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HomeMy WebLinkAbout17000100130000_Variances_10-10-2013lilOIOlDl'Si __________ »u DOC# 1135287 Date Stamp 1135287 Fee: $46.00 Well Certificate [ ] Rec'd OFFICE OF COUNTY RECORDER OTTER TAIL COUNTY, MINNESOTA Certified, Filed, and/or Recorded: October 14, 2013 4:00 PM Brian Armstrong, Recorder Returned To:j r LAND & RESOURCE By: LL L&R Initial THE ABOVE SPACE IS RESERVED FOR THE COUNTY RECORDER APPLICATION FOR VARIANCE 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 5'0O.0OApplication Fee COMPLETE THIS APPLICATION IN BLACK INK Receipt Number Accepted By / Date no I' 5. I o.>/o(TeG DAYTIME PHONEPROPERTY OWNER \{s , HO S S'Q-e? [-:XSMn Aue S Gr )"MAILING ADDRESS O k'V cy v-\ LAKE NAME 9«g_\ i C- G., SECTION ID TOWNSHIP ) 3 RANGE O M X TOWNSHIP NAME LAKE CLASSLAKE NUMBER \A tr\ \\ E-911 ADDRESS PARCEL NUMBER 5oH^i p , 5 Vv Le_ A1 g O C3 O loo ) 3 O O to 43 O g. ^ V <:> i i~ J- Cj^o i LEGAL DESCRIPTION Tax Desc:Sect-10 Twp-137 Range-042 PT GL 3 COM NW COR SEC 10, E 928.14', S 1 DEG E 68.41 PT BG, W 35.41', SLY ALG TO TYPE OF VARIANCE REQUESTED (Please Check) X Cluster WECS Misc.Structure Size Sewage System SubdivisionStructure Setback SPECIFY HOW YOUR PROJECT VARIES FROM ORDINANCE REQUIREMENTS. PLEASE BE BRIEF AS THIS WILL BE USED FOR PUBLIC NOTIFICATION. f\ofv - sulosi"^ CL rd i ^ "t” b . CL C y e 9/ i > h CLV-, c. e. V\ b € * RCj X(o Lo / p^ruiouS k ar/' /3' jN uO C. O V'\ 'r' C o- v-i u V Vn •€ e-i" ■}" Vn 'ft. rcpoii^^ dy:Vs-/<A<^ Ccio. Fi^K(L< ^ rO fy\ V-./ Kt Uv'bo ^O yC_c_K U c_ IOG_V n “d* OS. 4o (--t. |3 d-fclL Jtv*- OHu^L. <^uk. I n K Hlu>'Cxlo u;. I UNDERSTAND THAT I HAVE APPLIED FOR A VARIANCE FROM THE REQUIREMENTS OF THE SHORELAND MANAGEMENT ORDINANCE/SUBDIVISION CONTROLS ORDINANCE / SANITATION CODE / SETBACK ORDANAND AN/OR WECS 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. SIGNATURE OF PROPERTY OWNER / AGENT FOR OWNER DATE APPLICANT MUST BE PRESENT AT THE HEARING (Applicant Will Receive Notification As To The Date/Time Of Hearing) f ■ 345,194 • Victor Lundeen Co.. Printers • Fergus Falls. Minnesota TimeDate Of Hearing Motion Gerald A. and Marlene Nolte - Variance application was approved as requested. (7:05 p.m.) After discussion and consideration, Thomas Lee made a motion, second by Marion Gill and unanimously carried, to approve the proposed development as described in the variance application dated September 4, 2013 and as depicted on the drawings submitted with the application. Existing development will be removed and the proposed development will be further back from the ordinary high water level than the existing development and the proposed development will also result in a reduction in the impervious surface coverage from 31 % to 23.5%. Chairman/dtier Tail County Board of Adjustment Permit(s) required from Land & Resource Management ^ Yes (Contact Land & Resource Management) No Copy of Application Mailed to Applicant, Co. Assessor and the MN DNR L R Official/Date bk 072011-001 . October 10, 2013 Page # 2 Anthony and Donna Moorhouse - Variance application was approved with a modification and conditions. (7:53 p.m.) Anthony and Donna Moorhouse, Lots 36 and 37, Crystal Beach and part of Government Lot 6 Section 24 of Dora Township by West McDonald Lake, requested the following: We are requesting a variance of 2’ (roadside) and 4’ (backside) from the required side lot line setback of 10’ for the placement of a 24’ by 32’ garage 8’ from the side lot line on the roadside and 6’ from the side lot line on the backside. The purpose of the garage is to provide adequate protection for our vehicles and stored items so we can reside at the location permanently year-round. Dimensionally, no other useable space exists on the lot to build the