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Home My WebLink AboutClitherall Lake Campground_10000110071002_Shoreland Permits_APPLICATION FOR SITE PERMIT LAND & RESOURCE MANAGEMENT OTTER TAIL COUNTY COURT HOUSE Phone:(218) 739-2271 • FERGUS FALLS. MN 56537 WHITE ■ Office GOLDENROD - Inspector YELLOW - Owner PINK - Assessor ■f p f Gl. H Permit No.LEGAL DESCRIPTION BLUFF ZONEAND □ YESLOCATION LAKE NUMBER LAKE/RIVER NAME , « LAKE/RIVER 4.-231! SECTION TWP NO.RANGE TW^AME ,, ifQ13^ PARCEL NUMBER (S)TOPOGRAPHICAL ALTERATION □ YES # OF CUBIC YARDS □ NO FIRE NUMBER lO-CVD- il-OOll-oD^ IDENTIFICATION: Please Print All Information TELEPHONE NO. Lag! Name^ FirstIniliaJMailing Address — No. Street, City, Stale, and Zip CodeIre4o.K5CYl Gi(kixjtd ~ 3L MaJ 'Vj|1^MjillJ/ (flAV^/i'Uyvi ^ (Daytime) Property Owner 'S^ ip i ^h NameContractor State Lie. # PRQ^^D PROJECT PROPOSED USE ^)we»f^truclure(s) Dwelling ■J^(6^on-Dwelling U ( ) Water Oriented Accessory Structure \ (WOAS) ONSITE WATER SUPPLY dividual ( ) Public ( ) None ONSITE SEWAGE TREATMENT SYSTEM ; ^^^<Tndividual Permit It ^ r^ I l",j^<fXddition(s) ( ) MH/RV _r2 ( ) Collector Permit #. ( )OTLSD CHARACTERISTICS OF NON-DWELLING ( ) Garage ( ) Utility Structure CHARACTERISTICS OF WOAS ( ) Boathotsse ( ) Screen Porch CHARACTERISTICS OF DWELLING ( ) Dwelling ( ) Addition to Dwelling ( ) Baserrfent ( ) WalkouP^sement Outside Dimension_______\ ArM'^ / Q Ft.x ^ ^ Ft. /D Ft & / O Ft. f laty (_>^No ( ) Gazebo ( ) Utility Structure(>^Other Outside Dimension ( ) Other Outside DimensionFt.x .Ft.Lotline Setbacks .Ft. Lotline Setbacks Ft.&Ft.OHWL Setback .Ft. Lotline Setbacks Ft.&.Ft. \OHWL Setback .Ft.Bathroom:( )Yes (If Yes / a comptyiiiq Sewage System Required)OHWL Setback Ft. Total Bedrooms__________________ Maximum Height / 30 Ft. (2 story)Maximum Height 18 Fi^ story)Maximum Height /10 ft. (1 story) Lot Area is (Sq. Ft.).. Water frontage Ft. Maximum depth of lot Ft. 3Elevation of lowest floor above OHWL (3 Ft. Min.)Ft. Slope of lot %in £> Cipxgsn,structure setback to right-of-way /ostructure setback to septic tank Ft. (10’minimum) (Sewage System Permit required before installation). Dwelling setback to Soil Absorption System Ft. (20’minimum) (Sewage System Permit required before installation). iQNon dwelling setback to Soil Absorption System Ft. (10’minimum) (Sewage System Permit required before installation). THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES. Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set forth and according to the provisions of the Ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express condition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Ordinance of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said ordinances. I understand that it is my responsibility to inform the Land & Resource Management of%ih£L^j^ding footings have been constructed.P nrirp Dated: Signature of Owner Dated: Land & Resource Management OfficeOQ_I >3^3^PERMIT FEE $RECEIPT NO. Comments: Hr \]<Xf, R- f/? 10 U 9 f —„k> .cy ^ > T- (uxiL (jrl V ’ -fr, fg' In.GAf 4-4 sTdsL\iJii[s Qjx 'Wi i Form No. BK — 0795-002 277,418 • Victor Lundoen Co Prmiers • Fergus Foils. MN • 1-600-346-4870 APPLICATION FOR SITE PERMI LAND & RESOURCE MANAGEMENT OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 • FERGUS FALLS, MN 56537 WHITE ■ Office GOLDENROD - Inspector YELLOW - Owner PINK - Assessor iWl ^ p/ ^ Permit No.LEGAL DESCRIPTION BLUFF ZONErAND □ YESLOCATION LAKE NUMBER LAKE/RIVER NAME ^ LAKE/RIVER SECTION TWP NO.RANGE TW^AME ^^0 Q /1 —II PARCEL NUMBER (S)TOPOGRAPHICAL ALTERATION □ YES # OF CUBIC YARDS □ NO FIRE NUMBERW' l(~001hoDd-^II IDENTIFICATION: Please Print All Information TELEPHONE NO. Last Name First Initli Mailing Address — No. Street, City, State, and Zip Code (Daytime))-\ /dfC TyA\ k \ (lyiiAcJ ^ ^ OO j^L Vj I k-k gxKs. (ahi^ri/^ uyvtly Name Xy Property Owner )<\ £(j^iContractor State Uc. # PROPOSED PROJECT PROPOSED USE \{yJ / {>) New Structure(s) ; t Dwelling .J><.)