The URL can be used to link to this page

Home My WebLink AboutTwin City Reel & Trigger Club_36000190132000_Septic System Permits_f l;.8».:'JE^gfe,'JE;.a»: JEiat..-j :-‘^s- mm k'. -a [\ CERTIFICATE OF APPROVAL SEWAGE SYSTEM J. 119 ?2November77iij certificate has been issued this to certify that the sewage system itistalled as per sewage permit number indicated below has been approved for use 30th day of MBrr. by Otter Tail County, Minnesota.IPl The premises covered by this certificate are legally described as: Twp. NnmpLEAF MOUNTAINRange 395&-1A0 Sec. 19 Twp. 131Lake No. r.-?i19 131 39 13. 65 LOT 10 TUITN rTTV RFn S/ TRTQQgR CLUBOwner: Name Address y.-ROBERT A-ANDERRON. _ST__PAULi MN Zip No.03 Permit No. SP 8438 ASigned by: Land & Resource Management Ofricial Oucr Tail County. MinnesotaMKL-0987001 aA 6,.\J'JSi JT-263191 Victor Lundeen Co.. Printers, Fergus Falls, Minnesota r 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 Permit No.LEGAL ADESCRIPTION /oAND LOCATION LAKE/RIVER NAME LAKE/RIVER CLASS SECTION RANGE TWP NAMELAKE NUMBER TWP F ./f /B//Ke PARCEL NUMBER(S) FIRE OR LAKE ASSOCIATION NUMBER -If-6132. -oco IDENTIFICATION: Please Print All Information First Mailing Address — No. Street, City and SlateLast Name Zip Code Telephone No.Initial /t/Z-fA/ C,\4~^ ^'T'r'i^c^A/Property Owner Y)<>j -^.s~^3 Sewage System Installer Name A.M. ► This System will be ready for inspection on.P.M., 19-at S'This space for office use only NUMBER OF BEDROOMS: A.M. P.M19 GARBAGE DISPOSAL: ( ) YES ( X ) NO Date Rec'd Time Rec’d Phone Call Rec’d By SEWAGE DISPOSAL SYSTEM DATA: MINIMUM REQUIREMENTSTYPE OF SEWAGE SYSTEM ( ) Holding tank ( ) Septic tank ( Drain field ( ) Standard ( ) Modified TANK DRAIN FIELD 7S3 Sq Ft.IS:o(DCapacity GIs. sn:)Distance from nearest well Ft. Ft. ( Bed () Trench /roDistance from lake or stream Ft.Ft. ( ) Mound C 7S% PRCt/ 1 ioDistance from building Ft.Ft.20 /G (0Distance from property line Ft.Ft.63EFFLUENT DISTRIBUTION 3Distance from bottom to Water Table Ft. Ft.) Gravity( ( V<Pr All distances are shortest distance between nearest pointsassure WATER WELL DEPTH: ^0 , 19 19 C, - 7^1 r<fPERCOLATION TEST DATA: Date of First Test__ Date of Second Test Rate <)fik Fe.t\hf^e.£> ' ’ 1st Test TakelSy c 7G ' -2,7 Rate H..7LTItf \16First Test -F 2nd Test 2 Rate2nd Test Taken By Agreement: The undersigned hereby makes application for permit to install or extend Sewage Disposal System herein specified, agreeing to do all such work in strict accordance with Ordinances of the County of Otter Tail, Minnesota and Minnesota 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 isyready tor inspection. . /j 6 -DATE: Sigtature 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. .and & Resource Management Office 0~Z?