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HomeMy WebLinkAboutLost Valley Resort_08000160125001_Septic System Permits_APPLICATION FOR PERMIT TO INSTALL SEWAGE TREATMENT SYSTEM LAND & RESOURCE MANAGEMENT OTTER TAIL COUNTY COURT HOUSE 121 W. JUNIUS AVE. • SUITE 130 Phone:(218)739-2271 • FERGUS FALLS, MN 56537 WHITE - Office YELLOW -L&R Inspector PINK - Owner / Contractor (after issue) \ Permit No.H72.1APPLICATION MUST BE COMPLETE IN ORDER TO BE PROCESSED LAKE NUMBER LAKE/RIVER NAME LAKE/RIVER CLASS SECTION TWP NO.RANGE TWP NAME i£o mPARCEL NUMBER (S) OF PROPERTY BEING SERVICED E-911 ADDRESSe? / o 6 ~oo/ 6O^OqoJJJ^ LEGAL DESCRIPTION ' fT 6-L 8 H 917 7 Scu\Ft Fogy t/sc Last Name First Initial Mailing Address Daytime Phone No. Property Owner tYfJJl S(jui/^ Foot (y6v2^S ______________7 i / j; sr 1/ -7o^LContractor Lie.# 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 Official ySEWAGE TREATMENT SYSTEM DESIGN DATA Size ^ /qoq TYPE OF INSTALLATION (CIRCLE ONE) TANK DRAINFIELD ro^)GIs.^OOAdd-On/New System (20) Trench, Rock (21) Trench, Gravelless (22) Trench, Chamber (23) Bed (24) Mound (25) At Grade Replacement ^2)3ank, Septic ^3^^ank, Lift rjpSffiSTisnch. Rock (35) Trench, Gravelless (36) Trench, ChambergsTtSed (38) Mound (39) At Grade (40) Combination /OO-f-Setback to nearest well Ft.Ft.^oo Z' Setback to OHWL (lake &/or river)Ft.Ft. Setback to wetland Ft.Ft. Setback to dwelling Ft.Ft.Collector System (26) Trench, Rock (27) Trench, Gravelless (28) Trench, Chamber (29) Bed (30) Mound (30) At Grade Setback to non-dwelling Ft.Ft.600 7^ /oo Ft.Setback to nearest property line Ft.other (41) Tank, Holding (42) Outhouse (43) Sewer Line (44) Performance (45) Warrantied (46) Miscellaneous lo<jy Ft./ 0^Setback to road right-of-way Ft. Elevation above restrictive layer Ft.Ft. ALL DISTANCES ARE SHORTEST DISTANCE BETWEEN NEAREST POINTS.# BEDROOMS 5* Art^r^ f^SORPTION AREA FOR MOUNDS GARBAGE DISP. Y / © ABATEMEf^g) Designer___ Designer Lie. # DEPTH OFmERWEIsL djUf\(eO^ Ft 2EFFLUENTDISTRIBUTION ( ) Gravity Pressure HOLDING TANK MONITOR/xr DISPOSAL contract;;^ ( ) Yes ( ) No;l<&flCan Not Process PERCOLATION TEST DATA O JX 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. A copy of the final Inspection Report will serve as the Certificate of Compliance for approved installations. Date of Test.Highest Rate __o c> /O/O^o/ /O/o^o / Date:Permit Fee $22 Signature mermgent forjopet Date:Rec. No. .and & Resource Management Office Comments: Form No. BK — 0201-003 306,475 • Victor Lundeen Co., Printers « Fergus Falls, Minnesota f ' APf^LICATION FOR PERMIT TO INSTALL SEWAGE TREATMENT SYSTEM LAND & RESOURCE MANAGEMENT OTTER TAIL COUNTY COURT HOUSE 121 W. JUNIUS AVE. • SUITE 130 Phone:(218)739-2271 • FERGUS FALLS, MN 56537 WHITE - Office YELLOW -L&R Inspector PINK - Owner / Contractor (after issue) /V7^7 !APPLICATION MUST BE COMPLETE IN ORDER TO BE PROCESSED Permit No. LAKE NUMBER LAKE/RIVER NAME LAKE/RIVER CLASS SECTION TWP NO.RANGE TWP NAME f^o/3/2/ C)6Ti m V/ PARCEL NUMBER (S) OF PROPERTY BEING SERVICEDo/O b -UU/ 6 (! E-911 ADDRESS O^^oo / '^ /jb LEGAL DESCRIPTION ^ 3<^\FT T^L iJrlUkcjpoi~ 8no Last Name First Initial Mailing Address Daytime Phone No. /^ooT /^L (y C/’^67iS Property Owner 7 V6 ycr7 izTf-So-3\^/ J/ ^ r ST P/ ^'(^3 u ~ y 6T6 7 7 y jyy ^y/5; Contractor Lie.# hcFT THIS SPACE FOR OFFIC^USE ONL] ieoon___________________ djn \t> I nloi A.M.rP’.c^Q>• Tns System will bi , the year o(P.M.at.for inspe( £ TYPE OMNSTSEESffON (CIRCLE ONE) ^ loi‘> ' Jjffte Received A.M. P.M. L&R Official SEWAGE TREATMENT SYSTEM DESIGN DATA /__TANK J s~oo DRAINFIELD</ ‘-1L.------------ P /uog Cof^)'W Ft"^QQSizeGIs.Add-On/New System (20) Trench, Rock (21) Trench, Gravelless (22) Trench, Chamber (23) Bed (24) Mound (25) At Grade Replacement C(32) Tank, Septic Ci33) Tank, L <i^JJ:3rench /OO iSetback to nearest well Ft. Ft./oo 7- Lift 7r-T~/T^-hSetback to OHWL (lake &/or river)Ft.Ft. , Rock (35) Trench, Gravelless , Chamber Setback to wetland Ft.Ft.