^?iddilion(s) ■p^kNon-Dwelling ( ) MH/RV I Cl ly' ( ) Oi'iS'’'6'l Accessory Slructure pABTvV^Vr (WOAS) ONSITE WATER SUPPLY Individual ( ) Public ( ) None ONSITE SEWAGE : ^^^jfi4Tndividual Permit # ( ) Collector Permit #_ ( )OTLSD CHARACTERISTICS OF DWELLING CHARACTERISTICS OF NON-DWELLING ( ) Garage ( ) Utility Structure CHARACTERISTICS OF WOAS ( ) Dwelling ( ) Addition to Dwelling ( ) Basement ( ) Waikoui'Basement Outside Dimension________\ ( ) Boathouse ( ) Screen Porch if) R , ^ Ft If) RIt ID Ft. f lOO (>iNo ( ) Gazebo(>)-Other Outside Dimension ( ) Utiiity Structure ( ) Other. Outside DimensionFt.x .Ft.Lotline Setbacks .Ft. Lotline Setbacks Ft.&.Ft.OHWL Setback .Ft. Lotline Setbacks Ft.&Ft. OHWL Setback .Ft.Bathroom: ( ) Yes (If Yes / a complyiod Sewage System Required)OHWL Setback Ft. Total Bedrooms ^18 F^Jl story) ^ ^Maximum Height / 30 Ft. (2 story)Maximum Heigh Maximum Height /10 ft. (1 story) Lot Area is (Sq. Ft.)______^___________________ Elevation of lowest floor above OHWL (3 Ft. Min.) Structure setback to right-of-way_______________ Structure setback to septic tank________________ Dwelling setback to Soil Absorption System____ Non dweliing setback to Soii Absorption System _ ,. Water frontage .Ft. Maximum depth of lot Ft. 5 .Ft. Slope of lot .%^ C jt Ft.^ 10 lo .Ft. (10'minimum) (Sewage System Permit required before installation). .Ft. (20’minimum) (Sewage System Permit required before installation). Ft. (10’minimum) (Sewage System Permit required before installation). 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 Taii County, Minnesota. I further agree that any plans and specifications submitted herewith shail become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express condition that the person to whom it is granted, and his agent, employees and workmen shall conform in ail respects to the Ordinance of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said ordinances. I understand that it is my responsibility to inform the Land & Resource Management o^gejonce the building footings have been constructed. 2^Dated: Signature of Owner Dated: Land & RescHJrce Management Office0^i PERMIT FEES RECEIPT NO. 4 Comments:4-X $(ri£ iii/(/(S ■'RfH Ik) —'( ' /, Ml. ,y LQ\\\~UVJ^ .1 -f) 'fi C( f L Form No. BK — 0795-002 277.418 • Victor Lundeen Co Printers * Fergus Falls. MN * 1-600-346-4870 INSPECTION RESULTS Mate all measurements and computations "V-Structure Set Back from Ordinary High Water Level Ft.Ft.( OO Structure set Back from Top of Bluff Ft. Ft. /A^ot/trT> %.f\ f*~Ft.Structure Set Back from Road Right of Way /o-^Ft. & Ft.Ft.Ft.&Structure set Back from Lot Lines sU^Ft.Ft.Structure Height o/\ /O'^Ft. Ft.Structure Set Back from Septic Tank /a^structure Set Back from Absorption System Ft.Ft. Elevation Of Lowest Floor Above Ordinary High Water Level____________________IQ^Ft.Ft. %%Land Slope at Building Line Inspector’s Comments / Sketch: L ^ (1 1 ^ Inspector's Signature 5> - 96 Dale of Inspection r.oo Time of Inspection I feet/inches GRID PLOT PLAN SKETCHING FORMScale: Each grid equals a IDated: I ^ Signature Please sketch your lot indicating setbacks from road right-of-way, lake and,M^ard for each building currently on lot and any proposed structures. 