The URL can be used to link to this page

Home My WebLink AboutSwan Lake Club_13000190112000 _ 22738_Septic System Permits_I Department of LAND AND RESOURCE MANAGEMENT OTTER TAIL COUNTY Government Services Center - 540 West Fir Fergus Falls, MN 56537 PH: 218-998-8095 Otter Tail County’s Website; www.co.otter-tail.mn.us 10/12/2012 Swan Lake Club Inc Attn Richard C Baker 22630 Swan Lake Rd N Fergus Falls MN 56537 8235 RE;Primary Owner: Swan Lake Club Inc Sewage Treatment System Servicing Tax Parcel Number: 13000190112000 Described as;Sec 19 Twp Dane Prairie Twp Sect-19 Twp-132 Range-042 29.64 AC PT G.L. 3 (REC BK 203 PG 486) Lake: 56-781 Swan As of 09/10/2012 the holding tank (Sewage Treatment Installation Permit # 21789 servicing your property was determined to be in compliance with the provisions of the Sanitation Code of Otter Tail County. If you have any questions regarding this matter, please contact our office. Sincerely, Eric Babolian Inspector sen AffPLICATION FOR PERMIT TO INSTALL SEWAGE TREATMENT SYSTEM LAND & RESOURCE MANAGEMENT, OTTER TAIL COUNTY (218-998-8095) GOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS FALLS, MN 56537 www.co.otter-tail.mn.usWHITE - Office YELLOW -L&R Inspector PINK - Owner/ Contractor (after issue) Permit No.APPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED RANGE TWP NAMESECTIONTWP NO.LAKE/RIVER CLASSLAKE/RIVER NAMELAKE NUMBER E-911 ADDRESS OR DIRECTIONS FROM NEAREST PUBLIC ROADPARCEL NUMBER (S) OF PROPERTY BEING SERVICED c4/irie^ iSir/cc- LEGAL DESCRIPTIONAr 3 Daytime Phone No.Mailing AddressInitialFirstLast Name lb loo 5^^^ ^h .Aje~ MtchfifI, S53yb Property Owner 7/^3" 2-^^k . /OQJContractor Lie.# THIS SPACE FOR OFFICE USE ONLY A.M. P.M., the year of at.► This System will be ready for inspection on A.M. P.M. L&R OfficialTime ReceivedDate Received SEWAGE TREATMENT SYSTEM DESIGN DATA AS SHOWN ON DRAWING TYPE OF NSTALLATION (circle ONE) Other Est. (E) New (F) Replacement Collector^Jtosjdential(A)_Ne}^ (BTRe^acement (C) New (D) Replacement Soil Treatment Area LiftTank Effluent Distribution ( ) Gravity ( ) Pressure DegigiLElow (Gallons/Day)(^1 2,49^ GIs Ft.GIs(H) 2,500 — 4,999 (I) 5,000 — 10,000 AxSize Setback To Nearest Well Ft. Ft.Ft.Type IIType I (27) Rapidly Permeable(20) Trench, Rock Ft.Ft.Ft.7b>Setback To OHWL(21) Trench, Gravelless (28) Flood Plain (22) Trench, Chamber (291 Privies ((^Holding ^nl^ (V) Monitoring/Disposal Contract Ft.Ft.Ft.Setback To Bluff(23) Bed (24) Mound Ft. Ft.Ft.Setback To Dwelling (25) At Grade Type III Setback To Non-Dwelling Ft. Ft.Ft.(31) Other/Problem Soils/<12“ Soil(26) Greywater Type IV Setback To Nearest Lot Line Ft.Ft.Ft.