structure; the only practical position is as described. The house door and drainage from the back slope forces one to provide a 5’ buffer between the house and garage, leaving little room to shift the garage towards the house. Also note the lot is 110’ roadside and angles to 90’ on the backside. The audience was polled with no one speaking for or against the variance as requested. After discussion and consideration, Paul Larson made a motion, second by Thomas Lee and unanimously carried, to approve placement of a 22’ wide garage no closer to the side lot line than 8’ with the condition, as verbally offered/proposed by the applicants, that the existing 8’ by 10’ shed must be removed and with the condition that impervious surface coverage cannot exceed what is permitted by the ordinance. Gerald A. and Marlene Nolle - Variance application was approved as requested. (7:05 p.m.) Gerald A and Marlene Nolte, part of Government Lot 3, Section 10 of Dunn Township by Pelican Lake, requested the following: New construction - substandard lot, .24 acres. We cannot meet the structure setback ordinance at 75’. Proposing to replace the existing cabin being 26’ from ordinary high water level. Requesting a 49’ variance from the ordinary high water level. Also proposing to replace the existing deck with pervious pavers being 16’ from the ordinary high water level. The existing cabin and deck are 13’ from ordinary high water level. The proposed cabin will be two stories. The audience was polled with no one speaking for or against the variance as requested. After discussion and consideration, Thomas Lee made a motion, second by Marion Gill and unanimously carried, to approve the proposed development as described in the variance application dated September 4, 2013 and as depicted on the drawings submitted with the application. Existing development will be removed and the proposed development will be further back from the ordinary high water level than the existing development and the proposed development will also result in a reduction in the impervious surface coverage from 31% to 23.5%. James C. Johnson - Variance application was approved as requested. (7:16 p.m.) James C. Johnson, Lot A, Jacobs Survey Lot of Government Lot 5, Section 11 of Pelican Township by Prairie Lake, requested the following: Installing a new system and tank will be 0’ to road right-of-way. Drain field will be approximately 20’ into road right-of-way. Required setback is 10’ from road right-of-way. The audience was polled with no one speaking for or against the variance as requested. A letter from William and Charlene Steinhoff in support of the variance application was read for the record. After discussion and consideration, Paul Larson made a motion, second by Michael Harris and unanimously carried, to approve a variance of 10’ from the required road right- of-way setback of 10’ for the placement of new system and tank 0’ from the road right-of-way as depicted on the plan prepared by Egge Construction Inc. noting that the drain field will be approximately 20’ into the road right-of-way. The letter from Pelican Township was noted for the record. The hardship/practical difficulty is the terrain features of the property and no other alternative sites for placement of the proposed system are available. Ken and Barbara Booth - Variance application approved as requested. (7:18 p.m.) Ken and Barbara Booth, part of Government Lot 6, Section 30 of Everts Township by North Turtle Lake, requested the following: House is at 200’ setback. I would like a swimming pool between house and lake. Setback from pool would be approximately 170’. Required setback for in ground pool is 200’. The audience was polled with no one speaking for or against the variance as requested. After