Loading...
HomeMy WebLinkAboutTONY SCHAFF LT 1 M -W DRILLING, Inc. P.O. Box 110378 * 10330 Old Seward Highway (907) 3498535 ANCHORAGE, ALASKA 99511 DRILLING LOG Well Owner Jim Sizemore Use of Well Domestic Location (ad-akeLqs of: T,)wnship, Range, Section, if known; or distance main road Lot I Tony Schaff, Resubdiv of Lot 93, US Survey 3042 - - -1 A I Gir%i uOui—Itt-aska Size of casing ---EIL—Depth of Tiole 161 feet Cased to 161 feet 68 Static water level ft. tbelow) land surface. Finish of well (check one) open end X Screen Perforated Describe screen or perforation—L Well pumping test at 20 galld s, of drawdown from static Date of completion- August: 237, Depth in feet from ground surface WX TO TO for----2---hours with 1007, ft. Note- Well dry grouted with 1 sk Enviroplug chips WELL LOG of formations penetrated, size of material, color and hardness a Silty/sandy. ral, small, very silt;y, wet from 20' down % A inPI 0 rn Boulder Grey Silt; very compact, wet - .3 gpm, dirty Silty Clay Water Gravee medium, siightY sandyisilUT- N-WWA Certified Contnactor 2—STA E ILI TO 8 T 12 TO 12 25 TO 25 35 TO 85 95 TO 95 113 TO 11.3125 To 125 126 TO 126 l4o TO 148 157 TO TO for----2---hours with 1007, ft. Note- Well dry grouted with 1 sk Enviroplug chips WELL LOG of formations penetrated, size of material, color and hardness a Silty/sandy. ral, small, very silt;y, wet from 20' down % A inPI 0 rn Boulder Grey Silt; very compact, wet - .3 gpm, dirty Silty Clay Water Gravee medium, siightY sandyisilUT- N-WWA Certified Contnactor 2—STA E ILI PAGE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL SYSTEM PERMIT PERMIT NUMBER:SW930236 DESIGN ENGINEER:DUMMY COMPANY OWNER NAME:SIZEMORE JAMES F & CAROL OWNER ADDRESS:6410 SWITZERLAND DRIVE ANCHORAGE, ALASKA 99516 DATE ISSUED: 7/20/93 EXPIRATION DATE: PARCEL ID:07509315 LEGAL DESCRIPTION: TONY SCHAFF LT 1 1 OF 7/20/94 LOT SIZE: 13902 (SQ. FT.) NUMBER OF BEDROOMS: 1 THIS PERMIT: 1 THIS PERMIT IS FOR THE CONTRUCTION OF: WELL SYSTEM 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 DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4329 OR 343-4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS DATE: DATE: Lot 4 • ,� two N R��;'• ' 68 .191 %'.*�d 10., 98,� . � 9 1 �\ Unlit / � j ,. .� . , . `tip' V• �` \Ease .` ..Jeremy k'Ou'rst .6 �'.'.Nei hbor's LS -11796 Neighbor's fij�• ••y`��, Shed ro '! i' ":: ' ' .5� � DFESB�Nt{� ( ti �t_. o it it Lot A Fairfield Subd. Neighbor's Boats/Trailers/Vehicles Parked �gtla Sta, Sur -v ying \, 0 15 30 US SURVEY FEET obi S 6816 �2., 1 Story . i 9.- 77 -Ali �\�f NOTES / 00 .a� Lot 2 All dimensions shown are grid bearings and ground distances, record boundaries are per Plat No. 66-22. 49th Star has conducted a physical survey of the property and all details shown on this Asbuiit Survey are correct. Under no :ircumstances should any data hereon be used for construction or the establishment of property lines. It is the owners responsibility to determine the existence of any easements, covenants, or restrictions which do not appear on the •ecorded subdivision plat. Approximately 2 feet of snow was present at time of survey; 49th Star is not responsible for improvements present that were not risible. AS BUILT SURVEY LEGEND Star r Power Pole -'� �i l ! t V� i fl _. ,w .. Loft 1 ® well 321 Fireoved Drive ------------------- Tony Schaff Easement Line Anchorage, AK 99508° (907)891-6111 Subdivision, U _V- Jerem Overhead Utility Line Y@ 9thStarSurveying.con Girdwood, AK n Fence Line " W.O. 2005 DATE: 01/27/2{ SCALE: 1"-30 S I- rr O z w t - U 0 z SUBDIVISION: T Sc� BLOCK: LOT: �F p 1 U� Z D � � v � 64- r ' Z' P SIZE MAIN: /' TYPE MAIN:--J-)::C `P DEPT AT MAIN: AT PROP. LINE: 17 CONNECT LOCATION: 5 3 ' �u INSPECTED BY: DATE: MUNICIPALITY OF ANCHORAGE WASTEWATER 93 4098 ASSESSMENTS CONNECT PERMIT ` J ' Ef Improvement District DATE OF APPLICATION E-26-93 SCHEDULED COMPLETION 12-93 0 R -O -W NO. �t/DATE •CtSINGLE FAMILY