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Home My WebLink AboutAcorn Acres_32000170128000_Shoreland Permits_OTTER TAIL COUNTY Lot Alteration Permit # 8245 PROPERTY OWNER___^ LAKE NO S^-'^e? SEC. LEGAL DESCRIPTION: UC i fo Z. TWP. NAME vrv WORK AUTHORIZED SVv\p V<iy TV 7(H^' Vr^v;^XU»irv ~Pi.«oaL^ *lo ^ di r\v w'k.^ AVr>VK.\V iLqQ- mV ^ <o ^ ^ v»A‘».u V><>^ ETC^ CuttPK^revckx) / fl^vvA V«.VfttW VsvO.'-i'v *IVx NOTE: This card shall be placed in a conspicuous place not more than 4 feet above grade on the premises on which work is to be done, & shall be maintained there until completion of such work. NOTIFY LAND & RESOURCE MANAGEMENT, 218-998-8095 WHEN AUTHOmZED WORK HAS BEEN COMPLETED. .^ q\v CA'^V'-V\ • 1. EARTHt/IOVING SHALL BE DONE BETWEEN ’s -tO-Hi 2. Entire area shall be stabilized within 10 days of completion of any earthmoving. 3. Owner is legally responsible for ail surface water drainage that may occur. 4. No fill shall enter or be taken from the beds of public water without a valid permit from the MN Department of Natural Resources. 5. If the terms of this permit are violated, the entire permit may be revoked and the owner may be subject to legal prosecution. 6. Erosion control measures must be implemented prior to any topographical alterations. & u-i-n m APPLICATION FOR LOT ALTERATION PERMIT TOPOGRAPHICAL ALTERATION / IMPERVIOUS SURFACE Land & Resource Management Government Services Center, 540 West Fir, Fergus Falls, MN 56537 218-998-8095 www.co.otter-tall.mn.us OTTER TflilCOUATT-aiHACIOTI Permit No.PLEASE PRINT OR TYPE ALL INFORMATION LAKE/RIVER #LAKE/RIVER NAME LAKE/RIVER SECTION TWP. NO.RANGE TWP NAME CLASS5^f\.os^ PARCEL NUMBER(S) /S')I') PROPERTY (E-911) ADDRESS L/j-f-1 ^ /v<gt ^ FirstLast Name Initial Mailing Address DAYTIME Phone No. Property Owner ir#lAe^SContractor Name IFA T)3X‘St-. 4L.Ty »r^-^ Tr\tiw.f tb<t. Lie. # NOTES: 1. A Scale Drawing & Impervious Surface Worksheet must be included with this Application. 2. The lotlines and project area(s) must be identified & staked onsite. 3. If project disturbs more than 1 acre of land, you must obtain a General Storm Water Permit from the MPCA. Date Stamp ^ECEWIED m II3 20I7 WND<y?ESOflBCE L&R Initial DESCRIBE YOUR PROJECT(S): TOPOGRAPHICAL ALTERATION: AREA TO BE CUT/EXCAVATED:3^Yds^Ft. - 27 =Ft. XFt. X Ave. DepthLength ~ , Yds^ - Yds^ <5^ Ft. -27 =Ft. XWALK-OUT ^.&Eiy[ENT PROJECTS: (Outside of thaJSuilding foundation) Ft. X Width Ave. DepthLength Ft. X Ft. - 27 =Ft. XAREA TO BE FILLED/LEVELED: Width Ave. DepthLength Yds^TOTAL EARTHMOVING REQUESTED = Ft.BACKFILL AT FOUNDATION:Ft. lioDistance From FoundationMax. Depth CULVERT: If Yes, must indicate size and location on drawing. Yes No %%Proposed Proposed IMPERVIOUS SURFACE BUILDING: Existing IMPERVIOUS SURFACE TOTAL; Existing % % ' Date /T)^•zon- icf< Receipt Numberiignature Of Property Owner/Agent For Owner 360,648 • Victor Lundeen Co.. Printers • Fergus Falls, MN • 1-800-346-4870BK04-2016 A m LAND & RESOURCE MANAGEMENT GOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS FALLS. MN 56537 218-998-8095 www.co.otter-tail.mn.us APPLICATION FOR SITE PERMIT WHITE - Office GOLDENROD - Inspector YELLOW - Owner (after issue) OTTER TRIIcouflTT-iiiinni O T R Permit No.APPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED. LAKE / RIVER NO.LAKE/RIVER NAME LAKE/RIVER SECTION TWP NO.RANGE TWP NAME6L-3Lb\i<os£ | I/3'T I I Nn&M T- PROPERTY (E-911) ADDRESS 30.9 /kuc^S PARCEL NUMBER (S) LEGAL DESCRIPTION /»7 lTcS^\3'^DEVELOPED UNDEVELOPED Last Name First Initial Mailing Address Daytime Phone No. /v7/y. Property Owner \3£Nr, ry)H. Contractor Name Lie.# 44S^IJL\V\or 1 PROPOSED PROJECT (please circle the appropriate number) (1 ) New Dwelling ( 4 ) MHA'R (7 ) Add'n To Non-Dwelling (10) Non-Conf. Replacement (identify)" (11) Other (identify) (12) Deck_____ (13) Fence n' ONSITE WATER SUPPLY fONSITE SEWAGE TREATMqt^TSYSTEM ( ) Individual ( ) Public ( ) None NOTE: MN Rules Chpt. 4725 (MN WelJ Code) requires a 3’ (minimum) structure setback to a well. / ( ) L&R Cert. orCompliance wj^n 5 yrs. ( ) Compliance Inaction B^Jrt within 3 yrs. (Attachea)\^ / I ( 2 ) Add'n to Dwelling/Attached Garage (3) Replacement Dwelling* ( 6) Detached Garage (9) W.O.A.S. (JJRCU/Year_____ \8)3lorage Structure ( ) OTWMD 'Must ha'^Sewage System Approval from OTWi Contact H6llie Ma (or tq issuing Site Permit 218-864-5533 ( ) New Septic ^rmit Issue! Z Permit ■ Inspector's Initial/D^ /■Removal of Existing Dwelling Verified by L&R "Existing Non-Conf. Structure Verified by L&R CHARACTERISTICS OF 'ROPOS0D W.O.A.S. (WATER ORIENTED ACC^SORY STRUCTURE Outside Dimension CHARACTERISTICS OF PROPOSED DWELLING (Must Include Attached Garage) Outside Dimension___ Sq. Ft. Setback to Lotline ____ Setback to Right of Way Setback to Ordinary High Water Level ___ Elevation Above Ordinary High Water Level Setback to Septic Tank___ Setback to Drainfield____ Setback to Bluff________ Total Bedrooms Maximum Proposed Height Roof Change ( ) Yes ( ) No Basement ( ) Yes ( ) No Walkout Basement ( ) Yes (side profile required) { ) No CHARACTERISTICS OF PROPOSED NON-DWELLING Outside ^ ^ Dimension Ft. x ^ o Ft." So Ft iHUh Ft. X Ft.**Ft. X Ft.** Sq. Ft. Setback to Lotline ___ Setback to Right of Way Setback to Ordinary High Water Level __ Elevation Above Ordinary High Water Level Setback to Septic Tank___ Setback to Drainfield____ Setback to Bluff________ Maximum Proposed Height Ft.&Ft."Setback to Lotline Setback to Right of Way Ft.** Setback to Ordinary High Water Level aiCO^ Ft. . Ft.&Ft.**Ft.&Ft.**Ft." Ft."Ft. Ft.Ft, Elevation Above Ordinary High Water Level Setback to Septic Tank Ft. Setback to Drainfield ^ Ft. Setback to Bluff Ft. Maximum Proposed Height Ft. Roof Change ( ) Yes [f ) No Bathroom Proposed ( ) Yes yC) No Ft.Ft. Ft.Ft.Ft. Ft. Ft.Ft. Ft. ( ) Boathouse ( ) Gazebo **Project/Lotlines/Right-of-ways Must be Staked Onsite Prior to Application / Inspection ( ) Screen Porch ( ) Storage Structure a^21 Cubic Yards - 999 Cubic Yards* Topographical Alteration / Earthmoving □ None * Must include on scale drawing, additional Permit may be required.□ 20 Cubic Yards or Less *□ 1,000 Cubic Yards or More* 30 Sj SqCHARACTERISTICS OF LOT:Lot Area..Ft.Water Frontage Bluff ( )Yes ( )NoFt. .%.% Building Surface Ratio Impervious Surface Ratio THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES. Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set forth and according to the provisions of the Ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express con dition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Ordinances of Otter Tail County, Minnesota. This permit may be revoked at any time upon vioiation of said Ordinances.I understand that it is my responsibility to inform the Land & Resource Management office once the building footings have been constructed. Date: Signature of Property Owner/Agent for Owner Date: Land & Resource M^aaement OfficialfiZ-ao1^0 PERMIT FEE $PROJECT(S) TOTAL SQ. FT.RECEIPT NO. Date StampComments: RECEIVED A us 119 2017 LANDSRESOURCF L&R Initial Form No. BK — 04-2016 360,647 • Victor Lundeon Co., Printers • Fergus Falls. Minnesota -4SCALE DRAWING FORM I i I^ 3.Q.CrrT^l^nldL^DOZD T Tax Parcel Number(s) The scale drawing must be a signed drawing which includes and identifies a graphic scale (feet), all existing and/or proposecf structures, septic tanks, drainfields, lotlines, road right-of-ways, easements, OHWLs, wells, wetlands and topographic features (i^e. bluffs). Must also complete the Impervious Surface Calculation (see back). Scale .Li:1': i ■ ■ Rp^BUED l|i| 2ot7 -i tAND&RKOORCF •f HP ^ V :j2_ ‘ T j 1 I T 4- T r T I 4—- I r O ^o —a lu 3oynos3y’?aN\nn1wLm z»o Nnr0 <HAI303tJIf t Signature of ■\ i Ui __I).CO -3-I ■y4-Cl ^ o ^Ct DateI rO 36O;0O0, • Victor Uindcen Co.. Prinlots • Fstgus Falla. MN • l-800-346.48roBK —042016 i, IMPERVIOUS SURFACE CALCULATION List & identify all existing & proposed onsite impervious surfaces on scale drawing. ?Lot Area (ft^):r Other Impervious SurfaceBuildings ProposedExistingProposedi-i2Existing Ft^Ft^Ft^Ft Deck(s)Dwelling Attached Garage Patio(s) Detached Garage Sidewalk(s) Storage Shed Landing(s) WOAS Driveway(s) RCU Parking Area(s) Retaining Wall(s)Miscellaneous Landscaping (Plastic Barrier) ; • Miscellaneous TOTAL BUILDINGS TOTAL OTHER Buildings Impervious Surface Percentage Maximum Allowable 20% Existing Proposed Total Impervious Surface Ratio Lot Area Ft^ Ft^Ft^Ft^Total Buildings 100X Buildings + Other Impervious Surface Percentage Maximum Allowable 25% Total Buildings + Other Impervious Surface Existing Total Impervious Surface Ratio Proposed Lot Area Ft^Ft^Ft^Ft + ;100X Impervious Surface Calculation Worksheet 04-11-2016 DateSignature: WHITE - Office GOLDENROD - Inspector YELLOW - Owner (after issue) PINK - Assessor APPLICATION FOR SITE PERMIT LAND & RESOURCE MANAGEMENT, COUNTY OF OTTER TAIL GOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS FALLS, MN 56537 218-998-8095 www.co.otter-tail.mn.us PLEASE PRINT OR TYPE ALL INFORMATION FXPIRHP LAKE / RIVER NO.LAKE/RIVER NAME LAKE/RIVER CLASS SECTION TWP NO.RANGE TWP NAME ^^0 Jjl<4. - IPARCEL NUMBER (S) PROPERTY (E-911) ADDRESS V 3'L<ooO tio0^0 ILEGAL DESCRIPTION La 7- / ^ 7- ^ -tiL / 7 Vu Ji<<iLast Name First Initial ilinf Address Daytime Phone No. eProperty Owner >l). /)}J(/ ,r4 . r w y<aM /i 2//?3^Z - 7,00^O OJL/ Contractor Name ' Lie. # ^ jK. C" A <3. /?n>K /SS it L)BA/r, /ffA/ StS'Lt?Zfr? -Z/8 02,OZZZC,'i 7 PROPOSED PROJECT (please circle the appropriate number)ONSITE SEWAGE TREATMENT SYSTEM ( ) Permit No. .t 7 .R 3________ ( ) OTWMD ‘Must tiaue Sewage System Approval Irom OTWMD prior to issumg Site Permit. Corrtact Rollie Marm at 218-864-5533 ONSITE WATER SUPPLY { 'J Individual ( ) Public ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3’ (minimum) structure setback to a well. r ( 3 ) ‘Replacement Dwelling ( 6 ) Detached Garage (9) W.O.A.S. (1 ) New Dwelling ( 4 ) MH/YR ( 7 ) Add'n To Non-Dwelling (10) Other ( 2 ) Add'n to Dwelling ( 5 ) RCU/Year_____ Storage Structure ‘Existing Dwelling to be removed before3 CHARACTERISTICS OF PROPOSED W.O.A.S. (WATER ORIENTED ACCESSORY STRUCTURE)CHARACTERISTICS OF PROPOSED DWELLING Outside Dimension CHARACTERISTICS OF PROPOSED NON-DWELLING Outside Dimension ?0 Ft. x f/ ^ Ft. Sq. Ft. /VVO Setback to Lotline ZeO ^ Ft. & LoO -A. Ft.”L^^ Setback to Right of Way -a Ft." Setback to Ordinary High Water Level 2.O0 -4- Ft. Elevation Above Ordinary High Water Level Setback to Septic Tank ZojP F Ft. Setback to Draintield .3^ 0 *■ Ft. Setback to Bluff Zoo H- Ft. MSximum Proposed Height ! 7. Ft. v Roof Change ( ) Yes () No Bathroom Proposed ( ) Yes (><^ ) Nov "V^Outside DimensionFt."Ft. x Ft. X Ft." Sq. Ft. Setback to Lotline ___ Setback to Right of Way Setback to Ordinary High Water Level ___ Elevation Above Ordinary High Water Level Setback to Septic Tank___ Setback to Drainfield____ Setback to Bluff________ Total Bedrooms Maximum Proposed Height Roof Change ( ) Yes ( ) No Basement ( ) Yes ( ) No Walkout Basement ( ) Yes (side profile required) ( ) No Sq. Ft. Setback to Lotline ____ 'Setback to Right of Way ' Setback to Ordinary High Water Level __ Elevation Above Ordinary High Water Level Setback to Septic Tank___ Setback to Drainfield____ Setback to Bluff________ Maximum Proposed Height ( ) Boathouse ( ) Gazebo Ft.&Ft." Ft.&Ft."Ft." Ft."Ft.V- Ft.Ft.h__fAFt.Ft. Ft.Ft. Ft.Ft. Ft.Ft. Ft. ( ) Screen Porch ( ) Storage Structure **Proiect/Lotlines/Right-of-ways Must be Staked Onsite Prior to Application / Inspection ^ 21 Cubic Yards • 299~Cubic Yards* ’ Must include on scale drawing, additional Permit may be required. Topographical Alteration / Earthmovinq □ None .u □ 300 Cubic Yards or More*□ 20 Cubic Yards or Less * CHARACTERISTICS OF LOT: Lot Area -Sf Ac <.€^.8 Sq. Ft. Water Frontage ^ oO Total Im^i^i^urface Onsite (FT^) Bluff ( )Yes (y)NoFt. T / gyp Z.Si z Impervious Surface Ratio . OImpervious Surface Ratio:Xt00 =,% Total Lot Area (FT^) THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES. Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set forth and according to the provisions of the Ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express con dition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Ordinances of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said Ordinances. I understand that it is my responsibiiity to inform the Land & Resource Management office once the building footings have been constructed. Date: ^ ~ Z9 - a'7 Signature of Property Owner / Agent for Owner (nJi/ln'-// MzjDate; Land <S Resource Mapegem^t OfficePERMIT FEE $ oA RECEIPT NO.PROJECT(S) TOTAL SQ. FT. t{V«-Lc ^V-' T. V'-vV A (i H) (■3.r- <0V'VVCl ¥ O >-s <Comments: V V» t \. ; 326,151 • Victor Lundeen Co., Printers • Fergus Falls, MInnesSe,Form No. BK — 1003-0506 SITE PERMIT INSPECTION RESULTS Inspector must make all measurements and computations U Ft.Ft.Structure Set Back from Ordinary High Water Level Ft.Ft.Structure Set Back from Top of Bluff Ft.Ft.Structure Set Back from Road Right of Way Ft.Ft.&Ft.Structure Set Back from Lot Lines 1^'Ft.Ft.Structure Height Ft.Ft.Structure Set Back from Septic Tank Ft.Ft.Structure Set Back from Drainfield Elevation Of Lowest Floor Above Ordinary High Water Level :r Ft.Ft. Land Slope at Building Site %% Inspector’s Comments / Sketch: 0^ r'5^Inspector’s Signature jw/r/( Date of Inspection P7Y______ Time of Inspection ^^ffkeject Approved^ Date / Initial received WHITE - Office GOLDENROD - Inspector YELLOW - Owner (after issue) PINK - Assessor APPLICATION FOR SITE PERMIT MAY 0 2 2007LAND & RESOURCE MANAGEMENT, COUNTY OF OTTER TAILGOVERNMENT SERVICES CENTER, 540 WEST FIR, FER(RE€^EIVEID15653?^ND & RESOURCE 218-998-8095 JUN 0*7 2007 LAND & RESOURCEPerfriit No. J^3S38www.co.otter-tail.mn.us PLEASE PRINT OR TYPE ALL INFORMATION LAKE / RIVER NO.LAKE/RIVER NAME LAKE/RIVER CLASS SECTION TWP NO.RANGE TWP NAME /-/a/J1nPARCEL NUMBER (S)PROPERTY (E-911) ADDRESS 3'l^o O O iz.pi OOG LEGAL DESCRIPTION yo j’f. / Lay- / CoT- 7 JUL ^ Last Name First Initial Mailing Address Daytime Phone No. Property Owner d,__jvsji. V zhA/ •£'d< r J>/.P3^Z - 2,00*?G ox/ ^Contractor Name Lie. #/2eit( /<^S______ siTd-g^ Z,OZZZC>'> 7 ^//f V^8 -Z(80 ONSITE SEWAGE TREATMENT SYSTEM i { ) Permit No. ff *7fl 3______ { ) OTWMD "Must have Sewage System Approval from OTWMD prior to issuirtg Site Permit. Contact Rollie Mann at 218-864-5533 PROPOSED PROJECT (please circle the appropriate number) ( 2 ) Add'n to Dwelling ( 5 ) RCUA'ear_____ Storage Structure 'Existing Dwelling to be removed before ONSITE WATER SUPPLY (^/Individual ( ) Public ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3' (minimum) structure setback to a well. (1 ) New Dwelling ( 4 ) MHA'R ( 7 ) Add’n To Non-Dwelling (10) Other ( 3 ) 'Replacement Dwelling ( 6 ) Detached Garage (9 ) W.O.A.S.O CHARACTERISTICS OF PROPOSED W.O.A.S. (WATER ORIENTED ACCESSORY STRUCTURE)CHARACTERISTICS OF PROPOSED DWELLING Outside Dimension CHARACTERISTICS OF PROPOSED NON-DWELLING Outside Dimension . ?0 Ft. x V ^ Ft. Sq. Ft /yyO Setback to Lotline ZeO Ft. & ZoO ^ Ft."k^ Setback to Right of Way -jL Ft." ' Setback to Ordinary High Water Level ZOO Ft. Elevation Above Ordinary High Water Level (s Setback to Septic Tank Zo C F Ft. Setback to Drainfield +■ Ft. Setback to Bluff 2oo H- Ft. Maximum Proposed Height / 2 Roof Change ( ) Yes ()^) No Bathroom Proposed ( ) Yes (>^) N Outside DimensionFt. X Ft." Ft. X Ft." Sq. Ft. Setback to Lotline ___ Setback to Right of Way Setback to Ordinary High Water Level___ Elevation Above Ordinary High Water Level Setback to Septic Tank___ Setback to Drainfield____ Setback to Bluff________ Total Bedrooms Maximum Proposed Height Root Change ( ) Yes ( ) No Basement ( ) Yes ( ) No Walkout Basement ( ) Yes (side profile required) { ) No Sq. Ft. Setback to Lotline ___ ■'Setback to Right of Way^^^tback to Ordinary High Water Level __ Elevation Above Ordinary High Water Level Setback to Septic Tank___ Setback to Drainfield____ Setback to Bluff________ Maximum Proposed Height ( ) Boathouse ( ) Gazebo Ft.