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Home My WebLink AboutMecklenburg_10000120082001_Shoreland Permits_Emil H. Salvog ;| 5340 Maryland Ave. N^J Crystal, MN 55428^9 APPLICATION FOR SITE PERMIT LAND & RESOURCE MANAGEMENT OTTER TAIL COUNTY COURT HOUSE 121 W. JUNIUS AVE. • SUITE 130 Phone: (218) 739-2271 • FERGUS FALLS, MN 56537 WHITE - Office GOLDBHROD - Inspector YELtOW - Owner (after issue) PINK - Assessor ^4^- Permit No.LEGAL DESCRIPTION CrrL A Ziluicilj ^0. f)C BLUFF ZONEAND□ YES i^NO LOCATION LAKE NUMBER SECTION RANGE TWP NAME .LAKE/RIVER UcthutAm r^\ \ LAKeRIVER NAME TWP NO. ^/iMUrULY FIRE NUMBERSURFACE WATER DRAINAGE □ CHANGE,YRDS^, DRAINAGE PLAN REQUIRED ^NO CHANGE PARCEL NUMBER (S) lO 000 /a 00^^000 /3SO IDENTIFICATION; Please Print All Information TELEPHONE NO. (Daytime)Mailing Address — No. Street, Cit)(, Slate, and Zip Code AM ¥ PiiBiiiuJj . YM-f? InitialLast N'ijpie _______________^ First_________']Ad-nJlLh ■ /]Tl.<lfi7tJProperty Owner NameContractor State Lie. # ONSITE SEWAGE TREATMENT SYSTEM (^JJfltJi^ual Permit #_____ ( ) Collector Permit #______ ( )0TLSD* ONSITE WATER SUPPLY (iL^Jfi^ividual ( ) Public ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3' (minimum) structure setback to a well. PROPOSED PROJECT Structure(s) ( ) Addition(s) ( )MH/RV________________ PROPOSED USE ( ) Dwelling (^J,blerrt)welling ( ) Water Oriented Accessory Structure (WOAS) 9I3& YEAR CHARACTERISTICS OF PROPOSED WOASCHARACTERISTICS OF PROPOSED NON-DWELLING (l^tility Structure CHARACTERISTICS OF PROPOSED DWELLING ( ) Screen Porch( ) Boathouse( ) Detached Garage( ) Dwelling ( ) Replacement Dwelling ( ) Addition to Dwelling ( ) Existing Dwelling shall be removed on or before. Outside Dimension ( ) Basement ( ) Walkout ( ) Attached Garage ( ) Utility Structure( ) Gazebo( )Other Outside Dimension ^___Ft,x lA ( ) other. Outside Dimension .Ft. Sd soFt. X .Ft..Ft.Lotline Setbacks .Ft.&.Ft.Ft. X tooLotline Setbacks ,Ft,&.Ft..Ft.OHWL Setback .Ft..Ft.&Lotline Setbacks OHWL Setback Ft.Bathroom: ( ) Yes ( ) No (If Yes / a complying Sewage System Required)Ft.OHWL Setback Total Bedrooms 11 IMaximum Height / 35 Ft. (2 story)Maximum Height /10 ft. (1 story)Maximum Height Ft..story ^■43 IT.-06 .%.Sq. Ft. Impervious Surface Ratio.Sq. Ft. Impervious SurfaceLot Area Ft. (3' minimum)Ft. Elevation of lowest floor above OHWLWater Frontage .%____________Ft. Slope of lot Ft. (10'minimum) (Sewage System Permit required before installation). .Ft. (20'minimum) (Sewage System Permit required before installation). Ft. (10'minimum) (Sewage System Permit required before installation). Structure setback to right-of-way /astructure setback to septic tank Dwelling setback to Soil Absorption System /ONon dwelling setback to Soil Absorption System 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 Ordinance 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. * This permit is oniy valid after verification from the O.TL.SD. that a confj Tfgs^age system will be installed to service this lot... Contact Rollie Mann at 864-5533. Sf/'j/noDated: Land & Resource Management Office arjAOO. RECEIPT NO.PERMIT FEE $ RECEIVEDComments: MAY 1 0 200fr LAND & RESOURCE -800-346 4870299.050 • Victor Lundoeri Co . Printers • Fergus Falls, MN •Form No. BK — 0597-002 \APPLICATION FOR SITE PERMIT LAND & RESOURCE MANAGEMENT OTTER TAIL COUNTY COURT HOUSE 121 W. JUNIUS AVE. • SUITE 130 Phone: (218) 739-2271 • FERGUS FALLS, MN 56537 WHITE - Otfice%r GOLDENROD - Inspector YELLOW - Owner (after Issue) PINK - Assessor ■o \ LEGAL ‘ DESCRIPTION BiUFF ZONEAND YESLOCATION 3 NONA^ TWP NCA RANGESECTIONLAKE/RIVER CLASSLAKE NUMBER LAKE/RIVER NAME /AtlitJuAaW FIRE NUf-IBERSURFACE WATER DRAINAGE □ CHANGEYRDS^, DRAINAGE PLAN REQUIRED ^^NO CHANGE PARCEL NUMBER (S) ) /a fjoi^Y'OO A /5t)0. f: : I TELEPHONE NO.IDENTIFICATION: Please Print All Information (Daytime)Mailing Address — No. Street, City, State, and Zip CodeInitiiLast Name Ad<l ^'3i3dm(Ljnijir)KJProperty Owner (3Mf uJJj. /k^ 1.Name V iContractor State Lie. #iONSITE SEWAGE TREATMENT SYSTEM (^jiJJndrvidual Permit #____ ( ) Collector Permit #_____ ( )0TLSD* ONSITE WATER SUPPLY (yjndividual ( ) Public ( )None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3’ (minimum) structure setback to a well. PROPOSED PROJECT (Structure(s) ( ) Addition(s) ( )MH/RV______________ PROPOSED USE ( ) Dwelling (^JiSlerl-tlwelling ( ) Water Oriented Accessory Structure (WOAS) (H3L>I.