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HomeMy WebLinkAboutPaul Lake Resort_20000990341000_Shoreland Permits_Pre-Application Site Inspection Request Assigned To/Date: 'F'f^ V NOTE: Onsite Inspections will be done between April 15*'’ & October 1®*, unless the Land & Resource Administrator determines current weather conditions are suitable for onsite inspections. Lake / River No.Lake / River Name Lake/River Class Section Twp Name /r335Pfluf. ________ 4ooo0^^^5og7o^)/ , AiiWoWJ’Vtcvo Property (E-911) Address *V*W\ OParcel(s) No. I*' r^roProperty Owner Information; Name(s); "SiMiaXt- ____________________________ V>1% Paul Uk/ih/} (ftcAl/4^ ur/jAddress: 3j/vt z/g- 3Daytime Phone; Type of Request: Bluff: Date Stamp Determination __Stake Setback ^Stake Setback Verify Setback RffBOEDOHWL:Determination Verify Setback bEP 19 2017 LANDSRESOUBCtBuilding Line:Shore Impact Zone:Verification Stake Setback Wetland:Shoreland Area:Determination Determination Soils:Restrictive Layer Determination / Vertical Separation L&R Initial Describe Request: C\iS3 ivVc/ -trs c:p-g_e A scale bo 1V ctivnor LCrv^ 0 drawing must accompany Pre-Application Site Inspection Request & request must be staked onsite Property Ovi/ner Date INSPECTION COMPLETED (Inspection must be done within 10 days of receipt): ‘iln/n Date bnsite hi £3 Date Property Owner Notified Inspector 700' n> c.Fee:Receipt Number; Inspector must provide site drawing or field notes on other side. mbowman Application & Forms Pre-Application Site Insp Request Form 06/2012 i > >« i t "4 /I O-Hif^'t^"Z- 3' ^ I i (?-^h iC^A.'J I i(0' ▼ I.60<yCf .>\ v/^' \ ■ \ \ r 9 r >.r T f ■''W •>''k ' .-*fa ••O i’ rp V y>lr-w—— .— S—----■•>• mmssr-v^'‘ Ayr 4)cpf^ ' /✓//PARCEL C./ A’*', V •'’-2J,250 S.F.+/-■.'m:- '4; :■■;'' /■■ / j:\- F<s>. <« ->4,/%yax>•vV^'/%N'/Xft-/ft \/0 'UK /V / X<S- " "nJ PARCEL D /\/yr\/ M' /I A 1 . Ii Xfb\y%&X • 'S? <0| ■ o'10 ; I '*- \ '\ /7" V \... .2,2,164^ S.F+/-^ . ^'O ■ ••„ • ^^....—.-••**•-..cy ;>5^/\<./ / ^Hvvu 7I/\/ /y//X /SV 7 '/////\/\'//a2 ,0X0// '' A / . /;'/// '/\N .N/7\'X</A /"-Z ‘b/•//\X ////’■/\/\/V/V/-A/7/\ /X \7 /O^ - >^'( KV9 ; '/V x9 ■ •■■' X) '/ CRSON LAND SURVEYING, INC. 31 3 SOUTH GUS FALLS, MILL STREET MINNESOTA S653T Mapi I Otter Tail Countj X Q Interactive Land Viewer - X C © svww.ottertailcounty.net’'flex\iewers/land/ Wj DIter lad Couity, MN - Meractne Land Map (Parcels) ^ex Viewer v2 5H Mote...2D13PhOtO 5^'r ■Enhanced Search/Identrfy Search Layer:County Parcels Search by Parcel Number (PIN) [E)ample: 03000200143004] >•■-■£ T~- a la ® ©|f^d) iji:jfy Start White - Office Yellow — Owner Pink — Aikeesor Goldenrod — Inspector SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 — Fergus Falls, Minnesota 56537 APPLICATION FOR SITE PERMIT/ a-4 >cA4lili<W Pl^rf in 6ou4 U>+ Ij 5o0+-h pf 1 Permit No„LEGAL DESCRIPTION AND LOCATION raij I KmLske No. Lin Lake Name Lake Classif.Sec.Range TWP Name IDENTIFICATION: Please Print All Information Last Name First Initial Zip No.Tel. No.bailing Addr^— No. Street, City and State_____________^ Perl\o-M , 7477 MT:Owner m:NameContractor Architect Name. TYPE OF IMPROVEMENT: ^^New Buildina ( ) One Family Dwelling ■7\€vJ 3lZC i ^0 Xjy*' (^Multiple Dwelling RESIDENTIAL PROPOSED USE:NON-RESIDENTIAL PROPOSED USE: Specify:. ( ) Alteration Units ( ) Other ( ) Other Size IESTIMATED COST OF IMPROVEMENT $ PRINCIPAL TYPE OF FRAME:TYPE OF SEWAGE DISPOSAL:DIMENSIONS: >^No ( ) Masonry _t^ Wood Frame ( ) Structural Steel ( ) Other — Specify ( ) Public Individual Septic Tank, etc. WATER SUPPLY: ( ) Public Individual Well Basement: ( ) Yes Stories above basement: ...................................« Sq. feet (outside dimension) . Bedrooms Baths / i^e^or+ Type of Roof: CHARACTERISTICS:(gOOj>t|UUlL' ruCT.Water frontage is feet.Lot Area is Maximum depth of lot feet. IQ-SoBuilding set back from high water mark is Land height above high water mark at building line is Building set back from State highway right of way.... Side yard is Structure will be located feet. (Building Line feet :iofeet — from road right of way is •feet. ID ...1.0... and feet. .feet from septic tank (Sewage System Permit must be obtained before installation), feet from soil absorption system (Cesspool, Drainfield, etc.).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 specifi^pns 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.3THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16. MINNESOTA STATE STATUTES.0Signature of Owner 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 fail County, Minnesota. This permit may be reyoked at any time upon 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 e ''—'^hordand Management Official Dated 30'^ tRi!<K»SbiPermit Fee $. ------UlCt Se.Hyj.dC CQ /)U Ayf. on T- wtll Imf()-I>4) ii|V|-sh D4ts will b "fone oueK uexus- V\)ill L aY\.\AOCL\\\\/■ ' I 19S676@ VICTOR LUNOECN CO.. PRINTERS. FERGUS FALLS. MINN.Fofm^No. MKL-6771-OO: f OfficeWhite Yellow Owner Pink - Assessor ^ZTENJ). 