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107 Chevy Chase Drive - 36-118-23-41-0009
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Last modified
8/22/2023 5:03:57 PM
Creation date
4/7/2016 2:25:16 PM
Metadata
Fields
Template:
x Address Old
House Number
107
Street Name
Chevy Chase
Street Type
Drive
Address
107 Chevy Chase Drive
Document Type
Land Use
PIN
3611823410009
Supplemental fields
ProcessedPID
Updated
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-�--SiA1E 11F MIMNESOiA DEPARTI�NT OF HEALTH <br /> ABANDONED MELL RECORD <br /> 1. LOGTION Of YELL• M�'+Et Dlank NfOnoE known)NO• <br /> c°""`'' ""' Henne in <br /> Townshtp Maw Township Nuabtr Rang� Nu�ber S�ctlon No. Frutto� 0. MEII DEPTN (caql�t�d) Dat� s�al�d <br /> N E ti k of y <br /> Orono. 118 S� 2.3 M� 36 �' �i' SE � I � ft. 1 ' .3 f —I oZ <br /> Nwnerlcal Strtet Addnss �nd City of M�11 Loeatton or Oist�nce fro� qad 5. RiL N6 l�THOD (if known) <br /> Interstctton ��bl� tool IQ Wrtrs� 7[]pHv�n 1�Duy <br /> 107 Chevy Chase Drive Wayzata, NII�i. 55391 �-� <br /> 2[]Mo11ov itod 50 Atr �Bor�d 11[] <br /> Show �xact loutton of rNl l � ��Li�Y 60 Jttt�d �Powr Auq�r <br /> (tn s�ctlon qrid rith 'X") St�tch Mp of w�il location <br /> N 6. OBSTRUCTtONS <br /> J�'Z Wil obstnutN s No <br /> - � . _ ._ _. p`N � 3 1y �structiouf r�d Yu ❑No If o�structlons cannot b� <br /> � . _ � �t` n�ov�d. tontact MDN <br /> M - - - � -- -�- � - E ��s.•i��9. <br /> , _ : ; T �'he� C'/,use 7�rr�e. �..�1 <br /> ' ', y.i. � ; f�,q Dow�sttc {�MoMtoNnq �N�at loop <br /> ' ' _ : I � 2Q Irrigatlon 50 Publte � Indnstry <br /> ..�. . ..�.. <br /> � S 1 �C..ulPl� �T�st U�ll �Nuniclpal 1fQ Co�rclal <br /> ►--1 .iL---+ 7(]Mr Wnditlonlaq 11Q <br /> . 2. PROPENTY OMNER'S NAIfE Mailiny Addnss if dlfferont than 8. SIN6(S) <br /> property �ddnss indic�ted abov� 1�'Blatk �Thruded 7(� <br /> Karen Geier SAME �p s,,�, sp w�aa <br /> 3p Pi,:t�c �sat�t.:: sc..i � <br /> MARONESS OF <br /> 3. fORlYITION LO6 COLOR FOR►NTION FROM TO � �A' � ��J ft. <br /> !f not known, indicett forwatton log fro� n�w w�ll o� n��My wil. in, to ft. <br /> �Tllt � �/�� 9� ❑Scn�n�d wll frro�_ft. to ft. <br /> (if knawn) <br /> tL(�f���cil���;'�c'`lt�' j<I'S ' ��1C�' �ov.e Nol. rro. ,t,�rc. w�rs. <br /> 10. S?ATIC MATER LEYE <br /> �l� ft. Wlor []�bove <br /> l�nd u c� OaU Il��sund I � <br /> 11. YELLHEAD COIpLETION <br /> 10 Pitl�ss Adapt�r �Found Buri�d <br /> 2Q Basarnt offs�t � <br /> �Wll Ptt <br /> 16. REMARKS, ELEVATION. SOURCE OF DATA - CASINGS RElqYED. CASIN65 PERFOMTED. E1C. <br /> 12.�6RQUTIN6 INFORMIITION <br /> jp`I Neac Ca�nt_ 20�ntoMte � <br /> Grout 3" Well Approx. Z10' Deep ('jrpyL qUI'�.i rro.�w v fc. tu. yds <br /> 14 Bags Cement <br /> 16 Lbs. Bentonite — — <br /> 2 Men, Labor, Rig and Cement Grout P�m�tp 1�. NEARE57 SWRCFS OF CWITANINATION <br /> �_ f��t dtr�ction LYP� <br /> Ikil disint�ct�d b�foh sN11ny1 �Y�s <br /> 1�• VUNi Raowd ❑Not Pnsent <br /> Typ�: 1�Subwersibl• �L.S. Turoine �Reciprouttng <br /> �,l�t �C�ntMfuysl 5� <br /> I5. E1(ISTING YEILS (Pleas� sketch locattons of �bandon�d and <br /> activ� w�tls 1n ruarks sec on o� on back.) <br /> Other unus�Q r�ll(s) on prop��tyT �Yes No <br /> Abandon�d: �°�P�rtinent �TNporary [] t s�al�d <br /> / <br /> 17. MATER MELL CONTNACTORS CEATIFICATI011 <br /> TAts wll ws seal�d und�r q �urisdlctton and thls nport <br /> 1s tru� to tM bttt of q knowl�dy� �nd D�it�f. <br /> DON STODOLA WELL DRI <br /> Lic�ns�� luftn�tf NaM Ltunt� No�717Z <br /> Addr�si 45 <br /> s�9�: ,� au -3- 2 <br /> ark G. Sto o a a�, - - <br /> FFICIAI ABANppNEO YELL ItECORO (14y b� usW for iroptrty Tr�nsf�r) Nawe of Dr111�� <br /> IJ�T11ITr llld IIIITQ �� <br />
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