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United Sportsman Club_14000270213000_Septic System Permits_
OTTER TAIL COUNTY LAND & RESOURCE MANAGEMENT PUBUC WORKS DIVISION VWWV CO OTTER-TAiL MN USOTT6R Tflil GO'/ERNWENT SERVICES CENTER 540 WEST FIR AVENUE FERGUS FALLS. MN 56537 218-993-8095 FAX: 218-993-8112 8/14/2015 United Sportsmen Club Attn Tim Troje 16427 Harvard Dr Lakeville MN 55044 6304 RE: Primary Owner: United Sportsmen Club Sewage Treatment System Servicing Tax Parcel Number: 14000270213000 Sec 27 Twp Dead Lake Township Sect-27 Twp-135 Range-040 118.90 AC LOTS 3, 4& N1/2 NE1/4 Described as: Lake: 56-383 Dead As of 08/13/2015 the sewage treatment system (Sewage Treatment Installation Permit # 23474 servicing your property was determined to be in compliance with the provisions of the Sanitation Code of Otter Tail County for a 3 bedroom home. Please be advised that this certification is only valid for five years from the date of this inspection 8/13/2020 If you have any questions regarding this matter, please contact our office. Sincerely, Alex 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.usWOTTER Tflll WHITE - Office YELLOW - L & R Inspector PINK - Owner / Contractor (after issue)coamrainaiioTa 2 2^1^APPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED Permit No. LAKE NUMBER LAKE/RIVER NAME LAKE/RIVER CLASS SECTION TWP NO.RANGE TWP NAME A/T / ?X I ^(9 rtlBLIC ROADPARCEL NUMBER (S) OF PROPERTY BEING SERVICED E-911 ADDRESS OR DIRECTIONS FROM NEAREST LEGAL DESCRIPTION ? . </ a/£ ^// 8^ Last Name First Initial Mailing Address Daytime Phone No. Z.A/<fe U't/ It, I ^ AKIf»/TS C IuhProperty Owner y - ^30 yr>t n ^7779Contractor Lie.# THIS SPACE FOR OFFICE USE ONLY A.M. ► This System will be ready for inspection on , the year of at P.M. A.M. P.M. Date Received Time Received L & R Officiai TYPE OF NSTALLATION (circle one)SEWAGE TREATMENT SYSTEM DESIGN DATA AS SHOWN ON DRAWINGResidentialCollectorOther Est. (D) New (E) Repiacement (F) Add on (G) New (H) Replacement (I) Add on (B Soil Treatment Area orr Tank Lift Design Flow (Gallons/Day) (J) 0_---------- (T — 2,49y(L) 2,500^,999 (M) 5,000— 10,000 Effluent Distribution ( ) Gravity Pressure (K)GIs GIsShd7W)Size Setback To Nearest WeiiType I Type II Ft. (20) Trench, Rock (27) Rapidiy Permeable Ft.Ft.Setback To OHWL(21) Trench, Gravelless (28) Flood Plain (22) Trench, Chamber (29) Privies Ft..— Ft.— Ft.Setback To Bluff(^) Bedj (30) Holding Tank (Contract Required)(24) Mound !Ft.Ft.Setback To Dweiling (25) At Grade Type III Setback To Non-Dwelling /(26) Greywater (31) Other/Problem Soils/<12" Soil Ft.Ft.//oLoType IV(34) Tank Only Setback To Nearest Lot Line 3^04 Ft- y^-£^Ft. Jf04^ ft.(32) Public Domain & Proprietary Technologies(35) Other Setback To Road Right-Of-WayDepth of Well Ft.3b04Type V Total # Bedrooms 3 Abatement Y / ^ (33) Performance Garbage Disposal Y Elevation Above Restrictive Layer JFt.Ft. PERC TEST DATA Designej Agreement: The undei^ned 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.This 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 Ratef( sianakfre of Property Owner/Agent for Owner ^pup;)/'—) Land & Resource Man^ement Official \1S^Date:Permit Fee $ 7-/g-/f SLOKT-SY.Date:Rec. No., CXfVvk.^\.tA-«-><LC ^ Date StampComments: rNoi" • » V U 4* L&R InitialForm No. BK — 04-2014-06 357,243 • Victor Lundeen Co., Printers • Fergus Falls. Minnesota •^r . 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 OTTCR mil WHITE - Office YELLOW - L & R Inspector PINK - Owner / Contractor (after issue)eoiflTY-aiaiciOTii 347Permit No.APPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED TWP NAMELAKE/RIVER CLASS SECTION TWP NO.RANGELAKE NUMBER LAKE/RIVER NAME / ? 5' PUBLIC ROAD A b E-911 ADDRESS OR DIRECTIONS FROM NEARESTPARCEL NUMBER (S) OF PROPERTY BEING SERVICED \zoooy LEGAL DESCRIPTION // i: 3 /7^ c >Y>S Daytime Phone No.Initial Mailing AddressFirstLast Name /-/i !<€> L^ > / ) c , •(■(•/} spot/C l^jhProperty Owner -C!TO</y - 37779Contractor Lie.#UI I /Lj4o/7 }y D s TH/S SPACE FOR OFFICE USE ONLY Ml ^Q/S" at JO-SO P.M., the year of>■ This System will be ready for inspection on 3/l'2^h<C m(]p^A. L & R OfficialTime ReceivedDate 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 (G) New (H) Replacement (I) Add on (D) New (E) Replacement (F) Add on Soil Treatment Area LiftTankEffluent Distribution ( ) Gravity Pressure Design Flow (Gallons/Day) (J) Q, (K) '-Izr, 2J99 (L) 2,500 — 4,999 (M) 5,000 — 10,000 GIS GIS Ft.^6Size Setback To Nearest Well Ft.Ft. Ft.Type IIType I 9-9 S (27) Rapidly Permeable(20) Trench, Rock « , Ft.Ft.Ft.Setback To OHWL 9'CQ7 Ou ••(21) Trench, Gravelless (28) Flood Plain ' ■1 (22) Trench, Chamber (29) Privies Ft.- Ft.Ft.Setback To Bluff(30) Holding Tank (Contract Required) (23) Bed (24) Mound Ft.Ft.Ft.//70Setback To Dwelling IAl(25) At Grade Type III Setback To Non-Dwelling Ft.Ft.Ft.(31) Other/Problem Soils/<12" Soil(26) Grey water loC Lo //oType IV(34) Tank Only Setback To Nearest Lot Line Ft./ 7 0 Ft- -Vi’C04 4 Ft. 3tor (32) Public Domain & Proprietary Technologies(35) Other J- Setback To Road Right-Of-WayDepth of Well Ft. Ft. .1 Type V Total # Bedrooms ...(33) Performance Elevation Above Restrictive Layer 3Ft. Ft.Garbage Disposal Y /(^NAbatement Y / N PERC TEST DATA J./ // a-w Highest RateLicense #Date of TestDesigner Agreement: The under*igned hereby makes application for permit to install, alter, repair or extend Sewage Treatment System herein specified, agreeing to do ali 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). l-Zr-ZO I Permit Fee $ / 73Date: BignatOre of Property Owner/Agent for Ovmer 7 -/5'. /•-Rec. No. - 'Date:U Land & Resource Management Official V-e/Comments:NEDt B^iaraiForm No. BK — 04-2014-06 357,243 • Vidor Lundeon Co.. Printers • Fergus FaMs, Minnesota SEWAGE TREATMENT SYSTEM PERMIT INSPECTION RESULTS STA (Soil Treatment Area) OUTHOUSE TRENCH REDUCTIONHOLDING SEPTIC TANK LIFT TANKCATEGORY Rock trenches with inchesFT2CapacitylOosGLS. GLS. of sidewall for %Mr:166^FTFTFTSetback from Nearest Well reduction / equivalent toSetback from Buried Water Suction Pipe FTFT STA CALCULATION (Soil Treatment Area) Ft X rtj Setback from Buried Pipe Distributing Water Under Pressure 10^10^FT FTFT Setback from OHWL (lake &/or river)FTFTFT Ft. FT FTSetback from Bluff FT 9^FT MOUND / AT-GRADEFTFTSetback from Dwelling ROCK BED4-FT FTSetback from Non-Dwelling FT <z/_FT FTSetback from Nearest Property Line FT Ftr-X-—Ft. \% sr<^^ FTSetback from Right-of-Way FT FT Ft* FT FTElevation above Restrictive Layer FT SAND IN MOUNDINSTALLERS COMMENTS SEPTIC TANK(S)Holding Tank / Lift Alarm Ij^YES □ NO ^YES nNO i# Tanks InstalledWeep HolesOld System Pumped & Destroyed v-rs \<:)2 Manuf. r 5 INLateral Pipe SizeNumber of Laterals #fA- Model #Perforation Diameter Size INPerforation Spacing Ft. Gallons Per Minute | | Feet of Total Head %FILTERS DYESPUMPS Inspector’s Comments: Sketch: 6^'V Cr- 16.^AIL , the above described sewage system installationAs of was found to be compliant with the provisions of the Sanitation Code of Otter Tail County.Time initial / L & R OffidaiDale Land & Resource Management Official Form No. BK — 04-2014-06 357,243 • Victor Lundoon Co., Printers • Fergus Fells. Minnesota • ’ * •System design ?nust 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, bluff and all water wells within 150’ of the sewage system. If there are any questions, see the University of Minnesota Site Evaluation worksheets. . 3 O feet__inch(es) equalsScale;grid(s) equals feet, or MPCA LICENSE #: DESIGNED FIRM NAME: -S//g. D-lLICENSE CATEGORY: L /:?cDATE: ADDRESS:SIGNATURE: / o ^ K ^ ill^ U ^ ''/A/ !' Vvv \\ / I h'rj ^Od: /// CO/^/ Selves, a JV7/ 354.251 • Victor Lundeen Co, Printers • Fergus Fails. MN • 1-800-346-487CBK - 04-2014 - 029 SITE DATA WORKSHEET m * «LAND & RESOURCE MANAGEMENT GOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS FALLS, MN 56537 218-998-8095 www.co.otter-tail.mn.us * OTTER TflllCO»«TT-HI»IIIOTi Sewage Treatment System Permit #OWNER: C A. ypf'e ^ F!R<iT C ^LAST NAME ^S' MIDDLE TELEPHONE NUMBER ADDRESS: STAT^CITY___STR./RT ZIP CODE _/'Ss' yc.*■ LAKE/RIVER NO. LEGAL DESCRIPTION: 9 ^ ./s 4 V Aj'/z LAKE NAME SEC.RANGETWP TWP NAME SOIL BORING LOG DEPTH (INCHES) COLOR a MUNSELL NO.TEXTURE STRUCTURE gtoc^ PL^fY /V 'QOO Jiyo<R/S ce>o PARCEL NUMBER Locp ?^o y0^7*7 PRISMATIC NONE POfTYy-/T /c>/h77E-911 Address or Directions From Nearest Public Road PRISMATIC NONE3NUMBER OF BEDROOMS BLOCKY PLATY PRISMATIC NONE ^OZEry)/J’35GARBAGE DISPOSAL: YES WELL: CASING DEPTH S'^Fft. SEWER LINE SEPARATION: 'TOFft. BLOCKY PLATY PRISMATIC NONE FLOODPLAIN: YES BLUFF: YES 'rrestriaOVEGETATION: AQUATIC BLOCKY PLATY PRISMATIC NONE SLOPE AT INSTALLATION SITE:% TYPE OF OBSERVATION: Probe Pit PARENT MATERIAL: ^ Outwash ORIGINAL SOIL: 0) No COMPACTED SOIL: Yes DEPTH OF BORING (To T or restrictive layer):__ PERCTEST #1 Loess Bedrock Alluvium L/so f/SDate of Soil Boring ft.Date of Perc Test PERC TEST #2- TWO TESTS ARE REQUIRED - WATER DROPTIMEINTERVAL (MINUTES)WATER DEPTH PERC RATE TIME INTERVAL(MINUTES)WATER DEPTH WATER DROP PERC RATE START START TIME DROP PERC TIME DROP PERC INTERVAL (MINUTES)WATER DEPTH WATER DROPTIME PERC RATE TIME INTERVAL(MINUTES!WATER DEPTH WATER DROP PERC RATE REFILL REFILL TIME DROP PERC PERC RATE TIME DROP PERC TIME INTERVAL (MINUTES) REFILL WATER DEPTH WATER DROP TIME INTERVAL(MINUTES! REFILL WATER DEPTH WATER DROP PERC RATE TIME DROP PERC DROP PERCTIME WATER DROPTIMEINTERVAL (MINUTES)WATER DEPTH PERC RATE TIME INTERVALIMINUTES) REFILL WATER DEPTH WATER DROP PERC RATE REFILL PERCTIMEDROP TIME DROP PERC INTERVAL IMINUTES) REFILL WATER DEPTH WATER DROPTIME PERC RATE TIME INTERVAL(MINUTES! REFILL WATER DEPTH WATER DROP PERC RATE TIME DROP PERC PERCTIMEDROP TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATE TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATERffILLREFILL DROP PERCTIME PERCTIME DROPTIMEINTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATE TIME INTERVAL IMINUTES)WATER DEPTH WATER DROP PERC RATERffILLREFILL TIME DROP PERC TIME DROP PERCTIMEINTERVAL IMINUTES!WATER DEPTH WATER DROP PERC RATE TIME INTERVAL (MINUTES!WATER DEPTH WATER DROP PERC RATEREFILLREFILL PERCTIMEDROP TIME DROP PERC SEPTIC TANK MANUFACTURER: PROPOSED DESIGN: XTTRENCHBED.ATGRADE.MOUND.HOLDING TANK GRAVITY DIST.PRESSURE DIST, BrJSEWER LINE OUTHOUSE.OTHER.SPECIFY:, — SYSTEM DESIGN ON BACK -t- %■ OSTP Design Summary Worksheet University OF MinnesotaMinnesota Pollution Control Agency v05.13.14Property Owner/Client: United Sportmens Club, Derek Leyde Project ID: Site Address: 36007 380th Ave. Richville, MN 56576 Date: 6/30/15 1. DESIGN FLOW AND TANKS Note: The estimated design flow is considered a peak flow rate including a safety factor. For tong term performance, the average daily flow is recommended to be < 60% of this value. Gallons, in 450A. Design Flow:Gallons Per Day (GPD) B. Septic Tanks: Minimum Code Required Septic Tank Capacity:1000 1 Tanks or Compartments Recommended Septic Tank Capacity:1000 Gallons, in 1 Tanks or Compartments Effluent Screen: optional elecAlarm: C. Holding Tanks Only: Minimum Code Required Capacity:Gallons, in Tanks Designer Recommended Capacity:Gallons, in Tanks Type of High Level Alarm: 500 GallonsD. Pump Tank 1 Capacity (Code Minimum):Gallons Pump Tank 2 Capacity (Code Minimum): 500 GallonsPump Tank 1 Capacity (Designer Rec):Gallons Pump Tank 2 Capacity (Designer Rec): 48.0 GPM Total Head 47.8 ft GPM Total HeadPump 1 Pump 2 ft Supply Pipe Dia. 2.00 in Dose Volume: 110.0 Supply Pipe Dia.in Dose Volume:gal gal 2. SYSTEM TYPE C3Gravlty Distribution (pressure Distribution-Level * Selection Required Benchmark Elevation: (^TTrench (§)Bed OMound QAt-Grade (3Drip Otlolding Tank Oolher QPressure Distribution-Unlevel 100.00 ft Benchmark Location: System Type Type Of Distribution Media: rTferainfield Rock rtteoistered Treatment Media:0 Type I □ Type II □ Type III □ Type IV □ Type V 3. SITE EVALUATION: 62 2.0Depth to Limiting Layer:A.5.2 ft B. Measured Land Slope %:%in loamC.Elevation of Limiting Layer:Soil Texture:D. GPD/ft'Loc. of Restricive Elevation:0.60Soil Hyd. Loading Rate:F.E. 36G. Minimum Required Separation:3.0 ft MPIinPerc Rate:H. I. Code Maximum Depth of System:26 in Comments: 4. DESIGN SUMAtARY Trench Design Summary ft'Dispersal Area Sidewall Depth Trench Width ftin Code Maximum'Trench DepthTotal Lineal Feet Number of Trenchesft in Contour Loading Rate ft Designer's AAax Trench Depth in Bed Design Summary 750 ft'Absorption Area Depth of sidewall Code AAaximum Bed Depth 26.0 in6.0 in Bed Width Designer's Max Bed Depth 26.0 in15Bed Length 50.0 ftft 3t'--- ' OSTP Design Summary Worksheet University OF MinnesotaMinnesota Pollution Control Agency Mound Design Summary Bed WidthBed LengthAbsorption Bed Area ft Berm Width (0-1%)Clean Sand LiftAbsorption Width ftft ft Endslope Berm Width ftUpslope Berm Width ftft Downslope Berm Width gal/ftTotal System Width ft Contour Loading RateTotal System Length ft At-Grade Design Summary System HeightAbsorption Bed Length ft ftAbsorption Bed Width ft Downslope Berm Widthgal/ft Upslope Berm Width ftftContour Loading Rate System WidthSystem Length ft ftEndslope Berm Width ft Level 8t Equal Pressure Distribution Summary 7/323Perforation DiameterPerforation Spacing ftNo. of Perforated Laterals 5 in 1.50 galgalMaximum Delivered Volume 113106Min. Delivered VolumeLateral Diameter in Non-Level and Unequal Pressure Distribution Summary Perforation SizePipe Volume (gal/ft) Pipe LengthElevation Spacing (ft)Spacing (in)Pipe Size (in)(ft)(in)(ft) Minimum Delivered VolumeLateral 1 galLateral 2 Lateral 3 AAaximum Delivered VolumeLateral 4 galLateral 5 Lateral 6 5. Additional Info for Type IV/Pretreatment Design A. Calculate the organic loading 1. Organic Loading to Pretreatment Unit = Design Flow X Estimated BOD in mg/L in the effluent X 8.35 1,000,000 mg/LX8.35 v 1,000,000 =gpd X lbs BOD/day 2. Type of Pretreatment Unit Being Installed: 3. Calculate Soil Treatment System Organic Loading: BOD concentration after pretreatment ^ Bottom Area = Ibs/day/ft^ Ibs/day/ft^fe =mg/L X 8.35 t 1,000,000 r Comments/Special Design Considerations: I hereby certify that I have completed this work in accordance with all applicable ordinances, rules and laws. 06/30/15634Randy Anderson iz7 (Date)(License #)(Signature)(Designer) ■A i 7^ OSTP Bed Design Worksheet University OF MinnesotaMinnesota Pollution Control Agency v05.13.14Project ID:1. SYSTEM SIZING: inches 450A. Design Flow (Design Sum.lA): Designers Maximum Depth:2626 inchesB. Code Maximum Depth*: C. Soil Loading Rate: 0. Required Bottom Area: Design Flow (1.A) ^ Loading Rate (1.C) = Initial Required Bottom Area GPD/ft^= 0.60 GPD/ft^ ft^450 0.60 750GPD~ E. Select Distribution Method: El Pressure □ Gravity ________________________________________ 0 Rock □ Registered G. If distribution media is installed in contact with sandy or loamy sand or with a percolation rate of 0.1 to 5 mpi indicate distribution or treatment method: F. Select Dispersal Type: 2. BED CONFIGURATION: (for sites with less than 6% slope) 1.0 = pressurized or 1.5 = gravity1.0A. Select size Multiplier: B. Req'd Bottom Area = Bottom Area (1 .D) X Size Multiplier = ft^X 750 ft^1.0750.0 ft = 750 Optional upsizins of bed areaC. Designed Bottom Area:ft 15D. Select Bed Width: E. Calculate Bed Length: Designed Bottom Area 4 Bed Width = Bed Length ft ft^- [750 50.015.0 ftft = 3. MATERIAL CALCULATION: ROCK A. If drainfield rock is being used, select sidewall absorption 6.0 inches = B. Media Volume: (Media Depth + depth to cover pipe) X Designed Bottom Area = ft^ 750.0 ft^ ^1 750 C. Calculate Volume in cubic yards: Media volume in cubic feet t 27 = cubic yards 750 Ift^ - 27 = 0.50 ft ft'0.50.5 ft +ft)X( yd'28 4. MATERIAL CALCULATION: REGISTERED PRODUCTS - CHAMBERS AND EZFLOW A. Registered Product: ftB. Component Length: ftC. Component Width: D. Component depth (louver or depth of sidewall loading)in D. Number of Components per Row = Bed Length divided by Component Length (Round up) ft^-ft =components E. Actual Bed Length = Number of Components X Component Length: components X F. Number of Rows = Bed Width divided by Component Width ft = ft =ft rows Adjust width so this is an whole number.ft T G. Total Number of Components = Number of Components per Row X Number of Rows X components OSTP Pressure Distribution Design Worksheet "i: University OF Minnesota Minnesota Pollution Control Agency V 05.13.14Project ID: ft151. Media Bed Width: 2. Minimum Number of Laterals in system/zone = Rounded up number of [(Media Bed Width - 4) t 3] + 1. laterals v.^oes not apply to at-grades5■ 4 ) + 1 =15( 53. Designer Selected Number of Laterals: Cannot be less than line 2 (accept in at-grades) laterals 3.0 ftu4. Select Perforation Spacing: 7/32 in5. Select Perforation Diameter Size: IVilw. 6. Length of Laterals = Media Bed Length - 2 Feet. 48 ft Perforation can not be closer then 1 foot from edge. Determine the Number of Perforation Spaces. Divide the Length of Laterals by the Perforation Spacing and round down to the nearest whole number. 50 2ft 7. 16 Spaces Number of Perforations per Lateral is equal to 1.0 plus the Number of Perforation Spaces. Check table 8. below to verify the number of perforations per lateral guarantees less than a 10% discharge variation. The value is double with a center manifold. 348ft ftNumber of Perforation Spaces --T = Perforations Per Lateral =1716Spaces + 1 =Perfs. Per Lateral Maximum lihjmber of Ferforatiom Per Ijtefai to GuararAeo < 10% DHchar^ Variatkn Inch Perforations Ferforations Pipe Diameter (Inches)Pipe Diameter (Inches)Perforation Spacing (FeetlPerforation Spacing (Feet)2 3231inm 6S162121121013ISm£0 mm 20 3214 64828 54 101216 I 30 60391432552812 16 1 /8 Inch P^oratiom3.'16 Inch Perforations Pipe Diameter (Inches)Pipe Diameter (Inches)Perforation SpacingPerforation Spac^ (Feet)(Feet)2 31h231114m1114 74 1492 21 33 442687212 18 46 211211 30 69 13520174080411224 33 29 38 64 128202237 751216 9. Total Number of Perforations equals the Number of Perforations per Lateral multiplied by the Number of Perforated Laterals. 