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Home My WebLink About08000990486000_Variances_10-12-1999855196 OFFICE OF COUNTY RECORDER OTTER TAIL MINNESOTA I hereby certify that _this instrument # 855196 was filed/recorded irUhis office _L__day of_1999 at JUS anj^pr^ Wendy L. Metcalf, County Reorder for record on the AtOJ Bqduty'I 0-W .recording fee- well certificate THE ABOVE SPACE IS RESERVED FOR THE COUNTY RECORDER APPLICATION FOR VARIANCE COUNTY OF OTTER TAIL COURTHOUSE, FERGUS FALLS, MN 56537 (218) 739-2271 COMPLETE THIS APPLICATION IN BLACK INK*** Application Fee I ba^siReceipt Number LAKE NAME i“00 ^ PROPERTY OWNER DAYTIME PHONE ADDRESS LAKE NUMBER LAKE CLASS (jy^iA-AO'CmSECTIONTOWNSHIPRANGETOWNSHIP NAME OMOO-PARCEL NUMBER .FIRE / LAKE I.D. NUMBER oK-~cyiy- LEGAL DESCRIPTION UCoUdi^ yVo'e$> TYPE OF VARIANCE REQUESTED (Please Check) Structure Setback Structure Size___Sewage System Subdivision___ Cluster Misc. SPECIFY VARIANCE REQUESTED (k e (X. Z^- 5-^0S'forc^e, ‘f -v\««cl fo cIyv| ^i^dt. ~lt) <xt(<7vvJ it) I UNDERSTAND THAT I HAVE APPLIED FOR A VARIANCE FROM THE REQUIREMENTS OF THE SHORELAND MANAGEMENT ORDINANCeSUBDMSION CONTROLS ORDINANCE OF OTTER TAIL COUNTY. I ALSO UNDERSTAND THAT OTHER PERMITS MAY BE REQUIRED, IT IS MY RESPONSIBILITY TO CONTACT LAND & RESOURCE MANAGEMENT REGARDING THIS MATTER. AL / SIGNATURE OF PROPERTY OWNER DATE APPLICANT MUST BE PRESENT AT THE HEARING(Applicant Will Receive Notification As To The Date/Time Of Hearing) NovembJA?^ ~5 j Page 10 hd7/^ 4^i SOO S'/ // 5oldcr S/^ 5-/3^^(4>dzLi S0^;ci(xi2^ 5/5 5^' 5d4 ^OldxA^ /o4> (0(\^(^^ L & R Official/Date 'Accepted By Land & Resource /9<>9VDate Of Hearing Time Motion James and Dolly Oettel - Approved Motion was made by Randall Mann, second by Cecil Femling and carried with Mark Steuart voting no, to approve the variance as requested noting that the structure is approximately 800’ from the lake, is separated from the lake by two roads, is in the third tier of development, is for storage purposes only, and there is no water or sewer connected to this structure. n/Otter tail County Board oj^justmentChain (M iC/KdiV ijuuut 77 Permit(sTrequired from Land & Resource Management Yes (Contact Land & Resource Management) No Copy of Application Mailed to Applicant And the MN DNR L R Official/Date bk 0198-001 291.306 • Viclof Lundeen Co.. Printers • Fergus Falls. Minnesota November 4, 1999 Page 4 Daniel Sillerud - Approved Daniel Sillerud, Fergus Falls, MN, requested a variance which would allow residential development of a back lot, substandard by current ordinance requirements and which was created after 1971 and before 1992. The property is described as Lot 18, Block 1, Oakview Heights, Otter Tail River in Aurdal Township. The audience was polled with no one speaking for or against the request. After consideration, motion was made by David Holmgren, second by Linda Bergerud and unanimously carried, to approve the variance as requested noting that the lot met the minimum standards when the lot was originally platted, that the lot has access to a public road and has adequate room for two on-site septic systems. B. John Barry - Denied B. John Barry, Newport, MN, requested a variance of 13’ from the 18’ maximum height of a non dwelling structure for the construction of an out building in the lakeshore impact area having a height of 31 ’. The property is described as part of Government Lot 