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Home My WebLink AboutPine Beach Resort_51000990451000_Shoreland Permits_aUiGrade & Fill Permit # 63021 PROPERTY OWNER LAKE NO. g^-2>-MS- SEC. U TWP. NAME ^ LEGAL DESCRIPTION: toT^ S^\d . ^ toT” I 3 03 ck'"\v^A.-x-Q-^ <«>*>• v>»\WORK AUTHORIZED “pyg T ^ r yvN-ST \VJL^r^s^'v w \ u- 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. 1. EARTHMOVING SHALL BE DONE BETWEEN IZ- & ^-(-f2- 2. Entire area shall be stabilized within 10 days of completion of any earthmoving. 3. Owner is legally responsible for all surface water drainage that may occur. ! >4. No fill shall enter or be taken from the beds of public 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 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 L’hO'l.Permit No.PLEASE PRINT OR TYPE ALL INFORMATION LAKE/RIVER # LAKE/RIVER NAME LAKE/RIVER CLASS SECTION TWP. NO.RANGE TWP NAME (0& PARCEL NUMBER(S) 5/ Qb PROPERTY (E-911) ADDRESS S' LEGAL DESCRIPTION Last Name First Initial Mailing Address____________DAYTIME Phone No, (0/77/y^nz.Property Owner // Ciio If Contractor Name /P- 0/3)( /fs~_____^i C-<__ HLie.#t' i NOTES: 1. The lotlines and project area(s) must be staked. 2. If project disturbs more than 1 acre of land you are required to obtain a General Storm Water Permit from the MPCA. Received L&R Official DATE PROJECT REQUEST (You may use the^id on back for required scale drawing): /9^r^6,DESCRIBE YOUR PROJECT(S): ^ / ' /9'PrPc.. SiO/. 30 X 9- (^C> '■V? ^ Jb f, £> r\ 'HTSU ~0ii Z> }h _____________________________________________ 'V T't lb .- r 'To/. ^ ^ ^ __________________________ f A/Tf O. DETAILED INFORMATION: AREA TO BE CUT/EXCAVATED;Yds^Ft. - 27 =Ft. X Ft. X Width Ave. DepthLength Yds^Ft. - 27 =WALK-OUT BASEMENT PROJECTS; (Outside of the building foundation) Ft. X Ft. X Length ! J.O AREA TO BE FILLED/LEVELED; . ^ Length Width Ave. Depth ^ // 7 . S' TOTAL EARTHMOVING REQUESTED = Yds^ Ft. X Yds^Ft. - 27 =Ft. X Width Ave. Depth Ft.BACKFILL AT FOUNDATION:Ft. Distance From FoundationMax. Depth CULVERT:If Yes, must indicate size and location on drawing. Yes No %IMPERVIOUS SURFACE: eCAN‘^.^ED 7 (Vo DATE^NT FOR OWNER RECEIPT NUMBERSIGNATURE OF PROPERTY OWNER/A BK02/09 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 AKE/RIVER CASS SECTION TWP. NO.RANGE TWP NAME /3L. 03^V ' ( I s5<S: PARCEL NUMBER(S)PROPERTY (E-911) ADDRESS alx., LxoTj) 00/ LEGAL DESCRIPTION Lo-t / ^Lo1- S. 'BitIf / Last Name First Initial Mailing Address DAYTIME Phone No. D/??h^ryProperty Owner c /-TxJ^S ~7Po / / ~h>e Contractor Name A/r- 731-4323%Lie# NOTES: 1. The lotlines and project area(s) must be staked. 2. If project disturbs more than 1 acre of land you are required to obtain a General Storm Water Permit from the MPCA. Received L&R Official DATE PROJECT REQUEST (You may use the grid on back for required scale drawing): DESCRIBE YOUR PROJECT(S): ^ / Z' \ ^% /9r^c. jt4x4s io L'«. ^ 7) 7?i/t T)Pt/9-yP " 7 4S'k 7S' (' 7^/avA /7// VL U /4'L 7i/A''T:i3-'l- ,f'i~ /9-r^ cZ 5ySr ) J? i'i -£• I.C tv/ f I/V/f /f il //(✓ t//tlr 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 = AREA TO BE FILLED/LEVELED: Width Ave. Depth yS~ ■pf. ^27= Yds^ S' .po Ft. X V"cP^-Ft. X Width TOTAL ^^HMOVING REQUESTED = Length Ave. DepthPS'V 's A Yds^ 7^.BACKFILL AT FOUNDATION:Ft.Ft. Max. Depth Distance From Foundation CULVERT:If Yes, must indicate size and location on drawing. Yes No IMPERVIOUS SURFACE:% OZWvniED WL300 SIGNATURE OF PROPERTY OWNEft/AGEN^OR OWNER DATE RECEIPT NUMBER BK02/09 1- 4-i !i ;i ;1T r 1- ] The scale drawing must be a sigried-drawing whichjncludes and identifies a graphic; scalej(feet)J all existing and^or-proposed structures, septicttanks, - fdrainfieldsrlotlinesilrbad rightj-of^vraysreasementsrOljlWLs^twellsrwetlahds.'topographic features (l;erbtuffs); and onsite impervious surface calculations, 'f. H -j- T -f-f-i I :1f t IScale - I - t 1 1 \:I I • : - I- i . 1 f- -I-ri ■>1j I' i- 4I -t IT 1 1 - 4--(-- - + --I :'• 1 !t r -r-; j • r .-4Hr , i:; I ’ iiT 1 ■ t 4. f-4-1-1- i I i- ; 1 I-t • -ii r •T 1 . ^_ 4 .-H-! 4-- t- - - -i . 1 I I[I-r 1 I T -1 ; i i ti-:ir I- r t I (Ii 1f-•1 ;j i 41tif-■IJi U-!—Jt --I V;.a4i-JX --T-LT rr-- '-t I ‘4—h4 -t-4 -!J r*4-4,#4 4 ■'1i4r:r :-P1L--------- ::!! -|~+ i-'rTT- —j-pp-j -p- I-1 I- 1 -I ; -T- i" I - r 1 L:, 4'^ - I 4 .p -I f U-ir.r 41 11 : i' •: "I 'I r 'I^Ut::r > -MLt4'i I ;-4 I 11.-‘t ;■T1'1-4;IL-4tl •;--I •■I— ;•i-I- 1. i -f- f-•1•1 * t-4-4- Ki 1 Ii -t 4 1T-t- -I 1 Ir[;■ 4 'i I-r :i1 1 ::I \I--1 r 1 i 1-i 4 : Vi--I ^i4V ■t ■t:l4 r-r t i t 4 T T . 1-4 • ;-I !4 - I i I . -i ,p -I -T-} f h-f- . _ .. -i- 1 'h'1 ^ I - ; 1- J . ii. ■I-- T -f-M !