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HomeMy WebLinkAboutLoon Echo Resort_32000080066004_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: www.co.otter-tail.mn.us 10/08/2013 Jimmy L & Terri B Usher 500 Juniper Ave E FrazeeMN 56544 4434 RE: Primary Owner: Jimmy L & Terri B Usher Sewage Treatment System Servicing Tax Parcel Number: 32000080066004 Described as:Sec 08 Twp Hobart Township Sect-08 Twp-137 Range-040 4.00 AC PT GL 8 COM MC #66 W 317.2', Lake: 56-360 Rose As of 10/07/2013 the sewage treatment system (Sewage Treatment Installation Permit # 22567 servicing your property was determined to be in compliance with the provisions of the Sanitation Code of Otter Tail County for a 9 bedroom home. If you have any questions regarding this matter, please contact our office. Sincerely, Eric Babolian Inspector APPUCATION FOR PERMIT TO INSTALL SEWAGE TREATMENT SYSTEM LAND & RESOURCE MANAGEMENT, OTTER TAIL COUNTY (218-998-8095) GOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS FALLS, MN 56537 www.co.otter-tail.mn.usWHITE - Office YELLOW - L & R Inspector PINK - Owner / Contractor (after issue) APPLICATION MUST BE COMPLETE IN ORDER TO BE PROCESSED Permit No. LAKE/RIVER CLASS SECTION TWP NO.RANGE TWP NAMELAKE NUMBER LAKE/RIVER NAME eo Hoy<^r F\n OHO E-911 ADDRESS OR DIRECTIONS FROM NEAREST PUBLIC ROADPARCEL NUMBER (S) OF PROPERTY BEING SERVICED 3Cl(DcxDO^ooeGoo^3^'7,5L( Co A LEGAL DESCRIPTION PTGL J3)7.2'//'g.^4xlY/sgGA;g»7g'^yy?T32<:T/^ U^SLjLTTpr5smx,^c-,/JL0Ut:6:^c Daytime Phone No.Last Name First Initial Mailing Address II'Ipv "oOSci (Jsh -erProperty Owner (<icU«vj \/<3.feWr^Co 16^2IS-SV7-3/77Contractor Lie.#Ute I(1A^ gfeSOI1^10 THIS SPACE FOR OFFICE USE ONLY A.M. >• This System will be ready tor inspection on ,P.M.. the year of at. A.M. P.M. Date Received L & R OfficialTime Received TYPE OF NSTALLATION (circle one)SEWAGE TREATMENT SYSTEM DESIGN DATA AS SHOWN ON DRAWINGResidential (A) New (B) Replacement Collector Other Est. New Replacement (C) New (D) Replacement i Soil Treatment Area Tank Lift D^ign Flow (Gallons/Day) 1 — 2,499 tR) 2,500 — 4,999 (I) 5,000— 10,000 Effluent Distribution Gravity ( ) Pressure GIsSize Setback To Nearest Well >56'Ft,Type I Type II Ft.>7$: Ft. (20) Trench, Rock (27) Rapidly Permeable •?IOOFt.>7^ Ft.Ft.Setback To OHWL(21) Trench, Gravelless (28) Flood Plain Trench, Chamber (29) Privies a //fy Ft.yj/\Ft.Ft.Setback To Bluff(30) Holding Tank ( ) Monitoring/Disposal Contract >7^ Ft.(24) Mound >&^Ft.Ft.Setback To Dwelling (25) At Grade Type III Setback To Non-Dwelling > iO Ft.(26) Greywater (31) Other/Problem Soils/<12" Soil >/0 Ft.Ft. Type IV I Setback To Nearest Lot Line XO'Ft.'>{0 Ft.Ft.Depth of Well (32) Public Domain & Proprietary Technologies>6c' Ft.>Setback To Road Right-Of-Way >50 Ft.Ft.Type VTotal tf Bedrooms £§(33) Performance >y'Ft.Elevation Above Restrictive Layer Ft. Ft.&Abatement Y /Garbage Disposal Y / PERCTEST DATA OiVUgA 1510 ~7- P-IADesigner 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 accor­ dance with Sanitation Code of Otter Tail County, Minnesota. Applicant agrees that the Site Data Worksheet submitted herewith and which is approved by a Land & Resource Management Official shall become a part of the permit. Applicant further agrees that no part of the system shall be covered until it has been inspected and approved for use. It shall be the responsibility of the applicant tor 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 Sanitatioh Code. License #Date of Test Highest RateS' NOTE: I.This permit is valid for a period of six (6) months. 