Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
Shady Grove Resort_53000260162000_Memos,Correspondences, File Notes_
I - (c ^1_ A«»C^fe=> 1-^0^ (g> Cjftr^HsiS - !<^S^/f^SC - Zs:a:DC=> C, O.?. S^rteg-r - Ki:>Dii:^t= ofi Tb. L-4-X>^ ^ __________________ f^vJSE_U^To__ « c - ui l u<_ 3>FAih^ c;:^/v<-vs^t3>3f£;>rNO |0(Z7|0^ I I M I N N [ S 0 T A I MDH WR 0 6 2006IdepartmentofhealthI landProtecting, maintaining and improving the health of all Minnesotans ADt; February 28, 2006 Mr. Wes and Ms. Theresa Jeltema 35686 Rush Lake Loop Ottertail, Minnesota 56571 Dear Mr. and Ms. Jeltema: Subject: Food and Beverage Equipment at Shady Grove Resort, Inc., Ottertail, Otter Tail County, Minnesota, Plan No. 061898 We are enclosing a copy of our report covering an examination of plans and specifications on the above-designated project. The plans and specifications appear to be in general compliance with the standards of this department. Please see the enclosed report for additional changes and/or comments. It is the project owner's responsibility to retain the plans at the project location. This review does not pertain to the Engineering design (i.e., plumbing, swimming pools, service connections, sewage systems). A separate report regarding the Engineering Review will be sent. Ten working days prior to completion of the project, please contact Mr. Rick Toms with our Fergus Falls district office at 218/739-1379 in order to arrange for a final on-site inspection. If you have any questions in regard to the information contained in this report, please contact me at 651/201-4512. Sincerely, Laura Huseby, REHS Plan Review Environmental Health Services Section P.O. Box 64975 St. Paul, Minnesota 55164-0975 LMH:jlr Enclosure cc: Mr. William Kalar, Zoning Administrator City of Ottertail Mr. Rick Toms, Minnesota Department of Health General Information; (651) 201-5000 ■ TDD/TYY: (651) 201-5797 ■ Minnesota Relay Service: (800) 627-3529 ■ www.health.state.mn.us For directions to any of the MDH locations, call (651) 201-5000 • An equal opportunity employer ml MINNESOTA DEPARTMENT OF HEALTH Division of Environmental Health REPORT ON PLANS Plans and specifications on food and beverage equipment: Shady Grove Resort, Inc., Plan No. 061898 Location: 35686 Rush Lake Loop, Ottertail, Otter Tail County, Minnesota Date Received: February 10, 2006 November 30, 2005 Date Examined: February 28, 2006 Submitted by: Mr. Wes and Ms. Theresa Jeltema, 35686 Rush Lake Loop, Ottertail, Minnesota 56571 Phone#: 218/346-6040 Esser Plumbing & Heating, 542 West Main Street, Perham, Minnesota 56573 Phone#: 218/346-3530 • Cr Ownership: Mr. Wes and Ms. Theresa Jeltema, 35686 Rush Lake Loop, Ottertail, Minnesota 56571 Phone#: 218/346-6040 The following are corrections or requests for additional information necessary before construction of your project: 1. Food and Beverage service equipment must meet the applicable standards of NSF International. Evaluation to these standards by ETL and UL are also approved. The proper sticker must be displayed.; Specifications were submitted for the following item(s), but could not be verified as NSF or equivalent: Ice Cream Cooler/Dipper well (no manufacturer provided). 2. Used food and beverage equipment cannot be changed or altered from its original condition. It is the project owners responsibility to insure it meets the standard. Approval of the existing or used equipment will be made'by Mr. Rick Toms inspecting sanitarian from our Fergus Falls district office. 3. Primary food preparation surfaces (tables/counters) must be of stainless steel construction in compliance with Standard No. 2 of NSF International. Cabinetry within the food service area: a. All counters shall be on 6-inch stainless steel legs or castors meeting NSF standards, or on a solid masonry base. 4. Provide and adequate amount of storage space for supplies necessary for operation. Provide approved shelving, a minimum of six inches above the floor. a. shelving must be NSF approved. Shady Grove Resort, Inc. Food & Bev. Equip. Plan No. 061898 -2-February 28, 2006 5.Provide a minimum of a three-compartment sink meeting the applicable standards of NSF International with two integrally attached drainboards in the utensil washing area. Bar glass washing sinks are not acceptable for food utensil washing and sanitizing. Sink bowls must be large enough to accept the largest utensil to be cleaned. Provide approved racks, shelves or dishtables for air drying of equipment and utensils next to the warewash sink. Provide and routinely use a chemical test kit to determine the strength of the sanitizing agent in:6. a. The final rinse water of the three-compartment utensil washing sink. b. In-place cleaning solutions (sanitizing buckets). Floors in kitchens; bar; other rooms where food is stored, prepared or washed; dressing or locker rooms, toilet rooms, and janitor's closet shall be smooth, nonabsorbent and easy to clean, and durable. 7. Approved floors include commercial grade quarry tile, ceramic tile, terrazzo and an epoxy resin surface with a 5 mil application installed on a smooth concrete surface. Commercial-grade vinyl submitted in plan, no manufacturer provided. No basecove provided. A 4-inch coved base constructed of the same material, must be integral with the flooring installed at the floor/wall juncture. Wall surfaces in food preparation, dishwashing and storage areas and janitor's closet shall be smooth, light colored, easily cleanable and nonabsorbent to the highest level of splash or spray. 8. Ceilings in food preparation, dishwashing, food storage areas, bar areas, restroom and janitor's closet shall be smooth, nonabsorbent, light colored, easily cleanable, and must not be perforated, fissured or textured. 9. No exposed rafters or studs are permitted. 10. Provide effective shielding, such as plastic shields, plastic sleeves with end caps, shatterproof bulbs and other approved devices for all artificial lighting fixtures in areas of exposed food, clean equipment, utensils, and linens, or unwrapped single- service and single-use articles. 11. Toilets must be of the elongated type and provide with seats of the open front type. A covered waste receptacle or a separate sanitary napkin/tampon disposal container shall be provided in all women’s or unisex toilet rooms. Toilet rooms must be mechanically ventilated. All toilet room doors must be self-closing and tight fitting. f February 28, 2G06Shady Grove Resort, Inc. . Food & Bev. Equip. Plan No. 061898 -3- 12. Provide adequate hangers for mops and other cleaning devices to dry.i 13. Plans on the plumbing system have not been submitted. A separate on-site inspection will be conducted by the state plumbing inspector to determine compliance with the Minnesota Plumbing Code. Indirect waste connection discharges waste through an air gap into the sanitary sewer system. Refrigeration equipment (including walk-in refrigerators and freezers), ice machines, steam tables, steam cookers, ice bins, salad bars, dipper wells and other similar fixtures shall be, indirectly wasted to.the sewer. 14. A running water dipper well is required at ice cream station/cooler. The water supply line must have an approved air gap. The dipper well must be indirectly wasted to a floor drain. 15. Each handwashing sink must provide water at a temperature of at least 110 degrees F through a mixing valve or a combination faucet. 16. A full time state certified food manager must be employed within 45 days of opening. Contact your field sanitarian for more information. Theresa N. Jeltema attended class needs to apply for state certification. Materials enclosed. ; 17. If menu changes occur in the future, additional equipment or remodeling may be required and must be approved prior to installation. Contact your field sanitarian. Scope of Project: Installation of hard ice cream dispensing area at resort. Sincerely,0 Taura Huseby, REHS Plan Review Environmental Health Services Section P.O. Box 64975 St. Paul, Minnesota 55164-0975 ..P file MEMO PARCEL #S300^^^_OS3_2£00 (OAK^ RIVER/WETLA /^CSs/O* PROPERTY OWNER ^ ND NAME /i^SH f5X- \^l\ Date L&R Official iVLr&Tyf it/ ^ff\a oi,r^tTFSAction/Com ments. ^ CJ^)r>s 3 />V^i ^..^TigJ' 4 CA(\sASi7£^ X A i7)AAu,f^^ t^ x 'ThiLa €Lu^ ts*»j0 £>uA TH^i u^*^u> Lul^ it - 77*6 ful - 7^ Thf. (±11") \/A*hAi^<£ A^’(\t^ATur^s 0^ ^aT LiST TL^-6'^-i ^ /<W<3.? ihJ Th£ X ■=v4iO X Ui^^uj hJTtr^ 7a T71^£ Ai Tfi/^^UjA^St j. -rv( />Mrry/t /J/ Action/Comments f2? \J\tWtC l^Wfi *- S'^/ t94T«M IS.I:!^lii' fiA OmtLS _______________________■ Date L&R Official mujartj^ Action/Comments <C^ jyAJ0iS4Tk>hi ^i77f 77o^ 37AT-<f/ti/j -* TH //^/l 77/4T /^ rJr/<X*0 TT> f^QQ ^ ^lOCA/fy^>r^J Rf'. ^i4'y*--,v:v Nry^ii^rij ^^.