1, part of the Southeast Quarter of the Northeast Quarter, Section 9 of Dunn Township by Pelican Lake. Dale Gustafson represented the applicant at the public hearing. A letter from Vern and Barbara Johnson in support of the applicant’s request was read for the record. A letter from Roger Stadum expressing concerns with the applicant’s request was read for the record. The audience was polled with no one speaking for or against the request. After consideration, motion was made by Mark Steuart, second by Randall Mann and carried, with Cecil Femling abstaining, to deny the variance as requested as no adequate hardship unique to the property had been shown that would allow for the granting of the variance as requested. James and Dolly Oettel - Approved James and Dolly Oettel, Verges, MN, requested a variance to allow a portion of our garage to have a second story for storage of stamps and antiques (collectibles). The property is described as Lots 3 and 4, Woodland Acres, Loon Lake in Candor Township. A letter from Robert A. Leinum noting the existence of registered covenants was read for the record. The audience was polled with no one speaking for or against the request. After consideration, motion was made by Randall Mann, second by Cecil Femling and carried with Mark Steuart voting no, to approve the variance as requested noting that the structure is approximately 800’ from the lake, is separated from the lake by two roads, is in the third tier of development, is for storage purposes only, and there is no water or sewer connected to this structure. CERTIFICATE OF APPROVAL SEWAGE SYSTEM DRAINFIELD 71 g f day of February ft 3?/9 Q7This certificate has been issued this to certify' that the sewage system installed as per sewage permit number indicated below has been approved for use by Otter Tad County, Minnesota. The premises covered by this certificate are legally described as:i:! Lake No. 56-523 Sec. 36 137 Range 41 Twp. Name CandorTwp. m tM 08-000-99-0485-000 & 08-000-99-0486-000 Woodland Acres Lots 3 & 4 lMs-.. .. -James OettelOwner: Name Box 126, Vergas, MNAddress 56587Zip No. Si 10989Permit No. SP Land & Resource Management Official Signed by: Otter Tail County, MinnesotaMKI,-()9R7(X)1 284,909 • Victor Lundeer> Co . Printers • Feigus falls, MN • 1-0OO-346-487O APPLICATION FOR PERMIT TO INSTALL SEWA GE TREATMENT SYSTEM j WHITE — Office Yellow — Inspector Pink — Owner LAND & RESOURCE MANAGEMENT OTTER TAIL COUNTY COURT HOUSE Phone:(218)739-2271 - FERGUS FALLS, MN 56537 LEGAL Permit No.1DESCRIPTION (j<^)NoAbatement: ( ) YesAND LOCATION LAKE NUMBER LAKE/RIVER NAME SECTIONL-AKE/RIVER CLASS RANGETWP. NO.TWP NAME 1^7kd-) PARCEL NUMBER(S)FIRE OR LAKE ASSOCIATION NUMBER '}y/ IDENTIFICATION: Please Print All Information Last Name First Initial Mailing Address — No. Street, City and State Telephone No.Zip Code /^ (/ /Mr____ __________ Qe-Utl Property Owner !ujL 'd n7 7USewage System Installer Name / ..M2, This System will be ready^for inspect^^n. This space for office use only . 19 7^ at P.M. ~0 O'^lAT' ------JNUMBER OF BEDROOMS: Dale Re?d\.„..