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Home My WebLink AboutSouth Turtle Lake Resort_57000360226003_Septic System Permits_-vc\Issued Permit7/28/2020 DEPARTMENT OF LAND & RESOURCE MANAGEMENT 540 West Fir Avenue Fergus Falls, MN 56537 Office; 218-998-8095 Fax: 218-998-8112OTTCR Tflillaokattaixiiaii UNDERWOODCommunity 26663Permit Number HERTEL & STAVAAS TSTOwner 33531 RESORT TRL .Owner Address Scott EliingsonApplicant PERMISSION IS HEREBY GRANTED To execute the work specified in this permit on the following identified property upon express condition that said persons and their agents, and employees shall conform in all respects to the provisions of Otter Tail County Sanitation Code. This permit may be revoked at any time upon violation of any of the provisions of said ordinance. Project Address 33531 RESORT TRL 57000360226003Parcel Number Scott's Septic Services LLCDesigner Type of System: Repiacement System Mound Mound SizingDesign Criteria Pressure Distriibution Number of Laterais: 3Rock Bed Width: 10.00 Feet Depth to Restriction: 16 inches Rock bed Length; 52.00 Feet Perforation Spacing: 3.0 Feet Land Siope 6.00%Absorption Width: 26.00 Feet Perforation Diameter: 7/32 inch Fiow Rate: 600.00 GPD Depth of Ciean Sand: 2.00 Feet Laterai Diameter: 1-1/2 inches Downsiope Dike Width: 26.60 Feet Totai Dynamic Head: 15.6000000000 Upsiope Dike: 14.70 Feet Pump 1; 29 GPM Tank Sizes Length of Dike: 92.40 Feet Totai Pump Tank Capacity: 500 Gallons Pump Tank 1: 500 Gallons Authorized Work/Special Conditions The granting of this permit does not alleviate the applicant from obtaining any other Federal, State, or local permits required by law for this project. https://onegov.oo.ottertail.mn.us/admst/viewcard.php?card=9&app=12437 k. Department of LAND AND RESOURCE MANAGEMENT OTTER TAIL COUNTY GOVERNMENT SERVICES CENTER 540 WEST Fir Avenue - Fergus Falls MN 56537 Phone; 218 - 998 ■ 8095 otter Tail County Website: www.ottertailcountvmn.us OTTER TfllloouriTT'ininniiOTn AS-BUILT REPORT SUBSURFACE SEWAGE TREATMENT SYSTEM SITE/OWNER INFORMATION [<le^or4 4fl-Property ID# 7 CsQO Co6 3Site Address Property Owner r r4r. L Mailing Address Mail City c, joJ Mail State/Zip SSTS CONTRACTOR INFORMATION MPCA License# 01'] "3Installation Business Date of Installation 7'"^' 3-^ ^Certified Individual on Job SYSTEM INFORMATION TANK I □ Registered Tank□ Registered Tank ManufacturerManufacturer S4i r\a-f>r£SSgg«iT».sM?i Model Number Model Number Liquid Capacity gallons Liquid Capacity gallons Date of Manufacture Date of Manufacture Maximum Depth Allowed ftftMaximum Depth Allowed ftActual Depth Buried ft Actual Depth Buried TANKS PUMP TANK □ Registered Tank□ Registered Tank I 0 A IManufacturer Manufacturer Model Number Model Number Liquid Capacity gallons Sho gallonsLiquid Capacity - ip TPDate of Manufacture Date of Manufacture Maximum Depth Allowed ft Maximum Depth Allowed ft Actual Depth Buried ft Actual Depth Buried ft DRAINFIELD SPECS PRESSURE DISTRIBUTION SPECS Number of Laterals□ Drop Box □ Distribution Box □ Pressurized Trenches Number of Trenches Perforation Diameter in Total Lineal Feet of Trenches ft Perforation Spacing ft Depth of Trenches from Grade in Lateral Spacing ft Total Area Installed sq ft Clean-Outs Installed at End Laterals PRESSURE BED SPECS PUMP INFORMATION Bed Length & Width ManufacturerX Depth of Bed from Grade;in Model Number MOUND/AT-GRADE SPECS TREATMENT MEDIA Bed Length & Width X □ Drainfield Rock □ Registered Treatment Media inSand Below Bed (Upslope Side)Treatment Media Downslope Berm Width ft CERTIFICATION I hereby certify that the system at the above referenced address was installed according to the Otter Tail County Sanitation Code and Minnesota Rules, Chapter 7080-7083. ;?i73 Installer MPCA Lie#Installer Signature Date Address of Installation Scale 1: tNorth .V. {'h Aid 5x> joy^oZ 1355 ' U-^t c5 ' 5vopp(sj li'AiL i'/^,'' LaWo^lS 3' ^oles^pcvc^ Wes fir / i>weii 44pt. / saa f Q ) VO y f t ??!!iI! o!'? /5"(p -ff^A S .1!■ i Iitp.5^r.c'^'es pe^'CloSi // ^6^.5 oa/pjC/i/'-^p fciA'? / 0■pu^p i, \\ \ \ V •V, u. otter Tail County Land & Resource Management Subsurface Sewage Treatment System Inspection FormOTTER TAILCOUNTY-MINNESOTA 9^0AddressProperty ID No.Permit No.□ Non-Shoreland & -City/Twp.V Installer/MPCA #MPCAType III IV □ New □ Repak,)^^l A'Replacement □ Other Type of System □ Trench □ Pressure Bed Mound □ At-Grade Soil Treatment Area Inspection Other Inspection:Final InspectionTank Inspection InspectorDateInspectorInspectorDateInspector Date ICorrections Y N Corrections Y N Corrections Y N Corrections Y N TREATMENT MEDIA MOUNDS/AT.GRADE / TREATMENT MEDiA Drainfieid Rock □ Registered Treatment Media Percent SlopeMound□ At-Grade Sand Below Bed on Upslope Side(in):Bed Width(ft):|^ Bed Length(ft)^^Registered Treatment Media: SEWAGE/HOLDING TANKS Downslope(ft):Upslope(ft): Sideslope(ft): Capacity (Gallons) Manufactuer Model No.Rock Below Pipe(in): PRESSURE DISTRIBUTION1st Tank:□ New □ Existing □ Combo/V 3 ^ Lateral Dia(in)^^^^0^New □ Existing □ Combo2nd Tank:Number of Laterals:Lateral Spacing(ft) Perforation Dia(in)^^Q Perforation Spacing(ft)6”3□ New □ Existing □ ComboPump Tank Cleanouts: PUMPINFOTRENCHES/PRESSURE BEDS\/ \y^cnKir□ Gravity/^ y T rench _ Pressure ^ Bed□ Drop Box End Fed □ DisTBox Pump Manufacturer/Model No: Rock Below Pipe('in)□ Drop Box Center Fed □ 6 0 12 0 18' □ 24 Flow Measurement Reading:n Event Counter □ Run-Time Clock\/\ V SETBACKSTrench Depth (in)V Tj T3 T4 Ts\ \Dwelling Non-Dwelling Dwelling Non-DweliingLj I Building(s)toSTA(ft) ^Trench Length (ft)T,T2 Ta T4 Ts Building(s) to tanks(ft) t/ Trench Depth (in)Te Tr T,o Surface water(ft)Well(s)Sensitive Well// /\\ Property lines(fl)2^^ Road R.O.W.^^ ^Trench Length (ft)Te T7 Te T9 T10 Bluff// //Vertical Separation-^ A Provided(in): y ^Depth of Restriction(in):Depth of System(in):Bed Width(ft):Bed Length(ft):Pressure Bed Dimensions Comments: Final Inspector SignatureSSTS Inspection Form 04-26-2020 . SEWAGE TREATWlEfrffr SYSTEM PERHWT INSPECTION RESULTS TRENCH REDUCTIONDm)HOLDINQ SEPTIC TANK 1 UFTTANK OUTHOUSEUEGOHY MnsRock trenches \irilhFT®ipacity GLS.QLS. _ %PyI ofsktewallter_____ Pj. I reducBon/equivalent to FTibaek from Nearest Well FT tPtba^ Iront Burled aer SucMott Pine FTFT STA CALCULATIONtbadc from Burled Pipe ailbutInB Water Under Pressure FTFTFT Am)(Sen Ft XFT .Ft.FTFTitba^ from OHWL (lake &/or river) FTFT Ft*itbaOk from Bluff FT MOUND/AT*QRAOEFTFTaback from Dwelling FT ROCK BEDaback from Non-Dwelling FTFTFT itback from Nearest Property Line FTFT FT Ft X .PL abad( from Right-of-Way FT FT FT FI* svatlon above Restrictive Layer FT FT FT SAND IN MOUND Ft8TALLERS TOMMENTS SEPTIC TANK(s)•Iding Tank"/ Lift Alarm □ YES □ NO eibnke Installed□ NO Weep Holes fj System Pumped & Destroyed GYES Marail.irttber of Laterals #Lateral Pipe Size IN Model#rforation Spacing Ft.Perforation Diameter Size IN Gallons Per Minute [Feet of Total Head [IRLTERS OYES ONOIMPS actor's Comments; A J ¥3 4- o As Of. ^ above tiescribod sewage system InstallaHonws found to be compliant with the provisions of ttte SaniMon Code of Otter Tbll County. Data Time mnratrLSflOfflfew land A nesMim MsiMpemanl No. BK — 04-2014-0B ^ofr.// I cmAvaL ✓' \J/■"SS^- /'T/fR TWO Z-/W£V.. 'TcLiri^^ LdJ^POLE BARN »i ■d Z' ^ w-N»*1 \A ^1 \\N.\\\y \V \\\ 1 «l'»l IP -^esc tP5)4^»/L-& - BtN 3 rxJO’I <u rr?r70ST H'LT CORNER OF ICl C3 nEN'i BA iHRoan . :■ 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 ;• April 26, 2005 Roger & Harriet Hertel 33531 Resort TrI. Underwood, MN 56586 RE:Sewage Treatment System Servicing Tax Parcel Number 57000360226003 Described as Pt GL 4... (8.44 Acres), Section 36 of Sverdrup Township, South Turtle Lake (56-377) ; As of April 22, 2005, the sewage treatment system (Sewage Treatment Installation Permit #14450 & #17381) servicing your property was determined to be in compliance with the provisions of the Sanitation Code of Otter Tail County for a 6 Bedroom Duplex. Please note that Permit Number #17381 also includes a new 1000 gallon septic tank for the owners dwelling and a new 1000 gallon holding tank for an RV site. If you have any questions regarding this matter, please contact our office. Sincerely, . Mark Ronning Inspector , ■ y I I 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) APPLICATION MUST BE COMPLETE IN ORDER TO BE PROCESSED Permit No. SECTION TWP NO. 135’rs/ LAKE NUMBER LAKE/RIVER NAME LAKE/RIVER CLASS RANGE TWP NAME m \A/Rn>SvER.I>1ZWf’ E-911 ADDRESS OR DIRECTIONS FROM NEAREST PUBLIC ROADPARCEL NUMBER (S) OF PROPERTY BEING SERVICED S7-cao~3C> - LEGAL DESCRIPTION Pt~ ¥■ . ' Last Name First Initial Mailing Address Daytime Phone NdT /4efLT^yh fUiA^ier^Property Owner S36Si ggSgjgT- 'TrUL. DA4DEguJQg>^ Mrl 2MUj~7 ^lo'^ Ai/B4esg UxcAvl^i tJ6r-ZJ^Contractor Lie.#. Ma/7SI 47/7 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 L&R OfficiaiTime Received ..i SEWAGE TREATMENT SYSTEM DESIGN DATA - AS SHOWN ON DRAWINGDRAINFIELD ^TYPE OF INSTALLATION (CIRCLE ONE) TANK Size Gis./O^OAdd-On/New System (20) Trench, Rock (21) Trench, Graveiiess (22) Trench, Chamber (23) Bed (24) Mound (25) At Grade Replacement (32) Tank, Septic (33) Tank, Lift r^j‘4Bff'rench. Rock (3^ Trench, Graveiiess (36) Trench, Chamber (37) Bed (38) Mound (39) At Grade (40) Combination HoSetback to nearest weil Ft. Setback to OHWL (iake &/or river)Ft.Ft.2^C> Setback to wetland ^ 7-Ft. Ft.5^7- Setback to dwelling Bo Ft. Ft.Collector System (26) Trench, Rock (27) Trench, Graveiiess (28) Trench, Chamber (29) Bed (30) Mound (31) At Grade Setback to non-dwelling Ft./O +- Ft. 175" Ft.Setback to nearest property line Ft./525Other Tank, Holding (42) Outhouse (43) Sewer Line (44) Performance _ Miscellaneous Setback to road right-of-way J0 +Ft. Ft. 3i~ Ft.2^-Elevation above restrictive layer Ft. ALL DISTANCES ARE SHORTEST DISTANCE BETWEEN NEAREST POINTS. DEPTH OF WATER WELL #BEDROOMS GARBAGE DISP. Y ABATEMENT Y (^' ABSORPTION AREA FOR MOUNDS'fUl&CO L/iP Ft^EFFLUENT DISTRIBUTION {* ) Gravity (t^T^ssure HOLDING TANK MONITOR/ DISPOSAL CONTRACT (.