(1, j, <^-4/h/^/TO ^ ^ i7£/Dat<r FtA. i? /V4$ otJ ~ -T 7Z>^ //^A T?J^r Ukfft^cc' MP“ 4^>3y£<T 1^ ^{frwLAA. rr).M tjTh^ O*^ CMteJ J hr^d 2 Bs Ihi- Ec. ?,? j r'kxyi^^7m^f>/r nuTl^^y i^^CLudi::^ CA&>rJS ^>€/^)iTLC J7fi ^^fTifVi,((i*'i^ 72> T7fi ujMiC ^^Ld St ** S'^IS s**€ TH€ Btt /mi)€ ^0d7 (SfT€ P^i^4iiT « Date L&R OfTidal I K/ ■ \ Joyce Thompson Theresa Jeltema came to the office to obtain copies of documentation on the septic system at the resort. She also wanted documentation of the original approval for the ice cream shop at the resort. I pulled the files and went through all documents (Bill Kalar had put them in order on 12/22/05). I found and copies all septic system documents for her. However I could find no reference in any of the documents with regard to the “approval” for the ice cream parlor. Ms. Jeltema said that in a recent conversation she had with Bill, he had told her that he had seen information about the ice cream parlor in the file. I told her that Bill was in a meeting (at the time of her visit) and that 1 would ask him to locate the information for me. I would then send a copy of the information to her, I spoke with Bill later in the afternoon and explained what Ms. Jeltema was requesting. He looked through the files himself and the only information available about the ice cream parlor was a reference to it in a brochure about the resort. Bill explained that the ice cream parlor was probably already a part of the original resort operations and existed before the SMO went into effect. We would have no other documentation on it. I called & left a voicemail message for Ms. Jeltema regarding this information. Note: During my conversation with Ms. Jeltema & in reviewing the file folders with her, she told me that the parcels containing the Rush Lake Mini Golf, with separate dwelling & sewer, are no longer a part of the resort but are owned by another individual. Reference Parcel’s 53000990335000 fc 53000990336000. A separate file folder was created for these parcels. January 20, 2006 Sli i- r L&R OfTicialDate Action/Comments_ ly ^H4iCH HCSt^kT hoo 0. Date L&R Official Action/Comments. .'i- Department of LAND AND RESOURCE MANAGEMENT OTTER TAIL COUNTY Government Services Center • 540 West Fir Fergus Falls, MN 56537 Ph: 218-998-8095 Otter Tail County’s Website: www.co.ottertail.mn.us February 3, 2006 Theresa Jeltema Shady Grove Resort 35686 Rush Lake Loop Ottertail. MN 56571 ■ : > RE: Ice Cream Service at Shady Grove Resort, Rush Lake (56-141) Dear Ms. Jeltema: Enclosed please find a copy of a brochure, which appears to date back to at least 1984, that we have on file in our Office. As you will see, this brochure clearly indicates that Shady Grove Resort has offered ice cream service in past years. Since it is my understanding that you intend to modernize your existing facilities and riot expand your service, a new Conditional Use Permit from Otter Tail County is not required. If you have any further questions regarding this matter, please contact me at (218- 998-8095). Sincerely, BilIKalar Administrator i.' : Everything You’ll Need and More COMFORTABLE VACATION LIVING At Shady Grove, you’ll never need a trip to town for your vacation supplies. Our store stocks a complete line of groceries, meals, fresh vegetables, fruits and beverages, and our Gift Shoppe offers a variety of interesting and uniciue items. Tackle and fishing accessories ttrat are proven "winners” are also available. For short snacks and lunches, we serve sanrlwiches and pizzas, and our regular visitors can attest to the ex-* cellent pfo'dutts sdfVed'in dtir own Ice Crearrf Parlor. You’ll find that our cottages are equipped to make your vacation "home away from home" comfor table and relaxing. All our cottages are completely modern with showers and hot water, gas for cook ing and heal. We furnish everything you’ll need except towels and toasters. FISHING Action and Activity • • • • * Shady Grove offers great fishing on one of Min nesota's better lakes. Walleyes, Northerns, Black Grapple, Sunfish and Bass are taken in abun dance each year. Of course, the best fishing is in May and June, and again in September and Oc tober, but you can always count on catching fish. Your hosts will be glad to give you tips on tackle and bait and will gladly direct you to the choice Rush Lake fishing holes. We know you’ll be comfortable in our cottages, whether you choose 1, 2 or 3 bedrooms. All Shady Grove accommodations offer clean, spacious living areas designed to give you plenty of elbow room. Our cottages are nestled amidst large shade trees, affording you privacy as well as cool and refreshing vacation living on warm sum mer days. Pfciitt -iiii- "r .sY Scenic Camping Our secluded campground affords piivacy anil the all-essential “peace and quiet" necessary tor those interested in getting closer to nature. The scenic location, complemented by modern facilities with complete hook-ups, makes Shady Grove camping a unique and pleasurable ex perience. BOATS and MOTORS AVAILABLE for your FISHING or BOATING PLEASURE Enjoy Area Activities Morlhern Minnesota otters a variety ot summer time activities tor atl to enjoy. • There are 2 excellent golf courses within 10 miles ot Shady Grove, both with lush greens and fairways. Three more courses are within 25 miles of the resort. Golf clubs and equipment can be rented at any of the courses, and your hosts will be glad to make reservations for you. • For evening entertainment, tliere are numerous supper clubs and nile-spols within a few miles of line resort, for your dancing and dining pleasure. • Area fun-tests, fairs and zoos for the children are nearby. Just ask your hosts for a calendar of summer activities. • Picnics and scenic tours have always been popular in our area. Let us help you plan a visit to the many historical and scenic locations just a lew minutes' drive from Shady Grove. Let Shady Grove serve as the hub of your vacation activities. FARGO Directions to SHADY GROVE « PERHAMMINN. RESORT78 -/RUSH P LAKE BATTLE LAKE ON RUSH LAKEI/s 94 U.S. 10 Shady Grove Resort is located on the west side of scenic Rush Lake, six miles south of Perham on Minnesota Hwy. 713. It you’re arriving from the south, Shady Grove is 20 miles north of Battle Lake on Minnesota Ftwy. 7 8. ST. CLOUD MINNEAPOLIS i ST. PAUL Airport Service For our friends who fly, we offer free pick-up and return to our area airports, including Perham and Detroit Lakes. Perham Municipal Airport has a 2900 foot grass runwav. Detroit Lakes has a 4500 foot hard-surfaced, lighted runway and is on OMNI 111.2 frequen(',y. UNICOM 122.8 radar surveillance from Fargo, N.D. is also available. For your vaceition pleasure... As resorters dedicated to your vacation enjoy ment, we have tried to present an honest descrip tion of our resort in this brochure. For your vaca tion pleasure, we are constantly keeping our facilities clean, up-to-date, and improving them as we go along. We feel we have a first class resort, offering you plenty of enjoyment at reasonable rates, and we will continue to maintain and im prove our resort because we know our guests en joy it here. Family Recreation Shady Grove Offers activities that the whole family can enjoy. Our heated pool is a favorite with our guests and is reserved tor their exclusive use. The whole lamily can get involved at our playground, with horseshoes, volleyball, badminton and cro quet equipment available. Bicycles, waterskiing and recreation room games are also available at a modest lee. And, or course, there's just plain relaxation in abundance. For Reservations or Further Information... Write, Wire or Phone FOR COMPLETE VACATION EHJOYIVIENT Shady Grove Resort 218-346-6040 Contact Your Hosts Owen and Jane Stowman Ottertail, Minnesota 56571 218-346-6040Ottertail, MN 56571 Owen & Jane Stowman. vour hosts ^H4C1 FlU F.£\^(£U f?usi* lAlU S(^ ^lllie>lHlii,0^Si<^rtA4_fkg^ il/ l'// 77 14s€ - fi.€diycsr/s:^ ^ c/ittsf^mis 6f>a*0 ^/cS/77 Pd. ^tce/nmti^C OCNtAL if F^a. f iTHinP^trts CfiLi * l) CQ OCtHiO UlSt^T feA V CAmfStm .............................. 