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HomeMy WebLinkAboutBambi Resort_25000990376000_Shoreland Permits_SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone 218-739-2271 - Fergus Falls, Mn. 56537 APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY White — Office Yeiiow — Owner Pink — Assessor Goidenrod — inspector a ^ ^ ^Permit No.,LEGAL ^-2- »/- IJDate.DESCRIPTION AND LOCATION Pgg r- It, Lake Classif.Sec.TWP TWP NameLake No.Lake Name Range IDENTiFICATiON; Please Print Ail Information Last Name First Initial Mailing Adi^css— No. Street, City and State Zip No.Tel. No. B AA r r~ / g- r~ClOwner Mn . NameContractor Architect Name. TYPE OF IMPROVEMENT;RESIDENTIAL PROPOSED USE;NON-RESIDENTIAL PROPOSED USE; I ) New Building ( ^.K^eration ()Other ( ) One Family Dwelling ( ) Multiple Dwelling Specify: Units ff>^the(Size ^~o i>,ESTIMATED COST OF IMPROVEMENT $(omit cents) PRINCIPAL TYPE OF FRAME:TYPE OF SEWAGE DISPOSAL:DIMENSIONS: f ra. f Basement: ( ) Yes ( Stories above basement: Sq. feet (outside dimension) Bedrooms ............................. ( ) Masonry (Awood Frame ( ) Structural Steel ( ) Other — Specify ( ) Public ( ) Individual Septic Tank, etc. WATER SUPPLY: ( ) Public (<_J,-tTf3[vidual Well MECHANICAL EQUIPMENT : Elevator: ( ) Yes Air Conditioning: ( ) Yes ( ) Central /A r' Baths...../. HEATING; ( ) Electric (-^''’Cas ( ) Oil ( ) None Type of Roof:([[^ ^ ^ (( ) Coal Other:( ) Unit CHARACTERISTICS: 7i2JivLot Area is .......square feet. cm f Building set back from high water mark is Land height above high water mark at building line is Building set back from State highway is...................... Side yard is Building will be located Building will be located y-. STD.feet — from road or street is to.>- oand feet. Rear yard is feet from septic tank (Sewage System Permit must be obtained before installation), feet from soil absorption system (Cesspool, Drainfield, etc.). feet. Ll ^ 6 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. ^gnafum of Owner {/ Dated. Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon thePermit: 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. ^ - -z 'I - 7 7Dated Management Officialh ■ I} 7 /Shi y - 0 0 ■ <rvPermit Fee $.State Surcharge $. Comments; Form No. MKL-0771-002 >158899 vierga kun»lin 4 co.. MiitttM. rceaui fall*. •!SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone 218-739-2271 - Fergus Falls, Mn. 56537 APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY White — Office Yellow — Owner Pink — Assessor Goldenrod — Inspector Permit No,.LEGAL Date.DESCRIPTION AND LOCATION TWP TWP NameLake Classif.Sec.RangeLake NameLake No. IDENTIFICATION: Please Print All Information Mailing Address— No. Street. City and State Zip No.Tel. No.First InitialLast Name .Owner NameContractor Architect Name. NON-RESIOENTIAL PROPOSED USE:TYPE OF IMPROVEMENT:RESIDENTIAL PROPOSED USE: ( ) One Family Dwelling ( ) Multiple Dwelling Specify:.( ) New Building ( ) Alteration Units ( ) OtherI ) Other Size ESTIMATED COST OF IMPROVEMENT $(omit cents) TYPE OF SEWAGE DISPOSAL:DIMENSIONS:PRINCIPAL TYPE OF FRAME: Basement: ( ) Yes ( ) No Stories above basement: Sq. feet (outside dimension) Bedrooms ( ) Masonry ( ) Wood Frame ( ) Structural Steel ( ) Other — Specify ( ) Public ( ) Individual Septic Tank, etc. WATER SUPPLY: ( ) Public ( ) Individual Well MECHANICAL EQUIPMENT : Elevator: ( ) Yes Air Conditioning: ( ) Yes ( ) Central Baths HEATING: ( ) Electric ( ) Gas ( ) Coal Other: ( ) No < ) OilType of Roof: ( ) No I ) None ( ) Unit CHARACTERISTICS: feet.Lot Area is square feet.Water frontage is , feet. (Building Line) ...............................feet 4- Building set back from high water mark is.................... Land height above high water mark at building line is Building set back from State highway is........................ Side yard is.................... Building will be located Building will be located r- ' 0 feet.feet — from road or street is .......................................feet. Rear yard is feet from septic tank (Sewage System Permit must be obtained before installation), feet from soil absorption system (Cesspool, Drainfield, etc.). feet.and 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. Dated. Signature of Owner Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon thePermit: 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. Dated Shoreland Management Official /State Surcharge $.Permit Fee $. Comments: Not i L Form No. MKL-0771-002 ,158899(CD Vimi UtKittH 4 M.. MHITCM. 4(R4UI <> INSPECTOR'S CHECK LIST Make all measurements and computations ACTUAL IS I MINIMUMShall Be i Sg. Ft, Lot Area (Square feet)Sq. Ft Sq. Ft. Water Frontage Ft.Ft. Building Set Back from High Water Mark Ft.Ft. 50 Ft.Building Set Back from State Highway Ft. 40 Ft.Ft.Building Set Back from Street or Road Side Yard &&Ft. Ft. Rear Yard Ft.Ft. Occupied Building to Septic Tank Ft.10 Ft. Occupied Building to Absorption System Ft.20 Ft. Elevation at Building Line above High Water Mark_____________Ft.3 Ft. Inspector's Comments: Inspector's Signature Title Inspection Dated 19 Agency vicToit ujNOCEii » CO . eoiNTfiia. riRoua