--1- + - J t +-j . ; T .1 I { -4ir I ;44- I4;!Ir ;4 I. I- L...!J t ;I ;1 ■i T l'Bk.4jo209J . .1 336,629 • Victoi Lundeen Co. Primers ‘-Fergus Falls. MN • 1-800-346-4870v'-lv J !;1" ! i“r r iI ; r 'T a" z •r ■ n ^_J r- rn \( y \* ^ y O < H \ Vi H ^ A 3 3 03’f3'l4‘hl 505.3‘1r3\j\r-I ■• -. . _y^.-^--wf/' ' APPLICATION FOR SITE PERMIT LAND & RESOURCE MANAGEMENT, COUNTY OF OTTER TAIL GOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS FALLS, MN 56537 218-998-8095 www.co.otter-tail.mn.us - WHITE - Office - GOLDENROD - Inspector YELLOW - Owner (after issue) PINK - Assessor . n' Permit No.PLEASE PRINT OR TYPE ALL INFORMATION TWP NAMERANGESECTIONTWP NO.LAKE/RIVER CLASSLAKE/RIVER NAMELAKE / RIVER NO. CxJJCia PTL^i/\dLW^io 3^/5<bCsi o PROPERTY (E-911) ADDRESSPARCEL NUMBER (S) \ oooo<4p^n2jOO]Sh fh k. LEGAL DESCRIPTION I Mailing Address Daytime Phone No.InitialFirstLast Name Property Owner ‘to Srt- , tv, n <iZS?g - i I ^PjmA Sm^Jj lOjiU^TD ^53 Contractor Name Lie. # ^ Td ni ScM^^i "Z ^ P-wkct^in. l-'l- £-^D ^PROPOSED PROJECT (please circle the appropriate number) (2) Add’n to Dwelling (3) •Replacement Dwelling ^fij)Attached ^^tached Gar^ , (7) Add’n To Non-Dwelling (8) Storage Structure ^ (9) W.O.A.J. ^7o])Non-Conf. Replacement (identify), ^j(TT])0ther (identify)_______ •ExistingTJwellIngtobe removed prioj^ ONSITE SEWAGE TREATMENT SYSTEM ( H^ermit No. ( ) OTWMD 'Must have Sewage System/^, from OTWMD prior to issuing Site Permit. Contact Roitie Mann at 218-864-5533 ONSITf WATER SUPPLY (vfMividual ( ) Public ( ) None(T) New Dwelling (4)MH/YR____(5)RCU/Year. NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3’ (minimum) structure CHARACTERISTIC^F PROPOSED 1TOI Outside Dimension So. Ft. fl^ Setback to Lotline 9 <4 Ft. & i 3 ? 7 Ft." Setback to Right of Way j Ft.** Setback to Ordinary High Water Levelj _ Elevation Above Ordinary High Water Level Setback to Septic Tank *75 Ft. Setback to Drainfield 2-3 Ft. i Setback to Bluff Maximum Proposed Height i"^ 'L. Ft. Roof Change ( ) Yes ''^) No Bathroom Proposed ( ) Yes (>0^° mval wnu CHARACTERISTICS OF PROPOSED DWELLING ' (Must Include Attached Garage) CHARACTERISTICS OF PROPOSED W.O.A.S. (WATER ORIENTED ACCESSORY STRUCTURE) Outside Dimension N-DWELLING *~V V Ft. X ZH\ Ft.** Ft. XOutside Dimension___ Sq. Ft. Setback to Q)t(ine ____ Setback to RigM'd Way : Setback to Ordinar^gh Water LeydT___ . Elevation Above Ordin^High ^ter Level -. Setback to Septic Tank . Setback to Drainfield _ - Setback to Bluff____^ Total Bedrooms___/ Ft.**Ft. X Sq. Ft. X Setback to Lotlins.. Setback to Right of' Setback to Ordinary Higf)sWafer Level __ Elevation Above Ordinary H^ Water Level Setback to Septic J^k Setback to Dr^ield _ Setback to^tf_____ Ft.**Ft.& Ft.**Ft.Ft:** Ft.**Ft.(‘6^ Ft. Ft.Ft.3'Ft..^Ft.Ft. Ft.Ft. Ft.Fb Ft.Ft. Maximum Proposed Height : Roof Change BasementX Maximurh Proposed Height ( ) Boathouse ( ) Gazebo **Project/Lotllnes/Right-of-ways Must be Staked Onsite Prior to Application / Inspection Ft.' )Yes ( )No; X,^ -).Yes ( ) No X. Walkout'^asement ( ) Yes (side profile required) ( X No ( ) Screen Porch ( ) Storage Structure( * Must include on scale drawing, additional Permit may be required. r^ftTopoaraphical Alteration / Earthmovinq □ ■ None □ 20 Cubic Yards or Less * ^ 21 Cubic Yards - 299 Cubic Yards*□ 300 Cubic Yards or More* CHARACTERISTICS OF LOT: 'l3p(4JSo Impervious Surface Ratio: Bluff ( )Yes ■fe^.No.Ft.. Ft: ■ Water Frontage:Lot Area. 3XL1■ . oq 11 Total Lot Area (FTO .%X100 =Impervious Surface RatioTotal Impervious Surface Onsite (FT*) 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 T and according to the provisions of the Ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express con- ditiori 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, Mirinesota. ■ This permit may be revoked at any time upon violation of said Ordinances. . I I understand that it is my responsibiiity to inform the Land & Resource Management office once the buiiding footings have been constructed. fTiAjVLe-^Date: >wner/Agent for OwnerSignature of Propei /wc \/2-—o1Date: PROJECT(S) TOTAL SQ. FT. II 3>3 Land & Resound Mana^nwntbWce 'Abnno RECEIPT NO.PERMIT FEE $ Comments: 1~ I 5^. C-A v>.\ v\cA i io ^ i \ ^ Vvirv^yiNtY^o(r- ^r v*sS tv.iT’a 329,582 • Victor Lundeen Co., Printers • Fergus Faiis, MinnesotaForm No. BK — 1003-0407 pec^'*IE-Office JLDENROD - Inspector YELL<9iA/ - OWt%r (after issue) PINK - Assessor APPLICATION FOR SITE PERMIT 0-1^S'-tzLAND & RESOURCE MANAGEMENT, COUNTY OF OTTER TAIL GOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS FALLS, MN 56537 cbs*-218-998-8095 e'xW4*'4 -|-\|( lZ^'2/p^ www.co.otter-tail.mn.us /lA- S i4 ♦ PLEASE PRINT OR TYPE ALL INFORMATION Permit No. LAKE / RIVER NO.LAKE/RIVER NAME LAKE/RIVER CLASS SECTION TWPNO.RANGE TWPNAME j- 'j L L' >U -r PARCEL NUMBER (S)PROPERTY (E-911) ADDRESS LEGAL DESCRIPTION ^ C VU>f I ■■ H *Name First Initial Mailing Address Daytime Phone No. Property Owner f ’X I 3 ‘I V-^ i I‘ Cf”1 i.