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HomeMy WebLinkAboutAcorn Acres_32000170128000_Septic System Permits_1 rl■Iwi 2iN-r x\*%&afea3&SrBa B8»y-~<i3 j^-. VJ t\>'li('i /<■ jCERTIFICATE OF APPROVAL SEWAGE SYSTEMm 1 •'-'4 s J:This Certificate has been issued this 1ST of FEBRUARY that the sewage system installed as per Sewage Treatment System Permit Number 11655 has been approved for use by Otter Tail County, Minnesota. , to certify 7?r fe:.mWl:\i»iThe property served by this Sewage System is legally described as: UNPLATTED LOTS 2 & 1 EX TRS Parcel Nijmber(s): 32000170128000 Section: 17 Township: 137 Range: 040 Township Name: HOBART TOWNSHIP Lake/River Number: 56-360.2 Lake/River Name: ROSE,L ROSE (MUD) giT Lm.m (ROSE RIDGE RESORT)ii mm piK.,-vi&2| li wl Current Property Owner: ROLAND D & BARBARA J OLSON Number of Bedrooms: * 13 CAMPERS li p-gPHI-TANK & LIFT WITH DRAINPIELD (6 CAMPERS & SHOWERSHOUSE) PHII-HOLDING TANKS & SEPTIC TANK <7 CAMPERS) I' Land & Resource Management Official m r/i\^1 ■?s 7^■i’ F:l 284.709 • Viciot Lundeen Co.. Printers • Fergus Falls, MN ■ 1-800-346-4870 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 )Yes C^) ^ ^ I S3.. 5 O Permit No.LEGAL DESCRIPTION Abatement: (No AND Ros>^9j2^Sor'^LOCATION 1-^ LAKE/RIVER CLASS SECTION RANGE TWP NAMELAKE NUMBER LAKE/RIVER NAME TA/VP. NO. /-](? La^r- “h137I 7RD FIRE OR LAKE ASSOCIATION NUMBERPARCEL NUMBER(S) 3 2 'do o- n - 2 9 - Oc> o IDENTIFICATION: Please Print All Information Mailing Address — No. Street, City and Stale Zip Code Telephone No.Last Name First Initial Ao/qvi./l?l?3 fi crisisProperty Owner Sewage System Installer Name A.M. This System will be ready for inspection on , 19-at Cjkr>*-f9 ovi NUMBER OF BEDROOMS: This space for office use only /3A.M. P.M19 ) YES ) NOGARBAGE DISPOSAL: (Date Rec'd Time Rec'd Phone Call Rec’d By SEWAGE TREATMENT SYSTEM DATA: MINIM^REC^IREM TANK ^ ENTSTYPE OF SEWAGE SYSTEM ) l^lding tank (Alarm Required) V/^f^pptic tank ( vO Lift station (Alarm required) ( ) Drainfiefd i/fTrenches DRAIN FIELD(9PCi y/ /osz? Q's tS“o - /077 sqCapacity Ft.(■ Distance from nearest well Ft. Ft. 7S^7S'Distance from lake or stream Ft.Ft.( ( ) Bed ( ) Mound ( ) Outhouse ( ) Sewer line ZC/6Distance from building Ft. Ft. /o /QDistance from property line Ft.Ft. 3Distance from bottom to Water Table Ft.Ft. EFFLU^T DISTRIBUTION ( .yfGravity ( ) Pressure All distances are shortest distance between nearest points PERCOLATION TEST DATA: WATER WELL DEPTH ft) . IKA'Perc Tester.\ Date of Perc Test t'2^1 \ T>0Rate of 1 St 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 f^r the permit to notify the County Shoreland Management that the job is ready for inspection. V DATE: o^Ignature Permit: Permission is hereby granted to the above named appiicant 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, empioyees and workmen shall conform in ali 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 & Resou\e i ^ - I 1Issued Date:w Management Office Fee $.Rec #. pKv'^ X Wtfj lyiL (QP'::i <v( -h" Wt(t ^£yS^ •f"ti TV W I.w I ' Comments: t1 DK 0795-003 APPLICATION FOR PERMIT TO INSTALL SEWAGE TREATMENT SYS)\f[^ . i WHITE — Office Yellow — igapector Pink — Owner LAND & RESOURCE MAf^AGpUN' OTTER TAIL COUNTY COURT HOUSE Phone:(218)739-2271 - FERGUS FALLS, MN 71^i37 t cP- ^ J ^^.5 0 LEGAL Permit No. 0DESCRIPTION 'Abatement: () Yes (^ ) NoAND '*/RoSje. R\Jl Rasd'rLOCATION SECtlOtJ TIAtsISELAKE NUMBER LAKE/RIVER NAME LAKE/RIVER CLASS TWP. NO.TWP NAME V *" 3 6c / 7RD0$ PARCEL NUMBER(S)FIRE OR LAKE ASSOCIATION NUMBER 3 2 ~ oo o -f 17 - 0/ 9 ' Oo o IDENTIFICATION: Please Print All Information Last Name