^3 YEAR CHARACTERISTICS OF PROPOSED WOASCHARACTERISTICS OF PROPOSED NON-DWELLING ( D<tftility Structure CHARACTERISTICS OF PROPOSED DWELLING ( ) Screen Porch( ) Boathouse( ) Detached Garage( ) Dwelling { ) Replacement Dwelling ( ) Addition to Dwelling ( ) Existing Dwelling shall be removed on or before. Outside Dimension ( ) Basement ( ) Walkout ( ) Attached Garage I i ( ) utility Structure{ ) Gazebo( ) Other Outside Dimension ( ) other. Outside DimensionSo.Ft. X .Ft..Ft.&.Ft.Lotline Setbacks .Ft..Ft. X IDOLotline Setbacks .Ft._Ft.&.Ft.OHWL Setback .Ft..Ft.&Lotline Setbacks OHWL Setback .Ft.( )NoBathroom: ( ) Yes (If Yes / a complying Sewage System Required).Ft.OHWL Setback.Total Bedrooms \1 IMaximum Height / 35 Ft. (2 story)Maximum Height /10 ft. (1 story)Ft.Maximum Height story .%,Sq. Ft. Impervious Surface RatioSq. Ft. Impervious SurfaceLot Area Ft. (3’ minimum)Ft. Elevation of lowest floor above OHWLWater Frontage .%___________Ft. Slope of lot _Ft. (10’minimum) (Sewage System Permit required before installation). _Ft. (20’minimum) (Sewage System Permit required before installation). _Ft. (10’minimum) (Sewage System Permit required before installation). Structure setback to right-of-way. 3QStructure setback to septic tank Dwelling setback to Soil Absorption System /sNon dwelling setback to Soil Absorption System 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 Ordinance 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. * This permit is only valid after verification from the O.T.L.SD. that a conforming sewage system wili be instalied to service this iot-... Contact Rollie Mann at 864-5533. ^ignap/S of Owner Dated:L.trr* / /Dated: Land & Resource Management Office , jzvyzMi^25’RECEIPT NO.PERMIT FEE $ Comments: ! Form No. BK — 0597-002 299,650 • Victor Lundeen Co.. Printers • Fergus Falls. MN • 1-800-346-4870 - .^4,; 7iV INSPECTION RESULTS Make all measurements and computations -f~~.Structure Set Back from Ordinary High Water Level Ft.Ft. Structure set Back from Top of Bluff Ft.Ft. ~2^ ^Structure Set Back from Road Right of Way Ft.Ft. Ft.&//-Ft.Structure set Back from Lot Lines ,Ft.&Ft. 0 fStructure Height Ft.Ft. /Oi~^Structure Set Back from Septic Tank Ft.Ft. Structure Set Back from Absorption System Ft.Ft. Elevation Of Lowest Floor Above Ordinary High Water Level____________________7^Ft.Ft. Land Slope at Building Line %% m ht Qf3 2oyoC»')Inspector’s Comments / Sketch^, 7^ Inspector's Signature Date of Inspection Tune of In^yection n'^^TTTr.....f™”{I I{i-ii rIfii?i^•:V-,-; V"|i ■ '": . • |- '.'r \ii4III4Iii4I1-JrtT?!I f i‘1 I sI '!»i1rS f>s -4.i iitI4.t itTIII;i I 5 1!fB!fI«t::¥1 i I Ii+It Iff&It 4-t;!i;II ■f 1ii I f ii!i:«1 I It1Itt-mTrIfIi1m iIiIiII5III!IiI #!ii 1s+iirrrII+tT !Iii 7iiiII!i I !II1fiiifIi\I4r--4tI■ :ijf!I^ I I ?f 1 !1 V i4"I iI?I - I i AW..UJ IfI f IIIfsIi!i'’\ii . (i i 4tBTtI II ■Ii II4I?4 !4-!fIi■"I iiI )i \tIiiI5 Ht It■"Ti5 !!*£I f {i tit4-Ti— r r 5!i i4,sJ i4I-4 4-I tI ff!i 1I t tIf (i RiSgEBuT"' i 14 i+”r I5 t!!i II!!iI i f tI5I iI u!4 tii iI1I11sI:I4ffTt!t!f'HiiI■4ii tj%i4 k:----«A-■!■ I''X"-A •f “i 1/ tA)i:>•s sI 4.4•I I f-t7*rt X i tV ^"k '"■'k‘II4rxF*Ittt 4 rT T !i I i i11 f?!£I tT Ttt!!I !!i SI Ii4-f4 2!T=S4sdr.TI i1!£If f:4 4 t4If4TTjii!i O&i fIi !T!?IIIr—-#4r—T-TJ l4 44M ! 4<:t'Ij/+1 t 4.t t I ■i 4^\\IIf r fTtr 45 iii■i Ji!i!i.tI -%•tA4 T s■f'»r—f !I i It\s !i ii■II 4 !!I r-w-'-r4!ffiIJjiI I1♦T 1' ■' ~l ■' '■ ri1SiI!4i ...4 lZ,„4444:. .CrrurTy ____a/iAchz..................Sr... 4. ua.c.^.4444' I IIIi;s i r 1 i 44 t4.4.t tt ff4!'^71 \!