WATER & WASTEWATER UTILITY 401 W. INTL AIRPORT RD. ❑ MULTI -DWELLING PHONE: 564-2762 No. APTS LOTtTRACT 1 O COMMERCIAL BLOCK SUBDIVISION TONY SCHAFF TAX CODE 075-093-15 GRID AS -BUILT No. STREET ADDRESS HOTTRNTOT I-aNE ROAD OWNER JAMES F & CAROL SIZEUORE PHONE MAIL ADDRESS 6410 M71TZER1AITD DR ANCIi0IL,AGE Ar 99516 CONTRACTOR: COIMAD ASSESSMENTS EPAIR EXISTING SERVICE 4N PROPERTY ONLY 0 MAIN TAP- TO PROPERTY LINE ONLY 0 Tobe levied upon.connection 0 Main extension agreement (MOA or Stale Row Permit required) ' Ef Improvement District 0 MAIN TAP & ON PROPERTY CONNECT (MOA Or State Row Permit required) 0 Extend connect agreement O Pending 0 R -O -W NO. 0 Paid 1 CONNECTION SIZE 411 CHARGE $ 'PERMIT ISSUED BY: CATHY INSPECTION PEE 104.00 pIpAID. D CASH PERMITFEE R`s.�i0 CKt/' IIS REIMBURSIBLE INSPECTED BY: , NUMBER DEPOSIT $ ) J TOTAL $ 139.90 DATE: REMARKS; PERMITTEE (Please Print)PHONE / l MAIL ADDRESS I HAVE READ THE CONDITIONS AND REGULATIONS ON THE REVERSE SIDE OF THIS PERMIT AND AGREE TO COMPLY WITH THEM. /r . PERMITTEE SIGNATURE POST IN A'CONSPICUOUS PLACE AT THE JOB SITE POS ,.mo, ON PROPERTY" Service Line Location By Sketch Ac s o £ c, Show Location of Control Manhole o' STR -E ALLEY fD MR (L o 2 i W L_o T No 10 � N �aSt�CnNTtAL o D � 0 � r 0 Comments `r1�G SBTa�trc LiN E. A el axt-*�., f3'DEE AtiD `-F-LoaAc,D Fv1 C S • Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 A F E T Y Certificate of On -Site Systems Approval Expiration Date: �2a L® Parcel I.D. 075-093-15 1. GENERAL INFORMATION: Complete legal description TONY SCHAFF; LOT 1 S Location (site address) 242 Hottentot Mine Road *Girdwood 99587 Current Property owner(s) Carol Sizemore Day phone 907-746-3454 Mailing address Real Estate Agent 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 1 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual ElIndividual Water Storage ElHolding Tank ElCommunity Class Well ❑ Community 1:1Public Water System ElPublic Sewer WaiverNariance request for: Distance: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee L16. &b Date of Payment a? / 01 2�z 96 Receipt Number (37-5496 COSA # 05/9 9610692 Date: Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATRMENT, OF.INS^PEGrT1W BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) 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(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm: Gayness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101- Anchorage, Alaska 99507 Engineer's Printed Name: Jeffrey A. Garness Date: In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. 6. D-SD,SIGNATURE System #1 Approved for -bedrooms System #2 Approved for bedrooms Disapproved X Conditional approval for I_ bedrooms, with NE TO BE MOVED IN 0 .. ......... : c A. Garntess r� •c< Pro fessio�11 � #AECC884 ON-SITE �vG, WATER AND m' VVAST' VI V E. R � i EoIlOA,Av(S_Vjetiiation f - is ATTACHED QUOTE AND ESCROW LETTER). W D rR'_ t ed tfV 1 � i L6—A 1-4e Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist Septic System Advisory Well Flow Advisory N i t rate�,lvi sn rye.,; `.1 Arsenic Agviso`ry Other ; C A Municipality of Anchorage On -Site Water and Wastewater Program (907) 343-7904 Certificate of On -Site Systems Approval Parcel I.D. 075-093-15 1. GENERAL INFORMATION: Complete legal description TONY SCHAFF; LOT 1 8 A P E T Y Expiration Date: Z© Location (site address) 242 Hottentot Mine Road *Girdwood 99587 Current Property owner(s) Carol Sizemore Day phone 907-746-3454 Mailing address Real Estate Agent 2. TYPE OF DWELLING: ® Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 1 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual El Individual Water Storage ❑ Holding Tank ❑ Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer WaiverNariance request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ M6.66 Waiver Fee $_ Date of Payment 0? Date of Payment Receipt Number] Receipt Number COSA # Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) 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(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm: Garness Engineerinq Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101- Anchorage, Alaska 99507 JJ 1 Engineer's Printed Name: Jeffrey A. Garness Date: In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the system/s on the date/s of the evaluation. Separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. #AECC884 6. DSD—SIGNATURE �������'(Y OFr,P System #1 Approved for bedrooms `,��`��,�Q 361 System #2 Approved for bedrooms ON-SITE��` WATER AND Disapproved WAST�_v''AT_ER Z; X Conditional approval for _� bedrooms, with 10—" ollo,W1>Y9;s Il,tio\r SEPERATION DISTANCE REQUIREMENT FROM THE WELL HEAD 0\1 LETTER). WELL HEAD AND WIRING TO BE BROUGHT TO MOA CODE REQUIREMENTS IN SPRING 2020 (SEE ATTACHED QUOTE AND ESCROW LETTER). It Original Certificate Date: _ �1 —2— The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate;-,Advi'»s Arsenic Agviso`ry •�. ,ray Other .�,�•:: �, fes`. '�. �'r. !, "', �', Legal Description: TONY SCHAFF; LOT 1 If more than 1 septic system on lot: COSA Checklist # 1 of 1 A. WELL DATA ❑ WeN.4dgis filed -with Onsite (or attached) Date drilled 8/23/93 Total depth 161 ft Cased to 161 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 1/31/20 Parcel ID: 075-093-15 Structure served by this system 1 Well production at time of test 7.9+ gpm Water storage tank volume NIA gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic 9.32 ug/L ❑ Arsenic less than MRL (ND) Collected by GEG AND AAROW PUMP & WELL SERVICES Date of Sample 1/31/20 & 2/4/20 Static water level at beginning of test 71.3 ft. Comments 'SEE ATTACHED QUOTE FOR WELL REPAIR WORK AND EMAIL COORESPONDANCE WITH MOA ONSITE EMPLOYEE TIM ECKLUND �AWWL1 SEWER B. TANK DATA Age of tank(s) years Tank type/material Measured operating fluid level in septic tank F-1 Standpipes/foundation per record drawing Date of D. ABSORPTION 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) ❑ NIA — pressurized field ❑ Monitor tubes go to bottom of effective. If not, st depth into effective ❑ Code -required soil cover over fie ❑ System presoaked (Required if vacant f eater than 30 days prior to date of test) Gall ntroduced gallons COSA Checklist yellow sheet C. LIFT STATION ❑ Required mainti station years Lift station material Comments: Adequacy test date Results ❑ Pass F bedrooms Fluid depth pri test in Wat ed gal ew depth in Elapsed time min Final fluid depth in Absorption rate gpd Any rejuvenation treatment (past 12 months) If yes, enter date E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' NSA Community Sewer Manhole/Cleanout > 100' ** F1Yes if No ft ❑ Yes if No ft Neighboring Tank > 100' ❑✓ Yes if No ft Private Sewer/Septic Line > 25' ❑ Yes if No ft Absorption Field on Lot > 100' ❑ Yes if No N/A ft Holding Tank > 100' ❑✓ Yes if No ft Neighboring Absorption Fields > 100' Animal Containment > 50' ❑✓ Yes if No ft ❑✓ Yes if No ft * Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' ❑✓ Yes if No ft ❑✓ Yes if No ft From Septic/Holding Tank Lot to: I AWWU SEWER on (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No ft Surface Water > 100' ❑ Yes i ft Property Line > 5' ❑ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' ❑ Yes if No ft Private Wells > 10 ' ❑ Yes if No ft Water Main > 10' ❑ Yes if No ft Commu , ells > 200' ❑ Yes if No ft Water Service Line > 10' ❑ Yes if No ft If is tank is under driveway comment below From Absorption Field on Lot to: (Please enter dist es if less than required) Building Foundation > 10' ❑ Yes ft If absorption field is under driveway comment below Property Line > 10' es if No ft Wells on Adjacent Lots: Water Main > 10' ❑ Yes if No ft Private Wells > 100' ❑ Yes if No Water Serv• ine > 10' ❑ Yes if No ft Community Wells > 200' ❑ Yes if No ce Water > 100' ❑ Yes if No ft F. ENGINEER'S COMMENTS *PER 1988 AWWU RECORD DRAWINGS **MANHOLE SOUTH OF WELL WAS NOT LOCATED - APROXIMATLEY 95 FEET PER 1988 AWWU RECORD DRAWINGS ***SEE ATTACHED QUOTE FROM CONTRACTOR TO MOVE SEWER LINE 25' FROM WELL HEAD oobooO'b G. ENGINEER'S CERTIFICATION o O� I certify that 1 have determined through field inspections and review of Municipal records that the above systems are in conformance with ' C'j . 