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HomeMy WebLinkAboutLindy's Lake View Resort_53000990852000_Shoreland Permits_WHITE - Office G OLDENROD- - Jnspector 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 ^73-o3Permit No.APPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED. LAKE / RIVER NO.LAKE/RIVER NAME LAKE/RIVER SECTION TWP NO. RANGE TWP NAME PROPERTY (E-911) ADDRESS |2^5>000W35^00(3 SfcCnO ({u^ UkLt Loop PARCEL NUMBER (S)J^7/ LEGAL DESCRIPTION ;3j- LL\r\dem^nn ArLd/Y LOT! ?,IK I Last Name First Initial Mailing Address Daytime Phone No. Properly Owner Contractor Name Lie.* /Vone_ PROPOSED PROJECT (please circle the appropriate number) (1 ) New Dwelling (4 ) MH/YR (7) Add’n To Non-Dwelling (to) Non-Conf. Replacement (11) Other (identify)_______________ (12 ) Deck______________________ ONSITE WATER SUPPLY ONSITE SEWAGE TREATMENT SYSTEM (-'T Permit No. ( ) OTWMD ‘Must have Sewage System Approval from OTWMD prior to issuing Site Permit. Contact Roltie Mann at 218-864-5533 U( 2) Add’n to Dwelling ( 5) RCU/Year_____ Storage Structure (3) Replacement Dwelling* (6 ) Attached / Detached Garage (9) W.O.A.S. Individual ( ) Public ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3’ (minimum) structure setback to a well. 'Removal of Existing Dwelling Verified by L&R "Existing Non-Conf. Structure Verified by L&R Inspector's Initial/Date Inspector's Initiai/Dale CHARACTERISTICS OF PROPOSED W.O.A.S. (WATER ORIENTED ACCESSORY STRUCTURE) Outside Dimension CHARACTERISTICS OF PROPOSED DWELLING (Must Include Attached Garage) Outside Dimension iY^ty< Ft. x r 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________ Total Bedrooms Maximum Proposed Height Roof Change ( ) Yes ( ) No Basement ( ) Yes ( ) No Walkout Basement ( ) Yes (side profile required) ( ) No CHARACTERISTICS OF PROPOSED NON-DWELLING Outside Dimension ! 0-—Ft. x / jo Ft.**Ft."Ft. X Ft." Sq. Ft. Setback to Lotline Setback to Right of Way Setback to Ordinary High Water Level Elevation Above Ordinary High ^Jgr Level Setback to Septic Tank Ft. Setback to Drainfield Setback to Bluff__ Maximum Proposed Height jC) Ft. Roof Change ( ) Yes ( ) No Bathroom Proposed ( ) Yes 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/Lotllnes/Right-of-ways Must be Staked Onsite Prior to Application / Inspection I'mFt.&Ft."Ft.&Ft."Ft."Ft.&yooFt."Ft.**.Ft."Ft. Ft.Ft.h.Ft.Ft. Ft.Ft.,d f/PO Ft. /V0U Ft. Ft. Ft.Ft. Ft. ( ) Screen Porch ( ) Storage Structure (y5No Tyoqraphical Alteration / Earthmoving ^yg^None □ 20 Cubic Yards or Less * * Must include on scale drawing, additional Permit may be required.□ 21 Cubic Yards - 299 Cubic Yards*□ 300 Cubic Yards or More* CHARACTERISTICS OF LOT: FI. Total Lot Area (FT2) Sq. Ft.Lot Area.Water Frontage Bluff ( ) Yes ( ) No Impervious Surface Ratio:X100 =.%Total Impervious Surface Onsite (R^)Impen/ious 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 8yTtespurce Management office once the building footings have been constructed. Date: aFfA Owru Date: Land & Resourc^Management Officia /L77L9PROJECT(S) TOTAL SQ.FT.PERMIT FEE $RECEIPT NO. f- fcf A//Dale StampComments: p^^ED MAV6/, 2013JUL 2 5 2C13 ..Mf; A PFSO:,!