-9o I L/Vv^Issued Date: ^s-vorFee $.Rec H. Comments: Form No. BK — 0292-003 260,771 — Victor Lundeen Co., Printers. Fergus Falls, Minnesota f...... 7^/ 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 Permit No.LEGAL DESCRIPTION /o KAND LOCATION LAKE/RIVER NAME SECTIONLAKE NUMBER LAKE/RIVER CLASS TWP RANGE TWP NAME Lcn f nrr ■/3/Ole PARCEL NUMBER(S)FIRE OR LAKE ASSOCIATION NUMBER -/f-^/32. -oco IDENTIFICATION: Please Print All Information Last Name Mailing Address — No. Street, City and Slate Telephone No.First Initial Zip Code TwHa7 C^i-hy '^TV %Property Owner /3. Pkjo&'^so'J Pciv/, nrNl -Tr/03^ I h) tP /6 Sewage System Installer Name A.M.at iA' 3P)This System will be ready for Inspection on , 19.P.M. This space for office use oniy sNUMBER OF BEDROOMS:5“// 19 P.M..GARBAGE DISPOSAL: ( ) YES ( X ) NODate Rec'd Time Rec’d Phone Call Rec'd By SEWAGE DISPOSAL SYSTEM DATA: MINIMUM REQUIREMENTSTYPE OF SEWAGE SYSTEM ( ) Holding tank () Septic tank ( iXT Drain field ( ) Standard ( Bed ( TANK DRAIN FIELD 733 Sq Ft.IS ■oaCapacity GIs. SO s~dDistance from nearest well Ft.Ft. ) Trench /S-CJDistance from lake or stream Ft.Ft. ( ) Modified ( ) Mound C DFrjxy JODistance from building Ft.Ft.20 /(T JoDistance from property line Ft. Ft.(S--63 #EFFLUENT DISTRIBUTION ( ) Gravity ( vXTPi'essure 3Distance from bottom to Water Table Ft.Ft. Alt distances are shortest distance between nearest points WATER WELL DEPTH: , 19_^C - '7S]J <JPERCOLATION TEST DATA: Date of First Test Rate C-7^ ^ 1st Test Takefiicy Date of Second Test Rate, 19 Ll/ \I (JOFirst Test + 2nd Test Rate2nd Test Taken By 2 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 Off ideal 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. ' V 3 ////-‘JO >r.'DATE: 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. and STResource fJ^nagement Office 0-2?- /O LIssued Date: 9^0/Fee $.Rec #. Comments: Form No. BK — 0292-003 260.771 — Vicior Lundeen Co.. Printers. Fergus Falls, Minnesota 1 INSPECTION RESULTS Inspector must make all measurements SEWAGE DISPOSAL SYSTEM STATISTICS SEPTIC TANK DRAIN FIELDCATEGORYActualMinimumActualMinimum /"SODgis.SF FT SLS.SFCapacity sa//sz> FT%)-g3 FTDistance from Nearest Well^ ^ tl 50 FT FTFTDistance from Buried Water Suction Pipe 50 FT 50 FT FTDistance from Buried Pipe Distributing Water Under Pressure ft FT FT10 10 ISO (So FTQ/ FTDistance from Lake or River (OHWL)ft FT p -/ffO FT FT Distance from Nearest Building 10 FT 20 FT FTDistance from Nearest Property Line 10 FT 10 FT V PTDistance 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 FT20 SF uJ-dlQ cLcp^tt^ (^p<jus !r*- Inspector’s Comments: 'tA:Rjj <>2ness A n~c SKETCH: f: / Af!