, groundwater monitoring, and the percolation test results. 2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications. 3. SURFACE WATERS: There is a stream north of the proposed septic system. It was surveyed in by S4 Group and its 100 foot separation distance is shown on page 1 of 4 and page 2 of 4. 4. TOPOGRAPHY: As can be seen on page 2 of 4, the average topography around the proposed drainfield is 10-15%. The original grade near the testhole was excavated out by the homeowner and is unkown. Based upon the uphill topography, we believe that approximately 4 feet has been removed. In addition to the disturbance of the natural topography near the testhole, there are slopes greater than 25% less than 50 feet away from the proposed drainfield. We are therefore requesting that your department issue a waiver from the required separation distance of 50 feet to slopes 3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907} 338-3246 * Website: www.garnessengineering,com Page 2 of 2 greater than 25% down to 30 feet. See attached design drawing (page 2 of 4) and topographic profile drawing (page 3 of 4) for more details regarding this waiver. Justification for granting this waiver is as follows: · We will be using CAT II advanced treatment; the effluent quality will be much greater than that of conventional treatment in terms of BOD, TSS and Pathogens. · The system will be remotely monitored and inspected periodically to ensure proper function. · The downhill slopes of the trench are vegetated 5. ALTERNATE SITE: Given the site conditions (slopes, groundwater, percolation rate, surface water) we proposing the alternate site be rebuilding the proposed drainfield. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact us at 337-6179. Thank you for your as.~istance. Presk P.E., M.S. 3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www. garnessengineering.com MOUNTAIN VALLEY ESTATES; J MOUN S; MOU N VALLEY ESTATES ~ ' w \ ~ FRENCH O~IN~I J ~PT'O I . AR~ ~ /I GARNESS ENGINEERING GROUP, Ltd ..... ~ .... , c,V,L ~ ~.v..o..~.~.~,.~.~ ~-4JJ~'~" ' ' PREPARED FOR: JPHON[ NUMBER: PA6[ NUMBER: ~ ~arness~ PAUL ~ARNET LEGAL DESCRIPTION: D~WN MOUNTAIN VALLEY ESTATES; BLOCK 4, LOT 1 D.J.G. wP[ OF WO,K: DAT[~/28/201 ES % SEPTIC SYSTEM DESIGN UPGRADE 6 DESIGN NUMBER OF BEDROOMS: 4 PER DAY (GPD): 600 PERCOLATION RATE/S: 11 MIN/INCH PROPOSED APPUCATfON RATE: MINIMUM DP~,INFIELB SQ.FT.: 200 FT'z DRAINFIELD DESIGN: MAXIMUM DEPTH OF EXCAVATION: '2 FEET WIDTH: 5.0 FEET LENGTH: 40 FEET EFFECTIVE: 0.5 FEET SAND fILTER: 2 FEET ACTUAL SQ.FT.: 200 fTz *BELOW EXISTING GRADE GEG, Ltd. HAS A 8 LETfER THAT PERTAINS TO THIS DESIGN. TO OBTAIN A COPY OF THE LETTER CONTACT GEG, BY PROCEEDING FORWARD WITH THIS INSTALLATION, THE ENGINEER, WELL DRILLER, CONTRACTOR AND PROPERTf OWNER AGREE THAT THEY HAVE READ THESE SPECIFICATIONS AND AGREE TO ACCEPT THE TERMS AND CONDITIONS OUTLINED, NOTE: THE CONTRACTOR SHALL HAVE THE SOUTH & WEST LOT LINES, ALL WELL RADII AND 100 FOOT SETBACK OF SURFACE WATER FLAGGED BY A REGISTERED LAND SURVEYOR PRIOR 70 CONSTRUCTION. x I OFFSET OF STREAM PROFESSIONALLY LOCATED BY THOMAS H, DREYER, P. LS. / / SEWER LINE UNTIL HOUSE IS INSTALLE~. / DOUBLE DLEANOUTS BEFORE THE TANK DRAINFIELD I 650 AEROCELL POD 50% GROUNDWATER MONITORING TUBE INSTALLED BY OWNER, '~--APPROXIMATE LOCATION OF SLOPES >25% MOUNTAIN VALLEY ESTATES ~1; BLOCK 4, LOT 2 MOUNTAIN VALLEY ESTATES; BLOCK 4-, LOT g I GARNESS ENGINEERING GROUP, Ltd CIVIL & ENVIRONMENTAL ENGINEERS PREPARED FOR: I PHONE NUMBER: PAGe NUMBER: PAUL GARNET I (g07)955-9222 2 Of 4 LEGAL DESCRIPTION: DRAWN BY: MOUNTAIN VALLEY ESTATES; BLOCK 4, LOt 1 D.J.G. TYPE Of WORK: SEPTIC SYSTEM DESIGN UPGRADE DATE: SCALE: 1"=20' TOP OF T.H.