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HomeMy WebLinkAboutFranzky_14000180145000_Shoreland Permits_RECEIVED JUL 2 0 2010 GOVERNMENT SERVICES CENTER. 540 WEST FIR, FERGUS FALLS, MN 56537218-998-8095 RECEIVED LAND & RESOURCE 'WHITF,-''Office GOLDENROD - Inspector YELLi>W - Owner (after issue) PINK - Assessor APPLICATION FOR SITE PERMIT LAND & RESOURCE MANAGEMENT, COUNTY OF OTTER TAIL www.co.otter-tail.mn.us JUL 0 2 2010PLEASE PRINT OR TYPE ALL INFORMATION Permit No. LAKE / RIVER NO.LAKE/RIVER NAME LAKE/RIVER CLASS SECTION 13i" TWP NAME I?OEAD LhHf laKiF PARCEL NUMBER (S)PROPERTY (E-911) ADDRESS co4l-Sr- 0 \ LEGAL DESCRIPTION fr GE ^ Last Name First Initial Mailing Address Daytime Phone No. Pal/L 6r?Y ^33 ^ i ^ bo/V A7 0 ■ s'ggS'-yProperty Owner A\ Contractor Name Lie.# PROPOSED PROJECT (please circle the appropriate number) (1 ) New Dwelling (4 ) MH/YR (7 ) Add'n To Non-Dwelling ^0~)‘^n-Cont. Replacement (identify) ________________________ (11) Other (identity) RfePLAoT S~rok/\(-£ ‘^TI^OC-Tu^ C 'Existing Dwelling to be removed prior to________________________________ ONSITE WATER SUPPLY Public ( ) None ONSITE SEWAGE TREATMENT SYSTEM(2) Add’n to Dwelling ( 5) RCU/Year_____ (8) Storage Structure ( 3) 'Replacement Dwelling (6) Attached / Detached Garage (9) )«.O.A.S. ( ) Individual NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3’ (minimum) structure setback to a well. Permit No. ( ) OTWMD ‘Must have Sewage System Approval from OTWMD prior to issuing Site Permit. Contact Roilie Mann at 218-864-5533 V.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. Setback to Lotline ___ Setback to Right of Way Setback to Ordinary High Water L^l ___ Elevation Above Ordinary HiolYWater Level Setback to Septic Tank A Setback to Draintieldx Setback to Bluff ✓ Total Bedroopre Maximutn/^oposed Height Roof Omnge ( ) Yes ( ) No Bag^ient ( ) Yes ( ) No 'Walkout Basement ( ) Yes (side profile required) { ) No CHARACTERISTICS OF PROPOSED NON-DWELLING Outside Dimension So Ft 200 Setback to Lotline J O A Ft. & /OA Ft." Setback to Right of Way A Ft." Setback to Ordinary High Water Level izJkFt. X Ft,"Ft. X T."Ft. X Ft." Sq. Ft. \ Setback to Lotline Setback to Right of Way Setback to Ordinary High WafctLevel Elevation Above Ordinary High W^r 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,&Ft." Ft.&Ft."1." JcP ' Ft.Ft."Ft. Ft.Ft. Elevation Above Ordinary High Water Level ?eptie4ank tO-h Ft. Ft.Ft.Ft. Setback to Setback to-Dialiifleig' —Fb Ft. Ft. Ft. Setback to Bluff ’ ~ Ft. ^ Maximum Proposed Height ^ Ft. Roof Change ( )Yes Bathroom Proposed ( ) Yes Ft.Ft. Ft. ( ) Screen Porch ( ) Storage Structure Topographical Alteration / Earthmovinq 01 None □ 20 Cubic Yards or Less ' □ 21 Cubic Yards ■ 299 Cubic Yards' ' Must include on scale drawing, additional Permit may be required.□ 300 Cubic Yards or More* CHARACTERISTICS OF LOT: Bluff ( )Yes ^;>4noWater Frontage 0Lot Area.