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HomeMy WebLinkAboutGeorge Gerlach Et Al_56000990356000_Shoreland Permits_';hite — Office - Owner Assessor i — ^Inspector SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 — Fergus Falls, Minnesota 56537 APPLICATION FOR SITE PERMIT ■ V Permit No.,LEGAL txXDESCRIPTION AND LOCATION TWP NameRangeTWPLake Classif.Sec.Lake No.Lake Name IDENTtFICATION: Please Print Ail Information Zip No.Tel. No.Mailing Address- No. Street. City and StateLast Name InitialFirst fS ej-yJLacLVAOwner NameContractor Architect Name. NON-RESIDENTIAL PROPOSED USE:TYPE OF IMPROVEMENT:RESIDENTIAL PROPOSED USE: New Building -V-Ci M CioJoJvrcN ( ) One Family Dwelling ( ) Multiple Dwelling Specify: Units( ) Alteration ( ) Other( ) Other Size ESTIMATED COST OF IMPROVEMENT $ PRINCIPAL TYPE OF FRAME:TYPE OF SEWAGE DISPOSAL:DIMENSIONS: ( ) Yes No Stories above basement: ......... ( ) Masonry ( ) Wood Frame ( ) Structural Steel ( ) Other — Specify ( ) Public ( ) Individual Septic Tank, etc. WATER SUPPLY: ( ) Public ( ) Individual Well Basement; Sq. feet (outside dimension) Bedrooms I2- iW: (^aJ3Lr\ Baths ..I__L. Type of Roof: CHARACTERISTICS: .W.fe.feet.Maximum depth of lotsquare feet.Water frontage is feet.Lot Area is t..feet. (Building Line)Building set back from high water mark is....................... Land height above high water mark at building line is Building set back from State highway right of way.... Side yard is 3 feet .3D,feet — from road right of way is feet. ,LO..'.t.pii.and feet. feet from septic tank (Sewage System Permit must be obtained before installation), feet from soil absorption system (Cesspool, Drainfield, etc.). Structure will be located Structure will be located Agreement; I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above se forth and according to the provisions of the ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications/SIJbmitted herewiti shall become a part of this permit application. I also understand that this permit is valid for a period of^x (6) months. THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA ST A TE ST A TUES.of Owrgnafl Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon the express condition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the ordinances of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said ordinances. Permit: OUt. fyfs Shoreland Management Official Dated \3t\ Permit Fee $. Comments; I9S676© i No. MKL-0771-002 VICTOR LU.S'DCEN CO.. PRiNTERS, f-ERCUS FALl.S. MINN. V '•'•^7r " ^9 — Office V — Owner SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 — Fergus Falls, Minnesota 56537 APPLICATION FOR SITE PERMIT Asse^or d Inspector 1 1Permit No..LEGAL V ^ \'^ 0DESCRIPTION cAND LOCATION i IVc i.T ,? y >- TWP NameLake Classif.Sec.TWP RangeLake No.Lake Name IDENTIFICATION: Please Print AM Information Tel. No.Mailing Address— No. Street, City and State Zip No.InitialLast Name First 1 -VAOwner VO Arvr 'ilA NameContractor fArchitectName, TYPE OF IMPROVEMENT:RESIDENTIAL PROPOSED USE:NON-RESIDENTIAL PROPOSED USE: \t.^) New Building ( ) Alteration ( ) Other '( :) One Family Dwelling ( ) Multiple Dwelling Specify:, Units ( ) Other Size ESTIMATED COST OF IMPR0VEMENT|$ PRINCIPAL TYPE OF FRAME;TYPE OF SEWAGE DISPOSAL:DIMENSIONS: '~Tt-( ) Masonry ( ) Wood Frame ( ) Structural Steel ( ) Other — Specify ( ) Public ( ) Individual Septic Tank, etc. WATER SUPPLY: ( ) Public ( ) Individual Well Basement: ( ) Yes ^ ) No Stories above basement: ......... Sq. feet (outside dimension)..... Bedrooms 0 Bathsnr v' ^ ).\\(? ^ lu t’ 1:^0 tjType of Roof: i . CHARACTERISTICS: V-_square feet. Water frontage is Building set back from high water mark is.............................................. Land height above high water mark at building line is..................... Building set back from State highway right of way............................ Side yard is ......................... Structure will be located feet.Maximum depth of lotLot Area is feet. feet. (Building Line) feet feet — from road right of way is ,feet. and feet. ,feet from septic tank (Sewage System Permit must be obtained before installation), feet from soil absorption system (Cesspool, Drainfield, etc ).Structure will be located Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above forth and according to the provisions of the ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewit shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. se THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUES.<ul^\Signature of Own^rV -S' Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon thePermit: express condition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the ordinances of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said ordinances. f N-MDated i*) -Shoreland Management Official (. )NO CERTlFir/.TPermit Fee i Comments: *f 19S676®Form No. MKL-0771-002 VICTOR LUNDGEN CO,. PRiNTC'.rs. FA. LS. MIN'*. INSPECTOR’S CHECK LIST Make all measurements and computations Ih ACTUAL IS 1 MINIMUM Shall Be Sq. Ft. IX, Sq. FtLot Area (Square feet)Sq. Ft.J Water Frontage Ft.Ft. VO* F,.21:Building Set Back from High Water Mark Ft. Building Set Back from State Highway Ft.50 Ft. Building Set Back from Street or Road Ft.40 Ft. Ft.FtSide Yard toRear Yard Ft.Ft. Occupied Building to Septic Tank Ft.10 Ft. Occupied Building to Absorption System Ft.20 Ft. Elevation at Building Line above High Water Mark_____________3 Ft. 3 Ft. Inspector's Comments: 4 Inspector's Signature Title Inspection Dated <r- iS 19 Agency ViCTOt LVHBttN 4 C».. BKIDTEtt. rC««US MIMtl.