~2 PiPE (INCLUDING STICK-UP) = 100.00 BLOCK 5, LOT 3) = 125.7 EXISTING GRADE AT PROPOSED TRENCH LOCATION = 95.81 PROPOSED BOTTOM OF BED = 95.81 BIRDSONG DRIVE 40% (ORIGINAL ORADE) O.W. ELEVATION IN T.H.#I ON 5/5/2016= BOttOM OF T.H,~I EL~AT~ON = B2.3~' fTOP OF PIPE = 102.39 -PROPOSED DRAINFIELD PROPOSED TOP OF MOUND MTC~ /~0-15~ SLOPES (EXISTING GRADE) ~ ~. /---$3~ LINE AT 2 PEET ABOVE THE TOP OF ROCK ~-~.""~ ~ J THAT CONVERTS TO 25~ ONCE OUTSIDE THE MOUNDED ~ ~ PORTION AND IN NATIVE MATER[~L ~- BOTTOM O~ 40-55~ SLOPES .... DE) 38.5 FEET ~ HIGHLAND ROAD GROUNDWATER IN T.H.f~2 WAS AT 89.83 ON 5/5/2016 / J I'(:;ARNESS Ltd PAUL GARNETT I (907)953-9222 LEGAL DESCRIPTION: MOUNTAIN VALLEY ESTATES; BLOCK 4, LOT 1 ~PE OF WORK: ?. 17/1/2016 PROFILE DRAWING OF SLOPES WITH ELEVATIONS GARNESS ENGINEERING GROUP, CIVIL & ENVIRONMENTAL ENGINEERS LEGAL DESCRIPTION: MOUNTAIN VALLEY ESTATES; BLOCK 4, LOT 1 PERFORMED FOR' PAUL GARNET DATE' 9/25/2015 ORG/PEAT ITEST HOLE #1 I EXISTING GRADE; APPROXIMATELY4 FEETREMOVED. GH SOIL CLASSIFICATIONS ORG HL CL OL HH CH OH SC DEPTH TO DATE GROUNDWATER DRY 9/15/2015 *9.2 5/512016 ~5,2 FEET BELOW EXISTING GRADE SITE PLAN SCALE: 1"=100' DATE READING CLOCK NET TIME WATER LEVEL NET DROP TIHE (HINUTES) READING (INCHES) 5/5/2016 1 2:36 6" 2 3:06 30 3.25" 2.75" 3 3:06 6" 4 3:36 30 3.25" 2.75" 5 3:36 6" 6 4:06 30 3.25" 2.75" PERCOLATION RATE ~o.9 (rHIN,/INCH) PERC. HOLE DIA, (INCHES) TEST RUN BETWEEN 3 FT. AND 4 FT. A FOUR HOUR PRESOAK WAS PERFORI"IED: · YES [] NO SOILS LOGGED BY: ROB CAMPBELL PERCOLATION TEST PERFORHED BY: ERIKWIDGER C01~IENTS: PERCOLATION READINGS ARE WITHIN 1/16 OF INCH. PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PEI~FOF~MED IN ACCORDANCE GUIDELINES IN EFFECT ON THIS DATE: WITH ALL STATE AND MUNICIPAL GARNESS ENGINEERING GROUP, Ltd LEGAL DESCRIPTION: MOUNTAIN VALLEY ESTATES; BLOCK 4, LOT 1 PERFORMED FOR' PAUL GARNET DATE' 9/25/2015 ORG/PEAT GRADE; APPROXIMATELY 4 FEET REMOVED FROM ORIGINAL GRADE GM ITEST HOLE #21 DEPTH T0 DATE GROUNDWATER i DRY 9/15/2015 '9.2 5/5/2015 ~52 FEET BELOW EXISTING GRADE SOIL CLASSIFICATIONS SITE PLAN ORG ML CL OZ MH OH ,¢,0 sc SCALE: DATE READING CLOCK NET TIME WATER LEVEL NET DROP TINE (MINUTES) READING (INCHES) 5/5/2016 1 2:35 6" J 2 3:05 30 6" 0" LIQUID LEVEL DID NOT DROP DURING 30 MINUTE READING DUE TO RUNOFF INTO THE PERK BENCH SOILS LOGGED BY: ROB CAMPBELL COHMENTS: PERCOLATION READINGS ARE WITHIN 1/16 OF INCH. PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: PERCOLATION RATE UNKNOWN(MIN./INCH) PERC. HOLE DIA. TEST RUN BETWEEN 3 FT. AND 4 FT. A FOUR HOUR PRESOAK WAS PERFORMED: · YES [] NO PERCOLATION TEST PERFORMED BY:. ERIKWlDGER 6 (INCHES) STANDARD TANK CONFIGURATION 1500 DIAMETER TOTAL LENGTH SHELL COMPARTMENT A COMPARTMENT B ON/OFF FLOAT iNLET INVERT HIGH WATER ALARM OVERRIDE FLOAT 55,, 145" 12 GA. 97" 48" 51" 34"(46") 32"(44") 24"(36") NOTE: FLOAT LEVELS ARE FROM BOTTOM Of PUMP. (#) IS FROM BOTFOM OF TANK COMPONENTS SUPPLY NOTE= t. THE TANK~ FLANGE GASKET, AND BOLTS/NUTS/WASHERS FOE FLANGE ARE SUPPLIED BY GARNEES ENGINEERING. 2. THE INSULATED RIGERtLID, BOLT ON FLANGE, PUMP, FLOATS, INTERNAL PIPING~ GROMMETS, CONTROL PANEL, AND AEROCELL UNIT ARE SUPPLIED BY GARNESS ENGINEERINGr THE ALASKA STATEWIGE DISTRIBUTOR FOR QUANICS INC. 3. ALL OTHER EXTERNAL COMPONENTS SUCH AS PIPING, FITTINGS, WIRING, INSULATION, ETC.