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Home My WebLink About03000290215001_Septic System Permits_Septic System Permits t Barcode 128 OTTER TAIL COUNTY LAND & RESOURCE MANAGEMENT PUBLIC WORKS DIVISION WWW.CO.OTTER-TAIL MN.USqrrfRTAji GOVERNMENT SERVICES CENTER 540 WEST FIR AVENUE FERGUS FALLS, MN 56537 218-998-8095 FAX: 218-998-8112 05/30/2014 Leon Kugler & S Sundblad 22984 County Highway 1 Fergus Falls MN 56537 8156 RE: Primary Owner: Leon Kugler & S Sundblad Sewage Treatment System Servicing Tax Parcel Number: 03000290215001 Described as:Sec 29 Twp Aurdal Township Sect-29 Twp-133 Range-042 1.49 AC PT NW1/4 SW1/4 BG 70’ S OF Lake: As of 05/29/2014 the sewage treatment system (Sewage Treatment Installation Permit # 22784 servicing your property was determined to be in compliance with the provisions of the Sanitation Code of Otter Tail County for a 3 bedroom home. If you have any questions regarding this matter, please contact our office. Sincerely, Denise Gubrud Inspector SCA^;,cu APPLICATION FOR PERMIT TO INSTALL SEWAGE TREATMENT SYSTEM LAND & RESOURCE MANAGEMENT, OTTER TAIL COUNTY (218-998-8095) GOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS FALLS, MN 56537 www.co.otter-tail.mn.usWHITE - Office YELLOW - L & R Inspector PINK - Owner/ Contractor (after issue) o2isyPermit No.APPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED TWP NAMETWP NO.RANGELAKE/RIVER CLASS SECTION Z9I )y\KE/RIVER NAMELAKE NUMBER / </:yI '/ E-911 ADDRESS OR DIRECTIONS FROM NEAREST PUBLIC ROADPARCEL NUMBER (S) OF PROPERTY BEING SERVICED -7V''1b V U''2. y Ir -VC-t. LEGAL DESCRIPTION I Daytime Phone No.Initial Mailing AddressFirstLast Name f 8'/ry , / /Property Owner C. '/r <^•'0'/ ’ c c- y ,»"■' ■ ?f Ar r\J L-' /. ^ rvrContractor Lie. # r L-^ ■'{ i f r /"///<' m Date Received Y f / Time Received vsitrS THIS SPACE FOR OFFICE USE ONLY A.M., the year of ^l:dd P.M.>■ This System will be ready for inspection on P.M. L & R Official SEWAGE TREATMENT SYSTEM DESIGN DATA AS SHOWN ON DRAWING NSTALLATION (circle one)TYPE OF Other Est. (E) New (F) Replacement CollectorResidential (A) New (B) Replacement (C) New (D) Replacement Soii Treatment Area LiftTank Effluent Distribution ( , ) Gravity ( ) Pressure Design Fiow (Gailons/Day) (G) 1 — 2,499 (H) 2,500 — 4,999 (I) 5,000— 10,000 GIs Ft.GIsSizeJ--F Setback To Nearest Well Ft. Ft.Ft.Type IIType I i." (27) Rapidly Permeable(20) Trench, Rock Ft.Ft.Ft.Setback To OHWL(28) Flood Plain(21)Tren.c,h,..Grayel)e5s ■ (22) Trench, Chamber (29) Privies Ft.Ft.Ft.Setback To Bluff(30) Holding Tank ( ) Monitoring/Disposal Contract (23) Bed (24) Mound Ft.Ft.Ft.Setback To Dwelling Type III(25) At Grade Setback To Non-Dwelling Ft.Ft.Ft.(31) Other/Problem Soils/<12" Soii(26) Grey water Type IV Setback To Nearest Lot Line r,. Ft.Ft,Ft.2“^(32) Public Domain & Proprietary Technologies Deoth of Well Setback To Road Right-Of-Way -r Ft.Ft.Ft.Type VTotal # Bedrooms (33) Performance Elevation Above Restrictive Layer .Ft.Ft.Ft.Garbage Disposal Y / (.1 /Abatement Y / N , PERCTEST DATA , C1c Highest RateDate of TestLicense #Designer__.. Agreement: The undersigned hereby makes application for permit to install, alter, repair