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Home My WebLink AboutWinter Haven_21000170112004_Septic System Permits_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.ottertail.mn.us July 30, 2004 ji; Richard & Solveig Konrad 13505 485th Ave. Parkers Prairie, MN 56361 RE: Sewage Treatment System Servicing Tax Parcel Number 21000170112001 Described as PtGL 6 Com SE Cor. of GL 6..., Section 17 of EffingtonTownship, Block Lake (56-79) ; As of July 19, 2004, the sewage treatment system (Sewage Treatment Installation Permit #16692) servicing your property was determined to be in compliance with the provisions of the Sanitation Code of Otter Tail County for a 4 bedroom home. If you have any questions regarding this matter, please contact our office. Sincerely, 1 Mark Ronning Inspector I c APPLICATION FOR PERMIT TO INSTALL SEWAGE TREATMENT SYSTEM LAND & RESOURCE MANAGEMENT OTTER TAIL COUNTY COURT HOUSE 121 W. JUNIUS AVE. • SUITE 130 Phone: (218) 739-2271 • FERGUS FALLS, MN 56537 WHITE-Offide ' YELLOW -L&R Inspector PINK - Owner / Contractor APPLICATION MUST BE COMPLETE IN ORDER TO BE PROCESSED Permit No. SECTION TWP NO.RANGE TWP NAMELAKE/RIVER CLASSLAKE NUMBER LAKE/RIVER NAME Z- */V^ 1els'/7 12)(fD PARCEL NUMBER (S) OF PROPERTY BEING SERVICED E-911 ADDRESS ; 3 5-0 S' '-/)(/.^-9)OOOI70ll5^®g>l LEGAL DESCRIPTION tr^ 6-L Cl M 1 A) W, 99*-)e>PT CL G SE COV-, Daytime Phone No.First Initial Mailing AddressLast Name /3S-OS- tl^S'VD 4^^^vc ig(? tho/ f\^ € CcjKoyi rAc(Property Owner fatr^frS . <lh Sl^OI Nuuy \3^f Ht inmih^ J So fe i^ic S-e I c<Contractor Lie.# A.M. RM,the year of> This System will be ready for inspection on_.at. This space for office use only A.M. P.M. L&R OfficialDate Received Time Received SEWAGE TREATMENT SYSTEM DESIGN DATA CTYPE OF INSTALLATION (CIRCLE ONE) TANK )S^/SizeAdd-On/New System (20) Trench, Rock (21) Trench, Graveiiess (22) Trench, Chamber (23) Bed Mound (0) At Grade ;Replacement (32) Tank, Septic (33) Tank, Lift (34) Trench, Rock (35) Trench, Gravelless (36) Trench, Chamber (37) Bed (5^ Mound (39) At Grade (40) Combination 7S~^n.75"Setback to nearest well Ft. /oo'/Oo'Setback to OHWL (lake &/or river)Ft.Ft. Ft.SC>'Setback to wetland Ft. I I Ft.Setback to dwelling Ft.10/oCollector System (26) Trench, Rock (27) Trench, Gravelless (28) Trench, Chamber (29) Bed (30) Mound (30) At Grade I rSetback to non-dwelling Ft.Ft.[0 (O I ioLSetback to nearest property line Ft.Ft.\0Other (41) Tank, Holding (42) Outhouse (43) Sewer Line (44) Performance (45) Warrantied (46) Miscellaneous I loL10 Ft.Setback to road right-of-way Ft. ;S'Ft. Ft.Elevation above restrictive layer ALL DISTANCES ARE SHORTEST DI^NCE BETWEEN NEAREST POINTS.#BEDROOMS GARBAGE DISP. Y ABATEMENT Y /(l^ ABSORPTION AREA FOR MOUNDSDEPTH OF WATER WELL I 5^^Ft^HOLDING TANK MONITOR/ DISPOSAL CONTRACT ( )Yes ( ) No-L&R Can Not Process EFFLUENTDISTRIBUTION Designer ^ f esigner Lie. #_j3_5S_____ClI _____ Highest Rate 7 PERCOLATION TEST DATA( ) Gravity (■^) Pressure 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 con dition 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. A copy of the final Inspection Report will serve as the Certificate of Compliance for approved installations. O oS' - 3.1- 0 LI /t9oPermit Fee $Date: Date: < / O *0 Rec. No. Land & Resource Management Office \Comments: Ir ■o Form No. BK — 0201-003 305.392 • Victor Lundeen Co., Printers • Fergus Falls, Minnesota APPLICATION FOR PERMIT TO INSTALL SEWAGE TREATMENT SYSTEM LAND & RESOURCE MANAGEMENT OTTER TAIL COUNTY COURT HOUSE 121 W. JUNIUS AVE. • SUITE 130 Phone:(218)739-2271 • FERGUS FALLS, MN 56537 WHITE - Office. YELLOW -L&R Inspector PINK - Owner / Contractor Permit No.APPLICATION MUST BE COMPLETE IN ORDER TO BE PROCESSED RANGE TWP NAMELAKE/RIVER CLASS SECTION TWP NO.LAKE/RIVER NAMELAKE NUMBER L -T-r I03Y7IIi 5'6 56/ mMI, PARCEL NUMBER (S) OF PROPERTY BEING SERVICED E-911 ADDRESS Pur ( fit -tr/O I i^oc I I LEGAL DESCRIPTION . b E G., oT G-L 1.1-' nS,S'AJ(/V 'V. S(r^ p/- (/> Oc m Oif r, I11- 6jLLr LLl Daytime Phone No.Last Name First Initial Mailing Address IJS-e’S- Piif