First Initial Mailing Address — No. Street, City and State Zip Code Telephone No. )^R3 B^5i3ar<k~Property Owner rra. z f Sewage System Installer Name 7 iphaisiX)A.M.SZ► This System will be ready for inspection on , 19 at NUMBER OF BEDROOMS: 'O This space for office use only 97 ///rP CSP2v£19 (X) NOGARBAGE DISPOSAL: ( ) YESDate Rec'd Time Rec'd Phone Call Rec'd By SEWAGE TREATMENT SYSTEM DATA: MINIMUM REQUIREMENTSTYPE OF SEWAGE SYSTEM ( ) Holding tank (Alarm Required) ( y-*) Septic tank ( 'PfLitt station (Alarm required) ( ) Drainjield ( XTrenches ( ) Bed ( ) Mound ( ) Outhouse ( ) Sewer line TANK DRAIN FIELD 7co, / /os^ sro/zGc? 7^ Capacity GIs. Distance from nearest well 5"^Ft.Ft. 7^Distance from lake or stream Ft.Ft. Distance from building 70 Ft.Ft. 70Distance from property line /<7Ft.Ft. 3Distance from bottom to Water Table Ft.Ft. ' 2EFFLUENT DISTRIBUTION ( Gravity ( ) Pressure All distances are shortest distance between nearest points A iPERCOLATION TEST DATA: WATER WELL DEPTH ft) - liQ^Perc Tester.Date of Perc Test,3 Lza I -30Rate 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 Flealth. 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. / ' V ^ •VDATE: .-^gnature 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. 3 i Issued Date: Land & Resoufap Management Office3S/7GOOO 6'CO IlW ^Fee $. Comments: ** __________-Ar JL vntf ^<1- Rec if. Will h>C A k/qoo It tf /fnirj ScA 277.212 • Victor Lundeen Co.. Printers • Fergus Falls. Minneosta^BK 0796-003 i t.INSPECTION RESULTS Inspector must make all measurements SEWAGE DISPOSAL SYSTEM STATISTICS DRAIN FIELDHOLDING SEPTIC TANK LIFT TANKCATEGORY MinimumActual 1 /{r^jrt)GLS. FT SFGLS.Capacity 36^7- ft FTFTDistance from Nearest Well Distance from Buried Water Suction Pipe FTFTFTFT50 /Q FTDistance from Buried Pipe Distributing Water Under Pressure ’/of-FTFT10 /O^ FT /d:id7-~Fi FTFTFTDistance from Lake or River (OHWL) 10/20 FTFTDistance from Nearest Building FT e;Of ft FTFT10Distance from Nearest Property Line /0-k ft FT3FTFTDistance from Bottom to Water Table NOHolding 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 .FTFTX 3^0-/- FT /(o rOFT20 SF Inspector’s Comniehts: y SKETCH: i Time of Inspection J 1« X 17 MINTXD OM MO. 1000K CLEARMIMT*7 [U1 • SiTEwoRK Construction • Onsite Sewage Treatment Systems • Demolition/Roll-Off Box Service • Snow Removal and Hauling • Landscape Restoration, Design & Construction ©OJOIHlLANDSCAPING, INC. Onsite Sewase Treatment System Design Data Rose Ridge Resort Vergas, MN Septic Tank Requirements: Estimated (Maximum) Daily Flow; 6 campsites with central bath (100 gpd) = 600 gpd total Sizing Formula: (600*.75)+l 125 = 1575 gallon (minimum) septic tank capacity required \Pesigned Septic Tank Capacity: 2000 Gallons Drainfield Requirements; Estimated (Average) Daily Flow *13 Campsites with central bath (100 gpd) = 1300 gpd total Sizing Formula: 1300gpd* 1.27 (soil sizing factor) =1651 s.f drainfield required or 551 l.f 10" graveless pipe. \Designed Drainfield Area: 640 if. 10" graveless pipe - 1920 s.f. Other System Components: Lift Station Size: 1000 gallons Pump Size: .50hp Meyers (45 'total dynamic head @ 35 gpm.) Pressure Line: 2" Sch. 40 Pressure rated and tested Gravity Line: 4" Sch. 40 (pressure tested) Notes: The campground sanitary system is planned to be constructed in two phases: one phase will be complete in Fall '97 and the other phase sometime in '98. The drainfield is sized for the entire site development. Our intentions are to basically set up two separate tank and lifts station systems with a common drainfield. In reference to the accompanying site plan, sites A,B,C,D,E, F and the shower house will be sewered in the '97 phase. Sites G,H,I,J,K,L,M will be sewered in '98. System Designed By: Michael Hough MPCA D-l#770 Hwy. 59 North □ P.O. Box 2 □ Detroit Lakes, MN 56502-0002 □ 218-847-7391 □ Fax 218-847-2380 PUMP SELECTION PROCEDURE A. Determine pump capacity: Gravity Distribution 1. Minimum suggested is 20 gpm 2. Maximum suggested is 45 gpm Pressure Distibution X 3. a. Select number of perforated b. Select peritoration spacing^?