or extend Sewage Treatment System herein specified, agreeing to do all such work in strict accor dance with Sanitation Code of Otter Tail County, Minnesota. Applicant agrees that the Site Data Worksheet submitted herewith and which is approved by a Land & Resource Management Official shall become a part of the permit. Applicant further agrees that no part of the system shall be covered until it has been inspected and approved for use. It shall be the responsibility of the applicant for the permit to notify Land & Resource Management that the installation is ready for inspection. Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express condition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Sanitation Code of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of the Sanitation Code. NOTE: I.This permit is vaiid for a period of six (6) months. 2.This permit does not include the building sewer (sewer line). 17b2 .2-Permit Fee $Date: Signature of Property Owner/Agent for Owner [y )S/t-S/v 1‘^-i‘y. 3s7. .7 ^ r-Rec. No..Date;t/. Land & Resource Management Official Comments: Form No. BK — 07-2011-06 345,197 • Victor Lundesn Co., Printers • Fergus Falls, Minnesota SEWAGE TREATMENT SYSTEM PERMIT INSPECTION RESULTS Inspector must make all measurements SOIL TREATMENT AREA HOLDING SEPTIC TANK OUTHOUSELIFT TANKCATEGORY /fC/yO FT2CapacityFT2GLS.GLS. FTFTFTFTSetback from Nearest Well Setback from Buried Water Suction Pipe FT FTFTFT Setback from Buried Pipe Distributing Water Under Pressure FT FTFTFT'2J> FTSetback from OHWL (lake &/or river)FT FTFT FTFT FTSetback from Bluff FT 3^20 FT FTFTSetback from Dwelling FT iji FTFTFTSetback from Non-Dwelling FT 79 V-FTFT FTSetback from Nearest Property Line FT r-/SOisa FT FTSetback from Right-of-Way FTFT FT FTElevation above Restrictive Layer FTFT Holding Tank/Lift Alarm YES Old System Pumped & Destroyed YES NO1^ k TRENCH REDUCTIONSOIL TREATMENT AREA CALCULATION MOUND / AT-GRADESEPTIC TANK(S) # Tanks Installed FILTER ROCK BED (4-? Cap >eMrenehes wittL IX inches □ YES □ NO p- Oof sidewall for.,% Ft. XFt.Ft.f(2reduction / equivalent to Soil Treatment Area.F^Ft* Inspectors Comments:/(JO jt,Uu-tvLLo u) Co I ...__Sketch: vox0" y 3 4 1-i i i\\It. iyeI,1!I A 1 i4 ja pf ADt.IU fain TQaI * Date f 77^Initial / L & R Official As of _C- I ^*1 the above described sewage system installation was found to be compliant with the provisions of the Sanitation Code of Otter Tail County. ) Land A Resource Management Official i^ggForm No. BK — 07-2011-06 345,197 • Victor Lundeen Co., Printers • Fergus Faiis, Minnesota APPLICATION FOR PERMIT TO INSTALL SEWAGE TREATMENT SYSTEM LAND & RESOURCE MANAGEMENT, OTTER TAIL COUNTY (218-998-8095) GOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS FALLS, MN 56537 www.co.otter-tail.mn.usWHITE - Office YELLOW -L&R Inspector PINK - Owner / Contractor (after issue) 021SYAPPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED Permit No. RANGE TWP NAMESECTIONTWP NO./RIVER NAME LAKE/RIVER _______LAKE NUMBER 133 A c E-911 ADDRESS OR DIRECTIONS FROM NEAREST PUBLIC ROADPARCEL NUMBER (S) OF PROPERTY BEING SERVICED ^03ocjc>2.9f LEGAL DESCRIPTION Daytime Phone No.First initiai Maiiing AddressLast Name 2,Z<f8^ Y^o.r,ry / ^rJ ^^r37 Property Owner A RYZa fr /e yc^(^4T:Contractor Lie.