i rf'i> 'P r & I r < V. ^ (o / 01 ‘K- byProperty Owner a /Con^r^U. S^OOI 7 / U ’?Q (fj /-(Lc/./ / 3^^-k:. i C 7'^-x' f \J t ( ■<Contractor Lie. #i’ A.M. > This System will be ready for inspection on.the year of .at This space for office use only^ m zaP.M. Date Re j^rSed L&R OfficialTime Received r:?. ,C T Ip 0SEWAGE TREATMENT SYSTEM DESIGN DATATYPE OF INSTALLATION (CIRCLE ONE) DRAINFIELDTANK ipoo/S^J Ft^SizeAdd-On/New System (20) Trench, Rock (21) Trench, Gravelless (22) 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 I J75Setback to nearest well Ft.Ft.7S /&€>'/Oxj'Setback to OHWL (lake &/or river)Ft. Ft. /so'SoSetback to wetland Ft.Ft. I »Setback to dwelling Ft.Ft./1;/OCollector System (26) Trench, Rock (27) Trench, Gravelless (28) Trench, Chamber (29) Bed (30) Mound (30) At Grade ISetback to non-dwelling Ft. Ft.10 (O (Setback to nearest property line Ft.Ft.\0other (41) Tank, Holding (42) Outhouse (43) Seiwer Line (44) Performance (45) Warranted (46) Miscellaneous iO Iic;Setback to road right-of-way Ft.Ft. ■ o Ft.Elevation above restrictive layer Ft. ALL DISTANCES ARE SHORTEST DISTANCE BETWEEN NEAREST POINTS. it BEDROOMS H GARBAGE DISP. Y I K ABATEMENT Y / 'Nf) ABSORPTION AREA FOR MOUNDSDEPTH OF WATER WELL Ft^HOLDING TANK MONITOR/ DISPOSAL CONTRACT ( )Yes ( ) No-L&R Can Not Process EFFLUENTDISTRIBUTION ( ) Gravity ('< ) Pressure ''v'cr K r 1C ^ V f t/17 h/Designer ■,PERCOLATION TEST DATA Designer Lie. #__; ¥Highest Rate ~1Date 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 con dition 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. A copy of the final Inspection Report will serve as the Certificate of Compiiance for approved instailations. O w/k:>oPermit Fee $Date: Signatim of Property Owner/Agefft for QjpneO. /^/ /o b Rec. No.Date: Land & Resource Management Office Comments:7^t)/ ^XQ- r .'j_ <-.Z' H / ^ 7i... '■ / -z/ Form No. BK — 0201-003 305,392 • Victor Lundeen Co.. Printors • Fergus Fells, Minnesote % , iSEWAGE TREATMENT SYSTEM PERMIT INSPECTION RESULTS Inspector must make all measurements SEPTIC TANK OUTHOUSEDRAINFIELDLIFT TANKCATEGORY miJa6o FT2CapacityFT®GLS.GLS.C FT/o<a-4^ ftFTSetback from Nearest Well (on Setback from Buried Water Suction Pipe (o <1t~ ^FTfO ^ ; S-0 7- ^ 5-0^ ft Setback from Buried Pipe Distributing Water Under Pressure FT FTFT / So ■) A-»- ? 5^-^FTSetback from OHWL (lake &/or river)FT FTSetback from Setback from Wetland FT FTFTSetback from Dwelling _5-0^ FT^0-7- ft ft/6 FT2 o^Setback from Non-Dwelling FTFTSetback from Nearest Property Line FT 10/0~»- FT/o^ ftSetback from Right-of-Way FT/ Cu- ft /O r*~ 7 FTFTFTElevation above Restrictive Layer FT Holding Tank/Lift Alarm NO Old System Pumped & Destroyed NO FILTERSEPTIC TANK DRAINFIELD CALCULATIONSewer Line to Well Separation 5fOQ s<r j/) MinimumActual FTx m□ YESManuf. ft®<•00o LPModel #□ NO FT 20 MOUND CALCULATION MOUND /AT-GRADE ROCK REDUCTION Inspector’s Comments: ABSORBTION AREA inchesRock trenches with of rock under pipe f(.%Ft. X Ft.ft® DF.K reduction / e^ivalent to SKETCH: lOO tJ^4 , the Sewage Treatment System serving the previously described property is approved for use. N Land & Resource Manage^^it^OffipllIDateTimeInitial Copy of Inspection Report Mailed to Applicant L & R Official / Date System {design must be to scale and must include the proposed location of the sewage system, all existing/proposed buildings, property lines, the ordinary high water level of the water body, wetlands, bluff and all water wells within 1 50' of the sewage system. I___grid(s) equals C” feet, or inch(es) equals feetScale: S'-'^iO'OQ______ SUBMITTED BY: Rah iPn ■!