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Home My WebLink AboutLake Five Resort_32000050044000_Septic System Permits_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: wwWiCO.OTTER-TAiL:MN.us,!• October 30, 2008 Fair Hills Inc (5 Lakes Resort) PO Box 6 Detroit Lakes, MN 56501 Sewage Treatment System Servicing Tax Parcel Number 32000050044000 & 320000800640000 Described as GL 5 EX PART SLY OF CENTER LINE TWP ROAD & LOTS 7, 8, & 9, Section 5 & 8 of Hobart Township, Lake Five (56-357) RE: As of October 28, 2008, the sewage treatment system (Sewage Treatment Installation Permit #20085) servicing your property was determined to be in compliance with the provisions of the Sanitation Code of Otter Tail County for a shop. Important Note: Draihfield is in pasture. It must be fenced to keep livestock off of drainfield or certification is VOID. If you have any questions regarding this matter, please contact our office. SincerelyI Mark Ronning Inspector ■ APPLICATION FOR PERMIT TO INSTALL SEWAGE TREATMENT SYSTEM LAND & RESOURCE MANAGEMENT, OTTER TAIL COUNTY (218-998-8095T -- GOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS FALLS, MN 56537 www.co.otter-tail.mn.us uLl C. ! lUUOIVH/TE - Office YELLOW -L&R Inspector PINK - Owner / Contractor (after issue) APPLICATION MUST BE COMPLETE IN ORDER TO BE PROCESSED Permit No. TWP NAMELAKE NUMBER LAKE/RIVER NAME LAKE/RIVER CLASS SECTION TWP NO.RANGE /^jke S~^ 6 lJ PARCEL NUMBER (S) OF PROPERTY BEING SERVICEDA A-.5 ~~ 0C C ~cT'S “ " C C € f\. '^ - C^r -ck -Ctt i'-Qt'C LEGAL DESCRIPTION5 A"/ hifi- Sly r> 7 c-7 E-911 ADDRESS OR DIRECTIONS FROM NEAREST PUBLIC ROAD 3^1-1'6 f C^r/~hcr' of" Kci Last Name First Daytime Phone No.Initiai Mailing Address /a/^s h JPV^'Po fHa i ^ ~T Property Owner 2-0O •' QCO»’eO gyQ - SisnyvT V\v \\<> ^ersa r-^sz>sr> / ^:>zs^r smrs- 7i p / 2^1 IContractor Lie.#/y/»T rnifAK’6^is=^/C 5Tr7 THIS SPACE FOR OFFICE USE ONLY A.M. >■ This System will be ready for inspection on , the year of .P.M.at. A.M. P.M. Date Received Time Received L&R Officiai SEWAGE TREATMENT SYSTEM DESIGN DATA - AS SHOWN ON DRAWINGTYPE OF INSTALLATION (CIRCLE ONE)PLUS //c;Ag/A^c-TANK DRAIN FI ELD Size /S~^o GIs.Add-On/New System (20) Trench, Rock 21) Trench. Gravelless 22) Trench, Chamber 7) (23) Bed (24) Mound (25) At Grade Replacement (32) Tank, Septic (33) Tank, Lift (34) Trench, Rock (35) Trench, Gravelless (36) Trench, Chamber (37) Bed (38) Mound (39) At Grade (40) Combination Setback to nearest well Ft..2 Ft- <1 Setback to OHWL (lake &/or river) 7j7y-Ft.Ft.^no ^'^OO ^ Setback to wetland Ft. Ft. Setback to dwelling Ft.^CO *- Ft.2 oo JrCollector System (26) Trench, Rock (27) Trench, Gravelless (28) Trench, Chamber (29) Bed (30) Mound (31) At Grade Setback to non-dwelling Ft.Ft.3^ yco y* Ft.Setback to nearest property line /- Setback to road right-of-way Ft.OthOF T-^DIiT I Inldirnr(3i;) uuinouse 10^/o 0 Ft.Ft./QC> (43) Sewer Line (44) Performance (45) Miscellaneous 3Elevation above restrictive layer Ft.Ft. It BEDROOMS gy GARBAGE DISP. Y ABATEMENT Y /<^ DEPTH OF WATER WELL ABSORPTION AREA FOR MOUNDS Q=>ep>EFFLUENT DISTRIBUTION (VL? Gravity { ) Pressure HOLDING TANK MONITOR/ DISPOSAL CONTRACT |Z)Yes ( ) No-L&R Can Not Process Designer Designer Lie. # PERCOLATION TEST DATA 9/^r/o VDate of Test Highest Rate Agreement: The undersigned hereby makes application for permit to install, alter, repair or extend Sewage Treatment System herein specified, agreeing to do all such work in strict accordance 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: This permit is valid for a period of six (6) months. cc$yCCh kjiiSbJl^/3CDate:Permit Fee $ Signature of Property Owner/Agen mer Land & Resource Management Office Date:Rec. No., Comments:'r-e>t>.rr^ Form No. BK — 0906-003 327.315 • Victor Lundeen Co.. Printers • Fergus Falls, Minnesota 1. .^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) tI ty \uo(r\APPLICATION MUST BE COMPLETE IN ORDER TO BE PROCESSED Permit No. LAKE NUMBER LAKE/RIVER NAME LAKE/RIVER CLASS O ;ECTlp^TWP NO.RANGE TWP NAME //-4s //O r)<T“Lb n Vc uj PARCEL NUMBER (S) OF PROPERTY BEING SERVICED/ ca -000 ~os ~ - 000 ~oS -Odh y~ Op'S Xr?7'ONA^+ S/y leii 7, S.^f E-911 ADDRESS OR DIRECTIONS FROM NEAREST PUBLIC ROAD 3^!p^6 Co./n f> Chert-i-h fid Mailing AddressLast Name First Initial Daytime Phone No. // yProperty Owner V nhA.C L0» p rvr >7TtulALpC; S’7T-2j ^ y T i{ Tcr H r-ty V ^ /6- '11Contractor Lie.#irc^'^6 L~/C yu- j'u /t-hr THIS SPACE FOR OFFICE USE ONLY J''oo- f-^4rw£:;__IO~e^7>• This System will be ready for inspection on , the year of at P.M. Date Received Time Received L&R Official SEWAGE TREATMENT SYSTEM DESIGN DATA - AS SHOWN ON DRAWINGTYPE OF INSTALLATION (CIRCLE ONE)> /i TANK DRAINFIELD ■ L- f /I' ^Size /b CO GIs.Add-On/New System (20) Trench, Rock (21) Trench, Gravelless (^2) Trenchj Chambej. (23) Bed (24) Mound (25) At Grade Replacement (32) Tank, Septic (33) Tank, Lift (34) Trench, Rock (35) Trench, Gravelless (36) Trench, Chamber (37) Bed (38) Mound (39) At Grade (40) Combination Setback to nearest well Ft.Ft. Setback to OHWL (lake &/or river) ?y^-Ft.Ft.CO ic- Setback to wetland Ft.Ft. Setback to dwelling Ft.Ft.^OO Pry «ro -r/ICollector System (26) Trench, Rock (27) Trench, Gravelless (28) Trench, Chamber (29) Bed (30) Mound (31) At Grade Setback to non-dwelling Ft.Ft.J’V' bo o ^ Ft.Setback to nearest property line Ft.^ Other. ..b^'^41) Tank,, Holding^ J42) Outhouse (43) Sewer Line (44) Performance (45) Miscellaneous Zl ASetback to road right-of-way /O 6Ft.Ft. JElevation above restrictive layer Ft. Ft. ALL DISTANCES ARE SHORTEST DISTANCE BETWEEN NEAREST POINTS.If BEDROOMS 1DEPTH OF WATER WELL #/ABSORPTION AREA FOR MOUNDS GARBAGE DISP. Y / iP)/ ABATEMENT Y L-R^EFFLUENT DISTRIBUTION Gravity ( ) Pressure HOLDING TANK MONITOR/ DISPOSAL CONTRACT (^)Yes { ) No-L&R Can Not Process X Designer Designer Lie. If, PERCOLATION TEST DATA r //cDate of Test Highest Rate Agreement: The undersigned hereby makes application for permit to install, alter, repair or extend Sewage Treatment System herein specified, agreeing to do all such work in strict accordance 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: This permit is valid for a period of six (6) months. i 00drCCh kjLC&M Signature of Property Owner/Agent for Owner In I A/) //oY IM.Date: /Permit Fee $ : cDate:.-• /Rec. No./ Land Si Resource Management Office yy’ 4^.' y y<p yt- -*■ s cy "yr ccComments:/ f I t , r-’,y /^ b y y-' ■ ^ ’/ •F-6 Form No. BK — 0906-003 327,315 • Victor Lundeon Co.. Printers ■ Fergus Falls. Minnesota SEWAGE TREATMENT SYSTEM PERMIT INSPECTION RESULTS Inspector must make all measurements X. - ■HOtOtWG SEPTIC TANK DRAINFIELD OUTHOUSELIFT TANKCATEGORY Capacity / 5~oo gls.FT2LS. Setback from Nearest Well FT FT FT Setback from Buried Water Suction Pipe ^ FT FT FT FT Setback from Buried Pipe Distributing Water Under Pressure FT FT fO rf-FT FT ^0(i /—^Setback from OHWL (lake &/or river)FT FT FT Setback from Setback from Wetland FT FT FT FT Setback from Dwelling /gut"- ^FT /o«^ ft FT Setback from Non-Dwelling -2^4FT FT FT Setback from Nearest Property Line / FT FT /gu ^ ft FT / ftSetback from Right-of-Way i ^FT FT Elevation above Restrictive Layer FTFTFT FT Holding Tank/Lift Alarm YES NO Old System Pumped & Destroyed NO SEPTIC TANKfSt #Tanks Installed ^______ 3^ FILTER Sewer Line to Well Separation DRAINFIELD CALCULATION Actual Minimum ^ ^ FT^^-^ FT □ YESManuf. /oo f-/roo FT FT20Model # MOUND CALCULATION MOUND /AT-GRADE ROCK REDUCTIONInspector’s Comments: ^ PA b I ABSORBTION AREA Rock trenches with inches of rock under piperor .%Ft. X ft^ DRreductj/»tT/ equivalent toFt2 SKETCH; y Tvhir~Initial/L & ROfficial/y>/Xr/o<? As of y Q y/(\ . the above described sewage system installation was found to be compliant with the provisions of the Sanitation Code of Otter Tail County. /— Land S Resource Management Official) RrzcEn/EDSITE 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 OCT 2 1 2000 U.KJ & L;:;UUUi\Cr Sewage Treatment System Permit #OWNER: - ^/s-7 FIRST ierScn MIDDLE TELEPHONE NUMBERLAST NA ADDRESS: ME A f-n^-zc-c. _____STATE y /39 STR./RT CITY ZIP CODE RANGESEC.TWPLAKE/RIVER NO.LAKE NAME TWP. NAME LEGAL DESCRIPTION:SOIL BORING LOG ^*2jOOO 37,00 o &a Pr ^Y6^5 7/ S’* 9" COLOR & MUNSELL NO. DEPTH (INCHES)TEXTURE STRUCTURE BLOCKY PLATY PRISMATIC ooo 5^'i‘Y /oA/-fc /OfP Vi.6-/0 PARCEL NUMBER 3^(0^'^ cA/n/> a^peitu /ioAb BLOCKY PLATY PRISMATIC jConE) S/^no/ /OA-*— E-911 Address or Directions From Nearest Public Road rrx>t^ NUMBER OF BEDROOMS /o zs~P>t / BLOCKY PLATY PRISMATIC IHO^tE^ Sf^nV^ /©» &^s-HtGARBAGE DISPOSAL: YES SEWER LINE SEPARATION: ^ ^ ft. BLUFF: YES te^striaQ WELL: CASING DEPTH BLOCKY PLATY PRISMATIC /O'// ^//FLOODPLAIN: YES 5/4-^0y/- ?z VEGETATION: AQUATIC BLOCKY PLATY PRISMATIC NONE SLOPE AT INSTALLATION SITE:% Pit ^oHn^TYPE OF OBSERVATION: PARENT MATERIAL: Till Loess Bedrock Alluvium 9 23 -0 /ORIGINAL SOIL: , No Date of Soil Boring. COMPACTED SOIL: Yes y -DEPTH OF BORING (To 7' or restrictive layer):ft.Date of Perc Test PERC TEST #1 PERC TEST #2- TWO TESTS ARE REQUIRED - WATER DROPTIMEINTERVAL (MINUTES)WATER DEPTH PERC RATE TIME INTERVAL (MINUTES)WATE^EPTH PERC RATEWATER DROP~5..T.START,/y/r-.......5 ......TIME DROP PERC TIME DROP PERC TIME INTERVAL IMINUTESI WATEB. DEPTH WATER DROP PERC RATE TIME INTERVAL (MINUTESI WATER z DEPTH WATER DROP PERC RATE ■yy.r7, ^T..._r.5;^xyy:.TIME DROP PERC TIME DROP PERC INTERVAL (MINUTES)WATEP.DEPTH WATER DROP PERC RATE TIME INTERVAL (MINUTESI EPTHTIMEWAT WATER DROP PERC RATE REFILL REFILLSL/3^-y 7y.r.yjTIMEDROPPERC TIME DROP PERC TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATE TIME INTERVAL (MINUTES!WATER DEPTH WATER DROP PERC RATE REFILL REFILL TIME DROP PERC TIME DROP PERC WATER DEPTH WATER DROP PERC RATE TIMETIMEINTERVAL (MINUTES)INTERVAL (MINUTES!WATER DEPTH WATER DROP PERC RATEREFILL REFILL -----------r----------- =TIME DROP PERC TIME DROP PERC TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATE TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATEREFILL REFILL TIME DROP PERC DROPTIME PERC INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATE TIME INTERVAL (MINUTESI WATER DEPTHTIME WATER DROP PERC RATEREFILL REFILL TIME DROP PERC TIME DROP PERC WATER DEPTHTIMEINTERVAL (MINUTES)WATER DROP PERC RATE TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATEREFILL REFILL TIME DROP PERC TIME DROP PERC PROPOSED DESIGN: TRENCH BED.GRAVITY DIST. ^ PRESSURE DIST.ATGRADE.MOUND.HOLDING TANK. SPECIFY:.SEWER LINE.OUTHOUSE.OTHER. — SYSTEM DESIGN ON BACK — System design must be to scale and must include the proposed location of the sewage system, all existing/proposed buildings, property lines, the ordinary high water level of the water body, wetlands, bluff and all water wells within 150’ of the sewage system. If there are any questions, see the University of Minnesota Site Evaluation worksheets. / inch(es) equals feet.grid(s) equalsScale:feet, or MPCA LICENSE #; LICENSE CATEGORY: /DESIGNED BY: ^—yr FIRM NAME: >^jC»^-^o^ ADDRESS: O DATE:/ SIGNATURE: t 1i T ii CJ1 0 o /'/ooz' Orjo-, /y?if9y "Act 4 r ^ o /A^OQ BK — 1003 — 029 315.904 • Victor Lundeon Co., Printer* •. Fergus Falls. MN • 1-800-346-4870 RECEIVED OCT 2 1 2008University of Minnesota Trench and Bed Worksheet AU boxed rectangles must be entered, the rest will be calculated. Trcatmcnt Prooram 1. Flow A. Estimated Flow 300 |gpd (Fig. A-1) A-1 Estimated Sewage Flows in GPD ClassNumber of Bedrooms IVI 60% of1802252300 Pump tank Minimum Sizing218300the3450 500 gallons or 100% of Average Design Flow (A-1) or dual alternating pump system_____ values in the 375 2564600 450 2947505 332 Class I,5256900 370600 II or II10507 408 columns6758 1200 2. Minimum Septic Tank Capacity B. Septic tank capacity (F/gC-f) C. Effluent filter (yes/no) Number of tanks/compartments [21500gallons no C-1 Minimum Septic Tank Capacity in Gallons Capacity with GD and pump in basement ** Number of Bedrooms Minimum Capacity Capacity vwth GD* 150011252 or less 3or4 5 or 6 750 1500 20001000 300015002250 2000 3000 40007,8or9 * GD = garbage disposal, Must have multiple tanks or compartments ** Must have multiple tanks, compartments or effluent screen 3. Pump Tank Specifications D. Pump tank needed (yes/no)Minimum size if needed gallonsno 4. SOILS (Site evaluation data) E. Depth to restricting layer =ft6 3 ft63F. Maximum depth of system Item E - 3 ft =r ]mpi[Percolation Rate if available 6G. Texture sandy loam 1.27 Ift^/gpd (see figure D-15)H. SSF 3 1%I. % Slope D-15 Soil Characteristics & SSF Soil Sizing Factors ft^/gpd Perc Rate Soil Texture mpi Coarse sand Medium sand Loamy sand Fine sand Sandy loam Loam Silt loam, silt Clay loam, sandy clay or silty day Clay, sandy or silty day 0.83<0.1* 0.830.1-5 ’ No trench >25% of total system ” Soil with >50% fine sand particles *” A mound must be used An other or performance system 1.670.1-5** 1.276-15 1.6716-30 31-45 46-60 2.00 2.20 4.2061 -120*** Page 1 of 2>120*«** / Method of DistributionDistribution Media Type5. System Type Pressure Drop Boxes Dist. Box {<3% slope) Other: Pressure Bed (<6% slope) Gravity Bed (<6% slope) Trenches Rock Chamber Gravelless Other__ XX X 6. TRENCH OR BED BOnOM AREA J. For trenches with 6 inches of wide wall beneath the pipe or 10' diameter gravelless pipe: AxH = K. For trenches with 12 inches of sidewall: A X H x 0.8= 381.0 ft^1.27 ft/gpd300gpd rX 304.8ft/gpd X 0.8 =1.27300,gpd X L. For trenches with 18 inches of sidewall: AxHx0.66= 300 gpd M. For trenches with 24 inches of sidewall: 300 gpd 251.5ft/gpd X 0.66 =1.27X 228.6 fl^ft/gpd X 0.6 =1.27AxHx0.6=X N. For gravity beds with 6 or 12 inches of rock below the pipe; 1.5xAxH = 1.5x ft'NA1.27 ft/gpd300gpdx 0. For pressure beds with 6 or 12 inches of rock below the pipe; AxH =ft'ft/gpd NA3000gpdxS 7. Trench and Bed Dimensions P. Select required square feet of bottom area required based on depth of rock/gravelless pipe or height of chamber slats381.0"^ |ft^ (must use S' of rock square footage for beds) Q Select width of trench or bed | ________ (use 3' for gravelless pipe, width of chamber or width of excavation for rock in trenches & beds can not be wider the 25') 3.0 ft R. For trenches or pressure beds the lineal feet required = required square footage / width of bottom of trench or bed 127.0 lineal feet381.0 ft" /3.0 ft S. For gravity beds the lineal feet required = required square footage / width of bed 381.0 ft" /lineal feet3.0 ft r 8. Rock Sizing and Volume T. Depth of media below pipe Cubic feet of rock needed = Rock depth below distribution pipe plus 0.5 foot times bottom area: (Rock depth + 0.5 foot) x Area (J, K, L, M) ( 0.5 ft + 0.5 ft) X 381.0 ft'= 381.0 ft' Volume in cubic yards = volume in cubic feet divided by 27 ]ft0.5 yd^I 27=14.1381.0 Weight of rock in tons = cubic yards times 1.4 X 1.4= Add in 10% extra for constructability = 1.1 X 19.814.1 tons 21.719.8 tons= 9. Layout Select an appropriate scale; one inch = Show pertinent property boundaries, rights-of-way, easements. Show location of house, garage, driveway, and all other improvements, existing or proposed. Show location and layout of sewage treatment system, well and dimensions of all elevations 30 I ft I here^ certify that I have completed this work in accordance with all applicable ordinances, rules and laws. z 9/29/2008 (date)634 (license#)(signature) Local UnK of Government Approval (registration #)(date)(signature) Page 2 of 2 Department of LAND AND RESOURCE MANAGEMENT OTTER TAIL COUNTY Gov^nment Services Center - 540 West Fir Fergus Falls, MN 56537 PH: 218-998-8095 Otter Tail County’s Website; www.co.otter-tail.mn.us May 9, 2007 Fair Hills, Inc P.O. Box 6 Detroit Lakes, MN 56502-0006 Sewage Treatment System Servicing Tax Parcel Number 32000080064000 Described as GL 5 EX PART SLY CENTER LINE OF TWP ROAD, Section 8 of Hobart Township, Lake Five (56-357) RE: As of May 8, 2007, the sewage treatment system (Sewage Treatment Installation Permit #18968) servicing your property was determined to be in compliance with the provisions of the Sanitation Code of Otter Tail County for a 4 bedroom home. If you have any questions regarding this matter, please contact our office. Sincerely, Eric Babolian Inspector APPLICATION FOR PERMIT TO INSTALL SEWAGE TREATMENT MAY 0 2 2007 LAND & RESOURCE 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 lV/ j/r£ - Office YELLOW - L & R Inspector PINK - Owner / Contractor (after issue) APPLICATION MUST BE COMPLETE IN ORDER TO BE PROCESSED Permit No. LAKE/RIVER NAME U Jl—LAKE NUMBER LAKE/RIVER SECTION TWP NO,RANGE TWP NAME /S')HoC({o PARCEL NUMBER (S) OF PROPERTY BEING SERVICED E-911 ADDRESS OR DIRECTIONS FROM NEAREST PUBLIC ROAD 'S^ccc oft’cQ Q ^do o LEGAL DESCRIPTION (Ro ^ <0 Last Name First Initial Mailing Address Daytime Phone No. c Q>p'<\ir H<LL ^Property Owner Di2TRar (js t-e y (j^i- Ha-‘Contractor Lie.#Ay THIS SPACE FOR OFFICE USE ONLY A.M. ► This System will be ready for inspection on_the year of at._P.M. A.M. P.M. Date Received Time Received L & R Official SEWAGE TREATMENT SYSTEM DESIGN DATA - AS SHOWN ON DRAWINGTYPE OF INSTALLATION (CIRCLE ONE)TANK DRAINFIELD Yio Ft"Size GIs.Add-On/New System (20) Trench, Rock (21) Trench. Gravelless p^pTronph Chamber Replacement (32) Tank, Septic (33) Tank, Lift (34) Trench, Rock (35) Trench, Gravelless (36) Trench, Chamber (37) Bed (38) Mound (39) At Grade (40) Combination '1 oSetback to nearest well Ft. Ft. //cSetback to OHWL (lake &/or river)Ft.Ft.(23) Bed (24) Mound (25) At Grade 0 0 i- Ft.Setback to wetland Ft. (Setback to dwelling Ft.Ft.Q.C CJHCollector System (26) Trench, Rock (27) Trench, Gravelless (28) Trench, Chamber (29) Bed (30) Mound (31) At Grade Setback to non-dwelling Ft.Ft. 3oc ^Setback to nearest property line Ft.Ft.Other (41) Tank, Holding (42) Outhouse (43) Sewer Line (44) Pedormance (45) Miscellaneous IbO'fh' Ft.3 CO t/-Setback to road right-of-way Ft. 3Elevation above restrictive layer Ft. Ft. ALL DISTANCES ARE SHORTEST DISTANCE BETWEEN NEAREST POINTS.# BEDROOMS ‘■i GARBAGE DISP.CJ?/ N ABATEMENT Y /d> DEPTH OF WATER WELL ABSORPTION AREA FOR MOUNDS /jr Ft^EFFLUENT DISTRIBUTION ( ) Gravity ( ) Pressure HOLDING TANK MONITOR/ DISPOSAL CONTRACT ( )Yes ( ) No-L&R Can Not Process __(oiH__________ Highest Rate /■ o__________ Designer____ Designer Lie. # PERCOLATION TEST DATA ij g 7Date of Test Agreement: The undersigned hereby makes application for permit to install, alter, repair or extend Sewage Treatment System herein specified, agreeing to do all such work in strict accordance 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 con dition 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: This permit is valid for a period of six (6) months. T Date:A'Permit Fee $ign^fdfe of Property Owrter/^^^^r Owner hillDate:Rec. No. Land & Resource Management Office Comments: iForm No. BK — 0203-003 315,609 • Victor Lundeen Co.. Printers • Fergus Falls. Minnesota V 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 WHITE - Office YELLOW - L & R Inspector PINK - Owner/ Contractor (after issue) X APPLICATION MUST BE COMPLETE IN ORDER TO BE PROCESSED Permit No. LAKE NUMBE^^ LAKE/B(VER NAME LAKE/RIVER i CLASS SECTION P NO.RANGE TWP NAME Rro /~/o —Q(/o\ PARCEL NUMBER (S) OF PROPERTY BEING SERVICED E-911 ADDRESS OR DIRECTIONS FROM NEAREST PUBLIC ROAD aHoR; r H ROZJoooof?QoG^/ooO LEGAL DESCRIPTION rOGli; SLy Last Name First Initial Mailing Address Daytime Phone No. 0 y Gy GH iLL<. T/O (f_Property Owner I r ■ ufr Qjg 1R 01 T~ a/. ■ ,<~-T' 7/y^ <%>S'62 ijj> 7-^ „ ^f/ic. HaContractor Lie.#Ay^ r 7 0-^11 3^/^- THIS SPACE FOR OFFICE USE ONLY > This System will be ready for inspection on_the year of .at. Date Received ' ^'/OS^ /k^Gy. Tin^ Received ^^L & R Officiai SEWAGE TREATMENT SYSTEM DESiGN DATA - AS SHOWN ON DRAWINGTYPE OF INSTALLATION (CIRCLE ONE) TANK DRAINFIELD rC(j \ lo Ft'^ GIs.SizeAdd-On/ Replacement (32) Tank, Septic (33) Tank, Lift (34) Trench, Rock (35) Trench, Graveiless (36) Trench, Chamber (37) Bed (38) Mound (39) At Grade J40) Combination New System (20) Trench, Rock (21) Trench, Gravelless (SSpTrench, Chamber (23) Bed (24) Mound (25) At Grade 'z oSetback to nearest well Ft.Ft. iloSetback to OHWL (lake &/or river)1^9.Ft.Ft. Setback to wetland 5^-p fy 0 o Ft.Ft. Setback to dwelling Ft.Ft.Qo '7o'Collector System (26) Trench, Rock (27) Trench, Gravelless (28) Trench, Chamber (29) Bed (30) Mound (31) At Grade Setback to non-dwelling Ft.Ft. 3oo ■f'Setback to nearest property line oooi~Ft.Ft.Other (41) Tank, Holding (42) Outhouse (43) Sewer Line (44) Performance (45) Miscellaneous Joo-h- Ft.Setback to road right-of-way T oo -f-Ft. 3Elevation above restrictive layer Ft.Ft. ALL DISTANCES ARE SHORTEST DISTANCE BETWEEN NEAREST POINTS. DEPTH OF WATER WELL #BEDROOMS GARBAGE DISP.:ir7/ n ABATEMENT Y /(H> ABSORPTION AREA FOR MOUNDS Ft^EFFLUENT DISTRIBUTION ( ) Gravity ( ) Pressure HOLDING TANK MONITOR/ DISPOSAL CONTRACT ( ) Yes ( ) No-L&R Can Not Process /a / ^ i/ / ji \ ^ rDesigner____ Designer Lie. #, PERCOLATION TEST DATA (o "7 ^ { LDate of Test.Highest RateI u Agreement: The undersigned hereby makes application for permit to install, alter, repair or extend Sewage Treatment System herein specified, agreeing to do all such work in strict accordance 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 con dition 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: This permit is valid for a period of six (6) months. if i- y <!L2L./Date:Permit Fee $ S^na}tfte of Property Owner/Agent tor Owr)er f-y-rn hu if/-IDate:Rec. No. Land & Resource Management Office Comments: Form No. BK — 0203-003 315,609 • Victor Lundeen Co.. Printers • Fergus Falls. Minnesota 1 SEWAGE TREATMENT SYSTEM PERMIT INSPECTION RESULTS Inspector must make all measurements HOLDING SEPTIC TANK OUTHOUSEDRAINFIELDLIFT TANKCATEGORY Capacity Z 510 FT2 FT2GLS.GLS. FT FT FT FTSetback from Nearest Well Setback from Buried Water Suction Pipe FT FTFT FT Setback from Buried Pipe Distributing Water Under Pressure FT 'h FT FTFT/o /O /oa - FT FTSetback from OHWL (lake &/or river)FTFT ftSetback from Setback from Wetland FT FTFT 37Setback from Dwelling FT FT FTFT Pfoo^ ftSetback from Non-Dwelling FT FT FT/oo FT FTSetback from Nearest Property Line FTFTloo i f-Setback from Right-of-Way FT FT FT FTjOO 3Elevation above Restrictive Layer FT FT FT FT Holding Tank/Lift Alarm YES NO Old System Pumped & Destroyed NO FILTER Sewer Line to Well Separation DRAINFIELD CALCULATION/Actual Minimum# Tanks Installed.)^YES 3H" Siu VO FTX Manuf..¥0^.ft^□ NO FT 20Model # MOUND CALCULATION MOUND /AT-GRADE^ ROCK REDUCTION Inspector’s Comments: gTkei< cHjA Rock trcnohoc with _ of-rook under pipe for 10?' pf /tz.ABS«IRBTIQN<REA inchesOLt^ <,yST€t^ 2^0 %.Ft. X \r^iTknt<A. SKETCH: 6^0 ft2 DF.reduction / equivalent to rz\- r f )00-l 1 I \L i lnkal/L&V"dfficialTimeDate PAs Of S'*-on Code of Otter Tail County. ., the above described sewage system installation was found to be compliant with the provisions of the Sanitation ^■ /Sx ---^ Land & Resource Manag ment Official /MR TEST CERTIFICATION (date), an air test of the sewer line installed under Sewage Disposal System Permit Number ___________ (owner), on (lake/river) was made. At that time, the sewer line held inch for for .5'pounds per square minutes. TInstaller s Signature License No.Date FORMS:airtst RECEIVED SITE DATA WORKSHEET!MAY 0 2 Z007LAND & RESOURCE MANAGEMENT, COUNTY OF OTTER TAIL GOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS FALLS, MN 56537LAND & RESOURCE 218-998-8095. -L www.co.otter-tail.mn.us Sewage Treatment System Permit # C> ^OWNER: /-/cLL- LAST NAME >FIRST MIDDLE TELEPHONE NUMBER iADDRESS:i QjL't-iKo; r0 Jn 0>F‘y?A^ STATEiSTR./RT CITY ZIP CODE 08 (3^/-/q 13 Cc ^ t~Qi/o LAKE NAMELAKE/RIVER NO.SEC.TWP.RANGE TWP. NAME ; LEGAL DESCRIPTION:SOIL BORING LOG COLOR a MUNSELL NO.DEPTH(INCHES)TEXTURE STRUCTURE BLOCKY PLATY PRISMATIC ■<rTJUT^ - ^rdoJl/ "''9- <0 3 OQOii SqqG OQ Q o~ SH 2PARCEL NUMBER BLOCKY PLATY PRISMATIC NONE E-9H Address or Directions From Nearest Public Road \NUMBER OF BEDROOMS GARBAGE DISPOSAL: NO lK BLOCKY PLATY PRISMATIC NONEWELL: CASING DEPTH . SEWER LINE SEPARATION: FLOODPLAIN: YES ! BLUFF: NO VEGETATION: AQUATIC <^RRFSTmAT^ .ft. BLOCKY PLATY PRISMATIC NONE BLOCKY PLATY PRISMATIC NONE ^___ %SLOPE AT INSTALLATION SITE: TYPE OF OBSERVATION:Probe PARENT MATERIAL: .gL Outwash ORIGINAL SOIL: No1 COMPACTED SOIL: Yes (@_ Loess Bedrock Alluvium cf -Jo ' o'?Date of Soil Boring. 