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Home My WebLink AboutBonnie Beach Resort_10000110069000_Shoreland Permits_https://onegov.co.ottertail.mn.us/admst/viewcard.php?card=5&app=3216 OTTER TAIL COUNTY Land & Resource Management ^0031 ^ Phone (218) 998-8095 PERMIT NUMBER 30037Site and Lot Alteration Permit (combined)_______________ PERMIT TYPE PROPERTY OWNER Megtar Lie LAKE INFORMATION Clitherall DNR ID(S)238 LOCATION Parcel(s): 10000110069000 Township Name: Clitherall Township Property Address(es): 20341 BONNIE BEACH RD Section/Township/Range: Sect-11 Twp-132 Range-040 Legal: 5.34 AC GL 3 EX TRS & EX PT PLATTED &NLY 160' ONjJ<_GE-GL 4 E OF WORK AUTHORIZED 32 X 40 duplex 8 X 40 deck per cup # 6684 Brittany A. Walters 07/18/2018 02:46 PM 516513b2cfa957de5e89d44c5123ca52 37a38c3a243469f578f36d 166f37f6cc 07/18/2018 07/18/2019 ISSUE DATE DATE EXPIRESLand and Resource Management Official/Date NOTE: • This permit must be placed in a conspicuous place not more than 6 feet above grade on the premises on which work is to be done, and must be maintained there until completion of such work. • If the terms of this permit are violated, the entire permit maybe revoked and the owner/contractor maybe subject to legal prosecution. • Property Owner is legally responsible for all surface water drainage which may occur. • Topographical Alteration projects shall be stabilized within 10 days of the completion unless otherwise stated. • No part of the Septic System shall be covered until it has been inspected or approved. • Notify Land & Resource Management when job is ready for inspection (218) 998-8095. 1 of 1 7/18/2018,2:47 PM https;//onegov.co.ottertail.mn.us/view.php?id=3216Land & Resource Permit Applications Land & Resource Management Government Services Center 540 Fir Avenue West Fergus Falls MN 56537 Phone: 218-998-8095 1 ■: ■i Site and Lot Alteration Permit (combined) Permit # 30037 Valid: 07/18/2018 - 07/18/2019 Applicant Information Applicant Information;Name: Ronald W Sugden Jr Phone: (218 ) 405 - 0470 I Email Address fwsugdenj r@gmail.com Mailing Address 20092 Campground Road Battle Lake MN 56518 9272 Property OwnerI am the: Work Performed By (Site Permit) Woilt to be performed by (Site Pemiit): Contractor Contractor’s Contact Information (Site Permit) Contractor Information;Name: Dan Barbre Company or Business Name: Dan Barbre Construction Contractor License Number BC 707950 Phone:Additional Phone: (218 ) 862 - 7000 ( ) Email: katrina.barbre@gmail.com Address; 39658 Girard Beach Rd Battle Lake MN 56515 Work Performed By (Lot Alteration Permit) Work to be perfonried by (Lot Alteration): Self Property Information Property Please search by one of the following: Parcel #, name, or Physical Address. Click the blue "Select" to select Selected: Primary Name/AddressProperty Attributes Property Address Legal Description Primary Address Line 1 CityParcel #Property Address City Legal Description Legal Description Legal Description Name NLY 160’ ON LK OF GL 4 E OF MEGTAR 20092 CAMPGROUND BATTLE LAKE 10000110069000 20341 BONNIE BEACH RD BATTLE LAKE 5.34 AC GL3EXTRS & EX PT PLATTED 8 LLC RD 283074 Square FeetLot Area: Is the property Developed or Undeveloped? Developed On Site Sewage Treatment System: Onsite Water Individual Supply: Compliance Inspection Report within 3 yrs. 7/18/2018,2:48 PM1 of 4 https://onegov.co.ottertail.mii.us/view.php?id=3216Land & Resource Permit Applications r Shoreland Information Associated Lakes:Selected: Lake Class LR CDLake Name DNRID 56-238Oitherall238RD 600 FeetWater Frontage: Bluff; Proposed Project (Site) Proposed Dwelling;Duplex Is there an Attached Garage? ^ Proposed Non-Dwelling:Deck(s) None Proposed Water Oriented Accessory Structure; Please list outside dimensions (in 32 x 40 duple^ feet) of above items you are applying None 8 X 40 deck per cup # 6684 for: Characteristics of Proposed Dwelling N^ or Replacement:New 2240 Square FeetSquare Feet: Maximum Proposed Height:29.8 Feet 40 FeetSetback to Lot Lines (indicate closest lot lines); 550 Feet Setback to Right of Way: Setback to Ordinary High Water Level: 1150 Feet 83 Feet Setback to Septic Tank:120 Feet Setback to Drainfield:170 Feet Setback to Bluff:na Feet 10 FeetElevation above Ordinary High Water Level; Total Bedrooms:6 Roof Change: Characteristics of Proposed Deck Square Feet;320 Square Feet 4.5 Feet ^ Feet Maximum Proposed Height: Deck Stbck Lot Line 1 (indicate closest lot lines): 550 Feet Setback to Right of Way; Setback to Ordinary High Water 83 Feet Level: 1150 Feet Elevation above Ordinary High Water Level; 10 Feet Setback to Septic Tank:120 Feet Setback to Drainfield: Setback to Bluff; 170 Feet na Feet Proposed Project (Lot Alteration^ John Christensen will be doing the dirtwork approved per CUP #6684Project Type:Site Prep Crawlspace Project Description; Foundation Type: Area to be Cut/Excavated Length:0 FeetLength:OFeet Width;0 Feet Average Depth:0 Feet Total Cubic Yards: 0( 0 Feet0 Feet Width:Width:0 Feet Average Depth;0 Feet Total Cubic Yards: 0 Length: Average Depth;0 Feet Total Cubic Yards: 0 itamial Walk-Out Basement Project 0 Feet Total Cubic Yards:QLength:OFeet Width: 0 Feet Average Depth;[Cditmatel Area to be filled/Leveled 0 FeetTotal Cubic Yards:Q Length:Length:OFeet Width:0 Feet Average Depth;0 Feet Total Cubic Yards: 0 0 Feet Width:0 FeetWidth:0 Feet Average Depth;0 Feet Length: iiaigiiEal Average Depth;0 Feet Total Cubic Yards: 0 jCaicuiB^ I Backfill at Foundation 0 Feet Backfill Total:0Linear Length:0 Feet Average Width: 0 Feet Average Depth:I caiciirat6j 1 7/18/2018, 2:48 PM2 of 4 https://onegov.co.ottertail.mn.us/view.php?id=3216Land & Resource Permit Applications Impervious Surface - Buildings 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet Dwelling Proposed: Attached Garage Proposed: Detached Garage Proposed: 0 Square FeetDwelling Existing: 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet Attached Garage Existing: Detached Garage Existing; Storage Shed Proposed:Storage Shed Existing: Water Oriented Accessory Structure Proposed: Water Oriented Accessory Structure Existing: 0 Square FeetRecreational Camping Unit Proposed:Recreational Camping Unit Existing:0 Square Feet 0 Square Feet 0 Square Feet Miscellaneous Proposed:0 Square Feet 0 Square Feet l-Caltulatell Miscellaneous Existing: Total Building Proposed Imperious: Total Building Existing Impeivous: Impervious Surface Calculation - Buildings Total Building Existing Impervious; 0 Square Feet 0 Square FeetTotal Building Proposed Imperious: Total Building Imperious Sur^ce: 0 Square Feet right 283074 Square FeetLot Area: Impenious Sur^ce Ratio: Buildings ImperMOus Surtece Percentage; 0.0000 0.00 % Impervious Surface - Other 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet Deck(s) Proposed:Deck(s) Existing; Patio(s) Existing:Patio(s) Proposed:0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet Sidewalk(s) Proposed;Sidewalk(s) Existing; Landing(s) Proposed:Landing(s) Existing; Driveway(s) Existing:Driveway(s) Proposed; Parking Area(s) Proposed:Parking Area(s) Existing: Retaining Wall(s) Existing: Landscaping Existing; Miscellaneous Existing; Retaining Wall(s) Proposed: Landscaping Proposed; Miscellaneous Proposed; Other Existing Total:Other Proposed Total: Impervious Surface Calculation - Buildings & Other Total Building + Other Existing 0 Square Feet Impervious: Total Building + Other Proposed 0 Square Feet Imperious: Total Building + Other Imperious 0 Square Feet Sur^ce; Lot Area:283074 Square Feet Building Other Impervious Surface Ratio; 0.0000 Building Other Impervious Sur^ce Percentage: 0.00 % Shore Impact Zone Impervious Building(s) Proposed: Deck(s) Proposed: Patio(s) Proposed: Sidewalks(s) Proposed: 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet Parking Area(s) Proposed: 0 Square Feet Retaining Wall(s) Proposed: 0 Square Feet 0 Square Feet 0 Square Feet Total Proposed Impervious In the 0 Square Feet Shore Impact Zone: Building(s) Existing: Deck(s) Existing: Patio(s) Existing: Sidewalk(s) Exisiting: Landlng(s) Existing: Driveway(s) Existing: Parking Area(s) Existing: 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet Landing(s) Proposed; Driveway(s) Proposed: Retaining Wall(s) Existing: Landscaping Existing: Miscellaneous Existing; Landscaping Proposed: Miscellaneous Proposed: Total Existing Imperious in the Shore impact Zone: 0 Square Feet | Cqleutett |Total Impervious in the Shore Impact Zone: Documentation ^ bonnie_beach.pdfPLEASE NOTE PROPOSED PROJECT AREA MUST BE STAKED ;File 1: Attach Supporting Documentation: Total Proposed Area to Determine 2560 Square Feet Fee: Total Earthmoving Request to Determine Fee: 0 Cubic Yards ' 3 of 4 7/18/2018, 2:48 PM https://onegov.co.ottertail.mn.us/view.php?id=3216Land & Resource Permit Applications Applicant Approval Sugden, Ronald Jr 07/16/2018 Applicant Signature: Date Signed: I understand that checking this box constitutes a legal signaturePlease check to appro\e; All earthmoving was approved under CUP #6684.Comments: Terms Notes TTie lot lines and project area(s) must be identified & staked onsite. Site Permit Terms THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES Notes ■ If project disturbs more than 1 acre of land, you must obtain a General Stono Water Permit from the MPCA. Agreement I hereby certify that the Information contained herein is correct and agree to do the proposed work in accordance with the description abo>« 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. Once Permit is approved, I also understand that this permit is valid for twelve (12) months from the date of approval unless otherwise indicated on permit. Footings I understand that it is my responsibility to inform the Land & Resource Management office once the building footings ha>e been constructed. Invoice 07/17/2018 Quantity TotalCostCharge Site & Lot Permit Fee #3A (1,000 or larger Sq Ft and 0 Cubic yds) added 07/16/2018 2:41 PM $250 Fee $250.00$250.00 X 1 Grand Total $250.00Total (Paid) ADorovals SignatureApproval #1 Received and Assigned Brittany A. Walters - 07/18/2018 2:40 PM 49c41266763f7dd82dlc93961132dbcd 786b95db46d4e9609ac30b4af2b473f5 Brittany A. Walters - 07/18/2018 2:46 PM fcac52b40c6al426e0ab5d000eb719a2 bf6254527d09f0705972fa3863a53243 Brittany A. Walters - 07/18/2018 2:46 PM 88ccbd23bcf84e9e8194f3c6a35a3fa5 596340f1327466a59dd2526da29d9236 #2 Permit Review #3 Permit Review #4 Perniit Issuance Brittany A. Walters - 07/18/2018 2:46 PM 516513b2cfa957de5e89d44c5123ca52 37a38c3a243469f578f36dl66f37f6cc Print View 4 of 4 7/18/2018,2:48 PM « SITE PERMIT INSPECTION RESULTS Inspector must make all measurements and computations 6^structure Set Back from Ordinary High Water Level Ft. Ft. Structure Set Back from Top of Bluff Ft. Ft. y'mStructure Set Back from Road Right of Way Ft.Ft. I OiP -IStructure Set Back from Lot Lines Ft.