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Swanson's Campground_37000320179000_Septic System Permits_
4/20/2020 Issued Permit Vi(' DF' This System will be ready for inspection on , the year of ^2Q----Q OTTCR TRIl a.m.eoDiTtaiaiiioTi Community PELICAN RAPIDS 2-'-30pm Date Received Time ReceivedPermit Number 26372 CSLM PROPERTIES LLCOwner 416 3RD ST N ,Owner Address L&tR Official Ross SeifertApplicant PERMISSION IS HE. 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 23618 STATE HWY 108 /J 37000320179000Parcel Number Ross Seifert Septic Service, LLCDesigner \ Type of System: Tank Only Holding Tank N/A Pressure DistributionDesign Criteria Flow Rate: 150.00 GPD Tank Sizes PH 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. 6 Holding Tanks 4 New 1500 Holding Tanks 2 Existing Holding Tanks (compliance in system) Call by 4pm the business day before the time you need an inspection. Required Inspections: dc57a6daaa38897e2ef875ae2ed8a45c 7999c994c4248e5edal4abe8668b61dd Permit Issuance Date: 04/20/2020 Permit Expiration Date: 04/20/2021 https://onegov.co.ottertail.mn.us/admst/viewcard.php?card=9&app=9757 4/20/2020 Issued Permit f Andrea Perales 04/^20/20^- Issued! https://onegov.co.ottertail.mn.us/admst/viewcard.php?card=9&app=9757 212 SEWAGE TREATMENT SYSTEM PERMIT INSPECTION RESULTShi TRENCH REDUCTIONS1A (Soil Ihrahwnt Aim) OUTHOUSE HOLDING SEPTIC TANK LIFTTANKCATEGORY [i?C^jMtVUGLS.inches with inchesFT^ R(Capacity GLS. J %.o< sidewall forSetback from Nearest Well FTFTFT fPreduction/equivalent to.Setba^ from Buried Water Suction Pipe FTFT STA CALCULATION tteatment Area) Setback from Buried Pipe Dlsbfbutlng Water Under Pressure FT FTFT FT FTSetback from OHWL (lake &/or riven .Ft FTSetback from Bluff FT FT \Setback from Dwelling FT FTFT MOUND/AT-GRADE ROCK BEDVS'P)Setback from Non-Dwelling FT FT ■; FtVv7Setback from Nearest Property Line FT FT //V6^Setback from Right-of-Way FT FT FT /1Elevation above Restrictive Layer FT FT FT SAND IN MOUNgL^ \INSTALLERS COMMENTS ^^3^S GNO SEPTIC TANK(s)Holding Tank'/ Lift Alarm U« Tanks InstalledOld System Pumped & Destroyed riYES -Weep-Holer Manuf.Number of Laterals #'^derat°PipeGize»<>>«-o.IN IM)Model#PerforEition Spacing *"^tr INPerforation Diameter Size a,i^allons-Per-Mlffliter|FILTERS GYES‘PeeToflbtd HeadPUMPS ^spector's Comments:i'2' df' <7Y\ -1 T iketch: 41 99N cm ft se»\ \gmck 1] 0 W.- : Jf ■0\As of the above described sewage system installation was found to be compliant with the provisions of the Sanitation Code of Otter Tall County. Date 79m9 tnim/L&R<MGial r~\\IzZLamSt Pesouice MafUgsmsm Offiebt arm No. BK — 04-2014-06 WIM3 • Vldoi Ca. Printi • PerfiuoPAUa MIrmewl* Land & Resource Permit Applications4/20/2020 Land & Resource Management Government Services Center 540 Fir Avenue West Fergus Falls MN 56537 Phone: 218-998-8095 :aTTCRTlIltooBOTV-ninaiioTA Septic Installation Permits Septic Installation Permit Permit # 26372, Application # 1387, UID # 9757 Valid: 2020-04-20 - 04/20/2021 Applicant Information Applicant Contact information:Name: Ross W Seifert Phone: (701 )219 -4139 Email Address; seifertseptic@gmaii.com Mailing Address: 47000 180th ave Pelican Rapids MN 56572 Are you the owner of the property? ^ Open Design Steps:Yes Property Information Project Location:Primary Name/AddressLegal DescriptionProperty AddressProperty Attributes Primary Address Line 1 CityLegal Description Legal Description NameCityLegal DescriptionParcel #Property Address SABINCSLM PROPERTIES 416 3RD STNSUB LOT 1 OF GOVT LOT 2 PELICAN RAPIDS .97 AC3700032017900023618 STATE HWY 108 LLC Single Family UseUse of the Building: Is the property Shoreland located in the Shoreland or Non- Shoreland area? Shoreland Information Associated Lakes: Lake Class LR CDLake Name DNR ID 56-747747GDLida NoBluff: Design Contractor Information Design Contractor Information;Designer InspectorInstallerService ProviderAddressMaintainerLicense Number Phone NumberName Yes YesYesNo701-219-4139 47000 180th Ave Pelican Rapids. MN 56572 YesRoss Seifert Septic Service. LLC LI 322 i Please search for and choose OTHER if what you need does not appear In the list YesIs the Designer also the Install Contractor? Design Contractor Email Address: seifertseptic@gmail.com 1/3https://onegov.co.ottertail.mn.us/view.php?id=9757#option-results Land & Resource Permit Applications4/20/2020 . Property Owner Information Property Owner:Name: CSLM Properties LLC Phone: (701 )367 -2927 Email Address: arturoesco@gmail.com MailingAddress: 416 3RD STN Sabin MN 56580 Application Type What work is proposed:Tank Only System Type System Type: Design Flow: Type II 150 Gallons Per Day System Components Holding TankComponents: Are any tanks being replaced/installed? Yes Design Attach a copy of the design:1 File 1: ^ csln_propertiesJlc.pdf 1 ' L ^Design Summary - System Type System Components: Holding Tank Gravity DistributionDistribution Types; System Type:Type II Septic installation Permit Attention ' this permit is for 6 holding tanksGenerai Comments: Terms MINNESOTA STATUTE 15.99, SUBDIVISION 2 •: , I UNDERSTAND THAT iN ACCORDANCE WiTH MINNESOTA STATUTE 15.99, SUBDIVISION 2, OTTER TAIL COUNTY HAS UP TO SIXTY (60) DAYS TO REVIEW AND . . APPROVE OR DENY THE PERMIT APPLICATION. DURING THE COVID-19 PUBLIC HEALTH EMERGENCY DECLARATION, OR UNTIL DECEMBER 31,2020. WHICHEVER COMES FIRST, IN ACCORDANCE WITH MINNESOTA STATUTE 15.99, SUBDIVISION 3 (F), OTTER TAIL COUNTY HAS EXTENDED THE REVIEW TIME BY AN ADDITIONAL SIXTY (60) DAYS, AND HAS UP TO ONE-HUNDRED AND TWENTY (120) DAYS TO REVIEW AND APPROVE OR DENY THE PEFtMIT APPLICATION. Terms and Conditions The following exhibits are required as part of the application and shall be attached hereto: Percolation-Test Reports: Soil Boring Logs; Site Plan drawn to scale showing location of buildings, lot lines, percolation test holes, soil boring holes, proposed location of system and location of well(s); and one (1) copy of the System Design. The house and drainfield areas must be staked. Inaccurate or incomplete information will result in delays in processing. AGREEMENT: The undersigned hereby makes Application for Permit to Install or Extend the Sewage Treatment System herein specified, agreeing.that all work shall be done in - strict accordance with ordinances and regulations.of the County of Otter Tail, Minnesota. Applicant agrees that the Site Plan; Sketches, and Design submitted herewith, and which are reviewed by Otter Tail County, together with any requirements and/or restrictions made necessary by conditions peculiar to a particular location, shall become part of the permit. Applicant further agrees to provide access, at reasonable times, to Otter Tail County for the purpose of performing inspections required and that no part of the system shall be covered until it has been irispected and accepted. APPLICATION IS'FOR AN INSTALLATION AT A SPECIFIC LOCATION; ANY DEVIATION FROM THE APPROVED LOCATION WILL VOID THE PERMIT. It shall be the responsibility of the applicant