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Home My WebLink AboutMaple Lane Resort_41000030015006_Shoreland Permits_■r /WHITE-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.PLEASE PRINT OR TYPE ALL INFORMATION *''r^ge 'Section I'TWP NAMELAKE/ RIVER NO. LAKE/RIVER NAME LAKE/RIVER . CLASS V , TWP NO. 35bRo PROPERTY (E-911) ADDRESSPARCEL NUMBER (S); LEGAL DESCRIPTIONPT Q>i.^ @\t).^ PrCL ^___________Coo Mailing Address Daytime Phone No.Last Name First initiai MAJ bh G lLAiaJ^ y. Property Owner / Contractor Name Uc. # ]/ [/I^NSITE SEWAGE TREATMENT SYSTEM - ()(PermitNo.___^ PROPOSED PROJECT (please circle the appropriate number) {2) Add'n to Dwelling ( 5 ) RCU/Year_____ Storage Structure _ 'Existing Dwelling to be removed before ONSITE WATER SUPPLY Individual ( ) Public I|^^9e NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3' (minimum) structure setback to a well. M(1) New Dwelling (4) MH/YR (7) Add’n To Non-Dwelling 'no I Other (3) 'Replacement Dwelling (6) Detached Garage (9) W.O.A.S. ( ) OTLSD * This permit is only valid after verification from the 0. T.LS.D. that a conforming sew age system will be installed to service this lot contact Hoiiie Mann at 864-5533. CHARACTERISTICS OF PROPOSED DWELJDNG Outside Dimension CHARACTERISTICS OF PROPOSED W.O.A.S. (WATER ORIENTED ACCESSORY STRUCTURE) Outside Dimension CHARACTERISTICS OF PROPOSED NON-DWELLING Outside _ Dimension _ rfs Ft't/^ Ft. X Ft.'V Ft. X •t." Sq. Ft. /[vLro.<oSq.Ft.; Setback to Lotline ___ Setback to Right of Way Setback to Ordinary High Water C^l ___ Elevation Above Ordinary HighJprat^Level Setback to Septic Tank__ Setback to Drainfield__/ Setback to Bluff / Total Bedrooms / Maximum Propos^ Height Roof Change ^) Yes ( ) No Basement (/) Yes ( ) No Walkout Ba/ement ( ) Yes ( ) No V Sq. Ft.______\ Setback to LotlineV__ Setback to Right of Way Ft."Ft.&Setback to Lotline Ft. & Ft." Setback to Right of Way ’In -H FlS^Ft."h." Ft."-5^0 ^ Ftk”^ 1 ■ Setback to Ordinary Hi^Water Level __ ^ Elevation Above Ordinmyxjigh Water Level Setback to Septic ^k Setback to Drainfield _ Setback to Bbm Ft. Setback to Ordinary High Water Level Elevation Above Ordinary High Water Level Setback to Septic Tank Ft. Setback to Drainfield Ft. Setback to Bluff V/zR- Ft. Ft. Ft>Ft. Ft.Ft. Ft.Ft. Ft. -1^ _£A_R!lK b<)No Ft.Ft.Maximum Proposed Height Roof Change ( )Yes Bathroom Proposed ( ) Yes (sC) No Maximum/roposed Height ( ) Bomouse ( ) Gazebo Ft. ( ) Screen Porch ( ) Storage Struclure "Project/Lotlines/Righ^ot-ways Must be Stated Onsite Prior to Application / Inspection ST 21 Cubic Yards - 299 Cubic Yards' □ 300 (Jubic Yards or More* H3-y^ Topographical Alteration / Earthmovin □ None ' Must include on scale drawing Permit may be required□ 20 Cubic Yards or Less ' CHARACTERISTICS OF LOT: ° Lot Area j Sq. Ft.W~ /■7gImpervious Surface Ratio:X100 =Total Lot Area (FT*)Total Impervious Surface Onsite (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: Thereby 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 & R£^urce Management office once the building footings have been constructed. ^3 -Date: tu^of Properw Ownt 2>— /<3—QyDate: PROJECT(S) TOTAL SQ. FT. 1^00 Land & Resource Managei_____ PERMIT FEE $RECEIPT NO. Comments^ y , t:^ -Ho w«-rai <L~(r <TW’ WoYVy•bo i4f1 Vs ^00 f-bu V' ^ v^c\, ,Form