7 V- 3 ^ )DEPTH OF BORING (To T or restrictive layer):.ft.Date of Perc Test PERC TEST # 1 PERC TEST #2- TWO TESTS ARE REQUIRED - INTERVAL (MINUTES)WATER DEPTH PERC RATETiMEWATER DROP TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATE10[U3.I H< i1 f » I O iSTARTSJfijiTI ^i'O-tI )TIME DROP PERC TIME DROP PERC TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATE INTERVAL (MINUTES)TIME WATER DEPTH WATER DROP PERC RATEt; »i llAA 12 / o1EFiaREj^ILL ■X1±1M'9-TIME DROP PERC TIME DROP PERC TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATE TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATE/>t s y 19J L9.lOw....:§;g:-REFILL REFILL I( ^ L 'J- ,gS L 5TIMEDROPPERC TIME DROP PERC PERC RATE TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATETIMEINTERVAL (MINUTES)WATER DEPTH WATER DROP REFILLREFILL TIME DROP PERCDROPPERCTIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATEWATER DROP PERC RATE TIMEINTERVAL (MINUTES)WATER DEPTHTIME REFILLREFILL TIME DROP PERCPERCTIMEDROP PERC RATEWATER DEPTH WATER DROPPERC RATE TIME INTERVAL (MINUTES)WATER DROPINTERVAL (MINUTES)WATER DEPTHTIME REFILLREFILL PERCTIMEDROPDROPPERCTIME WATER DROP PERC RATEINTERVAL(MINUTES)WATER DEPTHPERC RATE TIMEWATER DROPINTERVAL (MINUTES)WATER DEPTHTIME REFILLREFILL TIME DROP PERCDROPPERCTIME PERC RATEWATER DROPINTERVAL (MINUTES)WATER DEPTHPERC RATE TIME WATER DEPTH WATER DROPINTERVAL (MINUTES)TIME REFILLREFia DROP PERCTIMEPERCTIMEDROP PROPOSED DESIGN: GRAVITY DIST. K'PRESSURE DIST..HOLDING TANK.MOUND.ATGRADE.BED.TRENCH. /? Cl-.7SPECIFY:. — SYSTEM DESIGN ON BACK — OTHER.OUTHOUSE.SEWER LINE. A r System .design must be to scale arid must include the proposed location of the sewage system, all existing/proposed buildings, property lines, the ordinary high water level of the water body, wetlands, bluft and all water wells within 150' of the sewage system. If there are any questions, see the University of Minnesota Site Evaluation worksheets. y_DI.inch(es) equals feet,grid(s) equals feet, orScale: MPCA LICENSE #: LICENSE CATEGORY: £) c. ^DESIGNED ik typeWr/ (7oji0FIRM NAME:U' 3<^'- Q 7DATE: ADDRESS:j '-t /SIGNATURE:\ - Sio ^ A C.ps, P U‘ 3(50 ; flf vl 7o'-7 ■^s'O'7 , iLi 11 cP Roo /.T-u '/T 5"- 1^7 BK — 1003 — 029 315.904 • ViclDT Lundeen Co., Printers •. Fergus Falls, MN • l'8OO-346-4870 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; wvtfw.co.ottertail.mn.us December 6, 2004 Fair Hills, Inc. PO Box 6 Detroit Lakes, MN 56502 RE;Sewage Treatment System Servicing Tax Parcel Number 32000080064000 Described as GL 5 Ex Part Sly of Center Line of Twp. Road, Section 08 of Hobart Township, Lake Five (56-357) As of December 1, 2004, the sewage treatment system (Sewage Treatment Installation Permit #17287) servicing your property was determined to be in compliance with the provisions of the Sanitation Code of Otter Tail County for a 3 bedroom home. If you have any questions regarding this matter, please contact our office. Sincerely, Eric Babolian Inspector ‘ APPLICATION FOR PERMIT TO INSTALL SEWAGE TREATMENT SYSTEM Vlfc 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 WHITE ■'••Office YELLOW-L & R Inspector PINK - Owner / Contractor (after issue) APPLICATION MUST BE COMPLETE IN ORDER TO BE PROCESSED Permit No. LAKE/RIVER CLASS SECTION TWP NO.RANGE TWP NAMELAKE NUMBER LAKE/RIVER NAME ^ /3> olio H(,g/4-R.r.^-36-7 fLuJi BJl E-911 ADDRESS OR DIRECTIONS FROM NEAREST PUBLIC ROADPARCEL NUMBER (S) OF PROPERTY BEING SERVICED rJ^ g? OO C» ^ __GAL DESCRIPTION ^ O /] GL 5 of <ooo LEGAL DESCRIPTION Daytime Phone No.First Initial Mailing AddressLast Name br n ^ ^_______ D^fRo/r ^ ^_____/Pn/i/" ^ o CL /^ALOAi^L Dau£ A/'CL Ja/JL- Property Owner r Pajl i) tZ(*=>Contractor Lie.#TC rr> T(all THIS SPACE FOR OFFICE USE ONLY A.M. the year of P.M.► This System will be ready for inspection on_at. .A.M. P.M. L & R OfficialDate Received Time Received SEWAGE TREATMENT SYSTEM DESIGN DATA - AS SHOWN ON DRAWINGTYPE OF INSTALLATION (CIRCLE ONE) DRAINFIELDTANK Ji TLot (p)C) 5 ^Oo Ft'GIs.SizAddnOnZNew System (20) Trench, Rock (21) Trench, Gravelless (22) Trench, Chamber (23) Bed (24) Mound (25) At Grade (^^Replacement ‘ (32) Tank, septic ^Setback to nearest well Ft. Ft. El(3^ Tank, Lift Trench. RocR~-:=i '■~-i^5)'Tlferrch, Grat^less (36) Trench, Chamber (37) Bed (38) Mound (39) At Grade (40) Combination Ft.Setback to OHWL (lake &/or river)Ft. Ft.Setback to wetland Ft. f<d'?0Setback to dwelling Ft.Ft.Collector System (26) Trench, Rock (27) Trench, Gravelless (28) Trench, Chamber (29) Bed (30) Mound (31) At Grade Ft.Setback to non-dwelling Ft. c^OO j-Setback to nearest property line 3oo Ft.Ft.Other (41) Tank, Holding (42) Outhouse (43) Sewer Line (44) Performance (45) Miscellaneous ^ (oO 4-^OQ +• Ft.Setback to road right-of-way Ft. 3Ft. Ft.Elevation above restrictive layer ALL DISTANCES ARE SHORTEST DISTANCE BETWEEN NEAREST POINTS.#BEDROOMS .? GARBAGE DISP. Y /<U ABATEMENT Y ABSORPTION AREA FOR MOUNDSDEPTH OF WATER WELL /9r7 Ft^HOLDING TANK MONITOR/ DISPOSAL CONTRACT McjfYes ( ) No-L&R Can Not Process EFFLUENT DISTRIBUTION ( ) Gravity ( ) Pressure Designer Designer Li PERCOLATION TEST DATA Date of 1/ <3 ~ ^Highest Rate Agreement: The undersigned hereby makes application for permit to install, alter, repair or extend Sewage Treatment System herein specified, agreeing to do all such work in strict accordance 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 con dition 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: This permit is vaiid for a period of six (6) months. m-/)nPermit Fee $Date:. It for Ownerlature of Property _ ______ _0^/177Rec. No.Date: Land & Resource Management Office Comments:(_a h /!M/J --Y.J ^ n?n3~003 f * 315,609 ♦ Victor Lundoen Co.. F^ftitors • Fergus F§Jl*<'lfllnnesotaForm No. BK 11-30^^4 l"S -{Uxy^< r\Z-('0ir^. '"‘Application for permit to install sewage treatmenTsy^tem^ /l-f-oY <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 WHITE - Office YELLOW- L&R Inspector PINK - Owner / Contractor (after issue) rf 0 4 yAPPLICATION MUST BE COMPLETE IN ORDER TO BE PROCESSED Permit No. LAKE NUMBER LAKE/RIVER NAME LAKE/RIVER CLASS SECTION TWP NO.RANGE TWP NAME r7-‘li;? "3^1 'yg I Hg g/i- fa. rLoi/‘.P E-911 ADDRESS OR DIRECTIONS FROM NEAREST PUBLIC ROADPARCEL NUMBER (S) OF PROPERTY BEING SERVICED rJ3J{ nn/) ^ so r) LEGAL DESCmPTION / ^£)( ra-rh sty/ of ten hr LfA/e.0rl!^p ^ R. thC-4 1 i i ft 59% Daytime Phone No.Last Name First Initiai Maiiing Address Jf^-hroiA-r /flAC v5 4a; s^. A L ij A /// D/J i/ (£Property Owner MrTJs. //%' - ^Contractor Lie.#-4> '// ------------------- Of3(cdl THIS SPACE FOR OFFICE USE ONLY uh at tA the year of> This System will be ready for inspection on. IllQyi/ Received (f ~ 0^ Time Received C_/ AdM 1 & R Off/cial P.M. Date SEWAGE TREATMENT SYSTEM DESIGN DATA - AS SHOWN ON DRAWINGTYPE OF INSTALLATION (CIRCLE ONE) TANK DRAINFIELD 74c> (/oo<ySiz GIs.Add-On/ Bee!icemen|------^ Setback to nearest well (32) Tank, Septic (33) Tank, Lift '(34) Trench, Rock (35) Trench, Gravelless (36) Trench, Chamber (37) Bed (38) Mound (39) At Grade (40) Combination New System (20) Trench, Rock (21) Trench, Gravelless (22) Trench, Chamber (23) Bed (24) Mound (25) At Grade Ft. Ft. Setback to OHWL (lake &/or river)Ft.Ft./OO c:. Setback to wetland Ft. Ft. .? oSetback to dwelling Ft. Ft.Collector System (26) Trench, Rock (27) Trench, Gravelless (28) Trench, Chamber (29) Bed (30) Mound (31) At Grade Setback to non-dwelling Ft.Ft. Aooi~Ft.Ft.Setback to nearest property line Aoa j-Other (41) Tank, Holding (42) Outhouse (43) Sewer Line (44) Performance (45) Miscellaneous rPoO i~ Ft.Setback to road right-of-way Ft. 3Elevation above restrictive layer Ft. Ft. ALL DISTANCES ARE SHORTEST DISTANCE BETWEEN NEAREST POINTS.* BEDROOMS %ABSORPTION AREA FOR MOUNDSDEPTH OF WATER WELL <AO GARBAGE DISP. Y ! ABATEMENT Y LM’ y7<Ft^HOLDING TANK MONITOR/ DISPOSAL CONTRACT \ ) No-L&R Can Not Process EFFLUENT DISTRIBUTION ( ) Gravity ( ) Pressure &Designer / /x' Designer Lifc3# PERCOLATION TEST DATA Date of Test -- - <.2 ( /Highest Rate Agreement: The undersigned hereby makes application for permit to install, alter, repair or extend Sewage Treatment System herein specified, agreeing to do all such work in strict accordance 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 con dition 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: This permit is vaiid for a period of six (6) months. \//)/]■/)() 7 / ‘I Permit Fee $Date:_o Si^nsture of Property Owner/Agent for Oivner Rec. No.Date:r AA -h--Larni S Resource Mariagement Office .//.■fr / Form No. BK — 0203-003 315,609 ■ Victor Lundeen Co., Printers * Fergus Falls. Minnesota i SEWAGE TREATMENT SYSTEM PERMIT INSPECTION RESULTS Inspector must make all measurements HOLDING SEPTIC TANK DRAINFIELD OUTHOUSELIFT TANKCATEGORY tIbooCapacityFT2Uoo GLS.FT*GLS. lo FTFT loo ^ FT FTSetback from Nearest Well Setback from Buried Water Suction Pipe FT FT FT FT Setback from Buried Pipe Distributing Water Under Pressure lO^ FTrc?-FFT FTFT Setback from OHWL (lake &/or river)FT FT FTFT10 i> Setback from Setback from Wetland FT FT FT FT Setback from Dwelling FT /(bul ^FT Setback from Non-Dwelling FT FTFT Setback from Nearest Property Line IFT FT FT FTto FTSetback from Right-of-Way FT FTFT Elevation above Restrictive Layer 3FTFT FT FT Holding Tank/Lift Alarm VJ Old System Pumped & Destroyed SEPTIC TANKfSf ES NO FILTER T Line to Well Separation DRAINFIELD CALCULATION 1 Actual Minimum# Tanks Installed.5 /o oFTX□ YES n/pT c^l,3> Manuf.. 3 oo .ft^FT20Model # MOUND CALCULATION^ MOUND /AT-GR^t0E ROCK REDUCTIONInspector’s Comments: PiP^ ( Ofllgovtll U|•fVr/^ \Qo'! K-pi- r/o _____________________________ ZYABSORBXION AREA Rock trenches with inches of rock under pipe for %Ft. X S~oO .ft*DF.reduction / equivalent toFt2 SKETCH: |0O /ot? I ,<r IKs iM-A I'/ti Initial/L & fl OmcialTimeDate the above described sewage system installation was found to be compliant with the provisions of the SanitationAs of Code of Otter Tail County. Land & Resource Management Official 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.ottertail.mn.us )S)oM. IQ Zoo^________■f p.q. Bigy L. "bfTlZqt’T mAJ €%USo*L. Lake# 5Ce> • 3S7RE: Inspection on Sewage Treatment System Permit # 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 reason(s): 7L. 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-conforming sewage system had not been destroyed. There was not a well onsite. The Installer had not completed the air test. Our Office has not received the Well Abandonment Certification. A variance is required for non-complying setbacks: ______ Ordinary High Water Level ______ Lotline ______ Road Right-Of-Way ______ Structure ______ Wetland ______ Miscellaneous Be aware that failure of obtaining the variance will result in removal of the non-complying portion of the system. Please contact our office for a reinspection of your sewage system when the problem is corrected. Approval of the system can not occur until this matter is resolved. CC/INSTALLER: l^tTCR PjAtjcL, g~C^y73 Note: The entire sewage system must be installed prior to the Permit’s expiration date. Inspector FRMLTRS/ss~noi I^T4:T ■ 4..J tJ.■ 4J 1tThrSYsferh designIrmJstpbpTtOpScatpand ^ - ex1stm^/p^p|o'se(jj£)u|il*ding|sI-p|r(^ertY-line^ th|e| ordirijary hi ghj water - Il-yyatet|-Wells^ithin^1 sbi^pf-^^sewage^ystjenri^ li-th|ere-a --1^irmesota -Sitel-Eva^hliatiori wo'dcsh^eetst^ '’‘-Ut-Ill-.-UU - uLlLil _ _ ...........i f|i . l±i":!±j:t......................................r..-,..............-;} - ■ ill' t^iL. h.(.....^J;^- -orl.;..1 I-J... ^. L -'i 1 i,, [ [ L_j~f---4“4—f-4 + I I- —LoC|a|ti o n of t he- 'sewag e syste m J-a 11 r Ie>l/e I th e yvatewjetlatji^Sr a re-aiiyJc|uestidn^ s;ep thet(|n iversity4~p '---—H 'l 'Ilf-------H 4LI J.. ■f nch(es) -eaual^ii/Cci ....I ...-....h-H...F^\ '•r- grid(s)i equals i_l_ ........ i 4 { I'll---■ i i '—--- -U-1 i1 Scale:__Lfeet, M i ! i r- eeti i [- ^ii■H i-__l. +.I'Ii!1 i [ 111"I i iJI-t MPGA GENSEi-# /'Acij i© , ‘ I . , -~i _|j ' ■; \ \if/< , I , i i K I i T i~r^ uScy.' '/?i^ —Y *'’' ’' ' i"i'I! I i....f .h I /n''=IY (/-hi ....-Y41 .l. DESIGNED BY: .. LIGEh SE GATEGOII!-|.l-ijJji..II iNAME:HIRM It?,4 i DATE:1T ..\-rrjirF-riADDRESS:1 [ 1 (-1—I?!GNf|4^I. ..tiI\■(Li10411^^r th;<%4ulLvi-vi I -fO_rMM-I"II mm4 rT44.EH f , t -j....t-:i tf Iri.![,f-ESSI-.4. i IITL-I.}:.i.I'Lilztx:T 414..4..□UT_[HH n ■f ..._I I fr:4 41 1 1 It ••-1- 4..!..4fI 44'4ti;-4-FfF-tf:F-4:; 44q4::T:t: :44:m:: I- (•1--,4..14-□■ Z4-f.‘-n tU h-i !![ri<4^QIZiSii IH-rZ 4 JI 1 “TI..i,l..I...Irrr i r„i_...r--rtr'1-• •4...-r I..I..I...[...L. r rT! ' I4 Z i.I.[.f..i.!.}4tt+4'^", ! I...!.I f: - htif.f Z.....I n I zrfI i 4....U-i T ii-•t T""t ! I•i.If ..L.I.IiI,,L ..1.rII1•t....^!""!1 tr■■ I T'1[Tr ■ t\\\...I.. i 1[■1-•f-t-h-i 1 4.t"..