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Home My WebLink AboutZorbaz's_77000020032001_Septic System Permits_■: 1j Wednesday, November 28, 2018 at 1:10:25 PM Central Standard Time Subject: Zorbaz Date: Tuesday, November 27, 2018 at 1:31:04 PM Central Standard Time From: Mike Lovelace To: Chris LeClair Chris, Just a quick update on the Zorbaz Sepbc job. We have all the underground work done. The inspections were done by the City of Perham building inspector. The old tanks and drain field have been demoed. At this time we are still pumping the new tanks untilthe city installs the pumps We are expecting the city to install them the week of December. 3rd. Until then we will pump the tanks as per the original agreement. Please let me know if you have any questions. Thanks - Mike Mike Lovelace Project Manager 25130 County Highway 6 Detroit Lakes, MN 56501 (218) 847-1800 office (218) 847-4414 fax (218) 640-1314 cell www.Ddmidwest.com •• CONFIDENTIALITY NOTICE****** ****** NOTICE: This message and any attachments are confidential and/or privileged information and for the sole use of the intended recipient(s). If you are not the intended recipient or their agent, any copying, forwarding, disclosure, distribution, storage or use of any part of this message or its attachments is strictly prohibited and may be unlawful. If you believe that you received this email in error, please do not read it or any attachments thereto, and notify the sender immediately by email and then delete this message from your system. Thank you. Page 1 of 1 Chris LeClair DirectorOTTER TAIL COUNTY LAND & RESOURCE MANAGEMENT PUBLIC WORKS DIVISION WWW.CO.OTTER-TAIL.MN.US Kyle Westergard Asst. DirectorOTTfflTflll GOVERNMENT SERVICES CENTER 540 WEST FIR AVENUE FERGUS FALLS, MN 56537 218-998-8095 FAX: 218-998-8112 August 9, 2018 51000020032001 Zorbaz on Little Pine c/o Mike Netland, Operating Partner 45738 County Highway 51 Perham MN 56573 IMMINENT THREAT TO PUBLIC HEALTH & SAFETY On August 8, 2018, the Otter Tail County Land & Resource Management Department was notified by Otter Tail County Public Health that an imminent threat to public health and safety (ITPHS) exists at Zorbaz located at 45738 County Highway 51 in the City of Perham, Minnesota. The ITPHS exists due to septic tank effluent and raw sewage being discharged to the surface from both the septic tank and from the building sewer. The surface discharge of septic tank effluent is a violation of the Otter Tail County Sanitation Code for Subsurface Sewage Treatment Systems and MN Rules, Chapter 7080.1500, Subp. 4 which states: The ISTS must be protective of public health and safety. A system that is not protective is considered an imminent threat to public health or safety. At a minimum, a system that is an imminent threat to public health and safety is a system with a discharge of sewage or sewage effluent to the ground surface, drainage systems, ditches, or storm water drains or directly to surface water; systems that cause a reoccurrIng sewage backup into a dwelling or other establishment; systems with electrical hazards; or sewage tanks with unsecured, damaged or weak maintenance hole covers. Based on the observations by Otter Tail County Public Health, the subsurface sewage treatment system (SSTS) located at 45738 County Highway 51 in the City of Perham, MN, is hereby declared an imminent threat to public health & safety. As a result, the Otter Tail County Department of Public Health has issued immediate closure orders for the establishment. The following corrective actions must be taken: 1. Immediately prevent the further discharge of wastewater into the system by stopping the usage of water. 