<:■€j£ Se>my(C€ ADDRESS: Co Utcy SIGNATURE: FIRM NAME:DATE: MPCA LICENSE #: / 9 S9 LICENSE CATEGORY: Q / a//^ 3^)0 «¥q/ , /I - 0599 - 029 300.8t7 • Victof Lundddn Co . Priniofs * Fergus Falls. MN • 1-800-346-4070 SITE DATA WORKSHEET LAND AND RESOURCE MANAGEMENT Otter Tail County 121 W. Junius Ave., Suite 130 Fergus Falls, MN 56537 OWNER:V. FIRST ^ Ko\rv r<xci LAST NAME MIDDLE TELEPHONE NUMBER ADDRESS: I ^$"0S /^\/. fct r Pi/^ou \r-€-3 6 //^(\L STR./RT.CITY ZIP CODESTATE 13) 03& f-PfyUH3(d' 79 LAKE/RIVER NO. LEGAL DESCRIPTION: G- L 6) S' E Co i^N. Iisrs' Deg (//. RANGE TWP. NALAKE NAME SEC.TWP. -/(^L.SOIL boring log - Datevr. o COLOR & MUNSELL NO. DEPTH (INCHES)STRUCTURETEXTURE BLOCKY PLATY PRISMATIC i/eui/3 !acKg-gt^lOOO/70n5g)Q/0-^PARCEL NUMBER i^S t>S'V/3 BLOCKY PLATY PRISMATIC ( tl'M L-o^v*^ FIRE NUMBER & f'cPUjio NUMBER OF BEDROOMS BLOCKY PLATY PRISiyi^lCGARBAGE DISPOSAL: YES NO SD*±ft.WELL CASING DEPTH:BLOCKY PLATY PRISMATIC NONE FLOODPLAIN: YES VEGETATION: AQUATIC TERRESTRIAL BLOCKY PLATY PRISMATIC NONE n_%SLOPE AT INSTALLATION SITE: (goring^TYPE OF OBSERVATION: Probe Pit PARENT MATERIAL: Till Outwash Loess Bedrock Alluvium COMMENTS: 0)ORIGINAL SOIL:No COMPACTED SOIL: Yes 3DEPTH OF BORING:ft. PERC TEST #2PERC TEST #1 - TWO TESTS ARE REQUIRED - PERC RATEPERC RATE WATER DEPTH WATER DROPTIMEINTERVAL (MINUTES!WATER DEPTH WATER DROP TIME iINTERVAL (MINUTES) ...LSI&STARTSTART .tLYfm17s TIME DROP PERC PERC RATEWATER DROPWATER DROP PERC RATE TIME INTERVAL IMINUTESl WATER DEPTHTIMEINTERVAL IMINUTES)WATER DEPTH<>m REFILLREFILL TIME DROP PERC L^..7.L2J.DROPTIME PERC PERC RATEPERC RATE WATER DEPTH WATER DROPTIMEINTERVAL (MINUTES)WATER DEPTH WATER DROP TIME INTERVAL IMINUTESlIS)/3/REFILLREFILL-TmT • ^7^- ^^^_L=_Z,211^.5..7- TIME DROP PERC PERC RATEWATER DROPPERC RATE INTERVAL (MINUTES)WATER DEPTHTIMEINTERVAL (MINUTES)WATER DEPTH WATER DROP TIME isleJ3SL REFILL TIME ' DROP REFILL I'y...............7 XU y..PERCDROPTIMEPERC PERC RATEWATER DROPPERC RATE INTERVAL (MINUTES)WATER DEPTHTIMEINTERVAL (MINUTES)WATER DEPTH WATER DROP TIME 'mkifeREFILLREFILL L^UL-_2.>.2.UdJk .....-7-I LjS ......../3k TIME DROP PERCDROPTIMEPERC PERC RATEWATER DROPPERC RATE TIME INTERVAL (MINUTES!• WATER DEPTHTIMEINTERVAL (MINUTES)WATER DEPTH WATER DROPXfl /OWIMSREFILLREFILLs.TIME ’ D^OP Pe7.1m.......7- TIME DROP PERC PERC RATEPERC RATE INTERVAL IMINUTESl WATER DEPTH WATER DROPINTERVAL (MINUTES)WATER DEPTH WATER DROP TIMETIME REFILLREFILL TIME DROP PERCTIMEDROPPERC PERC RATEPERC RATE INTERVAL (MINUTES)WATER DEPTH WATER DROPINTERVAL (MINUTES)WATER DEPTH WATER DROP TIMETIME REFILLREFILL TIME DROPTIME DROP PERCPERC PROPOSED DESIGN: A'MOUND X HOLDING TANK PRESSURE DIST.GRAVITY DIST.TRENCH ATGRADEBED OUTHOUSE OTHER SPECIFY: — SYSTEM DESIGN ON BACK — SEWER LINE "W -■ ll'MOUND DESIGN WORKSHEET (For Flows up to 1200 gpd) I A. FLOW Fj»imate<i Sewage Rows in Gallons per (god) Estimated gpd or measured Ji^O_ x 1.5 = gpd. Number Type inType I Typen ¥ofBedmoms 1802253002 60%2184503 .300 of (beB: SEPTIC TANK UQUID VOLUMES ) gallons 2566003754 values7502944505in3329005256TypeL normcolunins 37010506007 40867581200I't ;C. SOILS (refer to site evaluation) 1. Depth to restricting layer = 2. Depth of percolation tests = 3. Texture_____C ? Percolation rate b % I Septic Tank Cmwdiia (ia talloostinches 5 feet inches Liquid capaaty with disposaUt lift inside Number of Bednuos Mioiomm liquid Capacity Liquid apadiy with garbage tSsposal 1 15002urlen 3(ir4 S nr A 7.RurV 750 1125mpi 2000100015003000150022504. Land slope 400020003000 D. ROCK LAYER DIMENSIONS 1. Multiply flow rate by 0.83 to obtain required area of rock layer: A x 0.83 = gpd X 0.83 sq. ft./gpd = sq. ft. 2. Select width of rock layer (max 10' if <120 mpi max 5’) = Length of rock layer jm_sq. ft. ^ _ V.t10 ft. = area width = lO ft.= ft. 3. Length ft <-•i 'Width <120mpi <10* >120mpi <5’E. ROCK VOLUME Multiply rock area by rock depth to get cubic feet of rock: sq. ft. x _J_ ft. = cu. ft. Divide cu. ft. by 27 cu. ft. /cu. yd. to get cubic yards; S5Q cu. ft. + 27 = /^•S~ cu. yd. Multiply cubic yards by 1.4 to get weight of rock in tons; l^L^cu. yd. x 1.4 ton/cu. yd. = tons. %1. } 2. 3. F. ABSORPTION WIDTH 1. Percolation rate in top 12 inches of soil is Texture /jaaro 2. Select allowable soil loading rate from table; fgpd/fP 3. Calculate adsorption width ratio by dividing rock layer loading rate of 1.20 gpd/ft2 by allowable soil loading rate:1.20 gpd/fP-s-_ij{^gpd/fF= . ^ / 6>7 . V AbsorptioD Width Sizmg Table 7 mpi fecdatiaD Ram in Minutes per Inch (MR)per per square RanoofAbsiapdon widtb to Rock Layer Widdi Soil Texture Faster than 0.1 0.1 to 5 O.I to5 6 to IS 16 to 30 311045 46060 600 120 Slower iban 120 1.20Coarse Sand 1.00 Sand 120 1.00 2.00Fine Sand Sandy Loam Loam Sill Loam Clay Loam Cby ' 0.60 2.40 ^ 2.67^- 0.79 u' 0.600500.45024 5.00Clay020' 6.00 :■ 4. Multiply adsorption width ratio by rock layer width to get required adsorption ividth; X I n ft - : ■-? r.