7 SHORELAND MANAGEMENT COUNTY OF OTTER TAtL COUNTY COURT HOUSE Phone: (218) 739 -2271 — Fergus Falls, Minnesota 56537 APPLICATION FOR SITE PERMIT Goldenrod — I A IV i I Permit No..LEGAL f t" ^i 1DESCRIPTION >■ i I • +■'f ~V . i ■ft ' \ ' ';1ANDI LOCATION iI Lake No.Sec.TWP NameLake Name Lake Clanif.TWP Range 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: I ) New Building ( I Alteration ( ) One Family Dwelling ( ) Multiple Dwelling ( )Other Specify:. Units ( )Other Size ESTIMATED COST OF IMPROVEMENT $ PRINCIPAL TYPE OF FRAME:TYPE OF SEWAGE DISPOSAL:DIMENSIONS: ( ) Masonry ( ) Wood Frame ( ) Structural Steel ( ) Other — Specify ( ) Public ( ) Individual Septic Tank, etc. WATER SUPPLY: ( ) Public ( ) Individual Well Basement: ( ) Yes ( ) No Stories above basement: ........ Sq. feet (outside dimension) ..... Bedrooms ' ^ ) Baths t Type of Roof: CHARACTERISTICS: square feet. Water frontage is feet. Maximum depth of lot. feet. (Building Line)<^ Lot Area is feet. z:dLBuilding set back from high water mark is. Land height above high water mark at building line is... Building set back from State highway right of way.....:: Side yard is ..................... Structure will be located feet M ofeet — from road right of way is ■feet. and feet. .feet from septic tank (Sewage System Permit must be obtained before installation), feet from soil absorption system (Cesspool, Drainfield, etc.). •i. 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 e 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.Signature of Owner 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 upon 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 Official!1i!■ Permit Fee $. 7 - > k'-■’ J •i ,1 fComments:i i ‘v I• t T-Vii ! ^I ! 1 ! I 19S676® VICTOR LUNOEEN CO.. PRINTERS. FERGUS FALLS. MINN.Form No. MKL-0771-002 ! S> '■v LO)L^EJ0 jU/1^r,^ii-----<* ^^ •>ffM INSPECTOR'S CHECK LIST Make all measurements and computations f ACTUAL IS i MINIMUMShall Be i Sq. Ft, CD Sq. Rr ^0 ^ 060Lot Area (Square feet)Sq. Ft. ^00Water Frontage Ft.Ft.5 ^ICOBuilding Set Back from High Water Mark Ft.Ft. 1'^ ^££^1^ Building Set Back from State Highway 50 Ft.Ft. ;w^JS) ^ Ft.Building Set Back from Street or Road Ft. )d & Ft./^ ' & \0' Ft.Side Yard 7LRear Yard Ft.Ft. \DOccupied Building to Septic Tank 10 Ft.Ft. Occupied Building to Absorption System Ft.20 Ft. Elevation at Building Line above High Water Mark_____________2>Ft.3 Ft. Inspector's Comments: to >50- Inspector's Signature ^ I oT 19*^ Title Inspection Dated Agency VICTOM UIHBCCM t 60 . IIHTtI riu.t.t. Mil Department of ! LAND & RESOUI^CE MANAGEMENT COUNTY OF OTTER TAIL Phone 218-739-2271 Court House Fergus Falls, Minnesota 56537 :•I MALCOLM K. LEE, Administrator i 1 1 1 have been informed by the Land & Resource Office that I must contact Sck2^o^\\A!j^LovJ^ 5 (To%mship Name) in (Township Chairman) order to determine whether or not any additional permits are required by the township for my proposed project. (Date) SHORELAND MANAGEMENT ORDINANCE - DIVISION OF EMERGENCY SERVICE - SUBDIVISION CONTROL ORDINANCE SOLID WASTE ORDINANCE - RIGHT-OF-WAY SETBACK ORDINANCE - FUEL AND ENERGY COORDINATION SEWAGE SYSTEM CLEANERS ORDINANCE - RECORDER, OTTER TAIL COUNTY PLANNING ADVISORY COMMISSION 1'Office Owner White Yellow Pink — Assevor Goldenrod /- Inspector SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone; (218) 739-2271 — Fergus Falls, Minnesota 56537 APPLICATION FOR SITE PERMIT/ I Permit No.,LEGAL DESCRIPTION AND LOCATION Lake Classif. Sec. TWP_______Range TWP NameLake No.Lake Name IDENTIFICATION: Please Print All Information Tel. No.Mailing Address— No. Street. City and State Zip No.InitialLast Name First V-1 N|Sosy-i avfe-q1 son ^----(^g.orae.Owner )^76 NameContractor Architect Name, NON-RESIOENTIAL PROPOSED USE:TYPE OF IMPROVEMENT:RESIDENTIAL PROPOSED USE: ^^One Family Dwelling ( ) Multiple Dwelling ^^He\N Building Specify: Mobilr?. homeUnits( ) Alteration VK<3C,'() Other ( ) Other Size ESTIMATED COST OF IMPROVEMENT $ PRINCIPAL TYPE OF FRAME:TYPE OF SEWAGE DISPOSAL:DIMENSIONS: ( ) Masonry ( ) Wood Frame (^^_Structural Steel ( ) Other — Specify ( ) Public Basement: ( ) Yes (/) No Stories above basemenr ....... Sq. feet (outside dimension)..... Bedrooms Individual Septic Tank, etc. WAT^ SUPPLY: ( ) Public Individual Well /Baths Type of Roof: CHARACTERISTICS: /.D.Qsquare feet.Water frontage is feet.Maximum depth of lot ... feet.Lot Area is Building set back from high water mark is.............j..\. Land height above high water mark at building line is Building set back from State highway right of way.... feet. (Building Line) -f-feet ...feet — from road right of way is ...........feet. /,oSide yard is .....feet. Structure will be located feet from septic tank (Sewage System Permit must be obtained before installation), feet from soil absorption system (Cesspool, Drainfield, etc.).Structure will be located Agreement: I hereby certify that the information contained herein is correct and agree to do the proposefLwork in accordance with the description above set forth and according to the provisions of the ordinances of Otter Tail County, Minnesota. I further agcde th^ 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 (Bl/months., _ THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUES.----^Signature of Owne 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 Iboreland Manageme'nf''Official Permit Fee $. '/o(A ^6 Commeritsf 195676@ VICTOR LU.NOCEN CO.. PRINTERS. FERGUS FALLS. MINN.iForm No. MKL-0771-002 OfficeWhite Yellow — Owner Pink — AssessorGoldenrod' SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 — Fergus Falls, Minnesota 56537 APPLICATION FOR SITE PERMIT Inspector ;i Permit No..LEGAL j \DESCRIPTION 1/i. f i ■ AND LOCATION TWP NameLake No.Sec.TWP RangeLake Classif.Lake Name IDENTIFICATION: Please Print All Information Last Name Mailing Address— No, Street. City and State Zip No.Tel. No.First Initial 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 $ PRINCIPAL TYPE OF FRAME:TYPE OF SEWAGE DISPOSAL:DIMENSIONS: ( ) Masonry ( ) Wood Frame I ) Structural Steel ( ) Other — Specify ( ) Public ( ) Individual Septic Tank, etc. WATER SUPPLY: ( I Public Individual Well Basement: ( ) Yes (/) No Stories above basement; Sq. feet (outside dimension) Bedrooms Baths ....I,M ik'\N Type of Roof: CHARACTERISTICS: itsquare feet. Water frontage is Building set back from high water mark is......................................... Land height above high water mark at building line is................... Building set back from State highway right of way................. Side yard is ..................... Structure will be located feet.Maximum depth of lotLot Area is feet. feet. (Building Line) t feet feet — from road right of way is •feet. feet.and .feet from septic tank (Sewage System Permit must be obtained before installation), feet from soil absorption system (Cesspool, Drainfield, etc.).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 STATUES.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 $. Comments: CA-LLED 195676® VICTOR LUNOCEN CO,. PRINTERS. FERGUS FALLS. MtNN-Form No. MKL-0771-002 V, INSPECTOR'S CHECK LIST Make all measurements and computations ACTUAL IS i MINIMUM Shall Be 4-Sq. Ft. Lot Area (Square feet)Sq. Ft Sq. Ft. Water Frontage Ft. Ft. Building Set Back from High Water Mark Ft.Ft. Building Set Back from State Highway Ft.50 Ft. Building Set Back from Street or Road Ft.40 Ft. Side Yard &&Ft.Ft. Rear 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: Inspector's Signature Title Inspection Dated 19 Agency VietO* LUNDCIH t M . PMIHTCI White — Office Yellow — Owner Pink — Assessor Goldenrod — Inspector SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 — Fergus Falls, Minnesota 56537 APPLICATION FOR SITE PERMIT Permit No..LEGAL Lj A iDESCRIPTION AND LOCATION J£___13L -Vt Range TWP NameLake Classif.Sec.TWPLake No.Lake Name IDENTIFICATION: Please Print All Information Tel. No.Last Name Zip No.First Initial Mailing Address—-No. Street, City and State/2 AT A'l..O ) 5 C ^Owner NameContractor Architect Name. TYPE OF IMPROVEMENT: 1^) New Building ( ) Alteration NON-RESIDENTIAL PROPOSED USE:ilARESIDENTIAL PROPOSED USE: (.('fll/'/( ) One Family Dwelling ( ) Multiple Dwelling Other Specify: Units ( ) Other Size IESTIMATED COST OF IMPROVEMENT $ PRINCIPAL TYPE OF FRAME:TYPE OF SEWAGE DISPOSAL: (\^Public ( ) Individual Septic Tank, etcn WATER SUPPLY: DIMENSIONS:c (%yNo ( ) Masonry Wood Frame ( ) Structural Steel ( ) Other — Specify Basement: ( ) Yes Stories above basement: Sq. feet (outside dimension) Bedrooms ..............................Public ( ) Individual Well Baths Type of Roof: rCHABACTERISTICS: ..£p..o.luM:square feet. Water frontage is Building set back from high water mark is. Land height above high water mark at building line is Building set back from State highway right of way..... Side yard is Structure will be located feet.Maximum depth of lotLot Area is feet. /oa feet. (Building Line) J.1 feet feet — from road right of way is .feet. and.../.£J±feet. .feet from septic tank (Sewage System Permit must be obtained before installation), feet from soil absorption system (Cesspool, Drainfield, etc.).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 si )'jTionths. THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUES.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. I V7Dated 7ShofeWnd ManageipL/s^^ment Official Permit Fee $. Comments: 19S676(@ VICTOR Lt>NOEEN CO.. PRINTERS. FERGUS PALLS. MINNForm No. MKL-0771-002 White Yellow Pink — As^ssor Goldenrod — Inspector Office SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 - Fergus Falls, Minnesota 56537 APPLICATION FOR SITE PERMIT Owner Permit No._.LEGAL Lj /ADESCRIPTION Po^vAND LOCATION A IT*-■!S Qr.