&Ft." Ft.&Ft."Ft." Ft."Ft. Ft.Ft. Ft.Ft. Ft.Ft. Ft.Ft. Ft.Ft.v^Ft. Ft.v/ ( ) Screen Porch ( ) Storage Structure **Project/Lotlines/Right-of-ways Must be Staked Onsite Prior to Application A>n 21 Cubic Yards - 299 Cubic Yards' □ 300 Cubic Yards or More' spection •2 0 C.* Must include on scale drawing, additional Permit may be required. T^ographical Alteration / Earthmovina □ 20 Cubic Yards or Less CHARACTERISTICS OF LOT: Lot Area Sq. Ft. Water Frontage ‘90 0 Total Ir^i^l^u^c?Onsite (FTO Bluff ( )Yes (X')No.Ft. Total Lot Area (FT?) 2,S 2Impervious Surface Ratio:xioo =,% Imperious Surface Ratio THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES. Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set forth and according to the provisions of the Ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express con dition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Ordinances of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said Ordinances. I understand that it is my responsibiiity to inform the Land & Resource Management office once the buiiding footings have been constructed. Date: ~ Z9 - O'? Signature of Property Owner / /^nt for Owner (e/l//0'JDate: Land & Resource M PERMIT FEE $RECEIPT NO.PROJECT(S) TOTAL SQ.FT., - Q I'- ( 0 f IJ-v <^\ v\V V<\\\Cl Hi nr VveC». Cl wComments:V'- p ;»♦ 1 \ . Form No. BK — 1003-0506 326,151 • Victor Lundeen Co., Printers • Fergus Falls, Minnesota 'i ll'O RECEIVm fr-»>l •>> \k\;\Ci A)JUN 0*7 2007 0>1 K tA_ & resource.N z: t)A r» received 0 2 2007 land & REHOURCL // / r-StjCaJ ^ 1^0 0 ♦ X j:i ^ 00 " Cy1 \ / • ^ » dovt aau V dO'Mr otstk)/(£,H ■ tm/itktwbMk) O'diMO Umkl^MA Mi> &vMui£) 04. <ldEjLUiiZOvu • _ v'VjOt> owo ^ikonjL r RECEIVED JUN072007 1 tANQARESOURCI. SCALE DRAWING FORMi Tax Parcel Number(s) The scale drawing must include the outside dimension (lotlines) of the property above the ordinary high water level, and must identify the type, size (square feet), and location of all existing and proposed structures, additional onsite impervious surfaces, road right-of-way(s), ordinary high water level(s), septic tank(s), drainfieid(s), bluff(s) & wetland(s). Must aiso include all proposed topographical alterations. % Impervious Surface Ratio (Must Complete Worksheet On Other Side) Scale received - MAY 02 2007 land & RESOURCE i s I ! ■i )i i 4 1 I t ! 1 i !I I I Ir i1 !i f! ;Iiij. f f t i Signature of Property Owner Date BK — 0207 329.086 • Victor Lundeen Co„ Printers ■ Fergus Falls. ^ • 1-800-346-4870 IMPERVIOUS SURFACE CALCULATION WORKSHEET; List of Onsite (Existing and Proposed) Impervious Surfaces (must be shown on scale drawing): Ft^ /£)0 <. Pt Ft2 Driveway(s): 6b40^C ~ Structure(s): Deck(s): 14_Ft2Patio(s): Ft2Sidewalk(s): 3iO£ Ft2Stairway(s); Ft2Retaining Wall(s): Ft2Landscaping: (Plastic Barrier) Other:Ft2 V2^-gS.l Ft2TOTAL IMPERVIOUS SURFACE: /£.9A^P4'0 Ft2LOT AREA: .%2 -5'4.X 100 = TOTAL IMPERVIOUS SURFACE ■F / PU O ■Lot AREA IMPERVIOUS SURFACE RATIO No vicinify map shown as all significani Section and I/I6fh hnes arc shown. CERTIFICATE OF SURVEY IN SECTION 17-137-40 OTTER TAIL COUNTY, MINNESOTA RECEIVED JUN:0‘72007 LAND & resource Meander Corner No. 66 'V V -- S 69°55'28"w 239.80' 317. 20 ' - - —^SURVEYOR:7 ' 77.40'-A\North line of Section 17-137-40 \Roy A. Smith and Associates Lincoln Professional Center Detroit Lakes, MN \ 'ft1 \1 o1 Control line for legal description I hereby certify that the subdivided property described in this survey meets the County requirements for public road access and sewage treatment systems. OWNER See Roy Smith Certificate of Survey T 3579-12 October 8, 198 7I' 320' i —_________283.09’ N84°ir'22"w/I LEGENDI I I Culvert ^ -- 05°26‘42" ff - 1273. 24' L - 121.00' OH. r 120.96' CH. BRG. • = Denotes iron monuments found, o = Denotes iron monuments set, marked with Minnesota Registration No. 12004/43807. Orientation of this bearing system is assumed. Scale: I inch = 100 feet. * -- N03°I4'38"£:\ ■West line of Gov't Lot I \I I I I I /D graphic 100 scale 200i Q UJ 00 rnIroI I CT B1in i /^, 1^^? C\J C\JooO Cerfificafion for Tract AUjCO COI OI I 0: J IT ;C Uj I- K- I I \ \ 86 OO'oo "------S West line of Gov’t Lot 2 I ^ of inptace drive li-) East line of Gov’t Lot 2 r - I-•-J o r-O S» ''N r -s. yNti Southeast corner of Gov’t Lot 2Southwest corner of Gov’t Lot 2 South line of Gov’t Lot 2 /PUBLICEXISTING ROAD T 5483-15f>> r LAND & RESOURCE MANAGEMENT OTTER TAIL COUNTY COURT HOUSE 121 W. JUNIUS AVE. • SUITE 130 Phone; (218) 739-2271 • FERGUS FALLS, MN 56537 APPLICATION FOR SITE PERMITWHITE - Office GOLDENROD - Inspector YELLOW - Owner (after issue) PINK - Assessor 19,1%Permit No.PLEASE PRINT OR TYPE ALL INFORMATION TWP NAMELAKE / RIVER NO.LAKE/RIVER CLASS,. ^jy SECTION TWP NO.RANGELAKE/RIVER NAME R.O si=J1 HOi316% E-911 ADDRESSPARCEL NUMBER (S) 32- ooo- n - Ol 2S ~ooo LEGAL DESCRIPTION 6cTS / ^. 2L Daytime Phone No,Mailing AddressLast Name First Initial Property Owner DIrtNn6L.^O/V' ■•?V7-?o4D Contractor Lie.#JImwuL (^CtJcac^V ONSITE SEWAGE TREATMENT ONSITE WATER SUPPLY Individual ( ) Public ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3’ (minimum) structure setback to a well. PROPOSED PROJECT (please circle the appropriate number) (2 ) Add’n to Dwelling (5) RCU/Year_____ (7 ) Add’n To Non-Dwelling ( 8) Utility/Stg Structure ( 9 ) WOAS (10) Other &( 3) 'Replacement Dwelling (6) Detached Garage ()() Permit No. ( )0TLSD* * This permit is only valid alter veriticalion from the 0. T.LS.D. that a conforming sewage system wilt be installed to service this tot contact Rottie Mann at 864-553^_____ (4) MH/YR. 'Existing Dwelling to be removed before. CHARACTERISTICS OF PROPOSED NON-DWELLINGCHARACTERISTICS OF PROPOSEDDWELLING. AL' X .3^' Dimension 2. fe Ft. x ^ Ln Ft." Setback to Lotline /fOO Ft. & /Vfl Ft." Setback to Right of Way JSOO Ft." Setback to OHWL /OO Ft. Elevation Above OHWL 12. Ft. Setback to Septic Tank / ^iP Ft, Setback to Drainfield ,/ Ft. Setback to Bluff CHARACTERISTICS OF PROPOSED WOAS Outside Dimension Setback to Lotline ___ Setback to Right of Way Setback to OHWL ___ Elevation Above OHWL Setback to Septic Tank _ Setback to Drainfield_ Setback to Bluff_____ Maximum Proposed Height Bathroom Proposed ( ) Yes ( ) No Outside Dimension Setback to Lotline___ Setback to Right of Way Setback to OHWL ___ Elevation Above OHWL, Setback to Septic Tank _ Setback to Drainfield__ Setback to Bluff_____ Maximum Proposed Height ( ) Boathouse ( ) Gazebo Ft. X Ft."Ft."Ft. X Ft."Ft.&Ft."Ft.& Ft."Ft." Ft.Ft. Ft.Ft. Ft.Ft. Ft.Ft. Maximum Proposed Height /.T Ft. I Ft.Ft. Basement Walkout Basement__ Total Bedrooms 2. No Ft.Ft. ( ) Screen Porch ( ) Utility Structure **Project/Lotlines/Right-of-ways Must be Staked Onsite Grade/Fill/Excavation « \ LST^es (scale drawing required) □ No fdU 5^0^ ) **Project/Lotlines/Right-of-ways Must be Staked Onsite Spoil Disposal ^ Onsite (scale drawing required) □ Offsite □ Within Shoreland Area □ Outside Shoreiand Area CHARACTERISTICS OF LOT: Lot Area HO ACKeS SerFF—Bluff Onsite____Yes X NoI35QFt,Water Frontage .%Impervious Surface RatioX 100 =.% Total Lot AreaTotal Impervious Surface Onsite (FT^)tm. THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES. Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set forth and according to the provisions of the Ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express condition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Ordinances of Otter Tail County, Minnesota, This permit may be revoked at any time upon violation of said Ordinances. I understand that it is my responsibiiity to inform the Land & Resource Management office once the building footings have been constructed. Date: Signature of Propei ler /-A9'DIDate: Land & Resource Management Office / m t QmjaI7ai4 - Uujjl puma) Mjixue) A /5£ V- 7 Th/m PilJAty AiJif /ifji..ir/Hi4/l rJhtft H tkdiyyi ys.ndPERMIT FEE $RECEIPT NO. Project/Lotlines/Right-of-Way MUST be Staked Onsite Prior to Submission of Application.Comments: Form No. BK — 0500-002 301.934 • Victor Lundeen Co . Pnntors • Fergus Falls. MN • 1-8 00-346-4870 I/ i OTTER TAIL COUNTY Conditional Use Permit # 5%0°\____ f?o$e 0(^ ^(^3 Piraz^^ i Owner’s Name Address < ;•• 'i 'Location: Lake No.*^"3toSec. *7 Twp. /iy Range ^0 Twp.Name■■. :•! 3 000- n- 0 i<yr-ov^ Work AuthorizGcl! broi^^^ ^ tree Is -j ycccct-fe Av/- v3i-He>' 1'^.^. LJuAy(!^ IfanvAH ct,Wef(cAAJ ry\ KfCLCDu^d Ji-K) 6<n^lz \60O') -h^doMJL. /fei^ceLs ^ k O^/Ifed ci^v- vSeffeetj Hfef te roA(j Ac/s•^ (KA^LCt Hfl wt+'lft.'id, -3^-00 I I Issued: Expires: Land and Resource Management Official;/ 1. Earthmoving shall be done between I. Entire area shail be stabilized within 10 days of the completion of any earthmoving. & 3. Owner is iegally responsible for all surface water drainage that may occur. 4. No fill shall enter or be taken from the beds of a public water without a valid permit from the State of Minnesota Department of Natural Resources. 5. If the terms of this permit are violated the entire permit may be revoked and the owner may be subject to legal prosecution. 6. This card shall be placed in a conspicuous place not more than 4 feet above grade on the premises on which work is to be done, and shall be maintained there until completion of such work. 7. NOTIFY DEPARTMENT OF LAND AND RESOURCE MANAGEMENT, TELEPHONE (218) 739-2271, WHEN AUTHORIZED WORK HAS BEEN COMPLETED. .1 i BK-1099-046 298.111 • Victor LundMnCBHMdOfS • FtrgiB Falii. MN • 1 •600-348-4870 f-v : • .•- . ■: d « ; •V // • • -isV -n ■iSS'-■•tS:/ V■■ ■ ■«. ■ -.S'?.■s APPLICATION FOR SITE PERMIT LAND & RESOURCE MANAGEMENT ^ OTTER TAIL COUNTY COURT HOUSEPINK - Assesso\^ 121 W. JUNIUS AVE. • SUITE 130 t A* •■^T'hone: (218) 739-2271 • FERGUS FALLS, MN 56537 WHITE - Office GOyDENROD - Inspector YELLOW - Owner (after issue) Permit No.PLEASE PRINT OR TYPE ALL INFORMATION SECTION RANGE TWP NAMETWP NO.LAKE / RIVER NO.LAKE/RIVER NAME LAKE/RIVER CLASS Kose Jl i31 E-911 ADDRESSPARCEL NUMBER (S) 32- ooo- n - <Dl 2S ' OOO LEGAL DESCRIPTION (^oo Lo r5 / <» z Daytime Phone No.Mailing AddressLast Name First Initial Property Owner /-> l f} ,■/1 , /TO / ✓ Ly ( 3 ; P.3>4?-7>o i-,0 Contractor Lie.#V v^uL (tenVeo■/ fV ■ ONSITE SEWAGE TREATMENT SYSTEM ONSITE WATER SUPPLY Individual ( ) Public ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3’ (minimum) structure setback to a well. PROPOSED PROJECT (please circle the appropriate number) ^^New Dwelling (4) MH/YR ' ' (7) Add'n To Non-Dwelling (8) Utility/Stg Structure (9) WOAS •Existing Dwelling to be removed before. (3) 'Replacement Dwelling (6) Detached Garage (2 ) Add’n to Dwelling (5 ) RCU/Year_____()() Permit No. ( )OTLSD* * This permit is on/y valid after verification from the 0.T.LS.D. that a conforming sewage system will be installed to service this lot contact Rollie Mann at 864-5533.(10) other. CHARACTERISTICS OF PROPOSED NON-DWELLINGCHARACTERISTICS OF PROPOSED DWELLING ' '' CHARACTERISTICS OF PROPOSED WOAS :<Outside Dimension Yi Ft. x ^ Ft.** Setback to Lotline Ft. & Ft." Setback to Right of Way /Tnn Ft." Setback to OHWL Ft. Elevation Above OHWL 17. Ft. Setback to Septic Tank / ?/0 Ft. Setback to Drainfield ^ O Ft.Setback to Bluff /{i^ Maximum Proposed Height /T Basement Yes Outside Dimension Setback to Lotline ___ Setback to Right of Way Setback to OHWL___ Elevation Above OHWL. Setback to Septic Tank _ Setback to Drainfield__ Setback to Bluff_____ Outside Dimension Setback to Lotline___ Setback to Right of Way Setback to OHWL ___ Elevation Above OHWL. Setback to Septic Tank _ Setback to Drainfield__ Setback to Bluff_____ Maximum Proposed Height ( ) Boathouse ( ) Gazebo / Ft. X Ft."Ft. X Ft." Ft.&Ft."Ft.&Ft." Ft."Ft." Ft.Ft. Ft.Ft. Ft.Ft. Ft.Ft.f Ft. I sroerj fes^i! U'f't' N(/^ Ft.Ft. Ft.Maximum Proposed Height Bathroom Proposed ( ) Yes ( ) No Ft. Walkout Basement__ Total Bedrooms 2L ( ) Screen Porch ( ) Utility Structure **Project/Lotlines/Right-of-ways Must be Staked Onsite □'Yes (scale drawing required) □NO . Grade/Fill/Excavation **Pro j ect/Lotl i n es/Ri gh t-of-way s Must be Staked Onsite Spoil Disposal p Onsite (scale drawing required) □ Offsite □ Within Shoreland Area □ Outside Shoreland Area CHARACTERISTICS OF LOT: Yes X Noi A S /YLot Area - 'i :,t c .r So. Ft.Bluff Onsite.Water Frontage .Ft. Impervious Surface Ratio .%X 100 =.% Total Lot AreaTotal Impervious Surface Onsite (FTr)(FTP THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES. Agreement; I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set forth and according to the provisions of the Ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express condition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Ordinances of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said Ordinances. I understand that it is my responsibility to inform the Land & Resource Management office once the building footings have been constructed. Date: Signature of Property Qwner Date: Land & Resource Managenwnt Office / PERMIT FEE $RECEIPT NO. Project/Lotlines/Right-of-Way MUST be Staked Onsite Prior to Submission of Application.- iUiild rJlAfj) iJvhWrri i- 7 t.g. V: L Comments: to. AylLL 1\ 3 ! f 3 ■! 301.934 • Victor Lundecn Co . Printers • Fergus Foils. MN • 1-800-346-4870Form No. BK — 0500-002I SITE PERMIT INSPECTION RESULTS Inspector must make all measurements and computations Structure Set Back from Ordinary High Water Level Ft.Ft.rwStructure Set Back from Top of Bluff Ft.Ft. Structure Set Back from Road Right of Way Ft.Ft. Ft.Structure Set Back from Lot Lines Ft.Ft. &Ft. 4" dbStructure Height Ft.Ft. Structure Set Back from Septic Tank Ft.Ft. 103+Structure Set Back from Drainfield Ft. Ft. Elevation Of Lowest Floor Above Ordinary High Water Level 16^Ft.Ft. Land Slope at Building Site /5 +%% Inspector’s Comments / Sketch: Inspector's Signature 9 /O'Cf Date of Inspection IhMTime of Inspection <P '/C -cr'^^^^^o\ect Approved Date/Initial OTTER TAIL COUNTY eectv PmT v^~ - cne<L^ I Grade & Fill Permit^ /s-^/ Cj^OSC ^\OC;C/^oc (PiSCKf5r?pi^'OWNER’S NAME;f6fi- H.T 3 Box Sis ^ LiOCd-tlOn* Lake Nn^^’^ae,/7 ^^./3^ Range Vp Twp Name HieMCr F'HAiee./ytrJAddress@ j Sublet oF nijN t/uj *JtfExce^as <3.\.z<kL)c7<^ *((4k-^ <Ss s4-^\ c^V V- 5 p m (V-3J -M>-n-DOS -OCO ^ Issued^^^/2__1 9_£l_, Expires_Z£i^^^ 19_f^ Work Authorized^4oi^ p ..a 5 ■ l^n/AA Ois^Mtsm <y«ttyTtrP<3 3 ( Lull g>/=~ Ttfg OKTUaAAt^t^^ — /l/<0 fViaTH A^6L>ir./f; UJiTHimt Sc' Ofi Tt*C LA-!<.C - A/^ £‘t^itXH^^vinG LJi7»tf^ 3£> Fpt^^e. Uf^e fOV/g ~ />1tt^r />^/%g/vg»nrf thrtTCH tle>rto HciGht Orf iEi-meo stoe/HAV. oemi Cur NOTE: This card shall be placed in a conspicous place not more than 4 feet above grade on the premises on which work is to be done, and shall be maintained there until completion of such work. NOTIFY DEPARTMENT OF LAND AND RESOURCE MANAGEMENT, TELEPHONE (218) 739-2271 WHEN AUTHORIZED WORK HAS BEEN COMPLETED. EricSfCH CjayuTH^L -OTTER TAIL COUNTY, MINNESOTA Board of County CommissionersS, Land and Resource Ms^pagement Official !