&Ft.Ft.&Ft. Structure Height Ft.Ft. Structure Set Back from Septic Tank Ft.Ft. Structure Set Back from Drainfield Ft.Ft. Elevation Of Lowest Floor Above Ordinary High Water Level 3 ^Ft.Ft. Land Slope at Building Site %% Inspector’s Comments / Sketch: \ Inspector's Signature /v Date of Inspection II Time of Inspection Q/Prr^ect AoDroved ' ^ '' ^ f Date/Initial WHITE-Office GOLDENROD - Inspector YELLOW - Owner (after issue) APPLICATION FOR SITE PERMIT LAND & RESOURCE MANAGEMENT GOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS FALLS, MN 56537 218-998-8095 www.co.otter-tail.mn.usOTTER TflllconaTT-aiaaiioT« Permit No.APPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED. LAKE/RIVER NAMELAKE / RIVER NO.LAKE/RIVER CLASS _ SECTION TWPNO.RANGE TWP NAME ^0C/; 7Aem| 1 C/ifJ\ 11/3aII PARCEL NUMBER (S)PROPERTY (E-911) ADDRESS OOOiDl i 000,9 000 003^ / 3mA/ c SeticK ^/yW & LEGAL DESCRIPTION DEVELOPEDtH (,L3(B it (a ^tnniz.UNDEVELOPED Last Name First Initial Mailing Address Daytime Phone No. 3 d jfZ <L Sr. if It. /hH ShSiS La) , L.LZ, t. /^T»X {) t'V Property Owner 76 6ti tip-1rarA ^cacKContractor Name Lie.# Dcm ^<ai< j>TTi Qt^AsTf (jc*i i6r^ N ^^5iS 8C 1D19SO PROPOSED PROJECT (please circle the appropriate number) (1 ) New Dwelling ( 4 ) MH/YR____ (7 ) Add'n To Non-Dwelling ( 8 ) Storage Structure ( 10 ) Non-Conf. Roplaromont (irtofiUM" (11) Other (identify) (12 ) Deck_______ (13) Fence______ 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 ( ) L&R Cert, of Compliance within 5 yrs. ( ) Compliance Inspection Report within 3 yrs. (Attached) ( ) OTWMD 'Must have Sewage System Approvai from OTWMD prior to issuing Site Permit. Contact Rollie Mann at 218-864-5533 ( ) New Septic Permit Issued Permit # ( 2 ) Add'n to Dwelling/Attached Garage ( 3) Replacement Dwelling’ (6) Detached Garage (9) W.O.A.S. (5) RCU/Year. 5*5 £>< Lo ■Removal of Existing Dwelling Verified by L&R “Existing Non-Conf. Structure Verified by L&R Inspector's Initial/Date Inspector's Initial/Date CHARACTERISTICS OF PROPOSED W.O.A.S. (WATER ORIENTED ACCESSORY STRUCTURE)CHARACTERISTICS OF PROPOSED DWELLING (Must Include Attached Garage) Outside Dimension ^ Ft.x Ft." Sq. Ft JaMD Setback to Lotline QQ Ft. & SCO Ft." Setback to Right of Way // S'C) Ft." Setback to Ordinary High Water Level Ft. Elevation Above Ordinary High Water Level /O Ft. Setback to Septic Tank /O O Ft. Setback to Drainfield /SO Ft. Setback to Bluff /V A Ft. Total Bedrooms Maximum Proposed Height Ft. Roof Change ( ) Yes ( y.) No Basement ( ) Yes (T(i) No Walkout Basement ( ) Yes (side profile required) ( ) No CHARACTERISTICS OF PROPOSED NON-DWELLING Outside Dimension OutsideV DimensimFt. X Ft." Ft. X Ft." Sq. Ft. X Setback to Lotlin^ Setback to Right of Setback to Ordinary High’Vtater Level __ Elevation Above Ordinary HigmWater Level Setback to Septic Tank___ Setback to Drainfield____ Setback to Bluff________ Maximum Proposed Height Roof Change ( ) Yes ( ) No Bathroom Proposed ( ) Yes ( ) No Sq. Ft. \ Setback to LotlinH.___ Setback to Right of^y Setback to Ordinary Hig)\Water Level __ Elevation Above Ordinary hli^ Water Level Setback to Septic Tank Setback to Drainfield _ Setback lo Bluff_____ Ft.&Ft."Ft.&Ft." Ft."Ft." Ft.Ft. Ft.Ft. Lt.Ft. Ft. Ft.Ft. Ft. Maximum Proposed Height ( ) Boathouse ( ) Gazebo **Project/Lotlines/Right-of-ways Must be Staked Onsite Prior to Appiication / Inspection Ft. ( ) Screen Porch ( ) Storage Structure Topographical Alteration / Earthmoving □ None ’ Must include on scale drawing, additional Permit may be required.□ 20 Cubic Yards or Less *□ 21 Cubic Yards - 999 Cubic Yards*□ 1,000 Cubic Yards or More* 6>OQCHARACTERiSTICS OF LOT:Lot Area.Sq. Ft.Water Frontage Bluff ( ) Yes ( ) No 1*4 Cp^r CUP Ft. .%.% 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 violation of said Ordinances.I understand that it is my responsibility to inform the Land & Resource MMagement office once the building footings have been constructed. Date:a -Signature of ProperjiL Owner / Agent fc Iwner Date: Land & Resource Management Official^^ 2-00PROJECT(S) TOTAL SQ. FT.PERMIT FEE $RECEIPT NO. Date StampComments: Q^cCEiVcD 2 S 2017 i t/IX >LU 360.647 • Victor Lundeen Co., PPinters ■ Fergus Falls. Minnesota L&R Initial[ifeglForm No. BK - - 04-2016 w APPLICATION FOR SITE PERMIT LAND & RESOURCE MANAGEMENTGOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS FALLS, MN 56537 218-998-8095 www.co.otter-tail.mn.us sue) \^jir tfc10OTTER TflilCOVlTT-BIIIIIIOTi Permit No.APPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED. TWPNO.RANGE TWP NAMELAKE/RIVER NAME LAKE/RIVER CLASS SECTIONLAKE / RIVER NO. ^0 Qi) IC// MeraM II PARCEL NUMBER (S)PROPERTY (E-911) ADDRESS OOOQ( {00^9000 aos*-// Sof>^>c8tr,ck ^c/..A/V s^iS F4 . Ga L ^ n / c >> C <L<-« ^ LEGAL DESCRIPTION DEVELOPED. UNDEVELOPED “InilialLast Name First Mailing Address Daytime Phone No. ^ d tZ ti hciUxL.LC. Property Owner 3‘945^6<l?/ri»r<dl R me h /■?1Contractor Name Lie.# or-.*©Oar^ Bax O&^S'tfLiciittn Be 1019 SO PROPOSED PROJECT (please circle the appropriate number) (1 ) New Dwelling (4) MHA'R____ (7) Add'n To Non-Dwelling (8 ) Storage Structure ( 10 ) NOn-COnf. (11) Other lidentifv)(12) Deck_______ XZZ!^ (13) Fence______ ONSITE WATER SUPPLY 0^ Individual ( ) Public ( ) None NOTE: MN Rules Chpt, 4725 (MN Well Code) requires a 3' (minimum) structure setback to a well. ONSITE SEWAGE TREATMENT SYSTEM ( ) L&R Cert, of Compliance within 5 yrs. ( ) Compliance Inspection Report within 3 yrs. (Attached) ( ) OTWMD ‘Must have Sewage System Approval from OTWMD prior to issuing Site f^rmit. Contact Rollie Mann at 218-864-5533 ( ) New Septic Permit Issued Permit It (2 ) Add’n to Dwelling/Attached Garage ( 3 ) Replacement Dwelling* (6 ) Detached Garage (9) W.O.A.S. (5) RCU/Year. 5\ ly V-rpl^r A C.TfXS'i ^Removal of Existing Dwelling Verified by L&R “Existing Non-Conf. Structure Verified by L&R Inspector's Initial/Date Inspector's Initial/Date CHARACTERISTICS OF PROPOSED W.O.A.S. (WATER ORIENTED ACCESSORY STRUCTURE) Outside, Dimensiorv^ Sq. Ft.___ Setback to Lotlirik___ Setback to Right of Way Setback to Ordinary HigfvWater Level __ Elevation Above Ordinary Hlg|i Water Level Setback to Septic Tank Setback to Drainfield _ Setback to Bluff CHARACTERISTICS OF PROPOSED DWELLING (Must Include Attached Garage) CHARACTERISTICS OF PROPOSED NON-DWELLING Outside Dimension Sq. Ft. Setback to Lotlii^ Ft. X Ft.**Ft. X Ft.**Outside Dimension Qn Ft A‘-I-' ' Ft. X Ft.** Setback to Lotline QO Ft. & ^OO Ft.** Setback to Right of Way // Ft.** Setback to Ordinary High Water Level Ft. Elevation Above Ordinary High Water Level Setback to Septic Tank /O O Ft.\/’ Setback to Drainfield /SO Ft.^ Setback to Bluff AAA Ft. —^ Total Bedrooms Maximum Proposed Height Ft. 5^ Roof Change ( ) Yes (SC ) No Basement ( ) Yes ( yT ) No Walkout Basement ( ) Yes (side profile required) { ) No Ft.&Ft.**Ft.&Ft.** Setback to Right of Wa^Ft.**Ft.** lO ' /x.Setback to Ordinary HighYt(^ter Level __ Elevation Above Ordinary HighVyater Level Setback to Septic Tank__ Setback to Drainfield____ Setback to Bluff________ Maximum Proposed Height Roof Change ( ) Yes ( ) No Bathroom Proposed ( ) Yes ( ) No Ft.Ft. Ft.Ft. T.\ Ft. Ft. Ft.Ft. Ft. Maximum Proposed Height ( ) Boathouse ( ) Gazebo **Project/Lotlines/Right-of-ways Must be Staked Onsite Prior to Appiication / inspection Ft. ( ) Screen Porch ( ) Storage Structure Topographical Alteration / Earthmoving □ None * Must include on scale drawing, additional Permit may be required.□ 20 Cubic Yards or Less *□ 21 Cubic Yards - 999 Cubic Yards*□ 1,000 Cubic Yards or More* Cp^T cu r CHARACTERISTICS OF LOT:Lot Area. Sq. Ft.Water Frontage Ft.Bluff ( ) Yes ( ) No .%.% 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. 1 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: !/ 2^ Signature of Proper^ Owner / Agent ksf OwnerQOjS) I fr Date:Z iLand & Resource Management Official^., |^Qf7-l Mp-7 OO 1PERMIT FEE $ *^PROJECT(S) TOTAL SQ. FT.RECEIPT NO. Comments:1 ■1L i7^1^1 A IX r i [>! 1,'i H-f " IlQ rT2»TfU f> ^ n iPC-fey/ 360,647 • Victor Lundeen Co.. Pfiniers • Fergus Falls, Minnesota V/{ f X No. BK -4- 04-2016 A >f- SITE PERMIT INSPECTION RESULTS Inspector must make all measurements and computations Structure Set Back from Ordinary High Water Levei Ft.Ft. Structure Set Back from Top of Biuff Ft.Ft. structure Set Back from Road Right of Way Ft.Ft. Structure Set Back from Lot Lines Ft.&Ft.Ft.&Ft. Structure Height Ft.Ft. mStructure Set Back from Septic Tank Ft.Ft. Structure Set Back from Drainfield Ft.Ft. Elevation Of Lowest Fioor Above Ordinary High Water Level Ft.Ft. Land Slope at Building Site LAP %% Inspector’s Comments / Sketch: Inspect^ Signature late of Inspection Z'.30 Time of Inspection iSf^t^e^ADoroved 1^1 I ^ Date 7 Initial ^ WHITE - Office GOLDENROD - Inspector YELLOW - Owner (after issue) APPLICATION FOR SITE PERMIT LAND & RESOURCE MANAGEMENT GOVERNMENT SERVICES CENTER, 540 WEST FIR. FERGUS FALLS, MN 56537 218-998-8095 www.co.otter-tail.mn.us i OTTCR TflIIcouaTT-aiaaiioTn Permit No.APPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED. LAKE / RIVER NO.LAKE/RIVER NAME LAKE/RIVER CLASS SECTION TWP NO.RANGE TWP NAME C 'e.r<a I I/53s~ ^C i i T K gyo. 1 (I i PARCEL NUMBER (S)PROPERTY (E-911) ADDRESS R I Dooo / / Q 0 OOP LEGAL DESCRIPTION DEVELOPEDS-eekch. ^^Ctp Pt UNDEVELOPED#1 e ✓Last Name Jtial Mailing ^OCjgt'3. rQu»A ci /^ci tH C- ^ ,^L> 5 i ^ Daytime Phone No. Property Owner ?oContractor Name Lie.#3e<tt /e. ZaSioS i S gC COO ^HOCo PROPOSED PROJECT (please circle the appropriate number) (1 ) New Dwelling (4 ) MHA'R_____ ( 7) Add’n To Non-Dwelling ( 8 ) Storage Structure (10) Non-Conf. Replacement (identify)"______________________________________(11) Other /identify) Clrjhilrx .a*- M c/x L < . 