3/'^/77 SfeCiAL 14S£ fi(fkiA'nt>‘ - fCtSivUSTCj) P tV>d\'n‘y^M. (fAmfiiXii ^ <:neai^Ti'[ ^ ^SiTt')CFiu * d Pc FiA ^Attiflirts C^ T^tial) - (f\ii */) _*</h/7? C 4 (fiu I I M I N N E S 0 T A I MDHiDEPARTMENTofHEALTHi Protecting, maintaining and improving the health of all Minnesotans December 20, 2005 Mr. Wes and Ms. Theresa Jeltema 35686 Rush Lake Loop Ottertail, Minnesota 56571 Dear Mr. and Ms. Jeltema: Subject:Request for Additional Information for Food and Beverage Equipment at Shady Grove Resort, Inc., Ottertail, Otter Tail County, Minnesota, Plan No. 061898 The Minnesota Department of Health received a copy of plans indicating an alteration, addition, remodel or proposed new construction of a facility at the above address. A preliminary review of your current submission find the plan is missing: zoning'ap^ovarfbr^ice cream shop addition T2^ertiticate of compliance for the septic system ---- ___a finish schedule for floors, walls and ceiling finishes ___an equipment list indicating existing and/or used or new equipment __a easily readable floor plan or layout of the entire establishment ___additional information (ie: dry storage, restrooms, utility/mop sink •T{irA fY]g ztXJuf'/} LiAn. 31L. 3 - / Failure to contact the Minnesota Department of Health, Environmental Health Services Plan Review about your establishments’ alterations within the next 30 days may result in adverse action against your license or plans being approved. This review does not pertain to the Engineering design (i.e., plumbing, swimming pools, service connections, sewage systems). A separate report regarding the Engineering Review will be sent. When submitting additional information, please refer to plan no. 061898. If you have questions concerning this review, please communicate with me at 651/201-4512. Sincerely, Laura Huseby, REHS Plan Review Environmental Health Services Section P.O. Box 64975 St. Paul, Minnesota 55164-0975 LMH:jlr Mr. Rick Toms, Mirmesota Department of Health General Information; (651) 201-5000 ■ TDD/TYY: (651) 201-5797 ■ Minnesota Relay Service: (800) 627-3529 ■ www.health.state.mn.us For directions to any of the MDH locations, call (651) 201-5000 ■ equal opportunity employer cc: Print Key Output Page 101/23/06 09:37:55OTTER5722SS1 V5R3M0 040528 Display Device User .... RCB310M1 RECAP Collection System R 53000260162000Calc thru: 1/23/2006 MP#: R 53000260162000 Total: EMV850,800Dist: 5301 TIE Dist : Plat : Sect QPADEVOOIDJTHOMPSO Inquiry - General Summary (A) R 2007 Mod? Taxpayer Deeded acresLMV113812WESLEY G & THERESA JELTEMA 35671 RUSH LAKE LOOP OTTERTAIL MN 56571-9427 850,800 BlockTwnshp Range Lot 135PT GL 1 COM NW COR GL 1 S 1487' S 89 DEG E 174' S 13.05' HSTD - RES DUPLEX/TRIPLEX 039Alternate26 Subd: ♦MOREEscrow ♦MOREProp Address35686 RUSH LAKE LOOP OTTERTAIL MNOriginal 56571- Ad j /Chg Unpaid BalPaymentsTNet Tax Special Asmt Tot before P&I Penalty Interest Fees♦ ♦TotalsF2=Tier F14=Legal F16=Notes F17=APINs F19=OtherNames F24=MoreKeysA=GS B=ASM C=DQ E=TR F=SP H=THST I=PRASC J=COJ P=PA R=ADJ U=CAMA Y=CMP t • Print Key Output Page 1 01/23/06 09:33:11OTTER5722SS1 V5R3M0 040528 Display Device User .... RCB310M1 RECAP Collection System R 53000990337000Calc thru: 1/23/2006 MP#: R 53000260162000 Total: EMV 35,800Dist: 5301 TIE Dist:Plat: 01462 Sect QPADEVOOIDJTHOMPSO Inquiry - General Summary (A) R 2007 Mod? TaxpayerWESLEY G & THERESA JELTEMA 35671 RUSH LAKE LOOP OTTERTAIL MN 56571-9427 Alternate Escrow Prop Address35671 RUSH LAKE LOOP OTTERTAIL MNOriginal Deeded acresLMV 35,800113812 SNODGRASS BASSWOOD GROVE BlockTwnshp Range Lot 03927 135 Subd:LOT 3*MORE NON-HSTD - MA & PA RESORTS 56571- Ad j / Chg Unpaid BalPaymentsTNet Tax Special Asmt Tot before P&I Penalty Interest Fees* ‘TotalsF2=Tier F14=Legal F16=Notes F17=APINs F19=OtherNames F24=MoreKeysA=GS B=ASM C=DQ E=TR F=SP H=THST I=PRASC J=COJ P=PA R=ADJ U=CAMA Y=CMP Print Key Output Page 101/23/06 09:32:145722SS1 V5R3M0 040528 OTTER Display Device User .... RCB310M1 RECAP Collection System R 53000990338000Calc thru: 1/23/2006 MP#: R 53000260162000Total: EMV12,900Dist: 5301 TIE Dist:Plat: 01462 Sect QPADEVOOIDJTHOMPSO Inquiry - General Summary (A) R 2007 Mod?Taxpayer WESLEY G & THERESA JELTEMA 35671 RUSH LAKE LOOP OTTERTAIL MN 56571-9427 Deeded acresLMV11381212,900 SNODGRASS BASSWOOD GROVE BlockTwnshp Range 039 LotAlternate27135 Subd:LOT 4♦MOREEscrow MA & PA RESORTSNON-HSTDProp Address Adj/Chg Unpaid BalOriginalPaymentsTNet Tax Special Asmt Tot before P&I Penalty Interest Fees* *TotalsF2=Tier F14=Legal F16=Notes F17=APINs F19=OtherNames F24=MoreKeysA=GS B=ASM C=DQ E=TR F=SP H=THST I=PRASC J=COJ P=PA R=ADJ U=CAMA Y=CMP r ' 530009iMioP/W & FILE MEMO LAKE/RIVER/WETLAND NAME fk&£yr?f/}.PARCEL #PROPERTY OWNER Joyce ThompsonJanuary 20, 2006 m 1 Theresa Jeltema came to the office to obtain copies of documentation on the septic system at the resort. She also wanted documentation of the original approval for the ice cream shop at the resort. I pulled the files and went through all documents (Bill Kalar had put them in order on 12/22/05). I found and copies all septic system documents for her. However I could find no reference in any of the documents with regard to the “approval” for the ice cream parlor. Ms. Jeltema said that in a recent conversation she had with Bill, he had told her that he had seen information about the ice cream parlor in the file. 1 told her that Bill was in a meeting (at the time of her visit) and that 1 would ask him to locate the information for me. I would then send a copy of the information to her. 1 spoke with Bill later in the afternoon and explained what Ms. Jeltema was requesting. He looked through the files himself and the only information available about the ice cream parlor was a reference to it in a brochure about the resort. Bill explained that the ice cream parlor was probably already a part of the original resort operations and existed before the SMO went into effect. We would have no other documentation on it. I called 86 left a voicemail message for Ms. Jeltema regarding this information. Note: During my conversation with Ms. Jeltema 8& in reviewing the file folders with her, she told me that the parcels containing the Rush Lake Mini Golf, with separate dwelling 86 sewer, are no longer a part of the resort but are owned by another individual. Reference Parcel’s 53000990335000 & 53000990336000. A separate file folder was created for these peu'cels. ! m Action/ Comments. Date.L&R Official Action/Comments. L&R OfficialDate Action/Comments. L&R OfficialDate Action/Comments. Date L&R Official Action/Comments Date L&R Official Action/Comments. ^2hUjL PoA&£^Ohl. NOUJmFRO^/Wtt ^ )<UiLcijj- ^mh. ofa^ YlUm Uimui ^ LAND & RESOURCE MANAGEMENT' MKL Q871-030 ,7, /y #TTER TAIL COUNTY -7 n \'^iLfc/ u 1 T /1 t ,, c n/W yh 7r—Q tfl oJ ^ Fergus falls, minn. File Opening Date----------/ ~: °^r 19 (? 7 V_« lU^ /LC^-U, ^ ^ ___ Special Use ( ) ' ILUA/P le mn/Use DescriptionSubdivision File ( )Subdivision Name __________/4-A./<gS^¥>y T^if44S/i KLt- CaXX^ ' Address: 2t j—^y£»L t CLUSTER I ijfHJ.iJ-P)L (sltteAl'yju St. w No. / CJtv State Zip No; Phon« No. OIL.S3 f^l^-141 C3>D S^, 3? )3S J'? •c. Twp. Range -C^:V?J^^v.■^,.A7/7j^»^47Zt^Vvo'7S^^/<r / ~ ^?i -oon ■^'^~o'\'i'S-a Ut A, - 53.-OOP- - 03 3^-00 i First MiddleLast Name 'Lake or River Name ^'L^O-'tz-CyTwp NameClasslf. Lake No. I yv?y^7: 4^~Vf> €^-BtrttDING FLHMI ly VARIANCES ON BUILDING PERMITS Date NotifiedNO./Date ___________________Purposa Hearing JudgementAppl. Date Hearing DateResultsctity lytv ___________________imm( -4J- 0 SEWAGE SySTSM-PERiym?VARIANCES ON SEWAGE SYSTEM PERMITS Hearing Judgement Date NotifiedAppl. Date Hearing DateResultsDate InspectedPurposeDate ^kkiJ Q ro rc\ 0 SPECIAL USE PERMITS Application Date Notice Mailed •COMMENTa sseiiof*Hearing Date ^^*11 /CIIMI aei.f 1%rO <o<r <y cr<r i//x7o±(^Aiunui O O ^ CQ iQi ur> Accompanying Documents Filed in Cabinet No. ®.. .... miisNOTE: ©and 0 See enclosed Inspectors Copy of Permit Application. © See enclosed Special Use Permit Application. ,/< 4-. Print Key Output Page 1 08/10/04 11:51:555722SS1 V5R2M0 020719 OTTER Display Device User ....QPADEV0031MSAMUELS RCB310M1 RECAP Collection2000 ^Mod? ^ Calc°thru^^°8/loT2004 MP#: Taxpayer 25544DALE W HOWE 26047 349TH AVE CHAMBERLAIN SD 57325-6811 Inquiry - General Summary (A)R R 53000260162000 LMV 4,900 Total:Deeded acresEMV 4,900Dist: 5301 TIP Dist: Plat: 01462 Sect SNODGRASS BASSWOOD GROVE BlockTwnshp Range Lot 135 LOT 1 Alternate 27 039N 75 Subd:I Escrow NON-HSTD COMM LAND & BLDGSProp Address T 10/16/2000 Net Tax Special Asmt Tot before P&I Penalty Interest Fees Adj/ChgOriginal 128.00 128.00 Unpaid BalPayments 128.00- 128.00- * *Totals 128.00 128.00-F2=Tier F14=Legal F16=Notes F17=APINs F19=0therNames F24=MoreKeys A=GS B=ASM C=DQ E=TR F=SP H=THST I=PRASC J=COJ P=PA R=ADJ U=CAMA Y=CMP Print Key Output Page 108/10/04 11:52:335722SS1 V5R2M0 020719 OTTER Display Device User ....QPADEV0031MSAMUELS RCB310M1 RECAP Collection System 34199 R 53000990335000 -2003 Mod? Calc thru: 8/10/2004 Taxpayer Inquiry - General Summary (A) *N0TES EXISTMP#: R 53000990335000 4,800 R Total: EMV 4,800Dist: 5301 TIE Dist: Plat: 01462 Sect Deeded acres120305JUNE ELKHATEEB & DAWN ANAS 35643 RUSH LAKE LOOP OTTERTAIL MN 56571-9427 LMV SNODGRASS BASSWOOD GROVE BlockTwnshp Range Lot 039Alternate27135 Subd:N 75 I LOT 1Escrow♦MORE COMM LAND & BLDGSNON-HSTDProp Address T 10/15/2003 Net Tax Special Asmt Tot before P&I Penalty Interest Fees Adj/ChgOriginal 98.00 Unpaid BalPayments 98.00- 98.00 98.00-11.76-11.76 * *Totals 11.76 109.76-F2=Tier F14=Legal F16=Notes F17=APINs F19=OtherNames F24=MoreKeys A=GS B=ASM C=DQ E=TR F=SP H=THST I=PRASC J=COJ P=PA R=ADJ U=CAMA Y=CMP 98.00 Print Key Output Page 108/10/04 11:52:555722SS1 V5R2M0 020719 OTTER Display Device User ....QPADEV0031MSAMUELS RCB310M1 RECAP Collection System 34201 R 53000990336000 2003 Mod? Calc thru: 8/10/2004 Taxpayer Inquiry - General Summary (A) ♦NOTES EXIST Deeded acres R MP#:Total : EMV 30,900Dist: 5301 TIE Dist: Plat: 01462 Sect 120305JUNE ELKHATEEB & DAWN ANAS 35643 RUSH LAKE LOOP OTTERTAIL MN 56571-9427 LMV30,900 SNODGRASS BASSWOOD GROVE BlockTwnshp Range Lot 135Alternate27 039 Subd:LOT 2Escrow♦MORE NON-HSTD - SEASONAL REC RESProp Address 35643 RUSH LAKE LOOP RICHVILLE MNOriginal324.00 24.00348.00 56576- Ad j / ChgT 10/15/2003 Net Tax Special Asmt Tot before P&I Penalty Interest Fees Unpaid BalPayments324.00- 24.00-348.00- ♦ ♦Totals 348.00 F16=Notes 348.00-F17=APINs F19=OtherNames F24=MoreKeys=CMPF2=TierA=GS B=ASM C=DQ E=TR F=SP H=THST I=PRASC J=COJ P=PA R=ADJ U=CAMA YF14=Legal Minnesota Department of Natural Resources DNR WATERS 1221 FIR AVENUE EAST FERGUS FALLS, MN 56537 218-739-7576 March 30, 1999 S (/)lij I' Dale W. Howe Shady Grove Resort Rotue 1, Box 436 Ottertail, MN 56571 Dear Mr. How'e; ADMINISTRATIVE WITHDRAWAL, PERMIT APPLICATION 99-1156, RUSH LAKE (56- 141P), OTTER TAIL COUNTY Our office received a new permit application from you on March 5, 1999. This permit application is for a beach sand blanket. After reviewing your application, it was determined that a permit is not required from the Minnesota Department of Natural Resources. Therefore, permit application 99- 1156 is hereby designated as officially withdrawn. We are requesting our St. Paul office to refund your application fee of $75.00. You will however need a permit from Otter Tail County Land and Resource Management. You can contact them at 218-739-2271. If you have any questions please contact me at 218-739-7576. Sincerely,■ 0 3 0 — Terrence R. Lejcher Area Hydrologist TRL/LB:lb St. Paul Waters Region I Waters Region 1 Wildlife Region I Fisheries Region 1 Enforcement East Otter Tail County S WCD Otter Tail County Zoning USCOE c: DNR Information: 651-296-6157 • 1-888-646-6367 • TTY: 651-296-5484 • 1-800-657-3929 An Equal Opporliinity Employer Who Values Diversity Printed on Recycled Paper Containing a Minimum of 10% Post-Consumer Waste Local - State - Federal Water Resource Project Notification / Application FormNA-02620^01 _________________ Use this form to notify/apply to the U.S. Army Corps of Engineers, the Minnesota Department of Natural Resources, and your Local Government Unit of a proposed water/wetland project or work which may fall within their jurisdiction. These agencies should advise you of their jurisdiction or perrhit requirements within 45 days. Some LGU’s may also require submission of their own application forms. Fill out this form completely and mail a copy, with plans, maps, etc. to each of the agencies listed on the reverse of the form. Keep a copy for your records. YOU MUST OBTAIN ALL REQUIRED AUTHORIZATIONS BEFORE BEGINNING WORK. AGENCY USE ONLY: LGU NUMBER:CORPS NUMBER:MDNR NUMBER: Applicant's Name4Last,^irst, M.l.) Authorized Agent, if any//d(^6 Ju/iiS CO> mBA ShAJi/6'^ot^r Area Code, TelephoneI. Addr^s (Street, RFD, Box Number, City, State, Zip Code)/if / Se X Vife /Hf> S6S'?/I II. Location of proposed project (attach drawing showing how to get to site) V, QUARTER SECTION(s) SECTIONS(s) No. TOWNSHIP(s) No. RANGE(s) No.Lot, Block, Subdivision3?^7 NAME (^WATERBODY AFFECTED and NUMBER (IF KNOWN)FIRE No., BOX No., OR PROJECT ADDRESS /■7f3^V 3 96 'III. ESTIMATED PROJECT COST; $LENGTH OF SHORE AFFECTED (in feet): IV. VOLUME OF FILL OR EXCAVATIOr^Cubio Yard^ /S'O AREA FILLED OR EXCAVATED IS ^ ~ ^ Acres, OR ' (NOTE: You'may substitutB dimensions) Square Feet " X yg' X (/ V. TYPE-OF WORK AND AREA (CHECK ALL THAT APPLY); □ CONSTRUCT □ DRAIN □ REMOVE , □ Culvert □ damplCSANDBLANKET□ Bridge □ Riprap □ ACCESS Path □ Dock .□ EXCAVATE □ REPAIR□ FILL a LAKE SHORELINE □ WATERWAY □ WETLAND OTHER (DESCRIBE): WETLAND TYPE(S) AND ACREAGE(S) PROPOSED TO BE FILLED/DRAINED:^^___________________ ' - Attach applicable drawings, plans, and ASCS crop photos. Include a description of any proposedrcompensatory mitigation. Important: Identify any disposal and borrow areas. Describe the work below: how it would be done; what equipment would be used, i VI. PROJECT PURPOSE (v^y is this projecyneeded--what benefits will it provide?): _ 6 ' 1 -.4»v/ i VII. ALTERNATIVES (describe any other sites or methods that could be used to achieve the purpose of your project while avoiding or minimizing wetland/water impacts: AttacTi additional sheets, if needed).i ! VIII. DATK; Proposed start of activity: Ai4y /?9fIf 9 9 Proposed completion: (Identify any completed work on an attached drawing) IX. ADJOINING PROPERTY OWNERS (Attach list if more than two) Nanle /) C" , Address State Zip /]£ X. PERMITS have been received (enter an R) or already applied for (enter an A) from; ____DNR J____ARMY CORPS OF-EnGINEERS A COUNTY Watershed District archaeological survey of the project site been done? /JO Town/City MN Pollution Control agency iHas an If so, by whom: I •I hereby notify the recipients of this form of the project proposed herein and request that I be advised of any permits or other determinations concerning this project that I must obtain, l understand that proceeding with work before all required authorizations are obtained may subject me to Federal, State, and/or local administrative, civil and/or. criminal penalties. 4?m 6/DATE: ■ Signature of Person Proposing Project or Agent < < < PLEASE CAREFULLY READ AND COMPLETE BACK OF FORM > > > INSTRUCTIONS-PLEASE READ CAREFULLY A copy of this form, with copies of all plans, drawings, etc., should be sent to each agency indicated below. Please check the appropriate spaces below to show everywhere you are sending this form. Remember to keep a copy for your records. Local Government Unit (LGU); city, county, or watershed management organization.^ Specify the LGU to which you are sending the form: A't' The local Soil and Water Conservation District (SWCD) for the project. Specify the county SWCD: Watershed District (if one exists for the project area). Specify the Watershed District:_______________________ Minnesota Department of Natural Resources (MDNR) regional office U.S. Army Corps of Engineers (ACOE). Send the ACOE copy to: Department of the Army, Corps of Engineers, St. Paul District, ATTN: CO-R, 190 Fifth Street East, St. Paul, MN 55101-1638 The above agencies may provide a copy of your completed form to the Minnesota Pollution Control Agency (MPCA). MPCA water quality rules may apply to your proposed project. Note: ATTENTION (FROM USDA): Any activity including drainage, dredging, filling, leveling or other manipulations, including maintenance, may affect a landuser's eligibility for USDA benefits under the 1985 Food Security >?ict as amended. Check with your local USDA office to request and complete Form AD-1026 prior to initiating activity. IMPORTANT: Some agencies, including the Corps of Engineers and the MDNR accept this form as a permit application form. If you wish this form to constitute an application to the Corps and/or MDNR for any necessary permits for your project please carefully read the following information and sign where indicated. nnniinnxiixinmnmimxiixmixiniiiinnmxxmxnii Application is hereby made for a permit or permits to authorize the activities described herein. I certify that I am familiar with the information contained in this application, and that to the best of my knowledge and belief such information is true, complete, and accurate. I further certify that I possess the authority to undertake the proposed activities or I am acting as the duly.authorized agent of the applicant. Signature of Applicant Date Signature of Agent Date Note:The application must be signed by the person who desires to undertake the proposed activity (applicant) or it may be signed by a duly authorized agent if the information requested below is provided. Agent's Name and title: Agent's address: )Agent's telephone: ( 1 8 U.S.C. Section 