&/3 s1. Earthmoving shall be done between 2. Entire area shail be stabilized within 10 days of the completion of any earthmoving. 3. Owner is legally responsible for all surface water drainage that may occur. 4. No fill shall enter or be taken from the beds of a public water without a valid permit from the State of Minnesota Department of Natural Resources. 5. If the terms nf this nerrhit are violated the entire nermit mav be revoked and the owner mav be subject APPLICATION FOR SITE PERMIT LAND & RESOURCE MANAGEMENT OTTER TAIL COUNTY COURT HOUSE Phone:(218) 739-2271 • FERGUS FALLS, MN 56537 WHITE - Office C^LDENROD - Mspector YELLOW'- Owner PINK - Assessor HonRose I 'frs Permit No.LEGAL DESCRIPTION BLUFF ZONEAND □ YES □ NO LOCATION LAKE NUMBER LAKE/RIVER NAME LAKE/RIVER CLASS SECTION TWP NO.RANGE TWP NAME ri JjfD^6-360 /3'7-3^ PARCEL NUMBER (S)TOPOGRAPHICAL ALTERATION □ YES # OF CUBIC YARDS FIRE NUMBER /// 7 0 4,3Z~C>ot)~n. - - oo o NO IDENTIFICATION; Please Print All Information TELEPHONE NO. Last Name First Initial Mailing Address — No. Street, City, State, and Zip Code (Daytime) Property Owner ^^3 Am. „. azj^'P^Z'-7.o63)CySQH I Oe>G- Name gj CO IZ.Contractor State Lie. # PROPOSED PROJECT (X) New Slructure(s) ( ) Additlon(s) ( ) MH/RV______________ PROPOSED USE ( ) Dwelling fVMWalef Oriented Accessory Structure ■'^'^(TOAS) ONSITE WATER SUPPLY ()^ Individual ( ) Public ( ) None ONSITE SEWAGE TREATMENT SYSTEM (I'fTndividual Permit # ^ ( ) Collector Permit #_____ ( )OTLSDYEAR CHARACTERISTICS OF NON-DWELLING ( ) Utility Structure {t/fOlher fiS\^ CL£RH\r><3 Outside Dimension CHARACTERISTICS OF DWELLIN ( )^ng ( ) Additibnlo Dwelling ( ) BasemenK ( ) Walkout B^ment Outside Dimension CHA^CTERISTICS OF WOAS ( ) Boatflause ( ) Screen Porch( ) Garage (X) Utility ^ruciure '( ) Gazebo 8___Ft.x ___Ft.( ) Other. Outside DimensionFt.x Ft.Lotline Setbacks Ft.&.Ft. Lotline Setbacks..Ft.OHWL Setback Ft. Lotline Setbacks FIS'Ft. OHWL Setback Ft.Bathroom: ( )Yes ()<[)No (If Yes / a complying Sewage System Required)OHWL Setbai y bu .Ft. Total Bedrooms Maximum Height /10 ft. (1 story)Maximum Height / 30 Ft. (2 story)Maximum Height /18 Ft. (1 story) Lot Area is (Sq. Ft.) SO QC£.irS .. Water frontage Ft. Maximum depth of lot Ft. /OElevation of lowest floor above OHWL (3 Ft. Min.)Ft. Slope of lot .% Structure setback to right-of-way Ft. Structure setback to septic tank_________ Dwelling setback to Soil Absorption System Non dwelling setback to Soil Absorption System ’Z-OT) Ft. (10’minimum) (Sewage System Permit required before installation). Zoo Ft. (20’minimum) (Sewage System Permit required before installation). Ft. (10’minimum) (Sewage System Permit required before installation). ms IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16. MINNESOTA STATE STATUTES. Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set forth and according to the provisions of the Ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express condition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Ordinance of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said ordinances. I understand that it is my responsibility to inform the Land & Resource Management office once the building footings have been constructed. f). wner 3 - ■? -9 c>Dated: Signature of O Dated: Land & Resource Management Office PERMIT FEE $ O O ckJ^3l9S'RECEIPT NO. % sisrems TMC —Comments: Form No. BK — 0795-002 277.A10 • Victor Luirdeen Co Printers • Fergus Falls. MN • 1-800-346-4870 J WHITE - Office GOLDENHOif- Inspector YELLOW - Ovmer PINK - Assessor APPLICATION FOR SITE PERMIT LAND & RESOURCE MANAGEMENTOTTER TAIL COUNTY COURT HOUSE Phone:(218) 739-2271 • FERGUS FALLS, MN 56537 X HO/I/Zwc^E Permit No.LEGAL DESCRIPTION BLUFF ZONEAND □ YES □ NO LOCATION LAKE NUMBER LAKE/RIVER NAME LAKE/RIVER CLASS SECTION TWP NO.RANGE TWP NAME /7-3^0 J3-73^‘3^ PARCEL NUMBER (S)TOPOGRAPHICAL ALTERATION □ YES # OF CUBIC YARDS NO_______________________ FIRE NUMBER PZ -OOA- Jy - 0/ z 8 - 00 O /V/70 G IDENTIFICATION: Please Print All Information TELEPHONE NO. Last Name First Initial Mailing Address — No. Street, City, State, and Zip Code (Daytime) Property Owner 1^0i Q £ g. 3 K SjS P. t'Ez /nri. . y ,, ;^o6 0(CX-SON Ro,S^ i^e-SorCT NameContractor State Uc. # PROPOSED PROJECT (X) New Structure(s) ( ) Addition(s) ( ) MH/RV______________ PROPOSED USE ( ) Dwelling ’p4^Non-Dwelling /VljriWater Oriented Accessory Structure ’ ^(WOAS) ONSITE WATER SUPPLY 0^ Individual ( ) Public ( ) None ONSITE SEWAGE TREATMENT SYSTEM (P^ndividual Permit #__it ( ) Collector Permit #_____ ( )0TLSD ■ YEAR CHARACTERISTICS OF DWELLIN ( jOivelling ( ) Additibg to Dwelling ( ) Basemenf\^ ( ) Walkout Bbsement Outside Dimension_______X\ CHARACTERISTICS OF NON-DWELLING ( ) Utility Structure (✓J^ther Outside Dimension CHARACTERISTICS OFWOAS ( ) Boathoyse ( ) Screen Poich( ) Garage / ( ) Gazebo S___Ft.x £__Ft.( )Other, Outside DimensionLotline SetbacksFt.x .Ft..Ft.&.Ft.isSrUFt. Lotline Setbacks.■t.&.Ft.OHWL Setback .Ft. Lotline Setbacks .FI.Ft. OHWL Setback .FI.(>ONoBathroom: ( ) Yes (If Yes / a complying Sewage System Required)//bX)OHWL Setbi FI. Total Bedrooms mfjriMaximum Height / 30 Ft. (2 story)Maximum Height /18 Ft. (1 story)Maxi m Height /10 ft. (1 story) Lot Area is (Sq. Ft.) ac iL trS .. Water frontage .Ft. Maximum depth of lot Ft. /OElevation of lowest floor above OHWL (3 Ft. Min.) Structure setback to right-of-way----------- ---------- Structure setback to septic tank______________ Dwelling setback to Soil Absorption System____ Non dwelling setback to Soil Absorption System Z. o O .Ft. Slope of lot .% .Ft. 7 an Ft. (10’minimum) (Sewage System Permit required before installation). ZoC>Ft. (20’minimum) (Sewage System Permit required before installation). Ft. (10'minimum) (Sewage System Permit required before installation). THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES. Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set forth and according to the provisions of the Ordinances of Otter Tail County, Minnesota. 1 further agree that any plans and specifications submitted herewith shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express condition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Ordinance of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said ordinances. I understand that it is my responsibiiity to inform the Land & Resource Management office once the building footings have been constructed. 3 ~ -Z <r' J.Dated: Sf^yature of Owner Dated: Land & Resource Management Office\PERMIT FEE $ 3 0 RECEIPT NO. %: ^iSTToxi, Tyc —Commertts: Form No. BK — 0795-002 277.4f8 * Victor LonOeen Co Printers * Fergus Falls. MN * 1-600-346-4870 -W- ;-V* '*» iINSPECTION RESULTS Make all measurements and computations -h Ft.Structure Set Back from Ordinary High Water Level Ft./OO o«C Ft.Ft.Structure set Back from Top of Bluff ~h Ft.Structure Set Back from Road Right of Way Ft. Ft.& -S'cf Ft.Ft.Ft.&Structure set Back from Lot Lines 10 ^Ft.Ft.Structure Height 4-Ft.Structure Set Back from Septic Tank Ft.10 Ft. Ft.Structure Set Back from Absorption System Elevation Of Lov\/est Floor Above Ordinary High Water Level____________________4-Ft.Ft./o — %%Land Slope at Building Line Inspector’s Comments / Sketch: S* ^ I!ii ! ( //X V ( 4-VE7 ^ +L/00t A ^ 4^Inspector's Signature \ \II- 'lA'ri Date of Inspection 1 Time of Inspection t \’PT: 4-r f t fsiS-I ;p/t^ w • fl 0/x^ 4f ^<•f 1I :t itII1i - 4 • I!I T^ii^c,a€s^He ^' "rIi'r'ti!I!t»:'tirr Ts;if!Ii;f I i »-j i !tiiT 4 ^o/>c<aT^ B/oc(C \i->I!i T jt J 11IJ1!--;II I:I ■4-1 .; s/^s ;I- iH k H8'4.T t *4-I I !1-i ;i r-I;i I;IiIt t 4- I CotocoIJ 1 *1 I 1- iX - : 72>jtJc' /PS /O^A /P7a^/c' ;1!0i. !