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HomeMy WebLinkAboutVierzba Family Cluster_53000320250000_Septic System Permits_OTTER TAIL COUNTY LAND & RESOURCE MANAGEMENT PUBLIC WORKS DIVISION WWW.CO.OTTER-TAILMN.USOTT€R Tflil GOVERNMENT SERVICES CENTER 540 WEST RR AVENUE FERGUS FALLS. MN 56537 218-998-8095 FAX: 218-998-8112 12/10/2015 Sha\wn Vierzba Et Al 601 IstStS Cold Spring MN 56320 2301 RE: Primary Owner: Shawn Vierzba Et Al Sewage Treatment System Servicing Tax Parcel Number: 53000320250000 Described as:Sec 32 Twp Rush Lake Township Sect-32 Twp-135 Range-039 42.60 AC PART GOVT LOTS 1, 2 & 3 COM Lake: 56-210 Long As of 12/09/2015 the holding tanks (Sewage Treatment Installation Permit # 23418 servicing your property was determined to be in compliance with the provisions of the Sanitation Code of Otter Tail County. Please be advised that this certification is only valid for five years from the date of this mailing 12/9/2020. If you have any questions regarding this matter, please contact our office. Sincerely, bet/u. Denise Gubrud Inspector yj! 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 Tflll WHITE - Office YELLOW -L&R Inspector PINK - Owner / Contractor (after issue)eoNaTT-ainaKOTa Permit No.APPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED TWP NO.FTANGE TWP NAMELAKE/RIVER NAME LAKE/RIVER CLASS SECTIONLAKE NUMBER 3^S'6-13S E-911 ADDRESS OR DIRECTIONS FROM NEAREST PUBLIC ROADPARCEL NUMBER (S) OF PROPERTY BEING SERVICED jip^?>C003tOZ5ooOO LEGAL DESCRIPTION ?^r op \,2<SAc.«• • Daytime Phone No.First Initial Mailing AddressLast Name St S.320-ZSO-1067Property Owner /jr?AJ sy32£> 5Ala AfJA C4 VAri*!^9B8^ /O A/iVContractor Lie.# L/c ^ jy/ THIS SPACE FOR OFFICE USE ONLY A.M. P.M., the year of>• This System will be ready lor inspection on at. A.M. P.M. L&R OfficialDate Received Time Received SEWAGE TREATMENT SYSTEM DESIGN DATA AS SHOWN ON DRAWING TYPE OF NSTALLATION (CIRCLE ONE) isidential Collector Other Est. (E) New (F) Replacement (C) New (D) Replacement (/^Ne>Soil Treatment Area (1 leplacement LiftTank Design Flow (Gallons/Day) rToTj)— 2,499 *11^ 2,500 — 4,999 (I) 5,000 — 10,000 Effluent Distribution Gravity ( ) Pressure 2,000 GIs GIs Ft. Size Setback To Nearest Well Ft.Ft.Ft.Type I Type II ns(27) Rapidly Permeable(20) Trench, Rock /65 Ft.Ft. Ft.Setback To OHWL(21) Trench, Gravelless (28) Flood Plain (22) Trench, Chamber i ^(29) Privies '(30) Holing Tank (Contract Required) J ‘AA*Ft.Ft.Ft.Setback To BluffA(23) Bed (24) Mound 3<D Ft.Ft.Ft.Setback To Dwelling (25) At Grade Type III ^/aSetback To Non-Dwelling Ft.Ft.Ft.(31) Other/Problem Soils/<12“ Soil(26) Greywater Type IV(34) Tank Only Setback To Nearest Lot Line >ioo Ft.Ft.Ft.(32) Public Domain & Proprietary Technologies(35) Other Setback To Road Right-Of-WayDepth of Well Total # Bedrooms >100 Ft.Ft.Ft.Type V (33) Performance Elevation Above Restrictive Layer Ft.Ft. Ft.Garbage Disposal Y /Abatement Y / PERC TEST DATA Tim yc'Date of Test__—Highest RateLicense #Designer Agreement; The undersigned hereby makes application for permit to install, alter, repair or extend Sewage Treatment System herein specified, agreeing to do all such work in strict accor­ dance with Sanitation Code of Otter Tail County, Minnesota. Applicant agrees that the Site Data Worksheet submitted herewith and which is approved by a Land & Resource Management Official shall become a part of the permit. Applicant further agrees that no part of the system shall be covered until it has been inspected and approved for use. It shall be the responsibility of the applicant for the permit to notify Land & Resource Management that the installation is ready for inspection. Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express condition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Sanitation Code of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of the Sanitation Code. NOTE; I.This permit is valid for a period of six (6) months. 2.This permit does not include the building sewer (sewer line). /r Permit Fee $Date:1 Signature of Property Owner/AgenMor C^ner Land & Resource Management Official ----------------------------^------ Rec. No.,Date: Date StampComments: 1~1 L&R InitialForm No. BK — 04-2014-06 354.2S0 • Vidor Lundeen Co., Printers • Fergus Falls, Minnesota 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 £ >5 tf r P/NK - Owner / Contractor (after issue) ~ K)o (li OTTCR mil WHITE - OfTice YELLOW -L&R InspectorCOUnTY-MIAAIIOTII 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 JZ2 ^0 35L \ PARCEL NUMBER (S) OF PROPERTY BEING SERVICED E-911 ADDRESS OR DIRECTIONS FROM NEAREST PUBLIC ROAD >■>600310150000 LEQAL DESCRIPTION ?&{i7 Of COM'T. LOTS \^2'^3f<c.« • « Last Name First Initial Mailing Address Daytime Phone No. 60} Sf 5.Property Owner At.ro(^ /^aJ 5632.0 /O /V^_________________ %'2.0 5A-' ^ £it cAContractor Lie.#: Lie THIS SPACE FOR OFFICE USE ONLY 2-ol'S~' „ ''•Z-'on >• This System will be ready for inspection on , the year of \zhh>Jra.M Date Received Time Received L&R Official TYPE OF NSTALLATION (circle one)SEWAGE TREATMENT SYSTEM DESIGN DATA AS SHOWN ON DRAWINGResidential New (B) Replacement Collector Other Est. (E) New (F) Replacement (C) New (D) Replacement Soil Treatment Area LiftTank Design Flow (Gallons/Day) (G) 1,-2,499 '2,500 —4,999 (I) 5,000 — 10,000 Effluent Distribution ( Gravity ( ) Pressure 2r.O0 GIs GIs Ft.2 y Tgt)Size Setback To Nearest WellType I Type II Ft.Ft. Ft.ns(20) Trench, Rock (27) Rapidly Permeable its Ft.Ft. Ft.Setback To OHWL(21) Trench, Gravelless (28) Flood Plain - (29) Privies )(22) Trench, Chamber Ft.Ft.Ft.Setback To Bluff'7331 'Molding Tank'" (Contract Required) ) (23) Bed (24) Mound 3^)Ft.Ft.Ft.Setback To DwellingV Type nr —(25) At Grade Setback To Non-Dwelling •^/a(26) Greywater (31) Other/Problem Soils/<12" Soil Ft. Ft.Ft. Type IV(34) Tank Only Setback To Nearest Lot Line >iOO Ft.Ft. Ft.(32) Public Domain & Proprietary Technologies(35) Other Setback To Road Right-Of-WayDepth of Well ;>i0V Ft.Ft.Ft.Type V Total # Bedrooms G> .(33) Performance %Elevation Above Restrictive Layer Ft. Ft.Ft.Garbage Disposal Y / ’1T>Abatement Y / N PERC TEST DATA a/a IDesigner .-. ir l * }fJC /License #Date of Test Highest Rate i Agreement: The undersigned hereby makes application for permit to install, alter, repair or extend Sewage Treatment System herein specified, agreeing to do all such work in strict accor- i 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 1 of the applicant for the permit to notify Land & Resource Management that the installatidn 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). ! ! -i /l\ ■ Signature of Property Owner/Agenidbr Owiwr Date; 2 4 /T Permit Fee $■I y Date:Rec. No..,ij Comments:'■‘i •143 Form No. BK — 04-2014-06 354,250 * Victor Lundeen Co.. Printars * Fergus Falls. Minnesota . .■ ^ I SEWAGE TREATMENT SYSTEM PERMIT INSPECTION RESULTS Inspector must make all measurements SOIL TREATMENT AREA HOLDING SEPTIC TANK OUTHOUSELIFT TANKCATEGORY 30OD QLS.Capacity FT2 FT2GLS. l5Cr FTSetback from Nearest Well FT FT FT rSetback from Burled Water Suction Pipe 50 FT FT FT Setback from Buried Pipe Distributing Water Under Pressure FT FT FT FT Setback from OHWL (lake &/or river)FT FT FT FT Setback from Bluff FT FT FT FT •i'iSetback from Dwelling FT FT FT Setback from Non-Dwelling FT FT FT FT Setback from Nearest Property Line FT FT FT FT I 00'^Setback from Right-of-Way FT FT FT FT Elevation above Restrictive