discussion and consideration, Michael Harris made a motion, second by Thomas Lee and unanimously carried, to approve a variance of 30’ from the required ordinary high water level setback of 200’ for the placement of swimming pool 170’ from the ordinary high water level. The proposed location will not obstruct the view from the adjacent properties. Bryce and Julie Anderson - Variance application approved as requested. (7:25 p.m.) Bryce and Julie Anderson, Lot 20 Sky Blue Water Beach, Lake Six in Hobart Township, requested the following: We are requesting a 13’ variance from the 100’ ordinary high water level setback for the purpose of adding an accessible screen room to our house. The screen room is important for a disabled resident to enjoy the outdoors. We tried to position the screen room beyond the setback but the septic tank setback, sewer vent pipes, gas furnace intake and exhaust and other utilities interfere. We positioned it as far back from the front of the house as possible and still be accessible from the house. SCALE DRAWING FORM1 ft i^OC>Qlc>C> Tax Parcel Number(s) The scale drawing must be a signed drawing which includes and identifies a graphic scale (feet), all existing and/or proposed structures, septic tanks, drainfields, lotlines, road right-of-ways, easements, OHWLs, wells, wetlands, topographic features (i.e. bluffs), and onsite impervious surface calculations. %Scale Impervious Surface Ratio (Must Complete Worksheet On Other Side) s11'^! 0^ ! ■ ^pin\ i I I pah^ 4 u-i-L-TTv 35 V 15 \X)'^yio ti.he ! L(&‘w*'*!**:i I: IS' e iitl-i ! 1.1.P'if\P' noUl;® ^‘t) ...p0^ UJt^pr.. tRoaJ L I ■+ 4;rIiJ / I I t I I ^ Signature of Property Owner 4. ^-11-13.! Date BK — 0909 Victor Lund«en Co., Printers ■ Fergus Falls,33a596 1-8OF346-4870 ! SCALE DRAWING FORMf f fi iHoOc^'lOQ j-^OOoca Tax Parcel Number(s) The scale drawing must be a signed drawing which inciudes and identifies a graphic scaie (feet), aii existing and/or proposed structures, septic tanks, drainfields, iotiines, road right-of-ways, easements, OHWLs, wells, wetlands, topographic features (i.e. bluffs), and onsite impervious surface calculations. %Scale Impervious Surface Ratio (Must Complete Worksheet On Other Side) \A ;I )| ' -k; ! rVP rcifq\ 4^t- t T / cp V O V oU i f r St lIL L_a4-Cw-t 1 1 I; T'--""------ S - —i' W ( S Ca}o: n , ^6 )i '3-5L ........t- f ( !^G-OjrOCi -e IC 4o -1? 4jCjV L'jrtt <5iOV«=^^ I t T T 1 ■ ; ■ ! ■ ' ' .r :.p !'! i cirn-i< LuOr'^ \H.-+ ,o«> j : —.....■ i—••i' i , t I-.. i 1 +r-k-1 •f5 ....1 )r- ;:T I!r' 1 I....5^ -i •r I I i I Er■ f 5AJ-- i to Signature of Property O^ner 1 I !! I------------------------------Date rutRftR • Victor UlOdAda Co. Printau • Parous iUUs. MN * 1-80O-346-4870Ri^_nono I SCALE DRAWING FORM ..Lr •t- I 'I Ooo loo 13 o oo c_» Tax Parcel Number(s) The scale drawing must be a signed drawing which includes and identifies a graphic scale (feet), all existing and/or proposed structures, septic tanks, drainfields, lotlines, road right-of-ways, easements, OHWLs, wells, wetlands, topographic features (i.e. biuffs), and onsite impervious surface calculations. I Sti SI Ouj\Kq^r.%Scale Impervious Surface Ratio (Must Complete Worksheet On Other Side)i Lake. 0\ ^ ,t>o*(Of\ /VVtA D^cW.ao<,rS r?‘ -fo ^ lo-l- i ... cK i Cf-eck.Crd.rO.<\ e -7it-io1/ r X Crcuo\s U0+ : r s I T .i 4. i !•a-sp Ui(^t"t ci Ui! onCj'i^l SU e pcL\)crS>, BJ ttc' Grect-'- 2>rflu) A -S./riAU--fccr^ka+i /11 ____,)^u^g; irojciL I' 1 I^ -M Signature of Property Owner Date !Fergus ialls. UNBK —0909 Vlcto| Lundeen Co. Printers338,596 1.