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HomeMy WebLinkAboutROBERT JOHNS LT 5A-1
I~ ~ ' MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
,,_ PHONE I © NEW
MAILING ADDRESS
~ NO. O~EDROOMS
~(~ Z Manufactur~.~F~Fv~ ~ ~ MateriaV~
Liq. c~acity in 9allons Inside length Width Liquid de~th
'~Z DISTANCE/ TO: Well /~?/~ Dwelling PERMIT ~O.
O Z ~ Manufacturer Material Liquid capacity in gallons
Q Well Foundation Nearest lot line PERMIT NO,
.~. DISTANCE TO:
~ ~ ~ No. of lines Length of e Total length of lines Trench width Distance between lines
~nches
~ ~ Top of tile to finish grade Material beneath tile Total effective absorption area
Q inches
Length Width Depth PERMIT NO.
~<~ Typeofcrib ~ ?;~ ~& Cribdepth Total effective ab,orption area
~ ~ ~ ' Well Building foundation Nearest lot line
~ DISTANCE TO:
~ DISTANCE TO: Building fouddation Sewer line Septic tank ~ Absorption area(s}
OTHER ..... ' ~ ...." ' '
DATE LEGAL
F .~04 F7,1~ 171
LEGF'~L L 5R:t B 5 ~41.4 ROF4ERT :5.
I..L-II' SIZE
::LEi'~E~C~ SI]!I_IFtRIE F'E!;2T
t"IFI::.:;IP1Lli"I I'.,II..Jf,IE~EF.: ElF BEE:,F..:CIOP1S = 4
SO]:L. F.::F:ITII'.,IG ,.iS;! FT,-."E:IT::,= ~
]"t-IE REL::!UIF.:ED SIZE OF' THE SEa:EL. F.IBSOITPTIE~N L.?,'STEH I'.2:
THE LENCiTH [:,IP1ENSZON IS THE LENGTH (IN FEET::, ElF EFtCH :~;I[:E FL~ FI SEEPFIEiE PIT.
THE DEPTH OF R TRENCH OF.'. PIT IS THE DI%'TIRNC:E E:ETHEEN THE $UF.:FF.ICE OF THE
GROUND FIND THE BOTTOP1 OF THE EF:',CFI'v'F~TION (If-,I FEET).
]"HE GRF.I'v'EL. DEF'TH IS THE MINIMUH DEF'TH OF GITFI',,,'EL E:ETHEEN THE OUTFRLL PIPE:
RND Tt4E E:OTTOH OF' THE E',:.:',CRVRTION (IN FEET>.
PEF.:M I T FIF.'F'L I CFII'.,!T HI::IS THE RE;:,F Ijhl:, I E, I L. I ] T 'FO I NFOF.:H I'H f '.¥ [:,EPRRTHEt'.,IT DUR I NE.i THE'
I 1'.,I';'STFILLFI-I"I EIN I I'.,ISPEL-:T 1131'-,IS C F FIl",l"r' 1.4E:IJ..S FtE:,JRCENT 'T'O TH I'.5 F'ROPEF.:T"r' F.II",I[:, THE
NI...IPIE:EF.: OF F.:ESIE:,ENC:E'.E; "FHFIT THE [,]EL.[.. H I[..L. SEF.:'v'E.
DEF'FIF.:'THENT HILL. BE :,UB._IE..1 TO F'F.'~-EEEJTI3N.
MINIP1UM DIS"F'FtNCE BETHFEN R HELL RND RN"r' ON--'SITE SEHFIGE [:,ISF'OSFIL. S'¢SI"EM IS
FEET FOR R PRI'v'RTE HE[..i..~ OF.:
TO 2C~E~ FEET FROPi R PL.IBLIC HELL DEPENDING UF'ON THE T"r'PE OF PUE,'L..i'E: HEL.L
O'I"HER REQUIREP1EZNTS h'tF¢'r' RPPL.'T'. SPECIFICFtTIONS AN[:) CONSTRUC]"ION Di(f]GRRI'IS F.IF.'.E
FYv'RILF:tBLE TO INSURE PROPER tNSTRt...LFITtC~N.
I C:IERT I F"'¢ THRT
".L' I FIM FRPIlLIF~R HITH THE REQI_IIF..:EMEN'I"S FOR ON-.SITE SEHEF.:S FINE)I.,.IEL. LS FIS SET
E'ORTH EW THE IILI'~IL.~FHLI] T AF RNCHOF.'.F:tL3E.
