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Owner Information <br />Date 5/18/2022 See / Twp / Rng 5-32-26 <br />Parcel ID 75-481-0120 LUG (county, city, township) City of Elk River <br />Property Owner: Lloyd Barthel Owners address (if different) <br />'Property Address: 17801 Joplin Street NW <br />City / State / Zip: Elk River, MN 55330 <br />Flow Information and Waste TVDe / Strength <br />Estimated Design flow — 750 Anticipated Waste strength E3 Hi Strength 0 Domestic <br />Comments: Any Non -Domestic Waste EJ Yes (class V) No <br />Sewage ejector/grinder purnp EJ Yes [2] No <br />Water softener ❑ Yes E] No <br />Garbage Disposal ❑ Yes Q No <br />Daycare / In home business ❑ Yes ❑ No <br />Site Information <br />Existing & proposed lot P1 Yes F-1 No Well casing depth 50'+ <br />improvements located (see site map) <br />Easements on lot located <br />El Yes <br />❑ No <br />Drainfield Win 100' of <br />❑ Yes <br />❑ No <br />(see site map) <br />residential well <br />Property lines determined <br />Yes <br />❑ No <br />Site w/in 200' of transient <br />E]Yes <br />❑ No <br />(see site map) <br />noncommunity water supply (TNCWs) <br />Req'd setbacks determined <br />MV Yes <br />E] No <br />Sitew/in an inner wellhead <br />Yes <br />❑ No <br />(see site map) <br />mgmt zone (CWS/NTNCWS) <br />Utilities located & identified <br />❑ Yes <br />❑ No <br />Buried water supply pipe <br />❑ Yes <br />❑ No <br />(gopher state one call) <br />w/in 50' of system <br />Access for system maintenance <br />Q Yes <br />❑ No <br />Site located in Shorcland <br />El Yes <br />❑ No <br />(shown on site map) <br />(-,AT/in 1000'of lake, 300'of river) <br />Soil treatment area protected <br />Yes <br />❑ No <br />Site map prepared with <br />Yes <br />❑ No <br />previous items included <br />Construction related issues <br />