——------- M GARBAGE DISPOSAL: ( ) YES ( X^) NOTime Rec’d Phone Call Rac'd By SEWAGE TREATMENT SYSTEM DATA: MINIMUM REQUIREMENTSTYPE OF SEWAGE SYSTEM ( ) Holding tank (Alarm Required) ( ) Septic tank ( ) Lift Station (Alarm required) (^ ) Drain field ( )Bed ( ) Mound ( ) Outhouse ( ) Sewer line TANK DRAIN FIELD ^ Ft.Capacity /tGIs. Distance from nearest well Ft. Ft. 7 7^" Ft.Distance from lake or stream Ft.Trenches Distance from building Ft. Ft. Distance from property line Ft. Distance from bottom to Water Table Ft.Ft. EFFLUENT DISTRIBUTION ()<^) Gravity ( ) Pressure All distances are shortest distance between nearest points PERCOLATION TEST DATA: WATER WELL DEPTH 1 -F /U OMl loo &T Perc Tester.Date of Perc Test, a /) 60) Rate of 1st Test 'h ■ZL Rate of 2nd Test 'J-Average Rate Agreement: The undersigned hereby makes application tor permit to install or extend Sewage Disposal System herein specified, agreeing to do all such work in strict accordance with Ordinances of the County of Otter Tail, Minnesota and Minnesota Individual Sewage Disposal Code Minimum Standards set forth by Minnesota Department of Health. Applicant agrees that plot plan sketches and specifications submitted herewith and which are approved by Shoreland Management Officical 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 accepted. It shall be the responsibilty of the applicant for the permit to notify the County Shoreland Management that the job is ready for inspection. /Atr /dcJn&DATE:Jr ,1 .1,/ lure 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 Ordinance of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of any said ordinances. NOTE: Permit void if work is not commenced within six (6) months. Osljlmi j - Q ■ ^/(r[6Issued Date: \Land & Mesource Management Office7A00 Fee $.Rec #. Comments: 277,212 ■ Victor Lurtdeen Co . Printers • Fergus Falls. MinneosiaBK 0796-003 % ■- INSPECTION RESULTS Inspector must make all measurements SEWAGE DISPOSAL SYSTEM STATISTICS DRAIN FIELDHOLDING SEPTIC TANK LIFT TANKCATEGORY MinimumActuai h^yO SF 3 7V SFGLS. GLS.Capacity ' ft 7 (o FT FTFTDistance from Nearest Well Distance from Buried Water Suction Pipe FT FT50FTFT Distance from Buried Pipe Distributing Water Under Pressure FTFTFT FT 10>0 5?7 5oo^ ft FTDistance from Lake or River (OHWL)FT jP FT ft 10/20 FTC-FTDistance from Nearest Building y V +fO FT FTFT10FTDistance from Nearest Property Line 3"FTFT FT 3FTDistance from Bottom to Water Table ^ Iv.vlf* A ClYESNOHolding Tank/Lift Alarm YES NOOld System Pumped & Destroyed DRAINFIELD CALCULATIONSewer Line to Well SeparationINTERPRETATION OF ABBREVIATIONS GLS. = Gallons SF = Square Feet FT = Linear Feet Actual Minimum 3/36 FTX FT FT20 SF Jo -3Inspector’s Comments: t^ 30 JSil 5/1. ly/u. - /r</A /2 2x3' C<^ueK S^'Oc SKETCH: roX. <V6 •W ==JPN »\) [k risersv'|0o' p\e^o'0 <1 C^^>Ur\\0c/' 2^ Inspector's Signature Date of Inspection Time of Inspection APPLICATION FOR PERMIT TO INSTALL SEWAGE TREATMENT SYSTEM WHITE — Office Yellow — Inspector Pink — Owner LAND & RESOURCE MANAGEMENT OTTER TAIL COUNTY COURT HOUSE Phone:(218)739-2271 - FERGUS FALLS, MN 56537 TzjmPermit No.LEGAL DESCRIPTION Abatement; ( ) Yes NoAND LOCATION LAKE NUMBER LAKE/RIVER NAME LAKE/RIVER SECTION TWP. NO.RANGE TWP NAMECLAKD- 3^137 PARCEL NUMBER(S)FIRE OR LAKE ASSOCIATION NUMBER IDENTIFICATION; Please Print All Information Mailing Address — No. Street, City and SlateFirstInitial Zip Code Telephone No.Last Name Property Owner 6Z, .