[1.1-rt ■I 114.4-4-“!...[■4-4-"Tij.!■ t '■ ■(..i.■|..h4..\.-Ht’4-t ..j."T"tt I, ., Zll Z L!.J J i j_ L i ! _ 1 I ! i i _ i [ • Victor LundeensCo.. Printers • Fergus.f...t.ft".’.i4..1.1.1...rl 7......... ■■I T I100340294..i-Zt .i..1..1b'kt—):|qj Fails M N....■■■T-800;346-4870“'IZ4F47"—-p-7!! 315.904t.■■f—T 7'F-(.....1..1..ri i rr'i..i "TI i !11 j 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 y.'u A i OA L, _ Sewage Treatment System Permit #OWNER: Oaub TELEPHONE NUMBERFIRSTMIDDLELAST NAME ADDRESS: (Rn (n s-cZIP CODECITYSTATESTR./RT. X£- Vli SEC. TWP /V o /SAP'T TWP NAMERANGELAKE/RIVER NO.LAKE NAME LEGAL DESCRIPTION:SOIL BORING LOG COLOR & MUNSELL NO. DEPTH (INCHES)STRUCTURETEXTURE poP <BLOCIC^ PRISMATIC NONE ^ C> ^ ^^ f'/ O O 0-S&} ^ PARCEL NUMBER CgLSCKY^ PRISMATIC NONE dLAfE-911 Address or Directions From Nearest Public Road /^'SS 3NUMBER OF BEDROOMS BLOCKY PLATYSa^o(3>GARBAGE DISPOSAL: YES PRISMATICl <^(/^ JqIonO8S_£5ft. SEWER LINE SEPARATION:.ft.WELL: CASING DEPTH BLOCKY PLATY PRISMATIC FLOODPLAIN: YES Cgi5^. BLUFF: YES VEGETATION: AQUATIC ^ftERRESTRlAir^ ^A/oid6o -oH .cNONg. BLOCKY SLOPE AT INSTALLATION SITE:%PLATY PRISMATIC NONEPit <>.^oring~'>TYPE OF OBSERVATION:Probe PARENT MATERIAL:Outwash Loess Bedrock Alluvium A/d (A O_^ /\Ro Qr •' ^ ~ O ORIGINAL SOIL: <3^ No Yes C^52- DEPTH OF BORING (To T or restrictive layer):. Date of Soil Boring COMPACTED SOIL; z ft.Date of Perc Test PERC TEST #2PERC TEST #1 - TWO TESTS ARE REQUIRED - TIME WATER DROP PERC RATEINTERVAL (MINUTES!WATER DEPTH WATER DROP PERC RATE INTERVAL (MINUTES)WATER DEPTHTIME fotryp'i7-6.(o ___P,JSTARTSTART Time Prop perc .....^......TIME DROP PERC WATER DROP PERC RATEINTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATE TIME INTERVAL (MINUTES)WATER DEPTHTIME /q !<3{ .....J2,J.£ >a-U/ REFILL TIME DROP PERC TIME DROP PERC WATER DROP PERC RATE TIME INTERVAL (MINUTES)WATER DEPTH WAT^ DROP PERC RATEINTERVAL (MINUTES)WATER DEPTHTIME :.Z^./C2SJJ%fOssX/...O REFILLREFILL Time drop percm TIME drop PERC WATER DEPTH WATER DROP PERC RATE TIME WATER DEPTH WATER DROP PERC RATEINTERVAL (MINUTES)INTERVAL (MINUTES)TIME REFILLREFILL -r---------- =TIME DROP PERC TIME DROP PERC WATER DEPTH WATER DROP PERC RATE TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATETIMEINTERVAL (MINUTES)REFILLREFILL PERCTIMEDROPPERCTIMEDROP WATER DROP PERC RATEINTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATE TIME INTERVAL (MINUTES)WATER DEPTHTIME REFILLREFILL TIME DROP PERC TIME DROP PERC WATER DEPTH WATER DROP PERC RATE TIME INTERVAL (MINUTES!WATER DEPTH WATER DROP PERC RATEINTERVAL (MINUTES)TIME REFILLREFILL DROP PERCTIMEDROPPERCTIME WATER DEPTH WATER DROP PERC RATE TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATETIMEINTERVAL (MINUTES)REFILLREFILL DROP PERC TIME DROP PERCTIME PROPOSED DESIGN: HOLDING TAI PRESSURE DIST..ATGRADE.MOUND.GRAVITY DIST..TRENCH BED. ^ .1} SQ.OUTHOUSE.OTHER. SPECIFY:,SEWER LINE. — SYSTEM DESIGN ON BACK — Department of LAND & RESOURCE MANAGEMENT COUNTY OF OTTER TAIL Phone: (218) 739-2271 Court House FERGUS FALLS. MINNESOTA 56537 July 1, 1999 4::•'iDavid H. Kaldahl Fair Hills, Inc. Route 1 Detroit Lakes MN 56501 Fair Hills Resort, Sec 5 & 6, Hobart Twp., Lakes Five & Six, 56-357 & 369RE: Dear Mr. Kaldahl, As you may know our office is doing an abatement survey of Lakes Five, Six and Seven. Mike Douglas and I visited your resort property on Lake Five on June 24, 1999 to conduct a sewer compliance inspection. John Freeman gave us a tour of the site. He was very pleasant and helpful and. answered all of our questions even when they required some research. He deserves a raise.«•. During the course of our inspection we discovered some minor problems. Hopefully these can be corrected without going through the abatement process. Here are the problems we found: The greywater line from the laundry was crushed. The septic tanks for cabins 6-& 7 had no visible risers or clean outs The septic tank for cabin 6 is only 8 'A' from the cabin, not the required 10’. 1) 2) 3) The septic tank indicated in #3 will not be a concern since it was installed under permit but not inspected by our office. Since we have allowed this situation to exist for so long we will classify the location of this tank as “approved for use”. However, problems #1 and #2 need to be corrected. Both of these are relatively minor in nature and should be easy to fix. Please note that a sewer permit must be obtained to do this work. Please have the necessary corrections done by August 15, 1999 and call our office for an inspection. You may contact me if you have any questions. SincpKly, I George Hausske Inspector GH/jlt LAND & RESOURCE MANAGEMENT OTTER TAIL COUNTY FERGUS FALLS. MINN. MKL-0871-030 '^£t^<uMXr 19 8qFile Opening Date. Individual File Q() Name of Applicant; Subdivision File ( )Subdivision Name,Special Use ( )Use Description. J^c, /^DcLu<r/. ry)AJ S(^o/Address:StateSt. & No.Last Name First Middle City Zip No.Phone No. iLegal De^fi^tioj ^-4, _£T) S'iClassif.Lake No.L^ke^r River Name Sec.Twp.Range Twp Name -y O BUILDING PERMITS VARIANCES ON BUILDING PFRMIT.R Date NotifiedDatePurposeAppl. Date Hearing DateDate Inspected ResuUs Hearing JudgementNO. ^5'33 yg 3H 1Mor CMMiP/5" /?' ^6%^b05 Ca,^ ___?sn ■ 11; ' I ; ^ Appl. Date I e^Oanr '\p(JK \@ SEWAGE SYSTEM PERMITS Date Purpose Date Inspected ResultsNO.Date Notified HOT G"CUva accallerlO*)XL 4.Lz.3^. V OkfUorS I cs fjorCB2^$'II/ * A r t I^OTIVVv \ca-llm> n/eu sysTeMO^Pfims)bj^16>o( A A A-i A / /f/oM S^s-jc^/LuiincU <2:3»?^(f4 /(V3 «•.'AAccompanying Documents Filed in Cabinet No. vicios .uNtf £<i i eo.. »»ii(ittt. rc«eus r*ii.».NOTE: ©and @ See enclosed Inspectors Copy of Permit Application. © See enclosed Special Use Permit Application... 197155 % CAof- n 9^" I?•)Ct>'«L + n? A4 \/'AlNlC> ‘io Mir^-d v-A^i A 31V/C' 5/^c^r" Jrj oK /><. AUt^ 4 Ofv>^f\i ^5C>'O'"7.TAii7 c?i:t-—7(,o y ^ 'Tav^'C rcA3P O'A 1> p pa,^ 7cc?^ Cac/i^ J •V— 7 Ot \ T a H / (2) c'er'-^^ O/C ^ -to^ .r? (('/ f^\\ SR CERTinCATE OF APPROVAL SEWAGE SYSTEMft 'i^'2nd day of Mouejnbg/i.19 MThis 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.m The premises covered by this certificate are legally described as:: Lake No.Sec. _5 Twp. 137 Range 40 Twp. Name doboAt. Fcua HWU, Lake FLve Ruofut {Laundh.y) Fcua Hilti, Jnc./Vavfd H, KatdahlOwner: Namea'. PO Box 6 VeXAoiX. Lakz6^ MNAddress 56501Zip No. 1*8464Permit No. SP Ll/aJ2i2lq^Signed by: Land & Resource Managemeni OfTicial Otter Tail County. MinnesotaMKL-098700I SVii a, Victor Lundecn Co. Printers. 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 Yellow —Alnspector Pink — Owner Permit No..ILEGAL DESCRIPTION AND R t> 5 WDS*>6-357 FiV<LOCATION Lake No. Lake Classif.Lake Name Sec.TWP TWP NameRange IDENTIFICATION: Please Print All Information. Mailing Address — No. Street, City and StateLast Name _____First Initial Zip No.Tel. No. r>41/^OWNER SEWAGE SYSTEM INSTALLER Name This System will be ready for inspection , 19.on. This space for office use only 19 .M Date Rec'd Time Rec'd Phone Call Rec'd By Owner or Agent Signature fWMBER OF BEDROeWS:ESTIMATED COST: SEWAGE DISPOSAL SYSTEM DATA: SEPTIC TANK EEPAGE PIT DRAIN FIELD ¥■GIs.I •^3APC)f) X So' Ft.Sq. Ft.Capacity 50 Ft.Ft.Ft.Distance from nearest well D£ISFt.Ft.Ft.Distance from lake or stream D.D10Ft.Ft.Distance from occupied building Ft. Id10Distance from property line Ft.Ft.Ft. 3Ft.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 M By Lz.ii 5., 19 10 .PERCOLATION TEST DATA:Date of First Test Rate 5.k.zM m..Date of Second Test 19 Rate 1st Test s IQ.2First Test + 2nd Test 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 in ■agsyisposal Code Minimum Standards set forth by Minn- h^afid which are approved by Shoreland Management Offi- ed until « has been inspected and accepted. It shall be the eJtJbii ready »/inspection.CL Agreement: strict accordance with ordinances of the County of Otter Tail, Minnesota and Minnesota Individu^ esota Department of Health. Applicant agrees that plot plan, sketches and specifications submit cial shall become a part of the permit. Applicant further agrees that no part of the systerprSfi responsibility of the applicant for the permit to notify the County Shoreland Manage jarfherewit all be cmitff t that the I understand that I have been granted a sewage system site permit in accordance Vtith 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. Permission is hereby granted to the above named applicant to perform the work described in the above state/ient. 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. Signature Permit: Issued Date: Shoreland Management Office Fee $Rec # ~frcurL uj 19," rpr kComments: Form No. MKL-032085 237,443 — Victor Lundeen Co., Printers, 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 Yellow —* Inspector Pink — Owner mil}~A\\rl\ills La S'Permit No.,LEGAL T^(>€DESCRIPTION AND j-fo lo4r^kb 5 m LIDr\[/^LOCATION Lake No,Lake Name Lake Classif.Sec.TWP Range TWP Name IDENTIFICATION: Please Print All Information. Mailing Address — No. Street, City and StateLast Name InitialFirst Tel, No.Zip No.^4 IdU it hOWNER SEWAGE SYSTEM INSTALLER .0<?Name.0- 31 This System will be ready for inspection on., 19. This space for ofUce u^oniy X '. ^ O fifr\ Time Rec’cf !/• Date Rec'd Phone Call Rec'd By Owner or Agent Signature / Vm ij nH V viNUMBER OF BEDROOMS:ESTIMATED COST: SEWAGE DISPOSAL SYSTEM DATA: SEEPAGE PIT /^D^IN f7SEPTIC TANK Sq. Ft>si^ GIs.l-3^.go ri XCapacity Ft. /0so/100Ft.Ft.Ft.Distance from nearest well / IS.15,ft.Distance from lake or stream Ft.Ft. :x010Ft.Distance from occupied building Ft.Ft. 1010Distance from property line Ft.Ft.Ft. \3Ft.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 ,JVI By LzJl 5.IQ....,\PERCOLATION TEST DATA; R . H Date of First Test Rate19 5TO,Date of Second Test 19 Rate ■11st Test _r5sID.2 i First Test + 2nd Test S Rate2nd Test Taken By 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 .SewagerPisposal Code Minimum Standards set forth by Minn esota Department of Health. Applicant agrees that plot plan, sketches and specifications submitted herewith and whigh 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 if has been inspected and accepted. It shall be the responsibility of the applicant for the permit to notify the County Shoreland Managerneht that the,job rS ready W 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. 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. Signature Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express ,■4/0Issued Date:z ✓Shoreland Management Office0/ Fee $Rec # B ^Comments: r-----iBgUEd Form No. MKL-032085 237,443 — Victor Lundeen Co., Printers, Fergus Falls, Minnesota 2-9^9-10 TTV^A^7" ^ 4s6v.OJ^,^r^J^■C^ Q/<W *^C -^«rTXv^.^A 3 ^ ^--W-T^^Li2^ Xl^yn-3 Jlio arm“'^-~^ ■ ^ n S^0O P \ ^ /d-V.io.,,V.2^,.4!£-/’ C>^Ar^Ji l^iiLFT^ ^Jl, /pINSPECTION RESULTS'^ -P--J wra.^ -' Insoector must make all measurements *^ (y5* ^l3SoFf^ 57 ^ /7 ^ X .4L 3 tr-s PT V ;cx.^ y-'etJC^SL^ SEWAGE DISPOSAL SYSTEM STATISTICS SEPTIC TANK SEEPAGE PIT DRAIN FIELDCATEGORYActualShould Be Actual Should Be Actual Should Be Z- /5'CJ'O /S3i^Capacity GIs.GIs.S F S F S F S Fr?Q-iu-fJ S’ Distance from Nearest Well ^ ^ i—Vf-VA—vs»-x V—^o-----*------. -----— Distance from Lake or Stream ^5 7 f wt It F 4^0 e3^F F F F F So FFFF F c.