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HomeMy WebLinkAbout37000990835000_Variances_12-05-2007r IZ'5‘20O1 1038320 OFFICE OF COUNTY RECORDER OTTER TAIL MINNESOTA I hereby certify that this instrument #_ was filed/recorded in this office for record on the (o day of l[lif 2008 atMlQanVp^ 1038320 Wei m Deputyby: recording fee well certificate THE ABOVE SPACE IS RESERVED FOR THE COUNTY RECORDER APPLICATION FOR VARIANCE recBVSD COUNTY OF OTTER TAIL GOVERNMENT SERVICES CENTER 540 WEST FIR, FERGUS FALLS, MN 56537 (218) 998-8095 Otter Tail County’s Website: www.co.ottertail.mn.us NOV 1 4 Z007 LA!\!D & RESOURCE Receipt Number I ^ ^ ^ , Accepted By / Date H jiM (q^J DAYTIME PHONE BHH Application Fee COMPLETE THIS APPLICATION IN BLACK INK (JLf e tSTAiTC TO LOrroifvc. Ua,r\0 PROPERTY OWNER JoW A Q~e-LgLCn LjiuAgA________ CT. Olflindo PL\4*438 raJn\o/ijA 3M-7 MAILING ADDRESS L4DA LAKE CLASSLAKE NAMELAKE NUMBER SECTION J4 TOWNSHIP ^5 U RANGE M'X TOWNSHIP NAME LlOft E-911 ADDRESS PARCEL _ _ _NUMBER ^30QO OOP XVrleT ^(UJr\ PUJ PeuV^n mn LEGAL DESCRIPTION Let U> , XnVcT TVriVd^l TYPE OF VARIANCE REQUESTED (Please Check) X structure Size ClusterSewage System Subdivision Misc.Structure Setback SPECIFY VARIANCE REQUESTED .\J(XAi6^CJL of -2^' frcrvv upuQnoct. hoio^ tAirAfve OYi^^iwu fticrtipiri’AT- vlptumf ^ , , , _ . • VtVO'cuACjC! Of ^.2: o. I'TdryiX i/\ OO'-^xVsOU CflLtovn f^tpWAt. • Prcpoie^S roof oP neuj cok^i'n not to 8cM'^ht,oooo Stcfpih^ 0-^ fvOrvN Lo4<i-G . • Vouo'ar^(U- vJoJLk.-0\/-T fC.'VZX.xVi iVa^ W^a-AAS. OaaJ I UNDERSTAND THAT I HAVE APPLIED FOR A VARIANCE FROM THE REQUIREMENTS OF THE SHORELAND MANAGEMENT ORDINANCE/SUBDIVISION 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. \x)o yrjoiid founDA'^ fdjDAmjnbhirt \ SIGH^kTURE OF PROPERTY OWNER * Yshi DATE APPLICANT MUST BE PRESENT AT THE HEARING(Applicant Will Receive Notification As To The Date/Time Of Hearing) ^H V^LAXonCJL oJLKdi to Lt-. On '*bi4c ^ ou-r- Of f>C4_ fWcJnijtcJDjUre^ ffirrO- )p^Lul ?o fecj>c %Alrvcrr> mn ‘z)(^#573> /S?/^ /ol TimeDate Of Hearing Motion John and JeLain Lund - Approved the modified plan as submit on May 1, 2008 with a condition. (9:19 p.m.) May 1, 2008 meeting - The applicants were represented by Judy Lund. After discussion and consideration, Michael Harris made a motion, second by Carl Zick and carried with Paul Larson voting no and with Rod Boyer abstaining, to approve the placement of the proposed residence and garage (including porch) as depicted on the revised drawing submitted at the public hearing and dated April 23, 2008 and to allow repair of the existing retaining walls, with a 10’ by 10’ lake feature deck over the top of the existing retaining walls, in the location as depicted and described on the drawing; however, if the retaining wall closest to the lot line cannot be repaired then the retaining wall must be replaced at a location which is at least 10’ from the lot line and the other wall must be either replaced/repaired in its current location with the condition that no more than 25% of the total allowable lot area can be covered with impervious surfaces. It was noted that the revised plan is a significant improvement over the plan previously submitted for consideration. Itshould also be noted thatJhe-tQ^p of the retaining walls can be covered with a lake feature deck. Chaifrnan/Otter Tail County Board of Adjustment Permit(s) required from Land & Resource Management I Yes (Contact Land & Resource Management) No Copy of Application Mailed to Applicant, Co. Assessor and the MN DNR L R Official/Date bk 0903-001 315.694 • Victor Lundeen Co., Printers • Fergus Falls, Minnesota LU O\Q bu\JOB NO: 40166 DATE: 11/12/07 THIS ORAHINS IS COPTRlfiffTH? AND SHALL NOT BE Ra=RODOCED HITHOrr AROHITEorS t«TTB4 PERMISSION 3M\> ° s\lU\ > oQEiJ o Cl \ \\\ \< \ \\ \5TRIN6LINE AS EST. BY COUNTY------------- EXI5TIN6 WALK-OUT 5TORACE Af^A fBELOK) ----- \>\\ \ \ IEXISTINO \ RETAINING \ WALL TO BE' REPAIRED < MINIMIZED — o .NEW • DRIVtPROPOSED'a*-®- PROPOSED PROPOSEDRESIDENCE ADDITION ♦ OP NEW ^PTIC EXISTINC BUILDINC OUTLINE — EXISTING DECK \ h-H 35 051 OS I \LAKE LIDA LOT SIZE:q,453 SF\\CLASSinCATION: WGD-GENERAL DEVELOPMENT^ OHW ELEV: ' 13U.3 (NGVD 1912) HIGHEST KNOWN WATER ELEV: 1316.03 (05/09/02) \PROPOSED HOUSE: LAKESIDE DECK: COVERED ENTRY: PROPOSED 6ARA6E: 526 SF 270 SF 1377 SF 126 SF 24 SF1 z V) 9\ ffi Lul ^ z 0.DRIVE:\o%PROPOSED COVERAGE: 24.656 < ♦ S ® Q^pt OHXS\INLET BEACH THIRD ADDITION LOT 6 \dLLJgHy!