# z£>2>73(-7^0' THIS SPACE FOR OFFICE USE ONLY A.M. P.M., the year of at► This System will be ready for inspection on A.M. P.M. L&R OfficialTime ReceivedDate Received SEWAGE TREATMENT SYSTEM DESIGN DATA AS SHOWN ON DRAWING NSTALLATION (circle one)TYPE OF Other Est. (E) New (F) Replacement CollectorResidential New^/ (B) Replacement (C) New (D) Replacement Soil Treatment Area LiftTank Effiuent Distri^tion (^5^) Gravity ( ) Pressure Design Fiow (G^lons/Day) 1 — 2,499 l/ GIs7^ o A(H) 2,500 — 4,999 (I) 5,000 — 10,000 Size Setback To Nearest Well /1^0 FtFt.I 20 Ft^Type itType t iX (27) Rapidly Permeable(20) Trench, Rock Ft.Ft.Ft.Setback To OHWLjBT] Tr'?nr~h rtra\/pi|pgg ■ (28) Flood Plain Trench, Chamber 7 (29) Privies Ft.Ft.Ft.Setback To Bluff(30) Holding Tank ( ) Monitoring/Disposal Contract (23) Bed (24) Mound Sojy'Ft.Setback To Dwelling Type ill(25) At Grade Setback To Non-Dwelling Ft^Ft.(31) Other/Problem Soils/<12“ Soil(26) Greywater Type iV Setback To Nearest Lot Line 3^Ft.(32) Public Domain & Proprietary Technologies D *pth of Well / Setback To Road Right-Of-Way Ft.7r Type VTotal # Bedrooms (33) Performance Elevation Above Restrictive Layerw7"Ft. Ft.Garbage Disposal Y / JftAbatement Y / PERC TEST DATA Z83C AbScTT'Highest RateDate of TestLicense #Designer Agreement: The undersigned hereby makes application for permit to install, alter, repair or extend Sewage Treatment System herein specified, agreeing to do all such work in strict accor dance with Sanitation Code of Otter Tail County, Minnesota. Applicant agrees that the Site Data Worksheet submitted herewith and which is approved by a Land & Resource Management Official shall become a part of the permit. Applicant further agrees that no part of the system shall be covered until it has been inspected and approved for use. It shall be the responsibility of the applicant for the permit to notify Land & Resource Management that the installation is ready for inspection. Permit: Permission is hereby granted to the above named applicant to perform the work described in the above staterftent. This permit is granted upon express condition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Sanitation Code of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of the Sanitation Code. NOTE: I.Thls permit Is valid for a period of six (6) montlX. 2.This permit does not include the building sewer (sewer line). s'- 2/- // Date: S'■ Z 5^ Permit Fee $Date: Slgnaturfof Property Owner/Agent for Owner—^ Land & Resource Management Official N^Ss-?Rec. No.. Date StampComments: L&R InitialForm No. BK — 07-2011-06 345,197 • Victor Lundoon Co., Prtnters • Fargus Falls, MInnasota SITE DATA WORKSHEETV LAND & RESOURCE MANAGEMENT, COUNTY OF OTTER TAIL GOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS FALLS, MN 56537 218-998-8095 www.co.otter-tail.nnn.us Sewage Treatment System Permit #OWNER: LAST NAME FIRST MIDDLE TELEPHONE NUMBER ADDRESS: /V| *J STR./RT. LAKE/RIVER NO. LEGAL DESCRIPTION: CITY STATE ZIP CODE 2.