(%\\0 r i i. Ir1 ;i i -r- * i-Ji r--!.__t_! s/*s i I ■t--f!8' \f— •:.t3iI11 /s'Scale: Each grid equals feet/inches GRID PLOT PLAN SKETCHING FORM /S/i'/ee* /A, Dated:19 Signature Please sketch your lot indicating setbacks from road right-of-way, lake and sideyard for each building currently on lot and any proposed structures. I \ du/c/e^7— firf ¥\PuSLlC. Accessr^ar'^ 4^y Pf/Oy/ascO //CiAiriT' :ii -h VI \ t KK------1 4■---------r C: H tj -/aso* Ttix TduU/SAty/ Me/i MKL-0871-029 21S98 7@ VICTOR LUNDEEN CO.. PRINTERS. FERGUS FALLS. UINN. SHORELAND MANAGEMENT — COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 • FERGUS FALLS, MN 56537 APPLICATION FOR SITE PERMIT WHITE — Office GOLDENROD — Inspector YELLOW — Owner PINK — Assessor yZMSPermit No.LEGAL / qc; Z- DESCRIPTION AND oo C~o 7~ LOCATION LAKE/fWSR NAME SECTION TWP RANGE TWP NAMELAKE NUMBER LAKE/FWe« CLASS //o&/^YeLT~2oStr Vo5^'3bO / 7 PARCEL NUMBER (S)FIRE OR LAKE ASSOCIATION NUMBER 32.-000 - ti ~ o/zs-ooa // / 7 o fo IDENTIFICATION: Please Print All Information Mailing Address — No. Street, City and State Zip CodeLast Name First Initial Telephone No. ^ a r\ O ^Ef2.3 Box S’/S ,/n*/OUSoN gYZ-Zc.feOProperty Owner D NameContractor State Lie. # RESIDENTIAL USE NON-RESIDENTIAL USE ( ) Garage ( ) Utility Structure ( ) Water Orientated Accessory Structure ( X ) OtherSK<*J<- CHARACTERISTICS OF PROPOSEDPROPOSED PROJECT ( ) New Structure ( ) Addition ( ) Other PROPOSED USE ( ) Residential ( ^ ) Non-Residential ( ) One Familv,0^lling ( ) Multiple^Owelling Units ( ) Basement ( ) Walkout Basement ( ) Outside Dimension of Structure_____.i4 X i6 Ft. TYPE OF FRAME ( ^) Masonry ( X') Wood ( ) Structural Steel ( ) Other ONSITE SEWAGE DISPOSAL SYSTEM ONSITE WATER SUPPLY Height of Structure. # Of Stories Ft. I( ) Public (/) OFFICE USE ONLY ( iJfi) Bluff Impact Zone (lyrt’) Shore Impact Zone Sensitive Area ( ) Public ft Of BedroomsIndividual # Of Bathrooms) None ( ) OTLSD LOT SIZE AND SETBACKS: feet. Maximum depth of lot feet.equore feet. Water frontage isLot Area is /(DOBuilding set back from ordinary high water level is feet. (String Test) f^tg- ^ / V g p 1 4 1992 /oLand height above ordinary high water level at building line is feet. Slope o % 2Building set back from road right-of-way.feet. 10 feet.Lot line setback is and feet from septic tank (Sewage System Permit must be obtained befoVi^fi'ih&llation).199^2^Structure will be located /O oStructure will be located feet from soil absorption system (Sewage System Permit must be obtained before installation). Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set forth and according to the provisions of the Ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES. Signafure of Owner Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon the express condition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Ordinance of Otter Tall County, Minnesota. This permit may be revoked at any time upon violation of said ordinances. g - Z2.Dated: ts.^-/g-9D SO.OD Dated: Land & Resource Manageiyfent Office Permit Fee $Receipt No. Comments: ^ O'Tl— Zq 262,358 — Victor Lundeen Gn Minnesoi ..-S' r 10s«SHORELAND MANAGEMENT — COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 • FERGUS FALLS, MN 56537 APPLICATION FOR SITE PERMIT WHITE — Office GOLDENHOD — Inspector YELLOW — Owner PINK — Assessor imsPermit No.LEGAL ■ 1-DESCRIPTION AND <co r~acJ LOCATION SECTION RANGE TWP NAMETWPLAKE NUMBER LAKE/RtVER NAME LAKE/RWER CLASS Vof>'o”3toO n )S 1 / FIRE OR LAKE ASSOCIATION NUMBERPARCEL NUMBER (S) 3Z--oc^o ~ / 7 ~ OT ZS~ noa / ■/ / 7 O io IDENTIFICATION: Please Print All Information Mailing Address — No, Street, City and State Zip Code Telephone No.First InitialLast Name |C _ I r': o 'CiL. -L C:.CK ^r L tL o U Q: . : ■ /} ] /VProperty Owner V ■cName A CContractor State Lie. # NON-RESIDENTIAL USE ( ) Garage ( ) Utility Structure ( ) Water Orientated Accessory Structure CHARACTERISTICS OF PROPOSEDPROPOSED USE ( ) Residential ( ) Non-Residential RESIDENTIAL USE ( ) One Family Dwelling ( ) Multiple Dwelling tToI Units { ) PROPOSED PROJECT Basement ( ) Walkout Basement ( Outside Dimension of Structure. ( > ) New Structure ( ) Addition ) Other .iJUS—Ft.iI (J. ONSITE SEWAGE DISPOSAL SYSTEM ONSITE WATER SUPPLYTYPE OF FRAME ( ) Masonry ( ) Wood ( ) Structural Steel ( ) Other ( X ) Other Height of Structure. # Of Stories______ Ft. /( ) Public (/) OFFICE USE ONLY ( Bluff Impact Zone (l>/W) Shore Impact Zone (Sensitive Area ( ) Public ( >: ) Individual ,. *Permit # 3^83 ( ) OTLSD # Of BedroomsIndividual •z..# Of Bathrooms) None LOT SIZE AND SETBACKS: feet. Maximum depth of lot feet..square feet. Water frontage isLot Area is feet. (String Test)Building set back from ordinary high water level is feet. Slope of lot %Land height above ordinary high water level at building line is 2 O feet.Building set back from road right-of-way -f-lA feet.andLot line setback is 26 feet from septic tank (Sewage System Permit must be obtained before installation).Structure will be located feet from soil absorption system (Sewage System Permit must be obtained before installation).Structure will be located Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set forth and according to the provisions of the Ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16. MINNESOTA STATE STATUTES. - y . -y:Dated: SignaXure of Owner Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon the express condition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Ordinance of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said ordinances. •Mad. ..'•r IdDated: Land & Resource Mana^ment Office Receipt No. / L ' 2Permit Fee $. '-.Arc \il yJ r /V y ^ S'Comments:/ ,7.2. <2 (a' /7>W:\A V 7 / L_/ X...QAf Form No. BK — 0292-002 ' *=-“• Minnesota262.358 - ' '■ '*' ••T-),-''V. ‘ " ,• r' J »INSPECTION RESULTS Make all measurements and computations: .\. * : ACTUAL MINIMUM Sq. Ft. Lot Area (Square feet)Sq. Ft.Sq. Ft. Water Frontage Ft.Ft. to (Building Set Back from High Water Level Ft.Ft. Building Set Back from Top of Bluff Ft.Ft.30 ^OcH~Building Set Back from Road Right of Way 20 Ft.Ft. fO^ Ft. & (Q-^Building Set Back from Lot Line Set Back Ft.Ft. Ft. Ft.Building Height Building Set Back from Septic Tank 10 FtFt. I‘/OBuilding Set Back from Absorption System 20 FtFt. Elevation Above High Water Level at Building Line 3 Ft.Ft. Land Slope at Building Line o/o Inspector’s Comments: \ 1* Sketch: c4f r~ o f rurr O r\(rt' Inspector s Signature Date of Inspection Time of Inspection APPLICATION FOR SITE PERMIT LAND & RESOURCE MANAGEMENT OTTER TAIL COUNTY COURT HOUSE Phone:(218)739-2271 • FERGUS FALLS, MN 56537 WHITE ■ Office GOLDENROD - Inspector YELLOW ■ Owner PINK - Assessor /S3SS'€co Cc / ^£ri<strt^r /2/O^C Permit No.LEGAL DESCRIPTION BLUFF ZONEAND9/□ YESLOCATION s NO SECTION TWP NO.RANGE TWP NAMELAKE/RIVER CLASSLAKE/RIVER NAMELAKE NUMBER 11 /37 //o S/J/ZRo Sg-VO GRADING / FILLING □ YES # OF CUBIC YARDS □ NO FIRE NUMBERPARCEL NUMBER (S) /-//7OC,3z~ OOP -n - 0/zff - <700 IDENTIFICATION: Please Print All Information TELEPHONE NO. Mailing Address — No. Street, City, State, and Zip Code (Daytime)First InitialLast Name Property Owner 3 .rAJVVj2o/anTi -2aL0Cl -s'oa/ NameContractor State Lie. # ONSITE WATER SUPPLY (<»f1ndividual ( ) Public ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3' (minimum) structure setback to a well. ONSITE SEWAGE TREATMENT SYSTEM (i^ndividual Permit # ( ) Collector Permit # ( )OTLSD* PROPOSED PROJECT (*)^1ew Structure(s) ( ) Addition(s) ( ) MH/RV______________ PROPOSED USE ( ) Dwelling (</)^on-Dwelling ( ) Water Oriented Accessory Structure (WOAS) WOAS 0YEAR CHARACTERISTICS OF NON-DWELLING ( ) Garage (y) Other 'fCh & u1 e» rZ. ti ft i,l.5 «L Outside Dimension CHARACTERISTICS OFCHARACTERISTICS OF DWELLING ( ) Utility Structure ( ) Boathouse ( ) Screen Porch( ) Dwelling ( ) Addition to Dwelling ( ) Basement ( ) Walkout Basement Outside Dimension__________ ( ) Gazebo ( ) Utility Structure )8W .FI.