^-TYes ( ) No-L&R Can Not Process Designer Designer Lie. # 2.7£,. _______ Highest Rate PERCOLATION TEST DATA S. !Date 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 vaiid for a period of six (6) months. /a£>.a£>z.Date:Permit Fee $ Signature of Property Ojfner/Agent for Owner / 177.Z9Date:Rec. No. Land & Resource Management Office Also /NSPect Afej Z>es'/<9*/yf- Cat/e/Z. aj/ T/h^^.Comments: PEA Ujf^Cr A-TTArCfL BnTANK'hbP Arts sePAKArB ^//o/p//g AoptJ TO sec^e^T/tY^/zoForm No. BK -'0203-003 ^ ^315,609 • Victor Lundeen Co., Printers • Fergus Falls. Minnesota r 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)-r APPLICATION MUST BE COMPLETE IN ORDER TO BE PROCESSED Permit No. LAKE NUMBER LAKE/RIVER NAME LAKE/RIVER CLASS SECTION TWPNO.RANGE TWP NAME Li\ W, TURTtr 4^'.“A - >;'-7r PARCEL NUMBER (S) OF PROPERTY BEING SERVICED E-911 ADDRESS OR DIRECTIONS FROM NEAREST PUBLIC ROAD 57- cao-SL ' 0^2-6.- LEGAL DESCRIPTION S’ > ^ V Last Name First Initial Mailing Address Daytime Phone No. Property Owner 33C3< ^EOYiR-r TgL LjfJbEPMJC02>, UeS-g ZPU-P/ AueContractor Lie.#21 e U-Mbef?ioc2)i'^ ^i/v ~73! ^7 / 7 THIS SPACE FOR OFFICE USE ONLY 3' 00 ^>■ This System will be ready for inspection on^the year of jjpS- Date Received ~M-Time Received L & R Official .•a'SEWAGE TREATMENT SYSTEM DESIGN DATA - AS SHOWN ON DRAWINGTYPE OF INSTALLATION (CIRCLE ONE) DRAINFIELDTANK Size GIs.5"7loopAdd-On/ Replacement (32) Tank, Septic (33) Tank, Lift TjsjLTrench, Rock (§5) 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 iS?Setback to nearest well Uq ^Ft. Setback to OHWL (lake &/or river)Ft.Ft.3£0 too Setback to wetland Ft.Ft.-h 50-h Bp Ft.Setback to dwelling Ft.SoCollector System (26) Trench, Rock (27) Trench, Gravelless (28) Trench, Chamber (29) Bed (30) Mound (31) At Grade Setback to non-dwelling Ft.Ft.lo -F Setback to nearest property line Ft./15- Ft./5z0Other Tank, Holding Outhouse (43) Sewer Line (44) Performance 05J) Miscellaneous Setback to road right-of-way Idf ■AFt. Ft.10 i Elevation above restrictive layer Ft.Ft. ALL DISTANCES ARE SHORTEST DISTANCE BETWEEN NEAREST POINTS.DEPTH OF WATER WELL iBEDROOMS GARBAGE DISP. Y TTIT’ ABATEMENT Y / ABSORPTION AREA FOR MOUNDS Ft^EFFLUENTDISTRIBUTION (. ) Gravity (Pressure HOLDING TANK MONITOR/ DISPOSAL CONTRACT (^es ( ) No-L&R Can Not Process Designer Designer Lie. # 1 "yC, s ______ Highest Rate PERCOLATION TEST DATA / - ^57 ~371Date 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. 4'13-02-/E)£> . ^Date:Permit Fee $ Signature of ProperlytpeffyOmter/Agent for Oemer / T 77.^ 9Date: 0/O r Rec. No.,7—---- Land & Resource Management Office A LEO jN5Perrr ,hJoL6/h/3- SS^-TAAJk' Z>FS^/d=-A/ h/2iJ a// TAaJ*^ .Comments: St: Oi3Auyi/^6- AurtCHtn4 OP Hior Form No. BK — 0203-003 315,609 • Victor Lundeen Co.. Printers • Fergus Falls, Minnesota SEWAGE TREATMENT SYSTEM PERMIT INSPECTION RESULTS Inspector must make all measurements •ySTTANK DRAINFIELD OUTHOUSECATEGORYSEPTIC TANK /popCapacity/OOP GLS.FT2GLS. ^ O -h ^<-> -f' ft FTSetback from Nearest Well Setback from Buried Water Suction Pipe 5Ti -t- FT FT FT5-0 FT Setback from Buried Pipe Distributing Water Under Pressure ft / ot ft / U ft FT Setback from OHWL (lake &/or river)ft ■7^^ ft FTft Setback from Setback from Wetland FT FT FT FT /J?Setback from Dwelling iO-yL FTFT FT/Oi»- FT Setback from Non-Dwelling /o ft FTftft Setback from Nearest Property Line f ft FT FT Setback from Right-of-Way ft/o y- ft FTFT FTElevation above Restrictive Layer FT FT FT 'a-Holding Tank/Lift Alarm NO Old System Pumped & Destroyed NO SEPTIC TANKfSt # Tanks Installed 2- FILTER Sewer Line to Well Separation DRAINFIELD CALCULATION Actual Minimum FTX y/I FT□ YESManuf..79So-r- pT^NO .ft^20Model # MOUND CALCULATION MOUND /AT-GRADE ROCK REDUCTION Inspector’s Comments: Rock trenches withABSORBTION AREA inches Hoof rock under pipe for %Ft. X Ft drreduction / equivalent to,Ft2 SKETCH: I ! IZ2 0 0 a-c? Q 0/ iRo B0000 D CA ^ Initial/L & FI Official s,, the above described sewage system installation was found to be compliant with the provisions of the Sanitation Code of Otter Tail County. Land iS Resource Management Qgj^ai 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. grid(s) equals lO feet, orScale:jnch(es) equals feet MPCA LICENSE #: DESIGNED BY:LICENSE CATEGORY:. DATE:FIRM NAME: ADDRESS:SIGNATURE:•4m. B\ ; t i ..L T L. Cx \. I ! £U«5«^ ■ \c/t>□ ^60fY J. TRi- i 1I ;t ■.... r I BK - 1003 - 029 31B.904 • Victor Lundeen Co.. Printeri • Fergus Falls, MN • 1-800-346-4870 1SITE 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 # / f OWMER: ^06G/Z ^f^rGATBL 7~ TELEPHONE NUMBERLAST NAME FIRST MIDDLE ADDRESS: DhJDBAJ*iaO£>53S'3) TtiL AJa/ CITY ZIP CODESTR./RT.STATE 3ip l33A aJ-1 jv'77iA:r/^Sl-377 LAKE NAME SEC.RANGE TWP NAMELAKE/RIVER NO.TWP. LEGAL DESCRIPTIOIM:SOIL BORING LOG &L COLOR & MUNSELL NO. DEPTH (INCHES)STRUCTURE <6L0CI^ PLATY PRISMATIC NONE TEXTURE^ /C 5^7- - B&> - 02.^ - CCS ^1Tdficti0'12-parcel NUMBER PLATY PRISMATIC NONE 3353J TflL PY-E-911 Address or Directions From Nearest Public Road SAa/o NUMBER OF BEDROOMS__Z,^ci^ GARBAGE DISPOSAL: YES WELL: CASING DEPTH SEWER LINE SEPARATION: tCD ft. FLOODPLAIN: YES VEGETATION: AQUATIC (^ERRESTRIA^ SLOPE AT INSTALLATION SITE: PRISMATIC NONE (|LOCj^ PLATY(0^ YESBLUFF: PRISMATIC NONEVi BLOCKY PLATY PRISMATIC NONE I % TYPE OF OBSERVATION: Probe CJh) Boring PARENT MATERIAL: ORIGINAL SOIL: COMPACTED SOIL: Yes DEPTH OF BORING (To 7' or restrictive layer):. Outwash Loess Bedrock Alluvium No Date of Soil Boring. ft.Date of Perc Test PERC TEST #1 PERC TEST #2- TWO TESTS ARE REQUIRED - INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATE TIMETIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATE START START TIME DROP PERC DROPTIME PERC WATER DEPTH WATER DROP PERC RATETIMEINTERVAL (MINUTES)TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATE REFILL REFILL TIME DROP PERC TIME DROP PERC WATER DEPTH WATER DROP PERC RATETIMEINTERVAL (MINUTES)TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATEREFILLREFILL TIME DROP PERC DROP PERCTIME TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATE TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATEREFILLREFILL PERCTIMEDROP TIME DROP PERC TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATE TIME WATER DEPTHINTERVAL (MINUTES)WATER DROP PERC RATEREFILLREFILL DROP ___ =PERC TIME DROP PERCWAJefTPEPTH'PBKi^RATETIMEINTERVAL (MINUTES)WATER DROP TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATEREFILLREFILL TIME DROP PERC TIME DROP PERC INTERVAL/dVfINUTES) WATER DROPTIME TIME INTERVAL [MINUTES)WATER DEPTH WATER DROP PERC RATEIREFILLREFILL2:TIME DROP PERC TIME DROP PERC TIME INTERVADUMINUTES) WATER DEPTH WATES DROP PERC RATE TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATEREFllREFILL TIME DROP PERC TIME DROP PERC PROPOSED DESIGN: TRENCH.BED.ATGRADE.MOUND.HOLDING TANK.GRAVITY DIST._i.PRESSURE DIST.. SEWER LINE.OUTHOUSE.OTHER.SPECIFY:. — SYSTEM DESIGN ON BACK — 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 October 11, 2004 Roger & Harriet Hertel 33533 Resort Trail Underwood, MN 56586 RE; Sewage Treatment System Servicing Tax Parcel Number 57000360226003 Described as Pt GL 4..., Section 36 of Sverdrup Township, South Turtle Lake (56-377) As of September 27, 2004, the sewage treatment system (Sewage Treatment Installation Permit #17132) 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 r-a Mark Ronning Inspector 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 - Office YELLOW- L&R Inspector PINK - Owner / Contractor (alter issue) APPLICATION MUST BE COMPLETE IN ORDER TO BE PROCESSED Permit No.9 LAKE NUMBER LAKE/RIVER NAME LAKE/RIVER CLASS SECTION TWP NO.RANGE TWP NAME 7/ y<7/ f-/33 7./77 - 7 -7 y PARCEL NUMBER (S) OF PROPERTY BEING SERVICED E-911 ADDRESS OR DIRECTIONS FROM NEAREST PUBLIC ROAD S3S33 ryVyy LEGAL DESCRIPTION I 1 Last Name First Initial Mailing Address Daytime Phone No. 33S35 T/^^tLProperty Owner ple^7r^Y Y /4vaVa-7- Ko^t>jr Ha rn / /-kr ^ ! I4ess ■________________^-7 (37 7 3t o AueContractor Lie.#Umoe fi-ix)<ar^o, Al 7 '9s!:^7^cr 7 -] I "7 THIS SPACE FOR OFFICE USE ONLY 7/-.QO A.M. >• This System will be ready tor inspection on_the year of .P.M.ai DateT«ceived^ 'Time Received :m. R Official SEWAGE TREATMENT SYSTEM DESIGN DATA - AS ^HOWN ON DRAWING TYPE OF INSTALLATION (CIRCLE ONE) TANK DRAINFIELD Ft"SizeAdd-On/New System (20) Trench, Rock (21) Trench, Gravelless (22) Trench, Chamber (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.^8 Setback to OHWL (lake &/or river)Ft./ba-ff Ft-fOC) Setback to wetland Ft.Ft.$2»f~h Setback to dwelling Ft..2^Ft.loCollector System (26) Trench, Rock (27) Trench, Gravelless (28) Trench, Chamber (29) Bed (30) Mound (31) At Grade Setback to non-dwelling Ft.Ft.IZ- Setback to nearest property line Ft. Ft.lo-hOther (41) Tank, Holding (42) Outhouse (43) Sewer Line (44) Performance (45) Miscellaneous lO lo-h lo-hSetback to road right-of-way Ft.Ft. '7 I 0 +-/Elevation above restrictive layer Ft.Ft.23J ALL DISTANCES ARE SHORTEST DISTANCE BETWEEN NEAREST POINTS.#BEDROOMS '/DEPTH OF WATER WELL ABSORPTION AREA FOR MOUNDS GARBAGE DISP. Y /' N. ABATEMENT Y /(FD Ft^EFFLUENT DISTRIBUTION (‘^) Gravity ( ) Pressure HOLDING TANK MONITOR/ DISPOSAL CONTRACT (*' ) Yes ( ) No-L&R Can Not Process ...yDesigner___ Designer Lie. # PERCOLATION TEST DATA ' rZ77 7- 2’3-b'yDate 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 vaiid for a period of six (6) months. Date:Permit Fee $ Signature^ Prb^rfyOimer/A^nt ktr Qwn^r„.