^S7 AsAJpJuhCSewage System Installer Name A.M. This System will be ready for inspection on., 19.P.M.at This space for office use only NUMBER OF BEDROOMS: A.M. 19 P.M GARBAGE DISPOSAL: ( ) YES ( NODate Rec'd Time Rec’d Phone Call Rec’d By SEWAGE TREATMENT SYSTEM DATA: MINIMUM REQUIREMENTSTYPE OF SEWAGE SYSTEM ( ) Holding tank (Alarm Required) ( ) Septic tank ( ) Lift station (Alarm required) TANK DRAIN FIELD sSTiCapacityGIs.Sq Ft. Distance from nearest well Ft. Ft. Drain field (-^) Trenches ('^ ) Bed ) Mound ( ) Outhouse ) Sewer line 75 Ft.Distance from lake or stream Ft. /qmDistance from building ;;Ft. Ft. ( /ODistance from property line Ft,Ft. (Distance from bottom to Water Table Ft. Ft. EFFLUENT DISTRIBUTION (X) Gravity ( ) Pressure All distances are shortest distance between nearest points PERCOLATION TEST DATA: WATER WELL DEPTH Perc Tester.Date of Perc Test 3-o2Rate of 1st Test Rate of 2nd Test Average Rate Agreement: The undersigned hereby makes application for permit to install or extend Sewage Disposal System herein specified, agreeing to do all such work in strict accordance with Ordinances of the County of Otter Tail, Minnesota and Minnesota Individual Sewage Disposal Code Minimum Standards set forth by Minnesota Department of Health. Applicant agrees that plot plan sketches and specifications submitted herewith and which are approved by Shoreland Management Officical 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 accepted. It shall be the responsibilty of the applicant for the permit to notify the County Shoreland Management that the job is ready for inspection. DATE: 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 Ordinance of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of any said ordinances. NOTE: Permit void if work is not commenced within six (6) months. Issued Date: Land sAfesource Management OfficeooatFee $.Rec it. Comments: 277,212 • Victor Lundeen Co.. Pfiniets • Fergus Falls, MlnneosiaBK 0795-003 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 and all water wells within 150' of the sewage system. GRID PLOT PLAN feet SKETCHING FORMi___grid(s) equals /Q jnch(es) equalsScale:feet, or I ADDRESS: ______________ SIGNATURE:SUBMITTED BY: LDATE:FIRM NAME: MPCA LICENSE #: LICENSE CATEGORY: 261.183 • Vicior Luodeen Co.. Printers • Fergus falls. MN • 1-800-346-4870BK - 0496 - 029 SITE DATA * LAND AND RESOURCE MANAGEMENT Otter Tail County Fergus Falls, MN 56537 OWMER: c?// XS! 7iHia ^1. f e 3 TELEPHONE NUMBERFIRSTMIDDLELAST NAME ADDRESS: 'zip CODE 'STATE/CITYSTR./RT. 2^ V7,Z Y/LcSi-o n1 TWP NAMERANGESEC.LAKE NAME TWPLAKE/RIVER NO. LEGAL DESCRIPTION:SOIL BORING LOG Lo f COLOR & MUNSELL NO. DEPTH (INCHES)TEXTURE STRUCTURE BLOCKY PLATY PRISMATIC NONE I\piC 5-^: APARCEL NUMBER X.BLOCKY PLATY PRISMATIC NONE lOYFIRE NUMBER 3NUMBER OF BEDROOMS BLOCKY PLATY PRISMATIC NONE sLirjtoyGARBAGE DISPOSAL; YES ft.||. VWELL CASING DEPTH:BLOCKY PLATY PRISMATIC NONE FLOODPLAIN: YES VEGETATION: AQUATIC ^ERRESTRIAL BLOCKY PLATY PRISMATIC NONE %SLOPE AT INSTALLATION SITE: TYPE OF OBSERVATION: Probe COMMENTS: X T W t k (X (A«-.,jP a C,PARENT MATERIAL; Till Outwash Loess Bedrock Alluvium No P r> ORIGINAL SOIL: COMPACTED SOIL: Yes DEPTH OF BORING; ^ PERC TEST #2PERC TEST * 1 - TWO TESTS ARE REQUIRED - WATER DEPfi?WATER DEPTH WATER DROP PERC RATEINTERVAL (MINUTES)WATER DR»Pv TIMEPERC RATEINTERVAL tMlNUTES)TIME TIME DROP PERC * \ ^^ERC RATEw A)STARTSTART111 tn_^l2T.'iAy ^ME DROP PERCW0IC-V.'0...ao.... WA^H DEPTH PERC RATEWATER DROPINTERVAL IMINUTEStWATEB DROP TIMEWATER DEPTHTIMEINTERVAL (MINUTES! ^ I REFILL /O TIME * DROP PERC REFia 10^2^ ,2^p 9iJ>-.ti-.PERCTIMEDROP PERC RATEWATEB DROPtDEPTHINTERVAL fMINUTES)WATPERC RATE TIMEWATER DEPTH