2. Prior to reopening the establishment, pump the septic tank to prevent any further discharge of effluent to the ground surface. 3. Prior to reopening the establishment, repair the building sewer to prevent the discharge of sewage to the surface. 4. Prior to reopening the establishment, the septic tank must be converted it to a holding tank. A permit from Land & Resource Management is required to perform this work. Prior to reopening the establishment, provide Land & Resource Management with a contract between the establishment and a licensed SSTS maintenance business to provide pumping services. The septic tank must be pumped at a frequency to prevent the further discharge of septic tank effluent to the surface. Within 90 days, the SSTS must be replaced. A permit from Land & Resource Management is required to complete this work. 5. 6. The above orders must be completed within the timeframe established in each order. If you have any questions or comments, please contact me at 218.998.8105. Sincerely, Christopher W. LeClair, R.E.H.S. Director Land & Resource Management 218.998.8105 cleclair@co.ottertail.mn.us Rick West, Public Works Division Director Michelle Eldien, County Attorney John Dinsmore, County Administrator Doug Huebsh, County Commissioner Anthony Georgeson, Sanitarian Diane Thorson, Director of Public Health Bruce Jaster, Director, Clay County Environmental Health c: To whom it may concern. We have recently talked to Mike at Zorbaz on Little Pine Lake in Perham MN. We as Sewer Service will be available to pump the septic tank on a regular basis and as needed including after regular hours and weekends. Sewer Service (218)385-3880 or (218)346-7436 )STATE OF MINNESOTA ) ss. AFFIDAVIT OF PERSONAL SERVICE COUNTY OF OTTER TAIL ) I, Chris LeClair of the City of Fergus Falls, County of Otter Tail, in the State of Minnesota, being duly sworn, says that on the day of August 2018, (s)he served the annexed: IMMENMENT THREAT TO PUBLIC HEALTH & SAFETY On the following person, by hand delivering a copy thereof, enclosed in an envelope directed to said person at the following address: Zorbaz on Little Pine c/o Mike Netland, Operating Partner 45738 County Hwy 51 Perham MN 56573 Chris LeClair, Director Land & Resource Management Subscribed and sworn to before me thiss 9th (Jay Qf August 2018 i NotaiT Public My Commission Expires January 31, 2020 AMY JO BUSKOP Notary PubHc-MtnnMota y My CommiMlon Expirat Jan 31,20B0 IFomiLtrs^ertifiedMailingMS Department of LAND & RESOURCE MANAGEMENT COUNTY OF OTTER TAIL Phone 218-739-2271 Court House Fergus Falls, Minnesota 56537 MALCOLM K. LEE, Administrator June 11, 1990 Jeffrey Tweeton R»1 Box 532 Perhain, HN 56573 RE: Site Permit <9575, Little Pine Lake (56-142). Dear Mr. Tweeton: On October 25, 1989, Site Permit #9575 (copy enclosed) was Issued to you for the construction of a 24' X 30' addition to your house. One of the conditions of Site Permit #9575 was that your sewage system be enlarged to serve a 5 bedroom home on or before June 1, 1990. Our records Indicate that as of today's date this has not been done. Since this is the case, please contact our office on or before June 22, 1990 so that this matter can be resolved. -AO. . Sincerely, c^o Bill Kalar Asst. Administrator J4’)I a) I4t.mgb Mi. a X) 7-k. AJk. ^ _ /OiPa ' . ^ MC^-.