^^°i • iS -OH 13753)Date:Rec. No. Larvf&fi&ource Management (^Ijpe Comments: Form No. BK — 0203-003 315,609 • Victor Lundeen Co.. Printers ■ Fergus Falls, Minnesota SEWAGE TREATMENT SYSTEM PERMIT INSPECTION RESULTS Inspector must make all measurements «0tDINGi SEPTIC TANK OUTHOUSEDRAINFIELDLIFT TANKCATEGORY /Ocio 600Capacity ^0/ ft^FT2GLS.GLS. Setback from Nearest Well cpD FT _ro>- ^ FT FT Setback from Buried Water Suction Pipe FT FT FT-1- Setback from Buried Pipe Distributing Water Under Pressure FT /Of- ^FT FT/O ^£>0 f~ ftSetback from OHWL (lake &/or river)/ao /- ft } gx2i4~ ft FT Setback from Setback from Wetland FT FT FT FT ILSetback from Dwelling /I±-FT FT FT FT20 Setback from Non-Dwelling FT /of ^ ft FT FT\± Setback from Nearest Property Line / G ^ ft FT FT/o Setback from Right-of-Way FT FT^0 FTrc>i~ 3-^;Elevation above Restrictive Layer FT FT FT FT Holding Tank/Lift Alarm NO Old System Pumped & Destroyed NO SEPTIC TANKfSt FILTER Sewer Line to Well Separation DRAINFIELD CALCULATION Actual Minimum# Tanks Installed_____ Manuf. Model # /g? FTX□ YES S-O^-ft^4 yr FT FT20 MOUND CALCULATION MOUND /AT-GRADE ROCK REDUCTION Inspector’s Comments:, ABSORBTION AREA Rock trenches with inches of rock under pipe for .%Ft.rX ,ft2 DRreduction / equivalent toFt2 SKETCH: " S-if^<9 5-0/ I A c I \ I I \y I /oO r Initial/L & R OfficialTime e compliant with the provisions of the Sanitation, the above described sewAs of Code of Otter Tail County. Land & Resource ManagemenJ,Pm:ial ■4 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) 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 545^-37-7 I 'Ti^fvrLe,ISS m S)/&/z^ieM.P PARCEL NUMBER (S) OF PROPERTY BEING SERVICED E-911 ADDRESS OR DIRECTIONS FROM NEAREST PUBLIC ROAD LEGAL DESCRIPTION Pr &L ^ Last Name First Initial Mailing Address Daytime Phone No. Property Owner -33533S. TircATtE tPMG ilBsaA.r V //A^GT’UfJOB/juiaetO. /»a/ f4e:ss .3to'^ Aus-Contractor Lie.#2.1^ UtJoeHjA^coOi 'f3(2-7^S- ^1\1 TH/S 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 SEWAGE TREATMENT SYSTEM DESIGN DATA - AS SHOWN ON DRAWINGTYPE OF INSTALLATION (CIRCLE ONE) DRAI N FI ELDTANK ■) Ft" ' : ■SizeAdd-On/New System (20) Trench, Rock (21) Trench, Gravelless f22) Trench, Chamber Q23],Be3> T3Replacement (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.^8 Setback to OHWL (lake &/or river)iCd-h Ft.Ft.loo (24) Mound (25) At Grade Setback to wetland Ft.Ft.^■h3-0-h Setback to dwelling Ft. Ft.loCollector System (26) Trench, Rock (27) Trerich, Gravelless (28) Trench, Chamber (29) Bed (30) Mound (31) At Grade Setback to non-dwelling Ft.ic-t/2- Setback to nearest property line Ft. Ft.10+other ID (41) Tank, Holding (42) Outhouse (43) Sewer Line (44) Performance (45) Miscellaneous Id+~lc+-Setback to road right-of-way Ft.Ft. S+- Ft.tg /Elevation above restrictive layer Ft. ALL DISTANCES ARE SHORTEST DISTANCE BETWEEN NEAREST POINTS.#. BEDROOMS H GARBAGE DISP. Y <3) ABATEMENT Y /(g) > DEPTH OF WATER WELL ABSORPTION AREA FOR MOUNDS Ft^HOLDING TANK MONITOR/ DISPO^ CONTRACT ( ) No-L&R Can Not Process EFFLUENT DISTRIBUTION (*-T^avity (■ ) Pressure Designer___ Designer Lie. # PERCOLATION TEST DATA Highest Rate ^Date 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 submitteid herevyith 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 tor 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: Thjs permit is valid for a period of six (6) months. Date:Permit Fee $Signataf^W^ent for rr • zDate;Rec. No.Land^^t^f^ource Management ^ Comments: Form No. BK — 0203-003 315,609 • Victor Lundeen 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. .grid(s) equals feet, orLScale:.inch(es) equals feet MPCA LICENSE #:DESIGNED BY: 'TUu^ flsss FIRM NAME: LICENSE CATEGORY: g" DATE:7 3/^ 4t/gADDRESS: Ma/ SkSVl SIGNATURE: ; 1 . _ L/i/Zs: \ 1 t ("fuP!fLS TfiL. I i 1 § ki t (V. : oi I I ■; f I i 1 f i.{ 1t I !!IIji 1!I i If! !I I IBK - 1003 — 029 315.904 • Victor Lundeen Co.. Printers • Fergus'Falls. MN • 1 •BOO-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 #QMtNfiB; S, Tkfirte L/y>ce LAST NAME FIRST TELEPHONE NUMBERMIDDLE ADDRESS: STR./RT.CITY ZIP CODESTATE 30 1333. ~rUK7iceS‘L-317 LAKE/RIVER NO.LAKE NAME SEC.TWP.RANGE TWP. NAME LEGAL DESCRIPTION:SOIL BORING LOG COLOR & MUNSELL NO.Pr (?c ^DEPTH (INCHES)STRUCTURETEXTURE <C^L0CI^ PLATY PRISMATIC NONE -30- 02JZ0 - 0^3 V/PARCEL NUMBER J3S‘yS /2esaKT nZA/c.BLOCKY PLATY PRISMATIC NONE it.1^ E-911 Address or Directions From Nearest Public Road NUMBER OF BEDROOMS ________ GARBAGE DISPOSAL: YES WELL: CASING DEPTh3><^ ft. SEWER LINE SEPARATION: BLUFF: YES (1^ VEGETATION: AQUATIC ClER^STRIAL^ BLOCKY PLATY PRISMATIC NONE It .ft.BLOCKY PLATY PRISMATIC NONE(3>FLOODPLAIN: YES BLOCKY PLATY PRISMATIC NONE SLOPE AT INSTALLATION SITE:% BoringTYPE OF OBSERVATION:Probe PARENT MATERIAL:Outwash Loess Bedrock Alluvium ORIGINAL SOIL:No Date of Soil Boring.re: COMPACTED SOIL: Yes ±3ZDEPTH OF BORING (To T or restrictive layer):.ft.Date of Perc Test 5^ PERC TEST #1 5^ PERC TEST #2- TWO TESTS ARE REQUIRED - INTERVAL (MINUTES)ATER QEP..jegr 3,W WATER TH WATER DROPTIME PERC RATE TIME INTERVAL (MINUTES)WATER PypH water depth ziW WATER DROP PERC RATESTARTSTART TIME DROP TCRC 3.id.TIME DROP PERC TIME INTERVAL (MINUTES)WATER WATER DROP PERC RATE TIME INTERVAL (MINUTES!WATER DROP PERC RATEf.v/ TIME DROP PffiC REFILL REFILL Ji>-u TIME DROP PERC TIME INTERVAL (MINUTES) WATER D^TH WATER DROP PERC RATE TIME INTERVAL (MINUTES) WATER DEPTH WATER DROP PERC RATE ^TTZ.MREFILLREFILL4^ TIME DROP PERC $-3.% TIME ' DROP PERC JA TIME INTERVAL (MINUTES) WATER DfiBW 3^3 WATER DROP PERC RATE TIME INTERVAL (MINUTES)If WATER DROP PERC RATEREFILLREFILL TIME ' DROP PEITC Id 3...itk TIME PERCDROP TIME INTERVAL (MINUTES)WATFROEPTH.PERC RATE TIME INTERVAL (MINUTES!WATER DROPREFILLREFILL TIME DROP PERC TIME DROP >ERC MlflqiTES)prINTBRVAL (TIME . -INTERVAL (MINUTETIMEtrWATER DROP :rc rate DEPTH WATER DROP PERC RATEIREFIREFILL TIMI DROP PERC TIME DROP PERC WATER DEPiK7TIMEINTERVAL (MINUTES)DEPTH WATER DROP PERC RATE TIME INTERVAL (MINUTES!WATER DROP PERC R>REFILL REFILL TIME DROP PERC TIMI DROP PERC>iME WATER DEPTil^=^^ATER DROPINTERVAL (MINUTES!PERC RATE TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATElEFILLREFILL TIME DROP PERC DROP PERCTIME PROPOSED DESIGN: BED 7<PRESSURE DIST. XTRENCH.ATGRADE.MOUND.HOLDING TANK.GRAVITY DIST. SEWER LINE.OUTHOUSE.OTHER. SPECIFY:. — SYSTEM DESIGIM OR! BACK — 1 LAND & RESOURCE MANAGEMENTOTTER TAIL COUNTY COURT HOUSE 121 W. JUNIUS AVE. • SUITE 130 Phone:(218)739-2271 • FERGUS FALLS, MN 56537 APPLICATION FOR PERMIT TO INSTALL SEWAGE TREATMENT SYSTEM WHITE - Office YELLOW -L&R Inspector PINK - Owner / Contractor APPLICATION MUST BE COMPLETE IN ORDER TO BE PROCESSED Permit No. SECTION TWP NO.RANGE TWP rWiMEJ^KBPIVER NAME LAKE/RIVER Td 3C V/ E-911 ADDRESS ] \ -f— /) I3 3 S 3 / x-laJl LAKE NUMBER £Q3V PARCEL NUMBER (S) OF PROPERTY BEING SERVICED f\5laeo 36o 3^ &0c3 LEGAL DESCRIPTION fh GL.^ Daytime Phone No.Initial Mailing Address ^ ^Last Name . .. „ .....First Property Owner Contractor Lie.# A.M. the year of P.M.> This System will be ready for inspection on.at. This space for office use only A.M. P.M. L&R OfficialDate Received Time Received SEWAGE TREATMENT SYSTEM DESIGN DATATYPE OF INSTALLATION (CIRCLE ONE) DRAINFIELDTANK /Sc3d10 00% &00Size GIs.Add-On/New System (20) Trench, Rock (21) Trench, Gravelless (22) Trench, Chamber (23) Bed (24) Mound (25) At Grade Replacement (32) Tank, Septic Tank, Lift Trench, Rock (35) Trench, Gravelless (36) Trench, Chamber (37) Bed (38) Mound (39) At Grade (40) Combination 50 IMFt.• Ft.Setback to nearest well Ft.Setback to OHWL (lake &/or river)}no Ft. IQZ^-ISSetback to wetland Ft. -^Ft.Setback to dwelling Ft.Collector System (26) Trench, Rock (27) Trench, Gravelless (28) Trench, Chamber (29) Bed (30) Mound (30) At Grade /■ ^ 10 MIZlSetback to non-dwelling Ft. ^ lo Ft.Setback to nearest property lineOther (41) Tank, Holding (42) Outhouse (43) Sewer Line (44) Performance (45) Warrantied (46) Miscellaneous lo Ft.Ft.Setback to road right-of-way Ln.A Ft.Ft.Elevation above restrictive layer ALL DISTANCES ARE SHORTEST DIS^NCE BETWEEN NEAREST POINTS. ABSORPTION AREA FOR MOUNDSDEPTH OF WATER WELL #BEDROOMS GARBAGE DISP. Y /' ABATEMENT Y / ^Ft^HOLDING TANK MONITOR/ DISPOSAL CONTRACT ( )Yes No-L&R Can Not Process EFFLUENT DISTRIBUTION ( ) Gravity Pressure DesignerPERCOLATION TEST DATA Date of Test ~ (0 ^ C ( •t Designer Lie. #i3^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. A copy of the final Inspection Report will serve as the Certificate of Compliance for approved installations. - n /^_ftrty^Owner/Agentmr Owner ti Permit Fee $Date: Signature of Prope fr-i-g I /130-roRec. No.Date: Land & Resource Management Office Comments: Form No. BK — 0201-003 305,392 • Victor Lundeon Co.. Printers • Fergus Falls. Minnesota LAND & RESOURCE MANAGEMENTOTTER TAIL COUNTY COURT HOUSE 121 W. JUNIUS AVE. • SUITE 130 Phone:(218)739-2271 • FERGUS FALLS, MN 56537 APPLICATION FOR PERMIT TO INSTALL SEWAGE TREATMENT SYSTEM WHITE - Office ^ YELLOW-L & R Inspector PINK - Owner / Contractor ''j ■i’i APPLICATION MUST BE COMPLETE IN ORDER TO BE PROCESSED Permit No. lAke/river CLASS - LAKE NUMBER f\SECTION TWP NO.RANGE TWP NAMELAKE/RIVER NAME 00 3C '331 V/ S3./ st J7? PARCEL NUMBER (S) OF PROPERTY BEING SERVICED E-911 ADDRESS 3^R 51 poo iC>0 2^ LEGAL DESCRIPTION i ; Daytime Phone No.Last Name ......First Initiai Maiiing Address Property Owner V iContractor Lie.