1001 provides that: Whoever, in any manner within the jurisdiction of any department or agency of The United States knowingly and willfully falsifies, conceals, or covers up by any trick, scheme, or device a material fact or makes any false, fictitious or fraudulent statements or representations or makes or uses any false writing or document knowing same to contain any false, fictitious, or fraudulent statement or entry, shall be fined not more than $10,000 or imprisoned not more than five years, or both. SEE ATTACHMENT ABOUT MDNR PERMIT FEES - ADDENDUM- Notice to Applicants for DNR Permit to Change The Course, Current or Cross-Section of Protected Waters The Department of Natural Resources (DNR) and the Pollution Control Agency (PCA) ore worlring together to ovoid duplica tion In state agency permit review of proposed octivities affecting protected waters In Minnesota. The attached form was prepared by the DNR and the F>CA to minimize your work in contacting state agencies for project approval. Please complete this form by placing on 'X‘ in the oppropriote box or boxes. If your project does not involve ony of the actions listed on this form, ploce on 'X' in the box after item 9. If your project will it^volve any of the actions listed for boxes 1 through 8. a copy of your DNR permit application v/ill be forwarded to the PCA for their review. If a separate PCA permit or approval is required, you v/ill be so notified by the PCA. Place an'X'In the appropriate box(es): □1. The project will Involve the deposition of aspholt. concrete, cut vegetation or other solid waste as fill material. 2. The project will involve excavation of materials from protected waters through the use of any device v/hich removes materials by pumping or suction action (ie. hydraulic dredging). 3. The project will involve excavation of more than 1,000 cubic yards of material from the beds of the following v/oters: □ Lake Pepin of the Mississippi River (River Miles 763 to 787 USCE charts). □ Pool #2 In the Mississippi River from Lock & Dam # 1 (the Ford Dam) to Lock & Dam #2 (Hastings - River Miles 725 to 814 USCE charts). Q Minnesota River from Savoge to its mouth at the Mississippi River (Mile 844 USCE River chart.) Q Duluth Superior Harbor and the St. Louis Boy area of the St. Louis River extending to Spirit Lake. □ The Foirmont chain of lakes including Budd. Siseton. Hall and Amber Lakes in Martin County. □ Albert Lea Lake, Freeborn County. Q. Warroad River Upper Harbor Area extending from the mouth of the Warroad River to CSAH No. 11. □ Red River of the North from Wahpeton to the Canadian border. 4. The project will involve excavotion and/or fill in protected waters for construction of utility lines carrying any moteriols except treated water in a liquid or semi-solid state, including but not limited to petroleum or-petroleum products, chemicals, sewage or cool slurries. 5. The project will involve construction of docks, piers or v/harves which v/ill Involve new fuel handling facilities, 6. The project will involve new construction, reconstruction or repair of structures for generation of hydroelectric power. 7. The project will involve construction of new ancillary facilities for sanitary sewers, boat pumpouts, on-site waste treatment or holding tanks, 8. The project will involve the on-site disposal by burning of vegetation to be removed during project construction, 9. The project will not involve any of the obove. ■ • □ □ □ .□□. □ Applicant Nome (type or print)Appjcont Signoture Applicant Address / ^ For additional inlormation and assistance, contact the appropriate Regional Ollice or the Division ol V/aters in St. Paul.1-^r?v^.Region 1 2115 BirchmonI Beach Road N.E. Bamidii. MN 56601 (210) 755 3973 Region 4 Box 756. Highway 15 South New Ulm. MN 56073 (507) 359-6053 "I j— — 2 1 Regton 5 2300 Sitver Creek Rd. N.E. Rochester. MN 55903 (507) 285-7430 Regton 2 1201 East Highway 2 Grand Rapids. MM 55744 (218) 327-44 16I Regions 1200 V/arner Road St. Paul. MN 55106 (612)772-7910 Region 3 1601 Minnesota Drive Brainerd, MN 56401 (218) 828-2605 Central 500 Latayetle Road Office St. Paul, MN,55155-4032 (612) 296-4800Printed on Recycled Paper Contairhs 10% postconsumer waste ____I T.This information is available in an alterncrfive format upon request. • ? © 1994 Slate of Minnesota, Department of Natural Resources 4 I Ir3%if- Shady Grove Resort Layout RUSH LAKE j' ■ ...i m , .jL''. i,;.’r-i'.t'- ffli-M '1;i: •i ■ p>LAUNDRY-^-FISH - -CLEANINGIkW Hi i'.. I' j:_ 4»4»LU 19 18 17CO o POOL XL I\* RUSH LAKE ROAD ") //■ a i I- /s' -i /•3?^ X X / /'wsj^jPTr^—WO') ./ai.. -riS je3'sej*sr£ cZ!D o X 36tIt; i (77^1 Jj* V. ^^3 -ylOO 7053 1 ^ iM .. ./ZAS 4. ...1 ■Si IS,*Vu!*_M v3 N8N*1 >1 40/oo ?t/40«"'i7BASSWOOD^v^uor\^oo^<jI£>c';o5 <2iT)'5'<liGROVE6■^\tiO33 7^i S'?5 Izy> •T^cc!.. >/...I"-.. . -I-.■«h-4'<j 'I iQ \1 3. ^NJ Clara /V£/>: 3^k ^ir^r DUDS, /3.J ^ cS> X■SJ 28 K*vESERVE LOT A *» —II/)K1 ' ' •> '^0■ W-l!\ 315 i ■\44Zi'.i.. Cf-.41^4... r .fit •U'‘ A'%: \»{D\Qsi-^]'2✓\ ^i\' '-»/|V«\ • -»y-o\:<\\/h-:ba>»»U'4s 0> (/sT^KLINGER 3 u «*r (TF^ S Zo/ S Fr.A:/s wur /as [nsJ I|Ji9 I 4 (785-^X=x tp\<;K»/Z5Sf i sas‘3io7'£■»■»'-; rive:r$idE5 /4»d \. ?l I VLx3/S -z Xgf‘^'0/"iv \/5/\^0+\s ^i /IN siP*c'cri/ / I^Xo /if' MBifS'Jire Tdm&rack RARI Urbank OHER TAIL COUNTY DEPARTMENT OF PUBLIC HEALTH SUB OFFICE: 330 WEST MAIN PERHAM, MINNESOTA 56573 MAIN OFFICE OHER TAIL COUNTY COURT HOUSE FERGUS FALLS. MINNESOTA 56537 218-739-2271 tAND&RESOUIgl August 18, 1986 Mr. Owen Stowman Shady Grove Resort Box 436 Ottertail, MN. 56571 Dear Mr. Stowman: Our office has received the diagram of the water and sewer hookups for your campground, as requested. The conditions of the Planning Commission, so stated, have now been met. Your camping area is now eligible to be licensed as a recreational campground. It is understood that there are 8 complete hookups present on the campground designated as Lots 3 & 4 of the Old Snodgrass Addition. It is also understood “that the presence of the 8 hookups will allow you the flexibility to site up to 6 units within the campground at' any one time. Thank your for your cooperation. Sincerely, Daniel DeLano Environmental Health Assistant DD/dc Tim Griep, Land & Resources Managementcc: Cabins - Boats - Tackle License - Gifts - Groceries Ottertail, Minnesota 56571 Phone (218) 346-6040 Shady Grove ResortI ^ -On Rush Lake Owen and Jane Stowman; ' August 1986 Mr. Gerald Winkelman, Director of Environmental Health Dear Mr. Winkelman, With regard to your memo of August 12, please find enclosed a drawing of the campground water and sewer systems serving these sites as well as location of the shower and toilet facilities. Again in reference to my earlier memo of July 3^* each of the sites shown had existing power supply and we upgraded these camp sites to include water and sewer facilities. We trust this is the information vrtiich you requested. Thank you,/ Owen L. Stowman1 Enc.; • OlS/jms OHER TAIL COUNTY DEPARTMENT OF PUBLIC HEALTH MAIN OFFICE OTTER TAIL COUNTY COURT HOUSE FERGUS FALLS. MINNESOTA 56S37 218-739-2271 SUB OFFICE: 330 WEST MAIN PERHAM, MINNESOTA 56573 i received AUG 1 4 1986 1AND& RESOURCE August 12, 1986 Mr. Owen Stowman Shady Grove Resort Box 436 Ottertail, MN 56571 Dear Mr. Stowman, Thank you for your letter of July 30, 1986, relating the back ground of the recreational camping sites located at your resort. Upon conferring with the Land and Resource office, it was agreed that it would be best for you to submit a drawing of the campsites showing their location, and the water and sewer system by which they are served. I do not doubt that you submitted a drawing in 1976; however; this drawing has not been located. , Our Department can only license what has been approved by the Otter Tail County Planning Commission. It is my understanding that the submission of the drawing will satisfy the original request of the planning commission. Being it is nearing the end of the camping season for this year, we would just like to get this matter clarified for now and then our Department will license you effective for the 1987 season as a recreational campground. Sincerely yours. Gerald Winkelman, Director of Environmental Health Tim Griep, Land and Resource Managementcc: GW/sw AU6 0 1 19QQ July 30, 1986 Mr. Gerald Winkelnan Director of Envirorunental Health Department of Public Health Otter Tail County Court House Fergus Falls, MN 58537 Dear Mr. Winkelman, This letter is in regard to Mr. DeLano's memorandum dated July 22 about the mix up in record keeping regarding the licensing for Shady Grove Campground. We purchased Shady Grove Resort and Campground