* Contractor Name Lie.# PROPOSED PROJECT (please circle the appropriate number) (1 ) New Dwelling (4) MHA-R (7) Add'n To Non-Dwelling (10) Non-Conf. Replacement (identity) _ (11) Other (identify)______________ 'Existing Dwelling to be removed prior to. 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(2) Add’n to Dwelling (5) RCU/Year______ (8) Storage Structure (3) ‘Replacement Dwelling (6) Attached / Detached Garage (9) W.O.A.S. ( ) Permit No.____________________ ( ) OTWMD 'Must have Sewage System Approval from OTWMD prior to issuing Site Permit Contact Roilie Mann at 218-864-5533 CHARACTERISTICS OF PROPOSED W.O.A.S. (WATER ORIENTED ACCESSORY STRUCTURE) Outside Dimension CHARACTERISTICS OF PROPOSED NON-DWELLING Outside Dimension CHARACTERISTICS OF PROPOSED DWELLING (Must Include Attached Garage) Outside Dimension___ Sq. Ft. Setback to Lotline___ Setback to Right of Way Setback to Ordinary High Water Level ___ Elevation Above Ordinary High Water Level Setback to Septic Tank___ Setback to Drainfield____ Setback to Bluff________ Total Bedrooms Maximum Proposed Height Roof Change ( ) Yes ( ) No Basement ( ) Yes ( ) No Walkout Basement ( ) Yes (side profile required) ( ) No Ft."Ft. XFt. X Ft."Ft. X Ft." Sq.Ft. Setback to Lotline ___ Setback to Right of Way Setback to Ordinary High Water Level Elevation Above Ordinary High Water Level__^ Setback to Septic Tank___ Setback to Drainfield____^ Setback to Bluff________ Maximum Proposed Height Roof Change ( ) Yes (- ) No Bathroom Proposed ( ) Yes ( <■) No Sq. Ft. Setback to Lotline ___ Setback to Right of Way Setback to Ordinary High Water Level __ Elevation Above Ordinary High Water Level Setback to Septic Tank Setback to Drainfield _ Setback to Bluff________ Maximum Proposed Height ( ) Boathouse ( ) Gazebo **ProjectA-otlines/Right-of-ways Must be Staked Onsite Prior to Application / Inspection Ft.&Ft."Ft.&Ft."Ft.&Ft.”Ft.”Ft."Ft."Ft. Ft.Ft.Ft. Ft.Ft. Ft.Ft.Ft. Ft.Ft.Ft. Ft.Ft.Ft.Ft.Ft. ( ) Screen Porch ( ) Storage Structure Topographical Alteration / Earthmovinq □ None □ 20 Cubic Yards or Less * □ 21 Cubic Yards - 299 Cubic Yards' ' Must include on scale drawing, additional Permit may be required.□ 300 Cubic Yards or More* CHARACTERISTICS OF LOT: Sq. Ft.Water Frontage Bluff ( )Yes ( - )NoLot Area.Ft. Impervious Surface Ratio:X100 =Total Impervious Surface Onsite (FTr)Impervious Surface RatioTotal Lot Area (FT') THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES. Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set forth and according to the provisions of the Ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express con dition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Ordinances of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said Ordinances. I understand that it is my responsibiiity to inform the Land & Resource Management office once the buiiding footings have been constructed. Date: Signature of Property Owner/Agent for Owner 2- - oDate: Land & Resource Management Office PERMIT FEE $___________;I r'PROJECT(S) TOTAL SQ.FT.,RECEIPT NO. ■.AComments: \ I 329,562 • Victor Lundeen C^.. Printers • Fergus Falls. Minnesota^Form No. BK — 1003-0407 A// ♦ • « SITE PERMIT INSPECTION RESULTS Inspector must make all measurements and computations I /|(fer> Cov<fo» S X f5y /c2 Sl^Oct Ft.Ft.Structure Set Back from Ordinary High Water Levei )oo^ Ft.Ft.Structure Set Back from Top of Bluff 5^(o'~Ft.Ft.Structure Set Back from Road Right of Way Ft. & ^J>o Ft.Ft.&Ft.Structure Set Back from Lot Lines Ft.Ft.Structure Height iq' *'/o'*Ft.Ft.Structure Set Back from Septic Tank Ft.Ft.Structure Set Back from Drainfield Eievation Of Lowest Fioor Above Ordinary High Water Level 5=^Ft.Ft. Land Slope at Building Site %%Itve / /l4/a/yu^ ^V<r/6v^ ______ Inspector’s Comments / Sketch: tJ€ <- L. (O Inspector's Signature Date of Inspection 3'-Cd Time of Inspection ( Project Approved.^ Date / InitialSSCZT\A 1 o3rtu«f ^-------------------------------------------- j" ^^ocr^eTdaTr-------^^suKver utc 21m( o.X • oJ :aDs;Z___ I C) ^ >►.\ o’S"^-rnI«» I « I «a t ~ T i mm -------;.'T'OcinJUTluy^ i7^ I MXS4J SJLM Jrmw sta.50V" I INGRESS &EGRESS EASEMENT * « 5 or in^'w ifoSiM ^.i^uUrf ^^Wcijta.n'r^ kinx^ btOlL ^ fl“^l.Tb Id mv>mo-*3’^, '>-/ ^ . \ r 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 TWP NAMERANGETWP. NO.LAKE/RIVER CLASS SECTIONLAKE/RIVER NAMELAKE/RIVER #/36O&yiLs h PROPERTY (E-911) ADDRESSPARCEL NUMBER(S) ^6~ / Dq n 2x>o/ LEGAL DESCRIPTIONViiQtLI ^ di/cJU^ DAYTIME Phone No.Mailing AddressInitial'Last Name First ^0(0^ 9^ SirifJProperty. ■ Owner mh ^^7^£L/[a/^ j. Contractdr Name Lie. #r • r NOTES: 1. The lotlines and project area(s) must be staked. 