2.This permit does not include the building sewer (sewer line). ‘^-(3-/3 175-^Date:Permit Fee $ Signature ot^operty Owner/Agent for O^e 9-30'i4B6dr>Date;Rec. No..LaM-^Thesource Management Office *'.i ^ S'OOComments: ^SCMD SEP 2 6ncc m - —TTT^f. Form No. BK — 0209-003 335,812 • Victor Lundeon Co., Printors • Fergus Falls, Minnesota - 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 ia-3-l3 S WHITE - Office YELLOW -L&R Inspector PINK - Owner / Contractor (after issue) 7Permit No.APPLICATION MUST BE COMPLETE IN ORDER TO BE PROCESSED i TWP NAMESECTIONTWP NO.[RANGELAKE/RIVER CLASSLAKE/RIVER NAMELAKE NUMBER n Li)/-rV ' T- ,rn■T',i' E-911 ADDRESS OR DIRECTIONS FROM NEAREST PUBLIC ROADPARCEL NUMBER (S) OF PROPERTY BEING SERVICED I; v"-C^'00 6G0O*-/I I--^LEGAL DESCRIPTION ( ,-AK-i j i q Sc L.ft4 Ax 7.y '7/47" 5y ^ ^ - /< r-, A^u j-/rn r(•^G a.A~v/T '/>/ <[ /A- r- Daytime Phone No.Initial Mailing AddressFirstLast Name t ~F / f~>V r ••._____ll \ n (. ^ r ?1S YiO-'I 'J’i 7.Property Owner ~\J I «AA. * i I C- < I r { % ; - U 10 j'is >V7- ;/77;?r/V i^r.lY-r /('Jj 1"){T\ r \\ i ..xV e* Contractor Lie.# •Vj' I ’^7oDTHIS SPACE FOR OFFICE USE ONLY !/o-m>7 , the year of>• This System will be ready tor inspection on S‘SS /k^. RM. L&R OfJicialTime ReceivedDate Received SEWAGE TREATMENT SYSTEM DESIGN DATA AS SHOWN ON DRAWING TYPE OF NSTALLATION (C/flCLEOA/Ej Other Est. (E) New (D) Replacement (F) Replacement CollectorResidential (A) New (B) Replacement (C) New Soil Treatment Area f. 'LiftTankrfDesign Flow (Gallons/Day) iG) ' 1 — 2,499 (H) 2,500 — 4,999 (I) 5,000 — 10,000 ____ Effluent Distribution ( r ) Gravity ( ) Pressure / / : /Ft.GIs ' GIsSize f Setback To Nearest Well N ' Ft.Ft.Ft.Type IIType I (27) Rapidly Permeable(20) Trench, Rock Ft. Ft.Ft.Setback To OHWL(21) Trench, Gravelless (28) Flood Plain (22) Trench, Chamber (29) Privies Ft.Ft.Ft.Setback To Bluff(^3) iHWIlBed (30) Holding Tank ( ) Monitoring/Disposal Contract(24) Mound Ft.Ft.Ft.Setback To Dwelling (25) At Grade Type III Setback To Non-Dwelling Ft.Ft.Ft.(31) Other/Problem Soils/<12“ Soil(26) Greywater Type IV Setback To Nearest Lot Line Ft.■ Ft.Ft.(32) Public Domain & Proprietary Technologies Depth of Well i Setback To Road Right-Of-Way Ft. Ft. Ft.Type VTotal # Bedrooms (33) Performance Elevation Above Restrictive Layer ’ / Ft.Ft.Ft.Garbage Disposal Y / r NAbatement Y / N PERC TEST DATA HtiHighest RateDate of TestLicense #Designer 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 accor­ dance with Sanitation Code of Otter Tail County, Minnesota, Applicant agrees that the Site Data Worksheet submitted herewith and which Is approved by a Land & Resource Management Official shall become a part of the permit. Applicant further agrees that no part of the system shall be covered until it has been inspected and approved for use. It shall be the responsibility of the applicant for the permit to notify Land & Resource Management that the installation is ready for inspection. Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express condition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Sanitation Code of Otter Tail County, Minnesota, This permit may be revoked at any time ^ upon violation of the Sanitation Code, NOTE: I.This permit is valid for a period of six (6) months, 2,This permit does not inciude the building sewer (sewer iine). 