3: I UN[:,ER:~[ai I[~, 'T'I~IRT~X(~HE ON-SITE :,EI.4ER STSTE:i"~ i"lFi~ RE6.!JIRE Ei'.4LRRGEHEI'.,Ff'
F~:ESI[)ENE:E /IS/ I i~f'tl~:,l~.L[~;,\ T~FJ II'.,ICLUDE HOF.'.E: THRN 4 BEDROOHS.
I F THE
GREATER ,_NCHORAGE AREA Bk .tOUGH
HEALTH DEPARTMENT
397 Eagle St. Anchorage, Alaska 99501 279-2511
Case N o.
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMII'
NAME OF APPLICANT ~h ~r~O ~ ~
RESIDENCE ADDRESS ~/~e 4 C0f~o¢¢/:1/')0
LEGAL DESCRIPTION
APPLICATION TO INSTALL: SEPTIC TANK
TO SERVE THE FOLLOWING FACILITY ~
FINANCED THROUGH ~) ~
MAILING ADDRESS ~0~/,.~ Z~
LOCATION OF INSTALLATION
SEEPAGE PIT , DRAIN FIELD , OTHER
PERCOLATION TEST RESULTS
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
TO BE INSTALLED BY '~)A/q
ANTICIPATED DATE OF COMPLETION
g-~l~ I; I?i~ .
THIS IS TO SERVE AS
DISTANCES:
g ¢o d .-~i'~
~4~, '5~ ¢.,A., ~ )~ , PERMIT TO INSTALL A .~/~ h ~ ¢~/4~
AS DESCRIBED BELOW. SIZE OF UNITTO DESERVED
SEPTIC TANKSIZE /~) TYPE ~/~/ SEEPAGE AREA ~5/5~W4 TYPE DIAGRAM OF SYSTEM
r
Authority
I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the
above described system is in accordance with said code.
.... ¢
SEW:-'~. DISPOSAL SYSTEM - APPLICATION'--~?ERMIT
Name of Applicant ~.%k ~'~O^' ¢ . Mailing Add~ss_~dv
Residence ~ddPess._ ~5~o ~' ~o ~o M~ ~ ~ Location of Installation
, ,
Application to Install: Septic t~k,,~,, ~, Seepage pit~, D~ain fleld~,
To Serve the F~llowlng~ Fa illty ,~ .Se .~o ~
Financed Throu~ c
Oe ~ f To be Installed by,.
Pemcolation Test Results ,.. ~ticipated Date of Co~letion
~_~ BELOW TO BE FILLED OUT BY HEALTH DEPART~NT
This is to semve as~ ~f. ~oA;~ , ,. pePmit to ~nstall a .......
as described below, Size of ~it to be se~ved~ ,.~ /f>.~ ~ ~r~
· ~Dtic tank slze/OdO~ Type~ Seepage ~ea Type
~i%EATEB A!,K;~!OF, A~E A?~EA
G.-c~z. ~c~oPage ~ea Borough
Omdln~ce No. 28-68 ~d that the ~ove descPibed system ~s in accomd~ce with' said code.
I~tUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
GENERAL INFORMATION
(a)
Application Date
Legal Description (include lot, block, .subd~ision, sec..J~n, ~wnsh[p, ~ange)
Location (address or directions)
1/ /
(b) Applicant Name .~/'~/// p~ C/' [,~" Telephone:Home Business~ 3 ~-~'~' ~' 7
Applicant Address p 0 ~O~L. (~ ~ ;~"~t~ ,~"/Y" ~' /~
(c) Applicant is (check one): Lending Institution []; Owner/builder/~.Buyer []; Other [] (explain);
(d) Lending Institution ~ c~ ,~J ,-,-,-,-,-,-,-,-,-,~' Telephone
Address
(e) Real Estate Company and Agent
Address
Te.lephone
~ ,
(f) ~Zrhe HAA to the following address: '
TYPE OF RESIDENCE
Single-Family [] Multi-Famil/~,~
Number o~ Bedrooms
Other
WATER SUPPLY
Individual Well [] Community [] Publi'c~
Note: If community well system, must have written Confirmation from the State Department of Environ mental Conservation
attesting to the legality and status.
SEW/~ DISPOSAL
Onsite/E_~ Public [] Community [] Holding Tank []
Note:~" -If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page 1 of 2 72-025 (11/84)
ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health
Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained
from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on
the date of this inspection.