-t /o(32) Public Domain & Proprietary Technologies Depth^^ell Setback To Road Right-Of-Way Ft. Ft.Type VTotal # Bedrooms 7 7(33) Performance Elevation Above Restrictive LayerYzS Ft. Ft.Ft.Garbage Disposal YAbatement PERC TEST DATA Highest RateDate of TestLicense #Designer Agreement: The undersigned hereby makes application for permit to install, alter, repair or extend Sewage Treatment System herein specified, agreeing to do all such work in strict accor dance with Sanitation Code of Otter Tail County, Minnesota. Applicant agrees that the Site Data Worksheet submitted herewith and which is approved by a Land & Resource Management Official shall become a part of the permit. Applicant further agrees that no part of the system shall be covered until it has been inspected and approved for use. It shall be the responsibility of the applicant for the permit to notify Land & Resource Management that the installation is ready for inspection. Permit: Permission is hereby granted to the above named applicant to perform the work described in the above staterhent. This permit is granted upon express condition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Sanitation Code of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of the Sanitation Code. NOTE: I.This permit is valid for a period of six (6) months. 2.This permit does not include the building sewer (sewer line). MititI Permit Fee $Date: Signature of Property Owner/Agent for Owner Land & Resourve Management Official ‘T/naha Rec. No..Date: Date StampComments: 2 2 2012mnfesiL&R InitialForm No. BK — 07-2011-06 345,197 • Victor Lundoort Co.. Priniors • Fergus Fails, Minnesota APPLICATION FOR PERMIT TO INSTALL SEWAGE TREATMENT SYSTEM ^ LAND & RESOURCE MANAGEMENT, OTTER TAIL COUNTY (218-998-8095) GOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS FALLS, MN 56537 ‘ www.co.otter-tail.mn.usWHITE -pfice YELLOW -L&R Inspector PINK - Owner / Contractor (after issue) Permit No. I ^ ^APPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED SECTION TWP NO.RANGE TWP NAMELAKE/RIVER CLASSLAKE NUMBER LAKE/RIVER NAME / ..n■h^ E-911 ADDRESS OR DIRECTIONS FROM NEAREST PUBLIC ROADPARCEL NUMBER (S) OF PROPERTY BEING SERVICED /3mj/'/o//xoa> LEGAL DESCRIPTION 7^ // /.w- Daytime Phone No.First Initial Mailing AddressLast Name 5/ /i/c 5V- mK /v /, rn^^ 55^ -7 o Property Owner 'a'. />/><. /Ha ^7J r'_Contractor Lie.# ; THIS SPACE FOR OFFICE USE ONLY ^-/D 1^', the year of at_>■ This System will be ready for inspection on /hnu L&R Offiefei 0-ZO P.M. Time ReceivedDate Received SEWAGE TREATMENT SYSTEM DESIGN DATA AS SHOWN ON DRAW NG TYPE OF NSTALLATION (circle ONE) Other Est. (E) New (F) Replacement CollectorResidential (A) New (B) Replacement (C) New (D) Replacement Soil Treatment Area Tank Lift Design Fiow (Gaiions/Day) (G) 1 — 2,499 (H) 2,560 — 4,999 (I) 5,000 — 10,000 Effiuent Distribution ( ) Gravity ( ) Pressure GIs Ft.GIs'V/'i-Size Setback To Nearest Weil Ft.1 Ft.Ft.Type IIType I (27) Rapidly Permeable(20) Trench, Rock Ft.Ft. Ft.Setback To OHWL(21) Trench, Gravelless (28) Flood Plain (22) Trench, Chamber (29) Privies Ft.Ft. Ft.Setback To Bluff43O) Holding Tank , ( , ■) Monitoring/Disposal Contract (23) Bed (24) Mound Ft.Ft.Ft.Setback To Dwelling (25) At Grade Type III Setback To Non-Dwelling Ft. Ft.Ft.(31) Other/Problem Soils/<12" Soil(26) Greywater \\Type IV Setback To Nearest Lot Line ■, Ft.Ft.Ft.