2JS987®MKL-0871-029 VICTOK LUNDCCN CO.. PRINTCIIS. FERGUS FALLS. MINK. APPLICATION FOR SITE PERMIT LAND & RESOURCE MANAGEMENTOTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 • FERGUS FALLS, MN 56537 WHITE - Office GOLDENROD - Inspector YELLOW - Owner PINK - Assessor CJ ^ 3 fx .y B >y Sl^ /i ^ (2L V /hscL^ u)>y do^ 3^^- Permit No.LEGAL 2" ^ Ss'S^, 2.8' DESCRIPTION BLUFF ZONEAND/083^ 37 □ YESLOCATION ;>eij)io RANGE TWP NAMETWP NO.SECTIONLAKE/RIVER CLASSLAKE/RIVER NAMELAKE NUMBER 13^dL)'^RP II FIRE NUMBERPARCEL NUMBER (S) If/c -oco- / / - oo ^ TELEPHONE NO.IDENTIFICATION: Please Print All Information (Daytime)Mailing Address — No. Street, City, State, and Zip CodeInitialFirstLast Name oXjfS iP^±Y^.£Sdr\. -S'A: £ ie.y Property Owner f NameContractor state Lie. # ONSITE SEWAGE TREATMENT SYSTEM ( ) Individual Permit # ( ) Collector Permit #. ( )OTLSD ONSITE WATER SUPPLY '^^dividual ( ) Public ( ) None PROPOSED USE ( ) Dwelling ()ij Non-Dwelling ( ) Water Oriented Accessory Structure (WOAS) PRC^SED PROJECT J^<(^ew Structure(s) ( )Addition(s) ( )MH/RV____________ IWI . ^ iYEAR CHARACTERISTICS OF WOAS ( ) BoatTObM ( ) Screen Porch CHARACTERISTICS OF NON-DWELLING ( ) Garage lARACTERISTICS OF DWELLING Utility Structure( j^t^lling ( ) Addilt^ to Dwelling ( ) BasemehC ( ) Walkout BHsement OutsideDimension________^ ( ) Gazebo (X Utility Structure( ) Other Outside Dimension U2 ( ) Other , Outside Dimension Ft. X Ft. 50 sO p,£)oFt. X .Ft.Lotline Setbacks Ft. &.Ft. 1(10Ft.Lotline Setbacks .R- &.Ft.OHWL Setback .Ft.Lotline Setbacks .Ft.& .Ft.OHWL Setback.Bathroom: ( ) Yes (II Yes / a complying Sewage System Required)Ft.OHWL Setback injafir^feight /10 ft. (1 story)Total Bedrooms________________\ Maximum Height / 30 Ft. (2 story)Maximum Heigm / 18 R. (il story)Maxi Ft.Ft. Maximum depth of lot. Water frontageLot Area is (Sq. Ft.) .Ft. Slope of lotElevation of lowest floor above OHWL (3 Ft. Min.) Ft.Structure setback to right-of-way £1 Ft. (10’minimum) (Sewage System Permit required before installation). Ft. (20’minimum) (Sewage System Permit required before installation). .Ft. (10’minimum) (Sewage System Permit required before installation). Structure setback to septic tank. Dwelling setback to Soil Absorption System___ Non dwelling setback to Soil Absorption System./oTHIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES. Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set forth and according to the provisions of the Ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express condition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Ordinance of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said ordinances. I understand that it is my responsibility to inform the Land ^Resourcejlanagement office oncejhe^uilding footings have been constructed. 4Dated: Signature of Owner MDated: Land & Resource ManagemenrOfficeSO^RECEIPT NO.PERMIT FEE $ 'j Comments: "jVi6 ili iUiT^ ^mucTuac niiiST Fi^rrs THIS Uirl-£N^ui:^ jlic izAisru/cB <LxitnPCri /5 oTUerz f\M LJiTH OfPiCC fftZC POPpje . C^l !Uj^5Form No. BK — 0295-002 275.386 • Victor LurtOeen Co . Printers • Fergus Falls. MN • 1-800-3A6-4870 N. 9^ /APPLICATION FOR SITE PERMIT^) LAND & RESOURCE MANAGEMENT I j OTTER TAIL COUNTY COURT HOUSE V ^ Phone:(218)739-2271 • FERGUS FALLS. MN 56537 WHITE - Office GOLDENROD - Inspector YELLOW-Owner PINK ■ Assessor IU) SI 3 f X A' ' S ^ yix IA/ ij ^ cSL V £Ss(z^ laa Ca/Y\ /0^3.37' 3 ^ 333'. 28' Permit No.LEGAL DESCRIPTION O BLUFF ZONE □ YES >Q1no AND (Aj>y (2o/^ ^ //, Q, Q^-AjuiA LOCATION TWP NAMERANGESECTIONTWP NO.LAKE/RIVER NAME LAKE/RIVER CLASSUKE NUMBER Lfike I33>^ 40KPn FIRE NUMBER ic PARCEL NUMBER (S)r A-/, ^ ooo- f Ioo 7J~ oo :2. TELEPHONE NO.IDENTIFICATION; Please Print All Information (Daytime)Mailing Address — No. Street, City, State, and Zip CodeInitialFirstLast Name i yr\Ha0 .yg}?j> ‘->X70/n Property Owner yKrf-€.