^______c. Subtract 2 f\from the layer length. / feet. ler of spaces between perforations. ft. +_______ft. =____spaces _ perforations/lateral f. Multiply p^orationSsner lateral by number of laterals to get totaj^mber of perforatioi^. x =----gpmX Perforation Discharges in GPM feet.Head Perforation diameter finches)(feet) - 2\ =7m 1/4RixJi layer lengthd. Determine the l.Oa 0.56 0.741.5 0.69 0.90Length perf. sp>« =2.0b 0.80 1.04e.spaces = a Use 1.0 foot single homes, b Use 2.0 feet for anything else.perforations.peris/uieralS- SELECTED PUMP CAPACITY gpm Soil treatment sys^.r-.B. Determine head requirements: 1. Elevation difference between pump and point of discharge. If pumping to a pressure distribution system, five feet for pressure required at manifold if gravity system, zero. feet feet Total pipe length 2. pipe PI Elevation Di^erenceiFriction loss a. Enter friction loss table with gpm and pipe diameter. ||........ Read friction loss in feet per 100 feet from table (F-14). F.L. = ft./100 ft of pipe b. Determine total pipe length from pump to discharge point. Estimate by adding 25 percent to pipe length for fitting loss, or use a fitting loss chart (F-15 Equivalent pipe length -1.25 times pipe length = X 1.25 = feet c. Calculate total friction loss by multiplying friction loss in ft/100 ft by equivalent pipe length. ,Total friction loss = x _!^^^Q_+100 = Total head required is the sum of elevation difference, special head requirements, and total friction loss. 3.T>1 Friction Loss in Plastic Pipe Nominal pipe dia.feet). Flow Rate gpm 1.5"2"3" 20 2.47 0.73 0.11 25 3.73 1.11 0.16feet5.23 1.55 2.06 30 0.23 0.304.35 6.96 40 8.91 2.64 0.39 45 11.07 3.28 0.48 (2) ^3c) dliMfeet 55 50 13.46 3.99 0.5S 55 4.76 0.70(1)60 5.60 0.82 65 6.48 0.95 70 7.44 1.09TOTAL HEAD C. Pump selection 1. A pump must be selected to deliver at least (Step A) with at least 4^ feet of total head (Step B).gpm Hough Landscaping, Inc. POBCX2Detroit Lakes. MN 56501 1 V. Onsite Septic System Site Evaluation/Design Fire Number Tax Parcel Number Legal Description: 1 .ake/Stream Class Section TWP JBJUtge.Township Name1 .ake/Stream Name Phone NumberProperty Owner LAV<-e- - City. Sliile. Zip CotieAddress goA iin y^i--Zj>Uo License Number Address 7eAbV CX/iqH ISTS Desipner 1 / Designer I.Phone Number v/grtu.KK Site Plan The site plan must be drawn to dimension or to scale: *Soil Boring & Perc Test Locations ♦Dimensions of Lot ♦Tank Access Route ♦Scale - One inch = ♦Existing & Proposed Buildings ♦Easements ♦Distance from Water Lines within 50 ft of System(existing & proposed) ♦Distance from OHW ♦Distance from Property Lines ♦Location of any Unsuitable Disturbed/Compacted Soil ♦All Wells within 100 feet of the System ♦Distance from all Wells within 100 ft of System ft SOIL INFORMATION „ TEST HOLE #2TEST HOLE H1 ^ DEPTH IN a INCHES DEPTH IN INCHES STRUCTURE SOIL TEXTURE MUNSELL COLOR SOIL MUNSELL COLOR STRUCTURE TEXTURE BLOCKY PLATY PRISMATIC BLOCKY PLATY PRISMATIC BLOCKY PLATY PRISMATIC BLOCKY PLATY PRISMATIC IdaiHiji] BLOCKY PLATY PRISMATIC BLOCKY4Av^v/,PLATY PRISMATIC24,(OVfS.m BLOCKY PLATY PRISMATIC NONE BLOCKY PLATY PRISMATIC NONE Depth to standing