\ Cl. SHORELAND MANAGEMENT ORDINANCE - DIVISION OF EMERGENCY SERVICE - SUBDIVISION CONTROL ORDINANCE SOLID WASTE ORDINANCE SEWAGE SYSTEM CLEANERS ORDINANCE - RECORDER, OTTER TAIL COUNTY PLANNING ADVISORY COMMISSION 'O •“•‘L, » RIGHT-OF-WAY SETBACK ORDINANCE FUEL AND ENERGY COORDINATION OTTER TAIL COUNTY DEPARTMENT OF PUBLIC HEALTH SUB OFFICE 222 2nd AVENUE S.E. PERHAM, MINNESOTA 56573 218-346-3175 MAIN OFFICE OTTER TAIL COUNTY COURTHOUSE FERGUS FALLS, MINNESOTA 56537 218-739-2271 February 1991 Licensed Recreational Campgrounds and ResortsTO: Uoug Johnson, R.S.FROM: New Construction Plan ReviewRE: Consultation with the Shoreland Management Office has resulted In the following policy concerning remodeling or new construction at a resort or recreational campground. Effective February 1, 1991, prior to the Shoreland Management Office issuing the required permit, you will need to provide them with a complete plan review form from the Health Department. (Copy Enclosed). The addition of permanent rooms and screened porches to recreational vehicles is not consistent with the Otter Tall County Recreational Campground Ordinance, however this construction has been permitted by the Shoreland Management Office. This policy interpretation error has resulted in recreational camping vehicles being altered to the extent that they no longer meet the definition of a recreational camping vehicle. (Copies Enclosed). The existing construction will be allowed to remain as Is and will be evaluated by the County Health Department on an individual basis during routine inspections. This Department will work with the campground owners in an effort to bring these structures into compliance with current regulations. Such structures may need to be reclassified as cabin instead of a recreational vehicle.a The construction of permanent accessory structures on recreational ^ camping sites will no longer be permitted. Any temporary accessory structure such as attached awnings, carports or individual storage facilities and accessory structures on manufactured home sites must meet all set back requirements of the County Manufactured Home Park and Recreational Camping Area Ordinance. If you should have any questions regarding this matter please feel free to contact me at 218-739-2271, Ext. 290. cc: Wally Senyk cc : Shoreland Management Office FIELD NOTES DATEua MAW FIRE MO.UXB MO. S’. V ^ ^ r<7: ^ LEGAL DECRIPTION OF LOT;9^ n-570 'n <ZoCSOJ OUNSU MAKE Pp^ico^^ ^7^,OWNERS ADDRESS TYPE OF SEWAGE SYSTEM (Inspector's Comments) SEPARATION DISTANCES - FEET Septic Tank Soli Disposal AreaCategory Well - Lot Line • Occupied Eulldlng ~ Elevation of Area , REASON SYSTEM WAS ABATED; SKETCH OF LOT ON BACK f •, ^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 Whil»-Office Y9thw — Intpecfor Pink — Owner Card— Owner Vy r/Permit No.,LEGAL DESCRIPTION u Gyy-JL AND 3. !3i 39<3k N2 L. RJ.GOLOCATION TWP NameTWP RangeSec.Lake Classif.Lake NameLake No. IDENTIFICATION; Please Print All Information. Tel. No.Zip No.Mailling Address —No. Street, City and StateInitialFirstLast Name /C/C£~l/r^ A/ SOWNER 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 Rac'd Phone Call Rec'd By 3NUMBER OF BEDROOMS:ESTIMATED COST: SEWAGE DISPOSAL SYSTEM DATA: SEEPAGE PITSEPTIC TANK DRAIN FIELD 7*// GIs.Sq. Ft.Sq. Ft.Capacity ^o/1^6GOFt.Ft.Ft.Distance from nearest well SO Ft.Ft. Ft.Distance from lake or stream QlOlOFt.Ft. Ft.Distance from occupied building il.Ft.Ft.Distance from property line Ft. Ft.Ft.Ft.Distance from bottom to Water Table AH distances are shortest distance between nearest points RECORD OF TESTS: 19 , Time ,M ByInspection was made on LI2... L::AJ.... ...LA2. ,, 19 RatePERCOLATION TEST DATA:Date of First Test cm Test Taker^ .................. 19..^.:^^...., O.A1....