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896 Lakewood Hills Rd - Septic System Records 2022-06-15'"*111 INDIVID 4AL -3 WAGE SYSTEM A -S -BUIL g Date Insfa�� lle�ePermit No. Owner: �? i a _ Project Address House Type_ 011. Ill Property 1€J IvR.(PIIv) L� - L S a - ��%,� �(� {Dak Co Tax info B5 i�3& X570, or v nti.co.dakoia.mn.usl I installed for____Bdrms or cs o gal ay Commercial Use? Yf ❑Naw 2FR8pl21ce ❑pair ❑Aadltir �a.. Property Transfer Upgrade?0 N _ e,rmt Lr,< pump? YgFuiure? Y JaCu— i? fist Garb Dls ? f N r Soil Survey Map Un - kip", S Soil Com act ? Y N Fit Sol/.3 t Circle Soil Tem ure: (Faster than 0.1 €npi) Coarse Sand �!l " `. Medium Sand � r +'� Loamy Sand 0.83 J, y ti Ff AND 1.67 3 ` Sandy Loam 1.2. f Silt Loam, Silt 2.00 � 1 Sandy Clay Loam 2.2 Silly Clay Logm LV Clay Loam Silty Clay, Clay 4.2 (Slower ihan 120 mpf) Soil dry enough for Cpn5fRlCiiRr] � SET SACKS -Prop. Lines 10' 0 l ..� Bidgs 10' to Tank & 20' to Drnfldl-z' Wells) setb8CI< � ' ( )trot installed yet Well Depth( )iOdg" Welt Record ( )Measured Distance to Lake" Creek_ Wetland Buried Water Pressure Lines 10' to Tank & Drnfld? v r System located by Photos GPS? Y i SEPTIC I HOLDING TANKS) ( New ❑ Existing Liquid Capacity Z2'5"o - Z €compartment in r0 Made by Watertight?C5 N Baffle Type: Fiberglass Saniiary-T Concr to No. of Inspection Pipes— d" / 6' diarpf . Tank Level - IN NoJDiam- Manhole Access. ���/_Inlet / Outlet I center No. & Height of Manhole Risers New Tanks 4 ft or less below Final Grade N Pipes into T ank Sealed? with„q y N Riser into Tank Base Sealed? with L Y N Outle vent F€ter?1 ype A (a.�, „- /z� MtjUl�i] ATGRA E: ' nt Slope 4�;"_ /a Scarification Method. - Dike Width -5-/, ethod:DikeWidth_5-/_ Ue--ZY-fDown�Side Clean Rock N Depth Below Pipe__2 T1— inches Clean Sand. N Depth Upslope_ y ” DawnsloijeZ',�! Inches to MoiEiin �� PipetSizefSpacing'� Parf Size/Spacin Final Cover Depth_" Rock Bed Size a w Supp€ier:� Sand Base Size -� _V -Supplier: Upsiope needing drat diversiol{ ht Provided? Y® Grading done_ Roup Final 4LIQSeeding ( )Sod to be done by -- 1 y_1 hereby ceriify, as lrisiafler, that this individual sewage treatment system vras installed accorciing tri trle eutwoved riBsigri_ ano 2S 2005=bfa- this Municipality's Sewage Treatrrignt System ordinance, & accurately locates all sr Siem components for i relor,Zbr, Sian h da-: pproved: leo es Yes with Conditions: Line drawn from Tanks t Pump Truck Access < 100'? Y N RESERVE AREA? Y f) Fenced Off? Y& Owner imormed to preserve Reserve Area? Y f Owner given Septic System Owner Guide? Y N TRENCHES I BED OR GRAVELLESS DRAINVELD, Drop boxes level? Y 1 N Type concrete I plastic Trench Depth - Width Number of Trenches Trench Bottom Level Y IN i rench Lengths Spacing. Rock Clean?YIN 2" over Pipe? YIN GeoTextile Cover?YIN Depth Below Pipe? " Soil Backfill Depth " Graveliess Pipe Size? Made by Chamber Size? Made by Absorption Area: Sq Ft Lineal Ft Trench Bottom to mottling f bedrock? inches PUMP TANK Made by Ca aci' o No. & Height of Risers — Sealed? �; N - Pump Manufacturer z Model # .2V3- it Horsepower,GPM Feet of Head _Z!_ Cycles Per Day, =_ Y _ Gallons Per Cycle Siza of Discharge Line Type of Electrical Hookup t & box Alarm LDCBtion para e ; basement Alarm: Tank gi<i ]Level Alarm her CY01e CounV? -Y 1 N Wafer me er_ I 1 Prein�a;en�l PCA Lic. No. :11-1 7 Gomoany Address /ZU—T/Gff_ While chs. y_Countf Yellow.Owner Pirt1:_lnstaller o:iemgmtlformskwalmkisslas-built-form.doc