( ) Other, Outside Dimension Ft. X Lotline Setbacks .300 Ft. & ‘7 S Q Ft..Ft.Ft. X Ft. X .Ft. 350Lotline Setbacks .Ft.&.Ft.OHWL Setback .Ft. Lotline Setbacks Ft.&FI. .Ft.OHWL Setback Bathroom: (X) Yes ( ) No (If Yes / a complying Sewage System Required)OHWL Setback .Ft. Total Bedrooms__________________ Maximum Height / 35 Ft. (2 story)/Q Ft._L Maximum Height / 10 ft. (1 story)Maximum Height story So /Vo Q -SqrFl. Impervious Surface .Sq. Ft. Impervious Surface Ratio .%Lot Area .Ft. Elevation of lowest floor atx>ve OHWL .Ft. (3’ minimum)Wafer Frontage .Ft. Slope of lotStructure setback to right-of-way .% Ft. (10'minimum) (Sewage System Permit required before installation).Structure setback to septic tank tfca..Ft. (20'minimum) (Sewage System Permit required before installation).Dwelling setback to Soil Absorption System I5Q Ft. (10’minimum) (Sewage System Permit required before installation).Non dwelling setback to Soil Absorption System THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES. Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set forth and according to the provisions of the Ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express condition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Ordinance of Otter Tail County Minnesota. This permit may be revoked at any time upon violation of said ordinances. I understand that it is my responsibiiity to inform the Land & Resource Management office once the buiiding footings have been constructed. * This permit is only valid alter verification from the O.T.LSD. that a conforming sewage system will be installed to service this lot... Contact Rollie Mann at 864-5533. RECEIVED9 -/c- 97Dated; SignatuFB of Owner SEP 19 1997TTZT"-Dated; Land S Resource Management Office Li . ■I2-Cj1iq-PERMIT FEE $RECEIPT NO. Comments:/o /7r)/i7T>^ yi/^uy ^ V>«-Cr " \-^\\ 3pprcvi V?y I Svv Form No. BK — 0597-002 287.666 • Victor Lundeen Co . Printers > Fergus Fells. MN • 1-8OO-346-407O APPLICATION FOR SITE PERMIT LAND & RESOURCE MANAGEMENT OTTER TAIL COUNTY COURT HOUSE Phone:(218)739-2271 • FERGUS FALLS. MN 56537 WHITE - Off/c* GOLDENROD - Inspector YELLOW-Owner \ PINK - Assessor VC- 77~/Vi Permit No.LEGAL DESCRIPTION BLUFF ZONEAND □ YES E] NO -------X------------------- LOCATION TSECTIONTWP NO.RANGE TWP NAMELAKE/RIVER CLASSLAKE/RIVER NAMELAKE NUMBER /3, i/Z /,<i o S fe~V/ 3Oi■ GRADING / FILLING □ YES # OF CUBIC YARDS □ NO FIRE NUMBERPARCEL NUMBER (S) -7 Z - OOP ~ n ~ O ! zs -j ■' IDENTIFICATION: Please Print All Information TELEPHONE NO. Mailing Address — No. Street, City, Stale, and Zip Code (Daytime)InitialFirstLast Name Property Owner l2O //tj'i n Ta J'v H 3^7 -?nL(Ju L QA/o V uT/S' t-<■. / • 2.. cr cy /}’ / Y S' A rm fcNameContractor State Uc. # nPROPOSED USE Y . i ) | ( ) Dwelling ,m i i ) (, )-Non-Dwelling ( ) Water Oriented Accessory Structure (WOAS) 'ONSITE SEWAGE TREATMENT SYSTEM (i ^Individual Permit # //^ C ) Collector Permit #_ ( )OTLSD* ONSITE WATER SUPPLY (,')1ndividual ( ) Public ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3' (minimum) structure setback to a well. PROPOSED PROJECT .£( ) New Slructure(s) ( ) Addition(s) ( ) MH/RV_______ ■.i \ ! 6 I"/YEAR .1h.r“-IdCHARACTERISTICS OF WOASCHARACTERISTICS OF NON-DWELLING ( ) Garage ( ) Utility Structure CHARACTERISTICS OF DWELLING ( ) Screen Porch( ) Boathouse( ) Dwelling ( ) Addition to Dwelling ( ) Basement ( ) Walkout Basement Outside Dimension____________ ( ) Gazebo ( ) Utility Structure(X) Other *^'h a i-J e /c. Outside Dimension 1 i e_ hi___Fix IS ( )other. Outside Dimension .Ft. I Lotline Setbacks 30O Ft. & ~7 5 O Ft..Ft.Ft. X .Ft. X .Ft. .Ft.Lotline Setbacks .Ft.&OHWL Setback .Ft. Lotline Setbacks .Ft.&.Ft. .Ft.OHWL Setback Bathroom: (X) Yes { ) No (If Yes / a complying Sewage System Required)OHWL Setback.Ft. Total Bedrooms_____________________ Maximum Height / 35 Ft. (2 story)i C> Ft. S story Maximum Height /10 ft. (1 story)Maximum Height So ^.^Sq.'Ff. Impervious Surface Sq. Ft. Impervious Surface Ratio .%Lot Area a±L/yo Q .Ft. (3’ minimum).Ft. Elevation of lowest floor above OHWLWater Frontage 3oO Ft. Slope of lot .%Structure se'.back to right-of-way Z.<DO Ft. (10’minimum) (Sewage System Permit required before installation).Structure setback to septic tank Ft. (20’minimum) (Sewage System Permit required before installation). Ft. (10’minimum) (Sewage System Permit required before installation). Dwelling setback to Soil Absorption System___ Non dwelling setback to Soil Absorption System ;5G THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES. Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set forth and according to the provisions of the Ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express condition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Ordinance of Otter Tail County Minnesota. This permit may be revoked at any time upon violation of said ordinances. I understand that it is my responsibility to inform the Land & Resource Management office once the building footings have been constructed. * This permit is only valid after verification frora the O. T.LSD. that a conforming sewage system will be installed to service this lot... Contact Rollie Mann at 864-5533. ■ ’•‘4 9 - y c - 9 ^Dated: Signature of Owner (■ iDated: Land & Resource Managwnent OfSoe i -hiv -vVRECEIPT NO.PERMIT FEE $ 7 Comments: ■ '..'o.:... f ypylAT C.S'. r•r-:: • ..X7^ iL- Ijl /v>|-}- IS;V ^C» Y —E K Vr ov;o o rN \k. 6 Form No. BK — 0597-002 287.686 * Victor Lundeen Co. Printers • Fergus Falls. MN ■ 1-BOO-346-4870 INSPECTION RESULTS I Make all measurements and computations I Structure Set Back from Ordinary High Water Level Ft. Ft. Structure set Back from Top of Bluff Ft. Ft. ^crO j-Ft. Ft.Structure Set Back from Road Right of Way Ft. &^W4rFt.Ft.&Ft.Structure set Back from Lot Lines /6 4^Ft.Structure Height Ft. /06 'h Ft.Structure Set Back from Septic Tank Ft. 16^Structure Set Back from Absorption System Ft. Ft. Elevation Of Lowest Floor Above Ordinary High Water Level____________________lO ^Ft.Ft. % %Land Slope at Building Line Inspector’s Comments / Sketch:r Inspector's Signature Date of Inspection 'Ahinspection APPLICATION FOR SITE PERMIT LAND & RESOURCE MANAGEMENT OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 • FERGUS FALLS, MN 56537 WHITE - Office GOLDENROD - Inspector YELLOW - Owner PINK - Assessor iGiiC)Permit No.LEGAL DESCRIPTION / y(^^0- Uorfs BLUFF ZONEANDK1 YES □ NO LOCATION LAKE/RIVER CLASS SECTION TWP NO.RANGE TWP NAMELAKE NUMBER LAKE/RIVER NAME /I /31 ¥0 GRADING / FILLING YES # OF CUBIC YARDS □ NO PARCEL NUMBER (S)FIRE NUMBER R.3ZOOHO/28COO IDENTIFICATION: Please Print All Information TELEPHONE NO. First Mailing Address — No. Street, City, State, and Zip Code (Daytime)InitialLast Name Property Owner D /2£3 Spy S/S 2i8-3»42.'ZoCOO^-SiC/Y ^£.CF^NameContractor State Lie. # ONSITE WATER SUPPLY ( ) Individual ( ) Public None NOTE: MN Rules dipt. 4725 (MN Well Code) requires a 3' (minimum) structure setback to a well. ONSITE SEWAGE TREATMENT SYSTEM Individual Permit # ( ) Collector Permit #_ ( jOTLSD* PROPOSED USEPROPOSED PROJECT New Structure(s) ( ) Addition(s) ( )MH/RV______________ ( ) Dwelling Non-Dwelling { ) Water Oriented Accessory Structure (WOAS)YEAR CHARACTERISTICS OF WOASCHARACTERISTICS OF NON-DWELLING Utility Structure CHARACTERISTICS OF DWELLING , ( ) Screen Porch( ) Boathouse( ) Detached Garage( ) Basemen)/ ( ) Walkout ( ) AJtefched Garage or before ( ) Dweltina ( ) ReplacemefttsQwelling ( ) Addition to Dweliiilgv ( ) Existing Dwelling shall beTqmovei Outside Dimension. ( ) Utility Structure( )G^bo( ) Other Outside Dimension 3M ZS Ft.