1 j i 175 ■ ■■■•Permit Fee $Date: Signature of Property Owner/Agent tor Ownpr^- ■ iRec. No..Date: Land & Resource Management Office */ - XT Comments:/ ' A Form No. BK — 0209-003 335,612 • Victor Lundeen Co., Printers • Fergus Falls. Minnesota 4 SEWAGE TREATMENT SYSTEM PERMIT INSPECTION RESULTS Inspector must make all measurements SOIL TREATMENT AREA HOLDING SEPTIC TANK OUTHOUSELIFT TANKCATEGORY gls.Capacity n-2ft 2GLS. ft /C^OFT FT FTSetback from Nearest Well Setback from Buried Water Suction Pipe cJ FT FT FT FT Setback from Buried Pipe Distributing Water Under Pressure FTFT FT FT ■L ftSetback from OHWL (lake &/or river)FT FT FTZoozyo Setback from Setback from Bluff FT FT FT FT fO'/Oi)'^ FTSetback from Dwelling FT FT FT/OO Setback from Non-Dwelling FT FT FT FT FTSetback from Nearest Property Line FT PS FT FT Setback from Right-of-Way FT /OO - ft FT FT Elevation above Restrictive Layer FT FT FT FT Holding Tank/Lift Alarm NO /aOld System Pumped & Destroyed YES na MOUND / AT-GR^pg' ROCK SE6 SEPTIC TANK(S) # T^ks Installed FILTER SOIL TREATMENT AREA CALCULATION TRENCH REDUCTION l^ccJiook tronehes with inches JD.□ YES 0 NO 3Manuf. Ft.of sidewall for.,% I? (AT Ft. X Ft.Ft. X Ft» 7 reduction / equivalent to Soi Treatment Area. # Ft* n /9 H Inspector's Comments:ir, .gxCV 10-3-133 [“tc/ m4. piA £ir!- A/o nth IC MSketch: ‘fesqaac / fC)o '^4's\ a'X\I T •ft* * 13 Time Initial / L & R Official blil^ewa^ system installation was found to be compliant with the provisions of the Sanitation Date QAs of /o / Code of Otter Tail County. , the above descri 4 Land S Resource Management Official Form No. BK — 0209-003 336,656 • Victor Lundoen Co., Printers • Fergus Falls, Minnesota 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. ' ■ s \ 1 30inch(es) equals.grid(s) equals feet, or feetScale:_iL_i hioMPCA LICENSE #: DESIGNED BY:LICENSE CATEGORY:_ FIRM NAME: ADDRESS: _ (AAa DATE: Cc lOH SIGNATUR U(Ae <v A -r > cf — 1003 - 029 316.904 • Victor Lundeen Co.. Printers •. Fergus Falls. MN • 1-S00*346-4870 SITE DATA WORKSHEET LAND & RESOURCE MANAGEMENT, COUNTY OF OTTER TAIL GOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS FALLS, MN 56537 218-998-8095 www.co.otter-tail.mn.us Sewage Treatment System Permit # ~] __'p/f OWMER: i(Jslu&r I FIRSTLAST NAME MIDDLE TELEPHONE NUMBER ADDRESS: I Co fUjy U CITY ZIP CODESTR./RT.STATE ^loloCX.'r'h5^%\in OH6 LAKE/RIVER NO.SEC.LAKE NAME TWP RANGE TWP. NAME LEGAL DESCRIPTION:SOIL BORING LOG COLOR & MUNSELL NO. DEPTH (INCHES)TEXTURE STRUCTURE *^ock7> PLATY PRISMATIC NONE (oYie“T5p'3>?-OQoo S’oo ^400^V,I -zPARCEL NUMBER foYreld-\ Co 4 t~rg-.^<£g BLOCKY PLATY PRISMATIC <sJM0Np BLOCKY PLATY PRISMATIC <ijPNE) dE-911 Address or Directions From Nearest Public Road %O t-H4 At) NUMBER OF BEDROOMS GARBAGE DISPOSAL: YES * WELL: CASING DEPTH SEWER LINE SEPARATION: h. ( > (oVe BLOCKY PLATY PRISM/^IC Onon^ BLOCKY PLATY PRISMATIC NONE (n?(0FLOODPLAIN: YES BLUFF: YES %6k 6^RRESTRIAIQ VEGETATION: AQUATIC 5SLOPE AT INSTALLATION SITE:% TYPE OF OBSERVATION:Probe PARENT MATERIAL: Cfiu> Outwash Loess Bedrock Alluvium lS-\3ORIGINAL SOIL:No Date of Soil Boring. COMPACTED SOIL: Yes DEPTH OF BORING (To 7' or restrictive layer):.ft.Date of Perc Test PERC TEST #1 PERC TEST #2- TWO TESTS ARE REQUIRED - TtME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATE TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATE■9'/f 4START START3...A3.