1 la 1S!. Rei-koi-s l ONSITE WATER SUPPLY ONSITE SEWAGE TREATMENT SY^ ( ) L&R Cert, of Compliance within 5 yr^^1 ( ) Compliance Inspection Report withia 3w (Attached) V / ( ) OTWMD 'Must have Sewage System/tpp from OTWMD prior to issuing Site Permit. Contact Rome Mann at 2)8-864-5533 ( ) New Septic Permit Issued Permit # (2 ) Add'n to Dwelling/Attached Garage QJ) Replacement Dwelling" ( 6 ) Detached Garage (9) W.O.A.S. (^Individual ( (Public ( (None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3' (minimum) structure setback to a well. (5) RCU/Year. rai "Removal of Existing Dwelling Verified by L&R ""Existing Non-Conf. Structure Verified by L&R \f\spec\of$ Initial/Date Inspector's Initial/Date CHARACTERISTICS OF PROPOSED W.O.A.S. (WATER ORIENTED ACCESSORY STRUCTURE) "Outside Dimension" CHARACTERISTICS OF PROPOSED DWELLING (Must Include Attached Garage) Outside Dimension .? ^ Ft. x HO Ft."" Sq. Ft. Setback to Lotline /ec Ft. & 'Yot> pt."" Setback to Right of Way r’f ya Ft."" Setback to Ordinary High Water Level / / A Ft. Elevation Above Ordinary High Water Level / O Ft. Setback to Septic Tank "7P Ft. Setback to Drainfield /30 Ft. Setback to Bluff /Y A Ft. Total Bedrooms L» Maximum Proposed Height Roof Change ( ) Yes (/ ) No Basement ( ) Yes (')C) No Walkout Basement ( ) Yes (side profile required) ()C) No CHARACTERISTICS OF PROPOSED NON-DWELLING Outside Dimension Ft. X Ft."" Ft. X Ft."" Sq. Ft. Setback to Lotline____ Setback to Right of Way Setback to Ordinary High Water Levfek/ Elevation Above Ordinary High Wdfer Lev! Setback to Septic Tank _. Setback to Drainfield / Setback to Bluff / Maximum PrafSosed Height Roof Cfjalige ( ) Yes ( ) No BalKroom Proposed ( ) Yes ( ) No Sq. Ft. \ Setback to LotlineN Setback to Right of Setback to Ordinary HighVater Leve|/ Elevation Above Ordinary Hi^Waler Level Setback to Septic Tank Setback to Drainfield Ft.&■1" Ft.&Ft.** Ft.**Ft.*> Ft.Ft. Ft.Ft. Ft.Ft. Ft.Ft; Ft. S^ack to Bluff ______ Maximum Proprwed Height ( ) BoaJtKxise ( ) G^ebo **Project/Lotlines/Right-of-ways Must be Staked Onsite Prior to Application / Inspection Ft. Ft.Ft. ( ) Screen Porch ( ) Storage Structure Topographical Alteration / Earthmovlng □ None * Must include on scale drawing, additional Permit may be required.□ 20 Cubic Yards or Less *□ 21 Cubic Yards - 999 Cubic Yards*□ 1,000 Cubic Yards or More* Ft. Bluff ( ) Yes ( ) No \ Impervious Surface Ratio H./* CHARACTERISTICS OF LOT:Lot Area.Water Frontage .% V / a (|il(lir() ^rface 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 responsibility to inform the Land & Resource Management office once the building footings have been constructed. 0B-rP3-^0v6?.g- ^Date; Signature of Property Owner/Agent for Owner Date: Land & Resource M^agereent Official A ^ ^ FEE $ __________(sj^PROJECT(S) TOTAL SQ.FT.RECEIPT NO. Forrn No. BK — 04-2016 / [i^liov ^ 350,647 • victor LunOeen Co.. Printers • Fergus Falls, Minnesota Date StampComments: received AU6 3 I 201S LAND&RESOUF.OE L&R Initial WHITE - Office' GOLDENROD - ihi^tor YELLOW - Owner (after issue) APPLICATION FOR SITE PERMIT LAND & RESOURCE MANAGEMENT GOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS FALLS, MN 56537 218-998-8095 www.co.otter-tail.mn.us s XPIROTTER TAIlcoviTT-aiaaifOTi IPermit No.APPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED. RANGE TWPNAMELAKE / RIVER NO.LAKE/RIVER NAME LAKE/RIVER CLASS SECTION TWPNO. llI 5 3-C r»HOC I I ~t h cyol\1 I Ikn PARCEL NUMBER (S)PROPERTY (E-911)ADDRESS R I DOOO I I OC> OOP LEGAL DESCRIPTION la'Xffifffess ^ DEVELOPED /•'i* Or L~^ Ron ni e R A RrSOf'i’UNDEVELOPED-rat BonAi-e. gLLd___________ I S^'-utL d rK V Last Name itial Mailiog IL Daytime Phone No.iProperty Owner ..aOQcx'a. rOu>-v d a.‘5 vl-5o^7C) ; % i ?o> govL ^15Contractor Name Lie.# WcKy.getV/c S g C OOP (IgSDCo PROPOSED PROJECT (please circle the appropriate number)ONSITE WATER SUPPLY ONSITE SEWAGE TREATMENT SYSTEM ( ) L&R Cert, of Compliance within 5 yry w ) Compliance Inspection Report withii^ 3 (Attached) \ ^ ( 2 ) Add'n to Dwelling/Attached Garage Replacement Dwelling* (5) RCU/Year. (1 ) New Dwelling (4 ) MH/YR____ ( 7 ) Add'n To Non-Dwelling ( 8 ) Storage Structure (10) Non-Conf. Replacement (identify)"___ (11) Other lidentifvl rVvh.^ ^ (12) Deck. )(^» Individual ( (Public ( (None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3’ (minimum) structure setback to a well. ((6) Detached Garage (9) W.O.A.S./ . I ( ) OTWMD 'Must have Sewage System 'Appmt/al from OTWMD prior to issuing Site Permit. Contact Rollie Mann at 218-864-5533 ( ) New Septic Permit Issued Permit # I ICTrt'oje/^yr i''l ALI (13) Fence. ‘Removal of Existing Dwelling Verified by L&R •'Existing Non-Conf, Structure Verified by L&R Inspector's InitiaWate Inspector's Initial/Date ■iCHARACTERISTICS OF PROPOSED W.O.A.S. (WATER ORIENTED ACCESSORY STRUCTURE)CHARACTERISTICS OF PROPOSED DWELLING (Must Include Attached Garage) Outside Dimension -1 Ft. x Ft." Sq. Ft. J «-t L) Setback to Lotline /o& Ft. & S'o Ft." Setback to Right of Way /( fcs Ft." Setback to Ordinary High Water Level / / A Ft. Elevation Above Ordinary High Water Level / T) Ft. Setback to Septic Tank ’7D Ft. Setback to Drainfield / 30 Ft. Setback to Bluff . V Ar Ft. Total Bedrooms Maximum Proposed Height ,7<?*<?^^Ft. Roof Change ( ) Yes (X ) No Basement ( )Yes (yc)No Walkout Basement ( ) Yes (side profile required) (>£.) No CHARACTERISTICS OF PROPOSED NON-DWELLING Outside Dimension /Outside Dimension .Ft. x Ft."i Ft. X Ft."\ Sq. Ft. Setback to Lotline Setback to Right of Way Setback to Ordinary High Water Le\H/ Elevation Above Ordinary High Wafer Lev Setback to Septic Tank X Ft. Setback to Drainfield i ____VSq. Ft. Setback to LotlineX^ Setback to Right of Wb^ Setback to Ordinary High Water Leve Elevation Above Ordinary Hi^ Setback to Septic Tank V Setback to Drainfield l^tback to Bluff ^______ X ''Maximum Proposed Height ( ) Boathouse ( ) Qezebo *’'Project/Lotlines/Rlght-of-ways Must be Staked Onsite Prior to Application / Inspection Ft.&T"Ft.&Ft." Ft."Ft.*/ Ft.Ft. ^ Wafer Level XV Ft. Ft.X //Ft.Ft' Setback to Bluff ^ Maximum Prpposed Height Roof Cljafige ( ) Yes ( ) No Bathroom Proposed ( ) Yes ( ) No Ft.Ft. Ft.Ft. ( ) Screen Porch ( ) Storage Structure Topographical Alteration / Earthmoving □ None * Must include on scale drawing, additional Permit may be required.□ 20 Cubic Yards or Less '□ 21 Cubic Yards - 999 Cubic Yards'□ 1,000 Cubic Yards or More* r 1 iZ '7 - ?CHARACTERISTICS OF LOT:Lot Area.q. Ft.Water Frontage Ft.Bluff ( )Yes ( )No mo I r j.% Building Surface Ratio Imperviou^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 thaf 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 responsibility to inform the Land & Resource Management office once the building footings have been constructed. Q^- e) ^ JoDate: Signature of Properly Owner / Agent for Owner i.c U>or 7 . - ~ ' y I - "Date; Land & Resource Management Official a ^ ^ > PROJECT(S) TOTAL SQ. FT._ il-.-IPERMIT FEES RECEIPT NO.J ■'iL_1Comments:-J . ( (kv /x h'Z^-Zeio) <ytihKr L|lH-1*7 'i7v( moKl(H-('' — -plus* 7,i ^ /‘ ¥VKicflIs •JixJj-riL.r -7/. Form No. BK — 04-2016 360.647 ■ Victor Lund««n Co.. Prinlors • Fergus Falls. Minnesota 1 ... • 4.P f SITE PERMIT INSPECTION RESULTS Inspector must make all measurements and computations Otc«-s |I6^J2^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.&-Ft.wStructure Set Back from Lot Lines Ft.Ft.& TStructure Height Ft.Ft. &Structure Set Back from Septic Tank Ft.Ft. Structure Set Back from Drainfield Ft.Ft. Elevation Of Lowest Floor Above Ordinary High Water Level Ft.Ft. Land Slope at Building Site % % lii liM^ - fV<6rf Inspector’s Comments / Sketch: w □=} Il?2- ‘J Of, B1 Inspector’s Signature 9- z> n Date of Inspection )[0o Time of Inspection Project Approved. Date / Initial 1 t c<) f -(S’ APPLICATION FOR SITE PERMIT LAND & RESOURCE MANAGEMENT GOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS FALLS, MN 56537 218-998-8095 www.co.otter-tail.mn.us WHITE - Office GOLDENROD - Inspector YELLOW - Owner (after issue) OTTCR TAIl CONiTY IIIIIiCSOTi Permit No.APPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED. TWP NAMETWP NO.RANGELAKE/RIVER CLASS SECTIONLAKE/RIVER NAMELAKE / RIVER NO. cdheral]f)(o' j OI rf^hg/cu \ i PARCEL NUMBER (S) I I PROPERTY (E-911) ADDRESS LEGAL DESCRIPTION DEVELOPED. Pf GrL 3 l^rSiiirf UNDEVELOPED Daytime Phone No.Mailing AddressFirstInitialLast Name j/6Property Owner r/5~1 YC^-n S.C < S 2ZOC5M25*Contractor Name Lie.#itotfU /^/V ^hSlS 6C. 000^0^ PROPOSED PROJECT (please circle the appropriate number) ( 2 ) Add'n to Dwelling/Attached Garage Replacement Dwelling' (6) Detached Garage (9) W.O.A.S. ONSITE WATER SUPPLY^ (V'lhdividual ( ) Public ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3’ (minimum) structure setback to a well. ONSITE SEWAGE TREATMENT SYSTEM ( ) L&R Cert, of Compliance within 5 yrs. ( ) Compliance Inspection Report within 3 yrs. (Attached) ( ) OTWMD ‘Musi have Sewage System Approval from OTWMD prior to issuing Site Permit. Contact Rollie Mann at 2 tS-864-5533 (1 ) New Dwelling ( 4 ) MH/YR_____( 5 ) RCUA'ear______ (7) Add'n To Non-Dwelling (8 ) Storage Structure (10) Non-Conf. Replacement (identiM“______________(11) Other lidentiM GgL^B\^^ ^ } (12) Deck. (13) Fence ( ) Undeveloped Lot "Existing Non-Conf. Structure Verified by L&R‘Removal of Existing Dwelling Verified by L&R Inspector's Initial/DateInspector's Initiai/Date CHARACTERISTICS OF PROPOSED W.O.A.S. (WATER ORIENTED ACCESSORY STRUCTURE) Oufside Dimension CHARACTERISTICS OF PROPOSED NON-DWELLING Outside Dimension CHARACTERISTICS OF PROPOSED DWELLING (Must Include Attached Garage) Outside Dimension Ft. x ^^ Ft." Sq. Ft. Setback to Lotline /CO Ft. & 47&0 Setback to Right of Way // fO Ft.'W^ Setback to Ordinary High Water Level Ft. Ft. X Ft."Ft."Ft. X 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 Roof Change ( ) Yes ( ) No Bathroom Proposed ( ) Yes ( ) 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 **Proiect/Lotlines/Right-of-ways Must be Staked Onsite Prior to Application / Inspection □ 21 Cubic Yards - 999 Cubic Yards' Ft.&Ft.”Ft.&Ft.” Ft.”Ft.” Ft. Elevation Above Ordinary High Water Level Setback to Septic Tank & O Ft. Setback to Drainfield 7JO Ft. Setback to Bluff Ft. Ft. Ft. Ft.Ft. Ft.Ft. Total Bedrooms . ^ ^ Maximum Proposed Height ^ Ft. Roof Change ( ) Yes ( )/.) No Basement ( ) Yes ( )0 No Walkout Basement ( ) Yes (side profile required) (j^)No Ft.Ft. Ft.Ft. ( ) Screen Porch ( ) Storage Structure * Must include on scale drawing, additional Permit may be required. Topographical Alteration / Earthmoving □ None □ 1,000 Cubic Yards or More'□ 20 Cubic Yards or Less * f Building Surface Ratio Bluff ( )Yes ^NoCHARACTERISTICS OF LOT:Sq. Ft.Ft.Lot Area.Water Frontage THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, M/WW£SOTASTA7^ 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 serfortn 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 responsibility to inform the Land & Resource M^agement office once the building footings have been constructed. /oZH/ Signature of Property Owner / Agenfpr Own .