Layer FT FT FT FT Holding Tank/Lift Alarm #—NO Old System Pumped & Destroyed YES NO SEPTIC TANK^) # Tanks Installed MOUND / AT-GRADEFILTER SOIL TREATMENT AREA CALCULATION TRENCH REDUCTION ROCK BED —Rock trenches with inches □ yiManuf. n of sidewall %Ft. redfjction / equivalent to. Soil Treatment Area. fPNO_ Model #Ft^ A T.4<SInspector's Comments:t t Kii^/ Sketch: O c 4,0 I / Date 7 77me Jnm)LAROffickU i'2^1 tolls'.the above described sewage system installation was found to be compliant with the provisions of the SanitationAs of Code of Otter Tail County. ^ Lan^ J^esource Management Official i^BsraForm No. BK — 04-2014-06 354,250 • Victor Lundoon Co., Printort • Forgut Fallt, MInnoaoU SITE DATA WORKSHEET LAND & RESOURCE MANAGEMENT GOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS FALLS, MN 56537 218-998-8095 www.co.otter-tail.mn. usOTTER TflIICO¥HTT-aillRIJOTI Sewage Treatment System Permit #OWNER: \HeiVZBA g/ /4/ LAST NAME FIRST MIDDLE TELEPHONE NUMBER ADDRESS: S-h S- Co!/^ST SL320LO! /7___STR./RT.CITY STATE ZIP CODE 32 135 3^5^- VO LohJ Cr-iArfCe LAKE/RIVER NO.LAKE NAME SEC.TWP RANGE TWP. NAME SOIL BORING LOG ^ DEPTH ^CHES) - ^7-7LEGAL DESCRIPTION: COLOR a MUNSELL NO.TEXTURE STRUCTURE BLOCKY PLATY PRISMATIC BLOCKY PLATY PRISMATICOgO^T BLOCKY PLATY PRISMATIC BLOCKY PLATY PRISMATIC O\loi^ BLOCKY PLATY PRISMATIC NONE V>I>68^3ooo3ZozsoooO Sa^O PARCEL NUMBER ^ Lay-E ^oa-o (o^£. 5A^0E-911 Address or Directions From Nearest Public Road NUMBER OF BEDROOMS Cr ^0 ^ GARBAGE DISPOSAL: YESzfifJO pzx^rr ^ .ft. SEWER LINE SEPARATION: lOHd is.SAfjr> Cm£T) WELL: CASING DEPTH ft. (5 MVFLOODPLAIN: YES BLUFF: YES (N^SAyoD VEGETATION: AQUATIC TERRESTRIAL 5 *1^ a-pt^ ts ^ljt P(U£6 tVfTF/ TO zfl" SLOPE AT INSTALLATION SITE:% TYPE OF OBSERVATION: Probe Pit CSutwaiE^PARENT MATERIAL: Till Loess Bedrock Alluvium /^-27-/yORIGINAL SOIL: No COMPACTED SOIL: Yes DEPTH OF BORING (To 7' or restrictive layer): Date of Soil Boring /> ft.Date of Perc Test PERC TEST #1 PERC TEST #2- TWO TESTS ARE REQUIRED - TIME INTERVAL fMINUTESl WATER DEPTH WATER DROP PERC RATE TIME INTERVAL (MINUTESI WATER DEPTH WATER DROP PERC RATESTARTSTART 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 TIME INTERVAL (MINUTES!WATER DEPTH WATER DROP PERC RATE TIME INTERVAL (MINUTES!WATER DEPTH WATER DROP P£RC RATEREFILLREFILL TIME DROP PERC TIME DROP PERC TIME INTERVAL (MINUTES!WATER DEPTH WATER DROP PERC RATE ■ TIME INTERVAL IMINUTESI WATER DEPTH WATER DROP PERC RATEREFILLREFILL TIME DROP PERC TIME DROP PERC ■TJME INTERVAL (MINUTESt 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 tMINUTESi WATER DEPTH WATER DROP PERC RATEREFILLREFILL TIME DROP PERC TIME DROP PERC TIME INTERVAL (MINUTES! REFILL WATER DEPTH WATER DROP PERC RATE TIME INTERVAL (MINUTES!WATER DEPTH WATER DROP PERC RATEREFILL TIME DROP PERC TIME DROP PERC TIME INTERVAL (MINUTES!WATER DEPTH WATER DROP PERC RATE TIME INTERVAL(MINUTES) WATER DEPTH WATER DROP PERC RATEREFILLREFILL -r--------- =TIME DROP PERC TIME DROP PERC SEPTIC TANK MANUFACTURER: PROPOSED DESIGN: HOLDING TANK GRAVITY DIST..TRENCH BED ATGRADE OUTHOUSE OTHER MOUND,PRESSURE DIST., SEWER LINE 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, bluff and all water wells within 150' of the sewage system. If there are any questions, see the University of Minnesota Site Evaluation worksheets. grid(s) equalsScale:inch(es) equalsfeet, or feet MPCA LICENSE LICENSE CATEGORY: /k>i>AhiCeC>7/^DESIGNED BY: FIRM NAME: .3-15-ZjOISDATE: ADDRESS: P(^(7 SIGNATURE:S7^ M/J ^ ^-rrACfteO ^ BK — 04-.7014 — 029 354.251 • Victor Lundeen Co . Prinieri, • Ferqus Falls, MN • 1-8DO-346'4870 cP3^/S' Owner's Management Plan for Holding Tank Septic Systems University OF Minnesota 4921Property Owner/Ctient:Shawn