(^3d7\X /-S~>» V 7 NameContractor State Lie. # ONSITE WATER SUPPLY ^lf>44.ndividual ( ) Public ( ) None ONSITE SEWAGE TREATMENT SYSTEM ( ) Individual Permit # ( ) Collector Permit #. ( )OTLSD PROPOSED USE ( ) Dwelling Non-Dwelling ( ) Water Oriented Accessory Structure (WOAS) PROPOSED PROJECT jfxi^New Structure(s) ( )Addition(s) ( )MH/RV____________ rc 'k ftHi YEAR •■‘I ■■j CHARACTERISTICS OF WOAS ( j Boathouse ( ) Sgreen Porch ( ) Gazebo CHARACTERISTI9S OF NON-DWELLING ( ) Garage CHARACTERISTICS OF DWELLING ■ j Utility Structure( ) Dwelling ( ) Addition to Dwelling ( ) Basement ( ) Walkout Basement Outside Dimension Utility Structure( ) Other Outside Dimension in£\i.Ft.( )Other Outside Dimension Ft. X 3Cl _Ft. & -SO Ft.£J 0 Ft..Ft._Ft.x Lotline Setbacks /ao.Ft.Lotline Setbacks :xFt. &Ft.OHWL Setback,.Ft.Ft. &Lotline Setbacks .Ft.OHWL Setback.Bathroom: ( ) Yes (If Yes / a complying Sewage System Required)Ft.OHWL Setback Total Bedrooms Maximum Height / IB story) ^Maximum Height / 10 ft. (1 story)Maximum Height / 30 Ft. (2 story) Ft.,R. Maximum depth of lot,. Water frontageLot Area is (Sq. Ft.) %Ft. Slope of lotElevation of lowest floor above OHWL (3 Ft. Min.) Ft.Structure setback to right-of-way. /a Ft. (10'minimum) (Sewage System Permit required before installation). Ft. (20’minimum) (Sewage System Permit required before installation). Ft. (10’minimum) (Sewage System Permit required before installation). Structure setback to septic tank Dwelling setback to Soil Absorption System___ Non dwelling setback to Soil Absorption System. THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES. Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set forth and according to the provisions of the Ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express condition that the person to whom it is granted, and his agent, employees and workmen shall conform In all respects to the Ordinance of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said ordinances. I understand that it is my responsibility to inform the Land & Resource Management office once the building footings have been constructed. ~ ' .....^) hr\tnDated: Signature of Owner u Land & Resource Management Ofhee / •' Dated: 5(9'^RECEIPT NO.PERMIT FEES /3u 'j CL-, --A-Comments: - j'mAJor^' u I iiiT^ ^lHij^ruar. musr /^x: 'Tfiis U.J H f ij t'K T~AC E'Ai^ru/c js rin-; ryj -^'7- ~ . / > /i. a' . /? n/r-,•.' r'hj 7 s Form No. BK — 0295-002 275.366 • Victor U.ndeen Co . Prirtters • Fergus Falls. MN • 1-800-346-4870 INSPECTION RESULTS Make all measurements and computations 4, Ft.Ft.Structure Set Back from Ordinary High Water Level Ft.Ft.Structure set Back from Top of Bluff b'b Ft.Ft.Structure Set Back from Road Right of Way Mil_Ft. & Ft.Ft.Ft. &Structure set Back from Lot Lines •Ft.Ft.Structure Height Ft.Ft.Structure Set Back from Septic Tank Ft.Ft.Structure Set Back from Absorption System Elevation Of Lowest Floor Above Ordinary High Water Level____________________e-l-Ft.Ft. %%Land Slope at Building Line 2Inspector’s Comments / Sketch:, (HD nrcn a/ i nil sl^th^ \}^ It a a Date ol InapecUon Utt Time of Inspection \ 30 ........J3..,j^.