• Ft..Ft. Impervious Surface Ratio:X100 =Total Impervious Surface Onsite (FT')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 tor 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. ‘\P" 3 o - ^ (7 t oDate: Signature of Property Owner / Agen^>wner Date: Land & Resource ManagementJQOPROJECT(S) TOTAL SQ. FT.PERMIT FEE $RECEIPT NO. STAucT/j^l:/? c ct^iAj iTI\ X IA- StRucJ-qAc To Comments: u> (TK /^ 'Eo I^ P ’tTr^U^ l\ I &r l\ Uh A LL ^ ‘A IS <E-A~Ti s> h L f) uc^7~u ______________ !r>M /H A _____________________________________________ Form No. BK — 1003-0407 329,582 • Victor Lundeen Co., Printers • Fergus Falls. Minnesota •'•Cl. r«•^Hlfe^OWce 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 YELl^W - Oititer (after issue) PINK - Assessor ■f ‘ PLEASE PRINT OR TYPE ALL INFORMATION Permit No. LAKE/RIVER NAME LAKE/RIVER CLASS SECTION TWP NO.RANGE TWPNAMELAKE / RIVER NO.t i135"I ‘yJL- /\ Kfp /' A D 1I \PARCEL NUMBER (S)PROPERTY (E-911) ADDRESS ' CC I'-'C l^jirroi Co4fJr LEGAL DESCRIPTION / Last Name First Initial Mailing Address Daytime Phone No. H.Property Owner 5 4^5. V -1#r Tv-f'"5. S<5^/ T-4 Contractor Name Lie.# PROPOSED PROJECT (please circle the appropriate number) (1 ) New Dwelling (4 ) MH/YR_______ (7) Add’n To Non-Dwelling ({^) Nbn-Conf. Replacement (identify) _ (11) Other fidentitvl ’ ' ■ ‘Existing Dwelling to be removed prior to 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 Permit No. ( ) OTWMD 'Must have Sewage System Approval from OTWMD prior to issuing Site Permit. Contact Rotlie Mann at 218-S64-5533 1(2) Add’n to Dwelling (5) RCUA'ear_____ (8) Storage Structure ( 3) "Replacement Dwelling ( 6) Attached / Detached Garage (9) W.O.A.S. J CHARACTERISTICS OF PROPOSED W.O.A.S. (WATER ORIENTED ACCESSORY STRUCTURE)CHARACTERISTICS OF PROPOSED DWELLING (Must Include Attached Garage) / Outside Dimension Sq. Ft. Setback to Lotline Setback to Right of Way _ Setback to Ordinary High Water Elevation Above Ordinary Hi Setback to Septic Tank y Setback to Draintieldx Setback to Bluff X Total Bedrooms________ Maximury*roposed Height Roof9f(ange( )Yes ( )No Bas^ient ( ) Yes ( ) No "Walkout Basement ( ) Yes (side profile required) ( ) No CHARACTERISTICS OF PRQPOSED NON-DWELLING Outside Dimension Sq. Ft. 7 -^0 Setback to Lotline / O i Ft. & /O Z- Ft.” Setback to Right of Way O f- Ft.” ^ Setback to Ordinary High Water Level L?dr** pt. Elevatiorr'AbovaOrdinary Hi^ Water Levek‘ F^ Setback to Se^ Tank Jo*~ Ft. Setback to Drainfieia~~y 6 Z— -ftr- Setback to Bluff ~~ Ft. , Maximum Proposed Height ^ Roof Change ( )Yes ( Bathroom Proposed ( ) Yes (^p>4^o h Outside\ DimensionFt.”Ft. X ■t." Ft. X Ft." Sq. Ft._______\ Setback to Lotline \ Setback to Right of Way Setback to Ordinary High Watbi;^evel ___ Elevation Above Ordinary High Wa^r Leve^ Setback to Septic Tank__ Setback to Drainfield____ Setback to Bluff________ Maximum Proposed Height ( ) Boathouse ( ) Gazebo **ProjectA.otlines/Right-of-ways Must be Staked Onsite Prior to Application / Inspection Ft.&Ft.” Ft.&Ft." /ater Lgllel Iralrwater Ft."Ft. ater Level Ft.Ft. 7 "-^ » ■jFt. 'Ft. Ft.1Fh Ft. Ft.7 Ft.Ft.Ft.Ft. ( ) Screen Porch ( ) Storage Structure i j Topographical Alteration / Earthmoving □ None * Must include on scale drawing, additional Permit may be required. ■'! 1□ 21 Cubic Yards - 299 Cubic Yards*□ 20 Cubic Yards or Less *□ 300 Cubic Yards or More* CHARACTERiSTiCS OF LOT: ^ . I / W- '-'-Sq. Ft. .1 i >2Lq 0 A Bluff ( )Yes (;;,4!NoLot Area,Water Frontage .Ft. Impervious Surface Ratio:T X100 =.