Vierzba, et al. Job #: 3/13/1541488 Long Lake Rd, Ottertail MN 56571Site Address:Date: The goal of a septic system is to protect human health and the environment by properly treating wastewater before returning it to the environment. Your holding tank system is designed to store your used water before it is recycled back into our lakes, streams and groundwater. Your management plan will identify the operation and maintenance activities necessary to ensure complaince with applicable rules and regulations. Some of these activities must be performed by you, the homeowner. Other tasks must be performed by a licensed septic maintainer or service provider. However, it is YOUR responsibility to make sure all tasks get accomplished in a timely manner. The University of Minnesota's Septic System Owner's Guide contains additional tips and recommendations designed to extend the effective life of your system and save you money over time. Proper septic system design, installation, operation and maintenance means safe and clean water! Fill out for your reference: 320.363.1300Phone #System Designer:Watab Inc., L2116 Phone » ^70-3^3System Installer: Phone# 3^0Service Provider/Maintainer: Keep this Management Plan with your Septic System Owner's Guide. The Septic System Owner's Guide includes a folder to hold maintenance records including pumping, inspection and evaluation reports. Ask your septic professional to also: • Attach permit information, designer drawings and as-builts of your system, if they are available. • Keep copies of all pumping records and other maintenance and repair invoices with this document. • Review this document with your maintenance professional at each visit; discuss any changes in product use, activities or water-use appliances For a copy of the Septic System Owner's Guide, call 1 -800-876-8636 or go to http://shop.extension.umn.edu/ http: //septic, umn.edu The septic system design and as-built inspection report are important sources of information for maintenance and repair of this system. Before replacing any system components (pumps, floats, etc.) or adjusting any settings (control panel, timer, floats, etc.) verify proper equipment and settings with the information provided in the design. If you have any questions, call your system designer or installer. A J -1 - Owner's Management Plan for Holding Tank Septic Systems Homeowner Management Tasks These operation and maintenance activities are your responsibility. Use the chart on page 5 to track your activities. Identify the service intervals recommended by your system designer and your local government. The tank assessment for your system will be the shortest interval of these three intervals. Your pumper/maintainer will determine if your tank needs to be pumped. University OF Minnesota Tank capacity 4- (# of occupants X 50 Gallons/day) = # of days between cleaning OR Within 24 hours of alarm signal System Designer: check every 7 days My tank needs to be emptied everydaysLocal Government: check every days Seasonally • Monitor alarm daily - make sure the alarm has not signaled. Alarms signal when your holding tank is nearly full; contact your maintainer. • Measure and note your average daily water usage on page 4. Conserving water saves you money! • Leaks. Check (listen, look) for leaks in toilets and dripping faucets. Repair leaks promptly. Annually • Establish a contract for tank cleaning services with a state licensed maintenance business. • Caps. Make sure that all caps and lids are intact and in place. Inspect for damaged caps at least every fall. Fix or replace damaged caps before winter to help prevent freezing issues. • Water conditioning devices. See Page 4 for a list of devices. When