(32) Public Domain &Proprietary TechnologiesDepth of Well Setback To Road Right-Of-Way i. Ft.Ft./ Ft.Type VTotal # Bedrooms (33) Performance Elevation Above Restrictive Layer / Ft.Ft.Ft.Garbage Disposal Y / NAbatement Y / N / PERC TEST DATA , / Y .'"y .Highest RateDate of TestLicense ftDesigner Agreement: The undersigned hereby makes application for permit to install, alter, repair or extend Sewage Treatment System herein specified, agreeing to do all such work in strict accor dance with Sanitation Code of Otter Tail County, Minnesota. Applicant agrees that the Site Data Worksheet submitted herewith and which is approved by a Land & Resource Management Official shall become a part of fhe permit. Applicant further agrees that no part of the system shall be covered until it has been inspected and approved for use. If shall be the responsibility of the applicant for the permit to notify Land & Resource Management that the installation is ready tor inspection. Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express condition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Sanitation Code of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of the Sanitation Code. NOTE: I.This permit is valid for a period of six (6) months. 2.This permit does not include the building sewer (sewer line). ./i'K^ H kio t / Permit Fee $r. - -C Signature of Property Owner/Ageht for Owner ■i y.v:> '/Rec. No..Date: Land & Resource Management Official Comments: } 5SCANNED ;; Form No. BK — 07-2011-06 345,197 • Victor Lundoan Co., Printers • Fergus Falls, Minnesota J SEWAGE TREATMENT SYSTEM PERMIT INSPECTION RESULTS Inspector must make all measurements e SOIL TREATMENT AREA HOLDING SEPTIC TANK OUTHOUSELIFT TANKCATEGORY li /SoO(i^^090 GLS.Capacity FT2 FT2GLS. FTFTFTFTSetback from Nearest Well Setback from Buried Water Suction Pipe FTFT FTFT Setback from Buried Pipe Distributing Water Under Pressure 1^FTFTFTFT ■f|05"-FTSetback from OHWL (lake &/or river)FTFT FT FTSetback from Bluff FTFTFT FT FTSetback from Dwelling FTFT FT FT FTSetback from Non-Dwelling FT FTSetback from Nearest Property Line FT FTFT /C?FT FTSetback from Right-of-Way FT FT FTElevation above Restrictive Layer FT FTFT Holding Tank/Lift Alarm NO Old System Pumped & Destroyed NO TRENCH REDUCTIONSOIL TREATMENT AREA CALCULATION MOUND / AT-GRADESEPTIC TANK(s) # Tanks Installed FILTER ROCK BED inchesRock trenches with □ YES 0 NO Manuf.of sidewall for.%Ft. Ft.Ft. X Ft. X reduction / equivalent to Soil Treatment Area. Model #,Ft* Ft* Inspectors Comments: Sketch: 0 io I O /52>p/t-& / f-/o -iz- IInitial / L S R OfHeMTimeDate As of ^’-rcP'/'L. Code of Otter Tail County. , the above described sewage system installation was found to be compliant with the provisions of the Sanitation /l/ M5,1?7 •Form No. BK — 07-2011-06 Victor Lundoon Co.. Printort • Forgut Falla, Minnasota System design must be to scale and must include the proposed location of the sewage system, all