85 Total Number of Perf.5 Number of Perf. Lat. =17 Perf. Per Lat. X 10. Select Type o/Mon;/o/d Connection (End or Center): Q End □ Center v/ 1.5011. Select Lateral Diameter (See Table):in 0r ■■■ C<«II OSTP Pressure Distribution Design Worksheet University OF Minnesota Minnesota Pollution Control Agency 12. Calculate the Square Feet per Perforation. Recommended value is 4-11 ft ^ per perforation. Does not apply to At-Grades a. Bed Area = Bed Width (ft) X Bed Length (ft) ft^75050ft15ftX~ b. Square Foot per Perforation = Bed Area divided by the Total Number of Perforations. ft^/perforationsft^perforations 8.875085V 1.0 ft13. Select Minimum Average Head: 0.56 GPM per Perforation14. Select Perforation Discharge (GPM) based on Table: 15.Determine required Flow Rate by multiplying the Total Number of Perfs. by the Perforation Discharge. GPM48850.56Perfs X GPM per Perforation = 0.110 Gallons/ft16. Volume of Liquid Per Foot of Distribution Piping (Table II): 17. Volume of Distribution Piping = = [Number of Perforated Laterals X Length of Laterals X (Volume of Liquid Per Foot of Distribution Piping] Table II Volume of Liquid in Pipe Pipe Diameter (inches) Liquid Per Foot (Gallons) 26.4480.1105 gal/ft Gallonsft XX 18. Minimum Delivered Volume = Volume of Distribution Piping X4 1 0.045 1.25 0.078 gals X 4 =105.626.4 Gallons 1.5 0.110 2 0.170 3 0.380 4 0.661 Comments/Special Design Considerations: Must use 1.5” lift line for the pump cycles to come out right. > - ‘ ■ OSTP Basic Pump Selection Design Worksheet I University OF MinnesotaMinnesota Pollution Control Agency 1. PUMP CAPACITY Project ID: OCravity ®PressurePumping to Gravity or Pressure Distribution:Selection required GPM (10 -45 spm)1. If pumping to gravity enter the gallon per minute of the pump: 48.02. If pumping to a pressurized distribution system:GPM Demand Dosing Soil Treatment3. Enter pump description: ioll ireiitnient systcnt & poi nt o1 <J schaicje2. HEAD REQUIREMENTS 35A. Elevation Difference between pump and fxjint of discharge: ft niet p*p« B. Distribution Head Loss:5 ft C. Additional Head Loss:ft (due to special equipment, etc.) Table I.Friction Loss In Plastic Pipe per 100ft Pipe Diameter (inches)1................T.5... "2 Distribution Head Loss Flow Rate (GPM)Gravity Distribution = Oft Pressure Distribution based on AAinimum Average Head Value on Pressure Distribution Woricsheet: 1.3 0.3109.1 3.1 12.8 4.3 1.8 0.412 Distribution Head Losslyiinimum Average Head 17.0 5.7 2.4 0.6141ft 5ft 21.8 7.3 3.0 0.7162ft 6ft 9.1 3.8 0.9IS5ftlOft201.111.1 4.6 25 16.8 6.9 1.7 9.7 2.43023.52.0D. 1. Supply Pipe Diameter:in 12.9 3.235 2. Supply Pipe Length:110 ft 40 16.5 4.1 20.5 5.045 E. Friction Loss in Plastic Pipe per 100ft from Table I:50 6.1 7.355ft per 100ft of pipe5.66Friction Loss =8.660 F. Determine Equivalent Pipe Length from pump discharge to soil dispersal area discharge point. Estimate by adding 25% to supply pipe length for fitting loss. Supply Pipe Length (D.2) X 1.25 = Equivalent Pipe Length 10.065 70 11.4 13.075 85 16.4 137.5110X 1.25 ftft 20.195 G. Calculate Supply Friction Loss by multiplying Friction Loss Per 100ft (Line E) by the Equivalent Pipe Length (Line F) and divide by 100. Supply Friction Loss = 7.8137.5 100 ft5.66 ftft per 100ft X -r H. Total Head requirement is the sum of the Elevation Difference (Line A), the Distribution Head Loss (Line B), Additional Head Loss (Line C), and the Supply Friction Loss (Line G )/ 7.8 47.835.0 5.0 ft =ftft +ft ft ++ 3. PUMP SELECTION 47.848.0 / GPM (Line 1 or Line 2) with at least feet of total head.A pump must be selected to deliver at least /77Comments: 5r*- OSTP Pump Tank Design Worksheet University OF MinnesotaMinnesota Pollution Control Agency DETERMINE TANK CAPACITY AND DIMENSIONS Project ID:V 05.13.14 4501.A. Design Flow (Design Sum. 1A)GPD; l/^.Recommended pump tank capacity:500500 GalB. Min. required pump tank capacity:Gal Demand to PressureD. Pump tank description: MEASURED TANK CAPACITY (existing tanks): 2. A. Rectangle area = Length (L) X Width (W)Widthft^X ftft B. Circle area = 3.14r^ (3.14 X radius X radius) 3.14 X 2 ft^ft Length C. Calculate Gallons Per Inch. Multiply the area from 1.A or 1.B, by 7.5 to determine the gallons per foot the tank holds and divide by 12 to calculate the gallons per inch, ft^ X 7.5 gal/ft* t 12 in/ft Gallons per inch D. Calculate Total Tank Volume Depth from bottom of inlet pipe to tank bottom : Total Tank Volume = Depth from bottom of Inlet pipe (Line 4.A) X Gallons/lneh (Line 2) Gallons Per Inch = in 11.0X Gallonsin MANUFACTURER'S SPECIFIED TANK CAPACITY (when available): Note: Design calculations are based on this specific tank. Substituting a different tank model will change the pump float or timer settings. Contact designer if changes are necessary. brownA. Tank Manufacturer:3. 1500 2CB. Tank Model: 504C. Capacity from manufacturer:Gallons 11.0 Gallons per inchD. Gallons per inch from manufacturer: 46.0E. Liquid depth of tank from manufacturer:inches DETERMNE DOSING VOLUME 4. Calculate Volume to Cover Pump (The inlet of the pump must be at least 4-inches from the bottom of the pump tank & 2 inches of water covering the pump is recommended) (Pump and block height + 2 inches) X Gallons Per Inch (2C or 3E) in + 2 inches) X 11.0 15412 GallonsGallons Per Inch( 5. Minimum Delivered Volume = 4 X Volume of Distribution Piping: - Line 17 of the Pressure Distribution or Line 11 of Non-level 6. Calculate Maximum Pumpout Volume {25% of Design Flow) Design Flow: 106 Gallons (minimum dose) 0.25 113450GPD X Gallons (maximum dose) Gallons7. Select a pumpout volume that meets both Minimum and Maximum: 8. Calculate Doses Per Day - Design Flow r Delivered Volume gpdv 110 Volume of Liquid in Pipegal =450 110 4 Doses 9. Calculate Drainback: A. Diameter of Supply Pipe- Pipe Diameter (inches) Liquid Per Foot (Gallons) 2 inches 110 feetLength of Supply Pipe =B. 0.170 Gallons/ftC.Volume of Liquid Per Lineal Foot of Pipe = Drainback - Length of Supply Pipe X Volume of Liquid Per Lineal Foot of Pipe ft X oilTO Igal/ft = 0.0451 D.0.0781.25 18.7110 Gallons 1.5 0.110 10. Total Dosing Volume = Delivered Volume plus Drainback 2 0.170 gal +18.7 gal =129110 Gallons 0.3803 11. Minimum Alarm Volume = Depth of alarm (2 or 3 inches) X gallons per inch of tank in X 4 0.661 gal/in =22.011.02 Gallons * OSTP Pump Tank Design Worksheet University OF MinnesotaMinnesota Pollution Control Agency TIMER or DEMAND FLOAT SETTINGS ^iDemand DoseSelect Timer or Demand Dosing: A. Timer Settings 12. Required F/ow Rote: A. From Design (Line 12 of Pressure Distribution or Line 10 of Non-Level*): B. Or calculated: GPM = Change in Depth (in) x Gallons Per Inch / Time Interval in Minutes gal/in T C])nmer GPM ‘Note: This value must be adjusted after GPM installation based on pump calibration. in X min = GPM13. Flow Rate from Line 12.A or 12.B above. 14. Calculate TIMER ON setting: Total Dosins Volume/CPM gal V Minutes ONgpm = 15. Calculate TIAAER OFF setting: Minutes Per Day (1440)/Doses Per Day - Minutes On 1440 min Minutes OFFdoses/day - 16. Pump Off Float ■ Measuring from bottom of tank: Distance to set Pump Off Float=Gatlons to Cover Pump / Gallons Per Inch: gal F ____________ 17. Alarm Float ■ Measuring from bottom of tank: Distance to set Alarm Float = Tank Depth(4A) X 90% of Tank Depth in X0.90 = minV gal/in =inches in B. DEMAND DOSE FLOAT SETTINGS 18. Calculate Float Separation Distance using Dosing Volume. Total Dosing Volume /Gallons Per Inch 129 gal V 11.7 Inchesgal/in =11.0 19. Measuring from bottom of tank: A. Distance to set Pump Off Float = Pump » block height + 2 inches in =14 Inches2in + B. Distance to set Pump On Float=Distance to Set Pump-Off Float + Float Separation Distance in + 12 26 Inches11.7 in =14 C. Distance to set Alarm Float = Distance to set Pump-On Float + Alarm Depth (2-3 inches) in +28 Inches2.0 in =26 FLOAT SETTINGS TIMED DOSINGDEMAND DOSING r aInches for Dose:11.7 in FLrx_ inAlarm DepthAlarm Depth 27.7 in Pump On 25.7 in Pump Off 14.0 in 22 Gal Pump Off129 Gat in s154 Gal 1“' ■it I*- University OF Minnesota OSTP Soil Observation Log Project ID:v05.13.14 P 14000270213000Legal Description/ GPS:Client/ Address: OOutwash [j Lacustrine f~l Loess PI Till I I Alluvium I I Bedrock O Organic MatterSoil parent material(s): (Check all that apply) PI Summit Q Shoulder CH Back/Side Slope P] Foot Slope □ Toe Slope Slope shape linearLandscape Position: (check one) Soil survey map units 718Cwooded Sloped 2.0 Elevation:Vegetation 06/30/15clear, amWeather Conditions/Time of Day:Date Observation Type:#2Observation #/Location:auger Structure IIRockMottle Color(s)Redox Kind(s)Indicator(s)Matrix Color(s)Depth (in)Texture Frag. %ConsistenceShapeGrade FriableModerateBlockyloam<25 10yr2/20-7 FriableBlockyModerate<20 10yr4/3loam7-14 FriableplateyModerate14-36 loam <20 2.5y4/4 FirmplateyModerate36-62 clay loam <20 2.5y5/4 "T > Comments I hereby certify that I have completed this work in accordance with all applicable ordinances, rules and laws. ^ /30 ^ (Date)(Designer/Hfis'pector)(Signature)(License #) 1 '*.ivi «<tirv<wO rM x > I r t;. S» WAt'.r T fM ATSVU.MT r* I ^ O < > K x'X f v! Additional Soil Observation Logs Project ID: Client/ Address:Legal Description/ GPS:P14000270213000 I i Outwash lH Lacustrine Q Loess [2] Till I I Alluvium O Bedrock [j Organic MatterSoil parent material(s): (Check all that apply) 0 Summit C] Shoulder O Back/Side Slope C] Foot Slope O Toe Slope Slope shapeLandscape Position: (check one) Soil survey map units 718EVegetation Sloped Elevation:2.0 Weather Conditions/Time of Day:clear 06/30/15Date Observation #/Location:#3 Observation Type:auger Rock StructureI IDepth (in)Texture Matrix Color(s)Mottle Color(s)Redox Kind(s)Indicator(s)Frag. %ConsistenceShapeGrade 0-8 loam <20 10yr2/2 FriableblockyModerate 8-15 loam <20 10yr4/3 FriableModerateblocky 15-40 loam <20 2.5y4/4 Platey FirmModerate 40-62 loam <20 2.5y5/4 FirmPlatey Moderate Comments Observation #/Location:Observation Type: Rock Structure IDepth (in)Texture Matrix Color(s)Mottle Color(s)Redox Kind(s)Indicator(s)Frag. %ConsistenceShapeGrade / ->> St' ' Comments Subsoil Indicator(s) of Saturation: 51. Distinct gray or red redox features 52. Depleted matrix (value >/=4 and chroma </=2) 53. 5Y chroma </= 3 54. 7.5 YR or redder faint redox concentrations or redox depletii Consistence: Loose- Textures: c-clay sic-silty clay sc-sandy clay Intact specimen not available Friable- Slight force between fingers Moderate force between fingers Extremely Moderate force between hands or slight foot pressure Foot pressure Firm- cl-clay loam firm- Rigid-If yes to one of the above indicators then: Topsoil Indicator(s) of Saturation: T1. Wetland Vegetation T2. Depressional Landscape T3. Organic texture or organic modifiers T4. N 2.5/ 0 color T5. Redox features in topsoil T6. Hydraulic indicators sicl-silty clay loam scl-sandy clay loam si-siIt sil-silt loam l-loam sl-sandy loam* Is-loamy sand* s-sand* Slope Shape: Slope shape is described in two directions: up and down slope (perpendicular to the contour), and across slope (along the horizontal contour); e.g. Linear, Convex or LV. *Sand Modifiers co-coarse m-medium f-fine vf-very fine Soil Structure Grade: Massive - ■"‘i,!, No observable aggregates, or no orderly arrangement of natural lines of weakness Poorly formed, indistinct peds, barely observable in place Moderate- Well formed, distinct peds, moderately durable and evident, but not distinct in Durable peds that are quite evident in un-displaced soil, adhere weakly to one another, withstand displacement, and become separated when soil is disturbed No peds, sandy soil 'L Weak- Strong- L.nuctscnpr Position: Svinimil [........................ Loose- »• f * i *SUouldt'i u,1 Foot Sloi>e j •s J Bvtck SideSoil Structure Shape: Granular- The peds are approximately spherical or polyhedral and are commonly found in topsoil. These are the small, rounded peds that hang onto roots The peds are flat and plate like. They are oriented horizontally and are usually overlapping. Platy structure is commonly found in forested The peds are block-like or polyhedral, and are bounded by flat or slightly rounded surface that are casting of the faces of surrounding peds. Prismatic- Flat or slightly rounded vertical faces bound the individual peds. Peds are distinctly longer vertically, and faces are typically cast or molds of Single Grain The structure found in a sandy soil. The individual particles are not held together. Too Slope Platv- Blocky- Map Unit Description: Naytahwaush loam, 15 to 30 percent slopes—Otter Tail County, Minnesota j- otter Tail County, Minnesota 718E—Naytahwaush loarri, 15 to 30 percent slopes Map Unit Setting National map unit symbol: gmis Elevation: 1,100 to 1,600 feet Mean annual precipitation: 22 to 25 inches Mean annual air temperature: 37 to 43 degrees F Frost-free period: 95 to 130 days Farmland classification: Not prime farmland Map Unit Composition Naytahwaush and similar soils: 85 percent Minor components: 15 percent Estimates are based on observations, descriptions, and transects of the mapunit. Description of Naytahwaush Setting Landform: Hillslopes on moraines Landform position (two-dimensional): Summit, shoulder, backslope Down-slope shape: Convex Across-slope shape: Linear Parent material: Loamy and clayey glacial till Typical profile A - 0 to 5 inches: loam E - 5 to 10 inches: fine sandy loam Bt -10 to 31 inches: clay Bk,C -31 to 60 inches: clay loam Properties and qualities Slope: 15 to 30 percent Depth to restrictive feature: More than 80 inches Natural drainage class: Well drained Capacity of the most limiting layer to transmit water (Ksat): Moderately low to moderately high (0.06 to 0.20 in/hr) Depth to water table: More than 80 inches Frequency of flooding: None Frequency of ponding: None Calcium carbonate, maximum in profile: 25 percent Gypsum, maximum in profile: 4 percent Available water storage in profile: High (about 10.1 inches) Interpretive groups ^ Land capability classification (irrigated): None specified Land capability classification (nonirrigated): 6e Flydrologic Soil Group: C Other vegetative classification: Steep; Fine Texture (G057XN017MN) 4^-Web Soil Survey National Cooperative Soil Survey Natural Resources Conservation Service t-.. 1'iL Map Unit Description: Naytahwaush loam, 15 to 30 percent slopes—Otter Tail County, Minnesota Minor Components Areas with more or less slope Percent of map unit: 3 percent Mahkonce Percent of map unit: 3 percent Parnell Percent of map unit: 3 percent Landform: Swales Snellman Percent of map unit: 3 percent Cathro Percent of map unit: 2 percent Landform: Depressions Soils that formed in outwash Percent of map unit: 1 percent Data Source Information Soil Survey Area: Otter Tail County, Minnesota Survey Area Data: Version 10, Sep 16, 2014 6/30/2015 Page 2 of 2 ^ Web Soil Survey National Cooperative Soil Survey Natural Resources Conservation Service OSIM 218-758-2438 P.1Jul09 1501;20p Frontier Manor Land & Resource Management GSC, 54D W Fir, Fergus Falls, MN 56537 218-998-8095; Website: vjww.co.ottertail.mri.usOTTSRTflH Subsurface Sewage Treatment System Management Plan Sewage Treatment System Permit Number: Property Owner. ^^ Parcel Number: O ^^ a O Lake Name / Number: A Section; 5. 7 Township Name; ____________________ E-911 Address: ac3:7 3 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 ora manual float, vjhen 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 forcorrosion 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). maintain the sewage treatment system on this property in accordanceI understand it is my responsibility to properly operate apd with this Management Plan. ^/ Date:Property Owner: Signature Cj Signature / 1/J3Received by Land & Resource Management:Date: The following link will provide irforrr.ation from the University of Minnesota, regarding a Septic System Owner's Guide; http://wvw.extension.umn.edu/environment/housing-technology/moisture-manage.Tient/septic-svstem-owner-guide/ LR: S5TS Management Plan 07-23-2014 f 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 October 5, 2007 United Sportsmen Club: Attn Tim Troje 16427 Harvard Dr Lakeville, MN 55044 RE: Sewage Treatment System Servicing Tax Parcel Number 14000270213000 Described as Lots 3 & 4 & N 1/2 NE 1/4, Section 27 of Dead Lake Township, Dead Lake (56-383) As of October 3, 2007, the sewage treatment system (Sewage Treatment Installation Permit #19377) servicing your property was determined to be in compliance with the provisions of the Sanitation Code of Otter Tail County for a 3 bedroom home. If you have any questions regarding this matter, please contact our office. Sincerely, Eric Babolian Inspector APPLICATION FOR PERMIT TO INSTALL SEWAGE TREATMENT 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 mmED SEP 18 Z007 LAND & RESOURCE mil 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 HoPI(3^ PARCEL NUMBER (S) OF PROPERTY BEING SERVICED E-911 ADDRESS OR DIRECTIONS FROM NEAREST PUBLIC ROAD LEGAL DESCRIPTION Ac, (of-^ S «i- Y^ ruNO Last Name First Initial Mailing Address Daytime Phone No. errProperty Owner hiXrt.r\■7<T-7<f ?D 3/(Contractor Lie.