water Depth standing water to Ai\ Depth I mottling Depth mottling toto vHAr Describe the surface features (slope, runoff, weather conditions, vegetation type, evidence of compaction, etc.) (•(f^^VITY FLOW ( ) PRESSURE DISTRIBUTION DEPTH OF SYSTEM ([ O SYSTEM DESIGNNEW { ) REPAIRSYSTEM IS NUMBER OF BEDROOMS NUMBER OF BATHROOM TOTAL SQ. FT OF STRUCTURE WATER USES:% SYSTEM DESIGN FLOW I'^o^-g/^^PD( ) washing machine (■ ) DlfltlWAQlIER^ ( ,.) WATER SOFTENER (.) GARjaAGE DISPOSAL SOIL SIZING FACTOR j • Z-T;ZrXiO l^ifOO) \ r)C) LaiA^AJcji^ so FT TANK SIZE PUMP SIZE LIFT STATION SIZE SOIL TREATMENT AREA SIZE______ DOSE VOLUME Tvpp-er REGiDraiCE LENGTH OF LIFT LINE 2.1Q («)-TYPfcII( ; 1 Ire I (' )T7PKTv TOTAL DYNAMIC HEAD(“ J I K Pb'lIT / TYPE OF WELLWELL INFORMATION-Property’s Well DEPTH OF WELL Type of WellsNeighboring wells (within 100 ft of system) Depth of Wells Date of Site Evaluation ^ 7 Phone Name of Designer l\ Designer II 847--73q/-rH)MPCA Number I certily that the site evaluation has been completed in accordance with all provisions of ISTS Minnesota Rules Chapter 7080.r y 7DateSignature of Evaluatoi /For Office Use Only Received byDate Site Evaluation / Design received Approved byDate Site Evaluation approved INDIVIDUAL SEWAGE TREATMENT SYSTEM WORKSHEET FLOW X 1.5= __ Esiimated Sewage Flows in Gallons per day (gpd)gpdEstimated measured A.Number Typel Type U TypelUgpdof Bedrooms^ SEPT/ z^iooojIC TANK VOLUME ____gallons2ooQB.3002 225 180 60%3 450 300 218 of the6003752564valuesSOILS (Site evaluation data) Depth to restricting layer = _____ Maximum depth of system C - 3 ft = Texture /iM Percolation rate ^ ‘ SSF \‘Z-7 sq ft/gpd Slope 1^__% 5 750 450 294 in6900525332Typel.c.feet 7 1050 600 370 Dorfeet81200675D.408 01 columnsMPIE. F.Septic Tank Capacities (in gallons) G. Number of Bedrooms Minimum Liquid Capacity Liquid capacity with garbage disposalTRENCH BOTTOM AREA 2 or less 3 or 4 5 or 6 7. 8 or 9 750 1125For trenches^vyifK" 6 inches of rock below the pipe: sq ft of bottom area For trenches with 12 inches of rock below the pipe; X 0.8 =____sq ft of bottom area For trenche^s^^ 18 inches of rock below the pipe: X 0.66 = H.1000 1500 1500 2250A x/F =2000 3000I. A X F x\p.8 =Soil Characteristics and Required Areas for Sewage TreatmentJ-Percolaiion Rate in Minutes per Inch (MPI) Square feet per gallon per day sq ft of bottom areaA X F x 0.66 =Soil Textureck below the pipe: 6^ sq ft of bottom area For trenches with 24 inches A X F X 0.6 = K. Faster than 0.1 * 0.1 to 5 0.1 to 5 6 to 15 16 to 30 31 to 45 46 to 60 Slower than 60*** Coarse Sand Sand Fine Sand •* Sandy Loam Loom Silt Loam Clay Loam X 0.0.83 BED BOTTOM AIUEA For seepage beds with 6 or 12 inches of r^ck below the pipe; sq ft of bottom area 1.671.27 L.1.67 2.001.5 X A X F = 1.5 X 220Clay * Soil too coarse for sewage treatmenL Use systems for rapidly permeable soils. ** Soil having 50% or more of fine sand plus very fine sand. ***Soil with too high a percentage of clay for installation of an inground standard system. ROCK VOLUME IN CU Rock dej^ below distribution pipe plus 0.5 foot times bottom area: 7M =Rock depth + 6 inches x Area (H,IJ,L,K) CU ft M. (____+ 0.5 ft) X ROCK VOLUME IN CU YDS 7Volume in CUN. CU ydsM + 27 = CU yds ROCK WEIGH 6 inches= 0% Reduction’*' 12 inches= 20% Reduction 18 inches= 34% Reduction 24 inches= 40% Reduction * sizing for gravelless trench Cubic yards times 1.4 = tons N X 1.4 = tons _ O. X 1.4 =tons SYSTEM LENGTH P. Select trencm^idth = Q. Divide bottom areSTtr lineal feet idth: (H,I,J,orK) + P = Geotextile Fabric iir^K m^m I 2" Rock Cover=___lih^l feet+ Ql. Gravelless Design A X F -i- ( 3 for 10" pipe, 2 for 8" pipe, width of the Chamber)4" Dist. Pipe\%nVX3^LAWN AREA Select trench spacing, center to center = Multiply trench spacing by lineal feet R x Q = sq ft of lawn area sqft feetR. S.6-24" Rock 3/4-2 1/2" X If the site evaluation determines a mound system, please attach the mound design worksheets.18-36" Width (- PERCOLATION TEST SHEET -- PERCOLATION TEST SHEET - r^of Date test hole was prepared: Oij 71 Dace test hole was prepaxed:.Test hole location Depth oi hole bottom: Soil Data from test hole: Test hole location Depth of hole bottom: Soil Data from test hole: Hole «Hole i Li[Le inchesinches Diameter of hole:inchesDiameter of hole:inches depths inchesdepth, inches soil texture t wr> soil texture:soil color .p(Lt ftg-OUl-1feeY Ui4t1 Q- Method of scratching sidewall: j Date and hour of Initial water fUling: Method used to maintain 12" of water oep^ in hole for 4 hours: Percolation test conducted by; Maximum water depth above hole bottom during tesh tching sidewall: Depth of pea size gravel in bottom of hole: Date and hour of initial water filling. J^ Depth of initial water filling Method used to maintain 12" of water depth in hole for 4 houM: (M ^ Percolation test conducted by; V*A ^npV.X-^ 4" Maximum water depth above hole bottom during test: Depth of pea size gravel in bottom of hole; Depth of initial water filling / inchesMethod of serainches I2-'>above hole bottomabove hole bottom iiOPercolation test started atPercolation test started at inchesinches conversesconvefiioftsWATER DROP (doclmal) WATERDROP (doctmal) WATER DROP (fraction) WATER DROP(fraction)PERC RATE CALCULATIONPERC RATE CALCULATION WATERDEPTHWATER DEPTHINTERVAL(MINUTES)INTERVAL(MINUTES)TIME TIME 1;16 r X1/16 r.06 '5}ikW 12-^ (Oecim»l)(Du 7^2-t.Ss.:3€i;s:.i38.0 7:14..STARTSTART .K}y:-W-..AD...ai6:.19 IQ \o XI.V1E ■ DKOt* Pl£Ra _______________(De«.-imal> «fp TIME ■ Oi^P PERC/r>^girr>alN m li.lLXi.I *1:4 = :•1.'4ii5 7-REFILL -li7^^..4-D-is?.TIME ROP PERC S16 S .31&'16xJl IfiI i-ife710 Jim.mc7ge>7.REFILL .ID Uz.ii13 = JJ DROP PERC rDecimal^ TIME 7.16 =.« . n=i M61.W DREFILLREFILLE> Yim£ '<o“TIME KOP PERC 'drop(OucirriKl)PERC Wsi 9/15 s.569/16 sio e:e:REFILL REFILL DROP f Dec>fr>»0 DROP(Decim»l> TIME PERCTimePERC i3=.a13 = .53 FFREFILLREFILL 11/16 :.:i11/16 = 39 DROP (Ducimal)DR'(Dcci PERCTIMETIME OP PERC i'4 s .75a’4 = .75 cGREFILLREFILL TfS/lE •RO^ pEAC ■ DR' (DeciOP PERC im»n 1116 :i1Ttme 1116 = J1 Ut.li7/8 :i8 HREFILLREFILLH TIME 'PERC lSl6:i4 TIME ■ DROP(Decimal)Lmop(Decimatl)PERC 1S16 = 34 TeivE^rcent Calculation *T«:ent Calculation * B.C.D B.C.D of Au<_' S«v»Mll«at 3* OT I.rC> H OI UiJLJ TTD"A* €»i ul:dnre 5t«ni Wot IIUUVi M o.ao •K 0.10 m O.SU Mm U. ■(» .a»rRon«»t 3»Vjf nr"DSm«« I l»«n U nr ll't 1 L>C.D.E O.E.FO.E.F C.D.E F-”c""CDB EtarRM* 3* uCFfeaaritwt 40 of U fc F SrRtiRlIa^l R*r UL!l't* of CD Smasll. 3W or DEbfwvollos* 4* or CD SVTROir Eorwaat *t or R 0.10 ••H o.ao o K 0.10 oK 0.11» m h>rniR OI iTl-.l-a»*«»oH««( 4tl Of CDE.o «»t IJE.F.G F.G.HF.G.H E.F.G a>«T»oiiMt m or EKO» or KFG ^ of Sm< m 0.10 —m 0.10 o a u.ao or U.1C» o ^ OI F <.i • I S»VF»oll< a»i»»on«—« *1 or teFc a»n»ou«wn or fca-O * If the top number In each set of boxes is larger than the bottom number then take an the top number is equal or smaller than bottom number, average the three numbers fo. l.xPj-f A27 i iz7^_ top number in each set of boxes is larger than the bottom number then take an number is equal or smaller than bottom number, average the three numbers fo• If the the top oiner reaoii r the perc r ng. If ate.other read r the perc r ng. If 'ate. /•‘ :h jOf /• HpiC'/ZL X si:c; /km ijS^.. .M^ . S^' .r^v^/ />t:-\ SSL.',} m>. yro'w r-L- / CERTIFICATE OF APPROVAL SEWAGE SYSTEMa' m\ %K MlgThis 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 Tail County, Minnesota. day oflUk RcnimtuzJL 19 99 ■1 I* Wit. m M L The premises covered by this certificate are legally described as: Twp. Name HohaJit& ^Twp. mLake No.Range 40Sec. _11 fc- ri Loti, / g 2 ex Vu,mi '1 m CnPovrrl p HP Ann f, Rnfihafta T. hln.t7hpMg Of AnnfiCiOwner: Name ms.MTfiazzz, MSIAddress m bbb44Zip No. ’'mi Permit No. SP S9g3 pSigned by: Land & Resource Management OfTicial OUcr Tail County. MinnesotaMKL-0987001 1 '■■3 mm■f.ig JT-263191 Victor Lundecn Co.. Prinim, Fergus Falls, Minnesota / SHORELAND MANAGEMENT — COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone 218-739-2271 • Fergus Falls, MN 56537 APPLICATION FOR PERMIT TO INSTALL SEWAGE DISPOSAL SYSTEM White — Office Yeflow — Inspector Pink — Owner /ZcKSE.Permit No.LEGAL 3Z.~a£iO -/7~<D/Zfi ~DESCRIPTION ^OO. C^oTS / V 2 Parcel Number AND /Z.V ■/2cstr Aa/ir’e /-/o8ax.7~ao/7 /37LOCATION Lake No. Lake Name Lake Classif.Sec.TWP TWP NameRange IDENTIFICATION: Please Print All Information. Mailing Address — No, Street, City and StateLast Name Tel. No.First Initial Zip No. (DtLSo/V £~3 3ck /-/MZes-. NOWNER SEWAGE SYSTEM INSTALLER Name JL/JirO/J <!(. ^ This System will be ready for inspection on., 19. This space for office use only 19 Date Rac'd Time Rac'd Phone Call Rac'd By NUMBER OF BEDROOMS; SESTIMATED COST: SEWAGE DISPOSAL SYSTEM DATA: SEPTIC TANK SEEPAGE PIT DRAIN FIELD r. N3'*/ SoO GIs.I Ft.Capacity Sq. Ft. <o/)£>V6oFt.Ft.Ft.Distance from nearest well Ft.Ft.Distance from lake or stream Ft. w Ft.Distance from occupied building Ft.Ft. iP.Distance from property line Ft.Ft.Ft. 3Ft.Distance from bottom to Water Table F Ft. Ail distances are shortest distance between nearest paints (a I io(a 13,3^ = ii ii II..PERCOLATION TEST DATA: fZ>6i>V Date of First Test 19 , 19....!.' Rate Date of Second Test , Rate ^s| Taka/I By /f First Test + 2nd Test...2 Rate2nd Test Taken By The undersigned hereby makes application for permit to install or extend Sewage Disposal System herein specified, agreeing to do all such work inAgreement: strict accordance with ordinances of the County of Otter Tail, Minnesota and Minnesota Individual Sewage Disposal Code Minimum Standards set forth by Minn­ esota Department of Health. Applicant agrees that plot plan, sketches and specifications submitted herewith and which are approved by Shoreland Management Offi­ cial 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 responsibility of the applicant for the permit to notify the County Shoreland Management that the job is ready for inspection. I understand that I have been granted a sewage system site permit in accordance with the requirements of the Shoreland Management Ordinance of Otter Tall County. I understand I must contact my township in order to determine whether or not any addi­ tional permits are required by the township for my proposed project. /7 ^Signature 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 agents, employees and workmen shall conform in all respects to ordinances of Otter Tail County Minnesota. This permit may be revoked at any time upon violation of any said ordinance. NOTE: Permit void if work is not commenced within six (6) months. S,Issued Date: Land S Resource Management Office /o/a&20.00Fee $Rec # 4Comments: Form No MKL 082090 ■VCa CL 253,056 — Victor Lundeen Co., Printers, Fergus Falls, Minnesota /'^'o uV^l/aM'•v SHORELAND MANAGEMENT — COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone 218-739-2271 • Fergus Falls, MN 56537 APPLICATION FOR PERMIT TO INSTALL SEWAGE DISPOSAL SYSTEM / . White — Office Y^fow — inspector Pink — Owner Permit No.)LEGAL Parcel NumberDESCRIPTIONCo^-^ / y 2 AND /ZoS /^.OLOCATION /7 /j?7 Lake No.Lake Name Lake Clasilf.Sec.TWP Range TWP Name IDENTIFICATION: Please Print All Information. Mailing Address — No. Street, City and StateLast Name Initial Zip No.Tel. No.First .3i t I /V ^/VOWNER/( O/'l ' Ij o \T~. SEWAGE SYSTEM INSTALLER Name.I- jr■ c: L -7/1 This System will be ready for inspection on. f , 19. iThis space for office use only ■f. „?