Name of Firm ¢~ 2 ''~ ~.¢,i~[NF.~,I[~E~ Telephone
Date
DHEP APPROVAL
Approved for/z-~.¢, (~ bedrooms by ~.,~. ~L..~--,,--~ (~*~..,.~-~-./~-
Approved ~ ' Disapproved ~ Conditional
Date
Terms of Conditional Approval
CAUTION
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional
engineer registered in the State of ALaska, The DHEP does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or
analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the
professional engineer's work.
'~-'~ MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH &
MUNICIPALITY OF ANCHORAGE (MOA) ENVIRONMENTAL PROTECTION
264-4720 --
LealDscrition EIVED
WELL DATA
Well Classification
Well Log Present (Y/N)
If A, [3, C, D.E.C. Approved (Y/N)
Yield
Date Completed
Depth of Grouting
Pump Set At
Sanitary Seal on Casing (Y/N)
Depression Around Wellhead (Y/N)
; On Adjoining Lots
; On Adjoining Lots '"~'¢
To Nearest Public Sewer
To Nearest Sewer Service Line on Lot
; Date
Total Depth Cased to
Static Water Level
Casing Height Above Ground .
Electrical Wiring in Conduit (Y/N)
Separation Distances from Well:
To Septic/He~d;,,u T-ank on Lot 2., ~ ~
To Nearest Edge of Absorption Field on Lot ~ ¢;
To Nearest Public Sewer Line Cleanout/Manhole
Water Sample Collected by
Water Sample Test Results
Comments ,~"~"~ i~ /~
SEPTIC/HOLDING TANK DATA
Date Installed_J ¢~ ~r~ Size/~~0 ~ No. of Compartments
Standpipes~N) ~'__ Air-tight Cap,N) ~ Foundation Clea~~ ~
Depression over Tank (Y~ /~ate Last Pumped
Pumping/Maintenance Contract on File (Y/N) ~ ~ ; for
Holding Tank High-Water Alarm (Y/N) ~/~ Temporary Holding Tank Permit (Y/N)
Separation Distances' from Septic/H~Tank:
To Water-Supply Well
To Property Line
To Water.4~e~/Service Line
Course
To Building Foundation
To Disposal Field
To Stream, Pond, Lake, or Major Drainage
Comments
Page 1 of 2
C, ABSORPTION FIELD DATA
Soils Rating in Absorption,Strata
Datelnstalled (¢/ C 6~2
Width of Field / '~'
Square Feet of Absorption Area
Depression over Field (Y6)~
V
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well
To Building Foundation
Lot
Type of System Design
Length of Field
Depth of Field
Gravel Bed Thickness
Standpipes PresentON-)-
Date of Last Adequacy Test
To Property Line
To Existing or Abandoned System on
; On Adjoining Lots
To Water Malr~Service Line ~'~ '¢~
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments
To Cutbank (if present)
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Dimensions
Manhole/A~cess (Y/N)
~/v ; ~[.y/N)Z'fump/Off" Level at
"P~mping Cycles during Adequacy Test. Meets MOA
Comments
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified, or conformed to all MO~ and HAA g uid~elines in effect on the date of this inspection.
Company3L~ 'R'IV__.E~I~,,S,',,~ ~F¢7~' MOA No
Receipt No. ,"S ~ ~ d
Amount: $
Page 2 of 2
72-026 (11/84)
MUNICIPALITY OF ANCHORAGE MUNICIPALITY O;~ ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIONDEPL C)i- ;: ~.^,[.]'H &
825 L Street - Anchorage, Alaska 99501 ENVI,~ONMEN]'AL ~;O £ECTJON
t ENVIRONMENTAL ENGINEERING DIVISION JUl~/
Telephone 264-4720
DIRECTIONS: Complete all parts on page 1, Incomplete requests will not be processed, Please allow ten (10) days for processing.
