HomeMy WebLinkAboutPreviously Received ReportsACHD �
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July 7, 2017
Matt Derr, P.E.
Breckon Landdesign
RE: Avebury Subdivision / SUBP17-0042
PLAN REVIEW ACCEPTANCE
Paul Woods, President
Rebecca W. Arnold, Vice President
Sara M. Baker, Commissioner
Jim D. Hansen, Commissioner
Kent Goldthorpe, Commissioner
The District has reviewed the plans for the above referenced project, and they are accepted for public
street construction once the following items are completed:
1. Sheet C9: you added keynote 21 to call out the inlet protection in the pond. Can you apply that
to the inlet protection location
2. Please note: Effective December 7, 2016 the ACHD plat approval process has been changed
and scheduling the plat on a Commission meeting agenda is no longer required. All standard
requirements prior to plat approval are still required and ACHD staff kindly requests that you
give us sufficient time to review and prepare the final plat for signature.
3. For plat signature; please reserve sufficient time in your schedule forACHD staff to review all
the items associated with the plat, to include (but not limited to) agreements, easements and
the final plat. All required items must be submitted and approved by ACHD prior to approval of
the final plat. A minimum of one week must be allowed for ACHD to review and comment on
some of the required items (i.e., but not limited to; Draft CC & R's and M & O Manuals). No
assurances can be made for delayed submittals.
4. Comply with all Standard Requirements of approval.
By stamping and signing the improvement plans, the Registered Engineer ensures the District that the
plans conform to all District policies and standards. Variances or waivers must be specifically and
previously approved by the District in writing. Acceptance of the improvement plans by the District
does not relieve the Registered Engineer of these responsibilities.
The fees and surety amount are shown on the attached checklist. Please provide original drawings to
be stamped and signed.
Required Pre -Construction Submittals:
Provide one -original set of civil plans for ACHD stamp and approval. If construction does
not commence and the project is delayed, the approval is subject to withdrawal under the
following conditions. A new review will need to be conducted that will be subject to an
additional plan review fee:
• Changes in federal regulations that would result in necessary changes to the plan; i.e. ADA
Requirements, water quality requirements, etc.
• Expiration of the preliminary plat.
Ada County Highway District • 3775 Adams Street • Garden City, ID • 83714 • PH 208 387-6100 • FX 345-7650 • www.achdidaho.org
2. Once approved by the District, provide two 11x17 scalable copies of the stamped plans
w/plat to ACHD Development Review prior to scheduling a Pre -Construction Conference. The
ACHD Inspection Division will not schedule a Pre -Construction Conference or issue a permit for
work in the right-of-way until this is complete.
48 hours prior to requestinq the Pre -Construction Conference:
• Pay Plan Review Fee.
• Submit signed Inspection Agreement.
• Pay Inspection Fee Deposit. Please note: The inspection deposit amount is an estimate for
the inspection time for the project. Under the terms of the Inspection Agreement; the
Developer will be responsible for any additional charges that may arise.
• Provide approved copy of plans.
• Provide the contractor and materials information on the attached form.
• Notice: ACHD is now accepting SWPPP/ESC submittals on CD or thumb drive.
The owner applicant must submit a Sediment and Erosion Control/Construction Site
Discharge Control Narrative and Map prepared by a Certified Plan Designer to ACHD
DevelopmentServices for approval prior to scheduling a Pre -Construction Conference.
Note: ACHD will no longer accept SWPPP/ESC plans for review prior to ACHD acceptance
of the civil plan. Please make sure the site plan submitted with the SWPPP/ESC Plans is an
exact replication of the approved drainage plan and include any ACHD stamped sheets
pertinent to the drainage design. Provide the ACHD Inspection Division one copy of the
Erosion & Sediment Control Plan for offsite utility work i.e. the typewritten narrative &
associated map for ACHD stamp and approval. Note: this must be separate from what has
been submitted for the subdivision work. Please go to the link below for submittal
requirements:
http://achdweb achdidaho.orq/Departments/Enqineerinq/Stormwater/constErosionControl.aspx
4. Contact ACHD Development Services at 387-6284 to request the Pre -Construction
Conference. The Pre -Construction Conference will not be scheduled until all the above
conditions are met.
