Compliance Inspection Compliance Inspection Compliance Inspection # CI-2021-2594, Submission # Submission-2021-2776, UID # 33703
Status: Compliance Inspection Accepted
 

System Status

System status on date: 04/29/2021 System Status: Compliant

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
27029203300051090 PARIS AVENUE CT N, TOWN OF WEST LAKELAND1090PARIS AVENUECTNSTILLWATERTOWN OF WEST LAKELAND55082WILLERT BRAD J & MUFF92ST CROIX VISTA1997
Owner's representative:
Name:
Brad Willert
Phone:
(651805 - 1200
Email:
brad.willert@icloud.com

Impact on Public Health

System discharges sewage to
the ground surface:
No System discharges sewage to
drain tile or surface waters:
No System causes sewage backup
into dwelling or establishment:
No
Verification method(s):
Searched for surface outlet
Searched for seeping in yard/backup into home
Homeowner testimony (See Comments/Explanation)

Tank Integrity

System consists of seepage pit,
cesspool, drywell, or leaching pit:
No
Sewage tank(s) leak below their
designed operating depth:
No
Verification method(s):
Examined empty (pumped) tank(s)

Other Compliance Conditions

Maintenance hole covers are damaged, cracked,
unsecured, or appear to be structurally unsound:
No
Other issues (electrical hazards, etc.) to
immediately and adversely impact public
health or safety:
No
System is non protective of groundwater for other
conditions as determined by the inspector:
No

Date of Install

Date of install known: Yes
Date of installation: 08/22/1997

Soil Separation

Shoreland/Wellhead Protection/Food, beverage, lodging? No
Drainfield has at least a three-foot vertical separation
distance from periodically saturated soil or bedrock.:
Yes
Drainfield meets the designed vertical separation
distance from periodically saturated soil or bedrock.:
Yes
Verification method(s):
Conducted soil observation(s) (Attach boring logs)
A. Bottom of distribution media: 2 Decimal Feet
B. Periodically saturated soil/bedrock: 5.5 Decimal Feet
C. System separation: 3.5 Decimal Feet
D. Required compliance separation: 3 Decimal Feet

Operating Permit and Nitrogen BMP

Is system operating under an Operating Permit: No
Is the system required to employ Nitrogen BMP: No

Comments and File Attachments

Certification

Inspector:
NameLicense NumberPhone NumberAddressMaintainerInstallerService ProviderDesignerInspector
David R. BrownL3649651-788-3296PO Box 251026 Woodbury, MN 55125NoNoNoYesYes
Please search for and choose SELF/OTHER if what you need does not appear in the list
Inspector Email Address: drufusb1@yahoo.com

Terms

Certification
  • By submitting this form I hereby certify that all the necessary information has been gathered to determine the compliance status of this system. No determination of the future
    system performance has been nor can be made due to unknown conditions during system construction, possible abuse of the system, inadequate
    maintenance, or future water usage

Invoice #6747 (05/12/2021)

Charge Cost Quantity Total
Non-Taxable
added 05/12/2021 2:09 PM

$42 Flat Fee

$42.00 x 1 $42.00
Grand Total
Total $42.00
Payment 05/12/2021$42.00
Due$0.00

Approvals

ApprovalSignature
ApplicantDavid R. Brown - 05/12/2021 2:09 PM
39dca36309c9da41061efb91705015b0
cd4e4eb03430421ae8d7f8c6e1d8bb56
#1 Compliance Inspection AcceptedBarbara Pena - 05/17/2021 3:47 PM
167d9c705bb7bd64df7599c72bb062ea
1a03dce488051c30d72722f4bade4815
Inspection has been approved. All signatures have been obtained.

Public Notes

Text:
File(s):

    Internal Notes

    Text:
    File(s):
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