- j_'' '■ •. >■•■ ‘ ; ,.• . :-:. -; «.; ••■. •• ,;. •'■• <■■ ■. ••: .• ;• ■ ' ■ ■•.' •. Soil CharacteristiGS and Required Areas for Sewage Treatment Square feet per gallon per day Percolation Rate in Minutes per Inch (MP!) Soil Texture ! \Faster than O.I ” 0.1 to 5 0.1 to 5 6 to IS 16 to 30 31 to 45 46 to 60 Slower than 60**” Coarse Sand !I ■ i0.83Sand1.67Hne Sand ** Sandy Loam Loam Silt Loam Clay Loam .■ 1.27 1.67 100 120 Clay * Soil too coarse for sewage treatment. Use systems for rapidly penneable soils. ** Soil having 50% or more of fine sand plus very fine sand. Soil with too high a percentage of clay for installation of an inground standard system. ; :: '. ■■ ■ : 9 ............ • r-;f' • ■ i* . •••... . * •. •.•• ■•: .; , : •*:; *. . .r Cover 1’Slope:____ Ri^ Rock r 'G. DOWNSLOPE BERM WIDTH 1. If landslope is Less than 1% : Absorption Width feet 2. Calculate minimum moimd size QeanSand____ ■ 6" Topsoil p Natural Soil. Downslope Widtha. Determine depth of clean sand fill at upslope edge of rock layer: Separation: 3' CX ft =_ Upslop^^iidth Ro<i^idth Absorption Widthi_feet b. Add depth of clean sand for separation (2a) at upslope edge, depth of rock layer (1 foot) to depth of cover (1 foot) to find the mound height at the upslope edge of rock layer; t ft + 1ft + 1ft = 3 feet c. Multiply upslope movmd height by 4 to find upslope berm width: 3 X 4 = feet d. Multiply rock layer width by landslope to determine drop in elevation; 10 X %-^lQ0= n feet e. Add depth of clean sand for slope difference (2d) at downslope edge, to the moimd height at the upslope edge of rock layer (2b) to find the downslope height; ft + ^ 5 ft ~ <S!> 3 feet f. Multiply downslope mound height by 4 to get downslope berm width: X 4 = feet g. The width is the sum of upslope berm (G.2c) width plus rock layer width (D.2) plusdownslope berm width(G.2f); )Qv ft+ fO ft+ ft= 3^ feet Subtract the minimiun width (G2.g) from the adsorption area (F.4) to find the additional downslope area for adsorption ft - 3lo»7 ft = J2i3_feet j. Add the additional width (G2.g2) to the upslope (G2.c) and downsolpe width (G2.f) Upslope: 7^3 ft + ft = I i»3 feet Downslope: ft + 7^3 ft = fQ/5 feet Total width is the sum of upslope berm (G.2jl) width plus rock layer width (D.2) plus downslopelserm width(G.2j2); ^ft+ 10 ft-f iV.3 ft= W0i4 feet k. Total mound length is the sum of upslope berm width (G2.c) plus rock layer length (D.3) plus upslope berm width (G2.c): 1^ ft+ ^0 ft+ ft= 7M feet ;,U[jdo5e Width :V. Upslope \A^dth: Rock Bed i-Upslope Width‘^ Width 70 Length JZ T .;• \i•a ; ii.?|2 Downslope Width Absorption Width U if i vti i • r Tnfal T.pnf>1:h 7^ Cover rSlope:____G. DOWNSLOPE BERM WTOTH 1. If landslope is 1% or more^ subtract rock layer width from adsorption width to obtain minimum downslope berm toe feet 2. Calculate Minimum moimd Size a. Determine depth of clean sand fill at upslope edge of rock layer: Separation 3' - b. Add depth of clean sand for separation (2a) at upslope edge, depth of rock layer (1 foot) to depth of cover (1 foot) to find the mound height at the upslope edge of rock layer; ft + 1ft + 1ft =____feet ^ QeanSand ^ 6" Topsoilft =ft-NaturalSoil Downslope WiddiUpslope Widdi Rode Mdth Absorption Vfidth feetft = c. Enter table with landslope and upslope berm ratio. Select berm multiplier of^. d. Multiply berm multiplier by upslope moimd height to find upslope berm width: iUpslope Width ■£feet ■a e. Multiply rock layer width by landslope to determine drop in elevation; feet s : Downslope Width . ■ Absorption Width.