possible, discharge clear water sources to another location. Program the recharge frequency based on water demand (gallons) rather than time (days). Recharging too frequently will result in increased pumping costs. • Review your water usage rate. Review the Water Use Appliance chart on Page 4. Discuss any major changes with your pumper/maintainer. During each visit by a pumper/maintainer • Ask if your pumper/maintainer is licensed in Minnesota. • Make sure that your pumper/maintainer has clear access to the holding tank and completely empties the tank. • Ask your pumper/maintainer to accomplish the tasks listed on the Professional Tasks on Page 3. 4 -2- Owner's Management Plan for Holding Tank Septic Systems Professional Management Tasks University OF Minnesota These are the operation and maintenance activities that a pumper/maintainer performs to help ensure long­ term performance of your system. Professionals should refer to the 0/M Manual for detailed checklists for tanks, pumps, alarms and other components. Call 800-322-8642 for more details. • Written record provided to homeowner after each visit. Plumbing/Source of Wastewater • Review the Water Use Appliance Chart on Page 4 with homeowner. Discuss any changes in water use and the impact those changes may have on the frequency of maintenance. • Review and document water usage rates with homeowner. Holding Tanks • Maintenance hole lid. A riser is recommended if the lid is not accessible from the ground surface. Insulate the riser cover for frost protection. • Liquid level. Check to make sure the tank is not leaking. • Inspection pipes. Replace damaged caps. • Alarm. Verify that the alarm works and that there is at least 25% reserve capacity. • End of year seasonal property pumping. Remind homeowner of most frequent causes of tank and building sewer freeze-ups. Ensure that there are no "micro-sources" of water such as a high efficiency furnace or other dripping devices. Determine a logical winter water use plan that will not result in need for emergency visit(s). All Other Components - inspect as listed here: V V .; , -3- Owner's Management Plan for Holding Tank Septic Systems Water-Use Appliances and Equipment in the Home University OF Minnesota Management TipsImpacts on SystemAppliance • Use of a garbage disposal is not recommended. • Minimize garbage disposal use. Compost instead. • Uses water and increases pumping frequency and expense. _________________ Garbage disposal • Choose a front-loader or water-saving top-loader, these units use less water than oldermodels. • Wash only full loads. • Do laundry off site. • Uses water and increases pumping frequency and expense. Washing Machine • Wash only full loads.• Uses water and increases pumping frequency and expense. Dishwasher • Take short showers to conserve water.• Uses water and increases pumping frequency and expense. Large bathtub (whirlpool) Management TipsImpacts on SystemClean Water Uses • Re-route water into a sump pump or directly out of the house. Do not route furnace recharge to your septic system. • Drip may result in frozen pipes during cold weather.High-Efficiency Furnace • These sources produce water that is not sewage and should not go into your septic system. • Re-route water from these sources to another outlet, such as a dry well, draintile or old drainfield. • When replacing consider using a demand-based recharge vs. a time based recharge. • Check valves to ensure proper operation; have until serviced per manufacturer directions. • Uses water and increases pumping frequency and expense.Water Softener Iron Filter Reverse Osmosis • Uses water and increases pumping frequency and expense.Surface Drainage Footing Drains Maintenance Log