5. Provide additional sets of ACHD approved/signed construction plans for each contractor at time
of Pre -Con.
Prior to signature of the final plat the District will require the following items to be completed.
1. All fees paid (plat, surety). Developer must provide a financial surety for the amount shown on
the attached surety calculation sheet. Acceptable forms of surety include cash, bank certificate
of deposit in ACHD's name, or irrevocable letter of credit.
Letters of credit must be issued by an FDIC insured financial institution with a local branch in
Ada County. The letter of credit shall be for a term not less than six months and shall allow
ACHD to present documents to draw on the letter of credit at the local branch. ACHD shall be
the sole beneficiary of the financial surety (Attached is a description identifying surety
requirements). Bonds shall meet the requirements as set forth in ACHD Policy Section 7103.
If providing a letter of credit or bond, please email a draft of the LOC or bond to ACHD
staff to review, prior to submitting the final document.
2. Provide signed Subdivision Improvement Agreement.
3. Provide an exact 8'/2" x 11" reduction of all sheets of the final plat mylar. Note, plat reduction
must be signed and stamped by the PLS.
4. Provide 8'/2" x 11" vicinity map.
5. Provide final plat mylar signed by the owner and notarized
6. Provide original signed License Agreement for the storm drain easement areas. Allow 3 weeks
for processing.
7. Provide original signed Master Storm Drain Confirmation Agreement
8. A copy of the amended CC & R's and the Maintenance and Operation Manual for any drainage
facilities to be located in a common lot to be owned and maintained by the homeowners
association. Allow 1 Week for review.
Maintenance and Operation Manuals shall be bound and include the following:
Note: Multi -phase developments under the same Homeowners Association must have one manual
that includes all previous phases of the development.
1. An 11" x 17" reduction of the stamped approved construction plans of the subdivision showing
the location of all storm drainage facilities.
2. An 8 1/2" x 11" copy of the final plat(s).
3. Engineering drawings of the facility. These drawings must show the details of each facility that
accepts ACHD drainage that the homeowners are responsible for maintaining. The plan sheets
must be folded and appended to the manual.
4. A written description of the maintenance required by the Homeowners Association.
5. An itemized list of the annual operating and maintenance tasks for the Homeowners
Association.
6. A statement describing the primary purpose of the facility is for storm water. Any additions to the
facility (such as park benches or additional landscaping) should be considered temporary and may
be removed when heavy maintenance of the facility is needed. Replacement of these items will be
the responsibility of the Homeowners Association.
CC & R's Requirements
1. The recorded restrictive covenants shall include a section describing the maintenance
responsibilities of the property owners within the development. The approved and recorded CC
& R's must be submitted electronically to ACHD prior to the release of any monies and
acceptance of the streets for maintenance.
2. The Maintenance and Operation Manual outlined above must be referenced.
3. The recorded restrictive covenants shall include wording that:
a. Gives the District the right to inspect such facilities, and if necessary, promptly perform
any required maintenance.
b. Requires District concurrence with any proposed changes in the previously approved
documents.
C. Allows the District to assess the costs of any required maintenance to the property within
the development, including the use of liens and/or assessment of maintenance costs
against real property within the development.
d. If there are roadside swales, CC&R's must describe the primary purpose of the swales
adjacent to the lots is for storm water. Swales shall be maintained by the Home Owners
Association and the individual homeowner. Swales are located within the District's Right -
of -Way.
• Include language to specify only one tree allowed per common lot line. Tree to be
planted on the back side of swales.