% Imperviou 9- T- ,Por^Date: V- P‘0 (“3 Jju^:t) A ^0/5. Date: Land & Resource Management Official Sdd-ooPERMIT FEE $PR0JECT(S) TOTAL SQ. FT.RECEIPT NO. Date StampComments: L&R InitialForm No. BK — 04-2014 354,252 • Victor LunOeon Co.. Printers • Fergus Falls, Minnesota WHITE-Office GOLDENROD - Inspector YELLOW - Owner (after issue) 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 I OTTER TimCOiUTY-aillACIOTi Permit No.APPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED. TWP NO.RANGE TWP NAMELAKE/RIVER CLASS SECTIONLAKE / RIVER NO.LAKE/RIVER NAME /S ^ I I PARCEL NUMBER (S) Rli i Ii PROPERTY (E-911) ADDRESSi R I0^6C> \l LEGAL DESCRIPTION DEVELOPED. 7^ Gt/. 3 ^-rOCln UNDEVELOPED. Daytime Phone No.First Initial Mailing AddressLast Name Property Owner p/6^050V?6 r4 r iS'f^anc-fd. ^'T' &.0 X. ^ / SContractor Name Lie.# Qor^ r^yL>f ^iC-^ /hN ^t>5 f S 6(L ^Ci^LHOiO? PROPOSED PROJECT (please circle the appropriate number) ( 2 ) Add'n to Dweiiing/Attached Garage (0) Replacement Dwelling* (6 ) Detached Garage (9) W.O.A.S. ONSITE SEWAGE TREATMENT SYSTEM ( ) L&R Cert, of Compliance within 5 yrs. ( ) Compliance Inspection Report within 3 yrs. (Attached) ( ) OTWMD ’Must have Sewage System Approval from OTWMD prior to issuing Site Permit. Contact Roilie Mann at 218-864-5533 ONSITE WATER SUPPLY (V^ Individual ( ) Public ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3’ (minimum) structure setback to a well. V'' (1 ) New Dwelling (4 ) MHA'R_____(5) RCUYear (7) Add’n To Non-Dweiiing ( 8) Storage Structure (10) Non-Conf. Repiacement (identity)’’______________ (11 ) Other lidenlifv) /Ju^trsr ) (12) Deck______________________________________ (13) Fence______________________________________( ) Undeveloped Lot L •Removal of Existing Dweiling Verified by L&R "Existing Non-Conf. Sfructure Verified by L&R Inspector's Initial/Date Inspector's Initial/DateI CHARACTERISTICS OF PROPOSED W.O.A.S. (WATER ORIENTED ACCESSORY STRUCTURE) Outside Dimension CHARACTERISTICS OF PROPOSED DWELLING (Must Include Attached Garage) Outside Dimension 3^ Ft.x Sq. Ft. PDSD Setback to Lotline /OO '^t. & ^&0 Ft.'^" Setback to Right of Way // CO Ft.'t'''^ Setback to Ordinary High Water Level ! SI Ft. CHARACTERISTICS OF PROPOSED NON-DWELUNG Outside DimensionHO Ft. X Ft."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 Roof Change ( ) Yes ( ) No Bathroom Proposed ( ) Yes ( ) 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 **Project/Lotlines/Right-of-ways Must be Staked Onsite Prior to Appiication / inspection Ft.&Ft.**Ft.&Ft." Ft.**Ft.** Ft. Elevation Above Ordinary High Water Level Setback to Septic Tank ^ P Ft. Setback to Drainfield /JD Ft. Setback to Bluff A! fA- Ft. Total Bedrooms ^ ^ ^ Maximum Proposed Height-^ Ft. Roof Change ( ) Yes (X) Ho Basement ( ) Yes ( X) Ho Walkout Basement ( ) Yes (side profile required) (^ ) No Fti^Ft. Ft. Ft.Ft. Ft,Ft. Ft.Ft. Ft.Ft. ( ) Screen Porch ( ) Storage Structure Topographical Alteration / Earthmoving □ None □ 20 Cubic Yards or Less * * Must include on scale drawing, additional Permit may be required. / □ 21 Cubic Yards - 399 Cubic Yards*□ 1,000 Cubic Yards or More* CHARACTERISTICS OF LOT: IT ^012. Bluff ( )Yes (><JNoSq. Ft.Ft.Lot Area.Water Frontage /.%.% Impervious Surface RatioBuilding Surface Ratio; THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES, /'//y,/!^ 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. -/‘ H-Date: Signature of Property Owner / Agen/for Owner '-Nt"Q. r-i- PPqi'ZDate: Land & Resource Management Official■VDO-OOPERMIT FEE $RECEIPT NO.PROJECT(S) TOTAL SO. FT,. iiDu fyk \<i C<. i( <J U.(j "'1 jv’t I /r 't!)( Comments: / I ■ tli W f "(f 'y ,OJ?I Form No. BK — 04-2014 3S4.252 • Victor Lundeen Co.. Printers • Fergus Falls. Minnesota ./ SITE PERMIT INSPECTION RESULTS Inspector must make all measurements and computations }6C^Ft.Structure Set Back from Ordinary High Water Level Ft. Ft. Ft.Structure Set Back from Top of Bluff }CO‘^Ft.Structure Set Back from Road Right of Way Ft. Ft.Ft.&Structure Set Back from Lot Lines Ft.&Ft. 5'^Ft.Ft.Structure Height y Ft.Structure Set Back from Septic Tank Ft. jbo*'Ft.Structure Set Back from Drainfield Ft. Elevation Of Lowest Floor Above Ordinary High Water Level 3^Ft.Ft. Land Slope at Building Site %% Inspector’s Comments / Sketch: I lOO^ 20 LlLl 4^^ Cc,b'*^ 'A ^4*AT5 Inspector's Signature Date of Inspection ^V)0 Time of Inspection ^Project Approved Inl^ Date / Initial r WHITE - Office APPLICATION FOR SITE PERMIT GOU^NROP' -^Inspector YELLOW - Owner (after issue) PINK - Assessor 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 21500Permit No.APPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED. SECTION TWP NO.RANGE TWP NAMELAKE/RIVERLAKE / RIVER NO.LAKE/RIVER NAME CLASS- A3 81 C i I I \ I R D C I \HOZ33. PROPERTY (E-911) ADDRESSPARCEL NUMBER (S)S^SiS S K. R cAA03H1 gR \ OOQO 11 OOP \Cinnt c. LEGAL DESCRIPTION Brr:c\,cJ\ RxrSori~iVg C.LK p SHP+ GtL 0>^ A / t Daytime Phone No.First Initial Mailing AddressLast Name 3iOO^'^ C.q.vr>. p<^vOU>\cL ^cLProperty Owner 0\ e.^*bs>.v^ ^ *-C. rye- icL -S"utg ^ ^ .3/y VQ5e^7t) 9.R ?5 C-^Y RA It /N /d /7i Ai S(a 3d 0> Contractor Name Lie.# I('r/c/ Coir\si~uci~t0r\Il~l I sc 36 50 ,365 ONSITE SEWAGE TREATMENT SYSTBMV^ ( ) L&R Cert, of Compliance within 5 yrs. ( ) Compliance Inspection Report within 3 yrs. (Attached) PROPOSED PROJECT (please circle the appropriate number) (1 ) New Dwelling (4) MHA'R (7) Add'n To Non-Dwelling (10) Non-Conf. Replacement (identity)" (11) Other (identify), (12) Deck_ (13) Fence ONSITE WATER SUPPLY (■^ Individual ( ) Public ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3’ (minimum) structure setback to a well. ^^Replacement Dwelling’ \ (6 ) Attached / Detached Gar^e ( 9 ) W.O.A.S. / (2) Add'n to Dwelling ( 5) RCU/Year______ ( 8) Storage Structure ( ) OTWMD 'Must have Sewage System Approval from OTWMD prior to issuing Site Permit.\ daK K ^ ^ {Aupir / f Contact Rotlie Mann at 218-864-5533 "Existing Non-Conf. Structure y^rif^d by LJR _____I ________r CHARACTERISTICS OF PROPOSED NON-DWEL^NG JJSlac5>6 Inspector's Initial/D^ 1•Removal of Existing Dwelling Verified by L&R ■/ntii CHARACTERISTICS OF PRi MtER oriented ACCESSORY STRUCTUCHARACTERISTICS OF PROPOSED DWELLING (Must Include Attached Garage) Outside Dimension Sq.Ft.^2JuMi^ Setback to Lotline / Ft. & 550 Ft." Setback to Right of Way Ft." Setback to Ordinary High Water Level I Ft. Elevation Above Ordinary High Water Level Setback to Septic Tank Ft. Setback to Drainfield O Ft. Setback to Bluff A//A Total Bedrooms Maximum Proposed Height Ft. Roof Change ( ) Yes (^C ) No Basement ( ) Yes (■^ No Walkout Basement ( ) Yes (side prohle required) ( y) le Outside\ DimensionFt. X ^ O Ft."Ft. X Ft."Dimensti Ft. X Ft.” Sq. Ft. \ Setback to Lolling Setback to Right of Setback to Ordinary High Level X Elevation Above Ordinary High WMZLevel Setback to Septic Tank___ Setback to Drainfield__y Setback to Bluff / Maximum Proposm Height Roof ChangZT ) Yes ( ) No Bathrooj/Proposed ( ) Yes ( ) No Sq. Ft._______X Setback to Lotline Setback to Right of Way Setback to Ordinary High Watgii^el __ ' Elevation Above Ordinary HioKY/at^evel Setback to Septic Tank / Setback to Drainfield/ Setback to Bluffy \ Maximum P/posed Height ( ) Boamouse (/Gazebo **Project/Lotllnes/Rl^t-of-ways Must be Staked Onsite,Prior to Apfjfication / Inspection 999 Cubic Yards* □ 1,(fco Cubic Yards or More* Ft.&•t.”Ft."Ft.& Ft." / 3* Ft.Ft. Ft. F^Ft. Ft.Ft. Ft.Ft. Ft.Ft. ( ) Screen Porch ( ) Storage Structure * Must include on scale drawing, additional Permit may be required. Topographical Alteration I Earthmovinq □ None □ 20 Cubic Yards or Less *□ 21 Cubic Yards - CHARACTERISTICS OF LOT: Lot Area A65 0 T 4 ^ ' Building Surface Rrio | THlTlsTsiTEPERMITON^ANDDoWNOTCONSTnilTEABUILDING 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 responsibility to inform the Land & Resource Management office once the building footings have been constructed. Bluff (Sq. Ft.Water Frontage Ft. m 4pQt^ ^-fZ^Impervious Surface Ratio Owner Date: Tor OmSignaKire of Property Owner / Agent -------^ &^esourcpmfan^^ment Official Date: Land iaoPERMIT FEE $RECEIPT NO.PROJECT(S) TOTAL SQ.FT. Comments/^ VJt Id -----so A NIM r Date Stamp -MrL&R InitialForm No. BK — 08-01S-2013 352,196 • Victor Lundeen Co., Printers • Fergus Falls. Minnesota WHITE - Office APPLICATION FOR SITE PERMIT G^iLDfNROD - Inspector YELLOW - Owner (after issue) PINK - Assessor 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 r 7V^0OPermit No.APPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED. LAKE / RIVER NO.LAKE/RIVER NAME LAKE/RIVER CLASSCi IK [\ \ R SECTION TWP NO.RANGE TWP NAME C \ \HOi 1 13 0. PARCEL NUMBER (S)PROPERTY (E-911) ADDRESS I te. 0R\ DOQQl I 006^ OOP LEGAL DESCRIPTION C5 cl\p ^ ^S H/- ’i' G? ^ ^On n I c FirstLast Name Initial Mailing Address Daytime Phone No. Property Owner f^sc^r\r. id 'S~ug;o/i*» ^ Cayvt pc^YO So-Hie /*7rS/ S’iffSiS 4?/y HOSbHltjU ^ Contractor Name Lie.# Kr I C i C^on s7~Ur:f jjos/s /nl ' SC su>30 ONSITE SEWAGE TREATMENT SYST^Wf/J/ ( ) L&R Cert, of Compliance within 5 yrs. ( ) Compliance Inspection Report within 3 yrs. (Attached) ( ) OTWMD 'Must have Sewage System Approval Irom OTWMD prior to issuing Site Permit. _________ I Contact Rome Mann at 218-864-5533 3 kaircn p "Existing Non-Conf. Structure wriffed by LJR I______________■ Inspectors tniliai/Dale \ ^ ^f()\/^0 CHARACTERISTICS OF PROPOSE^NON-DWEL^lW’ Outside Dimension 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_____, ONSITE WATER SUPPLY (*)4 Individual ( ) Public ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3' (minimum) structure setback to a well. ^t^Replacement Dwelling* \ ( 6 ) Attached / Detached Garape ( 9 ) W.O.A.S. / ( 2 ) Add’n to Dwelling ( 5 ) RCUA'ear______ ( 8 ) Storage Structure ^ ^ f duptr- \•Removal of Existing Dwelling Verified by L&R mk CHARACTERISTICS OF PROPOSED W.O.A.s’., (WATER ORIENTED ACCESSORY STRUCTURE) Outside Dimension'' i \CHARACTERISTICS OF PROPOSED DWELLING (Must Include Attached Garage) Outside Dimension ^ Qu Ft. x ^ O Ft.** Sq.Ft.^i^pi^ Setback to Lotline / Ft. & "!^SO Ft.** Setback to Right of Way f/SZi Ft.** Setback to Ordinary High Water Level / p-O Ft. Elevation Above Ordinary High Water Level / ^ Ft. Setback to Septic Tank Ft. Setback to Drainfield 7^0 Ft. Ft. X Ft. X Ft.