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Home My WebLink AboutRustling Leaf Resort_35000180171000_Shoreland Permits_White - Office Yeiiow — 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 •i iinPermit No„LEGAL DESCRIPTION AND LOCATION ( V/ 3gr UK-C%-llif \kJe<rt Lake No.TWP NameRangeSec.TWPLake Classif.Lake Name IDENTIFICATION: Please Print All information Tel. No-Zip No.First Mailing Address— No. Street. City and State_______ / InitialLast Name LiAitrsOwner NameContractor Architect Name. NON-RESIDENTIAL PROPOSED USE:RESIDENTIAL PROPOSED USE:TYPE OF IMPROVEMENT:\hl-e hirK\New Building ( ) Alteration Specify:.( ) One Family Dwelling ( ) Multiple Dwelling (^' Other Units ( ) Other Size IESTIMATED COST OF IMPROVEMENT $ DIMENSIONS:TYPE OF SEWAGE DISPOSAL:PRINCIPAL TYPE OF FRAME: (L-crC ( ) Yes ^ ) No Stories above basement: Sq. feet (outside dimension) Bedrooms ....jO. ( ) Masonry Wood Frame ) Structural Steel ( ) Other — Specify ( ) Public ( ) Individual Septic Tank, etc. WATER SUPPLY: ( ) Public 1V) Individual Well Basement:I Baths ...^?. CHARACTERISTICS:laQi feet.Maximum depth of lot feet.Water frontage issquare feet.Lot Area is feet. (Building Line)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 3 feet srO feet.feet — from road right of way is if?.-l-S?..............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). .;. and 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. TH/S IS A S/TE PER/VHT 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. Dated. Signaturg^^^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. 30®- Dated Slt5reland Man^ment Official p-aioPermit Fee $.Receipt No. Comments: Form No. MKL-0286-019 229971® VICTOR LUNDEEN CO.. PRiNTRRS, FERGUS FALLS. MINN. / •“ 4,2 / ■“White - Office Yeliow ^ Owner Pink — Assessor Goidenrod — inspector SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 - Fergus Falls, Minnesota 56537 APPLICATION FOR SITE PERMIT* Permit No..;\{yi lr{LEGAL JDESCRIPTIONI AND LOCATION ■s T ■ TWP NameTWPRanfleSec.Lake Classif.Lake Name.ake No. IDENTIFICATION: Please Print All Information Tel. No.Zip No.Mailing Address— No. Street. City and StateInitialFirstLast Name >Owner NameContractor ■j Architect Nante. NON-RESIDENTIAL PROPOSED USE:RESIDENTIAL PROPOSED USE:TYPE OF IMPROVEMENT: Specify;.( ) One Family Dwelling ( ) Multiple Dwelling ( ) New Building ( ) Alteration Units ( ) Other Size( )Other V ESTIMATED COST OF IMPROVEMENTS DIMENSIONS:TYPE OF SEWAGE DISPOSAL:PRINCIPAL TYPE OF FRAME: Basement; ( ) Yes ( ) No Stories above basement; Sq. feet (outside dimension) Bedrooms ( I Masonry ( ) Wood Frame ( ) Structural Steel ( ) Other — Specify ( ) Public ( ) Individual Septic Tank, etc. WATER SUPPLY: ( ) Public ( ) Individual Well Baths *■; -.1CHARACTERISTICS:i1)Water frontage is ...IL Maximum depth of lot feet.feet.square feet.Lot Area is feet. (Building Line)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 •feet.feet — from road right of way is and .............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).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 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 my 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 Shoreland Management Official :Permit Fee $.Receipt No. Comments: T A' No. MKL-0286-019 229971@ VICTOR LUNDEEN CO., PRINTERS. PBROUS PALLS. MINN. ;■ .-S'■: - V # .p INSPECTOR'S CHECK LIST Make all measurements and computations ACTUAL IS i MINIMUM Shall Be X Sq. Ft ^doooLot Area (Square feet)Sq. Ft.Sq. Ft. noWater Frontage Ft.Ft. 100"^ Ft.100Building Set Back from High Water Mark Ft. Building Set Back from State Highway Ft. 50 Ft. jff Ft. /d & Id Ft. Building Set Back from Street or Road Ft. tSide Yard &Ft. Rear Yard Ft. Ft. tjnOccupied Building to Septic Tank 10 Ft.Ft. Occupied Building to Absorption System 20 Ft.Ft. Elevation at Building Line above High Water Mark_____________Ft.3 Ft. Inspector's Comments: 3^..jU (utr I tI- P' ■fUMI ^ _is~‘- __ I nipector's Signature Title Inspection Dated 3- 3!19 Agency vieren uimiim 4 eo.. mNTt<r«.i q-.qdflfnf 3-31 3^ Ajkn, >«-o- / / o jL , GRID PLOT PLAN SKETCHING FORMfeet/inchesScale: Each grid equals f Dated:19 Signature Please sketch your lot indicating setbacks from road right-of-way, lake and sideyard for each building currently on lot and any proposed structures. I ; ..i , 1 ; II!! 4 i t I I !;-r LI i ■4 - ^i; ■; ■i 1 1 I r I iT /- ItT VIU-I I I I I 1!!I(■■ i 21598 7®MKL-0671-029 vicToa LUNOttN oe.. MiNuaa. ftaaua r*iLS. hikn.