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OTTER TAIL COUNTY
Land & Resource Management
Phone (218) 998-8095
SITE AND LOT ALTERATION PERMIT NUMBER 30457
PERMIT (COMBINED)
PERMIT TYPE
Robert & Anita MeisenheimerPROPERTY OWNER
StuartLAKE INFORMATION
91 ADNR ID(S)
LOCATION
Parcel(s): 41000030019007
Township Name: Nidaros Township
Property Address{es): 21244 GREENHEAD DR
Section/Township/Range: Sect-03 Twp-132 Range-039
Legal: PART GL 8 COM SW COR SEC 3 S 87 DEG E 1246’ N 38 DEG E957.8' N 16 DEG E 819.65'
S73
WORK AUTHORIZED
Construct a 30x56 replacement dwelling and 30x40 storage building onsite.
Excavate basement for 1680sqft dwelling (30x56x7) Back fill around foundation 6 inches and taper out
10 feet to existing grade. Level/fill area for a 1200sqft storage building and back fill around building
and taper out to existing grade. Top dress, seed and stabilize disturbed areas. Must control and store
water run off. Any excess fill material to be hauled off site.
Eric Babolian 05/21/2019 10:26 AM
73140b64721867520d224c92bc7a75a3
873a02b8bea38979057b178751adef4d 05/21/202105/21/2019
ISSUE DATE DATE EXPIRESLand and Resource Management Official/Date
NOTE:
• 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 may be revoked and the owner/contractor
may be 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.
• Notify Land & Resource Management when building footings/foundation have been completed
and/or when work authorized is complete and ready for inspection (218) 998-8095.
5/4/2020https://onegov.co.ottertail.mn.us/admst/viewcard.php?card=5&app=5650
https://onegov.co.ottertail.mn.us/admst/viewcard.php?card=5&ap...
OTTER TAIL COUNTY
Land & Resource Management
Phone (218) 998-8095
i
PERMIT NUMBERPERMIT TYPE Site and Lot Alteration Permit
(combined)_____________
30457
PROPERTY OWNER Robert & Anita Meisenheimer
LAKE INFORMATION Stuart
DNR ID(S)191
LOCATION
Parcel(s): 41000030019007
Township Name: Nidaros Township
Property Address(es): 21244 GREENHEAD DR
Section/Township/Range: Sect-03 Twp-132 Range-039
Legal: PART GL 8 COM SW COR SEC 3 S 87 DEG E 1246' N 38 DEG E957.8' N 16 DEG E 819.65' S 73
WORK AUTHORIZED
Construct a 30x56 replacement dwelling and 30x40 storage building onsite.
Excavate basement for 1680sqft dwelling (30x56x7) Back fill around foundation 6 inches and taper out 10 feet to
existing grade. Level/fill area for a 1200sqft storage building and back fill around building and taper out to existing
grade. Top dress, seed and stabilize disturbed areas. Must control and store water run off. Any excess fill material to
be hauled off site.
Eric Babolian 05/21/2pi9 10:26 AM
73140b64721867520.d224c92bc7a75a3
873a02b8bea38979057b178751adef4d 05/21/2019 05/21/2020r
Land and Resource Management Official/Date DATE EXPIRESISSUE DATE
NOTE:
• 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 may be revoked and the owner/contractor may be 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.
• Notify Land & Resource Management when building footings/foundation have been completed and/or when work
authorized is complete and ready for inspection (218) 998-8095.
:
1
1
I'ofl 5/21/2019, 10:27 AM
https://onegov.co.ottertail.mn.us/view.php?id=5650#outer_wrapper, Land & Resource Perfnit Applications
,■I Land & Resource Management
Government Services Center
1 540 Fir Avenue West
Fergus FaUs MN 56537
OTT£ll TAli 218-998-8095
o e a DTT-fflI a a•IOT a
I
Site Permit Appiications Sjte and Lot Aiteration Permit (combined) Permit # 30457, App. # 797, UiD # 5650
Valid; 05/21/2019 - 05/21/2020I
Applicant Information
Applicant Information:Name:
Brian Richard Brogard
Phone:
(218 )583 -2041
Email Address
brogardplbg@riotmail.com
Mailing Address
306 Industrial Dr
PO Box 336!