\2sMz$3 I t Ji.4t ITj 4Izu \ t I1 i f sJf’s • r.v j j ,.|T rt t11 4_£a|I •*•tr\ I !I4i4-p i 4♦r r t !I !i;?1 1 i t !i!!f'!Ii iII"I!I»4 ftt1T~T~“'"£'—'”4 t t T t-T I T 4 :!•'5 i i'II ii1i!IiI.+i!■4 4 f f■»■!£1IJ5----[1 i i I!i !I i I i£14ji—-t -tttTI4-i i M 1 * !■ !f(1 II 1£t 1........I ■f ■i-TITi WHITE - Office GOLDENROD - Inspector YELLOW - Owner (after issue) PINK - Assessor APPLICATION FOR SITE PERMIT LAND & RESOURCE MANAGEMENT OTTER TAIL COUNTY COURT HOUSE 121 W. JUNIUS AVE. • SUITE 130 Phone: (218) 739-2271 ■ FERGUS FALLS, MN 56537 ✓ Permit No,LEGAL DESCRIPTION M VJ/BLUFF ZONE □ YES NO AND LOCATION LAKE NUMBER LAKE/RIVER NAME LAKE/RIVER SECTION TWP NO.RANGE TWP NAME , ¥0/3^ PARCEL NUMBER (S)SURFACE WATER DRAINAGE □ CHANGE.______YRDS^, DRAINAGE PLAN REQUIRED ^NO CHANGE FIRE NUMBER jO 00012 OOUODO /> /503O IDENTIFICATION: Please Print All Information TELEPHONE NO. Last N inilial Mailing Address — No, Street. Cit]^ Slate, and Zip Code ¥ ('’lltBilJAj/J. yJI/n ■ ^_______________ y. First_________I AaY-j (Daytime) Properly Owner NameContractor State Lie. # PROPOSED PROJECT Strijcture(s) ( ) Addition(s) { )MH/RV_______________ PROPOSED USE ( ) Dwelling {^J,.Nert^Dwelling ( } Water Oriented Accessory Structure (WOAS) ONSITE WATER SUPPLY ()[jjrt0ividual ( ) Public ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3' (minimum) structure setback to a well. ONSITE SEWAGE TREATMENT SYSTEM (^JJpdmdual Permit ff ! ( ) Collector Permit *. ( )OTLSD* YEAR CHARACTERISTICS OF PROPOSED DWELLING ( ) Dwelling ( ) ReplacemenI Dwelling ( ) Addition to Dwelling ( ) Existing Dwelling shall be removed on or belore_____ Outside Dimension. CHARACTERISTICS OF PRQP0§EDN0NWEt1JfclG (i^^tility Structure . CHARACTERISTICS OF PROPOSED WOAS ( ) Boathouse ( ) Screen Porch( ) Basement { ) Walkout ( ) Attached Garage ( ) Detached Garage ( ) Gazebo ( ) Utility Structure( ) Other Outside DiiBension 1 lAFt. X Ft.( )Other. Outside DimensionFt * Ft..Ft. X .Ft.Lotline Setbacks Ft. X Ft. mLolline Setbacks .FLi FI.OHWL Setback .FI. Lolline Setbacks .FI.&.Ft. OHWL Setback .FI. Bathroom: ( ) Yes ( ) No (II Yes / a complying Sewage System Requited)OHWL Setback..FI. Total Bedrooms Maximum Height / 35 Ft. (2 story)Maximum Height Maximum Height /10 ft. (1 story)story xr.— D-E> %Lot Area .Sq. Ft. Impervious Surface Sq. Ft. Impervious Surface Ratio Water Frontage Structure setback to right-of-way. Structure setback to septic tank _ .Ft. Elevation of lowest floor above OHWL Ft. (3’ minimum) .Ft. Slope of lot /a .Ft. (10’minlmum) (Sewage System Permit required before installation). Dwelling setback to Soil Absorption System___ Non dwelling setback to Soil Absorption System .Ft. (20‘minimum) (Sewage System Permit required before installation). /O .Ft. (10'minrmum) (Sewage System Permit required before Installation). 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 Ordinance 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. permit is only valid after verification from the O. T.L.SD. that a conforming sewage system will be installed lo service this lot. .. Contact Rolhe Mann at 864-5533. Signtiun ot Omm Land S Resourcd Msnagemeni Oftice RECEIPT NO. Comments: I Pfirm No. BK — 0597^09 . I ann.^ijK aa>n sV r:V■>T --;.' v?'- ■.t1 rJ :i;I I4•I2fSME.,i ii.: !•■:i •;iIi-■-^-X...^,/s:7t \. ■ ■i.V^'Ti ; "^■4” ' ^ r ..-“i&cjar:..’^ssSI^i5 V...lM..}It —t'/i;i....4.....4....,-,4„.,. 1:.ti{.1h ,L.//;!.z.I 7;.SV.V,. 5 ■L,rt1 7? /!!.1,:7‘-:o..j'l in: iI j.i ! 7i/^ Iy :.i. -‘■''•'r-'-'r-jy > (7#--in.I- ^r'n 1I4i.:f'KTI ■“■'T......r:-T!■;I, ./■ - 5 17?nm7 -73 r fr'i^';7?- ■ •.....;55r ■' l,..7k /iJ I r? f i;'d I•"-y ,y.r ,y147I ; /4-€■ 1 "1i'eicMA..j.f Tr 4.Emi :i-v -•••i'i:.::,4.777<k;.JSf-A...:... s i...,.fi 7 \I\<i / ■ / / fc»!i .,v.i.v..t''r--y'i/’ t [7 ii■': [i IiI / "Ws'^ \: 1 ^.'/.1.V"-', .71 iz.iy'ivi'a.... 777&'.. ..