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Home My WebLink AboutFaith Haven Camp_18000100064006_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 (after issue) PINK - Assessor LEGAL DESCRIPTION ?66' BLUFF ZONEAND □ YESLOCATION LAKE NUMBER LAKE/RIVER NAME LAKE/RIVER SECTION TWP NO.RANGE TWP NAME 5^-^ /O PARCEL NUMBER (S) ^ ~ ^ ItcOOfOOOfe'iOOl € C0(o400(o /5! <45 FIRE NUMBERSURFACE WATER DRAINAGE □ CHANGE___ & NO CHANGE YRDS®, DRAINAGE PLAN REQUIRED IDENTIFICATION: Please Print All Information TELEPHONE NO. First Irtltlal Mailing Address — No. Street, Cljy, State, and Zip CodeLast Name (Daytime) Property Owner NameContractor State Lie. # ONSITE SEWAGE TREATMENT SYSTEM (t^^nUividual Permit #_____ ( ) Collector Permit It______ ( )OTLSD* PROPOSED PROJECT ( ) New Structure(s) (t.)^dition(s) ( )MH/RV PROPOSED USE (U^-Owelling ( ) Non-Dwelling ( ) Water Oriented Accessory Structure (WOAS) ONSITE WATER SUPPLY (i^JJndividual ( ) Public ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3' (minimum) structure setback to a well.YEAR CHARACTERISTICS OF PROPOSED NON-DWELLING ( ) Detached Garage CHARACTERISTICS OF PROPOSED WOASCHARACTERISTICS OF PROPOSED DWELLING ( ) Basement ( ) Walkout ( ) Attached Garage ( ) Utility Structure ( ) Boathouse ( ) Screen Porch( ) Dwelling ( ) Replacement Dwelling ({>Addition to Dwelling -jlh ( ) Existing Dwelling shall be removed on or before. Outside Dimension ( ) Gazebo ( ) Utility Structure( ) Other Outside Dimension .Ft.( ) Other. Outside Dimension .Ft. X 4^*^ Ft Ft. X Lotline Setbacks _,Ft.&.Ft. Ft. X .Ft. ./3 Ft. & /<0 Ft.. Lotline Setbacks OHWL Setback .Ft. Lotline Setbacks .Ft.&.Ft. OHWL SetbacJ .Ft.Bathroom: ( )Yes ( )No (If Yes l a complying Sewage System Required).Ft: ■OHWL SetbackTotal Bedroi Maximum Hmght / 35 Ft. (2 story)Maximum Height / 10 ft. (1 story)Maximum Height Ft..story .Sq. Ft..Sq. Ft. Impervious Surface Impervious Surface Ratio .%Lot Area______ Water Frontage - Structure setback to right-of-way______________ Structure setback to septic tank ______________ Dwelling setback to Soil Absorption System___ Non dwelling setback to Soil Absorption System .3 .Ft. (3’ minimum).Ft. Elevation of lowest floor above OHWL .Ft. Slope of lot _% Id .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). £0 THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES. Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set forth and according to the provisions of the Ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express • condition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Ordinance of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said ordinances. I understand that it is my responsibility to inform the Land & Resource Management office once the building footings have been constructed. * This permit is oniy valid after verification from the O.T.L.SD. that a confining sewage system will he installed to service this lot... Contact Rollie Mann at 864-5533. Dated: 7^Signature of Owner Dated: Land S Resource Management Office tMdiJZ/nO -ff: 777/Lf.^j I3MTRECEIPT NO.PERMIT FEE $ Comments: Form No. BK — 0597-002 296.17B • Victor Lundeen Co.. Prirttets • Fergus Falls. MN • 1-800-346-4870 APPLICATION FOR SITE PERMIT LAND & RESOURCE MANAGEMENT OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 • FERGUS FALLS, MN 56537 WHIT^ - Office \GOLDENROD - Inspector I YELLOW - Owner (after issue) PINK - Assessor EXPIR^g ;.St ! V JPermit No.LEGAL E50' d-,i/1DESCRIPTION>7 BLUFF ZONEAND □ YES [3,NO LOCATION LAKE NUMBER LAKE/RIVER NAME LAKE/RIVER CLASS (7'-^ SECTION TWP NO.RANGE TWP NAME 7''/Vr ^ 7-iaL^// PARCEL NUMBER (S)SURFACE WATER DRAINAGE □ CHANGEYRDS3, DRAINAGE PLAN REQUIRED a NO CHANGE FIRE NUMBER/ t f (--7 r IDENTIFICATION: Please Print All Information TELEPHONE NO. Last Name First Initial Mailing Address — No. Street, City, State, and Zip Code (Daytime) rp/f/) //•/Property Owner ,/7: , ) 7 V/77V- ■;A'■f Name V_Contractor state Lie. #...i PROPOSED PROJECT ( ) New Structure(s) (c,fAddition(s) ( )MH/RV______________ PROPOSED USE (i^^Owelling ( ) Non-Dwelling ( ) Water Oriented Accessory Structure (WOAS) 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 (j ) Individual Permit #_____ ( ) Collector Permit #_____ ( )OTLSD* s j .'i YEAR 1CHARACTERISTICS OF PROPOSED NON-DWELLING ( ) Detached Garage CHARACTERISTICS OF PROPOSED WOAS ( ) Boathouse ( ) Screen Porch CHARACTERISTICS OF PROPOSED DWELLING ( ) Utility Structure( ) Dwelling ( ) Replacement Dwelling (;) Addition to Dwelling ■* ( ) Existing Dwelling shall be removed on or before. Outside Dimension. ( ) Basement ( ) Walkout ( ) Attached Garage • 'A1\ ( ) Gazebo ( ) Utility Structure( ) Other Outside Dimension A.Ft. X .Ft.( ) Other. Outside Dimension ■I .Ft. X Ft.Lotline Setbacks .Ft. 4 .Ft.Ft. X Ft. Ft. 4 /O R.Lotline Setbacks OHWL Setback Ft. Lotline Setbacks .Ft. 4 Ft. •;OHWL Setbaejt^ Total Bedro ^ Maximum Height / 35 Ft. (2 story) .Ft.Bathroom; ( ) Yes ( ) No (If Yes / a complying Sewage System Required) jr- OHWL Setback .Ft. Maximum Height Ft.,Maximum Height / 10 ft. (1 story).story . "7^<X?.Sq. Ft. Impervious Surface ,Sq. Ft. Impervious Surface RatioLot Area .% Water Frontage .Ft. Elevation of lowest floor above OHWL .Ft. (3’ minimum) Ft. Slope of lotStructure setback to right-of-way .% Structure 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). Non dwelling setback to Soil Absorption System .Ft. (10’minimum) (Sewage System Permit required before installation). ms IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES. Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set forth and according to the provisions of the Ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express condition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Ordinance of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said ordinances. I understand that it is my responsibility to inform the Land & Resource Management office once the building footings have been constructed. * This permit is only valid after verification from the O.T.L.SD. that a conforming sewage system will be installed to service this lot... Contact Rollie Mann at 864-5533. Dated; Signature o1 Owner ! h?. Inn }■ Dated: Land & Resource Management Office RECEIPT NO. /■/ : n / /PERMIT FEE $L i /a/.'7/^^ U(y C/•Comments: r ^ 'TZ/y// Form No. BK — 0597-002 296.178 ■ Victor Lundeen Co. Printers • Fergus Fells. MN • 1-800-346-4870 INSPECTION RESULTS (Make all measurements and computations /) 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 2^^Ft. Ft. Ft.& Ft.1"“ IStructure set Back from Lot Lines Ft.&.Ft. '/Structure Height I } T>r^j Ft. Ft. jo J-Structure Set Back from Septic Tank Ft.Ft. Structure Set Back from Absorption System Ft.Ft. Elevation Of Lov^est Floor Above Ordinary High Water Level____________________Ft.Ft. Land Slope at Building Line %%0 - Inspector’s Comments / Sketch:, 'T rr C> /o^ A\b 3o i Inspector's Signatur^ Dato Inspection Time of Inspection MM VATO UC LOWCR LFTO LTVtl n. CLDDRMTTgRYGYHNASIUH LffVO LTVtL n. CL fTD BALI HELD SITE PLAN ~ i • I - i \ ■ -.A 1 \ r'--T'* i \o DOR/^ I TORY sn.n li !Lf I J \h=T T=.I"11il 'g0’O*‘i->•i ■■•r' ; A:'-;!* • >. ,i. ■f :/-■v y- f-^rl •s Sf •:- *•T. :. ■•V' C, : ■'■^ /-'-■■ i.-C A-..' y"'. ' .. _ .•• ■ • • . *''" ' . ■'" ; . 'AJ>V ' •' /:. •; pm p'opc£ ^ p .... ^PMf- i /^AlTHAVEN S/Bl-£ IAEOUTjj£'/v£7?■ PROAOSto ■ 5Cf>U- 4 ''2-•Q" f GRID PLOT PLAN feet SKETCHING FORM ■feet, or / 'V inchtest equals /<30grid(s) equals /doScale: f ■ oDated;, 19 Signature Please sketch your lot indicating setbacks from road right-of-way, lake.isideyard and septic tank and drain- field for each building currently oir^ and any proposed structures. MKL — 0871 — 029 281949 ■ VM:ior Lund««n Co. Pnnivrs • Fecgus F»irs MN • l800 346-4^nI I; * Grade & Fill Permit #2116 PROPERTY OWNER \-VW Wos.\/>^v\ oc\yv\^ LAKE NO.~^--^3seC. lO TWP. /3/-^^WP. NAME - 'p-t- (aC. t___________________________LEGAL DESCRIPTION; w<s VoywY^a<A.^v Os Vq Cj>a:V 6<^V Vt>p SovV.____tS ?~0 WORK AUTHORIZED ~p(lr\tcv.y~oc> I • / o p l I cS A\vov>•Vwp YVwxi^ ^oVV«»>^ $p<-o * C\Y (LX». .r*# O-O. v\O VN "^VX ^vViL. —S"V"*ckO VvnV>\<^^ C5iV''/' • V'cs.w'v'^v 5NOTE: This card shall be placed in a conspicuous place not more than 4 feet above grade on "the premises on which work is to be done, & shall be maintained there until completion of such work. NOTIFY LAND & RESOURCE MAN AGEMENT. 218-739-2271 WHEN AUTHORIZED WORK HAS BEEN COMPLETED. 1. EARTHMOViNG SHALL BE DONE BETWEEN. 2. Entire area shall be stabilized within 10 days of completion of any earthmoving. 3. Owner is legally responsible for all surface water drainage that may occur. 4. No fill shall enter or be taken from the beds of public, vvater without a valid permit from the MN Department of Natural Resources. 5. If the terms of this permit are violated, the entire permit may be revoked and the owner may be subject to legal prosecution. VA/vn., Grade & Fill Permit #1818 F^a't-hlr^ Cawyp Xn/Q-PROPERTY OWNER LAKE NO.^-2-g3sEC. TWP.^^/ ^^6TWP. NAME LJC , pi- (oL.1 I yj .ILEGAL DESCRIPTION: \n) 9S~0 iWORK AUTHORIZED ^w'tXt^ /^gyxA Vcjyp ^ OyWC 4*0 »*^p(u.CL^ Cliljft,CK»^4 f-Q____ wV>.t,Y»t_ old Wc.l\C,V/u^ Co W c—T t'V C-- U.VV^ V»j Oc w\u y't.4w\w\yv,^ <K \\Ir Av &OM.5SusVop G_qasV4c •i i CkwvvY g s\»riro y ckW vvs NOTE: This card shall be placed in a conspicuous place not more than 4 feet above grade on the premises on which work is to be done, & shall be maintained there until completion of such work. NOTIFY LAND & RESOURCE MAN AGEMENT, 218-739-2271 WHEN AUTHORIZED WORK HAS BEEN COMPLETED. 1. EARTHMOVING SHALL BE DONE BETWEEN & 9W-2£ 2. Entire area shall be stabilized within 10 days of completion of any earthmoving. 3. Owner is legally responsible for all surface water drainage that may occur. 4. No fill shall enter or be taken from the beds of public water without a valid permit from the MN Department of Natural Resources. 5. If the terms of this permit are violated, the entire permit may be revoked and the owner may be subject to legal prosecution. 33WS3H1? Ql^fi rrr ■ I ♦♦ ♦♦ :t,:XTzn < OMC VMJ( BCCK up*EH Lcvn. n. el 100^ OLD MAIN GYM/DCRMITOJ^SP / / V/® T yi/ “LDWC* LTSAEL FL €L »»7 4m.<^5^ I ■P/bPitf 1o' , (9 CONC VMJCUu.e9 ^ tc/ I 5 ^-(A S ' ^ C ^CIX s>/^ /> y. /3 /<y *?IxJ Cf-'f f sr t eagle LAKE a 79% VATa ________ 9TCR MS TAM(OMC VALK UF^H LCV1L FL EL UWOLD MAIN GYM/BORMrrQRY ■VO MH ^ UFfO LTVtL n. CLDORMITDRY LMl lCN^ fV CL wn GYMNASIUM cat: VALKsrox fwpam: (m tm«Pk90\AUDI TicJN *rr STORAGE PK7€C TAUisr RT V r/ APPLBCATBON FOR SBTE PERMBT LAND & RESOURCE MANAGEMENT OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 • FERGUS FALLS, MN 56537 WHITE - Office GOLDENROD - Inspector YELLOW - Owner PINK - Assessor u gr-o' fri &L I AlE-ky Permit No. / VLEGAL DESCRIPTION BLUFF ZONEAND LOCATION e-vX r yVW^ LAKE NUMBER LAKE/RIVER NAME LAKE/RIVER CLASS SECTION TWP NO.RANGE TWP NAME / ^ / ^C> /fc L.t!c5G/o PARCEL NUMBER (S)TOPOGRAPHICAL ALTERATION □ YES # OF CUBIC YARDS □ NO FIRE NUMBERA/ a) ‘xC IDENTIFICATION: Please Print All Information TELEPHONE NO, Mailing Address — No. Street, City, State, and Zip Code ,( Br.;r \L'i'4Last Name First (Daytime)Initial Property Owner NameContractor State Lie. # PROPOSE (s/fNew Structure(s) ( ) Addition(s) ( ) MH/RV______ ONSITE SEWAGE TREATMENT SYSTEM ^ ( ) Individual Permit # / ( ) Coilector Permit #______ ( )OTLSD D PROJECT PROPOSED USE ( ) Dweiiing (^^f^on-Dweliing ( ) Water Oriented Accessory Structure (WOAS) ONSITE WATER SUPPLY ( ) Individual ( ) Public (l/^one L>OtAK.Oi(^ -t. YEAR CHARACTERISTICS O^dN-DWELLING ( ) Garage (^'ftjtility Structure CHARACTERISTICS OF WOASCHARACTERISTICS OF DWELLING ( ) Screen Porch( ) Boathouse( ) Dweiiing ( ) Addition to Dweiiing ( ) Basement ( ) Walkout Basement Outside Dimension ( ) Utility Structure( ) Gazebo( ) Other Outside Dimension ^ Ft Z^Ft. ( ) Other, Outside Dimension.Ft.Ft.x Lotline Setbacks Ft.&Ft.x .Ft. 7ZLotline Setbacks .Ft.Ft.&OHWL Setback .Ft. Lotline Setbacks .Ft.&.Ft. .Ft.OHWL Setback Bathroom: ( ) Yes (If Yes / a complying Sewage System Required).Ft.OHWL Setback Total Bedrooms Maximum Height /10 ft. (1 story)Maximum Height / 30 Ft. (2 story)Maximum Heig ^ Sq. Ft. Impervious Surface 2^zOO o Sq. Ft. Impervious Surface Ratio .%Lot Area 3 Ft. (3’ minimum).Ft. Elevation of lowest floor above OHWLWater Frontage 6> '_S-.%Ft. Slope of lotStructure setback to right-of-way. Structure setback to septic tank_15 0 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). 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. ^ /3 7 Signature ot Owner ^ ^ Dated: Dated: Land & Resource Management Office !2C>I3XPERMIT FEE $RECEIPT NO. Comments: Form No. BK — 0496-002 201.017 • Victor Lundeon Co.. Printers • Fergus Falls. MN • 1-800-346-4870 APPLICATION FOR SITE PERMIT LAND & RESOURCE MANAGEMENT OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 • FERGUS FALLS, MN 56537 WHITE - Office ^ GOLDEN^OD ‘inspector YELLOW-Owner PINK - Assessor u gTo' (VL 6L I ^ Permit No. '' ‘/LEGAL DESCRIPTION BLUFF ZONEAND□ YES, NO ,UK LOCATION RANGE TWP NAMETWPNO,LAKE/RIVER CLASS SECTIONLAKE/RIVER NAMELAKE NUMBER 5‘r-/O /3/Qr^_>■ FIRE NUMBER a;TOPOGRAPHICAL ALTERATION □ YES # OF CUBIC YARDS □ NO PARCEL NUMBER (S) TELEPHONE NO.IDENTIFICATION: Please Print All Information (Daytime)Mailing Address — No. Street, City, State, and Zip Code______ bTTtTKFirstInitialLast Name HWlf'a: f kProperty Owner - f3cc~H I Uci\r^ rT)^\ VNameContractor State Lie. # ONSITE SEWAGE TREATMENT SYSTEM ( ) Individual Permit It ( ) Collector Permit #_ ( )OTLSD ONSITE WATER SUPPLY ( ) Individual ( ) Public (l^one PROPOSED PROJECT (>,)TJew Structure(s) ( ) Addition(s) ( )MH/RV____________ PROPOSED USE ( ) Dwelling 4,-)rNon-Dwelling ( ) Water Oriented Accessory Structure (WOAS)YEAR CHARACTERISTICS OF WOASCHARACTERISTICS Of WON-DWELLING ( ) Garage CHARACTERISTICS OF DWELLING (t--)lMity ( ) Screen Porch( ) BoathouseStructure( ) Dwelling ( ) Addition to Dwelling ( ) Basement ( ) Walkout Basement Outside Dimension ( ) Utility Structure( ) Gazebo( ) Other Outside Dimension ^ Ft.x ^ Ft. Ft. & ^ Ft. ( ) Other. Outside DimensionFt.x .Ft.Lotline Setbacks .Ft.Ft.x ~7 S'.Ft..Ft.&Lotllne Setbacks .Ft.OHWL Setback Ft..Ft.&Lotllne Setbacks .Ft.OHWL Setback Bathroom: ( ) Yes (-><4 No (If Yes / a complying Sewage System Required).Ft.OHWL Setback Total Bedrooms__________________ Maximum Height / 30 Ft. (2 story)Height /18, F]^ story) j Maximum Height /10 ft. (1 story)Maximum oJ/I ' t A e>^r)- ___ .%.Sq. Ft. Impervious Surface Ratio.Sq. Ft. Impervious Surface ■Lot Area . O Ft. (3’ minimum)Ft. Elevation of lowest floor above OHWLWater Frontage Structure setback to right-of-way____________ Structure setback to septic tank_____________ Dwelling setback to Soil Absorption System___ Non dwelling setback to Soil Absorption System __________Ft. Slope of lot Ft. (10’minimum) (Sewage System Permit required before installation). .Ft. (20’minimum) (Sewage System Permit required before installation). .Ft. (10’minimum) (Sewage System Permit required before installation). IZ.O___ -4 ^OO 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 statemeut. This permit is granted upon express condition that the person to whom it is granted, and his agent, employees and workmen shall cortform 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. "//J /Vv 7 *■ fDated:-J- Signature of Owner Dated: Land & Resource Management Office PERMIT FEE $RECEIPT NO. >' -V.O / 7 ^LL a f i I I Ici ~pB-Comments:9. W 281.017 • Vicfor Lundeen Co.. Printers • Fergus Fafis. MN • 1-800-346-4870Form No. BK —0496-002 ) INSPECTION RESULTS Make all measurements and computations 4-Structure Set Back from Ordinary High Water Level Ft.Ft./2.«3 — Ft.Structure set Back from Top of Bluff Ft.(yO t Ft.Ft.Structure Set Back from Road Right of Way -4.2:o Ft.&S^<5 Ft.Ft.,Ft.&Structure set Back from Lot Lines Ft.Ft.Structure Height Structure Set Back from Septic Tank Ft.Ft. /Za-^Ft.Structure Set Back from Absorption System Ft. Elevation Of Lowest Floor Above Ordinary High Water Level____________________.4-Ft.Ft.2o %Land Slope at Building Line S^v<SI Inspector’s Comments / Sketch: \ CP :! L* L_o gx)0 \ -a i /' Inspector's Signature\ Z7-9{ Date of Inspection Time of Inspection { OTTER TAIL COUNTY Grade & Fill Permit I 5^ IAiWE.iv/ CavY^y> XMc^- ee**" \ Box n<?V Lk rniJ ST,r/jr FwxrHOWNER’S NAME: ADDRESS-______ LiOCSltlOnS Lake Nor^S Sec. Twp. Range Twp. Name S^(oCacK . ^. ____________________________________________________________________ f Issued-Szii__Expires Work Authorized^^ VtJ V'VV-N V-v>».>rv^S'l^g. i-fc. . So\l ^ras*oy\ ? ro-i- 19^0 S \4>e- Vjo«i»\V<5^X‘lsV\v> viAK. oj4'w*^v^ 1 <* 1^ o•• ry c.^<1 S AA +V*_ N-Oi^VtQ. VN _________________________________________________________________________________________ __________________________________________________________________________ NOTE: This card shall be placed in a conspicous place hot more than 4 feetabove grade on the premises on which work is to be done, and shall be maintained there until completion of such work. NOTIFY DEPARTMENT OF LAND AND RESOURCE MANAGEMENT,.TELEPHONE (218) 739-2271 WHEN AUTHORIZED WORK HAS BEEN COMPLETED. OTTER TAIL COUNTY, MINNESOTA Board of County Commissioners Land and Resource Management Official 1. Earthmoving shall be done between 2. Entire area shali be stabilized within 10 days of the completion of any earthmoving. 3. Owner is legally responsible for all surface water drainage that may occur. 4. No fill shall enter or be taken from the beds of a public water without a valid permit from the State of Minnesota Department of Natural Resources. & ' A c/) rt CL.t L f6^P >iL_7 V /aI i \CS'Cn >•o \ -"^ <2*e^^-----^ * O (UaI) *■ HOuna^saNinvi^ S65I 6 z snv 3 ^ 03AI333U ^ :r" <; r'- >^ -- - _^^ c/o^^ ^ /_5 5o5 *■ r :.m0 ay_—^------- COC VMJl^—^O’ W ip"oi ixvtL n. Q. uvn □LD MAIN GYM/DORMrrORYTggr im LCVfL n.LOwn LCVCL n. o. «ntfTB 90'LXVDlGYMNASIUM V KOPMC GAS TM«AUDI Tlc^N STORAGE PIOOC TAUigr GARVGE COURT BALL FIELD /hit* — Offic* /allow — 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 •7nrPermit No^LEGAL Faith-^ou-TH Z-o4yLDESCRIPTION AND LOCATION /^> /3/*Ssc. ______TWPRenge ^ TWP NameT7U /? Lake Name Lake Classif.Lake No. IDENTIFICATION: Please Print All Information Zip No.Tel. No.Mailing Address— No. Street, City and StateInitialFirstLast Name ^JTeLl jLa/(3^ AIaA Owner NameContractor Architect Name. NON-RESIDENTIAL PROPOSED USE:RESIDENTIAL PROPOSED USE:TYPE OF IMPROVEMENT:i) New Building f ^ ^Specify:( ) One Family Dwelling ( ) Multiple Dwelling ( )Other ( Units( ) Alteration AAArt / /( ) Other Size ESTIMATED COST OF IMPROVEMENT $ DIMENSIONS: Basement: ( ) Ye* (X) No Stories above basement: Sq. feet (outside dimension) Bedrooms .............................. TYPE OF SEWAGE DISPOSAL:PRINCIPAL TYPE OF FRAME: ( ) Public Individual Septic Tank WATER SUPPLY: ( ) Masonry Wood Frame ( ) Structural Steel ( ) Other — Specify / , etc. Baths( ) Public Individual Welliii CHARACTERISTICS: feet.Maximum depth of lot feet.Water frontage issquare feet. Building set back from high water mark is. Lot Area is feet. (Building Line) 3 feetLand height above high water mark at building line is Building set back frorn State highway right of I ’ t o'L!t............ and ' ^ ,feet.feet — from road right of way isway .............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). Side yard is rIQ.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 ONL Y AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STA TE 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. 7 . Signat^e of OwnerDated.'2^/ Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted uF>on 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. 3 - IDated Shoreland Management Official ■?o -Permit Fee $.Receipt No. I 'yLc\-<^K % -f~<J ^0 /on Comments: )S v\0s ^^ p y ct >\-.-i a i YY\ ^ So Form No. MKL-0286-019 229971@ VICTOR LUNOEBN CO.. PRINTERS. FERGUS FALLS. MINN. F White — Office Yeiiow — Owner Pink Goldenrod SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739 -2271 — Fergus Falls, Minnesota 56537 APPLICATION FOR SITE PERMIT Assessor ^ Inspector 1 Permit IMo„LEGAL /- 7 r/f rJDESCRIPTION AND LOCATION TWP NameTWPLake Ciaetif.Sec.RangeLake NanreLake No. IDENTIFICATION: Please Print All Information Zip No.Tel. No.Mailing Address— No. Street. City and StateInitialFirstLast Nanrie Owner NameContractor Architect Name. NON-RESIDENTIAL PROPOSED USE:TYPE OF IMPROVEMENT:RESIDENTIAL PROPOSED USE: Specify:.I ) New Building ( ) Alteration ( ) One Family Dwelling I ) Multiple Dwelling Units ( ) Other ( ) Other Size ESTIMATED COST OF IMPROVEMENT $ DIMENSIONS:TYPE OF SEWAGE DISPOSAL:PRINCIPAL TYPE OF FRAME: Basement: ( ) Yes ( ) No Stories above basement: Sq. feet (outside dimension) Bedrooms ( ) Masonry ( ) Wood Frame ( ) Structural Steel { ) Other — Specify ( ) Public ( ) Individual Septic Tank, etc. WATER SUPPLY: ( ) Public ( ) Individual Well Baths f! CHARACTERISTICS: ■! Maximum depth of lotfeet.feet.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..... and 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). Side yard is !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 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: i Form No. MKL-0286-019 229971@ VICTOR LUNDEEN CO.. PRINTERS. FCR(3U6 FALLS. MINN.i J ^ ■!» s; ■ INSPECTOR'S CHECK LIST Make all measurements and computations ACTUAL IS Jr 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 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 Inspector's Comments: Cftps -to *75^ “V # \ - » ■ (T J Inspector'* Signature Title Inspection Dated I 19 Agency WICT«a LUNOCCN 4 CO.. 00HI110C. MOOUi rM.L4. HIMH. i feet/inches GRID PLOT PLAN SKETCHING FORMScale: Each grid equals Ijn3//.<>■I Signature v Please sketch your lot indicating setbacks from road right-of-way, lake and sideyard for each building currently on lot and any proposed structures. 19Dated:/ I a. Si II i I i ; 21598 7®MKL-0871-029 VICTOR LUNDCCN CO . RRINTCRS. FERCUS FALLS. U>NN. 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 you^H uoaSDESCRIPTION AND LOCATION !6 111 I/O LK~ TWP NameLake Clatsif.Sec.TWP RangeLake No.Lake Name IDENTIFICATION: Please Print All Information Mailing Address— No. Street. City and State Zip No.Tel. No-Last Name First Initial S/^TTLE ,rr) NOwner NameContractor Architect Name. TYPE OF IMPROVEMENT:RESIDENTIAL PROPOSED USE:NON-RESIDENTIAL PROPOSED USE:!lyf^ew Building j ^ ^yC 3 (3 ( ) Alteration ^ [y f\J ( ) One Family Dwelling ( ) Multiple Dwelling Specify:. Units ( ) Other I Size ESTIMATED COST OF IMPROVEMENT $ PRINCIPAL TYPE OF FRAME: TYPE OF SEWAGE DISPOSAL:DIMENSIONS:Y^No ( ) Masonry (vfwood Frame ( ) Structural Steel ( ) Other — Specify ( ) Pjjhiic ( yt Individual Septic Tank, etc. WATER SUPPLY: ( ) Public ( yT^ndividual Well Basement: ( ) Yes ( Stories above basement; Sq. feet (outside dimension) Bedrooms L BatRT Type of Roof:(LOi^P • CHARACTERISTICS; M.0Water frontage is ...square feet.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 feet. (Building Line)3 feet S.Q..Building set back froyi State highway right oLway Side yard is ............... and........................... feet — from road right of way is .feet. feet.1/J..Structure will be located .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 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 STA TE STA TUTES. Permission is hereby granted to the above named applicant to perform the work descriPermit: 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. in the above statement. This permit is granted upon t /J3.-7-Dated Shoreland Management Official 2>o>oa 'Permit Fee $. Comments: 19S676@ VICTOR LUNDEEN CO.. PRINTERS. FERGUS FALES, MINN-Form No. MKL-0771-002 Office Owner Assessor Goldenrod — Inspector SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone; (218) 739-2271 — Fergus Falls, Minnesota 56537 APPLICATION FOR SITE PERMIT 4 Permit No_FfiiTHLEGAL mvsiA/LaoGfzDESCRIPTION AND LOCATION Lake No.Lake Name Lake Classif.Sec.TWP Range TWP Name IDENTIFICATION: Please Print All Information Last Name First Initial Mailing Address— No. Street. City and State Zip No.Tel. No. B/FTTl (E LF^kLlEFaith HA^Sr\/rhtVOwner NameContractor Architect Name, TYPE OF IMPROVEMENT;RESIDENTIAL PROPOSED USE;NON-RESIDENTIAL PROPOSED USE;/ i(irf^ew Building ( ) One Family Dwelling ( I Multiple Dwelling Specify:. ( ) Alteration Units/ ( ) Other ( ) Other Size IESTIMATED COST OF IMPROVEMENT $ PRINCIPAL TYPE OF FRAME;TYPE OF SEWAGE DISPOSAL;DIMENSIONS: ( (Public J t{ ( Individual Septic Tank, etc.WATER SUPPLY; J- V V ^ V ( ) Public Individual Well Basement: ( ) Yes {i>>TTIo Stories above basement: ....... { ) Masonry (•''fwood Frame ( i'f'Structural Steel I ) Other — Specify / 7U3 V£ Sq. feet (outside dimension) Bedrooms Baths Type of Roof: CHARACTERISTICS: Lot Area is ‘T.K'S..rriiiiira f-rtt Water frontage is feet.Maximum depth of lot feet. U£..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) 3 feet feet — from road right of way is .feet. and feet. M .feet from septic tank (Sewage System Permit must be obtained before installation), feet from soil absorption system (Cesspool, Drainfield, etc.).a.GStructure 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 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. THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTASTATE STATUES, signature^m Owner ' se Permit: 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. Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon the J3.C- /7- yy 00 Dated -it Shoreland Management Official Permit Fee $. Comments: 195676®vicroR lunocen CO., printers. Fergus falls, minn.Form No. MKL-0771-002 feet/inches GRID PLOT PLAN SKETCHING FORMScale: Each grid equals 19Dated:Signature Please sketch your lot indicating setbacks from road right-of-way, lake and sideyard for each building currently on lot and any proposed structures. i-s-A N I t/)Pi $ V k^ 0 f3 fj vJ 1 21598 7®VICTOR LUHOEEN CO.. PRINTERS. FERGUS FALLS. WINN.MKL-0871-029 White - Office Yellow — Owner Assessor 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 Pink Goldenrod — Inspector Permit No„LEGAL Date.DESCRIPTION AND LOCATION /3^ 4ElSec.yfWP NameLake No.Lake Classit.e Name TWP Range IDENTIFICATION: Please Print All Information Last Name a_______________First Initial Mailing Address— No. Street, City and State Zip No,Tel. No. Owner NameContractor Architect Name. TYPE OF IMPROVEMENT: ( ) New Building Alteration ^ 2 ^ ( ) Other___ _____________ RESIDENTIAL PROPOSED USE:NON-RESIDENTIAL PIJOPOSED USE: Soeciiv:C7^j0/^-^ ( ) One Family Dwelling (^ Multiple Dwelling ( ) Other ✓Units Size ESTIMATED COST OF IMPROVEMENTS (omit cents) PRINCIPAL TYPE OF FRAME:TYPE OF SEWAGE DISPOSAL:DIMENSIONS: Basement: ( ) Yes No Stories above basement: Sq. feet (outside dimension) .. Bedrooms .............................. ( ) Masonry j^^LWood Frame ( ) Structural Steel ( ) Other — Specify ( ) Public ()^ Individual Septic Tank, etc. WATER SUPPLY: ( ) Public ( It Individual Well MECHANICAL EQUIPMENT : Elevator: ( ) Yes Air Conditioning: ( ) Yes ( ) Central Baths HEATING: ( ) Electric ( ) Coal Other: Type of Roof:( ) No < ) Gas ( ) None ( ) Oil ( ) No ( ) Unit CHARACTERISTICS: Lot Area is square feet.Water frontage is. feet. (Building Line) ...............................feet feet. 7.S'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 /c> +■ feet — from road or street is feet. =20-<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 feet. Z...0. 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 per application. I also understand that this permit is valid for a period of six (6) months. d ‘zzj4o CD 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. j /7 Dated Shoreland Management OfficialcoState Surcharge $.Permit Fee $. Comments: Form No. MKL-0771-002 1S8899 VICT«a UIH0CCH ft CO.. MMHTtOO. FCMSUO P«U.O. 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 Office — Owner Assessor/ Inspectordenrod Permit No„LEGAL Date.DESCRIPTION AND LOCATION La Kp '-'TWP Name /|0 /oSec.TWP RangeLake Classif.Lake No. ake Name IDENTIFICATION: Please Print All Information Initial Mailing Address— No. Street. City and State Zip No.Tel. No.Last Name First /Ti fL. /JtOwner NameContractor Architect Name. TYPE OF IMPROVEMENT:NON-RESIOENTIAL PROPOSED USE:RESIDENTIAL PROPOSED USE: /(6-HMew Building ( ) Alteration ( ) One Family Dwelling ( ) Multiple Dwelling (t.-XJther Specify:, Units Size 57) X /no aLW( ) Other c? 3000ESTIMATED COST OF IMPROVEMENT $(omit cents) PRINCIPAL TYPE OF FRAME: TYPE OF SEWAGE DISPOSAL:DIMENSIONS: Basement: ( ) Yes (•A-'tiS Stories above basement: Sq. feet (outside dimension) Bedrooms ................7........... ( ) Masonry ( ) Wood Frame ( jJ-€tfuctural Steel ( ) Other — Specify ( ) Public ( ) Individual Septic Tank, etc. WATER SUPPLY: ( ) Public ( ) Individual Well MECHANICAL EQUIPMENT : Elevator: ( ) Yes Air Conditioning: ( ) Yes ( ) Central J ...:C5:a.aQ. Baths........../1/crrY^ HEATING: ( ) Electric ( ) Gas ( ) Coal Other: Type of Roof:( ) No ( ) Oil ?