-3,3V Date of Second Test Rate i I First Test -I- 2nd Test 2 Rata2nd 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 hastbeen Inspected and accepted. It shall be the responsibility of the applicant for the permit to notify the County Shoreland Managem^t that the mb is readyfor inspection^ {Catfor use attached mailer notice.) 7^/T A IDatedsi^atui^V Permission Is hereby granted to the above named applicant to perform the work described In the above statement. This permit is granted upon expressPermit: 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. /3.Issued Date: Shoreland Management Office/Of 0 6 jp-Fee S ca QA 3 4 lO- Comments:. /y '-r^Form No. MKL-0771-003 [^VKW SATTU LAKE. MINNESOTA 14 t. (,4 INSPECTION RESULTS Inspector must make all measurements i i SEWAGE DISPOSAL SYSTEM STATISTICS SEPTIC TANK SEEPAGE PIT DRAIN FIELDCATEGORY ActualShould beActualShould be Actual Should be Capacity !SFGIs.GIs.S F S F S F Distance from Nearest- Well 75 '..50FFF F ■ F F Distance from Lake or Stream F F F F F F 20Distance frorfi Occupied Building Distance from Property Line 10 20FFFF F F 1010 10FFFF F F 3Distance from Bottom to Water Table 3FFF F F F Inspector's Comments; Date of Inspection.19___ Time of Inspection ,M ; t T\signature of InspectorINTERPRETATION OF ABBREVIATIONS GIs » Gallons SF ^ Square Feet Linear Feet Job TitleF AgencyMKL-0771.003-Backer \ •-> f * / 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 m—OKct y»l(ow—ln«p«tor Pink — Own«f Card — Own*r i j f Permit No.. LEGAL DESCRIPTION AND /LOCATION TWP NameTWPRangeLake Classif.Sec.Lake No.Lake Name IDENTIFICATION: Please Print All Information. Tel. No.Zip No.Mailling Address —No. Street, City and StateInitialFirstLast Name OWNER SEWAGE SYSTEM INSTALLER Name, This System will be ready for inspection on.cy '—, 19. This space for office use only M/(/ - 2-1-19^^ Phone Call Rec'il By Owner or Agent SignatureDate Rec'd Time Rec'd NUMBER OF BEDROOMS:ESTIMATED COST: 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 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 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 Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon expressPermit: condition that the p>erson 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 (61 months. Issued Date: jssuedFee $ ■'i Comments:, ■ V- ■S‘a-V Form No. MKL-0771-003 [^VIEW BATTLE LAKE. MINNESOTA 1T JV' ■ ' ’• ”!H ‘V »^3^. ■ "■ ”» »I5W‘- 'T yT-f<5-^ 7^ «f?1 1 ^ 1 INSPECTION RESULTS Inspector must make all measurements SEWAGE DISPOSAL SYSTEM STATISTICS SEPTIC TANK SEEPAGE PIT DRAIN FIELDCATEGORY Actual Should ba Actual Should be Actual Should be Distance from Nearest Well Capacity I CBC- Gis.Is.S F S F S F S F 5075FFFFF F rJ®Distance from Lake or Stream F F F F F IW FzsDistance from Occupied Building 2010 20FFFF F 1^.toDistance from Property Line 10 10 10FFFF F Distance from Bottom to Water Table 33FFFF FF ■Inspector's Comments; i,19^^Date of Inspection ( 0 ~~~ 2- ^ Time of Inspection.M signature of InspectorINTERPRETATION OF ABBREVIATIONS Git - Gallons SF “ Square Feet F ■ Linear Feet Job Title AgencyMKL-0771-003-Backer y\' • f 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 Whrto-office Ve/tew—Inspector Pink — Owner Cord— Owner VfffPermit No. LEGAL DESCRIPTION So ^ f ______ J2_ J2L AND LOCATION TWP NameTWPRangeLake Classif.Sec.Lake NameLake No. IDENTIFICATION; Please Print All Information. Zip No.Tel. No.IVIailling Address —No. Street, City and StateInitialFirstLast Name m37ZJOWNER SEWAGE SYSTEM INSTALLER Name. This System will be ready for inspection , 19.on. This space for office use only 19 Owner or Agent SignatureDate Rec'd Phone Call Rec'd ByTime Rec'd /oNUMBER OF BEDROOMS;ESTIMATED COST; SEWAGE DISPOSAL SYSTEM DATA: SEEPAGE PITSEPTIC TANK DRAIN FIELD U‘iS Sq2. .7 S T- Gl,.. Ft.Sq. Ft.Capacity i Ft.Ft.Ft.Distance from nearest well 90 Ft.Ft. Ft.Distance from lake or stream JO Ft.Ft.Ft.Distance from occupied building fOFt.