No. BK — 1003-0505 322,179 • Victor Lundeen Co., Printers • Fergus Falls, Minnesota -«v- 1j 1WHITER- Office 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 1r'ELLOW - Owner (after issue) PINK - Assessor .4i4•I E X PIR E©it No. .ixissr ■j PLEASE PRINT OR TYPE ALL INFORMATION i^ TWP NAME^RANGE' LAKE/RIVER CLASS TWP NO.SECTION i.LAKE / RIVER NO. ►LAKE/RIVER NAME •iV'I cKD • .J:V.if-LC PROPERTY (E-911) ADDRESS •n ^ooo '^'^ PARCEL NUMBER (S) yv<}/.i / O’" o'^o’5r LEGAL DESCRIPTION HcA wdmv} (w C.or L(/f 1jA n 4Daytime Phone No.Last Name First Initial Mailing Address 'iProperty Owner \// 5 MAJX I//14>^/c2.. [AiA^r\\ ' l I \ - -Contractor Name Lie.#-HI PROPOSED PROJECT (please circle the appropriate number) (2) Add’n to Dwelling ( 5 ) RCU/Year_____ ( 7) Add’n To Non-Dweliing ^^ BjStorage Structure (10) Other. ONSITE SEWAGE TREATMENT SYSTEM ONSITE WATER SUPPLY individual ( ) Public NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3' (minimum) structure setback to a well. : ) ~ 5■'I -(1) New Dwelling (4) MH/YR____ (3) ’Replacement Dwelling (6) Detached Garage (9) W.O.A.S. (^1), Permit No. ( ) OTLSD * This permit is oniy vaiid after verilicatirm from the O.T.L.S.D. that a conforming sew age system wilt be instalied to service this iot contact floltie Mann at 864-5533. rt ■ ’Existing Dwelling to be removed before. CHARACTERISTICS OF PROPOSED W.O.A.S. (WATER ORIENTED ACCESSORY STRUCTURE) Outside Dimension CHARACTERISTICS OF PROPOSED DWELLING Outside Dimension CHARACTERISTICS OF PROPOSED NON-DWELUNG Outside Dimension Ft.’V"Ft. X Ft.”Ft.x -Ft. X Ft.” v-Sq. Ft. ' -i Setback to Lotline Sq. Ft. Setback to Lotline___ Setback to Right of Way Setback to Ordinary High Water L%v6l __ Elevation Above Ordinary High^ater Level Setback to Septic Tank Setback to Drainfield _ Setback to Bluff Total Bedrooms Maximum Proposed Height /Root Change ) Yes ( Basement ( / ) Yes ( Walkout Basement ( ) Yes ( ) No 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____ Ft.&Ft.”rFt.. r~ Ft.S Ft.”Ft.&FtXSetback to Right of Way ' t Setback to Ordinary High Water Level Sao Elevation Above Ordinary High Water Level__, Setback to Septic Tank Ft. Setback to Drainfield i f Ft. ,, Setback to Bluff Maximum Proposed Height / ^ Ft. )Yes (>;)No X Ft.”Ft. Ft.Ft. Ft. Ft.\ \ Ft./Ft.'-T Ft. •\Maximum proposed Height ( ) Boathouse ( ) Gazebo ^Ft. ( ) Screen Porch ( ) Storage Structure Roof Change ( Bathroom Proposed ( ) Yes (^) No **Project/Lotlines/Right-of-ways Must be Staked Onsite Prior to Application / Inspection7^/ (EU^lT'/ly.1 ;Topographical Alteration / Earthmovinq>-j y ( □ None □ 20 Cubic Yards or Less ’ « 21 Cubic Yards - 299 Cubic Yards’ ’ Must include on scale drawing Permit may be required□ 300 Cubic Yards or More’ CHARACTERiSTICS OF LOT: HLCLot Area.. Sq. Ft. Water Frontage ty'' .Ft.Bluff )Yes K)No /-50A7 o00 O ; .pnImpervious Surface Ratio:X100 =.% Total Impervious Surface Onsite (FTr) Total Lot Area (FTr)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 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 responsibiiity to inform the Land & Resource Management office once the buiiding footings have been constructed. Date: - 'Sgllldture of Property Owner^iI \3>— /^~o^\ CV.WDate: Land S Resource ManagerttetrtXdffice PERMIT FEE $ ' ' - ■_______1 707PROJECT(S) TOTAL SQ. FT. / A 00 RECEIPT NO.■i1 1Comments;,____________________^ y /V../ .-•/L.-f‘J / S V -X < Form No. BK — 1003-0505 322,179 • Victor Lundeen Co., Printers • Fergus Fells, Minnesota SITE PERMIT INSPECTION RESULTS Inspector must make all measurements and computations Structure Set Back from Ordinary High Water Level Ft.Ft.V 2.0 O Ft.Ft.Structure Set Back from Top of Bluff I “h Ft.Structure Set Back from Road Right of Way Ft.A S 75 Ft.& ■/75' tut Ft.&Ft.Ft.Structure Set Back from Lot Lines Ft.Ft.Structure Height 15 Ft.Ft.Structure Set Back from Septic Tank ^ 7.0 1 Ft.Structure Set Back from Drainfield Ft.7^ 2^0 Elevation Of Lowest Floor Above Ordinary High Water Level____________________Ft.2 Ft. Land Slope at Building Site S’%% Inspectors Comments / Sketch: 1 or-^0 7»S Qty Inspector’s Signature Date of Inspection Time of Inspection if Project Approved Date / Initial Grade & Fill Permit #ns 0^335 PROPERTY OWNER IHI j j LAKE NO.SXo^ m "Vr MXiickv'Oi SEC.TWR NAME /q.7 .LEGAL DESCRIPTION: prr C»o 3 WcA"fvw^cV Vjjv-Vys ~V'Q»Nf>\Vv*\fiWORK AUTHORIZED *vV"S .IV^VA>V.V ^O/<^o' *^V«TK oiaV o-t Noorrovj Oivcjvs. q».v>.^ ^WVvvN.Vo'H w ij Vv^%kV<»^ . zaoAK ^-V". *5-V\»*wpA b ^'\U kOC ^Vop*tj 3V I SV«»p*- 0>,tf\.V cxv**-^ vAyS \o»^ ^\r»ia‘v\\x*>^ • v.»\vv ^^fv>vV<j>vw vjJvvy 'T«»*.'Nj'\vvv. \v^ \V ti^ • NOTE: This card s^rall 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 MAN AGEMENT, 21J WHEN AUTHORIZED WORK HAS BEEN COMPLETED. g, o/-oc,>1. EARTHMOVING SHALL BE DONE BETWEEN 2. Entire area shall be stabilized within 10 days of completion of any earthmoving. 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 waterwithout a valid permit from the MN Department of Natural Resources.. APPLICATION FOR GRADE & FILL PERMITs '« ■ i'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.PLEASE PRINT OR TYPE ALL INFORMATION RANGE TWP NAMELAKE/RIVER SECTION TWP. NO.LAKE/RIVER NAMELAKE/RIVER # PRO^^firV (E-911) ADDRESSPARCEL NUMBER^) K 4/£Ocol><x>/5^ ^\ LEGAL DES DAYTIME Phone No.Mailing AddressFirst InitialLast Name —Property Owner 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 DATE PROJECT REQUEST (You may use the grid on back for required scale drawing): DESCRIBE YOUR PROJECT(S): X? >£)// ^ A- ^ A- .7^ K 12^' DETAILED INFORMATION: Ft.7 Ft.AREA TO BE CUT/EXCAVATED: Maximum DepthWidthLength Ft.AREA TO BE FILLED/LEVELED:Ft. Ft. Maximum DepthWidthLength Ft.SLOPE OF BACKFILL AT FOUNDATION:Ft. Distance Extended From FoundationMaximum Depth CULVERT:If Yes, must indicate size and location on drawing. Yes No Y?7aJFi^ <7n XZTcTYPE OF SOILS AND/OR FILL MATERIAL: TOTAL CUBIC YARDS OF EARTHMOVING REQUESTED: I'iTTC/-? SIG^URE OF PROPERTY ^NEI BK0106 V../ RECEIPT NUMBER£WNER DATE Tax parcel Nutnber(s) ’Drawing must be to scale. Drawing shall identify project and include the setbacks to all of the existing and proposed lotiines, road right-of-way(s), ordinary high water level(s), structure(s), septice tank(s), drainfield(s), bluff(s) & wetland(s). Must also include all proposed topographical alterations. /- 7*9^I ^ /3g>%Scale Impervious Surface tDate 322.180 • Victof Lundeen Co. Printers • Fe'gus Fa”s. MN • 1-800-346'4870 » Tax parcel Number(s) 'Drawing must be to scale. Drawing shall identify project and include the setbacks to all of the existing and proposed lotlines, road right-of-way(s), ordinary high water level(s), structure(s), septice tank(s), drainfield(s), bluff(s) & wetland(s). Must also include all proposed topographical alterations. / - /. lo / %Scale Impervious Surface \ Date 322.^80 • V»clor U*TKj»®n Cc Pi• F«rQ.i$ fa's • 1-800-3A6-487D GRID PLOT PLAN SKETCHING FORM.feet/inches.Scale: Each grid equals .19.Application for Building Permit Dated Application for Sewage System Permit Dated Building Permit Number_________________ Applicant agrees that this plot plan is a part of application (s) indicated above. J - 19 i - Sewage System Permit Number. f ■M-+ 19.:; Dated. S ignatu re Indicate all present buildingsOn this form moke a drawing of your lot.with solid lines and all proposed buildings or additions with dotted 11 lines. Also indicate in feet; lake setback, side yard setback and rear yard setback.-H : \k a -tf-; r+ - i4^ ^ ■ 1 , • ■ : t ■ 1 i t i-- I -4^ 4-4t r ]1 I ■t-I t.!4- ^5 o \T ^ < /4- • t: --t i .L._.i- i----------f-- rr ±r i 4—y 4..t- I i 1 T t r T4-T -i- r 44- _j_I J .J-4- r i i III 4 109104 ® rnnin ujniu > m.. ■Iw.l—---------r~;:4.4-|:UMKL-0B7Wn?fl 44. I ^ OTTER TAIL COUNTY Grade & Fill Permit*/jg? ITf^OO Hour\JQIOWNER’S NAME; A /gr / U/AZ/n/G />lVu.Address . 138^Location: lake N(^Sec. 3^ Twp /33 RangfiJ? Twp. Name G\AA(ID mr^PLf^ LAhje Bmumt ________ Issued_^,^^Vi__19 ‘fS , Expires g// 19_?i: Work Authorized c6*/57Kyer .s ' I m a.€Tf^it>fiH(o uiALL ny BoifT i^Ame roA /» 3S\ UJIU feuJUM g>o^v<S ToPi><SitAP»H ee Atsoyfc TH-€ O^ujl sa>u)i 3 / * ^UP n> )0 yj)$ /A^ UfH^H^uT^ C,€>h*y7tiu<T i^oom^tiftiL So of Lot^tJL 0^TUj$e^ uf»$Aed^fHJ> NOTE: This card shall be placed in a conspicous place not more than 4 feet above grade on the premises on which work is to be done, and shall be maintained there until completion of such work. NOTIFY DEPARTMENT OF LAND AND RESOURCE MANAGEMENT, TELEPHONE (218) 739-2271 WHEN AUTHORIZED WORK HAS BEEN COMPLETED.mert ft>^o £11 u>rfp TH/S ^<S/vT _T/K AttSA COUNTY, MINNESOTA Board of County CommissionersLjAiMtO SA*^0 AccK. * i.//3hs 2. Entire area shall be stabilized within 10 days of the completion of any earthmoving. 3. Owner is legally responsible for ail surface water drainage that may occur. 4. No fill shall enter or be taken from the beds of a public water without a valid permit from the State of Minnesota Department of Natural Resources. 5. If the terms of this permit are viblated the entire permit may be revoked and thei owner may be subject rm ujMjLi Land and Resource Management Officiaj^^ "Jlt€ Earthmoving shall be done between1.& I . // j2^ ) >I / 4. S , S&JM^; @> <r. I Scale: Each grid equals feet/inches GRID PLOT PLAN SKETCHING FORM Dated: ^19 Signature mg currentlyPlease sketch your lot indicating setbacks from road right-of-way, lake ai on lot and any proposed structures. ^'deyard for e< -A ^ !_ VA -B 1^ tj, V'> '^ "S' "5TL->■\P \Tvrr ^ i o IT7V -I »3?' J t » { I I t I\ii./ J >T•- ? #! •»> ’*V-/) "t'•.!r(f I *I 'I I I I i ? 1 3 ^^ I; i.> *w.4:)e!