for the permit to notify the Otter Tail County Department of Land'and Resource Management that the installation is ready for inspection. . PERMITS WILL NOT BE ISSUED ,ONCE FROZEN GROUND CONDITIONS EXIST due to the inability to conduct soil reviews unless^arrangements are made BY THE APPLIC/\NT to provide a backhoe, geo-probe, dr.any other device that can penetrate the frozen soil to allow Otter Tail County to conduct a soil review. I hereby certify the above to be true and correct. I hereby give the. Otter Tail County Department of Land and Resource Management permission to enter upon my property during- normal business.hours for the purpose of determining the suitability of the location, design, and construction, which may include minor excavations or soil boring(s) by the - Department, t ... •. • ' ' - -.NOTE: Once a permit is approved it is valid for a period of twelve (12) months from the date of approval unless otherwise indicated on permit. i. https://onegov.co.ottertail.mn.us/view.php?id=9757#option-results 2/3 Land & Resource Permit Applications4/20/2020 Involfee #7014 (04/17/2020) Quantity TotalCostCharge Tank Only PermH and Vault Privy added 04/20/202012:50 PM $175.00$175.00 X 1 Grand Total $175.00Total $175.00Payment 04/20/2020 $0.00Due Approvals SignatureApproval Ross W. Seifert - 04/17/2020 11:52 AM alc399af7e57ad6ead076dd60e4ce4c8 55cl09al4982960716e4eee96bd3863b Applicant Emma Barry - 04/17/2020 11:54 AM7c71ef655c83374d7af23d0be3d6c511 lfaa40cb55c50c3e06e614bcddd05eS2 #1 Received and Assigned Kyle Westerqard - 04/17/2020 12:10 PM4d805a470f2ff8b68e866b2f4c72249e943ac7ab865ba749a41fdae082fffl30 #2 Initial Office Review Andrea Perales - 04/20/2020 2:32 PMdc57a6daaa38897e2ef875ae2ed8a45c 7999c994c4248e5edal4abe8668b61dd #3 Issue Permit Public Notes Text: 2^ ]File(s):t Internal Notes Text: ]File(s):[ Print View 3/3https://onegov.co.ottertail.mn.us/view.php?id=9757#option-results e Land & Resource Management GSC, 540 W Fir, Fergus Falls, MN 56537 f»1TCRTf{il 218-998-6095; Website: wvifw.co.ottertail.iiin.us Subsurface Sewage Treatment System Management Plan Sewage Treatment System Permit Number: Property Information: Lake I River Number Lake / River Name Lake / River Ciass Section Township Name Lida747GD32Lida Parcei Numbeits)Property's E-911 Address 23618 St HWY 108 5657237000320179000 Property Owner CSLM Properties LLC This management plan will identify the operation and maintenance activities necessary to ensure long-term performance of your septic system. Some of these activities must be performed by you, the homeowner. Other tasks must be performed by a licensed septic service provider. Homeowner’s Management Tasks - Should Be Checked Every 6 months: Leaks - Check (look, listen) for leaks in toilets and dripping faucets. Repair teaks promptly. Surfacing sewage - Regularly check for wet or spongy soil around your soil treatment area. Effluent filter (if applicable) - Inspect and clean twice a year or more. Pump Tank Alarms - Alarm signals when there is a problem. Contact a service provider any time an alarm signals. Holding Tank Alarms - Can be either an electronic or a manual float, when activated, service (pumping) is required. Event counter or water meter (if applicable) - Record your water use. Vegetative Cover- Establish and maintain a vegetative cover over the sewage system. Professional’s (Licensed Septic Service Provider) Management Tasks - Should Be Checked Every 24 Months (2 Years): Check to make sure tank is not leaking. / Check and clean the in-tank effluent filter. Check the sludge/scum layer levels in all septic tanks. Recommend if tank should be pumped. Check inlet and outlet baffles. Check the drainfield effluent levels in the rock layer. Check the pump and alarm system functions. Check wiring for corrosion and function. Provide homeowner with list of results and any action to be taken. Check inspection pipe caps (replace as necessary). / Check manhole cover (accessibility, security, or damage). / £ / / / £1£ £ £ I understand it is my responsibility to property operate and maintain the sewage treatment system on this property in accordance with this Subsurface Sewaoa'Tfeatment System Management Plan. ' Date Property Owner; The following link will provide information from the University of Minnesota, regarding a Septic System Owner’s Guide: http://www.extension.umn.edu/environment/housinQ-technoloQv/moisture-manaQement/seDtic-svstem-owner-Quide/ LR: Online Permitting Forms 2016: SSTS Management Plan Fillabte 07-27-2016 \ r '^.~- ^ ■■ TVVKiCf/ ■ • M' W, O , t/.\ VV\‘lt*ov«>aWV\ ’■■"fesjn*! -TV\fovL_• III •_ <'-.f'‘J :G?t' •.''.•"{'•T'-".- » >1 C'C..?•''* i \-\- W£? iiCC, SEIFERT SEPTIC SERVICE, LLC 47000 180th Aye Pelican Rapids, MN 56572 Ross Seifert 701-219-4139 Pumping Contract This contract is between (home owner) ^7fyy>.^iA n9£>oaParcel # And Seifert Septic Service, LLC License #1322 As home owner, I agree to contract Seifert Septic Service(as needed) When my septic holding tank high ievei aiarm indicates its time to be pumped. t Signature:7(home o^er) Seifert Septic Service, LLC:__^Ross Seifert/Li^#T3^2 1 s i otter Tall County Land & Resource Management Subsurface Sewage Treatment System Inspection FormOTTER TAILCOUNTY-MINNESOTA ‘“^ki8_£tHwVj0S Property ID N!^'^OoD5ZOn9ooO □ Non-Shoreland Permit No. l2f)g5e/jo4Installer/MPCA #MPCA Type I VIV ^New □ Repair □ Replacement □ Other Type of System □ Trench □ Pressure Bed □ Mound □ At-Grade Tank Inspection Other Inspection:Final Inspection orDateInspectorDateInspectorDate,Inspector Date Inspector Corrections Corrections Y N Corrections CorrectionsY N Y Tft|^MENT MEDIA MOUNDS/AT-GRADE TREATMENT MEDIA □ Drainfield Rocl<□ Registered Treatment Media Percent Slope□ Mound □ At-Grai Sand Below Bed on Upslope Side(in):Registered Treatment Media:Bed Width(ft):Bed Length(ft): XSEWAGE/HOLDING TANKS Downslope(ft): Upslope(ft): Sideslope(ft): Capacity (Gallons) Manufactuer Model No. Rock Below Pipe(in): /'l^oo PRESSURE DISTRIBUTION,1st Tank: New □ Existing □ Combo•a ( New Number of Laterais:2nd Tank:□ Existing □ Combo >ateral Spacing(ft)Lateral Dia(in)"2- teen Perforation Dia(in)□ Existing □ Combo Perforation Sl>^ing(ft)Cleanouts: Y N3rd Tank:ew iA -X PUMP INFO□ New □ Existing □ ComboPump Tank \TRENCHES/PRESSURE BEDS Pump Manufacturer/Model No: . Pump Trench Pressure □ Gravity 'El-Flow Measurement Reading:□ Drop Box End Fed □ Dist Box □ b»(ent Counter □ Run-Time ClockBed Rock Below Pipe(in)SETBACKS□ Dro^v^o^enter Fed □ 6 □ 12 □ 18 □ 24S Dwelling Non-Dwelling Buijding(s) to tanks(ft)?’ Dwelling Non-DwellingT,T2 T3 T,TsTrench Depth (in,Building(s) to STA(ft) Well(s) .50' ■ 100) kmM-foT,T3Trench Length (ft)T4 T5 Surface water(ft)Property lines(ft) Road ROWTeTrench Depth (in)Tt Tg T,o Bluff —Pressure Test: Depth'of ___ Restriction(in): ! Depth of System(in):Vertical Separation Provided(in): ' ------------ TeTranch Length (ft)T7 Te Tg T10, NComments: 2- CoNfLt^&kdr\ ^(kAJC ;v Final Inspector Signatory SSTS Inspection Form 02-05-2020 PT-869491 • Wetor Lundeen Co.