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 , Rate, 19 , 19 t>st Test Taken By Date of Second Test , Rate........ ...... LJ2First 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 unUljt has been inspected and accepted. It shall be the responsibility of the applicant for the permit to notify the County Shoreland Management thatjhe job is ready for inspection. (Call..pr use attached mailer notice.) -X ■srr—-A"Slgnatur^Dated Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon expressPermit: 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. 13 K/O - r - €Issued Date: Shoreland Management Office Fee $ Comments:. Form No. MKL-0771-003 lAini LAKf, MiNMSOTA •p I « INSPECTION RESULTS Inspector must make all measurements ■■ ^ SEWAGE DISPOSAL SYSTEM STATISTICS SEEPAGE PITSEPTIC TANKV . DRAIN FIELD■iCATEGORY Should beActualShould be Actual Should be Actual Capacity GIs.GIs.S F S F S F S F •; 50Distance from Nearest Well ■ 75FFF FF F■i Distance from Lake or Stream F F F F F F Distance from Occupied Building 2010 20FF F F F F Distance from Property Line 1010 10FF F F F F Distance from Bottom to Water Table 33FFFFF F Inspector's Comrhents: % 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-Backw • i ; 1 p iX y. f 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 Whil9 - Offic9 Yellow — Inspector Pink — Owner Cord— Owner Permit No., LEGAL DESCRIPTION rAND LOCATION TWP NameTWPRangeLake Classif.Sec.Lake NameLake No, IDENTIFICATION: Please Print All Information. Tel. No.Zip No.Mailling Address —No. Street, City and StateInitialFirstLast Name OWNER SEWAGE SYSTEM INSTALLER Name. This System will be ready for inspection ,, 19.on. This space for office use only ,19 ,M Owner or Agent SignatureDate Rac'd Phone Call Rac'd ByTime Rec'd 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. 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 ByInspection was made on PERCOLATION TEST DATA: Date of First Test 19 , Rate Date of Second Test.,19 , Rate 1st Test Taken By -I- 2nd TestFirst Test 2 Rate 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. (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 expressPermit: 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 $ NO C ERTIFICATPComments:. Form No. MKL-0771-003 [Review BATTLE LAKE, MINNESOTA f' 4 t># 1 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 50FFFFF F Distance from Lake or Stream F F F F F F Distance from Occupied Building 2010 20FFFF F F Distance from Property Line 10 10 10FFFFF F Distance from Bottom to Water Table 33FFFFF F Inspector's Comments: Date of Inspection..19___ Time of Inspection.M Signature of InspectorINTERPRETATION OF ABBREVIATIONS Git • Gallons SF ■ Square Feet P ■ Linear Feet Job Title AgencyMKL-0771*003-Backer 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 Whif»-Office Yellow — Inspector Pink — Owner Card—Owner 'T”Permit No., LEGAL DESCRIPTION AND S/< / 7 -2 / ■GOLOCATION TWP NameTWPRangeLake Classif.Sec.Lake No.Lake Name IDENTIFICATION: Please Print All Information. Zip No.Tel. No.Mailling Address —No. Street, City and StateInitialFirstLast Name 17-v"-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 Signature / ^ 3 Phone Cali Rec'd ByDate Rec'd Time Rec'd NUMBER OF BEDROOMS:ESTIMATED COST: SEWAGE DISPOSAL SYSTEM DATA: SEEPAGE PITSEPTIC TANK DRAIN FIELD 3^30 Gls,2‘i’fO Sq. FI.