--: ■: L&R Initial^1^51Form No. BK — 04-2013-05 351.158 * Victor Lundeen Co., Printers • Fergus Falls. Minnesota WHIJE-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.APPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED.:: LAKE / RIVER NO._____ TWPNAME039 f\u3h LaICE--' ^ 63000990^5^000 S0C7J Ukic Lxip Ofk^J/iu LAKE/RIVER NAME LAKE/RIVER CLASS SECTION TWP NO.RANGE La.\C€^c^3G3>/ .ds -PARCEL NUMBER (S) PROPERTY (E-911) ADDRESS t LEGAL DESCRIPTION S<-e-i-a^TWp. /3r 6r^e.05‘i Lir'Jfrry^nn LOT) 6,1 K I Last Name First Initial Mailing Address Daytime Phone No. I....latLfAuo If 6o<W ^ r “ Property Owner /iiAi 5^S75 t ij ~n .-44/ i,- Contractor Name Lie.# (\lo/\e^i . PROPOSED PROJECT (please circle the appropriate number) (2 ) Add’n to Dwelling (5J RCU/Year_____ (7) Add’ti To Non-Dwelling ^ ( sjstorage Structure (10) Non-Conf. Replacement (!3enf;^j" _____ (11 ) Other (/denhfy;. . |12)DecK_ ONSITE WATER SUPPLY ly) Individual ( ) Public ( ) None ONSITE SEWAGE TREATMENT SYSTEM /^cf^(1 ) New Dwelling (4) MHA-R____ ( 3) Replacement Dwelling* (6) Attached / Detached Garage (9) W.O.A.S. (v^ Permit No. ( ) OTWMD 'Must have Sewage System Approval from OTWMD prior to issumg Site Permit. Contact Roitie Mann at 218-864-5533 NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3’ (minimum) structure setback to a well. ' ‘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 CHARACTERISTICS OF PROPOSED DWELLING (Must Include Attached Garage) Outside Dimension ( Ft. x Sq. Ft._______ __ Setback to Lotting____ Setback to RightWay Setback to Ordinary High Water Level ___ Elevation Above Ordinary High Water Level Setback to Septic Tank___ Setback to Drainfield____ Setback to Bluff________ Total Bedrooms________ Maximum Proposed Height Roof Change) )Yes T') No ' - Basement ( ) Yes ( ) No Walkout Basement ( ) Yes (side profiie required) { ) No CHARACTERISTICS OF PROPOSED NON-DWELUNG Outside Dimension - Ft. xFt.**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 / Ft. Setback to Drainfield 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 ( .)Screen Porch ( ) Gazebo **Project/Lotlines/Rlght-of-ways Must be Staked Onsite Prior to Application / Inspection -Si, Ft.&Ft.** Ft.&Ft.**Ft;*f ' ^',5 Ft.**Ft. 1Ft.Ft. Ft.Ft.Ft. Ft.Ft.id f/0^ Ft. Ft- Ft.Ft. Setback to Bluff Maximum Proposed Height If) Ft. Roof Change) )Yes (~-)No . ■- Bathroom Proposed ( ) Yes (V) No Ft.Ft. Ft. 3 ( ) Storage Structure Topographical Alteration / Earthmovinq ^d^None □ 20 Cubic Yards or Less * * Must Include on scale drawing, additional Permit may be required.□ 21 Cubic Yards - 299 Cubic Yards*□ 300 Cubic Yards or More* CHARACTERISTICS OF LOT: O 0 'Lj_ Sq. Ft.Lot Area.WateT Frontage Bluff) )Yes ( )No a.iImpervious Surface Ratio:X100 =% tTotal Impervious Surface Onsite (FT!)Total Lot Area (FT')Impervious Surface Ratio 1 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 agr^ to do the proposed work.