^Areux£> Ok> Tss^ & f > Inspector s Signature\S- /%-?z Date of Inspection Time of Inspection A PERCOLATION TEST DATA LAND AND RESOURCE MANAGEMENT Otter Tail County Fergus Falls, MN 56537 OWNER: Tlj 1 W Cl iy Reel •C Tr^ q a cC' Club J J FIRST MIDDLE 'LEPHONE NUMBERILAST NAME I i ADDRESS:I K(^§ XS/ez/ACT 4l/-f. ST. fiAoL CITY 1 \\cc STATE ZIP CODESTR./RT r TWP. NAMESEC. TWP.RANGELAKE NAMELAKE/RIVER NO. LEGAL DESCRIPTION: PARCEL NUMBER FIRE NUMBER NUMBER/BEDROOMS — TWO TESTS ARE REQUIRED — TEST HOLE NO. 2TEST HOLE NO. 1 a q 6<!o Depth To Bottom of Hole Diameter of Hole inchesinches; Diameter of Hole,inches inches;Depth To Bottom of Hole Jupyg. Ql 19 _2-2 J~u A f 71 19 ^DateSoil TextureDepth, Inches DateDepth, Inches Soil Texture l£>la VAlMlLJkr+ -5qn d Xir 1' j g Q Ad311Firm Name Firm NameOcIcCA Consf.f) tlzc f' Cov\S Pal 4-0i^l+6r\ Mf\.\r\ AAAddressAddress Otter Tail County License No. Otter Tail County License No. PERC TEST # 2PERC TEST # 1 WATER DEPTH Water DROP PERC RATEINTERVAL n>41NlJTHS>TIME INTHRVALOi<mUTBS>Wi'AT^I^PTHTIME WATER DROP PERC RateXiT Z120 3I_30 1S2S START START,a::-ill..... .5:......j:...... TIME INTERVAL rMTNUTEm Wi MER DEPTH WATER DROP PERC RATE PMB INTERVAL rMINUTEST PERC RATHW.’ATBR DEPTH WATER DROP 2L12 3131 3iyo REFILL RB^LL5/3"9 V" TIME * BACp" PBRC~WATER WATER DROP PERC RATEINTERVAL IMINIJTBSI DJCTTH TIME INTERVAL IMIWOTBS) WATER DEPTHTIME WATER DROP PERC RATE4>3:3 7 ilVti ■•-5-75-7l^/y"REFILL RBFILL 3/s^"/O ^ US'. ^.1 nWB t>ROP PfaAc~ \yyi7n—■ 7L9.7 ,»3.r. 3, TIME faROP PERC_ 3: y/•? Wi DEPTH WATER DROP PERC RATH TIMETIMEINTERVAL (MlNl/TEO.INTERVAL fltflNUTBa M^iyTHW.WATER DROP PERC RATE ■t3T7J i:Sd. i?9l ItRBFILLTd'-'-///o .5.337 ^/, </ TIMB " DROP PBRC^ a /D ^ ^ . r TlWS^ ^ DROP PBJIC a '/vk7/yi.JA bL INTERVAL IMINllTEa WATER DEPTH WATER DROP rotc^TB TIME INTERVAL (MINUTESITIME WATER DEFTH WATER DROP PERC RATEC,"REFILL REFILL/ '/^ "f >0 TPrtfl DROP i»ERC~ 10 S' 'IIWE" ^tiROP PERC a VvtoJ.o‘/101 INTERVAL (MINl/TEa RBFILL PERC RATE INTERVAL (MTNUTBS3WATER DBFIH WATERING OP TIMETIME WATER DEPTH WATER PROP PERC RATE...4::REFILL / Vy"J/C ID /JO 'IIMM "drop PERC ~rj------u-is’.Sn TIME ^bROP PBRC ..Id__'QIX"'/bV7jI.Ty. INTERVAL fMTNUTEn PERORATETIMEWATER DEPTH WATER PROP TIME INTERVAL (MINUTBS)■^nDEPTH WATER DROP PERORATE v;ar V.7VREFILL1"RBFILLW . t _ JO TIME * bROP PBRC 10lb TTIjB INTERVAL fMTNUTBSI WATER DEPTH WATER PROP PERORATE TIME INTERVAL IMINUTBSI 2^DEPTH WATER PROP PERORATE V.icW""^ I . /oTlMd~ * bROP P^C~ jO .I.u_ 4o7 TIME ~ DROP PERC ~ via"''s''' COMMENTS/CALCULATIONS: ’ MKL — 0390 - 005 250,615 — Victor Lundeen Co., Printers. Fergus Falls, Minnesota GRID PLOT PLAN SKETCHING FORM (Must Be To Scale) Scale: Each grid equals feet/ inches -r ■7 19Mu t " ■ cDated: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. L a tS 1 f z tr ^ I 1 ^T r-rrtt .J_1j(I 1 I (I/ j.1 a_S Of J ^00^ f 17^/7 \J\1 IS'i1, /S'O I I i \ i Wtl|</'r.