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 Ft.Ft.Ft.Distance from property line Ft.Ft.Ft.Distance from bottom to Water Table '5 AH distances are shortest distance between nearest points RECORD OF TESTS: ......... , Time ................ ....19 ,JV1 By, 19Inspection was made on , RatePERCOLATION TEST DATA: Date of First Test tit 1 Date of Second Test 19 , Rate Test Taken By /. 33 /, LI3i= 3 3-5First Test -I- 2nd Test 2 Rate 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 ior^spectioft.-1Cajl or use attached mailer notice.) ^ ’ Signature ~ ^ ^ ' Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon expressPermit: 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. i3. X'Ji/o-cIssued Date: Shoreland Management Office Fee $iSc) 3 Comments:. [Review BAinE LAKE, MINNESOTAForm No. MKL-0771-003 > « INSPECTION RESULTS Inspector must make all measurements i SEWAGE DISPOSAL SYSTEM STATISTICS SEEPAGE PIT.SEPTIC TANK DRAIN FIELDCATEGORY Should beActualShould be Actual Should be Actual Capacity GIs.GIs.S F S F S F S F Distance from Nearest Well 75 50FFF F F ■F Distance from Lake or Stream F F F F F F 20Distance from Occupied Building 10 20FFFF F F Distance from Property Line 1010 10FFFF F F Distance from Bottom to Water Table ; 33FF■ FFF F ■ Inspector's Comments:___ ■r Date of Inspection 19___ 1Time of Inspection.M Signature of inspectorINTERPRETATION OF ABBREVIATIONS GIs ° Gallons SF » Square Feet *» Linear Feet Job TitleF AgencyMKL-0771<603-Backer -:t•I/• ■ 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 Whifv — Offic* Yetlow — Irwpecfor Pink — Owner Card — Owner Permit No,, LEGAL DESCRIPTION AND LOCATION TWP NameTWPRangeLake Classif.Sec.Lake NameLake No. IDENTIFICATION: Please Print All Information. Tel. No.Zip No.Mailling Address —No. Street, City and StateInitialFirstLast Name OWNER SEWAGE SYSTEM INSTALLER Name. TIj/s System will be ready for inspection , 19.on. This space for office use only .M.19 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.GIs.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 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 ,M ByInspection was made on PERCOLATION TEST DATA:Date of First Test 19 Rate Dat-e 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. AppI icant 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 -X.Fee $Lfjr-^BNOCERTIF\<-/iTp I Comments:. Form No. MKL-0771-003 [Review sattle uke. minnesoia I'• ^I I INSPECTION RESULTS Inspector must make all measurements SEWAGE DISPOSAL SYSTEM STATISTICS SFEPAGE PITSEPTIC TANK DRAIN FIELDCATEGORY Actual Should be Actual Should be Actual Should be Capacity GIs.GIs.s F S F S FS F Distance from Nearest Well 75 50FFFFF F Distance from Lake or Stream F F F F F F Distance from Occupied Building 2010 20FFFFF F Distance from Property Line 10 10 10FFFFF F Distance from Bottom to Water Table 33FFF F F F y Inspector's Comments:V <<2 7 7 Date of Inspection..19___ Tinte of Inspection..M signature of InipectorINTERPRETATION OF ABBREVIATIONS Gli ~ Gallons SF ■ Square Feat F ■ Linear Feet Job Title AgencyMKL-07T 1>003-Backet 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 Cord — Owner £Permit No.,LEGAL e^ori- fra CLDESCRIPTION t AND cFtczP :i /JAIjLOCATION/1-7 e Lake Classif.TWP NameTWPRangeSec.Lake No. Lake Name IDENTIFICATION: Please Print All Information. Tel. No.Zip No.Mailling Address —No. Street, City and State j__ r/l InitialLast Name First t: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 Owner or Agent SignatureTime Rec'd Phone Call Rec'd By NUMBER OF BEDROOMS:ESTIMATED COST: SEWAGE DISPOSAL SYSTEM DATA: SEEPAGE PIT-SEPTIC TANK DRAIN FIELD Sq.GIs.q^Ft.Capacity Ft.Ft.Ft.Distance from nearest well Ft.Ft.Ft.Distance from lake or stream 7 ZFt. Ft. Ft.Distance from occupied