\ o< 1__I CO eg? \ Qy\PLAN NORTH §=)S I ^ —J ^ K sSITE PLAN < s SCALE - I" = 20'-0"@ 2007 LJJooQ JOB NO: 40166 DATE: 11/12/07 THIS DRAO^NS IS CCPTRISHTH? ANP SHALL NOT BE F®T?ODllCED MITTCin' AROHITECTS HRITTBI PBWISSlOH 3C3 oCOdJfy01 oes>LU o Q '2'< r ID ti o ■sM m ittr:mm amW/n H z '-DECK RAILIN6 NOT 5HOHN -EXISTING CABIN OUTLINESTORAOE ACCESS TO REMAI^o>EXISTING WEST/ LAKESIDE ELEVATION PROPOSED WEST/ LAKESIDE ELEVATION »-H 8 SCALE - 1/6" = I'-O"S?SCALE - 1/6“ = I'-O" O <1 !8 0511oSj7H'z122 w9 a.LU^ Q. d ♦ g ^ K|| inxirrLiiLiliiiLiillll'z<OBUJ4>4'-0" SIDEINALLS e REARiEKH 0. QLUSjfiiiiiiiLfgSagSgigs ijiMiumi4 fq'-6" SIDEWALLS O FRONT 6'-0" SIDEWALLS e REAR <^ LU n1=Si m Qyffi s-CO u ;m16" RISE IN FLOOR ^ O REAR K S <1 S olOCOFLOOR O EXISTING CABIN LEVEL I <-----STRINCLINE SETBACKEXISTING CABIN OUTLINE © 2007IPROPOSED SOUTH ELEVATION SCALE - 1/6" = I'-O" Compliance Inspection FormMinnesota Pollution Control Agency 520 Lafayette Road North St. Paul, MN 55155-4194 Existing Subsurface Sewage Treatment Systems (SSTS) Doc Type: Compliance and Enforcement Instructions on page 6 Summary Form (Completed form must be submitted to the local unit of government within 15 days.) Parcel number System status: J2l Compliant □ Noncompliant (based on all compliance requirements) For Local Tracking PurpoS^EiVED OCT 1 5 2010 Property Information . Property owner name(s): . VVyw ___________________ Property address: 6.X |/llty. Property owner address (if different): .\,\D & RESOURCE Property owner phone: 7 4 County: 6iV4.Vtt.jl CA-i Permitting authority: \ _____________ ____ Reason for inspection: ■ r Vfo I b'S System Description Brief system ill* U description: — Local permit number: o it-H Is the system: In Shoreland area? An U.S. Environmental Protection Agency (EPA) Class V Injection Well? □ Yes ^No Compliance Status (Based on state requirements - additional local requirements may also apply.) Based on the information gathered and reported on attached forms, the compliance status of this system is (check one): Certificate of Compliance - valid until (3 years from date of report): _ Notice of Noncompliance - For Noncompliant systems: The reason for noncompliance is: _____________________________________ This noncompliant system is classified as (check one below): □ Imminent threat to public health & safety □ Failing to protect ground water □ Not in compliance with operating permit Date system constructed: Number of bedrooms:Design flow rate: ^ ^ ^^es □ No □ Yes j^No □ Yes [f^o In Wellhead Protection Area? System serving a Minnesota Department of Heath (MDH) licensed facility? Certification I hereby certify that all the necessary information has been gathered to determine the compliance status of this system. No determination of future system performance has been nor can be made due to unknown conditions during system construction, possible abuse of the system, inadequate maintenance, or future water usage. L-WNaVme Certification number: Busine SS license name and 113 inumbeor 10r: Nam e of local unit of gove ■ mm ent: Sig nat Date:ure: Rguired Attachments □ J □ Operating Permit Form (if applicable)Hydraulic Performance □ Soil Boring Logs Tank Integrity Soil Separation □ System drawing/As-built drawing □ Any local requirements that are different from what is required on this form □ Other information (iist); Upgrade Requirements (derived from Minn. Stat. §115.55) An imminent threat to public