#o Ji /Ma> :6^G 7 - (>-o /'V A.M.P.M.the year of► r/i/s System will be ready for inspection on..at. This space for office use only. _ /^^lyo f IJate Received Time Received A.M. P.M. L & R Official ' SEWAGE TREATMENT SYSTEM DESIGN DATATYPE OF INSTALLATION (CIRCLE ONE) DRAINFIELDTANK 10 00% IsOO /Sod GIs.SizeAdd-On/ 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 New System (20) Trench, Rock (21) Trench, Gravelless (22) Trench, Chamber (23) Bed (24) Mound (25) At Grade 4-;So IM Ft.Ft.Setback to nearest well A '-4-.7(3'loo Ft.Setback to OHWL (lake &/or river)Ft. S'4ISFt.Setback to wetland A ■^Ft.lA Ft.Setback to dwellingCollector System (26) Trench, Rock (27) Trench, Gravelless (28) Trench, Chamber (29) Bed (30) Mound (30) At Grade Setback to non-dwelling Ft.Lo ■hFt.ja Ft.Setback to nearest property lineOther -=F(41) Tank, Holding (42) Outhouse (43) Sewer Line (44) Performance (45) Warranted (46) Miscellaneous (o Ft. ■ /O Ft.Setback to road right-of-way Ft.Elevation above restrictive layer ALL DISTANCES ARE SHORTEST DISTANC# BEDROOMS S GARBAGE DISP. Y/(n) ABATEMENT Y / A EN NEAREST POINTS.m ABSORPTION AREA FOR MOUNDSDEPTH OF WATER WELL .Ft^LHOLDING TANK MONITOR/ DISPOSAL CONTRACT ( ^ )Yes No-L&R Can Not Process EFFLUENT DISTRIBUTION ( ) Gravity Pressure DesignerPERCOLATION TEST DATA Date of Tesf!*' ~7 ~ ' O ^ Designer Lie. #_ Highest Rate Agreement: The undersigned hereby makes application for permit to install, alter, repair or extend Sewage Treatment System herein specified, agreeing io do all such work in strict accordance with Sanitation (iode 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. Appiicant further agrees that no part of the system shall be covered until it has been inspected and approved for use. ready for inspection. It shall be the responsibility of the applicant for the permit to notify Land & Resource Management that the installation isw r 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 hts agent,, employees and workmen shall conform in all rgspec^s4|ytlg^9qflfl|8n'^«te'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 otsix (6) months. A copy of the final Inspection Report will serve as the Certificate of Compliance for approved installations. ropefl^Oivner/AQfithr Owner / f T A Land & Resource Management Office ^ yAcjoilyrnJ Xlj2AJMjcjuv y y h-.^^^rmitJ^ee^Date: : Signature ofP. /136/70Rec. No.Date: A Comments: i Form No. BK — 0201-003 305,392 • Victor Lundeen Co.. Printers • Fergus Falis, Minnesota SEWAGE TREATMENT SYSTEM PERMIT INSPECTION RESULTS Inspector must make all measurements HOLDING SEPTIC TANK OUTHOUSEDRAINFIELDLIFT TANKCATEGORY LP\o FT2 FT2CapacityGLS.GLS. 100'^FTFTFTFTSetback from Nearest Well Setback from Buried Water Suction Pipe FT FTFT FT Setback from Buried Pipe Distributing Water Under Pressure -f FTFTFTFT FTSetback from OHWL (lake &/or river)FT FT FTFTSetback from Setback from Wetland FT FT /QO 5o +FTFTFTSetback from Dwelling FT FT10 -f-Setback from Non-Dwelling FT FT lo ^FTFTSetback from Nearest Property Line FT FT lo +FTFTFTSetback from Right-of-Way FT d-FT FTElevation above Restrictive Layer FT FT Holding Tank/Lift Alarm YES NO A^/ AOld System Pumped & Destroyed YES NO FILTERSEPTIC TANK DRAINFIELD CALCULATIONSewer Line to Well Separation Actual Minimum 3FTX□ YES ”^NO Manuf., 5o'V/yModel #FT 20 MOUND CALCULATION MOUND /AT-GRADE ROCK REDUCTION Inspector’s Comments: 3 L| ^_'ABSORBTION AREA/ »inchesRock trenches with of rock under pipe for reduction / equivalent to ft^ DF. %Ft. X Ft2 SKETCH: a IXjplfA L ReicT-'^ >• ^ ^■ ‘r'y H o!the Sewage Treatment SystemAs of serving the previi^ly desci^ed ^opeil^ is approved for use. ■y ■4^‘j. Land & Resou nt OfficialTimeDateInitial Copy of Inspection Report Mailed to Applican L & R Official / D&te /CO/ a/Jnch(es) equals feet.grid(s) equals feet, orScale: Please use this sheet for the required scale drawing of your proposal. Be sure to include lot dimension, water frontage, and setbacks from RW, lake, lot lines, sewage system, top of bluff, existing structures and all imper vious surface. Required impervious surface coverage calcuiation (See definition in Shoreland Management Ordinance) X 100 =%4- Total Lot Area (FT2) Total Impervious Surface Onsite (FT2) m. @ W BC i ht\ - r i 4 4 / \ I 0\< , 4 / r—% ^ y'N (X X ' X - ' VN V \r\ n 1 H To rhvvt/) /IC'. W>4tu The Dated 304,678 • Victor Lundeen Co.. Printer* • Fergus Fan*. MN • 1*800-346-4870BK — 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 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 PARCEL NUMBER (S) OF PROPERTY BEING SERVICED E-911 ADDRESS f '70003G0 7.7iG OOj -oHf rr&L v 30 s /o7c?^ / ^ Nc<y coF. VeG- O ^ LEGAL DESCRIPTION Last Name First Initial Mailing Address Daytime Phone No. Property Owner Ccyic/€$ri^<£>a^' MN G-j'Contractor Lie.#9^e/V/- A.M. >• This System will be ready for inspection on the year of P.M..at. This space for office use only A.M. P.M. Date Received Time Received L & R Official SEWAGE TREATMENT SYSTEM DESIGNTYPE OF INSTALLATION (CIRCLE ONE) (2) TANK DRAINFIELD Ft"SizeAdd-On/ 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 New System (20) Trench, Rock (21) Trench, Gravelless (22) Trench, Chamber (23) Bed (24) Mound ' (25) At Grade fHf' Setback to nearest well Ft. Ft. Setback to OFIWL (lake &/or river)'V- /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 JO-t- /9"?^ 175' / ax' ■^y-/-£9a' Setback to non-dwelling Ft.Ft. Setback to nearest property line Ft.Ft.Other Tank, Holding (42) Outhouse (43) Sewer Line (44) Performance (45) Warrantied (46) Misceilaneous Setback to road right-of-way Ft.Ft. Elevation above restrictive layer Ft.Ft. ALL DISTANCES ARE SHORTEST DISTANCE BETWEEN NEAREST POINTS. DEPTH OF WATER WELL # BEDROOMS_____ GARBAGE DI^Y /<S> ABATEMENTO//.N ABSORPTION AREA FOR MOUNDS [09 ,Ft^HOLDINGJANK MONITOR/ DISPO^ CONTRACT (U%s EFFLUENT DISTRIBUTION ( ) Gravity ( ) Pressure y&2AVt /3 _Designer_____ Designer Lie. #, PERCOLATION TEST DATA( ) No-L&R Can Not Process 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 vaiid for a period of six (6) months. A copy of the final Inspection Report will seme as the Certificate of Compliance for approved installations.■s>\ 13 $'-3-0/Date:Permit Fee $ -^ignaty^f Props fer/Agent for Owner Date:Rec. No. Land & Resource Maftagement Office r- /E-3 v-.P-V f-Comments: 0[c\ | /iy<£~ S' ^ G 0 W M Form No. BK — 0201-003 304,485 • Victor Lundeen Co., Printers • Fergus Falls, Minnesota APPLICATION FOR PERMIT TO INSTALL SEWAGE TREATMENT LAND & RESOURCE MANAGEMENT OTTER TAIL COUNTY COURT HOUSE 121 W. JUNIUS AVE. • SUITE 130 Phone:(218)739-2271 • FERGUS FALLS, MN 56537 APPLICATION MUST BE COMPLETE IN ORDER TO BE PROCESSED WHITE - Office * YELLOW -L&R Inspector PINK - Owner / Contractor Permit No. i LAKE NUMBER LAKE/RIVER NAME LAKE/RIVER CLASS SECTION TWP NO.RANGE TWP NAME ■ ■;*R C? PARCEL NUMBER (S) OF PROPERTY BEING SERVICED E-911 ADDRESS 5"70003COTiT- GOOj . O'.% ■tr'u^?- tjy 'OHf rr^LH S(^S /orip.t' Nt<y coF. VE(Sr fF7,CPT/N e LEGAL DESCRIPTION 'i I Last Name First Initial Mailing Address Daytime Phone No. Tf^Le Property Owner 7^y Contractor Lie.#rrf-K t ^6>t> ^ ^ m A.M. >■ This System will be ready for inspection on_., the year of This space for office use only Date Received P.M. Time Received & » Official SEWAGE TREATMENT SYSTEM DESIGNTYPE OF INSTALLATION (CIRCLE ONE) (V TANK DRAINFIELD /5^ /(^oOg\^.Ft"SizeAdd-On/ 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 New System (20) Trench, Rock (21) Trench, Gravelless (22) Trench, Chamber (23) Bed (24) Mound (25) At Grade 7Y' / Ho'^Setback to nearest well Ft.Ft.V U1 70' / 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 /o-P /5-3Setback to non-dwelling Ft.Ft. //?yy //;^'Ft.Setback to nearest property line Ft.Other (411) Tank, Holding (42) Outhouse (43) Sewer Line (44) Performance (45) Warrantied (46) Miscellaneous Setback to road right-of-way| y -/)Ft.\1 :/■ Elevation above restrictive layer Ft.Ft.j 5ALL DISTANCES ARE SHORTEST DISTANCE BETWEEN NEAREST POINTS.DEPTH OF WATER WELL #BEDROOMS____GARBAGE DI^Y /<S? ABATEMENT/S^/^N ABSORPTION AREA FOR MOUNDS EFFLUENT DISTRIBUTION ( ) Gravity ( ) Pressure ‘ HOLDING TANK MONITOR/ DISPOSAL CONTRACT ( )Yey)(^L&R Can Not Process .Ft^ •j ^3 !Designer____^ Designer Lie. # PERCOLATION TEST DATA( 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. A copy of the final Inspection Report will serve as the Certificate of Compliance for approved Installations. T[)3L- ijf-- y/1Date:Permit Fee $.1Signature of Property Owner/Agent for (Mner :■] IDate:aRec. No. Resource Management OfficeLands I I.L tc. U M, Koq K- l7 ^ 1 h) I , P-? ^ P-HComments: ,.x-1f Mil ^ Ly'\ Q{('^ r 7^H " ) v 1 -f 0 H V ) M IForm No. BK — 0201-003 304,485 • Victor Lundean Co., Printers • Fergus Fails, Minnesota SEWAGE TREATMENT SYSTEM PERMIT INSPECTION RESULTS Inspector must make all measurements HOLDING SEPTIC TANK DRAINFIELD OUTHOUSELIFT TANKCATEGORY /sooCapacity FT2 FTZGLS.GLS. “?/Setback from Nearest Well FT FT FT FT Setback from Buried Water Suction Pipe FT FT FT FT Setback from Buried Pipe Distributing Water Under Pressure FT FT FT FT /crO^ FTSetback from OHWL (lake &/or river)FT FT FT % FTSetback from Setback from Wetland FT FT FT Setback from Dwelling FT FT FT /6lSetback from Non-Dwelling FT FT FT FT ^6^Setback from Nearest Property Line FT FT FT FT /(0 '-hSetback from Right-of-Way FT FT FT Elevation above Restrictive Layer FT FT FT FT Holding Tank/Lift Alarm NO Old System Pumped & Destroyed YES NO SEPTIC TANK FILTER Sewer Line to Well Separation DRAINFIELD CALCULATION [Yr&o rSitjO Actual Minimum Manuf..□ YES FTX FT &0 h ^Model #.ft^□ NO 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 toFt2 SKETCH: ■' I I PP 1 otl- i i 5-?-ol the Sewage Treatment System serving the previously described property is approved for use. As of ✓y Y-D/jO30 hr-'ywL b-rs:sr~w Initial 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 \^^ater wells within 150' of the sewage system. /inch(es) equals IO O feetfeet, orgrid(s) equalsScale: /SlStA/SIGNATURE:SUBMITTED BY: DATE:FIRM NAME: C\Q.iLliMPCA LICENSE #:ADDRESS: LICENSE CATEGORY: A 9 - ' i 300,817 • Victor Lundean Co.. Printers • Fergus Falls. MN • t-800-346-4870BK - 0699 - 029 SITE DATA WORKSHEET LAND AND RESOURCE MANAGEMENT Otter Tail County 121 W. Junius Ave., Suite 130 Fergus Falls, MN 56537 OWNER: FmST TELEPHONE NUMBERMIDDLELAST NAME ADDRESS: 7^/-' ZIP CODE RANGE STATESTR./RT.CITY F& -37/ ^(pccF^ /ccy-t3^133 ^ TWP. NAMESEC.TWP.LAKE/RIVER NO.LAKE NAME LEGAL DESCRIPTION:SOIL BORING LOG - Date COLOR & MUNSELL NO.DEPTH(INCHES)STRUCTURETEXTURE BLOCKY PLATY PRISMATIC NONE J^5'70C?