building /ODistance from property line ' Ft.Ft.Ft. 7Ft.Ft.Ft.Distance from bottom to Water Table AH distances are shortest distance between nearest points RECORD OF TESTS: Inspection was made on , Time M By PERCOLATION TEST DATA:Date of First Test 19 , Rate....f 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^ysteoishall be covered until ^has been inspected and accepted. It shall be the responsibility of the applicant for the permit to notify the County Shoreland Managemantrffiat joBT for ,7^-7...7 ■ /fZJDated Signatuft 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 Shoreland Management Office J.r:/ - /9STIssued Date:__i Fee $ Comments:. Form No. MKL-0771-003 [Review satile lake, Minnesota 1'i V! ■ : ■-*■•••- .- -‘ 'j*' ■ V s.■A _'‘,' -'r^i -'■T;0 *H *1. ■:T O- J ■r> .. '.- »-5 .INSPECTION RESULTS'■ ;.rs ■*► fi.'-Inspector must make all measurements s -... •- -< y—::- ■l.*-C SEWAGE DISPOSAL SYSTEM STATISTICS * N SEEPAGE PIT DRAIN FIELDSEPTIC TANKCATEGORY Should baActualShould be ActualActualShould be Capacity S FGIs.S F S F S FGIs. 50Distance from Nearest Well 75 FFF F F F Distance from Lake or Stream F F F FFF 20 2010Distance from Occupied Building FFFFFF 1010Distance from Property Line 10 FF F F FF 33Distance from Bottom to Water Table ■sFFF F F F Inspector's Comments: ■; Date of Inspection 19___ !Time of Inspection,M r Signature of InspectorINTERPRETATION OF ABBREVIATIONS GIs ~ Gallons SF » Square Feet F * Linear Feet Job Title .. • Vx:-. ■ - Ta^z~ r ■ y ' : ! ;• <f '■ •.■ . .<i- '■ i. ^ r.. ■ ) ■■’•j , »ju Agency MKL-0771-003-Backer '! ■ ■I •* r 3’'. •: , '.t- . fit , - -■'tt 3 ■■ <J . V , ■f’. » V.‘7 ■L' . l -.i; ■ y' V:• A;N •\ s %■ r- \i - * >' »' -n. ? ;■’ ...I' h ■■■d...... ■r ^ i-- . V1.TT -.1 • r.\^A 9a' • • •- i , in . t .• A' i'-*. *». -lU':. s\V\r\ a. -- iy -‘A .■f ■ cv>»i -1A' . Ill 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 Y0HOW — In$p0ctor fiink — OwTw Cord — Owrmr / Permit'Noi^ LEGAL )DESCRIPTION ■:p AND LOCATION In If - / / f i ^ Lake No.Lake Name Lake Classif.Sec.TWP TWP NameRange IDENTIFICATION; Please Print All Information. Zip No.Tel. No.Initial Mailling Address —No. Street, City and StateLast Name First OWNER SEWAGE SYSTEM INSTALLER Name, }QOThis System will be ready for inspection on., 19 This space for office use only 2'.oof’.19 Date Rec'd Time Rec'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.Sq. Ft.Capacity 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.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 By PERCOLATION TEST DATA;Date of First Test , 19 , Rate1../' Data of Second Test 19 ., Rate 1st Test Taken 6v First Test -I- 2nd Test 2 Rate2nd Test Taken By Agreement: strict accordance with ordinances of the County of Otter Tail, Minnesota and Minnesota Individual Sewage Disposal Code Minimum Standards set forth by Minn esota Department of Health. Applicant agrees that plot plan, sketches and specifications submitted herewith and which are approved by Shoreland Management Offi cial shall become a part of the permit. Applicant further agrees that no part of the system shall be covered until it has been inspected and accepted. It shall be the responsibility of the applicant for the permit to notify the County Shoreland Management that the job Is ready for inspection. The undersigned hereby makes application for permit to install or extend Sewage Disposal System herein specified, agreeing to do all such work in Dated Signature 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:7 Shoreland Management Office Fee $ Comments:. Form No. MKL-0771-003 (^VIEW lATTlE lAKI, MtNNiSOIA T f.f r-> W' r ' * I V.. 