health and safety (ITPHS) must be upgraded, replaced, or its use discontinued within ten months of receipt of this notice or within a shorter period if required by local ordinance. If the system is failing to protect ground water, the system must be upgraded, replaced, or its use discontinued within the time required by local ordinance. If an existing system is not failing as defined in law, and has at least two feet of design soil separation, then the system need not be upgraded, repaired, replaced, or its use discontinued, notwithstanding any local ordinance that is more strict This provision does not apply to systems in shoreland areas. Wellhead Protection Areas, or those used in connection with food, beverage, and lodging establishments as defined in law. ti V /-----1,i n IiIi iV i!I 3%'Si -I¥ ■I f1II I fI! 1 Isi l-reci) V System status; W Compliant □ Noncompliant (as determined o^is form)Parcel number: Hydraulic Performance and Other Compliance - Compliance Inspection Form for Existing SSTS Compliance Issue #1 of 4 Date of observation; This form expires upon next itispecfion or in three years, whichever occurs first: Reason for observation: Compliance questions/criteria: (Required) (Check the appropriate box) Verification Method*: (Optional) (Check the appropriate box) Searched for surface outlet □ Performed hydraulic test ^ Searched for seeping in yard Checked for backup in home □ Excessive ponding in soil system/D-boxes □ Homeowner testimony □ Examined for surging in tank □ “Black soil” above soil dispersal system n System requires “emergency” pumping □ Performed dye test □ Other; ___________________________ □ Yes ^NoDoes the system discharge sewage to the ground surface?____________________ □ Yes 1^0Does the system discharge sewage to drain tile or surface waters? □ YesDoes the system cause sewage backup into dwelling or establishment?_______ □ Yes ^NoDo other situations exist that have the potential to immediately and adversely impact or threaten public health or safety (electrical, unsafe covers, etc.)?_______ Any “yes” answer indicates that the system is an imminent threat to pubiic heaith and safety. □ Yes l^l^oDoes the system pose a threat to ground water for any conditions deemed non- protective as determined by the inspector? “Yes" indicates that the system is faiiing to protect ground water. If “yes", describe the condition noted: * No standard protocol exists. This list is not exhaustive, in sequential order, nor does it indicate which combinations are necessary to make this determination. Certification This form is to be completed and attached to the Summary Form of the Minnesota Pollution Control Agency’s (MPCA) Compliance Inspection Form for Existing Subsurface Sewage Treatment Systems. Observations, interpretations, and conclusions must be completed by an inspector. Completed fonn must be submitted to the local unit of government within 15 days. QoAkProperty ovimer name(s): Property address: ____ Property owner’s address (if different): County: V ssc /(pj i y;A/o 7^ Property owner phone; S _____________ / hereby certify that I personally made the observations, interpretations, and conclusions reported on this fonn and that they are conect Name:Certification number Date; j_UBusiness license name and number: Name of local unit of govejiynent; Signature:H System status: ^Compliant □ Noncompliant (as determined by'this form) Parcel number. Tank Integrity and Safety Compliance - Compliance Inspection Form for Existing SSTS Compliance Issue #2 of 4 i Date of observation: U) / This form expires on (three yeOTs): JO R^son for observation: Verification Method**: (Optional) (Check the appropriate box) Probed tank bottom □ Observed low liquid level □ Examined constmction records D Examined empty (pumped) tank □ Probed outside tank for “black soil” D Pressure/vacuum check Compliance questions/criteria: (Required) (Check the appropriate box)_____________________ Does the system consist of a seepage pit*, □ Yes ^No cesspool, drywell, or leaching pit? □ Yes I^NoDo any sewage tank(s) leak below their designed operating depth?