^finters • Fergus Falls, MN • 1-800-346-4870' £10^2-3 Otter Tail County Land & Resource Management Subsurface Sewage Treatment System Inspection FormOTTER TAIL COUNTY - MINNESOTA , Permit No.Address Property ID No.□ Non-Shoreland CiW/Twp. MPCAType ^,0^ew □ Repair □ Replaceme^t'^f^^ther Installer/MPCA #VIIV □ At-GradeType of System □ Trench □ Pressure Bed □ Mound Other Inspection:Final InspectionTank inspection 41iaVi^Date Inspector Date Inspector Date Inspector Inspector Corrections Corrections Y N CorrectionsCorrectionsY N "^^-OI^^TMENT MEDIA MOUNDS/AT-GRADE Percent Slope□ Mound□ Drainfield Roa □ Registered Treatment MediaTREATMENT MEDIA Sand Below Bed on Upslope Side(in):Bed Width(ft):Bed Length(ft):Registered Treatment Media: SEWAGE/HOLDING TANKS lideslope(ft);Downslope(ft): Upslope(ft): Capacity (Gallons) Manufactuer Model No. Rock Below Pipe(in); j/PRESSURE DISTRIBUTION■ □ New Existing □ Combo1st Tank: 0m Number of Laterals:Lateral Spacing(ft)□ New □ Combo Lateral Dia(ln)2nd Tank: PerforatiorTs^tiBg^) s&i ./Ig®Perforation Dia(in) Cleanouts: Y NNew □ Existing □ Combo3rd Tank: PUMP INFO□ New □ Existing □ ComboPump Tank TRENCHES/PRESSURE BEDS Pump Manufacturer/Model 1^ '□''^^ent.Q^nter □ Run-Time ClockPump PressureTrench□ Drop Box End Fed □ Dist Box □ Gravity □Flow Measurement Reading:Bed Rock Below Pipe(in)SETBACKS□ Drop Box Centfes^d □ 6 □ 12 □ 18 □ 24 Dwelling Non-Dwelling Dwelling Non-DwellingT,l3 T4 TsTrench Depth (in)Building(s) to tanks(ft)Building(s) to STA(ft) Property lines(ft) | qT4T5T,T2 Surface water(ft)Trench Length (ft)Well(s) Road R.O.W.^^-^T9 T,oTeT7TsTrench Depth (in)Bluff Pressure Test: IDepth of Restriction(in): Depth of System(in): Vertical Separation Provided(in):Te Tg T,oTeT7Trench Length (ft) Comments: of COsliAd ^ K SSTS Inspection Form 02-05-2020 PT-869491 • Viciot^undeen Co., Printers • Fergus Falls, MN • 1-800-346-4870 ai c Department of m 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 OTTCR TflIIQO0»TToaf«OtfOTII AS-BUILT REPORT SUBSURFACE SEWAGE TREATMENT SYSTEM SITE/OWNER INFORMATION Property ID# % Mail City Site Address Property Owner ClfsL Mailing Address ^ AdV Mail State/Zip SSTS CONTRACTOR INFORMATION Certified Individual on Job MPCA License # Date of Installation Installation Business SYSTEM INFORMATION TANKl TANK 2□ Registered Tank □ Registered Tank ZUH ujXManufacturerManufacturer ^lOO /^!v 11^1 Ml_______ OiSOti -zoo Ma/Model NumberModel Number jSS^. <T7gallonsLiquid Capacity gallonsLiquid Capacity td ~Date of ManufactureDate of Manufacture ft Maximum Depth AllowedMaximum Depth Allowed ft ft Actual Depth BuriedActual Depth Buried ft WiHVIPTANK VTANKS□ Registered Tank □ Registered Tank /yiK/ 4;pjT ^ 1^36. m/y ManufacturerManufacturer Model Number Model Number /^gr7 •Jl Liquid CapacityLiquid Capacity gallons gallons Date of Manufacture Date of Manufacture ftMaximum Depth Allowed Maximum Depth Allowed ft2L 2=.Actual Depth Buried ft Actual Depth Buried ft DRAINFIELD SPECS PRESSURE DISTRIBUTION SPECS Number of Laterals□ Drop Box □ Distribution Box p Pressurized Trenches Number of Trenches Perforation Diameter in Total Lineal Feet of Trenches ft Perforation Spacing ft Depth of Trenches from Grade Lateral Spacingin ft Total Area Installed sqft Clean-Outs Installed at End Laterals PRESSURE BED SPECS PUMP INFORMATION Bed Length & Width X Manufacturer Depth of Bed from Grade:Model Numberin MOUND/AT-GRADE SPECS TREATMENT MEDIA Bed Length & Width X □ Drainfield Rock □ Registered Treatment Media Sand Below Bed (Upslope Side)in 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. ^ Installer Si^li^ureInstallerMPCA Lie#Date r ' Address of Installation Scale 1: tNorth ; I! : I I ! i t \ s’ I hereby certify that the system drawn above was installed according to the Otter Tail County Sanitation Code and Minnesota Rules, Chapter 70800rp^. ^ ^ MPCALic# ! Date^/Qn/taller SigrtgggFeInstaller f-' • ik Hi.o ■ T^jg_ .■ ■'■■ -^>u . .. r «\ o'* VVun>\<v»il«+v-\ Hi.O So.\f S>v\j 7Tv»iK>i__ OTTER TAIL COUNTY LAND & RESOURCE MANAGEMENT PUBLIC WORKS DIVISION VWVW CO OTTER-TAIL MN LJRmmm GOVERNMENT SERVICES CENTER 540 WEST FIR AVENUE FERGUS FALLS, MN 56537 218-998-8095 FAX; 218-998-8112 10/26/2016 SCAHNEDJerry Swanson 41619 450th St PerhamMN 56573 8626 RE; Primary Owner; Jerry Swanson Sewage Treatment System Servicing Tax Parcel Number; 37000320179000 Described as:Sec 32 Twp Lida Township Sect-32 Twp-136 Range-042 .97 AC SUB LOT 1 OF GOVT LOT 2 Lake: 56-747 Lida As of 10/26/2016 the holding tank (Sewage Treatment Installation Permit # 24386 servicing your property was determined to be in compliance with the provisions of the Sanitation Code of Otter Tail County. Please be advised that this certification is only valid for five years from the date of this mailing 10/26/2021. If you have any questions regarding this matter, please contact our office. Sincerely, Alexander Kvidt Inspector APPLICATION FOR PERMIT TO INSTALL SEWAGE TREATMENT SYSTEM LAND & RESOURCE MANAGEMENT GOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS FALLS, MN 56537 218-998-8095 www.co.otter-tail.mn.us OTTER Tflil WHITE - Office YELLOW -L&R Inspector PINK - Owner / Contractor (after issue)couriTTMinniioTfi APPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED Permit No. LAKE NUMBER I LAKE/RIVER N/^E uv« LAKE/RIVER SECTION TWP NO.RANGE TWP NAME 0^-5^ \o4o- I E-911 ADDRESS OR DIRECTIONS FROM NEAREST PUBLIC ROADPARCEL NUMBER (S) OF PROPERTY BEING SERVICED LEGAL DESCRIPTION /Q-t ^i Last Name First Initial Mailing Address Daytime Phone No. Property Owner f f-LjI,, /- £ L^i4r'jAr>i, ___________________fContractor Lie.# ^6 ^ 9 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. L&R OfficialDate Received Time Received TYPE OF NSTALLATION (circle one)SEWAGE TREATMENT SYSTEM DESIGN DATA AS SHOWN ON DRAWINGOther Est.Residential (A) New (B) Replacement (C) Add on Collector New fey Replacement ^ Add on (G) New (H) Replacement (I) Add on Soil Treatment Area Tank Li'Design Flow (Gallons/Day) Effluent Distribution ( ) GravityLD 0 'fOyO J^OO— 2,499 2,500 — 4,999 (M) 5,000 — 10,000 GIs Ft.() Pressure Size Setback To Nearest WellType I Type II Ft. Ft. (20) Trench, Rock (27) Rapidly Permeable t'Ft.Ft.Setback To OHWL(21) Trench, Gravelless (28) Flood Plain (22) Trench, Chamber (29) Privies (0) Holding Tank (Contract Required) .-Ft.Ft. Ft.Setback To Bluff(23) Bed (24) Mound ±Ft. Ft. Ft.Setback To Dwelling (25) At Grade Type III rSetback To Non-Dwelling(26) Greywater (31) Other/Problem Soils/<12" Soil Ft.Ft. Ft. Type IV(34) Tank Only rSetback To Nearest Lot Line I Ft.Ft. Ft.