Henning MN 56551
i
I am trie:Agent/Designer
Property Owner's Contact Information
Property Owner Contact Information:Name:
Robert and Anita Meisenheimeri
Phono:
(218 ) 864 - 5803
Email Address
mallardbavresort1@yahoo.com
Mailing Address'
21244 Greenhead dr.t
githerall ^ 56524
Work Performed By (Site Permit)
Work to be performed by
(Site Permit):
Property Owner
Work Performed Bv (liot Alteration Permit)
Work to be Performed by
(Lot Alteration):
Contractor
Contractor's Contact information (Lot Alteration)
Contractor Information:Name:
Brian Richard Brogard
Company or Busnese Name:
Brogard Plumbing & Heating
Contractor License Number
060456PM
Phone:
Additional Phone:
;(218 ) 583 - 2041 (Z^ )579 -0469
Email:
brogardplbg@hotmail.com
Address
(
306 Industrial Dr
PO Box 336
Henning MN 56551
Property Informationi
Project
Location:Property Attiibutea Property Address Legal Description Primary Name/Address
Parcel;#Primary Address Line 1 CityProperty Address City Legal Description Legal Description Legal Description Name
41000030019007 21244
GREENHEAD DR
CLITHERALL 957.8' N 16 DEG E
819.65’S 73
ROBERTS
ANITA
MEISENHEIMER
21244 GREENHEAD DR CLITHERALLPART GL 8 COM
SW COR SEC 3S
87 DEG E 1246' N
38 DEG E
Lot Area:154748 Square Feet
Is the property
Developed or Undeveloped?
Developed
;
L&R Cert, of Compliance within 5yrs.On Site Sewage
Treatment
System:
i
i
Onsite Water Individual Supply:
1 of 4 5/21/2019, 10:27 AM
https;//onegov.co.ottertail.mn.us/view.php?id=5650#outer_wrapperLand & Resource Perinit Applications
I
Shoreland Information i
Associated Lakes:
Lake Name DNR ID Lake Class LR CD!I Stuart 191 RD 56-191
Stuart.191/rdRiver/Stream Name and
Classification (I.e. Otter Tail / AG):
Water Frontage:581 Feet
Bluff:NO
Proposed Project (Site!
Proposed Dwelling:Single Family
Is there an Attached Garage?^2:
Proposed Non-Dwelling:Storage ShedNone
Proposed Water Oriented
Accessory Structure:
None
Please list outside dimensions (iri
feet) i
of above items you are applying fipr:
30x56 home
30x40 storage shed
Ctiaracterlstics of Proposed Dwelling
New or Replacement:Replacement
1
Square Feet:1680 Square Feet
20 Feet
200 Feet
i
Maximum Proposed Height:
Setback to Lot Lines
(indicate (2) closest lot lines)::200 Feet
Setback to Right of Way:150 Feet
Setback to Ordinary High Water Level:110 Feet
!
Setback to Septic Tank:12 Feet
^ Feet
0 Feet
Elevation abo\e Ordinary High Water ^ Feet
Level: ‘ '
Total Bedrooms:
Roof Change:
t
Setback to Drainfield:
Setback to Bluff
(3
Characteristics of Proposed Storage Shed
Square Feet: 1200 Square Feet
20 Feet
50 Feet
i 1
;Maximum Proposed Height:
Setback to Lot Lines
(indicate (2) closest lot lines):
400-*- Feet
Setback to Right of Way: i
Setback to Ordinary High Waterj 110 Feet
Lewi: ^
Elevation above Ordinary High Water 10 Feet Level:
Setback to Septic Tank:
Setback to Oainfield:
125 Feet
;
100-*- to nearest tank Feet
175+ to nearest drainfield Feet
Setback to Bluff:0 FeetI
Roof Change:NoI
Bathroom Proposed:
Proposed Project (Lot Alteration!
Project Type:0!!Project Description:Demo old house and replace with new one. Dig basement and haul fill
to location on lot for fill for shed.
Foundation Type:Basement
Area to be Cut/Excav'ated
56 Feet Width:Length:^ Feet Average Depth:436 Please Describe
Cut/Excavated Area:
this is
new
basement
7 Feet Total Cubic Yards:!
0 Feet Width:Length:0 Feet Average Depth:0 Feet Total Cubic Yards:0 0 FeetLength:
|Ca1t!suai>|
0 Feet Average Depth:Width:0 Feet Total Cubic Yards:0
Walk-Out Basement Project
iLength:g Feet Width:0 Feet Average Depth:g Feet Total Cubic Yards:0
Area to be filled/Leveled
80 Feet Width:Length:60 Feet Average Depth:2 Feet Total Cubic Yards:356 Please Describe
Filled/Leveled Area:
low
area
to befilled
for
shed
g Feet Width:Length:g Feet Average Depth:g Feet Total Cubic Yards:0 Length:0 Feet
Width:g Feet Average Depth:0 Feet Total Cubic Yards:0
tCalcufctte.j
Backfill at Foundation
Linear Length:172 Feet Average Width:^ Feet Average Depth:^ Feet Backfill Total:32
|Cat«W»rtaj
2 of 4 5/21/2019, 10:27 AM
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I https://onegov.co.ottertail.mn.us/view.php?id=5650#outer_wrapperLand & Resource Permit Applications
I
Culvert and Road Authority
Culvert?m
Road Authority Approve!;N/A
Impervious Surface ■ Buildings
1680 Square Feet0 Square Feet
0 Square Feet
Detached Garage Existing: \ 0 Square Feet
400 Square Feet
Water Oriented Accessory Staicture 0 Square Feet
Existing: ^
Recreational Camping Unit Existlrig: 0 Square Feet
Dwelling Proposed;Dwelling Existing:
Attached Garage Existing; Attached Garage Proposed: 0 Square Feet
0 Square Feet
1200 Square Feet
Water Oriented Accessory Stnjcture 0 Square Feet Proposed:
Recreational Camping Unit
Proposed:
Miscellaneous Proposed:
Detached Garage Proposed;
Storage Shed Existing:Storage Shed Proposed:
0 Square Feeti
;
0 Square Feet
Total Building Proposed impervious: 2880 Square Feet
Miscellaneous Existing:0 Square Feet
Total Building Existing Imperv/ious: 4^ Square Feet [
Impervious Surface Calculation ■ Buildings
Total Building Existing ImpenAous: ^ Square Feeti
Total Building Proposed Impervious: 2880 Square Feet
Total Building Impervious Surface:- 3280 Square Feet right
154748 Square FeetLot Area:
Impervious Sur^ce Ratio;
Buildings Impervious Surfece 2.12 %Percentage:
0.0212
Impervious Surface - Other!Deck(s) Existing:0 Square Feet
0 Square Feet
0 Square Feet
0 Square Feet
3000 Square Feet
600 Square Feet
0 Square Feet
0 Square Feet
0 Square Feet
3800 Square Feet
Deck(s) Proposed: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
1
Patio(s) Existing:Patio(s) Proposed:
Sidewalk(s) Existing:
Landing(s) Existing:
Driveway(s) Existing:
Parking Area(s) Existing;
SidevAetk(s) Proposed;
Landing(s) Proposed:
Driveway(s) Proposed;
Parking Area(s) Proposed:I
Retaining Wall(s) Existing;Retaining Wall(s) Proposed:
iLandscaping Existing:
Miscellaneous Existing:
Other Existing Total:
Landscaping Proposed:I
Miscellaneous Proposed:
Other Proposed Total:
Impervious Surface Calculation - Buildings & Other
Total Building + Other Existing ;
Impervious; '
4200 Square Feet
Total Building + Other Proposed ! 2880 Square FeetImpervious:
Total Building + Other Impervious 7080 Square Feet Surface:
Lot Area:154748 Square FeetI
Building + Other Impervious Sur^ce 0.0458 Ratio:
Building + Other Impervious Sur^ce 4.58 % Percentage:
Shore Impact Zone Impervious
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) 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
5200 Square Feet
5200 Square Feet
Building(s) Proposed:
Deck(s) Existing:Deck(s) Proposed:I
Patio(s) Existing:Patio(s) Proposed:
Sidewalk(s) Exisiting:
Landing(s) Existing;
Sidewalks(s) Proposed:
:Landing(s) Proposed;
Driveway(s) Existing:Driveway(s) Proposed:
Parking Area(s) Proposed:Parking Area(s) Existing:
Retaining Wail(s) Existing:Retaining Wall(s) Proposed:
Landscaping Existing: Landscaping Proposed:1
Miscellaneous Existing:
Total Existing Impervious in the
Shore Impact Zone:
Total Impervious in the Shore Impact 5200 Square Feet j
^ne:
Miscellaneous Proposed:
Total Proposed Impervious in the
Shore Impact Zone:
i
Documentation
File 1: ^PLEASE NOTE PROPOSED
PROJECT AREA MUST BE
STAKED
Mallard_Bay_Drawing.pdf
Attach Supporting Documentation;
Total Proposed Area to Determine 2880 Square FeetFee:
Total Earthmoving Request to
Determine Fee:
824 Cubic Yards
Applicant Approval
Applicant Signature:■ Robert Meisenheimer
Date Signed:04/27/2019
Please check to approve:I understand that checking this box constitutes a legal signature
Comments:Have reviewed with Marsha
Terms
;:
5/21/2019, 10:27 AM3 of 4
Land & Resource Permit Applications https://onegov.co.ottertail.mn.us/view.php?id=5650#outer_wrapper
Notes
The lot lines and project area(s) must be identified & staked onsite.
If project disturbs more than 1 acre of land, you must obtain a General Storm Water Permit from the MPCA.
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
Agreement L
I hereby certify that the information contained herein is correct and agree to do the proposed work In accordance with the description abo\« 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.
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 #4349 (05/21/20191
Charge Cost Quantity Total
Site & Lot Permit Fee #3E (1,000 or larger Sq Ft and 501-1,000 Cubic yds)added 05/21/2019 9:30 AM
$500 fee
$500.00 $500.00X 1
Grand Total
$500.00Total
$500.00Payment 05/21/2019
$0.00Due
Approvals
Approval Signature
#1 Received and Assigned Sheila Dahl - 04/29/2019 8:58 AM038a323d991c32fdl3e4ef0f675764fb
fcf8530b90bd51e72b82f7fbe0b681e2
#2 Permit Review Kyle Westergard - 04/30/2019 8:17 AM0f2d840bac5992e83d376677b8c683ae
399f306bd99f9b2246b07aad96d7b70c
#3 Permit Review Eric Babolian - 05/21/2019 9:12 AM5dd60ac3c798671del2115f3b63006c6
Cb736865fef09f0467a2989d9cf26f24
#4 Permit Issuance Eric Babolian -05/21/2019 10:26 AM73140b64721867520d224c92bc7a75a3
873a02b8bea38979057bl78751adef4d
Public Notes
Text:
■;
File(s):
Internal Notes
Text:
File(s):i^-
Print View
1-
4 of 4 5/21/2019, 10:27 AM
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Please sketch all stru^ur^ and septic systems on the property;
Include setbacks and wells widun 100 fe^ of the {noperty.joi*?YEAR
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SITE PERMIT
INSPECTION RESULTS
Inspector must make all measurements and computations
D u—e U r/'f
ll3It I Ft.Ft.Structure Set Back from Ordinary High Water Level
Structure Set Back from Top of Bluff Ft.Ft.
“f"Structure Set Back from Road Right of Way Ft.Ft.
iOo-*- Ft.&30 r20 0Structure Set Back from Lot Lines Ft.Ft.&Ft.
Pa si5Structure Height Foot Ft.Ft.
Structure Set Back from Septic Tank Ft.Ft.
5’0 TStructure Set Back from Drainfield Ft. Ft.
Elevation Of Lowest Floor Above Ordinary
High Water Level___________3-^Ft.Ft.
Land Slope at Building Site %%
Loi- lfo<Q/\dInspector’s Comments / Sketch:
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Time of Inspection
u/iv^ cc^Protect Approved________
/ Date/Initial