The URL can be used to link to this page

Home My WebLink AboutFisherman's Village Resort_25000990589000_Septic System Permits_r > w ■ ■............■' fci » ^1m§Miiiill r#'. rS^S PImM m3 mm CERTIFICATE OF COMPLIANCEK SEWAGE SYSTEM One System Only lUth day n f February 1971This certificate has been issued this to certify compliance with regulations of Shoreland Management Ordinance, Otter Tail County, Minnesota. wmksi The premises covered by this certificate are legally described as: Lake No ^6-293 Sec. A PiRangeHTwp. 133 Lot & 7 Beauty Beach Pour Seasons Resort Twp. Name Everts wM lili11 mZi w- SS Tom SchmittOwner: Name.PftelRt. 2> Battle Lake. f-RTAddress.Wc4fe;fi ^6'3l^Zip No. 2199Permit No. SP_ Signed by:.CmMalcolm K. Lee, Shoteland Administrator Otter Tail County, Minnesota _______________________________________flz.Sf SSsStl £'Wi:tfS^S8583WXtf3V^^Sl MKL-0871-009 159035 Lu«6U«i 4 eo. rt»eu« »i»'< 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 W te - Office V low — Inspector Pii.. Card. V- Owner Owner Permit No.,LEGAL to -3^-7<^Date DESCRIPTION AND £d 6 1^-^ AiOsi.2.?? Os^LOCATION Lake No.Lake Classif.Lake Name Sec.TWP TWP NameRange IDENTIFICATION: Please Print All Information. Initial Mailling Address —No. Street, City and State______(2:L^ ^ (fkxXiAi- ^cJU,Zip No.Tel. No.Last Name First pjo l\/v>vjL. d \ (vm OWNER /i. SEWAGE SYSTEM INSTALLER Name, This System will be ready for inspection on.., 19. This space for office use only .19 ,M Date Rec'd Time Rec'd Phone Call Rec'd By Owner or Agent Signature NUMBER OF BEDROOMS:ESTIMATED COST: SEWAGE DISPOSAL SYSTEM DATA: SEEPAGE PITSEPTIC TANK DRAIN FIELDSq/^. Sl\X) Sq.GIs.Capacity Ft. Ft.Ft.Ft.Distance from nearest well Ft.Ft.Distance from lake or stream Ft. va Ft.Distance from occupied building Ft.Ft. 10 Ft.Distance from property line Ft.Ft. H-Ft.Ft.Distance from bottom to Water Table Ft. AH distances are shortest distance between nearest points RECORD OF TESTS: Inspection was made on , 19 , Time ....M By 19 FUa...,/PERCOLATION TEST DATA:Date of First Test Rate /Date of Second Test , 19 ,, Rater\ A/v>-\ 1st Test Taken By IiIFirst Test -I- 2nd Test 2 Rate2nd Test Taken By Agreement: 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. (Call or use attached mailer notice.) The undersigned hereby makes application for permit to install or extend Sewage Disposal System herein specified, agreeing to do all such work in Signature ^ (s> - ^C-~7/LDated Permit: condition that the person to whom it is granted, and his agents, employees and workmen shall conform in all respects to ordinances at 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. Permission is hereby granted to the above named applicant to perform the work described in the above statement. This Mrmit is granted upon express (q ~ ^ O (o Issued Date: Shoreland Management Office5^66 ^ HT16Fee $Surcharge $__i. Comments:. Form No. MKL-0771-003 ®158906 VICTOa LUHBCCK a CO,. PKlNUtO. rC0«u8 fALLl, Mian 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 W ;te V low — Inspector Card Owner Office Owner Permit No.,LEGAL Date DESCRIPTION I AND LOCATION Lake No.Lake Name Lake Classif.Sec.TWP TWP NameRange IDENTIFICATION; Please Print All Information. Last Name First Initial Mailling Address —No. Street, City and State Zip No,Tel. No. OWNER SEWAGE SYSTEM INSTALLER Name. r'-3Q A.imThis System will be ready for inspection , 19 7Cson. This space for office use only (a ' _____1 o L 3 P__M Date Rec'd Time Rec'd Phone Call Rec'd By Owner or Agent Signature NUMBER OF BEDROOMS;ESTIMATED COST: SEWAGE DISPOSAL SYSTEM DATA: SEPTIC TANK SEEPAGE PIT DRAIN FIELD GIs.Capacity Sq. Ft.Sq. Ft. Ft.Ft.Ft.Distance from nearest well Ft.Distance from lake or stream Ft.Ft. Ft.Distance from occupied building Ft.Ft. Distance from property line Ft.Ft.Ft. Ft.Distance from bottom to Water Table Ft.Ft. AH distances are shortest distance between nearest points RECORD OF TESTS: Inspection was made on 19 , Time ,JVI By PERCOLATION TEST DATA:Date of First Test ,, 19 . Rate Date of Second Test 19 , Rate 1st Test Taken By First Test + 2nd Test 2 Rate2nd Test Taken By Agreement: 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. (Call or use attached mailer notice.) The undersigned hereby makes application for permit to install or extend Sewage Disposal System herein specified, agreeing to do all such work in Dated Signature Permit: 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. Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express Issued Date: Shoreland Management Office Fee $Surcharge $ Comments:. Form No. MKL-0771-003 VICT»I LUHDCItl A C».. PAIKTCHf. FALLA. (158906y >' INSPECTION RESULTS Inspector must make all measurements SEWAGE DISPOSAL SYSTEM STATISTICS SEPTIC TANK SEEPAGE PIT DRAIN FIELDCATEGORY Actual Should be Actual Should be Actual Should be Co ^/O SFCapacityGIs.GIs.S F SF S FN. lOO^ FDistance from Nearest Well F 75FF 50F F Distance from Lake or Stream }CQ^ FFFFF F Distance from Occupied Building 2AL 10 2020FFFF F 4^-Distance from Property Line 10 F10 10FFFF F Distance from Bottom to Water Table 14 4FFFFF F Inspector's Comments; ■I 7-?.192^Date of Inspection. Time of Inspection, 6v yyU /. d [gnature^f Insp^orINTERPRETATION OF ABBREVIATIONS GIs = Gallons SF “ Square Feet * Linear Feet Job TitleF AgencyMKL-0771-003> Backer PERCOLATION TEST DATA Price $1.00 per pad. SHORELAIMD MANAGEMENT OTTER TAIL COUNTY Fergus Falls, Minnesota 56537 Ph. No.Owner:Mailing Address: St. & No.StateLast Name Middle City Zip No.Legal Description:. LAKE OR RIVER NO.SEC.TWP.RANGE TWP NAME 3'^^ST HOLE NO. 1 TEST HOLE NO. 2 56 4 LS3>Depth To Bottom of Hole.Depth to Bottom of Hole.inches; Diameter of Hole inches; Diameter of Hole.inches jnches jateDepth, Inches 19 7(oSoil Texture zaDepth, Inches Soil Texture ,Date An -^LV- 30 I lU ^ £Percolation ' Test By___ Percolation Test By____(A )n -IE aFirmName.OC FirmName.jG Do111IT 1~)0 LJJAddress.QC Address< COOtter Tail County License No..Otter Tail County License No^I-CO1X1Measurement, Inches Depth in Water Level, Inches K Measurement, Inches Depth in Water Level. Inches Time Remarks Time Remarks ^ /;3^ p/n I A 35~ /;3>r pAK / ^ SiTP /v\ yT7754SA-V i(?-£ F-' // !■ p/h j >Xd j , Hb p n<) ! ' >4d pOf\ / ’'S'O 2>rr\ ITKuS.A2L T 33 3 7a^ WEjZ3^ i04 MAl 44 I3/ / MKL-0871-028 See Booklet, "How to Run a Percolation Test" by Agriculture Ext. Service, Un. of Minn. Wm& 3rd /9_73Januaryday of^=r.This certificate has been issued this to certify compliance with regulations of Shoreland Management Ordinance, Otter Tail County, Minnesota. The premises covered by this certificate are legally described as: fc 56-298 gpc 6 133 40 EvertsTwp. Name.Twp.RangeLake No. Beauty Beach Resort *Owner: Name.Remi'l th Rmnyord Address. m Zip No.■565LS Termit No. SP_198. Signed by:. Malcolm K. Lee, Shoreland Administrator Otter Tail County, Minnesota One System OnlyMKL-0871-009 [w 'J, 159035 SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone 218-739-2271 - Fergus Falls, Mn. 56537 APPLICATION FOR PERMIT TO INSTALL SEI/VAGB DISPOSAL SYSTEM White - Office Yeliow — inspector Pink — Owner Card — Owner kc^ori-/9^Permit No., LEGAL ^ / 7Date DESCRIPTION AND mLOCATION TWP NameSec,TWP RangeLake Ciassif.Lake NameLake No. IDENTIFICATION: Please Print All Information. Zip No.Tel. No.Maillino Address —No. Street, City and StateinitialFirstLast Name jSttinyCLCxiOWNER .Sei£SEWAGE SYSTEM INSTALLER Name, This System will be ready for inspection , 19.on. This space for office use only 19 ,M Phone Call Rec'd By Owner or Agent SignatureDate Rec'd Time Rec'd SEWAGE DISPOSAL SYSTEM DATA: SEEPAGE PITSEPTIC TANK DRAIN FIELD /^O Sq. Ft.CfOn y- GIs.. Ft.Capacity ‘ ^ Ft.Ft.Ft.frn pDistance from nearest well 7S' f-7<Ft. Ft. Ft.Distance from lake or stream c2-0 f- Ft.Ft.Ft.Distance from occupied building /Cj t/A Ft.Ft. Ft.Distance from property line Ft.Ft.Ft.Distance from bottom to Water Table AH distances are shortest distance between nearest points RECORD OF TESTS: Inspection was made on 19 , Time ..........JVl By , , 19 ...2.x,, , 19....?