*n accordance with the description above set forth - and according to the provisions of the Ordinances of Otter Tail County, Minnesota, (.further agree that any plans ahd specifications submitted herewith shall become ^ a part of this permit application. I also understand that this permit is valkJ for a^riod of six (6) months. Permit: Permission is hereby granted to the above named applicant to perforpnhe work described in the above statement. This permit is granted upon express con- dttion 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. 139/3 Date:'--- Si^aturept Pre^Ttf O^pjfr /fjOwm Date: Land & Resourc^Manegement omda Hr- "!PROJECT(S) TOTAL SQ. FT.,PERMIT FEE $RECEIPT NO. ■OjLio I^c/r Comments: i if' ■ - \ V ?i A 'IForm No. BK — 04-2013-05 351,158 • Victor Lundeen Co.. Printors ■ Fargus Falls, Minnesota i - , f f SITE PERMIT INSPECTION RESULTS Inspector must make all measurements and computations Y/J -r3lD0 Ft.Structure Set Back from Ordinary High Water Level Ft. Ft.Ft.Structure Set Back from Top of Bluff Ft.Ft.Structure Set Back from Road Right of Way \d0 Ft.Ft.&Ft.&Ft.Structure Set Back from Lot Lines Ft.Ft.Structure Height I'zpr 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: ; \ r'7 J Inspecloos Signature hIioIi^__ 1 lOate of Inspection ( '20 Time of Inspection 3^oJect Approved. J Steel Siding, Steel Roof, Set on 6x6 Timbers,Cabin 1:26x28,728 s.f.Cabin 2; 28x30,840 s.f.LAKE FROMTACE CALC. 197U72515 = 7.88 RES.NO concrete pad Cabin 3:24x30,720 s.f. TIER jit CALC.05SF/20,000SF - TIER #2 CALC. 50,97X6F/2O,00OSF TIER |3 CALC. 30,3I^/20,OOOSF - 41.0 2.05 RES. X 1.5 - 3.07 I - 2.54 RES. X 1.5 - 3.8 Rl 151 RES. X 2.0 - 35 Rl SCALE DRAWING FORM A QQn^^ ,lOO 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, topographic features (i.e. bluffs), and onsite impervious surface calculations. %Scale Impervious Surface Ratio (Must Complete Worksheet On Other Side) i 4- ■'T .1.. r T ! 4. ; ! t r .1. LT ! ■■ r ■rt 4 1 rr .1 t 1"+• + i Signature of Property Owner Date BK — 0909 33S.&96 • Victo: Lundsen Co. Primers • Fergus Palls. MN * 1.800.346-1870 1 IMPERVIOUS SURFACE CALCULATION WORKSHEET: List of Onsite (Existing and Proposed) Impervious Surfaces (must be shown on scale drawing): Ft2Structure(s): /i/k Ft2Deck(s): di.Ft2Driveway(s): iIal Ft2Patio(s): Ft2' Sidewalk(s): Ak Ft2Stairway(s): Ft2^ Retaining Wall(s): Landscaping: (Plastic Barrier) Other: Allrd Ft2 At Ft2 Ft2TOTAL IMPERVIOUS SURFACE: Ft2LOT AREA: ,07^%X100 = IMPERVIOUS SURFACE RATIOLOT AREATOTAL IMPERVIOUS SURFACE OTTER TAIL COUNTY 6151Grade & Fill Permit ^ &fe.ileAfe IV //-cu/t,!/ Ira Lv-V^_____________ PROPERTY OWNER 3L^TWP. NAME_ l~oT I V X ^ SEC.LAKE NO. LEGAL DESCRIPTION; A.4-Vv. c-T SS , P^\\ o^x'VVn u(b ^ c>io-f rvvv.Wv'-1 ^v.w^(s/, AU VfcL. e. 11 w>-Av>^s ^■^^«vCc/nV . Fm TaV AV> ^ WORK AUTHORIZED 1^ 4 Vfc.^ f^A.Vl\. ^ \q\ccC-.^ ^V-r'^ ^ Se.g. ^V.ifN^ Ck.\V &T<.^c-S<.^ \AA.l/^V l.c.uvyof •vW.o.fs \ce, Tv-Vy. I i iAAt>S't Vfc.^cr ~V^ Q C L«-/^c^V\ Ciyt^^ \ lrVN.YVV.-t. cT U/^.«k.. o<.A+\r«< \.ovV>.r\e^ . /A^\ t~brvc-^^ \AA.v./^S \>^ V/vAjb.s'Ts^wv.VN.