\ n1 f L»Ar<»rr' \i: ; f1i r, f tif I C!t K V ; F 1t’: HNs ;5-\\ V X't VVI >J:i MKU-,0871^29 21598 7®VICTOR LUNOEtN CO.. RRINTCR8. rCRCUO FALLS. yiNH. * ^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 Permit No„LEGAL A Date.DESCRIPTION AND LOCATION eo Si /33 (rr-i '^3.Sfuja rf Lake No.Lake Name Lake Classif.Sec.TWP Range TWP Name IDENTIFICATION: Please Print AH Information Last Name First Initial Mailing Address— No. Street, City and State Zip No.Tel. No. "76Owner (yy\\r\. NameContractor Architect Name. TYPE OF IMPROVEMENT:RESIDENTIAL PROPOSED USE: (^-“TOne Family Dwelling ( ) Multiple Dwelling NON-RESIDENTIAL PROPOSED USE: ( ) New Building (•"TAIteration Specify:. Units ( ) Other ( )Other Size HO^>ESTIMATED COST OF IMPROVEMENTS (omit cents) PRINCIPAL TYPE OF FRAME:TYPE OF SEWAGE DISPOSAL:DIMENSIONS: ( ) Masonry (^^^iTood Frame ( ) Structural Steel ( ) Other — Specify ( ) Public ( ♦•f'Tridividual Septic Tank, etc. WATER SUPPLY: ( ) Public ( ) Individual Well MECHANICAL EQUIPMENT : Elevator: ( ) Yes Air Conditioning: ( ) Yes I ) Central Basement: ( ) Yes ( ) No IStories above basement: Sq. feet (outside dimension) Bedrooms Baths HEATING: ( ) Electric ( ) Coal Other: Type of Roof:< ) No ( ) Gas ( ) None ( ) Oil ( ) No ( ) Unit CHARACTERISTICS: «20Q.aiLot Area is squdh e red.Water frontage is feet. ]..O.Q,tBuilding 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. (Building Line) ?.feet ,r:VO.±feet — from road or street is feet. .r2C?...t.:^o±.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.1.0 .a-.o 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 six (6) months. Signature of Owner Dated.i Permit: 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 ut>on violation of said ordinances. Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon the Dated Shoreland Management OfficialSlP°2^Permit Fee $.State Surchiarge $. Comments: Form No. MKL-0771-002 viCToa Luascia 4 M.. amaTtai. naaui r«.ca. ilS8899 • NSHORELAIMD 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 OJ ? Permit No„LEGAL >iy\ Oup^Ll S DateCX/y^JiDESCRIPTION AND Pia ~hf I fLOCATION Lake No.Lake Classif.Lake Name Sec.TWP Range TWP Name IDENTIFICATION: Please Print All Information Last Name First Initial Mailing 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 ( ) One Family Dwelling ( ) Multiple Dwelling Specify:, Units ( ) Other ( ) Other Size ESTIMATED COST OF IMPROVEMENT $(omit cents) PRINCIPAL TYPE OF FRAME:TYPE OF SEWAGE DISPOSAL:DIMENSIONS: ( ) Masonry ( ) Wood Frame ( ) Structural Steel ( ) Other — Specify ( ) Public ( ) Individual Septic Tank, etc. WATER SUPPLY: ( ) Public ( ) Individuai Weil MECHANICAL EQUIPMENT : Elevator: ( ) Yes Air (kinditioning: ( ) Yes ( ) Central Basement: ( ) Yes ( ) No Stories above basement: Sq. feet (outside dimension) Bedrooms Baths HEATING: ( ) Electric ( ) Gas ( ) Coal Other; Type of Roof:( ) No ( ) Oil ( ) No ( ) None ( ) 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 Surcharge $. Comments: CERTIFICAIL Form No. MKL-0771-002 ,158899 VICTOM U1M0CCM 4 n.. PKIHTIKt. FCDSPB rM.LS. INSPECTOR'S CHECK LIST Make all measurements and computations ACTUAL IS Xr MINIMUM Shall Be 4-Sq. Ft, Lot Area (Square feet)Sq. Ft.Sq. Ft. Water Frontage Ft.Ft. ^0 Ft.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. Side Yard &Ft.