|V J \■;77-If:Z„., '"Tj'"2 i....417.7 ,//2>:l4 ..1 >{.i A- 3:1.7 X'1 -UJ r iI 'i APPLICATION FOR SITE PERMIT LAND & RESOURCE MANAGEMENTOTTER TAIL COUNTY COURT HOUSE Phone:(218) 739-2271 • FERGUS FALLS, MN 56537 WHITE-Office ' GOLDENHOD - Inspector YELLOW - Owner PINK - Assessor /^sypr<^L.z, . ,0 2-' ^ /L , S loo * Permit No.LEGAL DESCRIPTION 5 ^/e / Cfo'BLUFF ZONE/lY Jo CO d(j-AND □ YES ~^N0LOCATION LAKE NUMBER LAKE/RIVER NAME LAKE/RIVER CLASS SECTION TWP NO.RANGE TWP NAME 2.7cK I J2-/JZ-‘YO PARCEL NUMBER (S)GRADING / FILLING □ YES It OF CUBIC YARDS FIRE NUMBER /P Ir^Poo ia^ooZfji.oot -;;^JMO IDENTIFICATION: Please Print All Information TELEPHONE NO. Last Name First Mailing Address — No. Street, City, State, and Zip CodeInitial (Daytime) h-e—yProperty Owner 2-/t - a/2f u L~. NameContractor 59/06State Lie. # PROPOSED PROJECT ^4"New Structure(s) ( ) Addition(s) ( )MH/RV______________ PROPOSED USE ( ) Dwelling ^4^on-Dwelling ( ) Water Oriented Accessory Structure (WOAS) ONSITE WATER SUPPLY ^^Individual ( ) Public ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3’ (minimum) structure setback to a weli. ONSITE SEWAGE TREATMENT SYSTEM (^^ndividuai Permit # ^Q ( ) Collector Permit #_____________ ( jOTLSD*YEAR CHARACTERISTICS OF NON-DWELLING ^^Utility Structure CHARACTERISTICS OF WOASCHARACTERISTICS OF DWELLING ( ) Detached Garage (>kBoathouse ( ) Screen Porch(^Dwelling ( ) Basement ( ) Walkout ( ) Attached Garage ( )ilacement Dwelling ( ) Addition to Dwelling ( ) Existing ON^Iing shall be removed on or before. Outside Dimension. ( )Gaz(( ) Utility Structure( ) Other Outside Dimension ( ) Other, Outside Dimension.Ft. X Ft.Lotline Setbacks .Ft. X .Ft. Lotllne Setbacks .Ft.&.Ft.OHWL Setback Ft.Lotline Setbacks & OHWL Setback .Ft.Bathroom: ( )Yes (No (if Yes / a complying Sewag^ystem Required)OHWL Setback .Ft.Total Bedrooms /fr F.. /\ Maximum Height / 35 Ft. (2 story)Maximum Height /10 ft. (1 story)Maximum Height story yjij OOP / ^ %Sq. Ft. Impervious Surface Sq. Ft. Impervious Surface RatioLot Area > 7 ^Ft. (3’ minimum)Water Frontage Elevation of lowest floor above OHWL >Structure setback to right-of-way Ft. Slope of lot .% Ft. (10'minimum) (Sewage System Permit required before installation).Structure setback to septic tank_____________ Dwelling setback to Soil Absorption System___ Non dwelling setback to Soil Absorption System > Xo Ft. (20’minimum) (Sewage System Permit required before installation). Ft. (10'minimum) (Sewage System Permit required before installation). 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 Ordinance 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 * This permit is only valid after verification from the O.T.L.SD.tfiat a copfSrming sewage system will be installed to service this lot... Contact Rollie Mann at 864-5533. lesource Management office once the building footings have been constructed. Dated: Signature of Ownfr 2 f ^ LaM& Res^ce Management Office / - Dated: . 60 -OdPERMIT FEE $RECEIPT NO. Comments: Form No. BK — 0597-002 290.821 • Victor Lundeen Co., Printers • Fergus Fads. MN • 1-800-346-A870 L. f- APPLICATION FOR SITE PERMIT LAND & RESOURCE MANAGEMENT / OTTER TAIL COUNTY COURT HOUSE Phone:(218)739-2271 • FERGUS FALLS, MN 56537 \ WHITE-Office GOLDENROD - Inspector YELLOW- Owner PINK - Assessor \ pr z ^ rt- ' S 7oa ' Permit No.LEGAL DESCRIPTION 5 /(/M, BLUFF ZONEJOAND n YESLOCATION ■J UKE NUMBER LAKE/RIVER NAME LAKE/RIVER CLASS SECTION TWPNO.RANGE TWP NAME i J2./J^'7 yjy PARCEL NUMBER (S) ^6’C Lf j/7^/eAciI I GRADING / FILLING □ YES # OF CUBIC YARDS -OLno FIRE NUMBER Lr A /J, )qO I PL O o ^ oo / IDENTIFICATION: Please Print All Information TELEPHONE NO. Last Name First Initial Mailing Address — No. Street, City, State, and Zip Code (Daytime) Property Owner JP/^ 2- btr-y/2oo/ycr<i //.7/t A/A^c ‘Z Ci-t 7tt^/2-All , 5"-7—,2 ■ ' r/^jvNameContractor State Lie. # PROPOSED PROJECT ^ New Structure(s) ( )Additlon(s) ( )MH/RV______________ PROPOSED USE ( ) Dwelling p)4Non-Dwelling ( ) Water Oriented Accessory Structure (WOAS) 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 (■ ) Individual Permit # ( ) Collector Permit #_ ( )OTLSO* I- YEAR CHARACTERISTICS OF NON-DWELLING ^^Utility Structure CHARACTERISTICS OF WOASX CHARACTERISTICS OF DWELLING ( ) Basement ( ) Walkout ( ) Attached Garage ( ) Existing Dwelling shall be removed on or before Outside Dimension. ( ) Detached Garage (NjBoathouse ( ) Screen Porch(\JDwelling ( ) Re^acement Dwelling ( ) Addition to Dwelling ( ) Gazebo ( ) Utility Structure( ) Other Outside Dimension ^ rP' Ft. X Q .Ft.