Compliance Inspection Compliance Inspection Compliance Inspection # CI-2021-2687, Submission # Submission-2021-2889, UID # 34567
Status: Compliance Inspection Accepted
 

System Status

System status on date: 06/29/2021 System Status: Compliant

Property Information

Property Information:
Compliance StatusProperty RecordProperty AddressProperty OwnerProperty Attributes
Compliance ExpirationCompliance StatusParent GeoCodePINSite AddressBuilding NumberStreet NameTypeDirCityMunicipalityzipOwnerLotBlockPlat Year BuiltProperty Hold
300322044002619083 LARKSPUR AVE N, CITY OF SCANDIA19083LARKSPURAVENMARINE ON ST CROIXCITY OF SCANDIA55047GARY D CREGER & SEPTEMBER H CREGER TRS72HOLIDAY BEACH 2ND PLAT1965
Property Owner's Mailing Address
(if different than property address):
5265 269th Ave NE
Isanti MN 55040
Owner's representative:
Name:
Danielle Lang
Phone:
(763244 - 7430
Email:
mjlcontract@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 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? Yes
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: 1.92 Decimal Feet
C. System separation: 3.92 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

Certification

Inspector:
NameLicense NumberPhone NumberAddressMaintainerInstallerService ProviderDesignerInspector
MJL Contracting IncL2449763-444-66685265 269th Ave NE Isanti, MN 55040YesYesNoYesYes
Please search for and choose SELF/OTHER if what you need does not appear in the list
Inspector Contact (If 'self/other' is selected from the Inspector Lookup): Danielle Lang
Inspector Email Address: mjlcontract@gmail.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 #6986 (06/29/2021)

Charge Cost Quantity Total
Non-Taxable
added 06/29/2021 4:12 PM

$47 Flat Fee

$42.00 x 1 $42.00
Grand Total
Total $42.00
Payment 06/29/2021$42.00
Due$0.00
Action: Print  

Approvals

ApprovalSignatureOptions
ApplicantDanielle Lang - 06/29/2021 4:12 PM
b278e5573e5960aa6b479d8d5e70322d
2358388a16f451d407ce62addfbbf654
 
#1 Compliance Inspection AcceptedSarah Borrell - 07/20/2021 7:22 AM
4867f72217245d588c8df9a43939f753
53d9bdc1b68cfa69ba9a447ae8329e8d
 
Inspection has been approved. All signatures have been obtained.
Text:
File(s):
    Text:
    All components replaced in 2016. Does not change compliance status for vertical separation. See email.
    File(s):
    Compliance Letter Type: Certificate of Compliance Who's signature should be on the letter? Sarah Borrell Permit number to reference in "No Replace" letter:
    Was the letter sent? Yes Compliant/Non-Compliant: Compliant
    Certificate of Compliance:
      Letter of Non-Compliance:
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