^.....11iq /7 /fc /y-i(V-’rT>-j__2I I iVI5HAffI 7 0?Os rO Jq/«ns [■,3 I A/3 7 •i' !L wr 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 "i' ‘f ^Permit No..LEGAL DESCRIPTION AND LOCATION // /3t^ TWP NameTWPRangeLake Classif.Sec.Lake NameLake No. IDENTIFICATION: Please Print All Information Tel. No.Zip No.Mailing Address— No. Street. City and StateInitialLasyName________________ First /TU.Owner NameContractor Architect Name. NON-RESIDENTIAL PROPOSED USE:RESIDENTIAL PROPOSED USE:fC ( ) One Family Dwelling ( ) Multiple Dwelling TYPE OF IMPROVEMENT: , /X 'y/('Specify:,I ) New Building ( ) Alteration Units ( ) Other Size( ) Other ESTIMATED COST OF IMPROVEMENT $ TYPE OF SEWAGE DISPOSAL:DIMENSIONS:PRINCIPAL TYPE OF FRAME: Basement: ( ) Yes ( ) No( ) Public ( ) Individual Septic Tank, etc. WATER SUPPLY: ( ) Public ( ) Individual Well ( ) Masonry Wood Frame ( ) Structural Steel ( ) Other — Specify StoriesBbojtgbasement: Sq. feet (out$ide^^ttncQs|^) Bedrooms,,r<r!T7......................iths CHARACTERISTICS: Lot Area is square feet. Water frontage is Building set back from high water mark is. Land height above high water mark at building line is.............'H.. j^'2. c—^Maximum depth of lot feet.feet. feet. (Building Line) feet 2-er5^feet.feet — from road right of way isBuilding set back from State highway right of way Side yard is .Z-:.rC..Oand .............feet. .feet from septic tank (Sewage System Permit must be obtained before instailation). feet from soil absorption system (Sewage System Permit must be obtained before installation). 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 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 townshjp-iqr my proposedxfrbject. V.^ r f rDated. Signature of Owner Permit: Permission is hereby granted to the above named applicant to perform the work described in the ai^ve statement. This permit is granted upon the express condition that the person to whom it is granted, and his agent, employees and workmen shall conformSfl-ethT^pects to the ordinances of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said ordinances. r/Dated 7^Shoreland Management Official JPermit Fee $.Receipt No. Comments: Form No. MKL-0286-019 229971@ VICTOR LUNOEEN CO.. PRINTERS. FERGUS FALLS. MINN. 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 /Permit No..LEGAL //'VIDESCRIPTION AND LOCATION /TWP NameTWPRangeLake Classif.Sec.Lake NameLake No. IDENTIFICATION: Please Print All Information Zip No.Tel. No.Mailing Address— No. Street. City and StateInitialLast Name First Owner NameContractor Architect Name. NON-RESIDENTIAL PROPOSED USE:RESIDENTIAL PROPOSED USE:TYPE OF IMPROVEMENT: Specify:,( ) One Family Dwelling ( ) Multiple Dwelling I ) New Building ( ) Alteration Units ( ) Other Size( ) Other ESTIMATED COST OF IMPROVEMENT $ DIMENSIONS:TYPE OF SEWAGE DISPOSAL: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 ( ) Masonry ( ) Wood Frame ( ) Structural Steel ( ) Other — Specify Baths CHARACTERISTICS: Maximum depth of lot...'......feet.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 1 » \'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 Structure will be located Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set forth and according to the provisions of the ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES. 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@ VIcrOA LUNDECN CO.. PRINTERS. FERGUS PALLS. MINN. * I ■if' A1 .1 INSPECTOR'S CHECK LIST Make all measurements and computations ACTUAL IS 1 MINIMUM Shall Be j Sq. Ft, Lot Area (Square feet)Sq. Ft.Sq. Ft. Water Frontage Ft.Ft. -h) SOBuilding Set Back from High Water Mark Ft.Ft. Building Set Back from State Highway Ft.50 Ft. Building Set Back from Street or Road I c)Ft.40 Ft. I/OSide Yard &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. I ^ ^Inspector's Comments: -^0 Inspector'! Signature Title Inspection Dated Co 19 Agency VICTOK LUNDIIN t CO.. OKIHTtM. rfOOUO rM.ll. MINN. White - Office Yellow — Owner Pink — Assessor Goldenrod — Inspector SHORELANO MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739 -2271 - Fergus Falls, Minnesota 56537 APPLICATION FOR SITE PERMIT /\JUJ 1'^ of TJUemCI /t> // 4^0 C^Hie^d Permit