965 Cliff Rd - Individual Sewage Sys. AS-BUILTINDIVIDU L SEWAGE SYST
Owner: GIVE k 4111; t' Project dress
House Type; ,...1 II III Property ID No.(PIN) _ -
/Twp G 974fre% Installed for q Bdrms or
al /d Commercial Use? Y / V
New 1:1 Replace ❑Repair Addition
Property Transfer Upgrade? fY / N
Bsmt Lift Pump? Y,� Future? Y /f$
Jacuzzi? Y,) Garb Disp? Y I1 -
Soil Survey Map Unit
Soil Compacted? Y / ✓®
Fill Soil? Y /(
Circle Soil Texture:.
(Faster than 0.1 mpi) .'
Coarse Sand �
Medium Sand fi.'e"
Loamy Sand 0.83
FINE SALVO 1.67
andy Loam 1.27
Loam 1. 7
Silt Loam, Silt 2.00
Sandy Clay Loam 2.2
Silty Clay Loam
Clay Loam
Silty Clay, Clay 4.2
(Slower than 120 mpi)
Soil dry enouqp for
construction V/ N
SETBACKS: Prop.Lines 10'L
Bldgs 10' to Tank y & 20' to Drnfld y
Well(s) setback/001- ( )not installed yet
Well Depth () Orig. Well Record ( )Measured
Distance to Lake Creek4404' Wetland
Buried Water Pressure Lines 10' to Tank & Drnfld?/V
System located by Photos? Y GPS? Y
SEPTIC / HOLDING TANK(S) ❑ New 14 Existing
Liquid Capa ty ) 1 compartment - 17)
Made by Watertight? t/ N
Baffle Type. Plash Fiberglass Sanitary-T Concrete
No. of Inspection Pipes_ 4" / 6" diam. nk Level? LLN
No. /Diam. Manhole Access if Outlet
No. & Height of Manhole Risers
New Tanks 4 ft or less below Final rade
Pipes into Tank Sealed? with 6-esVe
Riser into Tank Base Sealed? with ..5 /"'
Outlet Effluent Filter? Y /( Type
1111 +UND / ATGRADE:
Perce lope % Scarification Method:
Dike Widt Up Down
Clean Rock? Y Depth Below Pipe
Clean Sand? Y / N 1 *th Upslope
Inches to Mottling
Perf Size /Spacing i Cover Depth
Rock Bed Size Supplie .
Sand Base e Supplier:
Ups' needing drainage /diversion? Y / N P
f G ding done: Rough / Final
( )Seeding ( )Sod to be done by:
Inspects
Sign
White cop .County Yellow:Owner Pink: Installer
o:\emgmt\forms\walm\ists\as-built-form.doc
Date:
V/ N
mY/ N
I
e
inches
Downslope
- etSpacing
ed? Y/ N
I hereby certify, as installer, that this individual sewage treatment system
was installed accordi g to the approved design, and as applicable, this
Municipality's Sewa. - Treatme' •.y.tem Ordinance, & accurately locates
all system comp' f for lat atio.
Installer
�4� /
Date: 7
Approved: No
Date Installed?".??-1/Permit No.
(Dak Co Tax Info 651 - 438 -4576, or www.co.dakota.mn.us)
Line drawn from Tan s to Pump Truck Access < 100'? N
RESERVE AREA ?Y / N Fenced Off? Y / (d
Owner informed to preserve Reserve Area? Y I
Owner given Septic System Owner Guide? Y
TRENCHES / BED OR GRAVELLESS DRAINFIE
Drop boxes level ?( / N Type concrete
Trench Depth 364 Width
Number of Trenches . T rench Bottom Level&/ N „ /
Trench Lengths ac-- A Spacing
Rock Clean ?Y /N 2" over Pipe? YIN GeoTextile over ?Y /N
Depth Below Pipe? 1)- " Soil Backfill Depth f "
Gravelless Pipe Size? Made by
Chamber Size? ; " P Made by ` e fi '''
Absorption Area: Sq Ft Lineal Ft 4
Trench Bottom to mottling / bedrock? S inches
P TANK Made by Capacit
t of Risers Seal
No. &
Pump Manufa -r Mo
Horsepower F
Cycles Per Day
Size of Discharge Line 1.5" / 2"
Type of Electrical .okup p• box by tank
Alarm Loca garage / b. -. ent
Alar • nk Alert / Level Alarm / Other
cle Counter? Y/ N Water Meter? Y/ N
Designated Registered
Professional Onsite
KL f1 , / /`� <<
Yes witic onditions:
ic,('t-n n'"q~ IMiT/ ~ a057a
f
Peek TeSt
any
Septic Desirgn,
.
For
r
Cv S/- 67S - Sb 7G
By: Mulvihill Excavating,, Inc.
Glenn Mulvihill
MPCA, #l21
1-612-598,-2455.
