HomeMy WebLinkAboutIsle View Resort_39000990350000_Shoreland Permits_APPLICATION FOR SITi PERIRIT
LAND & RESOURCE MANAGEMENT, OTTER TAIL COUNTY (218-998-8095)
121 W. JUNIUS AVE. SUITE 130, FERGUS FALLS, MN 56537
www.co.otter-tail.mn.us
WHITE - Office ,
GOLDENROD - Inspector
YELLOW - Owner (after issue)
PINK - Assessor
Permit No.PLEASE PRINT OR TYPE ALL INFORMATION
TWP NO.RANGE TWP NAMELAKE/RIVER SECTIONLAKE/RIVER NAMELAKE / RIVER NO.
S(mH^ U da /3s- \ I A
PROPERTY (E-911) ADDRESS f ' a79 \){^ -7T2u^
-----39oqqq9<^<3 6 9603LEGAL DESCRIPTION v, I /!■5 Q\kU-^ )-lJL4 >^r\Jizir<La
Daytime Phone No.Mailing AddressFirst InitialLast Name
Qjkvart^ uJProperty
Owner A/p 7±
S’ei^Contractor
Name
Lie.#
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.
PROPOSED PROJECT (please circle the appropriate number)
( 2 ) Add'n to Dwelling
( 5 ) RCU/Year_____
|?^torage Structure
_ 'Existing Dwelling to be removed before.
( 3) ‘Replacement Dwelling
( 6 ) Detached Garage
(9) W.O.A.S.
( t Permit No. / 0 0
( ) OTLSD * This permit is only valid after verification
from the O.T.LS.D. that a conforming
sewage system will be installed to service
this lot contact Rollie Mann at 864-5533.
(t ) New Dwelling
(4 ) MHA'R
(7 ) Add'n To Non-Dwelling
(10 ) Other____________
CHARACTERISTICS OF PROPOSED W.O.A.S.
(WATER ORIENTED ACCESSORY STRUCTURE)
Outside
Dimension
CHARACTERISTICS OF PROPOSED NON-DWELLING
Outside ^ IDimension Ps Ft. x /
Sq. Ft. 9 ^
Setback to Lotllne
Setback to Right of Way
Setback to Ordinary High Water Level
Elevation Above Ordinary High Water Level
Setback to Septic Tank
Setback to Drainfield Ft.
Setback to Bluff N) A- Ft. ^
Maximum Proposed Height ‘ ~7 Ft.
Bathroom Proposed ( )Yes ("^No
CHARACTERISTICS OF PROPOSED DWELLING
Outside
Dimension Ft."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
Basement_____
Walkout Basement
Total Bedrooms_
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____
33aFt."Ft.&Ft.&Ft.”Ft."Ft.&Ft."Ft."Ft."Ft.i Ft.y Ft.Ft.Ft.
Ft.Ft.^ ^ Ft.Ft.Ft.
Ft.Ft.Ft.
Ft.NoYes
Ft.Maximum Proposed Height
( ) Boathouse
( ) Gazebo
**Project/Lotlines/Right-of-ways Must be Staked Onsite Prior to Appiication / inspection
NoYes
( ) Screen Porch
( ) Storage Structure
* Must include on scale drawing
Permit may be required
Topographical Alteration / Earthmovinq
None □ 20 Cubic Yards or Less * □ 21 Cubic Yards - 299 Cubic Yards’□ 300 Cubic Yards or More*
CHARACTERISTICS OF LOT:
9d3S3 -Yes _X^'NoBluffFt.Water Frontage.Sq. Ft.Lot Area.
^ go, 3-S3impervious Surface Ratio:X too =.%
Impervious Surface RatioTotal Impervious Surface Onsite (FT2)Total Lot Area (R^)
THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES.
Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set forth
and according to the provisions of the Ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith shall become
a part of this permit application. I also understand that this permit is valid for a period of six (6) months.
Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express
condition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the 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 & Resouixie M^agement office once the building footings have been constructed.