WATER DROPINTERVAL (MINUTES)TIME pr/G W REFILL 3'y DROP 'PERC REFILL \o3.K..3^iO--PERCTIMEDROPTIME WATER DROP PERC RATEINTERVAL (MINUTES)WATER DEPTHTIMEWATER DROP PERC RATEWATER DEPTHINTERVAL (MINUTES)TIME REFILLREFIU PERCTIMEDROPPERCTIMEDROP WATER DROP PERC RATEWATER DEPTHINTERVAL IMINUTESIPERC RATE TIMEWATER DEPTH WATER DROPINTERVAL IMINUTES)TIME REFILLREFIU DROP PERCTIMETIMEDROPPERC WATER DROP PERC RATEWATER DEPTHINTERVAL (MINUTES)TIMETIMEWATER DROP PERC RATEINTERVAL (MINUTES)WATER DEPTH REFIUREFIU PERCDROPTIMETIMEpercratE^DROP WATER DROP PERC RATEWATER DEPTHINTERVAL (MINUTES!WATER DROP-INTERVAL IMINUTES)WATER DEPTHTIME REFIUREFIU PERCTIMEDROPPERCTIMEDROP PERC RATEWATER DROPWATER DEPTHINTERVAL IMINUTES)PERC RATE TIMEWATER DEPTH WATER DROPTIMEINTERVAL (MINUTES!REFIUREFIU DROP PERCTIMEPERCTIMEDROP PROPOSED DESIGN: 1 X PRESSURE DIST..GRAVITY DIST..ATGRAOE.MOUND.HOLDING TANK.BED.TRENCH. OTHER.SPECIFY;______________ — SYSTEM DESIGN ON BACK — OUTHOUSE.SEWER LINE. SEWAGE SYSTEM HOLDING TANK 19 95DecemberThis certificate has been issued this day of to certify that the sewage system installed as per sewage permit number indicated below has been approved for use *5 by Otter Tail County, Minnesota. m The premises covered by this certificate are legally described as: CandorRange 41s..Twp. 1.37Sec. -3bLake No.Twp. Namem. I Lot 3 & 4 Woodland Acres 1^' Tames Dolly OettelmOwner: Name Roy 1 9f) Verges, MNAddressEm 56587Zip No. 10779Permit No. SP Signed by: Land & Resource Managcmcnl Official Oiler Tail Counly, MinnesotaMKL-0987001 f-%- JT-263191 Vidor Lundeen Co.. Printers, Fergus Falls, Minnesota -rr;-- APPLICATION FOR PERMIT TO INSTALL SEWAGE TREATMENT SYSTi WHITE — Office Yellow — Inspector Pink — Owner LAND & RESOURCE MANAGEMENT OTTER TAIL COUNTY COURT HOUSE Phone:(218)739-2271 - FERGUS FALLS, MN 56537 Permit No.LEGAL Vy<} 0 d dLoT'^ - 3 4^DESCRIPTION Port 5,AND location •J SECTIONLAKE NUMBER RANGE TWP NAMELAKE/RIVER CLASS TWP. NO.LAKE/RIVER NAME l-oo tJ 137 HI3*^ FIRE OR LAKE ASSOCIATION NUMBERPARCEL NUMBER(S) IDENTIFICATION: Please Print All Information Zip Code Telephone No.Mailing Address — No. Street, City and State- First InitialLast Name r ^ ca3 /n k/Property Owner ( » J~h. LV ^ mSewage System Installer Name T u '\ A.M./21 P.M.. 19-This System will be ready for inspection on_____at This space for office use oniy /NUMBER OF BEDROOMS: / T/me Rec'd A.M. P.M19/GARBAGE DISPOSAL: ( ) YES ( ) NOPhone,C^I Rec'd ByDate Rec'd r SEWAGE TREATMENT SYSTEM DATA: MINIMUM REQUIREMENTSTYPE OF SEWAGE SYSTEM ( X) Holding tank (Alarm Required)^ (xfBeptic tank ( ) Lift sfetion ( ) Drain fiel^X ( ) Standard ( ) Modified ( ) Moun<r ( ) Outhouse tDRAIN FIELDTANK/ GIs.Ft.Capacity -TO Ft.Ft.Distance from nearest well Ft. Ft.Distance from lake or stream rench Ft.Ft.Distance from building /alo Ft.Ft.Distance from property line Ft.Ft.Distance from bottom to Water Table oEFFLU^T DISTRIBUTION (xj Gravity ( ) Pressure All distances are shortest distance between nearest poims PERCOLATION TEST DATA: WATER WELL DEPTH D O Pv ^ irrOate of Perc TestPerc Tester. Rate of IstTfest Rate of 2nd Test Average Rate Agreement: The undersigned hereby makes application for permit to install or extend Sewage Disposal System herein specified, agreeing to do all such work in strict accordance with Ordinances of the County of Otter Tail, Minnesota and Minnesota Individual Sewage Disposal Code Minimum Standards