( ) Other. Outside DimensionFt./2-.Ft. X Ft.. Lotline Setbacks .Fix .Ft./zLotline Setbacks Ft.&.Ft.OHWL Setback .Ft. Lotline Setbacks &.Ft. Bathroom: ( )Yes (^^^No (If Yes / a complying SewagO System Required) OHWL Setback Ft. OHWL Setback..Ft. Total Bedrooms Maximum Height / 35 Ft. (2 story)X /<r IMaximum Height Maximum Height / 10 ft. (1 story)Ft...story \ Ooo / ^ %Impervious Surface *-(Lot Area Sq. Ft. .Sq. Ft. Impervious Surface Ratiof Water Frontage Elevation of lowest floor above OHWL .Ft. (3’ minimum)y >Structure setback to right-of-way_________ Structure setback to septic tank_________ Dwelling setback to Soil Absorption System .Ft. Slope of lot .% cy 2'T .Ft. (10’minimum) (Sewage System Permit required before installation). .Ft. (20’minimum) (Sewage System Permit required before installation).> ao Non dwelling setback to Soil Absorption System Ft. (10’minimum) (Sewage System Permit required before installation). 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 Ordinance 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. * This permit is only valid after verification from the O.T.L.SD. that a conforming sewage system will be installed to service this lot... Contact Rollie Mann at 864-5533. ■ / ff ■ nr) Dated: Signature ot Ounf Dated:r? ;■! -■J ", Land & Resource Management Office 3^ / PERMIT FEE $RECEIPT NO. \Comments:cl 1■1 Form No. BK — 0597>002 290.821 • Vretor Urmeen Co. Printers • Fergus FaMs. MN • 1-800-346-4870 INSPECTION RESULTS Make all measurements and computations Structure Set Back from Ordinary High Water Level Ft.Ft.2,^© Structure set Back from Top of Bluff Ft. Ft.A/0<ft Structure Set Back from Road Right of Way Ft.Ft. Ft.&>/<^Ft.Structure set Back from Lot Lines Ft.&Ft. -t/0 Structure Height Ft.Ft. Structure Set Back from Septic Tank Ft.Ft. Structure Set Back from Absorption System Ft.Ft. Elevation Of Lowest Floor Above Ordinary High Water Level____________________-F IS Ft.Ft. -3 - ^e>Land Slope at Building Line %% Inspector’s Comments / Sketch: hr cX5 m r (a o~c^ 1 I 4 • t «k.6) 2/ ‘ » ^ ^ ' ^{0 UJO inspector's Signature Ik Date of Inspection Time of Inspectionj- /AA'^Lu^ r- ■ ( ; !k:sh'[itA lyiJ '^7r" i i c»-4^<i. S Q^ V%fc — ^~t:::^rd>6:4r 0ir ^K)r L ■1Qj Ui<Rod A/I \+P~\i:^IyIX' t iI i \ 2~i i 04 A: qc^:'tu \\ T \) T y/:0^.,.- H>T J_:5w1 72(5 tVp^Ql yT N 7*^~y'^^iCf' Di?rr3.C ! i T Mi /ijy/.L. i^f''! /c> •J/ZV' u.>hi.-Li^-i J^JLki. t >< L» Xr/i /lAr L f' P ' A 9y(Ul^L 'Srut;i^\/f£, 'll.iS'// KMVqH^3 ;f > APPLICATION FOR SITE PERMIT LAND & RESOURCE MANAGEMENT OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 • FERGUS FALLS, MN 56537 WHI7E — Office GOLDENBOD — Inspector YELLOW — Owner PINK — Assessor 12^'^ 7(S> L,Permit No.LEGAL DESCRIPTION AND LOCATION TWP NO.LAKE NUMBER LAKE/RIVER NAME LAKE/RIVER CLASS^0 SECTION RANGE TWP NAME C, L > 6-C.Cl-r'h^4^0 Cc^17 PARCEL NUMBER (S)FIRE OR LAKE ASSOCIATION NUMBER ^ / 'j rs/o-OQo-iy^- -oo I IDENTIFICATION: Please Print All Information Mailing Address — No. Street, City and StateLast Name First Initial Zip Code Telephone No. ^ if 2^ /TfI'i 4-O K4dA-'Property Owner -7 A4ciA-y jCo oNameContractor S90 •>State Lie. It PROPOSED PROJECT PROPOSED USE RESIDENTIAL USE NON-RESIDENTIAL USE (X ) Garage CHARACTERISTICS OF PROPOSED ( ^1) One Family Dwelling ( ) Multiple Dwelling It of Units ( ) ( ) New Structure ( X ) Addition ( ) MH/RV ( JO Residentiai ( ) Non-Residential Basement () ( ) Utiiity Structure Wal ^sement () JCOutside Dimei of Structure_() Water Orientated Accessory Structure .Tt.YEAR ■^D Ft.TYPE OF FRAME ( ) Masonry () Wood ( ) Structurai Steel ( ) Other ONSITE