^PI . .♦ -1 Dro; A f; ci i •a 3V'ftCfl. -a- ++4- r: ■ I i-1 f 4 rT +J I- 1!-f ‘I :i:■ 1iIh“1 —i-— 4r-r-—i-4 1f 1.- 1 •t i--—-Tt 1j 4 1 i 1 1 I 4 I :I t1 : 1 1 t^-74-- t J I 1 f ! 4. f . .. I .4f !i-t IT - |-1 I t f 1* J-i - +';L 41 I i T STATE OF MINNESOTA DEPARTMENT OF HEALTH ABANDONED WELL RECORD MINNESOTA UNIQUE WELL NO. (Uivt bUnk If net known)1. loaTioN or vcu «County Ottertail DaU itiUd4. ucu DCPTH (conplitld)Stctlon No.frtctlonTownship Nsaio Township Nuatbof*Rsngt Nunbtr i NW'‘ sV'Nfe131 I, 39 6-30-922519Leaf Mtn.ft.«r Ws NuMrlctl SCrtiC Addriti tnd City sf Uill Locitlon «r OUtinci froi^ Ao<d Utirstctld*S. OmuiNC HCTHOO (If known). iQ C*bU tool 40 lUvorn Orlvtn 1CT~| Duo 20 Hollow Rod 50 Ain 10 lorid 11T~I 0 Rotiry 60 Jittid 50 Powtr Aujor RR#1 Cli'therall, MN Skew diet locitlon of woll (in Kctlon grid wItA *A*)Skttcn up of well locitlon 6. OBSTRUCTIONS Htll okttrucud 0 Yd 0 No Obttructlont rtwvid 0 Yd 0 No If obitroctloni cinnot bo rtwvod, contict HON btfort idling. .l; c ^ r/ ^i I NOV 2 3 1992To(Iu E 7. USEr10 Domitlc 40 Monitoring B0 Hut Loop 20 Irrlgitlon 0 Public 50 Induitry 0 Tilt Wtll 0 Hunicipil 10ConMrc1ll 70 Air Conditioning 10 LAND & RlSCURGE• k «• r S -c.• I• '•U 0 a ••• •• at . • t -Ctn 8. CASINC(S) 10 Blick 0 Thriidod 0 iCfOiW. 0M«Idtd 0 Pintle 0 Stilnldt Stdl 1 V In. to 21____ In. to 2. PROPERTY OUNCR'S KANE Killing Addrdi If difforint thin propirty iddrdi Indlcitld ibovt 868 Ingle hart Ave. St. Paul, MN 55104 ^r. Henry Cannon HARDNESS OP FORHATIOK ft.FROM TO).FORHATIOK LOC .COLOR If not known, Indlcito forutlon log froa now wall or ntirby will. 9. SCREEN [3Scrttntd woll froa ^ ft. to ^ ^ 0 Optn Roll 0 25Glacial Drift ft. (If known) ft. to ft.froa 10. STATIC WATER LEVEL __ft. 0 btlow 0 ibovf Iind iurfico 1 Dlto Mdturid 6—BO— II. WELLHEAD COHPLEYIOK 10 PItIdi Adiptir 0 Bdinnt offiot 0Will Pit <f~l Found Rurltd o 16. REHARLS. ELEVATION. SOURCE OF DATA . CASINGS REHOVEO. CASINOS PERFORATED. ETC.12. GROUTINS INFORHATION 0Ndt Ctunt 0B«ntonlto 0 Portlarv^a 6 to25 ft.Grout Mtirlil cu. ydi___ 13. NEAREST SOURCES OF CONTAHINATIOK25 fdt Will dlilnfictid bifori tilling? Q Yd SeverSdlrictton typi 14. PUHP 0 Rinovid 0 Not Priiint Typi: 10 Suburtlbli 0 L.S. Turblni 0 Riciproetting 0 Jit 0Cintrlfugil 0 IS. EXISTING WELLS (Plidi tkitch locitioni of ibindonid ind ictivi Willi In riurki iictton or on back.) Othir unuiid win(t) on propirtyl 0 Tit No Abindonid: 0 Firainint 0 Tiaporiry 0 Not tdlid 17. WATER WELL CONTRACTORS CERTIFICATION Thit will wii iiilid undir ay Jurtidtctlon ind thii riport It Crui to thi blit of ay knowlidgi ind billif. LIcinid Builniii Ntai _ _ Llcinti No,Pohertson Well Drilling 26144 56309AshbyAddritt ,oiti 6-30-92 .7 04 tt Kim of OrlUOFFICIAL AIAKDOKCO WELL RECORD (Hiy bi uiid for Propirty Trtnifir) xxrairAjrr, rzLM nn dsxb STATE OF MINNESOTA DEPARTMENT OF HEALTH ABANDONED WELL RECORD MINNESOTA UNIQUE WELL NO.