No„LEGAL DESCRIPTION AND LOCATION TWP NameTWP RangeLake Classif.Sec.Lake NameLake No. IDENTIFICATION: Please Print All Information Laa Narne_______________________Fict , InitialPefcfStno ,Tel. No-Zip No.Mailing Address— No. Street. City and State Owner 7* NameContractor Architect Name. NON-RESIDENTIAL PROPOSED USE: .RESIDENTIAL PROPOSED USE:TYPE OF IMPROVEMENT: Jp’T^^'N Building ( ) Alteration Specify:( ) One Family Dwelling ( ) Multiple Dwelling Units jt'^Xfther( ) Other Size IESTIMATED COST OF IMPROVEMENT $ DIMENSIONS:TYPE OF SEIjVAGE DISPOSAL:( ) Public T22 (nSTC^^e^ (*-f^ndividual Septic Tank, etc. WATER SUPPLY: ( ) Public A—Plndividual Well PRINCIPAL TYPE OF FRAME: { ) Yes Noyl-'T^lasonry J„.A^ood Frame ( ) Structural Steel ( ) Other - Specify Basement: Stories above basement: Sq. feet (outside dimension) Bedrooms ..........i-?..............'To Baths .t|as> CHARACTERISTICS:4,:;^.<???..rfeet. ...........feet. (Building Line) Maximum depth of lot......Water frontage issquare feet.Lot Area is .Z.ec?,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 3 feet .o5.C?.feet.feet — from road right of way is ZQ..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 Z.O Structure will be located Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set forth and according to the provisions of the ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. THIS IS A SITE PERMIT ONL Y AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STA TE STA TUTES. I understand that I have been granted a site permit in accordance with the requirements of the Shoreland Management Ordinance of Otter Tall 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 pj iroject. C'Dated. Signature of Owner Permission is hereby granted to the above named applicant to perform the work described in the abSlTestatement. 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 Shgpeland^Mpnagerr/nt Official Permit Fee $.Receipt No. Comments; I Form No. MKL-0286-019 229971@ VICTOR LUNOGEN CO.. PRINTERS, FERGUS PALLS. MINN. White - Office Yeilow — Owner Pink — Anessor Goidenrod — Inspector SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 - Fergus Falls, Minnesota APPLICATION FOR SITE PERM I (Kd. Permit No.LEGAL DESCRIPTION AND LOCATION l^>M7) /TWP TWP Nomeike No.RangeSec.Lake Clatsif.Lake Name IDENTIFICATION: Pleaae Print All Information Tel. No-Zip No.Mailing Address— No. Stteet. City arwl StateInitial1^ NamenFii« 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 Size( ) Other 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: .ifeet.Maximum depth of lotfeet.square feet. Water frontage 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 right of way......................... Side yard is ..................... Structure will be located Lot Area is feet. (Building Line) 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 Structure will be located 1 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 ONL Y AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STA TE STA TUTES. 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: 1 Form No. MKL-0286-019 229971®VICTOR LUNDECN CO.. PRINTERS. PEROU8 PALLS. MINN. S'•o . INSPECTOR'S CHECK LIST Make all measurements and computations ACTUAL IS Jr MINIMUMShall Be i Sq. Ft Lot Area (Square feet)Sq. Ft Sq. Ft, Water Frontage Ft.Ft. I Building Set Back from High Water Mark Ft. Ft. Building Set Back from State Highway Ft.50 Ft. IScsoBuilding Set Back from Street or Road 40 Ft.Ft. 'f'/6 &_l_Q_Ft.Side Yard &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_____________10 Ft.3 Ft Inspector's Comments: l^LOOk c\(\V i 0 Intpector's Signature ^ Title Inspection Dated ?(o19 Agency VICTSR tUOOECH t CO.. RHIMTII