#m/J 3 /win THIS SPACE FOR OFFICE USE ONLY A.M. >■ This System will be ready for inspection on , the year of at.P.M. A.M. P.M. Date Received Time Received L & R Official SEWAGE TREATMENT SYSTEM DESIGN DATA - AS SHOWN ON DRAWINGTYPE OF INSTALLATION (CIRCLE ONE) TANK DRAINFIELD 6»50 R"Size GIs.Add-On/ Replacement (32) Tank, Septic (33) Tank, Lift (34) Trench, Rock (35) Trench, Graveiless (36) Trench, Chamber (37) Bed (38) Mound (39) At Grade (40) Combination New System (20) Trench, Rock (21) Trench, Gravelless ^^S^rench, Chamber (23) Bed (24) Mound (25) At Grade Setback to nearest well Ft.Ft. 9T71Setback to OHWL (lake &/or river)Ft.Ft. yOA-Setback to wetland hi AtFt. Setback to dwelling Ft.Ft.2.0 3(Collector System (26) Trench, Rock (27) Trench, Gravelless (28) Trench, Chamber (29) Bed (30) Mound (31) At Grade Setback to non-dwelling Ft.Ft. Setback to nearest property line Ft.Ft-Other (41) Tank, Holding (42) Outhouse (43) Sewer Line (44) Performance (45) Miscellaneous Ft.Setback to road right-of-way Ft. 5Elevation above restrictive layer Ft.Ft. ALL DISTANCES ARE SHORTEST DISTANCE BETWEEN NEAREST POINTS # BEDROOMS 3 GARBAGE DISP. Y / ABATEMENT Y /rfft DEPTH OF WATER WELL ABSORPTION AREA FOR MOUNDS .Ft^EFFLUENTDISTRIBUTION ( ^Gravity ( ) Pressure HOLDING TANK MONITOR/ DISPOSAL CONTRACT ( )Yes ( ) No-L&R Can Not Process Designer Yt_ Designer Lie. ______ Highest Rate /Q PERCOLATION TEST DATA 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 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: This permit is vaiid for a period of six (6) months. //5Date:Permit Fee $le^gent ‘^'I°lc7Date:Rec. No..Land S^s^urce ManagerYnL^wce Comments: Form No. BK — 0906-003 327,315 • Victor Lundoon Co., Printsrs ■ Fergus Falls. Minnesota ,< •APPLICATION FOR PERMIT TO INSTALL SEWAGE TREATMENT SYSTEM 10-''} 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 .V 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 TWPNO.RANGE TWP NAME P (r>kc.^/O PARCEL NUMBER (S) OF PROPERTY BEING SERVICED E-911 ADDRESS OR DIRECTIONS FROM NEAREST PUBLIC ROAD H ooo 9”7 9 » t>0(Xj LEGAL DESCRIPTION ■^4- Y <-rO V‘9 p\}E '/‘Yc. Last Name First Initial Mailing Address Daytime Phone No. Property Owner ''•"V C>r^ rl 4>(~OI3-- U.¥U-^d 1/^AtdA} T<CT" C/uJ, T/P 'trfu'-c. /^VJ'7 4^' ^ 3 / ( 7<T77X r~i Jp-‘L’r/eX>1A .3 ti3- A93y.Contractor Lie.#P-e^th THIS SPACE FOR OFFICE USE ONLY /o- J ~2^o<yl g - A:>>• This System will be ready for inspection on , the year of at A.M. Date Received Time Received L&R Official SEWAGE TREATMENT SYSTEM DESIGN DATA - AS SHOWN ON DRAWINGTYPE OF INSTALLATION (CIRCLE ONE) TANK DRAINFIELD Ft"Size GIs.6»50/OOiSAdd-On/New System (20) Trench, Rock (21) Trench, Gravelless •:(2^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.uo ^'I'lSetback to OHWL (lake &/or river)Ft.Ft. Setback to wetland rOA-fsi/Ar ^Z^^aFLFt. Setback to dwelling Ft. Ft.20Collector System (26) Trench, Rock (27) Trench, Gravelless (28) Trench, Chamber (29) Bed (30) Mound (31) At Grade 3 I Setback to non-dwelling Ft.Ft.2| Setback to nearest property line Ft.Ft.feooOther (41) Tank, Flolding (42) Outhouse (43) Sewer Line (44) Performance (45) Miscellaneous Ft.Setback to road right-of-way Ft. 5Elevation above restrictive layer Ft.Ft. ALL DISTANCES ARE SHORTEST DISTANCE BETWEEN NEAREST POINTS. DEPTH OF WATER WELL # BEDROOMS GARBAGE DISP. Y / JiL) ABATEMENT Y /(N^ ABSORPTION AREA FOR MOUNDS Ft^EFFLUENTDISTRIBUTION ( /} Gravity ( ) Pressure HOLDING TANK MONITOR/ DISPOSAL CONTRACT ( )Yes ( ) No-L&R Can Not Process Designer /, , ,■ Designer Lie. #_ PERCOLATION TEST DATA / y / f-i ^ jy -.Highest Rate /O'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 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: This permit is valid for a period of six (6) months. /^5‘1'- K -ip }Date:Permit Fee $/stature of Pfope^' "A n 6 7 IAIQ'(.2>Date:Rec. No.. Land S Resource ManagemyntJOffice Comments: Form No. BK — 0906-003 327,315 • Victor Lundeen Co., Printers • Fergus Falls, Minnesota '*i \SEWAGE TREATMENT SYSTEM PERMIT INSPECTION RESULTS Inspector must make all measurements HOLDING SEPTIC TANK DRAINFIELD OUTHOUSELIFT TANKCATEGORY Capacity GLS.ft 2 FT2GLS,) 0 OO "7^ - FTSetback from Nearest Well FT FT FT7o Setback from Buried Water Suction Pipe FT FT FT FT Setback from Buried Pipe Distributing Water Under Pressure FT FT FT FT/o-rlO tZ»*' FTSetback from OHWL (lake &/or river)FT FT FT Setback from Setback from Wetland FT FT FT FT Setback from Dwelling ZO FT FT FT FT3l 4-Setback from Non-Dwelling 30 FT FT FT FT to*Setback from Nearest Property Line FT FT FT FT/ o St>*Setback from Right-of-Way FT FT FT FT Elevation above Restrictive Layer 3FTFT FT FT Holding Tank/Lift Alarm YES NOA/A A/A ^Old System Pumped & Destroyed YES NO SEPTIC TANKfSt FILTER Sewer Line to Well Separation DRAINFIELD CALCULATION Actual Minimum# Tanks Installed___3)^YES □ NO __FTX /Cag* sc>y 7" Sck VoManuf. .ft^/OOP FT 20Model # MOUND CALCULATION MOUND /AT-GRADE^ ROCK REDUCTIONInspector’s Comments: 61^ A ftp U .TH AHi)Tht|g Rock"^rsncliev"with_ of rOck under pipe for ABSORBTIOhPAREA /2 inches ZoFt. X reduction / equivalent to ft^ DF.Ft2 SKETCH: uOt'-'' \3 01^^'- Initial / L & R Official LJ , th'e‘'ateoiffi_ described sewage system installation found to be compliant with th^^rovisions of the Sanitation Zoo* As of_____ Code of Otter Tail County. Land & Resource Manageme, t Official AIR TEST CERTIFICATION On lO'’ (J^_______ (date), an air test of the sewer line installed Sewage Wsposal System Permit Number fiA/r6^ CLjr> (owner), on ____ under for (lake/river) was made. /At that time, the sewer line held inch for pounds per square minutes. 43/NI^ Installer s Signature License No.Date RECEIVED SITE DATA WORKSHEET LAND & RESOURCE MANAGEMENT, COUNTY OF OTTER TAIL GOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS FALLS, MN 565b9lND & RESOURCE 218-998-8095 SEP 182007 www.co.otter-tail.mn.us n 37 7Sewage Treatment System Permit #OWNER: LA^ NAME ^ ' FIRST 4- ha.K-er^/„ 7«r'7‘? TELEPHONE NUMBER j~o^ MIDDLE ADDRESS: />W S'6^S~ J^onnjir cj- CITY /Oj> (. K-€ LAKE NAME STR./RT.STATE ZIP CODE LAKE/RIVER NO. 13^ SEC. TWP.RANGE TWP. NAME LEGAL DESCRIPTION:SOIL BORING LOG h5^-^d .^c. 3,^ ^ /\jVa COLOR & MUNSELL NO.DEPTH(INCHES)AJ6 ^^Lj TEXTURE STRUCTURE BLOCKY PLATY PRISMATIC ^ AfONE> fopSfj.'{ PARCEL NUMBER ^ 3Co PLATY ^jLki-ry\.IH~30> E-911 Address or Directions From Nearest Public Road /O PRISMATIC NONEzNUMBER OF BEDROOMS GARBAGE DISPOSAL: YES WELL: CASING DEPTH ft. SEWER LINE SEPARATION: ft gLOCKY-^^L3^c( PLATY PRISMATIC NONE I Oe_v/v /Oi/lZ- BLOCKY PLATY PRISMATIC NONE FLOODPLAIN: YES BLUFF: YES VEGETATION: AQUATIC <<TeRRFSTrTaI:> BLOCKY PLATY PRISMATIC NONE SLOPE AT INSTALLATION SITE:% Z'^rma^TYPE OF OBSERVATION: Probe Pit PARENT MATERIAL:Outwash Loess Bedrock Alluvium /S--4T-7ORIGINAL SOIL:Date of Soil Boring. COMPACTED SOIL: nDEPTH OF BORING (To 7' or restrictive layer):.ft.Date of Perc Test PERC TEST #1 PERC TEST #2- TWO TESTS ARE REQUIRED - TIME INTERVAL fMINUTES)WATER DEPTH WATER DROP PERC RATE TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATE213^LP.7 ioc^'zJoa yp.START START<-■T TIME DROP PERC TIME DROP PERC TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATE TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATE 51^ ~i\d !.t>REFILL REFILL Itr.S'5T ijT =DROP7r.TIME DROP PERC TIME PERC TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATE TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATEl\SO 1\«....... I'.to^h.lO.REFILL [hr:..c:,S = i C> TIME DROP PERCTIMEDROPPERCTIMEINTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATE TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATEREFILLREFILL TIME DROP PERC TIME DROP PERCTIMEINTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATE TIME INTERVAL (MINUTES!WATER DEPTH WATER DROP PERC RATEREFILLREFia TIME DROP PERC TIME DROP PERCTIMEINTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATE TIME INTERVAL (MINUTES) WATER DEPTH WATER DROP PERC RATEREFILLREFIU TIME DROP PERC TIME DROP PERC TIME INTERVAL IMINUTESl WATER DEPTH WATER DROP PERC RATE TIME INTERVAL (MINUTES!WATER DEPTH WATER DROP PERC RATEREFILLREFILL TIME DROP PERC TIME DROP PERC TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATE TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATEREFILLREFILL TIME DROP 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 — T rn-TD T -......M...;.. r TIT!!r:1 If I 1 System^d^e^sig^^must! be| to-scale arid niu}ist| include the proposed rlocationj of the 'Sewage, systemi-all exisitmg/proposed ibuilding'si property lines,LtWe: ordinaryi highi water! level: ofi the water body,: wetlarjids, _ J-ibluffJa'nd-ali-wa^tertwells-yyithih+TSpj^pf fhe~sewage-fsysterTi4lf-4hereiaTe-ahy4questiohs,--seieithe of'Minnesota Sitej Evaluation worksheets. : i , | ' j i \ \ 1 r1.1 ia...LIr II--. i I r•] ! 1 -h-f1!t4-I I C. i1iinch(es) equals [ —L ,,l |... ... ..I...^ ;Scale:4 1 i ' ' rH~ fept, -on j__gnd(^).equaW .feet 1 ,t.rI1.L t!r-T 3^III r f-i-'t.^..IJ..MP|CA LI6ENSE *:'A31uL1 i LICENSE ckUcORY:! ' ^ . 'll'! i i ' ' ' J ! ' ' ■ ; uln ' : -DATE:l4 \1 I i I .‘ h f DESIGNED BY: ' I 44:fT:a:p|:................................ [ | jFIR ivi IN AM : ItIr._..L t 4 I ..t■ri:II1 I"•f TSSW.[.I 4-4 'III■I ]ADDR .ill 1-h-i—■r SIGNATiURE: rr-!"!! i jlUlt!4. r f •i \1 [ ...I..r..If!!■ r'U(irq:1.I! 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'!.!.!..I..I....!....r 4.[..I■f'1ftTI!X.tj!T !^4 14riI1•TI't rTI i...j.T !4-:.[4::i4.].:.L.i 1i-•f h Fi4-fL (I1JtIT1444 ”1 i IJ—!f _uT1 I-t--Ir ]_..1.1-i [.;.I..ri;:i4l;ri r.i 1—h I. i_.^.!r 4- I 4Dwellingi ' -r'"!.f..i'-[' 4.4-I!1 ! r iLtn I-h•1 i:i"t•Ln.m.r'TT j" I .L II'Ii±n 4--t-•!•—4—X1'4.T ..i.t 1-;tr I..L...44l._.[..l“l i >( i Ii !..4 r.[..i...rT""' T IIII..i.....L-I'I I1 i]rTiij.i__:j:t4:rr f ' 1 11: I : 5 \..f..t:f 4 rTi : ! h:.4:^q=h4p>n:rtt I4-4---'3.,._L ..Li..l.I LHtjJ-....It r4TT'-r-T=i==64-^-iir¥,.L.i\-+ II•1 ■II i. -iTI..1.11T1TjI--T i.:,L ?r 3 BR 1welling 1.!.I■ I-I-! 1 1 m --1.„4_..!■4-|--(--rTu:i ■f 4..!•..1...I ti4ttTni4-1.hf-i tI1-4-4 T U [-4-T qj..i ..L1 1F-41—be^ -wellr 'i— ...... i M i i I M _i M i. I : t i i j Co.." Printers •;''Fe7gus|'Falls.iMN • I-800J346-4870 jiF I '315:904..• Vicip"1003 - 029—IBK Lundeen I-tIIFijj.Ii J_iiA. A'1 SEWAGE SYSTEM W-smi MM .l3This Certificate has been issued this 20th of May, 1999 , to certify that the sewage system installed as per Sewage Treatment System Permit Nximber 12234(B) has been approved for use by Otter Tail County, Minnesota.ilIII Hr* *'3 m V The property served by this Sewage System is legally described as:simL Lots 3, 4 & Nl/2 NEl/4 (118.90 Acres) £ m iMi mParcel Number(s):14000270213000 Section: 27 Township: 135 Range: 40 Township Name: Dead Lake Lake Number: 56-383 Lake Name: Dead Lake *• wM1l\ m f: Current Property Owner: United Sportsman Club c/o Charles Hauck Number of Bedrooms:4 1/ leJU^UJxmu^ 9 ind & Resource I<(anagement Official * This System services Cabin #5 & Shower House9a ['i ■'N* 284.709 * Victor Lundeen Co . Printers • Fergus Falls. MN • 1 •600-346‘4870 APPLICATION FOR PERMIT TO INSTALL SEWAGE TREATMENT SYSTEM LAND & RESOURCE MANAGEMENTOTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 - FERGUS FALLS, MN 56537 WHITE — Office YELLOW — Inspecfor PINK — Owner CrLs 3d-v ^ /YLEGAL Permit No. Abatement: ( ^ ) YesDESCRIPTION ) NoAND LOCATION LAKE NUMBER LAKE/RIVER NAME LAKE/RIVERCLASS SECTION TWR NO.RANGE TWP NAME UU2 7 I3XAJ L PARCEL NUMBER(S)FIRE OR LAKE ASSOCIATION NUMBER ol ?y.ooo IDENTIFICATION: Please Print All Information Last Name First Initial Mailing Address — No. Street. City and Stale Zip Code Telephone No. A- /Aa/ ClrLM- A rJc. Property Owner S-h ^ S//t.,'sraS’ Sewage System Installer Name State Lie. # A.M. > This System will be ready for inspection on the year of PM.at This space tor office use oniy NUMBER OF BEDROOMS: AM. PM.GARBAGE DISPOSAL: ( ) YES ( Date Rac'd Time Rec’dYear of Phone Call Rec’d By TYPE OF SEWAGE SYSTEM ( ) Holding tank (Alarm Required) (■><1) Septic tank ( Lift station (Alarm Required) ( ^ Drainfield ( y<t) Trenches ( ) Bed ( ) Mound ( ) Outhouse ( ) Sewer line SEWAGE TREATMENT SYSTEM DATA: MINIMUM REQUIREMENTS TANK DRAINFIELD Ft*Capacity GIs. SODistance from nearest well Ft.Ft. Distance from lake or stream Ft.Ft.iS^OI Distance from dwelling Ft.Ft./6>2^0 Distance frorn non-dwelling Ft./ O F*-Lo Distance from property line Ft.Ft./O /O EFFLUENT DISTRIBUTION ( ) Gravity ( X) Pressure Distance from bottom to Water Table Ft.Ft.3 All distances are shortest distance between nearest points PERCOLATION TEST DATA:WATER WELL DEPTH Perc Tester 't^aXe of Perc Test o7.6 Avefage^ateRate of 1 St Test Rate of 2nd Test 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 Official shall become a part of the permit. Applicant further agrees that no part of the system shall be covered i^il it has been inspected and accepted. It shall be the respon sibility of the applicant for the permit to notify the County Shoreland Man:ent that the4ob is ready/qcinspepttofi.(2 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 con dition 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 Office?.Fee St—-33^ Rec # j ^ r'A -SliComments:OoJ vr BK 0795-003 ?9l.0lt5 * Viriof l.uiKiri.'n Co. Pruiiiifs • Hrttiiis falls. Minn rr System design must be to scale and must include the proposed location of the sewage existing/proposed buildings, property lines, the ordinary high water level of the water body and a\ wells within 150' of the sewage system.m1YEIPlti GRID PLOT PL /__inch(es) equals 3 ^ feet SKETCHING FOlScale;.grid(s) equals feet, or !: SUBMITTED BY:/SIGNATURE: i. _ A 5^7 / u FIRM NAME:DATE: C o H * ^1 'fV. I, i 1 fj% iADDRESS:MPCA LICENSE #:»t-PJ LICENSE CATEGORY:. r]'TT:]-j-|I /i/ I ,L ; ■j t I fi -r -iI 'h \\I'.i I V ;i ! I I (!/s i I- i//r i I I 1 ,1. -I..V //‘/■ • \1..■/ |-i:- ■/• I \'■V\X II/■-i \\V-\‘ ■7I I:;. I ;i“S : ft \‘ /ai \N>/i !i’f•: .1 _r 1 ;!ik (( : I j :RECE'® : I i( j r : I, h:I !;S>7 1939\r■ I .IIyCR -l-H-:'h"i’r r '--iifi \1If -l\ :I i i:J......— i »• I\\\1SiIi; :—I—1. _ ' i ..!__;.1^0 oKX::-I ;1i—l- -r ! "i' -■\-4'^4 ;;\ ' ■ j ' ■ ' i i -i ■ ^ \; .. !-|_j J... ,f---|---------; ■: ■ -rri T ■; ii ‘ ., .:|irnt!J t.- ! !-I Dni :- .1 .i \ —j"! ■ i • - ^ 'J. ' ,!r r1II\1V.i’1r;• - j__i ._j. - J- !. I.:'F4r •]—i-|■ I J"1 i !I-;i:!■ ;1 4 [ 1 ,• 7 T ^ 7-:r r •; I • I- . -I 1 h-t-M-t r ■]<1 ,1 i .I--•IBK — 0496 — 029 281.183 • Vidor Lundein Co.. Primera • Forgus Falls. MN • 1*80Q'346-487CI . Vno. Ln.«l..-.rnt:o.PM.«m • F^.llsM-n.-sol.29109‘i BK 0795-003 r APPLICATION FOR PERMIT TO INSTALL SEWAGE TREATMENT SYSTEM LAND & RESOURCE MANAGEMENTOTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 - FERGUS FALLS, MN 56537 VHITE — Ollice <^ELLOW — Inspector ^INK — Owner \C-L's 3d-V ^ ^ //t 4^7LEGAL Permit No. Abatement: ( ^ ) YesDESCRIPTION ( )NoAND LOCATION SECTIONLAKE/RIVER NAME LAKE/RIVER CLASS TWP. NO.TWP NAME.AKE NUMBER RANGE UU!3XAJ L ^0 ’ARCEL NUMBER(S)FIRE OR LAKE ASSOCIATION NUMBER DL1^-000--000 IDENTIFICATION; Please Print All Information First Initial Mailing Address — No. Street. City and SlateLast Name Zip Code Telephone No. Property Owiter S-h 5 S'//^,A-^hK/ CL^cr-l^S J^A ArJc. Sewage System Installer Name State Lie. # A.M. ► This System will be ready tor inspection on , the year of PM..at. This space for office use only NUMBER OF BEDROOMS; A.M. .PM.GARBAGE DISPOSAL: ( ) YES ( ^)NO Phone Call Rec’d ByYear ol Time Rec'dDate Rec’d TYPE OF SEWAGE SYSTEM ( ) Holding tank (Alarm Required) 0<1) Septic tank ( Lift station (Alarm Required) ( yt) Drainfield ( X) Trenches ( ) Bed ( ) Mound ( ) Outhouse ( ) Sewer line SEWAGE TREATMENT SYSTEM DATA: MINIMUM REQUIREMENTS TANK DRAINFIELD Ft'Capacity GIs./ 0(9^0 SO //CroDistance from nearest well Ft.Ft. Distance from lake or stream Ft.Ft.J^O! ^ Distance from dwelling Ft.Ft./<o 0^0 Distance from non-dwelling Ft./ O Ft-/O Distance from property line Ft. Ft./O /£f EFFLUENT DISTRIBUTION ( ) Gravity ( X) Pressure Distance from bottom to Water Table Ft. Ft.3 All distances are shortest distance between nearest points PERCOLATION TEST DATA:WATER WELL DEPTH V ^c.fjytt/fu^da'ie of Perc TestPerc Tester c^.4 JIS Avefage^ateRate of 1 St Test Rate of 2nd Test 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 Flealth. Applicant agrees that plot plan sketches and specifications submitted herewith and which are approved by Shoreland management Official shall become a part of the permit. Applicant further agrees that no part of the system shall be covered i^il it has been inspected and accepted. It shall be the respon sibility of the applicant for the permit to notify the County Shoreland Man^geinent that tt^ob is ready/^inspeofipri. 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 con dition 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 Office?.3^Fee $:Rec # P- >$‘/lComments:0 t,r BK 0795-003 29IOUl.r • Vir.inr l.iiiu|>-rn Lfi . Pr-nli.-r'. •la r.-ill, M-niN'vrjl,i SiiTE DATA LAN D AN D R ESO U RC E MAN AG EMENT Otter Tail County Fergus Falls, MN 56537 OWNER: U::>ck. X 4dI LAST NAME FIRST MIDDLE TELEPHONE NUMBER ADDRESS: STR./RT.CITY LAKE NAME STATE ZIP CODE LAKE/RIVER NO.SEC.TWP.RANGE TWP. NAME LEGAL DESCRIPTION:SOIL BORING LOG COLOR 8 MUNSELL NO. DEPTH (INCHES)TEXTURE STRUCTURE BLOCKY PLATY PRISMATIC NONE /P //f& /rPARCEL NUMBER 7 BLOCKY PLATY PRISMATIC NONE FIRE NUMBER 7NUMBER OF BEDROOMS BLOCKY PLATY PRISMATIC NONE GARBAGE DISPOSAL: YES WELL CASING DEPTH:ft.BLOCKY PLATY PRISMATIC NONE FLOODPLAIN: YES VEGETATION: AQUATIC <;fER^jaJAt? BLOCKY PLATY PRISMATIC NONE £SLOPE AT INSTALLATION SITE:% (^Krin^TYPE OF OBSERVATION: Probe Pit PARENT MATERIAL: Till ORIGINAL SOIL: No Outwash Loess Bedrock COMMENTS:, COMPACTED SOIL: Yes 2JLDEPTH OF BORING:.ft. PERC TEST #1 PERC TEST #2- TWO TESTS ARE REQUIRED - WATER DEPTH*TIME INTERVAL (MINUTES! WATER DROP PERC RATE TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATE'/z-If, ‘IL #/..Je... -3^-- ;gs~START START /C.