set forth by Minnesota Department of Health. Applicant agrees that plot plan sketches and specifications submitted herewith and which are approved by Shoreland Management Officical 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 accepted. It shall be the responsibilty of the applicant for the permit to notify the County Shoreland Management that the job is ready for inspection. / jL 'yfm the work desgptSed in the above statement. This permit is granted upon express condition DATE: Signature Permit: Permission is hereby granted to the above named applicant to perfo that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Ordinance of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of any said ordinances. NOTE: Permit void if work is not commenced within six (6) months. Land & Resource Manahen^t OfficeilTxJ)Issued Date:f33-^Rec #.Fee $. Comments: 272.868 • Victor Lundeen Co.. Printers. Fergus Falls. MinnesotaHe. BN-oaaa-ooa wwm INSPECTION RESULTS Inspector must make all measurements SEWAGE DISPOSAL SYSTEM STATISTICS % DRAIN FIELDSEPTIC TANK CATEGORY Actual MinimumMinimumActual / jr^ GLS.SF SFGLS.Capacity u FTFT FT FTDistance from Nearest Well 50 Distance from Buried Water Suction Pipe FT FTRR5050 Distance from Buried Pipe Distributing Water Under Pressure RRRR1010 ft RRDistance from Lake or River (OHWL)R 35 10/20 RRRRDistance from Nearest Building 10 R RR10Distance from Nearest Property Line 10 RRRR3Distance from Bottom to Water Table YES NOHolding Tank/Lift Alarm DRAINFIELD CALCULATIONSewer Line to Well SeparationINTERPRETATION OF ABBREVIATIONS GLS. = Gallons SF = Square Feet R = Linear Feet Actual Minimum RX RR20 SF Inspector's Comments: nSKETCH: y^~/- 4'3' (6J- /pi* Inspector's Signature 1 '12^ r Date of Inspection li<K) Time of Inspection APPLICATION FOR PERMIT TO INSTALL SEWAGE TREATMENT SYSTEM WHITE — Office Yellow — Inspector Pink — Owner LAND & RESOURCE MANAGEMENT OTTER TAIL COUNTY COURT HOUSE Phone:(218)739-2271 - FERGUS FALLS, MN 56537 Permit No.LEGAL W<? 0 <Ji ILq ( s 2 4^L(DESCRIPTION AND LOCATION RANGE TWP NAMELAKE/RIVER CLASS SECTION TWP. NO.LAKE/RIVER NAMELAKE NUMBER CO --^3 J~oo tJ Hf/37 FIRE OR LAKE ASSOCIATION NUMBERPARCEL NUMBER(S) IDENTIFICATION: Please Print All Information Zip Code Telephone No.Mailing Address — No. Street, City and SlateFirst InitialLast Name \ ^ ^ ' ,<-or67.Property Owner FT Xy^L t JBn cl<rs mr»'Sewage System Installer S:Name r A.M. P.M., 19.This System will be ready for inspection on at 3This space for office use oniy NUMBER OF BEDROOMS: Avf)'1 A.M. P.M GARBAGE DISPOSAL: ( ) YES ( ) NOPhonejC^I Rec'd ByTime Rec'dDale Rec'd SEWAGE TREATMENT SYSTEM DATA: MINIMUM REQUIREMENTS^—>TYPE OF SE^ ( )(} Holding tank (Alarm Required) EM iDRAIN FIELDTANK Ft.GIs.Capacityitic tank ( ) Lift sfeUt^ ( ) Drain fiel^\ ( ) Standard ( ) Modified ( )Moup«K (. Ft.Ft.Distance from nearest well Ft.Ft.Distance from lake or stream Ft.Ft.Distance from building /Q /a?Ft.Ft.Distance from property line ( )louse Ft.Ft.Distance from bottom to Water Table EFFU^T DISTRIBUTION ( ✓^Gravity ( ) Pressure All distances are shortest distance between nearest poiffts PERCOLATION TEST DATA: WATER WELL DEPTH n O ^ ^ ite of Perc TestPerc Tester. Rate of Rate of 2nd Test Average Rate!St Agreement; The undersigned hereby makes application for permit to install or extend Sewage Disposal System herein specified, agreeing to do all such work in strict accordance