\0_3A5_-J_l.O.LC.TIME DROP PERC DROP PERCTIME TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATE TIME INTERVAL (MINUTES!WATER DEPTH WATER DROP PERC RATE .:3..... REFIU.REFILL 3..d.3.(O -5./.a 3.TIME DROP PERC TIME DROP PERC TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATE TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATE (02 REFILL10 335. t ic J7.S? -3IQ.TIME DROP PERC DROP PERCTIME TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATE TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATE .71 Id < Q ^^.C.3- 92. 43 TIME DROP PERC TIME DROP PERC INTERVAL (MINUTES)WATER DEPTHTIME WATER DROP PERC RATE TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATEREFILLREFILL DROP PERCTIME TIME DROP PERC TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATE TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATEREFILLREFILL PERCTIMEDROP TIME DROP PERC INTERVAL (MINUTES)WATER DEPTH WATER DROPTtME PERC RATE TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATEREFILL REFILL TIME DROP PERC TIME DROP PERC TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATE TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATEREFILLREFILL TIME DROP PERC TIME DROP PERC PROPOSED DESIGN: XATGRADE.TRENCH.BED.MOUND.HOLDING TANK.GRAVITY DIST..PRESSURE DIST.. SEWER LINE.OUTHOUSE.OTHER. SPECIFY:. — SYSTEM DESIGN ON BACK — OZ9t'-9PC-OO0-l • NtN stlBj sn6»9j . sjaiutij 03 uoapunn joioiA • 60t'r82 A ^•j S'^yl ?;■ « .0 ri )r%CERTIFICATE OF APPROVAL SEWAGE SYSTEM HOLDING TANKS Mm This Certificate has been issued this 26th of April, 1999 , to certify that the sewage system installed as per Sewage Treatment System Permit Number 12166 has been approved for use by Otter Tail County, Minnesota. /W’The property served by this Sewage System is legally described as: UNPLATTED PT GL 8 COM MC #66 W 317.2', NE 369.31' TO BG, NE 475.51', SE 382.25' TO LK, SWLY TO PT SE FROM BG, NW 405.3' TO BG Parcel Number(s): 32000080066004 Section: 08 Township: 137 Range: 040 Township Name: HOBART TOWNSHIP Lake/River N\amber: 56-3 60 Lake/River Name: ROSE IS?:, s li..3 iS m-.Sfi • :uh. mM Current Property Owner: WILLIAM A & SANDRA K KING Number of Bedrooms: Campsites 1-4 'P w Land & Resource Management Official I^IL m [TOAit'/ APPLICATION FOR PERMIT TO INSTALL SEWAGE TREATMENT SYSTEM LAND & RESOURCE MANAGEMENTOTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 - FERGUS FALLS, MN 56537 WHITE — Office YELLOW — Inspector PINK — Owner LEGAL Permit No. DESCRIPTION Loott &Ao- Poc^aJ. lAKE/RIVER CLASS Abatement: ( ) YesAND LOCATION LAKE NUMBER LAKE/RIVER NAME SECTION TWR NO.RANGE TWP NAME fP I 3" \ HI \io PARCEL NUMBE fose^ EL NUMBER(S)2 3.-O00 - bl-0T)(cQ- •OO >f FIRE OR LAKE ASSOCIATION NUMBER IDENTIFICATION: Please Print All Information Last Name__________________,_______WttictLM First Initial MailiM Address — No. Street. City and State____________________ .yH/J Zip Code TelephongJ^o. (5-:z-Property Owner 3V>- 50^Sewage System Installer Name State Lie. It A.M. > This System will be ready for inspection on_the year of atPM. ^ NUMBER OF BEDROOMS:This space for office use only A.M. P.M.GARBAGE DISPOSAL: ( ) YESDate Rac'd Year of Time Rac’d Phone Call Rec’d By . TYPE OF SEWAGE SYSTEM Holding tank (Alarm Required) ( ) Septic tank ( ) Lift station (Alarm Required) ( ) Drainfield SEWAGE TREATMENT SYSTEM DATA: MINIMUM REQUIREMENTS P)TANK DRAINFIELD Distance from nearest well ISOO/ /lOCgisCapacity ^ —Fi^ sn Ft. ) Trenches .1^'^ ( )-d ( )Moun^^ ) Outhouse / (^^Sewer line' ^ Ft. IS-Distance from lake or stream(Ft.Ft. lODistance from dwelling Ft. Ft. Distance from non-dwelling Ft.Ft.