~ SHALL BE SUPPLIED BY THE CONTRACTOR. TANK NOTES: · GEG RECOMMENDS ALL PIPE PENTRATIONS/JOINTS AND RISER CONNECTION ASSOCIATED WITH A TANK THAT WILL BE SUBMERGED IN GROUNDWATER BE ENCASED IN BENTONITE CHIPS. ,, IF GROUNDWATER IS ENCOUNTERED, THE CONTRACTOR SHALL INSURE THAT SOIL COVER AND/OR BALLASTING IS PROVIDED AS NECESSARY TO OVERCOME BUOYANCY FORCES. THE CONTRACTOR SHALL CONTACT THE ENGINEER REGARDING THE BALLASTING REQUIREMENTS. QUANiCS CUSTOM CONTROL PANEL WITH SENSAPHONE AND ACTUATOR CONTROLS QUANICS AEROCELL CAT. II QUANICS AEROCELL SYSTEM CATEGORY II CONFIGURATION (3 TO 4 BEDROOM SYSTEMS) JLE WITH INTERNAL DIVIDER WALL AND CLEANOUT8 ELECTRICAL WIRE/S (SUPPLIED BY CONTRACTOR). SEE INSTALLATION -4"CLEANOUT SIM/TECH INSULATION CENTERED OVER PIPES BY 4' WIDE RIGID INSULATION CENTERED OVER PIPE - 4" VISUAL PORT 24" RISER. TOP 4 FEET INSULATED WITH 2 INCHES URETHANE WITH PVC CONDUIT FOR ELECTRICAL CONNECTIONS (FLOATS & PUMF 2" OF INSULATION OVER TANK IS RECOMMENDED ON ALL INSTALLATION REGARDLESS LINE BUSHING 2" DISCHARGE LINE ~ TO DRAI~NFIELD .- 1,25" SUPPLY LINE 2" RECIRCULATION LINE 1500 GALLON S.T.E.P. TANK SUPPLIED BY GREER TANK 10 GAUGE. RATED FOR 10' BURIAL BAFFLE (SEALED) - WELDED AROUND ENTIRE PERIMETER FLOAT LOW LEVEL CUTOFF FLOAT (ON/OFF) GOULDS PE51M FROM ALASKA PUMP OR EQUIVALENT (SUPPLIED BY GARNESS ENG.) PLATFORM NOTE: ALL PIPING FROM S.T.E,P TANK TO AEROCELL MOOULE SHALL BE PLACED ON SUITABLE BEDDING MATERIAL THAT IS MECHANICALLY COMPACTED. ALL LINES SHALL BE GRADED SO THAT THEY WILL DRAIN AFTER EACH PUMP CYCLE AND WILL NOT RETA N ANY STANDING WATER. NOTE: ALL PRESSURIZED PIPES ARE TO BE SCHEDULE 40 PVC UNLESS NOTED OTHERWISE, J Ld Z ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT BETWEEN MUNICIPALITY OF ANCHORAGE THIS MAINTENANCE AND REPAIR AGREEMENT made and entered into as of this Dayof /X~o,~ of20lko by and between .~(~u,.,I (..?o.f~e ,~ herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this Maintenance and Repair Agreement agree as follows: 1. Advanced Wastewater Treatment Systems. Mm~icipality grunts permission to Owner to utilize a~d operate an Advanced Wastewater Treatment System (AWWTS), described as located at (legal description). Definitions, Alteration. Any change to the design or function of an AWWTS that includes the installation or removal of any parts, components or pieces not included in the original construction permit and design. Certificate of On-Site Systems Approval (COSA). An approval by the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with Anchorage Municipal Code (hereinafter, "AMC") 15.65. These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. Maintenance and Repair. The scheduled and as needed replacement of existing pans, components and pieces of an AWWTS that were included in the original design which would allow the AWWTS to continue to perform as designed. Permit. An On-Site Wastewater Disposal Permit as required by AMC 15.65 to construct and operate an AWWTS. 3. Term. The term of this Maintenance and Repair Agreement shall begin on the date of approval by the Municipality to operate lhe installed system or issuance of a COS& and shall continue while the AWWTS is in use or is operational or until the property is sold or title is transferred by the owner and a new COSA is issued to the new owner or transferee of the property. 