£^^60 3 PARCEL NUMBER 33^3/BLOCKY PLATY PRISMATIC NONE FIRE NUMBER T-7.-r-/ NUMBER OF BEDROOMS BLOCKY PLATY PRISMATIC NONE GARBAGE DISPOSAL: YES NO WELL CASING DEPTH: /05~ ft. BLOCKY PLATY PRISMATIC NONE FLOODPLAIN: YES NO VEGETATION: AQUATIC TERRESTRIAL BLOCKY PLATY PRISMATIC NONE %SLOPE AT INSTALLATION SITE: TYPE OF OBSERVATION: Probe Pit Boring PARENT MATERIAL: Till Outwash Loess Bedrock Alluvium COMMENTS: ORIGINAL SOIL:Yes No COMPACTED SOIL: Yes No DEPTH OF BORING:ft.} (• PERC TEST #2PERC TEST #1 'O TESTS ARE REQUIRED -X ~7 PERC RATEWATER DROPX PERC BATE TIME INTERVAL (MINUTES)WATER DEPTHWATER DROPTIMEINTERVAL (MINUTESI WATER DEPTH /STARTSTART DROP PERCTIME WATER DROP*PERC RATEWATER DR0£_INTERVAL (MINUTES)WATER DEPTHPERC RATE TIMEINTERVjH. (MINUTES)WATER DEPTHTIME lEFILLREFll DROP PERCTIMEDROPPERCTIME ^ WATER DROP PERC RATEWtfTER DROP INTERVAL (MlMlTES)WATER DEPTHINTERVAL IMINUTE^ >. WATER DEPTH PERC RATE TIMETIME REFILLREFILL 2:PERCTIME DROPPERCTIMEDROP S/VATBR DEPTH PERC RATEWATER DROPWATERINTERVAL (MINUTESIWATER DROP PERC RATE TIMEINTERVAL (MINUTESITIME REFILLREFILL V V DROP PERCTIMEDROPPERCTIME WATER DEfrfH PERC RATEINTERVAL (MINUIK)'WATER DROPWAT^R DEPThT W^ER DR'OP PERC RATE TIMEINTERVAL (MINUTES)TIME REFILL,REFILL DROP PERCTIMEDROPPERCTIME PERC RATEINTER^L (MINUTES)'tATER DROPWATER DEPTHWATER DROP >PERC RATE TIMEINTERVAL (MINUTESy WATER DEPTHTIME REFILLREFILL DROP PERCTIMEDROPPERC WATER OHOF PERC RATEPEKC RATE TIME /INTERVAL (MINUTES)WATER DEPTHINTERVAL (MINUTES)"WATER DROPTIMEWATER DEPTH /REFILLRrflLL / /DROP PERCV TIMEDROP;rcTIME V/ TIME PERC RATEPERC RATE X WATER DROPINTERVAL (MINUTES)WATER DEPTHINTERVAL (MINUTES)WATER DEPTH WATER DROPTIME 7 REFILLREFILL TIME DROP PERCDROPPERCTIME PROPOSED DESIGN: PRESSURE DIST.GRAVITY DIST.HOLDING TANKMOUNDATGRADETRENCHBED SPECIFY: — SYSTEM DESIGN ON BACK — OUTHOUSE OTHERSEWER LINE SITE DATA WORKSHEET LAND AND RESOURCE MANAGEMENT - ' Otter Tail County s'/ _ / I V21 W. Junius Ave., Suite 130 ^ Fergus Falls, MN 56537 OWNER: lASTNAn^TELEPHONE NUMBERFIRSMIDDLE ADDRESS; i/P \ A ^AVv> STR./RT. \ ^ C/ry ^ .A STATE 'I —^ 3 0 lAkE/WvER NO. LAKE NAME SEC. Z/P CODE 133TWP. SOIL BORING LOG - Date PA/V( d /LEGAL DESCRIPTION: COLOR & MUNSELL NO. DEPTH (INCHES!STRUCTURETEXTURE to P ■3ai L~> BLOCKY PLATY0-^r.PRISMAIICQ^ONE]PARCEL NUMBER BLOCRY PLATY PRISMA^C(NON^Y'V.1FIRE NUMBER 75“WKNUMBER OF BEDROOMS BLOCKY PLATY PRISMATIC NONE^-<?YGARBAGE DISPOSAL: YES WELL CASING DEPTH:ft.BLOCKY PLATY PRISMATIC NONE FLOODPLAIN: YES ;VEGETATION: AQUATIC ■ERRESTRIAL BLOCKY PLATY PRISMATIC NONE %SLOPE AT INSTALLATION SITE: TYPE OF OBSERVATION: Probe GPARENT MATERIAL:Outwash Loess Bedrock Alluvium COMMENTS: ORIGINAL SOIL: COMPACTED SOIL: DEPTH OF BORING:ft. 3 P PERC TEST #2O PERC TEST #1 - TWO TESTS ARE REQUIRED - ~ER DEPThiJa Q ^:k PERC RATEWATER DROPPERC RATE INTERVAL (MINUTES)WATTIMEINTERVAL (MINUTES)WATER DEPTH WATER DROP TIME .IS5 TIME DROP PERC PERC RATE LWATER IhOP ________TIME INTERVAL (MINUTES)PERC RATEWATER DROPINTERVAL (MINUTES)WATER DpTyTIMEWATER DEPTHmSJL(f TIME DROP PERC3lo.REFILL PERCTIME DROP PERC RATEWATER DEPjTH WATER DROPPERC RATE TIME INTERVAL (MINUTES)INTERVAL (MINUTES)WATER PEP'WATER DROPTIME ...lU.2TT i.REFILLREFILL La.La a-3r TIME DROP PERC WATER DROP PERC RATEINTERVAL (MINUTES)WATER DEPTHTIMEINTERVAL (MINUTES)WATER pep'WATER DROP PERC RATETIME REFILLREFILL DROP PERCTIMEROP PERCFWAlfc»-PC^T -RATF"^El INTERVAL (MINUTES)WATER DEPTHlATETIMEINTERVAL iMINUTES)WATER DROPTIME REFILLREFILL ? SI PERCTIMEDROPDROPPERCTIME INTERVAL Jj<llNUTESl/PERC RATEPERC RATE TIMETIMEINTERV/^ (MIN :filllEFILL 3 TIME DROP PERCTIME DROP p ;rc PERC^fffkTE' INTEF4/AL (MINUTES)WATER DEPTHPERC RATE TIMETIMEINTERVAL (MINI T [S],WATER DEPTH TER DROP .REFILL•FILL lE^'^^ERC PERCTIMEDROPORQTIME^aewuRATT INTERVAL (MliJHgESl WATEiKffrOP PERC RATEWATER DEPTHINTERVAL (MHIUTESI WATER DEPTH WATER DROP TIMETIME REFILLREFILL PERCTIMEDROPTIME DROP PERC PROPOSED DESIGN: PRESSURE DIST.GRAVITY DIST.HOLDING TANKMOUNDATGRADETRENCHBED SPECIFY: — SYSTEM DESIGN ON BACK — OTHEROUTHOUSESEWER LINE Department of LAND & RESOURCE MANAGEMENT COUNTY OF OTTER TAIL Phone; (2J8J 739-227 J Court House FERGUS FALLS, MINNESOTA 56537 ■: •VApril 27, 2001 Roger 86 Harriett Hertel 33531 Resort Trail Underwood MN 56586-9567 RE: Septic Systems, South Turtle Lake Resort, South Turtle Lake (56-377) Dear Mr. 86 Ms. Hertel, Just a note to review our discussions of yesterday (April 26, 2001) and today regarding the failed septic systems. The holding tanks that were installed in 1993 and are currently inundated with lake water obviously cannot be used until the water drops to a level that allows for use. The tanks must also be resealed to insure that they are watertight. The septic system installed in 1985 that is servicing the duplex and mobile home adjacent to it must have the drainfield abandoned and the septic tank converted to a holding tank. If you wish to install a new drainfield, the existing tank can be used.; This conversion to a holding tank must be done upon receipt of this letter. Please contact me if you have any questions. I Sincerely, Kyle Westergara Inspector KWW/jlt ;• • k.' ■;*- r :. Print Key Output Page 1 04/25/01 12:30:335769SS1 V4R5M0 000526 OTTER Display Device User ....QPADEV0035JTHOMPSO Inquiry Parcel ValuesTC906B 10 T56 ACS Tax System Bill No.Parcel No.NameROGER F & HARRIETT HERTELMvR EdR*-Tax/Credits/SpAsmts-* R R 57000360226003 MP# R 57000360226003 S 00/00/0000 R 00/00/0000 EdA H----Values/Acres-------* * NET Tax Capacities-* EMV Land 88800 TOT TMV 145600EMV Bldg 56800Total EMV 145600Acres 7.00SWF Units 9.00 02002RateStNInsS+ — Classification 221 Homestea Shaice & MA & PA RESORTS PRF 1 FULL HOMESTEAD001■ Rectf 2 of Mod? Action?♦PROPOSED PROPERTY TAX* --------A=CSM B=ASM C=DQ D=NAL E=TR F=SP P=PA S=GS U=CAMA 4 'Of Lij If: T/G/er e Qf’ "3 S. JC-z/f* //- lie -<7/ 3 s. 7iv<A ll.r; CERTIFICATE OF APPROVAL SEWAGE SYSTEM 21st FebruaryThis certificate has been issued this 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. The premises covered by this certificate are legally described as: SVERDRUP36133Range ^ ^56-377Lake No.Sec.Twp.Twp. Namemmi36 133 41 S. 44 PT GL 4 BG S 1070. 1 ' FR NWiCOR N 64 DEG E 197.07'N 25 DEG E 351. 1 S 69 DEG E S 21 DEG W 396. 15'514. 94',• HAUGSE, ROGER GLORIAs:Owner: Namemmi SOUTH TURTLE LAKE RESORT, UNDERWOOD, MNAddress mmj 56586Zip No. 10835Permit No. SP y>02.Signed by: Land & Resource Management OfficialkyOtter Tail County. MinnesotaMKL-098700I '/ a..\Vi JT 279005 Victor Londen Co.. Printera. Fergus Falls. Minnesoca PERCOLATION TEST DATA%LAND AND RESOURCE MANAGEMENT Otter Tail County Fergus Falls, MN 56537 OWNER: LAST NAME FIR^ °TELEPHONE NUMBERMIDDLE ADDRESS: mu ZIP CODESTATECITYSTR./RT. TWP. NAMERANGETWP.SEC.LAKE NAMELAKE/RIVER NO. LEGAL DESCRIPTION: PARCEL NUMBER NUMBER/BEDROOMSFIRE NUMBER — TWO TESTS ARE REQUIRED — TEST HOLE NO. 2TEST HOLE NO. I X r inchesDiameter of Holeinches: Depth To Bottom of Holeinches; Diameter of Hole.inches Depth To Bottom of Hole Soil TextureDepth, Inches Depth, Inches Soil Texture So / ^—^Percolation Test By____ Firm Name ___ p P Percolation Test By _ Firm . Name __lL I;w Address Address ~)GL(76 yOtter Tail County License No. Otter Tail County License No. PERCTEST#2PERC TEST # 1 PgRCRATB INTERVAL <M1N1JTBS> -36^- WATER DROPWATER DROP PERC RATEINTERVAL fVqNUTRaIMB 7 J..• TART‘jr /o PERC RATETIME wPERC RATE INTERVAL fMINUTR«)WATER DEPTH WATER DROPWATER DROPINTERVAL (VnNUTBSl W>H 'ITMH ^Id':.3. PERC RATE INTERVAL IMINinESI WATER DEPTHWATER DROP TIME WATER PROP PERC RATEINTERVAL iMINUTEm ________DEPmWATERTIME ^7 -V-i7^3^ 33 TMB 5kOP PERC lyop PHRC.3 RBF,ILLREFILLh.m... PERC RATE TIME INTERVAL <MDftfTB«>WATER DEPTH WATER DROPWATER DROP PERC RATEINTERVAL (MlNUTEft WATER DEPTHTIME REFILLREFILL TIMU DROP PERC 'IIMU DROP MrCTIMEINTERVAL IMlNUTEft WATER DEPTHPERC RATE WiOERDROP WATER DEPTH WATER DROP PERC RATEINTERVAL fMPnnESITIME REFILLREFILL •f •P 'HMU DROP PERt *HKE“ DftOP PERC RATE TIME INTERVAL IMPItnEEl WATER DEPTH W/qERPROP PERC RATEINTERVAL (MINUTBSl WATER DEPTH WATER DROPTIME REFILLREFILL 'lIMk DROP PERC TTOE” DROP PERC PERC RATE TIKffi INTERVAL IMINUTEE^WATER DEPTH WATER DROPINTBRVALtMINUTBEIWATER DROP PERC RATEWATER DEPTH REFILLREFILL 'lIKUi DROP PERC 'HMB DROP PERCTIMEINTERVAL fMINUTBftreRCRATE WATER DEPTHWATER DROP WATER DROP PERC RATEINTERVAL IMINirrESI WATER DEPTHTlfcig REFILLREFILL TIME DROP PERC TIME DROP PERC NCOMMENTS/CALCULA TIONS: 3 250,615 — Victor Lundeen Co., Printers, Fergus Falls. MinnesotaMKL — 0390 - 005 GRID PLOT PLAN SKETCHING FORM — (Must Be To Scale) ^ inches Scale: Each grid equals '/ 9-4 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.^ ^V ; 4 » 6^ ' -T O' r-f I ry. 7T 7ija ( V K. 