Required Post Construction Submittals:
Record Drawings
The following submittals are required after construction and prior to District acceptance of the public
street improvements within the subdivision OR prior to plat approval if a surety has not been provided:
1. (1) 11 x17 reduced copy, a CD with pdf, and the CAD files of the As -Built Construction Drawings w/
plat. Please see the ACHD website for details regarding the requirements for the CAD files:
http://achdweb.achdidaho.org/Documents/Forms/ZipFiles/CadToGIS.zip. Identify all changes and
provide corresponding note describing the change.
2. Note: The As -Built Drawings will not be considered "accepted" by ACHD until construction of the
subdivision is completed and approved.
Required Prior to ACHD Acceptance of the Streets for Maintenance:
Subdivision plat must be recorded; prior to ACHD accepting the streets for maintenance
The District cannot accept the street and drainage improvements for public maintenance or release the
developer's financial surety until these requirements have been met.
If you have any questions please feel free to contact me at 387-6354 or malexander@achdidaho.org.
Mike Alexander
Engineering Tech I
malexander(a)_achdidaho.org
cc: Guy Hendrickson
ACHD Surety Requirements
Minimum Surety Amount
• For plat signature, the minimum surety requirement is the amount calculated at plans
acceptance or any subsequent increase in project scope.
Developer may request an inspection for surety reduction if construction is partially complete
meeting the following minimum:
o All concrete work must be complete per plans and ACHD standards and signed off
by Inspector by requesting a "Concrete Final" inspection. Once concrete is deemed
complete, only the estimated value for the concrete will be reduced from the surety.
o OR All storm drain and paving is complete per plans and ACHD standards and
signed off by Inspector, storm drain is only included in the reduction if paving is
complete.
• To obtain plat signature with surety reduction punch list, Development Review may calculate
a reduced surety amount upon request.
• For plat signature with minimal punch list items (as determined by ACHD), the minimum
surety is $10,000.
• For plat signature with no punch list items (as determined by ACHD), but no record drawings
have been submitted, the minimum is $5,000.
• For subdivisions with roadside swales that are incomplete, the minimum will not be less than
two times the swale deposit, plus any other punch list items. For subdivisions with required
bridge work that is incomplete, the minimum will not be less than two times the cost estimate
for the bridge work, plus any other punch list items.
Surety Expiration
• For Letters of Credit, ACHD will attempt to send a written notice of expiration within 45 -days
of expiration. It is the developer and bank's responsibility to keep the surety current with
ACRD.
Letter of Credit extensions must be for minimum 90 -days.
• Construction final inspections must be scheduled 10 -days or more prior to demand date
of the Letter of Credit. If the work is not verified complete or final inspection scheduled
before 10 -days of the demand date, the Letter of Credit must be extended a minimum of 90 -
days or ACHD will file demand on the Letter of Credit.
Web links to standard Development Services forms
Bridge Design Checklist:
http://achdweb.achdidaho.org/Documents/Forms/mostDocs/BridgeReviewChecklist.pdf
Confirmation Agreement for Master Perpetual Storm Water Drainage Easement:
http://achdweb.achdidaho.org/Documents/Forms/mostDocs/StormwaterDrainageConfirmationAgreeme
nt2x
Master Storm Drain Easement Plat Note:
http://achdweb.achdidaho.org/Documents/Forms/mostDocs/StormDrainageEasementPlatNote.pdf
Current Fee Schedule:
http://achdweb.achdidaho.org/Documents/Forms/mostDocs/DevServicesFeeSched.pdf
Driveway Approach Request: (Required for new connections to the public roadway)