SEWAGE DISPOSAL SYSTEM ( ) Public ( ) OTLSD ONSITE WATER SUPPLY ( ) Other Height of Structure. # Of Stories_____( ) Public ( ^ Individual ( ) None OFFICE USE ONLY, ( ) Bluff Irn]’one # Of Bedrooms (>Shbre Impact Zone ) Sensitive Area ft Of Bathrooms LOT SIZE AND SETBACKS: square feet. Water frontage isLot Area is feet. Maximum depth of lot feet. / <5-0 feet. (String Test)Building set back from ordinary high water level is 3Land height above ordinary high water ievel at building line is feet. Siope of iot % Buiiding set back from road right-of-way.feet. /o /GLot line setback is and feet. /oStructure wiii be located feet from septic tank (Sewage System Permit must be obtained before installation). 47Structure will be located.feet from soil absorption system (Sewage System Permit must be obtained before installation). TH/S iS A S/TE PER/\/l/T ONL Y AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 15, MINNESOTA STA TE STA TUTES. Agreennent: 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 accord ing to the provisions of the Ordinances of Otter Tail County, Minnesota. I further application. I also understand that this permit is valid for a period of six (6) (I understand that it is my responsibility to inform the Lan; that any plans and specifications submitted herewith shall become a part of this permit iS :e Management office once the building footings have been constructed.)Lesou Dated: of Owner f Permit: Permission is hereby granted to the above named appiicant/o perform the wVk 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 Ordinance of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said ordinances. Sigj 7 " !H o,y/Dated: Land & Resource Management Office SO.Permit Fee $.Receipt No.. Comments: Form No. BK — 0292-002 270.500 • Victor Lundeen Co Printers • Fergus Falls. MN ♦ 1-800-346-4870 TTw-’- ->iy.> i&*<u»y-vTw^*c..t?irr 0^t q ^ APPLICATION FOR SITE LAND & RESOURCE MANAGEMENT OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 • FERGUS FALLS, MN 56537 . « WH/TE j~Office GOLDENROD — Inspector YELLOW — Owner PINK — Assessor A-S- /PS ? 7fa^ QL.g^L£GAL Permit No. DESCRIPTION LOCATION LAKE/RIVER NAMELAKE NUMBER LAKE/RIVER SECTION TWP NO.RANGE TWP NAME ::CL> f l^LQ 40 cl! I Cnx PARCEL NUMBER (S)FIRE OR LAKE ASSOCIATION NUMBER -Oo // /3 ro/c9 -OOo- / X - 00^ ?- IDENTIFICATION; Please Print All Information Last Name First Mailing Address — No. Street, City and StateInitial Zip Code Telephone No. / i SOr<^Property Owner d d, /■ Ca^ojd. /t/f ^AjomC Cc. r-^7LU d JCo fJNameContractor State Lie. # PROPOSED PROJECT PROPOSED USE RESIDENTIAL USE ( Y ) Family Dwelling ( ) Multiple Dwelling It of Units ( ) NON-RESIDENTIfL US^{C ) Garage /\ j hiCxjt} ( ) Utility Structure ( ) Water Orientated Accessory Structure CHARACTERISTICS OF PROPOSED ( ) Residential ( ) Non-Residential ( ) New Structure ( X) Addition ( ) MH/RV Basement () Walkout Basement ( ) Outside Dimension 7 V sC. of Structure ' f ^YEAR TYPE OF FRAME ( ) Masonry (y )Wood ( ) Structural Steel ( ) Other ONSITE SEWAGE DISPOSAL SYSTEM ( ) Public ( Y) Individual Permit It_________ ( ) OTLSD ONSITE WATER SUPPLY ( ) Other Height of Structure. # Of Stories_____ Ft. ( ) Public ( Y) Individual ( ) None OFFICE USE ONLY. ( ) Bluff hjipact Zone ^r^ore Impact Zone ( ) Sensitive Area -} ■A # Of Bedrooms (/# Of Bathrooms LOT SIZE AND SETBACKS:7crXDLot Area is square feet. Water frontage is feet. Maximum depth of lot feet. Building set back from ordinary high water level is feet. (String Test) .!3Land height above ordinary high water level at building line is Building set back from road right-of-way feet. Slope of lot %tP O feet. /o /oLot line setback is and feet. /oStructure will be located .feet from septic tank (Sewage System Permit must be obtained before installation). feet from soil absorption system (Sewage System Permit must be obtained before installation).structure will be located ;lTHIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES. Agreement: l 