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 Permit No.LEGAL ^uTH 'turtle lAkLCDESCRIPTION )Yes (KTnoAbatement: (AND LOCATION LAKE/RIVER CLASS SECTION RANGELAKE NUMBER LAKE/RIVER NAME TWP NAMETWP. NO. :^-377 5^5. TknTLE ^731133 FIRE OR LAKE ASSOCIATION NUMBERPARCEL NUMBER(S) f\)as\/E IDENTIFICATION: Please Print All Information Initial Mailing Address — No. Street, City and Slate Zip Code Telephone No.Last Name First flfl i iSj1^0 £.M- €)LProperty - Owner - Sewage System Installer Name A.M. ► This System will be ready for inspection on P.M.. 19.at This space for office use oniy ■±.NUMBER OF BEDROOMS: A.M. ( i^NOP.M19 GARBAGE DISPOSAL: ( ) YESPhone Call Rec'd ByDate Rec'd Time Rec’d SEWAGE TREATMENT SYSTEM DATA: MINIMUM REQUIREMENTSTYPE OF SEWAGE SYSTEM ( ) Holding tank (Alarm Required) (J'-'^eptic tank ( ) Lift station (Alarm required) (i'^Drain field ( i-'^renches ( ) Bed ( ) Mound ( ) Outhouse ( ) Sewer line DRAINTANK Capacity GIs. Distance from nearest well Ft.Ft. 1^Distance from lake or stream Ft.Ft. IDDistance from building Ft. Ft. ioDistance from property line LQ_Ft. Ft. 3Distance from bottom to Water Table Ft. Ft. EFFLUENT DISTRIBUTION (i^^Gravity ( ) Pressure All distances are shortest distance between nearest points PERCOLATION TEST DATA: WATER WELL DEPTH 10^' fVPerc Tester.Date of Perc Test io fiRate 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 inspectijp^ IP )LDATE:&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 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. IDjjJrllEIssued Date: Land & Resource Management OfficelAI a 3^35. ooFee $.Rec # ^ 3 /^6hrmL ^ <,iLv£tZc:/^(T^T ^ ___________ 5')U/£pc^^sr fj- — ld>00 GTfL. ^ FT^ P^OriWffTLO Comments: Z ,SJ2 •factor Lt/ndeen Co., PrimarsX. Fergus/falls. Minnoosia/t>r'^.f^J (Sr''E277. BK 0795-003 f APPLICATION FOR PERMIT TO INSTALL SEWAGE TREATMENT SYSTEM>■0> ^ . WHITER— Office Yellow — Inspector Pink — Owner LAND & RESOURCE MANAGEMENT OTTER TAIL COUNTY COURT HOUSE Phone:(218)739-2271 - FERGUS FALLS. MN 56537 /^g^35'iLEGALPermit No. Abatement: ( ) Yes DESCRIPTION AND lOCATION LAKE NUMBER LAKE/RIVER NAME SECTIONLAKE/RIVER CLASS TWP. NO.RANGE TWP NAME 377 Si>31 /33 PARCEL NUMBER{S)FIRE OR LAKE ASSOCIATION NUMBER IDENTIFICATION: Please Print All Information Last Name First Initial Mailing Address — No. Street, City and State Zip Code Telephone No, I l^l m- SXProperty Owner - Sewage System Installer Name at /30 <^P M ')5-Z► This System will be ready for inspection on , 19, This space for office use only NUMBER OF BEDROOMS:3-50 ^ Time Rec’d ^ ^-7 19 GARBAGE DISPOSAL: ( ) YESPhone Call Rac'd ByDate Rec’d SEWAGE TREATMENT SYSTEM DATA: MINIMUM REQUIREMENTSTYPE OF SEWAGE SYSTEM ( ) Holding tank (Alarm Required) ( P-iTSeptic tank ( ) Lift station (Alarm required) ( v-^Drain field ( i-'tTrenches ( ) Bed ( ) Mound ( ) Outhouse ( ) Sewer line TANK DRAIN FIELD Capacity GIs.Sq Ft. Distance from nearest well Ft.Ft. 1^Distance from lake or stream Ft.Ft. :koDistance from building 10 Ft.Ft. Distance from property line \0JAFt.Ft. 3Distance from bottom to Water Table Ft.Ft. EFFLUENT DISTRIBUTION (Gravity ( ) Pressure All distances are shortest distance between nearest points PERCOLATION TEST DATA: WATER WELL DEPTH 10$' GH£g tif^oA'iPerc Tester.Date of Perc Test, lo nRate of 1 st 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 inspectiop.-^ IP J/i /i£t -'1.DATE;XU2.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 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. ID //Lji^ Rec it ^ 3 ^ ^lLviTtZC/^<$T ^ OfcH- SiLW<ic^€<>T ^ 7^^ FT^ pefiit/FiFW Issued Date: Land & Resource Management Office3 S'.Fee $. Comments: 277.212 • Victor Lundeon Co.. Printers • Fergus Falls. MinneostaBK 0795-003 /i'3 ■3i 5 INSPECTION RESULTS Inspector must make all measurements SEWAGE DISPOSAL SYSTEM STATISTICS DRAIN FIELDHOLDING SEPTIC TANK LIFT TANKCATEGORY Actual Minimum looo 7SOS'SFGLS.SFCapacity lOO'^ FT)OC>Distance from Nearest Well FT FT FT Distance from Buried Water Suction Pipe FTFTFT 50 FT Distance from Buried Pipe Distributing Water Under Pressure __n-^ FTFT 10 FT(O)0 1^0^ FTft ftDistance from Lake or River (OHWL)FT 3>0 ft 3^0"^ ft 10/20 FTDistance from Nearest Building FT 3^0"^ ftftFT FTDistance from Nearest Property Line 10 S,g 7-^%Distance from Bottom to Water Table FT FT O 3 FT U Fs'JYESHolding Tank/Lift Alarm YE NOOld System Pumped & Destroyed Sewer Line to Well Separation DRAINFIELD CALCULATIONINTERPRETATION OF ABBREVIATIONS GLS. = Gallons SF = Square Feet FT = Linear Feet Actual Minimum S^8o FTX .FT gVQlod^ ^20 FT SF io (^Av>e.lU>yInspector’s Comments: " c^u£R oM /GY/g U-b /(gy/^ 7/5 7SY)e- 7/^ SKETCH:Laks co V ?,(u»/6vryfLc^ii.o' T tJfV\ /IP 'C .■o ,6 n**' t ^ Vi« I*TO 7 T>u»r Tsh''fUMO'to 3(p^00V /rs^rs ro ^1.;+ I6’ <C1’cuf(fn’M , .1 >1ll>^i /<£•ri.f/.7 7o Inspector's Signature s-g-% Oafe of /nspecf/on#%' r/me of Inspection 1a'' ^\ C^^/inches- * Scale: Each grid equals GRID PLOT PLAN SKETCHING FORM 19 ■Dated:-TV O 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. 7 ' c?v" t f j 1tiuo ^ Cr^h’-ly > r*n V f • '3y/ py^/nuj.35'3/'ivL J. rr-> ;4 t vjx- i: /A)I ?s-II rI(I I r \y •-r: I ( :i: 1 i J-- 215987®MKL-0871-029 VICTOR LUNDCCN CO . PRINTERS. PEROUS FALLS. HINN. SEWAGE SYSTEM HOLDING TANK This certificate has been issued this day of 19-17-Pi OF CFMR.ER to certify that the sewage system installed as per sewage permit number indicated below has been approved for use m by Otter Tail County, Minnesota. The premises covered by this certificate are legally described as:m 4 Lake No.Sec.Twp. 1 73 Range jLJ.Twp. Name P P DP UP7-d 36 133 A1 3.44 FI GL 4 5G S 1070. 1 ' F R NW CCR N 6 4 DEG E 187.C7' r N 2 5 C EG E 3 51.1'/ S 69 DEG E w.514.94'/ S 21 DEG W 386.15' fri Owner: Name HAUGSE/ -SCGER S GLORIA/cniT'r) TIIRTIP 1 AlfP RPRORT n-j. Address __EJ3.X 4-51/—UNP = .3WaCD/-WN m Zip No. Permit No. SP ^44-^ Signed by:% Land & Resource Managemcnl OfTicialiiOucr Tail Counly, MinnesotaMKL-0987001 JT-263191 Vidor Lundeen Co.. Primers, 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 South YutzviE Of Cl Permit No.LEGAL DESCRIPTION AND LOCATION LAKE/RIVER CLASS SECTIONLAKE NUMBER LAKE/RIVER NAME TWP RANGE TWP NAME ch'3'^? So. TUi^iLC 3L m133 SveapjOif PARCEL NUMBER(S)FIRE OR LAKE ASSOCIATION NUMBER S 1 - ooo -SU IDENTIFICATION; Please Print All Information Last Name Mailing Address — No. Street, City and SlateFirst Zip Code Telephone No.Initial fi/9u<2s'£fZo RR. I f3oX / 3/_____ UhJ'oea vjooD S2kJ^l3Property Owner Sewage System Installer Name A.M. ► This System will be ready for inspection on.P.M., 19-at This space for office use oniy H C.r}mp£ie.SNUMBER OF BEDROOMS: A.M. P.M19 GARBAGE DISPOSAL: ( ) YES (Phone Call Rac’d ByDate Rac'd Time Rac'd SEWAGE DISPOSAL SYSTEM DATA: MINIMUM REQUIREMENTSTYPE OF SEWAGE SYSTEM (l^'CHo\6\r\q tank ( ) Septic tank ( ) Drain field ( ) Standard ( ) Bed ( ) Trench ( ) Modified ( ) Mound TANK DRAIN FIELD iiOo *Capacity GIs.r^q Ft. Distance from nearest well Ft.Ft. 2£Distance from lake or stream Ft. Ft. Distance from building Ft.Ft. iODistance from property line Ft.Ft. EFFLUENT DISTOBUTION ( ) Gravjjy^^Distance from bottom to Water Table Ft.Ft. All distances are shortest distance between nearest points{Tessure WATER WELL DEPTH: U.’£U - lid - lao i t IJoiyC A&- dunieo1 -t zPERCOLATIONyTEST DATA: Date irst Test Rate -Z, 19 te of Second Test , 19 R, Test Taken By First Test + 2nd Test 2nd Test Taken By late 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. DATE: Signore 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. A- m - 9^Issued Date: Land & Resource Management Office35". ^ lull SB 2 ~ S'SO CffL. T/Tn/kf Fee $.Rec #. C £j9f^ PEPs'Comments: Cuiiilphi tly Form No. BK — 0292-003 260,771 — Vidor Lundeen Co.. Primers. Fergus Falls, Minnesota . .i* ■ r^lp'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 South TuiiTLe Of Gi '^‘4 LEGAL Permit No. DESCRIPTION AND LOCATION LAKE NUMBER LAKE/RIVER NAME LAKE/RIVER CLASS SECTION TWP RANGE TWP NAME So. Timrce fiO 3L /i3 S\/Et2pJ^U/^ PARCEL NUMBER(S)FIRE OR LAKE ASSOCIATION NUMBER ^7- 'SL 'p;iaL ~ ^^5 IDENTIFICATION; Please Print All Information First Mailing Address — No. Street, City and SlateLast Name Initiai Zip Code Telephone No. ti/9u<^S£<o RR I _____ u £ vjdDp yyj/x.J Property Owner Sewage System Installer Name y- =^-6 9 3 O3«!This System will be ready for inspection on., 19.Iat This space for office use oniy H (S.r9PT££i2.S>NUMBER OF BEDROOMS:8'0 5 I fj ^aiscrj9319 GARBAGE DISPOSAL: ( ) YES {Date Rec’d Time Rec’d Phone Call Rac'd By SEWAGE DISPOSAL SYSTEM DATA: MINIMUM REOUIREMENTSTYPE OF SEWAGE SYSTEM ) Septic tank ( ) Drain field TANK DRAIN FIELDtankWOO ^Capacity ,'^q Ft.GIs.( Distance from nearest well Ft.Ft. 2^( ) standard ( ) Bed ( ( ) Modified ( ) Mound ) Trench Distance from lake or stream Ft. Ft. /C>Distance from building Ft.Ft. IDDistance from property line Ft.Ft. EFFLUENT DISTFtlBClTION ( ) Gravity-’''^Distance from bottom to Water Table Ft. Ft. \¥xessuxe All distances are shortest distance between nearest points( WATER WELL DEPTH; rVEiSHiion - t Xlio Son H.rI\Jph/E tie- puiiieo120' PERCOLATIONyT^ST DATA; Date of (Cst Test / pate of Second Test First Test_____2^ z Rate ^. 19 Ri, 19 Test Taken By + 2nd Test 2 "?late2nd 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 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. DATE; Slgnafure 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. Issued Date: Land & Resource Management Office3^. OD / <o 7 ■tf- j./UL /g6 J ~ GSO GnL. Tfihrlis: Fee $.Rec #. D i<ls <2rJComments: £)u^,h/G <ZY)L. C^ilfiftyrLY 1 us: A Form No. BK — 0292-003 260,771 — Victor Lundeen Co., Printers, Fergus Falls. Minnesota INSPECTION RESULTS Inspector must make all measurements SEWAGE DISPOSAL SYSTEM STATISTICS ______ ^ /____ SEPTIC TANK J±//o /eZ/t, TCq )C CATEGORY Actual Minimum Actual Minimum SSO GLS.55o SFCapacity SFGLS. /5o'^ ft/So'^ ftDistance from Nearest Well FT FT50 Distance from Buried Water Suction Pipe FT FT FT50FT50 Distance from Buried Pipe Distributing Water Under Pressure FT FT FT 10 FT10 ^ Distance from Lake or River (OHWL)SI FT loo ft FTFT )S>Distance from Nearest Building FT FT FT FT1020 75'"Distance from Nearest Property Line FT FT FT1010 FTDistance from Bottom to Water Table FT FT 3 FT Sewer Line to Well Separation DRAINFIELD CALCULATIONINTERPRETATION OF ABBREVIATIONS GLS. = Gallons SF = Square Feet FT = Linear Feet Actual Minimum FTX FT FT FT20 SF so-syInspector’s Comments: To 6(V-£' 7~o of^S> u/<Kr6H XaJ tfoC£ To ujTTfiCA) ^ AJo c*Jf\7b(i, //oc'/<, To Rco's fiT o/~ ^^3p6'C SKETCH: >. I Inspector's Signature Date of Inspection XooOf// Time of Inspection f^(X. r t /-Ps£>^ - c/w /^ ^ C «. /}^o ^P- aos- 3^‘OS(^S7~ooo.^^jo^^f.^e^ ^ P -0£,o-^^9 o^^f P^cp*-f/ /3:5-y/ 6^yy i> Sc*. y i3(^^ yoP^ I' p Jg9.o*? ‘ pr QrL VlV Cor // . ^7. r -5 ^-*5 ^ CLc.y^> \ >^*’5 ^ y y- _5VV 9V ' .5 <5/ z?. <i M/ <^/5^ \3 J-! //«I r/ksyVy(^ CL/r\p ^ ^ .5:/6' .K (/' ^ • Oyf> 1*^ i ) LiU I ^ .........