http://achdweb.achdidaho.orq/Documents/Forms/mostDocs/DrivewayApproachReguest.pdf
Fire Dept Approval Form:
http://achdweb.achdidaho.org/Documents/Forms/mostDocs/FireDeptApproval.pdf
License Agreement Application:
http://achdweb.achdidaho.org/Documents/Forms/mostDocs/LicenseAgreementGuidelines.pdf
Plan Checklist: http://achdweb.achdidaho.org/Documents/Forms/mostDocs/PlanChecklist.pdf
Civil Plan Completeness Checklist:
http://achdweb.achdidaho.org/Documents/Forms/mostDocs/CivilPlanCompletenessChecklist.pdf
Plat Checklist: http://achdweb.achdidaho.org/Documents/Forms/mostDocs/PlatSubmittal.pdf
Impact Fee Schedule:
http://achdweb.achdidaho.org/Documents/Engineering/ImpactFees/Ordinance231/ExhibitA FeeSchedu
le.pdf
Impact Fee Information:
http://achdweb.achdidaho.org/Departments/En inq eering/DevelopmentServices/impactFees.aspx
CENTRAL
�• DISTRICT
HEALTH
DEPARTMENT MAIN OFFICE • 707 N. ARMSTRONG PL. • BOISE, ID 83704-0825 • (208) 375-5211 • FAX 327.8500
"To lutprove 1Ge itealf i of ourconanuailles by identiryittg sustainable solutions to cottantuttity health issues,
developing partnerships for intpletnentalion ofstrategies, and deutonstralbtg our success iltrougli rtteusureatent of oulconres. "
18-0333
May 16, 2018
Christopher D. Rich
Ada County Recorder
200 West Front Street
Boise, ID 83702
RE: Avebury Subdivision
Dear Mr. Rich:....
Central District Health Department has reviewed and does approve the final plat for this
subdivision f6r central water and central sewer facilities. Final approval was given
May 16, 2018.
Sanitary restrictions as required by Idaho Code, Title 50, Chapter 13 have been satisfied based
on a review by, a Qualified Licensed Professional Engineer (QLPE) representing the City of
Meridian and the QLPE approval of the design plans and specifications and the conditions
imposed on the developer for continued satisfaction of the sanitary restrictions. Buyer is
cautioned that at the time of this approval, no drinking water extensions or sewer extensions
were constructed. Building construction can be allowed with appropriate building permits if
drinking water extensions or sewer extensions have since been constructed or if the developer
is simultaneously constructing those facilities. If the developer fails to construct facilities then
sanitary restrictions may be reimposed, it! accordance with Section 50-1326, Idaho Code, by
the issuance of a certificate of disapproval, and no construction of any building or shelter
requiring drinking water or sewer/septic facilities shall be allowed.
Serving Valley, Eltttore, Boise, artd Ada Counties
Ada / Boise Coltnty Office
Elmore County Office
Valley County Office
707 N. Armstrong Pi,. '
520 E. 81h St. North
703 N. Ist St,
Boise, ID 83704
Mountain Home, ID 83647
McCall, ID 83638
Enviro. Health: 327.7499
Enviro. Health: 587-9225
Ph. 634-7194
Reproductive Health: 327.7400
Family Health: 587-4407
FAX: 634-2174
Immunizations. 327-7450
WIC: 587-4409
Senior Nutrition: 327-7460
FAX: 5873521
WIC: 327.7488
FAX: 327.8500
Fire .Department .Approval
City of:
F1 Boise N Meridian ❑ Eagle ❑ Kuna ❑ Star ❑ N.W. Ada
Subdivision: Avebury Subdivision Date: 6/8!17
Commercial Project:
Engineer/Developer: Breckon Land Design
Local Fire Department officials -please check appropriate items for your approval
F16. I itials Check Approved Items
® Reduced Street Section (approved width 24' BTB )
(standard is 36' back of curb to back of curb) rolled curb
❑ Roundabout
❑
Permanent Turnaround
❑
Temporary Turnaround
_.�. ❑
Emergency Turnaround
❑
Emergency Access
Comments -
Ada County Highway District • 3775 Adams Street • Garden qty, 10 • 83714 • PH 208 387 6170 • FX 387 6393 • www,achd.ada.ld.us
Fire Department Approval
City of:
�] Boise N� Meridian [-] Eagle ❑ Kuna ❑ Star ❑ N.W. Ada
Subdivision: Avebury Subdivision Date: 2/14/18
Commercial Project: N/A
Engineer/Developer: Matthew Derr, P.E.