in 1976 from Mr. Gus Weiss. At the time we purchased the resort there was an existing campground with shower building and electrical hook-ups on the campground. In 1976 we installed a, new State and County approved septic system and at that time we req^uested permission to upgrade ijie existing campground to include sanitary sewer and water. At no time have we ever attempted to conceal the fact that we are operating a campground on the Snodgrass Lot located directly across the road from Shady Grove Resort. Apparently there is a failure somewhere in the record keeping. I again repeat, iiae campground existed prior to 1976 (at least 13 years). T^e above facts were explained to Mr. DeLano at the time of his annual inspection of the resort. Please send the necessary permit forms and we would be glad to pay the required fee. Respectfully Submitted, (C( Owen L. Stowman Shady Grove Resort, Box 436 Ottertail, MN 56571 P.S. A drawing was submitted to the planning Commission at the time of the proposed upgrade of the existing campground. If it is necessary I can prepare an additional diagram showing where the campsites are located. We have not operated the campground exceeding the six campsites even though there are hookups in 10 different S. locations. This arrangement has allowed us flexibility in providing comfortable camping facilities when the campground is use, i.e. avoid overcrowding. ^^ ovs EAsrs'iJU ep V^vy ■b tUD ft. f 7K . w • OHER TAIL COUNTY DEPARTMENT OF PUBLIC HEALTH MAIN OFFICE OHER TAIL COUNTY COURT HOUSE FERGUS FALLS, MINNESOTA 56537 218-739-2271 SUB OFFICE: 330 WEST MAIN PERHAM. MINNESOTA 56573 July 22, 1986 Mr. Owen Stowman , Shady Grove Resort P.O. Box 436 Ottertail, MN 56571 Dear Mr. Stowman, An on-site inspection of your resort has revealed 10 recreational camping sices in the old Snodgrass Addition. to the number conditionally approved by the Planning Commission on April 22, 1977, pending the submission of a drawing of the proposed sites to the Land and Resource office. 6 sites were conditionally approved. This is in excess At that time The Health Department records, which in part are made up of the existing State records, show that you have never been licensed as a recreational campground. Your resort is entitled to operate 4 recreational camp sites without obtaining a recreational campground license. If you continue to operate as a recreational campground (5 or more sites) you must first receive approval from the Otter Tail County Planning Commission. If you can provide any information which -'ould help clarity th.5 situation please submit it in writing to tais office by August 1. IrSt. Sincerely, PIO Daniel D. DeLano Environmental Health Assistant Gerald Winkelman Director of Environmental Health Bill Kalar, Land & Resource officecc; DD/sw % Minnesota Department of Natural Resources ^jMInnesota wECOLOGICAL AND WATER RESOURCES 1509 I®* Avenue North Fergus Falls, MN 56537 (218) 739-7576 DQ>MmiB(T0FMniRAlSSOilRCES -0 October 20,2010 4Wes Jeitema 35686 Rush Lake Loop Ottertail, MN 56571 Dear Mr. Jeitema; PERMIT 2011-0228, RUSH LAKE (56-141P), SECTION 26, TOWNSHIP 135 NORTH, RANGE 39 WEST. OTTER TAIL COUNTY Enclosed is your permit authorizing placement of natural rock riprap along 340 feet of shoreline to prevent shoreline erosion. Please read all the conditions on your permit and assure that the enclosed Notice of Permit (orange card) is conspicuously displayed during construction. If you have any questions, please feel free to contact me at (218) 739-7576 ext 243. Sincerely, \J Julie Aadland Area Hydrologist JA/ck Enclosures Dan Lais, NW Region Waters Bill Kalar, Otter Tail County Zoning Darren Newville, East Otter Tail County SWCD Arlin Schalekamp, Fergus Falls Area Fisheries Supervisor Don Schultz, Fergus Falls Area Wildlife Manager Christopher Vinton, Conservation Officer Leonard Grabowski, USCOE DNR Central Office Permits Unit ec: www.dnr state mn us _ AN EQUAL OPPORTUNITY EMPLOYER PRINTED ON REOCIED PAPER CONTAINING A MINIMUM OF 10% POST CONSUMER WASTE PUBLIC WATERS WORK PERMIT Permit Number 2011-0228 0£p«miacoFNAniAALRESOUflCS Pursuant to Minnesota Statutes, Chapter 103G, and on the basis of statements and information contained in the permit appiication, letters, maps, and plans submitted by the applicant and other supporting data, all of which are made a part hereof by reference, PERMISSION IS HEREBY GRANTED to the applicant to perform the work as authorized below: Public Water Rush Lake (56-141P) County Otter Tail (56) Name of Permittee Wes Jeitema Telephone Number (Include Area Code) (218) 346-6040 Address (No. & Street, RFD, Box No., City, State, Zip Code) 35686 Rush Lake Loop, Ottertail, MN 56571 Authorized Work; Place natural rock riprap along 340 feet of shoreline. Clean granular fill shall be placed along the southern 180 feet of shore to fill scoured areas. The granular fill shall extend no more than 2 feet waterward of the toe of the existing lake bank. The rock may be underlain with a filter fabric. Rock shall be installed at a 3:1 (horizontal to vertical) slope. Rock shall be between 6-inches and 30- inches in diameter. The work shall extend no more than 9 feet waterward of the toe of the existing lake bank. Purpose of Permit: Prevent shoreline erosion. Expiration Date of Permit December 31,2012 Property Described As: NW1/4 NW1/4, Section 26, Township 135 North, Range 39 West, Otter Tail County UTM Zone 15 coordinates: Easting: 302564 Northing: 5150542 This permit is granted subject to the following CONDITIONS: 1. The permittee is not released from any rules, regulations, requirements, or standards of any applicable federal, state, or local agencies; including, but not iimited to, the U.S. Army Corps of Engineers, Board of Water and Soil Resources, MN Pollution Control Agency, watershed districts, water management organizations, county, city and township zoning. This permit does not release the permittee of any permit requirement of the St. Paul district, U.S. Army Corps of Engineers, Army Corps of Engineers Centre, 190 Fifth Street East, St. Paul, MN 55101-1638. 2. This permit is not assignable by the permittee except with the written consent of the Commissioner of Natural Resources. 3. The permittee shall notify the Area Hydrologist at least five days in advance of the commencement of the work authorized hereunder and notify him/her of its completion within five days. The Notice of Permit issued by the Commissioner shall be kept securely posted in a conspicuous place at the site of operations. 4. The permittee shall make no changes, without written permission previously obtained from the Commissioner of Natural Resources, in the dimensions, capacity or location of any items of work authorized hereunder. 5. The permittee shall grant access to the site at all reasonable times during and after construction to authorized representatives of the Commissioner of Natural Resources for inspection of the work authorized hereunder. 6. This permit may be terminated by the Commissioner of Natural Resources at any time deemed necessary for the conservation of water resources of the state, or in the interest of public health and welfare, or for violation of any of the provisions or applicable law of this permit, unless othenwise provided in the Special Provisions. 7. Construction work authorized under this permit shall be completed on or before the date specified above. The permittee may request an extension of the time to complete the project, stating the reason thereof, upon written request to the Commissioner of Natural Resources. 8. In all cases where the permittee by performing the work authorized by this permit shall involve the taking, using, or damaging of any property rights or interests of any other person or persons, or of any publicly owned lands or improvements thereon or interests therein, the permittee, before proceeding, shall obtain the written consent of all persons, agencies, or authorities concerned, and shall acquire all property, rights, and interests needed for the work. 9. This permit is permissive only. No liability shall be imposed by the State of Minnesota or any of its officers, agents or employees, officially or personally, on account of the granting hereof or on account of any damage to any person or property resulting from any act or omission of the permittee or any of its agents, employees, or contractors. This permit shall not be construed as estopping or limiting any legal claims or right of action of any person other than the state against the permittee, its agents, employees, or contractors, for any damage or injury resulting from any such act or omission, or as estopping or limiting any legal claim or right of action of the state against the permittee, its agents, employees, or contractors for violation of or failure to comply with the permit or applicable provisions of law. 10. Where the work authorized by this permit involves the draining or filling of wetlands not subject to DNR regulations, the permittee shall not initiate any work under this permit until the permittee has obtained official approval from the responsible local government unit as required by the Minnesota Wetland Conservation Act. 11. Erosion control measures shall be adequately designed for site characteristics. Measures such as staked haybales, silt fences and diversion structures shall be installed prior to project start and be maintained until exposed soil is stabilized with vegetation. 