existing/proposed buildings, property lines, the ordinary high water level of the water body, wetlands, bluff and all water wells within 150' of the sewage system. If there are any questions, see the University of Minnesota Site Evaluation worksheets. [_inch(es) equals feetgrid(s) equalsScale:feet, or MPCA LICENSE #: LICENSE CATEGORY: DESIGNED BY: /^JU. FIRM NAME:Schueller's Septic Solutions 23725 240th Avenue Fergus Falls, MN 56537 DATE: ADDRESS:SIGNATURE: N > l\1^^ V_ ^JeuJ deMuS 76' Ser£/!cj<1 j /^OO&AL /SX>MU (^CMr' U4/7£v<JA7 Q t BK — 1003 — 029 315.904 • Victor Lundeen Co.. Printers •. Fergus Falls. MN • 1-800-346-4870 SITE DATA WORKSHEET f 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 #OWNER: LAST NAME FIRST MIDDLE TELEPHONE NUMBER ADDRESS: /€5. fkus Mt/J STR./RT CITY STATE ZIP CODE /2_ Ya LAKE/RIVER NO.LAKE NAME SEC.TWP.RANGE TWP. NAME LEGAL DESCRIPTION:SOIL BORING LOG COLOR & MUNSELL NO. DEPTH (INCHES)&>l. 3 TEXTURE STRUCTURE BLOCKY PLATY PRISMATIC NONEPARCEL NUMBER BLOCKY PLATY PRISMATIC NONE E-911 Address or Directions From Nearest Public Road NUMBER OF BEDROOMS GARBAGE DISPOSAL: YES WELL: CASING DEPTH't^ft. Sbwtri liimc acrMOMi iui\i:-i 5P ft. BLUFF: YES i(^P> Irrestriai/ BLOCKY PLATY PRISMATIC NONE »t BLOCKY PLATY PRISMATIC NONE FLOODPLAIN: YES VEGETATION: AQUATIC BLOCKY PLATY PRISMATIC NONE oSLOPE AT INSTALLATION SITE:% TYPE OF OBSERVATION: Probe Pit Boring PARENT MATERIAL: Till Outwash Loess Bedrock Alluvium ORIGINAL SOIL:Yes No Date of Soil Boring. COMPACTED SOIL: Yes No DEPTH OF BORING (To 7' or restrictive layer):.ft.Date of Perc Test PERC TEST #1 PERC TEST #2- TWO TESTS ARE REQUIRED - TIME INTERVAL (MINUTES)WATER DEPTH WATER PROP PERC RATE TIME INTERVAL (MINUTES!WATER DEPTH WATER DROP PERC RATESTARTSTART TIME DROP PERC TIME DROP PERC WATER DEPTPTTIMEINTERVAL (MINUTES)WATER DftOP PERC RATE TIME INTERVAL (MINUTESI WATER DEPTH WATER DROP PERC RATEREFILLREFia TIME DROP PERC TIME DROP PERC TIME INTERVAL (MINUTES)WATER Dim WATER DROP PERC RATE TIME / WATER PfiOFINTERVAL (MINUTES)WATflR DEPTH PERC RATE7RfflLLREFia TIME DROP PERC TIME DROP PERC WATER 6e^><'TIME INTERVAL (MINUTES!WATER DEPTH WATER DROP PERC RATE TIME INTERVAL (MINUTES!WATER DROP PERC RATEREFiaREFia Ff TIME DROP PERC TIME DROP PERC VWTER DROTWATER DEPTTIMEINTERVAL {MINUTES)PERC RATE TIME INTERVAL (MINUTES!WATER DEPTH WATER DROP PERC RATE/REFia REFia /f•/TIME DROP PERC TIME DROP PERC VVATER DEPTHTIMEINTERVAL (MINUTES)WATER PI PERC RATE TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATEREFiaREFILL TIME DROP PERC TIME DROP PERC V^ER DEPTHTIMEINTERVAL (MINUTES) WATER DROP PERC RATE TIME INTERVAL (MINUTES!WATER DEPTH WATER DROP PERC RATERe=ia REFia TIME DROP PERC TIME DROP PERC INTERVAL (MINUTES)WATER DEPTH WATER DROPTIME PERC RATE TIME WATER DEPTHINTERVAL (MINUTES)WATER DROP PERC RATEREFiaREFia TIME cmop PERC TIME DROP PERC PROPOSED DESIGN: TRENCH,BED.ATGRADE.MOUND.HOLDING TANK GRAVITY DIST.,PRESSURE DIST.. SEWER LINE.OUTHOUSE.OTHER. SPECIFY:. — SYSTEM DESIGN ON BACK —