//TIME DROP PERCPERCTIMEDROP TIME INTERVAL (MINUTES! WATER DEPTH WATER DROP TIME PERC RATEPERC RATE INTERVAL (MINUTES)WATER DEPTH WATER DROP/El7 3 ®REFILL Ll'.Lz^..PERCTIMEDROPI PERC TIME DROP TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATE TIME WATER DEPTH PERC RATEINTERVAL (MINUTES!WATER DROP /HB 'A::fKY2:3^Irl'./DPREFIU /O? =3^3 DROP PERCTIME PERC INTERVAL (MINUTES)PERC RATETIMEWATER DEPTH WATER DROP PERC RATE I TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP REFILL REFILL PERCTIMEDROPTIMEDROPPERC INTERVAL {MINUTES! WATER DROP WATER DROP PERC RATETIMEWATER DEPTH PERC RATE TIME INTERVAL (MINUTES!WATER DEPTHREFILLREFILL PERCTIMEDROPTIMEDROPPERCTIMEINTERVAL (MINUTES)WATER DROP WATER DEPTH WATER DROP PERC RATEWATER DEPTH PERC RATE TIME INTERVAL (MINUTES!REFILL REFILL TIME TIME DROP PERCDROPI PERCTIMEINTERVAL (MINUTES!WATER DEPTH WATER DROP-PERC RATE I INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATETIME REFILL REFILL PERCTIMEDROP .PERC TIME DROP TIME WATER DEPTHINTERVAL IMINUTESI WATER DEPTH WATER DROP PERC RATE TIME INTERVAL (MINUTES) WATER DROP PERC RATE /REFILL REFILL ' TIME PERCTIMEDROPPERCDROP PROPOSED DESIGN: GRAVITY DIST..PRESSURE DIST._BED.ATGRADE.MOUND.HOLDING TANK.TRENCH. SEWER LINE.OUTHOUSE.OTHER.SPECIFY:______________ — SYSTEM DESIGN ON BACK — 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 and all water wells within 150' of the sewage system. * GRID PLOT PLAN feet SKETCHING FORML___inch(es) equals.grid(s) equals feet, orScale: rSUBMITTED BY: a)ha SIGNATURE: DATE: MPCA LICENSE #: LICENSE CATEGORY: FIRM NAME: /Aa^ocv,^7y, : vl ij C;i . rr ^ /ADDRESS: / .JTCrP\1^ 'h I I f N > i D BK — 0496 — 029 281.183 • Victor Lundoon Co.. Printort • Fergus Fails. MN • 1-800*346-4870 GRID PLOT PLAN feet SKETCHING FORMinch(es) equalsScale:.grid(s) equals feet, or MA-f HA'cL^- Afri'Or rcv\cvO o ^I^oj ■ 19 ■Dated: Signature ¥.Please sketch your lot indicating setbacks from road right-of-way, lake, sideyard and septic tank and drain- fldlsLiireach building currently on lot and any proposed structures.CoLc & pK'^. c > CA-iiN J AUt-<- % ^ t. Vi P'(%-<?>• (>- > A \ “ty ^\ V V vT- ^ > <rVS «/'5- ^E.'<s h 1 1% o> FA/I £)F^,fOSS.LIy Jc,'sP od»xe-C^ €A sj) • IP Nr I 281.949 • Victor LotwJecn Co.. Prittwr* • Fergus Falls. MN • 1-800-346-4870MKL —0871 SEWAGE SYSTEM m This Certificate has been issued this 20th of May, 1999 , to certify that the sewage system installed as per Sewage Treatment System Permit Niimber 12234(A) has been approved for use by Otter Tail County, Minnesota.m The property served by this Sewage System is legally described as:s' m Lots 3, 4 & Nl/2 NEl/4Sir(118.90 Acres)Wi & Parcel Number(s): 14000270213000 S..Section; 27 Township; 135 Range: 40 Township Name: Dead Lake P'Lake Number: 56-383 Lake Name: Dead i United Sportsman Club c/o Charles HauckCurrent Property Owner; Nvimber of Bedrooms: 4 This System services Jim Hauck & Hank Troje Units Land & Resource Management Official 264,709 • VictOf Lundeen Co. Printers • Fergus Falls. MN • >•800-346-4870 P cea~ To cSLt-iiJ (2 ^|n^ f" f4fWi^ T^^JjC i e ^1^(3i ^ ^ ^ .9 , APPLICATION FOR PERMIT TO INSTALL SEWAGE TREATMENT SYSTEM LAND & RESOURCE MANAGEMENT OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 - FERGUS FALLS, MN 56537 WHITE — Office YELLOW — Inspector PINK — Owner G'Cs 3 ^ y /V ^4 Vv aLEGALPermit No. DESCRIPTION Abatement: ( ^) Yes ) NoAND LOCATION LAKE NUMBER LAKE/RIVER NAME SECTIONLAKE/RIVERCLASS TWR NO.RANGE TWP NAME Oj6^cL L.cJi'I3S Vc^7S6, -35^3 PARCEL NUMBER(S)FIRE OR LAKE ASSOCIATION NUMBER I ^-000- Ps?' 02,15 -Ooo ]>L ?y IDENTIFICATION: Please Print All Information Last Name First Initial Mailing Address — No. Street, City and State Zip Code Telephone No. /14^M CJrcLf'l'^s C si- ma/ Property Owner Sewage System Installer Name IMA/state Lie. # A.M. ► This System will be ready for inspection on , the year of P.M..at. This space for office use only NUMBER OF BEDROOMS:yA.M. .P.M.GARBAGE DISPOSAL: ( )YES (^) NODate Rec'd Year of Time Rec’d Phone Call Rec’d By TYPE OF SEWAGE SYSTEM ) Holding tank (Alarm Required) SEWAGE TREATMENT SYSTEM DATA: MINIMUM REQUIREMENTS TANK DRAINFIELD( Ft^( ><L) Septic tank ( yc) Lift station (Alarm Required) (;)C) Capacity GIs./ooa Distance from nearest well Ft. Ft.SoDrainfield ( X.) Trenches ( ) Bed ( ) Mound ) Outhouse ) Sewer line Distance from lake or stream Ft. Ft.O ISd Distance from dwelling Ft.Ft.JO t^O Distance from non-dwelling Ft. Ft./O(/o Distance from property line Ft.Ft./ o /o EFFLUENT DISTRIBUTION ( ) Gravity ( yC) Pressure Distance from bottom to Water Table Ft. Ft.3 All distances are shortest distance between nearest points PERCOLATION TEST DATA:WATER WELL DEPTH Perc Tester Date of Perc Test 2.^Cp 1^25-7Rate of 1 st Test Rate of 2nd Test ATOfage 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 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 accepted. It shall be the respon sibility of the applicant for the permit to notify the County Shoreland Manag'ejhent that the/fob is rea*!? for inspecJI^. Q 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 con dition 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 Office ckiOSoFee $ Comments: S' ^ Rec # S'r~a j -g-d 2 jf£ ~?0 —-Af' A |•tl|lls r:ili'‘%. Mintiiisoui8K 0795-003 291.0'Jb • Vinior l.uruici.Ti tlo, Ptmimr. • w- ^ APPLICATIOf^OR PERMIT TO INSTALL SEWAGE TREATMENT SYSTEM LAND & RESOURCE MANAGEMENTOTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 - FERGUS FALLS, MN 56537^,,^^ WHITE — Office YELLOW — Inspector PINK — Owner O'L's ZJ-V A/'/l 9 /?LEGAL Permit No. DESCRIPTION Abatement: ( yf) Yes ( )NoAND LOCATION LAKE NUMBER LAKE/RIVER NAME LAKE/RIVERCLASS SECTION TWR NO.RANGE TWP NAME I3S 9^1- 3^3 PARCEL NUMBER(S)FIRE OR LAKE ASSOCIATION NUMBER !^\-oo0- :^7'02\Z -Ooo 1>L ?y IDENTIFICATION: Please Print All Information Last Name First initial Mailing Address — No. Street, City and State Zip Code Telephone No. duJ^tl<ni \--tci S>^or'fProperty Owner A. KA /■ 44^ M p. -Sf ?c^S . s ■>Sewage System Installer Name O (JL> 0~}-4^r4~e^ i {_3state Lie. # / /AM. z> This System will be ready for inspection on.the year of 3d E33TThis space for office use only ^NUMBER OF BEDROOMS:I iJi )yes 3 ; <3< )no.P.M.GARBAGE DISPOSAL: ( Date Rec'd Year of Time Rec’d Phone Call Rec'd By TYPE OF SEWAGE SYSTEM ( ) Holding tank (Alarm Required) ( X) Septic tank ( X) Lift station (Alarm Required) ( y ) Drainfield ( >c) Trenches ( ) Bed ( ) Mound ( ) Outhouse ( ) Sewer line SEWAGE TREATMENT SYSTEM DATA: MINIMUM REQUIREMENTS TANK DRAINFIELD Capacity GIs./OOO S'o//OaDistance from nearest well Ft.Ft. Distance from lake or stream Ft.Ft.^ O Distance from dwelling Ft.Ft./O c2 O Distance from non-dwelling Ft.Ft./O /O Distance from property line Ft.Ft./O /O EFFLUENT DISTRIBUTION ( ) Gravity ( X^) Pressure Distance from bottom to Water Table Ft.Ft.3 All distances are shortest distance between nearest points i PERCOLATION TEST DATA:WATER WELL DEPTH I1pH? t.i S-2.a—Perc Tester _Date of Perc Test Z-7Rate 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 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 accepted. It shall be the respon sibility of the applicant for the permit to notify the County Shoreland Management that the job is ready for inspection. 9/ry/firDATE;A—A-1Signature f 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 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 Office ch cj! /c'r.y-'d-- Fee $Rec # Ls yI 4-/S4 ^•^5Comments:*A J (< <S«-fy7'i>Y7 7Trim-Y 7 O - &0 -f f 291.095 • Virior Lunrh'en Co Prtnlws • Fityiis falH. M>nnt'V>u»BK 0795-003 ,r~ INSPECTION RESULTS Inspector must make all measurements SEWAGE DISPOSAL SYSTEM STATISTICS •• DRAINFIELDHOLDING SEPTIC TANK LIFT TANKCATEGORY Actual Minimum c.Capacity O/6o^cP.FT=^FT2GLS. GLS.fDistance from Nearest Well FT(cry ft FF FT Distance from Buried Water Suction Pipe FT FT FT FT50 Distance from Buried Pipe Distributing Water Under Pressure A 1-1^ftFT FT FT10 /Distance from Lake or River S'!I ^0-(o p-pFTFT FT Distance from Dwelling 4^2 3,FT FT FT 10/20 FT Distance from Non-Dwelling ■^^0 FT liffZT.FT FT FT Distance form Nearest Property Line f O £5 pj-h 10 O pp FT 10 FT Distance from Bottom to Water Table FT FT FTFT3 Holding Tank/Lift Alarm Old System Pumped & Destroyed NO NO y -t-/'Sewer Line to Well Separation DRAINFIELD CALCULATIONINTERPRETATION OF ABBREVIATIONS GLS. = Gallons FT^ = Square Feet FT = Linear Feet Actual Minimum FTX ^ _ft^FT FT20 ROCK REDUCTION Inspector’s Comments: Rock trenches with inches of rock under pipe for .% ft2 DF.reduction / equivalent to SKETCH: r>/>esT»^ Inspector’s Signature /o Vtf /0-ii-i-iii Dale ol Inspection 3-r SS Time ol Inspection •^0 r.i , APPLICATION tOR PERMIT TO INSTALL SEWAGE TREATMENT SYSTEM LAND & RESOURCE MANAGEMENT OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 - FERGUS FALLS, MN 56537 WHITE — Office YELLOW — Inspector PINK — Owner Ht-rnU I0 Ls 3 d- V ^ /v' Vz. 4^ r //yLEGAL Permit No. Abatement: ( ) Yes DESCRIPTION ( )No*OCi\AND LOCATION LAKE NUMBER LAKE/RIVER NAME LAKE/RIVERCLASS SECTION TWP. NO.RANGE TWP NAME 2 7 ISS'AJ L f/0 PARCEL NUMBER(S)FIRE OR LAKE ASSOCIATION NUMBER ol ?y. ooo CX,-rr- IDENTIFICATION: Please Print All Information Mailing Address,— No. Street, City and StaleLast Name First Initial Zip Code Telephone No. /f/Z-A/ CUrKrUf C?50 du'^(<r CSProperty Owner F^J ^57/r., Sewage System Installer Name oState Lie. # > This System will be ready for inspection on.the year of .at. /rr/r>S/^y frvi ^ This space for office use only VNUMBER OF BEDROOMS: A MRM.GARBAGE DISPOSAL: ( ) YES ( X)NO4.^ Date Rac'd Year of Time Rec’d Phone Call Reo^d\,By TYPE OF SEWAGE SYSTEM ( ) Holding tank (Alarm Required) ('>^) Septic tank ( X) Lift station (Alarm Required) ( y') Drainfield ( XO Trenches ( )Bed ( ) Mound ) Outhouse ( ) Sewer line SEWAGE TREATMENT SYSTEM DATA: MINIMUM REQUIREMENTS TANK - 'DRAINFIELD Ft'Capacity GIs.) ooo J'O //CODistance from nearest well SO Ft. Distance from lake or stream Ft./S' Ft./ ^ C) Distance from dwelling Ft. Ft./ O X o Distance from non-dwelling Ft.y O Ft./o( Distance from property line Ft./e>yo EFFLUENT DISTRIBUTION ( ) Gravity ( X) Pressure Distance from bottom to Water Table Ft.a'Ft.l.d;. U All distances are shortest distance between nearest points IPERCOLATION TEST DATA:\WATER WELL DEPTH 1 i \1 ^ -ZS'- ?Q'Perc Tester Date of Perc Test X . ^Average RateRate of 1 St Test Ratefbf 2nd Test 1 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 Official shall become a part of the permit. Applicant further agrees that no part of the system shall be covered until it has beep inspected and accepted. It shall be the respon sibility of the applicant for the permit to notify the County Shoreland Management that the job is ready fpr inspection. DATE; Signature Permit: Permissiorrls 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 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.J V' Issued Date: Land & Resource Management Officer.s—•3'^Fee Rec It sL i\haux.f-0 Cut crComments: 7*^J■! BK 0795-003 291.095 • ViCICK LuixtiNtn . PriftKtis • Fergus Falt^ M'ruK'sol.i INSPECTION RESULTS Inspector must make all measurements SEWAGE DISPOSAL SYSTEM STATISTICS 4 DRAINFIELDHOLDING SEPTIC TANK LIFT TANKCATEGORY Actual Minimum Capacity /£>r!>f) GLS.FT2 FT2GLS. !0(ADistance from Nearest Well FTFTFF Distance from Buried Water Suction Pipe FT FT FT 50 Distance from Buried Pipe Distributing Water Under Pressure lot tot FTFTFT 10 FT7^Distance from Lake or River (OHWL)s [SO ftFTFT FT Distance from Dwelling -^5-^ ftFTFT 10/20 FT Distance from Non-Dwelling / Q<o FT FT FT FT Distance form Nearest Property Line 4- /60 ftFTFT 10 FT Distance from Bottom to Water Table + ^ FTFTFT FT3 Holding Tank/Lift Alarm Old System Pumped & Destroyed NO NO /v£K>t ^ *-r"Sewer Line to Well Separation DRAINFIELD CALCULATIONINTERPRETATION OF ABBREVIATIONS GLS. = Gallons FT® = Square Feet FT = Linear Feet Actual Minimum FTX 7o 5 ft^FT 20 ROCK REDUCTION Inspector’s Comments: Rock trenches with inches of rock under pipe for .% .ft® DF.reduction / equivalent to SKETCH: <70 35 no Jc^ l\'•tfr /I ir /y lit Inspector's Signature Dale of Inspection '3'iS S Time ot Inspection 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 and all water wells within 150' of the sewage system. GRID PLOT PLAN feet SKETCHING FORM.inch(es) equals.grid(s) equals feet, or /Scale: 't- SIGNATURE:SUBMITTED BY: DATE: MPCA LICENSE #: T LICENSE CATEGORY: FIRM NAME: 'B'sh. ^ "tTADDRESS: by o'- 5 \ ■\ \ \OP \ \ \\\\ \\ \\ \ \ \ \ ( -0 \ 281.183 • Victor Lundeen Co.. Printers • Fergus Falls. MN • 1-0OO-346-487O ABK — 0496 — 029 SITE DATA LAND AND RESOURCE MANAGEMENT Otter Tail County Fergus Falls, MN 56537 i OWNER: c//jyyvwLe.6i <^/Cb'r I' -i-TELEPHONE NUMBERFIRSTMIDDLELAST NAME ADDRESS: STATE ZIP CODECITYSTR./RT Lrxl/0 RANGE TWP NAMELAKE NAME SEC.TWPLAKE/RIVER NO. LEGAL DESCRIPTION:SOIL BORING LOG COLOR & MUNSELL NO. DEPTH (INCHES)STRUCTURETEXTURE BLOCKY PLATY PRISMATIC NONE/rPARCEL Number /BLOCKY PLATY PRISMATIC NONE FIRE NUMBER ifNUMBER OF BEDROOMS BLOCKY PLATY PRISMATIC NONE GARBAGE DISPOSAL: YES 7^ WELL CASING DEPTH:ft.BLOCKY PLATY PRISMATIC NONE FLOODPLAIN: YES <^^ESIRlAir^VEGETATION: AQUATIC BLOCKY PLATY PRISMATIC NONE SLOPE AT INSTALLATION SITE:% Pit.^(^^Boring^TYPE OF OBSERVATION: Probe PARENT MATERIAL: Till No Outwash Loess Bedrock<?^AIIuvium COMMENTS:. ORIGINAL SOIL: : 1S?COMPACTED SOIL: Yes DEPTH OF BORING:.ft. PERC TEST #2PERC TEST #1 - TWO TESTS ARE REQUIRED - WATER DEPTH PERC RATEINTERVAL (MINUTES)WATER DEPTH WATER DROPTIMEINTERVAL (MINUTES!WATER DROP PERC RATE TIME __3J___ — IlLlf STARTSTART ./V DROP PERCTIMEDROPPERCTIME PERC RATEINTERVAL (MINUTES)WATER DROPWATER DROP PERC RATE TIME WATER DEPTHTIMEINTERVAL (MINUTES)WATER DEPTH /n^7 12 'S3 / -■ ..3a.--(433REFILLI?-2P-3.'=L 3_2 O /_-r PERCTIMEDROPDROPPERCTIME PERC RATEWATER DROPWATER DROP PERC RATE TIME INTERVAL (MINUTES!WATER DEPTHTIMEINTERVAL (MINUTES)WATER DEPTH Uno'.SV.V.V. /o?:oo ..3l3..../Q ^ TIME ■ DROP PERC REEIU. REFia , DROP PERCTIME PERC RATEWATER DROPWATER DROP PERC RATE TIME INTERVAL (MINUTES!WATER DEPTHTIMEINTERVAL (MINUTES)WATER DEPTH REFILLREFILL DROP PERCTIMEDROPPERCTIME WATER DROP PERC RATEINTERVAL (MINUTES)WATER DEPTHWATER DEPTH WATER DROP PERC RATE TIMETIMEINTERVAL (MINUTES)REFILLREFILL DROP PERCTIMEDROPPERCTIME WATER DROP PERC RATEINTERVAL (MINUTES)WATER DEPTHTIMEINTERVAL IMINUTES)WATER DEPTH WATER DROP PERC RATE TIME REFILLREFILL TIME DROP PERCPERCTIMEDROP WATER DROP PERC RATEWATER DROP-PERC RATE INTERVAL (MINUTES!WATER DEPTHINTERVAL (MINUTES)WATER DEPTH TIMETIME REFILLREFILL DROP PERCPERCTIMETIMEDROP WATER DROP PERC RATEINTERVAL (MINUTES) REFia WATER DEPTHTIMEWATER DEPTH WATER DROP PERC RATE TIMEINTERVAL (MINUTES)REFILL PERCPERCTIMEDROPDROPTIME a.(#(PROPOSED DESIGN: PRESSURE DIST._HOLDING TANKMOUND.GRAVITY DIST.TRENCH.BED.ATGRADE. OUTHOUSE.OTHER. SPECIFY:.SEWER LINE — SYSTEM DESIGN ON BACK — i Bti I'm v]II CERTIFICATE OF APPROVAL SEWAGE SYSTEM sL^ ,1i si_-- m This Certificate has been issued this 1st of October, 1997 certify that the sewage system installed as per Sewage Treatment System Permit Number 11684 has been approved for use by Otter Tail County, Minnesota. , to lii# m The property served by this Sewage System is legally described as:Eri M-UNPLATTED LOTS 3, 4 & Nl/2 NEl/4 iJ ym it: h: K‘ * i Parcel N\imber(s): 14000270213000 Section:27 Township: 135 Range: 040 Township Name: DEAD LAKE TOWNSHIP Lake Number: 383 Lake Name: DEAD ' '-'ZiS-.m.] 1If MCurrent Property Owner: UNITED SPORTSMEN CLUB Number of Bedrooms: 2 m Land & Resource Management Official =*i m rSg!,^ m •V 284.709 • Victor Lundeon Co.. Printers ■ Fergus Falls. MN • 1-600-346-4870 APPLICATION FOR PERMIT TO INSTALL SEWAGE TREATMENT SYSTEM WHITE —‘OffZe Yellow — Ins/^'iiitior Pink — Owner LAND & RESOURCE MANAGEMENT OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 - FERGUS FALLS, MN 56537 V. 7^LEGAL Permit No. DESCRIPTION Abatement: (X ) Yes ( ) No AND LOCATION LAKE NUMBER LAKE/RIVER SECTION TWP. NO. RANGE TWP N^ME Ji7 /iS LAKE/RIVER NAME CL PARCEL NUMBER(S)FIRE OR LAKE ASSOCIATION NUMBER /7'000-,^7-0^/S- ooo IDENTIFICATION: Please Print All Information Last Name First Initial Mailing Address — No. Street, City and State Zip Code Telephone No. /T___ ./C> d/tflProperty Owner Sewage System Installer Name A.M. This System will be ready for inspection on , 19.P.M.at This space for office use oniy 3=rNUMBER OF BEDROOMS: A.M. P.M19 GARBAGE DISPOSAL: { ) YES NO Date Rec'd Time Rec'd Phone Call Rec'd By SEWAGE TREATMENT SYSTEM DATA: MINIMUM REQUIREMENTSTYPE OF SEWAGE SYSTEM ( ) Holding tank (Alarm Required) (^) Septic tank ( ) Lift station (Alarm required) TANK DRAIN FIELD 7r5/9Capacity GIs.Sq Ft. mDistance from nearest well Ft. Ft. Drain field (^) Trenches ( ) Bed ) Mound ( ) Outhouse ( ) Sewer line /SOISO)Distance from lake or stream Ft. Ft. /3) Ft. Distance from building Ft. Ft. ( 10_Distance from property line 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 iZ^nt4/Lr>L Perc Tester.Date of Perc Test S>-OIRate of 1 St 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 infection, ________ 7- f7DATE: 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. Issued Date: Land & Resource Management Office___izuiy?Fee $. Comments: 277.212 • Victor Lundeen Co.. Printers • Fergus Falls. MinneostaT03 application for permit to install sewage treatment system^ ^ /a- \■ i WHITE — Office Yellow — Inspector Pink — Owner LAND & RESOURCE MANAGEMENT OTTER TAIL COUNTY COURT HOUSE Phone:(218)739-2271 - FERGUS FALLS, MN 56537 .! 7^LEGAL Permit No. '4DESCRIPTION Abatement: ) Yes ( ) NoAND LOCATION LAKE NUMBER LAKE/RIVER NAME LAKE/RIVER CLASS; -7< SECTION TWP. NO.RANGE TWP NAME i^'7 // I PARCEL NUMBER(S)FIRE OR LAKE ASSOCIATION NUMBERi/(7'/7^ 7c>)7fL .y/ IDENTIFICATION: Please Print All Information Last Name First Initial Mailing Address — No. Street. City and State Zip Code Teiephone No. \ Yj,'q.'9p / //L-aj Property .Owner 1muL JUl/ Sewage System Installer Name 77 KU IQ-ip A.M. This System will be ready for inspection on . 