(36^ TrenchQaiPBed Z S't Ft.Setback to dwelling Ft.Collector System (26) Trench, Rock (27) Trench, Gravelless (28) Trench, Chamber (29) Bed (30) Mound (30) At Grade (38) Mound (39) At Grade (40) Combination Setback to non-dweliing Ft.Ft./ o O Y- /o<J 1~Setback to nearest property line Ft. Ft./oo /Other (41) Tank, Holding (42) Outhouse (43) Sewer Line (44) Performance (45) Warranted (46) Miscellaneous / Y 7 Ft.Setback to road right-of-way Ft. &Elevation above restrictive layer Ft. Ft. ALL DISTANCES ARE SHORTEST DISTANCE BETWEEN NEAREST POINTS. DEPTH OF WATER WELLG f / /)#BEDROOMS ^ ^ GARBAGE DISP. Y / ^ ABATEMENT., yj ABSORPTION AREA FOR MOUNDS(••//If/; Ft^EFFLUENTDISTRIBUTION ( ) Gravity Pressure HOLDING TANK MONITOR^ DISPOSAL CONTRACT ■ ( )Yes ( ) l^-&fiCan Not Process ^ . 'Or C- ^ (- y<7 6~Designer 7 ‘-'P H Designer Lie. #________ PERCOLATION TEST DATA ■O U V.Date 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 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. 4 copy of the final Inspection Report will serve as the Certificate of Compliance for approved installations.5*^oO Permit Fee $Date: ________S/gnafu^ pfJ^operty-Owne^gent forJJ¥^er . "P^/-y Date: /Rec. No. > Land & Resource Management Office Comments: Form No. BK — 0201-003 306,475 • Victor Lundeen Co.. Printors • Fergus Falls, Minnesota SEWAGE TREATMENT SYSTEM PERMIT INSPECTION RESULTS ' Inspector must make all measurements •5 HOLDING SEPTIC TANK OUTHOUSEDRAINFIELDLIFT TANKCATEGORY -ZvsoE!Capacity FT2GLS. GLS. 5o t ft /OO'f' PT FTFTSetback from Nearest Well Setback from Buried Water Suction Pipe FTFTFT FT Setback from Buried Pipe Distributing Water Under Pressure /o ^ ft FTFT FT 7£'^ ft looftSetback from OHWL (lake &/or river)FTFT Setback from Setback from Wetland FTFT FT FT 15+loo I' ftSetback from Dwelling FTFTFT /oo -Setback from Non-Dwelling FTFTFTFT Setback from Nearest Property Line FT FTFTFT/a ^ /O^Setback from Right-of-Way FT FTFTFT/oo^ 3+-Elevation above Restrictive Layer FTFTFTFT Holding Tank/Lift Alarm YES NO 7^Old System Pumped & Destroyed NO FILTER DRAINFIELD CALCULATIONSewer Line to Well Separation Actual Minimum //OFTX□ YESManuf.,So’' uT,a 7 So .ft^Model #FT 20 MOUND CALCULATION MOUND /AT-GRADE ROCK REDUCTION Inspector’s Comments: ABSORBTION AREA Rock trenches with inches of rock under pipe for %Ft. X ft2 DRreduction / equivalent to,Ft2 SKETCH: lo-n cl Initial/L&R OfficialTimeDate CERTIFICATION OF COMPLIANCE /Cf the above described sewage system installation was found to be compliant with the provisions of the SanitationAs of Code of OtterTTail County. ^'InloxL & R Officisi / Date^ Land^'Resource Management Official Copy of Inspection Report Mailed to Applican ' i L iL /o- n-O 1 10 \]Y T«.n^A \IGov\(* 1(» looo /C^IOOO L.Ct UWvU 56"-'/w"Liej r ! /IV OCO I lU/fVO IV Mf^L/ £.1 TOWNSHIP 137 NORTH, RANGE 41 WEST OTTER TAIL COUNTY. MINNESOTA loo'-/ I I r~r.y • ^ ‘fc ■ ' i 1. .•;r ‘ -P'. ■- >: :::- V-.* ‘t./ ■ •■>'.•; •-;-• « s 4(9.63' --_--N86®20'36"E / :■ /o/s/h) 7 =2.^/€&s8^ =y - / •fyf~ ^(%S ^F/2 OA Hi ^ m /V '■ 7.e^ ^(/'s V 2.,!T>6/II + / a o vre ; fcM ^ST. foa 2*a 5^^ yo0 5t <7 X. i 3/00 >< ,7i~ : y7uy- // 2j- -■fv^r ■ /Ooo. 3 P47^ SITE DATA WORKSHEET LAND AND RESOURCE MANAGEMENT Otter Tail County 121 W. Junius Ave., Suite 130 Fergus Falls, MN 56537 OWNER: ^ FIRST —I' ^ LAST N.MIDDLE TELEPHONE NUMBER ADDRESS: ^ CITY , /H/j STR./RT.STATE '•''A /77 ZIP CODE C/fA/a>o/r LAKE/RIVER NO.LAKE NAME TWP.RANGE TWP. NAMESEC. LEGAL DESCRIPTION:SOIL BORING LOG - Date COLOR & MUNSELL NO. DEPTH (INCHES)TEXTURE STRUCTURE0^00 O J(o Ci/2->r C^^QOdl^iO 106 Qd I BLOCKY PLATY PRISMATIC ^—NQN£_, BLOCKY ^ PLATY PRISMATIC NONE d-CPARCEL NUMBER FIRE NUMBER ^r-/c2"''3(0^ Q^ef^ NUMBER OF BEDROOMS 3' -Cg,. GARBAGE DISPOSAL: YES ^0^ WELL CASING DEPTH: BLOCKY PLATY PmSNIATIC(T^Ot^’ ft.BLOCKY PLATY PRISMATIC NONE FLOODPLAIN: YES VEGETATION: AQUATIC TERRESTRIAL BLOCKY PLATY PRISMATIC NONE SLOPE AT INSTALLATION SITE:% TYPE OF OBSERVATION: Probe Pit PARENT MATERIAL: Till ORIGINAL SOILC^^ Outwash Loess Bedrock Alluvium COMMENTS: No COMPACTED SOIL: Yes DEPTH OF BORING:ft. PERC TEST #2PERC TEST #1 - TWO TESTS ARE REQUIRED - PERC RATEINTERVAL (MINUTES)WATER DEPTH WATER DROPWATER DEPTH WATER DROP PERC RATETIMEINTERVAL (MINUTES)TIME STARTSTART ../.t'ld..J21 TIME DROP PERC PERC RATEWATER DROPINTERVAL (MINUTES!WATER DEPTHTIMEINTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATE TIME ........ REFILL5 TIME DROP PERC TIME DROP PERC PERC RATEINTERVAL (MINUTESl WATER DEPTH WATER DROPWATER DROP PERC RATE TIMETIMEINTERVAL (MINUTES)WATER DEPTH 5 PROF PERC REFILLREFILL.X -dLPERC../.2L^M .yt./S.d>.TIMETIMEDROP PERC RATEINTERVAL (MINUTES! REFILL WATER DROPWATER DEPTHWATER DROP PERC RATE TIMETIMEINTERVAL (MINUTES)WATER DEPTH 'U)5 TIME DROP PERCTIMEDROPPERC PERC RATEWATER DROPINTERVAL (MINUTES)WATER DEPTHINTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATE TIMETIME REFILLREFILL3.L1<2.DROPTIME PERCTIMEDROPPERC PERC RATEWATER DROPINTERVAL (MINUTES)WATER DEPTHWATER DROP PERC RATE TIMETIMEINTERVAL (MINUTES!WATER DEPTH REFILLREFILL TIME DROP PERCPERCTIMEDROP PERC RATEINTERVAL (MINUTES)WATER DROPWATER DEPTHWATER DEPTH WATER DROP PERC RATE TIMETIMEINTERVAL (MINUTES)REFILLREFILL DROP PERCTIMEPERCTIMEDROP PERC RATEINTERVAL {MINUTES!WATER DROPWATER DEPTHINTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATE TIMETIME REFILLREFILL DROP PERCTIMETIME DROP PERC PROPOSED DESIGN:/PRESSURE DIST.GRAVITY DIST.HOLDING TANKATGRADE MOUNDTRENCHBED ✓ SPECIFY; — SYSTEM DESIGN ON BACK — OTHEROUTHOUSESEWER LINE SEWAGE SYSTEM ABATEMENT NOTICE LAND & RESOURCE MANAGEMENT COUNTY OF OTTER TAIL COURTHOUSE, FERGUS FALLS, MN 56537 (218) 739-2271 Lake Niiznber: (56- 532) Lake Name: leek RONALD R & TAMMY A RICHTER ATTN LOST VALLEY RESORT RR 1 BOX 394A VERGAS, MN 56587 9789 You-.a^re hereby notified that the sewage system which you maintain on the following described property: UNPLATTED PT GL 8 COM SW COR SEC 15, N 2216.76' TO BG, SE 265.06', ELY 419.63', NE 578.76' TO LK, WLY ALONG LK TO SEC LN, S TO BG #100-001 & #125-001 NOT TO Sec:Twp:Range:15 137 041 CANDOR TOWNSHIP Parcel Ntunber: 08000i50i0000i gis #; 49337 lost valley rd is not constructed and/or located in accordance with minimum standards of the Shoreland Management Ordinance of Otter Tail County. Please be advised that you must correct this situation within 30 days, should contact this office in order to determine what corrections and permits are required prior to complying with this notification. You - Dated JULY 27,2001^Land ^ Resource Management Official - STATE OF MINNESOTA ) )ss. AFFIDAVIT OF SERVICE BY MAIL COUNTY OF OTTER TAIL) Mavis Samuelson, of the City of Fergus Falls, County of Otter Tail, in the State of Minnesota, being duly sworn, says that on the (27th day of July, 2001,) she served the annexed: ONSITE SEWAGE SYSTEM ABATEMENT NOTICE On the following person, by mailing a copy thereof, enclosed in an envelope, postage prepaid, and by depositing same in the post office at Fergus Falls, Minnesota, directed to said person at the following address: RONALD R & TAMMY A RICHTER ATTN LOST VALLEY RESORT RR 1 BOX 394A VERGAS, MN 56587 9789 Mavis Samuelson Land 8s Resource Management Official fore me thisSubscribed and sworn to day of J^nM llL in the year of I <3^. ^ mypa£TU .. A I,My Commission Expires iM 'iiiiriiini'Tiii—I — IjJOYCE L THOMPSON NOTARY PUBLIC-MINNESOTA Mv Commission Expires JAN. 31,2005 t Z_(9S>+ l/AlUy 2. iixo^ Mr. - Xen/i'n.^ ^ " I ixir - 2. 'ThlJ^iy cliLfck. MHL,- i :ioo^ t>i: iVet •f^r ^ ^koUjC4n> iiD 5Cn/^ (T^H(|> «5*?1 75o^Ai\t4K~ 4" ISo^ P*'^ f'Ot- > "/vv-^ $^743 _ d-tr-r 7;. 