%-5-100 = f. Add depth of clean sand for slope difference (2e)at downslope edge, to the mound height at the upslope edge of rock layer (2b) to find the downslope height; Total Length. ft =feetft + g. Enter table with landslope and downslope berm ratio. Select berm multiplier of. h. Multiply berm multiplier by downslope mound height to get downslope berm width: feet BERM SLOPE MULIXPUEBS i. Compare the values of step G.l and Step G.2h Select the greater of the two values as the downslope berm width;________ j. Total mound width is the sum of upslope berm (G.2d) width plus rock layer width (D.2) plus downslope berm width(G.2i); DOWNSLOPE berm multipliers for various benn slope ratios Land Slope, UPSLOPE berm multipliers for various berm slope ratiosin % feet 3:1 4:1 M 6:1 7:1 3.0 4.0 5.0 . 6.0 7.0 3.09 4.17 5.26 6J8 7J3 3.i9 4.35 5.56 6.82 8.14 3.30 4.54 5.88 7J2 8.86 3.41 4.76 6.25 7.89 9.72 3.53 5.00 6.67 8.57 10.77 3.66 5.26 7.14 9.38 1107 3.80 5.56 7.69 10.34 13.73 3.95 5.88 8.33 11.54 15.91 4.11 6.25 9.09 13.04 18.92 4.29 6.67 10.00 15.00 23.33 4.48 7.14 11.11 17.65 30.43 4.69 7.69 1150 21.43 43.75 3:1 4:1 5:1 6:1 7:1 8:1 0 3.0 4.0 5.0 6.0 7.0 8.0 191 3.85 4.76 5.66 6.54 7.41 2.83 3.70 4.54 5.36 6.14 6.90 2.75 3.57 4.35 5.08 5.79 6.45 2.68 3.45 4.17 4.84 5.46 6.06 2.61 3.33 4.00 4.62 5.19 5.71 2.54 3.23 3.85 4.41 4.93 5.41 2.48 3.12 3.70 4.23 4.70 5.13 142 3.03 3.57 4.05 4.49 4.88 2.36 194 3.45 3.90 4.30 4.65 131 186 3.33 3.75 4.12 4.44 126 178 3.23 3.61 3.95 4.26 121 170 3.12 3.49 3.80 4.08 1 2 3 ft +ft =feetft +4 k. Total mound length is the sum of upslope berm width (G.2d) plus rock layer length (D.3) plus upslope berm width (G.2d); ■ 5 6 7 8ft =feetft +ft + 9 10 Final Dimensions: X IM 11 12 A, CERTIFICATE OF APPROVAL SEWAGE SYSTEM This certifies that as of the 28th of November, 2000 the sewage treatment system serving the following described property is compliant with the provisions of the Sanitation Code of Otter Tail County. m.M' PART GL 6 COM SE COR OF GL 6 N 115.5 84 DEG W 263' TO SHORELN OF BLOCK LAKE NLY & ELY ALONG LAKE TO LN BEARS N 3 DEG W N 84 DEG W 99' TO BG N if-W- Parcel Number(s): 21000170112001 Section: 17 Township: 131 Range: 038 Township Name: EFFINGTON TOWNSHIP Lake/River Number: 56-79 Lake/River Name: BLOCK Current Property Owner: RICHARD G & SOLVEIG E KONRAD Niimber of Bedrooms: 4 cabins/2 BR's each Mi il pi f/. 264.709 • Victor Lundeen Co.. Primers • Fergus Falls. MN • 1-B00*346*4870 APPLICATION FOR PERMIT TO INSTALL SEWAGE TREATMENT SYSTEM LAND & RESOURCE MANAGEMENT OTTER TAIL COUNTY COURT HOUSE 121 W. JUNIUS /jkVE. • SUITE 130 Phone: (218) 739-2271 • FERGUS FALLS, MN 56537 WHITE - Office YELLOW -L&R Inspector ■ PINK - Owner / Contactor PLEASE PRINT OR TYPE ALL INFORMATION Permit No. SECTIONLAKE NUMBER LAKE/RIVER NAME LAKE/RIVER TWP NO.R,^NGE TWP NAME : 54,- 79 /7 3E-911 ADDRESSPARCEL NUMBER (S) SUNOCOGO/L. • I LEGAL DESCRIPTION ?r • r d Mailing Address unx /9^PnjUtm Pi/A/irJ 5634/ Last Name ^First Initial Daytime Phone No. . Property Owner' ■ 3c65> SfSPULr/^- 7939Contractor Lie.# I AM. ' > This System will be ready for inspection on.the year of ,P.M..at. This space.tor off ice. use only A.M. P.M. Date Received L&R OfficialTime Received 1-.. SEWAGE TREATMENT SYSTEM DATA: MINIMUM REQUIREMENTSTYPE OF INSTALLATION(DRAINFIELD-TANK(1 ) System (^T^olding Tank (Alarm Required) ( 3 ) Septic Tank ( 4 ) Lift Station (Alarm Required) (5) Drainfield ( A ) Trenches, Rock ( C ) Trenches, Graveiess ( D ) Moynd^ ( E ) Trenches, Chamber ( F^)^-Grade (6 ) Collector .(7 ) Outhouse ( 8 ) Greywater Systeni ( 9 ) Sewer Line / ( 10 ) Performance [ (11) Other V; Ft'5oooSize GIs. 50 Ft.Setback to nearest weli Ft. 75 Ft.Setback to OHWL (lake &/or river)Ft. Setback to wetiahd Ft.30( B ) Seepage Bed Ft. JO Ft.Setback to dwelling Ft. 10 Ft.S^back to non-dwelling Ft. /dSetback to property line Ft. yElevation above water table (OHWL)Ft.Ftl All distances are shortest.distance between nearest points ABS0R5I0N AREA FOR MOUNDS(^^^Gravity ( ) Pressure EFFLUENT DISTRIBUTION Ft^MOLDING TANK . K ^ MONIJOR/DISPOSAL CONTRACT WATER WELL DEPTH Designer____ Designer Lie. #. PERCOLATION TEST DATA ( ) No - L & R Can Not Process Date of Test Highest RateI 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 