^ 3B^Ji V ''^C > ^ h»nS - .^r5^A'i/' H.>;0S? V^ Co-/1^' l.pr*'^ ! ^ ^ rvi/s« A*S 1^1.^/: •fuf/ Cfq 15 Cc^h> ^Zff5E7[(TfP^^J>i«e k«p( > fT) 'To’^K k' //«'C«-»yf>rr COn^perC*- 'T' (?o-K C*- fiyp^ r IJ f A_5y^<& r ^ ! «PERCOLATION TEST DATA LAND AND RESOURCE MANAGEMENT Otter Tail County Fergus Falls, MN 56537 •;-•OWNER:'i<.I^ WJ5 TELE PHONE NUMBER £1MIDDLEFIRSTLAST NAME ADDRESS: STATE 3(e A3 Pc) I fvR /STRjRT.ZIP CODECITY! TWP. NAMETWP.RANGESEC.LAKE NAMELAKE/RIVER NO. LEGAL DESCRIPTION:t PARCEL NUMBER _____NUMBER/BEDROOMSFIRE NUMBER — TWO TESTS ARE REQl'IRED — TEST HOLE NO. 2TEST HOLE NO. I 4-22l inches; Diameter of Hole inchesDepth To Bottom of Holeinchesinches; Diameter of HoleDepth To Bottom of Hole. 0 I ^_19 9^______ Ut^ /f 7^ P Spa (AgAci J S S— 19DateDateSoil Texture Soil TextureDepth. Inches Depth, Inches !HZ5 0, 4-—Percolation —^—-— Test By _d-H H Firm Name;A' 5A EhiE \ A.vgt: P wr..^ nss- Address Address Otter Tail County License No. Otter Tail County License No. ;7 PERCTEST#2Xi PERC TEST # 1 pfmtVALrmmfrasiPBUCHATB TIME WAimDKOP reacitATBamBtvaa.<MPHfraft WAlTn»«■aij.START *ni5ur START .1.7-/a-/-a-TIME [KTERVACrMlNUTByiSBRCRATE SBRCRATHyrtTmntifirWATBRDI 3 Tlfc« /0,jf. /d rtMH bRbF Atec 1 ■/. 7t...y WATER E)BPTHPERORATEINTERVAL rMlNlTTB^WATER DROP PERCRATBWAIERPROP22HEINTERVAL ftmnngp WATER DEPTHTIME Ma .™L- riMB DEPP PBRC II 'HMU ^ 6rop PBRC REFILLREFILL .1...2 Id...-4-6- INTERVAL rMlNlfraft water WATER DROP PERCRATBPERCRATBWAIERDROPW^gERDEPTIMEprrBRVALrMDiuim .Jl}..*7 TIMB ^ PR6^ /'HMU ^ DR^P REFILL:7a..^—4^JUS.ua TIME INTERVAL IMPnjTBlI w W>OTRDROP PERCRATBPERCRATBWiCTERDROFtNTERVALOtCIWLrTBS^WATER DHyTHm i T^S~'*'racir~PEW^REFILLlA.m . !0*HMH DROP PBRC REFILLlo.I INTERVAL (MOOrTBPPERCRATBTIME WAIBR DEPTH WAIHRDROF PERCRATBWATER PROFINTERVALOflNUTER)WATER DEPTHTIME REFILLREFILL * *mtB~ DROP PBRC 'HMU DROP PERCTll>«IHlERWALfMlWTBr roc RATE WATER BEiy PERCRATBtopiMTBRwa.<»m*yiw]WitfBR DEPTH WATERTTMB REFILLREFILL i'HMfi” PROF" FEr CTlMfi DROP PBRC TIME INTERVAL fMimmam REFILL WATER DEPTH WATER PROP PERC RATEroc RATEWAIERDROP INTERVAL fMTWtfTRR^Water depthTIME REFILL ♦TImH” * DROP' PERC“DROP PBRC COMMENTS/CALCULA TIONS: -]C3i 250,815 — Victor Lundeen Co., Printers, Fergus Fails. MinnesotaMKL — 0390 - 005 a' tf. I 7H P X ■i '■'r * ~ »rv 7^''W'Z ■=i;a: Is^’^i-fl'o£s C'N saw'5^.yJ^ mm.» LS5y:: ll-^CERTIFICATE OF COMPLIANCE SEWAGE SYSTEM HOLVJNG TANK ^1 7 5th day nf JanuoAU 19 nThis certificate has been issued this Mn to certify compliance with regulations of Shoreland Management Ordinance, Otter Tail County. Minnesota. The premises covered by this certificate are legally described as: PmTwp. Name Sv&AyidAupLake No. 56-377 Twp. 7 33 Rangc_AlSec. 36 \SpZfJyUtoQJs^QA. Ruoht Vt. 0^ G. L. 4 South JuAttz Lak^ Re^oMt ifj ■■Kv/ !>■ RoqeA E, Haggle■Y4-Owner: Name. Undztupood. MtnneAotaAddress RuaclI Route 7 Box lOOAA kS 565S6Zip No. Ms 6746Permit No. SP_ Signed by:.Majcolm K. Lee, Shoreland Administrator C^ter Tail County, Minnesota miisfe MKL-087 1-009 *>\ m®159035 LvniCK 4 CO. MiaTItt. rct«u« fAUI. MW « 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 Whita — Office Yellow — Inspector Pink — Owner US /pltTT^Tcb F~T OP Lj Permit No.. LEGAL “He iScSo /DESCRIPTION v\ /• AND So /-He V/-2U, ^33S'(9-277LOCATION TWP NameTWP RangeSec.Lake Classif.Lake No. Lake Name IDENTIFICATION: Please Print All Information. Tel. No.Mailing Address — No. Street, City and State Zip No.InitialFirstLast Name Scj yc Ice A1AOWNER ejojT'TrJ I^c\Y yGj yeSEWAGE SYSTEM INSTALLER %Name. This System will be ready for Inspection on., 19. This space for office use only M.19 Owner or Agent SignaturePhone Call Rec'd ByDate Rec'd Time Rec'd NUMBER OF BEDROOMS:ESTIMATED COST: /-fqcfc>3>oSEWAGE DISPOSAL SYSTEM DATA: SEEPAGE PITCCPTie-TANK DRAIN FIELD /C^O GIs.Ft.iq. Ft.Capacity Ft.Ft.Ft.Distance from nearest well 1C Ft.Ft.Ft.Distance from lake or stream )o 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 M ByInspection was made on PERC 'LATION TEST DATA:Date of First Test , 19 , Rate Date of , Rateest 1st Test Taken By First Test + 2nd Test 2 R«r2nd 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, sketchesand 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 Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon exnressPermit: 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 Minnt rota. 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. Shoreland Managemen^OfficeIssued Date: Fee $Rec If Comments: Form No. MKL-032065 225239 — Victor Lundecn Co., Printers. Fergus Falls, MN « ■VSHORELAND MANAGEMENT — COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone 218-739-2271 • Fergus Falls, MN 56537 APPLICATION FOR PERMIT TO INSTALL SEWAGE DISPOSAL SYSTEM \ mit» — Office Yellow — Inspector Pink — Owner / ^ u ^ C. ■ Lf o <L,'i o < /Permit No.,; oLEGAL p|-4" /-N 4 C t- O TDESCRIPTIONIIM< AND ~ y I . I V■ V //LOCATION Lake Classif.TWP NameLake No. Lake Name See.TWP Range IDENTIFICATION; Please Print All Information. Mailing Address — No, Street, City and State Tel. No.Zip No.First InitialLast Name / i /iOWNER } i SEWAGE SYSTEM INSTALLER /Name. 4 Am4-Th/s System will be ready for inspection on., 19. This space for office use only uk4. 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.Sq. Ft.Capacity 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.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 PERCOLATION TEST DATA:Date of First Test , 19 , Rate Date of Second Test , 19 , Rate 1st Test Taken By First Test + 2nd Test 2 Rate2nd Test Taken By Agreement: strict accordance with ordinances of the County of Otter Tail. Minnesota and Minnesota Individual Sewage Disposal Code Minimum Standards set forth by Minn esota Department of Health. Applicant agrees that plot plan, sketches and specifications submitted herewith and which are approved by Shoreland Management Offi cial shall become a part of the permit. Applicant further agrees that no part of the system shall be covered until it has been inspected and accepted. It shall be the responsibility of the applicant for the permit to notify the County Shoreland Management that the job is ready for inspection. The undersigned hereby makes application for permit to install or extend Sewage Disposal System herein specified, agreeing to do all such work in / ‘V rr ('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 (61 months. /-'' A ' -I ■o7Issued Date: Shoreland Managemeijf Office 2 2-Fee $Rec # Comments: Form No. MKL-032085 225239 — Victor Lundeen Co., Printer. Fergus Falls. MN %r X * \\ I INSPECTION RESULTS Inspector must make all measurements SEWAGE DISPOSAL SYSTEM STATISTICS SEPTIC TANK SEEPAGE PIT DRAIN FIELDCATEGORYShould Be Should BeActual Actual Shoulc Be Actual zIS<JOCapacity GIs. Qls.S F S F S F S F Distance from Nearest Well F F F F F F FDistance from Lake or Stream F F FFFy/ 7^Distance from Occupied Building F F F F F F /Distance from Property Line F P F F FF 3 3Distance from Bottom to Water Table F F F F F F Inspector’s Comments: Date of Inspection 19 MTime of Inspection Signature of InspectorINTERPRETATION OF ABBREVIATIONS GIs = Gallons SF = Square Feet F = Linear Feet Job Title MKL • 032085 - Backer Agency ilvieo \ /3V_sl %i f ■ M ■ ^JL^JI^. H_iL. H.j^. 11 ,;sr.. M m. i V^/ » '^'J SIL k:VJ CERTIFICATE OF COMPLIANCE \/: SEWAGE SYSTEMfeS V VmmELV ONLY1% * eJanuary863Utday of.. 19.This certificate has been issued this Pj to certify compliance with regulations of Shoreland Management Ordinance, Otter Tail County, Minnesota.Si! &£SfP .The premises covered by this certificate are legally described as:\Wi:i iii Twp. Name Sv2AdMip36 Twp. 133 Range__^56-377 Sec.Lake No. mm Ifiti mSouth TuaXJLz La.ke ReAONtPt. 0^ Gov't Lot 4 mMM:pj Si 1RooeA HaggleOwner: Name.I mR^7. UndeAiPood. MSIAddress.mt 56586Zip No. Permit No. SP 6168 MH^olmK. Lee, Shoreland Administrator Otter Tail County, Minnesota Signed by:.l! iSl MKL-0871-009'I nv tfci A ®159035 >■="1. ni 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-OWc» Yellow — Inspector Pink — C^ner Card—0\^er A p/ or 0~C. ^ 60 TZkiz^tus- Lk: Rgsgtz'C' (n i■i Permit No.,I LEGAL DESCRIPTION AND -i^77 So. )^e.Tc£L Sv6^z:> PvjLjp3k_ <•//P.oLOCATION Lake No.Lake Name Lake Classif.Sec.TWP Range TWP Name IDENTIFICATION: Please Print All Information, Last Name First initial Zip No.Tel. No.Mailling Address —No. Street, City and State U hJ OEr*\.\iCc nOWNERit B/i ^ i&~=>SEWAGE SYSTEM INSTALLER Name. This System will be ready for inspection on.., 19. This space for office use only 19 .M Date Rec'd Time Rec'd Phone Caii Rec’d By Owner or Agent Signature NUMBER OF BEDROOMS: ^ESTIMATED COST: SEWAGE DISPOSAL SYSTEM DATA: SEPTIC TANK SEEPAGE PIT DRAIN FIELD I ooa V9J'GIs.Capacity Sq. Ft.Sq. Ft. S'<=>y/<jgS'a Ft.Ft.Ft.Distance from nearest well ■75^76"Distance from lake or stream Ft.Ft.Ft. /oDistance from occupied building Ft.Ft.Ft. /oDistance from property line Ft.Ft.Ft. Distance from bottom to Water Table Ft.Ft.Ft. All distances are shortest distance between nearest points RECORD OF TESTS: Inspection was made on 19,, Time ,JVI By .fsr.PERCOLATION TEST DATA:Date of First Test ., 19 Rate 1st Test TaKen By ^ \J 19Date of Second Test , Rate 3,70r /ir 1'^ .....2......First Test + 2nd Test 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 £V-3-Dated Sig Permit:Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit i anted upon expresscondition 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 !<7Fee $ Comments:. Form No. MKL-0771-003 (^VIEW lAmt LAKt, MWNISOTA rt ▼Iffy \^.:‘ , • ■■ ■ ■i^:- '' -•»''' 'W .r-w^ w ;t If ■•;. ft •'"- *■’ i-'.. ■• ■-- -t,. '■ ’ ■; ' ■■ '■ •/ \yV. . .. ►•■■> i :\•% . : r: ■ ^ v-v ■*■ #. '•],^'j ■f Y'V.-INSPECTION RESULTS•. 'S'isf-Inspector must make all measurements i-.-r.’,-. . . .' SEWAGE DISPOSAL SYSTEM STATISTICS t'.