~ EAGAN ~
VI~WED
BY ka
DATE 15, /it
BUILDING INSPECTIONS DEPT.,
TRENCH AND BED WORKSHEET
ge Flows In Gallons per Day
A. Estimated gpd (see figure A-1) Class I Class 11 Class III Class IV
1. AVERAGE DESIG FLOW Tmclassl.
or measured x (safety factor) = gpd 225 180 60%
5. Septic tank capacity gallons (see figure C-1) 300 218 or the
376 256 values
450 294 In the
2. SOILS (Site evaluation data) 525 332 class I.
r 111olumns.
C. Depth to restricting lay 0 675 408 c er = feet 600 370 11, o
D. Max depth Sys em tern 2C - 3 ft = ft - ft ,3. 3 ft
E. Texture P,e-4colatlon rate -/'2 MPI
F. Soil Sizing Facto F) -e-- sgft/gpd (see figure D-15)
G. % Land Slope C-1: Septic nk Ca settles (n allots
3. TRENCH or BED BOTTOM AREA Number of Minimum Liquid Liquid capacity with Li with disposal&
H. For trenches with 6 inches of rock below the pipe: Bedrooms Capacity garbage disposal tats inside
A x F = gpd x sgft/gpd = sgft 2orless 750 1126 I50o
6 For trenches with 12 inches of~k below the-pipe: 4~~', s o~6 isoo iiso 2°°0
A x F x 0.8 = 00 gpd x f sgft/gpd x 0.8 = 605sqft 7, s or 9 2000 3000 4000
J. For trenches with 18 inches of rock below the pipe:
d x s ft d x 0.66 = s ft D-15: Soil Characteristics and Solt Sizing
A x F x Q.66 = ~~p q /gp q Factor (SSF) 'separation)
K. For trenches with 24 inches of rock below the pipe: Percolation Rate Soil Sizing Factor
.6 = sgft minutes per inch sail Texture square feet/ allon
A x F x 0.6 = gpd x sqft/gpd x 0 m i erda a ftr• d
For gravity beds with 6 or 12 inches of rock below the pipe; faster than o.l' Coarse sand 0.63
L. 0.1 to s Medium sand 0.83
Loamy nand
1.5 x A x F =1.5 x gpd x sgft/gpd = sgft o.1 to 5•1 Fine sane ,.G7
6 to IS Sandy loam 1.29
For pressure beds with 6 or 12 inches of rock below the pipe; IG to 30 Luam 1.67
711o45 silt loam 2.00
epd x sgft/gpd = sgft 5la
A x F = JG to GO Clay, loam 2.20
Sandy clay
SMY clay 4.20
4. DISTRIBUTION (Check,-tell that apply) over6, to 170"' SaClay ndy clay
d 6% slope) Drop boxes (any slope) Rock slower than 170•'•• Silly `lay
Trenches Distribution box 3%) %~Chamber ae systems or rapidly permed a toils:
pressure distribution or serial distribution with
Pressure Grav Gravelless no trench >25% of the total system.
ity :'soil hamming so'Y or more fine sand phis very fine sand
••A mound must be used.
••'An other or performance system must be used
5. SYSTEM WIDTH, LENGTH and VOLUME
D-9: Soil Characteristics and soil sizing
M. Select trench width = _ ft factors (SSF) for Gravelless Pipe
N. If2sin rock, divide bottom area b width: (H, I, J,K or L) + M = percolalion rate lineal feet/
_sgft +~-ft= _2 lineal feet (n,tnutes/itjett) soil texture gallon/day
Rock depth below distribution pipe plus 0.5 foot times bottom area: Faster Ran O.l ' Coarse Sand
0.110 5 Medium Sand 0.28
Rock depth in feet + 0.5 feet x Area (H,I,J,K, or L) LoaniySand
0.1 to5 Fine Sand " • 0.6
(-f t + 0.5 ft) x sgft = cuft 6 to 15 Sandy Loam 0.42
16 to 30 Lin 0.56
Volume in cubic yards = volume in cult divided by 27 311045 Sil s~oam 0.67
Cuft + 27 = cuydS 46 to 60 Clay Loam (CL) 0.74
Sandy Cl.
Weight of rock in tons = cubic yards times 1.4 sandyy CL -
slower than 60"' C1ag
Cuyds x 1,4 = tons Sandy Clay
y
0. If using 10" Gravelless Pipe, Flow (A) x Gravelless SSF (see fcglfre D-9) Soil too coarse for sewage Silty Cla treatment.
d x lineal feet/gpd = lineal feet Use systems for rapidly permeable soils.
gp 'Soil having 50% or more line sand +very fine sand.
'
P. If using Chambers, H,I,J, or K (based on height of chamber slats) r ::'Soil will; too high a percentage of clay for
width of chamber in feet (M) installation of a standard inground system.