2, If project disturbs more than 1 acre of land you are required to obtain a General - Storm Water Permit from the MPCA. Received L&R Official PROJECT REQUEST (You may use the grid on back for required scale drawing): V..pr^AlQ VVOa Ateo ^S I XJ-DESCRIBE YOUR PROJECT(S): ■i DETAILED INFORMATION: Yds^AREA TO BE CUT/EXCAVATED:Ft. - 27 =Ft. X Ft. X Length Max DepthWidth Yds^WALK-OUT BASEMENT PROJECTS:Ft. X Ft. X Ft. - 27 = Length Max Depth' Width i, Ft. x_3z5i Ft. - 27 = ___ MaxDepth^^^^ ^ Q TOTAL EARTHMOVING REQUESTED = TZO Yds" Yds"AREA TO BE FILLED/LEVELED;Ft. X Length SLOPE OF BACKFILL AT FOUNDATION:Ft.Ft. Max. Depth Distance Extended From Foundation CULVERT:If Yes, must indicate size and ideation on drawing. Yes No )^Z.o^^o (^icuJyy-TYPE OF SOILS AND/OR FILL MATERIAL: : t / 0-7 .4 -Q-l±c /'SIGNATURE OF PROPERTY OWNER/A(|ENT FOR OWNER BK003/07 RECEIPT NUMBERDATE 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 LAKE/RIVER CLASS SECTION TWP. NO.RANGE TWP NAME /5c ^76ih CLylirs. PARCEL NUMBER(S) PROPERTY (E-911) ADDRESS LEGAL DESCRIPTIONV£Q>LI DAYTIME Phone No.Last Name First Initial Mailino Address f)h^ StCJe/^JProperty Owner Contractor Name ^yi^572&i.yy' Lie.# NOTES: 1. The lotlines and project area(s) must be staked. 2. If project disturbs more than 1 acre of land you are required to obtain a General Storm Water Permit from the MPCA. lOkylni DATE Received L&R Official PROJECT REQUEST (You may use the grid on back for required scale drawing): S I T/rDESCRIBE YOUR PROJECT(S):1 irojiyo DETAILED INFORMATION: Yds^AREA TO BE CUT/EXCAVATED;Ft. X Ft. X Ft. - 27 = Length Width Max Depth Yds'WALK-OUT BASEMENT PROJECTS:Ft. X Ft. X Ft. - 27 = Length Width Max Depth Ft. x_3LSL Ft. - 27 = __ MaxDepth^^^^ ^ Q TOTAL EARTHMOVING REQUESTED = T^'ZjQ Yds' Yds'AREA TO BE FILLED/LEVELED:~ Ft. X Length SLOPE OF BACKFILL AT FOUNDATION:Ft. Ft. Max. Depth Distance Extended From Foundation CULVERT:If Yes, must indicate size and location on drawing. Yes No (jZ-OV dO dTYPE OF SOILS AND/OR FILL MATERIAL: SIGNATURE OF PROPERTY 0WNER/A<SENT FOR OWNER DATE RECEIPT NUMBER BK003/07 trr >4- \\ « R o * rN MT COHNEM OT JEC ft r. fM. ft J9wTOWNSHIP 5 89'50’4S’W 1408.66 NORTH UNE Of SEC. 6 W PROPOSED SE¥€R EASEMENT An easoment for sewer purposes over, under and across that part of Government Lot 1, Section 6, Township 136, Range 39, Otter TaU County. Minnesota, descri>ed as follows: Commencing ot the northeast comer of said Section 6; thence on an assumed bearing of South 89 degrees 50 minutes 46 seconds West along the north the of said Section 6, a distance of 140866 feet; dtence South 2 degrees 28 minutes 04 seconds West a distance of 48350 feet to the point of beginning of the land to be described; thence continuing South 2 degrees 28 minute 04 seconds West a distance of 20,00 feet; thence North 87 degrees 20 minutes 01 seconds West a distonce of 40.00 feet; thence North 2 degrees 28 minutes 04 seconds West a distance of 20.00 feet; thence South 87 degrees 20 minutes 01 seconds East a distance of 40.00 feet to the point of beginning. PROPOSED LEGAL DESCRiPDON All that part of Government Lot 1, Section 6, Township 136, Range 39, Otter Tai County, Minnesota, descri>ed as follows: ;■ Commencing ot the northeast comer of said Section 6; thence on an assumed bearing of South 89 degrees 50 minutes 48 seconds West along the north line of said Section 6, a distance of 140866 feet; thence South 2 degrees 28 minutes 04 seconds West a distance of 399.96 feet to the point of beginning of the land to be described; thence North 2 degrees 28 minutes 04 seconds East a distance of 399.96 feet to said north line; thence South 89 degrees 50 minutes 48 seconds West dong said north line, a distance of 20.02 feet; thence Siouth 2 degrees 28 minutes 04 seconds West a distance of 93.36 feet; thence South 8 degrees 10 minutes 48 seconds West a distance of 52.22 feet; thence South 12 degrees 53 minutes 57 seconds a distance of 51.47 feet; thence South 15 degrees 58 minutes 26 seconds West a distance of 43.56 feet; thence South 82 degrees 38 minutes 10 seconds West a distance of 186 feet more or less to the shoreline of Dev9s Lake; thence southerly along said Mioreiine to the Intersection with a line which bears South 89 degrees 53 minutes 54 seconds West /tom the point of beginning thence North 89 degrees 53 minutes 54 seconds East a distance of 227 feet more or less to the point of beginning. Together with that part of Government Lot 1, Section 6, Township 136, Range 39, Otter Tail County, Minnesota, descried as follows: Commencing ot the northeast comer of said Section 6; thence on an assumed bearing of South 89 degrees 50 minutes 46 seconds West along the north One of said Section 6, a distonce of 1428.68 feet to t“ie point of beginning of the land to be described; thence South 2 degrees 28 minutes 04 seconds Wsst a disiatice of 60.06 feet; thence North 88 degrees 36 minutes 30 seconds West a distonce of 167.95 feet; thence South 82 degrees 49 minutes 01 seconds West a distance of 75 feet more or less to the shoreline of Devile Lake; thence northwesterly along sold shoreline to said line north line of Section 6; thence North 89 degrees 50 minutes 48 seconds East along sold north line, a distonce of 300 feet more or less to the point of beginning. Containing 1.28 acres more or less. Reserving a 20 foot krgreee and egress easement over and across said Government Lot 1, being a strip of land 20 feet in width, lying to the left of and adjoining the following described line: Commencing at the northeast comer of said Section 6; thence on an aseumed bearing of South 89 degrees 50 mkiutes 43 ssconds Wsst along ths north lins of said Section 6, a dietance of 1428.68 feet to the point of beginning of the One to be described; thence South 2 de^ees 28 minutee 04 eeconds West a distance of 93.36 feet; thence South 8 degreee 10 minutes 48 seconds Wsst a distance of 52.22 feet; thence South 12 degrees 53 minutes 57 seconds West a distance of 51.47 feet; thence South 15 degrees 58 minutes 26 seconds West a distance of 4356 feet to a point to be hereinafter referred- to os Point "A"; thence South 21 degrees 04 minutes 08 seconds Weit a distance of 50.52 feet; thence North 78 degrees 15 minutes 23 seconds IKtsf a distance of 16.89 feet; thence North 57 degrees 12 minutes 50 seconds Wsst a distance of 26.82 feet; thence North 9 degrees 14 minutes 56 seconds West a distance of 21.07 feet to the intersection with a line which bears South 82 degrees 38 minutes 10 seconds from said Point "4" and there terminating. The sidelines of said easement shall terminate on a line which bears South 82 degrees 38 minutes 10 seconds West from said Point "A“. 906030o I SCALE IN FEET I SCAIE: 1 INCH 30 FEET BEAMINGS ARE BASED ON AN ASSUMED DATUM. DENOTES IRON MONUMENT FOUND.DENOTES IRON MONUMENT SET MARKED " RLS 13620" . % DENOTES CAST IRON MONUMENT FOUND. I sI aI siwvryw’s certificateII w /I I hereby certify that this is o true and correct representation of a survey of the boundaries of the above described land, and that this survey was prepared by me or under my direct supervision and that I am a duly Registered Land Surveyor under the laws of the State of Mkineeota. Dated this 14th day of September, 2000. \ < David A.’ Anderson Land Surveyor Minn. Reg. No. 13620 LEGEND Ifl DENOTES SEPTIC TANK. DENOTES POWER POLE. DENOTES LIGHT POLE. DENOTES GUY WIRE. i tt: B r vO v)(t cT oUJ'SJ ) CERTIFICATE OF SURVEY FOR: LEE Sc KAREN OMBERG |i -6.fTELD BOOK ALS-t11/33 CONTRACT NUMBER 290-00Ar NDERSON LAND SURVEYING, INC. 313 SOUTH MIU STREET, FERGUS FALLS. MN 56638-0125 (216) 739-5268 916 WASHINGTON AVENUE. DETROIT LAKES. MN 56501 (218) 847-0500 ORATnm NUMBKBCOMPUTER FILE 290-000 4495/C DWOCRD 29791I SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 — Fergus Falls, Minnesota 56537 APPLICATION FOR SITE PERMIT WHITE -'Office GgJ.DENROD — Inspector YELLOW - Owner PINK,—' Assessor i O\Jb0 Pernnit No„LEGAL DESCRIPTION 3nO' f-SOo' ^ ^AND LOCATION Tr /fe I' fYX-HMIJeuibl-JV TWP NameTWP RangeLake Classif.Lake No.Lake Name IDENTIFICATION; Please Print Ail Information Tel. No., First Zip No.Mailing Address— No. Street. City and StateInitialLast Name Owner Cl c__^ NameContractor /McPns (• ^X^CiknClArchitectName. NON-RESIDENTIAL PROPOSED USE:TYPE OF IMPROVEMENT:RESIDENTIAL PROPOSED USE: ( ) One Family Dwelling f ) Multiple Dwelling Specify:.( ) New Building UnitsAlteration (jO gthgT^( ) Other Size ESTIMATED COST OF IMPROVEMENT|$ DIMENSIONS:TYPE OF SEWAGE DISPOSAL:PRINCIPAL TYPE OF FRAME: /( ) Masonry (‘-FWood Frame ( ) Structural Steel ( ) Other — Specify ( ) Yes ( n No( ) Public ( ) Individual Septic Tank, etc. WATER SUPPLY: ( ) Public ( ) Individual Well Basement: Stories above basement; Sq. feet (outside dimension) Bedroorhs Baths/:^^. CHARACTERISTICS: feet.Maximum depth of lot feet.