- SEEPAGE PIT DRAIN FIELDSEPTIC TANKCATEGORY Should be Actual Should beActualShould beActual Capacity 6 F SFGIs.SFGIs.S F 50Distance from Nearest Well 75 FF FFFF Distance from Lake or Stream F F FFFF 202010Distance from Occupied Building F F F FFF 10 10Distance from Property Line 10F F F FFF 33Distance from Bottom to Water Table F F F FFF Inspector's Comments: Date of Inspection 19___:..V. /tTime of Inspection.M •e‘ • signature of InspectorINTERPRETATION OF ABBREVIATIONS GIs - Gallons SF “ Square Feet “ Linear Feet Job Title *• ■ rr;F ■ T),.' ■ . V v; i/?_. ■ ■ - . -i’.. ■« ■ - ••V i:- •. •»AgencyMKte-0771-003-Backer 0 ^tUv• ■ oii- hi ■ A■:-X \'.wi: . -v' •.:ti-•I )■ hf ■■■. T - :>4' .}< :E*» f -if . ^ J'. ' \>i hk • • r-, I . U* > i -..hit-" I. ■ ' % ii 4'-‘r' ■; 1“f ' ':y.y■ *.4 ,v.■''rTV,. •=>V .X't ■ f-V,r*;•>v . .,k ... ». .. -e.. , , V' : -*r». . j-,i ■ye-■4 i ' . - .'if' ? •’• - ■ ■; •;i A , ... > ■ •' - -A44I—■•- >:• * ■ -S' -e* • -’ -’^1 ■* •->•a' • .'rtf' ■>, . 0>-\♦ 1 #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 Whitt-om« Ye//ow — frupecfor Wnk — Owner Cord— Owner a P/ or C-C. A/ 6 o ~TZk 12.T L(^ Pe3 O C2 ~P ■ Permit No.,LEGAL DESCRIPTION AND LOCATION Lake No,TWP TWP NameLake Name Lake Classif.Sec. Range IDENTIFICATION: Please Print All Information. Zip No.Tel. No.Mailling Address —No. Street, City and StateLast Name First Initial 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 Owner or Agent SignatureTime Rac'd Phone Call Rac'd By NUMBER OF BEDROOMS: ^ESTIMATED COST: SEWAGE DISPOSAL SYSTEM DATA: SEEPAGE PITSEPTIC TANK DRAIN FIELD 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 / :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 19. .S£.PERCOLATION TEST DATA:Date of First Test , 19 Rate 1.2..Date of Second Test ., Rate 1st Test Taken By 3. ^7'P c./o^5First Test ■f 2nd Test 2 Rate2nd Test Taken Bv 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 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/ - 3-2.Issued Date: Shoreland Management Office Fee $ ' Comments:. Form No. MKL-0771-003 Qlvttw lATUE lAKC. m:nnisota 'PPI INSPECTION RESULTS Inspector must make all measurements SEWAGE DISPOSAL SYSTEM STATISTICS ^x;^~Tr~A/G ( 1 X<=^3 SEEPAGE PIT____SEPTIC TAMK DRAIN FIELDCATEGORYActualShould be Actual Should beActualShould be 5^6 s F S'OOCapacityGIs. GIs.S F SFS F Jco F 50Distance from Nearest Well 75F FF F F y-2S-^ FDistance from Lake or Stream F FFFF / G>o F20 2010Distance from Occupied Building F FFFF /o' p 10 1010Distance from Property Line F F FF F ^ F 33Distance from Bottom to Water Table F F F F F Cj 11 Inspector's Comments:____ 6o\Y K \I s yS .Vf(v\["p^Qg 19-B^Date of Inspection ; Time of Inspection M i signature of InspectorINTERPRETATION OF ABBREVIATIONS GIs • Gallons SF “ Square Feet F “ Linear Feet Job Title AgencyMKL-0771-003-Backer I V TO BE COMPLETED BY PERSON INSTALLING SYSTEM I hereby attest that I am familiar with the minimum standards required by the OTTER TAIL COUNTY SHORELAND MANAGEMENT ORDINANCE regarding sewage systems and that I have installed the below system in accordance with those standards. Please complete and return along with a plot plan of the land within 150' of the subject sewage system which includes the separation distances between the sewage system and any existing or proposed buildings, property lines, water supply wells, buried water pipes, the ordinary high water mark of lakes, rivers, streams or flowage as well as the location, size and design of all parts of the sewage system within 10 days to Land & Resource Management Office, Court House, Fergus Falls, Minnesota 56537. r Classification Permit No., Lake No. 'XI Sec. Lake Name Two. I Range ^ / Twp. Of- 0 I Qr ^ 9. Name^ Legal Description: Owners AddressOwners Name // 5.3 Date of InstallationLicense No..7 7 ISeptic TankFill in below:Drainfield lOOC)CcXQ TCanac it v (pLj Sjt-tDistance from l^^arest Well l*-Distance from Lake or Stream Distance from Occupied Building 3ooDistance from Property Line XT ADistance from Bottom to Water Table 6 /7Signatur'Date 21SS02® VICTOR LUNDEEH CO.. RRiNTEIIt. FERSUS FALL!. UINM.MKL -0871 -028 PERCOLATION TEST DATA LAND AND RESOURCE MANAGEMENT Otter Tail County Fergus Falls, Minnesota 56537 Ph. No. Owner:Mailing Address: jQJL Last Nan^Zip No.StateMiddleSt. & No.Cityfi hirst l\ .7^--------------- — ~ ------------------ Legal Description:tli Li26^77 TWP.TWP nameRANGELAKE OR RIVER NO.NAME TEST HOLE NO. 2TEST HOLE NO. 1 a/Depth to Bottom of HoleDepth To Bottom of Hole,inches; Diameter of Hole Jnchesinches;Diameter of Hole inches Depth, Inches Soil Texture Depth, Inches Soil TextureDate DatelEx:fe I5~nIVp W'hJ-' .S A*^c| TOP C/Ky CAi^rC ClPercolation Test Bv Percolation Test By ^Q LU / 5Firm Name.GC Firm Name. aLU OC !6 LUAddress.QC Address < y/1COOtter Tail County License No..Otter Tail County License No^I-coLUMeasure ment, inches Time Intervals minutes Drop in water level, inches Percolation rate minutes per inch I-Time Interval, minutes Measure ment inches Percolation rate minutes per inch Drop in water level, inches Remarks:Time Remarks:Timeo5 ECUUlnD A /H •)/-70A<^a I-5^'1^ // fS ((A^n yCTv/TO q-*v^16 s:21I f Am xs:Jo O's mK 3-0 j j ^0 Ani\ Jl ']0Am 2mRlcPf'r^21 lUTj'TJ //2 i^j'//% 5L Ul2z.32 7 w.. See Booklet, "How to Run a Percolation Test" by Agriculture Ext. Service, Un. of MN Percolation rate =,minutes per inch minutes per inchPercolation rate * -mifIf. L:^^ ,1E,us! i Ej^3 m.A r•Mt w^mm I 1rk CERTIFICATE OF COMPLIANCE SEWAGE SYSTEM mWm22ndThis certificate has been issued this day nf December 79_ai m‘il to certify compliance with regulations of Shoreland Management Ordinance, Otter Tail County, Minnesota. A The premises covered by this certificate are legally described as:: -Si m.w-Lake No. 56-377 Sec. 36 Twp. 133 Range_Al.Twp. Name Sverdrupm liPt. of G.L. 4 M :Ms IL/ rlAOwner: Name.Roger Haiigsp F%Address.RR 1 Box 100 AA| nfidgTMOod^ MinTi^got-n 1 56586Zip No... 4379Permit No. SP_'■i?' Signed by:.<2.Malco^ K. Lee, Shoreland Administrator Otter Tail County, Minnesota ;MKL-0871-009 //A r.'r/,PIL IS •^4 1S903S 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 cTIPermit No.,LEGAL 4,Date DESCRIPTION AND I^D 36<S'~^'377 ^ ~TorrjL<?^LOCATION i/neLake No.Lake Name Lake Classif.Sec.TWP Range TWP Na IDENTIFICATION; Please Print All Information. Last Name Initial Mailling Address —No. Street, City and StateFirst Zip No.Tel. No. ^QyC AAOWNER 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 1707^0 GIs.Sd Ft.Capacity Sq. Ft. ^o//OC)Ft.Ft.Ft.Distance from nearest well 7<r Ft.Distance from lake or stream Ft.Ft. 7/6 Ft.Distance from occupied building Ft.Ft. /'6 LDistance from property line Ft.Ft.Ft. Ft.Distance from bottom to Water Table Ft.Ft. Ail distances are shortest distance between nearest points RECORD OF TESTS:VCT- Inspection was made on 19 , Time ,JVI By PERCOLATION TEST DATA:Date of First Test ,, 19 , Rate Date of Second Test 19 ,, Rate 1st Test Taken By First Test + 2nd Test 2 Rate2nd Test Taken By 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.) V IDated. Signatur 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 pot commenced within six (6) months. 4 itIssued Date: Shoreland Management Office Fee $Surcharge $ Comrnents;. Form No. MKL-0771-003 VICTOR kUHDCCH • CO.. ROiRTtRt. RCROUS rittLO. WIMR.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 te — Office V low — Inspector Pli.. — Owner Card — Owner Permit No.,LEGAL i/Date DESCRIPTION AND ;/J, 7LOCATION Lake No.Lake Name Lake Classif.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. OWNER SEWAGE SYSTEM INSTALLER Name. This System will be ready for inspection on. This space for office use only yO:so <(n19 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 GIs.Capacity Sq. Ft.Sq. Ft. Ft.Ft.Distance from nearest well Ft. 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 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 2nd Test Taken By 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 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 Fee $__i Surcharge $ CFRT SgUpn 2-^8^ Comrfients:. V- Form No. MKL-0771-003 vicToa LuMoeeN t ca., puiNTcaa. reaaus full*. 158906 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 /yoSFCapacityGIs.GIs.S F S F SF Distance from Nearest Well F 75 50F F F F F MiDistance from Lake or Stream F F F F F F Distance from Occupied Building 10 2020FFFFF F / Distance from Property Line 10 10 10FFF F F FT Distance from Bottom to Water Table 4 4FFFFF F Inspector's Comments: - ydDate of Inspection.19 Time of Inspection. I/Pnature of InspectorINTERPRETATION OF ABBREVIATIONS GIs B Gallons SF “ Square Feet F ■ Linear Feet Job Title AgencyMKL-0771«003-Backer •r. V.- A PERCOLATION TEST DATA SHORELAND MANAGEMENT OTTER TAIL COUNTY Fergus Falls, Minnesota 56537 Ph. No. Owner:Mailing Address: c-O <S(} o cLast /Name £/^ ^ / /V/ St. & No. ;.?3TWP. r/ Zip No. I J2Lf±First StateCity Legal Description;C.. r// 77.^ NAME SllAtlA. TWrSEC.LAKE OR RIVER NO.RANGE NAME J? l)ooy^J.ci y TEST HOLE NO. 2TEST HOLE NO. 1 II Ce? Depth to Bottom of Hole.inches; Diameter of Hole.jnchesDepth To Bottom of Hole.inches; Diameter of Hole inches Oyv ^ (E^mAiL 19Depth, Inches 19Soil Texture Depth, Inches Soil TextureDate. ^ ■Date rz„ r/f j.O.yf r/.IPercolation Test By____ Percolation Test Bv .,1 ^ J /u<y1 Ui 77 Zi. 17 Firm Name.oc FirmName.c3 7aHI cc VrUJ Ad dress.CC / Zk j' j ^ ^ --- - “U -I-AddressU < Otter Tail County License No..Otter Tail County License No.I- W UJ Drop In Water Level. Incites Measurement. inches Drop In Water Level. i/Khes Measurement, InchesTimeRemarksTime Remarks O //•'//<^ / z o //-; 7 z Jz> / / ^ )Z.' 7<( ^7 L? /Z"UJi a/z:tLM->346ZV/i ''7 4-7//0//7h /'■2A— JC ' c/ < // r’ ^ cA <"/ AC- \/ -n7"r14I~tt( ^L/ MKL-0871-028183818 ®v>cT»8 uiaacfN 4 M raiiTftt. riatus r«.L«. m<««/MlSee Booklet,"How to Run a Percolation Test" by Agriculture Ext. Service, Un. of Minn.