,
ti ~~P •••IIkr,Fdr
_sgfr + ft= lineal feet
~~Oti. a b','35g3"i~.b29~g::9. ~ 2'K,wtCnrR
e r •g t'
S,• ~;~os,, t•ol,
6, LAWN AREA Q. Select trench spacing, center to center = feet ;,'•q;%;:;as:6 b;bJ
R. M tiplytre ~ tr;p,•
acing by linea f t x Q = sgft of lawn area
ft x lineal feet sgft 's FOG 4745y 6.24•' Rock
a;s''dgc s:c;p' 3/421/2"
i~atztb a ;.s a t
as ..'s•ta:
7. LAYOUT
Include a drawing with scale ( one inch = feet). Show pertinent property boundaries, rights-of-way, ease-
meets, location of house, garage, driveway, and all other improvements, existing or proposed soil treatment system,
well and dimensions of all elevations, setbacks and separation distances.
I hereby certify that I have completed this work in accordance with applicable ordinances, rules and laws.
(signature) (license (date)
7.Tnn/rrlnnoi OUT SUT1UAE3X7T TTTUTATnIQ nvAvco7ineT VW.r 27•TT TTn7/7T/on
Ito
9
L °
41
O
Q
d
Cltb J%
e
r
vzi
i~
ZT00/fi000P1 OUT SUTIOAUDX9 TTTUTATnN 0VG2'Fg7GOGT YVA nP:TT TTn7/7T/Qn
Hug 12 11 utS:Saa bon rretermum DO 14J14.3L1 p. i
t~Hf~l UthELI LRI LING CO-
B
x at i,
GAP M. BOHN
CP-o
` LICENSE 1r'1043
~x 5 i • ` ( t \ 0 16550 BASELINE AVE. ~ ~ ~ ,
t~ 1 02 SHAKCf ~C. h.1N 55379
~ -
WATER EDGE
1 j x Ag / D 2
1 x \ l
864. CONT
ut
J1.2 -10
tip
6
\ %6z
i i ` ; ' 9~ \ \ \ 864.5 CONT
08"\ IN,
IN,
\ \ \ x
\i \ XB6 \a\ 864.5 CONT
\ 0 \ \ \
\ \ \ \ \ 1
IN
\ 586 \ \ \ \ \ \ \ \ 864.5 CONT
\ 85 \ S. \ \~a \ 8655\
o `
3 \ \ x ~l ' \ `
58 \ \ \ x 61
\ 626'
x
\584
89
x \ \ \ \ \ \ \ 1 1 \ \ i
J
' S~ i \ \ :-S\ \l 012\
x1 1 ~ \ \ \ \ f x ~ Y61~ \ ` 1 1 1 6 3
V1. /N
SbX \1' \ \ \ \ 1 \ \
\ . \ \ \ b25
x179 :P'S
\ \
1-3 ~~r \ \ 6x7 \
` 1 1\ \ L \
6*8
61 - \
X619 6 4 \ ; \ \
578 "576 \ v \ \ \ \ \ x
H0 OIS- SE'li\D 625\ \ \
ZT00/900001 OUT NUTISABOX9 TTTUTATnIV 0S'APPA7l,ngT Yv4 np:TT TTn7/7T/Qn
Aug 11 11 UU:Sya boo rreiermutn oo~4oi~~i N.~
_.....,r..
t Vic. e
,.i.... .f. ...f... ..j.• i• .
, r i' .r i i t i S i • . ~ T' .
r _ LO' ZtT
i"teoi i~sdie~es tkr toc=ti~u otc ~►aw wos ~e~k a z~s wa. aws~ ar a~ ~ea>~~s, ~sj. mv! aearoes+t a~rsles~
arxr.rat soft treyb=4 t>sss..eustntndcaits.ptoputty 2ner6wx*-Y4 medusiod sum (aw*&m i'&=twd3edby *e arttrey)
t>Sdv~IcsTxuaadioa~~dsppav~eiayaa,~,taa~sCws*tixed>zt'c~capo~istosod►sisaneamdbuiidFshs.-Pleaseatca~es~•
built dcsrrtys. iespeetiaa rapans.{~ittl3w{sj ai>vosap7itrece ttstd No! Ptottcatre~tmt~, iCaitraittt~ta .
6 Bodr*s (MAN Locate s~ boxing oa the map above, i uticate on tho tight of the colurm the sti I
me, stt:l mm. aolvr, depth of each dlffc=t saU tyM evidencc of umtiUng, bech-** and siaad'ing *ai ec
a ismucabt if the nivmi-.d is fin.
BR# j BR# BR #a HR# BR# BRA
e o
Y, F G
to ip-
-2 5010
j0q
xstoRO ~tTa or BwrruNa. sEAsaNALw(m WA'maoR SEmR GFcN AnovaL was
G1G~ l l1K~ o... ,
00:bjA
eemu. L
10
b~ b otiD, 27"
sus to be soatptet4 to Was LUC above; system Into camplisacc tI Cvund ant in cocrp3ianc=7 l
CS5i~s ~~~;dry ~-xG~ t
-7 1.
T000/T0002 OaI enT~WAVDY3 TTTIUATTIN 0£6£ESZL09T XVi 8£%01 IT09/91/80
7.TOO/900001 OUT BUTIUASDX'T TTTUTATnii1 0Pf;PP971,0GT VV.,T OP:TT TTO7/7T/Qn