77 10 Cl/4-i 5 y A X 4^-. m; ;': 44. ffiHIfj nt ------ Tail COUNTY^^fNNESOTA .t>\\ TROWBRIDGE fi ^^onder Corner FIELD NOTES c/i %h ILAKE NO- 56-DATE:LAKE.NAME: ^^337 Parcel No. O^^OiS C>IOOOO\ 0<iooo U e?t^ooi FIBE/LAKE NOLEGAL DESCSIPTION: L.o%f \jAilef ONNEBS NAME AND ADDRESS: I TYPE OF SEWAGE SYSTIM: Cesspool: ___Septic Tan)c / Drainfield: ___Holding Tank: ____ p Septage Pit, Drywell, or Leaching Pit: ___Other: COMMENTS: SEPARATION DISTANCES fiN FEET) OUTHOOScABSORPTION AREATANKSEWER LINE WELL ______ OHWL LOT LINE DWELLING NON DWELLING GROUND ELEVATION @ REASON(S) FOR ABATEMENT: -TanIt5 T«>t> t-lae to r>vNk. h DrAM 4rbri cip%* 7^ 6»U/ 50>l AUorifiO»4 fyjtfri ^ UHKN«u»H SecffriiDh ^ f 7^3 S>ix.ed 46r j. 1' //>3H T© ^ 6^14 f Hh Inspector's Signature(s)SKETCH ON BACK • • • 2 ZtuPer h^Hori -Povr-ed 114 p/AC^ (vlo H U^AlV-e-" A'\ Tan^S ' M* cAiji^i \ V 3SO c^rArGO o u D Ci UQf<l\^ \snf BH>3 J -^or; A^^rou^ I MH Ut IHcIu4^> a Mr -^pr- C4Hp<>Ao ^.t i>ltO{jJ<r ^oo^f OKIP' vt/K»tU fiw^^ ^ f-AMtr ^ four-id /jg ^Iac^ hi VJaIUi^ I^><^/vr-^’^Jf N)c> LAK<4 drAitJA\\ • /// / // T>\nj^5 ^ ~ H -frf>r1 c-4i>i'K> \ /J.' M ^ Si if'Pn t-^i>'u D o a □ o ‘I Vo '5 \ ' A|j>^rc>u«’«) -^Or- I MH M r -^j>r-^Anpi\~hcj o,t ^houJ'fr i ^0/^-wU>, it«Ci S^= ^<rn.'f w FIELD NOTES d/a.y/a(LAKE NO- 56-DATEs FIBE/LAKE NO.Parcel No. 0%£>^O I S OlOQOC>\ 0<lOOo ti Ol^OOf DESCEIPTION: ^9337 L_d)sf \/Ailef ^e^orT ONNEBS NAME AND ADDRESS: I TYPE OF SEWAGE SYSTEM: Septic Tank / Drainfield:Cesspool; ___Holding Tank: .___ ' Septage Pit, Drywell, or Leaching Pit: ___Other: COMMENTS: SEPARATION DISTANCES (IN FEET) ABSORPTION AREA OUTHOUSETANKSEWER LINE WELL OHWL LOT LINE 1'DWELLING NON DWELLING />3GROUND ELEVATION @ \Aj'A-+^r- M-v^rKB£ASON(S} FOB ABATEMENT: 'Too <( C>rl fCr4o«fc»H ” ^ h Too chit T© ^ 4r>rl TAhllti *>'©0 ctfii* To fe,u^ 5oil AU©rif/©»7 #5 L)H/<N«i©M ^ SCCfA-^a- (/>, f ffriion S-f! 7^3 Mils'/ fpt^j flnA'f 9k Ht^yi 1i*'h ■fJi4-+ /5 f HX> Inspector's Signature(s)SKETCH ON BACK • • •/ APPLICATION FOR PERMIT TO INSTALL SEWAGE TREATMENT SYSTEM » WHITE — Office Yellow — Inspector Pink — Owner LAND & RESOURCE MANAGEMENT OTTER TAIL COUNTY COURT HOUSE Phone:(218)739-2271 - FERGUS FALLS, MN 56537 109^ Permit No.LEGAL eDESCRIPTION Abatement; ( ) YesAND ffC-L S'LOCATION SECTIONLAKE/RIVER NAME TQ i ^l Co-W'or' PARCEL NUMBER(S) ^ 0 i OQ-COl if-O/lS-OOl LAKE NUMBER LAKE/RIVER RANGETWP. NO.TWP NAME FIRE OR LAKE ASSOCIATION NUMBER IDENTIFICATION: Please Print All Information Lasl Name,______________yQ_______First y Initial /cCcyiU^t^. /(c^olU Ma^lu^yyjdress — No. Street, City and State/Zff f \Jq7W)Zip Code Telephone No. t±Property Owner 4- AA_QSewage System Installer Name A.M. This System will be ready for inspection on., 19.P.M.at This space for office use only NUMBER OF BEDROOMS: A.M. P.M19 GARBAGE DISPOSAL: { ) YES () NODate Rec'd Time Rec’d Phone Call Rec’d By SEWAGE TREATMENT SYSTEM DATA: MINIMUM REQUIREMENT;TYPE OF SEWAGE SYSTEM ( ) Holding tank (Alarm Required) J^pxj[^eptic tank ( ) Lift station (Alarm required) TANK IAIN FIELD [7) I. 0UI-)Capacity Sq Ft.GIs. St)Distance from nearest well Ft.Ft. ( ) Drain field ( ) Trenches ( ) Bed ( ) Mound ( ) Outhouse ( ) Sewer line 73Distance from lake or stream Ft. Ft. mDistance from building Ft.Ft. mDistance from property line Ft. Ft. Distance from bottom to Water Table Tt.Ft. EFFLUENT DISTRIBUTION ( ) Gravity ( ) Pressure All distances are shortest distance between nearest points PERCOLATION TEST DATA: irf Will LieW -I -rSrO hh WATER WELL DEPT Perc Tester,Date of Perc Test. Rate of 1 St Test Rate of 2nd Test Average Rate Agreement: The undersigned hereby makes application for permit to install or extend Sew accordance with Ordinances of the County of Otter Tail, Minnesota and Minnesota li^ivi^u^fS of Health. Applicant agrees that plot plan sketches and specifications submittei of the permit. Applicant further agrees that no part of the system shall begsr^ the permit to notify the County Shoreland Management that the job Disposal System herein specified, agreeing to do all such work in strict l^age Disposal Code Minimum Standards set forth by Minnesota Department L-h^^fJtfTand which ag d^^mil it has b& Ir inspection. iproved by Shoreland Management Officical shall become a part \o4pdcie6 an^ccepted. It shall be the responsibilty of the applicant for DATE:7Signature Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This'permit is granted upon express condition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Ordinance of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of any said ordinances. NOTE: Permit