Local Fire Department officiats - please check appropriate items for your approval
Comments -
Check Approved Items f
J Reduced
Street Section (approved widthdard is 36' back of curb to back of curb)
❑ Roundabout
❑
Permanent Turnaround
❑
Temporary Turnaround
❑
Emergency Turnaround
❑
Emergency Access
Ada County Highway District • 3775 Adams Street • Garden City, ID • 83714 • PH 208 387 6170 • FX 387 6393 * www.achd.ada.id.us
EIDIAN..-1-.---
IDAHv /
May 08, 2017
Mr. Aaron Scheff
IDEQ Boise Regional Administrator
1445 N. Orchard Street
Boise, Idaho 83706
Re: Project Approval - Avebuiy Subdivision
Mayor Tammy de Weerd
City Council Members:
Keith Bird Joe Borton
Luke Cavener Genesis Milam
Ty Palmer Anne Little Roberts
Per the provisions in Idaho Code § 39-118(2)(d), the City of Meridian has retained the services of
Keller associates .as its Qualified Licensed Professional Engineer (QLPE), to verify that the plans and
specifications proposed for the above -referenced project comply with the IDEQ Facility and Design
Standards (IDAPA 58.01.16 and 58.01.08) and the applicable Meridian standards, and to approve the
project for construction. By virtue of their attached letter, they have reviewed and approved the
above referenced plans and specifications as complying with the Facility and Design Standards, and
Engineering Standards of Care as it relates to the reviewed elements.
The above referenced project complies with the City of 's current Wastewater Facility Plan, and
Sewer Master Plan, and our system has adequate capacity to accept sewage wastes for treatment.
These determinations have been made by use of computer models developed for our Sewer Master
Plan. This project is also within the City's urban service planning boundary. Our Domestic Water
distribution system can provide water service and the minimum required fire flow (1000 GPM) and
the minimum required residual pressure of 20 PSI. These determinations have been made by use of
computer models developed for our Water Master Plan.
The City of Meridian will own and operate the wastewater collection and domestic water distribution
systems within this project upon final inspection and acknowledgement by formal acceptance letter..
In essence, the City of Meridian "Will Serve" the project.
Attached for your records is a complete and accurate copy of the plans and specifications reviewed in
connection herewith, stamped "Approved for Construction."
Si cer y,
Warren Stewart, P.E.
Engineering Manager
Public Works Department . 33 E. Broadway Avenue, Suite 200 . , ID 83642
Phone 208-898-5500. Fax 208-898-9551 . www.meridiancity.org
KE L L E R 131 SW 511 Avenue, Suite A • Meridian, ID 83642
associate S 208.288.1992 phone • 208.288.1999 fax • www.kellerassociates.com
May 5, 2017
Development Services Division
City of Meridian
Attn: Amanda McNutt
33 E. Broadway Ave.
Meridian, ID 83642
Re: City of Meridian QLPE Review
-Avebury Subdivision
Keller Associates has reviewed the Avebury Subdivision construction plans dated May 3, 2017.
The plans are approved for construction as allowed under Idaho Code 39-118(2)(d). The
completed "Qualified Licensed Professional Engineer (QLPE) Review and Approval Checklist"
(QLPE Checklist) is attached. The QLPE Checklist was prepared to meet the transmittal letter
requirements specified in IDAPA 58.01.08.504.03(b) and 58.01.16.400.03(b). The plans were
marked as "Approved for Construction".
By stamping and signing the construction plans, the Registered Professional Engineer is
responsible to ensure that said construction plans conform to all City standards, ordinances, and
policies (arid State laws and statutes). Any variances or waivers to these standards, ordinances, or
policies must be specifically and previously approved in writing by the City. Acceptance of the
above referenced construction plans does not relieve the Registered Professional Engineer of
those responsibilities.