1. PROPERTY OWNER PHONE
Alva & Mary Ellen Roberts
MAI LING ADDRESS
13535 S.W. Hart Rd., Beaverton, Oregon 97005
PROPERTY RESIDENT (If different from above) PHONE
2. BUYER PHONE
Judith Davis 265-8942
MAILING AD DR ESS
1241 Inlet Place, Anchorage, AK
3. LENDING INSTITUTION I PHONE
Fred Meyer Savings & LoanI 274-~6R3
MAI LING ADDRESS
1000 E. Northern Lights Blvd., AnchoraGe, AK
4. REALTOR/AGENT ] PHONE
Maureen L. Clayton] 694-9555
MAILING ADDRESS
P.O. Box 249, Ea~e River,. AK 99577
5. LEGAL DESCRIPTION
Lot 5 A-1 Blk 5 Robert johns Subdivision
STREET LOCATION
Echo Streett Eagle River
6. TYPE OF RESIDENCE
[] SINGLE FAMILY
MULTIPLE FAMILY
NUMBER OF BEDROOMS
[] One [] Four
[] Two [] Five
[] Three [] Six
[] Other
7. WATER SUPPLY
[] INDIVIDUAL*
[] COMMUNITY
PUBLIC UTI LITY
* ATTACH WELL LOG. A well log is required for all wells drilled
since June 1975. For wells drilled prior to that date, give well
depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM
[] INDIVIDUAL/ON-SITE**
[] PUBLIC UTILITY
**If individual/on-site, give installation date 78
If system is over two (2) years old an adequacy test is required
by this Department.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010(3/78)
THIS SIDE FOR OFFICIAL USE ONLY
DATE RECEIVED
INSPECTION APPOINTMENTS
FIVE TIME TIME
DATE DATE DATE
I N8PECTOR INSPECTOR INSPECTOR
DIRECTIONS:
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2, WATER SUPPLY
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTILITY
Connection Verified LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[] IN DI VI DUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY
Connection Verified INSTALLER
[]Septic Tank or []Holding Tank
Size: -?,S~ '~ -~ If Tank is homemade SOILS RATING
give dimensions:
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
4, DISTANCES Septic/Holding Tank · Absorption Area Sawer Line I Nearest Lot Line
I
WELL TO:
Absorption Area to nearest Lot Line
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED
LEGAL DESCRIPTION
72-010 (Rev. 3/78)
MUNICIPALITY OF ANCHORAGE
. i MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL P~OTECTION!
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
825 LStreet-Anchorage, Alaska99501 [ '10V 2 1978
ENVIRONMENTAL ENGINEERING DIVISION RECk
, Te,e.hone 26*4720 i V E D
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
1. PROPERTY OWNER -- J PHONE
Dr. Alva Roberts/Presently out of town, Contact: Bryan ElsnerJ 276-1333
MAILING ADDRESS ,
S.E. Corner of C_oronado and Echo Streets, Ea~le River, Ak. 99577
PROPERTY RESIDENT {If different from aboye} P~-E?128 hm.
Carolyn Briar 279-9403 wk.
2. BUYER -: PHONE
Richard A. Berg ,: ~-~
MAILING ADDRESS
P.O. Box 808~ Eagle River~ Alaska 99577
3. LENDING INSTITUTION J PHONE
Peoples Bank & Trust Co. - Ann Morgan, Mtg. Loan ProcessorJ 279~7511
MAILING ADDRESS
Pouch 7-007, Anc. hora~e~ Alaska 99577
4. REALTOR/AGENT J PHONE
Bryan Eisner/Century-21 Heritage Homes and InvestmentsJ 276-1333
' MAILING ADDRESS
207 E. Northern.Lights Blvd., Anchorage, Alaska 99503 ,
5. LEGAL DESCRIPTION
Lot 5 A-i, Robert Johns Subdivision
STREET LOCATION ~
S.E. Corner of Coronado and Exho Streets
6. TYPE OF RESIDENCE
[] SINGLE FAMILY
[] MULTIPLE FAMILY
NUMBER OF BEDROOMS
[] One [] Four
[] Two [] Five
[] Three [] Six
[] Other
7. WATER SUPPLY [] INDIVIDUAL*
[] COMMUNITY
[] PUBLIC UTILITY
*ATTACH WELL LOG. A well log is required for all wells drilled
since June 1975. For wells drilled prior to that date, give well
depth (attach log if available.}
8. SEWAGE DISPOSAL SYSTEM
[] INDIVIDUAL/ON-SITE**
[] PUBLIC UTILITY
**If individual/on-site, give installation date , ,.
if system is over two (2) years old an adequacy test is required
by this Department.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72~)10(3/78)
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DEPT. OF ENVIRONMENTAL CONSERVATION
ANCHORAGE/WESTERN DISTRICT OFFICE
437 "E" STREET, SUITE 303
ANCHORAGE, ALASKA 99501
BILL SHEFFIELD, GOVERNOR
274-2533
April 15, 1985
S&S Engineering
SRB 196X
Eagle River, Alaska
99577
SUBJECT: Lot 5Al; Block 5; John Robert Subdivision,
Eagle River, Alaska (8521-DA-144)
Dear Sir:
In review of the subject on-site septic system we have found the adequacy
of the system to be satisfactory. It is noted that in our review we found
the loading of the absorption field high, but in our final review we
decided the system could operate adequately as built.