4. Alterations~ Installation and Removal of Additional Equipment. Prior to performing any alterations to an AWWTS, the owner agrees to obtain an On-site Wastewater Disposal Permit from the Municipality in accordance with AMC 15.65. 5. Maintenance and Repairs. A. Throughout the term of this Maintenance and Repair Agreement, the Owner shall maintain their AWWTS in a satisfactory condition capable of producing treated septic effluent in accordance with the equipment's approval for operation in the Municipality. The owner shall enter into a service agreement with an AWWTS service and maintenance provider approved by the municipality and the manufacturer of the AWWTS for the entire term of the AWWTS. In addition, it shall be the responsibility' of the Owner during the term of this Maintenance and Repair Agreement, and any renewals thereof, at the owner's sole expense, to pay for any and ali: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs. B. Owner agrees to comply with all applicable ordinance, laws, regulations, rules and orders for the AWWTS. C. Upon request by the Municipality', the owner agrees to provide the Municipality a w~ritten schedule of rontine maintenance and repairs which have been performed on the system. When a record of maintenance is documented and maintained by the system vendor, the o~vner agrees to allow the Municipality access to this information. D. Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be assessed in accordance with AMC 14.60 for improper discharge. E. Owner agrees that only maintenance and repair personnel approved by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the system. F. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. G. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On-Site Systems Approval. H. 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. 6. Nonwaiver. The failure of either party at any time to enforce a provision of this Maintenance and Repair Agreement shall in no way constitute a waiver of the provisions~ nor in any way affect the validity of the Maintenance and Repair Agreement or any part hereof, or the right of such party thereafter to enforce each and every provision hereof. 7. Amendment. A. This Maintenance and Repair Agreement shall only be a~mended, modified or changed by a writing, executed by authorized representatives of the parties~ with the same formality that this Maintenance and Repair Agreement was executed with~ and such writing shall be attached to this Maintenance and Repair Agreement as an m~endment. B. For the purposes of any amendment modification or change to the terms and conditions of this agreement, the only authorized representatives of the parties are~ a. Owner: ~C&~,.~ ~O~F~ ~_ ~ b. Municipality: Director, Community Development or designated authority C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. 8. Jurisdiction: Choice of Law. Any civil action arising from this Maintenance and Repair 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 m~der this Maintenance and Repair Agreement. 9. Severability. Any provisions of this Maintenance and Repair Agreement decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Maintenance and Repair Agreement. OWNER: / ~ '7~,O~-- ~ ~F--~:~' ~rintname) STATE OF ALASKA SS. THIRD JUDICIAL DISTRICT The foregoing instrument was acknowledged before me this [ ~ ~'dkay of 20~_, by ~C~,,~I 6-c~r-,-~¢_-~ . NOTAR~f PUBLIC FOR ALASKA My Commission expires: (~i,x I_I,~ M. ,2_ o MUNICIPALITY: By: .(signature) Date: .(print name) Title: