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Home My WebLink AboutFrank's Lodge & Campground_56000090057000_Shoreland Permits_https://onegov,co.ottertail.mn.us/admst/viewcard.php?card=5&app=39833/5/2018 , OTTER TAIL COUNTY 30H^^ Land & Resource Management Phone (218) 998-8095 PERMIT NUMBER 30165Site and Lot Alteration Permit (combined)_______________ PERMIT TYPE Frank's Lodge & Campground LiePROPERTY OWNER StarLAKE INFORMATION 385DNR ID(S) LOCATION Parcel(s): 56000090057000 Township Name: Star Lake Township Property Address(es): 30570 LODGE LOOP Section/Township/Range: Sect-09 Twp-135 Range-041 Legal: 9.89 AC N1/2 NW1/4, LOTS 4 & 5 EX STARLAKE BEACH & FX TRS EX FAR WORK AUTHORIZED 10X20 Deck 10x40 RCU Unit #8 Andrea Perales 09/05/2018 08:47 AM 4f76e697da6ee5754a8ed1dbc0abe429 3b24e486b87d5270c84fe3b26a3f8682 09/05/201909/05/2018 DATE EXPIRESISSUE DATELand and Resource Management OfYicial/Date NOTE: I • 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/r^https://onegov.co.ottertail.mn.us/admst/viewcard,php?card=5&app=3983 iLand & Resource Permit Applications9/5/2018 I .1 iiLand & Resource Management Government Services Center 540 Fir Avenue West Fei]gus Falls MN 56537 OTTCR Tflll Phone:218-998-8095 O O B n T Y - tn I (I 0 11 O T A 1 1 Site and Lot Alteration Permit (combined) Permit #30165 Valid: 09/05/2018 - 09/05/2019 (! ■i Applicant Information Applicant Information;Name:f John M Frank ! Phone: (218 ) ^ - 2876 iIEmail Address: frankslodge@arvig.net .1Mailing Address: 30570 Lodge LoopV,i Dent CA 56528 i Property OwnerI am the: !•Work Performed By (Site Permit) Work to be performed by (Site Permit): Self ;Work Performed By (Lot Alteration Permit)i: SelfWork to be performed by (Lot Alteration): iProperty Information fProperty Please search by one of the following: Parcel #. name, or Physical Address. Click the blue "Select" to select Selected: Property Attributes Primary Name/AddressLegal DescriptionProperty Address CityPrimary Address Line 1Legal Description Legal Description Legal Description NameParcel #Property Address City r30570 LODGE LOOP DENTLAKE BEACH & EX TRS EX FARM FRANK’S LODGE & 30570 LODGE LOOP DENT 9.89 AC N1/2 NW1/4, LOTS 4 & 5 EX STAR 56000090057000 i-:CAMPGROUND VLLC V 101874 Square FeetLot Area:I' Is the property Developed Developed or Undeveloped? On Site Sewage Compliance Inspection Report within 3 yrs.Treatment System: y r IndividualOnsite Water Supply:(, Shoreland Informationj Associated Lakes:Selected: Lake Class LR CDLake Name DNR ID SGDStar38556-385 450 FeetWater Frontage: •iBluff:No <! 1/5https://onegov.co.ottertail.mn.us/view.php?id=3983#option-results Land & Resource Permit Applications9/5/2018 ■ Proposed Project (Site) OtherProposed Dwelling: Is there an Attached Garage? ^ Proposed Non-Dwelling: Proposed Water Oriented Accessory Structure: Please list outside dimensions {in 10X20 deck & 10X40 PM trailer feet) of above items you are applying for: Deck(s) None Characteristics of Proposed Dwelling Please identify the parameters of the Dwelling: 8X40 Park Model with 80 sf of slide out. New or Replacement: Square Feet: Maximum Proposed Height: Setback to Lot Lines (indicate closest lot lines): Replacement 399 Square Feet 12 Feet 50 Feet 50 Feet Setback to Right of Way: Setback to Ordinary High Water Level: ^ Feet 400 Feet 20 FeetSetback to Septic Tank: Setback to Drainfield:20 Feet JSetback to Bluff:NA Feet ■i Elevation above Ordinary High Water Level: 40 Feet Total Bedrooms:2 •J’-i Roof Change: Characteristics of Proposed Deck 288 Square Feet 2 Feet Square Feet: Maximum Proposed Height: Deck Stbck Lot Line 1 (indicate closest'lot lines): i i*20 Feet ] 20 Feet 20 Feet 1 Setback to Right of Way: Setback to Ordinary High Water Level:400 Feel ! Elevation above Ordinary High Water Level: 40 Feet I I ^ Feet 20 Feet NA Feet Setback to Septic Tank: Setback to Drainfield:i Setback to Bluff: Proposed Project (Lot Alteration) Project Type:replacing old mobile home with park model trailerOtherProject Description: Area to be Cut/Excavated : 0 FeetTotal Cubic Yards:0 Length:Average Depth:0 Feet0 Feet Width:0 FeetLength: Calculate I 0 FeetLength:0 Feet Width:0 Feet Total Cubic Yards:00 Feet Average Depth:Width: I fcaieulato |• iI' 0 Feet Total Cubic Yards:0 I Calculate IAverage Depth:!1 liWaik-Out Basement Project 0 I Calciilaid I0 Feet Total Cubic Yards:0 Feet Average Depth:OFeet Width:Length: i- § iij: :• 2/5 jhttps://onegov.co.ottertail.mn.us/view.php?id=3983#option-results r Land & Resource Permit Applications"9/5/2018 ■ Area to be filled/Leveled 0 FeetTotal Cubic Yards:0 Length:Average Depth:0 Feet0 Feet Width:0 FeetLength: CalculatS I 0 Feet0 Feet Width:0 Feet Total Cubic Yards:0 [ €aicuiate I Length:0 Feet Average Depth:Width: Average Depth:0 Feet Total Cubic Yards:0 PCalculatfl I Backfill at Foundation 0 I ealcslaia I0 Feet Average Depth:0 Feet Backfill Total:0 Feet Average Width:Linear Length: Culvert and Road Authority Culvert?N/A Road Authority Approval:N/A Impervious Surface - Buildings 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet Dvi/elling Proposed: Attached Garage Proposed: Detached Garage Proposed: Storage Shed Proposed: Water Oriented Accessory Stnjcture Proposed: Recreational Camping Unit Proposed: Miscellaneous Proposed: Total Building Proposed Impervious: Dwelling Existing: Attached Garage Existing: Detached Garage Existing: Storage Shed Existing: Water Oriented Accessory Structure Existing: Recreational Camping Unit Existing: Miscellaneous Existing: 0 Square Feet 0 Square Feel 0 Square Feet 0 Square Feet 0 Square Feet 400 Square Feet0 Square Feet 0 Square Feet 400 Square Feet 0 Square Feet Total Building Existing Impervious: 0 Square Feet I Cak'ulalo | Impervious Surface Calculation - Buildings Total Building Existing Impervious: 0 Square Feet 400 Square FeetTotal Building Proposed Impervious: Total Building Impervious Surface: 400 Square Feet right 101874 Square FeetLot Area: Impen/ious Surface Ratio: Buildings Impervious Surface Percentage: 0.0039 0.39 % Impervious Surface - Other 200 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 200 Square Feet Deck(s) Existing: Patio(s) Existing: Sidewalk(s) Existing: Landing(s) Existing: Driveway(s) Existing: Parking Area(s) Existing: Retaining Wall(s) Existing: Landscaping Existing: Miscellaneous Existing: 880 Square Feet 0 Square Feet Deck(s) Proposed: Patio(s) Proposed: Sidewalk(s) Proposed: Landing(s) Proposed: Driveway(s) Proposed: Parking Area(s) Proposed: Retaining Wall(s) Proposed: Landscaping Proposed: Miscellaneous Proposed: Other Proposed Total: II 0 Square Feet 0 Square Feet 0 Square Feet 220 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet ; f i Other Existing Total:1100 Square Feet ;)Impervious Surface Calculation - Buildings & Other Total Building + Other Existing 1100 Square Feet Impervious: Total Building + Other Proposed 600 Square Feet Impervious: Total Building + Other Impervious 1700 Square Feet Surface: t- •i 101874 Square FeetLot Area: Building + Other Impervious Surface Ratio: 0.0167 Building Other Impervious Surface Percentage: 1.67 % r https://onegov.co.ottertail.mn.us/view.php?id=3983#option-results 3/5 975/2018 Land & Resource Permit Applications Shore Impact Zone Impervious Etuilding(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 Building(s) Proposed: Deck(s) Proposed; Patio(s) Proposed: Sidewalks(s) Proposed: Landing(s) Proposed: Driveway(s) Proposed: Parking Area(s) Proposed: Retaining Wall(s) Proposed; Landscaping Proposed: Miscellaneous Proposed; Total Proposed Impervious in the Shore Impact Zone: 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feel 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet Deck(s) Existing: Patio(s) Existing; Sidewalk(s) Exisiting: Landing(s) Existing: Driveway(s) Existing: Parking Area(s) Existing: Retaining Wall(s) Existing: Landscaping Existing: Miscellaneous Existing: Total Existing Impervious in the Shore Impact Zone: Total Impervious in the Shore Impact Zone: 0 Square Feet| CalcUlaU | Documentation Total Proposed Area to Determine 687 Square Feet Fee: Total Earthmoving Request to Determine Fee: 0 Cubic Yards Applicant Approval Applicant Signature:Frank; John M Date Signed:08/29/2018 I understand that checking this box constitutes a legal signaturePlease check to approve; Terms Notes The 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 musl obtain a General Storm 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 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 permil 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 have been constructed.<- Invoice 08/29/2018 Cost Quantity TotalCharge $200.00$200.00Site & Lot Permit Fee #2A (261-1,000 Sq Ft and 0 Cubic yds) added 08/31/2018 3:37 PM $200 Fee X 1 Grand Total $200.00Total (Paid) Approvals Approval Signature Sheila Dahl - 08/31/2018 8:44 AM 53db464788d525622771b2ec4ca68dc3 e203e31c3429cc8b23802c558ee73662 #1 Received and Assigned Andrea Perales - 08/31/2018 3:38 PM a5286f8d8ffl2c4ca23b2ef7c894ca30 3eafc9f0a55122745083f09e6c5dla83 #2 Permit Review #3 Permit Review Andrea Perales - 09/05/2018 8:47 AM 4/5https://onegov.co.ottertail.mn.us/view.php?id=3983#option-results i 63d97fabb3671a2f46elal255497c9c9 336775fba03f451be0d6d0ea7ele029b Land & Resource Permit ApplicationstJ/5/2018 k- Andrea Perales - 09/05/2018 8:47 AM 4f76e697da6ee5754a8edldbc0abe429 3b24e486b87d5270c84fe3b26a3f8682 #4 Permit Issuance 1 ;Print View ; 1, i: ,4 https;//onegoy.co.ottertail.mn.us/view.php?id=3983#option-results 5/5 ^4cale drawing must be a signed drawing which includes and identifies a graphic scale (feet), all existing and/or proposed structures, septic >, drainfields, lotlines, road right-of-ways, easements, OHWLs, wells, wetlands and topographic features (i.e. bluffs). Must also complete the j4)ervious Surface Calculation (see back). Tax Parcel Number(s) f I, U ", E Scale '! t O'l>"\r> H " rx ^ .. I a ---------^ l^o W300+ .^(X;^ Lu4. --: /tiL 7 ffh n TT'Z- s;v 7 lax/i'Hp T'l]c;'i?r.' r*. )a "fIi-/'-1 i o..-.>r -.- -i V □\bE:»th''>20is '^oncE^vpr'r-n \/ -A H SITE PERMIT INSPECTION RESULTS Inspector must make all measurements and computations vO\ V4W4m Ft.Ft.Structure Set Back from Ordinary High Water Level Structure Set Back from Top of Bluff Ft.Ft. MX I tvl Ft. & Ft. Structure Set Back from Road Right of Way Ft.Ft. P 5^ K. Ft. & ?J00^Structure Set Back from Lot Lines Ft. ID'Structure Height Ft.Ft. X-ioaStructure Set Back from Septic Tank Ft.Ft. Structure Set Back from Drainfield Ft.Ft. Elevation Of Lowest Floor Above Ordinary High Water Level lO*"Ft.Ft. Land Slope at Building Site %% (lijbLKjgol (kaijO)Inspector’s Comments / Sketch: liDUi A InspectQiy Signature Date of Inspection Time of Inspection ii Pro/ecf Approved ^ /f^ Date / Initial loPz WHITE - Office GOLDENROD - Inspector YELLOW - Owner (after issue) 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 c:annedOTTER Tfllleovarr-aiiiiiOTi PermitAPPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED. TWP NAMESECTIONTWP NO.RANGELAKE/RIVER CLASSLAKE / RIVER NO. LAKE/RIVER NAME f)3S HIS LOf7^^ \r S 7oO)'^ PROPERTY (E-911) ADDRESSPARCEL NUMBER (S) L>OP PrS^hT h <h “K/ v/2 Vi/, LOKLEGAL DESCRIPTION DEVELOPED. UNDEVELOPED. Daytime Phone No.First Initial Mailing AddressLast Name (Johh IP 5'70 1-/?a P^h-r Property Owner ■7^,(>ZP77. Contractor Name Lie. # PROPOSED PROJECT (please circle the appropriate number) (2 ) Add’n to Dwelling/Attached Garage Replacement Dwelling* (5) RCU/Year 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 issuirtg Site Permit. Contact Rollie Mann at 218-864-5533 New Septic Permit Issued ^ ^ r\ ^ n Permit it Z J a Z>o ONSITE WATER SUPPLY Individual ( ) Public ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3’ (minimum) structure setback to a well. (1 ) New Dwelling (4 ) MH/YR_____ ( 7) Add'n To Non-Dwelling (8 ) Storage Structure (10) Non-Conf. Replacement (identity)"_______ (11) Other (identify)_______________________ (12 ) Deck__________________________ (13) Fence_________________________ (6 ) Detached Garage (9) W.O.A.S. ••Existing Non-Conf. Structure Verified by L&R•Removal of Existing Dwelling Verified by L&R Inspector's fnitial/DaleIn^iectof's Inilial/bate CHARACTERISTICS OF PROPOSED W.O.A.S. (WATER ORIENTED ACCESSORY STRUCTURE) Outside Dimension CHARACTERISTICS OF PROPOSED NON-DWELLING Outside Dimension CHARACTERISTICS OF PROPOSED DWELLING (Must Include Attached Garage) Ft.x Ft.** Y'Ft. X Ft.**Outside Dimension Ft. X Ft.**So. Ft.-7 Sq. Ft. Setback to Lotline___ Setback to Right of Way PI 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 Application / Inspection Ft, & ZO Ft.**Setback to Lotllne Setback to Right of Way Ft.** Setback to Ordinary High Water Level Ft. Elevation Above Ordinary High Water Level Setback to Septic Tank *7^ Ft.&Ft.**Ft.**Ft.& Ft.**Ft.** Ft.Ft. Ft. K" O Ft. V" _Ft.V^ Ft. Ft.Setback to Drainfield. Setback to Bluff ^ Total Bedrooms ^ Maximum Proposed Height Ft. Roof Change ( ) Yes {^) Nc^ Basement ( ) Yes No Walkout Basement ( ) Yes (side profile required) (^0 No Ft. Ft.Ft. Ft.Ft. Ft.Ft. ( ) Screen Porch ( ) Storage Structure * Must Include on scale drawing, additional Permit may be required. Topographical Alteration / Earthmoving □ None □ 21 Cubic Yards - 999 Cubic Yards*□ 1,000 Cubic Yards or More*□ 20 Cubic Yards or Less * p)Bluff ( )Yes ()()NoCHARACTERISTICS OF LOT:Ft,Lot Area.Sq. Ft.Water Frontage SfyC -70.% Impervious Surface RatioBuildirtg 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 OrdinancI understand that it is my responsibility to inform the Land & Ri»ource Management offied on '.-yy ce the building footings have been constructed. npipiDate: ignature of Property Owner/At )r Owner Lsnd & Resource Management 6fft6u StDate: \ '10 luoPERMIT FEE $ -OQ RECEIPT NO.PROJECT(S) TOTAL SQ. FT.. oj^ Aiy.w>TJy Date StampComments: 9/r& 9 L&R InitialForm No. BK — 04-2016 .TsT----' 360,647 • Victor Lundoon Co., PrIntsrs • Fergus Falls, Minnesota !oP2. - Office _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 OTTER TflllCOVITT-MiaAISOTII Permit ^ APPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED. TWPNAMERANGETWP NO. /SECTIONLAKE/RIVER CLASS . " ar? LAKE/RIVER NAMELAKE / RIVER NO.V^' 5" PARCEL NUMBER (S) ^V'' < i,0£fDO<^PP>S 900}m i PROPERTY (E-911) ADDRESS j I pop Pe^hT h ,V CL cap ^0^.3 -4 ^ CV DEVELOPED----- i >vi '/'l '4-jLEGAL DESCRIPTION jI)'UNDEVELOPED.1 1 'i Daytime Phone No.Mailing AddressFirstInitialLast Name : 3P 500 P^^h T hh/ P Chhh M.:zjffj-g^h-KProperty Owner Contractor Name Lie.# A j fr ONSITE SEWAGE TREATMENT SYSTEM (7^ 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 Rollie Mann at 218-864-5533 0^ New Septic Permit Issued Permit # PROPOSED PROJECT (please circle the appropriate number) ( 2 ) Add’n to Dwelling/Attached Garage (3-) Replacement Dwelling* (6) Detached Garage (9) W.O.A.S. ONSITE WATER SUPPLY Individual ( ) Public ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3’ (minimum) structure setback to a well. (1 ) New Dwelling (4 ) MH/YR____(5 ) RCU/Year______ (7) Add'n To Non-Dwelling (8) Storage Structure (10) Non-Conf. Replacement (identity)"_______ (11) Other (identify)_______________________ (12 ) Deck______________________________ (13) Fence_____________________________ ; ; "Existing Non-Conf. Structure Verified by L&R‘Removal of Existing Dwelling Verified by L&R Inspector's Initial/DateInspector’s Initial/Daie CHARACTERISTICS OF PROPOSED W.O.A.S. (WATER ORIENTED ACCESSORY STRUCTURE) Outside Dimension CHARACTERISTICS OF PROPOSED NON-DWELLING Outside Dimension CHARACTERISTICS OF PROPOSED DWELLING (Must Include Attached Garage) Outside Dimension ^ Ft. x So. Ft. 14 / ' Setback to Lotline Setback to Right of Way Setback to Ordinary High Water Level Elevation Above Ordinary High Water Level Setback to Septic Tank 4Ft. Setback to Drainfield ^ Ft. Ft. V'' HO Ft.**Ft. xFt.** .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_____ Ft. & Ft.** .Ft.**Ft.&Ft.**Ft.& Ft." ^Ft.**Ft."____Ft. 'MO Ft.Ft.Ft. Ft.Ft. ; I Ft.Ft. Setback to Bluff Total Bedrooms Maximum Proposed Height Root Change ( )Yes (...^)No Basement ( ) Yes (_i) No Walkout Basement ( ) Yes (side profile required) (.V) No Ft.Ft. Ft.Ft.Ft.Ft. Maximum Proposed Height ( ) Boathouse ( ) Gazebo **Project/Lotlines/Right-of-ways Must be Staked Onsite Prior to Application / inspection 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*□ 21 Cubic Yards - 999 Cubic Yards*□ 20 Cubic Yards or Less * Bluff ( )Yes ( lI^NoFt.CHARACTERISTICS OF LOT:Sq. Ft.Water FrontageLot Area. ZZC 70 .%.% 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. 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 ihat it is my responsibility to inform the Land & Resource Management offic# once the building footings have been constructed. Date:I//:-■-7^ / " '. Signature of Property Owner / Apent for Owner l \ : 1\Date:'-J, )i. ‘_____i___-) r L&nd S Resource Management Odt&al\M RECEIPT NO.'2.0 \ t"* ^ IcO I IPERMIT FEE $PROJECT(S) TOTAL SQ. FT.- O)^ h}4. w>TJn f. r h d m K Comments: 9 piiiiyffl Form No. BK — 04-2016 360.647 • Victor Lundeen Co.. Printers ■ Fergus Falls, Minnesota I -•« SITE PERMIT INSPECTION RESULTS Inspector must 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 Ft. Ft. Structure 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 Ft.Ft. Land Slope at Building Site %% Inspector’s Comments / Sketch: Inspector’s Signature Date of Inspection Time of Inspection I □ Project Approved.Date/Initial -20F2 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 OTTER TflKCOUOTT-aiQOIIOTO Permit No.APPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED. LAKE / RIVER NO.RANGE TWP NAMESECTIONTWP NO.LAKE/RIVER CLASSLAKE/RIVER NAME r ns 1 hj5G DSUooo 5h ^ PROPERTY (E-911) ADDRESSPARCEL NUMBER (S) VLEGAL DESCRIPTION DEVELOPED j Lo J/7^gyhJ p /^(yu-h First Initial '^Mailing Mdress UNDEVELOPED, Last Name Daytime Phone No. Rc^SIO LodJohtA /u •218" HenA-, ukj Property Owner ~/5Sgj'T(p Contractor Name Lie.# 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 Rottie Mann at 218-864-5533 PROPOSED PROJECT (please circle the appropriate number) | (2 ) Add’n to Dwelling/Attached Garage Replacement Dwelling* ( 5) RCU/Year (6 ) Detached Garage(7) Add’n To Non-Dwelling (8) Storage Structure ( 9 ) W.O.A.S. | (to) Non-Conf. Replacement.(/denWy)"______ (11) Other (identify)____________________ ; (12 ) Deck__________________________ (13) Fence,________________________ ONSITE WATER SUPPLY (X) Individual ( ) Public ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3' (minimum) structure setback to a well. (1) New Dwelling ( 4) MH/YR____ I I ^) New Septic Permit Issued •‘Existing Non-Conf. Structure Verified by L&R'Removal of Existing Dwelling Verified by L&R Inspector's Initial/DateInspector's Initial/Date CHARACTERISTICS OF PROPOSED W.O.A.S. (WATER ORIENTED ACCESSORY STRUCTURE) Outside Dimension CHARACTERISTICS OF PROPOSED NON-DWELLING Outside CHARACTERISTICS OF PROPOSED DWELLING (Must Include Attached Garage) Outside Dimension Setback to Lolline ■' Setback to Right of Wav '3 DO Ft.**V^ Setback to Ordinary High Water Level PJ)0 Ft. Elevation Above Ordinary High Water Level Setback to Septic Tank Ft. 'v/ Setback to Drainfield / Ft.s/^ Setback to Bluff Ft. Total Bedrooms Maximum Proposed Height Ft. y/ Roof Change ( )Yes 0^)1^ Basement ( ) Yes ( X) No Walkout Basement ( ) Yes (side profiie required) ib Ft** Dimension Ft. X Ft.". FI. X Ft. X Ft." Sq. Ft. I Setback to Lotline ___ Setback to Right of Way Pj ^-'Setback to Ordinary High Water Level __ Elevation Above Ordinary High Water Level Setback to Septic jTank__ Setback to Drainfield___Setback to Bluff J______ Maximum Proposed Height Roof Change ( j) Yes ( ) No Bathroom Proposed ( ) Yes ( ) No H(l 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/L6tlines/Right-of-ways Must be Staked Onsite Prior to Appiication / inspection Ft."Ft.&FI.&Ft.**Ft."Ft.& Ft."Ft." Ft.Ft. Ft. Ft.Ft. Ft.Ft. Ft.Ft. Ft.Ft. ( ) Screen Porch ( ) Storage Structure I^)No * Must include on scale drawing, additional Permit may be required. Topographical Alteration / Earthmoving | □ None ^ 20 Cubic Yards or Less * □ 21 Cubic Yards - 999 .Cubic Yards*□ 1,000 Cubic Yards or More* l/>IS%CHARACTERISTICS OF LOT:Bluff ( )Yes (^NoSq. Ft.Water Frontage Ft.Lot Area. .%.% 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 isjcorrect 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 statemerit. 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 Lan^Resource Managem^t office ojfice the building footings have been constructed. D.», n Jji/ji_________ ^ Sjmaiure of Property Owner/Agent for Owner ^______t_____r-H____LancTtS [Resource Man^g^rnent Official ________ RECEIPT NO. Ir /3 j u|i5ln !; Date: ~ I LaGPERMIT F;EE $PROJECT(S) TOTAL SQ.FT., )qjC^ JyJ hi/O S)Date StampComments: il !!■ L&R InitialForm No. BK — 04-2016 360,647 • Victor Lundeen Co., Printers • Fergus Falls, Minnesota .3^ 0P2L.1IVH/TE - 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 3 OTTCR TflllCOfliTY-aiflNIIOTt 1Permit No.1APPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED. ITWP NAMERANGETWP NO.SECTIONLAKE/RIVER CLASSLAKE/RIVER NAMELAKE / RIVER NO.VY5 5"V;Y /iXl h)V N, PARCEL NUMBER (S) }fOCO f GOi .1PROPERTY (E-911) ADDRESS Lcpp fVS L> f )■> LEGAL DESCRIPTION VDEVELOPED. f' hd'^0 c Lp Jp Ca'hn p J UNDEVELOPED. ;L/.Daytime Phone No.Mailing AddressFirstInitialLast Name Lsx\c Oiy-Vro \R b^pK-\Property Owner Dm IfyyKJk.ukj Contractor Name Lie.# 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 issuirtg Site Permit. Contact Roiiie Mann at 218-864-5533 PROPOSED PROJECT (please circle the appropriate number) (2 ) Add'n to Dwelling/Attached Garage (3) Replacement Dwelling* (5) RCUA'ear ONSITE WATER SUPPLY {v") Individual ( ) Public ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3’ (minimum) structure setback to a well. (1 ) New Dwelling (4) MH/YR____ (7) Add’n To Non-Dwelling (8 ) Storage Structure (10 ) Non-Conf. Replacement (identify)"_______ (11) Other (identify)_______________________ (12 ) Deck______________________________ (13)Fence_____________________________ 1 ( 6) Detached Garage (9) W.O.A.S.[: i(;X’) New Septic Permit Issued ■Permit # 2.. 7) L •’Existing Non-Conf. Structure Verified by L&R•Removal of Existing Dwelling Verified by L&R Inspector's Inilial/DateInspector's Initial/Date CHARACTERISTICS OF PROPOSED W.O.A.S. (WATER ORIENTED ACCESSORY STRUCTURE) Outside Dimension CHARACTERISTICS OF PROPOSED NON-DWELLING Outside ■y'' Dimension Sq.Ft. Setback to Lotlin^ 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 CHARACTERISTICS OF PROPOSED DWELLING (Must Include Attached Garage) Ft. X Ft.**Ft. XFt.**Outside Dimension Sq. Ft. 1 If ^ Setback to Lotline Setback to Right of Way Setback to Ordinary High Water Level Ft. Elevation Above Ordinary High Water Level Ft. 'li-P fJlP p, 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 1Ft.**Ft.**,Ft.& Ft.**\-^'Ft.**Ft.& -Ft;** ^.i Ft.”i Ft.4.Ft. Ft.Ft."^Setback to Septic Tank _j Setback to Drainfield Setback to Bluff Ft. Total Bedrooms ' Ft.iFt.IFt. Ft.=2 Ft. V 'Ft. Ft. ^ R. Maximum Proposed Height Roof Change ( ) Yes (X ) UY Basement ( ) Yes ( )^) No Walkout Basement ( ) Yes (side profile required) (y*) No Ft.1Ft. ( ) Screen Porch ( ) Storage Structure ( ) Boathouse ( ) Gazebo **Project/Lotlines/Right-of-ways Must be Staked Onsite Prior to Application / inspection * Must include on scale drawing, additional Permit may be required. Topographical Alteration / Earthmoving □ None 0 20 Cubic Yards or Less * □ 21 Cubic Yards - 999 Cubic Yards*□ 1,000 Cubic Yards or fere* Ml?k !±5Z Ft. Bluff ( )Yes (X)NoCHARACTERISTICS OF LOT:Water FrontageSq. Ft.Lot Area, ^ 5 !.%.% 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. 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 opce the building footings have been constructed. i In/r/ri 7 ■ ________________Si^ialure of Property Owner / Agent for Owner Date:/ Date;1/ RECEIPT NO. and & Resource Managdment Offidai ^ I UQyjjj -O OPERMIT FEE $PROJECT(S) TOTAL SQ.FT., O Si }'P hrComments: Dfe }) L V iForm No. BK — 04-2016 360.647 • Victor Lundeon Co., Printors • Fergus Falls, Minnesota i SITE PERMIT INSPECTION RESULTS Inspector must make all measurements and computations MOO r"structure Set Back from Ordinary High Water Level Ft. Ft. Structure Set Back from Top of Bluff Ft.Ft. 3»oV*Structure Set Back from Road Right of Way Ft. Ft. Ft. &'ZM*- Ft. & Ft.Structure Set Back from Lot Lines Ft. 1^'Structure Height Ft.Ft. -Structure Set Back from Septic Tank Ft. Ft.STD 101^Structure Set Back from Drainfield Ft.Ft. Elevation Of Lowest Floor Above Ordinary High Water Level Ft.Ft.to Land Slope at Building Site %% Inspector’s Comments / Sketch: T ... -----^ r f -■-.f V V Si 1 \ i* L ‘i -I s 1 Ho I Inspected Signature IJ^I h) I Date of Inspection \{I i I o 3 ;t. n h>f jynH ^2>Time of Inspection I 1 ^ ^ ' t3^miect Aooroved ("V\ 218/863-6639 1-800/232-5270 Fax 218/863-6640 M ^ictory Home ■^Sales Inc. 42807 County Hwy. 9 Pelican Rapids, MN 56572 Installer #649675 Contractor #649691 EST. 1975 11/13/2017 To whom it may concern: Jeff and Jenny Jaszkowiak have chosen the enclosed floor plan with some modifications to the rear bedroom so it will be handicap accessible. This house is 15'4" x 60' for a square footage of 920. And the old home is 12'x56' plus the deck is a total square footage of 832. They will be over by 88 square feet. Please advise. Sincerely, Stephen S Berry Victory Home Sales, Inc '-T /■ o>ace ____PfAi^lL & FILE MEMO PROPERTY OWNER ^KE^VER/WETLANP NAME S'U COO^ OCSl CcoPARCEL # ^U0COO^C/i^lO£il @Upjpj.Date ___________ L&R Official /h^T" U^iTH FMiJiL THE ______ SHp^lA iJ/T /i pAndt^^ ^Ui£ iT T7AT n>A, Tl^c 4- THE i>F THE a/SU rhH is LEiS Th/hs/ ‘7T»|5 /y\t4 fJ^eULK t4tjiT'^ u u/piiLA ^aufp^ /f c.ufi MtjL£^ The tosuj l4iJCr f^AtfdrOi/ Aci£i^i^L€ /^: 7?<e ^ByJ 14^\T U LALCCA, Action/Comments. ^ MM ■» // ISS KE.tLA^^sjr 4>r L&R OfficialDate Action/Comments. Date L&R Official Action/Comments. 7r Tax Parcel Number(s) ‘' scale drawing must be a signed drawing which includes and identifies a graphic scale (feet), all existing and/or proposed structures, septic j, drainfields, lotlines, road right-of-ways,,easements, OHWLs, wells, wetlands and topographic features (i.e. bluffs). Must also complete the :pervious Surface Calculation (see back). I H Scale*. ; I iv>t 'rMs H " i p%7 I /z ^ ft, ..... I f yjl, \/hfxn^ "'7.7^J 5/^ ^ Ik:rjuf___LI ymit'Z' 5/Te« S:^)6 jm: r ^ i /V i ../.'I } rm rf ff~ ffiz'y M £:I]^J2r^ • Ec^y h" -A H \f li V C « oho^ni\ <2 r\ APPLICATION FOR SITE PERMIT LAND & RESOURCE MANAGEMENTRVICES 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 milCOiRTY-MIAIICfOTM Permit No.APPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED. RANGE TWP NAMELAKE / RIVER NO.LAKE/RIVER NAME LAKE/RIVER CLASS SECTION TWP NO. J3S V/10- D PROPERTY (E-911) ADDRESSPARCEL NUMBER (S)_£(f>C>C0Q ^ocS 'loot SU OCQCt ^ OoS'] 0^!3cb7o LEGAL DESCRIPTION DEVELOPED UNDEVELOPED. Daytime Phone No.Last Name First Initial Mailing Address 3d£10 \-oe>P Property Owner m Contractor Name Lie.# Self PROPOSED PROJECT (please circle the appropriate number) (2 ) Add’n to Dwelling/Attached Garage (5 ) RCUA'ear (7) Add’n To Non-Dwelling (8 ) Storage Structure (10) Non-Conf. Replacement (identify)"_________________ (11) Other (identify)_______________________________ (12 ) Deck_____________________________________ (13) Fence_____________________________________ ONSITE WATER SUPPLY(^^ndividual ( ) Public ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3’ (minimum) structure setback to a well. ONS^ SEWAGE TREATMENT SYSTEM ( vfl&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 Roliie Mann at 218-864-5533 (^ New Septic Permit Issued Permit # (1 ) New Dwelling (4) MHA'R____ (^^Replacement Dwelling" (6) Detached Garage (9) W.O.A.S. ■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^.A.S.' (WATER ORIENTED ACCESSORY STRJJCTURE) Oufside Dimension CHARACTERISTICS OF PROPOSED DWELLING (Must Include Attached Garage) Outside Dimension 12, 1 Ft. x Y^ Sq. Ft. SY^ y Setback to Lotline SO Ft. & 50 Ft." Setback to Right of Way -20^ Ft.” Setback to Ordinary High Water Level Elevation Above Ordinary High Water Level ^0 Ft. Setback to Septic Tank / 0 Ft. Setback to Drainfield V'^ Ft. Setback to Bluff /)JA- Ft. Total Bedrooms / Maximum Proposed Height Roof Change ( ) Yes (>^) No Basement ( ) Yes (^) No Walkout Basement ( ) Yes (side profile required) ( CHARACTERISTICS OF PROPOSED NON-DWELLING Out! DImensi Ft. X Ft." Ft. X Sq. Ft. \/ Sq. Ft.;Setback to Lotline Ft. & / Ft." \ ■/ Setback to Lotline__Setback to Right of Way>fTt.** ^\ Setback to Right of Way Setback to Ordinary Him WateKevel Ft.\y Setback to Ordinary High Wfer LevelElevation Above Ordinary Mh Water LevelFt. /, \ / \ Elevation Above Ordinai/High\/ater LevelSetback to Septic Tanly \ Ft. / \ Setback to Septic T Setback to Drainfiara_______\Ft. // \ Setback to Drainfield___Setback to BlujrFt. \ // Setback to ^ffMaximum Rroposed HeightFN. / / X Maximun/Proposed HeightRoot Change ( ) Yes ( ) No \ / / ( )mathouseBa^oom Proposed ( )Yes ( )No ^ **Project/L«tlines/Right-of-ways Must be Staked Onsite Prior to Application / Inspection Ft.** Ft Ft." Ft. Ft. Ft. Ft. ( ) Screen Porch > ( ) Storage Structure Topographical Alteration / Earthmoving y 20 Cubic Yards * Must include on scale drawing, additional Permit may be required.□ None or Less *□ 21 Cubic Yards - 999 Cubic Yards*□ 1,000 Cubic Yards or More* ( k<NoVSOCHARACTERISTICS OF LOT:Lot Area. Sq. Ft.Water Frontage Ft.Bluff ( ) Yes AS- 70.%.% 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 shali 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 & ilshi esou^e Management offite once the building footings have been constructed. Date: Stature of Property Owner / Agent for Owner Aryuj Land & Resourd^Management Official Date: o(Dtn-m UhJtPb dVPROJECT(S) TOTAL SQ. FT.,PERMIT FEE $RECEIPT NO. t C I rtv rf. I iY\ D Id /)1 ^ hi / /i a /id Date StampComments: L&R InitialForm No. BK — 04-2016 Iw ■»!360,647 • Victor Lundeen Co.. Printers • Fergus Falls, Minnesota WHITE - Office GOLDENROD - Inspector YELLOW - Owner (after issue) OR SITE PERMIT LAND & RESOURCE MANAGEMENTGOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS FALLS, MN 56537 218-998-8095 r-tail.mn.usOTTCR TfllleofiTT-aitiiiOTi Permit No.APPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED. RANGE TWPNAMESECTIONTWPNO.LAKE7RIVER CLASSLAKE / RIVER NO.LAKE/RIVER NAME /SE I //3Ta.r Lt k'r-SL -____I J^I^OOOO 'jooS 'loco 3~L 0600 ^ DoS'] 0^1 V(> D / PROPERTY (E-911) ADDRESSPARCEL NUMBER (S) 3C^70 c y\ LEGAL DESCRIPTION DEVELOPED UNDEVELOPED. Daytime Phone No.First Initial Mailing AddressLast Name CRAtLii ^ 7/^ /L/ifty.- L/,/,iO Y\ X^ /T't Y) J5^toS -T 0 h t\Property Owner mr Contractor Name Lie. it Mt 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. Replacement (identify)"_______ (11) Other (identify)_______________________ (12) Deck__________________________ (13) Fence_____________________________ ONSITE WATER SUPPLY (vf^ndividual ( ) Public ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3' (minimum) structure setback to a well. ONSI'^ SEWAGE TREATMENT SYSTEM ( v^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 Rome Mann at 218-864-5533 New Septic Permit Issued Permit ft (2) Add’n to Dwelling/Attached Garage ^JJ)Replacement Dwelling* (5) RCU/Year (6) Detached Garage (9) W.O.A.S. "Existing Non-Conf. Structure Verified by L&R•Removal of Existing Dwelling Verified by L&R Inspector's Initial/DtteInspector's Initial^ate CHARACTERISTICS OF PROPOSEb W.O.A.S. (WATER ORIENTED ACCESSORY STRUCTURE) Outside Dimension CHARACTERISTICS OF PROPOSED DWELLING (Must Include Attached Garage) Outside Dimension t 'i- ‘f Ft. x ^^ Sq. Ft. Setback to Lotline C Ft. & 5 0 Setback to Right of Way .2'.'. Ft." _ Setback to Ordinary High Water Level Vtf 4> Ft. Elevation Above Ordinary High Water Level 70 Ft. Setback to Septic Tank / O Setback to Drainfield 76 Ft. Setback to Bluff .VFt. Total Bedrooms / Maximum Proposed Height Roof Change ( ) Yes ( x^) No Basement ( ) Yes ) No Walkout Basement ( ) Yes (side profile required) (>^) No CHARACTERISTICS OF PROPOSED NON-DWELUNG Outside Dimen^Ft. X Ft."\Ft."Ft. X\ Sq. Ft. \ Setback to Lotime ___ Setback to Right onH(ay Setback to Ordinary Hi^t^Wat^Tevel __ Elevation Above Ordinary pl|gh Water Level Setback to Septic TanI/ \ Ft. Setback to Drainheld"JvFt. *Sq.Ft.________\ Setback to Lotline \ Setback to Right of Way Setback to Ordinary High \^er Level __ Elevation Above Ordinar/THighVater Level Setback to Septic Tapft^ Setback to Drainfifeld__ Setback to Qldff /Maximurp Proposed Height ( ) ^athouse ( ) Gazebo **Project/L6tlines/Right-of-ways Must be Staked Onsite Prior to Appiication / inspection Ft."Ft.&Ft."Ft.** Ft." Ft.Ft. Ft.Ft. \ V Ft. Setback to Blojk'Ft./<Z Ft.Ft. Maximum ^posed Height_____ Roof C^nge ( ) Yes ( ) No Bathroom Proposed ( ) Yes ( ) No ( ) 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* (F-lNo/6'/CHARACTERISTICS OF LOT:Sq. Ft.Lot Area.Water Frontage Ft.Bluff ( ) Yes '1.%.% 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 responsibiiity to inform the Land &,^esoui;ee Management office once the building footings have been constructed. - 7/ ,Vz5»/ 7______________Date: S^^ture of Property Owner / Agent for Owner 1Date: /(•t^ RECEIPT NO. p.. .- k ' k AXJ Land & Resourr^ Management Offidaf PROJECT(S) TOTAL SQ. FT.PERMIT FEE $ Did /)l n b t / /) ^Comments: Form No. BK — 04-2016 360,647 ■ Victor Lundeen Co.. Printers • Fergus Falls. Minnesota ■' 4 ^ 'T • * SITE PERMIT INSPECTION RESULTS Inspector must make all measurements and computations ^'50+'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. Structure Set Back from Lot Lines Ft.&Ft.Ft.&Ft. Structure Height Ft.Ft. [C>^structure Set Back from Septic Tank Ft.Ft. Structure Set Back from Drainfield Ft.Ft. rElevation Of Lowest Floor Above Ordinary High Water Level Ft.Ft. Land Slope at Building Site %% Inspector’s Comments / Sketch: Insp&jtor’s Signature ' Ddte of Inspection Time of Inspection U(/ioject Approved O \ i'll I ^ Ij M Date / Initiil * ^ J 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) OTTER TflllCOUftTY-ailfllfOTH Permit No.APPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED. LAKE / RIVER NO.LAKE/RIVER NAME LAKE/RIVER SECTION TWP NO.RANGE TWP NAME/ji' I <// I 5fntL<Li^e. PARCEL NUMBER (S)PROPERTY (E-911) ADDRESSSip OQOO ^OoS^dOD S(£> ODOO<^OCS 700/3oS7^ LpJ^e. Le>o/^^ D r^/Hn SdS~lS'e n LEGAL DESCRIPTION DEVELOPED UNDEVELOPED Last Name First Initial Mailing Address Daytime Phone No. f-Yl /v^ ^ Stt>hr\ fY\S70 Log g g. Lag P pe-nTj lOl _ Property Owner 1 Contractor Name Lie.# 6d«f 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. Replacement (identify)"______ (11) Other (identify)____________________ (12 ) Deck__________________________ (13) Fence_________________________ ^SITE WATER SUPPLY ( Vt^dividual ( ) Public ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3’ (minimum) structure setback to a well. ONSITE SEWAGE TREATMENT SYSTEM ( V^Tl&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 Rollie Mann at 218-864-5533 ■® New Septic Permit Issued , ^ _ Permit # ^Replacement Dwelling* (^ Detached Garage (9) W.O.A.S. ( 2 ) Add'n to Dwelling/Attached Garage ( 5 ) RCU/Year T •Removal of Existing Dwelling Verified by L&R "Existing Non-Conf. Structure Verified by L&R Inspector's Initial/Date Inspector's Initial/Dale CHARACTERISTICS OF PROPOSED W.O.A.S. (WATER ORIENTED ACCESSORY STRUCTU^OuSide Dimen^n CHARACTERISTICS OF PROPOSED DWELLING (Must Include Attached Garage) S Ft. X -•? ^ CHARACTERISTICS OF PROPOSED NON-DWELLIfiG Outsid^v Dimension'Ft. X Ft."Outside Dimension Sq.Ft. Setback to Lotline S/) Ft. & S0 Ft." Setback to Right of Way 2-C^ Ft."* Setback to Ordinary High Water Level 6 Ft. Elevation Above Ordinary High Water Level Ft. Setback to Septic Tank / 0 Ft. Setback to Drainfield _ Setback to Bluff fl/. Total Bedrooms al Maximum Proposed Height Roof Change ( ) Yes (No Basement ( )Yes (^) No Walkout Basement ( ) Yes (side profile required) Ft.**Ft. x Ft.** Sq. Ft._____\ Setback to Lotline Setback to Right of Waj Setback to Ordinary High >(atep4?evel __ Elevation Above Ordinary Water Level Setback to Septic Tari)y Setback to Drainfiplq____ Setback to B\yfi_______ Maximurn/Proposed Height Roof^ange ( )Yes ( ) No Bafnroom Proposed ( ) Yes ( ) No Sq. Ft. X Setback to Lotlin\ Setback to Right of Setback to Ordinary High'V(ate>fevel Elevation Above Ordinary l;jiomWater Level Setback to Septic Tan Setback to Drainfi Setback to B|tifi______ MaximumAoposed Height ( ) Bomhouse ( ]/Gazebo *'*Project/Lotlines/Right-of-ways Must be Staked Onsite Prior to Application / Inspection Ft.&Ft.**Ft.&Ft.** Ft.**■t.** Ft.Ft. Ft.Ft.^ Ft. /r Ft. Ft.it- :t.Ft. Ft./ Ft.Ft. it-Ft. ( ) Screen Porch ( ) Storage Structure('^)No 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* Bluff ( )Yes (P^No Water FrontageCHARACTERISTICS OF LOT:Lot Area. Sq. Ft.Ft. 7D.%.% 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 Date: esoorce D^naoement office once the building footings have been constructed. /i> - ^/-J ^nature of Property Owner/Agent for Owner Amu Land & Resourpa Management Official Date: ^ lojjttrOO-L/0PERMIT FEE $PROJECT(S) TOTAL SQ. FT.RECEIPT NO. OiA ko/h-YLhiL ^ IiX' rsr\(^ '//f fA/e Date StampComments: /Sf L&R InitialForm No. BK — 04-2016 360,647 • Victor Lundeen Co., Printers • Fergus Falls, Minnesota 5. fe 3 IM.'5p((fl8»Sj,WHITE - Office GOLDENROD - Inspector YELLOW - Owner (after issue) FOR SITE PERMIT LAND & RESOURCE MANAGEMENTGOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS FALLS, MN 56537 218-998-8095 www.co.otter-tail.mn.usOTTER TRIIcouiTT-aiiiiiOTi ^'/PermitNo.APPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED. RANGE TWP NAMELAKE / RIVER NO.LAKE/RIVER NAME LAKE/RIVER CLASS SECTION TWP NO. “■I 'llv> PROPERTY (E-911) ADDRESSPARCEL NUMBER (S)S(f OQOO iOO S’^000 S’0000 f 00S ’7oof Lpj^e. : PtL «r jyf/j SA.si ^ LEGAL DESCRIPTION DEVELOPED h k" Lodge if ntJ Cd.ni maund First Initial Mailing Address UNDEVELOPED Daytime Phone No.Last Name John S’/O ^ Log P 0^r\Tf i('y\ r\ , _ -7Property Owner •9 Contractor Name Lie.# ItLip :‘Al i ['i PROPOSED PROJECT (please circle the appropriate number) (1 ) New Dwelling (4 ) MHA'R____ (7) Add'n To Non-Dwelling (8 ) Storage S|ructure (10) Non-Conf. Replacement (identify)” . ' (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 ( Cert, of Compliance within 5 yrs. ( ) Compliance Inspection Report within 3 yrs. (Attached) ( ) OTWMD ‘Must have Sewage System Approvai from OTWMO prior to issuing Site Permit. Contact Rome Mann at 218-864-5533 M) New Septic Permit Issued ^ _ Permit # CHf. IvjAjzl f^jReplacement Dwelling" (b) Detached Garage (9)W.0.A.S. ( 2 ) Add'n to Dweliing/Attached Garage (5 ) RCU/Year T -i. ( ‘Removal of Existing Dwelling Verified by L&rt ■__1 “Existing Non-Conf. Structure Verified by L&R \ 'ynspector's Initial/Date CHARACTERISTICS'OF' proposed non-dwelung ^ 1 OutsiBe'"^ Dimension's Inspector's Initial/Date CHARACTERISTICS OF PROPOSED W.O.A.S. ^ (WATER ORIENTED ACCESSORY STRUCTURE^ Outside Dimenston CHARACTERISTICS OF PROPOSED DWELLING, (Must Include Attached Garage)f\.**X. :T Ft.x R.“Ft. XOutside Dimension Sq. Ft. L i ‘-j . Setback to Lotline Setback to Right of Way 2-iA Ft.** Setback to Ordinary High Water Level V/n /) Ft. Elevation Above Ordinary High Water Level Ft. f Sq.Ft.______\ Setback to Lotline Setback to Right of Waj Setback to Ordinary High Jteter^vel __ Elevation Above Ordinary Hr^Water Level Setback to Septic Tanj^ Setback to Drainfi^____ Setback to B\j^_________ MaximurmFroposed Height RoofJZnange ( )Yes ( ) No Bathroom Proposed ( ) Yes ( ) No SO Sq.Ft.--------- Setback to LotlitX^ Setback to Right of Setback to Ordinary High'Yi(ate^evel Elevation Above Ordinary fJidmWater Level Setback to Septic Tan Setback to DrainfipKf Setback to Bluff Ft.&Ft.**Ft.&Ft.** Ft.** Ft. Ft.Setback to Septic Tank / rJ Ft. Setback to Drainfield Ft. Setback to Bluff O/Ft. Ft. Ft. kb it-Ft. Total Bedrooms Maximum Proposed Height Roof Change ( ) Yes ( >,) No Basement ( )Yes (y^)No Walkout Basement ( ) Yes (side protile required) ) No _______________________________**Proiect/Lotlines/Right-of-ways Must be Staked Onsite Prior to Application / Inspection Ft./ d Ft.Ft. Lt. Maximurn^Proposed Height ( ) Bcathouse ( iGazebo 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* (F-'Ino/cJ Water Frontage 0CHARACTERISTICS OF LOT:Sq. Ft.Lot Area.Ft.Bluff ( )Yes 7/).%.% 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 responsibiiity to inform the Land ^esrarce Management o&ice once the buiiding footings have been constructed. Date: t<h U/ SO/0_____________ /Yl/ '.'S'A- ^nature of Property Owner / Agent for Owner PROJECT(S)TOTAL SQ. FT. 5^ f Date: Land & Resour^ Management Official PERMIT FEE $ ZiPC I'O A U-RECEIPT NO. 7-.^./ joju hM/k'iLOlA tvjn /? /Ye. Y 'Comments: C 3 314^ 1 V Form No>BK — 04-2016 liov wm 360.647 • Victor Lundeen Co.. Printors • Porgus Fails, Minnesota V • SITE PERMIT INSPECTION RESULTS Inspector must make all measurements and computations •Mlstructure 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. Structure Set Back from Lot Lines Ft.&Ft.Ft.&Ft. Structure Height Ft.Ft. lo"'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 %% Cu>-fUlA-Inspector’s Comments / Sketch: Inspector’s Signature Date of Inspection Time of Inspection Ct^fojectApproved if Date / IniOal ‘ PLICATION 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) OTTER THIICOM«TT-HINI)lfOTI Permit No.APPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED. TWPNO.RANGE TWP NAMELAKE/RIVER CLASS SECTIONLAKE / RIVER NO.LAKE/RIVER NAME Sfa P La. Kf/35- I ¥/SL-3%^IPROPERTY (E-911) ADDRESS &30 5(o Oooo ^00^PARCEL NUMBER (S) SL>good JooSlool LEGAL DESCRIPTION DEVELOPED f-ra-viK< LotJqg-C A UNDEVELOPEDO-Wt CTO a v\ First Mailing Address Daytime Phone No.Last Name Initial LaoPProperty Owner Contractor Name Lie.# Sdi PROPOSED PROJECT (please circle the appropriate number) ( 2) Add’n to Dwelling/Attached Garage (^Replacement Dwelling’ ( 5) RCU/Year_____ ( 7) Add’n To Non-Dwelling ( 8) Storage Structure (10) Non-Conf, Replacement (identify)"_______ (11) Other (identity)______________________ (12) Deck______________________________ (13) Fence_____________________________ ONSITE WATER SUPPLY (V^dividual ( ) Public ( ) None NOTE: MN Rules Chpt, 4725 (MN Well Code) requires a 3' (minimum) structure setback to a well. ONSITE SEWAGE TREATMENT SYSTEM ( Kl&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 # (1 ) New Dwelling (4) MHA-R_____( 6) Detached Garage (9) W.O.A.S. ’Removal of Existing Dwelling Verified by L&R "Existing Non-Conf. Structure Verified by L&R Inspector's \nitia\/Date Inspeciofs Mial/Date CHARACTERISTICS OF PROPOSED W.O.A.S. (WATER ORIENTED ACCESSORY STRUCTURE) Outside Dimenaon CHARACTERISTICS OF PROPOSED DWELLING (Must Include Attached Garage) Outside Dimension Sq.FL>^ 3p * So. Ft. \ Setback to Lotline 0 Ft & AJl------Ft." Setback to L^e ____ Setback to Richt of Wav fiUr Ft." . . .^ ^ Setback to Right«WaySetback to Ordinary High Water Level Ya>0 Ft. \ Elevation Above Ordinary High Water Level Ft. Ordinary\^gh Water^el — Setback to Septic Tank /h Ft. Elevation Above OrdinV Hiq*mater Level Setback to Draintield Ft. Setback to Septic Tank Setback to Bluff .gf/f Ft. Setback to DraintieIcK Total Bedrooms ------- Setback to BluJ^/__ Maximum Prooosed Heioht /oC .. _/ Maximum^oposed Height________^ Roof Change ( ) Yes (^ No / X Maximj^ Proposed HeightBasement! )Yes (V)No . R°^ange ( )Yes ( ) No \ ( ;^thouse Walkout Basement ( )'fes (side profile required) (V) No B^room Proposed ( )Yes ( )No ^ ) Gazebo “Project/iLotlines/Right-of-ways Must be Staked Onsite Prior to Application / Inspection CHARACTERISTICS OF PROPOSED NON-DWELLING Outside Dimeraon^ Ft. X Ft. X Ft."Ft."Ft. X Ft." Sq. Ft. \ Setback to Loilthe ____ Setback to Right oNway Setback to Ordinary H^Wat^Level __ Elevation Above Ordinar^^h Water Level Setback to Septic Tar Setback to Drainfjdld Setback to Bldrf___ Ft.&Ft."Ft.&Ft." Ft." Ft.Ft. Ft.Ft. Ft.Ft. Ft. FV Ft. Ft.Ft> ( ) Screen Porch ( ) Storage Structure Topographical Alteration / Earthmoving □ None ’ Must include on scale drawing, additional Permit may be required.M. 20 Cubic Yards or Less ’□ 21 Cubic Yards - 999 Cubic Yards’□ 1,000 Cubic Yards or More’ /a/Ji'yyCHARACTERISTICS OF LOT:)Yes ()^) NoLot Area, Sq, Ft.Water Frontage Ft.Bluff ( 2S''7D.%.% 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 Sr’fiesoufce Management offibe o^e the building footings have been constructed. Date: Si^fature of Property Owner / Agent for Owner # Land & Resource Management Official Date: RECEIPT NO. FraitlL’i Ud^-^MPROJECT(S) TOTAL SQ. FT.PERMIT FEE $ iTd. PfrLdi/tf /O/l k jti cOify •aOuTT'^_________________ Date StampComments: L&R InitialI^BSIForm No. BK — 04-2016 360,647 • Victor Lundeen Co., Printers • Fergus Falls. Minnesota 5(4^ PQJ^ 5,J£ permit WHITE - Office GOLDENROD - Inspector YELLOW - Owner (after issue)m LAND & RESOURCE MANAGEMENT GOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS FALLS, MN 56537 218-998-8095 www.co.otter-tail.mn.usOTTER milCOfRTT-ai«ailOT« Permit No.APPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED. TWP NAMERANGESECTIONTWP NO.LAKE/RIVER CLASSLAKE/RIVER NAMELAKE / RIVER NO. Sfa <r La K rI V/IPROPERTY (E-911) ADDRESS 4 D PARCEL NUMBER (S)5ii> Oooo I S(pDO00 looSJ ool r.<2 H LEGAL DESCRIPTIONf DEVELOPED K C j ^ t£- (Lvr.i J["UNDEVELOPED.kO r/^ u vn Daytime Phone No.Initial Mailing AddressFirstLast Name cT ^iC> c Loop*Property Owner Kl R sT <D h nx■f IContractor Name Lie.# <1 '' T TPROPOSED PROJECT (piease circle the appropriate number) (2 ) Add'n to Dweiiing/Attached Garage (^Repiacement Dweiling* (6 ) Detached Garage^.^ (9) W.O.A.S. ONSITE SEWAGE TREATMENT SYSTEM (Cert, of Compliance within 5 yrs. { ) Compiiance Inspection Report within 3 yrs. (Attached) ( ) OTWMD ‘Musi have Sewage System Approval from OTWMD prior to issuing Site Permit. Contact Rollie Mann at 218-864-5533 (^New Septic Permit Issued Permit # _ _________icjI ^jz) ONSITE WATER SUPPLY (V"^ndividual ( ) Public ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3' (minimum) structure setback to a well. (1 ) New Dwelling (4 ) MH/YR____( 5 ) RCU/Year_____ (7) Add'n To Non-Dweiiing (8) Storage Structure (10 ) Non-Conf. Repiacement (identify)"_______ (11) Other (identify)______________________ (12) Deck______________________________ (13) Fence_____________________________ •Removai of Existing Dweiiing Verified by L&R "Existing Non-Conf. Structure Verified by L&R In^foctor's Initial/Date Inspector's Initial/Date CHARACTERISTICS OF PROPOSE^ DWELLING ' j (Must Include Atta^ed Garage) Outside Dimension Sq.Ft..^^^*^? »■ Setback to Lotline D Ft. & J? 0 Ft," Setback to Right of Way Ft.” Setback to Ordinary High Water Level V&O Ft. Elevation Above Ordinary High Water Level 9^^ Ft. Setback to Septic Tank /D Ft. Setback to Drainfield. k/D pt. Setback to Biuff CHARACTERISTICS OF PROPOSED W.O.A.S. (WATER ORIENTED ACCESSORY STRUCTURE) Outside Dimension CHARACTERISTICS OFfROPOSED NON-DWELLING Outside Dimertsion I '2 / j Ft. X Ft."Ft. X k' /') Ft."Ft. X Ft."\ Sq.Ft._V_ , o ^X / Ft.Setback to Lotnne Ft. & X Ft." X*v Setback to Lotlfng ___ Setback to Right WayJf\" „ „ V,.,y Setback to Right otHWaySetback to Ordinarywigh Water l^el Ft. „ „ ,\ y Setback to Ordinary HitoWatp<Level Elevation Above Ordinky HighrWater LevelFt. „ \ y- Elevation Above OrdinaryyHtgh Water LevelSetback to Septic Tank \______Ft. Setback to Septic TaiSetback to Drainfield^ \ Ft. „ / \ Setback to DrainfjietdSetback to Bluff/________Ft\ „ „/ \ Setback to akfft Maximum^oposed Height______\ Ft. / / \ MaximunI Proposed HeightRoof Change ( ) Yes ( ) No \. / / / \ ( ^Boathouse Batfircom Proposed) )Yes ( )No \ ^ ^ **Project/Lotlines/Right-of-ways Must be Staked Onsite Prior to Application / Inspection Ft."Ft.& Ft."; Ft. Ft. Ft. Ft. Total Bedrooms Maximum Proposed Height / <3 Ft.Ft. Ff>Roof Change ( ) Yes (^) No Basement ( ) Yes (t,^ ) No Walkout Basement ( ) Yes (side profile required) { ) Screen Porch ( ) Storage Structure Topographical Alteration / Earthmoving □ None * Must include on scale drawing, additional Permit may be required.Si, 20 Cubic Yards or Less *□ 21 Cubic Yards - 999 Cubic Yards*□ 1,000 Cubic Yards or More* /c/.?7yCHARACTERISTICS OF LOT:Lot Area. Sq. Ft.Water Frontage Bluff ( )Yes (x;^)NoFt. js' 'yp.%.% Building Surface Ratio Impervious Surface Ratio 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 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 & pesoi fee Man^ement office once the building footings have been constructed. V -______Date: Siatature of Property Owner/Agent for Owner i PROJECT(S) TOTAL SQ. PT. Date:/-J I Land & Resource Management Official I I'OMl RECEIPT NO. WlPERMIT FEE $ !r ^ /)( cl /9l O ^ t i ho^'Vl //j PrX. r ^ ////) </& /____. ^.r/e__^_____/L ■JComments:\ i 1#^Form No. Bk — 04-2016 360,647 ■ Victor Lundeon Co., Printers • Fergus Falls, Minnesota SITE PERMIT INSPECTION RESULTS Inspector must make all measurements and computations Structure Set Back from Ordinary High Water Level Ft.Ft. Structure Set Back from Top of Bluff Ft.Ft. 1J>^Structure Set Back from Road Right of Way Ft.Ft. Ft. & 96^ Ft.Structure Set Back from Lot Lines Ft.&Ft. I a-'Structure Height Ft.Ft. (0Structure 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 %% (JJbcLjJu^iHc)0^Inspector’s Comments / Sketch: Inspectorp Signature Date of Inspection Time of Inspection Or^miect Approved.Of..Date / Initial ( APPLICATION FOR SITE PERMITM LAND & RESOURCE MANAGEMENT I GOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS FALLS, MN 56537 J 218-998-8095 www.co.otter-tail.mn.us WHITE - Office GOLDENROD - Inspector YELLOW - Owner (after issue) OTTER TflllcoiATr-aiaiiifOTa Permit No.APPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED. LAKE/RIVER CLASS SECTION TWP NO.RANGE TWP NAMELAKE/RIVER NO.LAKE/RIVER NAME ^6'3^^ >St<L h I S'fA. )r L<L 3oS70 /^dJ^cL 1-^0 be.n i~^ ±L135Gr D PARCEL NUMBER (S)PROPERTY (E-911) ADDRESSSC>ooooiooS7ooT> S^oodo9c>t> 5? 00/ LEGAL DESCRIPTION DEVELOPEDl^rfLvy^l'S djy\A CiLyy^ f ^ ird U n J Last Name First Initial Mailing Address UNDEVELOPED. Daytime Phone No. 3^5 lO l~aaP n t ] ry\ ^ 5L ^ v.T/?h.KProperty Owner —m. Contractor Name Lie.# Sei£ 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. Replacement (identify)"_______ (11) Other (identity)_______________________ (12 ) Deck______________________________ (13 ) Fence_____________________________ ONSITE WATER SUPPLY (Vfinclividual ( ) Public ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3’ (minimum) structure setback to a well. ONSlJE SEWAGE TREATMENT SYSTEM VfL&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 Rollie Mann at 218-864-5533 Septic Permit (2 ) Add’n to Dwelling/Attached Garage (^)Replacement Dwelling* (5) RCU/Year Tfr { 6) Detached Garage (9) W.O.A.S. (Bif. |o/i‘//zv)Permit # •Removal of Existing Dweliing Verified by L&R •'Existing Non-Conf. Structure Verified by L&R inspectors tnitiat/Oate Inspector's Initial/Date CHARACTERISTICS OF PROPOSED W.O.A.S. (WATER ORIENTED ACCESSORY STRUCTURE)CHARACTERISTICS OF PROPOSED DWELLING (Must Include Attached Garage)lb Ft. X CHARACTERISTICS OF PROPOSED NON-DWELyNG Outside Dimensir Outside DimensionrbFt. X Ft."Outside Dimension Ft."Ft. X Ft."Sq Ft.^ _ / Setback to Lotline 5 0 R- & Ft." Setback to Right of Way tO^ Ft." Setback to Ordinary High Water Level ^ lot) Ft. Elevation Above Ordinary High Water Level *V0 Ft. Setback to Septic Tank I <0 Sq. Ft. \ Setback to Lotlin^v Setback to Right of toV Setback to Ordinary High WSla Elevation Above Ordinary^ligh Water Level Setback to Septic Tapir Setback to Drainjwd____ Setback to Bklff________ Maximu^roposed Height RopKUhange ( ) Yes ( ) No 'Bathroom Proposed ( ) Yes ( ) No ✓Sq. Ft.\ Setback to Lotline \ Setback to Right of Wa)v Setback to Ordinary High Wat^r Level __ Elevation Above Ordinary^gtSlJ/ater Level Setback to Septic TanI Setback to Drainfi^, Setback to Blufy Ft.&Ft."Ft.” Ft."Ft.** Ft..evel Ft. Ft.Ft.Ft. Setback to Drainfield T.Ft.Ft. Setback to Bluff Total Bedrooms Maximum Proposed Height J .3 FI. Roof Change ( ) Yes (1^) No Basement ( ) Yes (y^ No Walkout Basement ( ) Yes (side profile required) Ft.Ft.Fft Ft. Ft. Ft. Maximum Qroposed Height ( ) Boathouse ( ) Gazebo **Project/Lotlines/Right-of-ways Must be Staked Onsite Prior to Application / Inspection ( ) Screen Porch \ ( ) Storage Structure('^No 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* W^o/QJ^ 3.S’ 7^4 CHARACTERiSTiCS OF LOT:Lot Area, Sq. Ft.Water Frontage Ft.Bluff ( )Yes ( .%% Building Surface Ratio Imperious Surface Ratio THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES. Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set forth and according to the provisions of the Ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express con dition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Ordinances of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said OrdinancesI understand that it is my responsibility to inform the Land & ^ce cJtceA U/he building footings have been constructed.ourc Date: Sigrawre of Property Owner / Agent for Owner ijsh Adam. Land iS Resourc^Management Official Date: Sib iAPOPROJECT(S) TOTAL SQ. FT.,PERMIT FEE $RECEIPT NO. /) iJ ry\nk:,/r hnnu. (iJHh TiH___________________ Date StampComments: L&R InitialForm No. BK — 04-2016 360.647 • Victor Lundean Co., Printars • Fergus Falls. Minnesota 1« WHITE-Office GOLDENROD - Inspector YELLOW - Owner (after issue) LIGATION 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 OTTER TflllCOWHTT-aiillllOTII { Permit No.APPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED. TWPNAMETWPNO.RANGELAKE/RIVER NAME LAKE/RIVER CLASS SECTIONLAKE / RIVER NO. / 3S H !____0 'fa. Ir 3oS 'yo kdd^<L /y {<? '5 L ncj ^ e. Co. v>v ro (A r) cl / PROPERTY (E-911) ADDRESSPARCEL NUMBER (S)5C>OooofooS7ooo JTIff coo D 9oo 3? 00/5/1 LEGAL DESCRIPTION DEVELOPED I-' r A. Y'UNDEVELOPED. Mailing Address Daytime Phone No.First InitialLast Name 3n .h’:’7n P 6 7. Property Owner J /JfJQl Contractor Name Lie.#Sdi 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. Replacement (identify)"_______ (11) Other (identify)_______________________ (12) Deck______________________________ ■ ( 13) Fence_____________________________ ONSITE WATER SUPPLY/ (Vf Individual ( ) Public ( ) None NOTE: MN Ruies Chpt. 4725 (MN Weii Code) requires a 3’ (minimum) structure setback to a well. ONSITE SEWAGE TREATMENT SYSTEM ^ Vf^L&R Cert, of Compliance within 5 yrs. ) Compliance Inspection Report within 3 yrs. (Attached) ( ) OTWMD 'Must have Sewage System Approvat from OTWMD prior to issuing Site Permit. Contact Rotiie Mann at 218-864-5533 { 2 ) Add'n to Dwelling/Attached Garage (jSJjReplacement Dwelling* (5) RCU/Year (6 ) Detached Garage , (9) W.O.A.S, Septic Permit ISHHl ^ Permit # CA dpjrc’fo (ftf. •Removal of Existing Dwelling Verified by L&R "Existing Non-Conf. Structure Verified by L&R inspectors Inilial/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 Sq.Ft. y Setback to Lotline Setback to Right of Way Ft." Setback to Ordinary High Water Level 7 Elevation Above Ordinary High Water Level WD Ft. Setback to Septic Tank / f} Ft. Setback to Drainfield Ft. CHARACTERISTICS OF PROPOSED NON-DWELUNG Outside Dimension ' \ > rSq.Ft._ Setback to Lotlin 7IU Ft. X f Lf Ft**Ft. X Ft.", \Ft. X Ft."t\\ >t. & 6 o'Sq.Ft.\ Setback to Lotiine \ Setback to Right of Wa Setback to Ordinary High Wim^r Level __ Elevation Above Ordinary HfghS(Vater Level Ft."Ft.&Ft."Ft.** Setback to Right of Wav. y Setback to Ordinary High watef level Elevation Above Ordinary^Kigh^ter Level Setback to Septic Tar Setback to Drainfi^ Setback to Maximuqir^roposed Height Rojimiange ( ) Yes ( ) No -mthroom Proposed ( ) Yes ( ) No Ft.**Ft." Ft.Ft. Ft.Ft. Setback to Septic Tank/___\, Ft.1. Setback to Bluff Total Bedrooms Maximum Proposed Height 7 .J Roof Change ( ) Yes ()(^) No Basement ( ) Yes (.j(^) No Walkout Basement ( ) Yes (side profUe required) (No Ft. Setback to DrainfleJeT Setback to Blufti( Maximum P/^posed Height ( ) Boathouse ( ) Gazebo **Project/Lotlines/Right-of-ways Must be Staked Onsite Prior to Appiication / Inspection z Ft./Ft.Ft.Ft. \( ) Screen Porch ( ) Storage Structure J 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* (1.^0Lot Area / D / 7 7 6CHARACTERISTICS OF LOT:Sq. Ft.Water Frontage Ft,Bluff ( ) Yes .%.% 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 II understand that it is my responsibiiity to inform the Land & FlMourcfe'Manageroent office c/ice the building footings have been Date: ^ ^ f ' 7 C / / ^ / constructed. Sigp^fure of Property Owner / Agent for Owner ___/h)-U Land & Resourc^Management Official to 0 Date: /CM *^743 1 PERMIT FEE $PROJECT(S) TOTAL SQ.FT.RECEIPT NO. Yc p la g!V ft ^_a/J n-\iik 't/c _JL)( H Comments: // V Form No. bK — 04-2016 360.647 • Victor Lundoon Co., Printers • Fergus Falls. Minnesota SITE PERMIT INSPECTION RESULTS Inspector must 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 Ft.Ft. Ft.& S~C)^Structure Set Back from Lot Lines 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: (U> lnspect>r's Signature %n[i / Date of Inspectionf Time of Inspection WilduLDate/Initial JProject Approved. POP pop„,p LAND & RESOURCE MANAGEMENT GOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS FALLS, MN 56537 218-998-8095 www.co.otter-tail.mn.usm WHITE - Office GOLDENROD - Inspector YELLOW - Owner (after issue) OTTER TRIICOVaTT-HiaiMIOTA Permit No.APPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED. SECTION TWP NO.RANGE TWPNAMELAKE / RIVER NO.LAKE/RIVER NAME LAKE/RIVER CLASS STa. r La. IYSL'3f,S\ SViLT I ‘LL!3SGo ^Loaob fooSyooo se oooD^ooS^ooJ PROPERTY (E-911) ADDRESSPARCEL NUMBER (S) 3oS7c> LoJ,Ucoj^^ Pr2-nT,hf)rt ^ ^Y'O LLY) d LEGAL DESCRIPTION DEVELOPEDPr k ^5 Vd i f Last Name First k c UNDEVELOPED.(Lk Initial Mailing Address Daytime Phone No. So ^'70 d ^ g- ^ Pd n yh n ,__S' Pr<^v\ liProperty Owner Contractor Name Lie.#M PROPOSED PROJECT (please circle the appropriate number) O (I) New Dwelling (2 ) Add’n to Dwelling/Attached Garage (^Replacement Dwelling* (Vj^ndividual ( ) Public ( ) None (AjMHrrR________ (5)RCU/Year________ ( 6 ) Detached Garage (7) Add'n To Non-Dwelling (8 ) Storage Structure ( 9 ) W.O.A.S. NOTE: MN Rules Chpt. 4725 (MN Well (10) Non-Conf. Replacement (identify)" Code) requires a 3’ (minimum) structure (II) Other (identify)______________________ setback to a well. (12 ) Deck______________________________ (13) Fence_____________________________ NSITE WATER SUPPLY ONSlJE SEWAGE TREATMENT SYSTEM (yfl&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 Roltie Mann at 218-S64-5533 New Septic Permit Issued iX. r-, Permit # . . ______ •Removal of Existing Dwelling Verified by L&R "Existing Non-Conf. Structure Verified by L&R Inspector's Iniliat/Date Inspector's Inilial/Date CHARACTERISTICS OF PROPOSED W.O.A.S. (WATER ORIENTED ACCESSORY STRUCTURE) Outside DimensiV CHARACTERISTICS OF PROPOSED DWELLING (Must Include Attached Garage) Outside Dimension CHARACTERISTICS OF PROPOSED NON-DWELLING, Outside DimensionFIX 2)3'Ft. X Ft.**Ft.**Ft. X SO Sq. Ft.\ Setback toNj^ne____ Setback to RighNiJ^ay Setback to Ordinary High Water LejjdT__ Elevation Above Ordinary FhgJjPWater Level Setback to Septic Tank y Setback to Draintield/ Setback to Bluff/^_______ Maximum Prosed Height Roof Chdnge ( ) Yes ( ) No Bathroom Proposed ( ) Yes ( ) No So Sq. Ft. \ Setback to Lo\ne____ Setback to Righ\l Way Setback to Ordinary>(igh \^er Level __ Elevation Above OrdinaVHigh Water Level Setback to Septic Tai Setback to Drainfji^ Setback to Blidr Setback to Lotline Setback to Right of Way JlCi^ Ft.** Setback to Ordinary High Water Level ^(^0 Ft. Elevation Above Ordinary High Water Level Ft. Setback to Septic Tank /G Setback to Drainfield . ^0 Ft.&Ft."Ft.&Ft."Ft.,Ft.** Ft.** Ft.Ft. Ft.Ft.Ft. Ft.Ft. a/s Ft.Ft. Setback to Bluff Total Bedrooms ^ Maximum Proposed Height / Ct Roof Change ( )Yes (X.) No Basement ( )Yes (X.)No Walkout Basement ( ) Yes (side profile required) Ft. Ft. Ft. Ft. Maximum woposed Height ( ) Boathouse ( ) Gazebo **Project/Lotlines/Right-of-ways Must be Staked Onsite Prior to Appiication / inspection Ft. ( ) Screen PorchX ( ) Storage Structur ()()No 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* /0/S7f Bluff ( )Yes ( ^<NoCHARACTERISTICS OF LOT:Lot Area,Sq. Ft.Water Frontage 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^^es^iBrce Man^ement offi^^ once the building footings have been constructed. Date: Mature of Property Owfler / Agent for Owner Resoufjb Management Date: Land & Peso Management Official 7oDov M-1'^PROJECT(S) TOTAL SQ. FT.PERMIT FEE $RECEIPT NO. 1 4 0\k iY\n b ■' / )r) S! key Date StampComments:VH g. L&R Initialliil^Form No. BK —04-2016 360,647 • Victor Lundeen Co., Printers • Fergus Fells, Minnesota ^ iO 5C^^|caTI0N 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 TflllCOUATT-ainAflOTN 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 SYf>.y 'Zl/Sir- iGD oooo ^ooS 7od0 dooD \oo5nooi PROPERTY (E-911) ADDRESSPARCEL NUMBER (S) S(oS ^^0-5 7p L 0(i a <L Loop. Pa y\ fI hri ^ OOP 'LEGAL DESCRIPTION DEVELOPED^ k *^3 iv T>i I UNDEVELOPED4Y'O UlY!Q. First Initial Mailing Address Daytime Phone No.Last Name (~'Y3 cJ ^ g- {■'Ort ‘£_L^L1_SLSIJo k tAProperty Owner a/i( 7aIi2RZ^i Ti n0-^ Contractor Name Lie.* PROPOSED PROJECT (please circle the appropriate number) ( 2) Add’n to Dwelling/Attached Garage {^JReplacement Dwelling* (5) RCUA'ear QNSITE WATER SUPPLY (t,^ndividual ( ) Public ( ) None NOTE: MN Rules Chpt, 4725 (MN Well Code) requires a 3’ (minimum) structure setback to a well. ONSITE SEWAGE TREATMENT SYSTEM ('yfL&R Cert, of Compliance within 5 yrs. ( ) Compliance Inspection Report within 3 yrs. (Attached) ( ) OTWMD 'Must have Sewage System Approvalfrom OTWMD prior to issuing Site ^rmit. Contact Roiiie Mann at 218-864-5533 (^ New Septic Permit Issued (1 ) New Dwelling (4)MHYR_____ (7) Add'n To Non-Dwelling ( 8) Storage Structure (10) Non-Conf. Replacement (identify)"_______ (11) Other (identify)_______________________ (12 ) Deck__________________________ (13) Fence_________________________ (6 ) Detached Garage (9) W.O.A.S. r ji Permit #'’■if7'^jOIhljll •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 NON-DWELUNG.' CHAJjACTERISTICS OF PR^^^ / (WATER ORIENTED ACCESSORY STRUCTURE) Dimension Ft. x Ft.** / Outside _ ^ Dimension Sq.Ft. \. Setback to L^e ___ Setback to RightSrf Way Setback Ip Ordinary\(igh Wpfer Level __ Elevation Above Ordinalj(High Water Level Setback to Septic Taolt /Setback to Drainfipfd _ /Setback to Blulf^ CHARACTERISTICS OF PROPOSED DWELLING (Must Include Attached Garage) Outside Dimension Sq. Ft. 3 ^ t Setback to Lotline Setback to Right of Way Setback to Ordinary High Water Level vFt. ^ Elevation Above Ordinary High Water Level/ y Ft. Setback to Septic Tank ■' /.) Setback to Drainfield V'P Setback to Bluff ft Ft. Total Bedrooms Maximum Proposed Height / 0 Roof Change ( ) Yes (K) No Basement ( ) Yes (y.) No Walkout Basement ( ) Yes (side profile required) Ft.x Ft.**1 Ft. X FT*-w V Sq. Ft. Setback to I*e(jine _____ Setback to Right'of Way _ Setback to Ordinary'll Water Le Elevation Above Ordinary Ftiglj^ater Level Setback to Septic Tank Setback to Drainfield/ Setback to Bluff//------------ Maximum Ptdposed Height Roof Chahge ( ) Yes ( ) No Bathfoom Proposed ( ) Yes ( ) No £0.£0 Ft.**F1.&Ft.&Ft.Ft.**Ft.** Ft.** •7'Ft.IFt.Ft.Ft. Ft.Ft. Ft. Ft.Ft.i/Ft. Maximum P/bposed Height ( ) Boatf'ic. ( ) Gazebo Ft. .]( ) Screen PorefK ( ) Storage Structur! ouse( )() No j**Project/Lotlines/Right-of-ways Must be Staked Onsite Prior to Appiication / Inspection Topographicai Aiteration / Earthmoving □ None ^ 20 Cubic Yards or Less * □ 21 Cubic Yards - 999 Cubic Yards* * Must include on scale drawing, additional Permit may be required.□ 1,000 Cubic Yards or More* /rJ/ J 9/Bluff ( )Yes (CHARACTERiSTiCS OF LOT:Sq. Ft.Ft.Lot Area.Water Frontage ■^3 7n .%.% 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 responsibiiity to inform the Land ^ Resource Management office once the buiiding footings have been constructed. J-/^ ' •' ______________________ ^^ature of Property Owner/Agent for Owner £ / ■ / yDate: '>.> •"7 JDate;\/ ' I. J 'Land & Resourgh Management Official too oc V.-•cT* PROJECT(S)TOTAL SQ. k RECEIPT NO. ^p|7- ^PERMIT FEE $I|~ A*, p f}/ V) i li o \ yV./o b ' I K) /T V />// /■ X ///yy X/fAu. S / /£> Comments:Tt ^ / I 3 360.647 . Vleror Lund..o Co.. PHo..r. . forgu, Fol,,. M>nn..o..Form No. BK — 04-2016 a I9 SITE PERMIT INSPECTION RESULTS Inspector must make all measurements and computations structure Set Back from Ordinary High Water Level Ft.Ft. Structure Set Back from Top of Bluff Ft.Ft. V “• -zcTStructure Set Back from Road Right of Way Ft.Ft. i-r"'5^Structure Set Back from Lot Lines ht. &Ft.Ft.&Ft. /Structure Height Ft.Ft. /■ 10Structure Set Back from Septic Tank Ft.Ft. Structure Set Back from Drainfield Ft.Ft. 3^Elevation Of Lowest Floor Above Ordinary High Water Level Ft.Ft. Land Slope at Building Site %% Inspector’s Comments / Sketch: Inspector’f Signature Date of Inspection Time of Inspection Project Approved. Tax Parcel Number(s) The scale drawing must be a signed drawing which includes and identifies a graphic scale (feet), all existing and/or proposed structures, septic tanks, drainfields, lotlines, road right-of-ways,.easements, OHWLs, wells, wetlands and topographic features (i.e. bluffs). Must also complete the Impervious Surface Calculation (see back). I '« j '!p l.:¥Scale i! .>L i , n ytv/ i fff) } ' Vh Vi H — Pp i'C I II Ir k"— 1•t[ /Z y f 4 1. - ----^ . —LZjyJ'j' /^y rn ¥"J 5/ ^ ^ ... &% p i-,f________ •>7 r* ^ _j /?x ?a )/ r: % /4' ......rNt/ .............A ..."i—'I 1 <*'sLtmmi / 57 i 2?A* h' 6^ y-6 ’T* ^ / r iI I I I III1 ?VT 4^ , -?vg _ til I a*' — — ^.a9‘‘^9’/a''^. /^Q o‘---------^1 s>> V*' rown- One *-i---------I //I / i >^.1 O'I 9^ .1 '?V\ IH<*' , MO 1IIJIIHo'MI X’ ■■!Iif said 1 1O ■ }>±♦ I ^'7 ■Ijr sec-1 T f _5i J«; be--Tt-IsA '4 *9V s.ty ?;-\I Hj'I U*- jr .3.------- H.«! Povlt^®<W I9I I%;i »3'-o'1l-IM-Q - —I r,•s-all L, ^vLfA I - V \Hj I-t I9 1(/a ‘lolI I»\->.fNI(ISo'\ Ts Tip T111 •SiI1IIj t51Vo'Vo'Ho'jUi .» -J .1 Q» i, Je f-J9I0;z <l) 0. ^t 5S i‘v-C ■a' <u (1 in VU I9/z (2>I>I V ‘UM^HPj, 0 /N^.<IVi♦_ s5, ay%*9vo" WK ^ j.^c '<£vr r~< ~/g J ;JL-Stjr sx' -W BI ^<9-7.^<5 ' £€'(iJS£ld.-*I^O' ‘I t/4A7 ?§V»*0 * ■ Tax Parcel Nuinber(s) The scale drawing must be a signed drawing which includes and identifies a graphic scale (feet), all existing and/or proposed structures, septic tanks, drainfields, lotlines, road right-of-ways, easements, OHWLs, wells, wetlands and topographic features (i.e. bluffs). Must also complete the Impervious Surface Calculation (see back). t ”P L:7|J Scale >L ^ n Ve.v\/ i ^ n wliMF ic [ y a 11 4.^ .. .. '>>'/k:r p |fp'V^j___.I YSSjf Pk:\rn j •---- t' .1 -■ »w4uJ»j }ey\wp€di'^' ............................ *- *l ^n:TSr fi,’ rZ ^//iL M-fTl /rjJF 57Z,/ nrII S-T/ h" : r {It II s I iII I O'* So.J i _ *tsi _ I _ ji?' j ?vnI _ f- 1*' - - •3^.89*A? /^O.O'----------■^l Town- ' One ---------I I 'fsl *?!’-' TcJr^=;9_ i .1 1\\I 'I II I IIHa*H<*' , H*'IHa*HI«.. . # ... ->-- •'■■ f~^ / »3 f said !IsT<»'Aer sec-!t)0 6 ^(Nf be--t ■f -^S-g't k •8,fV ?>. Hi*3;•5'tf‘l '^k i-''li ' ^ I ----TF. S’3. I(K‘iH<K T Po»t 0 iP i > i(j i V ------'3 JO \ t£Sj: \ I ok,p^ ^l^a' I-■(I I I»\(I I I .So‘— \ ?5 'CJ Tip T1j—c-------»<51%I (*'•0 I »>4 1 IPi k ^ <ra' A ; I ; JVo'«3 Vo**<4*I J u .1Ui,QV u S/e (i Vj (q ytQ;z •>f ^ ^S.■B' kJ (u^'1tj/z I^ I>Iki*^ >5.efvyv<3"^i< ^4C£-£!£iS,Z^/S^ /sr 13 .ra(flI -uo ’I »iS-t 1 //6 §?/3 14k,k) V LAND & RESOURCE MANAGEMENT GOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS FALLS, MN 56537 218-998-8095 www.co.otter-tail.mn.us APPLICATION FOR SITE PERMIT WHITE - Office GOLDENROD - Inspector YELLOW - Owner (after issue) OTTER TflllcoitTT-aiiaifOTi Permit No.APPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED. LAKE / RIVER NO.LAKE/RIVER NAME LAKE/RIVER CLASS SECTION TWPNO.RANGE TWP NAME 1a - 3SS y/!3S STdiT La^i<egp PARCEL NUMBER (S)SIcODOO ^06 ^(eOOCO ^OOS7£>6 ! PROPERTY (E-911) ADDRESS 3oS Tc Loop LaJ<fe r>i p g a.lo ^ Last Name First Initial Mailing Address ■ToKh /V\ 3oblZ' i^oo P ___________________________{^dht^ rv\n Contractor ' Name Lie.# LEGAL DESCRIPTION DEVELOPED. UNDEVELOPED Daytime Phone No. F n kProperty Owner PROPOSED PROJECT (please circle the appropriate number) (2 ) Add'n to Dwelling/Attached Garage Replacement Dwelling* ( 5) RCU/Year. ONSITE WATER SUPPLY (fc.<jr1ndividual ( ) Public ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3’ (minimum) structure setback to a well. ONSITE SEWAGE TREATMENT SYSTEM(trfC&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 218-864-5533 TSfl New Septic Permit Issued ^ ^ Permiti (1 ) New Dwelling ( 4 ) MH/YR____ ( 7) Add'n To Non-Dwelling ( 8) Storage Structure (10 ) Non-Conf. Replacement (identify)"______ (11) Other (identify)____________________ (12) Deck__________________________ (13) Fence_________________________ (6 ) Detached Garage (9) W.O.A.S. ■Removal of Existing Dweiling 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.** So. Ft. Setback to Lotline Ft. & 0‘I' Ft.** Setback to Right of Way Setback to Ordinary High Water Level Elevation Above Ordinary High Water Level ‘/rO Ft. Setback to Septic Tank /O Ft. Setback to Drainfield Ft. Setback to Bluff A'/?__Ft. Total Bedrooms Maximum Proposed Height Roof Change ( ) Yes ( '?^ No Basement ( ) Yes (-^ No Walkout Basement ( ) Yes (side profile required) ( ) No CHARACTERISTICS OF PROPOSED NOIMJWELLING Outside Dimensil Outside \ DimensionFt. X Ft.** Ft. X Ft.y Sq. Ft. \ Setback to Lotlifte ___ Setback to Right ofWay Setback to Ordinary h]^ Water Level __ Elevation Above Orjimary Njoh Water Level Setback to SepturTank__ Setback to Dpnfield____ Setback t^uff_______ Maximi^ Proposed Height Roof^hange ( ) Yes ( ) No BjThroom Proposed ( ) Yes ( ) No Sq.Ft._______\ Setback to Lotline N Setback to Right of Way Sefback to Ordinary High WalAJ-evel __Ft / \ Elevation Above Ordinary Wgh Wat^r Level Setback to Septic Tanly Setback to Drainfle Setback to Blu _______ Maximum loosed Height ( ) Boqjnouse ( ) Gazebo **Project/Lotlines/Right-of-ways Must be Staked Onsite Prior to Application / Inspection Ft.&Ft.**Ft.Ft.** Ft.**Ft.** Ft.Ft. Ft.Ft. Tt.Ft. Ft./Z Ft.Ft.■t. 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* BluH ( )Yespi f 21 Water Frontage ^CHARACTERiSTiCS OF LOT:Lot Area. Sq. Ft.Ft. Impervious Surface Ratio .%.% Building 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 iha)iit is responsibility to inform the Lan^ Resource Management.office once the building footings have been constructed. '^gnature of Property Owner/Agent for Owinc 01 (1 J^source Management Official Date: rU-04Date: LaVcf ■7y)\I i -h%3^0 PERMIT FEE $PROJECT(S) TOTAL SQ. FT.,RECEIPT NO. !A/: f A .S' $ i } Date StampComments:RECEDED NOV t»HB LAND&nOOUnCE r/Tv. L&R Initial Form No. BK — 04-2016 360.647 • Victor Lundeen Co., Printers • Fergus Falls. Minnesota MW^APPLICATION FOR SITE PERMIT WHITE - OfficeGOLDENROD - InJ^or YELLOW - Owner (after issue) LAND & RESOURCE MANAGEMENT GOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS FALLS, MN 56537 218-998-8095 . ........ www.co.otter-tail.fTirv^s .o ' I'\OTTCR Tnil 1COViTT-BliilfOTi Permit No.APPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED.1 LAKE / RIVER NO.-iLAKE/RIVER NAME LAKE/RIVER CLASS :.-r C SECTION TWPNO.RANGE TWP NAME <"7/ . i'v'A'I3S //STd.r3>Tll r /1SIdodoo ^06 57oooPARCEL NUMBER (S)PROPERTY (E-911) ADDRESS 7o Lod<^c Loop LEGAL DESCRIPTION DEVELOPED.FuLVik: 's Cd. m p ^ rooLh rlc rd. nd UNDEVELOPED Last Name First Initial Mailing Address Daytime Phone No. n K 3o3 7^ L a d^ e, l^cp P D g- h o S (p S ^ & JTo K r> (y\Property Owner \ Contractor Name Lie.# PROPOSED PROJECT (please circle the appropriate number) (2 ) Add’n to Dwelling/Attached Garage (,x} Replacement Dwelling* (5 ) RCU/Year______ (7) Add’n To Non-Dwelling ( 8 ) Storage Structure (10) Non-Conf. Replacement (identify)"_______ (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 Approval from OTWMD prior to issuing Site Permit. Contact Rome Mann at 218-864-5533 New Septic Permit Issued ^ Permit# (1) New Dwelling (4) MHA'R_____(6) Detached Garage (9) W.O.A.S, ‘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 Dimension _X, CHARACTERISTICS OF PROPOSED DWELLING (Must Include Attached Garage) CHARACTERISTICS OF PROPOSED NO>FDWELUNG Outside, Dimension Sq. Ft. \ Setback to LotlirW ___ Setback to Right onyay Setback to Ordinary Hjgl; Water Level / \Elevation Above O^hary Njoh Water Level Setback to Sei Setback to Dfainfield Setback tafiluff________ Maximurh Proposed Height Root/Change ( ) Yes ( ) No/Biihroom Proposed ( ) Yes ( ) No Ft. X Ft.”Outside Dimension V Ft. x ^ O Ft." ■ISq. Ft. Setback to Lotline ■Sq. Ft. Setback to Lotline Setback to Right of Way Setback to Ordinary High W^klevel Elevation Above Ordinary^High Water Level Setback to Septic Tank/ Setback to Drainfield^ Setback to Bluf(/______ Maximum Pedposed Height ( ) Boathouse ( ) Gazebo **ProJect/Lotlines/Right-of-ways Must be Staked Onsite Prior to Application / Inspection -r Ft.&Ft.**Ft.&Ft." Setback to Right of Way Setback to Ordinary High Water Level Elevation Above Ordinary High Water Level “'ZO Ft. Setback to Septic Tank___ Setback to Drainfield Ft. Setback to Bluff Total Bedrooms Maximum Proposed Height Roof Change ( ) Yes ( ^ No Basement ( ) Yes (-y.) No Walkout Basement ( ) Yes (side proliie required) ( ) No Ft **kio Ft.Ft.** Ft. Ft.Ft.Ft. ^Tank /Ft.Fb0 H Ft..Ft.Ft. Ft./Z Ft.Ft. ■t.Ft. ( ) Screen Porch ( ) Storage Structure i Topographical Alteration / Earthmoving [4 20 Cubic Yards * Must include on scale drawing, additional Permit may be required.□ 21 Cubic Yards - 999 Cubic Yards*□ 1,000 Cubic Yards or More*□ None or Less * Y? WirL£.Bluff ( ) Yes ( Z) NoCHARACTERISTICS OF LOT:Lot Area. Sq. Ft.Water Frontage Ft. .% .% 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. 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. Date: .eignature of Property Owner / figent for Owner \t4 g-1 •t--------------r (Date: LaM &. f^source Management Official — .)j-rrT Jjo iPERMIT FEE $RECEIPT NO.PROJECT(S)TOTAL SQ.FT.,■i .5 Comments: I "■ ,.i Form No. BK —04-2016 360,647 * Victor Lundeen Co.. Printers • Fergus Fails. Minnesota SITE PERMIT INSPECTION RESULTS Inspector must make all measurements and computations Structure Set Back from Ordinary High Water Level Ft.Ft. Structure Set Back from Top of Bluff Ft.Ft. fStructure Set Back from Road Right of Way Ft.Ft. Structure Set Back from Lot Lines Ft.Ft.Ft. & JO^Structure Height Ft.Ft. /6^Structure Set Back from Septic Tank Ft. Ft. Structure Set Back from Drainfield Ft.Ft. 1’'Elevation Of Lowest Floor Above Ordinary High Water Level Ft.Ft. Land Slope at Building Site % % Inspector’s Comments / Sketch: lo)- c f\o {^U I L < Inspector’s Signature )v-/7 Date of Inspection O'.to Time of Inspection MiC Date / Initial /Project Approved 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) OTTER TRII MiCOUnTY-ailAIIOTII 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 Sfa/-5It - 3m V/gp /3S SC? ^00 0^doS?d60 sc0000 9oo Sy00/ PARCEL NUMBER (S)PROPERTY (E-911) ADDRESS SoS7o AooP LEGAL DESCRIPTION DEVELOPED. First Initial Mailing Address ^ ' UNDEVELOPED Last Name Daytime Phone No. De, n't, JoC SJJ< Property Owner 21 i Contractor Name Lie.# PROPOSED PROJECT (please circle the appropriate number) (1) New Dwelling ONSITE WATER SUPPLY ONSlJE' ! jSa -a I / V n I.I- / 11,1 (✓H&R Cert, of Compliance within 5 yrs.(K^ndividual ( ) Public ( ) None compliance Inspection Report within 3 yrs. (Attached) ( ) OTWMD ‘Must have Sewage System Approval from OTWMD prior to issuing Site Permit. Contact Rollie Mann at 218-864-5533 SEWAGE TREATMENT SYSTEM(^Replacement Dwelling* ^ Detached Garage (9) W.O.A.S. (2 ) Add'n to Dwelling/Attached Garage ( 5) RCU/Year ( 7 ) Add'n To Non-Dwelling (8) Storage Structure (10 ) Non-Conf. Replacement (identify)"____________________ (11) Other (identify)____________________________________ (12 ) Deck___________________________________________ (13 ) Fence__________________________________________ NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3’ (minimum) structure setback to a well. (■^New Septic Permit Issued z' Permit ft gC3 o ■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 DWEJJJNG (Must Include Attached Garage) Outside Dimension H Ft. x /I. Sq Ft If lO^ iT A* Setback to Lotline ^0 'f' Ft. & O Or Ft." Setback to Right of Way O Ft." Setback to Ordinary High Water Level L/ UO Ft. Elevation Above Ordinary High Water Level Ft. Setback to Septic Tank / O Ft. Setback to Drainfieid Ft. Setback to Bluff Ft. Total Bedrooms J Maximum Proposed Height /2a Ft. Roof Change ( ) Yes ( ) No Basement ( ) Yes () No Walkout Basement ( ) Yes (side profile required) ( ) No CHARACTERISTICS OF PROPOSED NON-DWELLING Outside Dimension Outside DimensionFt. X Ft."Ft.**Ft. X Ft.** Sq. Ft. \ Setback to Lo)li()e ___ Setback to Right oKWay Setback to Ordinary High Water LeM^__ Elevation Above Ordinary r^h^ter Level Setback to Septic Tank / Setback to PrainfieldM Setback to Bluff / Maximum PM^sed Height Roof Chjrfige ( ) Yes ( ) No Bathtrom Proposed ( ) Yes ( ) No Sq. Ft.____X Setback to Lotlin Setback to Right of m Setback to Ordinary HiolWater Level Elevation Above Ordihary Hi^Water Level Setback to Septunank Setback to D^nfield____ Setback t^luff________ Maximiyn Proposed Height { ) wathouse ( )^azebo **Project/Lotlines/Rjght-of-ways Must be Staked Onsite Prior to Application / Inspection Ft.&Ft."1.&Ft.** Ft.** Ft.Ft. Ft.Ft. Ft.Ft. Ff> Ft.Ft. Ft. ( ) Screen Porch ( ) Storage Structure Topographical Alteration / Earthmoving □ None * Must Include on scale drawing, additional Permit may be required.X 20 Cubic Yards or Less *□ 21 Cubic Yards - 999 Cubic Yards*□ 1,000 Cubic Yards or More* Bluff ( )Yes ( i/fioCHARACTERISTICS OF LOT:Lot Area, Sq. Ft.Water Frontage Ft. XS TB.%.% 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 personae 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 thayit is my responsibility to inform the Land & l^source Management office once the building footings have been constructed. Date: h/PV/f ^ ' / y^ignature Property Owner / Agent for Owner PERMIT FEE $\ * i ^Date: I±sidh m DSd?PROJECT(S) TOTAL SQ.FT.RECEIPT NO hn/^bilTdA. h9>)r/^ /rJ/fhSh Date StampComments:HEOfMED NOV SFWounoe \AJiTh 7-7</ h>JD fo J'/? IrUh J mH fi ^LiGt*iU lalc&l IV /hcrifr - ScfS l£i1SfL Fil££Im t^ « ? f I' / Vi h- L&R Initial iwti_ 360,647 • Victor Lundeen Co., Printers * Fergus Falls, MinnesotaForm No. BK — 04-2016 .'Nw WHITE - Office (^tL GOLDENROD - Inspector ■ Owner (after issue)(% ■M'l'/ 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 OTTER TflllCOUATT-HinniJOTII 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 O / L / ' /• ,'jL. M'/r'c 767I PARCEL NUMBER (S) ^ q S?d60 •56odoc> 9oo ^7/ PROPERTY (E-911) ADDRESS \ r LE8M. DESCRIPTION DEVELOPED Last Name First Initial Mailing Address FaWA' . -JdMa/ 7n UNDEVELOPED Daytime Phone No. Dk.jr\Ti />1A/ TProperty Owner < 7£-^-^^74A >\Contractor Name Lie.#TTt PROPOSED PROJECT (please circle the appropriate number) , ' ^SITE WATER SUPPLY (1 ) New Dwelling , ( 2 ) Add’n to Dwelling/Attached Garage 0 Replacement ^welling* i^nmAua\ I ) Public ( ) None MH/YR ^ ^ (SlRCUA-ear_______ ( 6 ) Detached Gara^ ( 7) Add’n To Non-Dwelling (8 ) Storage Structure (9)W.0.A.S. NOTE: MN Rules Chpt. 4725 (MN Well (10 ) Non-Conf. Replacement (identify)"------------------------------------------------------------------ Code) requires a 3' (minimum) structure (11) Other (identify)___________________________ setback to a well. (12) Deck______________________________ (13) Fence_____________________________ ONSIJFSEWAGE TREATMENT SYSTEM { p 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 Rollie Mann at 218-864-5533 (Vi,New Septic Permit Issued .. ^ f Permit It ^ ‘Removal of Existing Dwelling Verified by L&R "Existing Non-Conf. Structure Verified by LSR Inspector's Initial/Dale Inspectors InWal/Date I CHARACTERISTICS OF PROPOSED W.O.A.S. (WATER ORIENTED ACCESSORY STRUCTURE) Outside -Dimensiftn CHARACTERISTICS OF PROPOSED DWELLING (Must Include Attached Garage) Outside Dimension ' FL x Sq. Ft. 11 I / J V ) Setback to Lolline 0 ^ Ft. & Setback to Right of Way ^ Ft." . , Setback to Ordinary High Water Level Ft. Elevation Above Ordinary High Water Level Ft. Setback to Septic Tank Setback to Drainfield Ft. Setback to Bluff / tFt. Total Bedrooms ^ Maximum Proposed Height Roof Change ( ) Yes ( ) No Basement ( ) Yes (v' ) No CHARACTERISTICS OF PROPOSED NON-DWELLING Outside Dimension62 Ft. XFt."Ft. X___t L ft."ISq. Ft. \ Setback to Setback to Right ^yVay_______ Setback to Ordinary Hlg(i Water Le Elevation Above Ordinary^tjJffeter Level Setback to Septic Tank Setback to Drainfiel^ Setback to Bluff 6______ Maximum ^posed Height ;i)«tnge ( )Yes ( )No Battjroom Proposed ( ) Yes ( ) No 'VSof \Sq.Ft, Setback to lotlinV. / ^tbacfii) Ijnght-of W&i(^. Setback to Ordinary Hjgh Elevation Above OijJihary Hi^Water Level / Setback to Septie^Tank__ Setback to D/alnfield____ Setback tj>4luff - . Matfimurii Proposed Height ■1 / - . ' ( ) Boathouse ( T Gazebo - **Project/Lotlines/Right-of-ways Must be Staked Onsite ^rior to ApplicaMpn / Inspection : i ’ * ■I I □ ],Q0p Cubic Yards or More* ! ! i'f Cr '-iFt."Ft."' !Ft.&e 6 T&Ft." Ft."7^Ft. fater Level Ft. /' 0 Ft.Ft. 'Ft. /Ft.\ Ft.13.I Ft> Ft.:n Ft Ft. Ft.4Roof C ( ) Screen Porch ( ) Storage Structure I '73 Walkout Basement ( ) Yes (side profile required) ( ) No Topographical Alteration / Earthmoving □ None (3 20 Cubic Yards or Less * □ 21 Cubic Yards - 999 Cubic Yards* * Must include on scale drawing, additional Permit may be required.■I .1 fPl 7-' Bluff ( )Yes ( a4 NoCHARACTERISTICS OF LOT:Sq. Ft.Lot Area.Water Frontage Ft.7t j.TT 1!r % ‘1.% ' :iBuilding Surface Ratio Impemous Surface Ratio i THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES. Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed vybrk 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 plan's and specifications submitted herewith shall become a part of this permit application. I also understand that this permit is valid for a period of sb< (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. /I!/Date: Signature «r Property Owner / Agent for Owner "io Land & hesdurce Mamgement Official JDate:jl.Jl' /±\ PERMIT FEE $\I : {OJ-1 RECEIPT NOPROJECT(S) TOTAL SQ. FT.,i 77),7 tn/dhi Jp - h7)v^-P fh ]ydj/'} h ho/f Comments:Ai h FiA h k's la____________ ■1 \ TTfti. m/V <//rTH.'X1 It^AFr-fL JV (\DA /V iir~ ('r^_____ ! teaForm No. BK —04-2016 360,647 • Victor Lundeen Co.. Printers • Fergus Falls. Minnesota SITE PERMIT INSPECTION RESULTS Inspector must 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 Ft.Ft. Structure 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.3^Elevation Of Lowest Floor Above Ordinary High Water Level If:Ft.Ft. Land Slope at Building Site % % y\- fJAC/ ______ Inspector’s Comments / Sketch: Inspector’s Signature Date of Inspection Time of Inspection Project Approved. Date / Initial / M ictory Home ^ V BASales Inc. EST. 1975 218/863-6639 1-800/232-5270 Fax 218/863-6640 42807 County Hwy. 9 Pelican Rapids, MN 56572 Installer #649675 Contractor #649691 November 16, 2016 To whom it may concern: Wayne Olson rents lot #6 at Franks Lodge and is requesting a permit for placement of a new home from Otter Tail County. The new unit chosen by the customer is 180 square feet larger than the previous one. Wayne and his wife chose this home for basically 2 reasons; 1. The price. This is a factory select home built to HUD code same as others but has a lower introductory price. who is handicap. Wayne stated that his dad loves to come to the lake and he wanted to make it more enjoyable then before. With minimal changes such as a high rise stool and some grab bars this home with its open floor plan would work the best and was still in there price range. 2. His father, I have checked both at county and state levels and there are no regulations found for handicap in single family dwelling homes. But we would like to help everyone concerned. I have talked about handicap homes with several different folks to try and help Mr. Olson: Randy Vogt, D.O.L.I. Head of Manufactured Structures, Karen Gridley, D.O.L.I. Accessibility Specialist, John Beal, Friendship Homes. I hope that this short note helps in your decision for customer Wayne & Sharon Olson and resort owner John Frank of Frank’s Lodge. f[ (TCS SThank you. Sincerely, oi-p3t-Stephen S Berry PS. Enclosed is the floor plan of proposed new home.7754-t DV Vi I 187500ES err DIWNS AREA tnunr awD ^WTY «BEDRCX3U 29'-4'xl0'-9*LMWa RtXXI JW/H FURNBEDROOU 1ll'-8'jcl4'-4'£3'-I0'xI4'-4*BEDROOM 3 8'-10'xl4'-4' 2BATH 1 fWJKnCHEN C-. -Ila aiffl I ©OPTMNl 72'-D' VICTORY HOUE SALES, INC. 42807 County Hwy 9 Pelican Rapids, MN 56572 Office; (218) 863-6639 Toll Free; 1-800-232-5270 Fax; (218) 863-6640 received NOV ( 8 2016 WND&RESOURCE MODEL 7616 3B SBA CK UTL •CJI* 3A6'-r-«*J 3/1^6 •JMO WlMtM. OUUDC cr nopfBw IOCS or kom. Bum BiBax187500ESPC, aPTura Ama srsna mill S ffi»si tea iiai liMl 111 ii ;■•-■. •••^ ,’ mm MS>i. m '13 u^MiiFRANK’S LODGE STAR lAKE TWP S6-000-09 0057-000 itj a IIsd 11 illm o*>m«l lif i'lM SS^3 lllfi I '■■V •^1MM5. /■ : It.I f .llit m \ py\Y AREA Ltete1 iilK,i '■: .1 '., ’ /• - . " iT' pf PO",: ti; • f B2 !.. *...Ai mis 11 p?iisisrsv? ,‘i'li ; ii ,?■ ..: a: : 3Qi >>■■■ Mm.i ,tsi BllJ ; teMtei iiikiiiii ; • Tax Parcel Number(s) • The scale drawing must be a signed drawing which includes and identifies a graphic scale (feet), all existing and/or proposed structures, septic tanks, drainfields, lotlines, road right-of-ways, easements, OHWLs, wells, wetlands and topographic features (i.e. bluffs). Must also complete the Impervious Surface Calculation (see back). L " .I r ¥Scale 5^/0- Ip -Jt- [ /Z Y fi.1•I t. i- {yyjif ^.>■ J5/ 5 ¥ _ ..[JTTPmIh^....~'i—r fb--T% ^ !r ^^—--4 ^2 £¥- n ^ «— r fay, r<Tr '-tf- ,T y,'%- t f ax5'!p’; ic' ?: 9 ; L>:y *xf9pl i A-; I!i ; {] yd -ii ^« X jt l» PI" -Vi ,i i li '«i , .i L -> j. j__________ \y/€^^ i.4ri^ P‘0'9 v’w, ut,«^D OTTER TAIL COUNTY LAND & RESOURCE MANAGEMENT PUBLIC WORKS DIVISION V'‘'/WW.CO OTTER-TAIL MN.USqiTfRTfl|i GOVERNMENT SERWES CENTER 540 WEST FIR AVENUE FERGUS FALLS, MN 56537 218-998-8095 FAX; 218-998-8112 10/17/2016 Frank's Lodge & Campground Lie 30570 Lodge Loop DentMN 56528 9227 RE:Primary Owner; Frank's Lodge & Campground Lie Sewage Treatment System Servieing Tax Pareel Number: 56000090057000 Deseribed as:See 09 Twp Star Lake Township Seet-09 Twp-135 Range-041 9.89 AC N1/2 NW1/4, LOTS 4 & 5 EX STAR Lake: 56-385 Star As of 10/14/2016 the sewage treatment system (Sewage Treatment Installation Permit # 23828 servieing your property was determined to be in eomplianee with the provisions of the Sanitation Code of Otter Tail County for a 2450 gallons per day. Please be advised that this eertifieation is only valid for five years from the date of this inspeetion 10/14/2021 If you have any questions regarding this matter, please eontaet our offiee. Sineerely, Alexander Kvidt Inspector ^ Wi »l'ii VIU.U Bill Kalar Anthony Georgeson Thursday, October 13, 2016 9:57 AM Bill Kalar Franks MHP From: Sent: To: Subject: Otter Tail public health does not have a certified ADA compliance officer. The Fergus Falls building inspector may have a contact for an officer or be able to assist. Tony Sent from my iPhone 1 Bill Kalar Anthony Georgeson Wednesday, October 12, 2016 4;08 PM Bill Kalar franks lodg From: Sent: To: Subject: I left you a voice mail about Franks Campground. If they are just expanding a site for a larger trailer and not adding or reconfiguring the park, then no plans are needed to be submitted to health. Partncr>hip4H«anh Tony Georgeson, M.S. Otter Tail County Public Health Environmental Health Services 560 West Fir Avenue Fergus Falls, MN 56537 218-998-8342 1 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) OTTER TAIIcovaTT-aiaaiioTi Permit No.APPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED. TWPNO.RANGE TWP NAMELAKE7RIVER CLASS SECTIONLAKE / RIVER NO.LAKE/RIVER NAME WL S~|k, r /-A13SSi±iL^O’ D PARCEL NUMBER (S) SG000t>PROPERTY (E-911) ADDRESS 3c>S7o Loc/^^ LdoP OQoo 9co 57Obi LoJja ■* Ca.n\ Sh rsoot^ot 5 7 CO / XLEGAL DESCRIPTION 5(odooo 57^00 DEVELOPED. UNDEVELOPED, Daytime Phone No.Mailing AddressFirstInitialLast Name 3o37d Aod^e, Loopf^tiSunProperty Owner mf Og--v> / ^ A>~> >1 frAjuklf^Lw/j^g. 4. (?/iwtp^ »oavi/j $6. If_________________ Contractor Name Lie.# 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 ^^<f1ndividual ( ) Public ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3' (minimum) structure setback to a well. ONSITE SEWAGE .—TREATMENT SYSTEM-^^'' +'IC ( ) L&R Cert, of Compliance within 5 yrs. (X) Compliance Inspection Report within 3 yrs. ^ (Attached) { ) OTWMD 'Musi have Sewage System Approval from OTWMD prior lo issuing Site Permit. Contact Rollie Mann at 218-864-5533 (1 ) New Dwelling ( 4 ) MH/YR_____(5) RCU/Year_____ (7 ) Add’n To Non-Dwelling ( 8) Storage Structure (10 ) Non-Conf. Replacement (identity)''_______ (11) Other (identify)______________________ (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 Initial/Date CHARACTERISTICS OF PROPOSED W.O.A.S. [WATER ORIENTED ACCESSORY STRUCTURE.RACTERISTICS OF PROPOSED NON-DWELLIICHARACTERISTICS OF PROPOSED DWELLII (Must Include Attached Garage) Outside Dimension ZP Ft. x Sq. Ft. 'V'^^ ’■ . Setback to Lotline ^0 Ft. & Setback to Right of Way ^ Ft.** v oK- Setback to Ordinary High Water Level Elevation Above Ordinary High Water Level AO Setback to Septic Tank /Q Setback to Drainfield Setback to Bluff Total Bedrooms ^ OutsI Outsihe Dimens'Ft."DifnensiNi Sq. Ft. * \ Setback to LotlineN, Setback to Right of W^ /Setback to Ordinary High Wajfc^evel __ Elevation Above Ordinaryfligh WaraK^^evel Setback to Septic Tac Setback to Drainp^d Setback to Bluff___ Ft. x Ft.**Ft. X Sq. Ft. \ Setback to Lotting Setback to Right of Setback to Ordinary High Ytejef Level __ Elevation Above Ordinar^igK^ater Level Setback to Septic Tai«__ Setback to Drainffeld____ Setback to Btdff________ MaximupfProposed Height V ( iZoathodse \ Y) Gazebo **Project/Lotlines/Right-of-ways Must be Staked Onsite Prior to Application / Inspection Ft.&Ft."Ft."Ft.& Ft. Ft.**Ft.” Ft. Ft. V Ft. _Ft. v/ Ft. 7 Ft. Ft.Ft. Ft.Ft.Ft? Ft.Ft. Maximum Proposed Height Roof Change ( ) Yes No ^ Basement ( )Yes (X)^lo Walkout Basement ( ) Yes (side profile required) ) No Ft.Maximuni/Proposed Height_______ Roof^ange ( ) 'I'es ( ) No Bafnroom Proposed ( ) Yes ( ) No Ft. yv/ ( ) Screen Porch ( ) Storage Structure * Must include on scale drawing, additional Permit may be required. Topographical Alteration / Earthmoving□ None'^ ^20 Cubic Yards □ 1,000 Cubic Yards or More*□ 21 Cubic Yards - 999 Cubic Yards*or Less * CHARACTERISTICS OF LOT: Lot Area 7/^Bluff ( )Yes (X,)NoFt.Water FrontageSq. Ft. < S.5%.%.% 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. 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 Lan^^es^rce Movement office once the building footings have been constructed. Date: ^.S^nature of Property Owner/Agent for Owner Date: Land & Resource Management Official RECEIPTflS^ V■K^QOPERMIT FEE $PROJECTfS) TOTAL SQ. FT.. ^5~(^SeA dgj _________ ZZ 7 ' y( 30 ' y Form No. BK — 04-2014 Date StampComments: RECEIVED SEP 1 I 2015 land & RESOURCE . 354.252 • Vidor Lundeen Co.. Printers • FergusFalls. Minnesota \yv L&R InitiallAirsps] l^lsor WKi ; (ycAPPLICATION 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) \ OTTER TflllCONIITT-ailllKOTi lK>l\ofl%Permit No. TWP NO/ APPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED. !TWPNAMERANGELAKE/RIVER CLASS SECTIONLAKE / RIVER NO.LAKE7RIVER NAME[■ y/1 /ssG-DIPARCEL NUMBER (S) S(o000t> ‘^C0-^7£>00 PROPERTY (E-911) ADDRESSI ______3^syo Lod^^ LcoP ^ r^y\k's LoJ^Q. '* Ca.ny S if 0 001)^00 5 7 Co f XS^cooo foo oopo '/oo 5700! 1LEGAL DESCRIPTION DEVELOPED. UNDEVELOPED Daytime Phone No.Initial Mailing AddressFirstLast Name 3o^ 7d Aod^c f. m/1. 56,S2J? F'riur) k'Property Owner m ij D« >T J's kf: -> Ca Vf S?,l F_____________ tCPti Contractor Name Lie.# J 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)______________________ (12 ) Deck______________________________ (13) Fence_____________________________ ONSITE SEWAGE TREATMENT SYSTEM ( ) L&R Cert, of Compliance within 5 yrs. i/J Compliance Inspection Report within 3 yrs. (Attached) ( ) OTWMD ‘Must have Sewage System Approval from OTWMD prior to issuing Site Permit. Contact Rotlie Mann at 218-864-5533 ONSITE WATER SUPPLY '^<(lndividual ( ) Public ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3’ (minimum) structure setback to a well. (2 ) Add’n to Dwelling/Attached GarageJLTJ Replacement Dwelling* (5) RCUA-ear ( 6 ) Detached Garage (9) W.O.A.S. to ( ) Undeveloped Lot ••Existing Non-Conf. Structure Verified by L&R•Removal of Existing Dwelling Verified by L&R Inspector's Initial/DateInspector's Initial/Date \ CHARACTERISTICS OF PROPOSED W.O.A.S. / N(WATER ORIENTED ACCESSORY STRUCTURE) Outside Dimensioi^ Sq. Ft.___ Setback to LotlineX 'Characteristics of proposed NON-DWELUnd OutsMe CHARACTERISTICS OF PROPOSED DWELLING (Must Include Attached Garage) ^ v/ Outside Dimension Ft. x Ft Sq. Ft. m Setback to Lotline Ft. & Ft.” Setback to Right of Way ^ ^ Ft.** ^tback to Ordinary High Water Level Elevation Above Ordinary High Water Level Setback to Septic Tank /0 Ft. Setback to Drainfield Ft. 7 Setback to Bluff Ft. v/" Total Bedrooms Maximum Proposed Height Roof Change ( ) Yes No Basement ( ) Yes (X ) No Walkout Basement ( ) Yes (side profile required) ) No / Ft.**Ft. XDjnenpj6q^_Ft.**Ft. XL/ \ Setback to Lotline\^ Setback to Right of Ft.**Ft. " , \ X Pj ^ /Setback to Ordinary High Wafet^Level __ Elevation Above OrdinaryHigh WafftiLUvel Setback to Septic Tanlt^__ Setback to Drainftild____ Setback to Bluff________ Maximuirv'f^roposed Height Roo^hange ( ) Yes ( ) No ^throom Proposed ( ) Yes ( ) No Ft.”Ft.&Ft.**Ft.& Setback to Right of Wav Setback to Ordinary HigtiWaldr Level y Ft.** Ft.Ft.1Ft. Elevation Above OrdinatylHi^Water Level Setback to Septic T^lt Setback to Draipfteld _ Setback to ptiiff________ Maximum Proposed Height ( ) boathouse , (■ ) Gazebo **Project/Lotlines/Right-of-ways Must be Staked Onsite Prior to Application / Inspection Ft. Ft.Ft. Ft.Ft> ^'^Ft.Ft.iFt. Ft. jFt. y y ( ) Screen Porch ( ) Storage Structure i * Must include on scale drawing, additional Permit may be required. Topographical Alteration / Earthmoving □ None ^20 Cubic Yards or Less *□ 21 Cubic Yards - 999 Cubic Yards*□ 1,000 Cubic Yards or More*-1 Lot Area S 7 ^Bluff ( ) Yes (X ) NoCHARACTERISTICS OF LOT:Ft.Water FrontageSq. Ft. <.%.% Impereious Surface RatioBuilding Surface Ratio TH/S 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, empioyees and workmen shall conform in all respects to the Ordinances of Otter Tail County, Minnesota. I 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. ‘y / ■?//pDate: ^gnature of Property Owner/Agent for Owner^ I Date: ILand & Resource Management Official RECEIPT NO.PERMIT FEE $PROJECT(S) TOTAL SQ.FT., 4T 3“ (See, J tnCu> ___________ ! n i~o /(i L 1. '' Comments: SCANHED '.j Form No. BK — 04-2014 354.252 • Victor Lundeen Co.. Printers • Fergus Falls, Minnesota SITE PERMIT INSPECTION RESULTS i i Inspector must make all measurements and computations 1161 Ft.Structure Set Back from Ordinary High Water Level Ft. Ft.Structure Set Back from Top of Bluff Ft. ^6^Ft.Ft.Structure Set Back from Road Right of Way Ft. & Ft.Ft.&Ft.Structure Set Back from Lot Lines Ft.Ft.Structure Height }0^Ft.Ft.Structure Set Back from Septic Tank Ft.Ft.Structure Set Back from Drainfield Elevation Of Lowest Floor Above Ordinary High Water Level____________________Ft.Ft. Land Slope at Building Site %% Inspector’s Comments / Sketch: I \ 05 ■ ^ At Inspector's Signature lO^WlC' Date of Inspection I Time of inspection A Date / Initiai ’ ro]ect Approved n 'Sr.&o^^.C 'jS. A^O/^TW Z/'-V/S: 0/-=- £C y' \ \ S "V, N % r ~i» f .•H’'•X 1i!■**- J —r--n1=1 nij!\!\ J^ Czil .•'* V a Iu'■1 I\1i*'-xv'\/y _/1G0"r *=■—-t- f :■^v-rx.,. - \\<■ u U L^ A -,V '*■■ /^v. A5:Z CO I \&rn <>.S S m H □ V-.#’-r» i riAuf^vj^ ir-' oc V3^^73 <_nO/m C>"It iI V,tS< ^ Edw»Ifs. r*-! M t I hrom: usiuna, Natalie (MUH/ <natalie.osiunaio>s[ate rnn us> Subject: RE: Plan Review Date: Tuesday. 09/01/2015 06:29 Hi Kdttiy, I just wanted to tell you I iiave approved your pfan for remodel of cabin #5. When John submitted the application he submitted for remodeling 5-9 cabins, which I assume is because you have that many. Since you are only remodeling one you need to just submit for less than 5 which is $250 and not $350.1 have talked to the person who enters in our applications and she submitted a refund request yesterday to oui finance division for the exUd $J00. She stated it usually takes 3-4 weeks to process a refund, hut i just wanted to let you know. There Luiinttg Lo you soon! rShow: te)d html hJcvCcdCe^Oilundi H.S.Mail Contacts Webmail•N RECEIVED SEP 1 12015 LAND & RESOURCE i V w/ jj1£Di-i:- 9/11/7,0 IShttn //wehmail arvip net/siirpeweh PIye ^ APh t^Plh f/w : ^ 1* n3L'>jl-^t " I W~~1“r^j--~:“T'^iT w7 >fc 'hI i S ^i?V/#-iK I ' ^r'!W jt?i.■JO '10 ' 6 i A >C;I1 B6it ''N 1 *i6VI LUI'Ji)rJVt5 of ' ♦*^ '6^ .-tu LO or•4 Q:.;-J rjUJSfCNJio\■\>IZ^03NENOIsf-'- - l^'^ 0 oLU" 1-1o; & 2CO “ ccA-)l^)1^ /ii 2i3:J 5f H-L 1•<;h-I 0 >/3.-3^1/p rP-''iV/*A Dr1 ■I!) ;)£t ' f )!J 1 !)i 1)i )i I i i I ) ) ) ;)i ) )H0I4i^ )H iltP±A 1I1w . - 1 / Die!)) c r I i I i DUPLICATE I Site Permit iI I Twp. IIS' Range Twp. Name SSMM. i^i£ -• ■________________________________________________________________________________________________________ Sec.Location: Lake No.! W fMfM-LakeOwner’s Name; Work Authorized:eli.^ flrr; NOTE: 1. This card must be place in a conspicuous place not more than p feet above grade on the premises on which work is to be done, and must be maintained there until completion Of such work. 2. Notify Land and resource Management when building footings have been completed. (218) 998-8095 3. Property owner is legally responsible for all surface water drainage which may occur. i , i i ;i t Expires;I - -Land and Resource Management Official BK-0203-02 313,010 * Victor Lundeert Co,. Primers * Fergus Falls, MN < 1-800-346-4870 i OTTER TAIL COUNTY DUPLICATE Q5*ilf - fi^ R 4-c Twp. Range ^ Twp. Name StHfi. IME PiAiilCs f ________ Site Permit 5L-S^D. Sec.Location: Lake No Owner’s Name Lake Work Authorized: a, 4-3fii^ fh(L )_______________ NOTE: 1. This card must be place in a conspicuous place not more than 6 feet above grade on the premises on which work is to be done, and must be rriaintained there until completion of such work. 2. Notify Land and resource Management when building footings have been completed. (218) 998-8095 3. Property owner is legally responsible for all surface water drainage which may occur. V///3pate:Expires: and Resource Management Official BK-0203-02 313.010 • Victor Lundeen Co., Printers • Fergus Fails. MN • 1-800-346-4870 ; M^/re - QfTice GOLDENROD - Inspector YELLOW - Owner (after issue) PINK - Assessor APPLICATION FOR SITE PERMIT LAND & RESOURCE MANAGEMENT, COUNTY OF OTTER TAIL GOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS FALLS, MN 56537 218-998-8095 www.co.otter-tail.mn.us Permit No. JfAPPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED. SECTION TWP NO.RANGE TWP NAMELAKE / RIVER NO.LAKE/RIVER NAME LAKE/RIVER CLASS HIGDIAS PROPERTY (E-911) ADDRESSPARCEL NUMBER (S) ; 5^ Q 4- slpOi>o 30 SIQ Log f LEGAL DESCRIPTION Loo<^B ^ Daytime Phone No.Mailing AddressLast Name First Initial FkAt^\L 3^ ^1/0 LoOc^r: Lji/if OElrJ ) J />\tJ S L>^3. Property Owner sSo\-ij rr) Contractor Name Lie.# PROPOSED PROJECT (please circle the appropriate number) (I) New Dwelling ■ ( 4) MH/YR (7) Add’n To Non-Dwelling (10) Non-Cont. Replacement (identity) _ (II) Other (identify)____________ (12 ) Deck___________________ •Existing Dwelling to be removed prior to ONSITE SEWAGE TREATMENT SYSTEM (i^f^ermit No. / le> ^S'l ( ) OTWMD ’Must.have Sewage System Approval from OTWMD prior to issuirtg Site Permit. Contact Rollie Mann at 218-864-5533 ONSITE WATER SUPPLY ( ) Individual ( ) Public ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3’ (minimum) structure setback to a well. ^^jReplacement Dwelling (6) Attached / Detached Garage (9) W.O.A.S. (2) Add’n to Dwelling ( 5) RCU/Year_____ ( 8) Storage Structure CHARACTERISTICS OF PROPOSED W.0.A.& WATER ORIENTED ACCESSORY STRUCT^E)CHARACTERISTICS OF PROPOSED NON-DWELJJNG Ouli^de DimMsion CHARACTERISTICS OF PROPOSED DWELLING (Must Include Attached Garage) Outside Dimension ^ Sq.Ft._J|.____ Setback to Lotline_______________ Setback to Right of Way Ft.**Setback to Ordinary High Water Level “"iS Ft. Elevation Above Ordinary High Water Level ^ Setback to Septic Tank Ft. Setback to Drainfield Ft. Setback to Bluff Ft. Total Bedrooms Maximum Proposed Height ^*1 Roof Change ( ) Yes ( ) No Basement (\//f^s ( ) No Walkout Basement (#»^es (side profile required) ( ) No OutsideDimen^Ft. X ^Ft. X Ft.**Ft.**Ft.**XFt. X Sq. Ft. \_____ Setback to^tline ___ Setback to Rm of Way Setback to Ordin^ High Water La^l __ Elevation Above Or^ary High^ter Level Setback to Septic Tank\ Setback to Drainfield ^ Setback to Bluff / Maximum Propospfl Height Roof Change / ) Yes ( ) No \ Bathrpom^posed ( ) Yes ( ) n1 Sq. Ft. \ Setback to Loffine ___ Setback to Right OWay Setback to Ordinary N(qh Wate^evel __ Elevation Above Ordinar^^Hidn Water Level Setback to Septic Tank Setback to Drainfiel^ Setback to Bluff / Ft. & SiO Ft.**Ft.**Ft.&Ft.&Ft.** Ft.** Ft.Ft.Ft. Ft.Ft. Ft.Ft. Ft.Ft. Ft.Ft.Ft.Ft.Maximum Projjbsed Height ( ) Boa^use ( ) Screen PorctK ( ) Storage Structurl( );ebo **Project/Lotlines/Right-of-ways Must be Staked Onsite\prior to Application / Inspection * Must include on scale drawing, additional Permit may be required. Topographical Alteration / Earthmovino BT*20 Cubic Yards or Less *□ 300 Cubic Yards or More*□ 21 Cubic Yards - 299 Cubic Yards*□ None CHARACTERISTICS OF LOT: _Ft.Bluff ( )Yes (Water FrontageSq. Ft.Lot Area. ~Asr%Impervious Surface Ratio:X100 =% Impervious Surface RatioTotal Impervious Surtace Onsite (FT4 Total Lot Area (FT^) TH/S ;s 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. n/n/n __II jlLjll Date: Sigg^re of Property Owner/Agent for Owner tend & Resource Management Official Date: A//t RECEIPT NO. LPERMIT FEESPROJECT(S) TOTAL SQ. FT.. ^ dyi&ifj * I /<ff. DPALjid<k\ fippLA/.p Yi cA&\^ ft X c:aa\^ Date StampComments:III fi^ii /«DEctcj uAu<3JA'\Pr 7 k /)< NEEDPth mL&R Initial , 345,196 • Victor Lundeen Co., Printers • Fergus Fails. MinnesotaForm No. BK — 07-2011-05 WHITE.Office SITE PERMIT - GOLDENROD - Inspect^ ^ ! O I VEk^^OW- Owne' i * IXMD & RESOURCE MANAGEMENT, COUNTY OF OTTER TAIL PINK - Assessol .dsLoA. . ” =—W»4rKNMLNI ULUVI4^UWER, 540 WEST FIR, FERGUS FALLS, M c li- ovv c3, ) 218-998-8095 ■co.otter-tail.mn.us ermit No. QlUOT DC OOMPLhIhU IN'ORDERTO BE PROCESSED.APPLIC RANGE TWP NAMESECTIONTWP NO.LAKE/RIVER CLASSAKE / RIVER NO.AKE/RIVER NAME STn(^13S‘-i PROPERTY (E-911) ADDRESSPARCEL NUMBER (S) ODD Q^POoo^Di>ti^of>\\ 30^10 LunP LdO<^c f LEGAL DESCRIPTION Daytime Phone No.Mailing AddressInitialFirstLast Name Property Owner 3o S la__l~DOciZ L^f___ __Or,JT rr^y g L. <^*J2?h ^------4JQ- t- Contractor Name Lie.# PROPOSED PROJECT (please circle the appropriate number)ONSITE SEWAGE TREATMENT SYSTEM ONSITE WATER SUPPLY ( ) Individual ( ) Public ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3' (minimum) structure setback to a well. j^iryiReplacement Dwelling (Tf Attached / Detached Garage (9) W.O.A.S. ( 2) Add’n to Dwelling (5) RCU/Year______ (8 ) Storage Structure (1 ) New Dwelling (4) MH/YR (7) Add’n To Non-Dwelling (10 ) Non-Conf. Replacement (identify) (11) Other (identify)_____________ !•Tj <ri(1.4’^ Permit No. ( ) OTWMD 'Must have Sewage System Approval from OTWMD prior to issuing Site f^rmit. Confact Rollie Mann at 218-864-5533 i ,i (12 ) Deck______________________ 'Existing Dwelling to be removed prior to. CHARACTERISTICS OF PROPOSED W.O.A.S. (WATER ORIENTED ACCESSORY STRUCTURE)CHARACTERISTICS OF PROPOSED NON-DWELUNG Outside Dimension ‘ CHARACTERISTICS OF PROPOSED DWELLING (Must Include Attached Garage) Outside Dimension Ft. x Sq. Ft. ______ Setback to Lotline <'n Ft. & ' Ft." Setback to Right of Way ')£) Ft." Setback to Ordinary High Water Level ~~fjh Ft. Elevation Above Ordinary High Water Level _ ? Ft. Setback to Septic Tank Ft. Setback to Drainfield 0/7 ’^Ft. Setback to Bluff k-- Ft. Total Bedrooms Maximum Proposed Height Ft. Roof Change ( ) Yes ( ) No ' Basement (( ) No Walkout Basement ( ^i^es (side profile required) ( ) No Outside Dimension /'Ft." /Ft. XFt."Ft."Ft. X Sq. Ft.. V__ Setback to LmHne ___ Setback to Rights Way Setback to Ordinary 'High WatejJJevel __ Elevation Above Ordinary^ Hjgli Water Level Setback to Septic Tank. Setback to Drainfield/ Setback to Bluff Sq.Ft. \______ Setback to Lotline \ Setback to Right of Way Setback to Ordinary High Water Leym __ Elevation Above Ordigary High W^ter Level / Setback to Septic Tank'S / Ft. Setback to Drainfield ^ Setback to Bluff / Maximum Propos^Height / Roof Change (• ) Yes ( ) No Bathroom PYoposed ( ) Yes ( ) Ft."Ft.&Ft."Ft.& **JFf." Ft.Ft. Ft.Ft. Ft. Ft.Ft. a /Ft.N\/Ft.S^Ft. ( ) Screen Porch ( ) Storage Structu Maximum Proposed Height ( ) Boathduse ( ) Gazebo "Project/Lotlines/Right-of-ways Must be Staked Onsit^-,^Prior to Application / Inspection \ hIb \V * Must include on scale drawing, additional Permit may be required. Topographical Alteration / Earthmovina □ None □ "50 Cubic Yards or Less *□ 21 Cubic Yards - 299 Cubic Yards*□ 300 Cubic Yards or More* CHARACTERISTICS OF LOT: Bluff ( )Yes ( v-frl7Ft.Sq. Ft.Water FrontageLot Area ■•A--Y A’_______ Impervious Surface Ratio u..%Impervious Surface Ratio:XIOOb: Total Lot Area (FT*)Total Impervious Surface Onsite (FT*) THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES. Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set forth and according to the provisions of the Ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express con dition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Ordinances of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said Ordinances. I understand that it is my responsibiiity to inform the Land & Resource Management office once the buiiding footings have been constructed. Date: Signature of Property Oiwier / Agent for Ov^r/ III//1 itDate: Land & Resource Management Official ' PERMIT FEE $ H'-__________PROJECTfS) TOTAL SQ. FT.____^RECEIPT NO. A y rA&u________a AY/TH y ^7-' prr'K jl./AUiUA'\ Comments: IIrl' W3V Form No. BK — 07-2011-05 345,196 • Victor Lundeen Co.. Printars • Fergus Falls. Minnesota SITE PERMIT INSPECTION RESULTS Inspector must make all measurements and computations > 3t> Ft.Ft.Structure Set Back from Ordinary High Water Level Ft.Ft.Structure Set Back from Top of Bluff y-Ft.Ft.Z,CC^Structure Set Back from Road Right of Way Q 07^ Ft. & 7^^Ft.Ft.Ft. &Structure Set Back from Lot Lines I Ft.Ft.Structure Height Ft.Ft.Structure Set Back from Septic Tank r-Ft.Ft. I Structure Set Back from Drainfield Elevation Of Lowest Floor Above Ordinary High Water Level Ft.Ft. Land Slope at Building Site %%0 -4, Inspector’s Comments / Sketch: 9.si [yC'i':^ fa1 6\ptyV^ InspectMs Signature t aMbate of Inspection Time of Inspection i^rojectApproved^ Date/Initial 'UkL WHITE - Office GOLDENROD - Inspector APPLICATION FOR SITE PERMIT LAND & RESOURCE MANAGEMENT, COUNTY OF OTTER TAIL GOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS FALLS, MN 56537 218-998-8095 www.co.otter-tail.mn.us YELLOW - Owner (after issue) PINK - Assessor Permit No.APPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED. SECTION TWP NO.RANGE TWP NAMELAKE/RIVER NAME LAKE/RIVER CLASSLAKE / RIVER NO.I, 13^ PROPERTY (E-911) ADDRESSPARCEL NUMBER (S)^U>£>DOO C£>V <2^ 474) /yo L^OcE La£iP LEGAL DESCRIPTION L^J>CC ^ Daytime Phone No.Mailing AddressLast Name First Initial 30<1D LpOk^ UiaP 31Property Owner 7Y^. Z)£kj_ff\J r Contractor Name Lie.# PROPOSED PROJECT (please circle the appropriate number) (1 ) New Dwelling (4)MHYR (7) Add’n To Non-Dwelling (10) Non-Conf. Replacement (identify) _ (11) Other (identify)______________ (12) Deck_____________________ 'Existing Dwelling to be removed prior to ONSITE SEWAGE TREATMENT SYSTEM (i^)^ermit No. I _________ ( ) OTWMD ’Must have Sewage System Approval Irom OTWMD prior to issuing Site Permit. Contact Rollie Mann at 2I8-8S4-5533 ONSITE WATER SUPPLY ( ) Individuai ( j Pubiic ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3’ (minimum) structure setback to a weil. 'Replacement Dwelling ) Attached / Detached Garage (9)W.0.A.S. (2 ) Add’n to Dwelling ( 5) RCU/Year_____ (8 ) Storage Structure CHARACTERISTICS OF PROPOSED W.O.A.S^ [WATER ORIENTED ACCESSORY STRUCT!^CHARACTERISTICS OF PROPOSED N0N-DWEJ4.ING Ouhijde Dimension CHARACTERISTICS OF PROPOSED DWELLING (Must Include Attached Garage) Outside Dimension Sq. Ft. 'it .. Setback to Lotline Setback to’Right of Way 3JD ^ Ft.*' Setback to Ordinary High Water Level _ Eievation Above Ordinary High Water Level 3 Setback to Septic Tank ID Setback to Drainfield (2n Setback to Bluff f\/]^ Total Bedrooms <3 Maximum Proposed Height ^*4 Roof Change ( ) Yes ( ) No Basement ({''J'^s ( ) No Waikout Basement ( u^J^s (side profile required) ( ) No Outsio^^ Dimensii____Ft.x Ft. X Ft."Ft."Ft. X Ft." Sq. Ft. \ Setback to Loiltqe ____ Setback to Right oN(Vay Setback to Ordinary Hi^t^Water bCvel __ Elevation Above Ordinary Hl^Water Level Setback to Septic Tank / Setback to Drainfield/ Setback to Bluff / Maximum ProfSosed Height Roof Ch/ge ( ) Yes ( ) No Bathurom Proposed ( ) Yes ( ) No T So. Ft. \ Setback to Lotiin^^ Setback to Right of W< Setback to Ordinary High ?toei^vei __ Eievation Above Ordinary HjgfrWater Levei Setback to Septic Tank / Setback to Draintietar Setback to Bluf^/______ Maximum Broposed Height ( ) Bpmhouse (./Gazebo Ft. & Ft." Ft."Ft.&FI.&Ft." T."■t." Ft.Ft.Ft. Ft.Ft.Ft. Ft.Ft.■I Ft.Ft;Ft. Ft.Ft.Ft.Ft.Ft. ( ) Screen Porch ( ) Storage Structure **Proiect/Lotlines/Right-of-ways Must be Staked Onsite Prior to Application / Inspection * Must include on scale drawing, addilionai Permit may be required. Topographical Alteration / Earthmovina ar^O Cubic Yards □ 21 Cubic Yards - 299 Cubic Yards*□ 300 Cubic Yards or More*or Less *□ None CHARACTERISTICS OF LOT: i^L^H_Sq.Ft.Bluff ( ) Yes ( Hllo^.Ft.Water FrontageLot Area. Impervious Surface Ratio:Xioo =.% Impervious Surface RatioTotal Impervious Surface Onsite (FT*)Total Lot Area (FT*) THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES. Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set forth and according to the provisions of the Ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express con dition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Ordinances of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said Ordinances. I understand that it is my responsibiiity to inform the Land & Resource Management office onoe the buiiding footings have been constructed. liJiLjli )LDate; 'Signa0e of Property Owner/Agent for Owner Date: Land & Resource Management OfficialtJ£t RECEIPT NO. _[PERMIT FEE $PROJECT(S) TOTAL SQ. FT.. !/¥ IU'yl SSf 3^* ufiTH R ,3V' x 34» Date StampComments: Pi rlAAiii n 7 ‘ Y OBOl ___________ SdL. IXJ\L1 Re t/^pd Rs R nJD Cujs^ W LAxLt. ----------------------— L&R Initial Form No. BK — 07-2011-05 345,196 • Victor Lundeen Co., Printers • Fergus Falls. Minnesota WHI TE - Ompe GOLDENROD - Inspedlqr - i APPLICATION FOR SITE PERMIT T>LAND & RESOURCE MANAGEMENT, COUNTY OF OTTER TAIL GOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS FALLS, MN 5& YELLOW - Owner (after issue) PINK - Assessor 218-998-8095 www.co.otter-tail.mn.us 10-V-\ Permit No. a\APPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED. TWP NO.RANGE TWP NAMELAKE/RIVER CLASS SECTIONLAKE/RIVER NAMELAKE / RIVER NO. OOD /9/> <7 <?4) / al Hi SIM__I PROPERTY (E-911) ADDRESSPARCEL NUMBER (S) UdDc.f Lmp LEGAL DESCRIPTION Daytime Phone No.Mailing AddressFirstInitialLast Name Property Owner LpCi<r:t ! aaP O^rjT . fr\J__m 1Contractor Name Lie.# '■i 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___________________ 'Existing Dwelling to be removed prior to. ONSITE SEWAGE TREATMENT SYSTEM (i^fermW No. , '. ^'1 ( ) OTWMD 'Must have Sewage System Approval from OTWMD prior to issuing Site Permit. Contact Rotlie Mann at 218-864-5533 ONSITE WATER SUPPLY ( ) Individual ( ) Public ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3' (minimum) structure setback to a well. j<fT^'Replacement Dwelling Attached / Detached Garage (9) W.O.A.S. (2) Add’n to Dwelling ( 5 ) RCU/Year_____ (8 ) Storage Structure CHARACTERISTICS OF PROPOSED W.O.A.S./ s.(WATER ORIENTED ACCESSORY STRUCTURE) Outsid^Dimensir CHARACTERISTICS OF PROPOSED NON-DWELJ.ING Outs.ide Dimension Sq. Ft. Setback to Loflioe___ Setback to Rightot-Way Setback to Ordinary Hi5t(Water J,,#tel __ Elevation Above Ordinary Hlgtr'^ater Level Setback to Septic Tank / Setback to Draintield ✓ Setback to Bluff Maximum Proposed Height RoofChafl^ ( )Yes ( )No Bathrd6m Proposed ( ) Yes ( ) No CHARACTERISTICS OF PROPOSED DWELLING (Must Include Attached Garage) Ft." /Ft. XFt.x FI."Outside Dimension Sq.Ft.^ji------ Setback to Lotline Setback to Right of Way .Tif) Ft." Ft."Ft. X T Sq.Ft.____\ Setback to LotlinX Setback to Right of WSy Setback to Ordinary High Wpter Ldvel __ Ft. V--' Elevation Above Ordinary High'Water Level Setback to Septic Tank / ^vFt. Setback to Drainfi^. Setback to Bluff,^__ Maximum Pjdposed Height ( ) Boathouse ( I^Gazebo *’'Project/Lotlines/Right-of-ways Must be Staked Onsite Prior to Application / Inspection Ft. & <Z? Ft."Ft.&Ft."Ft."Ft.& ■t." A"Setback to Ordinary High Water Level Elevation Above Ordinary High Water Level_3 Setback to Septic Tank | Q Setback to Drainfield J C* Setback to Bluff jS Total Bedrooms Maximum Proposed Height Roof Change ( ) Yes ( ) No Basement ( ( ) No Walkout Basement ( (side profile required) ( ) No Ft.Ft.Ft. Ft.Ft. Ft.Ft. Ft.Ft'Ft. Ft.Ft.Ft.Ft.Ft. ( ) Screen Porch ( ) Storage Structure i; * Must include on scale drawing, additional Permit may be required. Topographical Alteration / Earthmovina □ None □ ■‘20 Cubic Yards or Less *____□ 21 Cubic Yards - 299 Cubic Yards*□ 300 Cubic Yards or More* CHARACTERISTICS OF LOT: U <t~>Bluff ( ) Yes (.Ft.Water FrontageSq. Ft.Lot Area. .%Impervious Surface Ratio:X100 =T Impervious Surface RatioTotal Lot Area (FT»)Total Impervious Surface Onsite (FT') THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES. Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set forth and according to the provisions of the Ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. Permit; Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express con dition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Ordinances of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said Ordinances. I understand that it is my responsibiiity to inform the Land 4 Resource Management office once the buiiding footings have been constructed. / u/ iini V) natqK of Property Owrter/ Agent for Owner Date:-7^ / WllLjW___ PROJECT(S) TOTAL SQ.FT. ^ Date:Land iS Resource Management Official I RECEIPT NO.PERMIT FEE $ . * n- lUyv ^ r.d Comments: ^ n_ As .--^A Form No. BK — 07-2011-05 icjJ- @ LkZjjr^ TP Lqf'jL ::±.v" r litea 345,196 • Victor Lundeon Co.. Printers « Fergus Falls. Minnesota ■V SITE PERMIT INSPECTION RESULTS Inspector must make all measurements and computations _____________Hi-Ft.Ft.Structure Set Back from Ordinary High Water Level Ft.Ft.Structure Set Back from Top of Bluff Ft.Ft.Structure Set Back from Road Right of Way Pocj*' Ft. & Ft.Ft.Ft.&Structure Set Back from Lot Lines Ft.Ft.Structure Height %Ft.Ft.Structure Set Back from Septic Tank 160*'Ft.Ft.Structure Set Back from Drainfield Elevation Of Lowest Fioor Above Ordinary High Water Levei ''/o Ft.Ft. 0-U %Land Slope at Building Site % Inspector’s Comments / Sketch: m Inspectqr’s Signature Data of Inspection \Z0^ Time of Inspection jo'5-/"//^ Date/Initial□ Project Appro\md l! WHITE - Ofice APPLICATION FOR SITE PERMITI; 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 Permit No. www.co.otter-tail.mn.us APPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED. TWP NO.LAKE/RIVER CLASS SECTION RANGE TWP NAMELAKE / RIVER NO.LAKE/RIVER NAME 5k-.311 Z35'5 m.<so■smxi PARCEL NUMBER (S)PROPERTY (E-911) ADDRESS£>£> $1^CD OODt Zo^io L^OGB LEGAL DESCRIPTION fAAK/lL\ U>0<^B X' Daytime Phone No.Last Name First Initial Mailing Address rr\.Li>^P — Property Owner 7<7r^ 74/ Contractor Name Lie.# PROPOSED PROJECT (please circle the appropriate number) (I) New Dwelling (4 ) MH/YR (7 ) Add’n To Non-Dwelling (10 ) Non-Conf. Replacement (identify). (II) Other (identify)______________ (12 ) Deck_____________________ 'Existing Dwelling to be removed prior to ONSITE SEWAGE TREATMENT SYSTEM (i<'1*^ermit No. / _______ ( ) OTWMD 'Must have Sewage System Approval from OTWMD prior to issumg Site Permit. Contact Roilie Mann at 218-864-5533 ONSITE WATER SUPPLY ( ) Individual ( ) Public ( ) None NOTE: MN Rules Chpf. 4725 (MN Well Code) requires a 3' (minimum) structure setback to a well. n 3J/Replacement Dwelling lS) Attached / Detached Garage (9) W.O.A.S. (2 ) Add'n to Dwelling (5) RCU/Year. (8) Storage Structure CHARACTERISTICS OF PROPOSEOW.O.A.S. (WATER ORIENTED ACCESSORY^RUCTURE) Outside Dimension CHARACTERISTICS OF PROPOSED NON-DW^LING Outsjde Dimension CHARACTERISTICS OF PROPOSED DWELLING (Must Include Attached Garage) Outside Dimension Afe Ft. x -So. Ft. ^ Setback to Lotline Setback to Right of Way Ft." Setback to Ordinary High Water Level Hi Elevation Above Ordinary High Water Level 3 Setback to Septic Tank iP Ft. Setback to Drainfield J20 Ft. Setback to Bluff h/A Ft. Total Bedrooms ^ Maximum Proposed Height_____ Roof Change ( ) Yes ( ) No Basement ( )Yes ( Walkout Basement ( ) Yes (side profile required) ( Ft. X Ft>Ft."Ft. X Ft." Sq. Ft. \ Setback to LoHine ___ Setback to RIghm Way Setbaok to Ordinar^igh W^r Level __ Elevation Above Ordinan^igh Water Level Setback to Septic Tan) Setback to Drainfi^. Setback to Bluy 3^Ft. & 5^ Ft."Sq. Ft. \ Setback to Lotltse ___ Setback to Right onUay Setback to Ordinary HiOT(Water Level __ Elevation Above Ordurary FtiJiliWater Level Setback to Septic^nk__ Setback to Dr^ield____ Setback tomft________ Maximu^Proposed Height ( )^athouse ( T Gazebo **Project/Lotlines/Rlght-of-ways Must be Staked Onsite Prior to Application / Inspection Ft."Ft.Ft."•t.& Ft."Ft."Ft. Ft.Ft.Ft. Ft. Ft.Ft. Ft.FD Ft.Ft.Ft.Maximum^oposed Height \ RoofCKange ( )Yes ( )No\ B^oom Proposed ( ) Yes ( ) Ft. ( ) Screen Porch ( ) Storage Structure ' Must include on scale drawing, additional Permit may be required. Topographical Alteration / Earthmovina □ 20 Cubic Yards or Less * ®'^ne □ 21 Cubic Yards - 299 Cubic Yards*□ 300 Cubic Yards or More* CHARACTERISTICS OF LOT: iOl Sq. Ft Bluff ( )Yes.Ft.Water FrontageLot Area./ Impervious Surface Ratio:X100 =_% Impervious Surface RatioTotal Impervious Surface Onsite (FT=)Total Lot Area (FT^) THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES. Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set forth and according to the provisions of the Ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express con dition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Ordinances of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said Ordinances. I understand that it is my responsibility to inform the Land & Resouue Management office once the building footings have been constructed. XDate: Siamture of Property Owner / Agent for Owner Land & Resource Management Official Date: PR0JECT(S) TOTAL SQ.hlfC.RECEIPT NO.PERMIT FEE $ ■f! IL'Ujmf IR ft < Efj OSLtL ZAhXtJ UJ\LL Utic L /^ATHC»C T7f/tW vDAx<r-.\NAL rLAAifJ Date StampComments: ii/il/iI (@> L&R Initial1^1^ Form No. BK — 07-2011-05 345,196 ' .Victor Lundeen Co., Printers • Fergus Falls, Minnesota WHITE - Office APPLICATION FOR SITE PERMIT GOLDENROD - Inspeblrf^ . « YELLOW - Owner Rafter issue) PINK - Assessor 0LAND & 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. ^lO'l 1MUST BE COMPLETED IN ORDER TO BE PROCESSED. I LAKE/RIVER NAME LAKE/RIVER I SECTION TWPNO. RANGE TWP NAME APPLICATION LAKE / RIVER NO.CLASS IfLfL Hi<L -I ■■■I PROPERTY (E-911) ADDRESSPARCEL NUMBER (S)i^4. £>D $1 ^CD PDD(i ^ ^7 43g/3o<lfO i^£>C.E UinP .* LEGAL DESCRIPTION » Daytime Phone No.Initial Mailing AddressFirstLast Name Property Owner ? r>< J n Lr?/\ rZ'fm. DeJi ?5y^.i Contractor Name Lie.# 1PROPOSED 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___________________ 'Existing Dweiling to be removed prior to. ONSITE SEWAGE TREATMENT SYSTEM Permit No. ( ) OTWMD ’Must have Sewage System Approval from OTWMD prior to issuing Site Permit. Contact Rotlie Mann at 218-864-5533 ONSITE WATER SUPPLY ( ) Individual ( ) Public ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3’ (minimum) structure setback to a well. /fs) iReplacement Dwelling Attached / Detached Garage (2 ) Add’n to Dwelling (5 ) RCU/Year_____ (8) Storage Structure (9) W.O.A.S. CHARACTERISTICS OF PROPOSED W.O.A.S. (WATER ORIENTED ACCESSORY STRUCTURE)CHARACTERISTICS OF PROPOSED NON-DWELLING Outside Dimension CHARACTERISTICS OF PROPOSED DWELLING (Must Include Attached Garage) Outside Dimension Sq. Ft._r^r------- ^ Setback to Lotline . YS ~ Ft. & Ft." Setback to Right of Way Ft." Setback to Ordinary High Water Level Elevation Above Ordinary High Water Level 3 Setback to Septic Tank jD ^ Ft. Setback to Drainfield ^ Ft. Setback to Bluff Ft. Total Bedrooms Maximum Proposed Height____ Roof Change ( ) Yes ( ) No Basement ( )Yes ( ^)>W' Walkout Basement ( ) Yes (side profile required) ( ^)"No Outside DimensionFt."Ft.x_^Ft."Ft. X\/Sq. Ft. Setback to Ldtiine ___\Setback to Right of Way Setback to Ordinar^,,High Wate/Level Elevation Above Ordinary High Water Level Setback to Septic Tanjy'^ Setback to Drainfiejd___ Setback to Bluff______ Maximum Proposed Height \ Roof Change ( ) Yes ( ) No\ Bathroom Proposed ( ) Yes ( ) X. So. Ft. -- Setback to Lolhtte_______ Setback to Right of^ay__Z Setback to Ordinary High Water Level __Ft.Elevation Above Ordinary High Water Level Setback to Septic Tank__ Setback to Drainfield___ Setback to Bluff_______ Maximunr Proposed Height ( ) Boathouse ( ) Gazebo "Project/Lotlines/Right-of-ways Must be Staked Onsite Prior to Appiication / Inspection / Ft."y Ft."Ft. Ft.Ft. Ft. Ft.Ft.X—Ft. V Ft.Ft.Ft.Ft. ( ) Screen Porch ( ) Storage StructureX * Must Include on scale drawing, additional Permit may be required. Topographical Alteration / Earthmoving □ None □ 300 Cubic Yards or More*□ 21 Cubic Yards - 299 Cubic Yards*□ 20 Cubic Yards or Less * CHARACTERISTICS OF LOT; Bluff ( )Yes (^4^15.Ft.Sq. Ft.Water FrontageLot Area : ^ J<.%X100 =Impervious Surface Ratio:Impervious Surface RatioTotal Lot Area (FT*)Total Impervious Surface Onsite (FT^) THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES. Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set forth and according to the provisions of the Ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith shall become a part of this permit application. I also understand that this permit Is valid for a period of six (6) months. Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express con dition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Ordinances of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said Ordinances. I understand that it is my responsibiiity to inform the Land & Resource Management office once the building footings have been constructed. uDate; * Signature of Property Owner/Agent for Owner / 11 \Date:_v Land & Resource Management Official! PROJECT(S) TOTAL SQ. FT. ^RECEIPT NO.PERMIT FEE $ :d.i- ^Comments: z». __iJCLY. i 3-.‘1t ■J/iV / ' '■ia--iU U- f't ~dirY1^1^ <ft- i'i'f ■ —T-t -------------- ; .-kJ.-J ut.lt.<r Form No. BK — 07-2011-05 iKWiKl 345,196 • Victor Lundeen Co., Printers • Fergus Falls, Minnesota 4- ' SITE PERMIT INSPECTION RESULTS rInspector must make all measurements and computations Itclu jC fl'7^Ft.Ft.Structure Set Back from Ordinary High Water Level Ft.Ft.Structure Set Back from Top of Bluff ?cCT Ft.R.Structure Set Back from Road Right of Way -ZoP Ft.Ft.&Ft.Ft.&Structure Set Back from Lot Lines Ft.Ft.Structure Height f100^Ft.Ft.Structure Set Back from Septic Tank lo6 rt lod Ft.Ft.Structure Set Back from Drainfield /OO Elevation Of Lowest Floor Above Ordinary High Water Level____________________Ft. 1loFt.(0 0^ H %Land Slope at Building Site % Inspector’s Comments / Sketch: VnI Cai>'» 3 eJly^ —-------— I Inspector’s Sig \ature aDate of Insdection mo Time of Inspection a^^ect Approved iUnJhmall 7Date/I r; h ■* ^^■fxECEiVED APR 0 1 2011 Land&resoj.^g WHITE-omce APPLICATION FOR SITE PERMIT / GOLDENROD - Inspector / YELLOW- Owner (after issue) LAND & RESOURCE MANAGEMENT, COUNTY OF OTTER TAIL / PINK-Assessor GOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS' FALL^,^ MN 5^537 218-998-8095 www.co.otter-tail.mn.us i3PLEASE PRINT OR TYPE ALL INFORMATION jRCS’ermit No!LANDc:*r\ LAKE / RIVER NO.LAKBRIVER NAME LAKE/RIVER CLASS SECTION TWP NO.RANGE TWP NAME Sr.G-D Sf<x V' Lci^Ke/. K €L(L y PARCEL NUMBER (S) CCCC fOO $7000 H-$h cccC fcc^ycot LEGAL dESCRIPTION M/n (to)/ Lots PROPERTY (E-911) ADDRESS 3cS/0 IcJ^C Lcop^ Ckni ^ (V\tJ Last Name First Initial Mailing Address Daytime Phone No. 3.$^ ']n Lodo^e i-cof .Pir\i\n'\tv5LSl8n A:: . ________—Property Owner Contractor Name Lie.# WWPROPOSED PROJECT (please circle the appropriate number) p (1 ) New Dwelling (2 ) Add’n to Dwelling (^^‘Replaceme (4 ) MH/YR_______ (5 ) RCU/Year {7 ) Add'n To Non-Dwelling (8 ) Storage Structure (10 ) Non-Conf. Replacement (identify)______________t_____i ,(11) Other (identify) pld fi.O /.Q ^ C / III •Existing Dwelling to be removed prior to A f! V JO ^ iQ ^ 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 (7^) Permit No. ^ S'/______ ( ) OTWMD ‘Must have Sewage System Approval from OTWMD prior to issuirtg Site Permit. Corttact Rollie Mann at 218-864-5533 |t' ( 6) Attached / Ditached Garage (9)W.0.A.S. J CHARACTERISTICS OF PROPOSED W.O.A.S. (WATER ORIENTED ACCESSORY STRUCTURE)CHARACTERISTICS OF PROPOSED DWELLING (Must Include Attached Garage) L.c dj ^ Outside Dimension Sq. Ft. /34.0 Setback to Lotline /^ 0 Ft. & Setback to Right of Way /CO Setback to Ordinary High Water Level 3O Ft. Elevation Above Ordinary High Water Level /Ft. Setback to Septic Tank /3o Ft. Setback to Drainfield Ft. Setback to Bluff ' Ft. Total Bedrooms / . Maximum Proposed Height otO Ft. Roof Change ( ) Yes ( ) No Basement (^) Yes ( ) No Walkout Basement ( ) Yes (side profile required) ( ) No CHARACTERISTICS OF PROPOSED NON-DWELLING Outside N Dimension Outside \ DimensionFt. X Vo Ft.**Ft. X Ft.** Ft. X Ft.** Sq. Ft.________\ Setback to Lotline ___ Setback to Right of Way Setback to Ordinary High Watertevel / Elevation Above Ordinary High Watpl^evel Setback to Septic Tank__ Setback to Drainfield y Setback to Bluff / Maximum Propdsed Height Roof Chan^ ( ) Yes ( ) No Bathroom Proposed ( ) Yes ( ) No /^O Sq. Ft. \ Setback to Lotline' Setback to Right of Setback to Ordinary HighNA/ater L^l Elevation Above Ordinary HiblvWater Level Setback to Septic Tank Setback to Drainfield > Setback to Bluff / Maximum Proodsed Height ( ) Boath^se ( ) Ga^o **Project/Lotllnes/Right-of-ways Mu^t be Staked Onsite Prior to^pplication / Inspection 299 Cubic Yards* □ 300 Cubic Yards or More* Ft.**Ft.&Ft.&Ft.** Ft.**Ftr Ft.Ft. Ft.Ft. Ft.Ft. Ft. Ft.Ft. Ft.Ft: ( ) Screen Porch ( ) Storage Structure Topographical Alteration / Earthmovinq □ None * Must include on scale drawing, additional Permit may be required. 0 X 21 Cubic Yards -□ 20 Cubic Yards or Less * CHARACTERISTICS OF LOT; Bluff ( )Yes (X)No . «coy Water Frontage Ft.Lot Area, • Z2r^ C UImpervious Surface Ratio:xioo =.% 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 & Resoiirce Management office once the building footings have been constructed. nature of Property Owner / Agent for Owner Fc^. h ■ 10 j ^ c //0*1Date: (VOollDate: 14^17^Land & Resource W^agement Office ____________ Tins __________I >00 PERMIT FEE $RECEIPT NO.PROJECT(S) TOTAL SQ. FT. St^inc/rxhjs^>7<S /'tl/ 6 (o 6L » 329.582 • Victor Lundeen Co.. Printers • Fergus Falls, MinnesotaForm No. BK — 1003-0407 Wui WHITE - Office APPLICATION FOR SITE PERMIT GOf.DENROD - Inspector 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 YELLOW - Owner (after issue) PINK - Assessor Permit No. ^ H I 1 PLEASE PRINT OR TYPE ALL INFORMATION LAKE / RIVER NO.LAKE/RIVER NAME LAKE/RIVER CLASS SECTION TWP NO.RANGE TWP NAME Sitx4/STa.y LcuKe.■ 1^0G-D liA PARCEL NUMBER (S) LEGAL DESCRIPTION / ooqt •*’ OOL. PROPERTY (E-911) ADDRESS 3oS ?/> D/.nf mrJ f/. ^ ,'p fforloTS \ Last Name First Initial Mailing Address Daytime Phone No. Property Owner v' Contractor Name Lie.# 0u)ir)(>r Lnnfrai.X O !' PROPOSED PROJECT (please circle the appropriate number) t (3) ’Replacement DwtHng -, (6) Attached / Detached Garage (9) W.O.A.S. / tykilTi '^b, ;Ck -/o ONSITE WATER SUPPLY ( ) Individual (,V1 Public ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3’ (minimum) structure setback to a well. ONSITE SEWAGE TREATMENT SYSTEM(1 ) New Dwelling (4 ) MHA'R (7) Add'n To Non-Dwelling (10) Non-Conf. Replacement (identify) (11) Other (identify)_;_______ ■Existing Dwelling to be removed prior to (2) Add’n to Dwelling (5) RCU/Year______ (8) Storage Structure ( ) Permit No. ( ) OTWMD ’Must have Sewage System Approval from OTWMD prior to issuing Site Permit. Contact Roliie Mann at 218-864-5533c Lo <i Q C CHARACTERISTICS OF PROPOSED W.O.A.S. (WATER ORIENTED ACCESSORY STRUCTURE)CHARACTERISTICS OF PROPOSED NON-DWELLING Outside Dimension CHARACTERISTICS OF PROPOSED DWELLING (Must Include Attached Garage) Outside Dimension Sq. Ft. -7 Setback to Lotline Setback to Right of Way ■ 'v ^ Ft.” Setback to Ordinary High Water Level Elevation Above Ordinary High Water Level /xT Ft. Setback to Septic Tank Setback to Drainfield _ Setback to Bluff____ Total Bedrooms Maximum Proposed Height Roof Change ( ) Yes ( ) No Basement ( ) Yes ( ) No Walkout Basement ( ) Yes (side profile required) ( ) No OutsideFt. x Ft.”Ft. X irO Ft.” Ft.& Dimension 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/Rlght-of-ways Must be Staked Onsite Prior to Application / Inspection Ft.”Ft.& Ft.&Ft.” Ft.”So Ft.Ft.” Ft.Ft. Ft.Ft. Ft. \,Ft.Ft.\Ft.Ft.Ft. Ft. Ft.Ft, Ft.Ft. ( ) Screen Porch ( ) Storage Structure T Topographical Alteration / Earthmovinq □ None ’ Must include on scale drawing, additional Permit may be required.21 Cubic Yards ■ 299 Cubic Yards*□ 20 Cubic Yards or Less *□ 300 Cubic Yards or Mojp*j- ICHARACTERISTICS OF LOT:4*.■i i'S'C Bluff ( )Yes (;V)NoLot Area.Water Frontage Ft. } Impervious Surface Ratio: ~X100 =.%—Total Impervious Surface Onsite (FTO Total Lot Area (FT^)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. Date; Signature of Property Owner / Agent for Owner Date: I i -r » I ^Land & Resource Management Office PERMIT FEE $PROJECT(S) TOTAL SQ.FT.,RECEIPT NO. Tf Comments: Form No. BK — 1003-0407 329,582 • Victor Lundeen Co.. Printers • Fergus Fails, Minnesi ta SITE PERMIT INSPECTION RESULTS Inspector must make all measurements and computations Structure Set Back from Ordinary High Water Level Ft.Ft. Structure Set Back from Top of Bluff Ft.Ft. /ovStructure Set Back from Road Right of Way Ft. Ft. ^ Ft.Structure Set Back from Lot Lines Ft.Ft.&Ft. Structure Height Ft. Ft. Structure Set Back from Septic Tank Ft.Ft./Of- Structure Set Back from Drainfield Ft. Ft. Elevation Of Lowest Floor Above Ordinary High Water Level Ft. Ft. Land Slope at Building Site % % ! Inspector’s Comments / Sketch: f *T7 'I Inspector's Signature Date of Inspection J HJ Time of Inspection [^/Project AoDroveJO/*3^/ ^ ' Date / Initial ^ )■ f^ECEiVED APR 0 I 2011 LAiMu & RESOURCE teCEIVED FEB 1 4 2011 UND & RESOURCE /! I r t 1:i I (I i -S'7~/jjrj xe. I»I1 III!1 IIiIDESCRIPTION OF MOBILE CAMP AREA iIv&;- -S-.g9 /^O. o'---------vl Jr- 1 _ -1*'1 V»'- iPart of Government Lot Four (4) in Section Nine (9), Town ship One Hundred Thirty Five (135) North, Range Forty One (41).West, Otter Tail County, Minnesota, described as follows: I =.'N-K* ^ (i -‘■I'fSl 'll?'•» !'i '^w I Ha' , S* ■?Ci-LII •?‘\1 TvMI1 II I;Ho*IHo'I .1 .. . I ... 'IV'^<5/((I0 >wiCommencing at the North quarter section corner of said Section 9; thence South 1618.52’feet'along' the quarter sec- tion'line; and theno-e West 33.00 feet to the_ point of be-- ginning; H-o ; ?:t tVt /i U-t)^<0!, I G 'I;\I \ vs-—<h r (i Thence South 89°49‘10'' 245.32 feet; Thence North 00°10’50” East 295.00 feet; Thence South 89°49'10" West 140.00 feet; Thence South 00°10’50" West 329.40 feet; Thence South 80‘^26'00" East 337.55 feet along the North right of way line of a 86.00 foVot wide strip of land reserved for road purposes; Thence North 64°30'00" East 58.24"feet along ; i'1 I1 ^0(j, 1 V 40! i 0 N ({said road reserve; Thence North 66.64 feet along said road reserve to the point of beginning. !(ft 5 ! ■ Containing 1.52 Acres. 5fi 1I II'■! IIt I ^4i! I 11i />v /yz./^cc. — £>^s/(3A/Ej[:> ;Xf { \ \ L E D G E N ^C • Denotes iron moniiments found. O Denotes iron monuments placed ( %" pipe ). Water and electrical service. ; Sewer line-:^ to tanks and drainf ield'^ . SCALE 1 inch #50 feet. 7~/^ /Q C7~ ^ ■ 45iz»f sf 5 ■i The quarter section line shown herein is assu-rned to have a bearing of Nor'b.h for di scrip- ’ tive purposes,/ y > 4.\ t FRANK’S TRAILE^QAl^P%■ SCAL.E DRAWN OY/ /NCH - sc^ A^r-.STAR LAKE TWP.REVISED GOV. LOT 4 SEC. 9, T.I35 N.RANGE 41 WESTKERMIT T. BJORGUM Land Surveyor Box 266 (218) 736-5986 FERGUS FALLS. MINNESOTA 56537 ORAWma NUMBERDATEAI»PROVEO BY AL.BANENE(^ 10 5455 ARCHITECTS* STANDARD FORMK-E MADE IN U.S.A.^ ^-Ajh €yX)-^^ ^ prd p 6S ^ y^l^ivejri eyitprihj fhj ; h 1 \ . > Ffuuck A LUOGi 30570 Lodge Loop Dent, Minnesota 56528 Ph. (218) 758-2876 , oiut Campground ^OH ' Mr. Bill Kalar, Administrator Land and Resource Management Otter Tail County Government Service Center 540 West Fir Fergus Falls, MN 56537 RE; Replacement Structures (Lodge & 3 Rental Cabins), Star Lake (56-385) Dear Mr Kalar: After our meeting of March 21, 2011,1 hope the following will clarify the questions and concerns you have listed: 1. I have signed the application. 2. 1 have changed the “lot Area” for my impervious surface calculations as per your direction. 3. The access road to ramp, decks, walk-ways and boat ramp are included in the impervious surface. 4. Please see attached letter from Minnesota Department of Health listing the lodging code of 4625 which accounts for the increase in size. All three cabins are the same size 672 SF each (24’X 28’) plus decks of 480 SF each. Cabin 1- Bunkhouse: New cabin will have a storm shelter under. Cabin size is 24’ X 28’, Existing SF of open deck is 173 SF. East side of cabin deck is 6’3”. South side(lake side) deck is T X 8’. Cabin 2 - Shady Nook: New cabin will have storm shelter under. Cabin size is 24’ X 28’. Existing deck is 176 SF on north and west side of cabin. 16’ X 5” on north side and 8’ X 12’ on west side. Cabin 3 - Hilltop: New cabin will be on block foundation with deck on east and South sides. Cabin and deck will be approximately six feet further North (away from lake). New cabin size is 24’ X 28’. Present deck Size is 176 SF on north and west sides of cabin. RECEIVED APR 0 1 2011 Famili; Owned and Operated Since 1934 LAND & RESOURCE Frank’s Lodge Replacement Structures Star Lake (56-385) Page 2 5. Total number of Bedrooms;Currently Proposed Lodge (destroyed by fire) 1 Irg. Bedroom slept 6 1 Bedroom - sleep 4 Cabin 1 -3 bedroom sleep 6 2 Bedroom - sleep 6 2 bedroom sleep 4Cabin 2 -2 Bedroom - sleep 4 2 bedroom sleep 4 2 Bedroom - sleep 4Cabin 3 - 6. Yes, the current structures have decks. They are not covered. Sizes and locations are listed on item #4. The decks are not expanding towards the lake. 7. The Lodge was two story. It will be approximately three feet higher than the old lodge was to provide proper ceiling height of 8’ or more in both basement and main floor. We also want to utilize the existing concrete foundation. Cabin 1 has a walk in storage area under it. Cabins 2 and 3 sit on stilts approximately 4 feet off the ground. Storm shelters will be built under cabins 1 and 2. Cabin 3 will not be raised. Please let us know if you have any other concerns. We have enclosed the “signed” application along with our check and the corrections you requested. Sincerelw John Frank P.S. I will be back to Star Lake approximately April 5‘*'. So please hold permit at your office and I will pick it up. Also we can discuss any further questions you might have at that time. Thanks. RECEi'/ED APR 01 2011 LAND & RESOURCE Page 1 of 1 Frank, 1. The lodging code is 4625 https://www.revisor.mn.gov/data/revisor/rule/current/4625/4625.pdf 2. It was observed that this establishment has 12 mobile home units. In regards to MN Department of Health requirements on the storm shelter: “(7) A manufactured home park with ten or more manufactured homes, licensed prior to March 1, 1988, shall provide a safe place of shelter for park residents or a plan for the evacuation of park residents to a safe place of shelter within a reasonable distance of the park for use by park residents in times of severe weather, including tornadoes and high winds. The shelter or evacuation plan must be approved by the municipality by March 1, 1989. The municipality may require the park owner to construct a shelter if it determines that a safe place of shelter is not available within a reasonable distance from the park. A copy of the municipal approval and the plan shall be submitted by the park owner to the Department of Health. The park owner shall provide each resident with a copy of the approved shelter or evacuation plan, as provided by section 327C.01, subdivision Ic.” “(8) A manufactured home park with ten or more manufactured homes, receiving an initial license after March 1, 1988, must provide the type of shelter required by section 327.205, except that for manufactured home parks established as temporary, emergency housing in a disaster area declared by the President of the United States or the governor, an approved evacuation plan may be provided in lieu of a shelter for a period not exceeding 18 months.” 327.205 SHELTER CONSTRUCTION STANDARDS. The commissioner of labor and industry shall adopt, by rule, minimum standards for the construction of low cost manufactured home park storm shelters by March 1, 1988. All shelters constructed after March 1, 1988, shall be constructed in accordance with these standards. http://\vwvv.dli.mn.gov/CCI.D/PDF/SBC/l 370.pdf. Enclosed is information on the minimum requirements for the construction of a storm shelter by the MN Department of Labor and Industry If you have any questions about the above rules, let me know. 3. Buckhom campground is licensed for 18 sites. If you are proposing to add additional sites, plans will need to be submitted to me for formal review. If you need a plan review application, etc., let me know. Todd Whalen MN Department of Health Plan Reviewer Phone. 651-201-5736 Fax: 651-201-4572 RECEIVED m 012011 tAND & resource file://C;\Documents and Settings\Kathleen Frank\Local Settings\Application Data\IM\Run... 3/29/2011 Minnesota Rules, Chapter 1370 Storm Shelters in designing storm shelters. The document is not subject to frequent change and is available: (1) in the Minnesota State Law Library; (2) from the Printing and Publications Division, Federal Emergency Management Agency, P.O. Box 8181, Washington, D.C. 20024; and from the Minnesota Department of Public Safety, Division of Emergency Management, 85 State Capitol, Saint Paul, Minnesota 55155. Subp. 2. Dual purpose storm shelters. A dual purpose storm shelter must comply with other applicable requirements of the state building code for its other intended uses. 1370.0140 PLANS, SPECIFICATIONS, PERMITS. Storm shelter plans, engineering calculations, diagrams, and other required data must be prepared by a registered architect or engineer licensed to practice in Minnesota. For permit procedures, see section 106 of the Uniform Building Code, incorporated by reference in part 1305.0010. 1370.0150 SPACE REQUIREMENTS. A minimum of four square feet per person must be provided within a storm shelter. A ceiling height of not less than seven feet must be provided over 60 percent of the floor area. 1370.0160 REQUIRED EXITS. Subpart 1. Exits; openings. At least two exits must be provided in compliance with chapter 10 of the Uniform Building Code. The second exit from a single purpose storm shelter may have an opening of at least nine square feet with a minimum of 20 inches in width and the bottom of the opening not more than 44 inches from the floor. Openings in the exterior walls of the shelter must be protected to prevent flying 1370.0100 PURPOSE. The purpose of parts 1370.0100 to 1370.0230 is to provide minimum standards of design and construction of buildings to provide protection for manufactured home park occupants from tornadoes and extreme winds. 1370.0110 SCOPE. Parts 1370.0100 to 1370.0230 apply to buildings or portions of buildings that are designed for use as manufactured home park storm shelters. 1370.0120 DEFINITIONS. Subpart 1. Scope. The definitions in this part apply to parts 1370.0100 to 1370.0230. Subp. 2. Storm shelter. “Storm shelter” means a structure or portion of a structure designed in compliance with parts 1370.0100 to 1370.0230. Subp. 3. Dual purpose storm shelter. “Dual purpose storm shelter” means a structure or portion of a structure designed for use as a storm shelter and also designed for some other secondary permitted use. Subp. 4. Single purpose storm shelter. “Single purpose storm shelter” means a structure designed for use only as a storm shelter. 1370.0130 APPLICABLE REQUIREMENTS. Subpart 1. Incorporation by reference. “Interim Guidelines for Building Occupant Protection from Tornadoes and Extreme Winds,” TR-83A January 1980, sections 1 and 2, published by the Federal Emergency Management Agency, Washington, D.C., is incorporated by reference and must be used to determine design loads and as a guide for use APR 0' 20111 — ^ ILAN~ I on page nine of the interim guidelines incorporated in part 1370.0130. 1370.0230 SANITATION FACILITIES. Sanitation facilities and water for drinking are not required for storm shelters. missiles from entering the interior of the shelter. !Subp. 2. Handicapped access. At least one of the exits must comply with chapter 1340, facilities for the handicapped. Subp. 3. Exit to exterior. When a portion of a structure is designed as a storm shelter, one exit must be directly to the exterior of the building or to an exit system complying with the state building code. 1370.0170 DRY INTERIOR. Provisions must be made to construct storm shelters outside of flood-prone areas and other nonwater ponding areas and so that the interiors remain reasonably dry. 1370.0180 UTILITY LINE HAZARDS. Hazardous utility lines must not be located in or near a storm shelter, underground electrical service required by part 1370.0200 is exempt from this requirement. 1370.0190 MINIMIZING FIRE DANGER. Storm shelters must be constructed to minimize the danger of fire from both external and internal sources. 1370.0200 ELECTRICAL POWER. Underground electrical service must be provided to a storm shelter. 1370.0210 ILLUMINATION. Subpart 1. Minimum illumination. At least five foot candles of illumination must be provided at floor level. Subp. 2. Source. An emergency lighting system must be supplied from storage batteries or an on-site generator installed in accordance with the requirements of the National Electrical Code, incorporated by reference in chapter 1315. 1370.0220 VENTILATION. Ventilation must comply with the criterion ; 1 : t. i The 2 Department of LAND AND RESOURCE MANAGEMENT OTTER TAIL COUNTY Government Services Center - 540 West Fir Fergus Falls, MN 56537 PH; 218-998-8095 OTTER Tail County’s Website: www.co.otter-tail.mn.us received APR 0 1 2011 land & RESOURCE February 24, 2011 John Frank Frank’s Lodge & Campground 30570 Lodge Loop Dent, MN 56528 RE; Replacement Structures (Lodge & 3 Rental Cabins), Star Lake (56-385) Dear Mr. Frank: I have had an opportunity to review the Site Permit Application you submitted to our office on February 14, 2011. From my review, I have many questions regarding your proposal. Since this is the case, I am returning your Site Permit Application, related material (including drawings), and application fee (check #1381 in the amount of $275.00). I would also ask that you contact me (218-998-8095) so that we can schedule a meeting which will hopefully resolve my concerns. Sincerely, Bill Kalar Administrator 9 HI. } f A*I: / r-f'I '’s /T\f I-s.—■ !\ fl AK-^fS ^/si. ^\ \ */ rV ■?' (y I !Z'1%^r rAp, ;><V IF V i / iii\i i(;i sI! 1 i ; > /i- Va /-> ;■ ' W I■j I t) ^^hd.'C^yp i ■r A<C esS^'^I^A. f }!■ ? /Vj' ^ \i-L.-T-i I/ I i.»U'5 r "((!I 1 n>r EroIkk ,■-'i >i/T A /V-?- 'J<S'^XiV / fI" n»/ >o y 'r••.Jl''-.4 ' N f..\A"i PL 0 iSL’JJhij Z>(rc^yI’ < ) RECV:;^'' ftB' ujjao&RE •i ■RECEIVE'^ APR f'' 2'' land & E'-SC - l^wI r/P I SOURCE ‘ } n n_an a_„i .-T '.VCt3/h>h f!^o}^pJtvh s r Ffumk^^s '4: 30570 Lodge Loop Dent, Minnesota 56528 Ph. (218) 758-2876 (uut Campground ‘M Sicui Xaker ■bi- ' RECEIVED ^ECE/VED F£B I 4 2011 '^'^0 a resource APR 01 2011 LAND & RESOURCE February 2, 2011 Todd Whalen, Plan Reviewer Minnesota Department of Health P.O. Box 64975 St. Paul, Minnesota 55164-0495 Re: Proposed construction of three cabins and one Lodge at Frank’s Lodge & Campground and two cabins on new parcel. Dear Mr. Whalen: In reply to your letter of February 1,2011, hopefully the following will clarily some of your concerns: General: 1. We have not applied for Coimty of Ottertail site permit yet. Mr. Bill Kaler of Lake Shore Management informed us that we needed your (The State of Minnesota) permits first. With that in hand, we could get a County site Grading permit for cabin and lodge replacements without having to go Through the Conditional Use Permit process. Replacement cabins: Cabin #2 1. You are correct. The present cabin has three double beds but of course the floor space per bedroom is too small. We are planning on two beds and a hide-a-bed couch or futon for the new cabin. Famili; Owned and Operated Since 1934 Frank’s Lodge & Campground Plan Review / 2011^^CEiVED APR ff I 2^ Ma/o Lodge la:1. We do intend to rent out the basement space. The original structure/lodge which burned is listed on our permit as one of seven residential units on the resort. It would be a “housekeeping” rental like the rest of our cabins are rented. 2. We are basically like a small grocery store. Our permit allows us to sell commercially wrapped food products such as candy bars, chips, ice cream bars, frozen pizzas etc which can be micro-waved by the purchaser, pop and bait. We do not prepare any of the food that is sold. The kitchen with stove, refrigerator. Microwave etc will be available for campers and guest to have special occasion gatherings like fish fries etc. They will provide and prepare their own food in the lodge when outside weather conditions are not favorable. New Cabins: 1. The address for the new property is 30594 Lodge Loop, Dent MN. 56528 and is owned by John and Kathleen Frank, Individuals. I believe it would be best to incorporate this into Frank’s Lodge & Campground, LLC if we can get approval for the two new cabins. All three structures would be used as cabin rentals. If this caimot be done, we could split the property and build another private residence on it. Sincerely, y c/John Frank t mwm,(uui Campground m Sim £ake yL " 30570 Lodge Loop Dent, Minnesota 56528 Ph. (218) 758-2876 i^tCc/VED APR 0 ) 2011 land a RESOURCE a resource received 1 li 2011 February 8,2011 Todd Whalen, Plan Reviewer Minnesota Department of Health P.O. Box 64975 St. Paul, Minnesota 55164-0495 Re: Proposed construction of three cabins and one Lodge at Frank’s Lodge & Campground and two cabins on new parcel Mr. Whalen: In reply to your e-mail of February 7,2011. We understood after our conversation with Mr. Kalar in November, 2010 that a site permit is required from Ottertail County to rebuild the Lodge and three cabins at Frank’s Lodge and Campground. But Mr. Kalar instructed us to get your approval of the plans first. Mr. Kalar also advised us that a Conditional Use Permit would be required for the two new cabins on the adjoining property. Therefore your willingness to phase the project is very much appreciated. Our tentative schedule would be to replace three cabins and the lodge for the first phase, hopefully in 2011 while applying for the C.U.P. and have it approved and ready to start construction of the two new cabins in 2012. We will apply for the site permit immediately. Sincerely, 4 ^olm Frank Familii Owned and Operated Since 1934 ^8 t 4 ?0(, '^"'“^'^esooRceAPR G . 2D1) L*>ivD & RESOURCE 5'-O' Hiillil IFIITOiiiinmmmmn ml □ □ DiUo U 12 41^ a'-o" r \2m' i'ThtlMi :/^i/I r □ □ o w-^2^ t/l/. K '^£0■''-^BVBD 0 / 201/^OitMA/£) 5'<)"55i-01.$'-0" I h •^^Irrecyti' C C 6^^ jC^ 0i»C>Q i|Flifl^ (TPt^ICK \3To t>V Q 0 O O 1 E^ -o 'St >so QX 'sc /;vfj. f,^c Sy^^' 6^6^ vz^arxe■/2^ai:i.^7Z6oa.i^■njsoavsi D P eck00 5.a0a.jflL h&^ih f k RECEIVED FEB 1 ^ 2011 land & RESOURCE 55*'0'' 7T / — X X ^~\e\ n U'hHJ Ito Io o VOlC\UnUTY %p\-3'^ Vo cs / 22''I"10''ll" 55'O" RECEIVED «L-od^^APR 0 t 2011\ c LA.ND & RESOURCE Page 1 of2 T f^ECEIVED ra 1 k 2Q\i ^?EC^"'7D APR f:2011frankslodgeLAND P. RF.qqijpq^XANDITRcoOURCE "Whalen, Todd (MDH)” <Todd.Whalen@state.mn.us> <fran kslodge@arvig. net> 'Wroblewski, David (MDH)" <David.Wroblewski@state.mn.us>; 'Tonneson, Rebecca (MDH)" <Rebecca.Tonneson@state.mn.us> Wednesday, November 03, 2010 10:28 AM From: To: Cc: Sent: Subject: Franks Lodge Frank, Per our phone conversation today, Plans will need to be submitted on the proposed project (construction of three cabins as well as the lodge). General overview of what should be provided; Lodging: 1. Layout of the cabins. Don't need to be done by an architect. Handwritten plans are fine, just need to be legible a. Provide occupancy of each sleeping room b. Provide interior (paint to paint) dimensions of the sleeping rooms 2. Provide a certificate of compliance on the septic system that is up to date a. If septic system was installed before 1996, it should be inspected every three years b. If septic system was installed after 1996, it should be inspected every five years 3. Provide a copy of the most current well results (coliform bacteria, nitrate) from the MN Department of Health - Groundwater section. If you don’t have them, let me know I would review the following lodging code requirements because they pertain to this plan; Ever\' room occupied for sleeping purposes by one person shall contain at least 70 square feet of usable floor space, and every r'oom occupied for sleeping purposes for more than one person shall contain not less than 60 square feet of sable floor space for each occupant thereof. Under no circumstances shall there be less than 400 cubic feet of air space per occupant. Usable floor space excludes closets and bathroom ar'eas. Beds placed side by side must be separated by a minimum of tiiree feet. No sleeping quarters shall be provided in any basement having more than half its clear floors to ceiling height below the average grade of the adjoining ground. Foodservice: 1. Layout of the lodge. Don’t need to be done by an architect. Handwritten plans are fine, just need to be legible. a. Label each room and provide drawings of what will be located in those areas (ex; laundry area - draw in washers, dryers and other things that will be located in that room) 2. Menu 3. Finish schedule for the lodge (attached to the plan review application) 4. Equipment list for the equipment involved with the foodservice There may be more information needed later, but this information can at least get the plan submitted and get us going on the review. 11/3/2010 Page 2 of 2PH r Below is the plan review application: http;//w\vw.health.state.mn.us/divs/eh/'food/license/prappremfbl.pdf Fill out the following sections on the application: Limited food, and cabins under 5 !; • If you have any questions, feel free to contact me.1= f Todd Whalen MN; Department of Health Plan Reviewer Phone: 651-201-5736 Fax: 651-201-4572 i -r i Todd Whalen MN Department of Health Plan Reviewer Phone: 651-201-5736 Fax; 651-201-4572 11/3/2010 > APPLICATION FOR SITE PERMIT l^pprn/rrQ VMVTE - Office GOLDENROD - Inspector YELLOW - Owner (after issue) PINK - Assessor PEP ’ P|537 MANAGEMENT, COUNTY OF OTTER TAIL GOVERNMENf SERVICES C^TER, 540 WEST FIR, FERGUS FALLS, \ 218-998-8095 '■co.otter-tail.mn.us LAND 8b CX 1 wRECEIVE FEB 1 ^ 2011 Permit No.PLEASE PRINT OR TYPE ALLINFORMATION AN 0- in r-'C: LAKE/RIVER NAME ‘ “TWPNO.fVER SECTIONLAKiLAKE / RIVER NO.s®S (t D 9'/s>y/Sia^r LrX. k oSfitr 4^/^r PROPERTY (E-911) ADDRESSPARCEL NUMBER (S) S~'/£‘C>rr< 9t>o 7CC/___3cS '/c y cj’Y Lt>o P, Otp >»F M A/ S(r 5 Z ^ loYs ‘/^S’ LEGAL DESCRIPTION f9ii >/j/- /{/li>93 /i/lS - /)/U'4'T / /} Daytime Phone No.Mailing AddressInitialFirstLast Name LtoPj Ai/V Sl>£^8i/yjProperty Owner Contractor Name Lie.*r^Lone ONSITE SEWAGE TREATMENT SYSTEM (X) Permit No. S'/________ ( ) OTWMD 'Must have Sewage System Approval from OTWMD prior to issuing Site Permit. Contact RoHie Mann at 218-864-5533 PROPOSED PROJECT (please circle the appropriate number) (1 ) New Dwelling (4 ) MH/YR____ (7) Add'n To Non-Dwelling (8) Stoi^ Structure ^ ®) W.O.A.S.(10) Non-Conf.Replacement(jdentilyt^^ ^/g C*ct^h HaS> (11 ) Other (identilY>Tri.^O iOt th .‘^Tc I'm SheliC r (?4t..Se rJ7£rif^ 'Existing Dwelling to be removed prior to (\j Oil / f __________________ 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 Garage (2) Add’n to Dwelling (5) RCU/Year_____ CHARACTERISTICS OF PROPOSED W.O.A.S. (WATER ORIENTED ACCESSORY STRUCTURE) Outside Dimension CHARACTERISTICS OF PROPOSED NON-DWELUNG Outside Dimension CHARACTERISTICS OF PROPOSED DWELUNG (Must Include Attached Garage) Outside Dimension <3 ^ Ft. x 3 (e Ft.** Sq. Ft. Sl'f ^ ^ _ Setback to Lotline /D D Ft. & 3 ^ Ft.** Setback to Right of Way Ft.'* Setback to Ordinary High Water Level Ft Elevation Above Ordinary High Water Level Setback to Septic Tank 73" Ft. Setback to Drainfield /-3~P FL Setback to Bluff________ Total Bedrooms C’ Maximum Proposed Height Roof Change ( ) Yes ( ) No Basement ()<^) Yes ( ) No Ft**Ft. X Ft. X Ft.** Sq.Ft Setback to Lotline ____ Setback to Right of Way Setback to Ordinary High Water Level ___ Elevation Above Ordinary High Water Level Setback to Septic Tank___ Setback to Drainfield____ Setback to Bluff________ Maximum Proposed Height Roof Change ( ) Yds ( ) No Bathroom Proposed ( ) Yes ( ) No Sq. Ft. Setback to Lotline____ Setback to Rig^t of Way Setback to Ordinary High Water Level __ Elevation Above Ordinary High Water Level Setback to Septic Tank Setback to Drainfield _ Setback to Bluff_____ Ft.**Ft.&FL&Ft.** Ft.**FL** FLQ-O Ft.Ft. Ft.Ft. Ft.Ft. Ft. Ft.Ft. Ft.•3.^ Ft.Ft. Ft.Ft.Maximum Proposed Height ( ) Boathouse ( ) Gazebo **Project/Lotlines/Right-of-ways Must be Staked Onsite Prior to Application / Inspection ( ) Screen Porch ( ) Storage StructureWalkout Basement (V) Yes (side profile required) ( ) No ' Must include on scale drawing, additional Permit may be required. Topographical Alteration / Earthmovino □ None □ 20 Cubic Yards or Less *iC 21 Cubic Yards - 299 Cubic Yards*□ 300 Cubic Yards or More* CHARACTERISTICS OF LOT: ^ Sq. Ft.Bluff ( )Yes (>^No . oo7 .Ft.Water FrontageLot Area,//i / N . /Z., ^ ^.%X100 =Impervious Surface Rat a: —? . ^ , ~ri iT-ervious Surface Onsite (FT;)Tf. / Pfr-iri -/OicSc// THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES. Agreement: ■ i-e'=". ;e-^ re -"--"ation contained herein is correct and agree to do the proposed work in accordance with the description above set forth and accord'''^ r". s r-e C" "a"ces of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith shall become a part of this ps""* ar: -a-'- as: .-ce-s-a'c f^af this permit is valid for a period of six (6) months. Permit: Perrriss :■ = :"a"a: ■: "a a:: .a "a~sP aoefcantto perform the work described in the above statement.This permit is granted upon express con- /Impervious Surface RatioTotal Lot Area (FTr) Department of LAND AND RESOURCE MANAGEMENT OTTER TAIL COUNTY Government Services Center • 540 West Fir Fergus Falls, MN 56537 Ph: 218-998-8095 Otter Tail County’s Website: www.co.ottertail.mn.us «m^ND& /APR 0 , 2g„ December 4, 2003 John M. Frank, Et Al Trustee 13980 Linda Vista Dr. Shasta Lake, CA 96089 RE: Sewage Treatment System Servicing Tax Parcel Number 56000090057000 & 56000090057001 Described as N1/2 NW1/4, Lots 4 & 5 (9.93 Ac) & N1/2 NW1/4, Lots 4 & 5 (91.26 Ac)..., Section 09 of Star Lake Township, Star Lake (56-385) As of November 21, 2003, the sewage treatment system (Sewage Treatment Installation Permit #16451) servicing your property was determined to be in compliance with the provisions of the Sanitation Code of Otter Tail County for 14 New Campsites. If you have any questions regarding this matter, please contact our office. Sincerely, Wayne Roisum Inspector \ 13^0 f=r^P(iji>/>^^CjQ/> S2' 33^ Ft ^A fyC/^ ! fr\0H i- SaTU^^ Si 2^ ■ = 5<9;:. P,h‘j< 3> J'.SiS'' /} 3S4, d-y'f- 3c ' I i * 4 Bill Kalar Whalen, Todd (MDH) <todd.whalen@state.mn.us> Tuesday, April 12, 2011 9:50 AM Bill Kalar Bill Kalar FW: Franks Lodge and Campground From: Sent: To: Cc: Subject: C,£fT ^ From: Whalen, Todd (MDH) Sent: Tuesday, March 29, 2011 9:44 AM To: 'frankkathleen@att.net' Subject: Franks Lodge and Campground SiVi Frank, 1. The lodging code is 4625 httDs://www.revisor.mn.qov/data/revisor/rule/current/4625/4625.pdf 2. It was observed that this establishment has 12 mobile home units. In regards to MN Department of Health requirements on the storm shelter: “(7) A manufactured home park with ten or more manufactured homes, licensed prior to March 1, 1988, shall provide a safe place of shelter for park residents or a plan for the evacuation of park residents to a safe place of shelter within a reasonable distance of the park for use by park residents in times of severe weather, including tornadoes and high winds. The shelter or evacuation plan must be approved by the municipality by March 1, 1989. The municipality may require the park owner to construct a shelter if it determines that a safe place of shelter is not available within a reasonable distance from the park. A copy of the municipal approval and the plan shall be submitted by the park owner to the Department of Health. The park owner shall provide each resident with a copy of the approved shelter or evacuation plan, as provided by section 327C.01, subdivision Ic.” “(8) A manufactured home park with ten or more manufactured homes, receiving an initial license after March 1, 1988, must provide the type of shelter required by section 327.205, except that for manufactured home parks established as temporary, emergency housing in a disaster area declared by the President of the United States or the governor, an approved evacuation plan may be provided in lieu of a shelter for a period not exceeding 18 months.” 327.205 SHELTER CONSTRUCTION STANDARDS. The commissioner of labor and industry shall adopt, by rule, minimum standards for the construction of low cost manufactured home park storm shelters by March 1, 1988. All shelters constructed after March 1, 1988, shall be constructed in accordance with these standards. http://www.dli.mn.gov/CCLD/PDF/SBC/137Q.pdf Enclosed is information on the minimum requirements for the construction of a storm shelter by the MN Department of Labor and Industry If you have any questions about the above rules, let me know. 1 V ; ii3. Buckhom campground is licensed for 18 sites. If you are proposing to add additional sites, plans will need to be submitted to me for formal review. If you need a plan review application, etc., let me know. f Todd Whalen MN Department of Health Plan Reviewer Phone: 651-201-5736 Fax: 651-201-4572 :.p- I ",3 ^3 3 f « • -c ’> !• • ! ; 2 CHAPTER 1370 DEPARTMENT OF LABOR AND INDUSTRY MANUFACTURED HOME PARK STORM SHELTER DESIGN 1370.0100 PURPOSE. 1370.0110 SCOPE. 1370.0120 DEFINITIONS. 1370.0130 REQUIREMENTS. 1370.0140 PLANS, SPECIFICATIONS, PERMITS. 1370.0150 SPACE REQUIREMENTS. 1370.0160 REQUIRED EXITS. 1370.0170 DRY INTERIOR. 1370.0180 UTILITY LINES. 1370.0200 ELECTRICAL POWER. 1370.0210 ILLUMINATION. 1370.0230 SANITATION FACILITIES AND DRINKING WATER. 1370.0361 FEMA361. History: 12 SR 2251; L 2007 c 140 art 4 s 61; art 12 s 4; L 2008 c 337 s 64; 35 SR 1427 APPLICABLE 1370.0120 DEFINITIONS. Subpart 1. Scope. The definitions in this part apply to parts 1370.0100 to 1370.0361. Subp. 2. Storm shelter. "Storm shelter" means a structure or portion of a structure designed in compliance with parts 1370.0100 to 1370.0361. Subp. 3. Dual purpose storm shelter. "Dual purpose storm shelter" means a structure or portion of a structure designed for use as a storm shelter and also designed for other permitted uses. 1370.0100 PURPOSE. The purpose of parts 1370.0100 to 1370.0361 is to provide minimum standards of design and construction of buildings to provide protection for manufactured home park residents from tornadoes and extreme winds. Subp. 3a. FEMA 361. "FEMA 361" means the Design and Construction Guidance for Community Shelters, FEMA 361, July 2000. Subp. 4. Single purpose storm shelter. "Single purpose storm shelter" means a structure designed for use only as a storm shelter. Statutory Authority: MS s 16B.59 to 16B.73; 326B.02; 326B.101 to 326B.151 History: 12 SR 2251; L 2007 c 140 art 4 s 61; art 13 s 4; L 2008 c 337 s 64; 35 SR 1427 Statutory Authority: MS s 16B.59 to 16B.73; 326B.02; 326B.101 to 326B.151 History: 12 SR 2251; L 2007 c 140 art 4 s 61; art 13 s 4; L 2008 c 337 s 64; 35 SR 1427 1370.0110 SCOPE. Parts 1370.0100 to 1370.0361 apply to buildings or portions of buildings that are designed for use as manufactured home park storm shelters.1370.0130 APPLICABLE REQUIREMENTS. Statutory Authority : MS s 16B.59 to 16B.73; 326B.02; 326B.101 to 326B.151 Subpart 1. Incorporation by reference. "Design and Construction Guidance for 1 Community Shelters," FEMA 361, July 2000, published by the Federal Emergency Management Agency, Washington, D.C., is incorporated by reference except as amended by this chapter, and must be used to determine design loads for designing storm shelters. The document is not subject to frequent change and is available: (1) in the Miimesota State Law Library; (2) from the Printing and Publications Division, Management Agency, P.O. Box 8181, Washington, D.C. 20024; and from the Minnesota Department of Public Safety, Division of Emergency Management, 85 State Capitol, Saint Paul, Minnesota 55155. Statutory Authority: MS s 16B.59 to 16B.73; 326B.02; 326B.101 to 326B.151 History: 12 SR 2251; L 2007 c 140 art 4 s 61; art 13 s 4; L 2008 c 337 s 64; 35 SR 1427 1370.0150 SPACE REQUIREMENTS. A minimum of four square feet per park resident must be provided within a storm shelter. The square footage of the storm shelter is determined by the total number of park residents. The total number of park residents is determined by the park owner, engineer and must be included in plans and specifications required by part 1370.0140. A ceiling height of not less than seven feet must be provided over 60 percent of the floor area. Federal Emergency architect. or professional Subp. 2. Dual purpose storm shelters. A dual purpose storm shelter must comply requirements of the state building code for its other intended uses. with other applicable Statutory Authority: MS s 16B.59 to 16B.73; 326B.02; 326B.101 to 326B.151 History: 12 SR 2251; L 2007 c 140 art 4 s 61; art 13 s 4; L 2008 c 337 s 64; 35 SR 1427 Statutory Authority: MS s 16B.59 to 16B.73; 326B.02; 326B.101 to 326B.151 History: 12 SR 2251; L 1987 c 71 s 2; L 2007 c 140 art 4 s 61; art 13 s 4; L 2008 c 337 s 64; 35 SR 1427 1370.0160 REQUIRED EXITS. Subpart 1. Exits; openings. At least two exits must be provided in compliance with chapter 10 of the International Building Code. The second exit from a single purpose storm shelter may have an opening of at least nine square feet with a minimum of 20 inches in width and the bottom of the opening not more than 44 inches from the floor. 1370.0140 PLANS, SPECIFICATIONS, PERMITS. Storm shelter plans, engineering calculations, diagrams, and other required data must be prepared by an architect or professional engineer licensed according to the Minnesota Board of Architecture, Engineering, Land Subp. 2. Disability access. At least one of the exits must comply with chapter 1341, Minnesota Accessibility Code. Surveying, Architecture, Geoscience, and Interior Design laws and rules. For permit requirements, see chapter 1300. Landscape Subp. 3. Exit to exterior. When a portion of a structure is designed as a 2 1370.0190 [Repealed, 35 SR 1427]storm shelter, one exit must be directly to the exterior of the building or to an exit system complying with the state building code. . f- 1370.0200 ELECTRICAL POWER.f : V-Underground electrical service must be provided to a storm shelter.Statutory Authority: MS s 16B.59 to 16B. 75; 326B.02; 326B.101 to 326B.151 History: 12 SR 2251; 23 SR 2042; L 2005 c 56 s 2; L 2007 c 140 art 4 s 61; art 13 s 4; L 2008 c 337 s 64; 35 SR 1- Statutory Authority: MS s 16B.59 to 16B.73; 326B.101 to 326B.151 History: 12 SR 2251; L 2007 c 140 art 4 s 61; art 13 s 4; L 2008 c 337 s 641427 1370.0210 ILLUMINATION.1370.0170 DRY INTERIOR. Provisions must be made to construct storm shelters outside flood-prone areas and other nonwater ponding areas so that the interior of the storm shelter remains reasonably dry. Subpart 1. Minimum illumination. At least five foot candles of illumination must be provided at floor level inside the storm shelter and at exits. Subp. 2. Source. An emergency lighting system must be supplied from storage batteries or an on-site generator installed in accordance with the requirements of chapter 1315. Statutory Authority: MS s 16B.59 to 16B.73; 326B.02; 326B.101 to 326B.151 History: 12 SR 2251; L 2007 c 140 art 4 s 61; art 13 s 4; L 2008 c 337 s 64; 35 SR 1427 r Statutory Authority: MS s 16B.59 to 16B.73; 326B.02; 326B.101 to 326B.151 History: 12 SR 2251; L 2007 c 140 art 4 s 61; art 13 s 4; L 2008 c 337 s 64; 35 SR 1427 1370.0180 UTILITY LINES. Only utility lines supplying the shelter with electricity, HVAC, plumbing, and , telecommunications may be located in the shelter. The utility lines that supply the shelter must be underground and installed in accordance with the applicable chapter of the Minnesota State Building Code. The shelter must not be located over or under electrical transmission, distribution, or building services lines to other buildings. 1370.0220 [Repealed, 35 SR 1427] 1370.0230 SANITATION FACILITIES AND DRINKING WATER. Sanitation facilities and water for drinking are not required for storm shelters. Statutory Authority: MS s 16B.59 to 16B.73; 326B.02; 326B.101 to 326B.151 History: 12 SR 2251; L 2007 c 140 art 4 s 61; art 13 s 4; L 2008 c 337 s 64; 35 SR 1427 Statutory Authority: MS s 16B.59 to 16B.73; 326B.02; 326B.101 to 326B.151 History: 12 SR 2251; L 2007 c 140 art 4 s 61; art 13 s 4; L 2008 c 337 s 64; 35 SR 1427 3 1. c i; Subp. 7. FEMA 361 Chapter 10. FEMA 361 Chapter 10, Design Commentary, is amended by deleting subsections 10.2.2, Design Wind Speeds for Hurricanes, and 10.2.3, Wind Speeds for Alaska, in their entirety. 1370.0361 FEMA 361. Subpart 1. FEMA 361 Chapter 1. FEMA 361 Chapter 1, Introduction, is deleted in its entirety.i Subp. 2. FEMA 361 Chapter 2. FEMA 361 Chapter 2, Protection Objectives, is deleted in its entirety. Subp. 8. FEMA 361 Appendix A. FEMA 361 Appendix A, Benefit/Cost Analysis Model for Tornado and Hurricane Shelters, is deleted in its entirety. Subp. 3. FEMA 361 Chapter 3. FEMA 361 Chapter 3, Characteristics of Tornadoes and Hurricanes, is amended deleting Hurricanes, and 3.2.3, Typhoons, in their entirety. subsections Subp. 9. FEMA 361 Appendix C. FEMA 361 Appendix C, Case Study I - Stand-Alone Community Shelter (North Carolina), is deleted in its entirety. by 3.2.2, Subp. 4. FEMA 361 Chapter 7. FEMA Chapter Considerations, is amended by deleting section 7.2, Seismic Hazard Conditions, in its entirety. Additional Subp. 10. FEMA 361 Appendix D. FEMA 361 Appendix D, Case Study II - School Shelter Design (Kansas), is deleted in its entirety. 361 7, Subp. 5. FEMA 361 Chapter 8.Statutory Authority: MS s 326B.02; 326B.101 to 326B.151 History: 35 SR 1427A. FEMA 361 Chapter 8, Human Factors Criteria, is amended by deleting section 8.2, Square Footage/Occupancy Requirements, in its entirety. B. FEMA 361 Chapter 8 is amended by deleting Section 8.4, Lighting, in its entirety. C. FEMA Chapter 8 is amended by deleting Section 8.5, Occupancy Duration, in its entirety. D. FEMA Chapter 8 is amended by deleting Section 8.6, Emergency Provisions, in its entirety. Subp. 6. FEMA 361 Chapter 9. FEMA 361 Chapter 9, Emergency Management Considerations, is deleted in its entirety. 4 (^rr\cn) .fdAd^L__ijSUyt^T /^ ___________ fi.m^rnzs. _J<^ FT^^ l __f^oM. fTj; J ________________^/L„„3 ^A (^QCA,boA\\________ .. ......................... (nQh ^TtA/n ^HECrt4S...fA4^ mn^ >4At „ <2 /3k- <l(4d/ /^4? __ .^A ^ JZ^ - ^3LpM^J?2^ Department ofiLAND AND RESOURCE MANAGEMENT OTTER TAIL COUNTY Government Services Center - 540 West Fir Fergus Falls, MN 56537 PH: 216-99S-S095 OTTER Tail County’s Website: www.co.otter-tail.mn.us CLUSTER DEVELOPMENT PRE-APPLICATION MEETING CHECKLIST LpOCe f ^ fpA. Cluster: Lake Number:Lake Name: 1 Siy\A. lAKcTwp. f\^ Rqe. /// Property Owner: fflArJiL Twp Name:Sec. «InWho Attended: Discussion: (Sec. IV. 11.) izf^pen Space 50% Total 25% Unmanicured Wild State yr'^^25% Recreational Facilities va""^pervious Surface _i^:^5% Maximum Annif 3c. Owners Association V0^=*resentation Requirements Land Surveyor, Civil Engineer or Architect Tier Location \/^ Tier Area __»/^re-Plat Requirements (Sec. IV. 10. D.) feT^en^y Calculation Water Frontage ^rea /a'^uffer Zone (Lot Line) 50 Feet Cluster Development - Pre-Application Meeting Checklist Page 2 Private Public Street Parking {y^2 / Dwelling Unit ya^tructure Setbacks Standard Maximum Density Increased Lake Setback Vegetative Screening LH'^egetative Strip ^ 1^ 20’Width 30' Recreational Access j^zT^entralized Sewage Treatment System (Verified by MN Licesned Sewage System Designer) l0"'^Cei^lized Shore Recreation Facilities ! ! _j^ Swimming Area(s) Reduced Visibility (Structures, Parking Area, & Other Facilities) tH^RCU’s C /t ^ ____ Current License ____ Open Deck (200 Ft^ Max.) ____ Storage Structure (20 Ft^ Max. & 6 Ft Max. Height) ^nsiderations (Sec. V. 3.1.) Compatibility Hazards Land Suitability Sensitive Areas t^/Noise tXj-ighting Time^ame / Phasing Existing__^ Dedicated to Project Topographic Alteration Any other possible adverse effects /jS’^rovided copy of SMO [y^Environmental Impact Density/Location Near Shore Depth Parking/Traffic i/' Hours Signage Lot Area & Water Frontage 3/^f n Signature Date PC: Cluster Development Pre-Application Checklist June 2008 N.1. teCEiVED FEB I h 2011 UND & RESOURCE i ! .? V I T1 <I »M?A^7W co^. -S'^c. ^ 7~/J^ -<1-/ ' y 11I1 1I IiI I IIIIDESCRIPTION OF MOBILE CAMP AREA 1 ?n •?'«I <So #1 *(*: _ 1 _ Ji?' ™ |L -i-i! - -• -^.89“^?'/a'"M/. /^O. o ’--------si y/IHo - IPart of Government Lot Four (4) in Section Nine (9), Town ship One Hundred Thirty Five (135) North, Range Forty One (41), West, Otter Tail County, Minnesota, described as follows: '-1-I ' /NII 1 I/f / i */^r.|/i 'll. i !%j .1 '^w 1 , Ha' , '*« LI1 7^I TvM 4o* I I1 1I (40*tHa'j , .H .. . I ... -I■O'- \1!III VCommencing at the North quartei- section corner of said Section 9; thence South 1618.52’feet'along' the quarter sec- tion'line; and then&e West 33.00 feet to the_point of be-- ginning; 1 1-I 1 (V0t7I i*IA '/i I 4ti Iti6 ^\■ !\! If I \k '0^4 --jra *-V, of a.fV ?i-\I• f (i KHiIt!'^..f^<5‘Thence South 89®49'10" 2A5.32 feet; , Thence North 00°10'50" East 295.00 feet; Thence South 89°49'10'’ West 140.00 feet; ' Thence South 00°10'50" West 329.40 feet; Thence South 80^26*00” East 337.55 feet along the North right of way line of a 66.00 foot wide strip of land reserved for road purposes; Thence North 64°30'00" East 58.24'"feet along said road reserve; Thence North 66.64 feet along'said road reserve to the point of beginning. J-Vi ' ?L ' ffl !•£. M. •«- ■; \L a 0VSI ■2 i*0I IV)I.7 INI! i %<I•;V .JI------------ i_0d—I 'i ■{V»1. - -t 0'1II1PAif<<»1 NII(IIIv-vf;II I1 -pg 0)>5J "Pip VI(V.1I I I iII0:1 1 II*^0'L _ j u _iJ „ „ ‘<i t __l _ItA:f I !;1 I,(Containing 1.52 Acres,W.3rv.2.-5*-jr-w.-5. ©y ;!{ ;/3N;% I:1i />v — ^^jr/GA/EU? \ .i\ Ij. . : 1L E D G E N DK ■h.i ■o )/■;l ;I!• Denotes iron mondments fouh^.'5 ;O Denotes iron monuments placeil ( pipe ). Water and efectrical service. Sewer line| to tanks and drainfields. JSCALE 1 inch #50 feet. III \.! ■; ' iySlZH r> The quarter section line shown herein *is assuped to have a bearing of North for discrip- tive purposes. I J y I\7 FRANK’S TRAILER-GAMP SCAUE DRAWN BY/ //VC/Z -STAR LAKE TWP.REVISED GOV. LOT 4 SEC. 9. T.135 N.RANGE 41 WESTKERMIT T. BJORGUM Land Surveyor Box 266 (218) 736-5986 FERGUS FALLS, MINNESOTA 56537 DRAWING NUMBERDATEAPPROVED BY ^-xL-y? AL.BANENE ^ 10 5A55 ARCHITECTS* STANDARD FORMK-E MADE IN U.S.A.#-exirr’<1\h< §h»<J f pra p as ^ ejJ Si^ yi/^, e-xisf/y s > \ I M I N N E S 0 T A I MDHIDEPARTMENTofHEALTHI Protecting, maintaining and improving the health of all Minnesotans February 25, 2011 r % 0, ^OiiJohn and Kathleen Frank 30570 Lodge Loop Dent, Minnesota 56528 Dear Mr. and Ms. Frank: Subject: Food and Beverage Equipment and Lodging at Frank's Lodge and Campground LLC, Dent, Otter Tail County, Minnesota, Plan No. 110386 Thank you for submitting your plans for remodel to the Minnesota Department of Health (MDH). We are enclosing a copy of our report covering an examination of your plans and specifications on the above- designated project. The plan appears to be in general compliance with the standards of this department and has been approved with the following changes and/or comments in the enclosed report. It is the project owner’s responsibility to retain the plans at the project location. Ten working days prior to completion of the project, please contact Mr. David Wroblewski with our Fergus Falls District Office at 218-332-5155 in order to arrange for a final on-site inspection. If you have any questions in regard to the information contained in this report, please contact me at 651/201-5736. Sincerely, Todd Whalen, RS Environmental Health Services Section P.O. Box 64975 St. Paul, Minnesota 55164-0975 todd.whalen@state.mn.us TJW:smp Enclosure Mr. William Kalar, Zoning Administrator Mr. Gary Topp, Plumbing Inspector Mr. Joshua Prussia, Electrical Inspector Mr. Kyle Johnson, MN Department of Health Ms. Sharon Smith, MN Department of Health Mr. David Wroblewski, MN Department of Health cc: General Information: 651-201-5000 • Toll-free: 888-345-0823 • TTY: 651-201-5797 •www.health.state.mn.us An equal opportunity employer MINNESOTA DEPARTMENT OF HEALTH Division of Environmental Health REPORT ON PLANS Plans and specifications on food and beverage equipment: Frank's Lodge and Campground LLC, Plan No. 110386 Location: 30570 Lodge Loop, Dent, Otter Tail County, Minnesota Date Examined: February 25, 2011 Date Received:January 3, 2011 Submitted by: John M. Frank, 30570 Lodge Loop, Dent, Minnesota 56528 Phone#: 218/758-2876 Ownership: John and Kathleen Frank, 30570 Lodge Loop, Dent, Minnesota 56528 Phone#: 218/758-2876 The following are corrections or requests for additional information necessary before construction of your project: Scope of project: Remodel/Addition project at an existing resort/campground Project will consist of: 1. Replacement of three (3) existing cabins with new cabins. 2. Building a new lodge in the same spot where the old one burned down. The new lodge has a cabin located on the lower level as well as a grocery store on the upper level. The proposed plan also included the addition of two new cabins. However, the proposal has not been reviewed or allowed by Otter Tail County. As a result, these cabins are not part of this review. Once zoning approval has been granted, provide it to the plan reviewer to initiate review on the two new cabins. General: All other approvals from local units of government shall be obtained prior to construction beginning. This includes building construction inspections, zoning approvals or other regulatory approvals. Provide a copy of the site permit granted by Ottertail County to the plan reviewer. A separate on-site inspection will be conducted by the State Fire Marshall to determine compliance with Minnesota Fire Code requirements. Contact them directly for submission of plans. Obtain an electrical inspection from the Minnesota Electrical Licensing and Inspections. All electrical systems must comply with the currently adopted edition of the National Electrical Code. Contact Mr. Joshua Prussia, 218-439-3895, for the above inspection. A safe adequate supply of water shall be provided and shall be located, constructed, and operated in accordance with rules governing water supplies. Existing well (s) Provide a certificate of compliance for all septic systems or sewage treatment facilities operated in conjunction with the licensed facility. Provide a certificate of compliance on the existing septic systems associated with the lodge and cabins to the plan reviewer or the inspecting sanitarian, Mr. David Wroblewski during the opening inspection. Frank's Lodge and Campground LLC February 25, 2011 Page 2 Food and Beverage Equipment Plan No. 110386 All plumbing plans shall be approved by the Minnesota Department of Labor and Industry (DOLI) or delegated agent. For information on submittal contact Department of Labor and Industry at 651- 284-5067 or visit their website at http://www.dli.mn.gov/CCLD/Plumbing.asp. Submit plumbing plans to the MN Department of Labor and Industry (DOLI) for review and approval. A separate on-site inspection will be conducted by the State plumbing inspector to determine compliance with the Minnesota Plumbing Code. Contact Mr. Gary Topp, 218-739-7206, for the above inspection. Comply with the Minnesota Clean Indoor Air Act (MCIAA). Grocery Store: Menu will consist of: • Pre-packaged ice • Pre-packaged bottled beverages • Packaged candy • Frozen pre-packaged ice cream bars and pizzas Contact the inspecting sanitarian, Mr. David Wroblewski, for review on this area. Provide information on the equipment for review before purchasing as well as Mr. Wroblewski will need to conduct an onsite evaluation of existing equipment. Lodging: Every building structure, or enclosure shall be kept in good repair and maintained to promote health, comfort, safety and well-being of persons accommodated, shall be kept clean and free of litter or rubbish. 1. Floors shall be smooth, easily cleaned, shall be kept clean and in good repair. Abrasive strips for safety purposes may be used to prevent accidents. 2. Walls and ceilings shall be kept clean and in good repair. Studs, joists, or rafters shall not be left exposed unless suitably finished and kept clean. 3. Every room occupied for sleeping purposes by one person shall contain at least 70 square feet of usable floor space, and eveiy room occupied for sleeping purposes for more than one person shall contain not less than 60 square feet of sable floor space for each occupant thereof. Under no circumstances shall there be less than 400 cubic feet of air space per occupant. Usable floor space excludes closets and bathroom areas. Beds placed side by side must be separated by a minimum of three feet. 4. Replacement cabins (#2,3,4) Each cabin has two sleeping rooms Proposed occupancy for each sleeping room is two (2) guests Proposed square footage (sq. ft.) for each sleeping rooms is 120 sq. ft. Frank's Lodge and Campground LLC February 25, 2011 Page 3 Food and Beverage Equipment Plan No. 110386 Preliminary approval is granted Lodge cabin (one sleeping area) Proposed occupancy for the sleeping room is two (2) guests Proposed square footage (sq. ft.) is 120 sq. ft. Preliminary approval is granted The final determination on the above spacing requirement for all rooms will be made by the inspecting sanitarian, Mr. David Wroblewski, during the opening inspection. When flies, mosquitoes, and other insects are prevalent all outside doors, windows and other openings shall be screened. 5. 6.All equipment, fixtures, furniture and furnishings, including windows, draperies, curtains, carpets, electrical appurtenances, decorative or utility items shall be kept clean and maintained in good order and repair. Toilets and bathrooms shall be kept clean and in good repair and shall be well lighted and ventilated.7. 8.The doors to all toilet rooms serving the public and employee shall be self-closing. 9.Handwashing signs shall be posted in each toilet room used by employees. All lavatories for public use or furnished in guest rooms shall be supplied with hot and cold running water and soap. Approved sanitary towels or warm air devices shall be provided for hand drying. 10. 11.The temperature of hot water which is provided in any public area or guest room, including but not limited to lavatories, bathtubs or showers, shall not exceed 130° F (approximately 55° C). Todd Whalen, RS Environmental Health Services Section P.O. Box 64975 St. Paul, Minnesota 55164-0975 todd.whalen(o)state.mn.us Department of LAND AND RESOURCE MANAGEMENT OTTER TAIL COUNTY Government Services Center - 540 West Fir Fergus Falls, mn 56537 PH: 218-998-8095 Otter Tail County's Website: www.co.otter-tail.mn.us February 24, 2011 John Frank Frank’s Lodge & Campground 30570 Lodge Loop Dent, MN 56528 RE: Replacement Structures (Lodge & 3 Rental Cabins), Star Lake (56-385) Dear Mr. Frank; I have had an opportunity to review the Site Permit Application you submitted to our office on February 14, 2011. From my review, I have many questions regarding your proposal. Since this is the case, I am returning your Site Permit Application, related material (including drawings), and application fee (check #1381 in the amount of $275.00). I would also ask that you contact me (218-998-8095) so that we can schedule a meeting which will hopefully resolve my concerns. Sincerely, d) A/ceVJ Bill Kalar Administrator i ^ Uku, tr WHITE - Office GOLDENROD - Inspector YELLOW-Owner (after issue) LAND & RESOURCE MANAGEMENT, COUNTY OF OTTER TAlb PINK-Assessor GOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS'FAlIis'rMN 56537 218-998-8095 www.co.otter-tail.mn.us APPLICATION FOR SITE PERMIT iRCS’ermit No.PLEASE PRINT OR TYPE ALL INFORMATION LAND^ RANGE TWP NAMETWP NO.LAKE/RIVER CLASS SECTIONLAKE/RIVER NAMELAKE / RIVER NO.Sgc o'? S)fcx y Lci^Ke&0STc<. y lL K C. PARCEL NUMBER (S) CCCC 7cO S? OOO ^c cco Jo o c o f I /I- T ~ ^ PROPERTY (E-911) ADDRESS 3c5 7a /-cJ^c LrcP ^ Ckni ^ fY\pJ ^ ^ i'f7 4^/47 (9cV J~cTS j^'hS mt LEGAL DESCRIPTION Daytime Phone No.Last Name First Initial Mailing Address 7(r3cio '7r. LcJj^e i~cof.Dini n'\N'5L-€i8Fra, n K TYc h n mProperty Owner Contractor Name Lie.# OldfKr Frn'trdcTcy PROPOSED PROJECT (please circle the appropriate number) (1 ) New Dwelling (4 ) MH/YR ( 7 ) Add'n To Non-Dwelling (10 ) Non-Cont. Replacement (identify) MllOHierddenlW Kc plat*& Ac g C "Existing Dwelling to be removed prior to A if V ‘ / n^c/O ONSITE SEWAGE TREATMENT SYSTEM (Permit No. /(^ 9^0? / ( ) OTWMD ‘Must have Sewage System Approval from OTWMD prior to issuing Site Permit. Contact Roltie Mann at 21d-864'5533 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 Garage ( 2 ) Add'n to Dwelling (5) RCU/Year______ (8) Storage Structure ( 9 ) W.O.A.S. CHARACTERISTICS OF PROPOSED W.O.A.S. (WATER ORIENTED ACCESSORY STRUCTURE)CHARACTERISTICS OF PROPOSED DWELLING (Must include Attached Garage) Ft. X Vo Ft." CHARACTERISTICS OF PROPOSED NON-DWELLING Outside Dimension Outside DimensionFt. X Ft." Outside Dimension Sq. Ft. /.3^0 Setback to Lotline /C D Ft. & Setback to Right of Way 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 /(cO 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/Lotfines/Right-cf'Ways Must be Staked Onsite Prior to Application / Inspection Ft."Ft.&Ft."Ft."Ft.& Ft."5c Ft.Ft." Setback to Ordinary High Water Level Elevation Above Ordinary High Water Level /S Ft. Setback to Septic Tank /3C Ft. Setback to Drainfield Ft. Setback to Bluff_____ Total Bedrooms / , Maximum Proposed Height Ft. Roof Change ( ) Yes ( ) No Basement (X)Yes ( ) No Walkout Basement { ) Yes (s/de proWe required) ( ) No Ft. Ft. Ft,Ft. Ft.Ft.Ft. Ft.Ft. Ft.Ft. ( ) Screen Porch ( ) Storage Structure * Must include on scale drawing, additional Permit may be required. Topographical Alteration / Earthmovina □ None ^ 21 Cubic Yards • 299 Cubic Yards'□ 300 Cubic Yards or More'□ 20 Cubic Yards or Less ‘ CHARACTERISTICS OF LOT: V5'o Bluff ( I Yes (X)No . . C07 Sq. Ft.Water Frontage .Ft.Lot Area. .724 Impervious Surface Ratio:X 100 =Total Impervious Surtace Onsite (FT?)Total tot Area (FT?)Impervious Surface Rat© 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. pg. H ■ 10, ac IfDate: Date: Land i Resource Mar^agement Otfice PROJECT(S) TOTAL SQ. FT.,PERMIT FEE $RECEIPT NO. T} ifix (L he. A She.tt'T daiCr<h^.S "Th r. Fat, b i n SComments: lou-.H-ir StezneYr-hJs rF/f _______________________ Form No. BK — 1003-0407 329.5S3 * Victor Lundoan Co.. Printers • Fergus Falls. Minnesota CL\^<SJ£>A. ^Cv'€^ /y^£^cv>^7 ^P?‘^<^7»*<ij!X / L^0<^6 3 (^£^Tr\L €y^ditis L >i^dCLU <U>/^ 4f <^uCS'TU>*^S j (D ^IT^ p£A/^^r fifflrl^l^f^ LJAS h/aT SiC^f^i^ @ LJi^r^C i^T /i/ur*f“ tft\Ptjti\/ii^>^S Si*A^^<S CALC^LAy\^r} + C^PAl>^T Sf^O LAt/€yfA<St Urf\iTS 1^ <Stor/ HIC^uCHTl^^ Vr ‘' /^4Cyi ^a/ ___ 3) SH^^u> ^ l^i$nofC of tS 1 JhB oci> fT^ ___ I [0 aJ^ ^tOK^r <^ ts" 8&>Xi foiU)^a>) R>t irtoArAsu stn^cr^^^ sizsj Jl,CMUM fT*fr^L£>occ ir IF so Ats Tuc'i oPCtJ (^ t^^ Hcor / • \ t ■ ■ ---------------------------------------- /r ^ _^_ Winr rJswrJ L*Ci V'rl Cs) ^ (f r)£^ IS r>rt Fy^4rlSu>J ^toLS LeCdB CMtJ ^) LAtS 0CO4HttJi ? TO ne Q SiR>Acru(te nci<sttT __ 5^- THC FMTir/^ ^sm^<Ti^Fs <a ^ra«v ? + If ^#«r ^ toMT IS Tue Tu£nF'<'^'no‘F fi>A. Tue yeimT e>/^ jyf Pre-Application Site Inspection Request Lake/River Class Twp NameLake / River No. Lake / River Name Section ST STfita. Li< Property (E-911) AddressParcel(s) No. OOOO^ ^oc>o OPS'? ool Loop Property Owner Information; Name(s): Address: Daytime Phone: Type of Request: Bluff:Verify SetbackStake SetbackDetermination OHWL:Verify SetbackDeterminationStake Setback Stringtest: Non-Conforming Repair or Replacement Structure: A Confirm Consistency With Existing Structure Miscellaneous: Describe Request: - D^<S^ynT:tjT‘ OAjnA<TG^ Determination ^JHuCaUat ^ f^/L flj^PiA<£yr\^T A scale drawing must accompany Pre-Application Site Inspection Request & request must be staked onsite DateProperty Owner Received By:Date“ce Management StaffLand & Ri INSPECTION COMPLETED (Inspection must be done within 10 days of receipt): InspectorDate Property Owner NotifiedDate Onsite (Inspector must provide site drawing or field notes on other side.) mbowman Application & Forms Pre-Application Site Insp Request Form10/1/07 T f-Jt) ptAK Top a/ 'fC S>AC* s'.0€ C^fLio^ T« Top B'f I'z" Top 01^ Dtc-< T& Top eoo^ ^ yv's"" Laa*. s,'ciT fSLb yl^iuirjr Cw<(uK OtCt ) 7'V I i ,'r" *:)H 5 T .'t (j)ecvi IIIssSL1 7'u" J>v'-s"- «7 •s5t>< \/fi^ t^g)' (Jfly €.v€-0---Q j-yztTA,'^:>ve^ Uail. Z ‘I A \i P' Ti’ Crop8li' TO ptAlC.to 1 Oec^o.w ^3'4- 6r>- 57- L ^r.' ^ -:■ 1 V*=^ wg^.>-.. "«< ii'- V : mi y^1-.^5Bi‘:f ' , f! iO P-| ?y 10 Li If'JtrJ 4 ■( 09/14/2010 [J)?■> ■4 -"S 4" WHITE - Office GOLDENROD - Inspector YELLOW - Owner (after issue) PINK - /Assessor APPLICATION FOR SITE PERMIT LAND & RESOURCE MANAGEMENT, COUNTY OF OTTER TAIL GOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS FALLS, MN 56537 218-998-8095 www.co.otter-tail.mn.us Permit No.PLEASE PRINT OR TYPE ALL INFORMATION RANGE TWP NAMESECTIONTWP NO.LAKE/RIVER NAME LAKE/RIVER CLASSLAKE / RIVER NO. GO PROPERTY (E-911) ADDRESSPARCEL NUMBER (S) -OC)S'7-Ot>/ LEGAL DESCRIPTION ^ Daytime Phone No.Initial Mailing AddressFirstLast Name Property Owner Contractor Name Lie.#Sa^IC ^0 ^ swage ISystem Approval PROPOSED PROJECT (please circle the appropriate number) (2) Add’n to Dwelling ( 5) RCU/Year______ ( 8) Storage Structure ON^E WATER SUPPLY ^^Individual ( ) Public ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3’ (minimum) structure setback to a well. ONSi: ENT SYS;(3) ‘Replacement Dwelling (6) Attached / Detached Garage (9) W.O.A.S. (1 ) New Dwelling (4) MHA’R (7) Add’n To Non-Dwelling (10) Non-Conf. Replacement (identify). /fT^Other (identifvl '’Existing Dwelling to be removed prior to <A Permit No. ( ) OTWMD 'MusTba frorrt OTWMD prior to issuing Site Permit. Contact Roitie Mann at 218-9^11-5533A-bA- stevve/s -j. CHAF^ISTlCSOFPROPOSa>NO««»|mrjG *J^“S™ScCESSORYSTI>UCTUR Dimension f/? Ft. x 2^ L ?V'( , . 94*®''*® Setback to Lotline fpt>r Ft. & //^T Ft." \ Setback to Lotline ___ Setback to Right of Way Ft." „ ^ , r, i“ Setback to Right of Way Setback to Ordinary High Water Level Uf’P ^ Ft. „ ~ ,^ Setback to Ordinary High Watepftiml __ Elevation Above Ordinary High Water Level Ft. ,... Elevation Above Ordinary fjigh Water Cayel Setback to Septic Tank Ft. Setback to Drainfield J.A-' Ft. „ ui'Setback to Drainfiptfl____ Setback to Bluff ------ Ft. „ , jfj ^ Setback to Bldfl Maximum Proposed Height / *7 Ft. .. / ,. . , ' Maximurw Proposed Height Roof Change ( ) Yes (^ No ' ( ) Boathouse Bathroom Proposed (.Jjj') Yes ( ) No ^ ^ Gazebo **Project/Lotlines/Right-of-ways Must be Staked Onsite Prior to Application / Inspection CHARACTERISTICS OF PROPOSED DWELLINj ,^ust Include Attached Garage) Ouftitje Dimension___ Sq. FtX Setback to Cqhine ___ Setback to Rigtihqf Way Setback to OrdinaryTtiqh Water Le^___ Elevation Above OrdinaryT^igh ^er Level Setback to Septic Tank Setback to Drainfield _ Setback to Bluff____. Total Bedrooms / Ft. X Ft."Ft. X Ft." Ft.&Ft." Ft."Ft.& Ft."Ft. Ft.Ft. Ft.Ft. Ft. Ft.Ft. Ft.Ft.Maximum Prop^d Height Roof Changa Basement / Ft.) Yes ( ) No ^ ) Yes ( ) No Walkout Basement ( ) Yes (side profile required) ( ) No ( ) Screen Porch ( ) Storage Structure * Must include on scale drawing, additional Permit may be required. Topographical Alteration / Earthmovina □ None ^ 20 Cubic Yards or Less * CHARACTERISTICS OF LOT: □ 300 Cubic Yards or More*□ 21 Cubic Yards - 299 Cubic Yards* 4|Bluff ( ) Yes.Ft.Lot Area Water Frontage -2.S— ' Total Lot Area (FT!)impervious Surface Ratio:X100 =.%Impervious Surface RatioTotal Impervious Surface Onsite (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. 1 further agree that any plans and specifications submitted herewith shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express 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. Sj0^ure of Properly Owner / Agent for Owner Date: Date: Land & Resource ManagementPERMIT FEE $ Q ^/‘iX7‘rIMIRECEIPT NO.PROJECT(S) TOTAL SQ.FT., ^ 2. $ 4- ~z- UuUnjr^Comments: Form No. BK — 1003-0407 329,582 • Victor Lundeen Co., Printers • Fergus Falls. Minnesota WHITE - Office APPLICATION FOR SITE PERMIT GOLDENROf?- Inspeclpr YELLOW - 0»«er (after issue) PINK - Assessor LAND & RESOURCE MANAGEMENT, COUNTY OF OTTER TAIL GOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS FALLS, MN 5653 218-998-8095 www.co.otter-tail.mn.us PLEASE PRINT OR TYPE ALL INFORMATION Permit No. LAKE/RIVER NAME LAKE/RIVER CLASS SECTION TWP NO.RANGE TWP NAMELAKE / RIVER NO. c/ PROPERTY (E-911) ADDRESS Log|>_____ PARCEL NUMBER (S) 7 S 7-^ I ^j.ZCeAt^ fJ Y> hi-' '' <2 LEGAL DESCRIPTION Initial Mailing Address Daytime Phone No.Last Name First Property Owner Contractor Name Lie.# ONSITE SEWAGE*T TREATMENT SYSTEM | Permit No. r I j| - ( ) OTWMD 'Must ha<ie ^wage 'System Approval from OTWMD prior to issuing Site Permit. Contact Polite Mann at 218-864-5533 PROPOSED PROJECT (please circle the appropriate number) (2) Add’n to Dwelling (5) RCU/Year______ (8) Storage Structure ON^E WATER SUPPLY ^^Individual ( ) Public { ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3' (minimum) structure . setback to a well. (3) ‘Replacement Dwelling ( 6) Attached / Detached Garage (9) W.O.A.S. (1 ) New Dwelling ( 4) MHA'R ( 7) Add’n To Non-Dwelling (10) Non-Conf. Replacement (identify) _ /ff^ther (identify) .A A ’Existing Dwelling to be removed prior to. / SKqla/C-vs -4-I n 4ql- i- li 1.^-L CHARACTERISTICS OF PROPOSED W.O.A.S. . (WATER ORIENTED ACCESSORY STRUCTURE) utside Itnension CHARACTERISTICS OF PROPOSED DWELLINCT (Must Include Attached Garage) Outside Dimension Sq. Ft. Setback to Co(line ____ Setback to RighTof. Way Setback to Ordinary High Water Le^ CHARACTERISTICS OF PROPOSED NON-DWELLING q Ft.& Y/y r Ft." Outside _ Dimension J/P iZ L> Ft.Ft. XFt.”Ft. X Ft.”Ft. XSa.Ft./^ Setback to Lotline Setback to Right of Way Ft.” Setback to Ordinary High Water Level * Ft. Elevation Above Ordinary High Water Level ^ Ft. Setback to Septic Tank /Z Ft. Setback to Drainfleld 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't‘»rel __ y' \Elevation Above Ordinary High Water Lsyel Setback to Septic TankZ Setback to Drainfiefd____ Setback to Bluff________ Maximum Proposed Height ( ) Boathouse ( ) Gazebo **Project/Lotlines/Right-of-ways Must be Staked Onsite Prior to Application / Inspection fpr^Ft.”Ft.& Ft.”Ft.&**/Ft.”Ft. \ /Elevation Above Ordinary>Hgh Welter Level Setback to Septic Tank '. A. Ft. Ft.Ft. Ft. Setback to Drainfleld Setback to Bluff___ Total Bedrooms ______ Maximum Proppsfed Height \ Ft. Roof Change.f^ ) Yes ( ) No \ Basement { ) Yes ( ) No \ Walkout Basement ( ) Yes (side prolilirequired) ( ) No Ft. Ft.Ft.s Ft.Ft.) V Ft. Ft. ( ) Screen Porch ( ) Storage Structure * Must Include on scale drawing, additional Permit may be required. Topographical Alteration / Earthmovinq □ None □ 20 Cubic Yards or Less *□ 300 Cubic Yards or More*□ 21 Cubic Yards - 299 Cubic Yards* CHARACTERiSTiCS OF LOT: a.'rr>)No.Ft.Bluff ( )YesWater FrontageLot Area. -25 Total Lot Ared (FT!)Impervious Surface Ratio:.%xioo =Impenrious Surface RatioTotal Impervious Surface Onsite (FT!) TH/S /S A SHE 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. /? ' Sifiature of Property Owner /J^gent for Owner Date: - Date; Land & Resource Management PERMIT FEES ~:RECEIPT NO.PROJECT(S) TOTAL SQ.FT, *^1 LGurnTf2- S¥.!Comments: T 0 II i329,562 • Victor Lundeon Co., Printers • Fergus Falls. MinnesotaForm No. BK — 1003-0407 r •• SITE PERMIT INSPECTION RESULTS Inspector must make all measurements and computations Si y—Structure Set Back from Ordinary High Water Level Ft.Ft. Structure Set Back from Top of Bluff Ft. Ft. /OO -7^Structure Set Back from Road Right of Way Ft.Ft. Ft. & S~^ 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 Drainfield Ft.Ft. Elevation Of Lowest Fioor Above Ordinary High Water Level JO ^Ft.Ft. Land Slope at Building Site %% Inspector’s Comments / Sketch: •o ^ 5- ; Inspector's Signaturt Date of Inspection Time of Inspection t^^roject Approve i Date / Initial INDBC OF SHEETS SHEET No.DESCRIPTION 1EXISTING CONDITIONS GENERAL LAYOUT 2 SOUTH ROAD PLAN AND PROHLE 3-4 NORTH ROAD PLAN AND PROFILE 7BOAT SLIP LAYOLIT PROPOSED BATH HOUSE BUILDING a i TIER 7 hW~I'i In:llW""T/1■"'a7/. YA #7 HkyM. tTE' . ---'' 11 Ir ,,__ ^ I A:] r~A'’ » UJI'lER 6 §io 2 I d'yMh TER 5 ■ WjYm:PROPERTY- OF MARY £ PIERRE DuCHARME « 1't!I:i '4;91^V}-li'Ir;-'' V IITIER 4 V/f 'O'300' f' Wi8|| f 7/./ -infkkk Tr GRAPHIC SCALE ■lai <:yy-iM /''■ISK] ui!y\' JfiiDS] ® iaJf'. <a3 ’/. //'.-■ • / • ,' •' ■/.: LEGEND 71 TiU’li APPROXIMATE PROPERTY BOUOL',1 Au-yp- ''QSWs ' ■. v.yyyyiT'iRX'-:. I .n/i CONTOUR UNE TIERBOUNDAmj 1000* SETBACK -----h—8HOREUNE TV LOT UNE •d------i-LOWLANO TREE UNE POWER POLE TELEPHONED OVERHEAD PC BURIED TELH w V GRAVEL RQATSTAR LAKE TRAB. n EXISTING DWi-f DOCKD Systerrades-ign must be to scale and must include the proposed location of the sewage system, all existing/proposed buildings, property lines, the ordinary high water level of the water body, wetlands, bluff and all water wells within 150' of the sewage system. If there are any questions, see the University of Minnesota Site Evaluation worksheets. ^ grid(s) equals feet, or Jnch(es) equals feetScale: MPCA LICENSE #: LICENSE CATEGORY: FIRM NAME: ^^irry ADDRESS: DESIGNED BY:X «■ DATE: SIGNATURE: to 4s --i—i' 1..~T--j-\f-TI ..4.. ...... 't-'i '.r ■ ^ !^4*- • - • • •I iI \ f J<3 ’ LcMvWoic’y__ ___Ji. X. 5^0'b/JoA ^00+klOtSeC^ 0)u-»-f«a ^rtyO OJeM^ ! ■: : ...; ,, L i. (,1/cf ?ov**J BK — 1003 — 029 316.904 • Victor Lundeen Co.. Printars *. Fergus Falls. MN ■ 1-600-346-4670