ffie permit. Applicant further agrees that no part of the system shall be covered until it has been inspected and approved tor use. It shall be the responsibility of the applicant for the permit to notify Land & Resource Management that the installation is ready for inspection.I 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 |t 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. >Date: Signa Iwny&^^entUr Date;✓ Land & Qi^urce Managemei^^iffl^& PERMIT FEE $RECEIPT NO. Comments: / ^5(70 C^t l^ ^~ ^ ! '^OO r^ic Form No. BK — 1099-003 300,315 • Vicior Lundeen Co., Pimiers • Fergus Fells, MN • 1-900-346-4870 r , APPLICATION FOR PERMIT TO INSTALL SEWAGE TREATMENT SYSTEM LAND & RESOURCE MANAGEMENT OTTER TAIL COUNTY COURT HOUSE 121 W. JUNIUS AVE. • SUITE 130 Phone: (218) 739-2271 • FERGUS FALLS, MN 56537 f :i:rWHITE - Office YELLOW - L & R Inspector PINR - Owner / Contactor Permit No. / '/PLEASE PRINT OR TYPE ALL INFORMATION LAKE NUMBER LAKE/RIVER NAME TWP NO.R^NGELAKE/RIVER CLAS^ SECTION TWPNAME ;LUc^/3//7 -3PARCEL NUMBER (S)E-911 ADDRESS OOO-n-0//^' oo/ \LEGAL DESCRIPTION \ •«f Last Name First Initial Mailing Address ,Daytime Phone No. \fV/h'chProperty Owner //i (A tbo \ / 9 4o A 7 /1; //.u) \ \Z-Y/5.S '"?(-P7/d ‘yj.toKt /939\Contractor Lie.*; I!■ c ► This System will be ready for inspection on.the year of This space for office use only W:S.//9r:> Date Receive Time Received L y R QBicial SEWAGE TREATMENT SYSTEM DATA: MINIMUM REQUIREMENTSTYPE OF INSTALLATION TANK DRAINFIELD(1 ) System '(2 ) Holding Tank (Alarm Required) ( 3 ) Septic Tank (4 ) Lift Station (Alarm Required) (5) Drainfield ( A ) Trenches, Rock ( C ) Trenches, Graveless ( D ) Mound ( E ) Trenches, Chamber ( F ) Al-Grade (6) Collector (7) Outhouse ( 8 ) Greywater System ( 9 ) Sewer Line (10) Performance ( 11 ) Other 7t'5 066Size GIs. /50Setback to nearest well Ft.Ft.I;75Setback to OHWL (lake &/or river)Ft.Ft.\\ ( B ) Seepage Bed 50Setback to wetland Ft. Ft.\V /O Ft.Setback to dwelling Ft. /OSetback to non-dwelling / 'v Ft.Ft. fdSetback to property line R.Ft. 7Elevation above water table (OHWL)Ft.Ftl All distances are shortest distance between nearest points ABSOFWON AREA FOR MOUNDS(<Xj Gravity ( ) Pressure EFFLUENT DISTRIBUTION .Ft^WATER WELL DEPTH HOLDING TANK MONITOR/DISPOSAL CONTRACT L*/e Designer____ Designer Lie. #. PERCOLATION TEST DATA( HVes ( ) No - L & R Can Not Process i Date of Test Highest Rate 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 con dition 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. Date: Signature of Property Ownwer/Agent to^mief / u - I 0C>Date: Land & Resource Managemenj-^caCP i5a/i/390PERMiT FEE $RECEIPT NO..5 1 Comments:i H G^eltric/ / Soo 61//c^ , / tr j / Sc:^' j Form No. BK — 1099-003 300.815 * Victor Lurtdeen Co . Printers • Fergus Falls. MN ■ 1-800-346-4870 SEWAGE TREATMENT SYSTEM PERMIT INSPECTION RESULTS Inspector must make all measurements HOLDING SfiPftCTANK OUTHOUSE‘DRAINFIELDLIFT TANKCATEGORY Capacity 3/00 FT 2FT 2GLS. GLS. Setback from Nearest Well FT FT FT FT Setback from Buried Water Suction Pipe 5^0 r FT FTFTFT Setback from Buried Pipe Distributing Water Under Pressure FT FTFTFT S* «/Setback from Lake, Wetland or River (OHWL)FTFTFTFT Setback from Dwelling /FTFTFTFT Setback from Non-Dwelling FTFTFTFT Setback form Nearest Property Line / o h'FT FTFTFT Elevation from Bottom to Water Table / Restrictive Layer FTFTFTFT NOHolding Tank/Lift Alarm NOOld System Pumped & Destroyed 33 DRAINFIELD CALCULATIONSewer Line to Well SeparationSEPTIC TANK FILTER MinimumActual31 FTXManuf.. Model # /6>0O-/ □ YES 4^//S-uo-Z. .ft"FT FT20 MOUND CALCULATION ROCK REDUCTIONInspector’s Comments: f- ABSORBTION AREA inchesRock trenches with Ft. X .%of rock under pipe for Ft2 .ft" DF.reduction / equivalent to ? I7Afi-I3^ /- PgnTlnspector’s Name Inspector's Signature /^e>cf \r Date / Time of Inspection □ Installation Approved L & R Official Initial / Date AIR TEST CERTIFICATION o ^ . od (date), an air test of the sewer line installed Permit Numberunde^so'^^ewage Disposal System /3^97 fiLrk -^SZ.