19.P.M.at This space for office use only ANUMBER OF BEDROOMS: A.M. 19 P.M { )YES (,\)N0GARBAGE DISPOSAL:Date Ree'd 'ime Rec’d 'ho«6 Call Rec’d By SEWAGE TREATMENT SYSTEM DATA: MINIMUM REQUIREMENTSTYPE OF SEWAGE SYSTEM ( ) Holding tank (Alarm Required) (7) Septic tank ( ) Lift station (Alarm required) (^ ) Drain field (7,) Trenches ( ) Bed ( ) Mound ( ) Outhouse ( ) Sewer line TANK DRAIN FIELD 25l2Capacity GIs.Sq Ft. Distance from nearest well Ft. Ft. /3n -/±>o FI-Distance from lake or stream Ft. r-PlO/zO/<0Distance from building Ft.Ft. /(D Ft.Distance from property line Ft. 7Distance from bottom to Water Table Ft.Ft. EFFLUENT DISTRIBUTION (:< ) Gravity ( ) Pressure Ail distances are shortest distance between nearest points PERCOLATION TEST DATA: WATER WELL DEPTH J / *r ■/'('K miH Perc Tester Act'Date of Perc Test, 4 /Rate of 2nd Test ^ ‘' Average Rate 5Rate of 1st Test 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 V. /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. / .**,■ Issued Date:/ Land & Resource Management Officelzul>\-7 iFee $.Rec #2 r7.Comments:t 277,212 • Victor Lundsen Co. Printers • Fergus Falls. MinneostaBK 0795-003 1 INSPECTION RESULTS Inspector must make all measurements SEWAGE DISPOSAL SYSTEM STATISTICS DRAIN FIELDHOLDING SEPTIC TANK LIFT TANKCATEGORY MinimumActual 3^ SF/ GLS.SFGLS.Capacity ft- 5 FTFTDistance from Nearest Well Distance from Buried Water Suction Pipe FTFT FT 50FT #J>7- FT ftDistance from Buried Pipe Distributing Water Under Pressure FTFT10 FT FTFTDistance from Lake or River (OHWL) /cmf- ft =T 10/20 FTFTDistance from Nearest Building FT10FTDistance from Nearest Property Line /- ft FT3FTFTDistance from Bottom to Water Table YES NOHolding Tank/Lift Alarm YES NOOld System Pumped & Destroyed DRAINFIELD CALCULATIONSewer Line to Well SeparationINTERPRETATION OF ABBREVIATIONS GLS. = Gallons SF = Square Feet FT = Linear Feet 3ActualMinimum FTX ^0 (h FT FT20 SF Inspector’s Comments: Lq, (4(f C SKETCH: Inspector's Signature 10-1^ ? 1 Date of Inspection I Time of Inspection ji. 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 and all water wells within 150' of the sewage system. GRID PLOT PLAN feet SKETCHING FORMrinch(es) equalsScale;.grid(s) equals feet, or SIGNATURE: DATE:_____ MPCA LICENSE #: LICENSE CATEGORY: SUBMITTED BY: FIRM NAME: a; ADDRESS; 'v'9rf It •HOu-St, AN 5 g?/9gV t^e/f fff\ao NO 281.183 • ViclOf Lunda«n Co., Printari • Fargus Falls. MN • 1-000-340-4870BK — 0496 — 029 SITE DATA 1 LAND AND RESOURCE MANAGEMENT Otter Tail County Fergus Falls, MN 56537 LAST NAME OWMER: (m^ TELEFFIRSTMIDDLEPHONE NUMBER ADDRESS: -2.r^ r finuf STR./RT CITY STATE ZIP CODE J^ec.0^ M "T^p LAKE/RIVER NO.LAKE NAME SEC.TWP.RANGE TWP. NAME LEGAL DESCRIPTIOM:SOIL BORING LOG COLOR 8 MUNSELL NO. DEPTH (INCHES)TEXTURE STRUCTURE BLOCKY PLATY PRISMATIC NONE i§I^6n0’;in Yi^\lOOb 5APARCEL NUMBER j]L ~!f)BLOCKY PLATY PRISMATIC NONE clayFIRE NUMBER V/s aNUMBER OF BEDROOMS BLOCKY PLATY PRISMATIC NONEy// & cl^‘/GARBAGE DISPOSAL: YES WELL CASING DEPTH:BLOCKY PLATY PRISMATIC NONE(9FLOODPLAIN: YES TERRESTRI,VEGETATION: AQUATIC BLOCKY PLATY PRISMATIC NONE 1SLOPE AT INSTALLATION SITE:% TYPE OF OBSERVATION: Probe Pit 9PARENT MATERIAL: ORIGINAL SOIL: ^ No Outwash Loess Bedrock Alluvium COMMENTS:, ©COMPACTED SOIL:Yes :zDEPTH OF BORING:. PERC TEST # 1 PERC TEST #2- T\A^O TESTS ARE REQUIRED - INTERVAL (MINUTES!TIME WATER DEPTH WATER DROP PERC RATE TIME INTERVAL (MINUTES!WATER DROP PERC RATEWATER DEPTH4'.<r/ST/^T START 3..../Omu-___TIME PERCDROP TIME PERCDROP WATER DEPTHTIMEINTERVAL (MINUTES)WATER DROP PERC RATE INTERVAL (MINUTES)TIME WATER DEPTH WATER DROP PERC RATETOlZ‘U>REFILL REFia 3.d.—/a...Ci*-.TILPERCTIMEDROP TIME DROP PERCTIMEINTERVAL (MINUTES)WATER DROP PERC RATEWATER DEPTH TIME INTERVAL IMiNUTES)WATER DROP PERC RATEWATER DEPTH 7 Zu7SREFILL REFILL10^ is. y TIME * DROP PERC .3...4?___L2 TIME DROP PERC TIME INTERVAL (MINUTES)WWTER DEPTH WATER DROP PERC RATE TIME INTERVAL (MINUTES)WATER DROP PERC RATEWATER DEPTH■p.i REFILL REFILL •7U PERCTIMEDROP TIME PERCDROP TIME INTERVAL (MINUTES! WATER DROPWATER DEPTH PERC RATE TIME INTERVAL (MINUTES)WATER DROP PERC RATEWATER DEPTHe{rREFILI REFia TIME * 4..Id,-7 TIME PERCDROP TIME INTERVAL (MINUTES)^ TII^,^ HWTERWL (MINUTES) REFILL i WATER DEPTH WATER DROP PERC RATE WATER DEPTH WATER DROP PERC RATEREFIU pfiMETIMEDROPPERC TIME DROP PERC PERORATE * DROe PERC INTERVAL (MINUTES)INTERVAL (WNIJTES)TIME WATER DEPTH WATER DROP-WATER DROPWATER DEPTH PERC RATEREFILLiFILL TIME TIME DROP PERC TIME INTERVAL (MINUTES!WATER DEPTH WATER DROP PERC R>TIME INTERVAL (MINUTES!WATER DROPWATER DEPTH PERC RATEREFILLREFILL PERCTIMEDROP TIME PERCDROP PROPOS^DESIGN: > BED.ATGRADE.MOUND.HOLDING TANK.TRENCH.GRAVITY DIST..PRESSURE DIST.. SEWER LINE.OUTHOUSE.OTHER.SPECIFY:______________ — SYSTEM DESIGN ON BACK — ^ JUN 16 i&sa- U«"iD^E£SOURG£ (Seo/^cj^ ________ ____ ____ /a<sV_ ;X j-y^lKeA oovA-W___ fc.K<xV C?i C <2X,Ai7?^C| />KJl__5i^<c4 "tTii „t—*1^ — /,'0- jIa1=»- J 4-^AS A ntvic^o CiJ<Lu_^A5=' ^ ^_<-_j CejA<^ / ^ <«J>;''-fe^ /-t Ask-jD itc:s -C :c o T^i <>7W2_ /3c^ ^14.S»-j s"^-e?c^ ___0>tCdls2. )iAg> -k\^<^__f<^ d 1 ^ JT^ -6d 0«>^oK __OX ?>^M do dic'"S toiX. ^ SA-?»^-«^ el^e 121- cA^O 9^3l_ '&c>«N. 2i1 T*'^.,0 -ir^t>*aj-j CAt<^ -Qi.^lt3<^ J?AO ^6^ ^ ,/_ o^ 7Ac_>-|* /^»0i:Coi-^’ -ft3^^<-tj>2vej!fe.<& I ^ /io^c2, -^,'c, /JfcA^ __________-_____ i _3L s. diC2 / y S'+eos. 'T, ^|/?o5g- _3'44. _........... lO, SP ^ . < >j^UZ~ ‘/5';'9‘^/S ' ■ I i h iUrgent □I For i Date Time While You Were Out iUMt I Of Phone AREA CODE NUMBER EXTENSION iTelephoned Q Came To See You □ Will Call Again □ Returned Your Call □ Wants To See You □ Please Call Q rr i Message i 1 iI ■ &ii "W m : DSigned K ADAMS BUSINESS FORMS9711 t i ;■: ' t-- I i| M : ! REOEiveo fJUN 16 1998 lamd^resodrcf i^AKe cAol^O/ii-^cO P^'kD c3r tp ^3 ’T^c/T^ TAJ^I \«*«k C?^/\e.c^^ l^\r^T^oT*- c>l<i T^»\^/7, sc*^«X TA Ai WyC«.■Fw.»^♦^V.— S+40<?._ QdoiJ Herf Ac ^ f% ri<^er "Koad 1 ■O >= T?*'A'iW>x v-iW.K V CiAp inCjA,A<iS I ■F;a<\■Reo ! OTTER TAIL COUNTY LAND & RESOURCE MANAGEMENT 121 W. JUNIUS, FERGUS FALLS, MN 56537 (218) 739-2271 June 5, 1998 United Sportsmen Club C/o Charles Hauck 250 East Butler Street . West St. Paul, MN 55118 I>■ rS ! •RE: Abatement Notice, Dead Lake (56-383) Dear United Sportsmen Club, It.has been almost one year since you received the Abatement•Notice on your Dead Lake property. To date, this matter remains unsatisfied. Please bring your septic system into compliance with the Sanitation Code of Otter Tail County by July 1, 1998. Please notify this office when-this will be completed or this matter will be referred to the County Attorney's Office.: Sincerely,i George Hausske ,Inspector mcm f. •Iv •r \ Date Resolved CHRONOLOGY REGARDING THE SEWAGE SYSTEM ABATEMENT T^o I ^ j f'rcu^ U /■^ r.Property Owner: 56- ^ Lake Ne.Lake Name: Parcel No.: Owner's Initial Response (date): /^^/<; /9" (jfayU/nc^ f\LJLci.V-o '7o X S^qJL . %/zs-hy Cla^cj^ 97 ^cJ / ff 5 / cJ^Q. J. Sol t'>^ /. i:;' ct.Vx. ^ /54i^ J^Cu^-oiy ^ ''('^ejUL-'^^ J>-^ 7 • /- '9 ^ aa^ s-e DTI^Y lXf~ ^ f -M/f S<f>n_g_ _ 7^ 7^^ AH <1, / S‘-^rwtxc.jX-tyUt^ f abatement.chronology7-94 SEWAGE SYSTEM ABATEMENT NOTICE LAND & RESOURCE MANAGEMENT COUNTY OF OTTER TAIL COURTHOUSE, FERGUS FALLS, MN 56537 (218) 739-2271 Lake Number: (56- 383) Lake Name: DEAD UNITED SPORTSMEN CLUB % CHARLES HAUCK, TREAS 250 E BUTLER ST WEST ST. PAUL, MN 55118 You are hereby notified that the sewage system which you maintain on the following described property: UNPLATTED LOTS 3, 4 & N1/2 NE1/4 Sec: 27 Twp: 135 Range: 040 DEAD LAKE TOWNSHIP Parcel Number: 14000270213000 Lake Assoc/Fire #: DL78 is not constructed and/or located in accordance with minimum standards of the Shoreland Management Ordinance of Otter Tail County. Please be advised that you must correct this situation within 30 days. You should contact this office in order to determine what corrections and permits are required prior to complying with this notification. Land & Resource Management Official - Dated 8/13/97 P bll 7St 3ia US Postal Service Receipt for Certified Mail No Insurance Coverage Provided. Do not fnr lntAm;9tinnAl M;^it rotmrcA) united sportsmen club V. CHARLES HAUCKr TREAS 250 E BUTLER ST WEST ST. PAUL, MN 55118 Certified Fee Special Delivery Fee Restricted Delivery FeetooicnReturn Receipt Shovnng to Whom & Date Delivered Return Receipt Showing to Whom, Date, 4 Addressee’s Address o.< 8 $TOTAL Postage 4 FeesCO Postmatk or Date§ ou.(00. LAND & RESOURCE MANAGEMENT OTTER TAIL COUNTY COURTHOUSE, FERGUS FALLS, MN 56537 218-739-2271 September 8, 1997 UNITED SPORTSMEN CLUB c/o Charles Hauck, Treas. 250 E. Butler St. West St. Paul, MN 55118 RE: Sewage System Abatements for United Sportsmen Club, Dead Lake (56-383). Dear Mr. Hauck, After a careful review of the United Sportsman Club file and an onsite visit to the property, it appears that the folowing structures need a sewer update: 1) The showerhouse 2) Cabin #5 3) Trailer of Joe Troje 4) Trailer of Frank Troje Sr. 5) Trailer of Henry Troje 6) Trailer of Steve Troje Please contact our office as soon as possible or before September ?, 1997 so we can decide how best to solve your Abatement problems. ^7 Sincerely, Pat Eckert Inspector Frank Troje, 1263 Calumet St. West St. Paul, MN 55118 Henry Troje, 7546 Jeanne Dr. Lino Lakes, MN 55014 Joesph Troje, 825 5th Ave. South South St. Paul, MN 55075 Stephan Troje, 346 Betty Ln West St. Paul, MN 55118 cc: mis f'frP cAakIo JJa^cK gentry Tr^j^ 'Trc^'^ S(L\A)tr ^]?Ar\ttiet&$ 4or UHtf^l Sff^aAsrtM cfol> 4)cAr $irp /hr <L/trc^o I ^r( |1^€ \jHcj~^l S^^risHm^ (iloL 4-^1*^ AI^I Am £>H^iiK 'T^ tire, Vi^ ^irt^ ^4-ure.s /4Pf^s I AdSe.iA)tr (£) ^lje>uj€f-f}t> (S) (ULiti ^ 5 fS> Tn^iler r(^ J^c 7]^^ 'fy'A-tler ^ J^ca-mLc. "th^ ® Trh-i'Ur /Jc'U y- / T*"{J X ^r. /^/^A^e dot^’t/h^'h 5>^> o or 3^^/pl"art \>e^'t' tb ^T>life yourc!«:Ci'^ liO^ i^roblen 5 ^ CZ-'JiJL^ , ■/" ^^ct/vvlc CP. Ceftcr^W d^Arlci ^ ^o'tl-ejr S^ ■Oe-ft S^ f/^( /iN ssirt ^ S26 6^^J. ^ J>«. Iroj-^ VWe—J■ If''fiii^. prAwlt i>£j< (y^—oaKJa\-<~ fS-L>i (Uilumdr Ht-fMri fV'iPJ-t' 'me----N. \fFfjr ^jAid ^aJitxL; y^i ^teoe 'T/'oj-a. 'hjLttu^yyiU cO l^mk 2qmA.' 55/!^ dArr< <^ Ouif'&<^ ^x'clxudU r/w Qt l)A> 6601^yyu nAt\s dok>\ ^Id:; I Lp/ l^Oc dSL^ ipra^lc j o ) ^ C©, 3 Ocdiu.y**^Ji^^ Uy ST PoaJL ^5-// 8 OO'^ CJ ST r Jebi/iMeE:ac ^ grid eij|i als b pi-OTPLAN SQR KETCHING FORMnchcs h /m-'s — I I Y>( j/ - Signdtun dMapy$r<^ jqr eacA ~qMdIngcu. r °nm ■ CUMr . r>I -f’/Msfc tlewf/? yaP^‘-^^'/idida'ti'pb sAtb^ckk frbfn rhhd fidHtMi- /; tplmdariV prppoSp€Uni\ctdr ?5. _ : ill; 111 ii „ I 11 way, lake ana^ f %-% ^€:> > fl A < >> o I 5: “> 1 ?- "N ft»^■4 ~i-I<0 •i 14/* i 5^.•5-\\ O"\- U xi -!-<i V/''/■IV>1 ■» r><1-'ki„ s/l J:el/ <1 - ffe:jp Jl.!' oz:.4:g;:<i'-5=N ;?'rG>tf' o v-. KJ) 1vJ1-A n/ V-V 21S98 7®MKL-0871-029 VICTOK LUHOCEM CO.. OOIMTCRO. rCNOUl rM.Lt. MiNH. --tA'J^ ^ ? (jUt^ “V t^VN ^ ^ff ^ 3bJr # T^jc^ ^ //;^5 AWc ^ nySO^Y 7^/i^.xk -froj^ y^/l. /5^y3 r :Jr A^ .^jlaJJ iju^ S' A>wi4 7 Cji^t bclOut 7^■er^s HtH^JUL^, / ^ V <T^ 1-? /^y TLeec^ /o A^LiAjT'As*^t/e \1 i:•**4u ' . C^V. '•■i 3* «tA >,' r '• (j - Vf • •vV.' ’^>' / ^ ^ y^ '*'^- ♦ *’^^ ■ . y )- r» >•.t.,^-..,v ■ > •>y»V^ ^»iJI }%,I r "> » rf V -*-•:.* »*l i* K' • V ji:nl •»#.•■N . i> /1 A vi.v":'^?\- '; ■ “'•r V >■r-f-^ 'S'^ .-*.... ; •4 . '\1 N»V ' V )//\W"•i \ >-■-* .9;vfV4/ X:.'.\ \aV? .A;> >C»■i %%/f .;•» 1 «*/:*• t rUUNUM [iUW (19S^ RICK CONMERS A / HORIZC:’ JSE MOBILES ON P.P. FOR PLATE ,f 213PCone. 4'•nCone. BIk. H -r / ir /k197612XS6 P/’rSTANDAPJD -7«L. Bfiek f\^ I-4-fJOVsStone W7?Piers \ JAITSS L¥-6B^ - T-^,£? i) a'' yV VINDALE 1962 DECK\?10X50 Pi‘ 10X14 EyrERIOR WALLS /^o £>k C-J-Single Siding r- Qy if O } 0 r cf / sj4»- >4. r ySiding & Sheeting FI t. V'ED V CShingles Composition G . .=> /LLt' 4, A«e. y-S'^ ^ 12X49 16X20 6X25 14XT8 1968CLARENCE WILLIAMS FAW1GARAGE DECK ENC. PORCH -t■%H r',SuAsb. Shakes i/I Stucco -k 1 S' k/Brick Veneer i >Jf!Csf1/ X ru /f eCom. or Brk.I J50 -t-7'.?'‘"4' 'f/FRANK TROJE JR.1972 ./ 14X64 f 12X24 ,’TX'/f 4-I ' ^ 2.y iBUDDY ENC. DECKYearDimensionstructure+Bit. v5 4. Jt: '/'/D>I--1/i/ i.py HOl-STTE DECK (ON BLOCKS) STORjlGE cG’ilb •+■ -/o5i>'4^61967 12X57 16X16 ^ 12X14 FRANK TROJEt i h77T ■4/ ---^<r 5-?demerit 3 2.-/ *1 -kf ^”3j? 7 ./orPorejH^^4tC~T>—//«A4> 3 f 3f I /^JLa '.pa£2l-I'fry? i.A/“ ,V4»' A' »«./\ I > 2 ;y-ROBERT TROJE VS% 4-1968 12X48 PP 14x18 16X18 Ea 22x24 ROLLAHOl-S ENC. PORCH 2 OPEN DECKS GARAGE C3 Jkxlr , /^ rrr -yj IA-* -T^JSo'kamvr ^J J e or Parlor 0 riXH£p.P P a■SM .7^-%4953 8X32 12X18 STEPHEN TROJE, “^PATHFINDER = Enc. PORCH yi-.i-.54 , i •■®\\j /^KUm '^1 -■>v'<ys% f -/'jVji-ea. 3'B /k / 5 -5' '4V i-514X58 9 12X8 10x30 HOLLY PJ£RI{ 1968 /STEEL STORAGE CONG. SLAB HANK TROJE Li . 73, ■< I V-o- f;i3-'j OA-kl -h ~/i)%Let, -/J -y k:-.7 ^ 4 -'. - -.> <#>> y . ..-ri* JOSEPH TROJE V , SICYLINE ENC. PBRCH CONC. SLAB -S f‘<^1969 12X49 15x13 20X10 7S^V 3^^------\K 'k &ned *~Sf7UZ3SZ*jse 3^^^ G *1—■'R, ^^0^6 ,2j^-v44^' |jjNyJ2 /_' 4: i> O' \i '.j t, o'•J .-*.► <*k..WV 1 \ J" T ; - Cone. Cone. BIk.[ Briek h Rigid Condu¥Grade:.ra—----------EteCT stone Piers Tar & GravelSunwoocinm Single Fixt.Romex-B.X. (Paneling Roil Comp.Hot W.H. Eleet.1^:Sty. Hgl..Asphalt Comp.Gas 1-e-jUEXTERIOR WALLS HEATING EXTRAS AMOUNTSi (-rSingle Siding ROOFS BASEMENT Electric Extra PIbg.$Cond.■A/ —/V fNone C FullFlatSiding & Sheating Fireplaces Extra Built Ins $INSPECTED GableShingles Partial %Stove Extra Kit. Cabts. ---------------Brick Veneer >$(y BY Composition Hip Unfinished Hot Air: Pipeless Fireplace MansardAsb. Shakes Partitioned Piped (Gravity) tCen. AigC^. A WalkoiK^afeirieni/' $ INSULATIONStucco Finished %Forced Circulation WallsBrick Veneer Radiant Concealed ^tra $Com. or Brk.CeilingsDATE Mi®'19^19 :~ 'l 1919_19 Year Sq. Ft.Rate/Market Value Rate/ Market ValueSq. Ft.Phy.Func. Econ.Rate/Market Value Rate/Market Value Rate/Market ValueStructureDimensions Sq. Ft.Sq. Ft.Bit.Total Rate Dep.Pep.iDep.Sq. Ft.Sq. Ft.Sq. Ft. House 3W3;?i93o?// 52n/OT-r.- _r S3C, J2. (f- a IS TTTTfement 3 Exlras ~ Breezeway or Porch II.U.'i'i iVFini;IC J? 7 X'i-'i . iG30\Z2t Z5HGarage j ^ ^!f(Xo^Q-xZ/:5'PS _______________________________ju>. - ■ t i. V . - '6 TX *' At pr.vTtLtoJ /3 ■i V<i_- Barn No. 2 CicctX^, ^3 Milk House or Parlor O' ' -1\' I n -Lcl it.5'iii 4z Llicf.A,, "](.in^ <.0^Lean tc Barn ilHL>o n^ \\r-'I U-rt-T-i -i.P -V,Silo c:? Silo Silo Quonset k Steel Bin XL J.y X (7Steel Bin ii 'Steel Bin Granary V ^ ■Corn Crib V-' Pole Shed —^0 -rj'L /'■j Pole Shed iZSIShop Shert^T..'!"-^'*^^-i/- 'd -O-h-ULd!^ 'I d/.Lr O ry . > .. :^2. f i.-iMachine Shed ■J :)Poultry House Hog House <vOther 3@$1ITZ5Total Market Value of Structures i. 9 « FIELD NOTES LAKE NAME: DEAD LAKE NO.: 56- 383 DATE bLieParcel \ \>{-QOO -6o(i FIRE NO.;LEGAL DESCRIPTION /^C OWNERS NAME AND ADDRESS: 7ihrhJ Oloih JU'Trf-® (JA.\^ Comments; SEPARATION DISTANCES(IN FEET) SEWER LINE OUTHOUSETANKABSORPTION AREA •7WELL < ISOOHWL C>KLOT LINE 7DWELLING NON DWELLING )DGROUND ELEVATION @ REASON(S) FOR ABATEMENT: 0 tru&u i c--4-y/3 f “2^ t" ^ 5^ “Toyi^ic. Jc^VOC^li S-<y9 6 U/T^ hn H SSo 'c SKETCH ON BACK...Inspector's Signature(s) 913 X^4- drr -/-/' ' <-«^ -P p , <-^ ) <j -l-t^/c Or^(XAJ^'(So#o FIELD NOTES LAKE NAME: DEAD LAKE NO.: 56- 383 DATE : \^-0Q0'X)^W3'(^Oo FIRE NO.: ?3Parcel No.LEGAL DESCRIPTION Uo /ic^ce.^ OWNERS NAME AND ADDRESS: UAOlV\ Ckt- Comments: SEPARATION DISTANCES(IN FEET) SEWER LINE TANK^t^ ABSORPTION AREA OUTHOUSE WELL OHWL LOT LINE DWELLING NON DWELLING GROUND ELEVATION @ REASON(S) FOR ABATEMENT: ^ S~yte-A SKETCH ON BACK----Inspector's Signature(s) I', OH - F r / dl C'X ^ )S 0 A•rl^-J- ■ 4 ^ Bt^^*' ■“*^ *-'^-C4' I'I'* o jO FIELD NOTES UduLAKE NAME: DEAD LAKE NO.: 56- 383 DATE Parcel No.: l^-OOd-^'7 ~QJL\3' 60c^ yibb NO.:LEGAL DESCRIPTION 0 LO'i'S 3 ^ A) /VI OWNERS NAME AND ADDRESS:3jLuJ(JL P /UoT caiUAeuLilAJt/ir, 7fV-(VU-* ^ Comments: SEPARATION DISTANCES(IN FEET) SEWER LINE TANK ABSORPTION AREA OUTHOUSE 7WELL OHWL LOT LINE 7 f-DWELLING NON DWELLING GROUND ELEVATION @ REASON(S) FOR ABATEMENT: Sysri-e^t/*^ i)cO£^li I )clI< C. ’ k -f<s\. 2^) D/^. ' cx^k -S • P.f^. -J- C-&U yfr r CX. trC C/ ■ >"i-e SLp SKETCH ON BACK...Inspector's Signature(s) stT-cr^^jL. cjy\ ___ oiiS-(f; 6$ ■$//ih 7 Sf^‘t-1-'^ -/-Wc ar D L '-f^h |c '^IvM'^ci'f^ '2> ^ol-e-S S4'<^ ^ cJ^ ;5 5 (7: 2 / FIELD NOTES khiljjLAKE NAME: DEAD LAKE NO.: 56- 383 DATE Parcel No.: • Ooq FIRE NO.:LEGAL DESCRIPTION 19^0 jLo-fs 3 OWNERS NAME AND ADDRESS: Um-l'U, . I Cl r Comments: SEPARATION DISTANCES(IN FEET) SEWER LINE TANK ABSORPTION AREA OUTHOUSE WELL ■ OHWL 2LOT LINE 2 -'f': 'DWELLING NON DWELLING GROUND ELEVATION @ REASON(S) FOR ABATEMENT: 3^ a/0 A/o r{^jirCs) 5^ r) ^jL/Ls 3 /hA /<>» ^5~f'' u i/X^ i 2-^c^et/V SKETCH ON BACK.• •Inspector's Signature(s) €St o N V M H FIELD NOTES. LAKE NO.: 56- 383 DATELAKE NAME: DEAD Dl7^LEGAL DESCRIPTION Parcel No.: 14000270213000 FIRE NO.:■\ 27 135 40 120.95 LOTS 3, 4 & Nl/2 NEl/4 ■■f OWNERS NAME AND ADDRESS: UNITED SPORTSMEN CLUB % CHARLES HAUCK, TREAS 250 E BUTLER ST - WEST ST. PAUL, MN 55118 Cominents: t • ;. r, SEPARATION DISTANCES(IN FEET) SEWER LINE ABSORPTION AREA OUTHOUSETANK ■ Hfr i-'.' -u WELL OHWL LOT LINE ■DWELLING NON DWELLING GROUND ELEVATION @ REASON(S) FOR ABATEMENT:'V 5uL.4xv>, ; . 1. ' ■ -n- FIELD NOTES duhiLAKE NAME: DEAD LAKE NO,; 56- 383 DATE Parcel No.: ood-Xl-62,[3-OOOLEGAL DESCRIPTION FIRE NO.; 1X0 Ac^r^S ^ L~0~t~ ^ -5 'f'V 'V A) £J/if OWNERS NAME AND ADDRESS: Comments: SEPARATION DISTANCES(IN FEET) SEWER LINE TANK ABSORPTION AREA OUTHOUSE WELL OHWL 2ZLOT LINE \DWELLING NON DWELLING GROUND ELEVATION @ REASON(S) FOR ABATEMENT; 0 ^ ^ OiAi /oM S ' 2, e ^ 6w^ r-! (^■^^') oyi /S-e^X'C' A^o ^ •' A- .A . Ic^iiC-tPn X-^0^>$>/ ^.C ^/V^ j ; SKETCH ON BACK...Inspector's Signature(s) I’,3 CI 9 ! 1 - -fVTi) u; f iO < f* >C o t.v Lj<s i lA ^■ ■; cu*.