Date:
Signature of Property Owner
Date:
Land & Resource Management OfficeQh RECEIPT NO.PERMIT FEE $PROJECT(S) TOTAL SQ. FT.
Comments:
313,012 • Victor Lundeen Co., Printers • Fergus Falls, MinnesotaForm No. BK — 0203-0501
APPLICATION FOR SITE PERMIT /
LAND & RESOURCE MANAGEMENT, OTTER TAIL COUNTY (218-998-8095)
121 W. JUNIUS AVE. SUITE 130, FERGUS FALLS, MN 56537
www.co.otter-tail.mn.us
WHITE - Office *GOLDENHOD - Inspector
YELLOJW - Owner (after issue)
PINK - Assessor
EXPIRNo. ^PLEASE PRINT OR TYPE ALL INFORMATION
LAKE/RIVER SECTION TWPNO.RANGE TWP NAMELAKE / RIVER NO.LAKE^IVER NAME
j}\(Ul£slu.nnr2y
PROPERTY (E-911) ADDRESS
,9 //3 79 Vr
9 \ J3t\
PARCEL NUMBER (S) , ■ jlo-h il
A<rh Y ^
<? ff t^arfO'/
_^9g>QCQQ<3<3 6?<1Q3
/ a ^ c3(su-/^h <S^■r>An 9Q f>^A96r0n
LEGAL DESCRIPTION”S r-.A'^A pt (L$ 3 A Ov<L^
Daytime Phone No.Initial Mailing AddressLast Name First
cSr-eg-n Uo\)^/T UJ / 9Ot^'Property
Owner ¥s7j9f^<l(hc^ A/D ^
j-9rContractor
Name
Lie.#
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
PROPOSED PROJECT (please circle the appropriate number)
(2 ) Add’n to Dwelling
(5) RCU/Year______
^S^torage Structure
__ 'Existing Dwelling to be removed before.
(3) 'Replacement Dwelling
(6) Detached Garage
(9) W.O.A.S.
(1 ) New Dwelling
(4) MH/YR
(7 ) Add’n To Non-Dwelling
(10) Other
' -( ) Permit No.
( ) OTLSD * TNs permit is oniy valid after veriUcation
from the O.T.L.S.D. that a conforming
sewage system witt be installed to service
this fot contact Rollie Mann at 864-5533.
CHARACTERISTICS OF PROPOSED W.O.A.S.
(WATER ORIENTED ACCESSORY STRUCTURE)CHARACTERISTICS OF PROPOSED NON-DWELLING
Outside ,
Dimension P’S Ft. x /
Sq. Ft. 9 ^
Setback to Lotline
CHARACTERISTICS OF PROPOSED DWELLING
Outside
Dimension Outside
DimensionFt."Ft. X Ft.”
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
Basement______
Walkout Basement
Total Bedrooms__
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_____
33^Ft.”Ft.&Ft.&Ft.”Ft.”Ft.&Ft.”Ft.”Setback to Right of Way
Setback to Ordinary High Water Level Ft.^Ft.
Ft.”Ft.
Ft.Ft.
Elevation Above Ordinary High Water Level
Ft,
Setback to Drainfield S^O Ft.
Setback to Bluff N) A- Ft.
Maximum Proposed Height
Bathroom Proposed ( ) Yes (^^ No
Ft.Ft.
Setback to Septic TankFt.Ft.
Ft.Ft.Ft.
Ft.iZIr.Yes No
Maximum Proposed Height
( ) Boathouse
( ) Gazebo
**Project/Lotlines/Right-of-ways Must be Staked Onsite Prior to Application / Inspection
Ft.Yes No
( ) Screen Porch
( ) Storage Structure
* Must include on scale drawing
Permit may be required
Topographical Alteration / Earthmovinq
^ None □ 21 Cubic Yards - 299 Cubic Yards*□ 300 Cubic Yards or More*□ 20 Cubic Yards or Less *
CHARACTERISTICS OF LOT:
/6,_Yes y NoBluff.Ft.Sq. Ft. Water Frontage
S"C 7 f QO,iSi
Lot Area.J-
9 .%Impervious Surface Ratio:xioo =
Impervious Surface RatioTotai Lot Area (FT^)Totai 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
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.