-7? for vK *pl r j\Q r J Ko (owner), on (lake/river) was made. /\t that time, the sewer line held VA ITQ s~pounds per square IS'inch for minutes. I ’I 3^ h jt License No. A4 I/, Installer's Signature Date crtDAA % r 'U %<?% % N i SITE DATA WORKSHEET 1 LAND AND RESOURCE MANAGEMENT Otter Tail County 121 W. Junius Ave., Suite 130 Fergus Falls, MN 56537 OWNER: l(oviYacl TELEPHONE NUMBERLAST NAME FIRST MIDDLE ADDRESS: STR./RT.CITY ZIP CODESTATE 6UgK n 131 3 S )vujfoH TWP. NAME - 79 LAKE/RIVER NO.LAKE NAME SEC.TWP.RANGE LEGAL DESCRIPTION:SOIL BORING LOG - Date COLOR & MUNSELL NO. DEPTH (INCHES)TEXTURE STRUCTURE BLOCKY PLATY PRISMATIC NONEPARCEL NUMBER BLOCKY PLATY PRISMATIC NONE FIRE NUMBER NUMBER OF BEDROOMS BLOCKY PLATY PRISMATIC NONE GARBAGE DISPOSAL: YES WELL CASING DEPTH:BLOCKY PLATY PRISMATIC NONE FLOODPLAIN: YES VEGETATION: AQUATIC V TERRESTRIAL BLOCKY PLATY PRISMATIC NONE SLOPE AT INSTALLATION SITE:% TYPE OF OBSERVATION: Probe Pit Boring PARENT MATERIAL: Till Outwash Loess Bedrock Alluvium COMMENTS: ORIGINAL SOIL:Yes No COMPACTED SOIL: Yes No DEPTH OF BORING:ft. PERC TEST #1 PERC TEST #2- TWO TESTS ARE REQUIRED - WATER DROP PERC RATETIMEINTERVAL (MINUTES1 WATER DROP PERC RATE TIME INTERVAL (MINUTES)WATER DEPTHWATER DEPTH START START -----------r r ______TIME DROP PERC TIME INTERVAL (MINUTES!WATER DROP WATER DROP PERC RATEWATER DEPTH PERC RATE TIME INTERVAL (MINUTES)WATER DEPTHREFILL REFILL TIME DROP PERCTIMEPERCDROP WATER DROP PERC RATETIMEINTERVAL (MINUTES)WATER DROP TIME INTERVAL (MINUTES!WATER DEPTHWATER DEPTH PERC RATEREFILL REFILL TIME DROP PERCPERCTIMEDROP WATER DROP PERC RATETIMEINTERVAL (MINUTESl WATER DROP TIME INTERVAL (MINUTES)WATER DEPTHWATER DEPTH PERC RATEREFILL REFILL TIME DROP PERCTIMEDROPPERC WATER DROP PERC RATETIMEINTERVAL (MINUTES)WATER DROP INTERVAL (MINUTES!WATER DEPTHWATER DEPTH PERC RATE TIME REFILL REFILL TIME PERCDROPPERCTIMEDROP WATER DROP PERC RATETIMEINTERVAL (MINUTESl WATER DROP PERC RATE TIME INTERVAL (MINUTES)WATER DEPTHWATER DEPTHREFILL REFILL TIME PERCDROPTIMEDROPPERC WATER DROP PERC RATEINTERVAL (MINUTES)TIME INTERVAL (MINUTES)WATER DEPTH WATER DROP PERC RATE TIME WATER DEPTHREFILLREFILL TIME PERCDROPTIMEDROPPERC WATER DROPWATER DROP INTERVAL (MINUTES)WATER DEPTH PERC RATETIMEINTERVAL {MINUTESl WATER DEPTH PERC RATE TIME REFILL REFILL TIME PERCDROPTIMEDROPPERC PROPOSED DESIGN: HOLDING TANK X GRAVITY DIST.PRESSURE DIST.MOUNDTRENCHBEDATGRADE SPECIFY; — SYSTEM DESIGN ON BACK — SEWER LINE OUTHOUSE OTHER ! ill • . tmmr4S.tO CERTIFICATE OF COMPLIANCE ^M I?., SEWAGE SYSTEM T/j ?3.^7^r J9jA12 th Janaa/Lt/This certificate has been issued this day of t >■: to certify compliance ^cith regidations of Shoreland Management Ordinance, Otter Tail County, Minnesota.§»1 ^4 !■ The premises covered hy this certificate are legally described as:'•'ji 1,V ITwp. Name E{]^tngton131Range 3g17Lake No. 56-79m-Twp.Sec.I'mil I ft'f i m)GL 6 Ex. Ttu. CoiitafYiinq 2.49 AcAei.I- m I Im i fi'111 1-Conhad Roz/UOwner: Name.\-W3116 Emtan Auenae. Mm Hope, lilnneAota tAddress.I*m.i • i ■55427Zip No. iwx-\Permit No. SP_493?mMalcolm K. Lee, Shoreland Administrator Otter Tail County, Minnesota IgSigned by:.>5 r «SiMKL-087 1-009 ^5: « 0^P.1*1^m fm .^W .*•kij 159035 > r 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 While-Offiw V»»ow—Irwpector Pink — Owner Cord—Owner Permit No.,L - ■LEGAL DESCRIPTION AND Tt / 31 e-t-V TthJ.-£kJl. RuicJc mr-LOCATION TWP NTWP RangeLake Classif.Sec.Lake NameLake No. IDENTIFICATION; Please Print All Information. Zip No.Tel. No.Mailling Address —No. Street, City and StateFirstLay Name Koira s. Initial EN<.Jc:^N __________ /yiN C^<rtiQf\C>OWNER SEWAGE SYSTEM INSTALLER Name. This System will be ready for inspection on., 19. This space for office use only .19 M Owner or Agent SignatureDate Rec'd Time Rec'd Phone Call Rec'd By NUMBER OF BEDROOMS: JZESTIMATED COST: SEWAGE DISPOSAL SYSTEM DATA: SEEPAGE PITSEPTIC TANK DRAIN FIELD Sq. Ft.GIs.Sq/Ft.Capacity ^7^ Ft.Ft.Distance from nearest well Ft.Ft.Distance from lake or stream /o Ft.Ft.Ft.Distance from occupied building JODistance from property line Ft.Ft.Ft. 3 .