(32) Public Domain & Proprietary Technologies (35) Other Setback To Road Right-Of-Way i'ODepth of Well Ft.Ft. Ft.Type V Total It Bedrooms (33) Performance Elevation Above Restrictive Layer Ft. Ft. Ft.Abatement Y / N Garbage Disposal V / N PERC TEST DMi Design(License #Date of Test Highest Rate£y Agreement: The undersigned hereby makes application for permit to install, alter, repair or extend Sewage Treatment System herein specified, agreeing to do all such work in strict accor dance with Sanitation Code of Otter Tail County, Minnesota. Applicant agrees that the Site Data Worksheet submitted herewith and which is approved by a Land & Resource Management Official shall become a part of the permit. Applicant further agrees that no part of the system shall be covered until it has been inspected and approved for use. It shall be the responsibility of the applicant for the permit to notify Land & Resource Management that the installation is ready for inspection. Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express condition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Sanitation Code of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of the Sanitation Code. NOTE: 1. This permits valid for a period of six (6) months 2. This not include the building sewer (sewer iine). Date:Permit Fee $ orty Owner^tgBftrfor Owner'>w^^ sffent ometat Date:Rec. No.. Land & Resource Manag — So Vo [i uXe — Date StampComments: m Form No. BK — 04-2014-06 Cl L&R Initial 357,243 • Victor Lundeen Co., Printers • Fergus Falls, Minnesota /Vv/V APPLICATION FOR PERMIT TO INSTALL SEWAGE TREATMENT SYSTEM LAND & RESOURCE MANAGEMENT GOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS FALLS, MN 56537 218-998-8095 www.co.otter-tail.mn.us OTTER TRIl WHITE - Office YELLOW - L & R Inspector PINK - Owner/ Contractor (after issue) Permit No. COHiTT-BINfllfOTil oVAPPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED LAKE NUMBER LAKE/RIVEB NAME LAKE/RIVER SECTION TWP NO.RANGE TWP NAME mCk^ PARCEL NUMBER (S) OF PROPERTY BEING SERVICED E-911 ADDRESS OR DIRECTIONS FROM NEAREST PUBLIC ROAD . yy LpGAL DESCRIPTION /\ Last Name First Initial Mailing Address Daytime Phone No. Property Owner i .■___________________r Y __________ C- / /y • . iA/ix t] </;r1 L / ‘u I -J !■ r1 .y ■ i Contractor Lie.#<.A, THIS SPACE FOR OFFICE USE ONLY %\\s) On'10 2(p A.M. >■ This System will be ready for inspection on , the year of .P.M. v6\g(i>\a(i Date Received P.M. Time Received L & R Officiai TYPE OF NSTALLATION (CiRCLEONE)SEWAGE TREATMENT SYSTEM DESIGN DATA AS SHOWN ON DRAWINGResidential (A) New (B) Repiacement (C) Add on Collector Other Est. (D) New (E) Replacement (F) Add on (G) New (H) Replacement (I) Add on Soil Treatment Area Tank LiftDesign Flow (Gallons/Day) (J) 0 (K) 1 — 2,499 (L) 2,500 — 4,999 (M) 5,000 — 10,000 Effluent Distribution ( ) Gravity ( ) Pressure GIs GIs Ft.Size Setback To Nearest WellType I Type II Ft.Ft.Ft. (20) Trench, Rock (27) Rapidly Permeable Ft.Setback To OHWL Ft.Ft.(21) Trench, Gravelless (28) Flood Plain (22) Trench, Chamber (29) Privies Ft.Ft.Ft.Setback To Bluff(23) Bed (30) Flolding Tank (Contract Required)(24) Mound Ft.Ft.Ft.Setback To Dwelling (25) At Grade Type III Setback To Non-Dwelling(26) Greywater (31) Other/Problem Soils/<12" Soil Ft.Ft. Ft. i ■Type IV(34) Tank Only Setback To Nearest Lot Line Ft. Ft.Ft.t(32) Public Domain & Proprietary Technologies (35) Other Setback To Road Right-Of-WayDepth of Well Ft.Ft.Ft.Type V Total # Bedrooms (33) Performance Elevation Above Restrictive Layer Ft.Ft.Ft.Abatement Y / N Garbage Disposal Y / N PERC TEST DATA Designer Agreement: The undersigned hereby makes application for permit to install, alter, repair or extend Sewage Treatment System herein specified, agreeing to do all such work in strict accor dance with Sanitation Code of Otter Tail County, Minnesota. Applicant agrees that the Site Data Worksheet submitted herewith and which is approved by a Land & Resource Management Official shall become a part of the permit. Applicant further agrees that no part of the system shall be covered until it has been inspected and approved for use. It shall be the responsibility of the applicant for the permit to notify Land & Resource Management that the installation is ready for inspection. Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express condition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Sanitation Code of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of the Sanitation Code. NOTE: I.Thls permit Is valid for a period of six (6) months. 2.This permit does not include the building sewer (sewer line). License #Date of Test Highest Rate Date:Permit Fee $ Signature of Property Owner/Agent lor Owner 7 otL> - / Y(Date: ( ' / L Lf Rec. No.. Land & Resource Managen^nt Official Comments: CjJL\AKf/^ f Form No. BK — 04-2014-06 IQlMriSL 357,243 • Vlnor tundeen Co., Prtntors • Forgot Folio, MInnosoto 4SEWAGE TREATMENT SYSTEM PERMIT INSPECTION RESULTS STA (Soil Treatment Area) OUTHOUSE HOLDING SEPTIC TANK TRENCH REDUCTIONLIFT TANKCATEGORY Rock freshes with inchesCapacityFT2GLS. GLS. of sidewail %FT FT FTSetback from Nearest Well redenion / equivalent t^Setback from Buried Water Suction Pipe FT FT Setback from Buried Pipe Distributing Water Under Pressure STA CALCULATION ^ (SoU^reatment Area)FT FT FT l‘?>^Setback from OHWL (lake &/or river) FT FT FT ■t. X Ft. Setback from Bluff FT FT FT FP smSetback from Dwelling FT FT FT MOUND / AT-GRADE ROCK BEISetback from Non-Dwelling FT FT FT FTSetback from Nearest Property Line FT FT Ft.Ft. Setback from Right-of-Way FT FT FP Elevation above Restrictive Layer FT FT FT y SAND IN MOUND ^FtINSTALLERS COMMENTS SEPTIC TANK(s)Holding Tank / Lift Alarm ^YES □NO PT(«,ail # Tanks Installed□ NOOld System Pumped & Destroyed Weep Manuf.Number of Lateral Lateral Pipe Size IN Model #Perforation Spacing Ft.Perforation Diameter Size IN FILTERS □ YES NOPUMPSGallons Per-Mti XInspector's Comments: Sketch: \it ._Arz o \0 U. |0'^-i4r. the above described sewage system installationAs of was found to be compliant with the provisions of the Sanitation Code of Otter Tail Countv.Date Time tnitial/L&R Official / Land & Resource Management Official Form No. BK — 04-2014-06 357.243 ■ Victor Lundoon Co.. Printort • Forgut Falls. MInnosota SITE DATA WORKSHEET LAND & RESOURCE MANAGEMENT GOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS FALLS, MN 56537 218-998-8095 WWW.CO otter-tail.mn.usOTTER Tflll COVRTT aiilKIOTi Sewage Treatment System Permit #OWNER: o LAST NAME ■IRST MIDDLE TELEPHONE NUMBER ADDRESS: A',f(SS I CITY___STR./RT STATE ZIP CODE 3^ J3/ O^P- 3^'da LAKE/RIVER NO.LAKE NAME SEC.TWP NAMETWP RANGE LEGAL DESCRIPTION:SOIL BORING LOG Si/^ Pa / af— 39 Qoo PP-0 PARCEL NUMBER E-911 Address or Directions From Nearest Public Road NUMBER OF BEDROOMS GARBAGE DISPOSAL: YES WELL: CASING DEPTH St) -fTt. SEWER LINE SEPARATION:ft. C)©FLOODPLAIN: YES BLUFF: YES (fERRESTRIA^ VEGETATION: AQUATIC SLOPE AT INSTALLATION SITE:% TYPE OF OBSERVATION: Probe----Pit----Bonna PARENT MATERIAL: TiU—^trtwssb—toess—Bedrock Alluvium ORIGINAL SOIL: Yes—Mo"Date of Soil Boring COMPACTED SOIL: Yes----Me- DEPTH OF BORING (To T or restrictive layer):.ft.Date of Perc Test PERC TEST #2PERC TEST#1 - TWO TESTS ARE REQUIRED - PERC RATETIMEINTERVAL (MINUTES) WATER DEPTH WATER DROP TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP START STARTA ^ ___ =DROP PERCTIMEDROPPERCTIME PBffC RATEWA! ER DROP WATER DEPTH WATER DROPTIMEintervalXminutesiWATER DEPTH PERC RATE JML INTERVAL(MINUTES) REFILLREFILL -r )P PERC DROP PERCTIME INTERVAL (Mft(UTES> REFILL \ WATER DROP TIME WATER DEPTH WATER DROP PERC RATETIMEINTERVAL IMINUTESI WATER DEPTH :rc rate REFILL DROP TIME DROP PERCTIMEPERC PERC RATEWATER DRQPX PERC RATE TIME INTERVALIMINUTESI ^^ER DEPTH WATER DROPTIMS.INTERVAL (MINUTES)WATER ■TH REFILLREFILL TIME PERCDROPPROP.