/ f-Ji? n „/A S'l Si. Date Rec'd Time Rec'd Phone Call Rac'd By tNUMBER OF BEDROOMS: ^SESTIMATED COST: SEWAGE DISPOSAL SYSTEM DATA: SEPTIC TANK SEEPAGE PIT DRAIN FIELD leop'*I. I‘I3'^3GIs.(. Ft.Capacity Sq. Ft.i<o/)dP‘So Ft. Ft.Ft.Distance from nearest well iSFt. Ft.Distance from lake or stream Ft. W 9^0Distance from occupied building Ft.Ft.Ft. IS.Distance from property line Ft.Ft.Ft. ./3Distance from bottom to Water Table Ft.Ft. AH distances are shortest distance between nearest pdints C.Li,‘i-3.5 It..iPERCOLATION TEST DATA:Date of First Test 19 Rate II It It Date of Second Test 19 ,..., Rate ■j. T^ Take;j By ft .u.First Test + 2nd Test...2 Rate2nd Test Taken'By The undersigned hereby makes application for permit to install or extend Sewage Disposal System herein specified, agreeing to do all such work inAgreement: strict accordance with ordinances of the County of Otter Tail, Minnesota and Minnesota Individual Sewage Disposal Code Minimum Standards set forth by Minn­ esota Department of Health. Applicant agrees that plot plan, sketches and specifications submitted herewith and which are approved by Shoreland Management Offi­ cial 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 responsibility of the applicant for the permit to notify the County Shoreland Management that the job is ready for inspection. I understand that I have been granted a sewage system site permit in accordance with the requirements of the Shoreland Management Ordinance of Otter Tail County. I understand I must contact my township in order to determine whether or not any addi­ tional permits are required by the township for my proposed project. i Permission is hereby granted to the above named applicant to perform tSg^work dgicribed in the above statement. This permit is granted upon express condition that the person to whom it is granted, and his agents, employees and workmen shall cdnform in all respects to ordinances of Otter Tail County Minnesota. This permit may be revoked at any time upon violation of any said ordinance. NOTE: Permit void if work is not commenced within six (6) months. Signature Permit; 7 H J4fO-H-il 5.tIssued Date: 2o,6o i "Aiand S Resource Management Office Rec # . / 0Fee $4 3U<yx TEe. jDujiJ~ Comments: ■1 I o.m-j .- *KL 062090 253,056 — Victor Lundoen Co., Printers, Fergus Falls. Minnesota . . smil ;• . » **• i - ■ . -c ■\ J: ;INSPECTION RESULTS.'♦'t Inspector must make all measurements SEWAGE DISPOSAL SYSTEM STATISTICS SEPTIC TANK SEEPAGE PIT DRAIN FIELDCATEGORYActualShould Be Actual Should Be Should BeActual tb6o !5odCapacity 5,?