(Uivi bUnk \( AO( Ilaowa)u lOCAnW Of WUL .County»«. ottertail 4. UCLC 0£PTH (coapUtid)StCtlOA NOo FrtcttoA 04tt itilidTowAsbIp N«ai TowAShIp Nuabtr Raaoi Nuabcr39 *^ or nW* Nfe 6-30-922219131 "Leaf Mtn.ft.or Ws i. ORILLIKS METHOD (<f known) IQ CibU tool 4Q Rivirto Orlvon ICQ (H19 !□ Hollow Rod iQAlr BQ Rorod llQ__ Rotiry EQ Jittod SQ fowir Augtr Muntricd Strut Addrott tnd City of Wtll tocitlon or Olitonct froa. Rood Utortoctlon ' RR#1 Clitherall, MN Show oioct locitloA of wtll (t« iictlon grid with *X*)Sketch Mp of woll locitlon R C S I V 6. OBSTRUCTIONS Hill obstructid Q Tii No Obstructlont riaovid Q] Tot Q No If obstruction! emnot bo rtaovid, conttet MON befori tullno. (. I .b I NOV 2 3 1992 LAND & RfSOURCE X EV 7. userIQ Domstrc <□ Monitoring I''rl9>tlon 5f~l Rubllc 3Q Tilt Will CQMunlcIpil Air Conditioning 11|~| tf~) Hilt loop SQ Industry ICQ Comrclil • r H-i. ± 1 I -CL> 8. CASING(S) IQ Blick <21 Thrudid 7Q TSCilv. SQHiIdid OO Rtistlc Q Stilnliis Still *7 In. to 1 B In. to Milling Addriss If diffirint thin propirty iddriss Ihdlcitid ibovi Z. RRORCRTY OWNER'S NAME 868 Inglehart Ave. St. Paul/ MN1r. Henry Cannon 55104 HARDNESS OF FORMATION If not known, Indlctti foraitlon log froa niw will or niirby will. FROM TO).FORMATION LOS COLOR .ft. 9. SCREENScninid will froa 1 8 ft. to 2 2 ft. ' I~1 Opin Nolo 220Glacial Drift (If known) froa ___ ft. to ft. 10. STATIC HATER LEVEL1 6 ft. @ bilow □ ibovo 1«a4 fturftcc IDili Miiiurid fi— ? 0— Q 7 ll. WELLHEAD completion IQ PItliil Adiptir ZQ Bisiaint offsit 30 Will Pit 4 I Found BurlId o 1(. REMARtS, ELEVATION. SOURCE OF DATA - CASINGS REMOVED. CASINGS PERFORATED. ETC.U. GROUTING INFORMATION 10NiitCiaint ZQBintonIto Q Portlan^oa6 to 22t. cu. ydsGrout Bitirlil 13. nearest sources OF CONTAMINATION _2i flit Will dlslnfictid bifori silling? Vis dirietlon Qot.to r-s typi K. PUMP Q Rinovid |3 Not Prisint Typi: 1[H Subiarslbli Q l.S. Turbino ^ Riclprocitlng ZQ Jit <Q Cintrlfugil tTI IS. EXISTING WELLS (Pliisi skitch locittons of Ibindonid ind ictivi wills In riairks sictlon or on blck.) Othir unusid will(s) on propirty? Q Vis GF*** Abindonid: □ Pirainint Q Tiaporiry QNotSiilid 17. WATER WELL CONTRACTORS CERTIFICATION This will wis siilid undir ay Jurisdiction ind this riport It trui to thi best of ay knowlidgi ind billif. LIcinsii Businiss Niai .... Licinii No.Uobertson Well Drilling 26144 56309y . M'Addriss A S Signid ___oiti 6— 30—92 Oiti Nial of OrllllOrnCUL kUXOOHlQ WELI aECOW OUy bf uud for frop«rty Trinjfir) ZMP<»TXMT» Tits viva DSSD