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 Lot Area is feet. (Building Line) feet SO feet.feet — from road right of way is IQ ID.feet.and ...a 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 setforth 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 ONE Y AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER I^INNESOTA STA TE STATUTES. I understand that I have bean granted a site permit in accordance with the requirements of the Shoreland Management Ordit^ance of Otter Tail County. I understand I must contact my township in order to determine whether or not any additional permits are required by th^townshii r mV proposed project. 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 Shoreiahd^MSnagement Officialw/ ooiil9Permit Fee $.Receipt No. Comments: Form No. MKL-0286-019 229971(g) VICTOR LIJNDGEN CO.. PRINTERS, FERGUS FALLS. MINN. SHORELANO MANAGEMENT - COUNTY Of^ COUNTY COURT HOUSE,^^ Phone: (218) 739 -2271 - Fergus FaK^^Minne APPLICATION FOR SIFE 1%^ WHITE —Office GOLDENROD — Inspector YELLOW - Owner PINK — Assessor VJ LEGAL DESCRIPTION 300' ^SOo' CM ^cri^ LofrIANDtvLOCATION t|3V 3.^15^-ais IbxTb Lake No. Lake Name If-TWP Nam?"TWP RangeLake Classif. IDENTIFICATION: Please Print All Information Tel. No.Zip No.Mailing Address— No. Street. City and StateInitialLast Name First lilt OdtlUJIJlM/' fj-iy\JuD ivA^uL Ad Owner fO/"4^q/|A1 +7 NameContractor Architect Name. RESIDENTIAL PROPOSED USE:TYPE OF IMPROVEMENT: 0)( ) One Family Dwelling f ) Multiple Dwelling ( ) New Building Oj A UnitsAlteration T(;) QthtfF Size( ) Other i ESTIMATED COST OF IMPROV|EMENT|$ PRINCIPAL TYPE OF FRAME:DIMENSIONS:TYPE OF SEWAGE DISPOSAL: ( ) Individual Septic Tank, etc. WATER SUPPLY: q( ) Public ' 11-J ( ) Individual Well /Basement: ( ) Yes ( Stories above basement: Sq. feet (outside dimension) Bedrooms ( ) Masonry (*4-Wood Frame ( ) Structural Steel ( ) Other — Specify .....^....... Bathsx0!^ CHARACTERISTICS: Maximum depth of lot feet.feet.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 Lot Area is ~1S feet. (Building Line) .3:.feet .sa feet — from road right of way is ./Q ,/a feet. ..............feet from septic tank (Sewage System Permit must be obtain^ before installation). feet from soil absorption system (Sewage System Permit must be obtained before installation) and /.a '*■ 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. rms IS A SITE PERMIT ONL Y AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STA TE STA TUTES. I understand that I have been granted a site permit in accordance with the requirements of the Shoreland Management Ordinance of Otter Tail County. I understand I must contact my township in order to determine whether or not any additional permits are required by the township for rtty proposed project. : Dated. Signature of Owner"^ Permission is hereby granted to the above named applicant to perform the work described in the above statement. This irmit 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 1Dated Shorel^d4fta(1agement Official0030/ nou>^Permit Fee $.Receipt No.; Comments: Form No. MKL-0286-019 229971® VICTOR LUNOEEN CO.. PRINTERS. FERGUS FALLS. MINN. *■ ,5 u .■V ^ '■■' iV ■»■' i }' ■.;: 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. 9d-‘U> Ft,2^Building Set Back from High Water Mark Ft. Ft.Building Set Back from State Highway -SO' Ft. '^)0O Ft.-40- Ft.Building Set Back from Street or Road & y-D> FtSide Yard Rear Yard Ft. ;Ft. FtOccupied Building to Septic Tank 10 Ft. \So-Oo Ft.Occupied Building to Absorption System 20 Ft. Elevation at Building Line above High Water Mark __________Ft.3 Ft. Q d? V5'XInspector's Comments: O ^_________________________________ IN tt/ rcyf 4^ C*hM\ n' t n Inspectora Signature Title Inspection Dated BzK 92^19 Agency Vicnil UMHC* • M.. r(*M» r«LL*. «!«•. SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 - Fergus Falls, Minnesota 56537 APPLICATION FOR SITE PERMIT WHITE - Office GOLDENPOD —Inspector YELLOW - Owner PINK — Assessor Permit No„LEGAL DESCRIPTION AND LOCATION /PTPty TWP NameTWPRangeSec.Lake Classif.Lake NameLake No. IDENTIFICATION: Pleage Print All Information Tel. No.Zip No.Mailing Address— No. Street. City and State6a^/Wi 'T I InitialNameFirst 'Cj/lPh ---- Owner > 3 NameContractor Architect Name. NON-RESIDENTIAL PROPOSED USE;RESIDENTIAL PROPOSED USE; One Family Dwelling ( ) Multiple Dwelling TYPE OF IMPROVEMENT: Specify:.( ) New Building j^^Alteration ( )Other_______ Units ( ) Other Size ESTIMATED COST OF IMPROVEMENT $ TYPE OF SEWAGE DISPOSAL: ,/X/j/DIMENSIONS: Basement: ( ) Yes No Stories above basement: Sq. feet (outside^tirpension) Bedrooms .................... PRINCIPAL TYPE OF FRAME: ( ) Public Individual Septic Tank, etc. WATER SUPPLY: ( ) Public ^ Individual Well ( ) Masonry p^Wood Frame ( ) Structural Steel ( ) Other — Specify /. Baths CHARACTERISTIC^ -A-A Maximum depth of lot feet.feet.