I understand that it is my responsibiiity to inform the Land & Resource Management office once the building footings have been constructed.
•y-v- 0 3 i-Date:T
Tty OwnerSignature of
i
Date:
Land S Resource Management Offk^7^./) AQin RECEIPT NO.PERMIT FEE $PROJECT(S) TOTAL SQ. FT.,
Comments:
313,012 • Victor Lundoen Co., Printers • Fergus Falls, MinnesotaForm No. BK — 0203-0501
SITE PERMIT
INSPECTION RESULTS
%
Inspector must make all measurements and computations
loo'^
• 1 ¥
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 luo
Ft. & <17'Ft.Ft.&Ft.Structure Set Back from Lot Lines
/Ft.Ft.Structure Height
Ft.Ft.■IStructure 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:
T f|0^
S-V.I c'
ui I i
tJz.
Inspectors SignatureSi
Date of Inspection
Time of Inspection
^^oject Approved /o 7'0 ?
Date/Initial
OTTER TAIL COUNTY, MINNESOTA4
✓
’O
SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL
COUNTY COURT HOUSE
Phone 218-739-2271 - Fergus Falls, Mn. 56537
APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY
Office
OwnerWhite •Yellow
Pink — AssessorGolde/>rod Tnspector
Permit No.LEGAL jyflA.1 'k?. n 7/Date.DESCRIPTION
AND
LOCATION
1 TWP NameLake No. / Lake Name
CoD B5 W7RangeSec.TWPLake Classif.
IDENTIFICATION: Please Print All Information
Tel. No.Zip No.Mailing Address— No. Street. City and StateFirstInitialLast Name
Owner
NameContractor
Architect Name.
NON-RESID^NTIAL PROPOSED USE:
'/rCi/X_____________
RESIDENTIAL PROPOSED USE;TYPE OF IMPROVEMENT:
Specify:.( ) One Family Dwelling
( LH?Iuitiple Dwelling
( ) New Building
C>
Units
( ) Other Size( ) Other
ESTIMATED COST OF IMPROVEMENT $ / % (90 {omit cents)
DIMENSIONS:
Basement: ( ) Yes
Stories above basement:
Sq. feet (outside dimension)
Bedrooms ....^...................
TYPE OF SEWAGE DISPOSAL:PRINCIPAL TYPE OF FRAME:
^Kmdividual siptic Tank, etc.
WATER SUPPLY:
( ) Public
(L-Kfndividual Well
MECHANICAL EQUIPMENT :
Elevator: ( ) Yes
Air Conditioning: ( ) Yes
( ) Central
( ) Masonry
Frame
( ) Structural Steel
( ) Other — Specify
/.
ME
Baths
HEATING:
i ) Electric
( ) Coal
Other:
( ) Oil( ) Gas
( ) None
Type of Roo(
a ( ) Unit
CHARACTERISTICS;
feet.Water frontage is .
feet. (Building Line)
...............................feet
square feet.Lot Area is...Z£Building set back from high water mark is
Land height above high water mark at building line is
Building set back from State highway is
Side yard is
Building will be located
Building will be located
(bf-
feet.feet — from road or street is
feet.feet. Rear yard is
feet from septic tank (Sewage System Permit must be obtained before installation),
feet from soil absorption system (Cesspool, Drainfield, etc.)._____________________
and
Lg..
.a>..£
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.
IDated.IJ
Signature of Owner
Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon thePermit:
express condition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the ordinances of Otter Tail
County, Minnesota. This permit may be revoked at any time upon violation of said ordinances.