void if work is not commenced wiUiin six (6) months. VIssued Date: Land & Resource Management Office3^Fee $.Rec #. Comments:/ Ui (a -f'Oi ' .0.. Pfiniers • Fergus Falls, Minnoosia277.212 • Victor LundeeiBK 0795-003 L'-Ir•■V ■ APPLICATION FOR PERMIT TO INSTALL SEWAGE TREATMENT SYSTEM WHITE — Office Yellow — Inspector Pink — Owner LAND & RESOURCE MANAGEMENT OTTER TAIL COUNTY COURT HOUSE Phone:(218)739-2271 - FERGUS FALLS, MN 56537 5 ' lO^! LEGAL Permit No. DESCRIPTION Abatement: ( ) YesAND f / (}L S'LOCATION LAKE NUMBER LAKE/RIVER NAME / T(o PARCEL NUMBER(S) Lt LAKE/RIVER SECTION RANGETWP. NO.TWP NAMETO lOiu 1^1 ^1CLA FIRE OR LAKE ASSOCIATION NUMBER OHllh (y~Oloo- coH of-cvo- n^-o/d^foDl IDENTIFICATION; Please Print All Information Initial Mailing Address — No. Street, City and Slate Zip Code Telephone No. /Property Owner uc<t ImJcJ-Ctv <Sewage System Installer Name IT A.M. atThis System will be ready for inspection on P.M. This space for office use oniy NUMBER OF BEDROOMS: A.M. P.M GARBAGE DISPOSAL: ( ) YES (NODate Rec’d Time Rec’d Phone Call Rec'd By SEWAGE TREATMENT SYSTEM DATA: MINIMUM REQUIREMENTSTYPE OF SEWAGE SYSTEM ( ) Holding tank (Alarm Required)t;><j^eptic tank ( ) Lift Station (Alarm required) TANK DRAIN FIELD 13) /.r)DQg's-\Capacity Sq Ft. iDistance from nearest well Ft.Ft.( ) Drain field ( ) Trenches ( ) Bed ( ) Mound ( ) Outhouse ( ) Sewer line Distance from lake or<stream Ft.Ft. zaDistance from building .Ft.Ft. inDistance from property line Ft.Ft. Distance from bottom to Water Table ■Ft.Ft. EFFLUENT DISTRIBUTION ( ) Gravity ( ) Pressure Alt distances are shortest distance between nearest points PERCOLATION TEST DATA: WATER WELL Perc Tester.Date of Perc Test. Rate of 1st Test Rate of 2nd Test Average Rate Agreement: The undersigned hereby makes application for permit to install or extend Sewage Disposal System herein specified, agreeing to do all such work in strict accordance with Ordinances of the County of Otter Tail, Minnesota and Minnesota Individual Sewage Disposal Code Minimum Standards set forth by Minnesota Department of Health. Applicant agrees that plot plan sketches and specifications submitted herewith and which are approved by Shoreland Management Officical shall become a part of the permit. Applicant further agrees that no part of the system shall be covered until it has been inspected and accepted. It shall be the responsibilty of the applicant for the permit to notify the County Shoreland Management that the job is ready for inspection. X. '/Lc/DATE:.jL JSignature Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express condition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Ordinance of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of any said ordinances. NOTE: Permit void if work is not commenced within six (6) months. ^ X- (cu-hXX Issued Date: Land & Resource Management OfficejsnFee $.Rec #_ Comments: 7 277.212 • Victor Lurtdeer>,^o.. Primers • Fergus Falls. MirtneostaBK 0796-003 r- •Ml V-. V \INSPECTION RESULTS Inspector must make all measurements SEWAGE DISPOSAL SYSTEM STATIf!o ^HOLDING ) «CTTIO TAWC DRAIN FIELDLIFT TANKCATEGORY Actual inimum cAOOO GLS.SFGLS.Capacity ^Tft FTFTDistance from Nearest Well y 5Distance from Buried Water Suction Pipe r FT.FT FTiDistance from Buried Pipe Distributing Water Under Pressure FT ^=F- FTDistance from Lake or River (OHWL) Vn FT FTFTDistance from Nearest Building /as-h «____-FTDistance from Nearest Property Line ( FT FTDistance from Bottom to Water Table FT S'ES NOHolding Tank/Lift Alarm YES NOOld System Pumped & Destroyed DRAINFIELD CALCULATIOISewer Line to Well SeparationINTERPRETATION OF ABBREVIATIONS GLS. = Gallons SF = Square Feet FT = Linear Feet Actual MinimutTi FTX ^5o FT 20 FT SF y /Vl ^ -_________ IC he /- Inspector’s Comments: /UyixJ ^ V LoUj</^ U Veil CCt CilL (ji!p'>f^ flJ Poi/s. o f I SKETCH: nspeifor's Signature Date of Inspection %'r- i-Lci^Time of mspection s GRID PLOT PLAN SKETCHING FORM — (Must Be To Scale) Scale: Each grid equals feet/ inches Dated: a Signature each building