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 Lot Area Is .. feet. (Building Line)3 feet ■feet.feet — from road right of way is (OJO feet... and/O .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).fibStructure 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 ONL Y AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STA TE STATUTES. I understand that I have been granted a site permit in accordance with the requirements of the Shoreland Management Ordinance of Otter Tail County. I understand I must contact my township in order to determine whether or not any additional permits are required by the township fopTlty proposed project. I yv\ P . / f^^l ignature of OwneK6 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 Official10 OA 11So.onPermit Fee $Receipt No. x)iJ)Comments: Form No. MKL-0286-019 229971® VICTOR LUNOEEN CO.. PRINTERS. FERGUS PALLS. MINN. SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739 -2271 — Fergus Falls, Minnesota 56537 APPLICATION FOR SITE PERMIT ^lector ler ,aS0r /T\ / PermitLEGAL AlT.)fDESCRIPTION ,0 ^rvAND LOCATION 0^777 7 //G-l)i/“■Z.ly TWP NameSec.TWP RangeLake Clatilf.Lake NameLake No. IDENTIFICATION: Pleaie Print All Information Tel. No.Zip No.Mailing Address— No. Street. City and StateInitialLast Name First ;// / / r /■ >Owner NameContractor TT Architect Name. /NON-RESIDENTIAL PROPOSED USE:^ X O . LRESIDENTIAL PROPOSED USE: One Family Dwelling I ) Multiple Dwelling TYPE OF IMPROVEMENT: /Specify:( ) New Building l^^^lteration ( ) Other_______ Units ( )Other Size IESTIMATED COST OF IMPROVEMENT^ TYPE OF SEWAGE DISPOSAL;, , , iY/X DIMENSIONS: Basement: ( ) Yes No Stories above basement; Sq. feet (outside dimension) Bedrooms .~.....W^...... PRINCIPAL TYPE OF FRAME: ( ) Public Individual Septic Tank, etc. WATER SUPPLY: ( ) Public ( ) Masonry pk^Wood Frame ( ) Structural Steel ( ) Other — Specify / SfrBaths... Individual Well CHARACTERISTIC^ Maximum depth of lot feet.feet.square feet. Water frontage is Building set back from high water mark Is.................... Land height above high water mark at building line Is Lot Area is .. feet. (Building Line) feet £<2..feet.feet — from road right of way isBuilding set back from State highway right of way J.L........ and fO feet.Side yard is iO .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 iioStructure 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. I understand that I have been granted a site permit in accordance with the requirements of the Shoreland Management Ordinance of Otter Tail County. I understand I must contact my township in order to determine whether or not any additional permits are required by the township for my proposed project. /f fH!Dated.1 3Signature of Owner 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 ordinances of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said ordinances. „ £Y>.on Dated Shoreland Management OfficiallOoY nPermit Fee $.Receipt No. yt] lJ ’ / XU) -ZJ/iLjid liMXy. Comments: / JJ-I .. Form No. MKL-0286-019 229971@ VICTOR LUNDEEN CO.. PRINTERS. FERGUS FALLS. MINN. ‘ / INSPECTOR'S CHECK LIST Make all measurements and computations ACTUAL IS 1 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: Intpector't Signature Title Inspection Dated 19 Agency t- mcna tunic* * nhhim. rc*«n r«uj. mm. Department of LAND & RESOURCE MANAGEMENT COUNTY OF OTTER TAIL Phone 218-739-2271 Court House Fergus Falls, Minnesota 56537 January 8, 1992 Chuck Scherz R#2 Box 427 Perham, MN 56573 RE:Site Permit #10652 for lot on Devils Lake (56-245). Dear Chuck Scherz: Please be advised that Site Permit #10652 has expired. To date our office has not been notified that your project was ready for inspection as is required. If your project is ready for inspection you should notify our office immediately, started and you still plan to proceed, you should seek renewal of your permit immediately. If your project has not yet been Please contact our office if you have any questions regarding this matter. Sincerely, Marsha Bowman Office Manager SHORELAND MANAGEMENT ORDINANCE - SUBDIVISION CONTROL ORDINANCE RIGHT-OF-WAY SETBACK ORDINANCE - SEWAGE SYSTEM CLEANERS ORDINANCE RECORDER, OTTER TAIL COUNTY PLANNING COMMISSION ^ ^ 0tic^i^^(^Lrt4^'^^ • /^£^ ~^)tJ t'i/-tv-*r^ ■ Al(^,(X 'i^ CHuilUA^^ />y- A€tUAd^ t/la. .JitALiUrlf^ W<^ /rC4“^ AifZtdit'^^ . ,ZI. ^t^4;W t r^' y J /' 'iy/U4- 4 4.