-800-3464870 IMPERVIOUS SURFACE CALCULATION WORKEHEET EXISTING Onsite Impervious Surface Building Impervious Surface Calculation - Not to Exceed 20% )<i n f7 /ays 9 w Building(s) - Total Square Footage Lot Area \Hkb - 10, ys9 = g i^i9 X100 =% Building Area Lot Area Building Surface Ratio EXISTING Lot Area Covered ^ Building(s) Total Impervious Surface Calculation - Not to Exceed 25% Building(s) 3^0 Ft^Deck(s) fFPatio(s) Q 10 f7Sidewalk(s) fFStairway(s) fFLanding(s) A 00dDriveway(s) Retaining Wall(s) fFLandscaping (Plastic Barrier) Other I ^ fFTotal Impervious Surface fFLot Area V Total Impervious Surface ^ = a. 3 il dj.X100 =% Lot Area Impervious Surface Ratio EXISTING Lot Area Covered By Impervious Surfabe 3/ ■% PROPOSED Onsite Impervious Surface Building Impervious Surface Calculation - Not to Exceed 20% fF/9 OS / Q ■ vts y /a.] Building(s) - Total Square Footage fFLot Area IIOS -r /0,t/>5V =X100 =%building Area Lot Area Building Surface Ratio PROPOSED Lot Area Covered By BuMding(s)% Total Impervious Surface Calculation - Not to Exceed 25% iloS fFBuilding(s) fFDeck(s) /(^S FdPatio(s) 3 3 O -4 A Sidewalk(s) p^rt/ious lieS Stairway(s)_______________Ft fFLanding(s) Ft 3 V..^Ft^ FI2 Driveway(s) t u\ ^_____________ Retaining Wall(s)p^rpioLL^ n tiAKX t ^ Landscaping (Plastic Barrier)____________________Ft fFOther _C-r< p.-t-___________ _______Total Impervious Surface LSL Ft^; Lot Area Ft' 53ZI__Total Impervious Surface ■=3 3 »cSX100 =% Impervious Surface RatioLot Area PROPOSED Lot Area Covered By Impervious Surface 3,3*^ % PROPOSED CHANGE IN IMPERVIOUS SURFACE : ^7.5 % Impervious Surface Calculalion Worksheet 08'07-2013 Notice of Hearing for Variance Otter Tail County Government Services Center 510FirAveW Fergus Faiis, MN 56537 (218) 998-8030/998-8041 Email - wstein@co.ottertail.mn.us www.co.otter-tail.mn.us Appiicant and/or appiicant’s representative must be present at the scheduied hearing. To Whom It May Concern: Gerald A and Marlene Nolle 802 28"’ Ave S Grand Forks, ND 58201 has/have made application to the Otter Tail County Board of Adjustment for a variance as per requirements of the Otter Tail County Shoreland Management Ordinance, the Otter Tail County Set Back Ordinance and/or the Subdivision Controls Ordinance. The Otter Tail County Board of Adjustment will assemble for this hearing on Thursday, October 10, 2013 at 6:30 p.m.. in the Commissioners’ Room of the Otter Tail County Government Services Center, Fergus Falls, MN. (Please use the public . entrance located on the northeasterly side of the Government Services Center. The second left off Fir Ave.) Individuals requiring special accommodations should contact the County Auditor’s office prior to the date of the public hearing. The property concerned in the application is legally described as part of Government Lot 3, Property Address - 50471 Fish Lake Road Section 10, Township 137, Range 42 - Township Name - Dunn Lake No. 56-786, Lake Name - Pelican, Class - GD The variance requested is - the following: New construction - substandard lot, .24 acres. We cannot meet the structure setback ordinance at 75’. Proposing to replace the existing cabin being 26’ from ordinary high water level. Requesting a 49' variance from the ordinary high water level. Also proposing to replace the existing deck with pervious pavers being 16’ from the ordinary high water level. The existing cabin and deck are 13’ from ordinary high water level. The proposed cabin will be two stories. 