currentlyPlease sketch your lot indicating setbacks from road right-of-way, lake and sideyard on lot and any proposed structures. . . .0 f iXCM^ (Xl^O 6'-/ ■fOh-e-Ti» K. Cl 0 (-:x-'3^' fzJ uSect <^*-5^ Q--fi- f p -^1 ^ I • ^ PERCOLATION TEST DATA V.LAND AND RESOURCE MANAGEMENT Otter Tail County Fergus Falls, MN 56537 OWNER: ‘telephone m UMBERLAST NAME LI /MIDDLEFIRST ADDRESS: m /\A !v\ STATE - 'Pi/*ZIP CODECITYSTR./RT TRpLAKE NANTE ' .TWP. NAMERANGESEC. TWP.LAKE/RIVER NO. LEGAL DESCRIPTION: ‘ PARCEL NUMBER NVMBER/BEDROOMSFIRE NUMBER — TWO TESTS ARE REQUIRED — TEST HOLE NO. 2TEST HOLE NO. 1 inches; ' Diameter , of Hole inchesinches Depth To Bottom of Hole 1inches; Diameter of HoleDepth To Bottom of Hole 19Dale 19Date Soil TextureDepth. Inches Soil TextureDepth. Inches Percolation Test By _ Firm Name _____ Percolation Test By_ Firm Name ____ Address Address Otter Tail County License No. Otter Tail County License No. PERC TEST # 2PERC TEST # 1 PERC Rate TIME INTERVAL tMINirrES)WATER DEPTH WAIBRDROPINTERVAL fMPWTBft WATER DEPTH WATER DROP PERC RATETIME - STARTSTART r 'flMU" DROP pfeRC”TIME “ DROP PERC PERC RATE TIMEWater depth Water drop interval (MDWJTBS)WATER DEPTH WATER DROP PERC RATEvmINTERVAL (MINinES> REFILLREFILL T T YIME" * DROP i^toc DRO> <»BRC WATER DROP PERC RATE TIME INTERVAL fMINUTBSI WATER DEPTH WATER DROP PERC RATEINTERVAL n»«INIJTBST WATER DEPTHTIME REFILLREFILL 4 4 TD5IB" DROP PEftC 'rtMii DROP TCRC RATE TIMEWATER PROP INTBRWa.fMlNUTBS1 WATER DEPTH WAITODR«»PERC RATEINTERVAL (MINinBa WyflBR DEPTHTIME REFILLREFILL 4 TIMU" DROP PBRC DROP PBRC PERC RATE TIME INTERVAL IMINUTES)WATER DEPTH WATER DROPWATER DROP ' PBRC RATEINTERVAL (MPn/TSa WATER DEPTHTIME REFILLREFILL.1 4 4 DftO> PERC”TEMB' DROP' rote RATE TIME INTERVAL (MTNl/TESTWATER DROP WATER DEPTH WATER DROP PERC RATEINTCTVALtMTNUTBaWATER DEPTHTIME REFILLREFILL 4 4 TLMU ' DROP PERC 'HME DRdP PESC~I PERC RATE TIME INTERVAL (MINUTBa WATER DEPTH PERC RATEINTERVAL (MlNUTBn WATER DROP WATER DROPWATER DEPTHTIME REFILLREFILL 4 ^flME“ DROP PERC 'llMli DROP PERCTIMEPERC RATE INTERVAL rMTNUTByt WATER DEPTH WATER DROP PERORATE INTERVAL rMTNUTES>WATER DEPTH WATER MtOPTIME REFILLREFILL T TUClfi ^ DROP PERC TIME bRc5f*~ PBRCI I COMMENTS/CALCULA TIONS:: I MKL — 0390 • 005 250.815 — 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 W :te - Office V low — InspectorPh.. Card — Owner Owner Permit No..LEGAL Date DESCRIPTION AND 7 rrrr.0 jhr t Nam^ 75 V/LOCATION /37 Lake No.Lake Lake Classif.Sec.TWP Range TWP Name IDENTIFICATION: Please Print All Information. Last JMame First Initial Mailling Address —No. Street, City and State Zip No.Tel. No. A?n.OWNER 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 CaU Rec'd By Owner or Agent Signa^tureNUMBER OF^^DRO^^Msf^ ^r //oxyS^ ESTIMATED COST: SEWAGE DISPOSAL SYSTEM DATA: SEPTIC TANK SEEPAGE PIT DRAIN FIELD GIs.r^2r)‘n> sq- Ft.Capacity '^50 scr Ft. 6^0 Ft.Ft.Ft.Distance from nearest well :S~C) Ft.Distance from lake or stream Ft.Ft. Distance from occupied building 7 n Ft.Ft.Ft. Distance from property line /O Ft.Ft./n Ft. Ft.Distance from bottom to Water Table Ft.Ft. AH distances are shortest distance between nearegt points 7 RECORD OF TESTS: Inspection was made on 19 , Time ..........M By , 19PERCOLATION TEST DATA: t/ef^ Test 'ri Date of First Test Rate Ji Date of Second Test 19tOfe , Ratea \1st aken By A.3.A.2.......= ...3..f^r.....r;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 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 3Dated. ligp^i 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: Shoreland Management Office 7“Issued Date:. . OO \Fee $Surcharge $ AoComments:. kTS t ¥3 <L. Form No. MKL-0771-003 viCTO* LiiafttCM * ee . p»iafca«. rcatut fM.Lt ■!<«■ 158906 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 to — Office V low — Inspector Pii.. Cerd Owner Owner Permit No.LEGAL Date DESCRIPTION AND LOCATION Lake No,Lake Name Lake Classif.TWPSec.Range TWP Name IDENTIFICATION; Please Print All Information. Last Name Initial Mailling Address —No. Street, City and State Tel. No.First Zip No. OWNER 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 GIs.Sq. Ft.Capacity Sq. Ft. Ft.Ft.Ft.Distance from nearest well Ft.Ft.Distance from lake or stream Ft. Ft.Distance from occupied building Ft.Ft. 