( ) No ( ) None ( ) Unit CHARACTERISTICS: 5XQ.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 .... .Qa..± .VQfeet — from road or street is feet. .St?.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. 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 ail respects to the ordinances of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said ordinances. U./ZDated Shoreland Management Official State Surcharge $.Permit Fee $. j-Comments: ~-'rm No. MKL-0771-002 1S8899 viere* Luiiatiii 4 e«.. phinum. racLi. 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 ,3 3-gCPermit No,.LEGAL Date.DESCRIPTION AND LOCATION G" ^ / l) /3 / ^ 0 WP NameTWPRangeSec.Lake Classif.ake NameLake No. IDENTIFICATION: Please Print All Information Zip No.Tel. No.Mailing Address— No. Street. City and StateInitialFirstLast Name HclU-€>^ yOLr/lvOwner NameContractor Architect Name. I / RESIDENTIAL PROPOSED USE: ( ) One Family Dwelling ( ) Multiple Dwelling NON-RESIDENTIAL PROPOSED USE:TYPE OF IMPROVEMENT: ) NHW Buildirig 0 K/ IX) Alteration UJCv/AC •''' /0)f/*2. ( ) Other____________________________________ Specify: Units ESTIMATED COST OF IMPROVEMENT $.;£rOO Other Size (omit cents) TYPE OF^EWAGE DISPOSAL:DIMENSIONS:PRINCIPAL TYPE OF FRAME: ^^[l^asonry Cxx-'(\no Basement: ( ) Yes 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 .1( ) Wood Frame Sllucturai Steel L. 1"^ ( ) Other — Specify Baths HEATING: ( ) Electric ( ) Coal Other: \) No Gas ( ) None ( ) OilType of Roof: \ „ . f 0-f No ♦ >( ) Unit CHARACTERISTICS: d-&-0 feet.Water frontage is . feet. (Building Line) ...............................feet square feet.Lot Area is .. :z.£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....................... J*o ..To feet.feet — from road or street is .^.0.S-O 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.)._____________________ Side yard is Building will be located...... Building will be located 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,xpecifications 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.h Dated ignature 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-I~7SDated State Surcharge $__*.Permit Fee $. Comments: Form No. MKL-0771-002 ,158899 VICTOR LUMOICO 4 CO.. ORIttTCOO. rCROUO FILLO. 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 -nf\o Permit No,.LEGAL Date.DESCRIPTION AND LOCATION <Leke Name 1aCyQ /6 )Z) Vn Lake No. Lake Classif.Sec.TWP Range WP Name IDENTIFICATION: Please Print All Information Last Name First Initial Mailing Address— No. Street. City and State Zip No.Tel. No. }2, iLOwner I //’/INameContractor Architect Name, TYPE OF IMPROVEMENT;RESIDENTIAL PROPOSED USE;NON-RESIDENTIAL PROPOSED USE: (L-I-New Building ( ) Alteration ( ) One Family Dwelling ( ) Multiple Dwelling Specify:, Units ( ) Other (u-H3ther Size ,SV>CjnESTIMATED COST OF IMPROVEMENT $(omit cents) PRINCIPAL TYPE OF FRAME:TYPE OF SEWAGE DISPOSAL;DIMENSIONS: Basement: ( ) Yes ( Stories above basement; ....... Sq. feet (outside dimension)..... Bedrooms ( ) Masonry ( H^ood Frame ( ) Structural Steel ( ) Other — Specify ( ) Public ( ) Individual Septic Tank, etc. WATER SUPPLY: ( ) Public ( ) Individual Well MECHANICAL EQUIPMENT : Elevator: ( ) Yes Air Conditioning: ( ) Yes ( ) Central / e.Baths HEATING: ( ) Electric ( ) Coal Other: (A^^as ( ) None (Type of Roof;( ) Oil Cjort^(l>No ( ) Unit CHARACTERISTICS; MOLot Area is square feet.Water frontage is . feet. (Building Line) ...............................feet feet. ...3:2.0.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 .30. :^0...j5..0..±:. .3}.0..±... feet — from road or street is feet. .^.o...±.Side yard is Building will be located Building will be located 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. ...<0...L ... 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 pe^d of six (BLunonths. ^ z' ) 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. /\ C -ODated Shoreland Mwagenrient Officialso3.Permit Fee $.State Surcharge $. Comments: Form No. MKL-0771-002 ,158899 VICTOR UiROCCH 4 CO.. RRIHTCI FM.LI.