12. The permittee is authorized to maintain the approved work to the dimensions herein described. Prior to commencing and maintenance work, the permittee shall advise the Department of Natural Resources of the extent and method of maintenance. Maintenance shall not be commenced until the permittee's receipt of the Department's approval. 13. Notify LGU if work is above OHW. The permittee shall contact the responsible local government unit official if any grading or filling is to be done above (landward) the ordinary high water mark. 14. End Sections. At each end of the stabilized shoreline, the finished slope of the riprap shall be varied in a fashion to produce a smooth transition with the natural shoreline. 15. Invasive Species. All equipment used must be free of prohibited invasive species and aquatic plants prior to transport to or use in public waters. All equipment used in waters known to contain aquatic invasive species shall be inspected by the permittee or the contractor and adequately decontaminated prior to being transported. The DNR is available to train or assist in these inspections. A list of designated infested waters is found at http ://files.dnr.stat6.mn.us/eco/invasives/inf estedwaters.pdf. A. Before transporting equipment from a work site, inspect all equipment that had been in contact with the water and remove all visible aquatic remnants [plants, seeds, mud, soil, and animals]. Power washing followed by drying (7 days) is an acceptable method to ensure killing and removal of invasive species. B. Before transporting equipment from a work site, drain all water from equipment where water may be trapped, such as tanks, pumps, hoses, silt curtain, and water-retaining components of boats/barges. C. After spraying and draining, dry equipment that has been in infested waters for a minimum of 7 days before reuse. 16. The permittee shall ensure the contractor has received and thoroughly understands all provisions of this permit. Contractors must obtain a signed statement from the property owner stating that permits required for work have been obtained or that a permit is not required, and mail a copy of the statement to the regional DNR Enforcement office where the proposed work is located. The Landowner Statement and Contractor Responsibility Form can be found at httD://www.bwsr.state.mn.us/wetlands/wca/index.html#Qeneral. ec: Dan Lais, NW Region Waters Bill Kalar, Otter Tail County Zoning Darren Newville, East Otter Tail County SWCD Leonard Grabowski, USCOE Christopher Vinton, DNR Conservation Officer Artin Schalekamp, Fergus Falls DNR Fisheries Supervisor Don Schultz, Fergus Falls DNR Wildlife Manager DNR Central Office Permits Unit Authorized Signature Julie Aadland Title Date i October 20,2010Area Hydrologist t (V 2 02 for MS WORD) 9/17/2007 Minnesota Local/State/Federal Application Form for Water/Wetland Projects NA-026620-03B For Internal Use Only Date Initial Application ReceivedField Office Code Date initial Application Deemed CompleteApplication No. PART I: BASIC APPLICATION “See HELP” directs you to important additional information and assistance in Instructions, Page I 1. LANDOWNER/APPLICANT CONTACT INFORMATION (SeeHelp I) Name: | O^.lVgrYXO-Phone: |^\g) Complete mailing address: LQOP O t1-et -VrXt. y Ka I A. AUTHORIZED AGE.NT (See Help 1.41 (Only if applicable; an agent is not required) (Sjg^g. I [ [Phone: [ Complete mailing address:[ 2. NAME, TYPE AND SIZE OF PUBLIC WATERS or WETLANDS I.MPACTED (Attach Additional Project Area sheets if needed) Name or l.D. # of Waters Impacted (if applicable; if known); I Rl^sk V-cxKC. (Check all that apply): BQ lake Q River Q Circular 39 Wetland type: □ l.D 11, □ 2. Q 3, Q 4, Q 5. □ 6, Q 7. D 8 Wetland plant community type': SI shallow open water, Q deep marsh. Q shallow marsh. Q sedge meadow. Q fresh meadow, Q wet to wet-tnesic prairie. O calcareous fen. Q open bog or coniferous bog, O shrub-carr/alder thicket, D hardwood swamp or coniferous swamp. Q floodplain forest, Q seasonally flooded basin Indicate size of entire lake or wetland (check one): □ Less than 10 acres (indicate size:! 1 )j □ 10 to 40 acres H Greater than 40 acres 3. PROJECT LOCATION (Information can he found on properly lax statement, property title or title insurance). Fire #: Range#: _______ Watershed (name or#) i | UTM location: N [*~*] I- | [ O-HetYai IProject street address:! VoriP 'A Section: I I Section: Lot#: [XI] j City (ifapplic County: iQrtfe’tAcu I able): ■fownship #: tl^3| Subdivision: | | Attach a simple site locator map. If needed, include on the map written directions to the site from a known location or landmark, and pn^vide distances from known locations. Label the sheet SITE LOCATOR MAP n:nX~1 lUjBlock: 4. TYPE OF PROJECT: Describe the type of proposed work. Attach TTPfi OF P/?OJ£C7 sheet if needed.I feyP R.a.p aro<eUif^(^ -j if 0 -fe-c-f ^ -b rP^ 5. PROJECT PURPOSE, DESCRIPTION AND DIMENSIONS: Describe what you plan to do and why it is needed, how you plan to |T( construct the project with dimensions (length, width, deptli), area of impact, and when you propose to construct the project. This is the most important part of your application. See HELP S before completing this section; see What To Include on Plans (Instructions, page I). Ktts.eh PROJECT DESCRIPTION sheet. Footprint of project: [ j acres or [ | square feet drained, filled or excavated. 6. PROJECT ALTERNATIVES: What alternatives to this proposed project have you considered that would avoid or minimize impacts to wetlands or waters? List at least TWO additional alternatives to your project in Section 5 that avoid wetlands (one of which may be “no build” or “do nothing”), and explain why you chose to pursue the option described in this application over these alternatives. Attach PROJECT .4/ TERN A Til ES shed i f needed. Sc (\irc\ cIaJift Of f^c4 f at 7. ADJOINING PROPERT^ OWNERS: For projects that impact more than 10,000 square feet of water or wetlands, list the complete mailing addresses of adjacent property owners on an attached separate sheet. (See HELP 7) 8. PORTION OF WORK COMPLE TED: Is any portion of the work in wetland or water areas already completed? QYes ClNo. If yes, describe the completed work on a separate sheet of paper labeled WORK ALREADY COMPLETED. (.See HELP 8) 9. S T.ATUS OF OTHER APPROX ALS: list any other permits, reviews or approvals related to this proposed project that are either pending or have already been approved or denied on a separate attached sheet. See HELP 9. 10. I am applying for state and local authorization to conduct the work described in this application. I am familiar with the infomiation contained iothis application) I o the best of my knowledge and belief, all information in Part I is true, complete, and accurate. I pos.sess the a'lHhority to undertake the work described, or I am acting as the duly authorized agent of the applicant/ jU/J_ . y-hiiO /iignature of applicant^ Landowner) Date Signature of agent (if applicable) ' / This block must be signed by the person who desires to undertake the proposed activity and has the necessary property rights to do so If only the Agent has signed, please attach a separate sheet signed by the landowner, giving necessary authorization to the Agent 'See H'ettand Plants and Plant Communities of Minnesota and fUsconsin (Eggers and Reed. 1997) as modified by the Board of Water and Soil Kesources. I nited States .Army Corps of Engineers. Dale ' :‘A Minnesota I ocal/Stale/l ederal Application forms tor Water/Wetland Projects Page I CCT 1 2 2010 LAND & RESOURCE t APPLICATION FOR DEPARTMENT OF THE ARMY PERMIT (33 CFR 32S)OiMB APPROVAL NO. 0710-003 Expires Dec 3J, 2004 The public burden for this collection of information is estimated to average 10 hours per response, although the majority of applications should require 5 hours or less This includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information Send comments regarding this burden estimate or any other aspect of diis collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Service Directorate of Information Operations and Reports. 