'Wc^ne Stein Board of Adjustment Secretary Date: September 20, 2013 * OTTER TAIL COUNTY Fergus Falls, Minnesota State of Minnesota ) )SS County of Otter Tail) I, Wayne Stein, Secretary for the Board of Adjustment for Otter Tail County, Minnesota, do hereby certify that on the 23rd, day of September, 2013 the attached Notice of Hearing for Variance was duly served upon the individuals listed below and/or included in the attachment: Gerald A and Marlene Nolte, 802 28*^ Ave S, Grand Forks, ND 58201 7005 Pelican Group Lake Impt. Dist., % Fred Manuel, 26271 Otoson Rd, Detroit Lakes, MN 56501 Faye Engkjer, Twp Clerk of Dunn, 51628 Pelican Pt Dr, Detroit Lakes, MN 56501 Otter Tail County Cola, % John Matteson, 23674 W Silver Lake Rd, Battle Lake,MN 56515 Richard West, OTC HWY Engineer, 505 S. Court St. Suite #1 Fergus Falls, MN 56537 Julie Aadland, DNR Eco & Water Resources, 1509 1^' Ave N, Fergus Falls, MN 56537 Board of Adjustment: Paul R. Larson, 21283 County Highway 65, Henning, MN 56551-9573 R. Stephen Schierer, 3310 Rollins Beach, Fergus Falls, MN 56537-4216 Thomas (Tom) Lee, 15600 Cty Hwy 118, Elizabeth, MN 56533-9559 Ward Uggerud, 933 E Cavour Ave, Fergus Falls, MN 56537 Michael Harris, 38019 Dead Lake Rd, Richville, MN 56576 Marion Gill, 40122 Aerovilla Rd, Perham, MN 56573 by placing a true and correct copy thereof in a sealed envelope, postage prepaid, and depositing the same in the United States Mail at Fergus Falls, MN, property addressed to each of the individuals listed above and/or listed in the attachment. Dated: September 23, 2013 Wayne Stein, Secretary Otter Tail County Board of Adjustment i flcLi-^By: Vi Manderud - t D&S INVESTMENT CO ATTN PELICAN BEACH RESORT PO BOX 14375 GRAND FORKS, ND 58208 4375 FRANDSEN BANK&TST 1616 WASHINGTON STS GRAND FORKS, ND 58201 9446 BRADLEY T ANDERSON 2520 WILLOW RD FARGO, ND 58102 2137 JAMES H& SALLY ANN LEHR 42420 COUNTY HIGHWAY 1 OTTERTAIL, MN 56571 9404 LEVOS PRTNRSHP 3501 ELM ST FARGO, ND 58102 1131 CHRISTOPHER J & LORI K KLEVEN 4845 ROSE CREEK PKWY FARGO, ND 58104 6844 GERALD A & MARLENE NOLTE 802 28TH AVE S GRAND FORKS, ND 58201 7005 DOUGLAS & ALYSON OLSON 416 4TH ST HOOPLE, ND 58243 0 MARC A & SHIRLEY NOKKEN 305 49TH AVE SW MOORHEAD, MN 56560 6785 PELICAN BEACH RESORT CLUB INC ATTN RODNEY WILSON 62 SLOPING HILLS CV GRAND FORKS, ND 58201 7953 STEVE C & CATHERINE SPICER 2184 12TH AVENE EMERADO, ND 58228 9723 LYNN P& FERN LSKABO 4312 MOURNING DOVE DR NAPLES, FL 34119 8869 RICHARD & BEVERLY STURLAUGSON 50461 FISH LAKE RD DETROIT LAKES, MN 56501 9446 EMMASTREYLETST 3645 PIERCE STS FARGO, ND 58104 7564 JAY P& STACEY SSTIBBE 2315 ROSE CREEK BLVD FARGO, ND 58104 6881 TNS PROPERTIES II LLC 4401 MAIN AVE W PO BOX 2044 FARGO, ND 58103 1010 ROBERT A TYLER ETAL 1461 BUTTE RD PRESCOTT, AZ 86303 4927 TNS PROPERTIES LLC 702 13TH AVE E WEST FARGO, ND 58078 3304 DUANE & WINNIE ULSCHMID 50495 FISH LAKE RD DETROIT LAKES, MN 56501 9446 i Department of LAND AND RESOURCE MANAGEMENT OTTER TAIL COUNTY Government Services Center - 540 West Fir Fergus Falls, MN 56537 PH: 218-998-8095 Otter Tail County’s Website: www.co.otter-tail.mn.us 06/23/2014 Gerald A & Marlene Nolle 802 28th Ave S Grand Forks ND 58201 7005 RE:Primary Owner: Gerald A & Marlene Nolle Inspection on Sewage Treatment System Servicing dwelling located at: 50471 Fish Lake Road Tax Parcel Number: 17000100130000Permit Nbr: 22751 Lake: 56-786 Pelican This is to inform you that an inspection was made on the above mentioned Permit. At that time we could not complete the inspection and approve the system for use, for the following reasons: □There was not a visual alarm on the lift station There was not an alarm on the holding tank There was not a dwelling onsite The non-comforming sewage system had not been destroyed □There was not a well onsite The installer had not completed the air test Miscellaneous Our office has not received the Well Abandonment Certification □ □□□□ CC/INSTALLER: Hough Inc. P. O. Box 2 Detroit Lakes, MN 56502 Please contact our office for a reinspection of your sewage system when the alarm is installed. Approval of the system cannot occur until this matter is resolved. \ Mark Ronning Inspector M- /I'. ; - 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.us i WHITE - Office YELLOW -L&R Inspector PINK - Owner/ Contractor (after issue) I! Permit No.APPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED TWP NO.RANGE ' TWP NAMESECTIONLAKE/RIVER CLASS ^ ^ jin i'^ii'"'42- E-^il ADDRESS OR DIRECTIONS FROM NEAREST PUBLIC ROAD V'l OOo ^co i>Lr‘ , ^alDESCRIPTION pp,Mvw co^ lo, s (itt, £. 