** Sq. Ft. Setback to Lotline'v^^ Setback to Right of WaK Setback to Ordinary High V^t^Level Elevation Above Ordinary High V Setback to Septic Tank____/ Setback to Drainfield / Setback to Bluff S' Ft. /Maximum Propo5e6 Height_______ Roof Change ) Yes ( ) No Bathroom't’roposed ( ) Yes ( ) No \\Sq. Ft. Setback to Lotline Ft.&Ft.** Setback to Right of Way \ A" Setback to Ordinary High 'WatdK\^e\ __ Elevation Above Ordinary HiglTWatSKl-Svel Setback to Septic Tank ^ Setback to Drainfiel Setback to Bluff ______ Maximum Proposed Height ( ) Boathouse (,)'6azebo **Project/Lotlines/Rigf)t-of-ways Must be Staked Onsite ,Priof to Application / Inspection vm□ 1,WI0 Cubic Yards or More* Ft. Ft. /Ft. Ft./Ft.4^(2Total Bedrooms Maximum Proposed Height D<^*C(** Ft. Roof Change ( ) Yes (yc,) No Basement ( ) Yes ( y) No Walkout Basement ( ) Yes (side profile required) (^) No Ft. Ft. :( ) Screen Porch ( ) Storage Structure ■ ITopographical Alteration / Earthmovinq □ None * Must include on scale drawing, additional Permit may be required.□ 20 Cubic Yards or Less *□ 21 Cubic Yards - 999 Cubic Yards* ;CHARACTERISTICS OF LOT: Lot Area 01 4 Sq. Ft. V i>vv:Hc" y %-Vlo\h Building Surface R^tlo I (oOO Bluff ( )Yes Of') NoWater Frontage Ft. IK V-T Impervious Surface Ratio 2_iI-L/Z— 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 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 responsibility to inform the Land & Resource Management office once the building footings have been constructed. _______y ir-»_____________________________________________________________________________Signature of Property Owner/Agent f6r Owner con- Date: . ."A Date; Land A^esource^.lent Official Nlr/^1PROJECT(S) TOTAL SQ. FT. ^ O PERMIT FEE $RECEIPT NO.1 Upncr- jr; p(-2:n P. IComments: 1‘. ) SCaMMp,f Form No. BK — 08-015-2013 352.196 • Victor Lundeon Co.. Printors • Fsrgus Fails. Minnasota SITE PERMIT INSPECTION RESULTS Inspector must make all measurements and computations Structure Set Back from Ordinary High Water Level Ft.Ft.I7J_ Structure Set Back from Top of Bluff Ft.Ft. -T'Structure Set Back from Road Right of Way Ft.Ft. Ft.&Structure Set Back from Lot Lines Ft.Ft.&Ft. ✓6^Structure Height Ft. Ft. k-Structure Set Back from Septic Tank Ft. Ft.5Z) rStructure Set Back from Drainfield Ft.Ft. Elevation Of Lowest Floor Above Ordinary High Water Level 5'Ft. Ft. a -Land Slope at Building Site %% Inspector’s Comments / Sketch: JjJfeL VO ( I % Inspector’s Signature Date of Inspection 3’(C Time of Inspection Uf^mject Approved Date / Initial / \ i 1 I WHITE - Office APPLICATION FOR SITE PERMIT GOLDENROD - Inspector'^ YELLOW - Owner (after issue) PINK - Assessor 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 Permit No.APPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED. SECTION TWP NO.RANGE TWP NAMELAKE / RIVER NO.LAKE/RIVER NAME LAKE/RIVER CLASS RdPARCEL NUMBER (S)PROPERTY (E-911) ADDRESS t^l OOOO I) 00 W 000 I W3AI Bowme Bea-cTi MN Daytime Phone No.First initial Mailing AddressLast Name LLC . ~ KXTY1oCfi..A Knel UYismohcrv -pio- CO/rv^(y!nA.v\A ______RnlVU liLfe AtO SLS)S Property Owner gSSS CAv^ iZ4 II K)fi A\eMinAy\aj AtM 5L30R Contractor Name Lie. #B>C^ 3(^3>o z.(^s' PROPOSED PROJECT (please circle the appropriate number) ONSITE WATER SUPPLY (I) New Dwelling (2) Add’n to Dwelling ^Replacement Dwelling* (/j individual ( ) Public ( ) None (4)MH/YR________ (5)RCU/Year________ (6 ) Attached/Detached ^ (7) Add'n To Non-Dwelling (8) Storage ^ucture ( 9 ) W.O.A.S. , NOTE: MN Rules Chpt. 4725 (MN Well (10) Non-Conf. Replacement (identify)" / * 1 *14' / requires a 3’ (minimum) structure (II) Other (identify)(^6^-*^ f \ ^ .^sAback to a well. (12) Deck 'T ^ ’ / ONSITE SEWAGE TREATMENT SYSTEM C|<P Permit No. ^ I ( ) OTWMD 'Must have Sewage System Approval from OTWMD prior to issuing Site Permit. Contact Rollie Mann at 218-864-5533 —I N I l3fet>p.ooPInsilector's Initial/Date 3‘Removal of Existing Dwelling Verified by L&R ___________-f-n LP }**/ ' CHARACTERISTICS OF PROPOSED NON-DWELLING Outside , Dimension "Existing Non-Conf. Structure Verified by L&R CHARACTERISTICS OF PROPOSED W.O.A.S. (WATER ORIENTED ACCESSORY STRUCTURE)CHARACTERISTICS OF PROPOSED DWELLING (Must Include Attached Garage) Outside Dimension ^ 2- Ft. x so.Ft.teha&~2.Z^O Setback to Lotline ZOO Ft. & 3QO Ft.** Setback to Right of Way [ lOO Ft.** Setback to Ordinary High Water Level \^0 Ft. Elevation Above Ordinary High Water Level I 2- Ft. Setback to Septic Tank (oO Setback to Drainfield 30 Ft. Setback to Bluff M A pt. Total Bedrooms (o , ^ Maximum Proposed Height ^ Ft. Roof Change ( ) Yes C]?^) No Basement ( )Yes (^)No Walkout Basement ( ) Yes (side profile required) (y(} No Outside Dimension40Ft."Ft. XFt."Ft. X Ft.** Sq. Ft. \ Setback to Lotline > Setback to Right of Way Setback to Ordinary High Waterteyel __ Elevation Above Ordinary High Waterbqvel Setback to Septic Tank___ Setback to Drainfield____ Setback to Bluff________ Maximum Proposed Height Roof Change ( ) Yes ( ) No Bathroom Proposed ( ) Yes ( ) No Sq. Ft.\ Setback to Lotline __j Setback to Right of Way Setback to Ordinary High Wat\ Level __ Elevation Above Ordinary High VV^er Level Setback to Septic Tank Setback to Drainfield Setback to Bluff___ Ft.&Ft.**Ft.&Ft.** Ft.**Ft.** Ft.Ft. Ft.Ft.Ft. Ft. Ft.Ft. Ft.Ft. Ft. limum Proposed Height ( ) Boathouse ( ) Gazebo Ft. ( ) Screen Porch ( ) Storage Structure **Project/Lotllnes/Right-of-ways Must be Staked Onsite Prior to Application / Inspection 21 Cubic Yards - 299 CuBic Yards* Topographical Alteration / Earthmovino □ None □ 20 Cubic Yards or Less * □ 21 * Must include on scale drawing, litional lired.□ 300 Cubic Yards or More* CHARACTERISTICS 0/ LOT: 0, ona.Sq. Ft.Lot Area Water Frontage 'bT, 799.? - Total Impervious Surface Onsite (Ft/ Total Lot Area^FT^)Impervious 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 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. Signature of Property Owner / Agent for Owner L J 9/?/2g|2- Date: POJ?-.Date: Land & Resource ManagementZ2Mo3.or>PROJECT(S) TOTAL SQ.FT.,PERMIT FEE $RECEIPT NO. Date StampComments: :>; ^mm - "'OlJFiCBt L&R Initial Form No. BK — 07-2011-05 347,646 • Victor Lundaen Co.. Printors • Fergut Falls, Mlnnasota WHITE - Office GOLDENROD ■ Inspe/Ctor'i 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 Z.lp'VoO218-998-8095 www.co.otter-tail.mn.us <3 ■iPermit No.APPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED. LAKE / RIVER NO.LAKE/RIVER NAME LAKE/RIVER CLASS SECTION TWP NO.RANGE TWP NAME[l CUiKeK:WlCAxtiveva A 'I PARCEL NUMBER (S) PROPERTY (E-911) ADDRESS ig-iOCX':■Oin\€ |2fA, AtK',I I GO (f q OOP 1.■ / ' )! LEGAL DESCRIPTION Lpf (-ill ?K'; Daytime Phone No.Last Name First Initial Mailing Address Z()0QZ vd KcV: iAla ‘^AuO ■S\n^)S m^^C4riOi Property Owner (L A I IciVNliucft-nA t iza )i hjeAtf.yfi fTftv'iA- AiM Contractor Name Lie.#^ 'im^siEdwBC- 3L>xoZ( PROPOSED PROJECT (please circle the appropriate number) (1 ) New Dwelling (2) Add’n to Dwelling (S') Replacement Dwelling" (4 ) MH/YR________ ( 5) RCU/Year________ (6) Attached / Detached (7) Add'n To Non-Dwelling ( 8) Storage Siructure (9) W.O.A.S. .■(10) Non-Conf. Replacement (identily)" / * ., 1 X ~)4- / (1 ,,v|( 'Oo (11) Other (identify)_______________\ ^ \ (12) Deck_______ ~ ■ •' ONSITE WATER SUPPLY ^,) Individual ( ) Public ( ) None OTE: MN Rules Chpt. 4725 (MN Well de) requires a 3' (minimum) structure ___I N "Existing Non-Conf. Structure Verified by L&R ONSITE SEWAGE TREATMENT SYSTEM (>-.) Permit No. ( ) OTWMD 'Must have Sewage System Approval ^ from OTWMD prior to issuing Site Permit.i( i r(' I'-i^Contact Rome Mann at 218-864-5533 Iz. t . > back to a well. tt, 1■Removal of Existing Dwelling Verified by L&R \ ^ ' \ P ^ CHARACTERISTICS OF PROPOSED NON-DWELLING CL /nspector's Initial/Date CHARACTERISTICS OF PROPOSED W.O.A.S. (WATER ORIENTED ACCESSORY STRUCTURE) Outside Dimension CHARACTERISTICS OF PROPOSED DWELLING (Must Include Attached Garage) Outside Dimension Sq. Ft. ^ i O Setback to Lotline Setback to Right of Way f tOO Ft.** Setback to Ordinary High Water Level 1 f>0 Elevation Above Ordinary High Water Level__ Setback to Septic Tank LnO Setback to Drainfield Setback to Bluff ^y/ A _ r. Total Bedrooms vb ^ Maximum Proposed Height Ft. Roof Change ( ) Yes fbC) No Basement ( ) Yes ( /) No Walkout Basement ( ) Yes (side profile required) (■>C) No Outside Dimension Ft.**Ft. XFt.**Ft. X Ft.** ;i I >Sq. Ft. Setback to Lotline __\ Setback to Right of Way \ Setback to Ordinary High Water Level Elevation Above Ordinary High Water'Lqyel Setback to Septic Tank__ Setback to Drainfield____ Setback to Bluff________ Maximum Proposed Height Roof Change ( ) Yes ( ) No Bathroom Proposed ( ) Yes ( ) No Sq.Ft.________ Setback to Lotline Setback to Right of Way \ Setback to Ordinary High Watbr I L B L R.& MXJ' Ft.**Ft.&Ft.**Ft.**Ft.& Ft.**V Ft.**Ft. Ft.12. Ft.Level __ Elevation Above Ordinary High W^r Level Setback to Septic Tank Setback to Drainfield Ft. Ft.Ft.Ft. Ft.Ft.i Ft.Ft. Ft. Setback to Bluff________ M^imum Proposed Height ( ) Boathouse ( ) Gazebo **ProJect/Lotlines/Right-of-ways Must be Staked Onsite Prior to Appiication / Inspection Ft. Ft.Ft. ( ) Screen Porch ( ) Storage Structure Topographical Alteration / Earthmovinq □ None * Must include on scale drawing, additional Permit-maybe required. LAj □ 21 Cubic Yards - 299 Cubic Yatds*□ 20 Cubic Yards or Less *□ 300 Cubic Yards or More* SU .J9CI CHARACTERISTICS OF LPT; B K <1, ( } iLot Area ' ’ )'■ /I Sq. Ft.Ft.Bluff ( ) YesWater Frontage /O-- 7, Y7'/-/ - Total Impervious Surface Onsite (FP) =L"lCm =Impervious Surface Ratio;.%imperVlous Surface RatioTolai 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.t understand that it is my responsibility to inform the Land & Resource Management office once the building footings have been constructed. 1 L'!9 hIZTtZ.( (•.rpiL-v-ADate:^___t Signature of Property Owner / Agent for Owner §d r. c-" I'.YDate: Land & Resource Management Official ^ -----------7'ioZ 2.^10 PERMIT FEE $PROJECT(S) TOTAL SQ. FT,.RECEIPT NO. Comments: SCANNEDr f-;r Form No. BK — 07-2011-05 347,648 • Victor Lundeen Co.. Printers • Fergus Falls. Minnesota SITE PERMIT INSPECTION RESULTS Inspector must make all measurements and computations AJ Euj /OQ ^structure Set Back from Ordinary High Water Level Ft.Ft. Ft.Structure Set Back from Top of Bluff Ft. Ft.Structure Set Back from Road Right of Way Ft. Sc ^Ft.Ft.&Ft.Ft.