____PiR£____ PERC HATE TIME WATER DROP PERC RATE^[E.R .DPQP-.-_. REFILI ITERVALtMir VATER DEPTH. REFILL PERCTIME__DROP____ _______PERC RATE TIME DROPPERC PERC RATETIMEINTERVAL tMINUTESi REFILL ER DEPTH /ATER DROPTIMEINTERVAL IMINUTES) WA1 REFIIL > LP]ER DRV -r--------- =___ =TIME DROP PEw:ML D.ROP___S. PERC RATE PERC INTERVAL (MINUT^ REFILL^/PERC RATETIMEWATER DEPTH WATER DR1UNUTI«AI£J kTER DROPJJ REFILL -r-------- =DROP PERCTIMEDROPPERC:iME INTERVAL (MI^TESt REMIL XWATER DEPTH PERC RATETIMEWATER DEPTH WATER DROP PERCl^ATE TIME INTERVAL (MINUTES)WATER DROPREFIIL TIME DROP PERCDROPTIMEXpc__I_1. SEPTIC TANK MANUFACTURER: PROPOSED DESIGN: PRESSURE DIST..GRAVITY DIST.,TRENCH, ATGRADE,MOUND,HOLDING TANBED, SEWER LINE,OUTHOUSE,OTHER, SPECIFY:. — SYSTEM DESIGN ON BACK — ‘ t';;I System design must be to scale and must include the proposed location of theisewage system, all existing/ proposed buildings, property lines, the ordinary high water level of the water body, bluff and jail water wells within-150r of the sewage-system.-lf there are any questions, see the University of Minnesota Site Evaluatiop" worksheets.II;Ii 1 grid(s) equals inch(es)l equals feetI_feet, orScale: I 3^II MPCA LICENSE *\ iDESIGNED BY;LICENSE CATEGORY:I I FIRM NAME:DATE:I-------------r’ ADDRESS:'!!SIGNATURE: I I 1 i 11 II I ! I f <2 .^!i L: 0 0 I(Cc(0I''P.4S'-^1 ~f TsiZTm I I I I I 1 (/i!G 15?1 I1■y Si tZl7 i \ iA/^'\pI 1 vs-c o i !On' I 1__________ .I I !II:I i ; I !iI I t \iI I ; 0 A ibnKS:[^) I'lo iJ, pc{^ (4 ^ iS?>rS:z f \^oO z n2. 1 I i I I 1 \II /'Bk — 04-2014 — 029 2‘i1 • Vijtur Liituieen Co Pntiieis • Fer,iiib Halls WN' • 1 •800-3‘^Si^70!1 .• 'Land & Resource Management GSC, 540 W Fir, Fergus Falls, MN 56537 218-998-8095; Website; www.co.ottertail.mn.us Subsurface Sewage Treatment System Management Plan Sewage Treatment System Permit Number: Prooertv Owner: 2?--7 • _ A. . _ Parcel Number: Section: ^3 ^ ^^ Lake Name / Number: _ Township Name: _________________ E-911 Address: /rf" /O ^ This management plan will identify the operation and maintenance activities necessary to ensure long-term performance of your septic system. Some of these activities must be performed by you, the homeowner. Other tasks must be performed by a licensed septic service provider. Homeowner's Management Tasks - Should Be Checked Every 6 months: leaks - Check (look, listen) for leaks in toilets and dripping faucets. Repair leaks promptly. Surfacing sewage - Regularly check for wet or spongy soil around your soil treatment area. Effluent filter (if applicable) - Inspect and clean twice a year or more. Pump Tank Alarms - Alarm signals when there is a problem. Contact a service provider any time an alarm signals. Holding Tank Alarms - Can be either an electronic or a manual float, when activated, service (pumping) is required. Event counter or water meter (if applicable) - Record your water use. Vegetative Cover - Establish and maintain a vegetative cover over the sewage system. Professional's (Licensed Septic Service Provider) Management Tasks - Shouid Be Checked Every 24 Months (2 Years): □ Check to make sure tank is not leaking. □ Check and clean the in-tank effluent filter. □ Check the sludge/scum layer levels in all septic tanks. □ Recommend if tank should be pumped. □ Check inlet and outlet baffles. □ Check the drainfield effluent levels in the rock layer. □ Check the pump and alarm system functions. □ Check wiring for corrosion and function. □ Provide homeowner with list of results and any action to be taken. □ Check inspection pipe caps (replace as necessary). □ Check manhole cover (accessibility, security, or damage). I understand it is my responsibility to properly operate and maintain the sewage treatment system on this property in accordance with this Management Plan. ‘^1 PropertvOwnerf4^^ 3- ^ Received by Land & Resource Management:__^ Date: Signature Date: Signature The following link will provide information from the University of Minnesota, regarding a Septic System Owner's Guide; http://www.extension.umn.edu/environment/housine-technologv/moisture-management/seDtic-svstem-owner-guide/ LR: SSTS Management Plan 07-23-2014 Department of LAND & RESOURCE MANAGEMENT COUNTY OF OTTER TAIL Phone: (218) 739-2271 Court House FERGUS FALLS, MINNESOTA 56537 r, December 1, 1993 1 Jerry Swanson RR#3 Box 359 Pelican Rapids, MN 56572 RE: Sewage Permit #9291, Sublot 1 of GL 2, Lake Lida (56-747). Dear Mr. Swanson, As per the above mentioned permit, a 1000 gallon holding tank was to be installed at your campground to serve one cabin and two seasonal campers. Although the tank and drainfield for the House, Showerhouse and Toilets have been inspected and approved, our office cannot certify your system until the holding tank is installed and approved. Please contact me prior to January 14, 1994 so we can discuss your plans for completion. Sincerely, Wayne Roisum Inspector SHORELAND MANAGEMENT ORDINANCE — SUBDIVISION CONTROL ORDINANCE RIGHT-OF-WAY SETBACK ORDINANCE - SEWAGE SYSTEM CLEANERS ORDINANCE RECORDER, OTTER TAIL COUNTY PLANNING COMMISSION 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 fan1 aP Gl ^LEGAL Permit No. DESCRIPTION AND LOCATION LAKE NUMBER LAKE/RIVER NAME LAKE/RIVER CLASS SECTION TWP RANGE TWP NAME I3>1.3;3lL\0/^lip/) PARCEL NUMBER(S)FIRE OR LAKE ASSOCIATION NUMBER ^7 - -37- 0H1 IDENTIFICATION: Please Print All Information Last Name First Initial Mailing Address — No. Street, City and State Zip Code Telephone No. fix 3SUjProperty Owner 54^. Sewage System Installer Name a,\r\<jL ^ A.M. This System will be ready for inspection on . 19-P.M.at This space for office use only ^ RfSSneSJ NUMBER OF BEDROOMS: A.M. P.M19 GARBAGE DISPOSAL: ( ) YES (Date Rec'd Time Rec’d Phone Call Rec’d By SEWAGE DISPOSAL SYSTEM DATA: MINIMUM REQUIREMENTSTYPE OF SEWAGE SYSTEM _ fr^Holdingtankl ^ ^ ( ^^-^eptic tank ( ^-ft)rain field { ) Standard ( ) Bed ( \/^) Trench ( ) Modified ( ) Mound TANK DRAIN FIELD(Capacity7 ti<^tf3€ ’t' pTHl» 3 ilesoex /0*a- IPOsoDistance from nearest well Ft.Ft. Distance from lake or stream Ft.Ft. IDDistance from building Ft.Ft. IP loDistance from property line Ft.Ft. EFFLUENT DISTRIBUTION ( Gravity ( ) Pressure 3Distance from bottom to Water Table Ft. Ft. All distances are shortest distance between nearest points WATER WELL DEPTH; I i ^ 3 1992 3 r ’^3^ u3-]XPERCOLATION TEST DATA: Date of First Test , 19.Rate 17 3 . ^33- f 7Date of Second Test . 