^5 Distance from Occupied Building 4-^F/TO F F F F F W)C>Distance from Property Line F F F F F F/ O t Distance from Bottom to Water Table 3 3FFFFF F Inspector’s Comments: / I3 ■< z-ci —3o'' J-.:>C. O -J3^ /OO 2cr -f-c* -/“V I ^oc4- M ^ y "z o' Cy 'C’ 0^ foC/lc ,( £5 0 yo« 'rcJDate of Inspection 19 ///3oTime of Inspection M / Lx^P/ p»o S^nafure o/ /nspectorINTERPRETATION OF ABBREVIATIONS GIs = Gallons SF = Square Feet F = Linear Feet -ioo Job Tm 't\ MKL • 032085 •:ker Agency.V r^> '72.3K /1 .d±4*. tAZ^ \ \■\ ■ »' PERCOLATION TEST DATA»LAND AND RESOURCE MANAGEMENT Otter Tail County Fergus Falls, MN 56537 OWNER: CLS TELEPHONE NUMBERMIDDLEFIRSTLAST NAME ADDRESS: ZIP CODESTATECITYSTR/RT TWP NAMERANGETWPSECLAKE/RIVER NO LAKE NAME LEGAL DESCRIPTION: PARCEL NUMBER NUMBER/BEDROOMSFIRE NUMBER — TWO TESTS ARE REQUIRED — TEST HOLE NO. 2TEST HOLE NO. I ___inches3^3A.inches; Diameter of HoW___inchesDepth To Bottom of Holeinches; Diameter of HoleDepth To Bottom of Hole. 19 19DateDateSoil TextureDepth. Inches Depth. Inches Soil Texture /^OC /MJL3toPercolation Test By Finn Name Percolation Test By__ Firm Name ___/ CTW L2^5^/O fiAddress Address Otter Tail County License No. Otter Tail County License No. PERC TEST # 2PERC TEST # 1 WAnapgPTH WATlflftDUCir^aCRATB TIME PrTBRVAL fMDIUTgS^ START JHSCJMItMTEItVALfl.QWUTaS>WATHk: DROPWATHRDCLPTHTIME START >T *nMH“ Crop perc TTMIT B1R5V fBRC>^CRATli TIME INTERVAL n>IDArra«2 m/ATER DEPTH WATER QRQP PBRCRATB INTERVAL fMTWtfTRft WArmDBKTM WASTODROPT1I»C 2.3 M RBPJJ^ T TSXE~ ^ tfPR5F' “fBKC~'nMB Crop pbjxc INTERVAL rMIWm«t RBPI^ water PeyTMWATER DEPTH WATER DROP PERC RATE TIME WATER DROP PERC RATEINTERVAL rMlNlTTBSl F.lWr ----^--- liME Zi"/:g;3RE 3.'M n V4 4*nSXB~ DROP PERC 'fTWP,' DROP" PBRC WATER DROPPERC RATE Til INTERVAL HrflNirTBI^WATER DEPTH PERC RATEWATER DEPTH WATER DROPINTERVAL 0»qWUTBST TIME ist-Ht iJiS/r '7t?RBPI>X 4 4TfMff" DROP 4brc TUCK" bRop PBRC PERC RATH TIME INTERVAL <MIWl/TES>WATER DEPTH WATER DROP PBRCRATBWATER DROPIKTERVAL fMTNirTBS^WATER DEPTHTIME Z RBPI^ gr: REF LX772)M.4 TTRE“ Crop peRC” PERC RATE TIME INTERVAL (MINVTES)WATER DEPTH WATER DROP PERC RATEWATER DROPINTERVAL 04IWl/rBSl WATER DEPTHjm zRBPI^RBP^UX^:32.m:M12^% TO»m~^DROP PERC ffmc ^-PROF PBRC " PERC RATE TIME INTERVAL <MINl/TBSI WATER DEPTH PBRCRATBINTERVAL IMDAHEST WAfTO DEPTH WATER DROP Tllbg TiWB bROF ll^BRC BI^P' ~^tczZRBl^«:ir Xa:::.Tm im. ...z>..... JJMBIFTHPVtKHTffVroflPERC RATE INTERVAL IMIWWESI WATER DEPTH WAXm DROP PERC RATEWATER PBPTH WATER DROP Tung RBPILLRSPILL ♦TTMH” drop PERC time” I>r<5P perc COMMENTS/CALCVLA TIONS: t-*T- -t----»---*•'PU^]T$KETCjHl qualsf::z_ _l_j_:>ee 1N<d Bellas “'Must B0, To Scal9)ii- i-• ^ \ Scale;Each grid1 it T mtBatfRlr tir ijciri/i&ijruxr at ch i^/ny ~puiranf/yj 1TPl99$9 sMch your mWWbmng am(m<;Ss|/rani ra&ngl ■ <w M ^ My pfippqaed ^ i, 41'++-" ■r fj- ::_ti ■Vi“f-t '►-r-..4 T-- i i I I ■■ 7J -;iA -Ml 41‘■lit Bn3S-_k<-j. i.'we T'Qp>S- \ —iA\n ■■-»*■ kj:i BbSl itrit i:^7 1 7^ m;e>4s )C^5?5E ¥ Si-351S' 3 do ;< a<^ 72> -h ! I :is' .... JO)yLUX^-^y^uJLJ ^ 'S^ O j X ^ >-7v-wXA.-<-^'--''''^-<-e^ Si ao Ag ■ S3 n^i sr^ ---. LL. jlzii 3VL '2vaa <PO-f(5 ^M..asS M6tiH£u Iv CERTinCATE OF APPROVAL SEWAGE SYSTEM 2nd NovembcA 19 11day ofThis 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. The premises covered by this certificate are legally described as: Hoba/URange ^0Twp. ^37Lake No. S6-357 Sec. _5 Twp. Name ¥oua HiZJU> Lak& (2 cabLns) Toaa HLIL6 Jnc./Vavfd H. KatdahtOwner: Name ?0 Box 6 VztAolt Laku. MMAddress 56501Zip No. tf&257Permit No. SP Signed by: Land &. Resource Managemenl OfTicial Oner Tail County. MinnesotaMKL-0987001 5^ 253.6 f 7 Vidor Lundem Co. Printers. 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 Cord — Owner Fflili Hill __ S' C Permit No.,LEGAL DESCRIPTION AND rt~35-7 ■S' / 37LOCATION Lake No.Lake Name Lake Classif.TWP NameSec.TWP Range IDENTIFICATION: Please Print All Information. Zip No,Tel. No.Last Name Mailling Address —No. Street, City and StateFirstInitial 14/lls rOWNER 4 61SEWAGE SYSTEM INSTALLER H S<g PLName r ki LMOLf . 1 cx ^5 , 19i^This System will be ready for inspection on./ This space for office use only X r i 19 .M 4./Xu^jV Or ^ Date Rec'd Time Rec'd Phone Call Rec'd By Owner or Agent Signature NUMBER OF BEDROOMESTIMATED COST: SEWAGE DISPOSAL SYSTEM DATA: SEPTIC TANK SEEPAGE PIT DRAIN FIELD looo GIs.Sq. Ft.Sq. Ft.Capacity 5^/'yy’l i- Ft. /,'r) -t R. i'./?-' t- F,. Ft.Ft.Distance from nearest well 75'Ft.Ft.Distance from lake or stream /fP Ft.Distance from occupied building Ft. 10 J'XW rDistance from property line Ft.Ft.Ft. JcF 4Ft.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 ,]M By 10-3\ .^.1 LLD.PERCOLATION TEST DATA:Date of First Test Rate 19...!^..1... ULl = -3.3V 19 ...» Dat-2 of Second Test 1st Test Taken Byh l.ul i-LlIII >First 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 p>art 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. 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: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. Issued Date: Shoreland Management Office S Urd . OrjJUXi ^0,00Fee $ Comments:. Form No. MKL-0771-003 [^VtlW BATUf LAKf. m:nNCS01A % INSPECTION RESULTS ^ Inspector must make all measurements \ SEWAGE DISPOSAL SYSTEM STATISTICS SEPTIC TANK SEEPAGE PIT DRAIN FIELDCATEGORY;Should beActual Should beActualActualShould be 'S FCapacity SFS FGIs. GIs.S F ' Distance from Nearest Well • F'5075 FF ■:F F F S ,-''F'Distance from Lake or Stream-F ' F F-F F 20 2010Distance from Occupied Building F -F F F FF ;1010Distance from Property Line 10F F FF F F 3■3Distance from Bottom to Water Table F'F FFFF - • Inspector's Comments:; ■ 'j' Date of Inspection 19___1 Time of Inspection ,M -- Signature of InspectorINTERPRETATION OF ABBREVIATIONS GIs ° Gallons SF a Square Feet Linear Feet Job TitleF AgencyMKL-0771-003-Backer i \ V • t,■i '■I t ,/i f. SHORELAIMD MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone 2t8-739-2271 - Fergus Falls, Mn. 56537 APPLICATION FOR PERMIT TO INSTALL SEWAGE DISPOSAL SYSTEM White-OWc« YbIIow — /nspecfor Pink — Owner Card — Owner l]tLL:y Permit No..iLEGAL 1 \ n ‘^oJoi n 4 DESCRIPTION AND '7LOCATION Lake No.Lake Name Lake Classif.TWP NameSec.TWP Range IDENTIFICATION: Please Print All Information. Mailling Address —No. Street, City and State Zip No.Tel. No.Last Name First Initial •' /OWNER fC i? ■ SEWAGE SYSTEM INSTALLER Name. J7 OO-l'O^/j This System will be ready for inspection on., 19— This space for office use only I M Date Rec'd Time Rec'd Phone Call Rec'd By Owner or Agent Signature A•t--' NUMBER OF BEDROOMS;ESTIMATED COST: SEWAGE DISPOSAL SYSTEM DATA: SEPTIC TANK SEEPAGE PIT DRAIN FIELD GIs.Sq. Ft.Sq. Ft.Capacity Ft.Ft.Ft.Distance from nearest well Ft.Ft.Distance from lake or stream Ft. Ft.Ft.Distance from occupied building Ft. Distance from property line Ft.Ft.Ft. Ft.Ft.Ft.Distance from bottom to Water Table All distances are shortest distance between nearest points RECORD OF TESTS; \' wInspection was made on __ 19____ , Time .jVl By hPERCOLATION TEST DATA:Date of First Test...-----1... 19 Rate..... Rate...., - i 19....£..IDate of Second Test.___ 1st Test Taken By /First Test + 2nd Test......j....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. 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 il 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. - i / Permit: £1 /C.//- /yissued Date:. Shoreland Management Office '■/££ V yFee $_ Comments: }|v /t_1 CERT ISSUED Form No. MKL-0771-003 [^VKW BAUIC LAKE V.INNtSOTA I INSPECTION RESULTS Inspector must make all measurementsI cry IZSEWAGE DISPOSAL SYSTEM STATISTICS /yc-V Vi SEEPAGE PITSEPTIC TANK DRAIN FIELDCATEGORYActualShould be Actual Should beActualShould be 7^^ SF sCapacityGIs.SFGIs.SFS F ^5^•60' FDistance from Nearest Well 5075F F F FF T/o(f 160 pDistance from Lake or Stream F F F F F F20 2010Distance from Occupied Building Distance from Property Line F FFF F ,6^!o10 1010F FF F F F F 33Distance from Bottom to Water Table F F F F F Vs. Wv d Xl.^^ f »v\ Inspector's Comments: V^oU'i- ;; I *5 ^ ^ {I ^ ^ •j~f Oy A.o|OV,01-7 H !I V5~yos IC~/3-^9llDate of Inspection. '/ Z') 3,0Time of Inspection.M (-3 Signature*of Inspector / INTERPRETATION OF ABBREVIATIONS GIs - Gallons SF • Square Feet ■ Linear Feet Job TitleF Agency MKL-0771-003-Backer ■f j i *r_ 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 While — Ottice Yellow — Inspector Pink — Owner ^5.-S'”7f=^ii^ Hills F)i/C Permit No.LEGAL DESCRIPTION AND R£>i42>LOCATION Lake No. Lake Classif.Sec.Range TWP NameLake Name TWP IDENTIFICATION: Please Print All Information. Mailing Address — No. Street, City and State Tel. No.Last Name First Initial Zip No. HILLS in/L,OWNER SEWAGE SYSTEM INSTALLER Name This System will be ready for inspection , IQ-on. This space for office use only 19 ,M Date Rac'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 lSi>o GIs.Sq. Ft.Sq. Ft.Capacity Ft.Ft.Ft.Distance from nearest well 7^7iTFt.Ft. Ft.Distance from lake or stream i o 'XoFt.Ft. Ft.Distance from occupied building 10 /oDistance from property line Ft.Ft.Ft. 3Ft.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 M By Id " HI ^1... 19..'!^..t.... PERCOLATION TEST DATA:Date of First Test Rate, 19 2, bDate of Second Test , Rate 1st Test Taken Bnr/I t -2.53,S'S.D2,S'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.Signature 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. Permit: //-/ -rfIssued Date: Shoreland Management Office Fee $Rec # Comments: Form No. MKL-032085 237,443 — Victor Lundeen Co., Printers, Fergus Falls. Minnesota 1.J 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 . -a White — Office Yellow — Inspector Pink — Owner A !■ I 7H-ILlS Fl^C Permit No.,1LEGAL•i DESCRIPTION 1 AND >w t4 ol3f}/< I5U3-LOCATION Lake No.Lake Name Lake Cla&sif.Sec.TWP Range TWP Name IDENTIFICATION: Please Print All Information. Mailing Address — No. Street, City and StateLast Name InitialFirst Zip No.Tel. No. Lfr3iK HiLiS .OWNER Ol^ Ti23?/f ?:> m rJ STTW: 1 SEWAGE SYSTEM INSTALLER Name. -j This System will be ready for inspection on.■N'., 19. This space for office use only 19 .M Date Rec'd Time Rec'd Phone Call Rec'd By Owner or Agent Signature 5 ■i NUMBER OF BEDROOMS;(ESTIMATED COST: SEWAGE DISPOSAL SYSTEM DATA: SEPTIC TANK SEEPAGE PIT DRAIN FIELD / Gis.Capacity Sq. Ft.Sq. Ft. So Ft.Ft.Ft.Distance from nearest well 15 7^Ft.Distance from lake or stream Ft.Ft. 5010Ft.Distance from occupied building Ft.Ft. 10 /oDistance from property line Ft.Ft.Ft. 3Ft.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 , 19 :d5..2...LPERCOLATION TEST DATA:Date of First Test Rate. Rate \ /r."/ h-’ .Date of Second Test ....><i> 1st Test Taken By 1 i 7,7 37..-L.7 .7.:..7First 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.Signature Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon expressPermit: 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. 0.-^1LLIssued Date; Shoreland Management (Mce ) I Fee $_Rec #'I I__ISSUED iiComments: Form No. MKL-032065 237,443 — Victor Lundeen Co.. Printers. Fergus Falls, Minnesota * 7 t r*5#^ I Ol \ oi tINSPECTION RESULTS Inspector must make all measurements II 5+ ,fl )C^ „ Dt //' yr« ( m' / .K. ^S^P«»SEWAGE DISPOSAL SYSTEM STATISTICS SEPTIC TANK SEEPAGE PIT DRAIN FIELDCATEGORYActualShould Be Actual Should Be Actual Should Be I}oou>Capacity t>/L^Vfe^ -V«.v-V<, ,iJ^)GIs. GIs.S F S F S F S F ArDistance from Nearest Well S'<=>0FFFF F F 4-1Distance from Lake or Stream F F F F F F I vrDistance from Occupied Building F F F F F F +(Distance from Property Line 10FFFF F F Distance from Bottom to Water Table 3 3FFFFF F I O prv*,Jr-Kl If Inspector’s Comments: Vq y ~2. j> ~DF I i ; 3 I > /Ds 0-^Y oO^ \C- 13-Date of Inspection.19 Time of Inspection M Signature of InspectorINTERPRETATION OF ABBREVIATIONS GIs = Gallons SF = Square Feet F = Linear Feet Job We I MKL - 032085 • Backer ;Agency :\ \ 1'■■r i .'.V'i i• '-r.- ♦ r- ’ 'A, ■* Ji 1 .5 Ml C'A/~ ^ cJOB ■HANSON’S PLUMBING & HEATING Vergas 342-2422 SHEET NO.OF Pelican Rapids 863-5696 CALCULATED BY DATE CHECKED BY DATE SCALE Pftooua 204-1 INebsI Inc.. Groton. Mass. 01471 21SS02® Vtftio* VUUfttlM CO.. OOlHliOO. f lOOua umil.MKL 0871 -028 PERCOLATION TEST DATA LAND AND RESOURCE MANAGEMENT Otter Tail County Fergus Falls, Minnesota 56537 Ph. No. Mailing Address:QwQSt: Zip Nu.Middle StateCitySt. & No.FirstLast Name LeyaL: Description: Wm:--TWP NAMERANGESEC.TWP.NAMELAKE OR RIVER NO. TEST HOLE NO. 2TEST HOLE NO. 1 7^__La_ —, Datar/I 19_2^ Depth to Bottom ol Hole nches; Diameter of HoleDupih To Bottom of Hole,JncheaInches; Diameter of Hole inches Depth. Inches Soil Texture Depth. Inches Soil Texture Date 19_____ /?>arQ?rbUL.-glriT—j- Percolation Test By____ Percolation Test By^__OlUFirmName.CC FirmName,3OLUOC aiAddress,OC Address < (/)Otter Tail County License No.,Otter Tail County License NOsH(/)lUMeasure ment,Inches Time Intervals minutes Drop in water ievei, Inches Percoiation rata minutes per inch H Time Interval, minutes Measure mentinches Percolation rate minutes per Inch Drop in water level, inches Remarks:. Time Time Remarks:O 5^ - 337 2o...3.^3 I3/ 3/2^ 3y<3 33 3 3e)22. _323l 3'Zjr3 3.£7.. p,s-y 3SI 2-5~ . 