60.41 ^ To ^ vV : fi-H LWL I^o.co4.^g', 7oW( W fife ttfc, rv <-><■, tIcY AU» lK 10 ‘-4 6lM -ykffi £>eli £ Er fch, ^ 9^ IaI LAKE NUMBER jjAKDRIVER NAME PtLlCA^i/ ]1/'txMU 5 5 PARCEL NUMBER (S) OF PROPERTY BEING SERVICED V 1! :: i. Daytime Phone No.Mailing AddressFirstInitialLast Name Soz A/L.!L Property Owner ^ hc4-^______bFJi^c.rr MN 5^^:TCZ csJiSi-i^ \\AC ZlContractor . Lie. # [/ no (KT- 0f.-<7/M4!■ THIS SPACE FOR OFFICE USE ONLY •pY' (VrM 'PV i%4 \'.c?0 A.M. P.M., the year of at.>■ This System will be ready for inspection on Dateideceived 'Time Received ^aP.M. L&R Official 7 SEWAGE TREATMENT SYSTEM DESIGN DATA AS SHOWN ON DRAWING TYPE OF NSTALLATION (circle ONE) Other Est. (E) New (F) Repiacement CollectorResidential ])ft) New (B) Replacement (C) New (D) Replacement Soil Treatment . Area LiftTank Effluent Distribution ( ) Gravity ( ) Pressure Design Flow (Gallons/Day) 4G1 1 — 2,499 (H) 2,500 — 4,999 (I) 5,000 — 10,000 ;y \2‘700’f,GlS\■,Size \ySetback To Nearest Weii AFt.Type I Type 11 /t(27) Rapidly Permeable(20) Trench, Rock /Ft.Ft.Setback To OHWL(28) Flood Plain(21) Trench, Gravelless i (29) Privies(22) Trench, Chamber HA- n s-)A Ft. Ft.Setback To Bluff(30) Holding Tank ('-.Q Monitoring/Disposal Contract (23) Bed Fi'\ Ft.(24) Mound Ft.Setback To Dwelling rftType III(25) At Grade Setback To Non-Dwelling H>c fy \Ft.(31) Other/Problem Soils/<12" Soil(26) Grey water ifType IV y /Setback To Nearest Lot Line Ft.Ft.Ft,, (32) Public Domain & Proprietary Technologies Deptli of Well \IIz Setback To Road Right-Of-Way /Ft;y Ft!* I ’ yType VTotal # Bedrooms 7■7 /(33) Performance Elevation Above Restrictive Layer K\^ Ft.\L Ft.Ft. ■Garbage Disposal Y / 1MAbatement Y / ' N PERC TEST DATA Highest Rate{f-tAf ~7lD K/VDate of TestLicense ItDesigner Agreement: The undersigned hereby makfes 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 otsix (6).maiiths. 2.This p^mit does not inciude the buiiding sewer (sewer iine)./ _ o'- mPermit Fee $C>lDateiZL Signature of Property Owne^^er^^.^i^^_ — fiy-F'O A Rec. No..Date; Land i Resource Mafiagement Official Comments: .SCANNED Form No. BK — 07-2011-06 Iww* bkI 345.197 • Victor Lundoon Co.. Printors • Fergus Falls, Minnesota f 't SEWAGE TREATMENT SYSTEM PERMIT INSPECTION RESULTS Inspector must make all measurements SOIL TREATMENT AREA HOLDING SERTICTANK OUTHOUSELIFT TANKCATEGORY 3Capacity FT2FT2GLS. GLS. FT FT FTFTSetback from Nearest Well Setback from Buried Water Suction Pipe FT FTFTFT Setback from Buried Pipe Distributing Water Under Pressure FTFTFTFT/O > P-0Setback from OHWL (lake &/or river)FT FT FTFT FT FTSetback from Bluff FT FT FTSetback from Dwelling /O FT FTFT FT FTSetback from Non-Dwelling FTFT FT FTSetback from Nearest Property Line FT FTfO I FT FTSetback from Right-of-Way FTFT/O FT FTElevation above Restrictive Layer FT FT 0Holding Tank/Lift Alarm YES Old System Pumped & Destroyed NO TRENCH REDUCTIONSOIL TREATMENT AREA CALCULATION MOUND / AT-GRADESEPTIC TANK(s) # Tank^nstalled FILTER ROCK BED Rock trenches with Inches □ YES ^ NO anuf.of sidewall for.