^4. c^fK. L>-V K.o\/^g. c.V\ ^ V)cA\^k-cs/V^ c-r~-'' <o oV\<7T\ --------- NOTE: This card shall be placed in a conspicuous place not more than 4 feet above grade on the premises on which work is to be done, & shall be maintained there until completion of such work. NOTIFY LAND & RESOURCE MANAGEMENT, 218-998-8095 WHEN AUTHORIZED WORK HAS BEEN COMPLETED. & 11-MJ1. EARTHMOVING SHALL BE DONE BETWEEN TilYJt 2. Entire area shall be stabilized within 10 days of completion of any earthmoying. 3. Owner is legally responsible for all surface water drainage that may occur. 4. No fill shall enter or be taken from the beds of public water without a valid permit from the MN Department of Natural Resources. If the terms of this permit are violated, the entire permit may be revoked and the owner may j subject to legal prosecution. ^ i^rosion^onj^i^j^Ti^sur^^^^t be Implemented prior to any topographical alterations. APPLICATION FOR GRADE & FILL PERMIT prrFiVED-r’ LAND & RESOURCE MANAGEMENT, COUNTY OF OTTER TAIL ^GOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS FALLS, MN 56537 '^ U2011 218-998-8095 www.co.otter-tail.mn.us - jCCRCE Permit No.PLEASE PRINT.OR TYPE ALL INFORMATION LAKE/RIVER # LAKE/RIVER NAME Lxke^ ___ PARCEL NUMBErI(S) i ^\oac\ LAKE/RIVER CLASS SECTION TWP. NO.RANGE TWP NAME I3S" 03^9.3 PROPERTY (E-911) ADDRESS 3(^070 I -T AAdyv/ / /^bdc / LEGAL DESCRIPTION 3tfc4 7 3 7lu^ -13-7 ^ J Last Name First Initial Mailing Address DAYTIME Phone No, 3>i^e\~Wr\-G 1ct4 P() 6ov 73 ^'^O-lbO-l‘^f7i4Property Owner A 1 S ^ \ f.!^ /29i g-.-______( 37 Contractor Name Lie.# NOTES: 1. The lotlines and project area(s) must be staked. 2. If project disturbs more than 1 acre of land you are required to obtain a General Storm Water Permit from the MPCA.RECEIVED SEEJjLZOIIReceived L&R Official DATE LAND iTFv .'URC" PROJECT REQUEST (You may use the grid on back for required scale drawing): 4) hi ri/rrsO L~n\i)Al <i I Jl 1^<\IAlA ^ V DESCRIBE YOUR PROJECT(S): ** -j^cv.Se. Lctkp _____7 •? ' S" mi\C{}QjiA IMilMAl JCU] IKJifh 3' bfioil io pKVlkPj- nikd-ff/JkOS^/cn DETAILED INFORMATION: AREA TO BE CUT/EXCAVATED:Yds^Ft. X Ft. X Ft. - 27 = Length Width Ave. Depth Yds^WALK-OUT BASEMENT PROJECTS: (Outside of the building foundation) Ft. X Ft. X Ft. - 27 = Length Ave. Depth Ft. X Ft. x_^7iL Ft. - 27 = <7^^ Ave. Depth TOTAL EARTHMOVING REQUESTED = ______ Width 131 Yds^AREA TO BE FILLED/LEVELED: Length Width Yds^ BACKFILL AT FOUND.ATION:Ft.Ft. Max. Depth Distance From Foundation CULVERT:If Yes, must indicate size and location on drawing. Yes No IMPERVIOUS SURFACE:% SIGtslAldRE-OF PFtdPERTyOWNER/AGENT FOR OWNER DATE RECEIPT NUMBER BK02/09 drainfields, lotlines, road righ^nways, e^enients. OHWL^w^, wetlands, topographic features (i.e. bluffs), and onsite impervious surface calcula^^^ ^ f' Scale ^ (fiOxro^’C\ i\j' V«-o>p^r t : <\<L fcS' vi' G1>' 195-' ^10'-^ e. V ^ ^cD“'—^ BK — 0209 336,629 • Victoi Lundeen Co. Primers • Fergus FaUs. MN • 1800-346'4870 09/16/2011 09:16 OTTERTAIL HOME CENTER (FAX)1 2183676025 P.001/001 —<■ . !■S V' W*.—r'V*« -------Hfter^yifc ■\4o •46r irv\^.>+^vl'>©rS3i^r^A(|b / I I N J /V t 1-7-/■ 7'•\i!J y Sir .'■ to«-—cv?f J_l_3i_?!uci^: I1 ^M\ ^•i: \Jr.I b f( I -e ; ■; iV •!II...L,I ■“!' n i_. I !-.)•IIII a j..5 I I ._!.1 I IIir'1 I!-IIII;I i"