Track maintenance activities here for easy reference. See list of management tasks on pages 2 6 3. Date Accomplished/Measured Water UsageActivity Check daily for a period of time and weekly once average use is determined: Water usage rate (gallons per day) Leaks: check for plumbing leaks Check annually: Establish and maintain contract for holding tank pumping services Water use appliances - review use - 4 - Owner’s Management Plan for Holding Tank Septic Systems University OF Minnesota Water Meter Reading and Tank Evacuation Schedule Water Meter Reading (in gallons) Total Gallons Removed Tank Contents Removed?Date Notes: Mitigation/corrective action plan: if any seepage or failure occurs, contact installer and county, asap. "As the owner of this SSTS, I understand it is my responsibility to properly operate and maintain the sewase treatment system on this property, utilizing the Management Plan. If requirements in this Management Plan are not met, I will promptly notify the permitting authority and take necessary corrective actions. If I have a new system, I agree to adequately protect the reserve area for future use as a soil treatment system." Date:Property Owner Signature: L2116Management Plan Prepared By:Tim Haeg, Watab Inc.License ft: 1 -5- WatabJob# 4921 Holding Tank Pumping Agreement PROPERTY OWNER: PROPERTY OWNER’S NAME: Shawn Vierzba, et al PROPERTY ADDRESS: 41488 Long Lake Road, Ottertail MN 56571 PARCEL IDENTIFICATION NUMBER: 53000320250000 MAILING ADDRESS: 601 1st St. S., Cold Spring MN 56320 DateProperty Owner’s Signati GENERAL REQUIREMENTS: The above referenced property contains a holding tank for the disposal of sewage. This serves as an agreement, entered into by and between an MPCA licensed Maintainer and the property owner to retain pumping services as needed as determined by the tank size and water usage. The pumping of the holding tank shall occur on a regular basis to prevent wastes from discharging to the ground surface and/or backing up into the dwelling or other establishment. The owner is prohibited from pumping or otherwise draining or removing any of the tank contents themselves. Pumping can be scheduled at either intervals, or an as-needed basis with proper advance notice. The owner shall be responsible for maintaining records of tank pumping. If required by the County or local regulating agency, the owner shall submit such records in the required timeframe (annually, etc.) to satisfy permit requirements. A copy of this agreement between shall be submitted to the County or local regulating agency. The MPCA licensed pumper agrees to maintain the tank(s) and properly dispose of sewage wastes in accordance to Minnesota Rules 7080 and any other applicable regulations. Failure maintain the holding tank(s) or failure to provide pumping receipts when required may result in enforcement action by the County or local regulating agency. LICENSED SEPTIC PUMPER: COMPANY NAME: Hawes Septic Tank Pumping, LLC ADDRESS: 35541 Co Hwy 67, New York Mills, MN 56567 MPCA LICENSE NUMBER: L3466 )PHONE: 218-385-3260 Licens^ Septic PunTper’s Signature I ^ ^ (S Date OTTER TAIL COUNTY LAND & RESOURCE MANAGEMENT PUBLIC WORKS DIVISION WWW.CO.OTTER-TAIL.MN USpnCRTAll GOVERNMENT SERVICES CENTER 540 WEST FIR AVENUE FERGUS FALLS. MN 56537 218-998-8095 FAX: 218-998-8112 08/11/2014 Shawn Vierzba Et Al 601 IstStS Cold Spring MN 56320 2301 RE: Primary Owner Shawn Vierzba Et Al Result of Onsite Sewage System Inspection, Non-Compliant Parcel(s) 53000320250000 Lake Name Long Lake No 56-210 Class RD Dear Shawn Vierzba Et Al: As part of Otter Tail County’s ongoing Sewage Systerrt Inspection Program, our Office inspected your sewer system located at 41488 LONG LAKE RD on 7/15/2014. At that time, we found your sewage system to be non-compliant for the following reason(s): Sf Hand Carried Sewage Above Ground Storage of Sewage Failure to protect ground H20 .