L
jLDated
Shoreiand l\Mnagement Official
State Surcharge $Permit Fee $
Comments:
Form No. MKL-0771-002 1S8899
V1CT9* LUBDCtH 4 CO.. PaiHTCM. fEKtua FM.L4. MthH
SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL
COUNTY COURT HOUSE
Phone 218-739-2271 — Fergus Falls, Mn. 56537
APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY
White — Office
Yellow — Owner
Pink — Ass^i>;or
Goldenrod - Inspector
t
Permit No,,LEGAL
Date.DESCRIPTION
AND
LOCATION
TWP NameTWPRangeSec.Lake Classif.Lake No. Lake Name
IDENTIFICATION: Please Print All Information
Tel. No,Zip No.Mailing Address— No. Street, City and StateFirstInitialLast Name
Owner
NameContractor
Architect Name.
NON-RESIDENTIAL PROPOSED USE:RESIDENTIAL PROPOSED USE:TYPE OF IMPROVEMENT:
Specify:( ) One Family Dwelling
( ) Multiple Dwelling
( ) New Building
( ) Alteration Units
( ) Other Size( ) Other
ESTIMATED COST OF IMPROVEMENT $(omit cents)
DIMENSIONS:TYPE OF SEWAGE DISPOSAL:PRINCIPAL TYPE OF FRAME:
( ) Yes ( ) No( ) Masonry
( ) Wood Frame
( ) Structural Steel
( ) Other — Specify
( ) Public
( ) Individual Septic Tank, etc.
WATER SUPPLY:
( ) Public
( ) Individual Well
MECHANICAL EQUIPMENT :
Elevator: ( ) Yes
Air Conditioning: ( ) Yes
( ) Central
Basement:
Stories above basement:
Sq. feet (outside dimension)
Bedrooms ..............................Baths
HEATING:
( ) Electric
( ) Coal
Other:
( ) Oil( ) Gas
( ) None
( ) NoType of Roof:
( ) No
( ) Unit
CHARACTERISTICS:
feet.square feet.Water frontage is .
feet. (Building Line)
...............................feet
Lot Area 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 is........................
Side yard is....................
Building will be located
Building will be located
feet.feet — from road or street is
feet........................................feet. Rear yard is
feet from septic tank (Sewage System Permit must be obtained before installation),
feet from soil absorption system (Cesspool, Drainfield, etc.).
and
Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set
forth and according to the provisions of the ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith
shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months.
Dated,
Signature of Owner
Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon thePermit:
express condition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the ordinances of Otter Tail
County, Minnesota. This permit may be revoked at any time upon violation of said ordinances.
Dated
Shoreland Management Official
State Surcharge $.Permit Fee $.
Comments;
VSSUEPX iFlCA'i ^
HU
Form No. MKL-0771-002 ,158899
VICTOR LUNOCEH 4 CO.. RRIMTERS. FEROUS FALLS.
INSPECTOR'S CHECK LIST
Make all measurements and computations
ACTUAL
IS X MINIMUM Shall Be 4-Sq. Ft,
Lot Area (Square feet)Sq. Ft.Sq. Ft.
Water Frontage Ft. Ft.
Building Set Back from High Water Mark Ft.Ft.
Building Set Back from State Highway 50 Ft.Ft.
Building Set Back from Street or Road 40 Ft.Ft.
Side Yard &Ft.&Ft.
Rear Yard Ft.Ft.
Occupied Building to Septic Tank 10 Ft.Ft.
Occupied Building to Absorption System 20 Ft.Ft.
Elevation at Building Line above
High Water Mark_____________Ft.3 Ft.
fr frcuInspector's Comments:r.i>\
^ (u. c^ ^ g;X.
/>
Inspector's Signature
Title
Inspection
Dated Cj ~ i^ ''t 19
Agency
VICTOR lUHOeCH t M., RRINTCRt. rCRSUS rM.1.0. HtHN.
r
lalo View Resort
R 5, Box 519
pelican Rapids
m 56572Shore Line Managament
Fergus palle, MN
Gentlemenj
Please note attached photo and drawing of
proposed addition to cabin § 4*
The proposed addition would have same footing*
roof line and same type of end that cabin § 4
has now with same type of siding and construction.