( )other. Outside Dimension Ft. X SF Lotline Setbacks SiD.Ft.T. X .Ft..Ft. Ft.Lotline Setbacks .Ft. &OHWLSetback ZoQ -h .Ft..Ft.Lotline Setbai ,FL Ft.OHWL Setback Bathroom: ( )Yes (X”)No (If Yes / a complying Sewage System Required).Ft.OHWL SetbackTotal Bedrooms__________________ Maximum Height / 35 Ft. (2 story) Maximum Height / 10 ft. (1 story)Ft.Maximum Height story <2 .%.Sq. Ft. Impervious Surface RatiojSq.-Ff. Impervious SurfaceLot Area nL/^oo .Ft. (3’ minimum).Ft. Elevation of lowest floor above OHWLWater Frontage Structure setback to right-of-way____________ Structure setback to septic tank_____________ Dwelling setback to Soil Absorption System___ Non dwelling setback to Soil Absorption System ci/<C .%__________Ft. Slope of lot Ft. (10’minimum) (Sewage System Permit required before installation). .Ft. (20’minimum) (Sewage System Permit required before installation). .Ft. (10’minimum) (Sewage System Permit required before installation). ^6 I .20 THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES. Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set forth and according to the provisions of the Ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith shail become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express condition that the person to whom it is granted, and his agent, employees and workmen shall conform in ail respects to the Ordinance of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said ordinances. I understand that it is my responsibiiity to inform the Land & Resource Management office once the building footings have been constructed. * This permit is only valid after verification from the O. T.L.SD. that a conforming sewage system wiii be installed to service this lot... Contact Rollie Mann at 864-5533. cJ.Dated:RECEIVED— -OCT—G 199B- lANnRFROlIRCE Signature of Owner la-Dated: Land S Resource Management OfficeI •L’?(TS~)PERMIT FEE $___RECEIPT NO. Comments: X Form No. BK — 0597-002 290.621 • Victor Lundeen Co . Printers • Fergus Falls. MN • 1-800-346-4870 APPLICATION FOR SITE PERMIT LAND & RESOURCE MANAGEMENTOTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 • FERGUS FALLS, MN 56537 \tf 'HITE - Office GOLDENROD - Inspector YELLOW - Owner PINK - Assessor \I* /' Permit No.LEGAL DESCRIPTION y / VGao- LoT-s BLUFF ZONEAND E YES □ NO LOCATION TWPNO.LAKE/RIVER CLASS SECTION RANGE TWP NAMELAKE NUMBER LAKE/RIVER NAME /7 T~/31 ^'OLAi<(enf-o GRADING / FILLING □' YES # OF CUBIC YARDS □ NO PARCEL NUMBER (S)FIRE NUMBER lOlZSOOO IDENTIFICATION: Please Print All Information TELEPHONE NO. Mailing Address — No. Street, City, State, and Zip CodeFirst (Daytime)InitialLast Name Property Owner O ,<a3 G’o)(2/S-3hI-ZoCOOL.S0/Y NameContractor State Lie. # PROPOSED PROJECT ( ) New Structure(s) ( ) Addition(s) ( )MH/RV______________ ONSITE WATER SUPPLY ( ) Individual ( ) Public None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3' (minimum) structure setback to a well. ONSITE SEWAGE TREATMENT SYSTEM PROPOSED USE ( ) Dwelling ()(^) Non-Dwelling ( ) Water Oriented Accessory Structure (WOAS) ^5 Individual Permit # / i ( ) Collector Permit #. ( )OTLSD*YEAR CHARACTERISTICS OF WOASCHARACTERISTICS OF NON-DWELLING I3> Utility Structure CHARACTERISTICS OF DWELLING ( ) Boathouse ( ) Screen Porch( ) Detached Garage( ) Basement ( ) Walkout ( ) Attached Garage ( ) Dwelling ( ) Replacement Dwelling ( ) Addition to Dwelling ( ) Existing Dwelling shall be removed on or before. ( ) Utility Structure( ) Gazebo( ) Other Outside Dimension Ft.23—fix ( )Other. Outside Dimension ( Outside Dimension.Lotline Setbacks -523 A Ft. &__^^L£__Ft.Ft..Ft. X .Ft. .Ft..Ft,&Lotline Setbacks OHWL Setback / OHWL Setback Zoo t-Ft..FtX/.Ft.Lotline Setbar /.Ft.Bathroom: ( ) Yes (>,') No (If Yes / a complying Sewage System Required).Ft.OHWL Setback Total Bedrooms__________________ Maximum Height / 35 Ft. (2 story)Maximum Height /10 ft. (1 story)Ft..Maximum Height .story .Sq. Ft. Impervious Surface Ratio .%.Sq^Pt. Impervious SurfaceLot Area .Ft. (3’ minimum)Ft. Eievation of lowest floor above OHWLWater Frontage - S-'/1 .%__________Ft. Slope of lot .Ft. (10’minimum) (Sewage System Permit required before installation). .Ft. (20’minimum) (Sewage System Permit required before installation). .Ft. (10’minimum) (Sewage System Permit required before installation). Structure setback to right-of-way____________ Structure setback to septic tank_____________ Dwelling setback to Soil Absorption System___ Non dwelling setback to Soil Absorption System 31 I THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES. Agreement; I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set forth and according to the provisions of the Ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith shall become a part of this permit application. I also understand that this permit is valid tor a period of six (6) months. Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express condition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Ordinance of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said ordinances. I understand that it is my responsibiiity to inform the Land & Resource Management office once the building footings have been constructed. * This permit is only valid after verification from the O.T.L.SD. that a conforming sewage system will be installed to service this lot... Contact Rollie Mann at 864-5533. --rDated:<1 Ci Signature ot Owner ^ ^ -----( I 'N /a - 1 c <—"Dated: Land S Resource Management Office -5:0 ■RECEIPT NO.PERMIT FEE $ Comments: 290.m ■ Victor Lundoon Co. Printers • Fergus Fells. MN • 1-800-346-4870Form No. BK — 0597-002 )/ 4 \%INSPECTION RESULTS Make all measurements and computations 2o-q j-Structure Set Back from Ordinary High Water Level Ft. Ft. Structure set Back from Top of Bluff Ft.Ft. 5o< -hStructure Set Back from Road Right of Way Ft. Ft. ^M^Ft.&_A^fFt.Structure set Back from Lot Lines Ft.&Ft. Structure Height Ft. Ft. Structure Set Back from Septic Tank Ft.Ft. Structure Set Back from Absorption System Ft.Ft. Elevation Of Lowest Floor Above Ordinary High Water Level____________________3'h Ft.Ft. Land Slope at Building Line %% Inspector’s Comments / Sketch:, ik s. Inspector's Signature Date of Inspection Tune of Inspe^ion /(h; ^ose ^I !Rt. 3, Box 51 IAiFrazee, MN sd[544 t UJ(218) 342-2060 Publico I- 11 r.' V. Q S 5UJ S o /I fiCCfSSIICOI 0> LSJUJ vi (X O o3 c S gI IKv »■; i?- ■X.’, Ivfc;- /;3/pro POPP’D -;property>K- 'K’.y .r D I V / 5 I 0 Wi t i i VO LU □m-1:--^sepi ic n^'/i r. .' ■( A ' / ,ri rrm SOL/D - EX tsT /NG DOTTED - PROPOSED '¥’ fe: ■■S :EL. OEPt^as- DRIVE- r- ■P!N/<- ACCESS DRiuE-\?:•?::EL. GRSEt^~ /?. K -S'/TVS&•g-. .s;^Qlue - r-r/v/T- s.res 1 L pit;i9p0i£Ogi. i':t5-r^i-ri ■ii:/ ;o JZt-PIp-'-'-'/fc:I-0 R p ilsg;-'UJ O O D E” D ■m ■r>efi'/v pifc-tD <3IPI-I M i L L^ 1^.00w.mmrhiV/o/ruLF%. ■Ip- ii-i/J5o' , i^''51;-X'-!?■ I f ’C//>K' W\ W-t.' i'-:■ ■ I-'-. r .Kv. w:&'■■■■. L 0 LO .-.V■•.V R-:." •v>. W66 r^pn»._7ou)/v s//:P. ..RsOflV ; o- T‘f tii'.*?r n :<^o«e-t/ ■ - -vM;! "i>-nt..3. Bo* 515(ti Fraiaa, M.N 53544v'V.4,(21^) 342if060■^esoJ'%M50' M ■’3 as'II I■:1 If ;I a/’Pr:<,V %■i I )abrv/- <I •|l#i !1 ? ^'if'tD RECEIVEDijIp OCT 6 19981 LAND RESOURC.! :•'S !§is r'UaUCI■ ! Rcce'ss■'?1 >oO'},i\B\At\40*ri 4 /i V f C /\ ^ ^!-XJI'■? V pforolE'D :i j pRO^BklVJ■4e-.—-i4 D ) V / 5 t 0 W ' r v»; ■ ■.;I-t V*.>-T*. -*'*f -31«cv. ^LOIV!II ■4-1,-;< fi aO£e.hieAC>T t tiof ■I I IU&iiy i1 Z>f< (^z) S{/c£’ d<»oii j ^Vj 4i^^Q*OS »# St^fr.rs .Ct 1 I i reu.ssfS X^ff se-r i 11 IVi\L P««Tr^ T^p £>r>■■ V OtSa/^ ^ Rt-3, Box SIS FrazM, MN 56544 <216J 342-2060 \ U/CCU I - uiIf: i RECEIVED OCT 6 1998 UNO RESOURCE I h:‘ -g ■1