4 g/T Q MOA COSA guidelines in effect on this date. �D D O.... .. . ...................� 0 eff A. o ess:• Q CE -795 `Q •mac O COSA Checklist yellow sheet �Qed Profess -W' o� #AECC884 ft Iii 'ARNESS ENGINEERING GROUP, Int ENGINEERING,, SALES n CONSULTING ..— ... March 3, 2020 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref: Conditional COSA Request for Tony Schaff; Lot 1 To whom it may concern: The subject property has several necessary repairs prior to COSA approval. Due to the frost/weather, we are requesting that your department issue a Conditional COSA with the following stipulations: ® The foundation cleanout is to be repaired and moved to meet MOA required separation distances from well head to sewer line of 25 feet • The existing sewer line is to be moved to meet the MOA required separation distance of 25 feet from sewer line to well head. ® The well head and well wires are to be brough to MOA onsite code standards The previously mentioned work is to be completed in spring of 2020, when frost no longer inhibits the completion of the proposed work. Attached with the COSA were quotes for the proposed work as well as the required escrow letter. If you have any questions, please contact us at 337-6179. Thank you for your assistance. Sincerely, Jeffrgy M Garb@ss, JP. 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 DocuSign Envelope ID: 607BBBCC-5144-477A-9078-80EB5F16799B Addendum or Amendment to the Purchase and Sale Agreement KA This form authorized for use ONLY by active Real Estate Licensee Subscribers of Alaska Multiple Listing Service, Inc. ALASKA MLS 1 Date 03/03/2020 2 In reference to the Purchase and Sale Agreement between: 3 Lynne Sere Langevin-Doran & Patrick Michael Doran Ak Revocable Trust the Buyer(s), and 4 Carol Sizemore the Seller(s), dated 5 02/06/2020 , covering the real property commonly known as: 6 Address: 242 Hottentot Mine Road Girdwood AK 99587 7 Legal (the Property): Tony Schaff L1 8 the undersigned Buyer(s) and Seller(s) hereby agree to the following (check only one): 9 ❑ Addendum — to be used when more space is needed on the Purchase and Sale Agreement 10 N Amendment — to be used only when changing an existing Purchase and Sale Agreement 11 1. In accordance with MOA requirement for Conditional COSA on the well, Buyer and Seller agree that the Seller 12 shall escrow 1.5 times the attached *Wilco Contractors estimate #834 dated 2/24/2020 in the amount of $7,880.00 13 for a total escrowed amount of $11,820.00 (eleven thousand eight hundred twenty dollars). Per estimate work to 14 be performed between 5/1/2020 and 9/1/2020. Escrow to be held at closing title company, First American Title. 15 2. Seller understands that the additional 1/2 times the bid amount, ($3830) is being held for the purpose of paying 16 for any unexpected overages that take place to accomplish the same scope of work. This amount may not be returned to the Seller in full at the end of escrow in the event there are additional unexpected expenses to 17 accomplish the exact same scope of work. Any funds remaining after the work is complete shall be retuned to the 18 Seller. 19 3. In the unlikely event that the work is not completed by 09/01/2020 the Buyer shall be solely responsible to the 20 Municipality of Anchorage for completion and sign off on the work completion, and could be responsible for any 21 penalties assessed by the Municipality of Anchorage in accordance with this unfinished work. 22 4. Buyer and Seller agree that the Sellers responsibilities with regards to the well and sewer shall terminate with 23 issuance of the Conditional COSA and transference of the deed into the Buyers name. With the exception of 24 providing written authorization of payment of contractors for work to be done after recording. The Seller is not responsible in any way for the private sewer line or well after closing/recording or any changes that may take place 25 prior to this work taking place or afterwards. 