■'1 TWP NameRangeLake Classif.Sec.TWPLake No.Lake Name IDENTIFICATION: Please Print All Information Tel. No.Last Name Mailing Address— No. Street. City and State Zip No.First Initial ; ■Owner NameContractor Architect Name. TYPE OF IMPROVEMENT:RESIDENTIAL PROPOSED USE:NON-RESIDENTIAL PROPOSED USE: ( ) New Building ( ) Alteration ( ) One Family Dwelling ( ) Multiple Dwelling Specify:, Units V' '( ) Other ( ) Other Size ESTIMATED COST OF IMPROVEMENTS PRINCIPAL TYPE OF FRAME:TYPE OF SEWAGE DISPOSAL:DIMENSIONS: ( ) Yes ( \s,No(H Public { ) Individual Septic T.ank, et(^^ WATER SUPPLY: (' ) Public ( ) Individual Well I ) Masonry ( ) Wood Frame ( ) Structural Steel ( ) Other — Specify Basement: Stories above basement: Sq. feet (outside dimension) Bedrooms .............................. r!ff Baths Type of Roof:I I- CHARACTERISTICS: ^OOWater frontage is ..Vnsquare feet. Building set back from high water mark is. feet.Lot Area is .:.Maximum depth of lot feet. feet. (Building Line)--.i Land height above high water mark at building line is Building set back from State highway right of way..... . i... feet feet — from road right of way is feet. Side yard is and feet. Structure will be located .feet from septic tank (Sewage System Permit must be obtained before installation), feet from soil absorption system (Cesspool, Drainfield, etc.).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 STATUES. (.'■ ' 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 the 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. Permit: ' /Dated /Shoreland Management Official Permit Fee $. ________Aj^ /OO a ChosJhComments: C /*iH{ji ic IU JU I rp 19S676® VICTOR LUNOEEN CO.. PRINTERS. FERGUS FALLS. MINN.Form No. MKL-0771-002 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 % L> I La l(e Lake Name Permit NiLEGAL Date.DESCRIPTION AND LOCATION /r /3CiX-13/ TWP NameSec.TWP RangeLake Classif.Lake No. IDENTIFICATION: Please Print All Information Tel. No.Zip No.Mailing Address— No. Street. City and StateInitialFirstLast Name_____________^-7, \D bSbciOwner i. \ P \ /foC^^Tcl Q{'xlNameContractor Architect Name. NON-RESIDENTIAL PROPOSED USE;RESIDENTIAL PROPOSED USE:TYPE OF IMPROVEMENT: /"TNew Building ( ) Alteration ^ ^ Specify:.^FOne Family Dwelling ( ) Multiple Dwelling Units ( ) Other Size( ) Other ESTIMATED COST OF IMPROVEMENTS OOO (omit cents)7*DIMENSIONS:TYPE OF SEWAGE DISPOSAL:PRINCIPAL TYPE OF FRAME: : ( ) No Stories above basement: Sq. feet (outside dimension) Baths ( ) Public L-+^ridividual Septic Tank, etc. WATER SUPPLY; ( ) Public JJrff"T1idividual Well MECHANICAL EQUIPMENT : Elevator: ( ) Yes Air Conditioning: ( ) Yes ( ) Central Basement( ) Masonry /r<Wood Frame ( ) Structural Steel ( ) Other — Specify ....................... Bedrooms HEATING: j^T^lectric ( ) Coal Other: ( ) Oil( ) Gas ( ) None ( ) NoType of Roof:-ft i ^^1^0 I 2 ( ) Unit CHARACTERISTICS; I feet.square feet.Water frontage is feet. (Building Line) ..............................feet Lot Area is 9.OIBuilding 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........ 1.2.. .../.i^.s..feet — from road or street is feet. /D C'...^..C...Q.......feet.feet. Rear yard is feet from septic tank (Sewage System Permit must be obtained before installation), feet from soil absorption system (Cesspool, Drainfield, etc.). and Agreement; I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set forth and according to the provisions of the ordinances of Otter Tail County, Minnesota. I further agree.rtf^'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 si|k (6)/months. to (90^ Signature'of Owner |4Dated. 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. VDated Shoreland Management Official Ar.°'='^ 3S’y^State Surcharge $.Permit Fee $. Comments: Form No. MKL-0771-002 1S8899 VICT«« iUMtCCM & M.. PHIHTII 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 Goldenrbd — Inspector t \Permit No„fiLEGAL . V Date.DESCRIPTION . IA /AND / LOCATION ! Lake Classif.Lake No.Lake Name Sec.TWP Range I-TWP Name IDENTIFICATION: Please Print All Information i i!lt) No.Last Name First Initial Mailing Address— No. Street, City and State Tel. No.I.f S’ Owner ■ k\TI / rNameContractor VArchitectName. : NON-RESIDENTIAL PROPOSED USE: Specify:________________________■ TYPE OF IMPROVEMENT:RESIDENTIAL PROPOSED USE: ( ) New Building ( ) Alteration ( ) One Family Dwelling ( ) Multiple Dwelling Units I ) 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 f ) Individual Septic Tank, etc. WATER SUPPLY: ( ) Public ( ) Individual Well MECHANICAL EQUIPMENT : Elevator: ( ) Yes Air Conditioning: ( ) Yes ( ) Central ( ) Yes ( ) NoBasement: ^ Stories above basement: Sq. feet (outside dimension) Bedrooms ..............................Baths HEATING: i ) Electric ( ) Coal Other: Type of Roof:( ) No ( ) Gas ( ) None ( ) Oil i , ( ) No /'( ) Unit CHARACTERISTICS:)/- Lot Area is.......................................'.............. ^^Building set back from high water mark is Land height above high water mark at building line is Building set back from State highway is........................ Side yard is.................... Building will be located Building will be located square feet.Water frontage is. feet. (Building Line) ...............................feet feet. feet — from road or street is feet. .......................................feet. Rear yard is feet from septic tank (Sewage System Permit must be obtained before installation). and feet. <feet from soil absorption system (Cesspool, Drainfield, etc.). 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:13 ATE wo Form No. MKL-0771-002 158899 VICTOR UINOCEN t C«.. MIHTfRI. FCROUO FM.LS. ■ i % INSPECTOR'S CHECK LIST Make all measurements and computations ACTUAL IS I MINIMUMShall Be i Sq. Ft. 5Lot ^rea (Square fee Sq. Ft.Sq. Ft. oo Ft.Ft.Water Frontage r i 90 Ft.Building Se^ Back from High Wjter Mark Buildmg Setback from Stati^^ighway Ft. 50 Ft.Ft. /qo ^Building Set Back from Street or Road Side Yard 40 Ft.Ft. m ■f Ft.