&Structure Set Back from Lot Lines Ft.Ft.Structure Height Ft.Ft.Structure Set Back from Septic Tank / O Z O -h-Ft.Structure Set Back from Drainfield Ft. Elevation Of Lowest Floor Above Ordinary High Water Level _____/S~Ft.Ft. Land Slope at Building Site %% -3* cr^ CInspector’s Comments / Sketch: r 6 B/t /Vjxo 5“C :t-(r I5®/- /A fv5*' \N\ Inspector’s SigrmftjK Date of Inspection Time of Inspection y^rofect Approved Date / lnHi0^mk,,^^ I 'OTTER TAIL COUNTY Conditional Use PermgOwner’s Name fettcR J\-esiovHv]&eiTA-K Li^c) Property Address Z. 0?> 41 fiAUxAr\ /iA_____ . Sec. II Twp. Range ^0 Twp.NameLocation: Ifl-OOO-ll-OOfcq-W)^* Work Authorized: it*f>l<tce ir co4>vrvs w h - ui€ Sew^i^4 w<^er . }ja^^ ddct6 t ohe cxyeco. iQ .1 Ai>woMu»i<? ^ostcuq <3>,frty&t Meo-su-ires Adovy/i n arfR^ource Managei^nt Otficial / Date ^. Entire area shall be stabilized within 10 days of the completion of any earthmoving unless otherwise stated. 2. Owner is legally responsible for all surface water drainage that may occur. 3. If the terms of this permit are violated the entire permit may be revoked and the owner may be subject to legal prosecution. 4. 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. Expires:Valid: 5. NOTIFY DEPARTMENT OF LAND AND RESOURCE MANAGEMENT, TELEPHONE (218) 998-8095, WHEN AUTHORIZED WORK HAS BEEN COMPLETED.SK-1004-046 319.993 ■ Victof LundMO Co.. Printers ■ Fergus FlUi, MN ■ 1-000-346-4670 CSCANNED V JljjO j V sSr-% I I White - Office Yellow — Owner Pink — Assessor Goldenrod — Inspector SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 — Fergus Falls, Minnesota 56537 APPLICATION FOR SITE PERMIT -t' _ '11S2Permit No^LEGAL DESCRIPTION AND LOCATION / rJ (Ic. I t-KS0'2H II TWP NameSec.TWP RangeLake ClaasIf.Lake No. Lake Name IDENTIFICATION: Please Print All Information Tel. No.Zip No.Maili^Address— No. Street. City and StateInitialEirst o Last Name Be ttec lX rv\ n(Owner t NameContractor Architect Name. NON-RESIDENTIAL PROPOSED USE;RESIDENTIAL PROPOSED USE;TYPE OM IMPROVEMENT: (y1 Mew Building ( ) Alteration iIX /V 02 ^ ^ Specify:.(vTone Family Dwelling ( ) Multiple Dwelling Units ( ) Other( ) Other Size ESTIMATED COST OF IMPROVEMENTS DIMENSIONS:TYPE OF SEWAGE DISPOSAL;PRINCIPAL TYPE OF FRAME:■Xuo )Basement: ( ) Yes (•. Stories above basement: Sq. feet (outside dimension) Bedrooms ( ) M^ (vI'Wood Frame ( ) Structural Steel ( ) Other — Specify ( l^blic (VI Individual Septic Tank, etc. WATER SUPPLY: ( ) ^blic ( ^dividual Well nry .J..X.Baths CHARACTERISTICS: feet.Maximum depth of lot feet.Water frontage issquare feet.Lot Area is I±9..feet. (Building Line)Building set back from high water mark Is Land height above high water mark at building line is Building set back from State highway right of way.... Side yard is Structure will be located J..feet 2^0£.Q,■feet.feet — from road right of way Is lO( o .............feet. ■feet from septic tank (Sewage System Permit must be obtained before installation). feet from soil absorption system (Sewage System Permit must be obtained before installation). and (a 2(fStructure 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. I understand that I have been granted a site permit in accordance with the requirements of the Shoreland Management Ordinance of Otter Tail County. I understand I must contact my township in order to determine whether or not any additional permits are required by the township for my propo A c)- 2..-roDated. Signature of/uwner Permission is hereby granted to the above named applicant to perform the work described in the d fement. 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 -j^h ) Dated Shoreland Management Official"io ■Permit Fee $,Receipt No. ^ g P I Ckc^'l moUiijL Kpi^v—<— ^ \4 K fc) I vACommentsr^' Form No. MKL-0286-019 229971@ VICTOR LUNOeCN CO.. PRINTERS. SEROUS PALLS. MINN. r White - Office Yellow — Owner Pink — Assessor Goidenrod — I nspector SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 — Fergus Falls, Minnesota 56537 APPLICATION FOR SITE PERMIT Permit No„LEGAL DESCRIPTION / L i (■ J i / !// • AND LOCATION TWP NameRangeSec.TWPLake ClassIf.Lake NameLake No. IDENTIFICATION: Please Print All Information Tel. No.Zip No.Mailing Address— No. Street. City and StateInitialFirstLast Name Owner NameContractor Architect Name. NON-RESIDENTIAL PROPOSED USE:RESIDENTIAL PROPOSED USE:TYPE OF IMPROVEMENT: Specify:.( ) One Family Dwelling ( ) Multiple Dwelling ( ) New Building ( ) Alteration Units ( ) Other( ) Other Size ESTIMATED COST OF IMPROVEMENT $ DIMENSIONS:TYPE OF SEWAGE DISPOSAL:PRINCIPAL TYPE OF FRAME: Basement: ( ) Yes ( I 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 Baths CHARACTERISTICS: feet.Maximum depth of lot feet.Water frontage issquare feet.Lot Area is feet. (Building Line)Building set back from high water mark is.............;...... Land height above high water mark at building line is Building set back from State highway right of way..... Side yard is ..................... Structure will be located Structure will be located feet .feet.feet — from road right of way is .............feet. .feet from septic tank (Sewage System Permit must be obtained before installation). feet from soil absorption system (Sewage System Permit must be obtained before installation). 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 p>art of this permit application. I also understand that this permit is valid for a period of six (6) months. THIS IS A SITE PERMIT ONL Y AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES. I understand that I have been granted a site permit in accordance with the requirements of the Shoreland Management Ordinance of Otter Tail County. I understand I must contact my township in order to determine whether or not any additional permits are required by the township for my proposed project. 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 Permit Fee $.Receipt No. ;Comments:^ ‘*■ Form No. MKL-0286-019 229971® VIcrOK LUNOECN CO.. PRINTERS. FERGUS FALLS. MINN. 0 INSPECTOR'S CHECK LIST Make all measurements and computations ACTUAL IS 1 MINIMUM Shall Be 4'Sq. Ft. Lot Area (Square feet)Sq. Ft Sq. Ft. Water Frontage Ft.Ft. I60Building Set Back from High Water Mark Ft.Ft. 0^Building Set Back from State Highway 50 Ft.Ft. Building Set Back from Street or Road Ft. 40 Ft. Side Yard &&Ft. oKRear Yard Ft. Ft. oKOccupied Building to Septic Tank Ft.10 Ft. 0^Occupied Building to Absorption System Ft. 20 Ft. Elevation at Building Line above High Water Mark_____________ f 3 Ft. (pi /o r; TcsInspector's Comments:S-Q •S:I()I I U/ q ?< ^ 0 Cc^b' 2f ^g\i"A (b _____bo s I \ »v\ Va Inspector's Signature Title Inspection Dated Agency VICTOK LUNBCEN 4 M.. —I oV, H ^1 L-Y\ ^ogvVjal /n )\0 D1AV. ; White — Office Yellow — Owner Pink ~ Assessor Goldenrod — Inspector SHORELAIMD MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 — Fergus Falls, Minnesota 56537 APPLICATION FOR SITE PERMIT Permit No. 7rv rv ) S /Scir^c l~f )LEGAL DESCRIPTION AND 1 LOCATION /Jc3 CL i THtrfSS^LL.LL TWP NameTWPRangeLake Classif.Sec.Lake No^Lake Name IDENTIFICATION: Please Print All Information Zip No,Tel. No,Mailing Address— No. Street. City and StateLast Name InitialFirst /3/iTTLE Li<U'CIOwner />? NameContractor Architect Name. TYPE OF IMPROVEMENT:NON-RESIOENTIAL PROPOSED USE:RESIDENTIAL PROPOSED USE: Building 5 W o?^ ( ) One Family Dwelling ( ) Multiple Dwelling Specify;. / ( ) Alteration Units ( ) Other ( ) Other Size ESTIMATED COST OF IMPROVEMENT $ PRINCIPAL TYPE OF FRAME:TYPE OF SEWAGE DISPOSAL:DIMENSIONS: 1^/3 (*rtoo( ) Masonry ( M'DVood Frame ( ) Structural Steel ( ) Other - Specify ( ) Public (»''1^ndividual Septic Tank WATER SUPPLY: ( ) Public ( ^XHdividual Well Basement: ( ) Yes Stories above basement: Sq. feet (outside dimension) Bedrooms / , etc. Baths Type of Roof: CHARACTERISTICS: Water frontage is ....feet.Maximum depth of lotsettsorc fuurT feet.Lot Area is JM.Building set back from high water mark is Land height above high water mark at building line is Building set back from State highway right of way.... Side yard is feet. (Building Line) .3,feet .£<2.feet — from road right of way is •feet. id /Aand feet. JA.feet from septic tank (Sewage System Permit must be obtained before installation), feet from soil absorption system (Cesspool, Drainfield, etc.). Structure will be located 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 se forth and according to the provisions of the ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewiti 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 STATUES. y 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. /3r'SXDated Shoreland Management Official QP,oo KecPermit Fee $. Comments: 19S676@ VICTOR LU.NOEEN CO,, PRrNTKFtS. FERGUS FALLS. MINN.Form No. MKL-0771-002 White - Office Yellow — Owner Pink — Assessor Goldenrod — Inspector SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 — Fergus Falls, Minnesota 56537 APPLICATION FOR SITE PERMIT>« Ar-s *7 ‘7 . ■ ' Permit No.^^£__t__' —yjir II Zf.'y f c c H <c /-V )LEGAL DESCRIPTION AND LOCATION Z. / 7-u LL ; /J TWP NameTWPRangeLake Oassif.Sec.Lake No. Lake Name IDENTIFICATION: Please Print All Information Tel. No.Mailing Address— No. Street, City and State Zip No.Last Name InitialFirst 1 ■I - yOwnerI ! NameContractor Architect Name. TYPE OF IMPROVEMENT; ( -T New Building ( ) Alteration RESIDENTIAL PROPOSED USE:NON-RESIDENTIAL PROPOSED USE: Specify:___________________________’ K ) G fr- ( ) One Family Dwelling ( ) Multiple Dwelling/Unitsi () Other ( ) Other Size IESTIMATED COST OF IMPROVEMENT $ PRINCIPAL TYPE OF FRAME:TYPE OF SEWAGE DISPOSAL;DIMENSIONS: ( ) Yes (lYTio( ) Masonry (VVood Frame ( ) Structural Steel ( ) Other — Specify ( ) Public (-1 Individual Septic Tank, etc. WATER SUPPLY; ( ) Public (7>Mndividual Well Basement:/ Stories above basement: Sq. feet (outside dimension) Bedrooms Baths........L.". / Type of Roof: CHARACTERISTICS: flosquaee-feetr* Water frontage is .... feet.Maximum depth of lotLot Area is feet. Building set back from high water mark is. Land height above high water mark at building line is Building set back from State highway right of way..... Side yard is ......•.............. Structure will be located feet. (Building Line) feet V A";- feet — from road right of way is .feet. and feet. .feet from septic tank (Sewage System Permit must be obtained before installation), feet from soil absorption system (Cesspool, Drainfield, etc.).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 se forth and according to the provisions of the ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewit shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. TH/S /S A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA ST A TE ST A TUES.