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Home My WebLink AboutRush Lake Resort_53000260179000_Septic System Permits_mi Iftjy-],iiS®&^Sli2&i\w■H 'A mmi w*i ^f^-^\\r/ uifi^ CERTIFICATE OF COMPLIANCE w# SEWAGE SYSTEM K »w §m feil4'ferl>b 'j 'm :%3^' i! MlWmPI mms)9>MpiIm 28 th day of December 79 76This certificate has been issued this miM to certify compliance with regulations of Shoreland Management Ordinance, Otter Tail County, Minnesota. The premises covered by this certificate are legally described as: WMmmmmfi Lake No. 56-141____Sec___24 Twp. 135 Range_33. Rush Lake Resort G.L. 1 mr4 Owner: Name Charlie Kress Address Ottertail f Minnesota 56571V"*' ■*W.MM R-sfe®* Zip No. ’A2102Permit No. SP_ Signed by :.______/J'Malc(^lm K. Lee, Shoreland Administrator Otter Tail County, Minnesota MKL-087 1-009 f -1 J ' — ■ < ®159035 *1^1'^'' tuaoers 4 co. msui r*iL9. Hi" 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 Pli.. — Owner Cerd — Owner J^/07-Permit No.LEGAL Date DESCRIPTION . L-iAND T77)LOCATION Lake Clatsif.Lake No.Lake Name Sec.TWP TWP NameRange IDENTIFICATION: Please Print All Information. Last Name First Initial Mailling Address —No. Street, City and State Zip No.Tel. No. (7** (i f ! (K o ^ /i/u^ ‘OWNER SEWAGE SYSTEM INSTALLER Name. 1^ This System will be ready for inspection on... 19. This space for office use only ,19 -M Date Rec'd Time Rec'd Phone Gail Rec'd By Owner or Agent Signa^ture NUMBER OF BEDROOMS;ESTIMATED COST: SEWAGE DISPOSAL SYSTEM DATA: SEPTIC TANK SEEPAGE PIT DRAIN FIELD Jooo ]Je.lOGIs.Sq. Ft.Capacity Sq. Ft. Ft.Ft.Ft.Distance from nearest well 5?^Ft.Distance from lake or stream Ft.Ft. lADistance from occupied buildinq Ft.Ft.Ft. /o>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 JVI By Ria ... 19 ...2..4. .... 19...2!..^.., / PERCOLATION TEST DATA:Date of First Test....,Rate Tl%L.iDate of Second Test.,Rate 1st Test Taken By /. I1.r / First Test -I- 2nd Test 2 Rats2nd 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/tffelob is re The undersigned hereby makes application for permit to install or extend Sewage Disposal System herein specified, agreeing to do all such work in or in$pc|ction. (Call or use attached mailer notice.) 2-,cDated Signature c ----- Permit: condition that the person to whom it is granted, and his agents, employees and workmen shall co This permit may be revoked at any time upon violation of any said ordinance. I NOTE: Permit void if work isnot comiMnced within six (6) months. I Permission is hereby granted to the above named applicant to perform the work described in the above statement. This rm in all respects to ordinances of Otter Tail County Minnesota. mit is granted upon express Issued Date: ihoreland ManagementyO^ice r"52Fee $Surcharge $ L.-U "n L 'ioo <^.^0 J f):>yX.ro 11^\Comments:. Form No. MKL-0771-003 151 vicToa kuHecea t e«.. 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 —'•'Inspecrtor Pl».. Card — ’ Owner Owner Permit No.,LEGAL Date DESCRIPTION AND LOCATION Lake No.Lake Name Lake Classif.Sec.TWP TWP NameRange IDENTIFICATION: Please Print All Information. Mailling Address —No. Street, City and State Zip No.Last Name First Initial Tel. 