Any future expansion of the subject project will require additional approval
from the ADEC. If you have any questions, please feel free to contact me
at our Anchorage/Western District Office.
Sincerely,
Michael P. Lewis
Environmental Engineer
MPL/msm
MUNICIPALITY OF ANCHORAG[~
DEPT. OF HEALTFI &
ENVIRONMENTAL PROTECTION
Al 2,3 1985
RECEIVED
David Slenkamp
Mechanical Engineer
694-9055
S&S ENGINEERING
SRB 196X
EAGLE RIVER, AK.
99577
Robert Shafer
Civil Engineer
694-2979
November 28, 1978
Dr. and Mrs. Alva Roberts
13535 Southwest Hart
Beaverton, Oregon 97005
Dear Dr. and Mrs. Roberts:
Your agent, Brian Elsner, Century 21, Heritage Homes, contacted this office to
perform a sewer adequacy test on your property located on Lot 5Al, Block 5,
John Roberts Division, Eagle River, Alaska.
The sewage systems adequacy test was conducted on 19 and 20 November 1978.
The septic tank was pumped and 750 gallons were removed. The septic tank
could not be verified to have a capacity in excess of this amount.
The water level in the seepage pit was recorded. The pit was then charged with
1,000 gallons of water. Percolation of a 24-hour period as recorded on 20 Nov-
ember 1978, resulted in the removal of approximately 810 gallons. It
can be, concluded that the percolation through this seepage pit will provide a
minimum of 202 gallons per bedroom over a 24-hour period.
On the basis of the above surveyanfid'.~est, it is determined that the seepage
pit is adequate; however, the septic tank capacity was inadequate for the
four bedroom residence. At the direction of Brian Elsner, an on-site sewer
upgrade permit #781050 was obtained from the Municipality of Anchorage
Department of Health and Environmental Protection. Mr. Paul Gibbs was con-
tracted to install an additional 500 gallon 'tank under this permit.
I inspected the installation of this tank and as a result of the completed
installation, I am happy to inform you. that th~upg~ade sewage system on the
referenced property is adequate.
~t Inclosures
Century 21, Heritage Homes
207 E. Northernlights Boulevard
Anchorage, Alaska 99503
.-
Peoples Bank and Trust Company
Real Estate Department
644 West 8th Avenue
Anchorage, Alaska 99510
Department of Health
Environmental Protection Agency
825 L Street
Anchorage, Alaska 99501
~ebrua~ 20. 1069
~r. Nash Reno
~ox 48
Eagle River, Alaska 99577
SUBJECT: Sewer and water approval for
VA lean, l. ot 5A Robert 3abas Sub.
Dear Mr. Rone~
The Greater Anchorage Area ~torouih Health Depa~ant has inspected both
sewer and water at the subject location. The water supply is provided
via Sunn~ Slopes water supply and is approved,
The present sewer syste~ is a cesspool ertly, Per VA purposes this
partmont requests that sufficient funds he placed in escrow for the
stallation of a 1,000 gallon septic tank on or before July 1, 1969.
This letter will serve as preltmiP-Al~/ approval for the installation of
the septic tank only. Fi~atlapproval ~ill bo based upon on-site inspec-
tion of this system prior to backfilling,
Sincerely,
DAVID R. L. ~UNCAN,
~edical Director
CC:
· % .
inst&I~on to conform to Borough Health code with Certified inspection
by that department.
IN WITNESS WHEREOF THE PARTIES HERETO HAVE SET THEIR ~NDS
and seals on the date above set forth. ~ /~?
Installer '~ ,(/¢"f~'h (' .... ¢-~ ~ ....
Owner
Dan C. Bell
"Nash Pone'
STATE OF ALASKA )
THIRD JUDICIAL DISTRICTiSS
This is to certify that on this .~__~=day of Feb. 1969,
before me, the undersigned, a Notary Public in the
and for the state of Alaska, personally appeared
Dan c. Bell and Nash Pone, to me known to be the
persons dlscribed in and who excuted the within and
foregoing instrument, and acknowledged to me volun-
tary act and deed for the uses and purposes therein
mentioned.
Witness my hand and Notarial Seal on the day
and year in this certificate .first above written.
Notary public? in 'and for State of Alaska
My commislon expires: ~. ~, :~.