with Ordinances of the County of Otter Tail, Minnesota and Minnesota Individual Sewage Disposal Code Minimum Standards set forth by Minnesota Department of Health. Applicant agrees that plot plan sketches and specifications submitted herewith and which are approved by Shoreland Management Officical 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 accepted. It shall be the responsibilty of the applicant for the permit to notify the County Shoreland Management that the job isjeady for inspection. DATE: fm the work desgwed in the above statement. This permit is granted upon express condition Signature Permit: Permission is hereby granted to the above named applicant to perfo that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Ordinance of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of any said ordinances. NOTE: Permit void if work is not commenced within six (6) months. /u Issued Date:Land S Resource ManaSpnent Officepo mRec #.Fee $. Comments: 272.856 * Victor Lundeen Co. Printers. Fergus Falls. MinnesotaPotm No. BK«89«003 GRID PLOT PLAN SKETCHING FORM — (Must Be To Scale) Scale: Each grid equals feet / inches r 19 ^ ^Dated: /'^UyCO / / Signature - Please sketch your lot indicating setbacks from road^right-of-way, iake and sideyard for each buiiding currently on lot and any proposed structures. fl<p ^ dp S.oTpA^^ 1'-^ ^ ' (pL u 5 4 qS £>er Lai'■vO 00 .1V\\j e^cPf? 0o> [JO M?/l f o1^/\Jo . i. PERCOLATION TEST DATA LAND AND RESOURCE MANAGEMENT Otter Tail County Fergus Falls, MN 56537OWNER: ZS Yp- ^ 7/f,ALAST NAME MIDDLE TELEPHONE NUMBER ADDRESS: 6 ZIP CODE Ca/(/A STATE cunLAKE/RIVER NO.LAKE NAME SEC.TWP.RANGE TWP. NAME LEGAL DESCRIPTION: PARCEL NUMBER sN UMBER/BEDR 00 MSFIRE NUMBER — TWO TESTS ARE REQUIRED — TEST HOLE NO. I TEST HOLE NO. 2 Depth To Bottom of Hole.inches; Diameter of Hole.inches Depth To Bottom of Hole inches; Diameter of Hole inches Date 19Depth. Inches Soil Texture Date 19Depth. Inches Soil Texture Percolation Test By _ Firm Name ___ Percolation Test By___ Firm Name ___ Address Address Otter Tail County License No.Otter Tail County License No. PERC TEST # 1 PERC TEST # 2 IKTBKViO-fMWtrrBg^TIME WAJTODgfTH WA1«ID»QP Kxm TIME PfmtVAL.fVflNtriHp WiOTltDBPrH WAim:top TCRC RATE ■ TAKT BTAET r r'HMU ’ DROP AfeAt *reaH~ DROP PBRC“time iWTBRVALftinWtfTR«DR<PERC RATH TIME WAWRoarm reRCRATBWAJRR REFILL RIPILL r TTime * drop abac 'flRB • drop pbrcrWTRRVALIMIIHJTRmWA3BR DEPTH WiORRDROPtime PERCRATC •ni>g IMTRR\fta.«MlNirrBft WATER nePTH WAITO US.PERC RATEREFILLREFILL 4 4nMU' DROP 'fTMU DROP ABACTIMEPnBKVALOXINinTOWATER DgyjH WiqBRMtOF FERCRATE TIME DfTBRVALfMlWtfTEa WATER DEPTH PERC RATEREFILLREFILL 4 'IIMU" bROP PERC 'flKlU DROP PBRC INTERVAL (MlWUrgg^TIME WATER PBPTW WATER PROF FERCRATE TIME INTERVAL ftENlfTEFy WATER DEPTH WATER DROP FERCRATE REFILL REFILL 4 -p TTOE" DROP PERC TIMB DROP PERCIWTER\M.<MDfUTE»Tlltg WiaERPBPTM WAIERDROF FERCRATE TIME IWTERWL<MIWUTBgl WATER DEPTH WATER DROP FERCRATE REFILL REFILL 4 4TTOE” DROP Perc TSXE~ DROP PBRC INTERVAL fMINUTBS>time WATER PEWH PERC Rate TIME INTERVAL <MIMtnER>WATER DEPTH WATER DROP FERCRATE REFILL REFILL 4 'HMB DROP PERC ilMti DROP PERCTIMEINTERVAL fMlNinESI WATER DEPTH WAIERDROF FERCRATE TIME INTElWALtMINUTES) WATER DEPTH WAIERDROF FERCRATE REFILL REFILL TTIME DROP PBRC TIME DkOP PERC COMM ENTS/CALCULA TIONS: MKL — 0390 - 005 250,815 — Victor Lundeen Co., Printers, Fergus Falls, Minnesota