19 Rate st^’^akerji ^y1st Te// '(3.33 C .11 = 3-HdFirst Test + 2nd Test 2 Rate2nd Test Taken By Agreement: The undersigned hereby makes application for permit to install or extend Sewage Disposal System herein specified, agreeing to do all such work in strict accordance with Ordinances of the County of Otter Tail, Minnesota and Minnesota 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. Signalu^^DATE: 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. ^ / f - f JLIssued Date; * Land 4 Resource Management OfficelOlfSik) _ ____ p\ \00^ Fi ^ o- G^S.tT.6..^ Fee $Rec if Comments: Cl lOOO yvi JUUL^tr Form No. BK — 0292-003 C-*' . Printefs, Fergus FaUs. Minnesota/o' -T« r\ 'r S r «rr r ro w - .w«;-i;Is/ n «/• ^A•f / V II•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 WHITE — Office Yellow — Inspector Pink — Owner r failf <5*^ (oL ^Permit No.LEGAL DESCRIPTION w AND LOCATION LAKE NUMBER LAKE/RIVER NAME LAKE/RIVER CLASS SECTION TWP RANGE TWP NAME a'7^17 /3^3;iUO/^GJPn * IIPJ^+ PARCEL NUMBER(S)FIRE OR LAKE ASSOCIATION NUMBER ^7- '37- onl - 0^0 IDENTIFICATION: Please Print All Information FirstLast Name Mailing Address — No. Street, City and StateInitial Zip Code Telephone No. tb: 3SUJ T\t\/51'yJ - 5jcjSProperty Owner Sewage System Installer Name e^fiy 4‘m A.M.oT%5This System will be ready for inspection on., 19.at NUMBER OF BEDROOMS: filSffPe. IThis space for office use only s; e ^f- 8 GARBAGE DISPOSAL: ( ) YES (Date Rec’d Time Rec'd Phone Call Rec'd By SEWAGE DISPOSAL SYSTEM DATA: MINIMUM REQUIREMENTSTYPE OF SEWAGE SYSTEM ( L^Holdingtank3 of ( ^/'f^eptic tank ( ^i*ft)rain field ( ) Standard ( { ) Modified ( ) Mound TANK DRAIN FIELD /X*M,/yx.Capacity? l4^uS€ PfH2T 3 flesour ) Bed { ) Trench SO / IPODistance from nearest well Ft. Ft. 5"^5^^Distance from lake or stream Ft.Ft. Distance from building ID Ft.Ft. iO loDistance from property line Ft.Ft. EFFLUENT DISTRIBUTION ( L ) Gravity ( ) Pressure Ft.3Distance from bottom to Water Table Ft. All distances are shortest distance between nearest points WATER WELL DEPTH: I 5'HRLl<»'^ I r9/=<?'^ •S.' I 7- IX fJL 3,23PERCOLATION TEST DATA: Date of First Test Rate, 19.■ 117R/>tz U-iw^3 . ^33- 17Date of Second Test . 19 Rate j^1st Test^Taker^ By ;11 3. 4S ^ ■ U = 3.3 33First Test + 2nd Test 2 Rate2nd Test Taken By Agreement: The undersigned hereby makes application for permit to install or extend Sewage Disposal System herein specified, agreeing to do all such work in strict accordance with Ordinances of the County of Otter Tail, Minnesota and Minnesota 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. //.'..--Ol-VuDATE:iy^ignsture/ Permit: Permission is hereby granted to the above n^eiappUcant to perform the worJt 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. 4 \\ ^f - f gIssued Date: Land & Resource Management Officei35'. 00 ^ ^ ^/ 3 i- 3lSr<^^,ta. — f ^ Form No. BK — 0292-003 ^ .^J'■ ■ / f ^ Will lot P/ac_cc’/ !o^ Fee $.Rec #. Comments: hOiPO yJi ’ /^ i I 260.^f — Victor Lundeen Cp., Printers, Fergus FallSrfMinnesota^cJ . Cfvmpa/’ «S \ry ftfvnnpor‘in^ f. I O «-«■ •!“'» O Y>* . ■r ^ INSPECTION RESULTS Inspector must make alt measurements SEWAGE DISPOSAL SYSTEM STATISTICS SEPTIC TANK DRAIN FIELD CATEGORY Actual Minimum Actual Minimum 7ro SF/S'CSC GLS.SFCapacityGLS. FTDistance from Nearest Well FT FT50 Distance from Buried Water Suction Pipe FTFTFT50 FT 50 FT loi FTDistance from Buried Pipe Distributing Water Under Pressure FT10FT10 FTAo FTDistance from Lake or River (OHWL)FTFT n.FT FTFT20Distance from Nearest Building 10 FT /o ft^0 FTFT FT 10Distance from Nearest Property Line 10 f FT FTDistance from Bottom to Water Table FT FT 3 DRAINFIELD CALCULATIONSewer Line to Well SeparationINTERPRETATION OF ABBREVIATIONS GLS. = Gallons SF = Square Feet FT = Linear Feet Actual Minimum 1 FTFTX 7FTFT20 SF Inspector’s Comments: SKETCH: Inspector's Signature Date of Inspection / V 3<3 Time of Inspection cu •? 1•l.*/ -%f I/ # i ciean>-*9 Hf^S< I tI 3 , je. rt 2,0'!V / IIaf^■ //I .Ii(Qaira}^/A(7^‘'I tr0 t >n I ' K' ^' ' -I ‘! 50’ 32 '2 "✓_53’»»rr(t T i > /I n'i>0 ,fS3 /r StjpMf HO^Sf—;/ ^% n<i'9'/■«. f' I:f'5"/i «//"**'C^ V ^ Sfot'/ y£>u5^ !!•"«N o 09 •:t!:s c!><U' Vk U^'» 3^' 215502® VICTOR LUMOCCH CO.. RRIHTERt. FERGUS FALLS.PERCOLATION TEST DATAMKL -0871 -028 LAND AND RESOURCE MANAGEMENT Otter Tail County Fergus Falls, Minnesota 56537 Ph. No. Mailing Address:Owner:/S/ tCjS vn f i/J. ] City ' ./SL3I Last Name Zip No.StateSt. & No.Fi Middle Z rrl a42Legal Description:3Z%-7AlLAKE OR RIVER NO.TWP NAMETWP.RANGESEC.NAME TEST HOLE NO. 2TEST HOLE NO. 1 2^Depth to Bottom of Hole inches; Diameter of Hole JnchesDepth To Bottom of Hole Diameter of Holeinches;inches Depth, Inches Soil Texture Depth. Inches Soil TextureDate 19 19_____Date11, i^d >.r*Z22U:A /r- I-uPercolation Test Bv____ Percolation Test By .\)hC 1110Z21/Q OJ^ P.'nC II Firm • Name. FirmName.I CC ±DaLUocnLUhKAddress.QC Address < (fi Otter Tail County License No..Otter Tail County License No...H COLUMeasure ment, inches Drop in water level, inches Percolation rate minutes per inch Time Intervals minutes Percolation rate minutes per Inch Time Interval, minutes Measure ment inches Drop in water level. Inches Remarks:Remarks:Time Timeo Tsi94‘Ya '.V' I- /Q ' J^A /UO^- ':}Ql inu-- /JiZ l - /L3t-~ /2f^'t\ /nlr> I PA 11 '2, //OiAiA /0'5C / / : UA-O- ntzo u: 3Z) /o^5 f t 11 Jn' 1 ^ j . AM /o 'X 0^ i_?^ minutes per inch See Booklet, "How to Run a Percolation Test" by Agriculture Ext. Service, Un. of MN Percolation rate minutes per inchPercolation rate = >-n/2_ '72^ ( L^o^ 00 ISO2^S ct>^0t k^‘>'ry\e^ - '^ % — % I o r^l<h THwy_D ^ ^ J2M •^>'*y~^ Y\o . ^3 FT^■mewcif U13^ F \-S FT/OO-^siy\iy>0Fifio ISO ^ ^ Q <Y^ / I C«j2'*4n ^ 0- tci^ ~~2^^ ey^ jc^ J 500 100jOej»-i«r. CAi^pova.;xaay. X - Department of LAND & RESOURCE MANAGEMENT COUNTY OF OTTER TAIL Phone 218-739-2271 Court House Fergus Falls, Minnesota 56537 June 23, 1992 Jerry Swanson R#3 Box 359 Pelican Rapids, «N 56572 RE: Property Located on Lake Lida (56-747).\ Dear Hr. Swanson: Recently you indicated to one of our inspectors (Wayne Roisum) that the septic system on your campground was not functioning correctly. A check of our file indicates that you present sewage system consists of 2 tanks, totaling 9<b(b gallons and approximately 210 square feet of dralnfield area. Our file also Indicates that this system is designed to handle the needs of your home only. Mark Ronnlng (Public Health Consultant) informed me that at this time your septic system is servicing your campground with 10 sites and 3 trailer hook ups. Our calculation indicates that to properly handle the sewage generated by your home and campground you should have a total of 2,200 gallons of tankage and 1578 square feet of dralnfield area. It would appear that your problems are related to the small size and the possible over use of your present system. Also, our files show not permits have been taken out for the addition of trailer hook-ups to this septic system and no permits were obtained for the enlargement of the campground for 5 sites in 1990 to 10 sites in 1992. Therefore, by July 2, 1992, you must contact our office to resolve these problems. Sincerely, George Hausske Inspector mgb SHORELAND MANAGEMENT ORDINANCE — SUBDIVISION CONTROL ORDINANCE RIGHT-OF-WAY SETBACK ORDINANCE — SEWAGE SYSTEM CLEANERS ORDINANCE RECORDER, OTTER TAIL COUNTY PLANNING COMMISSION i Cl 3 'ViTAiUr- l)0£>/i C^-J[yj ^0- 0^^\ i>OH AcJi^ </mi7vp\w cJli I Uk aUJUJ X< I cop]/\0^ ^ lOO 10/^ ^Aetoh /£to^ ^ [OOO ' Q4^-f^ W5o ' f'lou^-c. ^ ^ 5 JL 10 fljj. ^ l^^l ItdUL^6'-ja~^Hpo JU-rrd, ^ Tr-fclrf-^^/ (iCHi^f-^l/'c/h./ uoi AU< " t 1)00^ Ct 3-?V fcDUj jooo hlr ■ lyri' 4- > M f- ■■ lino 4H ■'i (,-2^ -^1? IJfHJ / c4*/3dL^ t/\ *.