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. /7. JDated Shoreland Management Official /< cc'.OPermit Fee $. Comments: WO CEBTlFIlCATF iSSl^HD 195676(g) VICTOR LUNOCeN CO.. PRiNTfF'.'t. FA..I.S. MIN')Form No. MKL-0771-002 INSPECTOR'S CHECK LIST Make all measurements and computations ACTUAL IS ir MINIMUM Shall Be j.Sq. Ft, Lot Area (Square feet)Sq. Ft Sq. Ft. Water Frontage Ft.Ft. Building Set Back from High Water Mark Ft.Ft. Building Set Back from State Highway Ft.50 Ft. Building Set Back from Street or Road Ft. 40 Ft. I-lo' & liN Ft.Ft.Side Yard iiaRear Yard Ft.Ft. Occupied Building to Septic Tank 10 Ft.Ft. TOccupied Building to Absorption System Ft.20 Ft. Elevation at Building Line above High Water Mark_____________s Ft.3 Ft. I ire Inspector's Comments: :r( • V r7 T U Pi Ins^ctors Signature Title Inspection Dated -19 Agency viciei LUNoecN k CO . imrci .1 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 (o A S Permit No,,LEGAL 2D.DateDESCRIPTION AND LOCATION //13^ TWP NameSec.TWP RangeLake Classif.Lake NameLake No. IDENTIFICATION: Please Print AH Information Tel. No.Mailing Address— No. Street. City and State Zip No.InitialFirstLart_ Name Owner NameContractor Architect Name. TYPE OF IMPROVEMENT: New Building ( ) Alteration NON-RESIDENTIAL PROPOSED USE:RESIDENTIAL PROPOSED USE: (^One Family Dwelling ( ) Multiple Dwelling /7 W<5 r Specify:. Units ( ) Other ( ) Other Size ESTIMATED COST OF IMPROVEMENT $ 3 (omit cents) PRINCIPAL TYPE OF FRAME: TYPE OF SEWAGE DISPOSAL:DIMENSIONS: Basement: ( ) Yes No Stories above basement: ...... ( ) 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 / Sq. feet (outside dimension) Bedrooms ,21./Baths '7^ HEATING: ( ) Electric ( ) Coal Other: Gas ( ) None ( V) NoType of Roof:( ) Oil ( ScTNo ( ) Unit CHARACTERISTICS: 16..A f(7 0Lot Area is square feet. Water frontage is . .. feet. (Building Line) .................................feet feet. c^odBuilding 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 DO ^feet — from road or street is feet. ^S..0.±and 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. / o ^ .Z=0:±:.. Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed wor)tJn accordance with the description above set plans and fihniittH herewithforth and according to the provisions of the ordinances of Otter Tail County, Minnesota. I further agree thj shall become a part of this permit application. I also understand that this permit is valid for a period ai inths.IX 3/t >Dated SignStureofr^wner Permission is hereby granted to the above named applicant to perform the work described in the above sti iment. This permit is granted upon the ■irrail respects to the ordinances of Otter Tail Permit: express condition that the person to whom it is granted, and his agent, employees and workmen shall cori County, Minnesota. This permit may be revoked at any time upon violation of said ordinances. z ^ /7'yDated Shoreland Management Offici-7S~/O oPermit Fee $.State Surcharge $. VPCA C L(Jlr<Comments: 111 nr-/re rrV Form No. MKU-0771-002 158899 VICT«M umBCCH 4 CO.. rCR«U« 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 k:0 Permit No„LEGAL Date.DESCRIPTION AND Pn^ 10.^^A. MLOCATION TWP NameSec.TWP RangeLake Classif.Lake No.Lake Name IDENTIFICATION: Please Print All Information Tel. No.Zip No.Mailing Address— No. Street. City and StateFirstInitialLast Name Owner NameContractor Architect Name. NON-RESIDENTIAL PROPOSED USE:TYPE OF IMPROVEMENT:RESIDENTIAL PROPOSED USE: ( ) New Building ( ) Alteration ( ) One Family Dwelling ( ) Multiple Dwelling Specify:, Units ( ) Other ( ) Other Size ESTIMATED COST OF IMPROVEMENT $(omit cents) PRINCIPAL TYPE OF FRAME: TYPE OF SEWAGE DISPOSAL:DIMENSIONS: ( ) 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 ( ) Yes ( ) NoBasement: Stories above basement: Sq. feet (outside dimension) Bedrooms ..............................Baths HEATING: ( ) Electric ( ) Gas ( ) Coal Other: ( ) NoType of Roof:( ) OileZ C.y ( ) No ( ) None ( ) Unit CHARACTERISTICS: Lot Area is square feet.Water frontage is. feet. (Building Line) ................................feet feet. 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 feet — from road or street is feet. and .......................................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. 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 Permit Fee $.State Surcharge $. Comments: certificate ISSU,:lD3 Form No. MKL<0771-002 VICTOt I.UHBCCH A Cft.. PMlIlTtM. FtBtua FALL*. .158899 INSPECTOR'S CHECK LIST Make all measurements and computations ACTUAL IS I’MINIMUM Shall Be X-Sq. Ft, Lot Area (Square feet)Sq. Ft Sq. Ft. Water Frontage Ft.Ft. Building Set Back from High Water Mark Ft.Ft. Building Set Back from State Highway Ft.50 Ft. Building Set Back from Street or Road Ft.40 Ft. 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. c'-(-Inspector's Comments: InspMtor s ^gnature Title Inspection Dated 19 Agency VieTOH UINDEIH t CO . MlHTtm. ECRtUt TALLt. HIHH. ;«SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone 218-739-2271 - Fergus Falls, Mn. 56537 APPUCATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY White — Office Yeilow — Owner Pink — Assessor Goldenrod — Inspector riY)i G Permit No„LEGAL Date.DESCRIPTION AND LOCATION r,/.w AO C-Zi '/Ti/Ci/V’, //A jL /y,iLAfS r-Cf S6C.Lake No.Lake Classif.Range TWP NameLake Name TWP IDENTIFICATION: Please Print Ail Information -ast Name_______________________Flr^ Initial Mailirig Address— No. SUeet, City and State Tel. No.Zip No. Owner r NameContractor Architect Name. TYPE OF IMPROVEMENT:RESIDENTIAL PROPOSED USE:NON-RESIDENTIAL PROPOSED USE: fCl-Wew Building ( *-FAlferation ( >4'Ohe Family Dwelling ( ) Multiple Dwelling ()Other Specify:. Units '7( ) Other Size ESTIMATED COST OF IMPROVEMENT $ PRINCIPAL TYPE OF FRAME: ( ) Masonry (—-HNood Frame ( ) Structural Steel ( ) Other — Specify (omit cents) TYPE OF SEWAGE DISPOSAL:DIMENSIONS: Basement: ( ) Yes ('•T'TTo Stories above basement: Sq. feet (outside dimension) Bedrooms .......^3. I ) Public ( -4"1hdividual Septic Tank, etc. WATER SUPPLY: ( ) Public ( >'Tndividual Well MECHANICAL EQUIPMENT : Elevator: ( ) Yes Air Conditioning: ( ) Yes ____ ( ) Central / Baths HEATING: ( ) Electric ( ) Coal Other: Type of Roof:( -M*d < ) Oil (( ) NoneNo ( ) Unit CHARACTERISTICS: .6-../9..Lot Area is ^ Building set back from high water mark is square feet.Water frontage is feet. (Building Line) feet. Land height above high water mark at building line is Building set back from State highway is Side yard is...........<>LO. Building will be located .. Building will be located .. ......feet feet — from road or street is........4^.Q, feet. ...xiLCX. feet. feet. Rear yard is ............. feet from septic tank (Sewage System Permit must be obtained before installation), feet from soil absorption system (Cesspool, Drainfield, etc.). and ....Z.O....TS 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 pjans 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) me ---------------------- /alt70 Dated. Signature of Owni Permission is hereby granted to the above named applicant to perform the work described in the abovePermit: 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. ent. This permit is granted upon the Shorelarid \^anagement Official ^ /D 7^Dated .K ^ OOPermit Fee $ ry .State Surcharge $. Comments: Form No. MKL-0771-002 V'crot LUMBCEH A C«.. PftIBTia*. FCN«U| r*CL*. MIH« 158899 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 NameLake No. Lake Classif.Sec.TWPLake Name Range IDENTIFICATION: Please Print All Information Last Name Initial Mailing Address— No. Street. City and StateFirst Zip No.Tel. No. Owner / NameContractor Architect Name. TYPE OF IMPROVEMENT:RESIDENTIAL PROPOSED USE:NON-RESIDENTIAL PROPOSED USE: ( ) New Building ( ) Alteration ( ) One Family Dwelling ( ) Multiple Dwelling Specify:. Units ( ) Other ( ) Other Size ESTIMATED COST OF IMPROVEMENT $(omit cents) PRINCIPAL TYPE OF FRAME:TYPE OF SEWAGE DISPOSAL:DIMENSIONS: ( ) Masonry ( ) Wood Frame ( ) Structural Steel ( ) Other — Specify ( )Yes ( ) No( ) Public ( ) Individual Septic Tank, etc. WATER SUPPLY: ( ) Public t ) Individual Well MECHANICAL EQUIPMENT ; Elevator: ( ) Yes Air Conditioning: ( ) Yes ( ) Central Basement: Stories above basement; Sq. feet (outside dimension) Bedrooms ..............................Baths HEATING: ( ) Electric ( ) Gas ( ) None Type of Roof:( ) No ( ) Oil ( ) No ( ) Coal Other:( ) Unit CHARACTERISTICS: Lot Area is square feet.Water frontage is . feet. (Building Line) ................................feet feet. 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 feet — from road or street is feet. and .......................................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. 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 Permit Fee $.State Surcliarge $. Comments: .LLLD 1 1t>IQT C.r Form No. MKL-0771-002 158899 viereR miietCN a co.. MtHTiRi. rciteus falli. INSPECTOR'S CHECK LIST Make all measurements and computations ACTUAL IS 4. MINIMUM Shall Be Sq. Ft. Lot Area (Square feet)Sq, Ft.Sq. Ft. Water Frontage Ft.Ft. Building Set Back from High Water Mark Ft.Ft. Building Set Back from State Highway 50 Ft.Ft. Building Set Back from Street or Road 40 Ft.Ft. 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 viCTca uiMeteN 4 co . ll■nl I f i t i!rI 1 !1I I ;!I ■i i;: 1 ;I I 1 I ■. i 1 1i!11 ;\i iI i(I: i ! :' 'T'!;1/i i i ! -------- ii UkCff . c j Sn^/J'.e-OCi /S;1i ;i I 1 !i Ii !I 1 !! OK i \0>V)JUCiL^!1i ' I 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 Goldenrod — Inspector pUttJ)G-L J ■ P/aTi Alt) 9 O.I',ri\<ra// All) IX Permit No..LEGAL Date.DESCRIPTION AND LOCATION // /30. yo QJ'iii-e-r'a.// TWP NameSec.TWP RangeLake Classif.Lake NameLake No. iPENTtFICATION: Please Print All Information Tel. No.Zip No.Mailing Address— No. Street, City and StateInitialFirstLast Name Owner NameContractor Architect Name. NON-RESIDENTIAL PROPOSED USE:TYPE OF IMPROVEMENT:RESIDEIDEpHl One Family Dwelling ( ) Multiple Dwelling AL PROPOSED USE: Specify:.I ) New Building ( ) AlteratioWohil-e Units/1^ XbCi'Ik ( ) Other SizeOther ESTIMATED COST OF IMPROVEMENT $(omit cents) TYPE OF SEWAGE DISPOSAL:DIMENSIONS:PRINCIPAL TYPE OF FRAME: Basement: ( ) Yes Stories above basement: Sq. feet (outside dimension) Bedrooms ............................. ( ) Masonry ( ) Wood Frame (LrfStructural Steel ( ) Other — Specify ( ) Public ( Mnndividual Septic Tank, etc. WATER SUPPLY:~7z.a .........) PuIjHE' jjr^dividual Well(Baths... ( MECHANICAL EQUIPMENT : Elevator: ( ) Yes Air Conditioning: ( ) Ye: ( ) Central HEATIN^ (t^^ectricf ( ) Oil( ) Gas ( ) None Type of Roof: ( ) Coal Other: CHARACTERISTICS:1,Lot Area is square feet.Water frontage is fept. (Building Line) feet.7".Z7.jr.Building set back from high water mark is . Land height above high water mark at building line is Building set back from Sta^ hjhway is Side yard is.....