Please note that: the certifications required for Sections II(B) and (C) of the QLPE checklist must
be satisfied with a will serve letter and declining balance statement from the City.
Electronic files have been uploaded to the City of Meridian's FTP site in accordance with the
terms of the contract and we are returning one copy to the City for your records.
If you have any questions, please do not hesitate to call Keller Associates at (208) 288-1992.
Sincerely,
KELLER ASSOCIATES, INC.
yan V. Morgan, P.E.
QLPE Reviewer
214]11-172/17-174
Engineering Solutions, Satisfied Clients
Clarkston a Idaho Falls • Meridian 9 Pocatello 9 Rocic Springs • Roseville . Salem
State of Idaho
Department of Environmental Quality
1410 North Milton • Boise, Idaho 83706 - (208) 373-0502
QUALIFIED LICENSED PROFESSIONAL ENGINEER (QLPE)
REVIEW AND APPROVAL CHECKLIST
About this form
• This checklist is optional to use and is guidance from DEQ to qualified licensed professional
engineers (QLPE). This checklist describes the required elements of a QLPE project transmittal letter
and is intended to assist DEQ in the tracking of drinking water and wastewater projects, as well as
assist the QLPE in reviewing and approving certain types of Plans and Specifications.
• This checklist should be filled out by the qualified licensed professional engineer (QLPE) when the
QLPE is reviewing and approving a project for construction under Idaho Code § 39-118(2)(d). If the
project requires DEQ approval prior to construction, the QLPE shall direct the Design Engineer to
submit the plans and specifications through the normal DEQ review process.
• This checklist may be used in place of a transmittal letter from the QLPE.
• This and other design checklists are available at any DEQ regional office or online at
http:Hwww deq state id us/water/assist business/engineers/checklists.cfin.
• The other checklists include additional information about submitting a package of plans and
specifications for DEQ review.
1. GENERAL PROJECT INFORMATION
Project Name:
2 Approving Authority*
Avebury Subdivisioin
CITY OF MERIDIAN
3 Qualified Licensed Professional Engineer:
Name: Ryan V. Morgan; P.E., LEED AP
Employer: Keller Associates
4 This approval is for:
® Public drinking water system simple water main extension
® Public sewer system simple wastewater main extension
5 Design Engineer
Name: Matthew S. Derr
Employer: Breckon Land
Project Owner or Developer: (Please provide exact name of owner or authorized representative)
Name: Guy Hendricksen
Firm: Avebury Development, LLC
Address: 408 S Eagle Road #103
City: Eagle State: ID ZIP: 83616
Approving Authority refers to the City, County, Quasi -Municipal Corporation, or Regulated Public Utility that
is approving the plans and specifications per Idaho Code 39-118(2)(d).
QLPE Review and Approval Form Page 1 of 3
Revised November 2008
QLPE CHECKLIST
11. REQUIRED CERTIFICATIONS
Checklist Item
Yes
A) I am the QLPE representing the Approving Authority.
B) This project consists of simple wastewater main extension(s), simple water main
extension(s), or both. It complies with the current facility plan or preliminary
engineering report. The water or wastewater system has adequate capacity for the
project. (If required, please include declining balance spreadsheet to demonstrate
capacity)
C) The Approving Authority has committed to serve this project and has reserved
capacity for it. (Attach separate will serve letter or other documentation if needed.)
D) The Approving Authority will own and operate the project upon completion of
construction. (Attach separate letter or other documentation if needed.)
E) I have reviewed the plans and specifications and verified that they comply with the
facility and design standards (IDAPA 58.01.08 and IDAPA 58.01.16) and engineering
standards of care.
W. PLAN & SPECIFICATION APPROVAL
Checklist Item
Yes
A) As the QLPE for the Approving Authority, I have approved the plans and
specifications for construction. I am not the design engineer, nor was I otherwise
involved in the design.
B) The plans and specifications have been marked as "Approved for Construction", and
a copy of the approved plans were transmitted to DEQ with this checklist.