■I- ^ jv\{a^ r FIELD NOTES LAKE NAME: DEAD LAKE NO.; 56- 383 DATE Parcel No. : ji/~ 0^l3- OOOLEGAL DESCRIPTION FIRE NO.: / Ac^tjL S (\ic CoHt^^rS ^^hrl Ar:f'e>$S FMf IN OWNERS NAME AND ADDRESS; CiJt^ Comments; SEPARATION DISTANCES(IN FEET) SEWER LINE TANK ABSORPTION AREA OUTHOUSE r7WELL OHWL LOT LINE 9T DWELLING NON DWELLING GROUND ELEVATION @ REASON(S) FOR ABATEMENT:Icytvd ^ ^ ^ jc/H ) & (L X ^ A. 0 (A^iy\ ^)>^r-AJo SKETCH ON BACK.• •Inspector's Signature(s) )l ^ u0-rc^ 1r ✓ ‘ FIELD NOTES LAKE NAME: DEAD LAKE NO.: . 56- 383 DATE : Dir? .LEGAL DESCRIPTION Parcel «o.: IH-660-S(7-£i^lJ-Oeo 13^0 U+^ FIRE NO. -OWNERS NAME AND ADDRESS:Ola : Coininents: SEPARATION DISTANCES(IN FEET) SEWER LINE TANK ABSORPTION AREA OUTHOUSE 7VWELL 1^0 ■' i^d>OHWL Ofc^ /CLOT LINE iKDWELLING : NON DWELLING GROUND ELEVATION @ -/-S' \f" REASON (S) FOR ABATEMENT: lopi- t CnJ ^ /- rSi0 -^y ^4-l4/l^ 4o11 y —^ ^^LaJ Q- SKETCH ON BACK__Inspector's Signature(s) 0^ ^^0 tv- W®Ai4- skiri^A cJ-t I ( Gb H'j-cS C^Mx,, Z'() (f ..iylAt •f-^^ S ( A. (<L.(_ y<^ ^-Z/iyO ~i-e> f£Al/*-€.CxJ . ^ ^/^<=’ r-<s>p _ h> i}~)£^'S , y'S-^^ •-K /■. /v'o i/<H.AXA. cVm. ?_ ^/-(yiAt/i k<A-oM. r' -6 cT^c4ejr''e-c_ )^"^\jutAL /'J -^£? -^r- 'tG-Aca^ '/-« ^ ' " ^ S0-fi~. ^iky^ n-ejt^ -00 n » lAjrl/ /£-G>’&‘^ ' S / e-^t_ £P--i ,iQ;.X^C^?vf:<-^ D r 1/ parLA,4%/-^iz.y/ FIELD NOTES LAKE NAME: DEAD LAKE NO.; 56- 383 DATE LEGAL DESCRIPTION Parcel No. : i 4-<5007 ' ^ ^ G - CT(^0 NO.: QL 7^ I 7.0 A OtJL 5 OWNERS NAME AND ADDRESS: l>\ jU>( Sf> O^Sot-v CLi Comments; SEPARATION DISTANCES(IN FEET) SEWER LINE TANK ABSORPTION AREA OUTHOUSE ?> WELL •70OHWL <p 1^:LOT LINE DWELLING NON DWELLING *^5GROUND ELEVATION @ REASON(S) FOR ABATEMENT; 3) ^ CO^ ^rertcy*^-^ixJ.- Sys'LCy^0^ \cy^ouP^ 5. Cl^c> cj ^fr ai.^ &L SKETCH ON BACK...Inspector's Signature(s) I-7.S /-<i uIp U)V v'all r4'01/*^ S Ov^ ^ OoAjL.o_ 6 Date Resolved CHRONOLOGY REGARDING THE SEWAGE SYSTEM ABATEMENT U/iAc'^ycJ^ Property Owner; :jS"3 Lake Name:Lake No. 56- l^-aod -A7- 06nParcel No.: S’VZ f^CUtA-Owner's Initial Response (date): abatement.chronology7-94 ___\\D W,'-S' [J. ^Dc ~Tr *v \*?Vfr^ /c T S'r =^c\\ta) c >- r r //a^L 'Ti'i/' y y.<' g\ ^ yd ^ cJ<^^ r:>^- '\o □X\ISychu X’P \\\n 'f^b I'^c/^ -f T"'2>n ^yy-Cjyuy r\0^^I f^/d/l^lc. '^y f~X ^g5g~^ ri\v^/&Mc ry^ -s5X35i3f\o:i V^^3 r£r:SA L II9S.y',. mc^-y.'■i: •'JSI CERTinCATE OF APPROVAL SEWAGE SYSTEM5^1 wfj St«i‘i 22nd Ve.cmbeA 19 JAThis certificate has been issued this to certify that the sewage system installed as per sewage permit number indicated below has been approved for use by Otter Tail County, Minnesota. day of pm % The premises covered by this certificate are legally described as:«■W/'li Vead Lake56-383 Sec.735 Twp. NameLake No.Twp.Range mmmir^Mi *United SpoAt&mm Club - Lot 3,4 N1/2 HEl/4& m.Kenneth S CdA-iandAa Le.t/d&Owner: Name Ciy..%L m’1 224 E. VaZe. S. St. Paul, McnnaotaAddress mm 55075Zip No.L-m. iT'7598Permit No. SP Signed by:. Malcolm K. Lee. Land & Resource Management Administrator Otter Tail County, MinnesotaMKL-0987001 \>1 i/i 243.984 — Victor Lundeen Co., Primers. Fer9us Falls, Minnesota 0 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 75^ gC/uh l-o-t 3--Y pJP?' AJCl^ Permit No.,LEGAL DESCRIPTION AND /3-T 9^0 / /ifAJtLOCATION Lake No.Lake Name Lake Cla&sif.Sec.TWP Range TWP Name IDENTIFICATION: Please Print All Information. Mailing Address — No. Street, City and StateLast Name First Initial Zip No.Tel. No. '^ss'J'Ssy r / LeuA^ ct r-^0 St /^C.//z^ Leud-e. Pas<,Av/)/Ci^ /a __ /LAjC/Ly^ ///^^//jAdpryflc/U - OWNER n ^ (r' i 5dC '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 3^\ISO GIs.Capacity s«r Ft.Sq. Ft. SO jtooSvFt.Ft.Ft.Distance from nearest well \SoI So Ft.Distance from lake or stream Ft.Ft. 3iOJOFt.Distance from occupied building Ft.Ft. 10 iODistance from property line Ft.Ft.Ft. 3Ft.Distance from bottom to Water Table Ft.Ft. AH distances are shortest distance between nearest points RECORD OF TESTS: Inspection was made on 19 , Time ,JVI By........................ Rate...... 19....?;??. PERCOLATION TEST DATA: PlJ2£L Date of First Test 19 4, II .(.7 = 5 ‘fl..u'.................... ±:.M.Date of Second Test , Rate 1st Test Taken By>1 M I I>1 s L.llFirst Test + 2nd Test 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. I understand that I have been granted a sewage system site permit in accordance with the requirements of the Shoreiand Management Ordinance of Otter Taii County. I understand i must contact my township In order to determine whether or not any addi tional permits are required by the township for my proposed project. Permit: 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. Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express 13,Issued Date; Shoreland Management Office 2.0,00Fee $Rec # ‘Comments: IS!jGS I PIH Form No. MKL-032085 237,443 — Victor Lundeen Co., Piinters, Fergus Falls, Minnesota '• ••V ■5 • 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 t V^hite — Office Yellow — Inspector Pink — Owner 75f gs C/l^ h /Vei^ ;Permit No\.LEGAL CERT 'SSUeo/^o / ■3- YDESCRIPTION AND 6^'3P)/fft:LOCATION O 'j Cj / ^ TWP NameLake No.Lake Name Lake Classif.Sec.TWP Range IDENTIFICATION: Please Print All Information. Mailing Address — No. Street, City and StateLast Name First Initial Zip No.Tel. No. Y<t: J /9\ 7aUl 5o St / /Ia^»' v'(v,.y <ci.OWNER / /I / T ■SEWAGE SYSTEM INSTALLER /- /)/ /IName. ^:OD p<n^,5^-This System will be ready for inspection on., 19. This space for office use only 9.'S- i9 Oy>S,19 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 3’‘glISOGIs.ScK Ft.Capacity Sq. Ft. ^0 jico I Sv Ft.Ft.Ft.Distance from nearest well ,!Ft.Ft.Distance from lake or stream Ft. /10 Ft.Ft.Distance from occupied building Ft. \0 !0Distance from property line Ft.Ft.Ft. \3Ft.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 RatePERCOLATION TEST DATA: fniKt. Date of First Test , 19 Pll2BL ........... Rate.....4..'....‘^.Z... L.kl....=..\L.P2.... = . .5:.?! ±:.M.Date of Second Test 1st Test Taken By I II) s 5First 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. i- •I understand that I have been granted a sewage system site permit in accordance with the requirements of the Shoreland Management Ordinance of Otter Tail County. I understand I must contact my township in order to determine whether or not any addi tional permits are required by the township for my proposed project. -3 r /7 7ThisPermit; 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. Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express c:^ -Issued Date: Shoreland Management Office23L-- xo^ooFee $Rec # Comments: // •--/' f (r> S -3u 4 Form No. MKL-032085 237,443 — Victor Lundeen Co., Printers, Fergus Palls, Minnesota 7 TH: » « INSPECTION RESULTS Inspector must make all measurements I y VOSEWAGE DISPOSAL SYSTEM STATISTICS 1/(t U Cl /'j SEPTIC TANK SEEPAGE PIT DRAIN FIELDCATEGORYShould BeActual Actual Should Be Should BeActual L/i^O Capacity Qls.GIs.S F S F S F S F ?Ml,Distance from Nearest Well F F F F F F -ZP^ FDistance from Lake or Stream F F F F F ( Distance from Occupied Building F F F FF F f-trr^!0Distance from Property Line F F F F F F /^63 3Distance from Bottom to Water Table F F F F F F V(»v> VJ o~piEg rr\ jg^l o O ol»iVy- j|S^ Q. W OJ- V s. Inspector’s Comments: % \ ' Q ip t a i -% ■1 ■p It ■ Date of Inspection 19 Time of Inspection M signatuiioffnsp^tor *1 INTERPRETATION OF ABBREVIATIONS GIs = Gallons SF = Square Feet F = Linear Feet 5 • «AJob Title i Ai MKL - 03208S • Baelwr Agency Vci \■. ^J\v\^ Sv«-i QjvjJ wS/V- ■' , ■ ■ 1'f i: i « ^ '■H tt* . . ♦ V • '•- -' ' I U ^ A_feet/in|;hes' qScale: Each grid equals.> IjwJ GRID PLOT PLAN SKETCHING FORM nDated:19 /^ 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. E A1 ^ V \\f 5 ^{ H\ r ' 5V t X <5.5 0t' I /I I I <5 \i: ; I fQI i't i 4- 4- I4.-JT4 . ; U--*. 4- t :t l; ''7G Q.,ai4.I 10x10 21598 7®MKL-0871-029 VICTOR LUNOEIN CO.. RRINTERS. FERSU9 FALLS. UINN. 215S02® VICTOK LUNOECM CO.. PRINTED*, FERGUS FALLS. WINN.PERCOLATION TEST DATAMKL -0871 -028 LAND AND RESOURCE MANAGEMENT Otter Tail County Fergus Falls, Minnesota 56537u iJSS- S3SV. 1 'll Ph. No..1 C 1c >< )IVIailinq Address: J aaV So- r-L. Owner: l^st Name rA KijiL First .a c-' Zip No.StateCitySt. & No.Middle 46Legal Description:___:.5^-'6 9s 57 /3S: TWP NAMETWP.RANGESEC.NAMELAKE OR RIVER NO. TEST HOLE NO. 2TEST HOLE NO. 1 i'773 (?•s 0 Depth to Bottom of Hole inches; Diameter of Hole JnchesDepth To Bottom of Hole,inches; Diameter of Hole inches 6ot /xi /Sf-/h/c So --------Soil TextureDepth, Inches Depth, Inches Soil Texture Date o .3 Percolation Test By____ Percolation Test Bv_.pO LUOo ‘Firm Name.FirmName.GC D/' 3 rX / ^ 'oLU cc UJAddress.QC Address < C/)Otter Tail County License No..Otter Tail County License No.,H-coLUMeasure ment, inches Drop in water level, inches Percolation rate minutes per inch h-Time I nterval, minutes Measure ment inches Drop in water level. Inches Percolation rate minutes per inch Time I ntervals minutes Remarks-Remarks:Time TimeO§ fiif t4 /<f I-?•f///^ /O^55"0 /o5ZS 1- 3 VF A fefaff. io» 3-r 77C?B.6<^/Z)3 0 !)7■7 a3 /<:).7//o T (CZA1 7o 1HF /•F3 3o X ,-o—- c4 (c .<1 t See Booklet, "How to Run a Percolation Test" by Agriculture Ext. Service, Un. of MN. Percolation rate »minutes per inchminutes per inch rate = 4 CERTIFICATE OF COMPLIANCE SEWAGE SYSTEM (ii ISth 3a.nu.aAuday of_This certificate has been issued this ?:to certify compliance with regulations of Shoreiand Management Ordinance, Otter Tail County, Minnesota. The premises covered by this certificate are legally described as: Twp. Name'O^U.d LoJtlZi'.Twp. ^ 35Sec. ^ 7 Range 40Lake No. S6-3S3 NE i 0^ Sec. 27 5g- GoAold /.et/de14-Owner: Name. ion 6th Aue. South South St. Paul. HinneJiOta.Address. 55075Zip No. 6S0SPermit No. SP_ 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 NkDESCRIPTION AND Mange TWP ^ame (kif -^<1 HE xn ri3 Lake No. Lake Name^ Lake Classif. Sec. LOCATION TWP IDENTIFICATION: Please Print All Information. Mailing Address — No. Sueet, City and State__________________ /OP-7 IS, J4- PaMJt Zip No.Tel. No.InitialFirstLast Name 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 Rec'd Phone Call Rec'd By <P~^NUMBER OF BEDROOMS:ESTIMATED COST: SEWAGE DISPOSAL SYSTEM DATA: SEPTIC TANK SEEPAGE PIT DRAIN FIELD 1S~D Gii-3?Sq. Ft.Sq. Ft.Capacity 50 loT)SO Ft.Ft.Ft.Distance from nearest well IS)irnFt.Ft.Ft.Distance from lake or stream LA 2SlFt.Ft.Ft.Distance from occupied building ISiaDistance from property line Ft.Ft.Ft. 3Ft.Ft.Distance from bottom to Water Table t. AH distances are shortest distance between nearest points RECORD OF TESTS: Inspection was made on ,, 19 , Time C’SS-^>-..PERCOLATION^ TJE^J DATA: Date of First Test 9St Test TalAn(V ^ Rate W Date of Second Test Rate 20-fu Rate First Test .. + 2nd Test 2nd 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. Dated Permit: 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 Minnewta. 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. Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express S-tS'YY'Issued Date: Shoreland Management Office Fee $Rec # Comments:+ Form No. MKL-032085 225239 — Victor Lintai Co.. Printers. Fergus Fails. MN •iti 4 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 I White0ffiG9 Yeitow ~ inspector Pink — Owner Permit No..XLEGAL tDESCRIPTION AND if. LOCATION Lake No. Lake Name Lake Clauif.Sec.TWP Range TWP Name IDENTIFICATION; Please Print All Information. Mailing Address — No. Street, City and StateLast Name First Initial Zip No.Tel. No. OWNER SEWAGE SYSTEM INSTALLER i Name. t 6 - "Z -z>'i opThis System will be ready for inspection on., 19. This space for office use only TT’-ya O__________M19 Date Rac'd Time Rac'd Phone Call Rac'd By Owner or Agent Signature NUMBER OF BEDROOMS:ESTIMATED COST: SEWAGE DISPOSAL SYSTEM DATA: SEPTIC TANK SEEPAGE PIT DRAIN FIELD !GIs.Sq. Ft.Capacity Sq. Ft.I Ft.Ft.Ft.Distance from nearest well I Ft.Distance from lake or stream Ft.Ft./ Ft.Distance from occupied building Ft.Ft. I Distance from property line Ft.Ft.Ft.I Ft.Distance from bottom to Water Table Ft.Ft. All distances are shortest distance between nearest points RECORD OF TESTS: Inspection was made on 19 , Time -i) -V' iJVI By . fPERCOLATION TEST DATA:jDate of First Test 19 , Rate:_.y . 19.....1.4'., Rate\Date of Second Test U...J. 1st Test Taken By /f First Test + 2nd Test......,...',S V22nd Test Taken By Rate 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 i 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 Dtter 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; II hIssued Date: I Shoreland Management Office Fee $Rec # Comments: Form No. MKL-032085 225239 Victor Lindun Co., Piintors. Forgus Fals, MN r ^ -- r.■T'J--- -<wy-< — I --^ T/^ I TO ^; ; ^ - . y 4 --r-»fir.'}^-—r •• jprr* f ' r'-S -A. '.INSPECTION RESULTS •2^ Inspector must make all measurements I Q 4T (SEWAGE DISPOSAL SYSTEM STATISTICS /z' DRAIN FIELDSEEPAGE PITSEPTIC TANKCATEGORY Should BeActualShould BeShould Be ActualActual 3^17So S FS FCapacitys FSFGIs.GIs. 2^4oo ^OO FFFDistance from Nearest Well FFF rf-/SoYoo FFDistance from Lake or Stream FFFF /o zo FFFDistance from Occupied Building F FF Co to FFFDistance from Property Line FFF / d rh//33Distance from Bottom to Water Table F FFFF F Inspector’s Comments: . -L> S~»«ux sSi sV»' tv\b> y Ay I-, ■ V.- 19Date of Inspection Z-/30 MTime of Inspection {I Signature of Inspects INTERPRETATION OF ABBREVIATIONS GIs = Gallons SF = Square Feet F = Linear Feet A ^ ■ 'ti * > %:\r • ^ :^ -v w ■ • -,p .A . ri : ..::h •*' i Job Title ,' ;r'r-. ... vX.r ;>•'..W tiMKt - 032085 • Backer Agency Ian, .‘ipif': 3: : it • 'f *; -4? .V-.' .. ' 'j -■ 'ii'tr: •• •f'* ■ ■3 ■; ito .rj iX iUjIiam r ’, 41r. -I tl- . -> (/■ ■ -- f^Sd*^" I 215S02@ v^TOH UUNOCCN CO.. PKINTeR*. FEROua FAI.LS. MINN.PERCOLATION TEST DATAMKL-0871 -028 LAND AND RESOURCE MANAGEMENT Otter Tail County Fergus Falls, Minnesota 56537 Ph. No. Mailing Address:Owner: J./6.^7 h-Ajyo JT5'6 -7 rIZip No.StateSt. & No.Cityast Name First Middle Lk'kci.Legal Description:/TG ^ -3 7 TWP NAMETWP.RANGESEC.NAMELAKE OR RIVER NO. TEST HOLE NO. 2TEST HOLE NO. 1 k SO'■SL-Depth to Bottom of Hole inches; Diameter of Hole.jnchesDepth To Bottom of Hole.inches;Diameter of Hole inches A//y .Jh /3,2. /I: I, 7/M Depth, Inches Soil Texture Depth, Inches Soil TextureDate Date o 'U c u. i Cc '■ 5/? t O (Si-iA(h - </ 71 • c jLPercolation Test Bv____ Percolation Test By .Q ^ / A J'/i KCi y/" 7 S ^ ^ > LU 5/1* i-E fS -^'C-Firm Name.Firm Name.D O UJ cc /I7 t\f Pc V h 7^/Ti it 'LU V AAddress.q:Address < COOtter Tail County License No..Otter Tail County License No..HCOLUMeasure ment,inches Time Intervals minutes Drop in water level, inches Percolation rate minutes per inch H-Measure- mentinches Percolation rate minutes per inch Time Interval, minutes Drop in water level, inches Remarks:Remarks:Time TimeIo§ k /D"!b s S>P/f p-Mf-/3 > ^ // c c /PISO 70p^lO I /3 A'Io_(£■:: sto 370 / It ''/jLPIh-7.07a ^lOOi // /-) 4 // /3 77 ^ 3 //^3 ■2. 751_2P 2^1P_71. i ) ^ o 1-A /JljJ ^ X(T' ^ P^UI h /C ISOC/J -P /o 7*9 ^32^Id 7 7 3o t7W7LH lA iioS 775(o ^ ip(0 A5"Z3Z —f—£ 1 See Booklet, "How to Run a Percolation Test" by Agriculture Ext. Service, Un. of MN. Percolation rate minutes per inch minutes per inchPercolation rate = □ D□6-*5 Uke ‘fleii Tova V '^ ^rcv.s'''-' o oJ ® i ( (oCiO -f€€~^ ^ie\ci To X-rAvler- Ta'(v'f^ To Tr<3^i I ol •^^5.^ v\_3o-TeeT I S -fe e~J~9e(oT i c e 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 W ;te —V low — Inspector Pli.. — Ov^ner Card — Owner (\L 3^V 3l1 Permit No. /l/.£. nr Ub LEGAL Date DESCRIPTION AND LOCATION TWP NameLake Classif.Sec.TWP RangeLake NameLake No. IDENTIFICATION; Please Print All Information. Zip No.Tel. No.Mailling Address —No. Street, City and StateFirstInitialLast Name i7/OWNER SEWAGE SYSTEM INSTALLER Name This System will be ready for inspection , 19.on. 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: QESTIMATED COST: SEWAGE DISPOSAL SYSTEM DATA: SEEPAGE PITSEPTIC TANK DRAIN FIELD 9ao GIs.Sq. Ft.Sq. Ft.Capacity y/06Ft.Ft.Ft.Distance from nearest well y/57>Ft.Ft.Ft.Distance from lake or stream Ft.Ft.Ft.Distance from occupied building sCJoDistance from property line Ft.Ft.Ft. yFt.Ft.Ft.Distance from bottom to Water Table AH distances are shortest distance between nearest pomts RECORD OF TESTS: Inspection was made on , 19 , Time M By S77..3...0,aPERCOLATION .TEST DATA:Date of First Test...;, 19 Rate.. *n 0 2_Date of Second Test 19 Rate 1st Test Taken By f((U.2First Test -I- 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 Sevyage 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.!all or use attached mailer notice.) rfdi X.6^Dated rSignafure Permission is hereby granted to the above named applicant to perform the work desc^bed 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 ini all respects to ordinancesrST^tter Tail County Minnesota. This permit may be revoked at any time upon violation of any said ordinance. \ j I \ /I NOTE: Permit void if work is not commenced within six (6) months. \ / i I // Permit: Issued Date:hf^eland Management Office Fee $Surcharge $___^ Comments:. victoa LUHecth « CO..Form No. MKL-0771-003 .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.. — Ow5ier Card — Owner 3 f VLu Permit No.,LEGAL Date DESCRIPTION AND LOCATION Lake No.Lake Classif.Lake Name Sec.TWP TWP NameRange IDENTIFICATION: Please Print All Information. Initial Mailling Address —No. Street, City and State ^ r ~fV) Zip No.Tel. No.Last Name First vaOWNER SEWAGE SYSTEM INSTALLER Name. This System will be ready for inspection on., 19. This space for office use only .19 M Date Rec'd Time Rec'd Phone Call Rec'd By Owner or Agent Signature NUMBER OF BEDROOMS:ESTIMATED COST: SEWAGE DISPOSAL SYSTEM DATA: SEPTIC TANK SEEPAGE PIT DRAIN FIELD GIs.Sq. Ft.Capacity Sq. Ft. Ft.Ft.Ft.Distance from nearest well Ft.Ft.Distance from lake or stream Ft. Ft.Distance from occupied building Ft.Ft. Distance from property line Ft.Ft.Ft. Ft.