Compliance Inspection Compliance Inspection Compliance Inspection # CI-2021-2601, Submission # Submission-2021-2782, UID # 33764
Status: Compliance Inspection Accepted
 

System Status

System status on date: 05/04/2021 System Status: Compliant

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
16029211400158928 36TH ST N, CITY OF LAKE ELMO892836THSTNLAKE ELMOCITY OF LAKE ELMO55042FLEISCHMAN ROBERT E & NATASHA22KENRIDGE 2ND ADD1988
Owner's representative:
Name:
Sean Ryther
Phone:
(763300 - 2777
Email:
sean.ryther@gmail.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: No

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: 6.5 Decimal Feet
C. System separation: 4.5 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 #6775 (05/18/2021)

Charge Cost Quantity Total
Non-Taxable
added 05/18/2021 8:52 PM

$42 Flat Fee

$42.00 x 1 $42.00
Grand Total
Total $42.00
Payment 05/18/2021$42.00
Due$0.00

Approvals

ApprovalSignature
ApplicantDavid R. Brown - 05/18/2021 8:52 PM
b5834b8a4dc4cf03aa7390bafb959efa
4e4d15dd80818fe9c79ef142ecf129ed
#1 Compliance Inspection AcceptedJoe Sanders - 06/03/2021 9:37 AM
859c093971c5ce1e746c35d8d3140a7e
5158888b4f99af51b5ed77bf37c72270
Inspection has been approved. All signatures have been obtained.

Public Notes

Text:
File(s):

    Internal Notes

    Text:
    File(s):
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