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HomeMy WebLinkAboutSouth Lida Resort_39000090076000_Shoreland Permits_White — Office Yellow — Owner Pink — Assessor Goldenrod — Inspector SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone; (218) 739 -2271 - Fergus Falls, Minnesota 56537 APPLICATION FOR SITE PERMIT Ju L z 9 Permit No..LEGAL £^/osDESCRIPTION AND LOCATION //'7 ^£nge / TWP Name2h.7-/55a DLake No.Lake Classif.Sec.TWPLake Name IDENTIFICATION: Please Print All Information Last Name Zip No.Tel. No.First Initial Mailing Address— No. Street. City and State ^ oy S JO 4K 5’'f'___________ ________S'(,^cc C /tecA; 0h)o^ bOwner NameContractor Architect Name. TYPE OF IMPROVEMENT:RESIDENTIAL PROPOSED USE:NON-RESIDENTIAL PROPOSED USE: ^ (t.'Xa. c\) New Building ( ) Alteration ( ) One Family Dwelling ( ) Multiple Dwelling Other Specify: Units ( ) Other Size ESTIMATED COST OF IMPROVEMENT $ PRINCIPAL TYPE OF FRAME:TYPE OF SEWAGE DISPOSAL:\ Public (£jiScf\J) ( ) Individual Septic Tank, etc. WATER SUPPLY: ( ) Public ^'tv.^^ndividual Well DIMENSIONS: l'\^No { ) Masonry Wood Frame ( ) Structural Steel ( ) Other — Specify Basement: ( ) Yes ( Stories above basement: Sq. feat (eulsIUU dimension) Be3rooms .............................. I Baths Type of Roof: CHARACTERISTICS: ...S&k. 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 o.f yyay.... Side yard is feet.Lot Area is Maximum depth of lot feet. feet. (Building Line) 3..±.feet 9.0.■5.U,feet — from road right of way is ,feet./O1^.and feet. Structure will be located .feet from septic tank (Sewage System Permit must be obtained before installation), feet from soil absorption system (Cesspool, Drainfield, etc.).Structure will be located Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set forth and according to the provisions of the ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. f ^ Signature of Owner Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon the THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16. MINNESOTA STATE STATUES. Permit: express condition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the ordinances of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said ordinances. Shorela'nd Jflanagement Official f Dated Permit Fee $C /'cmComments: 7 (A/ CopyT Lu; M A sst t\ ■f TAQ{ to vrH^_____tLe . j ^ 0^/195676(g)Form No. MKL-0771-002 VICTOR LUNDCEN CO.. PHiNTF.RS, FERGUS FALLS. MINN. White - Office Yellow — Owner Pink — Assessor Goldenrod — Inspector SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 — Fergus Falls, Minnesota 56537 APPLICATION FOR SITE PERMITA X Permit No.,LEGAL ■T"DESCRIPTION AND LOCATION / Lake No. TWP NameLake Name Lake Classif.Sec.TWP Range IDENTIFICATION: Please Print AM Information Last Name First Initial Mailing Address— No. Street, City and State Tel. No.Zip No. OOwner NameContractor Architect Name. TYPE OF IMPROVEMENT:RESIDENTIAL PROPOSED USE:NON-RESIDENTIAL PROPOSED USE: ( ) New Building ( ) Alteration ( ) One Family Dwelling ( ) Multiple Dwelling Specify: Units ( )Other ( ) Other Size ESTIMATED COST OF IMPROVEMENT $ PRINCIPAL TYPE OF FRAME:TYPE OF SEWAGE DISPOSAL:DIMENSIONS: Basement: ( ) Yes ( ) No Stories above basement: .......... Sq. feet (outside dimensioTil’...;.;. Bedrooms ( ) Masonry ( ) Wood Frame ( ) Structural Steel ( ) Other — Specify ( ) Public ( ) Individual Septic Tank, etc. WATER SUPPLY: ( ) Public ( ) Individual Well Baths Type of Roof:i y CHARACTERISTICS: Water frontage issquare feet. Building set back from high water mark is, Land height above high water mark at building line is Building set back from State highway right of way..... Side yard is feet.Lot Area is Maximum depth of lot feet. feet. (Building Line) feet feet — from road right of way is feet. and feet. Structure will be located .feet from septic tank (Sewage System Permit must be obtained before installation), feet from soil absorption system (Cesspool, Drainfield, etc.).Structure will be located Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set forth and according to the provisions of the ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16. MINNESOTA STATE STATUES.Signature of Owner Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon thePermit: express condition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the ordinances of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said ordinances. Dated Shoreland Management Official Permit Fee $. Comments: r, ^ rs.I C.'\Pl~ZYji 19S676® VICTOR LUNDEEN CO.. PRINTERS. FERGUS FALLS. MINN.Form No. MKL-0771-002 f INSPECTOR'S CHECK LIST Make all measurements and computations ACTUAL IS I MINIMUM Shall Be 4-Sq. Ft, Lot Area (Square feet)Sq. Ft.Sq. Ft. Water Frontage Ft. Ft. Building Set Back from High Water Mark Ft. Ft. Building Set Back from State Highway Ft.50 Ft. Building Set Back from Street or Road Ft.40 Ft. Side Yard &Ft.&Ft. Rear Yard Ft.Ft. Occupied Building to Septic Tank Ft.10 Ft. Occupied Building to Absorption System Ft.20 Ft. Elevation at Building Line above High Water Mark_____________Ft.3 Ft. Inspector's Comments: Inspector's Signature Title Inspection Dated 19 Agency vicTo* kUHOCCN t CO.. pmHTEm. rcitoua fall*, mihn.