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 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.) Dated Signature Permit: 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. Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express Issued Date:. Shoreland Management Office Fee $Surcharge $ Comments:. / Form No. MKL-0771-003 »uixl58906 VICTVa UMtiC« t M.. PtKtUS FALLS %INSPECTION RESULTS Inspector must make all measurements SEWAGE DISPOSAL SYSTEM STATISTICS SEEPAGE PITSEPTIC TANK DRAIN FIELDCATEGORY Should beActualShould be ActualActualShould be Capacity GIs.GIs.s F S F S FS F Distance from Nearest Well 75FF F F F F Distance from Lake or Stream F F F FFF 20Distance from Occupied Building 10 20FF F FFF 10Distance from Property Line 10 10FF F FF F 4 4Distance from Bottom to Water Table F F F F F F Inspector's Comments: Date of Inspection 19___ Time of Inspection..M Signature of InspectorINTERPRETATION OF ABBREVIATIONS GIs » Gallons SF • Square Feet ■ Linear Feet Job TitleF Agency MKL-0771-003'Backer ; -.L 'i PERCOLATION TEST DATA SHORELAND MANAGEMENT OTTER TAIL COUNTY Fergus Falls, Minnesota 56537 Ph. No.Owner:Mailing Address:i_Ic(r<y ' Lasi Name First Middle St. & No.City State Zip No.Legal Description: LAKE OR RIVER NO.SEC.NAME TWP.RANGE TWP NAME / .2^ - TEST HOLE NO. 2TEST HOLE NO. 1 3S''Depth to Bottom of Hole inches; Diameter of Hole.Depth To Bottom of Hoi inchesinches; Diameter of Hole inches Depth, Inches Soil Texture Depth. Inches Soil TextureDat19 DateO' yC>''O"Percolation Test By___ Percolation Test Byi /O -^<r t ..UJyFirmName.CE FirmName.D aUi cc LU Address.QC Address < COOtter Tail County License No..Otter Tail County License No..I-COLUMeasurement, Inches Drop In Water •Level. IrKhes Drop In Water Level. Inches I-Measurement, InchesTimeRemarksTime Remarksfo'7 ^2lS''4."I n^<I //3^ 7 jrr* /' ^c>/:3r(ICO }i /•I» T/!> y\yf T ^ol±SrdL n/n/opt 183818 ®MKL-0871-028 «>CT88 i,uii»(ia t e« 8iiian88. rca«u8 8«.Lt. mimn See Booklet,"How to Run a Percolation Test" by Agriculture Ext. Service, Un. of Minn. 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 W :te — Office V low — Inspector Pl».. Card 1 Owner O^hiner y o/jPermit No..LEGAL Date DESCRIPTION AND C_ Jn or HOLOCATION Lake No.Lake Clatsif.TWP TWP NameLake Name Sec.Range IDENTIFICATION: Please Print All Information. Initial Mailling Address —No. Street, City and State Zip No.Tel. No.Last Name First Mark^IlsJLjUt: 7^-OWNER SEWAGE SYSTEM INSTALLER Name. This System will be ready for inspection on., 19. This space for office use only 19 Date Rec'd Time Rec'd Phone Call Rec'd By Owner or Agent SIgna.ture £32^7'?f I NUMBER OF BEDROOMS: X-ESTIMATED COST: SEWAGE DISPOSAL SYSTEM DATA: SEPTIC TANK EPAGE PIT DRAIN FIELD 'I ^ /y Sq7 TP GIs.Sq. Ft.. Ft.Capacity Ft.Ft.Ft.Distance from nearest well lH Ft.Distance from lake or stream Ft.Ft. / 0 Ft.Distance from occupied building Ft.Ft. /O ^tODistance from property line Ft.Ft.Ft. " Ft.Distance from bottom to Water Table Ft.Ft. AH distances are shortest distance between nearest points RECORD OF TESTS: Inspection was made on 19 , Time JVI By .M..I^ I \ i7pPERCOLATION TEST DATA:Date of First Test , 19 t Rate. 19........Rate/h- F'V'_x>Date of Second Test 1st Test Taken By I ?■ J'7(ri First Test -I- 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 f<y the permit to notify the County Shoreland Management that the job is ready for inspection. (C^or use attached mailer notice.) ih hi Signature Dated \ Permission is hereby granted to the above named applicant to perform the work d^cribedVin 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 cc iform ih all respects to ordinan^e^f Otter Tail County Minnesota. This permit may be revoked at any time upon violation of any said ordinance. I j \ NOTE: Permit void if work is not commenced within six (6) months. / [ \ / / /y Permit: —Issued Date: ih^eland Management Offk 5Fee $Surcharge $ N- Piyi,Comments:. Form No. MKL-0771-003 158906 viCToa uineciM t c«.. piiHnat. riaiut raLLt. Mian SHORELAND MANAGEMENT - COUNTY OF OTTER TML COUNTY COURT HOUSE * / I Phone 218-739-2271 - Fergus Falls, Mn. 56537 /j[ 1 APPLICATION FOR PERMIT TO INSTALL SEWAGE DISPoi^LlsKrE W te — Office V low — Inspector Ph.. Card — Q^ner 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 InitialFirst Mailling Address —No. Street, City and State Zip No,Tel. No. OWNER SEWAGE SYSTEM INSTALLER Name. This System will be ready for inspection on... 19. This space for office use only .19 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 buildinq 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 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 22nd 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 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. Issued Date: Shoreland Management Office Fee $Surcharge $ Comments:. Form No. MKL-0771-003 vicrga luhcccn 4 es.. pRiHTt**. Fiaaus fkcL*. hmih.15S906 * INSPECTION RESULTS «4 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 GIs.GIs.S F S F S F SF Distance from Nearest Well F 75F 50FFF F Distance from Lake or Stream F F F F F F Distance from Occupied Building 10 2020FFFFF F Distance from Property Line 10 10 10FFFFF Distance from Bottom to Water Table 4 4FFFFF F Inspector's Comments: Date of Inspection 19. Time of Inspection.M Signature of InspectorINTERPRETATION OF ABBREVIATIONS GIs = Gallons SF = Square Feet “ Linear Feet Job TitleF AgencyMKL-0771-003-Backer PERCOLATION TEST DATA Price $ 1.00 per pad. SHORELAND MANAGEMENT OTTER TAIL COUNTY Fergus Falls, Minnesota 56537a0Ir- Ph. No.Owner:Mailing Address: First■ i -t;>Last Name Middle St. & No.City State Zip No.Legal /y / J Description:^ Lake or r'iver no.SEC.name TWP.RANGE TWP NAME (/*} 2J_9‘' TEST HOLE NO. 2TEST HOLE NO. 1 (f11loDepth To Bottom of Hole ^Depth to Bottom of Hole Inches: Diameter of Hole.inches; Diameter of Hole Jnchasinches S'S_Depth, Inches Soil Texture Depth, Inches Soil TextureDate19 Date Percolation Test By___ Percolation Test By____ifj^<rA Q mFirm Name CC FirmName. oUioc UIAddress.GC Address.< (/)Otter Tail County License No..Otter Tail County License No^Hc/>lUM^surement, fnches Depth in Water Level, Inches I-Measurement, Inches Depth in Water Level. Inches Time Remarks Time Remarks O'All y3' I A7 /"i '•/37" 31"' A"SJXi r S jjS • < 7 f V M/: MKL-0871-028 See Booklet, "How to Run a Percolation Test" by Agriculture Ext. Service. Un. of Minn. 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 Pii.. Cerd OwnerOwner J? V79 GL 7 Permit No..LEGAL C) /f/~7 ~7 a/B- D-Q /3r w Date DESCRIPTION AND LOCATION Lake No.Lake Name Lake Claasif.Sec.TWP Range TWP Name IDENTIFICATION: Please Print All Information. Mailling Address —No. Street, City and State 3 /l/. CL / f ^ J A i/Z.' Zip No.Tel. No.First InitialLast Name Hi ale.OWNER Pa iaJ 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 EPAGE PIT DRAIN FIELD 170GIs.Sq. Ft.Sq. Ft.Capacity .-fsn Ft.Ft.Ft.Distance from nearest well /3 ^/ 3o Ft.FtDistance from lake or stream Ft. 5^/o Ft.Ft.Distance from occupied building Ft. T/y /£/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 ~?1 2..PERCOLATION TEST DATA:Date of First Test 19 . 19 , Rate 2. IDate of Second Test Rate 1st Test Taken By r/2-2 . fFirst Test + 2nd Test 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.)idy for inspection. ^al Dated Signature " Permission is hereby granted to the above named applicant to perform the work describ^in the above statemenL This permit is granted upon express s of Otter Tail County Minnesota. Permit: condition that the person to whom it is granted, and his agents, employees and workmen shall confoi'm ih all respects to ordin 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. / /6 7f7 2 7 ^—■ Issued Date: ihqreland Management Office^2^la- PySfFee $Surcharge $ Comments:. Form No. MKL-0771-003 viCToe urasccii • co.. eaiHtte*. fcneus rskLi. Mina.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 to - Office V low — Inspector Pii.. Card Owner Owner Permit No.,LEGAL /,Date DESCRIPTION AND LOCATION Lake No.Lake Name Lake Classif.TWP NameSec.TWP Range 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.., 19. This space for office use only .19 ■M Date Rec'd Time Rec'd Phone Call Rec'd By Owner or Agent Signature NUMBER OF BEDROOMS:ESTIMATED COST: SEWAGE DISPOSAL SYSTEM DATA: SEPTIC TANK SEEPAGE PIT DRAIN FIELD GIs.Sq. Ft.Capacity Sq. Ft. Ft.Ft.Ft.Distance from nearest well Ft.Distance from lake or stream Ft.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 ,JVI 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 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.) Dated Signature Permit: 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. Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express Issued Date: Shoreland Management Office Fee $Surcharge $ Comments:. Form No. MKL-0771-003 VICTOR UtHDCCH 4 CO.. RRIKTCRO. FtROuS rM.kO HIND.158906 't>«INSPECTION RESULTS Inspector must make all measurements SEWAGE DISPOSAL SYSTEM STATISTICS SEPTIC TANK SEEPAGE PIT DRAIN FIELDCATEGORY Actual Should be Actual Should be Should beActual Capacity GIs.GIs.s F S F SF S F Distance from Nearest Well F 75F 5aFFF F Distance from Lake or Stream F F F F F F Distance from Occupied Building 10 2020FFFFF F Distance from Property Line 10 10 10FFFF F F Distance from Bottom to Water Table 4 4FFFF FF Inspector's Comments: Date of Inspection .19____ Time of Inspection.M signature of I nspectorINTERPRETATION OF ABBREVIATIONS GIs = Gallons SF “ Square Feet F “ Linear Feet Job Title AgencyMKL-0771-003-Backef •I j J PERCOLATION TEST DATA Price $1.00 per pad. SHORELAND MANAGEMENT OTTER TAIL COUNTY Fergus Falls, Minnesota 56537 Ph. No. Owner:Mailing Address: 38(c // ^ Sf. 0)1) I''Cr \ Last Name Zip No. 'I 1First Middle St. & No.State jjifA AL/tt. / C>^f1 ' TWP NAME City Legal Description:'CDJt. SEC.TWP.LAKE OR RIVER NO.NAME RANGE ■v, ■* 'i , ■fi 1 '>J.kP7uyy^ TEST HOLE NO. 2TEST HOLE NO. 1 1>5^ill V Depth to Bottom of Hole inches; Diameter of Hole inchesDepth To Bottom of Hole inches; Diameter of Hoi inches Depth, Inches Soil Texture Depth, Inches Soil TextureDat 19 Date I o - /< g /..C C /'>yTest By. Firm Name Firm Name.q: DoUJQC LU Address.GC Address < COOtter Tail County License No..Otter Tail County License No...H coUJMeasurement, Inches Depth in Water Level, Inches H Measurement, inches Depth in Water Level. Inches Time Remarks Time Remarks ot /d I .a '3^ /0:/< /o; j? T /Owe i IT■A //2 TT V >A .A \ji.k-ij \./2.7 MKL-0871-028159179 ®yiCTo* LUNDtCH ( ce roeus rALcs h’nn. See Booklet, "How to Run a Percolation Test" by Agriculture Ext. Service, Un. of Minn. L aay o o \ 5^ s V•• <r f \. vr; -i ,'^'1 N v't V '';■ \V \ \ i?*«sWMmAmm to certify compliance with regulations of Shoreland Management Ordinanee, Otter Tail County, Minnesota. The premises eovered by this certifieate are legally described as: c>56-383 27 135 159035 VICTOH UUNSCCt ( CO. PCRCUt PiLl.0. UIHV 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 — In'jpectorPink Card — Owner Owner G 4- 3 f V 2-3 /■70-O-Permit No.,LEGAL Date DESCRIPTION AND -^ake No. Lake Name /A,/2^ .37 </nULOCATION Lake Classif.Sec,TWP Range TWP Name IDENTIFICATION: Please Print All Information. iiw Atldrefe —No. Street, City and State cA £/t ]U MailliFirstInitial Zip No.Tel. No.Last Name TEUE l/A l/\ ■I yOWNER / I? <■ CSEWAGE SYSTEM INSTALLER iName. This System will be ready for inspection on.., 19. This space for office use only M,19 Phone Call Rac'd ByDate Rec'd Time Rec'd Owner or Agent Signature rNUMBER OF BEDROOMS:ESTIMATED COST: SEWAGE DISPOSAL SYSTEM DATA: SEPTIC TANK SEEPAGE PIT DRAIN FIELD ^0Zoo 0 Gis.Iq. Ft.Sq. Ft.Capacity jQoo QcJ J 0 n1 OO Ft.Ft.Ft.Distance from nearest well / <rv Ft.Ft.Ft.Distance from lake or stream ldL Ft.Ft.Ft.Distance from occupied building /U'^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: , 19Inspection was made on , Time M By 71.PERdpLATIQN^TESTaDATA:Date of First Test , 19 Rate Date of Second Test 19 Rate .3.Q3 3.First Test -I- 2nd Test 2 Rate 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.) cA__£ Q Signature ( / r - - Dated Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express nform in all respects to ordinances of Otter Tail County Minnesota. Permit: condition that the person to whom it is granted, and his agents, employees and workmen sh This permit may be revoked at any time upon violation of any said ordinance. NOTE: Permit void if work is noLcommenced within six (6) months. A,—jyjIssued Date:.Shoreland Managemen^'^fl'ice Fee $Surcharge $ bLPsyComments:. I .... 158906Form No. MKL-0771-003 vieret luhsccn t eo.. MUHTti SHORELAIMD 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 — loi^ector Pink — Owner Card Owner 7/V Permit No..JLEGAL i:Date /7 7DESCRIPTION AND 7 / X f ') 7 !LOCATION ' o /./ Lake Classif.Sec.TWPLake No. Lake Name Range TWP Name IDENTIFICATION; Please Print All Information. First Initial Mailling Address —No. Street, City and State Zip No.Tel. No.Last Name !rr 7 1 e /'-*IO^NER 7 T SEWAGE SYSTEM INSTALLER Name__l This System will be ready for inspection on.- O ^, 19. This space for office use only /9 19 Date Rec'd Phone Call Rec'd ByTime Rec'd Owner or Agent Signa^ture ViNUMBER OF BEDROOMS:ESTIMATED COST:u SEWAGE DISPOSAL SYSTEM DATA: SEPTIC TANK SEEPAGE PIT DRAIN FIELD I 0 '7 GIs.Sq. Ft.Sq. Ft.Capacity j 00 ®r Vr, i i iU Ft.Ft. Ft.Distance from nearest well /i 77 / S 7/ Ft.C.Ft. Ft.Distance from lake or stream Ft. Ft.Ft.Distance from occupied building ./u \Distance from property line Ft.Ft. Ft. .•-V' 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 M By / ^7PERCOLATION TEST DATA:Date of First Test , 19 , 19 , Rate 7Date of Second Test , Rate 1st Test Taken/By.'■ J 7 Ii!___.2First 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, 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. (Call or use attached mailer notice.) : 7Dated7^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 wo^ is not commenced within six (6) months. V. / 7 Permit: \ X ir A-'iissued Date: / / Shoreland Management Office ir------------->■; ^ <2 \■ JyFee $Surcharge $V'" - V 1K Comments:. •»r.N ,158906Form No. MKL-0771-003 viCToa iw«s((a • co.. pmihtim. r*LL8. INSPECTION RESULTS Inspector must make all measurements SEWAGE DISPOSAL SYSTEM STATISTICS SEEPAGE PITSEPTIC TANK DRAIN FIELDCATEGORYActualShould be Actual Should be Actual Should be Capacity GIs.GIs.S F SF S F S F Distance from Nearest Well F 75 50FFFF F» Distance 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 F Distance from Bottom to Water Table 4 4FFFFF F Inspector's Comments:£i>S- ^ ^ S' i> i: Date of Inspection 19___ Time of Inspection M *1 Signature of InspectorINTERPRETATION OF ABBREVIATIONS GIs “ Gallons SF * Square Feet F * Linear Feet >i Job Title AgencyMKL-0771-003-Backer •fr.-'i ■ - .= •»>< iV 'T ib "i i; •i rr*i';' -f,■ ;y- • - M.f tR ‘ vf 'i i .-■'•fi .’4 - { 11 •i 1 1 ] I i»♦ r . »;»» ..-ll • ^.. K1^jb...1E>.'^. JE„sJ6...j> mW‘i CERTIFICATE OF COMPLIANCE m SEWAGE SYSTEM 'h 26th 79_J^Aprilday of_This certificate has been issued this m':■ii:tr;W/to certify compliance with regulations of Shoreland Management Ordinance, Otter Tail County, Minnesota. The premises covered by this certificate are legally described as: Lake No ^6-383 Sec. 27 Twp. 135 Range ]|Q___ Twp. NameDeBd T.ak.e M m ’I G.L. 3 United Sportsman Clubm IL J m 1:^JairiftR T.fiyde_____________________ Address 1]|0 19th Ava. South St Owner: Name. HiPaul f. M3 nneso ta% \ m Zip No. Malcolrn K. Lee, Shoreland Administrator Otter Tail County, Minnesota m 112^Permit No. SP_ Signed by:. MKL-0871-009Ic-^v p.cXi 159035 VICTOK LUMOCtN t CO. ritlNTCRt. ftHBUt Klim 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 — OwnerCard — Owner Permit No..LEGAL Date DESCRIPTION AND 4.:-y!r? EW)IClx7 r>sLOCATION Lake Classif.Sec.TWPLake No.Lake Name Range TWP Name IDENTIFICATION: Please Print All Information. .. t Maitling>^ddress —No. Street, City ancj Stateo'^3./0 I'First Initial Zip No.Tel. No.Last Name ■ L ‘i V JQ.JL/OOWNER 5ZZ5ZZZS2 SEWAGE SYSTEM INSTALLER Name, This System will be ready for inspection on.19. This space for office use only ,M.19 Phone Call Rac'd ByDate Rac'd Time Rec'd Owner or Agent Signa^ture NUMBER OF BEDROOMS:ESTIMATED COST: SEWAGE DISPOSAL SYSTEM DATA: SEPTIC TANK SEEPAGE PIT DRAIN FIELD '^^0 Sq. Ft.GIs.Sq. Ft./ Af) DCapacity 0 ^ 0 0 Ft. Ft.Ft.Distance from nearest well "7 Ft.Ft.Ft.Distance from lake or stream f 7^231Ft.Ft.Ft.Distance from occupied building T aaDistance 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: 19 , TimeInspection was made on ,JVI By 19.2.2- -y.PERCOniATION TEST DATA: Date of First Test , 19 Rate e Date of Second Test ; Rate 1st Tesr Taken By'T £.s:First Test -I- 2nd Test Rate2nd Test Taken 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.) 7-X-fe - 7/Dated Permission is hereby granted to the above named applicant to perform the work described in the above statement. Tpis 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. ■7 - - 7/ Permit: Issued Date:. Ihoreland Management Ofmce ^ ■Sp_T-OO -PJ)Fee $Surcharge $ Comments:.% ....158906Form No. MKL-0771-003 vierea umaeiM t ea.. paiHTcai. riatui r*t.La. SHORELAND MANAGEMENT - COUNTY OF OTTER TAfL COUNTY COURT HOUSE Phone 218-739-2271 - Fergus Falls, Mn. 56537 APPLICATION FOR PERMIT TO INSTALL SEWAGE DISPOSAL SYSTEM /ellow — Inspector Owner Owner Pink Card G.L J Permit No..LEGAL Date OESCRIPTION AND // , //D-o.(xP X7 OV 'T)^0LOCATIONr . Lake Classif.Lake No.Lake Name Sec.TWP Range TWP Name IDENTIFICATION: Please Print All Information. First Initial Mailling.Address —No. Street, City and StateLast Name Zip No. j Tel. No./t /{//^ / C0 C'G\/^o -Ijr '] /k-..OWNER 7GJJ/r-/ • SEWAGE SYSTEM INSTALLER Name, n -3 , 19l£.^ This System will be ready for inspection on. 