/3-OdQls.GIs.S F S F SF SF . ¥r /SO j-x:/50Distance from Nearest Well F F F F F F 13 7SDistance from Lake or Stream F F F F F -i',M>Distance from Occupied Building /o^3 F F F>F F F 3<^/O /oDistance from Property Line 300 F F F F F F 7 "5^Distance from Bottom to Water Table 3FFFFF F 9^ 0 f o /aJjlJ ( <?V» ^ / 7-^Inspector’s Comments: 97 ^ ^______________/5o' -rc " /yo 0,F \ \ /O-Date of Inspection /'.3nTime of Inspection :A/? ■/qI/ Sigrtature of InspectorINTERPRETATION OF ABBREVIATIONS GIs = Gallons SF = Square Feet F = Linear Feet Job Title MKL • 032085 • Bactor Agency 9 I 0‘ 0—-0 ^ iT-m. \ /• •Scale: Each grid equalsr feet/inches GRID PLOT PLAN SKETCHING FORM m yo -/19 9/Dated: Signature Please sketch your lot indicating setbacks from road rmht-of-way, lake and sideyard for each building currently on lot and any proposed structures. -0 IV tt^ . r■I X-4 . I t51 Ia 1 t 5s '■■fr ■T---------- T t f ■; -i i - (■1 i"I f\ I s-A t X./ ^t t -A-r; ■ X![ I M CSi ~ri K)r X r> ^ InI 4 I .w ' ‘X <r\I-oTf•b I S]:D X o)33/InPi •H p 01r j -r- % 2L/ r*Vk «> 21598 7®MKL-0871-029 VICtOH LUNDEEH CO.. PRINTCMS. FERCUS FALLS. WINN. PERCOLATION TEST DATA r LAND AND RESOURCE MANAGEMENT Otter Tail County Fergus Falls, MN 56537 » OWNER: TELEPHONE NUMBERMIDDLEFIRSTLAST NAME ADDRESS: ZIP CODESTATECITYSTR./RT. TWP NAMETWP.RANGESEC.LAKE NAMELAKE/RIVER NO. LEGAL DESCRIPTION: PARCEL NUMBER NUMBER/BEDROOMSFIRE NUMBER — TWO TESTS ARE REQUIRED — TEST HOLE NO. 2 6TEST HOLE NO. 13-3j:/inches:inchesinches; Diameter of Holeinches Depth To Bottom of HoleDiameter of Hole V 19 Depth To Bottom of Hole. 19DateSoil Texture DateE)epth, Inches Soil TextureDepth. Inches / 2 /?>c/CLLPercolation Test By Firm Name Percolation Test By__ Firm Name __Slfl64^44^/V _oj^ ///7< /Address Address Otter Tail County License No. Otter Tail County License No. PERC TEST # 2PERC TEST # 1 PSKCRATB Tlli«INTB»VAL<»aWllTBS>WATBRDigTH WAnan nnorPfTBtVAL n»aWUTBSl WAlTODgFTTI WATHRDKOP f^TART;^ rmiT'^BieOF fBKC”PERCRATB TIME IKTBKVALrMPIOTBft WATEBI PgFTMWAraRDBFTHjE^2.fiBSLT»I« pfrekvAL fMPfUTBB KBPILL&REFILL 7±:::^ ■ 'Hk4li~ ^ PROP P*BRd ~■f ^nMB drop” INTERVAL IMlWtrrail WATER DEPTM WATER DROP PERC RATEWATER DEPTH WATER DROP rate Ml TIM^f^fnav^i rMtwuTBR^TIME 77--:57F1.LRBFREFILL ,2.■77 44/T1KIB~ PROP P'BKC"^HS~ PROP P^SLC PERC RATE TIMH IKTBRVALOiONlTTBlI 'ATBRDBP1 WATER DROP PERC RATEIKTERVALOaiNUrEn REFILL __ WiOBR DEPTH WATER DROP W.J2feB. rbPill ^7-tt n.4 4 'IIMU DROP PERC T1HB~ PROP PERCTIMEINTERWLfl4IKinES> ..:k Water depth WATl^BflgrINTERVAL <M1WUTER>WATER DRQP PERC RATE FBRCR^ATETHigWATER DEPTH /REFILL mI’lL .2-.m 4 4 TTRE” DROP PERC IlMir t>R<^ PER<f" CRATEINTERVAL Q4tWinE«^ RBPLLL. ....iL.... PERORATE TIME /.E.INTERVAL <MIWl/TES>WATER DEPTH WATER DROP WATERPBIJH WATERTlliffi L'i -m \tviz.REFILL m > T1MU pr6R PERC^reRCRATB PrTERVALfManJTETlPnERVAL Q»flMt/TER>WATER DEPTH WATER DROP TIME W/OER DEPTH WATER FERCRAIEJQtfi. 77;IX K , ( <. L i'(^ TO4B' *pkoF~ pEkei k : n . (: ’rtvar Bnop fBRg~ ftBFH,LPILLRE W :T.TI2-_________L Water depth J1JlfiE.MJtCRATE INTERVAL fMlWlfTEA^ WATER DEPTHINTERVAL fMTWmES^WATER DRqP /MCBrtffi ’mnr^BTFaP' fBfS~S-'VtL -/XMREFILL TTTMri DROP PERC COMMENTS/CALCVLA TIONS: OTTER TAIL COUNTY DEPT. OF PUBLIC HEALTH DIVISION OF ENVIRONMENTAL HEALTH COURT HOUSE FERGUS FALLS, MN 56537 218-739-2271 1 i:- ■ PLAN REVIEW RECORD /o/ y Ay_____Date Business NameOwner (Uj>fAddress /S/- ^3 £blKJ- .5^^S~Address u /T)n'AA^ jV Type of Business N/A:Date: Permits applied for (township, city, county) Shoreland Management approval Department of Natural Resources approval Pollution Control Agency approval Plans & specifications in writing MDH approval for plumbing MDH approval for swimming pools State Fire Marshal approval /o/o42±L The plan has been reviewed for the standards of the: Food, Beverage Ordinance Lodging Ordinance Recreational Camping Area, Mobile Home Park Ordinance The plan is approved as submitted:Yes No The following items must be corrected to meet the Standards: OwnerDate /b/4/^11 Public Health Sanitarian Date 7^/(OO % ^ j>X^<x. ^ O O y^ . 75 CIS -f IICIS I} eoo ^ I -<o Jre!^oo X*. --■0-<OvXC X /•^'^ /i,/n ^r^j : /^-3-