#-1-' Please contact our Office by 09/12/2014, at 218-998-8095, so that this matter can hopefully be resolved. % Sincerely, George Hausske Inspector Michael Douglas Inspector CHRONOLOGY REGARDING THE SEWAGE SYSTEM INSPECTION PROGRAM Primary Owner Shawn Vierzba Et Al Alternate Owner Shawn Vierzba Et Al RD56-210 LongLake 53000320250000Parcel No 41488 LONG LAKE RDGIS Address Date of Compliant Letter Date of Non-Compliant Letter Date Initial Response (owner) Date Sewer Permit Issued Date Abatement Notice Date Violation Issued Date to County Attorney Date Resolved No Further Action ^ Uue \)ir 0 on ft loJI ^ ^ re:frop<rrh^ Vh'fA-lJf IP Comments: C>// n^-\ki h-f‘ Hh (j Chronology Sewage System Inspection Program 1-2014 t SEWAGE SYSTEM INSPECTION PROGRAM FIELD NOTES LAKE NAME Long LAKE NO LAKE CLASS RD56-210 PARCEL NO PHY ADDR 41488 LONG LAKE RD53000320250000 /sTOWNSHiPRush Lake Township SECTION NO 32 PROPERTY OWNER Shawn Vierzba Et Al TAXPAYER Shawn Vierzba Et Al 601 1st St S Cold Spring MN 56320 2301 ONSITE INSPECTION FINDINGS - SKETCH ON BACK: Holding Tank Leaching Pit Sink Drain Septic Tank/Drainfield Cesspooi Porta Potty Seepage Pit Surface Discharge Outhouse Drywell Straight Pipe Primitive Dwelling SEPARATION / SETBACK DISTANCES (in feet): TANK ABSORPTION AREA OUTHOUSE OHWL RESTRICTIVE LAYER WELL ONSITE INSPECTION RESULTS: COMPLIANT (Send Compliant Letter) IMMINENT THREAT TO PUBLIC SAFETY OR HEALTH (Send 10 Day Abatement Notice) NON-COMPLIANT (Send Non-Compliant Letter) REVISIT NO FURTHER ACTION NECESSARY 5 ^cO'a- NoCOMMENTS:r 1:>jprAs9 A__/ r ali5J.d UDatenspector’s Signature(s) Existing File:Yes No Sewage System Inspection Program - Field Notes Fomn 6-1-2011 EJ fI i d VAfe rU UriCf rS ^u/^her- ^Bloe r^nK. I ivJ 7® r-^v^K I ti5 Tr4il-er5 (?H ype/Lf I x^l hCoi^^ Ar-^ WpTVIpv^i I Ml i ^^0 Tan>C. > T w.UJ^t-er^ J Ki |s/o-f TahV:! /uJ/i-f-e.r~ J ij J f'f-f<^OuIJn f~ pi’H lO tl{ <£' .Ml r,3 .■*: it.-»"-.-'r Ife^y :i5: M f‘s%\ tei^#*li^<r*'4 ^(^^i3-%L *\m■r •j» r i litS :iii»ip»t!^r"4 IS :;?Jlsiia S '|;-J..--^r«»i >73 ,<>. .,r--.-: 4' ■ MS3WCE \/i€r^»l©A 41 m vfff t»H| UU S&c 3X Ru^i, t4^e ThJa %^0OOdX0XBt>OOO OTTER TAIL COUNTY LAND & RESOURCE MANAGEMENT PUBLIC WORKS DIVISION WWW.CO.OTTER-TAIL.MN.USOTTCRTRIl GOVERNMENT SERVICES CENTER 540 WEST FIR AVENUE FERGUS FALLS, MN 56537 218-998-8095 FAX: 218-998-8112 5/8/2014 Shawn Vierzba Et Al 601 IstStS Cold Spring MN 56320 2301 RE; Primary Owner: Shawn Vierzba Et Al Onsite Sewage System Inspections Parcel: 53000320250000 Lake: 56-210 Long Dear Shawn Vierzba Et Al: As part of Otter Tail County’s ongoing effort to preserve and enhance water quality, the County Board of Commissioners has directed our Office to conduct onsite inspections of existing septic systems for compliance with the Sanitation Code of Otter Tail County. In order to complete this process, a map was created (July 10, 2008) which identifies the year in which an area of the County would be inspected. It appears your property is included in the area that will be inspected in 2014. Since this is the case, please be informed that starting in early June 2014 Inspectors from our Office will be checking existing septic systems in your area. Should a non-compliant septic system be discovered, our Office will contact the property owner and inform them of the need for their septic system to be brought into compliance with the provisions of our Sanitation Code. If you have any questions regarding this matter, please contact our Office (218-998-8095). Sincerely, Scott Ellingson Inspector