'his space for office use only 1-^,,!lsDate Rec'd Time Rec'd Phone Call Rec'd By Owner or Agent S!gna,ture NUMBER OF BEDROOMS:FST'MATED COST: , SEWAGE DISPOSAL SYSTEM DATA: SEPTIC TANK SEEPAGE PIT DRAIN FIELD c L mbO ' y X C Sq. Ft.GIs.Capacity / 10 0 C C'yy^y'vx., >1. (,^IT UX 1 Ft.Ft.Ft.Distance from nearest well f ; / . \!J ^ u 0’X.^.J1Distance from lake or stream / 9 0 \ Distance from occupied building Ft.Ft.7 Ft. AScv\/•)Ft.Ft.Ft.\ Distance from property line /J^Ft.Ft.Ft. (JFt.Distance from bottom to Water Table Ft.Ft. ^ 1 AH distances are shortest distance between nearest points\i _____________________ RECORD OF TESTS: Inspection was made on 19,, Time JVI By PERCOliATION TEST DATA: I r ■ ^ S Date of First Test 19 'Rate n!Tr"19.7 /T"Date of Second Test Ratet1st Te Taken By 'i First Test....+ 2nd Testf-"i 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 Vinn- esota Department of Health. Applicant agrees that plot plan, sketches and specifications submitted herewith and which are approved by Shoreland Management 0'?;- 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 sha'I be 'ha 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 ' Cn\/*^4Dated. Sin.,.,.- ^ '/ Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express“ermit: 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, ■^his 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. ssued Date:,/ Shor larragement Office %o/hG-'-/''■ S-b '/ijL.7 00 'PJ)Pee $Surcharge S t- 4Comments:, V \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 Yeliow — inspector Pink — Owner Card — Owner Permit No.,LEGAL Date DESCRIPTION AND LOCATION Lake Ciassif.Sec.TWPLake No.Lake Name Range TWP Name IDENTIFICATION; Please Print Ail Information. First Initial Mailling Address —No. Street, City and State Zip No,Tel. No.Last Name OWNER SEWAGE SYSTEM INSTALLER Name, ; ■! i^ - 5^This System will be ready for inspection on.cs\~,. 19 i^ . Yv' ,1Ct-JULip ■This space for office use only ! ^'-5'.19 Phone Call Rec'd ByDate Rec'd Time Rec'd Owner or Agent Signa.ture 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.Distance from occupied building Ft. 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 ,M By PERCOLATION TEST DATA:Date of First Test 19 , 19 Rate Date of Second Test Rate 1st Test Taken By i First Test -I- 2nd Test 2 Rato2nd 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.) Dated Signature Permit; 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. Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express % Issued Date: Shoreland Management Office Fee $Surcharge $ Comments:.IICAt£I .158906Form No. MKL-0771-003 VICTOII LUMBItN 8 CO.. POIHTEOO. riOOUO r«LkO. V / INSPECTION RESULTS Inspector must make all measurements SEWAGE DISPOSAL SYSTEM STATISTICS SEEPAGE PITSEPTIC TANK DRAIN FIELDCATEGORYActualShould be Actual Should be Actual Should be Capacity GIs.GIs.s F s F S F S F Distance from Nearest Well 75 50FF F F F F Distance from Lake or Stream F F F F F F Distance from Occupied Building 201020FFFFF F Distance from Property Line 10 10 10FFFF F F Distance from Bottom to Water Table 4 4FFFFF F _ io.'t L —Inspector's Comments:Ct Lc tJ^ 4 k ct^ 3* O O »%A. % ■ Date of Inspection 7 ///. / yTime of Inspection, oijprii7spectorSign^ureINTERPRETATION OF ABBREVIATIONS GIs = Gallons SF = Square Feet = Linear Feet Job TitleF Agency MKL-0771-003" Backer 4 S k SHORELAIMD 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 — InspectorOwner Owner Pink Card I 5A/^ -y af See X"]Permit No.LEGAL 7^Date DESCRIPTION AND -^0.T>e4 ^Cy Jiy A?:S~LOCATION Lake Classif.Sec,TWP Range TWP NameLake NameLake No. IDENTIFICATION: Please Print All Information. Mailling Address —No. Street, City and State Zip No.Tel. No.InitialFirstLast Name cub _______r i\ \/ ^ I ( fL Bok'Tfc\€.OWNER CUV) Ou]\t}r Al t w VvSj?<irT5MAVi SEWAGE SYSTEM INSTALLER Name, This System will be ready for inspection , 19.on. This space for office use only 19 Phone Call Rec'd By Owner or Agent SignatureDate Rec'd Time Rec'd SEWAGE DISPOSAL SYSTEM DATA: SEEPAGE PITSEPTIC TANK DRAIN FIELD /OO Sq. Ft.GIs.Sq. Ft.Capacity 5"0 ^Ft.Ft.Distance from nearest well /s-d rFt.Ft.Ft.Distance from lake or stream 7^TFt. Ft.Ft.Distance from occupied building S. T T Ft.lADistance from property line 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 ..........JVl By 19 .22.... . 19....7..^.., 5*PERCOLATION TEST DATA:Date of First Test Rate j. tif^-^-f 2Date of Second Test Rate 1st Test Taken By 2.5^/3First Test -I- 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 uje attached mailer notice.) /W iIX 1DatedSignature 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: fV\Issued Date: Shoreland Management Of^e20Fee $Surcharge $ kC / -p to [0 n0 u s ^Comments:. VICTOl kUOOICN t CO . PRINtlOI. flOOuS riu.L0. 1S8906Form No. MKL-0771-003 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 \ White — Office Yellow Pink - Card — — InspectorOwner Owner Permit No.,LEGAL Date DESCRIPTION AND LOCATION TWP NameLake Classif.Sec.TWP RangeLake NameLake No. IDENTIFICATION: Please Print All Information. Mailling Address —No. Street, City and State Zip No.Tel. No.First InitialLast Name OWNER SEWAGE SYSTEM INSTALLER Name 2t_ eUT y-'3»This System will be ready for inspection V , 19on. This space for office use only ^/// U-/lAJL.I Owner or Agent SignaturePhone Call Rec'd ByDate Rec'd Time Rec'd SEWAGE DISPOSAL SYSTEM DATA: SEEPAGE PITSEPTIC TANK DRAIN FIELD Sq. Ft.Sq. Ft.GIs.Capacity Ft.Ft.Ft.Distance from nearest well Ft.Ft. Ft.Distance from lake or stream 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 ,JVI ByInspection was made on PERCOLATION TEST DATA:Date of First Test ., 19 , 19 , Rate Date of Second Test ,, Rate 1st Test Taken By First Test -I- 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.) Dated Signature Permit: 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. Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express Issued Date: Shoreland Management Office37^Fee $Surcharge $ Comments;. CERTIFICATE IsauEP.m 158906 yierea uihoccn 4 ce.. p«i«tem. rcaeus fALit. mminForm No. MKL-0771-003 (.-V - - ' Ai INSPECTION RESULTS Inspector must make all measurements SEWAGE DISPOSAL SYSTEM STATISTICS SEEPAGE PITSEPTIC TANK DRAIN FIELDCATEGORYActualShould be Actual Should be Actual Should be Capa,city GIs.GIs.S F S F S F SF Distance from Nearest Well 75F 50FFFF F Distance from Lake or Stream F F F F F F Distance from Occupied Building 10 2020FFFFF F Distance from Property Line 10 10 10FFFFF F Distance from Bottom to Water Table 4 4FF F F F F Inspector's Comments: Date of Inspection 19. Time of Inspection, Signature of InspectorINTERPRETATION OF ABBREVIATIONS GIs = Gallons SF ~ Square Feet F ■ Linear Feet Job Title AgencyMKL-0771-003-Backer > PERCOLA TION TEST DA TA Price $ 1.00 per pad. SHORELAND MANAGEMENT OTTER TAIL COUNTY Fergus Falls, Minnesota 56537 Ph. No. Owner:Mailing Address: State TWP NAME 1/ (V C? ^ PcR / nc^ Last Name d^S'o ^^7 ^ First 0(^nO Zip No.Middle St. & No.City Legal Description:All SEC.LAKE OR RIVER NO.NAME TWP.RANGE f A'/'i ^ C/^‘V/yr'c^ /7c>c4S<£/"rS^.S c TEST HOLE NO. 2TEST HOLE NO. 1 Depth to Bottom of Hole inches; Diameter of Hole inchesDepth To Bottom of Hole,inches;Diameter of Hole inches Depth, Inches Soil Texture Depth, inches Soil Texture 19 7^19_ZDate Date /- //A. <r?/ - ^I^ Q '9Percolation Test By____ Percolation Test Sv .S J~- cg V/^<g 5^ - j y^yyrr ~r7/-'J-.- >L V/-/7)£r> Z’//g '-/ dclA/ UJ W - /7FirmName.Firm Name. CC =5 7oUJ oc /?MytVnr <HA A/ ^UJ Address.CC Address < CO Otter Tail County License No..Otter Tail County License No..Hco111Measurement, Inches Depth in Water Level, Inches 1-Measurement, Inches Depth in Water Level, inches Time Remarks Time Remarks o^ jS I /7 - J ^/D-/V Vg /r3 2.*) > ii 1__^r -y /C \ 7->t-/t>^✓z//'/a H •' ^//'■ 173 L//.' 3c>ft /•y': Ob f-y'US /■y j YS ^ L-///C! 2 y //> y ^ 7 y-Si /'y'. oc y^ly^/y/fT T’c/zV/t'Y : 2>0 /< ^3<^/ . e>o 3 C Vg />/VtiA 1711 / -'3^' 1: 3o 1/ //^61 c. Vs/■ Zk./f <vy/ 3 S' /g3 L li 11 <4z- yJo V^ ~py7aTiJylTi: — 3> At MKL-0871-028/(f CcL>^Tfty- See Booklet, “How to Run a Percolation Test" by Agriculture Ext. Service, Un. of Minn. 159179 ®/ fSyViCTOa LWHtlCN 4 CO SSiral) u.<<'o ]j mCERTIFICATE OF COMPLIANCE i« SEWAGE SYSTEMIsm SM1:43^^111p;, ■ <4 day of_This certificate has been issued this to certify compliance with regulations of Shoreland Management Ordinance, Otter Tail County, Minnesota. 19__72.■T«nimTy mmmM mmm siThe premises covered by this certificate are legally described as: 1*1 m Range_MO.Twp. Name__Dead LakeTwp. _L55Lake A^o._5£s383— Sec. _2Z NE% of Sec. 27te ri >;SJ. Si. '"i* W§ m (TTtv! fpH .'^pr>r j-gman n nh)Owner: Name.Bf>V> Trf>j«a WiAddress RI rhvl Tie, MI nnesoEa if!f*4f 5?m Zip No. Si ms Permit No. SP_222 Signed by:. Malcolm K. Lee, Shoreland Administrator Otter Tail County, MinnesotaONE SYSTEM ONLY MKL-087 1-009 : rCyi Y\ ©25903S lUKDttn « eo. ftPCI/l HIM > SHORELAIMD 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 Card — Owner ^ Sec ay Permit No.LEGAL Date DESCRIPTION AND LOCATION TWP NameLake Ciassif.Sec,TWP RangeLake NameLake No. IDENTIFICATION: Please Print All Information. Zip No.Tel. No.Mailling Address —No. Street, City and StateFirstInitialLast Name CUkQ/»V»-VOWNER ic SEWAGE SYSTEM INSTALLER Name This System will be ready for inspection on., 19. This space for office use only .M19 Phone Call Rac'd ByDate Rec'd Time Rec'd Owner or Agent Signature SEWAGE DISPOSAL SYSTEM DATA: SEPTIC TANK SEEPAGE PIT DRAIN FIELD ^70 Sq. Ft.t Gis.Sq/Ft.Capacity 57) -h Ft.Ft.Ft.Distance from nearest well /y^n -f- Ft.Ft.Ft.Distance from lake or stream ./O 7...Ft, /O ^ :2r> f Ft. /O -h Ft. Ft.Distance from occupied building Ft.Ft.Distance from property line 4^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 ..^.o. 5^., 19 . 19.7<^..., PERCOLATION TEST DATA:Date of First Test Rate "T.KDate of Second Test Rate 1st Test Taken By 4.isr.z.First Test -I- 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.) / Dated Signature Permission is hereby granted to the above named applicant to perform the work described in the above st 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 IWinnesota. 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:express ft Issued Date:■3^ Shoreland Management Office,50 Fee $Surcharge $ Comments:, I @ viCToii uiHVCdt « c«.. pRiNtcDt rcaaut calls, mi-.158906Form No. MKL-0771-003 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 Yeilow — Inspector Pink — Owner Card — Owner Permit No.LEGAL Date DESCRIPTION AND LOCATION Lake Name Lake Classif.Sec.TWP Range TWP NameLake No. IDENTIFICATION; Please Print All Information. IVIailling Address —No. Street, City and State Zip No.Tel. No,InitialFirstLast Name OWNER SEWAGE SYSTEM INSTALLER Name. , 19?^This System will be ready for inspection on. fi rry AThis space for office use only Time Rec'd^ Phone Call Rec'd By^ate Rec'd JlA Owner or Agent Signature SEWAGE DISPOSAL SYSTEM DATA: SEEPAGE PITSEPTIC TANK DRAIN FIELD GIs.Sq. Ft.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 ,JV1 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 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.) 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: t Issued Date: Shoreland Management Office Fee $Surcharge $ f rr- Comments:. I CERTIFIC4I£..(?.S,!.',ED..158906Form No. MKL-0771-003 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 GIs.GIs.S F S F S F S F Distance from Nearest Well F F 75F F 50F F Distance from Lake or Stream F F F F F F Distance from Occupied Building 10 20 20FFFFF F Distance from Property Line 10 10F 10FFFF F i Distance from Bottom to Water Table 4F 4FFFF F i Inspector's Comments; Date of Inspection 19___ Time of Inspection,M Signature of InspectorINTERPRETATION OF ABBREVIATIONS GIs ~ Gallons SF Square Feet F ■ Linear Feet Job Title Agency M KL-0771-003-Bac ker f r K I > r- s CERTIFICATE OF COMPLIANCE SEWAGE SYSTEM This certificate has been issued this day of.19__23.3xd Tttniiftry W' Mto certify compliance with regulations of Shoreland Management Ordinance, Otter Tail County, Minnesota.mThe premises covered by this certificate are legally described as: Lake No. 56-383 Sec.21 Twp._125.Range.Twp. Name tiill NE^ of Sec. 27, Twp. 135, R.AO (Pate Wtlllamii^Owner:Name.ntT< fpH Sporf gmiin PI nh py- Address ft50 nnksHplp,Paul, Minnesota 55ioa Zip No.■isinn Permit No. SP 144r « . Signed by:. Malcolm K. Lee, Shoreland Administrator Otter Tail County, Minnesota MKL-087 1-009 159035 vxT»t tMM SHORELAIMD 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 Card'— Owner kf ^ ,-7Zf t/l) Permit No. Date LEGAL 7DESCRIPTION AND UilaS) 'iJLfi2IL 05-c UJlLOCATION TWP NameLake Classif.Sec.TWP RangeLake NameLake No. IDENTIFICATION; Please Print All Information. Tel. No.Zip No.Mailling Address —No. Street, City and StateInitialFirstLast Name (p 0 cJkSlt.^0 . /)U\*7CSll/~4)9rmOWNER i ^ ([Aa'k •SEWAGE SYSTEM INSTALLER Name This System will be ready for inspection ., 19.on. This space for office use only .19 Owner or Agent SignaturePhone Call Rec'd ByDate Rec'd Time Rec'd SEWAGE DISPOSAL SYSTEM DATA: SEEPAGE PITSEPTIC TANK DRAIN FIELD / Cy Sq. Ft.^ ry GIs.-2- Sq. Ft.Capacity 751 TO Ft. 1^0 TO Ft.Ft.Distance from nearest well ; TO j 0 Ft. / ‘TV Ft.Ft. Ft.Distance from lake or stream ^0 Ft.Ft.Distance from occupied building / 0 Ft./Q lAFt. Ft.Distance from property line yHFt. Ft. Ft.Distance from bottom to Water Table AH distances are shortest distance between nearest points RECORD OF TESTS: 19Inspection was made on , Time ...........JVI By . 19 7.A..., . 19.2:^... 1.57..PERCOLATION TEST DATA:Date of First Test Rate 3 0Date of Second Test Rate = ....3 (2./.5I.First Test -I- 2nd Test Rate2np Test Tawn 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 ir use attached mailer notice.)responsibility of the applicant for the permit to notify the County Shoreland Management that theTpb is read ion. (C n. mxDated,f Signature Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon ^xpress 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 16) months. Permit; Issued Date:Management Offi^Ireland V TOFee $Surcharge $ Comments:. 158906Form No. MKL-0771-003 viCToK uiHpccH « c«.. oPiNTtat. rte«us r«LLi. him* SHORELAIMD 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 Card — Owner Permit No.LEGAL Date DESCRIPTION AND LOCATION Lake Classif.Lake No,Lake Name Sec.TWP Range TWP Name IDENTIFICATION: Please Print All Information. IVIailling Address —No. Street, City and State Zip No.Tel. No.First InitialLast Name OWNER SEWAGE SYSTEM INSTALLER Name This System will be ready for inspection , 19.on. This space for office use only 19 .M Phone Call Rec'd ByDate Rec'd Time Rec'd Owner or Agent Signa^ture SEWAGE DISPOSAL SYSTEM DATA: SEEPAGE PITSEPTIC TANK DRAIN FIELD GIs.Sq. Ft.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 M By PERCOLATION TEST DATA:Date of First Test ., 19 . 19 , Rate Date of Second Test ,, Rate 1st Test Taken By First Test -I- 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.) 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 $Surcharge $ Comments:. CERT[F[uaTl Form No. MKL-0771-003 vierea « ee.. tainTcat. Flatus falli. 158906 4 i k INSPECTION RESULTS Inspector must make all measurements SEWAGE DISPOSAL SYSTEM STATISTICS SEPTIC TANK SEEPAGE PIT DRAIN FIELDCATEGORYActualShould be Actual Should be Actual Should be Capacity GIs.GIs.S F S F S F S F Distance from Nearest Well F 75FF 50FF F 4=Distance from Lake or Stream F F F F F Distance from Occupied Building V1020 20FFF F '\J Distance from Property Line 10 10F 10FFFF F Distance from Bottom to Water Table 4F 4FFFF F Inspector's Comments: .,92?--XDate of Inspection V r MTime of Inspection. "Signature of ectorINTERPRETATION OF ABBREVIATIONS GIs = Gallons SF « Square Feet * Linear Feet Job TitleF AgencyMKL-0771-003-Backer 4 m ! 0» PERCOLATION TEST DATA Price $ 1.00 per pad. SHORELAND MANAGEMENT OTTER TAIL COUNTY Fergus Falls, Minnesota 56537 / Ph. No. Owner:Mailing Address: '.’"irD club (Pete Williams Trailer)St !:inn 551^0r-' Last Name First Middle St. & No.Zip No.City State Legal Description:^ ^ LAKE OR RIVER NO.SEC.NAME TWP.RANGE TWP NAME TEST HOLE NO. 2TEST HOLE NO. 1 -5'V dy.5Depth to Bottom of Hole,inches; Diameter of Hole inchesDepth To Bottom of Hole,inches; Diameter of Hole inches i-:qy 6 M-ay 619^19^ S. J . Hi Depth, Inches Soil Texture Depth, Inches Soil TextureDate.DatefiUc i: Q.J-O-'/i Percolation Test By____ Percolation Test Bv ,S. J. Bjfgrt H ^//- /d Q LUFirmName./ S' ' s.'CJa<.a:FirmName.Z) amtr Bte 2, ®crha:a, MnLUBte 2. ^erhan, MnAddress.OC Address < COOtter Tail County License No..Otter Tail County License No^HC/)LUMeasurement, Inches Depth in Water Level, Inches I-Measurement, Inches Depth in Water Level, Inches Time Remarks Time Remarks oV2- %3:r '/%,O? 40o^3c I- /'/«Z.J£> cC / o i C 3 IA/c - 5 9 /// a A 3o ) %/iWy '//Hoc ro •‘7^ 3 3 I7'A// ^// / c>•y ■> rkH / '/s 3 /</) ^J } CO / J / 'k>/V I{Vic / ■■y / a 72. %3 o // K HO A/,//3V Vi3 K '/ &C a/Cg r/rrviid' i 17c.2> 3 y-i3^-s- i ^ y-v-J/S'/ O <pc?3 V--2. PERCOL'.riOB R.’TB = 30-«;2/3 =_22 rAnuteF o 1'* t .Ble.t r, tc ground viater See Booklet, "How to Run a Percolation Test" by Agriculture Ext. Service, Un. of Minn. fro:r. bottom cT ab-orpti?.'.MKL-0871-028159179 ®trca iiicets di"t".icviCTsi lumdccn k CO oainnia. rcKBus rkcLt. SOIL ABSORPTION SYSTEM WORKSHEET Ovmer Name: Average Percolation Rate Number Bedrooms 7,Critical Slope i f sq. ft.Bedroom Absorption Area: 2.X Number of Bedrooms S ^ ^ i.Sq. feet required Septic Tank Requirements in Gallon Capacity 750 Gals.2 Bedrooms or less 900 Gals.3 Bedrooms 1,000 Gals.4 Bedrooms For each additional bedroom add 250 Gals. Percolation Rate Per BedroomPercolation Rate Per Bedroom 19811770 20228518 206310019 210115420 5 21 214125 218 y6135 222714023 2268150 24 230251609 2341016526 2381117027 2421217528 24613 180 29 a25014185 30 a45 30015190b3301619460 Unsuitable for seepage pits b Unsuitable for absorption system