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 accord ing 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 (I understand that it is my responsibility to inform the Land & Resource Management office once the building footings have been constructed.) ( H ^ 7' r Dated: Signatijte of Owner Permit: Permission is hereby granted to the above named applicant fo 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 Ordinance of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said ordinances. Dated: Land & Resource Management Officeso. ^//O ?YX-Permit Fee $,3Receipt No. 5 Comments: ,.i 1 ! Form No. BK — 0292-002 270.500 • Victor Lundetn Co Printort • Fergus Falls. MN • 1-800-346*4870 •-■7 INSPECTION RESULTS Make all measurements and computations ■4. ACTUAL MINIMUM Sq. Ft. Building Set Back from High Water Level Ft.Ft. /O y/ A 5-00^ Building Set Back from Top of Bluff Ft.30 Ft. Building Set Back from Road Right of Way Ft.20 Ft. Ft. & /O^ Ft.Ft.Building Set Back from Lot Lines ^ SoOv\{Building Height Ft.Ft.4 Building Set Back from Septic Tank Ft.10 Ft Building Set Back from Absorption System Ft.20 Ft Elevation Above High Water Level at Building Line Ft.3 Ft. Land Slope at Building Line % Inspector's Comments/Sketch:, Inspector's Signature .f S'II-99 \ IDate of Inspection ^ \ 0 -i Time of Inspection i ■■ Scale: Each grid equals feet/inches GRID PLOT PLAN SKETCHING FORM Dated:19 Signature Please sketch your lot indicating setbacks from road right-of-way, lake and sideyard for each building currently on lot and any proposed structures. t*—1 1- >h, _J 3 ! n i; rI IP Iip d f 4 , . ^ , 1 ' : ■ i ■ ‘ • 1 ti i ' r ; i 1 [-r - i i1f-i ll (-f f (yey - 1-! ! i -[ t V : !i i V' tT I I i J. tV. -i [ d) X. V ■ ■ ■> ' ->5.C k f i MKL-0871-029 21S98 7®VICTOR LUNOetN CO . PRINTERS. FERGUS FALLS. MINN. APPLICATION FOR SITE PERMIT SHORELAND MANAGEMENT — COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 • FERGUS FALLS, MN 56537 WHITE.*- Office GOLDENROD — Inspector YELLOW — Owner PIMK — Assessor II157tor ^ ejc Q W /w oir.^ Pf.j-' ar Si. ^ .-H So . LEGAL Permit No.\(DESCRIPTION AND LOCATION LAKE NUMBER LAKE/RIVER NAME LAKE/RIVER CLASS SECTION TWP RANGE TWP NAME PORDI3X5^ PARCEL NUMBER (S)FIRE OR LAKE ASSOCIATION NUMBER /O-ooo -/i - OOTYX rXU IDENTIFICATION: Please Print All Information Last Name First Mailing Address — No. Street, City and StateInitial Zip Code Telephone No, /-O "Sfcx 07^ 2-it 8^^-sff^Property Owner NamContractor U,.tYaJtTYPE OF PROJECT PROPOSED US RESiDENTIAL USE ( One Family Dwelling ( ) Multiple Dwelling # of Units ( ) NON-RESIDENTIAL USE ( ) Garage ( ) Utility Structure ( ) Water Orientated Accessory Structure CHARACTERISTICS //if)<yiNew Structure Residential Basement Walkout Basement f^O) Height of Structure 2^^ Ft. () Alteration ) Other () Non-Residential /TYPE OF FRAME ( ) Masonry (y ) Wood ( ) Structural Steel ( ) Other TYPE OF SEWAGE DISPOSAL ( ) Public { Y) Individual Permit #_ WATER SUPPLY ( ) Public ( ^sj^ndividual ( ) Other Outside Dimensio of Structure OFFICE USE ONLY Ol/iP) Bluff Impact Zone IlfjO) Shore Impact Zone {fj^ Sensitive Area a# Of Bedrooms If Of Bathrooms LOT SIZE AND SETBACKS: 5558'.3snLot Area is square feet. Water frontage is feet. Maximum depth of lot feet. Building set back from ordinary high water level is feet. (String Test) 3Land height above ordinary high water level at building line is Building set back from road right-of-way feet. Slope of lot % LS?fO feet. atrLot line setback is and feet. Structure will be located J__feet from septic tank (Sewage System Permit must be obtained before installation). __feet from soil absorption system (Sewage System Permit must be obtained before installation).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 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. THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16. MINNESOTA STATE STATUTES. / Dated: Fianature of Own Permit: 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 Ordinance of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said ordinances. Dated: Land & Resource Management Office n 'R,d"Receipt No._Z.Permit Fee $ Comments: OaxLu^cy?f7>7 4- Form No. BK — 0292-002 260.770 — Victor Lundeen Co.. Printers. Fergus Falls, Minnesota -.