<^ /? ? V2- LAKE NAME SEC.TWP RANGE TWP. NAME /./f SOIL BORING LOG ^oZc>ao 2.y<a o (sT'/no / COLOR & MUNSELL NO. DEPTH (INCHES)TEXTURE STRUCTURE PLATY PRISMATIC NONE Ri nfyr^ PLATY PRISMATIC NONE 7rZ/^vZ /2^JLrPARCEL NUMBER 3/ ^5E-911 Address or Directions From Nearest Public Road 3NUMBER OF BEDROOMS RLOngP PLATY PRISMATIC NONE GARBAGE DISPOSAL: YES WELL: CASING DEPTH SEWER LINE SEPARATION: \Z^\t. BLUFF: YES ■TERRESTm^ BLOCKY PLATY PRISMATIC FLOODPLAIN: YES *^t-> jSSn?VEGETATION: AQUATIC BLOCKY PLATY PRISMATIC NONE /SLOPE AT INSTALLATION SITE:%■> % TYPE OF OBSERVATION: Probe C^iJ> Boring PARENT MATERIAL: jju) ORIGINAL SOIL: - *■Outwash Loess Bedrock Alluvium zoi3NoDate of Soil Boring, COMPACTED SOIL: Yes 7 7o / 3DEPTH OF BORING (To 7' or restrictive layer);ft.Date of Perc Test PERC TEST #1 PERC TEST #2- TWO TESTS ARE REQUIRED - TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATE TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATEtoo WATER DEPTH 1-i.rSTARTST^/.yr»/<5 TIME DROP PERC TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATE TIME INTERVAL(MINUTES)WATER DROP PERC RATE17^iZ^..J 2— WATER DEpTh REFILL'REFILL I} -2 3 af.o ....^.<2.....TIME DROP PERCTIMEINTERVAL (MINUTES)WATER DROP PERC RATE TIMI INTERVAL (MINUTES)WATER DEPTH WATEfi DROP PERC RATE2^22- ____fO 7IT7 rIfill^ ..... REFia L.l<. HME DROP PERC I-LO-uTIMEDROPPERC TIME INTERVAL (MINUTES)WATER DE WATER DROP PERC RATE TIME INtEPVAL (MINUTES} ^ILL WATER DEPTH WATER DROP PERC RATE DEPW t-Z —*•-jjF.AI6z<srREFILL W-^-L *TTOE DROP IiO........t-f......TIME DROP PERC PERC INTERVAL (MINUTES)TIME WATER WATER DROP PERC RATE INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RA1REFILLREFILL ___^___ =TIME DROP PERC TIME DROP PERCTIMEINTERVAL(MINUTES)WATER DEPTH WATER DROP PERC RATE TIME INTERVAL (MINUTES)WATER DROTWATER DEPTH PERC RATEREFILLREFILL TIME DROP PERC TIME DROP PERCTIMEINTERVAL (MINUTES!WATER DEPTH WATER DROP PERC RATE TIME,INTERVAL (MINUTES!WATER DEPTH WATER DROP PERC RATEREFILLREFILL TIME WOP PERC TIME DROP PERC WATER DEPTH~^TIME INTERVAL (MINUTES!WATER DEPTH WATER DROP PERC RATE TIME INTERVAL (MINUTES!WATER DROP PERC RATEREFILLREFILL ---- =TIME DROP PERC TIME DROP PERC PROPOSED DESIGN: TRENCH f/^ BED.G^0£^|^j|ij^0^^ESSURE DIST.. ATGRADE MOUND.HOLDING TANK SEWER LINE.OUTHOUSE.OTHER.SPECIFY:. — SYSTEM DESIGN ON BACK — System design must be to scale and must include the proposed location of the sewage system, all existing/proposed buildings, property lines, the ordinary high water level of the water body, wetlands, bluff and all water wells within 150' of the sewage system. If there are any questions, see the University of Minnesota Site Evaluation worksheets. /jnch(es) equals /^ feetgrid(s) equalsScale;feet, or MPCA LICENSE *: LICENSE CATEGORY: DATE: /Wa/ ^ ^ y DESIGNED BY; A 8^0 rrFIRM NAME: ADDRESS: 2.r 7SZ> Cfi 2 ^ SIGNATURE: L !3'00 TXt)^ r; /X -ry * -f-i —r--i ■ i tt r' ■ ■"I... T "i-1 • I k I i 4.T 9 ..■i i. -!:OO IT rr !r=-)'T rL ri.r■ a3L-75''^ , .1 -:...../ f +■^7.P ■ ■■!■ • -j;I ; ■ tti'-'I00 T ■5C\.:...7D / ; c ;:A r ;■ rA. i i ,„ ,i„»- V !.....L. '.!;• '.1 r ' T ... .L ; iiTrTi 4 -'•-[t kUR — IWM — UZ3 e/(7T 315.904 • Victor Lundeen Co.. Printers •. Fergus Fails. MN ■ 1-800-346-4870