( mDistance from property line Ft.Ft. EFFLUENT DISTRIBUTION ( ) Gravity ( ) Pressure Distance from bottom to Water Table Ft.Ft. S!AcL^(/vvr~/ ^ I All distances are shortest distance between nearest points PERCOLATION TEST DATA:WATER WELL DEPTH W 1ST ite of Perc TestPerc Tester Rate of 1 St Rate of 2nd Test Avei late Agreement: The undersigned hereby makes applicatioajteHperrnitto install or extend Sewage Disposal System herein specified, agreeing to do allTucftkivork in strict accordance with Ordinances of the County of Otter Tail, Minnesota and Minnesota Individual Sewage Disposal Code Minimum Standards set forth by Minnesota Department of Health. Applicant agrees that plot plan sketches and specifications submitted herewith and which are approved by Shoreland management 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 accepted. It shall be the respon­ sibility of the applicant for the permit to notify the County Shoreland Management that the job is ready for inspection. Signature r g - 7 V- ^ rDATE: 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 Ordinance of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of any said ordinances. NOTE: Permit void if work is not commenced within six (6) months. _________Rec # ___ ('p (tiY' Issued Dale: Land & Resource Management Office Fee $ ryrComments:tw(rf 291.09b • Vicint (',o , Priniufs • 1 i.r(]iis r;)ll-,. Minru'slBK 0795-003 5 H~t's ^/sL doyrri^ ...A-uJLtX^ (O - V iUJty?nfisJLJLt^ jfUUuO application for permit to install sewage TREATMElM LAND & RESOURCE MANAGEMENTOTTER TAIL COUNTY COURT HOUSE^^^^ Phone: (218) 739-2271 - FERGUS FALLS, MN 56537 WHITE — Office YELLOW — Inspector PINK — Owner LEGAL DESCRIPTION toofl EtAo M Ao - Ph'ClS- ) YesAND (^LLOCATION / LAKE NUMBER LAKE/RIVER NAME LAKE/RIVER SECTION TWP. NO.RANGE TWP NAME K I 1^1‘iy~ PARCEL NUMBER(S)^ OOO - 0^-'OC)(f (^- 00 if FIRE OR LAKE ASSOCIATION NUMBER Ho goV IDENTIFICATION: Please Print All Information Last Name First Mailing Address — No. Street, City and StateInitial Zip Code Telephone >lo.wTriioM 3______PO/ 5T/ -fcm y-i 5-Property Owner Sewage System Installer Name state Lie. # %1 _ _ . A.M.at ny\yVf*r€ pm, NUMBER OF BEDROOMS: C H J ► This System will be ready for inspection on.the year of This s^cejpr Mice use only Ogx) RM.GARBAGE DISPOSAL: ( ) YESDate Rec'd Time Rec’dYear of Phone Call Rec’d By TYPE OF SEWAGE SYSTEM Holding tank (Alarm Required)j'' ( ) Septic tank V / SEWAGE TREATMENT SYSTEM DATA: MINIMUM REQUIREMENTS TANK DRAINFIELD 2- lloidiHi'i Isoo/ /,ac©'=Ft"Capacity 1( ) Lift station (Alarm Required) ( ) Drainfield ( ) Trenches ( ) Bed ( ) Mound/ -'iDistance from nearest well Ft.Si Ft.o3* s lADistance from lake or stream Ft.Ft. \A 10Distance from dwelling Ft. Ft.vv^ Distance from non-dwelling Ft.( ) Outhouse /^qFA (^Xf Sewer line^' Ft. mDistance from property line Ft. Ft. 30EFFLUENT DISTRIBUTION ( ) Gravity ( ) Pressure Ft.Distance from bottom to Water Table Ft.