■.isJFW ■ ’7'*'. ■■ *' » r. 4>^» SHORELAND MANAGEMENT — COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 • FERGUS FALLS, MN 56537 APPLICATION FOR SITE PERMIT WHITE —'Office GOLDENROD — Inspector YELLOW — Owner PINK — Assessor 11/37lor ^ /w /'^ or \lL>f p^f.3'* IQd.pr' vr ^ 't/f Permit No.LEGAL 6T /DESCRIPTION s/ /V, . -t- So.AND LOCATION LAKE NUMBER LAKE/RIVER NAME LAKE/RIVER CLASS SECTION RANGE TWP NAMETWP RD I3X PARCEL NUMBER (S)FIRE OR LAKE ASSOCIATION NUMBER /O-ODO -O - 00^X ecuMIDENTIFICATION: Please Print All I ation t Mailing Address — No. Street, City and StateLast Name First Initial Zip Code Telephone No. /p'/fA^£-y r P-cq.'B^k r-O Property Owner /Y. Sr^t^ Os YUS rNamContractor 17, . PROPOSED US^ ( yi) Residential ( ) Non-Residential TYPE OF PROJECT ( y ) New Structure ( ) Alteration RESIDENTIAL USE ( ^ ) One Family Dwelling ( ) Multiple Dwelling # of Units ( ) NON-RESIDENTIAL USE ( ) Garage ( ) Utility Structure ( ) Water Orientated Accessory Structure ( ) Other CHARACTERISTICS Basement Walkout Basement f^O) Height of Structure 2^0 Ft.( ) Other /TYPE OF FRAME ( ) Masonry (V. ) Wood ( ) Structural Steel ( ) Other TYPE OF SEWAGE DISPOSAL WATER SUPPLY ( ) Public ( y^lndividual Outside DimensiorF» ’ ^ of Structure A Oo ft. OFFICE USE ONLY Bluff Impact Zone ffjO) Shore Impact Zone Sensitive Area a( ) Public ( y ) Individual Permit # Of Bedrooms # Of Bathrooms LOT SIZE AND SETBACKS:IS38Lot Area is square feet. Water frontage is feet. Maximum depth of lot feet. /ooBuilding set back from ordinary high water level is feet. (String Test) S'~lc>Land height above ordinary high water level at building line is feet. Slope of lot %/ Building set back from road right-of-way.feet. Lot line setback is and feet. Structure will be located _feet from septic tank (Sewage System Permit must be obtained before installation). __feet from soil absorption system (Sewage System Permit must be obtained before installation).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 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. THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES. 3 /pgp /Dated: Tianature of Ow Permit: 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 Ordinance ot Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said ordinances. Dated:i'-t Land & Resource Management Office / 03Permit Fee $.Receipt No.. 5^Comments:3 ^ t-uvCo Pop <3-e> ^JL /d 7^ 'OcLCL ir Form No. BK — 0292-002 260.770 — Victor Lundeen Co.. Printers, Fergus Falls. Minnesota INSPECTION RESULTS S Make all measurements and computations f \ ACTUAL MINIMUM Sq. Ft. Lot Area (Square feet)Sq. Ft.Sq. Ft. Water Frontage Ft.Ft. Hox> fBuilding Set Back from High Water Level Ft.Ft. Building Set Back from Top of Bluff Ft.30 Ft. icro fBuilding Set Back from Road Right of Way Ft.20 Ft. H IM.Building Set Back from Lot Line Set Back Ft. &Ft.Ft. Building Height Ui Ft.Ft. j_i±Building Set Back from Septic Tank Ft.10 Ft Building Set Back from Absorption System Ft.20 Ft Elevation Above High Water Level at Building Line 10 f Ft.3 Ft. Land Slope at Building Line % X Inspector's Comments: •. • Sketch: I I lns0Bctor's Signature^ Date of Inspection Uio^ Time of Inspection / Scale: 'Each grid equals feet/inches ^RID PLOT PLAN SKETCHING FORM 3j <22^Dated:19 Signature Please sketch your lot indicating setbacks from road right-of^^way, lake and sideyard for each building currently on lot and any proposed structures. siU F. ^IIIS? I86i HOUi^ 5wcP ^!\(\l(00 fsh6 I I A.I' Vi wfAL y~(P/de r4LSo MoU Ho*A< Cjo^fy. OF Hou^^, IVir^I X4 • / 1 \ A V—/Ve? cttcrr k-^S€\jd€t Sysre^r nT\ t (r -r 1+1 . i.1 1 -i^ , : .4 .1 i 4“ I i 1>9 r0 0)1oc K V V \MKL-0871-029 21S98 7®CiitWriHL VICTO* LUNeCIN CO . PRIHTEHS. EERGUS FALLS. HIMN.