3:2-^ 7-3S3: 30 •2^ a. V ^:r:See Booklet. *'How to Run a Percolation Test'* by Agriculture Ext. Service, Un. of MN t’cicolaiion rate minutes per inch minutes per inchPercolation rate = < 21SS02® victo* iUMOCiii CO.. MiNTca*. riNau» wmii.PERCOLATION TEST DATAMKL -0871 -028 LAND AND RESOURCE MANAGEMENT Otter Tail County Fergus Falls, Minnesota 56537 Ph. No. Mailing Address:Ownur; S~Zip Nu.StateCityMiddleSt. & No.FirstLast Name /^6/rrr/^Legal ,.v. Description:—^^-------------------------— LAKE OR RIVER NO.TWP NAMERANGESEC. TWP.NAME I TEST HOLE NO. 2TEST HOLE NO. 1 3/i 3 ^(odepth to Bottom of Hole.Depth to Bottom of Hole inches; Diameter of Hole.Jnchesinches; Diameter of Hole inches Soil TextureSoil Texture Depth. InchesDepth; Inches Date Date IB 1 !=(—MiffPercolation Test Qy Percolation Test By ■.smjH. - 3e2..._o eUJFirm Name, Firm Name.CC 3OLU CC UJ CCAddress.Address < 00 Ouor Tail County License No..Otter Tail County License No..H00 LUMeasure ment,Inches K Time Interval, minutes Measure mentinches Percolation rata minutes per inch Drop in water level, inches Percolation rate minutes per inch Drop in water level. Inches TimeIntervals minutes Remarks:Ramarks:TimeTimaO Uoi ad m 3Z2^3 2^ /d 13=^m •5^0-2^UL 3/32A ______ _________ 3^2^ __3^■2_<3Sa. 3MM 3.30 3.m..f3>.S- Jim.l‘eicolation rate See Booklet. **Howv to Run a Percolation Test'" by Agriculture Ext. Service. Un. of MN minutes per inchminutes per inch Percolation rate = I< CERTIFICATE OF APPROVAL SEWAGE SYSTEM Pe.cejTibe-'i22nd S8This certificate has been issued this day of 19 mto certify that the sewage system installed as per sewage permit number indicated below has been approved for use by Otter Tail County, Minnesota. The premises covered by this certificate are legally described as: mHobaxtTwp. Jll Range556-357Lake No.Sec.Twp. Name 3 Luke, five ToJjl Hftti Re^oNt Fcua HCtti, Jnc.Owner: Name Ve.tAoit Lake^, Mlnm^otaAddress 56501Zip No. 7942Permit No. SP 'j/J Signed by:. Mal^lm K. Lee, Land & Resource Management Administrator Otter Tail County, MinnesotaMKL-0987001 f/y 243,984 — Victor Lundeen Co., Printers, 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 Yellow — Inspector Pink — Owner Permit No.,LEGAL 3DESCRIPTION AND << cLOCATION Lake NameLake No.Lake Classif.TWP TWP NameSec.Range IDENTIFICATION: Please Print All Information. Mailing Address — No. Street, City and State Zip No.Tel. No.InitialFirstLast Name OWNER r 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: ^3ESTIMATED COST: SEWAGE DISPOSAL SYSTEM DATA: SEPTIC TANK SEEPAGE PIT DRAIN FIELD y d 373.GIs.Sq. Ft.Sq. Ft.Capacity ^ /r/y,r/e=t 5^5^Ft.Ft.Ft.Distance from nearest well / y Ft-Ft.Ft.Distance from lake or stream Ft.Ft. Ft.Distance from occupied buildinq Z_E1 Distance from property line Ft.Ft.Ft. Jo Ft.Ft.Ft.Distance from bottom to Water Table AH distances are shortest distance between nearest points RECORD OF TESTS: M ByInspection was made on , 19 , Time PERCOLATION TEST DATA:Date of First Test 19 , Rate Date of Second Test 19 , Rate 1st Test Taken By c^p.First Test : + 2nd Test 22nd 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 b responsibility of the applicant for the permit to notify the County Shoreland Management t ’eBuntiljfr'nas^een inspected and accepted. It shall be the le job is reajlyrfor insmction. I understand that I have been granted a sewage system site permit in accordance wifh the requirements of the Shoreland Management Ordinance of Otter Tail Coufity. I understand I must contact my township in order to determine whether or not an^ddi- tional permits are required by the township for my proposed project. 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. "T Signature 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: ifioreland Management Office Fee S ^ O' Comments: Form No. MKL-032085 237,443 — Victor Lundeen Co.. Printers, Fergus Falls, Minnesota SHORELAND MANAGEMENT — COUNTY OF OTTER T^L COUNTY COURT HOUSE C A Phone 218-739-2271 • Fergus Falls, MN 56537 APPLICATION FOR PERMIT TO INSTALL SEWAGE DISPOSAL SYSTEM .i WhHe — Office Yellow — Inspector Pink — Owner • > Permit No.,LEGAL jDESCRIPTION AND ■n /)LOCATION ; Lake No,Lake Name Lake Classif.Sec.TWP Range TWP Name IDENTIFICATION: Please Print All Information. Mailing Address — No, Street, City and StateLast Name First Initial Zip No,Tel. No. tiOWNER SEWAGE SYSTEM INSTALLER Name, This System will be ready for inspection on.. 19 NUMBER OF BEDROOMS; ' This space for office use only u3/ Phone Call Rec'd By /I-in .Ati .r Date Rac'd Time Rec'd .M Agent Signatureer or ESTIMATED COST: 1SEWAGE DISPOSAL SYSTEM DATA: SEPTIC TANK SEEPAGE PIT DRAIN FIELD GIs.Capacity Sq. Ft.Sq. Ft. ^ V*5-rSlSF- - '5Ft.Ft.Ft.Distance from nearest well ; /r ./y, / ,f, r Ft.Distance from lake or stream Ft.Ft. Ft.Distance from occupied building Ft.Ft. Distance from property line Ft.Ft.Ft. 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 By.M PERCOLATION TEST DATA:Date of First Test 19 , Rate i- 'iDate of Second Test 19 , Rate 1st Test Taken By .(1.0Rate First Test + 2nd Test 22nd 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 Shoreiand 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.Signature ) - V, 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 y' Issued Date: Shoreland Management Office7 ■f IFee $Rec # fy ■IComments: Form No. MKL-032085 237,443 — Victor Lundeen Ck>., Printers. Fergus Falls, Minnesota rww '— C ^ , . ( i INSPECTION RESULTS Inspector must make all measurements S-o I i I ToOSEWAGE DISPOSAL SYSTEM STATISTICS I/S’ >cro SEPTIC TANK SEEPAGE PIT DRAIN FIELDCovaeei?CATEGORY Should BeActual Should BeActual Actual Should Be +-z-sso S'Tiix^I loo' GIs.Capacity GIs.S F S F S F S F /!0^'1-2.^Distance from Nearest Well r\o F F F F F F rr/2oDistance from Lake or Stream I Z^<JFFFF F F I I78Distance from Occupied Building F F F F F F /O /QDistance from Property Line F F F F F F ISDistance from Bottom to Water Table 3 3FFFF F F -lofyA/ moCT'zfiN CsNsn-iXtoD D J2 V 0 pN Inspector’s Comments: ^\'v //- —Date of Inspection 19 "n Time of Inspection M t S^nafure of InspectorINTERPRETATION OF ABBREVIATIONS GIs = Gallons SF = Square Feet F = Linear Feet Job Title MKL - 0320$$ - Backer Agency 'iP _p:y ) 00 0/ 8t0. V ,V 1 i{• Bi^- m.11 V^/W£jgp„ 4 ■' 'A»^lii?n ^mmi M A, CERTinCATE OF APPROVAL SEWAGE SYSTEMail 2 2nd VtcmbeA 19 _M.day of to certify that the sewage system installed as per sewage permit number indicated below has been approved for use by Otter Tail County, Minnesota. This certificate has been issued thisM ■J I;! l'\ tI* The premises covered by this certificate are legally described as:;,j I56-357 5 HoboAt137RangeLake No. Sec.Twp.Twp. Nameil! m’1 bcuA HiZti) Ro^oAt, Lake. Ffve (Cabitu HI, H2 f, 113] m 3i:ToIa % Vave KaZdahl VetAoiX Lake^. MM_________ Owner: Name2l [!mm7Address W’56501Zip No.L-m, 'i- 7601Permit No. SP 'M.Signed by:. Malcolm K. Lee, Land & Resource Management Administrator Otter Tail County, MinnesotaMKL-0987001 •1^1hImi ixiti^ 243,984 » Victor Lundeen Co.. Printers. Fergus Falls, Minr>esota r 'i tr:.'o3 iso^J 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 wtife —Offic* Yellow — Inspector Pink — Owner V*; 7go\FniK Huis H£Soq.\ (^LH)iE F\^£) Permit No..i4 LEGAL ©DESCRIPTION AND 131 HfDLOCATION TWP NameLake Clasiif.Sec.TWPLake Name RangeLake No. IDENTIFICATION: Please Print All Information. Mailing Address — No. Street, City and State Zip No,Tel. No.InitialFirstLast Name die K'/■/L I Cm ^3^^14^ I ifOWNER SEWAGE SYSTEM INSTALLER i'tz.^2^t' g.Name. Uj\h C,u/This System will be ready for inspection on.19. This space for office use only .19 .M Owner or Agent Signa^tureIf *Date Rec'd Time Rec'd Phone Call Rec'd By NUMBER OF BEDROOMS;ESTIMATED COST; SEWAGE DISPOSAL SYSTEM DATA: SEPTIC TANK SEEPAGE PIT DRAIN FIELD XOOD f53GIs.Sq Sq. Ft.Capacity 7 So/lOosoFt.Ft.Ft.Distance from nearest well IS 75Ft.Ft.Ft.Distance from lake or stream io 1.0Ft.Ft.Ft.Distance from occupied buildinq lO10Distance from property line Ft.Ft.Ft. 7 \3Ft.Ft.Distance from bottom to Water Table AH distances are shortest distance between nearest points RECORD OF TESTS: lnsF>ectlon was made on „ 19 , Time ,JVI By 5-/(-L. laL.... L / loL _ 13 , 3<A _ C, L>lo t.L.PERCOLATION TEST DATA: Bi9rV5^R_________ Date of First Test 19 Rate. 19...^.^...., RateS-lDate of Second Test 1st Test Taken Byn I) II ^ 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^ 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 regdyTw inspection. / \ " / Dated. 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. g- ?- gy d.Issued Date: Shor^w\P Management OfficeU3UFee $ 7^0 Rec # i ^2 : Comments:f H 6p)CexJlr'-^ ^ 3 ISO Form No. MKL-032085 2^239 — Vtotor Lindun Co.. Wmm. F«gui FA. MN r 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 mhe Yellow — Inspector Pink — Owner — Office ~7Permit No.^•ESoa\F;9)RLEGAL DESCRIPTION AND P.D G 137 JdALOCATION Lake No.Lake Name Lake Cla&sif.Sec.TWP TWP NameRange IDENTIFICATION: Please Print All Information. IVIailing Address — No. Street, City and StateLast Name InitialFirst Zip No.Tel. No. C/g On\JE. l^filLDAHi________ _____OEV^orr mi7 Fma HILLSOWNER 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: SEPTIC TANK SEEPAGE PIT DRAIN FIELD Sq/Ft.looo 7^^ Sq. Ft.GIs.Capacity 60 lidDFt.Ft.Ft.Distance from nearest well 7^7^Ft.Ft.Distance from lake or stream Ft. ID Ft.Distance from occupied building Ft.Ft. W loDistance from property line Ft.Ft.Ft. 7 3Ft.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 C> I 4j(c37/ - 3vY'rjo' PERCOLATION TEST DATA:Date of First Test , 19 , Rate 19....'?^..., Rate....IP..Date of Second Test 1st Test Taken ByH h h iL- LL , ...%;33c? >\DFirst 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. / 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 IS.cr -10 - srrDIssued Date: Shoreland Management Office Rec #______Fee $ Comments: — cr'\^djly\ ~X3o~ Form No. MKL-032085 237,443 — Victor Lundeen Co., Printers, Fergus Falls, Minnesota f- « 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 mite —Office Yellow — Inspector Pink — Owner I ISSUESLLRT ! Permit No.,LEGAL ©DESCRIPTION c AND : ”7 ,\If'LOCATION Lake Claulf.Sec.TWP TWP NameLake No.Lake Name Range I IDENTIFICATION; Please Print All Information. Mailing Address — No. Street, City and State Zip No.Tel. No.InitialFirstLast Name OWNER ISEWAGE SYSTEM INSTALLER > f / jName. - ■:V \ This System will be ready for inspection on.19. This space for office use only /?,')r a-I 1 //19 .M Date Rec'd Owner or Agent SignatureTime Rec'd Phone Call Rac'd By fNUMBER OF BEDROOMS: /ESTIMATED COST: SEWAGE DISPOSAL SYSTEM DATA: SEPTIC TANK SEEPAGE PIT 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: Inspection was made on .. 19,, Time ,JVI By 5 - I 5 /PERCOLATION TEST DATA:Date of First Test ., 19 . 19 Rateteieef Date of Second Test Rate 1st Test Taken By /L. .First Test + 2nd Test 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. 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: Shorelend Menegewent Office Fee $Rec # (' 3 tp)1Comments:i:A +r-■ (' ‘V : •. .-V '■ ■: 7. Form No. MKL-0320B5 -ft- 225239 — Victor LundMn Co., Printois. Fcrgui Fik. MN i •'iwi mk' niMU M Hljpi -«ip|fl«l, U fT'F*'" f t ' . - - ;C /4 ‘ " %. ■ •■•' ■ v'» •» ■5^.;v'. -■ -»« -' ■» vpr . ,vL .' I ^5■rai r^- * ■^•^',\r-.- T.;^'RESULli^<^^INSPECTION. i (\j^ Inspector must make all measurements ■> __a.1 ^ 3 s' jo' V 3^ s’ I ■/'^>^.'A SEWAGE DISPOSAL SYSTEM STATISTICS ' SEPTIC TANK DRAIN FIELDSEEPAGE PITCATEGORY Should BeShould Be Should Be ActualActual Actual '=?S3Capacity ST^ ^ ’1/00:^ioo S Fs F s FGIs.GIs.S F IS’ODistance from Nearest Well FF F F FF IniDistance from Lake or Stream FF F FFF -f-'2°)30"Distance from Occupied Building FFFFFF i-/(TDistance from Property Line /FFFF F F i-JS3 3Distance from Bottom to Water Table F F F FFF Inspector’s Comments: CA/yr^i ^ Z. <fAx^ G? / Co C/o,^lZ>^ \lcc^ ^^1-- \I >1 -V i ^ -L d » s4- f » -y ^ 3 5 > 5 ^(J ‘-r?’-Jt KV^ :-C f o 4-- o f ^ i-- n-19WDate of Inspection OZJ MTime of Inspection U-v. Signature of InspectorINTERPRETATION OF ABBREVIATIONS GIs = Gallons SF = Square Feet F * Linear Feet Job Title ^K.r.- ■ - - ''»qc \ MKL • 03208S • Backer AgencyV ;• .J,', .