The addition includes two bedrooms attached to
cabin jf 4 as shown in the drawing.
I submit the enclosed for your consideration
and approval and request a permit for this
addition.
We would like to start construction as soon
as possible and have it ready for rent in
May.I
Thank you for your consideration.
Yours truly.
R. W. Hager, Manager
- PH epos CD AOi>ir,}
r
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A—Y f
White - Office
Yellow — Owner
Pink — Assessor
Goldenrod — Inspector
SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL
COUNTY COURT HOUSE
Phone 218-739-2271 — Fergus Falls, Mn. 56537
APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY
/C79Permit No..LEGAL
cXJZ.. / /Date.DESCRIPTION
AND
LOCATION
Cc- -7^7
Lake No. Lake Name " TWP NameLake Classif.Sec.TWP Range
IDENTIFICATION: Please Print All Information
Last Name First Initial Mailing Address— No. Street, City and State Zip No.Tel. No.
(y C.A y j! S s?r?v7 c ^ ^ cOwner
NameContractor
Architect Name.
TYPE OF IMPROVEMENT:RESIDENTIAL PROPOSED USE:
One Family Dwelling
( ) Multiple Dwelling
NON-RESIDENTIAL PROPOSED USE:
^ (Af New Building ^Specify:.
( ) Alteration Units
( ) Other ( )Other Size
ESTIMATED COST OF IMPROVEMENT $ C (omit cents)
PRINCIPAL TYPE OF FRAME:TYPE OF SEWAGE DISPOSAL:DIMENSIONS:
( ) Masonry
Od Wood Frame
( ) Structural Steel
( ) Other — Specify
Basement: ^ Yes ( ) No
Stories above basement: .......
Sq. feet (outside dimension) ....
Bedrooms
( ) Public
Individual Septic Tank, etc.
WATER SUPPLY:
( ) Public
Individual Well
MECHANICAL EQUIPMENT :
Elevator: ( ) Yes
Air Conditioning: ( ) Yes
( ) Central
/
.dfr^.:Z /Baths
HEATING:
00 Electric ( ) Gas
( ) Coal
Other: Y" ^
Type of Roof:(X) No < ) Oil
No ( ) None
( ) Unit
CHARACTERISTICS:
Vo O -F-Lot Area is square feet.Water frontage is .
feet. (Building Line)
...............................feet
feet.
Building set back from high water mark is
Land height above high water mark at building line is
Building set back from State highway is
Side yard is
Building will be located
Building will be located
feet — from road or street is
t!
feet.
9^0 and feet. Rear yard is
feet from septic tank (Sewage System Permit must be obtained before installation),
feet from soil absorption system (Cesspool, Drainfield, etc.).
feet.
Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set
forth and according to the provisions of the ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith
shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months.
X—/IX' ^Ignatu/e of Owner
described in the above statern^^. This permit is granted upon the
? yDated.■tif
Permission is hereby granted to the above named applicant to perform the workPermit:
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.
ft--------------xyrCc V /in y
Shoreland Management Official
Dated
State Surcharge S "PPermit Fee $
7r aomments:
-7
No. MKL-0771-002 ^ vtcfw uMfMtM « w.. pcnaua tm-l*. m«imi.158899
SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL
COUNTY COURT HOUSE
Phone 218-739-2271 - Fergus Falls, Mn. 56537
APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY
White — Office
Yellow — Owner
Pink — Assessor
Goldenrod — Inspector
r*/Permit No„LEGAL
Date.DESCRIPTION
AND
LOCATION
7-v 7 ZJiV'
Lake Classif.Sec.Lake No.Lake Name TWP Range TWP Name
IDENTIFICATION: Please Print All Information
Last Name First Initial IVIailing Address— No. Street, City and State Zip No.Tel. No.
Owner
NameContractor
Architect Name
TYPE OF IMPROVEMENT:RESIDENTIAL PROPOSED USE:NON-RESIDENTIAL PROPOSED USE:
/^ ( ) New Building
( ) Alteration
( ) Other______
( ) One Family Dwelling
( ) Multiple Dwelling
Specify:.