__________ If yes, identify which sewage tank leaks. Any ‘‘yes’’ answer indicates that the system is failing to protect ground water. ^ Other: Cj >__________ * Seepage pits meeting 7080.2550 may be compliant if allowed in ordinance by local permitting authority. ** No standard protocol exists. This list is not exhaustive, in sequential order, nor does it indicate which combinations are necessary to make this determination. Safety Check □ Yes* ^No JgfYes DNo* 3. Was secondary access restraint present (safety pan, second cover, or safety netting) - highly recommended. □ Yes 4. Are other safety/health issue present? Explain: ______________________ 1. Are maintenance hole covers damaged, cracked, or appeared to be stmcturally unsound? 2. Were maintenance hole covers replaced in a secured manner (e.g., screws replaced)? □ Yes* *^^^0 *System is an imminent threat to public health and safety. Certification This form is to be completed and attached to the Summary Form of the Minnesota Pollution Control Agency’s (MPCA) Compliance Inspection Form for Existing Subsurface Sewage Treatment Systems. Observations, interpretations, and conclusions must be completed by an inspector, maintainer, or service provider. Completed form must be submitted to the local unit of government within 15 days. Properfy owner name(s): Property address: ____ Property owner’s address (if different): 77h Property owner phone; ~ ^3-^03 "7County: I hereby certify that I personally made the observations, interpretations, and conclusions reported on this form and that they are correct IM&IName:Certification number; L\IU"7_Business license name and number: Name of local unif^f Signature; emi Date:J-CiA f j status: □ Compliant □ Noncompliant (is dStdpnined by this form) Parcel number.S] S®SB Sepaira4n®!ra ©®mB3iBSaBB©© amsa ®S!h©ir ©©mpBianiic© - Compliance Inspection Form for Existing SSTS Compliance Issue #3 of 4 Date of observation; _________________ This information on this form does not expire. Reason for observation: Compliance questions/criteria: (Required) (Check the appropriate box)______________ Verification fiflethod**: (Optional) (Check the appropriate box) □ Conducted soii obseivation(s) (attach boring logs) □ Two previous verifications (attach boring logs) □ Other: For systems built prior to April 1,1996, and not located in Shoreland or Wellhead Protection Area or not serving a food, beverage or lodging establishment: Does the system have at least a two-foot vertical separation distance from periodically saturated soil or bedrock?□ Yes DNo For non-performance systems built April 1, 1996, or later or for non-performance systems located in Shoreland or Wellhead Protection Areas or serving a food, beverage or lodging establishment: Does the system have a three-foot vertical separation distance from periodically saturated soil or bedrock?* Soil observation does not expire. Previous observations by two independent parties are sufficient, unless site conditions have been altered. □ Yes □ No For reduced separation distance systems (i.e., “performance” systems under old 7080.0179 or Type IV or V system under new 7080.2350 or 7080.2400): Does the system meet the designed vertical separation distance from periodically saturated soil or bedrock?* * May be reduced by up to 15 percent if allowed in local ordinance. ** No standard protocol exists. This list is not exhaustive, in sequential order, nor does it indicate which combinations are necessary to make this determination.