%Ft.Ft. X Ft.Ft. X reduction / equivalent to Soil Treatment Area. tP Model #Ft*Ft* IInspectors Comments:bd-. QIC ' pfZAU>lfiJC^ Sketch: Ao iVJ 'HI o iLQ] -i I © /J/r \ Initial / L & R OfficialTime ., the above described sewage system installation was found to be compliant with the provisions of the SanitationAs of Code of Otter Tail County. Lana i Rasourca Management Official Form No. BK — 07-2011-06 345,197 • Victor Lundoof) Co., Printor* ■ Forpuo FoJIo, Mlnnotola 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) APPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED Permit No. LAKE NUMBER ^KE/RIVER NAME LAKE/RIVER SECTION TWP NO. RANGE , >''^TWPNAME E-911 ADDRESS OR DIR^TIONS FROM NEAREST PUBLIC ROAD Ur- frs- i>tr- LK, PARCEL NUMBER (S) OF PROPERTY BEING SERVICED t^OOo'tt) I^OOOD l/ ^AL DESCRIPTION P7-, CtM MW /O, fc ‘HI 9 (£ fc\3.4 I TO VV CM ZOWf M AU, jO tUrimShX. C&s, e ^ ^ u Daytime Phone No.First Initiai Maiiing AddressLast Name BOZ A/£^iProperty Owner Contractor | Q i~ Lie.#// ' ^ _________MeI r/O - IKT- THIS SPACE FOR OFFICE USE ONLY A.M. P.M., the year of at.► This System will be ready tor inspection on A.M. P.M. L&R OfficialTime ReceivedDate Received SEWAGE TREATMENT SYSTEM DESIGN DATA AS SHOWN ON DRAWING TYPE OF NSTALLATION (circle one) Other Est. (E) New (F) Replacement CollectorResident!^ >fi New :X (B) Replacement (C) New (D) Replacement Soil Treatmen] \ Area j LiftTank Effluent Distribution ( ) Gravity ( ) Pressure Design Flow (Galloi^Day) 1 — 2,499 j (H) 2,500 —4,99® (I) 5,000 — 10,000 2ff00‘t-GJSize Setback To Nearest Well ■t.■t.Type IIType I (27) Rapidly Permeable(20) Trench, Rock ~H&r'Ft.Ft.Setback To OHWL(28) Flood Plain(21) Trench, Gravelless (29) Privies(22) Trench, Chamber HA-T-tA-Ft.Ft. Ft.Setback To Bluff(30) Holding Tank ^7 Monitoring/Disposal Contract (23) Bed 1^ X(24) Mound I , Ft.Ft.Setback To Dwelling Type III(25) At Grade Setback To Non-Dwelling Ft.Ft.(31) Other/Problem Soils/<12" Soil(26) Greywater Type IV Setback To Nearest Lot Line Y-zo'jy [t.it.Depth ofWefi X Total # Bedrooms /f 7 (32) Public Domain & Proprietary Technologies Setback To Road Right-Of-Way FI FIType V LiZ) Performance Elevation Above Restrictive Layer Ft. Ft.EE ^ Garbage Disposal YAbatement Y / PERC TEST DATA Ha*770 Highest RateDate of TestLicense #Designer Agreement: The undersigned hereby makts application tor 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 Offer Tail County, Minnesota. This permit may be revoked at any time upon violation of the Sanitation Code. SCANNEDNOTE: I.Thls permit is valid for a peridH ef aiit (Of m>^s. 2.This f^rmit does not include the building sewer (sewer line). 27./yF2QiH Permit Fee $Date: S/pnafure oi Property Amu uLand & Resource Mshagement Official /m32>a Rec. No..Date: Date Stamp MBEMai APR 2 3 20I4 LANOAIffiSOURCE Comments:RCCOVED APR 3 0 2014 LAND & RESOURCE L&R InitialForm No. BK — 07-2011-06 . 345,197 • Victor Lundsen Co.. Printers • Fergus Falls. Minnesota -■-r — :■•'I -'' r ---. SCALE DRAWING FORM!I ... .... ^ -J Tm . :Q \1 ooc) loo II oooo r Tax Parcel Number(s)I The scale drawing must be a signed drawing which Includes and Identifies a graphic scale (feet), all existing and/or proposed structures, septic tanks, draintields, iotiines, road right-of-ways, easements, OHWLs, wells, wetlands, topographic features (i.e. bluffs), and onsite impervious surface calculations.;! ^ ^ .cS %I su. = I f 4, Scale % Impervious Surface Ratio (Must Complete Worksheet On Other Side) . :T I . I . .1-r:J'l;: :! 1,; t j- !- I ' ' .. I-,..;. .;-j "I r“j r*j" T- -f "T j 11 jxl ;.--I ...r.i ■ r 1. ^ ..J. — j-iH I ■ i-r. |. ^ I -I V/I f - * •j-’r• J i i ■T'i -'t rn Tl !bit l ' ■ ■■—^'-4o;so;.ft. ' I- -;I '■['iT 1 4. . • . . . ---. . I I j . . f. ... ,.... - i - f-..I .:/6 "I ■i..t.,... |..j nrl ! ! ' • . ..! 