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 ,2.:...3o...... “7 - 2 PERCOLATION TEST DATA:Date of First Test Rate, 19 2-GoO'pg.O V \ V Date of Second Test 19 ’, Rate I^^Test Taken By H 0.(0First Test + 2nd Test 2 Rate2nd Te«t 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 insps^tj^n. (Call or use attached mailer notice.) ~ L/~ f-2^JL^Dated Signature' Permission Is hereby granted to the above named applicant to perform the worl«'4^ribed 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 resfipcjs 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 Hto-1301Fee $0-0 Comments;. Form No. MKL-0771-003 [^fVIEW lATUE lAKt. MiNNfSOTA 1% 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 SF S F S F Distance from Nearest Well 5075FF F F F F Distance, from Lake or Stream F F F ■ F F F Distance from Occupied Building 20 2010FFFF F F Distance from Property Line 10 10 10FF F F F F Distance from Bottom to Water Table 33FFF •FFF Inspector's Comments; i Date of Inspection 19___ Time of Inspection,M Signature of inspectorINTERPRETATION OF ABBREVIATIONS GIs - Gallons SF = Square Feet F = Linear Feet Job Titler,. K. AgencyMKL-0771-003-Backer ;I 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 Whim — Office Y#/low — Inspector Pink — Owner Cord — Owner Permit No.. LEGAL DESCRIPTION •In■)t O ' '• "■ AND LOCATION TWP NameTWPRangeLake Classif.Sec.Lake NameLake No. IDENTIFICATION: Please Print All Information. Zip No.Tel. No.Mailling Address —No. Street, City and StateInitialFirstLast Name OWNER iSEWAGE SYSTEM INSTALLER Name. ^3 S'. ^This System will be ready for inspection , 19.on. This space for office use only c / Owner or Agent SignaturePhone Call Rec'd ByDate Rec'd Time Rec'd NUMBER OF BEDROOMS:ESTIMATED COST: SEWAGE DISPOSAL SYSTEM DATA: SEEPAGE PITSEPTIC TANK DRAIN FIELD Sq. Ft.Sq. Ft.GIs.Capacity Ft. Ft.Ft.Distance from nearest well 7.S''Ft.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 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 , 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 Office Fee $ CEF.TIFK ^ 'T-Comments:. ■ Form No. MKL-0771-003 [^iVliW ■Attn lAKI, MINNfSOTA A - \ m INSPECTION RESULTS Inspector must make all measurements SEWAGE DISPOSAL SYSTEM STATISTICS SEEPAGE PITSEPTIC TANK DRAIN FIELDCATEGORY Actual Should be Actual Should be Actual Should be Cp(gO SFno s^/Capacity Cii-t y I C^CKJ GIs.GIs.S F SF S F \'Distance from Nearest Well 75 50FFFFF F !75'/TDistance from Lake or Stream F F F F F F I[ FDistance from Occupied Building 2010 20FFFF F /Distance from Property Line 10 10 /Of 10FFFF F h FDistance from Bottom to Water Table 33FFFF F (I b r 0 )w Inspector's Comments^ C,\c}<./'f'Xy Y Cx\-Y\\ \ ^Ws f A {h g.I ^TO r c>v\-.'?-. q4-VxCL-Q.\C3L <j V>NsXs./ qV.O n I/ 1\\/.r‘ V\ ^ ■IDate of Inspection '7V/,S~ fci Time of Inspection,M 1 Civ Signature of InspectorINTERPRETATION OF ABBREVIATIONS GIs “ Gallons SF ■ Square Feet F - Linear Feet Job Title AgencyMKL-0771-003-Backer 25 Cf I f0O i! ■ , m !■ ro//:v^i f 0’^ «-7' yj9 fj S' 0 f 0 C' ry.J/’Y It .J C/<»- 7■7 <«# PERCOLATION TEST DATA Price $1.00 per pad. * SHORELAND MANAGEMENT OTTER TAIL COUNTY Fergus Falls, Minnesota 56537 Ph. No.Owner:Mailing Address: Last Name First Middle /9z ^ /r Rn NAME St. & No.City State Zip No.Legal Description:A"' 6 ^ ^ LAKE OR RIVER NO.SEC.TWP.RANGE TWP NAME ^ TEST HOLE NO. 2N-TEST HOLE NO. 1 L 640.Depth to Bottom of HoleDepth To Bottom of Hole inches; Diameter of Hole.inches; Diameter of Hole jnchesinches ZL-An 19Depth, Inches Soil Texture Depth. Inches Soil Texture 7'Date.Date 19 G‘'Percolation Test By____ Percolation Test By____LGl 1m-olUFirmNamexCC FirmName, O UJGC Address //Address < t fL g’i’to Otter Tail County License No..Otter Tail County License No..I-C/)tuMeasurement, Inches Depth in Water Level, Inches 1-Measurement, Inches Depth in Water Level, Inches Time Remarks Remarks > 6 2>r TEC If '2 L i i oUl JJL11 L L_a C ''11Vrll11uu9-7 i UlLl LlUL .— A o) TAj. MKL-0871-028 183-818 See Booklet, "How to Run a Percolation Test" by Agriculture Ext Service, Un. of Minn. (^EVIfW «ATTlf LAKE MINNESOTA