Units
( ) Other Size
ESTIMATED COST OF IMPROVEMENT $ / '(omit cents)
PRINCIPAL TYPE OF FRAME: TYPE OF SEWAGE DISPOSAL:DIMENSIONS:
( ) Masonry
(.a) Wood Frame
( ) Structural Steel
( ) Other — Specify
( ) Public
( ') Individual Septic Tank, etc.
WATER SUPPLY:
( ) Public
( ) Individual Well
MECHANICAL EQUIPMENT :
Elevator: ( ) Yes
Air Conditioning: ( ) Yes
( ) Central
Basement: {v ) Yes ( ) No
Stories above basement:
Sq. feet (outside dimension)
Bedrooms ..............................
/
; ''"y
Baths../
HEATING:
(•V ) Electric
( ) Coal
Other;
Type of Roof: ,( ■) No ( ) Gas
( ) None
( ) Oil'■It-
( ') No/
y - . •( ) Unit
CHARACTERISTICS:
Lot Area is square feet.Water frontage is .
feet. (Building Line)
...............................feet
feet.
Building set back from high water mark is
Land height above high water mark at building line is
Building set back from State highway is......................‘
Side yard is....................
Building will be located
Building will be located
feet — from road or street is feet.
and .......................................feet. Rear yard is
feet from septic tank (Sewage System Permit must be obtained before installation),
feet from soil absorption system (Cesspool, Drainfield, etc.).
feet.
Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set
forth and according to the provisions of the ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith
shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months.
Dated,
Signature of Owner
Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon thePermit:
express condition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the ordinances of Otter Tail
County, Minnesota. This permit may be revoked at any time upon violation of said ordinances.
Dated
Shoreland Management Official
Permit Fee $,State Surcfiarge $.
"T-k'Comments:__1
NOT CALLFH Ff 4-.20-»77
Form No. MKL-0771-002 .158899
Viera* uinaciii a ee..m*«. riiiAui
INSPECTOR'S CHECK LIST
Make all measurements and computations
MINIMUMShall Be 4- Sq. Ft,ACTUAL IS 1
Sq. Ft.Sq. FtLot Area (Square feet)
Ft.Ft.Water Frontage
Ft.Building Set Back from High Water Mark Ft.
50 Ft.Ft.Building Set Back from State Highway
40 Ft.Ft.Building Set Back from Street or Road
Ft.&&Ft.Side Yard
Rear Yard Ft.Ft.
10 Ft.Occupied Building to Septic Tank Ft.
20 Ft.Occupied Building to Absorption System Ft.
Elevation at Building Line above
High Water Mark_____________Ft.3 Ft.
Inspector's Comments:
Inspector's Signature
Title
Inspection
Dated 19
Agency
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WARRANTY DEED
THIS INDENTURE, Made this //, day of 1974 , between
RICHARD L. TAVIS and MARY TAVIS, his Wife, of the County of Champaign
and State of Illinois; GORDON TAVIS, a Single Man, of the County of
Stearns and State of Minnesota; LOUAYNE M. 0'DAY and PATRICK L. O’DAY,
her Husband, of the County of Cass and State of North Dakota; RONALD J.
TAVIS and MARILYN TAVIS, his Wife, of the County of Marion and State
of Indiana, parties of the first part, and CHARLES M. YOUNG and GRACE H.
YOUNG, of the County of Otter Tail and State of Minnesota, parties of
the second part.
WITNESSETH, That the said parties of the first part, in
consideration of the sum of ONE DOLLAR, to them in hand paid by said
parties of the second part, the receipt whereof is hereby acknowledged,
do liereby Grant, Bargain, Sell, and Convey unto the said parties of the
second part as joint tenants and not as tenants in common, their assigns,
the survivor of said parties, and the heirs and assigns of the survivor.