1215 Jefferson Davis Highway, Suite 1204, Arlington. VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0710-0003), Washington. DC 20503 Respondents should be aware that notwithstanding any other provision oflaw, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid 0MB control number Please DO NOT RKTURN your form to either of these addresses. Completed applications must be submitted to the District engineer having jurisdiction ovei the location of the proposed activity PRIVACY ACT STATEMENT: Authoriues: Rivers and Harbors Act. Section 10. 33 USC 403, Clean Water Act, Section 404,33 USC 1344, Marine Protection, Research and Sanctuaries Act, 33 USC 1413, Section 103, Pnncipal purpose: Information provided on this form will be used in evaluating the application for u permit. Routine uses This information may be shared with the Department of Justice and other Federal, state, and local government agencies Submission of requested information is voluntary, however, if infonnation is not provided, the permit application cannot be evaluated nor can a permit be issued ITEMS 1 THROUGH 4 TO BE FILLED IN BY THE CORPS I APPLICATION NO 2 FIELD office: CODE 1 DA rt’RECEIVED 4 date; application completed YOU DO A/OrNEED TO COMPLETE ITEMS 6-10 and 12-25 in the SHADED AREAS. All applicants must complete non-shaded items 5 and 26. If an agent is used, also complete items 8 and 11. This optional Federal form is valid for use only when included as part of this entire state application packet._______________________________ 5 APPLICANT’S NAME j 8 authorized AGENT’S NAME AND TITLE (an agent is not required) e /i."T">*7r7yiE3HH*l6.APW.ICANrSADDRESS£‘9. AGENT’S ADDRESS |7, APPLICANT S PHtJNE NO.I IQ AGENT’S PHONE NO 11. STATEMF.NT OF ALTHORIZATION (if applicable, complete onty if authorizing an agent) I hereby authorize supplemental information in support of this permit application to act on my behalf as my agent in the processing of this application and to furnish, upon request. APPLICANT"S SIGNATURE:DATE 12. PROJECT NAME OR TlTLl (see instructions) 1.7. NAME OF WATERBODY, IF KNOWN (if applicaMe)14 PROJECT STRI FT ADDRESS (if applicable) 15. LOCATION OF PROJECT 16 OTHER LOCA1 ION DE.SCRIPTIONS, IF KNOWTi (sec instructions) 17 DIRE CTIONS lO THE SITE IK NATURE OF ACTIVIEy 19. PROJECT PURPOSE 20 RE ASON($)FOR DISCHARGE 21 TYPES OF MATERIAL BEING DISCHARGED AND THE AMflUNT OF EACH T7 PE IN CUBIC VARI>S 22. SURFACE ARE A IN ACRES OF W E TLANDS OR OTHER WATE RS FILLED 23 IS ANY PORTION OF THE W ORK ALREADY COMPLETE^ VTS □ NO FI IF VTS PI SCRIBE COMPLETED WORK 24 ADDRESSES OF ADJOINING PROPERTY OWT4ERS, 25 UST OF 03 HER CERTIFK A1 IONS OR APPROVALS. DENIALS RECEIVED FROM OTHER FEDERAL STATE OR LOCAL AGENCIES FOR WOR^SCRI^fflTBIS APPLICATION___________________ 26. Application is hepeByTnade for a permit or permits to authorize the work described in this application. I certify that the infomialion in this .^plication is complete ana accurate I tlirther certify that 1 possess the authority to undertake the work described herein or am acting as the duly autJiorizM agent of the apmicanl ure of applirant /O U-/6 Dale,Si|DaleSignature of agent (if any) The aj^lication must besighed by the person who desires to undertal.c the proposed activity (applicant), or it may be signed by a duly authorized agent if the statement in Blocyf I has been filled out and signed 18 L'.S.C. Section 1001 provides lhat Whoever in any manner within the jurisdiction of any department or agency of the United Stales knowingly and willfully falsifies, conceals or covers up with any trick, scheme, or disguises a material fact or makes any false fictitious or fraudulent statements or representations or makes or uses any false writing or document knowing same to contain any false, fictitious or fraudulent statements or entry, shall he fined not more than $10,000 or imprisoned not more than five years or both EDITION OF FFI) 94 I.S OBSOl F TF.HNG FORM 434.5. Jul 97 (Proponent: C'FCW-OR) R'~r"!VP^Minnesota Local/State/Federal Application Forms for WalerAVelland Projects Page 2 OCT t 2 2010 LAND a RESCDRCE REcr.'V-’^ 1 2 2""' ^akes Loader Service Roy Steering, Owner R O. Box 115 • Dent, MN 56528 218/758-2829 PROPOSALt .CCT Lh-' WORK TO BE PERFORMED AT:SUBMITTED TO: , K«JI\f &rou^Date is 3^ J-OQ/g^ r)f4:^^i?.;/. ^5~7/ Job Name Job Location, State, Zip Job Phonehone We hereby propose to furnish the materials and perform the labor necessary for the completion of: j/o/O/g/C’dfidtoyt^ o2^ outi uUtr /■ w, / ^ U '/ O 'Cron ~t ^U ! 34^0 L ^ -f~ <. r i/:< i~ /r-y I'/■< c -t- /4i T7 /(Jxii 3^3^__V n54“K t fi- ^__/^// uJoi-k '/rc Jt^rJ r ^ < At- /-OCrf^A^/^ 3t>A$5 ^ ^c./ ✓n ^/'ocft/ ^Oft~ t/-f> //o 0c*4r}'^r fl /f> ■{or Kf A ~h- A>=W?/C?/^ ig AcL 1 All material is guaranteed to be as specified, and the above work to be performed in accordance with the drawings and specifications submitted for above work and completed in a substantial workmanlike for rhe sum of XV/.A- f.y i-n, .'y.-Jty' r -^^Oo ~ Dnllars ($ ~ ). with payments to be made as follows: Per Any alteration or deviation from above specifications involving extra costs, v^ill be executed only upon written orders, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, tornado and other necessary insurance upon above work. Worker's Compensation and Public Liability Insurance on above work to be taken out by: Respectfully submitted 9^ This proposal may be witKdrawn by days. NOTE:us if not accepted within 1 OWNERS RESPONSIBILITIES: 1. Owner shall be responsible for obtaining all needed permits. 2. Owner shall advise Lakes Loader Service of all potential above ground and of underground hazards and identify said hazards Including but not limited to under and above ground utilities, drainage tile and septic tanks. Owner shall withstand repair and moving costs. 3. Owner shall call Gopher State One at 1-800-252-1166. ACCEPTANCE OF PROPOSAL: The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Signature —, Signature Date 1 i -'*s.rr- PERHAMPRlh/TB^.ppRHAM MN 1 W-I Vtfc 'f «■I J PROPOSED 1 GARY LEE Gfmt Kla rfx tn4to Lo<s 3 and 4 of SNODGRASS'. record in the Office of the RefI'rS^X' I>1-Containing 2-00 acres more ot Subject to State Trunk Highwa Subject to easements and rest s y-(I DEHmS D. k PATRKiA SAUK)£RS DOCUMEHT NO. OStJZe I I AJ II■of INGRESS k EGRESS EASEklENTs srsrx'E i74.x t»^’39‘4^4-tr L 5 kfae'\ RESERVAVON FOR ACCESS, BOOK 201 OF DEEDS, RAGE 81. SOUWE^Y LINE OF DOCUNENT~NO B5102e~ 174.5067.10 AH that part of Government U West of the 5th Principal Meric as follows: '4.J1 f MU <11STj ie.'j 'E Hl"2&0 - -U4.J25.8 i, 17.96202o CABIN 14 >0 Commencing at the Northwesi assumed bearing of South a distance of 1487.00 feet to t thence South 89 degrees 57 north line of said Government a bearing of South a distance minutes 58 seconds East a d. comer of that tract of land c Quit Claim Deed Document No Recorder of said County, said to be described: thence North distance of 59.14 feet; thenci West a distance of 174.50 fet a bearing of South along said of 394.44 feet; thence South distance of 33.10 feet to a h continuing South 85 degrees i 202.37 feet to a found iron n 85 degrees 29 minutes 37 sec to the shoreline of Rush Lake; the intersection with the south Document No. 851,>.46; thence along said southerly line, a dis point of beginning. CABIN 9 CABfN a BLOCK WAU ENCLOSg^G GAS BARREL 2.90 ACRES V-LATVCE FENCE ENUOSING DIMPSTER s mi HOUSELR 32.2189.8 *0N CABIN 15 B 16 '>-ACCESS APPROACH 8 PR UiI46.7206.9 hJ Containing 2.90 acres more or 1 Subject to easements and reser Subject to Rush Lake Loop (fort under and across the westerly j Easements in: Book 251 of Deeds, page 36 Book 195 of Deeds, page 126 Book 233 of Deeds, page 4 Book 233 of Deeds, page 8 Book 233 of Deeds, page 442 are blanket easements and canni record. Property is located in Flood Zone SURVEYOR'S “I hereby certify to Wes and Ter Association, Title Professionals an Land Title Insurance Company, th attached legal description and th< which it is based were made in t Requirements for ALTA/ACSM Lan adopted by ALTA and ACSM in 1l Table A thereof." And that I am a duly Registered of Minnesota. Dated this 19th da. CHAIN UffK FENCE yRE.SORT SIGN 'lUNENT m CONCRETE A 52:oCJO 7J'I mpo o7}rnmr>o <CO mOI'OC3 Od 73 CD O m ALTA/AC SHAC CONTRACT NU 113-01 OF SEC. 26, T. 135, R.39 CRDFU: Ic