HomeMy WebLinkAboutWell info, misc ltr, survey (1966) wE�L OR BORING LOCATION MINNESOTA DEPARTMENT OF HEALTH Minnesota Well and Boring I„' ���
Counry Name
WELL AND BORING SEALING RECORD M nn'esoNa Unique Well No.
� Minnesota Statutes,Chapter f031 or W-series No.
(Leeva Dlenk il iwl krwwn)
Township Name Township No. Range No. Section No. Fraction(sm�Ig) Date Sealed Date Well or Boring Constructed
' �rono 117 23 20 2�—C1�32 �,.
GPS ���de de9rees minutes seconds L!
,
LOCATION: Depth Before Sealing Q� 1 ft. Original Depth ft.
LongRude degrees minutes seconds ppUIFER(S) STATIC WATER LEVE�
Numerical Street Address or Fire Number and City of Well or Boring Location ingle Aqu'rfer ❑Multiaqu'rfer
_ E�UBORING �Measured ❑Estimated
��r
y9,Water Supply Well ❑Monit.Well f� t
Show exact location ot well or ring Sketch map of well or boring }{
in section grid with"X" location,showing property ❑Env.Bore Hole ❑Other ��✓ ft. �below ❑above land surface
N � \ lines,roads,and buildings. SING TYPE S
4 ?
, .�.,-•.r_•, ,:�_�{ ..g.1 4!! ( ) r
_T' _ _ _ __ _l__ 1
�..f � + �Steel ❑Plastic ❑Tile ❑Other
/� _,.....f
. � W -- - -i-- -i-- -- -- E WELLHEAD COMPLETION
� � � Outside: ❑Well House Inside: ❑Basement Oftset
-;r- ---- -;-- -�-- e
' ��° ��t4�� '�Pitless AdaptedUnit ❑Well Pit
--�- -�-- -i-- --�-- � s�
❑Well Pit ❑Buried
S
�—�nM°—� ❑Buried
PROPERTY OWNER'S NAME/COMPANYp N.A�,MtE ���+ CASING(S)
� i�1s,i�d L�,�ii Diameter � Depth � Set in oversize hole? Annular space initially grouted?
Property owner's mailing address A diHerent than well location address indicated above '�I�
�„�, in.f�Om � to�ft. ❑Yes �o ❑Yes ❑No ❑Unknown
74(17 �a5tZ8Ca Bl�ci
StT��¢� �rA� � S J�FZ� in.frOm to ft. ❑Yes ❑No ❑Yes ❑No ❑Unknown
u�u.ia
in.from t0 ft. ❑Yes �Na ❑Yes ❑No ❑Unknown
� iJ;; i L � . 1`{ .�= � :';r
� WELLOWNER'S NAME/COMPANY AME SCREEWOPEN HOLE
1 �
Well owner's mailing address if diHerent than properry owner's address indicated above Screen from�t0�ft. Open Hole from t0 ft.
OBSTRUCTIONS
�Rods/Drop Pipe ❑Check Valve(s) ❑ Debris ❑ Fill ❑ No Obstruction '
�j '"_ ..��-
Type of Obstructions(Describe)-��l/111G�/� /'-L�F � s,,��. �
GEOLOGICAL MATERIAL COLOR HARDNESS OR FROM TO Obstructions removed? YeS ❑ NO Desc�ibe
FORMATION
If not known,indicate estimated fortnation log trom nearby well or boring PUMP
�r�.�� :J �1� TYPe
❑ Removed Not Present ❑Other
>�
- METHOD USED TO SEAL ANNULAR SPACE BETWEEN 2 CASINGS,OR CASING AND BORE HOLE:
No Annular Space Exists ❑ Annular space grouted with tremie pipe ❑ Casing PerforatioNRemoval
in.from to ft. ❑ Perforated ❑ Removed
in.from to ft. ❑ Perforated ❑ Removed
Type of perforator
❑ Other
- GROUTING MATERIAL(S) (One bag of cement=94 Ibs.,one bag of bentonite=50 Ibs.)
/ � tt
i
0 3 20 6 Grouting Material /�✓� � � �//.' %'fi—�+m to�ft. yards � bags
from to ft. yards bags
from to ft. yards bags
OTHER WELLS AND BORINGS
REMARKS,SOURCE OF DATA,DIFFICULTIES IN SEALING Other unsealed and unused well or boring on property? ❑ Yes No How many?
LICENSED OR REGISTERED CONTRACTOR CERTIFICATION
This well or boring was sealed in accordance with Minnesota Rules,Chapter 4725.The information contained in this report is
true to the best of my knowledge.
Tbri �tc�dola Well i)rillir�; Col. Snc. 1691.
Contractor Business me � License or Registration No.
:� �%'�..,! �',CJ
x o epresen ative Signa e Date
LOCALCOpY
H 25272� �;: -�- __:,�
Name of Person Sealing Well or Bonng ;
�,. .. . . ,... . _:..._„.... .. . . . .. . . _ ...... . .. . i. �
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�� � C ITY of OIZUNO
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�,, b ��.y'+��;� �Fr Municipal Offices
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.� �,'����,�;�� .�, Street Address: Mailing Address:
`�$',EgK04' 2750 Kelley Parkway P.O. Box 66
Orono, MN 55356 Crystal Bay, MN 55323-0066
Apri124, 1997
Ernie Blanchard
2585 Dunwoody Avenue
Wayzata, MN 55391
Dear Ernie,
Encicsed is a fax copy of the corrected Hennepin County plat maps showing the vacated roadway
attached to your property.
Please contact me at 473-7357 if I can be of further assistance.
Sincerely,
�,�=��,'S
i,� r---
Michael P. Gaffron
Asst. Planning & Zoning Administrator
encl.
Telephone (612) 473-7357 • FAX 473-0510
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Plat of 9urvey ` / a '
for J and G Caaatrnction, Inc. �
in Lot 12, B1ock 8, Tawneite of 18ngdc�n Park �
Hennepin Cauaty, Minneaota � �
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Certificate of Shrvey: �
I hereby certify that thia is a true and correct representation of a survey oP the boun-
dariea of that part of Lot 12, B1ock 8, Townaite of Iangdon Park, �ying South end Sautheast-
erly of the follrn+ing line: Beginning at a point on the Northeasterly line of said Int 12,
39.5 feet Sautheeaterly fram the Northeast corner of said lot; thence Southvesterly and
parallel with the Idorthwesterly line of aaid lot 12 a distance of 188 feet; thence at a
deflection to the right of the last mentioned line extended 8°35' a diatance of 1,47 feet
more or leas to ita intereection vith the shoreline of Ic�ke Minnetonka; AISO that part of
Blaine Avenue (formerly Lindley Avenue) lying Northwesterly of the centerline thereof, and
ad�aceat to IAt 12� Hlock 8, Tawnaite of Langdon Park, deacribed aa follo�,►as Beginning at
the most FBsterly corner of said Iot 12; thence Sautherly to a point in tha Sauth line of
Governnent Lot 3, Sectiaa� 20, Totimship 117 North, Range 23 6iaet, distant 87.6 feet Eeat of
the Southeaet corner of said Lot 12; thence Weat 87.6 feet to the Southesat corner of said
Lot 12; theace Northerly along the Sautheaat line of aeid Iot 12, 249.4 feet to the point
of beginning, the location of all buildings thereon, and the proposed location of a propoaed
building. It doee not parport to ahow encroachments, if any.
Scals: 1" = 50� Gordon F. Coffin �. No. 606Q
Date s 7-8-66 ���S ���� H�S BEEN �8 ���y��eaota�er
o s Iron me�rker
MICROFILMED
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