Forever, all the tract or parcel of land lying and being in the County of
Otter Tail and State of Minnesota described as follows, to-wlt;
Lot One (1), South Lida Shores, and all that part of
Government Lot Four (4), Section Nine (9), Township
One Hundred Thirty-Five (135) North, Range Forty-Tv/o
(42) West, Otter Tail County, Minnesota, described as
follows :
Beginning at a point located oh the southerly shore
of South Lake Lida and near the South edge of a Creek
flowing into said South Lake Lida, said point of beginning being located by measuring W. 401 ft. and S. 47°10’ W.
100 Ft. and S, 52°19’ W. 127 Ft. from the N.E. corner
\
/
of said Govt. Lot 4,
42 W. ,
Section 9, Township 135 N., Range
from thence beginning and running S. 32°11’ E.
along a line near the Southerly edge of said creek a
distance of 207 ft.; thence running S. 51°41' W. a distance
of 308 ft.; thence running N. 45 44' W. a distance of
245,5 ft.to the shore of said South Lake Lida; thence running N. 62°24' E. a distance of 192 ft. and N. 52°
19'E. a distance of 173 ft. along the shore of said South
Lake Lida to the Point of beginning and containing 1.7
acres.more or less, to gether with the perpetual right-of-
way and easement for the joint use of an access roadway
as now constructed and running from the public road,
located along the East line of said Govt. Lot 4 to a point
located on the Southeasterly boundary line of the above
described tract of land, said access roadv:ay being located
in Govt. Lot 4, Section 9, Twp. 135 N., Range 42 W. and
described as follows: Beginning at a point 856 ft. So.
of the N.E. corner of said Govt. Lot 4, thence beginning
and describing a center line of a strip of land sixteen
and five-tenths ft. in width and running North 70°2' W.,
a distance of 261 ft.; thence N. 61°2'
of 90 ft.; thence N. 35°58' W.W . , a distance
a distance of 418 ft.,
to a point located on the said Southeasterly boundary
line of the above described tract of land, said point
of termination being located 120 ft. Southwesterly measured
along the Southeasterly boundary line from the N.E. corner
of the above described tract of land.
TO HAVE AND TO HOLD THE SAME, Together with all the heredita
ments and appurtenances thereunto belonging or in anywise appertaining,
to the said parties of the second part, their assigns, the survivor of
said parties, and the heirs and assigns of the survivor. Forever, the
said parties of the second part taking as joint tenants and not as
tenants in common.
BOOKlIi^PAGEJ
• V
BOOKJl— PAGE-^
And the said parties of the first part, for their heirs,
executors and administrators do covenant with the said parties of the
second part, their assigns, the survivor of said parties, and the heirs
and assigns of the survivor, that they are well seized in fee of the
lands and premises aforesaid and have good right to sell and convey the
saiie in manner and form aforesaid, and that the same are free from all
incumbrances,
And the above bargained and granted lands and premises, in the
quiet and peaceable possession of the said parties of the secoTid part,
their assigns, the survivor of said parties, and the heirs and assigns
of the survivor, against all persons lawfully claiming or to claim the
v/hole or any part thereof, subject to incumbrances, if any, hereinbefore
mentioned, the said parties of the first part will Warrant and Defend.
IN TESTIMONY WHEREOF, The said parties of the first part have
hereunto set their hands the day and year first above written.
IN THE PRESENCE OF:
RrCTHARD L. TAVIS v.
GORDON TAVIS
PATRL.CK L. O’DAY
• y
ronaLd j . ^Vis-
cxot>-SMARILV'N TAVX^
STATE OF ILLINOIS )
) ss .
COUNTY OF CHAMPAIGN)
, 1974n-tL day of
tary Public, within and for said County and State, personally appear
ed RICHARD L. TAVIS and MARY TAVIS, his Wife, to me known to be
the person(s) described in, and who executed the f or ego±ng--'i.ns t^r-^um^nt,
and acknowledged that Jthej^ executed the same. ......
On this P-, before me, a No-
1
"Notary Public^
My Commission Expires :
(NOTARIAL SEAL).. \
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