&Ft. h Occupied Bujlding^jp /ooRear Yard Ft.Ft. I /V/\10 Ft.eptic Tank Ft. Occupied Building to Absorption System Ft.20 Ft. Elevation at Building Lirj^e above High Water Mark 3.0 * Ft.3 Ft.H-It Inspector's Comments: ■V Inspector's Sig^ture Title Inspection Dated 9r Agency I.. raiiink*. rAi.L*. hihn.vicToa iunmcA ft • • -V; SHORELAIMD 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 /o A )Permit No.LEGAL 6/2/ AoDate.DESCRIPTION AND LOCATION m.AT /3X: / Lake No. Lake Name Lake Classif.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. SS3R!t:/V)POwner Sr/fNameContractor Architect Name. TYPE OF IMPROVEMENT: 0() New Building ( ) Alteration RESIDENTIAL PROPOSED USE:NON-RESIDENTIAL PROPOSED USE: One Family Dwelling ( ) Multiple Dwelling ( ) Other Specify:, Units ( )Other Size ESTIMATED COST OF IMPROVEMENT $(omit cents) PRINCIPAL TYPE OF FRAME:TYPE OF SEWAGE DISPOSAL:DIMENSIONS: tf.+Yis ( ) No( ) Masonry ijf) Wood Frame ( ) Structural Steel ( ) Other — Specify ( ) Public Individual Septic Tank, etc. WATER SUPPLY: ( ) Public Individual Well Basement:/ Stories above basement: Sq. feet (outside dimension) Bedrooms Baths MECHANICAL EQUIPMENT : Elevator: ( ) Yes Air Conditioning: ( ) Yes ( ) Central HEATING: Electric ( ) Coal Other: Type of Roof:( ) Gas ( ) None (jpocid ( ) Oil (tuTo ( ) Unit 4CHARACTERISTICS; /Y 776 MaLot 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 •i.^.O..feet — from road or street is feet. feet. Rear yard is feet from septic tank (Sewage System Permit must be obtained before installation). and feet. Building will be located feet from soil absorption system (Cesspool, Drainfield, etc.). 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. /a:l <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. ^/7,3 Dated. Shoreland Management Official3. °°/t* '7)0.Permit Fee $.State Surctiarge $. o/rops___gjny___'(nr’tkgr Comments; ano—^----1 hn f y j ^ Form No. MKL-0771-002 1S8899 vicTB* LuM»ieN A CO., pmtrttot. rcoau*■V 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 OfficeWhite Yellow -r Owner Pink — Assessor {V \) C.j.Goldenrod Inspector % Permit No,./LEGAL Date.,7DESCRIPTION >7 r r-i >AND LOCATION / 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. 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 ( ) Individual Well MECHANICAL EQUIPMENT : Elevator: ( ) Yes Air Conditioning: ( ) Yes ( ) Central Basement: ( ) Yes ( ) No Stories above basement: Sq. feet (outside dimension) Bedrooms Baths HEATING: ( ') Electric ( ) Coal Other: ( ) NoType of Roof:( ) Gas ( ) None ( ) Oil ( ) No ( ) 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: ..%'C Y —G Form No. MKL-0771-002 158899 vierea lundccn t eo.. piiiiTtM. femaus minn ' # INSPECTOR’S CHECK LIST Make all measurements and computations MINIMUM Shall Be X Sq. FtACTUALIS jr 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.Side Yard Ft.Ft.Rear Yard 10 Ft.Ft.Occupied Building to Septic Tank 20 Ft.Ft.Occupied Building to Absorption System Elevation at Building Line above High Water Mark_____________3 Ft.Ft. Inspector's Comments: % S'0> / / Inspector's Signature Title Inspection Dated 19 Agency 1^ vcTo* iWNOCCN * eo .tINTII Page 1 of 1 Q/Wl ^TER TAIL COUNTY Land & Resource Management Phone (218) 998-8095 WiiPERMIT TYPE Site and Lot Alteration Permit (combined)______________ PERMIT NUMBER 29911 PROPERTY OWNER Kenna J & Adam L Dooley LAKE INFORMATION Paul DNR ID(S)335 LOCATION SCANNEDParcel(s): 20000990341000 Township Name: Edna Township Section/Township/Range; Sect-15 Twp-136 Range-040 Legal: HARRIS BEACH LOT 1 LIFE ESTATE JOSEPHINEOLSON * 47.74' TR IN SEC 15 WORK AUTHORIZED Construct 30'X52' dwelling, 24' X 26' attached garage with 12' X 24' covered porch with 6' X 12' entry. Site prep for the construction of the dwelling. Kyle Westergard 05/29/2018 08:09 AM 5534eee3b0bbaa7e00c330de4cb8a9ab b6bb9854711a98635b49d71ec652ad19 05/29/2018 05/29/2019 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 maybe revoked and the owner/contractor maybe 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. No part of the Septic System shall be covered until it has been inspected or approved. Notify Land & Resource Management when job is ready for inspection (218) 998-8095. 