■a All distances are shortest distance between nearest points PERCOLATION TEST DATA:WATER WELL DEPTH / Sf 'Io iOgte of Perc TestPerc Tester 1Average.Ba^Rate of 1 St Test Rate of 2nd Test 1 Agreement: The undersigned hereby makes applicationior-perffiit to install or extend Sewage Disposal System herein specified, agreeing to do all suePrwork in strict accordance with Ordinances of the County of Otter Tail, Minnesota and Minnesota Individual Sewage Disposal Code Minimum Standards set forth by Minnesota Department of Health. Applicant agrees that plot plan sketches and specifications submitted herewith and which are approved by Shoreland management 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 accepted. It shall be the respon­ sibility of the applicant for the permit to notify the County Shoreland Management that the job is ready for inspection. g ■.? V- <? ,rDATE: 1/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 con­ dition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Ordinance of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of any said ordinances. NOTE: Permit void if work is not commenced within six (6) months.V ■V V Issued Date: Land <S Resource Management Office liOO Citi,dcT(1 Fee $.Rec # Comments:iDOCrt*TYMonT) 291.095 • Victor Luntleen Co, Pfinlws •' f«.rqus Fall's. MirMu-sAiiiBK 0795-003 INSPECTION RESULTS Inspector must make all measurements- % SEWAGE DISPOSAL SYSTEM STATISTICS If ^ SEPTIC TANK DRAINFIELD LIFT TANKCATEGORY Actual Minimum S/fcrcroCapacity FT=^FT 2GLS. GLS. Distance from Nearest Well / FT FF FT FT Distance from Buried Water Suction Pipe FT FT FT 50 FT Distance from Buried Pipe Distributing Water Under Pressure FT FT FT FT10 Distance from Lake or River (OHWL)FT FT FT Distance from Dwelling cjOcJ-FT FT FT 10/20 FT Distance from Non-Dwelling FT FT FT FT Distance form Nearest Property Line ^C> V ft FT FT 10 FT Distance from Bottom to Water Table FT FT FT FT3 Holding Tank/Lift Alarm NO Old System Pumped & Destroyed YES NO Sewer Line to Well Separation DRAINFIELD CALCULATIONINTERPRETATION OF ABBREVIATIONS GLS. = Gallons FT® = Square Feet FT = Linear Feet V .Actual Minimum FTX FT .ft^FT FT20 ROCK REDUCTION Inspector’s Comments: Rock trenches with inches of rock under pipe for .% ft® DRreduction / equivalent to I'i poo 2m.Inspector's Signature Date ol Inspection /3irTime of InspectionrS rCN • X / y :lfl' 4 * I®# MS.- i.." - V.S',i " ■’ - •;V'' «'*'■ -’ V,. 'xsmmsmmmsMMmmssmm1% Wr w ?' Ni* -TfV^'fc'i^rv CERTIFICATE OF COMPLIANCE SEWAGE SYSTEM im w^mycm319^^day of_This certificate has been issued this 2rd Dtar pmhpr m a rtilfe| to certify compliance with regulations of Shoreland Management Ordinance, Otter Tail County, Minnesota. fM The premises covered by this certificate are legally described as: mym Lake No. 56-360 8 Twp. 137 Range 40 Twp. Name HobartSec. pi fei iipmifeifaifei Parcel In G.L, 8 Loon Echo Resort t-!William KingOwner: Name. WmsiAddress.Route ..#1, Frazee, Minnesota 56544 Zip No. M.3 910Permit No. SP_ Signed by:. Malcolm K. Lee, Shoreland Administrator Otter Tail County, Minnesota MKL-087 1-009 h ;a>45 ®15903S LUNStlN ( CO. PI>I1TE«». rtieut rACLt. 