^ Sl 'jiC /T^^f oi 7^ yyAd^z/^yiL^ ly ^^^i'uyAAfX^ A. ^TU^lx. ^ty9>\ yyK^^> « vn 7^ ,(f (L/Uik f^7 \ White — Of^ce Yellow — Cw 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 ner Permit No..LEGAL IDESCRIPTION2>C)0 /K/ L-6T" (Y S:oo Ok/AND LOCATION Lo 13(/7D£\/j:cs 0 , TWP NameTWPRangeLake Classif.Sec.Lake NameLake No. IDENTIFICATION: Please Print All Information Tel. No.Zip No.Mailing Address— No. Stre^ City and StateFirstInitialLast Name ry\iJ 3t AOwner NameContractor Architect Name. NON-RESIDENTIAL PROPOSED USE;RESIDENTIAL PROPOSED USE: (x/f^e Family Dwelling ( ) Multiple Dwelling ( ) Other TYPE OF IMPROVEMENT: (\)H^ew Building ( ) Alteration Specify:, Units, /-i^ize( ) Other ESTIMATED COST OF IMPROVEMENT $ DIMENSIONS;TYPE OF SEWAGE DISPOSAL:PRINCIPAL TYPE OF FRAME: ,3e Basement: ( ) Yes I Stories above basement: Sq. feet (outside dimension) Bedrooms ( ) Public( ) Masonry I'^^J'Cvood Frame I ) Structural Steel ( ) Other - Specify I( yOndividual Septic Tank, etc. WATER SUPPLY:S ^ srncJJ^J^Baths....../■ ( ) Public (yj^rfndividual Well CHARACTERISTICS: feet.feet.Maximum depth of lotWater fyintage issquare feet.Lot Area is -ys'feet. (Building Line)Building set back from high water mark is Land height above high water mark at building line is *3 Building set back from State highway ri*t of way LOl........ and'.^?/ lqL '2..P.L feet 2-0' .feet.feet — from road right of way is ............feet. 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). Side yard is Structure will be located 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 ISA SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES. I understand that I have been granted a site permit in accordance with the requirements of the Shoreland Management Ordiiunce of Otter Tail County. I understand I must contact my township in order to determine whether or not any additional permits are required by the township for riy proposed project. lAllDated 7Signature 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. F) ^Dated Shoreland Management OfficialSo- ^Permit Fee $.Receipt No. iivt1 X ) ^ Vq’K-VL Too a (0>^ .Comments: Form No. MKL-0286-019 229971@ VICTOR UJNDGEN CO.. PRINTERS. FERGUS FALLS. MINN. C^'ice White * 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 0 9 Permit No,,LEGAL !DESCRIPTION 2>oa I kl L-i j I fV <;oo Cifj J('4!C <L- T-r ■)AND ' J-LOCATION f-TJ(V,kn /-t/r ! /wi TWP NameTWPRangeSec.Lake Classif.Lake NarrteLake No, IDENTIFICATION: Please Print All Information Tel. No,Zip No.Mailing Address— No. Street. City and StateInitialFirstLast Name I )-7 J i . A ; .Owner NameContractor Architect Name. NON-RESIDENTIAL PROPOSED USE:RESIDENTIAL PROPOSED USE; (./T’One Family Dwelling ( ) Multiple Dwelling ( ) Other V’ Size TYPE OF IMPROVEMENT; ( ) f^ew Building ( ) Alteration Specify:. Units /I ( ) Other ESTIMATED COST OF IMPROVEMENT $ DIMENSIONS:TYPE OF SEWAGE DISPOSAL;PRINCIPAL TYPE OF FRAME: Basement; ( ) Yes ('vT No Stories above basement: Sq. feet (outside dimension) Bedrooms ( ) Public ( T Individual Septic Tank, etc. WATER SUPPLY: ( ) Public (■^j/fndividual Well ( ) Masonry ( ) Wood Frame ( ) Structural Steel ( ) Other — Specify . C ' n \ L L^ C?,/.Baths /■ CHARACTERISTICS: I ■ 'j .......feet. (Building Line) *feet.feet.Maximum depth of lotWater fi^ontage issquare feet.Lot Area is Building set back from high water mark is.•ir 3 feet 'Land height above high water mark at building line is Building set back frorp State highway right of way..... feet. -r ,feet.feet — from road right of way is andSide yard is / ■;.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 ii 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. I understand that I have been granted a site permit in accordance with the requirements of the Shoreland Management Ordinance of Otter Tail County. I understand I must contact my township in order to determine whether or not any additional permits are required by th^ township for my proposed project. /// ''’Xl/ ■U/' .ADated. 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. ■T' )Dated Shoreland Management Official ■] Receipt No.Permit Fee $."j ~—' i a 3-JComments: '‘V Form No. MKL-0286-019 229971@ VICTOR LUNOEEN CO.. PRINTERS. FEROUS FALLS. MINN.J / r \« c INSPECTOR'S CHECK LIST Make all measurements and computations ACTUALIS X MINIMUM Shall Be 4-Sq. Ft, ^^0, OOPLot Area (Square feet)Sq. Ft Sq. Ft. soc>looWater Frontage Ft.Ft. ISI lOBuilding Set Back from High Water Mark Ft.Ft. Building Set Back from State Highway Ft.50 Ft. {pOBuilding Set Back from Street or Road Ft.40 Ft. Ft.iO__& Ft.Side Yard oK '■LC5Rear Yard Ft.Ft. Occupied Building to Septic Tank Ft.10 Ft. ZoOccupied Building to Absorption System Ft.20 Ft. Elevation at Building Line above High Water Mark_____________ ^ I I 10 Ft.3 Ft. ( YInspector's Comments:% A/0 pLACd^ S-hAife j? Wv^K^MW -W V^ t v>WU\ Inspector's Signature m Title Inspection Dated 5 1 Agency VICTOe LUMOCEN 4 CO . MIHTCHt. flltavl rM.Lt. HIMM.