- ;■ vk / p V..ii h •:S’1-n • T-':U-V X ' V*^ V, V '.•tt \ V ••' --’^'\; 1t:>1t.\'\\->;*41 -l^r.‘ ^>-"f'- - 44‘• '*'tr-\r^-\' \ ■■ j!\r y>.br^4>>■ \!., V,^-i_-■■n ‘lV■r\r-a• >.■\f">■(*rXJ .,--f \\< . r r^VuJ \ V-, -:y■\*,i ^4'N ^■*. \V V \ V i' K > * \ • \'V t - i»9i *.S'^ x" '). ^!^ V Vi\I -i— K - ''O-.. J• * . \/'« S' , I T •? 4^ -;jJT ‘r .' \!r V^ i\## • V ; ■ 1 4fcji 4^' , '^tloia^ tptJ^ ^Mi'^ ShS"7^ 2>tujoit^s s dcu^i> S^l” 2 -V Ki. Sls>c32 /3^'V2(1.'AJS^t A> -2 cXjJOi I^H /U- Cg-W 1^ O (X^i'yJU—.^ C^-c-c/l/UU^ i r . yy^~i~ (T^PV»J /” OUUf^^ ^SLJu<. tJl^.M,^ ^ 0 t 4c" i" >-'— , 4 yvX^^/a./ /5 Cl A ^O #-.Vc %3 - 'V?' £■ - 0 U7 ft'' -vP'^ 4, ftA- ^ '' 6^^ |p‘i-..» • . j / t. SHORELAND MANAGEMENT COUNTY OF OTTER TAIL Phone 218-739-2271 Court House Fergus Fails, Minnesota 56537 MALCOLM K. LEE, Administrator TO; The Owner of this premise, building site or structure; This office does not have in its records a permit for land use or construction taking place at this site. On October 15, 1971 an Ordinance became effective to regulate the use and develop ment of the shorelands of public waters in the unincorporated areas of Otter Tail County, Minnesota Permits shall be obtained prior to erecting or installing a new structure or sewage disposal system or altering any structure or sewage disposal system. Please contact this office immediately. Thank you. Malcolm K. Lee, Shoreland Management Administrator MKL-0871-019 i ^^o>i 4)'*«^«'^*‘>-rUe/f J^,/ft-4 j^OoK ^iram b*7^^ d<Pn\fr)4’ ^Q H*y^ To /^&‘jp U‘ OTSm ^(oiM U O ^ fod «/ o/hfiiiJ /^‘ Cr ll ACCo/^Jf m y r. ■pvc^'*-> C"'<-li 7^/- 7S?y^/ c//~/^/u /^j<z/c{ c^/o ^ /Oe^I 9^ „,A To {:ll J,// ;J /^^So ' "P c/r^^:/J ■/'«'/</ Ca/o, ’u>*^ . ABATEMENT NOTICE Shoreland Management COUNTY OF OTTER TAIL Court House Fergus Falls, Minn. 56537 22nd June ] Q S4Dated this..day of_ To JeJUiy Swanson Route #3Address. City and State.Peytccan RaptcU, MN 56572Zip Code. the sewage &y6temYou are hereby notified that. Which you maintain at (Legal Description and Location) - Plus Fire No. SiA)o.n6on'6 Campground Sublot 1 0^ G.L. 2 GVLida 32 136 Lida4256-747 RangeClass.Sec.Twp.Lake NameLake No.Twp. Name constructed and/or locatedis not. in accordance with minimum standards of the Otter Tail County, Minnesota Shoreland Management Ordinance. 'thin_30 days from this date. If you fail toYou are hereby ordered to abate the above described conditio correct the above defect you may be subject to a fine, imprisokm^t or injunction proceedings. Shoreland Mahag^ent OfficialWvx PROOF OF SERVICE State of Minnesota County of Otter Tail Fergus Falls, Minnesota 56537 The above notice and order was served by me on._______________ 19___ by handing a copy thereof fthe (owner-occupant-agent) of the above describedto premises. *By posting a copy thereof upon the above described premises. Otter Tail County Sheriff Department *Strike out words that do not apply. CC: Otter Tail County Attorney MKL-0372-03601 220522 ®Viet* V Ce.. Frinicre, Fervea Fatla, SENDER: Completa items 1, 2, 3 and 4.•no Put your address in the "RETURN TO” space on the reverse side. Failure to do this will orevent this card from L>eir>.g returned to you. The return receipt fee will provide you the name of the person delivered to and the date of delivery. For additional fees the following services are available. Consult postmaster for fees and check box(es) for service(s) requested. CJ03 <i>0 Show to whom, date and address of delivery. 2. Q Restricted Delivery. u 3. Article Addressed to: JeAAc/ SMamon R. 3PeJU-cxm Rap^di, MN 56572 4. Type of Service: □ Registered □ Insured "SD Certified D COD n Express Mail Article Number P604-123-5S3 Always obtain signature of addressee or agent and DATE OELIVERED. 5. Signature - Addressee <o JSignatuj^-i X 6.C/1 X 3 7. Date of D^fvery / \\ ^m2 o, »9 8. Addressee's Address (ONLj if requested and fee paid)z9 mOm UNITED S10TES POSTAL SERVICE OmCML BUSINESS BENDER INSTRUCTIONS Wift your ■am*, eddrw, e»d Cede In the•pace below. e Completeitama1,2.3,and4f>nthere«erae. a Attach to fniirt of ardclaH apace pamriti^ othemlaa afllK to back of article, a Eadofee ardda ''Retiitn Racalpt Raquaatad** adlecent to number.___________________ UB.MAIL PEHALTY fon PRIVATE UK. *300 RETURN TO LAND 8e RESOURe&"!fiiRsefiMENT sO£t, or H.D. No.) FERGUS FALLS. MINNESOTA 56557 I (City, Stat«, and ZIP Coda)I V* a > P b□^ 1S3 Sfl3 RECEIPT FOR CERTIFIED MAIL NO INSURANCE COVERAGE PROVIDED NOT FOR INTERNATIONAL MAIL (See Reverse) Sent toN. J^AAu SwaniongStreet CO«0a> ^ and ZIP Code?2JU.can RaplcU).P.O., Sta6 MM 56572 $Postageq Z} Certified Fee* Special Delivery Fee Restricted Delivery Fee Return Receipt Showing to whom and Date Delivered CM00 Return receipt showing to whom, Date, and Address of DeiiveryO) i3 $TOTAL Postage and Feeseu. o Postmark or Dateos6-22-S4E ou.CO a. , STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE. . ClflTIFlEO MAIL FEE. ANO CHARGES FOR ANY SELECTED OPTIONAL SERVICES, (in front) 1 II you want this receipt postmarked, stick the gummed stud on the lett portion ol the address side ol the article leaving the receipt attached and present the article at a post ottice service window or hand it Id your rural carrier, (no extra charge! 2. It you do not want this receipt postmarked, stick the gummed stub on the left portion ol the address side ot the article, date, detach and retain the receipt, and mail the article. 