% Total Impervious Surface Onsite (FT:)Total Lot Area (FT')Impen/lous Surface Ratio THIS 1$ 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: Signature of Property Owner / AgenUorOwner^ Date: Land & Resource Management Offlpe^^PERMIT FEE $ JG \" -----loo J vva.. /PROJECT(S) TOTAL SQ. FT.,RECEIPT NO. S'/Hc-Ki-fior 5T^'<Jr-7/j£i~ Lu iTk P r :!)- F-F' 4 -- r, /D- t-.TfL rrrf-^ L nr Z' 1! frfii'—S 7/<[ ’ rjjj c:------- 7 .0 Comments: ■ I ’ (7 ^ i r tr h 'f <TIt. f Lj-JIT—ZJ-LL—Z.i /V-^ r-I '~p'"h / r o rcy r )/ .V. .■// > // Form No. BK — 1003-0407 329,562 • Victor Lundeen Co., Printers • Fergus Falls, Minnesota A ■ A I * • SITE PERMIT INSPECTION RESULTS Inspector must make all measurements and computations f 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. .Septic TankStructure Set Back from Ft.Ft. Structure Set Back from Drainfield Ft.Ft. Elevation Of Lowest Floor Above Ordinary High Water Level J?Ft.Ft. Land Slope at Building Site %% Inspectors Comments / Sketch: \ \ 'f L\ Inspector’s Signature\ D Date of Inspection Time of Inspection trProject Approved__ Date / Initial ^ RF^fTT/T^ JUL 2 0 2010 land & RESOURCE • -j?. I'j-s-1 - ■ “■ ... ■ rS'■k—.-------'T.v-a ■ ' T ■.‘^...,.-^iJ.>^ ■■- ■. ■-?-•...'i- I rr. v - "4.- ^ -pt •-f-r I "l‘,^T %T' V-- \-1 ■ ^y i -’fl ■iII -J-Jj, : M.r 1 y- .1 \f».* THE FOLLOW! MOL STATEMENTS ARE RELATtVE* TQi THE LINES IDENTIFIED BY LETTERS ON THE DRAWING. THIS IS WE SEPARATION OF BOUNDARY LINE LOCATIONS AS WE FIND THEM ON THE GROUND. THERE ARE SOME A!j©I GUI TIES IN THE LEGAL LAND DESCRIPTIONS OF THE BOUNDARIES IN THIS AREA. PER THESE LINES WE ARE ATTEMPTINC TO CORRELATE THE INTENT OF THE LEGAL LAND DESCRIPTIONS AS SHOWN ON DEEDS OF RECORD. THE LINE IDENTIFICATION WOULD BE AS FOLLOWS: (A)THE APPARENT ACCEPTED LOCATION! OF THE LINE STATED AS BEING THE SEPARATION BETWEEN THE EAST AND WEST i OF SUBLOT 2 (B)A POSSIBLE SEPARATION LINE OF EAST AND WEST i OF SUBLOT 2 (C)SOUTHERLY LINE OF TRACT DESCRIBED IN A CERTAIN DEED DATED OCTOBER 11. 1962 AS DEEDED TO PAUL B, FISHER AND ROSE MONSON (D)THE SOUTHERLY LINE OF THE RIGHT-OF-WAY OF THE OLD COUNTY HIGHWAY AS BEST THAT CAM BE DETERMINED AT TWM T I im^ SCALE DRAWING FORM RECEIVED JUL 2 0 2010 R / 1^0 /^/.^ LAND & khbOURCETax Parcel Number(s) The scale drawing must be a signed drawing which inciudes and identifies a graphic scale (feet), all existing and/or proposed structures, septic tanks, drainfields, lotlines, road right-of-ways, easements, OHWLs, weils, wetlands, topographic features (i.e. biuffs), and onsite impervious surface caiculations. /// L %Scale Impervious Surface Ratio (Must Complete Worksheet On Other Side) 1-^ <2 cO m< kj \ T Si"a- ^r»o iy\c I-L V)-i\7^;kTi U) I is 0 t3>VC PA<? Pc’S c is 5/m?0 L/ Vfc t DateSignature of Property Owner BK — 0909 338,596 • Victor Lundeen Co. Printers * Fergus Falls. MN * 1-800-346-4870 y TP pfi,vi~ Oft V ftvfci£ Qo«*'i D dTfrt Ki^io^ <r««t C.i’Nie// 6c; A If, w- '>' «a.'l " ■ SSOl\ r~i£^^ C-Wks fArt APm ffS'lW 33Ro -fetet=S:*=£»i m7a O'mmo« . MAV5, Sc «•»/, Wo?r M <Li'stoN N.£>5-70^y O 1^0 m . (=2 0 33 OO m O y ,,,55^ 'tfyv;6u/L^a:3^|^ t) ^lAcfc. •hr/H - 7tAv4 torf itiES.>UoH7 u;/ rTAf»6^_yn ; Ri4«-r - fr»W- 1 ^4.TA«k=>-' , 'I 4to"' ' OHU) D*^ '-*'• 6/\St /.V D\IWcA-b'nj LejAl is^' -^Xr 21/ SC+IAc^ D€aJ “'■■ Z S,F,^'7V VJdUN-^/dAit'^y CX)35 c(rA*u?Ki f by ^•^• Wc>r+{\