□ Yes DNo Any “no" answer indicates that the system is failing to protect ground water. Certification This form is to be completed and attached to the Summary Form of the Minnesota Pollution Control Agency’s (MPCA) Compliance Inspection Form for Existing Subsurface Sewage Treatment Systems. Obsen/ations, interpretations, and conclusions must be completed by an inspector or designer. Completed form must be submitted to the local unit of government within 15 days. Property owner name(s): ________ Property address: ______________ Property owner’s address (if different): County: _____________________Property owner phone: I hereby certify that I personally made the observahons, interpretations, and conclusions reported on this form and that they are correct. Name: _____________________ Business license name and number: Name of local unit of government: Signature: ___________________ Certification number or Date: Syst jm (as i ei^i tOsT^ □ Compliant □ Noncompliant ined by this form) Parcel number: ! ©peiraftSirag PeroiniDft CompIlSaiiiJce airadl MBiiirogeira CompBoairace - Compliance Inspection Form for Existing SSTS Compliance Issue #4.of 4 Applicability: Is the system operated under an Operating Permit? □ Yes □ No If “y^s”, then complete item A, below Is the system required to employ a nitrogen BMP? □ Yes □ No If “yes”, then complete item B, below If the answer to both questions is “no”, then this form does not need to be completed. Compliance questions/criteria: (Required) (Check the appropriate box) A. For systems with operating permits: Has all the required monitoring and maintenance taken place and does the monitoring indicate compliance with the permit thresholds? □ Yes □ No B. For a system that has a required nitrogen reducing BMP and does not have an operating permit: Is the nitrogen BMP in-place and appears to be properly operating? □ Yes □ No Any “no" answers indicates noncompliance Date of observation: __ Operating permit number: This form expires upon next inspection or in three years, whichever occurs first: Reason for observation: Certification This form is to be completed and attached to the Summary Form of the Minnesota Pollution Control Agency’s (MPCA) Compliance Inspection Form for Existing Subsurface Sewage Treatment Systems. Observations, interpretations and conclusions must be completed by an advanced inspector, service provider, or maintainer (maintainer for holding tanks only). Completed form must be submitted to the local unit of government within 15 days. Property owner name(s): _______ Property address: ______________ Property owner's address (if different): County: ____________________Property owner phone: / hereby certify that t personaity made the observations, interpretations and conciusions reported on this form and that they are correct. Name: _____________________ Business license name and number Name of local unit of government: Signature: ___________________ Certification number: or Date: Instructions - Compliance Inspection Form for Existing SSTS The Minnesota Pollution Control Agency’s (MPCA) compliance inspection form must be completed for all compliance inspections of existing Subsurface Sewage Treatment Systems (SSTS) (Minn. Stat. § 115.55 subdivision 5a (i)). A compliance inspection is an inspection for the purpose of issuing a certificate of compliance or notice of noncompliance (Minn. R. ch. 7080.1100, subpart 18). Additional local forms may also be required in local ordinance; if this is the case, attach the appropriate local form(s) as well. The inspection form is divided into five separate pages, each dealing with a separate compliance issue. The pages include; Summary Form, Hydraulic Performance and Other Compliance Form, Tank Integrity and Safety Form, Soil Separation and Other Compliance Form, and Operating Permit and Nitrogen BMP Compliance Form. The following table indicates which sheets need to be completed for which type of systems: Operating Permit and Nitrogen BMP Compliance Form Hydraulic Performance and Other Compliance Form Soil Separation and Other Compliance Form Tank Integrity and Safety Form Summary Form System Classification Type I and old Standard Systems XX X X Type II and old “Alternative” Systems X X X X Type III and