■jtvy.,' ' ,fi •■«■ j .. :h • .. yu-'* -V-:-•■a-. '.1 C i ■V -- . ‘-V',;• -,''t .1 •r-"5$ - -I- ; .jr i - “ f ■ i: ■ ->4-if V r 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 While — Office Yellow — Inspector Pink — Owner "7 ^ ^ iPermit No.,Res 0(1 \^]LL5LEGAL DESCRIPTION i - JAND RDCV-JS7 ^ _U2F\yb-LOCATION rLake No.Lake Classif.Lake Name Sec.TWP Range TWP Name IDENTIFICATION: Please Print All Information. Mailing Address — No. Street, City and StateLast Name First Initial Zip No.Tel. No. (Z) Oft\/L l^f\LDj9Hi_________ Oflfiz— iVfy' HILLSOWNER rSEWAGE SYSTEM INSTALLER Name \1 1This System will be ready for inspection on., 19. ;This space for office use only i 19 .M M iDate Rec'd Time Rec'd Phone Call Rec’d By Owner or Agent Signature NUMBER OF BEDROOMS:ESTIMATED COST;■! ■JSEWAGE DISPOSAL SYSTEM DATA:1SEPTIC TANK SEEPAGE PIT DRAIN FIELD . loop GIs.Sq/Ft.CapacityI poll OP IF PD Ft.Ft.Ft.Distance from nearest well IP •;Ft.Distance from lake or stream Ft.Ft. 10 Ft.Distance from occupied building Ft.Ft. ID IDDistance from property line Ft.Ft.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 ,JV1 By F'rjF Ih IPERCOLATION TEST DATA: fi 56 a/ Date of First Test , 19 Rate 19....'C?..., Rate....[P..•1 Date of Second Test 1st Test Taken By l(..Uc. u 10!«, I )i 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. 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. 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. The undersigned hereby makes application for permit to install or extend Sewage Disposal System herein specified, agreeing to do all such work in / Signature Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express 6\c - j'r'6Issued Date; Shoreland Management Office Fee $Rec #* ; 4 Ccj,:.. ^ I (Qi C£> C^oJjPy\ — Comments: V * .'Cs-SJ 1. Form No. MKL-032085 237.443 — Victor Lundeen Co.. Printers, Fergus Falls. Minnesota : ^ / I ,-r» • m'">,r'- A INSPECTION RESULTS Inspector must make all measurements SEWAGE DISPOSAL SYSTEM STATISTICS \/o y SEPTIC TANK SEEPAGE PIT DRAIN FIELDCATEGORYShould BeActual Should BeActual Actual Should Be laoo 70Z.Capacity GIs.GIs.S F S F S F S F Distance from Nearest Well F F F F F F 7/7^Distance from Lake or Stream F F F F F F ( 63Distance from Occupied Building F F F F F F T-10Distance from Property Line F F F F F F Distance from Bottom to Water Table 3 3FFFFF F Inspector’s Comments: . ' '7> \ q\cA \ QcX<^07 x:) s <^s>\ Vq \V-1^ V ,9^1/Date of Inspection “Z- \ O OTime of Inspection M .^O Signature of InspectorINTERPRETATION OF ABBREVIATIONS GIs s Gallons SF = Square Feet F = Linear Feet Job Vila MKL - 032085 - Backer Agency f -SiV- V..•••"tT' • I \ •jT ■*. _feet/inchesScale: Each grid equals GRID PLOT PLAN SKETCHING FORM y// 19Dated: Signature Please sketch your lot indicating setbacks from road right-of-way, lake and sideyard for each building currently on lot and any proposed structures. ■75' l uL. IS / 5 ‘fid’ 7t> /id 7/fdJ^ 'i’-t I _ } 215987®MKL-0871-029 VICTO* LVIMOEEN CO.. ^RIMTERS. fCMCUS fALLS. WINN. 215502®•>VICTOR UUNOCCH 00..:t;MKL-0871 -028 -I'- PERCOLA TION TEST DA TA LAND AND RESOURCE MANAGEMENT Otter Tail County Fergus Falls, Minnesota 56537 ■ t ) t' >I >' ■Ph. No.‘ . Owner:'- -Mailing Address: 5 Zip No.StateCityMiddleSt. & No.FirstLast Name I Legal Description:.TWP NAMERANGETWP.SEC.NAMELAKE OR RIVER NO. TEST HOLE NO. 2TEST HOLE NO. 1 .^.2=-i-.-inchesinches; Diameter of HoleDepth to Bottom of Hole.inches: Diameter of Hole inchesDepth To Bottom of Hole. Soil TextureDepth, InchesDepth, Inches Soil Texture 19 _ .DateDate.19 rLL Percolation Test By——. Percofation Test Bv %r -•*iL oTUJ FirmName.Firm Name,CC 3 aU oc/ UJ AddressOCAddress, < to Otter Toil County License No,Otter Tail County License No..I- i CO UJ Percolation rate minutes per inch Measure ment inches Drop in water level, inches Measure ment, inches Time Interval, minutes I-Percolation rate minutes per inch Drop in water level, inches Time Intervals minutes Remarks:Remarks:TimeTimeQ;5 i Q\|2- /□’- 3 12^12 /o )l\Sh /dn/6 /z.: <4■: //Z: TZ--.. /o/cPQ 2_ 1'7‘izi [/ft.'Z. 'f2^2Z / ' 02^ ~T^I^m I'lz^alO_iiai I Z- //:/o (ao 1I /I ■ r /c? / ' &?!/ See Booklet. ''How to Run a Percolation Test" by Agriculture Ext. Service, Un. of MN.Percolation rate *.minutes per inchminutes per inch Percolation rate *i! 21SS02® VICTOi LUMDCCM CO.. PMIHTCM. rCIISUI fAtLI. UtHH.PERCOLATION TEST DATA LAND AND RESOURCE MANAGEMENT Otter Tail County Fergus Falls, Minnesota 56537 MKL-0871 -028 •'f : i 'lf If • I W 'ine~>r-1 t >Ph. No..t > V Owner:Mailing Address:f > t ‘ I . Name K -Zip No.StateCitySt. & No.MiddleFirstLast Legal Description:.TWP NAMERANGETWP.SEC.NAMELAKE OR RIVER NO. TEST HOLE NO. 2TEST HOLE NO. 1 '3?incha> y'inches; Diameter of Hole.JnchesDepth to Bottom of HoieDepth To Bottom of Hole.inches; Diameter of Hole 7 Soil TextureSoil Texture Depth. InchesDepth, Inches 19_____DateData.19 y^c/t26L Percolation Test By .4^Oat Firm Name.CC DOUJ QC LU Address.CCAddress. < cn Otter Tail County License No.,Otter Tail County License No..h-c/>LU Percolation rate minutes per inch Measure ment. inches Time Interval, minutes Drop in water level, inches Measure ment inches Drop in water level, inches I-Percolation rate minutes per inch Time Intervals minutes Remarks-Remarks:TimeTimeo ^ ~7rV7z/II y/zl.1012JJ1 3^ihi 1W.or' ?t> i3\ir IQ 13 h.c3.l 3I3\ n I o Wi I a: 37 lh=.'12. lllL 11\-LAl I >12lO vj »See Booklet, *'How to Run a Percolation Test" by Agriculture Ext. Service, Un. of MN.minutes per inchPercolation rate *minutes per inch Percolation rate ■ tv. ■ r «/<2. ■V 3y7-' z^'2- "LK1 r u f 7^: <' r y 7 r~ f?/ o- JdjuMi'%oA^ ^ i yVo3C£, 5* ^ j2o.0-0./)__H 1^. _ ZL&.-'yJx. T fc)C>oo r^-£ X ,S3 H'f'S _f/_ £;)‘’i :3)2^•V- &) V2<? ■ :%• ---------- / 3. 7 a-H 1X0^ /3 3S \i:ljl 3, so i^eJe X , g-3 ; rv—J £7,t4.&^-:T' ^L } Ilp,V7 VH L . ■<fui “J y/i .o^; cz^ ^C. oo I + • : I |. ! i: J 4i 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 tmiif-offict Y»llow — (nsp*cfor Pink — Own0r Card — Ownmr Ft as)Permit No.,FfhRLEGAL RDESCRIPTION AND f- t"- 557 r/ue A DLOCATION TWP NameTWPRangeLake Classif.Sec.Lake NameLake No, IDENTIFICATION; Please Print All Information. Zip No.Tel. No.Mailling Address —No. Street, City and StateFirstInitialLast Name H iU^ -Xi ^ - D^-'Tlroi t L-i 'S'! £=-OWNER hfa iASEWAGE SYSTEM INSTALLER Name. IS-This System will be ready for inspection on. This space for office use only .M19 Owner or Agent SignatureDate Rec'd Phone Call Rac'd ByTime Rec'd NUMBER OF BEDROOMS:ESTIMATED COST: SEWAGE DISPOSAL SYSTEM DATA: SEEPAGE PITSEPTIC TANK DRAIN FIELD tcoo ^ Ft. ^ ~7 cP- Sq. Ft.Sq. Ft.GIs.Capacity ^ /lOOFt.Ft.Distance from nearest well IS/ A F) Ft.Ft.Ft.Distance from lake or stream Ft. Ft. Ft.Ft.Distance from occupied building IPFt.Ft.Distance from property line £3Ft. Ft.Ft.Distance from bottom to Water Table AH distances are shortest distance between nearest points RECORD OF TESTS; ±19.^..^, TimeInspection was made on JVI By \o£i..,SzJAPERCOLATION TEST DATA:Date of First Test , 19.: , 19.; Rate l2c>f5lh/ ...10£...zJADate of Second Test Rate 1st Test Taken 6''/f 'III f!!0 !0]A QA..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.) SignatureDated. Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon expressPermit; 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. 0,Issued Date: Shoreland Management Office Son RECEIVEDFee $ 4 MAY- 2 4 1984Comments:. »»_____________________________________________ Form No. MKL 0771-003 r^JD & RL'jUUkCE [^Vllw ft*mi LAKf. MiNNCSOTA • 5 t>>k \ t INSPECTION RESULTS Inspector must make all measurements \.. ^ - SEWAGE DISPOSAL SYSTEM STATISTICS SEEPAGE PITSEPTIC TANK DRAIN FIELDCATEGORYActualShould be Actual Should be Actual Should be Capacity GIs.GIs.S F S F S F S F Distance from Nearest Well 75 50FFFFF F Distance from Lake or Stream F F F F F F Distance from Occupied Building 2010 20FFFF FF Distance from Property Line 1010 10FFFFF F Distance from Bottom to Water Table 33FFFFF F Inspector's Comments; Date of Inspection .19___ Time of Inspection M Signature of InspectorINTERPRETATION OF ABBREVIATIONS Gli - Gallons SF “ Square Feet F - Linear Feat Job Title AgencyMKL-0771*003-Backer ;■ > S I ; \<z ■: S'"A ■ « 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 Yeifow — Inspector Pink —Ouvner Cord — Owner Permit No.. "^3Ffi / /cLEGAL <1 r. Lf^DESCRIPTION K ' K T‘7^ ■' \ AND LOCATION TWP NameTWPRangeLake Classif.Sec.Lake NameLake No. IDENTIFICATION; Please Print All Information. Tel. No.Zip No.Mailling Address —No. Street, City and StateInitialFirstLast Name OWNER SEWAGE SYSTEM INSTALLER Name ( This System will be ready for inspection on.., 19. This space for office use only M19 Owner or Agent SignaturePhone Call Rec'd ByDate Rec'd Time Rec'd NUMBER OF BEDROOMS:ESTIMATED COST: SEWAGE DISPOSAL SYSTEM DATA: SEEPAGE PIT DRAIN FIELDSEPTIC TANK Sq. Ft.GIs.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 Ft.Ft.Ft.Distance from property line Ft.Ft.Ft.Distance from bottom to Water Table All distances are shortest distance between nearest points RECORD OF TESTS: ., 19......;. , Time ,M ByInspection was made on 19 , RatePERCOLATION TEST DATA: Date of First Test , 19....., RateDate of Second Test 1st Test Taken By -I- 2nd TestFirst Test n 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 Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon expressPermit; 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. Issued Date; Shoreland Management Office Fee $. Son J 'J >Comments:. [^EVKW BATUC lAKf. MINNESOTAForm No. MKL 0771-003 r » 1'' I ?-4 .INSPECTION RESULTS Inspector must make all measurements SEWAGE DISPOSAL SYSTEM STATISTICS SEEPAGE PITSEPTIC TANK DRAIN FIELDCATEGORY Should beActual Actual Should be Actual Should be Capacity GIs.GIs.s F S F S F S F Distance from Nearest Well 75 50FFFFF F Distance from Lake or Stream F F FF FF Distance from Occupied Building 2010 20FFFFF F Distance from Property Line 10 10 10FFFFF F Distance from Bottom to Water Table 33FFFFF F 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 AgencyMKL-0771-003-Backer PBRcoLAnoN rtsr uata Price SI 00per pad. SHORELAND MANAGEMENT OTTER TAIL COUNTY Fergus Falls, Minnesota 56537 Ph. NoOwm-r;Mailing Address; Last Name Middle St. & No.City Zip No.State Legal Description;_______ LAKE OR RIVER NO.SEC.TWP.NAME RANGE TWP NAME TEST HOLE NO. 2TEST HOLE NO. 1 43o3tDepth to Bottom of HoleDepth To Bottom of Hole inches; Diameter of Hole jnchesInches;Diameter of Hole jnches ^ n... ■/(A' .—■----------------Depth, I nches Soil Texture Depth. Inches Soil Texture Date 19____3!Percolation Test Bv____S^dAoa-3aOLI'J 6Q/V"•7Q 11177Firm Name.Firm Name, QC DoLU (TTk LUAddress.QC Address <L C/5Otter Tail County License No..Otter Tail County License No^CO i -LUMeasurement, Inches.Depth in Water Level, Inches h-Measurement, Inches___Depth in Water Level, Inches Time Remarks Time Remarks 7^o a TWsyjsl .r vr 1'% 2oSl § I- /9Yir/^ /a zL i Z (YL 32ZL z&72 7<7 72^ iAIli //>Yin -_4^----- RESOURCE MKL 0871 -028i See Booklet, "How to Run a Percolation Test" by Agriculture Ext. Service, Un. of Minn. iii-.;----------- r ! ! jUD ; I 9 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 Whit>g-Ofnc* Yatlow — Inspector Pink — Ownof Cbtrf — Owner ^/F /////-^ ,-ZTic Permit No.LEGAL DESCRIPTION AND Z27EJlZSl t-r’ F,^LOCATION TWP NameTWPRangeLake Classif.Sec,Lake NameLake No. IDENTIFICATION: Please Print All Information. Zip No.Tel. No.Mailling Address —No. Street, City and StateFirstInitialLast Name _tLfLL.<^ jC~k\ COWNER S-VJ SEWAGE SYSTEM INSTALLER Name. ¥/ crThis System will be ready for inspection on.19-2:^ This space for office use only Owner or Agent Signature .M19 Date Rec'd Phone Call Rac'd ByTime Rec'd 3NUMBER OF BEDROOMS:ESTIMATED COST: SEWAGE DISPOSAL SYSTEM DATA: SEPTIC TANK SEEPAGE PIT DRAIN FIELD ^7 P- Sq. Ft.GIs.Sq. Ft.Capacity Ft.Ft.Ft.Distance from nearest well 15Ft.Ft.Ft.Distance from lake or stream Ft.2P.Ft.Ft.Distance from occupied building \0Ft.Ft.Distance from property line Ft. 3Ft.Ft.Ft.Distance from bottom to Water Table AH distances are shortest distance between nearest points RECORD OF TESTS: 0/.^..-...19„'^./?f , Time 5T- /S' ...... Inspection was made on M By ^..r ffPPERCOLATION TEST DATA:Date of First Test , 19.:Rate .....I.O..Dat-3 of Second Test 19 Rate 1st Test Taken By /I /A /,n 0 0 loFirst 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. (Call or use attached mailer notice.) Dated Signature Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon expressPermit: 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 (61 months. 1&. Issued Date: Shoreland Management Office 36H(d.oo RECEIVEDFee $ ^5:— a5cA,~^-5 /r. /f r'/,Comments:.MAY a '11984 'ND a RESOURCE [^V«W tAini lAKI, MMNHOfAForm No. MKL-0771-003 -WPWMr"'^ •-i' ■.Ifcp ft T -•T- N -■ .-fi ■,,)tV..