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.Distance from bottom to Water Table Ft.Ft. AH distances are shortest distance between nearest points RECORD OF TESTS: Inspection was made on 19,, Time ,JVI By PERCOLATION TEST DATA:Date of First Test , 19 I Rate Date of Second Test . 19 , Rate 1st Test Taken By First Test ■f 2nd Test 2 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 Individi^ Sewage Disposal Code Minimum Standards set forth by Minn esota Department of Health. Applicant agrees that plot plan, sketches and specifications submittgel 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 yiSlI be covered until it has been inspected and accepted responsibility of the applicant for the permit to notify the County Shoreland Management'fh^the job is ready for inspection. (Call or use attached mailer notice.). It shall be the r.\ Dated N.Signaturer Permit: Permission is hereby granted to the above named applicart^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, emflfo^es 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 M“f^«rdinance. NOTE: Permit void if work is not commenced within six (^■<1%nths. Issued Date: Shoreland Management Office Fee $Surcharge $ Comments:. Form No. MKL-0771-003 vierst LuaaccH • c«.. PCMvt fall*. 158906 INSPECTION RESULTS *«Inspector must make all measurements 1. . SEWAGE DISPOSAL SYSTEM STATISTICS i SEEPAGE PITSEPTIC TANK DRAIN FIELDCATEGORY Actual Should be Actual Should be Actual Should be SFCapacityGIs.GIs.S F S F S F r&o roDistance from Nearest Well F 75FF 50F F F ?-57f FDistance from Lake or Stream F F F F F FDistance from Occupied Building 10 2020FFFF F F/ otDistance from Property Line 10 10 10FFFF F FDistance from Bottom to Water Table 4 4FFFF F Inspector's Comments:I i', /M.nDate of Inspection /• Time of Inspection,.M -*■ feature of InspectorINTERPRETATION OF ABBREVIATIONS GIs = Gallons SF “ Square Feet F ■ Linear Feet /iz Job Title AgencyMKL-0771-003-Backer ■ L. r- . . S'• 7 1 PERCOLATION TEST DATA Price $1.00 per pad. SHORELAND MANAGEMENT OTTER TAIL COUNTY Fergus Falls, Minnesota 56537 Ph. No.Owner:Mailing Address:^%)0(^ y (~T (r C A G , Last Name First Middle St. & No.City.State Cj. f > /i/.O Zip No.Legal Description:59\r\ouaAJ / ^ -rLAKE OR RIVER NO.NAME SEC.TWP.RANGE TWP NAME TEST HOLE NO. 2TEST HOLE NO. 1 , ///>\Depth To Bottom of Hole,Depth to Bottom of Holeinches; Diameter of Hole inches; Diameter of Hole inchesinches ’yiJ/9 „.S' /)9 1 ’3 igj/v5^Depth, Inches Soil Texture Depth. Inches Soil Texture^ ^^Date_________--- . r./CJJ k . >"DateO-C>"0-6, "r'O' ^tyLX-/^ 'J yV,/ Percolation / Test By ^ n<.X-PercolationG>'/S \ ^ Test By. VXtO V-. y' f I Q1 - • --3 / '^.y/2/aOi_y O 9--3 LU I '>■tr Firm Name y-''- •'3 ■i// /oLUCC 5Address _0 • f -■/ ;■LUi- --- /Address QC <3d5 )a.r.CO 'j 'SOtter Tail County License No..Otter Tail County License No..COUJMeasurement, Inches Depth in Water Level, Inches K Measurement, Inches Depth in Water Level, Inches Time Remarks Time Remarks o 93 bg.h-70s/// ^'9it/f yf. y ^7€-7^’5(l7 •V: Lf.■A L/ 3 Zy'u\ :yy ■ - 3Rl7:5:5 n i5^79; s V - Y/ / - -T 7 59 5 A3■/: 5.5 L 9; ^5 9 5? 7?(^ I'\7^?<s }/<?%/;/5 c././;/r --5. (yc=»V ■k±93.//79 /r- • 55 ■■ /y.' g-5■H'yy',/7:.^-y MKL-0871-028 See Booklet, "How to Run a Percolation Test" by Agriculture Ext. Service, Un. of Minn. ^ .7/>