old “Other” Systems X X X X Type IV X X X X X Type V and old “Performance” Systems______ XXX XX ISTS or MSTS with nitrogen BMP X XX X X MSTS with advanced nitrogen reduction X X X X X ISTS = Individual Sewage Treatment Systems MSTS = Mid-Sized Subsurface Sewage Treatment Systems The purpose of multiple forms is to accommodate the different times the system may be assessed and the various individuals that may do the assessment. The goal of these forms is to document a continual state of compliance for the system. The final determination of compliance is determined on the Summary Sheet. This compliance status is based on the supporting compliance forms. Each supporting form has an expiration date (except the Soil Separation form), and, if not expired, will be used to support the Summary Sheet. 1. Summary Form Purpose and Intent This is the form that is completed once all the supporting information is gathered and the supporting forms are completed. This form acts as the official “Notice of Noncompliance” or “Certificate of Compliance". The supporting forms must be attached to the summary form. Line by Line instructions (for non self-evident queries) System Status (top line) - The “Compliant” or “Noncompliant” Section is based on all the required forms for that system. Property Owner Section - The “Date System Construction” query must be determined from records or owner testimony. If neither of these two sources are available, then a reasonable estimate should be made. The method used to determine the date (records, estimate, testimony, etc... could be provided near the date blank). System Description Section - The “Local Permit Number”, “Number of Bedrooms” and “EPA Class V Injection Well" queries are optional. An U.S. Environmental Protection Agency (EPA) Class V injection well is any system which serves more than one dwelling, or receives non-domestic waste, or a system which serves an Other Establishment which serves more than 20 persons per day. The “Design Flow Rate” must be determined or estimated to detennine if an advanced inspector is required to conduct the compliance inspection for that system. Wellhead Protection Areas can be found at: http://mdh-agua.health.state.mn.us/swa/pdwmain.cfm. .CompSianc® Status Section - The compliance status required to be recorded on this form is based on state rule and state statute requirements. The compliance status is based on the supporting compliance forms. If local compliance requirements differ, that can be noted on a separate document, but the state form still needs to be completed based on state criteria. Certification Section - The final determination of compliance must be done by an inspector (or advanced inspector for a Type IV, Type V, or system with a design flow of greater than 2,500 gallons per day). Required Attachments Section - The number of supporting compliance forms must be noted to ensure that the supporting information is complete. If you are filling the form out on your computer, click the “Print Preview" button at this point- this will trigger the automatic filling of system identification and inspector information on subsequent pages. 2. Hydraulic Performance and Other Compliance Form (Compliance issue #1) Purpose and Intent This form denotes compliance for surfacing of sewage or if an inspector is determining that the system is failing to protect ground water other than a leaking sewage tank (septic, pump, cesspool, seepage pit etc...) Line by Line Instructions (for non self-evident queries) System Status (top Sine) - The “Compliant” or “Noncompliant” Section is based only on the criteria evaluated on this form, not based on criteria on other forms. CompSiance Questions/Criteria Section - The question in the lowest left-hand box which states: “Does the system pose a threat to ground water for any condition deemed to be non-protective as determined by the inspector?" is meant to allow the inspector to make a determination outside of the obvious non-protective systems (separation distance, leaky sewage tanks, etc...). These systems could include such things as a system covered by an impermeable surface. 