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 Yeiiow — inspecftir Pink — Owner Card — Owner J.OO ro 9/0Permit No./ cvLEGAL f Date DESCRIPTION AND /37LOCATION Lake Ciassif.Sec.TWPLake No. Lake Name Range TWP Name IDENTIFICATION: Please Print All Information. First Initial Mailling Address —No. Street, City and State Zip No,Tel. No.Last Name xi/yv-./Vr.OWNER Xf>ppprSEWAGE SYSTEM INSTALLER Name, This System will be ready for inspection „ 19.on. This space for office use only .M.19 Phone Call Rec'd ByDate Rec'd Time Rec'd Owner or Agent Signa;ture NUMBER OF BEDROOMS:ESTIMATED COST: SEWAGE DISPOSAL SYSTEM DATA: SEEPAGE PITSEPTIC TANK DRAIN FIELDTYoc? yf^c)Sq./Ft.GIs.Sq. Ft.Capacity :^Ci^ Ft.Ft.Ft.Distance from nearest well :7:fr f- Ft.Ft.yS~ I^Ft.Distance from lake or stream /a -tl Ft.T Ft.Ft.Distance from occupied building yO r Ft./O T>^ Ft.Distance from property line Ft. T Ft.Ft. Ft.Distance from bottom to Water Table All distances are shortest distance between nearest poMts RECORD OF TESTS: Inspection was made on 19 , Time ..........JVI By. 19 , 19.....>.^...,M.p.x:.L.h AAPERCOLATION TEST DATA:Date of First Test....... Date of Second Test..... Rate i/opP><P T' 1st Test Taken By Rate /J...LilFirst 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 inspactioofl (Call or use attached mailer notice.) iADated 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: /A I. Ac. Vc jlp- V? Issued Date: Shoreland Management OfficeoO Fee $Surcharge $ i Ac3. --A-tAt IComments:./*)«0 f t to. /A I }tpr% \0^ Form No. MKL-0771-003 .... 158906VICTOI kWHDCfil 4 CO.. MiHTCI r«u J li 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 — Insnector , Pink - Owner ^ Card — Owner / rut'*" ? I CkL. /< (O So f ?/oPermit No.,LEGAL f Date\ oo riDESCRIPTION AND LTl "X' 73 7locationAr-;^r Lake No. Lake Classif.Lake Name Sec.TWP Range TWP Name IDENTIFICATION: Please Print All Information. Last Name First Initial Mailling Address —No. Street, City and State Zip No.Tel. No. / 'dlrLLLr, vv~v.OWNER SEWAGE SYSTEM INSTALLER Name i 4 \ '<t: P'A^ .This System will be ready for inspection on.I9J4L J This space for office use only Date Rec'd 19 i Phone Call Rec'd ByTime Rec'd Owner or Agent Signa^ture //NUMBER OF BEDROOMS;ESTIMATED COST; SEWAGE DISPOSAL SYSTEM DATA: SEPTIC TANK SEEPAGE PIT DRAIN FIELD77€>y' GIs.Sq. Ft.Capacity Sq. Ft.V 7 O " Ft.Ft.Ft.Distance from nearest well 75“ ^ Ft.Distance from lake or stream Ft.’ Ft. /o r- ^ Ft.Distance from occupied building / Ft.Ft. /A" V Ft.//-7Distance from property line 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 ,JVI By -•cJPERCOLATION TEST DATA:19Date of First Test Rate/....• >±..//-Date of Second Test.,, 19 Rater I /5 1st Test Taken By ,Z...///First Test + 2nd Test 2 Rate2nd Test Taken By Ji 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 7^ 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: /> / P./ Issued Date:IShoreland Management Office CEftTl r/nATg— oO /y C)Fee $Surcharge $Issued . ! J7^ 'Pr- o' V neyrr'.IComments:. / ^ AcAldCo b> f r>o ^ f i/ r fC\ t .... 158906orm No, MKL-0771-003 VICTfil LUHOCCM 4 M.. '*U J »4 h INSPECTION RESULTS ♦Inspector must make all measurements - ■l?1 *r i'v’'SEWAGE DISPOSAL SYSTEM STATISTICS -f..v--''v! ■-C; SEEPAGE PITSEPTIC TANK DRAIN FIELDCATEGORY Actual Should be Actual Should be Actual Should be f S F2Z2hCapacityGIs.GIs.s F S F S F 5VDistance from Nearest Well 75 50FFFF F FLDistance from Lake or Stream F F F F F Distance from Occupied Building 201020FFFF F 3K11Distance from Property Line 10 10 10FFFF F 4^Distance from Bottom to Water Table 4 4FFF F F -I—i 4'; J ' Ur/1 Ih SInspector's Comments: ly 9 (/r/pri 3 /^ /j I c r■^ 71 f>\, 7 / z X Ce-rT I Date of Inspection / /Time of Inspection,M Signatureoy InspectorINTERPRETATION OF ABBREVIATIONS GIs = Gallons SF = Square Feet = Linear Feet // i ^KJob Title F Agency M KL-0771-003-Backer V •> * ' %■ ■■.N ■7 '■V 'i.711 . --ft;-zx. •? »