&Ft. IRear 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_____________Ft.3 Ft. Inspector's Comments: 7 Inspector's Signature I Title Inspection Dated 19 Agency VICTCM LUHOieU « e«.. MtHTtl 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 Permit No„o CLEGAL >! y> ^Date.DESCRIPTION AND LOCATION 3JT _^5 ,'^9 r-dLft 'T TWP NameLake Classif.Sec.TWP RangeLake No. Lake Name IDENTIFICATION: Please Print All Information Mailing Address— No. Street. City and StateLast Name First Initial Zip No.Tel. No. }J/ at I ji-vOwner r f-i o/NameContractor Architect Name. TYPE OF IMPROVEMENT: I LM^ew Building ( ) Alteration RESIDENTIAL PROPOSED USE:NON-RESIDENTIAL PROPOSED USE: ( ) One Family Dwelling .( ) Multiple Dwelling (L^KIther Specify:. Units ( ) Other Size ESTIMATED COST OF IMPROVEMENT $(omit cents) PRINCIPAL TYPE OF FRAME:TYPE OF SEWAGE DISPOSAL:DIMENSIONS: ( ) Masonry ( LFVIood Frame ( ) Structural Steel ( ) Other — Specify ( ) Public ( ) Individual Septic Tank, etc. WATER SUPPLY: ( ) Public ( ) Individual Well MECHANICAL EQUIPMENT : Elevator: ( ) Yes Air Conditioning: ( ) Yes ( ) Central Basement: ( ) Yes Stories above basement: .................................... Sq. feet (outside dimension)............ Bedroomsi7cm^Baths HEATING: ( ) Electric ( ) Gas ( ) Coal Other: ( \XMoType of Roof:( ) Oil/(iVMo (“ )"1^ne I ) Unit CHARACTERISTICS: .:>Z)OQ..t.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 .1^0....c^..±. .... feet — from road or street is feet. .»2(D...±.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. Z 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 up)on violation of said ordinances. // />.2,Dated Shoreland Management Official Permit Fee $.State Surcharge $.■lOga Comments: Form No. MKL-0771-002 @ .,..158899 vieren luh»eem 4 m.. PHiiiTti 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 I \Permit No..y n •' CJ ’ 'Op <LEGAL Date.DESCRIPTION AND LOCATION i i.ILL / TWP NameTWPRangeLake Classif.Sec.Lake NameLake No. IDENTIFICATION: Please Print Ail Information Zip No.Tel. No.Mailing Address— No. Street^ City and StateFirstInitialLast Name Owner NameContractor Architect Name, / TYPE OF IMPROVEMENT;RESIDENTIAL PROPOSED USE;NON-RESIDENTIAL PROPOSED USE; ( ) One Family Dwelling ( ) Multiple Dwelling ( ) New Building ( ) Alteration Specify:. Units ( ) Other ( ) Other Size ESTIMATED COST OF IMPROVEMENT $(omit cents) PRINCIPAL TYPE OF FRAME: TYPE OF SEWAGE DISPOSAL:DIMENSIONS: Basement: ( ) Yes ( ) No Stories above basement; Sq. feet (outside dimension) Bedrooms ( ) 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 - -'e Baths HEATING: ( ) Electric ( ) Gas ( ) Coal Other: ( ) NoType of Roof:( ) Oil/( ) No ( ) None ( ) 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 Y'<Yifeet — from road or street is feet. and ..........................7...........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 Surcharge $, Comments; CERTIFICATE ISSUED Form No. MKL-0771-002 VICTOR UINOeCN 4 CO.. RRIHTCRI. TCRSUS FALLe. 158899 INSPECTOR'S CHECK LIST Make all measurements and computations MINIMUM Shall Be 4, Sq. FtACTUAL IS i Sq. Ft.Sq. Ft.Lot Area (Square feet) Ft.Ft.Water Frontage Ft.Ft.Building Set Back from High Water Mark 50 Ft.Ft.Building Set Back from State Highway 40 Ft.Ft.Building Set Back from Street or Road Ft.&Ft.&Side Yard Ft. Ft.Rear Yard 10 Ft.Ft.Occupied Building to Septic Tank 20 Ft.Occupied Building to Absorption System Ft. Elevation at Building Line above High Water Mark_____________3 Ft.Ft. Inspector's Comments: Inspector's Signature Title Inspection Dated 19 Agency V'CTei LUH»EEH 4 CO . PRiHTfa*. rcaau* rM.i.4. mimm.