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' Signature of Property Owner I i I -----------►■; j Date • Vlcto^ Lundtan Coj. Printara 1; ,1.:• Famut PbUs. MN » l-e0O'346-4e704l3etB9BPIT i_ nono I'/SITE DATA WORKSHEET LAND & RESOURCE MANAGEMENT, COUNTY OF OTTER TAIL GOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS FALLS, MN 56537 218-998-8095 www.co.otter-tail.mn.us Sewage Treatment System Permit # I OWNER: K\qL-TE-Z/8 “79/ /£z^ /.ASr MIDDLE TELEPHONE NUMBER ADDRESS: p^vCtat4 \ LAKE NAME iHD> ^ftzol- STR./RT CITY STATE ZIP CODE 'TbC.ih M-2- LAKE/RIVER NO.SEC.TWP.RANGE TWP. NAME LEGAL DESCRIPTION:SOIL BORING LOG COLOR & MUNSELL NO. DEPTH (INCHES)TEXTURE STRUCTURE BLOCKY PLATY PRISMATIC NONE n OOP loo i^oop 2[PARCEL NUMBER BLOCKY PLATY PRISMATIC NONE E-911 Address or Directions From Nearest Public Road *7 NUMBER OF BEDROOMS BLOCKY PLATY PRISMATIC NONE <n22>GARBAGE DISPOSAL: YES nIIoDEPTI^O ft. SEWER LINE SEPARATION?*^ ft.WELL: CASING BLOCKY PLATY PRISMATIC NONE FLOODPLAIN: YES BLUFF: YES VEGETATION: AQUATIC ERRESTRIAL BLOCKY PLATY PRISMATIC NONE SLOPE AT INSTALLATION SITE:__t % TYPE OF OBSERVATION: Probe Pit Boring PARENT MATERIAL: Till Outwash Loess Bedrock Alluvium ORIGINAL SOIL:Yes No Date of Soil Boring. COMPACTED SOIL: Yes No HA:DEPTH OF BORING (To T 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 RATE START START TIME DROP PERC TIME DROP PERC TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATE TIME INTERVAL (MINUTES!WATER DEPTH WATER DROP PERC RATEREFKlREFIU TIME DROP PERC TIME DROP PERCR^ WATER DEPTH \ WATER DROPTIMEINTERVAL (MINUTES)PERC TIME INTERVAL (MINUTES!WATER DEPTH ER DROP PERC RATE 1REFILL . y. REFILL TIME DROP TIME DROP PERCTIMEINTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATI (MINU WATER DROP PERC RATEAREFILLREFILL TIME DROP PERC TIME DROP PERC!TIME INTERVAL (MINUTS6I WATER DEPTH WATER DROP PERC RATE *■INTERVAL (MINUTES!WATER DEPTH WATER DROP PERC RATEREFILLREFILL TIME DROP PERC TIME DROP PERC INTERNAL (r/NUTES)TIME WATER DEPTH WATER DROP PERC RATE TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATEREWLLREFILL TIME DROP PERC DROPTIME PERCTIMEWATER DEPTHINTERVAL (MINUTES)WATER DROP PERC RATE TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATEREFILLREFILL TIME (3ROP PERC TIME DROP PERC TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATE TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATEREFiaREFILL -r---------- =TIME DROP PERC IME DROP PERC PROPOSED DESIGN: TRENCH BED.ATGRADE.MOUND.HOLDING TANK GRAVITY DIST.PRESSURE DIST. SEWER LINE.OUTHOUSE.OTHER.SPECIFY:________________ — SYSTEM DESIGN ON BACK — r T i i t;•i1 I i!;«i i-:iSystem design must bp to scale and must include the proposed location of the sewage system, a I 'existing/p^oposed ibuildingsi property lihes^ the drdirjiary^ high water level of; the vvater body, wetlapds, ~^~bluff4an:d-all-\yater^we|ls-vvithin-450>~of-the-sewage-system.-lf4here-jaTe-ahy-jquesti6tijSi4see|theUhiyersity-- ! jdf! Miriridsota Site Evdiiation worksljeets. ! ! H ! j ; ■ i -1 .j,I 1I !■ ii■ I equals i 1I IIIi!L^feet, or Jneh(es)U_grid(s)i equalsScale:!_feet I. ...1!!I 17^I i1 i:rr;j cUoiex-—i-1 MPCA LICENSE #: License category: .! rt'^-1 ,.. ,L i-ti , I "f i" I DESIGNED BY: ; ■ ; - ......................: *• | FIRM NAME: ADDRESS:! I ■' L |„ ,j -; .. i; 1 i . j ; -.| - — ! —•• ■ ■ '■ j ’■■■■ - > ;.r’/r-'-'r:..[.n...n......r"; ... ; i-;T ; If;; I iI m 0-. (NcGFL)£rL-US ■ V.......:...........'..................: .,.,i...Iql' -■■n-'-I.....; ■: ■: | 1"i IIa-I DATE:} i I' 1I1SIGNATURE:I r ■fI"I__4_I'r IL i i’rr~!,i !1 T'I I...... ;_Li.1"I !t .■ i II i'I....!'";r •f--I "I;■!i'■I I ;;Ii'i.4 I f'"T‘ I i-1"f'L:i-i 1i•I-i r(■T--ry[r^ "■ i' !t... .|i r .:.1 1 T.I4- I I...Ii1rrrT!iI •I:J.!i 1-1 ,;i [I 1 ; i -■n~rt ..i J.l'I I4- t ri 4 - ..4 I 4-...1.j......... J !t_.LiLi-"! .^4"I'[i,,..i 1 iI !ii I"I i-1 !.i ..u ;I !.i ■I5!1-....u.ii'I t iI!.! 1 ii ]■■■ i.::-;TL.I 1::.t.riIitn"t I1L.tFF-n T"1 iIiI1'f.T.:t [-,1 I.f T fIi. 1 !r.Ji:I !I ,1 Ii-!ii 1 I-rs !'s <i I.r ;f i ;; ri-I..f I •I-• i r[!.| FergusfFaMs, MN '• l-800-346'4870 ! I ■t1 ] 1I! . „L ^.1: ,.i..L .:. . Lundeen Co'.. Prin■" t--nn.(BK - 1003 - 029 i 315,904 • Victor ters •.rr [1 i