6/1/2018https://onegov.co.ottertail.inn.us/admst/viewcard.php?card=^5&app=2233 5/22/2018 Land & Resource Permit Applications V Land & Resource Management Government Services Center 540 Fir Avenue West Fergus Falls MN 56537 OTTER Tflil 218-998-8095OOVItTT-BiaiilOTA Site and Lot Alteration Permit (combined) Permit#___ Applicant Information Applicant Information:> Name; james ahemmelg^m Phone; (218 )346 -2377 i Email Address; hbi@aivig.net Mailirtg Address: Perham mn 56573 ContractorI am the; Property Owner's Contact Information Property Owner Contact Infonnallon: Name: KENNA & ADAM DOOLEY , Phone; (763 )807 - 7102 Email Address: Mailing Address; 5255 Niagra lane_N. Plymouth mn 55441 4597 Work Performed By (Site Permit) ContractorWork to be performed by (Site Permit): Contractor's Contact Information (Site Permit) Contractor Information:Name: james a hemmelgam Company or Business Name; hemmelgam builder inc. Contractor License Number: BC003628 Additional Phone;Phone: •1228;(218 )34f -2377 j )2n Email; hbi@arvig.net Address: 1p16^t ave n. Perham mn 56573 Work Performed By (Lot Alteration Permit) ContractorWork to be Performed by (Lot Alteration): Contractor's Contact Information (Lot Alteration) Contractor Information:Name: james^ hemmelgam Company or Business Name: hemmelgam builder ina Contractor License Number: 60003628 Additional Phone:Phone: (218 )371 -IMli (218 )346 -2377 i : Email: Address: 1016 St aven. Perham mn 56573 I 1/4https://onegov.co.ottertail.mn.us/view.php?id=2233&viewOnly=1&p= 5/22/2018 V Property Information Land & Resource Permit Applications Property Please search by one of the following: Parcel #, name, or Physical Address. Click the blue "Select” to select Selected: Primary Name/AddressProperty Attributes Property Address Legal Description Parcel #Property Address City Legal Description Legal Description Legal Description Primary Address Line 1 CityName 20000990341000 HARRIS BEACH LOT 1 LIFEESTATE JOSEPHINE OLSON • 47.74' TR IN SEC 15 KENNA J &ADAM 5255 NIAGRA LANE N PLYMOUTH L DOOLEY 21164 Square Feet. Developed Lot Area: Is the property Developed or Undeveloped? On Site Sewage Treatment System: New Proposed System Onsite Water Supply: Individual Shoreland Information Associated Lakes:Selected: Lake Name DNR ID Lake Class LRCD Paul 335 RD 56-335 River/Stream Name and Classification (i.e. Otter Tail / AG): Water Frontage: paul rd 137.7 Feet Bluff;No' Proposed Project (Site) Proposed Dwelling: Is there an Attached Garage? Proposed Non-Dwelling: Proposed Water Oriented Accessory Structure: Please list outside dimensions (in feet) of above items you are appiying for: Single Family Yes None None 30x52 new home 24x26 attached garage 12x24 covered porch 6x12 entry Characteristics of Proposed Dwelling New or Replacement: Square Feet: Maximum Proposed Height: Setback to Lot Lines (indicate closest lot lines): Replacement 1658 Square Feet Feet 14 Feet §2 Feet 40 Feet 54 Feet Setback to Right of Way: Setback to Ordinary High Water Level: 20 Feet ;^Feet -Feet ^ Feet Setback to Septic Tank: Setback to Drainfield: Setback to Bluff: Elevation above Ordinary High Water Level: Total Bedrooms:3 Roof Change:No Proposed Project (Lot Alteration) build up driveway and fill around north end of house, digging of crawl space and footing for garage, Approach/Driveway/Access Project Description:Project Type:Trail/Road Fill Foundation Type:Crawlspace Area to be Cut/Excavated 54 Feet Width:120______ Please Describe Cut/Excavated Area: need to dig 40" into hill and fill lower half 2 Feet Total Cubic Yards:^ Feet Average Depth:Length: of foundation on inside with what is used need to fill inside of garage with fill 2 Feet Total Cubic Yards:46 Please Describe pC8fcul;sta~| Cut/Excavated Area:24 Feet Average Depth:26 Feet Width:Length: fill in ' driveway 4' to nothing in 4 Feet Total Cubic Yards: Please Describe Cut/Excavate Area: 24 Feet Average Depth:1424^ Feet Width:Length: 40' Walk-Out Basement Project 0 Feet Total Cubic Yards:0.............. :| Gacuista |0 Feet Average Depth:OFeet Width:Length: 2/4https://onegov.co.ottertail.mn.us/view.php?id=2233&viewOnly=1&p= 5/22/2018 T'Area to be filled/Leveled Land & Resource Permit Applications p Feet Width:Length:0 Feet Average Depth:0 Feet Total Cubic Yards:0 Length:OFeet Width:0 Feet Average Depth:OFeet Total Cubic Yards:0 Length:0 Feet Width:0 FeetI Calduiate | Average Depth:0 Feet Total Cubic Yards:0 i| Caiculat# I Backfill at Foundation Linear Length:138 Feet Average Width:^ Feet Average Depth:4 Feet Backfiii Total:307 :[ iCMctiytis I Culvert and Road Authority Culvert?N/A Road Authority Approval:N/A Impervious Surface - Buildings Dwelling Existing: Attached Garage Existing; Detached Garage Existing: Storage Shed Existing; Water Oriented Accessory Structure Existing; Recreational Camping Unit Existing; Miscellaneous Existing: 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet Dwelling Proposed: Attached Garage Proposed: Detached Garage Proposed: Storage Shed Proposed: Water Oriented Accessory Structure Proposed: Recreational Camping Unit Proposed: Miscellaneous Proposed: Total Building Proposed Impervious: 1658 Square Feet 624 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 256 Square Feet 0 Square Feet 0 Square Feet Total Building Existing Impervious: 2M Square Feetf Gaicut^lS | 0 Square Feet 2262 Square Feet Impervious Surface Calculation - Buildings Total Building Existing Impervious: 256 Square Feet Total Building Proposed Impervious: Total Building Impervious Surface: 2538 Square Feet right 21164 Square Feet 2262 Square Feet Lot Area: Impervious Surface Ratio: Buildings Impervious Surface Percentage: 0.1199 11.99% ' ! •Impervious Surface - Other 192 Square Feet Deck(s) Proposed: Patio(s) Proposed; Sidewaik(s) Proposed: Landing(s) Proposed: Dhveway(s) Proposed: Parking Area(s) Proposed: Retaining Wall(s) Proposed: Landscaping Proposed: Miscellaneous Proposed: Other Proposed Total: 480 Square Feet 268 Square Feet 90 Square Feet 48 Square Feet 960 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 1866 Square Feet Deck(s) Existing: Patio(s) Existing: Sidewalk(s) Existing; Landing(s) Existing: Driveway(s) Existing; Parking Area(s) Existing: Retaining Wall(s) Existing: Landscaping Existing: Miscellaneous Existing; Other Existing Total; 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 192 Square Feet Impervious Surface Calculation - Buildings & Other Total Building + Other Existing Impervious: Total Building + Other Proposed Impervious: Total Building * Other Impervious Surface; 448 Square Feet 4148 Square Feet 4596 Square Feet 21164 Square Feet 0.2172 Lot Area: Building + Other Impervious Surface Ratio: Building + Other Impervious Surface Percentage: 21.72% Shore Impact Zone Impervious 0 Square Feet Building(s) Proposed: Deck(s) Proposed; Patio(s) Proposed: Sidewalks(s) Proposed; Landing(s) Proposed: Driveway(s) Proposed: Parking Area(s) Proposed: Retaining Wall(s) Proposed; Landscaping Proposed: Miscellaneous Proposed: Total Proposed Impervious in the Shore Impact Zone: 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: Deck(s) Existing; Patio(s) Existing: Sidewalk(s) Exisiting; Landing(s) Existing; Driveway(s) Existing: Parking Area(s) Existing: Retaining Wall(s) Existing; Landscaping Existing: Miscellaneous Existing: Total Existing Impervious in the Shore Impact Zone; Total Impervious in the Shore Impact Zone; 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 | ■ Caisuiat§~| 3/4https;//onegov.co.ottertail.mn.us/view.php?id=2233&viewOnly=1&p= 5/22/2018 V Documentation Land & Resource Permit Applications Total Proposed Area to Determine 1658 Square Feet Fee: Total Earthmoving Request to Determine Fee: 615 Cubic Yards Applicant Approval Applicant Signature: Date Signed: Please check to approve: Attention: Hemmelgam James A 05/22/2018 I understand that checking this box constitutes a legal signaturelKYLE Comments:wilt send over the land scale drawing Terms Notes ) The lot lines and project area(s) must beidentified & staked onsite. :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 Notes If project disturbs more than 1 acre of land, you must obtain a General Storm Water Permit from the MPCA. 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. 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 05/21/2018 Quantity TotalCharge Cost Grand Total $0.00Total (Unpaid) Approvals signatureApproval Brittany A. Walters - 05/22/2018 2:24 PM 9b6a54dc791c50bdlf2c91fada52d344 dble6d57bec4b85e840b75cd2970617c #1 Received and Assigned #2 Permit Review #3 Permit Review #4 Permit Issuance 4/4https;//onegov.co.ottertail.mn.us/view.php?id=2233&viewOnly=1&p= 3o‘ l6 I b /4fcvOr-b > I ^ I £ w ^ ;__1)^0 fe '. N. • .\:>v I !|^iS fiO.Isom- ow^I *' "" * K:' t C.r>\;!Uv.!i M^o 1/ ^XO?i-' HJfi-r I 0uj£i1 f- ^ •t ^ t5V ^i' /i7,7 1 DetaSignatuc* afPi ler MO^ • <nau undwn Ci>. P»>wi • raws f»> mn • VSOO 34t4«MBK—042016 I SCALE DRAWING FORM At(X)()iS6D9,lr,n I A 000 6 990 2^106 iisiidebimmmS:Tax Parcel NumBer(s) The scale drawing n"ijst be a signed drawing which includes and identifies a graphic scale (feel), all existing and/or proposed structures, septic tanks, drainfields, lotlines, road right-of-ways, easements, OHWLs, wells, wetlands and topographic features (i.e. bluffs). Must also complete the Impervious Surface Calculation (see back). i 4! Scale ^7.76 I ^AitwO u.' R £ u' A ^ 1- \ V i ^0^M ! m Cn\>iMv& JC.^)Cur4 ♦+I 0S4(-(T*/ ujH i ; r "'S'35 < —» . SITE PERMIT fNSPECTION RESULTS Inspector must make alt measurements and computations I I PRptoilUfiT ^ j2<Lpf(Wxmiwo't-5 Vstructure Set Back from Ordinary High Water Level Ft.Ft. Structure Set Back from Top of Bluff rv/A Ft.Ft. 5^7 F Ft:5(i?Structure Set Back from Road Right of Way Ft. 14 IP/ HStructure Set Back from Lot Lines Ft.&Ft. 7^1^'Structure Height Ft.Ft. -r 10-^ Ft.Structure Set Back from Septic Tank n Ft. Structure Set Back from Drainfield Ft.Ft. Elevation Of Lowest Floor Above Ordinary High Water Level Ft.Ft. Land Slope at Building Site %% Inspector’s Comments / Sketch: \ \ / I14<- I5"^1^1 ft .1 \inspector's Signature OfZG/19 Date of Inspection Time of Inspection i/project Aporoveg ^ ate/Initial OTTER TAIL COUNTY Grade & Fill Permit # 6823 PROPERTY OWNER 4- :TEAt^sr7Z LAKE NO. 54>- SEC, TWP. NAME £iOr//? ( S.OeXH> DdS-7 - Dt^SLjLlrJGLEGAL DESCRIPTION: ?T GL i ^ JL 3.0000 1$ oo9T 7 _ __ \ ^ 3ooov ^4 t>oo J ~~ dcSofij ) WORK AUTHORIZED /Qal<£- do^i (^\P/^AP /)Ptoy. a /JlS £fJJ) oF Du?£ujA^g LdT Sii /9^<tox. 33.^ (!/>/n> fiEi£}fcrfajiP£/iri) Sa^mFul. X>to£uj3C u>T iOlTH Ao‘(uiom) i3v 3 /PE/nu) cuea^^ r>u^ fyi^o ds^oar PaoPeaXS Pbl ?la3 ^csi\f£/> n\i ^jxLjii y^lEPiME UJilU UA'inJ£ /fiU&ilPi ~ ~^fc fif(£A UiTHiJ oF ^w>^u>J£ ti Ur>itr€J> TV Cl^Ar9, K^OAriUi^A. Flix. ~ TVC /94C4 C^CilS^ UO ft^ ipA^flL NOTE: This card shall be placed in a conspicuous place not more tharrT 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. ^S£B0Ed - l>fi^in/a<s£ f^u^T 8£ ^ t * 1. EARTHMOVING SHALL BE DONE BETWEEN 2. Entire area shall be stabilized within 10 days of completion of any earthmoving. i 3. Owner is legally responsible for all surface water drainage that may occur. V 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. 