^R »1 ‘v INSPECTION RESULTS Inspector must make all measurements -i ’*y- • , SEWAGE DISPOSAL SYSTEM STATISTICS SEPTIC TANK SEEPAGE PIT DRAIN FIELDCATEGORY Actual Should be Actual Should be Actual Should be Capacity GIs.GIs.S F SF SF SF Distance from Nearest Well 5075FFFFF F Distance from Lake or Stream F F F F F F Distance from Occupied Building 2010 20FFFFF F Distance from Property Line 10 10 10FFFF F F Distance from Bottom to Water Table 33FFFFF F ( ‘ Inspector's Comments: Date of Inspection 19___ ■•.V Time of Inspection .M \ Signature of InspectorINTERPRETATION OF ABBREVIATIONS GIs * Gallons SF “ Square Feet F * Linear Feet Job Title AgencyMKL-0771*003-Backer V t- V 0 •>! * I • •t V-i "i - , T ............. ' ’5 J»;,-■-1 m:. ^ •i -'■vr- s , ... ..*r t ■ : f • A;-V. y. 1 r 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 WhrW-office Ymitow — Inspmctor Pink — Osvner Cord —Owner / / ///.Permit No.^/r /-i / A l-icLEGAL ' •'!DESCRIPTION AND LOCATION TVWP NameTWPLake Classif.Sec.RangeLake No.Lake Name IDENTIFICATION: Please Print All Information. Zip No.Tel. No.Mailling Address —No. Street, City and StateInitialFirstLast Name OWNER SEWAGE SYSTEM INSTALLER Name, This System will be ready for inspection on... 19___' This space for office use only /f ...19 .M Owner or Agent SignatureDate Rec'd Time Rec'd Phone Call Rec'd By NUMBER OF BEDROOMS:ESTIMATED COST: 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 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: , 19 , Time MInspection was made on By PERCOLATION TEST DATA:Date of First Test , 19 , 19 ,.....> Rate, ...... RateDat-3 of Second Test 1st Test Taken By First Test -I- 2nd Test 2 Rate 2nd 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 Indiyidual Sewage Disposal Code Minimum Standards set forth by Minn esota Department of Health. AppI leant 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 respxjnsibility 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 Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upxm expressPermit: 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. Issued Date: Shoreland Management Office4)- 3ouFee $ ' XAComments:___1 [^Vlfw BATTLE LAKE, MINNESOTAForm No. MKL-0771-003 • «▼ - r*- 'wr ■"•. 'V 'n.' ■^ fan.'gpr m - r «'■ ' \ 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 Capacity GIs.GIs.S F S F S FS F Distance from Nearest Well 75 50FFFFF F Distance from Lake or Stream F F F F F F 20Distance from Occupied Building 10 20FFF F F F Distance from Property Line 10 10 10FFFFF F Distance from Bottom to Water Table 33FFF F F F 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 AgencyMKL-0771-003-Backer I L.•><• PEnCULA r/ON ILST DA TA Pri- e SJ 00 per pM/SHORELAND MANAGEMENT OTTER TAIL COUNTY Fergus Falls, Minnesota 56537 Ph. No,Owner:Addxessi Last Name 3 F irst Middle St. & No.Zip No.Legal Description: LAKE OR RIVER NO.NAME SEC.TWP.RANGE TWP NAME A>c>o:\U TEST HOLE NO. 2TEST HOLE NO. 1 (jP (k20Depth To Bottom of Hole.Depth to Bottom of Holeinches; Diameter of Hole inches; Diameter of Hole Jnchesinches Depth, Inches y 71Soil Texture Depth. Inches Soil Texture19 Date 19_____ C6ffy^ Percolation Test By____10Q £UJ 5// z-FirmName.GC Firm Name.3 aUJ t oc UJAddress.QC Address<rCOOtter Tail County Ltcenre No.Otter Tail County License No^F-coUJMeasurement, Inches Depth in Water Level, Inches F-Measurement, I nches Depth in Water Level, Inches Time Remarks Time Remarks oz5zS?,h-7 y ?5 I- A 772- ___/. s —7'. S F 7; y 7 9. S~?- c9i / 7 /7 ig 30 9^72^ _____^31 n 13R BSOfcLUuXi MAY 2 ti 1984 • > See Booklet, "How to Run a Percolation Test" by Agriculture Ext. Service, Un. of Minn. M..------ ' !J{^\ -rt- -W -----------r I •■r SHORELAIMD MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone 218-739-2271 - Fergus Falls, Mn. 56537 APPLICATION FOR PERMIT TO INSTALL SEWAGE DISPOSAL SYSTEM V'' te - Office V low — InspectorPli.. Card — Owner Owner Permit No. ^Co L. /"'llLEGAL Date DESCRIPTION AND D /'fola.t't ¥o ^ /{<^ SatULOCATION Lake No.Lake Name Sec.Lake Classif.RangeTWP TWP Name IDENTIFICATION: Please Print All Information. Last Name First Initial Mailling Address —No. Street, City and State Tel. No.Zip No. ^ ^eTco'it S'Y?OWNER Mn /iiv\SEWAGE SYSTEM INSTALLER Name, / (D UThis System will be ready for inspection on., 19. This space for office use only ,19 ,M Date Rac'd Time Rec'd Phone Call Rec'd By Owner or Agent Signa^Cure NUMBER OF BEDROOMS:ESTIMATED COST: SEWAGE DISPOSAL SYSTEM DATA; SEPTIC TANK SEEPAGE PIT DRAIN FIELD Ft.'1, Sq. Ft.GIs.Capacity Ft.Ft.Ft.Distance from nearest well 7S'Ft.Distance from lake or stream Ft.Ft. Ft.Distance from occupied building Ft.Ft. inDistance from property line Ft.Ft.Ft. 3-5^ 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 .JVI By 53 '3. 3J. PEBG^/yION TEST DATA:Date of First Test 19 . Rate Date of Second Test 19 , Rate = .....3..'...3.J3.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 thfijob-i for inspection. (Call or use attached mailer notice.) e-/r-/aDated 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 /3 .0.^ -"toIssued Date: Shoreland Management Office ^.OO . G'pFee $Surcharge $ Comments:.■a rm No. MKL-0771-003 vicToe ujHOCCM t CO., piihtim. rmaus mihn.158906 SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone 218-739-2271 - Fergus Falls, Mn. 56537 APPLICATION FOR PERMIT TO INSTALL SEWAGE DfSPOSAL SYSTEM W :te — Office V low — Inspector Pii.. — Owner Card Owner * Permit No.,LEGAL DESCRIPTION AND LOCATION Lake No.Lake Classif.Lake Name Sec.TWP TWP NameRange IDENTIFICATION: Please Print All Information. Last Name Initial Mailling Address —No. Street, City and State Zip No.Tel. No.First OWNER SEWAGE SYSTEM INSTALLER Name. This System will be ready for inspection on.., 19. This space for office use only .19 Date Rec'd Time Rec'd Phone Call Rec'd By Owner or Agent Signa:ture NUMBER OF BEDROOMS:ESTIMATED COST: SEWAGE DISPOSAL SYSTEM DATA: SEPTIC TANK SEEPAGE PIT DRAIN FIELD ____ Sq. Ft.GIs.Capacity Sq. Ft. Ft.Ft.Ft.Distance from nearest well Ft.Distance from lake or stream Ft.Ft. Distance from occupied building Ft.Ft.Ft. Distance from property line Ft.Ft.Ft. Distance from bottom to Water Table Ft.Ft.Ft. AH distances are shortest distance between nearest points RECORD OF TESTS: Inspection was made on 19 , Time ,M By “3, 3- '3 PERCOLATION TEST DATA:Date of First Test , 19 , 19 ., Rate 5'Date of Second Test , Rate 1st Test Taken By First Test + 2nd Test 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 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. Permit: Issued Date: Shoreland Management Office J Fee $Surcharge $r -- r! 3;"I Comments:. Form No. MKL-0771-003 VICToe UlODEEN ft C« . rCMUt EALLI 158906 INSPECTION RESULTS i Inspector must make all measurements SEWAGE DISPOSAL SYSTEM STATISTICS SEPTIC TANK SEEPAGE PIT DRAIN FIELDCATEGORY Actual Should be Actual Should be Actual Should be Capacity GIs.GIs.S F S F S F SF Distance from Nearest Well F 75 50FFFF F Distance from Lake or Stream F F F F F F Distance from Occupied Building 10 2020FFFFF F Distance from Property Line 10 10 10FFFF F F Distance from Bottom to Water Table 4 4FFFFF F Inspector's Comments: Date of Inspection 19___ Time of Inspection,M Signature of InspectorINTERPRETATION OF ABBREVIATIONS GIs = Gallons SF “ Square Feet - Linear Feet Job TitleF AgencyMKL-0771-003-Backer I PERCOLATION TEST DATA n~.SHORELAND MANAGEMENT OTTER TAIL COUNTY Fergus Falls, Minnesota 56537 Ph. No.Owner:Mailing Address: Last Name First Middle St. & No.City State Zip No.Legal Description: LAKE OR RIVER NO.SEC.NAME TWP.RANGE TWP NAME TEST HOLE NO. 2TEST HOLE NO. 1 3<C:>Depth to Bottom of HoleDepth To Bottom of Hole.inches; Diameter of Hole Jnchesinches; Diameter of Hole Depth, Inches Soil Texture Depth, Inches Soil Texture Date 19_____ Percolatii Test Bv_ Percolation Test Bv_^zo/O LU2^Firm Name.QC Firm Name.yOi/\-3 oUJ QC UJAddress.QC Address 7 < COOtter Tail County License No.Otter Tail County License No..I- COUJ Drop In Water Level.. Inches Measurement, Inches Drop In Water Level. IrKhes H Measurement,Time Remarks Time Remarks Inches .^3I TsmI Gd . 3^-7 T/L /c;. 'r-z^\T)iir^/2___ J■i^A ^ .3/ c/> J.42^ a> 27-/—- 3^^7' .Z? MKL-0871-028183818 ©>."><im r«Li See Booklet/'How to Run a Percolation Test" by Agriculture Ext. Service, Un. of Minn.A■<b> 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 - Olfice V low — InspectorPli.. Card ner M / .9^Permit No.,<SL l-HLEGAL Date DESCRIPTION AND -5'^-357 ^ D f)Uj frobatT Sec. TWP Range LOCATION Lake No.Lake Name Lake Classif.TWP Name IDENTIFICATION: Please Print All Information. Last Name First Initial Mailling Address —No. Street, City and State Tel. No.Zip No. Tty c-OWNER >5 //dyH^ ^ ( Ft /l/LyySEWAGE SYSTEM INSTALLER Name, Ma.^lo ^9R1Q This System will be ready for inspection on.'I This space for office use only .19 ,M Date Rec'd Time Rec'd Phone Call Rec'd By Owner or Agent Signature 3(Dcdo NUMBER OF BEDROOMS:ESTIMATED COST: SEWAGE DISPOSAL SYSTEM DATA: SEPTIC TANK SEEPAGE PI DRAIN FIELD Sq. Ft. J.^6 iq. Ft.Capacity <jO /16 0Ft.Ft.Distance from nearest well Ft.Distance from lake or stream Ft.Ft. 3^Ft.Distance from occupied building Ft.Ft. /(POO [0Distance from property line Ft.Ft.Ft. HFt.Distance from bottom to Water Table Ft.t. AH distances are shortest distance between nearest points RECORD OF TESTS: Inspection was made on 19 , Time ,JVI By ...PEB^L/5ATION TEST DATA:Date of First Test 19 , Rate Date of Second Test 19 , Rate 1 st,.Jestj 1>ken 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 thejob-i The undersigned hereby makes application for permit to install or extend Sewage Disposal System herein specified, agreeing to do all such work in idy fcyinspection. (Call or use attached mailer notice.) '7- /S'- 83 -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 73-Issued Date:. Shoreland Management OfficeSi.OO ■Fee $Surcharge $ Comments:. Form No. MKL-0771-003 @ viCT»e UIH0CIH 4 CD.. paiaTcei. Masus r«t.Li. mihm 15890^ f 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 — Olfice V low — InspectorPli.. Card — {pwner • Owner Permit No.,t~ I IglLEGAL Date DESCRIPTION AND LOCATION Lake No.Lake Name Lake Classif.Sec.TWP Range TWP Name IDENTIFICATION: Please Print All Information. Last Name Initial IVIailling Address —No. Street, City and State Tel. No.First Zip No. OWNER SEWAGE SYSTEM INSTALLER Name, TIt/s 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: SEPTIC TANK SEEPAGE PIT DRAIN FIELD Sq. Ft.GIs.Sq. Ft.Capacity Ft.Ft.Ft.Distance from nearest well Distance from lake or stream Ft. Ft.Ft. Distance from occupied building Ft.Ft.Ft. Distance from property line Ft.Ft.Ft. 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 '60 ,JVI By PERCOLATION TEST DATA:Date of First Test 19 r Rate Date of Second Test 19 , Rate 1st Test Taken By First Test -t- 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: 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. Issued Date:, Shoreland Management Office Fee $Surcharge $ /-■ Comments:. Form No. MKL-0771-003 VICT«« LUMBCIH • C«.. PMiattaS. ria«U> r«Ll.f MraM 15S906 IINSPECTION 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 Capacity GIs.GIs.S F S F S F S F Distance from Nearest Well F 75F 50FFF F Distance from Lake or Stream F F F F F F Distance from Occupied Building 10 2020FFFF F F Distance from Property Line 10 10 10FFFFF F Distance from Bottom to Water Table 4 4FFFFF F Inspector's Comments: Date of Inspection 19___ Time of Inspection,M Signature of InspectorINTERPRETATION OF ABBREVIATIONS GIs = Gallons SF “ Square Feet * Linear Feet Job TitleF AgencyM KL-0771-00 3-Backer PERCOLATION TEST DATA SHORELAND MANAGEMENT OTTER TAIL COUNTY Fergus Falls, Minnesota 56537 Ph. No.Owner:Mailing Address:r- Last Name First Middle St. & No.City Zip No.ItateLegal Description; LAKE OR RIVER NO.NAME SEC.TWP.RANGE TWP NAME TEST HOLE NO. 2TEST HOLE NO. 1 4Depth To Bottom of Hole,jnchesDiameter of Hole inches Depth, Inches Soil Texture Depth, Inches Soil Texture Date 19_____ Percolation Test Bv .t Q lUFirm Name CC Firm Name.Do/r LU GC LUAddress.QC Address < COOtter Tail County License No..Otter Tail County License No^h-coLU Drop In Water Level. Inches Measurement, Inches Drop In Water ■Level. It^ches H Measurement, Inches ^ Time Remarks Time Remarks o -y.'Oi sI- y.^no Sd. 'A 3y ! 60 V; Q..I 'OU OS'^2:yo z—yyiSi ■'T*' MKL-0871-028183818 ®• iCTOa UIM8CIM 8 CO.. 88ioTt«8. fttCUS rM.L8. MlOa.See Booklet/'How to Run a Percolation Test" by Agriculture Ext. Service, Un. of Minn. . . A