3. It you want a return receipt, write the certilied mail number and your name and address on a return receipt card. Form 3811. and attach It to the Iront ol the article by means ol the gummed ends it space permits. Otherwise, attix to back ot article. Endorse Iront ol artile RETURN RECEIPT REQUESTED adjacent to the number, 4. It you want delivery restricted to the addressee, or to an authorized agent ot the addressee, endorse RESTRICTED DELIVERY on the Iron! ol the article 5 Enter lees tor the services reguested in the appropriate spaces on the Iron! ol this receipt It return receipt is re quested. check the applicable blocks in item l ol Form 3811 6 Save this receipt and present It it you make inquiry SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone 218-739-2271 - Fergus Falls, Mn. 56537 APPLICATION FOR PERMIT TO INSTALL SEI/VAGE DISPOSAL SYSTEM W ;te - Office V low — Inspector Pli.. Cerd Owner Owner Permit No..LEGAL Date DESCRIPTION AND y74 /yZ5i-7H7 LiJ.yLOCATION Lake No.Lake Classif.Lake Name TWP TWP NameSec.Range IDENTIFICATION: Please Print All Information. Last Name Mailling Address —No. Street, City aInitial State Zip No.Tel. No.First P-ePA/ R ~OWNER SEWAGE SYSTEM INSTALLER Name. This System will be ready for inspection on.. 19. This space for office use only .19 .M Date Rec'd Time Rec'd Phone Call Rac'd By Owner or Agent Signa.ture NUMBER OF BEDROOMS: 3ESTIMATED COST: SEWAGE DISPOSAL SYSTEM DATA: SEPTIC TANK SEEPAGE PIT DRAIN FIELD Op GIs.ZjO^- Ft. Ft. Iq. Ft.Capacity ‘Pf) Ft.Ft.Distance from nearest well 5 0 Ft.Ft.Distance from lake or stream Ft. Z O Ft.lo ..Ft.:.Distance from occupied building Ft. LLiDistance from property line Ft.Ft.Ft. fFt.Distance from bottom to Water Table Ft.Ft. AH distances are shortest distance between nearest points RECORD OF TESTS: Inspection was made on , Time JM By.... 12...IPERCOLATION TEST DATA:r~Date of First Test 19 Rate /19..T?...?..., 1st Test Takanr By Test Taken By Date of Second Test Rate 4.I Ra^First Test + 2nd Test 2nd 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.) AT2Aj(1 ■ y )—/ / 77Dated 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 (6) months. #^■4 /f?yIssued Date:. Management Office Surcharge S V ^ ^1Fee $ A A Comments: 'rm No. MKL-0771-003 >158906 vicToa LUNOCCN 8 CO.. eeinTfag, pc*8ui r«LL(. SHORELAIMD MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone 218-739-2271 — Fergus Falls, Mn. 56537 APPLICATION FOR PERMIT TO INSTALL SEI/VAGE DISPOSAL SYSTEM V>' te - Office > low — Inspector Pli.. Card — Owner Owner Permit No.,LEGAL Date DESCRIPTION AND LOCATION Lake No.Lake Name Lake Classif.Sec.TWP Range TWP Name IDENTIFICATION; Please Print All Information. Last Name First Initial Mailling AcMress —No. Stgget, City and State Zip No.Tel. No. AOWNER SEWAGE SYSTEM INSTALLER Name, This System will be ready for inspection on., i9iz:z This space for office use only J=J^7^ 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.Capacity Sq. Ft.Sq. Ft. Ft.Ft.Distance from nearest well Ft. Distance from lake or stream Ft.Ft.Ft. Distance from occupied building Ft.Ft.Ft. Distance from property line Ft.Ft.Ft. Ft.Distance from bottom to Water Table Ft.Ft. AH distances are shortest distance between nearest points RECORD OF TESTS: Inspection was made on 19 , Time ,M 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 Rate2nd Test Taken By Agreement: strict accordance with ordinances of the County of Otter Tail, Minnesota and Minnesota Individual Sewage Disposal Code Minimum Standards set forth by Minn esota Department of Health. Applicant agrees that plot plan, sketches and specifications submitted herewith and which are approved by Shoreland Management Offi cial shall become a part of the permit. Applicant further agrees that no part of the system shall be covered until it has been inspected and accepted. It shall be the responsibility of the applicant for the permit to notify the County Shoreland Management that the job is ready for inspection. (Call or use attached mailer notice.) The undersigned hereby makes application for permit to install or extend Sewage Disposal System herein specified, agreeing to do all such work in Dated, Signature ivtxdress ir^nenta. Permit: condition that the person to whom it is granted, and his agents, employees and workmen shall conform in^ll This permit may be revoked at any time upon violation of any said ordinance. ( NOTE: Permit void if work is not commenced within six 161 months. v- Permission is hereby granted to the above named applicant to perform the work described in,,«he abo IS perratf>»^anted upo /j^JlAffi^Tail Coui^i^Mi itemei Inani Issued Date: Shoreland Management Office Fee $Surcharge $ Comments:. Form Nib. MKL-0771-003 VICTOa U/HVtlH 4 CO.. ORINTCOO. RCH0U4 f4LkO. y.0.158906 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 Capacity SFGIs.GIs.S F S F S F Distance from Nearest Well F 75F 50FF F Distance from Lake or Stream 5^/fFFFF F Distance from Occupied Building 10 20 20FFFF F Distance from Property Line 10 10F 10FFF F Distance from Bottom to Water Table 4 4FFFF F Inspector's Comments:■A- ; 19_Z.'^Date of Inspection. Time of Inspection.M Signature of InspectorINTERPRETATION OF ABBREVIATIONS GIs ~ Gallons SF * Square Feet F * Linear Feet Job Title AgencyMKL-0771-003-Backer * r •r d J .l.'.ilMqi"”- '-''I--' ■ ' ;■ I-"'*" I Tn be CO'l^LETED ^E^.COLATIOM TESTER I hereby attest that I an fanillar with the nininun standards recuired bv the OTTER TAIL COT:;ty SH0RELA!:D 'LAJTAi^E'-IENT ORDIb’A^CCS resardiny se:-racre svstens and that the land elevation T.’here soil absorption portion of sewage svsten vrill be installed in not less than six (6) feet above the high water level of the lake, stream or flowape involved. 9 Legal Description; r?-:d I* V Signature of Pe^c^latorOwners Name ter/ L Z7\' C DalfedLake Name Please return when completed to Land and Resource ^lanagement Office, Attach a copy of theCourt House, Fergus Fails, ’linnesota percolation test results. 56537. !CCL-Q574-045 PERCOLA TION TEST DA TA Price $ 1.00 per pad. SHORELAIMD MANAGEMENT OTTER TAIL COUNTY Fergus Falls, Minnesota 56537 Mailinq.^Address:1h. 'KC,3-SZ.4:'^Ph. No.Owner:/ StaterEJ.Sr AV LCIL^Xast Name First; J~.^j i d'lp) Middle St. & No.Cifv Zip No. iJ&y-Legal Description:5/ - 'M 7 r:'c^ LAKE OR RIVER NO.SEC.NAME TWP.RANGE TWP NAME TEST HOLE NO. 2TEST HOLE NO. 1 c3^1CCDepth To Bottom of Hole.Depth to Bottom of Holeinches; Diameter of Hole inches; Diameter of Hole inchesinches ^Jate 19Deoth, Inches Soil Texture Depth. Inches Soil Texture 19___:*Date L/ SO' 'nfUl L*:^ V\ /.VPercolation Test By____ Percolation Test Bv___a rzUJFirm Name.OC Firm Name.Z)omcc UlAddress.CC Address< cnOtter Tail County License No..Otter Tail County License No«.HtnUiMeasurement, Inches Depth in Water Level, Inches I-Measurement, Inches Depth in Water Level. Inches Time Rem,Time Remarks I ^I ^cC PdlcA4.00 il .4^//JO) SCI gc/4o^/) ii ?.ypf- V /U33k^'C7 jUaJZ. 4LL7L. AO 1 /j:/7ISUI/Qy/s.H ^ n z.^/% II 7^ /2 7m ILI^TyJKIL3^ 'Mjt iSfii/O/ai S3k40L±oL£/. 4 Seu 2S4:77 U 79.I MKL-0871-028 See Booklet, "How to Run a Percolation Test" by Agriculture Ext. Service, Un. of Minn. TTuUlJ* -^~t6^.<:^JU»o'YV-^ -^^CLol^ /)A.^^TOLc|L) ov w>^xCtr -"•'^G^ci tx) )yi~y(ywv-^ oA._UjfXA^_ iy(_ cl^yKji- S'- ^ -^7 Jty^xa--. . fH7- 0)jX4 ^'l5 :tr A TO DE COMPLETED BY PERSON INSPECTING SYSTEM I hereby attest that I ara familiar with the minimum standards required by the OTTER TAIL COUNTY SHORELAND MANAGEMENT ORDINANCE regarding sewage systems, and that I have Inspected this system and find it In accordance with those standards. Legal Description;<;~3 ^ Ti-fA ou I/ /otter Tail County License No. Shall be licensed and bonded in Otter Tail County, Minnesota Owner's Namd ^■CeS. Si^ature of Installer cf-n- 7-f Date of Inspection Date Please return when completed to Land & Resource Management Office Court House, Fergus Falls, Minnesota 56537 /LipoicOted no^ /v\e.'£T' , 00^+; 0^■to '■' / / d (>Urp-d^