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 CCapacity tOtiOGIs.GIs.S F SF S F SF SoDistance from Nearest Well 5075F F F F F F ^9Distance from Lake or Stream F F F F F F //' 2010 20Distance from Occupied Building F F F F F F Distance from Property Line 1010 10FFFFF F 3Distance from Bottom to Water Table 3FFF F F F Inspector's Comments: 19.£^Date of Inspection I'l 'oTime of Inspection.M /s. Signature of InspectorINTERPRETATION OF ABBREVIATIONS GIs B Gallons SF ■ Square Feet ■ Linear Feet Job TitleF Agency M KL-0771*003- Backer i PERCOLATION TEST DATA SHORELAND MANAGEMENT OTTER TAIL COUNTY Fergus Falls, Minnesota 56537 Mailing Address: Ph. No. Owner: First LiHir R y ,'j <£)/>/$•Wm La^Name L^l Description:, /)A I ^L (\[{ I ^ St. & No.^is:z3MiddleCityStateZip No. UA.X RANGE i LAKE OR RIVER NO.SEC.NAME TWP.TWP NAME i. TEST HOLE NO. 2TEST HOLE NO. 1 uDepth to Bottom of Hole inches; Diameter of HoleDepth To Bottom of Hole,Jnchesinches; Diameter of Hole inches fDepth, inches Soil Depth, Inches Soil TextureDate >c Date 19. t - S ~5 Percolation Test By____ Percolation Test By__oLUFirmName.OC FirmName.<T ^ c> ,y -t5-DoLU QC /rr^w <LU / d^ 7Address.cr Address < Otter Tail County License No..Otter Tail County License No..W UJ Drop in Water ■Level, Inches Drop In Water Level. Inches Measurement, Inches K Measurement, InchesTimeRemarksTime Remarks o 'l:b? la / C ?r= 1 ai-/3- ^ 6-1 Ll (0 X(2^ 7 z>'7 f f., . t '2— f C ~Cj 1 f'.-Ll "3 377 6 /C 5~~ d c 4-- ///^1/6 5 /fc ~ - /() f 'i c / c ■ /g : vz‘ (C/ /At /? I b F ^ -2- / 6 - \ 7 / 6 ? / lx/.I■N3 Tli3 .1> 33_43 33>IX .3 3 ^-5 MKL-0871-028183818 ®¥>CTO* LU«Bt(« 4 M »4iaTIM. MB8u8 r*LL8. WIM« See Booklet/'How to Rune Percolation Test" by Agriculture Ext. Service, Un. of Minn. ^ - 3^ 3^PERCOLATION TEST DATA SHORELAND MANAGEMENT OTTER TAIL COUNTY Fergus Falls, Minnesota 56537 5/^ - •?Ph. No. Owner:Mailing Address: City 1^' U /ril ‘ Last Name /[/^/ St. & No. X / m('' LT-^ /Y . First NAME Zip No. t Uil/\Middle State Legal Description:3:^ TWP NAMESEC.LAKE OR RIVER NO.TWP.RANGE /6 TEST HOLE NO. 2TEST HOLE NO. 1 'il ±LDepth to Bottom of Hole inches; Diameter of Hole.inchesDepth To Bottom of Hole,inches; Diameter of Hole inches ^ ^ 19Depth, Inches Soil Texture 19^2L'Soil TextureDepth. Inches DateDate C. - h!C •4 A- -Percolation Test By____ Percolation Test By .•Or P"Q UJ A/4 ''4'^Firm / Name (r FirmName.C't-4 >oUJ cc 41 / ^ *> ClAddress.Address. < COOtter Tail County License No..Otter Tail County License No..K coUJ Drop in Water Levei. Inches Measurement, Inches Drop In Water -Leveia Inches Measurement, Inches HTimeRemarks Time Remarks o I H / c ff ' K \ ^C2- //r(r^ I0-- //; 3$.' / ■'! (TO / /C ///f : H • !C a_3.*2. JTl L SkS. 3o:2_A? ;I If .3-A 3^'V ? yif f f.A.^—4-L C V.If . I.T42 7 ±n -3^t\ \ Hb 1, (g711 : t ) -4 u V: Y^'3X33 j \ 3 5 S'3_fe.n ; <~4 /// S"3 MKL-0871-028183818 ®yiCToa LuaOCta i CO aaiarc** rt*«u* r*fci.8.See Booklet/'How to Run a Percolation Test" by Agriculture Ext. Service, Un. of Minn. 1 ..Li■i'' ir^iH-1^ it u/;ll g, Ii.•0=^1 i •, f ^ 0-'"f ^ •''/■ —ffll -/ \y -~- =i <■ R ^7»/I /d<!S’H ?> rF //^TDo X /-T ^ (?X S ^ d'^i Sc\ 1^'3 -V- .1 o \ r? -<t ht \•a Za4^£ t' ^I 4 1 T>f<>' 0/fe>^!<- (f>t^c '^♦vf^£)0<5^O O, i®lg? ^^ tf!D g:> C?* ^ C?\asi/ff4-^/<_I ; / V. ■' /^■^/ -0 S~ V (3J A^7PjH~-^/ji<^ :1:1 JZJi 3 33^ ^ ^ ^ O-A^ - S ' ?- y—la- I iS^O !<i^ ^ V U ^ ^ / Jio^ ’L5Ji£ \o^Ho i^; . 7^ h^os . „ .......... ■i//5r fO* ^hX, S/T^f/tvC »S'VC’ X, g'-' Q ^Ho ^ 3330 r^- \HSu. XM. -’-X. •»c^'»J*''W» -tin •»' ■ T?T^ -■m -H-:. - 1'.. - 'f/. r •‘tj\■>*,. ■ .•A'- P /3^ '2 7 /. 6 7 _s J2^—5> ! 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