26 *attached and made apart of this agreement. 27 To the extent any provision of this Addendum/Amendment is inconsistent with the provisions of the Purchase and 28 Sale Agreement, the terms of this Addendum/Amendment shall control. 29 30 All other Terms and Conditions to remain the same. 31 This Addendum/Amendment shall expire unless the party making this Addendum/Amendment is notified of its 32 acceptance no later than 03/06/2020 (date) ❑ a.m. N p.m. (time). 33 Notification of acceptance of this Amendment/Addendum may be made only by one of the methods specified in the 34 paragraph titled 'Acceptance/Notice of Acceptance/Delivery' as contained in Purchase and Sale Agreement. 35 3/3/2020 36 Date: DocuSi nedb : Time: ❑ a.m. ❑ p.m. 37 ❑ Buyer 0 Seller 1:2: 3: 38 BrokeragejCLjdPr Cit 485..- Licensee(s) Sarb Daniel 39 The undersigned accepts the above Amen rR AMffliiftm 40 Upon execution by both parties, this agreement becomes an integral part of the referenced Purchase and Sale Agreement. 41 p 4:46 m 42 Date: 3/3/2020 DocuSignedby: Ti DocuSignedby: Ll a.m. LI p.m. 43 WBuyer ❑Sellert_�_ In-I�t t St Vt. ����br) DocuSigned by: 3: �y E:eFbangevin oran�bwl¢ E�bi>LJn ora 44 Brokerage C;laciar itv Raalty Inr, Licensee(sr Form 70718. Revised 03/13. © 2015 Alaska Multiple Listing Service, Inc. (AK MLS) All rights reserved. tiG ♦.V.;Re{' First Americav First American Title Insurance Company 3035 C Street Anchorage, AK 99503 (907)786-9523 Fax: (907)561-1948 To: First American Title Insurance Company ("Settlement File No.: 0201-3397965 (cmj) Agent") Christina Jones, Escrow Officer Date: March 03, 2020 Re: 242 Hottentot Mine Road, Girdwood, AK 99587 ("Property") "Buyer": Lynne Sere Langevin-Doran & Patrick Michael Doran Alaska Revocable Trust "Seller": Carol M. Sizemore (collectively and individually referred to herein as, "the Parties") AGREEMENT AND INSTRUCTIONS TO HOLD FUNDS IN ESCROW - MUTUAL RELEASE This Agreement and Instruction is to be used when the Parties agree to hold funds for repairs, rent, security deposits and other agreed upon items. It is not used to provide title insurance coverage for title matters, for lender required escrows, or for payment of federal tax withholding pursuant to FIRPTA. It constitutes authorized instructions to the Settlement Agent and may not contain terms for the Parties. The Parties agree and instruct Settlement Agent to hold funds in the amount of $11,820.00 (the "Escrowed Funds") pursuant to this agreement and the instructions contained herein. Mutual Instructions: Escrowed Funds are to be released pursuant to and upon receipt by the Settlement Agent of mutual written instructions from the Parties. Settlement Agent will continue to hold the Escrowed Funds until: 1. Written mutual instructions regarding the disbursement of the entirety of the Escrowed Funds are provided by the Parties to the Settlement Agent; OR 2. 9-1-2020 from receipt of the Escrowed Funds (such period being referred to herein as the "Dormancy Period"), after which date, provided Settlement Agent has not received written notice of a dispute over any of the Escrowed Funds held, Settlement Agent may issue one check in the amount of Escrowed Funds held, payable to seller, without further instructions from the Parties. (If this is left blank, Settlement Agent will proceed with the actions below). Settlement Agent may mail the check to the payee. Modification in Writing: Any modification of the Agreement and Instructions shall be given mutually by the Parties in writing. A modification