5. If the terms of this permit are violated, the entire permit may be revoked and the owner may be subject to legal prosecution. 6. Erosion control measures must be implemented prior to any topographical alterations. Land & Resource Management Official BK-0806-003 327.142 * Victor Lundoen Co.. Priniors * Fergus Falls. Minnesota APPLICATION FOR GRADE & FILL 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 LAKE/RIVER #___LAKE/RIVER NAME I c^c^i RtS) LAKE/RIVER CLASS SECTION TWP; NO.RANGE TWP NAME /5 PARCEL NUMBE PROPERTY (E-911) ADDRESS .fttol U-iu or. tO \0 r. lk'sO I SCOg7OZs. ZOOCO (SCO'^ICO (LEGAL DESCRIPTION ^ Last Name First Initial Mailing Address DAYTIME Phone No. 14 i0.r cO <Tl ^04 __________ 2dLiMLlJ£^^Property Owner ‘St>^cioV</5Contractor Name HO Lo Uit cWt rA/u i;~(.Lie. # Date Stapip received SEP fl 3 7m LAM0& resource 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. \ L&R Initial PROJECT REQUEST (You may use the grid on back for required scale drawing): DESCRIBE YOUR PROJECT(S): \ A f 6S l~ ^ Lq/^ I ■s,jQ p r>=v p lo ^ 1% O'rc.'— <T ^ I i ^ I LL Q /-<ivv ulrir- <6i I ,~Vop pt___' I UV Q 1‘^c-X. C <T<^' 1^1. V<^ L\ p O p|)9o^ ~Vc:p 4^ 'toclA- AAcvL- ^ tW-Vo si uA —r.pj-c.pcrope Id'W XRg^v^:V U 1.< \o{CjS>Vr\S Coo &;vv.pc DETAILED INFORMATION: AREA TO BE CUT/EXCAVATED:Yds^Ft. X Ft. - 27 =Ft. X Length Width Ave; Depth I Ft. X Ft. X 3i Ft. - 27= 4?Yds^ Ave; Depth iZS^_Ft. X /^O Ft. X Z- Ft. - 27= Yds^ Ave, Depth TOTAL EARTHMOVING REQUESTED = /5"7 5^ Yds^ WALK-OUT BASEMENT PROJECTS: (Outside of the building foundation)Length Width AREA TO BE FILLED/LEVELED; Length Width BACKFILL AT FOUNDATION:Ft.Ft. Max. Depth Distance From Foundation CULVERT:If Yes, must indicate size and location on drawing.■ANSxifcUYesNo IMPERVIOUS SURFACE:% ISO i, signature OF PROPERTY OWNER/AGENT FOR OWNER RECEIPT NUMBERDATE BK062011 The scale drawing must be a signed drawing which includes and identifies a graphic scale (feet), all existing and/or proposed structures, septic innks, drainfields, lotlines, road right-of-ways, easements, OHWLs, wells, wetlands, topographic features (i.e. bluffs), and onsite impervious surface calculations. cl'. I y c Vj \ i 5 / VCL- •4-1 ( L ? e •) BK — 0209 3^'>.19r> • Victof Lunrioon Cn, Pfihters • Foi^iis Fpll':, MN • 1 nOO-^'lO-^O/O i <1 Grade & Fill Permit #ns PROPERTY OWNER ^ LAKE NO. SEC. I ^ TWP. NAME g LEGAL DESCRIPTION: prrCsC. f _________ WORK AUTHORIZED ^cxrv^A-Tu^V "^cvvA VwW ^ fV\>v^V yv>o.^V- inSi.NrJ ror^ 10“^V /^/W\ IckieA^Vs - "\^KsV^yW^ <Jv/vc^S Vo^^VV W_ ^4rw^ tqLC\^\>r^WN.<.r<muVXOs. S^^Cv*-«-^OS o - Oj ^ V fo.vA~q^ *\ 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. & V(4o1. 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. i 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. 5. If the terms of this permit are violated, the entire permit may be revoked and the owner may be subject to legal prosecution. 6. Erosion control measures must be implemented prior to any topographical alterations. APPLICATION FOR GRADE & FILL PERMIT1LAND & 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 y r LAKE/RIVER NAME^X /SECTION jl/'TWP. NO. IJ<ANGE^_y I LAKE/RIVER LAKE/RIVER TWPNAME Cl £i15(oN PARCEL NUMBER(S)PROPERTY (E-911) ADDRESSpoo j i ‘‘-a coo lS'CiC)y7oii,i LEGAL DESCRIPTION ^ 0:Pc^uj dr, ■^ 7 r-5 k y. 3hi'P>L--^ DAYTIME Phone No. 5—^ - 1 I. S 7 4- ^ 1 oI3U ■ L e <y /, 1 S^_L_^ Last Name First Initial Mailing Address V ^ *7 i U i5-54 ^g«»\7\V<c____Property Owner , as. >-*- ILju Contractor Name (/AU U I ■c > Lie.# NOTES: 1. The lotlines and project area(s) must be staked. 2. If project disturbs more than 1 acre of land you are r^yjr^4.Q^ obtain a General Storm Water Permit from the MPCA. ''^0 fa I'lAtijl 'L&R Official Received DATE PROJECT REQUEST (You may use the grid on back for required scale drawing): u., Adescribe your PROJECT(S): I 0^ X -I ^ L?-\ \\ (3^L> v*^ fcV ~5V ^ \y^fi- c \fa*. V,' -V...i ■2i.\ A L*-’ X • ‘.■i V >i. I\\l aj. V ■ I ■ Y 5lk 4 V O'\A ^ y % eV A: W ■ 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 Wdth Ave. Depth Ft. X /C Ft. X 4 Ft. - 27 = Ave. Depth AT-Yds®AREA TOBEFILLE EVELED:So Length Wdth Yds®TOTAL EARTHMOVING REQUESTED = BACKFILL AT FOUNDATION:Ft.Ft. Max. Depth Distance From Foundation CULVERT: "A If Yes, must indicate size and location on drawing. Yes No IMPERVIOUS SURFACE:% Hf?pl I& signature of property OWNER/Z^GENT for OWNER RECEIPT NUMBERDATE BK02/09 The scale drawing must be a signed drawing which inciudes and identifies a graphic scaie (feet), ail existing and/or proposed structures, septic tanks, drainfields, lotiines, road right-of-ways, easements, OHWLs, wells, wetlands, topographic features (i.e. bluffs), and onsite impervious surface calculations. '' r= ’So' Scale "P/luL Zaki tV\/ /<J fA i uo E. A 4“ -It/ c? .1- Fa Hi 73 fc ft-v.. I u\Uj'e‘v4 V•.Ov -Ov c BK — 0209 336.629 • Victor Lundeen Co. Printefs • Fergus Falls. MN • 1-800-346-4870