^..., /PERCOLATION TEST DATA:Date of First Test Rate 1st Test Taken By /Date of Second Test Raterr\Ci rv. XL fI/ ^rf\~CX ¥\First Test -I- 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 jpb,^ ready for inspection. (Call or use attached mailer notice.) 7^ /? SignatureDated Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is grarMed 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. /? €1'Issued Date: Shoreland Management Office6"o Fee $Surcharge $ Comments:. 158906Form No. MKL-0771-003 VICTOB LUHttiH 4 CO . P8I8T(«I. Pfl«Uf FAkLI. HIHH 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 Yellow — Inspector Pink — Owner Card — Owner Permit No.,LEGAL Date DESCRIPTION AND LOCATION Sec.TWPLake No.Lake Name Lake Ciassif.Range TWP Name IDENTIFICATION: Please Print All Information. Initial Mailling Address —No. Street, City and State Zip No.Tel. No.FirstLast Name OWNER SEWAGE SYSTEM INSTALLER Name. i This S/stem will be ready for inspection on.■ -\, 19. This space for office use only 19 Phone Call Rac'd ByDate Rac'd Time Rac'd Owner or Agent Signature SEWAGE DISPOSAL SYSTEM DATA: SEEPAGE PITSEPTIC TANK DRAIN FIELD GIs.Sq. Ft.Sq. Ft.Capacity Ft.Ft.Ft.Distance from nearest well Ft.Ft. Ft.Distance from lake or stream Ft.Ft.Ft.Distance from occupied building Distance from property line Ft. Ft.Ft. Ft.Ft.Ft.Distance from bottom to Water Table AH distances are shortest distance between nearest points RECORD OF TESTS; , 19Inspection was made on , Time JVl By PERCOLATION TEST DATA:Date of First Test 19 , 19 , Rate Date of Second Test , Rate 1st Test Taken By First Test -I- 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. (Call or use attached mailer notice.) Dated Signature Permit: 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. Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express Issued Date: Shoreland Management Office Fee $Surcharge $ Comments:. CERTIFICATE ISSUFD yicret uunbccm i c«.. p«iatl*i. hi hn158906 'Form No. MKL-0771-003 -I » _ INSPECTION RESULTS Inspector must make all measurements SEWAGE DISPOSAL SYSTEM STATISTICS SFEPAGE PITSEPTIC TANK DRAIN FIELDCATEGORY Sho^d beActualShould be Actual Actual Should be litSFCapacityGIs.GIs.S F S F S F /\FDistance from Nearest Well 5FF F F m± Qjl F F Distance from Lake or Stream F F F F F ■ Distance from Occupied Building 201020FF F 10Distance from Property Line 10 10FFFF F FDistance from Bottom to Water Table 4 4FF F F F / f 7 Inspector's Comments: Date of Inspection .19___ Time of Inspection,.M Signature of InspectorINTERPRETATION OF ABBREVIATIONS GIs ~ Gallons SF * Square Feet F ■ Linear Feet Job Title Agency M KL-0771-003- Backer » PERCOLATION TEST DATA Price $ 1.00 per pad. SHORELAND MANAGEMENT OTTER TAIL COUNTY Fergus Falls, Minnesota 56537 Mailing. Address: b.iLast ft)Iame Owner: It /7^A Middle t. & No.State Zip No. VLegal Description: LAKE OR RIVER NO.SEC.TWP.iRANG,AMENAMETWI (JO 7, TEST HOLE NO. 2TEST HOLE NO. 1 Depth To Bottom of Hole_____^ f inches; ^ ml T^ture / ' Test By U.ffDepth to Bottom of Hole inches; Diameter of Hole JnchesDiameter of Hole inches ■ » \i?‘ 1 a*7 ^ i. g?Depth, Inches Depth. Inches iXtun Date 19- *4 2 /er iTest By. Firm Name.CC FirmName.DaUJ CC LU Address.CC Address < COOtter Tail County License No..Otter Tail County License No,^H coLUMeasurement, Inches Depth in Water H Measurement, Inches Depth in Water Level. InchesTimeRemarksTime Remarks I ?: Yz I ■-? - 4 7 ' 1 ; so 7 : . 7...U—4^ UU- J32-7^3^7 /?r. f / ///f. f,7 gw,'i/ ;: V£Cl.o 5^ 7' s 7 O-fc 5S30 ilik. 7 /7.r H-i il fI kr !-( 11 R e-i^t it Rf ^,11 CL^y; o3^p u.f , o :>a1 iCfi o? ' O? I Z f: It y. ff f: a.f xJX4 I^ ; \o <ir \ t \ :)o 7?dJ-76 /7 /<?7f Af7^L±MKL-0871-028159179 ®ViCTO* k.UNeili| 4 CO . »*IHTC«4. fEOOuO FALL!. See Booklet, "How to Run a Percolation Test" by Agriculture Ext. Service, Un. of Minn.