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ON-SITE SEWAGE TREATMENT <br />INSPECTION REPORT <br />On the North Sbore of <br />Lake Minnetonka <br />POST OFFICE BOX 66 <br />1335 S. Brown Rd. <br />Crystal Bay, MN 55323 <br />473.7357 <br />OWNER ,9AQCN,47eJ> A P,/4ME5 ADDRESS 41d15 .5- EAYsicar I(b <br />PHONE PERMIT NO'S. /217 _ DATES LR -21214-0 <br />City Ordinance No. 210 requires that each on-site sewage treatment system in Oronu be inspected on a .egular basis. <br />The on-site sewage treatment system at the above address has been inspected and appears to fall into the c,.tegory checked <br />below: <br />❑ Meets or exceeds current city standards in all respects relating to design, construction, and location. Appears <br />to be operating properly. <br />02 Does not most current city standards in some respects relating to design, construction, or location. Appears <br />to be operating properly. <br />IDDoes not meet current city standards in many respects relating to design, construction, or location. Appears <br />to be operating adequately. <br />❑ Does not meet current city standards of design, construction or location, is being overused, or is failing to <br />properly treat and dispose of the current input and is therefore endangering a water supply, is a source of <br />pollution to surface or groundwaters, is creating a safety hazard, or is otherwise creating a public nuisance. <br />Please contact the inspector to discuss requirements for repairs to your system. Soil testing may be re- <br />quired. In all cases a design and site plan must be submitted for review. Your contractor must obtain a permit <br />before work is started. <br />WORK REQUIRED: <br />❑ Septic tanks must he pumped within 48 hours. f <br />❑ Drainfield must be repaired or replaced within 90 days. I I -AP <br />❑ Inspection riser (4" diem, pipe) must be installed in each tank. QF -Ip Z- <br />❑D <br />Tank inspection indicates maintenance pumpout is needed as soon as possible. City ordinance requires that <br />tanks be pumped out every three years. <br />SITE CHARACTERISTICS: <br />Limiting Site Factors <br />Potential for System Failure <br />Site Capabilities for <br />❑ Slope <br />(depends on soil types, water <br />Future Expansion <br />Soil <br />table, and system condition) <br />❑ Adequate <br />❑High water table <br />❑ Low <br />Fair <br />[]Lot size <br />Medium <br />❑ Poor <br />[]Lake, wetland, or stream <br />❑ High <br />❑ Inadequate <br />❑Drainage <br />[:]System is causing visible <br />surface discharge. <br />COMMENTS: <br />Date of Inspection Septic System Ins or <br />This report must be kept on the premises with system location and pumping records. <br />WHITE COPY / Inspector's File GOLD COPY / Homeowner <br />