3, Tank Integrity and Safety Compliance Form (Compliance Issue #2) Purpose end Intent This form denotes compliance for watertight tanks. Water tightness only refers to water tightness below the tank's designed operating depth. Non-water tightness above the designed operating depth (i.e., water leaking into the tank) may be harmful for system operation, but is likely not a direct threat to environmental protection. Line by Line Instructions (for non seif-evident queries) System Status (top line) - The “Compliant” or “Noncomplianf Section is based only on the criteria evaluated on this form, not based on criteria on other forms. 4. Soil Separation Compliance and Other Compliance Form (Compliance issue #3) Purpose and Intent This form denotes compliance for the required vertical separation distance to the periodically saturated soil or bedrock. Line by Line Instructions (for non self-evident queries) System Status (top line) - The “Compliant” or “Noncomplianf Section is based only on the criteria evaluated on this form, not based on criteria on other forms. Compliance Questions/Criteria Section - The 15 percent reduction in separation distance is further explained by the following table: Required Separation Distance with 15% Reduction Required Separation DistanceSystem Type Example For systems built prior to April 1, 1996, and not located in Shoreland or Wellhead 24 inches (15% rule does not apply) Septic tank with trench system, built in 1980 not near a lake or stream 24 inchesProtection Area or not serving a Food, Beverage or Lodging Establishment For non-performance systems built April 1, 1996, or later or for non-performance systems located in Shoreland or Wellhead Protection /yeas or Serving a Food, Beverage or Lodging Establishment Septic tank with a trench system, built in 1980 within a Minnesota Department of Natural Resources (DNR) Shoreland Area, Or Septic tank with trench system, built in 2001, not in a DNR Shoreland Area 36 inches 31 inches For reduced separation distance systems (i.e., “performance” systems under old 7080.0179 or Type IV or V system under new 7080. 2350 or 7080.2400) Septic tank with advanced treatment to a trench system 12, 24 or 36 inches 10, 21, or 31 inches Verifficaltooini Mleihod Secftt'oin - The vertical separation distance must be determined. This determination can be made by the fbilowring: A. A new soil boring (which does not need to be verified by another for an existing system compliance inspection). B. Previous borings by two independent certified individuals (one can'be the original borings by the designer). C. For more complex or difficult site conditions, please refer to MPCA’s fact sheet on determining vertical separation distance for existing systems. The soil boring(s) must be attached to this form. i-. 5. Operating Permit Compliance and Nitrogen BMP Compliance Form (Compliance Issue #4) Purpose and Intent This form denotes compliance for proper system operation as determined by compliance with the system’s operating permit, or for systems which employ a best management practice for nitrogen, whether that practice is currently, in-place and property operating. These two conditions will only apply to a few systems which are required to have these measures, which began between the years 2008 and 2011. Line by Line Instructions (for non self-evident queries) System Status (top line) - The “Compliant” or “Noncompliant” Section is based only on the criteria evaluated on this form, not based on criteria on other forms. Compliance Questions/Criteria Section - The assessment of the nitrogen best management practice (BMP) can be a simple visual evaluation if the BMP is still present and whether it appears to be properly functioning at the time of inspection. ;