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 PERCOLATION TEST DATA:Date of First Test 19 , 19 , Rate Date of Second Test ,, Rate 1st Test Taken By First Test -I- 2nd Test 2 Rata2nd 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 (jerform 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 $Surcharge $ notcalledfor ikstect Comments:. Form No. MKL-0771-003 vicTo* (.uagccH 4 ca . aaintta*. rcaaui rM.Lt nixa 158906 i. 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 F S F Distance from Nearest Well F 75F 5QFF F 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 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 AgencyMKL-0771*003-Backet -I. • 9 ' *, ’ VV (^1 w? J:>k MI . _/.IlE< y /,=y>. CERTIFICATE OF COMPLIANCEm4 KSEWAGE SYSTEM<: Mm (W4 a8th19 7h ■JsnuaryThis certificate has been issued this day of.\ to certify compliance with regulations of Shoreland Management Ordinance, Otter Tail County, Minnesota.r 'ey p- ^ PI WThe premises covered by this certificate are legally described as: Twp. ^ 37 Range56-532 15 CandorTwp. Name.Lake No.Sec. nmWiLost Valley Resort M 1-1WeB Ralph RichterOwner: Name.rx= M:Verges, MinnesotaAddress. i-.56587 1)1Zip No. ^Malcolm K. Lee, Shoreland Administrator Otter Tail County, Minnesota 763S-.%Permit No. SP_ Signed by:. rmmMKL-087 1-009 NV '^mL IB ®1S903S ticTOH LuaeitN 4 CO. rRiaTi*«, rttflul rAiii, him SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone 218-739-2271 - Fergus Falls, Mn. 56537 APPLICATION FOR PERMIT TO INSTALL SEWAGE DISPOSAL SYSTEM White — Office Yellow — Inspector Pink — Owner Card — Owner Permit No.,ZLEGAL Date DESCRIPTION AND /?n df^T-T ,■ (53J^ /rcrz^Kt-i r/ck& Lake No. Lake Name^ /T7 4^LOCATION TWP NameLake Classif.Sec.TWP Range IDENTIFICATION: Please Print All Information. Zip No.Tel. No.Initial Mailling Address —No. Street, City and StateLast^ame First jJeri^ctS-OWNER A.SEWAGE SYSTEM INSTALLER r rvName, 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 Signa^ture J2. h>d>ci rcxrr^^ SEWAGE DISPOSAL SYSTEM DATA: SEEPAGE PITSEPTIC TANK DRAIN FIELD GIs.Sq. Ft.Sq. Ft.Capacity cm Ft.Ft. Ft.Distance from nearest well Ft.Ft. Ft.Distance from lake or stream >5~ /O Ft.Ft.Ft.Distance from occupied building -2.Ct Distance from property line Ft. Ft./C)Ft./Jl /<D ±Ft.Ft. Ft.Distance from bottom to Water Table AH distances are shortest distance between nearest points RECORD OF TESTS: ,, 19Inspection was made on , Time ..........JVI By............ 19 ....^3..' Rate. , 19.....?*:3.., Rate S/'yPERCOLATION TEST DATA:Date of First Test ___/-/a/iqp 1st yist Taken By Date of Second Test A3...L.Z.,Zr....s5,3.2nd Te^ Taken By First Test -I- 2nd Test 2 Rate 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 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. (Call or use attached mailer notice.) %jr Dated mature Permit: condition that the person to whom it is granted, and his agents, employees and workmen shall conform in all respects to ordinances of Otter Tail County Minnesota. This permit may be revoked at any time upon violation of any said ordinance. NOTE: Permit void if work is not commenced within six (6) months. Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express Issued Date: Shoreland Management Office. CToooFee S Q .AJeSurcharge $ Comments:. vicToi kuMecitt • cc.. pRiianMi. riaaus fu.Lt 158906Form No. MKL-0771-003 SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone 218-739-2271 — Fergus Falls, Mn. 56537 APPLICATION FOR PERMIT TO INSTALL SEWAGE DISPOSAL SYSTEM White — Office Yellow — Inspector Pink — Owner Card — Owner Permit No.,LEGAL Date DESCRIPTION AND LOCATION Lake Name Lake Classif.Sec.TWP Range TWP NameLake No. IDENTIFICATION: Please Print All Information. Mailling Address —No. Street, City and State Zip No,Tel. No.First InitialLast Name OWNER SEWAGE