C) The plans are for simple wastewater main extension(s), simple water main
extension(s), or both. No mechanical systems such as drinking water sources, treatment
facilities, booster stations, storage facilities, or wastewater systems such as lift stations
or treatment works are included with this project.
D) This extension project will connect to:
1) Existing drinking water and/or wastewater mains owned by the Approving Authority.
OR
2) A future main(s) not existing at the time of approval. The future main(s) will be
❑
owned by the Approving Authority. In such cases, sanitary restrictions will remain in
force.
�* Portions of a project that require DEQ approval must be approved by DEQ prior to the QLPE
approval of the drinking water or wastewater extensions. Alternatively, the drinking water and/or
wastewater extensions may be submitted to DEQ for approval of the entire project.
QLPE Review and Approval Form Page 2 of 3
Revised November 2008
QLPE CHECKLIST
IV. SANITARY RESTRICTIONS
If the project includes drinking water and wastewater main extensions that will be reviewed and
approved separately, the two Approving Agencies must coordinate the review and approval as it
pertains to the lifting of sanitary restrictions.
Recommendation Yes
I have reviewed and approved all drinking water and wastewater improvements included
in this project, and I recommend that the district health department release sanitary
restrictions.
OR
I have reviewed and approved only the drinking water[] wastewater ❑ (check one) ❑
improvements included in this project, and I recommend that the district health
department release sanitary restrictions once they receive the approval from the other
Approving Authority.
OR
I recommend that the district health department leave sanitary restrictions in place. ❑
V. NOTE ON RULES AND STANDARDS
This checklist addresses the majority of common items from the Idaho Rules for
Public Drinldng Water Systems (IDAPA 58.01.08), the Wastewater Rules (IDAPA
58.01.16, for QLPE approval of projects. However, this checklist is not all-inclusive,
and users are expected to fully understand the rules and standards, apply them
where necessary, and request interpretations from DEQ if there are any questions.
DEQ regional offices may have additional written information that will assist in the
design/approval process.
Vl. QLPE CERTIFICATION
All responses indicated on the checklist above are accurately reflected in the attached Plans and
Specifications.
QLPE's, Signature, Date and Seal
QLPE Review and Approval Form Page 3 of 3
Revised November 2008
251 Seo CERTIFICATE OF ORGANIZATION
y 0 LIMITED LIABILITY COMPANY FILED EFFECT'VL
Title 30, Chapters 21 and 25, Idaho Code 2016 NOV 16 P,�
rte* 04
Filing fee: $100 typed, $120 not typed 2• 4 1
Complete and submit the application in duplicate. SECR I s, R �, Or STATE
1. The name of the limited liability company is: STATE OF ioaHa
AD800, LLC
(Remember to include the words "Limited Liability Company," "Limited Company," or the abbreviations L.L.C„ LLC, or LC)
2. The complete street and mailing addresses of the principal office is:
408 S Eagle Road, Suite 103, Eagle ID 83616
Street Address
(Mailing Address, if different)
3. The name of the registered agent and street address of the registered agent:
Guy Hendricksen 408 S Eagle Road, Suite 103, Eagle ID 83616
(Name) (Address cannot be a post office box or postal mail box)
4. The name and address of at least one governor of the limited liability company:
Guy Hendricksen 408 S Eagle Road, Suite 103, Eagle ID 83616
(Name) (Address)
ame)
(Address)
(Name) (Address)
me
(Address)
5. Mailing address for future correspondence (annual report notices):
408 S Eagle Road, Suite 103, Eagle ID 83616
(Address)
Signature of orgapjzer(s)..
Signature:
Printed Nam : y Hendricksen
Signature:
Printed Name:
Rev 17!2015
Secretary of State use only
IDAHO SECRETARY OF STATE
11/16/2016 05:00
CK -.3041 CT : 331277 BH : 1555G23
1G 100.00 = 100.00 ORG-W LLC 02
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