^^...1^. Building will be located Building will be located .feet d.P.I'T-feet — from road or street is feet. ,. 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. r 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 specifica^iQjissubmitted herewith shall become a part of this permit application. I also understand that this permit is valid for a period oJ,a«rfSL^aoTff^. C ^ Dated. Signature of Owm Permission is hereby granted to the above named applicant to perform the wo^lt d^ribed in the above statement. This permit is granted upon the iTto'Vie ordinances of Otter Tail Permit: express condition that the person to whom it is granted, and his agent, employees and ^orkmtn shall conform in all resi County, Minnesota, This permit may be revoked at any time upon violation of said ordirjances. \ / Dated SKo?6»and Management Official Permit Fee $ gT.- * ^ ^ State Surcharge $. Comments: Form No. MKL-0771-002 VICTOI LUHOCCH 4 CO.. PKINTCM. rCIIOUO FM-Lt. WINN 158899 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 Goldenrod — Inspector r'Permit No„/LEGAL Date,DESCRIPTION P'/ ■/1.' AND LOCATION TWP NameLake No.Lake Name Lake Classif.Sec.TWP Range IDENTIFICATION: Please Print All Information Last Name First Initial Mailing Address— No. Street. City and State Tel. No.Zip No. Owner NameContractor Architect Name. TYPE OF IMPROVEMENT:RESIDENTIAL PROPOSED USE:NON-RESIDENTIAL PROPOSED USE: ( ) New Building ( ) Alteration I ) One Family Dwelling ( ) Multiple Dwelling Specify:, Units ( ) Other ( ) Other Size ESTIMATED COST OF IMPROVEMENT $(omit cents) PRINCIPAL TYPE OF FRAME:TYPE OF SEWAGE DISPOSAL:DIMENSIONS: ( I 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 Basement; ( ) Yes ( ) No Stories above basement: Sq. feet (outside dimension) Bedrooms Baths HEATING: ( ) Electric ( ) Gas ( ) Coal Other: Type of Roof:( ) No ( ) Oil ( ) No ( ) None ( ) Unit CHARACTERISTICS: Lot Area is square feet.Water frontage is. feet. (Building Line) ...............................feet feet. 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 feet — from road or street is feet. and feet. Rear yard is feet from septic tank (Sewage System Permit must be obtained before installation), feet from soil absorption system (Cesspool, Drainfleld, etc.). feet. 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 Permit Fee $.State Surcliarge $. Comments: Form No. MKL-0771-002 VlCHi UmMU 4 44.. PWT444. PtllUt FM.bl. MINH.158899 INSPECTOR'S CHECK LIST Make all measurements and computations ACTUAL IS 1 MINIMUMShall Be X Sq. 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.Building Set Back from Street or Road Ft. Side Yard &&Ft.Ft. Rear Yard Ft. Ft. Occupied Building to Septic Tank Ft.10 Ft. Occupied Building to Absorption System 20 Ft.Ft. Elevation at Building Line above High Water Mark_____________Ft.3 Ft. \ / :Inspector's Comments: c t Inispect^^ Signature Title Inspection Dated 19 Agency VICTOR LWHOtCIi 0 CO . 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 5^Permit No„LEGAL L Date.DESCRIPTION AND LOCATION // fO CJ. M fir Cl// Sec.TWP TWP NameLake Classif.RangeLake No.Lake Name IDENTIFICATION: Please Print All Information Last Name First Initial Mailing Address— No. Street. City and State Zip No.Tel. No. CxnJi)Owner NameContractor Architect Name. TYPE OF IMPROVEMENT:RESIDENTIAL PROPOSED USE:NON-RESIDENTI^ PROPOSED USE:/^<3 ~h( LHMew Building ( ) Alteration ( ) One Family Dwelling ( ) Multiple Dwelling Specify:. SicUnitsdrcv^e.iOATO SUeA( ) Other (toother Size ESTIMATED COST OF IMPROVEMENT $(omit cents) PRINCIPAL TYPE OF FRAME:TYPE OF SEWAGE DISPOSAL:DIMENSIONS: ( ) Masonry ( ) Wood Frame ( U^tructural Steel ( ) Other — Specify ( ) Public ( Individual Septic Tank, etc. WATER SUPPLY: ( ) Public ( J-'Individual Well MECHANICAL EQUIPMENT : Elevator: ( ) Yes Air Conditioning: ( ) Yes I ) Central Basement: ( ) Yes ( tUWo Stories above basement: ....... Sq. feet (outside dimension) ....a^rS3C).C?. Baths L Bedrooms HEATING: ( ) Electric ( ) Gas ( ) Coal Other: Type of Roof:((O^No « ) Oil (i>No (“-4-T9one ( ) Unit CHARACTERISTICS: ....At.cj..Lot Area is square feet.Water frontage is, feet. (Building Line) ...............................feet feet. 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 feet — from road or street is feet. .^Q.AO...1^.0.and 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. Building will be located Building 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. AsDated. 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 Shorelan ment Official zPermit Fee $.State Surcharge $. Comments; Form No. MKL-0771-002 ^ VM1M umtctli 4 M.. MMttM. FilUJ. hAih.1$SS99 V* 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 7 '■ 7Permit No.,LEGAL I /Date.fDESCRIPTION AND LOCATION TWP NameLake Classif.Sec.TWP RangeLake NameLake No. IDENTIFICATION: Please Print All Information Mailing Address— No. Street. City and State Zip No.Tel. No.InitialFirstLast Name Owner NameContractor Architect Name, NON-RESIDENTIAL PROPOSED USE:RESIDENTIAL PROPOSED USE:TYPE OF IMPROVEMENT: ( ) One Family Dwelling ( ) Multiple Dwelling Specify:.( ) New Building ( ) Alteration Units ( ) Other( ) 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 ( ) Public ( ) Individual Septic Tank, etc. WATER SUPPLY: ( ) Public ( ) Individual Well MECHANICAL EQUIPMENT : Elevator: ( ) Yes Air Conditioning: ( ) Yes ( ) Central ( ) Masonry ( ) Wood Frame ( ) Structural Steel ( ) Other — Specify Baths HEATING; ( ) Electric ( ) Gas ( ) Oil { ) None ( ) NoType of Roof:)r-( ) No ( ) Coal Other:( ) Unit CHARACTERISTICS: square feet.Water frontage is. feet. (Building Line) ...............................feet feet.Lot Area is 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 feet — from road or street is feet. and .......................................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. 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 $.'O Comments: NOl L^ALLt-U r Form No. MKL-0771-002 vicTei kuaoecM t co.. rcaout ,158899 INSPECTOR'S CHECK LIST Make all measurements and computations ACTUAL IS 1 MINIMUM Shall Be 4-Sq. 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.Building Set Back from Street or Road Ft. Side Yard &Ft.&Ft. Rear Yard Ft.Ft. Occupied Building to Septic Tank 10 Ft.Ft. Occupied Building to Absorption System 20 Ft.Ft. Elevation at Building Line above High Water Mark_____________Ft.3 Ft. Inspector's Comments: Inspector's Signature Title Inspection Dated 19 Agency VICTQII LUHVCEM « CO.. VBIHTCM. rC««U« fM.!.*. HliMI. f 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 67/Permit No.LEGAL ncfi /r?i.Date.DESCRIPTION AND LOCATION r^A if) p ^ li c^TMjujjJ/y Lake Classif.Lake Name Sec.Lake No.TWP Range TWP Name IDENTIFICATION: Please Print AH Information Last Name First Initial Mailing Address— N.o, Street. City and State Zip No.Tel. No. T r (A. Y\ ¥\^ r 0 uuOwner NameContractor Architect Name. TYPE OF IMPROVEMENT: (irf^ew Building RESIDENTIAL PROPOSED USE:NON-RESIDENTIAL PROPOSED USE: -2w yra'( ) One Family Dwelling ( ) Multiple Dwelling (U^the^-^^Size Specify:. ( ) Alteration Units ( ) Other 0ESTIMATED COST OF IMPROVEMENT $(omit cents) PRINCIPAL TYPE OF FRAME:TYPE OF SEWAGE DISPOSAL:DIMENSIONS: Basement: ( ) Yes (Ur^Q Stories above basement: ....... Sq. feet (outside dimension)..... Bedrooms ......... Baths .OEA<IEkU^ ( ) Masonry (L^'liVood Frame (--^^ructural Steel ( ) Other — Specify ( ) Public ( ) Individual Septic Tank, etc. WATER SUPPLY: ( ) Public /y ( ) Individual Well MECHANICAL EQUIPMENT : Elevator: ( ) Yes Air Conditioning: ( ) Yes ( ) Central A t UM. ii t\ ^ HEATING: ( ) Electric (uY^as ( ) Coal Other: (UHMoType of Roof:( ) Oil ( ) None ( ) Unit CHARACTERISTICS: i‘10Li...,(3si.aAa.Lot Area is ... tgiiarr frrt ....3.A..Q. Water frontage is feet. (Building Line) ........................feet feet. 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 .-Z..d1.r ...feet — frorrj^ro^ or street is feet. HO.^.ial.....and 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. 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. Got (o /9"? ZDated r^tanShor Management Official Fee State Surcharge $.Permit Comments: Form No. MKL-0771-002 ^ Vicnil LUHIUII 4 e*.. MIMIM. PCtWI IMIMI.15S899 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 Lake Classif.Sec.TWP NameLake No.Lake Name TWP Range IDENTIFICATION: Please Print All Information First Initial Mailing Address— No. Street. City and StateLast Name Zip No.Tel. No. Owner NameContractor Architect Name, TYPE OF IMPROVEMENT:RESIDENTIAL PROPOSED USE:NON-RESIDENTIAL PROPOSED USE: ( ) New Building ( ) Alteration ( ) One Family Dwelling ( ) Multiple Dwelling Specify:, Units ( ) Other ( ) Other Size ESTIMATED COST OF IMPROVEMENT $(omit cents) PRINCIPAL TYPE OF FRAME:TYPE OF SEWAGE DISPOSAL:DIMENSIONS: ( ) 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 Basement: ( ) Yes ( ) No Stories above basement: Sq. feet (outside dimension) Bedrooms Baths HEATING: ( ) Electric ( ) Gas ( ) None Type of Roof:( ) No ( ) Oil ( ) No ( ) Coal Other:( ) Unit CHARACTERISTICS: Lot Area is square feet.Water frontage is. feet. (Building Line) ...............................feet feet. 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 feet — from road or street is feet. and .......................................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. 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 Permit Fee $,State Surchiarge $. Comments: No ? r / Form No. MKL-0771-002 ,158899 VICTttR UfMKCM « CO.. MIHTCM. PERtU* PM.L«. INSPECTOR'S CHECK LIST Make all measurements and computations MINIMUMShall Be i Sq. FtACTUAL IS 4^ Lot Area (Square feet)Sq. Ft.Sq. Ft. Ft.Ft.Water Frontage Ft.Building Set Back from High Water Mark Ft. 50 Ft.BuiIding Set Back from State Highway Ft. 40 Ft.Ft.Building Set Back from Street or Road Ft.&Ft.&Side Yard Rear Yard Ft. Ft. 10 Ft.Occupied Building to Septic Tank Ft. Occupied Building to Absorption System 20 Ft.Ft. Elevation at Building Line above High Water Mark_____________3 Ft.Ft. Inspector's Comments: Inspector's Signature Title Inspection Dated 19 Agency VietO* LUNDEEH « CO . PKINTCOO. FCHOUO TALK. UINM.