regarding any matter other than the disbursement of Escrowed Funds will be of no force or effect unless agreed to and accepted by the Settlement Agent. Interpleader Action: Any time after the expiration of the Dormancy Period, in the event no mutual instruction to release funds is received by the Settlement Agent, Settlement Agent may, AT ITS SOLE DISCRETION, file an action in interpleader, or any other appropriate and necessary action, and deposit the Escrow Funds held with the clerk of the court. The Parties agree that all costs, fees and expenses including attorney's fees incurred by the Settlement Agent by filing an action may be deducted from the Escrow Funds held prior to or upon depositing any of the remaining Escrow Funds with the clerk of the court. Upon filing of an action in interpleader, or other appropriate and necessary action, the Settlement Agent will be deemed fully released and discharged from any obligations, duties or requirements imposed by these instructions. Page 1 of 2 First American Title Insurance Company File No.: 0.201-3397965 (cmj) Non -Interest -Bearing Account: Escrowed Funds will not be placed in an interest-bearing account. If Escrowed Funds, or any portion thereof, are to be held in an interest-bearing account, separate instructions that are accepted by Settlement Agent and a $n/a fee will be required for opening and maintaining the interest- bearing account. An interest-bearing account will not be opened for funds that will be held For less than thirty (30) days. State Escheatment Requirements: Settlement Agent will forward any remaining balance of the Escrowed Funds held to the applicable state agency or department requiring the disposition or handling of unclaimed property pursuant to the applicable state's unclaimed property act or administrative rules. Once any remaining balance of Escrowed Funds held has been escheated to the State, it may be necessary for the Parties to file a claim with the State in order to receive any of the Escrowed Funds deposited with the applicable state agency or unclaimed property department. YOU ARE REVIEWING, APPROVING AND SIGNING AN IMPORTANT DOCUMENT. LEGAL CONSEQUENCES FOLLOW FROM THE SELECTION AND USE OF THIS DOCUMENT. THESE. CONSEQUENCES AFFECT YOUR RIGHTS AND OBLIGATIONS. YOU MAY CONSULT AN ATTORNEY ABOUT THIS DOCUMENT. YOU SHOULD CONSULT AN ATTORNEY IF YOU HAVE QUESTIONS OR CONCERNS ABOUT THIS DOCUMENT. IT IS UNDERSTOOD BY THE PARTIES THAT THIS AGREEMENT CONSTITUTES THE WHOLE AGREEMENT BETWEEN SETTLEMENT AGENT AS AN ESCROW AGENT AND THE PARTIES. THESE INSTRUCTIONS PERTAIN TO THE DISBURSEMENT OF THE ESCROWED FUNDS AND MAY NOT INCLUDE ALL THE TERMS OF ANY OTHER AGREEMENT WHICH IS THE SUBJECT OF THE ESCROW. READ THIS AGREEMENT CAREFULLY AND DO NOT SIGN IT UNLESS IT IS ACCEPTABLE TO YOU. Indemnity, Hold Harmless and Limit of Liability: The Parties agree to indemnify and hold Settlement Agent harmless from any loss or damage arising from or pertaining to the Parties' conduct, requirements, action or inaction regarding the matters addressed herein or for any other loss or damage that is not caused by Settlement Agent. The Parties acknowledge and agree that Settlement Agent's sole responsibility arises under the instructions given to Settlement Agent. The Parties further expressly waive any special, incidental, punitive or consequential damages arising out of or in connection with these instructions to Settlement Agent and that Settlement Agent's liability is limited to and cannot exceed the amount of Escrowed Funds held. Dated: Dated: Carol M. Sizemore Lynne Sere Langevin-Doran & Patrick Michael Doran Alaska Revocable Trust Lynne Langevin-Doran, Trustee Patrick Doran, Trustee *funds being held for items contained in the addendum to the Purchase and sale Agreement dated 2/28/2020 For the purchase of 242 Hottentot Mine Rd Girdwood AK 99587. See attached addendum and bid from Wilco Contractors Page 2 of 2