SYSTEM INSTALLER Name. /iC)iao 4/^S~This System will be ready for inspection , 19.on. This space for office use only 19-Zj2 Phone Call Rec'd ByDate Rec'd Time Rec'd Owner or Agent Signature SEWAGE DISPOSAL SYSTEM DATA: SEEPAGE PITSEPTIC TANK DRAIN FIELD GIs.Sq. Ft.Sq. Ft.Capacity Ft.Ft.Ft.Distance from nearest well Ft.Ft. Ft.Distance from lake or stream Ft.Ft. Ft.Distance from occupied building Distance from property line Ft.Ft. Ft. Ft. Ft. Ft.Distance from bottom to Water Table AH distances are shortest distance between nearest points RECORD OF TESTS: Inspection was made on 19 , Time JVI By PERCOLATION TEST DATA:Date of First Test 19 . Rate Date of Second Test 19^., Rate 1st Test Taken By First Test -I- 2nd Test 2 Rate2nd Test Taken By The undersigned hereby makes application for permit to install or extend Sewage Disposal System herein specified, agreeing to do all such work inAgreement: strict accordance with ordinances of the County of Otter Tail, Minnesota and Minnesota Individual Sewage Disposal Code Minimum Standards set forth by Minn­ esota Department of Health. Applicant agrees that plot plan, sketches and specifications submitted herewith and which are approved by Shoreland Management Offi­ cial shall become a part of the permit. Applicant further agrees that no part of the system shall be covered until it has been inspected and accepted. It shall be the responsibility of the applicant for the permit to notify the County Shoreland Management that the job is ready for inspection. (Call or use attached mailer notice.) Dated Signature Permit: condition that the person to whom it is granted, and his agents, employees and workmen shall conform in all respects to ordinances of Otter Tail County Minnesota. This permit may be revoked at any time upon violation of any said ordinance. NOTE: Permit void if work is not commenced within six (6) months. Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express Issued Date: Shoreland Management Office Fee $Surcharge $ A Comments:. vicfoa Lu«»ccN 4 e» . pmimum. rcasus rtLLt. *■ »158906Form No. MKL-0771-003 <t •K INSPECTION RESULTS Inspector must make all measurements SEWAGE DISPOSAL SYSTEM STATISTICS / /DRAIN ^ELDSEEPAGE PITSEPTIC TANKCATEGORY y should beActualShould be Actual Should/be Actual \/ Capacity GIs.GIs.S F S F S F SF —^Distance from Nearest Well v,75 50F■F-F F F F 7CFDistance from Lake or Stream F F F F F />irvjL 1 FDistance from Occupied Building 201020FFF F ^ FDistance from Property Line 10 10 10FFFF F ^d-2 S';Distance from Bottom to Water Table 4 4FFFF F Inspector's Comments: \J>^ ^ r:^ct. <?: u. ^ ' s 19XlPDate of Inspection U-iTime of Inspection, Signature of InspectorU,~r\INTERPRETATION OF ABBREVIATIONS GIs = Gallons SF = Square Feet F * Linear Feet ^ Job Title Agency MKL-0771.003-Backer i » PERCOLATION TEST DATA Price $1.00 per pad. SHORELAND MANAGEMENT OTTER TAIL COUNTY Fergus Falls, Minnesota 56537 Mailing Address: jjgs.c-e'r- l/e.T(p'^ 5__y^/4^4^__ ^ State Zip No. Ph. No.Owner: K/CHTs,Z Last Name First Middle St. & No.Legal Description:/(S' 132a/ 2//eATknulh Rif^e NAME cy /f hi c )\^ LAKE OR RIVER NO.SEC.TWP.RANGE TWP NAME TEST HOLE NO. 2TEST HOLE NO. 1 I At'3 C "LDepth To Bottom of Hole,Depth to Bottom of Holeinches; Diameter of Hole inches; Diameter of Hole.Jnchesinches 19Z?19ZIDepth, Inches Soil Texture Depth, Inches Soil TextureDate.Date To p ^ToP Sor A0 - (0 b iecPercolation Test By____ Percolation Test By____y n £y DMA! - y ^i 4- 5 P U/ a CA/^y CJ/H //V sC> - ViK /L/PU.V./y/>FirmName.Firm Name. UJCC ^ AtlijAddress.QC ry >Address< COOtter Tail County License No.Otter Tail County License No.^I-I2Ky£..CO E)t?pn7 in LUMeasurement, Inches Qeaeh in Water Level, Inches H Measurement, I nches Water Level, Inches Time Remarks Time Remarks O5 7: SS I ' o S 7.^ H S ? 5 3 33 A A 4.0 3 L ZiA/TTb 7^^34. 2y/3^/'* / ■7,3‘y > s/( 73^»>1^: -L g < *»«it 5"»»37--< It •/ ‘ IZJ3 ^s3-ux 3'11 // 3^6li 7^TTKX~KW^ WmmWS- FskKKffi&- =- MKL-0871-028 Booklet, "How to Run a Percolation Test" by Agriculture Ext. Service, Un. of Minn.